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Abstract Introduction Respiratory syncytial virus (RSV) leads to significant morbidity in newborn infants in the United Kingdom (UK). Nirsevimab, a long-acting monoclonal antibody, received approval from the European Medicines Agency and has been licensed by the Medicines and Healthcare products Regulatory Agency for preventing RSV lower respiratory tract disease (LRTD) in neonates and infants during their first RSV season. The objective of this study was to assess the potential impact of nirsevimab on RSV-associated LRTDs, related costs, and loss of quality-adjusted life years (QALYs) in infants experiencing their first RSV season. Methods The impact of administering nirsevimab across all infant populations compared to palivizumab in the high-risk palivizumab-eligible population was assessed via a static decision-analytic model specified for a UK birth cohort experiencing their first RSV season. The RSV-related health events of interest included primary care (PC), accident and emergency (A&E) visits, hospitalizations [including hospitalizations alone and those resulting in intensive care unit (ICU) admissions], recurrent wheezing in infants who were previously hospitalized, and all-cause LRTD hospitalizations. Results Under the current standard of practice (SoP), RSV was estimated to result in 329,425 RSV LRTDs annually, including 24,381 hospitalizations and ICU admissions, representing £117.8 million (2024 GBP) in costs. Comparatively, universal immunization of all infants with nirsevimab could avoid 198,886 RSV LRTDs, including 16,657 hospitalizations and ICU admissions, resulting in savings of £77.2 million in RSV treatment costs. Considering the impact on all-cause LRTD of a universal immunization strategy, nirsevimab could be valued between £243 and £274, assuming willingness-to-pay (WTP) thresholds of £20,000 and £30,000 per QALY saved, respectively. Conclusions This analysis demonstrated that the health and economic burden of RSV would be substantially reduced in all infants experiencing their first RSV season in the UK (including term, preterm, and palivizumab-eligible infants) as a result of a universal immunization strategy with nirsevimab.

Abstract Apparent resistant hypertension (aTRH) is a significant public health issue. Once low adherence to antihypertensive treatment has been ruled out and true resistant hypertension is diagnosed, aldosterone-direct-renin-ratio (ADRR) aids in the screening of an aldosterone-producing adenoma (APA) and primary aldosteronism (PA). Once PA and other secondary causes have been ruled out, the values of aldosterone and renin allow patients to be classified into phenotypes such as low renin hypertension (LRH), Liddle’s-like (LLph), and primary hyperaldosteronism (PAph). These classifications could aid in the treatment decision-making process. However, optimal cut-off points for these classifications remain uncertain. This study aims to assess the prevalence of these phenotypes and the behavior of different cut-offs of the ADRR in an Afro-Colombian population with apparent resistant hypertension, as well to describe their sodium consumption. Afro-descendant individuals 18 years of age or older, diagnosed with resistant hypertension and attending to a primary care center in Colombia were recruited as volunteers. As part of the study, their plasma renin concentration (PRC) and plasma aldosterone concentration (PAC) were measured. The phenotypes were categorized into three groups based on multiple cut-off points from different authors: low renin and low aldosterone phenotype (LLph), low renin and high aldosterone phenotype (PAph), and high renin and high aldosterone phenotype, referred to as the renal phenotype (Rph). The prevalence of ADRR values exceeding the cut-off and phenotypes were calculated. A linear regression model was derived to assess the effect of sodium consumption with PAC, PRC and ADRR. A total of 88 patients with aTRH were included. Adherence to at least 3 antihypertensive medications was 62.5%. The median age was 56 years (IQR 48–60), 44% were female, and 20% had diabetes. The study found that the prevalence of ADRR values exceeding the cut-off ranged from 4.5 to 23%, while low-renin hypertension (LRH) varied from 15 to 74%, Rph was found in approximately 30 to 34% of patients, PAph in 30 to 51%, and the LLph in 15 to 41%, respectively, depending on the specific cut-off value by different authors. Notably, sodium consumption was associated with lower aldosterone (β − 0.15, 95% CI [− 0.27, − 0.03]) and renin concentrations (β − 0.75, 95% CI [− 1.5, − 0.02]), but ADRR showed no significant association with sodium consumption. There were no significant differences in prevalences between the groups taking

La obesidad es una afección crónica y no transmisible relacionada con enfermedades cardiovasculares, diabetes, hipertensión arterial, cáncer, entre otras, por lo que es un grave problema de salud pública y una de las mayores epidemias del siglo XXI. Esta revisión narrativa tiene como objetivo presentar un análisis comparativo de diferentes métodos doblemente indirectos de medición de la composición corporal en humanos: aspectos prácticos, ventajas y desventajas. La búsqueda bibliográfica se realizó en las bases de datos PubMed, SciELO, BVS, Dialnet y ScienceDirect. Se incluyeron 77 artículos la mayoría publicados entre 2013 y 2023. Los métodos directos de medición de la composición corporal como la disección de cadáveres y los métodos indirectos como las imágenes diagnósticas son confiables y precisos. Sin embargo, los parámetros antropométricos (métodos doblemente indirectos) son más usados en la práctica clínica, en especial en el IMC y el PA, dado que aportan información relevante y confiable sobre la obesidad y el riesgo cardiometabólico. Los métodos directos e indirectos de medición de la composición corporal son poco asequibles y costosos, pero poseen una alta confiabilidad. Por su parte, los índices antropométricos son más prácticos y fáciles de medir a pesar de su discreta confiabilidad; además, son mucho más económicos, de fácil interpretación y de gran utilidad en estudios epidemiológicos.

Abstract Objective To identify abuse and other risk factors associated with depression in older Ecuadorian adults using data from the 2012 Ecuador's Survey of Health, Welfare, and Aging (SABE). Methods This cross‐sectional study analyzed data from the 2012 SABE survey, which included 5235 adults aged 60 and above. The study evaluated residence, education level, ethnic self‐identification, self‐perceived health and memory, loneliness, cognitive status, and abuse. Depression was assessed using the Yesavage Depression Scale, short version (YDS‐SV). Categorical variables were analyzed with the Chi‐square test, differences between groups were calculated with the Kruskal–Wallis test, and multiple linear regression analysis was performed. A p‐value of ≤0.05 was considered statistically significant. Results The mean age was 71.39 ± 8.59 years and 55.10% of the sample were women. Abuse was absent in 72.1% (3.773) of the population. The Chi‐square test indicated significant associations between depression and poor self‐reported health (P = 0.000) and indigenous ethnicity (P = 0.000). Multiple linear regression analysis revealed that age (P

El presente documento tiene como propósito presentar una revisión bibliográfica de los estudios realizados sobre las consecuencias de índole económico que ha generado la pandemia del COVID-19, para su análisis desde la perspectiva del mercadeo. Se identifican las temáticas centrales como: la investigación de mercados; el efecto del COVID-19 en las empresas y sus indicadores económicos; y la teoría básica de mercadeo. El diseño metodoló-gico de este estudio se encuadra dentro del enfoque cuantitativo - deductivo y es de carácter descriptivo, para el cual se revisaron fuentes en el buscador especializado Google Scholar; posteriormente se realizó la clasificación de los artículos más importantes y el análisis de las citas. Los resultados mostraron que los efectos económicos del COVID-19 en las empresas fueron similares en distintas regiones alrededor del mundo, que el consumidor cambió, que su nueva definición aún es materia de estudio y que el área de mercadeo es donde más trabajo enfocarían las empresas para asegurar su existencia en el tiempo, toda vez que es de esta área que depende la permanencia económica de las mismas.

Hyponatremia, characterized by serum sodium

Summary: Background: Surgical care holds significant importance in healthcare, especially in low and middle-income countries, as at least 50% of the 4.2 million deaths within the initial 30 days following surgery take place in these countries. The Lancet Commission on Global Surgery proposed six indicators to enhance surgical care. In Colombia, studies have been made using secondary data. However, strategies to reduce perioperative mortality have not been implemented. This study aims to describe the fourth indicator, perioperative mortality rate (POMR), with primary data in Colombia. Methods: A multicentre prospective cohort study was conducted across 54 centres (hospitals) in Colombia. Each centre selected a 7-day recruitment period between 05/2022 and 01/2023. Inclusion criteria involved patients over 18 years of age undergoing surgical procedures in operating rooms. Data quality was ensured through a verification guideline and statistical analysis using mixed-effects multilevel modelling with a case mix analysis of mortality by procedure-related, patient-related, and hospital-related conditions. Findings: 3807 patients were included with a median age of 48 (IQR 32–64), 80.3% were classified as ASA I or II, and 27% of the procedures had a low-surgical complexity. Leading procedures were Orthopedics (19.2%) and Gynaecology/Obstetrics (17.7%). According to the Clavien–Dindo scale, postoperative complications were distributed in major complications (11.7%, 10.68–12.76) and any complication (31.6%, 30.09–33.07). POMR stood at 1.9% (1.48–2.37), with elective and emergency surgery mortalities at 0.7% (0.40–1.23) and 3% (2.3–3.89) respectively. Interpretation: The POMR was higher than the ratio reported in previous national studies, even when patients had a low–risk profile and low-complexity procedures. The present research represents significant public health progress with valuable insights for national decision-makers to improve the quality of surgical care. Funding: This work was supported by Universidad del Rosario and Fundación Cardioinfantil-Instituto de Cardiología grant number CTO-057-2021, project-ID IV-FGV017.

IntroductionSocial isolation during and after the COVID-19 pandemic has sparked interest in its psychological and neurobiological consequences. The pandemic has been associated with an increase in anxiety, depression, and stress, according to some cross-sectional studies. This study aims to analyze changes in the levels of anxiety, depression and stress by comparing the confinement phase to the post-confinement period in the Ecuadorian population.MethodsA longitudinal, comparative, prospective study was conducted using an online survey comprising two sections. The first section gathered demographic information, whereas the second section included the DASS-21 questionnaire. Ecuadorian participants who completed the survey during the initial data-collection period were included.ResultsIn total, 162 participants were included in the final analysis. The average age of the participants was 29.6 ± 11.7 years, and the majority were women (63.3%). In 2020, the median depression, anxiety, and stress scores were 6 (IQR 2–12), 6 (IQR 2–10), and 10 (IQR 6–16) respectively. In 2021, the median depression score was 8 (IQR 4–14), the median anxiety score was 8 (IQR 4–14.5), and the median stress and its interquartile range were 10 (IQR 6–18). The levels of depression, anxiety, and stress were significantly inversely correlated with age, number of children, self-reported general health, and self-reported mental health in both 2020 and 2021.ConclusionExercise, being a student, sex and having had COVID-19 examination may be predictors for the changes in the levels of psychological disorders. Implementing psychological strategies, such as cognitive behavioral therapy, and physiological interventions, like regular physical activity, early in the post-lockdown period could help mitigate the negative mental health impacts observed in the aftermath of the pandemic. These interventions can provide necessary support and coping mechanisms for those at higher risk, thereby improving overall mental health outcomes.

Climate change affects several environments, and one of the main problems is the availability and pollution of water resources. As a sustainable strategy, nature-based solutions and rescue of ancestral knowledge are economical and environmentally friendly measures. This study aimed to analyse the design of an alluvial dike by integrating ancestral and engineering knowledge to obtain a surface water reservoir that improves the recharge of the coastal aquifer in the Manglaralto community. This study considers a geological-geotechnical analysis of the study area and presents an environmental analysis of civil work to determine its impact on the surrounding ecosystem systems. The alluvial material dike, green structure, 8 m high, allows the reservoir of approximately 0.06 hm3 of water, which allows the recharge of the coastal aquifer with a field capacity (volumetric content) of 0.1 and conserves its ecosystem. From an environmental perspective, reforestation of the riverbank would reduce annual evapotranspiration, and from an economic perspective, the budget would be reduced considerably (60 % owing to ancestral knowledge and community work). The proposed construction of this second dike relates to the context of Sowing and Harvesting Water (SHW) and nature-based solutions, with community participation leading the processes, with technical accompaniment, to contribute to SDG 2030. This study provides the criterion that the integrality of the green structure offers more significant benefits for the ecosystem and its inhabitants.

Satellite remote sensing, particularly using the MODIS orbital platform, is crucial for large-scale lake monitoring, allowing the observation of optically active components with suitable spatial and temporal resolution for lakes with surfaces greater than 40 hectares. In this context, the objective of this article was to propose a methodology that improves the retrieval and monitoring of data related to Total Suspended Solids (TSS) in large lakes. The methodology employed involved defining a baseline to map the spatiotemporal dynamics of TSS using MODIS band 1, which generates information in the infrared spectrum and is centered at 645 nm. The method was tested in the Porto Primavera Reservoir (PPR), Brazil. To validate the model, two fieldwork campaigns were conducted in the PPR, where radiometric and water quality data were collected. An empirical model was fitted between reflectance and the TSS data set (r = 0.93, R2 = 0.85, p

The use of wastewater in agricultural practices poses a potential risk for the spread of foodborne diseases. Therefore, this study aimed to characterize the bacterial biodiversity in rhizospheric soil, irrigation water, and lettuce crops in three municipalities adjacent to the Bogotá River, Colombia. Samples were collected in Mosquera, Funza, and Cota municipalities, including rhizospheric soil, lettuce leaves, and irrigation water. The total DNA extraction was performed to analyze bacterial diversity through high-throughput sequencing of the 16S ribosomal RNA genes, utilizing the Illumina HiSeq 2500 PE 300 sequencing platform. A total of 198 genera from the rhizospheric soil were detected including a higher abundance of zOTUs such as Bacillus, Streptomyces, and clinically relevant genera such as Mycobacterium and Pseudomonas. In lettuce, the detection of 26 genera of endophytic bacteria showed to Proteobacteria and Firmicutes as the predominant phyla, with Staphylococcus and Bacillus as the most abundant genera. Notably, Funza's crops exhibited the highest abundance of endophytes, approximately 50 %, compared to Cota (20 %). Furthermore, the most abundant bacterial genera in the irrigation water were Flavobacterium and Pseudomonas. The most prevalent Enterobacteriaceae were Serratia, Enterobacter, Citrobacter, Klebsiella, Yersinia, Shigella, Escherichia, and Erwinia. The Bacillus genus was highly enriched in both rhizospheric soils and lettuce crops, indicating its significant contribution as the main endophytic bacterium.

ABSTRACT The aim of the present study was first to isolate Helicobacter pylori from gastric biopsy specimens and to test their antibiotic susceptibility. Second, it was to evaluate the efficacy of the standard triple therapy from patients of the west central region of Colombia. H. pylori positive patients received standard triple therapy with proton pump inhibitor (PPI) (40 mg b.i.d.), clarithromycin (500 mg b.i.d.), and amoxicillin (1 g b.i.d.) for 14 days. Thereafter, antibiotic susceptibility of the isolates was assessed by E-Test. From 94 patients enrolled, 67 were positive for H. pylori by histology or culture. Overall resistance to metronidazole, levofloxacin, rifampicin, clarithromycin, and amoxicillin was 81%, 26.2%, 23.9%, 19%, and 9.5%, respectively. No resistance was found for tetracycline. A total of 54 patients received standard triple therapy, 48 attended follow-ups testing, and of them, 30 had resistance test reports. Overall eradication rate was 81.2%. Second-line treatment was given to eight patients, four of whom were followed up with a 13C urea breath test (UBT) and remained positive for H. pylori. Eradication was significantly higher in patients with clarithromycin susceptible than in resistant strains (95.6% vs 42.8% P = 0.001). The updated percentages of resistance to clarithromycin in this geographical area had increased, so this value must be considered when choosing the treatment regimen.IMPORTANCEAntibiotic resistance in Helicobacter pylori has increased worldwide, as has resistance to multiple antimicrobials (MDRs), which seriously hampers the successful eradication of the infection. The ideal success rate in eradicating H. pylori infection (≥90%) was not achieved in this study (81.2%). This is the first time that MDR is reported (14.3%) in the region; the resistance to clarithromycin increased over time (3.8%–19%), and levofloxacin (26.2%) and rifampicin (23%) resistant isolates were detected for the first time. With these results, strain susceptibility testing is increasingly important, and the selection of treatment regimen should be based on local antibiotic resistance patterns.

Abstract Objective The aim of this study is to develop and validate a questionnaire for dental students in Ecuador to assess their reasons to study dentistry. Materials and methods A 25-item questionnaire was developed by the authors based on similar studies and a qualitative study. The questionnaire had five theoretical factors: economic, professional, vocational, social and academic reasons for study. In the first two samples, exploratory factor analysis was performed to identify the structure, and the models obtained were compared with confirmatory factor analysis in the third sample. Results Three samples were used, sample A with 201 participants, sample B with 623 participants, and sample C with 596 participants. Two-thirds of the participants were female and almost one-third were from coast region. The EFA applied in sample A resulted in a five-factor model with 18 items; in contrast, a three-factor model was obtained from sample B. According to the CFA in sample C, the best model was explained by three factors: labor, vocational and academic reasons. Considering two items to cross-load in labor and vocational factors, which are theoretically justified. Conclusion This study presents a 12-item questionnaire that assesses labor, vocational and academic reasons for studying dentistry in an Ecuadorian population.

Three-dimensional (3D) printing technology has advanced for applications in the field of reconstructive surgery. This study reports the application of a comprehensive methodology to obtain an anatomical model, using computed tomography and 3D printing, to treat a patient with cancer who designed a prototype oculopalpebral prosthesis for the reconstruction of the affected area of the face (left eye). A personalized prototype was obtained, which adapted to the face of the person, and improved the aesthetics and quality of life. The applied techniques helped to make definitive prostheses using materials that could be permanent. The training and tests carried out in this study favored the understanding and assimilation of the technology and the possibility of applying it to patients in need of facial prosthetic rehabilitation.

Margyricarpus pinnatus (Lam.) Kuntze, commonly name nigua or piquiyuyo in Ecuador, is a subshrub and grows primarily in the montane tropical biome. The chemical composition, antioxidant and antimicrobial activities of its essential oil from the leaves and flowers of plants grown in the Ecuadorian Andes were studied. The essential oil was obtained by hydrodistillation with a yield of 0.36 % v/m. With the aid of gas chromatography with mass and flame ionization detectors (GC-MS and GC-FID), 134 volatile constituents making up 97.5 % of the total oil constituents were identified. The major groups of compounds were aromatic compounds (51.9 %), oxygenated monoterpenes (16.3 %) and monoterpene hydrocarbons (12.5 %). The most abundant compounds were carvacrol (23.1%) and carvacryl acetate (19.2 %). Antioxidant activity was examined using DPPH and ABTS assays. The essential oil had a high scavenging effect and reduction of ferric ion capacity through FRAP assay. The results show that the essential oil scavenged DPPH∙ radical and ABTS·+ radical capacity as reflected by the IC50 values 1.18 ± 0.27 mg/mL and 4.47 ± 0.31mg/mL, respectively. These results agreed with the literature for essential oils that phenols possess high antioxidant activity. The antimicrobial activity was determined against four pathogenic bacterial strains and a pathogenic fungus strain using a modified agar-diffusion method. The results of the antimicrobial tests showed that Escherichia coli and Candida albicans were very sensitive to the effects of the essential oil

The mollusks represent the main invasive taxon of the freshwater ecosystem in North America. Environmental degradation may increase the susceptibility of the ecosystem to invasion and favor the abundance and density increment in some benthic mollusks. Melanoides tuberculata is a snail native from Africa and Asia that was introduced in Mexico in the sixties through aquarium activities. Its reproduction by parthenogenesis, fast growth, longevity, omnivore habits, and wide tolerance to pollution and environmental stressors, confers to this snail great capability like invasive species. However, the information concerning the relationships between the invasion stage of this exotic snail and environmental and biological variables is still unknown. This study aimed to document the establishment of several new registered populations of M. tuberculata in subtropical river drainage in central Mexico, since at least 10 years ago, and its relationship with indicator variables of environmental degradation. We visited 15 localities during the dry season in 2016 and 2022. At each study site, the macroinvertebrate assemblages were collected, and physical variables of habitat and physicochemical water characteristics were measured. In addition, the biological condition was assessed using aquatic macroinvertebrate assemblages. Each individual of M. tuberculata was counted and measured. The abundance and density of the snail with physical, chemical, and biological variables were correlated, and further multivariate analyses were performed to confirm these relationships. We demonstrated a positive relationship between the presence, abundance, and density of M. tuberculata with environmental variables that are indicators of degradation of physical attributes such as water flow alterations and loss of habitat heterogeneity in 2016 and 2022. We supported the hypothesis that anthropic habitat degradation can favor the invasion of M. tuberculata.