Geographic-Scale Coffee Cherry Counting with Smartphones and Deep Learning.

Deep learning and computer vision, using remote sensing and drones, are 2 promising nondestructive methods for plant monitoring and phenotyping. However, their applications are infeasible for many crop systems under tree canopies, such as coffee crops, making it challenging to perform plant monitoring and phenotyping at a large spatial scale at a low cost. This study aims to develop a geographic-scale monitoring method for coffee cherry counting, supported by an artificial intelligence (AI)-powered citizen science approach. The approach uses basic smartphones to take a few pictures of coffee trees; 2,968 trees were investigated with 8,904 pictures in Junín and Piura (Peru), Cauca, and Quindío (Colombia) in 2022, with the help of nearly 1,000 smallholder coffee farmers. Then, we trained and validated YOLO (You Only Look Once) v8 for detecting cherries in the dataset in Peru. An average number of cherries per picture was multiplied by the number of branches to estimate the total number of cherries per tree. The model's performance in Peru showed an R2 of 0.59. When the model was tested in Colombia, where different varieties are grown in different biogeoclimatic conditions, the model showed an R2 of 0.71. The overall performance in both countries reached an R2 of 0.72. The results suggest that the method can be applied to much broader scales and is transferable to other varieties, countries, and regions. To our knowledge, this is the first AI-powered method for counting coffee cherries and has the potential for a geographic-scale, multiyear, photo-based phenotypic monitoring for coffee crops in low-income countries worldwide.

The weekly P25 of the age of the influenza-like illness shows a higher correlation with COVID-19 mortality than rapid tests and could predict the evolution of COVID-19 pandemics in sentinel surveillance, Piura, Perú, 2021.

GOAL: To describe the dynamics of syndromic surveillance of ILI cases in seasonal and COVID-19 pandemic scenarios. METHODOLOGY: A descriptive study of the epidemiological behavior of ILI in the seasonal and COVID-19 pandemic scenarios. Of a sample of 16,231 cases of ILI from 2013 to 2021, the features of cases from 68 weeks before and during the pandemic were selected and compared; weekly endemic channels were built; data fluctuations on the trend of ILI cases were analyzed; and estimated weekly correlations between weekly P25 age, cases confirmed by rapid tests, and mortality from COVID-19. To analyze clinical-epidemiological and mortality data, Student's t test, Mann-Whitney U, Chi2, Spearman's Ro, polynomial, and multinomial regression with a 95% confidence interval were used. RESULTS: During the COVID-19 pandemic, those most affected with ILI were: adults and the elderly; higher median age; autochthonous cases predominated; a lower proportion of other syndromes; delays in seeking care; and a higher rate of pneumonia attack than in the seasonal period (p< 0.01). Rapid tests (serological and antigenic) confirmed 52.7% as COVID-19. Two ILI pandemic waves were seasonally consistent with confirmed COVID-19 cases and district mortality with robust correlation (p<0.01) before and during the pandemic, especially the ILI weekly P25 age, which has a more robust correlation with mortality than ILI and rapid tests (p<0.01) whose endemic channels describe and could predict the evolution of the pandemic (p<0.01). CONCLUSIONS: The pandemic changed the clinical and epidemiological behavior of ILI, and the weekly P25 of age is a more robust indicator to monitor the COVID-19 pandemic than a rapid test and could predict its evolution.

Negevirus Piura Suppresses Zika Virus Replication in Mosquito Cells.

We investigated the interaction between the insect-specific virus, Piura virus (PIUV), and the arbovirus Zika virus (ZIKV) in Aedes albopictus cells. We performed coinfection experiments in C6/36 cells. Piura virus (Cor 33 strain, Colombia) and ZIKV (PRVABC58 strain, Puerto Rico) were co-inoculated into C6/36 cells using two multiplicity of infection (MOI) combinations: 0.1 for both viruses and 1.0 for ZIKV, 0.1 for PIUV. Wells were infected in triplicate with either PIUV and ZIKV coinfection, ZIKV-only, or PIUV-only. Mock infected cells served as control wells. The cell suspension was collected daily 7 days post-infection. Zika virus load was titrated by TCID50 on Vero 76 cells. The ZIKV-only infection and PIUV and ZIKV coinfection experiments were also quantified by RT-qPCR. We also investigated whether ZIKV interfered in the PIUV replication. PIUV suppressed the replication of ZIKV, resulting in a 10,000-fold reduction in ZIKV titers within 3 days post-infection. PIUV viral loads were not reduced in the presence of ZIKV. We conclude that, when concurrently infected, PIUV suppresses ZIKV in C6/36 cells while ZIKV does not interfere in PIUV replication.

Características clínicas y laboratoriales de los diez primeros pacientes con diagnóstico de Guillain-Barré en Piura, 2023

El síndrome de Guillain Barré es una enfermedad derivada del compromiso en las neuronas del sistema nervioso periférico por una respuesta descontrolada del sistema inmune que conduce daño axonal y/o desmielinización. El objetivo de este reporte fue describir los 10 primeros casos sospechosos de Síndrome de Guillain Barré en Piura. Se logró identificar la presencia de Campylobacter jejuni en las muestras de heces del 80% de los pacientes reportados. Es muy importante reconocer rápida y oportunamente al paciente con diagnóstico sospechoso de Guillain Barré, y realizar los estudios necesarios en un brote para identificar los agentes desencadenantes del cuadro.

Guillain Barré syndrome is a disease derived from compromise in neurons of the peripheral nervous system by an uncontrolled response from the immune system that leads to axonal damage and/or demyelination. The objective of this report was to describe the first 10 suspected cases of Guillain Barre Syndrome in Piura. It was possible to identify the presence of Campylobacter jejuni in the stool samples of 80% of the reported patients. It is very important to quickly and opportunely recognize the patient with a suspected diagnosis of Guillain Barré, and to carry out the necessary studies in an outbreak to identify the triggering agents of the condition.

Surgical care and trauma patients capacity in Piura, Perú - Cross-sectional study.

Introduction: Low and medium income countries face challenges in access and delivery of surgical care, resulting in a high number of deaths and disabled individuals. Objective: To estimate the capacity to provide surgical and trauma care in public hospitals in the Piura region, Perú, a middle income country. Methods: A survey was administered in public hospitals in the Peruvian region of Piura, which combined the Spanish versions of the PIPES and INTACT surveys, and the WHO situational analysis tool. The extent of the event was assessed based in the absolute differences between the medians of the scores estimated, and the Mann-Whitney bilateral tests, according to the geographical location and the level of hospital complexity. Results: Seven public hospitals that perform surgeries in the Piura region were assessed. Three provinces (3/8) did not have any complexity healthcare institutions. The average hospital in the peripheral provinces tended to be smaller than in the capital province in INTACT (8.25 vs. 9.5, p = 0.04). Additionally, water supply issues were identified (2/7), lack of incinerator (3/7), lack of uninterrupted availability of a CT-scanner (5/7) and problems with working hours; in other words, the blood banks in two hospitals were not open 24 hours. Conclusions: There is a significant inequality among the provinces in the region in terms of their trauma care capacities and several shortfalls in the public sector healthcare infrastructure. This information is required to conduct future research on capacity measurements in every public and private institution in the Peruvian region of Piura.

Introducción: Los países de ingresos bajos y medianos tienen problemas en el acceso y la provisión de atención quirúrgica, lo cual ocasiona un alto número de fallecimientos y de personas con discapacidad. Objetivo: Estimar la capacidad para la atención quirúrgica y de pacientes traumatizados en los hospitales públicos en la región de Piura, Perú, un país de ingreso mediano. Métodos: En los hospitales públicos de la región peruana de Piura se aplicó una encuesta que combinaba las versiones en español de las encuestas PIPES e INTACT y de la herramienta de análisis situacional de la Organizacion Mundial de la Salud (OMS). Se evaluó la magnitud del evento mediante las diferencias absolutas entre las medianas de los puntajes calculados y pruebas bilaterales de Mann-Whitney según la ubicación geográfica y el nivel de complejidad hospitalaria. Resultados: Se evaluaron siete hospitales públicos que realizan cirugía en la región de Piura. Tres provincias (3/8) no contaban con instituciones sanitarias con complejidad de hospital. La mediana de los hospitales de las provincias periféricas tuvo tendencia a ser menor que la de la provincia capital en la INTACT (8,25 vs. 9,5, p = 0,04). Asimismo, se hallaron problemas de abastecimiento de agua (2/7), ausencia de incinerador (3/7), falta de funcionamiento permanente de tomógrafo (5/7) y problemas con el horario de funcionamiento de los bancos de sangre, ya que no funcionaban las 24 horas del día en 2 hospitales (2/7). Conclusiones: Se describe la alta desigualdad entre las provincias de la región en la capacidad de atención de trauma y varias carencias en la infraestructura sanitaria del sector público. Esta información es necesaria para desarrollar futura investigación de medición de capacidades en todos los establecimientos públicos y privados de la región peruana de Piura.

[Spatial analysis of hypertension in Peruvian adults, 2022]. / Análisis espacial de la hipertensión arterial en adultos peruanos, 2022.

Objectives: To perform a spatial analysis of arterial hypertension in the Peruvian adult population to identify geographic patterns with a higher concentration of cases. Materials and methods: A spatial analysis was conducted using data from the Demographic and Family Health Survey (ENDES) 2022. A sample of 29,422 adults was included, and the global Moran's index and Getis-Ord Gi* analysis were used to evaluate spatial autocorrelation and cluster concentration. Results: The age-standardized prevalence of arterial hypertension was 19.2%. Clusters with a high concentration of arterial hypertension were observed in departments along the Peruvian coast such as Tumbes, Piura, Lambayeque, La Libertad, Ancash, and Lima, as well as in the northern regions of the Highlands. Clusters were also found in the regions of Loreto and Madre de Dios in the Peruvian jungle. Conclusions: This study revealed geographic patterns of arterial hypertension in Peru, with a higher concentration of cases along the Peruvian coast and in certain regions of the Highlands and Jungle. These findings highlight the need to develop strategies for the prevention and control of the disease, especially in the areas identified as high-prevalence clusters.

Food insecurity in Piura, Peru, in the context of post-earthquake and the COVID-19 pandemic.

Introduction: Piura, located in a seismic zone, faces challenges related to food security. The aim of this study was to analyze aspects related to food insecurity in the region following the 6.1-magnitude earthquake that occurred in 2021, within the context of the COVID-19 pandemic. Methods: A secondary analysis was performed in 177 people exposed to the earthquake in Piura. Food insecurity was assessed with the Household Food Insecurity Access Scale. Its association with insomnia, resilience, anxiety/depressive symptoms, and general variables were determined using generalized linear models. Results: Food insecurity was observed in 31.1% (95% CI: 24.3-38.4) of participants. This prevalence was higher in people with mild (PR: 1.73, 95% CI: 1.12-2.70) and moderate (PR: 1.55, 95% CI: 1.09-2.22) anxiety symptoms, severe depressive symptoms (PR: 2.74, 95% CI: 1.24-6.03), and previous exposure to the El Niño Phenomenon (PR: 1.72; 95% CI: 1.06-2.81). An income higher than 5000 Peruvian soles (approximately 1300 US dollars) was associated with a lower prevalence of food insecurity (PR: 0.22, 95% CI: 0.13-0.40). Conclusions: Overall, three out of 10 individuals experienced food insecurity after the 2021 earthquake in Piura. Food insecurity may be aggravated by mental disorders, previous exposure to the El Niño phenomenon, and the COVID-19 pandemic. Our study contributes to the field by exploring a range of variables related to food insecurity in a unique context: post-earthquake and during the COVID-19 health emergency in Peru. These findings enhance our understanding of food insecurity at the regional level and highlight the need for preventive food security programs in seismic events.

Tick-associated diseases identified from hunting dogs during the COVID-19 pandemic in a Mayan community in Yucatan, Mexico.

Background: Hunting activity in the Mayan communities has increased due to COVID-19 and domestic dogs have gained more importance. Due to their proximity to humans, domestic dogs are a bridge between tick-borne diseases (TBDs) and humans and their peri-domestic environment. In Mexico, and especially in rural regions, there were not adequate records of TBDs during the SARS-CoV-2 pandemic. Aim: Identify TBD of ticks collected during the COVID-19 pandemic in a rural community. Methods: Tick capture was carried out in March 2021, in Teabo, Yucatan. Ticks were removed using from domestic dogs and placed in ethanol. Collected ticks were morphologically identified and underwent DNA extraction and a partial segment of the mitochondrial 16S-rDNA gene was amplified to corroborate the tick species. The DNA was screened for the presence of Anaplasma spp., Borrelia spp., Ehrlichia spp., and Rickettsia spp. Purified amplification products were submitted for sequencing and the results were compared to those deposited in GenBank using BLAST. Results: We collected 33 ectoparasites, Ixodes affinis, Rhipicephalus sanguineus, Rhipicephalus microplus, and Amblyomma mixtum on 11 hunting dogs. The most frequent ectoparasite was R. sanguineus (66%). We detected the presence of DNA of Rickettsia endosymbiont in I. affinis and Anaplasma platys in R. sanguineus. Rickettsia endosymbiont presented a similarity of 100% with the partial sequence of R. endosymbiont of I. affinis isolate IACACTM001 16S ribosomal RNA gene and the sequence of A. platys had a similarity of 100% with the partial sequence of the isolate 23-33TX 16S ribosomal RNA gene of A. platys from dogs from Texas, USA and with the partial sequence of the isolate L134 16S ribosomal RNA gene of Ehrlichia canis from dogs from Piura, Peru. Conclusion: We confirmed for the first time the presence of A. platys in R. sanguineus and R. endosymbiont in I. affinis ticks from dogs in the state of Yucatan.

A new species of the genus Brachytydeus Thor sensu André (Acari: Tydeidae) and a key to all known species from Peru.

Brachytydeus juanjosei sp. nov., a new species of Neotropical Tydeidae, is illustrated and described from females, males, and a tritonymph collected from the leaves of a native forest tree, Neltuma piurensis (Fabaceae), from Department of Piura in north-western Peru. The new tydeid mite was found all year long, but more frequently observed during spring in high populations (September/December). A key to the known Peruvian species of the subfamily Tydeinae is provided.

Pachyoliva columellaris G.B. Sowerby I, 1825 (Olividae, Caenogastropoda) in Peru: tidal migrations and population density

The gastropod Pachyoliva columellaris (formerly Olivella columellaris) is particularly common on many sandy beaches in North Peru. In the studied region north of Paita, Piura province, the species reaches densities of over 80,000 individuals per beach meter. The snails perform tidal migrations throughout the lunar cycle although tidal amplitudes differ four-fold between neap and spring tide. Not all animals complete their tidal migrations, and significant numbers remain above the water line at low tide. Throughout the tidal cycle, the proportion of small individuals is increased near the water line whereas large animals dominate in lower beach zones. I conclude that the sandy beaches north of Paita are well-suited for further studies of P. columellaris and the mechanisms underlying tidal migrations in invertebrates.

El gasterópodo Pachyoliva columellaris (antes Olivella columellaris) es particularmente común en las playas arenosas del norte de Perú. En la región estudiada al norte de Paita, provincia de Piura, la especie alcanza densidades de más de 80.000 individuos por metro de playa. Los caracoles realizan migraciones mareales durante todo el ciclo lunar, aunque las amplitudes de marea difieren cuatro veces entre la marea muerta y la marea viva. No todos los animales completan sus migraciones mareales y un número significativo permanece por encima del nivel del agua en marea baja. Durante todo el ciclo de marea, la proporción de individuos pequeños aumenta cerca del nivel del agua, mientras que los animales grandes dominan en las zonas bajas de la playa. Concluyo que las playas arenosas al norte de Paita son apropiadas para estudios adicionales de P. columellaris y los mecanismos de las migraciones de marea en invertebrados.

Vulnerabilidad de la infraestructura sanitaria en relación a la Covid-19 en el distrito de Castilla-Piura 2021- 2022

Objetivo: Analizar la relación entre la infraestructura sanitaria: equipos y suministros, ambientes construidos, humanización de la atención y la COVID-19 dentro del Desarrollo Urbano Sostenible en el distrito de Castilla - Piura en el año 2022. Métodos: Adopta el paradigma hermenéutico, con un diseño de tipo transversal, de tipo cualitativo, en base a encuestas aplicadas a una muestra estadística del sector de Castilla; a su vez, se realizaron entrevistas no estructuradas, dirigidas a expertos profesionales de la salud. Resultados: Se observa que el 100% de los hospitales de II y III nivel y centros de salud en Piura, se encuentran en condiciones inadecuadas para lograr la eficiencia y la efectividad en la atención, tanto en infraestructura sanitaria, equipos y suministros, como en los ambientes construidos y humanizados. Conclusión: El estado deficiente de los establecimientos de salud, ha determinado el incremento de casos de COVID-19, durante la pandemia, porque no cuentan con ambientes adecuados para atender diferentes patologías así como por la inadecuada zonificación de las áreas de aislamiento respiratorio y de vectores, las que deben responder a la realidad de esta región; esta situación plantea la necesidad de formular un plan de contingencia regional, la misma que garantice atención prioritaria y de calidad frente a situaciones de emergencia, así como la vivida durante la pandemia.

Objective: The relationship between the sanitary infrastructure, considering three aspects such as: equipment and supplies; built environments; humanization of care against COVID-19 in the district of Castilla - Piura in the year 2022. Methods: It adopts the Hermeneutic paradigm, with a cross-sectional, qualitative design, based on surveys applied to a statistical sample from the Castilla sector, unstructured interviews were conducted, aimed at health professional experts. Results: It is observed that 100% of the II and III level hospitals and health centers in Piura are in inadequate conditions to achieve efficiency and effectiveness in care, both in infrastructure-equipment, in built environment and humanized. Conclusion: The deficient state of health establishments has determined the increase in cases of COVID 19, during the pandemic, because they do not have adequate environments to treat different pathologies, as well as due to inadequate zoning of respiratory and vector isolation areas, those that must respond to the reality of this Region; This situation raises the need to formulate a regional contingency plan, the same one that guarantees priority and quality care in emergency situations, as well as life during the pandemic.

Clinical-epidemiological characteristics of deaths due to dengue during an outbreak in northern Peru. / Características clínicas y epidemiológicas de las muertes por dengue durante un brote en el norte del Perú.

Motivation for the study. To describe the characteristics of patients who died from severe dengue fever during the 2017 El Niño in Piura. Main findings. Mortality from severe dengue was higher in adult women. First contact with healthcare took place mostly in higher level hospitals. Admission to a specialized unit was late for severe dengue cases. Implications. Control of dengue fever involves several aspects, such as, access to health, prevention, water availability, vector control and education; therefore, it is important to strengthen public health policies in this regard. In order to achieve this goal, local and central government sectors must be involved.

Motivación para realizar el estudio. Describir las características de los pacientes fallecidos por dengue grave durante el fenómeno de El Niño del 2017 en Piura. Principales hallazgos. La mortalidad del dengue grave fue mayoritaria en las mujeres adultas, la primera atención se realizó en hospitales de mayor nivel y la atención para casos graves de dengue en una unidad especializada fue tardía. Implicancias. La mortalidad del dengue grave fue mayoritaria en las mujeres adultas, la primera atención se realizó en hospitales de mayor nivel y la atención para casos graves de dengue en una unidad especializada fue tardía.

Species of Peperomia (Piperaceae) from the Saña River Valley, Peru.

The Saña River Valley in Northern Peru is unusual for the western slopes of the Peruvian Andes because of its nearly year-round regime of precipitation instead of marked seasonal dry winters. This results in unexpected plant diversity. We surveyed the species of Peperomia (Piperaceae), occurring in this valley from 300 to 3000 m elevation, based on the study of specimens from ten herbaria and field collections, resulting in a total of 81 accessions, of which 48 were made by the authors. We found 16 different taxa: Peperomiacacaophila, from Ecuador, is reported for the first time in Peru; P.cymbifolia, P.dolabriformis and P.emarginulata are reported for the first time for the Saña River Valley; other widely distributed species like P.fraseri, P.galioides, P.haematolepis, P.hispidula, P.inaequalifolia, P.microphylla, and P.rotundata were also found. Five species new to science are described: P.pilocarpa, P.riosaniensis, close to P.palmiformis from Amazonas; P.sagasteguii, related to P.trinervis, P.symmankii, close to P.ricardofernandezii from Piura, and P.vivipara, related to P.alata. A key to the species of Peperomia from the Saña River Valley, based on vegetative characters, is provided.

ResumenEl valle del Río Saña en el norte de Perú es inusual para las vertientes occidentales de los Andes peruanos por su régimen de precipitación ininterrumpido en lugar de inviernos secos estacionales marcados. Esto resulta en una diversidad de plantas inesperada. Revisamos las especies de Peperomia (Piperaceae), del valle del Río Saña entre los 300 a 3000 m de altitud, basándonos en el estudio de especímenes de diez herbarios y colecciones de campo, resultando en un total de 81 accesiones, de las cuales 48 fueron realizadas por los autores. Encontramos 16 taxones diferentes: Peperomiacacaophila, de Ecuador, se reporta por primera vez en Perú; P.cymbifolia, P.dolabriformis y P.emarginulata se reportan por primera vez para el valle del Río Saña; otras especies ampliamente distribuidas como P.fraseri, P.galioides, P.haematolepis, P.hispidula, P.inaequalifolia, P.microphylla y P.rotundata también se encontraron. Se describen cinco especies nuevas para la ciencia: P.pilocarpa, P.riosaniensis, cercana de P.palmiformis de Amazonas; P.sagasteguii, relacionada con P.trinervis, P.symmankii, cercana a P.ricardofernandezii de Piura, y P.vivipara, relacionada con P.alata. Se presenta una clave para las especies de Peperomia del Valle del Río Saña basada en caracteres vegetativos.

The distribution of cadmium in soil and cacao beans in Peru.

Peru is the eighth largest producer of cacao beans globally, but high cadmium contents are constraining access to international markets which have set upper thresholds for permitted concentrations in chocolate and derivatives. Preliminary data have suggested that high cadmium concentrations in cacao beans are restricted to specific regions in the country, but to date no reliable maps exist of expected cadmium concentrations in soils and cacao beans. Drawing on >2000 representative samples of cacao beans and soils we developed multiple national and regional random forest models to develop predictive maps of cadmium in soil and cacao beans across the area suitable for cacao cultivation. Our model projections show that elevated concentrations of cadmium in cacao soils and beans are largely restricted to the northern parts of the country in the departments of Tumbes, Piura, Amazonas and Loreto, as well as some very localized pockets in the central departments of Huánuco and San Martin. Unsurprisingly, soil cadmium was the by far most important predictor of bean cadmium. Aside from the south-eastern to north-western spatial trend of increasing cadmium values in soils and beans, the most important predictors of both variables in nation-wide models were geology, rainfall seasonality, soil pH and rainfall. At regional level, alluvial deposits and mining operations were also associated with higher cadmium levels in cacao beans. Based on our predictive map of cadmium in cacao beans we estimate that while at a national level <20 % of cacao farming households might be impacted by the cadmium regulations, in the most affected department of Piura this could be as high as 89 %.

Association between level of anxiety and degree of psychosomatic features in medical students at a private university in Northern Peru / Relación entre nivel de ansiedad y grado de manifestaciones psicosomáticas en estudiantes de medicina humana de una universidad privada del Norte de Perú

Abstract Introduction University students experience multiple academic and social activities that cause enormous anxiety and stress, affecting them psychologically and physically. In this case, the psychosomatic symptoms, resulting from stress and anxiety, are part of a physical ailment and their emergence can be linked to the setting and time when they occur. Objective To determine the association between anxiety levels and the degree of psychosomatic features (PF). Method A study with a cross-sectional analytical design was developed, which included a total of 352 medical students from the city of Piura, Peru, to whom the PHQ-15 test was administered through Google Forms. Those with a previous psychiatric diagnosis were excluded. Results It was found that PF are influenced by being female (RPa = 1.45, CI 95% = [1.23, 1.71], p ≤ .001), and having mild (RPa = 1.11, CI 95% = [1.20, 1.63], p ≤ .001) and moderate anxiety levels (RPa = 1.7, CI 95% = [1.24, 2.34], p = .001). Discussion and conclusion The presence of a mental condition is necessary for the presence of PF. These stressors create selective alterations of large-scale brain networks involved in the cognitive control, regulation and processing of emotions, stress, and somatic-visceral perception. The study concludes that psychosomatic features are found in approximately 75% of medical students and anxiety in approximately 15%. Mild and moderate anxiety is an influential factor in psychosomatic features, as is being female.

Resumen Introducción Los estudiantes universitarios viven un escenario de acumulación de actividades académicas y sociales que generan gran ansiedad y estrés, afectándolos psicológica y físicamente. En este caso, los síntomas psicosomáticos, producto del estrés y la ansiedad, forman parte de una dolencia física y pueden vincular su aparición con el escenario y el tiempo que los presenta. Objetivo Determinar la asociación entre el nivel de ansiedad y el grado de manifestación psicosomática. Método Se desarrolló un estudio con diseño analítico transversal que incluyó un total de 352 estudiantes de medicina de la ciudad de Piura, Perú, a quienes se les aplicó mediante Google forms el test de PHQ-15. Se excluyeron a aquellos con diagnóstico psiquiátrico previo. Resultados Se encontró que las MS se ven influenciadas por el sexo femenino (RPa = 1.45, IC 95% = [1.23, 1.71], p ≤ .001), nivel de ansiedad leve (RPa = 1.11, IC 95% = [1.20, 1.63],p ≤ .001) y nivel de ansiedad moderada (RPa = 1.7 IC 95% = [1.24, 2.34]; p = .001). Discusión y conclusión Es necesario la presencia de una afección mental para la presencia de la MS. Estos factores estresantes generan alteraciones selectivas de redes cerebrales a gran escala implicadas en el control cognitivo, regulación y procesamiento de emociones, estrés y percepción somático-visceral. Se concluye que las manifestaciones psicosomáticas se encuentran en 75% y la ansiedad en 15% aproximadamente, en estudiantes de medicina. La ansiedad leve y moderada es un factor influyente en las manifestaciones psicosomáticas, así como el sexo femenino.

Identifying the origin of acrylamide in Peruvian panela production to inform strategies for its reduction.

Maximum levels of acrylamide have been set by the European Commission (EU) 2017/2158 for several food products due to its carcinogenic properties. Although not regulated yet, European buyers are requesting maximum levels of 0.8 mg kg-1 in artisanal panela (raw cane sugar) from northern Peru. Panela in this area is produced by 600 small holder farmers and exportation guarantees a respectable price in an area with a high index of poverty. The objective here was to determine the cause of high acrylamide concentrations in panela to inform cost effective minimisation strategies. We monitored panela production from field to final product to understand the scale of the problem, identify the cause of acrylamide formation, as well as the effect of storage on its concentration. We also determined the utility of rapid kits for asparagine quantification. Our results indicate that high acrylamide levels are a widespread problem (85% of samples analysed) and there was a correlation between acrylamide and asparagine of R2 = 0.58 (p < 0.001), but not with any post-harvest processing variable. We estimate that with a concentration of asparagine of <0.1 g l-1 in sugarcane juice, the threshold set by buyers for acrylamide can be met. Potential solutions to reduce asparagine include varietal selection, improved agronomic practices and the use of asparaginase during panela production. However, any proposed measure should be applicable in the context of the rural Peru. Additionally, we confirm the utility of rapid and low-cost kits for measuring asparagine. This pioneering study provides a baseline for effective management for acrylamide minimization in panela.

Surgical care and trauma patients capacity in Piura, Peru - Cross-sectional study / Capacidades para la atención quirúrgica y de pacientes traumatizados en la región de Piura, Perú. Estudio de corte transversal

Abstract Introduction: Low and medium income countries face challenges in access and delivery of surgical care, resulting in a high number of deaths and disabled individuals. Objective: To estimate the capacity to provide surgical and trauma care in public hospitals in the Piura region, Perú, a middle income country. Methods: A survey was administered in public hospitals in the Peruvian region of Piura, which combined the Spanish versions of the PIPES and INTACT surveys, and the WHO situational analysis tool. The extent of the event was assessed based in the absolute differences between the medians of the scores estimated, and the Mann-Whitney bilateral tests, according to the geographical location and the level of hospital complexity. Results: Seven public hospitals that perform surgeries in the Piura region were assessed. Three provinces (3/8) did not have any complexity healthcare institutions. The average hospital in the peripheral provinces tended to be smaller than in the capital province in INTACT (8.25 vs. 9.5, p = 0.04). Additionally, water supply issues were identified (2/7), lack of incinerator (3/7), lack of uninterrupted availability of a CT-scanner (5/7) and problems with working hours; in other words, the blood banks in two hospitals were not open 24 hours. Conclusions: There is a significant inequality among the provinces in the region in terms of their trauma care capacities and several shortfalls in the public sector healthcare infrastructure. This information is required to conduct future research on capacity measurements in every public and private institution in the Peruvian region of Piura.

Resumen Introducción: Los países de ingresos bajos y medianos tienen problemas en el acceso y la provisión de atención quirúrgica, lo cual ocasiona un alto número de fallecimientos y de personas con discapacidad. Objetivo: Estimar la capacidad para la atención quirúrgica y de pacientes traumatizados en los hospitales públicos en la región de Piura, Perú, un país de ingreso mediano. Métodos: En los hospitales públicos de la región peruana de Piura se aplicó una encuesta que combinaba las versiones en español de las encuestas PIPES e INTACT y de la herramienta de análisis situacional de la Organización Mundial de la Salud (OMS). Se evaluó la magnitud del evento mediante las diferencias absolutas entre las medianas de los puntajes calculados y pruebas bilaterales de Mann-Whitney según la ubicación geográfica y el nivel de complejidad hospitalaria. Resultados: Se evaluaron siete hospitales públicos que realizan cirugía en la región de Piura. Tres provincias (3/8) no contaban con instituciones sanitarias con complejidad de hospital. La mediana de los hospitales de las provincias periféricas tuvo tendencia a ser menor que la de la provincia capital en la INTACT (8,25 vs. 9,5, p = 0,04). Asimismo, se hallaron problemas de abastecimiento de agua (2/7), ausencia de incinerador (3/7), falta de funcionamiento permanente de tomógrafo (5/7) y problemas con el horario de funcionamiento de los bancos de sangre, ya que no funcionaban las 24 horas del día en 2 hospitales (2/7). Conclusiones: Se describe la alta desigualdad entre las provincias de la región en la capacidad de atención de trauma y varias carencias en la infraestructura sanitaria del sector público. Esta información es necesaria para desarrollar futura investigación de medición de capacidades en todos los establecimientos públicos y privados de la región peruana de Piura.

Características, estacionalidad y tendencia de las hospitalizaciones por enfermedad de Kawasaki en niños de Perú, 2015-2019

Introducción: Existen limitados reportes epidemiológicos de la enfermedad de Kawasaki (EK) en Latinoamérica. Objetivo: Describir las características, estacionalidad y tendencia de las hospitalizaciones por EK en niños. Métodos: Se realizó un estudio descriptivo de análisis secundario con datos de hospitalizaciones por EK de instituciones de salud de Perú en el periodo 2015-2019. Resultados: 297 hospitalizaciones fueron registradas. El 59,9% fueron varones. El 82,2% fue menor de cinco años y el 16,2% menor de un año. Los departamentos con más hospitalizaciones fueron Lima, Lambayeque y Piura con 202, 21 y 17 casos. Las estaciones con mayor registro fueron invierno y primavera. La incidencia de EK se incrementó de 0,52 a 2,28 casos/100 000 niños menores de cinco años entre el 2015 al 2019. Conclusiones: Hubo un incremento de las hospitalizaciones por EK, este fue más frecuente en niños menores de cinco años, varones y se presentó en todas las estaciones.

Introduction: There are limited epidemiological reports of Kawasaki disease (KD) in Latin America. Objetive: To describe the characteristics, seasonality, and trend of hospitalizations for KD in children. Methods: Descriptive study of secondary analysis was performed with data on hospitalizations due to KD from healthcare institutions from Peru, 2015-2019. Results: Two hundred ninety-seven hospitalizations were registered. 59.9% were male. 82.2% were under five years old, and 16.2% were under one year old. The departments with more hospitalizations were Lima (202 cases), Lambayeque (21 cases), and Piura (17 cases). The seasons of the year with more hospitalizations were winter and spring. The incidence of KD increased from 0.52 to 2.28 cases per 100,000 children under five years old between 2015 and 2019. Conclusions: There was an increase in hospitalizations due to KD, this was more frequent in children under five years of age and males, and it occurred in all seasons.

Clima organizacional del personal de salud y satisfacción de usuarios atendidos por Servicio de Atención Móvil de Urgencia (SAMU) en el contexto COVID-19, Piura 2021

Objetivo: Conocer la relación entre el clima organizacional del personal de salud y la satisfacción de los usuarios atendidos por el Servicio de Atención Móvil de Urgencias (SAMU) en el contexto COVID-19, Piura. Materiales y métodos: Se aplicó una encuesta a 80 trabajadores de salud para evaluar el clima organizacional y a 110 usuarios del SAMU para evaluar su nivel de satisfacción y si cumplían con los criterios de selección. La encuesta tuvo dos secciones: una dirigida a los trabajadores del SAMU y otra, al usuario. Se evaluaron con escala tipo Likert. Resultados: El 51,3 % del personal de salud fueron hombres, de una edad promedio de 32,65 ± 6,8 % años y hubo más licenciados en enfermería (32,50 %), seguido de médicos (31,30 %). El 54,5 % de usuarios fueron hombres, de una edad promedio de 58,78 ± 20,97 años, el 57,3 % no presentaron ninguna comorbilidad y el 84,5 % utilizaron el servicio una vez. El clima organizacional del personal y sus dimensiones fueron saludables (96,58 ± 3,21). La mayoría (51,60 %) de los usuarios del SAMU se encontraron satisfechos (57/110), mientras que el 38,2 % (42/110) manifestaron estar medianamente satisfechos y el 10,20 % (11/110) mostraron su insatisfacción. Se comprueba la hipótesis principal que existe asociación entre el clima organizacional y la satisfacción de los usuarios atendidos por el SAMU (p < 0,005) y existe asociación entre las cinco dimensiones con la satisfacción de los usuarios. Conclusiones: Existe relación entre el clima organizacional de los trabajadores de salud del Servicio de Atención Móvil de Urgencias y la satisfacción de usuarios atendidos por este servicio en Piura. El clima organizacional y sus dimensiones, comparados con el instrumento elaborado por el Minsa, se encuentran saludables, la mayoría de los pacientes atendidos se mostraron satisfechos con la atención recibida y las comorbilidades más frecuentes fueron la hipertensión y la diabetes mellitus tipo 2.

Objective: To determine the relationship between the organizational climate among healthcare personnel and the satisfaction of users assisted by the Mobile Emergency Care Service (SAMU) in the context of COVID-19, Piura. Materials and methods: A Likert-scale survey was administered to 80 healthcare workers to assess the organizational climate and 110 SAMU users to assess their satisfaction level and whether they met the selection criteria. The survey had one section addressed to SAMU workers and another one to SAMU users. Results: Out of all healthcare personnel, 51.3 % were men with an average age of 32.65 ± 6.8 % years, and there were more registered nurses (32.50 %) than doctors (31.30 %). Out of all users, 54.5 % were men with an average age of 58.78 ± 20.97 years, 57.3 % had no comorbidities and 84.5 % used the service once. The organizational climate and its dimensions showed healthy outcomes (96.58 ± 3.21). Most SAMU users (51.60 %) were satisfied (57/110) while 38.20 % (42/110) were moderately satisfied and 10.20 % (11/110) showed dissatisfaction. The main hypothesis concerning the relationship between the organizational climate and the satisfaction of SAMU users (p < 0.005) was confirmed. Moreover, there was a relationship between the five dimensions and the satisfaction of users. Conclusions: There is a relationship between the organizational climate among SAMU healthcare workers and the satisfaction of SAMU users in Piura. The organizational climate and its dimensions, compared to the instrument developed by MINSA, showed healthy outcomes. Most patients were satisfied with the care received and the most frequent comorbidities were hypertension and type 2 diabetes mellitus.

Características clínicas y epidemiológicas de las muertes por dengue durante un brote en el norte del Perú / Clinical-epidemiological characteristics of dengue deaths during an outbreak in northern Peru

Con el objetivo de describir las características clínicas y epidemiológicas de los pacientes fallecidos por dengue durante el 2017 en Piura, se realizó un estudio retrospectivo de revisión de 24 historias clínicas. El 67% de los casos fueron mujeres y tres (12,5%) estaban embarazadas. La diabetes (12,5%) y la hipertensión (16,7%) fueron las comorbilidades más frecuentes. Sólo en el 12,5% se reportó dengue previo. El tiempo transcurrido desde asistencia sanitaria hasta la muerte fue de 4,10 (DE: 5,34) días. Se hicieron transfusiones de glóbulos rojos en el 45,8% de los casos, plasma en el 25%, plaquetas en el 16,8% y crioprecipitado en el 16,8%. También fueron frecuentes la terapia con cristaloides (91,7%) y el tratamiento con fármacos vasoactivos (70,8%). En conclusión, la mortalidad del dengue grave fue mayoritaria en las mujeres adultas y el tiempo de atención desde el primer establecimiento de salud hasta una unidad especializada fue prolongada.

Objective: To describe the clinical-epidemiological characteristics of patients who died from dengue during 2017. Methods: We conducted a retrospective study of the information related to cases of dengue deaths in the department of Piura. Results: We reviewed 24 medical records. Sixty-seven percent were women and 3 (12.5%) were pregnant. Diabetes (12.5%) and hypertension (16.7%) were the most frequent comorbidities. Previous dengue fever was reported in only 12.5%. The time from health care and death was 4.10 ± 5.34 days. Red blood cell transfusions were performed in 45.8%, plasma in 25%, platelets in 16.8% and cryoprecipitate in 16.8% of cases. Crystalloid therapy (91.7%) and treatment with vasoactive drugs (70.8%) were also frequent. In conclusion, mortality from severe dengue fever was predominantly in adult women, and the time of care from the first health facility to a specialized unit was prolonged.