Fundación Para La Investigación Y Gestión En Servicios de Salud

Background and Objectives: We aimed to describe early real-world visual, refractive, and safety outcomes following implantation of a novel hybrid full range of vision intraocular lens (IOL) in patients undergoing cataract surgery. Materials and Methods: This prospective, single-center, non-randomized clinical study included 50 patients (100 eyes) undergoing bilateral sequential cataract surgery with implantation of the Max Vision™ IOL. Uncorrected and corrected distance visual acuity (UDVA, CDVA) and uncorrected near visual acuity (UNVA) at 32 cm and 40 cm were assessed using logarithmic charts. Spherical equivalent (SE) refraction, intraocular pressure (IOP), and safety outcomes were recorded preoperatively and at postoperative day 1, week 1, and month 1. Preoperative and postoperative values were compared statistically. Results: The mean age was 66.1 ± 7.9 years. At 1 month, mean UDVA improved from 0.58 ± 0.24 to 0.01 ± 0.03 logMAR, and mean CDVA from 0.18 ± 0.20 to -0.001 ± 0.01 logMAR (both p < 0.001). Mean UNVA improved from 0.64 ± 0.18 to 0.19 ± 0.10 logMAR at 32 cm and from 0.61 ± 0.15 to 0.13 ± 0.11 logMAR at 40 cm (both p < 0.001). Mean SE changed from 1.16 ± 1.7 D preoperatively to 0.04 ± 0.4 D at 1 month (p < 0.001). Mean IOP showed a transient increase on postoperative day 1 followed by a reduction at 1 month, without the need for additional hypotensive therapy. No eyes lost two or more lines of CDVA. One posterior capsular rupture occurred without postoperative sequelae. Conclusions: At 1 month after cataract surgery, implantation of the Max Vision™ IOL was associated with improved distance and near visual acuity, early refractive accuracy, and no major short-term safety concerns, under routine clinical conditions.

The province of Pastaza is a biodiversity hotspot in the Amazon but lacks up-to-date inventories of its herpetofauna. This study aimed to provide an updated characterization of the richness, composition and conservation status of amphibians and reptiles in different habitats. Between 2013 and 2018, standardized sampling was carried out using quadrats (8 × 8 m) and transects (100 × 20 m), as well as pitfall traps and daytime and night-time visual censuses. A total of 900 h of effort was distributed across six habitats. Coverage estimators, species accumulation curves, range abundance curves, and alpha diversity indices (Shannon, Simpson, and Chao-1) were used for data analysis, as well as similarity indices (Jaccard). A total of 75 species were recorded (51 anurans, eight lizards, 14 snakes and two salamanders), displaying habitat-dependent dominance patterns led by Dendropsophus sarayacuensis and Scinax ruber. Diversity is considered high according to the Chao-1 (19.63-60.53), Shannon-Weaver (2.402-3.223), and Simpson (0.861-0.947) indices, showing interannual variation with a temporary decrease in year 5 and an increase in year 6. The presence of species at risk (VU, n = 26 spp. and EN, n = 2) and high temporal variability highlight the need for continuous monitoring and conservation strategies tailored to specific habitats.

Biotic homogenization and differentiation are two possible outcomes of tropical forest fragmentation with ramifications for biodiversity conservation. The extent of either outcome may vary depending on spatial scale and heterogeneity of climate and habitats, but these relationships remain poorly understood for taxonomic, functional, and phylogenetic metrics of diversity. Our goal was to determine the extent to which fragmentation is associated with biotic homogenization and/or differentiation across multiple levels of diversity at landscape versus regional scales. We examined diversity and similarity of understory bird communities in northwestern Ecuador, an ecoregion characterized by climatic variation, habitat loss and fragmentation, and high levels of biodiversity and endemism. At the landscape level, fragmentation was associated with biotic differentiation of understory bird communities between formerly contiguous intact and fragmented humid forests. At the regional scale, we found taxonomic homogenization across climate zones and forest types: the bird community in the fragmented humid landscape was as similar to the nearby intact humid forest community (mean distance = 3.1 km) as it was to that of drier, seasonal intact forest 60 km away. Patterns of landscape-level differentiation and regional homogenization were present but substantially less pronounced for functional and phylogenetic diversity, indicating functional and phylogenetic redundancy despite turnover and abundance shifts among dominant species. Our results suggest fragmentation of tropical forest (associated with homogenization between humid and drier/seasonal forest) may have similar impacts on communities as climate drying, and while many species may be lost, fragmented communities may retain some functional and evolutionary resilience against environmental stressors.

Growing evidence suggests pesticide exposure can affect emotional well-being; limited research exists across adolescence and young adulthood. We examined cross-sectional and longitudinal associations of pesticide biomarkers with anxiety and depression scores. We analyzed 646 participants from Ecuadorian agricultural communities: 510 in 2016 (ages 11-17y) and 485 in 2022 (17-24y). Twelve urinary insecticide metabolites were measured. Validated questionnaires assessed depression and anxiety. Generalized estimating equations (GEE) estimated associations for continuous scores and logit GEE calculated odds ratios (OR) of elevated symptoms, adjusting for demographic and anthropometric variables. In 2016, an interquartile range higher overall pesticides summed (β=1.01 95%CI:[0.48, 1.53]), organophosphates summed (β=0.99 [0.47, 1.51]), 3,5,6-trichloro-2-pyridinol (TCPy; β=0.97 [0.49, 1.45]), pyrethroids summed (β=0.69 [0.11, 1.27]) and 3-phenoxybenzoic acid (β=0.31 [0.01, 0.61]) were positively associated with depression. Detectable 5-hydroxy imidacloprid (OHIM) doubled elevated depression odds. In 2022, higher sulfoxaflor isomers were protective, but higher clothianidin increased elevated depression odds. Longitudinally, depression was positively associated with overall pesticides summed (β=0.06 [0.02, 0.11]), organophosphates summed (β=0.05 [0.001, 0.10]), TCPy (β=0.06 [0.02, 0.10]), pyrethroids summed and trans-3-(2,2-dichlorovinyl)-2,2-dimethylcyclopropane carboxylic acid (trans-DCCA; β=0.01 [0.003, 0.02]). For anxiety, in 2016 detectable trans-DCCA (OR=2.52 [1.52, 4.16]) was associated with elevated symptoms. In 2022, higher clothianidin increased elevated anxiety odds (OR=1.44 [1.07, 1.93]). Longitudinally, trans-DCCA (OR=1.39 [1.03, 1.87]) and OHIM (OR=1.44 [1.02, 2.04]) increased elevated anxiety odds. Organophosphates, pyrethroids, and neonicotinoids were generally linked to higher depression and anxiety, while sulfoximines and one organophosphate appeared protective. OHIM and trans-DCCA showed consistent adverse associations across years.

In raptors, size-related differences between sexes affect the choice of prey. While the broad patterns of the globally endangered black-and-chestnut eagle’s (Spizaetus isidori) feeding habits are known in the northern Andes, specific knowledge of the sex-related diet differences in the species remains unknown. Here, we conducted direct observations to evaluate the differences in prey size between female and male eagles, as well as the numerical rates of prey delivery to nestlings, and the differences in prey diversity between sexes, in nine nests in Ecuador. Males provided more prey to nestlings than females (227 vs. 99 prey items, respectively), and females hunted heavier prey than males (on average 1.19 vs. 0.95 kg, respectively). The overlap in captured prey between sexes was relatively high (O = 0.67), which suggests potential for competition. There was no difference between male and female black-and-chestnut eagles in either prey diversity or the composition of the prey species when considering the main prey items. However, the sexes differed in the prey items at lower biomass contributions. Males’ prey were primarily bird species from the orders Galliformes, Columbiformes, and Psittaciformes, while females’ prey were mostly mammal species from the orders Primates and Carnivora, and some passerine birds. Both sexes preferred arboreal species, but males hunted more scansorial and terrestrial prey. Our data suggest that sex-related differences in the eagle’s dietary contribution to nestlings likely result from parental role differentiation, rather than intersexual competition.

Storytelling is a powerful pedagogical tool that enhances critical thinking, creativity, and student engagement by presenting complex concepts through narratives. This scoping review examines the integration of storytelling in Science, technology, engineering, and mathematics (STEM) education, focusing on its implementation, methodologies, and outcomes across primary and secondary levels. A total of 61 studies were analyzed to map key aspects of the interventions, including participant characteristics, educational levels, research approaches, and tools utilized. Results indicate a predominance of storytelling interventions in primary levels and science-related subjects, often employing digital narratives. The findings highlight the potential of storytelling to develop technical, cognitive, and socio-emotional skills, such as critical thinking, creativity, and collaboration, fostering interest in STEM fields. However, gaps persist in terms of the inclusion of storytelling strategies designed and applied to minority groups such as women and indigenous populations. This review underscores the need for more diverse, inclusive and rigorous approaches to maximize the impact of storytelling in STEM education.

There are limited longitudinal data from non-industrialized settings on patterns and determinants of gut bacterial microbiota development in early childhood. We analysed epidemiological data and stool samples collected from 60 children followed from early infancy to 5 years of age in a rural tropical district in coastal Ecuador. Data were collected longitudinally on a wide variety of individual, maternal, and household exposures. Extracted DNA from stool samples were analysed for bacterial microbiota using 16S rRNA gene sequencing. Both alpha and beta diversity indices suggested stable profiles towards 5 years of age. Greater alpha diversity and lower beta diversity were associated with factors typical of rural poverty including low household incomes, overcrowding, and greater agricultural and animal exposures. Consumption of unpasteurized milk was consistently associated with greater alpha diversity indices. Delivery method and antibiotic exposures during pregnancy and early childhood appeared to have limited effects on developmental trajectories of gut microbiota. Infants living in a non-industrialized setting in conditions of greater poverty and typically rural exposures appeared to acquire more rapidly a stable and diverse gut bacterial microbiome during childhood.

The detection and validation of novel pathogens have become increasingly important, as seen with the emergence of COVID-19 and mpox. Current detection and response capacities, especially in resource-poor regions, are insufficient, highlighting the key role of clinical laboratories. Despite the strides made by national and supranational agencies in targeting viruses and bacteria, parasites have been largely overlooked. The case of Urbanorum, a purportedly novel intestinal parasite reported from South America, illustrates the challenges in validating new pathogens. Compelling microscopic images have fostered belief in the existence and aetiological role of Urbanorum, posing grave challenges for health-care workers with poor parasitological knowledge, who might accept such results at face value and administer unnecessary treatments to affected individuals. Although the number of publications is scarce, these sources present a seemingly credible narrative that spreads through local social media. However, doubts about the existence of Urbanorum persist due to the absence of genetic and molecular analyses and inconsistencies in epidemiological data. This situation exemplifies the need for robust global pathogen verification mechanisms and authoritative guidance from organisations such as the US Centers for Disease Control and Prevention (CDC) and WHO to prevent misinformation and aid clinical judgement. A Latin American regional CDC could be instrumental in verifying claims of novel pathogens and providing credible guidance at both local and global levels. This Personal View emphasises the urgent need for enhanced global coordination, improved diagnostic methodologies, and reliable information dissemination to effectively manage threats regarding emerging pathogens.

Per- and polyfluoroalkyl substances (PFASs) and pesticides are ubiquitous environmental exposures with increasingly recognized adverse health outcomes; however, their impact on lung function, particularly in combination, remains poorly understood. We included 381 adolescent participants from a prospective cohort study in Ecuador who underwent measurements of serum PFAS (perfluorooctanoic acid [PFOA], perfluorooctanesulfonic acid [PFOS] and perfluorononanoic acid [PFNA]) and urinary herbicides (glyphosate, 2,4D) and fungicides (ethylene thiourea) and had spirometric measurements in either 2016 or 2022. We characterized the association between each PFAS or pesticide and each lung function measure in log-log models estimated via ordinary least squares regression. We used quantile g-computation to assess the association of the mixture of PFAS and pesticides with lung function outcomes. After accounting for multiple hypothesis testing, and in models adjusting for household income, parental education, and exposure to tobacco, we found that, individually, PFOA, glyphosate, and ETU were associated with slight increases in FEV1/FVC between 2016 and 2022. No other individual associations were significant. In mixtures analyses, a one quartile increase in all PFASs and pesticides simultaneously was also not associated with statistically significant changes in lung function outcomes after accounting for multiple hypothesis testing. In large part, we do not provide evidence for associations of PFAS and herbicide and fungicide pesticides with lung function among adolescents in moderate-to-high-altitude agricultural communities in Ecuador.