[In memoriam. Juan Vicente Sanchez-Andres (1959-2023)]. / Juan Vicente Sánchez-Andrés (1959-2023).

TITLE: Juan Vicente Sánchez-Andrés (1959-2023).

Determination of volatile compounds and their sensory impact in a biopolymer based on polylactic acid (PLA) and polyester.

Polylactic acid (PLA) is one of the most commonly used biopolymers for manufacturing food packaging; its control is very important to ensure consumers' health. In this work, a blend of PLA and polyester was studied and its volatile composition in the polymer and in the migration to food simulants was determined by gas chromatography-mass spectrometry (GC-MS) and atmospheric pressure gas chromatography-quadrupole-time of flight mass spectrometry (APGC-QTOF). The results showed that both techniques provided complementary information, to give complete information on the biopolymer's composition. Some compounds such as lactide or cyclopentanone were detected only by GC-MS while others, such as the cyclic dimer [AA-BD]2 (AA:adipic acid, BD:butanediol), were detected only by APGC-MS. In migration, lactide, AA-BD and [AA-BD]2 were identified in ethanol 95%. A GC-olfactometry study was also carried out. Some compounds showed sensory impact on the polymer odor but not in migration.

Fabric phase sorptive extraction as a reliable tool for rapid screening and detection of freshness markers in oranges.

A simple, fast and sensitive analyte extraction method based on fabric phase sorptive extraction (FPSE) followed by gas chromatography-mass spectrometry (GC-MS) and ultra-performance liquid chromatography-quadrupole time of flight mass spectrometry (UPLC-QTOF-MS) analysis was developed for the analysis of 12 volatile compounds that represent most of the principal chemical families possessing different polarities and volatilities. Five FPSE media coated with different sol-gel sorbent chemistries having different polarities and selectivities were studied: long chain poly(dimethylsiloxane) (PDMS), short chain poly(tetrahydrofuran) (PTHF), Carbowax 20M (CW20M), short chain poly(dimethyl siloxane) (SC PDMS) and polyethylene glycol-polypropylene glycol-polyethylene glycol triblock copolymer (PEG-PPG-PEG). CW20M coated FPSE media was found to be the most efficient extraction media for the analytes of interest in the intended study. The developed methodology was applied to the analysis of orange juice obtained from fresh oranges and oranges after storing at 5°C for two months in order to identify the best chemical markers, both volatiles and non-volatiles, attributed to the freshness of orange. For this purpose, aliquots of the same juice extracts were analysed by GC-MS as well as by UPLC-QTOF-MS. Monoterpenes and terpenoids, such as terpinene, citronellal or estragole were among the volatile compounds that endured the biggest decrease after the extended storage period. Three non-volatile compounds including one amide (subaphyllin) and two flavanoids (tangeretin and nobiletin) also showed a clear decrease in signal intensity (>70%) after orange stored for two months.

[Is an effort needed in order to replace the punitive culture for the sake of patient safety?]. / ¿Se necesita un esfuerzo para reemplazar la cultura punitiva por la de seguridad del paciente?

Efforts to introduce a safety culture have flourished in a growing number of health care organisations. However, many of these organisational efforts have been incomplete with respect to the manner on how to address the resistance to change offered by the prevailing punitive culture of healthcare organisations. The present article is intended to increase the awareness on three reasons of why an effort is needed to change the punitive culture before introducing the patient safety culture. The first reason is that the culture needs to be investigated and understood. The second reason is that culture is a complex construct, deeply embedded in organisations and their contexts, and thus difficult to change. The third reason is that punitive culture is not compatible with some components of safety culture, thus without removing it there are great possibilities that it would continue to be active and dominant over safety culture. These reasons suggest that, unless planning and executing effective interventions towards replacing punitive culture with safety culture, there is the risk that punitive culture would still prevail.

Intradermal and virosomal influenza vaccines for preventing influenza hospitalization in the elderly during the 2011-2012 influenza season: a comparative effectiveness study using the Valencia health care information system.

BACKGROUND: The use of intradermal vaccination or virosomal vaccines could increase protection against influenza among the vulnerable population of older adults. Studies assessing the comparative effectiveness of these two influenza vaccine types in this age group are lacking. METHODS: We conducted a retrospective cohort study to estimate the comparative effectiveness of intradermal seasonal trivalent-influenza vaccine (TIV) delivered by a microneedle injection system and a virosomal-TIV intramuscularly delivered for prevention of influenza hospitalization in non-institutionalized adults aged ≥65 years. We obtained administrative data on immunization status and influenza hospitalization for the 2011-2012 influenza season, and used Cox regression models to assess comparative effectiveness. We estimated crude and adjusted (age, sex, comorbidity, pharmaceutical claims, recent pneumococcal vaccination and number of hospitalizations for all causes other than influenza between the previous and current influenza seasons) hazard ratios (HR). RESULTS: Overall, 164,021 vaccinated subjects were evaluated. There were 127 hospitalizations for influenza among 62,058 subjects, contributing 914,740 person-weeks at risk in the virosomal-TIV group, and 133 hospitalizations for influenza among 101,963 subjects, contributing 1,504,570 person-weeks at risk in the intradermal-TIV group. The crude HR of intradermal-TIV relative to virosomal-TIV was 0.64 (95% confidence interval (CI): 0.50-0.81), and the adjusted Cox estimated HR was 0.67 (95% CI: 0.52-0.85). CONCLUSIONS: During the 2011-2012 influenza season the risk of hospitalization for influenza was reduced by 33% in non-institutionalized elderly adults who were vaccinated with intradermal-TIV compared with virosomal-TIV.

MF59-adjuvanted and virosomal influenza vaccines for preventing influenza hospitalization in older people: comparative effectiveness using the Valencia health care information system.

BACKGROUND: Adjuvanted influenza vaccines offer greater and broader immunogenicity to older adults than conventional vaccines. Studies assessing the comparative effectiveness of adjuvanted influenza vaccines in this age group are lacking. METHODS: We conducted a retrospective cohort study to estimate the comparative effectiveness of MF59-adjuvanted trivalent influenza vaccine (TIV) and virosomal-TIV for prevention of influenza hospitalization in adults aged ≥65 years. We obtained administrative data on immunization status and influenza hospitalization for the 2010-2011 influenza season. We used Cox regression models to assess comparative effectiveness; crude and adjusted by age, sex, comorbidity, deprivation, type of insurance, and travel time to hospital. We accounted for data clustering at the hospital level by using a multilevel random effects model. RESULTS: Overall, 373,798 vaccinated subjects were evaluated. There were 40 hospitalizations for influenza among 176,618 subjects, contributing 4,288,109 person-weeks at risk in the virosomal-TIV group, and 37 hospitalizations for influenza among 197,180 subjects, contributing 4,786,360 person-weeks at risk in the MF59-TIV group. The crude hazard ratio (HR) was 0.83 (0.53-1.30), and the adjusted Cox estimated HR of MF59-TIV relative to virosomal-TIV was 0.86 (0.55-1.35). After accounting for data clustering, the HR of influenza hospitalization associated with MF59-TIV relative to virosomal-TIV was 0.94 (0.37-2.38). CONCLUSION: During the 2010-2011 influenza season, we found no differences in the risk of influenza hospitalization in subjects aged ≥65 years vaccinated with MF59-TIV compared with those vaccinated with virosomal-TIV.

Spanish version of the Bayer Activities of Daily Living scale in mild cognitive impairment and mild Alzheimer disease: discriminant and concurrent validity.

AIMS: To test the discriminant and concurrent validity of the Spanish version of the Bayer Activities of Daily Living scale (B-ADL) in mild cognitive impairment (MCI) and mild Alzheimer disease (AD). METHODS: The B-ADL scale, the Blessed Dementia Rating Scale (BDRS), and the Interview for Deterioration in Daily Living in Dementia (IDDD) were administered to 277 elderly Spanish patients (78 MCI and 199 AD). Correlations between scales were performed, and ROC curves were plotted. RESULTS: In MCI and mild AD discrimination, an area under the ROC curve of 0.84 was found; a cut-off point of 3.3 was proposed with values of 0.81 for sensitivity and 0.72 for specificity. The B-ADL correlated positively to both the BDRS (r = 0.7) and the IDDD (r = 0.8). CONCLUSION: The B-ADL is a valid and sensitive scale that can be used to discriminate mild AD from MCI.

[Spanish version of the Memory Impairment Screen (MIS): normative data and discriminant validity]. / Versión española del Memory Impairment Screen (MIS): datos normativos y de validez discriminativa.

OBJECTIVE: Present data on discriminative and normative validity for the Memory Impairment Screen (MIS) in a cross-sectional validation study within a dementia-clinic setting using a Spanish adaptation of the MIS. Assess its usefulness as a screening instrument for memory problems related to primary dementing disorders, foremost Alzheimer's Disease (AD). MATERIAL AND METHODS: 403 subjects, including 188 demented subjects according to DSM-IV criteria (119 of which presented AD according to NINCDS-ADRDA criteria) and 215 controls, over 50 years. The MIS, a four word memory test using a specific encoding technique and scoring on a 0-8 range, formed part of the neuropsychological workup, but it was not used for diagnosis. Sensitivity, specificity and predictive values positive (PPV) and negative (NPV) were calculated for the MIS against the gold-standard of clinical diagnosis by two blinded clinicians. ROC curves for the discrimination between demented subjects and controls, and AD subjects and controls were plotted. RESULTS: Control subjects were significantly younger and better educated than the demented samples (p<0.001). No sex differences could be established. ROC curves demonstrated excellent discriminative validity of the MIS 402 for dementia on a whole (0.944) and even better for AD (0.978). The MIS presents satisfying results regarding sensitivity and specificity as well as PPV for different base rates, but the most effective cut-off score lies at < or = 4 points. For all demented subjects this cut-off represents a sensitivity of 0.74 and specificity of 0.96; for AD results are 0.86 and 0.96. More importantly, PPV values are above 0.65 for assumed base rates of 10% and more. Negative predictive values are almost 1 for all assumed base rates. CONCLUSION: The Spanish version of the MIS reliably differentiates between normal and demented subjects. Nevertheless one has to consider the setting of the study when interpreting the results. The use of the S-MIS seems to be justified as first level dementia screening tool.

Versión española del Memory Impairment Screen (MIS): datos normativos y de validez discriminativa / Spanish version of the Memory Impairment Screen (MIS): normative data

Objetivo. Presentar datos normativos y de validez discriminativa de la versión española del Memory Impairment Screen (MIS) en un estudio transversal en el ámbito de una consulta especializada, y valorar su utilidad como instrumento de cribado para trastornos de memoria relacionados con la demencia, sobre todo la enfermedad de Alzheimer (EA).Material y métodos. Cuatrocientos tres sujetos, incluyendo 188 pacientes con demencia según criterios DSM-IV (119 con EA según criterios NINCDS-ADRDA) y 215 controles, mayores de 50 años. Se administró el MIS, un test de memoria de cuatro palabras que utiliza técnicas específicas de codificación y se puntúa en un rango de O a 8 como parte de la exploración neuropsicológica, pero no se usó para el diagnóstico. Se calcularon valores de sensibilidad, especificidad y valores predictivos positivo (VPP) y negativo (VPN) para el MIS en comparación con el diagnóstico clínico de dos clínicos ciegos a la prueba. También se obtuvieron las curvas ROC para evaluar la capacidad de discriminación entre dementes y controles y con EA y controles.Resultados. Los pacientes con demencia fueron significativamente mayores de edad y con inferior escolaridad que los controles (p < 0,001). No había diferencias significativas por sexo. Las curvas ROC demostraron datos discriminativos excelentes para la demencia (0,944) y aún mejores para la EA (0,978). El MIS presenta resultados satisfactorios en cuanto a la sensibilidad, especificidad y los VPP para diferentes prevalencias basa les, pero el punto de corte más efectivo se sitúa en :S; 4 puntos. En este punto de corte y para los pacientes con demencia en general la sensibilidad es de 0,74 y la especificidad es de 0,96; para la EA los resultados son de 0,86 y 0,96, respectivamente. Más importante aún, los VPP son mayores del 65% para todas las prevalencias a partir del 10%, mientras que los VPN rozan el 100% en casi todas las prevalencias asumidas.Conclusión. La versión española del MIS diferencia de forma válida entre controles y pacientes con demencia, con mejores resultados para la EA. No obstante, hay que tener en cuenta los posibles sesgos de la población del estudio al interpretar los datos normativos. Se recomienda el uso del MIS como herramienta de cribado de primer nivel para la demencia

Objective. Present data on discriminative and normative validity for the Memory Impairment Screen (MIS) in a cross-sectional validation study within a dementia-clinic setting using a Spanish adaptation of the MIS. Assess its usefulness as a screening instrument for memory problems related to primary dementing disorders, foremost Alzheimer's Disease (AD).Material and methods. 403 subjects, including 188 demented subjects according to DSM-N criteria (119 of which presented AD according to NINCDS-ADRDA criteria) and 215 controls, over 50 years. The MIS, a four word memory test using a specific encoding technique and scoring on a 0-8 range, formed part of the neuropsychological workup, but it was not used for diagnosis. Sensitivity, specificity and predictive values positive (PPV) and negative (NPV) were calculated for the MIS against the gold-standard of clinical diagnosis by two blinded clinicians. ROC curves for the discrimination between demented subjects and controls, and AD subjects and controls were plotted.Results. Control subjects were significantly younger and better educated than the demented samples (p<0.00l). No sex differences could be established. ROC curves demonstrated excellent discriminative validity of the MIS for dementia on a whole (0.944) and even better for AD (0.978). The MIS presents satisfying results regarding sensitivity and specificity as well as PPV for different base rates, but the most effective cut-off score lies at <=4 points. For all demented subjects this cut-off represents a sensitivity of 0.74 and specificity of 0.96; for AD results are 0.86 and 0.96. More importantly, PPV values are above 0.65 for assumed base rates of 10% and more. Negative predictive values are almost 1 for all assumed base rates. Conclusion. The Spanish version of the MIS reliably differentiates between normal and demented subjects. Nevertheless one has to consider the setting of the study when interpreting the results. The use of the S-MIS seems to be justified as first level dementia screening tool

Estudios piloto de los tests neuropsicológicos: al césar lo que es del césar / Pilot study of the neuropsychological test: render therefore unto caesar the things which are caesar’s

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[Preliminary normative data for the second edition of the Boston Naming Test for young Spanish adults]. / Estudio normativo piloto de la segunda edición del Boston Naming Test en una muestra española de adultos jóvenes (20 a 49 años).

INTRODUCTION: The Boston Naming Test (BNT) is one of the most widely used tests in neuropsychological evaluation of language disorders, specifically when testing for anomia. The aim of this study is to establish preliminary normative data for the second edition of the BNT for young spanish adults (age range between 20 and 49 years). METHODS: A total of 160 subjects (60 % female and 40 % male) were administered the BNT. Mean age was 33.89 years (SD: 9.45) and average number of years of education was 13.98 (SD: 3.97). The version used in the present study is the second edition of the BNT (Kaplan et al., 2001) which includes two new components: multiple choice and error typology. STATISTICAL ANALYSIS: Descriptive statistics of the test's variables. Lineal regression to establish the possible degree of influence of the variables age and education on test performance. RESULTS: The sample's mean score was 51.84. Education significantly influences the final score (B: 0.476; p= 0.001). Multiple choice was effective in 89 % of cases. DISCUSSION: The present results will allow proper clinical interpretation of results in the BNT 2001 version in young Spanish adults.