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Background: Alzheimer's disease (AD) is the most frequent cause of cognitive impairment. Community knowledge of the disease has proven to be a very important aspect of the development of interventions and the evaluation of their effectiveness. However, it is necessary to have standardized and recognized tools in different languages. The aim of the current study was to develop a cross-cultural adaptation of the Spanish Dementia Knowledge Assessment Scale (DKAS-S) and to assess their psychometric properties with cohorts of health students and professional and non-professional caregivers of AD patients from several regions of Spain.Methods: We developed and translated the DKAS into Spanish following the forward-back-forward translation procedure. Then, we performed a cross-sectional study to assess the validity, reliability and feasibility of the DKAS-S. We also performed an analysis to obtain test-retest reliability measures. The study was performed in four medical centres across three regions in Spain. From May to September 2019, we administered the scale to students, professional and non-professional caregivers; including a subgroup of non-professional caregivers of patients with early-onset AD (< 65 years).Results: Eight hundred forty-six volunteer participants completed the DKAS-S: 233 students (mean age 26.3 ± 9.2 years), 270 professional caregivers (mean age 42.5 ± 11.7 years) and 343 non-professional caregivers of AD patients. (mean age was 56.4 ± 13.16). The DKAS-S showed good internal consistency (Cronbach's α = 0.819) and good test-retest reliability (time 1: 28.1 ± 8.09 vs time 2: 28.8 ± 7.96; t = - 1.379; p = 0.173). Sensitivity to change was also significant in a subgroup of 31 students who received education related to AD and dementias between each administration (time 1: 25.6 ± 6.03) to (time 2: 32.5 ± 7.12; t = - 5.252, p = 0.000). The validity of the construct was verified by confirmatory factor analysis, although there were challenges in the inclusion of some items in the original 4 factors.Conclusions: The 25-item DKAS-S showed good psychometric properties for validity and reliability and the factorial analysis when it was administered to a population of students and professional and non-professional caregivers. It was a useful instrument for measuring levels of knowledge about dementia in Spanish population. [ABSTRACT FROM AUTHOR]

Background and purpose: The COVID‐19 epidemic is affecting almost all individuals worldwide, and patients with Alzheimer's disease (AD) and amnesic mild cognitive impairment (MCI) are particularly at risk due to their characteristics and age. We analysed the impact of the pandemic on these patients' neuropsychiatric symptoms and their quality of life after 5 weeks of lockdown in Spain. Methods: A total of 40 patients with a diagnosis of MCI (n = 20) or mild AD (n = 20) from the Cognitive Stimulation Program of the Cognitive Disorders Unit were evaluated. All patients had undergone a previous evaluation during the month before the lockdown, and were re‐evaluated after 5 weeks of lockdown. The Neuropsychiatric Inventory (NPI) and EuroQol‐5D questionnaire (EQ‐5D) were used to assess neuropsychiatric symptoms in patients and the quality of life in patients as well in caregivers. Results: The mean (SD) total baseline NPI score was 33.75 (22.28), compared with 39.05 (27.96) after confinement (P = 0.028). The most frequently affected neuropsychiatric symptoms were apathy [4.15 (3.78) vs. 5.75 (4.02); P = 0.002] and anxiety [3.95 (3.73) vs. 5.30 (4.01); P = 0.006] in patients with MCI, and apathy [2.35 (2.70) vs. 3.75 (3.78); P = 0.036], agitation [0.45 (1.14) vs. 1.50 (2.66); P = 0.029] and aberrant motor behaviour [1.25 (2.86) vs. 2.00 (2.93); P = 0.044] in patients with AD. We did not observe differences in EQ‐5D scores during the re‐evaluation. The 30% of patients and 40% of caregivers reported a worsening of the patients' health status during confinement. Conclusions: The results of this study show the worsening of neuropsychiatric symptoms in patients with AD and MCI during 5 weeks of lockdown, with agitation, apathy and aberrant motor activity being the most affected symptoms. [ABSTRACT FROM AUTHOR]

Abstract: Intramuscular, subcutaneous and kidney knob fat depot fatty acid profiles were studied in 104 male suckling kids from seven Spanish breeds: Blanca Andaluza, Blanca Celtibérica, Moncaína, Negra Serrana-Castiza, Pirenaica, Malagueña and Murciano-Granadina. Kids were raised in the traditional production system on mother''s milk and slaughtered at around 7kg live weight. Differences were observed between dairy (Malagueña) and meat breeds (Blanca Andaluza, Blanca Celtibérica, Moncaína, Negra Serrana-Castiza, and Pirenaica). Malagueña showed higher monounsaturated and conjugated linoleic fatty acid levels than the other breeds. Highest percentages of saturated fatty acids were observed in meat breeds. For intramuscular fat depot, the range for desirable fatty acids was 66.16–72.27% was. The influence of breed on fatty acid profiles of intramuscular, subcutaneous and kidney knob fat depots studied was evident. Intramuscular fat depot is proposed as a differentiating factor between dairy and meat breed goat kids, but not between meat breed kids. [Copyright &y& Elsevier]

Abstract: A stochastic simulation model was used to assess the effects of diverse management strategies on beef herds under mountain conditions in the Spanish Pyrenees. Animals grazed on different seasonal resources (valley meadows, forest pastures and mountain pastures) and were fed with forages and concentrates during winter. The simulated management strategies were winter calving (WC, weaning at 180days), autumn calving (AC, weaning at 160days), 8-month calving (8MC, weaning at 180days), and two calvings in 3 years, with weaning taking place at either 170days of age (2C3Y) or at 9months (2C3Y9M). Each strategy was tested for two types of production systems: (i) cow–calf farms that market calves just after weaning; and (ii) cow–calf/finishing farms that fatten the animals by means of an intensive feeding system until achieving a suitable weight for slaughter. A herd of 100 cows was simulated over 15years, but only data obtained after reaching the steady state (year 6) was used in the analysis. The strategies were evaluated by considering reproductive, productive and economic performance. The percentages of pregnant cows at the end of the mating season were highest for 8MC, 2C3Y and 2C3Y9M (between 92% and 94%). The percentage was intermediate for AC (88%) and lowest for WC (78%), which also showed greater variability between years. The two strategies that extensified management (2C3Y, 2C3Y9M) produced, as expected, a lower number of calves weaned per year (59 and 60), whereas this figure was the highest for 8MC (90). Although AC and 8MC resulted in higher productive performances, the increased labour requirements and winter feeding costs resulted in low economic margins for these strategies, which also meant poorer utilization of natural resources. In economic terms, WC was the best strategy for cow–calf/finishing farms, whereas 2C3Y was the worst of the two types of production systems, although it resulted in the most intense utilization of grazing resources. The long lactating period of 2C3Y9M did not affect the reproductive performance of cows, so this strategy yielded the highest economic margin at weaning. The extensification strategies (2C3Y and 2C3Y9M) were less sensitive to changes in the price of feedstuffs. The information obtained from the simulation of the different strategies is useful for evaluating the possible trade-offs between production, economics, use of natural resources and labour requirements. [Copyright &y& Elsevier]

A total of 120 Iberian pigs of the Lampiña line that grew under outdoor conditions were used to study the effect of the age at the beginning of Montanera period (AM) on meat characteristics and fatty acid (FA) profile of subcutaneous fat. AM period is a free-range fattening phase from November to February in which pigs ate mainly acorns and grass. There were two treatments with two AM (20 pigs per treatment); 18 (P18) and 12 months (P12). Barrows and gilts were in the same proportion within each treatment. All the animals were slaughtered at the same time (at the end of Montanera period) reaching an average 160 kg of body weight. Meat from P18 had less protein and was more red (a*) ( P,0.05), but tended to show higher intramuscular fat content (P<0.10) than meat from P12. Loin from P18 had lower thawing (P<0.001) and cooking losses (P<0.10) than loin from P12. The fat from P18 had higher monounsaturated FA content than fat from P12 pigs (P<0.01) due to the higher level of C18:1 (P<0.01) and C20:1 (P<0.001). However, fat from P12 had higher polyunsaturated FA content than fat from P18 pigs (P<0.01) because of the higher level of C18:2 (P<0.001). It is concluded that both 12 and 18 months are adequate AM for purebred Iberian pigs from the commercial point of view. However, if the aim is to produce high-quality dry-cured Iberian products, the P18 pigs would be more advisable because had better meat and fat characteristics than the P12 pigs. [ABSTRACT FROM AUTHOR]

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The role of consumers' culinary skills on purchasing cues of pork, with emphasis on niche demands (outdoor husbandry and/or certified organic), was assessed in cross-country regions of Spain (Catalonia and Aragon) and Portugal (North). A sample of 974 respondents answered an on-line survey with questions regarding consumer purchasing habits, product involvement and intrinsic and credence attributes. They also chose between two contrasting boneless pork loins and express willingness to pay (WTP) for different product scenarios with different pig farm facilities and for organic pork standards. Two optimal segments were identified based on food-related habits: 'uninvolved' and 'innovative cook lovers', both similarly balanced across socio-demographics, score for credence attributes or consumer involvement dimensions. Overall mean WTP premium across countries was 11.8% for marbled pork, 20.0% for outdoor pork and 24.3% for organic logo stamp. Credence cues of pork claiming health issues (absence of antibiotics and hormone residues) rather than consumers' culinary skills defined the WTP for niche pork in these regions. • Two optimal segments were identified based on food-related habits. • 'Uninvolved' and 'innovative cook lovers' scored similarly credence cues of pork. • The respondents preferred purchasing the marbled over lean pork loin. • Credence cues claiming health issues defined the WTP for niche pork. • The overall mean WTP premium was 24.3% for organic logo stamp. [ABSTRACT FROM AUTHOR]

Abstract: In this study, a total of 163 young-bull carcasses belonging to seven Spanish native beef cattle breeds showing substantial carcass variation were photographed in order to obtain digital assessments of carcass dimensions and profiles. This dataset was then analysed using machine learning (ML) methodologies to ascertain the influence of carcass profiles on the grade obtained using the SEUROP system. To achieve this goal, carcasses were obtained using the same standard feeding regime and classified homogeneous conditions in order to avoid non-linear behaviour in grading performance. Carcass weight affects grading to a large extent and the classification error obtained when this attribute was included in the training sets was consistently lower than when it was not. However, carcass profile information was considered non-relevant by the ML algorithm in earlier stages of the analysis. Furthermore, when carcass weight was taken into account, the ML algorithm used only easy-to-measure attributes to clone the classifiers decisions. Here we confirm the possibility of designing a more objective and easy-to-interpret system to classify the most common types of carcass in the territory of the EU using only a few single attributes that are easily obtained in an industrial environment. [Copyright &y& Elsevier]

Background: The high prevalence and long-term use of benzodiazepines (BZDs) treatment are debated topics because of the risk they can cause to the patients. Despite the current information on the risk-benefit balance of these drugs, their consumption remains particularly high. We determined the trend in the consumption prevalence of benzodiazepines (BZDs) and drugs related to BZDs (Z-drugs) in the population of the Health Region of Lleida to explore patterns of use and the associated characteristics associated between 2002 and 2015., Methods: An analysis of secular trends was carried out between 2002 and 2015; the databased included all individuals from the Health Region of Lleida, which had 358,157 inhabitants in 2015, that consumed BZDs. The consumption of BZDs was evaluated using prescription billing data from the Public Health System. All types of BZDs and BZD analogues that had been approved by the drug agency were included. Trends by age and sex were investigated., Results: Over the whole study period, a total of 161,125 individuals accounted for 338,148 dispensations. Overall, 59% were women, and the mean age was 56 years. The dispensing prevalence of BZDs use in 2015 was 14.2% overall -18.8% in women and 9.6% in men-and was 36% in those over 65 years. According to the half-life of BZDs, the prevalence of short-intermediate BZD use, intermediate-long BZD use, and Z-drugs use was 9.7, 5.5 and 0.8%, respectively. The evolution of the annual prevalence of BZD dispensing showed a progressive decline, from 15.3% in 2002 to 14.2% in 2015, which was attributed to a decrease in the consumption of intermediate-long half-life BZDs (8.0% vs. 5.5%) and Z-drugs (1.4% vs. 0.8%)., Conclusion: The dispensing prevalence of BZDs and Z-drugs was high, although a small reduction was observed during this time period. The dispensing prevalence was especially high in the population over 65, despite the risk of cognitive decline and falls. Integral actions are required to lower the BZD prescription rate.

Objective: To assess the prevalence of obstructive sleep apnea (OSA) in patients with mild-moderate Alzheimer's Disease (AD) and to evaluate cognitive characteristics according to the severity of OSA., Methods: Patients with mild-moderate AD, recruited prospectively from a cognitive impairment unit, underwent overnight polysomnography. OSA was defined as an apnea-hypopnea index > 5/h. AD severity was assessed using the Mini-Mental State Examination and extensive neuropsychological battery. Epworth Sleepiness Scale and APOE status were analyzed., Results: The cohort included 128 patients with a median [IQR] age of 75.0 [72.0;79.2] years and 57.8% were women. OSA was diagnosed in 116 subjects (90.6%). The distribution of mild, moderate and severe severity of OSA was 29 (22.7%), 37 (28.9%) and 50 (39.1%), respectively. Regarding sleep symptoms, the cohort showed normal values of daytime sleepiness (median EES score 5 [3, 8]), while nycturia (89.1%) and snoring (71.1%) were the most common symptoms. Participants with severe OSA included a higher proportion of older men, were associated with snoring and sedentariness. No significant differences in cognitive assessment were found between patients with and without severe OSA in any of the domains. The prevalence of APOE ε4 was not significantly different between patients with and without severe OSA., Conclusion: There was a high prevalence of OSA in patients with mild-moderate AD. OSA was not associated with sleepiness or worse cognitive function. APOE ε4 was not related to the presence or severity of OSA. Further longitudinal studies will be required to evaluate whether OSA impairs cognitive evolution in AD patients.

Introduction: Large variability among Alzheimer's disease (AD) cases might impact genetic discoveries and complicate dissection of underlying biological pathways., Methods: Genome Research at Fundacio ACE (GR@ACE) is a genome-wide study of dementia and its clinical endophenotypes, defined based on AD's clinical certainty and vascular burden. We assessed the impact of known AD loci across endophenotypes to generate loci categories. We incorporated gene coexpression data and conducted pathway analysis per category. Finally, to evaluate the effect of heterogeneity in genetic studies, GR@ACE series were meta-analyzed with additional genome-wide association study data sets., Results: We classified known AD loci into three categories, which might reflect the disease clinical heterogeneity. Vascular processes were only detected as a causal mechanism in probable AD. The meta-analysis strategy revealed the ANKRD31-rs4704171 and NDUFAF6-rs10098778 and confirmed SCIMP-rs7225151 and CD33-rs3865444., Discussion: The regulation of vasculature is a prominent causal component of probable AD. GR@ACE meta-analysis revealed novel AD genetic signals, strongly driven by the presence of clinical heterogeneity in the AD series., (Copyright © 2019 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Farmers in dry mountain areas are changing their management strategies to improve livestock farming efficiency, by using different forages or different breeds. The effect of breed (Parda de Montaña vs. Pirenaica) and finishing diet (grazing on meadows vs. a total mixed ration (50% alfalfa, 40% maize grain, 10% straw)) on carcass characteristics and meat quality of steers was studied., Results: Parda de Montaña had a greater (P < 0.01) amount of intramuscular fat than Pirenaica. The finishing diet did not influence carcass fat color, but fatty acid composition was slightly affected. Finishing steers on a total mixed ration increased the percentage of fat of the 10th rib (P < 0.001). Supplementation with concentrates increased the diet energy concentration and also increased the dressing percentage., Conclusions: Both breeds had similar carcass characteristics. Consumers preferred beef from the Pirenaica breed because of its greater tenderness. Consumers did not differentiate between beef from animals fed different finishing diets. However, consumers who like meat very much preferred meat aged in a cooler at 4 °C for 15 days rather than 8 days., (© 2013 Society of Chemical Industry.)

Background and Objectives: A new radiological-clinical score (ABCDI) has been recently described to predict the risk of stroke recurrence after a transient ischemic attack (TIA). We validated this score in a cohort of patients with TIA (REGITELL)., Patients and Methods: We studied 310 consecutive patients with TIA. Clinical scales (ABCD and ABCD2) and radiological-clinical scales (ABCDI and ABCD2I) were quantified. Radiological clinical scales were calculated by adding one point for the presence of ischemic brain injury in CT scan to its eponymous clinical score. We established its relationship with the risk of recurrence at 7 and 90 days, and the presence of an atheromatous etiology (AE)., Results: During the first week of follow-up, 18 (5.8%) patients suffered a recurrence, whereas 24 (7.7%) had a recurrence at 90 days. The multivariate study (Cox regression) identified the recurrence of episodes (hazard ratio [HR] 2.92, 95% CI 1.11 to 7.64, p=0.029) and AE (HR 3.13 95% CI: 1.17 to 8.36, p=0.023) as independent predictors of new stroke at 7 days and only AE for stroke at three months (RR 3.33, 95% CI: 1,42-7,77, p=0.006). The predictors (logistic regression) of AE were recurrence of episodes (odds ratio [OR] 3.12, 95% CI 1.58-6.14, p=0.001) and presence of ischemic lesions on CT scan (OR 2.69, 1.38-5.28, p=0.004)., Conclusions: The ABCDI and ABCD2I scales are not useful in our population. The risk of recurrence after a TIA cannot only be established by clinical scores or CT scan findings., (Copyright © 2009 Elsevier España, S.L. All rights reserved.)

The SEUROP system is currently in use for carcass classification in Europe. Image analysis and other new technologies are being developed to enhance and supplement this classification system. After slaughtering, 91 carcasses of local Spanish beef breeds were weighed and classified according to the SEUROP system. Two digital photographs (a side and a dorsal view) were taken of the left carcass sides, and a total of 33 morphometric measurements (lengths, perimeters, areas) were made. Commercial butchering of these carcasses took place 24 h postmortem, and the different cuts were grouped according to four commercial meat cut quality categories: extra, first, second, and third. Multiple regression analysis of carcass weight and the SEUROP conformation score (x variables) on meat yield and the four commercial cut quality category yields (y variables) was performed as a measure of the accuracy of the SEUROP system. Stepwise regression analysis of carcass weight and the 33 morphometric image analysis measurements (x variables) and meat yield and yields of the four commercial cut quality categories (y variables) was carried out. Higher accuracy was achieved using image analysis than using only the current SEUROP conformation score. The regression coefficient values were between R(2)=0.66 and R(2)=0.93 (P<0.001) for the SEUROP system and between R(2)=0.81 and R(2)=0.94 (P<0.001) for the image analysis method. These results suggest that the image analysis method should be helpful as a means of supplementing and enhancing the SEUROP system for grading beef carcasses., (2009 Elsevier Ltd. All rights reserved.)

Aim: The transient ischemic attack (TIA) is a medical emergency because of their high risk of early recurrence. We study the evolution and management of patients with a TIA in our hospital before establishing a process management and treatment of this condition., Patients and Methods: We included 180 consecutive patients with suspected TIA attended in the emergency department of our hospital between January 2006 and March 2007. We collected clinical variables (risk factors, age, clinical symptoms, duration, ABCD2). Cases were reviewed by two neurologists to establish the correlation with the diagnosis. We established the risk of cerebral infarction after one year follow-up., Results: 31% of patients were discharged home. There were differences between the two groups regarding age (82.9 Y 7.5 vs 70.53 Y 10.7 years); ABCD2 scale score (1.5 Y 5.32 vs 4.44 Y 1.37); and atrial fibrillation (27.5% vs 8.6%). There was much greater delay and lack of complementary explorations. During follow-up, 23% of patients not hospitalized had recurrent stroke versus 6.7% of hospitalized patients. Despite the fact that only age more than 80 years was identified as predictor of stroke recurrence (hazard ratio = 8,72; 95% CI = 2.4-31.74; p = 0.001) in regression multivariate model, the Kaplan-Meier model showed a higher risk of stroke recurrence among not admitted patients (p = 0.012)., Conclusion: In our area, the management of TIA patients in the emergency room had high impact on the evolution of these patients. A process management should be performed in order to achieve improvement in clinical praxis.

Crossbred pigs (n=120) from Duroc sires mated to Landrace x Large White dams, with a mean BW of 110.5+/-2.3 kg, were used to investigate the effect of increasing the slaughter weight of gilts with regard to that of the barrows on the production of high quality dry-cured hams from Spain (Teruel ham). There were 3 treatments: barrows slaughtered at 130 kg of BW (B), gilts slaughtered at 130 kg of BW (G1), and gilts slaughtered at 134 kg of BW (G2). Growth performance was similar for G1 and G2, and both consumed less feed (P<0.001) and had less BW gain (P<0.05) and better G:F (P<0.01) than B. Also, the B treatment showed thicker backfat (P<0.001) and covering fat over the gluteus medius (GM) muscle (P<0.05) than G1 or G2, but no differences in carcass fat were detected between G1 and G2. Loin and ham yields were similar for B and G2, and both were less than those for G1 (P<0.01). Treatment did not affect the proportion of carcasses with a minimum weight of 84 kg, but the percentage of carcasses with a minimum fat depth over the GM muscle of 18 mm and the percentage of carcasses that fulfill both requirements (as required for the Teruel ham trademark) were less for G1 than for B or G2 (P<0.001). Meat from B had greater (P<0.05) intramuscular fat content than meat from G1 with loin from G2 being intermediate. Thawing losses of the loins were greater (P<0.05) for B than for G2 with loins from G1 being intermediate. Shear force value was greater for meat from G1 than for that from G2 with meat from B being intermediate (P<0.05). Fat over the GM muscle from the B treatment was more saturated and had decreased PUFA/SFA ratio than that from G1 with fat from G2 being intermediate (P<0.001). Also, backfat from the B treatment showed decreased (P<0.01) PUFA proportion than backfat from G1 or G2. We conclude that increasing the slaughter weight of gilts by 4 kg with respect to that of barrows optimized the 2 criteria used for the selection of carcasses destined for the production of Teruel ham.

Introduction: Guillain-Barré Syndrome is an acute immune-mediated inflammatory polyneuropathy characterized by flaccid paresia with arreflexia, changeable sensitive disorder and albuminocytologic dissociation in the cerebrospinal fluid (CSF)., Patients and Methods: We conducted a retrospective study of 30 GBS patients diagnosed in Hospital Clínico de Zaragoza between 1999 and 2005. Annual incidence, seasonal distribution, preceding acute infection; clinical, electrophysiological and electrocardiographic (ECG) data and evolution were all evaluated., Results: The incidence was 1.56/100000 inhabitants/year. We observed an upward tendency during winter months. The rates of incidence were higher in men (66.7%) and increased with age in both sexes. Main clinical presentation form was paraparesia of lower limbs followed on cranial nerve palsy. Immunoglobulin therapy was received by 62.5% of patients. The rate of death was 10%. Thirteen per cent of patients had dysautonomia. Electrocardiographic abnormalities were present in 37% of patients., Conclusions: GBS incidence in Aragon Country is similar to that found in other studies. An increase with age and an upward tendency during the winter months was observed. High percentage of abnormalities in ECG but the majority of patients was asymptomatic.