Metabolic Adaptation Establishes Disease Tolerance to Sepsis.

Sepsis is an often lethal syndrome resulting from maladaptive immune and metabolic responses to infection, compromising host homeostasis. Disease tolerance is a defense strategy against infection that preserves host homeostasis without exerting a direct negative impact on pathogens. Here, we demonstrate that induction of the iron-sequestering ferritin H chain (FTH) in response to polymicrobial infections is critical to establish disease tolerance to sepsis. The protective effect of FTH is exerted via a mechanism that counters iron-driven oxidative inhibition of the liver glucose-6-phosphatase (G6Pase), and in doing so, sustains endogenous glucose production via liver gluconeogenesis. This is required to prevent the development of hypoglycemia that otherwise compromises disease tolerance to sepsis. FTH overexpression or ferritin administration establish disease tolerance therapeutically. In conclusion, disease tolerance to sepsis relies on a crosstalk between adaptive responses controlling iron and glucose metabolism, required to maintain blood glucose within a physiologic range compatible with host survival.

Cancer Prevalence in Children with Inborn Errors of Immunity: Report from a Single Institution.

BACKGROUND: Inborn Errors of Immunity (IEI) comprise several genetic anomalies that affect different components of the innate and adaptive responses, predisposing to infectious diseases, autoimmunity and malignancy. Different studies, mostly in adults, have reported a higher prevalence of cancer in IEI patients. However, in part due to the rarity of most of these IEI subtypes (classified in ten categories by the Primary Immunodeficiency Committee of the International Union of Immunological Societies), it is difficult to assess the risk in a large number of patients, especially during childhood. OBJECTIVE: To document the cancer prevalence in a pediatric cohort from a single referral institution, assessing their risk, together with the type of neoplasia within each IEI subgroup. METHOD: An extensive review of clinical records from 1989 to 2022 of IEI patients who at some point developed cancer before the age of sixteen. RESULTS: Of a total of 1642 patients with IEI diagnosis, 34 developed cancer before 16 years of age, showing a prevalence (2.1%) significantly higher than that of the general age matched population (0.22). Hematologic neoplasms (mostly lymphomas) were the most frequent malignancies. CONCLUSION: This study represents one of the few reports focused exclusively in pediatric IEI cases, describing not only the increased risk of developing malignancy compared with the age matched general population (a fact that must be taken into account by immunologists during follow-up) but also the association of the different neoplasms with particular IEI subtypes, thus disclosing the possible mechanisms involved.

Health care utilization of Hispanic/Latino veterans with epilepsy: A national population-based study.

OBJECTIVE: Hispanic/Latino people with epilepsy are a growing population that has been understudied in clinical epilepsy research. U.S. veterans are at a higher risk of epilepsy due to greater exposures including traumatic brain injury. Hispanic/Latino Veterans with Epilepsy (HL-VWEs) represent a growing population; however the treatment utilization patterns of this population have been vastly understudied. METHODS: HL-VWE were identified from administrative databases during fiscal year 2019. Variables compared between Hispanic and non-Hispanic VWEs included demographics, rurality, service era, utilization of clinical services/investigations, and service-connected injury. Chi-square and Student's t tests were used for comparisons. RESULTS: Among 56 556 VWEs, 3247 (5.7%) were HL. HL-VWEs were younger (59.2 vs 63.2 years; p < .01) and more commonly urban-dwelling (81.6% vs 63.2%, p < .01) compared to non-HL-VWEs. They were also more likely to have served in recent missions such as the Persian Gulf War and post- 9/11 wars (p < .01). HL-VWEs had a higher utilization of all neurology services examined including neurology clinic visits, computed tomography (CT) scans, magnetic resonance imaging (MRI) scans, electroencephalography (EEG), epilepsy monitoring, and comprehensive epilepsy care (p < .01 for all). HL-VWEs were more likely to visit an emergency room or have seizure-related hospitalizations (p < .01). HL-VWEs were more likely to have a service-connected disability greater or equal to 50% (p < .01). SIGNIFICANCE: This study is one of the largest cohorts examining HL-VWEs. We found higher utilization of services in neurology, epilepsy, and neuroimaging by HL-VWEs. HL-VWE are younger, more commonly urban-dwelling, and more likely to have served during recent combat periods and have higher amounts of service-connected disability. Given that the proportion of Hispanic veterans is projected to rise over time, more research is needed to provide the best interventions and mitigate the long-term impact of epilepsy on this diverse patient group.

Observing the neighborhood multidimensionality and overweight in children of different developmental stages-the emergence of an unusual association.

The present study examines whether the association of the neighborhood environment and overweight in children is moderated by age. This was a cross-sectional study of 832 children aged 3 to 10 years living in the city of Oporto (Portugal). Children were recruited under the scope of the project "Inequalities in Childhood Obesity: The impact of the socioeconomic crisis in Portugal from 2009 to 2015." Overweight was defined according to the International Obesity Task Force criteria. Parents completed a self-administered questionnaire capturing sociodemographic characteristics and their perceptions of their neighborhood environment. Logistic regressions were used to examine the influence of parental perceived neighborhood characteristics (latent variables: attractiveness, traffic safety, crime safety, and walkability) on overweight in children. A stratified analysis by age category was conducted. Overall, 27.8% of the children were overweight, 17.4% were aged 3 to 5 years, and 31.8% were aged 6 to 10 years. Children aged 3 to 5 years were more sensitive to the neighborhood environment than children aged 6 to 10 years. For children aged 3 to 5 years, the risk of overweight was inversely associated with neighborhood crime safety (OR = 1.84; 95% CI 1.07-3.15; p = 0.030).    Conclusion: Our study suggests the existence of a sensitive age period in childhood at which exposure to a hostile neighborhood environment is most determining for weight gain. Until today, it was thought that the impact of the neighborhood environment on younger children would be less important as they are less autonomous. But it may not be true. What is Known: • The neighborhood environment may adversely affect children's weight status. However, the moderating role of child age in the association between neighborhood environment and overweight is uncertain. What is New: • The study highlights that the association between the neighborhood environment and child overweight is attenuated by age. It is stronger for preschoolers than for early school-age children.

Are sun exposure time, dietary patterns, and vitamin D intake related to the socioeconomic status of Portuguese children?

OBJECTIVES: To investigate the association among sun exposure time, vitamin D intake, dietary patterns, and socioeconomic status in Portuguese children. METHODS: Participants aged 3-11 years (50.1% females) were recruited from public and private schools (n = 118) in the districts of Coimbra (n = 2980), Lisbon (n = 3066), and Porto (n = 2426). Parents reported their children's daily sun exposure time during the summer season and reported children's food consumption, including vitamin D food sources, using standardized questionnaires. Parents' education level was used as a proxy measure to the socioeconomic status (SES). The principal component factor analysis (PCA) method was used to identify dietary patterns. The eight dietary patterns identified were labeled in: "fast food", "rich in vitamin D", "sugary drinks", "vitamin D", "candies", "supplements", "rich in calcium" and "vegetables/healthy". Linear regression analyses were performed to investigate the association between sun exposure time and dietary patterns according to SES. RESULTS: A total of 4755 children were included. Children from high SES had significantly longer sun exposure time (p < .001) and more frequently consumed vitamin D supplements (p < .001). "Fast food" pattern showed a negative association with sun exposure time in medium and high SES (p = .014 and p < .001, respectively). CONCLUSION: Children with lower SES spend less time exposed to the sun, consume fewer dietary sources of vitamin D, and consume more foods rich in fat and sugar.

An Integrated Strategy of UHPLC-ESI-MS/MS Combined with Bioactivity-Based Molecular Networking for Identification of Antitumoral Withanolides from Athenaea fasciculata (Vell.) I.M.C. Rodrigues & Stehmann.

BACKGROUND: Athenaea fasciculata, a Brazilian native species from the Solanaceae family, is recognized as a promising source of bioactive withanolides, particularly Aurelianolide A and B, which exhibit significant antitumoral activities. Despite its potential, research on the chemical constituents of this species remains limited. This study aimed to dereplicate extracts and partitions of A. fasciculata to streamline the discovery of bioactive withanolides. METHODS: Using ultra-high-performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS), various extracts-including n-hexane, methanol, and ethanol-were analyzed, and their mass spectrometry data were processed through the GNPS platform for the generation of molecular networking. The results indicated that crude extracts displayed comparable cytotoxicity against Jurkat cells, by treatment at 150 µg/mL, while alcoholic extracts achieved approximately 80% inhibition of K562 cells and K562-Lucena 1 at the same concentration. Notably, the dichloromethane partition exhibited the highest cytotoxicity across leukemia cell lines, particularly against Jurkat cells (IC50 = 14.34 µg/mL). A total of 22 compounds were annotated by manual inspection and different libraries, with six of them demonstrating significant cytotoxic effects. CONCLUSIONS: This research underscores the therapeutic potential of A. fasciculata and highlights the effectiveness of integrating advanced analytical methods in drug discovery, paving the way for further exploration of its bioactive compounds.

Body size, form, composition, and a healthy lifestyle associates with health-related quality of life among Portuguese children.

OBJECTIVES: This study aimed to describe the relationship between body size, form, and composition, and children's lifestyle on health-related quality of life (HRQoL). METHODS: This cross-sectional study comprised 1333 children (9.05 ± 0.75 years; 683 females) living in mainland Portugal. Objective anthropometric measures were collected. Parents answered a standardized questionnaire related with children's lifestyle (e.g., sport participation, screen- and sleep-time) and family socioeconomic status (e.g., parental education). HRQoL was measured using the Portuguese version of the KIDSCREEN-27. Scores were categorized into low and high using a sex-specific normative cut-off from European children. A healthier score was created including positive scores for body weight, abdominal obesity, sport participation, sleep- and screen-time. RESULTS: Body size, form and composition were correlated with children's physical wellbeing. However, sex differences were found in which parameters were associated with wellbeing. Among boys, the body mass index, waist circumference, waist-to-height ratio, subscapular and suprailiac skinfold were most correlated with wellbeing, while waist circumference and subscapular skinfold showed the strongest correlations for girls. Sleep duration and sport participation revealed a significant relationship with girls' HRQoL. A logistic regression analysis (adjusted for parental education) revealed that boys scoring 4 or 5 in the healthier index had an increased likelihood of high HRQoL level compared to those fulfilling none. CONCLUSIONS: Future programs aimed at reducing obesity, particularly central obesity, and incorporating multiple health indicators and behaviors, such as sport participation and sleep duration may help improve children's health and wellbeing.

Is more prolonged sun exposure associated with healthier life habits and obesity indicators in Portuguese children?

OBJECTIVES: Sun exposure seems to have an indirect effect on the development of obesity through vitamin D synthesis in the skin, the primary source of this vitamin. The present study aimed to investigate associations among sun exposure time, obesity indicators, and lifestyle habits in children. METHODS: A total of 4755 children (3-10 years; 49.86% boys) from the north, center and south-central Portugal were included in the present study. During 2016/2017 children's sun exposure time, screen time, time devoted to the practice of physical activity and active play were collected through standard questionnaires answered by parents. Statistical analyses were conducted to investigate differences among sun exposure time according to the sex, age, obesity indicators and lifestyle habits. RESULTS: Linear regression analysis showed that sun exposure time presented a negative association with Body Mass Index (ß = -0.09, 95% CI: -0.18; -0.003; p = .042), body fat % (ß = -0.31, 95%; CI: -0.54; -0.07; p = .010), computer time (ß = -0.08, 95% CI: -0.12; - 0.05; p < .0001) and a positive association with active play time (ß = 0.22, 95% CI: 0.17; 0.27; p < .0001) and total time of physical activity practice (ß = 10.01, 95% CI: 4.52; 15.20; p < .0001). CONCLUSIONS: The results reinforce the need for future guidance on the ideal sun exposure time, especially in children, who are at risk for vitamin D deficiency. Standardization of criteria for classifying optimal sun exposure time in this age group, considering the parameters that affect vitamin D status, such as age and seasonality, should be considered when planning future guidelines.

Phenotypic variation in milk fatty acid composition and its association with stearoyl-CoA desaturase 1 (SCD1) gene polymorphisms in Gir cows.

Individual variation in milk fatty acid (FA) composition has been partially attributed to stearoyl-CoA desaturase 1 (SCD1) gene polymorphisms in taurine breeds, but much less is known for Zebu breeds. This study investigated the phenotypic variation in milk FA composition, and the influence of SCD1 variants on this trait and on milk fat desaturase indices (DI) in Gir cows. The functional impact of SCD1 variants was predicted using bioinformatics tools. Milk and blood samples were collected from 312 cows distributed in 10 herds from five states of Brazil. SCD1 variants were identified through target sequencing, and milk FA composition was determined by gas chromatography. Phenotypic variation in milk FA composition fell within the range reported for taurine breeds, with SCD18 index showing the lowest variation among the DI. Fourteen SCD1 variants were identified, six of which not previously described. Regarding the A293V polymorphism, all cows were homozygous for the C allele (coding for alanine), whereas all genotypes were detected for the second SNP affecting the 293 codon (G > A), with compelling evidence for functional effects. Significant associations (based on raw p-values) were found between this SNP and C12:0, cis-9, trans-11 CLA and short-chain FA, and between another SNP (rs523411937) and C15:0 and odd-chain linear FA. A new SNP on Chr26:21277069 was associated with trans-11 C18:1, cis-9, trans-11 CLA, C18:3 n-3 and n-3 FA. These findings indicate that SCD1 polymorphisms also contributes to the phenotypic variation in milk FA composition of Gir cows, with potential use in their breeding programmes.

Combating Antimicrobial Resistance in the Post-Genomic Era: Rapid Antibiotic Discovery.

Constantly evolving drug-resistant "superbugs" have caused an urgent demand for novel antimicrobial agents. Natural products and their analogs have been a prolific source of antimicrobial agents, even though a high rediscovery rate and less targeted research has made the field challenging in the pre-genomic era. With recent advancements in technology, natural product research is gaining new life. Genome mining has allowed for more targeted excavation of biosynthetic potential from natural sources that was previously overlooked. Researchers use bioinformatic algorithms to rapidly identify and predict antimicrobial candidates by studying the genome before even entering the lab. In addition, synthetic biology and advanced analytical instruments enable the accelerated identification of novel antibiotics with distinct structures. Here, we reviewed the literature for noteworthy examples of novel antimicrobial agents discovered through various methodologies, highlighting the candidates with potent effectiveness against antimicrobial-resistant pathogens.

Neuropsychiatric Treatments for Epilepsy: Nonpharmacological Approaches.

Neuropsychiatric conditions are frequently found in patients with epilepsy (PWE). These entities can be as disabling as epilepsy resulting in a significant negative impact on the quality of life of this population if not addressed and treated appropriately. In this article, we provide an overview of non-pharmacological treatments currently available to these patients-and review their effect on mood and anxiety disorders as well as epilepsy. These treatment strategies will allow the practitioner to optimize clinical care during the initial evaluation, which begins with the recognition of the neuropsychiatric condition followed by the appropriate individualized psychotherapeutic approach and/or neuromodulation therapy. To plan a comprehensive treatment for PWE, practitioners must be familiar with these therapeutic tools. Additional clinical research is needed to further create a multidisciplinary team in the assessment and management of neuropsychiatric disorders in PWE.

Fumonisin-containing diets decrease the metabolic activity of myenteric neurons in rats.

Fumonisins are naturally occurring mycotoxins that contaminate food for human and animal consumption. They have neurotoxic effects, but the mechanisms by which these toxins affect the nervous system are not fully known. In the present study, male Wistar rats were fed between 21 and 63 days of age with diets that contained fumonisins B1+B2 at 0, 1, and 4 mg/kg. The following variables were assessed: food consumption, growth, body weight gain, and blood parameters. Morphoquantitave analyses of the most metabolically active myenteric neurons were performed, detected by NADH-diaphorase activity. Nitrergic neurons were detected by NADPH-diaphorase activity. The fumonisin-containing diets did not significantly alter food consumption or the body or plasma parameters. These diets decreased the metabolic activity of jejunal myenteric neurons, reducing neuronal density of the most metabolic active neurons by 30.8% and the cell body area by 4.3%. The diets also decreased the cell body area of nitrergic neurons by 22.1%. The effects of fumonisin B1 on the respiratory metabolism of isolated mitochondria in the brain and liver were also assessed. A decrease in oxygen consumption up to a 29% in the brain and 38% in the liver was observed in mitochondrial isolates to which 50 µM fumonisin B1 was added. The decrease in respiratory activity that was triggered by exposure to fumonisins was related to the lower metabolic activity of myenteric neurons, which had a negative impact on neuroplasticity of the enteric nervous system.

The Portuguese economic crisis is associated with socioeconomic and sex disparities on children's health-related behaviors and obesity: A cross-sectional study.

OBJECTIVES: Our objective was to examine the relationship between the 2008 and 2015 economic crisis and children's physical activity (PA) outcomes, eating behaviors and obesity prevalence, while considering sex inequalities and familial socioeconomic status. METHOD: This is a cross-sectional study, including data collected in 2016/2017 among 5134 children aged 6-11 years (mean age: 8.11 ± 1.24; 50.0% boys). Children's height, weight, and waist circumference were objectively measured. Children's sleep- and screen-time, participation in organized sports, and specific dietary habits were reported parental-reported using a standardized questionnaire. An economic crisis impact score, with data from 10 indicators of economic needs in the family, was used to characterize the crisis' impact. RESULTS: First, the prevalence of overweight and obesity was higher in children whose families had a higher impact of the crisis. Second, children's intake of fruit and high-fat food, screen-time, sleep-time, and participation in organized sports differed according to the level of impact of the economic crisis. Third, the association between health-related behaviors and the impact of the economic crisis was stronger for girls compared to boys. CONCLUSION: Our findings give us an indication of how economic crises may drive changes in health outcomes.

The Great Recession weighted on Portuguese children: A structural equation modeling approach considering eating patterns.

OBJECTIVES: Further evidence on how the Great Recession was associated with childhood obesity is needed, particularly when the world is facing a new and severe economic downturn caused by the COVID-19 pandemic. This study explores: (1) the direct association of the 2008's economic crisis with eating patterns and body mass index (BMI), among children, independently of their socioeconomic status (SES), and (2) the indirect association between the crisis and children's BMI, by using eating patterns as mediators. METHODS: A sample of children (n = 8472, mean age: 7.17 years old, 50.8% male) was recruited in schools from the cities of Porto, Coimbra and Lisbon, Portugal. Children's height and weight were objectively measured; BMI was calculated. Other data were collected by a parental questionnaire. A structural equation modeling studied the associations between the economic crisis impact, eating patterns, and BMI; model was adjusted for SES. RESULTS: Children in families that reported a greater impact of the economic crisis showed higher consumption of unhealthy food items and lower consumption of healthy foods, regardless of SES. Indirectly, children whose parents scored higher in the economic crisis impact had higher BMI mediated by a higher consumption of cakes/chocolates and lower intake of vegetables/salads. CONCLUSIONS: The economic crisis was associated with higher BMI and unhealthy eating patterns. Efforts to promote healthy diets and weight are needed at a population level rather than for specific social classes, particularly in the face of a new economic crisis caused by the COVID-19 pandemic.

Socioeconomic inequalities in the prevalence of overweight and obesity among Portuguese preschool-aged children: Changes from 2009 to 2016.

OBJECTIVES: We evaluated, for the first time in Portugal, the prevalence of overweight and obesity according to parental education in a population of preschool-aged Portuguese children in 2009/2010 and 2016/2017. METHODS: Anthropometric data were collected in public and private preschools (n = 1996 in 2009/2010; n = 2077 in 2016/2017). Body mass index was calculated and weight status categories were based on the International Obesity Task Force cutoff points. Parental education level was self-reported. RESULTS: Prevalence of overweight (17.1%-14.1%; p < 0.001) and obesity (6.6%-3.9%, p < 0.001) was lower in 2016/2017 than in 2009/2010, with higher rates being found in the north of the country. Parental education was significantly associated with childhood overweight and obesity and inequalities between low- and high-education increased between the two periods. CONCLUSIONS: While a decrease in childhood overweight and obesity were positive findings, the prevalence is still high and shows pronounced socioeconomic differences. Policies for obesity prevention need to be inclusive and tackle inequalities, with interventions tailored to suit local contexts.

In vitro activity of Schinus terebinthifolius extract and fractions against Sporothrix brasiliensis.

BACKGROUND: Sporothrix brasiliensis is the causative agent of zoonotic cases of sporotrichosis in Brazil and is associated with atypical and severe presentations in cats, dogs, and humans. Sporotrichosis treatment is usually time- and cost-consuming, sometimes with poor response and host toxicity. Schinus terebinthifolius has proven efficacy against bacteria and fungi of clinical interest. OBJECTIVE: To determine the in vitro activity of S. terebinthifolius against S. brasiliensis. METHODS: Five S. brasiliensis isolates and three reference strains were subjected to a hydroethanol extract derived from the leaves of S. terebinthifolius and its fractions. The minimal inhibitory concentration (MIC) was determined using the broth microdilution method according to the M38-A2 CLSI guidelines. Also, the fungicidal/fungistatic activity of the extract and fractions was studied. FINDINGS: The crude extract of S. terebinthifolius inhibited the growth of S. brasiliensis (MIC: 0.5-1.0 µg/mL), while the partitioned extracts dichloromethane, ethyl acetate, and butanol demonstrated growth inhibition at 8 µg/mL due to a fungistatic activity. MAIN CONCLUSIONS: Due to its in vitro efficacy against S. brasiliensis and its known pharmacological safety, S. terebinthifolius is a candidate to be tested using in vivo models of sporotrichosis.

Effect of peri-conception high-fat diets on maternal ovarian function, foetal and placentome growth, and vascular umbilical development in goats.

The objective of this study was to determine whether a high-fat diet (HFD) fed to goats for a brief period during peri-conception would optimize reproductive and foetal responses. Thirty-four Anglo-Nubian crossbred adult goats were allocated into three groups: control (n = 11), fed with a total mixed ration (TMR) based on chopped elephant grass and concentrate; HFBM (n = 11), given TMR supplemented with soybean oil on a 0.5% dry matter basis for 11 days starting nine days before mating (BM); and HFAM (n = 12), fed with soybean oil included in the TMR for 15 days after mating (AM). The TMR diets differed in their fat content (7.5% vs. 2.9%). All goats had oestrus synchronized for 14 days BM by intravaginal administration of 60 mg MPA sponge for 12 days. Forty-eight hours BM, the sponge was removed and 0.075 mg PGF2α was applied intramuscularly. After 36 h, 1 ml GnRH was administered intramuscularly, and goats were mated after sponge removal. The fat groups showed lower feed intake (p < .001) and higher cholesterol levels (p < .001) when HFD was administered. Doppler and B-mode ultrasound evaluations revealed a greater (p < .05) number of small (<3 mm, 10 ± 0.6 vs. 8 ± 0.5) and large (≥3 mm, 6 ± 0.4 vs. 5.0 ± 0.2) follicles and intraovarian blood area (p < .05) in the HFBM group during sponge removal (57.6%) and mating (24.2%) than those of the no-fat group. During AM, the fat-fed groups exhibited higher glutathione peroxidase levels (p < .05) and a reduction (p < .001) in corpus luteum size (19%) and vascularized Doppler area (41%). No difference (p > .05) between groups was found in foetal traits, placentome and umbilical vascular development, except for the embryonic vesicle where HFAM twin pregnancy showed a smaller size than the control (26.1 ± 3.5 cm vs. 33.7 ± 2.7 cm; p < .01). Thus, HFD applied during peri-conception of goats has no impact on later foetal development but improved the follicular growth when given before the mating. Thus, the use of HFD in periconception has no impact on foetal development but increases follicular growth before breeding time.

Initial experience with del Nido cardioplegia solution at a Pediatric and Congenital Cardiac Surgery Program in Brazil.

OBJECTIVE: The aim of this study was to evaluate outcome measures between our standard multidose cardioplegia protocol and a del Nido cardioplegia protocol in congenital heart surgery patients. METHODS: Retrospective single-center study including 250 consecutive patients that received del Nido cardioplegia (DN group) with a mandatory reperfusion period of 30% of cross clamp time and 250 patients that received a modified St. Thomas' solution (ST group). Groups were matched by age, weight, gender, and Risk Adjustment for Congenital Heart Surgery (RACHS-1) scores. Preoperative hematocrit and oxygen saturation were also recorded. Outcomes analyzed were the vasoactive inotropic score (VIS), lactate, ventilation time, ventricular dysfunction with low cardiac output syndrome (LCOS), intensive care unit (ICU) length of stay (LOS), hospital LOS, bypass and aortic cross-clamp times, and in-hospital mortality. RESULTS: Both groups were comparable demographically. Statistically significant differences (p ⩽ 0.05) were noted for cardiac dysfunction with LCOS, hematocrit at end of surgery (p = 0.0038), VIS on ICU admission and at end of surgery (p = 0.0111), and ICU LOS (p = 0.00118) with patients in the DN group having more desirable values for those parameters. Other outcome measures did not reach statistical significance. CONCLUSION: In our congenital cardiac surgery population, del Nido cardioplegia strategy was associated with less ventricular dysfunction with LCOS, a lower VIS and decreased ICU LOS compared with patients that received our standard myocardial protection using a modified St. Thomas' solution. Despite the limitation of this study, including its retrospective nature and cohort size, these data supported our transition to incorporate del Nido cardioplegia solution with a mandatory reperfusion period as the preferred myocardial protection method in our program.

Gait Analysis in Children with Cerebral Palsy: Are Plantar Pressure Insoles a Reliable Tool?

Cerebral palsy (CP) is a common cause of motor disability, and pedobarography is a useful, non-invasive, portable, and accessible tool; is easy to use in a clinical setting; and can provide plenty of information about foot-soil interaction and gait deviations. The reliability of this method in children with CP is lacking. The aim of this study is to investigate test-retest reliability and minimal detectable change (MDC) of plantar pressure insole variables in children with CP. Eight children performed two trials 8 ± 2.5 days apart, using foot insoles to collect plantar pressure data. Whole and segmented foot measurements were analyzed using intraclass correlation coefficients (ICC). The variability of the data was measured by calculating the standard error of measurement (SEM) and the MDC/ICC values demonstrated high test-retest reliability for most variables, ranging from good to excellent (ICC ≥ 0.60). The SEM and the MDC values were considered low for the different variables. The variability observed between sessions may be attributed to the heterogeneous sub-diagnosis of CP.

Piper tectoniifolium Kunth: A New Natural Source of the Bioactive Neolignan (-)-Grandisin.

The Piper species are a recognized botanical source of a broad structural diversity of lignans and its derivatives. For the first time, Piper tectoniifolium Kunth is presented as a promising natural source of the bioactive (-)-grandisin. Phytochemical analyses of extracts from its leaves, branches and inflorescences showed the presence of the target compound in large amounts, with leaf extracts found to contain up to 52.78% in its composition. A new HPLC-DAD-UV method was developed and validated to be selective for the identification of (-)-grandisin being sensitive, linear, precise, exact, robust and with a recovery above 90%. The absolute configuration of the molecule was determined by X-ray diffraction. Despite the identification of several enantiomers in plant extracts, the major isolated substance was characterized to be the (-)-grandisin enantiomer. In vascular reactivity tests, it was shown that the grandisin purified from botanical extracts presented an endothelium-dependent vasorelaxant effect with an IC50 of 9.8 ± 1.22 µM and around 80% relaxation at 30 µM. These results suggest that P. tectoniifolium has the potential to serve as a renewable source of grandisin on a large scale and the potential to serve as template for development of new drugs for vascular diseases with emphasis on disorders related to endothelial disfunction.