Overcoming Barriers in the Management of Hypertension: The Experience of the Cardiovascular Health Program in Chilean Primary Health Care Centers

Objective. To assess the blood pressure control and cardiovascular risk factors (CVRFs) in a population of hypertensive patients with access to care under a government-financed program, the Cardiovascular Health Program (CHP). Design. A cross-sectional and multicenter study. Setting. 52 primary care centers, metropolitan area of Santiago, Chile. Participants. 1,194 patients were selected by a systematic random sampling from a universe of 316,654 hypertensive patients. Key Measurements. Demographic information, blood pressure (BP) measurements, and CVRF were extracted from medical records of patients followed for a 12-month period. Results. 59.7% of patients reached target BP <140/90 mmHg. More women were captured in the sampling (2.1 : 1), achieving better BP control than men. Diabetic patients (26.4%) had worse BP control than nondiabetics. Antihypertensive medications were used in 91.5%, with multidrug therapy more frequent in patients with higher BP and more difficult control. Conclusions. The success in improving the BP control to values <140/90 mmHg from 45.3% to 59.7% underscores the contribution of this program in the Chilean primary care cardiovascular preventive strategies. However, fewer hypertensive men than women were captured by this program, and it is of concern the underperforming of BP control observed in diabetics

Efectos sobre la curva de respuesta a la luz y el intercambio gaseoso en F. x ananassa Y F. Chiloensis, bajo tres niveles de NaCl

45 p.La frutilla comercial (Fragaria x ananassa) es una especie relevante en fruticultura, siendo Estados Unidos y China los que lideran la producción mundial. La salinidad es uno de los factores más importantes que limita el normal crecimiento y desarrollo de las plantas. Por el contrario, se ha observado que ciertas accesiones de F. chiloensis son capaces de crecer en zonas costeras, con menor cantidad de nutrientes y mayores concentraciones de sal. Este estudio se desarrolló para comparar la tolerancia a la salinidad de F. x ananassa cv. Camarosa y F. chiloensis subsp. chiloensis accesión “Bau”. Las plantas fueron cultivadas en invernadero, bajo tres niveles de salinidad (0, 30 y 60 μmol de NaCl) por 86 días. A pesar de no encontrarse diferencias significativas en varias de las fechas y tratamientos, la tendencia general fue que en la medida que se aumentó la concentración salina la fotosíntesis máxima (Amax), el rendimiento cuántico (QE), la conductancia estomática (gs) y la tasa de transpiración (E) se mantuvieron o disminuyeron en las primeras tres fechas de evaluación, mientras que en la última aumentaron. Los resultados obtenidos en última fecha, pueden ser explicados por la disminución del área foliar por efecto del aumento de la salinidad, y el efecto compensatorio de la planta, aumentando Amax, gs y E por unidad de superficie. En general, F. chiloensis presentó los mayores niveles de Amax, gs y E. Pero al no encontrarse diferencias significativas en la mayoría de las evaluaciones y concentraciones de NaCl, estas variables en estudio, no resultaron ser indicadores efectivos para establecer las diferencias del efecto del estrés salino sobre ambas especies./ABSTRACT: Commercial strawberry (Fragaria x ananassa) is a relevant specie in horticulture, with the United States and China leading the world production. The salinity is one of the most outstanding factors affecting the growth and development of the plants. On the other hand, it has been shown that some accessions of F. chiloensis are able to grow in coastal areas, with less nutrients and higher salt concentrations. The aim of this study was to compare the tolerance to salinity of F. x ananassa cv. Camarosa and F. chiloensis subsp. chiloensis accession “Bau”. Plants were grown in a greenhouse, under three levels of NaCl (0, 30 and 60 μmol NaCl) for 86 days. Although there were not significant differences on various dates and treatments, the general trend was that as the salt concentration was increased, the máximum photosynthesis (Amax), quantum yield (QE), stomatal conductance (gs) and transpiration (E) were maintained or decreased in the first three test dates, while in the last increased. The results obtained in the last date, can be explained by the decrease in leaf area as a result of increased salinity, and compensatory effect of the plant, increasing Amax, gs and E per unit area. In general, F. chiloensis showed the highest levels of Amax, gs and E. But no significant differences were found in most assessments and NaCl concentrations, these variables under study, not proved effective indicators to establish the differences of the effect of salt stress on both species

Exploring Agronomic and Physiological Traits Associated With the Differences in Productivity Between Triticale and Bread Wheat in Mediterranean Environments

In Mediterranean climates soil water deficit occurs mainly during the spring and summer, having a great impact on cereal productivity. While previous studies have indicated that the grain yield (GY) of triticale is usually higher than bread wheat (Triticum aestivum L.), comparatively little is known about the performance of these crops under water-limited conditions or the physiological traits involved in the different yields of both crops. For this purpose, two sets of experiments were conducted in order to compare a high yielding triticale (cv. Aguacero) and spring wheat (cvs. Pandora and Domo). The first experiment, aiming to analyze the agronomic performance, was carried out in 10 sites located across a wide range of Mediterranean and temperate environments, distributed between 33°34′ and 38°41′ S. The second experiment, aiming to identify potential physiological traits linked to the different yields of the two crops, was conducted in two Mediterranean sites (Cauquenes and Santa Rosa) in which crops were grown under well-watered (WW) and water-limited (WL) conditions. The relationship between GY and the environmental index revealed that triticale exhibited a higher regression coefficient (Finlay and Wilkinson slope), indicating a more stable response to the environment, accompanied by higher yields than bread wheat. Harvest index was not significantly different between the two cereals, but triticale had higher kernels per spike (35%) and 1000 kernel weight (16%) than wheat, despite a lower number of spikes per square meter. The higher yield of triticale was linked to higher values of chlorophyll content, leaf net photosynthesis (An), the maximum rate of electron transport (ETRmax), the photochemical quantum yield of PSII [Y(II)] and leaf water-use efficiency. GY was positively correlated with Ci at anthesis and Δ13C in both species, as well as with gs at anthesis in triticale, but negatively correlated with non-photochemical fluorescence quenching and quantum yield of non-photochemical energy conversion at grain filling in wheat. These results revealed that triticale presented higher photosynthetic rates that contributed to increase plant growth and yield in the different environments, whereas wheat showed higher photoprotection system in detriment of assimilate production

Caracterización espacial de la incidencia de bitter pit en manzanas, en función de índices no destructivos de madurez y su posición en la planta

47 p.El bitter pit (BP) es uno de los principales desórdenes fisiológicos que se desarrolla durante el almacenamiento de manzanas, afectando a la industria frutícola a nivel mundial. En Chile, se estima que los daños y pérdidas afectan, entre el 5% y 30% de la producción. Los productores realizan muestreos de fruta en precosecha para predecir su incidencia, sin embargo, existe escasa información de las características de la fruta en la planta y la distribución espacial del desorden, que permitan optimizar las estrategias de muestreo en huerto. En este estudio se realizó un primer ensayo para el cv. Granny Smith (localidad de San Clemente), el que recibió 10 aplicaciones de calcio (Ca) foliar y condiciones de raleo definido por el huerto, como único tratamiento (control). Adicionalmente, un segundo ensayo consideró al cv. Brookfield, con dos tratamientos: T1, control del huerto (10 aplicaciones de Ca foliar y raleo) y T2 sin aplicaciones de Ca y sin raleo; Este ensayo, fue desarrollado en dos huerto localizados en Río Claro y San Clemente. Para ambos cultivares, al momento de la cosecha comercial, se recolectó toda la fruta de tres plantas (repeticiones) para cada tratamiento y se midió color de fondo, color de cubrimiento, peso y diámetro. La fruta fue clasificada según su procedencia de las ramas principales del árbol, dividiendo imaginariamente cada planta en tres niveles (superior, medio e inferior). Luego toda la fruta se almacenó durante 4 meses (0°C, 85% HR), y a la salida de almacenaje se expuso a 20°C por 7 días. En ese momento se analizó incidencia y severidad de BP. Como resultado se observó que, independiente del cultivar, entre 75% y 100% del BP, ocurrió en los frutos provenientes de las ramas del nivel superior de las plantas. De forma consistente no hubo presencia de BP en frutos de las ramas inferiores. Para el cv. Granny Smith los frutos del nivel superior presentaron, además, mayor peso y diámetro. Para el cv. Brookfield los frutos del nivel superior de T1 se caracterizaron por un mayor porcentaje de color, respecto de los que no fueron tratados. //ABSTRACT: Bitter pit (BP) is one of the main physiological disorders that develops during apple storage, affecting the fruit industry worldwide. In Chile, it is estimated that damages and losses, oscillates between 5% and 30% of the whole production. Producers carry out preharvest fruit samples to predict the incidence of this disorder, however, there is little information on the characteristics of the fruit in the plant and the spatial distribution of the disorder, that allows to be used for sampling strategies in the orchard. A first trial was carried out for cv. Granny Smith (San Clemente locality), which received 10 applications of foliar calcium (Ca) and fruit thinning defined by the orchard, as the only treatment. In addition, a second trial considered cv. Brookfield, with two treatments: T1, control of the orchard (10 applications of Ca foliar and thinning) and T2 without applications of Ca and without thinning; This trial was developed in two orchards located in Río Claro and San Clemente. For both cultivars, at the time of commercial harvest, all the fruit of three plants (repetitions) was collected for each treatment and background color, cover color, weight and diameter were measured. The fruit was classified according to its origin from the main branches of the tree, dividing each plant into three imaginary levels (upper, middle and lower). Then, all the fruit was stored for 4 months (0 ° C, 85% RH), and once finished the storage period, the fruit was exposed to 20 ° C for 7 days. At that time, the incidence and severity of BP was analyzed. As a result, it was observed, that independent of the cultivar, between 75% and 100% of the BP occurred in the fruits from the branches of the upper level of the plants. Consistently there was no presence of BP in fruits of the lower branches. For the cv. Granny Smith, the fruits of the upper level, got greater weight and diameter. For the cv. Brookfield the fruits of the upper level of T1 were characterized by a higher percentage of color, compared to those that were not treated

Corneal endothelium assessment in specular microscopy images with Fuchs’ dystrophy via deep regression of signed distance maps

Specular microscopy assessment of the human corneal endothelium (CE) in Fuchs’ dystrophy is challenging due to the presence of dark image regions called guttae. This paper proposes a UNet-based segmentation approach that requires minimal post-processing and achieves reliable CE morphometric assessment and guttae identification across all degrees of Fuchs’ dystrophy. We cast the segmentation problem as a regression task of the cell and gutta signed distance maps instead of a pixel-level classification task as typically done with UNets. Compared to the conventional UNet classification approach, the distance-map regression approach converges faster in clinically relevant parameters. It also produces morphometric parameters that agree with the manually-segmented ground-truth data, namely the average cell density difference of -41.9 cells/mm2 (95% confidence interval (CI) [-306.2, 222.5]) and the average difference of mean cell area of 14.8 µm 2 (95% CI [-41.9, 71.5]). These results suggest a promising alternative for CE assessment.This work has been partly funded by Ministerio de Ciencia, Tecnología e Innovación, Colombia, Project 124489786239 (Contract 763-2021), Universidad Tecnológica de Bolívar (UTB) Project CI2021P02, and Agencia Estatal de Investigación del Gobierno de España (PID2020-114582RB-I00/ AEI / 10.13039/501100011033). J. Sierra thanks UTB for a post-graduate scholarship.Peer ReviewedPostprint (published version

The nodD1 Gene of Sinorhizobium fredii HH103 Restores Nodulation Capacity on Bean in a Rhizobium tropici CIAT 899 nodD1/nodD2 Mutant, but the Secondary Symbiotic Regulators nolR, nodD2 or syrM Prevent HH103 to Nodulate with This Legume

Rhizobial NodD proteins and appropriate flavonoids induce rhizobial nodulation gene expression. In this study, we show that the nodD1 gene of Sinorhizobium fredii HH103, but not the nodD2 gene, can restore the nodulation capacity of a double nodD1/nodD2 mutant of Rhizobium tropici CIAT 899 in bean plants (Phaseolus vulgaris). S. fredii HH103 only induces pseudonodules in beans. We have also studied whether the mutation of different symbiotic regulatory genes may affect the symbiotic interaction of HH103 with beans: ttsI (the positive regulator of the symbiotic type 3 protein secretion system), and nodD2, nolR and syrM (all of them controlling the level of Nod factor production). Inactivation of either nodD2, nolR or syrM, but not that of ttsI, affected positively the symbiotic behavior of HH103 with beans, leading to the formation of colonized nodules. Acetylene reduction assays showed certain levels of nitrogenase activity that were higher in the case of the nodD2 and nolR mutants. Similar results have been previously obtained by our group with the model legume Lotus japonicus. Hence, the results obtained in the present work confirm that repression of Nod factor production, provided by either NodD2, NolR or SyrM, prevents HH103 to effectively nodulate several putative host plants.España Ministerio de Ciencia e Innovación y Universidades projects AGL2016-77163-R and PID2019-107634RB-I00España Ministerio de Ciencia e Innovación y Universidades FPU18/06248

3D collision-free trajectory generator for a UR3e manipulator with soft gripper

[EN] Pick-and-place operations are the most common in robotic applications, and often their design involves the presence of obstacles.This paper presents the development of a software platform that (allows-enables) the manipulation of a collaborative robot UR3ethrough the generation of 3D trajectories easily defined by the user, as well as a soft gripper capable of gripping objects withdifferent geometries. For this purpose, the development of a graphical interface in Unity is detailed, as well as the incorporation ofthe digital twin of the UR3e robot. In the same way, the different modules that allow the communication of the platform with themanipulator through ROS are exposed. The results show the creation of user-adapted paths for different cases in collision zones andthe arrangement of the gripper for gripping different objects. The accuracy error between the data sent and received from the robotduring the tracking of user-defined trajectories is also compared.[ES] Las operaciones pick-and-place son las más frecuentes en aplicaciones robóticas, y muchas veces su diseño incluye la presencia de obstáculos. En este trabajo se presenta la construcción de una plataforma software que permite la manipulación de un robot colaborativo UR3e mediante la generación de trayectorias 3D facilmente definidas por el usuario, además de una de pinza blanda capaz de sujetar objetos con diferentes geometrías. Para ello, se detalla el desarrollo de una interfaz gráfica en Unity, así como la incorporación del gemelo digital del robot UR3e. Del mismo modo, se exponen los diferentes módulos que permiten la comunicación de la plataforma con el manipulador a través de ROS. Los resultados muestran la creación de rutas adaptadas por el usuario ante diferentes casos en zonas de colisión y la disposición de la pinza para sujetar diferentes objetos. También se compara el error deprecisión entre los datos enviados respecto a los que se reciben desde el robot durante el seguimiento de trayectorias definidas por el usuario.Montenegro-Bravo, JS.; Ruiz-Flórez, JD.; Romero-Ante, JD.; Manrique-Córdoba, J.; Vivas Albán, OA.; Sabater-Navarro, JM. (2023). Generador 3D de trayectorias libres de colisiones para un manipulador UR3e con pinza blanda. Revista Iberoamericana de Automática e Informática industrial. 21(1):52-61. https://doi.org/10.4995/riai.2023.19332526121

The Rise and Fall of "Respectable" Spanish Liberalism, 1808-1923: An Explanatory Framework

The article focuses on the reasons behind both the consolidation of what I have termed “respectable” liberalism between the 1830s and the 1840s and its subsequent decline and fall between 1900 and 1923. In understanding both processes I study the links established between “respectable” liberals and propertied elites, the monarchy, and the Church. In the first phase these links served to consolidate the liberal polity. However, they also meant that many tenets of liberal ideology were compromised. Free elections were undermined by the operation of caciquismo, monarchs established a powerful position, and despite the Church hierarchy working with liberalism, the doctrine espoused by much of the Church was still shaped by the Counter-Reformation. Hence, “respectable” liberalism failed to achieve a popular social base. And the liberal order was increasingly denigrated as part of the corrupt “oligarchy” that ruled Spain. Worse still, between 1916 and 1923 the Church, monarch, and the propertied elite increasingly abandoned the liberal Monarchist Restoration. Hence when General Primo de Rivera launched his coup the rug was pulled from under the liberals’ feet and there was no one to cushion the fall

Women's Education Level, Maternal Health Facilities, Abortion Legislation and Maternal Deaths: A Natural Experiment in Chile from 1957 to 2007

The aim of this study was to assess the main factors related to maternal mortality reduction in large time series available in Chile in context of the United Nations' Millennium Development Goals (MDGs).Time series of maternal mortality ratio (MMR) from official data (National Institute of Statistics, 1957-2007) along with parallel time series of education years, income per capita, fertility rate (TFR), birth order, clean water, sanitary sewer, and delivery by skilled attendants were analysed using autoregressive models (ARIMA). Historical changes on the mortality trend including the effect of different educational and maternal health policies implemented in 1965, and legislation that prohibited abortion in 1989 were assessed utilizing segmented regression techniques.During the 50-year study period, the MMR decreased from 293.7 to 18.2/100,000 live births, a decrease of 93.8%. Women's education level modulated the effects of TFR, birth order, delivery by skilled attendants, clean water, and sanitary sewer access. In the fully adjusted model, for every additional year of maternal education there was a corresponding decrease in the MMR of 29.3/100,000 live births. A rapid phase of decline between 1965 and 1981 (-13.29/100,000 live births each year) and a slow phase between 1981 and 2007 (-1.59/100,000 live births each year) were identified. After abortion was prohibited, the MMR decreased from 41.3 to 12.7 per 100,000 live births (-69.2%). The slope of the MMR did not appear to be altered by the change in abortion law.Increasing education level appears to favourably impact the downward trend in the MMR, modulating other key factors such as access and utilization of maternal health facilities, changes in women's reproductive behaviour and improvements of the sanitary system. Consequently, different MDGs can act synergistically to improve maternal health. The reduction in the MMR is not related to the legal status of abortion