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This Medical News article discusses the American Heart Association’s new scientific statement on dietary guidance to improve cardiovascular health.
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The Simon Effect refers to the finding that simple left-right manual responses tend to be faster and more accurate when the response and stimulus are on the same side (congruent) compared to when they are on opposite sides (incongruent) even though the response is determined by a non-spatial attribute (e.g., color). We compared the Simon Effect with stimuli at reachable and unreachable distances within a virtual reality environment to test its dependence on the potential to interact with the stimulus. We controlled for confounds by matching image size and the viewing angle of stimuli within the environment across groups of participants. The magnitude of the Simon Effect was larger for stimuli in reachable than unreachable locations. These findings held regardless of image-size and viewing-angle conditions. This implies that task-irrelevant spatial congruence, like task-irrelevant motor affordances, is computed in ways that reflect the potential interactions with objects in a three-dimensional world.
The Centers for Disease Control and Prevention has recommended contact precautions for healthcare personnel caring for COVID-19 patients since the beginning of the pandemic. However, current scientific evidence points to transmission through small respiratory droplets or aerosols and not contaminated fomites as the dominant routes of transmission of SARS-CoV-2. We believe science shows there is no benefit and thus only negative consequences to patients, the environment, and the U.S healthcare system associated with ongoing contact precautions for patients with SARS-CoV-2 infection, and we advocate for updated guidelines reflecting current science.
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Total neoadjuvant therapy (TNT) has rapidly gained global acceptance as a standard treatment for locally advanced rectal cancer (LARC). Supported by multiple phase III trials, TNT improves pathological complete response (pCR) rates, enhances systemic control, and expands opportunities for non-operative management (NOM). These advantages have led to its inclusion in major international guidelines as a core strategy for stage II/III rectal cancer. However, not all regions have embraced TNT. Japan's 2024 colorectal cancer treatment guidelines weakly recommend against the routine use of TNT or NOM-making it one of the few countries to diverge from the global trend. This stance does not reflect a rejection of evidence, but rather the realities of a healthcare system where rectal cancer is often treated in non-specialized institutions. Unlike consensus guidelines designed for subspecialists, the Japanese guidelines are tailored to general surgeons practicing in a wide range of settings, many of whom manage rectal cancer infrequently. This reflects a broader challenge of limited centralization within Japan's otherwise equitable healthcare system. TNT also presents unresolved concerns, including toxicity, uncertain survival benefit, and increased surgical complexity-issues particularly relevant in resource-diverse environments. This review examines the global evolution of TNT and Japan's restrained response, analyzing key trials, guideline positions, and barriers to implementation. Japan's approach reflects practical realities rather than opposition, emphasizing the need to tailor TNT to each country's healthcare setting. The future of TNT lies not in universal application, but in thoughtful integration that balances oncologic efficacy with local context and patient-centered care.
Sepsis is common in hospitalized pediatric patients, leading to increased morbidity, including multiple organ dysfunction and mortality. Fluid resuscitation and antibiotic administration are the primary protective mechanisms for sepsis. However, not all infections are bacterial, and unnecessary antibiotic use increases the risk of developing multidrug resistance; therefore, it is essential to distinguish bacterial from viral or other infections. Routine laboratory investigations cannot always identify the cause of diseases, but assessing different biomarker levels can help identify these infections and treat sepsis accordingly. This mini-review aims to critically analyze the available evidence supporting the use of biomarkers in pediatric sepsis. We have used the search engines PubMed, Cochrane Library, and Google Scholar to retrieve relevant information. We reviewed studies evaluating various biomarkers used for sepsis diagnoses, like C-reactive protein, ferritin, lactate, procalcitonin, tumor necrosis factor-alpha, etc. Apart from the diagnosis, trials are being conducted to assess the role of these biomarkers in monitoring and guiding antibiotic therapy to promote early recovery. The sensitivity of each biological marker varied in different studies, and no single biomarker can identify all types of infections. More robust studies are necessary to compare the roles of various biomarkers in diagnosing and guiding the appropriate therapy.
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Aging and increased life expectancy generate growing challenges for end-of-life care in old age, particularly in rural contexts marked by territorial and health inequalities. From the perspective of gerontological geography and the notions of autonomy and agency of older adults, this study aims to generate an understanding of end-of-life as a lived experience from the subjective worlds of and with the people involved. To this end, a qualitative study, with an ethnographic approach and case study strategy, was conducted in the Los Lagos Region of Chile between 2022 and 2023. This included semi-structured interviews and ethnographic observation of rural older adults in the end-of-life stages, their caregivers, and rural health teams. The results show that remaining at home is a central desire and organizes care, sustained primarily by feminized family networks and rural primary care. The home becomes a space of care, and health teams play a key role in providing clinical and relational support at the end-of-life. It is concluded that end-of-life care in rural areas requires territorial approaches that recognize autonomy in old age and the structural inequalities of these processes. El envejecimiento y aumento de la esperanza de vida generan desafíos crecientes para los cuidados de fin de vida en la vejez, particularmente en contextos rurales marcados por desigualdades territoriales y sanitarias. Desde la geografía gerontológica, y las nociones de autonomía y agencia de las personas mayores, este estudio se propone generar una comprensión del fin de vida como experiencia vital desde los mundos subjetivos de y con las personas implicadas. Para ello, se realizó un estudio cualitativo, de enfoque etnográfico y estrategia de estudio de caso, en la Región de Los Lagos, Chile, entre 2022 y 2023, que incluyó entrevistas semiestructuradas y observación etnográfica a personas mayores rurales en etapas de fin de vida, las personas cuidadoras y los equipos de salud rural. Los resultados muestran que la permanencia en el hogar constituye un deseo central y organiza los cuidados, sostenidos principalmente por redes familiares feminizadas y por la atención primaria rural. El hogar se transforma en un espacio de cuidado y los equipos de salud cumplen un rol clave en acompañamiento clínico y relacional del fin de vida. Se concluye que los cuidados de fin de vida en la ruralidad requieren enfoques territoriales que reconozcan autonomía en la vejez y las desigualdades estructurales de estos procesos.
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