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Pocos acontecimientos políticos suscitaron el nivel de expectativa y preocupación y la diversidad de posiciones diplomáticas a lo largo y ancho de América Latina, como la guerra entre Argentina y Gran Bretaña entre abril y junio de 1982, por la soberanía de las islas del Atlántico Sur. No obstante, pese a las simpatías iniciales que en un momento despertó el reclamo argentino en latinoamericana, las particularidades políticas e intereses de cada nación y el mismo rumbo que iba tomando el conflicto, transformó considerablemente la posición que al respecto tenían diversos grupos políticos en cada país. El presente artículo centrará su estudio en los cambios en el caso colombiano, más específicamente en las variaciones que tuvo el discurso periodístico de la derecha tradicional colombiana frente al desarrollo del conflicto., Few political developments aroused such level of expectation and concern and the diversity of diplomatic positions throughout Latin America as the war between Argentina and Great Britain between April and June 1982, for the sovereignty of the islands in the South Atlantic region. However, despite the initial sympathies that the Argentine claim aroused at one point in Latin America, the political particularities and interests of each nation and the very direction that the conflict was taking considerably transformed the position that various political groups had in each country in this regard. This article will focus on the changes in the Colombian case, more specifically on the variations that the journalistic discourse of the traditional Colombian right had in the face of the development of the conflict., Dossier: A 40 años de Malvinas., Instituto de Relaciones Internacionales

Este trabajo investiga el impacto que ha tenido el aumento significativo en la IED por parte de China en la economía Colombia. Particularmente, el trabajo se focaliza sobre los efectos de la actividad económica china en los recursos mineros, la soberanía energética y el desarrollo económico de Colombia. This paper focuses on the impact of the significant increase in FDI from China into the Colombian economy. In particular, its findings relate to the effects of Chínese economic activity on Colombia’s mining resources, energy sovereignty, and economic development. Magíster en Relaciones Internacionales Maestría

Mold deterioration of historical documents in archives and libraries is a frequent and complex phenomenon that may have important economic and cultural consequences. In addition, exposure to toxic fungal metabolites might produce health problems. In this work, samples of broths of fungal species isolated from the documentary material and from indoor environmental samples of the Archive of Bogotá have been analyzed to investigate the presence of mycotoxins. High resolution mass spectrometry made possible to search for a large number of mycotoxins, even without reference standards available at the laboratory. For this purpose, a screening strategy based on ultra-high pressure liquid chromatography coupled to quadrupole-time of flight mass spectrometry (UHPLC–QTOF MS) under MSE mode was applied. A customized home-made database containing elemental composition for around 600 mycotoxins was compiled. The presence of the (de)protonated molecule measured at its accurate mass was evaluated in the samples. When a peak was detected, collision induced dissociation fragments and characteristic isotopic ions were also evaluated and used for tentative identification, based on structure compatibility and comparison with literature data (if existing). Up to 44 mycotoxins were tentatively identified by UHPLC–QTOF MS. 34 of these tentative compounds were confirmed by subsequent analysis using a targeted LC–MS/MS method, supporting the strong potential of QTOF MS for identification/elucidation purposes. The presence of mycotoxins in these samples might help to reinforce safety measures for researchers and staff who work on reception, restoration and conservation of archival material, not only at the Archive of Bogotá but worldwide. Generalitat Valenciana (research group of excellence PROMETEO II/2014/023; ISIC 2012/016), from Alcaldía Mayor de Bogotá (Special Agreement on Cooperation in Science and Technology No. 2215100-153-2013) and from Universidad Antonio Nariño Grant 2010246.

This study explores the biotechnological potential of lignocellulolytic fungi collected in an oak forest. Fungal collections were obtained from natural reserves located in Boyacá-Colombia, ranging from 2700 to 3000 m.a.s.l. Twenty-three strains were isolated on malt agar, molecular characterization was performed, and ligninolytic and cellulolytic enzymatic activities were screened. Several white-rot fungi of biotechnological importance were identified as follows: Trametes sp., Trametes versicolor, Trametes villosa, Pycnoporus sanguineus, Bjerkandera adjusta, Lentinula boryana, Panus conchatus, Antrodia neotropica, Brunneoporus malicola, Laetiporus gilbertsonii, Stereum sp., Ganoderma sp., and Dichomitus sp. The strains T. versicolor 0554 and 0583, T. villosa 0562, and B. adusta 0556 showed the highest response in the qualitative enzymatic assays. These strains were used to determine their ability to decolorate the dyes aniline blue and Congo red, and it was found that T. villosa 0562 reached a level of decolorization close to 90% after 48 h of submerged culture. The fungal strains obtained here could offer alternatives to develop a process to accomplish sustainable development objectives.

The prevention of high blood pressure (HBP) is an important public health initiative worldwide, since HBP is the main risk factor for cardiovascular diseases and increases the damage caused by coronavirus disease 2019 (COVID-19). We designed, implemented, and evaluated a program to identify effective and sustainable interventions for preventing HBP in a marginalized black population. Our study was conducted in Quibdó, a city in Colombia with the highest poverty rate and located in the Pacific coast, a subregion in Colombia with the highest prevalence of HBP. We followed an intervention mapping framework using a community-based participatory research approach. Focus groups, photovoice, literature reviews, and cross-sectional quantitative surveys were used for data collection. The community chose the time, place, and type of physical activity; led the physical activities; and strengthened their skills in seeking resources in their community to sustain the program. The evaluation was aimed at determining whether the interventions were able to achieve the program's primary aim. We used a before (September 2016) and after (December 2017) design for the evaluation. To decrease the selection bias and allow comparisons between homogeneous groups, we used a propensity score matching technique. The steps required to create a self-sustaining physical activity program were provided in detail. The pre-post test showed a decrease of the HBP (systolic, 13.4% points; p = 0.018; diastolic, 6.5% points; p = 0.002). The program may be an effective and self-sustaining intervention, and it can be replicated by policymakers and implemented in other population groups.

Tuberculosis continues to be an important public health problem. Particularly considering Beijing-family strains of Mycobacterium tuberculosis, which have been associated with drug-resistance and hypervirulence. The Beijing-like SIT190 (BL) is the most prevalent Beijing strain in Colombia. The pathogenic mechanism and immune response against this pathogen is unknown. Thus, we compared the course of pulmonary TB in BALB/c mice infected with Classical-Beijing strain 391 and BL strain 323. The disease course was different among infected animals with Classical-Beijing and BL strain. Mice infected with BL had a 100% mortality at 45 days post-infection (dpi), with high bacillary loads and massive pneumonia, whereas infected animals with Classical-Beijing survived until 60 dpi and showed extensive pneumonia and necrosis. Lung RNA extraction was carried out at early (day 3 dpi), intermediate (day 14 dpi), and late (days 28 and 60 dpi) time points of infection. Transcriptional analysis of infected mice with Classical-Beijing showed several over-expressed genes, associated with a pro-inflammatory profile, including those for coding for CCL3 and CCL4 chemokines, both biomarkers of disease severity. Conversely, mice infected with BL displayed a profile which included the over-expression of several genes associated with immune-suppression, including Nkiras, Dleu2, and Sphk2, highlighting an anti-inflammatory milieu which would allow high bacterial replication followed by an intense inflammatory response. In summary, both Beijing strains induced a non-protective immune response which induced extensive tissue damage, BL strain induced rapidly extensive pneumonia and death, whereas Classical-Beijing strain produced slower extensive pneumonia later associated with extensive necrosis. Abbreviations Mtb: Mycobacterium tuberculosis; SIT: Spoligotype International Type; TB: Tuberculosis; CTB: Classical-typical Beijing; BL: Beijing-Like; CCL3: Chemokine (C-C motif) ligand 3 (CCL3); CCL4: Chemokine (C-C motif) ligand four (CCL4); WHO: World health Organization; DR: Direct Repeats; IFN-γ: Interferon Gamma; IL: Interleukin; TGF-β: Transforming Growth Factor Beta; XDR: Extremely Drug Resistant; MDR: Multi Drug Resistant; MIRU-VNTR: Mycobacterial Interspersed Repetitive Units–Variable Number Tandem repeats; OADC: Oleic Albumin Dextrose Catalase; ATCC: American Type Culture Collection; MOI: Multiplicity of Infection; CFUs: Colony Forming Units; ELISA: enzyme-linked immunosorbent assay; qRT-PCR: Real-Time Quantitative Reverse Transcription PCR; RNA-seq: Ribonucleic Acid sequencing; RIN: RNA Integrity Number; RNA: Ribonucleic Acid; DNA: Deoxyribonucleic Acid; dsDNA HS: Double stranded Deoxyribonucleic Acid High Sensitivity; RAI: Red de Apoyo à la Investigacion, Mexico City, Mexico; DEG: Differential Expressed Genes; GO: Gene Ontology; KEGG: Kyoto Encyclopedia of Genes and Genomes; ORA: Over-Representation Analysis; SNPs: Single Nucleotide Polymorphisms; TNFα: Tumoral necrosis factor alpha; DE: Differential Expression; EPA: Enrichment Pathways Analysis; TLR: Toll-Like receptor; NLRP: NOD-like receptor with Pyrin domain; tRNA: Transfer RNA; MAPK: Mitogen-Activated Protein Kinase; NK: Natural killer; ATP: Adenosine Triphosphate; DGC: dystrophin-glycoprotein complex; PDIM: Ptiocerol Dimicocerosate; NCBI: National Center for Bioinformatics Information

Introduction Atypical hemolytic uremic syndrome (aHUS) is a rare and genetically mediated systemic disease most often caused by uncontrolled and chronic complement activation that leads to systemic thrombotic microangiopathy, renal and extra-renal damage. Materials and methods This is descriptive, retrospective and multicenter study, which reports demographic, clinical, laboratory, and genetic characteristics, as well as their treatment response and outcome of 20 aHUS patients diagnosed between 2014 and 2018. Results Most patients were female adults (75%) and 30% were associated to pregnancy/postpartum, 15% to autoimmune disease, and 65% to infections. Gastrointestinal involvement (75%) was the most frequent extra-renal organ damage. Antenatal mortality and mortality rate were 5% and 10%, respectively. 25% of the patients progressed to end-stage renal disease. In 4/8 of patients treated within 1 week of presentation, eculizumab treatment restored multi-organ function after 4 weeks of treatment. CFH (37%) and CFI (25%) mutations were the most frequent. Conclusion This is the first series of aHUS cases of Colombian Caribbean region which reports the clinical and epidemiological characteristics of this condition in this region.

In the last decade, Venezuela suffers a humanitarian crisis, leading to massive emigration. One of the most vulnerable migrants´ groups is pregnant women. We analyzed the perinatal outcomes of Venezuelan migrants in Colombia and identified if migration was associated with perinatal outcomes. Birth data were obtained from the 2017 Colombian national birth registry (1085 births in migrants and 654,829 in Colombians). Logistic and linear regression models were used to identify the association between the demographic, obstetric and neonatal characteristics with premature birth (PB), low birth weight (LBW), 1-min, and 5-min Apgar score. Venezuelan were more likely to have newborns with LBW, lower Apgar scores at 1-min and 5-min in comparison to Colombians. Furthermore, a difference was observed in the low health insurance coverage and antenatal care visits among Venezuelan in comparison to natives. Access to health care services for the migrants is desirable for the improvement of perinatal health conditions.

Background Real-time PCR is a sensitive and specific method for the analysis of Plasmodium DNA. However, prior purification of genomic DNA from blood is necessary since PCR inhibitors and quenching of fluorophores from blood prevent efficient amplification and detection of PCR products. Methods Reagents designed to specifically overcome PCR inhibition and quenching of fluorescence were evaluated for real-time PCR amplification of Plasmodium DNA directly from blood. Whole blood from clinical samples and dried blood spots collected in the field in Colombia were tested. Results Amplification and fluorescence detection by real-time PCR were optimal with 40× SYBR® Green dye and 5% blood volume in the PCR reaction. Plasmodium DNA was detected directly from both whole blood and dried blood spots from clinical samples. The sensitivity and specificity ranged from 93-100% compared with PCR performed on purified Plasmodium DNA. Conclusions The methodology described facilitates high-throughput testing of blood samples collected in the field by fluorescence-based real-time PCR. This method can be applied to a broad range of clinical studies with the advantages of immediate sample testing, lower experimental costs and time-savings.

Objective:This study aimed to examine in Colombian rural households the association between different severity levels of household food insecurity and the presence of the double burden of malnutrition (SCOWT), defined as the coexistence of a stunted child under 5 years of age and an overweight or obese (OWOB) mother.Design:A secondary data analysis was conducted using cross-sectional data from the Colombian National Nutritional Survey (ENSIN) 2015. Household food insecurity status was assessed by using the Latin-American and Caribbean Food Security Scale (ELCSA). The household SCOWT status (child stunting and OWOB mother) was determined using anthropometric data from a mother and her child.Setting:Rural Colombia.Participants:Totally, 2·350 mother–child pairs living in the same household.Results:Sixty-two per cent of the households were food-insecure and SCOWT was present in 7·8 % of the households. Moderate (OR: 2·39, 95 % CI (1·36, 4·21)) and severe (OR: 1·86, 95 % CI (1·10, 3·15)) food insecurity was associated with SCOWT in an unadjusted logistic regression. Only moderate food insecurity remained significantly associated with SCOWT in a multivariate logistic regression (adjusted OR: 2·41, 95 % CI (1·24, 4·68)).Conclusions:Colombian rural areas are not exempt from the worldwide concern of increasing OWOB rates while stunting is still persistent. These results highlight the need of implementing double-duty rural actions targeting the most vulnerable households to SCOWT, particularly in terms of overcoming food insecurity beyond hunger satisfaction to prevent all forms of malnutrition.

Struvite from nutrient-rich wastewaters has been identified as a potential substitute for commercial mineral fertilisers, with the added benefit of reducing threats to global food security by prolonging phosphate rock reserves. A fertilisation test using grass (Brachiaria brizantha Marandú) and a sand column leaching test was conducted to determine the agronomic effectiveness of struvite precipitates produced from the supernatant of dewatered sewage sludge (centrate) from a municipal Wastewater Treatment Plant (WWTP). The performance of this struvite as a fertiliser was compared with biosolids and commercial fertilisers (Urea and Triple15). The results show that the concentration of heavy metals in struvite was lower than in biosolids and below the limits of Colombia and European fertiliser regulations. Struvite increased the uptake of N and P in grass, resulting in crop yields similar to other treatments tested. Struvite use as an effective slow-release fertiliser is highly dependent on the size of crystal particles, particularly in achieving low P losses, but resulted in high N loss in the sand columns tested; N loses from struvite were higher than in the commercial fertilisers due to the struvite small particle size. Therefore, struvite represents a suitable opportunity to recover and recycle nutrients from municipal sewage sludge, facilitating the effective reuse of P and N in agriculture and uptake by plants. HIGHLIGHTS Heavy metal concentrations of the struvite from the studied centrate of a WWTP were below the threshold limits.; P uptake and apparent P recovery efficiency by the grass were significantly higher in two struvite treatments than in the commercial fertilised tested.; N and P leaching depend on particle size. Smaller crystals can produce greater N uptake by the grass but at the same time more significant N losses by leaching.

The objective of this work was to evaluate the microbiological quality of cheese produced by formal and informal micro-enterprises in Paipa, Colombia, to isolate potentially pathogenic bacteria and to determine their prevalence and resistance to antimicrobials such as antibiotics and biocides. Sixteen micro-enterprises of the seventy existing in the region were sampled during 3 years. Viable concentrations of aerobic mesophiles, total and fecal coliforms, Salmonella sp., Listeria monocytogenes, Staphylococcus sp., yeasts, and molds were determined. Seventy-three bacterial isolates were identified by 16S rRNA gene sequencing. The susceptibility of the isolates to antibiotics and biocides was determined. The results indicated that between 98 and 100% of the cheese samples (n = 48 samples) of formal and informal micro-enterprises presented populations of total and fecal coliforms and Staphylococcus sp. above the limits established by Colombian regulations and varied according to the micro-enterprise. The results also indicated that 56% of Staphylococcus isolates were S. aureus. L. monocytogenes was positive in 38% of the samples. Salmonella sp. was not detected. The coliforms that prevailed were Escherichia coli (25%), Citrobacter freundii (14%), and Proteus mirabilis (8%). All L. monocytogenes were sensitive to ampicillin but resistant to erythromycin and trimethoprim-sulfamethoxazole. S. aureus isolates were susceptible to most antibiotics, except tetracycline and erythromycin (7% resistance). Likewise, 30% of coliforms (n = 36) were multidrug-resistant to antibiotics but susceptible to biocides.

Objectives To assess hypertension prevalence and the extent and associated factors of hypertension diagnosis, follow‐up, treatment and control gaps in low‐income urban Medellin, Colombia. Methods We randomly sampled 1873 adults aged 35 or older. Unaware hypertensive individuals were defined as those without previous diagnosis whose average blood pressure was equal to or above 140/90 mmHg. For aware hypertensive patients, control was delimited as average blood pressure below 140/90 if under 59 years old or diabetic, and as less than 150/90 otherwise. We used logistic regression to identify care gap‐associated factors. Results Hypertension prevalence was 43.5% (95% CI 41.2–45.7). We found 28.2% aware and 15.3% unaware hypertensive individuals, which corresponds to a 35.1% (95% CI 31.9–38.5) underdiagnosis. This gap was determined by age, sex, education and lifestyle factors. 14.4% (95% CI 11.6–17.6) of aware hypertensive patients presented a follow‐up gap, 93.4% (95% CI 90.9–95.2) were prescribed antihypertensive drugs, but 38.9% (95% CI 34.7–43.3) were not compliant. The latter was strongly associated with follow‐up. The hypertension control gap in aware hypertensive patients, 39.0% (95% CI: 34.9–43.2), was associated with being older, having diabetes, weakly adhering to pharmacological treatment and receiving poor non‐pharmacological advice. Overall, 60.4% (95% CI 57.0–63.8) of aware and unaware hypertensive participants had either diagnosed but uncontrolled or undiagnosed hypertension. Conclusions We found high hypertension prevalence coupled with, from an international perspective, encouraging awareness and control figures. Still, there remains ample room for improvement. Our findings can assist in designing integrated primary healthcare measures that further strengthen equitable and effective access to hypertension care and control.

Marmato, Colombia, has been an important centre of gold mining since before the first Spanish colonizers arrived in 1536. The Marmato deposit is hosted in a dacite and andesite porphyry stock as sheeted sulphide-rich veinlet systems. The district is currently experiencing a surge in both major mining projects and artisanal mining, driven by sustained high gold prices. Ore from small-scale and artisanal gold mining is processed in numerous small mills (entables) around Marmato, which impact surface water quality through the discharge of milled waste rock slurry, highly alkaline cyanide-treated effluent, and high dissolved metal loads. To investigate the impact of artisanal mining and ore processing, water samples were collected in January 2012 from streams around Marmato. The average dissolved metal concentrations in impacted streams were Zn, 78 mg L−1; Pb, 0.43 mg L−1; Cu, 403 µg L−1 Cd, 255 µg L−1; As, 235 µg L−1; Ni, 67 µg L−1; Co, 55 µg L−1; Sb, 7 µg L−1; and Hg, 42 ng L−1, exceeding World Health Organization drinking water guidelines. In addition, arsenic speciation was conducted in-situ and indicated that 91–95% of inorganic arsenic species is in the form of As(V). Spatial analysis of the data suggests that entables processing ore for artisanal miners are the main contributor to water pollution, with high sediment loads, alkalinity and elevated concentrations of dissolved arsenic, cadmium, mercury and lead, caused by the processing of gold-bearing sulphides in the entables. Geochemical data from surface water were compared to a comprehensive data set of whole rock analyses from drill core and channel samples from the deposit, indicating that the deposit is significantly enriched in gold, silver, lead, zinc, arsenic, antimony, and cadmium compared to crustal averages, which is reflected in the surface water geochemistry. However, elevated mercury levels in surface water cannot be explained by enrichment of mercury in the deposit and strongly suggest that mercury is being added to concentrates during ore processing to amalgamate fine gold.

Estimating the effectiveness of protected areas (PAs) in reducing deforestation is useful to support decisions on whether to invest in better management of areas already protected or to create new ones. Statistical matching is commonly used to assess this effectiveness, but spatial autocorrelation and regional differences in protection effectiveness are frequently overlooked. Using Colombia as a case study, we employed statistical matching to account for confounding factors in park location and accounted for for spatial autocorrelation to determine statistical significance. We compared the performance of different matching procedures—ways of generating matching pairs at different scales—in estimating PA effectiveness. Differences in matching procedures affected covariate similarity between matched pairs (balance) and estimates of PA effectiveness in reducing deforestation. Independent matching yielded the greatest balance. On average 95% of variables in each region were balanced with independent matching, whereas 33% of variables were balanced when using the method that performed worst. The best estimates suggested that average deforestation inside protected areas in Colombia was 40% lower than in matched sites. Protection significantly reduced deforestation, but PA effectiveness differed among regions. Protected areas in Caribe were the most effective, whereas those in Orinoco and Pacific were least effective. Our results demonstrate that accounting for spatial autocorrelation and using independent matching for each subset of data is needed to infer the effectiveness of protection in reducing deforestation. Not accounting for spatial autocorrelation can distort the assessment of protection effectiveness, increasing type I and II errors and inflating effect size. Our method allowed improved estimates of protection effectiveness across scales and under different conditions and can be applied to other regions to effectively assess PA performance., Article impact statement: Spatial autocorrelation and sampling design can distort estimations of protected area effectiveness at reducing forest loss.

Background Traumatic brain injury (TBI) is a global public health problem. In Colombia, it is estimated that 70% of deaths from violence and 90% of deaths from road traffic accidents are TBI related. In the year 2014, the Ministry of Health of Colombia funded the development of a clinical practice guideline (CPG) for the diagnosis and treatment of adult patients with severe TBI. A critical barrier to the widespread implementation was identified—that is, the lack of a specific protocol that spans various levels of resources and complexity across the four treatment phases. The objective of this article is to present the process and recommendations for the management of patients with TBI in various resource environments, across the treatment phases of prehospital care, emergency department (ED), surgery, and intensive care unit. Methods Using the Delphi methodology, a consensus of 20 experts in emergency medicine, neurosurgery, prehospital care, and intensive care nationwide developed recommendations based on 13 questions for the management of patients with TBI in Colombia. Discussion It is estimated that 80% of the global population live in developing economies where access to resources required for optimum treatment is limited. There is limitation for applications of CPGs recommendations in areas where there is low availability or absence of resources for integral care. Development of mixed methods consensus, including evidence review and expertise points of good clinical practices can fill gaps in application of CPGs. BOOTStraP (Beyond One Option for Treatment of Traumatic Brain Injury: A Stratified Protocol) is intended to be a practical handbook for care providers to use to treat TBI patients with whatever resources are available. Results Stratification of recommendations for interventions according to the availability of the resources on different stages of integral care is a proposed method for filling gaps in actual evidence, to organize a better strategy for interventions in different real-life scenarios. We develop 10 algorithms of management for building TBI protocols based on expert consensus to articulate treatment options in prehospital care, EDs, neurological surgery, and intensive care, independent of the level of availability of resources for care.

El procés de pau i el paper dels mitjans de comunicació a Colòmbia. Una mirada als fets més rellevants durant el 2013, El proceso de paz en Colombia y análisis del papel que están desempeñando los medios de comunicación de masas

The relationship between times of crisis (natural disasters, pandemics) and religious behaviour has been the subject of long debate. Theoretical models of religious coping propose that adversity caused by adverse and unexpected events instigates people to use religion more intensively. This research explores this hypothesis, comparing the effects of religious practices among people who declare themselves Catholics in the Department of Nariño, Colombia, during the coronavirus pandemic. I found that gender, the type of religious practices and the frequency of pre-pandemic participation are significant predictors of religious intensification. These findings, as well as the description of the ideas and reactions that the people of Nariño have about COVID-19, contribute to a more nuanced understanding of religious behaviours and the significant implications for the future of Catholicism in this region.

Objective:Colombia is experiencing a nutrition transition, characterised by nutritionally poor diets and an increased prevalence of non-communicable diseases (NCD). We aimed to investigate the association between diet quality and general health outcomes related to the risk of NCD, in a nationally representative sample of Colombian adolescents and adults.Design:Cross-sectional analysis. The Alternative Healthy-Eating Index (AHEI) was derived to calculate diet quality. Adjusted regressions were used to examine the association between AHEI, self-perceived general health status (GHS) and anthropometric variables (i.e. age-specific z-scores for height, and BMI for adolescents; waist circumference and BMI for adults).Setting:Nationally representative data from the Colombian National Nutrition Survey (ENSIN) 2010.Participants:Adolescents aged 10–17 years (n 6566) and adults aged ≥18 years (n 6750).Results:AHEI scores were similar between adolescents (mean 29·3 ± 7·2) and adults (mean 30·5 ± 7·2). In the whole sample, a better diet quality (higher AHEI score) was associated with worse self-perceived GHS (adjusted (a) β-coefficient: –0·004; P < 0·001) and with a smaller waist circumference ((a) β-coefficient: –0·06; P < 0·01). In adults, a higher AHEI score was negatively associated with BMI ((a) β-coefficient: –0·02; P < 0·05), whilst in adolescents it was associated with a reduced height-for-age z-score ((a) β-coefficient: –0·009; P < 0·001).Conclusions:A better diet quality was associated with reduced prevalence of predictors of NCD and with some indicators of general health in the Colombian population. In light of the high prevalence of overweight, our findings support the need for public health interventions focused on sustainable positive changes in dietary habits in the general population.

This study assesses the economic and environmental impacts that have arisen from the adoption and use of genetically modified (GM) cotton and maize in Colombia in the fifteen years since GM cotton was first planted in Colombia in 2003. A total of 1.07 million hectares have been planted to cotton and maize containing GM traits since 2003, with farmers benefiting from an increase in income of US $301.7 million. For every extra US $1 spent on this seed relative to conventional seed, farmers have gained an additional US $3.09 in extra income from growing GM cotton and an extra US $5.25 in extra income from growing GM maize. These income gains have mostly arisen from higher yields (+30.2% from using stacked (herbicide tolerant and insect resistant cotton and +17.4% from using stacked maize). The cotton and maize seed technology have reduced insecticide and herbicide spraying by 779,400 kg of active ingredient (−19%) and, as a result, decreased the environmental impact associated with herbicide and insecticide use on these crops (as measured by the indicator, the Environmental Impact Quotient (EIQ)) by 26%. The technology has also facilitated cuts in fuel use, resulting in a reduction in the release of greenhouse gas emissions from the GM cotton and maize cropping area and contributed to saving scarce land resources.

Introduction: With the use of pneumococcal conjugate vaccines(PCV), the behavior of invasive pneumococcal disease(IPD) has changed relative to serotype distribution. The introduction of these vaccines in national immunization programs has reduced the incidence of IPD, with a marked decrease in the circulation of the serotypes included in the vaccine used in each country. However, the subsequent emergence of other serotypes not included in the vaccine, such 19A in case of PCV7 and PCV10, has been documented. Materials and methods: This was case series study (2008–2017) in pediatric patients admitted to 10 hospitals in Bogota who were diagnosed with IPD. It was conducted during the transitional period of implementing the PCV10 vaccine in Colombia in 2012. Cases of bacteremic pneumococcal pneumonia, meningitis, primary bacteremia and osteoarticular infection were included. A descriptive analysis of the demographic, clinical and laboratory variables of patients with IPD by Spn19A, its trend over time, profiles of antimicrobial susceptibility and clinical outcomes was performed. Results: There were 463 cases of IPD, 315(68%) with known serotypes. The prevalence of IPD by Spn19A was 17.7%(56 cases), tending to increase over time. During 2008–2011, the prevalence was 4.4%, and during 2014–2017, it was 32.4%, The most frequent diagnosis was pneumonia(80.4%). In nonmeningeal isolates, 39.6% were not susceptible to penicillin. An increase in the resistance was observed over time. Conclusion: Spn19A is a prevalent cause of IPD in the pediatric population of the analyzed cohort, with an increasing trend of this serotype during the surveillance period after the introduction of PCV10, being the most common serotype identified in recent years.

Resumen El color es uno de los atributos sensoriales que mejor define la calidad de un alimento, no obstante las investigaciones sobre el color superficial de pulpa de frutos de musáceas en Colombia son escasas. Esta información es de gran utilidad para identificar materiales promisorios destinados para consumo fresco y procesamiento agroindustrial. En este estudio se caracterizó el color superficial de la pulpa de 25 accesiones de plátano Musa sp. (Musaceae) del Banco de Germoplasma de Musáceas del Sistema de Bancos de Germoplasma de la Nación para la Alimentación y la Agricultura (SBGNAA) existente en la Corporación Colombiana de Investigación Agropecuaria (Agrosavia) en Palmira, Colombia. Las coordenadas CIEL.a.b. fueron determinadas por triplicado utilizando un colorímetro, entre ellas se calcularon parámetros de cromaticidad (C*), tonalidad (h°) y diferencia de color (AE). Las accesiones de plátano presentaron rangos de L*(17.31-79.30), a*(8.73-30.64). y b*(15.24-95.49), C*(17.77-98.22), h°(38.24-81.00) y AE*(147.07-6851.24). Las pulpas de plátano fueron clasificadas colorimétricamente entre amarillos tenues a amarillos intensos. La variación de las coordenadas colorimétricas a*, h°, y AE se ajustaron a una cinética de orden cero; y L*, b* y C* describieron una cinética de primer orden. Las accesiones Benedetta, Cachaco espermo, Cachaco sin bellota, Dominico mocho, Dominico mutante, GAEP-2, Hartón tigre y Maia Maoli Risaralda, fueron clasificadas como materiales promisorios para consumo en fresco o procesos agroindustriales, por los bajos valores de la constante de velocidad cinética (k) registrados en el presente estudio. Abstract Color is one of the sensory attributes that best define the quality of a food, however, to date there are no scientific investigations that record the study of superficial color of the fruit pulp of Musaceae, which provides useful information to identify promising materials destined for fresh consumption and agroindustrial processing. Surface color of plantain, Musa sp. (Musaceae) pulp from the Musaceae Germplasm Bank of the Corporación Colombiana de Investigación Agropecuaria (Agrosavia) was characterized. The CIEL.a.b. coordinates of the pulp of 25 plantain accessions were determined in triplicate using a colorimeter. From the coordinates of the surface color, parameters of chromaticity (C*), hue (h°), and color difference (ΔE) were calculated. Plantain accessions presented a range of L* (17.31-79.30), a* (8.73-30.64), and b* (15.24-95.49), C* (17.77) -98.22), h° 38.24-81.00) and ΔE* (147.07-6851.24). The plantain pulps can be classified colorimetrically among mild to intense yellows. Variation of the colorimetric coordinates a*, h°, and ΔE were adjusted to zero-order kinetics, and L*, b* and C* described a first-order kinetics. Accessions Benedetta, Cachaco espermo, Cachaco sin bellotae, Dominico mocho, Dominico mutant, GAEP-2, Hartón tigre and Maia Maoli Risaralda, are reported as promising materials for fresh consumption or agroindustrial processes, due to the low values of the constant speed kinetics (k) recorded in the present study.

1. Colombia with 1941 known recorded bird species is one of the most species rich countries in the world. Efforts are necessary to conserve, study and promote sustainable use of this important taxonomic group throughout Colombia’s vast territory. 2. In an ideal world, informed decisions that are based on sound scientific information should be likelier to have successful outcomes. Nevertheless, there are barriers that make it difficult to access and use information in a timely fashion. Those same barriers impede the study, conservation and sustainable use of bird species in Colombia. On the other hand, given that there is good documentation about the ecology of a large number of species, information about the distribution of birds can be easily incorporated into decision-making processes, once this information becomes readily available in a consumable format using Geographic Information Sciences tools. 3. In this context, the main objective of this paper is to present the first compilation of the current distribution of 1889 (97%) species of birds in Colombia, using expert criteria. The shapefiles were used to show the distribution and diversity of bird species in Colombia under both geopolitical and conservation geographic units. 4. The information provided in this paper can be used as a baseline for a huge number of initiatives that aim to strengthen conservation efforts and improve knowledge about one the most unique taxonomic groups in the country. These range from land use planning strategies at the municipal or department scale to sustainable use of bird species - such as those initiatives related to bird watching - in Colombia. This study has considered three key aspects: 1) the importance of birds for Colombia’s ecosystems, 2) the privileged place of Colombia in bird species richness and 3) the importance of data mobilisation in formats easily consumable by Geographic Information Systems (GIS) to facilitate the processes of informed decision-making. We present the first compilation - in shapefile format - for 1889 of the 1941 bird species recorded from Colombia. Using this novel collection, we showed the species richness of birds in Colombia’s 33 Departments plus its Captial District (DPs), 1122 Municipalities (MNs), 58 protected areas (PAs), 39 Regional Autonomous Corporations (the authorities responsible within their respective jurisdictions for regulating the environment and renewable natural resources in Colombia; CARs) and 916 Collectively Titled Territories (including both indigenous reservations and afro-descendant communities; CTTs). In addition, we provide a list of known bird species richness for the above geographic units found in the available literature. The information provided here can be used as a baseline for a huge number of initiatives concerning the study, conservation and sustainable use of bird species present in Colombia, providing access to key features of bird distribution that should facilitate decision-making.

In this work, the presence of 20 pharmaceuticals in wastewater from Colombia is investigated. Several widely consumed compounds have been detected in wastewater samples from different origins and geographical areas in Colombia. The studied pharmaceuticals included antibiotics, analgesics and anti-inflammatories, cholesterol lowering statin drugs, lipid regulators, and anti-depressants. The investigated samples were urban wastewater collected during one whole week before (influent) and after treatment (effluent) in the wastewater treatment plants (WWTPs) of Bogotá and Medellin. Raw wastewater from the Hospital of Tumaco and from the city of Florencia were also collected. Analyses performed by liquid chromatography-tandem mass spectrometry (LC-MS/MS) revealed that most of the target analytes were present in all the wastewater samples. The highest concentrations (up to 50 μg/L) corresponded to acetaminophen, but several antibiotics, such as azithromycin, ciprofloxacin and norfloxacin, and antihypertensive drugs, such as losartan and valsartan, were commonly present in influent wastewater (IWW) at levels above 1 μg/L. Moreover, the treatment applied in WWTPs seemed to not efficiently remove the compounds under study, because most pharmaceuticals were also present in effluent wastewater (EWW) at concentrations close to those of the IWW. Special emphasis was made in this work on the quality of data reported, performing a detailed study of quality control (QC) samples. The analytical approach used –direct injection of 5-fold diluted samples without any additional treatment – is simpler and faster than the commonly applied solid phase extraction (SPE). The use of 12 isotope-labelled internal standards ensured the satisfactory correction of matrix effects for the corresponding analytes. For the remaining 8 compounds, no drastic matrix effects were observed, and only four compounds (cloxacillin, doxycycline, losartan, tetracycline) presented QC recoveries near or slightly below 60%, revealing ionization suppression, particularly in the IWW. Data on the occurrence of pharmaceuticals reported in this paper are the basis for current studies that aim to develop efficient systems for the degradation/removal of these compounds from the aquatic environment. COL0111863 COL0125116

We describe the database of trees and shrubs of tropical dry forest patches of the Magdalena upper river basin in Colombia, preserved in the Herbarium of Universidad de Ciencias Aplicadas y Ambientales. The dataset includes 211 taxa, from which 156 were identified to species. We reported 48 families and 137 genera. The most species rich and abundant families were Fabaceae and Rubiaceae and the most abundant species was Talisia stricta (Sapindaceae). We found differences in diversity between north and south zones of the study area. The Magdalena river upper watershed region is an important tropical dry forest conservation area. Twenty nine species and 4 genera recorded in this study have not been reported in previous reviews of the region. Additionally, Oxandra espintana is reported in literature as critically endangered and Aspidosperma polyneuron is reported as endangered, but there are no studies about their conservation status in the region. Our results suggest the strong need to develop additional inventories of plants that contribute to the knowledge of the plant diversity of this ecosystem in the region and studies of their conservation status.

The role of anthropometric status on dengue is uncertain. We investigated the relations between anthropometric characteristics (height, body mass index and waist circumference (WC)) and two dengue outcomes, seropositivity and hospitalisation, in a cross-sectional study of 2038 children (aged 2–15 years) and 408 adults (aged 18–72 years) from Bucaramanga, Colombia. Anthropometric variables were standardised by age and sex in children. Seropositivity was determined through immunoglobulin G antibodies; past hospitalisation for dengue was self-reported. We modelled the prevalence of each outcome by levels of anthropometric exposures using generalised estimating equations with restricted cubic splines. In children, dengue seropositivity was 60.8%; 9.9% of seropositive children reported prior hospitalisation for dengue. WC was positively associated with seropositivity in girls (90th vs. 10th percentile adjusted prevalence ratio (APR) = 1.19; 95% confidence interval (CI) 1.03–1.36). Among adults, dengue seropositivity was 95.1%; 8.1% of seropositive adults reported past hospitalisation. Height was inversely associated with seropositivity (APR = 0.90; 95% CI 0.83–0.99) and with hospitalisation history (APR = 0.19; 95% CI 0.04–0.79). WC was inversely associated with seropositivity (APR = 0.89; 95% CI 0.81–0.98). We conclude that anthropometry correlates with a history of dengue, but could not determine causation. Prospective studies are warranted to enhance causal inference on these questions.

Cellulose nanofibers were obtained from the Colombian fique (Furcraea bedinghausii) and Acrylic hydrogels (H) and reinforced acrylic hydrogels with fique nanofibres (HRFN) were synthesized, using the solution polymerization method. The extraction was carried out using a combined extraction method (chemical procedures and ultrasound radiation). The raw material (NAT-F), bleached fibers (B-F), hydrolyzed fibers and fibers treated with ultrasound (US-F) were characterized by infrared spectroscopy (FTIR) and thermal stability analysis; also, in order to have a comparison criterion, a commercial microcrystalline cellulose sample (CC) was analyzed, which demonstrated the extraction of fique cellulose. The surface morphology of the NAT-F and the B-F was determined by scanning electron microscopy and the average particle size of the nanofibers was made through transmission electron microscopy. In H y HRFN the strain percent and compression resistance (Rc) were measured. The fique nanofibers showed diameter and length averages of 25.2 ± 6.2 nm and 483.8 ± 283.2 nm respectively. Maximum degradation temperature was 317 °C. HRFN presented higher compression resistance (16.39 ± 4.30 kPa) and this resistance was 2.5 greater than the resistance of H (6.49 ± 2.48 kPa). The results indicate that fique lignocellulosic matrix has potential application for obtaining polymeric type composite materials.

Objective:To identify and monitor food industry use of political practices during the adoption of nutrition warning labels (WL) in Colombia.Design:Document analysis of publicly available information triangulated with interviews.Setting:Colombia.Participants:Eighteen key informants from the government (n 2), academia (n 1), civil society (n 12), the media (n 2) and a former food industry employee (n 1).Results:In Colombia, the food industry used experts and groups funded by large transnationals to promote its preferred front-of-pack nutrition labelling (FOPL) and discredit the proposed warning models. The industry criticised the proposed WL, discussing the negative impacts they would have on trade, the excessive costs required to implement them and the fact that consumers were responsible for making the right choices about what to eat. Food industry actors also interacted with the government and former members of large trade associations now in decision-making positions in the public sector. The Codex Alimentarius was also a platform through which the industry got access to decision-making and could influence the FOPL policy.Conclusions:In Colombia, the food industry used a broad range of political strategies that could have negatively influenced the FOPL policy process. Despite this influence, the mandatory use of WL was announced in February 2020. There is an urgent need to condemn such political practices as they still could prevent the implementation of other internationally recommended measures to improve population health in the country and abroad, nutrition WL being only of them.

SUMMARYAlthough viral acute lower respiratory infections (ALRIs) are a major public health problem in tropical low- and middle-income countries (LMICs), and there is growing evidence showing their relationship with meteorological parameters, studies performed in these countries are scarce. In an analytical cross-sectional study, we determined which of the main meteorological parameters (temperature, absolute humidity, rainfall, wind speed, and solar radiation) predicted respiratory syncytial virus (RSV) activity in a population of hospitalized children with ALRI during a 5-year period, from January 2009 to December 2013. Out of a total of 4559 children included in the study (mean age 9·2 ± 8·5 months), 2953 (64·8%) presented RSV infection during the 3-month period from March to May. In the multivariate analysis, after controlling for absolute humidity, wind speed, and solar radiation, temperature [incidence rate ratio (IRR) 2·25, 95% confidence interval (CI) 1·11–4·53,P= 0·024], and rainfall (IRR 1·01, 95% CI 1·00–1·02,P= 0·044) were independently associated with the monthly number of RSV infections. In conclusion, in Bogota, the capital of a tropical LMIC lying slightly above the equator, RSV activity peaks in the 3-month period from March to May, the main rainy period of the year in the city. In addition, rainfall and temperature are the two most important meteorological parameters that are independently associated with RSV activity in hospitalized children with ALRI in the city.

The Biofire® Film Array Meningitis Encephalitis (FAME) panel can rapidly diagnose common aetiologies but its impact in Colombia is unknown. A retrospective study of adults with CNS infections in one tertiary hospital in Colombia. The cohort was divided into two time periods: before and after the implementation of the Biofire® FAME panel in May 2016. A total of 98 patients were enrolled, 52 and 46 were enrolled in the Standard of Care (SOC) group and in the FAME group, respectively. The most common comorbidity was human immunodeficiency virus infection (47.4%). The median time to a change in therapy was significantly shorter in the FAME group than in the SOC group (3 vs. 137.3 h, P < 0.001). This difference was driven by the timing to appropriate therapy (2.1 vs. 195 h, P < 0.001) by identifying viral aetiologies. Overall outcomes and length of stay were no different between both groups (P > 0.2). The FAME panel detected six aetiologies that had negative cultures but missed identifying one patient with Cryptococcus neoformans. The introduction of the Biofire FAME panel in Colombia has facilitated the identification of viral pathogens and has significantly reduced the time to the adjustment of empirical antimicrobial therapy.

A cross-sectional study was conducted to determine the associated factors of brucellosis in Colombia’s preeminent dairy region declared in quarantine. A total of 656 samples were collected from cows ≥ 2-year-old from 40 herds. Samples were screened by the Rose Bengal Plate Test, and the Fluorescence Polarized Assay test and Competitive ELISA were used as confirmatory tests. A cow was classified as positive if the screening and both confirmatory tests were positive. A herd was classified as positive if at least one cow was seropositive. The factors associated to seropositivity were tested using a logistic regression model with explanatory variables regarding cattle management, zootechnical parameters, and sanitary practices. The seroprevalence at the animal level was 6.6% (43/656) and at herd level 27.5% (11/40). In the model, five variables explained the animal cases: purchase or animal transfer between owner’s farms (OR = 2.79, 95% CI 1.42, 5.49), history of abortion (OR = 4.22, 95% CI 1.91, 9.33), birth of weak calves (OR = 13.77, 95% CI 2.75, 68.91), use of a bull for mating (OR = 9.69, 95% CI 2.23, 42.18), and the vaccination in adulthood (OR = 3.03, 95% CI 1.04.8.78). In the model at the herd level, two variables explained the cases: birth of weak calves (OR = 9.60, 95% CI 1.54, 59.76) and purchase or animal transfer between owner’s farms (OR = 7.22, 95% CI 1.03, 50.62). These results justify the need for a quarantine declaration in the region and the implementation of epidemiological studies as a public health measures used to combat outbreak.

In Colombia, pneumococcal conjugate vaccines (PCVs) were implemented into the infant universal mass vaccination program in a stepwise manner; PCV-7 between 2009 and 2011 in different geographic regions/cities, with nationwide introduction of a 10-valent vaccine (PHiD-CV) in 2012. We aimed to describe trends in all-cause pneumonia mortality and overall mortality, and in the incidence of all-cause pneumonia and otitis media (OM) in Colombian children

Objective:To examine the association of all forms of malnutrition and socioeconomic status (SES), educational level and ethnicity in children Design:Cross-sectional analysis of data from the 2010 Colombian National Nutrition Survey. The prevalence of malnutrition was compared across categories of SES, educational level and ethnicity.Setting:Colombia.Participants:The sample for the current analysis comprised children Results:In children Conclusions:These results suggest that public policies should address all forms of malnutrition that occur in the most vulnerable populations in Colombia using multiple strategies.

Background Control of cutaneous leishmaniasis by public health systems in the Americas relies on case identification and treatment. Point-of-care diagnostics that can be performed by health workers within or near affected communities could effectively bring the health system to the resource-limited sites providing early diagnosis and treatment, reducing morbidity and the burden of disease. Methodology/principal findings A cross-sectional study was undertaken to evaluate the diagnostic test performance of Isothermal Recombinase Polymerase Amplification (RPA) targeting Leishmania kinetoplast DNA, coupled with a lateral flow (LF) immunochromatographic strip, in a field setting and a laboratory reference center. Minimally invasive swab and FTA filter paper samples were obtained by community health workers and highly trained technicians from ulcerated lesions of > 2 weeks’ evolution from 118 patients’ ≥ 2 years of age in the municipality of Tumaco, Nariño. Extracted DNA was processed by RPA-LF at a reference center or in a primary health facility in the field. Evaluation was based on a composite “gold standard” that included microscopy, culture, biopsy and real-time polymerase chain reaction detection of Leishmania 18S rDNA. Standard of care routine diagnostic tests were explored as comparators. Sensitivity and specificity of RPA-LF in the reference lab scenario were 87% (95%CI 74–94) and 86% (95%CI 74–97), respectively. In the field scenario, the sensitivity was 75% (95%CI 65–84) and specificity 89% (95%CI 78–99). Positive likelihood ratios in both scenarios were higher than 6 while negative likelihood ratios ranged to 0.2–0.3 supporting the usefulness of RPA-LF to rule-in and potentially to rule-out infection. Conclusions/significance The low complexity requirements of RPA-LF combined with non-invasive sampling support the feasibility of its utilization by community health workers with the goal of strengthening the diagnostic capacity for cutaneous leishmaniasis in Colombia. Trial registration ClinicalTrials.gov NCT04500873., Author summary Limited access to diagnosis is a critical determinant of the “neglect” that defines the so-called Neglected Tropical Diseases (NTDs) including cutaneous leishmaniasis. Diagnostic tests that can be performed close to and involve the participation of the affected communities would improve access to treatment as well as diagnosis. Using non-invasive swab and filter paper samples obtained by Community Health Workers, we evaluated the diagnostic performance of an innovative and technically simple molecular test: Isothermal Recombinase Polymerase Amplification (RPA) to detect Leishmania DNA, coupled with a lateral flow (LF) strip to read the results with the naked eye. The RPA-LF test demonstrated high sensitivity and specificity and capacity to rule in or rule out a diagnosis of cutaneous leishmaniasis in both an endemic field setting and reference laboratory. The findings encourage the further optimization of the test format for Point-of-Care diagnosis by health personnel and rural health workers in endemic settings.

Background Epidemiologic surveillance of COVID-19 is essential to collect and analyse data to improve public health decision making during the pandemic. There are few initiatives led by public-private alliances in Colombia and Latin America. The CoVIDA project contributed with RT-PCR tests for SARS-CoV-2 in mild or asymptomatic populations in Bogota. The present study aimed to determine the factors associated with SARS-CoV-2 infection in working adults. Methods COVID-19 intensified sentinel epidemiological surveillance study, from April 18, 2020, to March 29, 2021. The study included people aged 18 years or older without a history of COVID-19. Two main occupational groups were included: healthcare and essential services workers with high mobility in the city. Social, demographic, and health-related factors were collected via phone survey. Afterwards, the molecular test was conducted to detect SARS-CoV-2 infection. Findings From the 58,638 participants included in the study, 3,310 (5·6%) had a positive result. A positive result was associated with the age group (18-29 years) compared with participants aged 60 or older, participants living with more than three cohabitants, living with a confirmed case, having no affiliation to the health system compared to those with social health security, reporting a very low socioeconomic status compared to those with higher socioeconomic status, and having essential occupations compared to healthcare workers. Interpretation The CoVIDA study showed the importance of intensified epidemiological surveillance to identify groups with increased risk of infection. These groups should be prioritised in the screening, contact tracing, and vaccination strategies to mitigate the pandemic. Funding The CoVIDA study was funded through donors managed by the philanthropy department of Universidad de los Andes.

This Selected Issues paper addresses key areas that would contribute to maintaining macroeconomic stability and inclusive growth. Strong economic growth in Colombia has significantly reduced poverty, but has had limited impact on reducing inequality. Strong growth and social programs have helped reduce poverty. Going forward, efforts to further strengthen education, pension, and tax systems stand to yield important social gains, as recognized by the national development plan. Labor market distortions have declined in recent years, but challenges remain. The elimination of infrastructure gaps will also play a key role in sustaining strong and broad-based growth, and supporting further economic diversification.

Background Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of mortality worldwide, with a prevalence of approximately 100 million patients. There is evidence that antiplatelet agents and antihypertensive medications could reduce the risk of new vascular events in this population; however, treatment adherence is very low. An SMS text messaging intervention was recently developed based on behavior change techniques to increase adherence to pharmacological treatment among patients with a history of ASCVD. Objective This study aims to evaluate the efficacy and safety of an SMS text messaging intervention to improve adherence to cardiovascular medications in patients with ASCVD. Methods A randomized controlled clinical trial for patients with a prior diagnosis of cardiovascular events, such as acute myocardial infarction, unstable angina, cerebrovascular disease, or peripheral artery disease, in one center in Colombia was conducted. Patients randomized to the intervention arm were assigned to receive SMS text messages daily for the first 4 weeks, 5 SMS text messages on week 5, 3 SMS text messages each in weeks 6 and 7, and 1 SMS text message weekly from week 8 until week 52. In contrast, patients in the control arm received a monthly SMS text message reminding them of the next study appointment and the importance of the study, requesting information about changes in their phone number, and thanking them for participating in the study. The primary endpoint was the change in low-density lipoprotein cholesterol (LDL-C) levels, whereas the secondary endpoints were the changes in thromboxane B2 levels, heart rate, systolic and diastolic blood pressure, medication adherence, cardiac and noncardiac mortality, and hospitalization. Linear regression analyses and bivariate tests were performed. Results Of the 930 randomized patients, 805 (86.5%) completed follow-up and were analyzed for the primary endpoint. There was no evidence that the intervention changed the primary outcome (LDL-C levels; P=.41) or any of the secondary outcomes evaluated (all P>.05). There was also no evidence that the intervention was associated with adverse events. Conclusions In this study, there was no evidence that a behavior modification intervention delivered by SMS text messaging improved LDL-C levels, blood pressure levels, or adherence at 12 months. More research is needed to evaluate whether different SMS text messaging strategies, including personalized messages and different timings, are effective; future studies should include mixed methods to better understand why, for whom, and in which context (eg, health system or social environment) SMS text messaging interventions work (or not) to improve adherence in patients with ASCVD. Trial Registration ClinicalTrials.gov NCT03098186; https://clinicaltrials.gov/ct2/show/NCT03098186 International Registered Report Identifier (IRRID) RR2-10.1136/bmjopen-2018-028017

The presence of antibiotics in drinking water and wastewater has not been widely studied because the sanitary engineering sector mainly focuses on the removal of organic matter and nutrients. There is a lack of environmental regulations for pollutants like antibiotics. Batch tests analyse biodegradability to measure the anaerobic degradation potential of the substrate, or they can be used as toxicity tests. Oxytetracycline, florfenicol (FLO), ceftiofur (CEF) and penicillin G (PEN), commonly used in Colombia for the treatment of livestock diseases, were added in different concentrations to anaerobic sludge contained in serological glass bottles. The production of methane stored in the empty spaces of the bottles was monitored in order to determine the effect of the aforementioned antibiotics on the anaerobic process. It was found that CEF did not have any inhibitory effect on methanogenic activity, while PEN showed inhibition at all concentrations evaluated.

SUMMARYA latent tuberculosis infection (LTBI) prevalence survey was conducted using tuberculin skin test (TST) and Quantiferon test (QFT) in 1218 healthcare workers (HCWs) in Medellín, Colombia. In order to improve the prevalence estimates, a latent class model was built using a Bayesian approach with informative priors on the sensitivity and specificity of the TST. The proportion of concordant results (TST+,QFT+) was 41% and the discordant results contributed 27%. The marginal estimate of the prevalence P(LTBI+) was 62·1% [95% credible interval (CrI) 53·0–68·2]. The probability of LTBI+ given positive results for both tests was 99·6% (95% CrI 98·1–99·9). Sensitivity was 88·5 for TST and 74·3 for QFT, and specificity was 87·8 for TST and 97·6 for QFT. A high LTBI prevalence was found in HCWs with time-accumulated exposure in hospitals that lack control plans. In a context of intermediate tuberculosis (TB) incidence it is recommended to use only one test (either QFT or TST) in prevalence surveys or as pre-employment tests. Results will be useful to help implement TB infection control plans in hospitals where HCWs may be repeatedly exposed to unnoticed TB patients, and to inform the design of TB control policies.

Introducción: Se obtuvo un conjunto de datos, como parte de una investigación más amplia, en relación a la incidencia de Síndrome Metabólico (SM) y su relación con algunas mediciones de composición corporal en trabajadores en Soledad. Métodos: Se registraron los datos del peso (P), talla (T), Indice de Masa Corporal (IMC), cintura, cadera, Indice Cintura-Cadera (ICC), porcentaje de grasa corporal (%GC), masa grasa, presión arterial (PA), glucosa sanguínea en ayunas (GSA), colesterol total (CT), lipoproteínas de alta densidad (LAD), lipoproteínas de baja densidad (LBD), lipoproteínas de muy baja densidad (LMBD) y triglicéridos (TG) en 236 obreros de una fábrica metalmecánica en Soledad, municipio del Departamento del Atlántico en la costa caribe Colombiana. Se utilizó para definir el Síndrome Metabólico (SM) los criterios del Adult Treatment Panel III (2001). Se calcularon los componentes del SM y las correlaciones con las mediciones de la composición corporal. Resultados: La prevalencia global del Síndrome Metabólico fue de 20.7% (95%CI=15%, 26%). La circunferencia de la cintura por encima de 102cm. se encontró en 11.8% (95%CI=7.5%, 16.2%); 43.2% (95%CI=36.6%, 49.7%) tenían niveles de triglicéridos mayores a 150mg/dl; la presión sanguínea ≥ 130/85 se encontró en 10.2% de los casos (95%CI=6.1%, 14.2%) y la GSA >100 mg/dl en 10.5% (95%CI=6.4%, 14.7%). El IMC y el %GC se correlacionaron bien con la cintura, la presión arterial, la glucosa sanguínea en ayunas y los triglicéridos. Conclusiones: La prevalencia de SM entre los obreros en esta muestra en Soledad, está de acuerdo con otros trabajos publicados en Colombia, así como en otros países. La obesidad abdominal estuvo por debajo de los datos nacionales. En esta población, el IMC y el %GC pudieran ser un buen aproximado para evaluar el SM

Annual trivalent influenza vaccines (TIV) containing 2 A strains and one B lineage have been recommended for the prevention of influenza in most of Latin American countries. However, the circulation of 2 B lineages (Victoria and Yamagata) and difficulties in predicting the predominating lineage have led to the development of quadrivalent influenza vaccines (QIV), including both B lineages. Thus, the objective was to estimate the public health impact and influenza-related costs if QIV would have been used instead of TIV in 3 Latin American countries. We used a static model over the seasons 2010–2014 in Brazil, 2007–2014 in Colombia and 2006–2014 in Panama, focusing on population groups targeted by local vaccination recommendations: young children, adults with risk factors and the elderly. In Brazil, between 2010 and 2014, using QIV instead of TIV would have avoided US$ 6,200 per 100,000 person-years in societal costs, based on 168 influenza cases, 89 consultations, 3.2 hospitalizations and 0.38 deaths per 100,000 person-years. In Colombia and Panama, these would have ranged from US$ 1,000 to 12,700 (based on 34 cases, 13–25 consultations, 0.6–8.9 hospitalizations and 0.04–1.74 deaths) and from US$ 3,000 to 33,700 (based on 113 cases, 55–82 consultations, 0.5–27.8 hospitalizations and 0.08–6.87 deaths) per 100,000 person-years, respectively. Overall, the broader protection offered by QIV would have reduced the influenza humanistic and economic burden in the 3 countries. Despite the lack of local data leading to several extrapolations, this study is the first to give quantitative estimates of the potential benefits of QIV in Latin America.

Zika virus infection in humans has been linked to severe neurological sequels and foetal malformations. The rapidly evolving epidemics and serious complications made the frequent updates of Zika virus mandatory. Web search query has emerged as a low-cost real-time surveillance system to anticipate infectious diseases’ outbreaks. Hence, we developed a prediction model that could predict Zika-confirmed cases based on Zika search volume in Google Trends. We extracted weekly confirmed Zika cases of two epidemic countries, Brazil and Colombia. We got the weekly Zika search volume in the two countries from Google Trends. We used standard time-series regression (TSR) to predict the weekly confirmed Zika cases based on the Zika search volume (Zika query). The basis TSR model – using 1-week lag of Zika query and using 1-week lag of Zika cases as a control for autocorrelation – was the best for predicting Zika cases in Brazil and Colombia because it balanced the performance of the model and the advance time in the prediction. Our results showed that we could use Google search queries to predict Zika cases 1 week earlier before the outbreak. These findings are important to help healthcare authorities evaluate the outbreak and take necessary precautions.

Objective:To identify modifiable risk factors associated with early initiation of breastfeeding (EIBF) and exclusive breastfeeding (EBF) in Colombia.Design:Cross-sectional study from the 2010 Colombia nationally representative Demographic Health Survey (DHS). Studied exposures were categorized into five hierarchical blocks of increasing proximity to the outcomes: household, maternal, health systems, child, and early feeding characteristics. The two outcomes examined were delayed breastfeeding initiation among infants Setting:Nationally representative cross-sectional survey from Colombia.Participants:The EIBF analytical sample included 6592 and the EBF sample 1512 women with young children.Results:EIBF prevalence was 65·6 % in children under 24 months and EBF was 43 % in infants under 6 months. Modifiable risk factors associated with delayed breastfeeding initiation were: C-section (PR = 2·08, CI 95 % = 1·92, 2·25), maternal overweight/obesity (PR = 1·09, CI 95 % = 1·01, 1·17), lack of skilled attendant at birth (PR = 1·09, CI 95 % = 1·01, 1·18). Modifiable risk factors for EBF interruption were C-section (PR = 1·12, CI 95 % = 1·02, 1·23) and prelacteal feeding (PR = 1·51, CI 95 % = 1·37, 1·68). Non-pregnancy intention was a protective factor for EBF interruption (PR = 0·82, CI 95 % = 0·72, 0·93).Conclusions:C-section, lack of skilled attendant at birth, prelacteal feeding, maternal nutritional status, and pregnancy intention were modifiable factors associated with suboptimal breastfeeding practices in Colombia.

BackgroundHealth information technologies (HITs) hold enormous promise for improving access to and providing better quality of mental health care. However, despite the spread of such technologies in high-income countries, these technologies have not yet been commonly adopted in low- and middle-income countries. People living in these parts of the world are at risk of experiencing physical, technological, and social health inequalities. A possible solution is to utilize the currently available HITs developed in other counties.ObjectiveUsing participatory design methodologies with Colombian end users (young people, their supportive others, and health professionals), this study aimed to conduct co-design workshops to culturally adapt a Web-based Mental Health eClinic (MHeC) for young people, perform one-on-one user-testing sessions to evaluate an alpha prototype of a Spanish version of the MHeC and adapt it to the Colombian context, and inform the development of a skeletal framework and alpha prototype for a Colombian version of the MHeC (MHeC-C).MethodsThis study involved the utilization of a research and development (R&D) cycle including 4 iterative phases: co-design workshops; knowledge translation; tailoring to language, culture, and place (or context); and one-on-one user-testing sessions.ResultsA total of 2 co-design workshops were held with 18 users—young people (n=7) and health professionals (n=11). Moreover, 10 users participated in one-on-one user-testing sessions—young people (n=5), supportive others (n=2), and health professionals (n=3). A total of 204 source documents were collected and 605 annotations were coded. A thematic analysis resulted in 6 themes (ie, opinions about the MHeC-C, Colombian context, functionality, content, user interface, and technology platforms). Participants liked the idea of having an MHeC designed and adapted for Colombian young people, and its 5 key elements were acceptable in this context (home page and triage system, self-report assessment, dashboard of results, booking and video-visit system, and personalized well-being plan). However, to be relevant in Colombia, participants stressed the need to develop additional functionality (eg, phone network backup; chat; geolocation; and integration with electronic medical records, apps, or electronic tools) as well as an adaptation of the self-report assessment. Importantly, the latter not only included language but also culture and context.ConclusionsThe application of an R&D cycle that also included processes for adaptation to Colombia (language, culture, and context) resulted in the development of an evidence-based, language-appropriate, culturally sensitive, and context-adapted HIT that is relevant, applicable, engaging, and usable in both the short and long term. The resultant R&D cycle allowed for the adaptation of an already available HIT (ie, MHeC) to the MHeC-C—a low-cost and scalable technology solution for low- and middle-income countries like Colombia, which has the potential to provide young people with accessible, available, affordable, and integrated mental health care at the right time.

The heterogeneity of the clinical outcome of Mycobacterium tuberculosis (Mtb) infection may be due in part to different strategies used by circulating strains to cause disease. This heterogeneity is one of the main limitations to eradicate tuberculosis disease. In this study, we have compared the transcriptional response of two closely related Colombian clinical isolates (UT127 and UT205) of the LAM family under two axenic media conditions. These clinical isolates are phenotypically different at the level of cell death, cytokine production, growth kinetics upon in vitro infection of human tissue macrophages, and membrane vesicle secretion upon culture in synthetic medium. Using RNA-seq, we have identified different pathways that account for two different strategies to cope with the stressful condition of a carbon-poor media such as Sauton’s. We showed that the clinical isolate UT205 focus mainly in the activation of virulence systems such as the ESX-1, synthesis of diacyl-trehalose, polyacyl-trehalose, and sulfolipids, while UT127 concentrates its efforts mainly in the survival mode by the activation of the DNA replication, cell division, and lipid biosynthesis. This is an example of two Mtb isolates that belong to the same family and lineage, and even though they have a very similar genome, its transcriptional regulation showed important differences. This results in summary highlight the necessity to reach a better understanding of the heterogeneity in the behavior of these circulating Mtb strains which may help us to design better treatments and vaccines and to identify new targets for drugs.

The new psychoactive substances (NPS) in Colombia are detected by national authorities, in blotters strip, in different circumstances and places: airports, music concerts, discos and parks. Blotters are marketed as LSD and cause several cases of intoxication and death in some consumers: due to acute intoxication or when mixed with other drugs and may have different effects on the central nervous system (CNS). This study was conducted to research into and identify the chemical composition of the drugs impregnated in the blotters sold in two Colombian cities. This research provides the analysis of 70 doses coming from forensic cases of the Colombian Attorney General's Office in Bogota and from the Laboratory of Narcotics of the Colombian National Institute of Legal Medicine and Forensic Sciences (North Headquarter) in Barranquilla. Mixtures of drugs, such as DOB, 25I-NBOMe, MDMA and 25I-NBOMe imine were found within the blotters through gas chromatography coupled to mass spectrometry (CGMS); these drugs are classified by international authorities as NPS belonging to the phenylethylamines group. The results clearly warn about a growing public health problem in the country.

Identifying the genetic and non-genetic determinants of obesity and related cardiometabolic dysfunctions is cornerstone for their prevention, treatment, and control. While genetic variants contribute to the cardiometabolic syndrome (CMS), non-genetic factors, such as the gut microbiota, also play key roles. Gut microbiota is intimately associated with CMS and its composition is heritable. However, associations between this microbial community and host genetics are understudied. We contribute filling this gap by genotyping 60 variants in 39 genes of three modules involved in CMS risk, measuring cardiometabolic risk factors, and characterizing gut microbiota in a cohort of 441 Colombians. We hypothesized that CMS risk variants were correlated with detrimental levels of clinical parameters and with the abundance of disease-associated microbes. We found several polymorphisms in genes of innate immunity, appetite control, and energy metabolism that were associated with metabolic dysregulation and microbiota composition; the associations between host genetics and cardiometabolic health were independent of the participants’ gut microbiota, and those between polymorphisms and gut microbes were independent of the CMS risk. Associations were also independent of the host genetic ancestry, diet and lifestyle. Most microbes explaining genetic-microbiota associations belonged to the families Lachnospiraceae and Ruminococcaceae. Multiple CMS risk alleles were correlated with increased abundance of beneficial microbiota, suggesting that the phenotypic outcome of the evaluated variants might depend upon the genetic background of the studied population and its environmental context. Our results provide additional evidence that the gut microbiota is under the host genetic control and present pathways of host–microbe interactions.

A Fenton like advanced oxidation process (AOP) employing scrap zerovalent iron (SZVI) and hydrogen peroxide (H2O2) was studied for industrial textile wastewater treatment from a textile manufacturing plant located at Medellin, Colombia (South America). The wastewater effluent studied contains a mixture of organic compounds resistant to conventional treatments. The effect of initial pH and SZVI concentration and H2O2 concentration were studied by a response surface methodology (RSM) Box-Behnken design of experiment (BBD). The combined SZVI/H2O2 process led to reductions of 95% color, 76% of chemical oxygen demand (COD) and 71% of total organic carbon (TOC) at optimal operating conditions of pH = 3, SZVI = 2000 mg/L and [H2O2] = 24.5 mM. Molecular weight distribution measurement (MWD), ultraviolet–visible (UV–Vis) spectroscopy, HPLC, biodegradability and toxicity were used to characterize the pollutants after the treatment process finding that the resulting effluent was polluted mostly by low molecular weight carboxylic acids. A remarkable biodegradability enhancement of the effluent was evidenced by a BOD5/COD ratio increase from 0.22 to 0.4; also, the SZVI/H2O2 process successfully reduced the toxicity from 60% to 20% of dead A. Salina crustaceans.

The phenols and fatty acids profile and in vitro antioxidant and hypoglycaemic activity of seed, peel, pulp or pulp plus seeds of Colombian fruits from Solanaceae and Passifloraceae families were investigated. Ultra-High Performance Liquid Chromatography (UHPLC)-High Resolution Mass Spectrometry (HRMS) revealed the presence of chlorogenic acid as dominant phenolic compound in Solanaceae samples. Based on the Relative Antioxidant Score (RACI) and Global Antioxidant Score (GAS) values, Solanum quitoense peel showed the highest antioxidant potential among Solanaceae samples while Passiflora tripartita fruits exhibited the highest antioxidant effects among Passifloraceae samples. P. ligularis seeds were the most active as hypoglycaemic agent with IC50 values of 22.6 and 24.8 &mu, g/mL against &alpha, amylase and &alpha, glucosidase, respectively. Considering that some of the most promising results were obtained by the processing waste portion, its use as functional ingredients should be considered for the development of nutraceutical products intended for patients with disturbance of glucose metabolism.

Our objective was to determine the frequency of zika (ZIKV), chikungunya (CHIKV) and dengue (DENV) virus coinfection and describe the mortality cases that occurred during the epidemiologic surveillance of the ZIKV epidemic in Colombia. We analysed all cases of suspected ZIKV infection that were reported to the National Institute of Health (October 2015–December 2016). DENV, CHIKV and ZIKV RNA were detected in serum or tissue samples using polymerase chain reaction assay. Medical records of the fatal cases were reviewed. We identified that 23 871 samples were processed. The frequency of viral agents was 439 (1.84%) for DENV, 257 (1.07%) for CHIKV and 10118 (42.38%) for ZIKV. Thirty-four (0.14%) cases of coinfection were identified. The CHIKV–ZIKV coinfection was present in 28 cases (82.3%), DENV–CHIKV in three (8.8%) and DENV–ZIKV in three (8.8%). Seven (20.6%) coinfection cases were fatal (two DENV–CHIKV cases and five CHIKV–ZIKV cases). Two cases were foetal deaths and the others were related to neurological syndrome and sepsis. In conclusion, the frequency of arbovirus coinfection during epidemic of ZIKV was low, and CHIKV–ZIKV coinfection was the most common. Mortality was high among coinfection patients. The role of each virus in the mortality cases of coinfection warrants further studies.