Background: It was previously established that Multiple sclerosis (MS) generates energy alterations at the mitochondrial level related to the loss of muscle mass. Ketone bodies, mainly beta-hydroxybutyrate (BHB), re-establish this energy alteration causing satiety, changes in body composition and a decrease in hormone-dependant hunger, such as ghrelin. The aim of this study was to establish possible improvements in body composition and the level of oxidation in patients with MS, by means of the satiating effect of a ketogenic diet. Methods: A pilot study was carried out with 27 MS patients who were given a Mediterranean isocaloric and ketogenic diet for 4 months. Anthropometric measurements, as well as satiety and hunger perception (VAS scale), were taken. In addition, BHB and paraoxonase 1 (PON1), as an oxidation marker, were measured by spectrophotometric automated assays, and ghrelin was determined by an enzyme immunoassay in the serum. All measurements were taken before and after the intervention. Results: A significant increase in satiety perception at lunch and dinner and of BHB in the blood was obtained. Hunger perception decreased significantly at lunch and dinner with similar levels of ghrelin. In addition, an important increase in lean mass and PON1 was observed. To our knowledge, this is the first study addressing improvements in body composition, oxidation state and metabolism in MS patients, based on the satiating effect of a Mediterranean isocaloric diet. Conclusion: A ketogenic diet increases lean mass and decreases inflammation and oxidation possibly as a consequence of an increase in satiety and decrease in hunger in MS patients.

Background: “DeepFakes” are synthetic performances created by AI, using neural networks to exchange faces in images and modify voices. Objective: Due to the novelty and limited literature on its risks/benefits, this paper aims to determine how young nursing students perceive DeepFake technology, its ethical implications, and its potential benefits in nursing. Methods: This qualitative study used thematic content analysis (the Braun and Clarke method) with videos recorded by 50 third-year nursing students, who answered three questions about DeepFake technology. The data were analyzed using ATLAS.ti (version 22), and the project was approved by the Ethics Committee (code UCV/2021–2022/116). Results: Data analysis identified 21 descriptive codes, classified into four main themes: advantages, disadvantages, health applications, and ethical dilemmas. Benefits noted by students include use in diagnosis, patient accompaniment, training, and learning. Perceived risks include cyberbullying, loss of identity, and negative psychological impacts from unreal memories. Conclusions: Nursing students see both pros and cons in DeepFake technology and are aware of the ethical dilemmas it poses. They also identified promising healthcare applications that could enhance nurses’ leadership in digital health, stressing the importance of regulation and education to fully leverage its potential.

Background: Alzheimer's disease is the most common neurodegenerative disorder in our society, mainly characterized by loss of cognitive function. However, other symptoms such as anxiety and depression have been described in patients. The process is mediated by alterations in the synaptic and extrasynaptic activity of the neurotransmitter glutamate, which are linked to a hypometabolism of glucose as the main source of brain energy. In that respect, Ketogenic diet (KD) has been proposed as a non-pharmacological treatment serving as an alternative energy source to the neurons increasing the fat percentage and reducing the carbohydrates percentage, showing promising results to improve the cognitive symptoms associated with different neurodegenerative disorders, including AD. However, the association of this type of diet with emotional symptoms and the modulation of glutamate neurotransmission systems after this dietary reduction of carbohydrates are unknown.Objective: The aim of this short review is to provide update studies and discuss about the relationship between KD, anxiety, depression, and glutamate activity in AD patients.Discussion: The main results suggest that the KD is an alternative energy source for neurons in AD with positive consequences for the brain at different levels such as epigenetic, metabolic and signaling, and that the substitution of carbohydrates for fats is also associated with emotional symptoms and glutamate activity in AD.

Clinical practice is considered fundamental in nursing studies for the effective education of nurses and students' satisfaction. Both the clinical environment and the clinical educator are key factors in students´ satisfaction. To analyze the influence of the socio-demographic variables of clinical educators and nursing students on satisfaction with the clinical practice. This was an observational, cross-sectional study. A clinical practice course at a private university in Valencia, Spain. The study included 527 nursing students enrolled on the clinical practice, supervised by 187 clinical educators. Two statistical methodologies were used for data analysis: hierarchical regression models (HRM) and fuzzy-set qualitative comparative analysis model (fsQCA). The results indicate that sociodemographic variables such as sex, being a woman, and being in the second grade year group, influence student satisfaction in both methodologies. According to our results, establishing specific academic plans for students in higher years (3rd and 4th) could improve nursing students' satisfaction with their clinical practice. Adequate training of students is a key factor in the provision of high-quality nursing care.

In response to the questions raised in the comment to the editor of R