Fundación Canaria de Investigación Sanitaria

ABSTRACT Background Fingerprint patterns are developed during pregnancy and share a common embryogenic origin with the central nervous system. Considering the observed relationship between prenatal abnormalities and higher risk for schizophrenia, we previously built fingerprint‐based algorithms achieving validation accuracies up to 70% in a large sample of patients with schizophrenia. In this new study, we apply them to a sample of patients with bipolar disorder. Methods Besides validating the developed algorithms with an independent sample of fingerprints from N = 127 patients with schizophrenia and N = 116 healthy controls, here we applied them to a sample of N = 118 bipolar disorder patients. Scores from a premorbid IQ scale were also obtained from all participants, and the link between these scores and the algorithm outcomes was analyzed. Results The initial validation provided balanced accuracies similar to those of the original study (57%–68%). When applied to subjects with bipolar disorder (against healthy individuals), algorithms also showed significant predictive power (accuracies: 55%–68%). Consequently, the capacity to discriminate between schizophrenia and bipolar disorder was poor (accuracies: 47%–57%). Regression analyses between averaged probabilities and premorbid IQ scores were significant in schizophrenia (r = −0.184; p = 0.041) and in the whole sample (r = −0.159; p = 0.002). Conclusions Algorithms were predictive of bipolarity, highlighting the existence of fingerprint abnormalities also in bipolar disorder. In addition, the observed associations with premorbid IQ underline the neurodevelopmental origin of fingerprint patterns and suggest the potential use of fingerprints for prediction in other neurodevelopmental disorders. The lack of specificity with the diagnosis of schizophrenia, though, points to the need for new algorithms for differential diagnosis in psychosis.

Exposomic determinants substantially influence the variability of molecular IgE-mediated sensitization in allergic rhinitis and conjunctivitis across bioclimatic regions, underscoring their relevance in precision allergology. This study aimed to characterize molecular sensitization profiles in Spanish patients with respiratory allergy from distinct geographic and climatic areas. A cross-sectional, multicenter study was performed in 12 Spanish cities. The study population comprised 291 patients diagnosed with allergic rhinitis and/or conjunctivitis according to the modified ARIA/DECA criteria. Participants underwent skin prick testing with standardized allergen extracts and multiplex molecular IgE analysis. Clinical, demographic, and regional bioclimatic variables were integrated to define exposomic sensitization patterns. Patients previously treated with allergen immunotherapy or biologics were excluded. Regional pooled sera were analyzed by ELISA and IgE immunoblotting to validate molecular data and identify IgE binding to nonrecombinant or poorly characterized allergenic components. Distinct regional sensitization profiles were identified. Grass pollen allergens predominated in oceanic and continental climates, while olive and cypress pollens were more frequent in Mediterranean areas. Sensitization to house dust mite, particularly Dermatophagoides pteronyssinus and Blomia tropicalis, was highly prevalent in subtropical and humid zones. Molecular assays confirmed skin test findings and identified major allergenic molecules, including Phl p 1, Ole e 1, Der p 1, and Der p 2, along with region-specific components such as Der p 23, Cup a 1, Alt a 1, and Pla a 2. This multicenter exposomic study demonstrated that climatic diversity modulates allergen sensitization in Spain, supporting region-tailored precision diagnostic and therapeutic strategies in respiratory allergy.

Abstract The tourism industry increasingly requires adaptive recommendation systems capable of understanding traveler preferences and learning from user behavior. Traditional conversational agents and retrieval-based systems remain limited by static knowledge and lack continuous personalization. This study presents an integrated framework combining Large Language Models, Retrieval-Augmented Generation, and Reinforcement Learning via Multi-Armed Bandit algorithms to develop an adaptive conversational assistant for dynamic travel itinerary recommendations. Orchestrated with LangGraph for stateful dialogue management and deployed on AWS, the system continuously updates its recommendation policies from user interactions. Case studies demonstrate its ability to balance exploration and exploitation. The conversational design emulates human travel advisors through guided questioning and preference elicitation. This architecture bridges the gap between static retrieval and adaptive learning, enabling a closed-loop conversational AI that evolves from user feedback. The research validates the feasibility of production-ready, reinforcement learning–driven personalization in tourism and provides a scalable foundation for adaptive recommendation systems beyond tourism.

unified cohort of 134 patients was formed using tissue microarrays from two sarcoma centers: 109 cases from MD Anderson Cancer Center and 25 from Fred Hutchinson Cancer Center (FHCC).Two mIHC panels were used: CD4, CD68/CD163, CD8, FoxP3, PD-1, PD-L1 (with post-mIHC ERG DAB) and CD68, CD20, CD3, CD163, CD206, CD34.Transcriptomic analysis was performed using the NanoString IO 360 panel on 25 angiosarcoma samples from FHCC with 9 hemangiomas as controls. Results:We observed significant differences in immune cell infiltration between cutaneous and non-cutaneous angiosarcomas, with higher levels of CD20+ B-cells (p=0.015),CD3+ T-cells (p=0.007),CD8+ T-cells (p< 0.001), FOXP3+ regulatory Tcells (p< 0.001), PD1+ cells (p=0.004) and CD4+ T-cells (p=0.015) in cutaneous tumors.Survival analysis demonstrated that higher CD20+ B-cell infiltration was significantly associated with improved overall survival (p=0.014).Gene expression analysis revealed higher MAPK pathway-related transcripts including MAP4K2 and MAPKAPK2 in angiosarcomas.Angiosarcomas also had higher complement levels (C5/C6), and lower expression of interleukin 1 receptor antagonist (IL1RN).When comparing angiosarcoma subtypes, scalp/face tumors showed distinctive immune profiles with lower complement expression and higher expression of inflammatory markers S100A8, S100A9, NOD2, and IL1B; paired with higher CD3+ and CD4+ cell infiltration on mIHC compared to other sites. Conclusion:These findings provide insights into the immunological landscape of angiosarcomas across different anatomical locations.The significantly higher immune infiltration in cutaneous versus non-cutaneous angiosarcomas suggests distinct immunological mechanisms, consistent with higher immunotherapy responsiveness in cutaneous angiosarcomas.Our results suggest that immune cell infiltration, particularly CD20+ B-cells, may serve as prognostic biomarkers in this rare disease.

Background: Chronic pelvic toxicity induced by radiotherapy and/or chemotherapy (R/CIPT) is a debilitating sequela in gynecological cancer survivors, often refractory to conventional treatments and potentially linked to gut microbiota dysbiosis. Ozone therapy (OT), particularly rectal insufflation, demonstrates anti-inflammatory and redox-modulating effects through hormetic mechanisms (Nrf2 activation/NF-κB inhibition). We hypothesize that its clinical benefit is mediated, in part, by restoring gut microbial homeostasis. Objective: This manuscript proposes a clinical study to evaluate the impact of rectal OT on the gut microbiota of patients with gynecological cancers and chronic R/CIPT. Proposed Methods: A prospective, observational study of 38 patients is outlined: 19 with CTCAE v5.0 Grade ≥2 chronic R/CIPT receiving compassionate rectal OT (~40 sessions over 4 months), and 19 matched controls without toxicity. Stool samples for 16S rRNA sequencing will be collected from the OT group pre- and post-intervention and once from controls. Primary endpoints are changes in microbiota composition/diversity and pelvic toxicity scores (CTCAE v5.0, EORTC QLQ-CX24). Secondary endpoints include quality of life (EORTC QLQ-C30, EQ-5D-5L), anxiety/depression (HADS), and serum inflammatory/oxidative stress biomarker analysis. Anticipated Results and Conclusion: This will be the first study to prospectively investigate whether rectal OT’s effect correlates with a beneficial shift in the gut microbiota, specifically an increase in commensals (e.g., short-chain fatty acids producers) and a decrease in pathobionts. If successful, OT could be assessed as a novel, microbiota-targeting intervention for R/CIPT. The findings from this pilot study will provide the necessary groundwork for a future randomized controlled trial to definitively establish causality and efficacy.

SummaryBackgroundAcute respiratory distress syndrome (ARDS) is a severe inflammatory process of the lung, often due to sepsis, and poses significant mortality burden in intensive care units. Here we conducted a genome-wide association study (GWAS) of ARDS to identify genetic risk loci that can help guide the development of new therapeutic options.MethodsWe performed a case–control GWAS in 716 cases with ARDS, mainly associated with severe infections, and 4399 at-risk controls from three independent studies. Results were meta-analysed across the three studies, with significance set at p < 5 × 10−8. Suggestive associations were declared for variants exhibiting consistent direction of effects, likely to replicate and nominal significance (p < 0.05) in all three studies. Prioritised loci were subjected to Bayesian fine mapping, in-silico functional assessments, and gene-based rare variant collapsing analysis using whole-exome sequencing data. Two independent studies with 430 ARDS cases and 1398 at-risk controls served as validation samples.FindingsWe identified a variant near HMGCR that showed genome-wide significant association with ARDS and had been previously linked to cholesterol metabolism. This locus was associated with ANKDD1B expression in artery. The rare exonic variant analysis showed associations between HMGCR and ARDS at nominal level (p < 0.05). While no nominal significance was achieved in the two additional validation cohorts, this variant exhibited a consistent direction of effects across all 5 studies.InterpretationA common variant near HMGCR was associated with ARDS risk, suggesting a link between cholesterol metabolism and ARDS risk. Validation in independent studies is needed.Funding10.13039/100010269Wellcome Trust, National Institute for Health Research Leicester Biomedical Research Centre, 10.13039/100000050National Heart, Lung, and Blood Institute, ATS Research Program, Gobierno de Canarias, 10.13039/501100023554Fundación Canaria Instituto de Investigación Sanitaria de Canarias, 10.13039/100017487Instituto Tecnológico y de Energías Renovables, Cabildo Insular de Tenerife, 10.13039/501100004587Instituto de Salud Carlos III, 10.13039/501100011033Agencia Estatal de Investigación, German Ministry of Education and Research, 10.13039/501100004404Thuringian Ministry of Education, Science and Culture, the Thuringian Foundation for Technology, Innovation, and Research, German Sepsis Society.

This study examines the generalizability of foreign economic evaluations to the Spanish healthcare system. The research aims to describe the cross-country adaptation methods identified in a scoping review of multinational cost-utility analyses and to examine the probability of concordant funding decisions between Spanish and foreign results, as well as to identify factors influencing generalizability. First, a scoping review of multinational studies reporting cost-utility analyses for at least two countries, including Spain, was conducted using MEDLINE, PubMed, Embase and Web of Science in April 2025. Data related to transferability were extracted and a narrative synthesis was performed. Second, a dataset of case comparisons-each defined as a technology against a comparator in a specific population-was developed from the identified studies. Each foreign comparison was matched to its Spanish equivalent within the same study. Incremental cost-effectiveness ratios (ICERs) were converted to 2024 Spanish Euros and compared against a threshold of €30,000 per quality-adjusted life year (QALY). A multilevel logit model was used, with a binary variable indicating decision concordance between Spanish and foreign ICERs/dominance as the dependent variable. We also analysed the distances in the incremental costs and incremental QALYs between countries using a log-normal bivariate model. Country-specific and other study-related factors were considered as independent variables in both models. The review included 57 studies. Most were funded by drug manufacturers and conducted in Europe. The majority of authors did not specify their reasons for selecting countries. All but three studies attempted to use local costs, probabilities and/or epidemiological data. Twelve studies incorporated country-specific utilities. A total of 644 comparisons were analysed; 142 were Spanish results and 502 were foreign results with their Spanish equivalents. The cost-effectiveness plane quadrant of the foreign result matched the Spanish result in 84% of cases. Assuming a threshold of €30,000 per QALY, the funding decisions were the same in 93% of cases. The probability of decision concordance was higher when the study was conducted in a Eurozone country or in the United Kingdom. Sensitivity analysis showed the variability of decisions depending on the selected cost-effectiveness threshold. Similar variables were found as relevant factors explaining the distance in the incremental QALYs analysis. Foreign cost-effectiveness results of those studies analysing drugs from Eurozone countries such as France, Germany, Italy, or from the United Kingdom can often be generalizable and provide meaningful insights for decision making in Spain. However, these findings should not be used as a reason to avoid country-specific studies if they are feasible. Further research is needed to determine if these findings apply to other health technologies. Limitations of the study include the lack of a formal assessment of the methodological quality of the selected studies and the potential risks of bias.

Background Ciguatoxin poisoning (CP) is the most common non-bacterial seafood poisoning. The first recorded outbreak in the Canary Islands was in 2004. Since 2008, cases have been reported every year. Aim To summarise the epidemiological characteristics of CP outbreaks in the Canary Islands between January 1, 2008 and July 1, 2025, and to describe an outbreak produced by the consumption of a fish species not subject to ciguatoxin control in the Canary Islands (Sphyraena viridensis) purchased in a supermarket. Methods Retrospective observational descriptive study of the CP outbreaks in the Canary Islands. Fish remains were analyzed for any toxin detection when available. Results 28 outbreaks were detected. The most frequent fish was amberjack (Seriola spp.) and grouper (Epinephelus spp.). Four outbreaks were caused by species not included in the control program. Four people required hospital admission. In June 2025, an outbreak caused by a 2 kg yellowmouth purchased at a local supermarket was reported, where one of the affected persons presented symptoms for a month without being diagnosed. Conclusion It is advisable to have a continuous review of the species and weights in the ciguatoxin control program, as well as to train emergency physicians to be capable of recognizing the disease.