Modelos de distribución de especies y estado de conservación de murciélagos amenazados en la región tumbesina de Ecuador y Perú / Species distribution models and conservation status of threatened bats in the Tumbesian region of Ecuador and Perú

Resumen Introducción: La biodiversidad se está perdiendo a un ritmo acelerado como resultado del cambio global. Herramientas como los modelos de distribución de especies (MDEs) han sido ampliamente usados para mejorar el conocimiento sobre el estado de conservación de las especies y ayudar a desarrollar estrategias de gestión para mitigar la pérdida de biodiversidad. Objetivo: Determinar cómo la distribución potencial predicha por los MDEs para ocho especies de murciélagos amenazados difiere de los mapas de distribución reportados por la UICN. También, inferir el área de distribución y estado de endemismo de cada especie, y evaluar la importancia de la región tumbesina para su conservación. Métodos: Basados en registros de presencia del rango global de las especies, usamos MDEs para evaluar el estado de conservación de estas ocho especies en la región tumbesina de Ecuador y Perú. Resultados: Las áreas estimadas por los MDEs eran 35-78 % más pequeñas para cuatro especies (Eptesicus innoxius, Lophostoma occidentale, Platalina genovensium y Lonchophylla hesperia) y 26-1 600 % más grandes para tres especies (Amorphochilus schnablii, Promops davisoni y Rhogeessa velilla) que aquellas reportadas por la UICN. Para Tomopeas ravus, el área estimada por el MDE y la UICN fue similar, pero difirió en la distribución espacial. Los MDEs coincidieron con áreas de endemismo informadas por autores previos para E. innoxius, R. velilla y T. ravus, pero fueron diferentes para A. schnablii, P. genovensium, P. davisoni y L. hesperia, debido en parte a las distribuciones proyectadas para estas últimas especies en valles secos interandinos según los MDEs. Conclusiones: La región tumbesina representa una porción significativa (40-96 %) de la distribución predicha de siete de las ocho especies estudiadas, subrayando la importancia de esta región para la conservación de murciélagos. Nuestros resultados muestran las probables distribuciones para estas especies y proporcionan una base importante para identificar vacíos de investigación y desarrollar medidas de conservación para murciélagos amenazados en el punto caliente de biodiversidad de Tumbes.

Abstract Introduction: Biodiversity is being lost at an accelerating rate because of global change. Tools such as species distribution models (SDMs) have been widely used to improve knowledge about species' conservation status and help develop management strategies to mitigate biodiversity loss. SDMs are especially important for species with restricted distributions, such as endemic species. Objective: To determine how potential distribution predicted by SDMs for eight threatened bat species differed from the distribution maps reported by the IUCN. Also, to infer the area of distribution and state of endemism of each specie, and to evaluate the importance of the Tumbesian region for their conservation. Methods: Based on presence records across the species' entire ranges, we used SDMs to assess the conservation status of these eight species in the Tumbesian region of Ecuador and Peru. Results: The areas estimated by SDMs were 35-78 % smaller for four species (Eptesicus innoxius, Lophostoma occidentale, Platalina genovensium and Lonchophylla hesperia) and 26-1 600 % larger for three species (Amorphochilus schnablii, Promops davisoni and Rhogeessa velilla) than those reported by the IUCN. For Tomopeas ravus, the area estimated by the SDM and IUCN was similar but differed in spatial distribution. SDMs coincided with areas of endemism reported by previous authors for E. innoxius, R. velilla, and T. ravus, but were different for A. schnablii, P. genovensium, P. davisoni, and L. hesperia, due in part to projected distributions for these latter species in dry inter-Andean valleys according to the SDMs. Conclusions: The Tumbesian region represents a significant portion (40-96 %) of the predicted distribution of seven of the eight species studied, underscoring the importance of this region for bat conservation. Our results show likely distributions for these species and provide an important basis for identifying research gaps and developing conservation measures for threatened bats in the Tumbes biodiversity hotspot.

Self-Reported ICD-11 Personality Disorder Severity in Peruvian Adolescents: Structure, Validity, and Tentative Cutoffs.

Personality disorder (PD) is particularly common in adolescents, which underscores the significance of early screening, diagnosis, and intervention. To date, the definition of PD in the new ICD-11 has not yet been investigated in adolescents. This study therefore aimed to investigate the unidimensionality and criterion validity of self-reported ICD-11 PD features in Peruvian adolescents using the Personality Disorder Severity ICD-11 (PDS-ICD-11) scale. A total of 1,073 students (63% female; age range 12-16 years) were administered the PDS-ICD-11 scale along with criterion measures of personality pathology and symptom distress. The PDS-ICD-11 score showed adequate unidimensionality and conceptually meaningful associations with external criterion variables. The findings indicate that ICD-11 PD features, as measured with the PDS-ICD-11 scale, are structurally and conceptually sound when employed with adolescents. Norm-based cutoffs derived from the present study may be used for clinical interpretation. The PDS-ICD-11 may be employed as an efficient screening tool for personality dysfunction in adolescents.

Ecological approach to the characteristics and determinants of sexual violence against adolescents in Perú / Aproximación ecológica a las características y factores determinantes de la violencia sexual contra adolescentes en Perú.

Introduction. Sexual violence against adolescents is a global problem that affects young people around the world. The ecological model examines its forms and determinants through interconnected levels. Objective. To determine the frequency, characteristics, and predictors of sexual violence in adolescents attending school in Perú. Materials and methods. This was a cross-sectional study that secondarily analyzed data from the Encuesta Nacional de Relaciones Sociales (2019). A stratified probabilistic sample involved 1,579 youth aged 12-17 from 93 schools. The questionnaire evaluated physical, psychological, and sexual violence in the family and at school. Models were estimated using logistic regression analysis, calculating odds ratio (OR). Results. Eighteen point sixty eight per cent (95% CI: 16.80-20.60) suffered some type of sexual assault. In addition, 9.75% (95% CI: 8.28-11.21) reported having been touched in some part of the body and 1.84% (95% CI: 1.17-2.50) reported that was a victim of rape. Age was identified as a risk factor in the microsystem (OR = 1.48) (95% CI: 1.26-1.74), while the age of the first experienced sexual violence acted as a protective factor (OR = 0.61) (95% CI: 0.54-0.69). In addition, in the macrosystem, the perception that violence occurs mainly outside the home increased the risk (OR = 2.06) (95% CI: 1.01-4.19). Conclusions. Approximately two out of ten respondents reported having experienced some type of sexual violence, with verbal harassment and invasive personal contact being the most common. No single level or factor can fully explain adolescent sexual violence without considering its ecological interconnectedness.

Introducción. La violencia sexual contra los adolescentes es un problema global que afecta a jóvenes de todo el mundo. El modelo ecológico examina sus formas y factores determinantes a través de niveles interconectados. Objetivo. Determinar la frecuencia, las características y los predictores de la violencia sexual contra adolescentes escolarizados en Perú. Materiales y métodos. Se llevó a cabo un estudio transversal en el cual se analizaron de manera secundaria los datos de la Encuesta Nacional de Relaciones Sociales (2019). Una muestra probabilística estratificada incluyó a 1.579 jóvenes de 12 a 17 años de 93 escuelas. Con el cuestionario se evaluó la violencia sexual en la familia y en la escuela. Se estimaron modelos mediante análisis de regresión logística, calculando la razón de momios (odds ratio, OR). Resultados. El 18,68 % (IC95%: 16,80-20,60) sufrió algún tipo de agresión sexual. Además, el 9,75 % (IC95%: 8,28-11,21) informó haber sido tocado en alguna parte del cuerpo y el 1,84 % (IC95%: 1,17-2,50) informó que fue víctima de violación. La edad se identificó como factor de riesgo en el microsistema (OR=1,48) (IC95%: 1,26-1,74), mientras que la edad de la primera violencia sexual actuó como factor protector (OR=0,61) (IC95%: 0,54-0,69). Además, en el macrosistema, la percepción de que la violencia ocurre principalmente fuera del hogar incrementó el riesgo (OR=2,06) (IC95%: 1,01-4,19). Conclusión. Aproximadamente, dos de cada diez encuestados informaron haber experimentado algún tipo de violencia sexual, siendo el acoso verbal y el contacto personal invasivo los más comunes. Ningún nivel del modelo ecológico o factor único puede explicar completamente la violencia sexual contra los adolescentes sin considerar su interconexión ecológica.

Net primary productivity and litter decomposition rates in two distinct Amazonian peatlands.

Measurements of net primary productivity (NPP) and litter decomposition from tropical peatlands are severely lacking, limiting our ability to parameterise and validate models of tropical peatland development and thereby make robust predictions of how these systems will respond to future environmental and climatic change. Here, we present total NPP (i.e., above- and below-ground) and decomposition data from two floristically and structurally distinct forested peatland sites within the Pastaza Marañón Foreland Basin, northern Peru, the largest tropical peatland area in Amazonia: (1) a palm (largely Mauritia flexuosa) dominated swamp forest and (2) a hardwood dominated swamp forest (known as 'pole forest', due to the abundance of thin-stemmed trees). Total NPP in the palm forest and hardwood-dominated forest (9.83 ± 1.43 and 7.34 ± 0.84 Mg C ha-1 year-1, respectively) was low compared with values reported for terra firme forest in the region (14.21-15.01 Mg C ha-1 year-1) and for tropical peatlands elsewhere (11.06 and 13.20 Mg C ha-1 year-1). Despite the similar total NPP of the two forest types, there were considerable differences in the distribution of NPP. Fine root NPP was seven times higher in the palm forest (4.56 ± 1.05 Mg C ha-1 year-1) than in the hardwood forest (0.61 ± 0.22 Mg C ha-1 year-1). Above-ground palm NPP, a frequently overlooked component, made large contributions to total NPP in the palm-dominated forest, accounting for 41% (14% in the hardwood-dominated forest). Conversely, Mauritia flexuosa litter decomposition rates were the same in both plots: highest for leaf material, followed by root and then stem material (21%, 77% and 86% of mass remaining after 1 year respectively for both plots). Our results suggest potential differences in these two peatland types' responses to climate and other environmental changes and will assist in future modelling studies of these systems.

Mediciones de la productividad primaria neta (PPN) y la descomposición de materia orgánica de las turberas tropicales son escasas, lo que limita nuestra capacidad para parametrizar y validar modelos de desarrollo de las turberas tropicales y, en consecuencia, realizar predicciones sólidas sobre la respuesta de estos sistemas ante futuros cambios ambientales y climáticos. En este estudio, presentamos datos de PPN total (es decir, biomasa aérea y subterránea) y descomposición de la materia orgánica colectada en dos turberas boscosas con características florísticas y estructurales contrastantes dentro de la cuenca Pastaza Marañón al norte del Perú, el área de turberas tropicales más grande de la Amazonia: (1) un bosque pantanoso dominado por palmeras (principalmente Mauritia flexuosa) y (2) un bosque pantanosos dominado por árboles leñosos de tallo delgado (conocido como 'varillal hidromórfico'). La PPN total en el bosque de palmeras y el varillal hidromórfico (9,83 ± 1,43 y 7,34 ± 0,84 Mg C ha­1 año­1 respectivamente) fue baja en comparación con los valores reportados para los bosques de tierra firme en la región (14,21­15,01 Mg C ha­1 año­1) y para turberas tropicales en otros lugares (11,06 y 13,20 Mg C ha­1 año­1). A pesar de que la PPN total fue similar en ambos tipos de bosque, hubo diferencias considerables en la distribución de la PPN. La PPN de las raíces finas fue siete veces mayor en el bosque de palmeras (4,56 ± 1,05 Mg C ha­1 año­1) que en el varillal hidromórfico (0,61 ± 0,22 Mg C ha­1 año­1). La PPN de la biomasa aérea de las palmeras, un componente ignorado frecuentemente, contribuyó en gran medida a la PPN total del bosque de palmeras, representando el 41% (14% en el varillal hidromórfico). Por el contrario, la tasa de descomposición de materia orgánica de Mauritia flexuosa fue la misma en ambos sitios: la más alta corresponde a la hojarasca, seguida por las raíces y luego el tallo (21%, 77% y 86% de la masa restante después de un año, respectivamente para ambos sitios). Nuestros resultados sugieren diferencias potenciales en la respuesta de estos dos tipos de turberas al clima y otros cambios ambientales, y ayudarán en futuros estudios de modelamiento de estos sistemas.

Diagnostic accuracy of an exhaled breath test for TB in hospitalized patients with cough or risk.

Closing the TB diagnostic gap is an urgent priority, for which non-sputum-based tests are needed. We evaluated the diagnostic accuracy of Aeonose, an exhaled breath test (EBT), as a TB triage test.Patients with cough or TB risk factors admitted to a tertiary hospital in Lima, Peru, were prospectively enrolled and underwent EBT. We evaluated EBT sensitivity and specificity for diagnosing pulmonary TB using culture and Xpert as primary and secondary reference standards and conducted stratified analyses based on risk factors.EBT sensitivity was 85% (95% CI 72.9-93.4), and specificity was 51% (95% CI 46.0-56.6) in the training cohort (n = 417). EBT sensitivity was 70% (95% CI 47.1-86.8), and specificity was 54% (95% CI 44.8-63.6) in the validation cohort (n = 139) using the culture reference standard, with higher sensitivity (78%) when using the Xpert reference standard (n = 156). Sensitivity (60%) and specificity (48%) were lower when patients with prior TB were included. In a subset of participants randomly selected for interviews, 94% (15/16) preferred EBT to sputum-based testing.EBT had moderate sensitivity and low specificity as a TB triage test in this hospitalised cohort with cough or risk factors. Diagnostic accuracy was lower in people with prior TB..

Assessing the prevalence and impact of preserved ratio impaired spirometry in low-income and middle-income countries: a post-hoc cross-sectional analysis.

BACKGROUND: More than 90% of the morbidity and mortality from chronic respiratory disease occurs in low-income and middle-income countries (LMICs), with substantial economic impact. Preserved ratio impaired spirometry (PRISm) is a prevalent lung function abnormality associated with increased mortality in high-income countries. We aimed to conduct a post-hoc analysis of a cross-sectional study to assess the prevalence of, the risk factors for, and the impact of PRISm in three diverse LMIC settings. METHODS: We recruited a random, age-stratified and sex-stratified sample of the population in semi-urban Bhaktapur, Nepal; urban Lima, Peru; and rural Nakaseke, Uganda. Quality-assured post-bronchodilator spirometry was performed to American Thoracic Society standards and PRISm was defined as a forced expiratory volume in one second (FEV1) of less than 80% predicted with a FEV1/forced vital capacity ratio of 0·70 or more. We used t tests and χ2 analyses to assess the relationships between demographic, biometric, and comorbidity variables with PRISm. Multivariable logistic models with random intercept by site were used to estimate odds ratios (ORs) with 95% CIs. FINDINGS: 10 664 participants were included in the analysis, with a mean (SD) age of 56·3 (11·7) years and an equal distribution by sex. The prevalence of PRISm was 2·5% in Peru, 9·1% in Nepal, and 16·0% in Uganda. In multivariable analysis, younger age (OR for each decile of age 0·87, 95% CI 0·82-0·92) and being female (1·37, 1·18-1·58) were associated with increased odds of having PRISm. Biomass exposure was not consistently associated with PRISm across sites. Individuals with PRISm had impairment in respiratory-related quality of life as measured by the St George's Respiratory Questionnaire (OR by decile 1·18, 95% CI 1·10-1·25). INTERPRETATION: The prevalence of PRISm is heterogeneous across LMIC settings and associated with age, female sex, and biomass exposure, a common exposure in LMICs. A diagnosis of PRISm was associated with worse health status when compared with those with normal lung function. Health systems in LMICs should focus on all spirometric abnormalities as opposed to obstruction alone, given the disease burden, reduced quality of life, and size of the undiagnosed population at risk. FUNDING: Medical Research Council.

Functional prediction based on 16S rRNA metagenome data from bacterial microbiota associated with macroalgae from the Peruvian coast.

Macroalgae are vital reservoirs for essential epibiotic microorganisms. Among these are growth-promoting bacteria that support the growth and healthy development of their host macroalgae, and these macroalgae can be utilized in agriculture as biostimulants, offering an alternative to traditional agrochemicals. However, to date, no comparative studies have been conducted on the functional profile and bacterial diversity associated with coastal macroalgae of Peru. In this study, we employed amplicon sequencing of the V3-V4 region of 16S rRNA gene in twelve host macroalgae collected from two rocky shores in central Peru to compare their bacterial communities. The results revealed high bacterial diversity across both sites, but differences in microbial composition were noted. The phyla Bacteroidota and Pseudomonadota were predominant. The functional prediction highlighted 44 significant metabolic pathways associated with the bacterial microbiota when comparing host macroalgae. These active pathways are related to metabolism and genetic and cellular information processing. No direct association was detected between the macroalgal genera and the associated microbiota, suggesting that the bacterial community is largely influenced by their genetic functions than the taxonomic composition of their hosts. Furthermore, some species of Chlorophyta and Rhodophyta were observed to host growth-promoting bacteria, such as Maribacter sp. and Sulfitobacter sp.

Cost-sharing and associated factors in the Peruvian private health care system.

BACKGROUND: The costs associated with healthcare are of critical importance to both decision-makers and users, given the limited resources allocated to the health sector. However, the available scientific evidence on healthcare costs in low- and middle-income countries, such as Peru, is scarce. In the Peruvian context, the health system is fragmented, and the private health insurance and its financing models have received less research attention. We aimed to analyse user cost-sharing and associated factors within the private healthcare system. METHODS: Our study was cross-sectional, using open data from the Electronic Transaction Model of Standardized Billing Data-TEDEF-SUSALUD, between 2021-2022. Our unit of analysis is the user's medical bills. We considered the total amount of cost-sharing, proportion of total payments as cost-sharing, and cost-sharing as a proportion of minimum salaries. We use a multiple regression model to perform the analyses. RESULTS: Our study included 5,286,556 health services provided to users of the private health insurance in Peru. We found a significant difference was observed in the cost-sharing for hospitalization-related services, with an average of 419.64 soles per day (95% CI: 413.44 to 425.85). Also, we identified that for hospitalization-related services per day is, on average, 0.41 (95% CI: 0.41 to 0.41) minimum salaries more expensive than outpatient care, although cost-sharing per day of hospitalization represent on average only 14% of the total amount submitted. CONCLUSIONS: Our study provides a detailed overview of cost-sharing in the private healthcare system in Peru and the factors associated with them. Policymakers can use the study's finding that higher cost-sharing for inpatient hospitalization compared to outpatient care in private insurance can create inequities in access to healthcare to design policies aimed at reducing these costs and promoting a more equitable and accessible healthcare system in Peru.

External validation of Finnish diabetes risk score (FINDRISC) and Latin American FINDRISC for screening of undiagnosed dysglycemia: Analysis in a Peruvian hospital health care workers sample.

AIMS: To evaluate the external validity of Finnish diabetes risk score (FINDRISC) and Latin American FINDRISC (LAFINDRISC) for undiagnosed dysglycemia in hospital health care workers. METHODS: We carried out a cross-sectional study on health workers without a prior history of diabetes mellitus (DM). Undiagnosed dysglycemia (prediabetes or diabetes mellitus) was defined using fasting glucose and two-hour oral glucose tolerance test. LAFINDRISC is an adapted version of FINDRISC with different waist circumference cut-off points. We calculated the area under the receptor operational characteristic curve (AUROC) and explored the best cut-off point. RESULTS: We included 549 participants in the analysis. The frequency of undiagnosed dysglycemia was 17.8%. The AUROC of LAFINDRISC and FINDRISC were 71.5% and 69.2%; p = 0.007, respectively. The optimal cut-off for undiagnosed dysglycemiaaccording to Index Youden was ≥ 11 in LAFINDRISC (Sensitivity: 78.6%; Specificity: 51.7%) and ≥12 in FINDRISC (Sensitivity: 70.4%; Specificity: 53.9%). CONCLUSION: The discriminative capacity of both questionnaires is good for the diagnosis of dysglycemia in the healthcare personnel of the María Auxiliadora hospital. The LAFINDRISC presented a small statistical difference, nontheless clinically similar, since there was no difference by age or sex. Further studies in the general population are required to validate these results.

Challenges associated with follow-up care after implementation of an HPV screen-and-treat program with ablative therapy for cervical cancer prevention.

BACKGROUND: Cervical cancer is a preventable cancer; however, decreasing its prevalence requires early detection and treatment strategies that reduce rates of loss to follow-up. This study explores factors associated with loss to follow-up among HPV-positive women after implementation of a new HPV-based screen-and-treat approach for cervical cancer prevention in Iquitos, Peru. METHODS: We conducted semi-structured interviews with "obstetras" (i.e., midwives) (n = 15) working in cervical cancer prevention and women (n = 24) who were recorded as lost to follow-up after positive HPV results. We used the Health Care Access Barriers Model to guide analyses. We utilized manifest content analysis to describe barriers to follow-up according to the obstetras and thematic analysis to report themes from the women's perspectives. We also report the steps and time taken to contact women. RESULTS: We found an incomplete and fragmented patient monitoring system. This incomplete system, in conjunction with challenges in contacting some of the women, led to structural barriers for the obstetras when attempting to deliver positive results. Women in this study expressed a desire to receive treatment, however, faced cognitive barriers including a lack of understanding about HPV results and treatment procedures, fear or anxiety about HPV or treatment, and confusion about the follow-up process. Women also reported having important work matters as a barrier and reported frequently using natural medicine. Reported financial barriers were minimal. CONCLUSION: This study highlights the barriers to follow-up after implementation of a primary-level HPV-based screen-and-treat approach. While some barriers that have previously been associated with loss to follow-up were not as prominently observed in this study (e.g., financial), we emphasize the need for screen-and-treat programs to focus on strategies that can address incomplete registry systems, structural challenges in results delivery, cognitive barriers in understanding results and treatment, and work-related barriers.

Problematic use of the internet as a predictor of oral health-related quality of life: the mediating role of lifestyles in Peruvian schoolchildren.

BACKGROUND: The pervasiveness of the Internet in everyday life, especially among young people, has raised concerns about its effects on mental health, education, and, recently, oral health. Previous research has suggested a complex relationship between Problematic Internet Use (PIU), lifestyles, and oral health-related quality of life, highlighting the need to examine these interactions further. This study seeks to explore the PIU as a predictor of oral health-related quality of life and examine the mediating role of lifestyles between both in a sample of Peruvian schoolchildren. METHODS: A cross-sectional study was carried out with 293 Peruvian students aged 12 to 17 years (M = 14.42, SD = 1.5), using structural equations to analyze the relationship between PIU, lifestyles, and quality of life related to oral health. The data collection procedure was through a face-to-face survey. Validated instruments measured PIU, lifestyles, and oral health-related quality of life. The study's theoretical model was analyzed through structural equation modeling with the MLR estimator. The fit assessment was performed using the comparative fit index (CFI), root mean square error of approximation (RMSEA), and standardized root mean square residual (SRMR). RESULTS: They indicated significant correlations between PIU, lifestyles, and oral health-related quality of life. A negative influence of PIU on lifestyles (ß = -0.30, p < .001) and on oral health-related quality of life (ß = -0.35, p < .001) was observed, as well as a positive relationship between PIU and oral health-related quality of life (ß = 0.29, p < .001). The mediation of lifestyles was statistically significant, suggesting that they mediate the relationship between PIU and oral health-related quality of life. CONCLUSIONS: The study confirms that PIU can negatively affect adolescents' oral health-related quality of life, mediated by unhealthy lifestyles. It underlines the importance of promoting balanced Internet use and healthy lifestyles among young people to improve their oral well-being.

One-step purification and characterization of a haloprotease from Micrococcus sp. PC7 for the production of protein hydrolysates from Andean legumes.

The high content and quality of protein in Andean legumes make them valuable for producing protein hydrolysates using proteases from bacteria isolated from extreme environments. This study aimed to carry out a single-step purification of a haloprotease from Micrococcus sp. PC7 isolated from Peru salterns. In addition, characterize and apply the enzyme for the production of bioactive protein hydrolysates from underutilized Andean legumes. The PC7 protease was fully purified using only tangential flow filtration (TFF) and exhibited maximum activity at pH 7.5 and 40 °C. It was characterized as a serine protease with an estimated molecular weight of 130 kDa. PC7 activity was enhanced by Cu2+ (1.7-fold) and remained active in the presence of most surfactants and acetonitrile. Furthermore, it stayed completely active up to 6% NaCl and kept Ì´ 60% of its activity up to 8%. The protease maintained over 50% of its activity at 25 °C and 40 °C and over 70% at pH from 6 to 10 for up to 24 h. The determined Km and Vmax were 0.1098 mg mL-1 and 273.7 U mL-1, respectively. PC7 protease hydrolyzed 43%, 22% and 11% of the Lupinus mutabilis, Phaseolus lunatus and Erythrina edulis protein concentrates, respectively. Likewise, the hydrolysates from Lupinus mutabilis and Erythrina edulis presented the maximum antioxidant and antihypertensive activities, respectively. Our results demonstrated the feasibility of a simple purification step for the PC7 protease and its potential to be applied in industrial and biotechnological processes. Bioactive protein hydrolysates produced from Andean legumes may lead to the development of nutraceuticals and functional foods contributing to address some United Nations Sustainable Development Goals (SDGs).

Impact of the COVID-19 Pandemic on the Treatment of Cancer Patients at a Hospital in Peru.

BACKGROUND: The appearance of the new coronavirus, SARS-CoV-2, in Wuhan - China, in 2019 led to the declaration of a COVID-19 pandemic by the World Health Organization. Peru confirmed its first case on March 6, 2020, prompting a significant change in medical care. PURPOSE: Our objective was to determine the impact of the COVID-19 pandemic on cancer treatment in Peru. METHODS: A retrospective analysis of hospital data from the National Institute of Neoplastic Diseases revealed substantial decreases in oncological treatments in 2020 compared to 2019. RESULTS: Oncological treatments involving bone marrow transplantation had a greater impact between the months of April and September, at -100% (p=0.003). However, treatments involving surgery in April (-95% [p≤0.001]), radiotherapy in May (-76% [p=0.002]) and chemotherapy in June (-71% [p≤0.001]) also showed significant impacts. Comparative analysis with international data revealed similar trends in cancer care interruptions in different countries. However, variations in the magnitude of the impact were observed, influenced by regional health policies and the severity of the pandemic. CONCLUSIONS: The findings underscore the challenges cancer care providers face during public health crises, requiring adaptive strategies to ensure continued access to essential treatments. Addressing these challenges requires comprehensive public health responses to mitigate the impact of future crises on cancer care systems.

Risk Factors for Depression Among Middle-Aged to Older People Living With HIV in Lima, Peru.

INTRODUCTION: Depression is prevalent among aging people living with HIV (PLWH) worldwide. We sought to identify depression risk factors among a group of middle-aged and older PLWH in Lima, Peru. MATERIALS AND METHODS: We assessed risk factors for depression among PLWH over age 40 receiving care in an HIV clinic in Lima, Peru. The Patient Health Questionnaire-9 (PHQ-9) was administered. We performed descriptive statistics and logistic regression analyses. RESULTS: Mean age was 51.7 ± 7.7 years with 15.3% females. One-quarter of participants had depression with higher frequency in females. Risk factors that significantly increased the risk of depression included female sex (adjusted prevalence ratio [aPR] = 2.19 [95%CI 1.07-4.49]), currently smoking (aPR = 2.25 [95%CI 1.15-4.43]), and prior opportunistic infection (aPR = 2.24 [95%CI 1.05-4.76]). DISCUSSION: Our study demonstrates that PLWH who are female, current smokers, or had an opportunistic infection have higher risk of depression. Identifying PLWH at-risk for depression is key to early mental health interventions.

Factors affecting depression in older people with HIV in PeruIntroductionDepression is common in older people living with HIV (PLWH) worldwide. We identified depression risk factors among a group of middle-aged and older PLWH in Lima, Peru.Materials and MethodsWe assessed risk factors for depression among PLWH over age 40 receiving care in an HIV clinic in Lima, Peru. The Patient Health Questionnaire-9 (PHQ-9) was administered.ResultsMean age was 51.7 ± 7.7 years with 15.3% females. One-quarter of participants had depression with higher frequency in females. Risk factors that significantly increased the risk of depression included female sex (adjusted prevalence ratio [aPR] = 2.19 [95%CI 1.07-4.49]), currently smoking (aPR = 2.25 [95%CI 1.15-4.43]), and prior opportunistic infection (aPR = 2.24 [95%CI 1.05-4.76]).DiscussionOur study demonstrates that PLWH who are female, current smokers, or had an opportunistic infection have higher risk of depression. Identifying PLWH at-risk for depression is key to early treatment or interventions that can improve mental health in PLWH in Peru.

Body Mass Index, Adherence to a Healthy Lifestyle, and Breakfast Consumption Associated with Religious Affiliation in Peruvian University Students: A Cross-Sectional Study.

BACKGROUND: Despite evidence suggesting a relationship between religiosity and health habits, there is a paucity of studies specifically examining this association in the context of Peruvian university students. This study compared body mass index (BMI), adherence to a healthy lifestyle, and breakfast consumption in Peruvian university students of four religious denominations: Seventh Day Adventists (SDA), Catholics, Baptists, and Evangelicals. METHODS: A cross-sectional study was conducted online among 4557 students from a Peruvian university. The BMI and the frequency of breakfast consumption were evaluated, and the Diet and Healthy Lifestyle Scale (DEVS) was applied. The variables studied were associated using simple and multiple linear regression and Poisson models with robust variance. RESULTS: Baptist (B = 0.44, 95% CI: 0.10-0.78; p = 0.011), Catholic (B = 0.3, 95% CI: 0.12-0.47; p = 0.001), and Evangelical (B = 0.32, 95% CI: 0.09 to 0.64; p = 0.014) students had a significantly higher BMI compared to SDA. Baptist (B = -0.2, 95% CI: -0.37--0.05; p = 0.017) and Evangelical (B = -0.13, 95% CI: -0.28--0.03; p = 0.012) students exhibited a lower mean score on the measure of healthy lifestyles compared to SDA students. Additionally, Baptist (PR = -0.32, 95% CI: -0.92--0.12; p = 0.035) and Catholic (PR = -0.3, 95% CI: -0.99--0.19; p = 0.016) students exhibited a lower probability of eating breakfast regularly compared to SDA students. CONCLUSIONS: Health professionals should consider these findings when designing and implementing health promotion programs that are culturally sensitive and respectful of the beliefs and practices of all religious groups in university settings.

Soil depth and physicochemical properties influence microbial dynamics in the rhizosphere of two Peruvian superfood trees, cherimoya and lucuma, as shown by PacBio-HiFi sequencing.

The characterization of soil microbial communities at different depths is essential to understand their impact on nutrient availability, soil fertility, plant growth and stress tolerance. We analyzed the microbial community at three depths (3 cm, 12 cm, and 30 cm) in the native fruit trees Annona cherimola (cherimoya) and Pouteria lucuma (lucuma), which provide fruits in vitamins, minerals, and antioxidants. We used PacBio-HiFi, a long-read high-throughput sequencing to explore the composition, diversity and putative functionality of rhizosphere bacterial communities at different soil depths. Bacterial diversity, encompassing various phyla, families, and genera, changed with depth. Notable differences were observed in the alpha diversity indices, especially the Shannon index. Beta diversity also varied based on plant type and depth. In cherimoya soils, positive correlations with Total Organic Carbon (TOC) and Cation Exchange Capacity (CEC) were observed, but negative ones with certain cations. In lucuma soils, indices like the Shannon index exhibited negative correlations with several metals and specific soil properties. We proposed that differences between the plant rhizosphere environments may explain the variance in their microbial diversity. This study provides insights into the microbial communities present at different soil depths, highlighting the prevalence of decomposer bacteria. Further research is necessary to elucidate their specific metabolic features and overall impact on crop growth and quality.

Psychometric analysis and adaptation of the generalized anxiety questionnaire (GAD-7) to the Collao Quechua language in Peru. / Adaptación y análisis psicométrico del cuestionario de ansiedad generalizada (GAD-7) al Quechua Collao en Perú.

OBJECTIVES.: To adapt the 7-item Generalized Anxiety Questionnaire (GAD-7) from English to the cultural and linguistic context of Quechua Collao and to analyze its psychometric properties in Puno, Peru. MATERIAL AND METHODS.: The GAD-7 in its original version was translated into the Collao Quechua variety and its psychometric properties were analyzed. The participants were bilingual (Spanish and Quechua), over 18 years of age and of both sexes. The exploratory factor analysis (EFA) was evaluated using parallel analysis, confirmatory factor analysis (CFA) and goodness-of-fit indices; reliability was also analyzed using McDonald's classic alpha and Omega. RESULTS.: Judges and focus group participants conducted the cultural and linguistic adaptation of the GAD-7 to Quechua Collao; the EFA reported the presence of a single factor (KMO=0.88, p=0.01); while the CFA confirmed adequate adjustments in the unifactorial model (CFI=0.994; TLI=0.991; SRMR=0.027; RMSEA=0.092), good reliability (α=0.896; ω=0.894) and was also invariant across age groups, sex, marital status and educational level. CONCLUSIONS.: The questionnaire showed validity for a unidimensional model of the GAD-7 adapted to the Collao Quechua, as well as optimal reliability and invariance by the evaluated groups. Its use could benefit anxiety research and care.Motivation for the study. Peru has the largest Quechua population; however, the measurement of anxiety is not validated in the cultural and linguistic context of the Collao Quechua variety mainly spoken in Puno. Main findings. The adaptation of the 7-item Generalized Anxiety Questionnaire (GAD-7) to Collao Quechua reported adequate internal validity, invariance, and optimal reliability. Implications. The GAD-7 adapted to Collao Quechua could be implemented in primary health care for screening for generalized anxiety symptoms.

Detection of SARS-CoV-2 variants in hospital wastewater in Peru, 2022. / Detección de variantes del SARS-CoV-2 en aguas residuales de hospitales en Perú, 2022.

OBJECTIVE.: To identify the presence of the SARS-CoV-2 virus in wastewater from hospitals in Peru. MATERIALS AND METHODS.: Water samples were collected from the effluents of nine hospitals in Peru during March and September 2022. SARS-CoV-2 was identified by using Illumina sequencing. Variant, lineage and clade assignments were carried out using the Illumina and Nextclado tools. We verified whether the SARS-CoV-2 variants obtained from wastewater were similar to those reported by the National Institute of Health of Peru from patients during the same period and region. RESULTS.: Eighteen of the 20 hospital wastewater samples (90%) provided sequences of sufficient quality to be classified as the Omicron variant according to the WHO classification. Among them, six (30%) were assigned by Nextclade to clades 21K lineage BA.1.1 (n=1), 21L lineage BA.2 (n=2), and 22B lineages BA.5.1 (n=2) and BA .5.5 (n=1). CONCLUSIONS.: SARS-CoV-2 variants were found in hospital wastewater samples and were similar to those reported by the surveillance system in patients during the same weeks and geographic areas. Wastewater monitoring could provide information on the environmental and temporal variation of viruses such as SARS-CoV-2.Motivation for the study. To contribute to the surveillance of environmental samples from hospital effluents in order to achieve early warning of possible infectious disease outbreaks. Main findings. The Omicron variant of the COVID-19 virus was detected in wastewater from hospitals in Puno, Cuzco and Cajamarca; these results are similar to the reports by the Peruvian National Institute of Health based on nasopharyngeal swab samples. Implications. The presence of the Omicron variant in hospital wastewater during the third wave of the pandemic should raise awareness of the treatment system before wastewater is discharged into the public sewer system.

"They treat us equally, they guide us": peer navigation for HIV care linkage in men who have sex with men and transgender women in Lima, Peru. / «Nos trata por igual, nos guía¼: navegación de pares para la vinculación al cuidado del VIH en hombres que tienen sexo con hombres y mujeres transgénero en Lima, Perú.

OBJECTIVE.: To analyze the elements of a navigation program in Lima that facilitated the linkage of men who have sex with men (MSM) and transgender women (TW) with HIV care. MATERIAL AND METHODS.: We conducted interviews with 20 users receiving navigation services and 4 peer navigators living with HIV. RESULTS.: The work of the navigators contributed to filling a gap in HIV services, providing personalized accompaniment to navigate the health care system and facilitating the process of engaging with care. CONCLUSIONS.: Patient navigation based on the development of users' strengths can be a useful and feasible strategy to improve linkage to medical care for MSM and TW in Peru, incorporating peer navigators to health teams, horizontality in treatment and public health strategies with greater community participation.Motivation for the study. In Peru, men who have sex with men (MSM) and transgender women (TW) present low levels of linkage to HIV medical care, which is crucial to consider it a chronic disease, guarantee a healthy life and prevent transmission. Main findings. We implemented a program with specialized personnel called peer navigators, which helped MSM and TW to identify personal strengths and become autonomous within a fragmented and unfriendly health system. Implications. Incorporating peer navigators is a useful and feasible strategy that contributed to filling a gap in HIV care services, providing accompaniment, education and horizontal treatment to improve linkage to medical care for MSM and TW.

Carbapenems and colistin resistance genes isolated in Musca domestica from a garbage dump near a hospital in Lima. / Genes resistentes a carbapenémicos y colistina aislados en Musca domestica proveniente de un basural cercano a un hospital de Lima.

Motivation for the study. The presence of antibiotic resistance genes in bacteria isolated from common flies is a potential public health hazard because it facilitates the presence and spread of antibiotic resistance genes in the environment. Main findings. Thirty-eight bacterial strains identified in 14 species were isolated from within the fly bodies, of which 31 strains showed resistance to carbapenems and 26 strains showed resistance to colistin. Seven bacterial strains showed carbapenem resistance genes and one Escherichia coli strain had resistance to KPC, OXA-48 and mcr-1. Implications. This is the first report of antibiotic resistance genes in bacteria carried by common flies in Peru. The objective was to determine the presence of carbapenem resistance genes and plasmid resistance to colistin (mcr-1) in bacteria isolated from Musca domestica in a garbage dump near a hospital in Lima, Peru. Bacteria with phenotypic resistance to carbapenemics were isolated on CHROMagar mSuperCARBATM medium and colistin resistance profiling was performed using the colistin disk elution method. Detection of blaKPC, blaNDM, blaIMP, blaOXA-48, blaVIM and mcr-1 genes was performed by conventional PCR. The antimicrobial susceptibility profile was determined using the automated MicroScan system. We found that 31/38 strains had phenotypic resistance to carbapenemics and 26/38 strains had phenotypic resistance to colistin with a minimum inhibitory concentration ≥ 4 µg/ml. Finally, we identified seven bacterial strains with carbapenem resistance genes (OXA-48 and KPC) and one bacterial strain with plasmid resistance to colistin (mcr-1). One Escherichia coli strain had three resistance genes: KPC, OXA-48 and mcr-1.

El objetivo fue determinar la presencia de genes de resistencia a carbapenémicos y resistencia plasmídica a colistina (mcr-1) en bacterias aisladas de Musca domestica en un basural cercano a un hospital de Lima, Perú. Las bacterias con resistencia fenotípica a los carbapénemicos se aislaron en medio CHROMagar mSuperCARBATM y el perfil de resistencia a colistina se realizó mediante el método de elución de discos de colistina. La detección de genes blaKPC, blaNDM, blaIMP, blaOXA-48, blaVIM y mcr-1 se realizó mediante PCR convencional. El perfil de susceptibilidad antimicrobiana se determinó mediante el sistema automatizado MicroScan. Las bacterias con resistencia fenotípica a carbapenémicos fueron 31/38 cepas y a colistina fueron 26/38 cepas con una concentración inhibitoria mínima ≥ 4 µg/ml. Finalmente, se identificaron siete cepas bacterianas con genes de resistencia a carbapenémicos (OXA-48 Y KPC) y una cepa bacteriana con resistencia plasmídica a colistina (mcr-1). Una cepa de Escherichia coli presentó tres genes de resistencia: KPC, OXA-48 y mcr-1. Motivación para realizar el estudio. La presencia de genes de resistencia a antibióticos en bacterias aisladas de moscas comunes es un peligro potencial para la salud pública debido a que facilita la presencia y dispersión de genes de resistencia a antibióticos en el medio ambiente. Principales hallazgos. Se aislaron 38 cepas bacterianas identificadas en 14 especies dentro del cuerpo de las moscas, de las cuales 31 cepas mostraron resistencia a los carbapenémicos y 26 cepas mostraron resistencia a colistina. Siete cepas bacterianas presentaron genes de resistencia a carbapenémicos y una cepa de Escherichia coli con resistencia a KPC, OXA-48 y mcr-1. Implicancias. Se realiza el primer reporte en el Perú de genes de resistencia a antibióticos en bacterias movilizadas por moscas comunes.