Engineering of bioaerogels as key ingredients in the development of functional foods to deliver health through diet

This Ph.D. research project aims at exploiting the peculiar characteristics of innovative porous food-grade materials, called bioaerogels, in the development of foods with tailored health-related functionalities. In particular, bioaerogels will be used to develop: (i) delivery systems able to protect bioactives through the gastrointestinal tract; (ii) fat replacers rich in unsaturated fatty acids, able to mimic the technological functions of traditional saturated hard fats; (iii) lighting ingredients, able to incorporate air in food formulations, thus leading to caloric density reduction

Controlling aerogel surface porosity to enhance functionality in foods

Aerogels based on biopolymers, such as proteins, are food-grade materials characterized by distinctive physical properties, which make them intriguing candidates for the development of new ingredients with unique functionalities. The aerogel typical aerated structure can be exploited to deliver health-protecting bioactives or reduce food calories by increasing air content. However, aerogel porosity is easily lost upon contact with liquid food ingredients (water and oil). This issue might be overcome by closing the pores at the aerogel surface. In this work, processing and formulation strategies were applied to increase the structural stability of whey protein aerogels obtained by traditional ethanol exchange and supercritical-CO2-drying. Aerogels characterized by different levels of surface collapse were obtained by subjecting alcolgels to a controlled ethanol evaporation procedure prior to supercritical-CO2-drying. Alternatively, aerogels were coated with hydrophilic (alginate, agar) or hydrophobic (ethylcellulose) polymers. Aerogel microstructure was studied by SEM. Water and oil absorption kinetics were then measured. Ethanol evaporation time, polymer concentration and gelation rate were identified as key parameters affecting aerogel surface structure, allowing to significantly decrease water and oil absorption kinetics in the aerogels. This study suggests that aerogel structure-driven functionalities could be maintained in complex food formulations by controlling aerogel surface porosity

Potentialities of plant protein aerogels as innovative food ingredients

Protein aerogels are attracting large attention in the food sector, since presenting appealing characteristics as innovative food ingredients. Being made by proteins, commonly used food ingredients, they are largely accepted by consumers. Moreover, the structure of protein aerogels can be fine-tuned by acting on multiple processing (e.g., drying technique) and formulation (e.g., protein type, pH) factors, thus allowing the engineering of systems with a wide range of tailor-made functionalities. As a result, protein aerogels have been proposed as advanced food ingredients to develop bioactive delivery systems in the gastrointestinal tract, and structure liquid oil into plastic materials able to replace saturated fats in foods. Surprisingly, to date, the potentialities of protein aerogels as innovative food ingredients have been only demonstrated for animal protein-based systems, mainly egg and milk proteins, and studies regarding the development of aerogels from plant proteins are very limited. Nevertheless, the current concern about the poor environmental sustainability of animal proteins and their production is boosting the so-defined “plant-protein transition”, which has been identified as a key strategy to increase of food sustainability. In this context, plant-protein-based aerogels could represent an influential opportunity to favor the inlet of aerogels in the food sector. Based on these considerations, the aim of the present work was to study the possibility of producing food-grade aerogels based on plant proteins (pea and soy) and to collect preliminary data on their compatibility with food systems. To this aim, soy and pea protein isolate (SPI, PPI) hydrogels (10-20% w/w, pH 4.5 or 7.0) were converted into aerogel particles by grinding followed by ethanol solvent exchange and supercritical-CO2-drying. The obtained aerogel particles were analyzed for physical properties (BET surface area, porosity, density), and ability to interact with water and oil, commonly used food solvents. To this aim, aerogel water solubility and water and oil holding capacity (WHC, OHC) were assessed and compared to those of SPI and PPI. Aerogelation of SPI and PPI allowed obtaining porous particles, with BET internal surface and porosity in the range 50-150 m2/g and 60-80% respectively. The lowest values were found, as expected, at pH 4.5, corresponding to the isoelectric point. As compared to SPI and PPI, which presented a water solubility higher than 80%, the corresponding aerogels showed a water solubility around 25%. Aerogelation also significantly increased the WHC and OHC as compared to the protein isolates. The results obtained in this study demonstrate the possibility to produce plant-protein-based aerogels in the form of porous powders. The high ability to absorb water and oil, which can be exploited in the formulation of complex foods requiring rheological modulation (e.g., creams, spreads, dressings), associated with the vegetable origin of the used proteins, can be regarded as key characteristics able to stimulate the interest of the food sector in innovative aerogel ingredients

Protein aerogels as functional ingredients able to replace fat and modulate lipid digestion

Introduction The direct relation between saturated fat consumption and chronic diseases such as cardiovascular diseases, diabetes type II and obesity is nowadays well-established. However, fat substitution in foods is not simple, due to the important structural and sensorial properties of solid fat, which are hardly replicated by liquid oil. Nevertheless, oil can be structured into semi-solid materials (oleogels) by different “oleogelation” strategies. Oleogels not only mimic the structural properties of fats, but have been also shown to be useful in the modulation of lipid digestion. The aerogel-template approach, is a recent oleogelation strategy, based on the ability of aerogels to absorb oil in their porous network. In particular, food-grade protein aerogel particles have shown the peculiar ability to structure huge oil amounts into plastic systems presenting the mechanical properties of traditional fats. The aim of the present study was to assess the effect of aerogel-template oleogelation on lipid digestibility and to investigate the possibility to use aerogel-templated oleogels in the preparation of low-saturated fat cocoa creams. Experimental Methods Whey protein (WP) aerogel particles were prepared by grinding a heat-set WP hydrogel (20% w/w, pH=5.7), which was then subjected to ethanol exchange and supercritical-CO2 drying (SCD). Oleogels were than obtained by absorption of sunflower oil (SO) into aerogel particles. Lipid digestibility of the oleogel containing 80% (w/w) SO and 20% WP aerogel (w/w) was assessed by in vitro digestion, according to the INFOGEST protocol. Lipid digestibility was expressed as free fatty acids (FFA %), assessed by pH-stat method, i.e., by measuring the volume of NaOH (0.25 M) required to maintain the pH at 8.00 during digestion occurring in the small intestine. The choice of using pH 8.00 instead of 7.00 was based on the technical specifications of the used lipase. The digestate samples were analyzed by using dynamic light scattering (DLS) and confocal microscopy. The WP aerogel particles were then used to prepare cocoa creams containing sunflower oil (SO), icing sugar and cocoa powder. Different oil amounts were tested (40-65% w/w), while maintaining constant the ratio among the dried ingredients (WP aerogel:sugar:cocoa =1.5:5:1). Additional control samples were prepared by using native WP. The obtained creams were analyzed for oil release and rheological properties and compared to cocoa spreads available on the market. Results and discussion WP aerogel particles were used to structure SO into an oleogel, whose digestibility was then assessed. The lipid digestibility of SO and of the oleogel resulted respectively of 70% and 80%. These results can be attributed to the ability of aerogel protein particles to improve the emulsification of oil in the intestinal digestive mixture, leading to an enhanced activity of lipolytic enzymes. DLS, in fact, evidenced that the lipidic micelles formed during intestinal digestion of the oleogel resulted significantly smaller than those formed during SO digestion. This is probably attributable to the surface activity of WP aerogels, which are able to cover and stabilize the oil droplets in the digestive mixture. The applicability of WP aerogel particles as key ingredients for the preparation of low-saturated fat cocoa creams was then demonstrated, combining WP aerogel particles with SO in presence of sugar and cocoa powder. Native WP did not show oil structuring ability, leading to liquid-like cocoa creams, showing an apparent viscosity lower than 2 Pa∙s (50 1/s) and evident oil release upon resting at room temperature. By contrast, aerogel particles produced thicker creams, showing no flow under gravity, a significantly higher viscosity (50 Pa∙s), and no oil release under standard storage conditions. This was attributed to the modifications undergone by WP during conversion into porous aerogel particles. The range of rheological properties covered by the WP aerogel cocoa creams resulted comparable with a wide variety of commercial products (e.g. sauces and batters). Conclusions This work demonstrates the potentialities of WP aerogel particles as oil structuring agents, exploitable in the formulation of healthier food products with a reduced amount of saturated fatty acids. Such formulation strategy would not compromise the lipolytic action during digestion, making aerogels suitable carriers of bioactive molecules in the gastrointestinal tract

Compartmental tongue surgery for intermediate-advanced squamous cell carcinoma: A multicentric study

Background: A multicentric study was conducted on technical reproducibility of compartmental tongue surgery (CTS) in advanced tongue cancers (OTSCC) and comparison to standard wide margin surgery (SWMS). Methods: We studied 551 patients with OTSCC treated by CTS and 50 by SWMS. Oncological outcomes were analyzed. A propensity score was performed to compare survival endpoints for the two cohorts. Results: In the CTS group, survival and prognosis were significantly associated with positive lymph-nodes, extranodal extension, depth of invasion and involvement of the soft tissue connecting the tongue primary tumor to neck lymph nodes (T-N tract), independently from the center performing the surgery. SWMS versus CTS showed a HR Cause-Specific Survival (CSS) of 3.24 (95% CI: 1.71-6.11; p < 0.001); HR Loco-Regional Recurrence Free Survival (LRRFS) of 2.54 (95% CI: 1.47-4.40; p < 0.001); HR Overall Survival (OS) of 0.11 (95% CI: 0.01-0.77; p = 0.03). Conclusion: Performing the CTS could provide better CSS and LRRFS than SWMS regardless of the center performing the surgery, in advanced OTSSC

Protocol of the Italian Radical Cystectomy Registry (RIC): a non-randomized, 24-month, multicenter study comparing robotic-assisted, laparoscopic, and open surgery for radical cystectomy in bladder cancer

Bladder cancer is the ninth most common type of cancer worldwide. In the past, radical cystectomy via open surgery has been considered the gold-standard treatment for muscle invasive bladder cancer. However, in recent years there has been a progressive increase in the use of robot-assisted laparoscopic radical cystectomy. The aim of the current project is to investigate the surgical, oncological, and functional outcomes of patients with bladder cancer who undergo radical cystectomy comparing three different surgical techniques (robotic-assisted, laparoscopic, and open surgery). Pre-, peri- and post-operative factors will be examined, and participants will be followed for a period of up to 24\u2009months to identify risks of mortality, oncological outcomes, hospital readmission, sexual performance, and continence

Protocol of the Italian Radical Cystectomy Registry (RIC): a non-randomized, 24-month, multicenter study comparing robotic-assisted, laparoscopic, and open surgery for radical cystectomy in bladder cancer

Background: Bladder cancer is the ninth most common type of cancer worldwide. In the past, radical cystectomy via open surgery has been considered the gold-standard treatment for muscle invasive bladder cancer. However, in recent years there has been a progressive increase in the use of robot-assisted laparoscopic radical cystectomy. The aim of the current project is to investigate the surgical, oncological, and functional outcomes of patients with bladder cancer who undergo radical cystectomy comparing three different surgical techniques (robotic-assisted, laparoscopic, and open surgery). Pre-, peri- and post-operative factors will be examined, and participants will be followed for a period of up to 24 months to identify risks of mortality, oncological outcomes, hospital readmission, sexual performance, and continence. Methods: We describe a protocol for an observational, prospective, multicenter, cohort study to assess patients affected by bladder neoplasms undergoing radical cystectomy and urinary diversion. The Italian Radical Cystectomy Registry is an electronic registry to prospectively collect the data of patients undergoing radical cystectomy conducted with any technique (open, laparoscopic, robotic-assisted). Twenty-eight urology departments across Italy will provide data for the study, with the recruitment phase between 1st January 2017-31st October 2020. Information is collected from the patients at the moment of surgical intervention and during follow-up (3, 6, 12, and 24 months after radical cystectomy). Peri-operative variables include surgery time, type of urinary diversion, conversion to open surgery, bleeding, nerve sparing and lymphadenectomy. Follow-up data collection includes histological information (e.g., post-op staging, grading, and tumor histology), short- and long-term outcomes (e.g., mortality, post-op complications, hospital readmission, sexual potency, continence etc). Discussion: The current protocol aims to contribute additional data to the field concerning the short- and long-term outcomes of three different radical cystectomy surgical techniques for patients with bladder cancer, including open, laparoscopic, and robot-assisted. This is a comparative-effectiveness trial that takes into account a complex range of factors and decision making by both physicians and patients that affect their choice of surgical technique. Trial registration: ClinicalTrials.gov , NCT04228198 . Registered 14th January 2020- Retrospectively registered

From essential to persistent genes: a functional approach to constructing synthetic life

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Diabetic ketoacidosis at the onset of disease during a national awareness campaign: a 2-year observational study in children aged 0-18 years

After a previous survey on the incidence of diabetic ketoacidosis (DKA) at onset of type 1 diabetes in children in 2013-2014 in Italy, we aimed to verify a possible decline in the incidence of DKA at onset during a national prevention campaign

The Silent Epidemic of Diabetic Ketoacidosis at Diagnosis of Type 1 Diabetes in Children and Adolescents in Italy During the COVID-19 Pandemic in 2020

To compare the frequency of diabetic ketoacidosis (DKA) at diagnosis of type 1 diabetes in Italy during the COVID-19 pandemic in 2020 with the frequency of DKA during 2017-2019