Kelp forest food webs as hot spots for the accumulation of microplastic and polybrominated diphenyl ether pollutants.

Kelp forests (KFs) are one of the most significant marine ecosystems in the planet. They serve as a refuge for a wide variety of marine species of ecological and economic importance. Additionally, they aid with carbon sequestration, safeguard the coastline, and maintain water quality. Microplastic (MP) and polybrominated diphenyl ethers (PBDEs) concentrations were analyzed across trophic levels in KFs around Todos Santos Bay. Spatial variation patterns were compared at three sites in 2021 and temporal change at Todos Santos Island (TSI) in 2021 and 2022. We analyzed these MPs and PBDEs in water, primary producers (Macrocystis pyrifera), grazers (Strongylocentrotus purpuratus), predators (Semicossyphus pulcher), and kelp detritus. MPs were identified in all samples (11 synthetic and 1 semisynthetic polymer) and confirmed using Fourier-transform infrared microspectroscopy-attenuated total reflectance (µ-FTIR-ATR). The most abundant type of MP is polyester fibers. Statistically significant variations in MP concentration were found only in kelps, with the greatest average concentrations in medium-depth kelps from TSI in 2022 (0.73 ± 0.58 MP g-1 ww) and in the kelp detritus from TSI in 2021 (0.96 ± 0.64 MP g-1 ww). Similarly, PBDEs were found in all samples, with the largest concentration found in sea urchins from Punta San Miguel (0.93 ± 0.24 ng g-1 ww). The similarity of the polymers can indicate a trophic transfer of MPs. This study shows the extensive presence of MP and PBDE subtropical trophic web of a KF, but correlating these compounds in environmental samples is highly complex, influenced by numerous factors that could affect their presence and behavior. However, this suggests that there is a potential risk to the systems and the services that KFs offer.

Prenatal Genome-Wide Cell-Free DNA Screening: Three Years of Clinical Experience in a Hospital Prenatal Diagnostic Unit in Spain.

Genome-wide prenatal cell-free DNA (cfDNA) screening can be used to screen for a wide range of fetal chromosomal anomalies in pregnant patients. In this study, we describe our clinical experience with a genome-wide cfDNA assay in screening for common trisomies, sex chromosomal aneuploidies (SCAs), rare autosomal aneuploidies (RAAs), and copy-number variations (CNVs) in about 6000 patients over a three-year period at our hospital's Prenatal Diagnostic Unit in Spain. Overall, 204 (3.3%) patients had a high-risk call, which included 76 trisomy 21, 21 trisomy 18, 7 trisomy 13, 29 SCAs, 31 RAAs, 31 CNVs, and 9 cases with multiple anomalies. The diagnostic outcomes were obtained for the high-risk cases when available, allowing for the calculation of positive predictive values (PPVs). Calculated PPVs were 95.9% for trisomy 21, 77.8% for trisomy 18, 66.7% for trisomy 13, 10.7% for RAAs, and 10.7% for CNVs. Pregnancy and birth outcomes were also collected for the majority of RAA and CNV cases. Adverse perinatal outcomes for some of these cases included preeclampsia, fetal growth restriction, preterm birth, reduced birth weight, and major congenital structural abnormalities. In conclusion, our study showed strong performance for genome-wide cfDNA screening in a large cohort of pregnancy patients in Spain.

Environmental prospective of valorizing corn processing effluent to produce ferulic acid grafted chitosan polymer.

The food industry requires new production models that include more environmentally friendly waste management practices, considering that the environmental loads of solid waste and wastewater associated with this sector cause damage to the receiving ecosystems. The approach considered in this study focuses on the design and environmental assessment of an enzymatic process for the valorization of ferulic acid present in the effluent of a corn tortilla plant. The ferulic acid can be immobilized on chitosan so that the ferulic acid grafted chitosan can be used as a bioactive film with enhanced antioxidant properties with potential applications in the biotechnology sector. Its real projection approach requires the evaluation of its environmental and economic performance, trying to identify its benefits and potential in the value chain, using the Techno-Economic Analysis (TEA) as a phase for the conceptual design of the process and the Life Cycle Assessment (LCA) methodology for the environmental evaluation. It should be noted that the TEA indicators are promising, since the values of the financial indicators obtained are representative of the economic profitability, which makes the ferulic acid valorization a viable process. In terms of the environmental impact of the process, the buffer dose and the chitosan production process are identified as the main critical points. This double benefit in environmental and economic terms shows that the valorization of ferulic acid for chitosan functionalization is a promising alternative to improve the sustainability performance of corn processing.

Comparing fabrication techniques for engineered cardiac tissue.

Tissue engineering can provide in vitro models for drug testing, disease modeling, and perhaps someday, tissue/organ replacements. For building 3D heart tissue, the alignment of cardiac cells or cardiomyocytes (CMs) is important in generating a synchronously contracting tissue. To that end, researchers have generated several fabrication methods for building heart tissue, but direct comparisons of pros and cons using the same cell source is lacking. Here, we derived cardiomyocytes (CMs) from human induced pluripotent stem cells (hiPSCs) and compare the assembly of these cells using three fabrication methods: cardiospheres, muscle rings, and muscle strips. All three protocols successfully generated compacted tissue comprised of hiPSC-derived CMs stable for at least 2 weeks. The percentage of aligned cells was greatest in the muscle strip (55%) and the muscle ring (50%) compared with the relatively unaligned cardiospheres (35%). The iPSC-derived CMs within the muscle strip also exhibited the greatest elongation, with elongation factor at 2.0 compared with 1.5 for the muscle ring and 1.2 for the cardiospheres. This is the first direct comparison of various fabrication techniques using the same cell source.

Effectiveness of methotrexate and leflunomide as corticoid-sparing drugs in patients with polymyalgia rheumatica.

Objectives: The need for glucocorticoid-sparing drugs (GCSD) remains an important issue and is an unmet need in the treatment of polymyalgia rheumatica (PMR). We therefore aimed to assess the effectiveness and safety of methotrexate (MTX) and of leflunomide (LEF) in daily clinical practice in PMR patients from Argentina. Methods: A multicentre and observational study (medical records review) of PMR patients seen between 2007 and 2023, who had at least three months of follow-up after starting a GCSD, either MTX or LEF, was performed. Results are expressed as medians and interquartile ranges [25th-75th (IQR)] for continuous variables and percentages for categorical ones. The two treatment groups were compared using χ2 test for categorical variables, Mann-Whitney U test for continuous variables and the log-rank test for time-to-event data. Crude and adjusted odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using logistic regression. In all cases, a p-value <0.05 was considered statistically significant. Results: One-hundred and eighty-six patients (79% female) with a median age of 72 years (IQR, 65-77 years) were included. One-hundred and forty-three patients (77%) were prescribed MTX (15, IQR 10-15) and 43 (23%) LEF (20 mg, fixed dose). Flare-ups (relapses and recurrences) occurred in 13 patients (7%) and were comparable between both groups. Persistent GCSD intake was observed in 145 patients (78%). Glucocorticoid (GC) withdrawal was achieved in 67 of these 145 patients (46%) and this occurred more frequently in the LEF group (P = 0.001). Furthermore, time until prednisone discontinuation was shorter in the LEF-treated patients (4.7 months, IQR 3-20 on LEF versus 31.8 months, IQR 10-82 on MTX, P = 0.000). Remission was found more frequently in the LEF group (P = 0.003). In the multivariate analysis, the probability of remission was higher with LEF therapy (P = 0.010) and this finding persisted in the subgroup analysis who were followed up < 40 months (OR 3.12, 95% CI = 1.30-7.47, P = 0.011). Conclusions: This study demonstrated the clinical effectiveness of LEF and even its superiority in achieving remission when compared with MTX as GCSD in PMR patients. Further research is needed to support these findings.

Lemierre-like syndrome after soft tissue infection due to methicillin-resistant Staphylococcus aureus: A case report and literature review.

RATIONALE: Lemierre-like syndrome (LLS) is characterized by bacteremia, septic thrombophlebitis of the internal jugular vein, and metastatic abscesses. In contrast to classic Lemierre syndrome, sources of infection are not related to oropharyngeal infections, as are frequent soft tissue infections. In recent years, Staphylococcus aureus has been identified as an emergent pathogen that causes this syndrome. The mortality rate of LLS caused by this pathogen is approximately 16%. Timely diagnosis, antibiotic treatment, and infection control are the cornerstones to treat LLS. Anticoagulant therapy as adjuvant treatment remains controversial. PATIENT CONCERNS: A 31-year-old woman from California, United States (US), was admitted to the emergency room with a history of 2 days of fever and severe throbbing pain in the left cervical region. Thorax and neck CT tomography revealed confluent cavities suggestive of septic embolism in the lungs and a filiform thrombus in the lumen of the left internal jugular vein, with moderate swelling of the soft and muscular tissues. Methicillin-resistant Staphylococcus aureus (MRSA) was isolated from the blood culture. DIAGNOSIS: The thrombus in the internal jugular vein associated with cellulitis in the neck and multiple cavitary lesions in the lungs support the diagnosis of LLS caused by MRSA with septic embolization. INTERVENTIONS: During treatment, the patient received vancomycin IV for 25 days and returned to the US with linezolid orally. In addition, assisted video-thoracoscopy and bilateral mini-thoracotomy with pleural decortication were performed for infectious source control, where 1700cc of purulent pleural fluid was drained. OUTCOMES: The patient was discharged with optimal evolution. LESSONS: LLS should be suspected in patients with skin and soft tissue infections who develop thrombosis or metastatic infections. MRSA infections should be considered in patients from areas where this pathogen is prevalent.

Personal and Psychological Traits of University-Going Women That Affect Opportunities and Entrepreneurial Intentions.

The purpose of this research is to analyze how personality traits and psychological profiles influence the detection of entrepreneurial opportunities by, and the intentions of, university-going women in the northwest region of Mexico. It also examines how business opportunities are decisive when it comes to awakening entrepreneurial intention. The moderating and mediating effects of the detection of business opportunities and the psychological profile are also examined with respect to the direct relationship between personal traits and entrepreneurial intentions. For this study, information was collected from 1197 students attending the Autonomous University of Baja California and the Technological Institute of Sonora through a digital survey (Google Forms) distributed via email during the second half of 2022. The PLS-SEM statistical technique was used to test the hypotheses of the proposed theoretical model. The results revealed that personality traits have positive and significant effects on the psychological profile and on business opportunities. However, it was clearly observed that one's personal traits and psychological profile have little or no influence on entrepreneurial intentions. We also found that the psychological profile is the construct that most influences business opportunities. In addition, it was also highlighted that business opportunities contribute to awakening the entrepreneurial intentions of university-going women. On the other hand, it was revealed that business opportunities have a negative moderating effect on the relationship between the psychological profile and entrepreneurial intentions. Likewise, this study has shown that the detection of business opportunities and the psychological profile have indirect effects on the relationship between the personal traits and the entrepreneurial intentions of university-going women. This research contributes to the development and strengthening of trait theory, the theory of reasoned action, and the theory of planned behavior.

Risk Factors for Relapse and/or Prolonged Glucocorticoid Therapy in Polymyalgia Rheumatica: Multicenter Study in 185 Patients.

BACKGROUND: In polymyalgia rheumatica (PMR) relapses and long-term GC dependency are common. We assessed risk factors for higher relapse rate and/or prolonged glucocorticoid therapy in PMR patients. METHODS: A multicenter and observational study (chart review) of PMR patients seen between 2006 and 2021 who had at least a 3-month follow-up period after starting GCs was performed. Results were expressed as median and interquartile range 25th-75th or mean ± standard deviation for numerical variables and percentage for categorical ones. Relapse versus nonrelapse groups were compared using Cox proportional analysis. Hazards ratios (HRs) with 95% confidence intervals (CIs) are reported. In all cases, a p value <0.05 was considered to indicate statistical significance. RESULTS: We included 185 patients (69.1% female). The median follow-up time was 17.1 months (interquartile range, 6.8-34.7). Incidence of relapses was 1.2 per 100 persons/month. In univariate analysis, PMR patients with a previous history of dyslipidemia had a lower risk of relapse (HR, 0.55; 95% CI, 0.33-0.94; p = 0.03); high-dose GC (HR, 2.35; 95% CI, 1.42-3.87; p = 0.001) and faster GC dose reduction had higher risk of relapse (HR, 3.04; 95% CI, 1.77-5.21; p = 0.001). In multivariate analysis, a previous history of dyslipidemia had a lower risk of relapse (HR, 0.54; 95% CI, 0.32-0.92; p = 0.023), and high dose of GC (HR, 2.46; 95% CI, 1.49-4.08; p = 0.001) remained the only risk factors for relapse. CONCLUSIONS: Lower doses of corticosteroids and a slow rate of reduction are critical to avoid relapse in PMR. Risk factors for higher relapse rate rely on therapy more than clinical characteristics of the patients at the time of diagnosis of PMR.

Corrosion Assessment in Reinforced Concrete Structures by Means of Embedded Sensors and Multivariate Analysis-Part 1: Laboratory Validation.

Reinforced Concrete Structures (RCS) are a fundamental part of a country's civil infrastructure. However, RCSs are often affected by rebar corrosion, which poses a major problem because it reduces their service life. The traditionally used inspection and management methods applied to RCSs are poorly operative. Structural Health Monitoring and Management (SHMM) by means of embedded sensors to analyse corrosion in RCSs is an emerging alternative, but one that still involves different challenges. Examples of SHMM include INESSCOM (Integrated Sensor Network for Smart Corrosion Monitoring), a tool that has already been implemented in different real-life cases. Nevertheless, work continues to upgrade it. To do so, the authors of this work consider implementing a new measurement procedure to identify the triggering agent of the corrosion process by analysing the double-layer capacitance of the sensors' responses. This study was carried out on reinforced concrete specimens exposed for 18 months to different atmospheres. The results demonstrate the proposed measurement protocol and the multivariate analysis can differentiate the factor that triggers corrosion (chlorides or carbonation), even when the corrosion kinetics are similar. Data were validated by principal component analysis (PCA) and by the visual inspection of samples and rebars at the end of the study.

Ant Community Is Not Influenced by the Addition of Olive Mill Pomace Compost in Two Different Olive Crop Managements.

Industrial production of olive oil generates large amounts of solid waste called 'alperujo'. Its compost can fertilize many crops, especially olives. Furthermore, superintensive orchards are increasing their surface globally due to higher production and savings in different costs. Ants are considered an important part of the arthropod community in olive orchards and could even play a significant role in pest control. The tree canopy and ground were sampled to compare the ant assemblage in plots fertilized with compost and mineral products in two groves with different types of crop management (superintensive and traditional) over two years. The numbers of ants in both types of fertilization in each grove were not statistically different (p > 0.05), indicating that the type of fertilization did not have a significant impact on its populations in the ground or in the canopy, but the number of individuals was significantly higher in the superintensive grove than in the traditional grove (both in the ground and in the canopy, p < 0.01). The most frequent species in the ground were Pheidole pallidula, Plagiolepis smitzii and Aphaenogaster senilis (superintensive grove) and Pheidole pallidula, Tetramorium gr semilaeve, Plagiolepis pygmaea, and Tapinoma nigerrimum (traditional grove). In the canopy, the most frequent species were Plagiolepis spp. in both groves. Differences in ant densities and species between the groves could be due to the different management, especially of the soil, but it must be confirmed using more replicas and longer periods of study.

Perceptions and Intention to Get Vaccinated against Mpox among the LGBTIQ+ Community during the 2022 Outbreak: A Cross-Sectional Study in Peru.

Vaccination against mpox can control the outbreak by targeting high-risk groups such as the LGBTIQ+ community. The aim of the study was to evaluate the perceptions and intentions to get vaccinated against mpox among the LGBTIQ+ community in Peru. We conducted a cross-sectional study from 1 November 2022 to 17 January 2023 in Peru. We included individuals over 18 years old, belonging to the LGBTIQ+ community, and residing in the departments of Lima and Callao. To evaluate the factors associated with the intention to be vaccinated, we used Poisson regression with robust variance to create a multivariate model. The study comprised 373 individuals who self-identified as members of the LGBTIQ+ community. The participants had a mean age of 31 years (SD ± 9), with 85.0% males and 75.3% reporting to be homosexual men. The majority (88.5%) expressed their intention to receive the vaccine against mpox. Believing that the vaccine is safe was associated with a higher intention to be vaccinated (aPR: 1.24; 95% CI: 1.02 to 1.50; p = 0.028). Our study population showed a high level of mpox vaccination intent. Educational campaigns reinforcing the concept of vaccine safety should be conducted to increase the intention and possibly the vaccination rate in the LGBTIQ+ community.

Isquemia arterial aguda trombótica de los miembros inferiores / Acute thrombotic arterial ischemia of the lower limbs

Introducción: La enfermedad arterial periférica es una de las afecciones más prevalentes. Resulta habitual su coexistencia con la enfermedad vascular en otras localizaciones. El diagnóstico precoz tiene importancia para mejorar la calidad de vida del paciente y reducir el riesgo de eventos secundarios mayores, como el infarto agudo de miocardio o el ictus. Objetivo: Caracterizar el comportamiento de la isquemia arterial aguda trombótica en miembros inferiores en pacientes que ingresaron en el Instituto Nacional de Angiología y Cirugía Vascular. Métodos: Se realizó un estudio observacional, descriptivo y retrospectivo, con el fin de determinar factores pronósticos en la evolución final del tratamiento quirúrgico de la isquemia arterial aguda trombótica en miembros inferiores, en pacientes que ingresaron en los servicios de Arteriología y Angiopatía Diabética del Instituto Nacional de Angiología y Cirugía Vascular durante un período de cuatro años. Resultados: El grupo de edades más afectado estuvo entre 40 y 59 años, con un predomino del sexo masculino. El hábito de fumar fue el factor de riesgo vascular más frecuente; y la amputación mayor, el procedimiento quirúrgico más empleado, por lo que el patrón oclusivo femoropoplíteo resultó el más prevalente. Conclusiones: Predominaron el sexo masculino, el hábito de fumar, la amputación mayor y el patrón oclusivo femoropoplíteo(AU)

Introduction: Peripheral arterial disease is one of the most prevalent conditions. Its coexistence with vascular disease in other locations is common. Early diagnosis is important to improve the patient's quality of life and reduce the risk of major secondary events, such as acute myocardial infarction or stroke. Objective: To characterize the behavior of acute thrombotic arterial ischemia in lower limbs in patients admitted to the National Institute of Angiology and Vascular Surgery. Methods: An observational, descriptive and retrospective study was conducted in order to determine prognostic factors in the final evolution of surgical treatment of acute thrombotic arterial ischemia in the lower limbs in patients admitted to the Arteriology and Diabetic Angiopathy services of the National Institute of Angiology and Vascular Surgery for a period of four years. Results: The most affected age group was the one of 40 to 59 years, with a predominance of males. Smoking was the most frequent vascular risk factor; and major amputation, the most used surgical procedure, so the femoropopliteal occlusive pattern was the most prevalent. Conclusions: Male sex, smoking habit, major amputation and femoropopliteal occlusive pattern predominated(AU)

Successful Outcome after Treatment with Cidofovir, Vaccinia, and Extended Course of Tecovirimat in a Newly-Diagnosed HIV Patient with Severe Mpox: A Case Report.

PURPOSE: To report a case of severe mpox in a newly diagnosed HIV patient concerning for Immune Reconstitution Inflammatory Syndrome (IRIS) and/or tecovirimat resistance and to describe the management approach in the setting of refractory disease. CASE: 49-year-old man presented with 2 weeks of perianal lesions. He tested positive for mpox PCR in the emergency room and was discharged home with quarantine instructions. Three weeks later, the patient returned with disseminated firm, nodular lesions in the face, neck, scalp, mouth, chest, back, legs, arms, and rectum, with worsening pain and purulent drainage from the rectum. The patient reported being on 3 days of tecovirimat treatment, which was prescribed by the Florida department of health (DOH). During this admission, he was found to be HIV positive. A pelvic CT scan revealed a 2.5 cm perirectal abscess. Treatment with tecovirimat was continued for 14 days, along with an empiric course of antibiotics for treatment of possible superimposed bacterial infection upon discharge. He was seen in the outpatient clinic and initiated antiretroviral therapy (ART) with TAF/emtricitabine/bictegravir. Two weeks after starting ART, the patient was readmitted for worsening mpox rash and rectal pain. Urine PCR also returned positive for chlamydia, for which the patient was prescribed doxycycline. He was discharged on a second course of tecovirimat and antibiotic therapy. Ten days later, the patient was readmitted for the second time due to worsening symptoms and blockage of the nasal airway from progressing lesions. At this point, there were concerns for tecovirimat resistance, and after discussion with CDC, tecovirimat was reinitiated for the third time, with the addition of Cidofovir and Vaccinia, and showed an improvement in his symptoms. He received three doses of cidofovir and two doses of Vaccinia, and the patient was then discharged to complete 30 days of tecovirimat. Outpatient follow-up showed favorable outcomes and near resolution. CONCLUSION: We reported a challenging case of worsening mpox after Tecovirimat treatment in the setting of new HIV and ART initiation concerning IRIS vs. Tecovirimat resistance. Clinicians should consider the risk of IRIS and weigh the pros and cons of initiating or delaying ART. In patients not responding to first-line treatment with tecovirimat, resistance testing should be performed, and alternative options should be considered. Future research is needed to establish guidance on the role of Cidofovir and Vaccinia immune globulin and the continuation of tecovirimat for refractory mpox.

How are rheumatologists from Argentina managing patients with arthralgias suspicious for progressing to rheumatoid arthritis?

Patients with arthralgias who could be at risk of progressing to rheumatoid arthritis (RA) represent a clinical challenge. Recommendations for their management and treatment are lacking. The purpose of the present study was to determine how Argentinean rheumatologists deal with these patients. We developed an anonymous ad hoc survey which was sent to 522 Argentinean rheumatologists. The RA study group of our Argentinean Rheumatology National Society assisted in forwarding the surveys to its members via the internet (e-mail or WhatsApp). The findings of the collected data are presented as descriptive statistics. The questionnaires were completed by 255 rheumatologists (overall response rate of 48.9%), and 97.6% confirmed that their practices had received medical consultations to rule out RA in patients with arthralgias. Ultrasound (US) was the method of first choice (93.7%) as part of the evaluation of these patients. For those in whom US power Doppler signal was present in at least one joint, 93.7% of the participants would start treatment and methotrexate was the first choice (58.1%). In patients with tenosynovitis but no synovitis on US, most rheumatologists would start treatment (89.4%), being NSAIDs the drug of first choice (52.3%). Argentinean rheumatologists evaluate patients with imminent RA and treat them based on their clinical judgment and findings from the US evaluation of affected joints; the drug of first choice for these patients among these rheumatologists was methotrexate. Despite published data of recent clinical trials, recommendations for the management and treatment of these patients are necessary.

Such a fun-guy! Is this Candida or Histoplasma?

Histoplasmosis is a neglected mycosis with high mortality in immunocompromised individuals. The diagnosis can be delayed due to nonspecific clinical manifestations and similar morphology with other organisms. A high index of suspicion is required.

Magic-Religious practices in chronic diseases at in a third level hospital (Mexico) / Prácticas mágico-religiosas en enfermedades crónicas en un hospital de tercer nivel en 2019 (México)

The religious system intersects within the health system. Religious practices seek the intervention of divine actors through practices, prayers, rites and rituals. In turn, magical practices are described as everyday symbolic precepts to which power is attributed to achieve technical and utilitarian ends without the intervention of a sacred rank or being. We sought to characterize the ideal type of magical-religious practices carried out by mothers of patients with chronic diseases, cared for in a tertiary care hospital. In-depth interviews were conducted with 12 mothers of children with various chronic illnesses. In all of them, they used the magico-religious practices as emotional self-care when facing loneliness and crises in their environment, in order to feel tranquility and peace in search of well-being of them and their children. Because of the widespread use of magico-religious practices, it is necessary to understand how they go through the health-disease process to balance the tension between the biomedical and the religious-spiritual in the search for social and spiritual wellbeing of chronically ill children.

Dentro de la atención para la salud, se interseca el sistema religioso. Las prácticas religiosas buscan una intervención de actores divinos por medio de prácticas, rezos, ritos y rituales. A su vez, las prácticas mágicas se describen como preceptos simbólicos cotidianos a los que se les atribuye poder para conseguir multas técnicas y utilitarios sin intervención de un rango o ser sagrado. Se buscó caracterizar el tipo ideal de las prácticas mágico-religiosas realizadas por madres de pacientes con enfermedades crónicas, atendidos en un hospital de tercer nivel de atención. Se realizaron entrevistas a profundidad en 12 madres con hijos con diversas enfermedades crónicas.En todas ellas, se destaca el uso de las prácticas mágico-religiosas como auto-cuidado emocional al afrontar la soledad y las crisis de su entorno, con el fin de sentir tranquilidad y paz en busca de este bienestar de ellas y de sus hijos. Por el uso extendido de las prácticas mágico-religiosas es necesario comprender cómo intersecan el proceso de salud-enfermedad, en donde el personal para la salud busque equilibrar la tensión entre el componente biológico de la enfermedad y el aspecto religioso-espiritual, en la búsqueda de bienestar social y espiritual del vínculo madre-hijo.

El impacto de la pandemia del COVID-19 en la educación médica: adaptabilidad y experiencia con enseñanza a distancia de la Sociedad Médica Peruano Americana

La pandemia del COVID-19 tuvo un impacto significativo en el cuidado y la educación médicos en el Perú. En respuesta, la Sociedad Médica Peruano Americana (PAMS), una organización médica benéfica con sede en los EE.UU., adoptó sus misiones médicas y educativas en Perú usando estrategias virtuales. Desarrollamos colaboración con varias facultades de medicina y la Asociación Peruana de Facultades de Medicina (ASPEFAM) y ofrecimos un panel de veinte y cuatro miembros para brindar conferencias y seminarios multidisciplinarios en español. Hicimos 19 seminarios, incluyendo temas relacionados y no relacionados al COVID-19, que en los últimos dos años atrajo a 14 489 participantes de 23 países. Ellas fueron la base de 20 publicaciones en revistas médicas peruanas. Nuestro concurso de investigaciones clínicas y nuestro proyecto piloto de mentoría de investigación fueron recibidos positivamente. La pandemia del COVID-19 tuvo un efecto positivo en la misión educativa de PAMS en Perú.

The COVID-19 pandemic had a significant impact on medical care and medical education in Peru. In response, the Peruvian American Medical Society (PAMS), a charitable medical organization based in the USA, pursued its medical and educational missions in Peru by adopting virtual learning technology. We developed closer collaborative relationships with several medical schools and the Peruvian Association of Medical Schools (ASPEFAM) while offering a faculty panel of twenty-four members to provide lectures and multidisciplinary webinars in Spanish. We conducted 19 webinars including COVID -19 and non-COVID-19 related topics that over the last two years attracted 14,489 participants from 23 countries. They were the foundation for twenty publications in Peruvian medical journals. Our clinical investigations competition was positively received as was our pilot project on research mentorship. The COVID -19 pandemic had a positive effect on the educational mission of PAMS in Peru.

Level of Knowledge Regarding Mpox among Peruvian Physicians during the 2022 Outbreak: A Cross-Sectional Study.

Introduction: Due to the high incidence of mpox in Peru and the poor knowledge about this disease among healthcare workers in non-endemic countries, it is crucial to determine the knowledge status of Peruvian physicians. Methodology: We conducted an analytical cross-sectional study based on an online survey from August to September 2022. Physicians who had a medical license and lived and practiced medicine in Peru were included. To evaluate the factors associated with a higher level of knowledge, we used crude (cPR) and adjusted (aPR) prevalence ratios with 95% confidence intervals (95% CI) using Poisson regression. Results: We included 463 physicians. The mean age was 36.6 (SD: 10.3) years, and most were male (58.1%). Regarding knowledge, the median knowledge score was 14 [IQR: 13 to 15] out of 17 points. In terms of knowledge gaps, only 60.7% of the participants knew that there was an FDA-approved vaccine for mpox, 49.0% of participants knew about mpox proctitis and 33.3% acknowledged that it could be transmitted by the bite of an infected rodent. We found that taking care of patients with mpox (aPR: 1.39; 95% CI: 1.13 to 1.72) was associated with higher knowledge (>p50), while living in the eastern macro-region (aPR: 0.62; 95% CI: 0.42 to 0.93) was associated with lower knowledge (≤p50). Conclusions: Our study showed a high level of knowledge about mpox among Peruvian physicians. However, educational campaigns may be necessary, especially for physicians from the eastern region and those who do not have clinical experience with mpox.