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Copyright of Retos: Nuevas Perspectivas de Educación Física, Deporte y Recreación is the property of Federacion Espanola de Asociaciones de Docentes de Educacion Fisica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This research seeks to understand the factors that enabled Peru, a medium-sized country in Latin America, to take on a leadership role in the creation and development of the Lima Group—a multilateral mechanism whose main objective was to find a resolution to the democratic crisis in Venezuela—as well as the subsequent failure of this leadership. Using the analytical tools provided by Neoclassical Realism, this study argues that Peru's leadership was made possible not only by the growing importance of the Venezuelan crisis on the international agenda since 2015 but also by changes in regional and global power dynamics. These shifts allowed a country like Peru to exercise such leadership and garner greater interest from the United States. Additionally, the presence of a favorable domestic political climate and clear national interests led the Peruvian government to view this leadership as beneficial, not only for the region but also for Peru itself. However, despite the Venezuelan crisis remaining on the international agenda due to Nicolás Maduro's continued hold on power, the hardening of the U.S. stance on Venezuela and political changes at the regional level since 2018 fractured the Lima Group and undermined Peru's leadership. Moreover, domestically, political changes led to heightened instability, weakening Peru's external position. Finally, the surge in Venezuelan migration and the onset of the COVID-19 pandemic shifted the priorities of Peru's foreign policy, diminishing its focus on the Venezuelan crisis and contributing to the failure of its leadership. [ABSTRACT FROM AUTHOR]

Siendo la vivienda un elemento clave para la seguridad, así como el acceso a recursos y la integración de las personas migrantes, nos preguntamos por las formas de vulnerabilidad a las que estas están expuestas en el mercado de alquiler y los recursos usados (o no) para enfrentar dichas vulnerabilidades. Estudiamos el caso de Lima, la ciudad que ha recibido la mayor cantidad de migrantes venezolanos (1.1 millones) en los últimos años. Siendo un estudio exploratorio, recogimos 37 entrevistas a personas que alquilan vivienda (27 a migrantes venezolanos, 10 a peruanos). Analizamos los casos para cada grupo, buscando los problemas que son comunes y las formas de enfrentarlos. Encontramos que las personas venezolanas tienen problemas de búsqueda y de permanencia en la vivienda no solo por su ciudadanía recortada y sus empleos en el sector informal, sino por su poca disponibilidad de recursos sociales. Por este motivo, están más expuestos a eventos críticos que deben enfrentar por su propia cuenta. En consecuencia, su vulnerabilidad es mayor, y su permanencia en la vivienda es siempre inestable.

Background Composite T-grafts between left internal mammary artery (LIMA) and radial artery (RA) are a common concept in complete arterial myocardial revascularization. The aim of the present study was to investigate whether the use of the great saphenous vein (SV) instead of RA leads to comparably good results in terms of outcome in this context. Methods Patients who underwent myocardial revascularization with a T-graft using RA or a segment of SV to the right coronary artery or circumflex artery between the beginning of 2014 and the end of 2019 at the Department of Cardiovascular Surgery, University Hospital Schleswig-Holstein, Campus Kiel were included. To minimize surgical variation, only patients were observed by a single senior surgeon in the department. Exclusion criteria were previous cardiac surgery, preoperative extracorporeal circulatory support, off-pump surgery, additional aortocoronary bypasses, and cardiac combination procedures. Results A total of 115 patients were studied. In 55 patients, the T-graft was placed between the LIMA and SV, and in 60 patients, the T-graft was placed between the LIMA and RA. Patients in the SV group were older (70.6 ± 7.8 vs. 58.5 ± 10.0 years; p < 0.001), suffered more frequently from non-ST elevation myocardial infarction (12.7 vs. 1.7%; p = 0.027), arterial hypertension (83.6 vs. 61.7%; p = 0.009), and atrial fibrillation (18.2 vs. 1.7%; p = 0.003). They were less likely to be active smokers (16.4 vs. 38.3%; p = 0.009) and less likely to have a history of variceal surgery (0 vs. 15.0%; p = 0.003). Calcification of the ascending aorta was also found more frequently in the saphenous group (18.2 vs. 3.3%, p = 0.009). Operative times and number of distal anastomoses did not differ significantly between the two groups. Postoperative deliriums (16.7 vs. 5.0%; p = 0.043) were observed more frequently in venous patients. Wound healing disorders of the leg (11.1 vs. 0%; p = 0.011) did only occur in SV group and wound infections of the arm only in the RA group. Complete follow-up was achieved in 74.8% of cases. Median follow-up was 60.3 (39.6; 73.2) months. Serious adverse cardiac–cerebral events (19.0 vs. 22.7%; p = 0.675) and mortality (14.5 vs. 6.7%; p = 0.167) did not differ significantly between the groups at follow-up. Myocardial infarction (0 vs. 2.5%; p = 1.000) and stroke (0 vs. 7.5%; p = 0.245) were observed exclusively in RA group. Percutaneous coronary intervention was required in single patients of RA group (0 vs. 15.0%; p = 0.028). No patient from either group underwent repeat coronary artery bypass grafting (CABG). The patients of SV group had angiographically competent grafts and open anastomoses. Graft failure was noted in a single patient in RA group, in which case both grafts and native coronary vessels were stented. Kaplan–Meier analysis revealed no significant survival disadvantage for SV group compared with RA group. Conclusion CABG with a composite T-graft between LIMA and a segment of SV may be comparable to bypass surgery with a composite T-graft between LIMA and RA. This might be true in terms of morbidity and mortality over an intermediate-term observation period. The results of our studies give rise to the hypothesis that the decision not to perform aortic bypass anastomosis may be more important than the choice of graft material. [ABSTRACT FROM AUTHOR]

Background A significant impact of surgeons' experience on outcomes of off-pump coronary artery bypass (OPCAB) has been recognized through previous large-scale studies. However, a safe, effective, and concrete OPCAB training was yet to be identified. We evaluate a safety of our OPCAB training model with single left internal mammary artery (LIMA)–left anterior descending artery (LAD) as a reasonable first step. Methods Between January 2010 and June 2019, 180 patients with an isolated single coronary bypass of the LAD using LIMA as an in situ graft via median sternotomy fulfilled the inclusion criteria. Coronary arterial bypass under cardiopulmonary bypass (CPB), utilizing other graft material, minimal invasive direct coronary arterial bypass through left-sided thoracotomy, and multiple diseased coronary artery disease were excluded. The primary outcome is an early postoperative outcome (major adverse cardiac and cerebrovascular events [MACCEs]: myocardial infarction, coronary re-revascularization, stroke, acute renal failure, and all causes of death) between residents in training under supervision (group 1: n = 63) and experienced surgeons (group 2: n = 117). Trainees were already experienced in on-pump coronary artery bypass grafting. Results Preoperative variables were comparable. There was no significant difference in the rate of MACCEs between the two groups including hospital mortality (p = 1.000), perioperative myocardial infarction (p = 0.246), stroke (p = 0.655), and acute renal failure (p = 0.175). Conclusion The early postoperative outcome of off-pump LIMA to the LAD performed by trainees was comparable to those by experienced surgeons. Single LIMA-LAD was safely performed by trainees under supervision without CPB. In order to master OPCAB technique, single LAD bypass might be a reasonable first step to get into touch with the technical characteristics of this special procedure. [ABSTRACT FROM AUTHOR]

Background The best surgical treatment strategy for coexisting coronary artery disease (CAD) and lung cancer (LC) remains controversial. This study analyzed the safety and efficacy of a simultaneous minimally invasive procedure for patients with CAD and LC. Methods Patients who underwent simultaneous minimally invasive off-pump coronary artery bypass grafting and lung resection from January 2016 to December 2021 were retrospectively analyzed. The procedure was performed in the fourth intercostal space through a small left anterolateral minithoracotomy. Harvesting of the left internal mammary artery (LIMA) and sewing of the anastomoses were performed under direct vision. Lung resections were performed with or without the assistance of a thoracoscope. Results Sixteen patients were included with a mean age of 67.13 ± 10.61 years. Procedural success occurred in all patients with a mean operative time of 366.88 ± 94.48 minutes. All patients received at least one coronary artery bypass LIMA graft. Pneumonectomy, lobectomy, segment resection, and wedge resection were performed in one (6.25%), eight (50%), two (12.5%), and five (31.25%) patients, respectively. There were no perioperative deaths or new myocardial infarctions. Complications included one case of postoperative bleeding, two lung infections, two cases of atelectasis, one case of pleural effusion, and one case of cardiac arrhythmia. All the patients were followed up for 1 to 57 months, cancer recurrence occurred in two patients, and one patient died. The remaining patients showed no evidence of tumor recurrence or myocardial infarction. Conclusion This simultaneous minimally invasive procedure is safe and effective for selected patients with CAD and LC. [ABSTRACT FROM AUTHOR]

Given that housing is a key element for security, access to resources, and the integration of migrant individuals, we inquire, concerning the rental market, about the forms of vulnerability to which they are exposed and the resources used (or not) to confront them. We present the case of Lima, the city that has received the largest number of Venezuelan migrants (1.1 million) in recent years. As an exploratory study, we conducted 37 interviews with tenants (27 Venezuelan migrants, 10 Peruvians). We analyzed the cases for each group, seeking common problems and strategies to address them. We found that Venezuelan individuals face challenges in searching for and staying in housing not only due to their restricted citizenship and employment in the informal sector, but also due to their limited access to social resources. As a result, they are more exposed to critical events and must confront them on their own. Consequently, their vulnerability is greater, and their housing tenure is always unstable. [ABSTRACT FROM AUTHOR]

Social inequity is a global problem that often acutely materialises in cities, where people with lower incomes have reduced access to open spaces. This article examines how walkable access to open spaces mediated by urban morphology and topography differs for people with contrasting income profiles. Taking Lima as a case study, the spatial analysis adapted GIS tools to consider the steep slopes of informal settlements. The combined mapping and measuring of open space catchments and urban fabric permeabilities shows significant spatial inequities between low- and high-income residents that could not have been captured through traditional spatial analytical methods. [ABSTRACT FROM AUTHOR]

This article introduces an innovative mobile solution for Pterygium detection, an eye disease, using a classification model based on the convolutional neural network (CNN) architecture ResNext50 in images of the anterior segment of the eye. Four models (ResNext50, ResNet50, MobileNet v2, and DenseNet201) were used for the analysis, with ResNext50 standing out for its high accuracy and diagnostic efficiency. The research, focused on applications for ophthalmological medical centers in Lima, Peru, explains the process of development and integration of the ResNext50 model into a mobile application. The results indicate the high effectiveness of the system, highlighting its high precision, recall, and specificity, which exceed 85%, thus showing its potential as an advanced diagnostic tool in ophthalmology. This system represents a significant tool in ophthalmology, especially for areas with limited access to specialists, offering a rapid and reliable diagnosis of Pterygium. The study also addresses the technical challenges and clinical implications of implementing this technology in a real-world context. [ABSTRACT FROM AUTHOR]

Natural gas is widely used in many homes for cooking, but a lack of gas leak detection has led to large fires and accidents. This article presents the design and implementation of a natural gas detection and extraction system for domestic kitchens in Lima, Peru. The ESP32 microcontroller allowed remote circuit control, resulting in a more convenient setup than the Arduino UNO microcontroller. After calibration of the sensors and their corresponding programming, three actions were established in response to different gas levels: alarm activation, space ventilation and gas extraction, and thermal shutdown. Strategic sensor placement and improved physical presentation of the system were performed to ensure accurate readings and effective deployment. The results demonstrate the proper functioning of the circuit and its ability to prevent accidents related to gas leaks. The designed system offers the advantage of remote monitoring, providing access to the user from any location. In conclusion, this project offers a comprehensive solution to prevent accidents caused by gas leaks in home kitchens. With satisfactory results in terms of operation and rapid response, the project demonstrates its effectiveness in accident prevention. This design offers a practical and accessible solution, improving security and bringing peace of mind to homes. [ABSTRACT FROM AUTHOR]

Background: Mental health of university students has been impacted during the pandemic, highlighting the importance of understanding its psychosocial determinants. Nevertheless, there has been limited exploration into whether the digital inclusion conditions for remote education could mediate the effects that variables such as resilience, social support, and academic self-efficacy may have on mental health. Considering the above, there is evidence that shows a consistent relationship between resilience, social support and academic selfefficacy on mental health, to the extent that these are psychological variables. On the other hand, digital inclusion, which comprehends a contextual variable, not a psychological one, related to ICT access opportunities and mainly focused on the quality of Internet access, should be analyzed in a differential manner. Objectives: This study seeks to analyze the effect of resilience, social support and academic self-efficacy, on the mental health of a group of Peruvian university students; in addition, it seeks to analyze the mediating role of digital inclusion. Materials and methods: A cross-sectional study was conducted with 3,147 undergraduate students from a private university in Lima, Perú. From August to October 2020, data were collected online through questionnaire, this include The Depression, Anxiety and Stress Scale 21 (DASS-21), The 10-item version of the Connor-Davidson Resilience Scale (CD-RISC10), The Multidimensional Scale of Perceived Social Support (EMASP), The Perceived Self-Efficacy Specific for Academic Situations Scale (EAPESA) and to measure digital inclusion, the Perceived Quality of Internet Access reported by the students. The levels of participants' anxiety, depression and stress were described using frequency and percentage. Pearson Correlation test was used to measure the correlation between the variables and a Path analysis was conducted. Finally, The PROCESS macro for SPSS (Model 4) was applied to examine the mediating effect of the model controlling gender variable. Results: The results revealed significant levels of extremely severe symptoms of anxiety (36.8%), depression (33.4%) and stress (18.1%) among the participants. A path analysis, which indicated that resilience (β = -0.346), social support (β = -0.189), academic self-efficacy (β = -0.060) and digital inclusion β = -0.089) had significant impact on students' General Distress. In addition, digital inclusion plays a partial mediation role with low but significant effect size in the relationship between resilience, social support and self-efficacy with mental health. Conclusion: Mental health of university students during the pandemic shows alarming levels of general or emotional distress. The findings indicate that resilience, social support and self-efficacy protect college students' mental health by reducing general distress. However, the study shows that when there is a digital divide around internet quality the impact of these factors is affected. [ABSTRACT FROM AUTHOR]

Rationale: The persistent burden of tuberculosis (TB) disease emphasizes the need to identify individuals with TB for treatment and those at a high risk of incident TB for prevention. Targeting interventions toward those at high risk of developing and transmitting TB is a public health priority. Objectives: We aimed to identify characteristics of individuals involved in TB transmission in a community setting, which may guide the prioritization of targeted interventions. Methods: We collected clinical and sociodemographic data from a cohort of patients with TB in Lima, Peru. We used whole-genome sequencing data to assess the genetic distance between all possible pairs of patients; we considered pairs to be the result of a direct transmission event if they differed by three or fewer SNPs, and we assumed that the first diagnosed patient in a pair was the transmitter and the second was the recipient. We used logistic regression to examine the association between host factors and the likelihood of direct TB transmission. Measurements and Main Results: Analyzing data from 2,518 index patients with TB, we identified 1,447 direct transmission pairs. Regardless of recipient attributes, individuals less than 34 years old, males, and those with a history of incarceration had a higher likelihood of being transmitters in direct transmission pairs. Direct transmission was more likely when both patients were drinkers or smokers. Conclusions: This study identifies men, young adults, former prisoners, alcohol consumers, and smokers as priority groups for targeted interventions. Innovative strategies are needed to extend TB screening to social groups such as young adults and prisoners with limited access to routine preventive care. [ABSTRACT FROM AUTHOR]

Background: In Peru, one-third of transgender women (TW) are estimated to be living with HIV. While TW are recognized as a priority population, their sexual partners are an at-risk hidden population with unmet needs for HIV services. We conducted a study examining the practices and preferences for HIV services among partners of transgender women (PTW), as compared to TW, to better understand the needs of PTW and inform HIV service delivery for them in Peru. Methods: Between July-October 2022 we conducted a cross-sectional mixed methods study among PTW and TW in Lima, Peru. Using an explanatory sequential design, we administered online surveys to PTW (n = 165) and TW (n = 69), then interviewed a subset of participants (n = 20: 16 PTW, 4 TW). We quantitatively and qualitatively described PTW practices/perspectives on HIV testing and treatment and compared them to TW practices/preferences; we also compared practices/preferences among PTW based on their relationship with TW. Results: Overall, PTW and TW shared similar experiences and preferences for HIV testing/treatment, but fewer PTW reported accessing non-traditional HIV testing options and PTW expressed less strong preferences for HIV services. PTW practices/preferences varied by type of relationship with TWs. Surveys and interviews highlighted a need to prioritize efficiency for HIV testing, eliminate gender/sexuality-based discrimination in healthcare settings, increase privacy when delivering HIV services, and increase awareness of pre-exposure prophylaxis. Conclusion: PTW identified many aspects related to the location, convenience, and privacy of HIV services as important. Next steps could include a discrete choice experiment to further clarify priorities for HIV services for PTW in Peru. [ABSTRACT FROM AUTHOR]

Complex intracranial aneurysms (CIAs) comprise a subset of lesions with defiant vascular architecture, difficult access, and prior treatment. Surgical management of CIAs is often challenging and demands an assessment on a case-by-case basis. The generational evolution of bypass surgery has offered a long-standing potential for effective cerebral revascularization. Herein, we aim to illustrate a single-center experience treating CIAs. The authors conducted a retrospective analysis of clinical records of patients treated with cerebral revascularization techniques at Hospital Nacional Dos de Mayo, Lima, Peru, during 2018–2022. Relevant data were collected, including patient history, aneurysm features on imaging, preoperative complications, the intraoperative course, aneurysm occlusion rates, bypass patency, neurological function, and postoperative complications. Seventeen patients (70.59% female; median age: 53 years) with 17 CIAs (64.7% saccular; 76.5% ruptured) were included. The most common clinical presentation included loss of consciousness (70.6%) and headaches (58.8%). Microsurgical treatment included first-, second-, and third-generation bypass. In 47.1% of cases, an anastomosis between the superficial temporal artery and the M3 segment was predominantly used, followed by an A3-A3 bypass (29.4%), a superficial temporal artery-M2 bypass (17.6%), and an external carotid artery to M2 bypass (5.9%). The intraoperative aneurysm rupture rate was 11.8%. Postoperative complications included ischemia (40%), cerebrospinal fluid fistulas (26.7%), and pneumonia (20%). At hospital discharge, the median Glasgow Coma Scale score was 14 (range: 10–15). At the 6-month follow-up, 82.4% of patients had a modified Rankin Scale score ≤2, bypass patency was present in all cases, and the morbidity rate was 17.6%. CIAs represent a spectrum of defiant vascular lesions with a poor natural history. Bypass surgery offers the potential for definitive treatment. Our case series illustrated the predominant role of cerebral revascularization of CIAs with a critical case-by-case approach to provide optimal outcomes in a limited-resource setting. [ABSTRACT FROM AUTHOR]

Background: Candida auris, a multidrug‐resistant fungal pathogen, has received considerable attention owing to its recent surge, especially in South America, which coincides with the ongoing global COVID‐19 pandemic. Understanding the clinical and microbiological characteristics of outbreaks is crucial for their effective management and control. Objective: This retrospective observational study aimed to characterize a C. auris outbreak at a Peruvian referral hospital between January 2021 and July 2023. Methods: Data were collected from hospitalized patients with positive C. auris culture results. Microbiological data and antifungal susceptibility test results were analysed. Additionally, infection prevention and control measures have been described. Statistical analysis was used to compare the characteristics between the infected and colonized patients. Results: Thirty‐three patients were identified, mostly male (66.7%), with a median age of 53 years. Among them, 18 (54.5%) were colonized, and 15 (45.5%) were infected. Fungemia was the predominant presentation (80%), with notable cases of fungemia in tuberculosis patients with long‐stay devices for parenteral anti‐tuberculosis therapy. Seventy‐five percent of the isolates exhibited fluconazole resistance. Echinocandins were the primary treatment, preventing fungemia recurrence within 30 days. Infected patients had significantly longer hospital stays than colonized patients (100 vs. 45 days; p =.023). Hospital mortality rates were 46.7% and 25% in the infected and fungemia patients, respectively. Simultaneous outbreaks of multidrug‐resistant bacteria were documented. Conclusions: This study underscores the severity of a C. auris outbreak at a referral hospital in Peru, highlighting its significant impact on patient outcomes and healthcare resources. The high prevalence of fluconazole‐resistant isolates, leading to prolonged hospital stay and high mortality rates, particularly in cases of fungemia, underscores the critical need for effective infection prevention and control strategies. [ABSTRACT FROM AUTHOR]

Introduction: The anastomotic leak (AL) is one of the most feared complications of colorectal surgery, since it is associated with a high rate of morbidity, mortality, length of hospital stay and cost of care. Our aim was to determine the risk factors associated with anastomosis leak in colorectal cancer patients who underwent surgical resection with anastomosis. Methods: A multicentre observational, analytical, retrospective and case-control study was carried out. For each case, two controls were included from three national hospitals from Lima, Peru during the period 2021–2022. To determine the degree of association, multivariate logistic regression model was carried out. Results: A total of 360 patients were included, 120 from each hospital. The mean age of the population was 68.03 ± 14.21 years old. The majority were 65 years old or older (66.1%), 52.8% were female, and 63.3% had clinical stage III. The 40% of the patients had albumin levels lower than 3.5 g/dL. Regarding the surgery, 96.4% were elective, 68.9% underwent open approach, and 80.8% had an operative time of more than 180 minutes. Most of them had right colon cancer (50.8%). In the multivariate analysis, a significant association was found with the age variable (OR = 2.48; 95%CI:1.24–4.97), clinical tumour level (OR = 2.71; 95%CI:1.34–5.48), American Society of Anesthesiologists (ASA) Score (OR = 3.23; 95%CI:1.10–9.50), preoperative serum albumin (OR = 22.2; 95%CI:11.5–42.9). Conclusion: The most important independent risk factors associated with AL among patients with colorectal cancer were pre-operative such as lower preoperative serum albumin levels, followed by a higher ASA Score, clinical-stage III-IV, and an age ≥65 years old. [ABSTRACT FROM AUTHOR]

Pneumonia in Peru is a very serious problem. Its impact in recent years has been aggravated due to the Covid-19 pandemic, generating an increase in infections and deaths without distinguishing the age range, which placed this country on the mortality list due to the pandemic. That is why this research seeks the causes of this problem and evaluates what patterns were detected between the years 2019-2022 in patients with pneumonia in Peru from data set from the Comprehensive Health Insurance (SIS). The data presented values related to age, gender, medication and other significant values to understand the disease. The results of the research were achieved by using the PCA technique where the dimensionality of the data was reduced from 28 to 4 main features (Patient's year of health care, Age, BMI, Department). Finally, with this processed data set, the K-Means algorithm was used, where it was determined that patients in the 60 to 85 years range are the most affected by J189 pneumonia. In addition, an environmental pattern was found in J189 pneumonia. J128, resulting in a focus on patients on the Peruvian coast in places like Lima or La Libertad. [ABSTRACT FROM AUTHOR]

Background: Woolly Hair Syndrome (WHS) is a rare birth condition that affects the structure of hair in non‐black people. The pathogenesis is not yet defined. It is postulated that the hair follicle's desmosomes (specifically desmoplaquine, placoglobin and placofilin‐1, which are cell structural proteins that keep the adhesion among close cells) would be altered in this pathology, leading to fragility in the cellular union. It is subdivided into two large groups: the localized or circumscribed variant and the generalized variant. From birth or first months of life, patients with WHS are clinically characterized by the presence of a portion or entire scalp area of very short frizzy hair, usually of a smaller diameter, brittle and lighter color. The most frequent skin manifestations are pilar keratosis and palmo‐plantar keratodermia. The diagnosis is based on the clinical findings, and it is facilitated by trichotoscopic examination. However, a definitive diagnosis of WHS requires genetic testing. Oral agenesis, enamel defects (such as hypomineralization), atypical caries, dental inclusion, and malformed pin‐shaped teeth may occur. Objective: To describe an aesthetic alternative of oral rehabilitation using the mock‐up technique in a patient with WHS. Clinical case: A 5‐year‐old female patient diagnosed with WHS from the National Institute of Child Health Nihch: Breña, Lima, who was referred from the Genetic service to the Pediatric Dentistry service in order to screen outbreaks of infection associated with odontogenic origin and dental anomalies. At the ectoscopy, a patient with short capillary length, brittle and curly hair, dry skin, and nail dystrophy was observed. At the intraoral clinical examination, anterior pieces of 52, 51, 61, 62, and enamel hypomineralization were observed in all teeth. The radiographic examination showed agenesis of parts 41, 34, and 45. Integral dental treatment was performed in the operating room under general anesthesia due to the complexity of the case. Pulpectomy in pieces 52, 51, 61, 62, post of composite resin, and rehabilitation with supra‐nanow filling resin using the mock‐up technique were proposed as alternative treatments. Conclusion: The making of supra‐nano filling resin‐based crowns using the mock‐up technique is an alternative treatment for aesthetic oral rehabilitation in deciduous dentition of patients with WHS. The aesthetic treatment was achieved using supra nano‐filling resins. After 12 months of dental treatment, a favorable response was observed, improving the chewing, phonation and aesthetics of the patient. [ABSTRACT FROM AUTHOR]

Copyright of Virtual Archaeology Review is the property of Virtual Archaeology Review and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

A complete, fluvial stratigraphic record for the last glacial period of the Western Andes in Peru is not available due to preservation issues and spatial variability in sedimentation. Deposits are typically restricted to incomplete records of fluvial terraces or localised occurrences of alluvial fans and landslides. These landforms are thought to have formed under a regime of climate cyclicity controlling increases in precipitation. Because of the fragmented preservation of these deposits, as well as dating uncertainties, it remains unclear if orbital climate cycles, such as the precession cycle, or suborbital cycles, such as the wet Heinrich events, are driving Andean sedimentation. In this paper, we try to answer this question through a sedimentological–stratigraphical analysis of a much more complete sedimentary sequence than usually found in the region. We present the results of a grain size analysis of 5000 clasts and 13 new luminescence ages of a 52‐m‐long, stratigraphic section of the Lima fluvial fan in Peru. Bayesian age–depth modelling resulted in a robust chronostratigraphic framework and derived sedimentation rates. The stratigraphic record registered sedimentation from 121.7 ± 4 to 6.3−1.6+1.5 ka. Three major sedimentation periods occurred between 121.7 to 110−5+4, 87 ± 1 to 67−3+2, and 31−3+4 to 6.3−1.6+1.5 ka. These periods registered various unconformities and coarsening–fining upward sequences which chronologically correlate to suborbital pluvial periods, recognised from speleothems and lake records, that drove fluvial deposition. They also correlate with the timing of other recognised sedimentation events throughout the Western Andes. Marine regression resulted in fan progradation and not in incision. The Lima fan stratigraphy represents therefore the most complete, last glacial fluvial record for the Peruvian Western Andes to date and it highlights the potential of fluvial fans as recorders of suborbital climate variability. [ABSTRACT FROM AUTHOR]

Whole Genome Sequencing (WGS) is a promising tool in the global fight against tuberculosis (TB). The aim of this study was to evaluate the use of WGS in routine conditions for detection of drug resistance markers and transmission clusters in a multidrug-resistant TB hot-spot area in Peru. For this, 140 drug-resistant Mycobacterium tuberculosis strains from Lima and Callao were prospectively selected and processed through routine (GenoType MTBDRsl and BACTEC MGIT) and WGS workflows, simultaneously. Resistance was determined in accordance with the World Health Organization mutation catalogue. Agreements between WGS and BACTEC results were calculated for rifampicin, isoniazid, pyrazinamide, moxifloxacin, levofloxacin, amikacin and capreomycin. Transmission clusters were determined using different cut-off values of Single Nucleotide Polymorphism differences. 100% (140/140) of strains had valid WGS results for 13 anti-TB drugs. However, the availability of final, definitive phenotypic BACTEC MGIT results varied by drug with 10–17% of invalid results for the seven compared drugs. The median time to obtain results of WGS for the complete set of drugs was 11.5 days, compared to 28.6–52.6 days for the routine workflow. Overall categorical agreement by WGS and BACTEC MGIT for the compared drugs was 96.5%. Kappa index was good (0.65≤k≤1.00), except for moxifloxacin, but the sensitivity and specificity values were high for all cases. 97.9% (137/140) of strains were characterized with only one sublineage (134 belonging to "lineage 4" and 3 to "lineage 2"), and 2.1% (3/140) were mixed strains presenting two different sublineages. Clustering rates of 3.6% (5/140), 17.9% (25/140) and 22.1% (31/140) were obtained for 5, 10 and 12 SNP cut-off values, respectively. In conclusion, routine WGS has a high diagnostic accuracy to detect resistance against key current anti-TB drugs, allowing results to be obtained through a single analysis and helping to cut quickly the chain of transmission of drug-resistant TB in Peru. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the association of multidrug-resistant bacteria (MDRB) and adverse clinical outcomes in patients with diabetic foot infection (DFI) in a Peruvian hospital. Materials and methods: This retrospective cohort study evaluated patients treated in the Diabetic Foot Unit of a General Hospital in Lima, Peru. MDRB was defined by resistance to more than two pharmacological groups across six clinically significant genera. The primary outcome was death due to DFI complications and/or major amputation. Other outcomes included minor amputation, hospitalization, and a hospital stay longer than 14 days. Relative risks were estimated using Poisson regression for all outcomes. Results: The study included 192 DFI patients with a mean age of 59.9 years; 74% were males. A total of 80.8% exhibited MDRB. The primary outcome had an incidence rate of 23.2% and 5.4% in patients with and without MDRB, respectively (p = 0.01). After adjusting for sex, age, bone involvement, severe infection, ischemia, diabetes duration, and glycosylated hemoglobin, MDRB showed no association with the primary outcome (RR 3.29; 95% CI, 0.77–13.9), but did with hospitalization longer than 14 days (RR 1.43; 95% CI, 1.04–1.98). Conclusions: Our study found no association between MDRB and increased mortality and/or major amputation due to DFI complications, but did find a correlation with prolonged hospitalization. The high proportion of MDRB could limit the demonstration of the relationship. It is urgent to apply continuous evaluation of bacterial resistance, implement a rational plan for antibiotic use, and maintain biosafety to confront this threat. [ABSTRACT FROM AUTHOR]

This article deals with the fires that occurred in colonial Lima and the management of the authorities to control it. The economic, daily and constructive activities caused these fires. Sites at risk of generating them were bakeries, factories and intramural deposits of saltpeter and gunpowder. Risky neighborhood habits were the use of the roofs of the houses as storage areas, carelessness in the use of candles and fireworks during festivities. As for architecture, what could cause fires was the use of the quincha (cane and mud framework), even if it protected from earthquakes. The viceroy, the council and, later, the police administration tried to order the actions to be carried out in the event of the fires, especially in the eighteenth century, such as the availability of fire-fighting instruments, the use of water from the ditches and emergency notices through the ringing of church bells. [ABSTRACT FROM AUTHOR]

With global shifts towards sustainable energy models, the urgency to address rising fossil fuel prices, military conflicts, and climate change concerns has become evident. The article aims to identify the development of wind energy in Poland. This study introduces an integrated methodology for enhancing renewable energy capacities by selecting new construction sites for onshore wind farms across Poland. The proposed methodology utilises a hybrid model incorporating multiple criteria decision-making methods, such as the Analytic Hierarchy Process (AHP) and Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS), alongside the semiautomated spatial analysis method using QGiS software (v. 3.32 Lima). The model considers economic, social, and environmental criteria and limitations, offering a comprehensive approach to the decision-making process. It was found that wind farms occupy 460.7 km2 in Poland, with a 250 m buffer around each turbine and a total power capacity of 5818 MW. The results show that an additional 7555.91 km2 of selected areas, 2.34% of the country's area, theoretically offer significant opportunities for wind energy development. The spatial analysis identifies potential sites with promising opportunities for domestic and international renewable energy investors. The study's findings contribute towards achieving national and EU renewable energy targets while offering a replicable framework for informed spatial planning decisions in other regions. [ABSTRACT FROM AUTHOR]

A new species from the Malesherbia sect. Malesherbia is described for the department of Lima, Peru. Malesherbia anxia is found in arid areas of the valley of the Chancay River (Huaral, Lima), on the western slope of the Andes, between 1,580 to 2,600 m. This species has morphological affinities with M. weberbaueri and M. splendens. A key for the identification of other related species is presented, accompanied by a comparative table of diagnostic morphological characters. With this taxonomic novelty, the number of Malesherbia species in Peru rises to 14, of which 12 are endemic. [ABSTRACT FROM AUTHOR]

In Peru, 29 292 people were diagnosed with tuberculosis in 2022. Although tuberculosis treatments are effective, 3.4%–13% are associated with significant adverse drug reactions, with drug‐induced liver injury (DILI) considered the most predominant. Among the first‐line antituberculosis drugs, isoniazid is the main drug responsible for the appearance of DILI. In liver, isoniazid (INH) is metabolized by N‐acetyltransferase‐2 (NAT2) and cytochrome P450 2E1 (CYP2E1). Limited information exists on genetic risk factors associated with the presence of DILI to antituberculosis drugs in Latin America, and even less is known about these factors in the native and mestizo Peruvian population. The aim of this study was to determine the prevalence of NAT2 and CYP2E1 genotypes in native and mestizo population. An analytical cross‐sectional analysis was performed using genetic data from mestizo population in Lima and native participants from south of Peru. NAT2 metabolizer was determined as fast, intermediate and slow, and CYP2E1 genotypes were classified as c1/c1, c1/c2 and c2/c2, from molecular tests and bioinformatic analyses. Of the 472 participants, 36 and 6 NAT2 haplotypes were identified in the mestizo and native population, respectively. In mestizo population, the most frequent NAT2*5B and NAT2*7B haplotypes were associated with DILI risk; while in natives, NAT2*5G and NAT2*13A haplotypes were associated with decreased risk of DILI. For CYP2E1, c1/c1 and c1/c2 genotypes are the most frequent in natives and mestizos, respectively. The linkage disequilibrium of NAT2 single nucleotide polymorphisms (SNPs) was estimated, detecting a block between all SNPs natives. In addition, a block between rs1801280 and rs1799929 for NAT2 was detected in mestizos. Despite the limitations of a secondary study, it was possible to report associations between NAT2 and CYP2E alleles with Peruvian native and mestizo by prevalence ratios. The results of this study will help the development of new therapeutic strategies for a Tuberculosis efficient control between populations. [ABSTRACT FROM AUTHOR]

Copyright of Formación Universitaria is the property of Centro de Informacion Tecnologica (CIT) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background Coronary artery bypass graft (CABG) surgery represents a major cardiovascular operation and may be associated with post-operative ST-elevation myocardial infarction (STEMI) due to graft failure. This is challenging to diagnose and treat as the implanted grafts may be prone to complications when treated percutaneously with drug-eluting stents. Case summary A man in his 60 s underwent CABG and developed new persistent ST elevations of 2 mm in anterior leads with no significant chest pain, although, administered with intravenous opiates post-operatively. Transthoracic echocardiography was non-diagnostic. Invasive angiography performed emergently showed a thrombotic occlusion of the mid-left anterior descending artery at the site of the anastomosis with the left internal mammary artery (LIMA) graft. Intervention via the graft was considered high risk of complications, therefore, native coronary arteries were used to approach the occlusion, which was successfully cleared with a combination balloon angioplasty with a semi-compliant and then a drug-eluting balloon. The LIMA started working again with the resolution of ST elevation and no immediate complications. Discussion Early post-operative ST elevations in continuous leads should not be ignored as they often may be the only feature of new-onset STEMI. Drug-eluting balloons represent a feasible and possibly safer option than drug-eluting stents to treat these conditions. [ABSTRACT FROM AUTHOR]

Some studies have shown that inequality increased in pre-1930 Latin America as the economy and foreign trade grew. Others have shown that there was no clear relationship between economic growth and inequality. The information on nineteenth-century Peru is useful to estimate income inequality during a period of rapid economic growth. This article estimates the distribution of profits in Lima between 1838 and 1859 using information from tax reports. Mobility across social classes was possible for some guild members. However, financiers and large merchants experienced higher growth in profits than artisans and small traders. In addition, a comparison of profits and wages shows that the richest entrepreneurs experienced a rapid increase in profits during a period of declining real wages. Thus, the income gap between the richest and poorest residents of Lima widened during this period. [ABSTRACT FROM AUTHOR]

Introduction: Evaluating the professional competencies of Peruvian doctors is crucial for proposing necessary improvements. However, there is a lack of knowledge regarding the specific characteristics and competencies that are assessed in these studies. Objective: The objective of this study is to characterize published studies focusing on the assessment of professional competencies among physicians in Peru. Methods: A comprehensive scoping review was conducted, encompassing scientific journal publications that evaluated the professional competencies of physicians in Peru. The search was performed in PubMed, Google Scholar, Scopus, and SciELO, with the review period extending until 2022. The identified competencies were classified using the Accreditation Council for Graduate Medical Education (ACGME) and the Ministry of Health of Peru (MINSA) frameworks. The findings were presented using absolute and relative frequency measures. Results: A total of forty-nine studies focused on the assessment of professional competencies among physicians were identified, indicating an upward trend over the years. The primary focus of these studies was on evaluating competencies related to medical knowledge (79.6% according to ACGME classification) and the treatment of health problems (57.1% according to MINSA classification). However, there was a noticeable lack of emphasis on assessing behavioral competencies such as ethics, professionalism, and communication. Most of the included studies (65.3%) were exclusively conducted in Lima. Among the studies that disclosed their funding sources, 61% were self-funded. Conclusion: Most studies primarily concentrated on evaluating knowledge-based competencies, specifically in the areas of diagnosis and treatment. There is a scarcity of studies assessing other important competencies. Additionally, centralization and limited funding appear to be areas that require improvement in the evaluation of professional competencies among Peruvian physicians. [ABSTRACT FROM AUTHOR]

The present study, focused on pilgrimages as part of religious tourism, aimed to achieve the following objectives: Identify the motivations of the demand for religious tourism focused on pilgrimages; analyze the segmentation of the demand; identify the relationship between demand segments with satisfaction and loyalty; and establish the sociodemographic aspects that characterize demand segments. The study was conducted during the Pilgrimage of the Christ of Miracles in Lima, Peru. The sample was taken on-site from 384 tourists. The statistical techniques used were factor analysis and the k-means clustering method. The results reveal five motivational dimensions: Religious Experience, Belief Experience, Escape, Touristic Experience, and Shopping. Three attendee segments were also identified: Believers, related to belief experience; Religious, related to religious experience; and Passive, tourists with low motivations. The Religious segment had the highest satisfaction and loyalty levels among these groups. Sociodemographic differences were also found in the demand segments. The findings will contribute to management guidelines for destination administrators with religious events and provide insights into academic literature. [ABSTRACT FROM AUTHOR]

We explored the utility of brief Mycobacterium tuberculosis whole-genome sequencing (WGS) "snapshots" at a sentinel site within Lima, Peru, for evaluating local transmission dynamics over time. Within a 17-km2 area, 15 of 70 (21%) isolates with WGS collected during 2011–2012 and 22 of 81 (27%) collected during 2020–2021 were clustered (P =.414), and additional isolates clustered with those from outside the area. Isolates from the later period were disproportionately related to large historic clusters in Lima from the earlier period. WGS snapshots at a sentinel site may not be useful for monitoring transmission, but monitoring the persistence of large transmission clusters might be. [ABSTRACT FROM AUTHOR]

Copyright of Cuadernos del Centro de Estudios de Diseño y Comunicación is the property of Cuadernos del Centro de Estudios de Diseno y Comunicacion and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Recent studies on the figuration of the nation in nineteenth-century Hispanic America have used sophisticated analyses of different media to suggest that Indigenous references were progressively excluded from urban public space as national symbols. In these spaces, the creole authorities placed themselves and their ancestors centre stage. However, these studies have neglected a highly representative medium: street names. This article demonstrates that street nomenclature was key in figuring the nation in a capital city and shows a different trend from that established using other media. Specifically, after the 1861 municipal reform of street names in Lima, Peru, the majority of official names were Indigenous and did not celebrate creole or military elites. This article examines this reform and the conflicts it provoked. [ABSTRACT FROM AUTHOR]

The article titled "The Epic Mirror: Poetry, Conflict Ethics and Political Community in Colonial Peru" analyzes three important texts of Peruvian colonial poetry and traces a genealogy of their ethical and political ideas. The first chapter contextualizes the city of Lima in the late 16th century and establishes concepts such as political community, just war, republic, and empire. The second chapter analyzes the dialogue between La Araucana and Machiavelli's political treatises, focusing on the ideas of republic, real power, and just war. The third chapter focuses on Pedro de Oña's poem Arauco domado, exploring the mechanisms of power in early modernity and the representation of the Araucanian political community. The text analyzes two colonial epic poems: "El Arauco domado" and "Armas antárticas". In the case of the first one, the centrality of the viceroy's authority in relation to monarchical power is highlighted. The analysis also establishes parallels between the Araucanian celebrations and the rebellious communal festivities of Quito. As for "Armas antárticas", the heterogeneity and fragmentation of the plot are emphasized, as well as the limited attention to indigenous communities. The book offers a political interpretation of both poems, highlighting the importance of community in the defense of power. [Extracted from the article]

• Effective removal of surface contamination through washing, analyzed via image processing. • Improved textile preservation with a higher surfactant concentration during washing. • In-depth analysis of textiles from Pachacamac site, covering composition, morphology, and mechanics. • Resilience of internal textile crystalline structure post-washing and aging. • Significance of textile preservation in cultural heritage studies. Conservation of textiles is indubitably a delicate and relevant matter, as its focus is to preserve pieces that carry unmeasurable historical value. This work aims to evaluate the impact of washing and aging processes in the conservation of archaeological textiles. The samples used are Peruvian textiles found in the Museum of Site and Archeological Sanctuary of Pachacamac, located in the Lurín district, city of Lima, Perú. The museum's cleaning protocol was replicated using the immersion washing method with Orvus WA paste as a surfactant at concentrations of 0.5% and 1% w/w. Samples analyzed conditions included: unwashed control samples, samples washed with both concentrations, and samples washed and followed by a prolonged light exposure aging. Evaluated parameters were changes in tonality by conducting surface analysis through scanning electron microscopy and image processing, determining the crystallinity index using the X-ray diffraction method, analyzing surface properties via X-ray energy dispersion spectroscopy, and mechanical properties by tensile testing The obtained results show the effective removal of surface particles, mostly soluble salts. Prolonged light exposure caused a loss of color saturation on the textile due to photodegradation. Meanwhile, the washing process with a 1% surfactant concentration showed no loss in the mechanical properties; furthermore, previously washed aged samples showed the ability to better withstand the aging and photodegradation process and better retain their mechanical properties compared to the untreated uncleaned sample. [ABSTRACT FROM AUTHOR]

Coastal cities attract a significant flow of travelers who are currently seeking for biosecurity in their visits. This research, carried out during the COVID-19 pandemic, has the following objectives: (i) identify post-pandemic motivational dimensions of demand in a coastal city and (ii) determine post-pandemic motivational dimensions of demand that predict return, recommendation, and provide positive word-of-mouth about the coastal city as loyalty variables. The present study was conducted in Lima, an important tourist destination on the Peruvian Pacific coast. This quantitative study employed a sample of 354 valid questionnaires analyzed using a Factor Analysis and the Stepwise Multiple Regression method. The results show four post-pandemic motivational dimensions in coastal cities: “Novelty and social interaction,“ “Learning and culture,“ “Safety of the destination,“ and ”Safety of services.” Of these, the ”Safety of services” dimension is the most important and most influential predictor of tourist return, followed by the ”Learning and culture” dimension. The results will serve as management guidelines for DMOs and sources of information for companies involved in the marketing and development of post-pandemic tourist products. The study is also a contribution to the academic literature on coastal cities. [ABSTRACT FROM AUTHOR]

Background: The anthropause during the recent COVID-19 pandemic provided a unique opportunity to examine the impact of human activity on seabirds. Lockdowns in Peru prevented people from visiting coastal areas, thereby reducing garbage disposal on beaches and the movement of microplastics into the ocean. This cessation of activities likely led to a temporary decrease in plastic pollution in coastal regions. We aimed to investigate this phenomenon in inshore-feeding neotropic cormorants (Nannopterum brasilianus) along the Circuito de Playas Costa Verde (CPCV), situated on the coastal strip of Lima, Peru (∼ 11 million people). Methods: We collected and analyzed fresh pellets along the CPCV before (over 11 months) and during the pandemic lockdowns (over 8 months). Results: Our findings revealed a significant reduction in the occurrence of plastic in pellets during the pandemic period (% Oc = 2.47, n = 647 pellets) compared to pre-pandemic conditions (% Oc = 7.13, n = 800 pellets). The most common plastic debris item found in the pellets was threadlike microplastic. Additionally, our study highlights the direct correlation between human presence on beaches and the quantity of microplastics (mainly threadlike) found in cormorant pellets. We suggest that the reintroduction of these materials into the sea, previously accumulated on the coast, is likely facilitated by the movement and activity of beachgoers toward the ocean. [ABSTRACT FROM AUTHOR]

This investigation addresses the tsunami inundation in Lima and Callao caused by the massive 1746 earthquake (Mw 9.0) along the Peruvian coast. Numerical modeling of the tsunami inundation processes in the nearshore includes strong nonlinear numerical terms. In a comparative analysis of the calculation of the tsunami wave effect, two numerical codes are used, Tsunami-HySEA and TsunAWI, which both solve the shallow water (SW) equations but with different spatial approximations. The comparison primarily evaluates the flow velocity fields in inundated areas. The relative importance of the various parts of the SW equations is determined, focusing on the nonlinear terms. Particular attention is paid to the contribution of momentum advection, bottom friction, and volume conservation. The influence of the nonlinearity on the degree and volume of inundation, flow velocity, and small-scale fluctuations is determined. The sensitivity of the solution concerning the bottom friction parameter is also investigated, showing the effects of nonlinearity processes in the inundated areas, wave heights, current velocity, and the spatial structure variations shown in tsunami inundation maps. [ABSTRACT FROM AUTHOR]

The rise in global ozone levels over the last few decades has harmed human health. This problem exists in several cities throughout South America due to dangerous levels of particulate matter in the air, particularly during the winter season, making it a public health issue. Lima, Peru, is one of the ten cities in South America with the worst levels of air pollution. Thus, efficient and precise modeling and forecasting are critical for ozone concentrations in Lima. The focus is on developing precise forecasting models to anticipate ozone concentrations, providing timely information for adequate public health protection and environmental management. This work used hourly O 3 data in metropolitan areas for multi-step-ahead (one-, two-, three-, and seven-day-ahead) O 3 forecasts. A multiple linear regression model was used to represent the deterministic portion, and four-time series models, autoregressive, nonparametric autoregressive, autoregressive moving average, and nonlinear neural network autoregressive, were used to describe the stochastic component. The various horizon out-of-sample forecast results for the considered data suggest that the proposed component-based forecasting technique gives a highly consistent, accurate, and efficient gain. This may be expanded to other districts of Lima, different regions of Peru, and even the global level to assess the efficacy of the proposed component-based modeling and forecasting approach. Finally, no analysis has been undertaken using a component-based estimation to forecast ozone concentrations in Lima in a multi-step-ahead manner. [ABSTRACT FROM AUTHOR]

The study aimed to establish the influence of formative assessment on the attainment of scientific and technological competencies in a school in Lima, Peru. We formulated and subsequently tested hypothesis of the positive impact of formative evaluation on science and technology competencies. The authors used the questionnaire associated with formative evaluative practices and to measure the development of competencies gradings of 116 second-grade high school students. It was found that formative assessment significatively influences the development of scientific and technological competencies, predicting a 0.708 increase in educational outcomes (pseudo R-squared Nagelkerke). This influence on competency attainment was examined through regression analysis. It was concluded that formative assessment, along with all its dimensions, influences the achievement of competencies related to science and technology. We recommend that its implementation in classrooms should receive greater dissemination. [ABSTRACT FROM AUTHOR]

Copyright of Dilemas Contemporáneos: Educación, Política y Valores is the property of Dilemas Contemporaneos: Educacion, Politica y Valores and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In many languages, the present perfect has grammaticalized, gradually displacing the preterit. Within Spanish, this has been documented with the grammaticalization of the present perfect in Peninsular Spanish. To examine this possibility in two Latin American varieties, this study examined present perfect/preterit variation of 36 speakers from Lima and Mexico City from the PRESEEA corpus. While Lima Spanish presented overall more present perfect than Mexico City Spanish, a similar internal constraint hierarchy is predictive of present perfect use in both speech communities. However, Lima Spanish demonstrated a change in progress toward an expansion of the preterit among younger speakers with the indeterminate temporal reference as locus of change. The findings suggest that present perfect grammaticalization may not always be the most common cross-linguistic pathway but rather is subject to source constraints, which may lead to another pathway in which the preterit expands at the expense of the present perfect. [ABSTRACT FROM AUTHOR]

An "Innerburb" is an urban structure that emerged between the 1950s and 1980s, settled in rural areas, and is considered the first periphery of the Latin American city. This structure results from socio-spatial and territorial evolutionary processes, constituting the pinnacle of informal evolution. However, despite offering a comprehensive perspective on the informal problem, innerburbs have been scarcely reviewed in the literature. This article explores the Latin American innerburb by adopting as a method a comparative study of the public/private interface in the cases of San Cosme in Lima, Villa Rodolfo Ricciardelli in Buenos Aires and Vila Heliopolis in São Paulo, evaluating their adaptation and interconnection with the city through morphological indicators, using morphological mapping through satellite images as an analytical tool, and using Space Syntax as a topological approach in the analysis of connectivity and visibility indicators. The objective of the research is the detection of morphological patterns that alter the functioning of the public/private interface in innerburbs. The results show that the existence of impermeable facades, the lack of public spaces and the illegal appropriation in the development of informal practices are transgressive adaptability patterns at the micro-scale that affect the interface, drastically limiting the interconnection between the innerburb and the formal fabric, restricting its morphological openness and affecting the development of socioeconomic activities. As a discussion and conclusion, corrective measures for progressive improvement in innerburbs are established, focusing on the adaptability of housing and road space as a means of interconnection between the innerburb and the city. [ABSTRACT FROM AUTHOR]

The Metropolitan Area of Lima-Callao (MALC) is a South American megacity that has suffered a serious deterioration in air quality due to high levels of particulate matter (PM2.5 and PM10). Studies on the behavior of the PM2.5/PM10 ratio and its temporal variability in relation to meteorological parameters are still very limited. The objective of this study was to analyze the temporal trends of the PM2.5/PM10 ratio, its temporal variability, and its association with meteorological variables over a period of 5 years (2015–2019). For this, the Theil-Sen estimator, bivariate polar plots, and correlation analysis were used. The regions of highest mean concentrations of PM2.5 and PM10 were identified at eastern Lima (ATE station—41.2 µg/m3) and southern Lima (VMT station—126.7 µg/m3), respectively. The lowest concentrations were recorded in downtown Lima (CDM station—16.8 µg/m3 and 34.0 µg/m3, respectively). The highest average PM2.5/PM10 ratio was found at the CDM station (0.55) and the lowest at the VMT station (0.27), indicating a predominance of emissions from the vehicular fleet within central Lima and a greater emission of coarse particles by resuspension in southern Lima. The temporal progression of the ratio of PM2.5/PM10 showed positive and highly significant trends in northern and central Lima with values of 0.03 and 0.1 units of PM2.5/PM10 per year, respectively. In the southern region of Lima, the trend was also significant, showcasing a value of 0.02 units of PM2.5/PM10 per year. At the hourly and monthly level, the PM2.5/PM10 ratio presented a negative and significant correlation with wind speed and air temperature, and a positive and significant correlation with relative humidity. These findings offer insights into identifying the sources of PM pollution and are useful for implementing regulations to reduce air emissions considering both anthropogenic sources and meteorological dispersion patterns. [ABSTRACT FROM AUTHOR]

Introduction: Sarcopenia 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. Methods: This 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. Results: The 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). Conclusion: Our 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. [ABSTRACT FROM AUTHOR]

Background and Aim: Established antimicrobial resistance (AMR) surveillance in companion animals is lacking, particularly in low-middle-income countries. The aim of this study was to analyze AMR and its risk factors in Escherichia coli isolated from dogs at two veterinary centers in Lima (Peru). Materials and Methods: Ninety dogs were included in the study. Antimicrobial susceptibility was established by disk diffusion, whereas microdilution was used to determine colistin susceptibility. Mechanisms related to extended-spectrum β-lactamases (ESBL) and colistin resistance were determined by polymerase chain reaction. Clonal relationships of colistinresistant isolates were assessed by XbaI-pulsed-field gel electrophoresis. Results: Thirty-five E. coli strains were isolated. High levels of resistance to ampicillin (57.1%), nalidixic acid (54.3%), tetracycline (48.6%), and azithromycin (25.7%) were detected. Cephalosporin resistance levels were ≥20% and those for colistin were 14.3%. Twelve (34.2%) isolates were ESBL producers; of these, six blaCTX-M-55 (50.0%), 2 (16.6%) blaCTX-M-15, and 2 (16.6%) blaCTX-M-8-like genes were found. The five colistin-resistant isolates were clonally unrelated, with four of them presenting amino acid codon substitutions in the mgrB gene (V8A) or mutations in the mgrB promoter (a12g, g98t, and c89t). Furthermore, dog age, <6 years (p = 0.027) and raw diet (p = 0.054) were associated with resistance to a greater number of antibiotic families. Conclusion: Despite small number of samples included, the study found that dogs studied were carriers of multidrugresistant E. coli, including last-resort antimicrobials, representing a public health problem due to close contact between dogs and humans. This issue suggests the need for larger studies addressed to design strategies to prevent the spread of resistant micro-organisms in small animal clinics and domestic settings. [ABSTRACT FROM AUTHOR]

Evaluate clinical outcomes of stroke survivors in Peru discharged with artificial nutrition via a feeding tube (FT), and explore perspectives and experiences of these patients and their caregivers. Retrospective chart review to describe the prevalence of FT placement and characteristics of patients admitted with stroke to the Instituto Nacional de Ciencias Neurológicas in Lima, Peru between January 2019 and 2021. Follow-up calls to stroke survivors discharged home with FTs or their caregivers included quantitative and qualitative questions to assess long-term outcome and explore perspectives around poststroke care and FT management. We analyzed quantitative data descriptively and applied thematic analysis to qualitative data using a consensus-driven codebook. Of 812 hospitalized patients with stroke, 146 (18%) were discharged home with FT, all with nasogastric tubes (NGTs). Follow-up calls were performed a median of 18 months after stroke with 96 caregivers and three patients. Twenty-five patients (25%) had died, and 82% of survivors (n = 61) remained dependent for some care. Four themes emerged from interviews: (1) perceived suffering (physical, emotional, existential) associated with the NGT and stroke-related disability, often exacerbated by lack of preparedness or prognostic awareness; (2) concerns around compromised personhood and value-discordant care; (3) coping with their loved-one's illness and the caregiving role; and (4) barriers to NGT care and skill acquisition. We identified a high burden of palliative and supportive needs among severe stroke survivors with NGTs and their caregivers suggesting opportunities to improve poststroke care through education, communication, and support. [ABSTRACT FROM AUTHOR]

Objectives. Despite guideline recommendations for use of bilateral internal mammary artery (BIMA) in coronary artery bypass grafting (CABG), a large proportion of patients still receive saphenous vein grafts (SVG). We herein aimed to identify reasons for SVG use at a center with a BIMA utilization rate between 60 and 70% and compare outcomes of patients undergoing CABG with either BIMA or left internal mammary artery (LIMA) plus SVG. Methods. Between 2013 and 2022, 4145 consecutive patients underwent isolated CABG at our center. Of those, 2067 patients received BIMA (group 1) and 1206 patients received LIMA/SVG (group 2). A propensity score-matched analysis was performed to adjust for baseline differences. Results. Group 2 presented with higher age, more female patients, and more patients with acute coronary syndrome including NSTEMI/STEMI with more urgent/emergency CABG. In unadjusted analysis group 2 presented adverse 30-day outcomes compared to group 1 with a higher mortality (18/2067, 0.9% vs. 34/1206, 2.8%; p < 0.001), higher rate of re-revascularization (52/2067, 2.5% vs. 50/1206, 4.1%; p < 0.001), more stroke (20/2067; 1.0% vs. 33/1206, 2.7%; p < 0.001), and more postoperative renal failure (17/2067, 0.8% vs. 27/1206, 2.2%; p = 0.001). After adjustment for baseline characteristics, 30-day outcomes were comparable. Conclusions. After adjustment for baseline characteristics no differences in outcomes were found between groups suggesting a safe applicability of BIMA even in patients with acute coronary syndrome undergoing urgent/emergency CABG. Reasons for SVG use were higher age, female gender, and acute coronary syndrome with urgent/emergency CABG. Outcomes of both groups were excellent with low rates of primary endpoints. [ABSTRACT FROM AUTHOR]