Effect of various compounds on virgin olive oil stability measured by Rancimat

Phenolic and orthodiphenolic compounds together with carotenoids, tocopherols, pigments, and fatty acids were tested for their antioxidant effect in 79 samples of virgin olive oils cv. Picual and Hojiblanca. A linear regression based on the oleic/linoleic ratio and the contents of phenols and tocopherols showed a good correlation (adjusted-R(2) = 0.91) with the stability measured by Rancimat, later verified with an external text set (adjusted-R(2) = 0.95). A tentative study on the percentage contribution of each chemical variable to stability is discussed. The contribution of phenolic and orthodiphenolic compounds was around 51%, the composition of fatty acids 24%, and in less percentage alpha-tocopherol, carotenoids, and chlorophylls. No effect, or very little, was shown by beta- and gamma-tocopherols.

Effect of olive ripeness on the oxidative stability of virgin olive oil extracted from the varieties picual and hojiblanca and on the different components involved

The initial stability of virgin olive oil depends on various factors, among which are the variety and the degree of fruit ripeness. The former, which genetically determines the composition of the olive and its oil, also marks, to some extent, its stability. However, oil stability changes as the olive ripens, so it is obvious that the degree of ripeness is an important factor. The oils were obtained by the Abencor system. Acidity, peroxide index, UV absorption at 232 and 270 nm, sensory analysis, fatty acid composition, tocopherols, phenolic compounds, orthodiphenolic compounds, sterols, pigments, and oxidative stability were determined, and the results were analyzed statistically. During ripening there was a decrease in all of the parameters studied except linoleic acid, Delta-5-avenasterol, and oil content, which increased. Virgin oils showed very good correlation between stability and the concentrations of total phenols, o-diphenols, tocopherols, chlorophyll pigments and carotenoids, linoleic and linolenic acids, total sterols, beta-sitosterol, and Delta-5-avenasterol.

Transmission of HIV Drug Resistance and the Predicted Effect on Current First-line Regimens in Europe

Transmitted human immunodeficiency virus drug resistance in Europe is stable at around 8%. The impact of baseline mutation patterns on susceptibility to antiretroviral drugs should be addressed using clinical guidelines. The impact on baseline susceptibility is largest for nonnucleoside reverse transcriptase inhibitors.

Background. Numerous studies have shown that baseline drug resistance patterns may influence the outcome of antiretroviral therapy. Therefore, guidelines recommend drug resistance testing to guide the choice of initial regimen. In addition to optimizing individual patient management, these baseline resistance data enable transmitted drug resistance (TDR) to be surveyed for public health purposes. The SPREAD program systematically collects data to gain insight into TDR occurring in Europe since 2001.

Methods. Demographic, clinical, and virological data from 4140 antiretroviral-naive human immunodeficiency virus (HIV)–infected individuals from 26 countries who were newly diagnosed between 2008 and 2010 were analyzed. Evidence of TDR was defined using the WHO list for surveillance of drug resistance mutations. Prevalence of TDR was assessed over time by comparing the results to SPREAD data from 2002 to 2007. Baseline susceptibility to antiretroviral drugs was predicted using the Stanford HIVdb program version 7.0.

Results. The overall prevalence of TDR did not change significantly over time and was 8.3% (95% confidence interval, 7.2%–9.5%) in 2008–2010. The most frequent indicators of TDR were nucleoside reverse transcriptase inhibitor (NRTI) mutations (4.5%), followed by nonnucleoside reverse transcriptase inhibitor (NNRTI) mutations (2.9%) and protease inhibitor mutations (2.0%). Baseline mutations were most predictive of reduced susceptibility to initial NNRTI-based regimens: 4.5% and 6.5% of patient isolates were predicted to have resistance to regimens containing efavirenz or rilpivirine, respectively, independent of current NRTI backbones.

Conclusions. Although TDR was highest for NRTIs, the impact of baseline drug resistance patterns on susceptibility was largest for NNRTIs. The prevalence of TDR assessed by epidemiological surveys does not clearly indicate to what degree susceptibility to different drug classes is affected.

Psychometric properties of the Temperament and Character Inventory (TCI) questionnaire in a Spanish psychiatric population

OBJECTIVE

The psychometric properties of the Spanish version of Cloninger's Temperament and Character Inventory (TCI) were examined in a psychiatric population.

METHOD

Internal consistency, factor structure and concurrent validity were studied in a sample of 416 psychiatric patients.

RESULTS

A moderate to high internal consistency for all personality dimensions was found, except for Persistence. A confirmatory factor analysis of the TCI performed at the subscale level revealed an uncertain factor structure. However, when analysed separately, both the 11 temperament subscales (plus Persistence) and the 13 character subscales shaped four and three factors, respectively, in agreement with the biosocial model of personality. Finally, concurrent validity analyses were conducted using EPQ, SPSR and SSS questionnaires showing results consistent with theory.

CONCLUSION

The Spanish version of the TCI is a reliable and valid instrument, although the Persistence dimension might require further revision.

The gamut of paracoccidioidomycosis

Paracoccidioidomycosis is a systemic mycosis of importance in Latin America. Because of its polymorphic manifestations, it is not always suspected and patients are sometimes misdiagnosed. Case histories of patients with paracoccidioidomycosis are presented in order to illustrate its various manifestations, with emphasis on the primary pulmonary localization.

Increased risk of non-AIDS-related events in HIV subjects with persistent low CD4 counts despite cART in the CoRIS cohort

The aim was to analyze clinical complications in HIV-infected subjects who persistently maintain low CD4 levels despite virological response to cART in the Spanish CoRIS cohort. The main inclusion criteria were CD4 counts <200cells/mm(3) at cART-initiation and at least 2years under cART achieving a viral load <500copies/mL. Those patients with CD4 counts <250cells/mm(3) 2years after cART were classified as the Low-CD4 group, and clinical events were collected from this time-point. Poisson regression models were used to calculate incidence rate ratios of death, AIDS-defining events, serious non-AIDS-defining events (NAE) and of each specific NAE category (non-AIDS-defining malignancies (non-ADM), cardiovascular, kidney- and liver-related events). Of 9667 patients in the cohort, a total of 1128 met the criteria and 287 (25.4%) were classified in the Low-CD4 group. A higher risk of death (aIRR: 4.71; 95% CI: 1.88-11.82; p-value=0.001) and of non-ADM were observed in this group (aIRR: 2.23; 95% CI: 1.07-4.63; p=0.03). Our results stress the need to control accelerated aging in this population to counter their increased risk of non-AIDS-defining diseases, particularly cancer, and are consistent with the concept that clinical complications are potentially affected by genetics and lifestyle.

Determinant parameters and components in the storage of virgin olive oil. Prediction of storage time beyond which the oil is no longer of "extra" quality

This work studies the changes in the quality indices standardized by the European Union, together with the evolution of the oxidative stability and sterols, polyphenols, alpha-tocopherol, pigments, and fatty acids contents throughout the storage of Picual and Hojiblanca olive cultivar "extra" virgin olive oils at 2 degrees C + darkness and 30 degrees C + illumination. Only two quality indices (K(270) and sensory evaluation) indicate the loss of the extra quality of the oil during storage, and there is an excellent correlation between initial stability and the time to reach the limit of K(270) > 0.25 (after which the oil quality is no longer of "extra" quality). This time can be predicted with an error of <10%, which is of great commercial interest and previously unknown. Also unknown until now is that the changes in polyphenols, pigments, and alpha-tocopherol with storage time follow first-order kinetics.

Epidemiology of community-acquired pneumonia in adult patients at the dawn of the 21st century: a prospective study on the Mediterranean coast of Spain

This study presents data from a prospective study of adult patients with community-acquired pneumonia (CAP). Of 493 patients included in the study, 223 (45.2%) were aged > or = 65 years, and 265 (53.7%) had one or more underlying diseases, mostly chronic obstructive pulmonary disease, diabetes mellitus or dementia. In total, 281 microorganisms were identified in 250 (50.7%) patients, with two or more pathogens detected in 28 (5.7%) cases. Microbial diagnosis varied according to age, severity, co-morbidity and site-of-care, but there was much overlap among groups. Streptococcus pneumoniae was the single most prevalent organism in outpatients, patients admitted to hospital, and patients who died, either as a single pathogen or combined with another organism. Infections caused by 'atypical' pathogens were seen across all groups, including the elderly and patients with co-morbidities. Mortality varied according to the pneumonia severity index (PSI) of the pneumonia patient outcomes research team. Shock (OR 34.48), an age of > 65 years (OR 25) and altered mental status (OR 9.92) were factors associated independently with 30-day mortality. Key findings from this study were the advanced age of the population with CAP, and the high prevalence of dementia as an underlying disease. The study also revealed that microbiological diagnosis of CAP remains problematic. Although certain epidemiological features may help to predict the microbial aetiology, the overlap among groups reduces the usefulness of this information in guiding therapeutic decisions. Greater effort should be made to improve identification methods for microbial pathogens causing CAP.

Pathogenesis of paracoccidioidomycosis: a model based on the study of 46 patients

Forty-six Paracoccidioidomycosis patients were studied with emphasis on lung pathology. It was found that the greatest clinical involvement of the reticuloendothelial system occurred in younger individuals. On the other hand, the frequency of tegumentary lesions was low in young patients and increased with age. Lung involvement was nearly always demonstrated when searched for and showed no relationship to the patient's age. In the young patients the disease was acute while in the older individuals its course was chronic. The findings from this study permitted formulation of a model for the pathogenesis of paracoccidioidomycosis in which the respiratory tract is accepted as the primary site of infection. Based on this model, a classification of the various forms of the entity is proposed.

Cognitive dysfunctions in recovered melancholic patients

Cognitive dysfunctions were studied in symptom-free patients suffering from Recurrent Depressive Disorder with melancholia. Their performances on a standard neuropsychological battery were compared with those of a healthy sample matched for age and educational level. Statistically significant differences were found in Immediate Visual Memory, Delayed Logical and Visual Memory, Paired Learning and Block Design. Results seem to indicate that the cognitive disfunctions are not likely to be only mnesic. All these data suggest that these disfunctions found in some melancholic depressives could not be state-dependent.

Validity and reliability of the Spanish version of the Psychological General Well-Being Index

The Psychological General Well-Being Index (PGWBI) was adapted for use in Spain. The American version was translated and back-translated independently by three bilinguals and the comprehensibility of a consensuated version was tested in a pilot study. The construct validity and internal consistency of the questionnaire were tested in 104 patients (52 high blood pressure patients attending a primary health care centre and 52 end-stage renal disease patients undergoing hemodialysis). Concurrently to the PGWBI, patients were administered the General Health Questionnaire (GHQ-12) and three psychosocial categories of the Sickness Impact Profile (SIP-PD). Patients in the dialysis group were administered the PGWBI on two occasions, two weeks apart. The PGWBI was moderately to highly correlated with the GHQ-12 (r = -0.71) and with the SIP-PD (r = -0.69). Overall internal consistency as measured by Cronbach's alpha coefficient was 0.94. By dimensions, PGWBI alpha coefficients ranged from 0.56 (Self-control) to 0.88 (Anxiety). No differences were found in mean PGWBI scores between the two groups of patients studied. Two-week test-retest intraclass correlation coefficient was 0.76. The similarity of the operating characteristics supports the contention that the Spanish and American versions of the PGWBI are conceptually equivalent. More research is needed on the reliability and responsiveness of the different dimensions of the questionnaire. Our results suggest that only global scores should be used when making individual comparisons.

Psychometric Properties of the Spanish PID-5 in a Clinical and a Community Sample

The Personality Inventory for DSM-5 (PID-5) measures the trait part (Criterion B) of the alternative model for personality disorders proposed in Section III of DSM-5. Although its psychometric properties have proven adequate thus far, evidence is limited in other languages and in clinical samples. The Spanish PID-5 was examined in two samples comprising 446 clinical and 1,036 community subjects. Facet scales showed good internal consistency in both samples (median α = .86 and .79) and were unidimensional under exploratory and confirmatory approaches. They were also able to distinguish between clinical and community subjects with a mean standardized difference of z = 0.81. All facets except for Risk Taking were unipolar, such that the upper poles indicated pathology and the lower poles reflected normality, rather than the opposite pole of abnormality. The entire PID-5 hierarchical structure, from one to five factors, was confirmed in both samples with Tucker's congruence coefficients over .95.

Publication of European Union Research on Infectious Diseases (1991?2001): A Bibliometric Evaluation

The study presented here analyzed the contents of 36 international infectious diseases journals from 1991 to 2001 to determine the number of reports prepared by authors in the European Union and to compare the per country scientific productivity. Articles included in the study were identified using the PubMed website. The number of publications in infectious disease journals produced by authors in the European Union experienced an exponential growth from 461 (19.2% of world production) in 1991 to 2,401 (35.9%) in 2001. The mean impact factor increased from 2.259 in 1991 to 3.001 in 2001. The leading countries in the total number of publications were the UK, France, and Germany. After taking population figures into account, Sweden, Denmark, and Finland headed the list, and after correcting for gross domestic product, the greatest producers were Sweden, Finland, and the UK. Overall, the scientific production and repercussion index of European Union research on infectious diseases experienced a notable rise during the last decade of the 20th century.

Treatment of paracoccidioidomycosis with ketoconazole: a three-year experience

The results of ketoconazole therapy in 38 patients with active paracoccidioidomycosis are described. Treatment consisted of a 200 mg tablet a day for 6 months. Evaluation was accomplished by means of a scoring system and the results were as follows: none of the patients worsened during therapy, one was found to be unchanged, five had minor improvement, 330 had major improvement, and there was complete resolution of the pretherapy conditions in 13. These findings plus the lack of toxicity of the drug and the facility for oral administration, make of ketoconazole a first line drug for the treatment of paracoccidioidomycosis.

Relation of acidity and sensory quality with sterol content of olive oil from stored fruit

Composition of the sterol fraction, fatty acid, acidity, and the sensorial evaluation of virgin olive oils were studied in two eastern Spanish varieties grown and processed under the same conditions. Fruits were stored at 5 degrees C and ambient temperature for different times. During fruit storage, there was no significant variation (P = 0.05) in fatty acid composition. However, the sterol composition of the oil varied markedly (in particular, there was an increase in stigmasterol), acidity increased, and there was a very significant decrease in sensorial quality. The stigmasterol content presented a high correlation with the acidity and sensory evaluation (P < 10(-)(6)). The total sterol content increased gradually with olive storage time. Oils with stigmasterol greater than campesterol are graded to a low level (lampant). It is of interest that sensorial quality is revealed by stigmasterol content, a fact unknown until now.

Community-acquired pneumonia of mixed etiology: prevalence, clinical characteristics, and outcome

Community-acquired pneumonia (CAP) of mixed etiology has increasingly been appreciated in the literature, but its clinical significance remains unknown. The aim of this analysis was to describe the prevalence, clinical characteristics, and outcome of CAP of mixed etiology. Data were obtained from a 2-year prospective study of consecutive patients with CAP in whom an extensive microbiological workup was performed. Predefined strict criteria were used to establish the etiology. A total of 493 patients were included. A single pathogen was detected in 222 (45%) cases and two or more pathogens in 28 (5.7%) cases. Mixed infections were seen across all age groups and in patients treated both in hospital and as outpatients. The most frequent combinations of pathogens were those of a bacterium plus an "atypical" organism (28.6%) and of two bacterial organisms (28.6%). Compared with patients with monomicrobial pneumonia, patients with mixed pneumonia were more likely to have underlying conditions (64% vs. 45%, p=0.04) and dementia (25% vs. 10%, p=0.02). The incidence of a defined series of complications was higher in patients with mixed pneumonia (39.3% vs. 18.6%; OR=2.84; p=0.02). Community-acquired pneumonia of mixed etiology is uncommon. Patients with mixed pneumonia are more likely to have underlying medical conditions, and they may have a more severe course of disease.

Factorial study of the BDI in pregnant women

This study was carried out to investigate the significance of Beck Depression Inventory (BDI) scores and the influence of somatic items in a non-psychiatric population presenting with somatic complaints. Internal consistency, item frequency, factor dimensions, and correlation with Eysenck's 'N' were analysed in a sample of 882 non-psychiatric pregnant women. The BDI showed a high level of internal consistency (Cronbach alpha coefficient was 0.85). Factor analysis yielded two major factors. Low BDI scores were determined mainly by items related to somatic complaints or decreased activity without unequivocal depressive content. In contrast, it was unambiguous depressive items that were endorsed in high scores, and these showed higher correlations with neuroticism. It is concluded that in non-psychiatric populations the BDI may measure conditions other than depression and that low or medium range scores should not be interpreted as indicators of mild depressive symptomatology.

Are conjunctive inferences easier than disjunctive inferences? A comparison of rules and models

We report four experiments investigating conjunctive inferences (from a conjunction and two conditional premises) and disjunctive inferences (from a disjunction and the same two conditionals). The mental model theory predicts that the conjunctive inferences, which require one model, should be easier than the disjunctive inferences, which require multiple models. Formal rule theories predict either the opposite result or no difference between the inferences. The experiments showed that the inferences were equally easy when the participants evaluated given conclusions, but that the conjunctive inferences were easier than the disjunctive inferences (1) when the participants drew their own conclusions, (2) when the conjunction and disjunction came last in the premises, (3) in the time the participants spent reading the premises and in responding to given conclusions, and (4) in their ratings of the difficulty of the inferences. The results support the model theory and demonstrate the importance of reasoners' inferential strategies.

[Incubation period of COVID-19: A systematic review and meta-analysis]

BACKGROUND AND OBJECTIVE

The incubation period of COVID-19 helps to determine the optimal duration of the quarantine and inform predictive models of incidence curves. Several emerging studies have produced varying results; this systematic review aims to provide a more accurate estimate of the incubation period of COVID-19.

METHODS

For this systematic review, a literature search was conducted using Pubmed, Scopus/EMBASE, and the Cochrane Library databases, covering all observational and experimental studies reporting the incubation period and published from 1 January 2020 to 21 March 2020.We estimated the mean and 95th percentile of the incubation period using meta-analysis, taking into account between-study heterogeneity, and the analysis with moderator variables.

RESULTS

We included seven studies (n = 792) in the meta-analysis. The heterogeneity (I2 83.0%, p < 0.001) was significantly decreased when we included the study quality and the statistical model used as moderator variables (I2 15%). The mean incubation period ranged from 5.6 (95% CI: 5.2 to 6.0) to 6.7 days (95% CI: 6.0 to 7.4) according to the statistical model. The 95th percentile was 12.5 days when the mean age of patients was 60 years, increasing 1 day for every 10 years.

CONCLUSION

Based on the published data reporting the incubation period of COVID-19, the mean time between exposure and onset of clinical symptoms depended on the statistical model used, and the 95th percentile depended on the mean age of the patients. It is advisable to record sex and age when collecting data in order to analyze possible differential patterns.

Clinical characterisation of pneumonia caused by atypical pathogens combining classic and novel predictors

The aim of this study was to characterise community-acquired pneumonia (CAP) caused by atypical pathogens by combining distinctive clinical and epidemiological features and novel biological markers. A population-based prospective study of consecutive patients with CAP included investigation of biomarkers of bacterial infection, e.g., procalcitonin, C-reactive protein and lipopolysaccharide-binding protein (LBP) levels. Clinical, radiological and laboratory data for patients with CAP caused by atypical pathogens were compared by univariate and multivariate analysis with data for patients with typical pathogens and patients from whom no organisms were identified. Two predictive scoring models were developed with the most discriminatory variables from multivariate analysis. Of 493 patients, 94 had CAP caused by atypical pathogens. According to multivariate analysis, patients with atypical pneumonia were more likely to have normal white blood cell counts, have repetitive air-conditioning exposure, be aged <65 years, have elevated aspartate aminotransferase levels, have been exposed to birds, and have lower serum levels of LBP. Two different scoring systems were developed that predicted atypical pathogens with sensitivities of 35.2% and 48.8%, and specificities of 93% and 91%, respectively. The combination of selected patient characteristics and laboratory data identified up to half of the cases of atypical pneumonia with high specificity, which should help clinicians to optimise initial empirical therapy for CAP.