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    Item type:Publication,
    Multilevel barriers to clinical and nutritional research in Latin America: a socioeconomic comparative analysis
    (Frontiers Media SA, 2025-12-31)
    Evelyn Frias-Toral
    ;
    Jaime Angamarca-Iguago
    ;
    Isabel Calvo Higuera
    ;
    Jorge Carriel-Mancilla
    ;
    Guillermo Contreras
    Clinical and nutritional research in Latin America faces significant challenges that limit scientific development and evidence-based healthcare. Understanding these barriers is essential for developing effective strategies to enhance research capacity in the region. This study aimed to identify multilevel barriers to clinical and nutritional research in Latin America and compare them between countries of different socioeconomic levels. Methods A cross-sectional study was conducted with 327 healthcare professionals involved in clinical and nutritional research across Latin America. Data collection occurred via an online survey in which participants rated the importance of 16 potential barriers on a 3-point Likert scale. Analysis included descriptive statistics, chi-square tests to compare barriers between upper-middle and lower-middle-income countries, logistic regression to identify predictors of research participation, and k-means cluster analysis to identify researcher profiles. Results Funding (84.4%), research materials (71.6%), and time constraints (70.9%) emerged as the most significant barriers across all countries. Three barriers showed statistically significant differences between income levels: participant commitment (73.6% vs. 42.6%, < 0.001), frequent appointments (56.6% vs. 37.8%, = 0.02), and language barriers (39.6% vs. 22.9%, = 0.02), all of which were higher in lower-middle-income countries. Logistic regression identified the importance of research materials (OR = 0.36, = 0.002) and telemedicine (OR = 1.74,  = 0.044) as significant predictors of research participation. Cluster analysis revealed three distinct researcher profiles based on barrier perception patterns. Conclusion Multilevel barriers to research in Latin America are dominated by universal resource constraints (funding, materials, time), with lower-middle-income countries facing additional challenges in participant engagement and study logistics. The relative homogeneity of most barriers across income groups suggests that regional and institutional factors may be more influential than national income levels. These findings provide a foundation for developing targeted strategies to strengthen research capacity and infrastructure across Latin America.
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    Item type:Publication,
    Adenomatoid odontogenic tumor in an unusual posterior maxillary location: a rare case report in a young male
    (Frontiers Media SA, 2025-12-17) ;
    Estefanía Chávez-Mestanza
    ;
    Náthaly Mercedes Román-Galeano
    ;
    Claudia Reytor-González
    ;
    Daniel Simancas-Racines
    The adenomatoid odontogenic tumor is a rare benign epithelial odontogenic neoplasm that most frequently affects young women and typically occurs in the anterior maxilla. Its presentation in the posterior maxilla, especially in male patients, is uncommon and can create diagnostic challenges. This case describes a large posterior maxillary adenomatoid odontogenic tumor in a 16-year-old male who presented with a one-year history of progressive, painless swelling of the right cheek. Clinical examination revealed facial asymmetry, obliteration of the right nasolabial fold, and intraoral swelling extending from tooth 1.5 to the posterior maxilla. Panoramic radiography and computed tomography showed a multilocular radiolucent lesion with a “soap bubble” appearance, internal calcifications, and displacement of tooth 1.8 toward the floor of the right orbit, which remained intact. The lesion caused root resorption of adjacent teeth and extensive destruction of the maxillary bone. Surgical treatment consisted of enucleation and extraction of teeth 1.5–1.8, followed by histopathological confirmation of adenomatoid odontogenic tumor. Due to the degree of bone involvement, a subsequent wide resection of critical maxillofacial structures was necessary. Postoperative follow-up at five months showed no recurrence but significant residual anatomical changes. This case emphasizes the importance of including adenomatoid odontogenic tumor in the differential diagnosis of posterior maxillary lesions in male patients, and the need for careful surgical planning, histopathological confirmation, and long-term follow-up.