SIR-SI model with a Gaussian transmission rate: Understanding the dynamics of dengue outbreaks in Lima, Peru.

INTRODUCTION: Dengue is transmitted by the Aedes aegypti mosquito as a vector, and a recent outbreak was reported in several districts of Lima, Peru. We conducted a modeling study to explain the transmission dynamics of dengue in three of these districts according to the demographics and climatology. METHODOLOGY: We used the weekly distribution of dengue cases in the Comas, Lurigancho, and Puente Piedra districts, as well as the temperature data to investigate the transmission dynamics. We used maximum likelihood minimization and the human susceptible-infected-recovered and vector susceptible-infected (SIR-SI) model with a Gaussian function for the infectious rate to consider external non-modeled variables. RESULTS/PRINCIPAL FINDINGS: We found that the adjusted SIR-SI model with the Gaussian transmission rate (for modelling the exogenous variables) captured the behavior of the dengue outbreak in the selected districts. The model explained that the transmission behavior had a strong dependence on the weather, cultural, and demographic variables while other variables determined the start of the outbreak. CONCLUSION/SIGNIFICANCE: The experimental results showed good agreement with the data and model results when a Bayesian-Gaussian transmission rate was employed. The effect of weather was also observed, and a strong qualitative relationship was obtained between the transmission rate and computed effective reproduction number Rt.

Use of Smartphones for the Detection of Uterine Cervical Cancer: A Systematic Review.

Little is known regarding the usefulness of the smartphone in the detection of uterine cervical lesions or uterine cervical cancer. Therefore, we evaluated the usefulness of the smartphone in the detection of uterine cervical lesions and measured its diagnostic accuracy by comparing its findings with histological findings. We conducted a systematic review to identify studies on the usefulness of the smartphone in detecting uterine cervical lesions indexed in SCOPUS, MEDLINE/PubMed, Cochrane, OVID, Web of Science, and SciELO until November 2020. The risk of bias and applicability was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. A total of 16 studies that evaluated the usefulness of the smartphone in the detection of uterine cervical lesions based on the images clicked after visual inspection with acetic acid (VIA), Lugol's iodine (VILI), or VIA/VILI combination were included in the study. Five studies estimated diagnostic sensitivity and specificity, nine described diagnostic concordance, and five described the usefulness of mobile technology. Among the five first studies, the sensitivity ranged between 66.7% (95% confidence interval (CI); 30.0-90.3%) and 94.1% (95% CI; 81.6-98.3%), and the specificity ranged between 24.0% (95% CI; 9.0-45.0%) and 85.7% (95% CI; 76.7-91.6%). The risk of bias was low (20%), and the applicability was high. In conclusion, the smartphone images clicked after a VIA were found to be more sensitive than those following the VILI method or the VIA/VILI combination and naked-eye techniques in detecting uterine cervical lesions. Thus, a smartphone may be useful in the detection of uterine cervical lesions; however, its sensitivity and specificity are still limited.

[Competency-based assessment in medical education]. / Evaluación por competencias en la educación médica.

At present, competency-based curriculum is considered to be the most appropriate model in medical education. Much has been written about this model; however, a crucial aspect of the model is the assessment of competency development which is a different point compared to the traditional model of cognitive assessment. Assessment in the context of the competencybased curriculum model must be aligned with the profile of the competencies that the institution offers. This publication reports the evaluation experience in a Medical School of Peru that applies a competency-based curriculum.

Evaluación por competencias en la educación médica / Competency-based assessment in medical education

En la actualidad, se considera al modelo curricular por competencias el más apropiado para la educación médica. Mucho se ha escrito sobre este modelo curricular, sin embargo, un aspecto crucial es la evaluación del desarrollo de las competencias, este es el punto diferente frente al modelo tradicional de evaluación eminentemente cognitivo. La evaluación en el contexto del modelo curricular por competencias debe estar alineada con el perfil de competencias que la institución propone. La presente publicación reporta la experiencia de evaluación en una escuela de Medicina del Perú que aplica un currículo basado en competencias.

At present, competency-based curriculum is considered to be the most appropriate model in medical education. Much has been written about this model; however, a crucial aspect of the model is the assessment of competency development which is a different point compared to the traditional model of cognitive assessment. Assessment in the context of the competencybased curriculum model must be aligned with the profile of the competencies that the institution offers. This publication reports the evaluation experience in a Medical School of Peru that applies a competency-based curriculum.

Deficiencia aguda de zinc: reporte en un paciente con esofagitis caústica sometido a nutrición parenteral total / Acute zinc deficiency: a report of a patient with caustic esophagitis subjected to total parenteral alimentation

Se reporta a un joven de 22 años de edad, que ingirió ácido muriático que le produjo una severa esofagitis caústica, con estenosis total del lumen esofágico; situación que motivó progresivamente un estado de caquexia severa. Se decidió nutrición parental total para mejorar el status nutricional previo al acto quirúrgico planeado (transposición de colon); en la 8va. semana de nutrición parenteral presenta signos y síntomas característicos de un sindrome de deficiencia aguda de zinc: dermatitis foruncular en cara, dermatitis eczematoide periorificial, lesiones bulosas en extremidades, alopecía, depresión, diarrea y ageusia. Se documentan éstos hallazgos clínicos con el dosaje de Zinc sérico disminuido: 0.3 ug/dl (VN: 0.6 a 1.2). Es el primer reporte del déficit de éste oligoelemento en la literatura nacional, en el presente trabajo revisamos aspectos relacionados a la disminución de éste y otros elementos "traza" con la nutrición parenteral total