HPLC/PDA/ESI-MS Evaluation of Saffron (Crocus sativus L.) Adulteration

The present study evaluated the reliability of the ISO/TS 3632-2 UV-Vis spectrometric method for saffron classification, making experiments on saffron samples to which were added increasing concentrations of common saffron spice adulterants (safflower, marigold and turmeric). The results showed that the ISO/TS 3632-2 method is not able to detect addition of up to 10-20%, w/w, of saffron adulterants. For additions from 20 to 50%, w/w, of the three adulterants, saffron was classified in a wrong category; addition of higher than 50%, w/w, determined variations in the investigated parameters that did not allow identification of the product as "saffron". In all cases, the method did not permit the recognition of the nature of the adulterant. On the contrary, the specificity of the HPLC/PDA/MS technique allowed the unequivocal identification of adulterant characteristic marker molecules that could be recognized by the values of absorbance and mass. The selection of characteristic ions of each marker molecule has revealed concentrations of up to 5%, w/w, for safflower and marigold and up to 2% for turmeric. In addition, the high dyeing power of turmeric allowed the determination of 2%, w/w, addition using exclusively the HPLC/PDA technique

Amount and type of physical activity and sports from one year forward after hip or knee arthroplasty—A systematic review

Introduction After rehabilitation following total hip or knee arthroplasty (THA/TKA), patients are advised to participate in physical activity (PA) and sports. However, profound insight into whether people adopt a physically active lifestyle is lacking. Aim is to gain insight into the performed amount and type of PA (including sports) and time spent sedentarily by persons after THA/ TKA. Methods A systematic review (PROSPERO: CRD42020178556). Pubmed, Cinahl, EMBASE and PsycInfo were systematically searched for articles reporting on amount of PA, and on the kind of activities performed between January 1995-January 2021. Quality of the articles was assessed with the adapted tool from Borghouts et al. Results The search retrieved 5029 articles, leading to inclusion of 125 articles reporting data of 123 groups; 53 articles reported on subjects post-THA, 16 on post-hip-resurfacing arthroplasty, 40 on post-TKA, 15 on post-unicompartimental knee arthroplasty and 12 on a mix of arthroplasty types. With respect to quality assessment, 14 articles (11%) met three or fewer criteria, 29 (24%) met four, 32 (26%) met five, 42 (34%) met six, and 6 (5%) met seven out of the eight criteria. PA levels were comparable for THA and TKA, showing a low to moderately active population. Time spent was mostly of low intensity. Roughly 50% of -subjects met health-enhancing PA guidelines. They spent the largest part of their day sedentarily. Sports participation was relatively high (rates above 70%). Most participation was in low-impact sports at a recreational level. Roughly speaking, participants were engaged in sports 3 hours/week, consisting of about three 1-hour sessions. Conclusion Activity levels seem to be low; less than half of them seemed to perform the advised amount of PA following health-enhancing guidelines Sports participation levels were high. However, many articles were unclear about the definition of sports participation, which could have led to overestimation

Off-label long acting injectable antipsychotics in real-world clinical practice: a cross-sectional analysis of prescriptive patterns from the STAR Network DEPOT study

Introduction Information on the off-label use of Long-Acting Injectable (LAI) antipsychotics in the real world is lacking. In this study, we aimed to identify the sociodemographic and clinical features of patients treated with on- vs off-label LAIs and predictors of off-label First- or Second-Generation Antipsychotic (FGA vs. SGA) LAI choice in everyday clinical practice. Method In a naturalistic national cohort of 449 patients who initiated LAI treatment in the STAR Network Depot Study, two groups were identified based on off- or on-label prescriptions. A multivariate logistic regression analysis was used to test several clinically relevant variables and identify those associated with the choice of FGA vs SGA prescription in the off-label group. Results SGA LAIs were more commonly prescribed in everyday practice, without significant differences in their on- and off-label use. Approximately 1 in 4 patients received an off-label prescription. In the off-label group, the most frequent diagnoses were bipolar disorder (67.5%) or any personality disorder (23.7%). FGA vs SGA LAI choice was significantly associated with BPRS thought disorder (OR = 1.22, CI95% 1.04 to 1.43, p = 0.015) and hostility/suspiciousness (OR = 0.83, CI95% 0.71 to 0.97, p = 0.017) dimensions. The likelihood of receiving an SGA LAI grew steadily with the increase of the BPRS thought disturbance score. Conversely, a preference towards prescribing an FGA was observed with higher scores at the BPRS hostility/suspiciousness subscale. Conclusion Our study is the first to identify predictors of FGA vs SGA choice in patients treated with off-label LAI antipsychotics. Demographic characteristics, i.e. age, sex, and substance/alcohol use co-morbidities did not appear to influence the choice towards FGAs or SGAs. Despite a lack of evidence, clinicians tend to favour FGA over SGA LAIs in bipolar or personality disorder patients with relevant hostility. Further research is needed to evaluate treatment adherence and clinical effectiveness of these prescriptive patterns

The Role of Attitudes Toward Medication and Treatment Adherence in the Clinical Response to LAIs: Findings From the STAR Network Depot Study

Background: Long-acting injectable (LAI) antipsychotics are efficacious in managing psychotic symptoms in people affected by severe mental disorders, such as schizophrenia and bipolar disorder. The present study aimed to investigate whether attitude toward treatment and treatment adherence represent predictors of symptoms changes over time. Methods: The STAR Network \u201cDepot Study\u201d was a naturalistic, multicenter, observational, prospective study that enrolled people initiating a LAI without restrictions on diagnosis, clinical severity or setting. Participants from 32 Italian centers were assessed at three time points: baseline, 6-month, and 12-month follow-up. Psychopathological symptoms, attitude toward medication and treatment adherence were measured using the Brief Psychiatric Rating Scale (BPRS), the Drug Attitude Inventory (DAI-10) and the Kemp's 7-point scale, respectively. Linear mixed-effects models were used to evaluate whether attitude toward medication and treatment adherence independently predicted symptoms changes over time. Analyses were conducted on the overall sample and then stratified according to the baseline severity (BPRS < 41 or BPRS 65 41). Results: We included 461 participants of which 276 were males. The majority of participants had received a primary diagnosis of a schizophrenia spectrum disorder (71.80%) and initiated a treatment with a second-generation LAI (69.63%). BPRS, DAI-10, and Kemp's scale scores improved over time. Six linear regressions\u2014conducted considering the outcome and predictors at baseline, 6-month, and 12-month follow-up independently\u2014showed that both DAI-10 and Kemp's scale negatively associated with BPRS scores at the three considered time points. Linear mixed-effects models conducted on the overall sample did not show any significant association between attitude toward medication or treatment adherence and changes in psychiatric symptoms over time. However, after stratification according to baseline severity, we found that both DAI-10 and Kemp's scale negatively predicted changes in BPRS scores at 12-month follow-up regardless of baseline severity. The association at 6-month follow-up was confirmed only in the group with moderate or severe symptoms at baseline. Conclusion: Our findings corroborate the importance of improving the quality of relationship between clinicians and patients. Shared decision making and thorough discussions about benefits and side effects may improve the outcome in patients with severe mental disorders

Consumption of eggs and other animal source foods during the early complementary feeding period in rural Bangladesh: strengthening evidence for interventions

Background: Inadequate dietary intake contributes to linear growth faltering during the early complementary feeding period. Regular consumption of eggs, which are rich sources of complete protein, essential fatty acids, and multiple micronutrients, may be beneficial for infant nutrition. There is a need to strengthen evidence on the impact of egg consumption on infant nutrition outcomes in low- and middle-countries and inform how such evidence can be put into practice. Objective: This dissertation aimed to evaluate the impact of egg consumption on infant growth and dietary quality and examine the relationship between small-scale animal production and infant consumption of animal source foods (ASF) to strengthen evidence on the role of eggs during the early complementary feeding period and the potential of agricultural interventions to contribute to nutrition in a rural South Asian setting. Methods: A cluster-randomized controlled trial tested the combined and independent effects of a protein intervention and enteric pathogen control intervention on linear growth among infants in Bangladesh. Sectors were randomized to an antibiotic or placebo arm and then to a nutrition intervention arm (provision of a daily egg, protein-rich blended meal, or control blended meal) or to the control arm. Each arm received nutrition education. Subjects were enrolled at three months of age and assigned to an arm based on their sector of residence. This dissertation focused on the impact of the egg intervention and nutrition education versus nutrition education alone, irrespective of the enteric pathogen control intervention, on infant nutrition outcomes and explored the scalability of the intervention. Households were visited weekly to distribute eggs and monitor compliance for six months starting at six months of age. Longitudinal assessments of anthropometry, breastfeeding, and diet were collected at six, nine, and 12 months, and data on household animal production and maternal decision-making power were collected at 12 months. Results: There was no difference in mean length-for-age z-score (β = 0.01, 95% CI: -0.05, 0.06) or prevalence of stunting (PR = 1.01, 95% CI: 0.87, 1.15) between the egg and control arms at 12 months. Infants in the egg arm had significantly higher mean weight (β = 0.07, 95% CI: 0.02, 0.12), weight-for-length z-score (β = 0.11, 95% CI: 0.04, 0.18), and weight-for-age z-score (β = 0.07, 95% CI: 0.02, 0.12) than the control. Estimated mean usual intakes of energy, protein, and 14 out of the 18 micronutrients assessed were higher in the egg arm compared to the control at 12 months. Although the proportion of infants meeting intake recommendations for most micronutrients was higher in the egg arm compared to the control, it was <50% at 12 months for 13 of the 18 micronutrients among infants receiving the intervention. Household ownership of poultry and dairy-producing animals were associated with higher infant intakes of eggs and dairy, respectively, whereas ownership of meat-producing animals and fishponds were not associated with higher intakes of meat or fish, respectively. Maternal decision-making power was not a significant modifier in the relationship between household animal production and infant consumption of animal products. Conclusions: The provision of a daily egg for six months to infants improved ponderal but not linear growth. Although the intervention improved dietary quality, alone it was not sufficient to meet recommended intakes for numerous micronutrients among infants with relatively low consumption of nutrient-dense foods. Strategies intervening on household animal production may increase infants’ intakes of eggs and dairy, but not necessarily that of meat or fish in this rural South Asian context. Future research is needed in this setting on the role of other dimensions of women’s empowerment and other contextual factors in in the relationship between small-scale animal production and infant nutrition

Consumption of eggs and other animal source foods during the early complementary feeding period in rural Bangladesh: strengthening evidence for interventions

Background: Inadequate dietary intake contributes to linear growth faltering during the early complementary feeding period. Regular consumption of eggs, which are rich sources of complete protein, essential fatty acids, and multiple micronutrients, may be beneficial for infant nutrition. There is a need to strengthen evidence on the impact of egg consumption on infant nutrition outcomes in low- and middle-countries and inform how such evidence can be put into practice. Objective: This dissertation aimed to evaluate the impact of egg consumption on infant growth and dietary quality and examine the relationship between small-scale animal production and infant consumption of animal source foods (ASF) to strengthen evidence on the role of eggs during the early complementary feeding period and the potential of agricultural interventions to contribute to nutrition in a rural South Asian setting. Methods: A cluster-randomized controlled trial tested the combined and independent effects of a protein intervention and enteric pathogen control intervention on linear growth among infants in Bangladesh. Sectors were randomized to an antibiotic or placebo arm and then to a nutrition intervention arm (provision of a daily egg, protein-rich blended meal, or control blended meal) or to the control arm. Each arm received nutrition education. Subjects were enrolled at three months of age and assigned to an arm based on their sector of residence. This dissertation focused on the impact of the egg intervention and nutrition education versus nutrition education alone, irrespective of the enteric pathogen control intervention, on infant nutrition outcomes and explored the scalability of the intervention. Households were visited weekly to distribute eggs and monitor compliance for six months starting at six months of age. Longitudinal assessments of anthropometry, breastfeeding, and diet were collected at six, nine, and 12 months, and data on household animal production and maternal decision-making power were collected at 12 months. Results: There was no difference in mean length-for-age z-score (β = 0.01, 95% CI: -0.05, 0.06) or prevalence of stunting (PR = 1.01, 95% CI: 0.87, 1.15) between the egg and control arms at 12 months. Infants in the egg arm had significantly higher mean weight (β = 0.07, 95% CI: 0.02, 0.12), weight-for-length z-score (β = 0.11, 95% CI: 0.04, 0.18), and weight-for-age z-score (β = 0.07, 95% CI: 0.02, 0.12) than the control. Estimated mean usual intakes of energy, protein, and 14 out of the 18 micronutrients assessed were higher in the egg arm compared to the control at 12 months. Although the proportion of infants meeting intake recommendations for most micronutrients was higher in the egg arm compared to the control, it was <50% at 12 months for 13 of the 18 micronutrients among infants receiving the intervention. Household ownership of poultry and dairy-producing animals were associated with higher infant intakes of eggs and dairy, respectively, whereas ownership of meat-producing animals and fishponds were not associated with higher intakes of meat or fish, respectively. Maternal decision-making power was not a significant modifier in the relationship between household animal production and infant consumption of animal products. Conclusions: The provision of a daily egg for six months to infants improved ponderal but not linear growth. Although the intervention improved dietary quality, alone it was not sufficient to meet recommended intakes for numerous micronutrients among infants with relatively low consumption of nutrient-dense foods. Strategies intervening on household animal production may increase infants’ intakes of eggs and dairy, but not necessarily that of meat or fish in this rural South Asian context. Future research is needed in this setting on the role of other dimensions of women’s empowerment and other contextual factors in in the relationship between small-scale animal production and infant nutrition

UHPLC/MS-MS Analysis of Six Neonicotinoids in Honey by Modified QuEChERS: Method Development, Validation, and Uncertainty Measurement

Rapid and reliable multiresidue analytical methods were developed and validated for the determination of 6 neonicotinoids pesticides (acetamiprid, clothianidin, imidacloprid, nitenpyram, thiacloprid, and thiamethoxam) in honey. A modified QuEChERS method has allowed a very rapid and efficient single-step extraction, while the detection was performed by UHPLC/MS-MS. The recovery studies were carried out by spiking the samples at two concentration levels (10 and 40 μg/kg). The methods were subjected to a thorough validation procedure. The mean recovery was in the range of 75 to 114% with repeatability below 20%. The limits of detection were below 2.5 μg/kg, while the limits of quantification did not exceed 4.0 μg/kg. The total uncertainty was evaluated taking the main independent uncertainty sources under consideration. The expanded uncertainty did not exceed 49% for the 10 μg/kg concentration level and was in the range of 16–19% for the 40 μg/kg fortification level

Household animal ownership is associated with infant animal source food consumption in Bangladesh

Abstract Context‐specific research is needed on the relationship between household animal production and nutrition outcomes to inform programmes intervening in small‐scale animal production. We examined associations between household animal/fishpond ownership and animal source food (ASF) consumption among 6‐ to 12‐month‐old infants enroled in the control arm of a cluster‐randomised controlled trial in rural Bangladesh. We measured ASF consumption using a 7‐day food frequency questionnaire at 6, 9 and 12 months and assessed household animal/fishpond ownership at 12 months. We developed negative binomial regression models with random intercepts for infant and cluster, controlling for infant age and sex, maternal age, socioeconomic status and season. Models were stratified by a dichotomised maternal decision‐making score. Compared with infants in households without each animal type, those with 4–10 and ≥11 poultry consumed eggs 1.3 (95% confidence interval [CI]: 1.1, 1.6) and 1.6 (95% CI: 1.3, 2.0) times more, respectively; 2–3 and ≥4 dairy‐producing animals consumed dairy 1.9 (95% CI: 1.3, 2.7) and 2.0 (95% CI: 1.3, 3.1) times more, respectively; and ≥12 meat‐producing animals consumed meat 1.4 (95% CI: 1.0, 1.8) times more. It was unclear whether there was an association between fishpond ownership and fish consumption. Our results did not suggest that maternal decision‐making power was a modifier in the relationship between animal/fishpond ownership and ASF consumption. In this South Asian context, strategies intervening in household animal production may increase infant consumption of eggs, dairy and meat, but not necessarily fish. Research is needed on the role of market access and other dimensions of women's empowerment

Dietary diversity and child development in the far west of Nepal: A cohort study

Poverty adversely affects child development through multiple pathways in low- and middle-income countries. Relationships between diet and child development are poorly understood. In this study, we aimed to explore these associations in a longitudinal cohort of 305 children in rural Nepal (baseline mean age 14 months), evaluating dietary diversity and the consumption of specific food groups at three timepoints over 1.5 years. Child development was assessed using the Ages and Stages questionnaire-version 3 (ASQ-3). Associations between the number of days that children consumed minimum dietary diversity (MDD) (≥4/8 items) and specific food groups over time (range 0-3) and total and subscale ASQ scores at age 23-38 months were estimated using multiple linear and logistic regression, dichotomizing scores at the lowest quartile. After adjusting for confounders, each additional day of consuming MDD was associated with a 35% reduction in the odds of low total ASQ score [OR 0.65, 95% CI (0.46, 0.92)]. The consumption of animal source foods [OR 0.64, (0.46, 0.89)], and vegetables/fruits [OR 0.60, (0.41, 0.90), but not processed foods [OR 0.99, (0.62, 1.59)] was associated with lower odds of low total development. Vegetables, fruits and animal source foods may be important for child development in this setting

Dietary diversity and child development in the far west of Nepal: A cohort study

Poverty adversely affects child development through multiple pathways in low- and middle-income countries. Relationships between diet and child development are poorly understood. In this study, we aimed to explore these associations in a longitudinal cohort of 305 children in rural Nepal (baseline mean age 14 months), evaluating dietary diversity and the consumption of specific food groups at three timepoints over 1.5 years. Child development was assessed using the Ages and Stages questionnaire-version 3 (ASQ-3). Associations between the number of days that children consumed minimum dietary diversity (MDD) (≥4/8 items) and specific food groups over time (range 0-3) and total and subscale ASQ scores at age 23-38 months were estimated using multiple linear and logistic regression, dichotomizing scores at the lowest quartile. After adjusting for confounders, each additional day of consuming MDD was associated with a 35% reduction in the odds of low total ASQ score [OR 0.65, 95% CI (0.46, 0.92)]. The consumption of animal source foods [OR 0.64, (0.46, 0.89)], and vegetables/fruits [OR 0.60, (0.41, 0.90), but not processed foods [OR 0.99, (0.62, 1.59)] was associated with lower odds of low total development. Vegetables, fruits and animal source foods may be important for child development in this setting