Articles publicats (IRBLleida)
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L'IRBLleida és un centre de recerca conjunt entre la Universitat i el Departament de Salut de la Generalitat de Catalunya. Té com a funció potenciar les sinergies de recerca biomèdica entre ambdós institucions i està compromès en avançar en la recerca biomèdica com a mitja per millorar la salut de la població i facilitar una activitat assistencial òptima en situacions de malaltia. [Més informació].
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- ItemOpen AccessA treadmill training program in a gamified virtual reality environment combined with transcranial direct current stimulation in Parkinson’s Disease: Preliminary results of a mixed methods randomized controlled trial(Springer, 2026) Bosch-Barceló, Pere; Tersa-Miralles, Carlos; Martínez-Navarro, Oriol; Masbernat-Almenara, Maria; Pakarinen, Anni; Fernández-Lago, HelenaBackground: Gait impairments in Parkinson's disease (PD) worsen under cognitive load and often persist despite medication. Combining treadmill training with gamified virtual reality environments (GVRE) and transcranial direct current stimulation (tDCS) may address both motor and cognitive contributors. This study evaluated the effects and experiences of a cognitive-motor gait training program integrating GVRE and tDCS. Methods: In this mixed-methods RCT, 23 participants with mild-to-moderate PD were randomized to: (1) treadmill (n = 8), (2) treadmill+GVRE (n = 8), or (3) treadmill+GVRE+tDCS (n = 7). Participants completed 12 sessions over six weeks. Primary outcomes included spatiotemporal gait parameters and executive function under single- and dual-task conditions. Secondary outcomes included balance, motor severity, fear of falling and quality of life. Interviews explored perceived effects and motivational factors. Results: The intervention was safe and well tolerated, with high attendance (92%). No statistically or clinically meaningful changes were observed in gait speed. Balance improved across groups (MiniBESTest + 1.48 points; p = 0.0003). A timepoint-specific improvement in cadence during motor dual-task walking was observed in the treadmill+GVRE+tDCS group compared with treadmill. Interviews revealed increased walking confidence and adoption of mobility strategies in complex walking situations. Conclusions: This preliminary mixed-methods RCT supports the feasibility and acceptability of combining treadmill training with GVRE and tDCS in people with mild-to-moderate PD. While the intervention did not yield clinically meaningful improvements in gait speed, exploratory outcomes offered insight into participant experiences. Reported gains in confidence, self-monitoring, and walking strategies provide useful context. Findings should be interpreted cautiously. Larger, adequately powered, sham-controlled trials are needed to determine efficacy.
- ItemOpen AccessGenerative artificial intelligence use in nursing bachelor's theses: A qualitative study of students' technology integration and learning(Elsevier, 2026-07-04) Masot, Olga; Alzuria Alós, Rosa Mar; Roca Llobet, Judith; Torné Ruiz, Alba; Bonet Augè, Aida; Selva Pareja, Laia; Barallat Gimeno, Eva; Paraíso Pueyo, ElenaAim: To explore nursing students' generative artificial intelligence (GenAI) related practices during Bachelor Thesis (BT) preparation and to analyse their levels of technology integration, links with learning, and perceived barriers and facilitators. Methods: This descriptive qualitative study adopted a constructivist approach. Participants were 66 final-year nursing students who reported using GenAI tools during the preparation and defense of the BT. Data were collected using a qualitative open-ended questionnaire and analysed using thematic analysis. Findings were interpreted using the SAMR model (Substitution, Augmentation, Modification and Redefinition). Results: GenAI use spanned different levels of technology integration. At the Substitution and Augmentation levels, it primarily supported language correction, refinement of academic tone, and reference management. At the Modification and Redefinition levels, it supported critical reflection, knowledge reorganisation, integration of complex information, and co-creation of student-produced artefacts, with reports of a transformed learning experience. Nevertheless, students expressed concerns about the reliability of the information generated, the need for verification, and the ethical implications of using these tools. Conclusions: GenAI significantly shapes how nursing students construct knowledge and develop academic practice in the BT. When integrated more fully, it may support autonomy and critical thinking, provided its use remains reflective, ethically grounded and aligned with the discipline's educational objectives. These findings have implications for curriculum design, academic supervision and pedagogical approaches that encourage responsible GenAI use in nursing education.
- ItemOpen AccessRemote ischemic perconditioning and postconditioning reduced cerebral ischemic injury modulating inflammatory responses and metabolic pathways(Sage, 2026) Torres Querol, Coral; Pamplona Gras, Reinald; Arque, Gloria; Purroy Garcia, FranciscoRemote ischemic conditioning (RIC) mitigates ischemic injury through transient, repetitive vascular occlusion in a limb distant from the injury site. Although its protective effects are recognized, the underlying mechanisms remain incompletely understood. This study investigated the metabolic and inflammatory changes induced by RIC to identify novel cytoprotective targets. We used a mouse model of transient focal cerebral ischemia induced by 60-min occlusion of the distal middle cerebral artery. Two RIC protocols were applied: remote ischemic perconditioning (RIPerC), consisting of three cycles of 5-min hindlimb ischemia followed by 5-min reperfusion during ischemia, and remote ischemic postconditioning (RIPostC), applied after reperfusion. Plasma cytokines were quantified using a multiplex assay, and metabolomic profiles of plasma and brain samples were analyzed by untargeted liquid chromatography-mass spectrometry (LC-MS). Data were evaluated with univariate and multivariate statistical methods. RIC induced moderate changes in the brain metabolome but significantly increased three plasma metabolites: Cer (42:3), HexCer (36:1), and TG (28:0), suggesting systemic metabolic modulation during ischemia-reperfusion. Both RIPerC and RIPostC conferred neuroprotection, likely through regulation of peripheral immune responses. These findings demonstrate that RIPerC and RIPostC protect against ischemic injury by modulating inflammatory and metabolic pathways in systemic circulation and brain, providing insights into ischemic tolerance and biomarker discovery.
- ItemOpen AccessPhenogroup-based stratification of cardiovascular risk in obstructive sleep apnea(Elsevier, 2026) Kosasih, Anastasya Maria; Ou, Yihui; Koo, Chieh-Yang; Drager, Luciano F; Zhang, Junjie; Sethi, Rishi; Li, Ruogu; Ho, Hee-Hwa; Loo, Germaine; Ong, Thun-How; Sia, Ching-Hui; Chen, Zhengfeng; Sim, Hui-Wen; Kang, Giap-Swee; Sorokin, Vitaly; Wong, Serene; Chew, Nicholas; Chan, Mark Y; Richards, Arthur Mark; Chen, Shao-Liang; Tan, Huay-Cheem; Barbé Illa, Ferran; Tam, Wilson W; Lee, Chi-HangBackground: Obstructive sleep apnea (OSA) exhibits substantial phenotypic heterogeneity, but its prognostic relevance in patients with coronary artery disease (CAD) undergoing revascularization remains uncertain. Methods: We pooled data from two prospective cohorts of CAD patients undergoing percutaneous coronary intervention or coronary artery bypass grafting (n = 2318). Major adverse cardiac and cerebrovascular events (MACCE; cardiovascular death, non-fatal myocardial infarction, non-fatal stroke, and unplanned revascularization) were assessed over a mean follow-up of 1.9 ± 1.1 years. Latent class analysis using nine clinical variables identified phenogroups. Associations between OSA (apnea-hypopnea index ≥15) and MACCE were evaluated using Cox regression. Results: Three phenogroups were identified: (1) Younger-Sleepy-Hypoxia (42.2%), (2) Cardiorenal-Metabolic (30.9%), and (3) Old-Lean-Chinese (26.9%). OSA prevalence was similar across groups (45.5%, 50.7%, and 47.8%). The overall incidence of MACCE was 11.4% and did not differ significantly across phenogroups (p = 0.127). OSA was associated with increased MACCE risk in the overall cohort (adjusted HR 1.55, 95% CI 1.20-2.00; p < 0.001). In phenogroup analyses, this association was significant in phenogroup 1 (adjusted HR 1.57, 95% CI 1.04-2.36; p = 0.030), borderline in phenogroup 2 (adjusted HR 1.55, 95% CI 0.98-2.43; p = 0.059), and not significant in phenogroup 3 (adjusted HR 1.32, 95% CI 0.81-2.16; p = 0.263). Conclusions: In revascularized CAD patients, OSA was associated with increased cardiovascular risk in the overall cohort, with heterogeneity across phenogroups. These findings support phenogroup-based risk stratification, pending external validation.
- ItemOpen AccessHistory of sexually transmitted infections among mpox cases in the 2022 outbreak in Spain(Wiley, 2026-06-18T22:00:00Z) March-Yagüe, Aina; Toledo, Diana; Díaz, Asunción; Godoy i García, Pere; Pérez-Martínez, Olaia; Pericas, Carles; Sanchez-Migallon, Alonso; Chirlaque, María Dolores; Ospina, Jesús; Grau, María; Roig, Francisco; Domínguez, AngelaObjective: The aim was to describe the history of sexually transmitted infections (STIs) among adult mpox men cases and to analyse sociodemographic and epidemiological characteristics according to the presence or absence of any STI diagnosed 1 or 6 months previous to mpox diagnosis during the 2022 outbreak in Spain. Methods: A cross-sectional study was conducted as part of a multicentre study in seven Spanish regions. Mpox patients were enrolled by the epidemiological surveillance services from June 2022 to January 2023. We conducted descriptive and bivariate analyses to compare sociodemographic, epidemiological and clinical characteristics of mpox according to the presence of a previous STI diagnosis. Associations were assessed using logistic regression to estimate crude odds ratio (OR) and adjusted odds ratio (aOR) with 95% confidence intervals (95% CI). Results: A total of 1202 mpox individuals were included (96.4% were men); 36% (417/1159) of males had previous STI during the 6 months previous to mpox diagnosis. Chemsex practice (aOR 1.66, 95% CI: 1.11-2.47), practicing sex in leisure places (aOR 1.68, 95% CI: 1.12-2.51), having HIV diagnosis (aOR 1.91, 95% CI: 1.32-2.77) and using pre-exposure prophylaxis (PrEP) (aOR 4.43, 95% CI: 3.05-6.45) were more frequent among males with a history of STI in the 6 months previous to mpox diagnosis. No statistical differences were found in mpox clinical manifestations and hospitalization according to STI history. Conclusions: Overlapping risk behaviours and shared transmission routes contributed to the high prevalence of STI history in mpox cases. Epidemiological characteristics studied in mpox cases with previous STI may help identify target populations and planning an integrated prevention strategy.