Items where Author is "Sumalla Cano, Sandra"

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Number of documents: 9.

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Article Subjects > Nutrition Europe University of Atlantic > Research > Scientific Production
Ibero-american International University > Research > Scientific Production
Ibero-american International University > Research > Articles and Books
Universidad Internacional do Cuanza > Research > Scientific Production
University of La Romana > Research > Scientific Production Open English Background/Objectives: The growing integration of Artificial Intelligence (AI) and chatbots in health professional education offers innovative methods to enhance learning and clinical preparedness. This study aimed to evaluate the educational impact and perceptions in university students of Human Nutrition and Dietetics, regarding the utility, usability, and design of the E+DIEting_Lab chatbot platform when implemented in clinical nutrition training. Methods: The platform was piloted from December 2023 to April 2025 involving 475 students from multiple European universities. While all 475 students completed the initial survey, 305 finished the follow-up evaluation, representing a 36% attrition rate. Participants completed surveys before and after interacting with the chatbots, assessing prior experience, knowledge, skills, and attitudes. Data were analyzed using descriptive statistics and independent samples t-tests to compare pre- and post-intervention perceptions. Results: A total of 475 university students completed the initial survey and 305 the final evaluation. Most university students were females (75.4%), with representation from six languages and diverse institutions. Students reported clear perceived learning gains: 79.7% reported updated practical skills in clinical dietetics and communication were updated, 90% felt that new digital tools improved classroom practice, and 73.9% reported enhanced interpersonal skills. Self-rated competence in using chatbots as learning tools increased significantly, with mean knowledge scores rising from 2.32 to 2.66 and skills from 2.39 to 2.79 on a 0–5 Likert scale (p < 0.001 for both). Perceived effectiveness and usefulness of chatbots as self-learning tools remained positive but showed a small decline after use (effectiveness from 3.63 to 3.42; usefulness from 3.63 to 3.45), suggesting that hands-on experience refined, but did not diminish, students’ overall favorable views of the platform. Conclusions: The implementation and pilot evaluation of the E+DIEting_Lab self-learning virtual patient chatbot platform demonstrate that structured digital simulation tools can significantly improve perceived clinical nutrition competences. These findings support chatbot adoption in dietetics curricula and inform future digital education innovations. metadata Elío Pascual, Iñaki; Tutusaus, Kilian; Eguren García, Imanol; Lasarte García, Álvaro; Ortega-Mansilla, Arturo; Prola, Thomas and Sumalla Cano, Sandra mail inaki.elio@uneatlantico.es, kilian.tutusaus@uneatlantico.es, imanol.eguren@uneatlantico.es, UNSPECIFIED, arturo.ortega@uneatlantico.es, thomas.prola@uneatlantico.es, sandra.sumalla@uneatlantico.es (2026) Innovative Application of Chatbots in Clinical Nutrition Education: The E+DIEting_Lab Experience in University Students. Nutrients, 18 (2). p. 257. ISSN 2072-6643

Article Subjects > Engineering Europe University of Atlantic > Research > Scientific Production
Ibero-american International University > Research > Scientific Production
Ibero-american International University > Research > Articles and Books
Universidad Internacional do Cuanza > Research > Scientific Production
University of La Romana > Research > Scientific Production Open English Background/Objectives: Estimating energy and macronutrients from food images is clinically relevant yet challenging, and rigorous evaluation requires transparent accuracy metrics with uncertainty and clear acknowledgement of reference data limitations across heterogeneous sources. This study assessed ChatGPT-5, a general-purpose vision-language model, across four scenarios differing in the amount and type of contextual information provided, using a composite dataset to quantify accuracy for calories and macronutrients. Methods: A total of 195 dishes were evaluated, sourced from Allrecipes.com, the SNAPMe dataset, and Home-prepared, weighed meals. Each dish was evaluated under Case 1 (image only), Case 2 (image plus standardized non-visual descriptors), Case 3 (image plus ingredient lists with amounts), and Case 4 (replicates Case 3 but excluding the image). The primary endpoint was kcal Mean Absolute Error (MAE); secondary endpoints included Median Absolute Error (MedAE) and Root Mean Square Error (RMSE) for kcal and macronutrients (protein, carbohydrates, and lipids), all reported with 95% Confidence Intervals (CIs) via dish-level bootstrap resampling and accompanied by absolute differences (Δ) between scenarios. Inference settings were standardized to support reproducibility and variance estimation. Source stratified analyses and quartile summaries were conducted to examine heterogeneity by curation level and nutrient ranges, with additional robustness checks for error complexity relationships. Results and Discussion: Accuracy improved from Case 1 to Case 2 and further in Case 3 for energy and all macronutrients when summarized by MAE, MedAE, and RMSE with 95% CIs, with absolute reductions (Δ) indicating material gains as contextual information increased. In contrast to Case 3, estimation accuracy declined in Case 4, underscoring the contribution of visual cues. Gains were largest in the Home-prepared dietitian-weighed subset and smaller yet consistent for Allrecipes.com and SNAPMe, reflecting differences in reference curation and measurement fidelity across sources. Scenario-level trends were concordant across sources, and stratified and quartile analyses showed coherent patterns of decreasing absolute errors with the provision of structured non-visual information and detailed ingredient data. Conclusions: ChatGPT-5 can deliver practically useful calorie and macronutrient estimates from food images, particularly when augmented with standardized nonvisual descriptors and detailed ingredients, as evidenced by reductions in MAE, MedAE, and RMSE with 95% CIs across scenarios. The decline in accuracy observed when the image was omitted, despite providing detailed ingredient information, indicates that visual cues contribute meaningfully to estimation performance and that improvements are not solely attributable to arithmetic from ingredient lists. Finally, to promote generalizability, it is recommended that future studies include repeated evaluations across diverse datasets, ensure public availability of prompts and outputs, and incorporate systematic comparisons with non-artificial-intelligence baselines. metadata Rodríguez- Jiménez, Marcela; Martín-del-Campo-Becerra, Gustavo Daniel; Sumalla Cano, Sandra; Crespo-Álvarez, Jorge and Elío Pascual, Iñaki mail UNSPECIFIED, UNSPECIFIED, sandra.sumalla@uneatlantico.es, jorge.crespo@uneatlantico.es, inaki.elio@uneatlantico.es (2025) Image-Based Dietary Energy and Macronutrients Estimation with ChatGPT-5: Cross-Source Evaluation Across Escalating Context Scenarios. Nutrients, 17 (22). p. 3613. ISSN 2072-6643

Article Subjects > Nutrition Europe University of Atlantic > Research > Scientific Production
Fundación Universitaria Internacional de Colombia > Research > Scientific Production
Ibero-american International University > Research > Scientific Production
Ibero-american International University > Research > Articles and Books
Universidad Internacional do Cuanza > Research > Scientific Production Open English Much of nutrition research has been conventionally based on the use of simplistic in vitro systems or animal models, which have been extensively employed in an effort to better understand the relationships between diet and complex diseases as well as to evaluate food safety. Although these models have undeniably contributed to increase our mechanistic understanding of basic biological processes, they do not adequately model complex human physiopathological phenomena, creating concerns about the translatability to humans. During the last decade, extraordinary advancement in stem cell culturing, three-dimensional cell cultures, sequencing technologies, and computer science has occurred, which has originated a wealth of novel human-based and more physiologically relevant tools. These tools, also known as “new approach methodologies,” which comprise patient-derived organoids, organs-on-chip, multi-omics approach, along with computational models and analysis, represent innovative and exciting tools to forward nutrition research from a human-biology-oriented perspective. After considering some shortcomings of conventional in vitro and vivo approaches, here we describe the main novel available and emerging tools that are appropriate for designing a more human-relevant nutrition research. Our aim is to encourage discussion on the opportunity to explore innovative paths in nutrition research and to promote a paradigm-change toward a more human biology-focused approach to better understand human nutritional pathophysiology, to evaluate novel food products, and to develop more effective targeted preventive or therapeutic strategies while helping in reducing the number and replacing animals employed in nutrition research. metadata Cassotta, Manuela; Cianciosi, Danila; Elexpuru Zabaleta, Maria; Elío Pascual, Iñaki; Sumalla Cano, Sandra; Giampieri, Francesca and Battino, Maurizio mail manucassotta@gmail.com, UNSPECIFIED, maria.elexpuru@uneatlantico.es, inaki.elio@uneatlantico.es, sandra.sumalla@uneatlantico.es, francesca.giampieri@uneatlantico.es, maurizio.battino@uneatlantico.es (2024) Human‐based new approach methodologies to accelerate advances in nutrition research. Food Frontiers. pp. 1-32. ISSN 2643-8429

Article Subjects > Biomedicine
Subjects > Engineering
Subjects > Nutrition Europe University of Atlantic > Research > Scientific Production
Ibero-american International University > Research > Scientific Production
Ibero-american International University > Research > Articles and Books
Universidad Internacional do Cuanza > Research > Scientific Production Closed English Obesity and overweight has increased in the last year and has become a pandemic disease, the result of sedentary lifestyles and unhealthy diets rich in sugars, refined starches, fats and calories. Machine learning (ML) has proven to be very useful in the scientific community, especially in the health sector. With the aim of providing useful tools to help nutritionists and dieticians, research focused on the development of ML and Deep Learning (DL) algorithms and models is searched in the literature. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol has been used, a very common technique applied to carry out revisions. In our proposal, 17 articles have been filtered in which ML and DL are applied in the prediction of diseases, in the delineation of treatment strategies, in the improvement of personalized nutrition and more. Despite expecting better results with the use of DL, according to the selected investigations, the traditional methods are still the most used and the yields in both cases fluctuate around positive values, conditioned by the databases (transformed in each case) to a greater extent than by the artificial intelligence paradigm used. Conclusions: An important compilation is provided for the literature in this area. ML models are time-consuming to clean data, but (like DL) they allow automatic modeling of large volumes of data which makes them superior to traditional statistics. metadata Ferreras, Antonio; Sumalla Cano, Sandra; Martínez-Licort, Rosmeri; Elío Pascual, Iñaki; Tutusaus, Kilian; Prola, Thomas; Vidal Mazón, Juan Luis; Sahelices, Benjamín and de la Torre Díez, Isabel mail UNSPECIFIED, sandra.sumalla@uneatlantico.es, UNSPECIFIED, inaki.elio@uneatlantico.es, kilian.tutusaus@uneatlantico.es, thomas.prola@uneatlantico.es, juanluis.vidal@uneatlantico.es, UNSPECIFIED, UNSPECIFIED (2023) Systematic Review of Machine Learning applied to the Prediction of Obesity and Overweight. Journal of Medical Systems, 47 (1). ISSN 1573-689X

Article Subjects > Biomedicine
Subjects > Nutrition Europe University of Atlantic > Research > Scientific Production
Ibero-american International University > Research > Scientific Production
Ibero-american International University > Research > Articles and Books Closed English In the last decade, specific dietary patterns, mainly characterized by high consumption of vegetables and fruits, have been proven beneficial for the prevention of both metabolic syndrome (MetS)-related dysfunctions and neurodegenerative disorders, such as Alzheimer’s disease (AD). Nowadays, neuroimaging readouts can be used to diagnose AD, investigate MetS effects on brain functionality and anatomy, and assess the effects of dietary supplementations and nutritional patterns in relation to neurodegeneration and AD-related features. Here we review scientific literature describing the use of the most recent neuroimaging techniques to detect AD- and MetS-related brain features, and also to investigate associations between consolidated dietary patterns or nutritional interventions and AD, specifically focusing on observational and intervention studies in humans. metadata Pistollato, Francesca; Sumalla Cano, Sandra; Elío Pascual, Iñaki; Masías Vergara, Manuel; Giampieri, Francesca and Battino, Maurizio mail francesca.pistollato@uneatlantico.es, sandra.sumalla@uneatlantico.es, inaki.elio@uneatlantico.es, manuel.masias@uneatlantico.es, francesca.giampieri@uneatlantico.es, maurizio.battino@uneatlantico.es (2015) The Use of Neuroimaging to Assess Associations Among Diet, Nutrients, Metabolic Syndrome, and Alzheimer’s Disease. Journal of Alzheimer's Disease, 48 (2). pp. 303-318. ISSN 13872877

Generated on Sat Apr 4 23:48:29 2026 UTC.

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Benchmarking multiple instance learning architectures from patches to pathology for prostate cancer detection and grading using attention-based weak supervision

Histopathological evaluation is necessary for the diagnosis and grading of prostate cancer, which is still one of the most common cancers in men globally. Traditional evaluation is time-consuming, prone to inter-observer variability, and challenging to scale. The clinical usefulness of current AI systems is limited by the need for comprehensive pixel-level annotations. The objective of this research is to develop and evaluate a large-scale benchmarking study on a weakly supervised deep learning framework that minimizes the need for annotation and ensures interpretability for automated prostate cancer diagnosis and International Society of Urological Pathology (ISUP) grading using whole slide images (WSIs). This study rigorously tested six cutting-edge multiple instance learning (MIL) architectures (CLAM-MB, CLAM-SB, ILRA-MIL, AC-MIL, AMD-MIL, WiKG-MIL), three feature encoders (ResNet50, CTransPath, UNI2), and four patch extraction techniques (varying sizes and overlap) using the PANDA dataset (10,616 WSIs), yielding 72 experimental configurations. The methodology used distributed cloud computing to process over 31 million tissue patches, implementing advanced attention mechanisms to ensure clinical interpretability through Grad-CAM visualizations. The optimum configuration (UNI2 encoder with ILRA-MIL, 256 256 patches, 50% overlap) achieved 78.75% accuracy and 90.12% quadratic weighted kappa (QWK), outperforming traditional methods and approaching expert pathologist-level diagnostic capability. Overlapping smaller patches offered the best balance of spatial resolution and contextual information, while domain-specific foundation models performed noticeably better than generic encoders. This work is the first large-scale, comprehensive comparison of weekly supervised MIL methods for prostate cancer diagnosis and grading. The proposed approach has excellent clinical diagnostic performance, scalability, practical feasibility through cloud computing, and interpretability using visualization tools.

Producción Científica

Naveed Anwer Butt mail , Dilawaiz Sarwat mail , Irene Delgado Noya mail irene.delgado@uneatlantico.es, Kilian Tutusaus mail kilian.tutusaus@uneatlantico.es, Nagwan Abdel Samee mail , Imran Ashraf mail ,

Butt

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A Systematic Literature Review on Integrated Deep Learning and Multi-Agent Vision-Language Frameworks for Pathology Image Analysis and Report Generation

This systematic literature review (SLR) investigates the integration of deep learning (DL), vision-language models(VLMs), and multi-agent systems in the analysis of pathology images and automated report generation. The rapidadvancement of whole-slide imaging (WSI) technologies has posed new challenges in pathology, especially due to thescale and complexity of the data. DL techniques in general and convolutional neural networks (CNNs) and transform-ers in particular have signiﬁcantly enhanced image analysis tasks including segmentation, classiﬁcation, and detection.However, these models often lack generalizability to generate coherent, clinically relevant text, thus necessitating theintegration of VLMs and large language models (LLMs). This review examines the eﬀectiveness of VLMs and LLMsin bridging the gap between visual data and clinical text, focusing on their potential for automating the generationof pathology reports. Additionally, multi-agent systems, which leverage specialized artiﬁcial intelligence (AI) agentsto collaboratively perform diagnostic tasks, are explored for their contributions to improving diagnostic accuracy andscalability. Through a synthesis of recent studies, this review highlights the successes, challenges, and future direc-tions of these AI technologies in pathology diagnostics, oﬀering a comprehensive foundation for the development ofintegrated, AI-driven diagnostic workﬂows.

Producción Científica

Usama Ali mail , Imran Shafi mail , Jamil Ahmad mail , Arlette Zárate Cáceres mail , Thania Chio Montero mail , Hafiz Muhammad Raza ur Rehman mail , Imran Ashraf mail ,

Ali

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Fish consumption and cognitive function in aging: a systematic review of observational studies

Epidemiological studies consistently link higher fish intake with slower rates of cognitive decline and lower dementia incidence. The aim of the present study was to systematically review existing observational studies investigating the association between fish consumption and cognitive function in older adults. A total of 25 studies (8 cross-sectional and 17 prospective including mainly healthy older adults, age range of participants ranging from 18 to 30 years at baseline in prospective studies to 65 to 91 years, representing the upper limit of the age spectrum) were reviewed. Cognitive functions currently investigated in most published studies included various domains, such as global cognition, memory (episodic, working), executive function (planning, inhibition, flexibility), attention and processing speed. Existing studies greatly vary in terms of design (cross-sectional and prospective), geographical area, number of participants involved, and tools used to assess the outcomes of interest. The main findings across studies are not univocal, with some studies reporting stronger evidence of association between fish consumption and various cognitive domains, while others addressed rather null findings. The most consistently responsive domains were processing speed, executive functioning, semantic memory, and global cognitive ability among individuals consuming fish at least weekly, which are highly relevant to both neurodegenerative and vascular forms of cognitive impairment. Positive associations were also observed for verbal memory and general memory, though these were less uniform and often attenuated after multivariable adjustment. In contrast, associations with reaction time, verbal-numerical reasoning, and broad composite scores were inconsistent, and several fully adjusted models showed null results. In conclusion, the evidence suggests that regular fish intake (typically ≥1–2 servings per week) is linked to preserved cognitive performance, although some inconsistent findings require further investigations.

Producción Científica

Justyna Godos mail , Giuseppe Caruso mail , Agnieszka Micek mail , Alberto Dolci mail , Carmen Lilí Rodríguez Velasco mail carmen.rodriguez@uneatlantico.es, Evelyn Frias-Toral mail , Jason Di Giorgio mail , Nicola Veronese mail , Andrea Lehoczki mail , Mario Siervo mail , Zoltan Ungvari mail , Giuseppe Grosso mail ,

Godos

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A scalable and secure federated learning authentication scheme for IoT

Secure and scalable authentication remains a fundamental challenge in Internet of Things (IoT) networks due to constrained device resources, dynamic topology, and the absence of centralized trust infrastructures. Conventional password-based and certificate-driven authentication schemes incur high computation, storage, and communication overhead, limiting their suitability for large-scale deployments. To address these limitations, this paper proposes ScLBS, a federated learning (FL)–based self-certified authentication scheme for distributed and sustainable IoT environments. ScLBS integrates self-certified public key cryptography with FL-driven trust adaptation, enabling decentralized public key derivation without reliance on third-party certificate authorities or exposure of private credentials. A zero-knowledge mechanism combined with location-aware authentication strengthens resistance to impersonation, Sybil, and replay attacks. Hierarchical key management supported by a -tree enables efficient group rekeying and preserves forward and backward secrecy under dynamic membership. Formal security verification is conducted under the Dolev–Yao adversary model using ProVerif, confirming secrecy of private and session keys (SKs) and correctness of authentication. Extensive NS-3 simulations and ablation analysis demonstrate that ScLBS achieves lower authentication delay, reduced message overhead, improved network utilization, and decreased energy consumption compared to representative IoT authentication schemes, while maintaining bounded FL overhead. These results indicate that ScLBS provides a balanced trade-off between security strength, scalability, and resource efficiency for constrained IoT networks.

Producción Científica

Premkumar Chithaluru mail , B. Veera Jyothi mail , Fahd S. Alharithi mail , Wojciech Ksiazek mail , M. Ramchander mail , Aman Singh mail aman.singh@uneatlantico.es, Ravi Kumar Rachavaram mail ,

Chithaluru

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Human Activity Recognition in Domestic Settings Based on Optical Techniques and Ensemble Models

Human activity recognition (HAR) is essential in many applications, such as smart homes, assisted living, healthcare monitoring, rehabilitation, physiotherapy, and geriatric care. Conventional methods of HAR use wearable sensors, e.g., acceleration sensors and gyroscopes. However, they are limited by issues such as sensitivity to position, user inconvenience, and potential health risks with long-term use. Optical camera systems that are vision-based provide an alternative that is not intrusive; however, they are susceptible to variations in lighting, intrusions, and privacy issues. The paper uses an optical method of recognizing human domestic activities based on pose estimation and deep learning ensemble models. The skeletal keypoint features proposed in the current methodology are extracted from video data using PoseNet to generate a privacy-preserving representation that captures key motion dynamics without being sensitive to changes in appearance. A total of 30 subjects (15 male and 15 female) were sampled across 2734 activity samples, including nine daily domestic activities. There were six deep learning architectures, namely, the Transformer (Transformer), Long Short-Term Memory (LSTM), Gated Recurrent Unit (GRU), Multilayer Perceptron (MLP), One-Dimensional Convolutional Neural Network (1D CNN), and a hybrid Convolutional Neural Network–Long Short-Term Memory (CNN–LSTM) architecture. The results on the hold-out test set show that the CNN–LSTM architecture achieves an accuracy of 98.78% within our experimental setting. Leave-One-Subject-Out cross-validation further confirms robust generalization across unseen individuals, with CNN–LSTM achieving a mean accuracy of 97.21% ± 1.84% across 30 subjects. The results demonstrate that vision-based pose estimation with deep learning is a useful, precise, and non-intrusive approach to HAR in smart healthcare and home automation systems.

Producción Científica

Muhammad Amjad Raza mail , Nasir Mehmood mail , Hafeez Ur Rehman Siddiqui mail , Adil Ali Saleem mail , Roberto Marcelo Álvarez mail roberto.alvarez@uneatlantico.es, Yini Airet Miró Vera mail yini.miro@uneatlantico.es, Isabel de la Torre Díez mail ,

Raza

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