Search

Ensuring text accessibility and understandability are essential goals, particularly for individuals with cognitive impairments and intellectual disabilities, who encounter problems accessing information across various mediums such as web pages, newspapers, online administrative tasks, or health documents. Initiatives like Easy to Read and Plain Language guidelines aim to simplify complex texts; however, standardizing these guidelines remains challenging and often involves manual processes. This work presents an exploratory investigation into leveraging Artificial Intelligence (AI) and Natural Language Processing (NLP) approaches to simplify Spanish texts into Easy to Read formats, with a focus on utilizing Large Language Models (LLMs) for creating accessible texts, especially in generating Easy to Read content. The study contributes a parallel corpus of Spanish adapted for Easy To Read format, which serves as a valuable resource for training and testing text simplification systems. Additionally, several text simplification experiments using LLMs and the collected corpus are conducted, involving fine-tuning and testing a Llama2 model to generate Easy to Read content. A qualitative evaluation, guided by an expert in text adaptation for Easy to Read content, is carried out to assess the automatically simplified texts. This research contributes to advancing text accessibility for individuals with cognitive impairments, highlighting promising strategies for leveraging LLMs while responsibly managing energy usage.

Panama is a country with endemic Dengue virus (DENV) transmission since its reintroduction in 1993. The four serotypes have circulated in the country and the region of the Americas, however, DENV-4 confirmed autochthonous cases have not been identified since 2000, despite its circulation in neighboring countries. Here, we report DENV-4 detection in Panama in the last four-month period of 2023 with co-circulation of the other serotypes, this was associated with a peak of dengue cases during the dry season even though most dengue outbreaks are described in the rainy season. Complete genomes of DENV-4 allowed us to determine that cases were caused by DENV-4 genotype IIb, the same genotype as 23 years ago, with high similarity to DENV-4 sequences circulating in Nicaragua and El Salvador during 2023. This report shows the importance of maintaining serotype and genotype surveillance for early detection of new variants circulating in the country.

Background: Chronic heart failure (CHF) is a major health problem, representing the main cause of hospitalization in people over 65 years of age. Several studies have associated the Mediterranean diet with a cardioprotective function, improving prognoses in patients with high cardiovascular risk. Our main objective is to determine whether higher adherence to the Mediterranean diet is associated with a lower severity of CHF, based on the number of decompensations and disease complications. Methods: This study was a single-center retrospective cohort study conducted at the Virgen del Rocío Hospital (Seville). Adherence to a Mediterranean diet was determined by the Mediterranean Diet Adherence Screener (MEDAS) in patients with chronic heart failure in a state of clinical stability, the number of decompensations in the 12 months before inclusion, cardiac biomarkers (NT-proBNP and CA125), evaluation of dyspnea, and quality of life assessment according to NYHA and KCCQ scales and analytical profiles. Results: Seventy-two patients were included (35 with high adherence to the Mediterranean diet and 37 with low adherence). The mean age was 81.29 ± 0.86 years. A trend towards fewer decompensations (1.49 ± 0.14 vs. 1.92 ± 0.17, p = 0.054) and lower NT-proBNP values (2897.02 ± 617.16 vs. 5227.96 ± 1047.12; p = 0.088) was observed in patients with high adherence compared to those with low adherence to the Mediterranean diet. Conclusions: Our results suggest that patients with CHF and high adherence to the Mediterranean diet have a tendency towards an improved cardiac profile, indicated by fewer decompensations and lower NT-proBNP levels. Future clinical trials are needed to substantiate these hypotheses.

Este artículo analiza la construcción del discurso histórico en el universo transmedia de Canónicas. A diferencia de otros productos sobre la figura de Jack el Destripador, la centralidad de las biografías de las víctimas introduce una perspectiva de género que rompe con las narrativas tradicionales. Para ello, se plantea un análisis en tres niveles, atendiendo a los niveles transmedia: el podcast, la expansión basada en la profundización en el relato sonoro (web y Penny Dreadful Pods) y la centrada en conectar con el presente (canal de Twitter). Mediante este análisis, se busca reflexionar sobre cómo los nuevos formatos de comunicación y la disciplina histórica convergen.

Thanks to technologies such as the Internet and devices now available to people, we have increasingly greater access to larger quantities of information. However, people with ageing disabilities or intellectual disabilities, non-native speakers, and others have difficulties reading and understanding information. For this reason, it is essential to provide text simplification mechanisms when accessing information. Natural Language Processing methods can be applied to simplify textual content and improve understanding. These methods often use machine learning algorithms and models which require resources, such as corpora, to be trained and tested. This article presents the EASIER corpus, a resource that can be used to build lexical simplification methods to process Spanish domain-independent texts. The EASIER corpus is composed of 260 annotated documents with 8,155 words labelled as complex and 5,130 words with at least one proposed context-aware synonym associated. Expert linguists in easy-to-read and plain language guidelines have annotated the corpus based on their experience adapting texts for people with intellectual disabilities. Sixteen annotation guidelines that discriminate between complex and simple words have been defined to help other groups of experts to generate new annotations. Additionally, an inter-annotator agreement test was performed to validate the corpus, obtaining a Fleiss Kappa coefficient of 0.641. Furthermore, a qualitative evaluation was conducted with 45 users (including people with intellectual disabilities, elderly people, and a control audience). Complex word identification tasks achieved moderate results, but the synonyms proposed to replace complex words achieved almost perfect ratings. This resource has been integrated into the EASIER platform, a tool that helps people with cognitive impairments and intellectual disabilities to read and understand texts more easily.

BackgroundDue to an increase in life expectancy, the prevalence of chronic diseases is also on the rise. Clinical practice guidelines (CPGs) provide recommendations for suitable interventions regarding different chronic diseases, but a deficiency in the implementation of these CPGs has been identified. The PITeS-TiiSS (Telemedicine and eHealth Innovation Platform: Information Communications Technology for Research and Information Challenges in Health Services) tool, a personalized ontology-based clinical decision support system (CDSS), aims to reduce variability, prevent errors, and consider interactions between different CPG recommendations, among other benefits. ObjectiveThe aim of this study is to design, develop, and validate an ontology-based CDSS that provides personalized recommendations related to drug prescription. The target population is older adult patients with chronic diseases and polypharmacy, and the goal is to reduce complications related to these types of conditions while offering integrated care. MethodsA study scenario about atrial fibrillation and treatment with anticoagulants was selected to validate the tool. After this, a series of knowledge sources were identified, including CPGs, PROFUND index, LESS/CHRON criteria, and STOPP/START criteria, to extract the information. Modeling was carried out using an ontology, and mapping was done with Health Level 7 Fast Healthcare Interoperability Resources (HL7 FHIR) and Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT; International Health Terminology Standards Development Organisation). Once the CDSS was developed, validation was carried out by using a retrospective case study. ResultsThis project was funded in January 2015 and approved by the Virgen del Rocio University Hospital ethics committee on November 24, 2015. Two different tasks were carried out to test the functioning of the tool. First, retrospective data from a real patient who met the inclusion criteria were used. Second, the analysis of an adoption model was performed through the study of the requirements and characteristics that a CDSS must meet in order to be well accepted and used by health professionals. The results are favorable and allow the proposed research to continue to the next phase. ConclusionsAn ontology-based CDSS was successfully designed, developed, and validated. However, in future work, validation in a real environment should be performed to ensure the tool is usable and reliable.

We report an epidemiologic analysis of 4,210 cases of infection with severe acute respiratory syndrome coronavirus 2 and genetic analysis of 313 new near-complete virus genomes in Panama during March 9–April 16, 2020. Although containment measures reduced R0 and Rt, they did not interrupt virus spread in the country.

People with intellectual, language and learning disabilities face accessibility barriers when reading texts with complex words. Following accessibility guidelines, complex words can be identified, and easy synonyms and definitions can be provided for them as reading aids. To offer support to these reading aids, a lexical simplification system for Spanish has been developed and is presented in this article. The system covers the complex word identification (CWI) task and offers replacement candidates with the substitute generation and selection (SG/SS) task. These tasks have followed machine learning techniques and contextual embeddings using Easy Reading and Plain Language resources, such as dictionaries and corpora. Additionally, due to the polysemy present in the language, the system provides definitions for complex words, which are disambiguated by a rule-based method supported by a state-of-the-art embedding resource. This system is integrated into a web system that provides an easy way to improve the readability and comprehension of Spanish texts. The results obtained are satisfactory; in the CWI task, better results were obtained than with other systems that used the same dataset. The SG/SS task results are comparable to similar works in the English language and provide a solid starting point to improve this task for the Spanish language. Finally, the results of the disambiguation process evaluation were good when evaluated by a linguistic expert. These findings represent an additional advancement in the lexical simplification of texts in Spanish and in a generic domain using easy-to-read resources, among others, to provide systematic support to compliance with accessibility guidelines.

During the last months, the pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has hit cruelly elderly citizens living in nursing homes (NHs) across the world. As a matter of fact, NHs are highly vulnerable to the occurrence of this new coronavirus disease (COVID-19), which results in high lethality rates. In addition, most of the long-term care facilities are not yet prepared to manage with this new epidemiological and clinical scenario. In this article, we will review the impact of COVID-19 in NH, its causes and underlying factors, and the possible solutions of keeping SARS-CoV-2 at bay in NH from a triple perspective: the focus of public health policies and global measures, the operative level at NH institutions themselves, and the daily clinical scenario of clinicians and other health care workers.

BackgroundDespite having influenza vaccination policies and programs, countries in the Americas underutilize seasonal influenza vaccine, in part because of insufficient evidence about severe influenza burden. We aimed to estimate the annual burden of influenza-associated respiratory hospitalizations in the Americas.MethodsThirty-five countries in the Americas with national influenza surveillance were invited to provide monthly laboratory data and hospital discharges for respiratory illness (International Classification of Diseases 10th edition J codes 0-99) during 2010-2015. In three age-strata (ResultsSixteen of 35 countries (46%) contributed primary data to the analyses, representing 79% of the America's population. The average pooled rate of influenza-associated respiratory hospitalization was 90/100,000 population (95% confidence interval 61-132) among children aged ConclusionsInfluenza-associated respiratory hospitalizations impose a heavy burden on health systems in the Americas. Countries in the Americas should use this information to justify investments in seasonal influenza vaccination-especially among young children and the elderly.

BACKGROUND:Chikungunya virus (CHIKV) typically causes explosive epidemics of fever, rash and polyarthralgia after its introduction into naïve populations. Since its introduction in Panama in May of 2014, few autochthonous cases have been reported; most of them were found within limited outbreaks in Panama City in 2014 and Puerto Obaldia town, near the Caribbean border with Colombia in 2015. In order to confirm that Panama had few CHIKV cases compared with neighboring countries, we perform an epidemiological analysis of chikungunya cases reported from May 2014 to July 2015. Moreover, to understand this paucity of confirmed CHIKV cases, a vectorial analysis in the counties where these cases were reported was performed. METHODS:Chikungunya cases were identified at medical centers and notified to health authorities. Sera samples were analyzed at Gorgas Memorial Institute for viral RNA and CHIKV-specific antibody detection. RESULTS:A total of 413 suspected cases of CHIKV infections were reported, with incidence rates of 0.5 and 0.7 per 100,000 inhabitants in 2014 and 2015, respectively. During this period, 38.6% of CHIKV cases were autochthonous with rash and polyarthralgia as predominant symptoms. CHIKV and DENV incidence ratios were 1:306 and 1:34, respectively. A phylogenetic analysis of E1/E2 genomic segment indicates that the outbreak strains belong to the Asian genotype and cluster together with CHIKV isolates from other American countries during the same period. Statistical analysis of the National Vector Control program at the district level shows low and medium vector infestation level for most of the counties with CHIKV cases. This index was lower than for neighboring countries. CONCLUSIONS:Previous training of clinical, laboratory and vector workers allowed a good caption and detection of the chikungunya cases and fast intervention. It is possible that low/medium vector infestation level could explain in part the paucity of chikungunya infections in Panama.

Se reporta la presencia de una familia portadora del síndrome de Klein-Waardemburg en el municipio de Artemisa existiendo varios miembros afectados con diversos grados de expresividad en las tres últimas generaciones de esta enfermedad infrecuente, autonómica dominante que cursa con cierto grado de discapacidad cuando aparece la hipoacusianeurosensorial. No se pudo clasificar a los enfermos según las variantes del Síndrome, pues los mismos carecían de estudios genéticos. Se expone además una revisión bibliográfica de los aspectos genéticos que dan lugar a la aparición del síndrome.

Dengue virus (DENV) is the most prevalent arbovirus in terms of human public health importance globally. In addition to DENV epidemiological surveillance, genomic surveillance may help investigators understand the epidemiological dynamics, geographic distribution, and temporal patterns of DENV circulation. Herein, we aimed to reconstruct the molecular epidemiology and phylogeny of DENV in Panama to connect the epidemiological history of DENV dispersal and circulation in Latin America. We retrospectively analyzed the epidemiological data obtained during 25 years of DENV surveillance in Panama. DENV was reintroduced in Panama in 1993 after a 35 year absence of autochthonous transmission. The increase in the number of total dengue cases has been accompanied by an increase in severe and fatal cases, with the highest case fatality rate recorded in 2011. All four serotypes were detected in Panama, which is characterized by serotype replacement and/or co-circulation of multiple serotypes. Phylogenetic analysis of datasets collected from envelope (E) gene sequences obtained from viruses isolated from human sera demonstrated that circulating viruses were highly diverse and clustered in distinct clades, with co-circulation of clades from the same genotype. Our analyses also suggest that Panamanian strains were related to viruses from different regions of the Americas, suggesting a continuous exchange of viruses within the Americas.

Background: Little is known about the prevalence and impact of cognitive impairment in polypathological patients (PPs). Objectives: To assess the prevalence of cognitive impairment (CI) and delirium, their associated risk factors, and their impact on survival of a multicenter population of PPs. Methods: Prospective cohort study. Descriptive analysis of the prevalence, main clinical features of PPs with basal CI (by means of Short Portable Mental Status Questionnaire), and delirium (Confusion Assessment Method); and bivariate as well as multivariate assessment of the factors associated with both conditions. Survival analysis after 12 months follow-up by means of Kaplan–Meier curves, and multivariate analysis of mortality risk factors in PPs with CI, and those with delirium. Results: CI was present in 39% [28% mild to moderate (3–7 errors), and 11% severe (≥ 8 errors)] of the 1434 PPs assessed [in the remaining 11% (n=198) delirium was detected]; only 26% of them had been previously diagnosed with dementia. One-year mortality was 46%/31.4% in those with/without CI [p 2 mg/dL [p=0.003; RR=7.8 (2–26)], and polypharmacy [p=0.0019; RR=3.1 (1.2–8.1)]. Conclusion: CI, as well as delirium, is common in PPs. Both play a deleterious role in 12-month survival. A systematic cognitive assessment as well as prevention and early detection of delirium should be included in the clinical care of all PPs.

Background: Little is known about the fitness of the available tools in predicting functional decline of polypathological patients (PPs). Our objective was to assess accuracy of the Triage Risk Screening Tool (TRST), the Variable Indicative of Placement risk (VIP) and to develop a specific functional prognostic index adjusted to this population in a multicenter cohort of hospital-based PP. Methods: Prospective 12-month follow-up study of PPs from 36 hospitals. Functional decline was defined as loss of ≥20 points on Barthel’s index (BI). Accuracy of TRST/VIP was assessed by calibration/discrimination tests. Development of the new score was performed by dividing into a derivation cohort (constructing the index by logistic regression), and a validation cohort (in which calibration/discrimination of the index were tested). Results: Nine hundred and fifty-eight patients from the 1632 included survived during follow-up. Basal/12-month BI was 85/70, respectively. Mean fall in BI score was 11.7±24 points [353 (36.8%) fell by ≥20 points]. The activities for daily living that declined most frequently were toilet use, grooming, dressing and bathing. TRST/VIP fitted well but their discrimination power was poor (area under the curve=0.49 and 0.46, respectively). A simplified PROFUNCTION index was derived containing seven items (≥85 years, neurological condition, osteoarticular disease, III–IV functional class of dyspnea, ≥4 polypathology categories, basal BI

El tamizaje de personas aquejadas de disminución de la visión, puede realizarse a través de pruebas sencillas y valiosas, realizadas por diferentes personas. En esta investigación se utilizó una licenciada en enfermería para la toma de la agudeza visual de lejos y cerca, en los hogares de 309 personas comprendidas entre 5-90 años, pertenecientes al Consultorio Médico de la Familia # 24 de Cayajabos, municipio Artemisa, adscripto al Policlínico “Tomás Romay”, representando el 73,57% de la población, en aras de detectar enfermedades oculares causantes de pérdida visual, las cuales con un diagnóstico precoz se pudieran disminuir o erradicar. En el estudio predominó el grupo de 16 a 38 años, teniendo una baja incidencia los antecedentes de enfermedades crónicas. Al comparar los resultados de la toma de la agudeza visual antes y después de la prueba refractiva, se constata el ascenso de los porcentajes de 96 a 98,1% en la visión de lejos; así como en la visión cercana de un 58.6 % con Jaeger entre 1 y 3 antes de la prueba, a un 90,9% posteriormente. La baja visión (menos de 0,1) se presentó en 1% reduciéndose después de la prueba refractiva a 0,3 y 0,7% en OD y OI.

Uno de los principales determinantes de la supervivencia de los pacientes en hemodiálisis es la dosis de la misma, las fórmulas comúnmente utilizadas son aquellas basadas en el modelo cinético de la urea. Sin embargo, debido a la necesidad de al menos dos muestras sanguíneas, su aplicabilidad a todas las sesiones de diálisis es bastante escasa. Actualmente casi todos los monitores de diálisis están provistos de sensores de dialisancia iónica, lo que nos permite obtener de forma indirecta y en tiempo real, información acerca del aclaramiento de urea en todas las sesiones de diálisis y sin necesidad de obtener muestras sanguíneas. Con el objetivo de evaluar la correlación que existe entre la dosis de diálisis medida por dialisancia iónica y aquella medida por cinética de Urea mediante la ecuación de KT/V monocompartimental de segunda generación según Daugirdas, diseñamos un estudio transversal que incluye 28 pacientes prevalentes de nuestra unidad de diálisis, obtuvimos datos de dosis de diálisis (aclaramiento, KT, KT/V) por dialisancia iónica y el KT/V según fórmula de Daugirdas de segunda generación. La media de KT/V por dialisancia iónica fue de 1.79 ± 0.29 del KT/V según Daugirdas de 1.95 ± 0.35. En el análisis estadístico encontramos una importante correlación entre ambos métodos (R2 = 0.86 p< 0.001). Con los resultados de este estudio concluimos que la dialisancia iónica es una técnica útil para valorar la dosis de diálisis en nuestros pacientes y su uso debería generalizarse en las distintas unidades de diálisis.

Se estudiaron los niños nacidos con bajo peso reportados en las estadísticas del Policlínico Comunitario Docente “Tomás Romay” de Artemisa entre los años 1999 y 2002, constatando una baja incidencia de la enfermedad ocular. Se encontraron alteraciones leves en el fondo de ojo (14%), el estrabismo (2,3%) y con muy escasa frecuencia las alteraciones de los anexos y segmento anterior del globo ocular. La hipermetropía fue el defecto refractivo de mayor incidencia (52,2%). Desde el punto de vista pediátrico, los partos pretérminos fueron los más numerosos con 59,1%, con predominio del Apgar normal en un 90,9%. Fueron más numerosos aquellos nacidos con peso entre 2001 y 2500g para un 84,1%.

Se realizó un estudio clínico-epidemiológico, prospectivo y longitudinal en enfermos de glaucoma que acudieron a las reconsultas de Oftalmología del Policlínico Docente “Dr.Tomás Romay” y el Policlínico Comunitario de Las Cañas del municipio de Artemisa, Provincia La Habana, en los tres primeros meses del año 2004. Se analizan los hábitos higiénico-dietéticos, herencia y factores de riesgo, entre otros. Se detectó una prevalencia de l2,2%, siendo los factores de riesgo más predominantes los trastornos psicológicos (48,9%) y la hipertensión arterial con (42,4%). La herencia no fue determinante. El defecto refractivo más representado fue el astigmatismo con 76,1%. Dentro del tratamiento higiénico-dietético, el 80,5% refirieron dieta equilibrada, un 57,6% ingieren exceso de líquidos, el 17,3% refirieron realizar ejercicios físicos y ninguno practicaba ejercicios oculares. Se considera que debe enfatizarse el mejoramiento de los hábitos higiénicodietéticos con vistas a evitar las descompensaciones tan frecuentes de esta enfermedad.

Se realizó un estudio sobre discapacidad en el municipio de Artemisa, en abril del 2003, con vistas a determinar la prevalencia de la minusvalía visual, detectándose la misma en un 30,8%. Dentro de las causas más frecuentes se encontraron el glaucoma con 9,52% y las ametropías con 8,40%. Existió un subregistro de algunas enfermedades invalidantes de la agudeza visual como la retinosis pigmentaria, los cuadros degenerativos y las cataratas por presentar muy escaso porcentaje, siendo las mismas causas de cegueras en el mundo.

Se realizó una revisión bibliográfica en las guías terapéuticaas cubanas, mexicanas y españolas, con vistas a conocer los medicamentos contraindicados en el glaucoma, en aras de reducir su uso en aquellos pacientes portadores de esa enfermedad, y poder realizar de esa manera la prevención del glaucoma agudo yatrogénico, por el uso de medicamentos de esta índoleA bibliographic review on the Cuban, Mexican and Spanish therapeutic guides was made aimed at knowing those drugs contraindicated to treat glaucoma in order to reduce their use among patients carriers of this disease and to prevent acute iatrogenic glaucoma caused by the use of drugs of this type

This report compiles the data of the scientific production bout comunication generted by Facultad de Ciencias de la Información of Seville since its creation un 1989 until the month november of this year. Those data are the first purpose to compile the several investigation lines of the college.

This paper addresses methodology and tools applied to the monitoring of accessibility services in digital television at a time when the principles of accessibility and design are being considered in all new audiovisual media communication services. The main objective of this research is to measure the quality and quantity of existing accessibility services offered by digital terrestrial television (DTT). The preliminary results, presented here, offer the development of a prototype for automatic monitoring and a methodology for obtaining quality measurements, along with the conclusions drawn by initial studies carried out in Spain. The recent approval of the UN Convention on the Rights of Persons with Disabilities gives special relevance to this research because it provides valuable guidelines to help set the priorities to improve services currently available to users.

Semantic Web approaches try to get the interoperability and communication among technologies and organizations. Nevertheless, sometimes it is forgotten that the Web must be useful for every user, consequently it is necessary to include tools and techniques doing Semantic Web be accessible. Accessibility and usability are two usually joined concepts widely used in web application development, however their meaning are different. Usability means the way to make easy the use but accessibility is referred to the access possibility. For the first one, there are many well proved approaches in real cases. However, accessibility field requires a deeper research that will make feasible the access to disable people and also the access to novel non-disable people due to the cost to automate and maintain accessible applications. In this paper, we propose one architecture to achieve the accessibility in web-environments dealing with the WAI accessibility standard and the Universal Design paradigm. This architecture tries to control the accessibility in web applications development life-cycle following a methodology starting from a semantic conceptual model and leans on description languages and controlled vocabularies.

Background: Exposure to antigens is crucial for child immune system development, aiding disease prevention and promoting infant health. Some common food antigen proteins are found in human breast milk. However, it is unclear whether gluten antigens linked to celiac disease (CD) are transmitted through breast milk, potentially impacting the development of the infant's immune system. Objective: This study aimed to analyze the passage of gluten immunogenic peptides (GIP) into human breast milk. We evaluated the dynamics of GIP secretion after lactating mothers adopted a controlled gluten-rich diet. Methods: We prospectively enrolled 96 non-CD and 23 CD lactating mothers, assessing total proteins and casein in breast milk, and GIP levels in breast milk and urine. Subsequently, a longitudinal study was conducted in a subgroup of 12 non-CD lactating mothers who adopted a controlled gluten-rich diet. GIP levels in breast milk and urine samples were assayed by multiple sample collections over 96 hours. Results: Analysis of a single sample revealed that 24% of non-CD lactating mothers on a regular unrestricted diet tested positive for GIP in breast milk, and 90% tested positive in urine, with significantly lower concentrations in breast milk. Nevertheless, on a controlled gluten-rich diet and the collection of multiple samples, GIP were detected in 75% and 100% of non-CD participants in breast milk and urine, respectively. The transfer dynamics in breast milk samples were long-enduring and GIP secretion persisted from 0 to 72 h. In contrast, GIP secretion in urine samples was limited to the first 24 h, with inter-individual variations. In the cohort of CD mothers, 82.6% and 87% tested negative for GIP in breast milk and urine, respectively. Conclusions: This study definitively established the presence of GIP in breast milk, with substantial inter-individual variations in secretion dynamics. Our findings provide insights into distinct GIP kinetics observed in sequentially collected breast milk and urine samples, suggesting differential gluten metabolism patterns depending on the organ or system involved. Future research is essential to understand whether GIP functions as sensitizing or tolerogenic agents in the immune system of breastfed infants. [ABSTRACT FROM AUTHOR]