34 results on '"Antonio Berná"'
Search Results
2. Sarcopenia and sarcopenic obesity among community-dwelling Peruvian adults: A cross-sectional study.
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Oscar Flores-Flores, Alejandro Zevallos-Morales, Suzanne L Pollard, William Checkley, Trishul Siddharthan, John R Hurst, Antonio Bernabé-Ortiz, Fernando M Runzer-Colmenares, Miles D Witham, and Jose F Parodi
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Medicine ,Science - Abstract
IntroductionSarcopenia and sarcopenic obesity (SO) have emerged as significant contributors to negative health outcomes in the past decade. We aimed to estimate the prevalence of probable sarcopenia, sarcopenia, and SO in a community-dwelling population of 1151 adults aged ≥55 years in Lima, Peru.MethodsThis cross-sectional study was conducted between 2018 and 2020. Sarcopenia was defined as the presence of low muscle strength (LMS) and low muscle mass (LMM) according to European (EWGSOP2), US (FNIH) and Asian (AWGS2) guidelines. We measured muscle strength by maximum handgrip strength and muscle mass using bioelectrical impedance analyzer. SO was defined as a body mass index ≥ 30 kg/m2 and sarcopenia.ResultsThe study participants had a mean age of 66.2 years (SD 7.1), age range between 60 to 92 years old, of which 621 (53.9%) were men. Among the sample, 41.7% were classified as obese (BMI ≥30.0 kg/m²). The prevalence of probable sarcopenia was estimated to be 22.7% (95%CI: 20.3-25.1) using the EWGSOP2 criteria and 27.8% (95%CI: 25.2-30.4) using the AWGS2 criteria. Sarcopenia prevalence, assessed using skeletal muscle index (SMI), was 5.7% (95%CI: 4.4-7.1) according to EWGSOP2 and 8.3% (95%CI: 6.7-9.9) using AWGS2 criteria. The prevalence of sarcopenia based on the FNIH criteria was 18.1% (95%CI: 15.8-20.3). The prevalence of SO, considering different sarcopenia definitions, ranged from 0.8% (95%CI: 0.3-1.3) to 5.0% (95%CI: 3.8-6.3).ConclusionOur findings reveal substantial variation in the prevalence of sarcopenia and SO, underscoring the necessity for context-specific cut-off values. Although the prevalence of SO was relatively low, this result may be underestimated. Furthermore, the consistently high proportion of probable sarcopenia and sarcopenia point to a substantial public health burden.
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- 2024
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3. Who is getting screened for diabetes according to body mass index and waist circumference categories in Peru? a pooled analysis of national surveys between 2015 and 2019.
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Rodrigo M Carrillo-Larco, Wilmer Cristobal Guzman-Vilca, and Antonio Bernabe-Ortiz
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Medicine ,Science - Abstract
BackgroundAt the population level we would expect that people with obesity undergo diabetes screening tests more often than people with overweight and much more often than people with normal weight. We described the trends of diabetes screening according to body mass index (BMI) and waist circumference (WC) in Peru.MethodsPooled analysis of health national surveys (2015-2019); men and women aged 35-70 years. We used relative frequencies to study: among those who have had a glucose test in the last year, how many there were in each BMI and WC category. We fitted a Poisson model to study whether people with high BMI or WC were more likely to have had a glucose test.ResultsPeople with overweight (PR = 1.34; 95% CI: 1.29-1.38), obesity (PR = 1.57; 95% CI: 1.51-1.63) and central obesity (PR = 1.63; 95% CI: 1.35-1.96) were more likely to have had a glucose test. At the sub-national level, there was one (of twenty-five) region in which men with obesity were more often screened for diabetes than men with overweight and much more than men with normal weight. There were seven regions in which women with obesity were the most often screened for diabetes.ConclusionsConsistent with a risk-based prevention approach, people with obesity would be screened for diabetes more often than those with overweight and those with normal weight. This ideal profile was only observed in few regions. Diabetes screening strategies should be strengthened and homogenised, so that they reach those at high risk of diabetes.
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- 2021
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4. Construction and validation of the Basic Scale of Entrepreneurial Competencies for the Secondary Education level. A study conducted in Spain.
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Antonio Ramón Cárdenas-Gutiérrez, Antonio Bernal-Guerrero, and Elisabet Montoro-Fernández
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Medicine ,Science - Abstract
IntroductionThe impact of entrepreneurship training on the levels of compulsory education has been weak until now. Complementarily to the demand of greater effectiveness in entrepreneurship education, it is a priority to make scientifically verified instruments available to provide useful information about the achievement of the competences needed for the development of entrepreneurial capacities. Our research is focused on the design and assessment of entrepreneurship competency, tackling one the dimension concerning business skills or competences. Specifically, the aim of the study consists in the development, validation and reliability of an instrument, intended for secondary education, created with the purpose of detecting the strictly indispensable entrepreneurial competencies in the basic training of the business profile, the Basic Scale of Entrepreneurial Competencies (BSEC).MethodsThe research was developed in three phases via qualitative and quantitative methods. In the development phase the items were generated and the dimensions and components of entrepreneurship competency were identified. Also, the content and face validity were carried out, where experts (n = 48) and students (n = 24) took part. In the recruitment phase a multi-stage sampling stratified by conglomerates was performed, obtaining a sample of 1440 students, aged between 11 and 17 years old (M = 14.6, SD = 1.597) and a composition by sex of 679 girls and 761 boys. Construct validity was evaluated in the assessment stage through factor analysis (EFA and CFA). Later, the reliability was studied via the Cronbach´s α coefficient and the stability and reproducibility over time with the test-restest technique. Finally, the convergent and divergent validity were evaluated through the average variance extracted (AVE), the composite reliability (CR) and the square root of the AVE.Results44 items were developed in the phase of generating items. After carrying out the validity of the content, there were 14 items with acceptable values in the Content Validity Ratio (CVR.89) and in the Content Validity Index (CVI.92). During the validation of the scale, the results of the exploratory and confirmatory factor analysis confirmed a first-order trifactorial structure and a second-order factor. The scale's stability was appropriate, having an ICC = .92. The convergent validity results with Composite Reliability (CR) scores > 0.7 and the Average Variance Extracted (AVE) >. 0.50, along with the square root values of the AVE greater than the correlations between the other constructs show us important evidence of the validity of the Scale. The structure of the BSEC is made up of 13 items and three domains: Operations and Marketing Competencies (OMC), Competencies in Socio-Business and Legal Organization (CSBLO) and Economic-Financial Competencies (EFC).ConclusionsThe results of the research reflect its validity and reliability. This Scale has an evident usefulness for the training and assessment of entrepreneurship competence. Specifically, it is efficient for the valuation of entrepreneurial competencies in adolescent students in the stage prior to their incorporation into the work environment or their integration into the itineraries leading to higher education levels.
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- 2021
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5. The contribution of specific non-communicable diseases to the achievement of the Sustainable Development Goal 3.4 in Peru.
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Rodrigo M Carrillo-Larco, James E Bennett, Mariachiara Di Cesare, Edward W Gregg, and Antonio Bernabe-Ortiz
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Medicine ,Science - Abstract
BackgroundNon-communicable diseases (NCDs) have received political attention and commitment, yet surveillance is needed to measure progress and set priorities. Building on global estimates suggesting that Peru is not on target to meet the Sustainable Development Goal 3.4, we estimated the contribution of various NCDs to the change in unconditional probability of dying from NCDs in 25 regions in Peru.MethodsUsing national death registries and census data, we estimated the unconditional probability of dying between ages 30 and 69 from any and from each of the following NCDs: cardiovascular, cancer, diabetes, chronic respiratory diseases and chronic kidney disease. We estimated the contribution of each NCD to the change in the unconditional probability of dying from any of these NCDs between 2006 and 2016.ResultsThe overall unconditional probability of dying improved for men (21.4%) and women (23.3%). Cancer accounted for 10.9% in men and 13.7% in women of the overall reduction; cardiovascular diseases also contributed substantially: 11.3% in men) and 9.8% in women. Consistently in men and women and across regions, diabetes moved in the opposite direction of the overall reduction in the unconditional probability of dying from any selected NCD. Diabetes contributed a rise in the unconditional probability of 3.6% in men and 2.1% in women.ConclusionsAlthough the unconditional probability of dying from any selected NCD has decreased, diabetes would prevent Peru from meeting international targets. Policies are needed to prevent diabetes and to strengthen healthcare to avoid diabetes-related complications and delay mortality.
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- 2020
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6. Cancer-related mortality in Peru: Trends from 2003 to 2016.
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Jessica H Zafra-Tanaka, Janeth Tenorio-Mucha, David Villarreal-Zegarra, Rodrigo Carrillo-Larco, and Antonio Bernabe-Ortiz
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Medicine ,Science - Abstract
ObjectivesIn the last decade, Latin American (LA) countries, like Peru, have undergone an epidemiological transition that has changed the pattern of oncological cases. Given that Peru's oncological pattern could illustrate those of other LA countries, we aimed at determining trends and changes in cancer-related mortality by age and sex in Peru between 2003 and 2016.Methods and resultsA secondary data analysis using national deaths registries was conducted. Categories were created according to the 27 most frequent sites of presentation of cancer. We found that deaths attributed to cancer increased from 15.4% of all deaths in 2003 to 18.1% in 2016 (pConclusionsBetween the years 2003 and 2016, almost one fifth of deaths were attributed to cancer in Peru. Absolute and relative number of deaths due to cancer has increased in this period for both men and women; however, standardized mortality rates due to cancer have declined.
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- 2020
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7. Basic business knowledge scale for secondary education students. Development and validation with Spanish teenagers.
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Antonio Bernal-Guerrero, Antonio Ramón Cárdenas-Gutiérrez, and Elisabet Montoro-Fernández
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Medicine ,Science - Abstract
INTRODUCTION:In the current international context, entrepreneurship education claims a privileged place within educational systems, given that it contributes decisively to innovation and to the set of competences demanded in the new knowledge-based economy. The state of the research in this line highlights the existing formative deficiencies at these basic education levels, despite the fact that numerous initiatives of fostering business culture have already been developed. Among the currently existing gaps, conspicuous by its absence is the lack of instruments capable of efficiently measure the basic business knowledge, needed to progressively constitute a consistent business identity stands out. In this sense, we set ourselves the construction and validation of a basic business knowledge scale for the Secondary Education stage. METHODS:This study was implemented in two phases. In the first phase, the dimensions and components of the Basic Business Knowledge Scale were identified via a systematic review of the literature following the PRISMA-P protocol and a qualitative study. In the second phase, the scale was developed and validated. On the one hand, a content validation was conducted through interviews of experts and students, studying the content validity (the Content Validity Ratio and the Content Validity Index) and the face validity (Think-aloud protocols). On the other hand, the construct validity was analyzed through an Explanatory Factor Analysis (EFA) and a Confirmatory Factor Analysis (CFA). Then, the reliability was calculated with the Cronbach Alpha and the test stability with a test-retest. The convergent validity has been validated by the average variance extracted (AVE) and the discriminant validity between constructs was established through the AVE estimated for each construct with the squared interconstruct correlations associated with that factor. The sample was made up of 1440 students (679 girls and 761 boys) from age 11 to 17 (M = 14.6, SD = 1.597). RESULTS:The EFA and the CFA showed evidence of a first-order three-factor structure (Knowledge in Business Management (KBM), Legal Knowledge (LK) and Strategic Knowledge (SK)), and a second-order factor, Basic Business Knowledge. In the construct validity two items were eliminated due to their factor loadings being lower than .40. The results of the fit indices contributed acceptable values regarding the proposed model. The three subscales and the scale as a whole revealed a satisfactory internal consistency with Cronbach alphas over .75. The intraclass correlation coefficient (ICC) was above .90, showing an appropriate stability. The convergent validity offers values over .80 in the composite reliability (CR) and the average variance extracted (AVE) is greater than .50. Moreover, in the divergent validity, the values of the square root of the AVE are greater than the correlations with the other constructs. Finally, the Basic Business Knowledge Scale has 18 items. CONCLUSIONS:We find evidence concerning the validity and reliability of the Basic Business Knowledge Scale, tested with Spanish Secondary Education students within the compulsory stage of teaching. We believe that this Scale can contribute to a better understanding of the formation of indispensable basic culture to establish a genuine business spirit.
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- 2020
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8. Valid group comparisons can be made with the Patient Health Questionnaire (PHQ-9): A measurement invariance study across groups by demographic characteristics.
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David Villarreal-Zegarra, Anthony Copez-Lonzoy, Antonio Bernabé-Ortiz, G J Melendez-Torres, and Juan Carlos Bazo-Alvarez
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Medicine ,Science - Abstract
OBJECTIVE:Analyze the measurement invariance and the factor structure of the Patient Health Questionnaire-9 (PHQ-9) in the Peruvian population. METHOD:Secondary data analysis performed using cross-sectional data from the Health Questionnaire of the Demographic and Health Survey in Peru. Variables of interest were the PHQ-9 and demographic characteristics (sex, age group, level of education, socioeconomic status, marital status, and area of residence). Factor structure was evaluated by standard confirmatory factor analysis (CFA), and measurement invariance by multi-group CFA, using standard goodness-of-fit indices criteria for interpreting results from both CFAs. Analysis of the internal consistency (α and ω) was also pursued. RESULTS:Data from 30,449 study participants were analyzed, 56.7% were women, average age was 40.5 years (standard deviation (SD) = 16.3), 65.9% lived in urban areas, 74.6% were married, and had 9 years of education on average (SD = 4.6). From standard CFA, a one-dimensional model presented the best fit (CFI = 0.936; RMSEA = 0.089; SRMR = 0.039). From multi-group CFA, all progressively restricted models had ΔCFI
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- 2019
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9. An investigation of Y chromosome incorporations in 400 species of Drosophila and related genera.
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Eduardo G Dupim, Gabriel Goldstein, Thyago Vanderlinde, Suzana C Vaz, Flávia Krsticevic, Aline Bastos, Thadeo Pinhão, Marcos Torres, Jean R David, Carlos R Vilela, and Antonio Bernardo Carvalho
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Genetics ,QH426-470 - Abstract
Y chromosomes are widely believed to evolve from a normal autosome through a process of massive gene loss (with preservation of some male genes), shaped by sex-antagonistic selection and complemented by occasional gains of male-related genes. The net result of these processes is a male-specialized chromosome. This might be expected to be an irreversible process, but it was found in 2005 that the Drosophila pseudoobscura Y chromosome was incorporated into an autosome. Y chromosome incorporations have important consequences: a formerly male-restricted chromosome reverts to autosomal inheritance, and the species may shift from an XY/XX to X0/XX sex-chromosome system. In order to assess the frequency and causes of this phenomenon we searched for Y chromosome incorporations in 400 species from Drosophila and related genera. We found one additional large scale event of Y chromosome incorporation, affecting the whole montium subgroup (40 species in our sample); overall 13% of the sampled species (52/400) have Y incorporations. While previous data indicated that after the Y incorporation the ancestral Y disappeared as a free chromosome, the much larger data set analyzed here indicates that a copy of the Y survived as a free chromosome both in montium and pseudoobscura species, and that the current Y of the pseudoobscura lineage results from a fusion between this free Y and the neoY. The 400 species sample also showed that the previously suggested causal connection between X-autosome fusions and Y incorporations is, at best, weak: the new case of Y incorporation (montium) does not have X-autosome fusion, whereas nine independent cases of X-autosome fusions were not followed by Y incorporations. Y incorporation is an underappreciated mechanism affecting Y chromosome evolution; our results show that at least in Drosophila it plays a relevant role and highlight the need of similar studies in other groups.
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- 2018
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10. Association between perceived social support and induced abortion: A study in maternal health centers in Lima, Peru.
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Luis E Sánchez-Siancas, Angélica Rodríguez-Medina, Alejandro Piscoya, and Antonio Bernabe-Ortiz
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Medicine ,Science - Abstract
This study aimed to assess the association between perceived social support and induced abortion among young women in Lima, Peru. In addition, prevalence and incidence of induced abortion was estimated.A cross-sectional study enrolling women aged 18-25 years from maternal health centers in Southern Lima, Peru, was conducted. Induced abortion was defined as the difference between the total number of pregnancies ended in abortion and the number of spontaneous abortions; whereas perceived social support was assessed using the DUKE-UNC scale. Prevalence and incidence of induced abortion (per 100 person-years risk) was estimated, and the association of interest was evaluated using Poisson regression models with robust variance. A total of 298 women were enrolled, mean age 21.7 (± 2.2) years. Low levels of social support were found in 43.6% (95%CI 38.0%-49.3%), and 17.4% (95%CI: 13.1%- 21.8%) women reported at least one induced abortion. The incidence of induced abortion was 2.37 (95%CI: 1.81-3.11) per 100 person-years risk. The multivariable model showed evidence of the association between low perceived social support and induced abortion (RR = 1.94; 95%CI: 1.14-3.30) after controlling for confounders.There was evidence of an association between low perceived social support and induced abortion among women aged 18 to 25 years. Incidence of induced abortion was similar or even greater than rates of countries where abortion is legal. Strategies to increase social support and reduce induced abortion rates are needed.
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- 2018
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11. Perceived stress and high fat intake: A study in a sample of undergraduate students.
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E Jair Vidal, Daily Alvarez, Dalia Martinez-Velarde, Lorena Vidal-Damas, Kelly A Yuncar-Rojas, Alesia Julca-Malca, and Antonio Bernabe-Ortiz
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Medicine ,Science - Abstract
Different studies have reported the association between perceived stress and unhealthy diet choices. We aimed to determine whether there is a relationship between perceived stress and fat intake among undergraduate medical students.A cross-sectional study was performed including first-year medical students. The outcome of interest was the self-report of fat intake assessed using the Block Screening Questionnaire for Fat Intake (high vs. low intake), whereas the exposure was perceived stress (low/normal vs. high levels). The prevalence of high fat intake was estimated and the association of interest was determined using prevalence ratios (PR) and 95% confidence intervals (95%CI). Models were created utilizing Poisson regression with robust standard errors. Data from 523 students were analyzed, 52.0% female, mean age 19.0 (SD 1.7) years. The prevalence of high fat intake was 42.4% (CI: 38.2%-46.7%). In multivariate model and compared with those with lowest levels of stress, those in the middle (PR = 1.59; 95%CI: 1.20-2.12) and highest (PR = 1.92; 95%CI: 1.46-2.53) categories of perceived stress had greater prevalence of fat intake. Gender was an effect modifier of this association (p = 0.008).Greater levels of perceived stress were associated with higher fat intake, and this association was stronger among males. More than 40% of students reported having high fat consumption. Our results suggest the need to implement strategies that promote decreased fat intake.
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- 2018
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12. Older adults with disability in extreme poverty in Peru: How is their access to health care?
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Oscar Flores-Flores, Ruth Bell, Rodney Reynolds, and Antonio Bernabé-Ortiz
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Medicine ,Science - Abstract
BackgroundDisability rates increase with age. In 2012, Peruvian older adults (≥ 65 years) represented 9% of the population. Additionally, older population reported disabilities at about 5 times the rate of Peruvians between 36 and 64 years old, and 30% of older population lived in poverty. Peruvian seniors living in extreme poverty experience disabilities and the extent of their access to healthcare is unknown.ObjectiveThis study assesses associations between disability and access to healthcare among Peruvians older individuals living in extreme poverty.MethodsSecondary analysis of a national representative population based survey that utilizes information from Peru's 2012 survey Health and Wellbeing in Older Adults (ESBAM), which includes older adults living in extreme poverty. We define disability in terms of the Activities of Daily Living (ADL disability) framework. Healthcare access was assessed as having any of Peru's available health insurance schemes combined with preventive health services (vision assessment, influenza vaccination, blood pressure assessment, diabetes screening, and cholesterol assessment). Poisson robust regression models were used to evaluate the associations among relevant variables. Prevalence Ratios and 95% confidence intervals (95%CI) were reported.ResultsData from 3869 individuals (65 to 80 years old), of whom 1760 (45.5%) were females, were analyzed. The prevalence of ADL disability was 17.3% (95%CI: 16.0%-18.4%). In addition, more than 60% had never received any of the preventive measures evaluated, except for the blood pressure assessment. In the adjusted model, people with ADL disability had 63% less probability of having extensive insurance, compared to those without disability (pConclusionsThis study shows that this Peruvian older population living in extreme poverty has limited access to healthcare services. Although there was no consistent association between ADL disability and the healthcare access, there is an urgent need to reduce the inequitable access to healthcare of this poor Peruvian older population.
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- 2018
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13. Deregulation of the imprinted DLK1-DIO3 locus ncRNAs is associated with replicative senescence of human adipose-derived stem cells.
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Silvia García-López, Carmen Albo-Castellanos, Rocio G Urdinguio, Susana Cañón, Fátima Sánchez-Cabo, Alberto Martínez-Serrano, Mario F Fraga, and Antonio Bernad
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Medicine ,Science - Abstract
BACKGROUND:Human adult adipose-derived stem cells (hADSCs) have become the most promising cell source for regenerative medicine. However the prolonged ex vivo expansion periods required to obtain the necessary therapeutic dose promotes progressive senescence, with the concomitant reduction of their therapeutic potential. AIM AND SCOPE:A better understanding of the determinants of hADSC senescence is needed to improve biosafety while preserving therapeutic efficiency. Here, we investigated the association between deregulation of the imprinted DLK1-DIO3 region and replicative senescence in hADSC cultures. METHODS:We compared hADSC cultures at short (PS) and prolonged (PL) passages, both in standard and low [O2] (21 and 3%, respectively), in relation to replicative senescence. hADSCs were evaluated for expression alterations in the DLK1-DIO3 region on chromosome 14q32, and particularly in its main miRNA cluster. RESULTS:Comparison of hADSCs cultured at PL or PS surprisingly showed a quite significant fraction (69%) of upregulated miRNAs in PL cultures mapping to the imprinted 14q32 locus, the largest miRNA cluster described in the genome. In agreement, expression of the lncRNA MEG3 (Maternally Expressed 3; Meg3/Gtl2), cultured at 21 and 3% [O2], was also significantly higher in PL than in PS passages. During hADSC replicative senescence the AcK16H4 activating mark was found to be significantly associated with the deregulation of the entire DLK1-DIO3 locus, with a secondary regulatory role for the methylation of DMR regions. CONCLUSION:A direct relationship between DLK1-DIO3 deregulation and replicative senescence of hADSCs is reported, involving upregulation of a very significant fraction of its largest miRNA cluster (14q32.31), paralleled by the progressive overexpression of the lncRNA MEG3, which plays a central role in the regulation of Dlk1/Dio3 activation status in mice.
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- 2018
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14. EZSCAN for undiagnosed type 2 diabetes mellitus: A systematic review and meta-analysis.
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Antonio Bernabe-Ortiz, Andrea Ruiz-Alejos, J Jaime Miranda, Rohini Mathur, Pablo Perel, and Liam Smeeth
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Medicine ,Science - Abstract
The EZSCAN is a non-invasive device that, by evaluating sweat gland function, may detect subjects with type 2 diabetes mellitus (T2DM). The aim of the study was to conduct a systematic review and meta-analysis including studies assessing the performance of the EZSCAN for detecting cases of undiagnosed T2DM.We searched for observational studies including diagnostic accuracy and performance results assessing EZSCAN for detecting cases of undiagnosed T2DM. OVID (Medline, Embase, Global Health), CINAHL and SCOPUS databases, plus secondary resources, were searched until March 29, 2017. The following keywords were utilized for the systematic searching: type 2 diabetes mellitus, hyperglycemia, EZSCAN, SUDOSCAN, and sudomotor function. Two investigators extracted the information for meta-analysis and assessed the quality of the data using the Revised Version of the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) checklist. Pooled estimates were obtained by fitting the logistic-normal random-effects model without covariates but random intercepts and using the Freeman-Tukey Arcsine Transformation to stabilize variances. Heterogeneity was also assessed using the I2 measure. Four studies (n = 7,720) were included, three of them used oral glucose tolerance test as the gold standard. Using Hierarchical Summary Receiver Operating Characteristic model, summary sensitivity was 72.0% (95%CI: 60.0%- 83.0%), whereas specificity was 56.0% (95%CI: 38.0%- 74.0%). Studies were very heterogeneous (I2 for sensitivity: 79.2% and for specificity: 99.1%) regarding the inclusion criteria and bias was present mainly due to participants selection.The sensitivity of EZSCAN for detecting cases of undiagnosed T2DM seems to be acceptable, but evidence of high heterogeneity and participant selection bias was detected in most of the studies included. More studies are needed to evaluate the performance of the EZSCAN for undiagnosed T2DM screening, especially at the population level.
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- 2017
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15. Children's weight changes according to maternal perception of the child's weight and health: A prospective cohort of Peruvian children.
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Rodrigo M Carrillo-Larco, Antonio Bernabe-Ortiz, J Jaime Miranda, Hong Xue, and Youfa Wang
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Medicine ,Science - Abstract
The aim of the study was to estimate the association between maternal perception of their child's health status and (mis)classification of their child's actual weight with future weight change. We present cross-sectional and longitudinal analyses from the Peruvian younger cohort of the Young Lives Study. For cross-sectional analysis, the exposure was maternal perception of child health status (better, same or worse); the outcome was underestimation or overestimation of the child's actual weight. Mothers were asked about their perception of their child's weight (same, lighter or heavier than other children). Actual weight status was defined with IOTF BMI cut-off points. For longitudinal analysis, the exposure was (mis)classification of the child's actual weight; the outcome was the standardized mean difference between follow-up and baseline BMI. A Generalized Linear Model with Poisson family and log-link was used to report the prevalence ratio (PR) and 95% confidence intervals (95% CI) for cross-sectional analyses. A Linear Regression Model was used to report the longitudinal analysis as coefficient estimates (β) and 95% CI. Normal weight children who were perceived as more healthy than other children were more likely to have their weight overestimated (PR = 2.06); conversely, those who were perceived as less healthy than other children were more likely to have their weight underestimated (PR = 2.17). Mean follow-up time was 2.6 (SD: 0.3) years. Overall, underweight children whose weight was overestimated were more likely to gain BMI (β = 0.44); whilst overweight children whose weight was considered to be the same of their peers (β = -0.55), and those considered to be lighter than other children (β = -0.87), lost BMI. Maternal perception of the child's health status seems to influence both overestimation and underestimation of the child's actual weight status. Such weight (mis)perception may influence future BMI.
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- 2017
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16. Fruits and vegetables consumption and depressive symptoms: A population-based study in Peru.
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Isabella Wolniczak, José A Cáceres-DelAguila, Jorge L Maguiña, and Antonio Bernabe-Ortiz
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Medicine ,Science - Abstract
Among different factors, diet patterns seem to be related to depression. The aim of this study was to evaluate the association between the consumption of fruits and/or vegetables and depressive symptoms.A secondary data analysis was conducted using information from a population-based survey from 25 regions from Peru. The outcome was the presence of depressive symptoms according to the Patient Health Questionnaire (cutoff ≥15 to define major depressive syndrome); whereas the exposure was the self-reported consumption of fruits and/or vegetables (in tertiles and using WHO recommendation ≥5 servings/day). The association of interest was evaluated using Poisson regression models controlling for the complex-sample survey design and potential confounders. Data from 25,901 participants were analyzed, mean age 44.2 (SD: 17.7) and 13,944 (54.0%) women. Only 910 (3.8%; 95%CI: 3.5%-4.2%) individuals reported consuming ≥5 servings of fruits and/or vegetables/day; whereas 819 (2.8%; 95%CI: 2.5%-3.1%) had depressive symptoms. Those in the lowest tertile of fruits and/or vegetables consumption had greater prevalence of depressive symptoms (PR = 1.88; 95%CI: 1.39-2.55) than those in the highest tertile. This association was stronger with fruits (PR = 1.92; 95%CI: 1.46-2.53) than vegetables (PR = 1.42; 95%CI: 1.05-1.93) alone.An inverse relationship between consumption of fruits and/or vegetables and depressive symptoms is reported. Less than 5% of subjects reported consuming the amount of fruits and vegetables recommended by the WHO. There is a need to implement strategies to promote better diet patterns with potential impact on mental health.
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- 2017
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17. Mortality among MDR-TB cases: comparison with drug-susceptible tuberculosis and associated factors.
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Kocfa Chung-Delgado, Sonia Guillen-Bravo, Alejandro Revilla-Montag, and Antonio Bernabe-Ortiz
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Medicine ,Science - Abstract
An increase in multidrug-resistant tuberculosis (MDR-TB) cases is evident worldwide. Its management implies a complex treatment, high costs, more toxic anti-tuberculosis drug use, longer treatment time and increased treatment failure and mortality. The aims of this study were to compare mortality between MDR and drug-susceptible cases of tuberculosis, and to determine risk factors associated with mortality among MDR-TB cases.A retrospective cohort study was performed using data from clinical records of the National Strategy for Prevention and Control of Tuberculosis in Lima, Peru. In the first objective, MDR-TB, compared to drug-susceptible cases, was the main exposure variable and time to death, censored at 180 days, the outcome of interest. For the second objective, different variables obtained from clinical records were assessed as potential risk factors for death among MDR-TB cases. Cox regression analysis was used to determine hazard ratios (HR) and 95% confidence intervals (95%CI). A total of 1,232 patients were analyzed: mean age 30.9 ±14.0 years, 60.0% were males. 61 patients (5.0%) died during treatment, whereas the MDR-TB prevalence was 19.2%. MDR-TB increased the risk of death during treatment (HR = 7.5; IC95%: 4.1-13.4) when compared to presumed drug-susceptible cases after controlling for potential confounders. Education level (p = 0.01), previous TB episodes (p
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- 2015
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18. Applying the Triangle Taste Test to Assess Differences between Low Sodium Salts and Common Salt: Evidence from Peru.
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Lorena Saavedra-Garcia, Antonio Bernabe-Ortiz, Robert H Gilman, Francisco Diez-Canseco, María Kathia Cárdenas, Katherine A Sacksteder, and J Jaime Miranda
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Medicine ,Science - Abstract
In resourced-constrained settings, daily cooking practices are still the norm. Replacing sodium in regular salt to produce potassium-enriched salts are potential alternative routes to reduce sodium intake, paired with the benefit associated with potassium intake. This change would likely have effects on palatability and taste of prepared foods, yet a threshold to discriminate sensorial changes can be determined. The main goal of this study was to assess if the use of potassium-enriched salt substitutes lead to perceived differences in taste utilizing a sensory discrimination test.A triangle taste test was conducted and participants were offered samples of cooked rice prepared with different salts. The only ingredient that differed in the preparation was the salt used: 100%NaCl (regular salt) and salts where sodium was replaced by 50%, 33% or 25% KCl (potassium-enriched salt). Comparisons were carried out according to the minimum number of correct judgments. A total of 156 subjects, 49% males, mean age 41.0 years (SD±15.5) years, participated in the study. Samples using 25% potassium-enrichment were indistinguishable in terms of taste from regular salt, whereas samples with 33% and 50% potassium-enrichment were distinguishable. Results were consistent when stratified by sex and age. Less than 10% of participants attributed the differences to bitterness or metallic flavor.The 25% potassium-enriched salt is indistinguishable from regular salt. These findings suggest a potential to achieve sodium intake reduction strategies in cooking practices by substituting regular salt with potassium-enriched salt without affecting palatability.
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- 2015
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19. Metabolic Abnormalities Are Common among South American Hispanics Subjects with Normal Weight or Excess Body Weight: The CRONICAS Cohort Study.
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Catherine P Benziger, Antonio Bernabé-Ortiz, Robert H Gilman, William Checkley, Liam Smeeth, Germán Málaga, J Jaime Miranda, and CRONICAS Cohort Study group
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Medicine ,Science - Abstract
OBJECTIVE:We aimed to characterize metabolic status by body mass index (BMI) status. METHODS:The CRONICAS longitudinal study was performed in an age-and-sex stratified random sample of participants aged 35 years or older in four Peruvian settings: Lima (Peru's capital, costal urban, highly urbanized), urban and rural Puno (both high-altitude), and Tumbes (costal semirural). Data from the baseline study, conducted in 2010, was used. Individuals were classified by BMI as normal weight (18.5-24.9 kg/m2), overweight (25.0-29.9 kg/m2), and obese (≥30 kg/m2), and as metabolically healthy (0-1 metabolic abnormality) or metabolically unhealthy (≥2 abnormalities). Abnormalities included individual components of the metabolic syndrome, high-sensitivity C-reactive protein, and insulin resistance. RESULTS:A total of 3088 (age 55.6±12.6 years, 51.3% females) had all measurements. Of these, 890 (28.8%), 1361 (44.1%) and 837 (27.1%) were normal weight, overweight and obese, respectively. Overall, 19.0% of normal weight in contrast to 54.9% of overweight and 77.7% of obese individuals had ≥3 risk factors (p
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- 2015
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20. Short sleep duration and childhood obesity: cross-sectional analysis in Peru and patterns in four developing countries.
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Rodrigo M Carrillo-Larco, Antonio Bernabé-Ortiz, and J Jaime Miranda
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Medicine ,Science - Abstract
BackgroundWe aimed to describe the patterns of nutritional status and sleep duration in children from Ethiopia, India, Peru and Vietnam; to assess the association between short sleep duration and overweight and obesity, and if this was similar among boys and girls in Peru.Methods and findingsAnalysis of the Young Lives Study, younger cohort, third round. In Ethiopia there were 1,999 observations, 2,011, 2,052 and 2,000 in India, Peru and Vietnam, respectively. Analyses included participants with complete data for sleep duration, BMI, sex and age; missing data: 5.9% (Ethiopia), 4.1% (India), 6.0% (Peru) and 4.5% (Vietnam). Exposure was sleep duration per day: short (ConclusionsChildhood overweight and obesity have different profiles across developing settings. In a sample of children living in resource-limited settings in Peru there is no association between short sleep duration and obesity; the crude association was slightly attenuated by children-related variables but strongly diminished by family-related variables.
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- 2014
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21. Diabetic peripheral neuropathy in ambulatory patients with type 2 diabetes in a general hospital in a middle income country: a cross-sectional study.
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María de Los Angeles Lazo, Antonio Bernabé-Ortiz, Miguel E Pinto, Ray Ticse, German Malaga, Katherine Sacksteder, J Jaime Miranda, and Robert H Gilman
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Medicine ,Science - Abstract
We aimed to estimate the morbidity rate and associated factors for diabetic peripheral neuropathy (DPN) in a low-middle income country setting.Cross-sectional study, data was gathered at Peru's Ministry of Health national specialized hospital for endocrinological conditions through standardized interviews, anthropometric measurements and blood tests for glycated haemoglobin (HbA1c). DPN was evaluated using two techniques: the Semmes-Weinstein monofilament test and the diabetic neuropathy symptom score. Overall prevalence and 95% confidence intervals (95% CI) were calculated. Potential factors related to DPN explored included body mass index, years with disease (
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- 2014
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22. Polμ deficiency increases resistance to oxidative damage and delays liver aging.
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Beatriz Escudero, Daniel Lucas, Carmen Albo, Suveera Dhup, Jeff W Bacher, Aránzazu Sánchez-Muñoz, Margarita Fernández, José Rivera-Torres, Rosa M Carmona, Encarnación Fuster, Candelas Carreiro, Raquel Bernad, Manuel A González, Vicente Andrés, Luis Blanco, Enrique Roche, Isabel Fabregat, Enrique Samper, and Antonio Bernad
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Medicine ,Science - Abstract
Polμ is an error-prone PolX polymerase that contributes to classical NHEJ DNA repair. Mice lacking Polμ (Polμ(-/-)) show altered hematopoiesis homeostasis and DSB repair and a more pronounced nucleolytic resection of some V(D)J junctions. We previously showed that Polμ(-/-) mice have increased learning capacity at old ages, suggesting delayed brain aging. Here we investigated the effect of Polμ(-/-) deficiency on liver aging. We found that old Polμ(-/-) mice (>20 month) have greater liver regenerative capacity compared with wt animals. Old Polμ(-/-) liver showed reduced genomic instability and increased apoptosis resistance. However, Polμ(-/-) mice did not show an extended life span and other organs (e.g., heart) aged normally. Our results suggest that Polμ deficiency activates transcriptional networks that reduce constitutive apoptosis, leading to enhanced liver repair at old age.
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- 2014
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23. Increased learning and brain long-term potentiation in aged mice lacking DNA polymerase μ.
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Daniel Lucas, José M Delgado-García, Beatriz Escudero, Carmen Albo, Ana Aza, Rebeca Acín-Pérez, Yaima Torres, Paz Moreno, José Antonio Enríquez, Enrique Samper, Luis Blanco, Alfonso Fairén, Antonio Bernad, and Agnès Gruart
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Medicine ,Science - Abstract
A definitive consequence of the aging process is the progressive deterioration of higher cognitive functions. Defects in DNA repair mechanisms mostly result in accelerated aging and reduced brain function. DNA polymerase µ is a novel accessory partner for the non-homologous end-joining DNA repair pathway for double-strand breaks, and its deficiency causes reduced DNA repair. Using associative learning and long-term potentiation experiments, we demonstrate that Polµ(-/-) mice, however, maintain the ability to learn at ages when wild-type mice do not. Expression and biochemical analyses suggest that brain aging is delayed in Polµ(-/-) mice, being associated with a reduced error-prone DNA oxidative repair activity and a more efficient mitochondrial function. This is the first example in which the genetic ablation of a DNA-repair function results in a substantially better maintenance of learning abilities, together with fewer signs of brain aging, in old mice.
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- 2013
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24. Natural history of malignant bone disease in gastric cancer: final results of a multicenter bone metastasis survey.
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Nicola Silvestris, Francesco Pantano, Toni Ibrahim, Teresa Gamucci, Fernando De Vita, Teresa Di Palma, Paolo Pedrazzoli, Sandro Barni, Antonio Bernardo, Antonio Febbraro, Maria Antonietta Satolli, Paola Bertocchi, Vincenzo Catalano, Elisa Giommoni, Alessandro Comandone, Evaristo Maiello, Ferdinando Riccardi, Raimondo Ferrara, Antonio Trogu, Rossana Berardi, Silvana Leo, Alessandro Bertolini, Francesco Angelini, Saverio Cinieri, Antonio Russo, Salvatore Pisconti, Anna Elisabetta Brunetti, Amalia Azzariti, and Daniele Santini
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Medicine ,Science - Abstract
BackgroundBone metastasis represents an increasing clinical problem in advanced gastric cancer (GC) as disease-related survival improves. In literature, few data on the natural history of bone disease in GC are available.Patients and methodsData on clinicopathology, skeletal outcomes, skeletal-related events (SREs), and bone-directed therapies for 208 deceased GC patients with evidence of bone metastasis were statistically analyzed.ResultsMedian time to bone metastasis was 8 months (CI 95%, 6.125-9.875 months) considering all included patients. Median number of SREs/patient was one. Less than half of the patients (31%) experienced at least one and only 4 and 2% experienced at least two and three events, respectively. Median times to first and second SRE were 2 and 4 months, respectively. Median survival was 6 months after bone metastasis diagnosis and 3 months after first SRE. Median survival in patients who did not experience SREs was 5 months. Among patients who received zoledronic acid before the first SRE, the median time to appearance of first SRE was significantly prolonged compared to control (7 months vs 4 months for control; P: 0.0005).ConclusionsTo our knowledge, this retrospective analysis is the largest multicenter study to demonstrate that bone metastases from GC are not so rare, are commonly aggressive and result in relatively early onset of SREs in the majority of patients. Indeed, our large study, which included 90 patients treated with ZOL, showed, for the first time in literature, a significant extension of time to first SRE and increase in the median survival time after diagnosis of bone metastasis. Taken together, these data may support the beneficial effects of ZOL in GC patients.
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- 2013
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25. Clinicians' involvement of patients in decision making. A video based comparison of their behavior in public vs. private practice.
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Nicole Mongilardi, Víctor Montori, Alejandro Riveros, Antonio Bernabé-Ortiz, Javier Loza, and Germán Málaga
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Medicine ,Science - Abstract
BackgroundLittle is known about the extent to which Peruvian physicians seek to involve patients in shared decision making, or about the variation in these efforts across different settings.ObjectiveTo measure the extent to which Peruvian clinicians involve their patients in decision making and to explore the differences between clinicians' behavior in private vs. public practice.DesignVideographic analysis.Participants and settingSeven academic physicians who provided care to patients in a public and a private setting participate in this study. All the encounters in both settings were filmed on one random day of February 2012.ApproachTwo raters, working independently and in duplicate used the 12-item OPTION scale to quantify the extent of physician effort to involve patients in shared decision making (with 0 indicating no effort and 100 maximum possible effort) in 58 video recordings of usual clinical encounters in private and public practice.ResultsThe mean OPTION score was 14.3 (SD 7.0). Although the OPTION score in the private setting (mean 16.5, SD 7.3) was higher than in the public setting (mean 12.3 SD 6.1) this difference was not statistically significant (p = .09).ConclusionPeruvian academic physicians in this convenience sample barely sought to involve their patients in shared decision making. Additional studies are required to confirm these results which suggest that patient-centered care remains an unfulfilled promise and a source of inequity within and across the private and the public sectors in Peru.
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- 2013
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26. Association between Facebook dependence and poor sleep quality: a study in a sample of undergraduate students in Peru.
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Isabella Wolniczak, José Alonso Cáceres-DelAguila, Gabriela Palma-Ardiles, Karen J Arroyo, Rodrigo Solís-Visscher, Stephania Paredes-Yauri, Karina Mego-Aquije, and Antonio Bernabe-Ortiz
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Medicine ,Science - Abstract
ObjectivesInternet can accelerate information exchange. Social networks are the most accessed especially Facebook. This kind of networks might create dependency with several negative consequences in people's life. The aim of this study was to assess potential association between Facebook dependence and poor sleep quality.Methodology/principal findingsA cross sectional study was performed enrolling undergraduate students of the Universidad Peruana de Ciencias Aplicadas, Lima, Peru. The Internet Addiction Questionnaire, adapted to the Facebook case, and the Pittsburgh Sleep Quality Index, were used. A global score of 6 or greater was defined as the cutoff to determine poor sleep quality. Generalized linear model were used to determine prevalence ratios (PR) and 95% confidence intervals (95%CI). A total of 418 students were analyzed; of them, 322 (77.0%) were women, with a mean age of 20.1 (SD: 2.5) years. Facebook dependence was found in 8.6% (95% CI: 5.9%-11.3%), whereas poor sleep quality was present in 55.0% (95% CI: 50.2%-59.8%). A significant association between Facebook dependence and poor sleep quality mainly explained by daytime dysfunction was found (PR = 1.31; IC95%: 1.04-1.67) after adjusting for age, sex and years in the faculty.ConclusionsThere is a relationship between Facebook dependence and poor quality of sleep. More than half of students reported poor sleep quality. Strategies to moderate the use of this social network and to improve sleep quality in this population are needed.
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- 2013
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27. Induced sputum MMP-1, -3 & -8 concentrations during treatment of tuberculosis.
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Cesar A Ugarte-Gil, Paul Elkington, Robert H Gilman, Jorge Coronel, Liku B Tezera, Antonio Bernabe-Ortiz, Eduardo Gotuzzo, Jon S Friedland, and David A J Moore
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Medicine ,Science - Abstract
Tuberculosis (TB) destroys lung tissues and this immunopathology is mediated in part by Matrix Metalloproteinases (MMPs). There are no data on the relationship between local tissue MMPs concentrations, anti-tuberculosis therapy and sputum conversion.Induced sputum was collected from 68 TB patients and 69 controls in a cross-sectional study. MMPs concentrations were measured by Luminex array, TIMP concentrations by ELISA and were correlated with a disease severity score (TBscore). 46 TB patients were then studied longitudinally at the 2nd, 8th week and end of treatment.Sputum MMP-1,-2,-3,-8,-9 and TIMP-1 and -2 concentrations are increased in TB. Elevated MMP-1 and -3 concentrations are independently associated with higher TB severity scores (p
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- 2013
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28. Sex differences in risk factors for cardiovascular disease: the PERU MIGRANT study.
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Antonio Bernabe-Ortiz, Catherine Pastorius Benziger, Robert H Gilman, Liam Smeeth, and J Jaime Miranda
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Medicine ,Science - Abstract
Although men and women have similar risk factors for cardiovascular disease, many social behaviors in developing countries differ by sex. Rural-to-urban migrants have different cardiovascular risk profiles than rural or urban dwellers. The objective of this study was to evaluate the sex differences with specific cardiovascular risk factors in rural-to-urban migrants.We used the rural-to-urban migrant group of the PERU MIGRANT cross-sectional study to investigate the sex differences in specific cardiovascular risk factors: obesity, hypertension, metabolic syndrome, as well as exposures of socioeconomic status, acculturation surrogates and behavioral characteristics. Logistic regression analysis was used to characterize strength of association between sex and our outcomes adjusting for potential confounders. The sample of migrants was 589 (mean age 46.5 years) and 52.4% were female. In the adjusted models, women were more likely to be obese (OR=5.97; 95%CI: 3.21-11) and have metabolic syndrome (OR=2.22; 95%CI: 1.39-3.55) than men, explaining the greatest variability for obesity and metabolic syndrome but not for hypertension.Our results suggest that interventions for CVD in Peru should be sex-specific and address the unique health needs of migrant populations living in urban shantytowns since the risk factors for obesity and metabolic syndrome differ between males and females.
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- 2012
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29. A1C as a diagnostic criteria for diabetes in low- and middle-income settings: evidence from Peru.
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J Jaime Miranda, Antonio Bernabe-Ortiz, Sanja Stanojevic, German Malaga, Robert H Gilman, and Liam Smeeth
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Medicine ,Science - Abstract
To determine the prevalence of type 2 diabetes mellitus, in three groups of Peruvian adults, using fasting glucose and glycosylated hemoglobin (A1C).This study included adults from the PERU MIGRANT Study who had fasted ≥ 8 h. Fasting glucose ≥ 126 mg/dL and A1C ≥ 6.5% were used, separately, to define diabetes. Subjects with a current diagnosis of diabetes were excluded. 964 of 988 subjects were included in this analysis. Overall, 0.9% (95%CI 0.3-1.5) and 3.5% (95%CI 2.4-4.7) had diabetes using fasting glucose and A1C criteria, respectively. Compared to those classified as having diabetes using fasting glucose, newly classified subjects with diabetes using A1C (n = 25), were older, poorer, thinner and more likely to come from rural areas. Of these, 40% (10/25) had impaired fasting glucose (IFG).This study shows that the use of A1C as diagnostic criteria for type 2 diabetes mellitus identifies people of different characteristics than fasting glucose. In the PERU MIGRANT population using A1C to define diabetes tripled the prevalence; the increase was more marked among poorer and rural populations. More than half the newly diagnosed people with diabetes using A1C had normal fasting glucose.
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- 2011
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30. HBV infection in relation to consistent condom use: a population-based study in Peru.
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Antonio Bernabe-Ortiz, Cesar P Carcamo, John D Scott, James P Hughes, Patricia J Garcia, and King K Holmes
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Medicine ,Science - Abstract
Data on hepatitis B virus (HBV) prevalence are limited in developing countries. There is also limited information of consistent condom use efficacy for reducing HBV transmission at the population level. The study goal was to evaluate the prevalence and factors associated with HBV infection in Peru, and the relationship between anti-HBc positivity and consistent condom use.Data from two different surveys performed in 28 mid-sized Peruvian cities were analyzed. Participants aged 18-29 years were selected using a multistage cluster sampling. Information was collected through a validated two-part questionnaire. The first part (face-to-face) concerned demographic data, while the second part (self-administered using handheld computers) concerned sexual behavior. Hepatitis B core antibody (anti-HBc) was tested in 7,000 blood samples. Prevalences and associations were adjusted for sample strata, primary sampling units and population weights. Anti-HBc prevalence was 5.0% (95%CI 4.1%-5.9%), with the highest prevalence among jungle cities: 16.3% (95%CI 13.8%-19.1%). In the multivariable analysis, Anti-HBc positivity was directly associated with geographic region (highlands OR = 2.05; 95%CI 1.28-3.27, and jungle OR = 4.86; 95%CI 3.05-7.74; compared to coastal region); and inversely associated with age at sexual debut (OR = 0.90; 95%CI 0.85-0.97). Consistent condom use, evaluated in about 40% of participants, was associated with reduced prevalence (OR = 0.34; 95%CI 0.15-0.79) after adjusting for gender, geographic region, education level, lifetime number of sex partners, age at sexual debut and year of survey.Residence in highlands or jungle cities is associated with higher anti-HBc prevalences, whereas increasing age at sexual debut were associated with lower prevalences. Consistent condom use was associated with decreased risk of anti-HBc. Findings from this study emphasize the need of primary prevention programs (vaccination) especially in the jungle population, and imply that condom use promotion might be a potential strategy to prevent HBV infection.
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- 2011
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31. Weight variation over time and its association with tuberculosis treatment outcome: a longitudinal analysis.
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Antonio Bernabe-Ortiz, Cesar P Carcamo, Juan F Sanchez, and Julia Rios
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Medicine ,Science - Abstract
OBJECTIVE: Weight variation during therapy has been described as a useful marker to predict TB treatment outcome. No previous study has used longitudinal analysis to corroborate this finding. The goal of this study was to evaluate change and trends of patients' bodyweight over time depending on TB treatment outcome. METHODS AND FINDINGS: A retrospective cohort study with all TB cases diagnosed from 2000 to 2006 was carried out. Information from 5 public tuberculosis treatment facilities at Pampas de San Juan de Miraflores, Lima, Peru was analyzed. Poor outcome was defined as failure or death during TB therapy, and compared to good outcome defined as cured. Longitudinal analysis with a pre-specified marginal model was fitted using Generalized Estimating Equations to compare weight trends for patients with good and poor outcome adjusting for potential confounders. A total of 460 patients (55.4% males, mean age: 31.6 years) were included in the analysis: 42 (9.1%) had a poor outcome (17 failed and 25 died). Weight at baseline was not different comparing outcome groups (p = 0.17). After adjusting for age, gender, type of TB, scheme of treatment, HIV status and sputum variation during follow-up, after the first month of treatment, patients with good outcome gained, on average, almost 1 kg compared to their baseline weight (p
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- 2011
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32. Factors associated with anti-tuberculosis medication adverse effects: a case-control study in Lima, Peru.
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Kocfa Chung-Delgado, Alejandro Revilla-Montag, Sonia Guillen-Bravo, Eduardo Velez-Segovia, Andrea Soria-Montoya, Alexandra Nuñez-Garbin, Wilmer Silva-Caso, and Antonio Bernabe-Ortiz
- Subjects
Medicine ,Science - Abstract
BACKGROUND: Long-term exposure to anti-tuberculosis medication increases risk of adverse drug reactions and toxicity. The objective of this investigation was to determine factors associated with anti-tuberculosis adverse drug reactions in Lima, Peru, with special emphasis on MDR-TB medication, HIV infection, diabetes, age and tobacco use. METHODOLOGY AND RESULTS: A case-control study was performed using information from Peruvian TB Programme. A case was defined as having reported an anti-TB adverse drug reaction during 2005-2010 with appropriate notification on clinical records. Controls were defined as not having reported a side effect, receiving anti-TB therapy during the same time that the case had appeared. Crude, and age- and sex-adjusted models were calculated using odds ratios (OR) and 95% confidence intervals (95%CI). A multivariable model was created to look for independent factors associated with side effect from anti-TB therapy. A total of 720 patients (144 cases and 576 controls) were analyzed. In our multivariable model, age, especially those over 40 years (OR = 3.93; 95%CI: 1.65-9.35), overweight/obesity (OR = 2.13; 95%CI: 1.17-3.89), anemia (OR = 2.10; IC95%: 1.13-3.92), MDR-TB medication (OR = 11.1; 95%CI: 6.29-19.6), and smoking (OR = 2.00; 95%CI: 1.03-3.87) were independently associated with adverse drug reactions. CONCLUSIONS: Old age, anemia, MDR-TB medication, overweight/obesity status, and smoking history are independent risk factors associated with anti-tuberculosis adverse drug reactions. Patients with these risk factors should be monitored during the anti-TB therapy. A comprehensive clinical history and additional medical exams, including hematocrit and HIV-ELISA, might be useful to identify these patients.
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- 2011
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33. Altered hematopoiesis in mice lacking DNA polymerase mu is due to inefficient double-strand break repair.
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Daniel Lucas, Beatriz Escudero, José Manuel Ligos, Jose Carlos Segovia, Juan Camilo Estrada, Gloria Terrados, Luis Blanco, Enrique Samper, and Antonio Bernad
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Genetics ,QH426-470 - Abstract
Polymerase micro (Polmicro) is an error-prone, DNA-directed DNA polymerase that participates in non-homologous end-joining (NHEJ) repair. In vivo, Polmicro deficiency results in impaired Vkappa-Jkappa recombination and altered somatic hypermutation and centroblast development. In Polmicro(-/-) mice, hematopoietic development was defective in several peripheral and bone marrow (BM) cell populations, with about a 40% decrease in BM cell number that affected several hematopoietic lineages. Hematopoietic progenitors were reduced both in number and in expansion potential. The observed phenotype correlates with a reduced efficiency in DNA double-strand break (DSB) repair in hematopoietic tissue. Whole-body gamma-irradiation revealed that Polmicro also plays a role in DSB repair in non-hematopoietic tissues. Our results show that Polmicro function is required for physiological hematopoietic development with an important role in maintaining early progenitor cell homeostasis and genetic stability in hematopoietic and non-hematopoietic tissues.
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- 2009
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34. Molecular characterization of spontaneous mesenchymal stem cell transformation.
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Daniel Rubio, Silvia Garcia, Maria F Paz, Teresa De la Cueva, Luis A Lopez-Fernandez, Alison C Lloyd, Javier Garcia-Castro, and Antonio Bernad
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Medicine ,Science - Abstract
BACKGROUND: We previously reported the in vitro spontaneous transformation of human mesenchymal stem cells (MSC) generating a population with tumorigenic potential, that we termed transformed mesenchymal cells (TMC). METHODOLOGY/PRINCIPAL FINDINGS: Here we have characterized the molecular changes associated with TMC generation. Using microarrays techniques we identified a set of altered pathways and a greater number of downregulated than upregulated genes during MSC transformation, in part due to the expression of many untranslated RNAs in MSC. Microarray results were validated by qRT-PCR and protein detection. CONCLUSIONS/SIGNIFICANCE: In our model, the transformation process takes place through two sequential steps; first MSC bypass senescence by upregulating c-myc and repressing p16 levels. The cells then bypass cell crisis with acquisition of telomerase activity, Ink4a/Arf locus deletion and Rb hyperphosphorylation. Other transformation-associated changes include modulation of mitochondrial metabolism, DNA damage-repair proteins and cell cycle regulators. In this work we have characterized the molecular mechanisms implicated in TMC generation and we propose a two-stage model by which a human MSC becomes a tumor cell.
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- 2008
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