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Acerola seeds are a by-product of the food industry, which is rich in dietary fiber and antioxidants. This study evaluated the effects of cellulase treatment conditions, including the initial moisture content, enzyme dose, and incubation time, on the insoluble, soluble, and total dietary fiber content of acerola seed powder (ASP). The blends of wheat flour with untreated and cellulase-treated ASP (0, 10, 15, 20, 25, and 30%, w/w ) were then used to produce cookies. The suitable conditions for the enzymatic treatment were the initial moisture content of 6 g/g dry weight (DW), an enzyme dose of 10 U/g DW and incubation time of 90 min. The cookies produced from flour blends with ASP had higher dietary fiber, ascorbic acid and total phenolic contents, and antioxidant capacity, compared to the control cookies without ASP. Phytate content in the cookies obtained with the lowest level of fortification (10%, w/w ) was similar to that in the control cookies. The use of cellulase-treated ASP resulted in a lower ratio of insoluble to soluble dietary fiber in the cookies compared to when the untreated ASP was used. In addition, the cookies with cellulase-treated ASP had lower hardness and higher fracturability values than those fortified with the untreated ASP. The overall acceptability of the cookies produced with ASP was higher or comparable to the control cookies. For the first time, the low-cost ASP was used to improve the nutritional quality of cookies. The treated ASP is a novel promising dietary fiber- and antioxidant-rich ingredient for cookie preparation.

Electronic word-of-mouth (e-WOM) has gained popularity due to the fact that people can communicate and discuss brands through emotive expressions, remarks, and reviews regardless of their distance. The purpose and objectives of this study are to determine how e-WOM factors, such as brand image, brand awareness, and brand loyalty based on trust, influence brand equity. The study’s methodology included both qualitative and quantitative research to examine consumers’ perspectives and generalize the findings, respectively. For qualitative research on e-WOM variables, both in-depth interviews and focus groups are utilized. The next stage is to collect online responses from 410 participants and evaluate their relationships using a structural equation modeling (SEM) model. The findings suggest that content quality, the number of reviews, norm conflict, and sponsored recommendations are the characteristics that generate e-WOM and enhance the ability to establish trust in these reviews. This enhances the brand equity of digital businesses. This demonstrates the factors that managers should emphasize in order to enhance the positive effects of e-WOM and thereby increase brand equity.

Abstract Lilial (also called lysmeral) is a fragrance ingredient presented in many everyday cosmetics and household products. The concentrations of lilial in the final products is rather low. Its maximum concentration in cosmetics was limited and recently, its use in cosmetics products was prohibited in the EU due to the classification as reproductive toxicant. Additionally, according to the European Chemicals Agency, it was under assessment as one of the potential endocrine disruptors, i.e. a substance that may alter the function of the endocrine system and, as a result, cause health problems. Its ability to act as an androgen receptor agonist and the estrogenic and androgenic activity of its metabolites, to the best of our knowledge, have not yet been tested. The aim of this work was to determine the intestinal absorption, cytotoxicity, nephrotoxicity, mutagenicity, activation of cellular stress-related signal pathways and, most importantly, to test the ability to disrupt the endocrine system of lilial and its Phase I metabolites. This was tested using set of in vitro assays including resazurin assay, the CHO/HPRT mutation assay, γH2AX biomarker-based genotoxicity assay, qPCR and in vitro reporter assays based on luminescence of luciferase for estrogen, androgen, NF-κB and NRF2 signalling pathway. It was determined that neither lilial nor its metabolites have a negative effect on cell viability in the concentration range from 1 nM to 100 µM. Using human cell lines HeLa9903 and MDA-kb2, it was verified that this substance did not have agonistic activity towards estrogen or androgen receptor, respectively. Lilial metabolites, generated by incubation with the rat liver S9 fraction, did not show the ability to bind to estrogen or androgen receptors. Neither lilial nor its metabolites showed a nephrotoxic effect on human renal tubular cells (RPTEC/TERT1 line) and at the same time they were unable to activate the NF-κB and NRF2 signalling pathway at a concentration of 50 µM (HEK 293/pGL4.32 or pGL4.37). Neither lilial nor its metabolites showed mutagenic activity in the HPRT gene mutation test in CHO-K1 cells, nor were they able to cause double-strand breaks in DNA (γH2AX biomarker) in CHO-K1 and HeLa cells. In our study, no negative effects of lilial or its in vitro metabolites were observed up to 100 µM using different in vitro tests.

Background and aims: Is there any chance for an embryo having one of these types of abnormal cleavage including direct cleavage (DC), reverse cleavage (RC) or multinucleation can result in a healthy baby? The answer is still unclear and there are very few reports about this. In this study, we used a time-lapse (TL) monitoring system to identify whether there was a phenomenon of DC, RC or multinucleation in the developmental duration of blastocysts that were transferred in frozen cycles. And then we evaluated and compared the live birth rate in these cases. Materials and Methods: This study retrospectively reviewed 192 cases of embryo culture in TL system and subsequently transferred for the first time in frozen single blastocyst transfer cycles from November 2019 to June 2022. There were 2 groups: group I (83 cases) included patients with euploid blastocyst transfer and group II (109 cases) included patients with non-PGTA blastocyst transfer. In this study, the live birth rate (LBR) after transferring embryos with or without DC, RC and multinucleation were investigated and compared in each group. Results: In both of groups, there was no difference in the LBR of embryo transfers with DR, RC, multinucleation and embryo transfers without DC, RC, multinucleation (p>0.05, chi-square test). In group I, the LBR in cases of good blastocyst transfer (grade 1) was statistically higher than that in cases of grade 3 blastocyst transfer (64.8% (35/54) versus 11.1% (1/9), p0.05, chi-square test). Conclusion: In PGTA group and non-PGTA group, the live birth rates after frozen single blastocyst transfer were similar between the cases of blastocyst transfer with DC, RC, multinucleation and the cases of blastocyst transfer without DC, RC, multinucleation. A higher live birth rate following good quality blastocyst transfer than poor quality blastocyst transfer in both groups.

Background and Aims: Sometimes the preimplantation genetic testing for aneuploidy (PGTA) results return with “no result” (NR) even though the percentage of this type of result is quite small. Our desire was to rebiopsy these embryos and reanalysis, then determining whether it is efficient to perform reanalysis in “no result” embryos with different embryo qualities and evaluating the efficacy of rebiopsied blastocyst transfers. Materials and Methods: Performing trophectoderm rebiopsy for inconclusive blastocysts after PGTA test. The blastocysts would be transferred if the second analysis was eligible. Results: From September 2020 through December 2022, 2838 embryos were biopsied and tested for PGTA, 95 samples were returned as “no result”, accounting for 3.3%. There was no difference between the embryo quality grades in NR embryos (p>0.05), but the NR day 5 embryos was statistically higher than the group of day 6 embryos (85.3% vs 14.7%, p

Summary: Background: Improvements in the early diagnosis of dengue are urgently needed, especially in resource-limited settings where the distinction between dengue and other febrile illnesses is crucial for patient management. Methods: In this prospective, observational study (IDAMS), we included patients aged 5 years and older with undifferentiated fever at presentation from 26 outpatient facilities in eight countries (Bangladesh, Brazil, Cambodia, El Salvador, Indonesia, Malaysia, Venezuela, and Viet Nam). We used multivariable logistic regression to investigate the association between clinical symptoms and laboratory tests with dengue versus other febrile illnesses between day 2 and day 5 after onset of fever (ie, illness days). We built a set of candidate regression models including clinical and laboratory variables to reflect the need of a comprehensive versus parsimonious approach. We assessed performance of these models via standard measures of diagnostic values. Findings: Between Oct 18, 2011, and Aug 4, 2016, we recruited 7428 patients, of whom 2694 (36%) were diagnosed with laboratory-confirmed dengue and 2495 (34%) with (non-dengue) other febrile illnesses and met inclusion criteria, and were included in the analysis. 2703 (52%) of 5189 included patients were younger than 15 years, 2486 (48%) were aged 15 years or older, 2179 (42%) were female and 3010 (58%) were male. Platelet count, white blood cell count, and the change in these variables from the previous day of illness had a strong association with dengue. Cough and rhinitis had strong associations with other febrile illnesses, whereas bleeding, anorexia, and skin flush were generally associated with dengue. Model performance increased between day 2 and 5 of illness. The comprehensive model (18 clinical and laboratory predictors) had sensitivities of 0·80 to 0·87 and specificities of 0·80 to 0·91, whereas the parsimonious model (eight clinical and laboratory predictors) had sensitivities of 0·80 to 0·88 and specificities of 0·81 to 0·89. A model that includes laboratory markers that are easy to measure (eg, platelet count or white blood cell count) outperformed the models based on clinical variables only. Interpretation: Our results confirm the important role of platelet and white blood cell counts in diagnosing dengue, and the importance of serial measurements over subsequent days. We successfully quantified the performance of clinical and laboratory markers covering the early period of dengue. Resulting algorithms performed better than published schemes for distinction of dengue from other febrile illnesses, and take into account the dynamic changes over time. Our results provide crucial information needed for the update of guidelines, including the Integrated Management of Childhood Illness handbook. Funding: EU's Seventh Framework Programme. Translations: For the Bangla, Bahasa Indonesia, Portuguese, Khmer, Spanish and Vietnamese translations of the abstract see Supplementary Materials section.

In this study, Ag/Zn2TiO4 powder with uniform size (< 50 nm) and a specific surface area of 16.16 m2 g−1 was synthesized by sol–gel method and coated on enamel tiles to investigate its antibacterial activity against Escherichia coli and Staphylococcus aureus. Results obtained from XRD patterns and the curve fitting of XPS spectra revealed that silver metal and its oxides are presented in the synthesized powder. The enamel tiles coated by Ag/Zn2TiO4 exhibited good antibacterial activity against both bacteria. Besides, the Ag/Zn2TiO4 coating improved the surface mechanical properties of the enamel tiles. [ABSTRACT FROM AUTHOR]

Anti- N -methyl- d -aspartate (NMDA) receptor encephalitis is caused by altered patient immune reactions. This study reports the first patient with severe neurologic sequelae after NMDA receptor encephalitis treated with allogeneic umbilical cord–derived mesenchymal stem/stromal cells (UC-MSCs). A 5-year-old girl was diagnosed with NMDA receptor encephalitis and treated with immunosuppressive medicaments and intravenous immunoglobulin (IVIG). Despite intensive therapy, the patient’s condition worsened so that allogenic UC-MSC therapy was contemplated. The patient received three intrathecal infusions of xeno- and serum-free cultured UC-MSCs at a dose of 10 6 cells/kg. At baseline and after each UC-MSC administration, the patient was examined by the German Coma Recovery Scale (CRS), the Gross Motor Function Classification System (GMFCS), the Gross Motor Function Measure–88 (GMFM-88), the Manual Ability Classification System (MACS), the Modified Ashworth Scale, and the Denver II test. Before cell therapy, she was in a permanent vegetative state with diffuse cerebral atrophy. Her cognition and motor functions improved progressively after three UC-MSC infusions. At the last visit, she was capable of walking, writing, and counting numbers. Control of urinary and bowel functions was completely recovered. Cerebral atrophy was reduced on brain magnetic resonance imaging (MRI). Overall, the outcomes of this patient suggest a potential cell therapy for autoimmune encephalitis and its neurological consequences.

Background: We determined the occurrence frequency of Clinical signs, subclinical characteristics on positive anti-IgG Toxocara ELISA cases, and clinical response results after 1 month of albendazole-specific treatment. Methods: A number of 103 clinically treated patients were studied between 2018 and 2019 in two hospitals. Relevant data are collected from examination and medical records such as age, sex, job, resident, clinical and sub-clinical signs. Sera samples were subjected to anti-IgG Toxocara antigen using ELISA. Results: The median age of the patient was 43.6 ± 14.4 years. The most common symptom groups were the skin and mucosa (88.3%), followed by neurological symptoms (44%). There are 76.7% of patients with risk factors for contact with pet dogs and cats. The majority of eosinophils in the normal range (< 8%) accounted for 85.4%, the major results of the OD value of ELISA were in the group (≥ 0.3-< 1.5) accounted for 75.7%. The skin and mucosa lesions in toxocariasis patients related to IgE values were statistically significant (P

Background Of the estimated 10 million people affected by (TB) each year, one-third are never diagnosed. Delayed case detection within the private healthcare sector has been identified as a particular problem in some settings, leading to considerable morbidity, mortality and community transmission. Using unannounced standardised patient (SP) visits to the pharmacies, we aimed to evaluate the performance of private pharmacies in the detection and treatment of TB.Methods A cross-sectional study was undertaken at randomly selected private pharmacies within 40 districts of Vietnam. Trained actors implemented two standardised clinical scenarios of presumptive TB and presumptive multidrug-resistant TB (MDR-TB). Outcomes were the proportion of SPs referred for medical assessment and the proportion inappropriately receiving broad-spectrum antibiotics. Logistic regression evaluated predictors of SPs’ referral.Results In total, 638 SP encounters were conducted, of which only 155 (24.3%) were referred for medical assessment; 511 (80·1%) were inappropriately offered antibiotics. A higher proportion of SPs were referred without having been given antibiotics if they had presumptive MDR-TB (68/320, 21.3%) versus presumptive TB (17/318, 5.3%; adjusted OR=4.8, 95% CI 2.9 to 7.8). Pharmacies offered antibiotics without a prescription to 89.9% of SPs with presumptive TB and 70.3% with presumptive MDR-TB, with no clear follow-up plan.Conclusions Few SPs with presumptive TB were appropriately referred for medical assessment by private pharmacies. Interventions to improve appropriate TB referral within the private pharmacy sector are urgently required to reduce the number of undiagnosed TB cases in Vietnam and similar high-prevalence settings.