Search

Chronic kidney disease (CKD) is a prevalent health condition associated with numerous complications, including olfactory and taste dysfunction, and malnutrition. This systematic review focused on dysgeusia, smell disorders and malnutrition in CKD patients. The search included scientific databases such as PubMed, Cochrane Library, CINAHL, Scopus, and Web of Science, as well as sources of grey literature. Quality assessment and risk of bias were evaluated using JBI guidelines, while the certainty of evidence was assessed with the Oxford Centre methods. Seven studies were included: two focusing on anosmia and five on dysgeusia. Anosmia was associated with poorer nutritional status, and interventions such as intranasal theophylline showed promise in enhancing olfactory function. Dysgeusia studies highlighted the potential role of zinc deficiency in malnutrition among dialysis patients, with zinc supplementation showing mixed results to improve taste dysfunction. Taste alterations were correlated with upper gastrointestinal symptoms and malnutrition in CKD patients. The analysis of the interconnection between anosmia, dysgeusia, and malnutrition emerges as a crucial starting point for improving nutritional outcomes in chronic kidney disease (CKD) patients, emphasizing the need for accurate assessment and targeted therapeutic interventions to ensure better nutritional health and improved quality of life for these patients. Resumen: La enfermedad renal crónica (ERC) es una condición de salud prevalente asociada a numerosas complicaciones, incluyendo disfunción olfativa y gustativa, así como malnutrición. Esta revisión sistemática se centró en la disgeusia, los trastornos olfativos y la malnutrición en los pacientes con ERC. La búsqueda incluyó bases de datos científicas tales como PubMed, Cochrane Library, CINAHL, Scopus y Web of Science, así como fuentes de la literatura gris. La evaluación de la calidad y el riesgo de sesgo se analizaron utilizando las guías JBI, mientras que la certidumbre de la evidencia se evaluó mediante los métodos de Oxford Centre. Se incluyeron siete estudios: dos de ellos centrados en la anosmia y cinco en la disgeusia. La anosmia estuvo asociada a un peor estatus nutricional, y las intervenciones tales como teofilina intranasal resultaron prometedoras para mejorar la función olfativa. Los estudios sobre disgeusia destacaron el rol potencial de la deficiencia de zinc en la malnutrición entre los pacientes de diálisis, y la aportación de suplementos de zinc mostró resultados mixtos para mejorar la disfunción gustativa. Las alteraciones del gusto se correlacionaron con los síntomas del tracto gastrointestinal superior y la malnutrición en los pacientes de ERC. El análisis de la interconexión entre anosmia, disgeusia y malnutrición surge como punto de inicio fundamental para mejorar los resultados nutricionales en los pacientes con ERC, subrayando la necesidad de realizar evaluaciones precisas e intervenciones terapéuticas focalizadas para garantizar una mejor salud nutricional y mejorar la calidad de vida de dichos pacientes.

Background: Lifestyle medicine (LM) is a contemporary scientific discipline with a multidisciplinary approach. Case Management offers a viable alternative for the care of patients with Type 2 Diabetes (T2D). This study aimed to identify the role and clinical applications of the lifestyle medicine case manager nurse (LMCMN) for T2D patients internationally and to analyze the role of specialist nurses in Italy through a narrative review. A secondary objective was to define a job description (JD) for a future Delphi method. Methods: A narrative review of the literature was conducted using PubMed/Medline, Scopus, and grey literature sources to analyze the international and Italian regulatory contexts. Subsequently, a JD for the LMCMN was developed for application in a future Delphi Study. Results: Nurses play a strategic role in managing T2D, and the LM approach has demonstrated strong evidence of effectiveness. This study developed a specific JD for the LMCMN suitable for both Italian and international contexts. Conclusions: The specific role of the LMCMN is still underdeveloped internationally. In the context of territorial assistance and chronic disease management, this professional is crucial for delivering quality care and shaping health policies that meet community needs.

Background: Depression is a serious and debilitating condition with a rising prevalence. Anhedonia, a core symptom of depression, is notably significant and the second most weighted factor among the non-somatic concerns of depression, following depressed mood. The interaction between technology use, mood, emotions, depression, and anhedonia is a critical area of investigation. Aim: This study aims to develop a comprehensive Systematic Review Protocol to examine the emotional effects of Internet-related behavior in young people. Methods: A systematic review protocol was developed following PRISMA guidelines for systematic reviews. The research question was formulated according to the PICOS framework. The search was conducted using PubMed/Medline, Cochrane Library, Embase, Scopus, and PsycInfo, supplemented by gray literature sources via Google Scholar. The methodological quality and risk of bias was assessed using the Critical Appraisal Skills Programme (CASP) framework. This systematic review protocol was registered on the Open Science Framework with the registration DOI: 10.17605/OSF.IO/SHNJU. Conclusions: The findings of this systematic review are expected to provide new evidence on the correlations between depression, Internet addiction, and anhedonia, contributing to the development of targeted intervention strategies and improving the understanding of young peoples’ emotional well-being.

Background/Aim: Chronic kidney disease (CKD), primarily caused by diabetes, predisposes patients to a high risk of systemic complications, including vascular ulcers. This study aimed to evaluate the impact of arterial vascular ulcers in patients with CKD, with particular attention to predisposing factors including diabetes and prevention strategies. Methods: A narrative literature review was conducted, adopting the Scale for the Assessment of Narrative Review Articles (SANRA), using databases such as PubMed, CINAHL, Embase, and Cochrane Library, along with grey literature sources. Results: The literature review revealed a significant association between peripheral arterial disease (PAD) and CKD, highlighting the prevalence (41.5%) and associated risk factors, such as type 1 diabetes (OR, 2.993; 95% CI: 1.477–6.065, p = 0.002), type 2 diabetes (OR, 2.498; 95% CI: 1.466–4.256, p = 0.001), and hypertension (OR, 1.781; 95% CI: 1.293–2.450, p < 0.001) in hemodialysis patients. Preventive strategies were discussed, emphasizing the automation of ankle–brachial index (ABI) measurement. Conclusions: This review identifies risk factors and preventive strategies for PAD in CKD patients, emphasizing diabetes as a key contributor. Evidence supports current diagnostic approaches and guidelines but highlights the need for larger studies. Standardized protocols and targeted training are crucial for improved management.

Introduction: Pressure ulcers (PUs) represent a significant challenge in chronic care, particularly among the elderly with reduced mobility. They result in substantial socio-healthcare costs and negatively impact patients’ psychological well-being. Malnutrition is a key risk factor, hindering healing and increasing the risk of complications. As such, appropriate nutritional interventions are crucial for managing PUs. However, these interventions are often underestimated in clinical practice, underscoring the need for a more comprehensive approach to elder care and healthy aging. Objectives: The primary objective of this study was to identify the best scientific evidence on nutritional interventions implemented by nurses in community settings to prevent complications related to PUs. Additionally, qualitative and quantitative outcomes reported in the included studies were analyzed. Method: This systematic review was conducted following PRISMA international guidelines. Searches were performed in PubMed, Scopus, Embase, and CINAHL databases. A predefined search strategy using Boolean operators was employed, and two researchers independently selected papers, with a third researcher resolving any discrepancies. Additional sources and manual reviews were conducted to minimize selection bias. Results: Out of 1003 records, 6 studies were included. Findings indicate that nurses play a fundamental role in managing PUs in community settings through specific nutritional intervention assistance processes. These healthcare professionals are pivotal in the prevention, care, and rehabilitation of vulnerable individuals with PUs. Conclusions: Nurses are strategic in the management of PUs within community care for frail populations. With nutritional support that plays a key role in both preventing and accelerating the healing of PUs. Policymakers are encouraged to invest in nursing roles to enhance assistance in community contexts, supporting healthy aging and lifestyle medicine approaches.

Background: Diabetes affects over 460 million people worldwide and represents a growing public health challenge driven largely by dietary and lifestyle factors. While Type 2 diabetes (T2D) is more prevalent, Type 1 diabetes (T1D) presents unique therapeutic challenges, particularly in younger individuals. Advances in diabetes management, such as continuous glucose monitoring (CGM), insulin pumps (IP), and, more recently, smart multiple dose injection (MDI) pens, have significantly enhanced glycemic control and improved patients’ quality of life. Aim: This study aims to evaluate the baseline characteristics of patients switching from MDI therapy to the Medtronic Smart MDI system [composed of a smart insulin pen (InPenTM) and a connected CGM Medtronic SimpleraTM sensor] and to assess its impact on glycemic outcomes over different time periods (14, 30, and 90 days). Methods: A retrospective observational study was conducted among adults with T1D who initiated Medtronic Smart MDI therapy. Participants were enrolled voluntarily at the Diabetes and Nutrition Clinic in Ast Fermo, Marche Region, Italy. Glycemic parameters were monitored using CGM data and analyzed with descriptive statistics, including mean, standard deviation (SD), and interquartile range (IQR). Comparisons across time periods were performed using the Wilcoxon signed-rank test, with statistical significance set at p < 0.05. Results: This study included 21 participants with a mean age of 51.5 years, a mean BMI of 24.7, and a mean duration of T1D of 21.9 years. The transition from a traditional MDI system to the Smart MDI system resulted in significant improvements in key glycemic parameters: mean Sensor Glucose (SG) decreased from 171.0 mg/dL to 153.5 mg/dL (p = 0.035), Time In Range (TIR) increased from 58.0% to 64.4% (p = 0.005), and time above range (TAR; >180 mg/dL) decreased from 39.0% to 34.2% (p = 0.015). No significant differences were observed in the time below range (TBR). Conclusions: The transition to the Medtronic Smart MDI system significantly enhanced glycemic control by lowering mean glucose levels and increasing TIR. These findings highlight its efficacy in improving hyperglycemia management while maintaining a stable risk of hypoglycemia.

Background: As part of simulation-based learning, it is well known that debriefing plays a crucial role; ineffective debriefing can lead to a reiteration of errors in decision-making and a poor understanding of one’s limitations, compromising the learner’s psychological safety and making future simulated learning experiences less effective. In Italy, although simulation has been used in nursing education for more than 20 years, there is a general lack of data regarding the elements of debriefing. Methods: An exploratory, cross-sectional, multicenter nationwide study was conducted to identify current debriefing practices in Italian simulation-based nursing education. A non-probability sample of all directors of the Italian Bachelor school of Nursing and the directors of simulation centers on Italian national territory was surveyed with an online questionnaire. Results: Fifty-four nursing degree programs and 11 simulation centers participated in the survey. Significant differences were found between debriefing practices used by simulation centers and those used by the Bachelor School of Nursing. Specifically, differences concerned the training of debriefers, the knowledge of a debriefing framework, the use of different rooms for debriefing and the time spent on this activity. Conclusions: There is an emerging need for a harmonization process in Italian nursing education debriefing practices that would align the current reality with the best practices of the literature.

Background/Aims: Ultrasound is a key diagnostic tool in modern medicine due to its ability to provide real-time, high-resolution images of the internal structures of the human body. Despite its undeniable advantages, there are challenges related to the contamination of ultrasound probes, with the risk of healthcare-associated infections. The aim of this review was to identify the most effective disinfectants for disinfecting ultrasound probes to prevent the transmission of pathogens between patients. Methods: A narrative review was conducted using the PubMed, CINAHL, Embase, and Cochrane Library databases, resulting in the inclusion of 16 studies from an initial 1202 records. Results: Hydrogen peroxide (H2O2) was the most effective disinfectant, especially in automated systems, achieving a >5-log10 reduction in viral load, including that of resistant pathogens like Human Papillomavirus. Chlorhexidine gluconate (4%) demonstrated strong antibacterial efficacy, eliminating 84.62% of bacterial contamination, but was less effective against viral pathogens. Glutaraldehyde was effective in some cases, though its use carried a higher risk of probe damage. The use of sodium hypochlorite varied across guidelines; some endorsed it for COVID-19 prevention, while others cautioned against its application due to potential probe damage. Conclusions: This study highlights the importance of advanced disinfection technologies and strict adherence to protocols in improving infection control. Automated systems utilizing H2O2 strike an ideal balance between antimicrobial efficacy and equipment preservation. Future research should focus on developing disinfection methods that prioritize safety, cost-effectiveness, and environmental sustainability in various clinical environments.

Background: The aging population drives a growing demand for care, particularly in Europe. It is estimated that approximately 1.5–2 million individuals have a chronic wound. Among these, pressure ulcers (PUs) are one of the most prevalent complications in vulnerable individuals. Malnutrition is a primary risk factor, yet it can be mitigated through proper nutrition and adequate community support. The community nurse plays a crucial role in managing chronic conditions and nutrition through constant and professional monitoring. Aim: This article presents a comprehensive systematic review (SR) protocol to examine the role of community nursing of nutritional intervention of frail population with wound care. Methods: A SR will be conducted according to international standards and reported following the PRISMA Guidelines for SRs. The search will be conducted in PubMed/Medline, Scopus, Embase, and CINAHL, supplemented by grey literature sources. The methodological quality and risk of bias will be assessed using the Critical Appraisal Skills Programme (CASP) framework. The protocol has been registered in the Open Science Framework (OSF). Conclusions: It is anticipated that the findings of this SR will provide new evidence on the relationships between nutritional nursing interventions and wound care management primarily in the community setting.

Background and Objectives: In Italy, as in the rest of the world, government restrictions aimed at containing the spread of COVID-19 primarily imposed limitations on social relationships and personal behavior. This situation significantly affected the management of chronic illnesses, including type 2 diabetes (T2D). The objective was to evaluate the perceptions of patients with T2D regarding the quality of care received during the COVID-19 pandemic and the impact on dietary and physical activity behaviors. Materials and Methods: We conducted a retrospective cross-sectional survey. Data were collected from June to July 2023 using the convenience sampling of patients with T2D, and the Patient Assessment of Chronic Illness Care (PACIC) and Medi-Lite questionnaires were administered. Results: During the research period, out of the 130 subjects who met all enrollment criteria, 103 patients were included in this study (79.23%). The results of the administered questionnaires were heterogeneous. The average scores from the PACIC Questionnaire for each question displayed significant variability, indicating a range of experiences in the quality of care. In the Medi-Lite survey, fruit, cereals, and olive oil showed the highest adherence levels, with mean scores ranging from 2.58 (SD ± 1.18) for fruit to 1.89 (SD ± 0.34) for olive oil and 1.97 (SD ± 0.17) for cereals. Patients who reported increased food intake during the lockdown attributed it to having more time to prepare meals. Physical activity levels remained unchanged for 48 patients, decreased for 45 patients, and only 9 patients managed to exercise more during the COVID-19 restrictions. Conclusions: Healthcare systems must prioritize comprehensive care plans for T2D that address not only physical health, but also emotional and social well-being. Post-pandemic, promoting healthier lifestyles and empowering patients to manage their condition is crucial. A multidisciplinary and multidimensional approach could support the care of vulnerable individuals, such as patients with T2D, especially during crises like pandemics or other dramatic events.

Abstract Crassvirales (crAss-like phages) are an abundant group of human gut-specific bacteriophages discovered in silico. The use of crAss-like phages as human fecal indicators is proposed but the isolation of only seven cultured strains of crAss-like phages to date has greatly hindered their study. Here, we report the isolation and genetic characterization of 25 new crAss-like phages (termed crAssBcn) infecting Bacteroides intestinalis, belonging to the order Crassvirales, genus Kehishuvirus and, based on their genomic variability, classified into six species. CrAssBcn phage genomes are similar to ΦCrAss001 but show genomic and aminoacidic differences when compared to other crAss-like phages of the same family. CrAssBcn phages are detected in fecal metagenomes around the world at a higher frequency than ΦCrAss001. This study increases the known crAss-like phage isolates and their abundance and heterogeneity open the question of what member of the Crassvirales group should be selected as human fecal marker.

Introduction: Type 1 diabetes (T1D) is a disease that primarily occurs in pediatric populations. A school nurse (SN) can provide valuable support in the school setting for minors affected by this condition. Methods: The main objective of this study was to evaluate the impact of nursing care provided to adolescents and children with T1D using technological devices in school. Qualitative and quantitative outcomes considered in the included studies were collected and discussed. A systematic review was conducted in the PubMed, CINAHL, and Scopus databases and reported thought the PRISMA guidelines. Results: Eleven studies were included. The results showed that SNs need to enhance both their skills and organization to effectively manage young patients with T1D using technology. The response of both the pediatric population and their caregivers to the disease management by a SN has been positive. Conclusions: The management of chronic diseases is one of the most urgent public health issues, especially for Western healthcare systems. Proper management of patients with T1D at the school level is definitely an aspect that policymakers and healthcare managers should consider to improve the quality of life of this extremely vulnerable population, particularly those using technological management T1D.

Background: COVID-19 infection, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), quickly emerged as the most significant event of the new millennium. A balanced diet seems to ensure the proper functioning of the immune system and plays a fundamental role in the prevention of viral disease, inflammation, or thrombosis. The principal aim of this secondary study was to investigate the relationship between nutrients, lifestyle eating behaviors, and SARS-CoV-2 infection. Methods: A narrative review was conducted in the PubMed-Medline database, analyzing primary studies. Results: Our review identified 21 relevant studies: 13 focused on vitamins, 1 on omega-3 supplementation, 1 on probiotics, and 6 on lifestyle and dietary behaviors. Vitamin supplementation has shown promise in attenuating COVID-19 symptoms and reducing mortality risk. Specifically, vitamin D has demonstrated efficacy in enhancing immune responses among patients with the disease. While preliminary evidence suggests the potential benefits of omega-3 and probiotic supplementation in improving health outcomes for COVID-19 outpatients, further research is needed to solidify these findings. Conclusions: The lifestyle changes imposed by lockdown measures have adversely affected psychological well-being and exacerbated health issues associated with reduced physical activity and poor dietary habits.

Background: to prove the effectivity of fertility-sparing procedures in early-stage ovarian cancer by assessing pregnancy rates and obstetrical outcomes. Methods: we performed a retrospective multicenter study among 55 Spanish hospitals, collecting patients from 18 to 40 years old with diagnosis of early-stage ovarian cancer, epithelial (EOC) or non-epithelial (non-EOC), from January 2010 to December 2019. Data on the use of assisted reproductive techniques, pregnancy attempts and obstetrical outcomes were collected. Results: a total of 150 patients met inclusion criteria, 70 (46.6%) EOC and 80 (53.4%) non-EOC. Pregnancy attempts were reported in 51 (34%) patients, with 42 (28%) patients carrying the pregnancy to term. Among them, 30 (71.4%) underwent surgery alone and 12 (28.6%) had additional postoperative chemotherapy. A total of 32 (76.1% patients) had spontaneous pregnancies and 10 (23.9%) required in vitro fertilization. There was only one (2.4%) complication reported. Vaginal delivery was reported in twenty-nine (69%) patients and cesarean section in five (11.9%) patients. Conclusions: fertility-sparing management for ovarian cancer seems to be an option with proven good pregnancy rates and low complications. The selection of patients must consider strict criteria in order to maintain a good prognosis.

Mucopolysaccharidosis type I (MPS I) is an inherited lysosomal disease caused by lowered activity of the enzyme alpha-L-iduronidase (IDUA). Current therapeutic options show limited efficacy and do not treat some important aspects of the disease. Therefore, it may be advantageous to identify strategies that could improve the efficacy of existing treatments. Pharmacological chaperones are small molecules that protect proteins from degradation, and their use in combination with enzyme replacement therapy (ERT) has been proposed as an alternative therapeutic strategy. Using the SEE-Tx® proprietary computational drug discovery platform, a new allosteric ligand binding cavity in IDUA was identified distal from the active site. Virtual high-throughput screening of approximately 5 million compounds using the SEE-Tx® docking platform identified a subset of small molecules that bound to the druggable cavity and functioned as novel allosteric chaperones of IDUA. Experimental validation by differential scanning fluorimetry showed an overall hit rate of 11.4%. Biophysical studies showed that one exemplary hit molecule GT-01803 bound to (Kd = 22 μM) and stabilized recombinant human IDUA (rhIDUA) in a dose-dependent manner. Co-administration of rhIDUA and GT-01803 increased IDUA activity in patient-derived fibroblasts. Preliminary in vivo studies have shown that GT-01803 improved the pharmacokinetic (PK) profile of rhIDUA, increasing plasma levels in a dose-dependent manner. Furthermore, GT-01803 also increased IDUA enzymatic activity in bone marrow tissue, which benefits least from standard ERT. Oral bioavailability of GT-01803 was found to be good (50%). Overall, the discovery and validation of a novel allosteric chaperone for rhIDUA presents a promising strategy to enhance the efficacy of existing treatments for MPS I. The compound's ability to increase rhIDUA activity in patient-derived fibroblasts and its good oral bioavailability underscore its potential as a potent adjunct to ERT, particularly for addressing aspects of the disease less responsive to standard treatment.

Measurement(s) COVID-19 Protocols, Restrictions • Health Behaviors • Personality and Behavioral Change, CTCAE • Emotion • Message Framing • Self-Determination Technology Type(s) Survey • Experiment Design Type Factor Type(s) COVID-19 Protocols, Restrictions • Health Behaviors • Loss-Gain Framing • Cognitive Reappraisal • Self-Determination Messaging Sample Characteristic - Organism Homo Sample Characteristic - Environment Daily Life Sample Characteristic - Location North America • South America • Africa • Australia • Europe • United Kingdom • Asia

This paper presents a study based on wind tunnel research on biplane configurations. The objective of this research is to establish an experimental basis for relationships between the main geometrical parameters that define a biplane configuration (stagger, decalage, gap, and sweep angle) and the aerodynamic characteristics (CL, CD). This experimental study focuses on a 2D approach. This method is the first step towards dealing with the issue, and it allows the variables involved in the tests to be reduced. The biplane configuration has been compared with the monoplane configuration to analyze the viability for implementing the biplane configuration in the field of application for micro air vehicles (MAV). At present, the biplane and other unusual configurations have not been a common design for MAV; however, they do have unlimited future potential. A set of experimental tests were carried out on various biplane configurations at low Reynolds numbers, which allowed the criteria for selecting the best wing configuration to be defined. The results obtained here show that the biplane configuration provides a higher maximum lift coefficient (CLmax) than the planar wing (monoplane). Furthermore, it has a larger wetted surface than the planar configuration, so the parasitic drag increases for the biplane configuration. This research is focused on a drone flight regime (low Reynolds number), and in this case, the parasitic drag (profile drag) has an important role in the total drag of the airplane. This study considers whether the reduction in the induced drag due to three–dimensional configuration (biplanes, box–wings, and joined–wings) can reduce the total drag or if the increase in the parasitic drag is bigger. Additionally, the increase in lift and the decrease in parasitic drag (profile drag) will be studied to determine if they have a greater influence on the performance of the airplane than the increase in structural weight. Further research is planned to be performed on 3D prototypes, with the selected configurations, and applied to nonconventional wing planforms.

Resumen: Introducción: La simulación médica como un método para el desarrollo de habilidades técnicas y no técnicas ha probado ser efectiva porque permite la realización de diferentes procedimientos sin poner en riesgo al paciente en una situación real. La importancia de desarrollar estas habilidades durante una situación de crisis como RCP avanzada radica en que aumenta la seguridad del paciente y la supervivencia. El objetivo de este estudio fue demostrar la utilidad de la simulación de alta fidelidad por medio del método pausa reflexión durante el escenario. Material y método: El estudio fue mixto, observacional, comparativo, descriptivo y transversal, con n = 338 (39,85%) estudiantes del quinto año de la licenciatura Médico Cirujano de la Facultad de Medicina de la UNAM, los cuales se sometieron a un escenario de simulación clínica de alta fidelidad sobre RCP avanzada. Evaluó el desempeño de las habilidades técnicas y no técnicas, previas y posteriores a la intervención con el método pausa reflexión. Resultados: Se encontró una diferencia significativa (p

Resumen: En la actualidad, la medicina incorpora diferentes recursos y estrategias para mejorar la educación que brinda a los estudiantes, entre ellas las actividades de aprendizaje por simulación. La simulación trae consigo varios beneficios, pero para ello es necesario saber implementarla y contar con los recursos necesarios, y además, tener claros los objetivos de aprendizaje que se plantearán en esta y valorar qué tan útil resulta para el participante.Retomando lo anterior, se realizó un estudio descriptivo en el que participaron estudiantes de primer año de la licenciatura de médico cirujano de la Facultad de Medicina de la UNAM, quienes, a través de la simulación, tuvieron un acercamiento introductorio a la importancia de la relación médico-paciente y aprendieron la técnica de exploración ginecológica en una actividad dividida en 3 fases, utilizando pacientes estandarizados y simuladores de baja fidelidad. Al término de la actividad, esta fue evaluada por los participantes mediante una lista de cotejo clasificada en 4 rubros para conocer su perspectiva, que ayudará a mejorar la calidad de la simulación planteada y a saber si el estudiante considera que ha adquirido habilidades propias del médico. Abstract: Medicine currently incorporates different resources and strategies to improve the education it provides to students, including simulation-based activities. Simulation brings several benefits, but for this it is necessary to know how to implement it and have the necessary resources, as well as having clear learning objectives that will be raised in it and assess how useful it is for the participant.With this objective, a descriptive study was conducted in which first year medical students of the UNAM's Faculty of Medicine participated. Using the simulation, they had an introductory approach to the importance of the doctor-patient relationship, and learned the technique of gynaecological examination in an activity that was divided into 3 phases, using standardised patients and low fidelity simulation models. At the end, this was evaluated by the participants through a checklist classified into 4 areas in order to determine their perspective. This would help improve the quality of the simulation and to determine if the students consider that they have acquired their doctor skills.

Knowledge gaps exist in the socio-ecological systems of small touristic islands in Latin America. Understanding tourists’ perceptions of their environmental knowledge can help plan actions to prevent natural capital loss necessary for local economies. Tourists’ perceptions of a touristic hotspot, Holbox Island, were documented. Surveys demonstrated that tourists are aware of their environmental impacts and are interested in minimizing these. Results were compared with results on Bocas del Toro, Panama. Tourists’ perceptions had similarities among sites driven by similarities in tourists’ populations with a common geographic origin. Tourists lack site-specific knowledge to steer them towards environmentally conscious decisions in both regions. Findings suggest the need to promote local actions to gain tourists’ understanding about their destination and support education programs on island conservation. Addressing these needs can help build resilience to overcome the adverse socio-environmental effects of tourism, environmental disasters, and health crises as COVID-19 on small islands.

Introduction/Aim: Vitamin D plays a crucial role in immune modulation, which may influence the development of graft-versus-host disease (GvHD) in patients undergoing hematopoietic stem cell transplantation (HSCT). This study aims to evaluate the impact of vitamin D levels and supplementation on the incidence of GvHD in HSCT patients. Methods: A narrative review was conducted across PubMed/Medline, Cochrane Library, CINAHL, and Embase databases. Results: The reviewed studies indicated widespread vitamin D deficiency among HSCT patients, with baseline levels ranging from 12.8 to 29.2 ng/mL. Supplementation protocols varied significantly, with dosages ranging from 1000 IU/day to 60,000 IU/week. Post-supplementation levels improved in some studies. Studies exploring the relationship between vitamin D and GvHD showed mixed results. Lower baseline vitamin D levels were associated with an increased risk of acute GvHD in some studies, while others found no significant correlation. However, a significant association between low levels of vitamin D and the incidence of chronic GvHD was observed. Conclusion: Vitamin D deficiency is prevalent in HSCT patients and may influence the risk of developing chronic GvHD. Future research should focus on larger and more rigorous studies to determine the optimal role of vitamin D as an adjuvant therapy in the context of HSCT. [ABSTRACT FROM AUTHOR]

Background: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are a novel class of incretin mimetics for treating type 2 diabetes (T2D). This study evaluated the impact of semaglutide, the first oral GLP-1RA, on glycated hemoglobin (HbA1c), fasting plasma glucose (FPG), and body composition and anthropometric parameters. Additionally, the effects on cardiovascular risk factors and quality of life (QoL) in T2D patients were assessed. Methods: A prospective observational study with a six-month follow-up was conducted. Clinical parameters, including HbA1c, FPG, anthropometric measurements, blood pressure, cardiovascular risk factors, Diabetes Treatment Satisfaction Questionnaire (DTSQ) responses, and Short Form (36) Health Survey (SF-36) responses, were collected at baseline (T0) and at six months (T1). Results: Sixty-one subjects were enrolled, with there being an average T2D duration of 4.67 ± 3.93 years. Significant decreases were observed in HbA1c (µ = −1.24; SD = 1.33; p < 0.05), FPG (µ = −31.01 mg/dL; SD = 41.71; p < 0.05), body composition and anthropometric parameters (p < 0.05), and cardiovascular risk factors (p < 0.05), with an increase in DTSQ scores (p < 0.05). Conclusions: The administration of 14 mg/day oral semaglutide improved several clinical parameters after six months of treatment. These findings suggest semaglutide is effective in improving glycemic control, weight management, and some cardiovascular risk factors in T2D patients. [ABSTRACT FROM AUTHOR]

Background: COVID-19 infection, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), quickly emerged as the most significant event of the new millennium. A balanced diet seems to ensure the proper functioning of the immune system and plays a fundamental role in the prevention of viral disease, inflammation, or thrombosis. The principal aim of this secondary study was to investigate the relationship between nutrients, lifestyle eating behaviors, and SARS-CoV-2 infection. Methods: A narrative review was conducted in the PubMed-Medline database, analyzing primary studies. Results: Our review identified 21 relevant studies: 13 focused on vitamins, 1 on omega-3 supplementation, 1 on probiotics, and 6 on lifestyle and dietary behaviors. Vitamin supplementation has shown promise in attenuating COVID-19 symptoms and reducing mortality risk. Specifically, vitamin D has demonstrated efficacy in enhancing immune responses among patients with the disease. While preliminary evidence suggests the potential benefits of omega-3 and probiotic supplementation in improving health outcomes for COVID-19 outpatients, further research is needed to solidify these findings. Conclusions: The lifestyle changes imposed by lockdown measures have adversely affected psychological well-being and exacerbated health issues associated with reduced physical activity and poor dietary habits. [ABSTRACT FROM AUTHOR]

Fundamento: en la electrocardiografía es importante tener la habilidad de interpretar, además de confianza para lograr una definición certera en el diagnóstico y tratamiento. Objetivo: implementar un taller utilizando el aprendizaje basado en la simulación clínica para la interpretación del electrocardiograma. Métodos: se realizó un estudio de tipo descriptivo y longitudinal en la Facultad de Medicina de la Universidad Nacional Autónoma de México, durante 2018. Se utilizaron métodos teóricos: análisis-síntesis e inducción–deducción; y empíricos: una encuesta y un examen de interpretación de electrocardiograma antes y después del taller aplicado. Resultados: en la evaluación sobre la identificación del electrocardiograma hubo una mejoría significativa posterior a la realización del taller en aspectos como: la interpretación del ritmo, del eje cardíaco, de ondas y en la asignación de diagnósticos en un menor tiempo según el postest. Se constató la diferencia de resultados tanto en confianza, aptitudes obtenidas, resolución de dudas y de aprendizaje reflexivo centrados en la génesis de cada aspecto del electrocardiograma, lo que permitió al equipo de trabajo ubicarlos como puntos clave en la adquisición de habilidades prácticas e intelectuales. Conclusiones: la implementación del taller permitió una mejoría significativa en las habilidades de los estudiantes para la interpretación del electrocardiograma, lo cual condicionó que se sintieran más confiados en sus apreciaciones; por lo que se evidenció la efectividad de su aplicación.

Abstract The outstanding potential of Extracellular Vesicles (EVs) in medicine, deserves a detailed study of the molecular aspects regulating their incorporation into target cells. However, because EV size lies below the limit of resolution of optical techniques, quantification together with discrimination between EV binding to the target cell and uptake is usually not completely achieved with current techniques. Human tetraspanins CD9 and CD63 were fused to a dual EGFP-Renilla-split tag. Subcellular localization and incorporation of these fusion proteins into EVs was assessed by western-blot and fluorescence microscopy. EV binding and uptake was measured using either a classical Renilla substrate or a cytopermeable one. Incubation of target cells expressing DSP2 with EVs containing the complementary DSP1 portion could not recover fluorescence or luciferase activity. However, using EVs carrying the fully reconstituted Dual-EGFP-Renilla protein and the cytopermeable Renilla luciferase substrate, we could distinguish EV binding from uptake. We provide proof of concept of the system by analysing the effect of different chemical inhibitors, demonstrating that this method is highly sensitive and quantitative, allowing a dynamic follow-up in a high-throughput scheme to unravel the molecular mechanisms of EV uptake in different biological systems.

Introducción: Actualmente, la simulación clínica ha transformado la enseñanza de la medicina favoreciendo el aprendizaje experiencial y significativo de los médicos en formación, por lo que el objetivo de este estudio es evaluar el desempeño del profesionalismo y la comunicación, durante un escenario de simulación clínica con paciente estandarizado para estudiantes del quinto grado de la licenciatura de Médico Cirujano de la Facultad de Medicina de la Universidad Nacional Autónoma de México. Métodos: Es un estudio observacional, descriptivo y transversal, se obtuvo una muestra n=387 (45.6% del total) estudiantes de quinto grado de la Licenciatura de Medicina de la universidad. Se utilizó un escenario de simulación clínica con pacientes estandarizados, además de una rúbrica para evaluar el profesionalismo y la comunicación. Se realizó el cálculo estadístico con análisis de porcentajes por ítem y categoría. Resultados: Se realizó la base de datos y análisis estadístico con Excel de los 387 estudiantes y se encontró que la competencia profesionalismo es excelente en el 62%, bueno en el 33 % y deficiente en el 5% de la población, mientras que en comunicación es excelente en 60%, bueno en 37% y deficiente en 3%. Discusión: Se demuestra que en la relación médico-paciente existe justicia social, respeto y confidencialidad, pero carece de la conservación del principio de autonomía del paciente, empatía y compasión. Es posible evaluar el desempeño del profesionalismo y comunicación a través de la simulación clínica.

The compulsive habit model proposed by Everitt and Robbins has accumulated important empirical evidence. One of their proposals is the existence of an axis, on which each a person with a particular addiction can be located depending on the evolutionary moment of his/her addictive process. The objective of the present study is to contribute in addressing the identification of such axis, as few studies related to it have been published to date. To do so, the use/abuse of Information and Communication Technologies (ICT) was quantified on an initial sample of 807 subjects. Questionnaires were also delivered to measure impulsivity, compulsivity and symptoms of prefrontal dysfunction. Evidence of the existence of the proposed axis was obtained by means of Machine Learning techniques, thus allowing the classification of each subject along the continuum. The present study provides preliminary evidence of the existence of the Impulsivity-Compulsivity axis, as well as an IT tool so that each patient that starts getting treatment for an addiction can be statistically classified as “impulsive” or “compulsive.” This would allow the matching of each person with the most appropriate treatment depending on his/her moment in the addiction/abuse process, thus facilitating the individualized design of each therapeutic process and a possible improvement of the results of the treatment.

The progressive aging of the population represents a challenge for society. In particular, a strong increase in the number of people over 90 is expected in the next two decades. As this phenomenon will lead to an increase in illness and age-related dependency, the study of long-lived people represents an opportunity to explore which lifestyle factors are associated with healthy aging and which with the emergence of age-related diseases, especially Alzheimer's type dementia. The project "Factors associated with healthy and pathologically aging in a sample of elderly people over 90 in the city of Madrid" (MADRID+90) brings together a multidisciplinary research team in neurodegenerative diseases that includes experts in epidemiology, neurology, neuropsychology, neuroimaging and computational neuroscience. In the first phase of the project, a stratified random sampling was carried out according to the census of the city of Madrid followed by a survey conducted on 191 people aged 90 and over. This survey gathered information on demographics, clinical data, lifestyles and cognitive status. Here, the main results of that survey are showed. The second phase of the project aims to characterize individual trajectories in the course of either healthy and pathological aging, from a group of 50 subjects over 90 who will undergo a comprehensive clinical examination comprised of neurological and cognitive testing, MRI and EEG. The ultimate goal of the project is to characterize the biophysical and clinical profiles of a population that tends to receive little attention in the literature. A better understanding of the rapidly increasing group of nonagenarians will also help to design new policies that minimize the impact and future social and economic consequences of rapidly aging societies.

Resumen: La enseñanza médica por simulación es un método eficaz para el aprendizaje; mejora la adquisición de competencias, la práctica repetitiva y elimina riesgos para el paciente. Los simuladores de paracentesis existentes, tienen un alto costo y bajo nivel de realismo, por lo que se diseñó y elaboró un simulador híbrido de bajo costo. Se realizó un video representativo de un escenario clínico apropiado, que demuestra la técnica completa de paracentesis. Veinte médicos especialistas observaron el video y realizaron el procedimiento en simulador, posteriormente se aplicó un cuestionario sobre el realismo del simulador, utilidad del video e importancia del procedimiento en la educación médica. Los resultados mostraron que el 85% de los participantes considera que el simulador favoreció la experiencia de aprendizaje. El 90% consideró la apariencia clínica muy adecuada. El 100% opina que la adquisición de la habilidad de paracentesis es relevante en alumnos de pregrado. Abstract: Medical education by simulation is an effective method for learning; It improves competence acquisition, repetitive practice and eliminates risks for the patient. Existing paracentesis simulators have a high cost and low level of realism, so a low cost simulator was designed and developed. A representative video of a suitable clinical scenario was demonstrated, demonstrating the complete paracentesis technique. 20 medical specialists observed the video and performed the procedure in the simulator, later applied a questionnaire on the realism of the simulator, the utility of the video, and the importance of the procedure in medical education. The results show that 85% of the participants consider the simulator favored the learning experience. 90% considered the clinical appearance to be adequate. 100% believe that the acquisition of paracentesis ability is relevant in undergraduate students. Palabras clave: Diseño, Validación, Simulador, Híbrido, Educación, Keywords: Design, Validation, Simulator, Hybrid, Education

Abstract Background NKX2–1, a key molecule in lung development, is highly expressed in non-small cell lung cancer (NSCLC), particularly in lung adenocarcinoma (ADK), where it is a diagnostic marker. Studies of the prognostic role of NKX2–1 in NSCLC have reported contradictory findings. Two microRNAs (miRNAs) have been associated with NKX2–1: miR-365, which targets NKX2–1; and miR-33a, which is downstream of NKX2–1. We have examined the effect of NKX2–1, miR-365 and miR-33a on survival in a cohort of early-stage NSCLC patients and in sub-groups of patients classified according to the mutational status of TP53, KRAS, and EGFR. Methods mRNA and miRNA expression was determined using TaqMan assays in 110 early-stage NSCLC patients. TP53, KRAS, and EGFR mutations were assessed by Sanger sequencing. Results NKX2–1 expression was upregulated in never-smokers (P = 0.017), ADK (P