"When I saw walking I just kind of took it as wheeling": interpretations of mobility-related items in generic, preference-based health state instruments in the context of spinal cord injury

Background : In health economic analyses, health states are typically valued using instruments with few items per dimension. Due to the generic (and often reductionist) nature of such instruments, certain groups of respondents may experience challenges in describing their health state. This study is concerned with generic, preference-based health state instruments that provide information for decisions about the allocation of resources in health care. Unlike physical measurement instruments, preference-based health state instruments provide health state values that are dependent on how respondents interpret the items. This study investigates how individuals with spinal cord injury (SCI) interpret mobility-related items contained within six preference-based health state instruments.

Methods : Secondary analysis of focus group transcripts originally collected in Vancouver, Canada, explored individuals’ perceptions and interpretations of mobility-related items contained within the 15D, Assessment of Quality of Life 8-dimension (AQoL-8D), EQ-5D-5L, Health Utilities Index (HUI), Quality of Well-Being Scale Self-Administered (QWB-SA), and the 36-item Short Form health survey version 2 (SF-36v2). Ritchie and Spencer’s ‘Framework Approach’ was used to perform thematic analysis that focused on participants’ comments concerning the mobility-related items only.

Results : Fifteen individuals participated in three focus groups (five per focus group). Four themes emerged: wording of mobility (e.g., ‘getting around’ vs ‘walking’), reference to aids and appliances, lack of suitable response options, and reframing of items (e.g., replacing ‘walking’ with ‘wheeling’). These themes reflected item features that respondents perceived as relevant in enabling them to describe their mobility, and response strategies that respondents could use when faced with inaccessible items.

Conclusion : Investigating perceptions to mobility-related items within the context of SCI highlights substantial variation in item interpretation across six preference-based health state instruments. Studying respondents’ interpretations of items can help to understand discrepancies in the health state descriptions and values obtained from different instruments. This line of research warrants closer attention in the health economics and quality of life literature.

Production de biodiesel à partir de microalgues par catalyses homogène et hétérogène

Résumé : Au Canada, près de 80% des émissions totales, soit 692 Mt eq. CO[indice inférieur 2], des gaz à effet de serre (GES) sont produits par les émissions de dioxyde de carbone (CO[indice inférieur 2]) provenant de l’utilisation de matières fossiles non renouvelables. Après la Conférence des Nations Unies sur les changements climatiques, COP21 (Paris, France), plusieurs pays ont pour objectif de réduire leurs émissions de GES. Dans cette optique, les microalgues pourraient être utilisées pour capter le CO[indice inférieur 2] industriel et le transformer en biomasse composée principalement de lipides, de glucides et de protéines. De plus, la culture des microalgues n’utilise pas de terre arable contrairement à plusieurs plantes oléagineuses destinées à la production de biocarburants. Bien que les microalgues puissent être transformées en plusieurs biocarburants tels le bioéthanol (notamment par fermentation des glucides) ou le biométhane (par digestion anaérobie), la transformation des lipides en biodiesel pourrait permettre de réduire la consommation de diesel produit à partir de pétrole. Cependant, les coûts reliés à la production de biodiesel à partir de microalgues demeurent élevés pour une commercialisation à court terme en partie parce que les microalgues sont cultivées en phase aqueuse contrairement à plusieurs plantes oléagineuses, ce qui augmente le coût de récolte de la biomasse et de l’extraction des lipides. Malgré le fait que plusieurs techniques de récupération des lipides des microalgues n’utilisant pas de solvant organique sont mentionnées dans la littérature scientifique, la plupart des méthodes testées en laboratoire utilisent généralement des solvants organiques. Les lipides extraits peuvent être transestérifiés en biodiesel en présence d’un alcool tel que le méthanol et d’un catalyseur (catalyses homogène ou hétérogène). Pour la commercialisation du biodiesel à partir de microalgues, le respect des normes ASTM en vigueur est un point essentiel. Lors des essais en laboratoire, il a été démontré que l’extraction des lipides en phase aqueuse était possible afin d’obtenir un rendement maximal en lipides de 36% (m/m, base sèche) en utilisant un prétraitement consistant en une ébullition de la phase aqueuse contenant les microalgues et une extraction par des solvants organiques. Pour l’estérification, en utilisant une résine échangeuse de cations (Amberlyst-15), une conversion des acides gras libres de 84% a été obtenue à partir des lipides de la microalgue Chlorella protothecoïdes dans les conditions suivantes : température : 120°C, pression autogène, temps de réaction : 60 min, ratio méthanol/lipides: 0.57 mL/g et 2.5% (m/m) Amberlyst-15 par rapport aux lipides. En utilisant ces conditions avec une catalyse homogène (acide sulfurique) et une seconde étape alcaline avec de l’hydroxyde de potassium (température : 60°C ; temps de réaction : 22.2 min; ratio catalyseur microalgue : 2.48% (m/m); ratio méthanol par rapport aux lipides des microalgues : 31.4%), un rendement en esters méthyliques d’acides gras (EMAG) de 33% (g EMAG/g lipides) a été obtenu à partir des lipides de la microalgue Scenedesmus Obliquus. Les résultats démontrent que du biodiesel peut être produit à partir de microalgues. Cependant, basé sur les présents résultats, il sera necessaire de mener d’autre recherche pour prouver que les microalgues sont une matière première d’avenir pour la production de biodiesel.

Propolis components accountable for bactericidal accomplishment and antibiofilm activity

This study aimed at evaluating antimicrobial and antibiofilm activity of phenolic compounds present in propolis ethanol extracts (PEE). Seventy per cent ethanol extracts from seven types of propolis, one Green, two Red and four Brown collected in four Brazilian States were prepared and total phenolics, flavonoids, tannins and anthocyanins were assessed by high-performance liquid chromatography (HPLC). Minimum bactericidal concentration (MBC) and inhibitor effect on Staphylococcus aureus biofilm formation and capacity to disrupt established biofilms were assessed towards eight S. aureus isolates from milk of small ruminants with mastitis, one methicillin-resistant S. aureus (MRSA) and S. aureus ATCC 25923. To evaluate different propolis components accountability for bactericidal accomplishment and antibiofilm activity, the results were analysed by the non-parametric Spearman coefficient. Results of phenolic compounds were 216,21 to 312,08 gallic acid milligram equivalent per extract gram (mg EGA/g) of total phenolics, 55,08 to 140,6 quercetin milligram equivalent per extract gram (mg EQ/g) of flavonoids, 118,51 to 3766,16 catechin milligram equivalent per extract gram (mg EC/g) of tannins and 1,03 to 8,39 milligram per extract gram (mg/g) of anthocyanins. Red1 and Red2 showed higher tannin contents, while Red2 exhibited superior amount of anthocyanins and total phenolics. Brown3 presented higher flavonoid quantity. Green, Red1 and Red2 PEE showed the lowest levels of flavonoids, but the higher antimicrobial activity. Most PEE exhibit bactericidal activity at a concentration of 1.6 mg/mL. Brown4 PEE showed the worst capacity to inhibit S. aureus. Green PEE showed to be the most efficient in both preventing and disrupting biofilm. All PEE studied exhibited a better inhibitory activity prior-to than post-biofilm formation. According to non-parametric Spearman correlation analysis, there seems to be a significant negative correlation between the ability to disrupt biofilm and both tannins and anthocyanins contents.

A low fermentable oligo-di-mono saccharides and polyols (FODMAP) diet reduced pain and improved daily life in fibromyalgia patients

Fibromyalgia (FM) is a chronic, rheumatic disease characterized by widespread myofascial pain, of unknown aetiology, having a major impact on quality of life (QOL). Available pharmacotherapy for FM is marginally effective. FM is associated with co-morbidities of gastrointestinal (GI) disorders and Irritable Bowel Syndrome (IBS). There is growing evidence that diets low in FODMAPs, “fermentable oligo-, di- or mono-saccharides and polyols” [Low FODMAP Diet (LFD)], are effective in treating IBS. The aim of this pilot study was to examine the effects of LFDs on symptoms of FM, especially with regard to pain, QOL and GI disorders. Methods A longitudinal study using LFD intervention was performed on 38, 51 ± 10 year-old, female patients diagnosed with FM for an average of 10 years, based on ACR (American College of Rheumatology) 2010 criteria. The study was conducted from January through May, 2015, using a four-week, repeated-assessment model, as follows: Moment 0 – introduction of the protocol to participants; Moment 1 – first assessment and delivery of individual LFD dietary plans; Moment 2 – second assessment and reintroduction of FODMAPs; Moment 3 – last assessment and final nutritional counselling. Assessment tools used were the following: RFIQ (Revised Fibromyalgia Impact Questionnaire), FSQ (Fibromyalgia Survey Questionnaire), IBS-SSS (Severity Score System), EQ-5D (Euro-QOL quality of life instrument), and VAS (Visual Analogue Scale). Daily consumption of FODMAPs was quantified based on published food content analyses. Statistical analyses included ANOVA, non-parametric Friedman, t-student and Chi-square tests, using SPSS 22 software. Results The mean scores of the 38 participants at the beginning of the study were: FSQ (severity of FM, 0–31) – 22 ± 4.4; RFIQ (0–100) – 65 ± 17; IBS-SSS (0–500) – 275 ± 101; and EQ-5D (0–100) – 48 ± 19. Mean adherence to dietary regimens was 86%, confirmed by significant difference in FODMAP intakes (25 g/day vs. 2.5 g/day; p < 0.01). Comparisons between the three moments of assessment showed significant (p < 0.01) declines in scores in VAS, FSQ, and RFIQ scores, in all domains measured. An important improvement was observed with a reduction in the severity of GI symptoms, with 50% reduction in IBS scores to 138 ± 117, following LFD therapy. A significant correlation (r = 0.36; p < 0.05) was found between improvements in FM impact (declined scores) and gastrointestinal scores. There was also a significant correlation (r = 0.65; p < 0.01) between “satisfaction with improvement” after introduction of LFDs and “diet adherence”, with satisfaction of the diet achieving 77% among participants. A significant difference was observed between patients who improved as compared to those that did not improve (Chi-square χ2 = 6.16; p < .05), showing that the probability of improvement, depends on the severity of the RFIQ score. Conclusions Implementation of diet therapy involving FODMAP restrictions, in this cohort of FM patients, resulted in a significant reduction in GI disorders and FM symptoms, including pain scores. These results need to be extended in future larger studies on dietary therapy for treatment of FM. Implications According to current scientific knowledge, these are the first relevant results found in an intervention with LFD therapy in FM and must be reproduced looking for a future dietetic approach in FM.

Effect of seasons on enteric methane emissions from cattle grazing Urochloa brizantha.

Abstract: The objective of this study was to evaluate the effect of seasons under a tropical climate on forage quality, aswell the effect of an Urochloa brizantha cv. Marandu grazing system on enteric methane (CH4) emissions fromNellore cattle in the Southeast region of Brazil. Sixteen Nellore steers (18 months old and initial weight 318.0 ± 116.59 kg of LW; final weight 469 ± 98.50 kg of LW) were used for a trial period of 10 months, with four collection periods in winter (August), spring (December), summer (February) and autumn (May). Each collection period consisted of 28 days, corresponding to the representative month of each season where the last six days were designed for methane data collection. Animals were randomly distributed within 16 experimental plots, distributed in four random blocks over four trial periods. CH4 emissions were determined using the sulphur hexafluoride (SF6) tracer gas technique measured by gas chromatography and fluxes of CH4 calculated. The forage quality was characterized by higher CP and IVDMD and lower lignin contents in spring, differing specially from winter forage. Average CH4 emissions were between 102.49 and 220.91 g d-1 (37.4 to 80.6 kg ani-1 yr-1); 16.89 and 30.20 g kg-1 DMI; 1.35 and 2.90 Mcal ani-1 d-1; 0.18 and 0.57 g kg-1 ADG-1 and 5.05 and 8.76% of GE. Emissions in terms of CO2 equivalents were between 4.68 and 14.22 g CO2-eq-1 g-1 ADG. Variations in CH4 emissions were related to seasonal effect on the forage quality and variations in dry matter intake.