Biogeochemical characteristics of a long-lived anticyclonic eddy in the eastern South Pacific Ocean

Mesoscale eddies are important, frequent, and persistent features of the circulation in the eastern South Pacific (ESP) Ocean, transporting physical, chemical and biological properties from the productive shelves to the open ocean. Some of these eddies exhibit subsurface hypoxic or suboxic conditions and may serve as important hotspots for nitrogen loss, but little is known about oxygen consumption rates and nitrogen transformation processes associated with these eddies. In the austral fall of 2011, during the Tara Oceans expedition, an intrathermocline, anticyclonic, mesoscale eddy with a suboxic ( 0.5 µM), suggesting that active denitrification occurred in this water mass. Using satellite altimetry, we were able to track the eddy back to its region of formation on the coast of central Chile (36.1° S, 74.6° W). Field studies conducted in Chilean shelf waters close to the time of eddy formation provided estimates of initial O2 and N2O concentrations of the ESSW source water in the eddy. By the time of its offshore sighting, concentrations of both O2 and N2O in the subsurface oxygen minimum zone (OMZ) of the eddy were lower than concentrations in surrounding water and “source water” on the shelf, indicating that these chemical species were consumed as the eddy moved offshore. Estimates of apparent oxygen utilization rates at the OMZ of the eddy ranged from 0.29 to 44 nmol L−1 d−1 and the rate of N2O consumption was 3.92 nmol L−1 d−1. These results show that mesoscale eddies affect open-ocean biogeochemistry in the ESP not only by transporting physical and chemical properties from the coast to the ocean interior but also during advection, local biological consumption of oxygen within an eddy further generates conditions favorable to denitrification and loss of fixed nitrogen from the system

Estilos de aprendizaje en estudiantes de estomatología, Universidad Nacional Toribio Rodríguez de Mendoza, 2019

The present research was quantitative, univariate, descriptive, prospective and cross-sectional; where the objective was to determine which learning styles predominate in the students of Stomatology of the Universidad Nacional Toribio Rodríguez de Mendoza, Chachapoyas, 2019. A sample of 59 students enrolled in the academic semester 2019 - II was used, data was collected using the Honey Alonso questionnaire of Learning Styles (CHAEA) which had a reliability of 0.837 by Cronbach's Alpha. The results showed that the predominant learning style is the theoretical with 23.7% of university participants, followed by the combination of styles (active - theoretical - pragmatic) with 22%, while the reflective was of less predominance with 1.7%, the active learning style obtained very high preference of the students with 33. 9%, the reflective learning style had a moderate preference with 54.2%, while the theoretical learning style reached a preference of moderate and high with a percentage of 32.2% of students, and the pragmatic style had a very high preference of students with 33.9%. In conclusion, the learning style with the highest predominance was the theoretical one in the study sample.La presente investigación fue de tipo cuantitativo, univariado, descriptivo, prospectivo y transversal; donde se planteó como objetivo determinar que estilos de aprendizaje predominan en los estudiantes de Estomatología de la Universidad Nacional Toribio Rodríguez de Mendoza, Chachapoyas, 2019. Se utilizó una muestra de 59 estudiantes matriculados en el semestre académico 2019 – II, se recolectó los datos mediante el cuestionario de Honey Alonso de Estilos de Aprendizaje (CHAEA) que tuvo una confiabilidad de 0.837 por Alfa de Cronbach. Los resultados demostraron que el estilo de aprendizaje predominante es el teórico con 23.7% de universitarios participantes, seguido de la combinación de estilos (activo – teórico – pragmático) con 22%, mientras que el reflexivo fue de menor predominio con 1.7%, el estilo de aprendizaje activo obtuvo preferencia muy alta de los estudiantes con 33.9%, el estilo de aprendizaje reflexivo tuvo preferencia moderada con 54.2%, mientras que el estilo de aprendizaje teórico alcanzó preferencia de moderado y alto en porcentaje de 32.2% de educandos, además en el estilo pragmático se presentó una preferencia de muy alto de los estudiantes con 33.9%. En conclusión, el estilo de aprendizaje con mayor predominio fue el teórico en la muestra de estudio

Efectividad de la Técnica de Mohan P. Desarda modificada en Herniorrafía Inguinal, Hospital Público de Chachapoyas

Quantitative, explanatory, longitudinal research with epidemiological design of longitudinal cohort with the objective of determining the effectiveness of the modified Mohan Desarda technique in inguinal herniorrhaphy, public hospital of Chachapoyas, a sample of 50 patients who underwent surgery for inguinal herniorrhaphy was used, followed for 30 days to observe the post-surgical complications that were collected through the clinical evaluation form and analyzed by Cox regression. It was found that 32% of the patients were between 60-65 years old and 58.0% were male, 54.0% were operated by Lichtenstein and 46.0% by the Modified Desarda technique, 44.0% presented post-surgical complications, being 26.0% operated by Lichtenstein and 18.0% by Modified Desarda, 31.8% operated by Lichtenstein presented post-surgical complications of seroma, while 18. The Modified Desarda technique decreases the risk of post-surgical complications being a protective factor HR= 0.158; 95% CI 0.049- 0.507; p= 0.002, moreover, the more age increases the risk of complications is 1.250 and the more glucose levels increase the risk of complications is 1.658. Therefore, it is concluded that the patients operated by Modified Desarda have a longer survival time being effective in inguinal herniorrhaphy.Investigación cuantitativa, explicativo, longitudinal con diseño epidemiológico de cohorte longitudinal que tuvo como objetivo determinar la efectividad de la técnica de Mohan Desarda modificada en herniorrafía inguinal, hospital público de Chachapoyas, se utilizó una muestra de 50 pacientes intervenidos quirúrgicamente por herniorrafía inguinal, se siguió por 30 días para observar las complicaciones postquirúrgicas que se recolectó mediante la ficha de evaluación clínica y se analizó mediante una regresión de Cox. Se encontró que el 32% de los pacientes tuvieron entre 60- 65 años y el 58.0% fueron de sexo masculino, el 54.0% fueron intervenidos quirúrgicamente por Lichtenstein y el 46.0% por la técnica Desarda Modificada, el 44.0% presentó complicaciones postquirúrgicas, siendo el 26.0% intervenidos por Lichtenstein y el 18.0% por Desarda Modificada, el 31.8% intervenidos por Lichtenstein presentaron complicaciones postquirúrgicas de seroma, mientras que el 18.2% intervenidos por Desarda Modificada tuvieron complicaciones de seroma, la técnica Desarda Modificada disminuye el riesgo de complicaciones postquirúrgicas siendo un factor protector HR= 0.158; IC 95% 0.049- 0.507; p= 0.002, además cuanto más aumenta la edad existe 1.250 más riesgo de complicaciones y cuanto más aumenta los niveles de glucosa el riesgo de complicaciones es de 1.658. Por lo tanto, se concluye que los pacientes intervenidos por Desarda Modificada tienen mayor tiempo de supervivencia siendo efectiva en herniorrafía inguina

Analgesia Postoperatoria personalizada en el manejo del dolor en Pacientes Quirúrgicos, Hospital Público de Chachapoyas

Quantitative, experimental, prospective and longitudinal research aimed at determining the effectiveness of personalized postoperative analgesia in the management of pain in surgical patients, public hospital of Chachapoyas, a sample of 72 patients who underwent surgery was used, data was collected using the Visual Analog Pain Scale (VAS), which evaluates from 0 to 10 points and was analyzed by ANOVA for repeated measures. It was found that the most predominant age was between 64-70 years with 27.8%, 62.5% were male, 43.1% were operated on for cholecystectomy being this the highest percentage and 58.3% were treated postoperatively with local anesthetics, pain intensity scores 12 hours after management with personalized analgesia during the postoperative period (x̄ = 6. 85; σ= 1.057) were higher than those at 24 hours postoperatively (x̄ = 4.69; σ= 0.642; p <0.001; 95% CI [1.797- 2.511]), likewise they were higher than those at 72 hours postoperatively (x̄ = 2. 06; σ= 0.669; p<0.001; 95% CI [4.456- 5.127]); and the pain intensity at 24 hours postoperatively were higher than the 72-hour results (p<0.001; 95% CI [2.390- 2.888]). Therefore, it is concluded that statistically significant differences exist between the pain intensity measures of postoperative patients at the 12-hour, 24-hour and 72-hour times with a large effect size F (1.765) = 685.252; p < 0.001; η2= 0.906; β -1 =1.Investigación cuantitativa, experimental, prospectivo y longitudinal que tuvo como objetivo determinar la efectividad de la analgesia postoperatoria personalizada en el manejo del dolor en pacientes quirúrgicos, hospital público de Chachapoyas, se utilizó una muestra de 72 pacientes intervenidos quirúrgicamente, se recolectó los datos mediante la Escala visual análoga del dolor (EVA), que evalúa de 0 a 10 puntos y se analizó mediante ANOVA para medidas repetidas. Se encontró que la edad más predominante fue entre 64-70 años con 27.8%, el 62.5% fueron de sexo masculino, el 43.1% fueron intervenidos de colecistectomía siendo este el mayor porcentaje y el 58.3% fueron tratados en el postoperatorio con anestésicos locales, las puntuaciones de la intensidad del dolor a las 12 horas del manejo con analgesia personalizada durante el postoperatorio (x̄ = 6.85; σ= 1.057) fueron mayores a las de 24 horas del postoperatorio (x̄ = 4.69; σ= 0.642; p <0.001; IC 95% [1.797- 2.511]), así mismo fueron mayores a las de 72 horas postoperatorio (x̄ = 2.06; σ= 0.669; p <0.001; IC 95% [4.456- 5.127]); y la intensidad del dolor a las 24 horas postoperatorio fueron mayores que los resultados de 72 horas (p <0.001; IC 95% [2.390- 2.888]). Por lo tanto, se concluye que existe diferencias estadísticamente significativas entre las medidas de la intensidad del dolor de los pacientes postoperados en los tiempos de 12 horas, 24 horas y 72 horas con un tamaño de efecto grande F (1.765) = 685.252; p < 0.001; η2= 0.906; β -1 =1

Expectativas de estudio de posgrado de agremiados del Colegio Odontológico Región Amazonas, Perú

Quantitative, descriptive and cross-sectional research that had as an objective to know the expectations of postgraduate study of the members of the Colegio Odontológico Región Amazonas, Perú 2021, whose sample was 215 dental surgeons who were surveyed by means of a questionnaire whose validity by experts was Binomial test = 0.0094 and reliability by Ruder Richardson (KR 20) = 0.740. The results showed that 82.8% of the members would study a postgraduate degree to solve the needs of the community, 78.6% to be linked to higher social strata and 64.7% to have a high level of training and talent for professional experience, in addition 86.55 would like to study the specialty in Oral Rehabilitation, 78.6% in Medicine and stomatological pathology, 76.7% in Orthodontics and maxillary orthopedics, 70.7% in maxillofacial surgery, 69.7% in forensic dentistry, 70.7% in maxillofacial surgery and 69.7% in forensic dentistry. Also, 55.8% stated that they would like to study a master's degree in Management and Health Services Management and 51.2% a master's degree in Dentistry, while 48.1% stated that they would like to study a doctorate in dentistry, and 52.6% stated their desire to study in a national, 52.1% local and 50.7% international graduate school. Therefore, it is concluded that the expectations of dental surgeons to study a postgraduate degree is a necessity to serve the community and acquire new knowledge. Investigación cuantitativa, descriptiva y transversal que tuvo como objetivo conocer las expectativas de estudio de posgrado de los agremiados del Colegio Odontológico Región Amazonas, Perú 2021, cuya muestra fue 215 cirujanos dentistas que fueron encuestados mediante un cuestionario cuya validez por expertos fue prueba Binomial= 0.0094 y la confiabilidad por Ruder Richardson (KR 20) = 0.740. Los resultados evidenciaron que EL 82.8% de los agremiados estudiarían un posgrado para solucionar las necesidades de la comunidad, el 78.6% para vincularse en estratos sociales más altos y el 64.7% para tener un alto nivel de formación y talento para la experiencia profesional, además el 86.55 desearían estudiar la especialidad en Rehabilitación Oral, el 78.6% en Medicina y patología estomatológica, el 76.7% en Ortodoncia y ortopedia maxilar, el 70.7% en Cirugía maxilofacial, el 69.7% en odontología forense, el 64.2% en Odontopediatria y el 58.1% en endodoncia siendo los indicadores más importantes, también el 55.8% manifestaron que les gustaría estudiar la maestría en Gerencia y Gestión en los Servicios de Salud y el 51.2% maestría en Odontología, mientras que 48.1% manifestaron que estudiarían un doctorado en odontología, además el 52.6% manifestaron su deseo de estudiar en una escuela de posgrado Nacional, el 52.1% Local y el 50.7% Internacional. Por lo tanto, se concluye que las expectativas de los cirujanos dentistas en estudiar un posgrado es una necesidad para el servicio a la comunidad y adquirir nuevos conocimientos.&nbsp

Ética odontológica en el ejercicio profesional de los cirujanos dentistas de Chachapoyas, 2020

A quantitative, descriptive, prospective and cross-sectional research was carried out with the objective of determining the importance of dental ethics in the professional practice of dental surgeons in Chachapoyas, 2020; the information was collected by means of a survey applied to 60 dental surgeons working in private practice in the city of Chachapoyas. The results show that 41.66% of those surveyed had a high level of knowledge of ethics, 48.33% had a medium level of knowledge, and 48.33% had a high level of knowledge. On the other hand, when dental surgeons were surveyed on the application of ethics prior to the issuance of a treatment plan, 80% of dental surgeons indicated that they did apply ethical principles prior to the issuance of a treatment plan, while only 20% of dental surgeons mentioned that they did not apply ethical principles prior to the issuance of a treatment plan. It is concluded that dental surgeons in Chachapoyas do apply ethics in their professional practice, but that there is still a small group of dental surgeons who do not do so.Se realizó una investigación de tipo cuantitativa descriptivo, prospectivo y transversal; la cual tuvo como objetivo determinar la importancia de la ética odontológica en el ejercicio profesional de los cirujanos dentistas de Chachapoyas, 2020; se recolectó la información mediante una encuesta aplicado a 60 cirujanos dentistas que laboran en la práctica privada en la ciudad de Chachapoyas. Los resultados evidencian que el 41.66% de los encuestados presenta nivel de conocimiento alto sobre ética, el 48.33% presenta nivel de conocimiento medio y el 10% de los cirujanos dentistas presenta un nivel de conocimiento sobre ética bajo, por otro lado al encuestar a los cirujanos dentistas sobre aplicación de la ética previo a la emisión de un plan de tratamiento, el 80% de cirujanos dentistas indica que si aplica los principios éticos previo a la emisión de un plan de tratamiento, mientras que solo el 20% de los cirujanos dentistas, menciona que no aplica los principios éticos previo a la emisión de un plan de tratamiento. Concluyendo que los cirujanos dentistas de Chachapoyas si aplican la ética en su ejercicio profesional, pero que hay todavía un grupo reducidos de cirujanos dentistas que no lo realiza

Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories: a pooled analysis of 2181 population-based studies with 65 million participants

Summary Background Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents. Methods For this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5–19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence. Findings We pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the Netherlands, Montenegro, Estonia, and Bosnia and Herzegovina for boys; and the Netherlands, Montenegro, Denmark, and Iceland for girls) and those with the shortest populations (Timor-Leste, Laos, Solomon Islands, and Papua New Guinea for boys; and Guatemala, Bangladesh, Nepal, and Timor-Leste for girls). In the same year, the difference between the highest mean BMI (in Pacific island countries, Kuwait, Bahrain, The Bahamas, Chile, the USA, and New Zealand for both boys and girls and in South Africa for girls) and lowest mean BMI (in India, Bangladesh, Timor-Leste, Ethiopia, and Chad for boys and girls; and in Japan and Romania for girls) was approximately 9–10 kg/m2. In some countries, children aged 5 years started with healthier height or BMI than the global median and, in some cases, as healthy as the best performing countries, but they became progressively less healthy compared with their comparators as they grew older by not growing as tall (eg, boys in Austria and Barbados, and girls in Belgium and Puerto Rico) or gaining too much weight for their height (eg, girls and boys in Kuwait, Bahrain, Fiji, Jamaica, and Mexico; and girls in South Africa and New Zealand). In other countries, growing children overtook the height of their comparators (eg, Latvia, Czech Republic, Morocco, and Iran) or curbed their weight gain (eg, Italy, France, and Croatia) in late childhood and adolescence. When changes in both height and BMI were considered, girls in South Korea, Vietnam, Saudi Arabia, Turkey, and some central Asian countries (eg, Armenia and Azerbaijan), and boys in central and western Europe (eg, Portugal, Denmark, Poland, and Montenegro) had the healthiest changes in anthropometric status over the past 3·5 decades because, compared with children and adolescents in other countries, they had a much larger gain in height than they did in BMI. The unhealthiest changes—gaining too little height, too much weight for their height compared with children in other countries, or both—occurred in many countries in sub-Saharan Africa, New Zealand, and the USA for boys and girls; in Malaysia and some Pacific island nations for boys; and in Mexico for girls. Interpretation The height and BMI trajectories over age and time of school-aged children and adolescents are highly variable across countries, which indicates heterogeneous nutritional quality and lifelong health advantages and risks

Repositioning of the global epicentre of non-optimal cholesterol

High blood cholesterol is typically considered a feature of wealthy western countries(1,2). However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world(3) and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health(4,5). However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol-which is a marker of cardiovascular riskchanged from those in western Europe such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL cholesterol was responsible for an estimated 3.9 million (95% credible interval 3.7 million-4.2 million) worldwide deaths, half of which occurred in east, southeast and south Asia. The global repositioning of lipid-related risk, with non-optimal cholesterol shifting from a distinct feature of high-income countries in northwestern Europe, north America and Australasia to one that affects countries in east and southeast Asia and Oceania should motivate the use of population-based policies and personal interventions to improve nutrition and enhance access to treatment throughout the world.Peer reviewe

Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults

Background Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. Methods We used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5–19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI <18·5 kg/m2) and obesity (BMI ≥30 kg/m2). For schoolaged children and adolescents, we report thinness (BMI <2 SD below the median of the WHO growth reference) and obesity (BMI >2 SD above the median). Findings From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in 11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and 140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%) with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and 42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents, the increases in double burden were driven by increases in obesity, and decreases in double burden by declining underweight or thinness. Interpretation The combined burden of underweight and obesity has increased in most countries, driven by an increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesit

Global variation in diabetes diagnosis and prevalence based on fasting glucose and hemoglobin A1c

Fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) are both used to diagnose diabetes, but these measurements can identify different people as having diabetes. We used data from 117 population-based studies and quantified, in different world regions, the prevalence of diagnosed diabetes, and whether those who were previously undiagnosed and detected as having diabetes in survey screening, had elevated FPG, HbA1c or both. We developed prediction equations for estimating the probability that a person without previously diagnosed diabetes, and at a specific level of FPG, had elevated HbA1c, and vice versa. The age-standardized proportion of diabetes that was previously undiagnosed and detected in survey screening ranged from 30% in the high-income western region to 66% in south Asia. Among those with screen-detected diabetes with either test, the age-standardized proportion who had elevated levels of both FPG and HbA1c was 29-39% across regions; the remainder had discordant elevation of FPG or HbA1c. In most low- and middle-income regions, isolated elevated HbA1c was more common than isolated elevated FPG. In these regions, the use of FPG alone may delay diabetes diagnosis and underestimate diabetes prevalence. Our prediction equations help allocate finite resources for measuring HbA1c to reduce the global shortfall in diabetes diagnosis and surveillance