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Violence against women is a global concern, and its control remains challenging, particularly in the context of the Philippines. Despite existing laws aimed at mitigating this issue, many women continue to endure in silence, while dealing with the social stigma and feelings of shame. Addressing this pressing need is crucial to providing support and empowering these women. This study aims to investigate the experiences of women facing violence and the role of education sectors, and local government units, in responding to and preventing violence against women. This study uses a qualitative method employing participatory action research. As a result, many participants highlighted the prevailing culture of silence and the associated stigma that discourages victims from speaking out, often driven by fear of judgment, and societal perceptions, leading to feelings of shame. As to the community, government agencies implement policies and processes effectively, however, there is a lack of established group support that will help victims of violence create safe spaces and dialogue on the issues. Concerning the role of education, participants expressed an integration of Violence Against Women topics into various social studies, gender subjects, and health education to promote awareness and foster an inclusive environment.

Este estudio explora la relación entre violencia familiar y autoestima en estudiantes de una institución educativa rural en el Amazonas. La investigación, de enfoque cuantitativo y diseño descriptivo correlacional, evaluó a 120 estudiantes de secundaria: 58 varones y 62 mujeres, utilizando el test de violencia familiar VIFA y la escala de autoestima de Rosenberg. Los datos fueron analizados mediante estadística descriptiva e inferencial, aplicando pruebas de Chi-cuadrado y el coeficiente de correlación de Spearman. Además, se indica una relación inversa significativa entre violencia familiar y autoestima, con un coeficiente correlacional negativo de -0.704, lo cual implica que a mayores niveles de violencia familiar corresponde una autoestima más baja en los estudiantes. Asimismo, se observó que los varones presentaron niveles más altos de violencia familiar, especialmente en violencia física, mientras que las mujeres mostraron una autoestima más elevada en promedio. El estudio concluye que la violencia familiar tiene un impacto negativo en la autoestima de los estudiantes, afectando su desarrollo emocional y académico.

Introduction: The left ventricle (LV) serves as the primary source of mechanical energy in circulation, subsequently converted into kinetic energy throughout the arterial system (AS). Analyzing the specific area within an LV pressure-volume (PV) loop helps characterize the function of the cardiac pump. Simultaneously, the AS functions as a blood reservoir, receiving the blood ejected by the LV. The enclosed area in the AS PV-loop is linked to an energy dissipation process (where not all pressure work is regained), attributed to the viscous function of smooth muscle cells. Objective: The main objective of this work was to investigate wall energy dissipation in the vascular bed in terms of LV and AS PV-loop evaluation, to determine if different types of training could lead to differentiated levels of wall energy dissipation. The ‘coupling concept’ is proposed to be conceived from LV and AS loop energy interaction, quantified by a ‘ventricular-arterial damping factor’ (VADF). Material and Methods: Data from subjects with different kinds of training (soccer players and ballet dancers) were collected noninvasively and compared with a control group of untrained individuals to analyze the differentiating characteristics of the subjects, especially in terms of Stroke Work Dissipation (WDIS). To this end, a lumped parameters Windkessel (WK) model was proposed for the assessment of LV and AS loops, through an interactive process. Changes in wall energy dissipation were observed under training routines. Both soccer players and ballet dancers showed increased WDIS and VADF compared to the untrained individuals (p

La estrategia didáctica basada en el método científico es fundamental para promover el desarrollo de habilidades de indagación y experimentación en los estudiantes. Esta investigación descriptiva tiene como objetivo determinar el nivel de mejora de la capacidad de indagación y experimentación en estudiantes en el área de ciencia y ambiente, a través de la aplicación de estrategias didácticas basadas en el método científico. La población de estudio está constituida por los alumnos del primero al sexto grado de educación primaria de la Institución Educativa No. 18438 “Nuevo Progreso”, Omia, Rodríguez de Mendoza, Amazonas-Perú, utilizando una muestra de 38 estudiantes a los que se aplicó un pre-test y post-test. Los resultados encontraron que la implementación de estrategias didácticas fundamentadas en el método científico resultó en una mejora significativa en el desarrollo de la capacidad de indagación y experimentación en dicha área en los estudiantes de Educación Primaria. Por lo cual se concluye que el uso del método científico es valioso y puede tener un impacto positivo tanto en su aprendizaje como en su desarrollo profesional.

Objetivo: Revisar la tendencia de la mortalidad materna ocurrida en un Hospital Nacional del ex-Instituto Peruano de Seguridad Social (ahora EsSALUD). Diseño: Estudio epidemiológico descriptivo retrospectivo de las muertes maternas registradas en los archivos del Hospital. Sujetos: Doscientos once mujeres que fallecieron durante la gestación, el parto o el puerperio. Lugar: Departamento de Obstetricia y Ginecología del Hospital Nacional Edgardo Rebagliati Martins, ex-lPSS. Resultados: La muerte obstétrica directa representó el 72,5% (153 casos), incluyendo 25, 1 % (53 casos) por hipertensión inducida por el embarazo, 24,2% (51 casos) por infecciones, 15,6% (33 casos) por hemorragias y 7,6% (16 casos) por otras causas obstétrica directas. La mortalidad obstétrica indirecta fue 27,0% (57 casos) y la no relacionada 0,5% (1 caso). La tasa de mortalidad materna resultó 40,8/1 00000nv, no habiendo variado en los últimos diez años. Conclusión: Se discute las razones probables por las que no esté disminuyendo la mortalidad materna en nuestro Hospital y se hace énfasis en medidas que puedan contribuir a disminuirla, incluyendo una atención con calidad y calidez, una mejor referencia y contrarreferencia y modernizar el equipamiento.

El moldeado y vaciado de rostros, manos y pies formó parte de las diversas estrategias de conocimiento de los antropólogos desde el siglo XIX. Este estudio se centra en una colección de máscaras faciales obtenidas por el antropólogo alemán Otto Finsch a partir de sujetos vivos de pueblos nativos de Oceanía y conservadas en el Museo de La Plata, Argentina. Analizamos los materiales, archivos y catálogos; también, testimonios orales de trabajadores del museo que estuvieron en contacto con esta colección. En primer lugar, revisamos cómo surgieron estas máscaras, cómo fueron adquiridas por este museo, cómo fueron exhibidas y qué sucedió con ellas después de que fueron retiradas de la exposición. En segundo lugar, comentamos algunos puntos de discusión en torno a esta colección partiendo del supuesto de que estos materiales representan un patrimonio científico que no sólo da cuenta de la historia de la antropología y el contexto en el que se constituyó, sino que también es factible de ser reactivado en nuevas narrativas.

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.

Introduction: Ultrasound-guided nerve blocks (UGNB) represent a procedural skill set that can be used to treat acute pain by physicians in the emergency department (ED). However, limited access to education and training represents a barrier to widespread adoption of this core skill set. The implementation of UGNBs within the ED can aid in resource allocation, particularly in limited-resource settings.Case Series: In this case series we discuss our experience using tele-ultrasound to train emergency physicians on the use of UGNBs within our international point-of-care ultrasound fellowship in Peru. We highlight the potential role UGNBs serve in management of acute pain when working in resource-limited, public safety-net hospitals in Peru.Conclusion: Tele-ultrasound may represent a strategy for teaching procedures such as UGNBs via remote guidance and supervision.

The franciscana Pontoporia blainvillei is the only extant member of the family Pontoporiidae, and its occurrence is restricted to coastal waters from Brazil to Argentina. The species is one of the most threatened cetaceans in the southwestern Atlantic Ocean, due to unsustainable bycatch levels. A total of 11 Franciscana Management Areas (FMAs) have been defined throughout the species’ range. FMA Ia represents the northernmost franciscana population, demographically isolated on the north coast of Espírito Santo State, Brazil. In March 2018, aerial surveys were conducted to assess the distribution and estimate the abundance of franciscanas in FMA Ia. A total of 2986 km of survey effort was conducted, and 27 groups were seen (average group size: 2.52 ind., coefficient of variation [CV] = 0.50) in coastal habitats (average distance from the shore: 3.3 km, CV = 0.70). Abundance, corrected for visibility bias and group size bias, was estimated at 1183 (CV = 0.76) individuals, and the potential biological removal was computed at 1. Results suggest that at least during the summer, franciscanas in ES are distributed in coastal habitats between Conceição da Barra and Santa Cruz, with a high-density area observed near the estuary mouth of the Doce River. This is one of the smallest of all franciscana populations and one with a restricted range. The estimated abundance indicates that the ES population qualifies for listing as Endangered under IUCN Red List criterion C2a(ii). In order to reduce threats to this population, management actions are urgently needed.

Objetivo. Determinar la concordancia entre cinco criterios diagnósticos de síndrome metabólico (SM) entre adolescentes residentes de una zona altoandina del Perú. Materiales y métodos. Se realizó un estudio transversal con datos secundarios de un estudio de intervención en dos escuelas públicas en el año 2019. Participaron 397 adolescentes que residen en la ciudad de Cajamarca ubicada en la región andina del Perú. Se aplicaron cinco criterios diagnósticos: Third Adult Treatment Panel (ATP-III) modificados por Cook, de la Federación Internacional de Diabetes (IDF), de la American Heart Association (AHA), de Ferranti, y de la Organización Mundial de Salud (OMS). Se estimaron las prevalencias puntuales y de intervalo con los cinco criterios. Se estimó el coeficiente de concordancia de Kappa con su respectivo intervalo de confianza al 95% (IC 95%). Resultados. El criterio de Ferranti identificó un 17,1% (IC 95%: 13,4 a 20,8) de adolescentes con SM, seguido del criterio de la ATP-III con 4,3% (IC 95%: 2,3 a 6,3); los demás criterios identificaron una menor frecuencia. La mejor concordancia fue encontrada entre los criterios de la AHA y la ATP-III (k = 0,905), los criterios de la OMS e IDF tuvieron un coeficiente de 0,628. Los cinco criterios coincidieron en clasificar como SM a seis adolescentes (1,5%). Conclusiones. Los criterios de la AHA y la ATP-III modificados por Cook tuvieron una concordancia casi perfecta, que se mantuvo en ambos sexos. Los criterios ATP-III, de Ferranti, IDF, AHA y OMS concuerdan en menos del 2% en identificar SM en el mismo grupo de adolescentes.

Abstract The Atlantic goliath grouper Epinephelus itajara is the largest grouper species in the Atlantic Ocean. Despite the conservation status being Vulnerable (VU) globally and Critically Endangered (CR) in Brazil, the species continues to face threats from overfishing throughout its range. We used DNA barcoding employing the mitochondrial Cytochrome c oxidase subunit I (COI) gene to identify the illegal commercialization of E. itajara in fish markets from the northern (NC) and southern (SC) Brazilian coasts. Sampling was conducted in fish markets and aimed to confirm the identification of mischaracterized fish sold as E. itajara in the NC, as well as identifying fish fillets sold as the Dusky grouper in the SC. DNA barcoding allowed the unambiguous identification of 22 (84.6%) of the 26 analyzed fish market samples. Both sampled areas had confirmation of E. itajara illegal commercialization and from the 22 analyzed samples, 17 (77.3%) were confirmed to be E. itajara. Here we report two crimes, the illegal sale of E. itajara and commercial fraud by species substitution. This study has highlighted that the existing legislation that protects E. itajara in Brazilian waters requires the adoption of better public policies for the conservation of the species.

Point-of-care ultrasound (POCUS) enables physicians to make critical diagnosis and treatment decisions at the bedside. However, access to and expertise with this technology remain limited in Peru. Establishing longitudinal POCUS educational curriculums in remote, low-resource settings can be challenging due to geographical distances, encumbering the ability to provide ongoing hands-on support. Previously described educational interventions have focused on training individual users on clinical applications of POCUS, rather than training physicians how to teach POCUS, thereby limiting scalability and sustainable impact. We therefore describe our experiences establishing the first ultrasound fellowship curriculum in Peru, which incorporates tele-ultrasonography to circumvent traditional geographical barriers.

Actualmente, las redes sociales poseen un impacto directo en las sociedades. De esta manera, se evidencian transformaciones aceleradas en los diversos grupos sociales, concretamente en el sector juvenil, todo ello debido a que dicho sector es el más vinculado a este contexto tecnológico. Es por ello que, el objetivo estuvo enfocado a determinar el vínculo entre el clima social familiar y la adicción a las redes sociales en educandos de nivel secundario de una Institución Educativa de Chiclayo. Para ello se realizó un estudio con un enfoque cuantitativo, de tipo básico, y con un diseño no experimental y nivel correlacional. Los resultados constatan la relación inversa y significativa entre ambos constructos con un grado moderado. Asimismo, se evidencia que la adicción a las redes sociales irrumpe y afecta el clima sociofamiliar de los educandos que cursan el nivel secundario. Así, resulta necesario que se lleven a cabo diversos estudios que profundicen sobre esta temática, puesto que este sector emerge como el principal consumidor de nuevas tecnologías, específicamente de las denominadas redes sociales.

Fluidized bed boiler fly ash, previously calcined at 650 °C (FAT), was used to obtain geopolymers, after treatment with 8 M, and 10 M NaOH, as well with sodium silicate (silicate modulus MS = 2.5). The volume ratio of alkaline activating solution/FAT = 0.38 L/kg was kept constant; whereas that the molar ratios SiO2/Na2O = 1.18–1.50, and H2O/Na2O = 14.7–20.4, was used. The addition of extra water to the geopolymeric paste was done in two ways, in order to determine the effect on the dissolution rate of aluminosilicates and the strength development of the geopolymers obtained. By pre-grinding the FAT, controlling the mixing time, the H22O/Na22O ratio = 14.7 and thermal activation at 80 °C for 24 h, it was possible to obtain geopolymers with high strengths

Background/Objectives: Artificial intelligence and large language models like ChatGPT and Google's Gemini are promising tools with remarkable potential to assist healthcare professionals. This study explores ChatGPT and Gemini's potential utility in assisting clinicians during the first evaluation of patients with suspected neurogenetic disorders. Methods: By analyzing the model's performance in identifying relevant clinical features, suggesting differential diagnoses, and providing insights into possible genetic testing, this research seeks to determine whether these AI tools could serve as a valuable adjunct in neurogenetic assessments. Ninety questions were posed to ChatGPT (Versions 4o, 4, and 3.5) and Gemini: four questions about clinical diagnosis, seven about genetic inheritance, estimable recurrence risks, and available tests, and four questions about patient management, each for six different neurogenetic rare disorders (Hereditary Spastic Paraplegia type 4 and type 7, Huntington Disease, Fragile X-associated Tremor/Ataxia Syndrome, Becker Muscular Dystrophy, and FacioScapuloHumeral Muscular Dystrophy). Results: According to the results of this study, GPT chatbots demonstrated significantly better performance than Gemini. Nonetheless, all AI chatbots showed notable gaps in diagnostic accuracy and a concerning level of hallucinations. Conclusions: As expected, these tools can empower clinicians in assessing neurogenetic disorders, yet their effective use demands meticulous collaboration and oversight from both neurologists and geneticists. [ABSTRACT FROM AUTHOR]

Objetivo: Estimar el efecto de una intervención educativa basada en nutrición y estilos de vida saludables para incrementar la proporción de adolescentes libres de componentes del síndrome metabólico. Materiales y métodos: Se realizó un estudio preexperimental en una muestra representativa de adolescentes de dos escuelas de un distrito altoandino del Perú (ciudad de Cajamarca); 388 estudiantes completaron la intervención, así como la medición basal y la posintervención. La intervención tuvo nueve ejes temáticos, cada uno fue desarrollado en una sesión educativa de 45 min cada dos semanas. Se usó los criterios del National Cholesterol Education Program Expert Panel and Adult Treatment Panel III para el síndrome metabólico. Se realizó la comparación de proporciones pareadas (prueba de McNemar) para determinar el impacto de la intervención. Resultados: En la medición basal, el 20,4% (IC95%: 16,2 a 24,5) no tenía componentes de SM, posintervención dicha proporción se incrementó a 32,5% (IC95%: 27,7 a 37,3), la diferencia de proporciones fue 12,1% (IC95%: 7,5 a 16,8; p0,001). La prevalencia de síndrome metabólico fue 4,6% (IC95%: 2,4 a 6,9) basalmente; posintervención fue 2,3% (IC95%: 0,7 a 3,9). La diferencia de proporciones fue 2,3%, (IC95%: 0,3 a 3,2; p=0,022). Entre los componentes, la mayor reducción fue en la proporción de hipertrigliceridemia (diferencia de proporciones: 21,9%, IC95%: 16,9 a 26,9; p0,001), también se observó una reducción significativa de la hipertensión arterial (diferencia de proporciones: 3,1%, IC95%: 0,6 a 5,6; p=0,025). En los demás componentes no hubo diferencias significativas. Conclusiones: La intervención educativa incrementó en un 59,3% la proporción de estudiantes libres de algún componente del síndrome metabólico.

Many studies found that increased arterial stiffness is significantly associated with the presence and progression of Coronary Calcium Score (CCS). However, none so far have used machine learning algorithms to improve their value. Therefore, this study aims to evaluate the association between carotid-femoral Pulse Wave Velocity (cfPWV) and CCS score through computational clustering. We conducted a retrospective cross-sectional study using data from a cardiovascular risk screening program that included 377 participants. We used an unsupervised clustering algorithm using age, weight, height, blood pressure, heart rate, and cfPWV as input variables. Differences between cluster groups were analyzed through Chi-square and T-student tests. The association between (i) cfPWV and age groups, (ii) log (CCS) and age groups, and (iii) cfPWV and log(CCS) were addressed through linear regression analysis. Clusters were labeled post hoc based on cardiovascular risk. A “higher-risk group” had significantly higher left (0.76 vs. 0.70 mm, P

Fly ashes from the fluidized bed boiler were used to obtain zeolites by the alkaline fusion process, followed by a hydrothermal procedure. The melting was carried out with 98 % granulated NaOH, mixed with ashes in mass ratios 1.2/1, 1.4/1 and 1.6/1 and using three melting temperatures, 450 °C, 550 °C and 650 °C. For the crystallization of the zeolites, the hydrothermal procedure at 90 °C was used. The crystalline phases of the zeolitic materials were quantified by XRD analysis. The morphology of the crystals was identified by SEM. The FTIR spectra revealed that the transformation of sodalite mineral to zeolite A and zeolite X increased with the NaOH/CVT ratio and the temperature.

Background: Drug utilization research (DUR) is used to provide evidence-based data to inform policies and make decisions. The aim of this study was to map and describe available data sources for drug utilization research in Peru.Methods: We performed a search of data sources providing information on medication use on the website of governmental organizations. We also conducted a literature review using PubMed, LILACs, and BVS. Independently, researchers screened eligible data sources. Data characterization included accessibility, coverage data provider, type of data sources, and setting. We performed a descriptive analysis.Results: We identified seven data sources, CENAFyT, ICI, IDI (SISMED), and ENSUSALUD from MINSA, and CRI-ESSALUD, SGSS/ESSI, and ENSSA from ESSALUD. These presented information on adverse drug reactions (n = 2), drug consumption, and distribution (n = 2), prescription and drug dispensing (n = 1), and surveys addressed to medication users (n = 2). ENSUSALUD was the only data source publicly available. VIGIFLOW and ENSUSALUD have a national granularity from the public and private sectors. The setting of the data sources was both hospital and ambulatory care. Two data sources have individual-level data on adverse drug reactions and one on prescriptions. Four studies on drug utilization research in Peru were derived from ENSUSALUD.Conclusion: In Peru, few data sources are available for drug utilization research. There is an increased need to monitor medications for decision-making purposes. Local and international initiatives and partnerships of the government with academic institutions and the private sector might be a good strategy to increase the transparency of health data and for supporting decision-making using drug utilization research.

La gobernanza se manifiesta cuando la toma de decisiones públicas proviene de un poder colectivo, es decir, conformado por las autoridades públicas, la sociedad civil y el sector privado, con igualdad en sus decisiones. El objetivo de la investigación fue analizar las políticas públicas y gobernanza participativa local desde la mirada de los colaboradores de una municipalidad de Lima, la investigación se enmarca dentro del paradigma interpretativo o naturalista; fue de enfoque cualitativo, diseño fenomenológico, teniendo como muestra 13 personas, constituida por colaboradores que laboran en la municipalidad, vecinos del distrito de Lima. El instrumento utilizado fue la entrevista semi estructurada. Los resultados indican que las políticas públicas municipales, se implementan desde de actividades puntuales, desarticuladas y desvinculadas con los instrumentos de gestión del gobierno local, asimismo no responden a los lineamientos de la política nacional definida por el gobierno peruano. Se necesita una gobernanza en función de la participación ciudadana interviniendo los actores a nivel público, privado y sociedad civil para conocer las necesidades básicas de la ciudadanía y, a partir de la elaboración de políticas públicas, produzca un impacto positivo en la población, buscando una integración vecinal.

Al conmemorar este año el Bicentenario de la Independencia del Peru, no podemos dejar de mencionar aspectos de la historia de la cardiología y cirugía cardiovascular en el país y los aportes que estas especialidades han realizado a la sociedad.