Título del artículo:

Risk factors, cardiovascular disease, and mortality in South America: a PURE substudy

Aims: In a multinational South American cohort, we examined variations in CVD incidence and mortality rates between subpopulations stratified by country, by sex and by urban or rural location. We also examined the contributions of 12 modifiable risk factors to CVD development and to death. Methods and results: This prospective cohort study included 24 718 participants from 51 urban and 49 rural communities in Argentina, Brazil, Chile, and Colombia. The mean follow-up was 10.3 years. The incidence of CVD and mortality rates were calculated for the overall cohort and in subpopulations. Hazard ratios and population attributable fractions (PAFs) for CVD and for death were examined for 12 common modifiable risk factors, grouped as metabolic (hypertension, diabetes, abdominal obesity, and high non-HDL cholesterol), behavioural (tobacco, alcohol, diet quality, and physical activity), and others (education, household air pollution, strength, and depression). Leading causes of death were CVD (31.1%), cancer (30.6%), and respiratory diseases (8.6%). The incidence of CVD (per 1000 person-years) only modestly varied between countries, with the highest incidence in Brazil (3.86) and the lowest in Argentina (3.07). There was a greater variation in mortality rates (per 1000 person-years) between countries, with the highest in Argentina (5.98) and the lowest in Chile (4.07). Men had a higher incidence of CVD (4.48 vs. 2.60 per 1000 person-years) and a higher mortality rate (6.33 vs. 3.96 per 1000 person-years) compared with women. Deaths were higher in rural compared to urban areas. Approximately 72% of the PAF for CVD and 69% of the PAF for deaths were attributable to 12 modifiable risk factors. For CVD, largest PAFs were due to hypertension (18.7%), abdominal obesity (15.4%), tobacco use (13.5%), low strength (5.6%), and diabetes (5.3%). For death, the largest PAFs were from tobacco use (14.4%), hypertension (12.0%), low education (10.5%), abdominal obesity (9.7%), and diabetes (5.5%). Conclusions: Cardiovascular disease, cancer, and respiratory diseases account for over two-thirds of deaths in South America. Men have consistently higher CVD and mortality rates than women. A large proportion of CVD and premature deaths could be averted by controlling metabolic risk factors and tobacco use, which are common leading risk factors for both outcomes in the region.

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European Heart Journal

Título del artículo:

Immobilization Systems of Antimicrobial Peptide Ib−M1 in Polymeric Nanoparticles Based on Alginate and Chitosan

The development of new strategies to reduce the use of traditional antibiotics has been a topic of global interest due to the resistance generated by multiresistant microorganisms, including Escherichia coli, as etiological agents of various diseases. Antimicrobial peptides are presented as an alternative for the treatment of infectious diseases caused by this type of microorganism. The Ib−M1 peptide meets the requirements to be used as an antimicrobial compound. However, it is necessary to use strategies that generate protection and resist the conditions encountered in a biological system. Therefore, in this study, we synthesized alginate and chitosan nanoparticles (Alg−Chi NPs) using the ionic gelation technique, which allows for the crosslinking of polymeric chains arranged in nanostructures by intermolecular interactions that can be either covalent or non-covalent. Such interactions can be achieved through the use of crosslinking agents that facilitate this binding. This technique allows for immobilization of the Ib−M1 peptide to form an Ib−M1/Alg−Chi bioconjugate. SEM, DLS, and FT-IR were used to determine the structural features of the nanoparticles. We evaluated the biological activity against E. coli ATCC 25922 and Vero mammalian cells, as well as the stability at various temperatures, pH, and proteases, of Ib−M1 and Ib−M1/Alg-Chi. The results showed agglomerates of nanoparticles with average sizes of 150 nm; an MIC of 12.5 µM, which was maintained in the bioconjugate; and cytotoxicity values close to 40%. Stability was maintained against pH and temperature; in proteases, it was only evidenced against pepsin in Ib−M1/Alg-Chi. The results are promising with respect to the use of Ib−M1 and Ib−M1/Alg−Chi as possible antimicrobial agents.

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Polymers

Título del artículo:

Variations in the association of height with mortality, cardiovascular disease and cancer in low-, middle-and high-income countries

Background: Final adult height is a useful proxy measure of childhood nutrition and disease burden. Tall stature has been previously associated with decreased risk of all-cause mortality, decreased risk of major cardiovascular events and an increased risk of cancer. However, these associations have primarily been derived from people of European and East Asian backgrounds, and there are sparse data from other regions of the world. Methods: The Prospective Urban-Rural Epidemiology study is a large, longitudinal population study done in 21 countries of varying incomes and sociocultural settings. We enrolled an unbiased sample of households, which were eligible if at least one household member was aged 35-70 years. Height was measured in a standardized manner, without shoes, to the nearest 0.1 cm. During a median follow-up of 10.1 years (interquartile range 8.3-12.0), we assessed the risk of all-cause mortality, major cardiovascular events and cancer. Results: A total of 154 610 participants, enrolled since January 2003, with known height and vital status, were included in this analysis. Follow-up event data until March 2021 were used; 11 487 (7.4%) participants died, whereas 9291 (6.0%) participants had a major cardiovascular event and 5873 (3.8%) participants had a new diagnosis of cancer. After adjustment, taller individuals had lower hazards of all-cause mortality [hazard ratio (HR) per 10-cm increase in height 0.93, 95% confidence interval (CI) 0.90-0.96] and major cardiovascular events (HR 0.97, 95% CI 0.94-1.00), whereas the hazard of cancer was higher in taller participants (HR 1.23, 95% CI 1.18-1.28). The interaction p-values between height and country-income level for all three outcomes were <0.001, suggesting that the association with height varied by country-income level for these outcomes. In low-income countries, height was inversely associated with all-cause mortality (HR 0.88, 95% CI 0.84-0.92) and major cardiovascular events (HR 0.87, 95% CI 0.82-0.93). There was no association of height with these outcomes in middle-and high-income countries. The respective HRs for cancer in low-, middle-and high-income countries were 1.14 (95% CI 0.99-1.32), 1.12 (95% CI 1.04-1.22) and 1.20 (95% CI 1.14-1.26). Conclusions: Unlike high-and middle-income countries, tall stature has a strong inverse association with all-cause mortality and major cardiovascular events in low-income countries. Improved childhood physical development and advances in population-wide cardiovascular treatments in high-and middle-income countries may contribute to this gap. From a life-course perspective, we hypothesize that optimizing maternal and child health in low-income countries may improve rates of premature mortality and cardiovascular events in these countries, at a population level.

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International Journal of Epidemiology

Título del artículo:

Monkeypox outbreak, will it affect surgery services? – Correspondence

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International Journal of Surgery

Título del artículo:

Muscular Strength in Risk Factors for Cardiovascular Disease and Mortality: A Narrative Review

Cardiovascular disease is the leading cause of death globally, accounting for approximately 32% of all deaths in 2019. There has been increasing interest in understanding the role of low muscular strength as a risk factor for cardiovascular disease, given its association with other cardiovascular risk factors such as hypertension, diabetes mellitus, and metabolic syndrome. An inverse association between muscle strength, chronic disease, all-cause mortality, and cardiovascular-related death has been reported. Recent clinical trials have consistently shown that resistance exercise, which increases strength, and potentially muscle mass, significantly improves the control of known cardiovascular disease risk factors and reduces the risk of all-cause death and cardiovascular mortality. In the present article, we review the growing body of evidence that supports the need for future research to evaluate the potential of handgrip strength as a screening tool for cardiovascular disease and its risk factors in the clinical medical setting, as part of routine care using an affordable handgrip strength device. Moreover, it is crucial to devise large-scale interventions driven by governmental health policies to educate the general population and healthcare professionals about the importance of muscular strengthening activities and to promote access to these activities to improve cardiometabolic health and reduce incidence of cardiovascular disease and mortality.

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Anatolian Journal of Cardiology

Título del artículo:

Theoretical model of territorial agro-industrial development through multi-focus research analytics

This study sought to propose a theoretical model by determining the incident factors of agro-industrial territorial development based on the existing scientific literature and the exploration of successful case studies in the sector worldwide. A systematic review of the literature was carried out, with a bibliometric analysis and content analysis, recognizing elements associated with the improvement of competitiveness and territorial development. The factors identified as incidents of agro-industrial territorial development are: the short supply chain, protection of agri-food products with territorial identity, family farming, local food systems and agribusiness. These factors were integrated into a theoretical model in order to analyze the systemic interaction of each of the factors to find the causes or reasons for territorial development where activation mechanisms can be identified, such as: relational, spatial and technological proximity, the institutional framework from the territory, the support of public policy and the promotion of inclusive and integrated businesses in the value chain.

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Journal of Rural Studies

Título del artículo:

Environmental profile of a community\'s health (EPOCH): An instrument to measure environmental determinants of cardiovascular health in five countries

Background: The environment in which people live is known to be important in influencing diet, physical activity, smoking, psychosocial and other risk factors for cardiovascular (CV) disease. However no instrument exists that evaluates communities for these multiple environmental factors and is suitable for use across different communities, regions and countries. This report describes the design and reliability of an instrument to measure environmental determinants of CV risk factors. Method/Principal Findings: The Environmental Profile of Community Health (EPOCH) instrument comprises two parts: (I) an assessment of the physical environment, and (II) an interviewer-administered questionnaire to collect residents\' perceptions of their community. We examined the inter-rater reliability amongst 3 observers from each region of the direct observation component of the instrument (EPOCH I) in 93 rural and urban communities in 5 countries (Canada, Colombia, Brazil, China and India). Data collection using the EPOCH instrument was feasible in all communities. Reliability of the instrument was excellent (Intraclass Correlation Coefficient - ICC>0.75) for 24 of 38 items and fair to good (ICC 0.4-0.75) for 14 of 38 items. Conclusion: This report shows data collection with the EPOCH instrument is feasible and direct observation of ommunity measures reliable. The EPOCH instrument will enable further research on environmental determinants of health for population studies from a broad range of settings. © 2010 Chow et al.

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PLoS ONE

Título del artículo:

Burden of HIV and hepatitis B and C viruses in incoming Venezuelan migrants at the Colombian border: a laboratory-based cross-sectional study, 2021–2023

Objectives The socioeconomic crisis in Venezuela has urged many to seek refuge elsewhere, primarily in Colombia. The vulnerability to and epidemiology of blood-borne viruses causing chronic infections such as HIV, hepatitis B virus (HBV), and hepatitis C virus (HCV) in incoming migrants at the Colombian border remain uncertain, which we aimed to elucidate. Methods We conducted a cross-sectional study in 2469 adult Venezuelan migrants during 2021 ( n = 1582) and 2023 ( n = 887) encountered at governmental and nongovernmental organizations providing food and social services in Bucaramanga and Cúcuta, Colombia, close to the Venezuelan border. Demographic data and blood samples were collected and analysed by molecular, serological and bioinformatic tools. Results The age- and sex-weighted HIV prevalence was 1.2% (95% CI: 0.6–1.7; 16/1650) and was significantly higher in men than in women (2.0% [95% CI: 0.8–3.2; 11/501] vs. 0.4% [95% CI: 0.0–0.7; 5/1149], p 0.002). Median HIV viral load was 3.9 log10 IU/mL (range: 2.2–5.1 log10 IU/mL). HIV infections were almost exclusively detected in migrants without health insurance. Viral genomes clustered with phylogenetically diverse HIV-1 group M subtype B strains from Colombia and Venezuela, refuting regional point-source acquisition. In silico susceptibility to antiviral drugs suggested lack of treatment access. The adjusted HBV prevalence in migrants was low (0.8%, 95% CI: 0.4–1.2; 12/1647), with median viral loads of 3.3 log10 IU/mL (range: 2.5–3.6 log10 IU/mL). The HCV estimate was also low (0.5%, 95% CI: 0.2–0.8; 10/2406) with median viral loads of 5.3 log10 IU/mL (range: 4.9–6.0 log10 IU/mL). Both HBV and HCV rates were comparable to Colombian population-level estimates, whereas HIV rates in migrants were 2x higher. No coinfections of HIV, HBV, or HCV were found. High levels of HIV but not HCV suggested predominantly sexual transmission rather than illicit drug use or contaminated blood transfusions. Conclusions Our data revealed a high burden of HIV, but not HBV and HCV in incoming Venezuelan migrants. Implementation of testing, educational, and prophylactic programmes in this highly vulnerable population at the border region is imperative.

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Clinical Microbiology and Infection

Título del artículo:

Patency of the Ductus Arteriosus at 72 h in Extremely Preterm Infants Born at Two Altitudes in Colombia: A Preliminary Descriptive Study

Patent ductus arteriosus (PDA) is common in preterm neonates, especially before 28 weeks’ gestation, and is associated with morbidity such as bronchopulmonary dysplasia, hemorrhage, and necrotizing enterocolitis. Beyond immaturity, perinatal factors, postnatal interventions, and altitude, may affect ductal persistence; altitude is proposed as a modifier, though evidence is limited. The objective of the study is to describe the prevalence, the clinical, and echocardiographic characteristics of PDA at 72 h of life in neonates born before 28.6 weeks of gestation in two Colombian cities located at different altitudes. A prospective observational descriptive study with exploratory analysis was conducted from January 2022 to January 2024 in Bucaramanga (959 m above sea level) and Pasto (2,527 m above sea level). Sixty neonates born before 28.6 weeks underwent color Doppler echocardiography at 72 h. Hemodynamically significant PDA was defined using a standardized, center-agreed echocardiographic scoring system criteria adapted from previously described criteria. Patent ductus arteriosus was present in 85% of neonates at 72 h, although only 11.7% (n=7) fulfilled criteria for hemodynamic significance (hs). The frequency of hsPDA did not differ between altitudes. Neonates with hsPDA showed no differences in inotropic support, ventilatory support, or oxygen requirements. No differences were observed in other variables either, such as birth weight, gestational age, surfactant type, or early fluid intake. No differences in early PDA persistence or hemodynamic relevance were observed between altitudes. However, the high prevalence of PDA at 72 h supports the need for early, structured echocardiographic follow-up to identify hemodynamic compromise and guide timely clinical decision-making.

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Pediatric Cardiology

Título del artículo:

An application of Seismic Refraction Tomography (SRT), the MASW test and Electrical Resistivity Tomography (ERT) for the determination of the soil profile and dynamic parameters in the urban area of the municipality of Tocancipá, Cundinamarca

This study presents the application of indirect geophysical methods, specifically Seismic Refraction Tomography (SRT), Multichannel Analysis of Surface Waves (MASW), and Electrical Resistivity Tomography (ERT), in two sectors of the municipality of Tocancipá, Cundinamarca, Colombia. The scope of this work was to classify the soil type according to the average shear wave velocity of the first 30 meters (VS30) and to obtain dynamic soil parameters such as Poisson\'s ratio, unit weight, stiffness, Young\'s ratio, and Bulk’s modulus, which are useful in geotechnical applications and as input for detailed hazard, vulnerability, and risk studies. These parameters are calculated from the P-type (VP) and S-type (VS) seismic velocity values obtained through Seismic Refraction Tomography and Multichannel Analysis of Surface Waves tests, respectively. The methodology included the acquisition, processing, and interpretation of six Seismic Refraction Tomography sections, six Multichannel Analysis of Surface Waves profiles, and five Electrical Resistivity Tomography sections. In the study area, a first layer of clayey residual soil was identified, followed by a sandy-gravelly layer, and finally, a fractured Cretaceous basement corresponding to the Labor Tierna Formation (K2t). The calculated VS30 indicated very dense soil or soft rocks (Type C according to NSR-10). The dynamic parameters showed an increase with depth, suggesting a greater degree of compaction and an improvement in the geomechanical properties of the materials. The integration of seismic and geoelectric methods allowed for a detailed characterization of the subsoil, overcoming the intrinsic limitations of each technique separately.

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Boletin De Ciencias De La Tierra

Título del artículo:

Progressive generalized motor absence seizures. Regarding a clinical case

Progressive generalized motor absence seizures represent an unusual and severe variant of absence seizures, characterized by brief episodes of loss of consciousness accompanied by motor manifestations such as myoclonus or automatisms, which progressively worsen over time. In the context of the patient’s clinical case, who has shown an evolution from absence seizures to generalized tonic-clonic seizures, this spike-wave activity could suggest an imbalance in inhibitory and excitatory activity within the involved neural networks. The progression to tonic-clonic seizures may be associated with the propagation of epileptiform activity beyond the primary cortical areas, implicating additional cortical networks that could be related to the generation of motor activity. This aligns with the theory that the progression of seizures might involve a broader recruitment of the cortex, potentially explaining the emergence of more severe symptoms. In conclusion, the interpretation of this EEG and the correlation with clinical findings suggest a complexity in the presentation of epilepsy in this patient, highlighting the importance of comprehensive and personalized management. The evolution and response to treatment should be carefully monitored to adjust therapeutic strategies according to the progression of the disease.

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Revista De Neuro Psiquiatria

Título del artículo:

Association Between Ultraprocessed Food Intake and Inflammatory Bowel Disease Risk: A Propensity-Matched Analysis With Monte Carlo Simulation From the Prospective Urban Rural Epidemiology Study

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Gastroenterology

Título del artículo:

Life-course trajectories and modifiable risk factors for incident walking limitation and mortality in 25 high-income, middle-income, and low-income countries (PURE): a prospective cohort study

Background: Life expectancy is increasing globally, but if people are to age healthily, they must do so with fewer limitations in their daily activities. However, information on either the frequency or risk factors for limitations to walking ability or other key activities across different regions of the world is limited. Our aim was to describe the incidence, trajectories, risk factors, and population-attributable fraction of new-onset walking limitations in 25 countries at all socioeconomic levels. Methods: PURE is an ongoing, prospective cohort study. The current analysis included community-dwelling participants who lived in four high-income countries (HICs), 16 middle-income countries (MICs), and five low-income countries (LICs). Individuals aged 35–70 years at baseline who completed a baseline questionnaire about activity limitations between Jan 12, 2001, and May 6, 2019, were included in our analysis. The activity limitation screen included questions on self-reported difficulty with walking, grasping, bending, seeing close-up, seeing distance, and hearing. The primary outcome was incident walking limitation and our analytic sample comprised those with no walking limitation at baseline. We estimated the incidence rates, adjusted for age and sex, per 100 person-years in the overall PURE population, by country income level (and separately for China) and sex. We used multistate modelling to evaluate trajectories across the life course, analysed across continuous age, through three distinct sequential states: no limitation, walking limitation, and death. We used survival models to evaluate the associations of socioeconomic status, vascular and behavioural factors, community walkability, and incident adverse events, with incident walking limitations. We then calculated the population-attributable fraction of selected modifiable factors and compared the risk factors for walking limitation and mortality. Findings: 172 889 people from the PURE cohort answered questions on walking limitations at baseline, 150 221 of whom reported no walking limitation and were included in the multistate model. Of these 150 221 individuals, 122 538 had at least one follow-up assessment with walking limitations data (mean age at baseline 49·7 years [SD 9·5]; 71 424 [58·3%] female and 51 114 [41·7%] male). Mean follow-up was 14·5 years (SD 3·3). Incidence of a new walking limitation per 100 person-years was higher in LICs (3·34 [95% CI 3·27–3·41]), and lowest in China (0·58 [0·56–0·60]), compared with other MICs (1·80 [1·77–1·84]) and HICs (1·31 [1·27–1·37]). The incidence of walking limitation was higher in female participants (1·84 [1·81–1·87]) than in male participants (1·25 [1·22–1·28]). In multistate models, state transitions from no walking limitation to walking limitation and death occurred at a higher rate and earlier in LICs, where the age at which the probability of transitioning to a walking limitation was reached by an estimated one-third of people at 64 years compared with age 76 years in HICs. Female participants had a higher probability of incident walking limitation across the age spectrum compared with male participants. Many socioeconomic, vascular, and behavioural risk factors, community walkability, and incident adverse events, especially incident stroke, were associated with incident walking limitations. The population-level risk factors with the highest population-attributable fractions for walking limitation were low education (11·1% [95% CI 9·9–12·4]), obesity (5·2% [4·7–5·8]), hypertension (3·6% [2·2–5·0]), and low recreational physical activity (4·3% [2·3–6·3]), with obesity being the highest in HICs (12·9% [11·2–14·6]) and low education being the highest elsewhere. Potentially modifiable individual-level risk factors explained approximately 32·9% of the population\'s risk of walking limitations and approximately 47·4% of mortality, and four of the top five factors were shared for both outcomes (low education, low recreational activity, poor diet, and hypertension). Interpretation: Individuals in LICs had an accelerated transition to walking limitation, which was approximately 12 years earlier than those in HICs. Walking limitation and mortality shared a common set of modifiable risk factors, accounting for almost one-third of the population-level risk of walking limitations and highlighting opportunities for integrated prevention strategies in mid-life that simultaneously target disability and premature mortality across socioeconomic settings. Funding: Funding sources are listed at the end of the Article.

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Lancet Healthy Longevity

Título del artículo:

Pedagogical innovation and critical tensions in the teaching of morphophysiology in higher education: a systematic review

In the current educational context, characterized by a continuous demand for comprehensive training of students, particularly in skills such as creative thinking and research, it is a priority to evaluate how these skills interrelate with each other, contributing to meaningful learning and social impact. The article presents a quantitative methodological approach, with a non-experimental design and a survey as an instrument. The correlations between research skills and critical thinking are analyzed, focusing on fourth grade students of the advanced cycle of the Centro de Educación Básica Alternativa San José Marello, in La Molina. Among the main findings, the positive correlation between critical thinking and pro-blematization of situations stands out, which reflects that research skills substantially improve the students’ capacity to generate their own ideas, with reflective autonomy, contributing innovation to the educational act. It is concluded that it is important to integrate these competencies into the educational curriculum, since they guide students to face social demands, to confront their changes, thus preparing them for a changing world and for their insertion into citizenship and the labor market.

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Encuentros Maracaibo

Título del artículo:

Electro-Mechanical Dissociation in Chagas Cardiomyopathy: Comparative Analysis of Arrhythmic Burden Beyond LVEF

Background: Chronic Chagas cardiomyopathy (CCC) exhibits high arrhythmic risk despite preserved systolic function, challenging LVEF-based stratification. Methods: We performed a cross-sectional analysis of 146 heart failure patients (75 CCC, 71 Ischemic Cardiomyopathy [IC]) with comparable age, LVEF, and NT-proBNP. Results: CCC patients had a higher arrhythmic burden and NSVT prevalence (RR 4.37, 95% CI 1.67–11.39). NSVT prevalence in CCC was similar regardless of LVEF (p = 0.707). Conventional heart failure severity markers, including worse global and regional strain, were associated with NSVT in IC but not in CCC, where atrial fibrillation (p = 0.002) and ventricular aneurysms (p = 0.033) were the primary associated variables. Conclusions: Arrhythmic vulnerability in CCC appears decoupled from LVEF, suggesting that complementary substrate-based markers may improve risk stratification in this population.

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Journal of Arrhythmia

Título del artículo:

Artificial intelligence literacy in fibromyalgia: the inverse gap between informed patients and unprepared clinicians

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Reumatologia Clinica

Título del artículo:

WORK-BASED ISOMETRIC EXERCISES EFFECT ON BLOOD PRESSURE: THE EEFIT STUDY

Objective: – To evaluate the effect of two workplace isometric exercise interventions on blood pressure in hypertensive adults.Design and method: – A randomized controlled multicenter clinical trial conducted in hypertensive (>130 mmHg systolic blood pressure (SBP)) 35 to 65 years old in work places in Colombia. Participants were assigned to either of two interventions: isometric handgrip dynamometer training at 30% of maximum strength (HGD) or wall squat (WS), or to a control group following standard recommendations. The interventions were performed at the participant’s workplace and consisted of 4 sets of 2 minutes of sustained isometric contraction with 2 minutes’ rest between sets, 3 times per week for 12 weeks. SBP and diastolic blood pressure (DBP) were measured using an automatic device (Omron) with a standardized protocol before and after the 12-week intervention. Results: – Pre and post measurements were completed by 105 hypertensive participants: mean age of 45 years (SD 9.5), 63.8% of which were men. In the HGD group (n = 38) there were significant decreases in SBP [Pre: 141 mmHg (SD 7.8), Post: 127 mmHg (SD 9.1) (p < 0.001)], and in DBP [Pre: 87 mmHg (SD 5.8), Post: 82 mmHg (SD 9.5) (p < 0.001)]. There were also significant decreases in the WS-group (n = 35) in SBP [Pre: 139 mmHg (SD 7.5), Post: 126 mmHg (SD 12.4) (p < 0.001)], and in DBP [Pre: 86 mmHg (SD 5.2), Post 82 mmHg (SD 8.1) (p < 0.001)]. In the control group (n = 32), there were no significant changes in either in SBP [Pre: 140 mmHg (SD 8.4), Post: 137 mmHg (SD 12.9)], or DBP [Pre: 86 mmHg (SD 5.0), Post: 85 mmHg (SD 8.0) (p = 0.71)]. Conclusions: – Both workplace isometric training interventions resulted in significant and clinically relevant reductions in blood pressure in subjects with high blood pressure. The combination of effectiveness, modest time commitment (42 minutes per week) and ease with which the interventions can be implemented in the workplace setting makes them both attractive and practical options with minimal barriers for participation. Furthermore, WS can be performed without any equipment.

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Journal of Hypertension

Título del artículo:

Optimization of energy consumption in lighting through window-to-wall ratio (WWR) in prefabricated social housing under warm climate conditions

The influence of window-to-wall ratio (WWR) on energy consumption for lighting and visual comfort in a social housing building in Bucaramanga, Colombia, was investigated. Using parametric simulations in Design Builder, WWR between 0% and 100% were modeled in 10% increments, while structural and climatic conditions were kept constant. The results show that WWR values below 30% do not meet the minimum illuminance levels requires by Colombian regulations, while values above 70% lead to over-illumination and glare. The optimal range is between 40% and 60%, ensuring that regulations are met in most rooms. Monthly lighting energy consumption is reduced by up to 65% (approximately 650 kWh per year), and lighting uniformity is optimized. These results confirm that WWR regulation is an effective, reproducible, and cost-effective passive design strategy for increasing energy efficiency and living quality in social housing in warm climates.

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Heritage and Sustainable Development

Título del artículo:

Osteoporotic fractures prevalence in Latin American countries: A systematic review of literature and meta-analysis

Background: Osteoporotic fractures (OF), or fragility fractures, are a major cause of morbidity, mortality, and healthcare utilization worldwide. While their burden is well described in high-income countries, data in Latin America remain fragmented and poorly synthesized. Objective: To systematically review and synthesize available evidence on the prevalence of OF among adults in Latin America. Methods: We conducted a systematic review and meta-analysis of observational studies, following JBI methodology and PRISMA 2020 guidelines. MEDLINE, Scopus, Virtual Health Library, and Google Scholar were searched up to January 8, 2025. Random-effects meta-analysis with restricted maximum likelihood estimation and Hartung–Knapp adjustment was used. Subgroup and sensitivity analyses were conducted according to population type, fracture ascertainment method, age group, sex, country, setting, and fracture type. Univariable meta-regression was used to explore sources of heterogeneity. Risk of bias was assessed using the JBI checklist. Results: Twenty-two studies were included in the systematic review, and 16 contributed to the meta-analysis, comprising 1,182,219 participants and 47,954 osteoporotic fractures. The pooled prevalence of OF was 10.2% (95% CI 5.0–16.9%), with substantial heterogeneity (I2 = 100%). Prevalence varied significantly according to population type (p < 0.001), with higher estimates in clinical samples than in population-based studies, and by fracture type (p = 0.002), with vertebral fractures being the most frequent (19.1%). No overall sex differences were identified, although women had higher prevalence of vertebral and non-vertebral fractures after stratification. Meta-regression identified country and fracture type as significant contributors to heterogeneity. Conclusions: OF represent a substantial but highly heterogeneous health burden, and pooled prevalence estimates should be interpreted as indicative rather than precise estimates. Strengthening epidemiological surveillance and implementing early diagnosis and prevention strategies should be prioritized to address the growing impact of OF in the region.

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Bone

Título del artículo:

Ibero-American position statement on therapeutic recommendations for the preventive management of cardiovascular complications in latin-American patients with type 2 diabetes mellitus: consensus of the prevention council of the inter-American society of cardiology (SIAC-PREVENT)

Background: Type 2 diabetes mellitus (T2DM) affects an estimated 463 million adults worldwide, nearly 80% of whom live in low- and middle-income countries. Latin America and the Caribbean (LAC) are among the regions with the fastest-growing T2DM prevalence, with ~ 32 million affected individuals- Against this background, the SIAC Prevention Council (SIAC-PREVENT) developed regionally adapted, equity-oriented recommendations for the preventive management of cardiovascular complications in T2DM. Methods: We convened a multidisciplinary panel from across LAC and followed AGREE II and RIGHT principles. A comprehensive search (MEDLINE, Embase, Scopus, Web of Science, Cochrane Library, SciELO, LILACS, and grey literature) from 2010 to 2025. Risk of bias was assessed using RoB 2, ROBINS-I, and AMSTAR 2; certainty of evidence was graded with GRADE. Draft recommendations were iteratively reviewed and validated in virtual meetings and an in-person consensus conference, with recorded voting procedures. Findings: In LAC, T2DM prevalence reaches 13–14% in some countries, with high disability burden. Over 80% of patients are overweight or obese; MASLD and peripheral arterial disease are common. T2DM confers a 2–4-fold increased cardiovascular risk and higher rates of stroke and heart failure. The Council proposes an integrated, risk-based strategy combining: systematic cardiovascular risk stratification; early obesity management; a four-pillar cardiorenal approach (RAS blockade, SGLT2 inhibitors, finerenone, GLP-1 receptor agonists); preferential use of SGLT2 inhibitors and GLP-1 receptor agonists in high-risk patients; strict lipid and blood pressure control; and systematic screening and management of micro- and macrovascular complications. Conclusions: This Ibero-American position statement supports an evidence-based and equity-oriented approach to preventing cardiovascular complications in people with T2DM in Latin America and the Caribbean. By prioritizing the use of SGLT2 inhibitors, GLP-1 receptor agonists, and structured multidisciplinary care adapted to the realities of local health systems, the region could substantially reduce morbidity, mortality, and the overall burden that T2DM represents for healthcare systems. These recommendations must be explicitly integrated into primary care models and existing chronic disease management programs within health systems. Achieving this potential will require deliberate actions to reduce inequalities in access—through coherent health policies, sustainable financing mechanisms, and continuous education for both healthcare professionals and patients—so that these strategies can be implemented at scale and in a sustainable manner. Likewise, it will be necessary to strengthen multidisciplinary care networks, establish quality indicators and outcome monitoring systems, and promote procurement and coverage strategies that facilitate equitable access to high-value therapies.

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Diabetology and Metabolic Syndrome

Título del artículo:

The Role of Artificial Intelligence in Cardiovascular Diseases: Advances, Challenges, and Perspectives

Cardiovascular diseases remain the leading cause of morbidity and mortality world-wide, demanding innovative approaches for prevention, diagnosis, and treatment. Artificial intelligence has emerged as a transformative tool in cardiovascular medicine by enabling the analysis of large volumes of clinical, genomic, imaging, and electrophysiological data. This editorial discusses recent advances in machine learning and deep learning applications for cardiovascular diagnosis, risk prediction, and health system optimization. It highlights evidence demonstrating superior predictive performance compared with conventional methods, particularly in electrocardio-graphic interpretation and risk stratification. The article also addresses implementation challenges, including infrastructure investment, workforce training, digital cul-ture, and the ethical use of health data. Finally, it emphasizes the need for regulatory frameworks and sustained research efforts to ensure the responsible integration of artificial intelligence into cardiovascular care.

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Revista De Investigacion E Innovacion En Ciencias De La Salud

Título del artículo:

Effects of Isometric Exercise on Cardiovascular and Metabolic Outcomes in Patients with Coronary Artery Disease: a Systematic Review

Introduction. Coronary artery disease (CAD) remains a leading cause of morbidity and mortality worldwide. Although exercise-based interventions are a cornerstone of cardiac rehabilitation, existing evidence has predominantly focused on aerobic and dynamic resistance training. In contrast, the potential role of isometric exercise in patients with CAD remains insufficiently characterized, with limited and hetero-geneous evidence regarding study designs, intervention protocols, and outcome mea-sures, despite emerging findings suggesting favorable cardiovascular and metabolic adaptations when implemented through controlled protocols. Objective. To synthesize and critically appraise the available evidence on the effects of isometric exercise training on cardiovascular and metabolic outcomes in individuals with CAD. Method. A systematic search was conducted to identify randomized controlled tri-als (RCTs) published up to March 2026 in English, Portuguese, or Spanish. The databases searched included Scopus, Web of Science, PubMed, and Embase. Two independent reviewers performed the search, study selection, and data extraction. Methodological quality and risk of bias were assessed using the PEDro scale and the Cochrane Risk of Bias 2 (RoB 2) tool, respectively. Results. A total of 136 records were identified, of which thirteen met the eligibil-ity criteria. The included studies reported both chronic and acute effects. Positive chronic adaptations were observed in cardiac structure, blood pressure, and coronary perfusion, whereas acute effects during isometric exercise included increased coronary collateral flow, reduced time and medication requirements for stress echo-cardiography, significant post-exercise hypotension, and metabolic responses characterized by a predominant reliance on carbohydrates as the primary energy substrate. The methodological quality of the included studies ranged from fair to good, while the RoB 2 assessment indicated risks of bias ranging from low to high. Conclusion. Isometric exercise (IE) was well tolerated and demonstrated both chronic and acute benefits, supporting its potential to improve cardiovascular health and enhance the efficiency of diagnostic procedures in patients with CAD.

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Revista De Investigacion E Innovacion En Ciencias De La Salud

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Obesity rise plateaus in developed nations and accelerates in developing nations

Global reporting of obesity is commonly based on comparisons over multiple decades¹ and lacks a granular and systematic analysis of its dynamics. We used 4,050 population-based studies with measured height and weight data on 232 million participants to assess the worldwide dynamics of obesity from 1980 to 2024. The rise in obesity decelerated in school-aged children and adolescents throughout the 1990s in many high-income countries, and subsequently plateaued in most at age-standardized prevalences spanning 20 percentage points, from 3–4% for girls in Japan, Denmark and France to 23% for boys in the USA. There were indications of a small decline in obesity in children and adolescents in some high-income western countries (for example, Italy, Portugal and France) since the 2000s. Similar trends were seen in some countries in Central and Eastern Europe. In adults, the rise in obesity slowed down in high-income western countries about a decade after children, followed by a plateau or possibly a small reversal of the rise in some countries (for example, Spain). In most low-income and middle-income countries, the annual absolute change in prevalence has remained stable or increased over time, even though prevalence has surpassed that of high-income countries. These highly varied dynamics suggest that the social, economic and technological trends that influence the availability, affordability and use of different foods may have helped control the rise in obesity in high-income countries, but require policy interventions in low-income and middle-income countries.

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Nature

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A Hybrid Physics-Based and Data-Driven Framework for Predicting Water Velocities in a Draining Pipeline Using Pressurised Air

Draining operations using pressurised air can produce sub-atmospheric pressures that pose a significant risk to structural integrity, given the pipe stiffness class. This research presents a modelling strategy for predicting water velocities during the occurrence of this phenomenon. The proposed approach combines a physically based hydraulic formulation with machine learning techniques for making this prediction. A calibrated rigid water column model is first employed to reproduce the transient interaction between the expanding air phase and the draining water column. Input parameters include pipe bridge height varying from 0.5 to 3.0 m, a valve loss dimensionless coefficient ranging from 2.0 to 14.0, and an initial water column length between 163.0 and 286.3 m. Subsequently, a Monte Carlo scheme is used to generate a representative dataset. A total of 28 models were assessed, among which a wide neural network demonstrated superior predictive capability, achieving root-mean-square error values between 0.043 and 0.056 m/s and coefficients of determination ranging from 0.996 to 0.997 for the validation and testing stages, respectively. Sensitivity analyses indicate that the minor loss coefficient governs the water velocity response, whereas geometric features such as the pipe bridge height exert a comparatively minor influence.

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Water Switzerland

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Contributions of the PURE Study to the Definition of a Healthy Diet for the Prevention of Cardiovascular Diseases

Cardiovascular diseases (CVD) are currently the leading cause of mortality in Latin America and worldwide. The main population-attributable risk factors for CVD are hypertension, obesity, tobacco use, low muscular strength, and diabetes, while for overall mortality they are tobacco use, hypertension, low educational attainment, obesity, and diabetes. Most of these factors are related to diet and nutrition; therefore, this study reviews the evidence supporting the development of the PURE healthy diet, based on an analysis that included data from more than 245,000 individuals across 80 countries with high-, middle-, and low-income levels. Diet quality, with an emphasis on diversifying the intake of different protective food groups, is associated with up to a 30% reduction in the risk of death from any cause and a 20% reduction in the risk of developing cardiovascular diseases. The PURE healthy diet recom-mends adequate consumption of fruits, vegetables, nuts, legumes, fish, and whole-fat dairy products (non-skimmed). The recommendations of the PURE healthy diet should be considered in the development of food policies by governments, academia, the private sector, and civil society, in order to identify solutions that account for the complexity of food systems, as well as to increase the availability, acceptability, and access to and consumption of food groups identified as protective against the risk of developing CVD.

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Revista De Investigacion E Innovacion En Ciencias De La Salud