Measurement invariance of the Childhood Autism Rating Scale (CARS) across six countries

Education and Child Studie

Effect of Brine Composition and Brining Temperature on Cheese Physical Properties in Ragusano Cheese

Composition and physical properties of cheeses are influenced by temperature, salt, and calcium concentration of brine. This work aimed to examine conditions of brine under which the cheese matrix contracts or expands in absence of restrictions imposed by surface rind development during overnight block formation. Three experimental 4-kg blocks of Ragusano cheese were produced at 3 different stretching temperatures (70, 80, and 90°C) and cut into pieces weighing approximately 40 to 50 g. One piece from each was chemically analyzed at time 0. All other pieces were measured for weight and volume and placed in plastic bags containing 300 mL of different brine solutions (2% NaCl with 0.1% Ca; 10% NaCl with 0, 0.1, 0.2, or 0.4% Ca; 18% NaCl with 0.1% Ca; and 26% NaCl with 0.1% Ca) at 3 different temperatures (4, 12, and 20°C). After 24 h of brining, the cheeses were analyzed for weight, volume, chemical, and microstructural changes. Salt concentration in brine significantly influenced composition, weight, and volume of the cheeses after brining. Salt concentration was inversely related to cheese volume and weight. Changes in weight caused by altering the brining temperature were sufficient to reach statistical significance, and statistically significant volume changes were induced by brining temperature and its interaction with salt content. The highest volume increase (30%) occurred in the cheese stored in the 2% NaCl brine at the coldest temperature, whereas the greatest volume decrease was recorded in cheeses brined in the 26% NaCl brine. Composition was not affected by brining temperature. Calcium concentration did influence weight, volume, and composition, except on a fat-on-dry-basis. When cheeses were brined without added calcium, cheese volume and weight increased at all temperatures. At high calcium levels (0.4%), syneresis occurred and volume decreased, especially at 20°C (−16.5%). Microstructural investigation with porosity measurement confirmed weight and volume changes

Individual Patient Data Meta-Analysis of the Value of Microsatellite Instability As a Biomarker in Gastric Cancer

PURPOSE In the CLASSIC and MAGIC trials, microsatellite instability (MSI)–high status was a favorable prognostic and potential negative predictive factor for neoadjuvant/adjuvant chemotherapy in resectable gastric cancer (GC). Given the low prevalence of MSI-high status in GC and its association with other positive prognostic variables, large data sets are needed to draw robust evidence of its prognostic/predictive value. PATIENTS AND METHODS We performed a multinational, individual-patient-data meta-analysis of the prognostic/predictive role of MSI in patients with resectable GC enrolled in the MAGIC, CLASSIC, ARTIST, and ITACA-S trials. Prognostic analyses used multivariable Cox models (MVM). The predictive role of MSI was assessed both in an all-comer population and in MAGIC and CLASSIC trials by MVM testing of the interaction of treatment (chemotherapy plus surgery v surgery) with MSI. RESULTS MSI status was available for 1,556 patients: 121 (7.8%) had MSI-high status; 576 were European, and 980 were Asian. In MSI-high versus MSI-low/microsatellite stable (MSS) comparisons, the 5-year disease-free survival (DFS) was 71.8% (95% CI, 63.8% to 80.7%) versus 52.3% (95% CI, 49.7% to 55.1%); the 5-year overall survival (OS) was 77.5% (95% CI, 70.0% to 85.8%) versus 59.3% (95% CI, 56.6% to 62.1%). In MVM, MSI was associated with longer DFS (hazard ratio [HR], 1.88; 95% CI, 1.28 to 2.76; P < .001) and OS (HR, 1.78; 95% CI, 1.17 to 2.73; P = .008), as were pT, pN, ethnicity, and treatment. Patients with MSI-low/MSS GC benefitted from chemotherapy plus surgery: the 5-year DFS compared with surgery only was 57% versus 41% (HR, 0.65; 95% CI, 0.53 to 0.79), and the 5-year OS was 62% versus 53% (HR, 0.75; 95% CI, 0.60 to 0.94). Conversely, those with MSI-high GC did not: the 5-year DFS was 70% versus 77% (HR, 1.27; 95% CI, 0.53 to 3.04), and the 5-year OS was 75% versus 83% (HR, 1.50; 95% CI, 0.55 to 4.12). CONCLUSION In patients with resectable primary GC, MSI is a robust prognostic marker that should be adopted as a stratification factor by clinical trials. Chemotherapy omission and/or immune checkpoint blockade should be investigated prospectively in MSI-high GCs according to clinically and pathologically defined risk of relapse