https://hdl.handle.net/11000/7 2026-08-01T02:55:39Z https://hdl.handle.net/11000/40320 Título : Development and internal validation of GENADHECAR: a screening instrument for identifying probable statin non-adherence in patients with ischemic heart disease Autor : Quesada, Jose A.; López-Pineda, Adriana; NOUNI GARCÍA, RAUF; Cordero, Alberto; Carbonell Soliva, Álvaro; Esquerdo Arroyo, Amanda; PEREIRA-EXPOSITO, AVELINO; Guillen-García, Silvia; Arrarte, Vicente; Bertomeu-Gonzalez, Vicente; Nolasco, Andreu; Cazorla-Morallon, Diego; Osende, Julio; nalda-molina, Ricardo; Orozco-Beltrán, Domingo; Carratalá-Munuera, Concepción; Gil-Guillén, Vicente F Resumen : Background: No validated and practical tool exists to assess adherence to statins in secondary prevention of cardiovascular disease. Current reference methods for assessing adherence, including plasma drug measurements, are not feasible for routine clinical care or large clinical trials. Objective: To develop and internally validate a predictive screening instrument for identifying patients at risk of statin non-adherence. Methods: This multicenter cross-sectional study reports the results of the second phase of the GENADHECAR project in four Spanish hospitals. An initial set of 42 adherence-related items was refined and evaluated in a sample of patients with ischemic heart disease. Responses were compared against a pharmacokinetic reference method (plasma statin concentrations) to assess recent medication intake. A multivariate predictive model of non-adherence was then developed, selecting the best predictors and covariates to be included in the final screening instrument. Results: A total of 309 patients were included, of whom 49 (15.9%) were classified as non-adherent according to the pharmacokinetic reference method. The final GENADHECAR screening instrument comprised three questionnaire items (use of reminders, forgetfulness, and medication access) and two sociodemographic variables (sex and educational attainment). Internal bootstrap validation yielded an optimism-corrected AUC of 0.694 (95% CI 0.617–0.767), with adequate calibration (Hosmer–Lemeshow p = 0.994). At the selected probability threshold (0.15), sensitivity was 0.73, specificity 0.61, and positive and negative predictive values were 0.26 and 0.92, respectively. Overall, the model showed moderate discrimination and a high capacity to identify patients at low risk of non-adherence. Conclusion: To our knowledge, GENADHECAR is the first screening instrument with internal validation to identify statin non-adherence using a pharmacokinetic reference method. It offers a brief and practical approach for identifying patients at risk of non-adherence and may help overcome some limitations of conventional self-report methods in this population. Further external validation is needed before routine clinical implementation. 2026-07-31T11:05:30Z https://hdl.handle.net/11000/40319 Título : Metodología de Revisión Sistemática Simplificada (MRSS) para estudiantes de Grado y Máster Autor : Pina López, David; Puente Lopez, Esteban; López López, Reyes; Cascales Martinez, Andrea; Fernández Arce, Alejandro; López Ros, Paloma; García Campos, Jonatan; Vázquez Rodríguez, Carolina; Pamies Aubalat, Lidia; Pascual Rodríguez, Roberto 2026-07-31T11:04:00Z https://hdl.handle.net/11000/40292 Título : Diet, lifestyle, metabolic markers, and socioeconomic status are associated with cognitive function in school-aged children from a population-based cohort. Autor : Gómez-Vilarrubla, Ariadna; Sanchez Fernández , Mario José; Puerto-Carranza, Elsa; Martínez-Calcerrada, Jose Maria; Mas-Parés, Berta; Rivero, María José; Nso-Roca, Ana Pilar; Alvarez-Monell, Adam; Contreras Rodríguez, Oren; Garre-Olmo, Josep ; Lopez-Bermejo, Abel; Bassols, Judit Resumen : BackgroundCognitive development is associated with diet, activity, sleep, metabolic health, and socioeconomic status. However, evidence remains limited, as most studies have focused on clinical groups or single factors. We examined the combined associations of these variables with cognitive function in school-aged children from the general population.MethodsWe evaluated 170 school-aged children from a population-based cohort (mean age 6.33 ± 0.03 years; 49% female). Children were evaluated after an overnight fast (>8 h), and anthropometric, metabolic, and socioeconomic variables were evaluated. Diet and physical activity were assessed using validated questionnaires (Vioque FFQ and enKid). Cognitive function was assessed using NEPSY-II and TONI-2 subsets. Correlation and regression analyses were performed.ResultsCognitive function was positively associated with Mediterranean diet adherence, sleep duration, socioeconomic status, and negatively associated with ultra-processed food intake, TV viewing, and metabolic markers including insulin resistance (HOMA-IR), C-reactive protein, and gamma-glutamyltransferase (all p < 0.05). Multivariate analyses showed that Mediterranean diet adherence (OR 2.18, 95%CI 1.08–4.40), economic status (OR 2.50, 95%CI 1.13–5.49), sleep duration (OR 2.90, 95%CI 1.42–5.92), and HOMA-IR (OR 0.47, 95%CI 0.23–0.96) as independently associated with cognitive outcomes, particularly in attention, language, and memory.ConclusionsLifestyle factors and socioeconomic conditions are independently associated with cognitive function in children.ImpactKey message: Diet, sleep, metabolic health, and socioeconomic status are associated with cognitive function in school-aged children.Novelty: Simultaneously examines multiple factors associated with cognition in school-aged children from a population-based cohort.Impact on cognition: Mediterranean diet adherence, sleep duration, and metabolic health were positively associated with several cognitive domains, including attention, language, and memory.Practical use: Highlights the potential relevance of healthy lifestyles and social equity in relation to cognitive development.Broader significance: Highlights the multifactorial nature of cognitive development in children. 2026-07-29T12:21:46Z https://hdl.handle.net/11000/40291 Título : Phase angle and triglyceride-glucose index as biomarkers of glycemic control, body composition and cardiovascular risk in adolescents with type 1 diabetes: a cross-sectional study. Autor : García Poblet, Marta; Martínez Sanz, José Miguel; Alberola-Chazarra, Manuel Antonio ; Soler Climent, Esther; Nso-Roca, Ana Pilar; Sospedra, Isabel Resumen : Purpose Traditional markers such as HbA1c and BMI are commonly used to assess metabolic risk in adolescents with type 1 diabetes mellitus (T1DM), but novel biomarkers like the triglyceride-glucose (TyG) index and phase angle (PA) may provide a more comprehensive evaluation of metabolic risk. However, their potential role in this population remains unclear. We aimed (1) to evaluate the association of the TyG index and PA with glycemic control, cardiovascular risk and body composition in adolescents with T1DM, and (2) to determine optimal cut-off points for these biomarkers to predict metabolic risk. Methods Seventy-three adolescents (46.6% female, 10–19 years) with T1DM from two hospitals were included in this cross-sectional study. Sociodemographic, bioelectrical impedance (BIA) and clinical data were collected during routine visits. The TyG index was calculated from fasting triglyceride and glucose levels, and PA was measured via BIA. Correlations were analyzed using Pearson or Spearman coefficients, and ROC curve analyses were used to determine optimal cut-off points. Results PA correlated positively with skeletal muscle and fat-free mass and inversely with cardiovascular risk indicators. TyG was strongly associated with adiposity, glycemic variability and cardiovascular risk markers. A preliminary TyG threshold of 8.09 was identified, while no PA cut-off could be established. Conclusions PA and the TyG index are promising, non-invasive biomarkers that complement traditional measures in assessing metabolic risk in adolescents with T1DM. Integrating these biomarkers into routine evaluation may enhance early risk detection and support holistic management in this population. Trial registration number NCT07021326. 2026-07-29T12:21:08Z https://hdl.handle.net/11000/40290 Título : The Prognostic Value of Transcutaneous Oxygen Pressure (TcPO2) in Diabetic Foot Ulcer Healing: A Protocol for a Systematic Review Autor : Bordonado-Murcia, Andrea; Marco-Lledó, Javier; Nieto-Gil, Pilar; Zuluaga-Ríos, Luz Marina; López Ros, Paloma; Hernández-Martínez, Irene; Montoro Cremades, David; Garcia-Campos, Jonatan Resumen : Background/Objectives: Due to poor perfusion, diabetic foot ulcers (DFUs) create hypoxic environments, and their chronicity represents a negative factor in wound healing. Transcutaneous oxygen pressure (TcPO2) is a non-invasive method that provides information on oxygen supply to microvascular circulation, useful for determining the severity and progression of peripheral arterial disease (PAD) as well as potentially predicting DFU healing. However, the current literature does not provide strong support for the use of TcPO2 as an independent predictive tool. Methods: This protocol aims to systematically review the available evidence according to PRISMA (2020) guidelines, registered with the International Prospective Register of Systematic Reviews (registration number: CRD42024505907). The following databases will be used: Cochrane Library, EMBASE, Ovid Medline, PubMed, and Web of Science. Additionally, a manual search will be conducted through the references of the included articles. Results: The systematic review will summarize the current evidence on the prognostic value of TcPO2 in DFU healing, identifying gaps in knowledge and potential areas for future research. Conclusions: The findings of this study may clarify the prognostic value of TcPO2 in DFU healing, which could ultimately facilitate clinical management, decision-making, patient care, and potentially reduce treatment costs. 2026-07-29T12:14:04Z https://hdl.handle.net/11000/40289 Título : Experiences, Needs, and Beliefs Regarding Footwear Among People with Diabetes Mellitus in Spain: A Qualitative Focus Group Study Protocol Autor : López Ros, Paloma; Gonzalez-Ibanez, Aitor; Montoro Cremades, David; Tabernero Grau, Laura; Marco-Lledo, Javier; Martínez Córcoles, Vicenta; Garcia-Campos, Jonatan Resumen : Background/Objectives: Diabetes mellitus (DM) is a group of chronic metabolic disorders characterised by persistent hyperglycaemia and an increasing global prevalence, imposing a significant socioeconomic and healthcare burden. Among its associated complications, the diabetic foot is a critical condition that doubles the risk of mortality. Although therapeutic footwear is an essential preventive strategy, research on treatment adherence has predominantly focused on quantitative parameters. This protocol aims to explore the experiences, needs, and perceived barriers of people with DM regarding therapeutic footwear use from a qualitative perspective. Methods: A qualitative focus group study will be conducted in the province of Alicante, Spain. Participants will be adults with a confirmed diagnosis of DM recruited across IWGDF foot risk categories 1–3 through purposive sampling. A total of 8–10 focus groups of 10–12 participants will be conducted in separate in-person and online modalities. Data will be analysed using reflexive thematic analysis within a constructivist epistemological framework, following the six-phase approach proposed by Braun and Clarke. The study adheres to the Consolidated Criteria for Reporting Qualitative Research (COREQ). Ethical approval will be obtained from the relevant Ethics Committee prior to data collection. Results/Expected Outcomes: The findings are anticipated to generate patient-centred, evidence-based insights into the psychosocial and experiential dimensions of therapeutic footwear adherence, informing the development of novel educational strategies and improvements in footwear design to optimise treatment adherence and clinical outcomes. Conclusions: This protocol provides a rigorous and transparent methodological framework for qualitative investigation of therapeutic footwear adherence in people with DM, contributing to a more comprehensive and person-centred approach to diabetic foot prevention. 2026-07-29T12:12:16Z https://hdl.handle.net/11000/40288 Título : Cuaderno de Materiales Prácticos. Derecho Penal, Parte General, Autor : Gomez Bellvis, Ana Belen 2026-07-29T11:56:21Z https://hdl.handle.net/11000/40287 Título : Aproximación a la política criminal y las instituciones del control del delito en España Autor : Miró Llinares, Fernando; Gómez Bellvis, Ana Belén 2026-07-29T11:55:39Z https://hdl.handle.net/11000/40286 Título : Política criminal basada en evidencias: alcance, bases científicas y retos Autor : Castro Toledo, Francisco Javier; Gómez Bellvís, Ana Belen Resumen : El análisis crítico de la realidad delictiva, la toma de decisiones políticas y jurídicas basadas en ese análisis y, por último, la evaluación de los resultados y consecuencias que producen aquellas decisiones, constituyen el núcleo de la Política criminal. Su doble naturaleza, la de disciplina científica y la de política pública relacionada con la criminalidad, exige indagar acerca de cuáles son los contenidos esenciales de la misma y cómo deben organizarse de cara a su análisis y estudio por parte de los estudiantes universitarios vinculados, de forma preferente, a la Criminología y al Derecho. Siendo esta una tarea compleja, el Manual de Política Criminal busca facilitar la aproximación a la materia, con dos objetivos claros: identificar y analizar las herramientas generales que son necesarias para hacer un diagnóstico crítico de cualquier fenómeno delictivo; y, en segundo lugar, seleccionar y estudiar los espacios de debate actuales más relevantes asociados a las políticas públicas sobre la criminalidad 2026-07-29T11:54:47Z https://hdl.handle.net/11000/40285 Título : Revisión sistemática sobre la presencia de microplásticos en tejidos musculoesqueléticos humanos Autor : Zorrilla-Muñoz, Vanessa; Jiménez-García, Segundo; Andrés-Collado, Mariano; Madrigal-Verdú, Pilar; Ochando-Sánchez, Isabel; Montoro-Cremades, David; Marco-Lledó, Javier; Hernández-Borges, Javier; Martínez-Navarrete, Gema; Morales-Delgado, Nicanor; García-Campos, Jonatan Resumen : Objetivo La presente revisión sistemática tiene como propósito examinar la evidencia disponible sobre la detección de MPs en tejidos humanos del aparato locomotor, incluyendo articulaciones, cartílago, huesos o tendones, con el fin de esclarecer su distribución y valorar su posible implicación en procesos inflamatorios y degenerativos asociados a patologías musculoesqueléticas. Metodología El método de revisión se desarrolló de acuerdo con los estándares, incluyendo: protocolo de revisión, criterios de inclusión y exclusión, diseño de la estrategia de búsqueda y proceso de selección y recopilación de datos. 2026-07-27T16:41:13Z