Genotyped indigenous Kiwcha adults at high altitude are lighter and shorter than their low altitude counterparts

Background Anthropometric measures have been classically used to understand the impact of environmental factors on the living conditions of individuals and populations. Most reference studies on development and growth in which anthropometric measures were used were carried out in populations that are located at sea level, but there are few studies carried out in high altitude populations. Objective The objective of this study was to evaluate the anthropometric and body composition in autochthonous Kiwcha permanently living at low and high altitudes. Methodology A cross-sectional study of anthropometric and body composition between genetically matched lowland Kiwcha from Limoncocha (n = 117), 230 m in the Amazonian basin, and high-altitude Kiwcha from Oyacachi (n = 95), 3800 m in Andean highlands. Student's t-test was used to analyze the differences between continuous variables, and the chi-square test was performed to check the association or independence of categorical variables. Fisher's exact test or Spearman's test was used when the variable had evident asymmetries with histograms prior to the selection of the test. Results This study shows that high altitude men are shorter than their counterparts who live at low altitude, with p = 0.019. About body muscle percentage, women at high altitudes have less body muscle percentage (− 24.8%). In comparison, men at high altitudes have significantly more muscle body mass percentage (+ 13.5%) than their lowland counterparts. Body fat percentage was lower among low altitude women (− 15.5%), and no differences were found among men. Conclusions This is the first study to be performed in two genotyped controlled matching populations located at different altitudes to our best knowledge. The anthropometric differences vary according to sex, demonstrating that high altitude populations are, in general, lighter and shorter than their low altitude controls. Men at high altitude have more muscled bodies compared to their lowland counterparts, but their body age was older than their actual age

SARS-CoV-2 viral load analysis at low and high altitude: A case study from Ecuador

SARS-CoV-2 has spread throughout the world, including remote areas such as those located at high altitudes. There is a debate about the role of hypobaric hypoxia on viral transmission and COVID-19 incidence. A descriptive cross-sectional analysis of SARS-CoV-2 infection and viral load among patients living at low (230 m) and high altitude (3800 m) in Ecuador was completed. Within these two communities, the total number of infected people at the time of the study was 108 cases (40.3%). The COVID-19 incidence proportion at low altitude was 64% while at high altitude was 30.3%. The mean viral load from those patients who tested positive was 3,499,184 copies/mL (SD = 23,931,479 copies/mL). At low altitude (Limoncocha), the average viral load was 140,223.8 copies/mL (SD = 990,840.9 copies/mL), while for the high altitude group (Oyacachi), the mean viral load was 6,394,789 copies/mL (SD = 32,493,469 copies/mL). We found no statistically significant differences when both results were compared (p = 0.056). We found no significant differences across people living at low or high altitude; however, men and younger populations had higher viral load than women older populations, respectivel

A comparative analysis of lung function and spirometry parameters in genotype-controlled natives living at low and high altitude

Background: The reference values for lung function are associated to anatomical and lung morphology parameters, but anthropometry it is not the only influencing factor: altitude and genetics are two important agents affecting respiratory physiology. Altitude and its influence on respiratory function has been studied independently of genetics, considering early and long-term acclimatization. Objective: The objective of this study is to evaluate lung function through a spirometry study in autochthonous Kichwas permanently living at low and high-altitude. Methodology: A cross-sectional study of spirometry differences between genetically matched lowland Kichwas from Limoncocha (230 m) at Amazonian basin and high-altitude Kichwas from Oyacachi (3,180 m) in Andean highlands. Chi-square method was used to analyze association or independence of categorical variables, while Student's t test was applied to comparison of means within quantitative variables. ANOVA, or in the case that the variables didn't meet the criteria of normality, Kruskal Wallis test were used to compare more than two groups. Results: People from Oyacachi (high altitude) showed a higher predicted values than those from Limonocha (low altitude). The FVC and the FEV1 were significantly greater among highlanders than lowlanders (p value < 0.001). The FEV1/FVC was significantly higher among lowlanders than highlanders for men and women. A restrictive pattern was found in 12.9% of the participants. Conclusion: Residents of Oyacachi had greater lung capacity than their peers from Limoncocha, a finding physiologically plausible according to published literature. When analyzing the spirometric patterns obtained in these populations, it was evident that no person had an obstructive pattern, while on the other hand, the restrictive pattern appeared in Limoncocha and Oyacachi populations in 12.9% although it is clear that there is a predominance of this in the individuals belonging to Limoncocha

Hematological parameters, lipid profile and cardiovascular risk analysis among genotype-controlled indigenous Kichwa men and women living at low and high altitudes

Introduction: Human adaptation to high-altitude is due to characteristic adjustments at every physiological level. Differences in lipid profile and cardiovascular risk factors in altitude dwellers have been previously explored, nevertheless there are no reports available on genotype-controlled matches among different altitude adapted indigenous populations. Objective: To explore the possible differences in plasma lipid profile and cardiovascular risk among autochthonous Kiwcha people inhabitants of low and high-altitude locations. Methodology: A cross-sectional analysis of plasmatic lipid profiles and cardiovascular risk factors in lowland Kiwchas from Limoncocha (230 m) and high-altitude Kiwchas from Oyacachi (3,800 m). Results: In the low altitude group, 66% were women (n=78) and 34% (n=40) were men, while at high altitude, 59% (n=56) were women and 41% (n=41%) were men. We found the proportion of overweight and obese individuals to be higher among low altitude dwellers (p<0.05). Red blood cells (RBC), Hemoglobin concentration and SpO2% were higher among high altitude dwellers and erythrocyte's size was found to be smaller at high altitude .The group located at low altitude showed also lower levels of plasma cholesterol, LDL and HDL but most of these differences are not influenced by gender or elevation. Conclusions: Living at altitude elicits well-known adaptive physiological changes such as erythrocyte count, hemoglobin concentration, hematocrit, and serum glucose. We report also clinical differences in the plasma lipid profile, with higher levels of cholesterol and high density and low-density lipoproteins in Andes Mountain inhabitants versus their Amazonian basin peers. Despite we found altered underlying physiological pathways between the populations, this does not allow in a different cardiovascular risk

Stroke related mortality at different altitudes: A 17-year nationwide population-based analysis from Ecuador

Worldwide, more than 5.7% of the population reside above 1,500m of elevation. It has been hypothesized that acute short-term hypoxia exposure could increase the risk of developing a stroke. Studies assessing the effect of altitude on stroke have provided conflicting results, some analyses suggest that long-term chronic exposure could be associated with reduced mortality and lower stroke incidence rates. An ecological analysis of all stroke hospital admissions, mortality rates and disability-adjusted life years in Ecuador was performed from 2001-2017. The cases and population at risk were categorized in low (<1,500m), moderate (1,500m -2,500m), high (2,500m -3,500m) and very high altitude (3,500-5,500m) according to the place of residence. The derived crude and direct standardized age-sex adjusted mortality and hospital admission rates were calculated. A total of 38,201 deaths and 75,893 stroke-related hospital admissions were reported. High altitude populations (HAP) had lower stroke mortality in men (OR: 0.91 [0.88 - 0.95]) and women (OR: 0.83 [0.79 - 0.86]). In addition, HAP had a significant lower risk of getting admitted to the hospital when compared with the low altitude group in men (OR: 0.55 [CI95% 0.54 - 0.56]) and women (OR: 0.65 [CI95% [0.64 - 0.66]). This is the first epidemiological study that aims to elucidate the association between stroke and altitude using four different elevation ranges. Our findings suggest that living at higher elevations offers a reduction or the risk of dying due to stroke as well as a reduction in the probability of being admitted to the hospital. Nevertheless, this protective factor has a stronger effect between 2,000m to 3,500 m

Uso de fuentes de información y tecnologías de la información y comunicación (TIC) según el tipo de universidsad en siete países de América Latina

Objetivos: Identificar el uso de fuentes de información, así como, tecnologías de la información y comunicación (TIC) según el tipo de universidad en siete países de América Latina.Métodos:Estudio transversal en estudiantes de medicina de siete países de América Latina. Se midió el uso de fuentes y tecnologías de información y comunicación con el autoreporte sobre el uso de buscadores científicos (SciELO, PubMed, Google Scholar) y TIC (laptop, smartphone, wifi). Las variables secundarias fueron el país y el tipo de universidad de procedencia (pública/privada) de los estudiantes de medicina. Resultados: De 4463 encuestados, SciELO fue usado por el 83.3% y el 55.0% en una universidad pública y privada, respectivamente. Mientras que PubMed fue reportado por el 79.9% y 59.2% de estudiantes de universidad pública y privada, respectivamente. Las universidades privadas tuvieron mayor uso de TIC en Panamá y Bolivia, en contraste con aquellas de tipo públicas fueron Paraguay, México, Colombia y Argentina. La mayoría de los estudiantes usaban smartphone en más del 60%. Conclusiones: Se identificó que el smartphone fue utilizado por la mayoría de los estudiantes. El uso de Internet fue mayor en estudiantes de universidades privadas, además, no se encontraron grandes porcentajes del uso de PubMed y SciELO, en universidades públicas y privadas. Se deben reforzar las estrategias educativas en el campo de la educación médica, debido a pobre cultura de manejo de información basada en evidencias

5to. Congreso Internacional de Ciencia, Tecnología e Innovación para la Sociedad. Memoria académica

El V Congreso Internacional de Ciencia, Tecnología e Innovación para la Sociedad, CITIS 2019, realizado del 6 al 8 de febrero de 2019 y organizado por la Universidad Politécnica Salesiana, ofreció a la comunidad académica nacional e internacional una plataforma de comunicación unificada, dirigida a cubrir los problemas teóricos y prácticos de mayor impacto en la sociedad moderna desde la ingeniería. En esta edición, dedicada a los 25 años de vida de la UPS, los ejes temáticos estuvieron relacionados con la aplicación de la ciencia, el desarrollo tecnológico y la innovación en cinco pilares fundamentales de nuestra sociedad: la industria, la movilidad, la sostenibilidad ambiental, la información y las telecomunicaciones. El comité científico estuvo conformado formado por 48 investigadores procedentes de diez países: España, Reino Unido, Italia, Bélgica, México, Venezuela, Colombia, Brasil, Estados Unidos y Ecuador. Fueron recibidas un centenar de contribuciones, de las cuales 39 fueron aprobadas en forma de ponencias y 15 en formato poster. Estas contribuciones fueron presentadas de forma oral ante toda la comunidad académica que se dio cita en el Congreso, quienes desde el aula magna, el auditorio y la sala de usos múltiples de la Universidad Politécnica Salesiana, cumplieron respetuosamente la responsabilidad de representar a toda la sociedad en la revisión, aceptación y validación del conocimiento nuevo que fue presentado en cada exposición por los investigadores. Paralelo a las sesiones técnicas, el Congreso contó con espacios de presentación de posters científicos y cinco workshops en temáticas de vanguardia que cautivaron la atención de nuestros docentes y estudiantes. También en el marco del evento se impartieron un total de ocho conferencias magistrales en temas tan actuales como la gestión del conocimiento en la universidad-ecosistema, los retos y oportunidades de la industria 4.0, los avances de la investigación básica y aplicada en mecatrónica para el estudio de robots de nueva generación, la optimización en ingeniería con técnicas multi-objetivo, el desarrollo de las redes avanzadas en Latinoamérica y los mundos, la contaminación del aire debido al tránsito vehicular, el radón y los riesgos que representa este gas radiactivo para la salud humana, entre otros

Potential research ethics violations against an indigenous tribe in Ecuador: a mixed methods approach

BACKGROUND: Biomedical and ethnographic studies among indigenous people are common practice in health and geographical research. Prior health research misconduct has been documented, particularly when obtaining genetic material. The objective of this study was to crossmatch previously published data with the perceptions of the Waorani peoples about the trading of their genetic material and other biological samples.METHODS: We conducted a mixed methods study design using a tailored 15-item questionnaire in 72 participants and in-depth interviews in 55 participants belonging to 20 Waorani communities about their experiences and perceptions of participating in biomedical research projects. Additionally, we conducted a systematic review of the literature in order to crossmatch the published results of studies stating the approval of an ethics committee and individual consent within their work.RESULTS: A total of 40 men (60%) and 32 women (40%), with a mean age of 57 ± 15 years agreed to be interviewed for inclusion. Five main categories around the violation of good clinical practices were identified, concerning the obtention of blood samples from a recently contacted Waorani native community within the Amazonian region of Ecuador. These themes are related to the lack of adequate communication between community members and researchers as well as the voluntariness to participate in health research. Additionally, over 40 years, a total of 38 manuscripts related to the use of biological samples in Waorani indigenous people were published. The majority of the studies (68%) did not state within their article obtaining research ethics board approval, and 71% did not report obtaining the informed consent of the participants prior to the execution of the project.CONCLUSION: Clinical Research on the Waorani community in the Ecuadorian Amazon basin has been performed on several occasions. Unfortunately, the majority of these projects did not follow the appropriate ethical and professional standards in either reporting the results or fulfilling them. The results of our investigation suggest that biological material, including genetic material, has been used by researchers globally, with some omitting the minimum information required to guarantee transparency and good clinical practices. We highlight the importance of stating ethics within research to avoid breaches in research transparency.</p

Analysis of Excess Mortality Data at Different Altitudes During the COVID-19 Outbreak in Ecuador

Ortiz-Prado, Esteban, Raul Patricio Fernandez Naranjo, Eduardo Vasconez, Katherine Simbaña-Rivera, Trigomar Correa-Sancho, Alex Lister, Manuel Calvopiña, and Ginés Viscor. Analysis of excess mortality data at different altitudes during the COVID-19 outbreak in Ecuador. High Alt Med Biol. 22:406-416, 2021. Background: It has been speculated that living at high altitude confers some risk reduction in terms of SARS-CoV-2 infection, reduced transmissibility, and arguable lower COVID-19-related mortality. Objective: We aim to determine the number of excess deaths reported in Ecuador during the first year of the COVID-19 pandemic in relation to different altitude categories among 221 cantons in Ecuador, ranging from sea level to 4,300 m above. Methods: A descriptive ecological country-wide analysis of the excess mortality in Ecuador was performed since March 1, 2020, to March 1, 2021. Every canton was categorized as lower (for altitudes 2,500 m or less) or higher (for altitudes &gt;2,500 m) in a first broad classification, as well as in two different classifications: The one proposed by Imray et al. in 2011 (low altitude &lt;1,500 m, moderate altitude 1,500-2,500 m, high altitude 2,500-3,500 m, or very high altitude 3,500-5,500 m) and the one proposed by Bärtsch et al. in 2008 (near sea level 0-500 m, low altitude 500-2,000 m, moderate altitude 2,000-3,000 m, high altitude 3,000-5,500 m, and extreme altitude 5,500 m). A Poisson fitting analysis was used to identify trends on officially recorded all-caused deaths and those attributed to COVID-19. Results: In Ecuador, at least 120,573 deaths were recorded during the first year of the pandemic, from which 42,453 were catalogued as excessive when compared with the past 3 years of averages (2017-2019). The mortality rate at the lower altitude was 301/100,000 people, in comparison to 242/100,000 inhabitants in elevated cantons. Considering the four elevation categories, the highest excess deaths came from towns located at low altitude (324/100,000), in contrast to the moderate altitude (171/100,000), high-altitude (249/100,000), and very high-altitude (153/100,000) groups. Conclusions: This is the first report on COVID-19 excess mortality in a high-altitude range from 0 to 4,300 m above sea level. We found that absolute COVID-19-related excess mortality is lower both in time and in proportion in the cantons located at high and very high altitude when compared with those cantons located at low altitude.</p

Attitudes and perceptions of medical doctors towards the local health system: a questionnaire survey in Ecuador

BACKGROUND: Health systems worldwide rely on health professionals to deliver services and provide framework structures. Considering their opinions about their work environment, the public policies that regulate their work and the deficiencies of the health care system are key aspects of the governance within the system. The aim of this study was to assess the perceptions of Ecuadorian physicians about several aspects of the performance of the health delivery and monitoring systems locally.METHODS: A cross-sectional survey was performed in a group of physicians in Ecuador during 2017 using a self-selection sampling strategy. The participants were contacted by telephone, direct email or in person and asked to complete the online survey which contained 47 questions.RESULTS: A total of 607 full responses were received from physicians, where 68.6% of those had graduated within the last 17 years. 46.4% of respondents were medical specialists, 23.1% general practitioners, 10.0% rural health practitioners, 9.5% sub-specialists, 5.9% were formally enrolled in a specialty program and 5.1% were researchers or administrative physicians. Data analysis of the answers showed that approximately 62% of physician respondents in the study found their current workload at the time of the survey was unmanageable, the most common complaints about the Public Health system in the study being the amount of daily paperwork (78.4%), followed by a perceived lack of vision of the health authorities (60.1%) and the resource limitations within the public hospitals (53.5%). Additionally, 71.8% of respondents referred to limitations of the National Essential Medicines chart- especially on the availability of some drugs- and 57.5% of the respondents reported concerns about the quality of medicines available for treatment.CONCLUSIONS: The data provide basic inputs for health authorities regarding the functioning of the health system in Ecuador. Health professionals' concerns can be a valuable resource for monitoring and improving health system performance: however, there is a perceived sense of disconnection between the governance or management and the service delivery arms of the healthcare system in Ecuador. Whilst not representative of the entirety of the population of doctors, the study does give insight into where improvements to the health system might be made.</p