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This study evaluated the influence of novel beverage formulations on bioimpedance- and urine-based hydration markers. Thirty young healthy adults (n=16 females, n=14 males; age: 23.2±3.7 years; BMI: 24.3±3.3 kg/m2) participated in a randomized, double-blind, placebo-controlled, crossover study. Participants completed three conditions with baseline bioimpedance, urine, and body mass assessments, followed by ingestion of one liter of a test beverage over a 30-minute period. The three beverages were: active hydration formulation in still (AFstill) or sparkling (AFspark) water and a still water control. The active formulations were identical in concentrations of alpha-cyclodextrin and complexing agents. Following beverage ingestion, bioimpedance assessments were performed every 15 minutes for two hours, followed by final urinary and body mass assessments. The primary bioimpedance outcomes were phase angle at 50 kHz, resistance of the extra-cellular compartment (R0), and resistance of the intracellular compartment (Ri). Data were analyzed using linear mixed effects models, Friedman tests, and Wilcoxon tests. Statistically significant changes in phase angle values were observed at 30 (p=0.004) and 45 minutes (p=0.024) following the initiation of beverage ingestion in the AFstill condition as compared to the reference model (i.e., control condition at baseline). Although differences between conditions were not statistically significant at later time points, the data were consistent with AFstill having greater elevations in phase angle throughout the monitoring period. At the 30-minute time point only, statistically significant differences in R0 for AFspark (p

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Within the USA military, monitoring body composition is an essential component of predicting physical performance and establishing soldier readiness. The purpose of this study was to explore mobile phone three-dimensional optical imaging (3DO), a user-friendly technology capable of rapidly obtaining reliable anthropometric measurements and to determine the validity of the new Army one-site body fat equations using 3DO-derived abdominal circumference. Ninety-six participants (51 F, 45 M; age: 23·7 ± 6·5 years; BMI: 24·7 ± 4·1 kg/m 2 ) were assessed using 3DO, dual-energy X-ray absorptiometry (DXA) and a 4-compartment model (4C). The validity of the Army equations using 3DO abdominal circumference was compared with 4C and DXA estimates. Compared with the 4C model, the Army equation overestimated BF% and fat mass (FM) by 1·3 ± 4·8 % and 0·9 ± 3·4 kg, respectively, while fat-free mass (FFM) was underestimated by 0·9 ± 3·4 kg ( P < 0·01 for each). Values from DXA and Army equation were similar for BF%, FM and FFM (constant errors between -0·1 and 0·1 units; P ≥ 0·82 for each). In both comparisons, notable proportional bias was observed with slope coefficients of -0·08 to -0·43. Additionally, limits of agreement were 9·5-10·2 % for BF% and 6·8-7·8 kg for FM and FFM. Overall, while group-level performance of the one-site Army equation was acceptable, it exhibited notable proportional bias when compared with laboratory criterion methods and wide limits of agreement, indicating potential concerns when applied to individuals. 3DO may provide opportunities for the development of more advanced, automated digital anthropometric body fat estimation in military settings.

Background: Modern digital anthropometry applications utilize smartphone cameras to rapidly construct three-dimensional humanoid avatars, quantify relevant anthropometric variables, and estimate body composition., Methods: In the present study, 131 participants ([73 M, 58 F] age 33.7 ± 16.0 y; BMI 27.3 ± 5.9 kg/m 2 , body fat 29.9 ± 9.9%) had their body composition assessed using dual-energy X-ray absorptiometry (DXA) and a smartphone 3D scanning application using non-rigid avatar reconstruction. The performance of two new body fat % estimation equations was evaluated through reliability and validity statistics, Bland-Altman analysis, and equivalence testing., Results: In the reliability analysis, the technical error of the measurement and intraclass correlation coefficient were 0.5-0.7% and 0.996-0.997, respectively. Both estimation equations demonstrated statistical equivalence with DXA based on ±2% equivalence regions and strong linear relationships (Pearson's r 0.90; concordance correlation coefficient 0.89-0.90). Across equations, mean absolute error and standard error of the estimate values were ~ 3.5% and ~ 4.2%, respectively. No proportional bias was observed., Conclusion: While continual advances are likely, smartphone-based 3D scanning may now be suitable for implementation for rapid and accessible body measurement in a variety of applications., Competing Interests: GMT has received in-kind support for his research laboratory, in the form of equipment loan or donation, from manufacturers of body composition assessment devices, including Size Stream LLC; Naked Labs Inc.; Prism Labs Inc.; RJL Systems; MuscleSound; and Biospace, Inc. (DBA InBody). None of these entities played any role in the present investigation, beyond the role of Prism Labs described in the Funding Statement. SBH reports personal fees from Medifast Corporation, Tanita Corporation, Novo Nordisk, Amgen, Versanis, and Novartis, outside the submitted work. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Tinsley, Rodriguez, Florez, Siedler, Tinoco, McCarthy and Heymsfield.)

Background: Thermogenic supplements are often consumed by individuals seeking to improve energy levels and reduce body fat. These supplements are sold in powdered or ready-to-drink (RTD) forms and consist of a blend of ingredients such as caffeine, green tea extract, and other botanical compounds. While there is evidence that thermogenic supplements can positively affect resting energy expenditure (REE), the effect varies based on the combination of active ingredients. Additionally, there is some concern that thermogenic supplements may cause unwanted side effects on hemodynamic variables, like heart rate (HR) and blood pressure (BP). Therefore, further investigation into the efficacy and safety of commercially available products is warranted., Methods: Twenty-eight individuals (14 F, 14 M; age: 23.3 ± 3.9 yrs; height: 169.4 ± 8.6 cm; body mass: 73.3 ± 13.1 kg) completed two visits in a randomized, double-blind, crossover fashion. Each visit began with baseline REE, HR, and BP assessments, which were followed by ingestion of an active RTD thermogenic beverage (RTD; OxyShred Ultra Energy) or placebo (PL). Assessments were repeated at the intervals of 35-50- and 85-100-minutes post-ingestion. In addition, subjective outcomes of energy, focus, concentration, alertness, and mood were collected five times throughout each visit. Repeated-measures analysis of variance was performed with condition and time specified as within-subjects factors and sex and resistance training (RT) status as between-subjects factors. Statistical significance was accepted at p  < 0.05., Results: A significant condition × time interaction was observed for REE ( p  < 0.001). Higher REE values were demonstrated at 35-50 min (0.08 ± 0.02 kcal/min; p  = 0.001; 5.2% difference) and 85-100 min (0.08 ± 0.02 kcal/min; p  = 0.001; 5.5% difference) after RTD ingestion as compared to PL. No significant condition × time interactions were observed for respiratory quotient, HR, or BP. Condition main effects indicated lower HR (3.0 ± 0.9 bpm; p  = 0.003), higher SBP (3.5 ± 1.1 mm Hg; p  = 0.003) and higher DBP (3.5 ± 0.9 mm Hg; p  < 0.001) in RTD as compared to PL, irrespective of time. Condition × time interactions were observed for all subjective outcomes ( p  ≤ 0.02). Post hoc tests indicated statistically significant benefits of the RTD over PL for energy, focus, concentration, and alertness, without significant differences for mood after correction for multiple comparisons. Sex and RT status were not involved in interactions for any outcomes, except for a Sex × RT status interaction for energy, indicating higher energy ratings in non-resistance-trained vs. resistance-trained males., Conclusions: These data suggest that acute ingestion of a thermogenic RTD beverage significantly increases REE, and this elevated caloric expenditure is sustained for at least 100 minutes following ingestion. Furthermore, the RTD beverage increased measures of energy, focus, concentration, and alertness as compared to placebo. While minor differences in hemodynamic variables were observed between conditions, all values stayed within normal ranges. Individuals aiming to increase energy expenditure may benefit from acute ingestion of an RTD thermogenic supplement.

Aim: To evaluate the readiness of the Mexican healthcare system to implement the integrated care for older people (ICOPE) approach into an existing healthcare model., Methods: We conducted a cross-sectional study with data from 2473 healthcare workers analyzed using the model for understanding success in quality (MUSIQ) framework to gather data from healthcare professionals. Their perceptions regarding the readiness for ICOPE were assessed across five dimensions: team, microsystem, infrastructure, organization, and external environment., Results: Only 717 (29%) of the participants believed ICOPE could be successfully implemented in Mexico without any modifications. A total of 1261 (51%) participants rated the readiness of ICOPE with some barriers. The main barriers were reallocating resources and the external environment., Observation: Mexico's healthcare system faces barriers to innovation that could hinder the successful integration of the ICOPE approach. A systematic identification of these barriers provides an opportunity to suggest adaptations and refinements to increase the probability of success. Using the contextual factors identified as facilitators and the proposal of interventions such as the ICOPE app could improve the chances of success., Conclusion: The participants of this study evaluated ICOPE as ready to implement, with some contextual barriers. The readiness evaluation supports the stakeholders' and policymakers' decisions in implementing and monitoring the program in a natural setting. Evaluating the readiness of the intervention increases the possibility of aligning the innovation with contextual factors, increasing the chances of its successful adoption and implementation., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Gutierrez et al.)

Multi-ingredient thermogenic supplements can acutely increase resting energy expenditure (REE) and subjective energy. However, less is understood about the effects of chronic consumption on body composition, metabolism, and subjective variables such as mood, sleep quality, and eating behaviors. Fifty-two healthy, exercise-trained participants (50% female; mean ± SD age: 23.5 ± 3.0 years; body fat percentage: 27.3 ± 8.0%) were randomized 2:2:1 to take a whey protein supplement alone (PRO; n = 20), in combination with a thermogenic supplement (PRO + FB; n = 19), or no supplement at all (CON; n = 13) for four weeks. Body composition, anthropometric, metabolic, hemodynamic, and subjective outcomes were collected before and after the intervention. Greater changes in REE occurred in PRO + FB as compared to CON (111.2 kcal/d, 95% CI 2.4 to 219.9 kcal/d, p = 0.04), without significant differences between PRO and CON (42.7 kcal/d, 95% CI -65.0 to 150.3 kcal/d, p = 0.61) or between PRO + FB and PRO (68.5 kcal/d, 95% CI -28.3, 165.3, p = 0.21). No changes in hemodynamic outcomes (blood pressure and heart rate) were observed. In exercising adults, four weeks of supplementation with protein and a multi-ingredient thermogenic product maintained fasted REE as compared to no supplementation, for which a decrease in REE was observed, without differential effects on body composition, anthropometrics, or subjective variables.

Short sleep is linked to disturbances in glucose metabolism and may induce a prediabetic condition. The biological clock in the suprachiasmatic nucleus (SCN) regulates the glucose rhythm in the circulation and the sleep-wake cycle. SCN vasopressin neurons (SCN VP ) control daily glycemia by regulating the entrance of glucose into the arcuate nucleus (ARC). Thus, we hypothesized that sleep delay may influence SCN neuronal activity. We, therefore, investigated the role of SCN VP when sleep is disrupted by forced locomotor activity. After 2 h of sleep delay, rats exhibited decreased SCN VP neuronal activity, a decrease in the glucose transporter GLUT1 expression in tanycytes lining the third ventricle, lowered glucose entrance into the ARC, and developed hyperglycemia. The association between reduced SCN VP neuronal activity and hyperglycemia in sleep-delayed rats was evidenced by injecting intracerebroventricular vasopressin; this increased GLUT1 immunoreactivity in tanycytes, thus promoting normoglycemia. Following sleep recovery, glucose levels decreased, whereas SCN VP neuronal activity increased. These results imply that sleep-delay-induced changes in SCN VP activity lead to glycemic impairment, inferring that disruption of biological clock function might represent a critical step in developing type 2 diabetes., Competing Interests: Declaration of interests The authors declare no competing interests., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Concomitant use of a nasopharyngeal catheter is frequently used for oxygen supply during fiberoptic bronchoscopy (FOB). This is a procedure that presents possible complications that are not negligible. We demonstrate the case of a 61-year-old woman who underwent FOB due to a history of hemoptoic sputum. During the procedure, gastric rupture occurred with a large pneumoperitoneum and bilateral pneumothorax requiring immediate drainage of the air and an emergent laparotomy. This was probably a complication of the nasopharyngeal catheter. The knowledge of these complications is essential for their correct identification and treatment., Competing Interests: Conflicts of interest The authors declare no conflicts of interest., (Copyright © 2021. Published by Elsevier España S.L.U.)

Introduction: Given the progressive aging of the population, there is an urgent need at the health system level to implement effective models to care for older people (OP). Healthy aging is imperative to reach the Sustainable Development Goals. The World Health Organization (WHO) developed the Integrated Care for Older People (ICOPE) strategy to address this challenge. Implementing ICOPE requires its adaption to a specific context. We propose a pathway for such adaptation through an evaluation of the design of ICOPE; thus, we aim to describe the Theory of Change (ToC) of ICOPE and evaluate it for its implementation in Mexico City., Methods: Based on the WHO and published literature documentation, we drafted an initial ToC for ICOPE. Then, we validated the ToC with experts in ICOPE, after which we evaluated and refined it by discussing the causal pathway, intervention required to activate it, rationale, and assumptions in consecutive workshops with 91 stakeholders and healthcare workers, using the nominal group technique to reach a consensus., Results: The resulting ToC has the potential to contribute to healthy aging by three expected impacts: (1) prevention, reversal, or delaying of the decline of intrinsic capacity (IC) in OP; (2) improvement of the quality of life of OP; and (3) increase of disability-free life expectancy. The ICOPE causal pathway had ten preconditions, including the availability of resources, identifying at-risk individuals, available treatments, and evaluating results., Discussion: We adapted ICOPE to a specific implementation context by evaluating its ToC in a participatory process that allows us to identify challenges and address them, at least in terms of the guidelines to operate the strategy. As ICOPE is an approach for a primary healthcare system, its adoption in a community healthcare program is promising and feasible. Evaluation as a tool could contribute to the design of effective interventions. The evaluation of the design of ICOPE for its implementation contributes to the strength of its potential to improve care for OP. This design for implementing ICOPE has the potential to be applied to similar contexts, for example, in other lower-middle-income countries., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Gutiérrez-Barreto, Sosa-Tinoco, Rojas-Calixto, Deniss-Navarro, Avila-Avila and Gutierrez.)

Since the emergence of the COVID-19 pandemic, the most affected population group has been that of older people living in long-term care facilities (LTCFs), which has accumulated between 30 and 60 % of total number of deaths in the world. In Mexico, outbreaks have been reported in LTCFs of at least eight states. Various factors make this population group and LTCFs susceptible to COVID-1 outbreaks, mainly due to coexistence in common spaces, shared bedrooms and permanent physical contact with the personnel who work there, coupled with a lack of protocols and standards of care of mandatory observance, as well as personnel training limitations. There is evidence of the need to formally develop a National Care System that provides support to those in need of care and their families, and that includes LTCFs. In view of the challenges due to the lack of information and competencies in infection prevention and control at LTCFs, a group of experts, in collaboration with different public institutions, joined efforts with the purpose to update the guidelines in order to allow LTCFs face the pandemic and to contribute to the generation of said National Care System., (Copyright: © 2020 Permanyer.)

The autonomic nervous system (ANS) modulates the immune response through the engagement of an anti-inflammatory reflex. There is controversy regarding which efferent branch of the ANS, sympathetic or parasympathetic, downregulates the intensity of the inflammatory response. Furthermore, how information about the immune status of the body reaches the CNS to engage this reflex remains unclear. The present study demonstrates the existence of a liver-spinal axis that conveys early circulating inflammatory information to the CNS in response to lipopolysaccharide (LPS) and serves as the afferent arm of a sympathetic anti-inflammatory reflex. Furthermore, brainstem and spinal cord visceral sensory neurons show a time-of-day-dependent sensitivity to the incoming inflammatory information, in particular, prostaglandins (PG). Consequentially, the liver-spinal axis promotes the retention of tumor necrosis factor α (TNFα) in the liver and spleen during the resting period, resulting in low plasmatic TNFα levels. Consistently, low sensitivity for LPS during the active period promotes the release of TNFα from the organs into the circulation, resulting in high plasmatic TNFα levels. The present novel findings illustrate how the time-of-day-dependent activation of the liver-spinal axis contributes to the daily fluctuations of the inflammatory response., (Copyright © 2020 Soto-Tinoco et al.)

Objective: Glycemic control has been increasingly recognized as a critical element in inpatient care, but optimal management of blood glucose in the hospital setting remains challenging. The aims of this study were to describe and evaluate the impact of the implementation of an inpatient multidisciplinary glucose control management program on glucose control in hospitalized patients., Materials and Methods: Retrospective analysis of medical records and glucose monitoring data obtained by point- of-care testing (POCT) in hospitalized patients before (May 2014) and after (June 2015 and May 2017) the implementation of the program., Results: We analyzed 6888, 7290, and 7669 POCTs from 389, 545, and 475 patients in May 2014, June 2015, and May 2017, respectively. Hyperglycemia (≥ 180 mg/ dL) occurred in 23.5%, 19.6%, and 19.3% POCTs in May 2014, June 2015, and May/2017, respectively (p < 0.001), while severe hyperglycemia (≥ 300 mg/dL) was observed in 2.5%, 2.2%, and 1.8% of them, respectively (p = 0.003). Hyperglycemia (≥ 180 mg/dL) reduced significantly from May 2014 to June 2015 (16.3%, p < 0.001) and from May 2014 to May 2017 (178%, p < 0.001). No significant changes occurred in hypoglycemic parameters., Conclusions: The implementation of an inpatient multidisciplinary glucose control management program led to significant reductions in hyperglycemic events. The key elements for this achievement were the development of institutional inpatient glycemic control protocols, establishment of a multidisciplinary team, and continuing educational programs for hospital personnel. Altogether, these actions resulted in improvements in care processes, patient safety, and clinical outcomes of hospitalized patients.

New Findings: What is the topic of this review? Both branches of the autonomic nervous system are involved in the regulation of the inflammatory response. We explore how the hypothalamus may influence this process. What advances does it highlight? We analyse how a lipopolysaccharide signal is transmitted to the brain and which areas participate in the response of the brain to lipopolysaccharide. Recent studies show that the hypothalamus can influence the inflammatory response by modifying the autonomic output. The biological clock, the suprachiasmatic nucleus, is integrated into this circuit, putting a time stamp on the intensity of the inflammatory response. The brain is responsible for maintaining homeostasis of the organism, constantly adjusting its output via hormones and the autonomic nervous system to reach an optimal setting in every compartment of the body. Also, the immune system is under strong control of the brain. Apart from the conventional systemic responses evoked by the brain during inflammation, such as hypothalamic-pituitary-adrenal axis activation and the induction of sickness behaviour, the autonomic nervous system is now recognized to exert regulatory effects on the inflammatory response. Both branches of the autonomic nervous system are proposed to influence the inflammatory process. Here, we focus on those areas of the brain that might be involved in sensing inflammatory stimuli, followed by how that sensing could change the output of the autonomic nervous system in order to regulate the inflammatory response. Finally, we will discuss how the defenses of the body against a lipopolysaccharide challenge are organized by the hypothalamus., (© 2016 The Authors. Experimental Physiology © 2016 The Physiological Society.)

Oxygen or nutrient deprivation of early stage tumoral spheroids can be used to reliably mimic the initial growth of primary and metastatic cancer cells. However, cancer cell growth during the initial stages has not been fully explored using a genome-wide approach. Thus, in the present study, we investigated the transcriptome of breast cancer cells during the initial stages of tumoral growth using RNAseq in a model of Multicellular Tumor Spheroids (MTS). Network analyses showed that a metastatic signature was enriched as several adhesion molecules were deregulated, including EPCAM, E-cadherin, integrins and syndecans, which were further supported by an increase in cell migration. Interestingly, we also found that the cancer cells at this stage of growth exhibited a paradoxical hyperactivation of oxidative mitochondrial metabolism. In addition, we found a large number of regulated (long non coding RNA) lncRNAs, several of which were co-regulated with neighboring genes. The regulatory role of some of these lncRNAs on mRNA expression was demonstrated with gain of function assays. This is the first report of an early-stage MTS transcriptome, which not only reveals a complex expression landscape, but points toward an important contribution of long non-coding RNAs in the final phenotype of three-dimensional cellular models.

Glucose is the main energy substrate in brain but in certain circumstances such as prolonged fasting and the suckling period alternative substrates can be used such as the ketone bodies (KB), beta-hydroxybutyrate (BHB), and acetoacetate. It has been shown that KB prevent neuronal death induced during energy limiting conditions and excitotoxicity. The protective effect of KB has been mainly attributed to the improvement of mitochondrial function. In the present study, we have investigated the protective effect of D-BHB against neuronal death induced by severe noncoma hypoglycemia in the rat in vivo and by glucose deprivation (GD) in cortical cultures. Results show that systemic administration of D-BHB reduces reactive oxygen species (ROS) production in distinct cortical areas and subregions of the hippocampus and efficiently prevents neuronal death in the cortex of hypoglycemic animals. In vitro results show that D-BHB stimulates ATP production and reduces ROS levels, while the nonphysiologic isomer of BHB, L-BHB, has no effect on energy production but reduces ROS levels. Data suggest that protection by BHB, not only results from its metabolic action but is also related to its capability to reduce ROS, rendering this KB as a suitable candidate for the treatment of ischemic and traumatic injury.