2026

• 
  1.

  Vieira RJ, Gil-Mata S, Ferreira A, Riera-Serra P, Bognanni A, Duarte VH, Viegas H, Pereira AM, Ferreira-da Silva R, Ferreira-Cardoso H, Marques-Cruz M, Castro-Teles J, Campos-Lopes M, Teixeira-Ferreira A, Lourenço-Silva N, Boechat JL, Borowiack E, Sadowska E, Costa RA, Perestrelo P, Pereira MS, Pereira-Macedo J, Ierodiakonou D, Chu AWL, Calvi IP, Torres MI, Silva Ribeiro RA, Thomander T, Valiulis A, Cherrez-Ojeda I, Bedbrook A, Klimek L, Yepes Nuñez JJ, Zuberbier T, Fonseca JA, Schünemann HJ, Bousquet J, Sousa-Pinto B, Panel A 2024- 2025 G. Efficacy and Safety of Oral Antihistamines for Allergic Rhinitis: Network Meta-Analysis. The journal of allergy and clinical immunology. In practice [Internet]. United States; 2026 May;14(5):1175-83. https://pubmed.ncbi.nlm.nih.gov/41707943

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  BACKGROUND: Oral H1-antihistamines (OAHs) are among the most frequently used medications for the treatment of allergic rhinitis (AR). OBJECTIVE: To perform a systematic review and network meta-analysis comparing the efficacy and safety of individual OAHs in patients with AR. METHODS: We searched 4 electronic bibliographic databases and 3 clinical trial databases for randomized controlled trials assessing adults with perennial or seasonal AR, and comparing (1) OAH versus placebo or (2) different individual OAHs. We performed a network meta-analysis on the Total Nasal Symptom Score, Total Ocular Symptom Score, Rhinoconjunctivitis Quality-of-Life Questionnaire, development of adverse events, and withdrawals due to adverse events. Certainty of evidence for comparisons involving the most clinically relevant second-generation OAHs was assessed using Grading of Recommendations, Assessment and Evaluation approach to network meta-analysis. RESULTS: We included 74 randomized controlled trials (21 on perennial AR and 53 on seasonal AR). Cetirizine, ebastine, bilastine, and rupatadine were among the individual medications associated with the highest efficacy for improving nasal symptoms. For other efficacy outcomes, the most efficacious interventions varied. A similar frequency of adverse events was observed among different individual second-generation OAHs, with serious adverse events being rare. For most comparisons, the certainty of evidence was rated as "low" or "very low," indicating substantial uncertainty regarding the treatment effects. CONCLUSIONS: Although some OAHs seem to be more efficacious than others, most of the differences between individual second-generation medications are trivial or small. In addition, we did not find any relevant differences in the safety profiles of second-generation OAHs.

  @article{vieira2026efficacy,
  abstract = {BACKGROUND: Oral H1-antihistamines (OAHs) are among the most frequently used medications for the treatment of allergic rhinitis (AR). OBJECTIVE: To perform a systematic review and network meta-analysis comparing the efficacy and safety of individual OAHs in patients with AR. METHODS: We searched 4 electronic bibliographic databases and 3 clinical trial databases for randomized controlled trials assessing adults with perennial or seasonal AR, and comparing (1) OAH versus placebo or (2) different individual OAHs. We performed a network meta-analysis on the Total Nasal Symptom Score, Total Ocular Symptom Score, Rhinoconjunctivitis Quality-of-Life Questionnaire, development of adverse events, and withdrawals due to adverse events. Certainty of evidence for comparisons involving the most clinically relevant second-generation OAHs was assessed using Grading of Recommendations, Assessment and Evaluation approach to network meta-analysis. RESULTS: We included 74 randomized controlled trials (21 on perennial AR and 53 on seasonal AR). Cetirizine, ebastine, bilastine, and rupatadine were among the individual medications associated with the highest efficacy for improving nasal symptoms. For other efficacy outcomes, the most efficacious interventions varied. A similar frequency of adverse events was observed among different individual second-generation OAHs, with serious adverse events being rare. For most comparisons, the certainty of evidence was rated as "low" or "very low," indicating substantial uncertainty regarding the treatment effects. CONCLUSIONS: Although some OAHs seem to be more efficacious than others, most of the differences between individual second-generation medications are trivial or small. In addition, we did not find any relevant differences in the safety profiles of second-generation OAHs.},
  address = {United States},
  author = {Vieira, Rafael José and Gil-Mata, Sara and Ferreira, André and Riera-Serra, Pau and Bognanni, Antonio and Duarte, Vítor Henrique and Viegas, Hugo and Pereira, Ana Margarida and Ferreira-da Silva, Renato and Ferreira-Cardoso, Henrique and Marques-Cruz, Manuel and Castro-Teles, João and Campos-Lopes, Miguel and Teixeira-Ferreira, Ana and Lourenço-Silva, Nuno and Boechat, José Laerte and Borowiack, Ewa and Sadowska, Ewelina and Costa, Raquel Albuquerque and Perestrelo, Paula and Pereira, Marta Soares and Pereira-Macedo, Juliana and Ierodiakonou, Despo and Chu, Alexandro W L and Calvi, Izabela Pera and Torres, Maria Inês and Silva Ribeiro, Rita A and Thomander, Tuuli and Valiulis, Arunas and Cherrez-Ojeda, Ivan and Bedbrook, Anna and Klimek, Ludger and Yepes Nuñez, Juan Jose and Zuberbier, Torsten and Fonseca, João A and Schünemann, Holger J and Bousquet, Jean and Sousa-Pinto, Bernardo and Panel, ARIA 2024-2025 Guideline},
  journal = {The journal of allergy and clinical immunology. In practice},
  keywords = {evisap},
  month = {may},
  number = 5,
  pages = {1175--1183},
  title = {Efficacy and Safety of Oral Antihistamines for Allergic Rhinitis: Network Meta-Analysis},
  volume = 14,
  year = 2026
  }
  

  %0 Journal Article
  %1 vieira2026efficacy
  %A Vieira, Rafael José
  %A Gil-Mata, Sara
  %A Ferreira, André
  %A Riera-Serra, Pau
  %A Bognanni, Antonio
  %A Duarte, Vítor Henrique
  %A Viegas, Hugo
  %A Pereira, Ana Margarida
  %A Ferreira-da Silva, Renato
  %A Ferreira-Cardoso, Henrique
  %A Marques-Cruz, Manuel
  %A Castro-Teles, João
  %A Campos-Lopes, Miguel
  %A Teixeira-Ferreira, Ana
  %A Lourenço-Silva, Nuno
  %A Boechat, José Laerte
  %A Borowiack, Ewa
  %A Sadowska, Ewelina
  %A Costa, Raquel Albuquerque
  %A Perestrelo, Paula
  %A Pereira, Marta Soares
  %A Pereira-Macedo, Juliana
  %A Ierodiakonou, Despo
  %A Chu, Alexandro W L
  %A Calvi, Izabela Pera
  %A Torres, Maria Inês
  %A Silva Ribeiro, Rita A
  %A Thomander, Tuuli
  %A Valiulis, Arunas
  %A Cherrez-Ojeda, Ivan
  %A Bedbrook, Anna
  %A Klimek, Ludger
  %A Yepes Nuñez, Juan Jose
  %A Zuberbier, Torsten
  %A Fonseca, João A
  %A Schünemann, Holger J
  %A Bousquet, Jean
  %A Sousa-Pinto, Bernardo
  %A Panel, ARIA 2024-2025 Guideline
  %C United States
  %D 2026
  %J The journal of allergy and clinical immunology. In practice
  %N 5
  %P 1175--1183
  %R 10.1016/j.jaip.2025.12.034
  %T Efficacy and Safety of Oral Antihistamines for Allergic Rhinitis: Network Meta-Analysis
  %U https://pubmed.ncbi.nlm.nih.gov/41707943
  %V 14
  %X BACKGROUND: Oral H1-antihistamines (OAHs) are among the most frequently used medications for the treatment of allergic rhinitis (AR). OBJECTIVE: To perform a systematic review and network meta-analysis comparing the efficacy and safety of individual OAHs in patients with AR. METHODS: We searched 4 electronic bibliographic databases and 3 clinical trial databases for randomized controlled trials assessing adults with perennial or seasonal AR, and comparing (1) OAH versus placebo or (2) different individual OAHs. We performed a network meta-analysis on the Total Nasal Symptom Score, Total Ocular Symptom Score, Rhinoconjunctivitis Quality-of-Life Questionnaire, development of adverse events, and withdrawals due to adverse events. Certainty of evidence for comparisons involving the most clinically relevant second-generation OAHs was assessed using Grading of Recommendations, Assessment and Evaluation approach to network meta-analysis. RESULTS: We included 74 randomized controlled trials (21 on perennial AR and 53 on seasonal AR). Cetirizine, ebastine, bilastine, and rupatadine were among the individual medications associated with the highest efficacy for improving nasal symptoms. For other efficacy outcomes, the most efficacious interventions varied. A similar frequency of adverse events was observed among different individual second-generation OAHs, with serious adverse events being rare. For most comparisons, the certainty of evidence was rated as "low" or "very low," indicating substantial uncertainty regarding the treatment effects. CONCLUSIONS: Although some OAHs seem to be more efficacious than others, most of the differences between individual second-generation medications are trivial or small. In addition, we did not find any relevant differences in the safety profiles of second-generation OAHs.
  

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  1.

  Riera-Serra P, Serrano-Ripoll MJ, Fiol deRoque MA, García-Pazo P, Bennasar-Veny M, Yánez-Juan A, Leiva-Rus A, Ginard-Puigserver M, García-Toro M, Sitges C, Balle M, Gervilla E, Gonzalez-Garcia X, García-Buades ME, Blanes MW, Zamanillo-Campos R, Andreu-Rodrigo P, Ricci-Cabello I. Evaluation of the effectiveness of SOM-RIU, a multifaceted, school-based, suicide prevention intervention targeted to Spanish adolescents: study protocol for a cluster-randomised controlled trial. BMC psychiatry. 2026 Jan.;26(1):56.

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  BACKGROUND: Adolescent suicide is a major public health concern and the third leading cause of death among young people worldwide. Schools are widely recognized as effective settings for universal mental health promotion and suicide prevention. This study aims to evaluate the effectiveness of SOM-RIU, a multifaceted school-based intervention involving pupils and gatekeepers (teachers and parents) in preventing suicidal behaviour and promoting adolescent mental health. METHODS: We will conduct a six-month, two-arm, cluster-randomised controlled trial. We will recruit 2,280 pupils from 114 classrooms in 38 secondary schools across the Balearic Islands (Spain). Eligible pupils will be aged 12–16 and enrolled in the 2nd and 3rd years of compulsory secondary education. Schools will be randomly assigned (1:1) to either the intervention or control group. Schools in the intervention group will implement the SOM-RIU programme, which includes four weekly psychoeducational sessions for pupils, delivered by trained educational psychologists. These sessions focus on mental health literacy, emotional regulation, suicide risk detection and management, and help-seeking strategies. In parallel, gatekeepers (teachers and parents) will receive a digital educational co-intervention consisting in four multimedia modules to strengthen their role in suicide prevention. Schools in the control group will receive a minimal intervention consisting of educational posters on mental health and suicide prevention displayed within school premises. The primary outcome will be suicidal ideation (Paykel Suicide Scale). Secondary outcomes will include suicide attempts, depression symptoms, well-being, self-harm, substance use, internet addiction, bullying, and cognitive disconnection. Teachers and parents will report on suicide-related knowledge, self-efficacy, and student referrals. Data will be collected at baseline and six-month follow-up. Analyses will be conducted using generalized linear mixed models to account for clustering, and multiple imputation will be used for missing data. A qualitative process evaluation will explore implementation, acceptability, and perceived impact of the intervention, while also examining contextual factors and potential mechanisms of action that may have influenced the outcomes. DISCUSSION: This trial will generate evidence on the effectiveness of multifaceted, school-based suicide prevention interventions for adolescents. If effective, the SOM-RIU programme could serve as a practical model for enhancing mental health support within educational settings in Spain. TRIAL REGISTRATION: NCT06996054 (clinicaltrials.gov). Registration date: 2025-05-30. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12888-025-07570-0.

  @article{riera-serra_evaluation_2026,
  abstract = {BACKGROUND: Adolescent suicide is a major public health concern and the third leading cause of death among young people worldwide. Schools are widely recognized as effective settings for universal mental health promotion and suicide prevention. This study aims to evaluate the effectiveness of SOM-RIU, a multifaceted school-based intervention involving pupils and gatekeepers (teachers and parents) in preventing suicidal behaviour and promoting adolescent mental health. METHODS: We will conduct a six-month, two-arm, cluster-randomised controlled trial. We will recruit 2,280 pupils from 114 classrooms in 38 secondary schools across the Balearic Islands (Spain). Eligible pupils will be aged 12–16 and enrolled in the 2nd and 3rd years of compulsory secondary education. Schools will be randomly assigned (1:1) to either the intervention or control group. Schools in the intervention group will implement the SOM-RIU programme, which includes four weekly psychoeducational sessions for pupils, delivered by trained educational psychologists. These sessions focus on mental health literacy, emotional regulation, suicide risk detection and management, and help-seeking strategies. In parallel, gatekeepers (teachers and parents) will receive a digital educational co-intervention consisting in four multimedia modules to strengthen their role in suicide prevention. Schools in the control group will receive a minimal intervention consisting of educational posters on mental health and suicide prevention displayed within school premises. The primary outcome will be suicidal ideation (Paykel Suicide Scale). Secondary outcomes will include suicide attempts, depression symptoms, well-being, self-harm, substance use, internet addiction, bullying, and cognitive disconnection. Teachers and parents will report on suicide-related knowledge, self-efficacy, and student referrals. Data will be collected at baseline and six-month follow-up. Analyses will be conducted using generalized linear mixed models to account for clustering, and multiple imputation will be used for missing data. A qualitative process evaluation will explore implementation, acceptability, and perceived impact of the intervention, while also examining contextual factors and potential mechanisms of action that may have influenced the outcomes. DISCUSSION: This trial will generate evidence on the effectiveness of multifaceted, school-based suicide prevention interventions for adolescents. If effective, the SOM-RIU programme could serve as a practical model for enhancing mental health support within educational settings in Spain. TRIAL REGISTRATION: NCT06996054 (clinicaltrials.gov). Registration date: 2025-05-30. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12888-025-07570-0.},
  author = {Riera-Serra, Pau and Serrano-Ripoll, Maria Jesús and Fiol deRoque, Maria Antònia and García-Pazo, Patricia and Bennasar-Veny, Miquel and Yánez-Juan, Aina and Leiva-Rus, Alfonso and Ginard-Puigserver, Miquel and García-Toro, Mauro and Sitges, Carolina and Balle, Maria and Gervilla, Elena and Gonzalez-Garcia, Xandra and García-Buades, M. Esther and Blanes, Maria Wei and Zamanillo-Campos, Rocío and Andreu-Rodrigo, Pilar and Ricci-Cabello, Ignacio},
  journal = {BMC psychiatry},
  keywords = {grapp-caib},
  month = {jan},
  number = 1,
  pages = 56,
  title = {Evaluation of the effectiveness of SOM-RIU, a multifaceted, school-based, suicide prevention intervention targeted to Spanish adolescents: study protocol for a cluster-randomised controlled trial},
  volume = 26,
  year = 2026
  }
  

  %0 Journal Article
  %1 riera-serra_evaluation_2026
  %A Riera-Serra, Pau
  %A Serrano-Ripoll, Maria Jesús
  %A Fiol deRoque, Maria Antònia
  %A García-Pazo, Patricia
  %A Bennasar-Veny, Miquel
  %A Yánez-Juan, Aina
  %A Leiva-Rus, Alfonso
  %A Ginard-Puigserver, Miquel
  %A García-Toro, Mauro
  %A Sitges, Carolina
  %A Balle, Maria
  %A Gervilla, Elena
  %A Gonzalez-Garcia, Xandra
  %A García-Buades, M. Esther
  %A Blanes, Maria Wei
  %A Zamanillo-Campos, Rocío
  %A Andreu-Rodrigo, Pilar
  %A Ricci-Cabello, Ignacio
  %D 2026
  %J BMC psychiatry
  %N 1
  %P 56
  %R 10.1186/s12888-025-07570-0
  %T Evaluation of the effectiveness of SOM-RIU, a multifaceted, school-based, suicide prevention intervention targeted to Spanish adolescents: study protocol for a cluster-randomised controlled trial
  %V 26
  %X BACKGROUND: Adolescent suicide is a major public health concern and the third leading cause of death among young people worldwide. Schools are widely recognized as effective settings for universal mental health promotion and suicide prevention. This study aims to evaluate the effectiveness of SOM-RIU, a multifaceted school-based intervention involving pupils and gatekeepers (teachers and parents) in preventing suicidal behaviour and promoting adolescent mental health. METHODS: We will conduct a six-month, two-arm, cluster-randomised controlled trial. We will recruit 2,280 pupils from 114 classrooms in 38 secondary schools across the Balearic Islands (Spain). Eligible pupils will be aged 12–16 and enrolled in the 2nd and 3rd years of compulsory secondary education. Schools will be randomly assigned (1:1) to either the intervention or control group. Schools in the intervention group will implement the SOM-RIU programme, which includes four weekly psychoeducational sessions for pupils, delivered by trained educational psychologists. These sessions focus on mental health literacy, emotional regulation, suicide risk detection and management, and help-seeking strategies. In parallel, gatekeepers (teachers and parents) will receive a digital educational co-intervention consisting in four multimedia modules to strengthen their role in suicide prevention. Schools in the control group will receive a minimal intervention consisting of educational posters on mental health and suicide prevention displayed within school premises. The primary outcome will be suicidal ideation (Paykel Suicide Scale). Secondary outcomes will include suicide attempts, depression symptoms, well-being, self-harm, substance use, internet addiction, bullying, and cognitive disconnection. Teachers and parents will report on suicide-related knowledge, self-efficacy, and student referrals. Data will be collected at baseline and six-month follow-up. Analyses will be conducted using generalized linear mixed models to account for clustering, and multiple imputation will be used for missing data. A qualitative process evaluation will explore implementation, acceptability, and perceived impact of the intervention, while also examining contextual factors and potential mechanisms of action that may have influenced the outcomes. DISCUSSION: This trial will generate evidence on the effectiveness of multifaceted, school-based suicide prevention interventions for adolescents. If effective, the SOM-RIU programme could serve as a practical model for enhancing mental health support within educational settings in Spain. TRIAL REGISTRATION: NCT06996054 (clinicaltrials.gov). Registration date: 2025-05-30. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12888-025-07570-0.
  

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  1.

  Ramírez-Gallegos A, Tárraga López PJ, Ramírez Manent JI, Del Amo Ríos A, Coll-Campayo I, García-Samuelson M, López González Ángel A. Insulin resistance risk in domestic workers: a sex-specific assessment using TyG, METS-IR, and SPISE indices in a large Mediterranean cohort. Nutricion Hospitalaria. 2026 Feb.;.

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  INTRODUCTION: insulin resistance is a key contributor to cardiometabolic diseases, yet it remains understudied among domestic workers. This study evaluates the usefulness of the TyG, METS-IR, and SPISE indices as non-invasive tools to estimate insulin resistance risk in this population. BACKGROUND: insulin resistance (IR) is a major precursor of type 2 diabetes and cardiovascular disease, yet its prevalence and associated factors remain underexplored in informal labor sectors. This study aimed to evaluate the prevalence of elevated IR scores using validated non-invasive indices (TyG, METS-IR, and SPISE) and their association with sociodemographic and lifestyle variables in a large cohort of Spanish female domestic workers. METHODS: a cross-sectional analysis was conducted using health examination data from 6,321 adult female domestic workers in Spain. IR was assessed using three surrogate indices: the triglyceride-glucose index (TyG), the metabolic score for insulin resistance (METS-IR), and the single-point insulin sensitivity estimator (SPISE). Participants were classified into quartiles based on each index. Associations with age, smoking status, physical activity (IPAQ-SF), and adherence to the Mediterranean diet were evaluated using logistic regression models adjusted for potential confounders. RESULTS: a high proportion of participants were in the highest-risk quartile for TyG (25.3 \%), METS-IR (24.9 \%), and the lowest-risk quartile for SPISE (26.8 \%). Older age, smoking, low physical activity, and low Mediterranean diet adherence were significantly associated with unfavorable IR profiles across all three indices. Multivariate logistic regression showed that physical inactivity was strongly associated with high TyG (OR = 3.12), high METS-IR (OR = 3.28), and low SPISE (OR = 4.07) scores. The prevalence of high IR scores increased with age and was notably higher among smokers and individuals with poor dietary habits. CONCLUSIONS: this study reveals a concerning prevalence of elevated insulin resistance among female domestic workers in Spain and identifies modifiable lifestyle factors associated with metabolic risk. The use of simple, cost-effective indices such as TyG, METS-IR, and SPISE offers a valuable opportunity for early identification of cardiometabolic risk in underserved labour populations. Targeted interventions promoting physical activity, dietary improvement, and smoking cessation are urgently needed to reduce long-term health disparities in this occupational group.

  @article{ramirez-gallegos_insulin_2026,
  abstract = {INTRODUCTION: insulin resistance is a key contributor to cardiometabolic diseases, yet it remains understudied among domestic workers. This study evaluates the usefulness of the TyG, METS-IR, and SPISE indices as non-invasive tools to estimate insulin resistance risk in this population. BACKGROUND: insulin resistance (IR) is a major precursor of type 2 diabetes and cardiovascular disease, yet its prevalence and associated factors remain underexplored in informal labor sectors. This study aimed to evaluate the prevalence of elevated IR scores using validated non-invasive indices (TyG, METS-IR, and SPISE) and their association with sociodemographic and lifestyle variables in a large cohort of Spanish female domestic workers. METHODS: a cross-sectional analysis was conducted using health examination data from 6,321 adult female domestic workers in Spain. IR was assessed using three surrogate indices: the triglyceride-glucose index (TyG), the metabolic score for insulin resistance (METS-IR), and the single-point insulin sensitivity estimator (SPISE). Participants were classified into quartiles based on each index. Associations with age, smoking status, physical activity (IPAQ-SF), and adherence to the Mediterranean diet were evaluated using logistic regression models adjusted for potential confounders. RESULTS: a high proportion of participants were in the highest-risk quartile for TyG (25.3 \%), METS-IR (24.9 \%), and the lowest-risk quartile for SPISE (26.8 \%). Older age, smoking, low physical activity, and low Mediterranean diet adherence were significantly associated with unfavorable IR profiles across all three indices. Multivariate logistic regression showed that physical inactivity was strongly associated with high TyG (OR = 3.12), high METS-IR (OR = 3.28), and low SPISE (OR = 4.07) scores. The prevalence of high IR scores increased with age and was notably higher among smokers and individuals with poor dietary habits. CONCLUSIONS: this study reveals a concerning prevalence of elevated insulin resistance among female domestic workers in Spain and identifies modifiable lifestyle factors associated with metabolic risk. The use of simple, cost-effective indices such as TyG, METS-IR, and SPISE offers a valuable opportunity for early identification of cardiometabolic risk in underserved labour populations. Targeted interventions promoting physical activity, dietary improvement, and smoking cessation are urgently needed to reduce long-term health disparities in this occupational group.},
  author = {Ramírez-Gallegos, Alberto and Tárraga López, Pedro Juan and Ramírez Manent, José Ignacio and Del Amo Ríos, Andrea and Coll-Campayo, Irene and García-Samuelson, Miguel and López González, Ángel Arturo},
  journal = {Nutricion Hospitalaria},
  keywords = {grapp-caib},
  month = {feb},
  title = {Insulin resistance risk in domestic workers: a sex-specific assessment using TyG, METS-IR, and SPISE indices in a large Mediterranean cohort},
  year = 2026
  }
  

  %0 Journal Article
  %1 ramirez-gallegos_insulin_2026
  %A Ramírez-Gallegos, Alberto
  %A Tárraga López, Pedro Juan
  %A Ramírez Manent, José Ignacio
  %A Del Amo Ríos, Andrea
  %A Coll-Campayo, Irene
  %A García-Samuelson, Miguel
  %A López González, Ángel Arturo
  %D 2026
  %J Nutricion Hospitalaria
  %R 10.20960/nh.06313
  %T Insulin resistance risk in domestic workers: a sex-specific assessment using TyG, METS-IR, and SPISE indices in a large Mediterranean cohort
  %X INTRODUCTION: insulin resistance is a key contributor to cardiometabolic diseases, yet it remains understudied among domestic workers. This study evaluates the usefulness of the TyG, METS-IR, and SPISE indices as non-invasive tools to estimate insulin resistance risk in this population. BACKGROUND: insulin resistance (IR) is a major precursor of type 2 diabetes and cardiovascular disease, yet its prevalence and associated factors remain underexplored in informal labor sectors. This study aimed to evaluate the prevalence of elevated IR scores using validated non-invasive indices (TyG, METS-IR, and SPISE) and their association with sociodemographic and lifestyle variables in a large cohort of Spanish female domestic workers. METHODS: a cross-sectional analysis was conducted using health examination data from 6,321 adult female domestic workers in Spain. IR was assessed using three surrogate indices: the triglyceride-glucose index (TyG), the metabolic score for insulin resistance (METS-IR), and the single-point insulin sensitivity estimator (SPISE). Participants were classified into quartiles based on each index. Associations with age, smoking status, physical activity (IPAQ-SF), and adherence to the Mediterranean diet were evaluated using logistic regression models adjusted for potential confounders. RESULTS: a high proportion of participants were in the highest-risk quartile for TyG (25.3 \%), METS-IR (24.9 \%), and the lowest-risk quartile for SPISE (26.8 \%). Older age, smoking, low physical activity, and low Mediterranean diet adherence were significantly associated with unfavorable IR profiles across all three indices. Multivariate logistic regression showed that physical inactivity was strongly associated with high TyG (OR = 3.12), high METS-IR (OR = 3.28), and low SPISE (OR = 4.07) scores. The prevalence of high IR scores increased with age and was notably higher among smokers and individuals with poor dietary habits. CONCLUSIONS: this study reveals a concerning prevalence of elevated insulin resistance among female domestic workers in Spain and identifies modifiable lifestyle factors associated with metabolic risk. The use of simple, cost-effective indices such as TyG, METS-IR, and SPISE offers a valuable opportunity for early identification of cardiometabolic risk in underserved labour populations. Targeted interventions promoting physical activity, dietary improvement, and smoking cessation are urgently needed to reduce long-term health disparities in this occupational group.
  

• 
  1.

  García Samuelsson M, Tárraga López PJ, López González Ángel A, Busquets-Cortés C, Obrador de Hevia J, Ramírez Manent JI. Lipid profile and atherogenic risk in metabolically healthy and unhealthy obese individuals: A cohort analysis by sex and sociodemographic factors. Clinica E Investigacion En Arteriosclerosis: Publicacion Oficial De La Sociedad Espanola De Arteriosclerosis. 2026;38(3):500840.

  AbstractBibTeXEndNoteDOIBibSonomy

  OBJECTIVE: To analyze lipid profiles and sociodemographic factors associated with atherogenic risk in obese workers classified as metabolically healthy (MHO) or unhealthy (MNHO). METHODS: Cross-sectional study of 68,884 obese workers. Atherogenic lipid indices (total cholesterol/HDL-c, LDL-c/HDL-c, triglycerides/HDL-c) and prevalence of atherogenic dyslipidemia were assessed. Multinomial logistic regression identified factors linked to lipid risk. RESULTS: MNHO individuals exhibited significantly higher atherogenic indices across sexes and diagnostic criteria. Atherogenic dyslipidemia and lipid triad were more prevalent in MNHO. Male sex, older age, lower educational level, lower social class, physical inactivity, low adherence to the Mediterranean diet, and smoking were associated with higher lipid risk. CONCLUSION: Although MHO individuals show a more favorable lipid profile than MNHO, this advantage weakens with less stringent definitions. Sociodemographic and lifestyle factors strongly modulate atherogenic risk.

  @article{garcia_samuelsson_lipid_2026,
  abstract = {OBJECTIVE: To analyze lipid profiles and sociodemographic factors associated with atherogenic risk in obese workers classified as metabolically healthy (MHO) or unhealthy (MNHO). METHODS: Cross-sectional study of 68,884 obese workers. Atherogenic lipid indices (total cholesterol/HDL-c, LDL-c/HDL-c, triglycerides/HDL-c) and prevalence of atherogenic dyslipidemia were assessed. Multinomial logistic regression identified factors linked to lipid risk. RESULTS: MNHO individuals exhibited significantly higher atherogenic indices across sexes and diagnostic criteria. Atherogenic dyslipidemia and lipid triad were more prevalent in MNHO. Male sex, older age, lower educational level, lower social class, physical inactivity, low adherence to the Mediterranean diet, and smoking were associated with higher lipid risk. CONCLUSION: Although MHO individuals show a more favorable lipid profile than MNHO, this advantage weakens with less stringent definitions. Sociodemographic and lifestyle factors strongly modulate atherogenic risk.},
  author = {García Samuelsson, Miguel and Tárraga López, Pedro Juan and López González, Ángel Arturo and Busquets-Cortés, Carla and Obrador de Hevia, Joan and Ramírez Manent, José Ignacio},
  journal = {Clinica E Investigacion En Arteriosclerosis: Publicacion Oficial De La Sociedad Espanola De Arteriosclerosis},
  keywords = {grapp-caib},
  number = 3,
  pages = 500840,
  title = {Lipid profile and atherogenic risk in metabolically healthy and unhealthy obese individuals: A cohort analysis by sex and sociodemographic factors},
  volume = 38,
  year = 2026
  }
  

  %0 Journal Article
  %1 garcia_samuelsson_lipid_2026
  %A García Samuelsson, Miguel
  %A Tárraga López, Pedro Juan
  %A López González, Ángel Arturo
  %A Busquets-Cortés, Carla
  %A Obrador de Hevia, Joan
  %A Ramírez Manent, José Ignacio
  %D 2026
  %J Clinica E Investigacion En Arteriosclerosis: Publicacion Oficial De La Sociedad Espanola De Arteriosclerosis
  %N 3
  %P 500840
  %R 10.1016/j.arteri.2025.500840
  %T Lipid profile and atherogenic risk in metabolically healthy and unhealthy obese individuals: A cohort analysis by sex and sociodemographic factors
  %V 38
  %X OBJECTIVE: To analyze lipid profiles and sociodemographic factors associated with atherogenic risk in obese workers classified as metabolically healthy (MHO) or unhealthy (MNHO). METHODS: Cross-sectional study of 68,884 obese workers. Atherogenic lipid indices (total cholesterol/HDL-c, LDL-c/HDL-c, triglycerides/HDL-c) and prevalence of atherogenic dyslipidemia were assessed. Multinomial logistic regression identified factors linked to lipid risk. RESULTS: MNHO individuals exhibited significantly higher atherogenic indices across sexes and diagnostic criteria. Atherogenic dyslipidemia and lipid triad were more prevalent in MNHO. Male sex, older age, lower educational level, lower social class, physical inactivity, low adherence to the Mediterranean diet, and smoking were associated with higher lipid risk. CONCLUSION: Although MHO individuals show a more favorable lipid profile than MNHO, this advantage weakens with less stringent definitions. Sociodemographic and lifestyle factors strongly modulate atherogenic risk.
  

• 
  1.

  Sepúlveda LG, López PJT, Vicente-Herrero MT, Cañellas LR, González Ángel AL, Ramírez-Manent JI. Work engagement and its association with obesity and lifestyle factors in a large working population: a sex-stratified analysis. AIMS public health. 2026;13(1):306-2.

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  BACKGROUND: Work engagement, defined as a positive, fulfilling psychological state characterized by vigor, dedication, and absorption, has been proposed as a potential protective factor for cardiometabolic health. However, its relationship with obesity-particularly visceral adiposity-remains poorly understood. This study aimed to examine the association between work engagement and different adiposity indicators and to explore the mediating role of lifestyle behaviors in a large sample of Spanish workers. METHODS: A cross-sectional analysis was conducted among employees attending occupational health evaluations between 2021 and 2022. After applying inclusion and exclusion criteria, 111,612 participants (60.1\% men) were included. Work engagement was assessed using the Utrecht Work Engagement Scale (UWES-9) and categorized into very high, high, moderate, and low levels. Obesity and adiposity were evaluated through BMI, waist-to-height ratio (WtHR), CUN-BAE, and METS-VF. Logistic regression models estimated odds ratios (OR) and 95% confidence intervals (CI) for obesity outcomes across engagement levels, with progressive adjustment for sociodemographic and lifestyle covariates. Mediation analyses evaluated the indirect effects of physical activity, Mediterranean diet adherence, and smoking. RESULTS: Lower engagement levels were independently associated with higher odds of adiposity across all indices, particularly visceral fat (METS-VF). Participants with low engagement had an adjusted OR = 2.59 (95\% CI 2.34-2.85) for high METS-VF compared with those with very high engagement (p-trend \textless 0.001). Approximately 40% of this association was mediated by lifestyle factors, mainly physical activity. The results remained robust across sensitivity analyses, including nonlinear modeling, imputation, and cluster adjustment. CONCLUSIONS: Lower work engagement is strongly associated with increased visceral adiposity among Spanish workers, partly through behavioral mechanisms. Enhancing engagement may represent an effective psychosocial strategy to improve both psychological well-being and metabolic health in occupational settings.

  @article{sepulveda_work_2026,
  abstract = {BACKGROUND: Work engagement, defined as a positive, fulfilling psychological state characterized by vigor, dedication, and absorption, has been proposed as a potential protective factor for cardiometabolic health. However, its relationship with obesity-particularly visceral adiposity-remains poorly understood. This study aimed to examine the association between work engagement and different adiposity indicators and to explore the mediating role of lifestyle behaviors in a large sample of Spanish workers. METHODS: A cross-sectional analysis was conducted among employees attending occupational health evaluations between 2021 and 2022. After applying inclusion and exclusion criteria, 111,612 participants (60.1\% men) were included. Work engagement was assessed using the Utrecht Work Engagement Scale (UWES-9) and categorized into very high, high, moderate, and low levels. Obesity and adiposity were evaluated through BMI, waist-to-height ratio (WtHR), CUN-BAE, and METS-VF. Logistic regression models estimated odds ratios (OR) and 95% confidence intervals (CI) for obesity outcomes across engagement levels, with progressive adjustment for sociodemographic and lifestyle covariates. Mediation analyses evaluated the indirect effects of physical activity, Mediterranean diet adherence, and smoking. RESULTS: Lower engagement levels were independently associated with higher odds of adiposity across all indices, particularly visceral fat (METS-VF). Participants with low engagement had an adjusted OR = 2.59 (95\% CI 2.34-2.85) for high METS-VF compared with those with very high engagement (p-trend \textless 0.001). Approximately 40% of this association was mediated by lifestyle factors, mainly physical activity. The results remained robust across sensitivity analyses, including nonlinear modeling, imputation, and cluster adjustment. CONCLUSIONS: Lower work engagement is strongly associated with increased visceral adiposity among Spanish workers, partly through behavioral mechanisms. Enhancing engagement may represent an effective psychosocial strategy to improve both psychological well-being and metabolic health in occupational settings.},
  author = {Sepúlveda, Lucía Garrido and López, Pedro Juan Tárraga and Vicente-Herrero, María Teófila and Cañellas, Lluis Rodas and González, Ángel Arturo López and Ramírez-Manent, José Ignacio},
  journal = {AIMS public health},
  keywords = {grapp-caib},
  number = 1,
  pages = {306--326},
  title = {Work engagement and its association with obesity and lifestyle factors in a large working population: a sex-stratified analysis},
  volume = 13,
  year = 2026
  }
  

  %0 Journal Article
  %1 sepulveda_work_2026
  %A Sepúlveda, Lucía Garrido
  %A López, Pedro Juan Tárraga
  %A Vicente-Herrero, María Teófila
  %A Cañellas, Lluis Rodas
  %A González, Ángel Arturo López
  %A Ramírez-Manent, José Ignacio
  %D 2026
  %J AIMS public health
  %N 1
  %P 306--326
  %R 10.3934/publichealth.2026017
  %T Work engagement and its association with obesity and lifestyle factors in a large working population: a sex-stratified analysis
  %V 13
  %X BACKGROUND: Work engagement, defined as a positive, fulfilling psychological state characterized by vigor, dedication, and absorption, has been proposed as a potential protective factor for cardiometabolic health. However, its relationship with obesity-particularly visceral adiposity-remains poorly understood. This study aimed to examine the association between work engagement and different adiposity indicators and to explore the mediating role of lifestyle behaviors in a large sample of Spanish workers. METHODS: A cross-sectional analysis was conducted among employees attending occupational health evaluations between 2021 and 2022. After applying inclusion and exclusion criteria, 111,612 participants (60.1\% men) were included. Work engagement was assessed using the Utrecht Work Engagement Scale (UWES-9) and categorized into very high, high, moderate, and low levels. Obesity and adiposity were evaluated through BMI, waist-to-height ratio (WtHR), CUN-BAE, and METS-VF. Logistic regression models estimated odds ratios (OR) and 95% confidence intervals (CI) for obesity outcomes across engagement levels, with progressive adjustment for sociodemographic and lifestyle covariates. Mediation analyses evaluated the indirect effects of physical activity, Mediterranean diet adherence, and smoking. RESULTS: Lower engagement levels were independently associated with higher odds of adiposity across all indices, particularly visceral fat (METS-VF). Participants with low engagement had an adjusted OR = 2.59 (95\% CI 2.34-2.85) for high METS-VF compared with those with very high engagement (p-trend \textless 0.001). Approximately 40% of this association was mediated by lifestyle factors, mainly physical activity. The results remained robust across sensitivity analyses, including nonlinear modeling, imputation, and cluster adjustment. CONCLUSIONS: Lower work engagement is strongly associated with increased visceral adiposity among Spanish workers, partly through behavioral mechanisms. Enhancing engagement may represent an effective psychosocial strategy to improve both psychological well-being and metabolic health in occupational settings.
  

• 
  1.

  Llor C, Monfà R, Garcia-Sangenís A, Leiva A, Marín-Cañada J, Sánchez-Calavera MA, Moragas A, Aguilar-Sánchez M, Troncoso-Mariño A, Rodríguez-Barrientos R, Molero JM, Ouchi D, Miranda-Jiménez C, Fernández-García S, Morros R. Clinical and bacteriological effectiveness of three different short-course antibiotic regimens and single-dose fosfomycin for uncomplicated lower urinary tract infections in women (SCOUT): a pragmatic, multicentre, open-label, randomised clinical trial. Lancet. 2026 Apr.;407(10539):1603-1.

  AbstractBibTeXEndNoteDOIBibSonomy

  BACKGROUND: Most guidelines recommend nitrofurantoin, fosfomycin, and sometimes pivmecillinam for uncomplicated urinary tract infections (UTIs), but direct comparisons between these antibiotics are needed. This study evaluated the effectiveness and safety of a single dose of fosfomycin compared with two doses of fosfomycin and short-course regimens of nitrofurantoin and pivmecillinam in women with UTI symptoms. METHODS: This phase 4, pragmatic, multicentre, parallel-group, open-label, randomised clinical trial was conducted in Spanish primary care centres from 2022 to 2024. Women aged 18 years or older with at least one UTI-specific symptom (dysuria, urinary urgency, urinary frequency, or suprapubic tenderness) and a positive urine dipstick test for either nitrites or leukocyte esterase were randomly assigned (1:1:1:1) to one of four treatments: a single 3 g dose of fosfomycin, two 3 g doses of fosfomycin, nitrofurantoin (100 mg three times per day for 5 days), or pivmecillinam (400 mg three times per day for 3 days). Doctors and patients were not masked to group assignment. The primary outcome was the proportion of patients with clinical resolution (defined as the disappearance of all infection symptoms) at day 7. This trial is registered with ClinicalTrials.gov (NCT04959331) and EudraCT (2021-001332-26) and is completed. FINDINGS: Of the 804 patients assessed for eligibility between April 4, 2022 and Nov 14, 2024, 768 patients were randomly allocated (191 to the single-dose fosfomycin group, 194 to the two-dose fosfomycin group, 190 to the nitrofurantoin group, and 193 to the pivmecillinam group). Patients had a median age of 48 years (IQR 34-63). Race and ethnicity data were not collected. Among the 720 women with available data included in the primary analysis, single-dose fosfomycin had the lowest proportion of clinical resolution (109 [59\%] of 185 patients), while nitrofurantoin had the highest (128 [74\%] of 172 patients; difference 15·5 percentage points [95\% CI 5·9 to 25·1] vs single-dose fosfomycin; p=0·0168), followed by pivmecillinam (127 [70\%] of 182; difference 10·9 percentage points [1·1 to 20·6]; p=0·2352) and the two-dose fosfomycin group (122 [67\%] of 181; difference 8·5 percentage points [-1·4 to 18·3]; p=0·6935). Adverse events occurred in 38 (19·9\% [95\% CI 14·9 to 26·1) of 191 patients who received single-dose fosfomycin, 51 (26·3\% [20·6 to 32·9]) of 194 who received two-dose fosfomycin, 51 (26·8\% [21·0 to 33·6]) of 190 who received nitrofurantoin, and 41 (21·2\% [16·1 to 27·5]) of 193 who received pivmecillinam. Most adverse events were mild and self-limiting, primarily gastrointestinal. Four serious adverse events occurred, of which one was related to the study treatment (one case of pyelonephritis in the pivmecillinam group). INTERPRETATION: Nitrofurantoin was the most effective treatment and single-dose fosfomycin the least effective treatment for UTIs. Adverse events were mild. The role of fosfomycin as a first-line antibiotic for uncomplicated UTI should be re-evaluated. FUNDING: Carlos III Institute of Health, Spanish Ministry of Science and Innovation, and European Regional Development Fund.

  @article{llor_clinical_2026,
  abstract = {BACKGROUND: Most guidelines recommend nitrofurantoin, fosfomycin, and sometimes pivmecillinam for uncomplicated urinary tract infections (UTIs), but direct comparisons between these antibiotics are needed. This study evaluated the effectiveness and safety of a single dose of fosfomycin compared with two doses of fosfomycin and short-course regimens of nitrofurantoin and pivmecillinam in women with UTI symptoms. METHODS: This phase 4, pragmatic, multicentre, parallel-group, open-label, randomised clinical trial was conducted in Spanish primary care centres from 2022 to 2024. Women aged 18 years or older with at least one UTI-specific symptom (dysuria, urinary urgency, urinary frequency, or suprapubic tenderness) and a positive urine dipstick test for either nitrites or leukocyte esterase were randomly assigned (1:1:1:1) to one of four treatments: a single 3 g dose of fosfomycin, two 3 g doses of fosfomycin, nitrofurantoin (100 mg three times per day for 5 days), or pivmecillinam (400 mg three times per day for 3 days). Doctors and patients were not masked to group assignment. The primary outcome was the proportion of patients with clinical resolution (defined as the disappearance of all infection symptoms) at day 7. This trial is registered with ClinicalTrials.gov (NCT04959331) and EudraCT (2021-001332-26) and is completed. FINDINGS: Of the 804 patients assessed for eligibility between April 4, 2022 and Nov 14, 2024, 768 patients were randomly allocated (191 to the single-dose fosfomycin group, 194 to the two-dose fosfomycin group, 190 to the nitrofurantoin group, and 193 to the pivmecillinam group). Patients had a median age of 48 years (IQR 34-63). Race and ethnicity data were not collected. Among the 720 women with available data included in the primary analysis, single-dose fosfomycin had the lowest proportion of clinical resolution (109 [59\%] of 185 patients), while nitrofurantoin had the highest (128 [74\%] of 172 patients; difference 15·5 percentage points [95\% CI 5·9 to 25·1] vs single-dose fosfomycin; p=0·0168), followed by pivmecillinam (127 [70\%] of 182; difference 10·9 percentage points [1·1 to 20·6]; p=0·2352) and the two-dose fosfomycin group (122 [67\%] of 181; difference 8·5 percentage points [-1·4 to 18·3]; p=0·6935). Adverse events occurred in 38 (19·9\% [95\% CI 14·9 to 26·1) of 191 patients who received single-dose fosfomycin, 51 (26·3\% [20·6 to 32·9]) of 194 who received two-dose fosfomycin, 51 (26·8\% [21·0 to 33·6]) of 190 who received nitrofurantoin, and 41 (21·2\% [16·1 to 27·5]) of 193 who received pivmecillinam. Most adverse events were mild and self-limiting, primarily gastrointestinal. Four serious adverse events occurred, of which one was related to the study treatment (one case of pyelonephritis in the pivmecillinam group). INTERPRETATION: Nitrofurantoin was the most effective treatment and single-dose fosfomycin the least effective treatment for UTIs. Adverse events were mild. The role of fosfomycin as a first-line antibiotic for uncomplicated UTI should be re-evaluated. FUNDING: Carlos III Institute of Health, Spanish Ministry of Science and Innovation, and European Regional Development Fund.},
  author = {Llor, Carl and Monfà, Ramon and Garcia-Sangenís, Ana and Leiva, Alfonso and Marín-Cañada, Jaime and Sánchez-Calavera, María Antonia and Moragas, Ana and Aguilar-Sánchez, Mercedes and Troncoso-Mariño, Amelia and Rodríguez-Barrientos, Ricardo and Molero, José M. and Ouchi, Dan and Miranda-Jiménez, Cristina and Fernández-García, Silvia and Morros, Rosa},
  journal = {Lancet},
  keywords = {grapp-caib},
  month = {apr},
  number = 10539,
  pages = {1603--1613},
  title = {Clinical and bacteriological effectiveness of three different short-course antibiotic regimens and single-dose fosfomycin for uncomplicated lower urinary tract infections in women (SCOUT): a pragmatic, multicentre, open-label, randomised clinical trial},
  volume = 407,
  year = 2026
  }
  

  %0 Journal Article
  %1 llor_clinical_2026
  %A Llor, Carl
  %A Monfà, Ramon
  %A Garcia-Sangenís, Ana
  %A Leiva, Alfonso
  %A Marín-Cañada, Jaime
  %A Sánchez-Calavera, María Antonia
  %A Moragas, Ana
  %A Aguilar-Sánchez, Mercedes
  %A Troncoso-Mariño, Amelia
  %A Rodríguez-Barrientos, Ricardo
  %A Molero, José M.
  %A Ouchi, Dan
  %A Miranda-Jiménez, Cristina
  %A Fernández-García, Silvia
  %A Morros, Rosa
  %D 2026
  %J Lancet
  %N 10539
  %P 1603--1613
  %R 10.1016/S0140-6736(25)02171-3
  %T Clinical and bacteriological effectiveness of three different short-course antibiotic regimens and single-dose fosfomycin for uncomplicated lower urinary tract infections in women (SCOUT): a pragmatic, multicentre, open-label, randomised clinical trial
  %V 407
  %X BACKGROUND: Most guidelines recommend nitrofurantoin, fosfomycin, and sometimes pivmecillinam for uncomplicated urinary tract infections (UTIs), but direct comparisons between these antibiotics are needed. This study evaluated the effectiveness and safety of a single dose of fosfomycin compared with two doses of fosfomycin and short-course regimens of nitrofurantoin and pivmecillinam in women with UTI symptoms. METHODS: This phase 4, pragmatic, multicentre, parallel-group, open-label, randomised clinical trial was conducted in Spanish primary care centres from 2022 to 2024. Women aged 18 years or older with at least one UTI-specific symptom (dysuria, urinary urgency, urinary frequency, or suprapubic tenderness) and a positive urine dipstick test for either nitrites or leukocyte esterase were randomly assigned (1:1:1:1) to one of four treatments: a single 3 g dose of fosfomycin, two 3 g doses of fosfomycin, nitrofurantoin (100 mg three times per day for 5 days), or pivmecillinam (400 mg three times per day for 3 days). Doctors and patients were not masked to group assignment. The primary outcome was the proportion of patients with clinical resolution (defined as the disappearance of all infection symptoms) at day 7. This trial is registered with ClinicalTrials.gov (NCT04959331) and EudraCT (2021-001332-26) and is completed. FINDINGS: Of the 804 patients assessed for eligibility between April 4, 2022 and Nov 14, 2024, 768 patients were randomly allocated (191 to the single-dose fosfomycin group, 194 to the two-dose fosfomycin group, 190 to the nitrofurantoin group, and 193 to the pivmecillinam group). Patients had a median age of 48 years (IQR 34-63). Race and ethnicity data were not collected. Among the 720 women with available data included in the primary analysis, single-dose fosfomycin had the lowest proportion of clinical resolution (109 [59\%] of 185 patients), while nitrofurantoin had the highest (128 [74\%] of 172 patients; difference 15·5 percentage points [95\% CI 5·9 to 25·1] vs single-dose fosfomycin; p=0·0168), followed by pivmecillinam (127 [70\%] of 182; difference 10·9 percentage points [1·1 to 20·6]; p=0·2352) and the two-dose fosfomycin group (122 [67\%] of 181; difference 8·5 percentage points [-1·4 to 18·3]; p=0·6935). Adverse events occurred in 38 (19·9\% [95\% CI 14·9 to 26·1) of 191 patients who received single-dose fosfomycin, 51 (26·3\% [20·6 to 32·9]) of 194 who received two-dose fosfomycin, 51 (26·8\% [21·0 to 33·6]) of 190 who received nitrofurantoin, and 41 (21·2\% [16·1 to 27·5]) of 193 who received pivmecillinam. Most adverse events were mild and self-limiting, primarily gastrointestinal. Four serious adverse events occurred, of which one was related to the study treatment (one case of pyelonephritis in the pivmecillinam group). INTERPRETATION: Nitrofurantoin was the most effective treatment and single-dose fosfomycin the least effective treatment for UTIs. Adverse events were mild. The role of fosfomycin as a first-line antibiotic for uncomplicated UTI should be re-evaluated. FUNDING: Carlos III Institute of Health, Spanish Ministry of Science and Innovation, and European Regional Development Fund.
  

• 
  1.

  López-González Ángel A, Tárraga López PJ, Piña Dabreu MS, Rodas Cañellas L, Busquets-Cortés C, Ramírez-Manent JI. Waist-to-Height Ratio as a Simple Anthropometric Marker for Identifying Individuals at High Risk of MASLD: A Large Population-Based Analysis Using the Fatty Liver Index. Metabolites. 2026 Apr.;16(4):246.

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  BACKGROUND: Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common chronic liver disease worldwide and represents a major component of the global burden of metabolic disorders. Simple anthropometric markers capable of identifying individuals at increased risk of hepatic steatosis are of considerable interest for population-level screening. METHODS: In this cross-sectional population-based study, we evaluated the performance of waist-to-height ratio (WtHR) for identifying individuals with a high Fatty Liver Index (FLI ≥ 60), a widely used surrogate marker of hepatic steatosis. The study included 146,318 adult participants with available anthropometric and biochemical data. Discriminatory performance was assessed using receiver operating characteristic (ROC) curve analysis. Optimal WtHR thresholds were determined using the Youden index. Associations between WtHR and high FLI were evaluated using age-adjusted logistic regression models. Non-linear relationships were explored using restricted cubic spline models. Additional analyses included a comparison with body mass index (BMI) and waist circumference, decision curve analysis, and subgroup analyses across age and BMI strata. RESULTS: The prevalence of high FLI in the study population was 18.1%. WtHR demonstrated excellent discriminatory performance, with area under the ROC curve (AUC) values of 0.908 (95\% CI 0.906-0.910) in men and 0.972 (95\% CI 0.971-0.974) in women. Optimal WtHR thresholds for identifying individuals with high FLI were 0.52 in men and 0.53 in women. Each 0.01 increase in WtHR was strongly associated with higher odds of high FLI (OR 1.56 in men and 1.69 in women). Restricted cubic spline analysis demonstrated a non-linear relationship, with a marked increase in predicted probability of high FLI above WtHR values of approximately 0.50-0.52. WtHR showed discriminatory performance comparable to BMI and waist circumference and maintained strong associations with high FLI across age groups and BMI categories. CONCLUSIONS: Waist-to-height ratio is a simple anthropometric marker strongly associated with a high Fatty Liver Index in a large population-based cohort. Given its simplicity, low cost, and ease of calculation, WtHR may represent a practical screening indicator for identifying individuals at increased risk of MASLD-related phenotypes in both clinical practice and population health strategies.

  @article{lopez-gonzalez_waist--height_2026,
  abstract = {BACKGROUND: Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common chronic liver disease worldwide and represents a major component of the global burden of metabolic disorders. Simple anthropometric markers capable of identifying individuals at increased risk of hepatic steatosis are of considerable interest for population-level screening. METHODS: In this cross-sectional population-based study, we evaluated the performance of waist-to-height ratio (WtHR) for identifying individuals with a high Fatty Liver Index (FLI ≥ 60), a widely used surrogate marker of hepatic steatosis. The study included 146,318 adult participants with available anthropometric and biochemical data. Discriminatory performance was assessed using receiver operating characteristic (ROC) curve analysis. Optimal WtHR thresholds were determined using the Youden index. Associations between WtHR and high FLI were evaluated using age-adjusted logistic regression models. Non-linear relationships were explored using restricted cubic spline models. Additional analyses included a comparison with body mass index (BMI) and waist circumference, decision curve analysis, and subgroup analyses across age and BMI strata. RESULTS: The prevalence of high FLI in the study population was 18.1%. WtHR demonstrated excellent discriminatory performance, with area under the ROC curve (AUC) values of 0.908 (95\% CI 0.906-0.910) in men and 0.972 (95\% CI 0.971-0.974) in women. Optimal WtHR thresholds for identifying individuals with high FLI were 0.52 in men and 0.53 in women. Each 0.01 increase in WtHR was strongly associated with higher odds of high FLI (OR 1.56 in men and 1.69 in women). Restricted cubic spline analysis demonstrated a non-linear relationship, with a marked increase in predicted probability of high FLI above WtHR values of approximately 0.50-0.52. WtHR showed discriminatory performance comparable to BMI and waist circumference and maintained strong associations with high FLI across age groups and BMI categories. CONCLUSIONS: Waist-to-height ratio is a simple anthropometric marker strongly associated with a high Fatty Liver Index in a large population-based cohort. Given its simplicity, low cost, and ease of calculation, WtHR may represent a practical screening indicator for identifying individuals at increased risk of MASLD-related phenotypes in both clinical practice and population health strategies.},
  author = {López-González, Ángel Arturo and Tárraga López, Pedro Juan and Piña Dabreu, Mónica Silu and Rodas Cañellas, Lluis and Busquets-Cortés, Carla and Ramírez-Manent, José Ignacio},
  journal = {Metabolites},
  keywords = {grapp-caib},
  month = {apr},
  number = 4,
  pages = 246,
  title = {Waist-to-Height Ratio as a Simple Anthropometric Marker for Identifying Individuals at High Risk of MASLD: A Large Population-Based Analysis Using the Fatty Liver Index},
  volume = 16,
  year = 2026
  }
  

  %0 Journal Article
  %1 lopez-gonzalez_waist--height_2026
  %A López-González, Ángel Arturo
  %A Tárraga López, Pedro Juan
  %A Piña Dabreu, Mónica Silu
  %A Rodas Cañellas, Lluis
  %A Busquets-Cortés, Carla
  %A Ramírez-Manent, José Ignacio
  %D 2026
  %J Metabolites
  %N 4
  %P 246
  %R 10.3390/metabo16040246
  %T Waist-to-Height Ratio as a Simple Anthropometric Marker for Identifying Individuals at High Risk of MASLD: A Large Population-Based Analysis Using the Fatty Liver Index
  %V 16
  %X BACKGROUND: Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common chronic liver disease worldwide and represents a major component of the global burden of metabolic disorders. Simple anthropometric markers capable of identifying individuals at increased risk of hepatic steatosis are of considerable interest for population-level screening. METHODS: In this cross-sectional population-based study, we evaluated the performance of waist-to-height ratio (WtHR) for identifying individuals with a high Fatty Liver Index (FLI ≥ 60), a widely used surrogate marker of hepatic steatosis. The study included 146,318 adult participants with available anthropometric and biochemical data. Discriminatory performance was assessed using receiver operating characteristic (ROC) curve analysis. Optimal WtHR thresholds were determined using the Youden index. Associations between WtHR and high FLI were evaluated using age-adjusted logistic regression models. Non-linear relationships were explored using restricted cubic spline models. Additional analyses included a comparison with body mass index (BMI) and waist circumference, decision curve analysis, and subgroup analyses across age and BMI strata. RESULTS: The prevalence of high FLI in the study population was 18.1%. WtHR demonstrated excellent discriminatory performance, with area under the ROC curve (AUC) values of 0.908 (95\% CI 0.906-0.910) in men and 0.972 (95\% CI 0.971-0.974) in women. Optimal WtHR thresholds for identifying individuals with high FLI were 0.52 in men and 0.53 in women. Each 0.01 increase in WtHR was strongly associated with higher odds of high FLI (OR 1.56 in men and 1.69 in women). Restricted cubic spline analysis demonstrated a non-linear relationship, with a marked increase in predicted probability of high FLI above WtHR values of approximately 0.50-0.52. WtHR showed discriminatory performance comparable to BMI and waist circumference and maintained strong associations with high FLI across age groups and BMI categories. CONCLUSIONS: Waist-to-height ratio is a simple anthropometric marker strongly associated with a high Fatty Liver Index in a large population-based cohort. Given its simplicity, low cost, and ease of calculation, WtHR may represent a practical screening indicator for identifying individuals at increased risk of MASLD-related phenotypes in both clinical practice and population health strategies.
  

• 
  1.

  Egea Sancho M, Ramírez-Manent JI, López PJT, Coll Campayo I, Vicente-Herrero MT, López-González Ángel A. Associations of sociodemographic factors, healthy habits, and weight stigma with non-alcoholic fatty liver disease risk in obese workers: Findings from a large occupational cohort. Gastroenterologia Y Hepatologia. 2026 Jan.;49(1):502560.

  AbstractBibTeXEndNoteDOIBibSonomy

  BACKGROUND: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a growing global health concern, particularly among individuals with obesity. While metabolic and behavioral risk factors have been well described, the role of psychosocial determinants, such as weight stigma, remains underexplored. OBJECTIVES: To assess the association between sociodemographic variables, healthy lifestyle behaviors, and internalized weight stigma with MASLD risk in a large cohort of obese workers across Spain. PATIENTS AND METHODS: This cross-sectional study analyzed data from 26,816 obese employees who underwent occupational health screenings between January 2021 and December 2024. MASLD risk was assessed using three validated indices: the Fatty Liver Index (FLI), Hepatic Steatosis Index (HSI), and Lipid Accumulation Product (LAP). Sociodemographic characteristics, adherence to the Mediterranean diet, physical activity, smoking status, and weight stigma (assessed by the Weight Bias Internalization Scale) were evaluated. Multivariable logistic regression models were used to estimate associations. RESULTS: Weight stigma was significantly associated with higher risk of MASLD across all three indices, independent of age, sex, social class, and health behaviors. Participants with internalized weight stigma were 1.6-2.3times more likely to present with high-risk scores. Sociodemographic disparities and unhealthy lifestyle factors also contributed to elevated MASLD risk. CONCLUSIONS: Beyond metabolic and behavioral determinants, internalized weight stigma emerges as a strong independent factor associated with MASLD risk. These findings underscore the importance of incorporating psychosocial components into liver disease prevention strategies in occupational settings.

  @article{egea_sancho_associations_2026,
  abstract = {BACKGROUND: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a growing global health concern, particularly among individuals with obesity. While metabolic and behavioral risk factors have been well described, the role of psychosocial determinants, such as weight stigma, remains underexplored. OBJECTIVES: To assess the association between sociodemographic variables, healthy lifestyle behaviors, and internalized weight stigma with MASLD risk in a large cohort of obese workers across Spain. PATIENTS AND METHODS: This cross-sectional study analyzed data from 26,816 obese employees who underwent occupational health screenings between January 2021 and December 2024. MASLD risk was assessed using three validated indices: the Fatty Liver Index (FLI), Hepatic Steatosis Index (HSI), and Lipid Accumulation Product (LAP). Sociodemographic characteristics, adherence to the Mediterranean diet, physical activity, smoking status, and weight stigma (assessed by the Weight Bias Internalization Scale) were evaluated. Multivariable logistic regression models were used to estimate associations. RESULTS: Weight stigma was significantly associated with higher risk of MASLD across all three indices, independent of age, sex, social class, and health behaviors. Participants with internalized weight stigma were 1.6-2.3times more likely to present with high-risk scores. Sociodemographic disparities and unhealthy lifestyle factors also contributed to elevated MASLD risk. CONCLUSIONS: Beyond metabolic and behavioral determinants, internalized weight stigma emerges as a strong independent factor associated with MASLD risk. These findings underscore the importance of incorporating psychosocial components into liver disease prevention strategies in occupational settings.},
  author = {Egea Sancho, Mónica and Ramírez-Manent, José Ignacio and López, Pedro Juan Tárraga and Coll Campayo, Irene and Vicente-Herrero, María Teófila and López-González, Ángel Arturo},
  journal = {Gastroenterologia Y Hepatologia},
  keywords = {grapp-caib},
  month = {jan},
  number = 1,
  pages = 502560,
  title = {Associations of sociodemographic factors, healthy habits, and weight stigma with non-alcoholic fatty liver disease risk in obese workers: Findings from a large occupational cohort},
  volume = 49,
  year = 2026
  }
  

  %0 Journal Article
  %1 egea_sancho_associations_2026
  %A Egea Sancho, Mónica
  %A Ramírez-Manent, José Ignacio
  %A López, Pedro Juan Tárraga
  %A Coll Campayo, Irene
  %A Vicente-Herrero, María Teófila
  %A López-González, Ángel Arturo
  %D 2026
  %J Gastroenterologia Y Hepatologia
  %N 1
  %P 502560
  %R 10.1016/j.gastrohep.2025.502560
  %T Associations of sociodemographic factors, healthy habits, and weight stigma with non-alcoholic fatty liver disease risk in obese workers: Findings from a large occupational cohort
  %V 49
  %X BACKGROUND: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a growing global health concern, particularly among individuals with obesity. While metabolic and behavioral risk factors have been well described, the role of psychosocial determinants, such as weight stigma, remains underexplored. OBJECTIVES: To assess the association between sociodemographic variables, healthy lifestyle behaviors, and internalized weight stigma with MASLD risk in a large cohort of obese workers across Spain. PATIENTS AND METHODS: This cross-sectional study analyzed data from 26,816 obese employees who underwent occupational health screenings between January 2021 and December 2024. MASLD risk was assessed using three validated indices: the Fatty Liver Index (FLI), Hepatic Steatosis Index (HSI), and Lipid Accumulation Product (LAP). Sociodemographic characteristics, adherence to the Mediterranean diet, physical activity, smoking status, and weight stigma (assessed by the Weight Bias Internalization Scale) were evaluated. Multivariable logistic regression models were used to estimate associations. RESULTS: Weight stigma was significantly associated with higher risk of MASLD across all three indices, independent of age, sex, social class, and health behaviors. Participants with internalized weight stigma were 1.6-2.3times more likely to present with high-risk scores. Sociodemographic disparities and unhealthy lifestyle factors also contributed to elevated MASLD risk. CONCLUSIONS: Beyond metabolic and behavioral determinants, internalized weight stigma emerges as a strong independent factor associated with MASLD risk. These findings underscore the importance of incorporating psychosocial components into liver disease prevention strategies in occupational settings.
  

• 
  1.

  García Pertegaz P, Tárraga López PJ, Coll Campayo I, Busquets-Cortés C, López-González Ángel A, Ramírez-Manent JI. Purpose in Life and Estimated Type 2 Diabetes Risk: Cross-Sectional Associations Across Three Validated Risk Scores in 93,077 Spanish Working Adults. Medical Sciences. 2026 Feb.;14(1):113.

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  Background: Psychosocial well-being has been increasingly recognized as a relevant factor in cardiometabolic health; however, evidence linking Purpose in Life with type 2 diabetes risk across validated prediction tools remains limited. This study examined the association between Purpose in Life and estimated diabetes risk using three established risk scores. Methods: A cross-sectional analysis was performed in 93,077 Spanish working adults aged 18-69 years participating in routine occupational health assessments. Purpose in Life was measured with the 10-item Purpose in Life scale and categorized into high, moderate, and low levels. Estimated type 2 diabetes risk was evaluated using QDScore, FINDRISC, and CANRISK. Multivariable logistic regression models were applied to calculate odds ratios (ORs) and 95% confidence intervals (CIs), adjusting for age, sex, occupational social class, smoking status, dietary pattern, physical activity, and body mass index. Results: Lower levels of Purpose in Life were consistently associated with greater likelihood of high estimated diabetes risk across all three instruments. Compared with participants reporting high Purpose in Life, those with low Purpose in Life showed increased odds of high-risk classification for QDScore (OR 2.38; 95\% CI 2.19-2.57), FINDRISC (OR 2.49; 95\% CI 2.08-2.89), and CANRISK (OR 2.79; 95\% CI 2.50-3.09). Clear dose-response patterns were observed across Purpose in Life categories, and associations were similar in men and women as well as across lifestyle strata. Conclusions: Reduced Purpose in Life is strongly associated with higher estimated type 2 diabetes risk across multiple validated screening tools. Although causal direction cannot be inferred from this cross-sectional design, these findings suggest that psychosocial dimensions may provide complementary information for cardiometabolic risk assessment and prevention strategies.

  @article{garcia_pertegaz_purpose_2026,
  abstract = {Background: Psychosocial well-being has been increasingly recognized as a relevant factor in cardiometabolic health; however, evidence linking Purpose in Life with type 2 diabetes risk across validated prediction tools remains limited. This study examined the association between Purpose in Life and estimated diabetes risk using three established risk scores. Methods: A cross-sectional analysis was performed in 93,077 Spanish working adults aged 18-69 years participating in routine occupational health assessments. Purpose in Life was measured with the 10-item Purpose in Life scale and categorized into high, moderate, and low levels. Estimated type 2 diabetes risk was evaluated using QDScore, FINDRISC, and CANRISK. Multivariable logistic regression models were applied to calculate odds ratios (ORs) and 95% confidence intervals (CIs), adjusting for age, sex, occupational social class, smoking status, dietary pattern, physical activity, and body mass index. Results: Lower levels of Purpose in Life were consistently associated with greater likelihood of high estimated diabetes risk across all three instruments. Compared with participants reporting high Purpose in Life, those with low Purpose in Life showed increased odds of high-risk classification for QDScore (OR 2.38; 95\% CI 2.19-2.57), FINDRISC (OR 2.49; 95\% CI 2.08-2.89), and CANRISK (OR 2.79; 95\% CI 2.50-3.09). Clear dose-response patterns were observed across Purpose in Life categories, and associations were similar in men and women as well as across lifestyle strata. Conclusions: Reduced Purpose in Life is strongly associated with higher estimated type 2 diabetes risk across multiple validated screening tools. Although causal direction cannot be inferred from this cross-sectional design, these findings suggest that psychosocial dimensions may provide complementary information for cardiometabolic risk assessment and prevention strategies.},
  author = {García Pertegaz, Pilar and Tárraga López, Pedro Juan and Coll Campayo, Irene and Busquets-Cortés, Carla and López-González, Ángel Arturo and Ramírez-Manent, José Ignacio},
  journal = {Medical Sciences},
  keywords = {grapp-caib},
  month = {feb},
  number = 1,
  pages = 113,
  title = {Purpose in Life and Estimated Type 2 Diabetes Risk: Cross-Sectional Associations Across Three Validated Risk Scores in 93,077 Spanish Working Adults},
  volume = 14,
  year = 2026
  }
  

  %0 Journal Article
  %1 garcia_pertegaz_purpose_2026
  %A García Pertegaz, Pilar
  %A Tárraga López, Pedro Juan
  %A Coll Campayo, Irene
  %A Busquets-Cortés, Carla
  %A López-González, Ángel Arturo
  %A Ramírez-Manent, José Ignacio
  %D 2026
  %J Medical Sciences
  %N 1
  %P 113
  %R 10.3390/medsci14010113
  %T Purpose in Life and Estimated Type 2 Diabetes Risk: Cross-Sectional Associations Across Three Validated Risk Scores in 93,077 Spanish Working Adults
  %V 14
  %X Background: Psychosocial well-being has been increasingly recognized as a relevant factor in cardiometabolic health; however, evidence linking Purpose in Life with type 2 diabetes risk across validated prediction tools remains limited. This study examined the association between Purpose in Life and estimated diabetes risk using three established risk scores. Methods: A cross-sectional analysis was performed in 93,077 Spanish working adults aged 18-69 years participating in routine occupational health assessments. Purpose in Life was measured with the 10-item Purpose in Life scale and categorized into high, moderate, and low levels. Estimated type 2 diabetes risk was evaluated using QDScore, FINDRISC, and CANRISK. Multivariable logistic regression models were applied to calculate odds ratios (ORs) and 95% confidence intervals (CIs), adjusting for age, sex, occupational social class, smoking status, dietary pattern, physical activity, and body mass index. Results: Lower levels of Purpose in Life were consistently associated with greater likelihood of high estimated diabetes risk across all three instruments. Compared with participants reporting high Purpose in Life, those with low Purpose in Life showed increased odds of high-risk classification for QDScore (OR 2.38; 95\% CI 2.19-2.57), FINDRISC (OR 2.49; 95\% CI 2.08-2.89), and CANRISK (OR 2.79; 95\% CI 2.50-3.09). Clear dose-response patterns were observed across Purpose in Life categories, and associations were similar in men and women as well as across lifestyle strata. Conclusions: Reduced Purpose in Life is strongly associated with higher estimated type 2 diabetes risk across multiple validated screening tools. Although causal direction cannot be inferred from this cross-sectional design, these findings suggest that psychosocial dimensions may provide complementary information for cardiometabolic risk assessment and prevention strategies.
  

• 
  1.

  Marina Arroyo M, Ramírez Gallegos I, López-González Ángel A, Busquets-Cortés C, Obrador de Hevia J, Tárraga López PJ, Ramírez-Manent JI. Diagnostic accuracy of non-invasive fatty liver indexes and their association with ECORE-BF scale in a cohort of 386,924 Spanish workers. Gastroenterologia Y Hepatologia. 2026 Jan.;:502656.

  AbstractBibTeXEndNoteDOIBibSonomy

  OBJECTIVE: To evaluate the diagnostic accuracy of five non-invasive fatty liver indices and their association with obesity in a large cohort of Spanish workers, stratified by sex. PATIENTS AND METHODS: A cross-sectional analysis was conducted on 386,924 workers (232,814 men and 154,110 women) who underwent routine occupational health assessments between 2009 and 2019. Anthropometric, clinical, and biochemical parameters were collected following standardized procedures. Physical activity and adherence to the Mediterranean diet were assessed using validated IPAQ and PREDIMED questionnaires. Diagnostic performance was evaluated using ROC curves and area under the curve (AUC) values for each fatty liver index. RESULTS: All indices showed significant sex-based differences. FLI and LAP presented the highest AUC values for identifying obesity in both sexes (FLI: AUC 0.907 in men and 0.972 in women; LAP: AUC 0.836 in men and 0.878 in women). FLI also demonstrated the strongest association with higher obesity prevalence across tertiles. ZJU showed good performance, whereas HSI and FLD exhibited lower accuracy, particularly among men. Lifestyle factors and education level influenced index values, with sedentary behavior, low adherence to the Mediterranean diet, and lower educational attainment associated with worse index performance. CONCLUSIONS: FLI and LAP are the most accurate non-invasive indices for identifying obesity-associated fatty liver in this large Spanish working population. Their performance varies by sex and is influenced by sociodemographic and lifestyle factors. These findings support the relevance of FLI and LAP for large-scale screening and highlight the importance of integrating lifestyle assessments into occupational health evaluations. .

  @article{marina_arroyo_diagnostic_2026,
  abstract = {OBJECTIVE: To evaluate the diagnostic accuracy of five non-invasive fatty liver indices and their association with obesity in a large cohort of Spanish workers, stratified by sex. PATIENTS AND METHODS: A cross-sectional analysis was conducted on 386,924 workers (232,814 men and 154,110 women) who underwent routine occupational health assessments between 2009 and 2019. Anthropometric, clinical, and biochemical parameters were collected following standardized procedures. Physical activity and adherence to the Mediterranean diet were assessed using validated IPAQ and PREDIMED questionnaires. Diagnostic performance was evaluated using ROC curves and area under the curve (AUC) values for each fatty liver index. RESULTS: All indices showed significant sex-based differences. FLI and LAP presented the highest AUC values for identifying obesity in both sexes (FLI: AUC 0.907 in men and 0.972 in women; LAP: AUC 0.836 in men and 0.878 in women). FLI also demonstrated the strongest association with higher obesity prevalence across tertiles. ZJU showed good performance, whereas HSI and FLD exhibited lower accuracy, particularly among men. Lifestyle factors and education level influenced index values, with sedentary behavior, low adherence to the Mediterranean diet, and lower educational attainment associated with worse index performance. CONCLUSIONS: FLI and LAP are the most accurate non-invasive indices for identifying obesity-associated fatty liver in this large Spanish working population. Their performance varies by sex and is influenced by sociodemographic and lifestyle factors. These findings support the relevance of FLI and LAP for large-scale screening and highlight the importance of integrating lifestyle assessments into occupational health evaluations. .},
  author = {Marina Arroyo, Marta and Ramírez Gallegos, Ignacio and López-González, Ángel Arturo and Busquets-Cortés, Carla and Obrador de Hevia, Joan and Tárraga López, Pedro Juan and Ramírez-Manent, José Ignacio},
  journal = {Gastroenterologia Y Hepatologia},
  keywords = {grapp-caib},
  month = {jan},
  pages = 502656,
  title = {Diagnostic accuracy of non-invasive fatty liver indexes and their association with ECORE-BF scale in a cohort of 386,924 Spanish workers},
  year = 2026
  }
  

  %0 Journal Article
  %1 marina_arroyo_diagnostic_2026
  %A Marina Arroyo, Marta
  %A Ramírez Gallegos, Ignacio
  %A López-González, Ángel Arturo
  %A Busquets-Cortés, Carla
  %A Obrador de Hevia, Joan
  %A Tárraga López, Pedro Juan
  %A Ramírez-Manent, José Ignacio
  %D 2026
  %J Gastroenterologia Y Hepatologia
  %P 502656
  %R 10.1016/j.gastrohep.2026.502656
  %T Diagnostic accuracy of non-invasive fatty liver indexes and their association with ECORE-BF scale in a cohort of 386,924 Spanish workers
  %X OBJECTIVE: To evaluate the diagnostic accuracy of five non-invasive fatty liver indices and their association with obesity in a large cohort of Spanish workers, stratified by sex. PATIENTS AND METHODS: A cross-sectional analysis was conducted on 386,924 workers (232,814 men and 154,110 women) who underwent routine occupational health assessments between 2009 and 2019. Anthropometric, clinical, and biochemical parameters were collected following standardized procedures. Physical activity and adherence to the Mediterranean diet were assessed using validated IPAQ and PREDIMED questionnaires. Diagnostic performance was evaluated using ROC curves and area under the curve (AUC) values for each fatty liver index. RESULTS: All indices showed significant sex-based differences. FLI and LAP presented the highest AUC values for identifying obesity in both sexes (FLI: AUC 0.907 in men and 0.972 in women; LAP: AUC 0.836 in men and 0.878 in women). FLI also demonstrated the strongest association with higher obesity prevalence across tertiles. ZJU showed good performance, whereas HSI and FLD exhibited lower accuracy, particularly among men. Lifestyle factors and education level influenced index values, with sedentary behavior, low adherence to the Mediterranean diet, and lower educational attainment associated with worse index performance. CONCLUSIONS: FLI and LAP are the most accurate non-invasive indices for identifying obesity-associated fatty liver in this large Spanish working population. Their performance varies by sex and is influenced by sociodemographic and lifestyle factors. These findings support the relevance of FLI and LAP for large-scale screening and highlight the importance of integrating lifestyle assessments into occupational health evaluations. .
  

• 
  1.

  Vieira RJ, Gil-Mata S, Ferreira A, Riera-Serra P, Bognanni A, Duarte VH, Viegas H, Pereira AM, Ferreira-da Silva R, Ferreira-Cardoso H, Marques-Cruz M, Castro-Teles J, Campos-Lopes M, Teixeira-Ferreira A, Lourenço-Silva N, Boechat JL, Borowiack E, Sadowska E, Costa RA, Perestrelo P, Pereira MS, Pereira-Macedo J, Ierodiakonou D, Chu AWL, Calvi IP, Torres MI, Silva Ribeiro RA, Thomander T, Valiulis A, Cherrez-Ojeda I, Bedbrook A, Klimek L, Yepes Nuñez JJ, Zuberbier T, Fonseca JA, Schünemann HJ, Bousquet J, Sousa-Pinto B. Efficacy and safety of oral antihistamines for allergic rhinitis: Network meta-analysis. J Allergy Clin Immunol Pract. 2026;.

  BibTeXEndNoteDOIBibSonomyDownload

  @article{RN6,
  author = {Vieira, R. J. and Gil-Mata, S. and Ferreira, A. and Riera-Serra, P. and Bognanni, A. and Duarte, V. H. and Viegas, H. and Pereira, A. M. and Ferreira-da Silva, R. and Ferreira-Cardoso, H. and Marques-Cruz, M. and Castro-Teles, J. and Campos-Lopes, M. and Teixeira-Ferreira, A. and Lourenço-Silva, N. and Boechat, J. L. and Borowiack, E. and Sadowska, E. and Costa, R. A. and Perestrelo, P. and Pereira, M. S. and Pereira-Macedo, J. and Ierodiakonou, D. and Chu, A. W. L. and Calvi, I. P. and Torres, M. I. and Silva Ribeiro, R. A. and Thomander, T. and Valiulis, A. and Cherrez-Ojeda, I. and Bedbrook, A. and Klimek, L. and Yepes Nuñez, J. J. and Zuberbier, T. and Fonseca, J. A. and Schünemann, H. J. and Bousquet, J. and Sousa-Pinto, B.},
  journal = {J Allergy Clin Immunol Pract},
  keywords = {evisap},
  title = {Efficacy and safety of oral antihistamines for allergic rhinitis: Network meta-analysis},
  type = {Journal Article},
  year = 2026
  }
  

  %0 Journal Article
  %1 RN6
  %A Vieira, R. J.
  %A Gil-Mata, S.
  %A Ferreira, A.
  %A Riera-Serra, P.
  %A Bognanni, A.
  %A Duarte, V. H.
  %A Viegas, H.
  %A Pereira, A. M.
  %A Ferreira-da Silva, R.
  %A Ferreira-Cardoso, H.
  %A Marques-Cruz, M.
  %A Castro-Teles, J.
  %A Campos-Lopes, M.
  %A Teixeira-Ferreira, A.
  %A Lourenço-Silva, N.
  %A Boechat, J. L.
  %A Borowiack, E.
  %A Sadowska, E.
  %A Costa, R. A.
  %A Perestrelo, P.
  %A Pereira, M. S.
  %A Pereira-Macedo, J.
  %A Ierodiakonou, D.
  %A Chu, A. W. L.
  %A Calvi, I. P.
  %A Torres, M. I.
  %A Silva Ribeiro, R. A.
  %A Thomander, T.
  %A Valiulis, A.
  %A Cherrez-Ojeda, I.
  %A Bedbrook, A.
  %A Klimek, L.
  %A Yepes Nuñez, J. J.
  %A Zuberbier, T.
  %A Fonseca, J. A.
  %A Schünemann, H. J.
  %A Bousquet, J.
  %A Sousa-Pinto, B.
  %D 2026
  %J J Allergy Clin Immunol Pract
  %R 10.1016/j.jaip.2025.12.034
  %T Efficacy and safety of oral antihistamines for allergic rhinitis: Network meta-analysis
  

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  1.

  Vidal-Thomàs MC, Ripoll Amengual J, Cacereño Jiménez MB, Sempere Andrés P, Urbina Sampedro E, March Llull S. Qualitative evaluation of a community intervention in educational centres: Opinion of the professionals involved. Anales Del Sistema Sanitario De Navarra. 2026 Apr.;49(1):e1150.

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  BACKGROUND: Consulta Joven is a community intervention developed in primary care to address adolescents´ health needs. It offers open health consultations in secondary schools within a context of trust and confidentiality and is complemented by additional health promotion activities. This study explores the perceptions of professionals involved in the programme regarding challenges and key elements influencing its implementation. METHODS: A qualitative, descriptive-interpretive approach study was conducted in primary care in Mallorca (Spain) in 2017. Participants were recruited by Consulta Joven coordinators using purposive theoretical sampling. Three focus groups were conducted with ten nurses, four physicians, and six teachers. Two researchers independently coded transcripts using a general inductive approach. Categories were developed through content analysis and refined through team discussion. RESULTS: Four categories emerged: Perceived value and usefulness of Consulta Joven, Barriers to implementation, Key elements for programme development, and Proposals for improvement. Participants described Consulta Joven as an effective strategy to reach adolescents, promote healthy behaviours, and identify health problems before they seek medical care. Trust and confidentiality are highlighted as essential for its success, along with intersectoral collaboration with community stakeholders. Conclusions, Professionals perceive Consulta Joven as a useful intervention to adolescent health promotion. Strengthening institutional support and collaboration between the health and education sectors, and introducing the programme at earlier educational stages, may enhance its preventive impact.

  @article{vidal-thomas_qualitative_2026,
  abstract = {BACKGROUND: Consulta Joven is a community intervention developed in primary care to address adolescents´ health needs. It offers open health consultations in secondary schools within a context of trust and confidentiality and is complemented by additional health promotion activities. This study explores the perceptions of professionals involved in the programme regarding challenges and key elements influencing its implementation. METHODS: A qualitative, descriptive-interpretive approach study was conducted in primary care in Mallorca (Spain) in 2017. Participants were recruited by Consulta Joven coordinators using purposive theoretical sampling. Three focus groups were conducted with ten nurses, four physicians, and six teachers. Two researchers independently coded transcripts using a general inductive approach. Categories were developed through content analysis and refined through team discussion. RESULTS: Four categories emerged: Perceived value and usefulness of Consulta Joven, Barriers to implementation, Key elements for programme development, and Proposals for improvement. Participants described Consulta Joven as an effective strategy to reach adolescents, promote healthy behaviours, and identify health problems before they seek medical care. Trust and confidentiality are highlighted as essential for its success, along with intersectoral collaboration with community stakeholders. Conclusions, Professionals perceive Consulta Joven as a useful intervention to adolescent health promotion. Strengthening institutional support and collaboration between the health and education sectors, and introducing the programme at earlier educational stages, may enhance its preventive impact.},
  author = {Vidal-Thomàs, Maria Clara and Ripoll Amengual, Joana and Cacereño Jiménez, Maria Belén and Sempere Andrés, Pau and Urbina Sampedro, Elisa and March Llull, Sebastiá},
  journal = {Anales Del Sistema Sanitario De Navarra},
  keywords = {grapp-caib},
  month = {apr},
  number = 1,
  pages = {e1150},
  title = {Qualitative evaluation of a community intervention in educational centres: Opinion of the professionals involved},
  volume = 49,
  year = 2026
  }
  

  %0 Journal Article
  %1 vidal-thomas_qualitative_2026
  %A Vidal-Thomàs, Maria Clara
  %A Ripoll Amengual, Joana
  %A Cacereño Jiménez, Maria Belén
  %A Sempere Andrés, Pau
  %A Urbina Sampedro, Elisa
  %A March Llull, Sebastiá
  %D 2026
  %J Anales Del Sistema Sanitario De Navarra
  %N 1
  %P e1150
  %R 10.23938/ASSN.1150
  %T Qualitative evaluation of a community intervention in educational centres: Opinion of the professionals involved
  %V 49
  %X BACKGROUND: Consulta Joven is a community intervention developed in primary care to address adolescents´ health needs. It offers open health consultations in secondary schools within a context of trust and confidentiality and is complemented by additional health promotion activities. This study explores the perceptions of professionals involved in the programme regarding challenges and key elements influencing its implementation. METHODS: A qualitative, descriptive-interpretive approach study was conducted in primary care in Mallorca (Spain) in 2017. Participants were recruited by Consulta Joven coordinators using purposive theoretical sampling. Three focus groups were conducted with ten nurses, four physicians, and six teachers. Two researchers independently coded transcripts using a general inductive approach. Categories were developed through content analysis and refined through team discussion. RESULTS: Four categories emerged: Perceived value and usefulness of Consulta Joven, Barriers to implementation, Key elements for programme development, and Proposals for improvement. Participants described Consulta Joven as an effective strategy to reach adolescents, promote healthy behaviours, and identify health problems before they seek medical care. Trust and confidentiality are highlighted as essential for its success, along with intersectoral collaboration with community stakeholders. Conclusions, Professionals perceive Consulta Joven as a useful intervention to adolescent health promotion. Strengthening institutional support and collaboration between the health and education sectors, and introducing the programme at earlier educational stages, may enhance its preventive impact.
  

• 
  1.

  Ramírez-Gallegos I, Tárraga López PJ, Marina Arroyo M, López-González Á A, Coll Campayo I, Busquets-Cortés C, Ramírez-Manent JI. Metabolic age as a marker of cardiometabolic risk: Relationships with metabolic syndrome, hypertriglyceridemic waist, and hypertensive waist phenotypes in a large occupational cohort. Semergen. 2026 Feb.;52(4):102725.

  AbstractBibTeXEndNoteDOIBibSonomy

  BACKGROUND: Metabolic age (MA) has been proposed as an integrative, clinically intuitive indicator of physiological aging that may capture clustered cardiometabolic risk better than single traits. OBJECTIVE: We examined the association and discriminative performance of MA with metabolic syndrome (MetS) defined by NCEP ATP III, IDF, and Joint Interim Statement (JIS) criteria, and with the hypertriglyceridemic waist (HTGW) and hypertensive waist (HTAW) phenotypes, in a large occupational cohort. METHODS: Cross-sectional analytic study of Spanish workers attending routine occupational health examinations (January-June 2022). A total of 8590 employees (4104 men; 4486 women), aged 18-69 years, with standardized anthropometry, blood pressure, and fasting laboratory testing were included. MA was obtained via multifrequency bioelectrical impedance analysis; high MA was defined as MA ≥chronological age. Negative MA values (metabolic age lower than chronological age) indicate a metabolically younger or healthier profile, while positive values reflect accelerated metabolic aging and higher cardiometabolic risk. Five multivariable logistic models estimated adjusted odds ratios (ORs, 95\% CI) for high MA across the five phenotypes; covariates included sex, age group, social class, smoking, physical activity, and Mediterranean diet adherence. Sex-stratified ROC analyses assessed discrimination (AUC); optimal thresholds were derived using Youden's index. RESULTS: High MA showed strong, independent associations with all phenotypes: MetS NCEP ATP III, OR 8.01 (95\% CI 6.79-9.24); MetS IDF, OR 10.96 (9.23-12.80); MetS JIS, OR 7.94 (6.78-9.10); HTGW, OR 7.44 (6.10-8.79); HTAW, OR 13.97 (11.82-16.13). Behavioral and socioeconomic gradients were coherent across models (e.g., physical inactivity OR range 3.99-4.60; low Mediterranean diet adherence 2.38-2.61; smoking 1.17-1.23; lower social class III 2.27-2.42; men vs women 1.07-1.18). Sex-specific ROC analyses indicated good discrimination: AUCs (women/men) were 0.836/0.825 (NCEP ATP III), 0.835/0.833 (IDF), 0.819/0.807 (JIS), 0.813/0.849 (HTGW), and 0.827/0.865 (HTAW). Optimal MA cut-offs (difference MA-chronological age) ranged from -2 to +2 years across phenotypes and sex, yielding balanced sensitivity (∼75-82\%) and specificity (∼75-77\%). CONCLUSIONS: In a large occupational cohort, MA - derived from bioimpedance - was strongly and consistently associated with MetS (across three definitions) and with HTGW and HTAW, and it discriminated these phenotypes with AUCs ∼0.81-0.87. MA appears to be a feasible, low-burden metric that complements waist-based screening to prioritize preventive actions in workplace health programs. Longitudinal and interventional studies are warranted to confirm temporal relationships, refine MA thresholds by sex and age, and quantify incremental prognostic value beyond established risk indices.

  @article{ramirez-gallegos_metabolic_2026,
  abstract = {BACKGROUND: Metabolic age (MA) has been proposed as an integrative, clinically intuitive indicator of physiological aging that may capture clustered cardiometabolic risk better than single traits. OBJECTIVE: We examined the association and discriminative performance of MA with metabolic syndrome (MetS) defined by NCEP ATP III, IDF, and Joint Interim Statement (JIS) criteria, and with the hypertriglyceridemic waist (HTGW) and hypertensive waist (HTAW) phenotypes, in a large occupational cohort. METHODS: Cross-sectional analytic study of Spanish workers attending routine occupational health examinations (January-June 2022). A total of 8590 employees (4104 men; 4486 women), aged 18-69 years, with standardized anthropometry, blood pressure, and fasting laboratory testing were included. MA was obtained via multifrequency bioelectrical impedance analysis; high MA was defined as MA ≥chronological age. Negative MA values (metabolic age lower than chronological age) indicate a metabolically younger or healthier profile, while positive values reflect accelerated metabolic aging and higher cardiometabolic risk. Five multivariable logistic models estimated adjusted odds ratios (ORs, 95\% CI) for high MA across the five phenotypes; covariates included sex, age group, social class, smoking, physical activity, and Mediterranean diet adherence. Sex-stratified ROC analyses assessed discrimination (AUC); optimal thresholds were derived using Youden's index. RESULTS: High MA showed strong, independent associations with all phenotypes: MetS NCEP ATP III, OR 8.01 (95\% CI 6.79-9.24); MetS IDF, OR 10.96 (9.23-12.80); MetS JIS, OR 7.94 (6.78-9.10); HTGW, OR 7.44 (6.10-8.79); HTAW, OR 13.97 (11.82-16.13). Behavioral and socioeconomic gradients were coherent across models (e.g., physical inactivity OR range 3.99-4.60; low Mediterranean diet adherence 2.38-2.61; smoking 1.17-1.23; lower social class III 2.27-2.42; men vs women 1.07-1.18). Sex-specific ROC analyses indicated good discrimination: AUCs (women/men) were 0.836/0.825 (NCEP ATP III), 0.835/0.833 (IDF), 0.819/0.807 (JIS), 0.813/0.849 (HTGW), and 0.827/0.865 (HTAW). Optimal MA cut-offs (difference MA-chronological age) ranged from -2 to +2 years across phenotypes and sex, yielding balanced sensitivity (∼75-82\%) and specificity (∼75-77\%). CONCLUSIONS: In a large occupational cohort, MA - derived from bioimpedance - was strongly and consistently associated with MetS (across three definitions) and with HTGW and HTAW, and it discriminated these phenotypes with AUCs ∼0.81-0.87. MA appears to be a feasible, low-burden metric that complements waist-based screening to prioritize preventive actions in workplace health programs. Longitudinal and interventional studies are warranted to confirm temporal relationships, refine MA thresholds by sex and age, and quantify incremental prognostic value beyond established risk indices.},
  author = {Ramírez-Gallegos, I. and Tárraga López, P. J. and Marina Arroyo, M. and López-González, Á A. and Coll Campayo, I. and Busquets-Cortés, C. and Ramírez-Manent, J. I.},
  journal = {Semergen},
  keywords = {grapp-caib},
  month = {feb},
  number = 4,
  pages = 102725,
  title = {Metabolic age as a marker of cardiometabolic risk: Relationships with metabolic syndrome, hypertriglyceridemic waist, and hypertensive waist phenotypes in a large occupational cohort},
  volume = 52,
  year = 2026
  }
  

  %0 Journal Article
  %1 ramirez-gallegos_metabolic_2026
  %A Ramírez-Gallegos, I.
  %A Tárraga López, P. J.
  %A Marina Arroyo, M.
  %A López-González, Á A.
  %A Coll Campayo, I.
  %A Busquets-Cortés, C.
  %A Ramírez-Manent, J. I.
  %D 2026
  %J Semergen
  %N 4
  %P 102725
  %R 10.1016/j.semerg.2026.102725
  %T Metabolic age as a marker of cardiometabolic risk: Relationships with metabolic syndrome, hypertriglyceridemic waist, and hypertensive waist phenotypes in a large occupational cohort
  %V 52
  %X BACKGROUND: Metabolic age (MA) has been proposed as an integrative, clinically intuitive indicator of physiological aging that may capture clustered cardiometabolic risk better than single traits. OBJECTIVE: We examined the association and discriminative performance of MA with metabolic syndrome (MetS) defined by NCEP ATP III, IDF, and Joint Interim Statement (JIS) criteria, and with the hypertriglyceridemic waist (HTGW) and hypertensive waist (HTAW) phenotypes, in a large occupational cohort. METHODS: Cross-sectional analytic study of Spanish workers attending routine occupational health examinations (January-June 2022). A total of 8590 employees (4104 men; 4486 women), aged 18-69 years, with standardized anthropometry, blood pressure, and fasting laboratory testing were included. MA was obtained via multifrequency bioelectrical impedance analysis; high MA was defined as MA ≥chronological age. Negative MA values (metabolic age lower than chronological age) indicate a metabolically younger or healthier profile, while positive values reflect accelerated metabolic aging and higher cardiometabolic risk. Five multivariable logistic models estimated adjusted odds ratios (ORs, 95\% CI) for high MA across the five phenotypes; covariates included sex, age group, social class, smoking, physical activity, and Mediterranean diet adherence. Sex-stratified ROC analyses assessed discrimination (AUC); optimal thresholds were derived using Youden's index. RESULTS: High MA showed strong, independent associations with all phenotypes: MetS NCEP ATP III, OR 8.01 (95\% CI 6.79-9.24); MetS IDF, OR 10.96 (9.23-12.80); MetS JIS, OR 7.94 (6.78-9.10); HTGW, OR 7.44 (6.10-8.79); HTAW, OR 13.97 (11.82-16.13). Behavioral and socioeconomic gradients were coherent across models (e.g., physical inactivity OR range 3.99-4.60; low Mediterranean diet adherence 2.38-2.61; smoking 1.17-1.23; lower social class III 2.27-2.42; men vs women 1.07-1.18). Sex-specific ROC analyses indicated good discrimination: AUCs (women/men) were 0.836/0.825 (NCEP ATP III), 0.835/0.833 (IDF), 0.819/0.807 (JIS), 0.813/0.849 (HTGW), and 0.827/0.865 (HTAW). Optimal MA cut-offs (difference MA-chronological age) ranged from -2 to +2 years across phenotypes and sex, yielding balanced sensitivity (∼75-82\%) and specificity (∼75-77\%). CONCLUSIONS: In a large occupational cohort, MA - derived from bioimpedance - was strongly and consistently associated with MetS (across three definitions) and with HTGW and HTAW, and it discriminated these phenotypes with AUCs ∼0.81-0.87. MA appears to be a feasible, low-burden metric that complements waist-based screening to prioritize preventive actions in workplace health programs. Longitudinal and interventional studies are warranted to confirm temporal relationships, refine MA thresholds by sex and age, and quantify incremental prognostic value beyond established risk indices.
  

• 
  1.

  Oliva-Fanlo B, Esteva M, Ramírez-Manent JI, Albaladejo-Dávalos A, Corcoll-Reixach J, Gadea-Ruiz MC, Morán-Bayón Álvaro, Bulilete O. Lung ultrasound performed by primary care physicians as a predictive and diagnostic tool in COVID-19 patients. NPJ primary care respiratory medicine. 2026 Apr.;.

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  To assess the value of abnormal findings of lung POCUS performed by PCPs in patients with SARS-CoV-2 virus infection in predicting hospitalisations, intensive care admissions, and mortality. Additionally, this study aims to assess the validity of lung POCUS performed by PCPs for COVID-19 pneumonia diagnosis. This prospective observational study, conducted in Mallorca and Salamanca, Spain, during 2021, assessed 624 consecutive adult patients with confirmed SARS-CoV-2 infection and worsening symptoms. Eight PCPs with 5-hour standardized training performed 12-zone lung POCUS. POCUS was considered positive if pleural abnormalities with ≥3 B-lines, subpleural consolidation, or lobar consolidation were present. Patients were followed for 30 days to confirm pneumonia diagnosis via chest X-ray or CT scan. Multivariate models using Poisson regression were performed to identify independent predictors for hospitalization and ICU admission/death. Abnormal POCUS findings were observed in 58.8% of patients, of whom 50.3% presented pleural abnormalities with 3 or more B-lines in at least one scanned area, 27.6% subpleural consolidations, and 3.4% lobar consolidations. Patients with positive POCUS were referred to the hospital more frequently (72.4\% vs. 22.8\%; OR = 8.83). Abnormal lung POCUS was independently associated with an increased risk of hospitalization (RR 1.34; 95\% CI 1.07-1.67), along with age textgreater50 years, SpO2 textless95%, hypertension, and diabetes. POCUS was not independently associated with the composite outcome of ICU admission or death (RR 1.27; 95\% CI 0.62-2.61). For the diagnosis of COVID-19 pneumonia, overall POCUS sensitivity was 68.3%, specificity 43.6%, positive predictive value 78.7%, and negative predictive value 31.1%. Lung POCUS performed by PCPs is a valuable independent predictor for hospitalization in COVID-19 patients within community settings. While its incremental prognostic benefit over simple clinical variables is modest and its diagnostic accuracy for pneumonia is limited compared to conventional imaging, it could remain as a useful tool for risk stratification in resource-limited environments or home-based care. These findings support its use in resource-limited environments and highlight the need for standardised scanning protocols and training.

  @article{oliva-fanlo_lung_2026,
  abstract = {To assess the value of abnormal findings of lung POCUS performed by PCPs in patients with SARS-CoV-2 virus infection in predicting hospitalisations, intensive care admissions, and mortality. Additionally, this study aims to assess the validity of lung POCUS performed by PCPs for COVID-19 pneumonia diagnosis. This prospective observational study, conducted in Mallorca and Salamanca, Spain, during 2021, assessed 624 consecutive adult patients with confirmed SARS-CoV-2 infection and worsening symptoms. Eight PCPs with 5-hour standardized training performed 12-zone lung POCUS. POCUS was considered positive if pleural abnormalities with ≥3 B-lines, subpleural consolidation, or lobar consolidation were present. Patients were followed for 30 days to confirm pneumonia diagnosis via chest X-ray or CT scan. Multivariate models using Poisson regression were performed to identify independent predictors for hospitalization and ICU admission/death. Abnormal POCUS findings were observed in 58.8% of patients, of whom 50.3% presented pleural abnormalities with 3 or more B-lines in at least one scanned area, 27.6% subpleural consolidations, and 3.4% lobar consolidations. Patients with positive POCUS were referred to the hospital more frequently (72.4\% vs. 22.8\%; OR = 8.83). Abnormal lung POCUS was independently associated with an increased risk of hospitalization (RR 1.34; 95\% CI 1.07-1.67), along with age textgreater50 years, SpO2 textless95%, hypertension, and diabetes. POCUS was not independently associated with the composite outcome of ICU admission or death (RR 1.27; 95\% CI 0.62-2.61). For the diagnosis of COVID-19 pneumonia, overall POCUS sensitivity was 68.3%, specificity 43.6%, positive predictive value 78.7%, and negative predictive value 31.1%. Lung POCUS performed by PCPs is a valuable independent predictor for hospitalization in COVID-19 patients within community settings. While its incremental prognostic benefit over simple clinical variables is modest and its diagnostic accuracy for pneumonia is limited compared to conventional imaging, it could remain as a useful tool for risk stratification in resource-limited environments or home-based care. These findings support its use in resource-limited environments and highlight the need for standardised scanning protocols and training.},
  author = {Oliva-Fanlo, Bernardino and Esteva, Magdalena and Ramírez-Manent, José Ignacio and Albaladejo-Dávalos, Antonio and Corcoll-Reixach, Josep and Gadea-Ruiz, Mª Cristina and Morán-Bayón, Álvaro and Bulilete, Oana},
  journal = {NPJ primary care respiratory medicine},
  keywords = {grapp-caib},
  month = {apr},
  title = {Lung ultrasound performed by primary care physicians as a predictive and diagnostic tool in COVID-19 patients},
  year = 2026
  }
  

  %0 Journal Article
  %1 oliva-fanlo_lung_2026
  %A Oliva-Fanlo, Bernardino
  %A Esteva, Magdalena
  %A Ramírez-Manent, José Ignacio
  %A Albaladejo-Dávalos, Antonio
  %A Corcoll-Reixach, Josep
  %A Gadea-Ruiz, Mª Cristina
  %A Morán-Bayón, Álvaro
  %A Bulilete, Oana
  %D 2026
  %J NPJ primary care respiratory medicine
  %R 10.1038/s41533-026-00515-4
  %T Lung ultrasound performed by primary care physicians as a predictive and diagnostic tool in COVID-19 patients
  %X To assess the value of abnormal findings of lung POCUS performed by PCPs in patients with SARS-CoV-2 virus infection in predicting hospitalisations, intensive care admissions, and mortality. Additionally, this study aims to assess the validity of lung POCUS performed by PCPs for COVID-19 pneumonia diagnosis. This prospective observational study, conducted in Mallorca and Salamanca, Spain, during 2021, assessed 624 consecutive adult patients with confirmed SARS-CoV-2 infection and worsening symptoms. Eight PCPs with 5-hour standardized training performed 12-zone lung POCUS. POCUS was considered positive if pleural abnormalities with ≥3 B-lines, subpleural consolidation, or lobar consolidation were present. Patients were followed for 30 days to confirm pneumonia diagnosis via chest X-ray or CT scan. Multivariate models using Poisson regression were performed to identify independent predictors for hospitalization and ICU admission/death. Abnormal POCUS findings were observed in 58.8% of patients, of whom 50.3% presented pleural abnormalities with 3 or more B-lines in at least one scanned area, 27.6% subpleural consolidations, and 3.4% lobar consolidations. Patients with positive POCUS were referred to the hospital more frequently (72.4\% vs. 22.8\%; OR = 8.83). Abnormal lung POCUS was independently associated with an increased risk of hospitalization (RR 1.34; 95\% CI 1.07-1.67), along with age textgreater50 years, SpO2 textless95%, hypertension, and diabetes. POCUS was not independently associated with the composite outcome of ICU admission or death (RR 1.27; 95\% CI 0.62-2.61). For the diagnosis of COVID-19 pneumonia, overall POCUS sensitivity was 68.3%, specificity 43.6%, positive predictive value 78.7%, and negative predictive value 31.1%. Lung POCUS performed by PCPs is a valuable independent predictor for hospitalization in COVID-19 patients within community settings. While its incremental prognostic benefit over simple clinical variables is modest and its diagnostic accuracy for pneumonia is limited compared to conventional imaging, it could remain as a useful tool for risk stratification in resource-limited environments or home-based care. These findings support its use in resource-limited environments and highlight the need for standardised scanning protocols and training.
  

• 
  1.

  Riutord P, Tarraga PJ, Lopez-Gonzalez AA, Coll-Campayo I, Busquets C, Ramirez-Manent JI. Interplay of Lifestyle Social Determinants and Isolation in the Risk of Metabolic Syndrome Among Spanish Workers. Cureus. 2026 Jan.;18(1):e101624.

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  BACKGROUND: Metabolic syndrome (MetS) is a cluster of cardiometabolic abnormalities linked to cardiovascular disease and type 2 diabetes mellitus. While lifestyle and sociodemographic determinants are well established, the role of social isolation in MetS is less explored. METHODS: A nationwide cross-sectional study included 117,298 Spanish workers from multiple occupational sectors (2021-2024). MetS was defined using National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) III, International Diabetes Federation (IDF), and Joint Interim Statement (JIS) criteria. Sociodemographic, lifestyle, and psychosocial variables were assessed with standardized questionnaires, including the ENRICHD Social Support Instrument. Logistic regression estimated associations with MetS prevalence. RESULTS: MetS prevalence was 28.7% (NCEP ATP III), 32.1% (IDF), and 33.5% (JIS). Men had consistently higher prevalence than women (p\textless0.001). Prevalence rose with age, exceeding 40% in workers ≥55 years. Low socioeconomic status was linked to a higher prevalence (p\textless0.001). Lifestyle factors were strongly associated: physical inactivity doubled the odds of MetS (OR≈2.0); poor Mediterranean diet adherence and smoking increased risk, while regular activity and high dietary adherence were protective (all p\textless0.001). Low social support independently increased the odds of MetS across all definitions, even after adjustment. CONCLUSIONS: In this large cohort, MetS was highly prevalent and strongly influenced by lifestyle, sociodemographic, and psychosocial factors. Social isolation emerged as an independent determinant, underscoring the need for workplace strategies integrating lifestyle promotion with social support.

  @article{riutord_interplay_2026,
  abstract = {BACKGROUND: Metabolic syndrome (MetS) is a cluster of cardiometabolic abnormalities linked to cardiovascular disease and type 2 diabetes mellitus. While lifestyle and sociodemographic determinants are well established, the role of social isolation in MetS is less explored. METHODS: A nationwide cross-sectional study included 117,298 Spanish workers from multiple occupational sectors (2021-2024). MetS was defined using National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) III, International Diabetes Federation (IDF), and Joint Interim Statement (JIS) criteria. Sociodemographic, lifestyle, and psychosocial variables were assessed with standardized questionnaires, including the ENRICHD Social Support Instrument. Logistic regression estimated associations with MetS prevalence. RESULTS: MetS prevalence was 28.7% (NCEP ATP III), 32.1% (IDF), and 33.5% (JIS). Men had consistently higher prevalence than women (p\textless0.001). Prevalence rose with age, exceeding 40% in workers ≥55 years. Low socioeconomic status was linked to a higher prevalence (p\textless0.001). Lifestyle factors were strongly associated: physical inactivity doubled the odds of MetS (OR≈2.0); poor Mediterranean diet adherence and smoking increased risk, while regular activity and high dietary adherence were protective (all p\textless0.001). Low social support independently increased the odds of MetS across all definitions, even after adjustment. CONCLUSIONS: In this large cohort, MetS was highly prevalent and strongly influenced by lifestyle, sociodemographic, and psychosocial factors. Social isolation emerged as an independent determinant, underscoring the need for workplace strategies integrating lifestyle promotion with social support.},
  author = {Riutord, Pere and Tarraga, Pedro J. and Lopez-Gonzalez, Angel A. and Coll-Campayo, Irene and Busquets, Carla and Ramirez-Manent, Jose I.},
  journal = {Cureus},
  keywords = {grapp-caib},
  month = {jan},
  number = 1,
  pages = {e101624},
  title = {Interplay of Lifestyle Social Determinants and Isolation in the Risk of Metabolic Syndrome Among Spanish Workers},
  volume = 18,
  year = 2026
  }
  

  %0 Journal Article
  %1 riutord_interplay_2026
  %A Riutord, Pere
  %A Tarraga, Pedro J.
  %A Lopez-Gonzalez, Angel A.
  %A Coll-Campayo, Irene
  %A Busquets, Carla
  %A Ramirez-Manent, Jose I.
  %D 2026
  %J Cureus
  %N 1
  %P e101624
  %R 10.7759/cureus.101624
  %T Interplay of Lifestyle Social Determinants and Isolation in the Risk of Metabolic Syndrome Among Spanish Workers
  %V 18
  %X BACKGROUND: Metabolic syndrome (MetS) is a cluster of cardiometabolic abnormalities linked to cardiovascular disease and type 2 diabetes mellitus. While lifestyle and sociodemographic determinants are well established, the role of social isolation in MetS is less explored. METHODS: A nationwide cross-sectional study included 117,298 Spanish workers from multiple occupational sectors (2021-2024). MetS was defined using National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) III, International Diabetes Federation (IDF), and Joint Interim Statement (JIS) criteria. Sociodemographic, lifestyle, and psychosocial variables were assessed with standardized questionnaires, including the ENRICHD Social Support Instrument. Logistic regression estimated associations with MetS prevalence. RESULTS: MetS prevalence was 28.7% (NCEP ATP III), 32.1% (IDF), and 33.5% (JIS). Men had consistently higher prevalence than women (p\textless0.001). Prevalence rose with age, exceeding 40% in workers ≥55 years. Low socioeconomic status was linked to a higher prevalence (p\textless0.001). Lifestyle factors were strongly associated: physical inactivity doubled the odds of MetS (OR≈2.0); poor Mediterranean diet adherence and smoking increased risk, while regular activity and high dietary adherence were protective (all p\textless0.001). Low social support independently increased the odds of MetS across all definitions, even after adjustment. CONCLUSIONS: In this large cohort, MetS was highly prevalent and strongly influenced by lifestyle, sociodemographic, and psychosocial factors. Social isolation emerged as an independent determinant, underscoring the need for workplace strategies integrating lifestyle promotion with social support.
  

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  1.

  Fernández-Figares Vicioso MP, Vicente-Herrero MT, Sbert PR, Ramírez-Manent JI, Tárraga Marcos PJ, Del Barrio Fernández JL, López-González Ángel A. Atherogenic Risk in Commerce and Industry Workers: Associations with Sociodemographic and Lifestyle Factors in a Large Spanish Occupational Cohort. Clinica E Investigacion En Arteriosclerosis: Publicacion Oficial De La Sociedad Espanola De Arteriosclerosis. 2026 Jan.;:500873.

  AbstractBibTeXEndNoteDOIBibSonomy

  BACKGROUND: Atherogenic dyslipidemia (AD) and associated lipid ratios are critical markers for cardiovascular risk, yet little is known about how these markers vary by occupational sector and sociodemographic or lifestyle factors in working populations. OBJECTIVE: To evaluate the prevalence and determinants of elevated atherogenic risk according to total cholesterol/HDL-c (TC/HDL-c), LDL-c/HDL-c, triglycerides/HDL-c (TG/HDL-c), and AD in workers from the commerce and industry sectors, stratified by sex, age, education, physical activity, diet, and smoking. METHODS: This cross-sectional study included 56,856 Spanish workers (39,448 men and 17,408 women) from commerce (n=27,448) and industry (n=29,408). Sociodemographic, clinical, and lifestyle data were collected, and atherogenic risk was assessed using TC/HDL-c, LDL-c/HDL-c, TG/HDL-c ratios, and AD presence. Mean values and prevalence were compared by group, and multinomial logistic regression was used to estimate the association between risk markers and covariates. RESULTS: Workers in the industry sector showed higher mean values and prevalence of all atherogenic risk scales compared to those in commerce, particularly among men and older age groups. Male sex, older age, lower education, physical inactivity, absence of Mediterranean diet, and smoking were consistently associated with higher odds of elevated lipid ratios and AD. Notably, the absence of physical activity was strongly associated with all outcomes, with ORs ranging from 3.08 to 11.66. The industrial sector was independently associated with increased risk: TC/HDL-c (OR=1.23), LDL-c/HDL-c (OR=1.15), TG/HDL-c (OR=1.16), and AD (OR=1.19). CONCLUSIONS: Atherogenic risk profiles are less favorable among industrial workers and are significantly influenced by modifiable lifestyle factors. These findings support the need for preventive strategies tailored to the occupational context, with emphasis on promoting physical activity, smoking cessation, and healthier dietary habits, in order to reduce cardiovascular risk in these populations.

  @article{fernandez-figares_vicioso_atherogenic_2026,
  abstract = {BACKGROUND: Atherogenic dyslipidemia (AD) and associated lipid ratios are critical markers for cardiovascular risk, yet little is known about how these markers vary by occupational sector and sociodemographic or lifestyle factors in working populations. OBJECTIVE: To evaluate the prevalence and determinants of elevated atherogenic risk according to total cholesterol/HDL-c (TC/HDL-c), LDL-c/HDL-c, triglycerides/HDL-c (TG/HDL-c), and AD in workers from the commerce and industry sectors, stratified by sex, age, education, physical activity, diet, and smoking. METHODS: This cross-sectional study included 56,856 Spanish workers (39,448 men and 17,408 women) from commerce (n=27,448) and industry (n=29,408). Sociodemographic, clinical, and lifestyle data were collected, and atherogenic risk was assessed using TC/HDL-c, LDL-c/HDL-c, TG/HDL-c ratios, and AD presence. Mean values and prevalence were compared by group, and multinomial logistic regression was used to estimate the association between risk markers and covariates. RESULTS: Workers in the industry sector showed higher mean values and prevalence of all atherogenic risk scales compared to those in commerce, particularly among men and older age groups. Male sex, older age, lower education, physical inactivity, absence of Mediterranean diet, and smoking were consistently associated with higher odds of elevated lipid ratios and AD. Notably, the absence of physical activity was strongly associated with all outcomes, with ORs ranging from 3.08 to 11.66. The industrial sector was independently associated with increased risk: TC/HDL-c (OR=1.23), LDL-c/HDL-c (OR=1.15), TG/HDL-c (OR=1.16), and AD (OR=1.19). CONCLUSIONS: Atherogenic risk profiles are less favorable among industrial workers and are significantly influenced by modifiable lifestyle factors. These findings support the need for preventive strategies tailored to the occupational context, with emphasis on promoting physical activity, smoking cessation, and healthier dietary habits, in order to reduce cardiovascular risk in these populations.},
  author = {Fernández-Figares Vicioso, María Pilar and Vicente-Herrero, María Teófila and Sbert, Pere Riutord and Ramírez-Manent, José Ignacio and Tárraga Marcos, Pedro Juan and Del Barrio Fernández, José Luis and López-González, Ángel Arturo},
  journal = {Clinica E Investigacion En Arteriosclerosis: Publicacion Oficial De La Sociedad Espanola De Arteriosclerosis},
  keywords = {grapp-caib},
  month = {jan},
  pages = 500873,
  title = {Atherogenic Risk in Commerce and Industry Workers: Associations with Sociodemographic and Lifestyle Factors in a Large Spanish Occupational Cohort},
  year = 2026
  }
  

  %0 Journal Article
  %1 fernandez-figares_vicioso_atherogenic_2026
  %A Fernández-Figares Vicioso, María Pilar
  %A Vicente-Herrero, María Teófila
  %A Sbert, Pere Riutord
  %A Ramírez-Manent, José Ignacio
  %A Tárraga Marcos, Pedro Juan
  %A Del Barrio Fernández, José Luis
  %A López-González, Ángel Arturo
  %D 2026
  %J Clinica E Investigacion En Arteriosclerosis: Publicacion Oficial De La Sociedad Espanola De Arteriosclerosis
  %P 500873
  %R 10.1016/j.arteri.2025.500873
  %T Atherogenic Risk in Commerce and Industry Workers: Associations with Sociodemographic and Lifestyle Factors in a Large Spanish Occupational Cohort
  %X BACKGROUND: Atherogenic dyslipidemia (AD) and associated lipid ratios are critical markers for cardiovascular risk, yet little is known about how these markers vary by occupational sector and sociodemographic or lifestyle factors in working populations. OBJECTIVE: To evaluate the prevalence and determinants of elevated atherogenic risk according to total cholesterol/HDL-c (TC/HDL-c), LDL-c/HDL-c, triglycerides/HDL-c (TG/HDL-c), and AD in workers from the commerce and industry sectors, stratified by sex, age, education, physical activity, diet, and smoking. METHODS: This cross-sectional study included 56,856 Spanish workers (39,448 men and 17,408 women) from commerce (n=27,448) and industry (n=29,408). Sociodemographic, clinical, and lifestyle data were collected, and atherogenic risk was assessed using TC/HDL-c, LDL-c/HDL-c, TG/HDL-c ratios, and AD presence. Mean values and prevalence were compared by group, and multinomial logistic regression was used to estimate the association between risk markers and covariates. RESULTS: Workers in the industry sector showed higher mean values and prevalence of all atherogenic risk scales compared to those in commerce, particularly among men and older age groups. Male sex, older age, lower education, physical inactivity, absence of Mediterranean diet, and smoking were consistently associated with higher odds of elevated lipid ratios and AD. Notably, the absence of physical activity was strongly associated with all outcomes, with ORs ranging from 3.08 to 11.66. The industrial sector was independently associated with increased risk: TC/HDL-c (OR=1.23), LDL-c/HDL-c (OR=1.15), TG/HDL-c (OR=1.16), and AD (OR=1.19). CONCLUSIONS: Atherogenic risk profiles are less favorable among industrial workers and are significantly influenced by modifiable lifestyle factors. These findings support the need for preventive strategies tailored to the occupational context, with emphasis on promoting physical activity, smoking cessation, and healthier dietary habits, in order to reduce cardiovascular risk in these populations.
  

• 
  1.

  López-González Ángel A, Ramírez-Manent JI, Martínez-Almoyna Rifá E, Paublini Oliveira H, Martorell Sánchez C, Tárraga López PJ. Association between sociodemographic variables, lifestyle factors, and stress with lipoprotein ratio values. Clinica E Investigacion En Arteriosclerosis: Publicacion Oficial De La Sociedad Espanola De Arteriosclerosis. 2026;38(2):500803.

  AbstractBibTeXEndNoteDOIBibSonomy

  INTRODUCTION: Atherosclerosis is a multifactorial process underlying major cardiovascular diseases (CVDs). Among the associated risk factors, lipoprotein ratios have been identified as key indicators of atherogenic risk. However, the influence of sociodemographic variables, lifestyle factors, and stress levels on lipoprotein ratios remains underexplored. OBJECTIVE: To analyze the relationship between sociodemographic variables, healthy lifestyle habits, and stress levels with lipoprotein ratios and atherogenic risk in a large cohort of Spanish workers. MATERIALS AND METHODS: A cross-sectional study was conducted in 24,244 Spanish workers. The association between age, gender, socioeconomic status, tobacco and alcohol consumption, physical activity, adherence to the Mediterranean diet, and stress levels with atherogenic risk scales, including atherogenic dyslipidemia (AD) and atherogenic índices, was evaluated. RESULTS: A significant association was found between all analyzed variables and lipoprotein ratios. The strongest associations were observed with age and gender, followed by occupational status, tobacco and alcohol consumption, physical activity, diet, and stress levels. Men exhibited a higher atherogenic risk compared to women (OR 2.36; 95\% CI 2.18-2.55). The risk increased significantly with age, peaking in the 50-69 age group (OR 5.00; 95\% CI 3.70-6.31). Manual workers had a higher prevalence of atherogenic dyslipidemia compared to non-manual workers (OR 1.35; 95\% CI 1.27-1.41). Furthermore, smoking (OR 1.84; 95\% CI 1.71-1.97) and alcohol consumption (OR 1.45; 95\% CI 1.36-1.55), physical inactivity (OR 1.90; 95\% CI 1.76-2.05), and low adherence to the Mediterranean diet (OR 1.72; 95\% CI 1.60-1.84) were associated with higher atherogenic index values. CONCLUSIONS: The presence of an adverse lipoprotein profile is strongly influenced by sociodemographic factors, lifestyle habits, and stress. Identifying these determinants may enable the implementation of preventive strategies aimed at reducing atherogenic risk and improving cardiovascular health in working populations.

  @article{lopez-gonzalez_association_2026,
  abstract = {INTRODUCTION: Atherosclerosis is a multifactorial process underlying major cardiovascular diseases (CVDs). Among the associated risk factors, lipoprotein ratios have been identified as key indicators of atherogenic risk. However, the influence of sociodemographic variables, lifestyle factors, and stress levels on lipoprotein ratios remains underexplored. OBJECTIVE: To analyze the relationship between sociodemographic variables, healthy lifestyle habits, and stress levels with lipoprotein ratios and atherogenic risk in a large cohort of Spanish workers. MATERIALS AND METHODS: A cross-sectional study was conducted in 24,244 Spanish workers. The association between age, gender, socioeconomic status, tobacco and alcohol consumption, physical activity, adherence to the Mediterranean diet, and stress levels with atherogenic risk scales, including atherogenic dyslipidemia (AD) and atherogenic índices, was evaluated. RESULTS: A significant association was found between all analyzed variables and lipoprotein ratios. The strongest associations were observed with age and gender, followed by occupational status, tobacco and alcohol consumption, physical activity, diet, and stress levels. Men exhibited a higher atherogenic risk compared to women (OR 2.36; 95\% CI 2.18-2.55). The risk increased significantly with age, peaking in the 50-69 age group (OR 5.00; 95\% CI 3.70-6.31). Manual workers had a higher prevalence of atherogenic dyslipidemia compared to non-manual workers (OR 1.35; 95\% CI 1.27-1.41). Furthermore, smoking (OR 1.84; 95\% CI 1.71-1.97) and alcohol consumption (OR 1.45; 95\% CI 1.36-1.55), physical inactivity (OR 1.90; 95\% CI 1.76-2.05), and low adherence to the Mediterranean diet (OR 1.72; 95\% CI 1.60-1.84) were associated with higher atherogenic index values. CONCLUSIONS: The presence of an adverse lipoprotein profile is strongly influenced by sociodemographic factors, lifestyle habits, and stress. Identifying these determinants may enable the implementation of preventive strategies aimed at reducing atherogenic risk and improving cardiovascular health in working populations.},
  author = {López-González, Ángel Arturo and Ramírez-Manent, José Ignacio and Martínez-Almoyna Rifá, Emilio and Paublini Oliveira, Hernán and Martorell Sánchez, Cristina and Tárraga López, Pedro Juan},
  journal = {Clinica E Investigacion En Arteriosclerosis: Publicacion Oficial De La Sociedad Espanola De Arteriosclerosis},
  keywords = {grapp-caib},
  number = 2,
  pages = 500803,
  title = {Association between sociodemographic variables, lifestyle factors, and stress with lipoprotein ratio values},
  volume = 38,
  year = 2026
  }
  

  %0 Journal Article
  %1 lopez-gonzalez_association_2026
  %A López-González, Ángel Arturo
  %A Ramírez-Manent, José Ignacio
  %A Martínez-Almoyna Rifá, Emilio
  %A Paublini Oliveira, Hernán
  %A Martorell Sánchez, Cristina
  %A Tárraga López, Pedro Juan
  %D 2026
  %J Clinica E Investigacion En Arteriosclerosis: Publicacion Oficial De La Sociedad Espanola De Arteriosclerosis
  %N 2
  %P 500803
  %R 10.1016/j.arteri.2025.500803
  %T Association between sociodemographic variables, lifestyle factors, and stress with lipoprotein ratio values
  %V 38
  %X INTRODUCTION: Atherosclerosis is a multifactorial process underlying major cardiovascular diseases (CVDs). Among the associated risk factors, lipoprotein ratios have been identified as key indicators of atherogenic risk. However, the influence of sociodemographic variables, lifestyle factors, and stress levels on lipoprotein ratios remains underexplored. OBJECTIVE: To analyze the relationship between sociodemographic variables, healthy lifestyle habits, and stress levels with lipoprotein ratios and atherogenic risk in a large cohort of Spanish workers. MATERIALS AND METHODS: A cross-sectional study was conducted in 24,244 Spanish workers. The association between age, gender, socioeconomic status, tobacco and alcohol consumption, physical activity, adherence to the Mediterranean diet, and stress levels with atherogenic risk scales, including atherogenic dyslipidemia (AD) and atherogenic índices, was evaluated. RESULTS: A significant association was found between all analyzed variables and lipoprotein ratios. The strongest associations were observed with age and gender, followed by occupational status, tobacco and alcohol consumption, physical activity, diet, and stress levels. Men exhibited a higher atherogenic risk compared to women (OR 2.36; 95\% CI 2.18-2.55). The risk increased significantly with age, peaking in the 50-69 age group (OR 5.00; 95\% CI 3.70-6.31). Manual workers had a higher prevalence of atherogenic dyslipidemia compared to non-manual workers (OR 1.35; 95\% CI 1.27-1.41). Furthermore, smoking (OR 1.84; 95\% CI 1.71-1.97) and alcohol consumption (OR 1.45; 95\% CI 1.36-1.55), physical inactivity (OR 1.90; 95\% CI 1.76-2.05), and low adherence to the Mediterranean diet (OR 1.72; 95\% CI 1.60-1.84) were associated with higher atherogenic index values. CONCLUSIONS: The presence of an adverse lipoprotein profile is strongly influenced by sociodemographic factors, lifestyle habits, and stress. Identifying these determinants may enable the implementation of preventive strategies aimed at reducing atherogenic risk and improving cardiovascular health in working populations.
  

• 
  1.

  Maier L, Sun Y, Kronberg J, Abner E, Metspalu A, Esko T, Coley K, Marenholz I, Weiss S, Foraita R, Karramass T, Mykkänen J, Hernandez-Pacheco N, Wang CA, Kitaba NT, Pechlivanis S, Bouzigon E, Pedersen C-ET, Schoos A-MM, Curtin JA, Kress S, Hernangomez-Laderas A, Foppiano F, Ashley S, Batini C, Bryant L, Homuth G, Gieger C, Gilles S, Lyytikäinen L-P, Rovio S, Pahkala K, Vernet R, Valenta R, Llop S, Torrent M, Böck A, Tang MLK, Schmidt-Weber CB, Metspalu A, Esko T, Sprikkelman AB, John C, Lee Y-A, Beyer K, Völzke H, Pigeot I, Traidl-Hoffmann C, Duijts L, Lu H, Raitakari OT, Lehtimäki T, Kähönen M, Thio CHL, Melén E, Pennell CE, Holloway JW, Mutius E von, Siroux V, Bønnelykke K, Custovic A, Simpson A, Schikowski T, Bilbao JR, Schaub B, Peters R, Kersten ETG, Vonk JM, Thiering E, Peters A, Koppelman GH, Standl M. Meta-analysis of genome-wide association studies of food allergy and IgE sensitization. Journal of Allergy and Clinical Immunology [Internet]. 2026 Feb.;. https://www.jacionline.org/article/S0091-6749(26)00093-X/fulltext

  URLBibTeXEndNoteDOIBibSonomyDownload

  @article{maier_meta-analysis_2026,
  author = {Maier, Lisa and Sun, Yidan and Kronberg, Jaanika and Abner, Erik and Metspalu, Andres and Esko, Tõnu and Coley, Kayesha and Marenholz, Ingo and Weiss, Stefan and Foraita, Ronja and Karramass, Tarik and Mykkänen, Juha and Hernandez-Pacheco, Natalia and Wang, Carol A. and Kitaba, Negusse T. and Pechlivanis, Sonali and Bouzigon, Emmanuelle and Pedersen, Casper-Emil Tingskov and Schoos, Ann-Marie M. and Curtin, John A. and Kress, Sara and Hernangomez-Laderas, Alba and Foppiano, Francesco and Ashley, Sarah and Batini, Chiara and Bryant, Luke and Homuth, Georg and Gieger, Christian and Gilles, Stefanie and Lyytikäinen, Leo-Pekka and Rovio, Suvi and Pahkala, Katja and Vernet, Raphaël and Valenta, Rudolf and Llop, Sabrina and Torrent, Maties and Böck, Andreas and Tang, Mimi L. K. and Schmidt-Weber, Carsten B. and Metspalu, Andres and Esko, Tõnu and Sprikkelman, Aline B. and John, Catherine and Lee, Young-Ae and Beyer, Kirsten and Völzke, Henry and Pigeot, Iris and Traidl-Hoffmann, Claudia and Duijts, Liesbeth and Lu, Haojie and Raitakari, Olli T. and Lehtimäki, Terho and Kähönen, Mika and Thio, Chris H. L. and Melén, Erik and Pennell, Craig E. and Holloway, John W. and Mutius, Erika von and Siroux, Valérie and Bønnelykke, Klaus and Custovic, Adnan and Simpson, Angela and Schikowski, Tamara and Bilbao, Jose Ramon and Schaub, Bianca and Peters, Rachel and Kersten, Elin T. G. and Vonk, Judith M. and Thiering, Elisabeth and Peters, Annette and Koppelman, Gerard H. and Standl, Marie},
  journal = {Journal of Allergy and Clinical Immunology},
  keywords = {grapp-caib},
  month = {feb},
  note = {Publisher: Elsevier},
  title = {Meta-analysis of genome-wide association studies of food allergy and IgE sensitization},
  year = 2026
  }
  

  %0 Journal Article
  %1 maier_meta-analysis_2026
  %A Maier, Lisa
  %A Sun, Yidan
  %A Kronberg, Jaanika
  %A Abner, Erik
  %A Metspalu, Andres
  %A Esko, Tõnu
  %A Coley, Kayesha
  %A Marenholz, Ingo
  %A Weiss, Stefan
  %A Foraita, Ronja
  %A Karramass, Tarik
  %A Mykkänen, Juha
  %A Hernandez-Pacheco, Natalia
  %A Wang, Carol A.
  %A Kitaba, Negusse T.
  %A Pechlivanis, Sonali
  %A Bouzigon, Emmanuelle
  %A Pedersen, Casper-Emil Tingskov
  %A Schoos, Ann-Marie M.
  %A Curtin, John A.
  %A Kress, Sara
  %A Hernangomez-Laderas, Alba
  %A Foppiano, Francesco
  %A Ashley, Sarah
  %A Batini, Chiara
  %A Bryant, Luke
  %A Homuth, Georg
  %A Gieger, Christian
  %A Gilles, Stefanie
  %A Lyytikäinen, Leo-Pekka
  %A Rovio, Suvi
  %A Pahkala, Katja
  %A Vernet, Raphaël
  %A Valenta, Rudolf
  %A Llop, Sabrina
  %A Torrent, Maties
  %A Böck, Andreas
  %A Tang, Mimi L. K.
  %A Schmidt-Weber, Carsten B.
  %A Metspalu, Andres
  %A Esko, Tõnu
  %A Sprikkelman, Aline B.
  %A John, Catherine
  %A Lee, Young-Ae
  %A Beyer, Kirsten
  %A Völzke, Henry
  %A Pigeot, Iris
  %A Traidl-Hoffmann, Claudia
  %A Duijts, Liesbeth
  %A Lu, Haojie
  %A Raitakari, Olli T.
  %A Lehtimäki, Terho
  %A Kähönen, Mika
  %A Thio, Chris H. L.
  %A Melén, Erik
  %A Pennell, Craig E.
  %A Holloway, John W.
  %A Mutius, Erika von
  %A Siroux, Valérie
  %A Bønnelykke, Klaus
  %A Custovic, Adnan
  %A Simpson, Angela
  %A Schikowski, Tamara
  %A Bilbao, Jose Ramon
  %A Schaub, Bianca
  %A Peters, Rachel
  %A Kersten, Elin T. G.
  %A Vonk, Judith M.
  %A Thiering, Elisabeth
  %A Peters, Annette
  %A Koppelman, Gerard H.
  %A Standl, Marie
  %D 2026
  %J Journal of Allergy and Clinical Immunology
  %R 10.1016/j.jaci.2026.02.012
  %T Meta-analysis of genome-wide association studies of food allergy and IgE sensitization
  %U https://www.jacionline.org/article/S0091-6749(26)00093-X/fulltext
  

• 
  1.

  Riera-Serra P, Serrano-Ripoll MJ, Fiol deRoque MA, García-Pazo P, Bennasar-Veny M, Yánez-Juan A, Leiva-Rus A, Ginard-Puigserver M, García-Toro M, Sitges C, Balle M, Gervilla E, Gonzalez-Garcia X, García-Buades ME, Blanes MW, Zamanillo-Campos R, Andreu-Rodrigo P, Ricci-Cabello I. Evaluation of the effectiveness of SOM-RIU, a multifaceted, school-based, suicide prevention intervention targeted to Spanish adolescents: study protocol for a cluster-randomised controlled trial. BMC Psychiatry. 2026;26(1):56.

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  BACKGROUND: Adolescent suicide is a major public health concern and the third leading cause of death among young people worldwide. Schools are widely recognized as effective settings for universal mental health promotion and suicide prevention. This study aims to evaluate the effectiveness of SOM-RIU, a multifaceted school-based intervention involving pupils and gatekeepers (teachers and parents) in preventing suicidal behaviour and promoting adolescent mental health. METHODS: We will conduct a six-month, two-arm, cluster-randomised controlled trial. We will recruit 2,280 pupils from 114 classrooms in 38 secondary schools across the Balearic Islands (Spain). Eligible pupils will be aged 12–16 and enrolled in the 2nd and 3rd years of compulsory secondary education. Schools will be randomly assigned (1:1) to either the intervention or control group. Schools in the intervention group will implement the SOM-RIU programme, which includes four weekly psychoeducational sessions for pupils, delivered by trained educational psychologists. These sessions focus on mental health literacy, emotional regulation, suicide risk detection and management, and help-seeking strategies. In parallel, gatekeepers (teachers and parents) will receive a digital educational co-intervention consisting in four multimedia modules to strengthen their role in suicide prevention. Schools in the control group will receive a minimal intervention consisting of educational posters on mental health and suicide prevention displayed within school premises. The primary outcome will be suicidal ideation (Paykel Suicide Scale). Secondary outcomes will include suicide attempts, depression symptoms, well-being, self-harm, substance use, internet addiction, bullying, and cognitive disconnection. Teachers and parents will report on suicide-related knowledge, self-efficacy, and student referrals. Data will be collected at baseline and six-month follow-up. Analyses will be conducted using generalized linear mixed models to account for clustering, and multiple imputation will be used for missing data. A qualitative process evaluation will explore implementation, acceptability, and perceived impact of the intervention, while also examining contextual factors and potential mechanisms of action that may have influenced the outcomes. DISCUSSION: This trial will generate evidence on the effectiveness of multifaceted, school-based suicide prevention interventions for adolescents. If effective, the SOM-RIU programme could serve as a practical model for enhancing mental health support within educational settings in Spain. TRIAL REGISTRATION: NCT06996054 (clinicaltrials.gov). Registration date: 2025-05-30. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12888-025-07570-0.

  @article{RN7,
  abstract = {BACKGROUND: Adolescent suicide is a major public health concern and the third leading cause of death among young people worldwide. Schools are widely recognized as effective settings for universal mental health promotion and suicide prevention. This study aims to evaluate the effectiveness of SOM-RIU, a multifaceted school-based intervention involving pupils and gatekeepers (teachers and parents) in preventing suicidal behaviour and promoting adolescent mental health. METHODS: We will conduct a six-month, two-arm, cluster-randomised controlled trial. We will recruit 2,280 pupils from 114 classrooms in 38 secondary schools across the Balearic Islands (Spain). Eligible pupils will be aged 12–16 and enrolled in the 2nd and 3rd years of compulsory secondary education. Schools will be randomly assigned (1:1) to either the intervention or control group. Schools in the intervention group will implement the SOM-RIU programme, which includes four weekly psychoeducational sessions for pupils, delivered by trained educational psychologists. These sessions focus on mental health literacy, emotional regulation, suicide risk detection and management, and help-seeking strategies. In parallel, gatekeepers (teachers and parents) will receive a digital educational co-intervention consisting in four multimedia modules to strengthen their role in suicide prevention. Schools in the control group will receive a minimal intervention consisting of educational posters on mental health and suicide prevention displayed within school premises. The primary outcome will be suicidal ideation (Paykel Suicide Scale). Secondary outcomes will include suicide attempts, depression symptoms, well-being, self-harm, substance use, internet addiction, bullying, and cognitive disconnection. Teachers and parents will report on suicide-related knowledge, self-efficacy, and student referrals. Data will be collected at baseline and six-month follow-up. Analyses will be conducted using generalized linear mixed models to account for clustering, and multiple imputation will be used for missing data. A qualitative process evaluation will explore implementation, acceptability, and perceived impact of the intervention, while also examining contextual factors and potential mechanisms of action that may have influenced the outcomes. DISCUSSION: This trial will generate evidence on the effectiveness of multifaceted, school-based suicide prevention interventions for adolescents. If effective, the SOM-RIU programme could serve as a practical model for enhancing mental health support within educational settings in Spain. TRIAL REGISTRATION: NCT06996054 (clinicaltrials.gov). Registration date: 2025-05-30. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12888-025-07570-0.},
  author = {Riera-Serra, P. and Serrano-Ripoll, M. J. and Fiol deRoque, M. A. and García-Pazo, P. and Bennasar-Veny, M. and Yánez-Juan, A. and Leiva-Rus, A. and Ginard-Puigserver, M. and García-Toro, M. and Sitges, C. and Balle, M. and Gervilla, E. and Gonzalez-Garcia, X. and García-Buades, M. E. and Blanes, M. W. and Zamanillo-Campos, R. and Andreu-Rodrigo, P. and Ricci-Cabello, I.},
  journal = {BMC Psychiatry},
  keywords = {evisap},
  number = 1,
  pages = 56,
  title = {Evaluation of the effectiveness of SOM-RIU, a multifaceted, school-based, suicide prevention intervention targeted to Spanish adolescents: study protocol for a cluster-randomised controlled trial},
  type = {Journal Article},
  volume = 26,
  year = 2026
  }
  

  %0 Journal Article
  %1 RN7
  %A Riera-Serra, P.
  %A Serrano-Ripoll, M. J.
  %A Fiol deRoque, M. A.
  %A García-Pazo, P.
  %A Bennasar-Veny, M.
  %A Yánez-Juan, A.
  %A Leiva-Rus, A.
  %A Ginard-Puigserver, M.
  %A García-Toro, M.
  %A Sitges, C.
  %A Balle, M.
  %A Gervilla, E.
  %A Gonzalez-Garcia, X.
  %A García-Buades, M. E.
  %A Blanes, M. W.
  %A Zamanillo-Campos, R.
  %A Andreu-Rodrigo, P.
  %A Ricci-Cabello, I.
  %D 2026
  %J BMC Psychiatry
  %N 1
  %P 56
  %R 10.1186/s12888-025-07570-0
  %T Evaluation of the effectiveness of SOM-RIU, a multifaceted, school-based, suicide prevention intervention targeted to Spanish adolescents: study protocol for a cluster-randomised controlled trial
  %V 26
  %X BACKGROUND: Adolescent suicide is a major public health concern and the third leading cause of death among young people worldwide. Schools are widely recognized as effective settings for universal mental health promotion and suicide prevention. This study aims to evaluate the effectiveness of SOM-RIU, a multifaceted school-based intervention involving pupils and gatekeepers (teachers and parents) in preventing suicidal behaviour and promoting adolescent mental health. METHODS: We will conduct a six-month, two-arm, cluster-randomised controlled trial. We will recruit 2,280 pupils from 114 classrooms in 38 secondary schools across the Balearic Islands (Spain). Eligible pupils will be aged 12–16 and enrolled in the 2nd and 3rd years of compulsory secondary education. Schools will be randomly assigned (1:1) to either the intervention or control group. Schools in the intervention group will implement the SOM-RIU programme, which includes four weekly psychoeducational sessions for pupils, delivered by trained educational psychologists. These sessions focus on mental health literacy, emotional regulation, suicide risk detection and management, and help-seeking strategies. In parallel, gatekeepers (teachers and parents) will receive a digital educational co-intervention consisting in four multimedia modules to strengthen their role in suicide prevention. Schools in the control group will receive a minimal intervention consisting of educational posters on mental health and suicide prevention displayed within school premises. The primary outcome will be suicidal ideation (Paykel Suicide Scale). Secondary outcomes will include suicide attempts, depression symptoms, well-being, self-harm, substance use, internet addiction, bullying, and cognitive disconnection. Teachers and parents will report on suicide-related knowledge, self-efficacy, and student referrals. Data will be collected at baseline and six-month follow-up. Analyses will be conducted using generalized linear mixed models to account for clustering, and multiple imputation will be used for missing data. A qualitative process evaluation will explore implementation, acceptability, and perceived impact of the intervention, while also examining contextual factors and potential mechanisms of action that may have influenced the outcomes. DISCUSSION: This trial will generate evidence on the effectiveness of multifaceted, school-based suicide prevention interventions for adolescents. If effective, the SOM-RIU programme could serve as a practical model for enhancing mental health support within educational settings in Spain. TRIAL REGISTRATION: NCT06996054 (clinicaltrials.gov). Registration date: 2025-05-30. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12888-025-07570-0.
  

• 
  1.

  Gervilla-García E, García-Pazo P, Guillén-Solà M, Leguizamo F, Ricci-Cabello I, Serrano-Ripoll MJ, Bennasar-Veny M, Fiol deRoque MA, Angullo-Martínez E, Zamanillo-Campos R. Stakeholder Perspectives on Implementing DiabeText: Exploring Barriers and Facilitators for a Personalized Diabetes Self-Management SMS Intervention in Spain. Diabetology. 2026;7:17.

  AbstractBibTeXEndNoteBibSonomyDownload

  Background/Objectives: Mobile health (mHealth) interventions can enhance chronic disease management, but their integration into public healthcare systems remains complex. DiabeText is the first SMS-based intervention in Spain delivering personalized diabetes self-management support using electronic health record data. This study explored perceived barriers and facilitators to the implementation of DiabeText in the Spanish public health context from the perspective of key stakeholders. Methods: A qualitative study was conducted using semi-structured interviews with 14 purposively selected stakeholders involved in digital health, diabetes care, data protection, and healthcare management across several Spanish regions. Interviews were thematically analyzed using Braun and Clarke’s approach and guided by the Implementation Research Logic Model. Results: Participants reported several barriers, including concerns regarding data protection, uncertainty about long-term sustainability, insufficient training and engagement of healthcare professionals and low digital literacy among certain patient groups. Facilitators included favorable institutional momentum for digital innovation, funding availability, perceived clinical utility and scalability of DiabeText, and growing patient familiarity with digital tools. Recommended strategies included integration into existing healthcare systems and workflows, professional training and use of familiar communication platforms. Conclusions: Effective implementation of DiabeText requires addressing regulatory, organizational, and equity-related barriers while leveraging institutional support and readiness for innovation. Early involvement of healthcare professionals, robust data governance, and investment in digital literacy are essential to ensure sustainable and equitable adoption. These findings provide actionable insights to support the integration of mHealth tools into chronic disease care in Spain and similar settings.

  @article{gervillagarcia2026stakeholder,
  abstract = {Background/Objectives: Mobile health (mHealth) interventions can enhance chronic disease management, but their integration into public healthcare systems remains complex. DiabeText is the first SMS-based intervention in Spain delivering personalized diabetes self-management support using electronic health record data. This study explored perceived barriers and facilitators to the implementation of DiabeText in the Spanish public health context from the perspective of key stakeholders. Methods: A qualitative study was conducted using semi-structured interviews with 14 purposively selected stakeholders involved in digital health, diabetes care, data protection, and healthcare management across several Spanish regions. Interviews were thematically analyzed using Braun and Clarke’s approach and guided by the Implementation Research Logic Model. Results: Participants reported several barriers, including concerns regarding data protection, uncertainty about long-term sustainability, insufficient training and engagement of healthcare professionals and low digital literacy among certain patient groups. Facilitators included favorable institutional momentum for digital innovation, funding availability, perceived clinical utility and scalability of DiabeText, and growing patient familiarity with digital tools. Recommended strategies included integration into existing healthcare systems and workflows, professional training and use of familiar communication platforms. Conclusions: Effective implementation of DiabeText requires addressing regulatory, organizational, and equity-related barriers while leveraging institutional support and readiness for innovation. Early involvement of healthcare professionals, robust data governance, and investment in digital literacy are essential to ensure sustainable and equitable adoption. These findings provide actionable insights to support the integration of mHealth tools into chronic disease care in Spain and similar settings.},
  author = {Gervilla-García, Elena and García-Pazo, Patricia and Guillén-Solà, Mireia and Leguizamo, Federico and Ricci-Cabello, Ignacio and Serrano-Ripoll, María J. and Bennasar-Veny, Miquel and Fiol deRoque, Maria A. and Angullo-Martínez, Escarlata and Zamanillo-Campos, Rocío},
  booktitle = {Diabetology},
  keywords = {evisap telemedicine},
  pages = 17,
  series = 1,
  title = {Stakeholder Perspectives on Implementing DiabeText: Exploring Barriers and Facilitators for a Personalized Diabetes Self-Management SMS Intervention in Spain},
  volume = 7,
  year = 2026
  }
  

  %0 Journal Article
  %1 gervillagarcia2026stakeholder
  %A Gervilla-García, Elena
  %A García-Pazo, Patricia
  %A Guillén-Solà, Mireia
  %A Leguizamo, Federico
  %A Ricci-Cabello, Ignacio
  %A Serrano-Ripoll, María J.
  %A Bennasar-Veny, Miquel
  %A Fiol deRoque, Maria A.
  %A Angullo-Martínez, Escarlata
  %A Zamanillo-Campos, Rocío
  %B Diabetology
  %D 2026
  %P 17
  %T Stakeholder Perspectives on Implementing DiabeText: Exploring Barriers and Facilitators for a Personalized Diabetes Self-Management SMS Intervention in Spain
  %V 7
  %X Background/Objectives: Mobile health (mHealth) interventions can enhance chronic disease management, but their integration into public healthcare systems remains complex. DiabeText is the first SMS-based intervention in Spain delivering personalized diabetes self-management support using electronic health record data. This study explored perceived barriers and facilitators to the implementation of DiabeText in the Spanish public health context from the perspective of key stakeholders. Methods: A qualitative study was conducted using semi-structured interviews with 14 purposively selected stakeholders involved in digital health, diabetes care, data protection, and healthcare management across several Spanish regions. Interviews were thematically analyzed using Braun and Clarke’s approach and guided by the Implementation Research Logic Model. Results: Participants reported several barriers, including concerns regarding data protection, uncertainty about long-term sustainability, insufficient training and engagement of healthcare professionals and low digital literacy among certain patient groups. Facilitators included favorable institutional momentum for digital innovation, funding availability, perceived clinical utility and scalability of DiabeText, and growing patient familiarity with digital tools. Recommended strategies included integration into existing healthcare systems and workflows, professional training and use of familiar communication platforms. Conclusions: Effective implementation of DiabeText requires addressing regulatory, organizational, and equity-related barriers while leveraging institutional support and readiness for innovation. Early involvement of healthcare professionals, robust data governance, and investment in digital literacy are essential to ensure sustainable and equitable adoption. These findings provide actionable insights to support the integration of mHealth tools into chronic disease care in Spain and similar settings.
  

• 
  1.

  Fernández-Figares Vicioso MP, Vicente-Herrero MT, Ramírez Gallegos A, Ramírez-Manent JI, Tárraga López PJ, Del Barrio Fernández JL, López-González Á A. [Association between sociodemographic factors and health habits and the risk of MASLD assessed by FLI, HSI, and LAP in Spanish workers from the commerce and industry sectors]. Semergen. 2026;52(1):102671.

  AbstractBibTeXEndNoteDOIBibSonomy

  INTRODUCTION: Metabolic dysfunction-associated steatotic liver disease (MASLD) has become a growing public health concern. Identifying associated sociodemographic and lifestyle factors is essential for implementing effective preventive strategies. OBJECTIVE: To analyze the association between sociodemographic variables (age, sex, educational level, and employment sector), health habits (physical activity, adherence to the Mediterranean diet, and smoking), and the risk of MASLD assessed through three non-invasive indexes: Fatty Liver Index (FLI), Hepatic Steatosis Index (HSI), and Lipid Accumulation Product (LAP), in a large cohort of Spanish workers from the commerce and industry sectors. METHODS: A cross-sectional study involving 56,856 workers (34,448 men and 22,408 women). FLI, HSI, and LAP were calculated, and their associations with the independent variables were analyzed using descriptive statistics, group comparisons, and multinomial logistic regression. RESULTS: High MASLD risk was significantly associated with male sex, older age, lower education, employment in the industrial sector, physical inactivity, poor adherence to the Mediterranean diet, and smoking (all p\textless0.001). Physical inactivity and a non-Mediterranean diet showed the strongest associations with elevated scores in FLI, HSI, and LAP. CONCLUSIONS: Preventive interventions should prioritize high-risk subgroups. The combined use of FLI, HSI, and LAP allows accurate identification of MASLD risk in occupational settings.

  @article{fernandez-figares_vicioso_association_2026,
  abstract = {INTRODUCTION: Metabolic dysfunction-associated steatotic liver disease (MASLD) has become a growing public health concern. Identifying associated sociodemographic and lifestyle factors is essential for implementing effective preventive strategies. OBJECTIVE: To analyze the association between sociodemographic variables (age, sex, educational level, and employment sector), health habits (physical activity, adherence to the Mediterranean diet, and smoking), and the risk of MASLD assessed through three non-invasive indexes: Fatty Liver Index (FLI), Hepatic Steatosis Index (HSI), and Lipid Accumulation Product (LAP), in a large cohort of Spanish workers from the commerce and industry sectors. METHODS: A cross-sectional study involving 56,856 workers (34,448 men and 22,408 women). FLI, HSI, and LAP were calculated, and their associations with the independent variables were analyzed using descriptive statistics, group comparisons, and multinomial logistic regression. RESULTS: High MASLD risk was significantly associated with male sex, older age, lower education, employment in the industrial sector, physical inactivity, poor adherence to the Mediterranean diet, and smoking (all p\textless0.001). Physical inactivity and a non-Mediterranean diet showed the strongest associations with elevated scores in FLI, HSI, and LAP. CONCLUSIONS: Preventive interventions should prioritize high-risk subgroups. The combined use of FLI, HSI, and LAP allows accurate identification of MASLD risk in occupational settings.},
  author = {Fernández-Figares Vicioso, M. P. and Vicente-Herrero, M. T. and Ramírez Gallegos, A. and Ramírez-Manent, J. I. and Tárraga López, P. J. and Del Barrio Fernández, J. L. and López-González, Á A.},
  journal = {Semergen},
  keywords = {grapp-caib},
  number = 1,
  pages = 102671,
  title = {[Association between sociodemographic factors and health habits and the risk of MASLD assessed by FLI, HSI, and LAP in Spanish workers from the commerce and industry sectors]},
  volume = 52,
  year = 2026
  }
  

  %0 Journal Article
  %1 fernandez-figares_vicioso_association_2026
  %A Fernández-Figares Vicioso, M. P.
  %A Vicente-Herrero, M. T.
  %A Ramírez Gallegos, A.
  %A Ramírez-Manent, J. I.
  %A Tárraga López, P. J.
  %A Del Barrio Fernández, J. L.
  %A López-González, Á A.
  %D 2026
  %J Semergen
  %N 1
  %P 102671
  %R 10.1016/j.semerg.2025.102671
  %T [Association between sociodemographic factors and health habits and the risk of MASLD assessed by FLI, HSI, and LAP in Spanish workers from the commerce and industry sectors]
  %V 52
  %X INTRODUCTION: Metabolic dysfunction-associated steatotic liver disease (MASLD) has become a growing public health concern. Identifying associated sociodemographic and lifestyle factors is essential for implementing effective preventive strategies. OBJECTIVE: To analyze the association between sociodemographic variables (age, sex, educational level, and employment sector), health habits (physical activity, adherence to the Mediterranean diet, and smoking), and the risk of MASLD assessed through three non-invasive indexes: Fatty Liver Index (FLI), Hepatic Steatosis Index (HSI), and Lipid Accumulation Product (LAP), in a large cohort of Spanish workers from the commerce and industry sectors. METHODS: A cross-sectional study involving 56,856 workers (34,448 men and 22,408 women). FLI, HSI, and LAP were calculated, and their associations with the independent variables were analyzed using descriptive statistics, group comparisons, and multinomial logistic regression. RESULTS: High MASLD risk was significantly associated with male sex, older age, lower education, employment in the industrial sector, physical inactivity, poor adherence to the Mediterranean diet, and smoking (all p\textless0.001). Physical inactivity and a non-Mediterranean diet showed the strongest associations with elevated scores in FLI, HSI, and LAP. CONCLUSIONS: Preventive interventions should prioritize high-risk subgroups. The combined use of FLI, HSI, and LAP allows accurate identification of MASLD risk in occupational settings.
  

• 
  1.

  Tárraga Marcos PJ, López-González Ángel A, Martínez-Almoyna Rifá E, Paublini Oliveira H, Martorell Sánchez C, Tárraga López PJ, Ramírez-Manent JI. Atherogenic risk in 44,939 Spanish healthcare workers: Associated variables. Clinica E Investigacion En Arteriosclerosis: Publicacion Oficial De La Sociedad Espanola De Arteriosclerosis. 2026;38(1):500821.

  AbstractBibTeXEndNoteDOIBibSonomy

  The article evaluates the atherogenic risk in 44,939 Spanish healthcare professionals by identifying the variables associated with this risk. It explains atherogenesis as the key pathological process in the development of cardiovascular diseases, characterized by the formation of atherosclerotic plaques resulting from atherogenic dyslipidemia. To quantify this risk, lipid indices (total cholesterol/HDL-c, LDL-c/HDL-c, and triglycerides/HDL-c ratios) were analyzed and related to factors such as age, sex, professional category, smoking, physical activity, and adherence to the Mediterranean diet. The results indicate that increasing age, male sex, smoking, and the lack of physical activity or adherence to a healthy diet are associated with higher atherogenic risk values. Furthermore, the study discusses its strengths (such as the large sample size and rigorous methodological design) and limitations, emphasizing the importance of comprehensive interventions and public health policies for the prevention and management of cardiovascular disease.

  @article{tarraga_marcos_atherogenic_2026,
  abstract = {The article evaluates the atherogenic risk in 44,939 Spanish healthcare professionals by identifying the variables associated with this risk. It explains atherogenesis as the key pathological process in the development of cardiovascular diseases, characterized by the formation of atherosclerotic plaques resulting from atherogenic dyslipidemia. To quantify this risk, lipid indices (total cholesterol/HDL-c, LDL-c/HDL-c, and triglycerides/HDL-c ratios) were analyzed and related to factors such as age, sex, professional category, smoking, physical activity, and adherence to the Mediterranean diet. The results indicate that increasing age, male sex, smoking, and the lack of physical activity or adherence to a healthy diet are associated with higher atherogenic risk values. Furthermore, the study discusses its strengths (such as the large sample size and rigorous methodological design) and limitations, emphasizing the importance of comprehensive interventions and public health policies for the prevention and management of cardiovascular disease.},
  author = {Tárraga Marcos, Pedro Javier and López-González, Ángel Arturo and Martínez-Almoyna Rifá, Emilio and Paublini Oliveira, Hernán and Martorell Sánchez, Cristina and Tárraga López, Pedro Juan and Ramírez-Manent, José Ignacio},
  journal = {Clinica E Investigacion En Arteriosclerosis: Publicacion Oficial De La Sociedad Espanola De Arteriosclerosis},
  keywords = {grapp-caib},
  number = 1,
  pages = 500821,
  title = {Atherogenic risk in 44,939 Spanish healthcare workers: Associated variables},
  volume = 38,
  year = 2026
  }
  

  %0 Journal Article
  %1 tarraga_marcos_atherogenic_2026
  %A Tárraga Marcos, Pedro Javier
  %A López-González, Ángel Arturo
  %A Martínez-Almoyna Rifá, Emilio
  %A Paublini Oliveira, Hernán
  %A Martorell Sánchez, Cristina
  %A Tárraga López, Pedro Juan
  %A Ramírez-Manent, José Ignacio
  %D 2026
  %J Clinica E Investigacion En Arteriosclerosis: Publicacion Oficial De La Sociedad Espanola De Arteriosclerosis
  %N 1
  %P 500821
  %R 10.1016/j.arteri.2025.500821
  %T Atherogenic risk in 44,939 Spanish healthcare workers: Associated variables
  %V 38
  %X The article evaluates the atherogenic risk in 44,939 Spanish healthcare professionals by identifying the variables associated with this risk. It explains atherogenesis as the key pathological process in the development of cardiovascular diseases, characterized by the formation of atherosclerotic plaques resulting from atherogenic dyslipidemia. To quantify this risk, lipid indices (total cholesterol/HDL-c, LDL-c/HDL-c, and triglycerides/HDL-c ratios) were analyzed and related to factors such as age, sex, professional category, smoking, physical activity, and adherence to the Mediterranean diet. The results indicate that increasing age, male sex, smoking, and the lack of physical activity or adherence to a healthy diet are associated with higher atherogenic risk values. Furthermore, the study discusses its strengths (such as the large sample size and rigorous methodological design) and limitations, emphasizing the importance of comprehensive interventions and public health policies for the prevention and management of cardiovascular disease.
  

2025

• 
  1.

  Venter C, Alonso-Coello P, Beltran J, Bracchiglione J, Fernandez-Saenz K, Riera P, Solà I, Arasi S, Berni Canani R, Fleischer D, Eguíluz-Gracia I, Meyer R, Roberts G, Roth-Walter F, Santos AF, Skypala I, Smith PK, Sokolowska M, Torres MJ, Vassilopoulou E, Walter J, O’Mahony L. Protocol: Scoping review of the association between complementary feeding, growth, and immune health in infants and toddlers-An EAACI guideline paper. Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology [Internet]. England; 2025 Aug.;36(8):e70145-e70145. https://pubmed.ncbi.nlm.nih.gov/40747578

  AbstractURLBibTeXEndNoteDOIBibSonomy

  The European Academy of Allergy and Clinical Immunology (EAACI) is currently developing guidelines on immunomodulation and nutrition. To inform these recommendations, a scoping review will be conducted to synthesize and map the available empirical evidence on how complementary feeding affects immune health in infants and toddlers to explore the association between complementary feeding during the first year of life and immune health outcomes in children up to 3 years of age. The scoping review will be conducted using the Preferred Reporting Items for Systematic Reviews and Meta-analysis Scoping Review Extension for scoping reviews (PRISMA-ScR) guidelines. We have developed inclusion criteria using the PCC (Population, Concept and Context) format: the population will include healthy infants; the concept refers to specific factors related to introduction of complementary feeding; and the context will focus on studies conducted in settings representative of everyday nutrition and feeding practices for infants and toddlers. Evidence sources include systematic reviews. We will search in MEDLINE and Epistemonikos. Data will be extracted using a standardized form developed in REDCap, and the findings will be synthesized narratively. Only published literature will be included in this systematic review. Therefore, no ethical approval is required. The final review paper will be published in a peer-reviewed journal. OSF registration DOI: 10.17605/OSF.IO/T5F8.

  @article{venter2025protocol,
  abstract = {The European Academy of Allergy and Clinical Immunology (EAACI) is currently developing guidelines on immunomodulation and nutrition. To inform these recommendations, a scoping review will be conducted to synthesize and map the available empirical evidence on how complementary feeding affects immune health in infants and toddlers to explore the association between complementary feeding during the first year of life and immune health outcomes in children up to 3 years of age. The scoping review will be conducted using the Preferred Reporting Items for Systematic Reviews and Meta-analysis Scoping Review Extension for scoping reviews (PRISMA-ScR) guidelines. We have developed inclusion criteria using the PCC (Population, Concept and Context) format: the population will include healthy infants; the concept refers to specific factors related to introduction of complementary feeding; and the context will focus on studies conducted in settings representative of everyday nutrition and feeding practices for infants and toddlers. Evidence sources include systematic reviews. We will search in MEDLINE and Epistemonikos. Data will be extracted using a standardized form developed in REDCap, and the findings will be synthesized narratively. Only published literature will be included in this systematic review. Therefore, no ethical approval is required. The final review paper will be published in a peer-reviewed journal. OSF registration DOI: 10.17605/OSF.IO/T5F8.},
  address = {England},
  author = {Venter, Carina and Alonso-Coello, Pablo and Beltran, Jessica and Bracchiglione, Javier and Fernandez-Saenz, Karina and Riera, Pau and Solà, Ivan and Arasi, Stefania and Berni Canani, Roberto and Fleischer, David and Eguíluz-Gracia, Ibon and Meyer, Rosan and Roberts, Graham and Roth-Walter, Franziska and Santos, Alexandra F and Skypala, Isabel and Smith, Peter K and Sokolowska, Milena and Torres, Maria J and Vassilopoulou, Emilia and Walter, Jens and O'Mahony, Liam},
  journal = {Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology},
  keywords = {evisap},
  month = {aug},
  number = 8,
  pages = {e70145--e70145},
  title = {Protocol: Scoping review of the association between complementary feeding, growth, and immune health in infants and toddlers-An EAACI guideline paper},
  volume = 36,
  year = 2025
  }
  

  %0 Journal Article
  %1 venter2025protocol
  %A Venter, Carina
  %A Alonso-Coello, Pablo
  %A Beltran, Jessica
  %A Bracchiglione, Javier
  %A Fernandez-Saenz, Karina
  %A Riera, Pau
  %A Solà, Ivan
  %A Arasi, Stefania
  %A Berni Canani, Roberto
  %A Fleischer, David
  %A Eguíluz-Gracia, Ibon
  %A Meyer, Rosan
  %A Roberts, Graham
  %A Roth-Walter, Franziska
  %A Santos, Alexandra F
  %A Skypala, Isabel
  %A Smith, Peter K
  %A Sokolowska, Milena
  %A Torres, Maria J
  %A Vassilopoulou, Emilia
  %A Walter, Jens
  %A O'Mahony, Liam
  %C England
  %D 2025
  %J Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology
  %N 8
  %P e70145--e70145
  %R 10.1111/pai.70145
  %T Protocol: Scoping review of the association between complementary feeding, growth, and immune health in infants and toddlers-An EAACI guideline paper
  %U https://pubmed.ncbi.nlm.nih.gov/40747578
  %V 36
  %X The European Academy of Allergy and Clinical Immunology (EAACI) is currently developing guidelines on immunomodulation and nutrition. To inform these recommendations, a scoping review will be conducted to synthesize and map the available empirical evidence on how complementary feeding affects immune health in infants and toddlers to explore the association between complementary feeding during the first year of life and immune health outcomes in children up to 3 years of age. The scoping review will be conducted using the Preferred Reporting Items for Systematic Reviews and Meta-analysis Scoping Review Extension for scoping reviews (PRISMA-ScR) guidelines. We have developed inclusion criteria using the PCC (Population, Concept and Context) format: the population will include healthy infants; the concept refers to specific factors related to introduction of complementary feeding; and the context will focus on studies conducted in settings representative of everyday nutrition and feeding practices for infants and toddlers. Evidence sources include systematic reviews. We will search in MEDLINE and Epistemonikos. Data will be extracted using a standardized form developed in REDCap, and the findings will be synthesized narratively. Only published literature will be included in this systematic review. Therefore, no ethical approval is required. The final review paper will be published in a peer-reviewed journal. OSF registration DOI: 10.17605/OSF.IO/T5F8.
  

• 
  1.

  Tárraga Marcos PJ, López-González Ángel A, Martínez-Almoyna Rifá E, Paublini Oliveira H, Martorell Sánchez C, Tárraga López PJ, Ramírez-Manent JI. Body Fat and Visceral Fat Values in Spanish Healthcare Workers: Associated Variables. Nutrients [Internet]. Switzerland; 2025 Feb.;17(4):649-. https://pubmed.ncbi.nlm.nih.gov/40004977

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  BACKGROUND/OBJECTIVES: Excessive body adiposity is a significant public health challenge on a global scale. This study aimed to investigate the association between various sociodemographic factors and healthy lifestyle habits and the presence or absence of elevated body adiposity levels. METHODOLOGY: Two studies were conducted, a retrospective longitudinal study and a cross-sectional descriptive study. The analysis included 44,939 healthcare workers, categorised into four professional groups, to explore the relationship between age, sex, smoking, physical activity, and adherence to the Mediterranean diet and body adiposity, assessed as elevated body fat (BF) and visceral fat (VF) levels. Descriptive statistics encompassed categorical and quantitative variables, analysed using frequencies, Student's t-tests, chi-square tests, and multinomial logistic regression models. Associations, concordances, and correlations were further examined using logistic regression and Cohen's and Pearson's kappa coefficients. RESULTS: Age, sex, and physical activity were the factors most strongly associated with elevated BF and VF levels. Odds ratios (ORs) indicated the following significant associations: individuals aged 60 years and older exhibited ORs of 6.71 (95% CI: 5.68-7.74) for BF and 12.18 (95% CI: 10.01-14.26) for VF; male sex was associated with ORs of 2.21 (95% CI: 2.06-2.36) for BF and 12.51 (95% CI: 11.29-13.74) for VF. Sedentary behaviour was linked to ORs of 3.69 (95% CI: 3.41-3.97) for BF and 4.20 (95% CI: 3.78-4.63) for VF. Among healthcare professionals, nursing assistants and orderlies demonstrated the highest levels of adipose tissue accumulation. CONCLUSIONS: Elevated BF and VF levels among healthcare personnel are significantly associated by lifestyle factors, sex, and age, with the most pronounced risk observed in nursing assistants and orderlies. Further research focusing on the causal relationships between lifestyle behaviours and adiposity in this population will provide valuable insights and support the design of targeted preventive strategies to mitigate its prevalence.

  @article{tarragamarcos2025visceral,
  abstract = {BACKGROUND/OBJECTIVES: Excessive body adiposity is a significant public health challenge on a global scale. This study aimed to investigate the association between various sociodemographic factors and healthy lifestyle habits and the presence or absence of elevated body adiposity levels. METHODOLOGY: Two studies were conducted, a retrospective longitudinal study and a cross-sectional descriptive study. The analysis included 44,939 healthcare workers, categorised into four professional groups, to explore the relationship between age, sex, smoking, physical activity, and adherence to the Mediterranean diet and body adiposity, assessed as elevated body fat (BF) and visceral fat (VF) levels. Descriptive statistics encompassed categorical and quantitative variables, analysed using frequencies, Student's t-tests, chi-square tests, and multinomial logistic regression models. Associations, concordances, and correlations were further examined using logistic regression and Cohen's and Pearson's kappa coefficients. RESULTS: Age, sex, and physical activity were the factors most strongly associated with elevated BF and VF levels. Odds ratios (ORs) indicated the following significant associations: individuals aged 60 years and older exhibited ORs of 6.71 (95% CI: 5.68-7.74) for BF and 12.18 (95% CI: 10.01-14.26) for VF; male sex was associated with ORs of 2.21 (95% CI: 2.06-2.36) for BF and 12.51 (95% CI: 11.29-13.74) for VF. Sedentary behaviour was linked to ORs of 3.69 (95% CI: 3.41-3.97) for BF and 4.20 (95% CI: 3.78-4.63) for VF. Among healthcare professionals, nursing assistants and orderlies demonstrated the highest levels of adipose tissue accumulation. CONCLUSIONS: Elevated BF and VF levels among healthcare personnel are significantly associated by lifestyle factors, sex, and age, with the most pronounced risk observed in nursing assistants and orderlies. Further research focusing on the causal relationships between lifestyle behaviours and adiposity in this population will provide valuable insights and support the design of targeted preventive strategies to mitigate its prevalence.},
  address = {Switzerland},
  author = {Tárraga Marcos, Pedro Javier and López-González, Ángel Arturo and Martínez-Almoyna Rifá, Emilio and Paublini Oliveira, Hernán and Martorell Sánchez, Cristina and Tárraga López, Pedro Juan and Ramírez-Manent, José Ignacio},
  journal = {Nutrients},
  keywords = {grapp-caib},
  month = {feb},
  number = 4,
  pages = {649--},
  title = {Body Fat and Visceral Fat Values in Spanish Healthcare Workers: Associated Variables},
  volume = 17,
  year = 2025
  }
  

  %0 Journal Article
  %1 tarragamarcos2025visceral
  %A Tárraga Marcos, Pedro Javier
  %A López-González, Ángel Arturo
  %A Martínez-Almoyna Rifá, Emilio
  %A Paublini Oliveira, Hernán
  %A Martorell Sánchez, Cristina
  %A Tárraga López, Pedro Juan
  %A Ramírez-Manent, José Ignacio
  %C Switzerland
  %D 2025
  %J Nutrients
  %N 4
  %P 649--
  %R 10.3390/nu17040649
  %T Body Fat and Visceral Fat Values in Spanish Healthcare Workers: Associated Variables
  %U https://pubmed.ncbi.nlm.nih.gov/40004977
  %V 17
  %X BACKGROUND/OBJECTIVES: Excessive body adiposity is a significant public health challenge on a global scale. This study aimed to investigate the association between various sociodemographic factors and healthy lifestyle habits and the presence or absence of elevated body adiposity levels. METHODOLOGY: Two studies were conducted, a retrospective longitudinal study and a cross-sectional descriptive study. The analysis included 44,939 healthcare workers, categorised into four professional groups, to explore the relationship between age, sex, smoking, physical activity, and adherence to the Mediterranean diet and body adiposity, assessed as elevated body fat (BF) and visceral fat (VF) levels. Descriptive statistics encompassed categorical and quantitative variables, analysed using frequencies, Student's t-tests, chi-square tests, and multinomial logistic regression models. Associations, concordances, and correlations were further examined using logistic regression and Cohen's and Pearson's kappa coefficients. RESULTS: Age, sex, and physical activity were the factors most strongly associated with elevated BF and VF levels. Odds ratios (ORs) indicated the following significant associations: individuals aged 60 years and older exhibited ORs of 6.71 (95% CI: 5.68-7.74) for BF and 12.18 (95% CI: 10.01-14.26) for VF; male sex was associated with ORs of 2.21 (95% CI: 2.06-2.36) for BF and 12.51 (95% CI: 11.29-13.74) for VF. Sedentary behaviour was linked to ORs of 3.69 (95% CI: 3.41-3.97) for BF and 4.20 (95% CI: 3.78-4.63) for VF. Among healthcare professionals, nursing assistants and orderlies demonstrated the highest levels of adipose tissue accumulation. CONCLUSIONS: Elevated BF and VF levels among healthcare personnel are significantly associated by lifestyle factors, sex, and age, with the most pronounced risk observed in nursing assistants and orderlies. Further research focusing on the causal relationships between lifestyle behaviours and adiposity in this population will provide valuable insights and support the design of targeted preventive strategies to mitigate its prevalence.
  

• 
  1.

  Marzoa Jansana MD, Tárraga López PJ, Guarro Miquel JJ, López-González Ángel A, Riutord Sbert P, Busquets-Cortés C, Ramírez-Manent JI. Sociodemographic, Lifestyle, and Quality of Life Determinants of Atherogenic Risk: A Cross-Sectional Study in a Large Cohort of Spanish Workers. Journal of Clinical Medicine [Internet]. 2025 Sep.;14(19):6876. https://pmc.ncbi.nlm.nih.gov/articles/PMC12524400/

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Background: Atherosclerosis is a leading cause of cardiovascular morbidity and mortality worldwide. Although lipid-derived atherogenic indices are widely used for cardiovascular risk assessment, their relationship with sociodemographic factors, lifestyle behaviors, and health-related quality of life (HRQoL) in occupational populations remains insufficiently explored. This study aimed to evaluate the association between atherogenic risk, measured by total cholesterol/high-density lipoprotein cholesterol (TC/HDL-c), low-density lipoprotein cholesterol/high-density lipoprotein cholesterol (LDL-c/HDL-c), triglyceride/high-density lipoprotein cholesterol (TG/HDL-c), and atherogenic dyslipidemia (AD) and sociodemographic, lifestyle, and HRQoL variables in a large cohort of Spanish workers. Methods: We conducted a cross-sectional analysis of 100,014 Spanish workers aged 18–69 years, of whom 39.9% were women, with a mean age of 38.2 years (SD 10.2 or IQR) and 38.9 years (SD 10.3 or IQR) for men, during the health examinations carried out between 2021 and 2024. Sociodemographic variables included sex, age group, and occupational social class. Lifestyle factors comprised smoking status, adherence to the Mediterranean diet (MEDAS score), and physical activity (IPAQ categories). HRQoL was assessed using the 12-item Short Form Survey (SF-12), stratified into good vs. poor categories. Logistic regression models were applied to estimate odds ratios (OR) and 95% confidence intervals (CI) for moderate-to-high atherogenic risk across indices, adjusting for potential confounders. Results: Men exhibited a lower likelihood of moderate-to-high TC/HDL-c and LDL-c/HDL-c but a markedly higher probability of elevated TG/HDL-c and AD compared to women (OR range: 0.42–3.67, p \textless 0.001). A clear age-related gradient was observed across all indices, with participants aged 60–69 showing the highest risk (OR range: 2.28–7.84, p \textless 0.001). Lower social class, smoking, physical inactivity, poor diet, and poor SF-12 scores were significantly associated with increased atherogenic risk, with physical inactivity (OR up to 8.61) and poor diet (OR up to 4.98) emerging as the strongest predictors. Conclusions: Atherogenic risk in this large working cohort is strongly influenced by both traditional cardiovascular risk factors and HRQoL. Integrating lifestyle modification and quality-of-life improvement strategies into workplace health programs could substantially reduce the atherogenic burden. Longitudinal research is needed to confirm these associations and guide targeted interventions.

  @article{marzoa_jansana_sociodemographic_2025,
  abstract = {Background: Atherosclerosis is a leading cause of cardiovascular morbidity and mortality worldwide. Although lipid-derived atherogenic indices are widely used for cardiovascular risk assessment, their relationship with sociodemographic factors, lifestyle behaviors, and health-related quality of life (HRQoL) in occupational populations remains insufficiently explored. This study aimed to evaluate the association between atherogenic risk, measured by total cholesterol/high-density lipoprotein cholesterol (TC/HDL-c), low-density lipoprotein cholesterol/high-density lipoprotein cholesterol (LDL-c/HDL-c), triglyceride/high-density lipoprotein cholesterol (TG/HDL-c), and atherogenic dyslipidemia (AD) and sociodemographic, lifestyle, and HRQoL variables in a large cohort of Spanish workers. Methods: We conducted a cross-sectional analysis of 100,014 Spanish workers aged 18–69 years, of whom 39.9% were women, with a mean age of 38.2 years (SD 10.2 or IQR) and 38.9 years (SD 10.3 or IQR) for men, during the health examinations carried out between 2021 and 2024. Sociodemographic variables included sex, age group, and occupational social class. Lifestyle factors comprised smoking status, adherence to the Mediterranean diet (MEDAS score), and physical activity (IPAQ categories). HRQoL was assessed using the 12-item Short Form Survey (SF-12), stratified into good vs. poor categories. Logistic regression models were applied to estimate odds ratios (OR) and 95% confidence intervals (CI) for moderate-to-high atherogenic risk across indices, adjusting for potential confounders. Results: Men exhibited a lower likelihood of moderate-to-high TC/HDL-c and LDL-c/HDL-c but a markedly higher probability of elevated TG/HDL-c and AD compared to women (OR range: 0.42–3.67, p \textless 0.001). A clear age-related gradient was observed across all indices, with participants aged 60–69 showing the highest risk (OR range: 2.28–7.84, p \textless 0.001). Lower social class, smoking, physical inactivity, poor diet, and poor SF-12 scores were significantly associated with increased atherogenic risk, with physical inactivity (OR up to 8.61) and poor diet (OR up to 4.98) emerging as the strongest predictors. Conclusions: Atherogenic risk in this large working cohort is strongly influenced by both traditional cardiovascular risk factors and HRQoL. Integrating lifestyle modification and quality-of-life improvement strategies into workplace health programs could substantially reduce the atherogenic burden. Longitudinal research is needed to confirm these associations and guide targeted interventions.},
  author = {Marzoa Jansana, María Dolores and Tárraga López, Pedro Juan and Guarro Miquel, Juan José and López-González, Ángel Arturo and Riutord Sbert, Pere and Busquets-Cortés, Carla and Ramírez-Manent, José Ignacio},
  journal = {Journal of Clinical Medicine},
  keywords = {grapp-caib},
  month = {sep},
  number = 19,
  pages = 6876,
  title = {Sociodemographic, Lifestyle, and Quality of Life Determinants of Atherogenic Risk: A Cross-Sectional Study in a Large Cohort of Spanish Workers},
  volume = 14,
  year = 2025
  }
  

  %0 Journal Article
  %1 marzoa_jansana_sociodemographic_2025
  %A Marzoa Jansana, María Dolores
  %A Tárraga López, Pedro Juan
  %A Guarro Miquel, Juan José
  %A López-González, Ángel Arturo
  %A Riutord Sbert, Pere
  %A Busquets-Cortés, Carla
  %A Ramírez-Manent, José Ignacio
  %D 2025
  %J Journal of Clinical Medicine
  %N 19
  %P 6876
  %R 10.3390/jcm14196876
  %T Sociodemographic, Lifestyle, and Quality of Life Determinants of Atherogenic Risk: A Cross-Sectional Study in a Large Cohort of Spanish Workers
  %U https://pmc.ncbi.nlm.nih.gov/articles/PMC12524400/
  %V 14
  %X Background: Atherosclerosis is a leading cause of cardiovascular morbidity and mortality worldwide. Although lipid-derived atherogenic indices are widely used for cardiovascular risk assessment, their relationship with sociodemographic factors, lifestyle behaviors, and health-related quality of life (HRQoL) in occupational populations remains insufficiently explored. This study aimed to evaluate the association between atherogenic risk, measured by total cholesterol/high-density lipoprotein cholesterol (TC/HDL-c), low-density lipoprotein cholesterol/high-density lipoprotein cholesterol (LDL-c/HDL-c), triglyceride/high-density lipoprotein cholesterol (TG/HDL-c), and atherogenic dyslipidemia (AD) and sociodemographic, lifestyle, and HRQoL variables in a large cohort of Spanish workers. Methods: We conducted a cross-sectional analysis of 100,014 Spanish workers aged 18–69 years, of whom 39.9% were women, with a mean age of 38.2 years (SD 10.2 or IQR) and 38.9 years (SD 10.3 or IQR) for men, during the health examinations carried out between 2021 and 2024. Sociodemographic variables included sex, age group, and occupational social class. Lifestyle factors comprised smoking status, adherence to the Mediterranean diet (MEDAS score), and physical activity (IPAQ categories). HRQoL was assessed using the 12-item Short Form Survey (SF-12), stratified into good vs. poor categories. Logistic regression models were applied to estimate odds ratios (OR) and 95% confidence intervals (CI) for moderate-to-high atherogenic risk across indices, adjusting for potential confounders. Results: Men exhibited a lower likelihood of moderate-to-high TC/HDL-c and LDL-c/HDL-c but a markedly higher probability of elevated TG/HDL-c and AD compared to women (OR range: 0.42–3.67, p \textless 0.001). A clear age-related gradient was observed across all indices, with participants aged 60–69 showing the highest risk (OR range: 2.28–7.84, p \textless 0.001). Lower social class, smoking, physical inactivity, poor diet, and poor SF-12 scores were significantly associated with increased atherogenic risk, with physical inactivity (OR up to 8.61) and poor diet (OR up to 4.98) emerging as the strongest predictors. Conclusions: Atherogenic risk in this large working cohort is strongly influenced by both traditional cardiovascular risk factors and HRQoL. Integrating lifestyle modification and quality-of-life improvement strategies into workplace health programs could substantially reduce the atherogenic burden. Longitudinal research is needed to confirm these associations and guide targeted interventions.
  

• 
  1.

  Esteva M, March S, Martín-Rabadan M, Torres-Solera E, Ripoll J. Health-related quality of life and lifestyle in long-term survivors of colorectal cancer and a matched non-cancer reference group. Clinical & Translational Oncology [Internet]. 2025;27(10):3993-4002. https://pmc.ncbi.nlm.nih.gov/articles/PMC12460565/

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Objective To compare the long-term health status of a group of survivors of colorectal cancer (CRC) with a reference group of individuals who did not have cancer. We determined the physical, mental, and general health-related quality of life (HRQoL); overall morbidities and CRC-specific morbidities related to the delayed effects of treatment; and maintenance of a healthy lifestyle in these two groups. Methods This descriptive cross-sectional study was conducted from 2016 to 2019 in the Balearic Islands (Spain). CRC patients who were diagnosed from 2011 to 2012 and survived at least 5 years were randomly selected from the Majorca and Eivissa-Formentera cancer registries. The reference group consisted of individuals matched for gender and age who had no history of cancer. Results We examined 201 CRC survivors and 199 matched individuals without cancer. The global analysis showed that the two groups had similar scores in the physical and mental components of the Short Form 12 (SF-12) HRQoL scale and in general health status. The CRC survivors had significantly higher prevalence of general comorbidity and CRC-specific comorbidity. Multivariate analyses and calculation of odds ratios (ORs) showed that the groups had similar physical HRQoL (Model 1, OR: 1.01, 95\% CI: 0.99–1.03), mental HRQoL (Model 2, OR: 0.99, 95\% CI: 0.66–1.01), and general HRQoL (Model 3, OR: 1.67, 95\% CI: 0.39–1.13). However, the long-term CRC survivors had significantly greater ORs for an increased overall comorbidity index, number of CRC-specific comorbidity, and obesity in all three models (P \textless 0.05). Conclusions The CRC survivors and individuals without cancer had similar HRQoL, suggesting that CRC survivors do not need additional services that aim to improve HRQoL. Nonetheless, health care providers should be pro-active when caring for CRC survivors, because they are more likely to present with certain comorbidity and less likely to follow a healthy lifestyle.

  @article{esteva_health-related_2025,
  abstract = {Objective To compare the long-term health status of a group of survivors of colorectal cancer (CRC) with a reference group of individuals who did not have cancer. We determined the physical, mental, and general health-related quality of life (HRQoL); overall morbidities and CRC-specific morbidities related to the delayed effects of treatment; and maintenance of a healthy lifestyle in these two groups. Methods This descriptive cross-sectional study was conducted from 2016 to 2019 in the Balearic Islands (Spain). CRC patients who were diagnosed from 2011 to 2012 and survived at least 5 years were randomly selected from the Majorca and Eivissa-Formentera cancer registries. The reference group consisted of individuals matched for gender and age who had no history of cancer. Results We examined 201 CRC survivors and 199 matched individuals without cancer. The global analysis showed that the two groups had similar scores in the physical and mental components of the Short Form 12 (SF-12) HRQoL scale and in general health status. The CRC survivors had significantly higher prevalence of general comorbidity and CRC-specific comorbidity. Multivariate analyses and calculation of odds ratios (ORs) showed that the groups had similar physical HRQoL (Model 1, OR: 1.01, 95\% CI: 0.99–1.03), mental HRQoL (Model 2, OR: 0.99, 95\% CI: 0.66–1.01), and general HRQoL (Model 3, OR: 1.67, 95\% CI: 0.39–1.13). However, the long-term CRC survivors had significantly greater ORs for an increased overall comorbidity index, number of CRC-specific comorbidity, and obesity in all three models (P \textless 0.05). Conclusions The CRC survivors and individuals without cancer had similar HRQoL, suggesting that CRC survivors do not need additional services that aim to improve HRQoL. Nonetheless, health care providers should be pro-active when caring for CRC survivors, because they are more likely to present with certain comorbidity and less likely to follow a healthy lifestyle.},
  author = {Esteva, Magdalena and March, Sebastià and Martín-Rabadan, María and Torres-Solera, Elena and Ripoll, Joana},
  journal = {Clinical & Translational Oncology},
  keywords = {grapp-caib},
  number = 10,
  pages = {3993--4002},
  title = {Health-related quality of life and lifestyle in long-term survivors of colorectal cancer and a matched non-cancer reference group},
  volume = 27,
  year = 2025
  }
  

  %0 Journal Article
  %1 esteva_health-related_2025
  %A Esteva, Magdalena
  %A March, Sebastià
  %A Martín-Rabadan, María
  %A Torres-Solera, Elena
  %A Ripoll, Joana
  %D 2025
  %J Clinical & Translational Oncology
  %N 10
  %P 3993--4002
  %R 10.1007/s12094-025-03930-0
  %T Health-related quality of life and lifestyle in long-term survivors of colorectal cancer and a matched non-cancer reference group
  %U https://pmc.ncbi.nlm.nih.gov/articles/PMC12460565/
  %V 27
  %X Objective To compare the long-term health status of a group of survivors of colorectal cancer (CRC) with a reference group of individuals who did not have cancer. We determined the physical, mental, and general health-related quality of life (HRQoL); overall morbidities and CRC-specific morbidities related to the delayed effects of treatment; and maintenance of a healthy lifestyle in these two groups. Methods This descriptive cross-sectional study was conducted from 2016 to 2019 in the Balearic Islands (Spain). CRC patients who were diagnosed from 2011 to 2012 and survived at least 5 years were randomly selected from the Majorca and Eivissa-Formentera cancer registries. The reference group consisted of individuals matched for gender and age who had no history of cancer. Results We examined 201 CRC survivors and 199 matched individuals without cancer. The global analysis showed that the two groups had similar scores in the physical and mental components of the Short Form 12 (SF-12) HRQoL scale and in general health status. The CRC survivors had significantly higher prevalence of general comorbidity and CRC-specific comorbidity. Multivariate analyses and calculation of odds ratios (ORs) showed that the groups had similar physical HRQoL (Model 1, OR: 1.01, 95\% CI: 0.99–1.03), mental HRQoL (Model 2, OR: 0.99, 95\% CI: 0.66–1.01), and general HRQoL (Model 3, OR: 1.67, 95\% CI: 0.39–1.13). However, the long-term CRC survivors had significantly greater ORs for an increased overall comorbidity index, number of CRC-specific comorbidity, and obesity in all three models (P \textless 0.05). Conclusions The CRC survivors and individuals without cancer had similar HRQoL, suggesting that CRC survivors do not need additional services that aim to improve HRQoL. Nonetheless, health care providers should be pro-active when caring for CRC survivors, because they are more likely to present with certain comorbidity and less likely to follow a healthy lifestyle.
  

• 
  1.

  Riutord-Sbert P, Tárraga López PJ, López-González Ángel A, Coll Campayo I, Busquets-Cortés C, Ramírez Manent JI. Determinants of Atherogenic Dyslipidemia and Lipid Ratios: Associations with Sociodemographic Profile, Lifestyle, and Social Isolation in Spanish Workers. Journal of Clinical Medicine [Internet]. 2025 Jan.;14(19):7039. https://www.mdpi.com/2077-0383/14/19/7039

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Background: Atherogenic dyslipidemia is defined by the coexistence of high triglyceride concentrations, low levels of high-density lipoprotein cholesterol (HDL-C), and an excess of small, dense particles of low-density lipoprotein cholesterol (LDL-C). This lipid profile is strongly associated with an increased burden of cardiovascular disease and represents a leading cause of global morbidity and mortality. To better capture this risk, composite lipid ratios—including total cholesterol to HDL-C (TC/HDL-C), LDL-C to HDL-C (LDL-C/HDL-C), triglycerides to HDL-C (TG/HDL-C), and the atherogenic dyslipidemia index (AD)—have emerged as robust markers of cardiometabolic health, frequently demonstrating superior predictive capacity compared with isolated lipid measures. Despite extensive evidence linking these ratios to cardiovascular disease, few large-scale studies have examined their association with sociodemographic characteristics, lifestyle behaviors, and social isolation in working populations. Methods: We conducted a cross-sectional analysis of a large occupational cohort of Spanish workers evaluated between January 2021 and December 2024. Anthropometric, biochemical, and sociodemographic data were collected through standardized clinical protocols. Indices of atherogenic risk—namely the ratios TC/HDL-C, LDL-C/HDL-C, TG/HDL-C, and the atherogenic dyslipidemia index (AD)—were derived from fasting lipid measurements. The assessment of lifestyle factors included tobacco use, physical activity evaluated through the International Physical Activity Questionnaire (IPAQ), adherence to the Mediterranean dietary pattern using the MEDAS questionnaire, and perceived social isolation measured by the Lubben Social Network Scale. Socioeconomic classification was established following the criteria proposed by the Spanish Society of Epidemiology. Logistic regression models were fitted to identify factors independently associated with moderate-to-high risk for each lipid indicator, adjusting for potential confounders. Results: A total of 117,298 workers (71,384 men and 45,914 women) were included. Men showed significantly higher odds of elevated TG/HDL-C (OR 4.22, 95\% CI 3.70–4.75) and AD (OR 2.95, 95\% CI 2.70–3.21) compared with women, whereas LDL-C/HDL-C ratios were lower (OR 0.86, 95\% CI 0.83–0.89). Advancing age was positively associated with all lipid ratios, with the highest risk observed in participants aged 60–69 years. Lower social class, smoking, physical inactivity, poor adherence to the Mediterranean diet, and low social isolation scores were consistently linked to higher atherogenic risk. Physical inactivity showed the strongest associations across all indicators, with ORs ranging from 3.54 for TC/HDL-C to 7.12 for AD. Conclusions: Atherogenic dyslipidemia and elevated lipid ratios are strongly associated with male sex, older age, lower socioeconomic status, unhealthy lifestyle behaviors, and reduced social integration among Spanish workers. These findings highlight the importance of workplace-based cardiovascular risk screening and targeted prevention strategies, particularly in high-risk subgroups. Interventions to promote physical activity, healthy dietary patterns, and social connectedness may contribute to lowering atherogenic risk in occupational settings.

  @article{riutord-sbert_determinants_2025,
  abstract = {Background: Atherogenic dyslipidemia is defined by the coexistence of high triglyceride concentrations, low levels of high-density lipoprotein cholesterol (HDL-C), and an excess of small, dense particles of low-density lipoprotein cholesterol (LDL-C). This lipid profile is strongly associated with an increased burden of cardiovascular disease and represents a leading cause of global morbidity and mortality. To better capture this risk, composite lipid ratios—including total cholesterol to HDL-C (TC/HDL-C), LDL-C to HDL-C (LDL-C/HDL-C), triglycerides to HDL-C (TG/HDL-C), and the atherogenic dyslipidemia index (AD)—have emerged as robust markers of cardiometabolic health, frequently demonstrating superior predictive capacity compared with isolated lipid measures. Despite extensive evidence linking these ratios to cardiovascular disease, few large-scale studies have examined their association with sociodemographic characteristics, lifestyle behaviors, and social isolation in working populations. Methods: We conducted a cross-sectional analysis of a large occupational cohort of Spanish workers evaluated between January 2021 and December 2024. Anthropometric, biochemical, and sociodemographic data were collected through standardized clinical protocols. Indices of atherogenic risk—namely the ratios TC/HDL-C, LDL-C/HDL-C, TG/HDL-C, and the atherogenic dyslipidemia index (AD)—were derived from fasting lipid measurements. The assessment of lifestyle factors included tobacco use, physical activity evaluated through the International Physical Activity Questionnaire (IPAQ), adherence to the Mediterranean dietary pattern using the MEDAS questionnaire, and perceived social isolation measured by the Lubben Social Network Scale. Socioeconomic classification was established following the criteria proposed by the Spanish Society of Epidemiology. Logistic regression models were fitted to identify factors independently associated with moderate-to-high risk for each lipid indicator, adjusting for potential confounders. Results: A total of 117,298 workers (71,384 men and 45,914 women) were included. Men showed significantly higher odds of elevated TG/HDL-C (OR 4.22, 95\% CI 3.70–4.75) and AD (OR 2.95, 95\% CI 2.70–3.21) compared with women, whereas LDL-C/HDL-C ratios were lower (OR 0.86, 95\% CI 0.83–0.89). Advancing age was positively associated with all lipid ratios, with the highest risk observed in participants aged 60–69 years. Lower social class, smoking, physical inactivity, poor adherence to the Mediterranean diet, and low social isolation scores were consistently linked to higher atherogenic risk. Physical inactivity showed the strongest associations across all indicators, with ORs ranging from 3.54 for TC/HDL-C to 7.12 for AD. Conclusions: Atherogenic dyslipidemia and elevated lipid ratios are strongly associated with male sex, older age, lower socioeconomic status, unhealthy lifestyle behaviors, and reduced social integration among Spanish workers. These findings highlight the importance of workplace-based cardiovascular risk screening and targeted prevention strategies, particularly in high-risk subgroups. Interventions to promote physical activity, healthy dietary patterns, and social connectedness may contribute to lowering atherogenic risk in occupational settings.},
  author = {Riutord-Sbert, Pere and Tárraga López, Pedro Juan and López-González, Ángel Arturo and Coll Campayo, Irene and Busquets-Cortés, Carla and Ramírez Manent, José Ignacio},
  journal = {Journal of Clinical Medicine},
  keywords = {grapp-caib},
  month = {jan},
  number = 19,
  pages = 7039,
  title = {Determinants of Atherogenic Dyslipidemia and Lipid Ratios: Associations with Sociodemographic Profile, Lifestyle, and Social Isolation in Spanish Workers},
  volume = 14,
  year = 2025
  }
  

  %0 Journal Article
  %1 riutord-sbert_determinants_2025
  %A Riutord-Sbert, Pere
  %A Tárraga López, Pedro Juan
  %A López-González, Ángel Arturo
  %A Coll Campayo, Irene
  %A Busquets-Cortés, Carla
  %A Ramírez Manent, José Ignacio
  %D 2025
  %J Journal of Clinical Medicine
  %N 19
  %P 7039
  %R 10.3390/jcm14197039
  %T Determinants of Atherogenic Dyslipidemia and Lipid Ratios: Associations with Sociodemographic Profile, Lifestyle, and Social Isolation in Spanish Workers
  %U https://www.mdpi.com/2077-0383/14/19/7039
  %V 14
  %X Background: Atherogenic dyslipidemia is defined by the coexistence of high triglyceride concentrations, low levels of high-density lipoprotein cholesterol (HDL-C), and an excess of small, dense particles of low-density lipoprotein cholesterol (LDL-C). This lipid profile is strongly associated with an increased burden of cardiovascular disease and represents a leading cause of global morbidity and mortality. To better capture this risk, composite lipid ratios—including total cholesterol to HDL-C (TC/HDL-C), LDL-C to HDL-C (LDL-C/HDL-C), triglycerides to HDL-C (TG/HDL-C), and the atherogenic dyslipidemia index (AD)—have emerged as robust markers of cardiometabolic health, frequently demonstrating superior predictive capacity compared with isolated lipid measures. Despite extensive evidence linking these ratios to cardiovascular disease, few large-scale studies have examined their association with sociodemographic characteristics, lifestyle behaviors, and social isolation in working populations. Methods: We conducted a cross-sectional analysis of a large occupational cohort of Spanish workers evaluated between January 2021 and December 2024. Anthropometric, biochemical, and sociodemographic data were collected through standardized clinical protocols. Indices of atherogenic risk—namely the ratios TC/HDL-C, LDL-C/HDL-C, TG/HDL-C, and the atherogenic dyslipidemia index (AD)—were derived from fasting lipid measurements. The assessment of lifestyle factors included tobacco use, physical activity evaluated through the International Physical Activity Questionnaire (IPAQ), adherence to the Mediterranean dietary pattern using the MEDAS questionnaire, and perceived social isolation measured by the Lubben Social Network Scale. Socioeconomic classification was established following the criteria proposed by the Spanish Society of Epidemiology. Logistic regression models were fitted to identify factors independently associated with moderate-to-high risk for each lipid indicator, adjusting for potential confounders. Results: A total of 117,298 workers (71,384 men and 45,914 women) were included. Men showed significantly higher odds of elevated TG/HDL-C (OR 4.22, 95\% CI 3.70–4.75) and AD (OR 2.95, 95\% CI 2.70–3.21) compared with women, whereas LDL-C/HDL-C ratios were lower (OR 0.86, 95\% CI 0.83–0.89). Advancing age was positively associated with all lipid ratios, with the highest risk observed in participants aged 60–69 years. Lower social class, smoking, physical inactivity, poor adherence to the Mediterranean diet, and low social isolation scores were consistently linked to higher atherogenic risk. Physical inactivity showed the strongest associations across all indicators, with ORs ranging from 3.54 for TC/HDL-C to 7.12 for AD. Conclusions: Atherogenic dyslipidemia and elevated lipid ratios are strongly associated with male sex, older age, lower socioeconomic status, unhealthy lifestyle behaviors, and reduced social integration among Spanish workers. These findings highlight the importance of workplace-based cardiovascular risk screening and targeted prevention strategies, particularly in high-risk subgroups. Interventions to promote physical activity, healthy dietary patterns, and social connectedness may contribute to lowering atherogenic risk in occupational settings.
  

• 
  1.

  Mira-Martínez S, Malih N, Angullo-Martínez E, Zamanillo-Campos R, Yañez AM, Bennasar-Veny M, Gómez-Juanes R, Konieczna J, Jiménez R, Serrano-Ripoll MJ, Fiol deRoque MA, Leiva A, Galmes-Panades AM, Miralles-Xamena J, Vidal-Thomàs MC, Gómez-Cobo C, Gervilla E, Oña-Gil JI, Ricci-Cabello I. A Multifaceted Digital Intervention for the Prevention of Type 2 Diabetes Mellitus in Primary Care (PREDIABETEXT): Cluster Randomized Trial. Journal of Medical Internet Research [Internet]. 2025 Oct.;27(1):e70981. https://www.jmir.org/2025/1/e70981

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Background: The diabetes epidemic continues to surge worldwide, demanding urgent and innovative solutions. Digital health interventions, particularly those targeting behavior change, hold promise due to their affordability and scalability. However, research in this field remains in its early stages. Objective: This study aimed to evaluate the effectiveness of PREDIABETEXT (Prediabetes Text Message Digital Intervention for the Prevention of Type 2 Diabetes Mellitus), a digital health intervention, in reducing glycated hemoglobin (HbA1c) and in improving secondary clinical, physiological, and behavioral outcomes. Methods: We conducted a 6-month, 3-arm, pragmatic cluster randomized clinical trial. We recruited patients with prediabetes (HbA1c levels between 6\% and 6.4\% in the previous 3 months or 2 consecutive fasting plasma glucose measurements of 110-125 mg/dL) registered at primary care centers in the Balearic Islands, Spain. The PREDIABETEXT intervention consisted of 3 personalized SMS text messages per week aimed at supporting lifestyle behavior changes and online training for their primary health care professionals. A total of 58 professionals (clusters) from 16 centers participated in the study and were randomized (1:1:1) to intervention group A (patient SMS text messaging), intervention group B (patient SMS text messaging+health care professional web-based training), or the control group (usual care). Following the 6-month intervention period, we conducted individual qualitative interviews with 8 patients and 7 health care professionals to evaluate their experiences with the intervention in terms of utility, satisfaction, and implementation barriers. Results: In total, 58 health care professionals (clusters) were included, allocated to the control group (n=20, 34\%; 119/365, 32.6\% patients), intervention group A (SMS text messaging only; n=18, 31\%; 106/365, 29\% patients), and intervention group B (SMS text messaging+training; n=20, 34\%; 140/365, 38.4\% patients). The mean age of the patients was 59.79 (SD 9.75) years, and 54.5% (199/365) were female. The results of the intention-to-treat analysis at the 6-month time point showed that intervention A led to a small, nonsignificant reduction in HbA1c levels compared to the control group (β=−0.05, 95\% CI −0.21 to 0.10; P=.50), whereas intervention B showed a similar nonsignificant reduction (β=−0.04, 95\% CI −0.12 to 0.10; P=.56). No substantial differences were observed in the remaining secondary outcomes. Interviews revealed positive feedback from patients, who appreciated the intervention’s dietary messages and their frequency and practicality. Participants suggested enhancements such as increased personalization, links to recipes, and nursing follow-ups. Health care professionals valued the online training but highlighted time constraints, suggesting shorter or blended formats to improve accessibility. Conclusions: While PREDIABETEXT did not significantly improve HbA1c levels, it demonstrated potential benefits for patient engagement. Further studies involving more intensive interventions are warranted to confirm the clinical impact on diabetes prevention. Trial Registration: ClinicalTrials.gov NCT05110625; https://www.clinicaltrials.gov/study/NCT05110625

  @article{mira-martinez_multifaceted_2025,
  abstract = {Background: The diabetes epidemic continues to surge worldwide, demanding urgent and innovative solutions. Digital health interventions, particularly those targeting behavior change, hold promise due to their affordability and scalability. However, research in this field remains in its early stages. Objective: This study aimed to evaluate the effectiveness of PREDIABETEXT (Prediabetes Text Message Digital Intervention for the Prevention of Type 2 Diabetes Mellitus), a digital health intervention, in reducing glycated hemoglobin (HbA1c) and in improving secondary clinical, physiological, and behavioral outcomes. Methods: We conducted a 6-month, 3-arm, pragmatic cluster randomized clinical trial. We recruited patients with prediabetes (HbA1c levels between 6\% and 6.4\% in the previous 3 months or 2 consecutive fasting plasma glucose measurements of 110-125 mg/dL) registered at primary care centers in the Balearic Islands, Spain. The PREDIABETEXT intervention consisted of 3 personalized SMS text messages per week aimed at supporting lifestyle behavior changes and online training for their primary health care professionals. A total of 58 professionals (clusters) from 16 centers participated in the study and were randomized (1:1:1) to intervention group A (patient SMS text messaging), intervention group B (patient SMS text messaging+health care professional web-based training), or the control group (usual care). Following the 6-month intervention period, we conducted individual qualitative interviews with 8 patients and 7 health care professionals to evaluate their experiences with the intervention in terms of utility, satisfaction, and implementation barriers. Results: In total, 58 health care professionals (clusters) were included, allocated to the control group (n=20, 34\%; 119/365, 32.6\% patients), intervention group A (SMS text messaging only; n=18, 31\%; 106/365, 29\% patients), and intervention group B (SMS text messaging+training; n=20, 34\%; 140/365, 38.4\% patients). The mean age of the patients was 59.79 (SD 9.75) years, and 54.5% (199/365) were female. The results of the intention-to-treat analysis at the 6-month time point showed that intervention A led to a small, nonsignificant reduction in HbA1c levels compared to the control group (β=−0.05, 95\% CI −0.21 to 0.10; P=.50), whereas intervention B showed a similar nonsignificant reduction (β=−0.04, 95\% CI −0.12 to 0.10; P=.56). No substantial differences were observed in the remaining secondary outcomes. Interviews revealed positive feedback from patients, who appreciated the intervention’s dietary messages and their frequency and practicality. Participants suggested enhancements such as increased personalization, links to recipes, and nursing follow-ups. Health care professionals valued the online training but highlighted time constraints, suggesting shorter or blended formats to improve accessibility. Conclusions: While PREDIABETEXT did not significantly improve HbA1c levels, it demonstrated potential benefits for patient engagement. Further studies involving more intensive interventions are warranted to confirm the clinical impact on diabetes prevention. Trial Registration: ClinicalTrials.gov NCT05110625; https://www.clinicaltrials.gov/study/NCT05110625},
  author = {Mira-Martínez, Sofía and Malih, Narges and Angullo-Martínez, Escarlata and Zamanillo-Campos, Rocío and Yañez, Aina M. and Bennasar-Veny, Miquel and Gómez-Juanes, Rocío and Konieczna, Jadwiga and Jiménez, Rafael and Serrano-Ripoll, Maria J. and Fiol deRoque, Maria Antonia and Leiva, Alfonso and Galmes-Panades, Aina M. and Miralles-Xamena, Jerónima and Vidal-Thomàs, Maria Clara and Gómez-Cobo, Cristina and Gervilla, Elena and Oña-Gil, José Iván and Ricci-Cabello, Ignacio},
  journal = {Journal of Medical Internet Research},
  keywords = {grapp-caib},
  month = {oct},
  number = 1,
  pages = {e70981},
  title = {A Multifaceted Digital Intervention for the Prevention of Type 2 Diabetes Mellitus in Primary Care (PREDIABETEXT): Cluster Randomized Trial},
  volume = 27,
  year = 2025
  }
  

  %0 Journal Article
  %1 mira-martinez_multifaceted_2025
  %A Mira-Martínez, Sofía
  %A Malih, Narges
  %A Angullo-Martínez, Escarlata
  %A Zamanillo-Campos, Rocío
  %A Yañez, Aina M.
  %A Bennasar-Veny, Miquel
  %A Gómez-Juanes, Rocío
  %A Konieczna, Jadwiga
  %A Jiménez, Rafael
  %A Serrano-Ripoll, Maria J.
  %A Fiol deRoque, Maria Antonia
  %A Leiva, Alfonso
  %A Galmes-Panades, Aina M.
  %A Miralles-Xamena, Jerónima
  %A Vidal-Thomàs, Maria Clara
  %A Gómez-Cobo, Cristina
  %A Gervilla, Elena
  %A Oña-Gil, José Iván
  %A Ricci-Cabello, Ignacio
  %D 2025
  %J Journal of Medical Internet Research
  %N 1
  %P e70981
  %R 10.2196/70981
  %T A Multifaceted Digital Intervention for the Prevention of Type 2 Diabetes Mellitus in Primary Care (PREDIABETEXT): Cluster Randomized Trial
  %U https://www.jmir.org/2025/1/e70981
  %V 27
  %X Background: The diabetes epidemic continues to surge worldwide, demanding urgent and innovative solutions. Digital health interventions, particularly those targeting behavior change, hold promise due to their affordability and scalability. However, research in this field remains in its early stages. Objective: This study aimed to evaluate the effectiveness of PREDIABETEXT (Prediabetes Text Message Digital Intervention for the Prevention of Type 2 Diabetes Mellitus), a digital health intervention, in reducing glycated hemoglobin (HbA1c) and in improving secondary clinical, physiological, and behavioral outcomes. Methods: We conducted a 6-month, 3-arm, pragmatic cluster randomized clinical trial. We recruited patients with prediabetes (HbA1c levels between 6\% and 6.4\% in the previous 3 months or 2 consecutive fasting plasma glucose measurements of 110-125 mg/dL) registered at primary care centers in the Balearic Islands, Spain. The PREDIABETEXT intervention consisted of 3 personalized SMS text messages per week aimed at supporting lifestyle behavior changes and online training for their primary health care professionals. A total of 58 professionals (clusters) from 16 centers participated in the study and were randomized (1:1:1) to intervention group A (patient SMS text messaging), intervention group B (patient SMS text messaging+health care professional web-based training), or the control group (usual care). Following the 6-month intervention period, we conducted individual qualitative interviews with 8 patients and 7 health care professionals to evaluate their experiences with the intervention in terms of utility, satisfaction, and implementation barriers. Results: In total, 58 health care professionals (clusters) were included, allocated to the control group (n=20, 34\%; 119/365, 32.6\% patients), intervention group A (SMS text messaging only; n=18, 31\%; 106/365, 29\% patients), and intervention group B (SMS text messaging+training; n=20, 34\%; 140/365, 38.4\% patients). The mean age of the patients was 59.79 (SD 9.75) years, and 54.5% (199/365) were female. The results of the intention-to-treat analysis at the 6-month time point showed that intervention A led to a small, nonsignificant reduction in HbA1c levels compared to the control group (β=−0.05, 95\% CI −0.21 to 0.10; P=.50), whereas intervention B showed a similar nonsignificant reduction (β=−0.04, 95\% CI −0.12 to 0.10; P=.56). No substantial differences were observed in the remaining secondary outcomes. Interviews revealed positive feedback from patients, who appreciated the intervention’s dietary messages and their frequency and practicality. Participants suggested enhancements such as increased personalization, links to recipes, and nursing follow-ups. Health care professionals valued the online training but highlighted time constraints, suggesting shorter or blended formats to improve accessibility. Conclusions: While PREDIABETEXT did not significantly improve HbA1c levels, it demonstrated potential benefits for patient engagement. Further studies involving more intensive interventions are warranted to confirm the clinical impact on diabetes prevention. Trial Registration: ClinicalTrials.gov NCT05110625; https://www.clinicaltrials.gov/study/NCT05110625
  

• 
  1.

  Cameselle-Lago C, Rico-Blázquez M, Sánchez-Ruano R, Ayala A, Pascual-García M, Solé-Agustí M, Gimeno-Pi I, Echevarria-Echevarria A, González-Chordá VM, Esteban-Sepúlveda S, Pedraz-Marcos A, Company-Sancho MC, Cidoncha-Moreno M Ángeles, Vidal-Thomas MC, Taltavull-Aparicio JM, Moreno-Casbas MT. Changes in daily routines and health-related quality of life among Spanish older adults after the COVID-19 pandemic: analysis from a gender perspective. Frontiers in Public Health [Internet]. 2025 Oct.;13:1678003. https://pmc.ncbi.nlm.nih.gov/articles/PMC12554437/

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Aims To examine the association between perceived changes in daily routines due to the COVID-19 pandemic and health-related quality of life (HRQoL) among community-dwelling adults aged 75 and older in Spain, through a gender-stratified analysis. Design Cross-sectional, community-based, multicentre study using baseline data from the CUIDAMOS+75 cohort. Methods A total of 1,072 older adults over 75 from 11 Spanish regions were interviewed between June 2022 and June 2023. Data on SARS-CoV-2 exposure, sociodemographic and clinical characteristics and perceived changes in daily routines (basic-needs, healthcare and social routines) were collected. HRQoL was measured using the EQ-5D-5L utility index. Gender-stratified linear regression models were used to examine associations between changes in routines and HRQoL. Results Over half of the participants (52\%) reported considerable changes in their daily routines due to the pandemic, especially in social routines (48\%). Women reported more frequent changes across all routine types. Although women had lower overall HRQoL scores, changes in routines were more strongly associated with poorer HRQoL among men, particularly when healthcare routines were affected. Among women, significant associations were observed for disruptions in combined basic and social routines as well as when all three routine types were simultaneously affected. Notably, COVID-19 infection status was not associated with HRQoL after adjustment. Conclusion The COVID-19 pandemic led to substantial and persistent changes in daily routines among older adults in Spain, with gender-specific patterns in their association with HRQoL. These findings highlight the importance of incorporating a gender perspective in public health responses to health crises, particularly in strategies aimed at preserving daily routines to support autonomy and wellbeing in older populations.

  @article{cameselle-lago_changes_2025,
  abstract = {Aims To examine the association between perceived changes in daily routines due to the COVID-19 pandemic and health-related quality of life (HRQoL) among community-dwelling adults aged 75 and older in Spain, through a gender-stratified analysis. Design Cross-sectional, community-based, multicentre study using baseline data from the CUIDAMOS+75 cohort. Methods A total of 1,072 older adults over 75 from 11 Spanish regions were interviewed between June 2022 and June 2023. Data on SARS-CoV-2 exposure, sociodemographic and clinical characteristics and perceived changes in daily routines (basic-needs, healthcare and social routines) were collected. HRQoL was measured using the EQ-5D-5L utility index. Gender-stratified linear regression models were used to examine associations between changes in routines and HRQoL. Results Over half of the participants (52\%) reported considerable changes in their daily routines due to the pandemic, especially in social routines (48\%). Women reported more frequent changes across all routine types. Although women had lower overall HRQoL scores, changes in routines were more strongly associated with poorer HRQoL among men, particularly when healthcare routines were affected. Among women, significant associations were observed for disruptions in combined basic and social routines as well as when all three routine types were simultaneously affected. Notably, COVID-19 infection status was not associated with HRQoL after adjustment. Conclusion The COVID-19 pandemic led to substantial and persistent changes in daily routines among older adults in Spain, with gender-specific patterns in their association with HRQoL. These findings highlight the importance of incorporating a gender perspective in public health responses to health crises, particularly in strategies aimed at preserving daily routines to support autonomy and wellbeing in older populations.},
  author = {Cameselle-Lago, Candela and Rico-Blázquez, Milagros and Sánchez-Ruano, Raquel and Ayala, Alba and Pascual-García, Marcos and Solé-Agustí, María and Gimeno-Pi, Iraida and Echevarria-Echevarria, Aitziber and González-Chordá, Víctor M. and Esteban-Sepúlveda, Silvia and Pedraz-Marcos, Azucena and Company-Sancho, María Consuelo and Cidoncha-Moreno, María Ángeles and Vidal-Thomas, María Clara and Taltavull-Aparicio, Joana Maria and Moreno-Casbas, María Teresa},
  journal = {Frontiers in Public Health},
  keywords = {grapp-caib},
  month = {oct},
  pages = 1678003,
  title = {Changes in daily routines and health-related quality of life among Spanish older adults after the COVID-19 pandemic: analysis from a gender perspective},
  volume = 13,
  year = 2025
  }
  

  %0 Journal Article
  %1 cameselle-lago_changes_2025
  %A Cameselle-Lago, Candela
  %A Rico-Blázquez, Milagros
  %A Sánchez-Ruano, Raquel
  %A Ayala, Alba
  %A Pascual-García, Marcos
  %A Solé-Agustí, María
  %A Gimeno-Pi, Iraida
  %A Echevarria-Echevarria, Aitziber
  %A González-Chordá, Víctor M.
  %A Esteban-Sepúlveda, Silvia
  %A Pedraz-Marcos, Azucena
  %A Company-Sancho, María Consuelo
  %A Cidoncha-Moreno, María Ángeles
  %A Vidal-Thomas, María Clara
  %A Taltavull-Aparicio, Joana Maria
  %A Moreno-Casbas, María Teresa
  %D 2025
  %J Frontiers in Public Health
  %P 1678003
  %R 10.3389/fpubh.2025.1678003
  %T Changes in daily routines and health-related quality of life among Spanish older adults after the COVID-19 pandemic: analysis from a gender perspective
  %U https://pmc.ncbi.nlm.nih.gov/articles/PMC12554437/
  %V 13
  %X Aims To examine the association between perceived changes in daily routines due to the COVID-19 pandemic and health-related quality of life (HRQoL) among community-dwelling adults aged 75 and older in Spain, through a gender-stratified analysis. Design Cross-sectional, community-based, multicentre study using baseline data from the CUIDAMOS+75 cohort. Methods A total of 1,072 older adults over 75 from 11 Spanish regions were interviewed between June 2022 and June 2023. Data on SARS-CoV-2 exposure, sociodemographic and clinical characteristics and perceived changes in daily routines (basic-needs, healthcare and social routines) were collected. HRQoL was measured using the EQ-5D-5L utility index. Gender-stratified linear regression models were used to examine associations between changes in routines and HRQoL. Results Over half of the participants (52\%) reported considerable changes in their daily routines due to the pandemic, especially in social routines (48\%). Women reported more frequent changes across all routine types. Although women had lower overall HRQoL scores, changes in routines were more strongly associated with poorer HRQoL among men, particularly when healthcare routines were affected. Among women, significant associations were observed for disruptions in combined basic and social routines as well as when all three routine types were simultaneously affected. Notably, COVID-19 infection status was not associated with HRQoL after adjustment. Conclusion The COVID-19 pandemic led to substantial and persistent changes in daily routines among older adults in Spain, with gender-specific patterns in their association with HRQoL. These findings highlight the importance of incorporating a gender perspective in public health responses to health crises, particularly in strategies aimed at preserving daily routines to support autonomy and wellbeing in older populations.
  

• 
  1.

  Tosoratto J, Tárraga López PJ, López-González Ángel A, Obrador de Hevia J, Busquets-Cortés C, Ramírez-Manent JI. Association of Shift Work, Health Behaviors, and Socioeconomic Status with Diabesity in over 53,000 Spanish Employees. Journal of Clinical Medicine [Internet]. 2025 Aug.;14(17):5969. https://pmc.ncbi.nlm.nih.gov/articles/PMC12429148/

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Background: Diabesity, the coexistence of obesity and type 2 diabetes, is a major public health concern. Shift work and unhealthy lifestyle behaviors may exacerbate its prevalence, particularly in working populations. Objective: This study aims to evaluate the association between sociodemographic characteristics, health behaviors, and shift work and the prevalence of diabesity, using both BMI and the CUN-BAE estimator, in a large cohort of Spanish workers. Methods: This cross-sectional study included 53,053 workers (59.8\% men) aged 18–69 years who underwent occupational health examinations. Diabesity was defined as obesity (BMI ≥ 30 kg/m2 or high CUN-BAE) plus fasting glucose ≥ 100 mg/dL or prior diagnosis of diabetes. Adherence to the Mediterranean diet was assessed by the MEDAS questionnaire, physical activity by the IPAQ, alcohol intake by standard drink units (UBEs), and socioeconomic class by the CNAE-11 classification. Shift work was defined according to ILO criteria. Logistic regression was used to assess associations, adjusting for potential confounders. Results: Shift work was independently associated with increased odds of diabesity both in men and women. Diabesity prevalence was higher when assessed by CUN-BAE compared with BMI. Age, male sex, lower socioeconomic class, physical inactivity, smoking, poor diet adherence, and alcohol intake were all significantly associated with higher risk. The CUN-BAE index showed superior sensitivity in identifying individuals at risk. Conclusions: Shift work and unhealthy behaviors are key determinants of diabesity among Spanish workers. The use of adiposity estimators beyond BMI, such as CUN-BAE, should be encouraged in occupational health surveillance. Workplace-targeted interventions are urgently needed to address this growing metabolic burden.

  @article{tosoratto_association_2025,
  abstract = {Background: Diabesity, the coexistence of obesity and type 2 diabetes, is a major public health concern. Shift work and unhealthy lifestyle behaviors may exacerbate its prevalence, particularly in working populations. Objective: This study aims to evaluate the association between sociodemographic characteristics, health behaviors, and shift work and the prevalence of diabesity, using both BMI and the CUN-BAE estimator, in a large cohort of Spanish workers. Methods: This cross-sectional study included 53,053 workers (59.8\% men) aged 18–69 years who underwent occupational health examinations. Diabesity was defined as obesity (BMI ≥ 30 kg/m2 or high CUN-BAE) plus fasting glucose ≥ 100 mg/dL or prior diagnosis of diabetes. Adherence to the Mediterranean diet was assessed by the MEDAS questionnaire, physical activity by the IPAQ, alcohol intake by standard drink units (UBEs), and socioeconomic class by the CNAE-11 classification. Shift work was defined according to ILO criteria. Logistic regression was used to assess associations, adjusting for potential confounders. Results: Shift work was independently associated with increased odds of diabesity both in men and women. Diabesity prevalence was higher when assessed by CUN-BAE compared with BMI. Age, male sex, lower socioeconomic class, physical inactivity, smoking, poor diet adherence, and alcohol intake were all significantly associated with higher risk. The CUN-BAE index showed superior sensitivity in identifying individuals at risk. Conclusions: Shift work and unhealthy behaviors are key determinants of diabesity among Spanish workers. The use of adiposity estimators beyond BMI, such as CUN-BAE, should be encouraged in occupational health surveillance. Workplace-targeted interventions are urgently needed to address this growing metabolic burden.},
  author = {Tosoratto, Javier and Tárraga López, Pedro Juan and López-González, Ángel Arturo and Obrador de Hevia, Joan and Busquets-Cortés, Carla and Ramírez-Manent, José Ignacio},
  journal = {Journal of Clinical Medicine},
  keywords = {grapp-caib},
  month = {aug},
  number = 17,
  pages = 5969,
  title = {Association of Shift Work, Health Behaviors, and Socioeconomic Status with Diabesity in over 53,000 Spanish Employees},
  volume = 14,
  year = 2025
  }
  

  %0 Journal Article
  %1 tosoratto_association_2025
  %A Tosoratto, Javier
  %A Tárraga López, Pedro Juan
  %A López-González, Ángel Arturo
  %A Obrador de Hevia, Joan
  %A Busquets-Cortés, Carla
  %A Ramírez-Manent, José Ignacio
  %D 2025
  %J Journal of Clinical Medicine
  %N 17
  %P 5969
  %R 10.3390/jcm14175969
  %T Association of Shift Work, Health Behaviors, and Socioeconomic Status with Diabesity in over 53,000 Spanish Employees
  %U https://pmc.ncbi.nlm.nih.gov/articles/PMC12429148/
  %V 14
  %X Background: Diabesity, the coexistence of obesity and type 2 diabetes, is a major public health concern. Shift work and unhealthy lifestyle behaviors may exacerbate its prevalence, particularly in working populations. Objective: This study aims to evaluate the association between sociodemographic characteristics, health behaviors, and shift work and the prevalence of diabesity, using both BMI and the CUN-BAE estimator, in a large cohort of Spanish workers. Methods: This cross-sectional study included 53,053 workers (59.8\% men) aged 18–69 years who underwent occupational health examinations. Diabesity was defined as obesity (BMI ≥ 30 kg/m2 or high CUN-BAE) plus fasting glucose ≥ 100 mg/dL or prior diagnosis of diabetes. Adherence to the Mediterranean diet was assessed by the MEDAS questionnaire, physical activity by the IPAQ, alcohol intake by standard drink units (UBEs), and socioeconomic class by the CNAE-11 classification. Shift work was defined according to ILO criteria. Logistic regression was used to assess associations, adjusting for potential confounders. Results: Shift work was independently associated with increased odds of diabesity both in men and women. Diabesity prevalence was higher when assessed by CUN-BAE compared with BMI. Age, male sex, lower socioeconomic class, physical inactivity, smoking, poor diet adherence, and alcohol intake were all significantly associated with higher risk. The CUN-BAE index showed superior sensitivity in identifying individuals at risk. Conclusions: Shift work and unhealthy behaviors are key determinants of diabesity among Spanish workers. The use of adiposity estimators beyond BMI, such as CUN-BAE, should be encouraged in occupational health surveillance. Workplace-targeted interventions are urgently needed to address this growing metabolic burden.
  

• 
  1.

  García Samuelsson M, Tárraga López PJ, López González AA, Busquets-Cortés C, Obrador de Hevia J, Ramírez Manent JI. [Metabolically healthy obesity and cardiovascular risk: Analysis of risk scores in a large population cohort]. Semergen. 2025;51(8):102580.

  AbstractBibTeXEndNoteDOIBibSonomy

  INTRODUCTION: Metabolically healthy obesity (MHO) describes obese individuals without evident metabolic disturbances. However, its relationship with cardiovascular risk remains controversial. OBJECTIVE: To assess cardiovascular risk using different risk scores among MHO individuals compared to metabolically unhealthy obese (MUO) and normal-weight subjects in a large cohort of Spanish workers. METHODS: Cross-sectional study including 68,884 obese workers (45,498 men and 23,386 women). MHO and MUO were classified according to NCEP-ATPIII criteria. Cardiovascular risk was estimated using SCORE2, REGICOR, ERICE, DORICA, vascular age, and avoidable years of life lost. RESULTS: MHO individuals exhibited a better risk profile than MUO subjects but significantly worse than normal-weight individuals. Across all evaluated scores, MUO individuals showed the highest risk values, particularly among men. Lower educational attainment, low social class, physical inactivity, and smoking were independently associated with increased cardiovascular risk. CONCLUSIONS: Although considered intermediate risk, MHO is not a clinically benign phenotype. Targeted preventive strategies are necessary to reduce the progression toward metabolically unhealthy states in this subgroup.

  @article{garcia_samuelsson_metabolically_2025,
  abstract = {INTRODUCTION: Metabolically healthy obesity (MHO) describes obese individuals without evident metabolic disturbances. However, its relationship with cardiovascular risk remains controversial. OBJECTIVE: To assess cardiovascular risk using different risk scores among MHO individuals compared to metabolically unhealthy obese (MUO) and normal-weight subjects in a large cohort of Spanish workers. METHODS: Cross-sectional study including 68,884 obese workers (45,498 men and 23,386 women). MHO and MUO were classified according to NCEP-ATPIII criteria. Cardiovascular risk was estimated using SCORE2, REGICOR, ERICE, DORICA, vascular age, and avoidable years of life lost. RESULTS: MHO individuals exhibited a better risk profile than MUO subjects but significantly worse than normal-weight individuals. Across all evaluated scores, MUO individuals showed the highest risk values, particularly among men. Lower educational attainment, low social class, physical inactivity, and smoking were independently associated with increased cardiovascular risk. CONCLUSIONS: Although considered intermediate risk, MHO is not a clinically benign phenotype. Targeted preventive strategies are necessary to reduce the progression toward metabolically unhealthy states in this subgroup.},
  author = {García Samuelsson, M. and Tárraga López, P. J. and López González, A. A. and Busquets-Cortés, C. and Obrador de Hevia, J. and Ramírez Manent, J. I.},
  journal = {Semergen},
  keywords = {grapp-caib},
  number = 8,
  pages = 102580,
  title = {[Metabolically healthy obesity and cardiovascular risk: Analysis of risk scores in a large population cohort]},
  volume = 51,
  year = 2025
  }
  

  %0 Journal Article
  %1 garcia_samuelsson_metabolically_2025
  %A García Samuelsson, M.
  %A Tárraga López, P. J.
  %A López González, A. A.
  %A Busquets-Cortés, C.
  %A Obrador de Hevia, J.
  %A Ramírez Manent, J. I.
  %D 2025
  %J Semergen
  %N 8
  %P 102580
  %R 10.1016/j.semerg.2025.102580
  %T [Metabolically healthy obesity and cardiovascular risk: Analysis of risk scores in a large population cohort]
  %V 51
  %X INTRODUCTION: Metabolically healthy obesity (MHO) describes obese individuals without evident metabolic disturbances. However, its relationship with cardiovascular risk remains controversial. OBJECTIVE: To assess cardiovascular risk using different risk scores among MHO individuals compared to metabolically unhealthy obese (MUO) and normal-weight subjects in a large cohort of Spanish workers. METHODS: Cross-sectional study including 68,884 obese workers (45,498 men and 23,386 women). MHO and MUO were classified according to NCEP-ATPIII criteria. Cardiovascular risk was estimated using SCORE2, REGICOR, ERICE, DORICA, vascular age, and avoidable years of life lost. RESULTS: MHO individuals exhibited a better risk profile than MUO subjects but significantly worse than normal-weight individuals. Across all evaluated scores, MUO individuals showed the highest risk values, particularly among men. Lower educational attainment, low social class, physical inactivity, and smoking were independently associated with increased cardiovascular risk. CONCLUSIONS: Although considered intermediate risk, MHO is not a clinically benign phenotype. Targeted preventive strategies are necessary to reduce the progression toward metabolically unhealthy states in this subgroup.
  

• 
  1.

  Marina Arroyo M, Obrador de Hevia J, López-González Ángel A, Tárraga López PJ, Busquets-Cortés C, Ramírez-Manent JI. Comparative Accuracy of the ECORE-BF Index Versus Non-Insulin-Based Insulin Resistance Markers in over 400,000 Spanish Adults. Diabetology [Internet]. 2025 Nov.;6(11):130. https://www.mdpi.com/2673-4540/6/11/130

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Background: The early detection of insulin resistance (IR) is critical for the prevention of type 2 diabetes and cardiometabolic diseases. The ECORE-BF index is a simple anthropometric tool for estimating body fat percentage and overweight. However, its potential utility as a predictor of IR risk has not been previously evaluated in large populations using validated IR indices. Methods: This cross-sectional study included 418,343 Spanish workers (172,282 women and 246,061 men) who underwent occupational health evaluations. The ECORE-BF index was calculated for all participants, and its association with four validated surrogate markers of IR was analyzed: the triglyceride–glucose index (TyG), TyG-BMI, METS-IR, and SPISE. Subjects were classified into normal or high-risk IR groups based on established cut-off values. We evaluated the mean ECORE-BF values across groups, the prevalence of ECORE-BF-defined obesity, and the diagnostic performance of ECORE-BF using receiver operating characteristic (ROC) curve analysis. Results: Participants with elevated IR index values had significantly higher mean ECORE-BF scores than those with normal values (p \textless 0.001). The prevalence of ECORE-BF-defined obesity was substantially higher in all high-risk IR groups, exceeding 99% for METS-IR and SPISE in both sexes. ROC analysis demonstrated the high diagnostic accuracy of ECORE-BF in predicting elevated IR risk, with area under the curve (AUC) values ranging from 0.698 (TyG in men) to 0.992 (METS-IR in women). Sensitivity and specificity were also high, particularly for TyG-BMI, SPISE, and METS-IR, with optimal Youden indices above 0.75. Conclusions: ECORE-BF demonstrated high accuracy as a non-invasive tool for identifying individuals at increased insulin resistance risk; however, due to the cross-sectional design, predictive value for incident disease cannot be inferred. Its simplicity, cost-effectiveness, and high diagnostic accuracy support its potential utility in large-scale screening programs for early detection of metabolic risk.

  @article{marina_arroyo_comparative_2025,
  abstract = {Background: The early detection of insulin resistance (IR) is critical for the prevention of type 2 diabetes and cardiometabolic diseases. The ECORE-BF index is a simple anthropometric tool for estimating body fat percentage and overweight. However, its potential utility as a predictor of IR risk has not been previously evaluated in large populations using validated IR indices. Methods: This cross-sectional study included 418,343 Spanish workers (172,282 women and 246,061 men) who underwent occupational health evaluations. The ECORE-BF index was calculated for all participants, and its association with four validated surrogate markers of IR was analyzed: the triglyceride–glucose index (TyG), TyG-BMI, METS-IR, and SPISE. Subjects were classified into normal or high-risk IR groups based on established cut-off values. We evaluated the mean ECORE-BF values across groups, the prevalence of ECORE-BF-defined obesity, and the diagnostic performance of ECORE-BF using receiver operating characteristic (ROC) curve analysis. Results: Participants with elevated IR index values had significantly higher mean ECORE-BF scores than those with normal values (p \textless 0.001). The prevalence of ECORE-BF-defined obesity was substantially higher in all high-risk IR groups, exceeding 99% for METS-IR and SPISE in both sexes. ROC analysis demonstrated the high diagnostic accuracy of ECORE-BF in predicting elevated IR risk, with area under the curve (AUC) values ranging from 0.698 (TyG in men) to 0.992 (METS-IR in women). Sensitivity and specificity were also high, particularly for TyG-BMI, SPISE, and METS-IR, with optimal Youden indices above 0.75. Conclusions: ECORE-BF demonstrated high accuracy as a non-invasive tool for identifying individuals at increased insulin resistance risk; however, due to the cross-sectional design, predictive value for incident disease cannot be inferred. Its simplicity, cost-effectiveness, and high diagnostic accuracy support its potential utility in large-scale screening programs for early detection of metabolic risk.},
  author = {Marina Arroyo, Marta and Obrador de Hevia, Joan and López-González, Ángel Arturo and Tárraga López, Pedro J. and Busquets-Cortés, Carla and Ramírez-Manent, José Ignacio},
  journal = {Diabetology},
  keywords = {grapp-caib},
  month = {nov},
  number = 11,
  pages = 130,
  title = {Comparative Accuracy of the ECORE-BF Index Versus Non-Insulin-Based Insulin Resistance Markers in over 400,000 Spanish Adults},
  volume = 6,
  year = 2025
  }
  

  %0 Journal Article
  %1 marina_arroyo_comparative_2025
  %A Marina Arroyo, Marta
  %A Obrador de Hevia, Joan
  %A López-González, Ángel Arturo
  %A Tárraga López, Pedro J.
  %A Busquets-Cortés, Carla
  %A Ramírez-Manent, José Ignacio
  %D 2025
  %J Diabetology
  %N 11
  %P 130
  %R 10.3390/diabetology6110130
  %T Comparative Accuracy of the ECORE-BF Index Versus Non-Insulin-Based Insulin Resistance Markers in over 400,000 Spanish Adults
  %U https://www.mdpi.com/2673-4540/6/11/130
  %V 6
  %X Background: The early detection of insulin resistance (IR) is critical for the prevention of type 2 diabetes and cardiometabolic diseases. The ECORE-BF index is a simple anthropometric tool for estimating body fat percentage and overweight. However, its potential utility as a predictor of IR risk has not been previously evaluated in large populations using validated IR indices. Methods: This cross-sectional study included 418,343 Spanish workers (172,282 women and 246,061 men) who underwent occupational health evaluations. The ECORE-BF index was calculated for all participants, and its association with four validated surrogate markers of IR was analyzed: the triglyceride–glucose index (TyG), TyG-BMI, METS-IR, and SPISE. Subjects were classified into normal or high-risk IR groups based on established cut-off values. We evaluated the mean ECORE-BF values across groups, the prevalence of ECORE-BF-defined obesity, and the diagnostic performance of ECORE-BF using receiver operating characteristic (ROC) curve analysis. Results: Participants with elevated IR index values had significantly higher mean ECORE-BF scores than those with normal values (p \textless 0.001). The prevalence of ECORE-BF-defined obesity was substantially higher in all high-risk IR groups, exceeding 99% for METS-IR and SPISE in both sexes. ROC analysis demonstrated the high diagnostic accuracy of ECORE-BF in predicting elevated IR risk, with area under the curve (AUC) values ranging from 0.698 (TyG in men) to 0.992 (METS-IR in women). Sensitivity and specificity were also high, particularly for TyG-BMI, SPISE, and METS-IR, with optimal Youden indices above 0.75. Conclusions: ECORE-BF demonstrated high accuracy as a non-invasive tool for identifying individuals at increased insulin resistance risk; however, due to the cross-sectional design, predictive value for incident disease cannot be inferred. Its simplicity, cost-effectiveness, and high diagnostic accuracy support its potential utility in large-scale screening programs for early detection of metabolic risk.
  

• 
  1.

  Ribes Valles JL, Tárraga López PJ, López González Ángel A, Coll Campayo I, Busquets-Cortés C, Ramírez-Manent JI. Associations of Sociodemographic Factors, Lifestyle Habits, and Insomnia Severity with Obesity Indices in Spanish Workers: Sex-Specific Differences. Medical Sciences [Internet]. 2025 Nov.;13(4):271. https://pmc.ncbi.nlm.nih.gov/articles/PMC12641970/

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Background: Obesity and insomnia are prevalent public health issues with shared behavioral and physiological pathways. However, their interplay remains understudied in occupational cohorts. Obesity and insomnia are prevalent public health issues with shared behavioral and physiological pathways. However, their interplay remains understudied in occupational cohorts. This study aimed to evaluate the associations of sociodemographic factors, lifestyle habits, and insomnia severity with multiple obesity indices in a large population of Spanish workers. Methods: We conducted a cross-sectional analysis of 84,898 workers (2021–2024). Data were obtained from annual occupational health assessments conducted across multiple Spanish regions between 2020 and 2024. Insomnia severity was assessed using the Insomnia Severity Index (ISI), dietary quality using the 14-item Mediterranean Diet Adherence Screener (MEDAS-14), and physical activity using the International Physical Activity Questionnaire—Short Form (IPAQ-SF). Adiposity was measured using Body Mass Index (BMI), waist-to-height ratio (WtHR), the Clínica Universidad de Navarra–Body Adiposity Estimator (CUN-BAE), and the Metabolic Score for Visceral Fat (METS-VF). Multivariable logistic regression models were used to examine associations adjusted for age, sex, education, and occupational social class. Results: Higher ISI scores were significantly and independently associated with elevated adiposity across all indices, with the strongest association observed for METS-VF (odds ratio = 1.19, 95\% CI 1.14–1.25, p \textless 0.001). Women showed higher mean CUN-BAE and METS-VF values than men (CUN-BAE: 37.4 ± 6.2 vs. 25.6 ± 6.4; p \textless 0.001; METS-VF: 5.7 ± 0.7 vs. 6.4 ± 0.6; p \textless 0.001), despite lower BMI (25.3 ± 4.8 vs. 26.8 ± 4.3; p \textless 0.001). Lower physical activity (OR = 5.70; 95\% CI 4.91–6.50), poor adherence to the Mediterranean diet (OR = 3.29; 95\% CI 2.88–3.70), smoking (OR = 1.29; 95\% CI 1.22–1.36), and lower occupational class (Class III: OR = 1.77; 95\% CI 1.56–1.97) were also significantly associated with higher obesity markers. Associations were more pronounced among women and participants with severe insomnia symptoms. Conclusions: Insomnia severity, sociodemographic disadvantage, and unhealthy behaviors (low physical activity, poor diet, smoking) were all independent correlates of general and visceral adiposity. The findings underscore the need for comprehensive workplace health programs that integrate sleep quality assessment, dietary improvement, and physical activity promotion to prevent obesity and its metabolic consequences.

  @article{ribes_valles_associations_2025,
  abstract = {Background: Obesity and insomnia are prevalent public health issues with shared behavioral and physiological pathways. However, their interplay remains understudied in occupational cohorts. Obesity and insomnia are prevalent public health issues with shared behavioral and physiological pathways. However, their interplay remains understudied in occupational cohorts. This study aimed to evaluate the associations of sociodemographic factors, lifestyle habits, and insomnia severity with multiple obesity indices in a large population of Spanish workers. Methods: We conducted a cross-sectional analysis of 84,898 workers (2021–2024). Data were obtained from annual occupational health assessments conducted across multiple Spanish regions between 2020 and 2024. Insomnia severity was assessed using the Insomnia Severity Index (ISI), dietary quality using the 14-item Mediterranean Diet Adherence Screener (MEDAS-14), and physical activity using the International Physical Activity Questionnaire—Short Form (IPAQ-SF). Adiposity was measured using Body Mass Index (BMI), waist-to-height ratio (WtHR), the Clínica Universidad de Navarra–Body Adiposity Estimator (CUN-BAE), and the Metabolic Score for Visceral Fat (METS-VF). Multivariable logistic regression models were used to examine associations adjusted for age, sex, education, and occupational social class. Results: Higher ISI scores were significantly and independently associated with elevated adiposity across all indices, with the strongest association observed for METS-VF (odds ratio = 1.19, 95\% CI 1.14–1.25, p \textless 0.001). Women showed higher mean CUN-BAE and METS-VF values than men (CUN-BAE: 37.4 ± 6.2 vs. 25.6 ± 6.4; p \textless 0.001; METS-VF: 5.7 ± 0.7 vs. 6.4 ± 0.6; p \textless 0.001), despite lower BMI (25.3 ± 4.8 vs. 26.8 ± 4.3; p \textless 0.001). Lower physical activity (OR = 5.70; 95\% CI 4.91–6.50), poor adherence to the Mediterranean diet (OR = 3.29; 95\% CI 2.88–3.70), smoking (OR = 1.29; 95\% CI 1.22–1.36), and lower occupational class (Class III: OR = 1.77; 95\% CI 1.56–1.97) were also significantly associated with higher obesity markers. Associations were more pronounced among women and participants with severe insomnia symptoms. Conclusions: Insomnia severity, sociodemographic disadvantage, and unhealthy behaviors (low physical activity, poor diet, smoking) were all independent correlates of general and visceral adiposity. The findings underscore the need for comprehensive workplace health programs that integrate sleep quality assessment, dietary improvement, and physical activity promotion to prevent obesity and its metabolic consequences.},
  author = {Ribes Valles, José Luis and Tárraga López, Pedro Juan and López González, Ángel Arturo and Coll Campayo, Irene and Busquets-Cortés, Carla and Ramírez-Manent, José Ignacio},
  journal = {Medical Sciences},
  keywords = {grapp-caib},
  month = {nov},
  number = 4,
  pages = 271,
  title = {Associations of Sociodemographic Factors, Lifestyle Habits, and Insomnia Severity with Obesity Indices in Spanish Workers: Sex-Specific Differences},
  volume = 13,
  year = 2025
  }
  

  %0 Journal Article
  %1 ribes_valles_associations_2025
  %A Ribes Valles, José Luis
  %A Tárraga López, Pedro Juan
  %A López González, Ángel Arturo
  %A Coll Campayo, Irene
  %A Busquets-Cortés, Carla
  %A Ramírez-Manent, José Ignacio
  %D 2025
  %J Medical Sciences
  %N 4
  %P 271
  %R 10.3390/medsci13040271
  %T Associations of Sociodemographic Factors, Lifestyle Habits, and Insomnia Severity with Obesity Indices in Spanish Workers: Sex-Specific Differences
  %U https://pmc.ncbi.nlm.nih.gov/articles/PMC12641970/
  %V 13
  %X Background: Obesity and insomnia are prevalent public health issues with shared behavioral and physiological pathways. However, their interplay remains understudied in occupational cohorts. Obesity and insomnia are prevalent public health issues with shared behavioral and physiological pathways. However, their interplay remains understudied in occupational cohorts. This study aimed to evaluate the associations of sociodemographic factors, lifestyle habits, and insomnia severity with multiple obesity indices in a large population of Spanish workers. Methods: We conducted a cross-sectional analysis of 84,898 workers (2021–2024). Data were obtained from annual occupational health assessments conducted across multiple Spanish regions between 2020 and 2024. Insomnia severity was assessed using the Insomnia Severity Index (ISI), dietary quality using the 14-item Mediterranean Diet Adherence Screener (MEDAS-14), and physical activity using the International Physical Activity Questionnaire—Short Form (IPAQ-SF). Adiposity was measured using Body Mass Index (BMI), waist-to-height ratio (WtHR), the Clínica Universidad de Navarra–Body Adiposity Estimator (CUN-BAE), and the Metabolic Score for Visceral Fat (METS-VF). Multivariable logistic regression models were used to examine associations adjusted for age, sex, education, and occupational social class. Results: Higher ISI scores were significantly and independently associated with elevated adiposity across all indices, with the strongest association observed for METS-VF (odds ratio = 1.19, 95\% CI 1.14–1.25, p \textless 0.001). Women showed higher mean CUN-BAE and METS-VF values than men (CUN-BAE: 37.4 ± 6.2 vs. 25.6 ± 6.4; p \textless 0.001; METS-VF: 5.7 ± 0.7 vs. 6.4 ± 0.6; p \textless 0.001), despite lower BMI (25.3 ± 4.8 vs. 26.8 ± 4.3; p \textless 0.001). Lower physical activity (OR = 5.70; 95\% CI 4.91–6.50), poor adherence to the Mediterranean diet (OR = 3.29; 95\% CI 2.88–3.70), smoking (OR = 1.29; 95\% CI 1.22–1.36), and lower occupational class (Class III: OR = 1.77; 95\% CI 1.56–1.97) were also significantly associated with higher obesity markers. Associations were more pronounced among women and participants with severe insomnia symptoms. Conclusions: Insomnia severity, sociodemographic disadvantage, and unhealthy behaviors (low physical activity, poor diet, smoking) were all independent correlates of general and visceral adiposity. The findings underscore the need for comprehensive workplace health programs that integrate sleep quality assessment, dietary improvement, and physical activity promotion to prevent obesity and its metabolic consequences.
  

• 
  1.

  Fernández-Figares Vicioso MP, López-González Á. A, Ramírez-Manent JI, Del Barrio Fernández JL, Tárraga López PJ, Vicente-Herreros MT. Prevalence of obesity: Comparison of commerce vs. industry sector and associated variables. Hipertensión y Riesgo Vascular [Internet]. 2025 Oct.;42(4):276-88. https://www.sciencedirect.com/science/article/pii/S1889183725000492

  AbstractURLBibTeXEndNoteDOIBibSonomy

  Introduction and objectives Obesity has been considered the pandemic of the 21st century due to its high prevalence and the significant morbidity and mortality it entails. The aim of this study is to assess the prevalence of obesity in two occupational sectors and to determine the variables associated with it. Methodology This is a cross-sectional and descriptive study involving 56,856 workers from the commerce and industrial sectors. Anthropometric, clinical, analytical, and sociodemographic data were collected during medical examinations conducted between 2017 and 2019. Results The prevalence of obesity was found to be significantly higher in the industrial sector compared to the commerce sector. Factors such as age, sex, educational level, physical activity, adherence to the Mediterranean diet, and smoking showed significant associations with the four scales of excess weight evaluated. Among these, age, physical activity level, and adherence to the Mediterranean diet demonstrated the strongest associations. In the industrial sector, obesity may be related to work-related stress, prolonged shifts, and limited access to healthy food, whereas in the commerce sector, sedentary behaviour and poor dietary habits were identified as key contributing factors. Conclusions Specific strategies tailored to each occupational sector are recommended, including active breaks, the promotion of physical activity, and access to healthy foods. While the study has strengths such as its large sample size and multivariate analysis, the cross-sectional design and lack of control for certain confounding variables limit its ability to establish causality. The findings underscore the need for preventive policies adapted to workplace environments to mitigate the impact of obesity. Resumen Introducción y objetivos La obesidad se ha considerado como la pandemia del siglo xxi por su elevada prevalencia y la gran morbimortalidad que acarrea. El objetivo es valorar la prevalencia de obesidad en dos sectores laborales y determinar qué variables se asocian con ella. Metodología Estudio transversal y descriptivo en 56.856 trabajadores de los sectores comercio e industrial. Se recolectaron datos antropométricos, clínicos, analíticos y sociodemográficos durante exámenes médicos realizados entre 2017 y 2019. Resultados Se observa una prevalencia de obesidad significativamente mayor en el sector industrial en comparación con el comercio. Factores como edad, sexo, nivel educativo, actividad física, dieta mediterránea y tabaquismo presentaron asociaciones relevantes con las cuatro escalas de exceso de peso evaluadas. La edad, el nivel de actividad física y la dieta mediterránea fueron las variables con mayor asociación. En el sector industrial, la obesidad podría relacionarse con estrés laboral, turnos prolongados y acceso limitado a alimentos saludables, mientras que en el sector comercio el sedentarismo y los hábitos alimentarios inadecuados son factores destacados. Conclusiones Se recomienda desarrollar estrategias específicas para cada sector laboral, incluyendo pausas activas, promoción de actividad física y acceso a alimentos saludables. Aunque el estudio presenta fortalezas, como su amplio tamaño muestral y el análisis multivariado, el diseño transversal y la falta de control de algunas variables de confusión limitan su capacidad para establecer causalidad. Los hallazgos subrayan la necesidad de políticas preventivas adaptadas al entorno laboral para mitigar el impacto de la obesidad.

  @article{fernandez-figares_vicioso_prevalence_2025,
  abstract = {Introduction and objectives Obesity has been considered the pandemic of the 21st century due to its high prevalence and the significant morbidity and mortality it entails. The aim of this study is to assess the prevalence of obesity in two occupational sectors and to determine the variables associated with it. Methodology This is a cross-sectional and descriptive study involving 56,856 workers from the commerce and industrial sectors. Anthropometric, clinical, analytical, and sociodemographic data were collected during medical examinations conducted between 2017 and 2019. Results The prevalence of obesity was found to be significantly higher in the industrial sector compared to the commerce sector. Factors such as age, sex, educational level, physical activity, adherence to the Mediterranean diet, and smoking showed significant associations with the four scales of excess weight evaluated. Among these, age, physical activity level, and adherence to the Mediterranean diet demonstrated the strongest associations. In the industrial sector, obesity may be related to work-related stress, prolonged shifts, and limited access to healthy food, whereas in the commerce sector, sedentary behaviour and poor dietary habits were identified as key contributing factors. Conclusions Specific strategies tailored to each occupational sector are recommended, including active breaks, the promotion of physical activity, and access to healthy foods. While the study has strengths such as its large sample size and multivariate analysis, the cross-sectional design and lack of control for certain confounding variables limit its ability to establish causality. The findings underscore the need for preventive policies adapted to workplace environments to mitigate the impact of obesity. Resumen Introducción y objetivos La obesidad se ha considerado como la pandemia del siglo xxi por su elevada prevalencia y la gran morbimortalidad que acarrea. El objetivo es valorar la prevalencia de obesidad en dos sectores laborales y determinar qué variables se asocian con ella. Metodología Estudio transversal y descriptivo en 56.856 trabajadores de los sectores comercio e industrial. Se recolectaron datos antropométricos, clínicos, analíticos y sociodemográficos durante exámenes médicos realizados entre 2017 y 2019. Resultados Se observa una prevalencia de obesidad significativamente mayor en el sector industrial en comparación con el comercio. Factores como edad, sexo, nivel educativo, actividad física, dieta mediterránea y tabaquismo presentaron asociaciones relevantes con las cuatro escalas de exceso de peso evaluadas. La edad, el nivel de actividad física y la dieta mediterránea fueron las variables con mayor asociación. En el sector industrial, la obesidad podría relacionarse con estrés laboral, turnos prolongados y acceso limitado a alimentos saludables, mientras que en el sector comercio el sedentarismo y los hábitos alimentarios inadecuados son factores destacados. Conclusiones Se recomienda desarrollar estrategias específicas para cada sector laboral, incluyendo pausas activas, promoción de actividad física y acceso a alimentos saludables. Aunque el estudio presenta fortalezas, como su amplio tamaño muestral y el análisis multivariado, el diseño transversal y la falta de control de algunas variables de confusión limitan su capacidad para establecer causalidad. Los hallazgos subrayan la necesidad de políticas preventivas adaptadas al entorno laboral para mitigar el impacto de la obesidad.},
  author = {Fernández-Figares Vicioso, M. P. and López-González, Á. A. and Ramírez-Manent, J. I. and Del Barrio Fernández, J. L. and Tárraga López, P. J. and Vicente-Herreros, M. T.},
  journal = {Hipertensión y Riesgo Vascular},
  keywords = {grapp-caib},
  month = {oct},
  number = 4,
  pages = {276--288},
  title = {Prevalence of obesity: Comparison of commerce vs. industry sector and associated variables},
  volume = 42,
  year = 2025
  }
  

  %0 Journal Article
  %1 fernandez-figares_vicioso_prevalence_2025
  %A Fernández-Figares Vicioso, M. P.
  %A López-González, Á. A.
  %A Ramírez-Manent, J. I.
  %A Del Barrio Fernández, J. L.
  %A Tárraga López, P. J.
  %A Vicente-Herreros, M. T.
  %D 2025
  %J Hipertensión y Riesgo Vascular
  %N 4
  %P 276--288
  %R 10.1016/j.hipert.2025.04.002
  %T Prevalence of obesity: Comparison of commerce vs. industry sector and associated variables
  %U https://www.sciencedirect.com/science/article/pii/S1889183725000492
  %V 42
  %X Introduction and objectives Obesity has been considered the pandemic of the 21st century due to its high prevalence and the significant morbidity and mortality it entails. The aim of this study is to assess the prevalence of obesity in two occupational sectors and to determine the variables associated with it. Methodology This is a cross-sectional and descriptive study involving 56,856 workers from the commerce and industrial sectors. Anthropometric, clinical, analytical, and sociodemographic data were collected during medical examinations conducted between 2017 and 2019. Results The prevalence of obesity was found to be significantly higher in the industrial sector compared to the commerce sector. Factors such as age, sex, educational level, physical activity, adherence to the Mediterranean diet, and smoking showed significant associations with the four scales of excess weight evaluated. Among these, age, physical activity level, and adherence to the Mediterranean diet demonstrated the strongest associations. In the industrial sector, obesity may be related to work-related stress, prolonged shifts, and limited access to healthy food, whereas in the commerce sector, sedentary behaviour and poor dietary habits were identified as key contributing factors. Conclusions Specific strategies tailored to each occupational sector are recommended, including active breaks, the promotion of physical activity, and access to healthy foods. While the study has strengths such as its large sample size and multivariate analysis, the cross-sectional design and lack of control for certain confounding variables limit its ability to establish causality. The findings underscore the need for preventive policies adapted to workplace environments to mitigate the impact of obesity. Resumen Introducción y objetivos La obesidad se ha considerado como la pandemia del siglo xxi por su elevada prevalencia y la gran morbimortalidad que acarrea. El objetivo es valorar la prevalencia de obesidad en dos sectores laborales y determinar qué variables se asocian con ella. Metodología Estudio transversal y descriptivo en 56.856 trabajadores de los sectores comercio e industrial. Se recolectaron datos antropométricos, clínicos, analíticos y sociodemográficos durante exámenes médicos realizados entre 2017 y 2019. Resultados Se observa una prevalencia de obesidad significativamente mayor en el sector industrial en comparación con el comercio. Factores como edad, sexo, nivel educativo, actividad física, dieta mediterránea y tabaquismo presentaron asociaciones relevantes con las cuatro escalas de exceso de peso evaluadas. La edad, el nivel de actividad física y la dieta mediterránea fueron las variables con mayor asociación. En el sector industrial, la obesidad podría relacionarse con estrés laboral, turnos prolongados y acceso limitado a alimentos saludables, mientras que en el sector comercio el sedentarismo y los hábitos alimentarios inadecuados son factores destacados. Conclusiones Se recomienda desarrollar estrategias específicas para cada sector laboral, incluyendo pausas activas, promoción de actividad física y acceso a alimentos saludables. Aunque el estudio presenta fortalezas, como su amplio tamaño muestral y el análisis multivariado, el diseño transversal y la falta de control de algunas variables de confusión limitan su capacidad para establecer causalidad. Los hallazgos subrayan la necesidad de políticas preventivas adaptadas al entorno laboral para mitigar el impacto de la obesidad.
  

• 
  1.

  Sánchez Rodríguez C, Chela Álvarez X, Llobera J, Terrer E, Vidal Thomas MC, Zarzosa C, Bulilete O. Evaluation of an intervention based on lifestyle modification and coping with chronic pain and stress in reducing pain in hotel housekeepers: a cluster-randomised clinical trial in primary health care. Academic Journal of Health Sciences 2025, vol. 40, n.6 pp. 66-77 [Internet]. 2025;40(6). https://ibdigital.uib.es/greenstone/library/collection/medicinaBalear/document/AJHS_Medicina_Balear_2025v40n6p066

  URLBibTeXEndNoteBibSonomyDownload

  @article{sanchez_rodriguez_evaluation_2025,
  author = {Sánchez Rodríguez, Cristian and Chela Álvarez, Xenia and Llobera, Joan and Terrer, Estela and Vidal Thomas, María Clar and Zarzosa, Carmen and Bulilete, Oana},
  journal = {Academic Journal of Health Sciences 2025, vol. 40, n.6 pp. 66-77},
  keywords = {grapp-caib},
  number = 6,
  title = {Evaluation of an intervention based on lifestyle modification and coping with chronic pain and stress in reducing pain in hotel housekeepers: a cluster-randomised clinical trial in primary health care},
  volume = 40,
  year = 2025
  }
  

  %0 Journal Article
  %1 sanchez_rodriguez_evaluation_2025
  %A Sánchez Rodríguez, Cristian
  %A Chela Álvarez, Xenia
  %A Llobera, Joan
  %A Terrer, Estela
  %A Vidal Thomas, María Clar
  %A Zarzosa, Carmen
  %A Bulilete, Oana
  %D 2025
  %J Academic Journal of Health Sciences 2025, vol. 40, n.6 pp. 66-77
  %N 6
  %T Evaluation of an intervention based on lifestyle modification and coping with chronic pain and stress in reducing pain in hotel housekeepers: a cluster-randomised clinical trial in primary health care
  %U https://ibdigital.uib.es/greenstone/library/collection/medicinaBalear/document/AJHS_Medicina_Balear_2025v40n6p066
  %V 40
  

• 
  1.

  Bescos R, Gallardo-Alfaro L, Ashor A, Rizzolo-Brime L, Siervo M, Casas-Agustench P. Nitrate and nitrite bioavailability in plasma and saliva: Their association with blood pressure — A systematic review and meta-analysis. Free Radical Biology and Medicine [Internet]. 2025 Jan.;226:70-83. https://www.sciencedirect.com/science/article/pii/S0891584924010335

  AbstractURLBibTeXEndNoteDOIBibSonomy

  In this study, we conducted a systematic review and meta-analysis to determine plasma and salivary nitrate (NO3−) and nitrite (NO2−) concentrations under resting and fasting conditions in different type of individuals and their association with blood pressure levels. A total of 77 studies, involving 1918 individuals aged 19–74 years (males = 906; females = 1012), which measured plasma and/or salivary NO3− and NO2− using the chemiluminescence technique, were included. Mean plasma NO3− and NO2− concentrations were 33.9 μmol/L and 158.3 nmol/L, respectively. Subgroup analyses revealed lower plasma NO3− and NO2− concentrations in individuals with cardiometabolic risk (NO3−: 21.2 μmol/L; 95 \% CI, 13.4–29.0; NO2−: 122.8 nmol/L; 95 \% CI, 75.3–138.9) compared to healthy (NO3−: 33.9 μmol/L; 95 \% CI, 29.9–37.9; NO2−: 159.5 nmol/L; 95 \% CI, 131.8–187.1; P \textless 0.01) and trained individuals (NO3−: 43.0 μmol/L; 95 \% CI, 13.2–72.9; NO2−: 199.3 nmol/L; 95 \% CI, 117.6–281; P \textless 0.01). Mean salivary NO3− and NO2− concentrations were 546.2 μmol/L and 197.8 μmol/L, respectively. Salivary NO3−, but no NO2−, concentrations were higher in individuals with cardiometabolic risk (680.0 μmol/L; 95 \% CI, 510.2–849.8; P = 0.001) compared to healthy individuals (535.9 μmol/L; 95 \% CI, 384.2–687.6). A significant positive association (coefficient, 15.4 [95 \% CI, 0.255 to 30.5], P = 0.046) was observed between salivary NO3− and diastolic blood pressure (DBP). These findings suggest that the health status is positively associated with plasma NO3− and NO2− concentrations, but the circulatory levels of these anions are not associated with blood pressure. Only salivary NO3− showed a significant positive association with DBP.

  @article{bescos_nitrate_2025,
  abstract = {In this study, we conducted a systematic review and meta-analysis to determine plasma and salivary nitrate (NO3−) and nitrite (NO2−) concentrations under resting and fasting conditions in different type of individuals and their association with blood pressure levels. A total of 77 studies, involving 1918 individuals aged 19–74 years (males = 906; females = 1012), which measured plasma and/or salivary NO3− and NO2− using the chemiluminescence technique, were included. Mean plasma NO3− and NO2− concentrations were 33.9 μmol/L and 158.3 nmol/L, respectively. Subgroup analyses revealed lower plasma NO3− and NO2− concentrations in individuals with cardiometabolic risk (NO3−: 21.2 μmol/L; 95 \% CI, 13.4–29.0; NO2−: 122.8 nmol/L; 95 \% CI, 75.3–138.9) compared to healthy (NO3−: 33.9 μmol/L; 95 \% CI, 29.9–37.9; NO2−: 159.5 nmol/L; 95 \% CI, 131.8–187.1; P \textless 0.01) and trained individuals (NO3−: 43.0 μmol/L; 95 \% CI, 13.2–72.9; NO2−: 199.3 nmol/L; 95 \% CI, 117.6–281; P \textless 0.01). Mean salivary NO3− and NO2− concentrations were 546.2 μmol/L and 197.8 μmol/L, respectively. Salivary NO3−, but no NO2−, concentrations were higher in individuals with cardiometabolic risk (680.0 μmol/L; 95 \% CI, 510.2–849.8; P = 0.001) compared to healthy individuals (535.9 μmol/L; 95 \% CI, 384.2–687.6). A significant positive association (coefficient, 15.4 [95 \% CI, 0.255 to 30.5], P = 0.046) was observed between salivary NO3− and diastolic blood pressure (DBP). These findings suggest that the health status is positively associated with plasma NO3− and NO2− concentrations, but the circulatory levels of these anions are not associated with blood pressure. Only salivary NO3− showed a significant positive association with DBP.},
  author = {Bescos, Raul and Gallardo-Alfaro, Laura and Ashor, Ammar and Rizzolo-Brime, Lucia and Siervo, Mario and Casas-Agustench, Patricia},
  journal = {Free Radical Biology and Medicine},
  keywords = {grapp-caib},
  month = {jan},
  pages = {70--83},
  title = {Nitrate and nitrite bioavailability in plasma and saliva: Their association with blood pressure — A systematic review and meta-analysis},
  volume = 226,
  year = 2025
  }
  

  %0 Journal Article
  %1 bescos_nitrate_2025
  %A Bescos, Raul
  %A Gallardo-Alfaro, Laura
  %A Ashor, Ammar
  %A Rizzolo-Brime, Lucia
  %A Siervo, Mario
  %A Casas-Agustench, Patricia
  %D 2025
  %J Free Radical Biology and Medicine
  %P 70--83
  %R 10.1016/j.freeradbiomed.2024.11.010
  %T Nitrate and nitrite bioavailability in plasma and saliva: Their association with blood pressure — A systematic review and meta-analysis
  %U https://www.sciencedirect.com/science/article/pii/S0891584924010335
  %V 226
  %X In this study, we conducted a systematic review and meta-analysis to determine plasma and salivary nitrate (NO3−) and nitrite (NO2−) concentrations under resting and fasting conditions in different type of individuals and their association with blood pressure levels. A total of 77 studies, involving 1918 individuals aged 19–74 years (males = 906; females = 1012), which measured plasma and/or salivary NO3− and NO2− using the chemiluminescence technique, were included. Mean plasma NO3− and NO2− concentrations were 33.9 μmol/L and 158.3 nmol/L, respectively. Subgroup analyses revealed lower plasma NO3− and NO2− concentrations in individuals with cardiometabolic risk (NO3−: 21.2 μmol/L; 95 \% CI, 13.4–29.0; NO2−: 122.8 nmol/L; 95 \% CI, 75.3–138.9) compared to healthy (NO3−: 33.9 μmol/L; 95 \% CI, 29.9–37.9; NO2−: 159.5 nmol/L; 95 \% CI, 131.8–187.1; P \textless 0.01) and trained individuals (NO3−: 43.0 μmol/L; 95 \% CI, 13.2–72.9; NO2−: 199.3 nmol/L; 95 \% CI, 117.6–281; P \textless 0.01). Mean salivary NO3− and NO2− concentrations were 546.2 μmol/L and 197.8 μmol/L, respectively. Salivary NO3−, but no NO2−, concentrations were higher in individuals with cardiometabolic risk (680.0 μmol/L; 95 \% CI, 510.2–849.8; P = 0.001) compared to healthy individuals (535.9 μmol/L; 95 \% CI, 384.2–687.6). A significant positive association (coefficient, 15.4 [95 \% CI, 0.255 to 30.5], P = 0.046) was observed between salivary NO3− and diastolic blood pressure (DBP). These findings suggest that the health status is positively associated with plasma NO3− and NO2− concentrations, but the circulatory levels of these anions are not associated with blood pressure. Only salivary NO3− showed a significant positive association with DBP.
  

• 
  1.

  Guarro Miguel JJ, Tárraga López PJ, Marzoa Jansana MD, López-González Ángel A, Riutord Sbert P, Busquets-Cortés C, Ramirez-Manent JI. Diagnostic Accuracy of Anthropometric and Metabolic Indicators for Predicting MASLD: Evidence from a Large Cohort of Spanish Workers Using FLI and LAP. Medical Sciences [Internet]. 2025 Sep.;13(3):160. https://www.mdpi.com/2076-3271/13/3/160

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Background: Metabolic-dysfunction-associated steatotic liver disease (MASLD) is a major global health concern associated with insulin resistance, metabolic syndrome, and cardiovascular morbidity. Early identification of at-risk individuals through simple, non-invasive methods is essential, particularly in working populations. Objectives: This study aimed to assess and compare the diagnostic accuracy of four widely used anthropometric and metabolic indicators—body mass index (BMI), waist-to-height ratio (WtHR), triglyceride–glucose index (TyG), and waist–triglyceride index (WTI)—in identifying individuals at risk of metabolic-dysfunction-associated steatotic liver disease (MASLD), as determined by the Fatty Liver Index (FLI) and the Lipid Accumulation Product (LAP), within a large sample of Spanish workers. Methods: A cross-sectional analysis was performed on data from 386,924 Spanish employees aged between 18 and 69 years. Standardized anthropometric and laboratory measurements were obtained as part of routine occupational medical examinations conducted from 2021 to 2023. The presence of NAFLD was inferred using two validated surrogate markers: FLI and LAP. Receiver operating characteristic (ROC) curves and area under the curve (AUC) values were used to assess the discriminatory ability of each index, stratified by sex. Results: WTI and TyG demonstrated the highest diagnostic accuracy for both FLI- and LAP-defined NAFLD, with AUC values textgreater0.95 in both sexes. WTI showed the best overall performance, followed closely by TyG. WtHR outperformed BMI but was less accurate than the metabolic indices. Sex-stratified analyses confirmed consistent patterns, with slightly higher AUCs for TyG and WTI in women. BMI consistently yielded the lowest discriminatory performance. Conclusions: WTI and TyG are superior to BMI and WtHR for non-invasive screening of MASLD in occupational settings. Their simplicity, low cost, and strong predictive value support their integration into routine workplace health surveillance. Sex-specific thresholds and prospective validation are warranted to enhance clinical application.

  @article{guarro_miguel_diagnostic_2025,
  abstract = {Background: Metabolic-dysfunction-associated steatotic liver disease (MASLD) is a major global health concern associated with insulin resistance, metabolic syndrome, and cardiovascular morbidity. Early identification of at-risk individuals through simple, non-invasive methods is essential, particularly in working populations. Objectives: This study aimed to assess and compare the diagnostic accuracy of four widely used anthropometric and metabolic indicators—body mass index (BMI), waist-to-height ratio (WtHR), triglyceride–glucose index (TyG), and waist–triglyceride index (WTI)—in identifying individuals at risk of metabolic-dysfunction-associated steatotic liver disease (MASLD), as determined by the Fatty Liver Index (FLI) and the Lipid Accumulation Product (LAP), within a large sample of Spanish workers. Methods: A cross-sectional analysis was performed on data from 386,924 Spanish employees aged between 18 and 69 years. Standardized anthropometric and laboratory measurements were obtained as part of routine occupational medical examinations conducted from 2021 to 2023. The presence of NAFLD was inferred using two validated surrogate markers: FLI and LAP. Receiver operating characteristic (ROC) curves and area under the curve (AUC) values were used to assess the discriminatory ability of each index, stratified by sex. Results: WTI and TyG demonstrated the highest diagnostic accuracy for both FLI- and LAP-defined NAFLD, with AUC values textgreater0.95 in both sexes. WTI showed the best overall performance, followed closely by TyG. WtHR outperformed BMI but was less accurate than the metabolic indices. Sex-stratified analyses confirmed consistent patterns, with slightly higher AUCs for TyG and WTI in women. BMI consistently yielded the lowest discriminatory performance. Conclusions: WTI and TyG are superior to BMI and WtHR for non-invasive screening of MASLD in occupational settings. Their simplicity, low cost, and strong predictive value support their integration into routine workplace health surveillance. Sex-specific thresholds and prospective validation are warranted to enhance clinical application.},
  author = {Guarro Miguel, Juan José and Tárraga López, Pedro Juan and Marzoa Jansana, María Dolores and López-González, Ángel Arturo and Riutord Sbert, Pere and Busquets-Cortés, Carla and Ramirez-Manent, José Ignacio},
  journal = {Medical Sciences},
  keywords = {grapp-caib},
  month = {sep},
  number = 3,
  pages = 160,
  title = {Diagnostic Accuracy of Anthropometric and Metabolic Indicators for Predicting MASLD: Evidence from a Large Cohort of Spanish Workers Using FLI and LAP},
  volume = 13,
  year = 2025
  }
  

  %0 Journal Article
  %1 guarro_miguel_diagnostic_2025
  %A Guarro Miguel, Juan José
  %A Tárraga López, Pedro Juan
  %A Marzoa Jansana, María Dolores
  %A López-González, Ángel Arturo
  %A Riutord Sbert, Pere
  %A Busquets-Cortés, Carla
  %A Ramirez-Manent, José Ignacio
  %D 2025
  %J Medical Sciences
  %N 3
  %P 160
  %R 10.3390/medsci13030160
  %T Diagnostic Accuracy of Anthropometric and Metabolic Indicators for Predicting MASLD: Evidence from a Large Cohort of Spanish Workers Using FLI and LAP
  %U https://www.mdpi.com/2076-3271/13/3/160
  %V 13
  %X Background: Metabolic-dysfunction-associated steatotic liver disease (MASLD) is a major global health concern associated with insulin resistance, metabolic syndrome, and cardiovascular morbidity. Early identification of at-risk individuals through simple, non-invasive methods is essential, particularly in working populations. Objectives: This study aimed to assess and compare the diagnostic accuracy of four widely used anthropometric and metabolic indicators—body mass index (BMI), waist-to-height ratio (WtHR), triglyceride–glucose index (TyG), and waist–triglyceride index (WTI)—in identifying individuals at risk of metabolic-dysfunction-associated steatotic liver disease (MASLD), as determined by the Fatty Liver Index (FLI) and the Lipid Accumulation Product (LAP), within a large sample of Spanish workers. Methods: A cross-sectional analysis was performed on data from 386,924 Spanish employees aged between 18 and 69 years. Standardized anthropometric and laboratory measurements were obtained as part of routine occupational medical examinations conducted from 2021 to 2023. The presence of NAFLD was inferred using two validated surrogate markers: FLI and LAP. Receiver operating characteristic (ROC) curves and area under the curve (AUC) values were used to assess the discriminatory ability of each index, stratified by sex. Results: WTI and TyG demonstrated the highest diagnostic accuracy for both FLI- and LAP-defined NAFLD, with AUC values textgreater0.95 in both sexes. WTI showed the best overall performance, followed closely by TyG. WtHR outperformed BMI but was less accurate than the metabolic indices. Sex-stratified analyses confirmed consistent patterns, with slightly higher AUCs for TyG and WTI in women. BMI consistently yielded the lowest discriminatory performance. Conclusions: WTI and TyG are superior to BMI and WtHR for non-invasive screening of MASLD in occupational settings. Their simplicity, low cost, and strong predictive value support their integration into routine workplace health surveillance. Sex-specific thresholds and prospective validation are warranted to enhance clinical application.
  

• 
  1.

  Marzoa Jansana MD, Tárraga López PJ, Guarro Miquel JJ, López-González Ángel A, Riutord Sbert P, Busquets-Cortés C, Ramírez-Manent JI. Sociodemographic Factors, Healthy Habits, and Quality of Life in Relation to Insulin Resistance Risk in a Large Cohort of Spanish Workers. Medical Sciences [Internet]. 2025 Aug.;13(3):122. https://pmc.ncbi.nlm.nih.gov/articles/PMC12371977/

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Background: Insulin resistance (IR) is a key pathogenic mechanism underlying numerous cardiometabolic disorders. While sociodemographic and lifestyle determinants of IR are well-established, their association with health-related quality of life (HRQoL) remains understudied. This study explores the relationship between IR risk, as measured by TyG, METS-IR, and SPISE-IR indices, and HRQoL in a large cohort of Spanish workers. Methods: This cross-sectional study included 100,014 Spanish workers aged 18–69 years evaluated between January 2021 and December 2023. Exclusion criteria included incomplete clinical, laboratory, or questionnaire data. IR was assessed using TyG, METS-IR, and SPISE-IR indices. HRQoL was measured using the SF-12 questionnaire. Sociodemographic factors, physical activity (IPAQ), dietary habits (MEDAS-14), and social class (based on CNAE-11 and Spanish Society of Epidemiology criteria) were also evaluated. Statistical analysis was conducted using SPSS v29.0. Results: Higher IR risk was consistently associated with older age, male sex, lower social class, current smoking, low adherence to the Mediterranean diet, and physical inactivity. Lower HRQoL scores (both physical and mental components) were significantly associated with higher IR indices, particularly with METS-IR and SPISE-IR. These associations persisted after adjusting for sociodemographic and behavioral covariates. Conclusions: This study demonstrates a robust association between insulin resistance risk and diminished health-related quality of life. The integration of validated IR indices and subjective health perception tools such as the SF-12 may enhance early identification of at-risk individuals in occupational health settings.

  @article{marzoa_jansana_sociodemographic_2025,
  abstract = {Background: Insulin resistance (IR) is a key pathogenic mechanism underlying numerous cardiometabolic disorders. While sociodemographic and lifestyle determinants of IR are well-established, their association with health-related quality of life (HRQoL) remains understudied. This study explores the relationship between IR risk, as measured by TyG, METS-IR, and SPISE-IR indices, and HRQoL in a large cohort of Spanish workers. Methods: This cross-sectional study included 100,014 Spanish workers aged 18–69 years evaluated between January 2021 and December 2023. Exclusion criteria included incomplete clinical, laboratory, or questionnaire data. IR was assessed using TyG, METS-IR, and SPISE-IR indices. HRQoL was measured using the SF-12 questionnaire. Sociodemographic factors, physical activity (IPAQ), dietary habits (MEDAS-14), and social class (based on CNAE-11 and Spanish Society of Epidemiology criteria) were also evaluated. Statistical analysis was conducted using SPSS v29.0. Results: Higher IR risk was consistently associated with older age, male sex, lower social class, current smoking, low adherence to the Mediterranean diet, and physical inactivity. Lower HRQoL scores (both physical and mental components) were significantly associated with higher IR indices, particularly with METS-IR and SPISE-IR. These associations persisted after adjusting for sociodemographic and behavioral covariates. Conclusions: This study demonstrates a robust association between insulin resistance risk and diminished health-related quality of life. The integration of validated IR indices and subjective health perception tools such as the SF-12 may enhance early identification of at-risk individuals in occupational health settings.},
  author = {Marzoa Jansana, María Dolores and Tárraga López, Pedro Juan and Guarro Miquel, Juan José and López-González, Ángel Arturo and Riutord Sbert, Pere and Busquets-Cortés, Carla and Ramírez-Manent, José Ignacio},
  journal = {Medical Sciences},
  keywords = {grapp-caib},
  month = {aug},
  number = 3,
  pages = 122,
  title = {Sociodemographic Factors, Healthy Habits, and Quality of Life in Relation to Insulin Resistance Risk in a Large Cohort of Spanish Workers},
  volume = 13,
  year = 2025
  }
  

  %0 Journal Article
  %1 marzoa_jansana_sociodemographic_2025
  %A Marzoa Jansana, María Dolores
  %A Tárraga López, Pedro Juan
  %A Guarro Miquel, Juan José
  %A López-González, Ángel Arturo
  %A Riutord Sbert, Pere
  %A Busquets-Cortés, Carla
  %A Ramírez-Manent, José Ignacio
  %D 2025
  %J Medical Sciences
  %N 3
  %P 122
  %R 10.3390/medsci13030122
  %T Sociodemographic Factors, Healthy Habits, and Quality of Life in Relation to Insulin Resistance Risk in a Large Cohort of Spanish Workers
  %U https://pmc.ncbi.nlm.nih.gov/articles/PMC12371977/
  %V 13
  %X Background: Insulin resistance (IR) is a key pathogenic mechanism underlying numerous cardiometabolic disorders. While sociodemographic and lifestyle determinants of IR are well-established, their association with health-related quality of life (HRQoL) remains understudied. This study explores the relationship between IR risk, as measured by TyG, METS-IR, and SPISE-IR indices, and HRQoL in a large cohort of Spanish workers. Methods: This cross-sectional study included 100,014 Spanish workers aged 18–69 years evaluated between January 2021 and December 2023. Exclusion criteria included incomplete clinical, laboratory, or questionnaire data. IR was assessed using TyG, METS-IR, and SPISE-IR indices. HRQoL was measured using the SF-12 questionnaire. Sociodemographic factors, physical activity (IPAQ), dietary habits (MEDAS-14), and social class (based on CNAE-11 and Spanish Society of Epidemiology criteria) were also evaluated. Statistical analysis was conducted using SPSS v29.0. Results: Higher IR risk was consistently associated with older age, male sex, lower social class, current smoking, low adherence to the Mediterranean diet, and physical inactivity. Lower HRQoL scores (both physical and mental components) were significantly associated with higher IR indices, particularly with METS-IR and SPISE-IR. These associations persisted after adjusting for sociodemographic and behavioral covariates. Conclusions: This study demonstrates a robust association between insulin resistance risk and diminished health-related quality of life. The integration of validated IR indices and subjective health perception tools such as the SF-12 may enhance early identification of at-risk individuals in occupational health settings.
  

• 
  1.

  Riutord-Sbert P, Tárraga López PJ, López-González Ángel A, Coll Campayo I, Busquets-Cortés C, Ramírez Manent JI. Sociodemographic, Lifestyle, and Social Isolation Correlates of TyG, METS-IR, and SPISE-IR Scores in a Large Spanish Working Population. Medical Sciences [Internet]. 2025 Sep.;13(3):171. https://pmc.ncbi.nlm.nih.gov/articles/PMC12452687/

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Background: Insulin resistance (IR) is a central feature in the pathophysiology of type 2 diabetes and a major determinant of cardiovascular morbidity. While sociodemographic and lifestyle factors are established contributors, the role of social isolation as a potential determinant of IR remains underexplored in working populations. Objectives: To assess the association between sociodemographic variables, lifestyle habits, and social isolation with three validated insulin resistance indexes—Triglyceride–Glucose (TyG), Metabolic Score for Insulin Resistance (METS-IR), and Single Point Insulin Sensitivity Estimator (SPISE-IR)—in a large cohort of Spanish workers. Methods: A cross-sectional study was conducted involving 117,298 workers from occupational health centers across Spain. Sociodemographic data, lifestyle factors (Mediterranean diet adherence, physical activity, and smoking), and social support levels (ENRICHD Social Support Instrument) were recorded. Biochemical and anthropometric parameters were obtained through standardized protocols. Logistic regression models estimated the odds ratios (ORs) and 95% confidence intervals (CIs) for high IR risk across the three indexes, adjusting for potential confounders. Results: Male sex, older age, lower social class, smoking, low Mediterranean diet adherence, physical inactivity, and low social support were independently associated with higher odds of IR in all three indexes. The strongest associations were observed for physical inactivity (OR range 6.21–9.95) and low social support (OR range 1.98–3.76). Although effect sizes varied by index, patterns of association were consistent. Conclusions: Sociodemographic, lifestyle, and psychosocial factors, including social isolation, are strongly associated with insulin resistance in working populations. Integrating social support assessment into occupational health strategies may enhance early detection and prevention of IR and related cardiometabolic diseases.

  @article{riutord-sbert_sociodemographic_2025,
  abstract = {Background: Insulin resistance (IR) is a central feature in the pathophysiology of type 2 diabetes and a major determinant of cardiovascular morbidity. While sociodemographic and lifestyle factors are established contributors, the role of social isolation as a potential determinant of IR remains underexplored in working populations. Objectives: To assess the association between sociodemographic variables, lifestyle habits, and social isolation with three validated insulin resistance indexes—Triglyceride–Glucose (TyG), Metabolic Score for Insulin Resistance (METS-IR), and Single Point Insulin Sensitivity Estimator (SPISE-IR)—in a large cohort of Spanish workers. Methods: A cross-sectional study was conducted involving 117,298 workers from occupational health centers across Spain. Sociodemographic data, lifestyle factors (Mediterranean diet adherence, physical activity, and smoking), and social support levels (ENRICHD Social Support Instrument) were recorded. Biochemical and anthropometric parameters were obtained through standardized protocols. Logistic regression models estimated the odds ratios (ORs) and 95% confidence intervals (CIs) for high IR risk across the three indexes, adjusting for potential confounders. Results: Male sex, older age, lower social class, smoking, low Mediterranean diet adherence, physical inactivity, and low social support were independently associated with higher odds of IR in all three indexes. The strongest associations were observed for physical inactivity (OR range 6.21–9.95) and low social support (OR range 1.98–3.76). Although effect sizes varied by index, patterns of association were consistent. Conclusions: Sociodemographic, lifestyle, and psychosocial factors, including social isolation, are strongly associated with insulin resistance in working populations. Integrating social support assessment into occupational health strategies may enhance early detection and prevention of IR and related cardiometabolic diseases.},
  author = {Riutord-Sbert, Pere and Tárraga López, Pedro Juan and López-González, Ángel Arturo and Coll Campayo, Irene and Busquets-Cortés, Carla and Ramírez Manent, José Ignacio},
  journal = {Medical Sciences},
  keywords = {grapp-caib},
  month = {sep},
  number = 3,
  pages = 171,
  title = {Sociodemographic, Lifestyle, and Social Isolation Correlates of TyG, METS-IR, and SPISE-IR Scores in a Large Spanish Working Population},
  volume = 13,
  year = 2025
  }
  

  %0 Journal Article
  %1 riutord-sbert_sociodemographic_2025
  %A Riutord-Sbert, Pere
  %A Tárraga López, Pedro Juan
  %A López-González, Ángel Arturo
  %A Coll Campayo, Irene
  %A Busquets-Cortés, Carla
  %A Ramírez Manent, José Ignacio
  %D 2025
  %J Medical Sciences
  %N 3
  %P 171
  %R 10.3390/medsci13030171
  %T Sociodemographic, Lifestyle, and Social Isolation Correlates of TyG, METS-IR, and SPISE-IR Scores in a Large Spanish Working Population
  %U https://pmc.ncbi.nlm.nih.gov/articles/PMC12452687/
  %V 13
  %X Background: Insulin resistance (IR) is a central feature in the pathophysiology of type 2 diabetes and a major determinant of cardiovascular morbidity. While sociodemographic and lifestyle factors are established contributors, the role of social isolation as a potential determinant of IR remains underexplored in working populations. Objectives: To assess the association between sociodemographic variables, lifestyle habits, and social isolation with three validated insulin resistance indexes—Triglyceride–Glucose (TyG), Metabolic Score for Insulin Resistance (METS-IR), and Single Point Insulin Sensitivity Estimator (SPISE-IR)—in a large cohort of Spanish workers. Methods: A cross-sectional study was conducted involving 117,298 workers from occupational health centers across Spain. Sociodemographic data, lifestyle factors (Mediterranean diet adherence, physical activity, and smoking), and social support levels (ENRICHD Social Support Instrument) were recorded. Biochemical and anthropometric parameters were obtained through standardized protocols. Logistic regression models estimated the odds ratios (ORs) and 95% confidence intervals (CIs) for high IR risk across the three indexes, adjusting for potential confounders. Results: Male sex, older age, lower social class, smoking, low Mediterranean diet adherence, physical inactivity, and low social support were independently associated with higher odds of IR in all three indexes. The strongest associations were observed for physical inactivity (OR range 6.21–9.95) and low social support (OR range 1.98–3.76). Although effect sizes varied by index, patterns of association were consistent. Conclusions: Sociodemographic, lifestyle, and psychosocial factors, including social isolation, are strongly associated with insulin resistance in working populations. Integrating social support assessment into occupational health strategies may enhance early detection and prevention of IR and related cardiometabolic diseases.
  

• 
  1.

  Tosoratto J, Tárraga López PJ, López-González Ángel A, Busquets-Cortes C, Obrador de Hevia J, Ramirez-Manent JI. Associations Between Shift Work, Sociodemographic and Lifestyle Characteristics, Body Measurements, and MASLD. Life [Internet]. 2025 Jun.;15(6):961. https://www.mdpi.com/2075-1729/15/6/961

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most prevalent chronic liver disorder worldwide and is closely linked to the components of metabolic syndrome. Shift work, through its disruption of circadian rhythms and the promotion of adverse behavioral patterns, has been proposed as a potential contributor to metabolic dysfunction and liver disease, yet evidence on its association with MASLD remains limited in large, heterogeneous occupational populations. Objectives: To investigate the association between shift work and MASLD risk using multiple validated non-invasive indices in a large sample of Spanish workers, and to explore the influence of sociodemographic characteristics, lifestyle behaviors, and sex on these associations. Methods: This cross-sectional study analyzed data from 53,053 employed adults across diverse sectors in Spain, including 31,753 men and 21,300 women. The participants underwent standardized occupational health assessments between 2019 and 2020. The MASLD risk was evaluated using seven indices: fatty liver index (FLI), hepatic steatosis index (HSI), ZJU index, fatty liver disease (FLD) index, Framingham steatosis index (FSI), lipid accumulation product (LAP), and BARD score. Sociodemographic, anthropometric, clinical, biochemical, and lifestyle data were collected. Multinomial logistic regression models were used to assess independent associations between shift work and high-risk MASLD scores. Results: Shift workers exhibited significantly higher mean values and prevalence of elevated MASLD scores across all indices compared to non-shift workers, in both sexes. In men, the prevalence of high BARD scores increased from 43.5% (non-shift) to 71.5% (shift), while in women it rose from 49.9% to 85.7%. Multivariate analysis confirmed that shift work was independently associated with an increased MASLD risk, particularly for HSI (OR: 7.83; 95\% CI: 7.40–8.26) and ZJU (OR: 5.91; 95\% CI: 5.60–6.22). Male sex, older age, smoking, and blue-collar status were also consistently associated with elevated risk scores. Conclusions: Shift work is significantly associated with an increased MASLD risk, independent of sociodemographic and lifestyle factors. Women and blue-collar workers may be especially vulnerable to the hepatic consequences of circadian disruption. These findings support the inclusion of liver health screening in occupational health programs and highlight the need for targeted interventions to reduce the MASLD risk among shift-working populations. Cross-sectional design limits causality; longitudinal studies are needed to confirm temporal relationships.

  @article{tosoratto_associations_2025,
  abstract = {Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most prevalent chronic liver disorder worldwide and is closely linked to the components of metabolic syndrome. Shift work, through its disruption of circadian rhythms and the promotion of adverse behavioral patterns, has been proposed as a potential contributor to metabolic dysfunction and liver disease, yet evidence on its association with MASLD remains limited in large, heterogeneous occupational populations. Objectives: To investigate the association between shift work and MASLD risk using multiple validated non-invasive indices in a large sample of Spanish workers, and to explore the influence of sociodemographic characteristics, lifestyle behaviors, and sex on these associations. Methods: This cross-sectional study analyzed data from 53,053 employed adults across diverse sectors in Spain, including 31,753 men and 21,300 women. The participants underwent standardized occupational health assessments between 2019 and 2020. The MASLD risk was evaluated using seven indices: fatty liver index (FLI), hepatic steatosis index (HSI), ZJU index, fatty liver disease (FLD) index, Framingham steatosis index (FSI), lipid accumulation product (LAP), and BARD score. Sociodemographic, anthropometric, clinical, biochemical, and lifestyle data were collected. Multinomial logistic regression models were used to assess independent associations between shift work and high-risk MASLD scores. Results: Shift workers exhibited significantly higher mean values and prevalence of elevated MASLD scores across all indices compared to non-shift workers, in both sexes. In men, the prevalence of high BARD scores increased from 43.5% (non-shift) to 71.5% (shift), while in women it rose from 49.9% to 85.7%. Multivariate analysis confirmed that shift work was independently associated with an increased MASLD risk, particularly for HSI (OR: 7.83; 95\% CI: 7.40–8.26) and ZJU (OR: 5.91; 95\% CI: 5.60–6.22). Male sex, older age, smoking, and blue-collar status were also consistently associated with elevated risk scores. Conclusions: Shift work is significantly associated with an increased MASLD risk, independent of sociodemographic and lifestyle factors. Women and blue-collar workers may be especially vulnerable to the hepatic consequences of circadian disruption. These findings support the inclusion of liver health screening in occupational health programs and highlight the need for targeted interventions to reduce the MASLD risk among shift-working populations. Cross-sectional design limits causality; longitudinal studies are needed to confirm temporal relationships.},
  author = {Tosoratto, Javier and Tárraga López, Pedro Juan and López-González, Ángel Arturo and Busquets-Cortes, Carla and Obrador de Hevia, Joan and Ramirez-Manent, José Ignacio},
  journal = {Life},
  keywords = {grapp-caib},
  month = {jun},
  number = 6,
  pages = 961,
  title = {Associations Between Shift Work, Sociodemographic and Lifestyle Characteristics, Body Measurements, and MASLD},
  volume = 15,
  year = 2025
  }
  

  %0 Journal Article
  %1 tosoratto_associations_2025
  %A Tosoratto, Javier
  %A Tárraga López, Pedro Juan
  %A López-González, Ángel Arturo
  %A Busquets-Cortes, Carla
  %A Obrador de Hevia, Joan
  %A Ramirez-Manent, José Ignacio
  %D 2025
  %J Life
  %N 6
  %P 961
  %R 10.3390/life15060961
  %T Associations Between Shift Work, Sociodemographic and Lifestyle Characteristics, Body Measurements, and MASLD
  %U https://www.mdpi.com/2075-1729/15/6/961
  %V 15
  %X Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most prevalent chronic liver disorder worldwide and is closely linked to the components of metabolic syndrome. Shift work, through its disruption of circadian rhythms and the promotion of adverse behavioral patterns, has been proposed as a potential contributor to metabolic dysfunction and liver disease, yet evidence on its association with MASLD remains limited in large, heterogeneous occupational populations. Objectives: To investigate the association between shift work and MASLD risk using multiple validated non-invasive indices in a large sample of Spanish workers, and to explore the influence of sociodemographic characteristics, lifestyle behaviors, and sex on these associations. Methods: This cross-sectional study analyzed data from 53,053 employed adults across diverse sectors in Spain, including 31,753 men and 21,300 women. The participants underwent standardized occupational health assessments between 2019 and 2020. The MASLD risk was evaluated using seven indices: fatty liver index (FLI), hepatic steatosis index (HSI), ZJU index, fatty liver disease (FLD) index, Framingham steatosis index (FSI), lipid accumulation product (LAP), and BARD score. Sociodemographic, anthropometric, clinical, biochemical, and lifestyle data were collected. Multinomial logistic regression models were used to assess independent associations between shift work and high-risk MASLD scores. Results: Shift workers exhibited significantly higher mean values and prevalence of elevated MASLD scores across all indices compared to non-shift workers, in both sexes. In men, the prevalence of high BARD scores increased from 43.5% (non-shift) to 71.5% (shift), while in women it rose from 49.9% to 85.7%. Multivariate analysis confirmed that shift work was independently associated with an increased MASLD risk, particularly for HSI (OR: 7.83; 95\% CI: 7.40–8.26) and ZJU (OR: 5.91; 95\% CI: 5.60–6.22). Male sex, older age, smoking, and blue-collar status were also consistently associated with elevated risk scores. Conclusions: Shift work is significantly associated with an increased MASLD risk, independent of sociodemographic and lifestyle factors. Women and blue-collar workers may be especially vulnerable to the hepatic consequences of circadian disruption. These findings support the inclusion of liver health screening in occupational health programs and highlight the need for targeted interventions to reduce the MASLD risk among shift-working populations. Cross-sectional design limits causality; longitudinal studies are needed to confirm temporal relationships.
  

• 
  1.

  Garcia-Aymerich J, de las Heras M, Carsin A-E, Accordini S, Agustí A, Bui D, Dharmage SC, Dodd JW, Eze I, Gehring U, Gislason T, Granell R, Imboden M, Íñiguez C, Jeong A, Koch S, Koppelman GH, Leynaert B, Melén E, Perret J, Probst-Hensch N, Santa-Marina L, Torrent M, Vicendese D, Vonk JM, de Vries M, Walters EH, Wang G, Wedzicha JA, Jarvis D, Faner R. General population-based lung function trajectories over the life course: an accelerated cohort study. The Lancet Respiratory Medicine [Internet]. 2025 Jul.;13(7):611-22. https://www.sciencedirect.com/science/article/pii/S2213260025000438

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Background Lung function is a key determinant of health, but current knowledge on lung function growth and decline over the life course is based on fragmented, potentially biased data. We aimed to empirically derive general population-based life course lung function trajectories, and to identify breakpoints and plateaus. Methods We created an accelerated cohort by pooling data from eight general population-based child and adult cohort studies from Europe and Australia. We included all participants with information on lung function, smoking status, BMI, and asthma diagnosis status from at least two visits. We used cross-classified three-level linear mixed models to derive sex-specific life course trajectories of FEV1, forced vital capacity (FVC), and FEV1/FVC ratio based on observations at ages 4–80 years, and Bayesian time-series decomposition to identify breakpoints and plateaus. We repeated sex-specific analyses with separate stratification for asthma status (never had asthma vs persistent asthma, where persistent was defined as the risk factor being present at all participant visits) and smoking status (never smoker vs persistent smoker). Findings The accelerated cohort included 30 438 participants born between 1901 and 2006 (15 703 [51·6\%] female and 14 735 [48·4\%] male; mean age 26 [SD 16] years), who provided a total of 87 666 observations (range 2–8 observations per participant). In female participants, FEV1 increased non-linearly in two phases, at a mean of 234 (95\% CI 223 to 245) mL/year until age 13 (95\% credible interval [CrI] 12 to 15) years, then at 99 (76 to 122) mL/year until a peak at age 20 (18 to 22) years, and subsequently decreased throughout the rest of adulthood (−26 [−27 to −25] mL/year). In male participants, the pattern was similar, with an increase in FEV1 of 271 (263 to 280) mL/year until age 16 (14 to 18) years, which slowed to 108 (93 to 124) mL/year until reaching a maximum at age 23 (21 to 25) years, decreasing thereafter (−38 [−39 to −37] mL/year), representing a later peak than in female participants. In female participants, FVC increased non-linearly in two phases, at 232 (95\% CI 222 to 243) mL/year until age 14 (95\% CrI 12 to 15) years, then at 77 (59 to 94) mL/year until peaking at age 20 (19 to 22) years, after which it decreased throughout the rest of adulthood (−26 [−27 to −25] mL/year). In male participants, FVC also increased in two phases, at 326 (315 to 337) mL/year until age 15 (13 to 17) years, then at 156 (144 to 168) mL/year until a peak at 23 (19 to 30) years, and subsequently declined in two phases (−22 [−29 to −14] mL/year until age 42 [38 to 50] years, then −36 [−38 to −34] mL/year thereafter). No plateau after the peak was observed for either lung function parameter in both sexes. FEV1/FVC ratio decreased throughout life from the starting age of 4 years in both sexes with some distinct patterns. Stratified analysis showed that persistent asthma (vs never had asthma) was related to an earlier FEV1 peak, lower FEV1 throughout adulthood, and lower FEV1/FVC ratio across the life course in both sexes. Persistent smoking (vs never smoking) was related to an accelerated decrease in FEV1 and FEV1/FVC ratio during adulthood in both sexes. No statistically significant plateau was observed in any lung function parameter across the strata of asthma or smoking status. Interpretation In both sexes, FEV1 and FVC increased in two phases, with a fast increase until around age 13–16 years, and then a slower increase until a peak. Neither parameter showed a plateau phase after the peak, and decreases started earlier than previously described. FEV1/FVC ratio decreased throughout life. These observations provide an essential, but previously unavailable, framework to assess and monitor lung health over the life course. Funding EU Horizon 2020, Wellcome, European Respiratory Society, AstraZeneca, Chiesi, GSK, Menarini Group, and Sanofi.

  @article{garcia-aymerich_general_2025,
  abstract = {Background Lung function is a key determinant of health, but current knowledge on lung function growth and decline over the life course is based on fragmented, potentially biased data. We aimed to empirically derive general population-based life course lung function trajectories, and to identify breakpoints and plateaus. Methods We created an accelerated cohort by pooling data from eight general population-based child and adult cohort studies from Europe and Australia. We included all participants with information on lung function, smoking status, BMI, and asthma diagnosis status from at least two visits. We used cross-classified three-level linear mixed models to derive sex-specific life course trajectories of FEV1, forced vital capacity (FVC), and FEV1/FVC ratio based on observations at ages 4–80 years, and Bayesian time-series decomposition to identify breakpoints and plateaus. We repeated sex-specific analyses with separate stratification for asthma status (never had asthma vs persistent asthma, where persistent was defined as the risk factor being present at all participant visits) and smoking status (never smoker vs persistent smoker). Findings The accelerated cohort included 30 438 participants born between 1901 and 2006 (15 703 [51·6\%] female and 14 735 [48·4\%] male; mean age 26 [SD 16] years), who provided a total of 87 666 observations (range 2–8 observations per participant). In female participants, FEV1 increased non-linearly in two phases, at a mean of 234 (95\% CI 223 to 245) mL/year until age 13 (95\% credible interval [CrI] 12 to 15) years, then at 99 (76 to 122) mL/year until a peak at age 20 (18 to 22) years, and subsequently decreased throughout the rest of adulthood (−26 [−27 to −25] mL/year). In male participants, the pattern was similar, with an increase in FEV1 of 271 (263 to 280) mL/year until age 16 (14 to 18) years, which slowed to 108 (93 to 124) mL/year until reaching a maximum at age 23 (21 to 25) years, decreasing thereafter (−38 [−39 to −37] mL/year), representing a later peak than in female participants. In female participants, FVC increased non-linearly in two phases, at 232 (95\% CI 222 to 243) mL/year until age 14 (95\% CrI 12 to 15) years, then at 77 (59 to 94) mL/year until peaking at age 20 (19 to 22) years, after which it decreased throughout the rest of adulthood (−26 [−27 to −25] mL/year). In male participants, FVC also increased in two phases, at 326 (315 to 337) mL/year until age 15 (13 to 17) years, then at 156 (144 to 168) mL/year until a peak at 23 (19 to 30) years, and subsequently declined in two phases (−22 [−29 to −14] mL/year until age 42 [38 to 50] years, then −36 [−38 to −34] mL/year thereafter). No plateau after the peak was observed for either lung function parameter in both sexes. FEV1/FVC ratio decreased throughout life from the starting age of 4 years in both sexes with some distinct patterns. Stratified analysis showed that persistent asthma (vs never had asthma) was related to an earlier FEV1 peak, lower FEV1 throughout adulthood, and lower FEV1/FVC ratio across the life course in both sexes. Persistent smoking (vs never smoking) was related to an accelerated decrease in FEV1 and FEV1/FVC ratio during adulthood in both sexes. No statistically significant plateau was observed in any lung function parameter across the strata of asthma or smoking status. Interpretation In both sexes, FEV1 and FVC increased in two phases, with a fast increase until around age 13–16 years, and then a slower increase until a peak. Neither parameter showed a plateau phase after the peak, and decreases started earlier than previously described. FEV1/FVC ratio decreased throughout life. These observations provide an essential, but previously unavailable, framework to assess and monitor lung health over the life course. Funding EU Horizon 2020, Wellcome, European Respiratory Society, AstraZeneca, Chiesi, GSK, Menarini Group, and Sanofi.},
  author = {Garcia-Aymerich, Judith and de las Heras, Martí and Carsin, Anne-Elie and Accordini, Simone and Agustí, Alvar and Bui, Dinh and Dharmage, Shyamali C and Dodd, James W and Eze, Ikenna and Gehring, Ulrike and Gislason, Thorarinn and Granell, Raquel and Imboden, Medea and Íñiguez, Carmen and Jeong, Ayoung and Koch, Sarah and Koppelman, Gerard H and Leynaert, Bénédicte and Melén, Erik and Perret, Jennifer and Probst-Hensch, Nicole and Santa-Marina, Loreto and Torrent, Maties and Vicendese, Don and Vonk, Judith M and de Vries, Maaike and Walters, E Haydn and Wang, Gang and Wedzicha, Jadwiga A and Jarvis, Deborah and Faner, Rosa},
  journal = {The Lancet Respiratory Medicine},
  keywords = {grapp-caib},
  month = {jul},
  number = 7,
  pages = {611--622},
  title = {General population-based lung function trajectories over the life course: an accelerated cohort study},
  volume = 13,
  year = 2025
  }
  

  %0 Journal Article
  %1 garcia-aymerich_general_2025
  %A Garcia-Aymerich, Judith
  %A de las Heras, Martí
  %A Carsin, Anne-Elie
  %A Accordini, Simone
  %A Agustí, Alvar
  %A Bui, Dinh
  %A Dharmage, Shyamali C
  %A Dodd, James W
  %A Eze, Ikenna
  %A Gehring, Ulrike
  %A Gislason, Thorarinn
  %A Granell, Raquel
  %A Imboden, Medea
  %A Íñiguez, Carmen
  %A Jeong, Ayoung
  %A Koch, Sarah
  %A Koppelman, Gerard H
  %A Leynaert, Bénédicte
  %A Melén, Erik
  %A Perret, Jennifer
  %A Probst-Hensch, Nicole
  %A Santa-Marina, Loreto
  %A Torrent, Maties
  %A Vicendese, Don
  %A Vonk, Judith M
  %A de Vries, Maaike
  %A Walters, E Haydn
  %A Wang, Gang
  %A Wedzicha, Jadwiga A
  %A Jarvis, Deborah
  %A Faner, Rosa
  %D 2025
  %J The Lancet Respiratory Medicine
  %N 7
  %P 611--622
  %R 10.1016/S2213-2600(25)00043-8
  %T General population-based lung function trajectories over the life course: an accelerated cohort study
  %U https://www.sciencedirect.com/science/article/pii/S2213260025000438
  %V 13
  %X Background Lung function is a key determinant of health, but current knowledge on lung function growth and decline over the life course is based on fragmented, potentially biased data. We aimed to empirically derive general population-based life course lung function trajectories, and to identify breakpoints and plateaus. Methods We created an accelerated cohort by pooling data from eight general population-based child and adult cohort studies from Europe and Australia. We included all participants with information on lung function, smoking status, BMI, and asthma diagnosis status from at least two visits. We used cross-classified three-level linear mixed models to derive sex-specific life course trajectories of FEV1, forced vital capacity (FVC), and FEV1/FVC ratio based on observations at ages 4–80 years, and Bayesian time-series decomposition to identify breakpoints and plateaus. We repeated sex-specific analyses with separate stratification for asthma status (never had asthma vs persistent asthma, where persistent was defined as the risk factor being present at all participant visits) and smoking status (never smoker vs persistent smoker). Findings The accelerated cohort included 30 438 participants born between 1901 and 2006 (15 703 [51·6\%] female and 14 735 [48·4\%] male; mean age 26 [SD 16] years), who provided a total of 87 666 observations (range 2–8 observations per participant). In female participants, FEV1 increased non-linearly in two phases, at a mean of 234 (95\% CI 223 to 245) mL/year until age 13 (95\% credible interval [CrI] 12 to 15) years, then at 99 (76 to 122) mL/year until a peak at age 20 (18 to 22) years, and subsequently decreased throughout the rest of adulthood (−26 [−27 to −25] mL/year). In male participants, the pattern was similar, with an increase in FEV1 of 271 (263 to 280) mL/year until age 16 (14 to 18) years, which slowed to 108 (93 to 124) mL/year until reaching a maximum at age 23 (21 to 25) years, decreasing thereafter (−38 [−39 to −37] mL/year), representing a later peak than in female participants. In female participants, FVC increased non-linearly in two phases, at 232 (95\% CI 222 to 243) mL/year until age 14 (95\% CrI 12 to 15) years, then at 77 (59 to 94) mL/year until peaking at age 20 (19 to 22) years, after which it decreased throughout the rest of adulthood (−26 [−27 to −25] mL/year). In male participants, FVC also increased in two phases, at 326 (315 to 337) mL/year until age 15 (13 to 17) years, then at 156 (144 to 168) mL/year until a peak at 23 (19 to 30) years, and subsequently declined in two phases (−22 [−29 to −14] mL/year until age 42 [38 to 50] years, then −36 [−38 to −34] mL/year thereafter). No plateau after the peak was observed for either lung function parameter in both sexes. FEV1/FVC ratio decreased throughout life from the starting age of 4 years in both sexes with some distinct patterns. Stratified analysis showed that persistent asthma (vs never had asthma) was related to an earlier FEV1 peak, lower FEV1 throughout adulthood, and lower FEV1/FVC ratio across the life course in both sexes. Persistent smoking (vs never smoking) was related to an accelerated decrease in FEV1 and FEV1/FVC ratio during adulthood in both sexes. No statistically significant plateau was observed in any lung function parameter across the strata of asthma or smoking status. Interpretation In both sexes, FEV1 and FVC increased in two phases, with a fast increase until around age 13–16 years, and then a slower increase until a peak. Neither parameter showed a plateau phase after the peak, and decreases started earlier than previously described. FEV1/FVC ratio decreased throughout life. These observations provide an essential, but previously unavailable, framework to assess and monitor lung health over the life course. Funding EU Horizon 2020, Wellcome, European Respiratory Society, AstraZeneca, Chiesi, GSK, Menarini Group, and Sanofi.
  

• 
  1.

  Obrador de Hevia J, López-González Ángel A, Ramírez-Manent JI, Busquets-Cortés C, Tárraga López PJ, Riutord-Sbert P. Cross-Sectional and Longitudinal Assessment of Sociodemographic and Lifestyle Determinants of Metabolic Syndrome and Hypertriglyceridemic Waist Phenotypes in 139,634 Spanish Workers. Metabolites [Internet]. 2025 Jul.;15(7):474. https://pmc.ncbi.nlm.nih.gov/articles/PMC12298749/

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Objective: The objective of this study was to analyze the prevalence and key sociodemographic and lifestyle determinants of metabolic syndrome (MetS) and the hypertriglyceridemic waist (HTGW) phenotype in a large occupational cohort. Background: Metabolic syndrome (MetS) and the hypertriglyceridemic waist (HTGW) phenotype, defined as the simultaneous presence of elevated waist circumference and high triglyceride levels, are major predictors of cardiometabolic morbidity and mortality. Despite their clinical relevance, data on their distribution and determinants in large occupational populations remain limited. Methods: A cross-sectional analysis was conducted on 139,634 employed adults (56,352 women and 83,282 men) across Spain, based on standardized clinical evaluations and validated questionnaires assessing physical activity, diet, smoking, alcohol consumption, education, and occupational class. Logistic regression models were used to estimate associations with MetS and HTGW. A longitudinal subsample of 40,431 individuals was followed over a 10-year period (2009–2019) to assess trends in metabolic risk phenotypes. Results: Male sex, older age, lower educational attainment, and unhealthy lifestyle behaviors were associated with a higher prevalence of both MetS and the HTGW phenotype. Physical inactivity, low adherence to the Mediterranean diet, and alcohol consumption were significantly associated with increased risk. The HTGW phenotype proved useful in identifying high-risk individuals, with a steadily increasing prevalence over time. Conclusions: Sociodemographic disparities and modifiable lifestyle factors significantly influence the prevalence and progression of MetS and HTGW in the Spanish workforce. Preventive strategies should emphasize early workplace screening, promotion of healthy behaviors, and reduction in educational and socioeconomic inequalities to mitigate cardiometabolic risk.

  @article{obrador_de_hevia_cross-sectional_2025,
  abstract = {Objective: The objective of this study was to analyze the prevalence and key sociodemographic and lifestyle determinants of metabolic syndrome (MetS) and the hypertriglyceridemic waist (HTGW) phenotype in a large occupational cohort. Background: Metabolic syndrome (MetS) and the hypertriglyceridemic waist (HTGW) phenotype, defined as the simultaneous presence of elevated waist circumference and high triglyceride levels, are major predictors of cardiometabolic morbidity and mortality. Despite their clinical relevance, data on their distribution and determinants in large occupational populations remain limited. Methods: A cross-sectional analysis was conducted on 139,634 employed adults (56,352 women and 83,282 men) across Spain, based on standardized clinical evaluations and validated questionnaires assessing physical activity, diet, smoking, alcohol consumption, education, and occupational class. Logistic regression models were used to estimate associations with MetS and HTGW. A longitudinal subsample of 40,431 individuals was followed over a 10-year period (2009–2019) to assess trends in metabolic risk phenotypes. Results: Male sex, older age, lower educational attainment, and unhealthy lifestyle behaviors were associated with a higher prevalence of both MetS and the HTGW phenotype. Physical inactivity, low adherence to the Mediterranean diet, and alcohol consumption were significantly associated with increased risk. The HTGW phenotype proved useful in identifying high-risk individuals, with a steadily increasing prevalence over time. Conclusions: Sociodemographic disparities and modifiable lifestyle factors significantly influence the prevalence and progression of MetS and HTGW in the Spanish workforce. Preventive strategies should emphasize early workplace screening, promotion of healthy behaviors, and reduction in educational and socioeconomic inequalities to mitigate cardiometabolic risk.},
  author = {Obrador de Hevia, Joan and López-González, Ángel Arturo and Ramírez-Manent, José Ignacio and Busquets-Cortés, Carla and Tárraga López, Pedro Juan and Riutord-Sbert, Pere},
  journal = {Metabolites},
  keywords = {grapp-caib},
  month = {jul},
  number = 7,
  pages = 474,
  title = {Cross-Sectional and Longitudinal Assessment of Sociodemographic and Lifestyle Determinants of Metabolic Syndrome and Hypertriglyceridemic Waist Phenotypes in 139,634 Spanish Workers},
  volume = 15,
  year = 2025
  }
  

  %0 Journal Article
  %1 obrador_de_hevia_cross-sectional_2025
  %A Obrador de Hevia, Joan
  %A López-González, Ángel Arturo
  %A Ramírez-Manent, José Ignacio
  %A Busquets-Cortés, Carla
  %A Tárraga López, Pedro Juan
  %A Riutord-Sbert, Pere
  %D 2025
  %J Metabolites
  %N 7
  %P 474
  %R 10.3390/metabo15070474
  %T Cross-Sectional and Longitudinal Assessment of Sociodemographic and Lifestyle Determinants of Metabolic Syndrome and Hypertriglyceridemic Waist Phenotypes in 139,634 Spanish Workers
  %U https://pmc.ncbi.nlm.nih.gov/articles/PMC12298749/
  %V 15
  %X Objective: The objective of this study was to analyze the prevalence and key sociodemographic and lifestyle determinants of metabolic syndrome (MetS) and the hypertriglyceridemic waist (HTGW) phenotype in a large occupational cohort. Background: Metabolic syndrome (MetS) and the hypertriglyceridemic waist (HTGW) phenotype, defined as the simultaneous presence of elevated waist circumference and high triglyceride levels, are major predictors of cardiometabolic morbidity and mortality. Despite their clinical relevance, data on their distribution and determinants in large occupational populations remain limited. Methods: A cross-sectional analysis was conducted on 139,634 employed adults (56,352 women and 83,282 men) across Spain, based on standardized clinical evaluations and validated questionnaires assessing physical activity, diet, smoking, alcohol consumption, education, and occupational class. Logistic regression models were used to estimate associations with MetS and HTGW. A longitudinal subsample of 40,431 individuals was followed over a 10-year period (2009–2019) to assess trends in metabolic risk phenotypes. Results: Male sex, older age, lower educational attainment, and unhealthy lifestyle behaviors were associated with a higher prevalence of both MetS and the HTGW phenotype. Physical inactivity, low adherence to the Mediterranean diet, and alcohol consumption were significantly associated with increased risk. The HTGW phenotype proved useful in identifying high-risk individuals, with a steadily increasing prevalence over time. Conclusions: Sociodemographic disparities and modifiable lifestyle factors significantly influence the prevalence and progression of MetS and HTGW in the Spanish workforce. Preventive strategies should emphasize early workplace screening, promotion of healthy behaviors, and reduction in educational and socioeconomic inequalities to mitigate cardiometabolic risk.
  

• 
  1.

  Soler A, Huguet A, Leiva A, Vicens C, Bejarano-Romero F, Sempere E, Izquierdo T, Parera MM, Seco R, Fages M, Medina A, Castillo-Palomares L, López-Guerrero E, Ferrer BA, Ugarriza L, Llarena M, Gallardo-Alfaro L. A pharmacist-led educational and audit & feedback strategy to reduce antibiotic prescription in primary care: the AFA study. BMC Primary Care [Internet]. 2025 Jul.;26:228. https://pmc.ncbi.nlm.nih.gov/articles/PMC12275277/

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Introduction The increasing emergence of bacteria resistant to antibiotic treatments has become a global public health concern and one of the leading causes of death worldwide. This growing threat demands urgent and coordinated action from health systems across the globe. A key driver of antimicrobial resistance is the inappropriate and excessive use of antibiotics, which accelerates the development of resistant strains. At the same time, the lack of new antibiotics in development exacerbates the crisis. In this context, promoting the appropriate and prudent use of antibiotics is essential to limit the emergence and spread of resistance. Methods A randomized, multicentre, parallel-group clinical trial with a hybrid type I (effectiveness-implementation) design to reduce antibiotic prescriptions in primary care. General practitioners from three regional health systems in Spain will be randomly assigned (1:1) to an intervention or active control group. The intervention includes a monthly Audit & Feedback report, pharmacist-led consultations, clinical messages, patient information sheets, and an online training module. The primary outcome is the rate of antibiotic prescriptions per 100 patient visits at 12-month follow-up. Implementation outcomes will be assessed using the RE-AIM framework. All analyses will follow the intention-to-treat principle. Ethics and dissemination The study was approved by the Balearic island, Valencia and IDIAP Jordi Gol Ethical Committee, follows the Declaration of Helsinki, Good Clinical Practice guidelines, and applicable national and European regulations concerning clinical trials and data protection. Trial registration ISRCTN11175879, registration date: 11/12/2024.

  @article{soler_pharmacist-led_2025,
  abstract = {Introduction The increasing emergence of bacteria resistant to antibiotic treatments has become a global public health concern and one of the leading causes of death worldwide. This growing threat demands urgent and coordinated action from health systems across the globe. A key driver of antimicrobial resistance is the inappropriate and excessive use of antibiotics, which accelerates the development of resistant strains. At the same time, the lack of new antibiotics in development exacerbates the crisis. In this context, promoting the appropriate and prudent use of antibiotics is essential to limit the emergence and spread of resistance. Methods A randomized, multicentre, parallel-group clinical trial with a hybrid type I (effectiveness-implementation) design to reduce antibiotic prescriptions in primary care. General practitioners from three regional health systems in Spain will be randomly assigned (1:1) to an intervention or active control group. The intervention includes a monthly Audit & Feedback report, pharmacist-led consultations, clinical messages, patient information sheets, and an online training module. The primary outcome is the rate of antibiotic prescriptions per 100 patient visits at 12-month follow-up. Implementation outcomes will be assessed using the RE-AIM framework. All analyses will follow the intention-to-treat principle. Ethics and dissemination The study was approved by the Balearic island, Valencia and IDIAP Jordi Gol Ethical Committee, follows the Declaration of Helsinki, Good Clinical Practice guidelines, and applicable national and European regulations concerning clinical trials and data protection. Trial registration ISRCTN11175879, registration date: 11/12/2024.},
  author = {Soler, A. and Huguet, A. and Leiva, A. and Vicens, C. and Bejarano-Romero, F. and Sempere, E. and Izquierdo, T. and Parera, M. M. and Seco, R. and Fages, M. and Medina, A. and Castillo-Palomares, L. and López-Guerrero, E. and Ferrer, B. A. and Ugarriza, L. and Llarena, M. and Gallardo-Alfaro, L.},
  journal = {BMC Primary Care},
  keywords = {grapp-caib},
  month = {jul},
  pages = 228,
  title = {A pharmacist-led educational and audit & feedback strategy to reduce antibiotic prescription in primary care: the AFA study},
  volume = 26,
  year = 2025
  }
  

  %0 Journal Article
  %1 soler_pharmacist-led_2025
  %A Soler, A.
  %A Huguet, A.
  %A Leiva, A.
  %A Vicens, C.
  %A Bejarano-Romero, F.
  %A Sempere, E.
  %A Izquierdo, T.
  %A Parera, M. M.
  %A Seco, R.
  %A Fages, M.
  %A Medina, A.
  %A Castillo-Palomares, L.
  %A López-Guerrero, E.
  %A Ferrer, B. A.
  %A Ugarriza, L.
  %A Llarena, M.
  %A Gallardo-Alfaro, L.
  %D 2025
  %J BMC Primary Care
  %P 228
  %R 10.1186/s12875-025-02933-8
  %T A pharmacist-led educational and audit & feedback strategy to reduce antibiotic prescription in primary care: the AFA study
  %U https://pmc.ncbi.nlm.nih.gov/articles/PMC12275277/
  %V 26
  %X Introduction The increasing emergence of bacteria resistant to antibiotic treatments has become a global public health concern and one of the leading causes of death worldwide. This growing threat demands urgent and coordinated action from health systems across the globe. A key driver of antimicrobial resistance is the inappropriate and excessive use of antibiotics, which accelerates the development of resistant strains. At the same time, the lack of new antibiotics in development exacerbates the crisis. In this context, promoting the appropriate and prudent use of antibiotics is essential to limit the emergence and spread of resistance. Methods A randomized, multicentre, parallel-group clinical trial with a hybrid type I (effectiveness-implementation) design to reduce antibiotic prescriptions in primary care. General practitioners from three regional health systems in Spain will be randomly assigned (1:1) to an intervention or active control group. The intervention includes a monthly Audit & Feedback report, pharmacist-led consultations, clinical messages, patient information sheets, and an online training module. The primary outcome is the rate of antibiotic prescriptions per 100 patient visits at 12-month follow-up. Implementation outcomes will be assessed using the RE-AIM framework. All analyses will follow the intention-to-treat principle. Ethics and dissemination The study was approved by the Balearic island, Valencia and IDIAP Jordi Gol Ethical Committee, follows the Declaration of Helsinki, Good Clinical Practice guidelines, and applicable national and European regulations concerning clinical trials and data protection. Trial registration ISRCTN11175879, registration date: 11/12/2024.
  

• 
  1.

  Sánchez-Recio R, Oliván-Blázquez B, Méndez-López F, Gascón-Santos S, Martí-Lluch R, Zabaleta-Del-Olmo E, Tamayo-Morales O, Maderuelo-Fernández JA, Casajuana M, López-Jiménez T, Motrico E, Gómez-Gómez I, Sánchez-Pérez Álvaro, Rodero-Cosano ML, Llobera J, Bellón JA, Moreno-Peral P, Bolíbar B, Recio-Rodríguez JI, Ramos R, Clavería A. Self-reported health and depression among EIRA cohort: a moderated mediation model of sex and perceived social support. Frontiers in Psychology [Internet]. 2025 Jun.;16:1540530. https://pmc.ncbi.nlm.nih.gov/articles/PMC12202560/

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Background The positive relationship between health and good perceived social support has been widely demonstrated in the scientific literature. It is known that having a good social support influences the proper maintenance of health even as a protective factor, besides being a good predictor in the recovery of health during a disease process, influencing differently men and women. Aim This project aims to study the moderating effects of perceived social support in the relationship between depression and self-perceived health according to gender, after a complex multiple-risk intervention was carried out in patients of primary health care with low social support. Methods A cluster randomized clinical trial was developed in the subgroup of patients included in phase 3 of the EIRA project. CONSORT recommendations were followed to present the results. To determine the mediating effect between social support and self-perceived health, three regression analyses were carried out using the procedure designed by Hayes through the PROCESS macro for SPSS. Results 3,062 people (54.9\% women) participated in the study. Men reported experiencing more social support and self-perceived health (p \textless 0.001) than women at the beginning of the study, but women reported higher social support at post-intervention. Moderation analyses showed that, post-intervention, those women (bsimple = −2.9867, p \textless 0.001) and males (bsimple = −1.4337, p \textless 0.001) who scored lower in depression reported higher social support. Conclusion In primary care, it is necessary to encourage intervention strategies that promote social networks as a key element of positive action aimed at maintaining and improving the population’s health, especially in adults and more specifically in women. Clinical trial registration ClinicalTrials.gov, identifier NCT03136211.

  @article{sanchez-recio_self-reported_2025,
  abstract = {Background The positive relationship between health and good perceived social support has been widely demonstrated in the scientific literature. It is known that having a good social support influences the proper maintenance of health even as a protective factor, besides being a good predictor in the recovery of health during a disease process, influencing differently men and women. Aim This project aims to study the moderating effects of perceived social support in the relationship between depression and self-perceived health according to gender, after a complex multiple-risk intervention was carried out in patients of primary health care with low social support. Methods A cluster randomized clinical trial was developed in the subgroup of patients included in phase 3 of the EIRA project. CONSORT recommendations were followed to present the results. To determine the mediating effect between social support and self-perceived health, three regression analyses were carried out using the procedure designed by Hayes through the PROCESS macro for SPSS. Results 3,062 people (54.9\% women) participated in the study. Men reported experiencing more social support and self-perceived health (p \textless 0.001) than women at the beginning of the study, but women reported higher social support at post-intervention. Moderation analyses showed that, post-intervention, those women (bsimple = −2.9867, p \textless 0.001) and males (bsimple = −1.4337, p \textless 0.001) who scored lower in depression reported higher social support. Conclusion In primary care, it is necessary to encourage intervention strategies that promote social networks as a key element of positive action aimed at maintaining and improving the population’s health, especially in adults and more specifically in women. Clinical trial registration ClinicalTrials.gov, identifier NCT03136211.},
  author = {Sánchez-Recio, Raquel and Oliván-Blázquez, Bárbara and Méndez-López, Fátima and Gascón-Santos, Santiago and Martí-Lluch, Ruth and Zabaleta-Del-Olmo, Edurne and Tamayo-Morales, Olaya and Maderuelo-Fernández, José A. and Casajuana, Marc and López-Jiménez, Tomas and Motrico, Emma and Gómez-Gómez, Irene and Sánchez-Pérez, Álvaro and Rodero-Cosano, María Luisa and Llobera, Joan and Bellón, Juan A. and Moreno-Peral, Patricia and Bolíbar, Bonaventura and Recio-Rodríguez, José I. and Ramos, Rafel and Clavería, Ana},
  journal = {Frontiers in Psychology},
  keywords = {grapp-caib},
  month = {jun},
  pages = 1540530,
  title = {Self-reported health and depression among EIRA cohort: a moderated mediation model of sex and perceived social support},
  volume = 16,
  year = 2025
  }
  

  %0 Journal Article
  %1 sanchez-recio_self-reported_2025
  %A Sánchez-Recio, Raquel
  %A Oliván-Blázquez, Bárbara
  %A Méndez-López, Fátima
  %A Gascón-Santos, Santiago
  %A Martí-Lluch, Ruth
  %A Zabaleta-Del-Olmo, Edurne
  %A Tamayo-Morales, Olaya
  %A Maderuelo-Fernández, José A.
  %A Casajuana, Marc
  %A López-Jiménez, Tomas
  %A Motrico, Emma
  %A Gómez-Gómez, Irene
  %A Sánchez-Pérez, Álvaro
  %A Rodero-Cosano, María Luisa
  %A Llobera, Joan
  %A Bellón, Juan A.
  %A Moreno-Peral, Patricia
  %A Bolíbar, Bonaventura
  %A Recio-Rodríguez, José I.
  %A Ramos, Rafel
  %A Clavería, Ana
  %D 2025
  %J Frontiers in Psychology
  %P 1540530
  %R 10.3389/fpsyg.2025.1540530
  %T Self-reported health and depression among EIRA cohort: a moderated mediation model of sex and perceived social support
  %U https://pmc.ncbi.nlm.nih.gov/articles/PMC12202560/
  %V 16
  %X Background The positive relationship between health and good perceived social support has been widely demonstrated in the scientific literature. It is known that having a good social support influences the proper maintenance of health even as a protective factor, besides being a good predictor in the recovery of health during a disease process, influencing differently men and women. Aim This project aims to study the moderating effects of perceived social support in the relationship between depression and self-perceived health according to gender, after a complex multiple-risk intervention was carried out in patients of primary health care with low social support. Methods A cluster randomized clinical trial was developed in the subgroup of patients included in phase 3 of the EIRA project. CONSORT recommendations were followed to present the results. To determine the mediating effect between social support and self-perceived health, three regression analyses were carried out using the procedure designed by Hayes through the PROCESS macro for SPSS. Results 3,062 people (54.9\% women) participated in the study. Men reported experiencing more social support and self-perceived health (p \textless 0.001) than women at the beginning of the study, but women reported higher social support at post-intervention. Moderation analyses showed that, post-intervention, those women (bsimple = −2.9867, p \textless 0.001) and males (bsimple = −1.4337, p \textless 0.001) who scored lower in depression reported higher social support. Conclusion In primary care, it is necessary to encourage intervention strategies that promote social networks as a key element of positive action aimed at maintaining and improving the population’s health, especially in adults and more specifically in women. Clinical trial registration ClinicalTrials.gov, identifier NCT03136211.
  

• 
  1.

  Obrador de Hevia J, López-González Ángel A, Ramírez-Manent JI, Busquets-Cortes C, Tárraga López PJ, García Samuelsson M, Riutord-Sbert P. Atherogenic Risk and Its Association with Alcohol Consumption, Lifestyle Habits, and Sociodemographic Factors in a Population of Spanish Workers. Life [Internet]. 2025 Jun.;15(6):923. https://pmc.ncbi.nlm.nih.gov/articles/PMC12194332/

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Atherogenic dyslipidemia is a major contributor to cardiovascular disease, the leading cause of morbidity and mortality worldwide. While lipid abnormalities are well-established clinical risk factors, growing evidence highlights the influence of sociodemographic and lifestyle determinants on lipid profiles. However, large-scale epidemiological data addressing these associations within occupational settings remain limited. Objective: To assess the cross-sectional and longitudinal associations between atherogenic risk—measured through TC/HDL-c, LDL-c/HDL-c, TG/HDL-c ratios, and atherogenic dyslipidemia (AD)—and sociodemographic variables, health behaviors, and alcohol consumption in a large cohort of Spanish workers. Methods: A dual-phase study was conducted. The first phase was a cross-sectional analysis of 139,634 workers (83,282 men; 56,352 women) from multiple employment sectors undergoing routine occupational health assessments. The second phase was a longitudinal study of a subsample (n = 40,431) with complete data from 2009 and 2019. Clinical, anthropometric, and biochemical data were collected using standardized protocols. Lifestyle factors (smoking, physical activity, Mediterranean diet adherence, alcohol intake) and socioeconomic indicators (education, occupational class) were recorded. Multinomial logistic regression was used to determine independent associations with high-risk atherogenic profiles. Results: Higher atherogenic indices and prevalence of AD were associated with advancing age, lower educational level, lower social class, smoking, physical inactivity, poor diet quality, and alcohol consumption. Men exhibited higher TG/HDL-c and AD values, whereas women had higher TC/HDL-c and LDL-c/HDL-c. Physical inactivity showed the strongest association with TG/HDL-c (OR: 36.23; 95\% CI: 32.12–40.35) and AD (OR: 16.86; 95\% CI: 14.80–18.93). Alcohol intake also independently predicted higher TG/HDL-c (OR: 1.60) and AD (OR: 1.79). Over the decade, a general increase in atherogenic risk was observed, especially among older adults, socially disadvantaged groups, and those with unhealthy behaviors. Conclusions: Sociodemographic and lifestyle factors, particularly physical inactivity and alcohol consumption, are strongly associated with adverse atherogenic profiles in the working population. The observed rise in lipid-related cardiovascular risk over the past decade emphasizes the urgent need for workplace-based health promotion strategies targeting modifiable behaviors and structural health inequalities.

  @article{obrador_de_hevia_atherogenic_2025,
  abstract = {Atherogenic dyslipidemia is a major contributor to cardiovascular disease, the leading cause of morbidity and mortality worldwide. While lipid abnormalities are well-established clinical risk factors, growing evidence highlights the influence of sociodemographic and lifestyle determinants on lipid profiles. However, large-scale epidemiological data addressing these associations within occupational settings remain limited. Objective: To assess the cross-sectional and longitudinal associations between atherogenic risk—measured through TC/HDL-c, LDL-c/HDL-c, TG/HDL-c ratios, and atherogenic dyslipidemia (AD)—and sociodemographic variables, health behaviors, and alcohol consumption in a large cohort of Spanish workers. Methods: A dual-phase study was conducted. The first phase was a cross-sectional analysis of 139,634 workers (83,282 men; 56,352 women) from multiple employment sectors undergoing routine occupational health assessments. The second phase was a longitudinal study of a subsample (n = 40,431) with complete data from 2009 and 2019. Clinical, anthropometric, and biochemical data were collected using standardized protocols. Lifestyle factors (smoking, physical activity, Mediterranean diet adherence, alcohol intake) and socioeconomic indicators (education, occupational class) were recorded. Multinomial logistic regression was used to determine independent associations with high-risk atherogenic profiles. Results: Higher atherogenic indices and prevalence of AD were associated with advancing age, lower educational level, lower social class, smoking, physical inactivity, poor diet quality, and alcohol consumption. Men exhibited higher TG/HDL-c and AD values, whereas women had higher TC/HDL-c and LDL-c/HDL-c. Physical inactivity showed the strongest association with TG/HDL-c (OR: 36.23; 95\% CI: 32.12–40.35) and AD (OR: 16.86; 95\% CI: 14.80–18.93). Alcohol intake also independently predicted higher TG/HDL-c (OR: 1.60) and AD (OR: 1.79). Over the decade, a general increase in atherogenic risk was observed, especially among older adults, socially disadvantaged groups, and those with unhealthy behaviors. Conclusions: Sociodemographic and lifestyle factors, particularly physical inactivity and alcohol consumption, are strongly associated with adverse atherogenic profiles in the working population. The observed rise in lipid-related cardiovascular risk over the past decade emphasizes the urgent need for workplace-based health promotion strategies targeting modifiable behaviors and structural health inequalities.},
  author = {Obrador de Hevia, Joan and López-González, Ángel Arturo and Ramírez-Manent, José Ignacio and Busquets-Cortes, Carla and Tárraga López, Pedro Juan and García Samuelsson, Miguel and Riutord-Sbert, Pere},
  journal = {Life},
  keywords = {grapp-caib},
  month = {jun},
  number = 6,
  pages = 923,
  title = {Atherogenic Risk and Its Association with Alcohol Consumption, Lifestyle Habits, and Sociodemographic Factors in a Population of Spanish Workers},
  volume = 15,
  year = 2025
  }
  

  %0 Journal Article
  %1 obrador_de_hevia_atherogenic_2025
  %A Obrador de Hevia, Joan
  %A López-González, Ángel Arturo
  %A Ramírez-Manent, José Ignacio
  %A Busquets-Cortes, Carla
  %A Tárraga López, Pedro Juan
  %A García Samuelsson, Miguel
  %A Riutord-Sbert, Pere
  %D 2025
  %J Life
  %N 6
  %P 923
  %R 10.3390/life15060923
  %T Atherogenic Risk and Its Association with Alcohol Consumption, Lifestyle Habits, and Sociodemographic Factors in a Population of Spanish Workers
  %U https://pmc.ncbi.nlm.nih.gov/articles/PMC12194332/
  %V 15
  %X Atherogenic dyslipidemia is a major contributor to cardiovascular disease, the leading cause of morbidity and mortality worldwide. While lipid abnormalities are well-established clinical risk factors, growing evidence highlights the influence of sociodemographic and lifestyle determinants on lipid profiles. However, large-scale epidemiological data addressing these associations within occupational settings remain limited. Objective: To assess the cross-sectional and longitudinal associations between atherogenic risk—measured through TC/HDL-c, LDL-c/HDL-c, TG/HDL-c ratios, and atherogenic dyslipidemia (AD)—and sociodemographic variables, health behaviors, and alcohol consumption in a large cohort of Spanish workers. Methods: A dual-phase study was conducted. The first phase was a cross-sectional analysis of 139,634 workers (83,282 men; 56,352 women) from multiple employment sectors undergoing routine occupational health assessments. The second phase was a longitudinal study of a subsample (n = 40,431) with complete data from 2009 and 2019. Clinical, anthropometric, and biochemical data were collected using standardized protocols. Lifestyle factors (smoking, physical activity, Mediterranean diet adherence, alcohol intake) and socioeconomic indicators (education, occupational class) were recorded. Multinomial logistic regression was used to determine independent associations with high-risk atherogenic profiles. Results: Higher atherogenic indices and prevalence of AD were associated with advancing age, lower educational level, lower social class, smoking, physical inactivity, poor diet quality, and alcohol consumption. Men exhibited higher TG/HDL-c and AD values, whereas women had higher TC/HDL-c and LDL-c/HDL-c. Physical inactivity showed the strongest association with TG/HDL-c (OR: 36.23; 95\% CI: 32.12–40.35) and AD (OR: 16.86; 95\% CI: 14.80–18.93). Alcohol intake also independently predicted higher TG/HDL-c (OR: 1.60) and AD (OR: 1.79). Over the decade, a general increase in atherogenic risk was observed, especially among older adults, socially disadvantaged groups, and those with unhealthy behaviors. Conclusions: Sociodemographic and lifestyle factors, particularly physical inactivity and alcohol consumption, are strongly associated with adverse atherogenic profiles in the working population. The observed rise in lipid-related cardiovascular risk over the past decade emphasizes the urgent need for workplace-based health promotion strategies targeting modifiable behaviors and structural health inequalities.
  

• 
  1.

  García Samuelsson M, Tárraga López PJ, López-González Ángel A, Busquets-Cortés C, Obrador de Hevia J, Ramírez-Manent JI. Evaluation of Type 2 Diabetes Risk in Individuals With or Without Metabolically Healthy Obesity. Biology [Internet]. 2025 May;14(6):608. https://pmc.ncbi.nlm.nih.gov/articles/PMC12189814/

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Not all people with obesity are equally at risk for type 2 diabetes. Some individuals, although obese, do not show the typical signs of poor metabolic health—like high blood pressure, high blood sugar, or abnormal cholesterol levels. These individuals are known as “metabolically healthy obese” (MHO). This study looked at over 68,000 Spanish workers and compared MHO individuals to those with unhealthy obesity (MNHO). Researchers used several tools to estimate the risk of developing type 2 diabetes. They found that while MHO people had a lower risk than MNHO ones, their risk was still higher than people of normal weight with good metabolic health. The study also showed that lack of physical activity, poor diet, smoking, and low education levels were linked to higher diabetes risk. In short, even if someone with obesity appears healthy now, they may still face serious health risks later. The study highlights the importance of healthy habits and shows that weight alone is not enough to determine a person’s risk for diabetes., Background: The concept of metabolically healthy obesity (MHO) has emerged as a controversial yet clinically relevant phenotype, challenging the traditional view that all obese individuals are uniformly at high metabolic risk. However, the long-term health implications of MHO, particularly its association with type 2 diabetes mellitus (T2DM), remain poorly defined. Objective: To assess the risk of T2DM in individuals with MHO compared to those with metabolically non-healthy obesity (MNHO), using multiple validated diabetes risk scales across a large population-based cohort. Methods: This cross-sectional study analyzed data from over 68,884 adults stratified by sex and BMI-defined obesity status. Metabolic health was categorized using three progressively inclusive definitions based on the number of metabolic syndrome components. Diabetes risk was estimated using Finrisk, Canrisk, TRAQ-D, Thai, Oman, and QD-score tools. Multinomial logistic regression assessed associations between MHO/MNHO phenotypes and high-risk diabetes scores, adjusting for demographic, socioeconomic, and lifestyle variables. Results: Across all definitions and scales, MNHO individuals exhibited significantly higher mean diabetes risk scores and greater prevalence of high-risk categories compared to MHO participants (p \textless 0.001). Nevertheless, MHO individuals consistently showed elevated diabetes risk relative to non-obese, metabolically healthy controls. Physical inactivity, low educational level, lower socioeconomic status, smoking, and absence of a Mediterranean diet were independently associated with higher diabetes risk. MNHO phenotype was a strong and consistent predictor of high-risk classification across all models. Conclusions: While MHO individuals present a comparatively lower risk of T2DM than their MNHO counterparts, their risk remains substantially higher than that of non-obese individuals. These findings highlight the need to refine risk stratification approaches beyond BMI alone, and to consider metabolic health status in guiding prevention strategies for T2DM.

  @article{garcia_samuelsson_evaluation_2025,
  abstract = {Not all people with obesity are equally at risk for type 2 diabetes. Some individuals, although obese, do not show the typical signs of poor metabolic health—like high blood pressure, high blood sugar, or abnormal cholesterol levels. These individuals are known as “metabolically healthy obese” (MHO). This study looked at over 68,000 Spanish workers and compared MHO individuals to those with unhealthy obesity (MNHO). Researchers used several tools to estimate the risk of developing type 2 diabetes. They found that while MHO people had a lower risk than MNHO ones, their risk was still higher than people of normal weight with good metabolic health. The study also showed that lack of physical activity, poor diet, smoking, and low education levels were linked to higher diabetes risk. In short, even if someone with obesity appears healthy now, they may still face serious health risks later. The study highlights the importance of healthy habits and shows that weight alone is not enough to determine a person’s risk for diabetes., Background: The concept of metabolically healthy obesity (MHO) has emerged as a controversial yet clinically relevant phenotype, challenging the traditional view that all obese individuals are uniformly at high metabolic risk. However, the long-term health implications of MHO, particularly its association with type 2 diabetes mellitus (T2DM), remain poorly defined. Objective: To assess the risk of T2DM in individuals with MHO compared to those with metabolically non-healthy obesity (MNHO), using multiple validated diabetes risk scales across a large population-based cohort. Methods: This cross-sectional study analyzed data from over 68,884 adults stratified by sex and BMI-defined obesity status. Metabolic health was categorized using three progressively inclusive definitions based on the number of metabolic syndrome components. Diabetes risk was estimated using Finrisk, Canrisk, TRAQ-D, Thai, Oman, and QD-score tools. Multinomial logistic regression assessed associations between MHO/MNHO phenotypes and high-risk diabetes scores, adjusting for demographic, socioeconomic, and lifestyle variables. Results: Across all definitions and scales, MNHO individuals exhibited significantly higher mean diabetes risk scores and greater prevalence of high-risk categories compared to MHO participants (p \textless 0.001). Nevertheless, MHO individuals consistently showed elevated diabetes risk relative to non-obese, metabolically healthy controls. Physical inactivity, low educational level, lower socioeconomic status, smoking, and absence of a Mediterranean diet were independently associated with higher diabetes risk. MNHO phenotype was a strong and consistent predictor of high-risk classification across all models. Conclusions: While MHO individuals present a comparatively lower risk of T2DM than their MNHO counterparts, their risk remains substantially higher than that of non-obese individuals. These findings highlight the need to refine risk stratification approaches beyond BMI alone, and to consider metabolic health status in guiding prevention strategies for T2DM.},
  author = {García Samuelsson, Miguel and Tárraga López, Pedro Juan and López-González, Ángel Arturo and Busquets-Cortés, Carla and Obrador de Hevia, Joan and Ramírez-Manent, José Ignacio},
  journal = {Biology},
  keywords = {grapp-caib},
  month = {may},
  number = 6,
  pages = 608,
  title = {Evaluation of Type 2 Diabetes Risk in Individuals With or Without Metabolically Healthy Obesity},
  volume = 14,
  year = 2025
  }
  

  %0 Journal Article
  %1 garcia_samuelsson_evaluation_2025
  %A García Samuelsson, Miguel
  %A Tárraga López, Pedro Juan
  %A López-González, Ángel Arturo
  %A Busquets-Cortés, Carla
  %A Obrador de Hevia, Joan
  %A Ramírez-Manent, José Ignacio
  %D 2025
  %J Biology
  %N 6
  %P 608
  %R 10.3390/biology14060608
  %T Evaluation of Type 2 Diabetes Risk in Individuals With or Without Metabolically Healthy Obesity
  %U https://pmc.ncbi.nlm.nih.gov/articles/PMC12189814/
  %V 14
  %X Not all people with obesity are equally at risk for type 2 diabetes. Some individuals, although obese, do not show the typical signs of poor metabolic health—like high blood pressure, high blood sugar, or abnormal cholesterol levels. These individuals are known as “metabolically healthy obese” (MHO). This study looked at over 68,000 Spanish workers and compared MHO individuals to those with unhealthy obesity (MNHO). Researchers used several tools to estimate the risk of developing type 2 diabetes. They found that while MHO people had a lower risk than MNHO ones, their risk was still higher than people of normal weight with good metabolic health. The study also showed that lack of physical activity, poor diet, smoking, and low education levels were linked to higher diabetes risk. In short, even if someone with obesity appears healthy now, they may still face serious health risks later. The study highlights the importance of healthy habits and shows that weight alone is not enough to determine a person’s risk for diabetes., Background: The concept of metabolically healthy obesity (MHO) has emerged as a controversial yet clinically relevant phenotype, challenging the traditional view that all obese individuals are uniformly at high metabolic risk. However, the long-term health implications of MHO, particularly its association with type 2 diabetes mellitus (T2DM), remain poorly defined. Objective: To assess the risk of T2DM in individuals with MHO compared to those with metabolically non-healthy obesity (MNHO), using multiple validated diabetes risk scales across a large population-based cohort. Methods: This cross-sectional study analyzed data from over 68,884 adults stratified by sex and BMI-defined obesity status. Metabolic health was categorized using three progressively inclusive definitions based on the number of metabolic syndrome components. Diabetes risk was estimated using Finrisk, Canrisk, TRAQ-D, Thai, Oman, and QD-score tools. Multinomial logistic regression assessed associations between MHO/MNHO phenotypes and high-risk diabetes scores, adjusting for demographic, socioeconomic, and lifestyle variables. Results: Across all definitions and scales, MNHO individuals exhibited significantly higher mean diabetes risk scores and greater prevalence of high-risk categories compared to MHO participants (p \textless 0.001). Nevertheless, MHO individuals consistently showed elevated diabetes risk relative to non-obese, metabolically healthy controls. Physical inactivity, low educational level, lower socioeconomic status, smoking, and absence of a Mediterranean diet were independently associated with higher diabetes risk. MNHO phenotype was a strong and consistent predictor of high-risk classification across all models. Conclusions: While MHO individuals present a comparatively lower risk of T2DM than their MNHO counterparts, their risk remains substantially higher than that of non-obese individuals. These findings highlight the need to refine risk stratification approaches beyond BMI alone, and to consider metabolic health status in guiding prevention strategies for T2DM.
  

• 
  1.

  Ramírez-Gallegos I, Busquets-Cortes C, Paublini H, López-González Ángel A, Martínez-Almoyna-Rifá E, Tárraga López PJ, Ramírez-Manent JI. Association Between Bioimpedance-Determined Metabolic Age and MASLD Risk Scores in Spanish Workers. Metabolites [Internet]. 2025 May;15(5):343. https://pmc.ncbi.nlm.nih.gov/articles/PMC12113834/

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a prevalent liver disorder with significant metabolic implications. Metabolic age, determined through bioimpedance analysis, has emerged as a potential indicator of overall metabolic health. The objective of this study is to evaluate the association between metabolic age and MASLD risk scores in a cohort of Spanish workers. Methods: A cross-sectional study was conducted on 8590 Spanish workers who underwent annual occupational health examinations between 2019 and 2020. Metabolic age was determined using bioelectrical impedance analysis, and the Avoidable Lost Life Years (ALLY) index was calculated as the difference between their metabolic and chronological age. MASLD risk was assessed using various validated scales, including the Fatty Liver Index (FLI), Hepatic Steatosis Index (HSI), Zhejiang University Index (ZJU), Fatty Liver Disease Index (FLD), and Lipid Accumulation Product (LAP). A multinomial logistic regression analysis was performed to examine the association between metabolic age and MASLD risk scores, adjusting for sociodemographic and lifestyle variables. Results: Higher metabolic age values were observed in individuals with greater MASLD risk across all evaluated scales. The mean metabolic age was consistently lower in women compared to men, and these differences were statistically significant (p \textless 0.01). Multinomial logistic regression analysis revealed that the strongest associations with increased metabolic age were found for MASLD risk scores, physical inactivity, and poor adherence to the Mediterranean diet. ROC curve analysis demonstrated a high predictive capacity for the FLD (AUC: 0.935 in women and 0.917 in men) and FLI (AUC: 0.900 in women and 0.833 in men), with high Youden index values. Conclusions: Metabolic age is significantly associated with MASLD risk, suggesting its potential as a non-invasive biomarker for identifying individuals with a higher risk for metabolic liver disease. Lifestyle factors, including physical activity and dietary patterns, play a crucial role in modulating metabolic age, highlighting the importance of targeted interventions for MASLD prevention. Further research is warranted to validate metabolic age as a prognostic tool in MASLD risk assessment.

  @article{ramirez-gallegos_association_2025,
  abstract = {Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a prevalent liver disorder with significant metabolic implications. Metabolic age, determined through bioimpedance analysis, has emerged as a potential indicator of overall metabolic health. The objective of this study is to evaluate the association between metabolic age and MASLD risk scores in a cohort of Spanish workers. Methods: A cross-sectional study was conducted on 8590 Spanish workers who underwent annual occupational health examinations between 2019 and 2020. Metabolic age was determined using bioelectrical impedance analysis, and the Avoidable Lost Life Years (ALLY) index was calculated as the difference between their metabolic and chronological age. MASLD risk was assessed using various validated scales, including the Fatty Liver Index (FLI), Hepatic Steatosis Index (HSI), Zhejiang University Index (ZJU), Fatty Liver Disease Index (FLD), and Lipid Accumulation Product (LAP). A multinomial logistic regression analysis was performed to examine the association between metabolic age and MASLD risk scores, adjusting for sociodemographic and lifestyle variables. Results: Higher metabolic age values were observed in individuals with greater MASLD risk across all evaluated scales. The mean metabolic age was consistently lower in women compared to men, and these differences were statistically significant (p \textless 0.01). Multinomial logistic regression analysis revealed that the strongest associations with increased metabolic age were found for MASLD risk scores, physical inactivity, and poor adherence to the Mediterranean diet. ROC curve analysis demonstrated a high predictive capacity for the FLD (AUC: 0.935 in women and 0.917 in men) and FLI (AUC: 0.900 in women and 0.833 in men), with high Youden index values. Conclusions: Metabolic age is significantly associated with MASLD risk, suggesting its potential as a non-invasive biomarker for identifying individuals with a higher risk for metabolic liver disease. Lifestyle factors, including physical activity and dietary patterns, play a crucial role in modulating metabolic age, highlighting the importance of targeted interventions for MASLD prevention. Further research is warranted to validate metabolic age as a prognostic tool in MASLD risk assessment.},
  author = {Ramírez-Gallegos, Ignacio and Busquets-Cortes, Carla and Paublini, Hernán and López-González, Ángel Arturo and Martínez-Almoyna-Rifá, Emilio and Tárraga López, Pedro Juan and Ramírez-Manent, José Ignacio},
  journal = {Metabolites},
  keywords = {grapp-caib},
  month = {may},
  number = 5,
  pages = 343,
  title = {Association Between Bioimpedance-Determined Metabolic Age and MASLD Risk Scores in Spanish Workers},
  volume = 15,
  year = 2025
  }
  

  %0 Journal Article
  %1 ramirez-gallegos_association_2025
  %A Ramírez-Gallegos, Ignacio
  %A Busquets-Cortes, Carla
  %A Paublini, Hernán
  %A López-González, Ángel Arturo
  %A Martínez-Almoyna-Rifá, Emilio
  %A Tárraga López, Pedro Juan
  %A Ramírez-Manent, José Ignacio
  %D 2025
  %J Metabolites
  %N 5
  %P 343
  %R 10.3390/metabo15050343
  %T Association Between Bioimpedance-Determined Metabolic Age and MASLD Risk Scores in Spanish Workers
  %U https://pmc.ncbi.nlm.nih.gov/articles/PMC12113834/
  %V 15
  %X Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a prevalent liver disorder with significant metabolic implications. Metabolic age, determined through bioimpedance analysis, has emerged as a potential indicator of overall metabolic health. The objective of this study is to evaluate the association between metabolic age and MASLD risk scores in a cohort of Spanish workers. Methods: A cross-sectional study was conducted on 8590 Spanish workers who underwent annual occupational health examinations between 2019 and 2020. Metabolic age was determined using bioelectrical impedance analysis, and the Avoidable Lost Life Years (ALLY) index was calculated as the difference between their metabolic and chronological age. MASLD risk was assessed using various validated scales, including the Fatty Liver Index (FLI), Hepatic Steatosis Index (HSI), Zhejiang University Index (ZJU), Fatty Liver Disease Index (FLD), and Lipid Accumulation Product (LAP). A multinomial logistic regression analysis was performed to examine the association between metabolic age and MASLD risk scores, adjusting for sociodemographic and lifestyle variables. Results: Higher metabolic age values were observed in individuals with greater MASLD risk across all evaluated scales. The mean metabolic age was consistently lower in women compared to men, and these differences were statistically significant (p \textless 0.01). Multinomial logistic regression analysis revealed that the strongest associations with increased metabolic age were found for MASLD risk scores, physical inactivity, and poor adherence to the Mediterranean diet. ROC curve analysis demonstrated a high predictive capacity for the FLD (AUC: 0.935 in women and 0.917 in men) and FLI (AUC: 0.900 in women and 0.833 in men), with high Youden index values. Conclusions: Metabolic age is significantly associated with MASLD risk, suggesting its potential as a non-invasive biomarker for identifying individuals with a higher risk for metabolic liver disease. Lifestyle factors, including physical activity and dietary patterns, play a crucial role in modulating metabolic age, highlighting the importance of targeted interventions for MASLD prevention. Further research is warranted to validate metabolic age as a prognostic tool in MASLD risk assessment.
  

• 
  1.

  Guarro Miquel JJ, Tárraga López PJ, Marzoa Jansana MD, López-González Ángel A, Riutord Sbert P, Busquets-Cortés C, Ramirez-Manent JI. Comparison of Anthropometric and Metabolic Indexes in the Diagnosis of Metabolic Syndrome: A Large-Scale Analysis of Spanish Workers. Metabolites [Internet]. 2025 Jul.;15(8):495. https://pmc.ncbi.nlm.nih.gov/articles/PMC12388431/

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Background: Metabolic syndrome (MS) is a major public health concern linked to an elevated risk of type 2 diabetes and cardiovascular disease. Simple, reliable screening tools are needed for early identification, especially in working populations. Objective: To compare the diagnostic accuracy of body mass index (BMI), waist-to-height ratio (WtHR), triglyceride–glucose index (TyG), and waist–triglyceride index (WTI) for detecting MS based on NCEP ATP III and IDF criteria in a large cohort of Spanish workers. Methods: This cross-sectional study analyzed data from 386,924 Spanish workers. MS was diagnosed using NCEP ATP III and IDF definitions. The four indexes were evaluated by sex using a receiver operating characteristic (ROC) curve analysis. Area under the curve (AUC), optimal cut-off points, and Youden’s index were calculated. Results: TyG and WTI had the highest AUC values in men (0.911 and 0.901, respectively) for NCEP ATP III-defined MS, while WtHR and WTI achieved the best performance in women (0.955 and 0.953, respectively). WtHR outperformed BMI in all subgroups. Optimal cut-off values were identified according to sex and the definition of MS: TyG (8.95 men, 8.51 women), WtHR (0.54 men, 0.51 women), and WTI (170.6 men, 96.5 women), supporting their practical implementation in occupational health programs. All indexes showed significant discriminatory capacity (p \textless 0.001). Conclusions: TyG, WtHR, and WTI are more effective than BMI in detecting MS among Spanish workers, with sex-specific patterns. Their ease of use and diagnostic strength support their adoption in occupational health programs for early cardiometabolic risk detection.

  @article{guarro_miquel_comparison_2025,
  abstract = {Background: Metabolic syndrome (MS) is a major public health concern linked to an elevated risk of type 2 diabetes and cardiovascular disease. Simple, reliable screening tools are needed for early identification, especially in working populations. Objective: To compare the diagnostic accuracy of body mass index (BMI), waist-to-height ratio (WtHR), triglyceride–glucose index (TyG), and waist–triglyceride index (WTI) for detecting MS based on NCEP ATP III and IDF criteria in a large cohort of Spanish workers. Methods: This cross-sectional study analyzed data from 386,924 Spanish workers. MS was diagnosed using NCEP ATP III and IDF definitions. The four indexes were evaluated by sex using a receiver operating characteristic (ROC) curve analysis. Area under the curve (AUC), optimal cut-off points, and Youden’s index were calculated. Results: TyG and WTI had the highest AUC values in men (0.911 and 0.901, respectively) for NCEP ATP III-defined MS, while WtHR and WTI achieved the best performance in women (0.955 and 0.953, respectively). WtHR outperformed BMI in all subgroups. Optimal cut-off values were identified according to sex and the definition of MS: TyG (8.95 men, 8.51 women), WtHR (0.54 men, 0.51 women), and WTI (170.6 men, 96.5 women), supporting their practical implementation in occupational health programs. All indexes showed significant discriminatory capacity (p \textless 0.001). Conclusions: TyG, WtHR, and WTI are more effective than BMI in detecting MS among Spanish workers, with sex-specific patterns. Their ease of use and diagnostic strength support their adoption in occupational health programs for early cardiometabolic risk detection.},
  author = {Guarro Miquel, Juan José and Tárraga López, Pedro Juan and Marzoa Jansana, María Dolores and López-González, Ángel Arturo and Riutord Sbert, Pere and Busquets-Cortés, Carla and Ramirez-Manent, José Ignacio},
  journal = {Metabolites},
  keywords = {grapp-caib},
  month = {jul},
  number = 8,
  pages = 495,
  title = {Comparison of Anthropometric and Metabolic Indexes in the Diagnosis of Metabolic Syndrome: A Large-Scale Analysis of Spanish Workers},
  volume = 15,
  year = 2025
  }
  

  %0 Journal Article
  %1 guarro_miquel_comparison_2025
  %A Guarro Miquel, Juan José
  %A Tárraga López, Pedro Juan
  %A Marzoa Jansana, María Dolores
  %A López-González, Ángel Arturo
  %A Riutord Sbert, Pere
  %A Busquets-Cortés, Carla
  %A Ramirez-Manent, José Ignacio
  %D 2025
  %J Metabolites
  %N 8
  %P 495
  %R 10.3390/metabo15080495
  %T Comparison of Anthropometric and Metabolic Indexes in the Diagnosis of Metabolic Syndrome: A Large-Scale Analysis of Spanish Workers
  %U https://pmc.ncbi.nlm.nih.gov/articles/PMC12388431/
  %V 15
  %X Background: Metabolic syndrome (MS) is a major public health concern linked to an elevated risk of type 2 diabetes and cardiovascular disease. Simple, reliable screening tools are needed for early identification, especially in working populations. Objective: To compare the diagnostic accuracy of body mass index (BMI), waist-to-height ratio (WtHR), triglyceride–glucose index (TyG), and waist–triglyceride index (WTI) for detecting MS based on NCEP ATP III and IDF criteria in a large cohort of Spanish workers. Methods: This cross-sectional study analyzed data from 386,924 Spanish workers. MS was diagnosed using NCEP ATP III and IDF definitions. The four indexes were evaluated by sex using a receiver operating characteristic (ROC) curve analysis. Area under the curve (AUC), optimal cut-off points, and Youden’s index were calculated. Results: TyG and WTI had the highest AUC values in men (0.911 and 0.901, respectively) for NCEP ATP III-defined MS, while WtHR and WTI achieved the best performance in women (0.955 and 0.953, respectively). WtHR outperformed BMI in all subgroups. Optimal cut-off values were identified according to sex and the definition of MS: TyG (8.95 men, 8.51 women), WtHR (0.54 men, 0.51 women), and WTI (170.6 men, 96.5 women), supporting their practical implementation in occupational health programs. All indexes showed significant discriminatory capacity (p \textless 0.001). Conclusions: TyG, WtHR, and WTI are more effective than BMI in detecting MS among Spanish workers, with sex-specific patterns. Their ease of use and diagnostic strength support their adoption in occupational health programs for early cardiometabolic risk detection.
  

• 
  1.

  Paublini H, Arturo López-González Á, Tárraga López PJ, Martínez-Almoyna Rifá E, Vallejos D, Ignacio Ramírez-Manent J. [Usefullness of different scales of overweight and obesity to predict the presence of atherogenic dyslipidemia and lipid triad in 418,343 spanish workers]. Semergen [Internet]. 2025;51(4):102428. https://europepmc.org/article/med/39693830

  AbstractURLBibTeXEndNoteDOIBibSonomy

  INTRODUCTION AND OBJECTIVES: Obesity and atherogenesis are two highly prevalent pathological processes that are closely related to the increase in cardiometabolic diseases. The aim of this study is to assess the relationship between obesity and two parameters that measure the risk of atherogenesis: atherogenic dyslipidaemia (AD) and the lipid triad (TL). MATERIAL AND METHODS: Descriptive and cross-sectional study in 418,343 Spanish workers in which the possible association between AD and TL with different scales of overweight and obesity such as body mass index (BMI), waist/height index, Clínica Universitaria de Navarra Body Adiposity Estimator (CUN BAE), relative fat mass (RFM), Palafolls and Deuremberg formulas, body surface index (BSI), normalized weight-adjusted index (NWAI) and body roundness index (BRI) was assessed. RESULTS: The values of all overweight-obesity scales are higher in people with AD and LBP and the prevalence of AD and LBP increases as the values of these overweight-obesity scales increase. The overweight-obesity scales that best predict the occurrence of AD are Deuremberg and CUN BAE (AUC 0.813 and 0.811 in men and 0.810 and 0.802 in women) while for TL they are also Deuremberg and CUN BAE (AUC 0.793 and 0.786 in men and 0.802 and 0.786 in women). CONCLUSIONS: The different scales that assess excess weight, especially those that predict body fat such as the Deuremberg formula and CUN BAE, are good predictors of AD and LD.

  @article{paublini_usefullness_2025,
  abstract = {INTRODUCTION AND OBJECTIVES: Obesity and atherogenesis are two highly prevalent pathological processes that are closely related to the increase in cardiometabolic diseases. The aim of this study is to assess the relationship between obesity and two parameters that measure the risk of atherogenesis: atherogenic dyslipidaemia (AD) and the lipid triad (TL). MATERIAL AND METHODS: Descriptive and cross-sectional study in 418,343 Spanish workers in which the possible association between AD and TL with different scales of overweight and obesity such as body mass index (BMI), waist/height index, Clínica Universitaria de Navarra Body Adiposity Estimator (CUN BAE), relative fat mass (RFM), Palafolls and Deuremberg formulas, body surface index (BSI), normalized weight-adjusted index (NWAI) and body roundness index (BRI) was assessed. RESULTS: The values of all overweight-obesity scales are higher in people with AD and LBP and the prevalence of AD and LBP increases as the values of these overweight-obesity scales increase. The overweight-obesity scales that best predict the occurrence of AD are Deuremberg and CUN BAE (AUC 0.813 and 0.811 in men and 0.810 and 0.802 in women) while for TL they are also Deuremberg and CUN BAE (AUC 0.793 and 0.786 in men and 0.802 and 0.786 in women). CONCLUSIONS: The different scales that assess excess weight, especially those that predict body fat such as the Deuremberg formula and CUN BAE, are good predictors of AD and LD.},
  author = {Paublini, H. and Arturo López-González, Á and Tárraga López, P. J. and Martínez-Almoyna Rifá, E. and Vallejos, D. and Ignacio Ramírez-Manent, J.},
  journal = {Semergen},
  keywords = {grapp-caib},
  number = 4,
  pages = 102428,
  title = {[Usefullness of different scales of overweight and obesity to predict the presence of atherogenic dyslipidemia and lipid triad in 418,343 spanish workers]},
  volume = 51,
  year = 2025
  }
  

  %0 Journal Article
  %1 paublini_usefullness_2025
  %A Paublini, H.
  %A Arturo López-González, Á
  %A Tárraga López, P. J.
  %A Martínez-Almoyna Rifá, E.
  %A Vallejos, D.
  %A Ignacio Ramírez-Manent, J.
  %D 2025
  %J Semergen
  %N 4
  %P 102428
  %R 10.1016/j.semerg.2024.102428
  %T [Usefullness of different scales of overweight and obesity to predict the presence of atherogenic dyslipidemia and lipid triad in 418,343 spanish workers]
  %U https://europepmc.org/article/med/39693830
  %V 51
  %X INTRODUCTION AND OBJECTIVES: Obesity and atherogenesis are two highly prevalent pathological processes that are closely related to the increase in cardiometabolic diseases. The aim of this study is to assess the relationship between obesity and two parameters that measure the risk of atherogenesis: atherogenic dyslipidaemia (AD) and the lipid triad (TL). MATERIAL AND METHODS: Descriptive and cross-sectional study in 418,343 Spanish workers in which the possible association between AD and TL with different scales of overweight and obesity such as body mass index (BMI), waist/height index, Clínica Universitaria de Navarra Body Adiposity Estimator (CUN BAE), relative fat mass (RFM), Palafolls and Deuremberg formulas, body surface index (BSI), normalized weight-adjusted index (NWAI) and body roundness index (BRI) was assessed. RESULTS: The values of all overweight-obesity scales are higher in people with AD and LBP and the prevalence of AD and LBP increases as the values of these overweight-obesity scales increase. The overweight-obesity scales that best predict the occurrence of AD are Deuremberg and CUN BAE (AUC 0.813 and 0.811 in men and 0.810 and 0.802 in women) while for TL they are also Deuremberg and CUN BAE (AUC 0.793 and 0.786 in men and 0.802 and 0.786 in women). CONCLUSIONS: The different scales that assess excess weight, especially those that predict body fat such as the Deuremberg formula and CUN BAE, are good predictors of AD and LD.
  

• 
  1.

  Fernández-Figares Vicioso MP, Riutord Sbert P, Ramírez-Manent JI, López-González Ángel A, del Barrio Fernández JL, Vicente Herrero MT. Association Between Sociodemographic and Lifestyle Factors and Type 2 Diabetes Risk Scores in a Large Working Population: A Comparative Study Between the Commerce and Industry Sectors. Nutrients [Internet]. 2025 Jul.;17(15):2420. https://pmc.ncbi.nlm.nih.gov/articles/PMC12348608/

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Background: Type 2 diabetes (T2D) is a major global health concern influenced by sociodemographic and lifestyle factors. This study compared T2D risk scores between commerce and industry sectors and assessed the associations of age, sex, education, physical activity, diet, and smoking with elevated risk. Methods: This cross-sectional study included 56,856 men and 12,872 women employed in the commerce (n = 27,448) and industry (n = 42,280) sectors across Spain. Anthropometric, clinical, and biochemical data were collected. Four validated T2D risk scores (QDscore, Finrisk, Canrisk, and TRAQ-D) were calculated. Multinomial logistic regression models estimated adjusted odds ratios (ORs) for high-risk categories by sociodemographic and lifestyle characteristics. Results: Women in the industrial sector had significantly higher age, BMI, waist circumference, and lipid levels than those in commerce; differences among men were less marked. Across all participants, higher T2D risk scores were independently associated with physical inactivity (OR up to 12.49), poor Mediterranean diet adherence (OR up to 6.62), industrial employment (OR up to 1.98), and older age. Male sex was strongly associated with high Canrisk scores (OR = 6.31; 95\% CI: 5.12–7.51). Conclusions: Employment in the industrial sector, combined with sedentary behavior and poor dietary habits, is independently associated with higher predicted T2D risk. Workplace prevention strategies should prioritize multicomponent interventions targeting modifiable risk factors, especially in high-risk subgroups such as older, less-educated, and inactive workers.

  @article{fernandez-figares_vicioso_association_2025,
  abstract = {Background: Type 2 diabetes (T2D) is a major global health concern influenced by sociodemographic and lifestyle factors. This study compared T2D risk scores between commerce and industry sectors and assessed the associations of age, sex, education, physical activity, diet, and smoking with elevated risk. Methods: This cross-sectional study included 56,856 men and 12,872 women employed in the commerce (n = 27,448) and industry (n = 42,280) sectors across Spain. Anthropometric, clinical, and biochemical data were collected. Four validated T2D risk scores (QDscore, Finrisk, Canrisk, and TRAQ-D) were calculated. Multinomial logistic regression models estimated adjusted odds ratios (ORs) for high-risk categories by sociodemographic and lifestyle characteristics. Results: Women in the industrial sector had significantly higher age, BMI, waist circumference, and lipid levels than those in commerce; differences among men were less marked. Across all participants, higher T2D risk scores were independently associated with physical inactivity (OR up to 12.49), poor Mediterranean diet adherence (OR up to 6.62), industrial employment (OR up to 1.98), and older age. Male sex was strongly associated with high Canrisk scores (OR = 6.31; 95\% CI: 5.12–7.51). Conclusions: Employment in the industrial sector, combined with sedentary behavior and poor dietary habits, is independently associated with higher predicted T2D risk. Workplace prevention strategies should prioritize multicomponent interventions targeting modifiable risk factors, especially in high-risk subgroups such as older, less-educated, and inactive workers.},
  author = {Fernández-Figares Vicioso, María Pilar and Riutord Sbert, Pere and Ramírez-Manent, José Ignacio and López-González, Ángel Arturo and del Barrio Fernández, José Luis and Vicente Herrero, María Teófila},
  journal = {Nutrients},
  keywords = {grapp-caib},
  month = {jul},
  number = 15,
  pages = 2420,
  title = {Association Between Sociodemographic and Lifestyle Factors and Type 2 Diabetes Risk Scores in a Large Working Population: A Comparative Study Between the Commerce and Industry Sectors},
  volume = 17,
  year = 2025
  }
  

  %0 Journal Article
  %1 fernandez-figares_vicioso_association_2025
  %A Fernández-Figares Vicioso, María Pilar
  %A Riutord Sbert, Pere
  %A Ramírez-Manent, José Ignacio
  %A López-González, Ángel Arturo
  %A del Barrio Fernández, José Luis
  %A Vicente Herrero, María Teófila
  %D 2025
  %J Nutrients
  %N 15
  %P 2420
  %R 10.3390/nu17152420
  %T Association Between Sociodemographic and Lifestyle Factors and Type 2 Diabetes Risk Scores in a Large Working Population: A Comparative Study Between the Commerce and Industry Sectors
  %U https://pmc.ncbi.nlm.nih.gov/articles/PMC12348608/
  %V 17
  %X Background: Type 2 diabetes (T2D) is a major global health concern influenced by sociodemographic and lifestyle factors. This study compared T2D risk scores between commerce and industry sectors and assessed the associations of age, sex, education, physical activity, diet, and smoking with elevated risk. Methods: This cross-sectional study included 56,856 men and 12,872 women employed in the commerce (n = 27,448) and industry (n = 42,280) sectors across Spain. Anthropometric, clinical, and biochemical data were collected. Four validated T2D risk scores (QDscore, Finrisk, Canrisk, and TRAQ-D) were calculated. Multinomial logistic regression models estimated adjusted odds ratios (ORs) for high-risk categories by sociodemographic and lifestyle characteristics. Results: Women in the industrial sector had significantly higher age, BMI, waist circumference, and lipid levels than those in commerce; differences among men were less marked. Across all participants, higher T2D risk scores were independently associated with physical inactivity (OR up to 12.49), poor Mediterranean diet adherence (OR up to 6.62), industrial employment (OR up to 1.98), and older age. Male sex was strongly associated with high Canrisk scores (OR = 6.31; 95\% CI: 5.12–7.51). Conclusions: Employment in the industrial sector, combined with sedentary behavior and poor dietary habits, is independently associated with higher predicted T2D risk. Workplace prevention strategies should prioritize multicomponent interventions targeting modifiable risk factors, especially in high-risk subgroups such as older, less-educated, and inactive workers.
  

• 
  1.

  Hernáez Álvaro, Camps-Vilaró A, Polo-Alonso S, Subirana I, Ramos R, de Cid R, Rodríguez-Artalejo F, Elosua R, Chirlaque MD, Amiano P, Bermúdez-López M, Guevara M, Cinza-Sanjurjo S, Sánchez M-J, de León AC, Laclaustra M, Rojo-Martínez G, Guembe-Suescun MJ, Pérez-Gómez B, Vega-Alonso T, Torán-Monserrat P, Lora-Pablos D, Huerta JM, Valdivielso JM, Dégano IR, Félix-Redondo FJ, Gandarillas AM, Valdés S, Mundet-Tuduri X, Sánchez PL, Martín-Sánchez V, Rigo F, Alonso-Sampedro M, Moreno-Iribas C, Martín-Escudero JC, Delgado E, Grau M, Urrutia I, Ovejero D, Quintela I, Martí-Lluch R, Blay N, Banegas JR, Tizón-Marcos H, Gómez JH, Aizpurua A, Castro-Boqué E, Delfrade J, Prieto-Díaz M Ángel, Rodríguez-Barranco M, Almeida-González D, Moreno-Franco B, Oualla-Bachiri W, Sayón-Orea C, Plans-Beriso E, Lozano JE, López-Lifante VM, Cancelas-Navia P, Cabrera-Castro N, Cambray S, Zacarías-Pons L, Fernández-Bergés D, Donoso-Navarro E, Maldonado-Araque C, Franch-Nadal J, Dorado-Díaz PI, Villarín-Castro A, Frontera-Juan G, Gude F, Andueza N, Téllez-Plaza M, Ares-Blanco J, Cruz R, Ribas-Aulinas M, Barretina J, Guallar-Castillón P, Caínzos-Achirica M, Colorado-Yohar SM, Llorente A, Diaz-Tocados JM, Ardanaz E, Micó-Pérez RM, Fernandez-Martinez NF, del Cristo Rodríguez-Pérez M, Cenarro A, Calle-Pascual AL, Marrugat J. Cohort profile: the CORDELIA study (Collaborative cOhorts Reassembled Data to study mEchanisms and Longterm Incidence of chronic diseAses). European Journal of Epidemiology [Internet]. 2025;40(5):581-99. https://pmc.ncbi.nlm.nih.gov/articles/PMC12170779/

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  The CORDELIA Study (Collaborative Cohorts Reassembled Data to Study Mechanisms and Long-term Incidence of Chronic Diseases) combines 35 Spanish population cohorts to investigate the clinical, environmental, genetic, and omics determinants of cardiovascular disease in the Southern European population. It aims to conduct the largest genome-wide association study to date on cardiovascular disease in this population, improve predictions of cardiovascular incidence using genomic and clinical data, and identify subgroups that would benefit most from targeted pharmacological and lifestyle interventions. CORDELIA includes 196,632 individuals (ages 18–84, 54\% female, 96\% born in Spain, 20\% with higher education, recruited from 1989 to 2020, with follow-up periods ranging from 5 to 30 years), with DNA samples available for 117,342 participants (60\%). Of the participants, 24% were current smokers, 43% hypertensive, 11% diabetic, 15% medicated with lipid-lowering drugs, 44% overweight, and 27% obese. If not already available, genotyping is being performed using the Axiom™ Spain Biobank array (\textasciitilde 750,000 variants, including 115,000 specific and 50,000 rare functional variants from the Spanish population). The cohort also includes incident events (coronary heart disease, stroke, heart failure, peripheral artery disease, hypertension, diabetes); date and cause of death; and harmonized data on risk factors (body mass index, waist circumference, lipid profile, blood pressure, glucose, creatinine), lifestyle (smoking, physical activity, diet, alcohol), and socioeconomic status. 99,019 participants (50\%) also provide plasma samples. CORDELIA will significantly contribute to understanding the complex interplay of risk factors contributing to cardiovascular disease and advance the fields of precision medicine and public health in Southern European individuals.

  @article{hernaez_cohort_2025,
  abstract = {The CORDELIA Study (Collaborative Cohorts Reassembled Data to Study Mechanisms and Long-term Incidence of Chronic Diseases) combines 35 Spanish population cohorts to investigate the clinical, environmental, genetic, and omics determinants of cardiovascular disease in the Southern European population. It aims to conduct the largest genome-wide association study to date on cardiovascular disease in this population, improve predictions of cardiovascular incidence using genomic and clinical data, and identify subgroups that would benefit most from targeted pharmacological and lifestyle interventions. CORDELIA includes 196,632 individuals (ages 18–84, 54\% female, 96\% born in Spain, 20\% with higher education, recruited from 1989 to 2020, with follow-up periods ranging from 5 to 30 years), with DNA samples available for 117,342 participants (60\%). Of the participants, 24% were current smokers, 43% hypertensive, 11% diabetic, 15% medicated with lipid-lowering drugs, 44% overweight, and 27% obese. If not already available, genotyping is being performed using the Axiom™ Spain Biobank array (\textasciitilde 750,000 variants, including 115,000 specific and 50,000 rare functional variants from the Spanish population). The cohort also includes incident events (coronary heart disease, stroke, heart failure, peripheral artery disease, hypertension, diabetes); date and cause of death; and harmonized data on risk factors (body mass index, waist circumference, lipid profile, blood pressure, glucose, creatinine), lifestyle (smoking, physical activity, diet, alcohol), and socioeconomic status. 99,019 participants (50\%) also provide plasma samples. CORDELIA will significantly contribute to understanding the complex interplay of risk factors contributing to cardiovascular disease and advance the fields of precision medicine and public health in Southern European individuals.},
  author = {Hernáez, Álvaro and Camps-Vilaró, Anna and Polo-Alonso, Sara and Subirana, Isaac and Ramos, Rafel and de Cid, Rafael and Rodríguez-Artalejo, Fernando and Elosua, Roberto and Chirlaque, M. Dolores and Amiano, Pilar and Bermúdez-López, Marcelino and Guevara, Marcela and Cinza-Sanjurjo, Sergio and Sánchez, María-José and de León, Antonio Cabrera and Laclaustra, Martín and Rojo-Martínez, Gemma and Guembe-Suescun, María J. and Pérez-Gómez, Beatriz and Vega-Alonso, Tomás and Torán-Monserrat, Pere and Lora-Pablos, David and Huerta, José María and Valdivielso, José M. and Dégano, Irene R. and Félix-Redondo, Francisco J. and Gandarillas, Ana María and Valdés, Sergio and Mundet-Tuduri, Xavier and Sánchez, Pedro L. and Martín-Sánchez, Vicente and Rigo, Fernando and Alonso-Sampedro, Manuela and Moreno-Iribas, Conchi and Martín-Escudero, Juan Carlos and Delgado, Elías and Grau, Maria and Urrutia, Inés and Ovejero, Diana and Quintela, Inés and Martí-Lluch, Ruth and Blay, Natalia and Banegas, José R. and Tizón-Marcos, Helena and Gómez, Jesús Humberto and Aizpurua, Amaia and Castro-Boqué, Eva and Delfrade, Josu and Prieto-Díaz, Miguel Ángel and Rodríguez-Barranco, Miguel and Almeida-González, Delia and Moreno-Franco, Belén and Oualla-Bachiri, Wasima and Sayón-Orea, Carmen and Plans-Beriso, Elena and Lozano, José Eugenio and López-Lifante, Víctor M. and Cancelas-Navia, Pilar and Cabrera-Castro, Natalia and Cambray, Serafí and Zacarías-Pons, Lluís and Fernández-Bergés, Daniel and Donoso-Navarro, Encarnación and Maldonado-Araque, Cristina and Franch-Nadal, Josep and Dorado-Díaz, Pedro Ignacio and Villarín-Castro, Alejandro and Frontera-Juan, Guillem and Gude, Francisco and Andueza, Naroa and Téllez-Plaza, María and Ares-Blanco, Jessica and Cruz, Raquel and Ribas-Aulinas, Marc and Barretina, Jordi and Guallar-Castillón, Pilar and Caínzos-Achirica, Miguel and Colorado-Yohar, Sandra Milena and Llorente, Adrián and Diaz-Tocados, Juan Miguel and Ardanaz, Eva and Micó-Pérez, Rafael Manuel and Fernandez-Martinez, Nicolás Francisco and del Cristo Rodríguez-Pérez, María and Cenarro, Ana and Calle-Pascual, Alfonso L. and Marrugat, Jaume},
  journal = {European Journal of Epidemiology},
  keywords = {grapp-caib},
  number = 5,
  pages = {581--599},
  title = {Cohort profile: the CORDELIA study (Collaborative cOhorts Reassembled Data to study mEchanisms and Longterm Incidence of chronic diseAses)},
  volume = 40,
  year = 2025
  }
  

  %0 Journal Article
  %1 hernaez_cohort_2025
  %A Hernáez, Álvaro
  %A Camps-Vilaró, Anna
  %A Polo-Alonso, Sara
  %A Subirana, Isaac
  %A Ramos, Rafel
  %A de Cid, Rafael
  %A Rodríguez-Artalejo, Fernando
  %A Elosua, Roberto
  %A Chirlaque, M. Dolores
  %A Amiano, Pilar
  %A Bermúdez-López, Marcelino
  %A Guevara, Marcela
  %A Cinza-Sanjurjo, Sergio
  %A Sánchez, María-José
  %A de León, Antonio Cabrera
  %A Laclaustra, Martín
  %A Rojo-Martínez, Gemma
  %A Guembe-Suescun, María J.
  %A Pérez-Gómez, Beatriz
  %A Vega-Alonso, Tomás
  %A Torán-Monserrat, Pere
  %A Lora-Pablos, David
  %A Huerta, José María
  %A Valdivielso, José M.
  %A Dégano, Irene R.
  %A Félix-Redondo, Francisco J.
  %A Gandarillas, Ana María
  %A Valdés, Sergio
  %A Mundet-Tuduri, Xavier
  %A Sánchez, Pedro L.
  %A Martín-Sánchez, Vicente
  %A Rigo, Fernando
  %A Alonso-Sampedro, Manuela
  %A Moreno-Iribas, Conchi
  %A Martín-Escudero, Juan Carlos
  %A Delgado, Elías
  %A Grau, Maria
  %A Urrutia, Inés
  %A Ovejero, Diana
  %A Quintela, Inés
  %A Martí-Lluch, Ruth
  %A Blay, Natalia
  %A Banegas, José R.
  %A Tizón-Marcos, Helena
  %A Gómez, Jesús Humberto
  %A Aizpurua, Amaia
  %A Castro-Boqué, Eva
  %A Delfrade, Josu
  %A Prieto-Díaz, Miguel Ángel
  %A Rodríguez-Barranco, Miguel
  %A Almeida-González, Delia
  %A Moreno-Franco, Belén
  %A Oualla-Bachiri, Wasima
  %A Sayón-Orea, Carmen
  %A Plans-Beriso, Elena
  %A Lozano, José Eugenio
  %A López-Lifante, Víctor M.
  %A Cancelas-Navia, Pilar
  %A Cabrera-Castro, Natalia
  %A Cambray, Serafí
  %A Zacarías-Pons, Lluís
  %A Fernández-Bergés, Daniel
  %A Donoso-Navarro, Encarnación
  %A Maldonado-Araque, Cristina
  %A Franch-Nadal, Josep
  %A Dorado-Díaz, Pedro Ignacio
  %A Villarín-Castro, Alejandro
  %A Frontera-Juan, Guillem
  %A Gude, Francisco
  %A Andueza, Naroa
  %A Téllez-Plaza, María
  %A Ares-Blanco, Jessica
  %A Cruz, Raquel
  %A Ribas-Aulinas, Marc
  %A Barretina, Jordi
  %A Guallar-Castillón, Pilar
  %A Caínzos-Achirica, Miguel
  %A Colorado-Yohar, Sandra Milena
  %A Llorente, Adrián
  %A Diaz-Tocados, Juan Miguel
  %A Ardanaz, Eva
  %A Micó-Pérez, Rafael Manuel
  %A Fernandez-Martinez, Nicolás Francisco
  %A del Cristo Rodríguez-Pérez, María
  %A Cenarro, Ana
  %A Calle-Pascual, Alfonso L.
  %A Marrugat, Jaume
  %D 2025
  %J European Journal of Epidemiology
  %N 5
  %P 581--599
  %R 10.1007/s10654-025-01229-6
  %T Cohort profile: the CORDELIA study (Collaborative cOhorts Reassembled Data to study mEchanisms and Longterm Incidence of chronic diseAses)
  %U https://pmc.ncbi.nlm.nih.gov/articles/PMC12170779/
  %V 40
  %X The CORDELIA Study (Collaborative Cohorts Reassembled Data to Study Mechanisms and Long-term Incidence of Chronic Diseases) combines 35 Spanish population cohorts to investigate the clinical, environmental, genetic, and omics determinants of cardiovascular disease in the Southern European population. It aims to conduct the largest genome-wide association study to date on cardiovascular disease in this population, improve predictions of cardiovascular incidence using genomic and clinical data, and identify subgroups that would benefit most from targeted pharmacological and lifestyle interventions. CORDELIA includes 196,632 individuals (ages 18–84, 54\% female, 96\% born in Spain, 20\% with higher education, recruited from 1989 to 2020, with follow-up periods ranging from 5 to 30 years), with DNA samples available for 117,342 participants (60\%). Of the participants, 24% were current smokers, 43% hypertensive, 11% diabetic, 15% medicated with lipid-lowering drugs, 44% overweight, and 27% obese. If not already available, genotyping is being performed using the Axiom™ Spain Biobank array (\textasciitilde 750,000 variants, including 115,000 specific and 50,000 rare functional variants from the Spanish population). The cohort also includes incident events (coronary heart disease, stroke, heart failure, peripheral artery disease, hypertension, diabetes); date and cause of death; and harmonized data on risk factors (body mass index, waist circumference, lipid profile, blood pressure, glucose, creatinine), lifestyle (smoking, physical activity, diet, alcohol), and socioeconomic status. 99,019 participants (50\%) also provide plasma samples. CORDELIA will significantly contribute to understanding the complex interplay of risk factors contributing to cardiovascular disease and advance the fields of precision medicine and public health in Southern European individuals.
  

• 
  1.

  Standl M, Budu‐Aggrey A, Johnston LJ, Elias MS, Arshad SH, Bager P, Bataille V, Blakeway H, Bønnelykke K, Boomsma D, Brumpton BM, Bustamante Pineda M, Campbell A, Curtin JA, Eliasen A, Fadista JPS, Feenstra B, Gerner T, Medina‐Gomez C, Grosche S, Gutzkow KB, Halling A, Hayward C, Henderson J, Herrera‐Luis E, Holloway JW, Hottenga J, O’B Hourihane J, Hu C, Hveem K, Irizar A, Jacquemin B, Jessen L, Kress S, Kurukulaaratchy RJ, Lau S, Llop S, Løset M, Marenholz I, Mason D, McCartney DL, Melbye M, Melén E, Minica C, Murray CS, Nijsten T, Pardo LM, Pasmans S, Pennell CE, Rinnov MR, Santorelli G, Schikowski T, Sheehan D, Simpson A, Söderhäll C, Thomas LF, Thyssen JP, Torrent M, van Beijsterveldt T, Visconti A, Vonk JM, Wang CA, Xu C, Ziyab AH, Custovic A, Di Meglio P, Duijts L, Flohr C, Irvine AD, Koppelman GH, Lee Y, Reynolds NJ, Smith C, Langan SM, Paternoster L, Brown SJ. Gene–Environment Interaction Affects Risk of Atopic Eczema: Population and In Vitro Studies. Allergy [Internet]. 2025 Aug.;80(8):2201-12. https://pmc.ncbi.nlm.nih.gov/articles/PMC12368900/

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Atopic eczema is a complex trait resulting from multiple genetic and environmental factors. This study investigated evidence for interaction between 24 established eczema genetic risk variants and 18 environmental factors. One variant‐environmental pair showed nominally significant interaction in discovery, replication and meta‐analyses: early‐life dog exposure modulates the increased risk of rs10214237 and preliminary work suggests a mechanistic effect via IL‐7R. CCL2, C‐C motif chemokine ligand 2; chr 5, chromosome 5; CSF2, colony stimulating factor 2 (granulocyte‐macrophage); CXCL8, C‐X‐C motif chemokine ligand 8 (IL‐8); ELISA, enzyme‐linked immunosorbent assay; FLG, filaggrin; GWAS, genome‐wide association study; IL, interleukin; n, number of participants; OR, odds ratio; RT‐qPCR, reverse transcription quantitative polymerase chain reaction; TNF, tumour necrosis factor; TSLP, thymic stromal lymphopoietin.

  @article{standl_geneenvironment_2025,
  abstract = {Atopic eczema is a complex trait resulting from multiple genetic and environmental factors. This study investigated evidence for interaction between 24 established eczema genetic risk variants and 18 environmental factors. One variant‐environmental pair showed nominally significant interaction in discovery, replication and meta‐analyses: early‐life dog exposure modulates the increased risk of rs10214237 and preliminary work suggests a mechanistic effect via IL‐7R. CCL2, C‐C motif chemokine ligand 2; chr 5, chromosome 5; CSF2, colony stimulating factor 2 (granulocyte‐macrophage); CXCL8, C‐X‐C motif chemokine ligand 8 (IL‐8); ELISA, enzyme‐linked immunosorbent assay; FLG, filaggrin; GWAS, genome‐wide association study; IL, interleukin; n, number of participants; OR, odds ratio; RT‐qPCR, reverse transcription quantitative polymerase chain reaction; TNF, tumour necrosis factor; TSLP, thymic stromal lymphopoietin.},
  author = {Standl, Marie and Budu‐Aggrey, Ashley and Johnston, Luke J. and Elias, Martina S. and Arshad, S. Hasan and Bager, Peter and Bataille, Veronique and Blakeway, Helena and Bønnelykke, Klaus and Boomsma, Dorret and Brumpton, Ben M. and Bustamante Pineda, Mariona and Campbell, Archie and Curtin, John A. and Eliasen, Anders and Fadista, João P. S. and Feenstra, Bjarke and Gerner, Trine and Medina‐Gomez, Carolina and Grosche, Sarah and Gutzkow, Kristine B. and Halling, Anne‐Sofie and Hayward, Caroline and Henderson, John and Herrera‐Luis, Esther and Holloway, John W. and Hottenga, Joukejan and O’B Hourihane, Jonathan and Hu, Chen and Hveem, Kristian and Irizar, Amaia and Jacquemin, Bénédicte and Jessen, Leon and Kress, Sara and Kurukulaaratchy, Ramesh J. and Lau, Susanne and Llop, Sabrina and Løset, Mari and Marenholz, Ingo and Mason, Dan and McCartney, Daniel L. and Melbye, Mads and Melén, Erik and Minica, Camelia and Murray, Clare S. and Nijsten, Tamar and Pardo, Luba M. and Pasmans, Suzanne and Pennell, Craig E. and Rinnov, Maria R. and Santorelli, Gillian and Schikowski, Tamara and Sheehan, Darina and Simpson, Angela and Söderhäll, Cilla and Thomas, Laurent F. and Thyssen, Jacob P. and Torrent, Maties and van Beijsterveldt, Toos and Visconti, Alessia and Vonk, Judith M. and Wang, Carol A. and Xu, Cheng‐Jian and Ziyab, Ali H. and Custovic, Adnan and Di Meglio, Paola and Duijts, Liesbeth and Flohr, Carsten and Irvine, Alan D. and Koppelman, Gerard H. and Lee, Young‐Ae and Reynolds, Nick J. and Smith, Catherine and Langan, Sinéad M. and Paternoster, Lavinia and Brown, Sara J.},
  journal = {Allergy},
  keywords = {grapp-caib},
  month = {aug},
  number = 8,
  pages = {2201--2212},
  title = {Gene–Environment Interaction Affects Risk of Atopic Eczema: Population and In Vitro Studies},
  volume = 80,
  year = 2025
  }
  

  %0 Journal Article
  %1 standl_geneenvironment_2025
  %A Standl, Marie
  %A Budu‐Aggrey, Ashley
  %A Johnston, Luke J.
  %A Elias, Martina S.
  %A Arshad, S. Hasan
  %A Bager, Peter
  %A Bataille, Veronique
  %A Blakeway, Helena
  %A Bønnelykke, Klaus
  %A Boomsma, Dorret
  %A Brumpton, Ben M.
  %A Bustamante Pineda, Mariona
  %A Campbell, Archie
  %A Curtin, John A.
  %A Eliasen, Anders
  %A Fadista, João P. S.
  %A Feenstra, Bjarke
  %A Gerner, Trine
  %A Medina‐Gomez, Carolina
  %A Grosche, Sarah
  %A Gutzkow, Kristine B.
  %A Halling, Anne‐Sofie
  %A Hayward, Caroline
  %A Henderson, John
  %A Herrera‐Luis, Esther
  %A Holloway, John W.
  %A Hottenga, Joukejan
  %A O’B Hourihane, Jonathan
  %A Hu, Chen
  %A Hveem, Kristian
  %A Irizar, Amaia
  %A Jacquemin, Bénédicte
  %A Jessen, Leon
  %A Kress, Sara
  %A Kurukulaaratchy, Ramesh J.
  %A Lau, Susanne
  %A Llop, Sabrina
  %A Løset, Mari
  %A Marenholz, Ingo
  %A Mason, Dan
  %A McCartney, Daniel L.
  %A Melbye, Mads
  %A Melén, Erik
  %A Minica, Camelia
  %A Murray, Clare S.
  %A Nijsten, Tamar
  %A Pardo, Luba M.
  %A Pasmans, Suzanne
  %A Pennell, Craig E.
  %A Rinnov, Maria R.
  %A Santorelli, Gillian
  %A Schikowski, Tamara
  %A Sheehan, Darina
  %A Simpson, Angela
  %A Söderhäll, Cilla
  %A Thomas, Laurent F.
  %A Thyssen, Jacob P.
  %A Torrent, Maties
  %A van Beijsterveldt, Toos
  %A Visconti, Alessia
  %A Vonk, Judith M.
  %A Wang, Carol A.
  %A Xu, Cheng‐Jian
  %A Ziyab, Ali H.
  %A Custovic, Adnan
  %A Di Meglio, Paola
  %A Duijts, Liesbeth
  %A Flohr, Carsten
  %A Irvine, Alan D.
  %A Koppelman, Gerard H.
  %A Lee, Young‐Ae
  %A Reynolds, Nick J.
  %A Smith, Catherine
  %A Langan, Sinéad M.
  %A Paternoster, Lavinia
  %A Brown, Sara J.
  %D 2025
  %J Allergy
  %N 8
  %P 2201--2212
  %R 10.1111/all.16605
  %T Gene–Environment Interaction Affects Risk of Atopic Eczema: Population and In Vitro Studies
  %U https://pmc.ncbi.nlm.nih.gov/articles/PMC12368900/
  %V 80
  %X Atopic eczema is a complex trait resulting from multiple genetic and environmental factors. This study investigated evidence for interaction between 24 established eczema genetic risk variants and 18 environmental factors. One variant‐environmental pair showed nominally significant interaction in discovery, replication and meta‐analyses: early‐life dog exposure modulates the increased risk of rs10214237 and preliminary work suggests a mechanistic effect via IL‐7R. CCL2, C‐C motif chemokine ligand 2; chr 5, chromosome 5; CSF2, colony stimulating factor 2 (granulocyte‐macrophage); CXCL8, C‐X‐C motif chemokine ligand 8 (IL‐8); ELISA, enzyme‐linked immunosorbent assay; FLG, filaggrin; GWAS, genome‐wide association study; IL, interleukin; n, number of participants; OR, odds ratio; RT‐qPCR, reverse transcription quantitative polymerase chain reaction; TNF, tumour necrosis factor; TSLP, thymic stromal lymphopoietin.
  

• 
  1.

  Ramírez-Gallegos I, Tárraga López PJ, Paublini Oliveira H, López-González Ángel A, Martorell Sánchez C, Martínez-Almoyna-Rifá E, Ramírez-Manent JI. Relationship Between Metabolic Age Determined by Bioimpedance and Insulin Resistance Risk Scales in Spanish Workers. Nutrients. 2025 Mar.;17(6):945.

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  Introduction: Metabolic age (MA) is the difference between an individual's actual age and the age of their body based on physiological and biological factors. It is an indicator that reflects a person's physical and biological state, regardless of chronological age. Insulin resistance (IR) is a health disorder in which tissues exhibit a reduced response to the circulating glucose uptake stimulated by insulin. Objective: The aim of this study is to evaluate the association between MA, determined through bioelectrical impedance analysis, and the risk of IR, assessed using validated scales, in a cohort of Spanish workers. Methodology: A descriptive cross-sectional study was conducted on 8590 Spanish workers to assess the association between MA and a set of sociodemographic variables, health habits, and IR risk scales such as the Triglyceride-Glucose Index (TyG Index), Metabolic Score for Insulin Resistance (METS-IR), and Single Point Insulin Sensitivity Estimator (SPISE). Results: All analyzed variables were associated with MA values, with the strongest associations observed for IR risk scale values (OR 4.88 [95\% CI 4.12-5.65] for METS-IR, 4.42 [95\% CI 3.70-5.15] for SPISE, and 3.42 [95\% CI 2.97-3.87] for the TyG Index) and physical activity. Conclusions: Metabolic age is influenced by sociodemographic variables such as age, sex, and social class; health habits such as smoking, physical activity, and adherence to the Mediterranean diet; and by IR risk scale values.

  @article{ramirez-gallegos_relationship_2025,
  abstract = {Introduction: Metabolic age (MA) is the difference between an individual's actual age and the age of their body based on physiological and biological factors. It is an indicator that reflects a person's physical and biological state, regardless of chronological age. Insulin resistance (IR) is a health disorder in which tissues exhibit a reduced response to the circulating glucose uptake stimulated by insulin. Objective: The aim of this study is to evaluate the association between MA, determined through bioelectrical impedance analysis, and the risk of IR, assessed using validated scales, in a cohort of Spanish workers. Methodology: A descriptive cross-sectional study was conducted on 8590 Spanish workers to assess the association between MA and a set of sociodemographic variables, health habits, and IR risk scales such as the Triglyceride-Glucose Index (TyG Index), Metabolic Score for Insulin Resistance (METS-IR), and Single Point Insulin Sensitivity Estimator (SPISE). Results: All analyzed variables were associated with MA values, with the strongest associations observed for IR risk scale values (OR 4.88 [95\% CI 4.12-5.65] for METS-IR, 4.42 [95\% CI 3.70-5.15] for SPISE, and 3.42 [95\% CI 2.97-3.87] for the TyG Index) and physical activity. Conclusions: Metabolic age is influenced by sociodemographic variables such as age, sex, and social class; health habits such as smoking, physical activity, and adherence to the Mediterranean diet; and by IR risk scale values.},
  author = {Ramírez-Gallegos, Ignacio and Tárraga López, Pedro Juan and Paublini Oliveira, Hernán and López-González, Ángel Arturo and Martorell Sánchez, Cristina and Martínez-Almoyna-Rifá, Emilio and Ramírez-Manent, José Ignacio},
  journal = {Nutrients},
  keywords = {grapp-caib},
  month = {mar},
  number = 6,
  pages = 945,
  title = {Relationship Between Metabolic Age Determined by Bioimpedance and Insulin Resistance Risk Scales in Spanish Workers},
  volume = 17,
  year = 2025
  }
  

  %0 Journal Article
  %1 ramirez-gallegos_relationship_2025
  %A Ramírez-Gallegos, Ignacio
  %A Tárraga López, Pedro Juan
  %A Paublini Oliveira, Hernán
  %A López-González, Ángel Arturo
  %A Martorell Sánchez, Cristina
  %A Martínez-Almoyna-Rifá, Emilio
  %A Ramírez-Manent, José Ignacio
  %D 2025
  %J Nutrients
  %N 6
  %P 945
  %R 10.3390/nu17060945
  %T Relationship Between Metabolic Age Determined by Bioimpedance and Insulin Resistance Risk Scales in Spanish Workers
  %V 17
  %X Introduction: Metabolic age (MA) is the difference between an individual's actual age and the age of their body based on physiological and biological factors. It is an indicator that reflects a person's physical and biological state, regardless of chronological age. Insulin resistance (IR) is a health disorder in which tissues exhibit a reduced response to the circulating glucose uptake stimulated by insulin. Objective: The aim of this study is to evaluate the association between MA, determined through bioelectrical impedance analysis, and the risk of IR, assessed using validated scales, in a cohort of Spanish workers. Methodology: A descriptive cross-sectional study was conducted on 8590 Spanish workers to assess the association between MA and a set of sociodemographic variables, health habits, and IR risk scales such as the Triglyceride-Glucose Index (TyG Index), Metabolic Score for Insulin Resistance (METS-IR), and Single Point Insulin Sensitivity Estimator (SPISE). Results: All analyzed variables were associated with MA values, with the strongest associations observed for IR risk scale values (OR 4.88 [95\% CI 4.12-5.65] for METS-IR, 4.42 [95\% CI 3.70-5.15] for SPISE, and 3.42 [95\% CI 2.97-3.87] for the TyG Index) and physical activity. Conclusions: Metabolic age is influenced by sociodemographic variables such as age, sex, and social class; health habits such as smoking, physical activity, and adherence to the Mediterranean diet; and by IR risk scale values.
  

• 
  1.

  Riutord-Sbert P, Tárraga López PJ, López-González Ángel A, Coll Campayo I, Busquets-Cortés C, Ramírez Manent JI. Obesity indices and their sociodemographic, lifestyle, and social isolation correlates in a large Spanish working population. Frontiers in Endocrinology [Internet]. 2025 Oct.;16:1695705. https://pmc.ncbi.nlm.nih.gov/articles/PMC12549272/

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Background Obesity is a multifactorial condition shaped by biological, behavioral, socioeconomic, and psychosocial determinants. While lifestyle correlates are well documented, the impact of social isolation on obesity in occupational settings remains insufficiently explored. This study examined associations between sociodemographic variables, health behaviors, and social isolation with multiple obesity indices in a large cohort of Spanish workers. Methods We analyzed 117298 employees across Spain (2021–2024). Obesity was defined using body mass index (BMI), waist-to-height ratio (WtHR), Clínica Universidad de Navarra–Body Adiposity Estimator (CUN-BAE), and Metabolic Score for Visceral Fat (METS-VF). Sociodemographic data, lifestyle habits, and social isolation (ENRICHD Social Support Instrument, ESSI) were obtained through standardized protocols. Multivariable logistic regression estimated adjusted odds ratios (OR) and 95% confidence intervals (CI). Results Obesity prevalence ranged from 20.4% (BMI) to 39.6% (METS-VF). Male sex (OR up to 2.11, 95\% CI 2.05–2.18), older age (OR 2.83, 95\% CI 2.71–2.96 for ≥55 years vs. \textless35), and lower social class (OR 1.62, 95\% CI 1.54–1.71) were consistently associated with obesity across all indices. Poor adherence to the Mediterranean diet and physical inactivity increased the likelihood of obesity (OR 1.35 and 1.41, respectively). Social isolation independently predicted higher obesity risk (OR 1.27, 95\% CI 1.21–1.33), even after adjusting for sociodemographic and lifestyle factors. Associations remained robust in sensitivity analyses. Conclusions Obesity in Spanish workers is strongly associated with sociodemographic disadvantage, unhealthy lifestyles, and psychosocial vulnerability. Social isolation emerged as a novel determinant, reinforcing the need for multidimensional public health strategies that integrate lifestyle promotion, reduction of socioeconomic inequalities, and enhancement of social connectedness.

  @article{riutord-sbert_obesity_2025,
  abstract = {Background Obesity is a multifactorial condition shaped by biological, behavioral, socioeconomic, and psychosocial determinants. While lifestyle correlates are well documented, the impact of social isolation on obesity in occupational settings remains insufficiently explored. This study examined associations between sociodemographic variables, health behaviors, and social isolation with multiple obesity indices in a large cohort of Spanish workers. Methods We analyzed 117298 employees across Spain (2021–2024). Obesity was defined using body mass index (BMI), waist-to-height ratio (WtHR), Clínica Universidad de Navarra–Body Adiposity Estimator (CUN-BAE), and Metabolic Score for Visceral Fat (METS-VF). Sociodemographic data, lifestyle habits, and social isolation (ENRICHD Social Support Instrument, ESSI) were obtained through standardized protocols. Multivariable logistic regression estimated adjusted odds ratios (OR) and 95% confidence intervals (CI). Results Obesity prevalence ranged from 20.4% (BMI) to 39.6% (METS-VF). Male sex (OR up to 2.11, 95\% CI 2.05–2.18), older age (OR 2.83, 95\% CI 2.71–2.96 for ≥55 years vs. \textless35), and lower social class (OR 1.62, 95\% CI 1.54–1.71) were consistently associated with obesity across all indices. Poor adherence to the Mediterranean diet and physical inactivity increased the likelihood of obesity (OR 1.35 and 1.41, respectively). Social isolation independently predicted higher obesity risk (OR 1.27, 95\% CI 1.21–1.33), even after adjusting for sociodemographic and lifestyle factors. Associations remained robust in sensitivity analyses. Conclusions Obesity in Spanish workers is strongly associated with sociodemographic disadvantage, unhealthy lifestyles, and psychosocial vulnerability. Social isolation emerged as a novel determinant, reinforcing the need for multidimensional public health strategies that integrate lifestyle promotion, reduction of socioeconomic inequalities, and enhancement of social connectedness.},
  author = {Riutord-Sbert, Pere and Tárraga López, Pedro Juan and López-González, Ángel Arturo and Coll Campayo, Irene and Busquets-Cortés, Carla and Ramírez Manent, José Ignacio},
  journal = {Frontiers in Endocrinology},
  keywords = {grapp-caib},
  month = {oct},
  pages = 1695705,
  title = {Obesity indices and their sociodemographic, lifestyle, and social isolation correlates in a large Spanish working population},
  volume = 16,
  year = 2025
  }
  

  %0 Journal Article
  %1 riutord-sbert_obesity_2025
  %A Riutord-Sbert, Pere
  %A Tárraga López, Pedro Juan
  %A López-González, Ángel Arturo
  %A Coll Campayo, Irene
  %A Busquets-Cortés, Carla
  %A Ramírez Manent, José Ignacio
  %D 2025
  %J Frontiers in Endocrinology
  %P 1695705
  %R 10.3389/fendo.2025.1695705
  %T Obesity indices and their sociodemographic, lifestyle, and social isolation correlates in a large Spanish working population
  %U https://pmc.ncbi.nlm.nih.gov/articles/PMC12549272/
  %V 16
  %X Background Obesity is a multifactorial condition shaped by biological, behavioral, socioeconomic, and psychosocial determinants. While lifestyle correlates are well documented, the impact of social isolation on obesity in occupational settings remains insufficiently explored. This study examined associations between sociodemographic variables, health behaviors, and social isolation with multiple obesity indices in a large cohort of Spanish workers. Methods We analyzed 117298 employees across Spain (2021–2024). Obesity was defined using body mass index (BMI), waist-to-height ratio (WtHR), Clínica Universidad de Navarra–Body Adiposity Estimator (CUN-BAE), and Metabolic Score for Visceral Fat (METS-VF). Sociodemographic data, lifestyle habits, and social isolation (ENRICHD Social Support Instrument, ESSI) were obtained through standardized protocols. Multivariable logistic regression estimated adjusted odds ratios (OR) and 95% confidence intervals (CI). Results Obesity prevalence ranged from 20.4% (BMI) to 39.6% (METS-VF). Male sex (OR up to 2.11, 95\% CI 2.05–2.18), older age (OR 2.83, 95\% CI 2.71–2.96 for ≥55 years vs. \textless35), and lower social class (OR 1.62, 95\% CI 1.54–1.71) were consistently associated with obesity across all indices. Poor adherence to the Mediterranean diet and physical inactivity increased the likelihood of obesity (OR 1.35 and 1.41, respectively). Social isolation independently predicted higher obesity risk (OR 1.27, 95\% CI 1.21–1.33), even after adjusting for sociodemographic and lifestyle factors. Associations remained robust in sensitivity analyses. Conclusions Obesity in Spanish workers is strongly associated with sociodemographic disadvantage, unhealthy lifestyles, and psychosocial vulnerability. Social isolation emerged as a novel determinant, reinforcing the need for multidimensional public health strategies that integrate lifestyle promotion, reduction of socioeconomic inequalities, and enhancement of social connectedness.
  

• 
  1.

  Zamanillo-Campos R, Colom-Rossello M, Rodríguez-Calero MA, Martín MI, Planas T, Núñez-Jiménez C, Ramos M. Key components of effective non-pharmacological interventions for childhood obesity: a review considering social determinants of health. European journal of pediatrics [Internet]. Germany; 2025 Jun.;184(7):449-. https://pubmed.ncbi.nlm.nih.gov/40563002

  AbstractURLBibTeXEndNoteDOIBibSonomy

  Childhood obesity, driven by an obesogenic environment, remains a public health priority. To review the effectiveness of non-pharmacological interventions for treating childhood obesity, with a focus on weight reduction and consideration of social determinants of health (SDOH). The review included randomized and quasi-experimental studies, published between August 2016 and December 2021, that evaluated the effectiveness of interventions aimed at reducing body weight in children aged 2 to 14 years with obesity. (PROSPERO ID: CRD42022301191). A total of 59 interventions were identified, showing wide variability in design, duration, components and settings. Most included physical activity (93%) and nutrition (81%), while fewer incorporated psychological support (46%) or digital tools (25%). Despite the diversity of approaches, 56% of the interventions were effective, particularly those implemented in healthcare or school settings, involving physical activity, and delivered by multidisciplinary teams. However, only six demonstrated sustained effects beyond 6 months. Risk of bias was high in over half of the studies, and only a small proportion (22%) reported participants' social characteristics such as family structure, race, or socioeconomic status. Importantly, very few interventions were designed or evaluated with explicit consideration of SDOH. CONCLUSION: Overall, effective interventions tended to target both children and parents, include multiple components-especially physical activity-and be delivered in accessible settings such as schools or primary care. Yet, the generalizability of findings is limited, as most studies involved children from relatively advantaged backgrounds. Future interventions should integrate SDOH in both design and evaluation to ensure equity and long-term effectiveness in diverse populations. WHAT IS KNOWN: • Childhood obesity remains a critical public health issue, heavily influenced by obesogenic environments and social determinants of health (SDOH). • Non-pharmacological interventions, particularly those incorporating physical activity and nutritional guidance, have been commonly used to address childhood obesity, though with varying degrees of success. WHAT IS NEW: • This review highlights that interventions delivered in healthcare or school settings by multidisciplinary teams, and involving both physical activity and parental engagement, show higher effectiveness in reducing childhood obesity. • The study identifies a significant gap in the integration of social determinants of health in both the design and evaluation of interventions, limiting their long-term impact and equity across diverse populations.

  @article{zamanillocampos2025components,
  abstract = {Childhood obesity, driven by an obesogenic environment, remains a public health priority. To review the effectiveness of non-pharmacological interventions for treating childhood obesity, with a focus on weight reduction and consideration of social determinants of health (SDOH). The review included randomized and quasi-experimental studies, published between August 2016 and December 2021, that evaluated the effectiveness of interventions aimed at reducing body weight in children aged 2 to 14 years with obesity. (PROSPERO ID: CRD42022301191). A total of 59 interventions were identified, showing wide variability in design, duration, components and settings. Most included physical activity (93%) and nutrition (81%), while fewer incorporated psychological support (46%) or digital tools (25%). Despite the diversity of approaches, 56% of the interventions were effective, particularly those implemented in healthcare or school settings, involving physical activity, and delivered by multidisciplinary teams. However, only six demonstrated sustained effects beyond 6 months. Risk of bias was high in over half of the studies, and only a small proportion (22%) reported participants' social characteristics such as family structure, race, or socioeconomic status. Importantly, very few interventions were designed or evaluated with explicit consideration of SDOH. CONCLUSION: Overall, effective interventions tended to target both children and parents, include multiple components-especially physical activity-and be delivered in accessible settings such as schools or primary care. Yet, the generalizability of findings is limited, as most studies involved children from relatively advantaged backgrounds. Future interventions should integrate SDOH in both design and evaluation to ensure equity and long-term effectiveness in diverse populations. WHAT IS KNOWN: • Childhood obesity remains a critical public health issue, heavily influenced by obesogenic environments and social determinants of health (SDOH). • Non-pharmacological interventions, particularly those incorporating physical activity and nutritional guidance, have been commonly used to address childhood obesity, though with varying degrees of success. WHAT IS NEW: • This review highlights that interventions delivered in healthcare or school settings by multidisciplinary teams, and involving both physical activity and parental engagement, show higher effectiveness in reducing childhood obesity. • The study identifies a significant gap in the integration of social determinants of health in both the design and evaluation of interventions, limiting their long-term impact and equity across diverse populations.},
  address = {Germany},
  author = {Zamanillo-Campos, R and Colom-Rossello, M and Rodríguez-Calero, M A and Martín, M I and Planas, T and Núñez-Jiménez, C and Ramos, M},
  journal = {European journal of pediatrics},
  keywords = {evisap},
  month = {jun},
  number = 7,
  pages = {449--449},
  title = {Key components of effective non-pharmacological interventions for childhood obesity: a review considering social determinants of health},
  volume = 184,
  year = 2025
  }
  

  %0 Journal Article
  %1 zamanillocampos2025components
  %A Zamanillo-Campos, R
  %A Colom-Rossello, M
  %A Rodríguez-Calero, M A
  %A Martín, M I
  %A Planas, T
  %A Núñez-Jiménez, C
  %A Ramos, M
  %C Germany
  %D 2025
  %J European journal of pediatrics
  %N 7
  %P 449--449
  %R 10.1007/s00431-025-06279-2
  %T Key components of effective non-pharmacological interventions for childhood obesity: a review considering social determinants of health
  %U https://pubmed.ncbi.nlm.nih.gov/40563002
  %V 184
  %X Childhood obesity, driven by an obesogenic environment, remains a public health priority. To review the effectiveness of non-pharmacological interventions for treating childhood obesity, with a focus on weight reduction and consideration of social determinants of health (SDOH). The review included randomized and quasi-experimental studies, published between August 2016 and December 2021, that evaluated the effectiveness of interventions aimed at reducing body weight in children aged 2 to 14 years with obesity. (PROSPERO ID: CRD42022301191). A total of 59 interventions were identified, showing wide variability in design, duration, components and settings. Most included physical activity (93%) and nutrition (81%), while fewer incorporated psychological support (46%) or digital tools (25%). Despite the diversity of approaches, 56% of the interventions were effective, particularly those implemented in healthcare or school settings, involving physical activity, and delivered by multidisciplinary teams. However, only six demonstrated sustained effects beyond 6 months. Risk of bias was high in over half of the studies, and only a small proportion (22%) reported participants' social characteristics such as family structure, race, or socioeconomic status. Importantly, very few interventions were designed or evaluated with explicit consideration of SDOH. CONCLUSION: Overall, effective interventions tended to target both children and parents, include multiple components-especially physical activity-and be delivered in accessible settings such as schools or primary care. Yet, the generalizability of findings is limited, as most studies involved children from relatively advantaged backgrounds. Future interventions should integrate SDOH in both design and evaluation to ensure equity and long-term effectiveness in diverse populations. WHAT IS KNOWN: • Childhood obesity remains a critical public health issue, heavily influenced by obesogenic environments and social determinants of health (SDOH). • Non-pharmacological interventions, particularly those incorporating physical activity and nutritional guidance, have been commonly used to address childhood obesity, though with varying degrees of success. WHAT IS NEW: • This review highlights that interventions delivered in healthcare or school settings by multidisciplinary teams, and involving both physical activity and parental engagement, show higher effectiveness in reducing childhood obesity. • The study identifies a significant gap in the integration of social determinants of health in both the design and evaluation of interventions, limiting their long-term impact and equity across diverse populations.
  

• 
  1.

  Marques-Cruz M, Perestrelo P, Chu AWL, Gil-Mata S, Riera-Serra P, Sousa-Pinto B. Comparison between two tools assessing the methodological quality of systematic reviews: ReMarQ and AMSTAR 2. Clinical and Public Health Guidelines [Internet]. 2025;2(2):e70021. https://onlinelibrary.wiley.com/doi/abs/10.1002/gin2.70021

  URLBibTeXEndNoteDOIBibSonomyDownload

  @article{RN64,
  author = {Marques-Cruz, Manuel and Perestrelo, Paula and Chu, Alexandro W. L. and Gil-Mata, Sara and Riera-Serra, Pau and Sousa-Pinto, Bernardo},
  journal = {Clinical and Public Health Guidelines},
  keywords = {evisap},
  number = 2,
  pages = {e70021},
  title = {Comparison between two tools assessing the methodological quality of systematic reviews: ReMarQ and AMSTAR 2},
  type = {Journal Article},
  volume = 2,
  year = 2025
  }
  

  %0 Journal Article
  %1 RN64
  %A Marques-Cruz, Manuel
  %A Perestrelo, Paula
  %A Chu, Alexandro W. L.
  %A Gil-Mata, Sara
  %A Riera-Serra, Pau
  %A Sousa-Pinto, Bernardo
  %D 2025
  %J Clinical and Public Health Guidelines
  %N 2
  %P e70021
  %R https://doi.org/10.1002/gin2.70021
  %T Comparison between two tools assessing the methodological quality of systematic reviews: ReMarQ and AMSTAR 2
  %U https://onlinelibrary.wiley.com/doi/abs/10.1002/gin2.70021
  %V 2
  

• 
  1.

  Navarra-Ventura G, Riera-Serra P, Castro A, Montaño JJ, Roca M, Gili M. Longitudinal associations between melancholic depression and executive function in adult patients with major depressive disorder: a 12-month follow-up study. Psychiatry research [Internet]. Ireland; 2025 Jul.;351:116636-. https://pubmed.ncbi.nlm.nih.gov/40651192

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Major depressive disorder (MDD) is often associated with deficits in executive function, but the long-term cognitive impact of specific depressive subtypes, in particular melancholic depression (MelD), is underexplored. This is the first prospective study aimed at exploring longitudinal associations between MelD and executive function in adult patients with MDD. This is a secondary analysis using data from a larger project with assessments at baseline, 6 and 12 months. MelD was identified using an algorithm derived from a subset of eight items from the Inventory of Depressive Symptomatology-Self Rated, which provides a standardized framework for the identification of this specific depressive subtype. Executive function was assessed using the Cambridge Neuropsychological Test Automated Battery. Longitudinal associations between MelD and executive function, including a global domain, four subdomains (working memory, planning, response inhibition and decision-making), and eight individual variables used to calculate the composite scores of the five (sub)domains, were analyzed using linear mixed-effects models adjusted for demographic and clinical variables and psychomotor speed. One hundred and five patients (20.95 % MelD) were analyzed at baseline, 73 (17.81 % MelD) at 6 months, and 61 (19.67 % MelD) at 12 months. MelD, older age and female sex were significantly associated with worse performance in the global executive function domain, in the working memory subdomain, and in four individual variables within the working memory, planning and decision-making subdomains, independent of other demographic and clinical variables and psychomotor speed. The findings highlight MelD as a distinct risk factor for worse long-term executive function in adult patients with MDD.

  @article{navarraventura2025longitudinal,
  abstract = {Major depressive disorder (MDD) is often associated with deficits in executive function, but the long-term cognitive impact of specific depressive subtypes, in particular melancholic depression (MelD), is underexplored. This is the first prospective study aimed at exploring longitudinal associations between MelD and executive function in adult patients with MDD. This is a secondary analysis using data from a larger project with assessments at baseline, 6 and 12 months. MelD was identified using an algorithm derived from a subset of eight items from the Inventory of Depressive Symptomatology-Self Rated, which provides a standardized framework for the identification of this specific depressive subtype. Executive function was assessed using the Cambridge Neuropsychological Test Automated Battery. Longitudinal associations between MelD and executive function, including a global domain, four subdomains (working memory, planning, response inhibition and decision-making), and eight individual variables used to calculate the composite scores of the five (sub)domains, were analyzed using linear mixed-effects models adjusted for demographic and clinical variables and psychomotor speed. One hundred and five patients (20.95 % MelD) were analyzed at baseline, 73 (17.81 % MelD) at 6 months, and 61 (19.67 % MelD) at 12 months. MelD, older age and female sex were significantly associated with worse performance in the global executive function domain, in the working memory subdomain, and in four individual variables within the working memory, planning and decision-making subdomains, independent of other demographic and clinical variables and psychomotor speed. The findings highlight MelD as a distinct risk factor for worse long-term executive function in adult patients with MDD.},
  address = {Ireland},
  author = {Navarra-Ventura, Guillem and Riera-Serra, Pau and Castro, Adoración and Montaño, Juan José and Roca, Miquel and Gili, Margalida},
  journal = {Psychiatry research},
  keywords = {evisap},
  month = {jul},
  pages = {116636--116636},
  title = {Longitudinal associations between melancholic depression and executive function in adult patients with major depressive disorder: a 12-month follow-up study},
  volume = 351,
  year = 2025
  }
  

  %0 Journal Article
  %1 navarraventura2025longitudinal
  %A Navarra-Ventura, Guillem
  %A Riera-Serra, Pau
  %A Castro, Adoración
  %A Montaño, Juan José
  %A Roca, Miquel
  %A Gili, Margalida
  %C Ireland
  %D 2025
  %J Psychiatry research
  %P 116636--116636
  %R 10.1016/j.psychres.2025.116636
  %T Longitudinal associations between melancholic depression and executive function in adult patients with major depressive disorder: a 12-month follow-up study
  %U https://pubmed.ncbi.nlm.nih.gov/40651192
  %V 351
  %X Major depressive disorder (MDD) is often associated with deficits in executive function, but the long-term cognitive impact of specific depressive subtypes, in particular melancholic depression (MelD), is underexplored. This is the first prospective study aimed at exploring longitudinal associations between MelD and executive function in adult patients with MDD. This is a secondary analysis using data from a larger project with assessments at baseline, 6 and 12 months. MelD was identified using an algorithm derived from a subset of eight items from the Inventory of Depressive Symptomatology-Self Rated, which provides a standardized framework for the identification of this specific depressive subtype. Executive function was assessed using the Cambridge Neuropsychological Test Automated Battery. Longitudinal associations between MelD and executive function, including a global domain, four subdomains (working memory, planning, response inhibition and decision-making), and eight individual variables used to calculate the composite scores of the five (sub)domains, were analyzed using linear mixed-effects models adjusted for demographic and clinical variables and psychomotor speed. One hundred and five patients (20.95 % MelD) were analyzed at baseline, 73 (17.81 % MelD) at 6 months, and 61 (19.67 % MelD) at 12 months. MelD, older age and female sex were significantly associated with worse performance in the global executive function domain, in the working memory subdomain, and in four individual variables within the working memory, planning and decision-making subdomains, independent of other demographic and clinical variables and psychomotor speed. The findings highlight MelD as a distinct risk factor for worse long-term executive function in adult patients with MDD.
  

• 
  1.

  Arias-Alonso L, Barragán-Brun N, Elizondo-Alzola U, Boldu-Minguell A, Rocha-Calderón CA, Niño-de Guzmán E, Santandreu FM, Quesada-Carrasco F, Ricci-Cabello I, Gorrotxategi-Gorrotxategi PJ, de la Poza-Abad M, Mas-Dalmau G, Gibert-Agulló A, González-Lama J, Alonso-Coello P. Development and assessment of an online communication skills course to optimise antibiotic prescribing for children in primary care. BMC primary care [Internet]. England; 2025 Aug.;26(1):247-. https://pubmed.ncbi.nlm.nih.gov/40775754

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  BACKGROUND: Antibiotic overprescription is a complex global problem that contributes to antibacterial resistance. Enhancing professionals' communication skills is one of the most promising interventions for optimising antibiotic prescription in respiratory tract infections in children. METHODS: We developed a communication skills course for primary care paediatricians, paediatric nurses and community pharmacists. We conducted: 1) A scoping review, 2) brainstorming and selection of themes, 3) design of content, 4) user testing, through a survey and semi-structured interviews. A multidisciplinary advisory group gave feedback throughout the design and development process. We conducted a descriptive analysis of the survey results, and we used a predefined analytical framework for qualitative content. RESULTS: The course comprised four modules with nineteen themes, which included communication theoretical content, clinical cases, complementary reading, videos, and a glossary. It also included a forum and webinars, after each module. Sixteen users completed several themes and a survey, and eight were interviewed. They rated a mean of 4 or higher (5-point scale), across most of the domains evaluated. The videos received the highest rating (4.81; SD = 0.39). Suggestions for improvement included incorporating a workshop, and featuring more representation of other professionals. The majority of professionals (93%) expressed interest in completing the course. CONCLUSION: We developed a comprehensive, evidence-based online communication skills training course to optimise antibiotic prescribing in paediatric primary care. Integrating key communication strategies and insights from a scoping review, the course equips healthcare professionals with practical tools to enhance shared decision-making and antimicrobial stewardship. TRIAL REGISTRATION: Not applicable.

  @article{ariasalonso2025development,
  abstract = {BACKGROUND: Antibiotic overprescription is a complex global problem that contributes to antibacterial resistance. Enhancing professionals' communication skills is one of the most promising interventions for optimising antibiotic prescription in respiratory tract infections in children. METHODS: We developed a communication skills course for primary care paediatricians, paediatric nurses and community pharmacists. We conducted: 1) A scoping review, 2) brainstorming and selection of themes, 3) design of content, 4) user testing, through a survey and semi-structured interviews. A multidisciplinary advisory group gave feedback throughout the design and development process. We conducted a descriptive analysis of the survey results, and we used a predefined analytical framework for qualitative content. RESULTS: The course comprised four modules with nineteen themes, which included communication theoretical content, clinical cases, complementary reading, videos, and a glossary. It also included a forum and webinars, after each module. Sixteen users completed several themes and a survey, and eight were interviewed. They rated a mean of 4 or higher (5-point scale), across most of the domains evaluated. The videos received the highest rating (4.81; SD = 0.39). Suggestions for improvement included incorporating a workshop, and featuring more representation of other professionals. The majority of professionals (93%) expressed interest in completing the course. CONCLUSION: We developed a comprehensive, evidence-based online communication skills training course to optimise antibiotic prescribing in paediatric primary care. Integrating key communication strategies and insights from a scoping review, the course equips healthcare professionals with practical tools to enhance shared decision-making and antimicrobial stewardship. TRIAL REGISTRATION: Not applicable.},
  address = {England},
  author = {Arias-Alonso, Lucía and Barragán-Brun, Nieves and Elizondo-Alzola, Usue and Boldu-Minguell, Andrea and Rocha-Calderón, Claudio Alfonso and Niño-de Guzmán, Ena and Santandreu, Francisca María and Quesada-Carrasco, Fermín and Ricci-Cabello, Ignacio and Gorrotxategi-Gorrotxategi, Pedro Jesús and de la Poza-Abad, Mariam and Mas-Dalmau, Gemma and Gibert-Agulló, Anna and González-Lama, Jesús and Alonso-Coello, Pablo},
  journal = {BMC primary care},
  keywords = {evisap},
  month = {aug},
  number = 1,
  pages = {247--247},
  title = {Development and assessment of an online communication skills course to optimise antibiotic prescribing for children in primary care},
  volume = 26,
  year = 2025
  }
  

  %0 Journal Article
  %1 ariasalonso2025development
  %A Arias-Alonso, Lucía
  %A Barragán-Brun, Nieves
  %A Elizondo-Alzola, Usue
  %A Boldu-Minguell, Andrea
  %A Rocha-Calderón, Claudio Alfonso
  %A Niño-de Guzmán, Ena
  %A Santandreu, Francisca María
  %A Quesada-Carrasco, Fermín
  %A Ricci-Cabello, Ignacio
  %A Gorrotxategi-Gorrotxategi, Pedro Jesús
  %A de la Poza-Abad, Mariam
  %A Mas-Dalmau, Gemma
  %A Gibert-Agulló, Anna
  %A González-Lama, Jesús
  %A Alonso-Coello, Pablo
  %C England
  %D 2025
  %J BMC primary care
  %N 1
  %P 247--247
  %R 10.1186/s12875-025-02919-6
  %T Development and assessment of an online communication skills course to optimise antibiotic prescribing for children in primary care
  %U https://pubmed.ncbi.nlm.nih.gov/40775754
  %V 26
  %X BACKGROUND: Antibiotic overprescription is a complex global problem that contributes to antibacterial resistance. Enhancing professionals' communication skills is one of the most promising interventions for optimising antibiotic prescription in respiratory tract infections in children. METHODS: We developed a communication skills course for primary care paediatricians, paediatric nurses and community pharmacists. We conducted: 1) A scoping review, 2) brainstorming and selection of themes, 3) design of content, 4) user testing, through a survey and semi-structured interviews. A multidisciplinary advisory group gave feedback throughout the design and development process. We conducted a descriptive analysis of the survey results, and we used a predefined analytical framework for qualitative content. RESULTS: The course comprised four modules with nineteen themes, which included communication theoretical content, clinical cases, complementary reading, videos, and a glossary. It also included a forum and webinars, after each module. Sixteen users completed several themes and a survey, and eight were interviewed. They rated a mean of 4 or higher (5-point scale), across most of the domains evaluated. The videos received the highest rating (4.81; SD = 0.39). Suggestions for improvement included incorporating a workshop, and featuring more representation of other professionals. The majority of professionals (93%) expressed interest in completing the course. CONCLUSION: We developed a comprehensive, evidence-based online communication skills training course to optimise antibiotic prescribing in paediatric primary care. Integrating key communication strategies and insights from a scoping review, the course equips healthcare professionals with practical tools to enhance shared decision-making and antimicrobial stewardship. TRIAL REGISTRATION: Not applicable.
  

• 
  1.

  Chaplin A, Prohens L, Wordsworth J, Obrador-Hevia A, Guillot M, Ricci-Cabello I, Romaguera D, Sesé A. Identifying the key components of a diet and lifestyle screener for people living with and beyond cancer: an e-Delphi study. BMJ open [Internet]. England; 2025 Aug.;15(8):e097084-e097084. https://pubmed.ncbi.nlm.nih.gov/40784779

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  OBJECTIVES: There are currently no validated screeners that evaluate diet and lifestyle of people living with and beyond cancer (PLWBC). The purpose of this study was to reach a consensus among an international expert panel on the essential items to include in this type of instrument. DESIGN: A scientific committee developed the initial list of items, which were presented to an expert panel in a two-round-modified electronic Delphi. Panellists were asked to rate the adequacy, relevance and feasibility of self-reporting each item. Qualitative assessments were encouraged. SETTING: Four countries (Spain, UK, USA and Portugal). PARTICIPANTS: Experts working in a cancer-related health profession or cancer-related research were recruited. MAIN OUTCOME MEASURES: Items were initially categorised into seven domains (body composition, physical activity, diet, alcohol, smoking, sleep and psychosocial distress). A content validity index per item (CVI-i) and a scale-level CVI (S-CVI) were calculated (acceptable≥0.78). All items with a CVI-i≥0.78 were submitted to a final consensus meeting. RESULTS: A total of 108 items were proposed to the panel. In Round 1, 77 items were accepted, 10 items were excluded and 6 new items were proposed. During Round 2, 4 items were accepted and 19 were excluded. Diet and alcohol were merged into one domain. The final consensus meeting decided on 61 items categorised into six domains (S-CVI:0.94): body composition, physical activity, diet and alcohol, smoking, sleep and psychosocial distress. CONCLUSIONS: We identified the main items to be considered when developing a screener to evaluate diet and lifestyle in PLWBC in a clinical setting, and the results obtained will guide the content of the screener in the following validation study.

  @article{chaplin2025identifying,
  abstract = {OBJECTIVES: There are currently no validated screeners that evaluate diet and lifestyle of people living with and beyond cancer (PLWBC). The purpose of this study was to reach a consensus among an international expert panel on the essential items to include in this type of instrument. DESIGN: A scientific committee developed the initial list of items, which were presented to an expert panel in a two-round-modified electronic Delphi. Panellists were asked to rate the adequacy, relevance and feasibility of self-reporting each item. Qualitative assessments were encouraged. SETTING: Four countries (Spain, UK, USA and Portugal). PARTICIPANTS: Experts working in a cancer-related health profession or cancer-related research were recruited. MAIN OUTCOME MEASURES: Items were initially categorised into seven domains (body composition, physical activity, diet, alcohol, smoking, sleep and psychosocial distress). A content validity index per item (CVI-i) and a scale-level CVI (S-CVI) were calculated (acceptable≥0.78). All items with a CVI-i≥0.78 were submitted to a final consensus meeting. RESULTS: A total of 108 items were proposed to the panel. In Round 1, 77 items were accepted, 10 items were excluded and 6 new items were proposed. During Round 2, 4 items were accepted and 19 were excluded. Diet and alcohol were merged into one domain. The final consensus meeting decided on 61 items categorised into six domains (S-CVI:0.94): body composition, physical activity, diet and alcohol, smoking, sleep and psychosocial distress. CONCLUSIONS: We identified the main items to be considered when developing a screener to evaluate diet and lifestyle in PLWBC in a clinical setting, and the results obtained will guide the content of the screener in the following validation study.},
  address = {England},
  author = {Chaplin, Alice and Prohens, Lara and Wordsworth, Janna and Obrador-Hevia, Antònia and Guillot, Monica and Ricci-Cabello, Ignacio and Romaguera, Dora and Sesé, Albert},
  journal = {BMJ open},
  keywords = {evisap},
  month = {aug},
  number = 8,
  pages = {e097084--e097084},
  title = {Identifying the key components of a diet and lifestyle screener for people living with and beyond cancer: an e-Delphi study},
  volume = 15,
  year = 2025
  }
  

  %0 Journal Article
  %1 chaplin2025identifying
  %A Chaplin, Alice
  %A Prohens, Lara
  %A Wordsworth, Janna
  %A Obrador-Hevia, Antònia
  %A Guillot, Monica
  %A Ricci-Cabello, Ignacio
  %A Romaguera, Dora
  %A Sesé, Albert
  %C England
  %D 2025
  %J BMJ open
  %N 8
  %P e097084--e097084
  %R 10.1136/bmjopen-2024-097084
  %T Identifying the key components of a diet and lifestyle screener for people living with and beyond cancer: an e-Delphi study
  %U https://pubmed.ncbi.nlm.nih.gov/40784779
  %V 15
  %X OBJECTIVES: There are currently no validated screeners that evaluate diet and lifestyle of people living with and beyond cancer (PLWBC). The purpose of this study was to reach a consensus among an international expert panel on the essential items to include in this type of instrument. DESIGN: A scientific committee developed the initial list of items, which were presented to an expert panel in a two-round-modified electronic Delphi. Panellists were asked to rate the adequacy, relevance and feasibility of self-reporting each item. Qualitative assessments were encouraged. SETTING: Four countries (Spain, UK, USA and Portugal). PARTICIPANTS: Experts working in a cancer-related health profession or cancer-related research were recruited. MAIN OUTCOME MEASURES: Items were initially categorised into seven domains (body composition, physical activity, diet, alcohol, smoking, sleep and psychosocial distress). A content validity index per item (CVI-i) and a scale-level CVI (S-CVI) were calculated (acceptable≥0.78). All items with a CVI-i≥0.78 were submitted to a final consensus meeting. RESULTS: A total of 108 items were proposed to the panel. In Round 1, 77 items were accepted, 10 items were excluded and 6 new items were proposed. During Round 2, 4 items were accepted and 19 were excluded. Diet and alcohol were merged into one domain. The final consensus meeting decided on 61 items categorised into six domains (S-CVI:0.94): body composition, physical activity, diet and alcohol, smoking, sleep and psychosocial distress. CONCLUSIONS: We identified the main items to be considered when developing a screener to evaluate diet and lifestyle in PLWBC in a clinical setting, and the results obtained will guide the content of the screener in the following validation study.
  

• 
  1.

  Marques-Cruz M, Pinto F, Vieira RJ, Bognanni A, Perestrelo P, Gil-Mata S, Duarte VH, Barbosa JP, Cardoso-Fernandes A, Martinho-Dias D, Franco-Pego F, Germini F, Arienti C, Chu AWL, Riera-Serra P, Jemioło P, Rodrigues PP, Fonseca JA, Azevedo LF, Schünemann HJ, Cruz-Correia R, Jankin S, Sousa-Pinto B. Use of artificial intelligence to support the assessment of the methodological quality of systematic reviews. Journal of clinical epidemiology [Internet]. United States; 2025 Nov.;187:111944-. https://pubmed.ncbi.nlm.nih.gov/40865587

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  OBJECTIVES: Published systematic reviews display a heterogeneous methodological quality, which can impact decision-making. Large language models (LLMs) can support and make the assessment of the methodological quality of systematic reviews more efficient, aiding in the incorporation of their evidence in guideline recommendations. We aimed to develop an LLM-based tool for supporting the assessment of the methodological quality of systematic reviews. METHODS: We assessed the performance of 8 LLMs in evaluating the methodological quality of systematic reviews. In particular, we provided 100 systematic reviews for eight LLMs (five base models and three fine-tuned models) to evaluate their methodological quality based on a 27-item validated tool (Reported Methodological Quality (ReMarQ)). The fine-tuned models had been trained with a different sample of 300 manually assessed systematic reviews. We compared the answers provided by LLMs with those independently provided by human reviewers, computing the accuracy, kappa coefficient and F1-score for this comparison. RESULTS: The best performing LLM was a fine-tuned GPT-3.5 model (mean accuracy = 96.5% [95% CI = 89.9%-100%]; mean kappa coefficient = 0.90 [95% CI = 0.71-1.00]; mean F1-score = 0.91 [95% CI = 0.83-1.00]). This model displayed an accuracy >80% and a kappa coefficient >0.60 for all individual items. When we made this LLM assess 60 times the same set of systematic reviews, answers to 18 of 27 items were always consistent (ie, were always the same) and only 11% of assessed systematic reviews showed inconsistency. CONCLUSION: Overall, LLMs have the potential to accurately support the assessment of the methodological quality of systematic reviews based on a validated tool comprising dichotomous items.

  @article{marquescruz2025artificial,
  abstract = {OBJECTIVES: Published systematic reviews display a heterogeneous methodological quality, which can impact decision-making. Large language models (LLMs) can support and make the assessment of the methodological quality of systematic reviews more efficient, aiding in the incorporation of their evidence in guideline recommendations. We aimed to develop an LLM-based tool for supporting the assessment of the methodological quality of systematic reviews. METHODS: We assessed the performance of 8 LLMs in evaluating the methodological quality of systematic reviews. In particular, we provided 100 systematic reviews for eight LLMs (five base models and three fine-tuned models) to evaluate their methodological quality based on a 27-item validated tool (Reported Methodological Quality (ReMarQ)). The fine-tuned models had been trained with a different sample of 300 manually assessed systematic reviews. We compared the answers provided by LLMs with those independently provided by human reviewers, computing the accuracy, kappa coefficient and F1-score for this comparison. RESULTS: The best performing LLM was a fine-tuned GPT-3.5 model (mean accuracy = 96.5% [95% CI = 89.9%-100%]; mean kappa coefficient = 0.90 [95% CI = 0.71-1.00]; mean F1-score = 0.91 [95% CI = 0.83-1.00]). This model displayed an accuracy >80% and a kappa coefficient >0.60 for all individual items. When we made this LLM assess 60 times the same set of systematic reviews, answers to 18 of 27 items were always consistent (ie, were always the same) and only 11% of assessed systematic reviews showed inconsistency. CONCLUSION: Overall, LLMs have the potential to accurately support the assessment of the methodological quality of systematic reviews based on a validated tool comprising dichotomous items.},
  address = {United States},
  author = {Marques-Cruz, Manuel and Pinto, Filipe and Vieira, Rafael José and Bognanni, Antonio and Perestrelo, Paula and Gil-Mata, Sara and Duarte, Vítor Henrique and Barbosa, José Pedro and Cardoso-Fernandes, António and Martinho-Dias, Daniel and Franco-Pego, Francisco and Germini, Federico and Arienti, Chiara and Chu, Alexandro W L and Riera-Serra, Pau and Jemioło, Paweł and Rodrigues, Pedro Pereira and Fonseca, João A and Azevedo, Luís Filipe and Schünemann, Holger J and Cruz-Correia, Ricardo and Jankin, Slava and Sousa-Pinto, Bernardo},
  journal = {Journal of clinical epidemiology},
  keywords = {evisap},
  month = {nov},
  pages = {111944--111944},
  title = {Use of artificial intelligence to support the assessment of the methodological quality of systematic reviews},
  volume = 187,
  year = 2025
  }
  

  %0 Journal Article
  %1 marquescruz2025artificial
  %A Marques-Cruz, Manuel
  %A Pinto, Filipe
  %A Vieira, Rafael José
  %A Bognanni, Antonio
  %A Perestrelo, Paula
  %A Gil-Mata, Sara
  %A Duarte, Vítor Henrique
  %A Barbosa, José Pedro
  %A Cardoso-Fernandes, António
  %A Martinho-Dias, Daniel
  %A Franco-Pego, Francisco
  %A Germini, Federico
  %A Arienti, Chiara
  %A Chu, Alexandro W L
  %A Riera-Serra, Pau
  %A Jemioło, Paweł
  %A Rodrigues, Pedro Pereira
  %A Fonseca, João A
  %A Azevedo, Luís Filipe
  %A Schünemann, Holger J
  %A Cruz-Correia, Ricardo
  %A Jankin, Slava
  %A Sousa-Pinto, Bernardo
  %C United States
  %D 2025
  %J Journal of clinical epidemiology
  %P 111944--111944
  %R 10.1016/j.jclinepi.2025.111944
  %T Use of artificial intelligence to support the assessment of the methodological quality of systematic reviews
  %U https://pubmed.ncbi.nlm.nih.gov/40865587
  %V 187
  %X OBJECTIVES: Published systematic reviews display a heterogeneous methodological quality, which can impact decision-making. Large language models (LLMs) can support and make the assessment of the methodological quality of systematic reviews more efficient, aiding in the incorporation of their evidence in guideline recommendations. We aimed to develop an LLM-based tool for supporting the assessment of the methodological quality of systematic reviews. METHODS: We assessed the performance of 8 LLMs in evaluating the methodological quality of systematic reviews. In particular, we provided 100 systematic reviews for eight LLMs (five base models and three fine-tuned models) to evaluate their methodological quality based on a 27-item validated tool (Reported Methodological Quality (ReMarQ)). The fine-tuned models had been trained with a different sample of 300 manually assessed systematic reviews. We compared the answers provided by LLMs with those independently provided by human reviewers, computing the accuracy, kappa coefficient and F1-score for this comparison. RESULTS: The best performing LLM was a fine-tuned GPT-3.5 model (mean accuracy = 96.5% [95% CI = 89.9%-100%]; mean kappa coefficient = 0.90 [95% CI = 0.71-1.00]; mean F1-score = 0.91 [95% CI = 0.83-1.00]). This model displayed an accuracy >80% and a kappa coefficient >0.60 for all individual items. When we made this LLM assess 60 times the same set of systematic reviews, answers to 18 of 27 items were always consistent (ie, were always the same) and only 11% of assessed systematic reviews showed inconsistency. CONCLUSION: Overall, LLMs have the potential to accurately support the assessment of the methodological quality of systematic reviews based on a validated tool comprising dichotomous items.
  

• 
  1.

  Marques-Cruz M, Pinto F, Vieira RJ, Bognanni A, Perestrelo P, Gil-Mata S, Duarte VH, Barbosa JP, Cardoso-Fernandes A, Martinho-Dias D, Franco-Pego F, Germini F, Arienti C, Chu AWL, Riera-Serra P, Jemioło P, Rodrigues PP, Fonseca JA, Azevedo LF, Schünemann HJ, Cruz-Correia R, Jankin S, Sousa-Pinto B. Use of artificial intelligence to support the assessment of the methodological quality of systematic reviews. Journal of clinical epidemiology [Internet]. United States; 2025 Aug.;:111944-. https://pubmed.ncbi.nlm.nih.gov/40865587

  AbstractURLBibTeXEndNoteDOIBibSonomy

  INTRODUCTION: Published systematic reviews display an heterogeneous methodological quality, which can impact decision-making. Large language models (LLMs) can support and make the assessment of the methodological quality of systematic reviews more efficient, aiding in the incorporation of their evidence in guideline recommendations. We aimed to develop a LLM-based tool for supporting the assessment of the methodological quality of systematic reviews. METHODS: We assessed the performance of eight large language models (LLMs) in evaluating the methodological quality of systematic reviews. In particular, we provided 100 systematic reviews for eight LLMs (five base models and three fine-tuned models) to evaluate their methodological quality based on a 27-item validated tool (ReMarQ). The fine-tuned models had been trained with a different sample of 300 manually assessed systematic reviews. We compared the answers provided by LLMs with those independently provided by human reviewers, computing the accuracy, kappa coefficient and F1-score for this comparison. RESULTS: The best performing LLM was a fine-tuned GPT-3.5 model (mean accuracy=96.5% [95%CI=89.9-100%]; mean kappa coefficient=0.90 [95%CI=0.71-1.00]; mean F1-score=0.91 [95%CI=0.83-1.00]). This model displayed an accuracy >80% and a kappa coefficient >0.60 for all individual items. When we made this LLM assess 60 times the same set of systematic reviews, answers to 18 of 27 items were always consistent (i.e., were always the same) and only 11% of assessed systematic reviews showed inconsistency. CONCLUSION: Overall, LLMs have the potential to accurately support the assessment of the methodological quality of systematic reviews based on a validated tool comprising dichotomous items.

  @article{marquescruz2025artificial,
  abstract = {INTRODUCTION: Published systematic reviews display an heterogeneous methodological quality, which can impact decision-making. Large language models (LLMs) can support and make the assessment of the methodological quality of systematic reviews more efficient, aiding in the incorporation of their evidence in guideline recommendations. We aimed to develop a LLM-based tool for supporting the assessment of the methodological quality of systematic reviews. METHODS: We assessed the performance of eight large language models (LLMs) in evaluating the methodological quality of systematic reviews. In particular, we provided 100 systematic reviews for eight LLMs (five base models and three fine-tuned models) to evaluate their methodological quality based on a 27-item validated tool (ReMarQ). The fine-tuned models had been trained with a different sample of 300 manually assessed systematic reviews. We compared the answers provided by LLMs with those independently provided by human reviewers, computing the accuracy, kappa coefficient and F1-score for this comparison. RESULTS: The best performing LLM was a fine-tuned GPT-3.5 model (mean accuracy=96.5% [95%CI=89.9-100%]; mean kappa coefficient=0.90 [95%CI=0.71-1.00]; mean F1-score=0.91 [95%CI=0.83-1.00]). This model displayed an accuracy >80% and a kappa coefficient >0.60 for all individual items. When we made this LLM assess 60 times the same set of systematic reviews, answers to 18 of 27 items were always consistent (i.e., were always the same) and only 11% of assessed systematic reviews showed inconsistency. CONCLUSION: Overall, LLMs have the potential to accurately support the assessment of the methodological quality of systematic reviews based on a validated tool comprising dichotomous items.},
  address = {United States},
  author = {Marques-Cruz, Manuel and Pinto, Filipe and Vieira, Rafael José and Bognanni, Antonio and Perestrelo, Paula and Gil-Mata, Sara and Duarte, Vítor Henrique and Barbosa, José Pedro and Cardoso-Fernandes, António and Martinho-Dias, Daniel and Franco-Pego, Francisco and Germini, Federico and Arienti, Chiara and Chu, Alexandro W L and Riera-Serra, Pau and Jemioło, Paweł and Rodrigues, Pedro Pereira and Fonseca, João A and Azevedo, Luís Filipe and Schünemann, Holger J and Cruz-Correia, Ricardo and Jankin, Slava and Sousa-Pinto, Bernardo},
  journal = {Journal of clinical epidemiology},
  keywords = {evisap},
  month = {aug},
  pages = {111944--111944},
  title = {Use of artificial intelligence to support the assessment of the methodological quality of systematic reviews},
  year = 2025
  }
  

  %0 Journal Article
  %1 marquescruz2025artificial
  %A Marques-Cruz, Manuel
  %A Pinto, Filipe
  %A Vieira, Rafael José
  %A Bognanni, Antonio
  %A Perestrelo, Paula
  %A Gil-Mata, Sara
  %A Duarte, Vítor Henrique
  %A Barbosa, José Pedro
  %A Cardoso-Fernandes, António
  %A Martinho-Dias, Daniel
  %A Franco-Pego, Francisco
  %A Germini, Federico
  %A Arienti, Chiara
  %A Chu, Alexandro W L
  %A Riera-Serra, Pau
  %A Jemioło, Paweł
  %A Rodrigues, Pedro Pereira
  %A Fonseca, João A
  %A Azevedo, Luís Filipe
  %A Schünemann, Holger J
  %A Cruz-Correia, Ricardo
  %A Jankin, Slava
  %A Sousa-Pinto, Bernardo
  %C United States
  %D 2025
  %J Journal of clinical epidemiology
  %P 111944--111944
  %R 10.1016/j.jclinepi.2025.111944
  %T Use of artificial intelligence to support the assessment of the methodological quality of systematic reviews
  %U https://pubmed.ncbi.nlm.nih.gov/40865587
  %X INTRODUCTION: Published systematic reviews display an heterogeneous methodological quality, which can impact decision-making. Large language models (LLMs) can support and make the assessment of the methodological quality of systematic reviews more efficient, aiding in the incorporation of their evidence in guideline recommendations. We aimed to develop a LLM-based tool for supporting the assessment of the methodological quality of systematic reviews. METHODS: We assessed the performance of eight large language models (LLMs) in evaluating the methodological quality of systematic reviews. In particular, we provided 100 systematic reviews for eight LLMs (five base models and three fine-tuned models) to evaluate their methodological quality based on a 27-item validated tool (ReMarQ). The fine-tuned models had been trained with a different sample of 300 manually assessed systematic reviews. We compared the answers provided by LLMs with those independently provided by human reviewers, computing the accuracy, kappa coefficient and F1-score for this comparison. RESULTS: The best performing LLM was a fine-tuned GPT-3.5 model (mean accuracy=96.5% [95%CI=89.9-100%]; mean kappa coefficient=0.90 [95%CI=0.71-1.00]; mean F1-score=0.91 [95%CI=0.83-1.00]). This model displayed an accuracy >80% and a kappa coefficient >0.60 for all individual items. When we made this LLM assess 60 times the same set of systematic reviews, answers to 18 of 27 items were always consistent (i.e., were always the same) and only 11% of assessed systematic reviews showed inconsistency. CONCLUSION: Overall, LLMs have the potential to accurately support the assessment of the methodological quality of systematic reviews based on a validated tool comprising dichotomous items.
  

• 
  1.

  Navarra-Ventura G, Coronado-Simsic V, Riera-Serra P, Castro A, García-Toro M, Roca M, Gili M. Associations between unhealthy lifestyle and depression: Cross-sectional results from the Spanish National Health Survey. Spanish journal of psychiatry and mental health [Internet]. Spain; 2025;18(3):191-8. https://pubmed.ncbi.nlm.nih.gov/38591831

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  INTRODUCTION: Depression usually worsens lifestyle habits, but previous evidence also suggests that an unhealthy lifestyle (UL) increases the risk of depression. Many studies have analyzed the association between lifestyle and depression in several nationally representative samples, but none have done so in the Spanish adult population. Our aim was to examine the associations between UL habits and depression in Spain. MATERIALS AND METHODS: Analysis of cross-sectional data from the latest National Health Survey published in 2018 (N=23,089). Data on depression and 4 lifestyle factors (diet, physical exercise, smoking, and alcohol consumption) were used. These factors were combined into an UL index ranging from 0 (healthiest lifestyle) to 4 (unhealthiest lifestyle). The prevalence of depression at different levels of the UL index, and the association between depression and both the cumulative UL index and the 4 UL factors was analyzed using parametric and non-parametric tests. RESULTS: Sedentarism was the most prevalent UL factor, followed by unhealthy diet, smoking and high-risk alcohol consumption. Having ≥1 UL factors was associated with a higher prevalence of depression compared to having 0 UL factors (2.5% vs. ≥5.2%), regardless of the cumulative number UL factors (1, 2, 3 or 4). Being physically inactive (OR=1.6) and a smoker (OR=1.3) increased the likelihood of depression. Being a high-risk wine drinker (OR=0.26) decreased the likelihood of depression. Dietary intake was not significant. CONCLUSIONS: The prevalence of depression changes depending on several modifiable lifestyle factors. Policy makers should therefore spare no resources in promoting strategies to encourage healthy lifestyles and prevent the acquisition of UL habits.

  @article{navarraventura2025associations,
  abstract = {INTRODUCTION: Depression usually worsens lifestyle habits, but previous evidence also suggests that an unhealthy lifestyle (UL) increases the risk of depression. Many studies have analyzed the association between lifestyle and depression in several nationally representative samples, but none have done so in the Spanish adult population. Our aim was to examine the associations between UL habits and depression in Spain. MATERIALS AND METHODS: Analysis of cross-sectional data from the latest National Health Survey published in 2018 (N=23,089). Data on depression and 4 lifestyle factors (diet, physical exercise, smoking, and alcohol consumption) were used. These factors were combined into an UL index ranging from 0 (healthiest lifestyle) to 4 (unhealthiest lifestyle). The prevalence of depression at different levels of the UL index, and the association between depression and both the cumulative UL index and the 4 UL factors was analyzed using parametric and non-parametric tests. RESULTS: Sedentarism was the most prevalent UL factor, followed by unhealthy diet, smoking and high-risk alcohol consumption. Having ≥1 UL factors was associated with a higher prevalence of depression compared to having 0 UL factors (2.5% vs. ≥5.2%), regardless of the cumulative number UL factors (1, 2, 3 or 4). Being physically inactive (OR=1.6) and a smoker (OR=1.3) increased the likelihood of depression. Being a high-risk wine drinker (OR=0.26) decreased the likelihood of depression. Dietary intake was not significant. CONCLUSIONS: The prevalence of depression changes depending on several modifiable lifestyle factors. Policy makers should therefore spare no resources in promoting strategies to encourage healthy lifestyles and prevent the acquisition of UL habits.},
  address = {Spain},
  author = {Navarra-Ventura, Guillem and Coronado-Simsic, Victoria and Riera-Serra, Pau and Castro, Adoración and García-Toro, Mauro and Roca, Miquel and Gili, Margalida},
  journal = {Spanish journal of psychiatry and mental health},
  keywords = {evisap},
  number = 3,
  pages = {191--198},
  title = {Associations between unhealthy lifestyle and depression: Cross-sectional results from the Spanish National Health Survey},
  volume = 18,
  year = 2025
  }
  

  %0 Journal Article
  %1 navarraventura2025associations
  %A Navarra-Ventura, Guillem
  %A Coronado-Simsic, Victoria
  %A Riera-Serra, Pau
  %A Castro, Adoración
  %A García-Toro, Mauro
  %A Roca, Miquel
  %A Gili, Margalida
  %C Spain
  %D 2025
  %J Spanish journal of psychiatry and mental health
  %N 3
  %P 191--198
  %R 10.1016/j.sjpmh.2023.08.001
  %T Associations between unhealthy lifestyle and depression: Cross-sectional results from the Spanish National Health Survey
  %U https://pubmed.ncbi.nlm.nih.gov/38591831
  %V 18
  %X INTRODUCTION: Depression usually worsens lifestyle habits, but previous evidence also suggests that an unhealthy lifestyle (UL) increases the risk of depression. Many studies have analyzed the association between lifestyle and depression in several nationally representative samples, but none have done so in the Spanish adult population. Our aim was to examine the associations between UL habits and depression in Spain. MATERIALS AND METHODS: Analysis of cross-sectional data from the latest National Health Survey published in 2018 (N=23,089). Data on depression and 4 lifestyle factors (diet, physical exercise, smoking, and alcohol consumption) were used. These factors were combined into an UL index ranging from 0 (healthiest lifestyle) to 4 (unhealthiest lifestyle). The prevalence of depression at different levels of the UL index, and the association between depression and both the cumulative UL index and the 4 UL factors was analyzed using parametric and non-parametric tests. RESULTS: Sedentarism was the most prevalent UL factor, followed by unhealthy diet, smoking and high-risk alcohol consumption. Having ≥1 UL factors was associated with a higher prevalence of depression compared to having 0 UL factors (2.5% vs. ≥5.2%), regardless of the cumulative number UL factors (1, 2, 3 or 4). Being physically inactive (OR=1.6) and a smoker (OR=1.3) increased the likelihood of depression. Being a high-risk wine drinker (OR=0.26) decreased the likelihood of depression. Dietary intake was not significant. CONCLUSIONS: The prevalence of depression changes depending on several modifiable lifestyle factors. Policy makers should therefore spare no resources in promoting strategies to encourage healthy lifestyles and prevent the acquisition of UL habits.
  

• 
  1.

  Mira-Martínez S, Malih N, Angullo-Martínez E, Zamanillo-Campos R, Yañez AM, Bennasar-Veny M, Gómez-Juanes R, Konieczna J, Jiménez R, Serrano-Ripoll MJ, Fiol deRoque MA, Leiva A, Galmes-Panades AM, Miralles-Xamena J, Vidal-Thomàs MC, Gómez-Cobo C, Gervilla E, Oña-Gil JI, Ricci-Cabello I. A Multifaceted Digital Intervention for the Prevention of Type 2 Diabetes Mellitus in Primary Care (PREDIABETEXT): Cluster Randomized Trial. Journal of medical Internet research [Internet]. Canada; 2025 Oct.;27:e70981-e70981. https://pubmed.ncbi.nlm.nih.gov/41067715

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  BACKGROUND: The diabetes epidemic continues to surge worldwide, demanding urgent and innovative solutions. Digital health interventions, particularly those targeting behavior change, hold promise due to their affordability and scalability. However, research in this field remains in its early stages. OBJECTIVE: This study aimed to evaluate the effectiveness of PREDIABETEXT (Prediabetes Text Message Digital Intervention for the Prevention of Type 2 Diabetes Mellitus), a digital health intervention, in reducing glycated hemoglobin (HbA(1c)) and in improving secondary clinical, physiological, and behavioral outcomes. METHODS: We conducted a 6-month, 3-arm, pragmatic cluster randomized clinical trial. We recruited patients with prediabetes (HbA(1c) levels between 6% and 6.4% in the previous 3 months or 2 consecutive fasting plasma glucose measurements of 110-125 mg/dL) registered at primary care centers in the Balearic Islands, Spain. The PREDIABETEXT intervention consisted of 3 personalized SMS text messages per week aimed at supporting lifestyle behavior changes and online training for their primary health care professionals. A total of 58 professionals (clusters) from 16 centers participated in the study and were randomized (1:1:1) to intervention group A (patient SMS text messaging), intervention group B (patient SMS text messaging+health care professional web-based training), or the control group (usual care). Following the 6-month intervention period, we conducted individual qualitative interviews with 8 patients and 7 health care professionals to evaluate their experiences with the intervention in terms of utility, satisfaction, and implementation barriers. RESULTS: In total, 58 health care professionals (clusters) were included, allocated to the control group (n=20, 34%; 119/365, 32.6% patients), intervention group A (SMS text messaging only; n=18, 31%; 106/365, 29% patients), and intervention group B (SMS text messaging+training; n=20, 34%; 140/365, 38.4% patients). The mean age of the patients was 59.79 (SD 9.75) years, and 54.5% (199/365) were female. The results of the intention-to-treat analysis at the 6-month time point showed that intervention A led to a small, nonsignificant reduction in HbA(1c) levels compared to the control group (β=-0.05, 95% CI -0.21 to 0.10; P=.50), whereas intervention B showed a similar nonsignificant reduction (β=-0.04, 95% CI -0.12 to 0.10; P=.56). No substantial differences were observed in the remaining secondary outcomes. Interviews revealed positive feedback from patients, who appreciated the intervention's dietary messages and their frequency and practicality. Participants suggested enhancements such as increased personalization, links to recipes, and nursing follow-ups. Health care professionals valued the online training but highlighted time constraints, suggesting shorter or blended formats to improve accessibility. CONCLUSIONS: While PREDIABETEXT did not significantly improve HbA(1c) levels, it demonstrated potential benefits for patient engagement. Further studies involving more intensive interventions are warranted to confirm the clinical impact on diabetes prevention. TRIAL REGISTRATION: ClinicalTrials.gov NCT05110625; https://www.clinicaltrials.gov/study/NCT05110625. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.3390/ijerph192214706.

  @article{miramartinez2025multifaceted,
  abstract = {BACKGROUND: The diabetes epidemic continues to surge worldwide, demanding urgent and innovative solutions. Digital health interventions, particularly those targeting behavior change, hold promise due to their affordability and scalability. However, research in this field remains in its early stages. OBJECTIVE: This study aimed to evaluate the effectiveness of PREDIABETEXT (Prediabetes Text Message Digital Intervention for the Prevention of Type 2 Diabetes Mellitus), a digital health intervention, in reducing glycated hemoglobin (HbA(1c)) and in improving secondary clinical, physiological, and behavioral outcomes. METHODS: We conducted a 6-month, 3-arm, pragmatic cluster randomized clinical trial. We recruited patients with prediabetes (HbA(1c) levels between 6% and 6.4% in the previous 3 months or 2 consecutive fasting plasma glucose measurements of 110-125 mg/dL) registered at primary care centers in the Balearic Islands, Spain. The PREDIABETEXT intervention consisted of 3 personalized SMS text messages per week aimed at supporting lifestyle behavior changes and online training for their primary health care professionals. A total of 58 professionals (clusters) from 16 centers participated in the study and were randomized (1:1:1) to intervention group A (patient SMS text messaging), intervention group B (patient SMS text messaging+health care professional web-based training), or the control group (usual care). Following the 6-month intervention period, we conducted individual qualitative interviews with 8 patients and 7 health care professionals to evaluate their experiences with the intervention in terms of utility, satisfaction, and implementation barriers. RESULTS: In total, 58 health care professionals (clusters) were included, allocated to the control group (n=20, 34%; 119/365, 32.6% patients), intervention group A (SMS text messaging only; n=18, 31%; 106/365, 29% patients), and intervention group B (SMS text messaging+training; n=20, 34%; 140/365, 38.4% patients). The mean age of the patients was 59.79 (SD 9.75) years, and 54.5% (199/365) were female. The results of the intention-to-treat analysis at the 6-month time point showed that intervention A led to a small, nonsignificant reduction in HbA(1c) levels compared to the control group (β=-0.05, 95% CI -0.21 to 0.10; P=.50), whereas intervention B showed a similar nonsignificant reduction (β=-0.04, 95% CI -0.12 to 0.10; P=.56). No substantial differences were observed in the remaining secondary outcomes. Interviews revealed positive feedback from patients, who appreciated the intervention's dietary messages and their frequency and practicality. Participants suggested enhancements such as increased personalization, links to recipes, and nursing follow-ups. Health care professionals valued the online training but highlighted time constraints, suggesting shorter or blended formats to improve accessibility. CONCLUSIONS: While PREDIABETEXT did not significantly improve HbA(1c) levels, it demonstrated potential benefits for patient engagement. Further studies involving more intensive interventions are warranted to confirm the clinical impact on diabetes prevention. TRIAL REGISTRATION: ClinicalTrials.gov NCT05110625; https://www.clinicaltrials.gov/study/NCT05110625. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.3390/ijerph192214706.},
  address = {Canada},
  author = {Mira-Martínez, Sofía and Malih, Narges and Angullo-Martínez, Escarlata and Zamanillo-Campos, Rocío and Yañez, Aina M and Bennasar-Veny, Miquel and Gómez-Juanes, Rocío and Konieczna, Jadwiga and Jiménez, Rafael and Serrano-Ripoll, Maria J and Fiol deRoque, Maria Antonia and Leiva, Alfonso and Galmes-Panades, Aina M and Miralles-Xamena, Jerónima and Vidal-Thomàs, Maria Clara and Gómez-Cobo, Cristina and Gervilla, Elena and Oña-Gil, José Iván and Ricci-Cabello, Ignacio},
  journal = {Journal of medical Internet research},
  keywords = {evisap grapp-caib},
  month = {oct},
  pages = {e70981--e70981},
  title = {A Multifaceted Digital Intervention for the Prevention of Type 2 Diabetes Mellitus in Primary Care (PREDIABETEXT): Cluster Randomized Trial},
  volume = 27,
  year = 2025
  }
  

  %0 Journal Article
  %1 miramartinez2025multifaceted
  %A Mira-Martínez, Sofía
  %A Malih, Narges
  %A Angullo-Martínez, Escarlata
  %A Zamanillo-Campos, Rocío
  %A Yañez, Aina M
  %A Bennasar-Veny, Miquel
  %A Gómez-Juanes, Rocío
  %A Konieczna, Jadwiga
  %A Jiménez, Rafael
  %A Serrano-Ripoll, Maria J
  %A Fiol deRoque, Maria Antonia
  %A Leiva, Alfonso
  %A Galmes-Panades, Aina M
  %A Miralles-Xamena, Jerónima
  %A Vidal-Thomàs, Maria Clara
  %A Gómez-Cobo, Cristina
  %A Gervilla, Elena
  %A Oña-Gil, José Iván
  %A Ricci-Cabello, Ignacio
  %C Canada
  %D 2025
  %J Journal of medical Internet research
  %P e70981--e70981
  %R 10.2196/70981
  %T A Multifaceted Digital Intervention for the Prevention of Type 2 Diabetes Mellitus in Primary Care (PREDIABETEXT): Cluster Randomized Trial
  %U https://pubmed.ncbi.nlm.nih.gov/41067715
  %V 27
  %X BACKGROUND: The diabetes epidemic continues to surge worldwide, demanding urgent and innovative solutions. Digital health interventions, particularly those targeting behavior change, hold promise due to their affordability and scalability. However, research in this field remains in its early stages. OBJECTIVE: This study aimed to evaluate the effectiveness of PREDIABETEXT (Prediabetes Text Message Digital Intervention for the Prevention of Type 2 Diabetes Mellitus), a digital health intervention, in reducing glycated hemoglobin (HbA(1c)) and in improving secondary clinical, physiological, and behavioral outcomes. METHODS: We conducted a 6-month, 3-arm, pragmatic cluster randomized clinical trial. We recruited patients with prediabetes (HbA(1c) levels between 6% and 6.4% in the previous 3 months or 2 consecutive fasting plasma glucose measurements of 110-125 mg/dL) registered at primary care centers in the Balearic Islands, Spain. The PREDIABETEXT intervention consisted of 3 personalized SMS text messages per week aimed at supporting lifestyle behavior changes and online training for their primary health care professionals. A total of 58 professionals (clusters) from 16 centers participated in the study and were randomized (1:1:1) to intervention group A (patient SMS text messaging), intervention group B (patient SMS text messaging+health care professional web-based training), or the control group (usual care). Following the 6-month intervention period, we conducted individual qualitative interviews with 8 patients and 7 health care professionals to evaluate their experiences with the intervention in terms of utility, satisfaction, and implementation barriers. RESULTS: In total, 58 health care professionals (clusters) were included, allocated to the control group (n=20, 34%; 119/365, 32.6% patients), intervention group A (SMS text messaging only; n=18, 31%; 106/365, 29% patients), and intervention group B (SMS text messaging+training; n=20, 34%; 140/365, 38.4% patients). The mean age of the patients was 59.79 (SD 9.75) years, and 54.5% (199/365) were female. The results of the intention-to-treat analysis at the 6-month time point showed that intervention A led to a small, nonsignificant reduction in HbA(1c) levels compared to the control group (β=-0.05, 95% CI -0.21 to 0.10; P=.50), whereas intervention B showed a similar nonsignificant reduction (β=-0.04, 95% CI -0.12 to 0.10; P=.56). No substantial differences were observed in the remaining secondary outcomes. Interviews revealed positive feedback from patients, who appreciated the intervention's dietary messages and their frequency and practicality. Participants suggested enhancements such as increased personalization, links to recipes, and nursing follow-ups. Health care professionals valued the online training but highlighted time constraints, suggesting shorter or blended formats to improve accessibility. CONCLUSIONS: While PREDIABETEXT did not significantly improve HbA(1c) levels, it demonstrated potential benefits for patient engagement. Further studies involving more intensive interventions are warranted to confirm the clinical impact on diabetes prevention. TRIAL REGISTRATION: ClinicalTrials.gov NCT05110625; https://www.clinicaltrials.gov/study/NCT05110625. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.3390/ijerph192214706.
  

• 
  1.

  Chaplin A, Wordsworth J, Prohens L, Obrador-Hevia A, Guillot M, Ricci-Cabello I, Sesé A, Romaguera D. Validation and pilot feasibility study of a novel screener to assess diet, lifestyle and mental health in people living with and beyond cancer: Study protocols. PloS one [Internet]. United States; 2025 Jun.;20(6):e0323671-e0323671. https://pubmed.ncbi.nlm.nih.gov/40472046

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  BACKGROUND AND AIM: Current clinical care may not address behavioural and psychosocial elements which can influence quality of life (QoL) and recurrence risk of people living with and beyond cancer (PLWBC). There is a lack of validated tools to assess diet, lifestyle and mental health in PLWBC. We have developed a screener to identify individuals who may need further support beyond cancer recurrence. The aim is two-fold: 1) validate the screener in PLWBC; and 2) carry out a pilot feasibility study (PFS) to explore the impact of a lifestyle complex intervention (diet, physical activity and mental health components) on the QoL of PLWBC. METHODS: The study will be carried out at the University Hospital Son Espases (Spain) in PLWBC. A face validity study (n = 15) will assess construct interpretation, completion time, and acquiescence of the screener. For construct validity and reproducibility analysis (n = 100), participants will answer the screener together with validated diet, lifestyle, and mental health questionnaires for comparison. Body composition, physical activity, strength and cortisol levels will be assessed using validated instruments. All participants will answer the screener 7-10 days later for reproducibility analysis. Participants will then be randomized (1:1) to the Low Intervention (LI) or the High Intervention (HI) for the PFS study. LI will receive general advice regarding diet, lifestyle and mental health, and HI will receive individual and group sessions with specialised health professionals. Participants will be followed for three months. Primary outcomes include: 1) validity and reproducibility of the screener; and 2) feasibility of a complex intervention to improve QoL of PLWBC. Secondary outcomes include changes in screener answers and body composition. DISCUSSION: A validated screener which detects PLWBC's needs could be used in follow-up care plans. The PFS will inform on the recruitment of participants and identify potential shortfalls of the design and efficacy. TRIAL REGISTRATION: ClinicalTrials.gov NCT06582498.

  @article{chaplin2025validation,
  abstract = {BACKGROUND AND AIM: Current clinical care may not address behavioural and psychosocial elements which can influence quality of life (QoL) and recurrence risk of people living with and beyond cancer (PLWBC). There is a lack of validated tools to assess diet, lifestyle and mental health in PLWBC. We have developed a screener to identify individuals who may need further support beyond cancer recurrence. The aim is two-fold: 1) validate the screener in PLWBC; and 2) carry out a pilot feasibility study (PFS) to explore the impact of a lifestyle complex intervention (diet, physical activity and mental health components) on the QoL of PLWBC. METHODS: The study will be carried out at the University Hospital Son Espases (Spain) in PLWBC. A face validity study (n = 15) will assess construct interpretation, completion time, and acquiescence of the screener. For construct validity and reproducibility analysis (n = 100), participants will answer the screener together with validated diet, lifestyle, and mental health questionnaires for comparison. Body composition, physical activity, strength and cortisol levels will be assessed using validated instruments. All participants will answer the screener 7-10 days later for reproducibility analysis. Participants will then be randomized (1:1) to the Low Intervention (LI) or the High Intervention (HI) for the PFS study. LI will receive general advice regarding diet, lifestyle and mental health, and HI will receive individual and group sessions with specialised health professionals. Participants will be followed for three months. Primary outcomes include: 1) validity and reproducibility of the screener; and 2) feasibility of a complex intervention to improve QoL of PLWBC. Secondary outcomes include changes in screener answers and body composition. DISCUSSION: A validated screener which detects PLWBC's needs could be used in follow-up care plans. The PFS will inform on the recruitment of participants and identify potential shortfalls of the design and efficacy. TRIAL REGISTRATION: ClinicalTrials.gov NCT06582498.},
  address = {United States},
  author = {Chaplin, Alice and Wordsworth, Janna and Prohens, Lara and Obrador-Hevia, Antònia and Guillot, Monica and Ricci-Cabello, Ignacio and Sesé, Albert and Romaguera, Dora},
  journal = {PloS one},
  keywords = {evisap},
  month = {jun},
  number = 6,
  pages = {e0323671--e0323671},
  title = {Validation and pilot feasibility study of a novel screener to assess diet, lifestyle and mental health in people living with and beyond cancer: Study protocols},
  volume = 20,
  year = 2025
  }
  

  %0 Journal Article
  %1 chaplin2025validation
  %A Chaplin, Alice
  %A Wordsworth, Janna
  %A Prohens, Lara
  %A Obrador-Hevia, Antònia
  %A Guillot, Monica
  %A Ricci-Cabello, Ignacio
  %A Sesé, Albert
  %A Romaguera, Dora
  %C United States
  %D 2025
  %J PloS one
  %N 6
  %P e0323671--e0323671
  %R 10.1371/journal.pone.0323671
  %T Validation and pilot feasibility study of a novel screener to assess diet, lifestyle and mental health in people living with and beyond cancer: Study protocols
  %U https://pubmed.ncbi.nlm.nih.gov/40472046
  %V 20
  %X BACKGROUND AND AIM: Current clinical care may not address behavioural and psychosocial elements which can influence quality of life (QoL) and recurrence risk of people living with and beyond cancer (PLWBC). There is a lack of validated tools to assess diet, lifestyle and mental health in PLWBC. We have developed a screener to identify individuals who may need further support beyond cancer recurrence. The aim is two-fold: 1) validate the screener in PLWBC; and 2) carry out a pilot feasibility study (PFS) to explore the impact of a lifestyle complex intervention (diet, physical activity and mental health components) on the QoL of PLWBC. METHODS: The study will be carried out at the University Hospital Son Espases (Spain) in PLWBC. A face validity study (n = 15) will assess construct interpretation, completion time, and acquiescence of the screener. For construct validity and reproducibility analysis (n = 100), participants will answer the screener together with validated diet, lifestyle, and mental health questionnaires for comparison. Body composition, physical activity, strength and cortisol levels will be assessed using validated instruments. All participants will answer the screener 7-10 days later for reproducibility analysis. Participants will then be randomized (1:1) to the Low Intervention (LI) or the High Intervention (HI) for the PFS study. LI will receive general advice regarding diet, lifestyle and mental health, and HI will receive individual and group sessions with specialised health professionals. Participants will be followed for three months. Primary outcomes include: 1) validity and reproducibility of the screener; and 2) feasibility of a complex intervention to improve QoL of PLWBC. Secondary outcomes include changes in screener answers and body composition. DISCUSSION: A validated screener which detects PLWBC's needs could be used in follow-up care plans. The PFS will inform on the recruitment of participants and identify potential shortfalls of the design and efficacy. TRIAL REGISTRATION: ClinicalTrials.gov NCT06582498.
  

• 
  1.

  Benejam JMC, Herrera RB, Ricci-Cabello I. Uso inadecuado y riesgo de sobrediagnóstico en las pruebas de imagen en Atención Primaria. Actualización en Medicina de Familia: AMF. 2025;21(10):578-86.

  BibTeXEndNoteBibSonomy

  @article{RN3,
  author = {Benejam, Josep Maria Coll and Herrera, Rubén Blanco and Ricci-Cabello, Ignacio},
  journal = {Actualización en Medicina de Familia: AMF},
  keywords = {evisap},
  number = 10,
  pages = {578-586},
  title = {Uso inadecuado y riesgo de sobrediagnóstico en las pruebas de imagen en Atención Primaria},
  type = {Journal Article},
  volume = 21,
  year = 2025
  }
  

  %0 Journal Article
  %1 RN3
  %A Benejam, Josep Maria Coll
  %A Herrera, Rubén Blanco
  %A Ricci-Cabello, Ignacio
  %D 2025
  %J Actualización en Medicina de Familia: AMF
  %N 10
  %P 578-586
  %T Uso inadecuado y riesgo de sobrediagnóstico en las pruebas de imagen en Atención Primaria
  %V 21
  

• 
  1.

  Oliver LL, Peña MPA, Ricci-Cabello I. Deprescripción como estrategia de seguridad del paciente en el manejo de fármacos de tipo AINE, opioides, IBP y antiagregantes. Actualización en Medicina de Familia: AMF. 2025;21(10):606-19.

  BibTeXEndNoteBibSonomy

  @article{RN2,
  author = {Oliver, Lourdes Luzón and Peña, María Pilar Astier and Ricci-Cabello, Ignacio},
  journal = {Actualización en Medicina de Familia: AMF},
  keywords = {evisap},
  number = 10,
  pages = {606-619},
  title = {Deprescripción como estrategia de seguridad del paciente en el manejo de fármacos de tipo AINE, opioides, IBP y antiagregantes},
  type = {Journal Article},
  volume = 21,
  year = 2025
  }
  

  %0 Journal Article
  %1 RN2
  %A Oliver, Lourdes Luzón
  %A Peña, María Pilar Astier
  %A Ricci-Cabello, Ignacio
  %D 2025
  %J Actualización en Medicina de Familia: AMF
  %N 10
  %P 606-619
  %T Deprescripción como estrategia de seguridad del paciente en el manejo de fármacos de tipo AINE, opioides, IBP y antiagregantes
  %V 21
  

• 
  1.

  Bennasar-Veny M, Abbate M, Colom-Rosselló M, Capitán-Moyano L, Hernández-Bermúdez IC, Ricci-Cabello I, Yañez AM, Fernandez ME, investigators A. Impact of an adapted diabetes prevention program in a spanish primary care setting: protocol for a type II hybrid effectiveness-implementation cluster-randomized trial (ALADIM). Implementation science : IS [Internet]. England; 2025 Jun.;20(1):27-. https://pubmed.ncbi.nlm.nih.gov/40457444

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  BACKGROUND: Type 2 diabetes (T2D) is a global health concern affecting 10.5% of the adult population and is projected to rise significantly in the coming decades. Lifestyle modification programs, such as the Diabetes Prevention Program (DPP), can effectively reduce T2D risk among individuals with prediabetes. However, their implementation in real-world healthcare settings remains poor, particularly in Spain, where T2D prevalence is the highest in Europe. The ALADIM study aims to evaluate the effectiveness and implementation of an adapted DPP in Spanish Primary Care Centers (PCCs). The primary effectiveness outcome is weight, the co-primary implementation outcome is implementation fidelity. We will also assess the effect of DPP implementation on overall prediabetes management within the PCCs (spillover) by measuring the percentage of people with prediabetes receiving lifestyle advice. METHODS: The ALADIM trial is a hybrid type II effectiveness-implementation cluster-randomized controlled trial involving 10 PCCs of Mallorca (Balearic Islands, Spain). PCCs will be randomized to the intervention (5 PCCs) or control (5 PCCs) group in a 1:1 ratio. The intervention group will receive training and materials to implement and deliver the adapted DPP over 12 months. The control group will continue providing usual care. The DPP will be culturally adapted using the Intervention Mapping-ADAPT (IM-ADAPT) approach. The implementation strategy will be designed using Implementation Mapping. Measures of effectiveness will be assessed at the participant level at baseline, 6 and 12 months during the intervention period, and 18 months after baseline. Implementation outcomes will be assessed at the PCC level at multiple time-points throughout the study period. Spillover will be assessed at PCC level at months -1, 6 and 18. An intention-to-treat analysis will assess effectiveness and spillover effect using generalized estimating equations. Implementation outcomes will be evaluated using a mixed-methods approach. DISCUSSION: The ALADIM study has the potential to address the gap between research and practice by employing implementation science for evaluation, adaptation and implementation of an evidence-based diabetes intervention. The findings will contribute to the development of a sustainable and scalable implementation strategy for T2D prevention, with potential implications for policy and practice at regional and national levels. TRIAL REGISTRATION: ClinicalTrials.gov, NCT06871059. Registered 10 March 2025, https://clinicaltrials.gov/study/NCT06871059.

  @article{bennasarveny2025impact,
  abstract = {BACKGROUND: Type 2 diabetes (T2D) is a global health concern affecting 10.5% of the adult population and is projected to rise significantly in the coming decades. Lifestyle modification programs, such as the Diabetes Prevention Program (DPP), can effectively reduce T2D risk among individuals with prediabetes. However, their implementation in real-world healthcare settings remains poor, particularly in Spain, where T2D prevalence is the highest in Europe. The ALADIM study aims to evaluate the effectiveness and implementation of an adapted DPP in Spanish Primary Care Centers (PCCs). The primary effectiveness outcome is weight, the co-primary implementation outcome is implementation fidelity. We will also assess the effect of DPP implementation on overall prediabetes management within the PCCs (spillover) by measuring the percentage of people with prediabetes receiving lifestyle advice. METHODS: The ALADIM trial is a hybrid type II effectiveness-implementation cluster-randomized controlled trial involving 10 PCCs of Mallorca (Balearic Islands, Spain). PCCs will be randomized to the intervention (5 PCCs) or control (5 PCCs) group in a 1:1 ratio. The intervention group will receive training and materials to implement and deliver the adapted DPP over 12 months. The control group will continue providing usual care. The DPP will be culturally adapted using the Intervention Mapping-ADAPT (IM-ADAPT) approach. The implementation strategy will be designed using Implementation Mapping. Measures of effectiveness will be assessed at the participant level at baseline, 6 and 12 months during the intervention period, and 18 months after baseline. Implementation outcomes will be assessed at the PCC level at multiple time-points throughout the study period. Spillover will be assessed at PCC level at months -1, 6 and 18. An intention-to-treat analysis will assess effectiveness and spillover effect using generalized estimating equations. Implementation outcomes will be evaluated using a mixed-methods approach. DISCUSSION: The ALADIM study has the potential to address the gap between research and practice by employing implementation science for evaluation, adaptation and implementation of an evidence-based diabetes intervention. The findings will contribute to the development of a sustainable and scalable implementation strategy for T2D prevention, with potential implications for policy and practice at regional and national levels. TRIAL REGISTRATION: ClinicalTrials.gov, NCT06871059. Registered 10 March 2025, https://clinicaltrials.gov/study/NCT06871059.},
  address = {England},
  author = {Bennasar-Veny, Miquel and Abbate, Manuela and Colom-Rosselló, Miquel and Capitán-Moyano, Laura and Hernández-Bermúdez, Ivonne C and Ricci-Cabello, Ignacio and Yañez, Aina M and Fernandez, Maria E and investigators, ALADIM},
  journal = {Implementation science : IS},
  keywords = {evisap},
  month = {jun},
  number = 1,
  pages = {27--27},
  title = {Impact of an adapted diabetes prevention program in a spanish primary care setting: protocol for a type II hybrid effectiveness-implementation cluster-randomized trial (ALADIM)},
  volume = 20,
  year = 2025
  }
  

  %0 Journal Article
  %1 bennasarveny2025impact
  %A Bennasar-Veny, Miquel
  %A Abbate, Manuela
  %A Colom-Rosselló, Miquel
  %A Capitán-Moyano, Laura
  %A Hernández-Bermúdez, Ivonne C
  %A Ricci-Cabello, Ignacio
  %A Yañez, Aina M
  %A Fernandez, Maria E
  %A investigators, ALADIM
  %C England
  %D 2025
  %J Implementation science : IS
  %N 1
  %P 27--27
  %R 10.1186/s13012-025-01438-3
  %T Impact of an adapted diabetes prevention program in a spanish primary care setting: protocol for a type II hybrid effectiveness-implementation cluster-randomized trial (ALADIM)
  %U https://pubmed.ncbi.nlm.nih.gov/40457444
  %V 20
  %X BACKGROUND: Type 2 diabetes (T2D) is a global health concern affecting 10.5% of the adult population and is projected to rise significantly in the coming decades. Lifestyle modification programs, such as the Diabetes Prevention Program (DPP), can effectively reduce T2D risk among individuals with prediabetes. However, their implementation in real-world healthcare settings remains poor, particularly in Spain, where T2D prevalence is the highest in Europe. The ALADIM study aims to evaluate the effectiveness and implementation of an adapted DPP in Spanish Primary Care Centers (PCCs). The primary effectiveness outcome is weight, the co-primary implementation outcome is implementation fidelity. We will also assess the effect of DPP implementation on overall prediabetes management within the PCCs (spillover) by measuring the percentage of people with prediabetes receiving lifestyle advice. METHODS: The ALADIM trial is a hybrid type II effectiveness-implementation cluster-randomized controlled trial involving 10 PCCs of Mallorca (Balearic Islands, Spain). PCCs will be randomized to the intervention (5 PCCs) or control (5 PCCs) group in a 1:1 ratio. The intervention group will receive training and materials to implement and deliver the adapted DPP over 12 months. The control group will continue providing usual care. The DPP will be culturally adapted using the Intervention Mapping-ADAPT (IM-ADAPT) approach. The implementation strategy will be designed using Implementation Mapping. Measures of effectiveness will be assessed at the participant level at baseline, 6 and 12 months during the intervention period, and 18 months after baseline. Implementation outcomes will be assessed at the PCC level at multiple time-points throughout the study period. Spillover will be assessed at PCC level at months -1, 6 and 18. An intention-to-treat analysis will assess effectiveness and spillover effect using generalized estimating equations. Implementation outcomes will be evaluated using a mixed-methods approach. DISCUSSION: The ALADIM study has the potential to address the gap between research and practice by employing implementation science for evaluation, adaptation and implementation of an evidence-based diabetes intervention. The findings will contribute to the development of a sustainable and scalable implementation strategy for T2D prevention, with potential implications for policy and practice at regional and national levels. TRIAL REGISTRATION: ClinicalTrials.gov, NCT06871059. Registered 10 March 2025, https://clinicaltrials.gov/study/NCT06871059.
  

• 
  1.

  Marina Arroyo M, Ramírez Gallegos I, Paublini H, López-González Ángel A, Tárraga López PJ, Martorell Sánchez C, Sastre-Alzamora T, Ramírez-Manent JI. Usefulness of the Córdoba Equation for Estimating Body Fat When Determining the Level of Risk of Developing Diabetes Type 2 or Prediabetes. Medicina (Kaunas, Lithuania) [Internet]. Switzerland; 2025 Mar.;61(4):613-. https://pubmed.ncbi.nlm.nih.gov/40282904

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Background and Objectives: Type 2 diabetes (T2D) and prediabetes represent major global health concerns, with obesity being a key risk factor. However, recent evidence suggests that the adipose tissue composition and distribution play a more critical role in metabolic dysfunction than the total body weight or body mass index (BMI). This study evaluates the predictive capacity of the Córdoba Equation for Estimating Body Fat (ECORE-BF) for identifying individuals at high risk of developing T2D and prediabetes. Materials and Methods: A cross-sectional study was carried out involving 418,343 Spanish workers. Body fat percentage was estimated using the ECORE-BF equation, and diabetes risk was assessed using validated predictive models, including the Finnish Diabetes Risk Score (FINDRISC), QDiabetes score (QD-score), and others. The discriminatory power of ECORE-BF in predicting T2D and prediabetes was assessed using receiver operating characteristic (ROC) curve analysis. Results: ECORE-BF showed a strong correlation with high-risk classifications across all diabetes risk scales. The area under the ROC curve (AUC) exceeded 0.95 for both men and women, demonstrating high predictive accuracy. Conclusions: Adipose tissue distribution, particularly visceral adiposity, is a central factor in metabolic dysfunction. ECORE-BF provides a cost-effective alternative for large-scale T2D and prediabetes risk assessment. Future research should explore the impact of visceral adipose tissue reduction on diabetes prevention and the integration of estimation scales into clinical and public health strategies.

  @article{marinaarroyo2025usefulness,
  abstract = {Background and Objectives: Type 2 diabetes (T2D) and prediabetes represent major global health concerns, with obesity being a key risk factor. However, recent evidence suggests that the adipose tissue composition and distribution play a more critical role in metabolic dysfunction than the total body weight or body mass index (BMI). This study evaluates the predictive capacity of the Córdoba Equation for Estimating Body Fat (ECORE-BF) for identifying individuals at high risk of developing T2D and prediabetes. Materials and Methods: A cross-sectional study was carried out involving 418,343 Spanish workers. Body fat percentage was estimated using the ECORE-BF equation, and diabetes risk was assessed using validated predictive models, including the Finnish Diabetes Risk Score (FINDRISC), QDiabetes score (QD-score), and others. The discriminatory power of ECORE-BF in predicting T2D and prediabetes was assessed using receiver operating characteristic (ROC) curve analysis. Results: ECORE-BF showed a strong correlation with high-risk classifications across all diabetes risk scales. The area under the ROC curve (AUC) exceeded 0.95 for both men and women, demonstrating high predictive accuracy. Conclusions: Adipose tissue distribution, particularly visceral adiposity, is a central factor in metabolic dysfunction. ECORE-BF provides a cost-effective alternative for large-scale T2D and prediabetes risk assessment. Future research should explore the impact of visceral adipose tissue reduction on diabetes prevention and the integration of estimation scales into clinical and public health strategies.},
  address = {Switzerland},
  author = {Marina Arroyo, Marta and Ramírez Gallegos, Ignacio and Paublini, Hernán and López-González, Ángel Arturo and Tárraga López, Pedro J and Martorell Sánchez, Cristina and Sastre-Alzamora, Tomás and Ramírez-Manent, José Ignacio},
  journal = {Medicina (Kaunas, Lithuania)},
  keywords = {grapp-caib},
  month = {mar},
  number = 4,
  pages = {613--},
  title = {Usefulness of the Córdoba Equation for Estimating Body Fat When Determining the Level of Risk of Developing Diabetes Type 2 or Prediabetes},
  volume = 61,
  year = 2025
  }
  

  %0 Journal Article
  %1 marinaarroyo2025usefulness
  %A Marina Arroyo, Marta
  %A Ramírez Gallegos, Ignacio
  %A Paublini, Hernán
  %A López-González, Ángel Arturo
  %A Tárraga López, Pedro J
  %A Martorell Sánchez, Cristina
  %A Sastre-Alzamora, Tomás
  %A Ramírez-Manent, José Ignacio
  %C Switzerland
  %D 2025
  %J Medicina (Kaunas, Lithuania)
  %N 4
  %P 613--
  %R 10.3390/medicina61040613
  %T Usefulness of the Córdoba Equation for Estimating Body Fat When Determining the Level of Risk of Developing Diabetes Type 2 or Prediabetes
  %U https://pubmed.ncbi.nlm.nih.gov/40282904
  %V 61
  %X Background and Objectives: Type 2 diabetes (T2D) and prediabetes represent major global health concerns, with obesity being a key risk factor. However, recent evidence suggests that the adipose tissue composition and distribution play a more critical role in metabolic dysfunction than the total body weight or body mass index (BMI). This study evaluates the predictive capacity of the Córdoba Equation for Estimating Body Fat (ECORE-BF) for identifying individuals at high risk of developing T2D and prediabetes. Materials and Methods: A cross-sectional study was carried out involving 418,343 Spanish workers. Body fat percentage was estimated using the ECORE-BF equation, and diabetes risk was assessed using validated predictive models, including the Finnish Diabetes Risk Score (FINDRISC), QDiabetes score (QD-score), and others. The discriminatory power of ECORE-BF in predicting T2D and prediabetes was assessed using receiver operating characteristic (ROC) curve analysis. Results: ECORE-BF showed a strong correlation with high-risk classifications across all diabetes risk scales. The area under the ROC curve (AUC) exceeded 0.95 for both men and women, demonstrating high predictive accuracy. Conclusions: Adipose tissue distribution, particularly visceral adiposity, is a central factor in metabolic dysfunction. ECORE-BF provides a cost-effective alternative for large-scale T2D and prediabetes risk assessment. Future research should explore the impact of visceral adipose tissue reduction on diabetes prevention and the integration of estimation scales into clinical and public health strategies.
  

• 
  1.

  Pang Y, Szuecs A, Ricci-Cabello I, Gangannagaripalli J, Goh LH, Leong FL, Zhou LF, Valderas JM. Patient and family engagement interventions in primary care patient safety: systematic review and meta-analysis of randomised controlled trials. The British journal of general practice : the journal of the Royal College of General Practitioners [Internet]. England; 2025 May;:BJGP.2024.0369-. https://pubmed.ncbi.nlm.nih.gov/40355248

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  BACKGROUND: Engaging patients and families have been promoted as a key strategy for improving patient safety of health systems. However, evidence remains scarce on the effectiveness of this approach in primary care. AIM: To assess the combined effectiveness of primary care interventions in randomised controlled trials (RCTs) promoting patient and family engagement in patient safety. DESIGN AND SETTING: Systematic review and meta-analysis. METHODS: The review followed PRISMA and Cochrane guidelines. Five electronic databases (MEDLINE, CINAHL, Embase, Web of Science, CENTRAL) were searched from inception to 18 September 2024 with keywords in four blocks (patient and family engagement; patient safety; primary care; randomised controlled trial). Patient and family engagement levels were appraised. Where feasible and advisable, results were combined into meta-analyses. RESULTS: Of the 19 included records, 12 reported on completed RCTs. Only one intervention integrated patients/families into overall care safety (high engagement); six aimed at enhancing skills and tools (intermediate), and 12 infirmed patients/families how to engage and prompted them to do it (low). RCTs primarily targeted medication safety, with meta-analyses showing no significant effects on reducing adverse drug events (OR=0.83, 95%CI [0.70,1.08]) or improving medication appropriateness measured categorically (OR=0.92, 95%CI [0.76,1.13]) or continuously (MD=0.71, 95%CI [-0.10,1.52]). Overall risk of bias was low and certainty of evidence very low to moderate. CONCLUSION: Existing randomised controlled evidence on patient and family engagement in primary care remains inconclusive and limited in scope. Future interventions should include higher levels of engagement and address more diverse patient safety outcomes relevant for primary care.

  @article{pang2025patient,
  abstract = {BACKGROUND: Engaging patients and families have been promoted as a key strategy for improving patient safety of health systems. However, evidence remains scarce on the effectiveness of this approach in primary care. AIM: To assess the combined effectiveness of primary care interventions in randomised controlled trials (RCTs) promoting patient and family engagement in patient safety. DESIGN AND SETTING: Systematic review and meta-analysis. METHODS: The review followed PRISMA and Cochrane guidelines. Five electronic databases (MEDLINE, CINAHL, Embase, Web of Science, CENTRAL) were searched from inception to 18 September 2024 with keywords in four blocks (patient and family engagement; patient safety; primary care; randomised controlled trial). Patient and family engagement levels were appraised. Where feasible and advisable, results were combined into meta-analyses. RESULTS: Of the 19 included records, 12 reported on completed RCTs. Only one intervention integrated patients/families into overall care safety (high engagement); six aimed at enhancing skills and tools (intermediate), and 12 infirmed patients/families how to engage and prompted them to do it (low). RCTs primarily targeted medication safety, with meta-analyses showing no significant effects on reducing adverse drug events (OR=0.83, 95%CI [0.70,1.08]) or improving medication appropriateness measured categorically (OR=0.92, 95%CI [0.76,1.13]) or continuously (MD=0.71, 95%CI [-0.10,1.52]). Overall risk of bias was low and certainty of evidence very low to moderate. CONCLUSION: Existing randomised controlled evidence on patient and family engagement in primary care remains inconclusive and limited in scope. Future interventions should include higher levels of engagement and address more diverse patient safety outcomes relevant for primary care.},
  address = {England},
  author = {Pang, Yan and Szuecs, Anna and Ricci-Cabello, Ignacio and Gangannagaripalli, Jaheeda and Goh, Lay Hoon and Leong, Foon Leng and Zhou, Li Fan and Valderas, Jose Maria},
  journal = {The British journal of general practice : the journal of the Royal College of General Practitioners},
  keywords = {evisap},
  month = {may},
  pages = {BJGP.2024.0369--},
  title = {Patient and family engagement interventions in primary care patient safety: systematic review and meta-analysis of randomised controlled trials},
  year = 2025
  }
  

  %0 Journal Article
  %1 pang2025patient
  %A Pang, Yan
  %A Szuecs, Anna
  %A Ricci-Cabello, Ignacio
  %A Gangannagaripalli, Jaheeda
  %A Goh, Lay Hoon
  %A Leong, Foon Leng
  %A Zhou, Li Fan
  %A Valderas, Jose Maria
  %C England
  %D 2025
  %J The British journal of general practice : the journal of the Royal College of General Practitioners
  %P BJGP.2024.0369--
  %R 10.3399/BJGP.2024.0369
  %T Patient and family engagement interventions in primary care patient safety: systematic review and meta-analysis of randomised controlled trials
  %U https://pubmed.ncbi.nlm.nih.gov/40355248
  %X BACKGROUND: Engaging patients and families have been promoted as a key strategy for improving patient safety of health systems. However, evidence remains scarce on the effectiveness of this approach in primary care. AIM: To assess the combined effectiveness of primary care interventions in randomised controlled trials (RCTs) promoting patient and family engagement in patient safety. DESIGN AND SETTING: Systematic review and meta-analysis. METHODS: The review followed PRISMA and Cochrane guidelines. Five electronic databases (MEDLINE, CINAHL, Embase, Web of Science, CENTRAL) were searched from inception to 18 September 2024 with keywords in four blocks (patient and family engagement; patient safety; primary care; randomised controlled trial). Patient and family engagement levels were appraised. Where feasible and advisable, results were combined into meta-analyses. RESULTS: Of the 19 included records, 12 reported on completed RCTs. Only one intervention integrated patients/families into overall care safety (high engagement); six aimed at enhancing skills and tools (intermediate), and 12 infirmed patients/families how to engage and prompted them to do it (low). RCTs primarily targeted medication safety, with meta-analyses showing no significant effects on reducing adverse drug events (OR=0.83, 95%CI [0.70,1.08]) or improving medication appropriateness measured categorically (OR=0.92, 95%CI [0.76,1.13]) or continuously (MD=0.71, 95%CI [-0.10,1.52]). Overall risk of bias was low and certainty of evidence very low to moderate. CONCLUSION: Existing randomised controlled evidence on patient and family engagement in primary care remains inconclusive and limited in scope. Future interventions should include higher levels of engagement and address more diverse patient safety outcomes relevant for primary care.
  

• 
  1.

  Obrador de Hevia J, López-González Ángel A, Ramírez-Manent JI, Paublini H, Tárraga López PJ, Martorell Sánchez C, Riutord-Sbert P. Association Between Alcohol Consumption, Other Healthy Habits and Sociodemographic Variables and the Values of Different Insulin Resistance Risk Scales in 139,634 Spanish Workers. Healthcare (Basel, Switzerland) [Internet]. Switzerland; 2025 Apr.;13(8):921. https://pubmed.ncbi.nlm.nih.gov/40281870

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Background: Alcohol consumption is a major public health concern, influencing metabolic health and insulin resistance (IR). While moderate alcohol intake has been associated with potential metabolic benefits, excessive consumption is linked to IR and related disorders. This study examines the association between sociodemographic variables, health habits, and IR risk using validated metabolic indices. Methods: A dual-phase study was conducted, including a cross-sectional analysis of 139,634 Spanish workers and a retrospective longitudinal follow-up of 40,431 participants (2009-2019). Data on sociodemographic factors (age, sex and socioeconomic status) and health habits (smoking, alcohol consumption, diet and physical activity) were collected through standardized occupational health assessments. IR risk was assessed using the Triglyceride-Glucose Index (TyG), Metabolic Score for Insulin Resistance (METS-IR), and Single-Point Insulin Sensitivity Estimator (SPISE-IR). Binary logistic regression was used for statistical analysis. Results: Age, male sex, lower socioeconomic status, smoking, alcohol consumption, physical inactivity and low adherence to the Mediterranean diet were significantly associated with higher IR risk across all indices (p < 0.001). Alcohol consumption exhibited a dose-dependent relationship with IR, with excessive intake significantly increasing the risk of IR. Longitudinal data revealed a worsening IR profile over time, particularly among older, low-income and physically inactive individuals. Conclusions: Sociodemographic factors and lifestyle habits strongly influence IR. Preventive strategies focused on reducing alcohol consumption, smoking cessation and promoting physical activity and dietary improvements are essential to mitigate the risk of IR, especially in vulnerable populations. Further longitudinal studies are needed to establish causal relationships and refine intervention strategies.

  @article{obradordehevia2025association,
  abstract = {Background: Alcohol consumption is a major public health concern, influencing metabolic health and insulin resistance (IR). While moderate alcohol intake has been associated with potential metabolic benefits, excessive consumption is linked to IR and related disorders. This study examines the association between sociodemographic variables, health habits, and IR risk using validated metabolic indices. Methods: A dual-phase study was conducted, including a cross-sectional analysis of 139,634 Spanish workers and a retrospective longitudinal follow-up of 40,431 participants (2009-2019). Data on sociodemographic factors (age, sex and socioeconomic status) and health habits (smoking, alcohol consumption, diet and physical activity) were collected through standardized occupational health assessments. IR risk was assessed using the Triglyceride-Glucose Index (TyG), Metabolic Score for Insulin Resistance (METS-IR), and Single-Point Insulin Sensitivity Estimator (SPISE-IR). Binary logistic regression was used for statistical analysis. Results: Age, male sex, lower socioeconomic status, smoking, alcohol consumption, physical inactivity and low adherence to the Mediterranean diet were significantly associated with higher IR risk across all indices (p < 0.001). Alcohol consumption exhibited a dose-dependent relationship with IR, with excessive intake significantly increasing the risk of IR. Longitudinal data revealed a worsening IR profile over time, particularly among older, low-income and physically inactive individuals. Conclusions: Sociodemographic factors and lifestyle habits strongly influence IR. Preventive strategies focused on reducing alcohol consumption, smoking cessation and promoting physical activity and dietary improvements are essential to mitigate the risk of IR, especially in vulnerable populations. Further longitudinal studies are needed to establish causal relationships and refine intervention strategies.},
  address = {Switzerland},
  author = {Obrador de Hevia, Joan and López-González, Ángel Arturo and Ramírez-Manent, José Ignacio and Paublini, Hernán and Tárraga López, Pedro Juan and Martorell Sánchez, Cristina and Riutord-Sbert, Pere},
  journal = {Healthcare (Basel, Switzerland)},
  keywords = {grapp-caib},
  month = {apr},
  number = 8,
  pages = 921,
  title = {Association Between Alcohol Consumption, Other Healthy Habits and Sociodemographic Variables and the Values of Different Insulin Resistance Risk Scales in 139,634 Spanish Workers},
  volume = 13,
  year = 2025
  }
  

  %0 Journal Article
  %1 obradordehevia2025association
  %A Obrador de Hevia, Joan
  %A López-González, Ángel Arturo
  %A Ramírez-Manent, José Ignacio
  %A Paublini, Hernán
  %A Tárraga López, Pedro Juan
  %A Martorell Sánchez, Cristina
  %A Riutord-Sbert, Pere
  %C Switzerland
  %D 2025
  %J Healthcare (Basel, Switzerland)
  %N 8
  %P 921
  %R 10.3390/healthcare13080921
  %T Association Between Alcohol Consumption, Other Healthy Habits and Sociodemographic Variables and the Values of Different Insulin Resistance Risk Scales in 139,634 Spanish Workers
  %U https://pubmed.ncbi.nlm.nih.gov/40281870
  %V 13
  %X Background: Alcohol consumption is a major public health concern, influencing metabolic health and insulin resistance (IR). While moderate alcohol intake has been associated with potential metabolic benefits, excessive consumption is linked to IR and related disorders. This study examines the association between sociodemographic variables, health habits, and IR risk using validated metabolic indices. Methods: A dual-phase study was conducted, including a cross-sectional analysis of 139,634 Spanish workers and a retrospective longitudinal follow-up of 40,431 participants (2009-2019). Data on sociodemographic factors (age, sex and socioeconomic status) and health habits (smoking, alcohol consumption, diet and physical activity) were collected through standardized occupational health assessments. IR risk was assessed using the Triglyceride-Glucose Index (TyG), Metabolic Score for Insulin Resistance (METS-IR), and Single-Point Insulin Sensitivity Estimator (SPISE-IR). Binary logistic regression was used for statistical analysis. Results: Age, male sex, lower socioeconomic status, smoking, alcohol consumption, physical inactivity and low adherence to the Mediterranean diet were significantly associated with higher IR risk across all indices (p < 0.001). Alcohol consumption exhibited a dose-dependent relationship with IR, with excessive intake significantly increasing the risk of IR. Longitudinal data revealed a worsening IR profile over time, particularly among older, low-income and physically inactive individuals. Conclusions: Sociodemographic factors and lifestyle habits strongly influence IR. Preventive strategies focused on reducing alcohol consumption, smoking cessation and promoting physical activity and dietary improvements are essential to mitigate the risk of IR, especially in vulnerable populations. Further longitudinal studies are needed to establish causal relationships and refine intervention strategies.
  

• 
  1.

  Arregui-Gallego B, Orts-Cortés MI, Moreno-Casbas MT, Abad-Corpa E, Camacho-Bejarano R, Cidoncha-Moreno M Ángeles, Feria-Raposo I, Iruzubieta-Barragán J, Carmona M, Cristóbal-Domínguez E, Bernués-Caudillo L, Casado-Ramírez E, Recas-Martin A, Sánchez-López D, Company-Sancho MC, Rascón NL, Esteban-Sepúlveda S, Vidal-Thomàs MC, Alonso I, Muñoz-Jiménez D, Segura-Heras JV, Moncho J, Rich-Ruiz M. Factors modulating the impact of the COVID-19 pandemic on posttraumatic stress symptomatology of the Spanish healthcare workers: A cohort study. PLOS One [Internet]. 2025 Jun.;20(6):e0323777. https://pmc.ncbi.nlm.nih.gov/articles/PMC12169526/

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Introduction The COVID-19 pandemic generated a global health crisis that significantly impacted healthcare systems and professionals. Healthcare workers were exposed to high levels of psychological distress, including posttraumatic stress symptomatology (PTSS). Aim Analyse the evolution of PTSS among Spanish healthcare workers during the COVID-19 pandemic, and to identify associated factors. Method A multicenter prospective cohort study with a 12-month follow-up was conducted. PTSS was the primary outcome. Secondary variables included sociodemographic, occupational, psychological, and coping-related factors. Statistical analyses comprised bivariate comparisons and multivariate modelling, such as generalized linear models and linear mixed models. Results Of the 428 participants, 180 completed the 12-month follow-up. At baseline, changes in work posts, negative family-work relations, avoidant coping, burnout symptoms, and emotional intelligence were associated with PTSS levels. Linear mixed models showed a significant decrease in PTSS over the 12-month period, regardless of gender, age, household type, occupational role, contract type, job title, level of care or type of service (p \textless 0.001). The generalised linear model explained 25.5% of the variance in PTSS levels at baseline, highlighting the role of psychological and coping factors over sociodemographic or occupational characteristics. Conclusions This study highlights the need for early identification and intervention focused on psychological and coping mechanisms. Promoting emotional regulation, reducing burnout, and addressing maladaptive coping may help mitigate long-term psychological effects among healthcare workers during public health crises.

  @article{arregui-gallego_factors_2025,
  abstract = {Introduction The COVID-19 pandemic generated a global health crisis that significantly impacted healthcare systems and professionals. Healthcare workers were exposed to high levels of psychological distress, including posttraumatic stress symptomatology (PTSS). Aim Analyse the evolution of PTSS among Spanish healthcare workers during the COVID-19 pandemic, and to identify associated factors. Method A multicenter prospective cohort study with a 12-month follow-up was conducted. PTSS was the primary outcome. Secondary variables included sociodemographic, occupational, psychological, and coping-related factors. Statistical analyses comprised bivariate comparisons and multivariate modelling, such as generalized linear models and linear mixed models. Results Of the 428 participants, 180 completed the 12-month follow-up. At baseline, changes in work posts, negative family-work relations, avoidant coping, burnout symptoms, and emotional intelligence were associated with PTSS levels. Linear mixed models showed a significant decrease in PTSS over the 12-month period, regardless of gender, age, household type, occupational role, contract type, job title, level of care or type of service (p \textless 0.001). The generalised linear model explained 25.5% of the variance in PTSS levels at baseline, highlighting the role of psychological and coping factors over sociodemographic or occupational characteristics. Conclusions This study highlights the need for early identification and intervention focused on psychological and coping mechanisms. Promoting emotional regulation, reducing burnout, and addressing maladaptive coping may help mitigate long-term psychological effects among healthcare workers during public health crises.},
  author = {Arregui-Gallego, Beatriz and Orts-Cortés, María Isabel and Moreno-Casbas, María Teresa and Abad-Corpa, Eva and Camacho-Bejarano, Rafaela and Cidoncha-Moreno, Mª Ángeles and Feria-Raposo, Isabel and Iruzubieta-Barragán, Javier and Carmona, Montserrat and Cristóbal-Domínguez, Estíbaliz and Bernués-Caudillo, Leticia and Casado-Ramírez, Elvira and Recas-Martin, Alda and Sánchez-López, Dolores and Company-Sancho, M. Consuelo and Rascón, Noelia López and Esteban-Sepúlveda, Silvia and Vidal-Thomàs, María Clara and Alonso, Isabel and Muñoz-Jiménez, Daniel and Segura-Heras, José Vicente and Moncho, Joaquín and Rich-Ruiz, Manuel},
  journal = {PLOS One},
  keywords = {grapp-caib},
  month = {jun},
  number = 6,
  pages = {e0323777},
  title = {Factors modulating the impact of the COVID-19 pandemic on posttraumatic stress symptomatology of the Spanish healthcare workers: A cohort study},
  volume = 20,
  year = 2025
  }
  

  %0 Journal Article
  %1 arregui-gallego_factors_2025
  %A Arregui-Gallego, Beatriz
  %A Orts-Cortés, María Isabel
  %A Moreno-Casbas, María Teresa
  %A Abad-Corpa, Eva
  %A Camacho-Bejarano, Rafaela
  %A Cidoncha-Moreno, Mª Ángeles
  %A Feria-Raposo, Isabel
  %A Iruzubieta-Barragán, Javier
  %A Carmona, Montserrat
  %A Cristóbal-Domínguez, Estíbaliz
  %A Bernués-Caudillo, Leticia
  %A Casado-Ramírez, Elvira
  %A Recas-Martin, Alda
  %A Sánchez-López, Dolores
  %A Company-Sancho, M. Consuelo
  %A Rascón, Noelia López
  %A Esteban-Sepúlveda, Silvia
  %A Vidal-Thomàs, María Clara
  %A Alonso, Isabel
  %A Muñoz-Jiménez, Daniel
  %A Segura-Heras, José Vicente
  %A Moncho, Joaquín
  %A Rich-Ruiz, Manuel
  %D 2025
  %J PLOS One
  %N 6
  %P e0323777
  %R 10.1371/journal.pone.0323777
  %T Factors modulating the impact of the COVID-19 pandemic on posttraumatic stress symptomatology of the Spanish healthcare workers: A cohort study
  %U https://pmc.ncbi.nlm.nih.gov/articles/PMC12169526/
  %V 20
  %X Introduction The COVID-19 pandemic generated a global health crisis that significantly impacted healthcare systems and professionals. Healthcare workers were exposed to high levels of psychological distress, including posttraumatic stress symptomatology (PTSS). Aim Analyse the evolution of PTSS among Spanish healthcare workers during the COVID-19 pandemic, and to identify associated factors. Method A multicenter prospective cohort study with a 12-month follow-up was conducted. PTSS was the primary outcome. Secondary variables included sociodemographic, occupational, psychological, and coping-related factors. Statistical analyses comprised bivariate comparisons and multivariate modelling, such as generalized linear models and linear mixed models. Results Of the 428 participants, 180 completed the 12-month follow-up. At baseline, changes in work posts, negative family-work relations, avoidant coping, burnout symptoms, and emotional intelligence were associated with PTSS levels. Linear mixed models showed a significant decrease in PTSS over the 12-month period, regardless of gender, age, household type, occupational role, contract type, job title, level of care or type of service (p \textless 0.001). The generalised linear model explained 25.5% of the variance in PTSS levels at baseline, highlighting the role of psychological and coping factors over sociodemographic or occupational characteristics. Conclusions This study highlights the need for early identification and intervention focused on psychological and coping mechanisms. Promoting emotional regulation, reducing burnout, and addressing maladaptive coping may help mitigate long-term psychological effects among healthcare workers during public health crises.
  

• 
  1.

  García Samuelsson M, Tárraga López PJ, López-González Ángel A, Paublini H, Martínez-Almoyna Rifá E, Ramírez-Manent JI. Assessment of the Risk of Insulin Resistance in Workers Classified as Metabolically Healthy Obese. Nutrients [Internet]. Switzerland; 2025 Apr.;17(8):1345-. https://pubmed.ncbi.nlm.nih.gov/40284209

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Introduction and Objectives: Obesity constitutes a significant public health concern and is frequently linked to metabolic dysfunctions, particularly insulin resistance (IR). Nevertheless, a subset of obese individuals, referred to as metabolically healthy obese (MHO), do not exhibit overt metabolic abnormalities. The present study aims to assess the risk of developing IR among MHO workers and to explore the determinants contributing to this risk. Methods: This cross-sectional investigation utilized data from a cohort of 68,884 obese workers across multiple occupational sectors in Spain. The classification of participants as MHO was based on the number of metabolic syndrome components, in accordance with the criteria established by the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATPIII). Anthropometric, clinical, and biochemical parameters-including body mass index (BMI), waist circumference, lipid profile, glycemic levels, and blood pressure-were systematically assessed. The likelihood of developing IR was estimated through various validated risk assessment models. Results: The analysis indicates that, despite having a relatively favorable metabolic profile, individuals classified as MHO also show signs of metabolic deterioration, such as an increased risk of insulin resistance. Key risk factors such as physical inactivity, low adherence to the Mediterranean diet, and socioeconomic disparities were identified as significant contributors to the transition from the MHO phenotype to a metabolically unhealthy state. Logistic regression analyses corroborated that insufficient physical activity and suboptimal dietary habits were strongly associated with an elevated risk of IR. Conclusions: The findings underscore the dynamic and potentially transient nature of the MHO phenotype, emphasizing the necessity of proactive monitoring and early preventive strategies. Encouraging physical activity, promoting adherence to a nutritionally balanced diet, and implementing workplace health initiatives emerge as critical measures to attenuate the risk of IR and metabolic deterioration in MHO individuals. Future longitudinal studies are warranted to enhance risk stratification and to formulate tailored preventive interventions.

  @article{garciasamuelsson2025assessment,
  abstract = {Introduction and Objectives: Obesity constitutes a significant public health concern and is frequently linked to metabolic dysfunctions, particularly insulin resistance (IR). Nevertheless, a subset of obese individuals, referred to as metabolically healthy obese (MHO), do not exhibit overt metabolic abnormalities. The present study aims to assess the risk of developing IR among MHO workers and to explore the determinants contributing to this risk. Methods: This cross-sectional investigation utilized data from a cohort of 68,884 obese workers across multiple occupational sectors in Spain. The classification of participants as MHO was based on the number of metabolic syndrome components, in accordance with the criteria established by the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATPIII). Anthropometric, clinical, and biochemical parameters-including body mass index (BMI), waist circumference, lipid profile, glycemic levels, and blood pressure-were systematically assessed. The likelihood of developing IR was estimated through various validated risk assessment models. Results: The analysis indicates that, despite having a relatively favorable metabolic profile, individuals classified as MHO also show signs of metabolic deterioration, such as an increased risk of insulin resistance. Key risk factors such as physical inactivity, low adherence to the Mediterranean diet, and socioeconomic disparities were identified as significant contributors to the transition from the MHO phenotype to a metabolically unhealthy state. Logistic regression analyses corroborated that insufficient physical activity and suboptimal dietary habits were strongly associated with an elevated risk of IR. Conclusions: The findings underscore the dynamic and potentially transient nature of the MHO phenotype, emphasizing the necessity of proactive monitoring and early preventive strategies. Encouraging physical activity, promoting adherence to a nutritionally balanced diet, and implementing workplace health initiatives emerge as critical measures to attenuate the risk of IR and metabolic deterioration in MHO individuals. Future longitudinal studies are warranted to enhance risk stratification and to formulate tailored preventive interventions.},
  address = {Switzerland},
  author = {García Samuelsson, Miguel and Tárraga López, Pedro Juan and López-González, Ángel Arturo and Paublini, Hernán and Martínez-Almoyna Rifá, Emilio and Ramírez-Manent, José Ignacio},
  journal = {Nutrients},
  keywords = {grapp-caib},
  month = {apr},
  number = 8,
  pages = {1345--},
  title = {Assessment of the Risk of Insulin Resistance in Workers Classified as Metabolically Healthy Obese},
  volume = 17,
  year = 2025
  }
  

  %0 Journal Article
  %1 garciasamuelsson2025assessment
  %A García Samuelsson, Miguel
  %A Tárraga López, Pedro Juan
  %A López-González, Ángel Arturo
  %A Paublini, Hernán
  %A Martínez-Almoyna Rifá, Emilio
  %A Ramírez-Manent, José Ignacio
  %C Switzerland
  %D 2025
  %J Nutrients
  %N 8
  %P 1345--
  %R 10.3390/nu17081345
  %T Assessment of the Risk of Insulin Resistance in Workers Classified as Metabolically Healthy Obese
  %U https://pubmed.ncbi.nlm.nih.gov/40284209
  %V 17
  %X Introduction and Objectives: Obesity constitutes a significant public health concern and is frequently linked to metabolic dysfunctions, particularly insulin resistance (IR). Nevertheless, a subset of obese individuals, referred to as metabolically healthy obese (MHO), do not exhibit overt metabolic abnormalities. The present study aims to assess the risk of developing IR among MHO workers and to explore the determinants contributing to this risk. Methods: This cross-sectional investigation utilized data from a cohort of 68,884 obese workers across multiple occupational sectors in Spain. The classification of participants as MHO was based on the number of metabolic syndrome components, in accordance with the criteria established by the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATPIII). Anthropometric, clinical, and biochemical parameters-including body mass index (BMI), waist circumference, lipid profile, glycemic levels, and blood pressure-were systematically assessed. The likelihood of developing IR was estimated through various validated risk assessment models. Results: The analysis indicates that, despite having a relatively favorable metabolic profile, individuals classified as MHO also show signs of metabolic deterioration, such as an increased risk of insulin resistance. Key risk factors such as physical inactivity, low adherence to the Mediterranean diet, and socioeconomic disparities were identified as significant contributors to the transition from the MHO phenotype to a metabolically unhealthy state. Logistic regression analyses corroborated that insufficient physical activity and suboptimal dietary habits were strongly associated with an elevated risk of IR. Conclusions: The findings underscore the dynamic and potentially transient nature of the MHO phenotype, emphasizing the necessity of proactive monitoring and early preventive strategies. Encouraging physical activity, promoting adherence to a nutritionally balanced diet, and implementing workplace health initiatives emerge as critical measures to attenuate the risk of IR and metabolic deterioration in MHO individuals. Future longitudinal studies are warranted to enhance risk stratification and to formulate tailored preventive interventions.
  

• 
  1.

  Serrano-Ripoll MJ, Zamanillo-Campos R, Mira Martínez S, Fiol deRoque MA, Malih N, Angullo-Martínez E, Ricci-Cabello I. Engaging Primary Care Professionals and People at Risk of Type 2 Diabetes in the Design of PREDIABETEXT, a Multifaceted Digital Intervention Aimed at Preventing Type 2 Diabetes: A Qualitative Study. Diabetology. 2025;6.

  AbstractBibTeXEndNoteBibSonomyDownload

  Objectives: This study aims to explore perspectives and opinions from healthcare professionals and people at risk of type 2 diabetes mellitus (T2DM) to inform the design of PREDIABETEXT, a new digital multifaceted intervention to prevent T2DM. Methods: in this qualitative study, we purposefully recruited 15 healthcare professionals (doctors and nurses) working in primary healthcare centers in Mallorca (Spain), and 15 of their patients at risk of T2DM (HbA1c 6–6.4%, and/or fasting plasma glucose 110–125 mg/dL). We collected the data through semi-structured phone interviews, using an interview guide aimed at gathering participants’ views about the two PREDIABETEXT proposed co-interventions (educational intervention targeted at professionals and delivered as an online training course, and behavioral intervention targeted at individuals at risk of T2DM and delivered using SMS short text messages). The interviews were audio-recorded, verbatim transcribed, and analyzed using a thematic analysis approach. Results: Primary healthcare professionals valued a prediabetes training course for standardizing care and supporting diabetes prevention. They preferred a blended format with content on early detection, intervention, and monitoring. They perceived SMS reminders to their patients as potentially useful for reinforcing guidelines and improving care. Individuals at risk of T2DM, who faced challenges maintaining a healthy diet and exercise routine, viewed SMS as potentially motivational and informative, offering suggestions on content, format, and frequency to enhance its intended benefits. Conclusions: This qualitative study provided valuable insights from primary care professionals and people at risk of T2DM that will inform the user-centered design of the PREDIABETEXT intervention.

  @article{serranoripoll2025engaging,
  abstract = {Objectives: This study aims to explore perspectives and opinions from healthcare professionals and people at risk of type 2 diabetes mellitus (T2DM) to inform the design of PREDIABETEXT, a new digital multifaceted intervention to prevent T2DM. Methods: in this qualitative study, we purposefully recruited 15 healthcare professionals (doctors and nurses) working in primary healthcare centers in Mallorca (Spain), and 15 of their patients at risk of T2DM (HbA1c 6–6.4%, and/or fasting plasma glucose 110–125 mg/dL). We collected the data through semi-structured phone interviews, using an interview guide aimed at gathering participants’ views about the two PREDIABETEXT proposed co-interventions (educational intervention targeted at professionals and delivered as an online training course, and behavioral intervention targeted at individuals at risk of T2DM and delivered using SMS short text messages). The interviews were audio-recorded, verbatim transcribed, and analyzed using a thematic analysis approach. Results: Primary healthcare professionals valued a prediabetes training course for standardizing care and supporting diabetes prevention. They preferred a blended format with content on early detection, intervention, and monitoring. They perceived SMS reminders to their patients as potentially useful for reinforcing guidelines and improving care. Individuals at risk of T2DM, who faced challenges maintaining a healthy diet and exercise routine, viewed SMS as potentially motivational and informative, offering suggestions on content, format, and frequency to enhance its intended benefits. Conclusions: This qualitative study provided valuable insights from primary care professionals and people at risk of T2DM that will inform the user-centered design of the PREDIABETEXT intervention.},
  author = {Serrano-Ripoll, Maria J. and Zamanillo-Campos, Rocío and Mira Martínez, Sofía and Fiol deRoque, Maria A. and Malih, Narges and Angullo-Martínez, Escarlata and Ricci-Cabello, Ignacio},
  booktitle = {Diabetology},
  keywords = {evisap grapp-caib},
  series = 1,
  title = {Engaging Primary Care Professionals and People at Risk of Type 2 Diabetes in the Design of PREDIABETEXT, a Multifaceted Digital Intervention Aimed at Preventing Type 2 Diabetes: A Qualitative Study},
  volume = 6,
  year = 2025
  }
  

  %0 Journal Article
  %1 serranoripoll2025engaging
  %A Serrano-Ripoll, Maria J.
  %A Zamanillo-Campos, Rocío
  %A Mira Martínez, Sofía
  %A Fiol deRoque, Maria A.
  %A Malih, Narges
  %A Angullo-Martínez, Escarlata
  %A Ricci-Cabello, Ignacio
  %B Diabetology
  %D 2025
  %T Engaging Primary Care Professionals and People at Risk of Type 2 Diabetes in the Design of PREDIABETEXT, a Multifaceted Digital Intervention Aimed at Preventing Type 2 Diabetes: A Qualitative Study
  %V 6
  %X Objectives: This study aims to explore perspectives and opinions from healthcare professionals and people at risk of type 2 diabetes mellitus (T2DM) to inform the design of PREDIABETEXT, a new digital multifaceted intervention to prevent T2DM. Methods: in this qualitative study, we purposefully recruited 15 healthcare professionals (doctors and nurses) working in primary healthcare centers in Mallorca (Spain), and 15 of their patients at risk of T2DM (HbA1c 6–6.4%, and/or fasting plasma glucose 110–125 mg/dL). We collected the data through semi-structured phone interviews, using an interview guide aimed at gathering participants’ views about the two PREDIABETEXT proposed co-interventions (educational intervention targeted at professionals and delivered as an online training course, and behavioral intervention targeted at individuals at risk of T2DM and delivered using SMS short text messages). The interviews were audio-recorded, verbatim transcribed, and analyzed using a thematic analysis approach. Results: Primary healthcare professionals valued a prediabetes training course for standardizing care and supporting diabetes prevention. They preferred a blended format with content on early detection, intervention, and monitoring. They perceived SMS reminders to their patients as potentially useful for reinforcing guidelines and improving care. Individuals at risk of T2DM, who faced challenges maintaining a healthy diet and exercise routine, viewed SMS as potentially motivational and informative, offering suggestions on content, format, and frequency to enhance its intended benefits. Conclusions: This qualitative study provided valuable insights from primary care professionals and people at risk of T2DM that will inform the user-centered design of the PREDIABETEXT intervention.
  

• 
  1.

  Mira-Martínez S, Zamanillo-Campos R, Malih N, Fiol deRoque MA, Angullo-Martínez E, Jimenez R, Serrano-Ripoll MJ, Leiva A, Oña JI, Galmes-Panades AM, Bennasar-Veny M, Yañez AM, Gómez-Juanes R, Konieczna J, Miralles J, Romaguera D, Vidal-Thomasa MC, Llobera-Canaves J, García-Toro M, Gervilla-García E, Vicens C, Bulilete O, Montaño JJ, Gili M, Roca M, Colom A, Ricci-Cabello I. Describing the initial results of a pragmatic, cluster randomized clinical trial to examine the impact of a multifaceted digital intervention for the prevention of type 2 diabetes mellitus in the primary care setting: intervention design, recruitment strategy and participants’ baseline characteristics of the PREDIABETEXT trial. Frontiers in endocrinology [Internet]. Switzerland; 2025 Mar.;16:1524336-. https://pubmed.ncbi.nlm.nih.gov/40230484

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  INTRODUCTION: i) to describe PREDIABETEXT, a novel digital intervention for the prevention of type 2 diabetes; ii) to examine the performance of a strategy for virtual recruitment of participants in a trial to assess its impact, and; iii) to determine the baseline characteristics of the enrolled participants. METHODS: We developed PREDIABETEXT in a multistage process involving systematic literature reviews and qualitative research with end users (primary care patients and professionals). We combined multiple virtual strategies (SMS, phone calls, promotional videos) to recruit healthcare professionals and their patients. We collected baseline data from patients (sociodemographic, behavioral and clinical) and healthcare professionals (sociodemographic and professional experience). RESULTS: The intervention consisted in delivering personalized short text messages supporting lifestyle behavior changes to people at risk of type 2 diabetes; and online training to their primary healthcare professionals. We recruited 58/133 (43.6%) professionals (30 doctors; 28 nurses) from 16 centers. Most professionals (83%) were women [mean (SD) age 49.69 (10.15)]. We recruited 365/976 (37.4%) patients (54.5% women, 59.82 (9.77) years old. Around half (55.3%) presented obesity (BMI ≥25), 65% hypertension, 43.3% hypercholesterolemia, and 14.8% hypertriglyceridemia. CONCLUSIONS: The PREDIABETEX trial successfully recruited a representative sample of patients at risk of type 2 diabetes and their healthcare providers.

  @article{miramartinez2025describing,
  abstract = {INTRODUCTION: i) to describe PREDIABETEXT, a novel digital intervention for the prevention of type 2 diabetes; ii) to examine the performance of a strategy for virtual recruitment of participants in a trial to assess its impact, and; iii) to determine the baseline characteristics of the enrolled participants. METHODS: We developed PREDIABETEXT in a multistage process involving systematic literature reviews and qualitative research with end users (primary care patients and professionals). We combined multiple virtual strategies (SMS, phone calls, promotional videos) to recruit healthcare professionals and their patients. We collected baseline data from patients (sociodemographic, behavioral and clinical) and healthcare professionals (sociodemographic and professional experience). RESULTS: The intervention consisted in delivering personalized short text messages supporting lifestyle behavior changes to people at risk of type 2 diabetes; and online training to their primary healthcare professionals. We recruited 58/133 (43.6%) professionals (30 doctors; 28 nurses) from 16 centers. Most professionals (83%) were women [mean (SD) age 49.69 (10.15)]. We recruited 365/976 (37.4%) patients (54.5% women, 59.82 (9.77) years old. Around half (55.3%) presented obesity (BMI ≥25), 65% hypertension, 43.3% hypercholesterolemia, and 14.8% hypertriglyceridemia. CONCLUSIONS: The PREDIABETEX trial successfully recruited a representative sample of patients at risk of type 2 diabetes and their healthcare providers.},
  address = {Switzerland},
  author = {Mira-Martínez, Sofía and Zamanillo-Campos, Rocío and Malih, Narges and Fiol deRoque, Maria Antonia and Angullo-Martínez, Escarlata and Jimenez, Rafael and Serrano-Ripoll, Maria Jesús and Leiva, Alfonso and Oña, José Iván and Galmes-Panades, Aina M and Bennasar-Veny, Miquel and Yañez, Aina Maria and Gómez-Juanes, Rocío and Konieczna, Jadwiga and Miralles, Jerónima and Romaguera, Dora and Vidal-Thomasa, María Clara and Llobera-Canaves, Joan and García-Toro, Mauro and Gervilla-García, Elena and Vicens, Catalina and Bulilete, Oana and Montaño, Juan José and Gili, Margalida and Roca, Miquel and Colom, Antoni and Ricci-Cabello, Ignacio},
  journal = {Frontiers in endocrinology},
  keywords = {evisap grapp-caib},
  month = {mar},
  pages = {1524336--1524336},
  title = {Describing the initial results of a pragmatic, cluster randomized clinical trial to examine the impact of a multifaceted digital intervention for the prevention of type 2 diabetes mellitus in the primary care setting: intervention design, recruitment strategy and participants' baseline characteristics of the PREDIABETEXT trial},
  volume = 16,
  year = 2025
  }
  

  %0 Journal Article
  %1 miramartinez2025describing
  %A Mira-Martínez, Sofía
  %A Zamanillo-Campos, Rocío
  %A Malih, Narges
  %A Fiol deRoque, Maria Antonia
  %A Angullo-Martínez, Escarlata
  %A Jimenez, Rafael
  %A Serrano-Ripoll, Maria Jesús
  %A Leiva, Alfonso
  %A Oña, José Iván
  %A Galmes-Panades, Aina M
  %A Bennasar-Veny, Miquel
  %A Yañez, Aina Maria
  %A Gómez-Juanes, Rocío
  %A Konieczna, Jadwiga
  %A Miralles, Jerónima
  %A Romaguera, Dora
  %A Vidal-Thomasa, María Clara
  %A Llobera-Canaves, Joan
  %A García-Toro, Mauro
  %A Gervilla-García, Elena
  %A Vicens, Catalina
  %A Bulilete, Oana
  %A Montaño, Juan José
  %A Gili, Margalida
  %A Roca, Miquel
  %A Colom, Antoni
  %A Ricci-Cabello, Ignacio
  %C Switzerland
  %D 2025
  %J Frontiers in endocrinology
  %P 1524336--1524336
  %R 10.3389/fendo.2025.1524336
  %T Describing the initial results of a pragmatic, cluster randomized clinical trial to examine the impact of a multifaceted digital intervention for the prevention of type 2 diabetes mellitus in the primary care setting: intervention design, recruitment strategy and participants' baseline characteristics of the PREDIABETEXT trial
  %U https://pubmed.ncbi.nlm.nih.gov/40230484
  %V 16
  %X INTRODUCTION: i) to describe PREDIABETEXT, a novel digital intervention for the prevention of type 2 diabetes; ii) to examine the performance of a strategy for virtual recruitment of participants in a trial to assess its impact, and; iii) to determine the baseline characteristics of the enrolled participants. METHODS: We developed PREDIABETEXT in a multistage process involving systematic literature reviews and qualitative research with end users (primary care patients and professionals). We combined multiple virtual strategies (SMS, phone calls, promotional videos) to recruit healthcare professionals and their patients. We collected baseline data from patients (sociodemographic, behavioral and clinical) and healthcare professionals (sociodemographic and professional experience). RESULTS: The intervention consisted in delivering personalized short text messages supporting lifestyle behavior changes to people at risk of type 2 diabetes; and online training to their primary healthcare professionals. We recruited 58/133 (43.6%) professionals (30 doctors; 28 nurses) from 16 centers. Most professionals (83%) were women [mean (SD) age 49.69 (10.15)]. We recruited 365/976 (37.4%) patients (54.5% women, 59.82 (9.77) years old. Around half (55.3%) presented obesity (BMI ≥25), 65% hypertension, 43.3% hypercholesterolemia, and 14.8% hypertriglyceridemia. CONCLUSIONS: The PREDIABETEX trial successfully recruited a representative sample of patients at risk of type 2 diabetes and their healthcare providers.
  

• 
  1.

  Fiol deRoque MA, Valderas JM, Serrano-Ripoll MJ, Gens-Barbarà M, Martín-Luján F, Sánchez-Freire E, Montaño JJ, Mira-Martínez S, Pastor-Moreno G, Zamanillo-Campos R, Riera-Serra P, Ricci-Cabello I. Evaluating SinergiAPS, an intervention based on patient feedback to improve patient safety in primary care: a cluster randomized trial. BMC medicine [Internet]. England; 2025 Apr.;23(1):202-. https://pubmed.ncbi.nlm.nih.gov/40189506

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  BACKGROUND: Patient safety, defined by the WHO as the absence of preventable harm, is a critical component of healthcare quality and poses a significant challenge globally. This study aimed to evaluate the effectiveness of SinergiAPS, a patient-centred audit and feedback intervention, in improving patient safety in primary healthcare (PHC) centres. METHODS: We conducted a 12-month cluster randomized controlled, multicentre trial. Fifty-nine PHC centres (1053 PHC professionals) in Spain were recruited and randomly allocated (1:1) to usual care or SinergiAPS intervention. The SinergiAPS intervention comprised: a bespoke feedback report with results from audits of patient safety based on the Patient Reported Experiences and Outcomes of Safety in Primary Care (PREOS-PC) questionnaire, administered to 75 patients/centre; a set of educational materials, and a structured template to record safety improvement plans. The primary outcome (at the PHC professional level) was patient safety culture (Medical Office Survey on Patient Safety Culture (MOSPSC) questionnaire). Secondary outcomes (at the centre level) were patient-reported safety (six PREOS-PC scales), and rate of avoidable hospital admissions. After a 12-month follow-up, we conducted 15 semi-structured interviews with PHC professionals to explore their perceptions of the intervention. RESULTS: During the 12-month follow-up, 10 of the 30 centres in the intervention group held action plan team meetings and eight registered 57 safety improvement action plans. The plans aimed to improve patient activation, address treatment-related incidents, enhance communication between patients and providers, and strengthen patient safety culture. At 12 months, no significant differences were observed in MOSPSC mean score (intervention: 3.60 [95% CI 3.55 to 3.64] vs. control: 3.64 [3.60 to 3.68]). Similarly, no differences were observed in the secondary outcomes, with both groups experiencing a decline in patient-reported safety and avoidable hospital admissions. The qualitative interviews evidenced that the onset of the COVID-19 pandemic 6-9 weeks after initiating the follow-up period severely limited PHC's capacity of developing and implementing safety improvement action plans, despite high levels of acceptability and perceived utility of the SinergiAPS intervention. CONCLUSIONS: In the context of the health emergency caused by the COVID-19 pandemic, SinergiAPS did not improve patient safety in Spanish PHC centres. TRIAL REGISTRATION: ClinicalTrials.gov (NCT03837912).

  @article{fiolderoque2025evaluating,
  abstract = {BACKGROUND: Patient safety, defined by the WHO as the absence of preventable harm, is a critical component of healthcare quality and poses a significant challenge globally. This study aimed to evaluate the effectiveness of SinergiAPS, a patient-centred audit and feedback intervention, in improving patient safety in primary healthcare (PHC) centres. METHODS: We conducted a 12-month cluster randomized controlled, multicentre trial. Fifty-nine PHC centres (1053 PHC professionals) in Spain were recruited and randomly allocated (1:1) to usual care or SinergiAPS intervention. The SinergiAPS intervention comprised: a bespoke feedback report with results from audits of patient safety based on the Patient Reported Experiences and Outcomes of Safety in Primary Care (PREOS-PC) questionnaire, administered to 75 patients/centre; a set of educational materials, and a structured template to record safety improvement plans. The primary outcome (at the PHC professional level) was patient safety culture (Medical Office Survey on Patient Safety Culture (MOSPSC) questionnaire). Secondary outcomes (at the centre level) were patient-reported safety (six PREOS-PC scales), and rate of avoidable hospital admissions. After a 12-month follow-up, we conducted 15 semi-structured interviews with PHC professionals to explore their perceptions of the intervention. RESULTS: During the 12-month follow-up, 10 of the 30 centres in the intervention group held action plan team meetings and eight registered 57 safety improvement action plans. The plans aimed to improve patient activation, address treatment-related incidents, enhance communication between patients and providers, and strengthen patient safety culture. At 12 months, no significant differences were observed in MOSPSC mean score (intervention: 3.60 [95% CI 3.55 to 3.64] vs. control: 3.64 [3.60 to 3.68]). Similarly, no differences were observed in the secondary outcomes, with both groups experiencing a decline in patient-reported safety and avoidable hospital admissions. The qualitative interviews evidenced that the onset of the COVID-19 pandemic 6-9 weeks after initiating the follow-up period severely limited PHC's capacity of developing and implementing safety improvement action plans, despite high levels of acceptability and perceived utility of the SinergiAPS intervention. CONCLUSIONS: In the context of the health emergency caused by the COVID-19 pandemic, SinergiAPS did not improve patient safety in Spanish PHC centres. TRIAL REGISTRATION: ClinicalTrials.gov (NCT03837912).},
  address = {England},
  author = {Fiol deRoque, Maria Antònia and Valderas, José María and Serrano-Ripoll, María Jesús and Gens-Barbarà, Montserrat and Martín-Luján, Francisco and Sánchez-Freire, Encarna and Montaño, Juan José and Mira-Martínez, Sofía and Pastor-Moreno, Guadalupe and Zamanillo-Campos, Rocío and Riera-Serra, Pau and Ricci-Cabello, Ignacio},
  journal = {BMC medicine},
  keywords = {evisap grapp-caib},
  month = {apr},
  number = 1,
  pages = {202--202},
  title = {Evaluating SinergiAPS, an intervention based on patient feedback to improve patient safety in primary care: a cluster randomized trial},
  volume = 23,
  year = 2025
  }
  

  %0 Journal Article
  %1 fiolderoque2025evaluating
  %A Fiol deRoque, Maria Antònia
  %A Valderas, José María
  %A Serrano-Ripoll, María Jesús
  %A Gens-Barbarà, Montserrat
  %A Martín-Luján, Francisco
  %A Sánchez-Freire, Encarna
  %A Montaño, Juan José
  %A Mira-Martínez, Sofía
  %A Pastor-Moreno, Guadalupe
  %A Zamanillo-Campos, Rocío
  %A Riera-Serra, Pau
  %A Ricci-Cabello, Ignacio
  %C England
  %D 2025
  %J BMC medicine
  %N 1
  %P 202--202
  %R 10.1186/s12916-025-04029-7
  %T Evaluating SinergiAPS, an intervention based on patient feedback to improve patient safety in primary care: a cluster randomized trial
  %U https://pubmed.ncbi.nlm.nih.gov/40189506
  %V 23
  %X BACKGROUND: Patient safety, defined by the WHO as the absence of preventable harm, is a critical component of healthcare quality and poses a significant challenge globally. This study aimed to evaluate the effectiveness of SinergiAPS, a patient-centred audit and feedback intervention, in improving patient safety in primary healthcare (PHC) centres. METHODS: We conducted a 12-month cluster randomized controlled, multicentre trial. Fifty-nine PHC centres (1053 PHC professionals) in Spain were recruited and randomly allocated (1:1) to usual care or SinergiAPS intervention. The SinergiAPS intervention comprised: a bespoke feedback report with results from audits of patient safety based on the Patient Reported Experiences and Outcomes of Safety in Primary Care (PREOS-PC) questionnaire, administered to 75 patients/centre; a set of educational materials, and a structured template to record safety improvement plans. The primary outcome (at the PHC professional level) was patient safety culture (Medical Office Survey on Patient Safety Culture (MOSPSC) questionnaire). Secondary outcomes (at the centre level) were patient-reported safety (six PREOS-PC scales), and rate of avoidable hospital admissions. After a 12-month follow-up, we conducted 15 semi-structured interviews with PHC professionals to explore their perceptions of the intervention. RESULTS: During the 12-month follow-up, 10 of the 30 centres in the intervention group held action plan team meetings and eight registered 57 safety improvement action plans. The plans aimed to improve patient activation, address treatment-related incidents, enhance communication between patients and providers, and strengthen patient safety culture. At 12 months, no significant differences were observed in MOSPSC mean score (intervention: 3.60 [95% CI 3.55 to 3.64] vs. control: 3.64 [3.60 to 3.68]). Similarly, no differences were observed in the secondary outcomes, with both groups experiencing a decline in patient-reported safety and avoidable hospital admissions. The qualitative interviews evidenced that the onset of the COVID-19 pandemic 6-9 weeks after initiating the follow-up period severely limited PHC's capacity of developing and implementing safety improvement action plans, despite high levels of acceptability and perceived utility of the SinergiAPS intervention. CONCLUSIONS: In the context of the health emergency caused by the COVID-19 pandemic, SinergiAPS did not improve patient safety in Spanish PHC centres. TRIAL REGISTRATION: ClinicalTrials.gov (NCT03837912).
  

• 
  1.

  Martínez-Almoyna Rifá E, López González Ángel A, Tárraga López PJ, Paublini H, Vallejos D, Ramírez Manent JI. Relationship between diabesity and elevated values of metabolic-associated steatotic liver disease risk scales in Spanish workers using body mass index and the body adiposity estimator criteria of Clínica de Navarra. Nutricion hospitalaria [Internet]. Spain; 2025 Mar.;:10.20960/nh.05441-. https://pubmed.ncbi.nlm.nih.gov/40195779

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  INTRODUCTION: diabesity (coexistence of diabetes and obesity) and metabolic associated steatotic liver disease (MASLD) are two very frequent pathologies whose prevalence is increasing every day. OBJECTIVE: to find out how these two pathological entities are associated in a group of Spanish workers. METHODOLOGY: a descriptive, cross-sectional study was carried out in 219477 workers to assess the association between diabesity (applying a double criterion, the body mass index BMI and the Clínica Universitaria de Navarra body adiposity estimator CUN BAE) and different risk scales for MASLD and liver fibrosis. RESULTS: all MASH and liver fibrosis risk scales show higher values in people with diabesity applying the two criteria compared to people without diabesity. CONCLUSION: diabesity and MASLD and liver fibrosis risk scales show a significant association in our study.

  @article{martinezalmoynarifa2025relationship,
  abstract = {INTRODUCTION: diabesity (coexistence of diabetes and obesity) and metabolic associated steatotic liver disease (MASLD) are two very frequent pathologies whose prevalence is increasing every day. OBJECTIVE: to find out how these two pathological entities are associated in a group of Spanish workers. METHODOLOGY: a descriptive, cross-sectional study was carried out in 219477 workers to assess the association between diabesity (applying a double criterion, the body mass index BMI and the Clínica Universitaria de Navarra body adiposity estimator CUN BAE) and different risk scales for MASLD and liver fibrosis. RESULTS: all MASH and liver fibrosis risk scales show higher values in people with diabesity applying the two criteria compared to people without diabesity. CONCLUSION: diabesity and MASLD and liver fibrosis risk scales show a significant association in our study.},
  address = {Spain},
  author = {Martínez-Almoyna Rifá, Emilio and López González, Ángel Arturo and Tárraga López, Pedro Juan and Paublini, Hernán and Vallejos, Daniela and Ramírez Manent, José Ignacio},
  journal = {Nutricion hospitalaria},
  keywords = {grapp-caib},
  month = {mar},
  pages = {10.20960/nh.05441--},
  title = {Relationship between diabesity and elevated values of metabolic-associated steatotic liver disease risk scales in Spanish workers using body mass index and the body adiposity estimator criteria of Clínica de Navarra},
  year = 2025
  }
  

  %0 Journal Article
  %1 martinezalmoynarifa2025relationship
  %A Martínez-Almoyna Rifá, Emilio
  %A López González, Ángel Arturo
  %A Tárraga López, Pedro Juan
  %A Paublini, Hernán
  %A Vallejos, Daniela
  %A Ramírez Manent, José Ignacio
  %C Spain
  %D 2025
  %J Nutricion hospitalaria
  %P 10.20960/nh.05441--
  %R 10.20960/nh.05441
  %T Relationship between diabesity and elevated values of metabolic-associated steatotic liver disease risk scales in Spanish workers using body mass index and the body adiposity estimator criteria of Clínica de Navarra
  %U https://pubmed.ncbi.nlm.nih.gov/40195779
  %X INTRODUCTION: diabesity (coexistence of diabetes and obesity) and metabolic associated steatotic liver disease (MASLD) are two very frequent pathologies whose prevalence is increasing every day. OBJECTIVE: to find out how these two pathological entities are associated in a group of Spanish workers. METHODOLOGY: a descriptive, cross-sectional study was carried out in 219477 workers to assess the association between diabesity (applying a double criterion, the body mass index BMI and the Clínica Universitaria de Navarra body adiposity estimator CUN BAE) and different risk scales for MASLD and liver fibrosis. RESULTS: all MASH and liver fibrosis risk scales show higher values in people with diabesity applying the two criteria compared to people without diabesity. CONCLUSION: diabesity and MASLD and liver fibrosis risk scales show a significant association in our study.
  

• 
  1.

  Gómez-Gómez I, Rodero-Cosano ML, Bellón J Á, Zabaleta-Del-Olmo E, Maderuelo-Fernandez JA, Moreno-Peral P, Magallón-Botaya R, Oliván-Blázquez B, Casajuana-Closas M, López-Jiménez T, Bolíbar B, Llobera J, Clavería A, Sanchez-Perez A, Motrico E. Examining the influence of mental health and structural determinants of health on the stage of motivational readiness for health behaviour changes: A path analysis study. Journal of health psychology [Internet]. England; 2025 Mar.;30(3):470-85. https://pubmed.ncbi.nlm.nih.gov/38605575

  AbstractURLBibTeXEndNoteDOIBibSonomy

  This study explores the influence of mental health and structural determinants of health on motivational readiness for health behaviour change in 1462 Spanish primary healthcare users. Chi-square test and structural equation modelling were performed. Results showed that depression and anxiety were negatively associated with being in the action stages of motivational readiness for a healthy diet and physical activity. This association was statistically significant only for motivational readiness for a healthy diet and depression (β =  - 0.076; p = 0.046). Furthermore, women and workers were more likely to be in the action stages of motivational readiness for a healthy diet while older adults and adults with higher health-related quality of life were more likely to be in the action stages of motivational readiness for physical activity. The present study suggests that structural (being older, being a woman and being employed) and intermediary (suffering from depression and higher health-related quality of life) determinants of health influence motivational readiness for health behaviour changes.

  @article{gomezgomez2025examining,
  abstract = {This study explores the influence of mental health and structural determinants of health on motivational readiness for health behaviour change in 1462 Spanish primary healthcare users. Chi-square test and structural equation modelling were performed. Results showed that depression and anxiety were negatively associated with being in the action stages of motivational readiness for a healthy diet and physical activity. This association was statistically significant only for motivational readiness for a healthy diet and depression (β =  - 0.076; p = 0.046). Furthermore, women and workers were more likely to be in the action stages of motivational readiness for a healthy diet while older adults and adults with higher health-related quality of life were more likely to be in the action stages of motivational readiness for physical activity. The present study suggests that structural (being older, being a woman and being employed) and intermediary (suffering from depression and higher health-related quality of life) determinants of health influence motivational readiness for health behaviour changes.},
  address = {England},
  author = {Gómez-Gómez, Irene and Rodero-Cosano, María Luisa and Bellón, Juan Á and Zabaleta-Del-Olmo, Edurne and Maderuelo-Fernandez, José A and Moreno-Peral, Patricia and Magallón-Botaya, Rosa and Oliván-Blázquez, Bárbara and Casajuana-Closas, Marc and López-Jiménez, Tomàs and Bolíbar, Bonaventura and Llobera, Joan and Clavería, Ana and Sanchez-Perez, Alvaro and Motrico, Emma},
  journal = {Journal of health psychology},
  keywords = {grapp-caib},
  month = {mar},
  number = 3,
  pages = {470--485},
  title = {Examining the influence of mental health and structural determinants of health on the stage of motivational readiness for health behaviour changes: A path analysis study},
  volume = 30,
  year = 2025
  }
  

  %0 Journal Article
  %1 gomezgomez2025examining
  %A Gómez-Gómez, Irene
  %A Rodero-Cosano, María Luisa
  %A Bellón, Juan Á
  %A Zabaleta-Del-Olmo, Edurne
  %A Maderuelo-Fernandez, José A
  %A Moreno-Peral, Patricia
  %A Magallón-Botaya, Rosa
  %A Oliván-Blázquez, Bárbara
  %A Casajuana-Closas, Marc
  %A López-Jiménez, Tomàs
  %A Bolíbar, Bonaventura
  %A Llobera, Joan
  %A Clavería, Ana
  %A Sanchez-Perez, Alvaro
  %A Motrico, Emma
  %C England
  %D 2025
  %J Journal of health psychology
  %N 3
  %P 470--485
  %R 10.1177/13591053241241015
  %T Examining the influence of mental health and structural determinants of health on the stage of motivational readiness for health behaviour changes: A path analysis study
  %U https://pubmed.ncbi.nlm.nih.gov/38605575
  %V 30
  %X This study explores the influence of mental health and structural determinants of health on motivational readiness for health behaviour change in 1462 Spanish primary healthcare users. Chi-square test and structural equation modelling were performed. Results showed that depression and anxiety were negatively associated with being in the action stages of motivational readiness for a healthy diet and physical activity. This association was statistically significant only for motivational readiness for a healthy diet and depression (β =  - 0.076; p = 0.046). Furthermore, women and workers were more likely to be in the action stages of motivational readiness for a healthy diet while older adults and adults with higher health-related quality of life were more likely to be in the action stages of motivational readiness for physical activity. The present study suggests that structural (being older, being a woman and being employed) and intermediary (suffering from depression and higher health-related quality of life) determinants of health influence motivational readiness for health behaviour changes.
  

• 
  1.

  López González Ángel A, Martínez-Almoyna Rifá E, Paublini H, Martorrel Sánchez C, Tárraga López PJ, Ramírez-Manent JI. Association between sociodemographic variables, healthy habits and stress with vascular age and SCORE2. Nutricion hospitalaria [Internet]. Spain; 2025 Mar.;:10.20960/nh.05629-. https://pubmed.ncbi.nlm.nih.gov/40066594

  AbstractURLBibTeXEndNoteDOIBibSonomy

  INTRODUCTION: Cardiovascular diseases are a global public health concern due to their high morbidity, mortality, and prevalence. Numerous scales based on different risk factors have been used to assess cardiovascular risk (CVR). The aim of this study is to evaluate how various sociodemographic variables, healthy habits, and stress are associated with the values of two CVR scales. MATERIALS AND METHODS: a descriptive cross-sectional study was conducted with 22,976 Spanish workers, analyzing the association between sociodemographic variables (age, gender, socioeconomic status), healthy habits (smoking, alcohol consumption, adherence to the Mediterranean diet, and physical activity), and stress with two CVR scales: vascular age (VA) and the Systematic Coronary Risk Evaluation-2 (SCORE2). RESULTS: all the scales analyzed show an association with elevated VA and SCORE2 values. The variables with the strongest associations (highest odds ratios) are age, type of occupation, and smoking. CONCLUSIONS: the profile of individuals most at risk of having high VA and SCORE2 values is a male over 50 years old, belonging to lower socioeconomic strata (manual laborer), a smoker, a regular alcohol consumer, sedentary, with low adherence to the Mediterranean diet, and high stress levels.

  @article{lopezgonzalez2025association,
  abstract = {INTRODUCTION: Cardiovascular diseases are a global public health concern due to their high morbidity, mortality, and prevalence. Numerous scales based on different risk factors have been used to assess cardiovascular risk (CVR). The aim of this study is to evaluate how various sociodemographic variables, healthy habits, and stress are associated with the values of two CVR scales. MATERIALS AND METHODS: a descriptive cross-sectional study was conducted with 22,976 Spanish workers, analyzing the association between sociodemographic variables (age, gender, socioeconomic status), healthy habits (smoking, alcohol consumption, adherence to the Mediterranean diet, and physical activity), and stress with two CVR scales: vascular age (VA) and the Systematic Coronary Risk Evaluation-2 (SCORE2). RESULTS: all the scales analyzed show an association with elevated VA and SCORE2 values. The variables with the strongest associations (highest odds ratios) are age, type of occupation, and smoking. CONCLUSIONS: the profile of individuals most at risk of having high VA and SCORE2 values is a male over 50 years old, belonging to lower socioeconomic strata (manual laborer), a smoker, a regular alcohol consumer, sedentary, with low adherence to the Mediterranean diet, and high stress levels.},
  address = {Spain},
  author = {López González, Ángel Arturo and Martínez-Almoyna Rifá, Emilio and Paublini, Hernán and Martorrel Sánchez, Cristina and Tárraga López, Pedro Juan and Ramírez-Manent, José Ignacio},
  journal = {Nutricion hospitalaria},
  keywords = {grapp-caib},
  month = {mar},
  pages = {10.20960/nh.05629--},
  title = {Association between sociodemographic variables, healthy habits and stress with vascular age and SCORE2},
  year = 2025
  }
  

  %0 Journal Article
  %1 lopezgonzalez2025association
  %A López González, Ángel Arturo
  %A Martínez-Almoyna Rifá, Emilio
  %A Paublini, Hernán
  %A Martorrel Sánchez, Cristina
  %A Tárraga López, Pedro Juan
  %A Ramírez-Manent, José Ignacio
  %C Spain
  %D 2025
  %J Nutricion hospitalaria
  %P 10.20960/nh.05629--
  %R 10.20960/nh.05629
  %T Association between sociodemographic variables, healthy habits and stress with vascular age and SCORE2
  %U https://pubmed.ncbi.nlm.nih.gov/40066594
  %X INTRODUCTION: Cardiovascular diseases are a global public health concern due to their high morbidity, mortality, and prevalence. Numerous scales based on different risk factors have been used to assess cardiovascular risk (CVR). The aim of this study is to evaluate how various sociodemographic variables, healthy habits, and stress are associated with the values of two CVR scales. MATERIALS AND METHODS: a descriptive cross-sectional study was conducted with 22,976 Spanish workers, analyzing the association between sociodemographic variables (age, gender, socioeconomic status), healthy habits (smoking, alcohol consumption, adherence to the Mediterranean diet, and physical activity), and stress with two CVR scales: vascular age (VA) and the Systematic Coronary Risk Evaluation-2 (SCORE2). RESULTS: all the scales analyzed show an association with elevated VA and SCORE2 values. The variables with the strongest associations (highest odds ratios) are age, type of occupation, and smoking. CONCLUSIONS: the profile of individuals most at risk of having high VA and SCORE2 values is a male over 50 years old, belonging to lower socioeconomic strata (manual laborer), a smoker, a regular alcohol consumer, sedentary, with low adherence to the Mediterranean diet, and high stress levels.
  

• 
  1.

  Montero Muñoz N, Tárraga López PJ, López-González Ángel A, Paublini H, Martorell Sánchez C, Marínez-Almoyna Rifá E, Ramírez-Manent JI. Association Between Mediterranean Diet and Other Healthy Habits and Sociodemographic Variables with the Values of Vascular and Heart Age in Spanish Workers. Nutrients [Internet]. Switzerland; 2025 Mar.;17(5):903-. https://pubmed.ncbi.nlm.nih.gov/40077773

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Introduction: The assessment of cardiovascular risk has traditionally relied on validated scales designed to estimate the likelihood of experiencing a cardiovascular event within a specific timeframe. In recent years, novel methodologies have emerged, offering a more objective evaluation of this risk through indicators such as vascular age (VA) and heart age (HA). Objective: This study aimed to investigate the relationship between sociodemographic factors, lifestyle behaviors, and their impact on VA and HA. Materials and Methods: A dual study design, encompassing both cross-sectional and longitudinal retrospective approaches, was conducted among a cohort of employees. The variables assessed included sociodemographic characteristics (age, sex, and socioeconomic status) and health-related habits (smoking, physical activity, adherence to the Mediterranean diet, and alcohol consumption). Results: The findings revealed that all analyzed variables were significantly associated with elevated VA and HA values. Among these, age demonstrated the strongest association, with odds ratios (OR) of 114.91 (95% CI: 100.45-131.43) for high HA and 34.48 (95% CI: 31.41-37.56) for high VA. Conclusions: The profile of individuals most at risk for elevated VA and HA encompasses males of advanced age, characterized by low socioeconomic status, a sedentary lifestyle, poor adherence to the Mediterranean diet, and regular alcohol consumption.

  @article{monteromunoz2025association,
  abstract = {Introduction: The assessment of cardiovascular risk has traditionally relied on validated scales designed to estimate the likelihood of experiencing a cardiovascular event within a specific timeframe. In recent years, novel methodologies have emerged, offering a more objective evaluation of this risk through indicators such as vascular age (VA) and heart age (HA). Objective: This study aimed to investigate the relationship between sociodemographic factors, lifestyle behaviors, and their impact on VA and HA. Materials and Methods: A dual study design, encompassing both cross-sectional and longitudinal retrospective approaches, was conducted among a cohort of employees. The variables assessed included sociodemographic characteristics (age, sex, and socioeconomic status) and health-related habits (smoking, physical activity, adherence to the Mediterranean diet, and alcohol consumption). Results: The findings revealed that all analyzed variables were significantly associated with elevated VA and HA values. Among these, age demonstrated the strongest association, with odds ratios (OR) of 114.91 (95% CI: 100.45-131.43) for high HA and 34.48 (95% CI: 31.41-37.56) for high VA. Conclusions: The profile of individuals most at risk for elevated VA and HA encompasses males of advanced age, characterized by low socioeconomic status, a sedentary lifestyle, poor adherence to the Mediterranean diet, and regular alcohol consumption.},
  address = {Switzerland},
  author = {Montero Muñoz, Natalia and Tárraga López, Pedro Juan and López-González, Ángel Arturo and Paublini, Hernán and Martorell Sánchez, Cristina and Marínez-Almoyna Rifá, Emilio and Ramírez-Manent, José Ignacio},
  journal = {Nutrients},
  keywords = {grapp-caib},
  month = {mar},
  number = 5,
  pages = {903--},
  title = {Association Between Mediterranean Diet and Other Healthy Habits and Sociodemographic Variables with the Values of Vascular and Heart Age in Spanish Workers},
  volume = 17,
  year = 2025
  }
  

  %0 Journal Article
  %1 monteromunoz2025association
  %A Montero Muñoz, Natalia
  %A Tárraga López, Pedro Juan
  %A López-González, Ángel Arturo
  %A Paublini, Hernán
  %A Martorell Sánchez, Cristina
  %A Marínez-Almoyna Rifá, Emilio
  %A Ramírez-Manent, José Ignacio
  %C Switzerland
  %D 2025
  %J Nutrients
  %N 5
  %P 903--
  %R 10.3390/nu17050903
  %T Association Between Mediterranean Diet and Other Healthy Habits and Sociodemographic Variables with the Values of Vascular and Heart Age in Spanish Workers
  %U https://pubmed.ncbi.nlm.nih.gov/40077773
  %V 17
  %X Introduction: The assessment of cardiovascular risk has traditionally relied on validated scales designed to estimate the likelihood of experiencing a cardiovascular event within a specific timeframe. In recent years, novel methodologies have emerged, offering a more objective evaluation of this risk through indicators such as vascular age (VA) and heart age (HA). Objective: This study aimed to investigate the relationship between sociodemographic factors, lifestyle behaviors, and their impact on VA and HA. Materials and Methods: A dual study design, encompassing both cross-sectional and longitudinal retrospective approaches, was conducted among a cohort of employees. The variables assessed included sociodemographic characteristics (age, sex, and socioeconomic status) and health-related habits (smoking, physical activity, adherence to the Mediterranean diet, and alcohol consumption). Results: The findings revealed that all analyzed variables were significantly associated with elevated VA and HA values. Among these, age demonstrated the strongest association, with odds ratios (OR) of 114.91 (95% CI: 100.45-131.43) for high HA and 34.48 (95% CI: 31.41-37.56) for high VA. Conclusions: The profile of individuals most at risk for elevated VA and HA encompasses males of advanced age, characterized by low socioeconomic status, a sedentary lifestyle, poor adherence to the Mediterranean diet, and regular alcohol consumption.
  

• 
  1.

  García-Buades ME, Montañez-Juan M, Blahopoulou J, Ortiz-Bonnin S, Chela-Alvarez X, Bulilete O, Llobera J. Psychosocial Work Factors, Job Stress, and Self-Rated Health Among Hotel Housekeepers. Workplace health & safety [Internet]. United States; 2025 Mar.;73(3):116-30. https://pubmed.ncbi.nlm.nih.gov/39475436

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  BACKGROUND: Hotel housekeeping is widely recognized as a poor-quality job due to its high demands and limited resources. Hotel housekeepers (HHs) face both hard physical work and mentally demanding conditions, yet psychosocial factors in this feminized and precarious occupation remain under-researched. To address this gap, this study examines HHs' exposure to psychosocial factors at work and their impact on job stress and self-rated health. METHODS: A cross-sectional survey of a random sample of 926 HHs in the Balearic Islands (Spain) assessed job stress, self-rated health, psychosocial factors (job demands and resources), and sociodemographic variables using the Copenhagen Psychosocial Questionnaire II (COPSOQ-II) and the National Health Survey. Descriptive analysis and hierarchical linear regression models were applied. RESULTS: The prevalence of job stress was 61.1% (95% confidence interval [CI] = [57.8%, 64.1%]), while the prevalence of poor self-rated health was 59.9% (95% CI = [56.6%, 62.9%]). Hotel housekeepers were highly exposed to job demands such as intense work pace, job-specific stressors, work-life conflict, and emotional demands; highly available job resources were role clarity, task meaning, and social support. Regression models revealed work pace, work-life conflict, nationality, and weak leader support as key predictors of job stress; and work-life conflict and leadership quality as key predictors of self-rated health. CONCLUSION/APPLICATION TO PRACTICE: Although considered an eminently physical job, psychosocial work factors play a key role in explaining HHs' job stress and self-rated health. Occupational health professionals should design workplace interventions to reduce work pace, mitigate work-life conflict, and enhance resources such as leader support, sense of community, and leadership quality.

  @article{garciabuades2025psychosocial,
  abstract = {BACKGROUND: Hotel housekeeping is widely recognized as a poor-quality job due to its high demands and limited resources. Hotel housekeepers (HHs) face both hard physical work and mentally demanding conditions, yet psychosocial factors in this feminized and precarious occupation remain under-researched. To address this gap, this study examines HHs' exposure to psychosocial factors at work and their impact on job stress and self-rated health. METHODS: A cross-sectional survey of a random sample of 926 HHs in the Balearic Islands (Spain) assessed job stress, self-rated health, psychosocial factors (job demands and resources), and sociodemographic variables using the Copenhagen Psychosocial Questionnaire II (COPSOQ-II) and the National Health Survey. Descriptive analysis and hierarchical linear regression models were applied. RESULTS: The prevalence of job stress was 61.1% (95% confidence interval [CI] = [57.8%, 64.1%]), while the prevalence of poor self-rated health was 59.9% (95% CI = [56.6%, 62.9%]). Hotel housekeepers were highly exposed to job demands such as intense work pace, job-specific stressors, work-life conflict, and emotional demands; highly available job resources were role clarity, task meaning, and social support. Regression models revealed work pace, work-life conflict, nationality, and weak leader support as key predictors of job stress; and work-life conflict and leadership quality as key predictors of self-rated health. CONCLUSION/APPLICATION TO PRACTICE: Although considered an eminently physical job, psychosocial work factors play a key role in explaining HHs' job stress and self-rated health. Occupational health professionals should design workplace interventions to reduce work pace, mitigate work-life conflict, and enhance resources such as leader support, sense of community, and leadership quality.},
  address = {United States},
  author = {García-Buades, M Esther and Montañez-Juan, Maribel and Blahopoulou, Joanna and Ortiz-Bonnin, Silvia and Chela-Alvarez, Xènia and Bulilete, Oana and Llobera, Joan},
  journal = {Workplace health & safety},
  keywords = {grapp-caib},
  month = {mar},
  number = 3,
  pages = {116--130},
  title = {Psychosocial Work Factors, Job Stress, and Self-Rated Health Among Hotel Housekeepers},
  volume = 73,
  year = 2025
  }
  

  %0 Journal Article
  %1 garciabuades2025psychosocial
  %A García-Buades, M Esther
  %A Montañez-Juan, Maribel
  %A Blahopoulou, Joanna
  %A Ortiz-Bonnin, Silvia
  %A Chela-Alvarez, Xènia
  %A Bulilete, Oana
  %A Llobera, Joan
  %C United States
  %D 2025
  %J Workplace health & safety
  %N 3
  %P 116--130
  %R 10.1177/21650799241282787
  %T Psychosocial Work Factors, Job Stress, and Self-Rated Health Among Hotel Housekeepers
  %U https://pubmed.ncbi.nlm.nih.gov/39475436
  %V 73
  %X BACKGROUND: Hotel housekeeping is widely recognized as a poor-quality job due to its high demands and limited resources. Hotel housekeepers (HHs) face both hard physical work and mentally demanding conditions, yet psychosocial factors in this feminized and precarious occupation remain under-researched. To address this gap, this study examines HHs' exposure to psychosocial factors at work and their impact on job stress and self-rated health. METHODS: A cross-sectional survey of a random sample of 926 HHs in the Balearic Islands (Spain) assessed job stress, self-rated health, psychosocial factors (job demands and resources), and sociodemographic variables using the Copenhagen Psychosocial Questionnaire II (COPSOQ-II) and the National Health Survey. Descriptive analysis and hierarchical linear regression models were applied. RESULTS: The prevalence of job stress was 61.1% (95% confidence interval [CI] = [57.8%, 64.1%]), while the prevalence of poor self-rated health was 59.9% (95% CI = [56.6%, 62.9%]). Hotel housekeepers were highly exposed to job demands such as intense work pace, job-specific stressors, work-life conflict, and emotional demands; highly available job resources were role clarity, task meaning, and social support. Regression models revealed work pace, work-life conflict, nationality, and weak leader support as key predictors of job stress; and work-life conflict and leadership quality as key predictors of self-rated health. CONCLUSION/APPLICATION TO PRACTICE: Although considered an eminently physical job, psychosocial work factors play a key role in explaining HHs' job stress and self-rated health. Occupational health professionals should design workplace interventions to reduce work pace, mitigate work-life conflict, and enhance resources such as leader support, sense of community, and leadership quality.
  

• 
  1.

  Gordito Soler M, Ramírez-Manent JI, Tárraga López PJ, Martínez-Almoyna Rifá E, Paublini H, López González Ángel A. Usefulness of body and visceral fat determined by bioimpedancemetry versus body mass index and waist circumference in the identification of elevated values of different atherogenesis risk scales. Clinica e investigacion en arteriosclerosis : publicacion oficial de la Sociedad Espanola de Arteriosclerosis [Internet]. Spain; 2025 Mar.;37:500772-. https://pubmed.ncbi.nlm.nih.gov/40037953

  AbstractURLBibTeXEndNoteDOIBibSonomy

  INTRODUCTION: Obesity and atherogenesis are two highly prevalent pathological processes worldwide that also share several pathophysiological mechanisms. OBJECTIVES: Descriptive and cross-sectional study in 8,590 Spanish workers (4,104 men and 4,486 women) with an average age of 41.5years, in which the usefulness of four scales of overweight and obesity such as body mass index (BMI), waist circumference and percentages of body and visceral fat determined by bioimpedance measurement to identify high levels of atherogenic risk determined by atherogenic dyslipidemia (AD), lipid triad (LT) and several atherogenic indices is assessed. RESULTS: All the overweight and obesity scales show a predictive value between moderate and good, determined by the AUC of the ROC curves, with values ranging from 0.727 to 0.886 in women and 0.676 to 0.885 in men. Of all of them, the one with the highest AUC is visceral fat with values exceeding 0.800 and the lowest are for BMI. In all cases, the AUC is higher in women. CONCLUSIONS: The overweight and obesity scales analysed (BMI, waist circumference and percentage of body and visceral fat) show AUCs for predicting atherogenic risk between moderate and high, with visceral fat being the most useful of all.

  @article{gorditosoler2025usefulness,
  abstract = {INTRODUCTION: Obesity and atherogenesis are two highly prevalent pathological processes worldwide that also share several pathophysiological mechanisms. OBJECTIVES: Descriptive and cross-sectional study in 8,590 Spanish workers (4,104 men and 4,486 women) with an average age of 41.5years, in which the usefulness of four scales of overweight and obesity such as body mass index (BMI), waist circumference and percentages of body and visceral fat determined by bioimpedance measurement to identify high levels of atherogenic risk determined by atherogenic dyslipidemia (AD), lipid triad (LT) and several atherogenic indices is assessed. RESULTS: All the overweight and obesity scales show a predictive value between moderate and good, determined by the AUC of the ROC curves, with values ranging from 0.727 to 0.886 in women and 0.676 to 0.885 in men. Of all of them, the one with the highest AUC is visceral fat with values exceeding 0.800 and the lowest are for BMI. In all cases, the AUC is higher in women. CONCLUSIONS: The overweight and obesity scales analysed (BMI, waist circumference and percentage of body and visceral fat) show AUCs for predicting atherogenic risk between moderate and high, with visceral fat being the most useful of all.},
  address = {Spain},
  author = {Gordito Soler, María and Ramírez-Manent, José Ignacio and Tárraga López, Pedro Juan and Martínez-Almoyna Rifá, Emilio and Paublini, Hernán and López González, Ángel Arturo},
  journal = {Clinica e investigacion en arteriosclerosis : publicacion oficial de la Sociedad Espanola de Arteriosclerosis},
  keywords = {grapp-caib},
  month = {mar},
  pages = {500772-500772},
  title = {Usefulness of body and visceral fat determined by bioimpedancemetry versus body mass index and waist circumference in the identification of elevated values of different atherogenesis risk scales},
  volume = 37,
  year = 2025
  }
  

  %0 Journal Article
  %1 gorditosoler2025usefulness
  %A Gordito Soler, María
  %A Ramírez-Manent, José Ignacio
  %A Tárraga López, Pedro Juan
  %A Martínez-Almoyna Rifá, Emilio
  %A Paublini, Hernán
  %A López González, Ángel Arturo
  %C Spain
  %D 2025
  %J Clinica e investigacion en arteriosclerosis : publicacion oficial de la Sociedad Espanola de Arteriosclerosis
  %P 500772-500772
  %R 10.1016/j.arteri.2025.500772
  %T Usefulness of body and visceral fat determined by bioimpedancemetry versus body mass index and waist circumference in the identification of elevated values of different atherogenesis risk scales
  %U https://pubmed.ncbi.nlm.nih.gov/40037953
  %V 37
  %X INTRODUCTION: Obesity and atherogenesis are two highly prevalent pathological processes worldwide that also share several pathophysiological mechanisms. OBJECTIVES: Descriptive and cross-sectional study in 8,590 Spanish workers (4,104 men and 4,486 women) with an average age of 41.5years, in which the usefulness of four scales of overweight and obesity such as body mass index (BMI), waist circumference and percentages of body and visceral fat determined by bioimpedance measurement to identify high levels of atherogenic risk determined by atherogenic dyslipidemia (AD), lipid triad (LT) and several atherogenic indices is assessed. RESULTS: All the overweight and obesity scales show a predictive value between moderate and good, determined by the AUC of the ROC curves, with values ranging from 0.727 to 0.886 in women and 0.676 to 0.885 in men. Of all of them, the one with the highest AUC is visceral fat with values exceeding 0.800 and the lowest are for BMI. In all cases, the AUC is higher in women. CONCLUSIONS: The overweight and obesity scales analysed (BMI, waist circumference and percentage of body and visceral fat) show AUCs for predicting atherogenic risk between moderate and high, with visceral fat being the most useful of all.
  

• 
  1.

  Tárraga Marcos PJ, López-González Ángel A, Martínez-Almoyna Rifá E, Paublini Oliveira H, Martorell Sánchez C, Tárraga López PJ, Ramírez-Manent JI. Risk of Insulin Resistance in 44,939 Spanish Healthcare Workers: Association with Sociodemographic Variables and Healthy Habits. Diseases (Basel, Switzerland) [Internet]. Switzerland; 2025 Jan.;13(2):33-. https://pubmed.ncbi.nlm.nih.gov/39997040

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Introduction: Insulin resistance (IR) is a highly prevalent pathophysiological entity implicated in the development of a wide variety of metabolic, cardiovascular, and endocrine disorders. The aim of this study is to assess the association between sociodemographic variables and healthy habits with IR risk scales. Methodology: This dual study, incorporating both longitudinal-retrospective and cross-sectional designs, analyzed healthcare workers across four professional categories (physicians, nurses, healthcare technicians, and auxiliary personnel). It examined the association of age, sex, professional category, smoking status, physical activity, and adherence to the Mediterranean diet with elevated scores on insulin resistance risk scales. Results: All the variables analyzed were associated with the presence of elevated values of the IR scales, with age, sex, and physical activity showing the strongest association (reflected in the odds ratio values). Conclusions: The profile of an individual with a higher risk of presenting elevated values of the IR risk scales would be an elderly male auxiliary health worker who is a smoker and is physically inactive, with a low adherence to the Mediterranean diet.

  @article{tarragamarcos2025insulin,
  abstract = {Introduction: Insulin resistance (IR) is a highly prevalent pathophysiological entity implicated in the development of a wide variety of metabolic, cardiovascular, and endocrine disorders. The aim of this study is to assess the association between sociodemographic variables and healthy habits with IR risk scales. Methodology: This dual study, incorporating both longitudinal-retrospective and cross-sectional designs, analyzed healthcare workers across four professional categories (physicians, nurses, healthcare technicians, and auxiliary personnel). It examined the association of age, sex, professional category, smoking status, physical activity, and adherence to the Mediterranean diet with elevated scores on insulin resistance risk scales. Results: All the variables analyzed were associated with the presence of elevated values of the IR scales, with age, sex, and physical activity showing the strongest association (reflected in the odds ratio values). Conclusions: The profile of an individual with a higher risk of presenting elevated values of the IR risk scales would be an elderly male auxiliary health worker who is a smoker and is physically inactive, with a low adherence to the Mediterranean diet.},
  address = {Switzerland},
  author = {Tárraga Marcos, Pedro Javier and López-González, Ángel Arturo and Martínez-Almoyna Rifá, Emilio and Paublini Oliveira, Hernán and Martorell Sánchez, Cristina and Tárraga López, Pedro Juan and Ramírez-Manent, José Ignacio},
  journal = {Diseases (Basel, Switzerland)},
  keywords = {grapp-caib},
  month = {jan},
  number = 2,
  pages = {33--},
  title = {Risk of Insulin Resistance in 44,939 Spanish Healthcare Workers: Association with Sociodemographic Variables and Healthy Habits},
  volume = 13,
  year = 2025
  }
  

  %0 Journal Article
  %1 tarragamarcos2025insulin
  %A Tárraga Marcos, Pedro Javier
  %A López-González, Ángel Arturo
  %A Martínez-Almoyna Rifá, Emilio
  %A Paublini Oliveira, Hernán
  %A Martorell Sánchez, Cristina
  %A Tárraga López, Pedro Juan
  %A Ramírez-Manent, José Ignacio
  %C Switzerland
  %D 2025
  %J Diseases (Basel, Switzerland)
  %N 2
  %P 33--
  %R 10.3390/diseases13020033
  %T Risk of Insulin Resistance in 44,939 Spanish Healthcare Workers: Association with Sociodemographic Variables and Healthy Habits
  %U https://pubmed.ncbi.nlm.nih.gov/39997040
  %V 13
  %X Introduction: Insulin resistance (IR) is a highly prevalent pathophysiological entity implicated in the development of a wide variety of metabolic, cardiovascular, and endocrine disorders. The aim of this study is to assess the association between sociodemographic variables and healthy habits with IR risk scales. Methodology: This dual study, incorporating both longitudinal-retrospective and cross-sectional designs, analyzed healthcare workers across four professional categories (physicians, nurses, healthcare technicians, and auxiliary personnel). It examined the association of age, sex, professional category, smoking status, physical activity, and adherence to the Mediterranean diet with elevated scores on insulin resistance risk scales. Results: All the variables analyzed were associated with the presence of elevated values of the IR scales, with age, sex, and physical activity showing the strongest association (reflected in the odds ratio values). Conclusions: The profile of an individual with a higher risk of presenting elevated values of the IR risk scales would be an elderly male auxiliary health worker who is a smoker and is physically inactive, with a low adherence to the Mediterranean diet.
  

• 
  1.

  Marcos PJT, López PJT, López-González Ángel A, Rifá EM-A, Oliveira HP, Sánchez CM, Ramírez-Manent JI. Estimation of Cardiovascular Risk Using SCORE2, REGICOR and Vascular Age Scales in Spanish Healthcare Workers: A Retrospective Longitudinal Study. Healthcare (Basel, Switzerland) [Internet]. Switzerland; 2025 Feb.;13(4):375-. https://pubmed.ncbi.nlm.nih.gov/39997250

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Background/Objectives: Cardiovascular diseases (CVD) are one of the major public health concerns worldwide due to their high morbidity and mortality rates. This situation has necessitated the development of tools to assess cardiovascular risk (CVR) in order to prevent the onset of CVD. The aim of this study is to assess how sociodemographic variables and health habits are associated with the values of CVR scales, such as REGICOR, SCORE2, and vascular age. Methodology: This is a descriptive and cross-sectional study involving 44,939 Spanish healthcare workers, where the association between age, sex, type of work, smoking, physical activity, and Mediterranean diet with CVR scales such as REGICOR, SCORE2, and vascular age was evaluated. Results: All the variables analyzed showed an association with the occurrence of moderate-high values in all three CVR scales. Age was the variable that showed the highest odds ratio values: 13.446 (95% CI 11.16-14.77) for REGICOR, 13.90 (95% CI 12.01-15.81) for vascular age, and 14.12 (95% CI 12.01-16.23) for SCORE2. Conclusions: The profile of a healthcare worker with the highest risk of presenting moderate-high values on all three CVR scales would be a male over 60 years old, a nursing assistant or orderly, a smoker, sedentary, and with low adherence to the Mediterranean diet.

  @article{marcos2025estimation,
  abstract = {Background/Objectives: Cardiovascular diseases (CVD) are one of the major public health concerns worldwide due to their high morbidity and mortality rates. This situation has necessitated the development of tools to assess cardiovascular risk (CVR) in order to prevent the onset of CVD. The aim of this study is to assess how sociodemographic variables and health habits are associated with the values of CVR scales, such as REGICOR, SCORE2, and vascular age. Methodology: This is a descriptive and cross-sectional study involving 44,939 Spanish healthcare workers, where the association between age, sex, type of work, smoking, physical activity, and Mediterranean diet with CVR scales such as REGICOR, SCORE2, and vascular age was evaluated. Results: All the variables analyzed showed an association with the occurrence of moderate-high values in all three CVR scales. Age was the variable that showed the highest odds ratio values: 13.446 (95% CI 11.16-14.77) for REGICOR, 13.90 (95% CI 12.01-15.81) for vascular age, and 14.12 (95% CI 12.01-16.23) for SCORE2. Conclusions: The profile of a healthcare worker with the highest risk of presenting moderate-high values on all three CVR scales would be a male over 60 years old, a nursing assistant or orderly, a smoker, sedentary, and with low adherence to the Mediterranean diet.},
  address = {Switzerland},
  author = {Marcos, Pedro Javier Tárraga and López, Pedro Juan Tárraga and López-González, Ángel Arturo and Rifá, Emilio Martínez-Almoyna and Oliveira, Hernán Paublini and Sánchez, Cristina Martorell and Ramírez-Manent, José Ignacio},
  journal = {Healthcare (Basel, Switzerland)},
  keywords = {grapp-caib},
  month = {feb},
  number = 4,
  pages = {375--},
  title = {Estimation of Cardiovascular Risk Using SCORE2, REGICOR and Vascular Age Scales in Spanish Healthcare Workers: A Retrospective Longitudinal Study},
  volume = 13,
  year = 2025
  }
  

  %0 Journal Article
  %1 marcos2025estimation
  %A Marcos, Pedro Javier Tárraga
  %A López, Pedro Juan Tárraga
  %A López-González, Ángel Arturo
  %A Rifá, Emilio Martínez-Almoyna
  %A Oliveira, Hernán Paublini
  %A Sánchez, Cristina Martorell
  %A Ramírez-Manent, José Ignacio
  %C Switzerland
  %D 2025
  %J Healthcare (Basel, Switzerland)
  %N 4
  %P 375--
  %R 10.3390/healthcare13040375
  %T Estimation of Cardiovascular Risk Using SCORE2, REGICOR and Vascular Age Scales in Spanish Healthcare Workers: A Retrospective Longitudinal Study
  %U https://pubmed.ncbi.nlm.nih.gov/39997250
  %V 13
  %X Background/Objectives: Cardiovascular diseases (CVD) are one of the major public health concerns worldwide due to their high morbidity and mortality rates. This situation has necessitated the development of tools to assess cardiovascular risk (CVR) in order to prevent the onset of CVD. The aim of this study is to assess how sociodemographic variables and health habits are associated with the values of CVR scales, such as REGICOR, SCORE2, and vascular age. Methodology: This is a descriptive and cross-sectional study involving 44,939 Spanish healthcare workers, where the association between age, sex, type of work, smoking, physical activity, and Mediterranean diet with CVR scales such as REGICOR, SCORE2, and vascular age was evaluated. Results: All the variables analyzed showed an association with the occurrence of moderate-high values in all three CVR scales. Age was the variable that showed the highest odds ratio values: 13.446 (95% CI 11.16-14.77) for REGICOR, 13.90 (95% CI 12.01-15.81) for vascular age, and 14.12 (95% CI 12.01-16.23) for SCORE2. Conclusions: The profile of a healthcare worker with the highest risk of presenting moderate-high values on all three CVR scales would be a male over 60 years old, a nursing assistant or orderly, a smoker, sedentary, and with low adherence to the Mediterranean diet.
  

• 
  1.

  Pou Bordoy J, Leiva A, Albendín Ariza MJ, Llanos RE, Rigo Carratalà F, Romaguera D, Salas-Salvadó J, Babio N, Martinez-González MA, Toledo E, Fitó M, Aros F, Estruch R, Fiol Sala M. Major abnormalities of the electrocardiogram and cardiovascular risk in a medium and high-risk Mediterranean population. Medicina clinica [Internet]. Spain; 2025 Mar.;164(6):277-86. https://pubmed.ncbi.nlm.nih.gov/39706740

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  INTRODUCTION: Major electrocardiogram abnormalities (MECG) are common in middle-aged and older individuals and could be an important factor in predicting cardiovascular events. OBJECTIVE: To analyse the association between MECG (Minnesota classification) and CVE independently of classic cardiovascular risk factors (CVRF), and to assess whether they improve the prediction according to the Spanish Coronary Event Risk Function (FRESCO). METHOD: 1.752 participants included in three nodes of the PREDIMED study aged between 55 and 80 years with medium or high CVRF. Mean follow-up time was 5.1 years. Cumulative CVE incidence was estimated by sex with and without MECG, and hazard ratios by sex were estimated using multivariate Cox regressions adjusted for randomization group and CCRF (FRESCO). Harrel's C Indices, Nam d'Agostino, Net Reclassification Improvement, and Integrated Discrimination Improvement were calculated. RESULTS: At baseline, 25% of the participants shows major electrocardiogram abnormalities (AMECG). During follow-up, there were 112 cardiovascular events (16 cardiovascular deaths, 15 acute myocardial infarctions, 38 anginas, 43 strokes). MECG were significantly associated with the onset of CVE. In men, left ventricular hypertrophy (LVH) criteria were associated with T-wave inversion (HR: 17.88, 95% CI: 5.51-58.03, pvalor<.001) and QT interval prolongation (HR: 2.41, 95% CI: 1.38-4.21, pvalor=.002); in women, atrial fibrillation (HR: 5.7, 95% CI: 1.76-18.72, pvalor=.006) and ST-segment depression (HR: 3.24, 95% CI: 1.36-7.71, pvalor<.001) were associated. No significant improvement in MECG prediction compared to FRESCO was observed. CONCLUSIONS: MECG are independently associated with the occurrence of CVE, but do not improve risk prediction beyond traditional risk factors.

  @article{poubordoy2025major,
  abstract = {INTRODUCTION: Major electrocardiogram abnormalities (MECG) are common in middle-aged and older individuals and could be an important factor in predicting cardiovascular events. OBJECTIVE: To analyse the association between MECG (Minnesota classification) and CVE independently of classic cardiovascular risk factors (CVRF), and to assess whether they improve the prediction according to the Spanish Coronary Event Risk Function (FRESCO). METHOD: 1.752 participants included in three nodes of the PREDIMED study aged between 55 and 80 years with medium or high CVRF. Mean follow-up time was 5.1 years. Cumulative CVE incidence was estimated by sex with and without MECG, and hazard ratios by sex were estimated using multivariate Cox regressions adjusted for randomization group and CCRF (FRESCO). Harrel's C Indices, Nam d'Agostino, Net Reclassification Improvement, and Integrated Discrimination Improvement were calculated. RESULTS: At baseline, 25% of the participants shows major electrocardiogram abnormalities (AMECG). During follow-up, there were 112 cardiovascular events (16 cardiovascular deaths, 15 acute myocardial infarctions, 38 anginas, 43 strokes). MECG were significantly associated with the onset of CVE. In men, left ventricular hypertrophy (LVH) criteria were associated with T-wave inversion (HR: 17.88, 95% CI: 5.51-58.03, pvalor<.001) and QT interval prolongation (HR: 2.41, 95% CI: 1.38-4.21, pvalor=.002); in women, atrial fibrillation (HR: 5.7, 95% CI: 1.76-18.72, pvalor=.006) and ST-segment depression (HR: 3.24, 95% CI: 1.36-7.71, pvalor<.001) were associated. No significant improvement in MECG prediction compared to FRESCO was observed. CONCLUSIONS: MECG are independently associated with the occurrence of CVE, but do not improve risk prediction beyond traditional risk factors.},
  address = {Spain},
  author = {Pou Bordoy, Joan and Leiva, Alfonso and Albendín Ariza, Maria José and Llanos, Roberto Elosúa and Rigo Carratalà, Fernando and Romaguera, Dora and Salas-Salvadó, Jordi and Babio, Nancy and Martinez-González, Miguel Angel and Toledo, Estefanía and Fitó, Montserrat and Aros, Fernando and Estruch, Ramon and Fiol Sala, Miquel},
  journal = {Medicina clinica},
  keywords = {grapp-caib},
  month = {mar},
  number = 6,
  pages = {277--286},
  title = {Major abnormalities of the electrocardiogram and cardiovascular risk in a medium and high-risk Mediterranean population},
  volume = 164,
  year = 2025
  }
  

  %0 Journal Article
  %1 poubordoy2025major
  %A Pou Bordoy, Joan
  %A Leiva, Alfonso
  %A Albendín Ariza, Maria José
  %A Llanos, Roberto Elosúa
  %A Rigo Carratalà, Fernando
  %A Romaguera, Dora
  %A Salas-Salvadó, Jordi
  %A Babio, Nancy
  %A Martinez-González, Miguel Angel
  %A Toledo, Estefanía
  %A Fitó, Montserrat
  %A Aros, Fernando
  %A Estruch, Ramon
  %A Fiol Sala, Miquel
  %C Spain
  %D 2025
  %J Medicina clinica
  %N 6
  %P 277--286
  %R 10.1016/j.medcli.2024.10.010
  %T Major abnormalities of the electrocardiogram and cardiovascular risk in a medium and high-risk Mediterranean population
  %U https://pubmed.ncbi.nlm.nih.gov/39706740
  %V 164
  %X INTRODUCTION: Major electrocardiogram abnormalities (MECG) are common in middle-aged and older individuals and could be an important factor in predicting cardiovascular events. OBJECTIVE: To analyse the association between MECG (Minnesota classification) and CVE independently of classic cardiovascular risk factors (CVRF), and to assess whether they improve the prediction according to the Spanish Coronary Event Risk Function (FRESCO). METHOD: 1.752 participants included in three nodes of the PREDIMED study aged between 55 and 80 years with medium or high CVRF. Mean follow-up time was 5.1 years. Cumulative CVE incidence was estimated by sex with and without MECG, and hazard ratios by sex were estimated using multivariate Cox regressions adjusted for randomization group and CCRF (FRESCO). Harrel's C Indices, Nam d'Agostino, Net Reclassification Improvement, and Integrated Discrimination Improvement were calculated. RESULTS: At baseline, 25% of the participants shows major electrocardiogram abnormalities (AMECG). During follow-up, there were 112 cardiovascular events (16 cardiovascular deaths, 15 acute myocardial infarctions, 38 anginas, 43 strokes). MECG were significantly associated with the onset of CVE. In men, left ventricular hypertrophy (LVH) criteria were associated with T-wave inversion (HR: 17.88, 95% CI: 5.51-58.03, pvalor<.001) and QT interval prolongation (HR: 2.41, 95% CI: 1.38-4.21, pvalor=.002); in women, atrial fibrillation (HR: 5.7, 95% CI: 1.76-18.72, pvalor=.006) and ST-segment depression (HR: 3.24, 95% CI: 1.36-7.71, pvalor<.001) were associated. No significant improvement in MECG prediction compared to FRESCO was observed. CONCLUSIONS: MECG are independently associated with the occurrence of CVE, but do not improve risk prediction beyond traditional risk factors.
  

• 
  1.

  Munné-Barellas B, Monfà R, Llor C, Garcia-Sangenís A, Miranda-Jiménez C, Morros R, Moragas A, Alvarez-Greciano P, Leiva A, Lozano-Del Hoyo ML, Sánchez-Calavera MA, Marín-Cañada J, Sánchez-Ruano R. The Use of Antibiotics for Uncomplicated Urinary Tract Infections in Adult Women: Qualitative Findings From the SCOUT Trial. Patient preference and adherence [Internet]. 2025 Aug.;19:2673-85. https://pmc.ncbi.nlm.nih.gov/articles/PMC12410387/

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Background This paper focuses on women’s subjective experiences with UTIs and antibiotic use. Uncomplicated urinary tract infections (UTI) are among the most common infections treated in primary care, however, there is limited evidence regarding the experiences and their antibiotic treatment preferences. Objective The aim of this study is to gather experiences, beliefs, and attitudes regarding the use of antibiotics and the participation in the clinical trial. Methods This qualitative sub-study is part of the SCOUT project, which, through a clinical trial, aims to assess the effectiveness of four short antibiotic regimens (a single 3g dose of fosfomycin; 3g of fosfomycin for two days; 400mg of pivmecillinam for three days; and 100mg of nitrofurantoin for five days). A total of 68 semi-structured interviews were conducted in four regions of Spain (Catalonia N=19, Aragón N=19, Madrid N=15, and the Balearic Islands N=15). A purposive and theoretical sampling approach was employed. Participants were recruited after taking part in the clinical trial. Data collection took place between March and July 2024 and analysed using Thematic Analysis. Results UTI did not cause excessive concern, except in cases where the antibiotic was ineffective or when participants had experienced multiple infections in the past. Fosfomycin was the most widely recognized antibiotic, and the two-dose regimen was generally well-regarded for being easy to take while also being more effective than the single-dose treatment. Longer regimens could cause some side effects, but in certain cases, they were perceived as more effective. Participation in the clinical trial was viewed positively, as it contributed to increasing overall knowledge about UTI and the antibiotics used to treat them, as well as ensuring closer monitoring of each specific case. Conclusion This study gathers experiences related to UTI, antibiotic treatment regimens, and participation in the SCOUT clinical trial. It highlights the need to document the realities of UTI in order to improve future clinical trials.

  @article{munne-barellas_use_2025,
  abstract = {Background This paper focuses on women’s subjective experiences with UTIs and antibiotic use. Uncomplicated urinary tract infections (UTI) are among the most common infections treated in primary care, however, there is limited evidence regarding the experiences and their antibiotic treatment preferences. Objective The aim of this study is to gather experiences, beliefs, and attitudes regarding the use of antibiotics and the participation in the clinical trial. Methods This qualitative sub-study is part of the SCOUT project, which, through a clinical trial, aims to assess the effectiveness of four short antibiotic regimens (a single 3g dose of fosfomycin; 3g of fosfomycin for two days; 400mg of pivmecillinam for three days; and 100mg of nitrofurantoin for five days). A total of 68 semi-structured interviews were conducted in four regions of Spain (Catalonia N=19, Aragón N=19, Madrid N=15, and the Balearic Islands N=15). A purposive and theoretical sampling approach was employed. Participants were recruited after taking part in the clinical trial. Data collection took place between March and July 2024 and analysed using Thematic Analysis. Results UTI did not cause excessive concern, except in cases where the antibiotic was ineffective or when participants had experienced multiple infections in the past. Fosfomycin was the most widely recognized antibiotic, and the two-dose regimen was generally well-regarded for being easy to take while also being more effective than the single-dose treatment. Longer regimens could cause some side effects, but in certain cases, they were perceived as more effective. Participation in the clinical trial was viewed positively, as it contributed to increasing overall knowledge about UTI and the antibiotics used to treat them, as well as ensuring closer monitoring of each specific case. Conclusion This study gathers experiences related to UTI, antibiotic treatment regimens, and participation in the SCOUT clinical trial. It highlights the need to document the realities of UTI in order to improve future clinical trials.},
  author = {Munné-Barellas, Berta and Monfà, Ramon and Llor, Carl and Garcia-Sangenís, Ana and Miranda-Jiménez, Cristina and Morros, Rosa and Moragas, Ana and Alvarez-Greciano, Pablo and Leiva, Alfonso and Lozano-Del Hoyo, Mª Luisa and Sánchez-Calavera, Maria Antonia and Marín-Cañada, Jaime and Sánchez-Ruano, Raquel},
  journal = {Patient preference and adherence},
  keywords = {grapp-caib},
  month = {aug},
  pages = {2673--2685},
  title = {The Use of Antibiotics for Uncomplicated Urinary Tract Infections in Adult Women: Qualitative Findings From the SCOUT Trial},
  volume = 19,
  year = 2025
  }
  

  %0 Journal Article
  %1 munne-barellas_use_2025
  %A Munné-Barellas, Berta
  %A Monfà, Ramon
  %A Llor, Carl
  %A Garcia-Sangenís, Ana
  %A Miranda-Jiménez, Cristina
  %A Morros, Rosa
  %A Moragas, Ana
  %A Alvarez-Greciano, Pablo
  %A Leiva, Alfonso
  %A Lozano-Del Hoyo, Mª Luisa
  %A Sánchez-Calavera, Maria Antonia
  %A Marín-Cañada, Jaime
  %A Sánchez-Ruano, Raquel
  %D 2025
  %J Patient preference and adherence
  %P 2673--2685
  %R 10.2147/PPA.S531582
  %T The Use of Antibiotics for Uncomplicated Urinary Tract Infections in Adult Women: Qualitative Findings From the SCOUT Trial
  %U https://pmc.ncbi.nlm.nih.gov/articles/PMC12410387/
  %V 19
  %X Background This paper focuses on women’s subjective experiences with UTIs and antibiotic use. Uncomplicated urinary tract infections (UTI) are among the most common infections treated in primary care, however, there is limited evidence regarding the experiences and their antibiotic treatment preferences. Objective The aim of this study is to gather experiences, beliefs, and attitudes regarding the use of antibiotics and the participation in the clinical trial. Methods This qualitative sub-study is part of the SCOUT project, which, through a clinical trial, aims to assess the effectiveness of four short antibiotic regimens (a single 3g dose of fosfomycin; 3g of fosfomycin for two days; 400mg of pivmecillinam for three days; and 100mg of nitrofurantoin for five days). A total of 68 semi-structured interviews were conducted in four regions of Spain (Catalonia N=19, Aragón N=19, Madrid N=15, and the Balearic Islands N=15). A purposive and theoretical sampling approach was employed. Participants were recruited after taking part in the clinical trial. Data collection took place between March and July 2024 and analysed using Thematic Analysis. Results UTI did not cause excessive concern, except in cases where the antibiotic was ineffective or when participants had experienced multiple infections in the past. Fosfomycin was the most widely recognized antibiotic, and the two-dose regimen was generally well-regarded for being easy to take while also being more effective than the single-dose treatment. Longer regimens could cause some side effects, but in certain cases, they were perceived as more effective. Participation in the clinical trial was viewed positively, as it contributed to increasing overall knowledge about UTI and the antibiotics used to treat them, as well as ensuring closer monitoring of each specific case. Conclusion This study gathers experiences related to UTI, antibiotic treatment regimens, and participation in the SCOUT clinical trial. It highlights the need to document the realities of UTI in order to improve future clinical trials.
  

• 
  1.

  Tosoratto J, Tárraga López PJ, López-González Ángel A, Busquets-Cortés C, Obrador de Hevia J, Ramírez-Manent JI. Associations Between Shift Work and Insulin Resistance Markers in 53,053 Spanish Workers: A Sex-Stratified Cross-Sectional Analysis Using TyG, TyG-BMI, METS-IR, and SPISE-IR Indices. [Internet]. 2025 Jun.;. https://hdl.handle.net/20.500.13003/25413

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Background/Objective: Shift work has been increasingly associated with adverse metabolic outcomes, including insulin resistance (IR), a key contributor to cardiometabolic diseases. However, few large-scale studies have explored the association between shift work and validated IR indices across sociodemographic and lifestyle variables, stratified by sex. To investigate the relationship between shift work and four surrogate markers of insulin resistance-TyG índex, TyG-BMI, METS-IR (Metabolic score for insulin resistance), and SPISE-IR (Single-Point insulin Sensitivity estimator)-in a large Spanish working population and to assess how sociodemographic and behavioral factors modify these associations. Methods: This cross-sectional study included 53,053 employed adults (31,753 men and 21,300 women) across various regions and labor sectors in Spain. Participants were classified as shift or non-shift workers based on their work schedules. Data were collected during routine occupational health assessments and included anthropometric, clinical, biochemical, and behavioral variables. IR indices were calculated using standard formulas. Statistical analyses included t-tests, chi-square tests, and multivariable logistic regression, with stratification by sex. Results: Shift workers exhibited significantly higher levels of TyG, TyG-BMI, and METS-IR, and lower SPISE values compared to non-shift workers (all p \textless 0.001). These differences persisted after stratification by sex, age, education, and lifestyle factors. Logistic regression analyses confirmed that shift work independently predicted high IR risk across all indices, with adjusted ORs ranging from 1.49 to 1.89. Physical inactivity, low adherence to the Mediterranean diet, and alcohol consumption were the strongest modifiable predictors. Men exhibited a higher burden of IR than women across all indices. Conclusions: Shift work is independently associated with elevated insulin resistance in both men and women. These findings emphasize the importance of workplace health interventions targeting physical activity, diet, and substance use, particularly in populations engaged in non-standard work schedules.

  @article{tosoratto_associations_2025,
  abstract = {Background/Objective: Shift work has been increasingly associated with adverse metabolic outcomes, including insulin resistance (IR), a key contributor to cardiometabolic diseases. However, few large-scale studies have explored the association between shift work and validated IR indices across sociodemographic and lifestyle variables, stratified by sex. To investigate the relationship between shift work and four surrogate markers of insulin resistance-TyG índex, TyG-BMI, METS-IR (Metabolic score for insulin resistance), and SPISE-IR (Single-Point insulin Sensitivity estimator)-in a large Spanish working population and to assess how sociodemographic and behavioral factors modify these associations. Methods: This cross-sectional study included 53,053 employed adults (31,753 men and 21,300 women) across various regions and labor sectors in Spain. Participants were classified as shift or non-shift workers based on their work schedules. Data were collected during routine occupational health assessments and included anthropometric, clinical, biochemical, and behavioral variables. IR indices were calculated using standard formulas. Statistical analyses included t-tests, chi-square tests, and multivariable logistic regression, with stratification by sex. Results: Shift workers exhibited significantly higher levels of TyG, TyG-BMI, and METS-IR, and lower SPISE values compared to non-shift workers (all p \textless 0.001). These differences persisted after stratification by sex, age, education, and lifestyle factors. Logistic regression analyses confirmed that shift work independently predicted high IR risk across all indices, with adjusted ORs ranging from 1.49 to 1.89. Physical inactivity, low adherence to the Mediterranean diet, and alcohol consumption were the strongest modifiable predictors. Men exhibited a higher burden of IR than women across all indices. Conclusions: Shift work is independently associated with elevated insulin resistance in both men and women. These findings emphasize the importance of workplace health interventions targeting physical activity, diet, and substance use, particularly in populations engaged in non-standard work schedules.},
  author = {Tosoratto, Javier and Tárraga López, Pedro Juan and López-González, Ángel Arturo and Busquets-Cortés, Carla and Obrador de Hevia, Joan and Ramírez-Manent, José Ignacio},
  keywords = {grapp-caib},
  month = {jun},
  title = {Associations Between Shift Work and Insulin Resistance Markers in 53,053 Spanish Workers: A Sex-Stratified Cross-Sectional Analysis Using TyG, TyG-BMI, METS-IR, and SPISE-IR Indices},
  year = 2025
  }
  

  %0 Journal Article
  %1 tosoratto_associations_2025
  %A Tosoratto, Javier
  %A Tárraga López, Pedro Juan
  %A López-González, Ángel Arturo
  %A Busquets-Cortés, Carla
  %A Obrador de Hevia, Joan
  %A Ramírez-Manent, José Ignacio
  %D 2025
  %R 10.3390/jcm14134604
  %T Associations Between Shift Work and Insulin Resistance Markers in 53,053 Spanish Workers: A Sex-Stratified Cross-Sectional Analysis Using TyG, TyG-BMI, METS-IR, and SPISE-IR Indices
  %U https://hdl.handle.net/20.500.13003/25413
  %X Background/Objective: Shift work has been increasingly associated with adverse metabolic outcomes, including insulin resistance (IR), a key contributor to cardiometabolic diseases. However, few large-scale studies have explored the association between shift work and validated IR indices across sociodemographic and lifestyle variables, stratified by sex. To investigate the relationship between shift work and four surrogate markers of insulin resistance-TyG índex, TyG-BMI, METS-IR (Metabolic score for insulin resistance), and SPISE-IR (Single-Point insulin Sensitivity estimator)-in a large Spanish working population and to assess how sociodemographic and behavioral factors modify these associations. Methods: This cross-sectional study included 53,053 employed adults (31,753 men and 21,300 women) across various regions and labor sectors in Spain. Participants were classified as shift or non-shift workers based on their work schedules. Data were collected during routine occupational health assessments and included anthropometric, clinical, biochemical, and behavioral variables. IR indices were calculated using standard formulas. Statistical analyses included t-tests, chi-square tests, and multivariable logistic regression, with stratification by sex. Results: Shift workers exhibited significantly higher levels of TyG, TyG-BMI, and METS-IR, and lower SPISE values compared to non-shift workers (all p \textless 0.001). These differences persisted after stratification by sex, age, education, and lifestyle factors. Logistic regression analyses confirmed that shift work independently predicted high IR risk across all indices, with adjusted ORs ranging from 1.49 to 1.89. Physical inactivity, low adherence to the Mediterranean diet, and alcohol consumption were the strongest modifiable predictors. Men exhibited a higher burden of IR than women across all indices. Conclusions: Shift work is independently associated with elevated insulin resistance in both men and women. These findings emphasize the importance of workplace health interventions targeting physical activity, diet, and substance use, particularly in populations engaged in non-standard work schedules.
  

2024

• 
  1.

  Malih N, Konieczna J, Fernandez MN, Fiol deRoque MA, Zamanillo-Campos R, Ricci-Cabello I. Preparatory work for the safety evaluation by EFSA of Human-identical Milk Oligosaccharides as Novel Foods. EFSA Supporting Publications [Internet]. 2024;21:8955E. https://efsa.onlinelibrary.wiley.com/doi/abs/10.2903/sp.efsa.2024.EN-8955

  AbstractURLBibTeXEndNoteBibSonomy

  Abstract Background and aims This report describes a scoping literature review as preparatory work for the safety evaluation by EFSA of Human-identical Milk Oligosaccharides (HiMOs) as Novel Foods (NFs). The main objective was to gather information on the concentrations of Human Milk Oligosaccharides (HMOs) in human milk, both individual and total, and the combinations/mixtures of HiMOs/HMOs in commercially available products or those reported in the literature. Methods A scoping literature review was conducted, including a search strategy implemented in biomedical (PubMed) and multidisciplinary (Web of Science) databases from 2013 to March 2024, supplemented by an ad hoc search for primary studies included in two key recent systematic reviews and grey literature searches on relevant food business operators' websites. Both primary and secondary studies were selected to determine the individual concentrations of target HMOs, the total concentration of HMOs and relevant HMO fractions, and the combinations/mixtures of HiMOs/HMOs. Only studies with full text published in English or Spanish were eligible, excluding patents, editorials, conference abstracts, books, and dissertations. Results The structured searches yielded 2,851 unique references, with 218 selected for full-text evaluation and 36 additional unique references from the key systematic reviews. Ultimately, 171 publications were included in the review. Fourteen companies related to HiMOs were identified through grey literature. In most publications, concentration data for multiple groups of donors (e.g., based on factors like secretor status or lactation period) were reported. By groups of donors, the mean total concentration of HMOs in milk (excluding colostrum) was 6,740 mg/L, whereas the mean by publication was 5,341 mg/L. By publication, the mean concentrations of individual HMOs (mg/L, excluding colostrum) were: LNnT 288, LNT 971, 2'-FL 1,468, 3-FL 800, DFL 232, 3'-SL 212, 6'-SL 365, LNFP I 738, and LNT/LNnT 611. By groups of donors, the mean concentrations (mg/L, excluding colostrum) were: LNnT 382, LNT 1064.1, 2'-FL 1685, 3-FL 907, DFL 303, 3'-SL 225, 6'-SL 435, LNFP I 773, and LNT/LNnT 882. By publication, the mean concentration (mg/L) of groups of HMOs mean concentrations (excluding colostrum) was: 4,577 for total neutral; 851 for total acidic; 4,635 for total acidic fucosylated; 1,631 for α-1-3/4-fucosylated; 3,304 for α-1-2-fucosylated; 1,601 for non-fucosylated; 1,505 for total sialyllated; 2,293 for acidic sialyllated. By group of donors, the mean concentration (mg/L) of groups of HMOs mean concentrations (excluding colostrum) was: 3,942 for total neutral; 1,032 for total acidic; 6,477 for total acidic fucosylated; 1,650 for α-1-3/4-fucosylated; 3,748 for α-1-2-fucosylated; 2,026 for non-fucosylated; 1,957 for total sialyllated; 2,293 for acidic sialyllated. The most frequent combinations of HMOs/HiMOs were LNnT + 2'-FL (24 products, 32%) and 2'-FL + 3'-SL (12 products, 16%). Conclusions The findings of this review will support EFSA in the safety evaluation of HiMOs as NFs, in accordance with the EC mandate (M-2023-00157).

  @article{malih2024preparatory,
  abstract = {Abstract Background and aims This report describes a scoping literature review as preparatory work for the safety evaluation by EFSA of Human-identical Milk Oligosaccharides (HiMOs) as Novel Foods (NFs). The main objective was to gather information on the concentrations of Human Milk Oligosaccharides (HMOs) in human milk, both individual and total, and the combinations/mixtures of HiMOs/HMOs in commercially available products or those reported in the literature. Methods A scoping literature review was conducted, including a search strategy implemented in biomedical (PubMed) and multidisciplinary (Web of Science) databases from 2013 to March 2024, supplemented by an ad hoc search for primary studies included in two key recent systematic reviews and grey literature searches on relevant food business operators' websites. Both primary and secondary studies were selected to determine the individual concentrations of target HMOs, the total concentration of HMOs and relevant HMO fractions, and the combinations/mixtures of HiMOs/HMOs. Only studies with full text published in English or Spanish were eligible, excluding patents, editorials, conference abstracts, books, and dissertations. Results The structured searches yielded 2,851 unique references, with 218 selected for full-text evaluation and 36 additional unique references from the key systematic reviews. Ultimately, 171 publications were included in the review. Fourteen companies related to HiMOs were identified through grey literature. In most publications, concentration data for multiple groups of donors (e.g., based on factors like secretor status or lactation period) were reported. By groups of donors, the mean total concentration of HMOs in milk (excluding colostrum) was 6,740 mg/L, whereas the mean by publication was 5,341 mg/L. By publication, the mean concentrations of individual HMOs (mg/L, excluding colostrum) were: LNnT 288, LNT 971, 2'-FL 1,468, 3-FL 800, DFL 232, 3'-SL 212, 6'-SL 365, LNFP I 738, and LNT/LNnT 611. By groups of donors, the mean concentrations (mg/L, excluding colostrum) were: LNnT 382, LNT 1064.1, 2'-FL 1685, 3-FL 907, DFL 303, 3'-SL 225, 6'-SL 435, LNFP I 773, and LNT/LNnT 882. By publication, the mean concentration (mg/L) of groups of HMOs mean concentrations (excluding colostrum) was: 4,577 for total neutral; 851 for total acidic; 4,635 for total acidic fucosylated; 1,631 for α-1-3/4-fucosylated; 3,304 for α-1-2-fucosylated; 1,601 for non-fucosylated; 1,505 for total sialyllated; 2,293 for acidic sialyllated. By group of donors, the mean concentration (mg/L) of groups of HMOs mean concentrations (excluding colostrum) was: 3,942 for total neutral; 1,032 for total acidic; 6,477 for total acidic fucosylated; 1,650 for α-1-3/4-fucosylated; 3,748 for α-1-2-fucosylated; 2,026 for non-fucosylated; 1,957 for total sialyllated; 2,293 for acidic sialyllated. The most frequent combinations of HMOs/HiMOs were LNnT + 2'-FL (24 products, 32%) and 2'-FL + 3'-SL (12 products, 16%). Conclusions The findings of this review will support EFSA in the safety evaluation of HiMOs as NFs, in accordance with the EC mandate (M-2023-00157).},
  author = {Malih, Narges and Konieczna, Jadwiga and Fernandez, Mar Nafria and Fiol deRoque, Maria Antonia and Zamanillo-Campos, Rocío and Ricci-Cabello, Ignacio},
  booktitle = {EFSA Supporting Publications},
  keywords = {evisap},
  pages = {8955E},
  series = 7,
  title = {Preparatory work for the safety evaluation by EFSA of Human-identical Milk Oligosaccharides as Novel Foods},
  volume = 21,
  year = 2024
  }
  

  %0 Journal Article
  %1 malih2024preparatory
  %A Malih, Narges
  %A Konieczna, Jadwiga
  %A Fernandez, Mar Nafria
  %A Fiol deRoque, Maria Antonia
  %A Zamanillo-Campos, Rocío
  %A Ricci-Cabello, Ignacio
  %B EFSA Supporting Publications
  %D 2024
  %P 8955E
  %T Preparatory work for the safety evaluation by EFSA of Human-identical Milk Oligosaccharides as Novel Foods
  %U https://efsa.onlinelibrary.wiley.com/doi/abs/10.2903/sp.efsa.2024.EN-8955
  %V 21
  %X Abstract Background and aims This report describes a scoping literature review as preparatory work for the safety evaluation by EFSA of Human-identical Milk Oligosaccharides (HiMOs) as Novel Foods (NFs). The main objective was to gather information on the concentrations of Human Milk Oligosaccharides (HMOs) in human milk, both individual and total, and the combinations/mixtures of HiMOs/HMOs in commercially available products or those reported in the literature. Methods A scoping literature review was conducted, including a search strategy implemented in biomedical (PubMed) and multidisciplinary (Web of Science) databases from 2013 to March 2024, supplemented by an ad hoc search for primary studies included in two key recent systematic reviews and grey literature searches on relevant food business operators' websites. Both primary and secondary studies were selected to determine the individual concentrations of target HMOs, the total concentration of HMOs and relevant HMO fractions, and the combinations/mixtures of HiMOs/HMOs. Only studies with full text published in English or Spanish were eligible, excluding patents, editorials, conference abstracts, books, and dissertations. Results The structured searches yielded 2,851 unique references, with 218 selected for full-text evaluation and 36 additional unique references from the key systematic reviews. Ultimately, 171 publications were included in the review. Fourteen companies related to HiMOs were identified through grey literature. In most publications, concentration data for multiple groups of donors (e.g., based on factors like secretor status or lactation period) were reported. By groups of donors, the mean total concentration of HMOs in milk (excluding colostrum) was 6,740 mg/L, whereas the mean by publication was 5,341 mg/L. By publication, the mean concentrations of individual HMOs (mg/L, excluding colostrum) were: LNnT 288, LNT 971, 2'-FL 1,468, 3-FL 800, DFL 232, 3'-SL 212, 6'-SL 365, LNFP I 738, and LNT/LNnT 611. By groups of donors, the mean concentrations (mg/L, excluding colostrum) were: LNnT 382, LNT 1064.1, 2'-FL 1685, 3-FL 907, DFL 303, 3'-SL 225, 6'-SL 435, LNFP I 773, and LNT/LNnT 882. By publication, the mean concentration (mg/L) of groups of HMOs mean concentrations (excluding colostrum) was: 4,577 for total neutral; 851 for total acidic; 4,635 for total acidic fucosylated; 1,631 for α-1-3/4-fucosylated; 3,304 for α-1-2-fucosylated; 1,601 for non-fucosylated; 1,505 for total sialyllated; 2,293 for acidic sialyllated. By group of donors, the mean concentration (mg/L) of groups of HMOs mean concentrations (excluding colostrum) was: 3,942 for total neutral; 1,032 for total acidic; 6,477 for total acidic fucosylated; 1,650 for α-1-3/4-fucosylated; 3,748 for α-1-2-fucosylated; 2,026 for non-fucosylated; 1,957 for total sialyllated; 2,293 for acidic sialyllated. The most frequent combinations of HMOs/HiMOs were LNnT + 2'-FL (24 products, 32%) and 2'-FL + 3'-SL (12 products, 16%). Conclusions The findings of this review will support EFSA in the safety evaluation of HiMOs as NFs, in accordance with the EC mandate (M-2023-00157).
  

• 
  1.

  Sánchez-Rodríguez C, Capitán-Moyano L, Malih N, Yáñez AM, Bennasar-Veny M, Velasco-Roldán O, Bulilete O, Llobera-Canaves J. Prevalence of musculoskeletal disorders among hotel housekeepers and cleaners: A systematic review with meta-analysis. Musculoskeletal science & practice [Internet]. Netherlands; 2024 Feb.;69:102890-. https://pubmed.ncbi.nlm.nih.gov/38081106

  AbstractURLBibTeXEndNoteDOIBibSonomy

  BACKGROUND: Musculoskeletal disorders (MSD) are among the most frequent and costly occupational health problems with a rising prevalence globally. OBJECTIVE: This systematic review with meta-analysis was conducted to know and evaluate the prevalence of MSD by anatomic location among hotel housekeepers (HHs) and cleaners. METHODS: Electronic searches were conducted in PubMed, Web of Science, Scopus, Dialnet Plus, PEDro and Cochrane Database for Systematic Reviews using a search strategy to identify cross-sectional studies reporting on the prevalence of MSD in HHs or cleaners. The risk of bias was assessed with Joanna Briggs Institute tool for systematic reviews. A random-effects model was used in the meta-analysis. RESULTS: Nineteen studies were included in the systematic review, nine of them in the meta-analysis (n = 2299). The study sample sizes ranged from 24 to 1043 participants. The Standardized Nordic Musculoskeletal Questionnaire was the most common tool used to assess MSD among both HHs and cleaners (9/19 of the included studies). The three most affected anatomic locations were the low back 53.9% (95% CI: 43.3-64.6), shoulders 41.4% (95% CI: 27.1-55.8), and wrists/hands 40.1% (95% CI: 24.5-55.7). CONCLUSIONS: HHs and cleaners have a high prevalence of MSD. Low back pain is the most prevalent MSD among both HHs and cleaners affecting up to one of two people.

  @article{sanchezrodriguez2024prevalence,
  abstract = {BACKGROUND: Musculoskeletal disorders (MSD) are among the most frequent and costly occupational health problems with a rising prevalence globally. OBJECTIVE: This systematic review with meta-analysis was conducted to know and evaluate the prevalence of MSD by anatomic location among hotel housekeepers (HHs) and cleaners. METHODS: Electronic searches were conducted in PubMed, Web of Science, Scopus, Dialnet Plus, PEDro and Cochrane Database for Systematic Reviews using a search strategy to identify cross-sectional studies reporting on the prevalence of MSD in HHs or cleaners. The risk of bias was assessed with Joanna Briggs Institute tool for systematic reviews. A random-effects model was used in the meta-analysis. RESULTS: Nineteen studies were included in the systematic review, nine of them in the meta-analysis (n = 2299). The study sample sizes ranged from 24 to 1043 participants. The Standardized Nordic Musculoskeletal Questionnaire was the most common tool used to assess MSD among both HHs and cleaners (9/19 of the included studies). The three most affected anatomic locations were the low back 53.9% (95% CI: 43.3-64.6), shoulders 41.4% (95% CI: 27.1-55.8), and wrists/hands 40.1% (95% CI: 24.5-55.7). CONCLUSIONS: HHs and cleaners have a high prevalence of MSD. Low back pain is the most prevalent MSD among both HHs and cleaners affecting up to one of two people.},
  address = {Netherlands},
  author = {Sánchez-Rodríguez, Cristian and Capitán-Moyano, Laura and Malih, Narges and Yáñez, Aina M and Bennasar-Veny, Miquel and Velasco-Roldán, Olga and Bulilete, Oana and Llobera-Canaves, Joan},
  journal = {Musculoskeletal science & practice},
  keywords = {evisap},
  month = {feb},
  pages = {102890--102890},
  title = {Prevalence of musculoskeletal disorders among hotel housekeepers and cleaners: A systematic review with meta-analysis},
  volume = 69,
  year = 2024
  }
  

  %0 Journal Article
  %1 sanchezrodriguez2024prevalence
  %A Sánchez-Rodríguez, Cristian
  %A Capitán-Moyano, Laura
  %A Malih, Narges
  %A Yáñez, Aina M
  %A Bennasar-Veny, Miquel
  %A Velasco-Roldán, Olga
  %A Bulilete, Oana
  %A Llobera-Canaves, Joan
  %C Netherlands
  %D 2024
  %J Musculoskeletal science & practice
  %P 102890--102890
  %R 10.1016/j.msksp.2023.102890
  %T Prevalence of musculoskeletal disorders among hotel housekeepers and cleaners: A systematic review with meta-analysis
  %U https://pubmed.ncbi.nlm.nih.gov/38081106
  %V 69
  %X BACKGROUND: Musculoskeletal disorders (MSD) are among the most frequent and costly occupational health problems with a rising prevalence globally. OBJECTIVE: This systematic review with meta-analysis was conducted to know and evaluate the prevalence of MSD by anatomic location among hotel housekeepers (HHs) and cleaners. METHODS: Electronic searches were conducted in PubMed, Web of Science, Scopus, Dialnet Plus, PEDro and Cochrane Database for Systematic Reviews using a search strategy to identify cross-sectional studies reporting on the prevalence of MSD in HHs or cleaners. The risk of bias was assessed with Joanna Briggs Institute tool for systematic reviews. A random-effects model was used in the meta-analysis. RESULTS: Nineteen studies were included in the systematic review, nine of them in the meta-analysis (n = 2299). The study sample sizes ranged from 24 to 1043 participants. The Standardized Nordic Musculoskeletal Questionnaire was the most common tool used to assess MSD among both HHs and cleaners (9/19 of the included studies). The three most affected anatomic locations were the low back 53.9% (95% CI: 43.3-64.6), shoulders 41.4% (95% CI: 27.1-55.8), and wrists/hands 40.1% (95% CI: 24.5-55.7). CONCLUSIONS: HHs and cleaners have a high prevalence of MSD. Low back pain is the most prevalent MSD among both HHs and cleaners affecting up to one of two people.
  

• 
  1.

  Roldán-Espínola L, Riera-Serra P, Roca M, García-Toro M, Coronado-Simsic V, Castro A, Navarra-Ventura G, Vilagut G, Alayo I, Ballester L, Blasco MJ, Almenara J, Cebrià AI, Echeburúa E, Gabilondo A, Lagares C, Piqueras JA, Soto-Sanz V, Mortier P, Kessler RC, Alonso J, Forteza-Rey I, Gili M. Depression and lifestyle among university students: A one-year follow-up study. The European Journal of Psychiatry [Internet]. 2024;38(3):100250. https://www.sciencedirect.com/science/article/pii/S0213616324000016

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Background and objectives University stage is a risk period for development of mental disorders and major depression disorder (MDD) is one of the most prevalent disorders. There is increasing evidence about the influence of lifestyle factors on depression onset and maintenance, nevertheless there is a great heterogeneity between analyzed lifestyle factors and few longitudinal studies has been carried out. The current study aims to longitudinally assess the influence of lifestyle on MDD courses among first-year university students. Methods First-onset and persistence of MDD and lifestyle trajectories are measured using baseline and 12-months follow-up online surveys. Multivariate logistic regression analyses were performed to study longitudinal risk/protective associations between lifestyle factors and MDD. Results 1,292 participants were included. Mean age of included participants at baseline was 18.5 (SD= 1.16) and 75.7 % were female. First-onset and persistence of MDD at T2 were 10.3 % and 38.9 % respectively. Maintenance of healthy sleep (Adjusted Odds Ratio (aOR) = 0.26; 95 % CI =0.12–0.58) and physical activity (aOR = 0.24; 95 % CI = 0.10–0.58) were protectively associated against MDD first-onset. Adoption of healthy levels of social support showed a protective effect against MDD persistence (aOR = 0.17; 95 % CI = 0.07–0.44). Conclusions Lifestyle should be considered in order to improve depression prevention strategies among university students. Sleep, physical activity, and social support seem to have a crucial role in the onset and persistence of depression among this population.

  @article{RN65,
  abstract = {Background and objectives University stage is a risk period for development of mental disorders and major depression disorder (MDD) is one of the most prevalent disorders. There is increasing evidence about the influence of lifestyle factors on depression onset and maintenance, nevertheless there is a great heterogeneity between analyzed lifestyle factors and few longitudinal studies has been carried out. The current study aims to longitudinally assess the influence of lifestyle on MDD courses among first-year university students. Methods First-onset and persistence of MDD and lifestyle trajectories are measured using baseline and 12-months follow-up online surveys. Multivariate logistic regression analyses were performed to study longitudinal risk/protective associations between lifestyle factors and MDD. Results 1,292 participants were included. Mean age of included participants at baseline was 18.5 (SD= 1.16) and 75.7 % were female. First-onset and persistence of MDD at T2 were 10.3 % and 38.9 % respectively. Maintenance of healthy sleep (Adjusted Odds Ratio (aOR) = 0.26; 95 % CI =0.12–0.58) and physical activity (aOR = 0.24; 95 % CI = 0.10–0.58) were protectively associated against MDD first-onset. Adoption of healthy levels of social support showed a protective effect against MDD persistence (aOR = 0.17; 95 % CI = 0.07–0.44). Conclusions Lifestyle should be considered in order to improve depression prevention strategies among university students. Sleep, physical activity, and social support seem to have a crucial role in the onset and persistence of depression among this population.},
  author = {Roldán-Espínola, Lorenzo and Riera-Serra, Pau and Roca, Miquel and García-Toro, Mauro and Coronado-Simsic, Victoria and Castro, Adoración and Navarra-Ventura, Guillem and Vilagut, Gemma and Alayo, Itxaso and Ballester, Laura and Blasco, María Jesús and Almenara, José and Cebrià, Ana Isabel and Echeburúa, Enrique and Gabilondo, Andrea and Lagares, Carolina and Piqueras, José Antonio and Soto-Sanz, Victoria and Mortier, Philippe and Kessler, Ronald C. and Alonso, Jordi and Forteza-Rey, Inés and Gili, Margalida},
  journal = {The European Journal of Psychiatry},
  keywords = {evisap},
  number = 3,
  pages = 100250,
  title = {Depression and lifestyle among university students: A one-year follow-up study},
  type = {Journal Article},
  volume = 38,
  year = 2024
  }
  

  %0 Journal Article
  %1 RN65
  %A Roldán-Espínola, Lorenzo
  %A Riera-Serra, Pau
  %A Roca, Miquel
  %A García-Toro, Mauro
  %A Coronado-Simsic, Victoria
  %A Castro, Adoración
  %A Navarra-Ventura, Guillem
  %A Vilagut, Gemma
  %A Alayo, Itxaso
  %A Ballester, Laura
  %A Blasco, María Jesús
  %A Almenara, José
  %A Cebrià, Ana Isabel
  %A Echeburúa, Enrique
  %A Gabilondo, Andrea
  %A Lagares, Carolina
  %A Piqueras, José Antonio
  %A Soto-Sanz, Victoria
  %A Mortier, Philippe
  %A Kessler, Ronald C.
  %A Alonso, Jordi
  %A Forteza-Rey, Inés
  %A Gili, Margalida
  %D 2024
  %J The European Journal of Psychiatry
  %N 3
  %P 100250
  %R https://doi.org/10.1016/j.ejpsy.2024.100250
  %T Depression and lifestyle among university students: A one-year follow-up study
  %U https://www.sciencedirect.com/science/article/pii/S0213616324000016
  %V 38
  %X Background and objectives University stage is a risk period for development of mental disorders and major depression disorder (MDD) is one of the most prevalent disorders. There is increasing evidence about the influence of lifestyle factors on depression onset and maintenance, nevertheless there is a great heterogeneity between analyzed lifestyle factors and few longitudinal studies has been carried out. The current study aims to longitudinally assess the influence of lifestyle on MDD courses among first-year university students. Methods First-onset and persistence of MDD and lifestyle trajectories are measured using baseline and 12-months follow-up online surveys. Multivariate logistic regression analyses were performed to study longitudinal risk/protective associations between lifestyle factors and MDD. Results 1,292 participants were included. Mean age of included participants at baseline was 18.5 (SD= 1.16) and 75.7 % were female. First-onset and persistence of MDD at T2 were 10.3 % and 38.9 % respectively. Maintenance of healthy sleep (Adjusted Odds Ratio (aOR) = 0.26; 95 % CI =0.12–0.58) and physical activity (aOR = 0.24; 95 % CI = 0.10–0.58) were protectively associated against MDD first-onset. Adoption of healthy levels of social support showed a protective effect against MDD persistence (aOR = 0.17; 95 % CI = 0.07–0.44). Conclusions Lifestyle should be considered in order to improve depression prevention strategies among university students. Sleep, physical activity, and social support seem to have a crucial role in the onset and persistence of depression among this population.
  

• 
  1.

  Fiol deRoque MA, Mansilla GV, Maderuelo-Fernández JA, Tamayo-Morales O, Martín-Luján F, Astier-Peña P, Chacón-Docampo M, Orrego C, Gens-Barberà M, Andreu-Rodrigo P, Ricci-Cabello I, team S. Evaluation of SINERGIAPS, an intervention to improve patient safety in primary healthcare centers in Spain based on patients’ perceptions and experiences: a protocol for a hybrid type I randomized clinical trial. Frontiers in public health [Internet]. Switzerland; 2024 Mar.;12:1324940-. https://pubmed.ncbi.nlm.nih.gov/38596515

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  BACKGROUND: Adverse events in the primary care setting result in a direct cost equivalent to at least 2.5% of total healthcare spending. Across OECD countries, they lead to more than seven million avoidable hospital admissions annually. In this manuscript, we describe the protocol of a trial aimed at evaluating the effectiveness of SinergiAPS (a patient-centered audit and feedback intervention) in reducing avoidable hospital admission and explore the factors that may affect its implementation. METHODS: We will conduct a 24-month, parallel, open-label, multicenter, pragmatic, hybrid type 1 randomized clinical trial. 118 primary healthcare centers with wide geographical distribution in Spain will be randomly assigned (ratio 1:1) to two groups. The intervention group will receive two audits (baseline and intermediate at 12 months) based on information collected through the administration of the PREOS-PC questionnaire (a measure of patient-reported patient safety) to a convenience sample of 100 patients per center. The intervention group will receive reports on the results of both audits, along with educational resources aimed at facilitating the design and implementation of safety improvement plans. The control group will receive care as usual. The primary outcome will be the rate of avoidable hospitalizations (administrative data). Secondary outcomes: patient-reported patient safety experiences and outcomes (PREOS-PC questionnaire); patient safety culture as perceived by professionals (MOSPSC questionnaire); adverse events reported by healthcare professionals (ad hoc questionnaire); the number of safety improvement actions which the re has implemented (ad hoc questionnaire). Outcome data will be collected at baseline and 24 months follow-up. For the evaluation of the implementation of the SinergiAPS intervention, we will draw on the Consolidated Framework for Implementation Research (CFIR). We will collect and analyze qualitative and quantitative data (30 individual interviews, implementation logbooks; questionnaires for professionals from intervention centers, and level of use of the SinergiAPS web tool). DISCUSSION: This study will expand the scarce body of evidence existing regarding the effects and implementation of interventions aimed at promoting patient and family engagement in primary healthcare, specifically for enhancing patient safety. The study has the potential to produce an impact on clinical practice, healthcare systems, and population health.Clinical Trial Registration: https://clinicaltrials.gov/study/NCT05958108?term=sinergiAPS&rank=1 (NCT05958108).

  @article{fiolderoque2024evaluation,
  abstract = {BACKGROUND: Adverse events in the primary care setting result in a direct cost equivalent to at least 2.5% of total healthcare spending. Across OECD countries, they lead to more than seven million avoidable hospital admissions annually. In this manuscript, we describe the protocol of a trial aimed at evaluating the effectiveness of SinergiAPS (a patient-centered audit and feedback intervention) in reducing avoidable hospital admission and explore the factors that may affect its implementation. METHODS: We will conduct a 24-month, parallel, open-label, multicenter, pragmatic, hybrid type 1 randomized clinical trial. 118 primary healthcare centers with wide geographical distribution in Spain will be randomly assigned (ratio 1:1) to two groups. The intervention group will receive two audits (baseline and intermediate at 12 months) based on information collected through the administration of the PREOS-PC questionnaire (a measure of patient-reported patient safety) to a convenience sample of 100 patients per center. The intervention group will receive reports on the results of both audits, along with educational resources aimed at facilitating the design and implementation of safety improvement plans. The control group will receive care as usual. The primary outcome will be the rate of avoidable hospitalizations (administrative data). Secondary outcomes: patient-reported patient safety experiences and outcomes (PREOS-PC questionnaire); patient safety culture as perceived by professionals (MOSPSC questionnaire); adverse events reported by healthcare professionals (ad hoc questionnaire); the number of safety improvement actions which the re has implemented (ad hoc questionnaire). Outcome data will be collected at baseline and 24 months follow-up. For the evaluation of the implementation of the SinergiAPS intervention, we will draw on the Consolidated Framework for Implementation Research (CFIR). We will collect and analyze qualitative and quantitative data (30 individual interviews, implementation logbooks; questionnaires for professionals from intervention centers, and level of use of the SinergiAPS web tool). DISCUSSION: This study will expand the scarce body of evidence existing regarding the effects and implementation of interventions aimed at promoting patient and family engagement in primary healthcare, specifically for enhancing patient safety. The study has the potential to produce an impact on clinical practice, healthcare systems, and population health.Clinical Trial Registration: https://clinicaltrials.gov/study/NCT05958108?term=sinergiAPS&rank=1 (NCT05958108).},
  address = {Switzerland},
  author = {Fiol deRoque, Maria A and Mansilla, Georgina Vidal and Maderuelo-Fernández, José A and Tamayo-Morales, Olaya and Martín-Luján, Francisco and Astier-Peña, Pilar and Chacón-Docampo, Macarena and Orrego, Carola and Gens-Barberà, Montserrat and Andreu-Rodrigo, Pilar and Ricci-Cabello, Ignacio and team, SinergiAPS},
  journal = {Frontiers in public health},
  keywords = {evisap myown},
  month = {mar},
  pages = {1324940--1324940},
  title = {Evaluation of SINERGIAPS, an intervention to improve patient safety in primary healthcare centers in Spain based on patients' perceptions and experiences: a protocol for a hybrid type I randomized clinical trial},
  volume = 12,
  year = 2024
  }
  

  %0 Journal Article
  %1 fiolderoque2024evaluation
  %A Fiol deRoque, Maria A
  %A Mansilla, Georgina Vidal
  %A Maderuelo-Fernández, José A
  %A Tamayo-Morales, Olaya
  %A Martín-Luján, Francisco
  %A Astier-Peña, Pilar
  %A Chacón-Docampo, Macarena
  %A Orrego, Carola
  %A Gens-Barberà, Montserrat
  %A Andreu-Rodrigo, Pilar
  %A Ricci-Cabello, Ignacio
  %A team, SinergiAPS
  %C Switzerland
  %D 2024
  %J Frontiers in public health
  %P 1324940--1324940
  %R 10.3389/fpubh.2024.1324940
  %T Evaluation of SINERGIAPS, an intervention to improve patient safety in primary healthcare centers in Spain based on patients' perceptions and experiences: a protocol for a hybrid type I randomized clinical trial
  %U https://pubmed.ncbi.nlm.nih.gov/38596515
  %V 12
  %X BACKGROUND: Adverse events in the primary care setting result in a direct cost equivalent to at least 2.5% of total healthcare spending. Across OECD countries, they lead to more than seven million avoidable hospital admissions annually. In this manuscript, we describe the protocol of a trial aimed at evaluating the effectiveness of SinergiAPS (a patient-centered audit and feedback intervention) in reducing avoidable hospital admission and explore the factors that may affect its implementation. METHODS: We will conduct a 24-month, parallel, open-label, multicenter, pragmatic, hybrid type 1 randomized clinical trial. 118 primary healthcare centers with wide geographical distribution in Spain will be randomly assigned (ratio 1:1) to two groups. The intervention group will receive two audits (baseline and intermediate at 12 months) based on information collected through the administration of the PREOS-PC questionnaire (a measure of patient-reported patient safety) to a convenience sample of 100 patients per center. The intervention group will receive reports on the results of both audits, along with educational resources aimed at facilitating the design and implementation of safety improvement plans. The control group will receive care as usual. The primary outcome will be the rate of avoidable hospitalizations (administrative data). Secondary outcomes: patient-reported patient safety experiences and outcomes (PREOS-PC questionnaire); patient safety culture as perceived by professionals (MOSPSC questionnaire); adverse events reported by healthcare professionals (ad hoc questionnaire); the number of safety improvement actions which the re has implemented (ad hoc questionnaire). Outcome data will be collected at baseline and 24 months follow-up. For the evaluation of the implementation of the SinergiAPS intervention, we will draw on the Consolidated Framework for Implementation Research (CFIR). We will collect and analyze qualitative and quantitative data (30 individual interviews, implementation logbooks; questionnaires for professionals from intervention centers, and level of use of the SinergiAPS web tool). DISCUSSION: This study will expand the scarce body of evidence existing regarding the effects and implementation of interventions aimed at promoting patient and family engagement in primary healthcare, specifically for enhancing patient safety. The study has the potential to produce an impact on clinical practice, healthcare systems, and population health.Clinical Trial Registration: https://clinicaltrials.gov/study/NCT05958108?term=sinergiAPS&rank=1 (NCT05958108).
  

• 
  1.

  Navarra-Ventura G, Riera-Serra P, Roca M, Gili M, García-Toro M, Vilagut G, Alayo I, Ballester L, Blasco MJ, Castellví P, Colom J, Casajuana C, Gabilondo A, Lagares C, Almenara J, Miranda-Mendizabal A, Mortier P, Piqueras JA, Soto-Sanz V, Alonso J, study group U. Factors associated with high and low mental well-being in Spanish university students. Journal of affective disorders [Internet]. Netherlands; 2024 Jul.;356:424-35. https://pubmed.ncbi.nlm.nih.gov/38631424

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  BACKGROUND: Previous studies conducted in various nationally representative samples of the general population show that positive mental health is related to social prosperity. However, specific studies in university populations are scarce. In this study, we set out to explore factors associated with mental well-being (MWB) in a representative sample of first-year university students in Spain. METHODS: MWB was assessed with the short version of the Warwick-Edinburgh Mental Well-Being Scale. Multinomial logistic regressions were performed to explore the association between different blocks of factors, including relational, adversity, stress, lifestyle, spiritual, health, and self-perceived health variables with high and low MWB, controlling for sociodemographic and university-related variables. RESULTS: Data from 2082 students (18.6 ± 1.2 years; 56.6 % females) were analysed. Being male, being born in a foreign country, "high" self-perceived support, and "high" self-perceived mental health increased the odds of high MWB. Growing up in the suburbs, stressful experiences, and anxiety disorders reduced the odds of high MWB. Mood and anxiety disorders increased the odds of low MWB. "Middle" self-perceived support, sleeping ≥8 h per day, and "high" self-perceived mental health reduced the odds of low MWB. LIMITATIONS: The cross-sectional design precludes establishing causal relationships. Data were collected in the 2014-15 academic year using self-reported online surveys. CONCLUSION: The factors associated with high and low MWB do not always mirror each other, so specific plans are needed to successfully address each of the two poles. Interventions and policies targeting these factors for health promotion and disease prevention would improve the MWB of university students.

  @article{navarraventura2024factors,
  abstract = {BACKGROUND: Previous studies conducted in various nationally representative samples of the general population show that positive mental health is related to social prosperity. However, specific studies in university populations are scarce. In this study, we set out to explore factors associated with mental well-being (MWB) in a representative sample of first-year university students in Spain. METHODS: MWB was assessed with the short version of the Warwick-Edinburgh Mental Well-Being Scale. Multinomial logistic regressions were performed to explore the association between different blocks of factors, including relational, adversity, stress, lifestyle, spiritual, health, and self-perceived health variables with high and low MWB, controlling for sociodemographic and university-related variables. RESULTS: Data from 2082 students (18.6 ± 1.2 years; 56.6 % females) were analysed. Being male, being born in a foreign country, "high" self-perceived support, and "high" self-perceived mental health increased the odds of high MWB. Growing up in the suburbs, stressful experiences, and anxiety disorders reduced the odds of high MWB. Mood and anxiety disorders increased the odds of low MWB. "Middle" self-perceived support, sleeping ≥8 h per day, and "high" self-perceived mental health reduced the odds of low MWB. LIMITATIONS: The cross-sectional design precludes establishing causal relationships. Data were collected in the 2014-15 academic year using self-reported online surveys. CONCLUSION: The factors associated with high and low MWB do not always mirror each other, so specific plans are needed to successfully address each of the two poles. Interventions and policies targeting these factors for health promotion and disease prevention would improve the MWB of university students.},
  address = {Netherlands},
  author = {Navarra-Ventura, Guillem and Riera-Serra, Pau and Roca, Miquel and Gili, Margalida and García-Toro, Mauro and Vilagut, Gemma and Alayo, Itxaso and Ballester, Laura and Blasco, Maria Jesús and Castellví, Pere and Colom, Joan and Casajuana, Cristina and Gabilondo, Andrea and Lagares, Carolina and Almenara, José and Miranda-Mendizabal, Andrea and Mortier, Philippe and Piqueras, José Antonio and Soto-Sanz, Victoria and Alonso, Jordi and study group, UNIVERSAL},
  journal = {Journal of affective disorders},
  keywords = {evisap},
  month = {jul},
  pages = {424--435},
  title = {Factors associated with high and low mental well-being in Spanish university students},
  volume = 356,
  year = 2024
  }
  

  %0 Journal Article
  %1 navarraventura2024factors
  %A Navarra-Ventura, Guillem
  %A Riera-Serra, Pau
  %A Roca, Miquel
  %A Gili, Margalida
  %A García-Toro, Mauro
  %A Vilagut, Gemma
  %A Alayo, Itxaso
  %A Ballester, Laura
  %A Blasco, Maria Jesús
  %A Castellví, Pere
  %A Colom, Joan
  %A Casajuana, Cristina
  %A Gabilondo, Andrea
  %A Lagares, Carolina
  %A Almenara, José
  %A Miranda-Mendizabal, Andrea
  %A Mortier, Philippe
  %A Piqueras, José Antonio
  %A Soto-Sanz, Victoria
  %A Alonso, Jordi
  %A study group, UNIVERSAL
  %C Netherlands
  %D 2024
  %J Journal of affective disorders
  %P 424--435
  %R 10.1016/j.jad.2024.04.056
  %T Factors associated with high and low mental well-being in Spanish university students
  %U https://pubmed.ncbi.nlm.nih.gov/38631424
  %V 356
  %X BACKGROUND: Previous studies conducted in various nationally representative samples of the general population show that positive mental health is related to social prosperity. However, specific studies in university populations are scarce. In this study, we set out to explore factors associated with mental well-being (MWB) in a representative sample of first-year university students in Spain. METHODS: MWB was assessed with the short version of the Warwick-Edinburgh Mental Well-Being Scale. Multinomial logistic regressions were performed to explore the association between different blocks of factors, including relational, adversity, stress, lifestyle, spiritual, health, and self-perceived health variables with high and low MWB, controlling for sociodemographic and university-related variables. RESULTS: Data from 2082 students (18.6 ± 1.2 years; 56.6 % females) were analysed. Being male, being born in a foreign country, "high" self-perceived support, and "high" self-perceived mental health increased the odds of high MWB. Growing up in the suburbs, stressful experiences, and anxiety disorders reduced the odds of high MWB. Mood and anxiety disorders increased the odds of low MWB. "Middle" self-perceived support, sleeping ≥8 h per day, and "high" self-perceived mental health reduced the odds of low MWB. LIMITATIONS: The cross-sectional design precludes establishing causal relationships. Data were collected in the 2014-15 academic year using self-reported online surveys. CONCLUSION: The factors associated with high and low MWB do not always mirror each other, so specific plans are needed to successfully address each of the two poles. Interventions and policies targeting these factors for health promotion and disease prevention would improve the MWB of university students.
  

2023

• 
  1.

  Alonso-Bernáldez M, Palou-March A, Zamanillo-Campos R, Palou A, Palou M, Serra F. A Diet Profiling Algorithm (DPA) to Rank Diet Quality Suitable to Implement in Digital Tools-A Test Study in a Cohort of Lactating Women. Nutrients [Internet]. Switzerland; 2023 Mar.;15(6):1337-. https://pubmed.ncbi.nlm.nih.gov/36986066

  AbstractURLBibTeXEndNoteDOIBibSonomy

  Although nutrient profiling systems can empower consumers towards healthier food choices, there is still a need to assess diet quality to obtain an overall perspective. The purpose of this study was to develop a diet profiling algorithm (DPA) to evaluate nutritional diet quality, which gives a final score from 1 to 3 with an associated color (green-yellow-orange). It ranks the total carbohydrate/total fiber ratio, and energy from saturated fats and sodium as potentially negative inputs, while fiber and protein are assumed as positive items. Then, the total fat/total carbohydrate ratio is calculated to evaluate the macronutrient distribution, as well as a food group analysis. To test the DPA performance, diets of a lactating women cohort were analyzed, and a correlation analysis between DPA and breast milk leptin levels was performed. Diets classified as low quality showed a higher intake of negative inputs, along with higher energy and fat intakes. This was reflected in body mass index (BMI) and food groups, indicating that women with the worst scores tended to choose tastier and less satiating foods. In conclusion, the DPA was developed and tested in a sample population. This tool can be easily implemented in digital nutrition platforms, contributing to real-time dietary follow-up of patients and progress monitoring, leading to further dietary adjustment.

  @article{alonsobernaldez2023profiling,
  abstract = {Although nutrient profiling systems can empower consumers towards healthier food choices, there is still a need to assess diet quality to obtain an overall perspective. The purpose of this study was to develop a diet profiling algorithm (DPA) to evaluate nutritional diet quality, which gives a final score from 1 to 3 with an associated color (green-yellow-orange). It ranks the total carbohydrate/total fiber ratio, and energy from saturated fats and sodium as potentially negative inputs, while fiber and protein are assumed as positive items. Then, the total fat/total carbohydrate ratio is calculated to evaluate the macronutrient distribution, as well as a food group analysis. To test the DPA performance, diets of a lactating women cohort were analyzed, and a correlation analysis between DPA and breast milk leptin levels was performed. Diets classified as low quality showed a higher intake of negative inputs, along with higher energy and fat intakes. This was reflected in body mass index (BMI) and food groups, indicating that women with the worst scores tended to choose tastier and less satiating foods. In conclusion, the DPA was developed and tested in a sample population. This tool can be easily implemented in digital nutrition platforms, contributing to real-time dietary follow-up of patients and progress monitoring, leading to further dietary adjustment.},
  address = {Switzerland},
  author = {Alonso-Bernáldez, Marta and Palou-March, Andreu and Zamanillo-Campos, Rocío and Palou, Andreu and Palou, Mariona and Serra, Francisca},
  journal = {Nutrients},
  keywords = {evisap},
  month = {mar},
  number = 6,
  pages = {1337--},
  title = {A Diet Profiling Algorithm (DPA) to Rank Diet Quality Suitable to Implement in Digital Tools-A Test Study in a Cohort of Lactating Women},
  volume = 15,
  year = 2023
  }
  

  %0 Journal Article
  %1 alonsobernaldez2023profiling
  %A Alonso-Bernáldez, Marta
  %A Palou-March, Andreu
  %A Zamanillo-Campos, Rocío
  %A Palou, Andreu
  %A Palou, Mariona
  %A Serra, Francisca
  %C Switzerland
  %D 2023
  %J Nutrients
  %N 6
  %P 1337--
  %R 10.3390/nu15061337
  %T A Diet Profiling Algorithm (DPA) to Rank Diet Quality Suitable to Implement in Digital Tools-A Test Study in a Cohort of Lactating Women
  %U https://pubmed.ncbi.nlm.nih.gov/36986066
  %V 15
  %X Although nutrient profiling systems can empower consumers towards healthier food choices, there is still a need to assess diet quality to obtain an overall perspective. The purpose of this study was to develop a diet profiling algorithm (DPA) to evaluate nutritional diet quality, which gives a final score from 1 to 3 with an associated color (green-yellow-orange). It ranks the total carbohydrate/total fiber ratio, and energy from saturated fats and sodium as potentially negative inputs, while fiber and protein are assumed as positive items. Then, the total fat/total carbohydrate ratio is calculated to evaluate the macronutrient distribution, as well as a food group analysis. To test the DPA performance, diets of a lactating women cohort were analyzed, and a correlation analysis between DPA and breast milk leptin levels was performed. Diets classified as low quality showed a higher intake of negative inputs, along with higher energy and fat intakes. This was reflected in body mass index (BMI) and food groups, indicating that women with the worst scores tended to choose tastier and less satiating foods. In conclusion, the DPA was developed and tested in a sample population. This tool can be easily implemented in digital nutrition platforms, contributing to real-time dietary follow-up of patients and progress monitoring, leading to further dietary adjustment.
  

2022

• 
  1.

  Mounce LTA, Salema N-E, Gangannagaripalli J, Ricci-Cabello I, Avery AJ, Kadam UT, Valderas JM. Development of 2 Short Patient-Report Questionnaires of Patient Safety in Primary Care. Journal of patient safety [Internet]. United States; 2022 Apr.;18(3):161-70. https://pubmed.ncbi.nlm.nih.gov/35344976

  AbstractURLBibTeXEndNoteDOIBibSonomy

  OBJECTIVES: The Patient Reported Experiences and Outcomes of Safety in Primary Care (PREOS-PC) is a valid and reliable instrument (61 items across 5 domains) of patients' perceptions of safety. Stakeholder feedback has supported shorter versions for improving choice and facilitating uptake of routine patient-centered evaluation. We sought to develop 2 shorter versions of PREOS-PC: one including the shortest possible scales that met established measurement performance standards and a screening version including a single item per domain. METHODS: A total of 1244 patients from 45 general practices across England completed PREOS-PC questionnaires. All scale items in PREOS-PC underwent Item Response Theory analysis, applying standard criteria for the item reduction. Cognitive debriefing from 10 patient interviews allowed for the assessment of the instruments' readability. The instruments' psychometrics properties were reassessed in a validation sample of 1557 patients in 21 English general practices. RESULTS: "PREOS-PC Compact" includes 25 items and 2 open-ended questions across the 5 domains, 44% of the length of the original instrument. "PREOS-PC Screen" consists of 6 items: the best-performing single items for 2 domains, 1 item modified from original items for each of the remaining 3 domains, and 1 open-ended question. The evaluation of the instruments confirmed they were acceptable to patients and met standards for readability; construct, convergent, and divergent validity; and reliability. CONCLUSIONS: PREOS-PC Compact meets high-performance standards while reducing patient burden for routine monitoring of patient safety in primary care. PREOS-PC Screen is a concise tool apt for incorporation into audits and to target more in-depth review as needed.

  @article{mounce2022development,
  abstract = {OBJECTIVES: The Patient Reported Experiences and Outcomes of Safety in Primary Care (PREOS-PC) is a valid and reliable instrument (61 items across 5 domains) of patients' perceptions of safety. Stakeholder feedback has supported shorter versions for improving choice and facilitating uptake of routine patient-centered evaluation. We sought to develop 2 shorter versions of PREOS-PC: one including the shortest possible scales that met established measurement performance standards and a screening version including a single item per domain. METHODS: A total of 1244 patients from 45 general practices across England completed PREOS-PC questionnaires. All scale items in PREOS-PC underwent Item Response Theory analysis, applying standard criteria for the item reduction. Cognitive debriefing from 10 patient interviews allowed for the assessment of the instruments' readability. The instruments' psychometrics properties were reassessed in a validation sample of 1557 patients in 21 English general practices. RESULTS: "PREOS-PC Compact" includes 25 items and 2 open-ended questions across the 5 domains, 44% of the length of the original instrument. "PREOS-PC Screen" consists of 6 items: the best-performing single items for 2 domains, 1 item modified from original items for each of the remaining 3 domains, and 1 open-ended question. The evaluation of the instruments confirmed they were acceptable to patients and met standards for readability; construct, convergent, and divergent validity; and reliability. CONCLUSIONS: PREOS-PC Compact meets high-performance standards while reducing patient burden for routine monitoring of patient safety in primary care. PREOS-PC Screen is a concise tool apt for incorporation into audits and to target more in-depth review as needed.},
  address = {United States},
  author = {Mounce, Luke T A and Salema, Nde-Eshimuni and Gangannagaripalli, Jaheeda and Ricci-Cabello, Ignacio and Avery, Anthony J and Kadam, Umesh T and Valderas, José M},
  journal = {Journal of patient safety},
  keywords = {evisap},
  month = {apr},
  number = 3,
  pages = {161--170},
  title = {Development of 2 Short Patient-Report Questionnaires of Patient Safety in Primary Care},
  volume = 18,
  year = 2022
  }
  

  %0 Journal Article
  %1 mounce2022development
  %A Mounce, Luke T A
  %A Salema, Nde-Eshimuni
  %A Gangannagaripalli, Jaheeda
  %A Ricci-Cabello, Ignacio
  %A Avery, Anthony J
  %A Kadam, Umesh T
  %A Valderas, José M
  %C United States
  %D 2022
  %J Journal of patient safety
  %N 3
  %P 161--170
  %R 10.1097/PTS.0000000000000880
  %T Development of 2 Short Patient-Report Questionnaires of Patient Safety in Primary Care
  %U https://pubmed.ncbi.nlm.nih.gov/35344976
  %V 18
  %X OBJECTIVES: The Patient Reported Experiences and Outcomes of Safety in Primary Care (PREOS-PC) is a valid and reliable instrument (61 items across 5 domains) of patients' perceptions of safety. Stakeholder feedback has supported shorter versions for improving choice and facilitating uptake of routine patient-centered evaluation. We sought to develop 2 shorter versions of PREOS-PC: one including the shortest possible scales that met established measurement performance standards and a screening version including a single item per domain. METHODS: A total of 1244 patients from 45 general practices across England completed PREOS-PC questionnaires. All scale items in PREOS-PC underwent Item Response Theory analysis, applying standard criteria for the item reduction. Cognitive debriefing from 10 patient interviews allowed for the assessment of the instruments' readability. The instruments' psychometrics properties were reassessed in a validation sample of 1557 patients in 21 English general practices. RESULTS: "PREOS-PC Compact" includes 25 items and 2 open-ended questions across the 5 domains, 44% of the length of the original instrument. "PREOS-PC Screen" consists of 6 items: the best-performing single items for 2 domains, 1 item modified from original items for each of the remaining 3 domains, and 1 open-ended question. The evaluation of the instruments confirmed they were acceptable to patients and met standards for readability; construct, convergent, and divergent validity; and reliability. CONCLUSIONS: PREOS-PC Compact meets high-performance standards while reducing patient burden for routine monitoring of patient safety in primary care. PREOS-PC Screen is a concise tool apt for incorporation into audits and to target more in-depth review as needed.
  

• 
  1.

  Galmes-Panades AM, Angullo E, Mira-Martínez S, Bennasar-Veny M, Zamanillo-Campos R, Gómez-Juanes R, Konieczna J, Jiménez R, Serrano-Ripoll MJ, Fiol deRoque MA, Miralles J, Yañez AM, Romaguera D, Vidal-Thomas MC, Llobera-Canaves J, García-Toro M, Vicens C, Gervilla-García E, Oña JI, Malih N, Leiva A, Bulilete O, Montaño JJ, Gili M, Roca M, Ricci-Cabello I. Development and Evaluation of a Digital Health Intervention to Prevent Type 2 Diabetes in Primary Care: The PREDIABETEXT Study Protocol for a Randomised Clinical Trial. International journal of environmental research and public health [Internet]. Switzerland; 2022 Nov.;19(22):14706-. https://pubmed.ncbi.nlm.nih.gov/36429423

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  BACKGROUND: Type 2 diabetes mellitus (T2DM) is a highly prevalent disease associated with an increased risk of comorbidities, premature death, and health costs. Prediabetes is a stage of glucose alteration previous to T2DM, that can be reversed. The aim of the study is to develop and evaluate a low-intensity, multifaceted, digital intervention to prevent T2DM. The intervention comprises: (1) the use of mobile health technology to send tailored text messages promoting lifestyle changes to people at risk of T2DM and (2) the provision of online education to primary healthcare physicians and nurses about management of prediabetes. METHODS: In stages 1-4 we will design, develop and pilot-test the intervention. In Stage 5 we will conduct a phase II, six-month, three-arm, cluster randomized, clinical trial with 42 primary care professionals and 420 patients at risk of T2DM. Patients will be allocated to a control group (usual care), intervention A (patient messaging intervention), or intervention B (patient messaging intervention plus online education to their primary healthcare professionals). The primary outcome will be glycated haemoglobin. All the procedures obtained ethical approval in June 2021 (CEI-IB Ref No: IB4495/21PI). DISCUSSION: Digital health interventions can effectively prevent T2DM and reduce important T2DM risk factors such as overweight or hypertension. In Spain, this type of intervention is understudied. Moreover, there is controversy regarding the type of digital health interventions that are more effective. Findings from this study may contribute to address T2DM prevention, through a low-cost and easily implementable intervention.

  @article{galmespanades2022development,
  abstract = {BACKGROUND: Type 2 diabetes mellitus (T2DM) is a highly prevalent disease associated with an increased risk of comorbidities, premature death, and health costs. Prediabetes is a stage of glucose alteration previous to T2DM, that can be reversed. The aim of the study is to develop and evaluate a low-intensity, multifaceted, digital intervention to prevent T2DM. The intervention comprises: (1) the use of mobile health technology to send tailored text messages promoting lifestyle changes to people at risk of T2DM and (2) the provision of online education to primary healthcare physicians and nurses about management of prediabetes. METHODS: In stages 1-4 we will design, develop and pilot-test the intervention. In Stage 5 we will conduct a phase II, six-month, three-arm, cluster randomized, clinical trial with 42 primary care professionals and 420 patients at risk of T2DM. Patients will be allocated to a control group (usual care), intervention A (patient messaging intervention), or intervention B (patient messaging intervention plus online education to their primary healthcare professionals). The primary outcome will be glycated haemoglobin. All the procedures obtained ethical approval in June 2021 (CEI-IB Ref No: IB4495/21PI). DISCUSSION: Digital health interventions can effectively prevent T2DM and reduce important T2DM risk factors such as overweight or hypertension. In Spain, this type of intervention is understudied. Moreover, there is controversy regarding the type of digital health interventions that are more effective. Findings from this study may contribute to address T2DM prevention, through a low-cost and easily implementable intervention.},
  address = {Switzerland},
  author = {Galmes-Panades, Aina M and Angullo, Escarlata and Mira-Martínez, Sofía and Bennasar-Veny, Miquel and Zamanillo-Campos, Rocío and Gómez-Juanes, Rocío and Konieczna, Jadwiga and Jiménez, Rafael and Serrano-Ripoll, Maria Jesús and Fiol deRoque, Maria Antonia and Miralles, Jerónima and Yañez, Aina M and Romaguera, Dora and Vidal-Thomas, Maria Clara and Llobera-Canaves, Joan and García-Toro, Mauro and Vicens, Catalina and Gervilla-García, Elena and Oña, José Iván and Malih, Narges and Leiva, Alfonso and Bulilete, Oana and Montaño, Juan José and Gili, Margalida and Roca, Miquel and Ricci-Cabello, Ignacio},
  journal = {International journal of environmental research and public health},
  keywords = {evisap},
  month = {nov},
  number = 22,
  pages = {14706--},
  title = {Development and Evaluation of a Digital Health Intervention to Prevent Type 2 Diabetes in Primary Care: The PREDIABETEXT Study Protocol for a Randomised Clinical Trial},
  volume = 19,
  year = 2022
  }
  

  %0 Journal Article
  %1 galmespanades2022development
  %A Galmes-Panades, Aina M
  %A Angullo, Escarlata
  %A Mira-Martínez, Sofía
  %A Bennasar-Veny, Miquel
  %A Zamanillo-Campos, Rocío
  %A Gómez-Juanes, Rocío
  %A Konieczna, Jadwiga
  %A Jiménez, Rafael
  %A Serrano-Ripoll, Maria Jesús
  %A Fiol deRoque, Maria Antonia
  %A Miralles, Jerónima
  %A Yañez, Aina M
  %A Romaguera, Dora
  %A Vidal-Thomas, Maria Clara
  %A Llobera-Canaves, Joan
  %A García-Toro, Mauro
  %A Vicens, Catalina
  %A Gervilla-García, Elena
  %A Oña, José Iván
  %A Malih, Narges
  %A Leiva, Alfonso
  %A Bulilete, Oana
  %A Montaño, Juan José
  %A Gili, Margalida
  %A Roca, Miquel
  %A Ricci-Cabello, Ignacio
  %C Switzerland
  %D 2022
  %J International journal of environmental research and public health
  %N 22
  %P 14706--
  %R 10.3390/ijerph192214706
  %T Development and Evaluation of a Digital Health Intervention to Prevent Type 2 Diabetes in Primary Care: The PREDIABETEXT Study Protocol for a Randomised Clinical Trial
  %U https://pubmed.ncbi.nlm.nih.gov/36429423
  %V 19
  %X BACKGROUND: Type 2 diabetes mellitus (T2DM) is a highly prevalent disease associated with an increased risk of comorbidities, premature death, and health costs. Prediabetes is a stage of glucose alteration previous to T2DM, that can be reversed. The aim of the study is to develop and evaluate a low-intensity, multifaceted, digital intervention to prevent T2DM. The intervention comprises: (1) the use of mobile health technology to send tailored text messages promoting lifestyle changes to people at risk of T2DM and (2) the provision of online education to primary healthcare physicians and nurses about management of prediabetes. METHODS: In stages 1-4 we will design, develop and pilot-test the intervention. In Stage 5 we will conduct a phase II, six-month, three-arm, cluster randomized, clinical trial with 42 primary care professionals and 420 patients at risk of T2DM. Patients will be allocated to a control group (usual care), intervention A (patient messaging intervention), or intervention B (patient messaging intervention plus online education to their primary healthcare professionals). The primary outcome will be glycated haemoglobin. All the procedures obtained ethical approval in June 2021 (CEI-IB Ref No: IB4495/21PI). DISCUSSION: Digital health interventions can effectively prevent T2DM and reduce important T2DM risk factors such as overweight or hypertension. In Spain, this type of intervention is understudied. Moreover, there is controversy regarding the type of digital health interventions that are more effective. Findings from this study may contribute to address T2DM prevention, through a low-cost and easily implementable intervention.
  

• 
  1.

  Serrano-Ripoll MJ, Llobera J, Valderas JM, de Labry Lima AO, Fiol deRoque MA, Ripoll J, Ricci-Cabello I. Cross-Cultural Adaptation, Validation, and Piloting of the Patient Reported Experiences and Outcomes of Safety in Primary Care Questionnaire for Its Use in Spain. Journal of patient safety [Internet]. United States; 2022 Mar.;18(2):102-10. https://pubmed.ncbi.nlm.nih.gov/35188925

  AbstractURLBibTeXEndNoteDOIBibSonomy

  OBJECTIVE: This study aimed to cross-culturally adapt, validate, and pilot the Patient Reported Experiences and Outcomes of Safety in Primary Care questionnaire for its use in Spain. METHODS: After setting up an expert panel to determine its content validity, the questionnaire was translated and back-translated, and subjected to cognitive testing. The questionnaire was piloted in a cross-sectional study in 10 primary health care centers in Spain. Fifty patients per center completed the questionnaire while waiting for an appointment. We estimated (i) the acceptability of the questionnaire (response rate), (ii) scores distribution (floor and ceiling effects), (iii) internal consistency (Cronbach α), and (iv) construct validity (exploratory factor analyses and correlation between scales). To examine patients' evaluations of patient safety, we followed a mixed-methods approach: (i) statistical analyses at the scale and item levels based on responses to standardized items and (ii) qualitative content analysis based on responses to open-ended questions. RESULTS: Complete data were collected from 493 patients (participation rate, 77%). A ceiling effect was observed for 3 scales ("safety problems," "harm severity," "harm needs"). The internal consistency was adequate (α > 0.7) for the majority of scales. Exploratory factor analysis and correlation between scales suggested an appropriate construct validity. Two hundred twenty-six (45.8%) respondents experienced at least 1 safety problem, and 109 (23.2%) reported harm in the previous 12 months. CONCLUSIONS: The multidimensional primary health care patient safety instrument Patient Reported Experiences and Outcomes of Safety in Primary Care is now available for its use in Spain. Initial testing demonstrates its potential for use in primary care. Future developments will further address its use in actual clinical practice.

  @article{serranoripoll2022crosscultural,
  abstract = {OBJECTIVE: This study aimed to cross-culturally adapt, validate, and pilot the Patient Reported Experiences and Outcomes of Safety in Primary Care questionnaire for its use in Spain. METHODS: After setting up an expert panel to determine its content validity, the questionnaire was translated and back-translated, and subjected to cognitive testing. The questionnaire was piloted in a cross-sectional study in 10 primary health care centers in Spain. Fifty patients per center completed the questionnaire while waiting for an appointment. We estimated (i) the acceptability of the questionnaire (response rate), (ii) scores distribution (floor and ceiling effects), (iii) internal consistency (Cronbach α), and (iv) construct validity (exploratory factor analyses and correlation between scales). To examine patients' evaluations of patient safety, we followed a mixed-methods approach: (i) statistical analyses at the scale and item levels based on responses to standardized items and (ii) qualitative content analysis based on responses to open-ended questions. RESULTS: Complete data were collected from 493 patients (participation rate, 77%). A ceiling effect was observed for 3 scales ("safety problems," "harm severity," "harm needs"). The internal consistency was adequate (α > 0.7) for the majority of scales. Exploratory factor analysis and correlation between scales suggested an appropriate construct validity. Two hundred twenty-six (45.8%) respondents experienced at least 1 safety problem, and 109 (23.2%) reported harm in the previous 12 months. CONCLUSIONS: The multidimensional primary health care patient safety instrument Patient Reported Experiences and Outcomes of Safety in Primary Care is now available for its use in Spain. Initial testing demonstrates its potential for use in primary care. Future developments will further address its use in actual clinical practice.},
  address = {United States},
  author = {Serrano-Ripoll, María J and Llobera, Joan and Valderas, José M and de Labry Lima, Antonio Olry and Fiol deRoque, María A and Ripoll, Joana and Ricci-Cabello, Ignacio},
  journal = {Journal of patient safety},
  keywords = {evisap},
  month = {mar},
  number = 2,
  pages = {102--110},
  title = {Cross-Cultural Adaptation, Validation, and Piloting of the Patient Reported Experiences and Outcomes of Safety in Primary Care Questionnaire for Its Use in Spain},
  volume = 18,
  year = 2022
  }
  

  %0 Journal Article
  %1 serranoripoll2022crosscultural
  %A Serrano-Ripoll, María J
  %A Llobera, Joan
  %A Valderas, José M
  %A de Labry Lima, Antonio Olry
  %A Fiol deRoque, María A
  %A Ripoll, Joana
  %A Ricci-Cabello, Ignacio
  %C United States
  %D 2022
  %J Journal of patient safety
  %N 2
  %P 102--110
  %R 10.1097/PTS.0000000000000819
  %T Cross-Cultural Adaptation, Validation, and Piloting of the Patient Reported Experiences and Outcomes of Safety in Primary Care Questionnaire for Its Use in Spain
  %U https://pubmed.ncbi.nlm.nih.gov/35188925
  %V 18
  %X OBJECTIVE: This study aimed to cross-culturally adapt, validate, and pilot the Patient Reported Experiences and Outcomes of Safety in Primary Care questionnaire for its use in Spain. METHODS: After setting up an expert panel to determine its content validity, the questionnaire was translated and back-translated, and subjected to cognitive testing. The questionnaire was piloted in a cross-sectional study in 10 primary health care centers in Spain. Fifty patients per center completed the questionnaire while waiting for an appointment. We estimated (i) the acceptability of the questionnaire (response rate), (ii) scores distribution (floor and ceiling effects), (iii) internal consistency (Cronbach α), and (iv) construct validity (exploratory factor analyses and correlation between scales). To examine patients' evaluations of patient safety, we followed a mixed-methods approach: (i) statistical analyses at the scale and item levels based on responses to standardized items and (ii) qualitative content analysis based on responses to open-ended questions. RESULTS: Complete data were collected from 493 patients (participation rate, 77%). A ceiling effect was observed for 3 scales ("safety problems," "harm severity," "harm needs"). The internal consistency was adequate (α > 0.7) for the majority of scales. Exploratory factor analysis and correlation between scales suggested an appropriate construct validity. Two hundred twenty-six (45.8%) respondents experienced at least 1 safety problem, and 109 (23.2%) reported harm in the previous 12 months. CONCLUSIONS: The multidimensional primary health care patient safety instrument Patient Reported Experiences and Outcomes of Safety in Primary Care is now available for its use in Spain. Initial testing demonstrates its potential for use in primary care. Future developments will further address its use in actual clinical practice.
  

• 
  1.

  Zamanillo-Campos R, Chaplin A, Romaguera D, Abete I, Salas-Salvadó J, Martín V, Estruch R, Vidal J, Ruiz-Canela M, Babio N, Fiol F, de Paz JA, Casas R, Olbeyra R, Martínez-González MA, García-Gavilán JF, Goday A, Fernandez-Lazaro CI, Martínez JA, Hu FB, Konieczna J. Longitudinal association of dietary carbohydrate quality with visceral fat deposition and other adiposity indicators. Clinical nutrition (Edinburgh, Scotland) [Internet]. England; 2022 Oct.;41(10):2264-7. https://pubmed.ncbi.nlm.nih.gov/36084360

  AbstractURLBibTeXEndNoteDOIBibSonomy

  BACKGROUND & AIMS: The quality of dietary carbohydrates rather than total carbohydrate intake may determine the accumulation of visceral fat; however, to date, few studies have examined the impact of diet on adiposity using specific imaging techniques. Thus, the aim of this prospective study was to investigate the association between concurrent changes in carbohydrate quality index (CQI) and objectively-quantified adiposity distribution over a year. METHODS: We analyzed a cohort of 1476 participants aged 55-75 years with overweight/obesity and metabolic syndrome (MetS) from the PREDIMED-Plus randomized controlled trial. Dietary intake information was obtained at baseline, 6- and 12-months from a validated 143-item semi-quantitative food-frequency questionnaire, and CQI (range: 4 to 20) was calculated based on four dietary criteria: total dietary fibre, glycemic index, wholegrain/total grain carbohydrate ratio, and solid/total carbohydrate ratio. Overall and regional adiposity (total body fat, visceral fat and android-to-gynoid fat ratio) was quantified using dual-energy X-ray absorptiometry at all three time points. Multiple adjusted linear mixed-effects models were used to assess associations between concurrent changes in repeatedly measured CQI and adiposity over time. RESULTS: After controlling for potential confounding factors, a 3-point increment in CQI over 12-month follow-up was associated with a decrease in visceral fat (β -0.067 z-score, 95% CI -0.088; -0.046, p < 0.001), android-to-gynoid fat ratio (-0.038, -0.059; -0.017, p < 0.001), and total fat (-0.064, -0.080; -0.047, p < 0.001). Fibre intake and the ratio of wholegrain/total grain showed the strongest inverse associations with all adiposity indicators. CONCLUSIONS: In this prospective cohort of older adults with overweight/obesity and MetS, we found that improvements in dietary carbohydrate quality over a year were associated with concurrent favorable changes in visceral and overall fat deposition. These associations were mostly driven by dietary fibre and the wholegrain/total grain ratio. TRIAL REGISTRATION: The trial was registered at the International Standard Randomized. CONTROLLED TRIAL: (ISRCTN: http://www.isrctn.com/ISRCTN89898870) with number 89898870 and registration date of 24 July 2014, retrospectively registered.

  @article{zamanillocampos2022longitudinal,
  abstract = {BACKGROUND & AIMS: The quality of dietary carbohydrates rather than total carbohydrate intake may determine the accumulation of visceral fat; however, to date, few studies have examined the impact of diet on adiposity using specific imaging techniques. Thus, the aim of this prospective study was to investigate the association between concurrent changes in carbohydrate quality index (CQI) and objectively-quantified adiposity distribution over a year. METHODS: We analyzed a cohort of 1476 participants aged 55-75 years with overweight/obesity and metabolic syndrome (MetS) from the PREDIMED-Plus randomized controlled trial. Dietary intake information was obtained at baseline, 6- and 12-months from a validated 143-item semi-quantitative food-frequency questionnaire, and CQI (range: 4 to 20) was calculated based on four dietary criteria: total dietary fibre, glycemic index, wholegrain/total grain carbohydrate ratio, and solid/total carbohydrate ratio. Overall and regional adiposity (total body fat, visceral fat and android-to-gynoid fat ratio) was quantified using dual-energy X-ray absorptiometry at all three time points. Multiple adjusted linear mixed-effects models were used to assess associations between concurrent changes in repeatedly measured CQI and adiposity over time. RESULTS: After controlling for potential confounding factors, a 3-point increment in CQI over 12-month follow-up was associated with a decrease in visceral fat (β -0.067 z-score, 95% CI -0.088; -0.046, p < 0.001), android-to-gynoid fat ratio (-0.038, -0.059; -0.017, p < 0.001), and total fat (-0.064, -0.080; -0.047, p < 0.001). Fibre intake and the ratio of wholegrain/total grain showed the strongest inverse associations with all adiposity indicators. CONCLUSIONS: In this prospective cohort of older adults with overweight/obesity and MetS, we found that improvements in dietary carbohydrate quality over a year were associated with concurrent favorable changes in visceral and overall fat deposition. These associations were mostly driven by dietary fibre and the wholegrain/total grain ratio. TRIAL REGISTRATION: The trial was registered at the International Standard Randomized. CONTROLLED TRIAL: (ISRCTN: http://www.isrctn.com/ISRCTN89898870) with number 89898870 and registration date of 24 July 2014, retrospectively registered.},
  address = {England},
  author = {Zamanillo-Campos, Rocío and Chaplin, Alice and Romaguera, Dora and Abete, Itziar and Salas-Salvadó, Jordi and Martín, Vicente and Estruch, Ramón and Vidal, Josep and Ruiz-Canela, Miguel and Babio, Nancy and Fiol, Francisca and de Paz, José Antonio and Casas, Rosa and Olbeyra, Romina and Martínez-González, Miguel A and García-Gavilán, Jesús F and Goday, Albert and Fernandez-Lazaro, Cesar I and Martínez, J Alfredo and Hu, Frank B and Konieczna, Jadwiga},
  journal = {Clinical nutrition (Edinburgh, Scotland)},
  keywords = {evisap},
  month = {oct},
  number = 10,
  pages = {2264--2274},
  title = {Longitudinal association of dietary carbohydrate quality with visceral fat deposition and other adiposity indicators},
  volume = 41,
  year = 2022
  }
  

  %0 Journal Article
  %1 zamanillocampos2022longitudinal
  %A Zamanillo-Campos, Rocío
  %A Chaplin, Alice
  %A Romaguera, Dora
  %A Abete, Itziar
  %A Salas-Salvadó, Jordi
  %A Martín, Vicente
  %A Estruch, Ramón
  %A Vidal, Josep
  %A Ruiz-Canela, Miguel
  %A Babio, Nancy
  %A Fiol, Francisca
  %A de Paz, José Antonio
  %A Casas, Rosa
  %A Olbeyra, Romina
  %A Martínez-González, Miguel A
  %A García-Gavilán, Jesús F
  %A Goday, Albert
  %A Fernandez-Lazaro, Cesar I
  %A Martínez, J Alfredo
  %A Hu, Frank B
  %A Konieczna, Jadwiga
  %C England
  %D 2022
  %J Clinical nutrition (Edinburgh, Scotland)
  %N 10
  %P 2264--2274
  %R 10.1016/j.clnu.2022.08.008
  %T Longitudinal association of dietary carbohydrate quality with visceral fat deposition and other adiposity indicators
  %U https://pubmed.ncbi.nlm.nih.gov/36084360
  %V 41
  %X BACKGROUND & AIMS: The quality of dietary carbohydrates rather than total carbohydrate intake may determine the accumulation of visceral fat; however, to date, few studies have examined the impact of diet on adiposity using specific imaging techniques. Thus, the aim of this prospective study was to investigate the association between concurrent changes in carbohydrate quality index (CQI) and objectively-quantified adiposity distribution over a year. METHODS: We analyzed a cohort of 1476 participants aged 55-75 years with overweight/obesity and metabolic syndrome (MetS) from the PREDIMED-Plus randomized controlled trial. Dietary intake information was obtained at baseline, 6- and 12-months from a validated 143-item semi-quantitative food-frequency questionnaire, and CQI (range: 4 to 20) was calculated based on four dietary criteria: total dietary fibre, glycemic index, wholegrain/total grain carbohydrate ratio, and solid/total carbohydrate ratio. Overall and regional adiposity (total body fat, visceral fat and android-to-gynoid fat ratio) was quantified using dual-energy X-ray absorptiometry at all three time points. Multiple adjusted linear mixed-effects models were used to assess associations between concurrent changes in repeatedly measured CQI and adiposity over time. RESULTS: After controlling for potential confounding factors, a 3-point increment in CQI over 12-month follow-up was associated with a decrease in visceral fat (β -0.067 z-score, 95% CI -0.088; -0.046, p < 0.001), android-to-gynoid fat ratio (-0.038, -0.059; -0.017, p < 0.001), and total fat (-0.064, -0.080; -0.047, p < 0.001). Fibre intake and the ratio of wholegrain/total grain showed the strongest inverse associations with all adiposity indicators. CONCLUSIONS: In this prospective cohort of older adults with overweight/obesity and MetS, we found that improvements in dietary carbohydrate quality over a year were associated with concurrent favorable changes in visceral and overall fat deposition. These associations were mostly driven by dietary fibre and the wholegrain/total grain ratio. TRIAL REGISTRATION: The trial was registered at the International Standard Randomized. CONTROLLED TRIAL: (ISRCTN: http://www.isrctn.com/ISRCTN89898870) with number 89898870 and registration date of 24 July 2014, retrospectively registered.
  

2021

• 
  1.

  Gangannagaripalli J, Porter I, Davey A, Ricci Cabello I, Greenhalgh J, Anderson R, Briscoe S, Hughes C, Payne R, Cockcroft E, Harris J, Bramwell C, Valderas JM. STOPP/START interventions to improve medicines management for people aged 65 years and over: a realist synthesis [Internet]. Southampton (UK): NIHR Journals Library; 2021. https://pubmed.ncbi.nlm.nih.gov/34846830

  AbstractURLBibTeXEndNoteDOIBibSonomy

  BACKGROUND: Drug-related problems and potentially inappropriate prescribing impose a huge burden on patients and the health-care system. The most widely used tools for appropriate prescription in older adults in England and in other European countries are the Screening Tool of Older People’s Prescriptions (STOPP)/Screening Tool to Alert to the Right Treatment (START) tools. STOPP/START tools support medicines optimisation for older adults. OBJECTIVES: To identify, test and refine the programme theories underlying how interventions based on the STOPP/START tools are intended to work, for whom, in what circumstances and why, as well as the resource use and cost requirements or impacts. DESIGN: A realist synthesis. SETTING: Primary care, hospital care and nursing homes. PATIENTS: Patients aged ≥ 65 years. INTERVENTIONS: Any intervention based on the use of the STOPP/START tools. REVIEW METHODS: Database and web-searching was carried out to retrieve relevant evidence to identify and test programme theories about how interventions based on the use of the STOPP/START tools work. A project reference group made up of health-care professionals, NHS decision-makers, older people, carers and members of the public was set up. In phase 1 we identified programme theories about STOPP/START interventions on how, for whom, in what contexts and why they are intended to work. We searched the peer-reviewed and grey literature to identify documents relevant to the research questions. We interviewed experts in the field in our reference group to gain input on our list of candidate context–mechanism–outcome configurations, to identify additional context–mechanism–outcome configurations and to identify additional literature and/or relevant concepts. In phase 2 we reviewed and synthesised relevant published and unpublished empirical evidence and tested the programme theories using evidence from a larger set of empirical studies. RESULTS: We developed a single logic model structured around three key mechanisms: (1) personalisation, (2) systematisation and (3) evidence implementation. Personalisation: STOPP/START-based interventions are based on shared decision-making, taking into account patient preferences, experiences and expectations (mechanisms), leading to increased patient awareness, adherence, satisfaction, empowerment and quality of life (outcomes). Systematisation: STOPP/START tools provide a standardised/systematic approach for medication reviews (mechanisms), leading to changes in professional and organisational culture and burden/costs (outcomes). Evidence implementation: delivery of STOPP/START-based interventions is based on the implementation of best evidence (mechanisms), reducing adverse outcomes through appropriate prescribing/deprescribing (outcomes). For theory testing, we identified 40 studies of the impact of STOPP/START-based interventions in hospital settings, nursing homes, primary care and community pharmacies. Most of the interventions used multiple mechanisms. We found support for the impact of the personalisation and evidence implementation mechanisms on selected outcome variables, but similar impact was achieved by interventions not relying on these mechanisms. We also observed that the impact of interventions was linked to the proximity of the selected outcomes to the intervention in the logic model, resulting in a clearer benefit for appropriateness of prescribing, adverse drug events and prescription costs. LIMITATIONS: None of the available studies had been explicitly designed for evaluating underlying causal mechanisms, and qualitative information was sparse. CONCLUSIONS: No particular configuration of the interventions is associated with a greater likelihood of improved outcomes in given settings. STUDY REGISTRATION: This study is registered as PROSPERO CRD42018110795. FUNDING: This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 9, No. 23. See the NIHR Journals Library website for further project information.

  @book{gangannagaripalli2021stoppstart,
  abstract = {BACKGROUND: Drug-related problems and potentially inappropriate prescribing impose a huge burden on patients and the health-care system. The most widely used tools for appropriate prescription in older adults in England and in other European countries are the Screening Tool of Older People’s Prescriptions (STOPP)/Screening Tool to Alert to the Right Treatment (START) tools. STOPP/START tools support medicines optimisation for older adults. OBJECTIVES: To identify, test and refine the programme theories underlying how interventions based on the STOPP/START tools are intended to work, for whom, in what circumstances and why, as well as the resource use and cost requirements or impacts. DESIGN: A realist synthesis. SETTING: Primary care, hospital care and nursing homes. PATIENTS: Patients aged ≥ 65 years. INTERVENTIONS: Any intervention based on the use of the STOPP/START tools. REVIEW METHODS: Database and web-searching was carried out to retrieve relevant evidence to identify and test programme theories about how interventions based on the use of the STOPP/START tools work. A project reference group made up of health-care professionals, NHS decision-makers, older people, carers and members of the public was set up. In phase 1 we identified programme theories about STOPP/START interventions on how, for whom, in what contexts and why they are intended to work. We searched the peer-reviewed and grey literature to identify documents relevant to the research questions. We interviewed experts in the field in our reference group to gain input on our list of candidate context–mechanism–outcome configurations, to identify additional context–mechanism–outcome configurations and to identify additional literature and/or relevant concepts. In phase 2 we reviewed and synthesised relevant published and unpublished empirical evidence and tested the programme theories using evidence from a larger set of empirical studies. RESULTS: We developed a single logic model structured around three key mechanisms: (1) personalisation, (2) systematisation and (3) evidence implementation. Personalisation: STOPP/START-based interventions are based on shared decision-making, taking into account patient preferences, experiences and expectations (mechanisms), leading to increased patient awareness, adherence, satisfaction, empowerment and quality of life (outcomes). Systematisation: STOPP/START tools provide a standardised/systematic approach for medication reviews (mechanisms), leading to changes in professional and organisational culture and burden/costs (outcomes). Evidence implementation: delivery of STOPP/START-based interventions is based on the implementation of best evidence (mechanisms), reducing adverse outcomes through appropriate prescribing/deprescribing (outcomes). For theory testing, we identified 40 studies of the impact of STOPP/START-based interventions in hospital settings, nursing homes, primary care and community pharmacies. Most of the interventions used multiple mechanisms. We found support for the impact of the personalisation and evidence implementation mechanisms on selected outcome variables, but similar impact was achieved by interventions not relying on these mechanisms. We also observed that the impact of interventions was linked to the proximity of the selected outcomes to the intervention in the logic model, resulting in a clearer benefit for appropriateness of prescribing, adverse drug events and prescription costs. LIMITATIONS: None of the available studies had been explicitly designed for evaluating underlying causal mechanisms, and qualitative information was sparse. CONCLUSIONS: No particular configuration of the interventions is associated with a greater likelihood of improved outcomes in given settings. STUDY REGISTRATION: This study is registered as PROSPERO CRD42018110795. FUNDING: This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 9, No. 23. See the NIHR Journals Library website for further project information.},
  address = {Southampton (UK)},
  author = {Gangannagaripalli, Jaheeda and Porter, Ian and Davey, Antoinette and Ricci Cabello, Ignacio and Greenhalgh, Joanne and Anderson, Rob and Briscoe, Simon and Hughes, Carmel and Payne, Rupert and Cockcroft, Emma and Harris, Jim and Bramwell, Charlotte and Valderas, Jose M},
  keywords = {evisap},
  month = {nov},
  publisher = {NIHR Journals Library},
  title = {STOPP/START interventions to improve medicines management for people aged 65 years and over: a realist synthesis},
  year = 2021
  }
  

  %0 Book
  %1 gangannagaripalli2021stoppstart
  %A Gangannagaripalli, Jaheeda
  %A Porter, Ian
  %A Davey, Antoinette
  %A Ricci Cabello, Ignacio
  %A Greenhalgh, Joanne
  %A Anderson, Rob
  %A Briscoe, Simon
  %A Hughes, Carmel
  %A Payne, Rupert
  %A Cockcroft, Emma
  %A Harris, Jim
  %A Bramwell, Charlotte
  %A Valderas, Jose M
  %C Southampton (UK)
  %D 2021
  %I NIHR Journals Library
  %R 10.3310/hsdr09230
  %T STOPP/START interventions to improve medicines management for people aged 65 years and over: a realist synthesis
  %U https://pubmed.ncbi.nlm.nih.gov/34846830
  %X BACKGROUND: Drug-related problems and potentially inappropriate prescribing impose a huge burden on patients and the health-care system. The most widely used tools for appropriate prescription in older adults in England and in other European countries are the Screening Tool of Older People’s Prescriptions (STOPP)/Screening Tool to Alert to the Right Treatment (START) tools. STOPP/START tools support medicines optimisation for older adults. OBJECTIVES: To identify, test and refine the programme theories underlying how interventions based on the STOPP/START tools are intended to work, for whom, in what circumstances and why, as well as the resource use and cost requirements or impacts. DESIGN: A realist synthesis. SETTING: Primary care, hospital care and nursing homes. PATIENTS: Patients aged ≥ 65 years. INTERVENTIONS: Any intervention based on the use of the STOPP/START tools. REVIEW METHODS: Database and web-searching was carried out to retrieve relevant evidence to identify and test programme theories about how interventions based on the use of the STOPP/START tools work. A project reference group made up of health-care professionals, NHS decision-makers, older people, carers and members of the public was set up. In phase 1 we identified programme theories about STOPP/START interventions on how, for whom, in what contexts and why they are intended to work. We searched the peer-reviewed and grey literature to identify documents relevant to the research questions. We interviewed experts in the field in our reference group to gain input on our list of candidate context–mechanism–outcome configurations, to identify additional context–mechanism–outcome configurations and to identify additional literature and/or relevant concepts. In phase 2 we reviewed and synthesised relevant published and unpublished empirical evidence and tested the programme theories using evidence from a larger set of empirical studies. RESULTS: We developed a single logic model structured around three key mechanisms: (1) personalisation, (2) systematisation and (3) evidence implementation. Personalisation: STOPP/START-based interventions are based on shared decision-making, taking into account patient preferences, experiences and expectations (mechanisms), leading to increased patient awareness, adherence, satisfaction, empowerment and quality of life (outcomes). Systematisation: STOPP/START tools provide a standardised/systematic approach for medication reviews (mechanisms), leading to changes in professional and organisational culture and burden/costs (outcomes). Evidence implementation: delivery of STOPP/START-based interventions is based on the implementation of best evidence (mechanisms), reducing adverse outcomes through appropriate prescribing/deprescribing (outcomes). For theory testing, we identified 40 studies of the impact of STOPP/START-based interventions in hospital settings, nursing homes, primary care and community pharmacies. Most of the interventions used multiple mechanisms. We found support for the impact of the personalisation and evidence implementation mechanisms on selected outcome variables, but similar impact was achieved by interventions not relying on these mechanisms. We also observed that the impact of interventions was linked to the proximity of the selected outcomes to the intervention in the logic model, resulting in a clearer benefit for appropriateness of prescribing, adverse drug events and prescription costs. LIMITATIONS: None of the available studies had been explicitly designed for evaluating underlying causal mechanisms, and qualitative information was sparse. CONCLUSIONS: No particular configuration of the interventions is associated with a greater likelihood of improved outcomes in given settings. STUDY REGISTRATION: This study is registered as PROSPERO CRD42018110795. FUNDING: This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 9, No. 23. See the NIHR Journals Library website for further project information.
  

• 
  1.

  Zamanillo Campos R, Colomar Ferrer MT, Ruiz López RM, Sanchís Cortés MP, Urgelés Planella JR. Specific Quality of Life Assessment by the NutriQoL® Questionnaire Among Patients Receiving Home Enteral Nutrition. JPEN. Journal of parenteral and enteral nutrition [Internet]. United States; 2021 Mar.;45(3):490-8. https://pubmed.ncbi.nlm.nih.gov/32459026

  AbstractURLBibTeXEndNoteDOIBibSonomy

  BACKGROUND: Home enteral nutrition (HEN), including tube feeding and oral supplementation, can improve or worsen quality of life (QoL). The specific assessment of factors affecting QoL may identify the inherent problems associated with HEN. The aim of this study was to evaluate whether the validated NutriQoL® questionnaire is useful for assessing the QoL and the factors influencing it in patients receiving HEN. METHODS: A total of 78 patients receiving HEN completed both the NutriQoL and the SF-12 questionnaires during their routine visits to nutrition service at the hospital. RESULTS: Ninety percent of patients receiving HEN had cancer, 58% received oral supplements, and 42% received tube feeding. At recruitment, the mean score ± SD of the NutriQoL was 66 ± 14, whereas that of the SF-12 was 40 ± 9. A positive correlation between NutriQoL and SF-12 scores (ρ = 0.5; P < .001) was found. Multivariate analysis showed that HEN type (oral vs tube) (odds ratio [OR], 5.6; 95% CI 2.0-15.3; P = .001) and the absence of secondary effects (OR, 3.0; 95% CI, 1.2-7.9; P = .024) were both variables explaining NutriQoL results adjusted by sex and age. The SF-12 results did not show associations with nutrition factors. On visit 2, we observed significant improvements in NutriQoL results. CONCLUSION: The NutriQoL questionnaire identifies specific problems that affect the QoL of patients receiving HEN, whereas SF-12 does not. The route of entry and the occurrence of complications influence specific QoL. NutriQoL is a useful tool to identify the factors that worsen the QoL in patients receiving HEN.

  @article{zamanillocampos2021specific,
  abstract = {BACKGROUND: Home enteral nutrition (HEN), including tube feeding and oral supplementation, can improve or worsen quality of life (QoL). The specific assessment of factors affecting QoL may identify the inherent problems associated with HEN. The aim of this study was to evaluate whether the validated NutriQoL® questionnaire is useful for assessing the QoL and the factors influencing it in patients receiving HEN. METHODS: A total of 78 patients receiving HEN completed both the NutriQoL and the SF-12 questionnaires during their routine visits to nutrition service at the hospital. RESULTS: Ninety percent of patients receiving HEN had cancer, 58% received oral supplements, and 42% received tube feeding. At recruitment, the mean score ± SD of the NutriQoL was 66 ± 14, whereas that of the SF-12 was 40 ± 9. A positive correlation between NutriQoL and SF-12 scores (ρ = 0.5; P < .001) was found. Multivariate analysis showed that HEN type (oral vs tube) (odds ratio [OR], 5.6; 95% CI 2.0-15.3; P = .001) and the absence of secondary effects (OR, 3.0; 95% CI, 1.2-7.9; P = .024) were both variables explaining NutriQoL results adjusted by sex and age. The SF-12 results did not show associations with nutrition factors. On visit 2, we observed significant improvements in NutriQoL results. CONCLUSION: The NutriQoL questionnaire identifies specific problems that affect the QoL of patients receiving HEN, whereas SF-12 does not. The route of entry and the occurrence of complications influence specific QoL. NutriQoL is a useful tool to identify the factors that worsen the QoL in patients receiving HEN.},
  address = {United States},
  author = {Zamanillo Campos, Rocío and Colomar Ferrer, María Teresa and Ruiz López, Rosa María and Sanchís Cortés, María Pilar and Urgelés Planella, Joan Ramón},
  journal = {JPEN. Journal of parenteral and enteral nutrition},
  keywords = {evisap},
  month = {mar},
  number = 3,
  pages = {490--498},
  title = {Specific Quality of Life Assessment by the NutriQoL® Questionnaire Among Patients Receiving Home Enteral Nutrition},
  volume = 45,
  year = 2021
  }
  

  %0 Journal Article
  %1 zamanillocampos2021specific
  %A Zamanillo Campos, Rocío
  %A Colomar Ferrer, María Teresa
  %A Ruiz López, Rosa María
  %A Sanchís Cortés, María Pilar
  %A Urgelés Planella, Joan Ramón
  %C United States
  %D 2021
  %J JPEN. Journal of parenteral and enteral nutrition
  %N 3
  %P 490--498
  %R 10.1002/jpen.1852
  %T Specific Quality of Life Assessment by the NutriQoL® Questionnaire Among Patients Receiving Home Enteral Nutrition
  %U https://pubmed.ncbi.nlm.nih.gov/32459026
  %V 45
  %X BACKGROUND: Home enteral nutrition (HEN), including tube feeding and oral supplementation, can improve or worsen quality of life (QoL). The specific assessment of factors affecting QoL may identify the inherent problems associated with HEN. The aim of this study was to evaluate whether the validated NutriQoL® questionnaire is useful for assessing the QoL and the factors influencing it in patients receiving HEN. METHODS: A total of 78 patients receiving HEN completed both the NutriQoL and the SF-12 questionnaires during their routine visits to nutrition service at the hospital. RESULTS: Ninety percent of patients receiving HEN had cancer, 58% received oral supplements, and 42% received tube feeding. At recruitment, the mean score ± SD of the NutriQoL was 66 ± 14, whereas that of the SF-12 was 40 ± 9. A positive correlation between NutriQoL and SF-12 scores (ρ = 0.5; P < .001) was found. Multivariate analysis showed that HEN type (oral vs tube) (odds ratio [OR], 5.6; 95% CI 2.0-15.3; P = .001) and the absence of secondary effects (OR, 3.0; 95% CI, 1.2-7.9; P = .024) were both variables explaining NutriQoL results adjusted by sex and age. The SF-12 results did not show associations with nutrition factors. On visit 2, we observed significant improvements in NutriQoL results. CONCLUSION: The NutriQoL questionnaire identifies specific problems that affect the QoL of patients receiving HEN, whereas SF-12 does not. The route of entry and the occurrence of complications influence specific QoL. NutriQoL is a useful tool to identify the factors that worsen the QoL in patients receiving HEN.
  

• 
  1.

  Zamanillo Campos R, Rovira Boixadera L, Rendo Urteaga T. Common practices and beliefs in the preparation of complementary infant feeding in a Spanish sample: a cross-sectional study. Nutricion hospitalaria [Internet]. Spain; 2021 Oct.;38(5):919-34. https://pubmed.ncbi.nlm.nih.gov/34176276

  AbstractURLBibTeXEndNoteDOIBibSonomy

  Introduction: complementary feeding together with breast milk should cover the nutritional needs of children from 6 months onwards. Thus, inadequate dietary practices can lead to poor nutritional intake. The objective of this study was to examine infant food handling and cooking in Spanish households. Methodology: a cross-sectional study was carried out using an online survey in non-institutionalized adults living in Spain who usually prepare infant food for children under 2 years of age. Results: a total of 1,944 people (37.4 ± 6 years; 65.5 % women) answered the survey. Of these, 72 % prepared mainly mashed foods and 21 % used store-bought baby cereals frequently. Zucchini (39 %), chicken (62 %), hake (64 %) and banana (44 %) were the most commonly used foods. Boiling (63 %) and freezing (59 %) were the most widely used culinary and preservation practices. An inappropriate use of salt and some unsafe foods (large fish and chard) was identified, whereas olive oil and eggs were offered below the current nutritional recommendations. Conclusion: the population surveyed preferred to use mashed foods to feed children under 2 years of age. Even though they were aware that homemade food is nutritionally better, on certain occasions they offer store-bought baby cereal. Furthermore, some inappropriate feeding practices were detected, highlighting the need to implement nutritional education policies regarding infant food preparation.

  @article{zamanillocampos2021common,
  abstract = {Introduction: complementary feeding together with breast milk should cover the nutritional needs of children from 6 months onwards. Thus, inadequate dietary practices can lead to poor nutritional intake. The objective of this study was to examine infant food handling and cooking in Spanish households. Methodology: a cross-sectional study was carried out using an online survey in non-institutionalized adults living in Spain who usually prepare infant food for children under 2 years of age. Results: a total of 1,944 people (37.4 ± 6 years; 65.5 % women) answered the survey. Of these, 72 % prepared mainly mashed foods and 21 % used store-bought baby cereals frequently. Zucchini (39 %), chicken (62 %), hake (64 %) and banana (44 %) were the most commonly used foods. Boiling (63 %) and freezing (59 %) were the most widely used culinary and preservation practices. An inappropriate use of salt and some unsafe foods (large fish and chard) was identified, whereas olive oil and eggs were offered below the current nutritional recommendations. Conclusion: the population surveyed preferred to use mashed foods to feed children under 2 years of age. Even though they were aware that homemade food is nutritionally better, on certain occasions they offer store-bought baby cereal. Furthermore, some inappropriate feeding practices were detected, highlighting the need to implement nutritional education policies regarding infant food preparation.},
  address = {Spain},
  author = {Zamanillo Campos, Rocío and Rovira Boixadera, Laia and Rendo Urteaga, Tara},
  journal = {Nutricion hospitalaria},
  keywords = {evisap},
  month = {oct},
  number = 5,
  pages = {919--934},
  title = {Common practices and beliefs in the preparation of complementary infant feeding in a Spanish sample: a cross-sectional study},
  volume = 38,
  year = 2021
  }
  

  %0 Journal Article
  %1 zamanillocampos2021common
  %A Zamanillo Campos, Rocío
  %A Rovira Boixadera, Laia
  %A Rendo Urteaga, Tara
  %C Spain
  %D 2021
  %J Nutricion hospitalaria
  %N 5
  %P 919--934
  %R 10.20960/nh.03527
  %T Common practices and beliefs in the preparation of complementary infant feeding in a Spanish sample: a cross-sectional study
  %U https://pubmed.ncbi.nlm.nih.gov/34176276
  %V 38
  %X Introduction: complementary feeding together with breast milk should cover the nutritional needs of children from 6 months onwards. Thus, inadequate dietary practices can lead to poor nutritional intake. The objective of this study was to examine infant food handling and cooking in Spanish households. Methodology: a cross-sectional study was carried out using an online survey in non-institutionalized adults living in Spain who usually prepare infant food for children under 2 years of age. Results: a total of 1,944 people (37.4 ± 6 years; 65.5 % women) answered the survey. Of these, 72 % prepared mainly mashed foods and 21 % used store-bought baby cereals frequently. Zucchini (39 %), chicken (62 %), hake (64 %) and banana (44 %) were the most commonly used foods. Boiling (63 %) and freezing (59 %) were the most widely used culinary and preservation practices. An inappropriate use of salt and some unsafe foods (large fish and chard) was identified, whereas olive oil and eggs were offered below the current nutritional recommendations. Conclusion: the population surveyed preferred to use mashed foods to feed children under 2 years of age. Even though they were aware that homemade food is nutritionally better, on certain occasions they offer store-bought baby cereal. Furthermore, some inappropriate feeding practices were detected, highlighting the need to implement nutritional education policies regarding infant food preparation.
  

2020

• 
  1.

  Schünemann HJ, Lerda D, Quinn C, Follmann M, Alonso-Coello P, Rossi PG, Lebeau A, Nyström L, Broeders M, Ioannidou-Mouzaka L, Duffy SW, Borisch B, Fitzpatrick P, Hofvind S, Castells X, Giordano L, Canelo-Aybar C, Warman S, Mansel R, Sardanelli F, Parmelli E, Gräwingholt A, Saz-Parkinson Z, on Breast Cancer (ECIBC) Contributor Group ECI. Breast Cancer Screening and Diagnosis: A Synopsis of the European Breast Guidelines. Annals of internal medicine [Internet]. United States; 2020 Jan.;172(1):46-5. https://pubmed.ncbi.nlm.nih.gov/31766052

  AbstractURLBibTeXEndNoteDOIBibSonomy

  DESCRIPTION: The European Commission Initiative for Breast Cancer Screening and Diagnosis guidelines (European Breast Guidelines) are coordinated by the European Commission's Joint Research Centre. The target audience for the guidelines includes women, health professionals, and policymakers. METHODS: An international guideline panel of 28 multidisciplinary members, including patients, developed questions and corresponding recommendations that were informed by systematic reviews of the evidence conducted between March 2016 and December 2018. GRADE (Grading of Recommendations Assessment, Development and Evaluation) Evidence to Decision frameworks were used to structure the process and minimize the influence of competing interests by enhancing transparency. Questions and recommendations, expressed as strong or conditional, focused on outcomes that matter to women and provided a rating of the certainty of evidence. RECOMMENDATIONS: This synopsis of the European Breast Guidelines provides recommendations regarding organized screening programs for women aged 40 to 75 years who are at average risk. The recommendations address digital mammography screening and the addition of hand-held ultrasonography, automated breast ultrasonography, or magnetic resonance imaging compared with mammography alone. The recommendations also discuss the frequency of screening and inform decision making for women at average risk who are recalled for suspicious lesions or who have high breast density.

  @article{schunemann2020breast,
  abstract = {DESCRIPTION: The European Commission Initiative for Breast Cancer Screening and Diagnosis guidelines (European Breast Guidelines) are coordinated by the European Commission's Joint Research Centre. The target audience for the guidelines includes women, health professionals, and policymakers. METHODS: An international guideline panel of 28 multidisciplinary members, including patients, developed questions and corresponding recommendations that were informed by systematic reviews of the evidence conducted between March 2016 and December 2018. GRADE (Grading of Recommendations Assessment, Development and Evaluation) Evidence to Decision frameworks were used to structure the process and minimize the influence of competing interests by enhancing transparency. Questions and recommendations, expressed as strong or conditional, focused on outcomes that matter to women and provided a rating of the certainty of evidence. RECOMMENDATIONS: This synopsis of the European Breast Guidelines provides recommendations regarding organized screening programs for women aged 40 to 75 years who are at average risk. The recommendations address digital mammography screening and the addition of hand-held ultrasonography, automated breast ultrasonography, or magnetic resonance imaging compared with mammography alone. The recommendations also discuss the frequency of screening and inform decision making for women at average risk who are recalled for suspicious lesions or who have high breast density.},
  address = {United States},
  author = {Schünemann, Holger J and Lerda, Donata and Quinn, Cecily and Follmann, Markus and Alonso-Coello, Pablo and Rossi, Paolo Giorgi and Lebeau, Annette and Nyström, Lennarth and Broeders, Mireille and Ioannidou-Mouzaka, Lydia and Duffy, Stephen W and Borisch, Bettina and Fitzpatrick, Patricia and Hofvind, Solveig and Castells, Xavier and Giordano, Livia and Canelo-Aybar, Carlos and Warman, Sue and Mansel, Robert and Sardanelli, Francesco and Parmelli, Elena and Gräwingholt, Axel and Saz-Parkinson, Zuleika and on Breast Cancer (ECIBC) Contributor Group, European Commission Initiative},
  journal = {Annals of internal medicine},
  keywords = {evisap},
  month = {jan},
  number = 1,
  pages = {46--56},
  title = {Breast Cancer Screening and Diagnosis: A Synopsis of the European Breast Guidelines},
  volume = 172,
  year = 2020
  }
  

  %0 Journal Article
  %1 schunemann2020breast
  %A Schünemann, Holger J
  %A Lerda, Donata
  %A Quinn, Cecily
  %A Follmann, Markus
  %A Alonso-Coello, Pablo
  %A Rossi, Paolo Giorgi
  %A Lebeau, Annette
  %A Nyström, Lennarth
  %A Broeders, Mireille
  %A Ioannidou-Mouzaka, Lydia
  %A Duffy, Stephen W
  %A Borisch, Bettina
  %A Fitzpatrick, Patricia
  %A Hofvind, Solveig
  %A Castells, Xavier
  %A Giordano, Livia
  %A Canelo-Aybar, Carlos
  %A Warman, Sue
  %A Mansel, Robert
  %A Sardanelli, Francesco
  %A Parmelli, Elena
  %A Gräwingholt, Axel
  %A Saz-Parkinson, Zuleika
  %A on Breast Cancer (ECIBC) Contributor Group, European Commission Initiative
  %C United States
  %D 2020
  %J Annals of internal medicine
  %N 1
  %P 46--56
  %R 10.7326/M19-2125
  %T Breast Cancer Screening and Diagnosis: A Synopsis of the European Breast Guidelines
  %U https://pubmed.ncbi.nlm.nih.gov/31766052
  %V 172
  %X DESCRIPTION: The European Commission Initiative for Breast Cancer Screening and Diagnosis guidelines (European Breast Guidelines) are coordinated by the European Commission's Joint Research Centre. The target audience for the guidelines includes women, health professionals, and policymakers. METHODS: An international guideline panel of 28 multidisciplinary members, including patients, developed questions and corresponding recommendations that were informed by systematic reviews of the evidence conducted between March 2016 and December 2018. GRADE (Grading of Recommendations Assessment, Development and Evaluation) Evidence to Decision frameworks were used to structure the process and minimize the influence of competing interests by enhancing transparency. Questions and recommendations, expressed as strong or conditional, focused on outcomes that matter to women and provided a rating of the certainty of evidence. RECOMMENDATIONS: This synopsis of the European Breast Guidelines provides recommendations regarding organized screening programs for women aged 40 to 75 years who are at average risk. The recommendations address digital mammography screening and the addition of hand-held ultrasonography, automated breast ultrasonography, or magnetic resonance imaging compared with mammography alone. The recommendations also discuss the frequency of screening and inform decision making for women at average risk who are recalled for suspicious lesions or who have high breast density.