Francisco de Paula Santander University

Background:Rectus abdominis fat grafting (RAFG) has emerged as a valuable adjunct to liposuction and abdominoplasty to enhance muscular definition and abdominal contour. Despite its growing popularity, evidence regarding safety, standardization, and outcomes remains limited. This study described a standardized protocol for ultrasound-guided or direct-vision RAFG and evaluated clinical results, complications, and patient satisfaction.Methods:A retrospective review was conducted on 182 consecutive patients who underwent liposuction or abdominoplasty with intramuscular fat grafting to the rectus abdominis between 2022 and 2024. Fat was injected under high-frequency ultrasound guidance or direct vision during abdominoplasty. Demographics, operative time, graft volumes per metamere, complications, and pre- and postoperative BODY-Q abdomen scores were analyzed.Results:The cohort included 182 patients with a mean age of 37.2 years and a mean body mass index of 26.4 kg/m2. The average fat graft volume per patient was 85 mL, distributed across 4 metameres (15, 20, 20, and 30 mL). Complications directly related to the grafting procedure occurred in 2 patients (1.09%): 1 surgical-site infection and 1 fat necrosis. No cases of fat embolism were observed. Mean BODY-Q satisfaction scores improved from 12.5 to 26.2 on a 28-point scale.Conclusions:RAFG using ultrasound guidance or direct visualization with a metameric, small-volume protocol is a safe, reproducible technique that enhances abdominal definition. Its low complication rate and significant improvement in patient satisfaction support its inclusion in contemporary body contouring practices.

Polylactic acid (PLA)/crystalline cellulose (CC) composites have emerged as alternatives to non-biodegradable plastics in the food packing industry. However, PLA and CC are incompatible. Furthermore, compatibilizing agents used in PLA/CC composites are usually toxic, because they are derived from petrochemicals and are expensive. This study reports, for the first time, the use of glycerol citrate (GC) as a compatibilizing agent for the PLA/CC composites. GC is biodegradable, inexpensive and non toxic. All the composites were prepared by blending PLA (80% w/w), CC (20% w/w), and GC (0, 3, 6, 9 to 12% w/w). The composites exhibited both the Newtonian and pseudoplastic behavior. The Cole-Cole diagram and scanning electron microscopy (SEM) analysis provided evidence that GC improved the interactions between PLA and CC. GC did not act as a nucleating agent for PLA. Thermal stability of the PLA/CC composites prepared with and without the GC were statistically identical. Tensile modulus and strength of the PLA/CC composites increased with GC content, with tensile strength enhanced to between 23.6 and 78.7%. Furthermore, GC reduced moisture resistance of the PLA/CC composites, but the biodegradability rate increased to between 225 and 610%, and the maximum enhancement in opacity (OP) was 39.3%.

El objetivo de esta investigación fue diseñar un marco metodológico de gobierno y gestión de TI para las Instituciones de Educación Superior Públicas de Norte de Santander. basado en el marco de referencia COBIT 2019 y alineado con los objetivos estratégicos institucionales. Se desarrolló bajo un enfoque cuantitativo. descriptivo y documental. utilizando como técnica principal la encuesta dirigida a directores de tecnología de las instituciones participantes. A partir de los datos recopilados. se identificaron componentes. procesos. procedimientos y herramientas clave para estructurar un sistema de gobierno de TI ajustado al contexto regional. Los resultados evidenciaron deficiencias en la adopción de buenas prácticas. baja madurez en los procesos y escasa articulación entre la gestión tecnológica y el direccionamiento institucional. El modelo propuesto permitió integrar de forma sistemática los factores de diseño de COBIT 2019. generando una solución contextualizada. escalable y adaptable a las necesidades locales. Se discutió la necesidad de mayor compromiso de la alta dirección y de una planificación estratégica orientada a fortalecer la gobernanza digital. En conclusión. El marco metodológico diseñado constituye una herramienta eficaz para orientar la transformación digital de las instituciones. fortaleciendo la toma de decisiones. la eficiencia operativa y la calidad de los servicios educativos.

Introducción. Las lesiones penetrantes del cuello son un desafío clínico por la densidad de estructuras vitales en esta región. Tradicionalmente se ha indicado la exploración quirúrgica inmediata, especialmente en la zona II. Sin embargo, este enfoque ha sido cuestionado por la alta frecuencia de intervenciones no terapéuticas y las complicaciones asociadas. El uso de imágenes de alta resolución ha permitido implementar un manejo selectivo no operatorio en pacientes estables sin signos clínicos graves. El objetivo de este estudio fue comparar la seguridad y la eficacia de la exploración quirúrgica inmediata frente al manejo selectivo no operatorio en adultos con trauma penetrante cervical. Métodos. Se realizó una revisión sistemática de estudios comparativos (ensayos clínicos y cohortes observacionales) publicados hasta 2024. Se buscaron artículos en PubMed, Embase, Cochrane y Scopus. Se incluyeron adultos con lesiones cervicales penetrantes tratados con cirugía inmediata o manejo selectivo. Se evaluaron mortalidad, complicaciones, exploraciones no terapéuticas e intervenciones diferidas. Resultados. Se incluyeron 10 estudios (un ensayo aleatorizado y nueve cohortes). La mortalidad fue similar en ambos grupos. Las exploraciones no terapéuticas alcanzaron 71 % con cirugía obligatoria. El manejo selectivo redujo significativamente estas intervenciones, con tasas diferidas entre 0,5 % y 0,9 %, sin aumento de las complicaciones graves. Conclusiones. El manejo selectivo no operatorio es seguro en pacientes hemodinámicamente estables y disminuye las cirugías innecesarias. Su adopción es respaldada por la evidencia.

Leptospirosis is a zoonotic disease prevalent in tropical regions influenced by climatic factors such as precipitation and soil moisture, which are regulated by the El Niño-Southern Oscillation (ENSO). This study examines the causal relationship between El Niño and La Niña episodes and leptospirosis cases in Colombia at the municipal level from 2007 to 2023. Using an ecological longitudinal design, we analyzed laboratory-confirmed cases from the National Public Health Surveillance System, environmental data from remote sensing, and socioeconomic data, employing a causal machine learning framework with doubly robust estimation and overlap weighting. We estimated the Average Treatment Effect (ATE) and the Conditional Average Treatment Effect (CATE) for three scenarios: Neutral vs. La Niña, Neutral vs. El Niño, and El Niño vs. La Niña. Results showed 10,629 cases, predominantly in males, with the highest incidence in Cali, Barranquilla, San José del Guaviare, and Cartagena. La Niña was associated with a 1.2 percentage point reduction in the probability of excess leptospirosis cases (ATE = -0.012, 95% CI: -0.015 - -0.008), while El Niño corresponded with a 7.2 percentage point increase in the probability of excess leptospirosis cases (ATE = 0.072, 95% CI: 0.041 - 0.103) compared to Neutral episodes. The El Niño vs. La Niña comparison showed no significant effect. As sea surface temperatures rose in the Pacific Ocean off the Colombian coast, the impact of both El Niño and La Niña episodes was observed to diminish, according to the CATE analysis. Regional variations, particularly in the Orinoco and Amazon regions, seem to drive these national trends, probably due to inverse hydro-climatic responses to ENSO. Refutation tests indicated the presence of remaining bias for the scenarios Neutral vs. El Niño and El Niño vs. La Niña. These findings highlight the complex interplay between climate and leptospirosis, underscoring the need for region-specific public health strategies to mitigate climate-driven disease risks in Colombia.

BackgroundThe translation of successful health projects into public health practice is among the most relevant challenges to pursue better health results, including the outcomes established by the United Nations Sustainable Development Goals (SDGs). Healthcare interventions proven cost-effective should be expanded into broader policies and practices. This process is called scaling-up and its success depends on several factors. To critically think about how to scale-up projects or adapt programs, it is necessary to identify potential favoring and hindering factors. In this sense, this study aims to document the type of public health programs which have been scaled up, describe the favoring and hindering factors of this process, and critically analyze the findings about it.MethodsTo reach this goal, this project used the scoping review method to map and summarize the existing evidence on scaling up health interventions through available publications. The databases used in this review were PubMed, Web of Science, Cochrane Library, Scopus, VHL, Scielo, and Google Scholar.ResultsThrough the selection process from a total of 7,027 search hints, 30 relevant papers were included. The found factors that impacted the scaling-up process were organized based on categories of the ExpandNet/WHO framework. The results indicate that poor “user organization”, “institutional environment” and “resource mobilization” were the most frequently mentioned hindering factors for scaling-up processes. Favoring factors included strong leadership, well defined roles, good coordination, positive political environment and community support and engagement.ConclusionHindering and favoring factors do not exist in isolation, but are correlated, interact, enhance or hinder one another. Beyond the practical advice given in this paper, further research recommended that investigates the association between different factors.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12889-025-24770-1.