Posttranslational splicing modifications as a key mechanism in cytarabine resistance in acute myeloid leukemia.

Despite the approval of several drugs for AML, cytarabine is still widely used as a therapeutic approach. However, 85% of patients show resistance and only 10% overcome the disease. Using RNA-seq and phosphoproteomics, we show that RNA splicing and serine-arginine-rich (SR) proteins phosphorylation were altered during cytarabine resistance. Moreover, phosphorylation of SR proteins at diagnosis were significantly lower in responder than non-responder patients, pointing to their utility to predict response. These changes correlated with altered transcriptomic profiles of SR protein target genes. Notably, splicing inhibitors were therapeutically effective in treating sensitive and resistant AML cells as monotherapy or combination with other approved drugs. H3B-8800 and venetoclax combination showed the best efficacy in vitro, demonstrating synergistic effects in patient samples and no toxicity in healthy hematopoietic progenitors. Our results establish that RNA splicing inhibition, alone or combined with venetoclax, could be useful for the treatment of newly diagnosed or relapsed/refractory AML.

Estrategias de marketing en redes sociales de marcas de alimentos consumidos por niños y adolescentes en Argentina / Brand social media marketing strategies for foods consumed by children and adolescents in Argentina

Introducción. En la Argentina, según los datos de la última Encuesta Nacional de Nutrición y Salud, 4 de cada 10 niños, niñas y adolescentes (NNyA) entre 5 y 17 años presentan exceso de peso. Objetivo. Identificar las estrategias de marketing en las páginas de Facebook® e Instagram® de las marcas de los alimentos consumidos por niñas, niños y adolescentes (NNyA), y categorizarlos según las Guías Alimentarias para la Población Argentina (GAPA). Métodos. El análisis se realizó en las publicaciones de agosto y septiembre de 2019, se identificaron aquellas dirigidas a NNyA y se categorizaron los alimentos promocionados según las GAPA. Resultados. De las 200 marcas identificadas, 111 tenían página de Facebook® y 95 de Instagram®. Las marcas que tenían página de Facebook® presentaron 65 publicaciones y las que tenían Instagram®, 64 publicaciones. Las estrategias más utilizadas fueron la imagen del producto y la interacción con los consumidores. La mitad de las páginas estaban dirigidas a NNyA. De los alimentos promocionados, 6 de cada 10 correspondieron al grupo de opcionales según las GAPA. Conclusiones. Se evidencia la importancia de monitorear la implicancia de las redes sociales en las conductas alimentarias.

Introduction. As per the National Survey on Nutrition and Health, in Argentina, 4/10 children and adolescents aged 5­17 years are overweight. Objective. To identify marketing strategies on Facebook® and Instagram® of brands of foods consumed by children and adolescents and to categorize them according to the Dietary Guidelines for the Argentine Population (GAPA). Methods. The posts made between August and September 2019 were analyzed, identifying those targeted at children and adolescents and categorizing promoted foods according to the GAPA. Results. Out of 200 brands identified, 111 had a Facebook® page and made 65 posts and 95 had an Instagram® account and made 64 posts. Product image and interaction with consumers were the more used stategies. Six out of 10 of the foods promoted corresponded to the optional group according to the GAPA. Conclusions. It is important to monitor the implications social media have on eating behaviors.

Digital Health Literacy and Person-Centred Care: Co-Creation of a Massive Open Online Course for Women with Breast Cancer.

The diagnosis of breast cancer (BC) can make the affected person vulnerable to suffering the possible consequences of the use of low-quality health information. Massive open online courses (MOOCs) may be a useful and efficient resource to improve digital health literacy and person-centred care in this population. The aim of this study is to co-create a MOOC for women with BC, using a modified design approach based on patients' experience. Co-creation was divided into three sequential phases: exploratory, development and evaluation. Seventeen women in any stage of BC and two healthcare professionals participated. In the exploratory phase, a patient journey map was carried out and empowerment needs related to emotional management strategies and self-care guidelines were identified, as well as information needs related to understanding medical terminology. In the development phase, participants designed the structure and contents of the MOOC through a Moodle platform. A MOOC with five units was developed. In the evaluation phase, participants strongly agreed that their participation was useful for the MOOC's development and participating in the co-creation process made the content more relevant to them (experience in the co-creation); most of the participants positively evaluated the content or interface of the MOOC (acceptability pilot). Educational interventions designed by women with BC is a viable strategy to generate higher-quality, useful resources for this population.

Ethical, legal, organizational and social issues related to the use of scalp cooling for the prevention of chemotherapy-induced alopecia: A systematic review.

INTRODUCTION: Scalp cooling (SC) aims to prevent chemotherapy-induced alopecia. The goal of this systematic review is to tackle ethical, legal, organizational and social issues related to SC. METHODS: A critical appraisal of the literature was carried out using a systematic review design. MEDLINE, Embase and Web of Science databases were searched up until 2 June 2021. Studies addressing these aspects in English or Spanish were considered. Representatives of both patient associations and professional scientific societies related to the topic participated in the design of the protocol and the review of the findings. RESULTS: A total of 17 studies were included. Articles were critically appraised using the MMAT and SANRA. Findings were organized into four categories: (1) ethical aspects focused on equal access, gender equity and doctor-patient communication supported by Patient Decision Aids (PtDAs); (2) patient perspective and acceptability; (3) professional perspective and acceptability; (4) organizational aspects focused on accessibility and feasibility. CONCLUSION: Cancer patients' expectations when using SC need to be adjusted to reduce the potential distress associated with hair loss. PtDAs could help patients clarify their values and preferences regarding SC. Equal access to technology should be guaranteed. PATIENT OR PUBLIC CONTRIBUTION: In this systematic review, the representatives of the patient associations (Ms. María Luz Amador Muñoz of the Spanish Association Against Cancer [AECC] and Ms. Catiana Martinez Cánovas of the Spanish Breast Cancer Federation [FECMA]) participated in the review of the study protocol, as well as in the results, discussion and conclusions, making their contributions. In the type of design of these studies (systematic reviews), it is not usual to have the direct participation of patients, but in this one, we have done so, as it is a systematic review that is part of a report of the Spanish Network of Health Technology Assessment Agencies (ETS).

Information needs and research priorities in long-term survivorship of breast cancer: Patients and health professionals' perspectives.

OBJECTIVE: The objective of this work is to identify unmet information needs of long-term-survivors of breast cancer (BC) and future research needs from the perspectives of patients and health care professionals. METHODS: Two online Delphi surveys were conducted. Participants in Survey 1 were patients. Participants in Survey 2 were health care professionals from both primary and secondary care involved in BC care. Both surveys included three successive rounds. The first round aimed to identify research and information needs; the second round aimed to rank the relative importance of those needs; the third round aimed to find consensus. RESULTS: The most important information needs were self-management recommendations of common health problems after treatment and complications of breast reconstruction after 5 years. The most important research priorities were related to interventions and tools to increase information provision by professionals about certain tests, diet, and coordinated action between primary and specialised care during follow-up, and indications and safety issues of pregnancy in survivors. CONCLUSIONS: Two fundamental ideas were identified: (1) Patients request information about self-management common health problems after treatment and breast reconstruction complications. (2) Health care professionals emphasise the need for a standardised approach based on protocols, recommendations, and coordinated actions in the provision of information. IMPLICATIONS FOR CANCER SURVIVORS: Given the increasing number of BC survivors, it is essential to identify information and research needs to improve their care and health outcomes.

Safety and efficacy of ribociclib plus letrozole in patients with HR+, HER2- advanced breast cancer: Results from the Spanish sub-population of the phase 3b CompLEEment-1 trial.

BACKGROUND: Breast cancer is the most common malignancy and the second leading cause of cancer-related mortality in Spanish women. Ribociclib in combination with endocrine therapy (ET) has shown superiority in prolonging survival in patients with hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) advanced breast cancer (ABC) vs. ET alone. METHODS: CompLEEment-1 is a single-arm, open-label phase 3b trial evaluating ribociclib plus letrozole in a broad population of patients with HR+, HER2- ABC. The primary endpoints were safety and tolerability. Here we report data for Spanish patients enrolled in CompLEEment-1. RESULTS: A total of 526 patients were evaluated (median follow-up: 26.97 months). Baseline characteristics showed a diverse population with a median age of 54 years. At study entry, 56.5% of patients had visceral metastases and 8.7% had received prior chemotherapy for advanced disease. Rates of all-grade and Grade ≥3 adverse events (AEs) were 99.0% and 76.2%, respectively; 21.3% of patients experienced a serious AE, and 15.8% of AEs led to treatment discontinuation. AEs of special interest of neutropenia, increased alanine aminotransferase, increased aspartate aminotransferase and QTcF prolongation occurred in 77.8%, 14.8%, 11.4% and 4.0% of patients, respectively. Patients aged >70 years experienced increased rates of all-grade and Grade ≥3 neutropenia and anemia. Efficacy results were consistent with the global study. CONCLUSIONS: Results from Spanish patients enrolled in CompLEEment-1 are consistent with global data showing efficacy and a manageable safety profile for ribociclib plus letrozole treatment in patients with HR+, HER2- ABC, including populations of interest (NCT02941926). TRIAL REGISTRATION: ClinicalTrials.gov NCT02941926.

Gender differences in the decision-making process for undergoing total knee replacement.

OBJECTIVE: To assess gender differences in the decision-making process for treatment of knee osteoarthritis (OA). METHODS: A secondary analysis of a randomized trial was conducted (n = 193). Knowledge of OA and total knee replacement (TKR), decisional conflict, satisfaction with the decision-making process, treatment preference and TKR uptake 6 months later were compared by gender. Multivariate regression models were developed to identify gender-specific predictors. RESULTS: Women showed less knowledge (MD = -7.68, 95% CI: -13.9, -1.46, p = 0.016), reported less satisfaction (MD = -6.95, 95% CI: -11.7, -2.23, p = 0.004) and gave more importance to avoiding surgery (U = 2.09, p = 0.019). In women, more importance attributed to the time needed to relieve symptoms significantly reduced the odds of surgery (OR = 0.76, p = 0.016). CONCLUSION: The provision of information and/or promotion of shared decision-making could be of lower quality in female patients, although other explanations such as differences in information needs or preference for involvement in decision-making cannot be ruled out with the current evidence. Given the study's limitations, especially regarding the sample size, further confirmation is needed. PRACTICE IMPLICATIONS: A systematic, shared decision-making approach in consultation is needed to avoid potential gender-based biases.

Genome-wide analysis of fitness factors in uropathogenic Escherichia coli in a pig urinary tract infection model.

Uropathogenic Escherichia coli (UPEC) is the primary cause of urinary tract infections (UTIs) in animals and humans. We applied Transposon-Directed Insertion Site sequencing (TraDIS) to determine the fitness genes in two well-characterized UPEC strains, UTI89 and CFT073, in order to identify fitness factors during UTI in a pig model. This novel animal model better reflects the course of UTI in humans than the commonly used mouse model, and facilitates the differentiation between sessile and planktonic UPEC populations. A total of 854 and 483 genes in UTI89 and CFT073, respectively, were predicted to contribute to growth in pig urine, and 1257 and 764, were scored as required for colonization of the bladder. The combined list of fitness genes for growth in urine and cystitis contained 741 (UTI89) and 439 (CFT073) genes. The essential genes for growth on LB agar media supplemented with kanamycin and the fitness factors during growth in human urine were also analyzed in CFT073. A total of 457 essential genes were identified and the pool of fitness genes for growth in human urine included 215 genes. The gene rfaG, which is involved in lipopolysaccharide biosynthesis, was included in all the fitness-gene-lists and was further confirmed to be relevant for all the conditions tested regardless of the host and the strain. Thus, this gene may represent a promising target for the development of new therapeutic strategies against UTI UPEC-associated. Besides this important observation, the study revealed strain-specific differences in gene-essentiality as well as in the fitness-gene-repertoire for growth in human urine and UTI of the pig model, and it identified novel factors required for UPEC-induced UTIs.

Preoperative detection and evaluation of the need for psychological intervention in cancer and non-cancer patients referred to thoracic surgery.

OBJECTIVES: (a) to evaluate and compare the psychological treatment needs of patients with cancer and non-cancer, who are going to undergo scheduled thoracic surgery, and (b) evaluate and compare the diagnostic accuracy of the screening tests of psychological treatment needs for cancer and non-cancer patients. METHOD: The need for psychological treatment was evaluated in a total of 169 patients prior to thoracic surgery, through a clinical interview. The screening tests used were: the physician's judgment (yes/no), the Hospital Anxiety and Depression Scale (HADS) and, the single-item interview to assess depression "Do you feel depressed?" (DEPQ). RESULTS: The number of patients who needed psychological treatment in the total sample was 47 (27.81%), in non-cancer-patients: 22 (30.99%) and in cancer patients: 25 (25.51%). The participants with treatment needs were more often young women with primary education levels, with more fears and concerns regarding their disease. With respect to the screening tests, the HADS-T (cut-off point ≥13) obtained a sensitivity (SE) of 0.75 and Specificity (SP) of 0.81 in the total sample. In patients with cancer, the HADS total score (cut-off point ≥10) obtained an SE=0.84 and SP=0.80, and, in non-cancer patients, the HADS total score (cut-off point ≥13) showed an SE=0.59 and SP=0.84. The DEPQ and the physician's judgment did not achieve adequate levels of precision. CONCLUSIONS: A high percentage of patients have psychological treatment needs before performing thoracic surgery, which are similar for cancer and non-cancer patients. Preoperative detection of patients who need psychological intervention is feasible with a simple screening test: HADS, which achieves greater precision in cancer patients.

Genome-wide analysis of fitness-factors in uropathogenic Escherichia coli during growth in laboratory media and during urinary tract infections.

Uropathogenic Escherichia coli (UPEC) UTI89 is a well-characterized strain, which has mainly been used to study UPEC virulence during urinary tract infection (UTI). However, little is known on UTI89 key fitness-factors during growth in lab media and during UTI. Here, we used a transposon-insertion-sequencing approach (TraDIS) to reveal the UTI89 essential-genes for in vitro growth and fitness-gene-sets for growth in Luria broth (LB) and EZ-MOPS medium without glucose, as well as for human bacteriuria and mouse cystitis. A total of 293 essential genes for growth were identified and the set of fitness-genes was shown to differ depending on the growth media. A modified, previously validated UTI murine model, with administration of glucose prior to infection was applied. Selected fitness-genes for growth in urine and mouse-bladder colonization were validated using deletion-mutants. Novel fitness-genes, such as tusA, corA and rfaG; involved in sulphur-acquisition, magnesium-uptake, and LPS-biosynthesis, were proved to be important during UTI. Moreover, rfaG was confirmed as relevant in both niches, and therefore it may represent a target for novel UTI-treatment/prevention strategies.

Preoperative detection and evaluation of the need for psychological intervention in cancer and non-cancer patients referred to thoracic surgery.

OBJECTIVES: (a) to evaluate and compare the psychological treatment needs of patients with cancer and non-cancer, who are going to undergo scheduled thoracic surgery, and (b) evaluate and compare the diagnostic accuracy of the screening tests of psychological treatment needs for cancer and non-cancer patients. METHOD: The need for psychological treatment was evaluated in a total of 169 patients prior to thoracic surgery, through a clinical interview. The screening tests used were: the physician's judgment (yes/no), the Hospital Anxiety and Depression Scale (HADS) and, the single-item interview to assess depression "Do you feel depressed?" (DEPQ). RESULTS: The number of patients who needed psychological treatment in the total sample was 47 (27.81%), in non-cancer-patients: 22 (30.99%) and in cancer patients: 25 (25.51%). The participants with treatment needs were more often young women with primary education levels, with more fears and concerns regarding their disease. With respect to the screening tests, the HADS-T (cut-off point ≥13) obtained a sensitivity (SE) of 0.75 and Specificity (SP) of 0.81 in the total sample. In patients with cancer, the HADS total score (cut-off point ≥10) obtained an SE=0.84 and SP=0.80, and, in non-cancer patients, the HADS total score (cut-off point ≥13) showed an SE=0.59 and SP=0.84. The DEPQ and the physician's judgment did not achieve adequate levels of precision. CONCLUSIONS: A high percentage of patients have psychological treatment needs before performing thoracic surgery, which are similar for cancer and non-cancer patients. Preoperative detection of patients who need psychological intervention is feasible with a simple screening test: HADS, which achieves greater precision in cancer patients.

Revisión bibliográfica: alimentación vegetariana en la infancia y adolescencia / Vegetarian diet in childhood and adolescence

RESUMEN Introducción: la popularidad de las dietas vegetarianas y veganas está aumentando en países occidentales y son adoptadas por niños, niñas y adolescentes (NNyA). Las principales asociaciones de nutrición y dietética del mundo avalan este tipo de práctica alimentaria en estos grupos etáreos si son supervisados y acompañados por profesionales idóneos. Objetivo: tomar posicionamiento como Asociación Argentina de Dietistas y Nutricionistas Dietistas acerca de la implementación de dietas vegetarianas en edad pediátrica y adolescencia, considerando recomendaciones basadas en evidencias científicas. Materiales y método: revisión y actualización bibliográfica, no sistemática con búsquedas en Google Scholar, PudMed y Medline entre diciembre 2018 y marzo 2019. Resultados: la valoración nutricional, evaluando ingesta alimentaria utilizando recordatorio de 24 horas y frecuencia de consumo, orientará sobre cuáles son las potenciales deficiencias nutricionales que puede presentar para adecuar la dieta y/o suplementación de nutrientes específicos. La alimentación vegetariana tiene una densidad energética más baja que la no vegetariana, pero se logran alcanzar las recomendaciones. Las necesidades proteicas se satisfacen fácilmente cuando la dieta incluye variedad de alimentos y las calorías son adecuadas. Algunos autores sugieren aumentar un 10 a 15% la recomendación proteica. Además, considerar el aporte de ácidos grasos omega 3 (EPA y DHA) para lograr el equilibrio óptimo entre los ácidos grasos poliinsaturados omega3/omega6. Los requerimientos nutricionales de calcio no varían con respecto a los omnívoros. Es imprescindible suplementar vitamina B12 oral a todos los NNyA vegetarianos, incluso en ovolactovegetarianos o en NNyA que consuman habitualmente alimentos fortificados. La suplementación adecuada es la mejor forma de garantizar unos niveles óptimos de esta vitamina. Se recomienda evaluar el estado de la vitamina D suplementando según edad. Conclusiones: La Asociación Argentina de Dietistas y Nutricionistas Dietistas (AADYND) plantea que la alimentación vegetariana y/o vegana planificada, supervisada y suplementada por un profesional de la nutrición idóneo, son saludables en la niñez y adolescencia. Los profesionales de la alimentación y nutrición pueden desempeñar un papel clave en la educación y acompañamiento de las personas vegetarianas acerca de fuentes específicas de nutrientes, preparación de alimentos, y modificaciones dietéticas necesarias para satisfacer sus necesidades(AU)

ABSTRACT Introduction: the popularity of vegetarian and vegan diets is increasing in western countries and are adopted by children and adolescents (Ch&A). The main nutrition and dietetic associations in the world approve this type of dietary practice in these age groups if they are supervised and accompanied by qualified professionals. Objective: take a position as the Argentine Association of Dietitians and Dietitian Nutritionists about the implementation of vegetarian diets in pediatric and adolescent age, considering recommendations based on scientific evidence. Materials and Method: review and bibliographic update, non-systematic, with searches on Google Scholar, PudMed and Medline between December 2018 and March 2019. Results: The nutritional assessment, evaluating food intake using a 24-hour reminder and frequency of consumption, will provide guidance on what are the potential nutritional deficiencies that may come up, adapt the diet and/or supplementation of specific nutrients. The vegetarian diet has a lower energy density than the non-vegetarian diet but manages to meet the recommendations. Protein needs are easily met when the diet includes a variety of foods and calories are adequate. Some authors suggest increasing the protein recommendation by 10 to 15%. Considering the contribution of omega 3 fatty acids (EPA and DHA) to achieve the optimal balance between omega3/omega6 polyunsaturated fatty acids. The nutritional requirements of calcium do not vary with respect to omnivores. It is essential to supplement oral vitamin B12 to all vegetarian Ch&A, even in ovolactovegetarians or in Ch&A that habitually consume fortified foods. Proper supplementation is the best way to ensure optimal levels of this vitamin. It is recommended to evaluate the status of vitamin D by supplementing according to age. Conclusions: Argentine Association of Dietitians and Dietitian Nutritionists states that vegetarian and/or vegan food, planned, supervised and supplemented by a suitable nutrition professional, are healthy in childhood and adolescence. Food and nutrition professionals can play a key role in educating and mentoring vegetarians about specific sources of nutrients, food preparation, and dietary modifications necessary to meet their needs(AU)

Healthcare professionals' behaviour regarding the implementation of shared decision-making in screening programmes: A systematic review.

OBJECTIVE: To explore the barriers to and facilitators of healthcare professionals' implementation of SDM regarding screening programmes. METHOD: A systematic review was conducted in PubMed, Cochrane Library, CINHAL, and PsyscInfo. The barriers and facilitators identified were classified into three factors based on their origin: patients, healthcare system performance, and healthcare professionals themselves. RESULTS: Eight studies were selected: seven related to cancer screening. The most significant facilitators were literacy and interest in active participation, both of which have their origins in patients. The most significant barriers identified for the first time in a systematic review were legal conflict, lack of remuneration and lack of flexibility in clinical guidelines in screening programmes. CONCLUSION: The results of this study show that there are differences between barriers and facilitators for SDM when it is applied in the context of healthy people who perform preventive activities, particularly screening, in contrast to general medical consultation contexts. PRACTICAL IMPLICATIONS: The authors suggest that to advance in the practice of SDM, we need to develop and disseminate training documents. Further, SDM should be incorporated into clinical guidelines. There should be more studies focusing on healthcare professionals' behaviour within the context of the uncertainty of screening programmes.

Estrategias de marketing en sitios web de marcas de alimentos y bebidas consumidos por niños, niñas y adolescentes en la Argentina / Brand website marketing strategies for foods and beverages consumed by children and adolescents in Argentina

Internet permitió expandir la promoción de alimentos/bebidas a diferentes medios. El objetivo del estudio fue identificar las estrategias de marketing en sitios web de marcas de alimentos y bebidas consumidos por niños/as y adolescentes, y clasificarlos según las recomendaciones de las Guías Alimentarias para la Población Argentina.Se seleccionaron los alimentos/bebidas más consumidos por la población infantojuvenil según la Encuesta Alimentaria Nutricional de la Ciudad Autónoma de Buenos Aires. Se identificaron las páginas web de las marcas; se analizaron las estrategias de marketing y se clasificaron los alimentos/bebidas promocionados según las Guías.Se encontraron 80 páginas web, donde las estrategias más frecuentes fueron identificación de la marca, beneficios y declaraciones, y vínculos a páginas web y/o redes sociales. El 30 % de los sitios estaban dirigidos a niños/as/adolescentes, donde el 75 % de los alimentos/bebidas promocionados correspondieron al grupo de dulces y grasas, que incluye aquellos de bajo valor nutricional.

The Internet has allowed the expansion of food and beverage advertising in different media. The objective of this study was to identify the marketing strategies used in brand websites of foods and beverages consumed by children and adolescents, and classify them based on the Food Guidelines for the Argentinean Population.The foods and beverages most commonly consumed by the child and adolescent population as per the Survey on Nutritional Food Intake of the Autonomous City of Buenos Aires were selected. Brand websites were identified; marketing strategies were analyzed and marketed foods and beverages were classified based on the Guidelines.A total of 80 websites were found; the most common strategies were brand identity, benefits and claims, and links to websites and/or social media. Also, 30 % of sites were aimed at children and adolescents, and 75 % of marketed foods and beverages corresponded to the group of sweets and fats, including those of low nutritional value

Information needs and research priorities for fertility preservation in women with breast cancer: patients and experts' perspectives.

OBJECTIVE: To identify the information needs and research priorities that women with breast cancer (BC), their families and BC experts perceive on the fertility preservation. METHODS: We conducted two Delphi-based studies through three online rounds. The first was aimed to identify information and research needs; the second one to assess the importance of those needs and the third one to obtain consensus, defined as an interquartile range ≤2. RESULTS: The participation rate was 76.2% in study 1 and 53.7% in study 2. The most important information needs were the referral protocol, pregnancy options for women with BC, side effects of tamoxifen and menopause as a consequence of treatment. The most important research priorities were the participation of different health professionals to provide oncofertility information, referral protocols and efficacy and safety of FP options. CONCLUSION: Information about fertility preservation in the context of BC and different ways to get pregnant, considering risks and benefits, has emerged as an unmet need for patients and careers. The need for a participatory and coordinated approach to the provision of information on oncofertility has been agreed. Other research needs are described in an attempt to focus future research in the most necessary areas.

Measuring methods and advertisement planning: Uses of IMC / Métodos de medición y planeación publicitaria: usos de las comunicaciones integradas de marketing (CIM) / Métodos de planejamento e medição de publicidade: usos do IMC

ABSTRACT Given that one of the central elements in marketing spending is advertising, this study aims at analysing how the advertising planning process is influenced by the types of responses expected from the audience, the measurement methods used to assess advertising effectiveness and the expected results. This study was empirical and exploratory based on the application of a cross-sectional survey to 150 marketing managers of medium and large-sized companies in Colombia. The results show if organisations measure the level of compliance with the goals established in terms of IMC, they will make better decisions and allocate marketing budgets consistent with their objectives, resources and capabilities. As the results of the present study indicate, organisations can experience weaknesses in implementing measurement methods that guarantee the proper calculation of organisational results concerning advertising investment.

RESUMEN Dado que uno de los rubros protagonistas en el gasto de mercadeo es la publicidad, este estudio tiene por objetivo analizar cómo los tipos de respuestas esperados por parte de la audiencia, los métodos de medición utilizados para medir la eficacia publicitaria y los resultados esperados, influencian la planeación de la publicidad. Este estudio fue empírico exploratorio a partir de la aplicación de una encuesta de corte transversal a l50 gerentes de mercadeo de empresas medianas y grandes de Colombia. En los resultados se evidencia que los métodos de medición de la eficacia publicitaria no se relacionan de manera significativa con la gestión de la publicidad, lo cual dificulta la obtención de resultados fiables y limita la toma de decisiones organizacional.

RESUMO Dado que um dos principais itens dos gastos de marketing é a publicidade, este estudo tem como objetivo analisar como os tipos de respostas esperadas pelo público, os métodos de medição usados para medir a eficácia da publicidade e os resultados esperados influenciam o planejamento da publicidade. Este estudo foi empírico exploratório a partir da aplicação de uma pesquisa transversal a 150 gerentes de marketing de médias e grandes empresas da Colômbia. Os resultados mostram que os métodos de medir a eficácia da publicidade não estão significativamente relacionados ao gerenciamento da publicidade, o que dificulta a obtenção de resultados confiáveis e limita a tomada de decisão organizacional.

A Plasmid-Encoded FetMP-Fls Iron Uptake System Confers Selective Advantages to Salmonella enterica Serovar Typhimurium in Growth under Iron-Restricted Conditions and for Infection of Mammalian Host Cells.

The resistance plasmid pUO-StVR2, derived from virulence plasmid pSLT, is widespread in clinical isolates of Salmonella enterica serovar Typhimurium recovered in Spain and other European countries. pUO-StVR2 carries several genes encoding a FetMP-Fls system, which could be involved in iron uptake. We therefore analyzed S. Typhimurium LSP 146/02, a clinical strain selected as representative of the isolates carrying the plasmid, and an otherwise isogenic mutant lacking four genes (fetMP-flsDA) of the fetMP-fls region. Growth curves and determination of the intracellular iron content under iron-restricted conditions demonstrated that deletion of these genes impairs iron acquisition. Thus, under these conditions, the mutant grew significantly worse than the wild-type strain, its iron content was significantly lower, and it was outcompeted by the wild-type strain in competition assays. Importantly, the strain lacking the fetMP-flsDA genes was less invasive in cultured epithelial HeLa cells and replicated poorly upon infection of RAW264.7 macrophages. The genes were introduced into S. Typhimurium ATCC 14028, which lacks the FetMP-Fls system, and this resulted in increased growth under iron limitation as well as an increased ability to multiply inside macrophages. These findings indicate that the FetMP-Fls iron acquisition system exceeds the benefits conferred by the other high-affinity iron uptake systems carried by ATCC 14028 and LSP 146/02. We proposed that effective iron acquisition by this system in conjunction with antimicrobial resistance encoded from the same plasmid have greatly contributed to the epidemic success of S. Typhimurium isolates harboring pUO-StVR2.

Association of the prophage BTP1 and the prophage-encoded gene, bstA, with antivirulence of Salmonella Typhimurium ST313.

The prophage BTP1 is highly conserved among strains of the pathogenic lineage Salmonella Typhimurium ST313. We aimed to analyze the role of BTP1 and the gene bstA(BTP1-encoded) in virulence of S. Typhimurium D23580, the ST313 lineage 2 reference strain. The deletion mutant D23580ΔbstA showed significantly higher replication and survival rates within human-derived THP-1 macrophages than the wild-type (WT) strain, while the mutant isolate ΔBTP1, lacking the full prophage, did not significantly differ from the WT. Interestingly, during mice infection, ΔBTP1 yielded significantly higher counts in all tested organs [spleens, livers and mesenteric lymph nodes (MLN)] than the WT, and organs were significantly enlarged compared to WT-infected animals. D23580ΔbstA significantly outcompeted the WT during competitive infection of mice, and yielded significantly enlarged spleens and MLN compared to WT-infected animals during single strain infection. Moreover, increased cellular infiltration and focal necrosis were observed in the liver samples of mice infected with D23580ΔbstA and ΔBTP1 compared to WT-infected animals. In conclusion, removal of the gene bstA and the prophage BTP1 in S. Typhimurium D23580 led to increased virulence in mice, demonstrating that bstA is an antivirulence gene.

EQ-5D-5L utilities per health states in Spanish population with knee or hip osteoarthritis.

BACKGROUND: The objective of this study was to obtain utilities by means of EQ-5D-5L for different health states in patients with knee osteoarthritis (KOA) or hip osteoarthritis (HOA) in Spain, and to compare these values with those used in foreign studies with the aim of discussing their transferability for their use in economic evaluations conducted in Spain. METHODS: Primary study: Observational prospective study of KOA or HOA patients in Spain. Sociodemographic and clinical characteristics were collected to characterize the sample. Utilities were elicited using the EQ-5D-5L questionnaire. ANOVA and bivariable analyses were conducted to identify differences between health states. LITERATURE REVIEW: Using the bibliographic databases NSH EED and CEA Registry, we conducted searches of model-based cost utilities analyses of technologies in KOA or HOA patients. Health states and utilities were extracted and compared with values obtained from the Spanish sample. RESULTS: Three hundred ninety-seven subjects with KOA and 361 subjects with HOA were included, with average utilities of 0.544 and 0.520, respectively. In both samples, differences were found in utilities according to level of pain, stiffness and physical function (WOMAC) and severity of symptoms (Oxford scales), so that the worst the symptoms, the lower the utilities. The utilities after surgery were higher than before surgery. Due to limitations from our study related to sample size and observational design, it was not possible to estimate utilities for approximately half the health states included in the published models because they were directly related to specific technologies. For almost 100% of health states of the selected studies we obtained very different utilities from those reported in the literature. CONCLUSIONS: To our knowledge this is the first article with detailed utilities estimated using the EQ-5D-5L in Spain for KOA and HOA patients. In both populations, utilities are lower for worse health states in terms of level of pain, stiffness and physical function according to WOMAC, and according to the Oxford scales. Most utilities obtained from the Spanish sample are lower than those reported in the international literature. Further studies estimating utilities from local populations are required to avoid the use of foreign sources in economic evaluations.

Protein Carbonylation in Patients with Myelodysplastic Syndrome: An Opportunity for Deferasirox Therapy.

Control of oxidative stress in the bone marrow (BM) is key for maintaining the interplay between self-renewal, proliferation, and differentiation of hematopoietic cells. Breakdown of this regulation can lead to diseases characterized by BM failure such as the myelodysplastic syndromes (MDS). To better understand the role of oxidative stress in MDS development, we compared protein carbonylation as an indicator of oxidative stress in the BM of patients with MDS and control subjects, and also patients with MDS under treatment with the iron chelator deferasirox (DFX). As expected, differences in the pattern of protein carbonylation were observed in BM samples between MDS patients and controls, with an increase in protein carbonylation in the former. Strikingly, patients under DFX treatment had lower levels of protein carbonylation in BM with respect to untreated patients. Proteomic analysis identified four proteins with high carbonylation levels in MDS BM cells. Finally, as oxidative stress-related signaling pathways can modulate the cell cycle through p53, we analyzed the expression of the p53 target gene p21 in BM cells, finding that it was significantly upregulated in patients with MDS and was significantly downregulated after DFX treatment. Overall, our results suggest that the fine-tuning of oxidative stress levels in the BM of patients with MDS might control malignant progression.