Sci

Assisted Reproductive Technology Units (ARTUs) constitute a rapidly growing sector in healthcare, where service quality and patient safety are closely intertwined with ethical principles, technological precision, and managerial efficiency. This study aims to explore quality management practices and certification standards—such as ISO 9001, ISO 15189, and ISO 13485—within ARTUs, with the goal of developing a model that enhances patient-centered outcomes. The analysis focuses on the roles of leadership, staff training, and internal auditing mechanisms as key factors for the successful implementation of quality management systems (QMSs). Through a structured literature review and thematic synthesis, this study identifies challenges that ARTUs face in aligning with international standards and highlights strategies that strengthen patient trust, transparency, and continuous improvement. The proposed model connects measurable quality indicators with patient perceptions and experiences, providing a comprehensive framework for sustainable quality development. This article contributes to the academic discourse on healthcare quality governance and offers practical insights for policymakers and administrators seeking to improve patient experience and organizational resilience in reproductive medicine.

The winemaking industry represents one of the most important sectors of the Mediterranean agrifood economy, generating large amounts of solid residues, especially grape pomace. The study aimed to evaluate during two consecutive harvest years the influence of the production system (conventional vs. organic) and cultivar on the mineral, chemical, and antioxidant composition, as well as the colorimetric properties, of grape pomaces obtained from four Vitis vinifera L. cultivars in Alentejo-Portugal. The results showed that mineral composition was significantly affected by both production system and cultivar, with organic grape pomace showing higher K and Mn contents, whereas Ca and Cu showed consistently higher content under conventional. Protein content tended to increase under organic production, while fiber and fat were overall higher in conventional, particularly in the first year. Sugars displayed strong cultivar specificity, with Arinto showing the highest concentrations (30 to 40%), and considering all cultivars, total phenolic content ranged between 4000 ando 9000 mg GAE/100 g, while antioxidant capacity varied among cultivars and years. Colorimetric parameters were essentially influenced by cultivar and harvest year rather than production system. The PCA revealed that PC1 (44.06%) represented a gradient associated with mineral and antioxidant composition, while PC2 (21.26%) reflected minor variation in color and sugars, and the hierarchical clustering distinguished Syrah and Alicante Bouschet as the cultivars most responsive to production system, whereas Aragonez and Arinto exhibited greater compositional stability across years. Overall, the findings indicate that both cultivar and management practices (organic and conventional) influence the compositional profile of grape pomace, with organic showing a tendency to enhance K, Mn, protein, and antioxidant parameters, whereas conventional practices favored higher levels of Ca, Cu, and fiber. The results provide valuable insights for the valorization of grape pomace and the development of sustainable viticultural strategies in Mediterranean environments.

Background: Hermetia illucens larvae provide a sustainable bioconversion pathway that transforms agro-industrial residues into protein- and nutrient-dense biomass and frass, suitable for animal feed and soil amendment, respectively. Nevertheless, the potential spread of antibiotic resistance (AR) genes and pathogenic microorganisms poses biosafety concerns. This study examined the impact of four residue-based diet formulations; peas and chickpea (D1), peas and wheat (D2), onion and wheat (D3), and wheat with digestate (D4), on microbial safety during the bioconversion process. Methods: Enterococcus spp. (viable counts), Salmonella spp. (presence/absence), and 13 AR genes associated with resistance to tetracyclines, macrolide-lincosamide-streptogramin B, β-lactams, vancomycin, and aminoglycosides were quantified in single substrates, diets, larvae, and frass using qPCR. Results: Principal component analysis revealed diet-driven AR gene profiles. D1 lowered the levels of the greatest number of tested AR genes, particularly erm(B), tetracycline, and β-lactam genes in frass, as well as tet(O) and vanB in mature larvae. In contrast, D2 increased the AR gene levels in frass. All diets except D4 eliminated Salmonella spp. Enterococcus spp. loads varied by diet and larval stage, with D2 reducing counts in frass. Conclusions: Diet composition directly shapes microbial dynamics and AR gene dissemination, indicating that legume-based substrates may enhance biosafety in bioconversion systems.