Fasting effect on eating behavior in university students / Efecto del ayuno sobre la conducta alimentaria en estudiantes universitarios

Abstract Scientific evidence on the characterization of eating behavior indicates that food deprivation situations, such as fasting, the food value increases and alter the fee- ding pattern. Consequently food consumption increases and therefore caloric intake. The situation worsens when after a deprivation period the preferred foods are unhealthy or consumed in excess becoming tiggers for health problems (Capaldi, 1993; Gottschalk , Libby & Graff , 2000; Velez & Garcia , 2003). The aim of this study was to evaluate the effect of fasting on caloric intake and changing food preferences. This study was conducted with the participation of 9 university students who were classified according to their Body Mass Index (BMI) into three groups: Low-weight, Normo-weight and Over-weight. At the baseline participants were exposed to eight different foods. Same participants during the experimental phase were exposed to a period of fasting, subsequently were exposed to the same foods and record their consumption. Results showed that caloric intake and food preferences were altered after the fasting condition, differential effects among participants were observed. Low-weight group increased their food consumption while Normal-weight and Over-weight groups decreased. Resumen La evidencia científica sobre la caracterización de la conducta alimentaria señala que situaciones de privación de alimento, como el ayuno, aumentan el valor del alimento y modifican el patrón alimentario. En consecuencia se incrementa el consumo de alimentos y por ende el consumo calórico. La situación se agrava cuando los alimentos preferidos después del periodo de privación son poco saludables o se consumen en exceso convirtiéndose en detonadores de problemas de salud (Ca- paldi, 1993; Gottschalk, Libby & Graff, 2000; Vélez & Garcia, 2003). Con el objetivo de evaluar el efecto del ayuno sobre el consumo calórico y la modificación de las preferencias alimentarias, se diseñó un estudio en el cual participaron nueve jóvenes universitarios que fueron clasificados de acuerdo a su Índice de Masa Corporal (IMC) en tres grupos: Bajo-peso, Normo-peso y Sobre-peso. Fueron expuestos durante la línea base a ocho alimentos diferentes. Durante la fase experi- mental se expuso a los mismos participantes a un periodo de ayuno y posteriormente a los mismos alimentos registrando su consumo. Los resultados mostraron que el consumo calórico y la preferencia entre alimentos se modificaron. El grupo Bajo-peso aumentó su consumo de alimento mientras que en los grupos Normo-peso y Sobre-peso lo disminuyeron.

Goodbye Hartmann trial: a prospective, international, multicenter, observational study on the current use of a surgical procedure developed a century ago

Background: Literature suggests colonic resection and primary anastomosis (RPA) instead of Hartmann's procedure (HP) for the treatment of left-sided colonic emergencies. We aim to evaluate the surgical options globally used to treat patients with acute left-sided colonic emergencies and the factors that leading to the choice of treatment, comparing HP and RPA. Methods: This is a prospective, international, multicenter, observational study registered on ClinicalTrials.gov. A total 1215 patients with left-sided colonic emergencies who required surgery were included from 204 centers during the period of March 1, 2020, to May 31, 2020. with a 1-year follow-up. Results: 564 patients (43.1%) were females. The mean age was 65.9 ± 15.6 years. HP was performed in 697 (57.3%) patients and RPA in 384 (31.6%) cases. Complicated acute diverticulitis was the most common cause of left-sided colonic emergencies (40.2%), followed by colorectal malignancy (36.6%). Severe complications (Clavien-Dindo ≥ 3b) were higher in the HP group (P < 0.001). 30-day mortality was higher in HP patients (13.7%), especially in case of bowel perforation and diffused peritonitis. 1-year follow-up showed no differences on ostomy reversal rate between HP and RPA. (P = 0.127). A backward likelihood logistic regression model showed that RPA was preferred in younger patients, having low ASA score (≤ 3), in case of large bowel obstruction, absence of colonic ischemia, longer time from admission to surgery, operating early at the day working hours, by a surgeon who performed more than 50 colorectal resections. Conclusions: After 100 years since the first Hartmann's procedure, HP remains the most common treatment for left-sided colorectal emergencies. Treatment's choice depends on patient characteristics, the time of surgery and the experience of the surgeon. RPA should be considered as the gold standard for surgery, with HP being an exception

Global disparities in surgeons’ workloads, academic engagement and rest periods: the on-calL shIft fOr geNEral SurgeonS (LIONESS) study

: The workload of general surgeons is multifaceted, encompassing not only surgical procedures but also a myriad of other responsibilities. From April to May 2023, we conducted a CHERRIES-compliant internet-based survey analyzing clinical practice, academic engagement, and post-on-call rest. The questionnaire featured six sections with 35 questions. Statistical analysis used Chi-square tests, ANOVA, and logistic regression (SPSS® v. 28). The survey received a total of 1.046 responses (65.4%). Over 78.0% of responders came from Europe, 65.1% came from a general surgery unit; 92.8% of European and 87.5% of North American respondents were involved in research, compared to 71.7% in Africa. Europe led in publishing research studies (6.6 ± 8.6 yearly). Teaching involvement was high in North America (100%) and Africa (91.7%). Surgeons reported an average of 6.7 ± 4.9 on-call shifts per month, with European and North American surgeons experiencing 6.5 ± 4.9 and 7.8 ± 4.1 on-calls monthly, respectively. African surgeons had the highest on-call frequency (8.7 ± 6.1). Post-on-call, only 35.1% of respondents received a day off. Europeans were most likely (40%) to have a day off, while African surgeons were least likely (6.7%). On the adjusted multivariable analysis HDI (Human Development Index) (aOR 1.993) hospital capacity > 400 beds (aOR 2.423), working in a specialty surgery unit (aOR 2.087), and making the on-call in-house (aOR 5.446), significantly predicted the likelihood of having a day off after an on-call shift. Our study revealed critical insights into the disparities in workload, access to research, and professional opportunities for surgeons across different continents, underscored by the HDI

Infected pancreatic necrosis: outcomes and clinical predictors of mortality. A post hoc analysis of the MANCTRA-1 international study

: The identification of high-risk patients in the early stages of infected pancreatic necrosis (IPN) is critical, because it could help the clinicians to adopt more effective management strategies. We conducted a post hoc analysis of the MANCTRA-1 international study to assess the association between clinical risk factors and mortality among adult patients with IPN. Univariable and multivariable logistic regression models were used to identify prognostic factors of mortality. We identified 247 consecutive patients with IPN hospitalised between January 2019 and December 2020. History of uncontrolled arterial hypertension (p = 0.032; 95% CI 1.135-15.882; aOR 4.245), qSOFA (p = 0.005; 95% CI 1.359-5.879; aOR 2.828), renal failure (p = 0.022; 95% CI 1.138-5.442; aOR 2.489), and haemodynamic failure (p = 0.018; 95% CI 1.184-5.978; aOR 2.661), were identified as independent predictors of mortality in IPN patients. Cholangitis (p = 0.003; 95% CI 1.598-9.930; aOR 3.983), abdominal compartment syndrome (p = 0.032; 95% CI 1.090-6.967; aOR 2.735), and gastrointestinal/intra-abdominal bleeding (p = 0.009; 95% CI 1.286-5.712; aOR 2.710) were independently associated with the risk of mortality. Upfront open surgical necrosectomy was strongly associated with the risk of mortality (p < 0.001; 95% CI 1.912-7.442; aOR 3.772), whereas endoscopic drainage of pancreatic necrosis (p = 0.018; 95% CI 0.138-0.834; aOR 0.339) and enteral nutrition (p = 0.003; 95% CI 0.143-0.716; aOR 0.320) were found as protective factors. Organ failure, acute cholangitis, and upfront open surgical necrosectomy were the most significant predictors of mortality. Our study confirmed that, even in a subgroup of particularly ill patients such as those with IPN, upfront open surgery should be avoided as much as possible. Study protocol registered in ClinicalTrials.Gov (I.D. Number NCT04747990)

Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults

Background Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. Methods We used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5–19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI <18·5 kg/m2) and obesity (BMI ≥30 kg/m2). For schoolaged children and adolescents, we report thinness (BMI <2 SD below the median of the WHO growth reference) and obesity (BMI >2 SD above the median). Findings From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in 11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and 140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%) with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and 42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents, the increases in double burden were driven by increases in obesity, and decreases in double burden by declining underweight or thinness. Interpretation The combined burden of underweight and obesity has increased in most countries, driven by an increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesit

Global variation in diabetes diagnosis and prevalence based on fasting glucose and hemoglobin A1c

Fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) are both used to diagnose diabetes, but these measurements can identify different people as having diabetes. We used data from 117 population-based studies and quantified, in different world regions, the prevalence of diagnosed diabetes, and whether those who were previously undiagnosed and detected as having diabetes in survey screening, had elevated FPG, HbA1c or both. We developed prediction equations for estimating the probability that a person without previously diagnosed diabetes, and at a specific level of FPG, had elevated HbA1c, and vice versa. The age-standardized proportion of diabetes that was previously undiagnosed and detected in survey screening ranged from 30% in the high-income western region to 66% in south Asia. Among those with screen-detected diabetes with either test, the age-standardized proportion who had elevated levels of both FPG and HbA1c was 29-39% across regions; the remainder had discordant elevation of FPG or HbA1c. In most low- and middle-income regions, isolated elevated HbA1c was more common than isolated elevated FPG. In these regions, the use of FPG alone may delay diabetes diagnosis and underestimate diabetes prevalence. Our prediction equations help allocate finite resources for measuring HbA1c to reduce the global shortfall in diabetes diagnosis and surveillance

Minimal information for studies of extracellular vesicles (MISEV2023): From basic to advanced approaches

Extracellular vesicles (EVs), through their complex cargo, can reflect the state of their cell of origin and change the functions and phenotypes of other cells. These features indicate strong biomarker and therapeutic potential and have generated broad interest, as evidenced by the steady year-on-year increase in the numbers of scientific publications about EVs. Important advances have been made in EV metrology and in understanding and applying EV biology. However, hurdles remain to realising the potential of EVs in domains ranging from basic biology to clinical applications due to challenges in EV nomenclature, separation from non-vesicular extracellular particles, characterisation and functional studies. To address the challenges and opportunities in this rapidly evolving field, the International Society for Extracellular Vesicles (ISEV) updates its 'Minimal Information for Studies of Extracellular Vesicles', which was first published in 2014 and then in 2018 as MISEV2014 and MISEV2018, respectively. The goal of the current document, MISEV2023, is to provide researchers with an updated snapshot of available approaches and their advantages and limitations for production, separation and characterisation of EVs from multiple sources, including cell culture, body fluids and solid tissues. In addition to presenting the latest state of the art in basic principles of EV research, this document also covers advanced techniques and approaches that are currently expanding the boundaries of the field. MISEV2023 also includes new sections on EV release and uptake and a brief discussion of in vivo approaches to study EVs. Compiling feedback from ISEV expert task forces and more than 1000 researchers, this document conveys the current state of EV research to facilitate robust scientific discoveries and move the field forward even more rapidly

Bifunctional Aluminum Catalysts for the Chemical Fixation of Carbon Dioxide into Cyclic Carbonates

Bifunctional aluminum complexes supported by novel zwitterionic NNO-donor scorpionate ligands were found to be efficient bifunctional catalysts for cyclic carbonate synthesis from terminal and internal epoxides in good yields and with broad substrate scope. Neutral scorpionate ligands (<b>1</b>–<b>2</b>) were designed and used as precursors to obtain two novel zwitterionic NNO-heteroscorpionate ligands (<b>3</b>–<b>4</b>). Reaction of <b>3</b> or <b>4</b> with [AlX₃] (X = Me, Et) in a 1:1 or 1:2 molar ratio afforded the mononuclear and dinuclear cationic aluminum complexes [AlX₂{κ²-mbpzbdmape}]­I₂ (X = Me (<b>5</b>), Et (<b>6</b>)), [AlX₂{κ²-mbpzbdeape}]­I₂ (X = Me (<b>7</b>), Et (<b>8</b>)), [{AlX₂(κ²-mbpzbdmape)}­(μ-O)­{AlX₃}]­I₂ (X = Me (<b>9</b>), Et (<b>10</b>)), and [{AlX₂(κ²-mbpzbdeape)}­(μ-O)­{AlX₃}]­I₂ (X = Me (<b>11</b>), Et (<b>12</b>)) with elimination of the corresponding alkane. These complexes were investigated as catalysts for cyclic carbonate formation from epoxides and carbon dioxide in the absence of a co-catalyst. Complex <b>7</b> was found to be the most active catalyst for cyclic carbonate formation from various epoxides and carbon dioxide

Bifunctional Aluminum Catalysts for the Chemical Fixation of Carbon Dioxide into Cyclic Carbonates

Bifunctional aluminum complexes supported by novel zwitterionic NNO-donor scorpionate ligands were found to be efficient bifunctional catalysts for cyclic carbonate synthesis from terminal and internal epoxides in good yields and with broad substrate scope. Neutral scorpionate ligands (<b>1</b>–<b>2</b>) were designed and used as precursors to obtain two novel zwitterionic NNO-heteroscorpionate ligands (<b>3</b>–<b>4</b>). Reaction of <b>3</b> or <b>4</b> with [AlX₃] (X = Me, Et) in a 1:1 or 1:2 molar ratio afforded the mononuclear and dinuclear cationic aluminum complexes [AlX₂{κ²-mbpzbdmape}]­I₂ (X = Me (<b>5</b>), Et (<b>6</b>)), [AlX₂{κ²-mbpzbdeape}]­I₂ (X = Me (<b>7</b>), Et (<b>8</b>)), [{AlX₂(κ²-mbpzbdmape)}­(μ-O)­{AlX₃}]­I₂ (X = Me (<b>9</b>), Et (<b>10</b>)), and [{AlX₂(κ²-mbpzbdeape)}­(μ-O)­{AlX₃}]­I₂ (X = Me (<b>11</b>), Et (<b>12</b>)) with elimination of the corresponding alkane. These complexes were investigated as catalysts for cyclic carbonate formation from epoxides and carbon dioxide in the absence of a co-catalyst. Complex <b>7</b> was found to be the most active catalyst for cyclic carbonate formation from various epoxides and carbon dioxide

New Highly Active Heteroscorpionate-Containing Lutetium Catalysts for the Hydroamination of Aminoalkenes: Isolation and Structural Characterization of a Dipyrrolidinide–Lutetium Complex

The reactions of the hybrid scorpionate/cyclopentadiene compounds, as a mixture of regioisomers1-[2,2-bis­(3,5-dimethylpyrazol-1-yl)-1,1-diphenylethyl]-1,3-cyclopentadiene and 2-[2,2-bis­(3,5-dimethylpyrazol-1-yl)-1,1-diphenylethyl]-1,3-cyclopentadiene (bpzcpH) and 1-[2,2-bis­(3,5-dimethylpyrazol-1-yl)-1-<i>tert</i>-butylethyl]-1,3-cyclopentadiene and 2-[2,2-bis­(3,5-dimethylpyrazol-1-yl)-1-<i>tert</i>-butylethyl]-1,3-cyclopentadiene (bpztcpH)with [Lu­(CH₂SiMe₃)₃(thf)₂] proceed in very high yields to give the free solvent neutral heteroscorpionate dialkyl lutetium complexes [Lu­(CH₂SiMe₃)₂(bpzcp)] (<b>1</b>) and chiral [Lu­(CH₂SiMe₃)₂(bpztcp)] (<b>2</b>). The structures in solution of <b>1</b> and <b>2</b> were investigated by VT NMR spectroscopy, and a fluxional behavior corresponding to an exchange between the alkyl groups was observed. The lutetium complex [Lu­(CH₂SiMe₃)₂(bpztcp)­(thf)] (<b>3</b>) was isolated as an enantiomerically enriched complex. Supramolecular CH−π interactions between molecules in crystals of <b>3</b> have been identified in its X-ray molecular analysis, and they explain the formation of a conglomerate among molecules of <b>3</b>. Complexes <b>1</b>–<b>3</b> are efficient catalysts for the intramolecular hydroamination of aminoalkenes, giving TOF values of up to 475 h^–1 at 90 °C for 2,2-diphenyl-pent-4-enylamine (<b>4</b>) by using complex <b>3</b> as catalyst. Enantioselectivities up tp 70% ee were achieved in the cyclization of the 1,2-disubstituted olefin <b>6</b> with the high enantiopurity complex <b>3</b>. The hydroamination reactions show apparently zero-order rate dependence on substrate concentration and first-order rate dependence on catalyst concentration. Additionally, bicyclization of 2-allyl-2-methylpent-4-enylamine (<b>10</b>) was achieved at 60 and 100 °C, giving <i>exo</i>,<i>exo</i>-2,4,6-trimethyl-1-azabicyclo­[2.2.1]­heptane (<b>12</b>). The protonolysis reaction of complex [Lu­(CH₂SiMe₃)₂(bpztcp)] (<b>2</b>) with 2 equiv of 2,2-diphenyl-pent-4-enylamine (<b>4</b>) yielded a dipyrrolidinide lutetium complex [Lu­(NC₄H₅-2-Me-4,4-Ph₂)₂(bpztcp)] (<b>13</b>) as a mixture of two diastereoisomers. The structures of the complexes were determined by spectroscopic methods, and the X-ray crystal structures of <b>3</b> and <b>13</b> were also established