•Epicatechin concentration could predict the total flavanols and procyanidin content.•No correlation was found between catechin content and the rest of flavanols.•% Cocoa solids is no clear indicator ...of (−)-epicatechin, the most bioactive compound.
Assessment of the flavanol composition of 41 commercial chocolates was by HPLC-DAD. Among individual flavonols ranged from 0.095 to 3.264mgg−1, epicatechin was the predominant flavanol accounting for 32.9%. Contrary to catechin, epicatechin was a reliable predictive value of the polyphenol content. Conversely the percentage of theobromine used as a proxy measure for nonfat cocoa solids (NFCS) was not a good predictor of epicatechin or flavanol content. In a further chiral analysis, the naturally occurring forms of cocoa flavanols, (−)-epicatechin and (+)-catechin, was determined joint the occurrence of (+)-epicatechin and (−)-catechin due to the epimerization reactions produced in chocolate manufacture. (−)-Epicatechin, the most bioactive compound and predominant form accounted of 93%. However, no positive correlation was found with% cocoa solids, the most significant quality parameter.
Myelofibrosis (MF) occurs as part of the natural history of polycythemia vera (PV) and essential thrombocythemia (ET), and remarkably shortens survival. Although JAK2V617F and CALR allele burden are ...the main transformation risk factors, inflammation plays a critical role by driving clonal expansion toward end-stage disease. NF-κB is a key mediator of inflammation-induced carcinogenesis. Here, we explored the involvement of miR-146a, a brake in NF-κB signaling, in MPN susceptibility and progression. rs2910164 and rs2431697, that affect miR-146a expression, were analyzed in 967 MPN (320 PV/333 ET/314 MF) patients and 600 controls. We found that rs2431697 TT genotype was associated with MF, particularly with post-PV/ET MF (HR = 1.5; p < 0.05). Among 232 PV/ET patients (follow-up time=8.5 years), 18 (7.8%) progressed to MF, being MF-free-survival shorter for rs2431697 TT than CC + CT patients (p = 0.01). Multivariate analysis identified TT genotype as independent predictor of MF progression. In addition, TT (vs. CC + CT) patients showed increased plasma inflammatory cytokines. Finally, miR-146a
mice showed significantly higher Stat3 activity with aging, parallel to the development of the MF-like phenotype. In conclusion, we demonstrated that rs2431697 TT genotype is an early predictor of MF progression independent of the JAK2V617F allele burden. Low levels of miR-146a contribute to the MF phenotype by increasing Stat3 signaling.
The peels obtained as a byproduct from the processing of fruits (prickly pears) of the Cactaceae family are a rich source of mucilage, a hydrocolloid biopolymer that may have potential application in ...water/wastewater treatment as a natural coagulant. In this study, the structural (UPLC-QTOF-MS, FTIR, Raman, NMR, XRD, and zeta potential), morphological (SEM), and thermal (DSC/TGA) characterizations of the mucilage extracted from the peels of Opuntia ficus-indica (OFI) fruits were carried out. UPLC-QTOF-MS results revealed the presence of a branched polymer with an average molecular weight of 0.44 KDa for this mucilage in aqua media. The NMR spectra of mucilage in DMSO-d6 indicated that it seemed well-suited as a coagulant with its typical oligosaccharide structure. FTIR studies confirmed the presence of hydroxyl and carboxyl functional groups in the mucilage, indicating its polyelectrolyte nature that could provide coagulating properties through binding and adsorption mechanisms. Likewise, the zeta potential of −23.63 ± 0.55 mV showed an anionic nature of the mucilage. Power XRD technique evidenced the presence of crystalline poly(glycine-β-alanine), glutamic acid, and syn-whewellite. SEM images revealed an irregular and amorphous morphology with cracks, which are suitable characteristics for adsorption mechanisms. The mucilage exhibited two endothermic transitions, with a decomposition temperature in uronic acid of 423.10 °C. These findings revealed that mucilage obtained from OFI fruit peels has molecular and physicochemical characteristics that are suited to its possible application as a natural coagulant in water/wastewater treatments.
Background
Rapid gastric emptying (RGE) is defined as less than 30% retention at 1 h of solid meal ingestion. It is unclear whether RGE represents a separated clinical entity or part of the ...functional dyspepsia spectrum.
Aims
To determine clinical predictors of RGE in patients presenting with dyspeptic symptoms.
Methods
Retrospective study of patients who underwent solid Gastric Emptying Scintigraphy to evaluate dyspeptic symptoms from January 2011 to September 2012. Patients with delayed gastric emptying (> 10% gastric retention at 4 h) or prior gastric surgery were excluded. Patients with RGE were compared to those with normal gastric emptying (NGE) in a patient ratio of 1:3. Demographic data, symptoms, comorbidities, surgeries, endoscopy findings, medications, HbA1c, and TSH were analyzed. Univariate and multivariate logistic regression analyses were performed.
Results
A total of 808 patients were included, 202 patients with RGE and 606 patients with NGE. Mean gastric retention at 1 h was 18% 12.0, 24.0 and 65% 52.0, 76.0, respectively. Patient with RGE were more likely to present with nausea/vomiting (OR 2.4,
p
< 0.001), weight loss (OR 1.7,
p
= 0.008), and autonomic symptoms (OR 2.8,
p
= 0.022). Identified clinical predictors of RGE were older age (OR 1.08 1.01, 1.1,
p
= 0.018), male gender (OR 2.0 1.4, 2.9,
p
≤ <0.001), higher BMI (OR 1.03 1.00, 1.05,
p
= 0.018), diabetes (OR 1.8 1.2, 2.7,
p
= 0.05), and fundoplication (OR 4.3 2.4, 7.7,
p
≤ 0.001).
Conclusion
RGE represents a distinct population among patients presenting with dyspepsia in whom fundoplication, diabetes, and male gender were the strongest clinical predictors. RGE was significantly associated with nausea/vomiting, weight loss, and autonomic symptoms.
Autoimmune gastritis is characterized by atrophy of acid secreting parietal cells resulting in achlorhydria. Upper gastrointestinal symptoms are common in autoimmune gastritis and frequently result ...in prescriptions for acid suppressant medications despite the inability of the stomach to secrete acid. Evidence-based recommendations for management of gastrointestinal symptoms in autoimmune gastritis are lacking.
The most common symptoms in patients with autoimmune gastritis are dyspepsia, heartburn, and regurgitation. Gastroesophageal reflux should be confirmed by pH-impedance testing and is typically weakly acid or alkaline. Therapy for reflux focuses on mechanical prevention of reflux (i.e., elevation of the head of the bed and alginates) or when severe, antireflux surgery. The etiology of dyspepsia in autoimmune gastritis is unclear and largely unstudied. In the first half of the 20th century, oral administration of acid to "aid digestion" was widely used with reported success. However, randomized, placebo-controlled trials are lacking. Here, we provide suggestions for attempting gastric acidification therapy.
Upper GI symptoms are common in autoimmune gastritis. Their pathogenesis and therapy remain incompletely understood. Acid suppressant medications are useless and should be discontinued. A trial of acid replacement therapy is recommended especially in the form of placebo-controlled trials.
The use of simulation in medical education has been widely accepted. There are different types of medical simulators that vary in both accuracy to emulate the real world (fidelity) and cost of ...development or acquisition. There is significant evidence that supports the use of high-fidelity simulators (i.e. mannequins or dummies) to prepare students for clinical environments, less attention has been given to low-fidelity simulators. This article aims to present evidence regarding the effectiveness of a low-fidelity simulator: Virtual Patient (VP), which develops several interactive computer-based clinical scenarios, seeking to promote an alternative learning environment and the development of necessary medical skills such as clinical reasoning in students of medicine.
A quasi-experimental study was designed to investigate the results on the development of history taking and clinical reasoning skills in a group of undergraduate medical students, in a course devised under the concepts of constructivism in education, which used the Virtual Patient as the fundamental teaching tool. Results were measured through a mixed, quantitative and qualitative study, triangulating the results of the students' skills evaluation when facing a clinical case represented by an actor patient before and after the course. Additionally, the description of the students' and tool's performance was measured by way of a qualitative study.
The comparison of the students' skills on the evaluation matrix before-and-after the course evidenced a statistically significant advance (p < 0.01) in all aspects (interview, physical exam, clinical judgment, relevance of medical exams, and presentation of case). Students described the VP as an easy-to-use and motivating tool for learning without stress, especially at the beginning of their career. VP allowed them to create logical and structured processes, to be wrong without consequences, and to review and reassess information available. From the professor perspective, it allowed a better follow-up of the students' learning process and favored reflections on the teaching-learning process.
VP proved to be a valuable and useful tool for the development of clinical reasoning and history taking skills in medical students, as part of a constructivist learning course.
The degradation and replacement of natural ecosystems affect species abundance, diversity and interspecific interaction through the modification of resource availability and environmental conditions. ...Land uses preserving the forest canopy show higher species richness and similarity to the native forest.
In this study, we explored changes in the trophic niche overlap of dung beetles between the native forest and different land uses in the semideciduous Atlantic forest, under the hypothesis that trophic niche overlap increases with species richness.
We sampled dung beetles in protected native forests and four land uses (pine plantations, agroforestry parklands, silvo‐pastoral systems and open pastures), using seven potential food sources (monkey, feline, tapir and deer dung, decomposing fruit, decomposing fungi and carrion). The species richness of each habitat, the trophic niche overlap and the relation between both measures were analysed. Also, we explored species trophic preferences in each habitat to explain and discuss the results obtained in trophic niche overlap measures.
As expected, our results showed a positive relation between species richness and trophic niche overlap. Moreover, the addition of different resources in open habitats did not increase species richness, suggesting that resource availability may not be the main mechanism explaining the empoverished dung beetle community observed in open habitats. Other mechanisms, such as physiological restrictions, may play a role in limiting the use of these habitats. Studies on the mechanisms leading to the patterns of species abundance and diversity observed in land uses are necessary to propose management recommendations that increase the sustainability of open habitats.
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