Search Results (219)

Background: Cognitive decline is a growing public health concern in Latin America, driven by rapid aging, widespread micronutrient inadequacies, and socioeconomic disparities. Despite the recognized importance of nutrition, many older adults struggle to meet daily dietary micronutrients requirements, increasing the risk of mild cognitive impairment (MCI). This study aimed to establish expert consensus on the role of Multivitamin and Mineral supplements (MVMs) in promoting cognitive healthy aging among older adults in Latin America. Methods: A panel of nine experts in geriatrics, neurology, and nutrition applied a modified Delphi methodology to generate consensus statements. The panel reviewed the literature, engaged in expert discussions, and used structured voting to develop consensus statements. Results: Consensus was reached on 14 statements. Experts agreed that cognitive aging in Latin America is influenced by neurobiological, lifestyle, and socioeconomic factors, including widespread micronutrient inadequacies (vitamins B-complex, C, D, E, and minerals such as zinc, magnesium, chromium, copper, iron and selenium), which were identified as critical for global cognitive function and brain structures, yet commonly inadequate in the elderly. While a balanced diet remains essential, MVMs can be recommended as a complementary strategy to bridge nutritional gaps. Supporting evidence, including the COSMOS-Mind trials, demonstrate that MVM use improves memory and global cognition, and reduces cognitive aging by up to 2 years in older adults. Conclusions: MVMs offer a promising, accessible adjunct for cognitive healthy aging in Latin America’s elderly population, particularly where dietary challenges persist. Region-specific guidelines, public health initiatives, and targeted research are warranted to optimize outcomes and reduce health inequities. Full article

Background/Objectives: To investigate acute caffeine (CAF: 375 mg, ≈4.8 mg/kg body mass) effects on energy expenditure (EE) and substrate kinetics during high-intensity interval exercise in individuals with high (HBAT) versus low (LBAT) brown adipose tissue activity using time-trend polynomial modeling. Methods: This is a randomized, double-blind crossover study in which 35 highly-trained males [HBAT-CAF, HBAT-PLA (Placebo), LBAT-CAF, LBAT-PLA] performed 30-min treadmill HIIE. Infrared thermography (IRT) assessed BAT activity by measuring supraclavicular skin temperature (SST). Breath-by-breath ergospirometry measured EE (kcal/min) and carbohydrate (CHO), lipid (LIP), and protein (PTN) oxidation. We applied second- and third-order polynomial regression models to depict the temporal trajectories of metabolic responses. Results: HBAT groups showed 25% higher sustained EE versus LBAT (p < 0.001), amplified by CAF. CHO oxidation exhibited biphasic kinetics: HBAT had 40% higher initial rates (0.75 ± 0.05 vs. 0.45 ± 0.04 g/min; p < 0.001) with accelerated decline (k = −0.21 vs. −0.15/min; p = 0.01). LIP oxidation peaked later in LBAT (40 vs. 20 min in HBAT), with CAF increasing oxidation by 18% in LBAT (p = 0.01). HBAT-CAF uniquely showed transient PTN catabolism (peak: 0.045 g/min at 10 min; k = −0.0033/min; p < 0.001). Conclusions: BAT status determines EE magnitude and substrate-specific kinetic patterns, while CAF exerts divergent modulation, potentiating early glycogenolysis in HBAT and lipolysis in LBAT. The HBAT-CAF synergy triggers acute proteolysis, revealing BAT-mediated metabolic switching. Full article

Background: Soft tissue sarcomas (STSs) are a rare and heterogeneous group of mesenchymal tumors with limited response to current therapies, particularly in advanced stages. STS tumors were traditionally considered “cold” tumors, characterized by limited immune infiltration and low immunogenicity. However, emerging evidence is challenging this perception, highlighting a potentially critical role for the immune system in STS biology. Objective: Building on our previous findings suggesting impaired natural killer (NK) cell activity in STS patients, we aimed to perform an in-depth characterization of peripheral NK cells in STS. Methods: Peripheral blood samples from STS patients and sex- and age-matched healthy donors were analyzed to assess NK cell degranulation, IFNγ production, and receptor repertoire. Results: Functional assays revealed a notable reduction in both degranulation and IFNγ production in NK cells from STS patients. STS patients also exhibited dysregulated expression of activating and inhibitory NK cell receptors. Principal component analysis (PCA) identified CD27 and NKp44 as critical markers for distinguishing STS patients from healthy donors. Increased CD27 expression represents a shift towards a more regulatory NK cell phenotype, and we found that CD27 expression was negatively correlated with NK cell degranulation and IFNγ production. ROC curve analysis demonstrated strong potential to distinguish between the groups for both CD27 (AUC = 0.85) and NKp44 (AUC = 0.94). Conclusion: In conclusion, STS patients exhibited impaired NK cell function, altered receptor repertoire, and a shift towards a less cytotoxic and more regulatory phenotype. Full article

Background/Objectives: Ultrasonography is a diagnostic modality characterized by high sensitivity in detecting hepato-biliary pathology, particularly intrahepatic biliary duct dilation. This study compares the sonographic findings obtained by a radiographer/sonographer in a Basic Emergency Service (BES) using Point-of-Care Ultrasonography (POCUS) in Portugal with the sonographic findings from the same patients acquired by radiologists at a referral hospital (RH) for suspected intrahepatic biliary dilatation. Methods: Nineteen patients presenting with right upper quadrant (RUQ) pain and suspected abdominal pathology underwent sonographic screening using POCUS in the BES. Subsequently, the same patients were referred to the RH, where a radiologist performed a comprehensive ultrasound. Both examinations were compared to determine whether the findings obtained in the BES were confirmed by radiologists in the RH. Results: Cholestasis, cholangitis, lithiasis, pancreatitis, peri-ampullary lithiasis, and neoplasms were observed in association with intrahepatic biliary dilation in this study sample. All six variables showed a strong association between the BES and RH findings (Cramer’s V > 0.6; p < 0.006). A strong kappa measure of agreement between the radiographer and radiologist findings was obtained in “cholelithiasis/sludge/gallbladder acute sonographic changes” (k = 0.802; p = 0.000). A moderate kappa value was obtained for the variable “abdominal free fluid”, (k = 0.706; p = 0.001). Conclusions: In this study, all patients referred from the BES to the RH required hospitalization for treatment and additional imaging exams. Although pre-hospital screening ultrasound is not intended for definitive diagnoses, the early detection of intrahepatic biliary tract dilatation through screening sonography played a significant role in the clinical referral of patients, with a sensitivity of 94% and specificity of 75%. Full article

In this study, BiBaO₃ perovskite was successfully synthesized via the sol–gel method and thoroughly characterized to evaluate its structural, microstructural, dielectric, electrical, and magnetic properties. X-ray diffraction (XRD) confirmed the formation of a single-phase perovskite structure with high crystallinity. Scanning electron microscopy (SEM) coupled with energy-dispersive X-ray spectroscopy (EDX) revealed a uniform grain morphology and elemental composition consistent with the intended stoichiometry. Dielectric measurements exhibited strong frequency-dependent behavior, suggesting potential for capacitive applications. The electrical conductivity displayed thermally activated behavior, indicative of semiconducting characteristics. Magnetic measurements showed weak ferromagnetic behavior at room temperature, an unusual observation for undoped BaBiO₃-based systems. This magnetism may stem from subtle structural distortions or compositional variations introduced during synthesis. Comparison with previously reported studies underscores the significant influence of the synthesis route and microstructural features on the multifunctional properties of BiBaO₃. Overall, the results highlight the promise of sol–gel-derived BiBaO₃ as a candidate for multifunctional electronic and magnetic applications. Full article

Introduction: Idiopathic pulmonaryy fibrosis (IPF) is a progressive interstitial lung disease with a poor prognosis. While comorbidities like pulmonary hypertension and lung cancer have been studied extensively, less attention has been paid to the implications of malnutrition and sarcopenia in patients with IPF. This study aimed to assess the prevalence of malnutrition, sarcopenia, and the combined malnutrition-sarcopenia syndrome in patients with IPF using the latest diagnostic criteria from the Global Leadership Initiative on Malnutrition (GLIM) and the European Working Group on Sarcopenia in Older People 2 (EWGSOP2). Methods: A prospective, observational, multicenter study was conducted, focusing on patients with idiopathic pulmonary fibrosis (IPF). All participants provided informed consent, and the study followed ethical guidelines. Malnutrition was diagnosed based on the GLIM criteria, requiring one phenotypic and one etiological criterion, with muscle mass assessed via bioelectrical impedance analysis (BIA). Sarcopenia was screened following the EWGSOP2 recommendations. The statistical analysis was performed using JAMOVI version 2.3.22, with significance set at p < 0.05. Results: The findings revealed that 77.65% of the participants were malnourished, and 20% had sarcopenia. The malnourished patients had significantly lower body weight, height, and muscle mass compared to the non-malnourished patients. Furthermore, the patients with malnutrition exhibited poorer health-related quality of life scores. This study also identified the malnutrition-sarcopenia syndrome in 8.23% of the participants. Conclusions: Malnutrition, based on the GLIM criteria was identified in three out of four patients with IPF, while sarcopenia according to the EWGSOP2 was present in one out of five. This study underscores the necessity for routine screening for malnutrition and sarcopenia in patients with IPF. Full article

Background: The prevalence of malnutrition is high in post-intensive care unit (ICU) coronavirus disease 2019 (COVID-19) patients during hospitalization and after hospital discharge. This paper presents prospective results from the NutriEcoMuscle study, a multicenter observational study. The study aimed to evaluate changes in nutritional and functional status in post-ICU COVID-19 patients following nutritional and physical rehabilitation interventions. Secondary aims included assessing adherence to and tolerance of the oral nutritional supplement (ONS) used in the nutritional intervention. Methods: The study enrolled adults who had been admitted to the ICU due to severe COVID-19. At hospital discharge, the patients underwent a nutritional intervention based on oral nutritional supplements (ONSs) with 100% serum lactoprotein enriched with leucine and vitamin D and a physical rehabilitation program. They were followed up during three months. Performed assessments included Subjective Global Assessment (SGA), Global Leadership Initiative on Malnutrition (GLIM) criteria, Barthel index (BI), handgrip strength and Timed Up and Go test, bioelectrical impedance analysis (BIA), nutritional ultrasound (US), and tolerance and adherence to ONS. Sample size was calculated based on handgrip strength, and parametric and non-parametric tests were used to assess differences between the baseline and three-month outcomes. Results: The study included 96 patients (71.9% male, mean age 58.8 years, mean body mass index (BMI) of 28.8 kg/m², 36.5% obese). A total of 85 patients (62 men and 23 women) completed the 90-day follow-up. The mean weight gain after the intervention was 6.8 (SD 5.2) kg (similar in men and women; p = 0.263). The proportion of patients with malnutrition according to the SGA or GLIM criteria decreased from 100% to 11.8% and 36.4%, respectively (p < 0.00001 in both cases). The proportion of patients with functional limitations by BI decreased from 66.7% to 27.0% (p < 0.0001). Handgrip strength increased more than 40% in both men and women (p < 0.00001). The time to perform the Timed Up and Go (TUG) test decreased more than 40% in both men and women (p < 0.00001). According to BIA, the mean fat mass did not increase significantly in either men or women. The mean fat-free mass index (FFMI) increased significantly in both men and women. There were also significant increases in body cell mass, skeletal muscle mass index, and appendicular skeletal muscle mass index. The phase angle (PhA) increased significantly in both men (26.5%) and women (17.4%). In a multivariate analysis, age and baseline PhA were related to the PhA increase (adjusted R² = 0.5573). The US study showed a significant increase in the mean measurements of muscle area, muscle circumference, X-axis, and Y-axis in the rectus femoris. Regarding abdominal fat, there were no significant increases in total, superficial, or preperitoneal adipose tissue by US. Participants engaged in a median interquartile range (IQR) of 70 (0–120) min/week of strength exercise and 60 (0–120) min/week of moderate physical exercise. The supplement was well tolerated, and poor adherence (less than 50%) was low (4% of the participants). Conclusions: A three-month intervention, including ONS and physical rehabilitation, is associated with a significant improvement in nutritional and functional status. Patients gained weight primarily by increasing their muscle mass. There was no significant increase in fat mass, as measured by BIA or US. The intervention was well tolerated and had good adherence. Full article

Non-traumatic intracerebral hemorrhage (ICH) is one of the most devastating and disabling forms of stroke; however, there are no effective pharmacological therapies available following the insult. Angiogenesis appears as a key step to overcoming the damage and promoting functional recovery. In this context, endothelial progenitor cells (EPCs) mobilization improves oxidative stress and promotes neovascularization, which has been linked to beneficial outcomes following both ischemic and hemorrhagic stroke. The TNF-like weak inducer of apoptosis (TWEAK), binding to its receptor Fn14, has been suggested as an inducer of EPCs differentiation, viability and migration to the injury site in a model of myocardial infarction. Here, we have performed a proof-of-concept preclinical study in a rat model of ICH where we report that a 50 μg/kg dose of rat recombinant TWEAK (rTWEAK) promotes blood progenitor cells mobilization, mainly EPCs. As soon as 72 h post-injury, brain neovascularization, and, importantly, long-term hematoma reduction and improved functional recovery is reported. In contrast, a higher dose of 150 μg/kg blocked those beneficial outcomes. Therefore, a low dose of rTWEAK treatment promotes neovascularization and reduces brain damage in a rat model of ICH. Further clinical studies will be needed to demonstrate if rTWEAK could represent a new strategy to promote recovery following ICH. Full article

Background: Disease-related malnutrition (DRM) in outpatients is associated with increased mortality and functional decline. Morphofunctional assessments, including phase angle (PA), rectus femoris cross-sectional area (RF-CSA), and handgrip strength (HGS), provide valuable prognostic insights in the ambulatory setting. Nutritional recovery programs enriched with β-hydroxy-β-methylbutyrate (HMB) offer potential benefits in improving nutritional and functional outcomes. Objective: To evaluate the effects of a six-month nutritional recovery program combining HMB-enriched oral nutritional supplements (HMB-ONS), dietary recommendations, and exercise on survival, morphofunctional markers, and adherence in malnourished outpatients. Methods: This retrospective observational study included 135 malnourished outpatients diagnosed using GLIM criteria. Morphofunctional assessments included PA (bioimpedance analysis), RF-CSA (nutritional ultrasound), HGS (dynamometry), and the Timed Up and Go (TUG) test. Adherence was assessed using pharmacy retrieval records and a validated questionnaire. Changes in morphofunctional markers and their association with mortality were analyzed using multivariate Cox regression models. Results: After six months, significant improvements were observed in PA (+0.47°), RF-CSA (+0.90 cm²), HGS (+4.1 kg), and TUG (−0.93 s) (all p < 0.001). These improvements were more pronounced in the high-adherence group, which also exhibited a reduced mortality risk (HR 0.42, p < 0.05). Changes in PA and HGS were strongly associated with survival, with ΔPA showing an HR of 0.27 (95% CI: 0.15–0.50, p < 0.001) and ΔHGS showing an HR of 0.82 (95% CI: 0.75–0.89, p < 0.001). Conclusions: A nutritional recovery program with HMB-ONS significantly improves survival and morphofunctional markers in malnourished patients, with the greatest benefits observed in those with high adherence. These findings underscore the importance of adherence-support strategies in optimizing clinical outcomes and highlight the need for further research to confirm long-term benefits. Full article

Background: Malnutrition is a prevalent condition associated with adverse health outcomes, requiring the accurate assessment of muscle composition and fat distribution. Methods: This study presents a novel method for the automatic analysis of ultrasound images to estimate subcutaneous and visceral fat, as well as muscle, in patients with suspected malnutrition. The proposed system utilizes computer vision techniques to segment regions of interest (ROIs), calculate relevant variables, and store data for clinical evaluation. Unlike traditional segmentation methods that rely solely on thresholding or pre-defined masks, our method employs an iterative hierarchical approach to refine contour detection and improve localization accuracy. A dataset of abdominal and leg ultrasound images, captured in both longitudinal and transversal planes, was analyzed. Results: Results showed higher precision for longitudinal scans compared to transversal scans, particularly for length-related variables, with the Y-axis Vastus intermediate achieving a precision of 92.87%. However, area-based measurements demonstrated lower precision due to differences between manual adjustments by experts and automatic geometric approximations. Conclusions: These findings highlight the system’s potential for clinical use while emphasizing the need for further algorithmic refinements to improve precision in area calculations. Full article

Background: Emerging evidence suggests that emotions significantly influence clinical decision-making among healthcare professionals. Given that evidence-based nursing (EBN) relies heavily on clinical reasoning, and emotions play a critical role in shaping its quality, exploring the relationship between emotional competence and EBN is essential. Objective: This scoping review aims to map and synthesize existing knowledge on the relationship between nurses’ emotional competence and EBN, while identifying research methodologies and integration challenges. Methods: Following the Joanna Briggs Institute (JBI) methodology and PRISMA-ScR guidelines, a scoping review was conducted. The search strategy included studies from databases such as Scopus and CINAHL, as well as grey literature. Eligibility criteria included primary and secondary research articles in Portuguese, English, Spanish, and French, published since 1990, focusing on the relationship between emotional competence and EBN in nurses. Data were synthesized thematically. Results: Of 751 publications identified, 11 met the inclusion criteria. Three themes emerged: (1) the relationship between emotional competence and EBN in different healthcare contexts; (2) research methodologies used; and (3) integration challenges and suggestions. Findings suggest that nurses with higher emotional competence are more likely to adopt safer, evidence-based practices, facilitating EBN implementation and improving care quality and safety. Conclusions: The evidence highlights the importance of integrating emotional intelligence and EBN in nursing education and practice. Combined educational programs are recommended to enhance professional safety, performance, and well-being. Future research should further explore this relationship to develop practice models that reconcile emotional competencies with evidence-based nursing. Full article

Maghemite (γ-Fe₂O₃) nanoparticles have attracted considerable interest for electronic applications due to their tunable electrical properties. Doping strategies offer an effective way to optimize their resistive behavior for use in electronic devices. In this study, cobalt (Co) was incorporated into γ-Fe₂O₃ to enhance its resistive properties. X-ray diffraction (XRD) confirmed the retention of the cubic P4₃32 phase, with Co doping inducing subtle lattice distortions due to ionic substitution. Scanning and transmission electron microscopy (SEM/TEM) revealed morphological changes, where Co incorporation influenced particle shape and size distribution. Electrical conductivity analysis demonstrated a decrease in both AC and DC conductivity with the increase in Co content, indicating enhanced resistive behavior. The increase in activation energy suggests a reduction in charge carrier mobility, leading to higher resistivity. Impedance spectroscopy further confirmed increased real and imaginary impedance values, reinforcing the role of Co in suppressing charge transport. These results position cobalt-doped maghemite as a promising material for electronic resistive devices, such as tunable resistors and negative temperature coefficient (NTC) thermistors, where controlled conductivity and stable resistive behavior are essential. Full article

Halogenated benzaldehydes possess unique chemical properties that render them valuable in pharmaceutical synthesis, pesticide formulation, and dye production. However, thorough thermodynamic data for these compounds remain scarce. This study aims to fill this knowledge gap by investigating key physical properties of several halogenated benzaldehydes, namely 4-chlorobenzaldehyde, 4-bromobenzaldehyde, 2,3-dichlorobenzaldehyde, 2,4-dichlorobenzaldehyde, and 2,6-dichlorobenzaldehyde. The physical properties determined in this study include volatility, phase transitions, and water solubility, all of which are crucial for predicting the environmental fate of these compounds. The vapor pressures of both crystalline and liquid phases were measured using a reliable static method, allowing for the determination of standard molar enthalpies, entropies, and Gibbs energies of sublimation and vaporization, as well as their triple points. The melting temperature and molar enthalpy, along with the isobaric molar heat capacity of the crystalline phase, were assessed using differential scanning calorimetry. Water solubility was evaluated at 25 °C through the saturation shake-flask method, complemented by ultra-violet visible spectroscopy. By combining sublimation and solubility data, additional properties such as Gibbs energies of hydration and Henry’s law constants were derived. The experimental results were integrated into existing databases, enhancing the predictive models for properties including melting temperature, vapor pressure, solubility, Gibbs energy of hydration, and Henry’s constant. These findings significantly improve the environmental modeling capabilities, providing valuable insights into the mobility and fate of halogenated benzaldehydes in various environmental contexts. Full article

There is increasing evidence supporting the use of morphofunctional assessment (MFA) as a tool for clinical characterization and decision-making in malnourished patients. MFA enables the diagnosis of malnutrition, sarcopenia, obesity, and cachexia, leading to a novel phenotype-based classification of nutritional disorders. Bioelectrical impedance analysis (BIVA), nutritional ultrasound^® (NU) and computed tomography (CT) are included, along with functional tests like the Timed Up and Go test (TUG). Myoesteatosis, detectable via CT, can occur independently from nutritional phenotypes and has been identified as a significant mortality predictor in idiophatic pulmonary fibrosis (IPF). Our aim is to analyze the prevalence and overlap of nutritional phenotypes in IPF and evaluate the prognostic value of myoesteatosis. Our bicenter cross-sectional study included 82 IPF patients (84.1% male and with a medium age of 71.1 ± 7.35 years). MFA was performed using BIVA, NU, CT at the T12 level (CT-T12), the handgrip strength (HGS) test, and the TUG. CT-T12 BC parameters were analyzed using FocusedON^® software, while statistical analyses were conducted with JAMOVI version 2.3.22. All four major nutritional phenotypes were represented in our cohort, with significant overlap. A total of 80.5% met the GLIM criteria for malnutrition, 14.6% had cachexia, 17% were sarcopenic, and 28% were obese. Of the obese patients, 70% were also malnourished, while 100% of sarcopenic obese patients (5.9% of total) had malnutrition. A total of 55% of sarcopenic patients with available CT also had myosteatosis, suggesting muscle quality deterioration as a potential driver of functional impairment. The presence of myosteatosis > 15% in T12-CT was an independent predictor of 12-month mortality (HR = 3.13; 95% CI: 1.01–9.70; p = 0.049), with survival rates of 78.1% vs. 96.6% in patients with vs. without myosteatosis, respectively. To conclude, this study underscores the relevance of MFA in the nutritional characterization of patients with IPF, demonstrating its potential to identify specific phenotypes associated with malnutrition, functional impairment, and the presence of myoesteatosis, thereby providing a valuable tool for clinical decision-making. Full article