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We compared the cost-effectiveness (CE) of an active case-finding (ACF) programme for household contacts of tuberculosis (TB) cases enrolled in first-line treatment to routine passive case-finding (PCF) within an established national TB programme in Peru. Decision analysis was used to model detection of TB in household contacts through: (1) self-report of symptomatic cases for evaluation (PCF), (2) a provider-initiated ACF programme, (3) addition of an Xpert MTB/RIF diagnostic test for a single sputum sample from household contacts, and (4) all strategies combined. CE was calculated as the incremental cost-effectiveness ratio (ICER) in terms of US dollars per disability-adjusted life years (DALYs) averted. Compared to PCF alone, ACF for household contacts resulted in an ICER of $2155 per DALY averted. The addition of the Xpert MTB/RIF diagnostic test resulted in an ICER of $3275 per DALY averted within a PCF programme and $3399 per DALY averted when an ACF programme was included. Provider-initiated ACF of household contacts in an urban setting of Lima, Peru can be highly cost-effective, even including costs to seek out contacts and perform an Xpert/MTB RIF test. ACF including Xpert MTB/RIF was not cost-effective if TB cases detected had high rates of default from treatment or poor outcomes.

Our center launched the first antimicrobial stewardship program in Peru. From 2016 to 2023, the proportion of antimicrobial prescriptions audited increased from 60% to 95%, and 65% to 95% of recommendations were accepted. Vancomycin and meropenem use dropped by 95% and 84%, respectively. The proportion of recommendations for surgical prophylaxis exceeded 90%. [ABSTRACT FROM AUTHOR]

Clinical and epidemiological features of 7 human immunodeficiency virus–negative Peruvian patients coinfected with human T-lymphotropic virus type 1 (HTLV-1) and cryptococcosis (2006–2017) were studied. Most cases had meningeal involvement, were male, and originated from Peru's jungle. Patients with cryptococcosis should be tested for HTLV-1 in endemic areas of this retrovirus. [ABSTRACT FROM AUTHOR]

Tests, assessments, and evaluation instruments have long been ill-equipped to account for practices of translanguaging inherent within multilingual communities. Within the field of testing and assessment, much more emphasis has been placed on ensuring the design principles of the assessment. Countering over 100 years of deficit positioning of multilingualism in testing, recent work has emerged that values the knowledge, beliefs, and experiences of teachers. Drawing on Hornberger's (2005) distinction between ideological and implementational spaces, this participatory action research project examines translanguaging and assessment practices during a 5-week online course for classroom language testing for four Spanish/English bilingual teachers working in dual language bilingual education programs in elementary schools in the United States. Transcripts from online synchronous (via Zoom) and asynchronous discussions and individual and paired assignments served as our key data sources. We illustrate the co-learning, co-planning, and co-shifting of translanguaging and assessment practices during this course. We argue that collaboration such as the work presented in this paper is critical for creating communities to open and expand ideological and implementational spaces for translanguaging in general and in testing specifically. [ABSTRACT FROM AUTHOR]

Infiltrating gliomas are challenging to treat, as the blood-brain barrier significantly impedes the success of therapeutic interventions. While some clinical trials for high-grade gliomas have shown promise, patient outcomes remain poor. Microbubble-enhanced focused ultrasound (MB-FUS) is a rapidly evolving technology with demonstrated safety and efficacy in opening the blood-brain barrier across various disease models, including infiltrating gliomas. Initially recognized for its role in augmenting drug delivery, the potential of MB-FUS to augment liquid biopsy and immunotherapy is gaining research momentum. In this review, we will highlight recent advancements in preclinical and clinical studies that utilize focused ultrasound to treat gliomas and discuss the potential future uses of image-guided precision therapy using focused ultrasound. [ABSTRACT FROM AUTHOR]

BackgroundWe designed a pragmatic stepped-wedge cluster randomized controlled trial in order to evaluate provider-initiated evaluation of household contacts (HCs) of smear positive tuberculosis (TB) cases within a routine TB program in Lima, Peru.Methods/designNational TB program (NTP) officers of San Juan de Lurigancho District (Lima, Peru) and university-based researchers jointly designed a pragmatic stepped-wedge cluster randomized trial design in order to evaluate a planned active case finding (ACF) program for all HCs of smear-positive TB cases in 34 district healthcare centres. Randomization of time to intervention initiation was stratified by health centre TB case rate. The ACF intervention included provider-initiated home visits of all new sputum smear positive TB patients in order to evaluate household contacts for active TB. Active TB was diagnosed using symptom screening, sputum screening, chest x-ray and clinical evaluation. Once initiated, ACF was provided by NTP staff and integrated into the routine DOTS TB program activities.DiscussionThis study protocol describes the pragmatic stepped-wedge cluster randomized trial of active household contact evaluations within an NTP. The stepped-wedge design met overlapping needs of local TB programmers and researchers to adequately evaluate the large-scale roll out of a new control program in a TB endemic setting. Multiple planning meetings were required to develop the necessary networks and in order to understand the operations, needs and goals of the NTP staff and researchers collaborating on this project. The advantages and challenges of using this study design in practice and within existing routine TB programs in a middle-income country context are discussed.Trial registrationClinicalTrials.gov NCT02174380. Registered 24 Jun 2014.

Background: Active case finding (ACF) in household contacts of tuberculosis (TB) patients is now recommended for National TB Programs (NTP) in low- and middle-income countries. However, evidence supporting these recommendations remains limited. This study evaluates the effectiveness and cost-effectiveness of ACF for household contacts of TB cases in a large TB endemic district of Lima, Peru. Methods: A pragmatic stepped-wedge cluster randomized controlled trial was conducted in 34 health centers of San Juan de Lurigancho district. Centers were stratified by TB rate and randomly allocated to initiate ACF in groups of eight or nine centers at four-month intervals. In the intervention arm, NTP providers visited households of index patients to screen contacts for active TB. The control arm was routine passive case finding (PCF) of symptomatic TB cases. The primary outcomes were the crude and adjusted active TB case rates among household contacts. Program costs were directly measured, and the cost-effectiveness of the ACF intervention was determined. Findings: 3222 index TB cases and 12,566 household contacts were included in the study. ACF identified more household contact TB cases than PCF, 199.29/10,000 contacts/year vs. 132.13 (incidence rate ratio of 1.51 (95% CI 1.21–1.88)). ACF was associated with an incremental cost-effectiveness ratio of US $16,400 per disability-adjusted life year averted and not cost-effective assuming a willingness-to-pay threshold for Peru of US $6360. Conclusion: ACF of TB case household contacts detected significantly more secondary TB cases than PCF alone, but was not cost-effective in this setting. In threshold analyses, ACF becomes cost-effective if associated with case detection rates 2.5 times higher than existing PCF programs.

Background: Despite high mortality rates, physicians can alter the course of the Staphylococcus aureus bacteraemia (SAB) by following recommended standards of care. We aim to assess the adherence of these guidelines and their impact on mortality. Methods: Substudy from a prospective cohort of hospitalized patients with SAB from three hospitals from Peru. Hazard ratios were calculated using Cox proportional regression to evaluate the association between 30-day mortality and the performance of standards of care: removal of central venous catheters (CVC), follow-up blood cultures, echocardiography, correct duration, and appropriate definitive antibiotic therapy. Results: 150 cases of SAB were evaluated; 61.33% were MRSA. 30-day attributable mortality was 22.39%. CVC removal was done in 42.86% of patients. Follow-up blood cultures and echocardiograms were performed in 8% and 29.33% of cases, respectively. 81.33% of cases had appropriate empirical treatment, however, only 22.41% of MSSA cases were given appropriate definitive treatment, compared to 93.47% of MRSA. The adjusted regression for all-cause mortality found a substantial decrease in hazards when removing CVC (aHR 0.28, 95% CI: 0.10 - 0.74) and instituting appropriate definitive treatment (aHR 0.27, 95% CI: 0.08 - 0.86), while adjusting for standards of care, qPitt bacteraemia score, comorbidities, and methicillin susceptibility; similar results were found in the attributable mortality model (aHR 0.24, 95% CI: 0.08 - 0.70 and aHR 0.21, 95% CI: 0.06 - 0.71, respectively). Conclusions: Deficient adherence to standards of care was observed, especially definitive treatment for MSSA. CVC removal and the use of appropriate definitive antibiotic therapy reduced the hazard mortality of SAB.

Abstract Background Tuberculosis (TB) transmission has long been recognized as an important occupational hazard for healthcare workers (HCWs). HCWs have a 5.8% annual risk of exposure and three times greater risk of developing active TB than the general population. Methods We conducted an observational cross-sectional study between September 2014 and March 2015 among HCWs in a high-burden TB setting in Lima to estimate the prevalence of positive Tuberculin Skin Test (TST) and to investigate factors associated with a positive TST. Results Two hundred forty participants were included in the analysis; TST was administered to 190 (79.2%) while the rest were exempt due to a previous positive TST result, history of TB, or test refusal. A positive TST result was found among 56.2% of participants to whom the TST was applied (95% CI: 49.22–63.55%). When considering those who had a previous positive TST result and those with a history of TB, the prevalence of a positive TST result was 64.3% (95% CI: 57.8–70.3%). No significant differences were observed between clinical/paramedical and administrative staff in the health center. The use of N95 masks during work hours was reported by 142 (69.9%) participants. Prevalence ratios (PR) show that workers with more than 120 months as a HCW were 1.44 times more likely to be TST positive. The multivariate analysis found that HCWs with over 10 years of service were 1.52 times more likely to be TST positive. Conclusion This study supports previous reports that TB infection is an occupational hazard for HCWs. Prevention of TB transmission through control measures, as well as timely diagnosis of LTBI in this particular high-risk group, is critical for individual and public health.

© 2015 Shah et al. Background: We designed a pragmatic stepped-wedge cluster randomized controlled trial in order to evaluate provider-initiated evaluation of household contacts (HCs) of smear positive tuberculosis (TB) cases within a routine TB program in Lima, Peru. Methods/Design: National TB program (NTP) officers of San Juan de Lurigancho District (Lima, Peru) and university-based researchers jointly designed a pragmatic stepped-wedge cluster randomized trial design in order to evaluate a planned active case finding (ACF) program for all HCs of smear-positive TB cases in 34 district healthcare centres. Randomization of time to intervention initiation was stratified by health centre TB case rate. The ACF intervention included provider-initiated home visits of all new sputum smear positive TB patients in order to evaluate household contacts for active TB. Active TB was diagnosed using symptom screening, sputum screening, chest x-ray and clinical evaluation. Once initiated, ACF was provided by NTP staff and integrated into the routine DOTS TB program activities. Discussion: This study protocol describes the pragmatic stepped-wedge cluster randomized trial of active household contact evaluations within an NTP. The stepped-wedge design met overlapping needs of local TB programmers and researchers to adequately evaluate the large-scale roll out of a new control program in a TB endemic setting. Multiple planning meetings were required to develop the necessary networks and in order to understand the operations, needs and goals of the NTP staff and researchers collaborating on this project. The advantages and challenges of using this study design in practice and within existing routine TB programs in a middle-income country context are discussed. Trial registration: ClinicalTrials.gov NCT02174380. Registered 24 Jun 2014

BACKGROUND:Tuberculosis (TB) transmission may occur with exposure to an infectious contact often in the setting of household environments, but extra-domiciliary transmission also may happen. We evaluated if using buses and/or minibuses as public transportation was associated with acquiring TB in a high incidence urban district in Lima, Peru. METHODS:Newly diagnosed TB cases with no history of previous treatment and community controls were recruited from August to December 2008 for a case-control study. Crude and adjusted odd ratios (OR) and 95% confidence intervals (CI) were calculated using logistic regression to study the association between bus/minibus use and TB risk. RESULTS:One hundred forty TB cases and 80 controls were included. The overall use of buses/minibuses was 44.9%; 53.3% (72/135) among cases and 30.4% (24/79) among controls [OR: 3.50, (95% CI: 1.60-7.64)]. In the TB group, 25.7% (36/140) of subjects reported having had a recent household TB contact, and 13% (18/139) reported having had a workplace TB contact; corresponding figures for controls were 3.8% (3/80) and 4.1% (3/73), respectively[OR: 8.88 (95% CI: 2.64-29.92), and OR: 3.89 (95% CI: 1.10-13.70)]. In multivariate analyses, age, household income, household contact and using buses/minibuses to commute to work were independently associated with TB [OR for bus/minibus use: 11.8 (95% CI: 1.45-96.07)]. CONCLUSIONS:Bus/minibus use to commute to work is associated with TB risk in this high-incidence, urban population in Lima, Peru. Measures should be implemented to prevent TB transmission through this exposure.

SettingPeru reports among the highest multidrug-resistant tuberculosis (MDR-TB) rates in the Americas, with a growing proportion in previously untreated tuberculosis (TB) cases. The identification of clusters of primary MDR-TB compared with drug-susceptible TB (DS-TB) could help prioritize interventions.ObjectiveTo examine the clustering of primary MDR-TB case residences and their proximity to high-risk locations in San Juan de Lurigancho District, Lima, Peru.DesignEnrolled primary MDR-TB and primary DS-TB cases were interviewed and their primary residence was recorded using handheld Global Positioning System devices. Kuldorff's spatial scan statistic was used for cluster detection (SaTScan(TM), v. 9.1.1). Identified clusters were visualized in Quantum Geographic Information Systems software (v1.8.0). The following cluster centers were tested: a health centre with the highest TB and MDR-TB rates (Clinic X), a hospital and two prisons. Using regression analyses, we examined predictors of primary MDR-TB cases.ResultsA statistically significant cluster of primary MDR-TB cases was identified within a 2.29 km radius around Clinic X. Proximity to Clinic X remained a significant predictor of primary MDR-TB in adjusted regression analyses.ConclusionWe identified a hotspot of primary MDR-TB cases around Clinic X in a TB-endemic area. Causes of this clustering require investigation; targeted interventions for this high-risk area should be considered.

Subcallosal cingulate (SCC) deep brain stimulation (DBS) is an emerging therapy for refractory depression. Good clinical outcomes are associated with the activation of white matter adjacent to the SCC. This activation produces a signature cortical evoked potential (EP), but it is unclear which of the many pathways in the vicinity of SCC is responsible for driving this response. Individualized biophysical models were built to achieve selective engagement of two target bundles: either the forceps minor (FM) or cingulum bundle (CB). Unilateral 2 Hz stimulation was performed in seven patients with treatment-resistant depression who responded to SCC DBS, and EPs were recorded using 256-sensor scalp electroencephalography. Two distinct EPs were observed: a 120 ms symmetric response spanning both hemispheres and a 60 ms asymmetrical EP. Activation of FM correlated with the symmetrical EPs, while activation of CB was correlated with the asymmetrical EPs. These results support prior model predictions that these two pathways are predominantly activated by clinical SCC DBS and provide first evidence of a link between cortical EPs and selective fiber bundle activation. [ABSTRACT FROM AUTHOR]

Rosalina Penaloza,1–3 Joanna Itzel Navarro,1,4,5 Pauline E Jolly,1 Anna Junkins,1 Carlos Seas,6,7 Larissa Otero6,7 1University of Alabama at Birmingham, School of Public Health, Department of Epidemiology, Birmingham, AL, USA; 2David Geffen School of Medicine, University of California, Los Angeles, CA, USA; 3Charles R. Drew University, College of Medicine and Science, Los Angeles, CA, USA; 4Graduate School of Education and Information Systems, University of California, Los Angeles, CA, USA; 5Henry Samueli School of Engineering and Applied Science, University of California, Los Angeles, CA, USA; 6Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru; 7Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Peru Background: Tuberculosis (TB) case detection in Peru relies on passive case finding. This strategy relies on the assumption that the community is aware that a persistent cough or contact with a TB patient is an indication to seek formal health care. This study evaluated health literacy and TB knowledge among outpatients at Hospital Cayetano Heredia in Lima, Peru.Methods: A cross-sectional survey was performed between June and August 2017. Data on sociodemographic factors, TB knowledge, and health literacy were collected, and bivariate and multivariate logistic regressions were performed to study the associations between variables. Results: The analysis included 272 participants; 57.7% knew someone who had TB and 9% had TB in the past. A 2-week cough was reported as a TB symptom by 66 (24%) participants. High TB knowledge was found among 149 (54.8%) participants and high health literacy was found among 193 (71.0%) participants. Health literacy and TB knowledge were not significantly associated (OR=0.9; 95% CI 0.5–1.5). After controlling for sex, age, district, education, health insurance, frequency of hospital visits, and previous TB diagnosis, high TB knowledge was associated with knowing someone with TB (aOR=2.7; 95% CI 1.6–4.7) and inversely associated with being a public transport driver (aOR=0.2; 95% CI 0.05–0.9). Not living in poverty was the single factor associated with high health literacy (aOR=3.8; 95% CI 1.6–8.9). Conclusion: Although TB knowledge was fair, 30% did not know that cough is a symptom of TB and >70% did not know being in contact with a TB patient is a risk factor for TB. Tailoring educational strategies to at-risk groups may enhance passive case detection especially among transport workers and TB contacts in Lima, Peru. Keywords: health literacy, tuberculosis, tuberculosis knowledge, Peru

The effectiveness of a seeded cover crop to minimize soil nutrient losses was evaluated in a rainfed vineyard. Two sediment tanks were installed (ST2: drainage area with high ground cover (GC: 82%) and ST3: very high GC (89%)) and samples from 26 time-integrated periods (TIP) were collected over 15 months. The average soil nutrient content was previously estimated in the drainage areas of ST2 (Ntotal: 0.967 mg/g; Pava: 0.411 mg/g; Kava: 1.762 mg/g) and ST3 (Ntotal: 0.711 mg/g; Pava: 0.437 mg/g; Kava: 1.856 mg/g). The sediment nutrient concentrations and the sediment/soil enrichment ratios were comparable between ST2 and ST3, but the total loss of nutrients clearly differed among areas. The loss of nutrients in the area with lower GC (379.7 g N-P-K/ha/yr) was 8.3 times higher than in the area with higher GC (45.8 g N-P-K/ha/yr), and this pattern remained during the months with low, medium and high GC: 91.9, 2.1 and 2.1 g N-P-K/ha/month in ST2 and 6.9, 3.0 and 3.5 g N-P-K/ha/month in ST3. The benefits of greater GC promote the environmental and agronomic sustainability by the functions of the cover crop, favoring healthy soils and a reduction in the investment of the farmers in fertilizers. This is very relevant in a postpandemic world under the threat of the war in Ukraine, the lack of fertilizers and the need for a local production of food.

Countless uncertainties remain regarding the effects of global warming on biodiversity, including the ability of organisms to adapt and how that will affect obligate symbiotic relationships. The present study aimed to determine the consequences of temperature increase in the adaptation of plant endosymbionts (endophytes) that grow better at low temperatures (psychrophilic). We isolated fungal endophytes from a high-elevation (paramo) endemic plant, Chusquea subtessellata. Initial growth curves were constructed at different temperatures (4–25°C). Next, experiments were carried out in which only the psychrophilic isolates were subjected to repeated increments in temperature. After the experiments, the final growth curves showed significantly slower growth than the initial curves, and some isolates even ceased to grow. While most studies suggest that the distribution of microorganisms will expand as temperatures increase because most of these organisms grow better at 25°C, the results from our experiments demonstrate that psychrophilic fungi were negatively affected by temperature increases. These outcomes raise questions concerning the potential adaptation of beneficial endosymbiotic fungi in the already threatened high-elevation ecosystems. Assessing the consequences of global warming at all trophic levels is urgent because many species on Earth depend on their microbial symbionts for survival.

Resumen La dermatitis atópica o eczema, es la enfermedad cutánea crónica en recaídas más común, que afecta tanto a niños como adultos en todo el mundo y que aparece con frecuencia en familias con otras enfermedades atópicas como el asma, la rinitis alérgica y la alergia alimentaria. Se trata de una enfermedad multifactorial que resultante de la interacción de factores ambientales, defectos en la función barrera y una serie de factores inmunológicos. Este artículo ofrece una visión actualizada de la epidemiología, diagnóstico, tratamiento, prevención y factores que ayudan a disminuir los efectos negativos de la dermatitis atópica en la calidad de vida de los pacientes. Abstract Atopic dermatitis, or eczema, is the most common chronic skin disease in relapses, affecting both children and adults worldwide and appearing frequently in families with other atopic diseases such as asthma, allergic rhinitis, and food allergy. It is a multifactorial disease that results from the interaction of environmental factors, defects in barrier function and a series of immunological factors. This article offers an updated view of the epidemiology, diagnosis, treatment, prevention and factors that help decrease the negative effects of atopic dermatitis on the quality of life of patients.

BackgroundMultiple drug-resistance in new tuberculosis (TB) cases accounts for the majority of all multiple drug-resistant TB (MDR-TB) worldwide. Effective control requires determining which new TB patients should be tested for MDR disease, yet the effectiveness of global screening recommendations of high-risk groups is unknown.MethodsSixty MDR-TB cases with no history of previous TB treatment, 80 drug-sensitive TB and 80 community-based controls were recruited in Lima, Peru between August and December, 2008 to investigate whether recommended screening practices identify individuals presenting with MDR-TB. Odd ratios (OR) and 95% confidence intervals (CI) were calculated using logistic regression to study the association of potential risk factors with case/control variables.ResultsMDR-TB cases did not differ from drug-sensitive TB and community controls in rates of human immunodeficiency virus infection, reported hospital or prison visits in the 3 years prior to diagnosis. MDR-TB cases were more likely than drug-sensitive TB controls to have had a recent MDR-TB household contact (OR 4.66, (95% CI 1.56-13.87)); however, only 15 cases (28.3%) reported this exposure. In multivariate modeling, recent TB household contact, but not contact with an MDR-TB case, remained predictive of MDR-TB, OR 7.47, (95% CI 1.91-29.3). Living with a partner rather than parents was associated with a lower risk of MDR-TB, OR 0.15, (95% CI 0.04-0.51).ConclusionTargeted drug susceptibility testing (DST) linked to reported MDR-TB contact or other high-risk exposures does not identify the majority of new TB cases with MDR disease in Lima where it is endemic. All new TB cases should be screened with DST to identify MDR patients. These findings are likely applicable to other regions with endemic MDR-TB.

Abstract Background Although the study of calcium (Ca2+) is classically associated with excitable cells such as myocytes or neurons, the ubiquity of this essential element in all cellular processes has led to interest in other cell types. The importance of Ca2+ to apoptosis, cell signaling, and immune activation is of special import in cancer. Main Here we review the current understanding of Ca2+ in each of these processes vital to the initiation, spread, and drug resistance of malignancies. We describe the involvement of Ca2+, and Ca2+ related proteins in cell cycle checkpoints and Ca2+ dependent apoptosis and discuss their roles in cellular immortalization. The role of Ca2+ in inter-cellular communication is also discussed in relevance to tumor-stromal communication, angiogenesis, and tumor microinvasion. The role that Ca2+ plays in immune surveillance and evasion is also addressed. Finally, we discuss the possibility of targeting Ca2+ singling to address the most pressing topics of cancer treatment: metastatic disease and drug resistance. Conclusion This review discusses the current understanding of Ca2+ in cancer. By addressing Ca2+ facilitated angiogenesis, immune evasion, metastasis, and drug resistance, we anticipate future avenues for development of Ca2+ as a nexus of therapy.

Abstract Background Since 2006, the Peruvian National TB program (NTP) recommends voluntary counseling and testing (VCT) for all tuberculosis (TB) patients. Responding to the differential burden of both diseases in Peru, TB is managed in peripheral health facilities while HIV is managed in referral centers. This study aims to determine the coverage of HIV screening among TB patients and the characteristics of persons not screened. Methods From March 2010 to December 2011 we enrolled new smear-positive pulmonary TB adults in 34 health facilities in a district in Lima. NTP staff offered VCT to all TB patients. Patients with an HIV positive result were referred for confirmation tests and management. We interviewed patients to collect their demographic and clinical characteristics and registered if patients opted in or out of the screening. Results Of the 1295 enrolled TB patients, nine had a known HIV diagnosis. Of the remaining, 76.1% (979) were screened for HIV. Among the 23.9% (307) not screened, 38.4% (118) opted out of the screening. TB patients at one of the health care facilities of the higher areas of the district (OR = 3.38, CI 95% 2.17–5.28 for the highest area and OR = 2.82, CI 95% 1.78–4.49 for the high area) as well as those reporting illegal drug consumption (OR = 1.65, CI 95% 1.15–2.37) were more likely not to be screened. Twenty-four were HIV positive (1.9% of all patients 1295, or 2.4% of those screened). Of 15 patients diagnosed with HIV during the TB episode, ten were enrolled in an HIV program. The median time between the result of the HIV screening and the first consultation at the HIV program was 82 days (IQR, 32–414). The median time between the result of the HIV screening and antiretroviral initiation was 148.5 days (IQR 32–500). Conclusions An acceptable proportion of TB patients were screened for HIV in Lima. Referral systems of HIV positive patients should be strengthened for timely ART initiation.

This article, published in the Journal of Neurological Surgery, explores the use of machine learning and 3D MRI-based analysis to predict the pathologic grade of skull base meningiomas. The study analyzed preoperative MRIs from 38 patients and used a custom machine learning pipeline to predict the grade of the tumor. The results showed that the machine learning model had an area under the receiver operating characteristic curve (AUROC) of 0.75, indicating its potential for predicting the pathologic grade. However, further research with a larger sample size is needed to validate these findings and improve prognostication for patients with skull base meningiomas. [Extracted from the article]

This article discusses the development of a new technology called "TumorID" that uses machine learning and noncontact fluorescence spectroscopy to analyze meningioma tissue in real-time during surgery. The aim of this technology is to differentiate between Grade 1 and Grade 2 meningiomas, which have different prognostic and management implications. The study found that the multi-layer perceptron and logistic regression models performed the best in predicting the grade of meningiomas, with high accuracy. However, further research is needed to validate these findings on larger sample sizes. The authors hope that this technology will eventually improve the efficiency and accuracy of prognostication for patients with meningiomas. [Extracted from the article]

Fine polyacrylonitrile (PAN) fibers were produced through a scalable centrifugal spinning process. Sodium chloride (NaCI) was added to the PAN-dimethylformamide solution to decrease the surface tension and consequently promote a decrease in fiber diameter while increasing the fiber output. The fiber preparation process involved the centrifugal spinning of the PAN-based solution; developed fibers were stabilized in air at 240[degrees]C followed by carbonization at 800[degrees]C under a Nitrogen atmosphere. The addition of sodium chloride to the PAN solution led to a 37% decrease in the carbon fiber diameter. The carbon fibers were analyzed by scanning electron microcopy, transmission electron microscopy (TEM), X-ray diffraction, X-ray photoelectron spectroscopy (XPS) and electrochemical experiments. The TEM results revealed improved graphitization with the addition of sodium chloride. The XPS analysis showed increased functionality (e.g. [O.sub.2]) on the surface of carbon fibers obtained from PAN/NaCI precursor fibers. A significant improvement was achieved in the electrochemical performance of carbon fibers made from PAN/NaCI precursor fibers compared to those made from pure PAN precursor fibers. POLYM. ENG. SCI., 58:2047-2054, 2018., INTRODUCTIONThe interest in the production of carbon fibers has remained active because of their attractive electrical and thermo-physical properties and therefore, a myriad of potential applications [1, 2]. Carbon fibers [...]

Las universidades como organizaciones educativas que han ido transformándose a lo largo de su historia, a raíz de cambios políticos, sociales, económicos y del trabajo; están llamadas a seguir reinventándose para mejorar e innovar su quehacer, de forma tal que su existencia, responda a las necesidades, retos y desafíos, de manera pertinente, oportuna y de calidad. Los sistemas de posgrado, como parte de la organización universitaria, se ven llamados a liderar y acompañar los procesos de cambio desde su propia gestión, de manera colaborativa con las distintas unidades y en las áreas prioritarias de este tipo de institución educativa, como son, la docencia, la investigación, la extensión y la innovación.