Ejecución de gasto público por fuente de financiamiento en la Dirección de Red de Salud Yunguyo / Execution of public expenditure by financing source in the Yunguyo Health Network Directorate / Execução de despesas públicas por fonte de financiamento na Diretoria da Rede de Saúde de Yunguyo

El estudio tuvo por finalidad explicar de qué manera se correlaciona la ejecución de gasto público y la fuente de financiamiento de la Dirección de Red de Salud Yunguyo del periodo 2013 al 2023, Perú. Se optó por un diseño metodológico no experimental, longitudinal, cuantitativo y contraste Rho de Spearman. Los resultados identificaron que la ejecución de gasto público se correlaciona significativa y positivamente con la fuente de financiamiento por recursos ordinarios [rho (11) =0.77; p < 0.001], con la fuente de financiamiento por recursos directamente recaudados [rho (11) =0.83; p < 0.001] y, con la fuente de financiamiento por recursos determinados [rho (11) =0.74; p < 0.001]. Se concluye que, ejecutar eficazmente las intervenciones priorizadas por la Dirección de Red de Salud Yunguyo están ligadas a los lineamientos del Presupuesto Público y normatividad del sector con transparencia.

The purpose of the study was to explain how the execution of public spending and the source of financing of the Yunguyo Health Network Directorate are correlated from the period 2013 to 2023, Peru. A non-experimental, longitudinal, quantitative methodological design and Spearman's Rho contrast was chosen. The results identified that the execution of public spending is significantly and positively correlated with the source of financing through ordinary resources [rho (11) =0.77; p < 0.001], with the source of financing being directly raised resources [rho (11) =0.83; p < 0.001], and with the source of financing for determined resources [rho (11) =0.74; p < 0.001]. It is concluded that, effectively executing the interventions prioritized by the Yunguyo Health Network Directorate are linked to the guidelines of the Public Budget and regulations of the sector with transparency

O objetivo do estudo foi explicar como a execução dos gastos públicos e a fonte de financiamento da Diretoria da Rede de Saúde Yunguyo estão correlacionadas no período de 2013 a 2023, Peru. Optou-se por um desenho metodológico não experimental, longitudinal, quantitativo e contraste Rho de Spearman. Os resultados identificaram que a execução dos gastos públicos está significativa e positivamente correlacionada com a fonte de financiamento através de recursos ordinários [rho (11) =0,77; p < 0,001], sendo a fonte de financiamento recursos captados diretamente [rho (11) =0,83; p < 0,001], e com a fonte de financiamento de determinados recursos [rho (11) =0,74; p < 0,001]. Conclui-se que a execução eficaz das intervenções priorizadas pela Direção da Rede de Saúde Yunguyo está vinculada às diretrizes do Orçamento Público e à regulamentação do setor com transparência

Ejecución de gasto público por fuente de financiamiento en la Dirección de Red de Salud Yunguyo

El estudio tuvo por finalidad explicar de qué manera se correlaciona la ejecución de gasto público y la fuente de financiamiento de la Dirección de Red de Salud Yunguyo del periodo 2013 al 2023, Perú. Se optó por un diseño metodológico no experimental, longitudinal, cuantitativo y contraste Rho de Spearman. Los resultados identificaron que la ejecución de gasto público se correlaciona significativa y positivamente con la fuente de financiamiento por recursos ordinarios [rho (11)=0.77; p < 0,001], con la fuente de financiamiento por recursos directamente recaudados [rho (11)=0.83; p < 0,001] y, con la fuente de financiamiento por recursos determinados [rho (11)=0.74; p < 0,001]. Se concluye que, ejecutar eficazmente las intervenciones priorizadas por la Dirección de Red de Salud Yunguyo están ligadas a los lineamientos del Presupuesto Público y normatividad del sector con transparencia.

The purpose of the study was to explain how the execution of public spending and the source of financing of the Yunguyo Health Network Directorate are correlated from the period 2013 to 2023, Peru. A non-experimental, longitudinal, quantitative methodological design and Spearman's Rho contrast was chosen. The results identified that the execution of public spending is significantly and positively correlated with the source of financing through ordinary resources [rho (11) =0.77; p < 0.001], with the source of financing being directly raised resources [rho (11) =0.83; p < 0.001], and with the source of financing for determined resources [rho (11) =0.74; p < 0.001]. It is concluded that, effectively executing the interventions prioritized by the Yunguyo Health Network Directorate are linked to the guidelines of the Public Budget and regulations of the sector with transparency.

O objetivo do estudo foi explicar como a execução dos gastos públicos e a fonte de financiamento da Diretoria da Rede de Saúde Yunguyo estão correlacionadas no período de 2013 a 2023, Peru. Optou-se por um desenho metodológico não experimental, longitudinal, quantitativo e contraste Rho de Spearman. Os resultados identificaram que a execução dos gastos públicos está significativa e positivamente correlacionada com a fonte de financiamento através de recursos ordinários [rho (11) =0,77; p < 0,001], sendo a fonte de financiamento recursos captados diretamente [rho (11) =0,83; p < 0,001], e com a fonte de financiamento de determinados recursos [rho (11) =0,74; p < 0,001]. Conclui-se que a execução eficaz das intervenções priorizadas pela Direção da Rede de Saúde Yunguyo está vinculada às diretrizes do Orçamento Público e à regulamentação do setor com transparência.

Sampling strategies for genotyping common bean (Phaseolus vulgaris L.) Genebank accessions with DArTseq: a comparison of single plants, multiple plants, and DNA pools.

Introduction: Genotyping large-scale gene bank collections requires an appropriate sampling strategy to represent the diversity within and between accessions. Methods: A panel of 44 common bean (Phaseolus vulgaris L.) landraces from the Alliance Bioversity and The Alliance of Bioversity International and the International Center for Tropical Agriculture (CIAT) gene bank was genotyped with DArTseq using three sampling strategies: a single plant per accession, 25 individual plants per accession jointly analyzed after genotyping (in silico-pool), and by pooling tissue from 25 individual plants per accession (seq-pool). Sampling strategies were compared to assess the technical aspects of the samples, the marker information content, and the genetic composition of the panel. Results: The seq-pool strategy resulted in more consistent DNA libraries for quality and call rate, although with fewer polymorphic markers (6,142 single-nucleotide polymorphisms) than the in silico-pool (14,074) or the single plant sets (6,555). Estimates of allele frequencies by seq-pool and in silico-pool genotyping were consistent, but the results suggest that the difference between pools depends on population heterogeneity. Principal coordinate analysis, hierarchical clustering, and the estimation of admixture coefficients derived from a single plant, in silico-pool, and seq-pool successfully identified the well-known structure of Andean and Mesoamerican gene pools of P. vulgaris across all datasets. Conclusion: In conclusion, seq-pool proved to be a viable approach for characterizing common bean germplasm compared to genotyping individual plants separately by balancing genotyping effort and costs. This study provides insights and serves as a valuable guide for gene bank researchers embarking on genotyping initiatives to characterize their collections. It aids curators in effectively managing the collections and facilitates marker-trait association studies, enabling the identification of candidate markers for key traits.

In Vitro Embryos of Romosinuano and Tropical Milking Cattle during Three Seasons in Veracruz, Mexico.

One of the main factors that influences the fertility of cattle in grazing systems in hot tropical climates is heat stress. The objective of this study was to evaluate the effect of season, breed, hormonal and physiological condition on the quantity and quality of cumulus-oocyte complexes (COCs) and embryos produced in vitro, from Romosinuano (RM) and Tropical Milking (TM) donors. Three ovum pick-up and in vitro fertilization (OPU-IVF) were performed, one per season: hot dry (HD; 10, 10), hot humid (HH; 9, 9) and fresh dry (FD; 7, 10) in RM and LT donors. Serum levels of cortisol, insulin and glucose were measured, in addition to heart rate (HR), respiratory rate (RR) and rectal temperature (RT). Effect of season x genotype interaction (p ≤ 0.05) was observed in all COC variables and only in cleavage embryos (CLI) (p ≤ 0.05). Body weight (BW) affected all COC variables (p ≤ 0.01), except unviable (UNV) although affected degenerated embryos (DEG) (p ≤ 0.01) and total blastocysts (BLAST) (p ≤ 0.01). Cow age only affected viable COCs (VIAB) (p ≤ 0.05), code one blastocysts (BC1) and BLAST (p ≤ 0.01). Cortisol affected total COCs (COCsT), VIAB and total matured in vitro (TMIV) (p ≤ 0.01), as well as CLI, BC1 (p ≤ 0.01) and BLAST (p ≤ 0.05). Insulin affected COCsT (p ≤ 0.01), UNV (p ≤ 0.05), denuded oocytes (DE) (p ≤ 0.01), BC1 and code two blastocysts (BC2) (p ≤ 0.01). Glucose affected all COC variables (p ≤ 0.01), except UNV and all embryo variables except BC2. HR affected COCsT, DE, TMIV (p ≤ 0.01), CLI, BLAST and DEG (p ≤ 0.05). RR affected COCsT, UNV, VIAB, CLI (p ≤ 0.05), BC1, BLAST and DEG (p ≤ 0.01). RT only affected DE, VIAB (p ≤ 0.01) and BLAST (p ≤ 0.05). The seasonal climatic year variation of Veracruz and changes in physiological and hormonal variables have diverse effects on the cumulus-oocyte complexes and embryos produced by RM and TM donors.

Unraveling habitat-driven shifts in alpha, beta, and gamma diversity of hummingbirds and their floral resource.

Background: Biodiversity, crucial for understanding ecosystems, encompasses species richness, composition, and distribution. Ecological and environmental factors, such as habitat type, resource availability, and climate conditions, play pivotal roles in shaping species diversity within and among communities, categorized into alpha (within habitat), beta (between habitats), and gamma (total regional) diversity. Hummingbird communities are influenced by habitat, elevation, and seasonality, making them an ideal system for studying these diversities, shedding light on mutualistic community dynamics and conservation strategies. Methods: Over a year-long period, monthly surveys were conducted to record hummingbird species and their visited flowering plants across four habitat types (oak forest, juniper forest, pine forest, and xerophytic shrubland) in Tlaxcala, Mexico. Three locations per habitat type were selected based on conservation status and distance from urban areas. True diversity measures were used to assess alpha, beta, and gamma diversity of hummingbirds and their floral resources. Environmental factors such as altitude and bioclimatic variables were explored for their influence on beta diversity. Results: For flowering plants, gamma diversity encompassed 34 species, with oak forests exhibiting the highest richness, while xerophytic shrublands had the highest alpha diversity. In contrast, for hummingbirds, 11 species comprised the gamma diversity, with xerophytic shrublands having the highest richness and alpha diversity. Our data reveal high heterogeneity in species abundance among habitats. Notably, certain floral resources like Loeselia mexicana and Bouvardia ternifolia emerge as key species in multiple habitats, while hummingbirds such as Basilinna leucotis, Selasphorus platycercus, and Calothorax lucifer exhibit varying levels of abundance and habitat preferences. Beta diversity analyses unveil habitat-specific patterns, with species turnover predominantly driving dissimilarity in composition. Moreover, our study explores the relationships between these diversity components and environmental factors such as altitude and climate variables. Climate variables, in particular, emerge as significant contributors to dissimilarity in floral resource and hummingbird communities, highlighting the influence of environmental conditions on species distribution. Conclusions: Our results shed light on the complex dynamics of hummingbird-flower mutualistic communities within diverse habitats and underscore the importance of understanding how habitat-driven shifts impact alpha, beta, and gamma diversity. Such insights are crucial for conservation strategies aimed at preserving the delicate ecological relationships that underpin biodiversity in these communities.

How many animal-pollinated angiosperms are nectar-producing?

The diversity of plant-pollinator interactions is grounded in floral resources, with nectar considered one of the main floral rewards plants produce for pollinators. However, a global evaluation of the number of animal-pollinated nectar-producing angiosperms and their distribution world-wide remains elusive. We compiled a thorough database encompassing 7621 plant species from 322 families to estimate the number and proportion of nectar-producing angiosperms reliant on animal pollination. Through extensive sampling of plant communities, we also explored the interplay between nectar production, floral resource diversity, latitudinal and elevational gradients, contemporary climate, and environmental characteristics. Roughly 223 308 animal-pollinated angiosperms are nectar-producing, accounting for 74.4% of biotic-pollinated species. Global distribution patterns of nectar-producing plants reveal a distinct trend along latitudinal and altitudinal gradients, with increased proportions of plants producing nectar in high latitudes and altitudes. Conversely, tropical communities in warm and moist climates exhibit greater floral resource diversity and a lower proportion of nectar-producing plants. These findings suggest that ecological trends driven by climate have fostered the diversification of floral resources in warmer and less seasonal climates, reducing the proportion of solely nectar-producing plants. Our study provides a baseline for understanding plant-pollinator relationships, plant diversification, and the distribution of plant traits.

Barriers That Interfere with Access to Tuberculosis Diagnosis and Treatment across Countries Globally: A Systematic Review.

This study evaluated the barriers that interfere with access to diagnosis and treatment of tuberculosis (TB) from the perspective of the patient and health professionals globally. Using the PICo acronym, the question we asked was "What are the barriers that interfere with access to tuberculosis diagnosis and treatment (I) from the perspective of patients and/or health professionals (P) across countries globally (Co)?". We searched the following databases: EMBASE, Scopus, MEDLINE, Latin American and Caribbean Literature in Health Sciences (LILACS), and Web of Science. On Rayyan, duplicates were removed and extraction was done afterward by two authors independently, followed by a tiebreaker. Using a Critical Appraisal Tool proposed by the Joanna Briggs Institute, the methodological quality of the article was assessed. From 36 published articles, the barriers to tuberculosis diagnosis as obtained from our study include information scarcity/low TB knowledge, exorbitant cost of transport, sample collection challenges, long distance to health facility, gender limitations, lack of decentralized diagnostic services, payment for diagnosis and testing, medication side effects, multiple visits during therapy, delayed diagnosis, poor human resources, low knowledge of medical practitioners, concerns regarding the efficacy of treatment, poor facility coordination, poor socioeconomic factors, fear and stigmatization of TB, and wrong initial diagnosis. The review of studies on TB diagnosis and treatment barriers evidences the diverse barriers to the eradication of tuberculosis. Eliminating these barriers is an onus that lies on policy makers, citizens, and health workers alike, with the joint aim of reducing the global TB burden.

Unraveling genomic features and phylogenomics through the analysis of three Mexican endemic Myotis genomes.

Background: Genomic resource development for non-model organisms is rapidly progressing, seeking to uncover molecular mechanisms and evolutionary adaptations enabling thriving in diverse environments. Limited genomic data for bat species hinder insights into their evolutionary processes, particularly within the diverse Myotis genus of the Vespertilionidae family. In Mexico, 15 Myotis species exist, with three-M. vivesi, M. findleyi, and M. planiceps-being endemic and of conservation concern. Methods: We obtained samples of Myotis vivesi, M. findleyi, and M. planiceps for genomic analysis. Each of three genomic DNA was extracted, sequenced, and assembled. The scaffolding was carried out utilizing the M. yumanensis genome via a genome-referenced approach within the ntJoin program. GapCloser was employed to fill gaps. Repeat elements were characterized, and gene prediction was done via ab initio and homology methods with MAKER pipeline. Functional annotation involved InterproScan, BLASTp, and KEGG. Non-coding RNAs were annotated with INFERNAL, and tRNAscan-SE. Orthologous genes were clustered using Orthofinder, and a phylogenomic tree was reconstructed using IQ-TREE. Results: We present genome assemblies of these endemic species using Illumina NovaSeq 6000, each exceeding 2.0 Gb, with over 90% representing single-copy genes according to BUSCO analyses. Transposable elements, including LINEs and SINEs, constitute over 30% of each genome. Helitrons, consistent with Vespertilionids, were identified. Values around 20,000 genes from each of the three assemblies were derived from gene annotation and their correlation with specific functions. Comparative analysis of orthologs among eight Myotis species revealed 20,820 groups, with 4,789 being single copy orthogroups. Non-coding RNA elements were annotated. Phylogenomic tree analysis supported evolutionary chiropterans' relationships. These resources contribute significantly to understanding gene evolution, diversification patterns, and aiding conservation efforts for these endangered bat species.

Promiscuous potato: elucidating genetic identity and the complex genetic relationships of a cultivated potato germplasm collection.

A total of 3,860 accessions from the global in trust clonal potato germplasm collection w3ere genotyped with the Illumina Infinium SolCAP V2 12K potato SNP array to evaluate genetic diversity and population structure within the potato germplasm collection. Diploid, triploid, tetraploid, and pentaploid accessions were included representing the cultivated potato taxa. Heterozygosity ranged from 9.7% to 66.6% increasing with ploidy level with an average heterozygosity of 33.5%. Identity, relatedness, and ancestry were evaluated using hierarchal clustering and model-based Bayesian admixture analyses. Errors in genetic identity were revealed in a side-by-side comparison of in vitro clonal material with the original mother plants revealing mistakes putatively occurring during decades of processing and handling. A phylogeny was constructed to evaluate inter- and intraspecific relationships which together with a STRUCTURE analysis supported both commonly used treatments of potato taxonomy. Accessions generally clustered based on taxonomic and ploidy classifications with some exceptions but did not consistently cluster by geographic origin. STRUCTURE analysis identified putative hybrids and suggested six genetic clusters in the cultivated potato collection with extensive gene flow occurring among the potato populations, implying most populations readily shared alleles and that introgression is common in potato. Solanum tuberosum subsp. andigena (ADG) and S. curtilobum (CUR) displayed significant admixture. ADG likely has extensive admixture due to its broad geographic distribution. Solanum phureja (PHU), Solanum chaucha (CHA)/Solanum stenotomum subsp. stenotomum (STN), and Solanum tuberosum subsp. tuberosum (TBR) populations had less admixture from an accession/population perspective relative to the species evaluated. A core and mini core subset from the genebank material was also constructed. SNP genotyping was also carried out on 745 accessions from the Seed Savers potato collection which confirmed no genetic duplication between the two potato collections, suggesting that the collections hold very different genetic resources of potato. The Infinium SNP Potato Array is a powerful tool that can provide diversity assessments, fingerprint genebank accessions for quality management programs, use in research and breeding, and provide insights into the complex genetic structure and hybrid origin of the diversity present in potato genetic resource collections.

Ethnobotanical knowledge on non-conventional food plants and medicinal plants in Extractivist Reserve in the Brazilian Amazon / Conocimiento etnobotánico sobre plantas alimenticias no convencionales y plantas medicinales en una Reserva Extractivista en la Amazonía Brasileña

Information on the knowledge and ways of using food and medicinal plants by traditional populations, family farmers and Brazilian native population in the Amazon is essential to guarantee the food sovereignty of these groups. This study was conducted using semi-structured interviews applied to local respondents. A total of 269 species of both non-conventional food plants and medicinal plants were identified, distributed in 83 botanical families and 198 genera. The Arecaceae and Lamiaceae families had the highest species richness (11 and 7, respectively). The Shannon-Wiener (H') and Pielou (J') diversity indices were considered high (5.02 and 0.9, respectively) when compared to other ethnobotanical works. In the environment in which these families are found, these species become the only food and medicinal resources available.

La información sobre los saberes y formas de uso de las plantas alimenticias y medicinales por parte de las poblaciones tradicionales, agricultores familiares e indígenas brasileños en la Amazonía es fundamental para garantizar la soberanía alimentaria de estos grupos. Este estudio se realizó utilizando entrevistas semiestructuradas aplicadas a encuestados locales. Se identificaron un total de 269 especies tanto de plantas alimenticiasno convencionales como de plantas medicinales, distribuidas en 83 familias botánicas y 198 géneros. Las familias Arecaceae y Lamiaceae tuvieron la mayor riqueza de especies (11 y 7, respectivamente). Los índices de diversidad de Shannon-Wiener (H') y Pielou (J') fueron considerados altos (5,02 y 0,9, respectivamente) en comparación con otros trabajos etnobotánicos. En el ambiente en que se encuentran estas familias, estas especies se convierten en los únicos recursos alimenticios y medicinales disponibles.

Clinical characteristics and outcomes of people living with HIV and ocular syphilis during the COVID-19 health emergency.

BACKGROUND: The global shift in healthcare during the COVID-19 pandemic led to challenges in the care of people living with HIV. METHODS: We conducted a retrospective study that aimed to delineate sociodemographic, clinical characteristics and outcomes, of people living with HIV diagnosed with ocular syphilis. RESULTS: Fifty-three people living with HIV were identified with ocular syphilis. Thirty-eight (71.6%) presented ocular symptoms. Twenty-three (43.3%) underwent lumbar puncture, 5 (9.4%) were positive for neurosyphilis. Forty-seven (88.6%) received treatment, 32 (68%) received standard treatment with aqueous crystalline penicillin G, and 15 (31.9%) were treated with alternative regimens due to the impossibility of hospitalization. Six (11.3%) individuals were lost to follow-up and/or did not receive treatment. Eighteen (56.2%) out of 32 individuals in the aqueous crystalline penicillin G group experienced serological response, 5 (15.6%) experienced treatment failure, and 9 (28.1%) were lost to follow-up. In the alternative therapy group, 12 out of 15 individuals (80%) experienced serological response. One (6.7%) experienced treatment failure, and 2 (13.3%) were lost to follow-up. CONCLUSIONS: During the COVID-19 health emergency in Mexico, alternative treatments for ocular syphilis demonstrated favorable clinical outcomes amid challenges in accessing hospitalization.

[Low back pain and referral to the spine specialist: situation and resources in Buenos Aires]. / Lumbalgia y derivación al especialista de columna: situación y recursos en hospitales públicos de la Ciudad Autónoma de Buenos Aires.

INTRODUCTION: 90% of cases of acute low back pain have no specific underlying cause. International guidelines are available to help identify those individuals who require specialized care. However, in our country, there is a limited emphasis on primary healthcare, with the primary focus on hospital-based care. The aim of this study is to provide an overview of the diagnostic and therapeutic resources utilized in the initial care of patients experiencing low back pain at their first consultation with a specialist physician. METHODS: Descriptive and cross-sectional study, with prospective data collection through a questionnaire administered to patients experiencing low back pain during their first visit to a specialist's office. RESULTS: A total of 44 patients were included, with an average age of 53 years; 50% sought medical attention for chronic pain. Informal referrals were associated with the referring physician's specialty (non-orthopedic), patients with a higher number of emergency department visits, and longer waiting times to obtain the consultation; 52% of patients arrived with at least one complementary study. CONCLUSION: Most of the referrals were appropriate; however, informal referrals were more common. Only 1/5 of the patients underwent an physical examination, and less than 30% of those with red flag symptoms presented with suitable complementary studies. The median waiting time for the consultation was 24 days.

Introducción: El 90% de las lumbalgias agudas son de causa inespecífica. Existen guías internacionales que permiten identificar a aquellos pacientes que requieren atención especializada. En nuestro país la orientación a la atención primaria de la salud es escasa, centrada principalmente en la atención en los hospitales. El objetivo del presente estudio fue describir los recursos de salud, diagnósticos y terapéuticos, utilizados en la atención inicial de pacientes con dolor lumbar que acuden a la consulta del médico especialista Métodos: Estudio descriptivo y transversal, con recolección prospectiva de los datos a través de un cuestionario destinado a pacientes con dolor lumbar que acuden por primera vez a la consulta especializada. Resultados: Se incluyeron 44 pacientes, edad media 53 años; 50% concurrió por dolor crónico. La derivación informal se asoció con: especialidad de derivación (no traumatólogo), pacientes con mayor número de consultas a guardia y mayor demora en obtener la consulta. El 52% concurrió con al menos un estudio complementario. Conclusión: La mayor parte de las derivaciones fueron correctas, sin embargo, predominó la derivación informal. Solo 1/5 de los pacientes fue examinado y menos del 30% de los pacientes con banderas rojas acudió con estudios complementarios adecuados. La mediana del tiempo de espera para la consulta fue 24 días.

Effects of floral resources on honey bee populations in Mexico: Using dietary metabarcoding to examine landscape quality in agroecosystems.

The decline of honey bee populations significantly impacts the human food supply due to poor pollination and yield decreases of essential crop species. Given the reduction of pollinators, research into critical landscape components, such as floral resource availability and land use change, might provide valuable information about the nutritional status and health of honey bee colonies. To address this issue, we examine the effects of landscape factors like agricultural area, urban area, and climatic factors, including maximum temperature, minimum temperature, relative humidity, and precipitation, on honey bee hive populations and nutritional health of 326 honey bee colonies across varying landscapes in Mexico. DNA metabarcoding facilitated the precise identification of pollen from 267 plant species, encompassing 243 genera and 80 families, revealing a primary herb-based diet. Areas characterized by high landscape diversity exhibited greater pollen diversity within the colony. Conversely, colonies situated in regions with higher proportions of agricultural and urban landscapes demonstrated lower bee density. The maximum ambient temperature outside hives positively correlated with pollen diversity, aligning with a simultaneous decrease in bee density. Conversely, higher relative humidity positively influenced both the bee density of the colony and the diversity of foraged pollen. Our national-level study investigated pollen dietary availability and colony size in different habitat types, latitudes, climatic conditions, and varied levels and types of disturbances. This effort was taken to gain a better insight into the mechanisms driving declines in honey bee populations. This study illustrates the need for more biodiverse agricultural landscapes, the preservation of diverse habitats, and the conservation of natural and semi-natural spaces. These measures can help to improve the habitat quality of other bee species, as well as restore essential ecosystem processes, such as pollination and pest control.

[Effectiveness of the CNIC polypill in secondary cardiovascular prevention in the subgroup of patients of the NEPTUNO study using atorvastatin doses of 20 mg]. / Efectividad de la polipíldora CNIC en prevención cardiovascular secundaria en el subgrupo de pacientes del estudio NEPTUNO con dosis de atorvastatina de 20 mg.

Objective: To analyse the incidence and risk of recurrent major adverse cardiovascular events (MACE), level of risk factor control, treatment persistence and cost of the CNIC polypill version containing acetylsalicylic acid (ASA) 100 mg, atorvastatin 20 mg (A20), and ramipril 2.5, 5.0 or 10 mg in secondary cardiovascular prevention patients. Method: Subanalysis of the observational, retrospective, multicentre, NEPTUNO study in patients treated for two years with the CNIC polypill A20, the same monocomponents as single drugs, equipotent drugs, and other therapies. Results: 922 patients were included in each group. The risk of recurrent MACE was lower among CNIC A20 polypill users than all others (21%, 23% and 26% increased risk among the monocomponents, equipotent or other therapy cohorts, respectively; p < 0.05). The magnitude of the mean change in low-density lipoprotein cholesterol and blood pressure, as well as the increase in the proportion of patients achieving target goals, was also greater among patients treated with the CNIC A20 polypill than in any of the other cohorts (all p < 0.001). Treatment persistence was significantly higher in patients treated with the CNIC A20 polypill (p < 0.001) and was a less costly strategy than any other therapeutic option. Conclusions: In patients in secondary cardiovascular prevention, the CNIC A20 polypill (ASA 100 mg, atorvastatin 20 mg, and ramipril 2.5, 5.0 or 10 mg) constitutes a valid therapeutic option with similar benefits and outcomes to the version of the polypill with atorvastatin 40 mg.

Objetivo: Analizar la incidencia y el riesgo de eventos adversos cardiovasculares mayores (MACE) recurrentes, el nivel de control de factores de riesgo, la persistencia al tratamiento y el coste de la versión de la polipíldora CNIC que contiene 100 mg de ácido acetilsalicílico (AAS), 20 mg de atorvastatina (A20) y 2.5/5.0 ó 10 mg de ramipril en pacientes en prevención cardiovascular secundaria. Método: Subanálisis del estudio observacional, retrospectivo y multicéntrico NEPTUNO en pacientes tratados durante 2 años con la polipíldora CNIC A20, los mismos monocomponentes por separado, medicamentos equipotentes uotras terapias. Resultados: Se incluyeron 922 pacientes en cada grupo. El riesgo de sufrir un MACE recurrente en el grupode polipíldora CNIC A20 fue menor que en todas las demás cohortes (21%, 23% y 26% de aumento del riesgo en las cohortesde monocomponentes, equipotentes u otras terapias, respectivamente; p < 0.05). La magnitud del cambio en el colesterol unidoa lipoproteínas de baja densidad y la presión arterial, así como el incremento en la proporción de pacientes que alcanzaron losobjetivos establecidos, fueron mayores en los pacientes tratados con la polipíldora CNIC A20 que en cualquiera de las otrascohortes (p < 0.001). La persistencia al tratamiento fue mayor en los pacientes tratados con la polipíldora CNIC A20 (p < 0.001)y esta estrategia resultó ser menos costosa que cualquier otra opción terapéutica. Conclusiones: En pacientes en prevencióncardiovascular secundaria, la polipíldora CNIC A20 (AAS 100 mg; atorvastatina 20 mg; ramipril 2.5/5.0 ó 10 mg) constituye unaopción terapéutica válida con beneficios y resultados similares a la versión de la polipíldora con 40 mg de atorvastatina.

Postoperative intensive care allocation and mortality in high-risk surgical patients: evidence from a low- and middle-income country cohort.

BACKGROUND: The escalation of surgeries for high-risk patients in Low- and Middle-Income Countries (LMICs) lacks evidence on the positive impact of Intensive Care Unit (ICU) admission and lacks universal criteria for allocation. This study explores the link between postoperative ICU allocation and mortality in high-risk patients within a LMIC. Additionally, it assesses the Ex-Care risk model's utility in guiding postoperative allocation decisions. METHODS: A secondary analysis was conducted in a cohort of high-risk surgical patients from a 800-bed university-affiliated teaching hospital in Southern Brazil (July 2017 to January 2020). Inclusion criteria encompassed 1431 inpatients with Ex-Care Model-assessed all-cause postoperative 30-day mortality risk exceeding 5%. The study compared 30-day mortality outcomes between those allocated to the ICU and the Postanesthetic Care Unit (PACU). Outcomes were also assessed based on Ex-Care risk model classes. RESULTS: Among 1431 high-risk patients, 250 (17.47%) were directed to the ICU, resulting in 28% in-hospital 30-day mortality, compared to 8.9% in the PACU. However, ICU allocation showed no independent effect on mortality (RR = 0.91; 95% CI 0.68‒1.20). Patients in the highest Ex-Care risk class (Class IV) exhibited a substantial association with mortality (RR = 2.11; 95% CI 1.54-2.90) and were more frequently admitted to the ICU (23.3% vs. 13.1%). CONCLUSION: Patients in the highest Ex-Care risk class and those with complications faced elevated mortality risk, irrespective of allocation. Addressing the unmet need for adaptable postoperative care for high-risk patients outside the ICU is crucial in LMICs. Further research is essential to refine criteria and elucidate the utility of risk assessment tools like the Ex-Care model in assisting allocation decisions.

Burnout and Physical Activity as Predictors of Job Satisfaction Among Peruvian Nurses: The Job Demands-Resources Theory.

BACKGROUND: The Job Demands-Resources (JD-R) theory suggests that an imbalance between job demands and available resources can lead to burnout, negatively affecting job satisfaction. Physical activity is recognized for its positive effects on psychological well-being and could play a crucial role in mitigating burnout and improving job satisfaction, especially in high-demand professions such as nursing. OBJECTIVE: This study investigates the relationship between burnout, physical activity, and job satisfaction in Peruvian nurses, using the JD-R theory as a theoretical framework. METHODS: A cross-sectional and explanatory analysis was conducted on a sample of 420 Peruvian nurses, using a Structural Equation Modeling (SEM) design to analyze the relationships between burnout, physical activity, and job satisfaction. The instruments included the Ultra-Short Burnout Measure (IUB), the General Job Satisfaction Scale NTP 394, and the International Physical Activity Questionnaire (IPAQ). RESULTS: The findings showed a significant negative correlation between burnout and physical activity (ß = -.40, P < .001) and between burnout and job satisfaction (ß = -.46, P < .001). Physical activity exhibited a significant positive correlation with job satisfaction (ß = .22, P < .001). Moreover, mediation analysis confirmed that physical activity mediates the relationship between burnout and job satisfaction (ß = -.106, P < .001). CONCLUSIONS: The findings emphasize the importance of physical activity as a mediator in the relationship between burnout and job satisfaction among Peruvian nurses, highlighting the need to promote physical activity as a strategy to improve workplace well-being. It is suggested that enhancing access to and promotion of physical activity could mitigate the effects of burnout and improve job satisfaction, which is essential for the quality of care and the well-being of nursing staff. These findings underscore the need for organizational and public health strategies that promote a healthy work environment and balance between the demands and resources available.

Protein-Coding Gene Families in Prokaryote Genome Comparisons.

The identification of orthologous genes is relevant for comparative genomics, phylogenetic analysis, and functional annotation. There are many computational tools for the prediction of orthologous groups as well as web-based resources that offer orthology datasets for download and online analysis. This chapter presents a simple and practical guide to the process of orthologous group prediction, using a dataset of 10 prokaryotic proteomes as example. The orthology methods covered are OrthoMCL, COGtriangles, OrthoFinder2, and OMA. The authors compare the number of orthologous groups predicted by these various methods, and present a brief workflow for the functional annotation and reconstruction of phylogenies from inferred single-copy orthologous genes. The chapter also demonstrates how to explore two orthology databases: eggNOG6 and OrthoDB.

Ecological risk of metals in Andean water resources: A framework for early environmental assessment of mining projects in Peru.

Metallic contaminants in Andean water resources influenced by mining activities poses risks to aquatic ecosystems and a challenge to regulatory agencies responsible for environmental compliance. In this study, the Ecological Risk Assessment (ERA) framework was adapted to assess dissolved heavy metal concentrations at 283 surface water monitoring stations near to six mining projects during the dry and wet seasons. Reports from OEFA-Peru on Early Environmental Assessment (EEA) were used to apply various criteria and non-parametric statistical tests. They included ecological, ecotoxicological, chemical, and regulatory factors. The main goal of this research was to identify, analyze, characterize, and compare the risks present at different trophic levels. These levels were categorized as T1 (Microalgae), T2 (Zooplankton and Benthic invertebrates), and T3 (Fish). Individual risk (IR) was estimated using the quotient model, while total risk (TR) was assessed using the additive probability rule. Rainbow trout (Oncorhynchus mykiss), representing trophic level T3, showed the highest sensitivity to Fe and Cu. Statistical tests ranked the IR as Fe > Cu > Zn > Mn > Pb (p < 0.01). The TR was more prevalent during the wet season compared to the dry season (p < 0.01). Notably, around 50 % of the monitoring stations (n = 142) were classified as high risk, and 9 % (n = 13) showed extremely high-risk values for Cu and Fe. The adapted ERA framework demonstrated great effectiveness in identifying critical points of metal contamination in high Andean aquatic ecosystems under mining influence. However, specialized studies are suggested that allow the sources of pollution to be associated with specific regulatory actions.

Activities of the oral health teams in primary health care: a time-motion study.

BACKGROUND: Efficient planning of the oral health workforce in Primary Health Care (PHC) is paramount to ensure equitable community access to services. This requires a meticulous examination of the population's needs, strategic distribution of oral health professionals, and effective human resource management. In this context, the average time spent on care to meet the needs of users/families/communities is the central variable in healthcare professional workforce planning methods. However, many time measures are solely based on professional judgment or experience. OBJECTIVE: Calculate the average time parameters for the activities carried out by the oral health team in primary health care. METHOD: This is a descriptive observational study using the time-motion method carried out in five Primary Health Care Units in the city of São Paulo, SP, Brazil. Direct and continuous observation of oral health team members occurred for 40 h spread over five days of a typical work week. RESULTS: A total of 696.05 h of observation were conducted with 12 Dentists, three Oral Health Assistants, and five Oral Health Technicians. The Dentists' main activity was consultation with an average duration of 24.39 min, which took up 42.36% of their working time, followed by documentation with 12.15%. Oral Health Assistants spent 31.57% of their time on infection control, while Oral Health Technicians spent 22.37% on documentation. CONCLUSION: The study establishes time standards for the activities performed by the dental care team and provides support for the application of workforce planning methods that allow for review and optimization of the work process and public policies.

Persistent inequities in maternal mortality in Latin America and the Caribbean, 1990-2019.

BACKGROUND: Despite the resources and personnel mobilized in Latin America and the Caribbean to reduce the maternal mortality ratio (MMR, maternal deaths per 100 000 live births) in women aged 10-54 years by 75% between 2000 and 2015, the region failed to meet the Millenium Development Goals (MDGs) due to persistent barriers to access quality reproductive, maternal, and neonatal health services. METHODS: Using 1990-2019 data from the Global Burden of Disease project, we carried out a two-stepwise analysis to (a) identify the differences in the MMR temporal patterns and (b) assess its relationship with selected indicators: government health expenditure (GHE), the GHE as percentage of gross domestic product (GDP), the availability of human resources for health (HRH), the coverage of effective interventions to reduce maternal mortality, and the level of economic development of each country. FINDINGS: In the descriptive analysis, we observed a heterogeneous overall reduction of MMR in the region between 1990 and 2019 and heterogeneous overall increases in the GHE, GHE/GDP, and HRH availability. The correlation analysis showed a close, negative, and dependent association of the economic development level between the MMR and GHE per capita, the percentage of GHE to GDP, the availability of HRH, and the coverage of SBA. We observed the lowest MMRs when GHE as a percentage of GDP was close to 3% or about US$400 GHE per capita, HRH availability of 6 doctors, nurses, and midwives per 1,000 inhabitants, and skilled birth attendance levels above 90%. CONCLUSIONS: Within the framework of the Sustainable Development Goals (SDGs) agenda, health policies aimed at the effective reduction of maternal mortality should consider allocating more resources as a necessary but not sufficient condition to achieve the goals and should prioritize the implementation of new forms of care with a gender and rights approach, as well as strengthening actions focused on vulnerable groups.