Speleothem oxygen isotope records from the Caribbean, Central, and North America reveal climatic controls that include orbital variation, deglacial forcing related to ocean circulation and ice sheet retreat, and the influence of local and remote sea surface temperature variations. Here, we review these records and the global climate teleconnections they suggest following the recent publication of the Speleothem Isotopes Synthesis and Analysis (SISAL) database. We find that low-latitude records generally reflect changes in precipitation, whereas higher latitude records are sensitive to temperature and moisture source variability. Tropical records suggest precipitation variability is forced by orbital precession and North Atlantic Ocean circulation driven changes in atmospheric convection on long timescales, and tropical sea surface temperature variations on short timescales. On millennial timescales, precipitation seasonality in southwestern North America is related to North Atlantic climate variability. Great Basin speleothem records are closely linked with changes in Northern Hemisphere summer insolation. Although speleothems have revealed these critical global climate teleconnections, the paucity of continuous records precludes our ability to investigate climate drivers from the whole of Central and North America for the Pleistocene through modern. This underscores the need to improve spatial and temporal coverage of speleothem records across this climatically variable region.

Background: Sexually transmitted infections and pregnancy in adolescents are acknowledged public health problems in many countries. Although it is known that the proper use of condoms allows avoiding these health problems, their use in Chile is still limited, for unknown reasons. Objective: Based on planned behavioural theory, the aim was to validate a behaviour model regarding condom use by measuring the influence of the variables that predict this use among Chilean university students. Methods: A cross-sectional descriptive study was carried out in October 2016 among 151 Chilean university students belonging to the health and engineering areas. The information was collected through a self-administered survey. The sample was divided into two groups: stable and not stable relationships. Partial least squares (PLS) regression was used for the analysis. Results: It was possible to explain the condom use of the students by 57%. The attitude was the main variable related to the intention of using condoms, together with the perceived behavioural control. Additionally, there are statistically significant differences in the variables that predict condom use among students with stable relations compared to those without a stable relationship. Conclusions: The planned behavioural theory is useful for predicting condom use behaviour when students have a stable partner.

Background: Recent years have seen chaos in the neonatology use of antibiotics with diverse opinions and recommendations in international guidelines and societies. This has created great uncertainty in which cases to use, for how long, and which tests apply to make these decisions. We conducted a retrospective cohort study about the use of antibiotics in the EpicLatino neonatal units and a Latin American network database, after noting these variations in the 2019 report. Methods: For the year 2019 using the EpicLatino database, we included cases (only first admission) ≤32 weeks gestational age at birth, excluding one unit that did not accept to participate. The number of cases and days receiving antibiotics were recorded as well as the progression for each unit. Inappropriate use of antibiotics was defined as greater than 3 days in patients with negative cultures (blood/CSF cultures) excluding: major malformations, urinary tract infections, necrotizing enterocolitis (NEC) and cases with suspected chorioamnionitis in the mother (the latter two only during the course of diagnosis of NEC or chorioamnionitis). This study was approved by the EpicLatino board of directors and by the participating units. Results: A total of 6,543 days of antibiotics were observed, 49.5% of cases had at least one positive blood/CSF culture. A total of595 days of antibiotics without justification were found in 72 courses in 61 cases; 14/72(19.4%) had no diagnosis of infection in the database, 7/72(9.7%) did not document any culture throughout their stay, and 37/72(51,4%) obtained only one blood/CSF culture during their entire stay. Most diagnosis were clinical sepsis and in 24/58(41%) curses, a diagnosis of pneumonia with a poor positive culture correlation was found. Furthermore, 74% of the units didn´t use pneumonia as a justification to use antibiotics. Other diagnosis found: Conjunctivitis, NEC 1A and rotavirus NEC. Conclusions: Although the method of reviewing the use of antibiotics in a database has a number of limitations, especially the cause that motivated the use of antibiotics and other tools used for diagnosis of infections, the notable differences between units is striking. Although it is difficult to make recommendations to all units, it is important to control infections in some units and in others to reduce the excessive use of antibiotics, especially with diagnosis of pneumonia in neonates and negative blood/CSF cultures.

Nowadays, one of the biggest concern of human being is greenhouse gas emission, especially carbon dioxide emission in developed and under-developing countries. In this study, connectionist models including LSSVM (Least Square Support Vector Machine) and evolutionary methods are employed for predicting the amount of CO₂ emission in six Latin American countries, i.e., Brazil, Mexico, Argentina, Peru, Chile, Venezuela, and Uruguay. The studied region is modelled based on the available input data in terms of Million tons including oil (Million tons), gas (Million tons oil equivalent), coal (Million tons oil equivalent), $R_{ew}$ (Million tons oil equivalent), and Gross Domestic Product (GDP) in terms of billion US dollars.} Moreover, the available patents in the fields of climate change mitigation in six Latin American countries namely Brazil, Mexico, Argentina, Peru, Chile, Venezuela, and Uruguay has been reviewed and analyzed. The results show that except Venezuela, all other mentioned countries have invested in renewable energy R&D activities. Brazil and Argentina have the highest share of renewable energies which account for 60% and 72% respectively.

The period from 2019 to 2021 witnessed an enduring and severe drought that impacted southeast South America. Initially characterized as a meteorological drought, its influence later extended across the entire hydrological cycle. This paper explores the application of the S-TRACK method to monitor and characterize the 2019/21 drought in Southern Brazil (SB) and Southeast Brazil (SEB). Monthly precipitation data from reanalyses and satellites, alongside the Standardized Precipitation Index (SPI) for drought quantification, are utilized. Precipitation datasets, validated against rain gauge records, highlight ERA-5 and CHIRPS as having the highest correlation in both SB and SEB, with PERSIANN exhibiting a moderate correlation. The utilization of the S-TRACK method for spatial drought tracking revealed the temporal dynamics of the drought events, with three significant episodes occurring in 2020/2021. Initially, the onset of the drought was observed in the SB region, characterized by intensities ranging from moderate to extreme. Subsequently, the drought extended northward, reaching its maximum intensity at lower latitudes within the SEB region before either dissipating or experiencing a reduction in both its spatial extent and intensity. The prolonged presence of drought-affected areas in the same region over an extended period contributed significantly to the exacerbation of drought severity, particularly during the March to May trimester.

Circular Economy (CE) is noted as an emerging tool or framework to support sustainable production and consumption agenda. In addition, CE is aiming to be a trigger for redefining economic growth pathways to be sustainable, inclusive, and sensitive to ecological and environmental agendas and to focus its operational standards on co-creating societal benefits. Concerning the guiding principles and the standards of practice applied to implement and scale circular economy, this study will provide an overview of the water sector-specific circularity roadmaps and strategies in the Latin American Region. By using a semi-systematic review, document analysis, and qualitative assessment approach, we highlight framings and operational pathways, gaps, and needs within existing practices of circularity in the water sector. The results provide an overview of CE pathways at the national level of selected countries in LAR iterating those nations reflect various levels of advancement (low to high) with CE-focused innovations and policy support structures specific to the water and wastewater sectors. Towards the closing, the study is pointing to the ‘call for action’ to integrate outstanding advances and innovations in the circular economy within sectoral mandates for water and wastewater management, making an argument that circularity in the water sector could serve as an accelerator toward implementing the agenda outlined in Sustainable Development Goals (SDGs) and in particular for SDG 6 (water security for all).

Background: The febrile patient from tropical areas, in which emerging arboviruses are endemic, represent a diagnostic challenge and potential co-infections with other pathogens (i.e bacteria or parasites) are usually overlooked. Objectives: We present a case of an elderly woman diagnosed with dengue, chikungunya and Leptospira interrogans co-infection. Study Design: Case report. Results: An 87-year old woman from Colombia complained of upper abdominal pain, arthralgia, myalgia, hyporexia, malaise and intermittent fever accompanied with progressive jaundice. She had a medical history of chronic heart failure (Stage C, NYHA III), without documented cardiac murmurs, right bundle branch block, non-valvular atrial fibrillation, hypertension, and chronic venous disease. Her cardiac and pulmonary status quickly deteriorated after 24 hours of her admission without electrocardiographic changes and she required ventilatory and vasopressor support. In the next hours the patient evolved to pulseless electrical activity and then she died. Dengue IgM, NS1 ELISA, MAT for Leptospira interrogans and RT-PCR for chikungunya, were positive. Discussion: This case illustrates a multiple co-infection in a febrile patient from a tropical area of Latin America that evolved to death.

Drought events are evident effects of climate change around the globe and yield several socio-economic impacts. Such effects are even more relevant for South America (SA) since different activities essential for the continent, like agriculture and energy generation, depend highly on water resources. Thus, this study aimed to evaluate future changes in precipitation and hydro-logical droughts occurrence in SA through climate projections from eight global climate models (GCMs) of CMIP6. To this end, statistical downscaling was applied to the projections with the Quantile Delta Mapping technique, and the method proved to be efficient in reducing systematic biases and preserving GCMs’ trends. For the following decades, the results show considerable and statistically significant reductions in precipitation over most of SA, especially during the austral spring, with the most intense signal under the SSP5-8.5 forcing scenario. Furthermore, GCMs showed mixed signals about projections of the frequency and intensity of drought events. Still, they indicated agreement regarding the increase in duration and severity of events over all of SA and a substantial proportion of moderate and severe events over most of Brazil during the 21st century. These results can be helpful for better management of water resources by deci-sion-makers and energy planners.

Histoplasmosis is a systemic mycosis of universal distribution, highly endemic in the Americas. It is caused by a dimorphic fungus Histoplasma capsulatum var. capsulatum. It affects both immunocompetent and immunocompromised individuals where progressive and disseminated forms are observed. A very important risk factor is HIV infection/AIDS, with a mortality rate of 20-40% in Latin America. The diagnosis of this mycosis is made by conventional and molecular methods or by antigen and antibody detection. This study evaluated the sensitivity and specificity of a commercial kit for the detection of Histoplasma antigen by an EIA (HC-Ag) technique in 50 patients with histoplasmosis associated with AIDS. In addition, its performance was compared with that of other diagnostic techniques routinely used in our laboratory. HC-Ag had a sensitivity (S) of 94%, specificity (E) 95.5%, positive predictive value (PPV) 94% and negative predictive value (NPV) 95.5%. The delay time of the results was 4 days, similar to that of antibody detection and n-PCR and much less than that of blood cultures. The combination of methods improved S and NPV: 100%; with similar values in E and PPV. The HC-Ag method demonstrated its usefulness in the diagnosis of progressive disseminated histoplasmosis and the combination of methods is a good option to increase sensitivity and decrease the time to reach the diagnosis of certainty. This allows improving the strategy in the management of the disease and decreasing its case-fatality rate.

The objective of this research article is to determine if social and cultural capital are factors that cause inequalities in the level of knowledge in civic and citizenship education, between Latin American and European countries. To achieve this purpose, information from the National Study of Civic and Citizen Education -ICCS-, of the International Association for the Evaluation of Educational Achievement -IEA-, of the year 2016, is used. Methodologically speaking, the Educational Production Function -EPF- is estimated and subsequently, the Oaxaca-Blinder decomposition technique is applied to quantify the differences in civic and citizenship education and see how much they are explained by the characteristics of the student and their family. the school, the social and cultural capital. As a main result, educational inequalities were found in favor of European countries, and are due to a greater extent to differences in school resources, between Latin American and European countries, followed by differences in social and cultural capital, therefore, it is the European students who make the best use of and benefit from the differences in school endowments and in social and cultural capital.

The worldwide number of migrants has had a rapid increase during the last fifteen years. Despite the extensive research studies that elucidate the increase in migrants' recipient countries, we know little about the relationship between the climate factors and human mobility in the countries of origin. Hence, this study focuses on the effects of weather and the propensity of individuals to leave a territory by measuring the importance of rain precipitation or the lack of it in one of the critical food corridors of Central America, formed by El Salvador, Honduras, and Guatemala. To study the mobility process, we develop a stochastic frontier model; the main result shows a greater propensity to migrate when there is a significant drought event in the place of origin. Some other factors that motivate people to leave their homeland are the effect of other climate events measured through the control system (ENSO), homicide levels, economic performance, and exchange rate. The findings allow differentiating between drought and excess precipitation on a population and mobility to other territories. In addition, these results permit us to derive observable implications of the different effects of flooding and drought and create public policies of prevention, mitigation, and resilience.

Energy transitions are reshaping the global energy system. Such shift has taken the power system to become a critical infrastructure for achieving economic development of every nation in the planet, therefore, guaranteeing its security is crucial, not only for energy purposes but as a part of a national security strategy. This paper presents a multi-dimensional index developed to assess energy security of electrical systems in the long term. This tool, named Power System Security Index (PSIx), and which has been previously used for the evaluation of a country in two different time frames, is applied to evaluate the member countries of the Latin American Energy Organization, located within the Latin America and the Caribbean region, in order to measure their performance on energy security. Mixed results were obtained from the analysis, with clear top performers in the region such as Argentina, while there are others with broad areas of opportunity, as it is the case of Haiti.

The primary objective of this study is to examine the extent of financial integration between Latin American and US financial markets, particularly in light of recent efforts to foster integration through trade agreements. Spanning from January 1, 1990, to December 31, 2019, the sample focuses on major market indices and key sectors. Financial integration is quantified using a DCC multivariate GARCH model, incorporating a smooth transition model, structural breaks, and regression-based approaches. Results indicate increased comovement with the US for main market indices in Argentina, Chile, Colombia, Mexico, and Peru, while Brazil shows a decrease. Similar trends are observed in sectoral analyses. The study also reveals heightened correlation post-trade agreements. Structural break analysis highlights significant shifts in dynamic correlations for countries with US free trade agreements. These findings support the argument of increased financial integration, bearing significance for portfolio diversification and international policy formulation.

In a 1.5°C warmer world, the Northeastern (NE) South America’s ecosystems will experience more severe droughts, associated with decreasing rainfall. The severity of flash drought events based on vegetation and surface soil moisture has not been identified over the Caatinga ecosys-tem. This study aimed to characterize the impact of flash drought events on vegetation response via soil moisture over NE South America during the first two decades of the 2000s. Three drought indices were used to characterize flash droughts: the Standardized Difference Vegetation Index (SDVI) derived from Meteosat Second Generation (MSG), the Standardized Precipitation Index (SPI) from ground-data, and the Surface Soil Moisture (SSM) product-based Soil Moisture and Ocean Salinity (SMOS). Results revealed dramatic impacts of flash drought events on vegetation dynamics that caused abrupt changes in the regional vegetation phenology. The regional patterns of flash drought events in 2012 over NE South America were identified and had a severe impact on its Caatinga-like vegetation-dependent moisture response. In 2012, anomalously long dry spells with negative rainfall anomalies in the non-rainy season and persistent on vege-tation greenness and rapidly decreased soil moisture were prominent, thus identifying NE South America to the impacts of flash drought events. Additionally, the results from the trends analysis of radiance fluxes estimated from the MSG satellites over 18 years revealed that an overall drying trend in the NE South America semiarid ecosystem during the last two decades. Here, flash drought events were identified as the conse-quent rainfall deficiency at SPI-3< −1 for a period of five consecutive weeks or more, which the soil moisture content dropping from the 40th percentile to below the 20th percentile, with the NDVI lower than 0.30 unit. These results could be useful to guide flash-droughts early warning systems in NE South America.

Streptococcus suis serotype 2 is an important swine bacterial pathogen causing sudden death, septic shock, and meningitis. However, serotype 2 strains are phenotypically and genotypically heterogeneous and composed by a multitude of sequence types (STs) whose distribution greatly varies worldwide. It has been previously shown that lipoprotein (LPP) maturation enzymes diacylglyceryl transferase (Lgt) and signal peptidase (Lsp) significantly modulate the inflammatory host response and play a differential role in virulence depending on the genetic background of the strain. Differently from Eurasian ST1/ST7 strains, the capsular polysaccharide of a North American S. suis serotype 2 ST25 representative strain only partially masks sub-capsular domains and bacterial wall components. Thus, our hypothesis is that since LPPs would be more surface exposed in ST25 strains than in their ST1 or ST7 counterparts, the maturation enzymes would play a more important role in the pathogenesis of the infection caused by the North American strain. Using isogenic Δlgt and Δlsp mutants derived from the wild-type ST25 strain, our studies suggest that these enzymes do not seem to play a role in the interaction between S. suis and epithelial and endothelial cells, regardless the genetics background of the strain used. However, a role in the formation of biofilms (also independently of the STs) has been demonstrated. Moreover, the involvement of LPP dendritic cell activation in vitro seems to be somehow more pronounced with the ST25 strain. Finally, the Lgt enzyme seems to play a more important role in the virulence of the ST25 strain. Although some differences between STs could be observed, our original hypothesis that LPPs would be significantly more important in ST25 strains due to a better bacterial surface exposition could not be confirmed.

We have surveyed peer-reviewed literature on the awareness of human papillomavirus (HPV) infection among Indigenous males in North America and Oceania. Using keywords HPV plus male, men or boy, and ethnical filters such as Indigenous, Aboriginal or First Nations, we retrieved 47 articles based on titles of which we kept 14 after reading the abstracts. Reported HPV awareness was generally low in Indigenous males in North America with no peer-reviewed data from Oceania. The lower understanding by males compared to females was largely attributable to misconceptions about HPV-related diseases, their transmission, and prevention. Lack of awareness and concern toward the risk of contracting HPV infection in Indigenous males suggests an impediment in disseminating health information about this cancer-causing virus. Culturally sensitive education, with emphasis on Indigenous males, is needed to improve this group’s HPV knowledge. Researchers should also engage meaningfully with Indigenous communities by building rapport to achieve a positive change in attitude.

Dendroclimatology has gained relevance during the XXI century. We analyze the state of-the-art of dendroclimatology in Latin America during the past 28 years (1990 to 2019), identifying the current state and recent advances in the application of dendroclimatology in this region. We carried out a systematic review in ScienceDirect, Web of Science, and Scopus databases using Boolean operators to logically connect the keywords “dendrochronology,” “dendroclimatology,” “trend,” “climatic variability,” and “climatic variability trend”, for each country. Dendroclimatological research conducted in the region focused on climatic reconstruction and the evaluation of new tree species with dendrochronological potential, which increase in 2010, then there was a gap between 1995 and 1996, later increase to present. Dendroclimatological studies in Latin America have been mainly developed in temperate climate zones (82.4 %) followed by tropical or subtropical areas (17.6 %). Dendroclimatological research in Latin America has provided advances in the study of climate variability by defining response functions of tree rings to climate. The generated information allows for a better understanding of the spatial and temporal dynamics of climatic variability and about its effects on ecosystems and society. We also call for increased dendroclimatological research based on subtropical and tropical forests limited studied until today.

Coronavirus disease 2019 (COVID-19) fatal outcomes have been associated with multiple cardiovascular risk factors. In new epidemic areas, such as Latin America, there is a lack of studies about this. Here, we evaluated those factors in a retrospective cohort of patients in a national reference hospital of Lima, Peru. Design. A retrospective cohort observational study was done. For this study, information was obtained from clinical records of the hospital for the cases that were laboratory-diagnosed and related, during March 6^th and April 30^th, 2020. rRT-PCR was used for the detection of the RNA of SARS-CoV-2 following the protocol Charité, Berlin, Germany, from nasopharyngeal swabs at the National Institute of Health. Calculation of the odds ratio (OR) with the respective 95% confidence interval (95% CI) was done, also logistic regression for adjusted OR (multivariate) was done. Values of p < 0.05 were considered significant for all analyses. Results. One hundred six hospitalized patients were evaluated. The mean age of patients was 61.58 years (SD 16.81). Cardiovascular risk factors among them were hypertension (46.2%), diabetes (28.3%), and obesity (28.3%), among others. Fifty-six patients died (52.8%). Mortality associated factors at the multivariate analysis were arterial hypertension (OR=1.343, 95% 1.089-1.667), myocardial injury (OR=1.303, 95% 1.031-1.642), and mechanical ventilation (OR 1.262, 95% 1.034-1.665), as associated factors. Conclusion. As observed in other regions of the world, cardiovascular risk factors represent a significant and independent threat to be considered in patients with COVID-19. Further studies and interventions in Peru and Latin America are expected.

Introduction: Parameters used for neonatal mortality calculation vary among publications. Mortality in < 33 weeks gestational age at birth display global variations across different healthcare units. Objective: This study aims to explore trends in neonatal mortality among infants born preterm in the different units in Latin America and the Caribbean utilizing the EpicLatino Network Database in comparison to Canadian Neonatal Network (CNN) 2022. Materials and Methods: This study focused on an eight-year period, with a particular attention to mortality rates during the pre-pandemic (2015-2019) and pandemic/post pandemic (2020-2022) periods. Survival rates from CNN 2022 were included in the comparison analysis. Logistic regression analysis was confined to the 2020-2022 period. Adjustments were made for factors including gestational age, small for gestational age (SGA), Snape II score, inborn/outborn status, and center. As major malformations could account for mortality differences among units. The incidence of major congenital malformations, as defined by CNN, was compared among deceased patients. Results: A total of 15,454 records from 2015-2019 and 10,711 records from 2020-2022 were scrutinized. Overall, there were no significant differences in mortality rates between the two time periods (p=0.22). Moreover, the originating unit during the 2020-2022 period significantly influenced all statistical computations. Conclusions: Survival rates among infants < 26 weeks of gestation in Latin America and the Caribbean are on an upward trajectory, with the healthcare unit playing a pivotal role in this outcome within the EpicLatino database. Major malformations do not seem to be a significant contributing factor. These findings underscore the imperative of implementing quality improvement initiatives to elevate neonatal care standards in Latin America and the Caribbean.

Since 2017 Cartagena UNESCO World Heritage has threatened to be categorized as "in Danger" by UNESCO. This research analyzes two main critical aspects, Governance and Current state of the Site. Regarding Governance, the study aims to identify strengths, weaknesses, opportunities and treats in the UNESCO Site. Exemplary heritage management systems are studied to propose an adaptable management approach specifically for Cartagena. On the other hand, a comprehensive analysis is conducted utilizing a photographic report that highlights the major issues arising from inadequate heritage management. Hyperspectral images obtained from a previous study are employed to identify vegetation and asbestos-cement roofs within the cultural heritage Site. The study reveals that the ambiguity surrounding decision-making authority for heritage management, distributed between the Mayor's Office and the Ministry of Culture, is a primary challenge. This fragmentation has resulted in duplicated efforts and a lack of coordinated action, significantly compromising the conservation and protection of the cultural heritage Site. Moreover, twelve current shortcomings of cultural heritage in Cartagena are identified through authors' five-year on-site regular visits, photographic reports and observation. To address the prevailing concerns, a new line of command for cultural heritage management is proposed as the most effective means of tackling these challenges. Additionally, general recommendations are presented to mitigate the existing problems and prevent the classification of Cartagena's heritage as "at risk" by UNESCO in the near future. This research provides a scientific perspective, drawing upon years of experience studying heritage and residing in the city, devoid of political influences or conflicts of interest.

Energy imbalance gap (EIG) is defined as the average daily difference between energy intake (EI) and energy expenditure (EE). This study aimed to examine the associations between EIG and sociodemographic and anthropometric variables in the adolescent population of eight Latin American countries. A total of 680 adolescents aged 15 to 18 were included in this study. EI was estimated using two non-consecutive 24-hour dietary recalls. EE was predicted from Schofield equations using physical activity levels obtained through the long version of the International Physical Activity Questionnaire. Sociodemographic data and anthropometric measurements were also obtained. A descriptive analysis and multilevel linear regression models were used to examine associations between variables. The mean EI, EE, and EIG were 2091.3 kcal, 2067.8 kcal, and 23.5 kcal, respectively. Argentina and Colombia had the highest EI and EIG, whereas Chile and Costa Rica had the lowest EI and EIG. Males had a higher EI (2262.4 kcal) and EE (2172.2 kcal) than females (1930.1 kcal and 2084.5 kcal), respectively (p<0,05). Overweight subjects had a lower EIG than did underweight and normal-weight subjects (p<0,05). Subjects with high SES had a lower EE (2047.0 kcal) than those with low SES (1963.7 kcal) (p<0,05). Sex and BMI were associated with EIG in adolescents from Latin America.

Background: Some patients who have recovered from COVID-19 have experienced a range of persistent symptoms or the appearance of new ones after a SARS-CoV-2 infection. These symptoms can last from weeks to months, impacting everyday functioning to a significant number of patients. Methods: A cross-sectional analysis based on an online, self-reporting questionnaire was conducted in Ecuador from April to July 2022. Participants were invited by social media, radio, and TV to voluntarily participate in our study. A total of 2103 surveys were included in this study. We compared socio-demographic variables and long-term persisting symptoms at low (&lt; 2,500 m) and high altitude (&gt;2,500 m).Results: Overall, 1100 (52.3%) responders claimed to have long-term symptoms after SARS-CoV-2 infection. Most of these symptoms were reported by women (64.0%), the most affected group was young adults (68.5%), and the majority of long-haulers were mestizos (91.6%). We found that high altitude residents were more likely to report persisting symptoms (71.7%) versus those living at lower altitudes (29.3%). The most common symptoms were fatigue or tiredness (8.4%), hair loss (5.1%) and difficulty concentrating (5.0%). The highest proportion of persisting symptoms was observed among those who received an incomplete vaccine scheme.Conclusions: This is the first study describing post-COVID symptoms' persistence in low and high-altitude residents. Our findings demonstrate that women, especially those aging between 20-40, are more likely to describe sequalae associated with post-COVID. We also found that living at a high altitude was associated with earlier onset and longer symptom duration. Finally, we found a greater risk to report long lasting symptoms among women, those with previous comorbidities and those who had a severer acute SARS-CoV-2 infection.

This paper investigates the impact of price and real exchange rate volatility on Foreign Direct Investment (FDI) inflows in a panel of 10 Latin American and Caribbean countries, observed between 1990 and 2012. Both price and exchange rate volatility series are estimated through the Generalized Autoregressive Conditional Heteroscedasticity model (GARCH). Our results, obtained employing the Fixed Effects estimator, confirm the theory of hysteresis and option value, in so far it is found a statistically significant negative effect of exchange rate volatility on FDI. Price volatility, instead, turns out to be positive but insignificant. Moreover, we show that human capital and trade openness are key for attracting foreign capital. From the policy perspective, our analysis suggests the importance of stabilization policies as well as the one of government credibility in promoting trade openness and human capital formation.

In response to new developments of work and employment in high-income countries (HICs), psychosocial aspects of work and health received increased attention. In contrast, middle-income countries (MICs) are mainly concerned with severe challenges of noxious and dangerous material work environments, poor employment conditions, and deficient social policies, leaving psychosocial aspects in a marginal role at best. More recently, differences between these two worlds were even aggravated by the COVID-19 pandemic. Yet, with economic globalisation and growing worldwide interconnectivity, the world of work in MICs is being rapidly transformed, sharing several concerns with modern Western societies. In this process, psychosocial occupational health will become an increasingly pressing issue. This contribution explores to what extent psychosocial aspects of work and health are already addressed in research originating from MICs. A selective focus on recent findings from two regions, Asia Pacific and Latin America, reveals a high degree of awareness of, and inquiry into, work-stress related problems within these countries. Importantly, in addition to incorporating research progress from HICs, these analyses identify new aspects within specific cultural and socio-economic environments, thus enriching the international state of art.

(1) Background: Neglected tropical diseases (NTDs) have been overlooked on the global health agenda and in the priorities of national systems in low- and middle-income countries (LMICs). In 2012, the Sustainable Development Goals (SDGs) were created to ensure healthy lives and promoting well-being for all. This roadmap set out to accelerate work to overcome the global impact of NTDs. Almost a decade has passed since NTDs were re-launched as a global priority. Investment in research and development, as well as the production of scientific literature on NTDs, is expected to have increased significantly. (2) Methods: A bibliometric analysis of the scientific production of Latin America and the Caribbean (LAC) was carried out in relation to 19 endemic NTDs. These data were compared with the scientific production in malaria, tuberculosis and HIV / AIDS. The database available from Thomson Reuters Web of Science (WoS) was used. In addition, the average annual growth percentage was calculated for each disease. (3) Results: In the last decade, the NTDs with the highest number of publications in the world were dengue and leishmaniasis. The United States was the most prolific country in the world in 15 out of 19 NTDs analyzed. In the LAC region, Brazil was the largest contributor for 16 of the 19 NTDs analyzed. Arboviral diseases showed the highest average annual growth. The number of publications for malaria, tuberculosis and HIV /AIDS was considerably higher than for NTDs. The contribution of most LAC countries, especially those considered as LMICs, is inadequate and does not reflect the relevance of NTDs for the public health of the population. (4) Conclusion: This is the first bibliometric analysis to assess the trend of scientific documents on endemic NTDs in LAC. Our results could be used by decision makers both to strengthen investment policies in research and development in NTDs.

Congenital heart disease (CHD) is among the 4 more common causes of infant mortality in Latin America. Pulse oximetry screening (POS) is useful for early diagnosis and improved outcomes of critical CHD. We describe POS implementation efforts in Latin American countries guided and/or coordinated by the Ibero American Society of Neonatology (SIBEN) as well as the unique challenges that are faced for universal implementation. SIBEN collaborates to improve neonatal quality of care and outcomes. A few years ago, a Clinical Consensus on POS was finalized. Since then, we participated in 12 Latin American countries to educate neonatal nurses and neonatologists on POS and to help with its implementation. The findings reveal that despite wide disparities in care that exist between and within countries, and the difficulties and challenges for implementing POS, significant progress was made. We conclude that universal POS is not easy to implement in Latin America but, when executed, not only it has been of significant value for babies with CHD but also for many with other hypoxemic conditions. The successful and universal implementation of POS in the future is essential to reduce the mortality associated with CHD and other hypoxemic conditions and will ultimately lead to the survival of many more Latin American babies. POS saves newborns’ lives in Latin America.

The life and work of Ignacio Ellacuría, S.J. is of radical vision, and revolutionary change. His dynamic life and works accompanied El Salvador and the Universidad Centroamericana through perhaps the most tumultuous years of the country’s history, yet there has been limited work done to examine his contributions. This paper shows how Ellacuría viewed the role of a Christian intellectual, and a Christian university within his philosophical and theological framework. I argue that Ignacio Ellacuría held, similarly to his soteriological views, that the intellectual must also be willing to sacrifice all for the sake of his/her work in a pattern of discipleship/martyrdom prefigured by his exemplars Christ and Socrates. It was this dedication to praxis and theory that western theology and philosophy had respectfully lost since their foundations which he sought to restore to a central role. In conclusion, the Christian intellectual and institution, according to Ellacuría, must use its voice and life in service of the people even to the point of martyrdom; he would argue, the implicit reason for Christian martyrdom and the crucifixion of Christ himself.

Latin America and the Caribbean (LAC) is one of the worst-hit regions globally by COVID-19 pandemic. Yet, scarce literature exists that examines the research strategy of LAC in facing COVID-19. The present study aims to quantify and assess the production of COVID-19 publications in thirty-two countries in LAC during the first half of 2020. A Scopus/PubMed/LILACS search was performed to retrieve research articles related to COVID-19 published from January 1 to July 31, 2020. Subgroup analysis including only original publications was used to better ascertain the contribution of LAC countries, and standardization measures were applied to comparisons of country-specific contributions. We identified 1291 publications across the region. Overall, most articles in the region were non-original (81.6%), and the most productive countries were Brazil (43.9%), Mexico (9.14%), and Colombia (7.98%). This trend shifted to Chile after the standardization. Among original studies, the most common study design was cross-sectional (25.8%). LAC countries generate articles primarily pertaining to diagnosis and treatment (27.4%). In the subgroup analysis, however, epidemiology and surveillance was the most prevalent research focus (24.1%). LAC countries should perform more research with a higher level of evidence to inform health policy making to ease the burden of COVID-19 in the region.

City marathons have evolved and grown exponentially in type and popularity, managerial complexity, for their financial impact on their host cities and for the attraction of corporate sponsors. Much research has focused on evaluating the broad economic, urban, tourist, social, sporting, and symbolic effects of city marathons on host cities. Research have not examined the importance of the contribution of sponsors to the financial stability and its implications to the overall management and further success of marathons. This article focuses on the cases of the Bank of America Chicago Marathon and the Marathon Valencia Trinidad Alfonso and examines how effective has been the contribution of their sponsors to the financial stability and its implications for the management and success of both races over time. Results show that the international success of both events –in terms of sporting participation, performance and economic impact– is closely related to the design and management of the event; the synergies between the political, business and sporting spheres that the organizational leadership of the event has made it possible to implement and, as a consequence, the support received from sponsors, which has not only provided both races with financial stability, but also has contributed to improve the management of the race.

Background: In America, vaccine-related deaths constitute a significant contributor to child mortality. An essential means of reducing this is through broad vaccine coverage. The COVID-19 pandemic has posed a potential disruption to vaccine coverage due to its effects on the healthcare system. Objectives: This study aims to evaluate the impact of the COVID-19 pandemic on DTP3 vaccination coverage in the Americas, investigating trends from 2012 to 2022 to identify significant changes, regional disparities, and the overall effect of the pandemic on progress towards global immunization targets. Methods: This study used the coverage data for the third dose of the Diphtheria, Tetanus, and Pertussis Vaccine (DTP3) pulled from UNICEF databases spanning 2012 to 2022. We conducted a JoinPoint regression to identify points of significant trend changes. The annual percentage change (APC) and 95% confidence intervals (95% CI) were calculated for America and its regions. We also used segmented regression analysis. Using the Chi-square test, we compared DTP3 vaccination coverage for each country between 2019 and 2022. Results: Overall, America saw a decrease in vaccine coverage during this period, with an APC of -1.4 (95% CI -1.8.; -1.0). This trend varied across regions. In North America, the decrease was negligible (-0.1% APC). South America showed the steepest decrease, with an APC of -2.5%. Central America also signif-icantly declined, with an APC of -1.3%. Our findings suggest a concerning trend of declining DTP vaccination rates in the Americas, exacerbated in certain regions, in the wake of the COVID-19 pandemic. The absolute decrease in vaccine coverage in the Americas was -4 % between 2019 and 2022, with the most significant drop observed in Central America (-7 %). However, six countries reported increased vaccination rates post-COVID-19, led by Brazil, with a 7% increase. Conversely, twenty-two countries registered a decline in DTP3 vaccine coverage, with the average decrease being -7.37%. This decline poses a significant challenge to achieving the WHO's target of 90% coverage for the third dose of DTP by 2030, as evidenced by the reduction in the number of countries meeting this target from 2019 to 2022. Conclusions: The COVID-19 pandemic has impacted vaccine coverage in America, leading to a decrease, especially across Central America.

Vector-borne disease (VBD) accounts for more than 17% of the global infectious disease burden, disproportionately affecting developing nations within tropical and subtropical areas. As Aedes aegypti mosquitoes are the principal vector for the transmission of many Public Health pathogens, our study examined their population dynamics within the seasonal context of tropical dry biomes in El Salvador as incidence of VBD in this region has increased in recent years. Species that rely on sexual reproduction must maintain a balanced sex ratio (1:1) to support their population dynamics, however, our phenological analysis of field-collected A. aegypti specimens revealed significant sex ratio variations during dry and wet seasons. Interestingly, we detected a seasonal shift that favored female mosquitoes during the dry season, highlighting the dynamic nature of mosquito populations in highly urbanized environments like El Salvador. By linking sex ratio distortions to anthropogenic factors, our study underscores the importance of comprehensively characterizing the urban ecology of vectors for the development of effective biocontrol strategies. As such, we advocate for more nuanced vector control approaches that consider ecological factors as well as the human behaviors that influence mosquito breeding habitats to effectively combat the rise of VBDs amid global climate changes.

Since its 2013 emergence in the Americas, chikungunya virus (CHIKV) has posed a serious threat to public health. Early and accurate diagnosis of the disease, though currently lacking in clinics, is integral to enable timely care and epidemiological response. We developed a dual detection system: a CHIKV antigen E1/E2-based enzyme-linked immunosorbent assay (ELISA) and a lateral flow test using high-affinity anti-CHIKV antibodies. The ELISA was validated with 100 PCR-tested acute Chikungunya fever samples from Honduras. The assay had an overall sensitivity and specificity of 51% and 96.67%, respectively, with accuracy reaching 95.45% sensitivity and 92.03% specificity at a Ct cutoff of 22. As the Ct value increased from 22, ELISA sensitivity decreased. We then developed and validated two lateral flow tests using independent antibody pairs. The sensitivity and specificity reached 100% for both lateral flow tests using 39 samples from Colombia and Honduras at Ct cutoffs of 20 and 27, respectively. For both lateral flow tests, sensitivity decreased as the Ct increased after 27. Because CHIKV E1/E2 are exposed in the virion surfaces in serum during the acute infection phase, these sensitive and specific assays demonstrate opportunities for early detection of this emerging human pathogen.

Although numerous articles have been published to address drivers or barriers of corporate social responsibility (CSR), some parts of the world have received less attention. In this study, I reviewed the literature, from 2010 to 2021, to identify drivers and barriers of CSR in the the Middle East and North Africa (MENA) region and compare them with the findings in western countries. (2) Methods: For this study, I used a structured literature review method. By setting the inclusion and exclusion criteria, only 28 articles remained from selected database; (3) Results: The findings revealed some CSR drivers, such as leadership styles, profitability, reputation, moral commitment, and environmental conservation are common in both regions. There are also some differences between CSR drivers, for example religious beliefs, low concentration of ownership, and company characteristics are some of the drivers in the MENA region. Maintaining social license to operate, avoiding the risks of community opposition, pressure from the government, and consumer demand tend to be more important in western countries. Common barriers in both regions are lack of financial resources, cost, lack of CSR knowledge and awareness, and ownership concentration. This review also highlighted that lack of law enforcement, lack of stakeholder communication, lack of management commitment, lack of interests, corruption, and financial debts are some of the addressed barriers of CSR in the MENA region, while cost/benefit ratio, lack of customer interest, and lack of scientific frameworks are the special barriers in western countries. (4) Conclusions: While researchers in western countries have more focus on energy sector, there is a lack of research about drivers and barriers of CSR in the MENA region in several industries, including oil and gas.

In January and February 2001, El Salvador was hit by two strong earthquakes that triggered thousands of landslides, causing 1,259 fatalities and extensive damage. The analysis of aerial and SPOT-4 satellite images taken a few days after the events allowed us to map 6,491 coesismic landslides, which occurred in 14 study areas extending for about 400 km2. Four different Multivariate Adaptive Regression Splines (MARS) models were produced by using different covariate sets and landslide inventories, the latter containing the slope failures triggered by an extreme rainfall event of November 2009 and those induced by the earthquakes of 2001. Moreover, two validation scenarios were employed, including the 25% and 95% of the mapped landslides, respectively. The results of our experiment revealed that: (i) MARS algorithm provides reliable predictions of coesismic landslides; (ii) models calibrated with rainfall-induced landslides predict with acceptable accuracy landslides caused by deep earthquakes and distributed over vast areas; (iii) the best accuracy is achieved by models trained with both preparatory and trigger variables; (iv) a small portion of the landslides produced by an earthquake can be used to calibrate MARS predictive models that help to identify slopes where yet unreported landslides may have occurred.

This is a study of Political Economy on religion and migration management in the United States of America (USA). This paper offers a review of migrants-citizens relations in the USA, with attention to the pendulum effect, moving from integration policies (open doors and melting pot agenda) to official persecution (raids and deportations), with a high social opportunity cost. There has been a split between the State and civil society, causing civil disobedience and sanctuary network across the country. Also, it is paid attention to the American post-modern paradox, as a result of culture wars and identity politics that imply a violation of American constitutional principles (i.e. religious liberty, freedom of movement, to pursuit the happiness). Special attention is paid to the development of the Sanctuary Movement, as an ongoing example of the sociocultural upheaval bringing grassroots society into confrontation with powerful elites by promoting resistance and offering help to the needy, even if this results in sanctions. This movement was revitalized after the values crisis of 2008, but it has also been polarized between those who follow the traditional approach to socio-religious action in the form of peaceful civil disobedience, and those who follow the ideological anti-system and communitarian approach, which causes greater tension for the immigrants themselves

Non-ulcerated cutaneous leishmaniasis (NUCL) is an atypical and peculiar clinical form of the disease that was first described by Ponce et al. (1988) in Honduras (Central America), where iso-lated or disseminated popular and/or nodular skin lesions are commonly seen in adolescents and young adults. Leishmania (L.) chagasi was then incriminated as the causal agent of the disease, as well as of American visceral leishmaniasis (AVL), although NUCL has been shown to be more prevalent than AVL in the region. Considering, however, the dubious taxonomic character of the causal agent of NUCL, as there is no evidence of this form of disease associated with L. (L.) cha-gasi in South America, this study aimed to carry out a retrospective taxonomic analysis on a se-ries of studies on the diagnostic approach to the Honduran parasite in loco (El Tigre island, Amapala municipality, west coast of Honduras), where taxonomic characters of a biological (in vitro and in vivo), epidemiological (vector and canine reservoir), clinical-immunological (im-munopathological features of in situ skin lesion and systemic infection) and molecular (ge-nomic/phylogenetic analyses) nature were considered. The findings, particularly those of mo-lecular nature, such as: the Honduran parasite showed to be more ancestral (molecular clock analysis of the DNA polymerase alpha subunit gene) than all viscerotropic ones [L. (L.) chagasi, L. (L.) donovani and L. (L.) infantum], as well as presenting an absolutely unprecedented structural variation on chromosome 17 and the highest frequency of genomic SNPs (more than twice the number seen in the Brazilian parasite), in addition to representing a different phylogenetic lin-eage (mainly in the NJ - RNA Pol II tree) from those viscerotropic ones, have pointed to the characterization of a new leishmanine parasite, Leishmania (Leishmania) poncei n. sp. (Kinetoplas-tea: Trypanosomatidae), in honor of Professor Ponce, who was the first researcher to describe NUCL in Honduras.

We investigate how formal institutional distance (FID) moderates the relationship between cul-tural distance (CD) and the financial performance of foreign subsidiaries firms. Following recent research, we estimate the asymmetric effects of CD by considering its size and direction towards host countries on the opposite poles of each cultural dimension` scale. We propose that a limited understanding of the formal institutions in the host country, as measured by the magnitude and direction of the FID, can have a positive moderating effect, increasing the impact of CD on finan-cial performance. This is mainly because foreign subsidiary firms may be more reliant on their ca-pacity to navigate the less formal (and more implicit) aspects of the host country's institutional environment, such as their ability to cope with the CD. We use foreign subsidiary data from the Orbis database including 22 developed and 22 developing home countries and over 1400 foreign subsidiaries during a period of 3 consecutive years operating in 10 of the largest economies (host countries) in Latin America including: Argentina, Brazil, Colombia, Chile, Ecuador, Mexico, Panama, Peru, Uruguay, and Venezuela. Findings confirm the asymmetric effects of CD, howev-er, by considering the direction of FID, our findings reveal that the higher the FID towards less developed host countries, the more significant the effects of CD on the financial performance. These findings contribute to the knowledge of how formal and informal institutional distances in-teract by showing that the greater the FID towards less developed host countries, to higher the impact of CD on the financial performance of foreign subsidiary firms.