Physicochemical characteristics and finite element simulation of firmness in soursop fruits (annona muricata l. Cv. Elita) during postharvest

Soursop fruits (Annona muricata L. cv. Elita) at different ripening stages were evaluated for their physico-chemical characteristics: total soluble solids (TSSs), acidity, and pH. Firmness was determined through the application of puncture textural tests. The modeling and simulation of this parameter was carried out on Autodesk Inventor Professional 11.0 (ANSYS® Technology). The fruits showed an upward trend regarding TSS and acidity, reaching maximum values of 12.8°Brix, 0.74% acidity, and a pH below 3.43; all of which coincide with consumption maturity as observed on day 6. Firmness showed a decreasing trend throughout the entire postharvest period, with values of 79.43 N for day 0, and 3.62 N for day 9. Finite element modeling, the simulation of firmness, and its correlation with experimental data allowed for us to calculate the fracture force of the fruits with an exactness of more than 90%. Since it prevents the physical alteration of the product, this application becomes a nondestructive alternative for firmness assessment, useful in storage, transport, fresh consumption, packaging, and processingFrutos de guanábana (Annona muricata L. cv Elita) en diferentes etapas de maduración fueron evaluados, determinando sus características físico-químicas: sólidos solubles totales (SST), acidez y pH. La firmeza se encontró mediante la aplicación de pruebas de penetración uniaxial. El modelado y la simulación de la firmeza se llevó a cabo por el software Autodesk Inventor Professional 11.0 (ANSYS® Technology). Los frutos mostraron una tendencia creciente con respecto a los SST y la acidez, alcanzando valores máximos de 12,8°Brix y acidez de 0,74%, y un pH inferior a 3,43, valores que coinciden con la madurez de consumo, tal como se observa para el día 6. La Firmeza mostró una tendencia decreciente durante todo el período de poscosecha, con valores de 79,43 N para el día 0 y 3,62 N para el día 9. La simulación por elementos finitos de la fuerza de firmeza presentó alta correlación (>90 %) con respecto a los datos experimentales. La simulación por elementos finitos se convierte en una alternativa no destructiva para la evaluación de la firmeza, útil para el almacenamiento, transporte, consumo en fresco, envasado y procesamiento de éstas fruta

Aspectos clínicos de la angustia

Disposición para la angustia: Los accesos emocionales, entre ellos la angustia, tienen su asiento, según Fenichel, en factores biológicos y filogenéticos. Entendemos por el enunciado anterior la existencia de estructuras glandulares y nerviosas, de funcionamientos anclados sobre reacciones neuro-hormonales y bioquímicas, y de predisposiciones congénitamente adquiridas. Sobre lo anatómico y funcional nada podemos decir aquí; ese campo corresponde a la neurofisiología

International eDelphi Study to Reach Consensus on the Methotrexate Dosing Regimen in Patients With Psoriasis

Abstract Importance: A clear dosing regimen for methotrexate in psoriasis is lacking, and this might lead to a suboptimal treatment. Because methotrexate is affordable and globally available, a uniform dosing regimen could potentially optimize the treatment of patients with psoriasis worldwide. Objective: To reach international consensus among psoriasis experts on a uniform dosing regimen for treatment with methotrexate in adult and pediatric patients with psoriasis and identify potential future research topics. Design, setting, and participants: Between September 2020 and March 2021, a survey study with a modified eDelphi procedure that was developed and distributed by the Amsterdam University Medical Center and completed by 180 participants worldwide (55 [30.6%] resided in non-Western countries) was conducted in 3 rounds. The proposals on which no consensus was reached were discussed in a conference meeting (June 2021). Participants voted on 21 proposals with a 9-point scale (1-3 disagree, 4-6 neither agree nor disagree, 7-9 agree) and were recruited through the Skin Inflammation and Psoriasis International Network and European Academy of Dermatology and Venereology in June 2020. Apart from being a dermatologist/dermatology resident, there were no specific criteria for participation in the survey. The participants worked mainly at a university hospital (97 [53.9%]) and were experienced in treating patients with psoriasis with methotrexate (163 [91.6%] had more than 10 years of experience). Main outcomes and measures: In a survey with eDelphi procedure, we tried to reach consensus on 21 proposals. Consensus was defined as less than 15% voting disagree (1-3). For the consensus meeting, consensus was defined as less than 30% voting disagree. Results: Of 251 participants, 180 (71.7%) completed all 3 survey rounds, and 58 participants (23.1%) joined the conference meeting. Consensus was achieved on 11 proposals in round 1, 3 proposals in round 2, and 2 proposals in round 3. In the consensus meeting, consensus was achieved on 4 proposals. More research is needed, especially for the proposals on folic acid and the dosing of methotrexate for treating subpopulations such as children and vulnerable patients. Conclusions and relevance: In this eDelphi consensus study, consensus was reached on 20 of 21 proposals involving methotrexate dosing in patients with psoriasis. This consensus may potentially be used to harmonize the treatment with methotrexate in patients with psoriasis

International eDelphi Study to Reach Consensus on the Methotrexate Dosing Regimen in Patients with Psoriasis

Importance: A clear dosing regimen for methotrexate in psoriasis is lacking, and this might lead to a suboptimal treatment. Because methotrexate is affordable and globally available, a uniform dosing regimen could potentially optimize the treatment of patients with psoriasis worldwide. Objective: To reach international consensus among psoriasis experts on a uniform dosing regimen for treatment with methotrexate in adult and pediatric patients with psoriasis and identify potential future research topics. Design, Setting, and Participants: Between September 2020 and March 2021, a survey study with a modified eDelphi procedure that was developed and distributed by the Amsterdam University Medical Center and completed by 180 participants worldwide (55 [30.6%] resided in non-Western countries) was conducted in 3 rounds. The proposals on which no consensus was reached were discussed in a conference meeting (June 2021). Participants voted on 21 proposals with a 9-point scale (1-3 disagree, 4-6 neither agree nor disagree, 7-9 agree) and were recruited through the Skin Inflammation and Psoriasis International Network and European Academy of Dermatology and Venereology in June 2020. Apart from being a dermatologist/dermatology resident, there were no specific criteria for participation in the survey. The participants worked mainly at a university hospital (97 [53.9%]) and were experienced in treating patients with psoriasis with methotrexate (163 [91.6%] had more than 10 years of experience). Main Outcomes and Measures: In a survey with eDelphi procedure, we tried to reach consensus on 21 proposals. Consensus was defined as less than 15% voting disagree (1-3). For the consensus meeting, consensus was defined as less than 30% voting disagree. Results: Of 251 participants, 180 (71.7%) completed all 3 survey rounds, and 58 participants (23.1%) joined the conference meeting. Consensus was achieved on 11 proposals in round 1, 3 proposals in round 2, and 2 proposals in round 3. In the consensus meeting, consensus was achieved on 4 proposals. More research is needed, especially for the proposals on folic acid and the dosing of methotrexate for treating subpopulations such as children and vulnerable patients. Conclusions and Relevance: In this eDelphi consensus study, consensus was reached on 20 of 21 proposals involving methotrexate dosing in patients with psoriasis. This consensus may potentially be used to harmonize the treatment with methotrexate in patients with psoriasis.