Facultad de Ciencias de la Salud y Bienestar Humano
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Item type:Publication, Artificial intelligence in physical examination teaching in Latin America: a critical narrative review and conceptual model proposal(Frontiers Media SA, 2026-04-13); - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Bullying and cyberbullying victimization and associated mental health and behavioral risks among adolescents in Ecuador(Frontiers Media SA, 2026-04-28); Massuht, FresiaIntroduction Bullying remains a major public health concern among adolescents and is associated with adverse mental health and behavioral outcomes. Evidence from low- and middle-income countries, including Ecuador, remains limited. Methods We conducted a cross-sectional study using data from the Ecuadorian version of the Youth Risk Behavior Surveillance System (YRBSS). Associations between school bullying, cyberbullying, and emotional distress (sadness), suicidal behaviors (ideation, planning, attempts), and risk behaviors (alcohol use, marijuana use, and school fights) were assessed using chi-square tests and logistic regression. Odds ratios (OR) and relative risks (RR) with 95% confidence intervals (CI) were calculated. Results Among 300 adolescents, 10.0.3% reported school bullying and 16.0% reported cyberbullying. Bullying victimization was associated with higher odds of sadness (OR 3.33, 95% CI 1.50–7.35), suicidal ideation (OR 431, 1.99–9.0.32), suicidal planning (OR 5.45, 2.51–1183), and suicide attempts (OR 5.43, 2.39–12.36). Cyberbullying was strongly associated with alcohol consumption (RR 5.33, 95% CI 2.47–11.46) and marijuana use (RR 7.20, 1.86–27.92). Discussion Bullying and cyberbullying are strongly associated with emotional distress, suicidal behaviors, and substance use among adolescents in Ecuador. These findings underscore the urgent need for school-based prevention strategies and integrated public health interventions targeting adolescent mental health. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Serum Low-Density Lipoprotein Cholesterol and Neck Disability Among University Employees: A Cross-Sectional Study(MDPI AG, 2026-09-01) - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Distinguishing Isolated From Familial Microtia: Demographic, Clinical, and Anatomical Insights From Ecuador(SAGE Publications, 2026-06-29); - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Promise, Mimicry, and Surveillance: Responsibly Integrating Artificial Intelligence With Socratic Inquiry in Medical EducationLarge language models are increasingly proposed as a way to deliver Socratic dialogue at scale in medical education, offering personalized, always-available, and lower-stakes inquiry that human educators cannot logistically provide. In this viewpoint, I argue that this promise is plausible but unproven and that 2 failure modes deserve more attention than they currently receive. The first is the mimicry trap: a system that fluently generates Socratic-sounding questions can appear to cultivate reasoning while functioning as interactive content delivery. I position this as an educational instance of the ELIZA effect and of the proxy-outcome problem; separating conversational mimicry from genuine metacognitive gain remains a central unresolved evaluation problem. The second is what I term the Panopticon Paradox: the data collection that makes AI tutoring effective may erode the psychological safety that Socratic inquiry requires, pushing learners toward performative rather than authentic engagement, in a manner analogous to gaming behaviors documented in intelligent tutoring systems. I present this second construct as a testable causal model with specified mediators, moderators, and falsifiable predictions rather than as an established finding. Because the evidence base is dominated by proof-of-concept tools, cross-sectional surveys, and short-term evaluations, I argue that AI is complementary rather than a replacement technology, and I propose a 3-pillar framework (governance, curriculum, and faculty development) tied explicitly to the 2 failure modes. I distinguish 4 modalities of delegation and argue that ethical deliberation, emotionally complex communication, and ambiguous clinical judgment cannot presently be recommended for autonomous or primary AI delivery. © 2026 JMIR Publications Inc.. All rights reserved. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Paradoxes of Elimination and Persistence: Neglected Tropical Diseases in Ecuador Compared to Latin America and the CaribbeanObjective To describe, from a comparative Latin American perspective, the progress and gaps in the elimination of neglected tropical diseases (NTDs) in Ecuador, integrating recent data on arboviruses, American trypanosomiasis, leishmaniasis, and structural determinants such as water, sanitation, and hygiene (WASH). Methods A narrative review with a descriptive comparison of secondary data based on secondary sources published between 2015 and 2026. Sources were identified through structured searches of PubMed/MEDLINE, the PAHO Institutional Repository for Information Sharing (IRIS), the WHO Global Health Library, and the WHO/UNICEF Joint Monitoring Programme (JMP) data portal, supplemented by targeted retrieval of official technical reports from WHO, PAHO, UNICEF, and Ecuador’s Ministry of Public Health. Comparative indicators were constructed between Ecuador and the Region of the Americas or Latin America and the Caribbean (LAC) for: (a) burden and elimination of selected NTDs; (b) recent dengue dynamics; and (c) WASH service coverage. A synthetic two‐panel table with key indicators was prepared, and an interpretive narrative analysis was conducted. Results Globally, NTD and malaria prevalence decreased 58% between 1990 and 2021, but the reduction in disability‐adjusted life years was only 18%, with a disproportionate burden still in low‐ and middle‐income regions. In the Americas, Ecuador was the second country to certify onchocerciasis elimination in 2014, following intensive mass drug administration (MDA) campaigns with ivermectin, with posttreatment surveillance confirming absence of transmission. The Region recorded a record dengue outbreak in 2024 with over 12.6 million suspected cases and more than 7700 deaths, concentrated in four large Latin American countries; through epidemiological Week 21 of 2025, more than 3 million cases had been reported, of which 23,623 corresponded to Ecuador. In 2020, 75% of the LAC population used safely managed drinking water and 34% used safely managed sanitation; nevertheless, 17 million people still lacked access to even basic water services and 72 million lacked basic sanitation. In Ecuador, basic drinking water‐service coverage reached 95.7% in 2022, but only 41.6% used safely managed sanitation, and in rural areas, substantial proportions of unimproved water sources, surface water use, and open defecation persist. According to GBD 2023 data, the age‐standardized DALY rate for NTDs and malaria combined was 193.8 per 100,000 in Ecuador (95% UI: 139.4–267.6), substantially lower than Bolivia (388.9) and Brazil (313.3). Conclusions Ecuador illustrates a regional paradox that is primarily institutional and programmatic rather than biological. Vertical programs endowed with a dedicated external initiative, a donated single‐dose drug, a verifiable elimination endpoint, and long‐term technical accompaniment—as in onchocerciasis—can interrupt transmission of a historical NTD, whereas the persistence of structural determinants—poverty, precarious urbanization, and WASH gaps—sustains the burden of other NTDs and arboviruses. PAHO’s Communicable Disease Elimination Initiative offers an opportunity to articulate elimination goals with rural water and sanitation policies, entomological surveillance, and intercultural territorial approaches. Sustained investments in WASH, integrated surveillance, and strengthened primary care are required to transform punctual elimination achievements into structural health equity gains. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Crononutrición, Microbiota Intestinal y Riesgo Cardiovascular en el Envejecimiento: Una Revisión NarrativaIntroducción: El envejecimiento se asocia con una disminución de la diversidad y resiliencia de la microbiota intestinal, favoreciendo un estado de inflamación crónica de bajo grado (inflammaging) que se relaciona con un mayor riesgo de enfermedad cardiovascular. En este contexto, la crononutrición ha emergido como una estrategia potencial para modular los ritmos circadianos y la composición de la microbiota intestinal, con posibles implicaciones sobre la salud cardiometabólica. Objetivo: Analizar la interacción entre estos factores, describir los mecanismos fisiopatológicos implicados y evaluar el potencial de las estrategias crononutricionales como herramientas no farmacológicas para favorecer un envejecimiento cardiovascular saludable. Métodos: Se realizó una revisión narrativa mediante búsqueda en PubMed, Web of Science y Scopus de estudios publicados entre enero de 2012 y septiembre de 2025. Se priorizaron investigaciones en adultos ≥60 años e incluyeron estudios mecanísticos relevantes. Se incorporaron 69 estudios. Resultados: El envejecimiento se relaciona con menor diversidad microbiana, reducción de taxones beneficiosos como Akkermansia y Christensenellaceae y mayor disbiosis. Metabolitos como los ácidos grasos de cadena corta (AGCC) y el óxido de trimetilamina (TMAO) participan en procesos inflamatorios, oxidativos y vasculares. La alimentación con restricción de tiempo y dietas ricas en fibra podrían mejorar la composición de la microbiota y biomarcadores cardiovasculares, aunque la evidencia sigue siendo heterogénea. Conclusión: La interacción entre crononutrición y microbiota intestinal constituye un componente relevante del eje intestino-corazón durante el envejecimiento. Sincronizar los horarios de alimentación con los ritmos circadianos podría mejorar la composición y función de la microbiota y algunos biomarcadores cardiovasculares. No obstante, aún no existe evidencia suficiente para establecer una relación causal, por lo que se requieren ensayos clínicos aleatorizados y estudios longitudinales. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Ayuno Intermitente 16:8 y Ayuno 5:2 en el Control Glucémico de la Diabetes Mellitus Tipo 2: Revisión Sistemática y Síntesis Comparativa IndirectaIntroducción: El ayuno intermitente se ha propuesto como una estrategia nutricional complementaria para el control glucémico en adultos con diabetes mellitus tipo 2 (DM2). Sin embargo, la evidencia disponible para los esquemas 16:8 y 5:2 procede de estudios que, en su mayoría, los evaluaron por separado y frente a comparadores diferentes. El objetivo fue sintetizar de forma comparativa indirecta los efectos de ambos protocolos sobre el control glucémico. Métodos: Se realizó una revisión sistemática conforme a PRISMA 2020. Fueron elegibles estudios publicados desde el 1 de enero de 2015 hasta la fecha de la última búsqueda, realizada el 14 de enero de 2026, que evaluaran 16:8 o 5:2 en adultos con DM2 y contaran con un comparador contemporáneo. Se aplicaron RoB 2 a los ensayos aleatorizados y ROBINS-I a los no aleatorizados. No se realizó metaanálisis por heterogeneidad clínica y metodológica. La certeza global de la evidencia no se calificó mediante GRADE. Resultados: Se incluyeron siete estudios publicados entre 2019 y 2024: seis ensayos aleatorizados y un estudio controlado no aleatorizado. No se identificó ningún ensayo que comparara directamente 16:8 frente a 5:2. En 5:2 se observaron reducciones de HbA1c de magnitud variable, desde cambios modestos en el estudio no aleatorizado hasta −1,9 puntos porcentuales en el ensayo EARLY; en 16:8, los estudios también mostraron descensos de HbA1c, aunque las estimaciones se expresaron como cambios intragrupo o diferencias frente a controles distintos. La heterogeneidad de comparadores, duración, modalidades de intervención, tratamiento farmacológico y forma de reportar los desenlaces impidió jerarquizar válidamente un protocolo sobre el otro. No se observó una señal consistente de eventos adversos graves, pero el número y la duración de los estudios fueron insuficientes para establecer seguridad a largo plazo. Conclusión: La evidencia disponible sugiere que tanto 16:8 como 5:2 pueden asociarse con mejorías del control glucémico en adultos seleccionados con DM2. No obstante, la comparación entre ambos es indirecta, la certeza no fue evaluada formalmente con GRADE y no existe evidencia suficiente para afirmar superioridad de un esquema. Se requieren ensayos aleatorizados head-to-head, con desenlaces estandarizados y seguimiento prolongado. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Perimenopausal symptom burden: implications for health, work and earlier clinical management(Informa UK Limited, 2026-09-11) - Some of the metrics are blocked by yourconsent settings
Item type:Publication, The pharmaceutical industry’s multifaceted role in neglected tropical disease control: from market failure to global health innovationBackground: Neglected tropical diseases (NTDs) represent a profound market failure wherein pharmaceutical innovation systematically underserves populations with the greatest need. Despite affecting over 1.7 billion people globally, NTDs receive less than 2% of pharmaceutical research and development (R&D) investment. Objective: This review synthesises evidence on the pharmaceutical industry’s evolving role in NTD control, examining both traditional commercial models and innovative partnerships that have reshaped the global health landscape, with particular attention to implementation mechanisms and concrete operational pathways. Methods: We conducted a comprehensive analysis of WHO reports, G-FINDER data, peer-reviewed literature, and industry commitments spanning 2000–2024, focusing on drug development pipelines, mass drug administration programmes, and financing mechanisms. Results: Product Development Partnerships (PDPs) have delivered 183 approved products since 1999, though the majority represent reformulations or repurposed compounds rather than novel chemical entities (NCEs). Mass drug administration programmes have distributed over 17 billion treatments from pharmaceutical donations valued at approximately $30 billion (at wholesale prices), preventing millions of disability-adjusted life years. However, persistent innovation gaps remain: only 4 NCEs (0.5% of all new therapeutics 2000–2011) specifically targeted NTDs. Diagnostic development continues to lag due to commercial barriers and fragmented regulatory pathways. Conclusions: The pharmaceutical industry’s contribution to NTD control has evolved from minimal engagement to strategic partnerships blending philanthropic drug donation, nonprofit-led R&D, and market-based incentives. While mechanisms including Priority Review Vouchers and Advance Market Commitments show potential, their effectiveness remains debated in the literature, particularly regarding access provisions and additionality. Future progress requires sustained push funding for PDPs, multi-year donor commitments, expansion of WHO prequalification for diagnostics, and strengthened South–South technology-transfer partnerships with concrete implementation frameworks. © The Author(s) 2026.