Universidad Autonoma de Manizales

The rapid urbanization and proliferation of Internet of Things (IoT) devices in smart cities generate massive data volumes, raising critical challenges in real-time processing, security, privacy, trust, and energy consumption. This work proposes a secure and sustainable AIoT (Artificial Intelligence of Things) architecture that synergistically integrates edge intelligence, blockchain, and green computing principles to address these issues holistically. Edge intelligence enables low-latency, distributed AI inference at the network periphery, reducing cloud dependency, bandwidth usage, and response times for latency-sensitive applications such as traffic management, environmental monitoring, and emergency response. Blockchain provides decentralized trust, immutability, and tamper-resistant data sharing through smart contracts, ensuring secure authentication, access control, and transparent transactions among heterogeneous IoT devices while mitigating single-point-of-failure risks. To promote sustainability, green computing strategies—including energy-efficient edge node design, renewable-powered hardware, dynamic resource allocation, and low-power protocolsare embedded to minimize carbon footprint and operational energy demands in resource-constrained environments. The proposed layered architecture (perception, edge AI processing, blockchain-secured middleware, and application layers) is evaluated through simulation and prototype implementation, demonstrating up to 40–60% reduction in latency and energy consumption compared to traditional cloud-centric models, alongside enhanced security against common threats (e.g., DDoS, data tampering). Results highlight improved scalability, resilience, and environmental efficiency, making this framework suitable for next-generation sustainable smart cities. This integrated approach paves the way for trustworthy, eco-friendly urban ecosystems, aligning with global sustainability goals (e.g., UN SDGs 9, 11, 13) and offering practical insights for deployment in real-world smart city initiatives

Tuberculosis (TB) burden concentrates in low-income settings and remains the leading global cause of death from a single infectious agent, despite that it is preventable and treatable. TB-associated lung diseases (TBALD), a broad range of respiratory abnormalities which can start before or during a TB episode, may increase morbidity. TBALD may persist after successful completion of TB treatment as post-TB lung disease (PTLD). PTLD varies in severity and is characterised by persistent respiratory symptoms and lung impairment that can significantly impact social activities, health-related quality of life, and long-term survival. Risk factors for PTLD include increasing age, smoking, HIV infection, delayed diagnosis, and poor socioeconomic conditions.Action to limit PTLD may be taken before TB develops through TB screening, early diagnosis and TB preventive treatment, during treatment of TB, and upon its completion. Early detection, clinical assessment, and tailored management (including smoking cessation, immunisation, addressing respiratory comorbidities, pulmonary rehabilitation and social protection) can mitigate impairment and disability. Healthcare providers and national programmes play a vital role through clinical follow-up, patient education, and integration of TBALD care into broader health and social protection services. Sustained funding and research are crucial for this and to develop new tools to enhance care.

Abstract Background Defaecatory urgency is a cardinal and distressing symptom in ulcerative colitis (UC), strongly associated with disease activity and reduced quality of life. Its resolution represents a key therapeutic goal, often paralleling mucosal healing and remission. Upadacitinib (UPA), a selective JAK1 inhibitor, has demonstrated robust efficacy for induction and maintenance of remission in UC; however, its specific impact on urgency in real-world Latin American settings remains poorly characterised. Methods We conducted a multicentre observational study including adults with moderate-to-severe UC treated with UPA 45 mg/day for induction and 30 mg/day for maintenance. Changes in defaecatory urgency (present/absent), clinical response (≥3-point decrease in Mayo score), and clinical remission (Mayo < 2) were evaluated at weeks 8–16 (induction) and 24 (maintenance). Biochemical remission was defined as faecal calprotectin < 150 µg/g and/or C-reactive protein < 5 mg/L. Absolute differences were calculated with 95 % confidence intervals (CI), and Fisher’s exact test was applied for categorical variables (p < 0.05). Results A total of 47 patients with UC were included; mean age 39.8 ± 14.6 years; 59.6 % female; 83 % previously exposed to at least one anti-TNF agent. At baseline, 66 % of patients reported defaecatory urgency, which decreased to 31.9 % after induction (Δ − 34.1 %; 95 % CI − 49.5 to − 18.7; p = 0.001) and 25.5 % at six months (p = 0.003). Clinical response was achieved in 81.2 % (95 % CI 66.1–91.4), and clinical remission in 61.7 % (95 % CI 46.4–75.1). Improvement in urgency strongly correlated with clinical remission (r = 0.72; p < 0.001). Biochemical remission (faecal calprotectin < 150 µg/g or CRP < 5 mg/L) occurred in 57.4 % of patients. No serious adverse events were observed; mild transaminase elevations occurred in 8.5 %. Conclusion Upadacitinib rapidly and sustainably reduced defaecatory urgency in Colombian patients with moderate-to-severe UC, with improvement in over two-thirds of cases and a strong association with clinical remission and biomarker normalisation. These findings provide the first real-world Latin American evidence highlighting upadacitinib’s impact on patient-centred symptomatic control in ulcerative colitis, supporting its role as an effective induction and maintenance therapy.

Abstract Background Epidemiological and phenotypic variability across regions for IBD is well recognised; however, data from Latin America (LATAM) remain limited. Furthermore, specific data Crohn’s Disease (CD) related perianal fistula (PF-CD), a severe phenotype of CD is not available from across LATAM countries. This study aimed to compare the demographic, clinical, and phenotypic characteristics of PF-CD across four LATAM cohorts. Methods A retrospective study was conducted including patients with an established diagnosis of PF-CD from Argentina (N = 75), Chile (N = 49), Colombia (N = 145), and Peru (N = 22). Variables assessed included age at fistula diagnosis, CD duration prior to fistula onset, and prior exposure to immunomodulators and corticosteroids. Inter-country comparisons were performed using the chi-square test for categorical variables and the Kruskal–Wallis test for continuous variables. Results Based on the demographic profile described in Table 1, the cohort included 291 patients with a median age of 30 years at Crohn’s disease diagnosis and 31 years at PF-CD diagnosis, with a predominance of non-stricturing, non-penetrating disease (55%) and colonic or ileocolonic involvement (79%). As shown in Table 2, the median delay from CD diagnosis to PF-CD onset was 21 months [6–48], with substantial variation across countries. Overall, 54% of fistulas were classified as simple and 46% as complex. Active proctitis was present in 44% of patients, with the highest proportions observed in Argentina and Peru. Proctectomy was required in 3% of the cohort, though with notable inter-country variation. These findings highlight the clinical heterogeneity of PF-CD across Latin American settings. Conclusion This multicentre LATAM analysis demonstrates substantial inter-country variability in PF-CD presentation, including differences in disease behaviour, fistula complexity, and time to fistula development. Nearly half of patients presented with complex fistulas, and active proctitis was frequent across cohorts. These results underscore the importance of improving early detection and optimising multidisciplinary management. Overall, the findings highlight the phenotypic heterogeneity of PF-CD in Latin America and support the need for region-specific clinical strategies. Conflict of interest: Dr. Pavez, Carolina: No conflict of interest Juliao Baños, Fabián: No conflict of interest Balderramo, Domingo Cesar: No conflict of interest Cedron Cheng, Hugo Guillermo: No conflict of interest Hernandez-Rocha, Cristian: No conflict of interest Parra Izquierdo, Leidy Viviana: None Osorio, Laura: No conflict of interest Gil Parada, Fabio Leonel: No conflict of interest Puentes-Manosalva, Fabian: No conflict of interest Pizarro, Paula A.: No conflict of interest Etchevers, Maria Josefina: No conflict of interest Sobrero, Maria Josefina: No conflict of interest Montero, Joaquin: No conflict of interest Gil, Anibal Hector: No conflict of interest Sanchez, Maria Belen: No conflict of interest Sambuelli, Alicia: no Balaban, Ezequiel: No conflict of interest Rohwain, María José: No conflict of interest Alvarez-lobos, Manuel: No Conflicts Bellolio, Felipe: No conflict of interest Sepúlveda, Ignacia: No conflict of interest Hernandez, Elisa: No conflict of interest Pérez, Tamara: No conflict of interest Estay, Camila: No conflict of interest Rojas, René: No conflict of interest Sepulveda, Rolando: No conflict of interest Perez Alfaro, Ignacio: No conflict of interest Paredes Mendez, Juan: No conflict of interest Cervera Caballero, Luis: No conflict of interest Sebastian, Shaji: No conflict of interest Catalàn-Serra, Ignacio: No conflict of interest

Background:Osteology plays a central role in anatomical, biological, and clinical sciences. However, a comprehensive understanding of its global research landscape, historical development, and emerging trends has been lacking. This study aimed to fill that gap by conducting a scientometrics and visual analysis of bone tissue research over the past 190 years.Methods:A bibliometric study was conducted using Scopus, Web of Science All Collection, and PubMed. Publications were included if they focused on the structure or function of bones and were peer-reviewed articles. Variables included publication volume, journal quartile, citation metrics (h-index, g-index, m-index), collaboration networks, and keyword trends. Countries were classified by income level and geographic region.Results:A total of 8103 publications were included. The field showed modest growth until 1967, followed by a marked increase peaking in 2021. Most articles were original research (91%) and published in Q1 journals (63.9%). Europe and the Americas accounted for over 80% of publications, while low- and lower-middle-income countries contributed <4%. High-income countries dominated Q1 output and collaboration networks. The most common keywords included phylogeny, osteoporosis, and dinosaur. Technological and molecular approaches have become more prominent since the 2000s.Conclusions:This is the first global scientometrics analysis of osteology research. It reveals historical trends, regional inequalities, and thematic evolution, offering valuable insights for researchers, institutions, and policymakers to foster more inclusive and strategically guided research in osteology.

Physical exercise is a potent non-pharmacological strategy for the prevention and management of chronic non-communicable diseases (NCDs), including type 2 diabetes, cardiovascular diseases, obesity, and certain cancers. Growing evidence demonstrates that the benefits of exercise extend beyond its physiological effects and are largely mediated by coordinated molecular and cellular adaptations. This review synthesizes current knowledge on the key mechanisms through which exercise modulates metabolic health, emphasizing intracellular signaling pathways, epigenetic regulation, and myokine-driven inter-organ communication. Exercise induces acute and chronic activation of pathways such as AMPK, PGC-1α, mTOR, MAPKs, and NF-κB, leading to enhanced mitochondrial biogenesis, improved oxidative capacity, refined energy sensing, and reduced inflammation. Additionally, repeated muscle contraction stimulates the release of myokines—including IL-6, irisin, BDNF, FGF21, apelin, and others—that act through endocrine and paracrine routes to regulate glucose and lipid metabolism, insulin secretion, adipose tissue remodeling, neuroplasticity, and systemic inflammatory tone. Epigenetic modifications and exercise-responsive microRNAs further contribute to long-term metabolic reprogramming. Collectively, these molecular adaptations establish exercise as a systemic biological stimulus capable of restoring metabolic homeostasis and counteracting the pathophysiological processes underlying NCDs. Understanding these mechanisms provides a foundation for developing targeted, personalized exercise-based interventions in preventive and therapeutic medicine.