Drivers of fish choice: an exploratory analysis in Mediterranean countries.

Fish is an important source of healthy proteins and an important economic sector in Mediterranean countries. Despite the wealth of knowledge acquired in Western countries, a gap has been found in studies in developing countries, as in the Mediterranean southern shore. Therefore, we aimed to investigate consumers' perceptions of finfish attributes, with qualitative tools as focus groups, given the exploratory nature of the research. The focus groups have been held in Italy, Lebanon, Spain, and Tunisia; in each country, one was held in seaside areas and one in inland areas, in order to control for the availability of fish that shapes consumers' evaluations and expectations. The focus groups have been analysed through content and semantic analyses. Results of the study yielded main themes recurring in the discussions that have been categorized along such dimensions: (1) definition of fish products; (2) context; (3) search attributes; (4) experience attributes; and (5) credence attributes. Among attributes, the ones mostly guiding consumers' choices seem to be freshness and fish species, which are used as proxies for quality and sensory attributes. Most of the respondents preferred delicate white fish, while some exceptions were found in Tunisian respondents preferring blue fish and they also were the only ones who were not looking for convenient and already cleaned products. Trust also represented a critical element in guiding the decisions of consumers: with a lack of trust, consumers deviate from preferring local products, as noticeable especially in Lebanese respondents' opinions. Credence attributes such as animal welfare and sustainability received a minor attention from all the respondents.

Polenta-based snack development: from maize flour to final product by assessing structural, mechanical and sensory properties.

The aim of this paper was to study, step by step, the effect of ingredients and storage conditions on several properties of both the maize-based dough and the final product, during the new polenta-based snack food developing. Two different maize flours were characterized through water activity determination, particle size analysis, scanning electronic microscopy; then, dough made with different ratio of these were evaluated for mechanical properties and microstructure. According to the preliminary physicochemical characterization of both flour and dough, the final formulation was chosen for the polenta-based snacks. Thus, mechanical and sensory analyses, as well as microstructure determination, were performed on the final product. Results showed that the two maize flours presented different particle size distribution and gelatinization enthalpy, and affected the mechanical properties of intermediate products. The storage conditions dramatically affected the characteristics of the final products. Sensory results demonstrated that breading improves the crispness of external part but keeping creamy the product inside. The chosen approach was useful for understanding that flour particle size and storage are the critical factors that should be considered for this type of snack. The best formulation was made by mixing coarse and fine maize flours and by adding a batter.

Parathyroid hormone response to severe vitamin D deficiency is sex associated: an observational study of 571 hip fracture inpatients.

OBJECTIVES: To investigate the association between sex and parathyroid hormone response to severe vitamin D deficiency after hip fracture. DESIGN: Cross-sectional study. SETTING: Rehabilitation hospital in Italy. PARTICIPANTS: 571 consecutive inpatients with hip fracture and severe vitamin D deficiency (serum 25-hydroxyvitamin D < 12ng/ml), without hypercalcemia or estimated glomerular filtration rate (GFR) < 15ml/min. MEASUREMENTS: In each patient we assessed PTH (by two-site chemiluminescent enzyme-labelled immunometric assay), 25-hydroxyvitamin D (by immunoenzymatic assay), albumin-adjusted total calcium, phosphate, magnesium, and creatinine 21.3 ± 6.1 (mean ± SD) days after fracture occurrence. Functional level was assessed using the Barthel index. PTH response to vitamin D deficiency was classified as either secondary hyperparathyroidism (serum PTH >75pg/ml) or functional hypoparathyroidism, i.e., inappropriate normal levels of PTH (≤75pg/ml). RESULTS: Among the 571 patients, 336 (59%) had functional hypoparathyroidism, whereas 235 (41%) had secondary hyperparathyroidism. PTH status was significantly different between sexes (p=0.003): we found functional hypoparathyroidism in 61% of women and 43% of men (secondary hyperparathyroidism in 39% of women and 57% of men). The significance of the between-sex difference was maintained after adjustment for age, estimated GFR, phosphate, albumin-adjusted total calcium, albumin, Barthel index scores, 25-hydroxyvitamin D, and hip fracture type (either cervical or trochanteric). The adjusted odds ratio was 1.85 (95%CI from 1.09 to 3.13; p=0.023). CONCLUSIONS: Data shows that PTH response to vitamin D deficiency was sex-associated following a fracture of the hip. The higher prevalence of secondary hyperparathyroidism may play a role in the known prognostic disadvantage found in hip-fracture men.

Shelf life prediction of fresh Italian pork sausage modified atmosphere packed.

The shelf life of fresh Italian pork sausages packed in modified atmosphere was studied. Samples were packed using different levels of oxygen (high and low) with different levels of carbon dioxide (high-low) in the atmospheres headspace and were stored at 4 °C for 9 days. Microbial, physiochemical and sensory parameters were analyzed during storage. A consumer test was performed to determine the critical acceptability levels. Sensory data were mathematically modelled to estimate product shelf life. A first-order kinetic model and a Weibull-type model aptly described, respectively, the changes in fresh pork sausage odor and color over storage time. These models may be used to predict the sensory shelf life of fresh pork sausage. Results showed that 20% O(2) and 70% CO(2) extend fresh pork sausage shelf life to 9 days at 4 °C. The microbial quality of the samples at the critical sensory level of acceptability was within the range of microbial acceptability.

Hip-fracture type does not affect the functional outcome after acute in-patient rehabilitation: a study of 684 elderly women.

AIM: To investigate differences in the functional outcome between women sustaining cervical or trochanteric fractures of the hip. METHODS: We studied 684 of 736 women admitted consecutively to a rehabilitation hospital in Italy because of their first hip fracture. Functional recovery was assessed by using Barthel index scores. Fractures were classified as either cervical (n=335) or trochanteric (n=349) on the basis of surgical and radiographic findings. RESULTS: After acute in-patient rehabilitation, women with trochanteric fracture had a significantly lower Barthel index score than women with cervical fracture (median values were 85 and 90 respectively, interquartile ranges were 25 and 30 respectively, P=0.001). Length of stay in the hospital was significantly longer in women with trochanteric fractures (median was 37 days vs 36 days; interquartile range was 10 days vs 8 days, P=0.018). However, the differences between the two groups were no longer significant after adjustment for eight variables that affect functional ability in the same population (i.e., age, pressure ulcers, cognitive impairment, neurologic impairment, infections during the length of stay, bone mineral density, body mass index, and Barthel index scores assessed before rehabilitation). Further-more, we found no significant differences in the change of Barthel index scores during rehabilitation and in Barthel index efficiency (change in the Barthel index score after rehabilitation divided by the length of stay in hospital) between the two groups of women. CONCLUSIONS: After adjustment for several confounders, we did not show significant differences in the functional outcome between women with cervical or trochanteric fracture of the hip.

Body composition and hip fracture type in elderly women.

Many observations support the view that there are significant differences between patients sustaining trochanteric fractures and those sustaining cervical fractures of the hip. Our aim was to evaluate the association between soft tissue composition (fat and lean compartments) and the type of hip fracture sustained. Of 120 consecutive women affected by their first hip fracture admitted to our rehabilitation hospital 102 were included in this cross-sectional study. Body composition was assessed by DXA. Body fat mass was lower in the women with trochanteric fracture than in those with cervical fracture (difference between groups: 2.86 kg; 95% CI 0.10-5.61 kg; p=0.042). The percentage of fat was 30.75+/-8.77 (mean+/-SD) versus 34.75+/-7.29 (difference between groups: 4.00; 95% CI 0.84-7.16; p=0.014). In contrast, no meaningful differences in body lean mass were shown between the two groups. Logistic multiple regression showed that fat mass was associated with the type of fracture independently of age, height, weight, time between fracture occurrence and DEXA assessment, comorbidity, number of drugs in use, lean mass and bone mineral content. The logistic regression results were similar when fat percentage was substituted for fat mass. The data show that fat but not lean body mass is associated with the type of hip fracture, contributing to the definition of the differences between patients sustaining cervical or trochanteric fractures. We stress the importance of distinguishing the two types of fracture when clinical or epidemiological studies related to body composition, including those regarding nutrition or physical exercise, are performed.

A Dc- phenotype encoded by an RHCE-D(5-7/8)-CE hybrid allele.

BACKGROUND AND OBJECTIVES: The Rh system is genetically controlled by the homologous RHD and RHCE genes that encode the RhD and RhCcEe polypeptides, respectively. Deletions, point mutations and rearrangements between both genes are responsible for the great polymorphism of this system. The aim of this work was to analyse the genetic basis of a Dc- phenotype. MATERIALS AND METHODS: DNA samples from the Dc- propositus and family members were obtained from peripheral blood. RHCE intron 4-exon 5 and RH exons 4, 5, 6 and 7 were analysed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Exon 9 was studied by PCR-sequence-specific primers (SSP). The RH locus was further analysed by using a PCR designed for a hybrid allele. RESULTS: No RHCE-specific fragments were found when analysing exons 5, 6 and 7 of the RH locus from the propositus' DNA, while exons 4 and 9 of both RH genes were present. CONCLUSIONS: The results obtained indicated that the Dc- phenotype is encoded by a novel RHCE-D(5-7/8)-CE hybrid allele.

Fat body mass, leptin and femur bone mineral density in hip-fractured women.

Fat body mass (FBM) is a strong predictor of both bone mineral density (BMD) and risk of hip fracture, but the mechanisms responsible are not completely understood. We addressed whether leptin is the link between FBM and BMD in hip-fractured women. Sixty-two of 74 women with hip fractures were evaluated. Serum leptin was measured by radioimmunoassay, 23.4+/-9.1 days (mean+/-SD) after fracture occurrence. BMD and body composition were assessed by dual-energy X-ray absorptiometry (DXA). As expected, a positive linear correlation was found between FBM and both leptin (r=0.782; p<0.001) and femur BMD measured at five sites (r value ranging from 0.293 to 0.498 depending on the site of the femur BMD assessment, p<0.05). A positive correlation between leptin and BMD measured at the intertrochanteric area (r=0.259; p<0.05) but not at the other four sites was shown. At linear multiple regression [dependent variable = femur BMD; independent variables = age, weight, height, body mass index, fracture type, term fracture-DXA, Barthel index score, FBM, lean body mass, serum PTH, serum 25(OH)vitamin D and leptin], FBM was positively associated with BMD measured at all the five sites. The association between leptin and BMD was inverse and it was significant at four of the five sites of the BMD assessment. In conclusion, in a sample of hip-fractured women, the positive association between FBM and femur BMD was not explained by serum leptin. On the contrary, after adjustment for FBM and other confounding variables, an inverse association between leptin and BMD was found.

Early detection of RhD status in pregnancies at risk of hemolytic disease of the newborn.

The aim of this work was to investigate the presence of the RHD gene in fetal cells obtained from amniotic fluid. We studied 65 samples of amniotic fluid, 11 from RhD-negative mothers sensitized with anti-D alloantibodies. The fetal origin of the DNA was confirmed with the analysis of 1 VNTR locus and 3 STR loci in DNA samples from amniotic fluid and maternal blood. The RHD genotyping was performed in non-contaminated samples (n=62) using a multiplex polymerase chain reaction strategy that yields three amplification products from RhD-positive phenotypes (intron 4 of both RHCE and RHD genes and exon 10 of the RHD gene) and I DNA fragment from RhD-negative phenotypes (intron 4 of the RHCE gene). We genotyped 54 RhD-positive fetuses (8 from RhD-negative sensitized mothers) and 8 RhD-negative fetuses (3 from RhD-negative sensitized mothers). The fetal DNA genotyping allows the diagnosis, from a single amniocentesis, of fetuses at real risk of hemolytic disease of the newborn. When the fetus is determined to be RhD-negative invasive procedures can be avoided.

Femur bone mineral density, age and fracture type in 300 hip-fractured women.

BACKGROUND AND AIMS: Several studies showed that cervical and trochanteric hip fractures were associated with different levels of bone mineral density (BMD). Our aim was to investigate the association between femur BMD and hip fracture type at different ages. METHODS: We studied 300 postmenopausal women affected by their first hip fracture. 17 women could not undergo BMD measurement and were excluded. The fractures of the remaining 283 women were classified as either cervical (N=129) or trochanteric (N=154). The BMD of the unfractured femur was assessed by DXA. RESULTS: The women with trochanteric fracture had significantly lower BMD than those with cervical fracture at four sites: total proximal femur (p<0.001), trochanter (p<0.001), intertrochanteric area (p<0.01), and Ward's triangle (p<0.05). Logistic multiple regression showed that the association between hip fracture type and BMD was independent of age, weight, height, time between fracture occurrence and DXA assessment, number of concomitant diseases and number of drugs administered when BMD was evaluated at total proximal femur (p<0.001), trochanter (p<0.001), and intertrochanteric area (p<0.01). Age stratification showed that BMD was actually lower in the group with trochanteric fracture in the women aged 69 years and younger, and in those aged 80 years and older, but not in the intermediate age group (70-79 years). CONCLUSIONS: Data confirm previous reports showing that the two types of hip fractures are associated with different levels of BMD. Moreover, we show that the role played by BMD as a determinant of the hip fracture type varies with age.

Erythrophagocytosis assay in patients with autoimmune hemolytic anemia.

The aim of this paper is to evaluate the erythrophagocytosis assay (EA) in patients with autoimmune hemolytic anemia (AIHA). Direct antiglobulin test (DAT), indirect antiglobulin test (IAT) and EA were performed in blood samples from 46 patients with presumed AIHA. The EA was carried out incubating patients' erythrocytes and peripheral blood monocytes. A total of 200 monocytes were analysed to determine the percentage of active phagocytic cells (% APC). In 9 of these patients the applied treatment was evaluated by DAT, IAT and EA. In 14 transfusion requirements, the compatibility tests and EA were performed. For EA, patients' monocytes were incubated with erythrocytes from previously selected units sensitized with patients' sera. The % of APC was 32.1 +/- 1.7 in 35 patients with positive DAT and 17.8 +/- 1.3 in 11 patients with negative DAT. This last value was significantly higher than that with negative controls (3.7 +/- 0.3)(p < or = 0.01). As regards the applied treatment, patients with a successful response (n = 6) showed a significant decrease in the initial % APC (31.8 +/- 1.6 to 15.3 +/- 2.4; p < or = 0.05) while DAT and IAT remained positive. In those patients who required blood transfusion the compatibility tests were positive with all the units to be transfused, whereas the % APC varied for each one. Blood units were selected according to the lower % APC.

[Rh system genotyping in amniotic fluid]. / Genotipificación del sistema RH en líquido amniótico.

The aim of this work was to determine the presence of the RHD gene in fetal cells obtained from amniotic fluid (AF). We studied 65 samples of AF, 11 from RhD- mothers sensitized with anti-D. The fetal origin of the DNA was confirmed with the analysis of 1 VNTR locus and 3 STR loci in DNA samples from AF and maternal blood. The RHD genotyping was performed in non contaminated samples (n = 62) using a multiplex PCR strategy that yields 3 amplification products from RhD+ phenotypes and 1 DNA fragment from RhD- phenotypes. We genotyped 54 RhD+ fetuses (8 from RhD- sensitized mothers) and 8 RhD- fetuses (3 from RhD- sensitized mothers). Fetal DNA genotyping allows the diagnosis, from a single amniocentesis, of fetuses at real risk of hemolytic disease of the newborn. When the fetus is determined to be RhD- all invasive procedures can be avoided.

Erythrophagocytosis assay in patients with autoimmune hemolytic anemia.

The aim of this paper is to evaluate the erythrophagocytosis assay (EA) in patients with autoimmune hemolytic anemia (AIHA). Direct antiglobulin test (DAT), indirect antiglobulin test (IAT) and EA were performed in blood samples from 46 patients with presumed AIHA. The EA was carried out incubating patients erythrocytes and peripheral blood monocytes. A total of 200 monocytes were analysed to determine the percentage of active phagocytic cells (

APC). In 9 of these patients the applied treatment was evaluated by DAT, IAT and EA. In 14 transfusion requirements, the compatibility tests and EA were performed. For EA, patients monocytes were incubated with erythrocytes from previously selected units sensitized with patients sera. The

of APC was 32.1 +/- 1.7 in 35 patients with positive DAT and 17.8 +/- 1.3 in 11 patients with negative DAT. This last value was significantly higher than that with negative controls (3.7 +/- 0.3)(p < or = 0.01). As regards the applied treatment, patients with a successful response (n = 6) showed a significant decrease in the initial

APC (31.8 +/- 1.6 to 15.3 +/- 2.4; p < or = 0.05) while DAT and IAT remained positive. In those patients who required blood transfusion the compatibility tests were positive with all the units to be transfused, whereas the

APC varied for each one. Blood units were selected according to the lower

APC.

Genotipificación del sistema RH en líquido amniótico. / [Rh system genotyping in amniotic fluid]

The aim of this work was to determine the presence of the RHD gene in fetal cells obtained from amniotic fluid (AF). We studied 65 samples of AF, 11 from RhD- mothers sensitized with anti-D. The fetal origin of the DNA was confirmed with the analysis of 1 VNTR locus and 3 STR loci in DNA samples from AF and maternal blood. The RHD genotyping was performed in non contaminated samples (n = 62) using a multiplex PCR strategy that yields 3 amplification products from RhD+ phenotypes and 1 DNA fragment from RhD- phenotypes. We genotyped 54 RhD+ fetuses (8 from RhD- sensitized mothers) and 8 RhD- fetuses (3 from RhD- sensitized mothers). Fetal DNA genotyping allows the diagnosis, from a single amniocentesis, of fetuses at real risk of hemolytic disease of the newborn. When the fetus is determined to be RhD- all invasive procedures can be avoided.

Molecular determination of RhD phenotype by DNA typing: clinical applications.

Rhesus D (RhD) typing is performed by agglutination methods; however, in clinical situations where these techniques cannot be performed, RhD DNA typing is an alternative approach. The Rh antigens are encoded by the RHD and RHCE genes. In RhD-negative individuals the RHD gene is absent or grossly deleted, but variations in the arrangement of the RH locus in different populations are emerging. The aim of this study was to analyse the gross organization of the RH genes in our population using a previously described multiplex polymerase chain reaction (PCR) method with some modifications. We studied 253 DNA samples from Argentinian blood donors, 15 samples with a reduced expression of the D antigen and 1 Dc- phenotype. We evaluated the clinical utility of this method to ascertain the RhD antigen in 10 patients with warm-type autoimmune haemolytic anaemia (AIHA) and 14 samples of amniotic fluids. All Rh phenotypes were properly characterized and no discrepancies with serological typing were found. Analyses performed in the Dc- phenotype suggest the presence of a hybrid RHCE-RHD gene. DNA typing confirmed the RhD-negative type of one AIHA sample in which serological tests were inconclusive. Foetal DNA typing correctly indicated the RhD in every foetus. VNTR (variable number of tandem repeats) and STR (short tandem repeats) analysis detected maternal contamination in two amniocentesis samples and confirmed the foetal origin of 12. This multiplex PCR strategy is suitable for RhD determination in clinical situations in which serological typing cannot be accomplished with its usual ease.

Handgrip strength is an independent predictor of distal radius bone mineral density in postmenopausal women.

Several cross-sectional studies have reported a positive correlation between muscle strength and local bone mineral density. However, very few studies have evaluated the possible role of confounding variables, which may be substantial as both bone mineral density and muscle strength are multifactorial variables. We studied 140 postmenopausal women who underwent their first osteodensitometry in our hospital. Of these, 102 women affected neither by bone diseases apart from primary osteoporosis nor treated with drugs affecting bone mass were selected. Distal radius bone mineral density of the non-dominant arm was assessed by dual photon absorptiometry. Handgrip strength was measured by a handheld dynamometer. The following factors influencing bone mass were also considered: age, years since menopause, years of cyclic ovarian activity, body weight, body height, body mass index, and both calcium and alcohol dietary intake. Statistical evaluation was performed by stepwise multiple regression analysis. This showed that only two variables were independently related to bone mineral density: handgrip strength (which was the best bone density predictor among the studied independent variables) and years since menopause. R2 value was 0.43 (F=38.04, p < 0.001). All the other variables studied were not significantly related to bone density when the effects of both strength and years since menopause were considered. In conclusion, the data showed that handgrip strength was a strong independent predictor of distal radius bone mineral density in postmenopausal women. Clinical assessment of osteoporosis risk factors, including muscle strength, is recommended: although it is not an adequate substitute for bone densitometry, it can help clinicians to identify the risk groups at which to direct bone density measurement.