Outcomes of polytrauma patients with diabetes mellitus.

BACKGROUND: The impact of diabetes mellitus in patients with multiple system injuries remains obscure. This study was designed to increase knowledge of outcomes of polytrauma in patients who have diabetes mellitus. METHODS: Data from the Trauma Audit and Research Network was used to identify patients who had suffered polytrauma during 2003 to 2011. These patients were filtered to those with known outcomes, then separated into those with diabetes, those known to have other co-morbidities but not diabetes and those known not to have any co-morbidities or diabetes. The data were analyzed to establish if patients with diabetes had differing outcomes associated with their diabetes versus the other groups. RESULTS: In total, 222 patients had diabetes, 2,558 had no past medical co-morbidities (PMC), 2,709 had PMC but no diabetes. The diabetic group of patients was found to be older than the other groups (P <0.05). A higher mortality rate was found in the diabetic group compared to the non-PMC group (32.4% versus 12.9%), P <0.05). Rates of many complications including renal failure, myocardial infarction, acute respiratory distress syndrome, pulmonary embolism and deep vein thrombosis were all found to be higher in the diabetic group. CONCLUSIONS: Close monitoring of diabetic patients may result in improved outcomes. Tighter glycemic control and earlier intervention for complications may reduce mortality and morbidity

Análisis sincrónico de la gobernanza universitaria: una mirada teórica a los años sesenta y setenta

Resumen Estudiar las perspectivas en el campo del gobierno de las universidades tiene cada día mayor preeminencia, especialmente si se toma en cuenta la incuestionable necesidad de avanzar hacía organizaciones más eficientes, conectadas con las expectativas que sobre ellas tiene la sociedad. Considerando este escenario, el trabajo se ha planteado como propósito central realizar un análisis de carácter sincrónico del concepto de gobernanza y la constitución de los gobiernos universitarios. Desde el punto de vista metodológico se utilizaron fuentes secundarias: una revisión de papers publicados esencialmente en revistas de habla inglesa. El estudio comprende las décadas del sesenta y el setenta. Se centra en las raíces del concepto de gobernanza universitaria, en la delineación de los actores que participan en sus gobiernos y en las relaciones de poder que fluyen entre ellos.Entre las principales conclusiones, se pueden destacar como el estamento académico desde el principio de las universidades ha ocupado el rol casi plenipotenciario en su respectivo gobierno, producto de esto, en el correr del desarrollo y mientras la complejidad organizacional se incrementaba, es que fue necesario incorporar nuevos actores a los sistemas de gestión; todo lo anterior, teniendo en cuenta que dos elementos han sido fundamentales para la sobrevivencia de este tipo de instituciones, la legitimidad otorgada por la sociedad y los principios de estrategias del ámbito de la gestión

The Water Footprint of Diets: A Global Systematic Review and Meta-analysis.

Agricultural water requirements differ between foods. Population-level dietary preferences are therefore a major determinant of agricultural water use. The "water footprint" (WF) represents the volume of water consumed in the production of food items, separated by water source; blue WF represents ground and surface water use, and green WF represents rain water use. We systematically searched for published studies using the WF to assess the water use of diets. We used the available evidence to quantify the WF of diets in different countries, and grouped diets in patterns according to study definition. "Average" patterns equated to those currently consumed, whereas "healthy" patterns included those recommended in national dietary guidelines. We searched 7 online databases and identified 41 eligible studies that reported the dietary green WF, blue WF, or total WF (green plus blue) (1964 estimates for 176 countries). The available evidence suggests that, on average, European (170 estimates) and Oceanian (18 estimates) dietary patterns have the highest green WFs (median per capita: 2999 L/d and 2924 L/d, respectively), whereas Asian dietary patterns (98 estimates) have the highest blue WFs (median: 382 L/d per capita). Foods of animal origin are major contributors to the green WFs of diets, whereas cereals, fruits, nuts, and oils are major contributors to the blue WF of diets. "Healthy" dietary patterns (425 estimates) had green WFs that were 5.9% (95% CI: -7.7, -4.0) lower than those of "average" dietary patterns, but they did not differ in their blue WFs. Our review suggests that changes toward healthier diets could reduce total water use of agriculture, but would not affect blue water use. Rapid dietary change and increasing water security concerns underscore the need for a better understanding of the amount and type of water used in food production to make informed policy decisions

Global guideline for the diagnosis and management of candidiasis: an initiative of the ECMM in cooperation with ISHAM and ASM

Candida species are the predominant cause of fungal infections in patients treated in hospital, contributing substantially to morbidity and mortality. Candidaemia and other forms of invasive candidiasis primarily affect patients who are immunocompromised or critically ill. In contrast, mucocutaneous forms of candidiasis, such as oral thrush and vulvovaginal candidiasis, can occur in otherwise healthy individuals. Although mucocutaneous candidiasis is generally not life-threatening, it can cause considerable discomfort, recurrent infections, and complications, particularly in patients with underlying conditions such as diabetes or in those taking immunosuppressive therapies. The rise of difficult-to-treat Candida infections is driven by new host factors and antifungal resistance. Pathogens, such as Candida auris (Candidozyma auris) and fluconazole-resistant Candida parapsilosis, pose serious global health risks. Recent taxonomic revisions have reclassified several Candida spp, potentially causing confusion in clinical practice. Current management guidelines are limited in scope, with poor coverage of emerging pathogens and new treatment options. In this Review, we provide updated recommendations for managing Candida infections, with detailed evidence summaries available in the appendix. [Abstract copyright: Copyright © 2025 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.

Spanish Literature and the Recovery of Historical Memory

This article analyses the recovery of the historical memory of the Spanish Civil War in the last decade, after so many years of silence, forgetfulness and oblivion. Four points are developed: first, how this recovery is achieved by the civil society in general and by the Association for the Recovery of Historical Memory in particular. Secondly, there is a brief allusion to the quarrel between historians and philosophers about the place of memory and remembrance for the construction of the history of Spain. Thirdly, a reference to the recent Historical Memory Law is made, and finally there is a point about the important role played by literature in recovering the memory of many painful facts of the Civil War and Franco’s dictatorship from the point of view of the victims.Peer reviewe

The Old Man and the Manuscript

Lengthy review of Hemingway’s latest posthumously published book True at First Light by the editor of The Garden of Eden (1986), another of Hemingway’s posthumously published works. Characterizing True at First Light as a failed effort by a failing writer, Jenks outlines the events inspiring the book’s conception along with Patrick Hemingway’s difficulties in editing. Despite criticizing the book as “unformed, fragmentary, digressive, and anecdotal,” Jenks doubts its appearance will diminish Hemingway’s reputation or stem the flow of future posthumous works making their way into the marketplace