Manuel Vaquero-Abellán

The purpose of this study is to evaluate the feasibility and validity of 3D avatar-based anthropometry for assessing anthropometric indicators of overweight and obesity in children based on artificial intelligence–derived 3D body reconstruction. This cross-sectional study included 171 children aged 8–10 years from five primary schools in southern Spain. Due to technical constraints of the reconstruction software, 75 children meeting predefined image quality and body weight requirements (≥ 30 kg) were eligible for 3D avatar analysis. Manual anthropometric measurements were obtained following International Society for the Advancement of Kinanthropometry (ISAK) standards and compared with avatar-derived circumferences. Agreement was assessed by using Wilcoxon tests, Spearman correlations, Bland–Altman analyses, and false discovery rate-adjusted comparisons. Avatar-derived circumferences were consistently greater than manual measurements, although waist-to-hip and waist-to-stature ratios demonstrated no significant differences. Avatar and manual circumferences were moderately to strongly correlated (Spearman’s ρ = 0.62–0.72; adjusted p < 0.05). However, the mean absolute errors ranged from 6.21 to 7.11 cm, and Bland–Altman analysis revealed systematic overestimation with wide limits of agreement, particularly for waist and hip circumferences. Despite these discrepancies, both methods similarly discriminated between weight status categories. Conclusion: Image-based 3D avatar anthropometry is a feasible, noninvasive approach for population-level screening and research in pediatric settings. Although the system reliably captures relative differences and body proportions, its current accuracy is insufficient for individual-level clinical assessment. Further algorithmic refinement and validation in lighter and more diverse pediatric populations are needed before clinical implementation. What is Known: • Childhood obesity remains a major public health challenge requiring accurate monitoring. • Anthropometric assessment still relies mainly on manual measurements, while AI-based 3D body modeling offers a promising non-invasive alternative. What is New: • Image-based 3D avatar anthropometry is feasible in school settings but is constrained by technical requirements. • Avatar measurements are correlated with manual anthropometry and preserve weight status discrimination but demonstrate systematic overestimation and limited agreement.

Objectives: To examine the association between social media (SM) use and content exposure with the risk of developing eating disorders (EDs) among adolescents. Methods: A descriptive observational study was conducted using a structured questionnaire incorporating validated scales. The instrument assessed quantitative and qualitative variables related to eating habits, SM usage, self-esteem, and body image. The sample comprised students aged 12–17 years from a school in Córdoba, Spain. Results: A total of 115 students participated in the study. Among them, 43.5% were identified as being at risk of developing EDs. Of this subgroup, 54.0% were female, with male gender appearing as a protective factor against ED risk. A significant association was found between increased hours of SM use and higher ED risk, with an odds ratio (OR) of 5.54 (95% confidence interval [CI]: 2.03–14.33). Conclusions: The findings suggest that low self-esteem and negative body image are key factors associated with increased ED risk, and that SM may act as an amplifying influence. Preventive interventions should focus on enhancing self-esteem and fostering critical and conscious engagement with SM among adolescents to mitigate the development of eating disorders.

The presence of visceral adipose tissue implies a higher risk of cardiovascular diseases than subcutaneous adiposity, the most dangerous heart fat. Epicardial adipose tissue (EAT) could have great potential as a detection indicator of cardiovascular diseases, although it has seldom been studied in Spanish children. Objective: The objective of the current research was to describe the values of EAT in a Spanish pediatric population and to investigate the associations between EAT and anthropometric measures, blood pressure, lipid and glucose profiles, and metabolic syndrome. Method: An analytical cross-sectional study of elementary and high school students (aged 6 to 17) measured anthropometrics, blood pressure, lipid and glycemic profiles, and echocardiographic fat thickness. The analysis was based on regression and discriminant analysis. Results: The results of this study (N = 227) showed that the body mass index (BMI) was 20.29 ± 4.54, with an overweight set of 49.77%, and the percentage for metabolic syndrome was 5.3%. EAT was linked to being male, BMI percentile, waist circumference, waist-to-height ratio (p < 0.001), hypertension, higher low-density lipoprotein (LDL) levels, and metabolic syndrome (p < 0.05). Conclusions: This paper argues that in children with higher elevated EAT thickness values, this correlates with cardiovascular risk factors including high blood pressure, elevated LDL levels, and metabolic syndrome.

Background: People worldwide are concerned with the possibility of climate change, microplastics, air pollution, and extreme weather affecting human health. Countries are implementing measures to reduce environmental impacts. Nurses play a vital role, primarily through Green Teams, in the process of promoting sustainable practices and minimizing the environmental footprint of health care facilities. Despite existing knowledge on this topic, assessing nurses’ environmental awareness and behavior, including the barriers they face, is crucial with regard to improving sustainable health care practices. Aim: To analyze the environmental awareness and behavior of nurses, especially nurse leaders, as members of the Green Team and to identify areas for improvement with regard to the creation of a sustainable environment. Methods: A sequential mixed-method study was conducted to investigate Spanish nurses. The study utilized an online survey and interviews, including participant observation. An online survey was administered to collect quantitative data regarding environmental awareness and behavior. Qualitative interviews were conducted with environmental nurses in specific regions, with a focus on Andalusia, Spain. Results: Most of the surveyed nurses (N = 314) exhibited moderate environmental awareness (70.4%), but their environmental behavior and activities in the workplace were limited (52.23% of participants rarely performed relevant actions, and 35.03% indicated that doing so was difficult). Nurses who exhibited higher levels of environmental awareness were more likely to engage in sustainable behaviors such as waste reduction, energy conservation, and environmentally conscious purchasing decisions (p < 0.05). Additionally, the adjusted model indicated that nurses’ environmental behavior and activities in the workplace depend on the frequency of their environmental behaviors outside work as well as their sustainable knowledge (p < 0.01). The results of the qualitative study (N = 10) highlighted certain limitations in their daily practices related to environmental sustainability, including a lack of time, a lack of bins and the pandemic. Additionally, sustainable environmental behavior on the part of nursing leadership and the Green Team must be improved. Conclusions: This study revealed that most nurses have adequate knowledge, attitudes, and behaviors related to environmental sustainability both inside and outside the workplace. Limitations were associated with their knowledge and behaviors outside of work. This study also highlighted the barriers and difficulties that nurses face in their attempts to engage in adequate environmental behaviors in the workplace. Based on these findings, interventions led by nurses and the Green Team should be developed to promote sustainable behaviors among nurses and address the barriers and limitations identified in this research. Graphical

Objective: To analyze the current scientific knowledge and research lines focused on environmentally sustainable health systems, including the role of nurses. Background: There seem to be differences between creating interventions focused on environmentally sustainable health systems, including nurses, and the scarcity of research on this topic, framed on the Sustainable Development Goals. Methods: A bibliometric analysis was carried out, via three databases (Web of Science, Scopus, and Pubmed), and the guideline recommendations were followed to select bibliometric data. Results: The search resulted in 159 publications, significantly increasing the trends from 2017 to 2021 (p=0.028). The most relevant countries in this area were the United States of America, the United Kingdom, and Sweden. Also, the top articles were from relevant journals, indexed in Journal Citation Report, and the first and the second quartile linked to the nursing field and citations (p<0.001). Conclusion: Education is key to achieving environmentally sustainable health systems via institutions and policies. Implications for nursing management: There is a lack of experimental data and policies on achieving or maintaining environmentally sustainable health care systems, indicating that nurses have an important role and should be consulted and included in decision-making policies regarding sustainability in the healthcare systems.

Homelessness is a social and health problem with great repercussions in Europe. Many non-governmental organisations help homeless people by collecting and analysing large amounts of information about them. However, these tasks are not always easy to perform, and hinder other of the organisations duties. The SINTECH project was created to tackle this issue proposing two different tools: a mobile application to quickly and easily collect data; and a software based on artificial intelligence which obtains interesting information from the collected data. The first one has been distributed to some Spanish organisations which are using it to conduct surveys of homeless people. The second tool implements different feature selection and association rules mining methods. These artificial intelligence techniques have allowed us to identify the most relevant features and some interesting association rules from previously collected homeless data.

Cervical cancer is a global public health problem. It is the second leading cause of death among women of childbearing age worldwide. Several factors, including diet, have been shown to influence the risk of persistent HPV infection and tumor progression. This paper determines the relationship between dietary patterns and cervical cancer. It is an ecological study of multiple groups, based on two national sources: the High-Cost Account and the National Survey of Nutritional Situation of Colombia of 2015. The population consisted of 3472 women aged 35 to 64. The incidence of cervical cancer was used as the dependent variable while the independent variables included food consumption according to established patterns, area of residence, age, physical activity, and BMI, among other variables. The statistical analysis performed through associations between variables was evaluated by multiple linear regression using R2. 38.9% of the evaluated population belonged to the first quartile of wealth, and 76.5% resided in the municipal capital. The incidence of cervical cancer in Colombia was associated with being affiliated to a state-subsidized health regime and having diabetes mellitus. A conservative eating pattern, as well as belonging to a rural area, are evidenced as protective factors. These results invite the need to encourage public policies and promote healthy lifestyles.

Background: Metabolic syndrome (MetS) is a group of metabolic abnormalities characterised by central obesity, hypertension, dyslipidaemia, and dysregulation of blood glucose, which is associated with the risk of diabetes, cardiovascular disease, and overall mortality. White blood cell count is a selective marker of acute infection and inflammation, which could provide information on the metabolic status of subjects. This study aims to provide the best evidence on the association between MetS and white blood cell count by determining the effect size of this biomarker. Methods: A systematic review and meta-analysis of studies indexed in the PubMed and Scopus databases were performed. Methodological quality was assessed using the STROBE tool, overall risk of bias using RevMan (Cochrane Collaboration), and quality of evidence using Grade Pro. Results: We included 14 articles comparing leukocyte concentrations in 21,005 subjects with MetS and 66,339 controls. Subjects with MetS had a higher mean leukocyte count, 0.64 cells ×10⁹/L; CI95% 0.55–0.72; p < 0.00001; I² = 93%. Conclusions: An in-depth evaluation of the relationship of leukocytes in the pathophysiological process of MetS could lead to new insights into early diagnosis.