Personalized Versus Non-personalized Nutritional Recommendations/Interventions for Type 2 Diabetes Mellitus Remission: A Narrative Review.

It is a well-evidenced fact that diet significantly impacts type 2 diabetes mellitus (T2DM) prevention and management. However, dietary responses vary among different populations, necessitating personalized recommendations. Substantial evidence supports the role of diet in T2DM remission, particularly low-energy or low-carbohydrate diets that facilitate weight loss, enhance glycemic control, and achieve remission. This review aims to comprehensively analyze and compare personalized nutritional interventions with non-personalized approaches in T2DM remission. We conducted a literature search using the Academy of Nutrition and Dietetics guidelines, focusing on clinical and observational trials published within the past decade. We present the strengths and drawbacks of incorporating personalized nutrition into practice, along with the areas for research in implementing personalized interventions, such as cost-effectiveness and accessibility. The findings reveal consistently higher diabetes remission rates in personalized nutrition studies compared to non-personalized interventions.

Highly Effective Frontal Stunning Procedure Using a Pneumatic Penetrating Captive Bolt in Water Buffaloes.

An effective frontal stunning procedure in water buffaloes was assessed using a pneumatic penetrating captive bolt (PPCB) with high air pressure. The study contemplated two phases; first, 352 buffaloes and 168 post-mortem heads were evaluated to determine the most effective anatomical site for stunning. Then, the second phase (n = 182) was used to validate the stunning procedure at the discovered anatomical site in the first phase, which was located 8 cm dorsal above the middle of the forehead on an "X" formed between the eyes and the base of the contralateral horns, and 2 cm lateral, avoiding the midline, where the skull tended to narrow. A total of 95.1% of buffaloes received effective stunning at the first shot with evidence of the presence of collapse, absence of rhythmic breathing, and absence of ocular reflexes (corneal and palpebral). There were no differences in the stunning efficacy by sex, breed, or skull thickness. These findings demonstrated that stunning with a PPCB at pressures of 1379-1516.8 KPa (200-220 pounds per square inch (psi)) in the site reported here produces a highly effective stunning at the first shot in water buffaloes.

[Systematic review with analysis of bias and quality of interventions in the food environment of the workplace and their impact on the nutritional status of workers]. / Revisión sistemática con análisis de sesgo y calidad de intervenciones en el ambiente alimentario del lugar de trabajo y su impacto en el estado nutricional de los trabajadores.

Introduction: Introduction: workers' exposure to unhealthy eating is linked to the increase in overweight and obesity. Objective: this systematic review aims to analyze with bias and quality analysis the effect of interventions in the food environment of the workplace on the nutritional status of workers. Methods: the search was conducted in three electronic databases according to the Cochrane Collaboration and eight studies were included. Data were grouped according to type of environmental intervention, and methodological quality and validity with risk of bias was analyzed. Results: three studies had effects on reducing BMI and body weight, but one was judged to be reliable evidence of effectiveness, as they were at low risk of bias. Half of the included articles were assessed at high risk of bias (3/8) and unclear risk of bias (1/8), due to errors in selection and performance and missing data in the results. Conclusions: we conclude that there is not enough evidence to indicate that these types of interventions have an effect on body weight. To make effective interventions, the design of these studies has to avoid potential sources of bias, which were analyzed in detail in this study. The global food environment of workers and not just their workplace must be considered, deepening the interaction that exists between socioeconomic factors and food environments.

Introducción: Introducción: la exposición de los trabajadores a una alimentación no saludable tiene relación con el aumento del sobrepeso y la obesidad. Objetivo: esta revisión sistemática tiene como objetivo analizar con análisis de sesgo y calidad el efecto de las intervenciones en el ambiente alimentario del lugar de trabajo en el estado nutricional de los trabajadores. Métodos: la búsqueda se realizó en tres bases de datos electrónicas de acuerdo a Colaboración Cochrane y fueron incluidos ocho estudios. Los datos se agruparon según tipo de intervención ambiental, se analizó la calidad metodológica y se evaluó la validez con el riesgo de sesgo. Resultados: de los ocho estudios, tres tuvieron efectos en la reducción del índice de masa corporal (IMC) y peso corporal, pero uno fue considerado como evidencia confiable de efectividad por tener bajo riesgo de sesgo. La mitad de los artículos incluidos fueron evaluados con alto riesgo de sesgo (3/8) y riesgo de sesgo poco claro (1/8) por errores en la selección y la realización y datos faltantes en los resultados. Conclusiones: se concluye que no hay suficiente evidencia para indicar que este tipo de intervenciones tienen efecto sobre el peso corporal. Para realizar intervenciones efectivas, el diseño de estos estudios tiene que evitar las fuentes potenciales de sesgo, que fueron analizadas en detalle en este estudio. Se debe considerar el entorno alimentario global de los trabajadores y no solo su lugar de trabajo, profundizando la interacción que existe entre factores socioeconómicos y ambientes alimentarios.

A review of caregiver costs included in cost-of-illness studies.

INTRODUCTION: Economic evaluations typically focus solely on patient-specific costs with economic spillovers to informal caregivers less frequently evaluated. This may systematically underestimate the burden resulting from disease. AREAS COVERED: Cost-of-illness (COI) analyses that identified costs borne to caregiver(s) were identified using PubMed and Embase. We extracted study characteristics, clinical condition, costs, and cost methods. To compare caregiver costs reported across studies, estimated a single 'annual caregiver cost' amount in 2021 USD. EXPERT OPINION: A total of 51 studies met our search criteria for inclusion with estimates ranging from $30 - $86,543. The majority (63%, 32/51) of studies estimated caregiver time costs with fewer studies reporting productivity or other types of costs. Caregiver costs were frequently reported descriptively (69%, 35/51), with fewer studies reporting more rigorous methods of estimating costs. Only 27% (14/51) of studies included used an incremental analysis approach for caregiver costs. In a subgroup analysis of dementia-focused studies (n = 16), we found the average annual cost of caregiving time for patients with dementia was $30,562, ranging from $4,914 to $86,543. We identified a wide range in annual caregiver cost estimates, even when limiting by condition and cost type.

Immediate Postoperative Extubation Decreases Pulmonary Complications in Liver Transplant Patients.

BACKGROUND: Fast-track anesthesia in liver transplantation (LT) has been discussed over the past few decades; however, factors associated with immediate extubation after LT surgery are not well defined. This study aimed to identify predictive factors and examine impacts of immediate extubation on post-LT outcomes. METHODS: A total of 279 LT patients between January 2014 and May 2017 were included. Primary outcome was immediate extubation after LT. Other postoperative outcomes included reintubation, intensive care unit stay and cost, pulmonary complications within 90 days, and 90-day graft survival. Logistic regression was performed to identify factors that were predictive for immediate extubation. A matched control was used to study immediate extubation effect on the other postoperative outcomes. RESULTS: Of these 279 patients, 80 (28.7%) underwent immediate extubation. Patients with anhepatic time >75 minutes and with total intraoperative blood transfusion ≥12 units were less likely to be immediately extubated (odds ratio [OR], 0.48; 95% confidence interval [CI], 0.26-0.89; P = 0.02; OR, 0.11; 95% CI, 0.05-0.21; P < 0.001). The multivariable analysis showed immediate extubation significantly decreased the risk of pulmonary complications (OR, 0.34; 95% CI, 0.15-0.77; P = 0.01). According to a matched case-control model (immediate group [n = 72], delayed group [n = 72]), the immediate group had a significantly lower rate of pulmonary complications (11.1% versus 27.8%; P = 0.012). Intensive care unit stay and cost were relatively lower in the immediate group (2 versus 3 d; P = 0.082; $5700 versus $7710; P = 0.11). Reintubation rates (2.8% versus 2.8%; P > 0.9) and 90-day graft survival rates (95.8% versus 98.6%; P = 0.31) were similar. CONCLUSIONS: Immediate extubation post-LT in appropriate patients is safe and may improve patient outcomes and resource allocation.

Uso de Medicinas Complementarias por Estudiantes Universitarios Asociado a Teoría de Autocuidado / Uso de Medicinas Complementarias por Estudiantes Universitarios Asociado a Teoría de Autocuidado

El autocuidado, su relevancia y aprendizaje constituyen temas de constante trabajo para el profesional de enfermería. En este sentido, las medicinas complementarias se presentan como una opción válida para promocionar acciones de bienestar en la población, sobretodo en un grupo tan receptivo, y a la vez, tan susceptible a la presión como los estudiantes universitarios. El objetivo general de este estudio de tipo cuantitativo, no experimental, transeccional, descriptivo y correlacional es determinar en qué medida los estudiantes universitarios consideran las medicinas complementarias como una alternativa para su autocuidado. Para ello, esta investigación se basa en la recolección de datos mediante el instrumento de tipo cuestionario autoadministrado, el cual se ha aplicado a estudiantes universitarios de las carreras de periodismo, enfermería e ingeniería civil industrial, matriculados en tercer semestre o superior de la Pontificia Universidad Católica, Universidad de Chile, Universidad de Santiago de Chile y Universidad de las Américas. La muestra incluyó un total de 338 estudiantes universitarios que cumplieron los criterios de inclusión. Los resultados indican que el uso de las medicinas complementarias es aún bajo entre los estudiantes universitarios, en comparación con el universo encuestado, pero la disposición a utilizarlas resulta amplia siempre que se establezcan las circunstancias apropiadas para acceder a su uso. Así mismo se ha detectado que "el entorno del estudiante" es un factor influyente al uso de estas terapias, por encima de otros factores como el ingreso socioeconómico. Además, la mayoría de los consultados refiere que al momento de padecer alguna enfermedad, no concurren a una atención médica o incluso, se automedican, lo cual evidencia, según los criterios de Dorothea Orem, un déficit en su autocuidado. Dentro de los problemas de salud más frecuentes señalados por los estudiantes, se encuentran: los dolores de cabeza, estrés y los trastornos del sueño. El profesional de enfermería cuenta con un amplio campo de trabajo en la acción de acercar a la población las medicinas complementarias, pero más aún, de alentar a las personas a hacerse cargo de su propio estado de salud.

Bases neurológicas del lenguaje hablado y signado / Neurological bases of speech and sign languaje

El estudio de los lenguajes de signos, ha permitido ampliar la comprensión del sistema neuronal que subyace al lenguaje. El presente artículo tiene por objeto desarrollar una revisión de la literatura, respecto de las relaciones entre las regiones cerebrales implicadas en la comprensión y producción del lenguaje de signos en comparación con el lenguaje oral. En esta revisión, se presentan los estudios que distintos grupos de investigación, a nivel mundial, han desarrollado para explorar las complejas relaciones entre lenguaje y cerebro.

This article is a bibliographical review, respect of the most recent studies on the cerebral regions implied in the comprehension and production of the language of signs compared with the speech language. This review presents the research that groups different of investigation worldwide have developed to explore the relations complex between language and brain.