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Recent Submissions

A Systematic Review and Meta-Analysis on the Prevalence of Variants in the Pancreaticobiliary Duct Junction and Its Association with Cancer
(Multidisciplinary Digital Publishing Institute (MDPI), 2025-04) Valenzuela-Fuenzalida, Juan José; Beas-Gambi, Antonia; Matta-Leiva, Josefa; Martínez-Hernández, Daniela; Milos, Daniel; Orellana-Donoso, Mathias; Santibáñez, Alejandra Suazo; Bruna-Mejias, Alejandro; Riveros, Andres Sebastian; Becerra-Farfan, Alvaro; Sanchis-Gimeno, Juan; Gutierrez-Espinoza, Héctor; Bastidas-Caldes, Carlos; Universidad de Las Américas
Background/Objectives: The objective of this study was to describe the anatomical variants of the pancreaticobiliary junction and how its position or structural change could be associated with hepatic, duodenal, and pancreatic clinical complications. Methods: We searched MEDLINE, Scopus, Web of Science (WOS), Google Scholar, CINAHL, and EMBASE databases from their inception up to September 2024. Results: Two authors independently performed the search, study selection, data extraction, and assessed the methodological quality with an assurance tool for anatomical studies (AQUA). Finally, the pooled prevalence was estimated using a random effects model. A total of 59 studies with a total of 22,752 participants were included in this review. The overall prevalence of the anomalous pancreaticobiliary junction (APBJ) variant was 12% (95% CI = 6% to 18%). The prevalence of cancer associated with variants of APBJ was 29% (95% CI = 23% to 34%). Conclusions: In the present anatomical systematic review and meta-analysis, we found that a longer common channel correlated with a higher prevalence of bile duct or gallbladder malignancy, due to the backward flow of bile which occurs as a result of the position and distance of the bile ducts, as well as pancreatic failing. Hence, APBJs are of great interest for gastroduodenal surgeons. © 2025 by the authors.
Prevalence of Radial Artery Variants and Their Relationship with Clinical Considerations of the Antebrachial Region: Systematic Review and Meta-Analysis
(Multidisciplinary Digital Publishing Institute (MDPI), 2025-12) Sanchis-Gimeno, Juan; Loaiza-Giraldo, Jessica Paola; Alruiz, Yael; Vergara, Maximiliano; Navia, Maria Fernanda; Roman, Camila; Suazo-Santibañez, Alejandra; Nova-Baeza, Pablo; Orellana-Donoso, Mathias; Oyanedel-Amaro, Gustavo; Rodriguez-Luengo, Macarena; Bruna-Mejias, Alejandro; Valenzuela-Fuenzalida, Juan José; León-Rojas, Jose E.; Granite, Guinevere; Universidad de Las Américas
Background: The radial artery (RA) is one of the terminal branches of the brachial artery, extending along the lateral forearm, crossing the anatomical snuffbox, and contributing to the palmar arches. Anatomical variations in the RA are of great clinical relevance due to their implications in procedures such as transradial catheterization, arterial cannulation, and bypass grafting. These variants may alter the course, branching pattern, or origin of the vessel, potentially increasing procedural complexity and the risk of iatrogenic injury. In critically ill patients and in surgical or interventional settings, accurate identification of RA anatomy is essential. The objective of this study was to systematically identify and describe RA variants reported in the scientific literature and to analyze their clinical relevance. Methods: A systematic search was conducted across six electronic databases: Medline, Scopus, Web of Science, Google Scholar, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Latin American and Caribbean Literature in Health Sciences (LILACS), covering publications up to July 2025. Eligible studies included anatomical, radiological, and surgical investigations reporting RA variants. Study quality was evaluated using the Assessment of Quality in Anatomical Studies (AQUA) tool. Quantitative synthesis was performed using a random-effects model to estimate the pooled prevalence of RA variants and subgroup differences. Twenty-three studies met the inclusion criteria, and eleven were included in the meta-analysis, encompassing a total of 6320 participants. Results: Radial artery variants were categorized into three main types: variations in origin, course, and branching pattern. The pooled global prevalence of RA variants was 12% (95% CI: 6–18%), with substantial heterogeneity (I2 = 97.7%). Higher prevalence was found in imaging-based studies (14%) compared with donor-based studies (12%). Sex-based subgroup analysis revealed a higher prevalence in females (18%; CI: 9–28%) compared with males (3%; CI: 3–4%), with moderate heterogeneity (I2 = 61.3%). Regionally, European populations demonstrated a higher prevalence (20%) than Asian populations (11%), both showing high heterogeneity (I2 > 98%). Notably, only one study from the Americas and none from Africa or Oceania were identified, representing a major geographical limitation in the available data. The findings of this study highlight the considerable variability in RA anatomy across populations. Such variations hold significant clinical importance, particularly in the context of transradial interventions, arterial cannulation, and reconstructive procedures where vascular integrity is critical. The high degree of heterogeneity observed may reflect differences in population genetics, sample size, and imaging or dissection methodologies. The limited representation of certain regions underscores the need for further anatomical and radiological studies to obtain a more comprehensive understanding of global RA variability. Preoperative or pre-procedural imaging using Doppler ultrasonography or computed tomography angiography is recommended to identify anomalous patterns and minimize iatrogenic complications. Conclusions: Radial artery variants are frequent and diverse. Their recognition is fundamental for the safety and success of invasive and surgical procedures in the upper limb. A standardized approach to vascular evaluation, particularly through preoperative imaging, is essential to improve procedural outcomes and reduce the risk of arterial injury in clinical practice. © 2025 by the authors.
Validation of the G-Force Platform for Isometric Tests in Physically Active Young Adults: A Pilot Study
(Multidisciplinary Digital Publishing Institute (MDPI), 2025-12) Garrido-Osorio, Víctor; Fuentes-Barría, Héctor; Aguilera-Eguía, Raúl; Roco-Videla, Ángel; Quidel, Mauricio; Romero-Vera, Luis; Leschot-Gatica, Jorge; Sanhueza-González, Sebastián; Ñancupil-Andrade, Alberto; Pérez-Castilla, Alejandro; Rojas-Gómez, Diana; Universidad de Las Américas
Objectives: To evaluate the validity, accuracy, and reliability of the G-Force force platform during isometric tests, through comparison with a gold-standard force platform in physically active young adults. Methods: Nine physically active participants (23.67 ± 4.97 years; body mass index: 25.79 ± 3.02 kg/m2) performed isometric posterior lower limb muscle tests per leg, following a standardized warm-up and familiarization protocol. The G-Force platform and compared against a gold-standard device, the Valkyria Trainer Balance (VTB) force platform. The measured variables included Peak Force and peak rate of force development (RFD) at 50, 100 and 150 ms (RFD50, RFD100 and RFD150). Intra- and inter-platform reliability were assessed using intraclass correlation coefficients (ICC), standard error of measurement (SEM), coefficient of variation (CV%), Bland–Altman analysis and Pearson’s correlation coefficients between both platforms. Results: Peak Force showed excellent intra-platform repeatability (ICC = 0.86–0.91) and moderate-to-good inter-platform reliability (ICC = 0.75–0.77), with the G-Force platform generally reporting slightly lower absolute values than VTB. RFD measures demonstrated moderate reproducibility (ICC = 0.75–0.87) and higher variability (CV = 47–57%). Bland–Altman analyses revealed minimal bias for Peak Force, while regression analyses indicated strong, significant associations between G-Force and VTB measurements (R2 = 0.55–0.77; β = 0.74–0.88; p < 0.05). Conclusions: The G-Force force platform is a valid, reliable, and low-cost tool for assessing isometric strength in physically active young adults. © 2025 by the authors.
Extended reality (XR) in psychosocial and forensic interventions for child and adolescent sexual abuse: a systematic review of current applications and future directions
(Frontiers Media SA, 2025-12) Leiva, Varinia; Pereda, Noemí; Cenzano, Nicolás; Universidad de Las Américas
The integration of extended reality (XR) technologies—virtual (VR) and augmented (AR)—into child sexual abuse (CSA) interventions has grown over the past decade. This systematic review explores the application, efficacy, and ethical implications of XR tools in psychosocial, forensic, preventive, and therapeutic approaches addressing CSA. Following PRISMA guidelines, a comprehensive search was conducted across Scopus, Web of Science, and PubMed, identifying 11 empirical studies published between 2014 and 2024. Three main intervention categories emerged: (1) professional training, (2) prevention, and (3) therapeutic treatment. Most studies focused on enhancing forensic interviewing skills through avatar-based simulations and immersive training, demonstrating increased use of relevant questions and improved self-efficacy among professionals. Preventive interventions used VR and serious games in school settings to promote body safety awareness and protective behaviors in children. Despite their promise, only one study addressed therapeutic applications directly, highlighting the use of a nonverbal digital tool and serious game to facilitate trauma narration in children with CSA experiences, based on trauma-focused cognitive-behavioral therapy (TF-CBT). The findings emphasize XR's potential to foster engagement, realism, and emotional safety in highly sensitive contexts, specifically in CSA interventions. However, challenges include limited longitudinal evidence, lack of culturally diverse studies, and ethical concerns about exposure, re-victimization, and emotional risks for minors. This review underscores the need for more ethically rigorous research to determine the impact of XR-based interventions in child sexual victimization management. Copyright © 2025 Leiva, Pereda and Cenzano.
Exercise-Induced Molecular Adaptations in Chronic Non-Communicable Diseases—Narrative Review
(Multidisciplinary Digital Publishing Institute (MDPI), 2025-12) Fuentes-Barría, Héctor; Aguilera-Eguía, Raúl; Alarcón-Rivera, Miguel; López-Soto, Olga; Aristizabal-Hoyos, Juan Alberto; Roco-Videla, Ángel; Caviedes-Olmos, Marcela; Rojas-Gómez, Diana; Universidad de Las Américas
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. © 2025 by the authors.