Jhony Alejandro Díaz-Vallejo

Traditional flood risk assessment of health infrastructure focuses primarily on direct structural building damage, frequently overlooking the logistical functional isolation caused by road network disruption. This study aimed to quantify the spatial distribution of physical–social vulnerability and functional isolation across licensed healthcare facilities in Santiago de Cali, Colombia, evaluating whether flood risk exposure associates with institutional care complexity. A geospatial multicriteria decision analysis based on the Analytic Hierarchy Process integrated water hazard, area-level social vulnerability, and road isolation into a synthetic risk index for 863 licensed provider institutions. The association between complexity level (I, II, III) and risk category (1 to 5) was evaluated using the Monte Carlo χ² test of independence, Cramér’s V, and the adjusted Pearson residuals. Systemic accessibility resilience was modeled via a network-based travel time degradation analysis. No statistically significant association was observed between institutional complexity level and flood risk category (χ² = 12.69, df = 8, p = 0.122; Cramér’s V = 0.086). Public facilities exhibited a higher descriptive exposure share in high-risk categories (45.5%) compared to private facilities (4.3%). Functional isolation affected facilities across all complexity tiers, with severe travel time increases to advanced care concentrated in specific peripheral hotspots (comuna 22: +210.6%, comuna 1: +189.1%, comuna 20: +155.5%), whereas 82% of the urban population experienced negligible transit delays. Flood exposure across the municipal healthcare grid appears to be driven by pre-existing urban socioeconomic and topographic gradients rather than deliberate risk-sensitive institutional siting. These empirical insights highlight the value of incorporating network accessibility into resilient, equity-oriented urban health planning aligned with Sustainable Development Goals 3, 10, 11, and 13.

Background The trabeculae carneae contribute to ventricular flow, contraction, conduction, and myocardial development, yet the literature devoted to these structures spans disconnected anatomical, physiological, imaging, and cardiomyopathy traditions. We characterized how this body of research has changed over time and how its authors, countries, journals, access models, and topics are connected. Methods Records dated no later than 31 December 2025 were collected separately from PubMed, Scopus, and the Web of Science Core Collection. The files were merged, deduplicated, screened for topical relevance, and analysed with bibliometrix (R) and Python. We examined when and where the literature was produced, who contributed and collaborated, which sources were influential, how accessible the documents were, and how the research vocabulary changed. Results The three searches returned 1,659 records; 975 unique documents remained after removal of 684 duplicates. Original articles accounted for 96.51% of the corpus. Output expanded most strongly in recent decades, while the vocabulary of the field moved from experimental morphology and physiology toward cardiac imaging, echocardiography, and left ventricular non-compaction. Geographic concentration was pronounced: the largest share of records and the strongest international links involved European and North American contributors. Only 37.75% of documents were openly accessible. Conclusion The literature on trabeculae carneae now connects foundational cardiac morphology with clinically consequential questions of imaging interpretation and cardiomyopathy classification. Future progress will require reproducible measurement standards, broader geographic participation, stronger international collaboration, and improved access to the published evidence.

Colorectal cancer is recognized as the third most common malignant neoplasm worldwide. In Ecuador, it ranks fourth in incidence and third in mortality. The KRAS gene mutation has been associated with a poorer prognosis due to its contribution to resistance against anti-EGFR monoclonal antibody therapies. The aim of this study was to determine the prevalence and clinical characteristics associated with the KRAS gene mutation in Ecuadorian patients with colorectal cancer. A retrospective cross-sectional study was conducted, including patients diagnosed with colorectal cancer between 2018 and 2022 at a specialized cancer center, and the KRAS gene mutation status was evaluated. The relationship between KRAS mutation status and clinicopathological characteristics was analyzed. A total of 152 patients were included in the study. Of these, 52% were women, with a mean age of 62.01 years, and 78.3% were over 50 years old. The prevalence of the KRAS mutation was found to be 44.7%. The most frequent cancer stage was IV A (18.4%), and the majority of primary tumors were located in the rectum (34.9%). An association between KRAS mutation status and the location of the primary tumor was identified (p=0.030). However, no association was observed between mutation status and other sociodemographic or clinical variables. Approximately 4 out of 10 Ecuadorian patients with colorectal cancer were found to have the KRAS gene mutation. This mutation was associated with tumor location, particularly in the descending colon. However, no associations were identified with other sociodemographic or clinical variables.

Background/Objectives: Digital twins are emerging as a transformative technology in diabetes management, promising a shift from standardized protocols to highly personalized care. This scoping review aims to systematically map the current landscape of digital twin applications in diabetes, synthesizing evidence on their implementation architectures, analytical models, performance metrics, and clinical integration strategies to identify key trends and critical gaps. Methods: A systematic search was conducted across five electronic databases in accordance with PRISMA-ScR guidelines to identify empirical studies on digital twins for diabetes. Data from the selected articles were extracted to analyze bibliographic characteristics, population data, technological components, performance outcomes, and integration levels. A narrative synthesis was performed to map the evidence. Results: Seventeen studies were included, revealing a rapid increase in publications since 2022, with a notable concentration of research in India. The technological architecture shows a convergence toward machine learning models (e.g., LSTM) powered by data from IoT devices and wearables. Certain interventional studies have reported significant clinical impacts, including HbA1c reductions of up to 1.9% and T2DM remission rates as high as 76.5% in one trial. However, major implementation barriers were identified, including fragmented interoperability standards and low rates of full integration into clinical workflows (35.3%). Conclusions: Digital twins are emerging as powerful tools that show the potential to drive significant clinical outcomes in diabetes care. However, to translate this promise into widespread practice, future efforts must focus on overcoming the critical challenges of standardized interoperability and deep clinical integration. Rigorous, independently validated, long-term trials in diverse populations are essential to confirm these promising findings.

Background: Traditional aphasia therapy is often limited by insufficient dosage, a barrier that AI-assisted digital therapies are poised to overcome. However, it remains unclear whether gains on specific tasks translate to functional, real-world communication. This systematic review evaluates the effectiveness of these novel interventions and investigates the potential for a “generalization gap” when compared to conventional treatments for post-stroke aphasia rehabilitation. Methods: Following PRISMA guidelines, we systematically reviewed randomized controlled trials (2010–2024) from six databases. We included studies examining AI-powered digital platforms for adults with chronic post-stroke apha-sia that reported standardized language outcomes. Results: Our analysis of five trials (n = 366) shows that AI-assisted therapies successfully deliver high-dose interventions, leading to significant improvements in trained language skills, including word retrieval (up to 16.4% gain) and auditory comprehension. However, a critical “generalization gap” was consistently identified: these impairment-level gains rarely transferred to functional, real-world communication. Conclusions: AI-assisted digital therapies effectively solve the dosage problem in aphasia care and improve specific linguistic deficits. Their primary limitation is the failure to generalize skills to everyday use. Future platforms must therefore be strategically redesigned to incorporate therapeutic principles that explicitly target the transfer of skills, bridging the gap between clinical improvement and functional communication.

A thematic review was conducted on the pathophysiological aspects, clinical characteristics, and diagnostic criteria underlying the relationship between Helicobacter pylori (HP) and Immune Thrombocytopenic Purpura (ITP). Mechanisms such as molecular mimicry and the modulation of phagocytic activity have been proposed to explain this association. The diagnosis of ITP requires a comprehensive evaluation, including a detailed medical history and specific laboratory tests. Despite recent advances, challenges remain in understanding these mechanisms and in developing effective, personalized treatments for patients.

Objetivo. Analizar la producción científica en el ámbito del dolor en el trabajo de parto en Latinoamérica. Métodos. Se realizó un análisis bibliométrico utilizando las bases de datos PubMed, Scopus y la Biblioteca Virtual en Salud, recopilando artículos publicados desde enero de 2011 hasta diciembre de 2021 e identificando la frecuencia y tipo de publicaciones, la distribución temporal y los principales países contribuyentes. Resultados. Se revisaron 731 artículos científicos relacionados con el dolor en el trabajo de parto. Se hallaron que los artículos originales constituyen la mayoría de las publicaciones en todas las bases de datos consultadas. Brasil, Colombia y Chile emergen como los principales contribuyentes en la región. La distribución temporal de las publicaciones muestra fluctuaciones, con un incremento significativo en 2019. Conclusiones. La investigación sobre este tema es limitada en toda la región, lo que resalta la necesidad de promover una mayor colaboración y financiamiento para abordar esta problemática de manera más amplia y equitativa.

Morphological research serves as a fundamental pillar in the advancement of anatomical and medical knowledge, with broad applications in education, surgery, pathology, and forensic medicine. However, ethical considerations in this field remain largely overlooked and insufficiently regulated. Historically, the use of cadavers in anatomical studies has posed significant ethical challenges, ranging from the acquisition of bodies without consent to the present-day lack of specific regulatory frameworks. This article explores the existing gaps in applied ethics within morphological research, highlighting the urgent need for well-defined regulations and strict adherence to universal bioethical principles.

Introducción: El cáncer colorrectal es la tercera neoplasia maligna más incidente en el mundo. Aunque la incidencia y mortalidad ha disminuido en varios países de Latinoamérica durante los últimos años, existen excepciones. Metodología: Se realizó un estudio bibliométrico en Pubmed y Scopus para evaluar el estado de la investigación sobre adenocarcinoma colorrectal en América Latina en los últimos 11 años (enero de 2013- diciembre de 2023). Resultados: Se identificaron 234 artículos en PubMed y 952 en Scopus. El tipo de artículo más abundante en las dos bases de datos fue el Original. Los países con más publicaciones fueron Brasil (n=488), México (n=185) y Colombia (n=87). El artículo más citado hasta la fecha tiene 4 692 citaciones, y fue publicado en 2013 por la revista “Nature Communications” con la participación de un autor de afiliación mexicana. La revista que más publicaciones ha tenido en relación al tema, ha sido “Journal Of Coloproctology”. Conclusiones: A pesar de que ha existido un incremento progresivo entre 2013 y 2023, este análisis bibliométrico indica la necesidad de ampliar la investigación sobre cáncer colorrectal en América Latina.