Intermittent Theta Burst Stimulation Improves Sleep in Autism Spectrum Disorder by Reorganizing Overlapping Brain Networks With Neurochemical and Transcriptomic Signatures: A Randomized Controlled Tri

Prehabilitation has emerged over the last decade as an essential component of perioperative care in patients undergoing colorectal surgery. Defined as a preoperative multimodal intervention combining structured physical exercise, nutritional optimization, and psychological support, prehabilitation aims to improve the patient’s functional capacity before the surgical stress, with the goal of reducing postoperative complications and accelerating recovery [,,]. In this context, the patient’s nutritional status plays a central role. Malnutrition is highly prevalent in patients with colorectal cancer, with reported rates ranging from 20 to 50% depending on the diagnostic criteria used and is consistently associated with increased postoperative morbidity and mortality, higher rates of surgical site infection and anastomotic dehiscence, prolonged hospital stay, and impaired quality of life [,]. A 2026 network meta-analysis comparing different prehabilitation modalities in colorectal cancer surgery confirmed that combined exercise, nutrition, and psychological prehabilitation produced the most consistent improvement in postoperative functional recovery, although evidence remains inconsistent regarding hospital stay, readmission, and complication rates across modalities []. Early identification of malnutrition through validated screening tools, followed by formal diagnosis using standardized criteria such as the GLIM (Global Leadership Initiative on Malnutrition) criteria and preoperative correction, represents a Grade A recommendation in the major international guidelines, including the European Society for Clinical Nutrition and Metabolism (ESPEN) guideline on clinical nutrition in surgery [,]. The ESPEN guidelines on clinical nutrition in surgery, updated in 2025, explicitly state that nutrition must be integrated into the overall management of the surgical patient from the preoperative phase onwards. Specifically, they recommend systematic nutritional screening in all candidates for major surgery, the use of GLIM criteria for malnutrition diagnosis, preoperative nutritional optimization in patients with identified risk, and the prescription of hypercaloric, high-protein oral nutritional supplements (ONSs)—or immunonutrition with arginine, omega-3 fatty acids, and nucleotides—for at least 7–14 days before surgery in high-risk patients [,,]. However, despite the strength of these recommendations, their implementation in routine clinical practice remains incomplete and variable. It should be noted that the ERAS (Enhanced Recovery After Surgery) guidelines, while widely adopted, include nutritional recommendations that are at times generic and less elaborated than those of the ESPEN guidelines, which may contribute to the heterogeneity observed in perioperative nutritional practices.