Future fire-smoke PM2.5 health burden under climate change in Paraguay

Recent years have seen a rise in wildfire and extreme weather activity across the globe, which is projected to keep increasing with climate-induced conditions. Air pollution, especially fine particulate matter (PM2.5) concentration, is heavily affected by PM2.5 emissions from wildfire activity. Paraguay has been historically suffering from fires, with an average of 2.3 million hectares burnt per year during the 2003-2021 period. Annual PM2.5 concentration in Paraguay is 13.2 μg/m3, more than double the recommended by the WHO. We estimate that, historically, almost 40 % of fine air particulates can be attributed to fires. Using a random forest algorithm, we estimate future fire activity and fire related PM2.5 under different climate change scenarios. With global warming, we calculate that fire activity could increase by up to 120 % by 2100. Annual fire smoke PM2.5 from fires is expected to increase by 7.7 μg/m3 by 2100. Under these conditions, Paraguay is expected to suffer an increase in 3500 deaths per year attributable to fire smoke PM2.5 by 2100. We estimate the economic cost of fire smoke-related mortality by 2100 at US $ 5600 million, equivalent to 2.6 % of Paraguay's GDP, excluding other health- and productivity-related impacts on society.

C1q and HBHA-specific IL-13 levels as surrogate plasma biomarkers for monitoring tuberculosis treatment efficacy: a cross-sectional cohort study in Paraguay

Introduction

New diagnostic tools are needed to rapidly assess the efficacy of pulmonary tuberculosis (PTB) treatment. The aim of this study was to evaluate several immune biomarkers in an observational and cross-sectional cohort study conducted in Paraguay.

Methods

Thirty-two patients with clinically and microbiologically confirmed PTB were evaluated before starting treatment (T0), after 2 months of treatment (T1) and at the end of treatment (T2). At each timepoint plasma levels of IFN-y, 17 pro- and anti-inflammatory cytokines/chemokines and complement factors C1q, C3 and C4 were assessed in unstimulated and Mtb-specific stimulated whole blood samples using QuantiFERON-TB gold plus and recombinant Mycobacterium smegmatis heparin binding hemagglutinin (rmsHBHA) as stimulation antigen. Complete blood counts and liver enzyme assays were also evaluated and correlated with biomarker levels in plasma.

Results

In unstimulated plasma, C1q (P<0.001), C4 (P<0.001), hemoglobin (P<0.001), lymphocyte proportion (P<0.001) and absolute white blood cell count (P=0.01) were significantly higher in PTB patients at baseline than in cured patients. C1q and C4 levels were found to be related to Mycobacterium tuberculosis load in sputum. Finally, a combinatorial analysis identified a plasma host signature comprising the detection of C1q and IL-13 levels in response to rmsHBHA as a tool differentiating PTB patients from cured TB profiles, with an AUC of 0.92 (sensitivity 94% and specificity 79%).

Conclusion

This observational study provides new insights on host immune responses throughout anti-TB treatment and emphasizes the role of host C1q and HBHA-specific IL-13 response as surrogate plasma biomarkers for monitoring TB treatment efficacy.

Rescue and rehabilitation of maned wolf (Chrysocyon brachyurus) in Paraguay: Case description

The maned wolf, Chrysocyon brachyurus, is the largest South American canid, with a natural distribution that stretches across Peru, Bolivia, Brazil, Argentina, Paraguay and Uruguay. The present study reports the case of a rescued specimen of maned wolf that underwent a rehabilitation process in Paraguay, starting in October 2020 with its rescue, and finalising in May 2021 with the reintroduction. Herein, we document findings regarding the general management, biometrics, feeding and environmental enrichment; chemical immobilisation and monitoring; haematology, blood biochemistry and specific serology-relevant pathogens; skin examination and bone marrow cytology; orthopaedic, ophthalmological and dental evaluation; abdominal and cardiac ultrasonography; radiology and copro-parasitology. Main findings include the feeding habits of the individual and enrichment opportunities. The animal weighed 7 kg on arrival, with an estimated age of 5 months, and 18 kg on reintroduction, with an estimated age of 1 year. The animal tested negative to serologic tests for Brucella canis, Dirofilaria, canine distemper, Toxoplasmosis and canine parvovirus. Leptospira testing showed antibodies against L. grippotyphosa on both samplings, L. wolffi and L. ictero on the first sampling, and L. pomona on the second sampling. Abdominal organs were examined and measured through ultrasound evaluation and kidneys showed no alterations. Echocardiography showed preserved mitral, tricuspid and aortic valve flows, but turbulent pulmonary valve flow. Copro-parasitology reported the presence of Lagochilascaris sp. and Balantidium sp. All the information gathered aided in diagnosing the health status of the individual, and the response to environmental enrichment helped assess the behaviour, which led to the suggestion of reintroducing the animal. These data constitute the first published health check of a maned wolf in Paraguay, which can contribute to the species' conservation in the country. The protocol presented in this study can serve as a basis for developing an action plan for the maned wolf in Paraguay.

Hidden Diversity in Eigenmannia (Gymnotiformes: Sternopygidae) Populations from Upper Paraná and Paraguay Rivers

Eigenmannia is a highly diverse genus within the Sternopygidae family, comprising 30 species. Due to its complex taxonomy, molecular analyses have been crucial for species delimitation within this group. Therefore, the present study presents a genetic analysis using sequences of the mitochondrial gene cytochrome c oxidase subunit 1 (COI) in specimens previously identified through alpha taxonomy as E. correntes (with unpublished data), E. virescens, and E. trilineata, originating from various locations within the Upper Paraná and Paraguay River basins in Brazil. The molecular data confirm the taxonomic complexity of the genus, as individuals morphologically identified as E. virescens and E. trilineata shared the same haplotype (H52). Furthermore, the results of the species delimitation tests suggest that specimens morphologically identified as E. virescens belong to the species E. trilineata. In addition, samples morphologically identified as E. correntes may correspond to more than one Operational Taxonomic Units (OTUs). Furthermore, the intraspecific Kimura-2-parameter (K2P) distances within the different studied populations are significant. This study has contributed valuable information about genetic diversity in Eigenmannia, emphasizing the importance of using integrative analyses to resolve taxonomic conflicts within the group. It also supports biogeographical studies and assists in biodiversity conservation efforts.

Presence of Paraspidodera uncinata (Nematoda: Heterakidae) and Gyropus ovalis (Phthiraptera: Amblycera) in a wild specimen of Cavia aperea (Rodentia: Caviidae) from the campus of the Universidad Nacional de Asunción, San Lorenzo, Paraguay

An adult specimen of Cavia aperea was transferred to the Wild Animal Practice, in the Department of Wildlife and Natural Environment, Faculty of Veterinary Sciences, National University of Asunción. Fecal samples and necropsy samples revealed the presence of Paraspidodera uncinata in the digestive tract, and Gyropus ovalis. This is the first documented report of the presence of P. uncinata and G. ovalis in a wild specimen of Cavia aperea in Paraguay.

Clinical evolution and mortality of critically ill patients with SARS-CoV-2 pneumonia treated with remdesivir in an adult intensive care unit of Paraguay

BACKGROUND

The health crisis due to Covid-19 led to the search for therapeutics that could improve the evolution of the disease. Remdesivir, an antiviral that interferes with viral replication, was one of the first to be used for the treatment of this pathology.

OBJECTIVE

To determine clinical course and mortality of patients with severe SARS-CoV-2 pneumonia treated with remdesivir, in comparison of those who didn't receive the medication.

PATIENTS AND METHODS

Retrospective cohort study, with medical records review of COVID-19 patients, between August 2020 and August 2021. The subjects were divided into two groups, those who received remdesivir before or after admission to intensive care and those who didn't. The primary outcome variable was mortality in intensive care.

RESULTS

Of 214 subjects included, 109 (50,9%) received remdesivir. The median of days for the drug administration was 8 (2-20), IQR: 3. The bivariate analysis prove that the use of remdesivir was related with lower risk of develop Acute Respiratory Distress Syndrome (ARDS) (p = 0,019; OR: 0,521) and lower requirement of mechanical ventilation (p = 0,006; OR:0,450). Additionally, patients treated with remdesivir develop less kidney injury (p = 0,009; OR: 0,441). There was a total of 82 deaths, 29 (26,6%) in the remdesivir group and 53 (50,5%) in the control group [p < 0,001; OR: 0,356 (0,201-0,630)]. All the risk factors associated with mortality in the bivariate analysis were entered into the multivariate analysis by logistic regression, the use of remdesivir remained associated as an independent protective factor to mortality (p = 0.034; OR: 0.429).

CONCLUSION

Critically ill patients with SARS-CoV-2 pneumonia treated with remdesivir had a lower risk of death and need for mechanical ventilation and develop less ARDS as compared to the control group. No differences were found in the presentation of adverse effects.

[National competitive bidding analysis of osteosynthesis materials in pediatric patients with femur fractures]

INTRODUCTION

health promotion policy requires the identification of barriers to the adoption of public policies. Paraguay's national healthcare system is inequitable, expensive, and inefficient. The Ministry of Public Health and Social Welfare (MSPyBS) is the entity responsible for covering the needs of a significant portion of the population. In January 2022, the MSPyBS financed the purchase of titanium elastic nails through a National Public Tender for Osteosynthesis Materials (LPN 02/22) to provide them for free in the pediatric service. Using research as a tool, we seek to analyze the impact of the implementation of LPN 02/22 at the Trauma Hospital, believing that this action would help streamline administrative and bureaucratic processes, making them more efficient with the assistance of the hospital's human resources.

MATERIAL AND METHODS

a retrospective, analytical, and comparative study conducted at a high-complexity trauma center in Asunción, Paraguay. Patients aged 4 to 14 years with an indication for stabilization with elastic nails were included. Demographic data, the mechanism of injury, time elapsed from hospital arrival to surgical treatment, length of hospital stay, and the average hospital cost were analyzed based on the daily expense of pediatric patient hospitalization.

RESULTS

52 patients, divided into 25 cases in 2021 before implementation and 27 cases after implementation. The time elapsed from hospital arrival to definitive treatment was six days in the pre-implementation period, with an average stay from admission to discharge of 7.4 days. After implementation, the time from hospital arrival to definitive treatment was 4.3 days, and the average discharge time for the Post group was six days. The potential savings per patient amount to 332 dollars, offset by the institution's implant supply cost of 197 dollars, resulting in an approximate savings of 135 dollars per patient for the ministry.

CONCLUSIONS

we view the implementation of free titanium elastic nails for pediatric femur fracture patients positively. We encourage the institution to continue with similar policies and strive to achieve even greater benefits for users.

Mercury and methylmercury concentration in the feathers of two species of Kingfishers Megaceryle torquata and Chloroceryle amazona in the Upper Paraguay Basin and Amazon Basin

Mercury (Hg) contamination remains a significant environmental concern. In aquatic ecosystems, Hg can undergo methylation, forming its organic form, methylmercury (MeHg), which bioaccumulates and biomagnifies in the food chain, ultimately reaching the top predators, including waterfowl. The objective of this study was to investigate the distribution and levels of Hg in wing feathers, with a specific focus on evaluating heterogeneity in the primary feathers of two kingfisher species (Megaceryle torquata and Chloroceryle amazona). The concentrations of total Hg (THg) in the primary feathers of C. amazona individuals from the Juruena, Teles Pires, and Paraguay rivers were 4.724 ± 1.600, 4.003 ± 1.532, and 2.800 ± 1.475 µg/kg, respectively. The THg concentrations in the secondary feathers were 4.624 ± 1.718, 3.531 ± 1.361, and 2.779 ± 1.699 µg/kg, respectively. For M. torquata, the THg concentrations in the primary feathers from the Juruena, Teles Pires, and Paraguay rivers were 7.937 ± 3.830, 6.081 ± 2.598, and 4.697 ± 2.585 µg/kg, respectively. The THg concentrations in the secondary feathers were 7.891 ± 3.869, 5.124 ± 2.420, and 4.201 ± 2.176 µg/kg, respectively. The percentage of MeHg in the samples increased during THg recovery, with an average of 95% in primary feathers and 80% in secondary feathers. It is crucial to comprehend the current Hg concentrations in Neotropical birds to mitigate potential toxic effects on these species. Exposure to Hg can lead to reduced reproductive rates and behavioral changes, such as motor incoordination and impaired flight ability, ultimately resulting in population decline among bird populations.

Adherence to a gluten-free diet in celiac disease patients from Paraguay

INTRODUCTION AND AIM

The treatment for celiac disease is a gluten-free diet that should be strictly and permanently carried out. Our aims were to determine adherence to the gluten-free diet and the risk factors for non-adherence.

MATERIALS AND METHODS

An observational, cross-sectional, comparative study was conducted. It included individuals of both sexes and of any age that presented with celiac disease, lived in Paraguay from January to April 2021, and agreed to participate in the survey. Incomplete questionnaires were excluded. Non-probabilistic convenience sampling was utilized. Adherence was measured using the Leffler questionnaire. The study was approved by the Ethics Committee of the Universidad Privada del Este.

RESULTS

The sample consisted of 371 respondents, 322 (87%) of whom were adults, with a mean age of 38 ± 12 years, and 49 (13%) of whom were children and adolescents, with a mean age of 10 ± 5 years. Female sex was predominant (85%). Adherence to the gluten-free diet was detected in 59% of the adults and 73% of the children and adolescents. The factors significantly associated with adherence included belonging to the child and adolescent age group and having had the diagnosis for a longer time: 9 ± 8 years for the adherence group and 7 ± 8 years for the non-adherence group.

CONCLUSIONS

The present study demonstrated the frequency of adherence to the gluten-free diet in celiac patients in Paraguay. Psychologic and nutritional support is recommended for individuals with celiac disease that do not adhere to their treatment.

[On "the remedies and medications which were given to ailing negroes:" health and death spending on slaves by the Office of the Jesuit Province of Paraguay, 1711-1745]

This text analyzes the way sick slaves were treated at the Office (ofício) of the Jesuit Province of Paraguay and Santa Catalina Farm (estancia) between 1711 and 1745. The sources consulted - Libro de cuentas del Ofício, Memoriales, and Cartas ânuas - reveal that the sickness of the enslaved people generated expenses, not only for medications, clothing, and food, but also for shrouds for their burial. As for the slaves from the Santa Catalina Farm, the sources indicate that depending on the infirmity, they were sometimes sent to Córdoba, where they were treated by laypersons trained in the healing arts, which incurred different expenses, also recorded in the ledgers.

Clinical features and genetic biomarkers associated with different phenotypes of systemic lupus erythematosus in Paraguayan patients

Systemic lupus erythematosus (SLE) is a complex autoimmune disease characterized by a heterogeneous clinical picture that makes the diagnosis and follow-up of these patients difficult. This study aimed to identify correlations between clinical, immunological, and genetic biomarkers and clinical manifestations in SLE. A retrospective study of data from medical records and immunological and genetic studies of SLE patients in Paraguay was carried out. A descriptive analysis was performed based on the type of variable. Human leukocyte antigen (HLA) allele frequencies (DPA1, DPB1, DQA1, DQB1, and DRB1) were calculated, and univariate logistic regression analyses were performed between each of the explanatory variables and the presence or absence of each phenotype. Odds ratios, 95% confidence intervals, and p values were recorded. Associations with p<0.05 were considered statistically significant. 104 SLE patients were included: 86% were female, with a mean age of 32.80±10.36 years. An association was identified between anti-double stranded DNA (anti-dsDNA) and the presence of the renal phenotype and between anti-dsDNA and the absence of the joint and hematological phenotypes. Immunoglobulin M isotype rheumatoid factor was associated with the absence of a renal phenotype. HLA-DQB1*02:02 and HLA-DRB1*07:01 were associated with the cutaneous phenotype. An association was identified between age at disease onset over 30 years and the presence of the joint phenotype. No other associations were identified. Potential clinical, immunological, and genetic biomarkers of phenotypes have been identified in SLE Paraguayan patients.

[Mistreatment of Paraguayan medical residents in 2022: a multicenter study]

Introducción

los residentes de postgrado tienden a sufrir maltratos durante sus prácticas hospitalarias y estos comportamientos abusivos no deben considerarse normales. El objetivo fue describir la frecuencia y las características del maltrato en residentes de medicina del Paraguay en 2022.

Metodología

se aplicó un diseño observacional de corte transversal. Se incluyó a los residentes de hospitales del Paraguay que aceptaban completar una encuesta online difundida por las redes sociales. Se utilizó un cuestionario de 23 preguntas que evalúa el maltrato psicológico, físico, académico y sexual. Adicionalmente se solicitó datos demográficos, académicos y aspectos relacionados a la denuncia del maltrato.

Resultados

el cuestionario fue llenado por 348 residentes. La edad media fue 28 ± 3 años y hubo predomino del sexo femenino (63,2%). Participaron residentes de 32 hospitales, la mayoría era de 1° año (50,3%) y de especialidades clínicas (60,6%). Acorde al cuestionario, 339 residentes (97,4%) refirieron algún grado de maltrato. Relacionando las especialidades con el maltrato, el mismo fue mayor en las quirúrgicas: RR 1,4 IC 95% 1,0-1,9 (p 0,01). Los principales responsables del maltrato fueron los residentes superiores (55,2%) y los jefes de salas (31,8%). La denuncia fue realizada por 8% de los afectados. El principal motivo para no denunciar fue el temor a que realizarla le traería problemas (67,8%).

Conclusiones

el maltrato fue referido por 97,4% de los residentes, siendo mayor en las especialidades quirúrgicas. Urge aplicar medidas preventivas para evitar este tipo de abusos durante la residencia.

A Cross-Sectional Analysis of the Relationship Between Sabbath Practices and US, Canadian, Indonesian, and Paraguayan Teachers' Burnout

Across different faith traditions, Sabbath day observance shares a close relationship with theological conceptions of rest. Sabbath-keeping, with its promise of rest, may be a valuable spiritual practice in the context of teaching as prior research has consistently documented the adverse effects of teacher burnout. Yet no research has examined Sabbath-keeping and its connections to teaching practices and teacher burnout. We aim to fill this gap with a quantitative study of Sabbath-keeping and burnout among 1,300 teachers in Christian schools throughout the USA, Canada, Indonesia, and Paraguay. We report their conceptions of Sabbath and how those conceptions inform their teaching practice. We find an inverse and statistically significant relationship between Sabbath-keeping and burnout that is robust across several model specifications, suggesting that Sabbath-keeping may be helpful in reducing burnout among educators.

Genotypic characterization and clonal relatedness of metallo-β-lactamase-producing non-fermentative gram negative bacteria in the first 5 years of their circulation in Paraguay (2011-2015)

Pseudomonas aeruginosa and species of Acinetobacter calcoaceticus-baumanii complex are multiresistant intrahospital opportunistic pathogens, able to acquire carbapenemases and produce outbreaks with high morbidity and mortality. Pseudomonas putida has also emerged with similar characteristics. The aim of this research was to characterize the Metallo-β-lactamases (MBLs) detected by surveillance in Paraguay in the first 5 years of their circulation in hospitals. The coexistence of KPC and OXA-type carbapenemases was also investigated. 70 MBL-producing strains from inpatients were detected from clinical samples and rectal swab from 11 hospitals. The strains were identified by manual, automated, and molecular methods. Antimicrobial susceptibility was studied by Kirby-Bauer and automated methods, while colistin susceptibility was determined by broth macrodilution. MBLs were investigated by synergy with EDTA against carbapenems and PCR, and their variants by sequencing. KPC and OXA-carbapenemases were investigated by PCR. Clonality was studied by pulsed-field gel electrophoresis (PFGE). The results demonstrated the circulation of blaVIM-2 (60%), blaNDM-1 (36%), and blaIMP-18 (4%). The MBL-producing species were P. putida (45.7%), P. aeruginosa (17.2%), A. baumannii (24.3%), A. pittii (5.7%), A. nosocomialis, (4.3%) A. haemolyticus (1.4%), and A. bereziniae (1.4%). PFGE analysis showed one dominant clone for A. baumannii, a predominant clone for half of the strains of P. aeruginosa, and a polyclonal spread for P. putida. In the first 5 years of circulation in Paraguay, MBLs were disseminated as unique variants per genotype, appeared only in Pseudomonas spp. and Acinetobacter spp., probably through horizontal transmission between species and vertical by some successful clones.

Detection of neutralizing antibodies against flaviviruses in free-ranging birds, Paraguay (2016-2018)

Saint Louis encephalitis virus (SLEV), West Nile virus (WNV) and Ilheus virus (ILHV) are flaviviruses maintained by enzootic transmission networks between mosquitoes and birds. They have been detected in South America, with no records for Paraguay. We detected the presence of neutralizing antibodies for SLEV, WNV and ILHV in free-ranging birds collected in Paraguay (2016-2018). Four positive samples were detected in resident birds: one SLEV (rufous-bellied thrush), one WNV (barred antshrike) and two ILHV (white-tipped dove and shiny cowbird). These results bring new information about enzootic activity of flaviviruses in Paraguay.

A new species of Sturisoma Swainson, 1838 (Loricariidae: Loricariinae), from the Madeira River basin, with a discussion of historical biogeography of western Amazonas and Paraguay River basins

A new loricariin species of Sturisoma is described from the Cautário, Guaporé, Mamoré, Machado and Soteiro rivers, Madeira River basin, in Bolivia and Brazil. The new species is distinguished from its congeners by the presence of a middorsal longitudinal, thin dark brown stripe on the caudal peduncle, extending from two or three plates posterior to the dorsal-fin base, reaching the origin of the caudal fin, or one or two plates anterior to the origin of the caudal fin; small squarish anteriormost abdominal plates; and a middorsal longitudinal dark-brown stripe from first predorsal plate to near the dorsal-fin origin. Furthermore, the new species is diagnosed from congeners by plate morphology, counts on the median series, coalescent plates and ventrolateral thoracic plates, in addition to measurements related to body and head structures. An analysis of genetic distances using cytochrome C oxidase subunit 1 gene marker of the mitochondrial genome between the new species and several congeners is presented, in addition to a likelihood analysis to illustrate the position of the new taxon within Sturisoma. An identification key for species of the genus currently recorded at the upper Amazonas River basin is provided.

Analysis of cattle movement networks in Paraguay: Implications for the spread and control of infectious diseases

Beef exports represent a substantial part of Paraguay's agricultural sector. Cattle movements involve a high risk due to the possible spread of bovine diseases that can have a significant impact on the country's economy. We analyzed cattle movements from 2014 to 2018 using the networks analysis methodology at the holding and district levels at different temporal scales. We built two types of networks to identify network characteristics that may contribute to the spread of two diseases with different epidemiological characteristics: i) a network including all cattle movements to consider the transmission of a disease of rapid spread like foot and mouth disease, and ii) a network including only cow movements to account for bovine brucellosis, a disease of slow spread that occurs mainly in adult females. Network indicators did not vary substantially among the cattle and cow only networks. The holdings/districts included in the largest strongly connected components were distributed throughout the country. Percolation analysis performed at the holding level showed that a large number of holdings should be removed to make the largest strongly connected component disappear. Higher values of the centrality indicators were found for markets than for farms, indicating that they may play an important role in the spread of an infectious disease. At the holding level (but not at the district level), the networks exhibited characteristics of small-world networks. This property may facilitate the spread of foot and mouth disease in case of re-emergence, or of bovine brucellosis in the country through cattle movements. They should be taken into account when implementing surveillance or control measures for these diseases.

Adaptation of a Human Diagnostic Kit to Detect Dengue, Zika, and Chikungunya Viruses in Mosquito Samples (Aedes aegypti and Aedes albopictus): A Contribution to Public Health in the International Triple Border (Brazil, Paraguay, and Argentina)

Objective: The objective of this work was to adapt a diagnostic kit developed for humans to identify Dengue (DENV1, DENV2, DENV3, DENV4), Zika (ZIKV) and Chikungunya virus (CHIKV) in females of Aedes aegypti and Aedes albopictus and to verify if the occurrence of mosquitoes infected with these three arboviruses are being found in regions with high occurrence of these diseases in humans. Materials and Methods: For this purpose, live mosquitoes were captured between January and June 2020 using 3,476 traps permanently installed in the field were used. After capture, the species were identified, then the females were placed in a pool of 2 to 10 specimens and sent to the laboratory for detection of DENV1, DENV2, DENV3, DENV4, ZIKV and CHIKV by RT-PCR using a commercial human kit for arboviruses. Results: Of the 76 mosquito pools collected, six (7.9%) pools tested positive for the DENV2 virus. The DENV-positive mosquitoes were collected in regions with a high incidence of reported cases of Dengue or in adjacent areas. Conclusion: The absence of kits for the detection of these arboviruses in Aedes is a limiting factor and the adequacy of commercial kits, already used for the diagnosis of arboviruses in humans, the results presented demonstrate that it is possible to identify the presence of DENV2 in mosquitoes with the respective kit, reinforcing the use of RT-qPCR as a robust diagnostic tool for epidemiological surveillance allowing managers to receive timely results for decision-making regarding prevention and control actions.

"Coronaphobia" in Paraguay: Spanish Validation of the COVID-19 Phobia Scale

BACKGROUND

The COVID-19 is a highly transmissible disease caused by a new zoonotic coronavirus called SARS-CoV-2 that has led to several health, social, and economic issues worldwide. Anxiety and stress are predominant symptoms in the population during the quarantine; also, levels of fear or phobia have been reported.

SUBJECTS AND METHODS

This study validate the Spanish version of the COVID-19 Phobia Scale (C19P-S). Participants were recruited using an Internet-based survey. The survey was open from July 20 to July 31, 2021 and 1079 subjects were included.

RESULTS

Kaiser-Meyer-Olkin test was adequate (KMO=0.956) and sphericity tested significantly (p<0.0001). The model of adjustment was good as shown by fit indices (S-B χ²=351.67, df=164, p>0.05; RMSEA=0.033; SRMSR=0.042; CFI=0.995, NFI=0.990).

CONCLUSIONS

This confirms that the model of the Spanish version of the C19P-S may reproduce the same four-factors model from the original version of the scale and all items of these factors reported standardized loadings higher than 0.40 (p<0.001).

Chemical Profile and Biological Potential of Hornodermoporus martius (Agaricomycetes) from Paraguay

To further knowledge of the biological activity of native neotropical fungal species, this study aimed to determine the chemical composition and microbiological activity of Hornodermoporus martius. Ethanol, hexane, diethyl ether, and ethyl acetate fractions and the water residue were analyzed and resulted in a total phenolic compound content between 13 and 63 mg of gallic acid equivalents per gram of crude extract. The total antioxidants ranged between 3 and 19 mg of ascorbic acid equivalents per gram of crude extract, and the percentage of antioxidant activity was determined to be between 6 and 25%. A preliminary profile of compounds is provided for the first time for the species; the results from the nonpolar fraction showcased the presence of saturated and unsaturated acids, fatty alcohol, sterols, and cis-vaccenic acid. Our findings also revealed antimicrobial properties from compounds within the hexane and diethyl ether fractions at concentrations of 1 mg mL-1, which inhibited the growth of certain gram-positive and gram-negative bacteria. For the first time in academic literature, our work analyzed and documented the chemical characteristics and microbial properties of H. martius, suggesting potential for medicinal applications.

The Ancestry of Eastern Paraguay: A Typical South American Profile with a Unique Pattern of Admixture

Immigrants from diverse origins have arrived in Paraguay and produced important demographic changes in a territory initially inhabited by indigenous Guarani. Few studies have been performed to estimate the proportion of Native ancestry that is still preserved in Paraguay and the role of females and males in admixture processes. Therefore, 548 individuals from eastern Paraguay were genotyped for three marker sets: mtDNA, Y-SNPs and autosomal AIM-InDels. A genetic homogeneity was found between departments for each set of markers, supported by the demographic data collected, which showed that only 43% of the individuals have the same birthplace as their parents. The results show a sex-biased intermarriage, with higher maternal than paternal Native American ancestry. Within the native mtDNA lineages in Paraguay (87.2% of the total), most haplogroups have a broad distribution across the subcontinent, and only few are concentrated around the Paraná River basin. The frequency distribution of the European paternal lineages in Paraguay (92.2% of the total) showed a major contribution from the Iberian region. In addition to the remaining legacy of the colonial period, the joint analysis of the different types of markers included in this study revealed the impact of post-war migrations on the current genetic background of Paraguay.

Record-breaking wildfires in the world's largest continuous tropical wetland: Integrative fire management is urgently needed for both biodiversity and humans

In the Brazilian Pantanal, wildfire occurrence has increased, reaching record highs of over 40,000 km² in 2020. Smoke from wildfires worsened the situation of isolated, as well as urban communities, already under an increasing toll of COVID-19. Here we review the impacts and the possible causes of the 2020 mega-fires and recommend improvements for public policies and fire management in this wetland. We calculated the amount of area burnt annually since 2003 and describe patterns in precipitation and water level measurements of the Paraguay River. Our analyses revealed that the 2020 wildfires were historically unprecedented, as 43% of the area (over 17,200 km²) had not been burnt previously in the last two decades. The extent of area affected in 2020 represents a 376% increase compared to the annual average of the area burnt annually in the last two decades, double than the value in 2019. Potential factors responsible for this increase are (i) severe drought decreased water levels, (ii) the fire corridor was located in the Paraguay River flood zone, (iii) constraints on firefighters, (iv) insufficient fire prevention strategy and agency budget reductions, and (v) recent landscape changes. Climate and land use change will further increase the frequency of these extreme events. To make fire management more efficient and cost-effective, we recommend the implementation of an Integrated Fire Management program in the Pantanal. Stakeholders should use existing traditional, local ecological, and scientific knowledge to form a collective strategy with clear, achievable, measurable goals, considering the socio-ecological context. Permanent fire brigades, including indigenous members, should conduct year-round fire management. Communities should cooperate to create a collaborative network for wildfire prevention, the location and characteristics (including flammability) of infrastructures should be (re)planned in fire-prone environments considering and managing fire-catalysed transitions, and depending on the severity of wildfires. The 2020 wildfires were tackled in an ad-hoc fashion and prioritisation of areas for urgent financial investment, management, protection, and restoration is necessary to prevent this catastrophe from happening again.

Mapping of suspended sediment transport using acoustic methods in a Pantanal tributary

Generally, fluvial systems are used for different objectives including energy production, water supply, recreation, and navigation. Thus, many impacts must be considered with their use. An understanding of sediment dynamics in fluvial systems is often of value for a variety of objectives, given that erosion and depositional processes can change the fluvial system morphology and can substantially alter the fluvial environment. In this sense, sediment monitoring is important because it helps to explain and quantify sediment dynamics in the environment. Hence, this study presents an innovative sediment monitoring technique: the use of the acoustic Doppler current profiler, commonly used to obtain discharge measurements, to obtain suspended sediment concentration (SSC). This paper aims to describe the application of additional corrections to the ADP-M9 signal to obtain SSC from measurement campaigns that used the ADP only for discharge measurements. The analyses were based on traditional sediment sampling methods and discharge measurements, with the ADP-M9, from 7 field campaigns at the Taquari River, a major tributary from the Alto Paraguay Basin, in the Pantanal Biome, known as the largest freshwater wetland system in the world. The correlation was assessed considering the following: (a) the equipment frequency operation mode (Smart Pulse or Fixed Frequency) and (b) by checking the influence of the sediment attenuation coefficient. Furthermore, extrapolation was conducted in filtered and unmeasured areas of the ADP to map the suspended sediment concentration over the entire cross section. Results indicate that ADP correlations can be an effective tool for estimating SSC in the Taquari River when samples cannot be collected. Correlations could be applied to past and future ADP measurements made at the location where the correlation was created, as long as similar environmental conditions are present as when the correlation was developed. The described technique can expand the amount of sediment data available at a monitoring site even with reduced traditional sampling and by leveraging instruments used for other monitoring purposes.

Epidemiologic History and Genetic Diversity Origins of Chikungunya and Dengue Viruses, Paraguay

Paraguay has been severely affected by emergent Zika and chikungunya viruses, and dengue virus is endemic. To learn more about the origins of genetic diversity and epidemiologic history of these viruses in Paraguay, we deployed portable sequencing technologies to strengthen genomic surveillance and determine the evolutionary and epidemic history of arthropod-borne viruses (arboviruses). Samples stored at the Paraguay National Central Laboratory were sequenced and subjected to phylogenetic analysis. Among 33 virus genomes generated, we identified 2 genotypes of chikungunya and 2 serotypes of dengue virus that circulated in Paraguay during 2014–2018; the main source of these virus lineages was estimated to be Brazil. The evolutionary history inferred by our analyses precisely matched the available travel history of the patients. The genomic surveillance approach used was valuable for describing the epidemiologic history of arboviruses and can be used to determine the origins and evolution of future arbovirus outbreaks.

Automatic Diagnosis of Ocular Toxoplasmosis from Fundus Images with Residual Neural Networks

Ocular toxoplasmosis (OT) is commonly diagnosed through the analysis of fundus images of the eye by a specialist. Despite Deep Learning being widely used to process and recognize pathologies in medical images, the diagnosis of ocular toxoplasmosis(OT) has not yet received much attention. A predictive computational model is a valuable time-saving option if used as a support tool for the diagnosis of OT. It could also help diagnose atypical cases, being particularly useful for ophthalmologists who have less experience. In this work, we propose the use of a deep learning model to perform automatic diagnosis of ocular toxoplasmosis from images of the eye fundus. A pretrained residual neural network is fine-tuned on a dataset of samples collected at the medical center of Hospital de Clínicas in Asunción, Paraguay. With sensitivity and specificity rates equal to 94% and 93%,respectively, the results show that the proposed model is highly promising. In order to replicate the results and advance further in this area of research, an open data set of images of the eye fundus labeled by ophthalmologists is made available.

Toxicogenetic effects on fish species in two sub-basins of the upper Paraguay river, Southern Pantanal - Brazil

This study aimed to evaluate water quality using limnological parameters in two sub-basins of the Negro and Apa Rivers, along with the composition and structure of the landscape around the locations sampled in the two sub-basins and their possible contribution to the loss of water quality. We also set out to identify the genotoxic effects on the erythrocytes of Prochilodus lineatus and Leporinus friderici. In particular, we quantified total Cr, Ni and Pb in the muscle of these fish species to determine which genotoxic changes are related to the concentration of metals detected in the fish from these two sub-basins of the Paraguay River Basin. The sub-basin of the Apa River presented a greater proportion of surrounding pastureland in relation to the basin of the Negro River. The erythrocytes of P. lineatus showed a significant difference between the sub-basins for nuclear pyknosis, binucleated cells and lobed nuclei (p < 0.05). In L. friderici, vacuolated nuclei, nuclear pyknosis and lobed nuclei alterations also showed a significant difference between the sub-basins (p < 0.05). The genotoxicity index of the Apa River sub-basin presented higher frequencies of nuclear alterations in P. lineatus and L. friderici (p < 0.05), compared to the Negro River sub-basin. The concentration of total Cr, Ni and Pb in the muscles of P. lineatus and L. friderici in the Negro River sub-basin leads to genotoxic damage, mainly from the induction of lobed nuclei. Based on our results, it can be concluded that toxicogenetic effects in native fish species are an important source of environmental diagnosis in the Upper Paraguay River Basin.

Prevalence of Wheat/Gluten-Related Disorders and Gluten-Free Diet in Paraguay: An Online Survey-Based Study

Gluten-related disorders (GRDs) are increasing around the world, but their magnitude and relevance remain unknown in most Latin American countries. Thus, an online survey was conducted to estimate the prevalence of GRDs as well as adherence to a gluten-free diet (GFD) in Paraguayan adult population. There were 1058 individuals surveyed using a validated questionnaire (response rate of 93.9%). The self-reported prevalence rates were as follows (95% CI): gluten sensitivity (GS), 10.30% (8.53-12.29); non-celiac GS (NCGS), 5.19% (3.94-6.71); physician-diagnosed celiac disease (PD-CD), 3.11% (2.15-4.35); wheat allergy (WA), 2.07% (1.30-3.13); and adherence to GFD, 15.69% (13.55-18.02). Excluding CD, more women than men met the criteria for GRDs, adverse food reactions, and GFD (p < 0.05). Eight respondents reported the coexistence of NCGS with PD-CD and/or WA. Most cases on a GFD indicated medical/dietitian advice for following the diet (68.07%). Non-self-reported GS individuals indicated weight control (46.4%) and the notion that the GFD is healthier (20.2%) as the main motivations for following the diet. GRDs are not uncommon in Paraguayan adult population. It seems that there is awareness about GRDs and the GFD, but training about the diagnosis of GRDs is desirable because of the informed overlapping diagnoses of CD or WA with NCGS. Future studies involving face-to-face interviews are necessary.

Genetic and toxinological divergence among populations of Tityus trivittatus Kraepelin, 1898 (Scorpiones: Buthidae) inhabiting Paraguay and Argentina

Envenoming by scorpions in genus Tityus is a public health problem in Tropical America. One of the most medically significant species is Tityus trivittatus, which is known to occur from southwest Brazil to central-northern and eastern Argentina. In this work, we studied the lethality, composition, antigenicity, and enzymatic activity of venom from a T. trivittatus population found further north in urban areas of eastern Paraguay, where it has caused serious envenomation of children. Our results indicate that the population is of medical importance as it produces a potently toxic venom with an LD50 around 1.19 mg/kg. Venom neutralization in preliminary mouse bioassays was complete when using Brazilian anti-T. serrulatus antivenom but only partial when using Argentinean anti-T. trivittatus antivenom. Venom competitive solid-phase enzyme immunoassays and immunoblotting from Argentinean and Paraguayan T. trivittatus populations indicated that antigenic differences exist across the species range. SDS-PAGE showed variations in type and relative amounts of venom proteins between T. trivitattus samples from Argentina and Paraguay. MALDI-TOF mass spectrometry indicated that while some sodium channel toxins are shared, including β-toxin Tt1g, others are population-specific. Proteolytic activity by zymography and peptide identification through nESI-MS/MS also point out that population-specific proteases may exist in T. trivitattus, which are postulated to be involved in the envenoming process. A time-calibrated molecular phylogeny of mitochondrial COI sequences revealed a significant (8.14%) genetic differentiation between the Argentinean and Paraguayan populations, which appeared to have diverged between the mid Miocene and early Pliocene. Altogether, toxinological and genetic evidence indicate that T. trivitattus populations from Paraguay and Argentina correspond to distinct, unique cryptic species, and suggest that further venom and taxonomic diversity exists in synanthropic southern South American Tityus than previously thought.

[Implementation research of primary health care in Paraguay in three periods of government: political, technical and social dimensions at the subnational level.]

OBJECTIVE

The study hopes to contribute to the analysis of political, technical and social dimensions and sub-dimensions that affect the processes of adjustments to the health system model based on the renewed PHC (Primary Health Care) strategy, at the regional (meso) and local levels. (micro), levels where problems and obstacles are externalized and institutional capacity gaps are verified, in contexts of changes in political leadership, which put their sustainability at risk. The observation included three government periods (2008-2012, 2012- 2013 and 2013-2018), in two departments of Paraguay (Misiones -rural- and Central -urban-).

METHODS

Qualitative research on the implementation of public health policy in Paraguay, aimed at promoting improvements in health services in specific contexts, through case studies, complemented with a documentary review. It explores macro, meso, and micro health processes, disaggregated in their political, social, and technical dimensions, to trace the PHC management profile over time. Directors, managers, and professionals in the field of health with experience, commitment, adherence, and prior knowledge were interviewed, using a priori analysis categories. The data and selection of discursive fragments were processed with the Atlas Ti software and auxiliary matrices in Excel.

RESULTS

Social changes and health outcomes are perceived in the study regions, despite financial restrictions and no flexibility of public spending on health attributed to the leadership and individual performance of health workers, which establish differences in terms of empowerment, cohesion and commitment in the development of the strategies outlined by the technical teams and decision-makers responsible for the implementation of policy lines in primary health care.

CONCLUSIONS

There are technological limitations, asymmetries of the information subsystems that translate into management weaknesses, as well as little community participation in the design and evaluation of health plans. Coordination weaknesses and improvement plans were detected in operating units of the regional networks, as well as. different training modalities. The availability of specialists in family medicine is low.

Isotopic insights on continental water sources and transport in the mountains and plains of Southern South America

Hosting the flattest sedimentary plains and highest Andean range of the continent, southern South America faces hydrological transformations driven by climate and land use changes. Although water stable isotopes can help understand these transformations, regional synthesis on their composition is lacking. We compiled for the first time a dataset of H and O isotopic composition for 1659 samples (precipitation, rivers, groundwater and lakes) along latitude (22.4°S to 41.6°S), longitude (55.3°W to 71.5°W), elevation (1-4700 m) and precipitation (∼50 to ∼1500 mm/a) gradients encompassing the Chaco-Espinal-Pampas plains, their adjacent Andean Cordillera and smaller mountain ranges in-between. Emerging patterns reveal (i) only slight seasonal isotope trends in precipitation with no effects of event size, (ii) Atlantic/Amazonian vs. Pacific moisture supply to rivers north and south of the 'arid diagonal' of the continent, respectively, (iii) uniform isotopic composition in Atlantic/Amazonian-fed rivers vs. poleward isotope enrichment in Pacific-fed rivers caused by the elevation decline of the Andes, (iv) strong direct evaporation effect in rivers and shallow (<1 m) phreatic groundwater of the plains. We provide the first integrated water isotope geographical patterns of southern South America helping to improve our understanding of its water cycling patterns at the atmosphere and the land.

Molecular delimitation and taxonomic revision of the wimple piranha Catoprion (Characiformes: Serrasalmidae) with the description of a new species

A taxonomic revision of wimple piranhas of the genus Catoprion is performed in combination with a molecular analysis using mtDNA. Molecular phylogenetic analyses of 49 specimens using genetic distances, conventional likelihood and four delimitation methods yielded two distinct lineages of Catoprion, with the morphological analyses of 198 specimens of Catoprion corroborating the molecular results. We provide a redescription of Catoprion mento, from the Paraguay, Orinoco, and tributaries of western Amazon basin, keeping Mylesinus macropterus as a junior synonym of C. mento, and the description of Catoprion absconditus n. sp., from the Amazon and Essequibo basins. C. absconditus n. sp. differs from C. mento by the presence of 86-94 perforated scales in the lateral line (vs. 65-86 scales) and the presence of 35-40 circumpeduncular scales (vs. 29-34 scales). The distribution of C. mento follows the Amazonas-Paraguay-Orinoco lowlands, whereas C. absconditus follows the eastern Amazon biogeographic pattern.

Real-time RT-PCR for the detection and quantitation of Oropouche virus

Oropouche virus (OROV) causes an acute, systemic febrile illness, and in certain regions of South America, this represents the second most common human arboviral infection after dengue virus. A new real-time RT-PCR was developed for OROV and reassortant species. The new OROV rRT-PCR proved linear across 6-7 orders of magnitude with a lower limit of 95% detection of 5.6-10.8 copies/μL. Upon testing dilutions of OROV and Iquitos virus reference genomic RNA, all dilutions with >10 copies/μL were detected in both the OROV rRT-PCR and a comparator molecular assay, but the OROV rRT-PCR detected more samples with ≤10 copies/μL (8/14 vs 0/13, respectively, P = 0.002). In a set of 100 acute-phase clinical samples from Paraguay patients with a suspected arboviral illness, no patients tested positive for OROV RNA using either assay. The OROV rRT-PCR provides a sensitive molecular assay for the study of this important yet neglected tropical arboviral infection.

Iridoids and Amino Acid Derivatives from the Paraguayan Crude Drug Adenocalymma marginatum (ysypó hû)

The crude drug ysypó hû (Adenocalymma marginatum DC., Bignoniaceae) is used traditionally by the Guarani of Eastern Paraguayan as a male sexual enhancer. The aim of the present study was to identify the main constituents of the crude drug and to evaluate the in vitro inhibitory activity towards the enzyme phosphodiesterase-5 (PDE-5). The main compounds were isolated by counter-current chromatography (CCC). The metabolites were identified by spectroscopic and spectrometric means. The chemical profiling of the extracts was assessed by high-performance liquid chromatography coupled to mass spectrometry (HPLC-MS/MS). The crude extract and main isolated compounds were tested for their PDE-5 inhibitory activity using commercial kits. The iridoid theviridoside and 4-hydroxy-1-methylproline were isolated as the main constituent of the crude drug. Four chlortheviridoside hexoside derivatives were detected for the first time as natural products. Chemical profiling by HPLC-MS/MS led to the tentative identification of nine iridoids, six phenolics, and five amino acids. The crude extracts and main compounds were inactive towards PDE-5 at concentrations up to 500 µg/mL. Iridoids and amino acid derivatives were the main compounds occurring in the Paraguayan crude drug. The potential of ysypó hû as a male sexual enhancer cannot be discarded, since other mechanisms may be involved.

Predictive sampling effort and species-area relationship models for estimating richness in fragmented landscapes

Loss of habitat, specifically deforestation, is a major driver of biodiversity loss. Species-area relationship (SAR) models traditionally have been used for estimating species richness, species loss as a function of habitat loss, and extrapolation of richness for given areas. Sampling-species relationships (SSRs) are interrelated yet separate drivers for species richness estimates. Traditionally, however, SAR and SSR models have been used independently and not incorporated into a single approach. We developed and compared predictive models that incorporate sampling effort species-area relationships (SESARS) along the entire Atlantic Forest of South America, and then applied the best-fit model to estimate richness in forest remnants of Interior Atlantic Forest of eastern Paraguay. This framework was applied to non-volant small mammal assemblages that reflect different tolerances to forest loss and fragmentation. In order to account for differences in functionality we estimated small mammal richness of 1) the entire non-volant small mammal assemblage, including introduced species; 2) the native species forest assemblage; and 3) the forest-specialist assemblage, with the latter two assemblages being subsets of the entire assemblage. Finally, we geospatially modeled species richness for each of the three assemblages throughout eastern Paraguay to identify remnants with high species richness. We found that multiple regression power-law interaction-term models that only included area and the interactions of area and sampling as predictors, worked best for predicting species richness for the entire assemblage and the native species forest assemblage, while several traditional SAR models (logistic, power, exponential, and ratio) best described forest-specialist richness. Species richness was significantly different between assemblages. We identified obvious remnants with high species richness in eastern Paraguay, and these remnants often were geographically isolated. We also found relatively high predicted species richness (in relation to the entire range of predicted richness values) in several geographically-isolated, medium-size forest remnants that likely have not been considered as possible priority areas for conservation. These findings highlight the importance of using an empirical dataset, created using sources representing diverse sampling efforts, to develop robust predictive models. This approach is particularly important in geographic locations where field sampling is limited yet the geographic area is experiencing rapid and dramatic land cover changes. When combined, area and sampling are powerful modeling predictors for questions of biogeography, ecology, and conservation, especially when addressing habitat loss and fragmentation.

Carriage of Neisseria meningitidis and other Neisseria species among children and young adults in Paraguay

Introduction. Colonization by Neisseria meningitidis is the pre-requisite for the development of disease. We present the findings of a cross-sectional investigation onto the oropharyngeal carriage of N. meningitidis and Neisseria species in the population aged 3 to 21 in Paraguay.Aim. Carriage prevalence by age groups, risk factors associated with carriage, and phenotypic and genotypic characteristics of strains are described.Methodology. We collected 2011 oropharyngeal swabs from consenting participants aged 3-21 years. Infants were recruited at immunization clinics, and older children and young adults were identified at schools and universities. A single oropharyngeal swab was collected and processed for the identification and isolation of Neisseria. Additionally, participants, or their legal guardian if these were minors, were requested to fill a standardized questionnaire.Results. N. meningitidis was isolated in 42/2011 (2.1 %) participants, while other Neisseria spp. were identified in 306/2011 (15.2 %) subjects: N. cinerea and N. lactamica were identified in 39/2011 (1.9 %) and 43/2011 (2.2 %), respectively. Meningococcal strains belonged to ten different clonal complexes, of which six are associated with invasive disease (ST-32/ET5 complex, ST-11/ET37 complex, ST-103 complex, ST-167 complex, ST-35 complex and ST-41/44 complex/lineage 3).Conclusion. Prevalence of N. meningitidis carriage was low compared to that reported from other settings, however, the overall carriage of Neisseria spp. (including N. meningitidis) was comparable to meningococcal carriage prevalence reported in the literature. This study is the first of its kind conducted in Paraguay, and one of the few known in the Southern Cone of Latin America.

Population genetic structure and demographic history of Spodoptera frugiperda (Lepidoptera: Noctuidae): implications for insect resistance management programs

BACKGROUND

Spodoptera frugiperda is a destructive pest that often imposes difficult management due to its high polyphagy and rapid insecticide resistance evolution. Knowledge of species diversification, population structure, and host preference can aid efforts to manage pest populations. Here, we investigated the patterns of hybridization, genetic structure, and gene flow in S. frugiperda populations, discussing how we can apply this knowledge to insect resistance management programs in South America.

RESULTS

The corn-strain CS-h2 of S. frugiperda was the most frequent haplotype in all sampled populations. Spodoptera frugiperda populations are experiencing demographic expansion, and the ecoregions partially explain the genetic structure and not strains. We did not find a correlation between gene flow and susceptibility levels to flubendiamide and lufenuron insecticides, but populations with high LC₅₀ sent a great number of migrants to all other locations, maintaining resistance alleles in the geographic range.

CONCLUSION

High levels of population admixture, including between corn- and rice-strains, were found in sampled populations. We showed that S. frugiperda immigrants will not necessarily cause an increase in LC₅₀ upon arrival in a new location but will assure the constant presence of resistance alleles in the area. Increases in LC₅₀ largely depend on the local pesticide management adopted in the areas. Our results indicate that pesticide resistance management must be adopted on a local or small regional scale. © 2019 Society of Chemical Industry.

[Molecular characterization of Shiga toxin producing Escherichia coli isolated from 2 livestock establishments of Paraguay]

Shiga toxin-producing Escherichia coli (STEC) is a food-borne pathogen in humans, with cattle being the main reservoir. The objective of this study was to determine the carrying of STEC in Paraguayan bovines and to analyze the virulence profile and serotypes of these isolates. A total of 197 samples of bovine fecal samples and an average of 5 to 50 colonies from stx₁/stx₂ positive samples were studied. The stx₁, stx₂, saa, ehxA and eae genes were amplified by PCR. 84.8% of the cattle were carriers of STEC. The predominant virulence profiles were stx₂ and stx₂/saa/ehxA. The serotyping was performed by agglutination reactions for 60 selected isolates, resulting in isolation of serogroup O103, which could produce infections in humans. This work shows the first data of STEC carriers in Paraguayan cattle, and indicates the need for other studies with greater territorial coverage for a complete vision of this phenomenon.

Disability-Disaggregated Data Collection: Hospital-Based Application of the Washington Group Questions in an Eye Hospital in Paraguay

Disability-disaggregated data are increasingly considered important to monitor progress in Universal Eye Health Care. Hospital-based data are still elusive because of the cultural ambiguities of the term disability, especially in under-resourced Health Information Systems in low-and middle-income countries. The aim of this study was to estimate the hospital-based rate of disability in patients presenting at an eye department of a rural hospital in Paraguay and to discuss implications for the management of access barriers. Therefore, we introduced two standardized sets of the Washington Group (WG) Questions as a pilot project. In total, 999 patients answered the self-report WG short set (WG-SS) questionnaire with six functional domains, and 501 of these patients answered an extended set, which included additional domains for "anxiety" and "depression" (WG-ES3). Overall, 27.7% (95% Confidence Interval (CI) 24.9-30.3) were categorized as having a disability. A total of 9.6% (95% CI 7.9-11.6) were categorized as having a disability because of communication difficulties, which was second only to visual difficulties. The odds ratio for disability for patients aged 70 years and older was 8.5 (95% CI 5.0-14.4) and for male patients, it was 0.83 (95% CI 0.62-1.1). Of those patients who answered the WG-ES3, 3.4% were categorized as having a disability because of being worried, nervous or anxious and 1.4% because of feeling depressed. An analysis of the questions of the "depression" domain was impeded by a high rate of measurement errors. The results of the different domains can now be used to inform the identification and mitigation of potential access barriers to eye health services for different types of impairments.

Occurrence of Deoxynivalenol and Ochratoxin A in Beers and Wines Commercialized in Paraguay

Alcoholic beverages can be contaminated with mycotoxins. Ochratoxin A (OTA) is the most frequently detected mycotoxinin wine and is produced by several species of Aspergillus. This mycotoxin is nephrotoxic and carcinogenic. In beer, the most commonly identified mycotoxin is deoxynivalenol (DON). Ingestion of food contaminated with DON has been associated with adverse gastrointestinal effects. Despite the harmful effects of mycotoxins on health, there are no regulations regarding their limits in alcoholic beverages in Paraguay. Here we determine the presence of OTA and DON in wine and beer, respectively. Four commercial brands of wine and twenty-nine brands of craft and industrial beerwere tested by the Agra quant ELISA method. One brand of wine was positive for OTA and seven brands of beer (one of them craft) were positive for DON. The values found for both toxins are below the recommended maximum intake proposed by international standards. Giving the high consumption of these products in the country, regulations and monitoring systems mustbe established to check the maximum levels of mycotoxins allowed in alcoholic beverages.

Reassessing the role of grazing lands in carbon-balance estimations: Meta-analysis and review

Assuming a steady state between carbon (C) gains and losses, greenhouse gases (GHG) inventories that follow a widely used simplified procedure (IPCC Tier 1) tend to underestimate the capacity of soils in grazing-land to sequester C. In this study we compared the C balance reported by (i) national inventories that followed the simplified method (Tier 1) of IPCC (1996/2006), with (ii) an alternative estimation derived from the meta-analysis of science-based, peer-reviewed data. We used the global databases (i) EDGAR 4.2 to get data on GHG emissions due to land conversion and livestock/crop production, and (ii) HYDE 3.1 to obtain historical series on land-use/land cover (LULC). In terms of sequestration, our study was focused on C storage as soil organic carbon (SOC) in rural lands of four countries (Argentina, Brazil, Paraguay and Uruguay) within the so-called MERCOSUR region. Supported by a large body of scientific evidence, we hypothesized that C gains and losses in grazing lands are not in balance and that C gains tend to be higher than C losses at low livestock densities. We applied a two-way procedure to test our hypothesis: i) a theoretical one based on the annual conversion of belowground biomass into SOC; and ii) an empirical one supported by peer-reviewed data on SOC sequestration. Average figures from both methods were combined with LULC data to reassess the net C balance in the study countries. Our results show that grazing lands generate C surpluses that could not only offset rural emissions, but could also partially or totally offset the emissions of non-rural sectors. The potential of grazing lands to sequester and store soil C should be reconsidered in order to improve assessments in future GHG inventory reports.

Monitoring and modeling of household air quality related to use of different Cookfuels in Paraguay

In Paraguay, 49% of the population depends on biomass (wood and charcoal) for cooking. Residential biomass burning is a major source of fine particulate matter (PM_2.5 ) and carbon monoxide (CO) in and around the household environment. In July 2016, cross-sectional household air pollution sampling was conducted in 80 households in rural Paraguay. Time-integrated samples (24 hours) of PM_2.5 and continuous CO concentrations were measured in kitchens that used wood, charcoal, liquefied petroleum gas (LPG), or electricity to cook. Qualitative and quantitative household-level variables were captured using questionnaires. The average PM_2.5 concentration (μg/m³ ) was higher in kitchens that burned wood (741.7 ± 546.4) and charcoal (107.0 ± 68.6) than in kitchens where LPG (52.3 ± 18.9) or electricity (52.0 ± 14.8) was used. Likewise, the average CO concentration (ppm) was higher in kitchens that used wood (19.4 ± 12.6) and charcoal (7.6 ± 6.5) than in those that used LPG (0.5 ± 0.6) or electricity (0.4 ± 0.6). Multivariable linear regression was conducted to generate predictive models for indoor PM_2.5 and CO concentrations (predicted R²  = 0.837 and 0.822, respectively). This study provides baseline indoor air quality data for Paraguay and presents a multivariate statistical approach that could be used in future research and intervention programs.

Soybean-Macrophomina phaseolina-Specific Interactions and Identification of a Novel Source of Resistance

Charcoal rot, caused by the fungus Macrophomina phaseolina, is an economically important disease of soybean (Glycine max) worldwide. Objectives of the present research were to (i) study the genetic and pathogenic diversity in a collection of M. phaseolina isolates from Argentina and Paraguay and (ii) develop an improved in vitro phenotyping method to evaluate disease response of soybean genotypes to M. phaseolina isolates. Cluster analysis showed no clear association among simple sequence repeat profiles, year of collection, pathogenicity, and geographical origin of the isolates from Argentina and Paraguay. Subsequently, the response of four soybean genotypes against seven M. phaseolina isolates was evaluated in the field and the results were confirmed using the in vitro assay developed. This assay, which is based on root disease development on soybean seedlings, allowed the detection of a differential level of aggressiveness among the isolates on four soybean genotypes. The results suggest the existence of specific interactions among soybean genotypes and M. phaseolina isolates. In addition, cultivar Munasqa RR showed a superior response against M. phaseolina compared with DT 97-4290 (moderately resistant), thus becoming a novel source of resistance to charcoal rot.

Closing the rural-urban gap in child malnutrition: Evidence from Paraguay, 1997-2012

Between 1997 and 2012, Paraguay achieved not only remarkable improvements in child nutrition, but also a surprising elimination of the rural-urban differential in child height-for-age Z score (HAZ) and stunting. Our decomposition analysis, applied to four rounds of Paraguayan National Household Surveys, allows us to directly infer not only the contributions of changes in determinants of child nutritional status to the improvements in child nutritional status in rural and urban areas, but also their contribution to closing the rural-urban gap. We find that while common determinants of child nutritional status such as income, maternal education, sanitation, and access to piped water are strongly associated with improvements in child nutrition, they have contributed little to reducing the rural-urban gap (10%, p < 0.05). Improvements in health care utilization, family planning, and demographics have been the main drivers in closing the rural-urban gap in child nutritional status in Paraguay (32%, p < 0.05). The results highlight the potential need for multipronged nutritional strategies that consider the distinct needs of rural and urban communities.

"We think globally": the rise of Paraguay's Tabacalera del Este as a threat to global tobacco control

BACKGROUND

Leading transnational tobacco companies (TTCs) began to expand their operations in Latin America in the 1960s. This included legally exporting their cigarettes to Paraguay during the 1960s which, in turn, were illegally re-exported to Argentina and Brazil. By the 1990s, competition between BAT and PMI for this lucrative illicit market, focusing on low-priced brands, prompted manufacturing in Paraguay. Paraguayan manufacturing rapidly grew after the introduction of a new cigarette export tax in Brazil in 1999.

METHODS

We systematically searched Truth Tobacco Industry Documents (TTID) to understand the activities and strategies of leading TTCs in Paraguay and subregion over time. We applied the analytical framework of Lee and Eckhardt (2017) to understand Tabesa's global business strategy. We searched the websites of TTCs and Tabesa for activities since the mid 2000s to understand how the companies publicly describe these strategies. We used the United Nations Commodity Trade Statistics Database (UN Comtrade) as an independent source to crosscheck statements by Tabesa executives about export markets. We contextualized and triangulated our findings with 42 key informant interviews.

RESULTS

Tabesa became the largest cigarette manufacturer in Paraguay, and one of the largest companies in the country, through complicity in the illicit trade. Enabled by market conditions created by leading TTCs, and a permissive regulatory environment in Paraguay, evidence suggests Tabesa had become a major source of illicit cigarettes across Latin America and beyond by the late 2000s. Although Brazil continues to account for the bulk of Tabesa's revenues, findings suggest that the company is aspiring to compete with TTCs in markets worldwide through legal and illegal sales.

CONCLUSION

There is a need for fuller understanding of the risks to global tobacco control from local companies aspiring to compete with TTCs. The rise of Tabesa is part of the changing nature of the illicit trade in tobacco products which must be taken into account in implementing the Framework Convention on Tobacco Control (FCTC) and its Protocol to Eliminate Illicit Trade in Tobacco Products. Potential conflicts of interest concerning Tabesa illustrate the importance of FCTC Article 5.3 on industry interference. There is also an urgent need to address the lack of independent and rigorous data on the illicit tobacco trade in the region.

Attitude of Medical Students in Paraguay Towards Homosexuality

INTRODUCTION

The attitude of medical students towards homosexuality may affect the quality of care for homosexual patients. This study aimed to describe the attitude of medical students at the National University of Asuncion, Paraguay towards homosexuality.

METHODS

This observational, cross-sectional study was conducted in June 2016 in consecutive medical students from the National University of Asunción (Santa Rosa del Aguaray branch), Paraguay. The 10-item attitude towards homosexuality scale (EAH-10) was used to assess participants' acceptance/ rejection of homosexuals as individuals, homosexuality as a sexual orientation, and public manifestations of homosexuality.

RESULTS

A total of 48 female and 29 male participants (mean age, 21 ± 2 years) were included. Most were Catholic (71.4%), followed by non-Catholic Christian (10.4%), agnostic (9.1%), atheist (2.6%), and other (6.5%). 71.4% reported having at least one homosexual friend. The mean EAH-10 score was 27.23 ± 9.379. 42.9% of participants were indifferent or undecided in their attitude towards homosexuality and 28.6% were discriminatory. Having homosexual friends was associated with a lower EAH-10 score (t = -3.447 [75], p = 0.001).

CONCLUSION

Education about health issues of homosexuals is needed for medical students in Paraguay.

Evaluation of the Chemical Composition of Synthetic Leather Using Spectroscopy Techniques

Synthetic leather samples from Brazil and Paraguay were evaluated in this study using three spectroscopy techniques: inductively coupled plasma optical emission spectrometry (ICP-OES), laser-induced breakdown spectroscopy (LIBS), and wavelength dispersive X-ray fluorescence (WDXRF). The obtained information from each technique was separately inspected with principal component analysis (PCA). The concentrations of the elements determined in the synthetic leathers using ICP-OES decreased in the following order: Ca > Cr > Mg > Ba > Pb > Al > Fe > Zn > Sb > Ni with a concentration range below the limit of quantification (<LOQ, case of Ni) to 112 233 mg kg^-1 (case of Ca). Additionally, Cu, As, Sr, Ti, Cd, Mn, Co, and Ni were present in only few samples in a concentration range from <LOQ to 163 mg kg^-1. Principal component analysis was the tool used to evaluate the samples from their chemical content obtained quantitatively using ICP-OES and qualitatively using LIBS or WDXRF spectra. The results showed that the association of PCA with spectroscopic techniques was satisfactory for data inspection of synthetic leathers according to the chemical composition. Laser-induced breakdown spectroscopy and WDXRF were able to identify the presence of toxic elements like Cr (LIBS and WDXRF) and Pb (WDXRF).

Genetic structure and evidence of anthropogenic effects on wild populations of two Neotropical catfishes: baselines for conservation

Genetic diversity and structure of Pseudoplatystoma corruscans and P. reticulatum, large migratory South America catfishes, where overfishing and the construction of numerous dams in their feeding and reproducing areas are affecting their migratory processes negatively, were studied using microsatellites in samples from Paraguay (that comprises the Pantanal biome), and the upper and lower Paraná Basins. Genetic diversity was in accordance to that observed for other large migratory fishes, but the most geographically isolated populations of P. reticulatum and those P. corruscans subject to anthropogenic effects (stocking and dams) showed lower genetic diversity and evidences of bottlenecks compatible with low effective population size. Pseudoplatystoma reticulatum presented subtle genetic differentiation within the Paraguay area, especially between the edges of its distribution. Pseudoplatystoma corruscans, in this same area, presented a quite homogeneous but significant genetic break between the Paraguay and upper Paraná populations, apparently resulting from natural and historical isolation between the basins until recently. These data demonstrates that, although these Pseudoplatystoma spp. are abundant in the Pantanal area, anthropogenic events are leading to negative effects on their populations, particularly in the upper Paraná Basin. Genetic differentiation observed along each species distribution demands conservation actions to preserve each population's biodiversity. These results represent important genetic information using new microsatellite markers and the first genetic study of P. reticulatum covering this area of its native distribution. Data may also contribute to a better understanding of species migration patterns and to be used as a baseline for proper management.

Do Riparian Buffers Protect Stream Invertebrate Communities in South American Atlantic Forest Agricultural Areas?

We investigated the influence and relative importance of insecticides and other agricultural stressors in determining variability in invertebrate communities in small streams in intensive soy-production regions of Brazil and Paraguay. In Paraguay we sampled 17 sites on tributaries of the Pirapó River in the state of Itapúa and in Brazil we sampled 18 sites on tributaries of the San Francisco River in the state of Paraná. The riparian buffer zones generally contained native Atlantic forest remnants and/or introduced tree species at various stages of growth. In Brazil the stream buffer width was negatively correlated with sediment insecticide concentrations and buffer width was found to have moderate importance in mitigating effects on some sensitive taxa such as mayflies. However, in both regions insecticides had low relative importance in explaining variability in invertebrate communities, while various habitat parameters were more important. In Brazil, the percent coverage of soft depositional sediment in streams was the most important agriculture-related explanatory variable, and the overall stream-habitat score was the most important variable in Paraguay streams. Paraguay and Brazil both have laws requiring forested riparian buffers. The ample forested riparian buffer zones typical of streams in these regions are likely to have mitigated the effects of pesticides on stream invertebrate communities. This study provides evidence that riparian buffer regulations in the Atlantic Forest region are protecting stream ecosystems from pesticides and other agricultural stressors. Further studies are needed to determine the minimum buffer widths necessary to achieve optimal protection.

Morphometric variability among the species of the Sordida subcomplex (Hemiptera: Reduviidae: Triatominae): evidence for differentiation across the distribution range of Triatoma sordida

BACKGROUND

The Sordida subcomplex (Triatominae) comprises four species, Triatoma garciabesi, T. guasayana, T. patagonica and T. sordida, which differ in epidemiological importance and adaptations to human environments. Some morphological similarities among species make taxonomic identification, population differentiation and species delimitation controversial. Triatoma garciabesi and T. sordida are the most similar species, having been considered alternatively two and a single species until T. garciabesi was re-validated, mostly based on the morphology of male genitalia. More recently, T. sordida from Argentina has been proposed as a new cryptic species distinguishable from T. sordida from Brazil, Bolivia and Paraguay by cytogenetics. We studied linear and geometric morphometry of the head, wings and pronotum in populations of these species aiming to find phenotypic markers for their discrimination, especially between T. sordida and T. garciabesi, and if any set of variables that validates T. sordida from Argentina as a new species.

RESULTS

Head width and pronotum length were the linear variables that best differentiated species. Geometric morphometry revealed significant Mahalanobis distances in wing shape between all pairwise comparisons. Triatoma patagonica exhibited the best discrimination and T. garciabesi overlapped the distribution of the other species in the morphometric space of the first two DFA axes. Head shape showed differentiation between all pairs of species except for T. garciabesi and T. sordida. Pronotum shape did not differentiate T. garciabesi from T. guasayana. The comparison between T. garciabesi and T. sordida from Argentina and T. sordida from Brazil and Bolivia revealed low differentiation based on head and pronotum linear measurements. Pronotum and wing shape were different between T. garciabesi and T. sordida from Brazil and Bolivia and T. sordida from Argentina. Head shape did not differentiate T. garciabesi from T. sordida from Argentina.

CONCLUSIONS

Wing shape best delimited the four species phenotypically. The proposed cryptic species, T. sordida from Argentina, differed from T. sordida from Brazil and Bolivia in all measured shape traits, suggesting that the putative new species may not be cryptic. Additional studies integrating cytogenetic, phenotypic and molecular markers, as well as cross-breeding experiments are needed to confirm if these three entities represent true biological species.