Título del artículo:

Eosinophilic gastroduodenitis secondary to toxocariasis: a zoonosis simulating gastric lymphoma in children

We describe the case of a pediatric patient with eosinophilic gastroduodenitis secondary to visceral toxocariasis, presenting with clinical, endoscopic, and histological features suggestive of gastric lymphoma. The patient, from a rural area, exhibited severe gastrointestinal symptoms, persistent hypereosinophilia, deep ulcerative lesions in the stomach and duodenum, as well as systemic involvement. After an extensive immunological, hematological, and infectious disease evaluation, the diagnosis was confirmed by positive serology for Toxocara canis. The patient showed favorable clinical evolution with antiparasitic therapy, immunomodulation, and intensive nutritional support. This case highlights the importance of considering infectious etiologies in the differential diagnosis of eosinophilic gastroduodenal disorders, particularly in pediatric patients with systemic involvement and a presentation mimicking malignant disease.

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Revista De Gastroenterologia Del Peru Organo Oficial De La Sociedad De Gastroenterologia Del Peru

Título del artículo:

Viral metagenomics in mosquitoes as potential vectors of arboviruses in the Colombian Caribbean: characterisation of a \"core\" regional RNA viromeFIRST REVIEW ROUND - REVIEWERS COMMENTSAUTHORS RESPONSE TO REVIEWERSREVIEWERS COMMENTS

BACKGROUND: Mosquitoes are critical vectors in tropical regions where arboviruses like dengue and Zika are prevalent. This study focuses on characterising the RNA virome of mosquitoes in the Colombian Caribbean, emphasising the core regional virome and its role in the dynamics of arboviruses. OBJECTIVES: The objective was to identify and analyse the core RNA virome of mosquitoes across different genera and seasons in the Colombian Caribbean to understand its composition and potential influence on arbovirus transmission dynamics. METHODS: In 2023, 4,074 mosquitoes from the genera Mansonia, Coquillettidia, and Anopheles were collected across Córdoba, Sucre, Bolívar, and Magdalena during rainy and dry seasons. Specimens were pooled in groups of 50, subjected to RNA extraction, and sequenced on the MGI-G50™ platform. Bioinformatic analyses utilised the DIAMOND-MEGANizer pipeline and R packages (phyloseq, vegan, ggplot2) to identify viral communities. FINDINGS: The analysis identified 22 viral families and 24 unclassified RNA viruses. The core regional virome, consistently present across species and seasons, was dominated by insect-specific viruses (ISVs) such as Aedes aegypti to virus 1 and 2, Astopletus, and Cumbaru, alongside Picornaviridae (30% of reads), Rhabdoviridae (20%), Orthomyxoviridae, and Bunyavirales. Mansonia titillans (38 species) and Coquillettidia nigricans (21 species) exhibited the highest viral richness. No significant arboviruses were detected, highlighting ISV dominance. Virome composition varied seasonally, with greater diversity in the rainy season due to increased breeding site availability and temperature. MAIN CONCLUSIONS: The stability of the core virome suggests it modulates vector competence, potentially reducing arbovirus transmission. These findings advocate the use of metagenomics for enhanced vector surveillance and biological control strategies in neotropical ecosystems.

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Memorias do Instituto Oswaldo Cruz

Título del artículo:

Iatrogenic Hepatocellular Adenoma in Relation to an Unusual Complication of Cardiac Surgery

Background: Inferior vena cava (IVC) obstruction is a rare but serious complication after atrial septal defect (ASD) repair. Case Summary: A 50-year-old woman with prior ASD closure presented for liver transplant evaluation due to cirrhosis and a suspected hepatocellular adenoma. Examination revealed congestive hepatopathy and dyspnea (NYHA II). Imaging identified IVC obstruction from Eustachian valve entrapment and thrombus at the cavoatrial junction. She underwent successful IVC recanalization and thrombectomy, with resolution of symptoms, prompting suspension of transplant listing. Discussion: IVC obstruction after ASD repair is exceedingly rare but can mimic liver disease and precipitate Budd-Chiari syndrome. Unlike previously reported cases, our patient uniquely demonstrated the coexistence of cirrhosis and an HNF1A-inactivated hepatocellular adenoma, a combination not described before in this setting. This case underscores the need to consider cardiac causes in unexplained hepatopathy, especially post-ASD repair. Take-Home Messages: IVC obstruction should be suspected in post-ASD repair patients with hepatopathy. Early recognition allows curative intervention and avoids unnecessary transplantation.

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Jacc Case Reports

Título del artículo:

Clinical Outcomes of Percutaneous Mitral Valve Repair with Mitraclip®: A Longitudinal Observational Study (The Mitra-Angio-CDO Study)

Background: The MitraClip device is used as an endovascular therapy for mitral valve repair in patients with severe mitral insufficiency and high surgical risk. This therapy was used for the first time in Colombia in 2013, after its authorization by the National Institute of Drug and Food Surveillance. Materials and Methods: A quantitative, observational, descriptive, longitudinal study was conducted, with an analytical component stratified by age, in adults who underwent mitral valve repair with MitraClip from March 2013 to June 2022 to determine the clinical outcomes associated with hospitalization, mortality, complications, and health-related quality of life. Results: A total of 94 patients with a mean age of 70.3±10.3 years were evaluated, most of whom were male (65%), hypertensive (80%), and had New York Heart Association class III–IV classification (90.4%) and functional mitral insufficiency (93.6%) classified as severe (74.5%). The recurrence of all-cause hospitalization was 39.4%, of which 88% corresponded to heart failure. The immediate success of the procedure, determined as mitral insufficiency classified as ≤moderate after implantation, was 93.6% (p < 0.001). In-hospital mortality was 2.1%, mortality at 6 months was 12.8% (≤70 years 11.6% vs >70 years 13.7%, p = 0.007), mortality at 1 year was 16%, and mortality at 2 years was 20.2%. The incidence of complications was low, the most frequent one being de novo atrial fibrillation (7.4%), followed by major bleeding requiring transfusion (4.3%). The Kansas City Cardiomyopathy Questionnaire scale was used, with a mean score of 69.9±19.3. Conclusion: Percutaneous mitral valve repair with MitraClip is a safe technique that directly affects survival and quality of life. There was a low incidence of complications related to the procedure and the patient’s preoperative condition, with results comparable to those of studies carried out in Europe and the United States.

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Therapeutics and Clinical Risk Management

Título del artículo:

Effect of sea surface temperature in El Niño regions on dengue dynamics in Colombia: Evidence from causal machine learning

Dengue fever is among the most rapidly expanding vector-borne diseases globally, with Colombia ranking among the most affected countries in the Americas. Although previous research has linked climate variability and El Niño–Southern Oscillation (ENSO) episodes to dengue dynamics, the direct causal effect of sea surface temperature (SST) in El Niño regions remains insufficiently explored. We conducted a retrospective ecological analysis using monthly laboratory-confirmed dengue cases from 1,044 Colombian municipalities (2013–2023), combined with atmospheric, oceanic, and socioeconomic data. We emulated an experimental design to estimate the effect of SST in El Niño regions 1–2, 3, 3–4, and 4 on excess dengue cases. Confounder adjustment was guided by a Directed Acyclic Graph (DAG), and causal effects were estimated using Double Machine Learning (DML) with XGBoost learners. We estimated the Average Treatment Effect (ATE) and the Conditional Average Treatment Effect (CATE) conditioned on altitude. Robustness was evaluated with refutation tests introducing random confounders, subset replacement, and placebo exposures. A total of 455,329 confirmed dengue cases were reported during the study period, peaking in 2023. The strongest association was observed for El Niño region 3, where a standard deviation increase in SST (1.24 °C) raised the probability of excess dengue cases by 6.9 percentage points (ATE = 0.069, 95% CI = 0.056 – 0.083). El Niño regions 3–4 and 4 showed slightly weaker ATE yet significant effects (6.4% and 6.2%), while El Niño region 1–2 had the lowest effect (4.6%). The CATE analysis revealed that the effects of El Niño regions 1–2 and 3 were stronger at higher altitudes; meanwhile, for El Niño regions 3–4 and 4, the effects showed a slightly negative trend, suggesting a heterogeneous effect of El Niño regions on dengue incidence in Colombia based on altitude. Robustness checks indicated the presence of residual bias, particularly when applying the subset replacement test. These findings highlight the importance of integrating oceanic monitoring into early warning systems of the disease and tailoring vector-control strategies to local ecological contexts.

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Plos Global Public Health

Título del artículo:

Perioperative use of levosimendan in complex congenital heart disease management

This study evaluated the impact of perioperative levosimendan on in-hospital outcomes in children undergoing surgery for complex congenital heart disease. A retrospective cohort of 120 neonates and infants undergoing Norwood operation, arterial switch operation, or truncus arteriosus repair was analyzed. Median age at surgery was 29.5 days, and median weight was 4.0 kg. In-hospital mortality was higher in female patients, who exhibited a 2.64-fold greater mortality rate compared with males (33.3% vs. 12.6%). Levosimendan use was not significantly associated with a significant reduction in in-hospital mortality (aOR 0.76; 95% CI 0.07-1.46), major complications (aOR 0.87; 95% CI 0.44-1.30), or length of stay (aOR 0.76; 95% CI 0.36-1.16). However, treatment allocation was clinically based, introducing selection bias and confounding by indication, therefore still leaving the question of potential levosimendan efficacy in the CHD postoperative context unanswered. Thus, further studies are warranted. CONCLUSION:  In this retrospective cohort of high-risk pediatric patients undergoing complex congenital heart surgery, perioperative levosimendan was not associated with significant differences in in-hospital mortality, postoperative length of stay, or major complications. WHAT IS KNOWN: • Vasoactive support is central after complex pediatric cardiac surgery; levosimendan is a calcium-sensitizer/inodilator used perioperatively. • Pediatric evidence is mixed: some reports suggest fewer LCOS events, but no consistent reduction in in-hospital mortality, AKI, ventilation duration, or LOS. WHAT IS NEW: • In a national referral cohort from a middle-income country, perioperative levosimendan showed no significant difference in mortality, LOS, or major complications versus no levosimendan in complex congenital heart surgery (Norwood procedure, Arterial switch operation and  truncus arteriosus repair). • Among postoperative ECMO patients, LOS was numerically shorter with levosimendan but not statistically significant (exploratory).

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European Journal of Pediatrics

Título del artículo:

Response to the letter of editor entitled: Hematological biomarkers in ceftriaxone-induced pseudolithiasis: a complementary diagnostic and monitoring tool

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Andes Pediatrica

Título del artículo:

Evaluating Three Rapid Tests for Dengue in Febrile Patients in a Dengue-Endemic Area

Objective: Rapid diagnostic tests have been used mainly when it is not possible to carry out the recommended laboratory tests due to challenges derived from the infrastructure of the state surveillance system and, in the specific case of dengue, due to catastrophic climatic events that prevent the transport of samples. However, the performance of rapid diagnostic tests must be evaluated in the particular context of the population in which they are applied. We aimed to assess three rapid diagnostic tests used in Mexico for dengue diagnosis and epidemiologic surveillance. Method: We used three rapid diagnostic tests that were compared to the RT-PCR/IgM capture ELISA construct as the gold standard. Additionally, the NS1-only results of the three rapid tests were compared to the RT-PCR test as the standard. A total of 125 plasma samples were randomly selected from febrile patients with suspected dengue who requested care between 2 and 6 days after the onset of fever. Result: The best-performing test showed a sensitivity of 57.3% and a specificity of 100%. Regarding NS1 detection compared to RT-PCR, the best-performing test has a sensitivity of 84.4% and a specificity of 88.75%. Conclusions: Although these tests can serve as an alternative to RT-PCR in emergencies, they should always be accompanied by a study that considers the history of predominant infection in the population and the circulation of serotypes.

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Tropical Medicine and International Health

Título del artículo:

Genomic epidemiology of dengue virus 2 and 3 reveals repeated introductions and exportations of several lineages in Colombia

Dengue fever, a major mosquito-borne viral disease, is transmitted by Aedes mosquitoes and poses a significant global health burden. Despite extensive research, the spatiotemporal dynamics of dengue virus (DENV) lineages in Colombia remain understudied. Here, we analyze 11,443 complete genome sequences from Colombia and the Americas to map the genomic epidemiology of DENV-2 and DENV-3. Phylogeographic reconstruction revealed multiple independent introductions and exportations of the DENV-2 II and III lineages, as well as the DENV-3 lineage III_C.2, underscoring Colombia\'s critical role as both a source and a sink of viral traffic within the Americas. Antigenic profiling demonstrated distinct clustering of emergent lineages in antigenic space, consistent with immune-escape-driven turnover. These results highlight the necessity of sustained, high-resolution genomic surveillance to guide targeted public health interventions and mitigate dengue transmission across the region.

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Cell Reports

Título del artículo:

Effects of a Mindfulness- and Compassion-Based Intercare Program on Stress Levels in Parents of NICU Children: A Quasi-Experimental Study.

OBJECTIVE: To evaluate the effects of a mindfulness- and compassion-based intercare program (MBIP) on stress levels in parents of infants hospitalized in the Neonatal In¬tensive Care Unit (NICU). METHODOLOGY: This was a quasi-experimental cohort study of parents of infants hospitalized in the NICU who presented parental stress (PS), according to the NICU Parenting Stress Scale. PS was measured and participants were sequentially assigned to two groups (31 participants in each group): one group receiving the MBIP for eight weeks in virtual mode and the other a control group. Data were analyzed using STATA software, calculating proportions, means, t-tests, and analysis of covariance, with 95% confidence intervals and probability values (p). RESULTS: The baseline PE level was similar between the two groups: 3.53 (95% Cl 3.3 6-3.70) in the intervention group and 3.51 (95% Cl 3.3 7-3.66) in the control group. At the final measurement, the PE level in the intervention group was 2.25 (95% Cl 2.02-2.49), compared to 3.73 (3.53-3.93) in the control group, for a between-group difference in PE of 1.48 (95% Cl 1.20-1.77). Analysis of covariance showed that the differences persisted even after controlling for age, sex, and initial PE. Furthermore, 64% of the change in PE was explained by the mindfulness intervention (corrected R2 = 63.96%, p< 0.001). CONCLUSION: The mindfulness- and compassion-based intercare program showed a significant decrease in PE levels; its implementation is recommended as part of comprehensive NICU management.

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Acta Pediatrica De Mexico

Título del artículo:

Integrating causal inference and machine learning to quantify climate-malaria relationships: Evidence of temperature and rainfall thresholds from Colombian municipalities

Rainfall and temperature are key climate determinants of malaria incidence; yet their causal exposure-response curves on malaria incidence across the entire Colombian territory remain unquantified. We estimated the effects of rainfall and temperature on malaria incidence at the municipal scale from 2007 to 2023. We conducted an ecological observational study in 969 Colombian municipalities located below 1,600 meters. The monthly Standardized Incidence Ratio (SIR) of malaria was calculated for each municipality. Directed acyclic graphs guided the identification of the appropriate adjustments needed to emulate the corresponding experimental design and avoid inducing bias, and the effect was estimated using a modified approach of the Targeted Maximum Likelihood Estimation (TMLE). Exposure-response curves were estimated for two outcomes: the current month and the moving average for the current and previous month. A total of 1,075,112 cases of malaria were reported. The results suggest a non-linear relationship between rainfall and temperature concerning the SIR of malaria, indicating an optimal temperature of 25 °C and approximately 37 mm of rainfall for the highest incidence. The negative control test revealed the presence of residual confounding bias (p < 0.05) in all estimates. Meanwhile, the estimations of the E-value indicated low to moderate tolerance (E-value = 1.14 - 1.48) to an unmeasured confounder. These findings support the integration of rainfall and temperature thresholds into early-warning systems for targeted malaria control.

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Plos Global Public Health

Título del artículo:

Intraoperative aortic dissection

Acute aortic dissection represents a highly lethal cardiovascular emergency, characterized by the progressive separation of the layers of the aorta due to the formation of a column of blood. Associated cardiac complications are rapidly evolving and can be fatal, including cardiac tamponade, compression of the coronary ostium by the false lumen, and acute aortic insufficiency. It is estimated that surgical mortality in type A aortic dissection is higher than in cases of complications in cardiac surgery due to iatrogenic aortic dissection. In this context, we present the case of a 71-year-old patient with severe three-vessel coronary disease, who underwent myocardial revascularization surgery, and during cardiopulmonary bypass, a type A aortic dissection was identified and successfully managed.

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Revista Colombiana De Cardiologia

Título del artículo:

Biotechnological Production of Microbial Pigments

Biopigments of Microbial Origin: Innovations and Applications Across Industries” explores the fascinating world of pigments produced by microorganisms such as bacteria, fungi, and algae. These biopigments have gained significant attention due to their eco-friendly nature, diverse applications, and potential to replace synthetic dyes and pigments that can be harmful to the environment and human health. This book delves into the biosynthesis pathways of these natural pigments, the genetic and environmental factors influencing their production, and the various methods used for their isolation and purification. It highlights the wide range of applications for microbial pigments, from their use as natural colorants in the food industry to their roles in pharmaceuticals, cosmetics, textiles, and agriculture. Readers will find detailed discussions on the antioxidant and antimicrobial properties of microbial pigments, their economic and commercial viability, and the regulatory and safety aspects of their use. This book also includes case studies and success stories, illustrating real-world applications and the benefits of adopting microbial pigments. This book is important because it addresses the growing demand for sustainable and environmentally-friendly alternatives to synthetic dyes and pigments. By showcasing the potential of microbial pigments, it provides valuable insights for researchers, industry professionals, and policy makers interested in promoting green technologies and reducing the environmental footprint of various industries. This book also emphasizes the need for continued innovation and research in the field of biopigments, highlighting their role in fostering a more sustainable future.

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Biopigments of Microbial Origin Innovations and Applications Across Industries

Título del artículo:

Pragmatic solutions to reduce the global burden of stroke: a World Stroke Organization–Lancet Neurology Commission

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Lancet Neurology

Título del artículo:

Sedación paliativa en cuidado domiciliario

Introduction: The palliative sedation at home is a management alternative in the control of refractory symptoms of people in end-of-life, reducing the suffering of the sick person and his/her family. Materials and methods: It’s a quantitative, descriptive, number of cases study, based on the review of clinical records of patients who received subcutaneous palliative sedation treatment as part of end-of-life care in a Palliative care home program in Bucaramanga, Colombia. It’s shown absolute and relative frequencies for qualitative variables, and measures of central tendency for quantitative variables. Results: Most patients presented dyspnea as only refractory symptom at the end-of-life, a combination of morphine and midazolam was used in most cases, and the average duration from the onset of sedation to death was 1.72 days. Discussion: Unlike other studies, the proportion of patients with oncological and non-oncological diseases was equivalent, the dyspnea continues to be the main at end-of-life, patient death occurred in less than 48 hours, which ratifies the indication for palliative sedation.

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Medicina Paliativa

Título del artículo:

Delphi Consensus on the Use of Fenofibrate as Systemic Therapy for the Prevention of Diabetic Retinopathy Progression

Background: Diabetic retinopathy remains a leading cause of preventable blindness worldwide, yet screening and management practices vary widely. Evidence suggests that systemic therapies, including fenofibrate, may slow diabetic retinopathy progression, but their use is inconsistent across clinical settings. This study aimed to establish an evidence-informed consensus among endocrinology experts on the screening, diagnosis, and treatment of diabetic retinopathy, with a particular focus on recommendations for the use of systemic therapy to prevent disease progression. Methods: A modified three-round Delphi process was conducted with 19 endocrinology experts from diverse geographic regions. A core panel of 10 experts and an extended panel of 9 reviewed and rated 19 evidence-based statements. Consensus was defined as > 75% agreement. Results: All 19 statements achieved consensus, with 14 receiving > 80% agreement. The panel endorsed frequent diabetic retinopathy screening based on diabetes type and risk level, early initiation of fenofibrate in patients with mild to moderate non-proliferative diabetic retinopathy, and continued therapy to sustain retinal protection. Fenofibrate was recognized for its pleiotropic effects, and the experts agreed that the transient rise in serum creatinine with fenofibrate is not indicative of renal damage and should not prompt discontinuation. Conclusions: This consensus highlights the need for multidisciplinary care, coordinated pathways, and patient education in diabetic retinopathy care. It also offers unified, evidence-informed recommendations for endocrinologists for the early initiation of fenofibrate to reduce diabetic retinopathy progression. While further studies are needed, these findings offer a practical framework for improving diabetic retinopathy management globally.

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Journal of Diabetes

Título del artículo:

Advancing Cardiac Rehabilitation in Latin America: INSIGHTS FROM A BIBLIOMETRIC REVIEW

Purpose: – This study, based on a bibliometric analysis in the field of cardiac rehabilitation in Latin America, aims to (1) describe the number of publications per year, journal, country affiliation, and contributing authors; (2) identify collaborative networks; and (3) determine emerging research trends. Review Methods: – A defined search strategy was implemented in Scopus for documents indexed up to September 2023. The retrieved records were analyzed using VantagePoint software (Search Technology, 15.2) to extract activity indicators (publication frequency, countries, institutions, and authors), relationship indicators (coauthorship among countries and authors), and research trends through author-included keywords in each article. Summary: – A total of 124 records were selected. The highest publication frequency was observed between 2019 and 2023, with Brazil and Canada leading in publication counts. Regarding international collaboration, studies were frequently coauthored by institutions in Brazil, Canada, Colombia, and the United States. Most records associated cardiovascular rehabilitation with cardiovascular diseases (coronary disease), exercise, and questionnaires. This investigation offers insights that are instrumental in shaping the trajectory of future studies by analyzing publication patterns and identifying potential collaborative partners in the region. Through a detailed examination of bibliometric data, it sets a foundation for advancing research agendas and fostering partnerships in cardiac rehabilitation within Latin America.

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Journal of Cardiopulmonary Rehabilitation and Prevention

Título del artículo:

Recognising the family physician in asthma and COPD guidelines: a necessary step for effective primary care implementation

Asthma and chronic obstructive pulmonary disease (COPD) are the most prevalent chronic respiratory conditions globally, with management predominantly occurring in primary care settings. International guidelines from the Global Initiative for Asthma (GINA) and the Global Initiative for Chronic Obstructive Lung Disease (GOLD) have been instrumental in standardising care; however, these documents consistently use generic terminology such as “primary care physician” or “healthcare provider” without explicitly recognising the family physician as a distinct medical specialty. This omission creates a conceptual gap that may undermine guideline ownership, implementation fidelity, and coordinated care pathways—particularly in low- and middle-income countries where family physicians constitute the backbone of chronic respiratory disease management. This letter argues that explicit recognition of family physicians in future GINA and GOLD updates, alongside inclusion of family medicine representatives in guideline development committees and creation of implementation toolkits for primary care settings, would strengthen guideline relevance, enhance primary care engagement, and ultimately improve respiratory health outcomes worldwide.

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Npj Primary Care Respiratory Medicine

Título del artículo:

Perceived stress, coping strategies and associated factors among Colombian undergraduate health science students

Background: Students involved in health sciences programs usually experience high levels of stress due to the academic loads, clinical responsibilities, and emotional demands from caring for patients. This situation can negatively impact student performance. In Latin America, few studies have investigated this problem. We sought to identify the prevalence of stress perceived by health science university students in northeastern Colombia, as well as the associated factors and the relationships between these factors and individual coping strategies. Methods: We conducted an analytic cross-sectional study involving 783 undergraduate students from thirteen academic programs in the health sciences. The students completed the Spanish versions of the Perceived Stress Scale (PSS-14) and the Brief Coping Orientation Problems Experienced Inventory (COPE-28). In addition, sociodemographic variables related to lifestyle and the academic environment were collected. Frequencies and proportions were calculated for the qualitative variables, and measures of central tendency and dispersion were calculated for the quantitative variables. A backward stepwise logistic regression analysis was performed to evaluate the association between covariates and perceived stress; this was not a causal study. A p value < 0.05 was considered to indicate statistical significance. Results: The median age of the participants was 21 years (interquartile range [IQR]: 20–25), and the sample included 550 (70.2%) females. The overall mean (± Standard deviations [SD]) PSS-14 score was 27.6 (± 7.5); additionally, high levels of perceived stress were reported by 345 (44.1%) students. Having a medication-taking routine (adjusted OR [AOR] = 2.43, 95% CI: 1.59–3.71) and attending a public university (AOR = 2.58, 95% CI: 1.60–4.15) were associated with high perceived stress, whereas male sex (AOR = 0.46, 95% CI: 0.32–0.66) and engaging in physical activity (AOR = 0.70, 95% CI: 0.51–0.96) were negatively associated (protective factors) with perceived stress. Regarding coping strategies, self-distraction (AOR = 1.15, 95% CI: 1.02–1.30), behavioral disengagement (AOR = 1.17, 95% CI: 1.03–1.32) and self-blame (AOR = 1.77, 95% CI: 1.54–2.03) increased the likelihood of high perceived stress, whereas the use of informational support (AOR = 0.82, 95% CI: 0.71–0.93), positive reframing (AOR = 0.86, 95% CI: 0.76–0.98), and planning (AOR = 0.76, 95% CI: 0.66–0.88) decreased the likelihood of high perceived stress. Conclusions: High perceived stress was reported by 44.1% of the participants. Students employed different coping strategies, in which context active coping exhibited the highest mean score and substance use exhibited the lowest mean score.

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BMC Medical Education

Título del artículo:

Parasporin-2-Derived Peptide Fragments: Characterization and Synergistic Anticancer Activity with Sacha Inchi and Curcumin

Background/Objectives: Parasporin PS2Aa1, recently designated as Mpp46Aa1, is recognized for its selective anticancer activity against various human cell lines. In this study, specific regions of the native protein were fragmented, and targeted amino acid substitutions were introduced to improve cytotoxic selectivity and potency. Methods: The modified fragments were evaluated individually and in combination with curcumin, a polyphenol with well-documented anticancer properties, and Sacha inchi-derived matrices, known for their antioxidant and antiproliferative activities. Results: Experimental results demonstrated that the substituted variant designated T104L-G108W exhibited superior anticancer activity compared to the native peptide P102-K11. Synergism assays revealed that curcumin-bioconjugated peptides were more effective against the tested cell lines, whereas combinations with Sacha inchi reduced cytotoxicity, suggesting possible interference in the mechanisms of action. Functional assays, including caspase 3/7 and 9 activation, Annexin V-Cy3 staining, and cell viability analysis with 6-CFDA, confirmed increased sensitivity in SiHa and HeLa cell lines, particularly for peptide T104L-G108W. Conclusions: Collectively, these findings support the effectiveness of a substitution-based strategy in improving parasporin fragments and underscore the therapeutic potential of peptide T104L-G108W as a novel anticancer candidate. Furthermore, this study provides preliminary evidence that natural biomolecules can be optimized through targeted modifications and rational combinations, establishing a framework for the development of sustainable and selective therapeutic approaches in cancer treatment.

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Cancers

Título del artículo:

Artificial Intelligence in Family Medicine: Opportunities, Challenges, and an Ethical Roadmap for its Implementation

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Revista Cubana De Medicina General Integral

Título del artículo:

Factors associated with disease severity in hospitalized children with Staphylococcus aureus infection

Staphylococcus aureus is a common cause of serious infections in children, with the incidence of methicillin-resistant Staphylococcus aureus (MRSA) rising in recent decades. To identify the factors associated with disease severity in pediatric patients hospitalized with S. aureus infection in high-complexity institutions in Santander, Colombia. A cross-sectional study was conducted among children under 18 years of age with S. aureus infection who were hospitalized (2018-21). Clinical characteristics and outcomes were compared between MRSA and methicillin-susceptible Staphylococcus aureus (MSSA) infections. Factors associated with severity were identified through multivariate analysis with logistic and binomial regression. One hundred fifty-four cases of S. aureus infection were included, with 75 (48.7%) being MRSA. Among community-acquired infections, 55.7% (44/79) were caused by MRSA. Pediatric intensive care unit (PICU) admission was required in 55.8% of cases, and the infection-attributable case-fatality rate (CFR) was 1.9%. MRSA infections were associated with a greater need for vasopressor/inotropic support (prevalence ratio [PR], 2.06; 95% confidence interval [CI], 1.05-4.04; P = .036). Persistent bacteremia was associated with an increased PICU admission (PR 1.72; 95%CI: 1.19-2.46), mechanical ventilation (PR 8.63; 95%CI: 3.16-23.54), and vasopressor/inotropic support (PR 11.06; 95%CI: 4.59-26.58). S. aureus infections showed a high prevalence of MRSA, with a notable proportion of community-acquired cases. More than half required admission to PICU, but the infection-attributable CFR was low. MRSA infections and persistent bacteremia were associated with disease severity. These findings support the use of timely antibiotic therapy and reinforce the need for infection prevention and control strategies.

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Journal of Tropical Pediatrics

Título del artículo:

GUIDELINES AND PARAMETERS OF COOPERATION BETWEEN RUSSIA AND COLOMBIA IN THE FIELD OF EDUCATION

The article is devoted to the analysis of the indicators and parameters of cooperation between Russia and Colombia in the field of education in the context of the changing geopolitical situation and the actualization of the foreign policy of the Russian Federation. The key factors determining the relevance of educational cooperation are considered, including the internationalization of Russian education as a tool of \"soft power\", the progressive educational policy of Colombia, as well as the potential of bilateral partnership in the scientific, cultural, and economic spheres. Modern trends and promising areas for the development of integration processes – from academic mobility to the creation of joint research and educational platforms – are identified. The research underlines the importance of inter-university cooperation as a strategic tool for the formation of sustainable Russian-Colombian relations.

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Iberoamerica Russian Federation

Título del artículo:

Physical activity, sedentary behavior and screen time in young toddlers (1–2 years old) attending Spanish ECEC institutions

Objectives: This study was designed with three primary objectives: (a) to evaluate the levels of physical activity (PA) and sedentary behavior (SB) in toddlers during the school day at ECEC institutions in Spain; (b) to establish the rate of adherence to specific recommendations for total physical activity (TPA), moderate-to-vigorous physical activity (MVPA), sleep, and screen time; and (c) to characterize the relationship between individual and socioenvironmental correlates and toddlers’ TPA, light physical activity (LPA), MVPA, and SB during the school day. Methods: This study recruited 264 toddlers (14–23 months) via convenience sampling from public ECEC institutions across three cities. PA was quantified using ActiGraph accelerometry. Sleep behavior was evaluated using the Spanish version of the Brief Infant Sleep Questionnaire (BISQ-E), which was completed by parents. Parents reported their toddler’s average screen time. Results: (a) ECEC settings significantly contribute to young children achieving daily TPA recommendations (72%), despite high sedentary time (69%) during school hours. (b) Age positively correlated with LPA (β = 0.003, 95% confidence interval (CI) [CI 0.001, 0.005], p < 0.006), MVPA (β = 0.002, 95% CI [0.000, 0.003], p = 0.004]), and TPA (β = −0.005, 95% CI [0.002, 0.008], p = 0.001) and inversely with SB (β = −0.005, 95% CI [0.0082, 0.002], p = 0.001). (c) No associations were found for gender, BMI, or other personal and social factors with any PA/SB variables. (d) Most young children (64%) exceeded screen time recommendations, while sleep guidelines were largely met (81% adherence); however, no association was between these variables and PA and SB were found. (e) After ECEC hours, unstructured outdoor recreation was strongly preferred over structured activities, and visiting a park at least three times per week was associated with MVPA (β = −0.007, 95% CI [−0.015, 0.001], p = 0.05). Conclusion: Parents need to be aware of their influence on children’s media habits, and ECEC settings should develop strategies to reduce excessive screen time. A balanced approach to PA, reduced sedentary time, and limited screen exposure—alongside healthy sleep habits supported by such routines—is consistently linked in emerging evidence to better early childhood wellbeing.

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Frontiers in Education

Título del artículo:

LLMs on the Rise: Neuro-Symbolic AI for Knowledge Graph Construction in Manufacturing (Systematic Literature Review)

Numerous digitization activities in manufacturing led to an enormous increase in available, accessible data. Knowledge graphs (KGs) become increasingly popular in this domain as they show strengths in integrating different data sources and serve as a basis for downstream tasks. Yet, constructing a KG is still a challenging and time consuming process. Neuro-symbolic AI approaches, especially with powerful LLMs, have shown promising potentials in research and industry and can support KG construction. Nevertheless, KG construction with neural methods must be aware of, or ideally even handle, the inexplicability of results when applying the KG on manufacturing downstream tasks, e.g., on tasks of reliability- or safety-relevance. This makes it interesting to evaluate the utilization of neuro-symbolic AI and LLMs in KG construction in manufacturing. To the best of our knowledge, there is no systematic literature research on neuro-symbolic AI and LLMs in KGs in manufacturing, yet. Hence, this paper conducts a systematic literature review on neuro-symbolic AI and LLMs in KG construction in manufacturing. We show a solid increase of relevant publications on manufacturing KG construction and further show that BERT embeddings, RNN encodings, especially BiLSTM, CRF decodings, and, recently, LLMs, are common components of knowledge extraction from text documents to build KGs in manufacturing. With this systematic review we support both further research as well as industry application in this field. The main question to guide this review is “Which role play neuro-symbolic AI, especially LLM approaches in knowledge graph construction for manufacturing?”.

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IEEE Access