Dengue is an arboviral disease of major public health relevance in Colombia, where recurrent endemic-epidemic transmission intersects with climatic variability, urbanization, population mobility, co-circulation of viral serotypes and lineages, seasonal healthcare pressure, and substantial direct and indirect costs. Although dengue prevention and response in Colombia include epidemiological surveillance, clinical diagnosis, management of warning signs, vector-control activities, outbreak response, and assessment of preventive interventions, these components may be implemented unevenly across territories and may remain insufficiently integrated with health system planning, operational readiness, and economic risk assessment. This technical report proposes an evidence-informed conceptual preparedness framework for dengue in Colombia. The framework was developed through a structured narrative synthesis of peer-reviewed evidence, preparedness-oriented guidance, and Colombia-specific epidemiological, clinical, operational, and health system considerations. It is intended to complement, rather than replace, existing dengue surveillance, prevention, and response strategies by organizing decision points across five interrelated domains: surveillance-to-action, risk-stratified clinical triage, adaptive vector control, contextual vaccination assessment, and healthcare response capacity. A cross-cutting economic risk-mapping component is included to identify relevant cost domains and potential pathways of preventable burden related to outpatient care, hospitalization, productivity loss, outbreak response, severe disease, and healthcare service saturation, without constituting a formal economic evaluation. The framework emphasizes territorial prioritization, timely translation of risk signals into action, early recognition of patients at risk of progression, alignment between community-based interventions and healthcare capacity, and contextual assessment of emerging tools such as tetravalent dengue vaccines and Wolbachia-based vector strategies. It also recognizes implementation constraints, including data interoperability, laboratory and genomic capacity, workforce availability, territorial inequities, financing, pharmacovigilance, governance, and feasibility of local adoption. Future evaluation should assess operational indicators such as signal-to-alert time, triage performance, severe dengue incidence, hospitalization, healthcare resource utilization, stock availability, equity, and cost-effectiveness. In heterogeneous endemic settings, this conceptual framework may support more coordinated dengue preparedness; however, its operational usefulness, economic value, scalability, and policy relevance require stakeholder validation, territorial adaptation, pilot implementation, and prospective evaluation.
The Valle del Cauca region of Colombia is the homeland of the Hartón del Valle (HV) breed, which has been adapted to lowland tropical conditions for more than 500 years. The Lucerna breed is a Colombian synthetic breed composed of 40% Holstein, 30% Shorthorn and 30% HV. Therefore, this study examined the genetic diversity, admixture, and relationships of the Lucerna breed. Information was collected from the farms where the breed originated: El Hatico Nature Reserve and Hacienda Lucerna. Additionally, the HV conservation nucleus (CN) at the National University of Colombia in Palmira was included for comparison and to assess the status of the CN. Genealogical information was collected from 9,526 Lucerna and 64 HV individuals. DNA was extracted from 94 Lucerna and 10 HV animals. The GGP-Bovine 100 K chip was used, quality control was applied (Excluding SNPs with a MAF < 0.05 and missing data > 0.05), to estimate minor allele frequencies (MAF) and LD. ROH fragments, Ne, heterozygosity and Fis were estimated, PCA analysis, population structuring by Fst. Admixture (K = 2 to 12) and Treemix between breeds and with additional information from other breeds. The average MAF was 0.31 for Lucerna and 0.28 in HV-CN. The observed and expected heterozygosity was higher in Lucerna. The average ROH coverage was 8.43% for HV-CN and 7.00% for Lucerna, with a higher proportion of recent autozygosity in both breeds. Finally, genetic diversity was lower in HV-CN than in Lucerna, which coincides with FAO reports. Analyses show that Lucerna has its own genomic profile.
A previously healthy woman developed acute painless left-eye vision loss after travelling to Colombia, with recent febrile episodes and kitten exposure. Examination showed left neuroretinitis with papilledema and macular star. Bartonella henselae serology confirmed diagnosis. Treatment with doxycycline and rifampicin led to a gradual and complete visual recovery.
Household locations of pedestrian injuries and fatalities are disproportionately concentrated in lower socioeconomic neighborhoods, reflecting deep-rooted disparities in urban infrastructure, pedestrian exposure, and traffic safety. This study analyzes the relationship between socioeconomic levels and pedestrian incidents in Cali, Colombia, focusing on both the residential locations of injured individuals and the physical locations of fatalities. By separately examining injury residences and fatality locations, we begin to investigate how socioeconomic disparities influence both who is affected and where incidents occur. Residential injury data (2009-2010) and pedestrian fatality data (2008-2010) were analyzed using spatial mapping and Poisson regression modeling. Our preliminary findings reveal individuals injured in pedestrian incidents predominantly reside in lower socioeconomic neighborhoods, where inadequate infrastructure and increased exposure to traffic hazards are likely contributing factors. In contrast, fatal incidents tend to cluster in specific high-risk zones, particularly in middle-high socioeconomic neighborhoods characterized by dangerous road conditions and high vehicle speeds. Poisson regression identified socioeconomic levels and proximity to health centers were significant predictors of pedestrian fatalities, while road and population density showed weaker or nonsignificant associations. These findings provide an initial foundation for hypothesis generation and future research on urban safety disparities. They suggest socioeconomic context and access-related infrastructure together influence pedestrian risk, underscoring the need to integrate equity-focused and built-environment strategies into pedestrian safety planning and policy. By examining both socioeconomic context and physical risk, this study offers early, but critical insights for creating safer, more equitable urban environments.
A promising sustainable strategy for reducing arbovirus transmission by the mosquito vector Aedes aegypti is the deployment of individuals transinfected with Wolbachia pipientis, a bacterium that inhibits replication of viruses such as dengue and is being used in population replacement programs aimed at blocking Aedes-borne virus transmission. Between 2017 and 2022, the World Mosquito Program released Ae. aegypti infected with the wMel Wolbachia strain throughout Medellín, Colombia. Long-term Wolbachia surveillance following population replacement requires approaches that balance accuracy and cost while providing reliable information regarding infection persistence in targeted populations. Therefore, we assessed current Wolbachia prevalence in Ae. aegypti, surveying five comunas (geographic administrative units) of Medellín spanning ~32.66 km, using ovitrap collections and field sampling of adult mosquitoes and assessed Wolbachia infection using conventional PCR and quantitative PCR (qPCR) in pooled and individual samples. We found that Wolbachia infection remains widespread across the surveyed areas, with estimated infection frequencies ranging from ~60% to near fixation depending on sampling strategy and molecular detection method. Screening pooled adults emerging from ovitraps using conventional PCR provided a cost-effective method for confirming Wolbachia persistence across sites, whereas qPCR of individual field-captured adults provided more sensitive estimates of infection prevalence. Our results suggest that Wolbachia is broadly established in Ae. aegypti populations in the surveyed areas and demonstrate practical approaches for the long-term surveillance of Wolbachia-based vector control programs.
[This corrects the article DOI: 10.3389/fpsyg.2026.1783044.].
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This multicenter cross-sectional study evaluated the prevalence and variables statistically associated with primary and post-treatment apical periodontitis (AP) in subjects from eight Hispanic American countries. Digital panoramic radiographs from subjects living in Argentina, Colombia, Ecuador, Guatemala, Mexico, Dominican Republic, Uruguay and Venezuela were analyzed. Teeth were evaluated for diverse factors, including the periapical status and presence of root canal treatment, caries, coronal restoration, intraradicular post, root resorption and periodontal involvement. Quality of root canal treatment and coronal restorations was also recorded. Associations between these diverse variables and AP were evaluated using chi-square tests and multivariable mixed-effects logistic regression with a random intercept for patient to account for within-patient clustering of teeth. Overall, 11 850 subjects (294 662 teeth) were included; 51.5% of the subjects and 5.5% of the examined teeth had AP. Ecuador (62%) and Argentina (61%) had the highest AP prevalence per subject, whereas Mexico had the lowest (37%). Intermediate values were observed in Venezuela (57%), Guatemala (57%), Colombia (47%), Dominican Republic (46%) and Uruguay (45%). In general, 43% of the subjects had at least one root canal-treated tooth. Primary and post-treatment AP were observed in 3% and 42% of the teeth, respectively. Of the teeth with primary AP, 51% showed coronal restorations, and 32% had caries. Post-treatment AP was significantly associated with inadequate root canal fillings, inadequate coronal restorations and inadequate intraradicular posts (p < 0.05). The prevalence of AP in the Hispanic American countries evaluated was high, affecting nearly half of the population. Post-treatment AP was highly prevalent and predominantly linked to inadequate root canal fillings, deficient or absent coronal restorations and intraradicular posts. These findings emphasize the importance of strengthening caries prevention strategies and improving the quality of endodontic and restorative care to reduce the burden of apical periodontitis in these regions.
This article analyses national legal frameworks that regulate young people's access to abortion, focusing on how different approaches to decision-making authority can either facilitate or obstruct access to care. It explores how countries that have recently liberalised their abortion laws, namely Colombia, Argentina, and Mexico, have acknowledged the need to lower the ages of consent below 18 and integrate the principles of the "evolving capacities of the child" or "progressive autonomy" into their legislation. Each country's approach, whether lowering the age of consent in specific circumstances (Mexico), establishing differentiated age brackets with varying degrees of autonomy (Argentina), or removing age-based restrictions altogether (Colombia), offers a different mechanism for increasing young people's autonomy in decision-making involving abortion. The article also considers how a country that has experienced a recent regression in abortion rights, namely the United States, has also rolled back young people's ability to autonomously consent to abortion care and increased parental involvement in such decisions. Through a comparative analysis of these four countries' legal frameworks, the article concludes that sweeping changes to abortion law and policy - whether progressive or regressive in nature - can fundamentally alter young people's ability to consent to and access such care. It also issues a series of recommendations for the regulation of young people's abortion decision-making, including grounding relevant laws and policies in international human rights principles and linking them to laws and policies geared towards protecting young people's rights in general. Parents or adults often help young people with medical decisions, including abortion care. However, international organisations and experts stress the need to respect young people's autonomy in these choices, especially regarding sexual and reproductive health care. Recently, countries like Colombia, Argentina, and Mexico have passed laws allowing young people to consent to abortion without parental or other adult involvement. This shows a recognition of their ability to make important decisions. In contrast, the United States has restricted young people's rights to make independent choices about abortion care. This article compares how these four countries handle young people's abortion decisions. It considers the broader legal and political context behind new laws and policies. It also looks at how reforms to general abortion laws and international human rights principles have influenced each country's approach, either supporting or undermining young people's reproductive rights and autonomy.
Neotropical seasonally dry biomes are amongst the world's most threatened ecosystems and are predicted to lose more biodiversity with climate change. The capacity of natural populations to respond to these changes depends on their genetic variation, but is poorly understood in most Neotropical seasonally dry forest species. Here, we used genome-wide single nucleotide polymorphism (SNP) data for 109 individuals across 12 Colombian populations of Enterolobium cyclocarpum, a widespread deciduous legume tree found in seasonally dry tropical forests, human-disturbed and open landscapes from Central and Northern South America, to (1) explore population structure across the landscape, (2) determine local adaptation to heat and drought stress, and (3) assess genomic offset and adaptive potential under future climate change. Our results suggest clear genomic differentiation among regions and populations, as well as an uneven spatial distribution of adaptive alleles associated with drought and heat stress, together suggesting different degrees of local adaptation to climate across the landscape. Furthermore, all regions investigated (i.e., Caribbean, inter-Andean valleys, and Orinoquía) showed limited adaptive potential under future climate change scenarios. For some regions, gene flow may help buffer the effects of environmental change by bringing in adaptive alleles, however, this will likely be insufficient to counteract predicted mal-adaptation in certain regions, such as in the Orinoquía. Our results suggest that both barriers to gene flow (e.g., orography) and varying heat and drought stress conditions have shaped the genomic composition and adaptive potential of the species. Enterolobium cyclocarpum populations have adapted locally to current climate, but this adaptation may not be sufficient to cope with future climate change, particularly where population connectivity is low. Our findings have relevance for the conservation of species in highly threatened Neotropical biomes, such as seasonally dry tropical forests, which are expected to experience rising temperatures and greater drought under future climate change.
Bats host a diverse assemblage of ectoparasites that occupy specific anatomical microhabitats, yet the histological effects of these associations remain poorly documented. Here, we report a case of mite infestation of the external ear in the Neotropical bats species Carollia perspicillata and Carollia brevicauda, with a detailed histological characterisation of the auricle and inner ear of C. perspicillata. Bats were captured during biodiversity monitoring programmes in Antioquia, Colombia, and mites were collected and identified morphologically. Histological and histochemical analyses of ear tissues were conducted using haematoxylin and eosin, periodic acid-Schiff, and Masson's trichrome staining. Mites were identified as Spelaeorhynchus praecursor (Spelaeorhynchidae), occurring exclusively on the external ear with infestation frequencies of 6.6% for C. perspicillata and 5.8% for C. brevicauda. Histological examination of the auricle revealed a thin keratinised stratified squamous epithelium, abundant sebaceous glands, well-developed striated skeletal muscle, elastic cartilage, and prominent white adipose tissue at the auricular base. Only minimal focal leukocytic infiltrates were observed, with no evidence of severe pathological alterations associated with mite attachment. The inner ear displayed preserved cochlear architecture, with eosinophilic fibrillar and granular material in the scala vestibuli and scala tympani, interpreted as perilymphatic content or processing artefacts. This study provides baseline histological data on ear tissues in C. perspicillata and documents a localised mite-host association with limited tissue response, contributing to the understanding of bat ectoparasitism and ear morphology in Neotropical chiropterans.
Cardiovascular diseases are the leading cause of death worldwide. Taxi drivers constitute a high-risk occupational group due to prolonged sedentary work, extended shifts and chronic stress, beyond traditional cardiovascular risk factors. To describe the prevalence of coronary heart disease (CHD) risk factors and their sociodemographic and occupational associations among taxi drivers in Medellín, Colombia. We conducted a cross-sectional study of 484 taxi drivers recruited citywide. We obtained data using a structured questionnaire on sociodemographic and occupational factors and self-reported diagnoses of hypertension, dyslipidaemia and diabetes. We assessed physical activity with the International Physical Activity Questionnaire, and alcohol and tobacco use with the Alcohol, Smoking and Substance Involvement Screening Test. We estimated prevalences and analysed associations with multiple risk factors using chi-squared test and Poisson regression with a robust error variance. Sedentary lifestyle prevalence was 71%; hypertension 30%; dyslipidaemia 24%; hazardous alcohol use 25%; hazardous tobacco use 14%; and diabetes 10%. Overall, 52% of participants had two or more CHD risk factors. In adjusted models, a higher prevalence of multiple risk factors was observed among drivers with primary education (adjusted prevalence ratio [aPR] = 1.71; 95% CI 1.26-2.32) and secondary education (aPR = 1.43; 95% CI 1.06-1.93), more than 10 years of driving experience (aPR = 1.39; 95% CI 1.09-1.75) and mixed day and night shifts (aPR = 1.18; 95% CI 1.01-1.40), after adjustment for sociodemographic and occupational variables. Taxi drivers in Medellín show a high burden of CHD risk factors, underscoring the need for targeted occupational health interventions addressing modifiable conditions.
[This corrects the article DOI: 10.3389/fpubh.2026.1759427.].
Bypass surgery is an important option for treating complex intracranial aneurysms (IAs) and Moyamoya disease (MMD), particularly when conventional approaches are insufficient. However, the literature remains heterogeneous, with important limitations in reporting quality that hinder reproducibility and comparability. We aimed to evaluate the current evidence and propose a reporting guideline to improve transparency and methodological rigor. We searched PubMed, Embase, and Web of Science databases. Eligible studies were observational or randomized studies reporting clinical and/or surgical outcomes of bypass for IAs or MMD, including a sample size of ≥3 patients, and published in English between January 1, 2000, and January 1, 2025. Assessment focused on key domains: (1) Assessment of reported baseline characteristics; (2) assessment and reporting on imaging methods and pathology characteristics; (3) reporting on pivotal concept definitions; (4) reporting on neurosurgeon(s) and staff characteristics; (5) reporting on the anesthetic protocol; (6) reporting on vascular procedure details; (7) reporting on antiaggregant and anticoagulation protocol; (8) assessing and reporting on clinical and surgical outcomes, besides adverse events; (9) reporting on retreatment details; and (10) funding and conflicts of interest declarations. Thirty studies were included. Our assessment revealed substantial reporting gaps across all domains pertinent to bypass. A bypass reporting guideline was developed and organized into 10 domains, featuring a pragmatic checklist composed of one common domain and disease-specific sections for IA and MMD. The guideline emphasizes detailed technical reporting, graft patency assessment and verification, perioperative antithrombotic management, and standardized clinical and radiological outcome measures. This systematic review on bypass surgery for IA and MMD identified substantial methodological and reporting limitations that compromise evidence quality and comparability. The proposed reporting guideline provides a structured framework to address these gaps, enhancing transparency, reproducibility, and standardization, with the potential to strengthen the evidence base and improve patient care.
Leishmaniasis is a neglected tropical disease, transmitted by the bite of infected female sandflies and affecting the poor population. Current pharmacotherapy has remained largely unchanged for decades, and there are parasitic strains resistant to these conventional treatments. Thus, there is an urgent need to identify molecular targets to guide the rational design of new drugs. Thus, cysteine protease B (CPB) emerges as a promising target due to its roles in pathogenesis, virulence, and in modulating the host immune response. Given this potential, this review presents recent advances in CPB inhibitors, examining scaffolds, their structure-activity relationships (SARs), and the structural elements that confer selectivity for the parasitic target. Aziridine analogs and dipeptidyl nitriles stand out, and the SAR studies presented here indicate that structural modifications in the P1, P2, and P3 binding subsites influence compound affinity, thereby optimizing molecular fit in the enzyme. The stereochemical configuration (S,S) of the inhibitors is also essential for potency. Regarding selectivity, the Tyr210 residue is present in CPB but not in human cathepsin L. Taken together, these structural and mechanistic findings offer new perspectives for advancing medicinal chemistry targeting CPB, in the development of safer, more selective, and more effective antileishmanial agents.
The Fragility Index (FI) quantifies how small changes in trial outcomes can alter statistical significance, providing a measure of the numerical stability of randomized controlled trial (RCT) results. Despite its growing use, fragility has not been systematically examined in the perioperative evidence supporting anesthesiology guidelines. This study evaluated the FI, Reverse Fragility Index (rFI), and Fragility Quotient (FQ) of RCTs cited in North American and European perioperative clinical practice guidelines and explored trial characteristics associated with fragility. We conducted a methodological survey of RCTs referenced in clinical practice guidelines (CPGs) published between 2012 and 2022. Eligible trials included parallel-group or factorial RCTs with binary outcomes in adult, pediatric, obstetric, cardiovascular, and regional anesthesia populations. Following stratified random sampling, primary analyses were restricted to superiority trials. FI, rFI, and FQ were calculated for the superiority cohort using the binary outcome supporting each guideline recommendation. Trial characteristics associated with FI were explored using a prespecified exploratory negative binomial regression model. Out of 1,868 identified RCTs, 639 met the eligibility criteria, and primary analyses included 161 superiority trials. The median sample size was 120 participants (IQR, 80-310), and the median FI was 4 (IQR, 2-8). Cardiovascular trials had the highest median FI (6 [IQR, 1-13]), whereas pediatric trials had the lowest (1 [IQR, 1-5]). In the exploratory multivariable analysis, obstetric trials were associated with higher FI values than adult trials (incidence rate ratio [IRR], 1.63; 95% CI, 1.02-2.65), whereas single-center trials were associated with lower FI values than multicenter trials (IRR, 0.52; 95% CI, 0.35-0.76). Randomized superiority trials underpinning contemporary perioperative guideline recommendations are generally small and demonstrate modest Fragility Index values, indicating that statistical conclusions often depend on relatively few outcome events. Fragility metrics should complement, rather than replace, established measures of trial quality and evidence certainty when interpreting perioperative evidence.
This systematic review aimed to identify the most commonly used variables for monitoring external load during elite women's football matches and to compare reporting practices internationally and in Brazil. Searches were conducted in Web of Science, PubMed, and SciELO using the PICOS framework between February and March 2026, resulting in the inclusion of 35 studies. The main outcomes analysed were total distance covered (TD), distance covered across speed zones (HSR, VHSR, sprint), number of accelerations and decelerations, and maximum speed. TD and distance covered across speed zones were the most frequently reported indicators (94.3%), followed by HSR (82.8%) and sprint distance (68.5%). Considerable variability was observed in the classification of speed zones and thresholds used to define accelerations and decelerations, limiting comparisons between studies. External load values varied according to playing position and competition level, with international matches generally imposing greater demands than national competitions. Brazilian research remains limited and demonstrates notable methodological variability. This review proposes standardised speed and acceleration/deceleration thresholds based on the most recurrent ranges reported in the literature, supporting improved consistency in monitoring practices across elite women's football contexts.
The expression of certain genes and proteins in brain tumors, particularly gliomas, presents potential therapeutic targets and biomarkers. One of such genes encodes the protein PINK1 (PTEN-induced Kinase 1), which has been primarily studied due to its mutations being linked to Parkinson's disease (PD). Additionally, epidemiological studies have observed a reduced risk of developing certain types of cancer in patients with neurodegenerative diseases and vice versa. The GPR55 receptor (G protein-coupled receptor 55) exhibits pro-oncogenic properties, and its expression correlates with tumor aggressiveness and the activation of the MAPK/ERK signaling pathway. This review would aim to provide an overview of the current understanding of the relationship between PINK1 and GPR55 proteins in glioma pathophysiology and explore the potential use of plant extracts as a therapeutic alternative to regulate their expression.
Syphilis is caused by the bacterial spirochete Treponema pallidum and can be transmitted through blood transfusion. However, there have been less than 10 documented transfusion-transmitted cases since World War II. Global data comparing population-level syphilis trends with blood donor reactivity and screening practices are limited. This study aimed to compare syphilis screening practices worldwide and to explore the value of universal donor screening. A cross-sectional international survey was conducted among blood transfusion professionals. Participants reported data collected between 2018 and 2024 on syphilis prevalence, blood donor screening algorithms and reactivity rates, deferral policies and blood safety interventions. Descriptive analyses were performed by year and geographic region. Thirty-nine participants from 26 countries across five continents answered the survey. Universal donor screening was reported by 35 of 36 institutions providing policy data, with treponemal assays representing the predominant screening approach. Substantial variation was observed in confirmatory testing, donor deferral criteria and donor re-entry policies. Reactivity rates varied markedly across centres and were higher among first-time donors compared to repeat donors. Institutions with higher syphilis rates generally reported higher donor reactivity. Routine leukoreduction was reported by 66.7% of institutions, while pathogen reduction technologies were routinely used by 36.1%. Most centres apply indefinite donor deferral and have not considered removing screening. Syphilis screening and donor management practices vary across blood services worldwide despite widespread implementation of universal screening. Local epidemiology, testing strategies and donor eligibility policies contribute to observed differences in donor reactivity and surveillance practices.
Negative emotions, including anger, depressive symptoms, and chronic psychosocial stress, are increasingly linked to residual atherosclerotic cardiovascular disease (ASCVD) risk through neuroautonomic, inflammatory, endothelial, and thrombotic pathways. To synthesize epidemiologic, mechanistic, and interventional evidence relating anger and depressive affect to myocardial infarction (MI) risk, and to outline clinically actionable translational opportunities. We conducted a literature review of adult human studies identified through searches of MEDLINE/PubMed, Embase, PsycINFO, CINAHL, Web of Science, and the Cochrane Library from January 1990 to October 2025. After screening 1180 titles/abstracts and reviewing 146 full-text reports, 70 sources were included and narratively synthesized. Across cohorts and meta-analyses, depressive symptoms or major depressive disorder are associated with higher incident CHD/MI risk after multivariable adjustment, though effect sizes vary and residual confounding is possible. Case-crossover studies show a short-term increase in MI risk following intense anger episodes. Mechanistic evidence supports plausible pathways including autonomic surges, HPA-axis dysregulation, endothelial dysfunction, inflammatory signaling (e.g., IL-6/NLRP3), and catecholamine-related thrombogenicity. Interventions-β-blockers, SSRIs, cognitive behavioral therapy (CBT), and mindfulness-based stress reduction (MBSR)- improve emotional symptoms and selected surrogate vascular/inflammatory measures; evidence for reduction in hard cardiovascular outcomes remains limited and mixed. Negative emotions are consistently associated with MI risk and align with biologically plausible mechanisms overlapping with residual inflammatory and autonomic risk. Integrating validated emotion screening and scalable interventions into prevention and rehabilitation warrants rigorous evaluation with equity- and privacy-centered implementation.