Search

Background: Venereal syphilis, caused by the spirochete Treponema pallidum subsp. pallidum (TPA), is surging worldwide, underscoring the need for a vaccine with global efficacy. Vaccine development requires an understanding of syphilis epidemiology and clinical presentation as well as genomic characterization of TPA strains circulating within at-risk populations. The aim of this study was to describe the clinical, demographic, and molecular features of early syphilis cases in Cali, Colombia. Methods and findings: We conducted a cross-sectional study to identify individuals with early syphilis (ES) in Cali, Colombia through a city-wide network of public health centers, private sector HIV clinics and laboratory databases from public health institutions. Whole blood (WB), skin biopsies (SB), and genital and oral lesion swabs were obtained for measurement of treponemal burdens by polA quantitative polymerase chain reaction (qPCR) and for whole-genome sequencing (WGS). Among 1,966 individuals screened, 128 participants met enrollment criteria: 112 (87%) with secondary (SS), 15 (12%) with primary (PS) and one with early latent syphilis; 66/128 (52%) self-reported as heterosexual, while 48 (38%) were men who have sex with men (MSM). Genital ulcer swabs had the highest polA copy numbers (67 copies/μl) by qPCR with a positivity rate (PR) of 73%, while SS lesions had 42 polA copies/μl with PR of 62%. WB polA positivity was more frequent in SS than PS (42% vs 7%, respectively; p = 0.009). Isolation of TPA from WB by rabbit infectivity testing (RIT) was achieved in 5 (56%) of 9 ES WB samples tested. WGS from 33 Cali patient samples, along with 10 other genomic sequences from South America (9 from Peru, 1 from Argentina) used as comparators, confirmed that SS14 was the predominant clade, and that half of all samples had mutations associated with macrolide (i.e., azithromycin) resistance. Variability in the outer membrane protein (OMP) and vaccine candidate BamA (TP0326) was mapped onto the protein's predicted structure from AlphaFold. Despite the presence of mutations in several extracellular loops (ECLs), ECL4, an immunodominant loop and proven opsonic target, was highly conserved in this group of Colombian and South American TPA isolates. Conclusions: This study offers new insights into the sociodemographic and clinical features of venereal syphilis in a highly endemic area of Colombia and illustrates how genomic sequencing of regionally prevalent TPA strains can inform vaccine development. [ABSTRACT FROM AUTHOR]

The agricultural sector of Colombia supports the national economy and food security due to the rich lands for cultivation. Although Colombia has a vast hydrological basin, climate change can impact agricultural productivity, generating economic and social adverse effects. For this, we evaluated the impact of some environmental variables on the production of the most sold crops using production, climatic, and hydrological data of the 1121 municipalities from 2007 to 2020. We modeled the production of coffee, rice, palm oil, sugarcane, and corn, adopting a Bayesian spatio-temporal model that involved a set of environmental variables: average temperature, minimum temperature, maximum temperature, evapotranspiration, precipitation, runoff, soil moisture, vapor pressure, radiation, and wind speed. We found that increases in the average temperatures can affect coffee (-0.2% per °C), rice (-3.76% per °C), and sugarcane (-0.19% per °C) production, meanwhile, these increases can boost palm oil (+2.55% per °C) and corn (+1.28% per °C) production in Colombia. This statement implies that the agricultural sector needs to substitute land use, promoting the production of palm oil and corn. Although our results did not find a significant effect of hydrological variables in any crop, suggesting that the abundance of water in Colombia might balance the impact of these variables. The increases in vapor pressure impact all the crops negatively (between -11.2% to -0.43% per kPa), except rice, evidencing that dry air conditions affect agricultural production. Colombia must manage the production location of the traditional products and implement agro-industrial technologies to avoid the climate change impact on crops. [ABSTRACT FROM AUTHOR]

Introduction: The stigma and social discrimination against cisgender women sex workers lead many of them to live in conditions characterized by social inequality, marginalization, persecution, and limited opportunities for sexual health literacy. Consequently, they are often compelled to establish a framework of preventive beliefs with little scientific validity, which they use to identify, mitigate, or avoid sexual health risks arising from their interactions with clients. This study investigates the sexual health beliefs that influence self-care practices aimed at preventing sexually transmitted infections among cisgender women sex workers in Colombia. Methods: We conducted a qualitative study framed in Hermeneutic Phenomenology. In-depth interviews and discussion groups were conducted with 34 cisgender women sex workers over 18 years of age in the center of the cities of Bogotá and Barranquilla in Colombia. Results: Seven themes emerged from the reflective and inductive thematic analysis of the narratives: (1) popular habits for the prevention of contagion, (2) ocular assessment of genitals, (3) condom lubrication, (4) suspicion of a hidden infection in the client, (5) saliva and oral contact as a source of contagion, (6) avoidance of semen contact, (7) and trust in God as protection. Conclusions: The findings reflect the need for health and social professionals to promote participatory and inclusive cooperation with sex workers to update the framework of preventive beliefs that help them guide sexual health self-care with autonomy and self-efficacy, strengthening favorable beliefs and negotiating unfavorable ones. It is also essential to have a sex worker-informed sexual health policy that guides the promotion of sexual health that is sensitive to the needs and consistent with the risks of sex work and ensures friendly and non-oppressive preventive care environments for sex workers. [ABSTRACT FROM AUTHOR]

Objective: This study assessed the impact of nutrient warnings on product selection and ability to identify food products high in nutrients of concern in Colombia. Methods: In an online experiment (May-June 2023), Colombian adults were randomized to a nutrient warning, guideline daily amounts (GDA), Nutri-Score, or no-label condition (n = 8,004). Participants completed selection tasks between two fruit drinks labeled according to their condition, one high in sugar and one not. Next, participants answered questions about products high in sugar, sodium, and/or saturated fat ("high-in" product). Finally, they selected which label would most discourage them from consuming a high-in product. Results: Fewer participants (17%) exposed to the nutrient warning indicated they would purchase the high-sugar fruit drink compared to Nutri-Score (27%, Holm-adjusted (adj) p<0.001) and no label conditions (31%, adj p<0.001); there were no differences between the nutrient warning and GDA label (14%, adj p = 0.087). Compared to the nutrient warning, the GDA label was slightly more effective at helping consumers identify which drink was high in sugar (89% versus 92%, adj p<0.001), while the Nutri-Score and no-label conditions were less effective. Compared to all other conditions, nutrient warnings were more effective at helping participants identify that products were high in nutrients of concern, were more effective at decreasing intentions to purchase these high-in products and were perceived as more effective. Nutrient warnings were most often selected as the label that most discouraged consumption. Conclusions: Nutrient warnings are a promising policy to help consumers identify and discourage consumption of products high in nutrients of concern. Trial registration: Trial Registration: NCT05783726. [ABSTRACT FROM AUTHOR]

The adaptative responses and divergent evolution shown in the environments habited by the Cichlidae family allow to understand different biological properties, including fish genetic diversity and structure studies. In a zone that has been historically submitted to different anthropogenic pressures, this study assessed the genetic diversity and population structure of cichlid Caquetaia kraussii, a sedentary species with parental care that has a significant ecological role for its contribution to redistribution and maintenance of sedimentologic processes in its distribution area. This study developed de novo 16 highly polymorphic species-specific microsatellite loci that allowed the estimation of the genetic diversity and differentiation in 319 individuals from natural populations in the area influenced by the Ituango hydroelectric project in the Colombian Cauca River. Caquetaia kraussii exhibits high genetic diversity levels (Ho: 0.562–0.885; He: 0.583–0.884) in relation to the average neotropical cichlids and a three group-spatial structure: two natural groups upstream and downstream the Nechí River mouth, and one group of individuals with high relatedness degree, possibly independently formed by founder effect in the dam zone. The three genetic groups show recent bottlenecks, but only the two natural groups have effective population size that suggest their long-term permanence. The information generated is relevant not only for management programs and species conservation purposes, but also for broadening the available knowledge on the factors influencing neotropical cichlids population genetics. [ABSTRACT FROM AUTHOR]

Background: Forcibly displaced adolescents face increased risks for mental illness and distress, with adolescent girls disproportionately affected in part due to heightened gender inequity. Although the family unit has the potential to promote healthy development in adolescents, few family interventions have employed a gender transformative approach or included male siblings to maximize benefits for adolescent girls. Methods: This study will assess a whole-family and gender transformative intervention-Sibling Support for Adolescent Girls in Emergencies (SSAGE)-to prevent mental health disorders among adolescent girls in Colombia who were recently and forcibly displaced from Venezuela. The study will employ a hybrid type 1 effectiveness-implementation pilot randomized control trial (RCT) to test the program's effectiveness to explore determinants of implementation to establish the feasibility, acceptability, and fidelity of SSAGE. To address these aims, we will enroll 180 recently arrived, forcibly displaced adolescent girls in an RCT and examine the program's effectiveness in the prevention of mental illness (through reduction in anxiety, depression, interpersonal sensitivity, and somatization symptoms) one-month post-intervention. We will use contextually adapted to collect data on the hypothesized mechanistic pathways, including family attachment, gender-equitable family functioning, self-esteem, and coping strategies. The implementation evaluation will employ mixed methods to assess the program's feasibility, acceptability, fidelity, and barriers and facilitators to successful implementation. Discussion: Findings can support humanitarian program implementation, as well as inform policy to support adolescent girls' mental health and to prevent the myriad disorders that can arise as a result of exposure to displacement, conflict, and inequitable gender norms. [ABSTRACT FROM AUTHOR]

In recent decades, policy initiatives involving increases in the tobacco tax have increased pressure on budget allocations in poor households. In this study, we examine this issue in the context of the expansion of the social welfare state that has taken place over the last two decades in several emerging economies. This study explores the case of Colombia between 1997 and 2011. In this period, the budget share of the poorest expenditure quintile devoted to tobacco products of smokers' households doubled. We analyse the differences between the poorest and richest quintiles concerning the changes in budget shares, fixing a reference population over time to avoid demographic composition confounders. We find no evidence of crowding-out of education or healthcare expenditures. This is likely to be the result of free universal access to health insurance and basic education for the poor. For higher-income households, tobacco crowds out expenditures on entertainment, leisure activities, and luxury expenditures. This finding should reassure policymakers who are keen to impose tobacco taxes as an element of their public health policy. [ABSTRACT FROM AUTHOR]

The accurate monitoring of metabolic syndrome in older adults is relevant in terms of its early detection, and its management. This study aimed at proposing a novel semiparametric modeling for a cardiometabolic risk index (CMRI) and individual risk factors in older adults. Methods: Multivariate semiparametric regression models were used to study the association between the CMRI with the individual risk factors, which was achieved using secondary analysis the data from the SABE study (Survey on Health, Well-Being, and Aging in Colombia, 2015). Results: The risk factors were selected through a stepwise procedure. The covariates included showed evidence of non-linear relationships with the CMRI, revealing non-linear interactions between: BMI and age (p< 0.00); arm and calf circumferences (p<0.00); age and females (p<0.00); walking speed and joint pain (p<0.02); and arm circumference and joint pain (p<0.00). Conclusions: Semiparametric modeling explained 24.5% of the observed deviance, which was higher than the 18.2% explained by the linear model. [ABSTRACT FROM AUTHOR]

Objective: To estimate the baseline to measure one of the three indicators of the World Health Organization (WHO) End TB strategy (2015–2035), measure the costs incurred by patients affected by tuberculosis (TB) during a treatment episode and estimate the proportion of households facing catastrophic costs (CC) and associated risk factors, in Colombia, 2021. Material and methods: A nationally representative cross-sectional survey was conducted among participants on TB treatment in Colombia, using telephone interviews due to the exceptional context of the COVID-19 pandemic. The survey collected household costs (direct [medical and non-medical out-of-pocket expenses] and indirect) over an episode of TB, loss of time, coping measures, self-reported income, and asset ownership. Total costs were expressed as a proportion of annual household income and analyzed for risk factors of CC (defined as costs above 20% annual household income). Results: The proportion of TB-affected households incurring in costs above 20% annual household income (CC) was 51.7% (95%CI: 45.4–58.0) overall, 51.3% (95%CI: 44.9–57.7) among patients with drug-sensitive (DS) TB, and 65.0% (95%CI: 48.0–82.0) among drug-resistant (DR). The average patient cost of a TB case in Colombia was $1,218 (95%CI 1,106–1,330) including $860.9 (95%CI 776.1–945.7) for non-medical costs, $339 (95%CI 257–421) for the indirect costs, and $18.1 (95%CI 11.9–24.4) for the medical costs. The factors that influenced the probability of facing CC were income quintile, job loss, DR-TB patient, and TB type. Conclusion: Main cost drivers for CC were non-medical out-of-pocket expenses and income loss (indirect costs). Current social protection programs ought to be expanded to mitigate the proportion of TB-affected households facing CC in Colombia, especially those with lower income levels. [ABSTRACT FROM AUTHOR]

Cyphocharax magdalenae, a Colombian freshwater fish species, plays a vital role in nutrients distribution and serves as a significant food source for other fish species and local fishing communities. Considered a short-distance migratory species, C. magdalenae populations face substantial extinction risk due to human activities impacting their habitats. To address the lack of knowledge on genetic diversity and population structure, this study used next-generation sequencing technology to develop species-specific microsatellite loci and conducted a population genetics analysis of C. magdalenae in the middle and lower sections of the Cauca River, Colombia. Out of 30 pairs of microsatellite primers evaluated in 324 individuals, 14 loci were found to be polymorphic, at linkage equilibrium and, in at least one population, their genotypic frequencies were in Hardy-Weinberg equilibrium. Results showed high genetic diversity levels compared to other neotropical Characiformes, with inbreeding coefficients similar to those reported for phylogenetically related species. Moreover, C. magdalenae exhibits seasonal population structure (rainy-dry) consisting of two genetic stocks showing bottleneck signals and high effective population sizes. This information is essential for understanding the current species genetics and developing future management programs for this fishery resource. [ABSTRACT FROM AUTHOR]

This study investigates the intricate relationship between Venezuelan migration and urban growth in Colombia from 2018 to 2021. The study employs remote sensing data and social network metrics to uncover migration patterns and their impact on urban expansion. The methodology consists of three stages. Firstly, nighttime satellite imagery is used to analyze year-over-year urban growth in Colombia. Secondly, social network data estimates Venezuelan migration, overcoming challenges of underreporting and informal border crossings. Lastly, an econometric analysis explores the quantitative link between Venezuelan migration and urban growth, integrating socioeconomic variables to address endogeneity. The findings reveal the complex interplay of Venezuelan migration, socioeconomic factors, and urban growth. The study outlines remote sensing analysis, introducing the Anthropogenic Footprint Expansion Index (AFEI) to quantify urban growth. Facebook API data estimates migration trends and explores socioeconomic impacts on urban expansion. The analysis uncovers migration, poverty, aging, and urban population proportion as key factors affecting Colombia's urban landscape. Furthermore, the research underscores how Venezuelan migration affected short-term urban expansion pre- and post-COVID-19. Migration had a notable effect before the pandemic, but this influence waned afterward. The study highlights migration's short-term nature and emphasizes age demographics' role in medium-term dynamics. [ABSTRACT FROM AUTHOR]

Introduction: Outreach care has long been used in Canada to address the lack of access to specialist care in rural settings, but research on the experiences of specialists providing these services is lacking. This descriptive survey study aimed to understand 1) specialists' motivation for engaging in outreach work, (2) their perceptions of the quality of care at their rural outreach hospital, and (3) the supports they receive for their outreach work, in order to create a supportive framework to encourage specialist outreach contributions. Methods: In July 2022, specialist physicians who provide outreach operating room services at rural hospitals participating in the Rural Surgical and Obstetrical Networks initiative in the province of British Columbia were invited to complete an anonymous survey. Results: 21 of 45 invited outreach specialists completed the survey (47% response rate). Three-quarters of respondents had a surgical specialty. The opportunity to deliver care to underserved patients was the most common motivator for outreach work. Rural hospitals received high ratings from respondents on overall safety and various aspects of communication and teamwork. Postoperative care was a concern for a minority (one-fifth) of respondents, and about half had experienced unnecessary delays between procedures some or most of the time. Generally, respondents felt integrated into rural teams and reported receiving adequate nursing and anesthetic support. The two most common desired additional supports were better/more equipment and space and additional staffing. All 19 respondents not planning to retire soon intended to provide outreach services for at least three more years. Conclusion: Specialists providing outreach OR services in small volume rural hospitals in BC usually have altruistic motives for outreach work. For the most part, these specialists have positive experiences in rural hospitals, but they can be better supported through investment in infrastructure and health human resources. Specialists intend to provide outreach services long-term, indicating a stable outreach workforce. More research on the facilitators and barriers of specialist outreach work is needed. [ABSTRACT FROM AUTHOR]

Objective: To define the relationship between chronic chikungunya post-viral arthritis disease severity, cytokine response and T cell subsets in order to identify potential targets for therapy. Methods: Participants with chikungunya arthritis were recruited from Colombia from 2019–2021. Arthritis disease severity was quantified using the Disease Activity Score-28 and an Arthritis-Flare Questionnaire adapted for chikungunya arthritis. Plasma cytokine concentrations (interleukin (IL)-1β, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12p70, IL-13, interferon-γ and tumor necrosis factor (TNF)) were measured using a Meso Scale Diagnostics assay. Peripheral blood T cell subsets were measured using flow cytometry. Results: Among participants with chikungunya arthritis (N = 158), IL-2 levels and frequency of regulatory T cells (Tregs) were low. Increased arthritis disease activity was associated with higher levels of inflammatory cytokines (IL-6, TNF and CRP) and immunoregulatory cytokine IL-10 (p<0.05). Increased arthritis flare activity was associated with higher Treg frequencies (p<0.05) without affecting T effector (Teff) frequencies, Treg/Teff ratios and Treg subsets. Finally, elevated levels of IL-2 were correlated with increased Treg frequency, percent Tregs out of CD4+ T cells, and Treg subsets expressing immunosuppressive markers, while also correlating with an increased percent Teff out of live lymphocytes (p<0.05). Conclusion: Chikungunya arthritis is characterized by increased inflammatory cytokines and deficient IL-2 and Treg responses. Greater levels of IL-2 were associated with improved Treg numbers and immunosuppressive markers. Future research may consider targeting these pathways for therapy. [ABSTRACT FROM AUTHOR]

Worldwide women have increased their participation in STEM, but we are still far from reaching gender parity. Although progress can be seen at the bachelor's and master's level, career advancement of women in research still faces substantial challenges leading to a 'leaky pipeline' phenomenon (i.e., the continuous decrease of women's participation at advanced career stages). Latin America exhibits encouraging rates of women participation in research, but the panorama varies across countries and stages in the academic ladder. This study focuses on women's participation in research in natural sciences in Colombia and investigates career progression, leadership roles, and funding rates by analyzing data on scholarships, grants, rankings, and academic positions. Overall, we found persistent gender imbalances throughout the research ecosystem that were significant using classical statistical analyses. First, although women constitute >50% graduates from bachelors in natural sciences, <40% of researchers in this field are female. Second, women win <30% of research grants, and in turn, their scientific productivity is 2X lower than that of men. Third, because of the less research funding and output women have, their promotion to senior positions in academic and research rankings is slower. In consequence, only ~25% of senior researchers and full professors are women. Fourth, the proportion of women leading research groups and mentoring young scientist in Colombia is <30%. Our study deepens our understanding of gender gaps in STEM research in Colombia, and provides information to design initiatives that effectively target gender disparities by focusing on key areas of intervention, and then gradually building up, rather than tackling structural inequities all at once. [ABSTRACT FROM AUTHOR]

Sexism has implications for people's physical and mental health. Thus, understanding sexism and its prevalence is key to understanding the phenomenon. In the current study, 717 Colombian men and women completed the brief scales of Ambivalent Sexism toward women and men and the Gender Identity Scale. The assessment was conducted using a web-based method. Both scales, as expected, were two-dimensional. Reliability ranged from.83 to.88. Moderate and high correlations were observed with the Gender Identity Scale. Men showed higher levels of hostile and benevolent sexism toward women and benevolent sexism toward men. It was also found that the higher the level of education, the lower the rates of sexism toward men and women. The brief scales were valid and reliable for measuring hostile and benevolent sexism in Colombia. [ABSTRACT FROM AUTHOR]

Background: Studies in the West suggest that tombstone cost is associated with longevity. The objective of this observational study was to investigate the association between tombstone cost and longevity in a large cemetery in Latin America. Methods: Age at death was obtained from 2,273 consecutive death certificates held at the San Pedro Cemetery Museum in Medellín in Colombia. Subjects died in 2022, 2021, or 2020. Tombs are arranged in galleries in the cemetery and tombstone cost was based on the material from which the tombstone was made, its position in the gallery, and its ornamentation. Analysis of variance was used and the assumption of equal variance was not violated. Results: Approximately 77% of tombstones were of low cost, 21% of medium cost, and 2% of high cost. Data from 1,751 subjects were used to investigate differences in longevity according to tombstone cost while adjusting for sex, civil status, violent death, and year of death. Longevity was similar in the low-cost group and medium-cost group: 64.3 years (63.2, 65.3) versus 63.3 years (61.3, 65.3) [estimated mean (95% confidence interval)]. Longevity was lower in the high-cost group: 47.0 years (40.1, 53.9). Conclusions: The inverse association between tombstone cost and longevity would suggest that people in Medellín are inclined to spend more on tombstones when commemorating the tragic death of a young person. [ABSTRACT FROM AUTHOR]

Colombia's population is rapidly aging and older adults are living longer, however, we have limited information on the level of disability and number of years older Colombians spend with disability. We estimated age-and-gender specific ADL, IADL and mobility disability prevalence and disabled life expectancy (DLE) and to examined gender differences. Life tables came from the Colombian vital statistics and disability prevalence data came from the cross-sectional 2015 Colombia National Survey of Health, Well-being, and Aging. Disabled life expectancy (DLE) was calculated using Sullivan's method. About one-third to one-half of remaining years will be spent with IADL or mobility disability. The remaining years of life spent with ADL was relatively low at younger ages, but by age 85, about half of remaining life will be spent with disability. Compared to men, women had higher levels of disability and are estimated to spend more years with disability. Gender differences in ADL did not emerge until ages 70 and older. Older Colombians, in particularly women, are estimated to live a significant proportion of their life with disability, particularly IADL and mobility disability. High levels of disability are concerning because the country lacks adequate infrastructure and has limited options for long term care. [ABSTRACT FROM AUTHOR]

We conducted a lab-in-the-field experiment in which 214 Colombian rural workers must choose between cash or voucher payment for completing a real effort task. Although the voucher may be perceived as non-fungible, it halves the probability of suffering a negative shock that will reduce the participant's payment by two-thirds. Participants made four decisions in which we vary the voucher values such that this payment method offers, in expectation, between 88% to 123% of the cash payment (fixed across decisions). We find that uptake rates go from 32% to 56%, from the least to the most generous voucher. These rates are consistently larger compared to a reference sample of undergrad students from the same region (p–values from the χ2 tests for all four decisions fall below 0.035). Our between-subjects variations reveal that presenting the vouchers in descending order yields a higher uptake than the ascending order (p < 0.001 for the corresponding coefficient in a tobit and ordered logit regressions including municipality characteristics, an effect driven by the two decisions with the lowest voucher values, with p–values of 0.008 and 0.072 in the χ2 tests, respectively). We interpret this result as an endowment effect of the voucher's risk reduction. [ABSTRACT FROM AUTHOR]

In evolutionary studies of human populations based on the Y chromosome, the majority of Native Americans belong to the QM3 lineage. Therefore, to study the history of groups inhabiting northern South America, it is necessary to have a higher resolution of the tree. The objective of this work was to identify new SNPs of the QM3 lineage that would allow the evaluation of the phylogenetic relationships between Andean and Amazonian populations of Colombia. Sequences previously obtained from two Y chromosomes of Amazonian populations were used, from which 13 potential SNPs were selected and typed in 171 Amazonian samples from the Vaupés region and in 60 samples from the Pasto, Nasa, Embera, Arhuaco and Kogüi ethnic groups of the Andean region. In addition, the main SNPs/markers (L56, L54, M346, M848, Z780, CTS11780) defining autochthonous Q lineages were typed, along with others defined by different SNPs/markers as reported in the literature (CTS11357, SA05, Z19319, Z5915, and Z19384). It was found that all the new SNPs are present in the Amazonian samples and only 2 of them are shared with the Embera, Nasa and Pasto, but none with the Kogüi and Arhuaco from the northern Andes, in the Colombian Caribbean. Combining the 13 variants of the present study with 14 previously reported and using TMRCA, a new QM3 tree proposal is generated. This method makes it possible to increase the number of sublineages of QM3 with a higher resolution and to detect differences between the different populations of Vaupés in the Amazon, as in the case of the Kubeos and Pisamiras, the latter of which is in grave danger of extinction. These new sublineages are useful for microevolutionary studies of the Amerindian populations of South America. [ABSTRACT FROM AUTHOR]

Background: Arterial hypertension is one of the most prevalent chronic, non-communicable diseases and the leading preventable risk factor for cardiovascular disease (CVD) and all-cause mortality worldwide. Although its primary causes and consequences are preventable, it often remains undiagnosed. Consequently, this study aims to determine the prevalence and factors associated with normotensive, diagnosed, and undiagnosed hypertension in adults. Methods: A cross-sectional, population-based study was conducted in Sabaneta, Colombia, between 2021 and 2022, with 286 adults aged 18 and older. Stratified and systematic random sampling methods were employed. The World Health Organization STEP survey and the Perez Rojas test were utilized to assess behavioral risk factors and sedentary lifestyles. Body mass index, waist circumference, and arterial tension were measured using standardized instruments. The prevalence of hypertension was then estimated. Risk factors influencing normotensive, diagnosed, and undiagnosed hypertension were analyzed using multinomial regression. The outcome variable comprised three categories: normotensive (reference category), diagnosed hypertension, and undiagnosed hypertension. The multinomial regression coefficients were exponentiated and are presented as relative risk ratios (RRR) with 95% confidence intervals (CI). The model was adjusted for sex and sample weight per neighborhood. Results: The study revealed a hypertension prevalence of 38.5% and an undiagnosed hypertension rate of 50.9%. Those with undiagnosed hypertension were predominantly adults over 60 years (RRR = 0.68; 95% CI: 0.53–0.86), individuals with an elementary school education (RRR = 1.75; 95% CI: 1.27–2.42), those physically active (RRR = 1.52; 95% CI: 1.22–1.89), without prior diagnoses of chronic comorbidities (RRR = 1.42; 95% CI: 1.12–1.82), and with obesity (RRR = 2.25; 95% CI: 1.63–3.11) or overweight conditions (RRR = 1.70; 95% CI: 1.334–2.15). Conclusions: Undiagnosed hypertension was significant among populations without risk conditions. There is an urgent need for community-based early detection and education strategies to mitigate this issue. [ABSTRACT FROM AUTHOR]

Introduction: Hemophilia A and B are disorders associated with the deficit of coagulation factors VIII and IX. Objective: Was to determine the incidence of complications in a cohort of patients diagnosed with moderate and severe hemophilia A or B under treatment in a specialized institution. Methods: A retrospective study of a cohort of patients with replacement therapy for hemophilia A or B, evaluating treatment and complications between January/2012 and July/2019. Sociodemographic, clinical and disease management-related variables were extracted from the medical records. Time to inhibitor development and rate associated with bleeding and hospitalizations were evaluated. Results: A total of 159 male patients were identified with hemophilia A (n = 140; 88.1%) and B (n = 19; 11.9%) with a mean follow-up of 5.9±2.3 years. The mean age was 23.6±16.1 years, hemophilia was reported as severe in 125 patients in hemophilia A (89.3%) and 13 patients in hemophilia B (68.4%). Primary prophylaxis was registered in 17.0% of patients, 44.7% secondary, and 38.3% tertiary, with recombinant factors (n = 84; 52.8%) followed by plasma derived factors (n = 75; 47.2%). The incidence of inhibitor development was 0.3 per 100 patients/year, with mean time to event of 509 days. The incidence of bleeding was 192 per 100 patients/year, especially at the joint (n = 99; 62.3%) and muscle (n = 25; 15.7%) level. The incidence of hospitalization was 3.7 per 100 patients/year. Conclusions: The most common complication was joint bleeding which was expected in this type of patients. Low proportion of patients developed factor inhibitors during the follow up. [ABSTRACT FROM AUTHOR]

In 1995, Colombia signed the first legally binding international treaty that criminalizes all forms of violence against women. Subsequently, the government took several steps to improve laws and policies, but the progress was slow. This study uses a differences-in-differences approach and Demographic and Health Survey data to estimate the impact of a renewed effort to reduce intimate partner violence (IPV), based on recommendations by the UN. To identify the effect of the national policies, it uses the fact that while the central government passes laws and formulates policies, it partly relies on departments (provinces) to implement them. Of Colombia's 32 departments and Bogota D.C., approximately a quarter had some type of gender policy in place by 2011. The main finding is that self-reported intimate partner violence decreased from 20% to 16% between 2010 and 2015 in departments that had implemented IPV policies, while it remained at 19% in the others. [ABSTRACT FROM AUTHOR]

The genus Diatraea (Lepidoptera: Crambidae) includes stem borers representing the most critical sugarcane pests in the Americas. Colombia's most widely distributed and damaging Diatraea species include Diatraea saccharalis, D. indigenella, D. busckella, and D. tabernella. The reduced efficacy of biological tools commonly used in controlling several species highlights the importance of evaluating alternative management strategies, such as transgenic plants expressing insecticidal proteins from the bacterium Bacillus thuringiensis (Bt). The selection of optimal Bt insecticidal proteins for Diatraea control depends on bioassays with purified Bt proteins. Because there is no described artificial diet for borer species other than D. saccharalis and availability of most purified Bt toxins is restricted, this study aimed at developing a bioassay method using fresh corn tissue and providing proof of concept by testing susceptibility to the Cry1Ac insecticidal protein from Bt. Toxicity was evaluated with a single Cry1Ac dose applied directly to corn discs. Stem borer mortality after seven days was higher than 90% for all four tested Diatraea species, while control mortality was below 8%. In addition, we observed that Cry1Ac caused more than 90% weight inhibition in all survivors and delayed development. These results validate the use of this method to determine mortality and growth inhibition due to the consumption of the Cry1Ac protein in each of the Diatraea species. Furthermore, this method could be used to assess other entomopathogenic substances to control these insect pests. [ABSTRACT FROM AUTHOR]

This paper employs the concepts of sustainability and habitability to define and measure ecological urbanism in informal settlements founded by people who have been forcibly displaced by violence. The objective is to identify the obstacles in meeting the tenets of ecological urbanism in informal settlements. We offer primary research from La Primavera, an informal settlement founded by internally displaced people in the late 1970s, located in the corregimiento El Hatillo of Barbosa, Antioquia in northwestern Colombia. Primary research includes qualitative and quantitative data gathered through 72 surveys and 45 technical assessments of properties and houses in the settlement. Situated between the Aburrá River and the northbound highway, above a gas pipeline and under an electricity pylon, La Primavera exists in a state of extreme risk, exacerbated by increasing migration which threatens to exceed the carrying capacity of the territory. Moreover, in Article 35 of Law 388 of 1997, the territory was declared a protected or restricted area and earmarked for the development of the regional commuter train, called the Tren de Cercanías, in 2017. The case study highlights the contradictions in the development agenda in Colombia by showing how development projects designed for the economic betterment and environmental conservation of the region negatively impact the quality of life for the most vulnerable inhabitants and expose them to greater environmental, economic, and social risk. [ABSTRACT FROM AUTHOR]

Introduction: A complex relationship between donor and recipient characteristics influences kidney transplant (KT) success. A tool developed by Bae S. et al. (Survival Benefit Estimator, SBE) helps estimate post-KT survival. We aim to evaluate the predictive performance of the SBE tool in terms of 5-year patient survival after a kidney transplant. Methods: A retrospective cohort study of all deceased-donor KT recipients between January 2009 to December 2021. A descriptive analysis of clinical and sociodemographic characteristics was performed. The SBE online tool was used to calculate the predicted patient survival (PPS) and the survival benefit at five years post-KT. Comparisons between predictive vs. actual patient survival were made using quintile subgroups. Three Cox regression models were built using PPS, EPTS, and KDPI. Results: A total of 1145 recipients were evaluated. Mortality occurred in 157 patients. Patient survival was 86.2%. Predictive survival for patients if they remained on the waiting list was 70.6%. The PPS was 89.3%, which results in a survival benefit (SB) of 18.7% for our population. Actual survival rates were lower than the predicted ones across all the quintiles. In unadjusted analysis, PPS was a significant protective factor for mortality (HR 0.66), whereas EPTS (HR 8.9) and KDPI (HR 3.25) scores were significant risk factors. The discrimination of KDPI, PPS, and EPTS scores models were 0.59, 0.65, and 0.66, respectively. Conclusion: SBE score overestimated actual survival rates in our sample. The discrimination power of the score was moderate, although the utility of this tool may be limited in this specific population. [ABSTRACT FROM AUTHOR]

The number of health-related incidents caused using illegal and legal psychoactive substances (PAS) has dramatically increased over two decades worldwide. In Colombia, the use of illicit substances has increased up to 10.3%, while the consumption alcohol and tobacco has increased to 84% and 12%, respectively. It is well-known that identifying drug consumption patterns in the general population is essential in reducing overall drug consumption. However, existing approaches do not incorporate Machine Learning and/or Deep Data Mining methods in combination with spatial techniques. To enhance our understanding of mental health issues related to PAS and assist in the development of national policies, here we present a novel Deep Neural Network-based Clustering-oriented Embedding Algorithm that incorporates an autoencoder and spatial techniques. The primary goal of our model is to identify general and spatial patterns of drug consumption and abuse, while also extracting relevant features from the input data and identifying clusters during the learning process. As a test case, we used the largest publicly available database of legal and illegal PAS consumption comprising 49,600 Colombian households. We estimated and geographically represented the prevalence of consumption and/or abuse of both PAS and non-PAS, while achieving statistically significant goodness-of-fit values. Our results indicate that region, sex, housing type, socioeconomic status, age, and variables related to household finances contribute to explaining the patterns of consumption and/or abuse of PAS. Additionally, we identified three distinct patterns of PAS consumption and/or abuse. At the spatial level, these patterns indicate concentrations of drug consumption in specific regions of the country, which are closely related to specific geographic locations and the prevailing social and environmental contexts. These findings can provide valuable insights to facilitate decision-making and develop national policies targeting specific groups given their cultural, geographic, and social conditions. [ABSTRACT FROM AUTHOR]

Purpose: This article examines the influence of emotional intelligence on organizational citizenship behavior and transformational and transactional leadership, and the impact of these dimensions on operational effectiveness. Design/Methodology: The analysis was based on 180 valid questionnaires from organizations in Colombia's manufacturing sector of the Valle del Cauca region. The variables were analyzed using structural equation modeling to identify the relationships among the studied constructs. Findings: The results suggest that emotional intelligence positively affects organizational citizenship behavior. Nevertheless, emotional intelligence does not impact transformational leadership and only partially affects transactional leadership and operational effectiveness. Emotional intelligence has a strong and positive impact on operational effectiveness when mediated by organizational citizenship behavior, which does have a strong and positive predictive power on operational effectiveness. Hence, in the search for competitive advantage, leaders should seek to improve operational effectiveness by focusing on developing emotional intelligence and organizational citizenship behaviour skills. Interestingly, of the two leadership styles examined in this study, only transactional leadership impacts operational effectiveness, which is inconsistent with the current literature and indicates a need for further leadership training. Originality/Value: The value of this paper lies in discerning the current capabilities and strategies that individuals in an organization must address for proper transactional and transformational leadership. However, before operational effectiveness and a sustainable competitive advantage can be achieved, the role of leaders should be managed through the appropriate application of the concepts of emotional intelligence and organizational leadership behavior. [ABSTRACT FROM AUTHOR]

Introduction: Target 3.8 of the Sustainable Development Goals calls for the guaranteeing of universal health service coverage without generating financial risks for households and individuals. In Colombia, there is no up-to-date information on the proportion of households that suffer catastrophic health expenditure (CHE), nor about how these expenses are associated with the place of residence. To contribute to an understanding of these issues, this study analyses the differences in the levels of CHE among Colombian households, and their association with the province and area (urban or rural) of residence. Methods: This is a descriptive and analytical cross-sectional study using the 2016–2017 National Household Budget Survey, the household and population Census 2018, and the Register of Health Providers 2017. We used the definition of CHE proposed by the World Health Organization, with a threshold of 20%. We estimated the percentage of households facing CHE, and its intensity, and estimated a multi-level logistic regression model, using as the dependent variable the question of whether a household experienced CHE, and the province as a second level, where explanatory variables related to the province were included. Results: We found differences in CHE levels according to the province of residence. At the national level, 1.77% of households experienced CHE, and households in the provinces of Boyacá (5.04%), Nariño (4.04%), Cauca (3.82%), and Chocó (3.78%) faced the highest CHE. For most households with CHE in these provinces, spending on medicines and medical consultations represented close to 50% of their out-of-pocket spending. The multi-level logistic regression model indicated that there are significant variations in CHE attributed to the provinces under study, where the contextual variables of hospital-bed density (AOR = 0.91; 95% CI 0.86–0.96) and incidence of multi-dimensional poverty (AOR = 1.13; 95% CI 1.01–1.30) were factors associated with CHE. For an urban household, 6.58% of the CHE variation is attributed to the province in question, while for a rural household the corresponding variation is 1.56%. Conclusions: The geographical location of the household is a key factor when studying CHE in Colombia, where rural households present higher levels of CHE, mainly in the delivery of medicines and medical consultations. The findings reveal the need to analyse financial protection at the local level and establish policies to protect households, especially poor households, from CHE. [ABSTRACT FROM AUTHOR]

Predictions of hospital beds occupancy depends on hospital admission rates and the length of stay (LoS) according to bed type (general ward -GW- and intensive care unit -ICU- beds). The objective of this study was to describe the LoS of COVID-19 hospital patients in Colombia during 2020–2021. Accelerated failure time models were used to estimate the LoS distribution according to each bed type and throughout each bed pathway. Acceleration factors and 95% confidence intervals were calculated to measure the effect on LoS of the outcome, sex, age, admission period during the epidemic (i.e., epidemic waves, peaks or valleys, and before/after vaccination period), and patients geographic origin. Most of the admitted COVID-19 patients occupied just a GW bed. Recovered patients spent more time in the GW and ICU beds than deceased patients. Men had longer LoS than women. In general, the LoS increased with age. Finally, the LoS varied along epidemic waves. It was lower in epidemic valleys than peaks, and decreased after vaccinations began in Colombia. Our study highlights the necessity of analyzing local data on hospital admission rates and LoS to design strategies to prioritize hospital beds resources during the current and future pandemics. [ABSTRACT FROM AUTHOR]

Mesocarnivores play a key role in ecosystem dynamics through the regulation of prey populations and are sensitive to environmental changes; thus, they are often considered good model organisms for conservation planning. However, data regarding the factors that influence the habitat use of threatened small wild felids such as the Andean tiger cat (Leopardus tigrinus pardinoides) are scarce. We conducted a two-year survey with 58 camera trap stations to evaluate the determinants of Andean tiger cat habitat use in three protected areas in the Middle Cauca, Colombia. We developed site occupancy models and found that Andean tiger cat habitat use increased with leaf litter depth at intermediate elevations and far from human settlements. Through conditional cooccurrence models, we found that Andean tiger cat habitat use was invariant to the presence of prey or potential intraguild competitors and killers/predators, but its detectability increased when they were present and detected. This suggests that Andean tiger cats may be more likely to be detected in sites with high prey availability. We found that Andean tiger cats preferred sites with deep leaf litter, which is a particular feature of cloud forests that provides suitable conditions for ambush hunting and hiding from intraguild enemies. Our results showed that Andean tiger cats avoided human settlements, which may minimize potential mortality risks in those areas. Moreover, the restricted use of middle elevations by Andean tiger cats suggested that they could be used as a sentinel species to track the effects of climate change since their suitable habitat is likely to be projected upward in elevation. Future conservation actions must be focused on identifying and mitigating human-related threats close to the Andean tiger cat habitat while preserving microhabitat conditions and the existing networks of protected areas. [ABSTRACT FROM AUTHOR]

Collecting and interpreting self-reported outcomes among people with hemophilia A supports the understanding of the burden of the disease and its treatment to improve holistic care. However, in Colombia, this information is limited. Therefore, this study aimed to describe the knowledge, perception and burden of hemophilia A from the patients' perspective. A cross-sectional study was conducted in the context of a hemophilia educational bootcamp held from November 29th to December 1st, 2019, in Medellin, Colombia. The bootcamp was organized by a hemophilia patient association responsible for contacting and inviting patients with hemophilia A (PwHA). Information on patients' health beliefs, treatment experiences, and health-related quality of life (HRQoL) was obtained through focus groups, individual interviews and the Patient Reported Outcomes, Burdens and Experiences (PROBE) questionnaire. A total of 25 moderate or severe PwHA were enrolled in this study and completed the PROBE questionnaire. Acute pain was the most frequently reported symptom, with 88% of the patients reporting the use of pain medication. Difficulty with activities of daily living was reported by 48%. Furthermore, 52% reported having more than 2 spontaneous bleeding events in the last year. Treatment was administered at home for 72% of patients, with regular prophylaxis as the most common treatment regimen. In terms of overall HRQoL, the median EQ-5D VAS score was 80 (IQR: 50–100). PwHA in Colombia still suffer from disease complications related to bleeding events, pain and disability that affect their HRQoL, which highlights the need to develop patient-centered initiatives to improve the wellness of this population. [ABSTRACT FROM AUTHOR]

According to the national population Census of Colombia, 4.1 per cent of the population lives with a disability. Although information is available on the number of persons with disabilities in the country, little information exists on their levels of multidimensional poverty and deprivation, especially at the province of local level. Aiming to contribute to the analysis of the levels of poverty of persons with disabilities living at the municipal/province level, this study computes and analyses the levels of multidimensional poverty in households with and without members with disabilities in the 1.101 municipalities of Colombia. Using the 2018 national population census, we computed the percentage of people living with disabilities in each of the municipalities of the country, then we computed their levels of poverty and deprivation and analysed the difference between households with and without members with disabilities. We also analysed the availability of teachers and schools providing services for children living with disabilities and deprivations in terms of school attendance. The results reveal that households with members with disabilities are poorer than households without members with disabilities, These households present higher deprivations according to most indicators, and the intensity of their poverty is higher. In addition, households with members with disabilities usually present higher levels of deprivation in school attendance and live in municipalities where there is no provision of inclusive schools. These results highlight the importance of implementing specific policies designed to reduce the levels of poverty of persons with disabilities and their families and to guarantee their access to basic opportunities and services. [ABSTRACT FROM AUTHOR]

Poverty and scarcity of resources make children in low-and-middle-income countries at risk of not reaching their developmental potential. Despite a near-universal interest in risk reduction, effective interventions like enhancing reading skills in parents to diminish developmental delay remain elusive for the great majority of vulnerable families. We undertook a efficacy study for parental use of a booklet called CARE for developmental screening of children between 36 to 60 months old (M = 44.0, SD = 7.5). All participants (N = 50), lived in vulnerable, low-income neighborhoods in Colombia. The study followed a pilot Quasi-Randomised Control Trial design (i.e., control group participants assigned based on non-random criteria) of parent training with a CARE intervention group compared to a control group. Data was analyzed using two-way ANCOVA for sociodemographic variables' interaction with follow-up results and one-way ANCOVA to evaluate the relations between the intervention and post-measurement of developmental delays and cautions and other language related-skills outcomes, while controlling for pre-measurements. These analyses indicated that the CARE booklet intervention enhanced children's developmental status and narrative skills (developmental screening delay items, F(1, 47) = 10.45, p =.002, partial η2 =.182; narrative devices scores, F(1, 17) = 4.87, p =.041, partial η2 =.223). Several limitations (e.g., sample size) and possible implications for the analysis of children's developmental potential are discussed and considered for future research, along with the effects of the COVID-19 pandemic on the closure of preschools and community care centers. [ABSTRACT FROM AUTHOR]

This study intends to determine whether similarities of the functioning of the cerebral cortex exist, modeled as a graph, during the execution of mathematical tasks and programming related tasks. The comparison is done using network parameters and during the development of computer programming tasks and the solution of first-order algebraic equations. For that purpose, electroencephalographic recordings (EEG) were made with a volunteer group of 16 students of systems engineering of Universidad del Norte in Colombia, while they were performing computer programming tasks and solving first-order algebraic equations with three levels of difficulty. Then, based on the Synchronization Likelihood method, graph models of functional cortical networks were developed, whose parameters of Small-Worldness (SWN), global(Eg) and local (El) efficiency were compared between both types of tasks. From this study, it can be highlighted, first, the novelty of studying cortical function during the solution of algebraic equations and during programming tasks; second, significant differences between both types of tasks observed only in the delta and theta bands. Likewise, the differences between simpler mathematical tasks with the other levels in both types of tasks; third, the Brodmann areas 21 and 42, associated with auditory sensory processing, can be considered as differentiating elements of programming tasks; as well as Brodmann area 8, during equation solving. [ABSTRACT FROM AUTHOR]

This study seeks to understand how micro, small, and medium-sized enterprises (MSMEs) can be innovative while developing their reputation. In doing so, this study focuses on companies classified as promoters of Colombia's "orange economy," which relates to the country's cultural and creative diversity. Firms with a non-technological emphasis also require knowledge, innovation, and reputation to perform better. In this regard, the study is based on the work of Hormiga and Garcia-Almeida (2016) who proposed the relationship between accumulated knowledge and innovation as background of reputation. In this paper, the purpose is to understand the internal reputation-building process carried out by MSMEs and the variables that intervene. Therefore, this research accounts for how MSMEs can build their reputation through innovation and accumulated knowledge. For this, a survey was conducted in 320 orange economy MSMEs located in Bogotá, Colombia, and the relationship of these variables was statistically tested through a quantitative analysis of multivariate data. Innovation was found to not impact the performance of companies, but this can be associated to factors that were not considered in this research. However, it is proposed to refine the original model by considering the manager's perspective. It is recommended that entrepreneurs invest resources in accumulating internal (tacit) knowledge to improve skills that enhance reputation. [ABSTRACT FROM AUTHOR]

The genus Lonomia Walker, 1855 (Lepidoptera: Saturniidae) is of particular interest to the medical community, since the scoli of these caterpillars harbor a venom that induces hemorrhaging in humans. In Colombia, deadly encounters with Lonomia achelous (Cramer, 1777), have been reported since 2000. There is little information on the main biological and ecological aspects of this genus to help better understand and develop prevention strategies. This study aimed to describe morphological and biological aspects (especially of immature stages) of four recently reported species of Lonomia in Colombia that pose a risk to humans. We collected caterpillars and adults from five localities and reared them under laboratory conditions. Specimens were identified using DNA barcoding and dissection of adult male genitalia. We provided the first description, to our knowledge, of part of the life cycles of Lonomia casanarensis Brechlin, 2017 and Lonomia orientoandensis Brechlin & Meister, 2011 and the complete life cycles of Lonomia columbiana Lemaire, 1972 and Lonomia orientocordillera Brechlin, Käch & Meister, 2013. We also present the first records of the parasitoids of L. orientocordillera, and L. casanarensis and new host plants. This information will guide not only their morphological recognition and the identification of their parasitoids and hosts, but also will guide rearing methods of these and other Lonomia species in new studies to prevent incidents with humans and create specific antivenoms. [ABSTRACT FROM AUTHOR]

Intestinal parasitic infections have been considered a relevant public health problem due to the increased incidence worldwide. In developing countries, diarrhea and gastrointestinal symptoms cause impaired work capacity in adults and delayed rate growth in children. Enteric infections of unknown etiology can often lead to misdiagnosis, increased transmission, and morbidity. The aim of this study was to determine the prevalence of intestinal parasites in a young adult population and their pets. Stool samples from 139 university students and 44 companion animals were subjected to microscopy diagnosis using wet mounts, concentration by zinc sulphate flotation and staining techniques (Kinyoun and trichrome stain). Molecular diagnosis of protozoa was also performed by conventional PCR. The mean age was 24 years, 54% individuals were female, 46% were men, and 66% had at least one pet. The overall prevalence for at least one parasite was 74.8% and the rate of polyparasitism was 37.5%. Eighty-three patients (59.7%) were positive for Blastocystis spp., followed by Cryptosporidium spp. 24.5%, Endolimax nana 13.6%, Entamoeba dispar/E. moshkovskii 7.8% and Giardia intestinalis 1.4%. Molecular diagnosis substantially improved Cryptosporidium spp. and Blastocystis spp. detection and allowed to distinguish E. histolytica from commensals in the Entamoeba complex. Student's pets were also examined for parasitism. Samples from 27 dogs, 15 cats, one rabbit and one hen were analyzed, and parasites were detected in 30 (68.2%) as follows: Cryptosporidium spp. (24) Giardia spp. (4), hookworm (3), Endolimax nana (2) and Toxoplasma gondii (1). Overall, university students showed high prevalence of parasitism and polyparasitism suggesting exposure to parasite infected animals and contaminated environments. Cryptosporidium spp. was the predominant pathogen in human and domestic animals, and it was only detected by PCR, pointing out the need for sensitive tests in diagnosis and surveillance. Control strategies to prevent the effects of parasitic infections in young population should consider pets as reservoirs and transmission source. [ABSTRACT FROM AUTHOR]

Mycobacterium tuberculosis (Mtb) is still one of the primary pathogens of humans causing tuberculosis (TB) disease. Mtb embraces nine well-defined phylogenetic lineages with biological and geographical disparities. The lineage L4 is the most globally widespread of all lineages and was introduced to America with European colonization. Taking advantage of many genome projects available in public repositories, we undertake an evolutionary and comparative genomic analysis of 522 L4 Latin American Mtb genomes. Initially, we performed careful quality control of public read datasets and applied several thresholds to filter out low-quality data. Using a genome de novo assembly strategy and phylogenomic methods, we spotted novel south American clades that have not been revealed yet. Additionally, we describe genomic deletion profiles of these strains from an evolutionary perspective and report Mycobacterium tuberculosis L4 sublineages signature-like gene deletions, some of the novel. One is a specific deletion of 6.5 kbp that is only present in sublineage 4.1.2.1. This deletion affects a complex group of 10 genes with putative products annotated, among others, as a lipoprotein, transmembrane protein, and toxin/antitoxin system proteins. The second novel deletion spans for 4.9 kbp and specific of a particular clade of the 4.8 sublineage and affects 7 genes. The last novel deletion affects 4 genes, extends for 4.8 kbp., and is specific to some strains within the 4.1.2.1 sublineage that are present in Colombia, Peru and Brasil. [ABSTRACT FROM AUTHOR]

Introduction: Systemic lupus erythematosus is an autoimmune disease associated with serious complications and high costs. The aim was to describe the clinical characteristics and health care resource utilization of a Colombian systemic lupus erythematosus outpatient cohort. Methods: This was a retrospective descriptive study. Clinical records and claims data for systemic lupus erythematosus patients from ten specialized care centers in Colombia were reviewed for up to 12 months. Baseline clinical variables, Systemic Lupus Erythematosus Disease Activity Index, drug use, and direct costs were measured. Descriptive statistics were analyzed using SPSS. Results: A total of 413 patients were included; 361 (87.4%) were female, and the mean age was 42 ± 14 years. The mean disease evolution was 8.9 ± 6.0 years; 174 patients (42.1%) had a systemic manifestation at baseline, mostly lupus nephritis (105; 25.4%). A total of 334 patients (80.9%) had at least one comorbidity, mainly antiphospholipid syndrome (90; 21.8%) and hypertension (76; 18.4%). The baseline Systemic Lupus Erythematosus Disease Activity Index score was 0 in 215 patients (52.0%), 1–5 in 154 (37.3%), 6–10 in 41 (9.9%) and 11+ in 3 (0.7%). All patients received pharmacological therapy, and the most common treatment was corticosteroids (293; 70.9%), followed by antimalarials (chloroquine 52.5%, hydroxychloroquine 31.0%), immunosuppressants (azathioprine 45.3%, methotrexate 21.5%, mycophenolate mofetil 20.1%, cyclosporine 8.0%, cyclophosphamide 6.8%, leflunomide 4.8%) and biologicals (10.9%). The mean annual costs were USD1954 per patient/year, USD1555 for antirheumatic drugs (USD10,487 for those with biologicals), USD86 for medical visits, USD235 for drug infusions and USD199 for laboratory tests. Conclusions: Systemic lupus erythematosus generates an important economic and morbidity burden for the Colombian health system. Systemic lupus erythematosus outpatient attention costs in the observation year were mainly determined by drug therapy (especially biologics), medical visits and laboratory tests. New studies addressing the rate of exacerbations, long-term follow-up or costs related to hospital care are recommended. [ABSTRACT FROM AUTHOR]

Common bean is the world's most important directly consumed legume food crop that is popular for calories, protein and micronutrients. It is a staple food in sub-Saharan Africa, and a significant source of iron for anemic people. However, several pests, soil and weather challenges still impede its production. Long cooking time, and high phytic acid and polyphenols that influence bioavailable iron also limit the health benefits. To inform population improvement strategies and selection decisions for resilient fast cooking and iron biofortified beans, the study determined diversity and population structure within 427 breeding lines, varieties, or landraces mostly from Alliance Uganda and Columbia. The genotypes were evaluated for days to flowering and physiological maturity, yield, seed iron (FESEED) and zinc (ZNSEED) and cooking time (COOKT). Data for all traits showed significant (P≤0.001) differences among the genotypes. Repeatability was moderate to high for most traits. Performance ranged from 52 to 87 ppm (FESEED), 23–38 ppm (ZNSEED), 36–361 minutes (COOKT), and 397–1299 kg/ha (yield). Minimal differences existed between the gene pools in the mean performance except in yield, where Mesoamerican beans were better by 117 kg/ha. The genotypes exhibited high genetic diversity and thus have a high potential for use in plant breeding. Improvement of FESEED and ZNSEED, COOKT and yield performance within some markets such as red and small white beans is possible. Hybridization across market classes especially for yellow beans is essential but this could be avoided by adding other elite lines to the population. Superior yielding and fast cooking, yellow and large white beans were specifically lacking. Adding Fe dense elite lines to the population is also recommended. The population was clustered into three groups that could be considered for specific breeding targets based on trait correlations. [ABSTRACT FROM AUTHOR]

Dental size variation in modern humans has been assessed from regional to worldwide scales, especially under microevolutionary and forensic contexts. Despite this, populations of mixed continental ancestry such as contemporary Latin Americans remain unexplored. In the present study we investigated a large Latin American sample from Colombia (N = 804) and obtained buccolingual and mesiodistal diameters and three indices for maxillary and mandibular teeth (except third molars). We evaluated the correlation between 28 dental measurements (and three indices) with age, sex and genomic ancestry (estimated using genome-wide SNP data). In addition, we explored correlation patterns between dental measurements and the biological affinities, based on these measurements, between two Latin American samples (Colombians and Mexicans) and three putative parental populations: Central and South Native Americans, western Europeans and western Africans through PCA and DFA. Our results indicate that Latin Americans have high dental size diversity, overlapping the variation exhibited by the parental populations. Several dental dimensions and indices have significant correlations with sex and age. Western Europeans presented closer biological affinities with Colombians, and the European genomic ancestry exhibited the highest correlations with tooth size. Correlations between tooth measurements reveal distinct dental modules, as well as a higher integration of postcanine dentition. The effects on dental size of age, sex and genomic ancestry is of relevance for forensic, biohistorical and microevolutionary studies in Latin Americans. [ABSTRACT FROM AUTHOR]

Recent declines of insect populations at high rates have resulted in the need to develop a quick method to determine their diversity and to process massive data for the identification of species of highly diverse groups. A short sequence of DNA from COI is widely used for insect identification by comparing it against sequences of known species. Repositories of sequences are available online with tools that facilitate matching of the sequences of interest to a known individual. However, the performance of these tools can differ. Here we aim to assess the accuracy in identification of insect taxonomic categories from two repositories, BOLD Systems and GenBank. This was done by comparing the sequence matches between the taxonomist identification and the suggested identification from the platforms. We used 1,160 COI sequences representing eight orders of insects from Colombia. After the comparison, we reanalyzed the results from a representative subset of the data from the subfamily Scarabaeinae (Coleoptera). Overall, BOLD systems outperformed GenBank, and the performance of both engines differed by orders and other taxonomic categories (species, genus and family). Higher rates of accurate identification were obtained at family and genus levels. The accuracy was higher in BOLD for the order Coleoptera at family level, for Coleoptera and Lepidoptera at genus and species level. Other orders performed similarly in both repositories. Moreover, the Scarabaeinae subset showed that species were correctly identified only when BOLD match percentage was above 93.4% and a total of 85% of the samples were correctly assigned to a taxonomic category. These results accentuate the great potential of the identification engines to place insects accurately into their respective taxonomic categories based on DNA barcodes and highlight the reliability of BOLD Systems for insect identification in the absence of a large reference database for a highly diverse country. [ABSTRACT FROM AUTHOR]

Background: Colombia is currently the world's main recipient country for Venezuelan migrants, and women represent a high proportion of them. This article presents the first report of a cohort of Venezuelan migrant women entering Colombia through Cúcuta and its metropolitan area. The study aimed to describe the health status and access to healthcare services among Venezuelan migrant women in Colombia with irregular migration status, and to analyze changes in those conditions at a one-month follow-up. Methods: We carried out a longitudinal cohort study of Venezuelan migrant women, 18 to 45 years, who entered Colombia with an irregular migration status. Study participants were recruited in Cúcuta and its metropolitan area. At baseline, we administered a structured questionnaire including sociodemographic characteristics, migration history, health history, access to health services, sexual and reproductive health, practice of early detection of cervical cancer and breast cancer, food insecurity, and depressive symptoms. The women were again contacted by phone one month later, between March and July 2021, and a second questionnaire was applied. Results: A total of 2,298 women were included in the baseline measurement and 56.4% could be contacted again at the one-month follow-up. At the baseline, 23.0% of the participants reported a self-perceived health problem or condition in the past month and 29.5% in the past 6 months, and 14.5% evaluated their health as fair or poor. A significant increase was found in the percentage of women who reported a self-perceived health problem during the past month (from 23.1% to 31.4%; p<0.01); as well as in the share who reported moderate, severe, or extreme difficulty working or performing daily chores (from 5.5% to 11.0%; p = 0.03) and who rated their health as fair (from 13.0% to 31.2%; p<0.01). Meanwhile, the percentage of women with depressive symptoms decreased from 80.5% to 71.2% (p<0.01). Conclusion: This report presents initial information on the health status of Venezuelan migrant women in Colombia, and is a starting point for further longer longitudinal follow-ups to assess changes over time in health conditions. [ABSTRACT FROM AUTHOR]

Objective: Colombia hosts 1.8 million displaced Venezuelans, the second highest number of displaced persons globally. Colombia's constitution entitles all residents, including migrants, to life-saving health care, but actual performance data are rare. This study assessed Colombia's COVID-era achievements. Methods: We compared utilization of comprehensive (primarily consultations) and safety-net (primarily hospitalization) services, COVID-19 case rates, and mortality between Colombian citizens and Venezuelans in Colombia across 60 municipalities (local governments). We employed ratios, log transformations, correlations, and regressions using national databases for population, health services, disease surveillance, and deaths. We analyzed March through November 2020 (during COVID-19) and the corresponding months in 2019 (pre-COVID-19). Results: Compared to Venezuelans, Colombians used vastly more comprehensive services than Venezuelans (608% more consultations), in part due to their 25-fold higher enrollment rates in contributory insurance. For safety-net services, however, the gap in utilization was smaller and narrowed. From 2019 to 2020, Colombians' hospitalization rate per person declined by 37% compared to Venezuelans' 24%. In 2020, Colombians had only moderately (55%) more hospitalizations per person than Venezuelans. In 2020, rates by municipality between Colombians and Venezuelans were positively correlated for consultations (r = 0.28, p = 0.04) but uncorrelated for hospitalizations (r = 0.10, p = 0.46). From 2019 to 2020, Colombians' age-adjusted mortality rate rose by 26% while Venezuelans' rate fell by 11%, strengthening Venezuelans' mortality advantage to 14.5-fold. Conclusions: The contrasting patterns between comprehensive and safety net services suggest that the complementary systems behaved independently. Venezuelans' lower 2019 mortality rate likely reflects the healthy migrant effect (selective migration) and Colombia's safety net healthcare system providing Venezuelans with reasonable access to life-saving treatment. However, in 2020, Venezuelans still faced large gaps in utilization of comprehensive services. Colombia's 2021 authorization of 10-year residence to most Venezuelans is encouraging, but additional policy changes are recommended to further integrate Venezuelans into the Colombian health care system. [ABSTRACT FROM AUTHOR]

Reliable, timely and detailed information on lung cancer prevalence, mortality and costs from middle-income countries is essential to policy design. Thus, we aimed to develop an electronic algorithm to identify lung cancer prevalent patients in Colombia by using administrative claims databases, as well as to estimate prevalence rates by age, sex and geographic region. We performed a cross-sectional study based on national claim databases in Colombia (Base de datos de suficiencia de la Unidad de Pago por Capitación and Base de Datos Única de Afiliados) to identify lung cancer prevalent patients in 2017, 2018 and 2019. Several algorithms based on the presence or absence of oncological procedures (chemotherapy, radiotherapy and surgery) and a minimum number of months that each individual had lung cancer ICD-10 codes were developed. After testing 16 algorithms, those with the closest prevalence rates to those rates reported by aggregated official sources (Global Cancer Observatory and Cuenta de Alto Costo) were selected. We estimated prevalence rates by age, sex and geographic region. Two algorithms were selected: i) one algorithm that was defined as the presence of ICD-10 codes for 4 months or more (the sensitive algorithm); and ii) one algorithm that was defined by adding the presence of at least one oncological procedure (the specific algorithm). The estimated prevalence rates per 100,000 inhabitants ranged between 11.14 and 18.05 for both, the contributory and subsidized regimes over years 2017, 2018 and 2019. These rates in the contributory regime were higher in women (15.43, 15.61 and 17.03 per 100,000 for years 2017, 2018 and 2019), over 65-years-old (63.45, 56.92 and 61.79 per 100,000 for years 2017, 2018 and 2019) who lived in Central, Bogota and Pacific regions. Selected algorithms showed similar aggregated prevalence estimations to those rates reported by official sources and allowed us to estimate prevalence rates in specific aging, regional and gender groups for Colombia by using national claims databases. These findings could be useful to identify clinical and economical outcomes related to lung cancer patients by using national individual-level databases. [ABSTRACT FROM AUTHOR]

Background: Leprosy is a chronic infectious disease caused by Mycobacterium leprae. The development of leprosy involves several factors, including the causative agent, the individual host's immune response, environmental factors, and the genetic background of the host. Specifically, the host's innate immune response, encoded by genes, determines their susceptibility to developing leprosy post-infection. Polymorphic variants in the nucleotide-binding oligomerization domain 2 (NOD2) gene are associated with leprosy among populations in a variety of endemic areas around the world. Colombia, a country located in the tropical zone, has several leprosy-endemic regions, including Norte de Santander. The aim of this study was to analyze the rs7194886, rs2111234, rs3135499, and rs8057341 single nucleotide polymorphisms (SNPs) in the NOD2 gene using a case-control study to determine whether they confer greater or lesser susceptibility to the development of leprosy. Methodology: The TaqMan qPCR amplification system was used for SNPs detection. Findings: An association between the A-rs8057341 SNP (p = 0,006286) and resistance to leprosy was found. However, the rs3135499 (p = 0,9063) and rs2111234 (p = 0.1492) were not found to be associated with leprosy susceptibility. In addition, the rs7194886 SNP was not found to be in Hardy-Weinberg equilibrium (HWE) in the study population. The GAG haplotype, consisting of SNPs rs2111234-G, rs3135499-A, and rs8057341G, acts as a susceptibility factor for the development of leprosy in women. SNPs rs3135499 and rs8057341 are functionally related to decreased NOD2 expression according to an in-silico analysis. Conclusions: The SNPs rs8057341-A was related with resistance to leprosy and the haplotype rs2111234-G, rs3135499-A and rs8057341-G SNPs was related with susceptibility in the Norte de Santander Colombia, studied population. [ABSTRACT FROM AUTHOR]

Purpose: There is rising interest in Industry 4.0 as a factor in the competitiveness of the organization. Although many companies are aware of the importance of Industry 4.0, the development of such initiatives in Colombia is slow. Consequently, this research investigates the impact of additive technologies as part of the Industry 4.0 concept on operational effectiveness and, therefore, the competitiveness of the organization and tries to establish the factors that hinder the adequate implementation of such new, innovative technologies. Design/Methodology/Approach: Structural equation modeling was used to analyze the antecedents and outcomes of operational effectiveness. To this end, 946 usable questionnaires were collected from managers and personnel from Colombian organizations. Findings: Initial findings show that management is aware of Industry 4.0 concepts and implements strategies for such initiatives. Nevertheless, neither process innovation nor additive technologies have a significant impact on operational effectiveness and therefore on the competitiveness of the organization. Practical implications: The implementation of new innovative technologies requires the closure of the digital gap between urban and rural areas and between large and medium and small enterprises. Similarly, the concept of Industry 4.0 as a new, innovative manufacturing concept requires a transversal implementation to increase the competitiveness of the organization. Originality/Value: The value of this paper lies in discussing the current technological and human capabilities and strategies that Colombian organizations, as an example of a developing nation, should improve to leverage the benefits of Industry 4.0 to remain competitive. The results are probably generalizable to other regions in developing countries throughout the world. [ABSTRACT FROM AUTHOR]

In mathematical epidemiology, it is usual to implement compartmental models to study the transmission of diseases, allowing comprehension of the outbreak dynamics. Thus, it is necessary to identify the natural history of the disease and to establish promissory relations between the structure of a mathematical model, as well as its parameters, with control-related strategies (real interventions) and relevant socio-cultural behaviors. However, we identified gaps between the model creation and its implementation for the use of decision-makers for policy design. We aim to cover these gaps by proposing a discrete mathematical model with parameters having intuitive meaning to be implemented to help decision-makers in control policy design. The model considers novel contagion probabilities, quarantine, and diffusion processes to represent the recovery and mortality dynamics. We applied mathematical model for COVID-19 to Colombia and some of its localities; moreover, the model structure could be adapted for other diseases. Subsequently, we implemented it on a web platform (MathCOVID) for the usage of decision-makers to simulate the effect of policies such as lock-downs, social distancing, identification in the contagion network, and connectivity among populations. Furthermore, it was possible to assess the effects of migration and vaccination strategies as time-dependent inputs. Finally, the platform was capable of simulating the effects of applying one or more policies simultaneously. [ABSTRACT FROM AUTHOR]

A significant gap in understanding the response of biodiversity to urban areas is the lack of long-term studies. Most of the information on urban birds comes from studies carried out in the northern hemisphere, and they include data that don´t exceed three years. Although short-term studies contribute to knowledge about bird community diversity and their spatial distribution in urban areas, they could be biased towards more conspicuous species. One of the few multi-temporal datasets available for birds in urban areas is the Christmas Bird Count (CBC). Using annual CBC data available between 2001 and 2018 from 21 urban and peri-urban sample sites assessed from the main cities of Colombia, we identified and analyzed long-term trends on the cumulative diversity of bird communities as well as on their spatial distribution. We estimated comparative trends in richness, number of individuals counted, similarity, and complementarity of avifauna for each city and sample site based on their responses to urbanization and dietary guilds. We identified almost a quarter of the species registered in Colombia (464 of 1954). The representativeness of the community obtained for 18 years exceeds 84%, showing richness that ranges between 214 and 278 species in the three cities. Bird species and individuals registered showed wide variation of the sample sites. We found more dwellers, insectivorous and granivorous species in urban areas, with frugivores relegated to peri-urban sites, usually coinciding with avoider species. Natural peri-urban areas and intra-urban wetlands and urban parks were the most important refuges for birds and maintained the highest avoider and utilizer species richness. Long-term inventories are fundamental for determining consolidated bird diversity and distributional patterns. This information established a baseline for decision-making and applying recommendations that allow reconciling the growing demand for urban areas with the need to preserve the native avifauna in megadiverse Neotropical countries such as Colombia. [ABSTRACT FROM AUTHOR]

Recent studies have shown a relationship between air pollution and increased vulnerability and mortality due to COVID-19. Most of these studies have looked at developed countries. This study examines the relationship between long-term exposure to air pollution and COVID-19-related deaths in four countries of Latin America that have been highly affected by the pandemic: Brazil, Chile, Colombia, and Mexico. Our results suggest that an increase in long-term exposure of 1 μg/m3 of fine particles is associated with a 2.7 percent increase in the COVID-19 mortality rate. This relationship is found primarily in municipalities of metropolitan areas, where urban air pollution sources dominate, and air quality guidelines are usually exceeded. By focusing the analysis on Latin America, we provide a first glimpse on the role of air pollution as a risk factor for COVID-19 mortality within a context characterized by weak environmental institutions, limited health care capacity and high levels of inequality. [ABSTRACT FROM AUTHOR]