Fermented foods: a perspective on their role in delivering biotics

Fermented foods are often erroneously equated with probiotics. Although they might act as delivery vehicles for probiotics, or other 'biotic' substances, including prebiotics, synbiotics, and postbiotics, stringent criteria must be met for a fermented food to be considered a 'biotic'. Those criteria include documented health benefit, sufficient product characterization (for probiotics to the strain level) and testing. Similar to other functional ingredients, the health benefits must go beyond that of the product's nutritional components and food matrix. Therefore, the 'fermented food' and 'probiotic' terms may not be used interchangeably. This concept would apply to the other biotics as well. In this context, the capacity of fermented foods to deliver one, several, or all biotics defined so far will depend on the microbiological and chemical level of characterization, the reproducibility of the technological process used to produce the fermented foods, the evidence for health benefits conferred by the biotics, as well as the type and amount of testing carried out to show the probiotic, prebiotic, synbiotic, and postbiotic capacity of that fermented food.

Ultrasonographic scores for ileal Crohn's disease assessment: Better, worse or the same as contrast-enhanced ultrasound?

BACKGROUND

Intestinal ultrasound (IUS) is an increasingly used non-invasive tool to evaluate Crohn's disease (CD) activity. Recently, two IUS scores that evaluate inflammatory activity have emerged: the Simple Ultrasound Activity Score for CD (SUS-CD) and the International Bowel Ultrasound Segmental Activity Score (IBUS-SAS). We aimed to compare the accuracy of SUS-CD, IBUS-SAS and contrast-enhanced ultrasound (CEUS) in predicting inflammatory activity in the terminal ileum in ileocolonoscopy in CD patients.

METHODS

Retrospective study including all consecutive CD patients submitted to IUS with CEUS directed to the terminal ileum performed by a single operator between April 2016 and March 2020. Segmental SUS-CD and IBUS-SAS were calculated. A time-intensity curve of the contrast bowel wall enhancement was created with measurement of peak intensity using CEUS. The CD endoscopic activity in ileocolonoscopy was graded by Simple Endoscopic Score for CD (SES-CD) as inactive (SES-CD < 7) or active (SES-CD ≥ 7).

RESULTS

Fifty patients were included, 54.0% were female, with mean age of 34 ± 12 years, and most had isolated ileal disease (60.0%), and a nonstricturing, nonpenetrating behaviour (44.0%). Most of the patients (60.0%) had active endoscopic disease (SES-CD ≥ 7). SUS-CD and IBUS-SAS were not different between patients with active or inactive endoscopic disease (p = 0.15; 0.57, respectively), having a poor accuracy to correlate endoscopic activity (area under de curve (AUC) 0.62; 0.55, respectively). Peak intensity in CEUS was significantly different in patients with active or inactive endoscopic disease (p = 0.004), having a good accuracy to correlate endoscopic activity (AUC 0.80).

CONCLUSION

Unlike CEUS, SUS-CD and IBUS-SAS were not able to accurately correlate endoscopic activity in terminal ileum in CD. Therefore, CEUS is a non-invasive emerging method that should be increasingly integrated in the ultrasonographic evaluation of CD patients.

Total Shoulder Reverse Arthroplasty in Alkaptonuria: An Effective Option to Treat a Complication of a Rare Disease

Introduction

Alkaptonuria (AKU) is a rare autosomal recessive disorder in which tyrosine metabolism is altered. There is a deficiency of the Homogentisate 1,2-dioxygenase enzyme (homogentisic acid oxidase) This enzyme is responsible for the metabolism of the tyrosine - homogentisic acid - in maleylacetoacetic acid. Accumulation of homogenous acid occurs in urine and conjunctival tissue in the second with important deleterious effects on cartilage and bone. The most limiting complication is progressive degenerative arthropathy, especially in the axial and load load-bearing joints, with a lower tendency to affect the shoulder. Because of its rarity little is known about the results of arthroplasties in these patients.

Case Report

A 60 -years -old man, retired, with a history of right knee arthroplasty 6 years ago (performed in another hospital). Sent to the orthopedic consultation due to intense shoulder pain. The case was revealed to be a rare disease: arthropathy due AKU. He was treated with total shoulder reverse arthroplasty. Currently with two 2 years of follow-up, with excellent functional results.

Conclusion

The most commonly performed procedure, in this patients, is the hip prosthesis and there are few reported cases of shoulder arthroplasty. However, the results of our follow follow-up are good and encouraging.

Distinct Profiles of Relationships With Mothers, Fathers, and Best Friends and Social-Behavioral Functioning in Early Adolescence: A Cross-Cultural Study

Adolescents’ dyadic relationships are likely influenced by the cultural context within which they exist. This study applied a person‐oriented approach to examine how perceived support and negativity were manifested across youths’ relationships with mothers, fathers, and best friends, simultaneously, and how distinct relationship profiles were linked to adaptive and maladaptive functioning (aggression, anxious‐withdrawal, prosociality) within and across cultures. Participants resided in metropolitan areas of South Korea, the United States, and Portugal (10–14 years; N = 1,233). Latent profile analyses identified relationship profiles that were culturally common or specific. Additional findings highlighted commonality in the relations between a high‐quality relationship profile and adaptive functioning, as well as cultural specificity in the buffering and differential effects of distinct relationship profiles on social‐behavioral outcomes.

Loneliness and Social Functioning in Adolescent Peer Victimization

Interpersonal adversity such as peer victimization has been shown to have complex associations with other socio-emotional difficulties, particularly during adolescence. We used a multidimensional peer nomination measure on a sample of 440 (52% girls) 11- to 17-year-old (M = 13.14 years, SD = 1.26) Portuguese youths to identify three groups, classified by peers as (1) victimized adolescents who showed anxious withdrawn behaviors in the context of the peer group (n = 111), (2) victimized adolescents who did not exhibit anxious withdrawn behaviors (n = 104), and (3) non-victimized adolescents (n = 225). We compared these groups on their peer-reported social functioning and on their self-reported feelings of social and emotional loneliness (with peers and family). Anxiously withdrawn victims were viewed by peers as more excluded, less aggressive, less prosocial, and less popular than non-withdrawn victims and non-victims. Non-anxiously withdrawn victims were considered more excluded than non-victims, and more aggressive than both anxiously withdrawn victims and non-victims. Finally, anxiously withdrawn victims reported feeling less integrated and intimate with their peers than non-withdrawn victims and non-victims, which is indicative of greater feelings of social and emotional loneliness at school. Youths in the current study did not report feeling lonely in their family environment. Our findings thus provide further evidence that victimized youths constitute a heterogeneous group, which differ in the way they behave toward their peers and experience loneliness.

Perceptions of Portuguese parents about the acceptability of a multicomponent intervention targeted at behavioral inhibition during early childhood

High and stable behavioral inhibition during early childhood is a risk factor for later anxiety disorders. The few available interventions targeted at behavioral inhibition have not yet been implemented in European countries. Evaluating intervention acceptability is essential when introducing interventions in new cultures. This study aimed to explore the perceptions of parents about the acceptability of the multicomponent Turtle Program in Portugal. Participants were 12 parents (from seven families) of children with a positive screening on the Behavioral Inhibition Questionnaire and no diagnoses of developmental disorders/selective mutism. Children's mean age was 55.86 months and most children were female and first-born. Parents and children participated in the eight-sessions Turtle Program. After each session, parents completed weekly satisfaction checklists. Following completion of the full intervention, parents were invited to participate in individual qualitative in-depth interviews. The thematic analysis revealed that both parents perceived the intervention objectives and contents as relevant. Both parents suggested the introduction of follow-up sessions, the discussion of practical experiences, the need to be sensitive to cultural differences in positive language, and the provision of more feedback about children's activities. These findings support prior research on the acceptability and cultural tailoring needed for parenting and child socioemotional learning interventions.

Loneliness in adolescence: Confirmatory factor analysis of the relational provisions loneliness questionnaire (RPLQ) in a Portuguese sample

The present study assesses the factor structure, psychometric adequacy, and invariance across sex and age of the Relational Provisions Loneliness Questionnaire (RPLQ). Discriminant validity with an external criterion was also tested. In a sample of Portuguese adolescents, from 7th to 9th grade ( N = 817), Confirmatory Factor Analyses (CFA) were conducted to test a four-factor model of loneliness (lack of integration and/or intimacy in peer group and/or family). Results evidenced empirical support for the structure of the RPLQ loneliness scale, which fitted very well the proposed model, and provided adequate fit to the Portuguese data. There was substantial support for the construct validity (factorial, convergent, and discriminant) and reliability of the RPLQ. Measurement invariance (configural, metric, and scalar) was established across sex and age. Finally, it was assured discriminant validity, provided by the contrast with the social functioning dimensions in peer group. Overall, our findings support the conceptualization of loneliness in adolescence by peer- and family-related loneliness through lack of integration and intimacy. In a single instrument, the RPLQ loneliness scale combines measures of four important aspects of adolescents’ social life. This seems to be an adequate instrument to be used in the study of adolescents’ loneliness, in its different forms and across relational contexts.

Prosocial Behavior and Friendship Quality as Moderators of the Association Between Anxious Withdrawal and Peer Experiences in Portuguese Young Adolescents

Anxious withdrawal has been associated consistently with adverse peer experiences. However, research has also shown that there is significant heterogeneity among anxiously withdrawn youth. Further, extant research has focused primarily on negative peer experiences and outcomes; little is known about the more successful social experiences of anxiously withdrawn youth. We explored the possibility that the association between anxious withdrawal and group-level peer outcomes (exclusion, victimization, and popularity) might be moderated by peer-valued behaviors (prosocial behavior), friendship relational attributes, and sex, even after accounting for the effects of being involved in a reciprocal best friendship. Peer nominations of psychosocial functioning, and self-reports of best friendships and friendship quality were collected in a community sample of 684 Portuguese young adolescents. Regression analyses revealed that more anxious withdrawn adolescents showed worst group-level peer outcomes, but that: (a) prosocial behavior buffered the positive association between anxious-withdrawal and peer exclusion, particularly for boys; (b) higher friendship quality was associated with lower risk of peer victimization for more anxious-withdrawn girls, but with a higher risk for more anxious withdrawn boys; and (c) higher friendship conflict buffered the positive association between anxious withdrawal and peer exclusion for boys. Results are discussed in terms of the implications of peer-valued characteristics on the peer group experiences of anxiously withdrawn young adolescents.

Perceived attachment security to parents and peer victimization: Does adolescent's aggressive behaviour make a difference?

Peer victimization is one of the most prominent problems during adolescence. Research has distinguished aggressive and non-aggressive victims; however, there are still significant drawbacks in understanding the social and family functioning of these different groups of victimized adolescents. This study aimed to compare social behavior and perceived attachment security to parents of Portuguese adolescents, classified as aggressive victims, non-aggressive victims and non-victims. The sample consisted of 222 adolescents (115 boys, 107 girls) who completed the Kerns Security Scale and the Extended Class Play, to assess perceived attachment security and social behavior, respectively. Controlling for age and sex, aggressive victims and non-aggressive victims differed in anxious withdrawal but shared a similar profile in peer exclusion and prosocial behavior. Only aggressive victims reported lower attachment security to mother and father when compared to non-victims. These findings underline that victimized adolescents constitute a heterogeneous group in terms of their social and family functioning.

Perception Accuracy of Affiliative Relationships in Elementary School Children and Young Adolescents

There has been a rapid growth of studies focused on selection and socialization processes of peer groups, mostly due to the development of stochastic actor-based models to analyze longitudinal social network data. One of the core assumptions of these models is that individuals have an accurate knowledge of the dyadic relationships within their network (i.e., who is and is not connected to whom). Recent cross-sectional findings suggest that elementary school children are very inaccurate in perceiving their classmates' dyadic relationships. These findings question the validity of stochastic actor-based models to study the developmental dynamics of children and carry implications for future research as well as for the interpretation of past findings. The goal of the present study was thus to further explore the adequacy of the accuracy assumption, analysing data from three longitudinal samples of different age groups (elementary school children and adolescents). Our results support the validity of stochastic actor-based models to study the network of adolescents and suggest that the violation of the accuracy assumption for elementary school children is not as severe as previously thought.

Iodine deficiency a persisting problem: assessment of iodine nutrition and evaluation of thyroid nodular pathology in Portugal

BACKGROUND

The goal of eliminating iodine deficiency (ID) by the year 2000 has still not been achieved in several countries. More than 2 billion people worldwide (over 260 million school age children) remain ID. In Europe, there are still countries, such as Portugal, without national general population data on iodine nutrition (IN). This study aims at evaluating combined complementary data of the IN of the general population through urinary iodine concentration (UIC) and the thyroid histology profile from the inland region of Beira Interior (BI), in Portugal.

METHODS

UIC from a population sample of 214 volunteers (131 females and 83 males), with ages ranging from 8 to 97 years (mean 51.5 years ± SD 20.74 years), from BI was determined; the thyroid histology pattern in BI (6-year period) was evaluated; and the iodine content of the largest surface water reservoir of BI, never previously reported, was measured.

RESULTS

Median UIC of 62.6 μg/L was measured. Over 92 % of the population had UIC less than 100 μg/L. From 279 histology reports evaluated, the incidence of the different types of thyroid nodular pathology in BI was established. There were 60 histologic diagnoses of malignancy. The observed ratio of papillary to follicular carcinoma relatively close to 1 and the fairly high percentage of anaplastic carcinomas are characteristic of ID areas.

CONCLUSIONS

The findings of this first general population study on IN from the inland region of BI, Portugal, document significant ID. This problem, with its serious public health implications, could be corrected by having affordable iodised salt widely and generally available and by promoting a proactive population attitude generated by ample public information and educational programs as to the negative consequences of ID.

Effects of microcystin-LR and cylindrospermopsin on plant-soil systems: A review of their relevance for agricultural plant quality and public health

Toxic cyanobacterial blooms are recognized as an emerging environmental threat worldwide. Although microcystin-LR is the most frequently documented cyanotoxin, studies on cylindrospermopsin have been increasing due to the invasive nature of cylindrospermopsin-producing cyanobacteria. The number of studies regarding the effects of cyanotoxins on agricultural plants has increased in recent years, and it has been suggested that the presence of microcystin-LR and cylindrospermopsin in irrigation water may cause toxic effects in edible plants. The uptake of these cyanotoxins by agricultural plants has been shown to induce morphological and physiological changes that lead to a potential loss of productivity. There is also evidence that edible terrestrial plants can bioaccumulate cyanotoxins in their tissues in a concentration dependent-manner. Moreover, the number of consecutive cycles of watering and planting in addition to the potential persistence of microcystin-LR and cylindrospermopsin in the environment are likely to result in groundwater contamination. The use of cyanotoxin-contaminated water for agricultural purposes may therefore represent a threat to both food security and food safety. However, the deleterious effects of cyanotoxins on agricultural plants and public health seem to be dependent on the concentrations studied, which in most cases are non-environmentally relevant. Interestingly, at ecologically relevant concentrations, the productivity and nutritional quality of some agricultural plants seem not to be impaired and may even be enhanced. However, studies assessing if the potential tolerance of agricultural plants to these concentrations can result in cyanotoxin and allergen accumulation in the edible tissues are lacking. This review combines the most current information available regarding this topic with a realistic assessment of the impact of cyanobacterial toxins on agricultural plants, groundwater quality and public health.

Analysis of the use of microcystin-contaminated water in the growth and nutritional quality of the root-vegetable, Daucus carota

Toxic cyanobacterial blooms are often observed in freshwaters and may reflect the increased eutrophication of these environments and alterations in climate. Cyanotoxins, such as microcystins (MCs), are an effective threat to many life forms, ranging from plants to humans. Despite the research conducted to date on cyanotoxins, the risks associated to the use of contaminated water in agriculture require further elucidation. To tackle this aim, a research was conducted with the root-vegetable Daucus carota. The specific aims of this work were the following: (i) to evaluate the effects of MC-LR on the plant growth and photosynthesis; (ii) to evaluate the nutritional quality of carrot roots; and (iii) to measure bioaccumulation. To this purpose, young carrots were grown in soil during 1 month in natural conditions and exposed to Mycrocystis aeruginosa aqueous extracts containing environmentally realistic concentrations of MC-LR (10 and 50 MC-LR μg/L). The results showed that MC-LR may decrease root growth after 28 days of exposure to 50 μg/L and increase photosynthetic efficiency. We also observed changes in mineral and vitamin content in carrots as a result of the exposure to contaminated water. Moreover, MC-LR was detected in carrot roots by ELISA at very low concentration 5.23 ± 0.47 ng MC eq./g FW. The soil retained 52.7 % of the toxin potentially available for plants. This result could be attributed to MC-LR adsorption by soil particles or due to microbial degradation of the toxin. We conclude that the prolonged use of MC-LR-contaminated water may affect crop growth, alter the nutritional value of vegetable products, and potentiate contamination.