Assessing the Impact of Religion and College Life on Consumption Patterns of Ultra-Processed Foods by Young Adults: A Cross-Sectional Study.

(1) Background: University students, often constrained by time and influenced by socio-economic factors such as culture and religion, frequently adopt diets centred on ultra-processed foods (UPFs), increasing the risk of long-term non-communicable diseases. This study aimed to assess UPF consumption among Spanish university students and explore the potential impact of religion and the academic year on their eating habits. (2) Methods: In a cross-sectional study of 257 university students aged 18-31, UPF consumption was assessed using NOVA food classification at the academic year's start and end. Chi-square and Wilcoxon tests analysed UPF consumption changes, while binary logistic regression identified associations between religion and weekly UPF consumption. (3) Results: Muslim students had a consumption of industrial bakery products almost five times [95% CI: 2.694-9.259] higher than that observed among Christians. Similar data were observed for artificial juice consumption (OR = 3.897, 95% CI = 2.291-6.627) and candy consumption (OR = 3.724, 95% CI = 2.051-6.762). Moreover, a greater percentage of calories and grams of saturated fats from UPFs was observed for Muslims at the end of the study. (4) Conclusions: Highlighting the impact of religion on UPF consumption among students underscores the necessity of monitoring and intervening in dietary habits to prevent undesirable long-term complications such as cardiovascular diseases.

Ocular involvement in adult and paediatric patients with monogenic autoinflammatory diseases: a Spanish multicentre retrospective study.

OBJECTIVES: Ophthalmologic involvement in monogenic autoinflammatory diseases has been explored mainly in paediatric patients. The aim of this study is to characterise ophthalmologic manifestations, therapeutic management and visual outcomes in a Spanish (UVESAI) cohort of adult/paediatric patients with monogenic autoinflammatory diseases. METHODS: Multicentre and retrospective study of patients with monogenic autoinflammatory diseases and ocular involvement. Eye manifestations, structural complications, treatments used and visual outcomes were analysed, and compared with previous studies. RESULTS: Forty-six patients (44/2 adults/children; 21/25 adult/paediatric-onset) with monogenic autoinflammatory diseases [cryopyrin associated periodic syndromes (n=13/28.3%), mainly Muckle-Wells syndrome (MWS) (n=11/24%); familial Mediterranean fever (FMF) (n=12/26%); TNF receptor-associated periodic syndrome (TRAPS); (n=9/20%); Blau syndrome (n=8/17%); hyperimmunoglobulin D syndrome (HIDS) (n=2/4.3%), deficiency of adenosine deaminase-2 and NLRC4-Autoinflammatory disease] (one each) were included. Conjunctivitis (n=26/56.5%) and uveitis (n=23/50%) were the most frequent ocular manifestations. Twelve (26.1%) patients developed structural complications, being cataracts (n=11/24%) and posterior synechiae (n=10/22%) the most frequent. Conjunctivitis predominated in TRAPS, FMF, MWS and HIDS (mainly in adults), and uveitis, in Blau syndrome. Seven (8%) eyes (all with uveitis) presented with impaired visual acuity. Local and systemic treatment led to good visual outcomes in most patients. Compared with previous studies mainly including paediatric patients, less severe ocular involvement was observed in our adult/paediatric cohort. CONCLUSIONS: Conjunctivitis was the most common ocular manifestation in our TRAPS, FMF, MWS and HIDS patients, and uveitis predominated in Blau syndrome. Severe eye complications and poor visual prognosis were associated with uveitis. Adults with monogenic autoinflammatory diseases seem to exhibit a less severe ophthalmologic presentation than paediatric patients.

Reduction of disease activity, corticosteroids use, and healthcare resource utilisation in patients with systemic lupus erythematosus treated with belimumab in clinical practice settings: OBSErve Spain multicentre study / Reducción de la actividad de la enfermedad, el uso de corticosteroides y recursos sanitarios en pacientes con lupus eritematoso sistémico tratados con belimumab en práctica clínica real: estudio multicéntrico OBSErve España

Introduction and objectives: This OBSErve Spain study, a part of the international OBSErve programme, evaluated belimumab real-world use and effectiveness following 6 months of treatment in patients with active systemic lupus erythematosus (SLE) in clinical practice in Spain. Materials and methods: In this retrospective, observational study (GSK Study 200883), eligible patients with SLE receiving intravenous belimumab (10mg/kg) had their disease activity (physician assessed), SELENA-SLEDAI scores, corticosteroid use, and healthcare resource utilisation (HCRU), assessed after 6 months of treatment versus index (belimumab initiation) or 6 months pre-index. Results: Overall, 64 patients initiated belimumab, mainly due to ineffectiveness of previous treatments (78.1%) and to reduce corticosteroid use (57.8%). Following 6 months of treatment, 73.4% of patients achieved ≥20% overall clinical improvement, while only 3.1% of patients worsened. Mean (standard deviation, SD) SELENA-SLEDAI score decreased from 10.1 (6.2) at index to 4.5 (3.7) 6 months post-index. HCRU decreased from 6 months pre-index to 6 months post-index, with fewer hospitalisations (10.9% vs 4.7% patients) and ER visits (23.4% vs 9.4% patients). Mean (SD) corticosteroid dose decreased from 14.5 (12.5)mg/day at index to 6.4 (5.1)mg/day 6 months post-index. Conclusions: Patients with SLE receiving belimumab for 6 months in real-world clinical practice in Spain experienced clinical improvements and a reduction in HCRU and corticosteroid dose.(AU)

Introducción y objetivos: El estudio OBSErve España, que forma parte del programa internacional OBSErve, evaluó el uso y la eficacia de belimumab en la práctica clínica real española tras seis meses de tratamiento en pacientes con lupus eritematoso sistémico (LES) activo. Materiales y métodos: En este estudio observacional y retrospectivo (GSK Study 200883) fue evaluada la respuesta clínica, la actividad de la enfermedad (puntuación SELENA-SLEDAI), el uso de corticosteroides y los recursos sanitarios utilizados de los pacientes con LES que recibieron belimumab intravenoso (10mg/kg), al inicio y tras seis meses de tratamiento. Resultados: En total 64 pacientes iniciaron belimumab, principalmente por ineficacia de los tratamientos previos (78,1%) y para reducir los corticoides (57,8%). Después de seis meses de tratamiento, 73,4% de los pacientes lograron una mejoría clínica general de ≥20%, mientras que solo 3,1% de los pacientes empeoró. La puntuación media (desviación estándar, DE) de SELENA-SLEDAI disminuyó de 10,1 (6,2) a 4,5 (3,7). Los recursos sanitarios utilizados disminuyeron con menos hospitalizaciones (10,9 vs. 4,7%) y visitas a urgencias (23,4 vs. 9,4%). La dosis media (DE) de corticosteroides disminuyó de 14,5 (12,5mg/día) a 6,4 (5,1mg/día). Conclusiones: Los pacientes con LES que recibieron belimumab durante seis meses en la práctica clínica real en España experimentaron mejoras clínicas y una reducción de la dosis de corticosteroides y recursos sanitarios utilizados.(AU)

Reduction of disease activity, corticosteroids use, and healthcare resource utilisation in patients with systemic lupus erythematosus treated with belimumab in clinical practice settings: OBSErve Spain multicentre study.

INTRODUCTION AND OBJECTIVES: This OBSErve Spain study, a part of the international OBSErve programme, evaluated belimumab real-world use and effectiveness following 6 months of treatment in patients with active systemic lupus erythematosus (SLE) in clinical practice in Spain. MATERIALS AND METHODS: In this retrospective, observational study (GSK Study 200883), eligible patients with SLE receiving intravenous belimumab (10mg/kg) had their disease activity (physician assessed), SELENA-SLEDAI scores, corticosteroid use, and healthcare resource utilisation (HCRU), assessed after 6 months of treatment versus index (belimumab initiation) or 6 months pre-index. RESULTS: Overall, 64 patients initiated belimumab, mainly due to ineffectiveness of previous treatments (78.1%) and to reduce corticosteroid use (57.8%). Following 6 months of treatment, 73.4% of patients achieved ≥20% overall clinical improvement, while only 3.1% of patients worsened. Mean (standard deviation, SD) SELENA-SLEDAI score decreased from 10.1 (6.2) at index to 4.5 (3.7) 6 months post-index. HCRU decreased from 6 months pre-index to 6 months post-index, with fewer hospitalisations (10.9% vs 4.7% patients) and ER visits (23.4% vs 9.4% patients). Mean (SD) corticosteroid dose decreased from 14.5 (12.5)mg/day at index to 6.4 (5.1)mg/day 6 months post-index. CONCLUSIONS: Patients with SLE receiving belimumab for 6 months in real-world clinical practice in Spain experienced clinical improvements and a reduction in HCRU and corticosteroid dose.

Cardiovascular Screening Practices and Statin Prescription Habits in Patients with Psoriasis among Dermatologists, Rheumatologists and Primary Care Physicians.

Patients with psoriasis have a higher prevalence of cardiovascular risk factors. This study evaluated cardiovascular screening practices and statin prescribing habits among dermatologists, rheumatologists and primary care physicians (PCPs) through an online questionnaire, which was distributed through the Spanish scientific societies of the above-mentioned specialties. A total of 299 physicians (103 dermatologists, 94 rheumatologists and 102 PCPs) responded to the questionnaire. Of these, 74.6% reported screening for smoking, 37.8% for hypertension, 80.3% for dyslipidaemia, and 79.6% for diabetes mellitus. Notably, only 28.4% performed global screening, defined as screening for smoking, hypertension, dyslipidaemia, and diabetes mellitus by the same physician, and 24.4% reported calculating 10-year cardiovascular disease (CVD) risk, probably reflecting a lack of comprehensive cardiovascular risk assessment in these patients. This study also identified unmet needs for awareness of cardiovascular comorbidities in psoriasis and corresponding screening and treatment recommendations among PCPs. Of PCPs, 61.2% reported not being aware of the association between psoriasis and CVD and/or not being aware of its screening recommendations, and 67.6% did not consider psoriasis as a risk-enhancing factor when deciding on statin prescription. Thirteen dermatologists (12.6%) and 35 rheumatologists (37.2%) reported prescribing statins. Among those who do not prescribe, 49.7% would be willing to start their prescription.

Sexuality and Religious Ethics: Analysis in a Multicultural University Context.

Sexuality is still perceived by some cultures as a taboo subject. Although there is now a more open attitude towards sexuality, the maintenance of virginity is one of the most concerning issues in some religions. The aim of this research is to investigate the sexual behavior of university students and analyze how culture and religion influence the beliefs and maintenance of virginity in women and men. A mixed methodology was used, involving 355 students in the quantitative design and 18 informants for the qualitative study who took part in two focus groups. The results indicate that religion and the degree of religious practice are predictor variables for the decision to have penetrative sex, with Muslim women and men giving more importance to the maintenance of a woman's virginity. However, this hymen-centric view does not prevent other sexual practices, such as oral and/or anal sex, among young people who wish to maintain their virginity until marriage. Religious ethics continue to influence the sexual behavior of young people today. Therefore, nursing education must address these issues to improve the affective sexual health of the population.

Potential Molecular Targets of Oleanolic Acid in Insulin Resistance and Underlying Oxidative Stress: A Systematic Review.

Oleanolic acid (OA) is a natural triterpene widely found in olive leaves that possesses antioxidant, anti-inflammatory, and insulin-sensitizing properties, among others. These OA characteristics could be of special interest in the treatment and prevention of insulin resistance (IR), but greater in-depth knowledge on the pathways involved in these properties is still needed. We aimed to systematically review the effects of OA on the molecular mechanisms and signaling pathways involved in the development of IR and underlying oxidative stress in insulin-resistant animal models or cell lines. The bibliographic search was carried out on PubMed, Web of Science, Scopus, Cochrane, and CINHAL databases between January 2001 and May 2022. The electronic search produced 5034 articles but, after applying the inclusion criteria, 13 animal studies and 3 cell experiments were identified, using SYRCLE's Risk of Bias for assessing the risk of bias of the animal studies. OA was found to enhance insulin sensitivity and glucose uptake, and was found to suppress the hepatic glucose production, probably by modulating the IRS/PI3K/Akt/FoxO1 signaling pathway and by mitigating oxidative stress through regulating MAPK pathways. Future randomized controlled clinical trials to assess the potential benefit of OA as new therapeutic and preventive strategies for IR are warranted.

Correlation between anthropometric measurements and blood pressure in a population of Palestinian adults.

Obesity can be a major problem due to its potential to cause a number of health issues, including high blood pressure and diabetes. Many reports have come out of Palestine on overweight and obesity and their direct link to non-communicable diseases, although there is only limited evidence available on the connection between obesity and hypertension in Palestinian adults. We aimed to look at the associations between anthropometric and body composition variables and blood pressure in a large population of Palestinian adults (1337 subjects) and determine which anthropometric indices most strongly correlate with high blood pressure. Anthropometric measurements including height, waist circumference (WC), hip circumference (HC), body mass index (BMI), and total body fat (TBF) were assessed. A body composition analyzer was used to measure body weight, fat mass and fat-free mass. Systolic (SBP) and diastolic (DBP) blood pressure were measured using a Dinamap vital signs monitor. In both males and females, all the anthropometric measurements showed significant strong positive correlations with mean SBP and mean DBP (p < 0.01). SBP correlated the most strongly with waist circumference in all subjects (r = 0.444 in females, r = 0.422 in males), while DBP correlated the most strongly with WC in males (r = 0.386), but with TBF in females (r = 0.256). By controlling fat percentage, WC, HC, and BMI, which are affected by extra weight and lack of exercise, blood pressure levels can be regulated.

Efficacy, safety and cost-effectiveness of methotrexate, adalimumab or their combination in non-infectious non-anterior uveitis: a protocol for a multicentre, randomised, parallel three arms, active-controlled, phase III open label with blinded outcome assessment study.

INTRODUCTION: Non-infectious uveitis include a heterogeneous group of sight-threatening and incapacitating conditions. Their correct management sometimes requires the use of immunosuppressive drugs (ISDs), prescribed in monotherapy or in combination. Several observational studies showed that the use of ISDs in combination could be more effective than and as safe as their use in monotherapy. However, a direct comparison between these two treatment strategies has not been carried out yet. METHODS AND ANALYSIS: The Combination THerapy with mEthotrexate and adalImumAb for uveitis (CoTHEIA) study is a phase III, multicentre, prospective, randomised, single-blinded with masked outcome assessment, parallel three arms with 1:1:1 allocation, active-controlled, superiority study design, comparing the efficacy, safety and cost-effectiveness of methotrexate, adalimumab or their combination in non-infectious non-anterior uveitis. We aim to recruit 192 subjects. The duration of the treatment and follow-up will last up to 52 weeks, plus 70 days follow-up with no treatment. The complete and maintained resolution of the ocular inflammation will be assessed by masked evaluators (primary outcome). In addition to other secondary measurements of efficacy (quality of life, visual acuity and costs) and safety, we will identify subjects' subgroups with different treatment responses by developing prediction models based on machine learning techniques using genetic and proteomic biomarkers. ETHICS AND DISSEMINATION: The protocol, annexes and informed consent forms were approved by the Reference Clinical Research Ethic Committee at the Hospital Clínico San Carlos (Madrid, Spain) and the Spanish Agency for Medicines and Health Products. We will elaborate a dissemination plan including production of materials adapted to several formats to communicate the clinical trial progress and findings to a broad group of stakeholders. The promoter will be the only access to the participant-level data, although it can be shared within the legal situation. TRIAL REGISTRATION NUMBER: 2020-000130-18; NCT04798755.

Short Breastfeeding Duration is Associated With Premature Onset of Female Breast Cancer.

Currently, there is controversy concerning potential factors that contribute to the development of breast cancer. Our study analyzed the possible association between weight status, cigarette consumption, lactation period, serum estrogen levels, family history of breast cancer, and age at breast cancer diagnosis. We conducted a retrospective study at a University Hospital in Granada (Spain) by consulting the medical records of 524 women aged 19 to 91 years, all of them diagnosed and treated for breast cancer from 2011 to 2019. Our findings indicated that in non-morbidly obese females who were also non-smokers, a maternal lactation period of more than 3 months (p = .013) and the absence of family antecedents of cancer (p = .025) were statistically significant factors that led to a more advanced age at breast cancer diagnosis. Thus, maternal lactation seems to have a potential protective effect on breast cancer.

Assessment of Different Atherogenic Indices as Predictors of Metabolic Syndrome in Spanish Adolescents.

Background: Inconsistent results due to age, ethnic, and geographic differences have been found on the predictive capacity of atherogenic indices in previous studies. The aim of this study was to assess the predictive value of 6 atherogenic indices for MetS in a Spanish adolescent population. Methods: A cross-sectional study was performed on 981 adolescents (13.2 ± 1.2y) that were randomly recruited from schools in Southeastern Spain. Anthropometric and biochemical parameters were evaluated to identify the presence of MetS. The following atherogenic indices were calculated: triglyceride-glucose (TyG) index, atherogenic index of plasma (AIP), non-HDL cholesterol, triglycerides to HDL-cholesterol ratio (TG/HDL-c), LDL-cholesterol to HDL-cholesterol ratio (LDL-c/HDL-c), and total cholesterol to HDL-cholesterol ratio (TC/HDL-c). Results: The area under the curve (AUC) of receiver operating characteristic curves was used for discrimination purposes. AIP was the atherogenic index most strongly associated with MetS with an unadjusted odds ratio (OR) of 37.98 in boys and of 28.75 in girls. A high OR was maintained after adjustment by different factors. AUC values for all atherogenic indices were above 0.83 and 0.88 in boys and in girls, respectively. Conclusions: Among the 6 atherogenic indices studied, AIP was the one most strongly associated with MetS in Spanish adolescents. The AUC values obtained from ROC analyses suggest that all atherogenic indices have the ability to predict MetS. These atherogenic indices are interesting and useful predictive indicators for MetS. However, more studies are needed to explore in-depth this predictive capacity.

Effects of COVID-19 lockdown on the dietary habits and lifestyle in a population in southern Spain: a cross-sectional questionnaire.

BACKGROUND/OBJECTIVE: Few studies have assessed the effect of lockdown on physical activity and eating behaviours in a population from the Autonomous Community of Andalusia in southern Spain. The aim of our study was to describe the effect of COVID-19 pandemic home lockdown on eating habits and lifestyle in the Andalusian population. SUBJECTS/METHODS: A cross-sectional observational study was carried out on a population from southern Spain, Andalusian population. An online questionnaire was shared through social networks and snowball sampling. A total of 1140 people filled in the questionnaire. The questionnaire consisted of 34 items classified into three sections: sociodemographic data, work and leisure activities and questions on food consumption. Each item offered pre- and post-lockdown information. RESULTS: The participants were classified into three age groups: 18-35, 36-65 and over 65. Statistically significant differences were found between the three groups, with the younger age group undergoing greater changes, increasing their physical activity and consumption of fresh food, and decreasing both their consumption of fast food at home and alcohol intake. CONCLUSIONS: These findings suggest that, in the current social and health crisis, the citizens of southern Spain have become aware of the importance of maintaining an appropriate lifestyle to remain healthy, particularly the younger population with less well-consolidated habits.

cMetS Based on Z-Scores as an Accurate and Efficient Scoring System to Determine Metabolic Syndrome in Spanish Adolescents.

The definition of metabolic syndrome (MetS) based on dichotomous cut-off points is efficient in the adult population. However, to date, there is no international consensus on how to define MetS in the pediatric population. For that reason, a continuous MetS score (cMetS) has been proposed for the pediatric population. However, despite multiple attempts, cMetS has not been fully validated as there is no agreement about the most accurate score to calculate it. The purpose of the present study was to compare the validity of different scores (three siMS scores, z-score, principal components analysis (PCA), the sum of PCA, and confirmatory factor analysis) to calculate cMetS and determine MetS in Spanish adolescents. There were 981 subjects, ranging 11-16 years old, recruited for this cross-sectional study. Seven different approaches to pediatric cMetS scores were calculated. All cMetS scores calculated strongly correlated with each other, especially siMS scores. The area under the curve obtained from receiving operating characteristic curves was particularly elevated for z-scores 0.81 (95% CI: 0.784-0.838), showing a specificity of 64.4%. Our study shows that cMetS based on z-scores is accurate and efficient to be used for research instead of the dichotomized definition of MetS in adolescents; and cMetS based on siMS scores is useful for clinical practice.

Long-term follow-up of certolizumab pegol in uveitis due to immune-mediated inflammatory diseases: multicentre study of 80 patients.

OBJECTIVES: To evaluate effectiveness and safety of certolizumab pegol (CZP) in uveitis due to immune-mediated inflammatory diseases (IMID). METHODS: Multicentre study of CZP-treated patients with IMID uveitis refractory to conventional immunosuppressant. Effectiveness was assessed through the following ocular parameters: best-corrected visual acuity, anterior chamber cells, vitritis, macular thickness and retinal vasculitis. These variables were compared between the baseline, and first week, first, third, sixth months, first and second year. RESULTS: We studied 80 (33 men/47 women) patients (111 affected eyes) with a mean age of 41.6±11.7 years. The IMID included were: spondyloarthritis (n=43), Behçet's disease (n=10), psoriatic arthritis (n=8), Crohn's disease (n=4), sarcoidosis (n=2), juvenile idiopathic arthritis (n=1), reactive arthritis (n=1), rheumatoid arthritis (n=1), relapsing polychondritis (n=1), CONCLUSIONS: CZP seems to be effective and safe in uveitis related to different IMID, even in patients refractory to previous biological drugs.

Self-Care by Muslim Women during Ramadan Fasting to Protect Nutritional and Cardiovascular Health.

The practice of Ramadan involves a series of changes in lifestyle, mainly in eating habits. The research aim of this study is to determine the prevalence of overweight-obesity, the degree of compliance with dietary recommendations and the effects of religious fasting on cardiovascular health among a population of Muslim women living in Melilla, a Spanish city in North Africa. A follow-up cohort study was conducted on 62 healthy adult women (33.6 ± 12.7 years). Anthropometric and body composition parameters were obtained using bioimpedance and dietary records. All of the participants were overweight or obese, especially due to the non-compliance with dietary recommendations; however, more than 60% considered their weight was appropriate or even low. By the end of Ramadan, the women's body mass index and fat component values had fallen significantly (p < 0.001), but this loss was later recovered. Dietary records revealed an excessive consumption of lipids and sodium, and the presence of a high waist-to-hip ratio. All of these factors are related to cardiovascular risk. In conclusion, promoting nutritional health and encouraging year-round self-care among adult Muslim women is necessary in order to ensure healthy fasting during Ramadan.

Oleanolic Acid-Enriched Olive Oil Alleviates the Interleukin-6 Overproduction Induced by Postprandial Triglyceride-Rich Lipoproteins in THP-1 Macrophages.

Oleanolic acid (OA), a triterpene that is highly present in olive leaves, has been proposed as a component of functional foods for the prevention of metabolic syndrome, due to its anti-inflammatory activity. We analyzed the effects of OA on inflammatory parameters and signaling proteins in LPS-stimulated THP-1 macrophages. Thus, THP-1 macrophages were incubated with LPS for 48 h after pretreatment with OA at different concentrations. Pretreatment with OA was significantly effective in attenuating IL-6 and TNF-α overproduction induced by LPS in macrophages, and also improved the levels of AMPK-α. We also evaluated the effects of human triglyceride-rich lipoproteins (TRLs) derived from individuals consuming an OA-enriched functional olive oil. For this purpose, TRLs were isolated from healthy adolescents before, 2 and 5 h postprandially after the intake of a meal containing the functional olive oil or common olive oil, and were incubated with THP-1 macrophages. THP-1 macrophages incubated with TRLs isolated at 2 h after the consumption of the OA-enriched olive oil showed significant lower levels of IL-6 compared to the TRLs derived from olive oil. Our results suggest that OA might have potential to be used as a lipid-based formulation in functional olive oils to prevent inflammatory processes underlying metabolic syndrome in adolescents.

Peer Debriefing Versus Instructor-Led Debriefing for Nursing Simulation.

BACKGROUND: Debriefing is the reflective process following the simulation experience. We aimed to compare the debriefing assessment and debriefing satisfaction perceived by nursing students who underwent different debriefing methods. METHOD: An experimental study conducted on three groups (instructor-led debriefing, peer debriefing, and combined debriefing) was performed for 177 nursing students. Differences in the debriefing satisfaction were assessed using the Clinical Experience Simulation scale, the Visual Analogue scale, and the Debriefing Assessment for Simulation in Healthcare (DASH). RESULTS: VAS scores for satisfaction differed significantly between the instructor-led debriefing, peer debriefing, and combined debriefing groups. In the Clinical Experience Simulation scale, the combined debriefing group was significantly higher compared with instructor-led debriefing. The total score for DASH was significantly higher in the combined debriefing group compared with instructor-led debriefing, and in instructor-led debriefing compared with peer debriefing. CONCLUSION: Combining debriefing after a simulation session improves the debriefing satisfaction and the perceived debriefing assessment among nursing students. [J Nurs Educ. 2021;60(2):90-95.].

Prevalence and Incidence of Uveitis: A Systematic Review and Meta-analysis.

Background: Although the impact of uveitis on people's lives is clear, the frequency of this condition is unclear.Objective: To estimate the prevalence and incidence of uveitis.Methods: A systematic review with meta-analysis was conducted. Medline, Embase, and Cochrane Library were searched from inception to January 2019. The quality of the included studies was critically appraised with a grading system based on the Oxford Levels of Evidence. A detailed description of the populations studied and of factors affecting estimates was undertaken. Pooled analyses were conducted using a random-effects approach and expressed as incidence rates per 100,000 with 95% confidence intervals. Subgroup analyses by geographical region were conducted along with meta-regression to analyze possible factors for heterogeneity.Results: A total of 49 studies were included and critically appraised. Twenty-two were population-based, and 27 hospital-based. Heterogeneity was substantial in terms of populations studied, methods for ascertaining uveitis, including definitions, and reporting of results. This was especially important in prevalence studies, with data ranging from 9 to 730 cases per 100,000. For incidence studies, the meta-analysis yielded a pooled incidence of 50.45 per 100.000. The meta-regression showed the geographic region as an important explanatory factor of the heterogeneity between studies.Conclusion: Population-based estimates of the epidemiology of uveitis vary widely, owing to methodologies employed, definitions of uveitis and geographical regions; the representativeness and generalizability of many epidemiological studies of uveitis are limited.

Measuring Choroid Thickness as a Marker of Systemic Inflammation in Patients With Ankylosing Spondylitis.

BACKGROUND AND OBJECTIVE: Ankylosing spondylitis (AS) is an inflammatory disease, and choroidal thickness (CT) has been proposed and evaluated as a potential marker of systemic inflammation associated with AS and other inflammatory diseases. This study compared CT measurements taken from patients with severe AS disease activity without eye inflammation with those taken from healthy subjects. METHODS: This cross-sectional, multicenter study compared CT in 44 patients with high AS disease activity, and no history of eye inflammation with CT in 44 matched healthy subjects aged between 18 and 65 years. In the AS group, the correlation between CT and C-reactive protein, human leukocyte antigen (HLA) B27 positivity, disease duration, and disease activity was calculated. RESULTS: Mean CT values of patients with AS were significantly higher in the right eye, the left eye, and the thickest choroid eye. The right eye mean CT was 338.3 ± 82.8 µm among patients with AS and 290.5 ± 71.2 µm among healthy subjects (p = 0.005). The left eye mean CT was 339.5 ± 84.7 µm for patients with AS and 298.4 ± 68.9 µm for healthy subjects (P = 0.015). The thickest choroid eye CT was 358.4 ± 82.1 µm among patients with AS and 314.1 ± 65.2 µm among healthy subjects (P = 0.006). We did not find a significant correlation between CT and disease activity, C-reactive protein, human leukocyte antigen B27 positivity, or disease duration. CONCLUSIONS: Patients with active AS but without a history of eye inflammation had a thicker choroid than healthy subjects. This finding suggests that CT is a marker of systemic inflammation in patients with inflammatory disease, regardless of known eye symptoms.

Dietary Energy Density is Associated with Body Mass Index and Fat Mass in Early Adulthood.

A cross-sectional study was conducted to investigate the association between body composition parameters as well as body mass index (BMI), and dietary energy density in a population of 538 young adults. Fat mass, fat mass percent, fat-free mass, and visceral fat were measured using a body composition analyzer. Daily energy intake was assessed using a 72-hr diet recall, and dietary energy density was calculated. Significant differences in dietary energy density among underweight, normal-weight and overweight/obesity young adults were identified (M = 1.42, SD = 0.26 vs. M = 1.52, SD = 0.46 vs. M = 1.66, SD = 0.53, p = .002). Dietary energy density was associated with BMI (ß = .961; CI 95% = 0.335, 1.586; p = .0030), fat mass percent (ß = 1.921; CI 95% = 0.707, 3.135; p = .002), and fat mass (ß = 2.146; CI 95% = 0.827, 3.466; p = .001). Dietary energy density might be considered as an important aspect in the obesity nutritional education programs in young people.