Cayetano Heredia University (Spanish: Universidad Peruana Cayetano Heredia, UPCH; or simply Cayetano Heredia) is a private nonprofit university located in Lima, Peru. It was named in honor of Cayetano Heredia, one of the eminent Peruvian physicians of the 19th century. The university is overseen by a board of trustees (patronato) and is not owned by any private or state entity. It is considered one of the top medical schools in Peru, along the Faculty of Medicine "San Fernando" of National University of San Marcos, and is currently one of the major producers and publishers of scientific research in the country.
To assess the anthropogenic impact on carbon and nitrogen accumulation rates in wetlands associated with Lake Titicaca, sediment cores recording the past century in contrasting environmental conditions were analyzed using elemental and isotopic proxies. Duplicate 50-cm sediment cores were collected from wetlands within the National Reserve environment of Lake Titicaca, and from a wetland area under the direct influence of a sewage plant. Subsamples were analyzed for total organic carbon (TOC), total nitrogen (TN), δ13C, and δ15N. Sediment accumulation rates (SAR) and Mass accumulation rates (MAR) were calculated from 210Pb-excess activity using the Constant Flux Constant Sedimentation method (CFCS). The SAR in the impacted area averaged 0.38 cm yr−1, up to twofold higher than in the “National Reserve”, likely due to increased organic matter influx from anthropogenic activities. Although δ13C values showed no significant differences between the study areas, abrupt shifts in organic matter sources and significantly heavier δ15N values were observed in the impacted area after the 1970s, indicating that carbon and nitrogen sources derive from a mix of terrestrial vegetation, algae, and cyanobacteria, fertilized by nutrient enrichment from anthropogenic activities. Despite no significant differences in carbon and nitrogen fluxes between both studied areas, the lower stocks in the impacted area indicate a lower accumulation capacity due to a higher contribution of labile organic matter. This study underscores the crucial role of wetlands associated with Lake Titicaca in the deposition and accumulation of organic carbon driven by both natural and anthropogenic factors and highlights the importance of wetland preservation in maintaining the accumulation capacity of these ecosystems in the context of global wetland eutrophication.
Obstructive sleep apnea (OSA) is strongly associated with obesity, and weight loss is a cornerstone of its management. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), are a class of medications that induce significant weight loss and have shown promise in improving OSA severity. This meta-analysis aimed to evaluate the pooled efficacy of GLP-1 RAs on sleep-disordered breathing, body weight, and cardiovascular risk factors in patients with OSA. A systematic review and meta-analysis of four randomized controlled trials were performed, comparing GLP-1 RA therapy with placebo in adults with OSA. The primary outcomes analyzed were the mean differences in the change from baseline for the apnea-hypopnea index (AHI), body weight, and systolic and diastolic blood pressure. In the pooled analysis, treatment with GLP-1 RAs was associated with a robust and statistically significant reduction in AHI (mean difference [MD]: -13.89 events/hour; p < 0.01). Therapy also resulted in substantial weight loss compared to placebo (MD: -12.46 kg; p < 0.01). For cardiovascular parameters, the use of GLP-1 RA was associated with a significant reduction in systolic blood pressure (mean difference [MD]: -4.86 mmHg; p < 0.01) and diastolic blood pressure (p = 0.03). GLP-1 receptor agonists significantly reduce OSA severity, promote substantial weight loss, and lower systolic and diastolic blood pressure in patients with obstructive sleep apnea and obesity. These findings support the role of GLP-1 RAs as a multifaceted and effective therapeutic intervention for managing OSA.
The neutrophil-to-lymphocyte ratio (NLR) is an accessible biomarker of systemic inflammation with potential prognostic utility in cerebrovascular disease (CVD). Its relationship with prolonged hospitalization in stroke remains insufficiently explored in Peruvian populations. To evaluate whether the NLR at admission is associated with prolonged hospital stay (≥ 9 days) in patients with ischemic and hemorrhagic CVD treated at Hospital de Emergencias José Casimiro Ulloa (2022–2024) A retrospective observational study was performed including 227 adults with confirmed CVD. Clinical, demographic, and laboratory data were retrieved from medical records. Optimal NLR cut-offs were determined using RO1C curve analysis. Logistic regression models—stratified by stroke subtype—assessed associations between NLR and prolonged hospitalization, adjusting for relevant clinical variables and collinearity. Among 227 patients, 61.7
Insects make up the majority of all animal species, with 70% occurring in the tropics1, yet the impacts of warming on tropical insects remain highly uncertain2. This stems from sparse, taxonomically biased data on thermal tolerance of tropical insects and an incomplete understanding of the underlying physiological mechanisms3. Here we compared environmental temperatures with field-measured upper and lower thermal tolerance limits of around 2,300 insect species along Afrotropical and Neotropical elevational gradients and identified genomic signatures of thermal tolerance across the insect tree of life. We show that thermal tolerances do not proportionally track environmental temperatures but approach an asymptote in tropical lowlands. Insects at high elevations utilize plasticity to cope with rising temperatures, whereas lowland species have limited plastic abilities. Heat tolerance showed strong differences among insect orders and families, reflected in the thermal stability of proteins, suggesting that variation in thermal tolerance is founded in the fundamental protein architecture. Up to 52% of future surface temperatures and 38% of air temperatures in the Amazonian lowlands can cause heat mortality in half of the studied community. Our data suggest a limited capacity of insects in the Earth's most biodiverse regions to buffer future warming.
Digital technologies have the potential to transform early childhood development (ECD) interventions by delivering personalized support at scale. We conducted a cluster-randomized controlled trial in rural Peru to evaluate the effectiveness and cost-effectiveness of an artificial intelligence-supported digital parenting chatbot as well as traditional home visits as interventions to improve child development. Among 2461 caregiver-child dyads, both the digital and home-visiting interventions improved child development outcomes at 2.5 years of age, with standardized effect sizes of 0.11 and 0.17, respectively. At 1/15 of the cost of in-person support, the digital intervention yielded superior cost-effectiveness. These findings suggest that digital platforms can be a viable, scalable alternative to support children's development in resource-constrained settings.
