Comprehensive Two-Dimensional Gas Chromatography with a TOF MS Detector-An Effective Tool to Trace the Signature of Grape Varieties.

Varietal volatile compounds are characteristic of each variety of grapes and come from the skins of the grapes. This work focuses on the development of a methodology for the analysis of free compounds in grapes from Trincadeira, Cabernet Sauvignon, Syrah, Castelão and Tinta Barroca from the 2021 and 2022 harvests, using HS-SPME-GC × GC-TOFMS. To achieve this purpose, a previous optimization step of sample preparation was implemented, with the optimized conditions being 4 g of grapes, 2 g of NaCl, and 2 mL of H2O. The extraction conditions were also optimized, and it was observed that performing the extraction for 40 min at 60 °C was the best for identifying more varietal compounds. The fiber used was a triple fiber of carboxen/divinylbenzene/polydimethylsiloxane (CAR/DVB/PDMS). In addition to the sample preparation, the analytical conditions were also optimized, enabling the adequate separation of analytes. Using the optimized methodology, it was possible to identify fifty-two free volatile compounds, including seventeen monoterpenes, twenty-eight sesquiterpenes, and seven C13-norisoprenoids. It was observed that in 2021, more free varietal volatile compounds were identifiable compared to 2022. According to the results obtained through a linear discriminant analysis (LDA), the differences in volatile varietal signature are observed both among different grape varieties and across different years.

Characterization of Phenolic Compounds in Extra Virgin Olive Oil from Granada (Spain) and Evaluation of Its Neuroprotective Action.

The olive oil sector is a fundamental food in the Mediterranean diet. It has been demonstrated that the consumption of extra virgin olive oil (EVOO) with a high content of phenolic compounds is beneficial in the prevention and/or treatment of many diseases. The main objective of this work was to study the relationship between the content of phenolic compounds and the in vitro neuroprotective and anti-inflammatory activity of EVOOs from two PDOs in the province of Granada. To this purpose, the amounts of phenolic compounds were determined by liquid chromatography coupled to mass spectrometry (HPLC-MS) and the inhibitory activity of acetylcholinesterase (AChE) and cyclooxygenase-2 (COX-2) enzymes by spectrophotometric and fluorimetric assays. The main families identified were phenolic alcohols, secoiridoids, lignans, flavonoids, and phenolic acids. The EVOO samples with the highest total concentration of compounds and the highest inhibitory activity belonged to the Picual and Manzanillo varieties. Statistical analysis showed a positive correlation between identified compounds and AChE and COX-2 inhibitory activity, except for lignans. These results confirm EVOO's compounds possess neuroprotective potential.

Prevalence and Prognostic Impact of Stroke in a National Cohort of Infective Endocarditis.

BACKGROUND: Stroke is a common complication of infective endocarditis (IE). Our aim was to describe the prevalence and prognostic impact of stroke in a national prospective cohort of IE. METHODS: Consecutive inclusion at 46 Spanish hospitals between 2008 and 2021. RESULTS: Out of 5667 IE cases, 1125 had acute stroke (19.8%): 811 ischemic strokes (618 cardioembolic strokes, 193 cardioembolic strokes with hemorrhagic transformation, 4 transient ischemic attacks, 3 lacunar infarctions), 125 intracranial hemorrhages, and 29 other neurological complications (cerebral abscesses, encephalitis, meningitis, seizures). Compared to patients without stroke, those with stroke had a similar mean age (69 years) but were more frequently female (68.2% vs. 63.7%, p=0.04) and had a higher incidence of intracardiac complications (35% vs 30%, p=0.01), surgical indication (69.9% vs 65.9%, p=0.001), in-hospital mortality (40.9% vs. 22.0%, p<0.001), and one-year mortality (46.2% vs 27.9%, p<0.001). The following variables were independently associated with stroke: mitral location (odds ratio [OR] 1.5, 95% confidence interval [CI] 1.34-1.8, p<0.001), vascular phenomenon (OR 2.9, 95% CI 2.4-3.6, p=0.0001), acute renal failure (OR 1.2, 95% CI 1.0-1.4, p=0.021), septic shock (OR 1.3, CI 1.1-1.6, p=0.007), sepsis (OR 1.3, CI 1.1-1.6, p=0.005), surgery indicated but not performed (OR 1.4, 95% CI 1.2-1.7, p<0.001), community-acquired IE (OR 1.2, 95% CI 1-1.4, p=0.017), and peripheral embolization (OR 1.6, CI 1.4-1.9, p <0.001). Stroke was an independent predictor of in-hospital (OR 2.1, 95% CI: 1.78-2.51, p<0.001) and one-year mortality (hazard ratio 1.9, 95% CI 1.6-2.5). CONCLUSIONS: One fifth of patients with IE have concomitant stroke. Stroke is associated with mortality.

Características clínicas y evolución del paciente anciano mayor de 80 años en una Unidad de Cuidados Intensivos / Clinical features and disease progression of elderlypatients at the ICU setting

Objetivo Describir y caracterizar una cohorte de pacientes octogenarios ingresados en la UCI del Hospital Universitario Central de Asturias (HUCA). Diseño Estudio retrospectivo, observacional y descriptivo de 14 meses de duración. Ámbito Unidad de Cuidados Intensivos (UCI) Cardiaca y UCI Polivalente del Servicio de Medicina Intensiva del HUCA (Oviedo). Participantes Pacientes mayores de 80 años que ingresaron en la UCI durante más de 24 horas.Intervenciones Ninguna. Variables de interés principales Edad, sexo, comorbilidad, capacidad funcional, tratamiento, complicaciones, evolución, mortalidad. Resultados Los motivos de ingreso más frecuentes fueron la cirugía cardiaca y la neumonía. La estancia media de ingreso fue significativamente mayor en pacientes menores de 85 años (p=0,037). El 84,3% de estos últimos se benefició de ventilación mecánica invasiva (VMI) vs. 46,2% de los pacientes más mayores (p=<0,001). Los pacientes mayores de 85 años presentaron mayor fragilidad. El ingreso por intervención quirúrgica cardiaca se asoció con menor riesgo de mortalidad (hazard ratio [HR]=0,18; intervalo de confianza [IC] 95%, 0,062-0,527; p=0,002). Conclusiones Los resultados muestran una asociación entre el motivo de ingreso en UCI y el riesgo de mortalidad en pacientes octogenarios. La cirugía cardiaca se asoció con mejor pronóstico frente a la patología médica, donde la neumonía se asoció con mayor riesgo de mortalidad. Además, se observó una relación positiva significativa entre edad y fragilidad. (AU)

ObjectiveTo describe and characterize a cohort of octogenarian patients admitted to the ICU of the University Central Hospital of Asturias (HUCA). Design Retrospective, observational and descriptive study of 14 months’ duration. Setting Cardiac and Medical Intensive Care Units (ICU) of the HUCA (Oviedo). Participants Patients over 80 years old who were admitted to the ICU for more than 24hours. Interventions None. Main variables of interest Age, sex, comorbidity, functional dependence, treatment, complications, evolution, mortality. Results The most frequent reasons for admission were cardiac surgery and pneumonia. The average admission stay was significantly longer in patients under 85 years of age (p=0,037). 84,3% of the latter benefited from invasive mechanical ventilation compared to 46,2% of older patients (p=<0,001). Patients over 85 years of age presented greater fragility. Admission for cardiac surgery was associated with a lower risk of mortality (HR=0,18; 95% CI (0,062-0,527; p=0,002). Conclusions The results have shown an association between the reason for admission to the ICU and the risk of mortality in octogenarian patients. Cardiac surgery was associated with a better prognosis compared to medical pathology, where pneumonia was associated with a higher risk of mortality. Furthermore, a significant positive association was observed between age and frailty. (AU)

Clinical features and disease progression of elderly patients at the ICU setting.

OBJECTIVE: To describe and characterize a cohort of octogenarian patients admitted to the ICU of the University Central Hospital of Asturias (HUCA). DESIGN: Retrospective, observational and descriptive study of 14 months' duration. SETTING: Cardiac and Medical intensive care units (ICU) of the HUCA (Oviedo). PARTICIPANTS: Patients over 80 years old who were admitted to the ICU for more than 24 h. INTERVENTIONS: None. MAIN VARIABLES OF INTEREST: Age, sex, comorbidity, functional dependence, treatment, complications, evolution, mortality. RESULTS: The most frequent reasons for admission were cardiac surgery and pneumonia. The average admission stay was significantly longer in patients under 85 years of age (p = 0,037). 84,3% of the latter benefited from invasive mechanical ventilation compared to 46,2% of older patients (p = <0,001). Patients over 85 years of age presented greater fragility. Admission for cardiac surgery was associated with a lower risk of mortality (HR = 0,18; 95% CI (0,062-0,527; p = 0,002). CONCLUSIONS: The results have shown an association between the reason for admission to the ICU and the risk of mortality in octogenarian patients. Cardiac surgery was associated with a better prognosis compared to medical pathology, where pneumonia was associated with a higher risk of mortality. Furthermore, a significant positive association was observed between age and frailty.

MOG Antibodies Restricted to CSF in Children With Inflammatory CNS Disorders.

OBJECTIVES: To assess the clinical significance of myelin oligodendrocyte glycoprotein antibodies (MOG-abs) restricted to CSF in children with inflammatory CNS disorders. METHODS: Patients included 760 children (younger than 18 years) from 3 multicenter prospective cohort studies: (A) acquired demyelinating syndromes, including acute disseminated encephalomyelitis (ADEM); (B) non-ADEM encephalitis; and (C) noninflammatory neurologic disorders. For all cases, paired serum/CSF samples were systematically examined using brain immunohistochemistry and live cell-based assays. RESULTS: A total of 109 patients (14%) had MOG-abs in serum or CSF: 79 from cohort A, 30 from B, and none from C. Of these, 63 (58%) had antibodies in both samples, 37 (34%) only in serum, and 9 (8%) only in CSF. Children with MOG-abs only in CSF were older than those with MOG-abs only in serum or in both samples (median 12 vs 6 vs 5 years, p = 0.0002) and were more likely to have CSF oligoclonal bands (86% vs 12% vs 7%, p = 0.0001) and be diagnosed with multiple sclerosis (6/9 [67%] vs 0/37 [0%] vs 1/63 [2%], p < 0.0001). DISCUSSION: Detection of MOG-abs in serum or CSF is associated with CNS inflammatory disorders. Children with MOG-abs restricted to CSF are more likely to have CSF oligoclonal bands and multiple sclerosis than those with MOG-abs detectable in serum.

Epidemiology and Risk Factors of Mycotic Aneurysm in Patients With Infective Endocarditis and the Impact of its Rupture in Outcomes. Analysis of a National Prospective Cohort.

Background: Several aspects of the occurrence and management of mycotic aneurysm (MA) in patients with infective endocarditis (IE) have not been studied. Objectives: To determine the incidence and factors associated with MA presence and rupture and to assess the evolution of those initially unruptured MA. Methods: Prospective multicenter cohort including all patients with definite IE between January 2008 and December 2020. Results: Of 4548 IE cases, 85 (1.9%) developed MA. Forty-six (54.1%) had intracranial MA and 39 (45.9%) extracranial MA. Rupture of MA occurred in 39 patients (45.9%). Patients with ruptured MA had higher 1-year mortality (hazard ratio, 2.33; 95% confidence interval, 1.49-3.67). Of the 55 patients with initially unruptured MA, 9 (16.4%) presented rupture after a median of 3 days (interquartile range, 1-7) after diagnosis, being more frequent in intracranial MA (32% vs 3.3%, P = .004). Of patients with initially unruptured MA, there was a trend toward better outcomes among those who received early specific intervention, including lower follow-up rupture (7.1% vs 25.0%, P = .170), higher rate of aneurysm resolution in control imaging (66.7% vs 31.3%, P = .087), lower MA-related mortality (7.1% vs 16.7%, P = .232), and lower MA-related sequalae (0% vs 27.8%, P = .045). Conclusions: MA occurred in 2% of the patients with IE. Half of the Mas occurred in an intracranial location. Their rupture is frequent and associated with poor prognosis. A significant proportion of initially unruptured aneurysms result from rupture during the first several days, being more common in intracranial aneurysms. Early specific treatment could potentially lead to better outcomes.

Multimodal prehabilitation in elective oncological colorectal surgery enhances postoperative functional recovery: A secondary analysis of the PREHAB randomized clinical trial.

INTRODUCTION: Colorectal cancer (CRC) ranks as the second leading cause of cancer-related deaths. The PREHAB trial revealed that prehabilitation in colorectal surgery leads to a reduction of severe complications and enhanced functional capacity. Nevertheless, risk selection for prehabilitation and the potential benefits for patients without postoperative complications remains unclear. This study aims to assess postoperative functional capacity, also in patients without postoperative complications. MATERIALS & METHODS: This study was a secondary analysis of the PREHAB trial. Functional capacity tests, including cardiopulmonary exercise testing (CPET), steep ramp test (SRT), 6-min walking test (6MWT), stair climb test (SCT), 30" sit-to-stand test (STS), timed-up-and-go test (TUG), and muscle strength assessments, were conducted at baseline (T0) and 4 weeks postoperatively (T3). The primary outcome was the relative change in functional capacity from baseline to postoperative (ΔT0-T3) per group (i.e., prehabilitation vs control). Secondary, identical analysis were performed for patients without postoperative complications in each group. RESULTS: Intention-to-treat analysis included 251 patients. For postoperative functional capacity, prehabilitation patients showed improvements in VO2peak (p = 0.024), VO2AT (p = 0.017), SRT (p = 0.001), 6MWT (p = 0.049), SCT (p = 0.012), and STS (p = 0.001) compared to the control group. Regarding muscle strength, prehabilitation patients showed improvements in estimated 1RM lateral pull down (p = 0.016), 1RM chest press (p = 0.001), 1RM leg press (p = 0.001) and HGS (p = 0.005) compared to controls. Additionally, prehabilitation patients more often reached baseline levels at T3 in VO2AT (p = 0.037), SRT (p = 0.008), 6MWT (p = 0.013), STS (p = 0.012), estimated 1RM lateral pull down (p = 0.002), 1RM chest press (p = 0.001) and 1RM leg press (p = 0.001) compared to controls. Moreover, even patients without postoperative complications in the prehabilitation group showed better postoperative functional capacity and more often reached baseline levels at T3, compared to controls. CONCLUSION: Multimodal prehabilitation in CRC surgery is associated with improved postoperative functional capacity, even in patients without postoperative complications.

Prevalencia de caídas en pacientes ingresados en un hospital universitario / Prevalence of falls in patients admitted to a University Hospital

Objetivo: analizar la prevalencia de caídas de los pacientes hos­pitalizados en un hospital universitario, así como los factores asociados con la asistencia sanitaria (motivos de las caídas, especialidad más prevalente, turno más frecuente, si estaban solos o acompañados, etc.) en los pacientes que se cayeron y las posibles consecuencias de las caídas. Métodos: estudio transversal. Se incluyeron a todos los pacientes adultos ingresados en 20 unidades de hospitalización del Hospital Universitario de Burgos, que habían sufrido una caída en 2019 y estaban incluidos en el registro de caídas del programa GACELA Care®. El formulario consta de 28 campos de en­trada de datos, que aportan información relevante sobre la caída. Se llevó a cabo análisis descriptivo y comparativo, usando los test estadísticos correspondientes. Resultados: se registraron 244 caídas (0,9%). La edad media fue 73,3 años. El 54,4% tenía edad igual o mayor a 75 años. El 57,8% era del sexo masculino. En Medicina Interna (29,1%) y Psiquiatría (11,1%) se registró el mayor porcentaje de caídas. El 44,2% se produjo en turno de noche, en pacientes que estaban solos (71,7%), sin protecciones (70,5%); y deambulando (36,1%). El motivo principal fue la inestabilidad motora (48,4%). El 62,7% de los pacientes resultó ileso. La especialidad y el turno de trabajo se asociaron significativamente con las caídas. Conclusiones: la prevalencia de caídas en el hospital fue baja. Los factores que se relacionaron con mayor porcentaje de caídas fueron ser mayor de 75 años, sexo masculino, estar ingresado en unidades de especialidad médica y turno de noche. Las caídas ocurrieron habitualmente cuando el paciente estaba solo, sin protección, al levantarse y caminar. La mayoría de los pacientes no presentó lesiones.(AU)

Objective: to analyse the prevalence of falls in patients admitted to a University Hospital, as well as to identify the characteristics of those patients who experienced falls, the factors associated with patient care (reasons for falls, the most prevalent specialty, the most frequent shift, whether they were alone or accompanied, etc.) among patients who fell down, and the potential consequences of said falls. Methods: a cross-sectional study, including all adult patients admitted to 20 hospitalization units from the Hospital Universitario de Burgos, who had experienced a fall in 2019 and were included in the register of falls from the GACELA Care® program. The form consisted of 28 data entry fields, and included information about date, time and place of the fall; reasons for falls; consequences of falls, and action by professionals. Descriptive and comparative analysis was conducted, using the relevant statistical tests. Results: in total, 244 (0.9%) falls were registered. The mean age was 73.3 years; 57.8% were male. The highest proportion of falls was recorded at Internal Medicine (29.1%) and Psychiatry (11.1%); 44.2% occurred during the night shift, in patients who were alone (71.7%); without protections (70.5%); and walking around (36.1%). The main reason was motor instability (48,4%); 62.7% of patients remained unharmed. There was a significant association between specialty and work shift and falls. Conclusions: there was a low prevalence of falls in the hospital. The factors associated with a higher proportion of falls were being >75-year-old, male gender, being admitted to medical specialty units, and night shift. Falls commonly occurred when the patient was alone, without protection, when getting up and walking. Most patients did not present any lesions.(AU)

From feed to functionality: Unravelling the nutritional composition and techno-functional properties of insect-based ingredients.

In recent years, there has been a growing interest in using insects as a sustainable resource for biorefinery processes. This emerging field aims to convert insect biomass into valuable products while minimizing waste. The integration of emerging green technologies and the efficient extraction of high-value compounds from insects offer promising avenues for addressing the growing demand for sustainable food production and resource utilization. The review examines the impact of dietary modifications on the nutritional profile of insects. It highlights the potential for manipulating insect feed to optimize protein quality, amino acid profile, lipid content and fatty acid composition. Additionally, innovative green processing technologies such as ultrasound, high pressure processing, pulsed electric fields, cold plasma and enzymatic hydrolysis are discussed for their ability to enhance the extraction and techno-functional properties of insect-based ingredients. The review finds that dietary modifications can impact the nutritional composition of insects, allowing the customization of their nutrient content. By optimizing the insect feed, it is possible to increase the quantity and improve the quality of essential nutrients like proteins or lipids in the derived ingredients. Moreover, alternative processing technologies can improve the techno-functional properties (e.g., solubility, water and oil holding capacities, among others) of insect-based ingredients by modifying proteins' conformation. By harnessing these strategies, researchers and industry professionals can unlock the full potential of insects as a sustainable and nutritional food source, paving the way for innovative insect-based food products.

Improving Tenebrio molitor Growth and Nutritional Value through Vegetable Waste Supplementation.

Huge amounts of vegetable wastes are generated by the food industry. Their bioconversion into valuable products (e.g., insect flours or biofertilizer) through insect farming is a promising solution to reduce their negative environmental and economic impacts. This study evaluates the growth of Tenebrio molitor larvae and their nutritional profile after supplementing their diets with vegetable wastes. Over a 6-week period, 45-day larvae were fed a diet comprising wheat bran supplemented (1:1) with cucumber or tomato wastes from both conventional and ecological crops. The control diet consisted of wheat bran and an equivalent amount of water to compensate for the waste moisture. Larval weight was measured weekly, and length measures were taken fortnightly. Nutritional composition and fatty acid profile were analyzed at the end of the study in 90-day larvae. Regardless of using vegetable waste from conventional or ecological harvesting, the weight of 6-week supplemented larvae almost doubled that of larvae fed with just wheat bran, and their length was 15% higher. Supplementation also increased larval polyunsaturated fatty acid percentage by 22-37%, with linoleic acid being the most abundant. Likewise, larval protein content reached 50% after supplementation. This study demonstrates that both cucumber and tomato wastes from conventional or ecological crops are excellent supplements for T. molitor's diet, improving their nutritional value and reducing the time necessary for larvae growth.

Substrate promiscuity of inositol 1,4,5-trisphosphate kinase driven by structurally-modified ligands and active site plasticity.

D-myo-inositol 1,4,5-trisphosphate (InsP3) is a fundamental second messenger in cellular Ca2+ mobilization. InsP3 3-kinase, a highly specific enzyme binding InsP3 in just one mode, phosphorylates InsP3 specifically at its secondary 3-hydroxyl group to generate a tetrakisphosphate. Using a chemical biology approach with both synthetised and established ligands, combining synthesis, crystallography, computational docking, HPLC and fluorescence polarization binding assays using fluorescently-tagged InsP3, we have surveyed the limits of InsP3 3-kinase ligand specificity and uncovered surprisingly unforeseen biosynthetic capacity. Structurally-modified ligands exploit active site plasticity generating a helix-tilt. These facilitated uncovering of unexpected substrates phosphorylated at a surrogate extended primary hydroxyl at the inositol pseudo 3-position, applicable even to carbohydrate-based substrates. Crystallization experiments designed to allow reactions to proceed in situ facilitated unequivocal characterization of the atypical tetrakisphosphate products. In summary, we define features of InsP3 3-kinase plasticity and substrate tolerance that may be more widely exploitable.

What School-Based Speech-Language Pathologists Need to Know About Pediatric Swallowing and Feeding Development and Disorders.

PURPOSE: School-based speech-language pathologists are at the frontline for treating children with pediatric feeding disorders (PFDs). Often, speech-language pathologists are the primary allied health professionals who are charged with maximizing safety, supporting nutrition and neurodevelopmental growth. Due to the increasing need for assessment and treatment of PFDs in schools, it is fundamental that PFDs and dysphagia are detected, differentially diagnosed, and addressed to support developing children. This tutorial addresses the anatomy, physiology, and development of functional feeding and swallowing patterns across the spectrum of childhood for both PFDs and dysphagia. METHOD: A clinical expert review of the anatomy, physiology, and development of functional feeding and swallowing patterns in children across the spectrum of childhood will be completed. CONCLUSIONS: The aim of this tutorial is to support school-based speech-language pathologists in their understanding of the anatomy and physiology of feeding and swallowing. School-based speech-language pathologists should complete this tutorial with an increased understanding and breadth of knowledge related to typical anatomy and physiology versus atypical or disordered presentations. This tutorial would support school-based speech-language pathologists in determining whether a child presents with characteristics of oropharyngeal dysphagia and/or a PFD.

Misfolded α-Synuclein in Autosomal Dominant Alzheimer's Disease.

We analyzed Lewy body (LB) pathology in 18 autosomal dominant Alzheimer's disease (ADAD) brains via immunohistochemistry. Real-time quaking induced conversion was used to detect misfolded α-synuclein (α-syn) in 18 living ADAD cerebrospinal fluid (CSF) samples. Concomitant LB pathology was present in 44% ADAD brains. Only 6% CSF samples were positive for misfolded α-syn. In an additional AD sample, all patients with confirmed LB presented misfolded α-syn in postmortem CSF regardless of the LB staging. In conclusion, misfolded α-syn in CSF was scarce in symptomatic living ADAD individuals, in contrast to postmortem brain tissue. These results suggest late appearance of LB pathology in ADAD.

Hospital at Home Program for the Treatment of Pediatric Osteoarticular Infections.

OBJECTIVES: Hospital at home (HAH) replaces acute inpatient hospital care for selected patients by providing care in their homes. We sought to describe the characteristics, management, and complications of patients with osteoarticular infections (OAIs) treated in an HAH program and its economic impact. METHODS: We conducted a retrospective observational study evaluating an HAH program in a pediatric hospital in Spain, describing the characteristics of patients with confirmed OAIs requiring intravenous antibiotic therapy admitted to this program between January 2019 and December 2022. The program operates as a virtual ward with possible daily visits by physicians and nurses and 24/7 telephone contact. RESULTS: A total of 88 patients (median age, 4.1 years; interquartile range [IQR], 1.7-10.6) with OIAs were admitted to the HAH program. Osteomyelitis (57%) and septic arthritis (29%) were the most frequent infections. Cefuroxime (42%) and cefazolin (39%) were the most frequently prescribed antibiotics. Caregiver self-administration was performed in 99%, allowing multiple daily doses of antimicrobial therapy, 80% by peripheral line. Thirteen patients (15%) had drug-related adverse events, only 3 requiring drug modification. Two patients (2%) were readmitted during HAH, and 1 was readmitted within 30 days of HAH discharge. The median HAH stay was 7 days (IQR, 4-8.75). For osteomyelitis, hospital days lowered from 8.5 days (IQR, 4.5-12) to 4 days (IQR, 3-7) after HAH implementation (P = .005) with 68% per-patient estimated cost savings. CONCLUSIONS: HAH treatment of OAIs is effective and cost-efficient. Patient support by medical and nursing staff, adequate family training, and regular communication are essential to ensure safe home admission.

Building Trust and Partnership with Black Pediatric Patients and their Caregivers.

Systemic racism embedded within the US health care system results in disproportionately worse health outcomes for Black pediatric patients and their caregivers. One meaningful mechanism through which these health disparities persist is through discriminatory treatment and anti-Black bias from clinicians. Strengthening care provided to Black pediatric patients and their caregivers requires that clinicians adopt culturally tailored communication strategies that promote health equity and counter racism. We conducted a scoping review of evidence-based communication practices in the medical literature that improve care for Black pediatric patients. We mapped the specific practices to the Presence 5 for Racial Justice framework and identified cross-cutting themes to describe practices across the five domains. There are three cross-cutting themes that underlie the recommended practices: 1) promote unbiased implementation of clinician communication strategies (eg, providing equitable recommendations for preventive care), 2) tailor care to Black pediatric patients (eg, explore the importance of the family unit), and 3) address racism experienced by Black pediatric patients and their caregivers (eg, acknowledge any previous negative experiences with the health care system). This review highlights communication practices that clinicians can adopt to build trusting relationships, empower Black families, and promote racial justice in clinical care. Future opportunities include expanding to system level change and validating these practices with patients and clinicians.

Impact of demographics and comorbid conditions on plasma biomarkers concentrations and their diagnostic accuracy in a memory clinic cohort.

Plasma biomarkers have emerged as promising tools for identifying amyloid beta (Aß) pathology. Before implementation in routine clinical practice, confounding factors modifying their concentration beyond neurodegenerative diseases should be identified. We studied the association of a comprehensive list of demographics, comorbidities, medication and laboratory parameters with plasma p-tau181, glial fibrillary acidic protein (GFAP) and neurofilament light chain (NfL) on a prospective memory clinic cohort and studied their impact on diagnostic accuracy for discriminating CSF/amyloid PET-defined Aß status. Three hundred sixty patients (mean age 66.5 years, 55% females, 53% Aß positive) were included. Sex, age and Aß status-adjusted models showed that only estimated glomerular filtration rate (eGFR, standardized ß -0.115 [-0.192 to -0.035], p = 0.005) was associated with p-tau181 levels, although with a much smaller effect than Aß status (0.685 [0.607-0.763], p < 0.001). Age, sex, body mass index (BMI), Charlson comorbidity index (CCI) and eGFR significantly modified GFAP concentration. Age, blood volume (BV) and eGFR were associated with NfL levels. p-tau181 predicted Aß status with 87% sensitivity and specificity with no relevant increase in diagnostic performance by adding any of the confounding factors. Using two cut-offs, plasma p-tau181 could have spared 62% of amyloid-PET/CSF testing. Excluding patients with chronic kidney disease did not change the proposed cut-offs nor the diagnostic performance. In conclusion, in a memory clinic cohort, age, sex, eGFR, BMI, BV and CCI slightly modified plasma p-tau181, GFAP and NfL concentrations but their impact on the diagnostic accuracy of plasma biomarkers for Aß status discrimination was minimal.

ADDovenom: Thermostable Protein-Based ADDomer Nanoparticles as New Therapeutics for Snakebite Envenoming.

Snakebite envenoming can be a life-threatening medical emergency that requires prompt medical intervention to neutralise the effects of venom toxins. Each year up to 138,000 people die from snakebites and threefold more victims suffer life-altering disabilities. The current treatment of snakebite relies solely on antivenom-polyclonal antibodies isolated from the plasma of hyperimmunised animals-which is associated with numerous deficiencies. The ADDovenom project seeks to deliver a novel snakebite therapy, through the use of an innovative protein-based scaffold as a next-generation antivenom. The ADDomer is a megadalton-sized, thermostable synthetic nanoparticle derived from the adenovirus penton base protein; it has 60 high-avidity binding sites to neutralise venom toxins. Here, we outline our experimental strategies to achieve this goal using state-of-the-art protein engineering, expression technology and mass spectrometry, as well as in vitro and in vivo venom neutralisation assays. We anticipate that the approaches described here will produce antivenom with unparalleled efficacy, safety and affordability.