Documentos donde el Autor es "López-Izquierdo, Raúl"

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Número de documentos: 7.

Artículo

Artículo Materias > Biomedicina Universidad Europea del Atlántico > Investigación > Producción Científica
Fundación Universitaria Internacional de Colombia > Investigación > Producción Científica
Universidad Internacional Iberoamericana México > Investigación > Artículos y libros
Universidad Internacional Iberoamericana Puerto Rico > Investigación > Producción Científica
Universidad Internacional do Cuanza > Investigación > Producción Científica
Universidad de La Romana > Investigación > Producción Científica Abierto Inglés Background Nowadays, there is no correlation between levels of cortisol and pain in the prehospital setting. The aim of this work was to determine the ability of prehospital cortisol levels to correlate to pain. Cortisol levels were compared with those of the numerical rating scale (NRS). Methods This is a prospective observational study looking at adult patients with acute disease managed by Emergency Medical Services (EMS) and transferred to the emergency department of two tertiary care hospitals. Epidemiological variables, vital signs, and prehospital blood analysis data were collected. A total of 1516 patients were included, the median age was 67 years (IQR: 51–79; range: 18–103) with 42.7% of females. The primary outcome was pain evaluation by NRS, which was categorized as pain-free (0 points), mild (1–3), moderate (4–6), or severe (≥7). Analysis of variance, correlation, and classification capacity in the form area under the curve of the receiver operating characteristic (AUC) curve were used to prospectively evaluate the association of cortisol with NRS. Results The median NRS and cortisol level are 1 point (IQR: 0–4) and 282 nmol/L (IQR: 143–433). There are 584 pain-free patients (38.5%), 525 mild (34.6%), 244 moderate (16.1%), and 163 severe pain (10.8%). Cortisol levels in each NRS category result in p < 0.001. The correlation coefficient between the cortisol level and NRS is 0.87 (p < 0.001). The AUC of cortisol to classify patients into each NRS category is 0.882 (95% CI: 0.853–0.910), 0.496 (95% CI: 0.446–0.545), 0.837 (95% CI: 0.803–0.872), and 0.981 (95% CI: 0.970–0.991) for the pain-free, mild, moderate, and severe categories, respectively. Conclusions Cortisol levels show similar pain evaluation as NRS, with high-correlation for NRS pain categories, except for mild-pain. Therefore, cortisol evaluation via the EMS could provide information regarding pain status. metadata López-Izquierdo, Raúl; Ingelmo-Astorga, Elisa A.; del Pozo Vegas, Carlos; Gracia Villar, Santos; Dzul López, Luis Alonso; Aparicio Obregón, Silvia; Calderón Iglesias, Rubén; Sanz-García, Ancor y Martín-Rodríguez, Francisco mail SIN ESPECIFICAR, SIN ESPECIFICAR, SIN ESPECIFICAR, santos.gracia@uneatlantico.es, luis.dzul@uneatlantico.es, silvia.aparicio@uneatlantico.es, ruben.calderon@uneatlantico.es, SIN ESPECIFICAR, SIN ESPECIFICAR (2025) Association between blood cortisol levels and numerical rating scale in prehospital pain assessment. Communications Medicine, 5 (1). ISSN 2730-664X

Artículo Materias > Biomedicina Universidad Europea del Atlántico > Investigación > Producción Científica
Fundación Universitaria Internacional de Colombia > Investigación > Producción Científica
Universidad Internacional Iberoamericana México > Investigación > Artículos y libros
Universidad Internacional Iberoamericana Puerto Rico > Investigación > Producción Científica
Universidad Internacional do Cuanza > Investigación > Producción Científica
Universidad de La Romana > Investigación > Producción Científica Abierto Inglés Emergency medical services (EMSs) face critical situations that require patient risk classification based on analytical and vital signs. We aimed to establish clustering-derived phenotypes based on prehospital analytical and vital signs that allow risk stratification. This was a prospective, multicenter, EMS-delivered, ambulance-based cohort study considering six advanced life support units, 38 basic life support units, and four tertiary hospitals in Spain. Adults with unselected acute diseases managed by the EMS and evacuated with discharge priority to emergency departments were considered between January 1, 2020, and June 30, 2023. Prehospital point-of-care testing and on-scene vital signs were used for the unsupervised machine learning method (clustering) to determine the phenotypes. Then phenotypes were compared with the primary outcome (cumulative mortality (all-cause) at 2, 7, and 30 days). A total of 7909 patients were included. The median (IQR) age was 64 (51–80) years, 41% were women, and 26% were living in rural areas. Three clusters were identified: alpha 16.2% (1281 patients), beta 28.8% (2279), and gamma 55% (4349). The mortality rates for alpha, beta and gamma at 2 days were 18.6%, 4.1%, and 0.8%, respectively; at 7 days, were 24.7%, 6.2%, and 1.7%; and at 30 days, were 33%, 10.2%, and 3.2%, respectively. Based on standard vital signs and blood test biomarkers in the prehospital scenario, three clusters were identified: alpha (high-risk), beta and gamma (medium- and low-risk, respectively). This permits the EMS system to quickly identify patients who are potentially compromised and to proactively implement the necessary interventions. metadata López-Izquierdo, Raúl; del Pozo Vegas, Carlos; Sanz-García, Ancor; Mayo Íscar, Agustín; Castro Villamor, Miguel A.; Silva Alvarado, Eduardo René; Gracia Villar, Santos; Dzul López, Luis Alonso; Aparicio Obregón, Silvia; Calderón Iglesias, Rubén; Soriano, Joan B. y Martín-Rodríguez, Francisco mail SIN ESPECIFICAR, SIN ESPECIFICAR, SIN ESPECIFICAR, SIN ESPECIFICAR, SIN ESPECIFICAR, eduardo.silva@funiber.org, santos.gracia@uneatlantico.es, luis.dzul@uneatlantico.es, silvia.aparicio@uneatlantico.es, ruben.calderon@uneatlantico.es, SIN ESPECIFICAR, SIN ESPECIFICAR (2024) Clinical phenotypes and short-term outcomes based on prehospital point-of-care testing and on-scene vital signs. npj Digital Medicine, 7 (1). ISSN 2398-6352

Artículo Materias > Biomedicina
Materias > Ciencias Sociales
Materias > Ingeniería Universidad Europea del Atlántico > Investigación > Producción Científica
Fundación Universitaria Internacional de Colombia > Investigación > Producción Científica
Universidad Internacional Iberoamericana México > Investigación > Artículos y libros
Universidad Internacional Iberoamericana Puerto Rico > Investigación > Producción Científica
Universidad Internacional do Cuanza > Investigación > Producción Científica
Universidad de La Romana > Investigación > Producción Científica Abierto Inglés Aim: The development of predictive models for patients treated by emergency medical services (EMS) is on the rise in the emergency field. However, how these models evolve over time has not been studied. The objective of the present work is to compare the characteristics of patients who present mortality in the short, medium and long term, and to derive and validate a predictive model for each mortality time. Methods: A prospective multicenter study was conducted, which included adult patients with unselected acute illness who were treated by EMS. The primary outcome was noncumulative mortality from all causes by time windows including 30-day mortality, 31- to 180-day mortality, and 181- to 365-day mortality. Prehospital predictors included demographic variables, standard vital signs, prehospital laboratory tests, and comorbidities. Results: A total of 4830 patients were enrolled. The noncumulative mortalities at 30, 180, and 365 days were 10.8%, 6.6%, and 3.5%, respectively. The best predictive value was shown for 30-day mortality (AUC = 0.930; 95% CI: 0.919–0.940), followed by 180-day (AUC = 0.852; 95% CI: 0.832–0.871) and 365-day (AUC = 0.806; 95% CI: 0.778–0.833) mortality. Discussion: Rapid characterization of patients at risk of short-, medium-, or long-term mortality could help EMS to improve the treatment of patients suffering from acute illnesses. metadata Enriquez de Salamanca Gambara, Rodrigo; Sanz-García, Ancor; del Pozo Vegas, Carlos; López-Izquierdo, Raúl; Sánchez Soberón, Irene; Delgado Benito, Juan F.; Martínez Díaz, Raquel; Mazas Pérez-Oleaga, Cristina; Martínez López, Nohora Milena; Dominguez Azpíroz, Irma y Martín-Rodríguez, Francisco mail SIN ESPECIFICAR, SIN ESPECIFICAR, SIN ESPECIFICAR, SIN ESPECIFICAR, SIN ESPECIFICAR, SIN ESPECIFICAR, raquel.martinez@uneatlantico.es, cristina.mazas@uneatlantico.es, nohora.martinez@uneatlantico.es, irma.dominguez@unini.edu.mx, SIN ESPECIFICAR (2024) A Comparison of the Clinical Characteristics of Short-, Mid-, and Long-Term Mortality in Patients Attended by the Emergency Medical Services: An Observational Study. Diagnostics, 14 (12). p. 1292. ISSN 2075-4418

Artículo Materias > Biomedicina Universidad Europea del Atlántico > Investigación > Producción Científica
Fundación Universitaria Internacional de Colombia > Investigación > Producción Científica
Universidad Internacional Iberoamericana México > Investigación > Artículos y libros
Universidad Internacional Iberoamericana Puerto Rico > Investigación > Producción Científica
Universidad Internacional do Cuanza > Investigación > Producción Científica
Universidad de La Romana > Investigación > Producción Científica Abierto Inglés Objective The aim was to explore the association of demographic and prehospital parameters with short-term and long-term mortality in acute life-threatening cardiovascular disease by using a hazard model, focusing on elderly individuals, by comparing patients under 75 years versus patients over 75 years of age. Design Prospective, multicentre, observational study. Setting Emergency medical services (EMS) delivery study gathering data from two back-to-back studies between 1 October 2019 and 30 November 2021. Six advanced life support (ALS), 43 basic life support and five hospitals in Spain were considered. Participants Adult patients suffering from acute life-threatening cardiovascular disease attended by the EMS. Primary and secondary outcome measures The primary outcome was in-hospital mortality from any cause within the first to the 365 days following EMS attendance. The main measures included prehospital demographics, biochemical variables, prehospital ALS techniques used and syndromic suspected conditions. Results A total of 1744 patients fulfilled the inclusion criteria. The 365-day cumulative mortality in the elderly amounted to 26.1% (229 cases) versus 11.6% (11.6%) in patients under 75 years old. Elderly patients (≥75 years) presented a twofold risk of mortality compared with patients ≤74 years. Life-threatening interventions (mechanical ventilation, cardioversion and defibrillation) were also related to a twofold increased risk of mortality. Importantly, patients suffering from acute heart failure presented a more than twofold increased risk of mortality. Conclusions This study revealed the prehospital variables associated with the long-term mortality of patients suffering from acute cardiovascular disease. Our results provide important insights for the development of specific codes or scores for cardiovascular diseases to facilitate the risk of mortality characterisation. metadata del Pozo Vegas, Carlos; Zalama-Sánchez, Daniel; Sanz-Garcia, Ancor; López-Izquierdo, Raúl; Sáez-Belloso, Silvia; Mazas Pérez-Oleaga, Cristina; Dominguez Azpíroz, Irma; Elío Pascual, Iñaki y Martín-Rodríguez, Francisco mail SIN ESPECIFICAR, SIN ESPECIFICAR, SIN ESPECIFICAR, SIN ESPECIFICAR, SIN ESPECIFICAR, cristina.mazas@uneatlantico.es, irma.dominguez@unini.edu.mx, inaki.elio@uneatlantico.es, SIN ESPECIFICAR (2023) Prehospital acute life-threatening cardiovascular disease in elderly: an observational, prospective, multicentre, ambulance-based cohort study. BMJ Open, 13 (11). e078815. ISSN 2044-6055

Artículo Materias > Biomedicina Universidad Europea del Atlántico > Investigación > Producción Científica
Fundación Universitaria Internacional de Colombia > Investigación > Producción Científica
Universidad Internacional Iberoamericana México > Investigación > Artículos y libros
Universidad Internacional Iberoamericana Puerto Rico > Investigación > Producción Científica
Universidad Internacional do Cuanza > Investigación > Producción Científica Abierto Inglés Background: Nowadays, there is no gold standard score for prehospital sepsis and sepsis-related mortality identification. The aim of the present study was to analyze the performance of qSOFA, NEWS2 and mSOFA as sepsis predictors in patients with infection-suspected in prehospital care. The second objective is to study the predictive ability of the aforementioned scores in septic-shock and in-hospital mortality. Methods: Prospective, ambulance-based, and multicenter cohort study, developed by the emergency medical services, among patients (n = 535) with suspected infection transferred by ambulance with high-priority to the emergency department (ED). The study enrolled 40 ambulances and 4 ED in Spain between 1 January 2020, and 30 September 2021. All the variables used in the scores, in addition to socio-demographic data, standard vital signs, prehospital analytical parameters (glucose, lactate, and creatinine) were collected. For the evaluation of the scores, the discriminative power, calibration curve and decision curve analysis (DCA) were used. Results: The mSOFA outperformed the other two scores for mortality, presenting the following AUCs: 0.877 (95%CI 0.841–0.913), 0.761 (95%CI 0.706–0.816), 0.731 (95%CI 0.674–0.788), for mSOFA, NEWS, and qSOFA, respectively. No differences were found for sepsis nor septic shock, but mSOFA’s AUCs was higher than the one of the other two scores. The calibration curve and DCA presented similar results. Conclusion: The use of mSOFA could provide and extra insight regarding the short-term mortality and sepsis diagnostic, backing its recommendation in the prehospital scenario. metadata Melero-Guijarro, Laura; Sanz-García, Ancor; Martín-Rodríguez, Francisco; Lipari, Vivian; Mazas Pérez-Oleaga, Cristina; Carvajal-Altamiranda, Stefanía; Martínez López, Nohora Milena; Dominguez Azpíroz, Irma; Castro Villamor, Miguel A.; Sánchez Soberón, Irene y López-Izquierdo, Raúl mail SIN ESPECIFICAR, SIN ESPECIFICAR, SIN ESPECIFICAR, vivian.lipari@uneatlantico.es, cristina.mazas@uneatlantico.es, stefania.carvajal@uneatlantico.es, nohora.martinez@uneatlantico.es, irma.dominguez@unini.edu.mx, SIN ESPECIFICAR, SIN ESPECIFICAR, SIN ESPECIFICAR (2023) Prehospital qSOFA, mSOFA, and NEWS2 performance for sepsis prediction: A prospective, multi-center, cohort study. Frontiers in Medicine, 10. ISSN 2296-858X

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Association between socioeconomic and health variables and community-acquired pneumonia mortality rates in Chile from 1990 to 2021

Objectives To describe long-term trends in mortality attributed to community-acquired pneumonia (CAP) in Chile from 1990 to 2021, stratified by age group, and to evaluate associations with selected socioeconomic and demographic indicators. Study design Ecological, observational, longitudinal study using national secondary data. Methods CAP mortality rates were analyzed for the total population and by age group. Associations with the Human Development Index (HDI), poverty rate, aging index, and life expectancy at birth were examined using a hierarchical analytical approach. This included Spearman's rank correlation for initial exploration, multivariable linear regression to assess adjusted associations, and Prais–Winsten generalized least squares regression to account for first-order autocorrelation and shared temporal trends. Stationarity was evaluated using augmented Dickey–Fuller tests, with supplementary analyses using first-differenced variables. Missing data were imputed using time-based regression or interpolation, with sensitivity analyses performed. Results CAP mortality declined substantially across all age groups over the study period. Strong bivariate correlations were observed between mortality and all socioeconomic indicators; however, these associations were attenuated after adjustment for confounding and temporal autocorrelation. In multivariable and time-series models, HDI and the aging index remained significantly associated with CAP mortality in children (0–9 years) and older adults (≥65 years), whereas associations in intermediate age groups were not robust after accounting for shared secular trends. Poverty and life expectancy did not demonstrate independent associations in adjusted models. Conclusions CAP mortality in Chile has decreased markedly over the past three decades. Associations with socioeconomic indicators are strongest at the extremes of age and persist after accounting for temporal structure, although the ecological design precludes causal inference. These findings highlight the importance of considering demographic and socioeconomic context in population-level analyses of infectious disease outcomes.

Artículos y libros

Italo Salvador López Muñoz mail italo.lopez@doctorado.unini.edu.mx, Maria Loreto Romero Ladrón de Guevara mail , Christian R. Mejia mail , Shyla Del-Aguila-Arcentales mail , Aldo Alvarez-Risco mail , Neal M. Davies mail , Jaime A. Yáñez mail ,

López Muñoz

open

An Integrated Machine Learning and Genomic Framework for Precise Detection of Gastric Cancer

This study presents a novel integrative approach for the analysis of high-dimensional gene expression data, leveraging the complementary strengths of unsupervised clustering and supervised classification. Using K-means clustering, the dataset is stratified into three distinct clusters, revealing intrinsic biological patterns and relationships. The resulting cluster assignments are subsequently employed as pseudo-labels to train machine learning models, including support vector machines, random forest, and a stacking ensemble classifier. To validate and enhance the robustness of clustering, complementary methodologies such as hierarchical clustering and DBSCAN are employed, with results visualized through PCA-driven dimensionality reduction. The high predictive accuracy achieved by the classifiers underscores the separability and reliability of the identified clusters. Furthermore, feature importance analysis highlighted key genetic determinants within each cluster, offering actionable insights into potential biomarkers and critical genomic features. This framework bridges the gap between exploratory unsupervised learning and predictive supervised modeling, providing a scalable and interpretable methodology for analyzing complex genomic datasets. Its applicability extends to biomarker discovery, patient stratification, and other precision medicine applications, emphasizing its utility in advancing genomic research and clinical practice.

Producción Científica

Eshmal Iman mail , Sohail Jabbar mail , Shabana Ramzan mail , Ali Raza mail , Farwa Raoof mail , Stefanía Carvajal-Altamiranda mail stefania.carvajal@uneatlantico.es, Vivian Lipari mail vivian.lipari@uneatlantico.es, Imran Ashraf mail ,

Iman

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A novel approach for disease and pests detection in potato production system based on deep learning

Vulnerability of potato crops to diseases and pest infestation can affect its quality and lead to significant yield losses. Timely detection of such diseases can help take effective decisions. For this purpose, a deep learning-based object detection framework is designed in this study to identify and classify major potato diseases and pests under real-world field conditions. A total of 2,688 field images were collected from two research farms in Punjab, Pakistan, across multiple growth stages in various seasonal conditions. Excluding 285 symptoms-free images from the earliest collection led to 2,403 images which were annotated into four biotic-stress classes: blight disease (n = 630), leaf spot disease (n = 370), leafroll virus (viral symptom complex; n = 888), and Colorado potato beetle (larvae/adults; n = 515), indicating class imbalance. Several state-of-the-art models were used including YOLOv8 variants (n/s/m), YOLOv7, YOLOv5, and Faster R-CNN, and the results are discussed in relation to recent potato disease classification studies involving cropped leaf images. Stratified splitting (70% training, 20% validation, 10% testing) was applied to preserve class distribution across all subsets. YOLOv8-medium achieve the best performance with mean average precision (mAP)@0.5 of 98% on the held-out test images. Results for stable 5-fold cross-validation show a mean mAP@0.5 of 97.8%, which offers a balance between accuracy and inference time. Model robustness was evaluated using 5-fold cross-validation and repeated training with different random seeds, showing a low variance of ±0.4% mAP. Results demonstrate promising outcomes under the real-world field conditions, while, broader cross-region and cross-season validation is intended for the future.

Producción Científica

Ahmed Abbas mail , Saif Ur Rehman mail , Khalid Mahmood mail , Santos Gracia Villar mail santos.gracia@uneatlantico.es, Luis Alonso Dzul López mail luis.dzul@uneatlantico.es, Aseel Smerat mail , Imran Ashraf mail ,

Abbas

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Concern for mpox infection in Latin America

Background Mpox arrived in Latin America and quickly began to replicate, so it is important to measure the concern it generates among residents. The study aims to assess whether country or other factors are associated with concern about mpox infection in Latin America. Methods The study uses a cross-sectional, multicenter design. Sampling was conducted using non-random snowball sampling. From August to September 2022, concern about being infected with mpox was assessed using a previously validated questionnaire (Cronbach's Alpha: 0.85); it was divided into nine countries and other social variables. Results From 1404 respondents, the majority of respondents were female (60.3%) and young (median age 25 years); also, a few reported that it was a significant problem (6% almost all the time and 11% often) and were concerned (6% almost all the time and 11% often) about the possibility of mpox infection. In multivariate analysis, men (aPR: 0.85; 95% CI: 0.73–0.99; p-value=0.046), younger (aPR: 0.98; 95% CI: 0.97–0.99; p-value<0.001), single (aPR: 0.78; 95% CI: 0.62–0.99; p-value=0.042) and, compared to Peru, those living in Colombia (aPR: 0.75; 95% CI. 0.58–0.97; p-value=0.027) and Costa Rica (aPR: 0.65; 95% CI: 0.44–0.96; p-value=0.032) reported the lowest concern; also, Bolivia (aPR: 1.16; 95% CI: 0.94–1.43; p-value=0.176) and Honduras (aPR: 1.01; 95% CI: 0.80–1.27; p-value=0.943) reported that their concerns tend to be higher. Conclusions There were evident differences across respondents' countries; these baseline results show that the first report was made in many countries that were also significantly affected by mpox and now face a new epidemic threatening public health.

Artículos y libros

Christian R. Mejia mail , Aldo Alvarez-Risco mail , Luciana Daniela Garlisi-Torales mail , Telmo Raúl Aveiro mail , Jamil Cedillo-Balcázar mail , Néstor Valentin Rocha-Saravia mail , Andrea Retana-González mail , Medally C. Paucar mail , Beatriz Mejia Raudales mail , Jose Armada mail , Shyla Del-Aguila-Arcentales mail , Neal M. Davies mail , Jaime A. Yáñez mail jaime.yanez@unini.edu.mx,

Mejia

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Fish consumption and brain structure: a comprehensive systematic review of observational studies

Background Age-related structural changes in the human brain, including cortical atrophy, reductions in grey and white matter volumes, and the accumulation of small vessel–related lesions such as white matter hyperintensities (WMH) and cerebral microbleeds, represent critical biological substrates underlying cognitive decline and dementia. Fish consumption has been associated with slower cognitive decline and reduced risk of dementia, but a comprehensive evaluation of its relation with brain structures is lacking. Aims The aim of this study was to systematically review current scientific literature providing evidence of relation between fish intake and brain structures in human studies. Methods Studies indexed in two major electronic databases have been screened based on a combination of keywords and MeSH terms. Studies were eligible whether they assessed fish consumption in relation to brain structures in the adult populations. Results A total of 24 studies conducted predominantly on older adults met inclusion criteria. Most brain volume measures were obtained via magnetic resonance imaging (MRI) procedures. Higher fish consumption was associated with reduced severity of white matter hyperintensities (a biomarker of cerebral small vessel disease and white matter damage) and cerebral micro-bleed, preservation of certain brain areas volumes (i.e., hippocampus, temporal lobe and periventricle white matter) and cortical thickness of specific areas (i.e., precuneus, parietal, and cingulate grey matter), among others, compared to lower intake. Some analyses found no association and isolated findings suggested possible adverse associations that were not consistently replicated. Studies reporting null findings may underline the possible relevance of the overall diet (i.e., adherence to the Mediterranean diet). Conclusions Inclusion of fish in a healthy and balanced diet is associated with better white matter grades on MRI and slower progression of white matter hyperintensities and reduction of vascular-related lesions of the aging brain, suggesting a potential role in preventing neurocognitive deterioration. Heterogeneity across studies underscores the need for additional studies.

Producción Científica

Justyna Godos mail , Giuseppe Caruso mail , Agnieszka Micek mail , Alberto Dolci mail , Zoltan Ungvari mail , Andrea Lehoczki mail , Lisandra León Brizuela mail , Evelyn Frias-Toral mail , Andrea Di Mauro mail , Mario Siervo mail , Michelino Di Rosa mail , Giuseppe Grosso mail ,

Godos

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