Enriched Red Wine: Phenolic Profile, Sensory Evaluation and In Vitro Bioaccessibility of Phenolic Compounds.

The beneficial health effect of red wine depends on its phenolic content and the phenolic content in red wines is affected by ecological, agricultural, and enological practices. Enriched wines have been proposed as an alternative to increase the phenolic content in wines. Nevertheless, phenolic compounds are related to the sensory characteristics of red wines, so enrichment of red wines requires a balance between phenolic content and sensory characteristics. In the present study, a Merlot red wine was enriched with a phenolic extract obtained from Cabernet Sauvignon grape pomace. Two levels of enrichment were evaluated: 4 and 8 g/L of total phenolic content (gallic acid equivalents, GAE). Wines were evaluated by a trained panel to determine their sensory profile (olfactive, visual, taste, and mouthfeel phases). The bioaccessibility of phenolic compounds from enriched red wines was evaluated using an in vitro digestive model and phenolic compounds were quantified by High Performance Liquid Chromatography coupled to tandem mass spectrometry (HPLC-MS/MS). Enrichment increased mainly flavonols and procyanidins. Such an increase impacted astringency and sweetness perceived by judges. This study proposes an alternative to increase the phenolic content in wines without modifying other main sensory characteristics and offers a potential beneficial effect on the health of consumers.

Semi-Targeted Ultra-High-Performance Chromatography Coupled to Mass Spectrometry Analysis of Phenolic Metabolites in Plasma of Elderly Adults.

A group of 23 elderly persons was given functional meals (a beverage and a muffin) specially formulated for the prevention of sarcopenia (age-related loss of muscle mass). Plasma samples were taken at the beginning of the intervention and after 30 days of consuming the functional meals. A semi-targeted ultra-high-performance chromatography coupled with tandem mass (UPLC-MS/MS) analysis was carried out to identify phenolic compounds and their metabolites. Plasma proteins were precipitated with ethanol and the samples were concentrated and resuspended in the mobile phase (1:1 acetonitrile: water) before injection into the UPLC-MS/MS instrument. Separation was carried out with a C18 reverse-phase column, and compounds were identified using their experimental mass, isotopic distribution, and fragment pattern. Compounds of interest were compared to those of data banks and the internal semi-targeted library. Preliminary results showed that the major metabolites identified after the intervention were phenylacetic acid, glycitin, 3-hydroxyphenylvaleric acid, and gomisin M2.

Concordance between two intrapersonal psychological resilience scales: how should we be measuring resilience?

BACKGROUND: While resilience has generated a lot of interest in mental health, operationalizing the construct of resilience remains an important challenge. This study aims to evaluate the concordance of two resilience scales that evaluate intrapersonal aspects of resilience in adolescents. METHODS: Cross-sectional evaluation of internal consistency, concordance, and correlation of the Individual Protective Factors Index Questionnaire (IPFI) and the Adolescent Resilience Scale (ARS) in sixth grade students of three low-income public schools in Colombia. RESULTS: 325 adolescents (41.5% female) participated in the study (72.5% response rate). Mean age was 12.1 years (standard deviation [SD]: 1.04). Of a possible score from 1-4, the mean adjusted IPFI score was 3.3 (SD: 0.3; Cronbach's alpha: 0.87). Of a possible score from 21-105, the total ARS score was 76.4 (SD 13.0; Cronbach's alpha: 0.82); both distributions were non-normal and left-skewed. The Lin's concordance correlation coefficient was 0.34 and the Spearman correlation coefficient was 0.52 (p-value < 0.0001 for both). Notably, 10 adolescents (3.1% of the sample) had a score in the lowest quartile in one of the two instruments, and a score in the highest quartile in the other instrument. CONCLUSIONS: There was low concordance between the scales, with notable lack of overlap in who was identified as having "low" levels of resilience. To better elucidate and operationalize the construct of resilience, studies using resilience scales should consider greater focus in understanding what aspects of the construct are being measured and how they relate to meaningful variables (well-being, risk of illness, etc.).

Cardioprotective effect of red wine and grape pomace.

Several studies have related moderate consumption of red wine with prevention of cardiovascular diseases (CVD). According to epidemiological studies, those regions with high consumption of red wine and a Mediterranean diet show a low prevalence of CVD. Such an effect has been attributed to phenolic compounds present in red wines. On the other hand, by-products obtained during winemaking are also a significant source of phenolic compounds but have been otherwise overlooked. The cardioprotective effect of red wine and its byproducts is related to their ability to prevent platelet aggregation, modify the lipid profile, and promote vasorelaxation. Phenolic content and profile seem to play an important role in these beneficial effects. Inhibition of platelet aggregation is dose-dependent and more efficient against ADP. The antioxidant capacity of phenolic compounds from red wine and its by-products, is involved in preventing the generation of ROS and the modification of the lipid profile, to prevent LDL oxidation. Phenolic compounds can also, modulate the activity of specific enzymes to promote NO production and vasorelaxation. Specific phenolic compounds like resveratrol are related to promote NO, and quercetin to inhibit platelet aggregation. Nevertheless, concentration that causes those effects is far from that in red wines. Synergic and additive effects of a mix of phenolic compounds could explain the cardioprotective effects of red wine and its byproducts.

"It's a Race Against the Clock": A Qualitative Analysis of Barriers to Legal Abortion in Bogotá, Colombia.

CONTEXT: In 2006, the Colombian Constitutional Court issued a decision largely decriminalizing abortion; however, illegal abortion persists. Understanding the barriers that cause women to resort to unsafe, illegal abortions could help improve access to legal services. METHODS: In-depth interviews were conducted in 2014 with 17 women aged 18 or older who had had legal abortions in the past year in Bogotá, Colombia, to identify barriers to abortion access and elucidate the ways in which these barriers affect women's decision making regarding abortion. Interview transcripts were coded and analyzed using standard techniques to find patterns, parallels and differences; a phenomenological approach guided the thematic analysis. RESULTS: Barriers related to knowledge and information, along with logistic, emotional, financial, cultural and religious barriers culminated in delays in obtaining comprehensive abortion services. Religion influenced social stigma, which manifested most powerfully in the obstructive behavior of health care providers and health insurance companies. Lack of understanding of current laws on abortion and conscientious objection was evident on the part of patients, health care providers and insurers. CONCLUSION: Dissemination of accurate information regarding the availability of clinical and legal abortion is needed. Better training may help physicians, nurses and insurance company personnel understand their roles and legal responsibilities in abortion care and reduce delays in women's access to services.

Reliability of the BI-RADS Final Assessment Categories and Management Recommendations in a Telemammography Context.

PURPOSE: The aim of this study was to evaluate the intradevice and interdevice reliability of four alternatives for telemammography-computed radiography, printed film, a film digitizer, and a digital camera-in terms of interpretation agreement when using the BI-RADS® lexicon. METHODS: The ethics committee of the authors' institution approved this retrospective study. A factorial design with repeated measures with 1,960 interpretations was used (70 patients, seven radiologists, and four devices). Reliability was evaluated using the κ coefficient for intradevice and interdevice agreement on malignancy classification and on BI-RADS final assessment category. RESULTS: Agreement on malignancy classification was higher than agreement for BI-RADS final assessment category. Interdevice agreement on malignancy classification between the film digitizer and computed radiography was ranked as almost perfect (P < .001), whereas interdevice agreement for the other alternatives was ranked as substantial (P < .001), with observed agreement ranging from 85% to 91% and κ values ranging from 0.70 to 0.81. Interdevice agreement on BI-RADS final assessment category was ranked as substantial or moderate (P < .001), with observed agreement ranging from 64% to 77% and κ values ranging from 0.52 to 0.69. Interdevice agreement was higher than intradevice agreement. CONCLUSIONS: The results of this study show very high interdevice agreement, especially for management recommendations derived from malignancy classification, which is one of the most important outcomes in screening programs. This study provides evidence to suggest the interchangeability of the devices evaluated, thereby enabling the provision of low-cost medical imaging services to underserved populations.

Noninferiority and Equivalence Evaluation of Clinical Performance among Computed Radiography, Film, and Digitized Film for Telemammography Services.

Objective. The aim of this study was to evaluate and compare the clinical performance of different alternatives to implement low-cost screening telemammography. We compared computed radiography, film printed images, and digitized films produced with a specialized film digitizer and a digital camera. Material and Methods. The ethics committee of our institution approved this study. We assessed the equivalence of the clinical performance of observers for cancer detection. The factorial design included 70 screening patients, four technological alternatives, and cases interpreted by seven radiologists, for a total of 1,960 observations. The variables evaluated were the positive predictive value (PPV), accuracy, sensitivity, specificity, and the area under the receiver operating characteristic curves (AUC). Result. The mean values for the observed variables were as follows: accuracy ranged from 0.77 to 0.82, the PPV ranged from 0.67 to 0.68, sensitivity ranged from 0.64 to 0.74, specificity ranged from 0.87 to 0.90, and the AUC ranged from 0.87 to 0.90. At a difference of 0.1 to claim equivalence, all alternatives were equivalent for all variables. Conclusion. Our findings suggest that telemammography screening programs may be provided to underserved populations at a low cost, using a film digitizer or a digital camera.

"The Fetus Is My Patient, Too": Attitudes Toward Abortion and Referral Among Physician Conscientious Objectors in Bogotá, Colombia.

CONTEXT: In 2006, the Colombian Constitutional Court partially decriminalized abortion. However, barriers to access, including improper use of conscientious objection, remain. METHODS: To explore conscientious objection from the objectors' perspectives, in-depth interviews were conducted in 2014 with 13 key informants and with 15 Colombian physicians who self-identified as conscientious objectors. Recruitment included snowball and purposive sampling techniques. Analysis was conducted in tandem with data collection and focused on objectors' attitudes, beliefs and behaviors related to abortion and referral. RESULTS: Objectors had varied perspectives. Three types of objectors were evident: extreme, moderate and partial. Extreme objectors refused to perform abortions or make referrals, and often lectured their patients; they also provided misleading or false medical and legal information, preventing women from accessing abortions to which they were legally entitled. Moderate objectors would not perform abortions, but respected their patients and viewed referral as a way to save "one out of two" lives. Partial objectors performed some abortions but refused to do others on the basis of gestational age or case-by-case circumstances. Across the typology, objectors linked conscientious objection with medical ethics, and many described a duty to protect the fetus, which they conceptualized as a patient. CONCLUSION: Conscientious objectors exhibit diverse opinions and behaviors. Potential areas for future investigation include identifying factors that lead objectors to refer and estimating the prevalence of each type of objector. Results suggest potential interventions that could reduce the role of conscientious objection as a barrier to care.