Dispersion of SARS-CoV-2 lineage BA.5.1.25 and its descendants in Peru during two COVID-19 waves in 2022.

During the third year of the pandemic in Peru, the persistent transmission of SARS-CoV-2 led to the appearance of more transmissible and immune-evasive Omicron sublineages; in that context, the National Genomic Surveillance of SARS-CoV-2 performed by the Peruvian National Institute of Health detected spike mutations in the circulating Omicron BA.5.1.25 sublineage which was later designated as DJ.1 and increased during the fourth COVID-19 wave, this eventually branched into new sublineages. The introduction, emergence, and timing of the most recent common ancestor (tMRCA) of BA.5.1.25 and its descendants (DJ.1, DJ.1.1, DJ.1.2, and DJ.1.3) were investigated in this paper as well as the time lags between their emergence and identification by the Peruvian National Institute of Health. Our findings show that ongoing genomic surveillance of SARS-CoV-2 is critical for understanding its phylogenetic evolution and the emergence of novel variations.

Transparent Multi-Layer Acrylic Composites Reinforced with poly(Acrylated Urethane) Filled Low Grammage Bacterial Cellulose Nanopaper.

Cellulose nanopaper is a material structure that possess high mechanical performance and is widely regarded as a promising two-dimensional reinforcement for polymer matrix composites. This work explores the use of low grammage bacterial cellulose (BC) nanopaper as reinforcement for poly(acrylated urethane) interlayer adhesive to increase the impact performance of multi-layer acrylic composites. The BC nanopaper is impregnated with an acrylated urethane resin and laminated between acrylic sheets to create BC/acrylic composites consisting of one, three and five layers of BC nanopaper-reinforced poly(acrylated urethane) interlayer adhesive(s). Both the the poly(acrylated urethane)-filled BC nanopaper interlayer adhesive and the resulting laminated acrylic composites are optically transparent. The incorporation of BC nanopaper into the poly(acrylated urethane) interlayer adhesive improves the tensile modulus by eightfold and the single-edge notched fracture toughness by 60% compared to neat poly(acrylated urethane). It was also found that using poly(acrylated urethane)-filled BC nanopaper interlayer adhesive proved beneficial to the impact properties of the resulting laminated acrylic composites. In Charpy impact testing, the impact strength of the multi-layer acrylic composites increased by up to 130% compared to the "gold-standard" impact-modified monolithic acrylic, with a BC loading of only 1.6 wt.-%. This article is protected by copyright. All rights reserved.

Employee perception of precision technology use at the dairy farm.

The adoption of precision technologies on dairy farms has increased significantly in recent decades, leading to the challenge of providing employees with resources to maximize the efficient use of these tools. The objective of this study was to explore how dairy farm employees perceive the available precision technologies and to identify possible challenges they face when adapting to their use at the farm. An online survey consisting of four sections (employee demographics, precision technologies in use, perception of these technologies, and opportunities for adapting to technology use) was completed from September to December 2022 by 266 farm employees from three dairies operated under similar management. Most of the respondents were identified as male (72.2%), Hispanic or Latino (92.5%), aged between 21 and 30 (39.1%) or 31 and 40 yr (36.8%), with a bachelor's degree (34.6%) or completion of middle school (29.3%) and having basic or no English proficiency (74%). Overall, the respondents indicated being comfortable (95.6%) with and understanding (91.8%) the technology they use. Employees recognized precision technology as a tool that helps them to be more efficient (93.7%), identifying the technologies' benefits (92.1%). However, challenges for adapting to these technologies included personal limitations, such as not knowing the language of the technology (31%), visual impairments (24%), light sensitivity (14%), and not being able to read (7%). Environmental limitations were also recognized and included cold weather (64.3%), wind (46%), and surroundings that were too dark (31%) or too bright (21%). Significant associations between perception of the technology and age, level of education, and English proficiency were identified. Respondents indicated their desire to learn more about precision technologies implemented at work, which could eventually lead to improved efficiency at the dairy operation through innovations in the way users interact with these technologies, increasing employees' motivation. This study provides insights that could assist the dairy industry in addressing challenges and enhancing opportunities for a more efficient use of precision technologies at dairy farms.

Interior designers' strategies for creating social office space.

The rise of remote working has highlighted the importance of office spaces that support employees' social well-being. However, there is a lack of explicit knowledge on how to design such spaces. In order to address this gap, this study explored the strategies employed by practitioners in designing social office spaces. In-depth interviews with fifteen experienced interior designers were analysed using means-end chain theory. This revealed the designers' common aim to encourage informal social interactions through creating attractive, spacious, recognisable, and spatially integrated breakout spaces. Additionally, communicating group identity, promoting visibility, and offering a cosy atmosphere aimed to foster a sense of connectedness among employees. These findings not only enable more deliberate design decisions but also serve as valuable insights for less experienced designers. Moreover, the framework of design components, affordances and design objectives that emerged from this study can enhance communication between designers and stakeholders involved in office projects.

Experienced interior designers were interviewed about completed office projects to understand how they design social offices. They shared five important strategies to enhance co-worker connectedness and eleven strategies to encourage informal social interactions at work. The study identified ten types of social workplace affordances along with their specific design attributes.

Candida parapsilosis endocarditis without vegetations at Echocardiography: a case report / Endocarditis por Candida parapsilosis sin vegetaciones ecocardiográficas: Un reporte de caso

ABSTRACT Candida endocarditis is a very serious manifestation of candida infections, and it has increased in incidence over the past years. Of these, C. parapsilosis has been described as a cause of endocarditis in native valves of intravenous drug users and prosthetic valves. We report the case of a female that developed a cerebrovascular accident secondary to emboli from aortic prosthetic valve C. parapsilosis endocarditis, despite apparently normal echocardiography. She received antifungal therapy without surgical intervention.

RESUMEN La endocarditis por Candida spp. es una manifestación muy grave de las infecciones por este patógeno y su incidencia ha ido aumentando en los últimos años. La Candida parapsilosis se ha descrito como causa de endocarditis en válvulas nativas de usuarios de drogas intravenosas y prótesis valvulares. Presentamos el caso de una mujer que desarrolló un accidente cerebrovascular secundario a émbolos fúngicos procedentes de una prótesis valvular aórtica infectada por C. parapsilosis, a pesar de un ecocardiograma sin vegetaciones. La paciente recibió tratamiento antifúngico sin necesidad de intervención quirúrgica.

[Effects of postural control upon anti-saccade error rate in older people]. / Efectos del control postural en la tasa de error anti-sacádico en personas mayores.

BACKGROUND: The anti-saccadic (AS) error-rate is used to diagnose neurological disorders. The natural aging process could generate difficulty in carrying out parallel neural processes of conscious motor inhibition and eye movement. Therefore, if balance control is imposed on an elderly person in biped positions during an AS movement, an increase in the AS error-rate is expected. OBJECTIVE: To study the effects of postural control on the AS error-rate in older people. METHODS: An intra and intergroup comparison was made of AS error-rate in an experimental group of older people (PM) and another control group of young people (PJ). For this, blocks of AS and pro-saccadic movements (control) were used randomly in four different postures: (1)sitting (SENT), (2)standing normally (NORMAL), (3)feet together (REDUC), and (4)feet in line (TANDEM). RESULTS: The PM group, compared to the PJ group, showed a progressive increase in the AS error-rate from the sitting position to all standing positions, with the maximum AS error-rate in more complex vertical postures. In contrast, the PJ group did not present significative variability of this AS error-rate in all positions. CONCLUSIONS: It is confirmed that the aging process is associated with an increase in the AS error-rate. This study reveals for the first time a significant increase in the AS error-rate when control of body balance is required for PM, implying a decrease in the multiple processing capacity in PM for the execution of complex and parallel tasks.

Asociación entre el miedo al COVID-19 y la adherencia al tratamiento antirretroviral en personas con VIH-SIDA

Introducción. Una de las consecuencias psicológicas más frecuentes del COVID-19 es el miedo. Éste podría ocasionar una adherencia terapéutica no óptima y permitir la progresión de la enfermedad en personas con VIH. Objetivo. Evaluar la asociación entre el miedo a contraer COVID-19 y la adherencia al tratamiento antirretroviral en personas con VIH entre la tercera y cuarta ola epidémica de COVID-19 en el Perú. Métodos. Estudio transversal analítico en adultos con VIH del centro especializado Vía Libre enrolados por muestreo no probabilístico. Se empleó la escala Fear of COVID-19 Scale para medir el miedo a contraer COVID-19, y el cuestionario SMAQ para evaluar la adherencia terapéutica. Los resultados se presentaron de forma descriptiva, usando chi cuadrado para el análisis bivariado y modelos lineales generalizados familia Poisson para estimar razones de prevalencia crudas y ajustadas (RPa). Resultados. Entre febrero - julio del 2022, se enrolaron 149 personas con una mediana de edad de 35 años, el 91,3% fueron varones, y el 75,2% con carga viral indetectable. No se halló asociación entre el miedo a contraer COVID-19 y la adherencia terapéutica (RPa: 0,99; IC95%: 0,97 a 1,02). Adicionalmente, encontramos que las personas que presentaban alguna comorbilidad fueron 89% más adherentes que los que no las presentaban (RPa: 1,89; IC95%: 1,52 a 2,35). Conclusión. El miedo a contraer COVID-19 no se asoció a la adherencia al TARGA durante la tercera ola de pandemia en el Perú. Sin embargo, el presentar alguna comorbilidad se asoció a una adherencia terapéutica óptima. Se debe poner énfasis en los posibles factores que afecten la adherencia en personas con VIH durante la pandemia por COVID-19.

Introduction. One of the most frequent psychological consequences of COVID-19 is fear, which could lead to non-optimal therapeutic adherence and, therefore, to the disease progression. Objectives. To evaluate the possible association between the fear of contracting COVID-19 and adherence to antiretroviral therapy in persons with HIV during the period between the third and fourth epidemic wave of COVID-19 in Peru. Methods. Analytical cross-sectional study in adults with HIV from the specialized center "Vía Libre" enrolled by non-probabilistic sampling. The validated "Fear of COVID-19 Scale" was used to measure the fear of getting sick from COVID-19, and the "SMAQ" questionnaire to assess therapeutic adherence. Results were presented descriptively, using chi-square for bivariate analysis and generalized linear models, Poisson family to calculate crude and adjusted prevalence ratios (aPR). Results. Between February and July of 2022, 149 adults with a median age of 35 years were enrolled, 91.3% being male, and 75,2% had undetectable viral load levels. No association was found between fear of contracting COVID-19 and HAART adherence (aPR: 0,99; 95% CI 0,97 to 1,02). Persons with a comorbidity were 89% more adherent than persons withoutcomorbidities (RPa: 1,89; 95% CI 1,52 to 2,35). Conclusion. The fear of contracting COVID-19 was not associated with adherence to HAART during the third wave of COVID-19 pandemic in Peru. However, presenting a comorbidity was associated with optimal HAART adherence. Emphasis should be placed on potential factors affecting medication adherence in people with HIV during the COVID-19 pandemic.

Developing a Digital Medication Adherence Intervention for and With Patients With Asthma and Low Health Literacy: Protocol for a Participatory Design Approach.

BACKGROUND: Current eHealth interventions are poorly adopted by people with low health literacy (LHL) as they often fail to meet their needs, skills, and preferences. A major reason for this poor adoption is the generic, one-size-fits-all approach taken by designers of these interventions, without addressing the needs, skills, and preferences of disadvantaged groups. Participatory design approaches are effective for developing interventions that fit the needs of specific target groups; yet, very little is known about the practical implications of executing a participatory design project for and with people with LHL. OBJECTIVE: This study aimed to demonstrate the application of participatory design activities specifically selected to fit the needs and skills of people with LHL and how these were manifested within an overarching eHealth design process. In addition, the study aims to present reflections and implications of these activities that could support future designers to engage people with LHL in their design processes. METHODS: We used the design process of a smart asthma inhaler for people with asthma and LHL to demonstrate participatory design activities. The study was framed under 5 stages of design thinking: empathize, define, ideate, prototype, and test within 2 major iteration cycles. We integrated 3 participatory design activities deemed specifically appropriate for people with LHL: co-constructing stories, experience prototype exhibition, and video prototype evaluation. RESULTS: Co-constructing stories was found to deepen the understanding of the participant's motivation to use or not to use maintenance medication. This understanding informed and facilitated the subsequent development of diverse preliminary prototypes of possible interventions. Discussing these prototypes in the experience prototype exhibition helped provoke reactions, thoughts, and feelings about the interventions, and potential scenarios of use. Through the video prototype evaluation, we were able to clearly communicate the goal and functionality of the final version of our intervention and gather appropriate responses from our participants. CONCLUSIONS: This study demonstrates a participatory design approach for and with patients with asthma and LHL. We demonstrated that careful consideration and selection of activities can result in participants that are engaged and feel understood. This paper provides insight into the practical implications of participatory activities with people with LHL and supports and inspires future designers to engage with this disadvantaged target group.

Deposition of Graphene Oxide on an SPR Fiber Refractometer for Sensor Applications.

Graphene-based materials have been increasingly incorporated to optical fiber plasmonic sensors due to the peculiar physical and chemical properties of these materials (hardness and flexibility, high electrical and thermal conductivity, and very good adsorption for many substances, etc.). In this paper, we theoretically and experimentally showed how the addition of graphene oxide (GO) to optical fiber refractometers permits the development of surface plasmon resonance (SPR) sensors with very good characteristics. We used doubly deposited uniform-waist tapered optical fibers (DLUWTs) as supporting structures because of their already proven good performance. The presence of GO as an effective third layer is useful to tune the wavelength of the resonances. In addition, the sensitivity was improved. We depict the procedures for the production of the devices and characterize the GO+DLUWTs produced in this way. We also showed how the experimental results are in agreement with the theoretical predictions and used these to estimate the thickness of deposited GO. Finally, we compared the performance of our sensors with other ones that have been recently reported, showing that our results are among the best reported. Using GO as the medium in contact with the analyte, in addition to the good overall performance of devices, permit consideration of this option as an interesting possibility for the future development of SPR-based fiber sensors.

Non-destructive methods to assess pesticide exposure in free-living bats.

Bat populations are dwindling worldwide due to anthropogenic activities like agriculture, however the role that pesticide exposure plays on these declines is unclear. To address these research gaps, we first need to develop reliable methods to detect and monitor exposure to environmental pollutants and its effects on free-living bats. The use of biomarkers is a sensitive and informative tool to study sublethal effects in wildlife, however it requires laboratory validation and integrative approaches to be applicable to free-living species. In this study, we propose a set of non-destructive biomarkers to evaluate pesticide exposure in free-ranging bats and validated their suitability with dose-exposure experiments in captivity. We selected three biomarkers that have been widely used in vertebrate ecotoxicology and that combined represent sensitive, specific, and ecologically relevant responses to pollutants: DNA damage, AChE activity, and leukocyte profiles. We used two insectivorous bat species as model species Eptesicus fuscus (laboratory) and Pteronotus mexicanus (field). We found that micronuclei frequency (genotoxicity) and AChE activity (exposure and neurotoxicity) were robust indicators of toxicant exposure. The validity of this set of endpoints was supported by their consistent performance in laboratory and field experiments as well as by the significant correlation among them. Leukocyte profile (systemic stress) results were not consistent between laboratory and field studies, suggesting further evaluation of its suitability is needed. Integrative approaches, like the one we used here, maximize the insights about toxicant effects by combining the information of single biomarkers into more meaningful inferences, which can be applied to environmental risk assessments in wildlife. Furthermore, the use of non-destructive, cost-effective biomarkers is imperative when assessing toxicant exposure and effects in vulnerable wildlife and it should be a priority in the field of wildlife toxicology.

SARS-CoV-2 multi-antigen protein microarray for detailed characterization of antibody responses in COVID-19 patients.

Antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) target multiple epitopes on different domains of the spike protein, and other SARS-CoV-2 proteins. We developed a SARS-CoV-2 multi-antigen protein microarray with the nucleocapsid, spike and its domains (S1, S2), and variants with single (D614G, E484K, N501Y) or double substitutions (N501Y/Deletion69/70), allowing a more detailed high-throughput analysis of the antibody repertoire following infection. The assay was demonstrated to be reliable and comparable to ELISA. We analyzed antibodies from 18 COVID-19 patients and 12 recovered convalescent donors. The S IgG level was higher than N IgG in most of the COVID-19 patients, and the receptor-binding domain of S1 showed high reactivity, but no antibodies were detected against the heptad repeat domain 2 of S2. Furthermore, antibodies were detected against S variants with single and double substitutions in COVID-19 patients who were infected with SARS-CoV-2 early in the pandemic. Here we demonstrated that the SARS-CoV-2 multi-antigen protein microarray is a powerful tool for detailed characterization of antibody responses, with potential utility in understanding the disease progress and assessing current vaccines and therapies against evolving SARS-CoV-2.

Immunogenicity and reactogenicity of a third dose of BNT162b2 vaccine for COVID-19 after a primary regimen with BBIBP-CorV or BNT162b2 vaccines in Lima, Peru.

BACKGROUND: The administration of a third (booster) dose of COVID-19 vaccines in Peru initially employed the BNT162b2 (Pfizer) mRNA vaccine. The national vaccination program started with healthcare workers (HCW) who received BBIBP-CorV (Sinopharm) vaccine as primary regimen and elderly people previously immunized with BNT162b2. This study evaluated the reactogenicity and immunogenicity of the "booster" dose in these two groups in Lima, Peru. METHODS: We conducted a prospective cohort study, recruiting participants from November to December of 2021 in Lima, Peru. We evaluated immunogenicity and reactogenicity in HCW and elderly patients previously vaccinated with either two doses of BBIBP-CorV (heterologous regimen) or BTN162b2 (homologous regimen). Immunogenicity was measured by anti-SARS-CoV-2 IgG antibody levels immediately before boosting dose and 14 days later. IgG geometric means (GM) and medians were obtained, and modeled using ANCOVA and quantile regressions. RESULTS: The GM of IgG levels increased significantly after boosting: from 28.5±5.0 AU/mL up to 486.6±1.2 AU/mL (p<0.001) which corresponds to a 17-fold increase. The heterologous vaccine regimen produced higher GM of post-booster anti-SARS-CoV-2 IgG levels, eliciting a 13% increase in the geometric mean ratio (95%CI: 1.02-1.27) and a median difference of 92.3 AU/ml (95%CI: 24.9-159.7). Both vaccine regimens were safe and well tolerated. Previous COVID-19 infection was also associated with higher pre and post-booster IgG GM levels. CONCLUSION: Although both boosting regimens were highly immunogenic, two doses of BBIBP-CorV boosted with BTN162b2 produced a stronger IgG antibody response than the homologous BNT162b2 regimen in the Peruvian population. Additionally, both regimens were mildly reactogenic and well-tolerated.

Civismo como estrategia de prevención del acoso laboral en estudiantes de enfermería: Una revisión de la literatura / Civility as a prevention strategy for workplace bullying in nursing students: A review of the literatura

INTRODUCCIÓN El acoso laboral en estudiantes de enfermería afecta el bienestar de su salud física y mental dificultando el proceso de aprendizaje y la atención del paciente en el entorno clínico, disminuyendo su capacidad para prosperar y alcanzar su máximo potencial. OBJETIVO Conocer el civismo como estrategia de prevención, definiendo el concepto, y la promoción de una cultura de civilidad para que los estudiantes se desarrollen en ambientes educacionales positivos y puedan prosperar y alcanzar su máximo potencial. METODOLOGÍA Se realizó una revisión bibliográfica narrativa sistematizada, para lo cual se utilizaron las bases de datos PubMed, Science Direct y Epistmónikos, seleccionando 13 los artículos de acuerdo a criterio de inclusión y exclusión establecidos. RESULTADOS Se observa que en el 100% (13) de los artículos revisados se identificó la incivilidad o acoso laboral sufrida por estudiantes de enfermería durante su entorno clínico y en un 92% (12) de los estudios incentiva a formar una cultura de civismo en la educación en enfermería como estrategia para prevenir el acoso o incivilidad. El civismo puede ser implementado a nivel organizacional, de académicos y decanos y a nivel individual. CONCLUSIÓN Las organizaciones de educación en enfermería deben asumir la implementación de un cultura de civismo para promover la civilidad en los entornos de aprendizaje, donde lo primero que se debe realizar es implementar canales de comunicación efectiva, códigos de conducta profesional, y autorreflexión

INTRODUCTION Workplace bullying in nursing students affects the well-being of their physical and mental health, hindering the process of learning and patient care in the clinical environment, reducing their ability to thrive and reach their full potential. OBJETIVE Learn about civility as a prevention strategy, defining the concept, and promoting a culture of citizenship so that students develop in positive educational environments and can thrive and reach their full potential. METHODOLOGY A systematized narrative bibliographical review was carried out, for which the Pubmed, Science Direct and Epistmonikos databases were used, selecting 13 articles according to the established inclusion and exclusion criteria. RESULTS It is observed that in 100% (13) of the reviewed articles the lack of civility or workplace harassment suffered by nursing students during their clinical environment is identified and in 92% (12) of the studies it is encouraged. the formation of a culture of civility in nursing education as a strategy to prevent bullying or lack of civility. Citizenship can be implemented at the organizational, faculty and dean level, and at the individual level. CONCLUSION Nursing education organizations must assume the implementation of a culture of citizenship to promote citizenship in learning environments, where the first thing to do is implement effective communication channels, codes of professional conduct and self-reflection

Human immunomodulatory ligand B7-1 mediates synaptic remodeling via the p75 neurotrophin receptor.

Cell surface receptors, ligands, and adhesion molecules underlie development, circuit formation, and synaptic function of the central nervous system and represent important therapeutic targets for many neuropathologies. The functional contributions of interactions between cell surface proteins of neurons and nonneuronal cells have not been fully addressed. Using an unbiased protein-protein interaction screen, we showed that the human immunomodulatory ligand B7-1 (hB7-1) interacts with the p75 neurotrophin receptor (p75NTR) and that the B7-1:p75NTR interaction is a recent evolutionary adaptation present in humans and other primates, but absent in mice, rats, and other lower mammals. The surface of hB7-1 that engages p75NTR overlaps with the hB7-1 surface involved in CTLA-4/CD28 recognition, and these molecules directly compete for binding to p75NTR. Soluble or membrane-bound hB7-1 altered dendritic morphology of cultured hippocampal neurons, with loss of the postsynaptic protein PSD95 in a p75NTR-dependent manner. Abatacept, an FDA-approved therapeutic (CTLA-4-hFc fusion) inhibited these processes. In vivo injection of hB7-1 into the murine subiculum, a hippocampal region affected in Alzheimer's disease, resulted in p75NTR-dependent pruning of dendritic spines. Here, we report the biochemical interaction between B7-1 and p75NTR, describe biological effects on neuronal morphology, and identify a therapeutic opportunity for treatment of neuroinflammatory diseases.

Oral health in visually impaired patients: a literature review. / [Salud bucal en la población con discapacidad visual: revisión de literatura.]

Introduction: Even though oral diseases are highly prevalent in people with visual impairment (VI) and this population faces access barriers to dental services and is exposed to risk factors that increase their vulnerability, the existing literature on oral health in this population is scarce. Objective: To conduct a literature review in order to describe studies on oral health in persons with VI and provide health care professionals who treat and educate these patients with relevant information. Methods: This is a literature review with a descriptive approach. A total of 26 original articles were included. The selected studies were published in the last six years (2014-March 2020) in English, Portuguese, and Spanish. The search was conducted in the Virtual Health Library, SciELO, PubMed, Scopus, and Clinical Key databases. Keywords combined with Boolean operators "AND" and "OR" were used. Results: Few studies address the use of dental services by people with VI. There is evidence of poor levels of knowledge on oral health and related practices, which increases vulnerability to risk factors for developing diseases compared to the general population. Caries and periodontal disease are reported as the most prevalent oral diseases. Health promotion and education intervention should involve parents, caregivers, and guardians to increase the success rate. Conclusions: People with VI may develop oral diseases easily; therefore, they require dental care and health promotion interventions adapted to their needs.

Introducción: la literatura publicada relacionada con la salud bucal de las personas con discapacidad visual (DV) es escasa, esta población presenta barreras para el acceso a servicios odontológicos, tiene alta prevalencia de enfermedades bucodentales y está expuesta a factores de riesgo que aumentan su vulnerabilidad. Objetivo: realizar una revisión de la literatura científica para describir los estudios que abordan la salud bucal en personas con DV que sirva como insumo a los profesionales de la salud que atienden y educan a esta población. Métodos: revisión bibliográfica con enfoque descriptivo, se incluyeron 26 artículos originales. Los estudiosseleccionados fueron publicados en los últimos seis años (2014-2020 marzo) en inglés, portugués y español. Las bases de datos usadas fueron Biblioteca Virtual en Salud, SciELO, PubMed, Scopus y Clinical Key. Se usaron palabras clave combinadas con operadores booleanos "AND" y "OR". Resultados: existen pocos estudios sobre la asistencia de las personas con DV a los servicios odontológicos. Se evidencian deficientes niveles de conocimientos y prácticas en salud bucal, lo que aumenta la vulnerabilidad frente a factores de riesgo para adquirir patologías en comparación con la población en general. La caries y enfermedad periodontal se reportan como las patologías bucales más prevalentes. En las intervenciones en promoción y educación para la salud se recomienda involucrar a padres, cuidadores y tutores para aumentar la tasa de éxito. Conclusiones: las personas con DV adquieren con facilidad patologías bucales, por lo tanto requieren atención odontológica e intervenciones de promoción de la salud adaptadas a sus necesidades.

Antimicrobial Susceptibility of Neisseria gonorrhoeae Isolates From Peru, 2018 and 2019.

BACKGROUND: Currently, in Latin America, including Peru, the treatment of gonorrhea is still empiric and information regarding antimicrobial resistance is scarce in some countries because of the limited resources, which can contribute to the rising rates of reported multidrug-resistant gonococcal strains. In that context, it is mandatory to continuously monitor and report antimicrobial resistance in N. gonorrhoeae to update treatment recommendations. METHODS: This descriptive study analyzed genital and anal samples from symptomatic patients who attended 15 sexually transmitted infections health facilities from 8 different regions in Peru during the years 2018 to 2019 within the framework of Sentinel Surveillance. After establishing the presumptive diagnosis, the isolates were sent to the Laboratory of Sexually Transmitted Bacteria of the National Institute of Health of Peru in Lima where the species were confirmed (N = 165) and susceptibility profiles were determined. RESULTS: Among the 165 isolates, 95.2% corresponded to male patients, between 18 and 22 years of age (40.6%), half reported having a sexual partner and being heterosexual. Clinically, 89.7% manifested the presence of urethral exudate. Microbiology showed 95.2% of the isolates resistant to ciprofloxacin and 9.1% non-susceptible to azithromycin. Reduced susceptibility to ceftriaxone and cefixime was observed in 1.2% and 3.6% of the isolates respectively. All strains tested were susceptible to spectinomycin. CONCLUSIONS: This study demonstrated that in Peru, fluoroquinolones should not be recommended or used in N. gonorrhoeae infections due to the high percentage of resistant strains. In addition, nationwide access to gonococcal resistance testing, molecular diagnostics and antimicrobial stewardship should be implemented to control the spread of gonococcal antimicrobial resistance.

Loss of FOCAD, operating via the SKI messenger RNA surveillance pathway, causes a pediatric syndrome with liver cirrhosis.

Cirrhosis is usually a late-onset and life-threatening disease characterized by fibrotic scarring and inflammation that disrupts liver architecture and function. While it is typically the result of alcoholism or hepatitis viral infection in adults, its etiology in infants is much less understood. In this study, we report 14 children from ten unrelated families presenting with a syndromic form of pediatric liver cirrhosis. By genome/exome sequencing, we found recessive variants in FOCAD segregating with the disease. Zebrafish lacking focad phenocopied the human disease, revealing a signature of altered messenger RNA (mRNA) degradation processes in the liver. Using patient's primary cells and CRISPR-Cas9-mediated inactivation in human hepatic cell lines, we found that FOCAD deficiency compromises the SKI mRNA surveillance pathway by reducing the levels of the RNA helicase SKIC2 and its cofactor SKIC3. FOCAD knockout hepatocytes exhibited lowered albumin expression and signs of persistent injury accompanied by CCL2 overproduction. Our results reveal the importance of FOCAD in maintaining liver homeostasis and disclose a possible therapeutic intervention point via inhibition of the CCL2/CCR2 signaling axis.

Genomic surveillance of the Lambda SARS-CoV-2 variant in a global phylogenetic context.

The massive sequencing of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and global genomic surveillance strategies allowed the detection of many variants of concern and interest. The variant of interest Lambda (C.37), which originated in South America, has been the most prevalent in Peru and Chile, but its dispersion in other continents still remains unknown. The current study aims to determine the phylogenetic relationship among C.37 isolates worldwide, focusing on spike mutations to understand the spread of Lambda in pandemics. A total of 7441 sequences identified as C.37 were downloaded from the GISAID database; local analysis was carried out to identify spike mutations and phylogenetic analysis was carried out to determine the rate of spread of the virus. Our results showed some spike mutations of Lambda that allowed us to detect small local outbreaks in different countries that occurred in the past and identify several clades that have not yet been designated. Although the lineage C.37 is not epidemiologically relevant in Europe or North America, the endemic behavior of this variant in Peru had a major impact on the second SARS-CoV-2 wave.

Mortality risk during heat waves in the summer 2013-2014 in 18 provinces of Argentina: Ecological study.

Increased frequency of heat waves (HWs) is one of the prominent consequences of climate change. Its impact on human health has been mostly reported in the northern hemisphere but has been poorly studied in the southern hemisphere. The aim of this study was to analyze the effects of the HWs waves occurred in the warm season 2013-14 on mortality in the center-north region of Argentina, where 22 million people live. It was carried out an observational study of ecological-type contrasting the mortality occurred during the HWs of the summer 2013-14 with the mortality in the summers 2010-11 to 2012-13, free from HWs. The mortality was analyzed according to the following variables: place of residence, age, sex and cause of death. During the HWs of the summer 2013-14, 1877 (RR=1.23, 95%CI 1.20-1.28) deaths in excess were registered. Moreover, the death risk significantly increased in 13 of the 18 provinces analyzed. The mortality rates by sex revealed heterogeneous behaviour regarding both the time and spatial scale. The death risk increased with age; it was particularly significant in four provinces for the 60-79 years group and in six provinces in people of 80 years and over. The death causes that showed significantly increments were respiratory, cardiovascular, renal diseases and diabetes.