David Arturo Hernández-Paez

The letter analyzes the potential of three-dimensional photoacoustic ultrasound localization microscopy (3D-PAULM) for studying the glymphatic system and the challenges associated with its clinical translation. This technology combines three-dimensional photoacoustic tomography, intravascular microbubbles, and near-infrared tracers to obtain continuous, noninvasive, whole-brain imaging through the intact skull. In murine models, it enabled simultaneous visualization of glymphatic and vascular dynamics, identified alterations in cerebrospinal fluid transport associated with aging, cerebral ischemia, and isoflurane anesthesia, and overcame limitations of conventional neuroimaging modalities. These findings may contribute to understanding the pathophysiology of stroke, cognitive decline, and brain aging, while also challenging the presumed neurological neutrality of certain anesthetic strategies. However, its translation into clinical practice faces barriers related to cost, tracer availability, operational requirements, and ultrasound transmission through the skull. Although acoustic windows and sonolucent implants represent promising alternatives, the authors emphasize that the effective implementation of 3D-PAULM will depend on its accessibility, scalability, and economic feasibility, particularly in resource-limited healthcare systems.

Aligning mental health research with territorial health needs remains a critical goal, yet the global distribution, coherence, and impact of scientific output across income groups remain poorly understood. We conducted a meta-research study combining scientometric analyses with longitudinal data on 60 health and development indicators. Over 386,000 peer-reviewed publications were retrieved from five major databases. Linear regressions, meta-analyses, and meta-regressions were performed, stratified by World Bank income classification. We find that high-income countries (HICs) accounted for 67% of publications, exhibiting the highest research density but the lowest potential marginal health returns. In contrast, low-income countries (LICs) showed the strongest associations between research volume and improvements in life expectancy (β = 0.13; p < 0.01) and child mortality (β = −1.38; p < 0.01). Structural moderators such as governance quality, health expenditure, and education explained up to 48% of between-group variance. In conclusion, the global landscape of mental health research remains unequal. While scientific production is concentrated in HICs, its population-level association is greatest in LICs. These findings underscore the need to redirect investments and enhance research coherence with health needs, particularly through governance safeguards and capacity building in underrepresented regions.

Background: While most research on medical errors has focused on reducing these events within clinical settings, little is known about whether this scientific research translates into improvements in population-level health or system indicators. This study aimed to explore the potential impact of medical errors research on population health, health system, and research and development indicators. Methods: A longitudinal analysis was conducted using global data from 1995 to 2024. Annual publication counts on medical errors were matched with 18 global population and structural indicators across four domains: mortality, health systems, research and development, and financial risk. Countries were stratified into income groups, and associations were analysed using fixed-effects, negative binomial, and hierarchical mixed-effects models. Results: Higher research output on medical errors was associated with reductions in neonatal, infant, under-5, and adult mortality, particularly in high-income countries and upper-middle-income countries (UMICs). Significant associations were also found with reduced risk of catastrophic and impoverishing surgical expenditures in UMICs and low- and middle-income countries. Modest links were observed with hospital bed density and intellectual property flows. However, no consistent associations were found in low-income countries or in hierarchical models adjusting for income-level heterogeneity. Conclusions and implications: Scientific research on medical errors shows potential to influence key population health- and structural-level indicators, particularly in countries with developing research ecosystems. These findings address a critical knowledge gap by providing quantitative evidence of research relevance beyond academic metrics. Promoting equitable research capacity and translation may enhance the real-world impact of patient safety efforts globally.

Background: Overweight and obesity are priority global public health problems, because they have pandemic dimensions, and they are important cardiometabolic risk factors for the development of other chronic non-communicable diseases (NCDs) such as type 2 diabetes, metabolic syndrome and cancers, etc., the main causes of morbidity, mortality, and preventable disease globally. Objective: The main objective was to evaluate associations between diet quality, dietary patterns, and physical activity with anthropometric indices of body adiposity and cardiovascular risk (CVR), as well as with markers of atherogenesis and Framingham International and Colombia CVR scores in adults from Cartagena. Methodology: Cross-sectional prevalence study, which included native adults from Cartagena, screened between September/2023 and January/2024. Three main groups were formed: Normal weight, overweight, and obesity. In turn, obesity was classified as type I, II and III. The same general sampling unit (GSU) was divided as Non-diabetics, Insulin-resistants, type 2 diabetics, type 2 diabetic-Hypertensives, nondiabetic Hypertensives, and uncontrolled Hypertensives. Health professionals performed anamnesis, anthropometry, nutritional/physical activity assessment, and blood sampling. Results: Prevalence proportions were 99% for self-reported family history of NCDs, 92.7% for poor and regular diet quality, 60.3% for physical inactivity, 50% for atherogenic diet, and 46.3% for alcoholism. Prevalence proportions of 50% for high CVR, and 33% for very high CVR were 5-years forecasted. In type 2 diabetics, and type 2 diabetic Hypertensives, the 10-year forecasted CVR was estimated as high and very high, respectively, according to the Framingham Colombia scale. Conclusions: Poor and regular diet quality, atherogenic and Western dietary patterns, physical inactivity, glycaemia, insulinemia, HOMA-IR, insulin resistance status, adiponectinemia, and atherogenic markers were associated with increased obesity, central obesity, arterial hypertension, and CVR.

Background: Pharmacogenomics offers critical insights into interindividual variability in drug response, especially in complex diseases such as diabetes mellitus. However, most pharmacogenomic evidence is derived from populations of European ancestry, limiting its applicability in admixed and underrepresented populations. In Colombia, the lack of population-specific data hampers the implementation of precision medicine strategies in diabetes care. The aim of this study was to identify pharmacogenomic variants significantly associated with diabetes and exhibiting differential allele frequencies between Colombian populations of African and European ancestry. Methods: We extracted 115 variant annotations related to diabetes from PharmGKB and filtered them for statistical significance and availability of allele frequency data. Fourteen single-nucleotide polymorphisms (SNPs) were compared across five Colombian populations using the CÓDIGO genomic diversity database. Principal component analysis (PCA) was performed to assess genetic clustering, and Pearson correlation coefficients were used to assess pharmacogenomic similarity. Results: PCA revealed distinct genetic clustering patterns that aligned with geographical distribution and ancestral origins. Pharmacogenomic divergence was observed between African and European ancestry groups in Colombia, with certain SNPs (e.g., rs8192675-C for metformin, rs7754840-C for DPP-4 inhibitors) showing 2- to 3-fold higher frequency in African ancestry populations. The bibliometric analysis revealed that 76.1% of studies originated from high-income countries and 68.4% of participants were of European ancestry. No studies originated from Africa or low-income countries. Conclusions: Marked ancestry-based differences in pharmacogenomic variant frequencies in Colombian populations may impact drug efficacy and risk of diabetes. The global literature shows a strong geographic and economic bias, underscoring the need for inclusive, population-specific pharmacogenomic research. These findings offer a foundation for implementing precision diabetes therapies in Latin America and advancing equitable genomic medicine.