Nutritional Characterization of Strychnos madagascariensis Fruit Flour Produced by Mozambican Communities and Evaluation of Its Contribution to Nutrient Adequacy.

The indigenous fruit Strychnos madagascariensis is usually processed to flour, called nfuma, being highly consumed during staple food shortage. This study aimed to evaluate the nutritional composition of nfuma and its nutrient adequacy. Flours from four districts of Mozambique were analyzed using AOAC methods for proximate composition, HPLC for sugar, amino acids (AA), vitamin E and carotenoids and ICP-MS and FAAS for minerals. The results showed that nfuma stands out for its high content of fat (26.3-27.8%), mainly oleic acid, fiber (>6%), vitamin E (6.7 to 8.0 mg/100 g) and carotenes (2.2 to 2.6 mg/100 g). The main amino acids of nfuma protein were Arg, Asp and Glu, and Lys was the limiting one. The mineral composition reveals K (~1200 to 1700 mg/100 g) as the main macromineral followed by Mg > Ca > Na. The main trace element was Mn (~4 mg/100 g) followed by Fe > Zn > Cu > Cr > Co. Aluminum (~3 mg/100 g) was the main non-essential element and Rb, Ni, Sr, Ba, V, Cd were also quantified. Assuming the daily consumption of 50 g, nfuma provides 82% of Vitamin A dietary reference value for toddlers, while the consumption of 100 g contributes to 132% and 60% of Mn and vitamin A DRV for adults, respectively. Despite the nutritional advantages of nfuma, this flour can be a source of Ni, highlighting the importance of the study of good practices in its preparation to decrease the exposure to non-essential elements.

Chemical Characterization of the Oil Separated by Mechanical Pressing from Strychnos madagascariensis Dried Fruit Pulp Flour.

In Mozambique, rural communities produce flours from the dried pulp of Strychnos madagascariensis fruits. Owing to its high lipid content, the oil from this flour is frequently separated by pressing to be used as seasoning and medicine. Aiming to characterize this oil, flour samples (n = 24), dried at two different temperatures (55 °C and 65 °C), were collected from four local communities, together with a control sample prepared in the lab (50 °C). The resulting oil was fluid at room temperature, deep orange, and characterized by a high content of oleic acid (62-63%), followed by palmitic (20%) and linoleic (7%). It contained considerable amounts of tocols (25-34 mg/100 g) and carotenoids (8-10 mg/100 g), as well as sterols (431 ± 10 mg/100 g) and triterpenic alcohols (823 ± 4 mg/100 g mg/100 g). The overall composition was highly consistent between origins and temperatures, with only small statistically significant differences (p < 0.05), mostly between the community dried flours and control group. However, its high free fatty acid content (22-25%) reveals intensive enzymatic hydrolysis during the drying/fermentation steps, whose extension can be reduced by optimizing its technological process. Its chemical profile supports some of its folklore uses, revealing that it can be a promising source of edible oil, with health and technological potential that is worth optimizing and exploring.

MITO-FIND: A study in 390 patients to determine a diagnostic strategy for mitochondrial disease.

Mitochondrial diseases, due to nuclear or mitochondrial genome mutations causing mitochondrial dysfunction, have a wide range of clinical features involving neurologic, muscular, cardiac, hepatic, visual, and auditory symptoms. Making a diagnosis of a mitochondrial disease is often challenging since there is no gold standard and traditional testing methods have required tissue biopsy which presents technical challenges and most patients prefer a non-invasive approach. Since a diagnosis invariably involves finding a disease-causing DNA variant, new approaches such as next generation sequencing (NGS) have the potential to make it easier to make a diagnosis. We evaluated the ability of our traditional diagnostic pathway (metabolite analysis, tissue neuropathology and respiratory chain enzyme activity) in 390 patients. The traditional diagnostic pathway provided a diagnosis of mitochondrial disease in 115 patients (29.50%). Analysis of mtDNA, tissue neuropathology, skin electron microscopy, respiratory chain enzyme analysis using inhibitor assays, blue native polyacrylamide gel electrophoresis were all statistically significant in distinguishing patients between a mitochondrial and non-mitochondrial diagnosis. From these 390 patients who underwent traditional analysis, we recruited 116 patients for the NGS part of the study (36 patients who had a mitochondrial diagnosis (MITO) and 80 patients who had no diagnosis (No-Dx)). In the group of 36 MITO patients, nuclear whole exome sequencing (nWES) provided a second diagnosis in 2 cases who already had a pathogenic variant in mtDNA, and a revised diagnosis (GLUL) in one case that had abnormal pathology but no pathogenic mtDNA variant. In the 80 NO-Dx patients, nWES found non-mitochondrial diagnosis in 26 patients and a mitochondrial diagnosis in 1 patient. A genetic diagnosis was obtained in 53/116 (45.70%) cases that were recruited for NGS, but not in 11/116 (9.48%) of cases with abnormal mitochondrial neuropathology. Our results show that a non-invasive, bigenomic sequencing (BGS) approach (using both a nWES and optimized mtDNA analysis to include large deletions) should be the first step in investigating for mitochondrial diseases. There may still be a role for tissue biopsy in unsolved cases or when the diagnosis is still not clear after NGS studies.

Treatment failure in children diagnosed with constipation in a paediatric emergency department in relation to Rome III criteria.

OBJECTIVE: To determine if treatment failure varies based on ROME III classification and adherence to guideline congruent therapy among children diagnosed in an emergency department with functional constipation. METHODS: Children aged 1 month to 18 years who were diagnosed with constipation in a paediatric emergency department underwent chart review and 7-day phone follow-up to complete the ROME III questionnaire, confirm treatments administered, and assess treatment failure. Participants were classified according to the ROME III criteria as having functional constipation (FC) or irritable bowel syndrome - constipation (IBS-C) subtype. The primary outcome was treatment failure defined as ≥ 2 of the following: 1) presenting symptom persistence; 2) < 1 bowel movement every other day; 3) pain/difficulty passing stools; and 4) abdominal pain between bowel movements. RESULTS: Five hundred and thirteen children completed follow-up; 40% (204/513) had FC, 23% (118/513) IBS-C, and 37% (191/513) did not meet either criteria. Treatment failure rates in children who received guideline congruent treatment were 28% (38/135) among those classified as FC and 43% (37/86) among those with IBS-C; P=0.02, a difference of 15% (95% confidence interval [CI]: 0.02, 0.27). On regression analysis, ROME III classification was not an independent predictor of treatment failure (odds ratio [OR]: 1.56 [95% CI: 0.97, 2.51]). At 7-day follow up, pain in between bowel movements was present in 22% (44/204) in FC patients versus 45% (53/118) of IBS-C patients; P=0.001. CONCLUSIONS: Treatment failure rates in children who receive guideline congruent therapy are higher among those with IBS-C, however, after adjustment for known confounders the relationship was not statistically significant.

Cannabinoid agonist rescues learning and memory after a traumatic brain injury.

Traumatic brain injury can cause persistent challenges including problems with learning and memory. Previous studies suggest that the activation of the cannabinoid 1 receptor after a traumatic brain injury could be beneficial. We tested the hypothesis that posttraumatic brain injury administration of a cannabinoid 1 receptor agonist can rescue deficits in learning and memory. Young adult male rats were subjected to a moderately severe controlled cortical impact brain injury, with a subset given postinjury i.p. injections of a cannabinoid receptor agonist. Utilizing novel object recognition and the morris water task, we found that the brain-injured animals treated with the agonist showed a marked recovery.