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2024

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

2023

Article Subjects > Social Sciences Europe University of Atlantic > Research > Scientific Production
Fundación Universitaria Internacional de Colombia > Research > Articles and books
Ibero-american International University > Research > Scientific Production
Ibero-american International University > Research > Scientific Production
Abierto Inglés This research aims to gather opinions from experts in the European tourism sector regarding training needs to address severe crises, such as Covid, in Small and Medium-Sized Enterprises (SMEs) across five countries: Spain, Iceland, Ireland, Scotland, and Germany. This study was conducted within the scope of the European TC-NAV project, which is funded by the European Union. The ultimate goal of this project is to develop training solutions for European SMEs Most existing literature on tourism crises primarily examines the impact on destinations as a whole rather than on individual tourism enterprises. Thus, this research is both relevant and timely The methodology employed was qualitative, and data being collected using a 9-question interview guide. This guide underwent validation by experts, achieving a Cronbach's Alpha value of 0.7. In total, 30 individuals were interviewed: 5 civil servants, 9 company directors, 5 university professors, 6 researchers, and 5 entrepreneurs. Some notable findings include the importance of innovation for change, promoting sustainable tourism, fostering informal partnerships among regional companies, the essential role of government support, the benefits of flexible planning and service digitisation, and the ongoing need for training and upskilling. metadata Soriano Flores, Emmanuel and Prola, Thomas and Halldórsdóttir, Íris Hrund Halldórsdóttir and Taylor, Steve mail emmanuel.soriano@uneatlantico.es, thomas.prola@uneatlantico.es, UNSPECIFIED, UNSPECIFIED (2023) Diagnosing Training Needs in European Tourism SMEs: The TC-NAV Project for Managing and Overcoming Virulent Crises. Kurdish Studies, 11 (2). pp. 2011-2022. ISSN 2051-4883

Article Subjects > Social Sciences Europe University of Atlantic > Research > Scientific Production
Fundación Universitaria Internacional de Colombia > Research > Articles and books
Ibero-american International University > Research > Scientific Production
Ibero-american International University > Research > Scientific Production
Universidad Internacional do Cuanza > Research > Scientific Production
Abierto Inglés In the last two decades, there is an increasingly broad line of studies that warn about the emotional health of journalists and the challenges that it poses for communication professionals to be able to separate work issues from their personal lives. The coverage of COVID-19 exposed many journalists to situations of frustration, discomfort and stress for various reasons: long working hours, not having the appropriate technological material, added to an environment of uncertainty caused by the pandemic. This study aims to examine the possible scope of technostress –in some cases associated to digital divide– in journalists and analyze if they are aware of the uses of care of the self as a way to deal with stressful situations. For this, our research is based on documentary analysis, a survey answered by (50) fifty Argentinean journalists, and twelve (12) in-depth interviews to experienced journalists. Our findings suggest that constant exposure to computers and smartphones during the lockdown together with difficulties to connect to Internet or to have the adequate materials and the lack of coping strategies –as the care of the self– confirms the presence of technostress. Another result that emerges from this research, it should be addressed in future studies, is that some journalists’ reactions about care of the self could respond to the third person effect theory to maintain high self-esteem and not demonstrate vulnerability. metadata Escudero, Carolina and Prola, Thomas and Soriano Flores, Emmanuel and Silva Alvarado, Eduardo René mail UNSPECIFIED, thomas.prola@uneatlantico.es, emmanuel.soriano@uneatlantico.es, eduardo.silva@funiber.org (2023) The Scope of Technostress and Care of The Self on Journalists During the Pandemic. Przestrzeń Społeczna (Social Space), 23 (4). pp. 20-43. ISSN 20841558

2022

Article Subjects > Social Sciences
Subjects > Engineering
Europe University of Atlantic > Research > Scientific Production
Fundación Universitaria Internacional de Colombia > Research > Articles and books
Ibero-american International University > Research > Scientific Production
Ibero-american International University > Research > Scientific Production
Universidad Internacional do Cuanza > Research > Scientific Production
Abierto Inglés Innovation plays a pivotal role in the progress and goodwill of an organization, and its ability to thrive. Consequently, the impact analysis of innovation on the performance of an organization holds great importance. This paper presents a two-stage analytical framework to examine the impact of business innovation on a firm’s performance, especially firms from the manufacturing sector. The prime objective is to identify the factors that have an impact on firm-level innovation, and to examine the impact of firm-level innovation on business performance. The framework and its analysis are based on the latest World Bank enterprise survey, with a sample size of 696 manufacturing firms. The first stage of the proposed framework establishes the analytical results through Bivariate Probit, which indicates that research and development (R&D) has a significantly positive impact on the product, process, marketing, and organizational innovations. It thus highlights the important role of the allocation of lump-sum amounts for R&D activities. The statistical analysis shows that innovation does not depend on the size of the firms. Moreover, the older firms are found to be wiser at conducting R&D than newer firms that are reluctant to take risks. The second stage of the proposed framework separately analyzes the impacts of the product and organizational innovation, and the process and marketing innovation on the firm performance, and finds them to be statistically significant and insignificant, respectively. metadata Aslam, Mahrukh and Shafi, Imran and Ahmad, Jamil and Álvarez, Roberto Marcelo and Miró Vera, Yini Airet and Soriano Flores, Emmanuel and Ashraf, Imran mail UNSPECIFIED, UNSPECIFIED, UNSPECIFIED, roberto.alvarez@uneatlantico.es, yini.miro@uneatlantico.es, emmanuel.soriano@uneatlantico.es, UNSPECIFIED (2022) An Analytical Framework for Innovation Determinants and Their Impact on Business Performance. Sustainability, 15 (1). p. 458. ISSN 2071-1050

Article Subjects > Social Sciences Europe University of Atlantic > Research > Scientific Production
Fundación Universitaria Internacional de Colombia > Research > Articles and books
Ibero-american International University > Research > Scientific Production
Ibero-american International University > Research > Scientific Production
Universidad Internacional do Cuanza > Research > Scientific Production
Abierto Inglés This article proposes a discussion on the form of coexistence of local Development Agencies in Uruguay, with local governments in the face of the new scenarios marked by the decentralization process, initiated in the country with the Constitutional Reform of 1996 and culminating in February 2009, with the Law of Political Decentralization and Citizen Participation. The discussion applies in particular to the local development agency of the city of Rivera (ADR), located in the northeast of the country. A descriptive, mixed, bibliographic, documentary investigation was carried out with primary data collection to internal and external references to ADR. The results show that the coexistence of both institutions has been difficult, without defining clear roles. Promoting dialogue to define the role of each seems to be the great challenge facing the sustainability of the agency metadata Garat de Marin, Mirtha Silvana and Soriano Flores, Emmanuel and Rodríguez Velasco, Carmen Lilí and Silva Alvarado, Eduardo and Calderón Iglesias, Rubén and Álvarez, Roberto Marcelo and Gracia Villar, Santos mail silvana.marin@uneatlantico.es, emmanuel.soriano@uneatlantico.es, carmen.rodriguez@uneatlantico.es, UNSPECIFIED, ruben.calderon@uneatlantico.es, roberto.alvarez@uneatlantico.es, santos.gracia@uneatlantico.es (2022) Development Agencies and Local Governments—Coexistence within the Same Territory. Social Sciences, 11 (9). p. 398. ISSN 2076-0760

Article Subjects > Social Sciences Europe University of Atlantic > Research > Scientific Production
Fundación Universitaria Internacional de Colombia > Research > Articles and books
Ibero-american International University > Research > Scientific Production
Ibero-american International University > Research > Scientific Production
Universidad Internacional do Cuanza > Research > Scientific Production
Abierto Inglés Angola, as with many countries on the African continent, has great inequalities or asymmetries between its provinces. At the economic, financial, and technological level, there is a great disparity between them, where it is observed that the province of Luanda is the largest financial business center to the detriment of others, such as Moxico, Zaire, and Cabinda. In the latter, despite the advantages of high oil production, from a regional point of view, they remain almost stagnant in time, in a social dysfunction where the population lives on extractivism and artisanal fishing. This article analyzes the most important events in contemporary regional history, the Portuguese occupation that was the Portuguese colonial rule over Angola (1890–1930) and the civil war that was a struggle between Angolans for control of the country (1975–2002), in the consolidation of the asymmetries between provinces. For this work, a theoretical-reflective study was conducted based on the reading of books, articles, and previous investigations on the phenomenon studied. Considering the interpretation and analysis of the theoretical content obtained through the bibliographic research conducted, this theoretical construction approaches the qualitative approach. We conclude that the deep inequalities between regions and within them, between the provinces studied, originated historically in the form of exploitation of the regions and from the consequences of the war. The asymmetries, observed through the variables studied show that the provinces historically explored and considered object regions present a lower growth compared to those that were considered subject regions in which the applied geopolitical strategy, as they are centers of primary production flows, was different. We also observe that, due to the conflicts of the civil war in the less developed regions, the inequalities have deepened, contributing seriously to a higher level of poverty and a lower development of the provinces where these conflicts took place. metadata Catoto Capitango, João Adolfo and Garat de Marin, Mirtha Silvana and Soriano Flores, Emmanuel and Rojo Gutiérrez, Marco Antonio and Gracia Villar, Mónica and Durántez Prados, Frigdiano Álvaro mail UNSPECIFIED, silvana.marin@uneatlantico.es, emmanuel.soriano@uneatlantico.es, marco.rojo@unini.edu.mx, monica.gracia@uneatlantico.es, durantez@uneatlantico.es (2022) Inequalities and Asymmetries in the Development of Angola’s Provinces: The Impact of Colonialism and Civil War. Social Sciences, 11 (8). p. 334. ISSN 2076-0760

Revista Subjects > Social Sciences Europe University of Atlantic > Research > Scientific Magazines
Fundación Universitaria Internacional de Colombia > Research > Scientific Magazines
Ibero-american International University > Research > Scientific Magazines
Ibero-american International University > Research > Scientific Magazines
Universidad Internacional do Cuanza > Research > Scientific Magazines
Abierto Español MLS - Law and International politics (MLSLIP) es una publicación de periodicidad semestral con el objetivo de ser un canal que contribuya a la discusión, el intercambio de conocimiento y el debate entre académicos, responsables de política pública, empresarios, tecnólogos, científicos y los distintos actores interesados en temas de Derecho y Política, que deriven en el crecimiento del conocimiento científico de esas ciencias, producto de trabajo vinculado entre sectores público, privado y académico. MLS - Law and International politics (MLSLIP) se enfoca también en colaboraciones que engloben avances en materia de ciencia jurídica y política, con un impacto social y que contribuyan a la solución de problemas nacionales e internacionales. metadata UNSPECIFIED mail mls@devnull.funiber.org (2022) MLS Law and International Politics. [Revista]

Article Subjects > Social Sciences Fundación Universitaria Internacional de Colombia > Research > Articles and books
Ibero-american International University > Research > Scientific Production
Abierto Español La investigación se basó en el Modelo de madurez para la gestión de proyectos del sector público de la Alcaldía de Chinácota-Colombia. Su objetivo fue identificar las prácticas aplicadas por la organización en la madurez de sus procesos; aplicando el Modelo de madurez, se evaluó las capacidades y desempeño de los integrantes del área de gestión de proyectos. Para el desarrollo del trabajo se aplicó la investigación proyectiva, un diseño de campo No Experimental y Transversal, se empleó un enfoque mixto, la observación, el análisis FODA, la encuesta y la revisión bibliográfica; para el procesamiento de la información se empleó el SPSS y se aplicó la estadística descriptiva e inferencial para el análisis y tratamiento de los resultados. El enfoque teórico permitió fundamentar el Modelo de Madurez OPM3 para la Gestión de Proyectos en la organización; además, se analizó el marco legal y normas del Banco de proyectos de la inversión pública en Colombia. En conclusión, el grado de madurez resultante fue del 24,99% (bajo) relacionado al conocimiento, los factores internos-externos muestran problemas de conocimientos imprecisos dentro del área de proyectos, existe alta rotación de sus funcionarios, no se cuenta con suficientes recursos para su gestión; la práctica de proyectos evidencia indefinición y desactualización de la madurez en su gestión. También, se detectó que todas las prácticas asociadas a la gestión de riesgo y adquisiciones tienen exceso de burocracia, en los procesos de estandarización tienen alto grado de cumplimiento en la gestión del alcance, tiempo, integración y riesgo. metadata Bazurto Roldán, José Antonio and Piña Ararat, Mario Andrés mail jose.bazurto@unini.org, UNSPECIFIED (2022) Modelo de madurez aplicado al contexto organizacional de la gestión de proyectos para la Alcaldía de Chinácota-Colombia. Project Design and Management, 4 (2).

2019

Article Subjects > Social Sciences Fundación Universitaria Internacional de Colombia > Research > Articles and books Cerrado Inglés Introduction The judicialization of health arose following the possibility of judicially demanding the right to health before national and international courts. In the case of Colombia, health litigation is done through a constitutional tool called the tutela action, which allows for the immediate protection of fundamental rights. Methods A retrospective cross-sectional study using a probabilistic stratified sample of 1031 users of the tutela actions, in Medellín, Colombia, between 2011 and 2014. Bivariate and multivariate analyses were performed, using statistical tests and multiple logistic regression models. Results According to the respondents, 95.9% of the tutela actions succeeded in favour of the applicant. On average, the judicial process took 10.96 days (SD = 8.09). After the favourable decision of the tutela action, access to health care followed in 76.2% of cases, partial access was found for 14.0% (median, 10 d), and in 9.8% of cases, claimants had not received access to the health care they sought. Conclusion The tutela action is an essential constitutional mechanism that guarantees the access to health services. However, it must be strengthened from the legal point of view through the implementation of monitoring and control actions and by imposing the sanctioning measures and deadlines established in existing legislation. metadata Gómez‐Ceballos, Diego and Craveiro, Isabel and Gonçalves, Luzia mail UNSPECIFIED (2019) Judicialization of the right to health: (Un)compliance of the judicial decisions in Medellin, Colombia. The International Journal of Health Planning and Management, 34 (4). pp. 1277-1289. ISSN 0749-6753

This list was generated on Mon Dec 9 23:40:21 2024 UTC.

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Youth Healthy Eating Index (YHEI) and Diet Adequacy in Relation to Country-Specific National Dietary Recommendations in Children and Adolescents in Five Mediterranean Countries from the DELICIOUS Project

Background/Objectives: The diet quality of younger individuals is decreasing globally, with alarming trends also in the Mediterranean region. The aim of this study was to assess diet quality and adequacy in relation to country-specific dietary recommendations for children and adolescents living in the Mediterranean area. Methods: A cross-sectional survey was conducted of 2011 parents of the target population participating in the DELICIOUS EU-PRIMA project. Dietary data and cross-references with food-based recommendations and the application of the youth healthy eating index (YHEI) was assessed through 24 h recalls and food frequency questionnaires. Results: Adherence to recommendations on plant-based foods was low (less than ∼20%), including fruit and vegetables adequacy in all countries, legume adequacy in all countries except for Italy, and cereal adequacy in all countries except for Portugal. For animal products and dietary fats, the adequacy in relation to the national food-based dietary recommendations was slightly better (∼40% on average) in most countries, although the Eastern countries reported worse rates. Higher scores on the YHEI predicted adequacy in relation to vegetables (except Egypt), fruit (except Lebanon), cereals (except Spain), and legumes (except Spain) in most countries. Younger children (p < 0.005) reporting having 8–10 h adequate sleep duration (p < 0.001), <2 h/day screen time (p < 0.001), and a medium/high physical activity level (p < 0.001) displayed a better diet quality. Moreover, older respondents (p < 0.001) with a medium/high educational level (p = 0.001) and living with a partner (p = 0.003) reported that their children had a better diet quality. Conclusions: Plant-based food groups, including fruit, vegetables, legumes, and even (whole-grain) cereals are underrepresented in the diets of Mediterranean children and adolescents. Moreover, the adequate consumption of other important dietary components, such as milk and dairy products, is rather disregarded, leading to substantially suboptimal diets and poor adequacy in relation to dietary guidelines.

Producción Científica

Francesca Giampieri mail francesca.giampieri@uneatlantico.es, Alice Rosi mail , Francesca Scazzina mail , Evelyn Frias-Toral mail , Osama Abdelkarim mail , Mohamed Aly mail , Raynier Zambrano-Villacres mail , Juancho Pons mail , Laura Vázquez-Araújo mail , Sandra Sumalla Cano mail sandra.sumalla@uneatlantico.es, Iñaki Elío Pascual mail inaki.elio@uneatlantico.es, Lorenzo Monasta mail , Ana Mata mail , María Isabel Pardo mail , Pablo Busó mail , Giuseppe Grosso mail ,

Giampieri

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Performance of the 4C and SEIMC scoring systems in predicting mortality from onset to current COVID-19 pandemic in emergency departments

The evolution of the COVID-19 pandemic has been associated with variations in clinical presentation and severity. Similarly, prediction scores may suffer changes in their diagnostic accuracy. The aim of this study was to test the 30-day mortality predictive validity of the 4C and SEIMC scores during the sixth wave of the pandemic and to compare them with those of validation studies. This was a longitudinal retrospective observational study. COVID-19 patients who were admitted to the Emergency Department of a Spanish hospital from December 15, 2021, to January 31, 2022, were selected. A side-by-side comparison with the pivotal validation studies was subsequently performed. The main measures were 30-day mortality and the 4C and SEIMC scores. A total of 27,614 patients were considered in the study, including 22,361 from the 4C, 4,627 from the SEIMC and 626 from our hospital. The 30-day mortality rate was significantly lower than that reported in the validation studies. The AUCs were 0.931 (95% CI: 0.90–0.95) for 4C and 0.903 (95% CI: 086–0.93) for SEIMC, which were significantly greater than those obtained in the first wave. Despite the changes that have occurred during the coronavirus disease 2019 (COVID-19) pandemic, with a reduction in lethality, scorecard systems are currently still useful tools for detecting patients with poor disease risk, with better prognostic capacity.

Producción Científica

Pedro Ángel de Santos Castro mail , Carlos del Pozo Vegas mail , Leyre Teresa Pinilla Arribas mail , Daniel Zalama Sánchez mail , Ancor Sanz-García mail , Tony Giancarlo Vásquez del Águila mail , Pablo González Izquierdo mail , Sara de Santos Sánchez mail , Cristina Mazas Pérez-Oleaga mail cristina.mazas@uneatlantico.es, Irma Dominguez Azpíroz mail irma.dominguez@unini.edu.mx, Iñaki Elío Pascual mail inaki.elio@uneatlantico.es, Francisco Martín-Rodríguez mail ,

de Santos Castro

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Evolving epidemiology, clinical features, and genotyping of dengue outbreaks in Bangladesh, 2000–2024: a systematic review

Background: The 2023 dengue outbreak has proven that dengue is not only an endemic disease but also an emerging health threat in Bangladesh. Integrated studies on the epidemiology, clinical characteristics, seasonality, and genotype of dengue are limited. This study was conducted to determine recent trends in the molecular epidemiology, clinical features, and seasonality of dengue outbreaks. Methods: We analyzed data from 41 original studies, extracting epidemiological information from all 41 articles, clinical symptoms from 30 articles, and genotypic diversity from 11 articles. The study adhered to the standards of the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) Statement and Cochrane Collaboration guidelines. Conclusion: This study provides integrated insights into the molecular epidemiology, clinical features, seasonality, and transmission of dengue in Bangladesh and highlights research gaps for future studies.

Producción Científica

Nadim Sharif mail , Rubayet Rayhan Opu mail , Tama Saha mail , Abdullah Ibna Masud mail , Jannatin Naim mail , Khalaf F. Alsharif mail , Khalid J. Alzahrani mail , Eduardo René Silva Alvarado mail eduardo.silva@funiber.org, Irene Delgado Noya mail irene.delgado@uneatlantico.es, Isabel De la Torre Díez mail , Shuvra Kanti Dey mail ,

Sharif

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DiabSense: early diagnosis of non-insulin-dependent diabetes mellitus using smartphone-based human activity recognition and diabetic retinopathy analysis with Graph Neural Network

Non-Insulin-Dependent Diabetes Mellitus (NIDDM) is a chronic health condition caused by high blood sugar levels, and if not treated early, it can lead to serious complications i.e. blindness. Human Activity Recognition (HAR) offers potential for early NIDDM diagnosis, emerging as a key application for HAR technology. This research introduces DiabSense, a state-of-the-art smartphone-dependent system for early staging of NIDDM. DiabSense incorporates HAR and Diabetic Retinopathy (DR) upon leveraging the power of two different Graph Neural Networks (GNN). HAR uses a comprehensive array of 23 human activities resembling Diabetes symptoms, and DR is a prevalent complication of NIDDM. Graph Attention Network (GAT) in HAR achieved 98.32% accuracy on sensor data, while Graph Convolutional Network (GCN) in the Aptos 2019 dataset scored 84.48%, surpassing other state-of-the-art models. The trained GCN analyzed retinal images of four experimental human subjects for DR report generation, and GAT generated their average duration of daily activities over 30 days. The daily activities in non-diabetic periods of diabetic patients were measured and compared with the daily activities of the experimental subjects, which helped generate risk factors. Fusing risk factors with DR conditions enabled early diagnosis recommendations for the experimental subjects despite the absence of any apparent symptoms. The comparison of DiabSense system outcome with clinical diagnosis reports in the experimental subjects was conducted using the A1C test. The test results confirmed the accurate assessment of early diagnosis requirements for experimental subjects by the system. Overall, DiabSense exhibits significant potential for ensuring early NIDDM treatment, improving millions of lives worldwide.

Producción Científica

Md Nuho Ul Alam mail , Ibrahim Hasnine mail , Erfanul Hoque Bahadur mail , Abdul Kadar Muhammad Masum mail , Mercedes Briones Urbano mail mercedes.briones@uneatlantico.es, Manuel Masías Vergara mail manuel.masias@uneatlantico.es, Jia Uddin mail , Imran Ashraf mail , Md. Abdus Samad mail ,

Alam

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Clinical phenotypes and short-term outcomes based on prehospital point-of-care testing and on-scene vital signs

Emergency medical services (EMSs) face critical situations that require patient risk classification based on analytical and vital signs. We aimed to establish clustering-derived phenotypes based on prehospital analytical and vital signs that allow risk stratification. This was a prospective, multicenter, EMS-delivered, ambulance-based cohort study considering six advanced life support units, 38 basic life support units, and four tertiary hospitals in Spain. Adults with unselected acute diseases managed by the EMS and evacuated with discharge priority to emergency departments were considered between January 1, 2020, and June 30, 2023. Prehospital point-of-care testing and on-scene vital signs were used for the unsupervised machine learning method (clustering) to determine the phenotypes. Then phenotypes were compared with the primary outcome (cumulative mortality (all-cause) at 2, 7, and 30 days). A total of 7909 patients were included. The median (IQR) age was 64 (51–80) years, 41% were women, and 26% were living in rural areas. Three clusters were identified: alpha 16.2% (1281 patients), beta 28.8% (2279), and gamma 55% (4349). The mortality rates for alpha, beta and gamma at 2 days were 18.6%, 4.1%, and 0.8%, respectively; at 7 days, were 24.7%, 6.2%, and 1.7%; and at 30 days, were 33%, 10.2%, and 3.2%, respectively. Based on standard vital signs and blood test biomarkers in the prehospital scenario, three clusters were identified: alpha (high-risk), beta and gamma (medium- and low-risk, respectively). This permits the EMS system to quickly identify patients who are potentially compromised and to proactively implement the necessary interventions.

Producción Científica

Raúl López-Izquierdo mail , Carlos del Pozo Vegas mail , Ancor Sanz-García mail , Agustín Mayo Íscar mail , Miguel A. Castro Villamor mail , Eduardo René Silva Alvarado mail eduardo.silva@funiber.org, Santos Gracia Villar mail santos.gracia@uneatlantico.es, Luis Alonso Dzul López mail luis.dzul@uneatlantico.es, Silvia Aparicio Obregón mail silvia.aparicio@uneatlantico.es, Rubén Calderón Iglesias mail ruben.calderon@uneatlantico.es, Joan B. Soriano mail , Francisco Martín-Rodríguez mail ,

López-Izquierdo