https://hdl.handle.net/10481/24819 2026-04-11T12:57:24Z https://hdl.handle.net/10481/111598 Adherence to Plant-Based Dietary Patterns and Digestive Cancers: A Scoping Review Oncina Cánovas, Alejandro; Cabañas Alite, Luis; Comino, Iris; Mustieles Miralles, Vicente Background/Objectives: Digestive cancers are among the leading causes of death world wide. Although their etiology is not fully understood, diet is an important modifiable risk factor. This scoping review aimed to explore the existing evidence on the association between adherence to various plant‑based dietary (PBD) patterns and the risk of major di gestive cancers. Methods: The scoping review followed the Arksey and O’Malley frame work and Joanna Briggs Institute recommendations, and results were reported according to PRISMA‑ScR guidelines. A systematic search was performed in PubMed/MEDLINE, Scopus, EMBASE, and Web of Science between January 2020 and May 2025. Original ob servational studies and clinical trials in English or Spanish examining the association be tween PBD patterns and digestive cancers were included. Results: A total of 24 studies were identified, including 16 prospective cohort studies and 8 hospital‑based case–control studies, conducted mainly in Europe (n = 10), North America (n = 8), and Asia (n = 6). Most studies used food frequency questionnaires and predefined PBD indices, particu larly the plant‑based diet index (PDI), healthful (hPDI), and unhealthful (uPDI) (n = 13), while others assessed pro‑vegetarian (n = 2) or EAT‑Lancet dietary patterns (n = 3). Most studies reported protective associations with all digestive cancer localizations examined, particularly in relation to healthful PBD patterns: colorectal (13/15), pancreatic (6/7), liver (4/4), esophageal (4/5), stomach (3/4) and oropharyngeal (2/2) cancers. On the contrary, unhealthful PBD patterns were linked to a higher risk. Conclusions: Overall, the find ings of this review highlight that the quality of PBD patterns is crucial for digestive cancer risk. PBD patterns emphasizing whole and minimally processed plant foods were pro tective, while those characterized by refined or ultra‑processed plant products were dele terious. A future standardization of PBD indices would help to improve comparability among studies. https://hdl.handle.net/10481/109319 Disinfection Byproducts, Oxidative Stress, and Sleep Quality among Healthy Chinese Men Xu, Shiyu; Li, Guangming; Mustieles Miralles, Vicente; Zhang, Yu; Messerlian, Carmen; Gaskins, Audrey J.; Xiong, Chengliang; Meng, Tianqing; Pan, Susu; Wang, Yi-Xin Toxicological studies show that disinfection byproducts (DBPs) adversely affect neurological and psychiatric symptoms, which have been linked to poor sleep quality. This cohort study explored the associations between DBP exposure, oxidative stress, and sleep quality assessed by the Pittsburgh Sleep Quality Index (PSQI) questionnaire among young healthy Chinese men who provided 710 blood and 2647 repeated urinary samples over 3 months. We measured trihalomethanes in blood and haloacetic acids and oxidative stress markers in urine samples. In adjusted models, each 2.7-fold increase in urinary trichloroacetic acid (TCAA) concentrations was associated with a greater PSQI score of 0.29 (95% confidence interval: 0.07, 0.50). A clear dose–response relationship was observed when TCAA concentrations were included as quartile variables (P for trend = 0.01). In the analyses of individual PSQI components, TCAA was associated with a greater risk of difficulty in falling asleep, short sleep duration, and daytime dysfunction (odds ratios = 1.33 (1.04, 1.70), 1.35 (1.03, 1.78), and 1.39 (1.08, 1.78), respectively, per 2.7-fold increase in TCAA concentrations). Mediation analyses showed that 4-hydroxy-2-nonenal-mercapturic acid mediated 22.24% (4.44%, 80.00%) of the association between TCAA concentrations and PSQI scores. In summary, TCAA exposure may affect sleep quality, which is partly mediated by oxidative stress. https://hdl.handle.net/10481/108885 Multianalyte method to simultaneously evaluate occupational exposure to anesthetic gases in urine samples from healthcare professionals Espín Moreno, Lydia; Durán-López, Alfonso M.; Pérez Cantero, Ainhoa; Benavente-Romero, Alberto; Rodríguez Carrillo, Andrea; Mustieles Miralles, Vicente; Saz-Terrado, Tomás; Fernández, Mariana F. Objective: Monitoring occupational exposure in hospital settings requires valid non-invasive exposure assessment methods. We aimed to develop a multianalyte method to characterize and quantify urinary levels of anesthetic gases in healthcare professionals. Methods: Urine samples were collected from 37 recently exposed and 24 non-exposed professionals. A multianalyte method was developed and validated to measure urinary concentrations of desflurane, isoflurane, sevoflurane, and its main metabolite, hexafluoroisopropanol, using headspace gas chromatography coupled to mass spectrometry (HS-GC-MS). Results: The methodology was successfully validated. It demonstrated adequate linearity and sensitivity [correlation coefficients (R²): 99.5–99.9%]. Limits of detection for the anesthetic gases were 0.15 to 0.60 ng/mL, and limits of quantification were 0.5 to 2.0 ng/mL. The recovery percentage ranged from 95.17% to 102.40%, and relative standard deviations were below 15%. Detectable concentrations in exposed participants ranged from 1.0 to 3.80 ng/mL (mean 0.53 ng/mL) for desflurane, 0.5 to 19.59 ng/mL (mean 1.39 ng/mL) for sevoflurane, and 2.0 to 729.35 ng/mL (mean 49.74 ng/mL) for hexafluoroisopropanol (HFIP). No detectable concentrations of isoflurane were found in the exposed volunteers, nor were any of the anesthetics found in the non-exposed volunteers. Conclusions: A multianalyte HS-GC-MS method was successfully developed to simultaneously determine four anesthetic gases in urine samples and was validated in real-world samples from healthcare professionals. Future studies are needed to investigate the safety of exposure to these compounds for anesthesiologists and operating room nurses. Manuscrito sin revisión, subido a revista para su consideración por el editor.; This study was carried out in the framework of the European Partnership for the Assessment of Risks from Chemicals (PARC) and received funding from the European Union Horizon Europe research and innovation program under Grant Agreement #101057014. However, views and opinions expressed are those of the author(s) alone and do not necessarily reflect those of the European Union or the Health and Digital Executive Agency. Neither the European Union nor the granting authority can be held responsible for them. The study also received co-funding from the Biomedical Research Networking Center-CIBER de Epidemiología y Salud Pública (CIBERESP) of the Institute of Health Carlos III (ISCIII). The authors are grateful to the ISCIII for the predoctoral contract granted to A Pérez-Cantero (Grant no. FI24/00299), the Sara Borrell Program awarded to A Rodríguez-Carrillo (Grant no. CD24/00116), and the Miguel Servet Program granted to V Mustieles (Grant no. CP25/00111). The authors are also grateful for the Salvador de Madariaga Program del Ministerio de Universidades (PRX23_00541) for a grant to MF Fernández. This article is part of the PhD thesis developed by L Espín-Moreno under the Clinical Medicine and Public Health Program of the University of Granada. https://hdl.handle.net/10481/108241 Teaching Oncology in the Medical Degree: Integrating Knowledge and Experience of a Multidisciplinary Tumour Board Expósito-Hernández, José; Fernández, Mariana F.; Villalobos Torres, Mercedes; López Hidalgo, Javier Luis; Guerrero-Tejada, Rosario; Tovar-Martín, Isabel; Ching-López, Rosario Cancer is recognised as a major health problem that requires a multidisciplinary approach to achieve the best possible outcomes. The rapid and important changes in the understanding of cancer need to be incorporated into clinical practice. Because of both the magnitude and pace of these changes, medical schools must also assess and update the level of knowledge and skills that need to be taught in oncology training. Multidisciplinary tumour boards (MTB) integrate the knowledge of various healthcare disciplines, assuring treatment according to the best available evidence or multidisciplinary consensus. However, these attributes are not sufficiently integrated into the curricula of Spanish medical schools. To fill this gap, specific seminars were designed and implemented during the medical degree programme at the University of Granada (Spain), over two academic years for 510 students. The first group focused on integrating knowledge in the field of oncology, while the second group focused on the purpose of the MTB in clinical practice and its role in decision-making in specific tumour cases. All the seminars included real cases of patients with medium-complexity tumours, along with the clinical practice guidelines from a university hospital as a reference. After two years of development, the initiative has been evaluated (15-items survey), with a high level of satisfaction among students and teachers, but awaiting the collection of objective learning outcomes. This article describes the seminars, along with how they were organized. and discusses the value of introducing validated pedagogical techniques. The incorporation of well-received pedagogical innovations, such as team-based and small-group teaching, together with ‘flipped classroom’ techniques, focuses both on students’ individual knowledge and ability to interact with others. This Project has been partially funded through a Teaching Innovation Project (#22–109), within the FIDO programme of the University of Granada (Spain), 2022–2023 https://hdl.handle.net/10481/107150 Advancing ex-vivo meniscus tissue characterization: sensitivity and accuracy of shear modulus measurements via supersonic shear imaging vs. biomechanical testing Shahabodin Hashemi, Sayed; Martín Rodríguez, José Luis; Ruiz Molina, Ángel; Callejas Zafra, Antonio Manuel; Rus Carlborg, Guillermo Non-invasive measurement of meniscal mechanical properties is critical for advancing both meniscal pathophysiology research and represents a critical advancement in musculoskeletal diagnostics. This study aimed to evaluate the accuracy and sensitivity of ultrasound-based stiffness measurements using Supersonic Shear Imaging (SSI) compared to low-strain and high-strain tensile testing and to assess the ability of SSI to detect meniscal degeneration. Sixty bovine menisci were analyzed across seven regions, covering including the tibial and femoral layers, as well as the circumferential region, using shear wave elastography (SWE) and tensile testing. To evaluate tissue degeneration, samples underwent mechanical testing both before and after being subjected to five freeze–thaw cycles. Shear stiffness values obtained from SSI were compared against tensilederived parameters, including shear modulus at low strain, linear stiffness, and Young’s modulus measured from stress–strain curves up to failure, assuming small-amplitude shear wave propagation. Depth-dependent effects in Region of Interest (ROI) selection were evaluated, and Different SSI transducers were assessed using various receiver tests. Our results demonstrate significant agreement between SSI measurements and mechanical properties: 88 % sensitivity for stiffness and Young’s modulus in circumferential samples, and 91 % for shear modulus at 3 % strain in femoral and tibial regions. While intact samples showed strong positive correlations between stiffness measures, degenerated tissue exhibited inverse relationships. Our comprehensive transducer comparison and receiver tests yielded optimized protocols for ROI selection. Crucially, we identify for depthdependent measurement artifacts, proposing the ROI selection guidelines specific to meniscal elastography. This depth-aware acquisition strategy, together with the observed sensitivity of SSI to degeneration (p < 0.001), supports its clinical utility in contexts where conventional ultrasound elastography is limited. Overall, these findings validate SSI as a sensitive technique for biomechanical assessment of the meniscus, with direct translational potential for diagnosing degeneration and monitoring post/pre surgical tissue remodeling.