Sánchez Redrobán, José
Preferred name
Sánchez Redrobán, José
Main Affiliation
Quito
ORCID
0000-0003-4571-1618
Scopus Author ID
59772297900
16 results
Now showing 1 - 10 of 16
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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, 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. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Risk Factors Associated with Hyporesponsiveness to Erythropoietin in Chronic Kidney Disease Patients on Hemodialysis Who Present Anemia: A Multicenter Case-Control Study(2025)36 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, HIV Disease hospitalizations and factors associated with in‐hospital mortality in Ecuador: A nationwide analysis from 2015 to 2023(2025); Jhon Ernesto Delgado PinargoteHuman immunodeficiency virus (HIV) remains a significant public health concern worldwide, contributing to notable rates of hospitalization and mortality. This study aimed to analyse HIV disease hospitalization trends and factors associated with in‐hospital mortality in Ecuador during 2015–2023. Methods Official national hospital discharge data were used. Hospitalization and in‐hospital mortality rates were calculated. Multivariable logistic regression was performed to obtain adjusted odds ratios (aORs) and 95% confidence intervals (CIs) to identify factors associated with in‐hospital mortality. Results: Totally 28 408 HIV disease hospitalizations were analysed; the majority were males 61.19% (<jats:italic>n</jats:italic> = 17 383). Average hospitalization rate was 18.48 per 100 000 inhabitants. In‐hospital deaths accounted for 11.31% (<jats:italic>n</jats:italic> = 3214). Older age (≥40 years) was significantly associated with a higher likelihood of death, particularly in 60–69 years (aOR 1.78, 95% CI 1.49–2.13) and ≥70 years (aOR 1.79, 95% CI 1.36–2.34). Patients with HIV‐related Pneumocystis jirovecii pneumonia (aOR 2.74, 95% CI 2.28–3.29) and multiple malignant neoplasms (aOR 4.30, 95% CI 1.66–11.15) had the highest mortality likelihood. Although a declining trend in mortality rates was observed throughout 2015–2023, there was an increase in mortality probabilities in 2021 which may be linked to healthcare disruptions during the COVID‐19 pandemic, while subsequent decline in 2022 and 2023 suggests improvements in HIV care access.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>While HIV‐related hospitalizations and mortality have declined in Ecuador, older patients and those with severe opportunistic infections or malignancies remain at higher risk. These findings underscore the need for early diagnosis, enhanced management of HIV‐related complications and sustained antiretroviral therapy (ART) coverage, particularly during public health crises.29 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, A comprehensive framework for integrating modern educational technologies with problem-based learning in medical education(2025); Monserrat Vanessa Romero-DuranProblem-Based Learning (PBL) has evolved from its traditional roots into a sophisticated pedagogical approach enhanced by advanced digital technologies, including artificial intelligence as a subset of these digital innovations. This comprehensive framework provides medical educators with evidence-based guidance for implementing technology-enhanced PBL methodology, incorporating both traditional principles and modern technological tools. We synthesize current literature from 2019 to 2025, analyzing research findings to create actionable recommendations for educators seeking to implement or improve their PBL programs. Recent studies demonstrate significant improvements through technology integration: 34% enhancement in diagnostic accuracy (Yang et al. in J Pharm Educ Pract 12:112–120, 2024), 28% better knowledge retention (Yan et al. in BMC Med Educ 23:456, 2023), and 42% increase in student engagement (Matsuda and Izumi in Med Educ Online 29:2345, 678, 2024). The integration of virtual patients, simulation-based learning, and adaptive systems shows promising results in enhancing traditional PBL methodologies while maintaining core pedagogical principles. Our proposed framework addresses implementation planning, role definitions, assessment strategies, and quality assurance mechanisms that medical educators can immediately apply across diverse cultural and institutional contexts. © The Author(s) 2025.14 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Time Series Analysis of Dengue, Zika, and Chikungunya in Ecuador: Emergence Patterns, Epidemiological Interactions, and Climate-Driven Dynamics (1988–2024)(2025); 31 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, A Narrative Review of Human Papillomavirus (HPV) Vaccination in Ecuador: A Crisis of Inequity and an Evidence-Based Roadmap for Elimination(2025); ; Carlos SantillanBackground: Human Papillomavirus (HPV) remains the leading cause of cervical cancer in Ecuador, which suffers from systemic programmatic failures that undermine the global elimination strategy. Crisis: Ecuador’s HPV vaccination coverage (35.6% first dose; 17.3% complete) is the lowest in Latin America, starkly contrasting with the WHO’s 90% target for cervical cancer elimination (Pan American Health Organization 2025). Structural inequities, a profound genotypic mismatch with the circulating quadrivalent vaccine (HPV 58/31/52 prevalence), and fragmented implementation perpetuate this public health crisis (Jose Ortiz Segarra et al. Infectious Disease Reports, 15(3):267–278 2023). Key Findings: Our analysis reveals that the nation’s health-center-based model fails to reach vulnerable populations, a problem exacerbated by critical cold chain deficiencies in 30% of facilities. In contrast, regional successes, such as Peru’s school-based programs (94% coverage) and Colombia’s strategic adoption of the nonavalent vaccine, offer a clear roadmap for reform (Pan American Health Organization 2025, María Ines Sarmiento-Medina et al. PLOS ONE, 19(2):e0297579 2024). Recommendations: We propose an evidence-based 5-point plan to overhaul Ecuador’s strategy: a targeted nonavalent vaccine pilot, immediate adoption of a single-dose schedule, culturally adapted self-sampling programs, phased-in gender-neutral vaccination, and urgent investment in cold chain infrastructure28 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Neurobrucellosis manifesting as secondary hemiparkinsonism in a veterinary technician: A case report and evidence-based review(2025); 13 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Political stability, health system resilience, and macroeconomic shocks as factors associated with malaria control outcomes: a comparative analysis of Ecuador and Venezuela (2000–2023)(Springer Science and Business Media LLC, 2026-06-20);