Measuring impairments of functioning and health in patients with axial spondyloarthritis by using the ASAS Health Index and the Environmental Item Set : translation and cross-cultural adaptation into 15 languages

Introduction: The Assessments of SpondyloArthritis international society Health Index (ASAS HI) measures functioning and health in patients with spondyloarthritis (SpA) across 17 aspects of health and 9 environmental factors (EF). The objective was to translate and adapt the original English version of the ASAS HI, including the EF Item Set, cross-culturally into 15 languages. Methods: Translation and cross-cultural adaptation has been carried out following the forward-backward procedure. In the cognitive debriefing, 10 patients/country across a broad spectrum of sociodemographic background, were included. Results: The ASAS HI and the EF Item Set were translated into Arabic, Chinese, Croatian, Dutch, French, German, Greek, Hungarian, Italian, Korean, Portuguese, Russian, Spanish, Thai and Turkish. Some difficulties were experienced with translation of the contextual factors indicating that these concepts may be more culturally-dependent. A total of 215 patients with axial SpA across 23 countries (62.3% men, mean (SD) age 42.4 (13.9) years) participated in the field test. Cognitive debriefing showed that items of the ASAS HI and EF Item Set are clear, relevant and comprehensive. All versions were accepted with minor modifications with respect to item wording and response option. The wording of three items had to be adapted to improve clarity. As a result of cognitive debriefing, a new response option 'not applicable' was added to two items of the ASAS HI to improve appropriateness. Discussion: This study showed that the items of the ASAS HI including the EFs were readily adaptable throughout all countries, indicating that the concepts covered were comprehensive, clear and meaningful in different cultures

Post-transcriptional control of a stemness signature by RNA-binding protein MEX3A regulates murine adult neurogenesis

Neural stem cells (NSCs) in the adult murine subependymal zone balance their self-renewal capacity and glial identity with the potential to generate neurons during the lifetime. Adult NSCs exhibit lineage priming via pro-neurogenic fate determinants. However, the protein levels of the neural fate determinants are not sufficient to drive direct differentiation of adult NSCs, which raises the question of how cells along the neurogenic lineage avoid different conflicting fate choices, such as self-renewal and differentiation. Here, we identify RNA-binding protein MEX3A as a post-transcriptional regulator of a set of stemness associated transcripts at critical transitions in the subependymal neurogenic lineage. MEX3A regulates a quiescence-related RNA signature in activated NSCs that is needed for their return to quiescence, playing a role in the long-term maintenance of the NSC pool. Furthermore, it is required for the repression of the same program at the onset of neuronal differentiation. Our data indicate that MEX3A is a pivotal regulator of adult murine neurogenesis acting as a translational remodeller.© 2023. The Author(s)

Physical and Antimicrobial Properties of Compression-Molded Cassava Starch-Chitosan Films for Meat Preservation

[EN] Cassava starch-chitosan films were obtained by melt bending and compression molding, using glycerol and polyethylene glycol as plasticizers. Both the starch/chitosan and the polymer/plasticizer ratios were varied in order to analyze their effect on the physical properties of the films. Additionally, the antimicrobial activity of 70:30 polymer:plasticizer films was tested in cold-stored pork meat slices as affected by chitosan content. All film components were thermally stable up to 200 A degrees C, which guaranteed their thermostability during film processing. Starch and chitosan had limited miscibility by melt blending, which resulted in heterogeneous film microstructure. Polyethylene glycol partially crystallized in the films, to a greater extent as the chitosan ratio increased, which limited its plasticizing effect. The films with the highest plasticizer ratio were more permeable to water vapor, less rigid, and less resistant to break. The variation in the chitosan content did not have a significant effect on water vapor permeability. As the chitosan proportion increased, the films became less stretchable, more rigid, and more resistant to break, with a more saturated yellowish color. The incorporation of the highest amount of chitosan in the films led to the reduction in coliforms and total aerobic counts of cold-stored pork meat slices, thus extending their shelf-life.The authors acknowledge the financial support provided by the Spanish Ministerio de Economia y Competividad (Projects AGL2013-42989-R and AGL2016-76699-R). Author Cristina Valencia-Sullca thanks the Peruvian Grant National Program (PRONABEC Grant).Valencia-Sullca, CE.; Atarés Huerta, LM.; Vargas, M.; Chiralt, A. (2018). Physical and Antimicrobial Properties of Compression-Molded Cassava Starch-Chitosan Films for Meat Preservation. Food and Bioprocess Technology. 11(7):1339-1349. https://doi.org/10.1007/s11947-018-2094-5S13391349117Alves, V. D., Mali, S., Beleia, A., & Grossmann, M. V. (2007). Effect of glycerol and amylose enrichment on cassava starch film properties. Journal of Food Engineering, 78(3), 941–946.ASTM (1995). Standard test methods for water vapour transmission of materials. In: Standards designations: E96-95. Annual book of ASTM standards (pp. 406-413). Philadelphia, PA: American Society for Testing and Materials.ASTM (1999). Standard test method for specular gloss. In: Designation (D523). Annual book of ASTM standards, Vol. 06.01. Philadelphia, PA: American Society for Testing and Materials.ASTM (2001). Standard test method for tensile properties of thin plastic sheeting. In: Standard D882 annual book of American standard testing methods. Philadelphia, PA: American Society for Testing and Materials.Atarés, L., Bonilla, J., & Chiralt, A. (2010). Characterization of sodium caseinate-based edible films incorporated with cinnamon or ginger essential oils. Journal of Food Engineering, 100(4), 678–687.Bonilla, J., Atarés, L., Vargas, M., & Chiralt, A. (2013). Properties of wheat starch film-forming dispersions and films as affected by chitosan addition. Journal of Food Engineering, 114(3), 303–312.Bonilla, J., Fortunati, E., Atarés, L., Chiralt, A., & Kenny, J. (2014). Physical, structural and antimicrobial properties of poly vinyl alcohol-chitosan biodegradable films. Food Hydrocolloids, 35, 463–470.Bourtoom, T., & Chinnan, M. S. (2008). Preparation and properties of rice starch–chitosan blend biodegradable film. LWT-Food Science and Technology, 41(9), 1633–1641.Cano, A., Jiménez, A., Cháfer, M., González-Martínez, C., & Chiralt, A. (2014). Effect of amylose: amylopectin ratio and rice bran addition on starch films properties. Carbohydrate Polymers, 111(0), 543–555.Carvalho, A. J. F. (2008). Starch: Major sources, properties and applications as thermoplastic materials. In M. N. Belgacem & A. Gandini (Eds.), Monomers, polymers and composites from renewable resources. Amsterdam: Elsevier.Chillo, S., Flores, S., Mastromatteo, M., Conte, A., Gerschenson, L., & Del Nobile, M. A. (2008). Influence of glycerol and chitosan on tapioca starch-based edible film properties. Journal of Food Engineering, 88(2), 159–168.Commission Regulation, 2005 (EC) No 2073/2005 of 15 November 2005 on microbiological criteria for foodstuffs. In Official Journal of the European Union pp 338/1–338/26.Da Róz, A., Carvalho, A., Gandini, A., & Curvelo, A. (2006). The effect of plasticizers on thermoplastic starch compositions obtained by melt processing. Carbohydrate Polymers, 63(3), 417–424.Dang, K., & Yoksan, R. (2015). Development of thermoplastic starch blown film by incorporating plasticized chitosan. Carbohydrate Polymers, 115, 575–581.Dou, B., Dupont, V., Williams, P. T., Chen, H., & Ding, Y. (2009). Thermogravimetric kinetics of crude glycerol. Bioresource Technology, 100(9), 2613–2620.Fang, J., Fawler, P., Eserig, C., González, R., Costa, J., & Chamudis, L. (2005). Development of biodegradable laminate films derived from naturally occurring carbohydrate polymers. Carbohydrate Polymers, 60(1), 39–42.Hutchings, J. B. (1999). Food color and appearance (2nd ed.). Gaithersburg, Maryland, USA: Aspen Publishers, Inc..Jiménez, A., Fabra, M. J., Talens, P., & Chiralt, A. (2012a). Edible and biodegradable starch films: A review. Food Bioprocessing Technology, 5(6), 2058–2076.Jiménez, A., Fabra, M. J., Talens, P., & Chiralt, A. (2012b). Effect of re-crystallization on tensile, optical and water vapour barrier properties of corn starch films containing fatty acids. Food Hydrocolloids, 26(1), 302–310.López, O., Garcia, A., Villar, M., Gentili, A., Rodriguez, M., & Albertengo, L. (2014). Thermo-compression of biodegradable thermoplastic corn starch films containing chitin and chitosan. LWT-Food Science and Technology, 57(106), 106–1515.Mali, S., Grossmann, M. V. E., García, M. A., Martino, M. N., & Zaritsky, N. E. (2006). Effects of controlled storage on thermal, mechanical and barrier properties of plasticized films from different starch sources. Journal of Food Engineering, 75(4), 453–460.Mendes, J. F., Paschoalin, R. T., Carmona, V. B., Sena Neto, A. R. A., Marques, C. P., Marconcini, J. M., Mattoso, L. H. C., Medeiros, E. S., & Oliveira, J. E. (2016). Biodegradable polymer blends based on corn starch and thermoplastic chitosan processed by extrusion. Carbohydrate Polymers, 137, 452–458.Ortega-Toro, R., Jiménez, A., Talens, P., & Chiralt, A. (2014). Properties of starch–hydroxypropyl methylcellulose based films obtained by compression molding. Carbohydrate Polymers, 109, 155–165.Ortega-Toro, R., Morey, I., Talens, P., & Chiralt, A. (2015). Active bilayer films of thermoplastic starch and polycaprolactone obtained by compression molding. Carbohydrate Polymers, 127, 282–290.Pelissari, F., Grossmann, M., Yamashita, F., & Pineda, E. (2009). Antimicrobial, mechanical and barrier properties of cassava starch-chitosan films incorporated with oregano essential oil. Journal of Agricultural and Food Chemistry, 57(16), 7499–7504.Pelissari, F. M., Yamashita, F., García, M. A., Martino, M. N., Zaritzky, N. E., & Grossmann, M. V. E. (2012). Constrained mixture design applied to the development of cassava starch-chitosan blown films. Journal of Food Engineering, 108(2), 262–267.Song, R., Xue, R., He, L. H., Liu, Y., & Xiao, Q. L. (2008). The structure and properties of chitosan/polyethylene glycol/silica ternary hybrid organic-inorganic films. Chinese Journal of Polymer Science, 26(05), 621–630.v.Su, J. F., Huang, Z., Yuan, X. Y., Wang, X. Y., & Lim, M. (2010). Structure and properties of carboxymethyl cellulose/soy protein isolate blend edible films crosslinked by Maillard reactions. Carbohydrate Polymers, 79(1), 145–153.Thunwall, M., Boldizar, A., & Rigdahl, M. (2006). Compression molding and tensile properties of thermoplastic potato starch materials. Biomacromolecules, 7(3), 981–986.Tomé, L., Fernandes, S., Sadocco, P., Causio, J., Silvertre, A., Neto, P., & Freire, C. (2012). Antibacterial thermoplastic starch- chitosan based materials prepared by melt-mixing. BioResources, 7(3), 3398–3409.Villalobos, R., Chanona, J., Hernández, P., Gutiérrez, G., & Chiralt, A. (2005). Gloss and transparency of hydroxypropyl methylcellulose films containing surfactants as affected by their microstructure. Food Hydrocolloids, 19(1), 53–61.Xu, Y. X., Kim, K. M., Hanna, M. A., & Nag, D. (2005). Chitosan–starch composite film: Preparation and characterization. Industrial Crops and Products, 21(2), 185–192.Yang, L., & Paulson, A. T. (2000). Mechanical and water vapour barrier properties of edible gellan. Food Research International, 33(7), 563–570

The Antioxidant Potential of the Mediterranean Diet in Patients at High Cardiovascular Risk: An In-Depth Review of the PREDIMED

Cardiovascular disease (CVD) is the leading global cause of death. Diet is known to be important in the prevention of CVD. The PREDIMED trial tested a relatively low-fat diet versus a high-fat Mediterranean diet (MedDiet) for the primary prevention of CVD. The resulting reduction of the CV composite outcome resulted in a paradigm shift in CV nutrition. Though many dietary factors likely contributed to this effect, this review focuses on the influence of the MedDiet on endogenous antioxidant systems and the effect of dietary polyphenols. Subgroup analysis of the PREDIMED trial revealed increased endogenous antioxidant and decreased pro-oxidant activity in the MedDiet groups. Moreover, higher polyphenol intake was associated with lower incidence of the primary outcome, overall mortality, blood pressure, inflammatory biomarkers, onset of new-onset type 2 diabetes mellitus (T2DM), and obesity. This suggests that polyphenols likely contributed to the lower incidence of the primary event in the MedDiet groups. In this article, we summarize the potential benefits of polyphenols found in the MedDiet, specifically the PREDIMED cohort. We also discuss the need for further research to confirm and expand the findings of the PREDIMED in a non-Mediterranean population and to determine the exact mechanisms of action of polyphenols

Radiographers supporting radiologists in the interpretation of screening mammography: a viable strategy to meet the shortage in the number of radiologists.

BackgroundAn alternative approach to the traditional model of radiologists interpreting screening mammography is necessary due to the shortage of radiologists to interpret screening mammograms in many countries.MethodsWe evaluated the performance of 15 Mexican radiographers, also known as radiologic technologists, in the interpretation of screening mammography after a 6 months training period in a screening setting. Fifteen radiographers received 6 months standardized training with radiologists in the interpretation of screening mammography using the Breast Imaging Reporting and Data System (BI-RADS) system. A challenging test set of 110 cases developed by the Breast Cancer Surveillance Consortium was used to evaluate their performance. We estimated sensitivity, specificity, false positive rates, likelihood ratio of a positive test (LR+) and the area under the subject-specific Receiver Operating Characteristic (ROC) curve (AUC) for diagnostic accuracy. A mathematical model simulating the consequences in costs and performance of two hypothetical scenarios compared to the status quo in which a radiologist reads all screening mammograms was also performed.ResultsRadiographer's sensitivity was comparable to the sensitivity scores achieved by U.S. radiologists who took the test but their false-positive rate was higher. Median sensitivity was 73.3 % (Interquartile range, IQR: 46.7-86.7 %) and the median false positive rate was 49.5 % (IQR: 34.7-57.9 %). The median LR+ was 1.4 (IQR: 1.3-1.7 %) and the median AUC was 0.6 (IQR: 0.6-0.7). A scenario in which a radiographer reads all mammograms first, and a radiologist reads only those that were difficult for the radiographer, was more cost-effective than a scenario in which either the radiographer or radiologist reads all mammograms.ConclusionsGiven the comparable sensitivity achieved by Mexican radiographers and U.S. radiologists on a test set, screening mammography interpretation by radiographers appears to be a possible adjunct to radiologists in countries with shortages of radiologists. Further studies are required to assess the effectiveness of different training programs in order to obtain acceptable screening accuracy, as well as the best approaches for the use of non-physician readers to interpret screening mammography

Heterogeneity in Health Insurance Coverage Among US Latino Adults

We sought to determine the differences in observed and unobserved factors affecting rates of health insurance coverage between US Latino adults and US Latino adults of Mexican ancestry. Our hypothesis was that Latinos of Mexican ancestry have worse health insurance coverage than their non-Mexican Latino counterparts. The National Health Interview Survey (NHIS) database from 1999–2007 consists of 33,847 Latinos. We compared Latinos of Mexican ancestry to non-Mexican Latinos in the initial descriptive analysis of health insurance coverage. Disparities in health insurance coverage across Latino categories were later analyzed in a multivariable logistic regression framework, which adjusts for confounding variables. The Blinder-Oaxaca technique was applied to parse out differences in health insurance coverage into observed and unobserved components. US Latinos of Mexican ancestry consistently had lower rates of health insurance coverage than did US non-Mexican Latinos. Approximately 65% of these disparities can be attributed to differences in observed characteristics of the Mexican ancestry population in the US (e.g., age, sex, income, employment status, education, citizenship, language and health condition). The remaining disparities may be attributed to unobserved heterogeneity that may include unobserved employment-related information (e.g., type of employment and firm size) and behavioral and idiosyncratic factors (e.g., risk aversion and cultural differences). This study confirmed that Latinos of Mexican ancestry were less likely to have health insurance than were non-Mexican Latinos. Moreover, while differences in observed socioeconomic and demographic factors accounted for most of these disparities, the share of unobserved heterogeneity accounted for 35% of these differences

Monitoring Procalcitonin in Febrile Neutropenia: What Is Its Utility for Initial Diagnosis of Infection and Reassessment in Persistent Fever?

Background: Management of febrile neutropenic episodes (FE) is challenged by lacking microbiological and clinical documentation of infection. We aimed at evaluating the utility of monitoring blood procalcitonin (PCT) in FE for initial diagnosis of infection and reassessment in persistent fever.Methods: PCT kinetics was prospectively monitored in 194 consecutive FE (1771 blood samples): 65 microbiologically documented infections (MDI, 33.5%; 49 due to non-coagulase-negative staphylococci, non-CNS), 68 clinically documented infections (CDI, 35%; 39 deep-seated), and 61 fever of unexplained origin (FUO, 31.5%).Results: At fever onset median PCT was 190 pg/mL (range 30-26'800), without significant difference among MDI, CDI and FUO. PCT peak occurred on day 2 after onset of fever: non-CNS-MDI/deep-seated-CDI (656, 80-86350) vs. FUO (205, 33-771; p<0.001). PCT >500 pg/mL distinguished non-CNS-MDI/deep-seated-CDI from FUO with 56% sensitivity and 90% specificity. PCT was >500 pg/ml in only 10% of FUO (688, 570-771). A PCT peak >500 pg/mL (1196, 524-11950) occurred beyond 3 days of persistent fever in 17/21 (81%) invasive fungal diseases (IFD). This late PCT peak identified IFD with 81% sensitivity and 57% specificity and preceded diagnosis according to EORTC-MSG criteria in 41% of cases. In IFD responding to therapy, median days to PCT <500 pg/mL and defervescence were 5 (1-23) vs. 10 (3-22; p = 0.026), respectively.Conclusion: While procalcitonin is not useful for diagnosis of infection at onset of neutropenic fever, it may help to distinguish a minority of potentially severe infections among FUOs on day 2 after onset of fever. In persistent fever monitoring procalcitonin contributes to early diagnosis and follow-up of invasive mycose

Psychometric characteristics of the Spanish version of instruments to measure neck pain disability

Background: The NDI, COM and NPQ are evaluation instruments for disability due to NP. There was no Spanish version of NDI or COM for which psychometric characteristics were known. The objectives of this study were to translate and culturally adapt the Spanish version of the Neck Disability Index Questionnaire (NDI), and the Core Outcome Measure (COM), to validate its use in Spanish speaking patients with non-specific neck pain (NP), and to compare their psychometric characteristics with those of the Spanish version of the Northwick Pain Questionnaire (NPQ). Methods: Translation/re-translation of the English versions of the NDI and the COM was done blindly and independently by a multidisciplinary team. The study was done in 9 primary care Centers and 12 specialty services from 9 regions in Spain, with 221 acute, subacute and chronic patients who visited their physician for NP: 54 in the pilot phase and 167 in the validation phase. Neck pain (VAS), referred pain (VAS), disability (NDI, COM and NPQ), catastrophizing (CSQ) and quality of life (SF-12) were measured on their first visit and 14 days later. Patients' self-assessment was used as the external criterion for pain and disability. In the pilot phase, patients' understanding of each item in the NDI and COM was assessed, and on day 1 test-retest reliability was estimated by giving a second NDI and COM in which the name of the questionnaires and the order of the items had been changed. Results: Comprehensibility of NDI and COM were good. Minutes needed to fill out the questionnaires [median, (P25, P75)]: NDI. 4 (2.2, 10.0), COM: 2.1 (1.0, 4.9). Reliability: [ICC, (95%CI)]: NDI: 0.88 (0.80, 0.93). COM: 0.85 (0.75,0.91). Sensitivity to change: Effect size for patients having worsened, not changed and improved between days 1 and 15, according to the external criterion for disability: NDI: -0.24, 0.15, 0.66; NPQ: -0.14, 0.06, 0.67; COM: 0.05, 0.19, 0.92. Validity: Results of NDI, NPQ and COM were consistent with the external criterion for disability, whereas only those from NDI were consistent with the one for pain. Correlations with VAS, CSQ and SF-12 were similar for NDI and NPQ (absolute values between 0.36 and 0.50 on day 1, between 0.38 and 0.70 on day 15), and slightly lower for COM (between 0.36 and 0.48 on day 1, and between 0.33 and 0.61 on day 15). Correlation between NDI and NPQ: r = 0.84 on day 1, r = 0.91 on day 15. Correlation between COM and NPQ: r = 0.63 on day 1, r = 0.71 on day 15. Conclusion: Although most psychometric characteristics of NDI, NPQ and COM are similar, those from the latter one are worse and its use may lead to patients' evolution seeming more positive than it actually is. NDI seems to be the best instrument for measuring NP-related disability, since its results are the most consistent with patient's assessment of their own clinical status and evolution. It takes two more minutes to answer the NDI than to answer the COM, but it can be reliably filled out by the patient without assistance