New alternatives to holder pasteurization in processing donor milk in human milk banks.

Infectious and toxicological risks are the main potential hazards that operators of Human Milk Banks (HMBs) encounter and must eliminate. HMBs are trying to implement procedures that allow to manage and sanitize human milk without altering significantly its nutritional and biologically protective components, obtaining a product characterized by a valid balance between safety and biological quality. The history of human milk processing is linked to the origins of HMBs themselves. And although other forms of sterilization were used originally, pasteurization soon became the recognized most effective means for sanitizing milk: all the milk that arrives at the HMB must be pasteurized. Holder pasteurization (HoP) is the most used methodology, and it is performed using low temperature and long time (+62.5°C for 30 min). With HoP some bioactive milk components are lost to varying degrees, but many other precious bioactive compounds are completely or partially preserved. To improve the quality of human milk processed by HMBs, maintaining in the meantime the same microbiological safety offered by HoP, new technologies are under evaluation. At present, High-Temperature Short-Time pasteurization (HTST) and High-Pressure Processing are the most studied methodologies. HTST is already utilized in some HMBs for daily practical activity and for research purposes. They seem to be superior to HoP for a better preservation of some nutritional and biologically protective components. Freeze-drying or lyophilization may have advantages for room temperature storage and transportation. The aim of this study is to evaluate the advancement regarding the processing of DHM with a literature search from 2019 to 2022. The effects of the new technologies on safety and quality of human milk are presented and discussed. The new technologies should assure microbiological safety of the final product at least at the same level as optimized HoP, with an improved preservation of the nutritional and bioactive components of raw human milk.

Clinical Impact of Supplementation with Pasteurized Donor Human Milk by High-Temperature Short-Time Method versus Holder Method in Extremely Low Birth Weight Infants: A Multicentre Randomized Controlled Trial.

Nosocomial infections are a frequent and serious problem in extremely low birth weight (ELBW) infants. Donor human milk (DHM) is the best alternative for feeding these babies when mother's own milk (MOM) is not available. Recently, a patented prototype of a High-Temperature Short-Time (HTST) pasteurizer adapted to a human milk bank setting showed a lesser impact on immunologic components. We designed a multicentre randomized controlled trial that investigates whether, in ELBW infants with an insufficient MOM supply, the administration of HTST pasteurized DHM reduces the incidence of confirmed catheter-associated sepsis compared to DHM pasteurized with the Holder method. From birth until 34 weeks postmenstrual age, patients included in the study received DHM, as a supplement, pasteurized by the Holder or HTST method. A total of 213 patients were randomized; 79 (HTST group) and 81 (Holder group) were included in the analysis. We found no difference in the frequency of nosocomial sepsis between the patients of the two methods-41.8% (33/79) of HTST group patients versus 45.7% (37/81) of Holder group patients, relative risk 0.91 (0.64-1.3), p = 0.62. In conclusion, when MOM is not available, supplementing during admission with DHM pasteurized by the HTST versus Holder method might not have an impact on the incidence of catheter-associated sepsis.

Psychometric Evaluation of the Powe Fatalism Inventory (PFI).

Background and Purpose: Powe conceptually defined "cancer fatalism" and developed the Powe Fatalism Inventory (PFI) to operationalize cancer fatalism. Researchers report disparate underlying factor structures, and sparse evidence supports the validity and reliability of the PFI. Therefore, the purpose of this study was to examine the psychometric properties of the PFI. Specifically, we aimed to examine its (a) underlying dimensions, (b) internal consistency, and (c) construct validity. Methods: We recruited 400 post-menopausal women, 50-64 years old, for a study on mammographic breast density. Women completed the 15-item PFI and the 8-item Champion Breast Cancer Fear Scale (CBCFS). We conducted item analyses and exploratory factor analysis and evaluated different factor structures. We estimated internal consistency and conducted Pearson correlations between PFI and CBCFS scores to examine construct validity. Results: We found a two-factor solution. Factor 1, Predetermination, had an eigenvalue of 5.2 and explained 43% of the variance with factor loadings ranging from -0.59 to -0.83. Factor 2, Pessimism, had an eigenvalue of 4.5 and explained 15.2% of the variance with factor loadings ranging from 0.63 to 0.77. Both factors together explained 58.2% of the variance. There were no cross-loading items and no item loadings below 0.4. The two subscales both had alphas of .89. Cancer fatalism scores were positively related to fear scores (r =317, p < .001, 95% CI: .222, .406). Conclusion: Using PFI responses from postmenopausal women, we determined that the two-factor solution was the most parsimonious yet theoretically sound factor structure underlying the 15 items of the PFI. The subscales Predetermination (Factor 1; six items) and Pessimism (Factor 2; nine items) were internally consistent with the evidence of the construct validity.

Women's Health Beliefs and Intention to Use Chemoprevention for Breast Cancer.

OBJECTIVES: To investigate the associations between women's health beliefs and their intention to use chemoprevention. SAMPLE & SETTING: Participants were postmenopausal women (N = 400) aged 50-64 years who were recruited for a study on mammographic breast density. METHODS & VARIABLES: Participants completed a screening mammogram and breast cancer health belief questionnaires. The authors regressed intention to use chemoprevention onto health belief scores (breast cancer fatalism, fear, perceived threat, perceived benefits, barriers, and self-efficacy). RESULTS: Nearly half of the participants indicated that they would be interested in using chemoprevention if they were found to be at high risk for developing breast cancer. Women who reported higher perceived benefits of chemoprevention, higher perceptions of their ability to use chemoprevention (self-efficacy), and fewer logistic barriers to seeking health care had significantly higher intention to use chemoprevention. IMPLICATIONS FOR NURSING: Interventions aimed at reducing logistic barriers to health care may increase the uptake of chemoprevention among at-risk women. In addition, women at the time of mammography and women with higher levels of education may be motivated to consider using chemoprevention.

Associations of Dietary Intake and Nutrient Status with Micronutrient and Lipid Composition in Breast Milk of Donor Women.

The influence of the diet and nutritional status of milk donors on the nutritional composition of donor human milk (DHM) is unknown. The present study aimed to determine the nutritional profile of DHM and the associations between donors' dietary intake and nutritional status and the micronutrient and lipid composition in DHM. For this purpose, 113 donors completed a food frequency questionnaire, provided a five-day weighed dietary record, and collected milk for five consecutive days. Nutrient determinations in donors' erythrocytes, plasma, urine, and milk were performed. Multiple linear regressions were conducted for the evaluation of the associations. We highlight the following results: DHM docosahexaenoic acid (DHA) was positively associated with donors' plasma DHA content and donors' DHA intake (R2 0.45, p < 0.001). For every 1 g/day DHA intake, an increase of 0.38% in DHA content and 0.78% in total omega-3 content was observed in DHM (R2 0.29, p < 0.001). DHM saturated fatty acids were positively associated with erythrocyte dimethyl acetals, plasma stearic acid, trans fatty acids intake, and breastfeeding duration and negatively associated with erythrocyte margaroleic acid (R2 0.34, p < 0.01). DHM cholecalciferol was associated with plasma cholecalciferol levels and dairy intake (R2 0.57, p < 0.01). Other weaker associations were found for free thiamin, free riboflavin, pyridoxal, dehydroascorbic acid, and the lipid profile in DHM. In conclusion, the diet and nutritional status of donors influence the fatty acid profile and micronutrient content of DHM.

Human Milk Composition and Nutritional Status of Omnivore Human Milk Donors Compared with Vegetarian/Vegan Lactating Mothers.

Women of childbearing age in Western societies are increasingly adopting vegetarian diets. These women are sometimes rejected as milk donors, but little about the composition of their milk is known. The present study aimed to compare the intake, nutritional status, and nutritional composition of human milk from omnivore human milk donors (Donors) and vegetarian/vegan lactating mothers (Veg). Milk, blood, and urine samples from 92 Donors and 20 Veg were used to determine their fatty acid profiles, as well as vitamins and minerals. In a representative sample of both groups, we also determined the lipid class profile as a distribution of neutral and polar lipids, the molecular species of triacylglycerols, and the relative composition of phospholipids in their milk. A dietary assessment was conducted with a five-day dietary record (while considering the intake of supplements). We highlight the following results, expressed as the mean (SE), for the Veg vs. Donors: (1) Their docosahexaenoic acid (DHA) intake was 0.11 (0.03) vs. 0.38 (0.03) g/day; the plasma DHA was 0.37 (0.07) vs. 0.83 (0.06)%; and the milk DHA was 0.15 (0.04) vs. 0.33 (0.02)%. (2) Their milk B12 levels were 545.69 (20.49) vs. 482.89 (4.11) pM; 85% of the Veg reported taking B12 supplements (mean dose: 312.1 mcg/day); and the Veg group showed no differences with Donors in terms of total daily intake or plasma B12. (3) Their milk phosphatidylcholine levels were 26.88 (0.67) vs. 30.55 (1.10)%. (4) Their milk iodine levels were 126.42 (13.37) vs. 159.22 (5.13) mcg/L. In conclusion, the Vegs' milk was shown to be different from the Donors' milk, mainly due to its low DHA content, which is concerning. However, raising awareness and ensuring proper supplementation could bridge this gap, as has already been achieved for cobalamin.

Assessment of Iodine Concentration in Human Milk from Donors: Implications for Preterm Infants.

Preterm infants are particularly vulnerable to developing iodine deficiency. Donor human milk (DHM) is the preferred feeding option if the mother's own milk (MOM) is not available, but information on DHM iodine concentration (DHMIC) is lacking. Hence, we aimed to assess DHMIC to further evaluate the adequacy of iodine provision in preterm infants. Finally, associations that might influence DHMIC were studied. In 113 donors, we measured iodine intake by evaluating dietary records for five consecutive days with the DIAL® Software. From the second day of dietary record, donors provided human milk samples (at least one per day) for four consecutive days. Daily human milk samples were analyzed for DHMIC. A DHMIC ≥ 200 µg/L was considered an adequate iodine content for preterm infants. DHMIC and urine iodine concentration (UIC) were determined using ICP-MS. In our study, 83.2% of donors had a full-term infant. Breastfeeding time range was 1.5−49.4 months. During the dietary record, 55.8% took iodine-containing supplements, providing 40−200 µg/day of iodine. The medians (p25, p75) UIC and DHMIC were 112.4 (75.8, 160.1) and 148.5 (97.6, 206.1) µg/L, respectively. In this iodine-sufficient population, 70% had a DHMIC of <200 µg/L. Donors' intake of iodine-containing supplements was associated with higher DHMIC.

The relationship between cancer fatalism and education.

PURPOSE: Fatalism is defined by feelings of pessimism, hopelessness, and powerlessness regarding cancer outcomes. Early researchers reported associations between race and cancer fatalism. Yet current evidence suggests that social determinants of health are better predictors of cancer fatalism than race. Therefore, the aim of this study was to examine the association between age, race, education, and cancer fatalism. METHODS: Three hundred ninety (n = 390) women who attended a screening mammogram at the Joanne Knight Breast Health Center at Siteman Cancer Center at Washington University School of Medicine (St. Louis, MO) completed the Powe Fatalism Inventory (PFI), a 15-item self-report instrument used to operationalize cancer fatalism. We used Pearson's correlation, independent samples t-tests, one-way ANOVA with post hoc tests, and linear regression to analyze the relationships between PFI total scores and age, race, and education. RESULTS: There were no differences between the mean PFI scores for Non-Hispanic Whites (1.89, SD 0.55) and African Americans (2.02, SD 0.76, p = 0.092, 95% CI 0.27 to 0.02). We found significant differences between the mean PFI scores across levels of education. Women who attained a high school degree or less (n = 72) reported higher PFI scores (2.24, SD 0.77) than women who attended some college or post-high school vocational training (n = 111; 1.95, SD 0.61) and women with a college or postgraduate degree (n = 206; 1.83, SD 0.57). When PFI score was regressed onto age, race, and education, only education significantly explained fatalism (B = -0.19, p < 0.001). CONCLUSIONS: In this study, cancer fatalism did not differ between Non-Hispanic White and African American women attending a screening mammogram. However, lower educational levels were associated with higher cancer fatalism. The previously observed associations between race and cancer fatalism may be explained by racial disparities in social determinants of health, such as education. Importantly, study findings indicate that the people with the greatest need for cancer fatalism interventions are those with lower educational levels.

Nurse Counseling as Part of a Multicomponent Tobacco Treatment Intervention: An Integrative Review.

INTRODUCTION: Although tobacco use is widely recognized as a major cause of preventable morbidity and mortality, tobacco treatment remains challenging. PURPOSE: The purpose of this integrative review is to synthesize the research findings regarding multicomponent tobacco treatment interventions combining nurse counseling and nicotine replacement therapy (NRT). METHODS: Published literature from 1990 through April 2019 was searched using the databases PubMed, CINAHL, PsycINFO, and Scopus. We extracted data into a literature matrix to facilitate comparison across primary sources and make conclusions about this body of literature as a whole. FINDINGS: This integrative review includes 21 publications that investigated the effects of tobacco treatment interventions incorporating both nurse counseling and NRT. Articles were reviewed for quality indicators. RESULTS: The evidence from this set of studies indicates that nurse counseling is an effective intervention when combined with NRT. The most successful interventions included long-term face-to-face counseling with a nurse. In addition, interventions in which longer courses of NRT were offered for free or at subsidized rates were most successful at engendering smoking cessation. Moreover, interventions that maximized social support for participants attempting to quit smoking resulted in favorable outcomes. DISCUSSION: The findings can provide useful guidance regarding the designing and implementation of effective tobacco treatment interventions that incorporate various components. CONCLUSION: Nurse counseling augmented by additional effective tobacco treatment therapies including NRT leads to beneficial outcomes in smoking cessation. Future researchers should capitalize on this apparent synergistic relationship between multiple tobacco treatment components.

Clinical presentation and outcomes of hospitalized adults with COVID-19: A systematic review.

AIMS: The aims of this review were to: (a) determine the clinical presentation; and (b) outcomes of adult hospitalized patients with COVID-19 to provide practicing nurses with a cogent and concise clinical impression of COVID-19 patients. DESIGN: We conducted a systematic review of early published, peer-reviewed, original research where researchers presented data from adult hospitalized COVID-19 patients regarding their presenting signs, symptoms, and definitive survival outcomes. DATA SOURCES: We searched the databases PubMed, CINAHL, and Scopus for relevant articles published between 1 January 2020 -18 May 2020. REVIEW METHODS: We extracted data from each study and synthesized them across primary sources using a literature matrix table to provide a global impression of this rapidly growing body of literature. RESULTS: We retrieved 97 mainly descriptive observational studies. SARS-CoV-2 is efficiently transmitted between humans, particularly those in close contact. Symptomatic COVID-19 patients can present with a broad array of nonspecific symptoms. Fever and cough are the most commonly reported symptoms; some patients have atypical presentations. In patients with respiratory decompensation, disease progression can be rapid. Some patients experience mild symptoms that are self-limited; others experience organ failure and death. Risk factors for poor outcomes include older age, chronic medical conditions, male gender, obesity, and presenting with signs of declining respiratory status. CONCLUSION: Nurses can mitigate the spread of SARS-CoV-2 and sequelae of COVID-19 with prompt and capable responses. IMPACT: This study addresses the problem of the continued spread of SARS-CoV-2 while little is known about this virus. This review provides nurses with a summary of the most current evidence regarding the signs, symptoms, and outcomes of adult hospitalized COVID-19 patients that they might identify COVID-19 patients rapidly on presentation to medical care and be attuned to indicators of patient decompensation.

Association between meal intake behavior and blood pressure in Spanish adults

INTRODUCTION AND OBJECTIVES: Eating frequency has been suggested to modify blood pressure. Yet, the results are inconclusive, possibly because eating frequency, particularly meal intake behavior (MIB), does not differentiate between meals and snacks. Hence, the aim of this study was to examine the association between more specific MIBs, like the consumption of the three main meals, the intake of forenoon and afternoon meals and snacking between the regular meals, and systolic/diastolic blood pressure (SBP/DBP). METHODS: This cross-sectional study includes 1,314 Spanish adults aged 20-79 years. Data collection occurred during cardiovascular health day events organized in four Spanish cities (Madrid, Las Palmas, Seville and Valencia) in 2008. Linear regression analysis was performed to assess the independent association between the mentioned MIBs and SBP/DBP, controlling for several confounders in multiples models. RESULTS: After adjusting for sex, age and individual risk factors, having an afternoon meal was associated with lower SBP (ß -3.91, 95% CI [-6.33, -1.49]) and DBP (ß -2.35, 95% CI [-3.76, -0.94]). This association was attenuated when introducing dietary intake and waist circumference in the predictive models (SBP: ß -2.83, 95% CI [-5.25, -0.40]; DBP: ß -1.67, 95% CI [-3.04, -0.31]), although it still remained significant. None of the other investigated MIBs showed any associations with SBP/DBP. CONCLUSIONS: This study suggests that SBP/DBP might be reduced by the intake of an afternoon meal. However, population-based prospective studies are needed in order to confirm the consequences of the investigated associations on health.

Association between meal intake behavior and blood pressure in Spanish adults / Asociación entre conductas relacionadas con la ingesta de alimentos y tensión arterial en adultos españoles

Introduction and objectives: Eating frequency has been suggested to modify blood pressure. Yet, the results are inconclusive, possibly because eating frequency, particularly meal intake behavior (MIB), does not differentiate between meals and snacks. Hence, the aim of this study was to examine the association between more specific MIBs, like the consumption of the three main meals, the intake of forenoon and afternoon meals and snacking between the regular meals, and systolic/diastolic blood pressure (SBP/DBP). Methods: This cross-sectional study includes 1,314 Spanish adults aged 20-79 years. Data collection occurred during cardiovascular health day events organized in four Spanish cities (Madrid, Las Palmas, Seville and Valencia) in 2008. Linear regression analysis was performed to assess the independent association between the mentioned MIBs and SBP/DBP, controlling for several confounders in multiples models. Results: After adjusting for sex, age and individual risk factors, having an afternoon meal was associated with lower SBP (ß -3.91, 95% CI [-6.33, -1.49]) and DBP (ß -2.35, 95% CI [-3.76, -0.94]). This association was attenuated when introducing dietary intake and waist circumference in the predictive models (SBP: ß -2.83, 95% CI [-5.25, -0.40]; DBP: ß -1.67, 95% CI [-3.04, -0.31]), although it still remained significant. None of the other investigated MIBs showed any associations with SBP/DBP. Conclusions: This study suggests that SBP/DBP might be reduced by the intake of an afternoon meal. However, population-based prospective studies are needed in order to confirm the consequences of the investigated associations on health (AU)

Introducción y objetivos: evidencias sugieren que el número de ingestas alimentarias modifican la presión arterial. Sin embargo, los resultados encontrados no son concluyentes, probablemente debido a que esta conducta relacionada con la ingesta de alimentos (CRIA) no diferencia entre comidas y snacks. Este estudio examina la asociación entre CRIA más específicas como la realización de las tres comidas principales, de la media mañana, de la merienda y picar entre las comidas regulares, y la tensión arterial sistólica y diastólica (TAS y TAD). Métodos: es un estudio transversal, en el cual fueron incluidos 1.314 españoles (20-79 años). Los datos fueron recogidos en las Jornadas de Salud Cardiovascular en Madrid, Las Palmas, Sevilla y Valencia, durante el año 2008. Se aplicaron análisis de regresión lineal, controlando el efecto de diversos factores de confusión en múltiples modelos. Resultados: después de ajustar por sexo, edad y factores de riesgo individual, tomar la merienda se asoció directamente a menor TAS (ß -3,91, 95% CI [-6,33, -1,49]) y TAD (ß -2,35, 95% CI [-3,76, -0,94]). La introducción del consumo alimentario y la circunferencia de cintura en los modelos predictivos atenuó esta asociación (TAS: ß -2,83, 95% CI [-5,25, -0,40]; TAD: ß -1,67, 95% CI [-3,04, -0,31]). Ninguna de las otras CRIA investigadas mostró asociaciones con TAS y TAD. Conclusiones: el estudio sugiere que tanto la TAS como la TAD podrían verse reducidas mediante la ingesta de la merienda, aunque se requieren estudios adicionales para confirmar y profundizar en las consecuencias sobre la salud de las asociaciones investigadas (AU)

Lasing of surface-polished polycrystalline Ho: YAG (yttrium aluminum garnet) fiber.

A polycrystalline 1.5% Ho: YAG fiber with a diameter of 31 µm was prepared. Surface roughness from grain boundary grooving was reduced by polishing, which decreased the fiber scattering coefficient from 76 m-1 to 35 m-1. Lasing tests were done on this fiber with a SF57 Schott glass cladding. Lasing was confirmed by spectrum narrowing with threshold pump power lower than 500 mW and a slope efficiency of 7%. To our knowledge, this is the first lasing demonstration from a small diameter polycrystalline ceramic fiber.

Association between meal intake behaviour and abdominal obesity in Spanish adults.

The study aims to evaluate the association between abdominal obesity with meal intake behaviour such as having a forenoon meal, having an afternoon meal and snacking. This cross-sectional study includes n = 1314 participants aged 20-79 who were interviewed during the Cardiac health "Semanas del Corazon" events in four Spanish cities (Madrid, Las Palmas, Seville and Valencia) in 2008. Waist circumference, weight and height were assessed to determine abdominal obesity (waist circumference: ≥88 cm in women and ≥102 cm in men) and BMI, respectively. The intake of forenoon and afternoon meal and snacking between the participants' regular meals were assessed with a questionnaire that also included individual risk factors. The information obtained about diet was required to calculate an Unhealthy Habit Score and a score reflecting the Achievement of Dietary Guidelines. Adjusted logistic regressions were used to examine the association between abdominal obesity and the mentioned meal intake behaviour controlling for sex, age, individual risk factors, BMI and diet. Having an afternoon meal (OR 0.60; 95% CI (0.41-0.88)) was negatively associated with abdominal obesity after adjusting for all confounders, whereas the positive association of snacking (OR 1.39; 95% CI (1.05-1.85)) was not independent of BMI (OR 1.25; 95% CI (0.84-1.87)). Taking a forenoon meal did not show any associations (OR 0.92; 95% CI (0.63-1.34)) with abdominal obesity. The results obtained could be helpful in the promotion of healthy habits in nutritional education programmes and also in health programmes preventing abdominal obesity.

¿Cómo se asocian las conductas de consumo de alimentos con la ingesta de frutas y verduras en adultos españoles? / How are meal intake behaviours associated with the consumption of fruit and vegetables among Spanish adults?

Introducción: A pesar de la evidencia de que la ingesta de frutas y verduras es recomendable para la salud, el consumo de ambos grupos de alimentos no es adecuado en España. Objetivo: Identificar conductas de consumo de alimentos (CCA) que se asocien a un consumo recomendado de frutas (CRF) y verduras (CRV). Métodos: Durante las “Jornadas de Prevención en Salud” realizadas en cuatro ciudades de España en 2008, se recogieron datos de 1501 individuos (20-79 años) sobre distintas CCA como el número de comidas realizadas durante el día, comer algo a media mañana y en la merienda y comer entre las cinco comidas principales, así como sobre el consumo diario de raciones de frutas y verduras. Un consumo recomendado fue definido cuando se ingirieron más de una fruta y verdura al día, utilizándolos como variables dependientes en los análisis de regresión logística. Resultado: Tomar más de tres comidas diarias (OR 2.5; IC 95% 1.9-3.2), merendar (OR 2.0; IC 95% 1.5-2.6) y comer a media mañana (OR 1.7; IC 95% 1.3-2.3) se asocian con un CRF. Las probabilidades de un CRV aumenta con más de tres comidas diarias (OR 1.3; IC 95% 1.1-1.6) y comer a media mañana (OR 1.7; IC 95% 1.4-2.1). Las CCA estudiadas se asocian a un CRF y CRV, independientemente del sexo, edad y otros hábitos de vida. Conclusión: De forma que, incentivar la realización de más ingestas diarias, incluyendo consumos a media mañana y en la merienda, deberían ser promovidos en las acciones destinadas a la mejora del estado nutricional de la población española (AU)

Introduction: Despite the evidence that the intake of fruits and vegetables is a healthy habit, the consumption of both food groups is insufficient in Spain. Objective: The study aims to indentify meal intake behaviour (MIB) potentially associated with the recommended consumption of fruits (RCF) and vegetables (RCV). Methods: During the Cardiovascular Health events “Jornadas de Prevención en Salud” in four Spanish cities, we assessed MIB like the daily meal frequency, the intake of forenoon and afternoon meal and snacking between the five main meals, as well as information about the daily rations of fruit and vegetables, from 1501 Spanish adults aged 20-79 years. A recommended consumption was defined when more than one ration of fruit and vegetable were consumed per day and used as dependent variables in logistic regression. Results: Having more than three meals (OR 2.5; IC 95% 1.9-3.2), a forenoon meal (OR 1.7; IC 95% 1.3- 2.3) as well as having an afternoon meal (OR 2.0; IC 95% 1.5-2.6) were associated with the RCF. The probability of a RCV increased with the consumption of more than three meals per day (OR 1.3; IC 95% 1.1- 1.6) and having a forenoon meal (OR 1.7; IC 95% 1.4- 2.1). Our results were independent of sex, age and other lifestyle factors. Conclusion Therefore, the consumption of more than three meals, including a forenoon meal and an afternoon meal should be promoted to improve the nutritional status of the Spanish population (AU)

Associations between food consumption habits with meal intake behaviour in Spanish adults.

The aim of the present study is to explore the contribution of different types of meal intake behaviour on a healthy diet and seeks to find associations with food consumption habits. A cross-sectional survey with data from 1332 Spanish adults aged between 20 and 79 years was conducted. The survey was carried out during the cardiovascular health event 'Semanas del Corazon 2008' in four Spanish cities. Several food consumption habits such as the recommended intake of fruits, vegetables, milk and dairy products, as well as the regular consumption of fatty and salty food and ready-made meals, were used as dependent variables in logistic regression. We evaluated different meal intake behaviour such as the type of meals, snacking, and drinks taken with a meal. Our survey revealed that snacking is positively associated with the regular consumption of salty and fatty food, and having sugary drinks with meals was positively associated with the regular consumption of ready-made meals. Having a forenoon meal is positively associated with the consumption of two or more portions of milk and dairy products and vegetables, and taking an afternoon meal with the recommended intake of milk and dairy products and fruits. Drinking water during a meal increases the probability of consuming two or more portions of fruits and vegetables. Our results enhance the understanding of the contribution that meal intake behaviour makes to a healthy diet based on food consumption habits. This work provides an insight into eating behaviour and would make a useful contribution to interventions aimed at promoting healthier eating habits.

Surface modification of poly(hydroxybutyrate) films to control cell-matrix adhesion.

Tailoring surface properties of degradable polymer scaffolds is key to progress in various tissue engineering strategies. Poly(3-hydroxybutyrate) and poly(3-hydroxybutyrate-co-4-hydroxybutyrate) thin films were modified by low pressure ammonia plasma, low pressure water vapour plasma, or immersion in a sodium hydroxide solution to elaborate means to control the cell-matrix adhesion of human umbilical cord vein endothelial cells grown on these materials. Fibronectin (FN) heteroexchange and cell adhesion were correlated to the physicochemical characteristics of the modified polymer surfaces which were investigated by X-ray photoelectron spectroscopy (XPS), scanning force microscopy (SFM), electrokinetic measurements, and contact angle measurements. All treatments increased the hydrophilicity of the polymer samples, which could be accounted to newly created amine or carboxyl functionalities for ammonia plasma or water vapour plasma treatments, respectively, and ester hydrolysis for treatments with alkaline aqueous solutions. Main features of cell adhesion and FN reorganisation-evaluated after 1h and after 5 days-could be attributed to the anchorage strength of pre-coated FN layers at the polymer surface, which was, in turn found to be triggered by the type of modification applied. In line with earlier studies referring to different materials cell adhesion and matrix reorganisation were shown to be sensitively controlled through the physicochemical profile of poly(hydroxybutyrate) surfaces.

Fibronectin fibril pattern displays the force balance of cell-matrix adhesion.

Formation of fibrillar patterns of fibronectin on polymer substrates with gradated physicochemical surface properties was analysed during early stages of endothelial cell adhesion. Fibronectin was pre-adsorbed onto three maleic anhydride copolymer thin films with distinct differences in the protein adsorption strength as verified by heteroexchange experiments. The evolved micrometer scale fibrillar patterns of fibronectin on the compared polymer surfaces were characterized after 50 min of cellular reorganization by an auto-correlation analysis using fluorescence microscopy data. Statistical analysis revealed a decrease of the typical spacings of the fibronectin fibrils from 2.6 to 1.8 mum with decreasing fibronectin adsorption strength to the substrate. Size and density of focal adhesions correlated with this dependence of the fibronectin fibril pattern. From these data a model was developed relating the fibronectin fibril pattern to the fibronectin-substrate adsorption strength through the cytoskeletal force regulation mechanism of the cell.

Expression of GRP and its receptor in well-differentiated colon cancer cells correlates with the presence of focal adhesion kinase phosphorylated at tyrosines 397 and 407.

Gastrin-releasing peptide (GRP) and its receptor (GRP-R) are not normally expressed by epithelial cells lining the colon but are aberrantly expressed in cancer, where they act as morphogens and regulate tumor cell differentiation. Studies of colon cancer formation in mice genetically incapable of synthesizing GRP-R suggested that this receptor's morphogenic properties were mediated via focal adhesion kinase (FAK). We therefore set out to determine the presence of both total and phosphorylated forms of FAK in human colon cancer specimens as a function of tumor cell differentiation and GRP/GRP-R co-expression. Ten colon cancers containing 25 regions of distinct differentiation were randomly selected from our GI Cancer Tumor Bank. All specimens were immunohistochemically probed using antibodies recognizing GRP, GRP-R, total FAK, and FAK specifically phosphorylated at tyrosine (Y) 397, 407, 576, 577, 861, and 925. Antibody-specific chromogen was determined by quantitative immunohistochemistry (IHC) for each region of defined differentiation. Here we confirm that GRP/GRP-R co-expression is a function of differentiation, with highest levels observed in well-differentiated tumor cells. We also show that the amount of total FAK and of FAK phosphorylated at Y397 and Y407 tightly correlates with differentiation and with the amount of GRP/GRP-R co-expression. These findings are consistent with GRP/GRP-R acting as a morphogen by activating FAK, and suggest that this occurs via phosphorylation of this enzyme at two specific tyrosine residues.