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Abstract Biofilms are critical in the persistence of Pseudomonas aeruginosa infections, particularly in cystic fibrosis patients. This study explores the adaptive mechanisms behind the phenotypic switching between Small Colony Variants (SCVs) and revertant states in P. aeruginosa biofilms, emphasizing hypermutability due to Mismatch Repair System (MRS) deficiencies. Through experimental evolution and whole-genome sequencing, we show that both wild-type and mutator strains undergo parallel evolution by accumulating compensatory mutations in factors regulating intracellular c-di-GMP levels, particularly in the Wsp and Yfi systems. While wild-type strains face genetic constraints, mutator strains bypass these by accessing alternative genetic pathways regulating c-di-GMP and biofilm formation. This increased genetic accessibility, driven by higher mutation rates and specific mutational biases, supports sustained cycles of SCV conversion and reversion. Our findings underscore the crucial role of hypermutability in P. aeruginosa adaptation, with significant implications for managing persistent infections in clinical settings.

El objetivo de este estudio es desarrollar un diseño final para el Talud Noroeste de la Mina Cuajone (Perú) utilizando el cálculo del factor de seguridad (FS) mediante métodos de elementos finitos, planteando que este método permite una evaluación más precisa de la estabilidad del talud. La metodología incluyo la caracterización geológica y geotécnica del talud mediante mapeo de campo, análisis de muestras y pruebas de laboratorio. Se creo un modelo tridimensional usando el software Phase2 para simular la interacción entre la geometría del talud y las condiciones operativas, realizando un análisis de estabilidad bajo diferentes cargas y perturbaciones. Los resultados indican que el método de elementos finitos proporciono una evaluación detallada del factor de seguridad y del ángulo interrampa (IRA). En la zona sur (sección A-A'), se determina que un IRA de 43° genera un FS de 1.1. En la zona norte (sección B-B'), se recomienda un IRA de 38° para lograr un FS de 1.57. Los hallazgos son fundamentales para garantizar la seguridad y eficiencia operativa en la mina, ya que un diseño de talud inadecuado podría comprometer la integridad de la infraestructura y la seguridad de los trabajadores. La aplicación de métodos avanzados como el análisis de elementos finitos y la consideración de factores como el IRA y el factor de perturbación permite una evaluación precisa de la estabilidad del talud y la implementación de medidas de estabilización efectivas para gestionar los riesgos y desarrollar soluciones de refuerzo específicas según la configuración geotécnica del talud.

Abstract This paper reports the design of a biosensor for sensitive, low-cost measurement of lead in drinking water. The biosensor uses a genetically-modified strain of Escherichia coli, which serves as both signal amplifier and reporter of lead in water, measured via colour change. We developed the PlomBOX measurement platform to image this colour change and we demonstrate its capability to detect concentrations as low as the World Health Organisation upper limit for drinking water of 10 ppb. Our approach does not require expensive infrastructure or expert operators, and its automated sensing, detection and result visualisation platform is user-friendly and robust compared to existing lead biosensors—critical features to enable measurement by non-experts at the point of use.

En la administración de justicia en América Latina en su devenir histórico-evolutivo, el denominador común ha sido considerar los cargos judiciales como un modo de repartir el establishment político, adicionalmente la justicia en la región se ha visto afectado por conflictos de orden sociopolítico, trayendo esto como consecuencia un impacto negativo en la heterogeneidad y disimilitud en las decisiones judiciales. Por ello, esta investigación procura como propósito –a través del análisis hermenéutico-valorativo documental- reflexionar sobre la afectación de la corrupción en la independencia e imparcialidad del sistema judicial en la región. Se discute un constructo vinculante sobre el estado del arte de la corrupción en el sistema de justicia, las formas de corrupción y su vinculación con la percepción ciudadana. Finalmente los hallazgos muestran la perdida de credibilidad y confiabilidad del sistema de justicia debido al desgaste producido por la misma inacción de la justicia ante casos emblemáticos y comunes ocurridos en los últimos años en la región.

El artículo, abordado desde una perspectiva cualitativa y con apoyo de la exploración documental, tuvo por objetivo analizar la violencia de género dentro del ámbito conyugal, ofreciendo una visión crítica e interdisciplinar sobre esta patología social. La violencia doméstica es una de las manifestaciones de la violencia de género, conformando una realidad que afecta la integridad física, emocional y sexual de las mujeres, siendo un problema de salud pública y un atentado contra los derechos humanos. Entre los principales hallazgos se destaca que la violencia conyugal es ejercida por el hombre hacia la mujer, como parte de una lógica patriarcal que se encuentra inmersa dentro de la sociedad, afectando negativamente el desenvolvimiento de la mujer. Ante esta realidad, la disolución conyugal puede tomarse como una alternativa, como una conquista obtenida por las luchas feministas y por los estudios de género, que ven en esta una oportunidad para dignificar la condición de la mujer y vivir una vida libre de la violencia. Sin embargo, a pesar de los avances en esta materia, las desigualdades y la violencia siguen presentes, exponiendo a las mujeres a otra serie de dificultades y riesgos. Finalmente, se concluye en la necesidad de denunciar los patrones que dan continuidad a la violencia de género y a la visión patriarcal de la sociedad, promoviendo relaciones equitativas, fortaleciendo las políticas de género y la educación inclusiva, mediante enfoques holísticos y colaborativos, que deriven en el cambio social y la confección de sociedades justas y equilibradas.

Background: Tuberculosis (TB) is one of the leading causes of death worldwide. However, an accurate diagnosis contributes to timely treatment, reducing its adverse consequences. The aim of this research was to determine the diagnostic accuracy of the molecular test Xpert MTB/RIF and Xpert MTB/RIF Ultra (Xpert Ultra) for the diagnosis of pulmonary and extrapulmonary TB compared to Löwenstein-Jensen culture. Methods: We conducted a cross-sectional study of diagnostic accuracy. We included samples from patients who attended a Peruvian laboratory between 2011 and 2022. The index test was the Xpert MTB/RIF and Xpert Ultra and the reference standard was Löwenstein-Jensen solid culture for Mycobacterium tuberculosis. We calculated sensitivity, specificity, and positive and negative likelihood ratios. Results: We evaluated 1023 samples, of which 737 were pulmonary samples, 197 tested positive for the Xpert MTB/RIF and Xpert Ultra tests; and 151 tested positive for culture. The Xpert (MTB/RIF and Ultra) showed a joint sensitivity and specificity of: 97 % (95%CI: 93–99) and 93 % (95%CI: 91–95) in pulmonary samples, 100 % (95%CI: 29.2–100) and 98.3 % (95%CI: 94.1–99.8) in cerebrospinal fluid, 66.7 % (95%CI: 22.3–95.7) and 96.8 % (95%CI: 91–99.3) in pleural fluid, 100 % (95%CI: 15.8–100) and 94.3 % (95%CI: 80.8–99.3) in urine. For the detection of pulmonary TB, the Xpert MTB/RIF had a sensitivity and specificity of 97.1 % (95%CI: 89.9–99.6) and 95.6 % (95%CI: 92.9–97.5) and the Xpert Ultra of 97 % (95%CI: 88.5–99.6) 89.5 % (95%CI: 84.9–93.1) respectively. Conclusion: Our results suggest that the Xpert MTB/RIF and the Xpert Ultra are tests with high diagnostic performance for the detection of pulmonary TB and adequate specificity in pulmonary, cerebrospinal fluid, pleural, and urine samples. However, the results for other samples were imprecise.

Considerando que la eimeriosis en alpacas es una enfermedad mortal, se plantea el objetivo de brindar una alternativa profiláctica en alpacas destetadas. Se evaluaron 30 alpacas del CICAS “La Raya” Cusco en Agosto 2022, distribuidas en 3 grupos de 10 alpacas, grupo1 (G1) 15 mg/kpv, grupo2 (G2) 22,5 mg/kpv de Toltrazuril y grupo3 (G3) control. Se realizó análisis coproparasitológico cualitativo de concentración por flotación y cuantitativo mediante método de McMaster modificado pre y post tratamiento; un posible daño hepático se evidenció mediante niveles séricos de alanina aminotransferasa (ALT) y aspartato aminotransferasa (AST). Como resultados, se identificaron eimerias en el 93,33% de alpacas destetadas, siendo más prevalente E. macusaniensis (63,33%). Así mismo, Toltrazuril a 22,5 mg/kpv controla parcialmente E. macusaniensis, mientras que a 15 y 22,5 mg/kpv controlan efectivamente a E. lamae a los 14 días post tratamiento; los niveles de AST y ALT en alpacas con 22,5 mg/kpv de Toltrazuril fueron 5,7 UI/L y 195,8 UI/L, respectivamente. En conclusión, Toltrazuril logra controlar a eimerias patógenas en alpacas, de manera parcial a E. macusaniensis, pero de forma efectiva a eimerias pequeñas como E. lamae sin alterar la función hepática en alpacas destetadas.

La investigación se titula “Tecnoestrés y rendimiento académico en estudiantes de primer ciclo de estudios de la Universidad Andina del Cusco, 2021”, siendo su objetivo general establecer la relación existente entre el nivel de tecnoestrés y el rendimiento académico de los estudiantes de primer ciclo de estudios semestre académico 2021-II de la Universidad Andina del Cusco, la interpretación de la variable rendimiento académico se realiza considerando el modelo académico de la institución de educación superior donde se ejecutó el estudio, utilizándose para la mediana de tecnoestrés un instrumento con adecuados criterios psicométricos. El estudio se desarrolló desde un enfoque cuantitativo, de tipo aplicado, pues depende de los conocimientos y aportes de la investigación básica, además, al relacionar las variables se considera de alcance correlacional y con un diseño no experimental transversal, al encuestar a una muestra de 847 estudiantes. Entre los resultados más relevantes se encuentra la relación existente entre el tecnoestrés y rendimiento académico; y en entre todas las dimensiones del tecnoestrés con el rendimiento académico, la conclusión fue que mientras mayor sea el nivel de tecnoestrés, menor será el rendimiento académico de los estudiantes.

Small communities in the Arequipa region of Peru are susceptible to rockfall hazards, which impact their lives and livelihoods. To mitigate rockfall hazards, it is first necessary to understand their locations and characteristics, which can be compiled into an inventory used in the creation of rockfall hazard rating maps. However, the only rockfall inventory available for Arequipa contains limited data of large, discrete events, which is insufficient for characterizing rockfall hazards at the community scale. A more comprehensive inventory would result in a more accurate rockfall hazard rating map—a significant resource for hazard mitigation and development planning. This study addresses this need through a remote method for rockfall hazard characterization at a community scale. Three communities located in geographically diverse areas of Arequipa were chosen for hazard inventory and characterization, with a fourth being used for validation of the method. Rockfall inventories of source zones and rockfall locations were developed using high-resolution aerial imagery, followed by field confirmation, and then predictions of runout distances using empirical models. These models closely matched the actual runout distance distribution, with all three sites having an R2 value of 0.98 or above. A semi-automated method using a GIS-based model was developed that characterizes the generation and transport of rockfall. The generation component criteria consisted of source zone height, slope angle, and rockmass structural condition. Transport was characterized by rockfall runout distance, estimated rockfall trajectory paths, and hazard ratings of corresponding source zones. The representative runout distance inventory model of the validation site matched that of a nearby site with an R2 of 0.98, despite inventorying less than a third of the number of rockfalls. This methodology improves upon current approaches and could be tested in other regions with similar climatic and geomorphic settings. These maps and methodology could be used by local and regional government agencies to warn residents of rockfall hazards, inform zoning regulations, and prioritize mitigation efforts.

The acquisition of ECG signals offers physicians and specialists a very important tool in the diagnosis of cardiovascular diseases. However, very often these signals are affected by noise from various sources, including noise generated by movement during physical activity. This type of noise is known as Motion Artifact (MA) which changes the waveform of the signal, leading to erroneous readings. The elimination of this noise is performed by different filtering techniques, where the adaptive filtering using the LMS (least mean squares) algorithm stands out. The objective of this article is to determine which algorithms best deal with motion artifacts, taking into account the use of instruments or wearable equipment, in different conditions of physical activity. A comparison between different algorithms derived from LMS (NLMS, PNLMS and IPNLM) used in adaptive filtering is carried out using indicators such as: Pearson's Correlation Coefficient, Signal to Noise Ratio (SNR) and Mean Squared Error (MSE) as metrics to evaluate them. For this purpose, the mHealth database was used, which contains ECG signals taken during moderate to medium intensity physical activities. The results show that filtering by IPNLMS as well as PNLMS offers an improvement both visually and in terms of SNR, Pearson, and MSE indicators.

Oesophagostomum venulosum es un nematodo gastrointestinal (NGI) que tiene como hospedadores principalmente a los ovinos y caprinos. En Argentina la presencia de este parásito está informada en todas las regiones del país, principalmente en la especie ovina. En el Noroeste Argentino (NOA) está reportado en bovinos y camélidos. El objetivo de este trabajo fue describir por primera vez la presencia de O. venulosum en caprinos de la región del NOA. En marzo de 2023, el Servicio de Diagnóstico Veterinario Especializado INTA Salta, realizó una visita diagnóstica a un establecimiento de cría caprino de raza Criolla, ubicado en las cercanías de la ciudad capital de Salta, Argentina. El motivo de la visita fue por la muerte de una cabra que, según el relato del propietario, previo a su muerte presentó un cuadro de cólico y disnea, con pérdida progresiva de la condición corporal. Ante la sospecha de un cuadro parasitario, se decidió recolectar el tracto digestivo para la determinación de especímenes adultos. Se pudo observar la presencia de Haemonchus contortus en el abomaso, de Trichostrongylus colubriformis en el intestino delgado, y de O. venulosum en el colon. El hallazgo de O. venulosum en caprinos se suma a los informes de dicho NGI en otras especies de animales de interés zootécnico del NOA, y es, hasta nuestros conocimientos, la primera descripción en caprinos a nivel nacional.

El objetivo del presente estudio fue determinar la relación entre la actividad física con el deterioro cognitivo en adultos mayores;esta investigación tiene un enfoque cuantitativo, de diseño no experimental, transversal, de tipo descriptivo y causal que llegó a evaluar a un total de 203 sujetos mediante el cuestionario de Pfeiffer (SPMSQ) y el cuestionario internacional de actividad física IPAQ. Con respecto a los resultados se encontró que, en la actividad física un 33.99% de los evaluados tienen actividad moderada, un 33% tiene actividad alta y un 21.67% tiene actividad baja;en el deterioro cognitivo un 71.43% no cuenta con deterioro, un 16.26% tiene un deterioro leve y un 12.32% tiene un deterioro moderado; en el análisis de regresión se determinó, a un nivel de confianza del 95%, que la actividad física se relaciona con el deterioro cognitivo (p=0.02, p

ObjectiveTo assess quality of life and explore its associated factors in a group of patients with chronic kidney disease (CKD) undergoing hemodialysis in Peru.MethodologyWe conducted a cross-sectional analysis of patients with CKD treated at two medical centers in Tacna, Peru; between July and September 2023. We conducted a survey via telephone interviews with eligible patients using the Short Form 36 (SF 36) to assess their quality of life.ResultsOf 257 patients with CKD undergoing hemodialysis, we successfully interviewed 207 (59.9% males, median age: 62 years, median time on hemodialysis: 3.5 years). In the context of the SF-36 assessment, the dimensions with the lowest scores were physical role (mean: 13.9), emotional role (32.2), and physical function (32.4). Regarding the SF-36 summary scores, the average scores were 42.2 in the mental health domain and 32.0 in the physical health domain. In the adjusted model, the physical health domain score was higher in males (β = 2.7) and those with economic self-sufficiency (β = 3.0) and lower in older adults (β = -2.5). The score in the mental health domain was higher in those with a higher level of education (β = 4.1), in those with economic self-sufficiency (β = 3.8), and in those receiving care at one of the centers included (β: 4.2).ConclusionQuality of life was affected, particularly in the realms of physical and emotional well-being. Furthermore, both the physical and mental health domains tend to show lower scores among women, older individuals, those lacking economic self-sufficiency, individuals with lower educational levels, and those with comorbidities.

BackgroundDengue has emerged as an unprecedented epidemic in Peru, and it is anticipated that this issue will escalate further owing to climate change. This study aimed to determine the risk factors associated with death from dengue in patients treated at Hospital II in Pucallpa, Peru.MethodologyThis retrospective cohort study collected information from the medical records of patients with a diagnosis of dengue treated at Hospital II Pucallpa-Peru between January 2019 and March 2023. The primary outcome was death, and the secondary outcome was death, development of severe dengue, or Intensive Care Unit (ICU) admission. Cox regression models were used to determine risk factors.FindingsThe clinical records of 152 patients were evaluated, with a median age of 27.5 years (interquartile range, 11-45). Among all patients, 29 (19.1%) developed severe dengue, 31 (20.4%) were admitted to the ICU, and 13 (8.6%) died during follow-up. In the survival analysis, bilirubin >1.2 mg/dL was associated with a higher risk of death aHR: 11.38 (95% CI: 1.2 106.8). Additionally, factors associated with poor prognosis included having 1 to 3 comorbidities aRR: 1.92 (1.2 to 3.2), AST ≥251 U/L aRR: 6.79 (2.2 to 21.4), history of previous dengue aRR: 1.84 (1.0 to 3.3), and fibrinogen ≥400 mg/dL aRR: 2.23 (1.2 to 4.1).SignificanceElevated bilirubin was associated with death from dengue, whereas an increase in comorbidities and a history of previous dengue were related to a poor prognosis of the disease. Early identification of severe dengue would be more feasible with improved access to laboratory testing, particularly in tropical areas with a high dengue incidence.

Tachycardia-induced cardiomyopathy is an entity characterized by reversible dysfunction of the left ventricle, which can be induced by different types of arrhythmia such as atrial fibrillation, atrial flutter, incessant supraventricular tachycardia and ventricular arrhythmia (more frequent causes). Correct identification of the causative arrhythmia and normalization of the heart rate (e.g through medical treatment, electrical cardioversion, ablation) can lead to recovery of left ventricular function. Tachycardia-induced cardiomyopathy should be suspected in patients with tachycardia and left ventricular dysfunction (heart failure setting), especially when there is no history of previous heart disease. Its usual phenotype is that of non-ischaemic/non-valvular dilated cardiomyopathy and it can occur in both children (main cause: permanent junctional reciprocating tachycardia) and adults (main cause: atrial fibrillation). With proper treatment, most cases recover within a few months, though there is a risk of relapse, especially when the causal arrhythmia reappears or its control is lost. This is a narrative review that comprehensively addresses the pathophysiology, clinical manifestations, and therapeutic management of tachycardia-induced cardiomyopathy. This article is part of the Emerging concepts in heart failure management and treatment Special Issue: https://www.drugsincontext.com/special_issues/emerging-concepts-in-heart-failure-management-and-treatment

The modular multilevel converter has gained popularity in various applications, including photovoltaic (PV) solar energy conversion. Its modular structure allows for the transformation of an MMC into an MMC-based photovoltaic system, sharing key operational characteristics such as modularity, flexibility, redundancy, increased efficiency, and fault tolerance. To ensure the reliability and uninterrupted operation of the modified MMC, even in the event of potential failures in the photovoltaic submodules (PVSMs), a fault-tolerant strategy is developed in this study. It assumes that the Maximum Power Point Tracking (MPPT) of the PVSMs is already guaranteed. Redundant submodules (rSM) are utilized to maintain power balance between the converter arms through voltage control, while reserve submodules (RSMs) are in place to rescue the converter in case of a failure. The detection and localization of faults in the PVSMs/rSMs are achieved through sliding mode observers (SMOs), and the converter reconfiguration is carried out using the proposed permutation algorithms for switching signals and SMs voltages. For precise control of the output current and electrical grid connection, the $dq$ -reference frame control method is employed. To validate these proposed algorithms, time-domain simulations are conducted using the Simulink/Matlab software.

La llegada de la globalización ha sido caracterizada, sin lugar a dudas, por la creciente invasión de la tecnología y con ello una mayor exigencia a todo nivel de las sociedades, grupos e individuos, a ello es importante añadir la necesidad extrínseca de ciertas habilidades que hoy en día son indispensables en el desarrollo de cualquier sujeto para mantenerse competitivo, ya no solamente a nivel individual, sino también en un ámbito colectivo y una de esas habilidades es saber leer de manera comprensiva. Es en esa dirección que el presente artículo analiza la situación real respecto al desarrollo de la lectura comprensiva de estudiantes de tercero de primaria de la Unidad Educativa “Abraham Flores Velásquez” de la comunidad de Alalay quienes mostraron en el apartado del diagnóstico limitaciones en la comprensión de diferentes textos, donde presentan una lectura deletreada, que difícilmente pueden comprender lo que leen.

Pascalia glauca es una de las plantas tóxicas más importantes de Argentina. A pesar de que se sabe que las cabras son susceptibles a la intoxicación por P. glauca, los informes sobre esta especie son escasos. El objetivo de este trabajo fue caracterizar la intoxicación experimental en cabras con P. glauca. Se dividieron 12 cabras adultas de raza Saanen en 4 grupos en función de la cantidad de planta administrada. Los grupos 1 a 3 ingirieron 4 g/kg, 6 g/kg y 8 g/kg de planta seca respectivamente. El cuarto grupo fue el grupo control y se le ofreció solo heno de alfalfa. Los animales intoxicados fueron inspeccionados cada dos horas y se les tomaron muestras de sangre 6, 12, 24 y 48 horas después de la intoxicación para medir los niveles de enzimas hepáticas. Clínicamente, los grupos 2 y 3 mostraron anorexia, depresión, decúbito, mioclonía, convulsiones y muerte entre 9 y 24 horas después de la intoxicación. Los hallazgos patológicos incluyeron necrosis centrolobulillar con y sin hemorragias. Ambos grupos mostraron una actividad elevada de la aspartato aminotransferasa sérica entre 6 y 24 horas después de la ingestión de P. glauca. El grupo control y el grupo 1 no mostraron signos clínicos ni elevación de enzimas hepáticas a pesar de que fueron controlados durante 15 días después de la intoxicación. Este trabajo permitió obtener más información sobre los aspectos clínicos y patológicos de la intoxicación por P. glauca en cabras.

El objetivo de este trabajo fue evaluar los efectos de la suplementación con proteína y cobre en cabras lecheras naturalmente infectadas con nematodos gastrointestinales (NGI) en el Valle de Lerma, provincia de Salta, Argentina. Se analizaron tres grupos de 10 animales cada uno: GSP (grupo suplementado con 19% de proteína y cobre administrado por vía subcutánea a razón de 0,5 ml por cada 20 kg de peso al inicio del ensayo), GSPD (grupo suplementado con proteína y cobre como GSP y desparasitados mensualmente con Derquantel + Abamectina), y GC (grupo control, sin suplementación ni desparasitación). Se realizaron monitoreos cada 15 días desde principios de marzo de 2021 hasta el parto, a fines de julio de 2021. Además, los animales fueron examinados clínicamente y se determinó su condición de Famacha y corporal. Se examinó hematocrito y proteínas séricas, y se realizaron análisis coprológicos para confirmar y determinar la prevalencia de nematodos y EPG. Luego del parto, se midió la producción diaria de leche de cada animal hasta los 90 días de lactancia. Los géneros NGI prevalentes fueron Haemonchus y Trichostrongylus. En el momento del parto, CG difirió significativamente en el recuento de huevos NGI promedio de GSP y GSPD, con 4035 (±4873.8) para CG, 1225 (±1173.5) para GSP y 983 (±1854.8) para GSPD. En cuanto a los parámetros fisiológicos, el hematocrito fue de 27,7% (±4,4) en GC; 31,7% (±5,1) en GSP y 32% (±3,5) en GSPD; las proteínas séricas totales fueron 4 g/dl (±0,62) en GC, 5,8 g/dl (±0,69) en GSP y 6,2 g/dl (±0,61) en GSPD. La producción de leche en los grupos tratados (GSPD: 167,7 l ± 18,2 l; GSP: 153,3 ± 18,2 l) fue mayor que en el GC (85,7 ± 19,2 l). La suplementación proteica tuvo un efecto positivo sobre los parámetros parasitológicos, fisiológicos y productivos. Bajo las condiciones de este estudio, sería recomendable suplementar a los animales 45 días antes del parto para mejorar el control de NGI y la producción de leche.

El objetivo de este estudio fue comprender como la concentración de los sólidos solubles (Cp) y la temperatura (Tp) afectaron el comportamiento reológico de la pulpa de camu-camu. Los factores de Cp (10 – 20 °Brix) y Tp (30 – 60 °C) se variaron según un diseño factorial 3 × 7 con tres repeticiones. Los frutos maduros de camu-camu mostraron características biométricas de peso (10,81 g), diámetro axial (2,55 cm) y ecuatorial (2,68 cm) antes de ser despulpados. Las características fisicoquímicas de la pulpa fueron: solidos solubles (6,26 °Brix), pH (3,46), humedad (92,56%) y ácido ascórbico (1,78 g/100 g). La concentración de la pulpa se realizó en un rotavapor y las mediciones reológicas fueron evaluadas en un viscosímetro de Brookfield. Los parámetros reológicos ayudaron a calcular el índice de consistencia (K: 11,82 a 69,29 Pa·sn) e índice de flujo (n: 0,303 a 0,347) mediante el modelo de Ley de la Potencia (R2 > 0,99), revelando la naturaleza del adelgazamiento al cizallamiento (comportamiento pseudoplástico). La energía de activación varió de 8,51 a 10,21 kJ/mol. Los resultados reológicos de las pulpas concentradas de camu-camu pueden usarse como parámetro de control de calidad y dimensionamiento de equipos, tuberías, intercambiadores de calor, filtros y bombas.

Abstract This study aimed to understand how adding whole-banana flour (WBF) affected the physicochemical properties of extrudates intended for the development of breakfast flakes. The parameters: WBF addition (50% to 70%, dry basis), feed moisture (27% to 33%, wet basis), and barrel temperature in the last zone of the extruder (80 ºC to 100 °C) were varied according to a 23 factorial design with augmented center points. The addition of WBF linearly affected all the physical and chemical properties evaluated and showed a synergistic effect with barrel temperature for changes in hardness and carbohydrate content. WBF additions above 64.9%, adjusted to feed moisture between 29.6% to 32.6%, and thermomechanically cooked at barrel temperatures above 87 °C, consumed 216 to 257 kJ/kg of mechanical energy, which produced flakes with a hardness between 160 and 180 N. This work could contribute to the incorporation of WBF for developing more nutritious breakfast cereals, with a fiber content greater than 7.2 g/100 g.

ABSTRACT Enterotoxigenic Escherichia coli (ETEC) is one of the leading causes of infant diarrhea in low- and middle-income countries (LMICs). Diarrheal pathogens are transmitted through environmental reservoirs; however, the bacterial clones that spread across the human-environment interface remain unexplored. We aimed to determine the relationship and clonal dissemination of ETEC between children with diarrhea and polluted water samples from a local river in La Paz, Bolivia. By using WGS and the PhenePlates phenotypic system to analyze ETEC strains, we showed that ST218 and ST410 LT+STh ETEC expressing the colonization factor (CF) CS23 were found with high frequency in both samples. The CS23 ETEC isolates were found within several STs, E. coli phylogroups, and across ETEC lineages. Comparative genomic evaluation and PhenePlate screening of globally distributed clinical ETEC strains suggest that the CS23 gene is likely carried on plasmids acquired independently of the bacterial chromosomal background. Clinical strains were more often multidrug-resistant (MDR) than environmental isolates and harbored the class 1 integron-integrase gene intI1 next to the MDR cassettes. Retrospective analysis of antibiotic resistance in ETEC revealed a high frequency of MDR in clinical isolates. The LT+STh CS23 environmental ETEC isolates, showed an increased biofilm ability at environmental temperature, equal cytotoxicity, and significantly lower adherence to human epithelial cells compared to ETEC expressing other CFs. Together, we suggest that CS23 is more prevalent in ETEC than previously estimated, and the Choqueyapu River is a reservoir for LT+STh CS23 ETEC containing strains capable of causing diarrheal cases in children. IMPORTANCE The importance of clean water cannot be overstated. It is a vital resource for maintaining health and well-being. Unfortunately, water sources contaminated with fecal discharges from animal and human origin due to a lack of wastewater management pose a significant risk to communities, as they can become a means of transmission of pathogenic bacteria like enterotoxigenic E. coli (ETEC). ETEC is frequently found in polluted water in countries with a high prevalence of diarrheal diseases, such as Bolivia. This study provides novel insights into the circulation of ETEC between diarrheal cases and polluted water sources in areas with high rates of diarrheal disease. These findings highlight the Choqueyapu River as a potential reservoir for emerging pathogens carrying antibiotic-resistance genes, making it a crucial area for monitoring and intervention. Furthermore, the results demonstrate the feasibility of a low-cost, high-throughput method for tracking bacterial pathogens in low- and middle-income countries, making it a valuable tool for One Health monitoring efforts.

ABSTRACT The increasing prevalence of antibiotic-resistant bacteria is an emerging threat to global health. The analysis of antibiotic-resistant enterobacteria in wastewater can indicate the prevalence and spread of certain clonal groups of multiresistant bacteria. In a previous study of Escherichia coli that were isolated from a pump station in Norway over 15 months, we found a recurring E. coli clone that was resistant to trimethoprim, ampicillin, and tetracycline in 201 of 3,123 analyzed isolates (6.1%). 11 representative isolates were subjected to whole-genome sequencing and were found to belong to the MLST ST2797 E. coli clone with plasmids carrying resistance genes, including blaTEM-1B, sul2, dfrA7, and tetB. A phenotypic comparison of the ST2797 isolates with the uropathogenic ST131 and ST648 that were repeatedly identified in the same wastewater samples revealed that the ST2797 isolates exhibited a comparable capacity for temporal survival in wastewater, greater biofilm formation, and similar potential for the colonization of mammalian epithelial cells. ST2797 has been isolated from humans and has been found to carry extended spectrum β-lactamase (ESBL) genes in other studies, suggesting that this clonal type is an emerging ESBL E. coli. Collectively, these findings show that ST2797 was more ubiquitous in the studied wastewater than were the infamous ST131 and ST648 and that ST2797 may have similar abilities to survive in the environment and cause infections in humans. IMPORTANCE The incidence of drug-resistant bacteria found in the environment is increasing together with the levels of antibiotic-resistant bacteria that cause infections. The COVID-19 pandemic has shed new light on the importance of monitoring emerging threats and finding early warning systems. Therefore, to mitigate the antimicrobial resistance burden, the monitoring and early identification of antibiotic-resistant bacteria in hot spots, such as wastewater treatment plants, are required to combat the occurrence and spread of antibiotic-resistant bacteria. Here, we applied a PhenePlate system as a phenotypic screening method for genomic surveillance and discovered a dominant and persistent E. coli clone ST2797 with a multidrug resistance pattern and equivalent phenotypic characteristics to those of the major pandemic lineages, namely, ST131 and ST648, which frequently carry ESBL genes. This study highlights the continuous surveillance and report of multidrug resistant bacteria with the potential to spread in One Health settings.

Background The objective of this study was to identify antibiotic stewardship (AS) opportunities in Latin American medical–surgical intensive care units (MS-ICUs) and general wards (Gral-wards). Methods We conducted serial cross-sectional point prevalence surveys in MS-ICUs and Gral-wards in 41 Latin American hospitals between March 2022 and February 2023. Patients >18 years of age in the units of interest were evaluated for antimicrobial use (AU) monthly (MS-ICUs) or quarterly (Gral-wards). Antimicrobial data were collected using a standardized form by the local AS teams and submitted to the coordinating team for analysis. Results We evaluated AU in 5780 MS-ICU and 7726 Gral-ward patients. The hospitals' median bed size (interquartile range) was 179 (125–330), and 52% were nonprofit. The aggregate AU prevalence was 53.5% in MS-ICUs and 25.5% in Gral-wards. Most (88%) antimicrobials were prescribed to treat infections, 7% for surgical prophylaxis and 5% for medical prophylaxis. Health care–associated infections led to 63% of MS-ICU and 38% of Gral-ward AU. Carbapenems, piperacillin-tazobactam, intravenous (IV) vancomycin, and ampicillin-sulbactam represented 50% of all AU to treat infections. A minority of IV vancomycin targeted therapy was associated with documented methicillin-resistant Staphylococcus aureus infection or therapeutic drug monitoring. In both units, 17% of antibiotics prescribed as targeted therapy represented de-escalation, while 24% and 15% in MS-ICUs and Gral-wards, respectively, represented an escalation of therapy. In Gral-wards, 32% of antibiotics were used without a microbiologic culture ordered. Half of surgical prophylaxis antibiotics were prescribed after the first 24 hours. Conclusions Based on this cohort, areas to improve AU in Latin American hospitals include antibiotic selection, de-escalation, duration of therapy, and dosing strategies. [ABSTRACT FROM AUTHOR]

Evo Morales rose to power on the shoulders of Bolivia's most powerful social movements, ostracizing the neoliberal elite with a progressive-left populist discourse that swept through Latin America. After nearly 14 years in power, Morales's caudillo-style leadership shifted toward authoritarianism and a politics of division that ultimately led to his ouster as president. While many have been quick to adopt the narrative of a coup d'état, this perspective plays directly into the oversimplified binary politics used by the Morales administration, overlooking the complexity and fluidity of social forces and the changing state-society dynamics over time. Evo Morales suffered a crisis of legitimacy that was years in the making. His authoritarian tendencies, alliances with capitalists, and reliance on the extractive economy ultimately led to his downfall as he lost support from his social bases and was unwilling to give up state power. The electoral scandal in October 2019 and the subsequent departure of Evo Morales into political exile were only the tip of the iceberg. Evo Morales accedió al poder gracias a los movimientos sociales más poderosos de Bolivia, en conflicto con la élite neoliberal y utilizando un discurso populista de izquierda progresista que se extendió por América Latina. Después de casi 14 años en el poder, el liderazgo caudillista de Morales viró hacia el autoritarismo y una política divisoria que finalmente llevó a su destitución como presidente. Si bien muchos se han apresurado a adoptar la narrativa de un golpe de Estado, esta perspectiva se enfila directamente con la política binaria simplista utilizada por la administración misma de Morales, pasando por alto la complejidad y fluidez de las fuerzas sociales, así como la dinámica cambiante estado-sociedad a través del tiempo. Morales sufrió una crisis de legitimidad que se gestó durante años. Sus tendencias autoritarias, sus alianzas con las clases capitalistas y su dependencia de la economía extractiva finalmente llevaron a su caída: perdió el apoyo de sus bases sociales sin estar dispuesto a renunciar al poder estatal. El escándalo electoral de octubre de 2019 y su posterior exilio político fueron tan solo la punta del iceberg. [ABSTRACT FROM AUTHOR]

Olive leaves are residues from pruning and harvesting and are considered an environmental management problems. Interestingly, these residues contain high polyphenol concentrations, which can be used to treat chronic diseases. However, these compounds are a technological challenge due to their thermolability and reactivity during extraction. Thus, this study assessed the use of pressurized liquid extraction (PLE) with green solvents like water-ethanol and water-glycerol mixtures (0–15%) at 50 °C and 70 °C to yield polyphenol-rich antioxidant extracts with reduced glucose and fructose content. The use of 30% ethanol at 70°C presented the highest polyphenol content (15.29 mg gallic acid equivalent/g dry weight) and antioxidant capacity, which was expressed as IC50 (half maximal inhibitory concentration): 5.49 mg/mL and oxygen radical absorbance capacity (ORAC): 1259 μmol Trolox equivalent/g dry weight, as well as lower sugar content (glucose: 3.75 mg/g dry weight, fructose: 5.68 mg/g dry weight) compared to water–glycerol mixtures. Interestingly, ethanol exhibits a higher degree of effectiveness in recovering flavanols, stilbenes and secoiridoids, while glycerol improves the extraction of phenolic acids and flavonols. Therefore, to enhance the efficiency of polyphenol recovery during the PLE process, it is necessary to consider its solvent composition and chemical structure.

Salar de Ascotán is a high-altitude arsenic-rich salt flat exposed to high ultraviolet radiation in the Atacama Desert, Chile. It hosts unique endemic flora and fauna and is an essential habitat for migratory birds, making it an important site for conservation and protection. However, there is limited information on the resident microbiota’s diversity, genomic features, metabolic potential, and molecular mechanisms that enable it to thrive in this extreme environment. We used long- and short-read metagenomics to investigate the microbial communities in Ascotán’s water, sediment, and soil. Bacteria predominated, mainly Pseudomonadota, Acidobacteriota, and Bacteroidota, with a remarkable diversity of archaea in the soil. Following hybrid assembly, we recovered high-quality bacterial (101) and archaeal (6) metagenome-assembled genomes (MAGs), including representatives of two putative novel families of Patescibacteria and Pseudomonadota and two novel orders from the archaeal classes Halobacteriota and Thermoplasmata. We found different metabolic capabilities across distinct lineages and a widespread presence of genes related to stress response, DNA repair, and resistance to arsenic and other metals. These results highlight the remarkable diversity and taxonomic novelty of the Salar de Ascotán microbiota and its rich functional repertoire, making it able to resist different harsh conditions. The highly complete MAGs described here could serve future studies and bioprospection efforts focused on salt flat extremophiles, and contribute to enriching databases with microbial genome data from underrepresented regions of our planet.

Several recent studies have evidenced the relevance of machine-learning for soil salinity mapping using Sentinel-2 reflectance as input data and field soil salinity measurement (i.e., Electrical Conductivity-EC) as the target. As soil EC monitoring is costly and time consuming, most learning databases used for training/validation rely on a limited number of soil samples, which can affect the model consistency. Based on the low soil salinity variation at the Sentinel-2 pixel resolution, this study proposes to increase the learning database’s number of observations by assigning the EC value obtained on the sampled pixel to the eight neighboring pixels. The method allowed extending the original learning database made up of 97 field EC measurements (OD) to an enhanced learning database made up of 691 observations (ED). Two classification machine-learning models (i.e., Random Forest-RF and Support Vector Machine-SVM) were trained with both OD and ED to assess the efficiency of the proposed method by comparing the models’ outcomes with EC observations not used in the models´ training. The use of ED led to a significant increase in both models’ consistency with the overall accuracy of the RF (SVM) model increasing from 0.25 (0.26) when using the OD to 0.77 (0.55) when using ED. This corresponds to an improvement of approximately 208% and 111%, respectively. Besides the improved accuracy reached with the ED database, the results showed that the RF model provided better soil salinity estimations than the SVM model and that feature selection (i.e., Variance Inflation Factor-VIF and/or Genetic Algorithm-GA) increase both models´ reliability, with GA being the most efficient. This study highlights the potential of machine-learning and Sentinel-2 image combination for soil salinity monitoring in a data-scarce context, and shows the importance of both model and features selection for an optimum machine-learning set-up.

La coccidiosis es una infección intestinal causada por protozoos del género Eimeria. Cuando la enfermedad ocurre en invierno se conoce como coccidiosis de invierno. En julio de 2021, dos terneros fueron remitidos al INTA-Salta SDVE para determinar la causa de la muerte. Estos animales pertenecían a un rebaño que había presentado signos clínicos, como diarrea sanguinolenta, mal estado y muerte. Posteriormente, se decidió realizar una visita al establecimiento en donde se tomaron muestras de heces en la finca para estudios parasitológicos y se realizó la necropsia de otro animal muerto del mismo rodeo en una visita realizada al establecimiento. Sumado a esto, se recolectaron datos meteorológicos (Tmax, Tmin, Tmed) en el periodo previo a la muerte de los animales y al momento del brote. Los tres terneros a los que se les realizó la necropsia mostraron engrosamiento de la mucosa del ciego, colon y recto, con presencia de ulceraciones en la mucosa del ciego y coágulos de fibrina. Los valores medios de OPG fueron 986,6 (±1693,06), oscilando entre 0 y 5040 OPG y la especie de mayor prevalencia fue Eimeria zuernii. Por otro lado, se observó que las muertes estuvieron relacionadas al momento en donde las temperaturas disminuyeron. Con base en los resultados de los estudios, concluimos que el diagnóstico es coccidiosis de invierno.

Objetivo. Evaluar las características epidemiológicas, clínicas, quirúrgicas, patológicas y desenlaces en el seguimiento de los pacientes receptores de trasplante cardiaco en el Instituto Nacional Cardiovascular durante 2010-2020. Materiales y métodos. Estudio retrospectivo descriptivo de pacientes sometidos a trasplante cardiaco en un centro de referencia nacional, se describen las características clínicas, quirúrgicas, de laboratorio, de patología y la supervivencia de los pacientes hasta los 10 años de seguimiento. Resultados. Ochenta y seis pacientes fueron trasplantados en 10 años, la mediana de edad fue de 41 años (RIQ 28-56), con predominancia de varones (66,3%). Las tres primeras causas de indicación de trasplante cardiaco fueron: cardiomiopatía dilatada (48,9%), cardiopatía isquémica (17,4%) y miocarditis (6,9%). El tiempo de isquemia total fue de 160 min (RIQ 129,7-233,5). La sobrevida al año, cinco y diez años fue de 84,8%, 73,6% y 65,7%, respectivamente. La principal causa de muerte fue la infecciosa (39,1%) y de origen desconocido (26%). Conclusiones. La principal etiología de la insuficiencia cardiaca en el receptor de trasplante cardiaco en el Perú, en los últimos años, fue la cardiomiopatía dilatada no isquémica. Se observa que la tasa de sobrevida fue similar a la de registros internacionales; sin embargo, la tasa de mortalidad de causa infecciosa y muerte de origen desconocido es alta, lo cual plantea un desafío en el manejo de los pacientes postrasplante.

La presente investigación tuvo como finalidad establecer la relación entre el clima organizacional y la satisfacción laboral del personal administrativo universitario. Es de enfoque cuantitativo, alcance correlacional de diseño no experimental. Se consideró como población de estudio 251 trabajadores administrativos, tomando una muestra no probabilística de 111 trabajadores de la sede central y filiales de la Universidad Andina del Cusco. Para la medición de las variables se utilizó el cuestionario de Clima Organizacional Universitario (CCLIOU) que comprende 64 ítems distribuidos en cuatro dimensiones; y la Escala Multidimensional de Satisfacción Laboral (EMSLA) de 34 ítems distribuidos en 8 dimensiones. Los resultados al 95% de confianza, mediante el coeficiente de correlación de Spearman, demuestran que existe una relación positiva media de 0.337 entre el clima organizacional y la satisfacción laboral en trabajadores administrativos en la sede central y filiales; por otra parte, existe relación entre la satisfacción laboral con los componentes del clima organizacional: imagen gerencial, relaciones sociales, toma de decisiones y tarea.

Debido a la escasez y elevados costos de transporte de agregados pétreos en el oriente y noreste de Bolivia, se han buscado diferentes alternativas para su sustitución parcial o completa en la industria de la construcción y, específicamente, para la fabricación de hormigón. La presente investigación tiene como objetivo la evaluación de la trabajabilidad, resistencia a la compresión y velocidad de pulso ultrasónico (VPU) del hormigón producido totalmente con agregados gruesos lateríticos y un aditivo superplastificante comercial. Mediante el método IPT/EPUSP, se dosificó un hormigón con agregado grueso laterítico para 30 MPa (resistencia a la compresión de diseño). Se consideraron cinco diferentes porcentajes de aditivo (en peso del cemento): 0% (referencia), 0.6, 0.8, 1 y 1.2%. Si bien el aditivo superplastificante mejora la trabajabilidad a mayores porcentajes, las mezclas con 0.6, 0.8 y 1% presentaron mayor resistencia a la compresión y VPU, cuando se compararon a la referencia (0%). 1.2% de aditivo presentó los menores valores de resistencia a la compresión y VPU. El uso de aditivos, en este caso superplastificante, resulta beneficioso para la trabajabilidad y resistencia a compresión del hormigón laterítico; no obstante, se deben definir los contenidos más adecuados para su utilización.

BackgroundReplacement of cytology screening with HPV testing is recommended and essential for cervical cancer elimination. HPV testing for primary screening was implemented in 12 laboratories within 9 Latin American countries, as part of the ESTAMPA cervical cancer screening study. Our observations provide information on critical operational aspects for HPV testing implementation in diverse resource settings.MethodsWe describe the implementation process of HPV testing in ESTAMPA, focusing on laboratory aspects. We assess the readiness of 12 laboratories to start HPV testing and their continuity capacity to maintain good quality HPV testing until end of recruitment or up to December 2021. Readiness was based on a checklist. Information from the study database; regular meetings and monitoring visits; and a questionnaire on laboratory operational aspects sent in May 2020 were used to assess continuity capacity. Compliance with seven basic requirements (readiness) and eight continuity requirements (continuity capacity) was scored (1 = compliant, 0 = not compliant) and totaled to classify readiness and continuity capacity as very limited, limited, moderate or high. Experiences, challenges, and enablers of the implementation process are also described.ResultsSeven of 12 laboratories had high readiness, three moderate readiness, and of two laboratories new to HPV testing, one had limited readiness and the other very limited readiness. Two of seven laboratories with high readiness also showed high continuity capacity, one moderate continuity capacity, and the other four showed limited continuity capacity since they could not maintain good quality HPV testing over time. Among three laboratories with moderate readiness, one kept moderate continuity capacity and two reached high continuity capacity. The two laboratories new to HPV testing achieved high continuity capacity. Based on gained expertise, five laboratories have become part of national screening programs.ConclusionHigh readiness of laboratories is an essential part of effective implementation of HPV testing. However, high readiness is insufficient to guarantee HPV testing high continuity capacity, for which a “culture of quality” should be established with regular training, robust monitoring and quality assurance systems tailored to local context. All efforts to strengthen HPV laboratories are valuable and crucial to guarantee effective implementation of HPV-based cervical screening.

BackgroundIodine is essential for the biosynthesis of thyroid hormones, which are crucial for intrauterine growth and fetal neurocognitive development. Iodine requirements increase during pregnancy and lactation. The World Health Organization and the Swiss Confederation recommend a total daily iodine intake of 250 µg of iodine during preconception, pregnancy and lactation. To assure this goal, several professional organizations recommend complementing the nutritional iodine intake with supplements containing 150 μg of iodine daily.MethodsPrenatal and adult multivitamins widely available in Switzerland were compiled to determine their iodine content. Obstetricians verified that the list includes the most frequently prescribed supplements in Switzerland.ResultsA total of 44 adult multivitamin supplements were identified, 23 of which are specifically intended for women planning pregnancy, pregnant, or breastfeeding. Seven out of 23 (30.4%) prenatal multivitamins products, and 12/21 (57.1%) adult multivitamins contained no iodine. Among all the products, only 18/44 (40.9%) contain 150 µg of iodine or more.ConclusionSeveral widely used products contain no or insufficient amounts (

ABSTRACT Traditional studies on the evolution of antibiotic resistance development use approaches that can range from laboratory-based experimental studies, to epidemiological surveillance, to sequencing of clinical isolates. However, evolutionary trajectories also depend on the environment in which selection takes place, compelling the need to more deeply investigate the impact of environmental complexities and their dynamics over time. Herein, we explored the within-patient adaptive long-term evolution of a Pseudomonas aeruginosa hypermutator lineage in the airways of a cystic fibrosis (CF) patient by performing a chronological tracking of mutations that occurred in different subpopulations; our results demonstrated parallel evolution events in the chromosomally encoded class C β-lactamase (blaPDC). These multiple mutations within blaPDC shaped diverse coexisting alleles, whose frequency dynamics responded to the changing antibiotic selective pressures for more than 26 years of chronic infection. Importantly, the combination of the cumulative mutations in blaPDC provided structural and functional protein changes that resulted in a continuous enhancement of its catalytic efficiency and high level of cephalosporin resistance. This evolution was linked to the persistent treatment with ceftazidime, which we demonstrated selected for variants with robust catalytic activity against this expanded-spectrum cephalosporin. A “gain of function” of collateral resistance toward ceftolozane, a more recently introduced cephalosporin that was not prescribed to this patient, was also observed, and the biochemical basis of this cross-resistance phenomenon was elucidated. This work unveils the evolutionary trajectories paved by bacteria toward a multidrug-resistant phenotype, driven by decades of antibiotic treatment in the natural CF environmental setting. IMPORTANCE Antibiotics are becoming increasingly ineffective to treat bacterial infections. It has been consequently predicted that infectious diseases will become the biggest challenge to human health in the near future. Pseudomonas aeruginosa is considered a paradigm in antimicrobial resistance as it exploits intrinsic and acquired resistance mechanisms to resist virtually all antibiotics known. AmpC β-lactamase is the main mechanism driving resistance in this notorious pathogen to β-lactams, one of the most widely used classes of antibiotics for cystic fibrosis infections. Here, we focus on the β-lactamase gene as a model resistance determinant and unveil the trajectory P. aeruginosa undertakes on the path toward a multidrug-resistant phenotype during the course of two and a half decades of chronic infection in the airways of a cystic fibrosis patient. Integrating genetic and biochemical studies in the natural environment where evolution occurs, we provide a unique perspective on this challenging landscape, addressing fundamental molecular mechanisms of resistance.