Background: Precise measurement of resting energy expenditure (REE) is essential in the intensive care unit (ICU), where metabolic requirements evolve throughout the course of critical illness. Predictive equations frequently fail to capture this variability, and limited data describe phase-dependent changes in REE using indirect calorimetry (IC). This study aimed to evaluate phase-related variation in REE and metabolic phenotypes in mechanically ventilated adults and to identify clinical and physiological correlates of both absolute REE and REE normalized by ideal body weight (REE/IBW). Methods: We conducted an observational, retrospective cross-sectional study in two ICUs at different hospitals. A total of 149 mechanically ventilated adults with a valid IC measurement were included and classified by illness phase: acute (0–3 days), intermediate (4–14 days), or chronic (>14 days). Differences in metabolic and gas-exchange variables were assessed using ANOVA or Kruskal–Wallis tests. Two multivariable linear regression models were fitted, one using absolute REE and a second using REE/IBW, incorporating metabolic phenotype categories to account for body-size heterogeneity. Results: Metabolic profiles differed across illness phases. Median REE increased from the acute (1664 kcal/day) to the intermediate (1869 kcal/day) and chronic (2074 kcal/day; p = 0.024) phases. Hypometabolic profiles were more frequent in the acute phase (64%), whereas hypermetabolic profiles were more prevalent in later phases (48%). RQ values were higher in the chronic phase compared with the acute phase (median 0.99 vs. 0.80; p < 0.001). In multivariable analyses, illness severity scores showed weak or inconsistent associations with REE after adjustment for gas-exchange variables. VCO₂ was independently associated with absolute REE (adjusted R² = 0.83). In the REE/IBW model, VCO₂, RQ, BMI, and metabolic phenotype were associated with normalized energy expenditure, with higher adjusted R² (0.87) and lower prediction error metrics. Conclusions: Resting energy expenditure and metabolic phenotypes vary across phases of critical illness. Gas-exchange variables, particularly VCO₂, were more closely associated with measured energy expenditure than severity scores. Normalization of REE by ideal body weight reduced variability and improved model performance, highlighting the analytical value of indirect calorimetry for characterizing phase-dependent metabolic patterns in critically ill adults.

Cranium es una aplicación móvil que utiliza la realidad aumentada, que sirve como un medio de apoyo para el estudiante de medicina para el estudio de los huesos del cráneo. El objetivo principal de la aplicación que sea utilizado en conjunto con el libro de Anatomía Humana – Latarjet, me­­diante el reconocimiento de imágenes presentes que se mostrarán en contenido aumentado y en 3D con sus elementos. Para lo cual se identifica métodos y técnicas de aprendizaje que se implementarán para el uso de la aplicación móvil. En la actualidad para los estudiantes de medicina resulta muy complicado tener acceso a los huesos en físico, ya que los recursos dentro de la facultad de medicina para estas clases de anatomía son muy limitado o escaso. Se plantea una investigación cualitativa, divida en tres fases: de identificación, de desarrollo de aplicación aumentada y de evaluación con los usuarios de la aplicación desarrollada, para lo cual se utiliza encuestas y entrevistas a profundidad para la recolección de información. Cranium busca mejorar esta situación a la vez de elevar el interés por la asignatura en los estudiantes sin sustituir al libro mencionado. Además, presentara preguntas de autoevaluación que abarcara los huesos estudiados ayudando a reforzar los conocimientos adquiridos. Todo esto fue obtenido a través de resultados de encuestas, entrevistas y pruebas realizadas con los estudiantes.

Background: Accurately estimating resting energy expenditure (REE) in critically ill obese patients remains a significant clinical challenge, as predictive equations are consistently inadequate. Metabolic heterogeneity across obesity classes and the role of substrate utilization are insufficiently characterized. Objective: To evaluate the impact of different weight-normalization methods on the interpretation of REE and to identify independent metabolic determinants of weight-adjusted energy expenditure in critically ill patients with obesity. Methods: Bicentric cross-sectional study of 148 critically ill adults with obesity undergoing indirect calorimetry. REE normalized by actual body weight (REE/kg), ideal body weight (REE/IBW), and adjusted body weight (REE/AdjBW) was calculated. Multivariable models with robust standard errors (HC3), stratified analyses by obesity class (I–III) with a Chow test, and internal validation were performed using 10-fold cross-validation and bootstrap resampling (1000 iterations). Results: Absolute REE did not differ significantly between BMI categories (p = 0.679), while REE/kg progressively decreased from normal weight (27.8 kcal/kg/day) to class III obesity (16.9 kcal/kg/day; p < 0.001). The respiratory quotient (RQ) emerged as the most robust independent correlate of adjusted REE (β = −13 to −15 kcal·kg⁻¹·day⁻¹; p < 0.001), whereas clinical severity scores (SOFA, APACHE II) and comorbidity (Charlson) did not show significant associations. Stratified analyses revealed significant structural heterogeneity between obesity classes (F = 4.545, p = 0.0001), with no significant predictors identified in class III obesity, likely reflecting limited statistical power in this subgroup. Conclusions: Normalizing REE using different weight indices fundamentally alters its metabolic interpretation. RQ surpasses traditional clinical scores as a correlate of adjusted REE, consistent with a phenotype of metabolic inflexibility. The heterogeneity between obesity classes underscores the need for individualized indirect calorimetry rather than reliance on predictive equations.

Introduction. Cranium is a mobile application that uses augmented reality, which serves as a means of support for the medical student to study the bones of the skull. Objective to improve this situation while raising interest in the subject in students without replacing the aforementioned book. Materials and methods A qualitative research is proposed, divided into three phases: identification, development of augmented application and evaluation with the users of the developed application, for which surveys and in-depth interviews are used to collect information. Results87% indicates the great need to implement new technologies in education. Discussionat the icon level of the application was very well qualified with only a small observation to modify it a bit its aspect Conclusions make changes that will help the application to be more pleasant and functional for users

Objectives: Prediabetes is characterized by elevated blood glucose levels associated with insulin resistance, increasing the risk of progression to type 2 diabetes mellitus (T2DM) and cardiovascular disease. High-intensity interval training (HIIT) has emerged as an effective non-pharmacological strategy to improve insulin sensitivity and cardiorespiratory fitness. This study aimed to analyze the effects of HIIT alone or combined with a hypocaloric diet on metabolic and cardiorespiratory parameters in individuals with prediabetes. Methods: A controlled, longitudinal, single-blind intervention study enrolled 68 adults with prediabetes (mean age 42.22–46.60 years; 73.5% women) and randomized them to HIIT plus hypocaloric diet (n = 23), HIIT only (n = 23), or hypocaloric diet only (n = 22) for 13 weeks, with pre/post assessments of glucose, VO₂max, blood pressure, FINDRISC. Results: Significant post-intervention differences were observed among groups in body mass index (p = 0.049), VO₂max (p < 0.001), fasting glucose (p < 0.001), systolic blood pressure (p < 0.001), and diabetes risk (p = 0.038), with the greatest improvements consistently observed in Group A. In Group A, fasting glucose decreased from 111.94 to 91.28 mg/dL (−20.66 mg/dL; −18.5%), VO₂max increased from 21.27 to 24.02 mL·kg⁻¹·min⁻¹ (+2.75; +12.9%), and systolic blood pressure decreased from 163.56 to 150.13 mmHg (−13.43 mmHg; −8.2%). No significant between-group differences were found for body weight (p = 0.271) or waist circumference (p = 0.174). Conclusions: HIIT combined with a hypocaloric diet is an effective and safe strategy for managing prediabetes, producing superior improvements in cardiorespiratory fitness, glycemic control, and reduction in diabetes risk compared with either intervention alone.