Resumen En el contexto de la economía política internacional, el régimen de protección de derechos humanos y el régimen de inversores extranjeros atraviesan tensiones como resultado de una arquitectura jurídica que privilegia la libertad de capitales. Un análisis de contenido del Acuerdo de Escazú revelaría, respecto al acceso a la justicia en temas ambientales, que las personas y la sociedad civil acceden a instancias judiciales y administrativas contempladas en la legislación nacional de cada país, mientras que los inversores extranjeros, bajo la figura de los tratados bilaterales de inversión (TBI) y libre comercio (TLC), recurren a la justicia mediante tribunales de arbitraje internacional que no siempre son independientes, imparciales y que privilegian los intereses del mercado. Esta arquitectura jurídica condiciona el accionar de los Estados frente a la sociedad civil y sus derechos. El Acuerdo de Escazú atraviesa desafíos jurídicos frente al régimen de protección a los inversores, en el cual las garantías económicas limitan las acciones concretas para abordar la crisis climática, proteger el medioambiente o hacer efectivos los derechos humanos.

Abstract In the context of the international political economy, the human rights protection regime and the foreign investor regime are in tension because of a legal architecture that privileges freedom of capital. A content analysis of the Escazú Agreement would reveal, with respect to access to justice in environmental matters, that individuals and civil society have access to judicial and administrative instances contemplated in national legislation, while foreign investors under bilateral investment treaties (BITs) and free trade agreements (FTAs) have access to justice through international arbitration tribunals that are not always independent, impartial and that privilege the interests of the market. This legal architecture conditions the actions of States in relation to society and its rights. The conclusions point out that the Escazú Agreement faces legal challenges in terms of the investor protection regime, where economic guarantees limit concrete actions to address the climate crisis, protect the environment or enforce human rights.

There is widespread agreement that skills development is a vital dimension of the just energy transition (JET). Skills development for JET is rapidly emerging and involves complex inter-sectoral systems of skills development and new methods for demand analysis. Currently in South Africa, learning pathways into green jobs, enterprise development and more sustainable job options, including those required for JET at entry and technical levels, are unclear, ad hoc and fragmented. At best, we have fragmented offerings of courses and qualifications and few systemic approaches to skills analysis and development. There is also a narrow reliance on supply and demand discourses that are ill-fitting for the type of skills that need to be developed. Drawing on a group of regional and local studies focusing on skills supply and demand for JET, the paper analyses the responsiveness of skills systems, with specific focus on institutions and institutional arrangements that underpin skills planning and anticipation. The paper critiques the metaphor of 'supply' and 'demand', which, it argues, is the wrong lens, as it focuses attention on certain parts of the skills system dislocated from the broader conditions that they are imbedded in. We pose new methodological questions for engaged skills research that can enable a green and just future, and the systemic transformations that are needed to catalyse a low-carbon transition. SIGNIFICANCE: The research findings offer a critical reflection on the current approach to research focused on skills for the just energy transition. The review highlights the limitations of the dominant supply-demand approach of skills analysis, and we argue that it promotes a neoliberal, market-led discourse on skills that privileges industry and excludes the voices of communities and workers.

SUMMARY: The denomination of the "ulna" bone as "cubitus" bone is an error in terminology still observed in anatomy study texts and Chilean school textbooks, even though the term ulna was established as the official term in the 20th century. This problem is a reflection of the slow progressive change in academic communities and the population in general, through the traditional transfer of knowledge. Scientific dissemination allows for accelerating such a process, and in recent years, it has been enhanced through social networks and virtual platforms such as TikTok. Few studies relate the use of TikTok with anatomical learning. This research describes school students' perception of an informative video on correctly using the term "ulna." It analyzes the possible scope as a complementary activity to anatomical teaching for the school community and society. A TikTok video was developed and published four months before showing it to 17 11th-grade students from Viña del Mar, and then they were asked to complete a perception survey. In addition, statistical data provided by the TikTok platform itself was recorded. The results revealed a favorable reception of the informative content among the participating students, with a high percentage expressing total or partial agreement in all the statements evaluated (up to 82.4 %). The metrics delivered by the platform show an international reach, the main viewers being people from Chile (35.5 %), Mexico (25.3 %), and Colombia (7.2 %). Among the aspects mentioned by the students that need improvement, are the quality of visual editing and the fluency of the explanation. Given the positive perception obtained from the video, we consider that using these complementary tools can improve human anatomy's teaching and learning processes and broaden our practices' impact on the educational community and society.

RESUMEN: La denominación del hueso "ulna" como hueso "cúbito" es un error de terminología aún observado en textos de estudio de anatomía y en textos escolares chilenos, pese a que desde el siglo XX se ha establecido el término ulna como el oficial. Esto refleja la lentitud del proceso de cambio en las comunidades académicas y en la población general mediante la transmisión tradicional de conocimientos. La divulgación científica permite acelerar dicho proceso, y en los últimos años se ha potenciado por medio de redes sociales y plataformas virtuales como TikTok. Existen pocos estudios que relacionan el uso de TikTok con el aprendizaje anatómico. Esta investigación describe la percepción de estudiantes escolares frente a un vídeo divulgativo sobre el correcto uso del término "ulna" y analiza los posibles alcances como actividad complementaria de la enseñanza anatómica hacia la comunidad escolar y la sociedad. Se desarrolló un vídeo de TikTok publicado 4 meses antes de mostrarlo a 17 estudiantes de 3° de enseñanza secundaria, y luego se les solicitó completar una encuesta de percepción. Además, se registraron datos estadísticos entregados por la misma plataforma. Los resultados obtenidos revelan una favorable acogida del contenido divulgativo entre los estudiantes participantes, con un alto porcentaje expresando acuerdo total o parcial en todas las afirmaciones evaluadas (hasta un 82,4 %). Las métricas entregadas por la plataforma demuestran un alcance internacional, siendo los principales espectadores personas de Chile (35,5 %), México (25,3 %) y Colombia (7,2 %). Entre los aspectos a mejorar mencionados por los estudiantes está la calidad de edición visual y la fluidez de la explicación. Dada la positiva percepción obtenida frente al vídeo, consideramos que usar estas herramientas complementarias puede mejorar los procesos de enseñanza y aprendizaje de la anatomía humana y ampliar el impacto de nuestras prácticas en la comunidad educativa y la sociedad.

Resumen La cefalometría es un método diagnóstico morfológico y descriptivo que proporciona datos relevantes sobre maloclusiones esqueléticas y dentoalveolares de pacientes que buscan tratamiento de ortodoncia. Varios autores han propuesto diferentes mediciones cefalométricas para determinar la dirección del crecimiento facial y el biotipo facial, los resultados de estas diferentes mediciones de un mismo paciente no siempre coinciden en el diagnóstico. El objetivo de este estudio fue determinar el nivel de concordancia entre los análisis cefalométricos de Ricketts y Björk-Jarabak para la determinación de la dirección del crecimiento facial y el biotipo facial en pacientes de una población de Yucatán, México. Se trazaron digitalmente un total de 260 cefalogramas laterales de pacientes entre 18 y 59 años de edad utilizando los análisis cefalométricos de Ricketts y Björk-Jarabak para determinar la dirección del crecimiento facial y el biotipo facial utilizando el software Dolphin Imagine. Se realizó la prueba estadística kappa de Cohen para establecer la fuerza de concordancia entre los resultados diagnósticos obtenidos por los análisis cefalométricos. Se encontró una fuerza de concordancia diagnóstica deficiente para la dirección del crecimiento (K=0.105) y aceptable para el biotipo facial (K=0.362). Los niveles de concordancia para cada posibilidad diagnóstica (nivel) variaron de leve a aceptable, excepto para los biotipos braquifacial y dolicofacial, con un nivel de concordancia moderado. En conclusión, las mediciones cefalométricas de Ricketts y Björk-Jarabak utilizadas para la determinación del biotipo facial y la dirección del crecimiento facial podrían sugerir evaluaciones diagnósticas no concordantes en algunos individuos.

Abstract Cephalometry is a morphological and descriptive diagnostic method that provides relevant data on skeletal and dentoalveolar malocclusions of patients seeking orthodontics treatment. Several authors have proposed different cephalometric measurements to determine facial growth direction and facial biotype, the results of these different measurements from the same patient do not always agree on the diagnosis. The aim of this study was to determine the level of agreement between Ricketts and Björk-Jarabak cephalometric analyses for the determination of facial growth direction and facial biotype in patients from a population of Yucatan, Mexico. A total of 260 lateral cephalograms of patients between 18 and 59 years of age were digitally traced using the Ricketts and Björk-Jarabak cephalometric analyses to determine the direction of facial growth and facial biotype using Dolphin Imagine software. Cohen's kappa statistical test was performed to establish the strength of agreement between the diagnostic results obtained by the cephalometric analyses. A poor diagnostic concordance strength was found for growth direction (K=0.105), and acceptable for facial biotype (K=0.362). The concordance strengths for each diagnostic possibility (level) ranged from slight to acceptable, except for the brachyfacial and dolichofacial biotypes, with a moderate strength of agreement. In conclusion, the Ricketts and Björk- Jarabak cephalometric measurements used for the determination of facial biotype and facial growth direction could suggest non-concordant diagnostic assessments in some individuals.

ABSTRACT Background . Hypertrophic cardiomyopathy (HCM) is the most common genetic disease caused by cardiac sarcomere protein mutations, with considerable prevalence and different clinical presentation, varying from asymptomatic to heart failure and sudden death. Some patients are followed-up in nonspecialized centers, and it is necessary to know data that show the reality of their diagnosis, treatment, and prognosis. Objective. The aim of this study was to know the clinical characteristics, and diagnostic and therapeutic strategies when HCM is managed in centers not specialized in this disease. Methods. This was a national, cross-sectional, multicenter study, with quantitative analysis of patients with confirmed or highly probable HCM. Results. A total of 95 patients were recruited, mostly men, with hypertension (40%) and dyslipidemia (22%) as main risk factors. A low proportion of comorbidities was observed: chronic obstructive pulmonary disease (6%), prior myocardial infarction (5%), prior stroke (1%) and chronic kidney failure (1%). The main symptoms were dyspnea (47% and angina (27%), and the most used diagnostic methods were echocardiogram (97%) and cardiac magnetic resonance imaging (71%)). The most frequent localization was septal, with 37% of hypertrophic obstructive cardiomyopathy. The genetic test, performed in 33% of patients, was positive in more than half of cases. It was not performed in the rest of the patients, mainly due to lack of health coverage. Conclusions. These findings are in agreement with international registries. Based on our findings, emphasis should be placed in improving the access to more complex diagnostic studies and optimizing the resources in a fragmented health system.

RESUMEN Introducción. La miocardiopatía hipertrófica (MCH), es la enfermedad genética cardiovascular más común, causada por mutaciones en proteínas del sarcómero cardíaco, con una prevalencia considerable y clínica variable, desde asintomática hasta insuficiencia cardíaca y muerte súbita. Existen pacientes seguidos en centros no especializados, y es necesario conocer datos que puedan mostrar la realidad de su diagnóstico, tratamiento y pronóstico. Objetivo. Conocer las características clínicas, estrategias diagnósticas y terapéuticas al abordar la MCH en centros no especializados en la patología. Material y métodos. Estudio de corte transversal, multicéntrico, de alcance nacional, con análisis cuantitativo, de pacientes con MCH confirmada o altamente probable. Resultados. Se registraron 95 pacientes, mayormente hombres con hipertensión arterial (40 %) y dislipidemia (22 %) como principales factores de riesgo. Se observó baja proporción de comorbilidades: enfermedad pulmonar obstructiva crónica (6 %), infarto de miocardio previo (5 %), accidente cerebro vascular previo (1 %) e insuficiencia renal crónica (1 %). Los síntomas principales fueron la disnea (47 %) y el ángor (27 %), y los métodos diagnósticos más usados fueron el ecocardiograma (97 %) y la resonancia cardíaca (71 %). La localización más frecuente fue septal, con 37 % de tipo obstructivo. El test genético, realizado en un 33 %, fue positivo en más de la mitad de los pacientes. No se realizó en dos tercios de los casos principalmente por falta de cobertura. Conclusiones. Los hallazgos son concordantes con los de registros internacionales. Con base a nuestros hallazgos, se resalta la necesidad de mejorar el acceso a estudios diagnósticos más complejos y optimizar recursos en un sistema de salud fragmentado.

Resumen El objetivo del trabajo es analizar el grado de apertura y concentración/diversificación geográfica del comercio de Estados Unidos y China en el periodo 1990-2021. Para ello se utilizan dos indicadores de comercio exterior: el Coeficiente de Apertura y el Índice Herfindahl-Hirschman (IHH). El estudio muestra que Estados Unidos ha experimentado una presencia relativamente menor que China en los mercados internacionales, y que en ambas potencias económicas existe una mayor diversificación de productos y mercados de exportación. En 2018, derivado de la posición y el creciente dinamismo comercial de China en los mercados internacionales, Estados Unidos inició un cambio en la política comercial, desde una posición de mayor apertura hacia la construcción estratégica de un bloque regional proteccionista frente a China, materializado en el Tratado entre México, Estados Unidos y Canadá (T-MEC).

Abstract The objective of the paper is to analyse the degree of openness and geographic concentration/diversification of trade of the United States and China in the period 1990-2021. To do this, two foreign trade indicators are used: the Openness Coefficient and the HerfindahlHirschman Index (IHH). The study shows that the United States has experienced a relatively smaller presence than China in international markets, and that in both economic powers there is greater diversification of products and export markets. Derived from the position and the growing commercial dynamism of China in international markets, in 2018 the United States began a change in trade policy, from a position of greater openness, towards the strategic construction of a protectionist regional bloc against China materialized in the United States-Mexico-Canada Agreement (USMCA).

Resumen El departamento de Ayacucho, Perú, se encuentra entre los departamentos con mayor cantidad de Mypes dedicadas a las artesanías. También es una región con elevadas unidades productivas y población económicamente activa informal, generando la evasión de impuestos por parte de las empresas y el constreñimiento de la economía local y nacional. El objetivo de este estudio es conocer los efectos tributarios de las Mypes artesanales. La metodología es cualitativa, descriptiva y explicativa, siguiendo la declaración PRISMA. Las bases de datos consultadas para la revisión fueron SciELO, Scopus, Google Scholar, Dialnet y Redalyc. Los resultados dieron 21 investigaciones, entre artículos científicos, revisiones y tesis. Se concluye que la tributación de impuestos no solo mejora la economía local y nacional, sino que las Mypes obtienen facilidades y oportunidades de crecimiento en el mercado internacional. Sin embargo, la evasión tributaria e informalidad están sujetas al desconocimiento de los empresarios sobre las ventajas de la formalización, la falta de distribución por parte del Estado peruano, los engorrosos trámites burocráticos que implican la formalización y la ilusoria perspectiva de que al evadir impuestos se genera mayor rentabilidad en la empresa.

Abstract The department of Ayacucho, Peru, is among the departments with the highest number of small and medium-sized enterprises (SMEs) dedicated to handicrafts. It is also a region with high productive units and a significant portion of the economically active population being informal. This leads to tax evasion by companies and constrains both the local and national economy. The aim of this study is to understand the tax effects on artisanal SMEs. The methodology is qualitative, descriptive, and explanatory, and follows the PRISMA statement. The databases consulted for the review were SciELO, Scopus, Google Scholar, Dialnet, and Redalyc. The results yielded 21 investigations, including scientific articles, reviews, and theses. The study concludes that tax collection not only improves the local and national economy but also provides SMEs with facilities and opportunities for international market growth. However, tax evasion and informality are due to the entrepreneurs' lack of knowledge about the advantages of formalization, the lack of distribution by the Peruvian state, the cumbersome bureaucratic procedures involved in formalization, and the illusory perspective that evading taxes generates greater profitability in the company.

Abstract Costa Rica’s failure to ratify the Escazú Agreement adopted in Costa Rica in 2018 raises several questions. In addition to the damage caused by this absence to Costa Rica’s international image as a country that guarantees human rights and has advanced environmental regulations, there is also a series of alleged “arguments” presented by the Costa Rican corporate sector, which are completely stripped by the economic reality of the 15 States that have already ratified this regional instrument. Additionally, the Costa Rican Judiciary has proceeded with fanciful interpretations to unnecessarily complicate the approval process of the Escazú Agreement, particularly those expressed by a member of the Constitutional Chamber. Strangely enough, her arguments coincide with those of some Costa Rican business chambers. In view of this non-ratification, Costa Rica’s traditional international leadership in environmental matters is seriously eroded, while after Argentina and Mexico (2021), Chile (2022), Belize and Grenada (2023), Colombia and Brazil are preparing to ratify the Escazú Agreement in the near future.

Resumen La no ratificación, por parte de Costa Rica, del Acuerdo de Escazú adoptado en Costa Rica en el 2018 plantea una serie de interrogantes. Al dañoque ocasiona esta ausencia a la imagen internacional de Costa Rica como un país garante de los derechos humanos y con avanzada normativa en materia ambiental, se le suma una serie de pretendidos “argumentos” presentados por el sector corporativo costarricense, que desnuda, por completo, la realidad económica de los 15 Estados que ya han ratificado este novedoso instrumento regional. Adicionalmente, el Poder Judicial costarricense ha procedido a interpretaciones antojadizas para complicar innecesariamente el trámite de aprobación del Acuerdo de Escazú, en particular, las expresadas por una magistrada de la Sala Constitucional. Extrañamente sus argumentos coinciden con los de algunas cámaras empresariales costarricenses. Ante esta no ratificación, el tradicional liderazgo internacional, en materia ambiental, de Costa Rica se ve gravemente carcomido, mientras que, después de Argentina y México (2021), Chile (2022), Belice y Granada (2023), se aprestan a ratificar próximamente el Acuerdo de Escazú Colombia y Brasil.

Abstract: The present work aims to examine the apparent benefits and effects of free trade based on the dynamics of the former General Agreement on Tariffs and Trade (GATT) and its successor, the World Trade Organization (WTO). The eminently ideological nature of the tax premises is denounced according to which its effects are intrinsically beneficial for developing and underdeveloped economies in the generality of the assumptions. In this sense, an attempt is made to demonstrate that the reference institutions have consistently perpetuated the drifts that the "center-periphery" analytical model historically denounced to the latter's detriment. The methodology used has involved a literature review of the GATT system and the international trade framework of the WTO, based on a critical examination of these in relation to the theses of both classical and contemporary structuralist economics. The study's results indicate that the multilateral trade system, along with the trade policies of hegemonic nations, through the functioning first of the GATT and then of the WTO, has resulted in endemically detrimental effects for peripheral economies. In this sense, the implications of this research suggest the need for a reexamination, both at the national and interregional levels, of the currently inequitable terms governing international trade, along with a more active promotion, at both levels, of development policies that prove to be beneficial for economically disadvantaged countries.

Resumen: El presente trabajo tiene como propósito examinar los aparentes beneficios y efectos del libre comercio a partir de la dinámica propia del que fuera el General Agreement on Tariffs and Trade (GATT) y su sucesora, la Organización Mundial de Comercio (OMC). Se denuncia el carácter eminentemente ideológico de las premisas tributarias según las cuales sus efectos son, en la generalidad de los supuestos, intrínsecamente provechosos para las economías en desarrollo y subdesarrolladas. En este sentido, se intenta demostrar que las instituciones de referencia han perpetuado consistentemente las derivas que el modelo analítico "centro-periferia" históricamente denunciara en detrimento de esta última. La metodología empleada ha consistido en la revisión bibliográfica del sistema GATT y el esquema de comercio internacional de la OMC, a partir de un examen crítico de estas últimas en función de las tesis de la economía estructuralista cepalina tanto clásica como contemporánea. Los resultados del estudio señalan que el sistema multilateral comercial y las propias políticas comerciales de las naciones hegemónicas, a través del funcionamiento primero del GATT y luego de la OMC, han supuesto efectos endémicamente disvaliosos para las economías periféricas. Las implicaciones de la presente investigación sugieren la necesidad del reexamen tanto en el ámbito nacional como interregional de los términos -actualmente poco equitativos- que rigen el comercio internacional, y de una promoción más activa, en ambos espacios, de aquellas políticas de desarrollo que sean provechosas para los países económicamente desfavorecidos. Clasificación JEL: F01; F12; F13; F53; F60; F63.

ABSTRACT The requirements of health care facilities (HCF) being recognized as having ‘university’ status are relevant for providing high-quality clinical education to health profession students. However, no previous studies have reported the key features of the Chilean HCF as having university rank. Aim: To review international experiences and Chilean regulations to identify hospitals’ requirements for university status. Methods: A qualitative content analysis was carried out in 6 phases, taking Caceres’ proposal as a methodological reference. Results: 66 units of analysis were obtained, which were grouped into 8 codes: comprehensive management, teaching care agreement, strategic link, infrastructure, academic human resources, care-teaching-research management department, quality and safety in health and research, which were subsequently categorized into administrative-managerial, transversal collaboration and evidence-based healthcare. Codes that were later grouped into main and advanced dimensions, therefore, embrace the criteria found to designate a health establishment as a Teaching Care establishment. Conclusions: The findings represent a significant contribution to the requirements that must be considered to strengthen and develop health facilities that currently welcome students, in order to comprehensively develop safe and quality care, teaching and research, promoting effective collaboration between these institutions.

RESUMEN Los criterios asistenciales y docentes en los establecimientos de salud son esenciales para gestionar la formación del capital humano. Sin embargo, no se reportan estudios que sistematicen los criterios requeridos para que los establecimientos de salud chilenos sean catalogados con esta condición. Objetivo: Revisar las experiencias internacionales y normativas nacionales para proponer criterios que podrían ser de utilidad al momento de calificar a un hospital como docente-asistencial. Material y Método: Se realizó un análisis de contenido cualitativo en 6 fases, tomando como referente metodológico la propuesta de asistencial docente. Resultados: se obtuvieron 66 unidades de análisis, las cuales se agruparon en 8 códigos: gestión integral, convenio asistencial docente, vínculo estratégico, infraestructura, recurso humano académico, departamento de gestión asistencial-docente-investigación, calidad y seguridad en salud e investigación, los cuales a posterior se categorizaron en administrativo-gerencial, colaboración transversal y atención sanitaria basada en evidencia. Códigos que luego se agruparon en dimensiones principales y avanzadas, por tanto, acogen los criterios encontrados para denominar a un establecimiento de salud como un establecimiento asistencial docente. Conclusiones: Los resultados sugieren los criterios que deben considerarse para catalogar a los establecimientos de salud que actualmente acogen a estudiantes, como instituciones asistenciales docentes.

ABSTRACT Background: The growing number of echocardiographic tests and the need for strict adherence to international quantification guidelines have forced cardiologists to perform highly extended and repetitive tasks when interpreting and analyzing increasingly overwhelming amounts of data. Novel machine learning (ML) techniques, designed to identify images and perform measurements at relevant visits, are becoming more common to meet this obvious need for process automation. Objectives: Our objective was to evaluate an alternative model for the interpretation and analysis of echocardiographic tests mostly based on the use of ML software in order to identify and classify views and perform standardized measurements automatically. Methods: Images came from 2000 healthy subjects, 1800 of whom were used to develop ML algorithms and 200 for subsequent validation. First, a convolutional neural network was developed in order to identify 18 standard echocardiographic views and classify them based on 8 thematic groups (stacks). The results of automatic identification were compared to classification by experts. Later, ML algorithms were developed to automatically measure 16 Doppler scan parameters for regular clinical evaluation, which were compared to measurements by an expert reader. Finally, we compared the time required to complete the analysis of an echocardiographic test using conventional manual methods with the time needed when using the ML model to classify images and perform initial echocardiographic measurements. Inter- and intra-observer variability was also analyzed. Results: Automatic view classification was possible in less than 1 second per test, with a 90% accuracy for 2D images and a 94% accuracy for Doppler scan images. Stacking images had a 91% accuracy, and it was possible to complete the groups with any necessary images in 99% of cases. Expert agreement was outstanding, with discrepancies similar to those found between two human readers. Applying ML to echocardiographic imaging classification and measurement reduced time of analysis by 41% and showed lower variability than conventional reading methods. Conclusion: Application of ML techniques may significantly improve reproducibility and efficiency of echocardiographic interpretations and measurements. Using this type of technologies in clinical practice may lead to reduced costs and increased medical staff satisfaction.

RESUMEN Introducción: El número creciente de estudios ecocardiográficos y la necesidad de cumplir rigurosamente con las recomendaciones de guías internacionales de cuantificación, ha llevado a que los cardiólogos deban realizar tareas sumamente extensas y repetitivas, como parte de la interpretación y análisis de cantidades de información cada vez más abrumadoras. Novedosas técnicas de machine learning (ML), diseñadas para reconocer imágenes y realizar mediciones en las vistas adecuadas, están siendo cada vez más utilizadas para responder a esta necesidad evidente de automatización de procesos. Objetivos: Nuestro objetivo fue evaluar un modelo alternativo de interpretación y análisis de estudios ecocardiográficos, basado fundamentalmente en la utilización de software de ML, capaz de identificar y clasificar vistas y realizar mediciones estandarizadas de forma automática. Material y métodos: Se utilizaron imágenes obtenidas en 2000 sujetos normales, libres de enfermedad, de los cuales 1800 fueron utilizados para desarrollar los algoritmos de ML y 200 para su validación posterior. Primero, una red neuronal convolucional fue desarrollada para reconocer 18 vistas ecocardiográficas estándar y clasificarlas de acuerdo con 8 grupos (stacks) temáticos. Los resultados de la identificación automática fueron comparados con la clasificación realizada por expertos. Luego, algoritmos de ML fueron desarrollados para medir automáticamente 16 parámetros de eco Doppler de evaluación clínica habitual, los cuales fueron comparados con las mediciones realizadas por un lector experto. Finalmente, comparamos el tiempo necesario para completar el análisis de un estudio ecocardiográfico con la utilización de métodos manuales convencionales, con el tiempo necesario con el empleo del modelo que incorpora ML en la clasificación de imágenes y mediciones ecocardiográficas iniciales. La variabilidad inter e intraobservador también fue analizada. Resultados: La clasificación automática de vistas fue posible en menos de 1 segundo por estudio, con una precisión de 90 % en imágenes 2D y de 94 % en imágenes Doppler. La agrupación de imágenes en stacks tuvo una precisión de 91 %, y fue posible completar dichos grupos con las imágenes necesarias en 99% de los casos. La concordancia con expertos fue excelente, con diferencias similares a las observadas entre dos lectores humanos. La incorporación de ML en la clasificación y medición de imágenes ecocardiográficas redujo un 41 % el tiempo de análisis y demostró menor variabilidad que la metodología de interpretación convencional. Conclusión: La incorporación de técnicas de ML puede mejorar significativamente la reproducibilidad y eficiencia de las interpretaciones y mediciones ecocardiográficas. La implementación de este tipo de tecnologías en la práctica clínica podría resultar en reducción de costos y aumento en la satisfacción del personal médico.

ABSTRACT: Reducing food waste became a priority in the past decades for the majority of nations around the world. But while the interest in this topic is high, not all countries, including Romania - our case study- accurately estimate household food waste quantities. Determining the reality of food waste at household levels is highly valuable because in the end, it can bring insight into what would be the best methods to reduce waste and optimize resource consumption. The current study determined the causes, quantities, and main components of food waste in Romanian households by applying and subsequently analyzing a food waste survey. Our purpose was to determine not only how much food Romanians throw away per week, but also what type of food. In addition, by studying the households’ consumption habits we identified the main behavioral triggers of food waste. By applying the survey to a relevant sample of our country’s population, we obtained a relatively accurate depiction of food waste attitudes among Romanian consumers and our paper can be a starting point in developing an educational tool aiming to reduce food waste in households. This type of study is important not only for informational reasons but also from a societal standpoint. As a complex community, part of larger international structures and agreements, (such as the European Union, the United Nations, or The Paris Agreement on Climate Change), Romania needs to align itself with the other partners in order to decrease the negative impact on the environment of food waste. ABSTRACT world high countries quantities end causes week addition countrys country s population standpoint community agreements such Union Nations Change, Change , Change)

RESUMO: A redução do desperdício de alimentos tornou-se uma prioridade nas últimas décadas para a maioria das nações ao redor do mundo. Entretanto, enquanto o interesse nesse tópico é alto, nem todos os países, incluindo a Romênia - nosso estudo de caso - estimam com precisão as quantidades de resíduos de alimentos em domicílios. Determinar a realidade do desperdício de alimentos em níveis domiciliares é altamente valioso, porque no final pode trazer para o que seriam os melhores métodos para reduzir o desperdício e otimizar o consumo de recursos. O presente estudo teve como objetivo determinar as causas, quantidades e principais componentes do desperdício de alimentos em lares romenos, aplicando e subsequentemente analisando uma pesquisa sobre desperdício de alimentos. Nosso propósito foi determinar não apenas o quanto de comida os romenos jogam fora por semana, mas também qual tipo de alimento. Além disso, ao estudarmos os hábitos de consumo dos domicílios, identificamos os principais gatilhos comportamentais do desperdício de alimentos. Ao aplicar a pesquisa a uma amostra relevante da população de nosso país, obtivemos uma representação relativamente precisa das atitudes de desperdício de alimentos entre os consumidores romenos e nosso artigo pode ser um ponto de partida no desenvolvimento de uma ferramenta educacional voltada para a redução do desperdício de alimentos em domicílios. Esse tipo de estudo é importante não apenas por razões informativas, mas também do ponto de vista social. Como uma comunidade complexa, parte de estruturas e acordos internacionais maiores, (como a União Europeia, as Nações Unidas ou o Acordo de Paris sobre a Mudança Climática), a Romênia precisa se alinhar com os outros parceiros para diminuir o impacto negativo no meio ambiente do desperdício de alimentos. RESUMO tornouse tornou mundo Entretanto alto países domicílios valioso recursos causas semana alimento disso país informativas social complexa maiores Europeia Climática, Climática , Climática)

ABSTRACT Objective: To evaluate the agreement between body mass index (BMI) parameters applied to children aged six to ten years in the city of Montes Claros (MG), Brazil with national and international criteria, also calculating their sensitivity and specificity regarding excess weight screening. Methods: A sample comprising 4151 children aged six to ten years was assessed, with height and body mass determined for BMI calculation. The obtained values were classified according to cutoff points established by the World Health Organization (WHO), International Obesity Task Force (IOTF), Centers for Disease Control and Prevention (CDC), Conde & Monteiro, and a recent local proposal. The agreement index between the mentioned criteria was calculated and thereafter the sensitivity and specificity. Results: The local proposal was proven to be highly consistent in most combinations, especially concerning the excess weight criteria of the World Health Organization (WHO) (k=0.895). Regarding excess weight, the local proposal presented sensitivity and specificity values of 0.8680 and 0.9956, respectively, indicating high BMI discrimination power. Conclusions: The locally applied BMI parameters for children aged six to ten years represent a valid, highly viable and practical proposal for excess weight screening in this population group, improving professional decision-making in their follow-up. Objective (BMI MG, MG , (MG) Methods 415 assessed calculation WHO, WHO IOTF, IOTF (IOTF) CDC, CDC (CDC) Monteiro Results combinations (WHO k=0.895. k0895 k k=0.895 . 0 895 (k=0.895) 08680 8680 0.868 09956 9956 0.9956 respectively power Conclusions valid group decisionmaking decision making followup. followup follow up. up follow-up (MG 41 (IOTF (CDC k089 k=0.89 89 (k=0.895 0868 868 0.86 0995 995 0.995 4 k08 k=0.8 8 (k=0.89 086 86 0.8 099 99 0.99 k0 k=0. (k=0.8 08 0. 09 9 0.9 k=0 (k=0. k= (k=0 (k= (k

RESUMO Objetivo: Analisar a concordância dos parâmetros de índice de massa corporal (IMC) para crianças com idade de seis a dez anos da cidade de Montes Claros/MG com os demais critérios de abrangência nacional e internacional, bem como sua sensibilidade e especificidade no rastreio do excesso de peso. Métodos: Foi utilizada uma amostra de 4.151 crianças de seis a dez anos, sendo mensuradas estatura e massa corporal para a determinação do IMC. Os valores obtidos foram classificados de acordo com os pontos de corte da World Health Organization (WHO), International Obesity Task Force (IOTF), Centers for Disease Control and Prevention (CDC), Conde & Monteiro e uma recente proposta local. Calculou-se o índice de concordância entre os critérios mencionados e, em seguida, a sensibilidade e a especificidade. Resultados: A proposta local mostrou-se altamente concordante na maioria das combinações, principalmente para o excesso de peso com a WHO (k=0,895). Com relação ao excesso de peso, a proposta local apresentou valores de 0,8680 e 0,9956 para a sensibilidade e especificidade respectivamente, mostrando alto poder de discriminação do IMC. Conclusões: Conclui-se que os parâmetros locais de IMC para crianças de seis a dez anos representam uma proposta válida, altamente viável e utilizável para o rastreio do excesso de peso desse grupo populacional, melhorando a tomada de decisão profissional no acompanhamento de tais indivíduos. Objetivo (IMC ClarosMG Claros MG internacional Métodos 4151 4 151 4.15 WHO, , (WHO) IOTF, IOTF (IOTF) CDC, CDC (CDC) Calculouse Calculou se seguida Resultados mostrouse mostrou combinações k=0,895. k0895 k k=0,895 . 0 895 (k=0,895) 08680 8680 0,868 09956 9956 0,995 respectivamente Conclusões Concluise Conclui válida populacional indivíduos 415 15 4.1 (WHO (IOTF (CDC k089 k=0,89 89 (k=0,895 0868 868 0,86 0995 995 0,99 41 1 4. k08 k=0,8 8 (k=0,89 086 86 0,8 099 99 0,9 k0 k=0, (k=0,8 08 0, 09 9 k=0 (k=0, k= (k=0 (k= (k

RESUMEN Introducción: La literatura presenta varios cuestionarios científicamente validados y transculturalmente adaptados en el área de la ortopedia y Medicina del Deporte. Sin embargo, son anatómicamente específicos y no consideran las necesidades específicas de los atletas. El “4-Domain PROM for Orthopaedic and Sports Medicine” (4-Domain Sports PROM) es el primer cuestionario, en la literatura (International Journal of Sports Medicine - 2021), diseñado para evaluar atletas y practicantes de deportes altamente activos, y sus especificidades físicas y psicológicas. Comprende cuatro dominios: atleta sin lesión, después de una lesión deportiva, expectativa de tratamiento, evaluación del atleta sobre el tratamiento recibido. Objetivos: El objetivo de este trabajo es realizar la traducción y adaptación transcultural (TCA) a la lengua portuguesa. Métodos: El cuestionario fue autoadministrado por 50 participantes, practicantes habituales de actividades físicas y deportivas. El proceso de traducción y adaptación cultural involucró seis pasos: traducción; síntesis; traducción inversa; prueba previa; revisión por el comité de expertos; aplicación clínica y aprobación del autor de la versión original. Se evaluaron la equivalencia de traducción y la relevancia de los ítems del cuestionario. Resultados: La versión portuguesa del 4-DOMAIN SPORTS PROM tuvo una equivalencia de traducción de 0,94 y la relevancia de los ítems fue de 0,98, mientras que el porcentaje de acuerdo entre los pacientes para la comprensión fue de 0,98. Conclusión: La traducción y adaptación transcultural del 4-DOMAIN SPORTS PROM al portugués amplía las posibilidades de evaluar los diferentes momentos que involucran el tratamiento de lesiones deportivas, ya que este cuestionario fue diseñado para capturar datos sobre la percepción de los pacientes antes de la lesión, después de la lesión, expectativa y evaluación del trato recibido en deportistas y practicantes habituales de actividad física. Nivel de Evidencia II; Estudio Cualitativo Transversal. Introducción Deporte embargo 4Domain Domain 4 International 2021, 2021 , 2021) activos psicológicas dominios deportiva Objetivos TCA (TCA Métodos 5 participantes deportivas pasos síntesis inversa previa expertos original Resultados 4DOMAIN DOMAIN 094 0 94 0,9 098 98 0,98 Conclusión física II Transversal 202 09 9 0, 20 2

ABSTRACT Introduction: The literature presents several scientifically validated and cross-culturally adapted questionnaires in the area of orthopedics and Sports Medicine scientifically validated and cross-culturally adapted. However, they are anatomically specific, and do not consider the specific needs of athletes. The “4-Domain PROM for Orthopedic and Sports Medicine” (4-Domain Sports PROM) is the first questionnaire, in the literature (International Journal of Sports Medicine - 2021), designed to assess athletes and highly active sports practitioners, and their specificities. physical and psychological. It comprises four domains: athlete without injury, after sports injury, expectation of treatment, athlete's assessment of the treatment received. Objectives: This work aims to carry out the translation and cross-cultural adaptation (TCA) to the Portuguese language. Methods: The questionnaire was self-administered by 50 participants, regular physical and sports activities practitioners. The translation and cultural adaptation process involved six steps: translation; synthesis; back translation; pre-test; review by the Expert Committee, clinical application and author approval of the original version. The Equivalence of translation and relevance of questionnaire items were evaluated. RESULTS: The Portuguese version of the 4-DOMAIN SPORTS PROM had a translation equivalence of 0.94, and item relevance was 0.98, while the percentage of agreement between patients for understanding was 0.98. Conclusion: The translation and cross-cultural adaptation of the 4 Domain Sports PROM into the Portuguese version proved to be understandable and reproducible in all questionnaire domains (agreement above 90% and content validity index of 100%) to assess the treatment of the population of athletes and regular sports practitioners. Level of Evidence II; A cross-sectional qualitative study. Introduction crossculturally cross culturally However 4Domain International 2021, 2021 , 2021) practitioners specificities psychological injury s received Objectives crosscultural TCA (TCA language Methods selfadministered self administered 5 participants steps synthesis pretest pre test pre-test Committee evaluated RESULTS 4DOMAIN DOMAIN 094 0 94 0.94 098 98 0.98 Conclusion 90 100% 100 II crosssectional sectional study 202 09 9 0.9 10 20 0. 1 2

RESUMO Introdução: A literatura apresenta diversos questionários cientificamente validados e adaptados transculturalmente na área de na Ortopedia e Medicina Esportiva validados cientificamente e adaptados transculturalmente. Entretanto, eles são anatomicamente específicos, e não consideram as necessidades especificas dos atletas. O “4-Domain PROM for Orthopedic and Sports Medicine” (4-Domain Sports PROM) é o primeiro questionário, na literatura (International Journal of Sports Medicine - 2021), concebido para avaliar atletas e praticantes de esportes altamente ativos, e suas especificidades físicas e psicológicas. Ele compreende quatro domínios: atleta sem lesão, após lesão esportiva, expectativa do tratamento, avaliação do atleta sobre o tratamento recebido. Objetivos: O objetivo deste trabalho é realizar a tradução e a adaptação transcultural (TCA) à língua portuguesa. Métodos: O questionário foi autoadministrado por 50 participantes, praticantes regulares de atividades físicas e esportivas. O processo de tradução e adaptação cultural envolveu seis etapas: tradução; síntese; retrotradução; pré-teste; revisão pelo comitê de experts; aplicação clínica e aprovação do autor da versão original. Foi avaliado a Equivalência da tradução e relevância de itens do questionário. Resultados: A versão em português do 4-DOMAIN SPORTS PROM apresentou equivalência da tradução de 0,94 e relevância dos itens foi de 0,98, enquanto a porcentagem de concordância entre os pacientes para compreensão foi de 0,98. Conclusão: A tradução e adequação cultural do 4-DOMAIN SPORTS PROM para língua portuguesa mostrou-se compreensível e reprodutibilidade adequada em todos os domínios do questionário (concordância acima de 90% e Índice de Validade de Conteúdo de 100%) para avaliar o tratamento de população de indivíduos atletas e praticantes regulares de esportes. Nível de Evidência II; Estudo Qualitativo Transversal. Introdução Entretanto específicos 4Domain Domain 4 International 2021, 2021 , 2021) ativos psicológicas esportiva recebido Objetivos TCA (TCA Métodos 5 participantes esportivas etapas síntese retrotradução préteste pré teste pré-teste experts original Resultados 4DOMAIN DOMAIN 094 0 94 0,9 098 98 0,98 Conclusão mostrouse mostrou se 90 100% 100 II Transversal 202 09 9 0, 10 20 1 2

Abstract The shear strength of fiber reinforced elements is usually predicted through analytical models calibrated from experimental tests. Few results obtained from these tests consider the mechanical characterization of the material, allowing to evaluate the different performances of fiber reinforced concrete. This work evaluates the possibility of replacing the minimum shear reinforcement of reinforced concrete beams with steel fibers. For this, comparations were made evaluating the shear strength of 240 experimental tests of steel fiber reinforced concrete (SFRC) beams using formulations from the literature and international standards, to define which equations are in better agreement with the experimental data. Thus, once this expression was identified, SFRC beam design abacuses were developed to determine the amount of steel fibers needed to replace the minimum shear reinforcement, according to NBR 6118 [1]. The results showed that the model by Kwak et al. [2] presented results similar to those obtained in experimental tests of beams. Finally, it is concluded that the developed abacuses will facilitate decision-making in the design of SFRC beams. material 24 (SFRC standards data Thus identified 611 1. 1 . [1] al 2 [2 Finally decisionmaking decision making 61 [1 [ 6

Resumo A resistência ao cisalhamento de elementos reforçados com fibras é geralmente prevista por meio de modelos analíticos, calibrados a partir de ensaios experimentais. Poucos resultados obtidos através desses ensaios levam em consideração a caracterização mecânica do material, permitindo avaliar os diferentes desempenhos do concreto reforçado com fibras. Este trabalho avalia a possibilidade de substituição da armadura mínima de cisalhamento de vigas de concreto armado por fibras de aço. Para isso, foram feitas comparações avaliando a resistência ao cisalhamento de 240 ensaios experimentais de vigas de concreto reforçado com fibras de aço (CRFA), utilizando formulações da literatura e normas internacionais para definir quais equações apresentam uma maior concordância com os dados experimentais. Assim, identificada essa expressão, foram desenvolvidos ábacos de dimensionamento de vigas em CRFA que determinam a quantidade de fibras de aço necessárias para substituir as armaduras mínimas de cisalhamento, conforme a NBR 6118 [1]. Os resultados mostraram que o modelo de Kwak et al. [2] apresentou resultados semelhantes aos obtidos em ensaios experimentais de vigas. Por fim, conclui-se que os ábacos desenvolvidos facilitarão a tomada de decisão no dimensionamento de vigas CRFA. analíticos material isso 24 CRFA, , (CRFA) Assim expressão 611 1. 1 . [1] al 2 [2 fim concluise conclui se (CRFA 61 [1 [ 6