INTRODUCTION: Delirium is an acute and reversible neuropsychiatric syndrome characterized by alterations in consciousness, attention, and cognitive functions, which increases morbidity and mortality and leads to prolonged hospital stays and higher economic costs. Between 8 and 17% of patients aged 65 years or older who attend the Emergency Department (ED) may suffer from delirium. One of the axes of delirium research is based on early detection including validated scales.

OBJECTIVES: This study aimed to analyze the incidence of patients aged 65 years or older attending the ED of the Hospital Universitario de la Ribera (HULR) who are diagnosed with delirium. It also aimed to analyze sociodemographic characteristics and variables related to triage, emergency department, and discharge destination.

METHODS: A retrospective observational study was conducted, including patients aged 65 years or older who attended the ED from January 1, 2024 to December 31, 2024.

RESULTS: During the year 2024, 132,370 patients attended the Emergency Department of HULR. A proportion of 27.87% (n=36,893) were patients aged 65 years or older with a mean age of 77.68 (SD 7.98). A proportion of 0.07% (n=27) of patients had delirium as the primary diagnosis and 0.05% (n=2) had it as the secondary diagnosis, with urinary tract infection being the primary diagnosis with the highest percentage of 5.53% (n=2040). A proportion of 54.98% (n=20285) were women. The diagram most frequently used in triage was “limb problems” at 16.75% (n=6180), followed by “adult with poor general condition” at 16.39% (n=6046). A proportion of 66.4% (n=24493) were triaged as least urgent (priority P4) and 60.18% (n=22204) of the patients were placed in the consultation area. A proportion of 32.5% (n=8991) were admitted with a mean length of stay of 6.12 days (SD 7.31).

CONCLUSIONS: The percentage of patients diagnosed with delirium in the Emergency Department of HULR is below those of previous studies. Screening with scales such as the 4AT, which is easy and quick to apply, may help identify delirium in the ED and reduce its impact.

INTRODUCTION: Efferocytosis, the process by which macrophages clear apoptotic cells, is crucial for resolving inflammation and is often impaired in various inflammatory conditions. Previous studies suggest that natural products and their bioactive components can modulate macrophage functions, including activation, recruitment, polarization, and metabolism. In this context, our research explores the potential of Broccoli-Derived Nanovesicles (BDNVs) to enhance macrophage efferocytic capacity. We propose that pretreating macrophages with varying doses of BDNVs may improve their ability to remove apoptotic neutrophils.
METHODS: Human macrophages were obtained by stimulating monocytic THP1 cells with phorbol myristate acetate (PMA) for 72 hours. Human neutrophils were isolated from blood by Ficoll and their apoptosis was induced by exposing them to thermal shock at 43°C for 60 minutes, followed by a 24-hour incubation at 37°C. Broccoli-derived nanovesicles (BDNVs) were isolated from fresh Brassica oleracea L. sprouts using ultracentrifugation, and their concentration was quantified as weight per volume. PKH-26 labeled apoptotic neutrophils were then incubated with macrophages pretreated with BDNVs, and phagocytic activity was assessed using epifluorescence microscopy and flow cytometry.
RESULTS: Macrophage morphology was verified through microscopic analysis, and neutrophil apoptosis was assessed using the trypan blue exclusion method. Notably, our results demonstrated that macrophages treated with BDNVs showed a significantly higher phagocytic ability for apoptotic neutrophils compared to untreated macrophages. Specifically, epifluorescence microscopy revealed an increased intracellular PKH-26 signal that correlated with the BDNV concentration (ranging from 5 to 100 µg/mL). These findings were further supported by flow cytometry, which showed a higher percentage of PKH-26 positive macrophages following BDNV treatment, across a broad concentration range (0-5000 µg/mL).
CONCLUSIONS: Collectively, these results suggest that BDNVs promote the rapid clearance of apoptotic neutrophils through enhanced efferocytosis. BDNVs might be considered as pro-resolvent agents in the treatment of chronic inflammatory conditions.

Gestational diabetes mellitus (GDM) is a form of hyperglycemia that arises during pregnancy and is associated with increased maternal and fetal risks. The current diagnosis relies on an oral glucose tolerance test performed between 24 and 28 weeks of gestation, limiting the window for early intervention. This study aimed to analyze serum proteins as potential biomarkers for early diagnosis and monitoring of GDM in Mexican women. A cohort of 200 pregnant women was enrolled during their first trimester, with serum samples collected in each trimester. A GDM diagnosis was confirmed in the second trimester according to the international guidelines. After applying inclusion and exclusion criteria, 19 women with GDM and 15 women without GDM were included in the final analysis. Nine candidate proteins (ADIPOQ, PAPP-A, PAPP-A2, IGFBP-5, AFM, SHBG, FABP4, RBP4, and RETN) were measured in the first-trimester serum using a targeted antibody array. Multivariate and linear regression analyses identified SHBG, IGFBP-5, and FABP4 as promising biomarkers for early GDM detection. Quantification across all trimesters was performed using ELISA kits. The receiver operating characteristic (ROC) curve analysis showed that FABP4 exhibited the highest sensitivity and specificity for discriminating GDM cases during the first trimester. However, its diagnostic performance decreased as pregnancy progressed, limiting its utility for monitoring disease progression. These findings support the potential of FABP4 as a promising candidate for early GDM diagnosis in Mexican women.

Introduction

Cardiovascular diseases (CVDs) are modulated by a complex interaction between genetic, behavioral, and social factors. Healthcare professionals (HCPs), despite their medical knowledge, are often exposed to unique occupational and lifestyle factors, which can significantly increase their risk of CVDs. This study aimed to assess the association between these risk factors and CVD predisposition among a Moroccan cohort of HCPs.

Methods

A cross-sectional study was conducted among 156 HCPs using a structured questionnaire covering sociodemographic data, personal and family history of CVDs, fast-food consumption, alcohol consumption, smoking, drug use, physical activity, sleep quality, insomnia, and anxiety. Statistical analysis was performed by SPSS v20, including correlation, binary and multinomial logistic regressions, chi-square tests, and correspondence analysis.

Results

CVD predisposition was positively correlated with age (rs = 0.194, p = 0.016), comorbidities (rs= 0.326, p = 0.001), drug use (rs= 0.213, p = 0.008), alcohol consumption (rs = 0.168, p = 0.038), and insomnia (rs= 0.206, p = 0.01). In contrast, family history of CVDs and fast-food consumption were negatively associated (rs = -0.191 and p = 0.017, and rs = -0.206 and p = 0.01, respectively). Logistic regression highlighted age, family history, and insomnia as potential predictors. These associations were visually confirmed by correspondence analysis.

Conclusion

Our data highlights the influence of behavioral and occupational factors on CVD risk among HCPs, underlining the role of work-related stress. Hence, targeted prevention strategies are strongly recommended to promote healthier behaviors in this high-risk group.

Tuberculosis remains a significant global public health challenge. The relentless escalation of antimicrobial resistance necessitates urgent development of novel chemotherapeutic agents with clearly elucidated molecular targets, despite notable advancements in antimicrobial drug development over the past two decades. The present study systematically evaluates a series of three aroylhydrazones for their InhA inhibitory capacity. The compounds demonstrated high antymycobacterial activity against Mycobacterium tuberculosis H37Rv, with MIC values ranging from 0.0730 to 0.4412 µM, favorable cytotoxicity profiles (HEK-293T IC50: 217.5–361 µM), and a high selectivity index (SI: 633.49–3516). Molecular docking analyses revealed stable interactions between the derivatives and two crystallographic structures of InhA, prompting detailed enzymatic characterization. Spectrophotometric analysis of NADH-dependent InhA inhibition demonstrated concentration-dependent activity, with lead compounds achieving 48.6-59.1% enzyme suppression at micromolar concentrations. Comparative analysis with the reference inhibitor triclosan (62.5% inhibition) established the competitive potential of these novel aroylhydrazones. Quantitative structure--activity relationship analysis yielded half-maximal inhibitory concentrations ranging from 5.6 to 32.1 μM, confirming their pharmacological relevance. The current data will facilitate further research to enhance the therapeutic potential of these compounds and clarify their mechanisms of action.

Introduction:
Acute myocardial infarction is one of the leading causes of morbidity and mortality worldwide, representing a time-dependent emergency that requires prompt and prioritized care. In this context, nurse triage plays a crucial role by classifying patients early according to their clinical severity. Accurate priority assignment helps reduce critical care delays and optimizes management, particularly in high-incidence cardiovascular conditions such as acute coronary syndrome.

Objective:
This study aimed to describe the distribution of triage priority according to principal diagnosis, age, sex, and mode of arrival to the hospital in patients treated in the emergency department and analyze its potential association with these variables.

Methodology:
A descriptive, observational, and retrospective study was conducted in the emergency department of Hospital Universitario de La Ribera between January 1 and December 31, 2024. Adult patients triaged using the Manchester Triage System were included. Sociodemographic, clinical, and operational variables were analyzed. The study was approved by the Ethics Committee.

Results:
A total of 554 patients were included, with a mean age of 67.09 years (SD: 15.85); 70.9% (393) were male. The most frequent triage level was P3 39.0% (216), followed by P2 28.9% (160). The most common diagnoses were angina pectoris 32.3% (179), ST-elevation myocardial infarction 30.5% (169), and non-ST-elevation myocardial infarction 29.1% (161). The most frequently used triage diagram was chest pain 68.8% (381), followed by adult with general malaise 14.3% (79). Of all patients, 54.3% (301) arrived by ambulance—most classified as P1–P2—while 45.7% (253) arrived by their own means, mainly classified as P3–P4 (p < 0.001). Significant differences in care times were also observed based on triage level (p < 0.05).

Conclusion:
This study reinforces the essential role of nursing in initial clinical decision-making, demonstrating consistent priority assignment aligned with clinical severity and resource mobilization. Ongoing evaluation and improvement of nurse triage are key to ensuring patient safety and emergency care efficiency.

Background

Morocco is undergoing a health transition in the wake of 84% of deaths resulting from non-communicable diseases in 2022. Such deaths are often associated with a sedentary lifestyle and poor diet, including excessive consumption of carbohydrates, salt, and sugar, exceeding World Health Organization recommendations. The objective of this study is to assess the nutritional knowledge of doctors and nurses working in hospitals and primary health care centers in Morocco with regard to functional colopathy, iron deficiency anemia, vitamin B12 deficiency, overweight, hyperuricemia, or gout attack.

Materials and Methods

The study population consisted of 472 nurses and 185 physicians. A self-administered questionnaire was used for data collection, encompassing five main domains: irritable bowel syndrome, iron deficiency anemia, vitamin B12 deficiency, obesity, hyperuricemia, and gout. Statistical analyses were performed using SPSS software version 21.0, the Kolmogorov–Smirnov test, the Mann–Whitney test, and Spearman's rank correlation. Multiple linear analysis was also performed.

Result

Among the five domains studied, the highest median scores for doctors were reported for nutrition in overweight people and iron deficiency anemia (0.33 (IQR [0.22; 0.44]) and 0.67 (IQR [0; 0.67] respectively). Among nurses, nutrition in overweight people had a median score of 0.11 (IQR [0; 0.22]), which was lower than the doctors' median scores. Our results did not reveal any statistically significant association between the median scores of nurses or of doctors and their gender (p=0.383). Such scores were significantly associated with basic training (p < 0.00), continuous training (p=0.002), receiving information on nutrition (p=0.018), and the age of the doctor or nurse (p = 0.016).

Conclusions

The study reveals gaps in nutrition training among physicians and nurses, particularly with regard to the management of irritable bowel syndrome, iron deficiency anemia, vitamin B12 deficiency, and obesity, hyperuricemia, and gout attacks. It is crucial to strengthen nutrition training in health programs in Morocco.

Background:

Sepsis is a life-threatening condition characterized by the body’s response to infection, leading to tissue damage, organ failure, and death. Early detection is essencial for improving patient results. Traditional diagnostic methods often not succesed in timely identification. Recent progress in AI offer promising opportunities for early sepsis prediction by analyzing hospital data.

Methodology:

This review synthesizes findings from five studies conducted in 2022-2024, focusing on AI applications in sepsis prediction. The methodologies include various machine learning models, including Random Forest, XGBoost, and Transformer-based architectures, applied to diverse datasets such as electronic health records, vital signs, laboratory results, and clinical notes. These studies used techniques like feature selection, data preprocessing, and model evaluation to enhance predictive accuracy.

Results:

• A meta-ensemble model combining Random Forest, XGBoost, and Decision Tree algorithms achieved an AUC-ROC of 0.96, outperforming individual models in early sepsis detection.

• The NAVOY® Sepsis algorithm demonstrated high predictive performance with an accuracy of 0.79, sensitivity of 0.80, and specificity of 0.78, predicting sepsis onset three hours in advance.

• A Transformer-based model combining physiological time series and clinical notes outperformed six baseline models, highlighting the effectiveness of multimodal data integration.

• An AI-driven tool developed by Johns Hopkins University reduced sepsis mortality by 20% by analyzing EHRs in real-time, despite an accuracy rate of 38%.

• A novel approach combining AI with a blood test identified molecular markers indicative of septic shock, offering a potential for fast and accurate diagnosis.

Conclusions:

The integration of AI in clinical settings shows great potential in developing predictors, thereby enabling early detection and improved treatment outcomes. Machine learning algorithms, particularly ensemble methods and deep learning techniques, have demonstrated high effectiveness in accurately predicting abnormalities. However, challenges remain in model interpretability, data quality, and integration with clinical workflows. Further research should focus on addressing these challenges to unlock AI’s full potential in sepsis management.

Background:

In Morocco, non-communicable diseases were responsible for 84% of deaths in 2022. Risk factors include poor diet and a sedentary lifestyle. The objective of this study is to assess the nutritional knowledge of doctors and nurses working in hospitals and primary health care centers in Morocco for diabetes, high blood pressure, and high cholesterol.

Materials and Methods

This was a cross-sectional exploratory study using a self-administered questionnaire developed by standardized nutritional guides. We included 238 nurses and 131 doctors working in health centers and 234 nurses and 54 doctors working in hospitals. Statistical analyses were carried out using SPSS version 21.0 software, the Kolmogorov–Smirnov test, the Mann–Whitney test, and Spearmen's correlation. Multiple linear regression analysis was used to explore the most significant sociodemographic variables.

Results

Among the two nutritional content areas assessed in this study, we found that among doctors, the nutrition axis for high blood pressure and high cholesterol had a median correct response score of (0.57 IQR [0.28, 0.71]). The same was true for nurses, but with lower scores [respectively (0.28 IQR [0, 0.43]), (0.28 IQR [0.07, 0.42])].

Our results do not reveal any statistically significant association of the median of the total score of answers of both health professionals (nurses or doctors) with their gender (p=0.383). However, they were significantly associated with basic training (p < 0.00), continuous training (p=0.002), receiving information on nutrition (p=0.018), and their age (p = 0.016).

Conclusions

The nutritional knowledge of doctors and nurses in Morocco still needs to be improved. Diabetes, high blood pressure, and high cholesterol, as major non-communicable diseases, pose a major challenge to current health systems. Systematic efforts of policy makers should be devoted to basic and continuing education in nutrition in medical and nursing facilities.

Background: The Mediterranean Diet (MD) is characterized by high consumption of plant-based foods, extra virgin olive oil as the main fat source, regular fish intake, limited red meat intake, and moderate wine intake with meals. Despite it being recognized worldwide for its health benefits and it having an intrinsic cultural role in Italy, recent lifestyle changes have led to more Westernized diets. This study aimed to assess MD adherence among medical students, a group presumed to be health-conscious due to their education.

Methods: We evaluated MD adherence using the 14-item PREDIMED questionnaire in 300 medical students from the University of Bari “Aldo Moro”, equally distributed across six academic years. Anthropometric data (BMI for all; waist circumference for a subset) were collected.

Results: Their adherence was generally moderate, aligning with the national averages. No significant differences emerged between academic years, though the highest adherence was seen in sixth-year students (14%) and the lowest was seen in first-years (2%). Third-year students had the lowest adherence rate (28%). While adherence was not significantly linked to BMI or waist-to-height ratio, no obese students belonged to the high-adherence group, and only six were overweight. Females showed higher adherence and a lower prevalence of overweight (18% vs. 34%) compared to these values in males. Local and non-local students showed no differences. The weakest points were low fruit and vegetable intakes, while over half consumed processed foods regularly.

Conclusions: Adherence varied by sex and year, with better adherence in the final-year students, possibly due to their cumulative nutritional knowledge. Introducing nutrition education earlier may foster healthier habits. Improving campus access to fruits and vegetables while reducing processed foods could support MD adherence further. As future physicians, medical students must both practice and promote healthy lifestyles, highlighting the need for stronger nutritional training and supportive food environments.