Abstract The high prevalence of cardiovascular risk factors in firefighters is of great concern, since cardiovascular diseases are the main cause of illness and death in this population. The aim of this study was to describe and analyze cardiorespiratory capacity, dietary habits, and body fat percentage in Chilean firefighters. Sixty-five firefighters were recruited and a non-experimental approach of observational and analytical design was used. A cycloergometer exercise test and indirect calorimetry were used to measure maximum oxygen consumption [VO2max] as an indicator of cardiorespiratory capacity, a survey of dietary habits, and bioimpedance to determine the percentage of body fat mass. The mean VO2max was 26,60 ml kg-1min-1 [SD: 6,51]. 83,1% of the participants had excess malnutrition, and 78,5% had excess fat mass. A significant negative relationship was found between VO2max and BMI [rs = -0,468, p<0,001] and body fat percentage [rs = -0,640, p<0,001]. The cardiorespiratory capacity of 89,2% of the subjects was classified as “poor” or “very poor”. According to the results obtained and the available evidence, the projection of this study would be the search for protocols that protect aspects of preventive health and maintenance in Chilean firefighters.

Resumen La alta prevalencia de factores de riesgo cardiovascular en bomberos es de gran preocupación, debido a que las enfermedades cardiovasculares son la principal causa de enfermedad y muerte en esta población. El objetivo de esta investigación fue describir y analizar la capacidad cardiorrespiratoria, hábitos alimentarios y porcentaje de grasa corporal de bomberos chilenos. Fueron reclutados 65 bomberos y se utilizó un enfoque no experimental de diseño observacional y analítico. Se empleó una prueba de ejercicio en cicloergómetro y calorimetría indirecta para medir el consumo máximo de oxígeno [VO2máx] como indicador de la capacidad cardiorrespiratoria, encuesta para los hábitos alimentarios, y bioimpedancia para determinar el porcentaje de masa grasa corporal. El VO2máx promedio fue de 26,60 ml kg-1min-1 [DE: 6,51]. El 83,1% de los participantes presentaban malnutrición por exceso, y el 78,5% tenían exceso de masa grasa. Se encontró una relación negativa significativa entre el VO2máx e IMC [rs = -0,468, p<0,001] y el porcentaje de grasa corporal [rs = -0,640, p<0,001]. El 89,2 % de los sujetos tuvo una capacidad cardiorrespiratoria clasificada como “pobre” o “muy pobre”. Según los resultados obtenidos y la evidencia disponible, la proyección del presente estudio sería la búsqueda de protocolos que resguarden aspectos de salud preventiva y mantención en bomberos chilenos.

Abstract The tuna industry plays a fundamental role in the development and sustainability of Ecuador's economy. Sustainability has become a topic of great importance; therefore, the main objective of this research was to evaluate the level of performance of preventive sustainable maintenance, in tuna canning companies, based on its influence on the three pillars of the sustainability, based on the application of Key Performance Indicators. An evaluation model was applied based on the Analytical Hierarchy Process methodology, composed of a group of indicators measuring the impact on the three pillars of sustainability: economic, environmental and social. Using the Likert scale, the most relevant indicators were weighted and selected, and subsequently weighted using the Analytical Hierarchy Process methodology. Company 1 achieved a sustainable maintenance performance rating of 7.68 (rating: good), company 2 achieved 9.45 (rating: excellent), and company 3 achieved 6.61 (rating: fair). The results obtained in the evaluation of sustainable maintenance in the companies under study show opportunities for improvement, suggestions and instructions to take the necessary measures to improve sustainable maintenance.

Resumen La industria del atún juega un papel fundamental en el desarrollo y sostenibilidad de la economía del Ecuador. La sostenibilidad se ha convertido en un tema de gran importancia, por tanto, el objetivo principal de esta investigación fue evaluar el nivel de desempeño del mantenimiento sostenible preventivo, en empresas conserveras de atún, sobre la base de su influencia en los tres pilares de la sostenibilidad, a partir de la aplicación de los Indicadores Clave de Desempeño. Se aplicó un modelo de evaluación basado en la metodología del Proceso de Jerarquía Analítica, compuesta por un grupo de indicadores medidores del impacto en los tres pilares de la sostenibilidad: económico, ambiental y social. Mediante la escala de Likert se ponderaron y seleccionaron los indicadores más relevantes, y posteriormente se ponderaron mediante la metodología del Proceso de Jerarquía Analítica. La empresa 1 alcanzó una calificación 7,68 de desempeño de mantenimiento sostenible (calificación: bueno), la empresa 2 alcanzó 9,45 (calificación: excelente) y la empresa 3 obtuvo 6,61 (calificación: justo). Los resultados obtenidos en la evaluación del mantenimiento sostenible en las empresas objeto de estudio, muestran las oportunidades de mejora, sugerencias e instrucciones para que tomen las medidas necesarias para mejorar el mantenimiento sostenible

Abstract: Family dairy farming is relevant for national agriculture which, although it contributes to the generation of wealth and income, faces low efficiency, productivity and high production costs. The objective was to analyze the technical efficiency of family dairy farms in the State of Minas Gerais. Data Envelopment Analysis (DEA) with input-oriented BCC model was used. The higher the efficiency level of the DMUs, the fewer resources were used in excess. It was also identified the lack of DMUs that performed preventive maintenance of machines, implements and improvements, justifying the increase in the use, mainly, of the MIB input (maintenance of machines, implements and improvements). With this research, the Milk Input Commitment Index (ICIL) was suggested, which shows the percentage of production that is committed to purchase a given input. The higher the efficiency level of the DMUs, the lower the ICIL, which went from 49.36% (efficient) to 67.47% (low efficiency). This proved to be an important indicator of efficiency of dairy properties, responsible for showing the amount of milk produced that is committed to the payment of inputs used in the dairy activity. It also proved to be a valuable instrument to be used as a benchmark in dairy farms. Abstract income costs Gerais DEA (DEA inputoriented oriented excess machines improvements use mainly improvements. . improvements) research ICIL (ICIL suggested 4936 49 36 49.36 efficient (efficient 6747 67 47 67.47 efficiency. efficiency) properties activity 493 4 3 49.3 674 6 67.4 49. 67.

Resumo: A pecuária leiteira familiar é relevante para a agropecuária nacional que, embora contribua com a geração de riqueza e renda, enfrenta baixas eficiência, produtividade e custos de produção elevados. Objetivou-se analisar a eficiência técnica de propriedades leiteiras familiares no Estado de Minas Gerais. Utilizou-se a Análise por Envoltória de Dados (DEA) com modelo BCC orientado a inputs. Quanto maior foi o nível de eficiência das DMU’s, menos recursos foram utilizados em excesso. Foi identificada, ainda, a inexistência de DMU’s que realizaram manutenção preventiva de máquinas, implementos e benfeitorias, justificando o aumento da utilização, principalmente, do insumo MIB (manutenção de máquinas, implementos e benfeitorias). Com esta pesquisa, sugeriu-se o Índice de Comprometimento de Insumos em Leite (ICIL), que evidencia o percentual da produção que está comprometida para comprar um determinado insumo. Quanto maior foi o nível de eficiência das DMU’s, menor foi o ICIL, que passou de 49,36% (eficientes) para 67,47% (com eficiência baixa). Este se mostrou um importante indicador de eficiência de propriedades leiteiras, responsável por evidenciar a quantidade de leite produzido que está comprometida com o pagamento dos insumos utilizados na atividade leiteira. Também se mostrou valioso instrumento a ser utilizado como benchmark em propriedades leiteiras. Resumo renda elevados Objetivouse Objetivou Gerais Utilizouse Utilizou DEA (DEA inputs DMUs, DMUs DMU s, s excesso identificada ainda máquinas benfeitorias utilização principalmente benfeitorias. . benfeitorias) pesquisa sugeriuse sugeriu ICIL , (ICIL) 4936 49 36 49,36 eficientes (eficientes 6747 67 47 67,47 baixa. baixa baixa) (ICIL 493 4 3 49,3 674 6 67,4 49, 67,

Abstract L-carnitine, an increasingly vital compound in livestock nutrition, plays a pivotal role in facilitating the β-oxidation of fatty acids. This study aimed to investigate the impacts of L-carnitine supplementation, administered at varying doses, on pregnancy toxemia susceptible goats. A total of 150 goats underwent estrus synchronization, natural mating, and pregnancy confirmation. Among these, 90 goats carrying multiple fetuses were categorized into three groups on the 100th day of pregnancy, with their feed supplemented as follows: CAR50 (50 mg/kg of L-carnitine), CAR100 (100 mg/kg of L-carnitine), and CON (control without L-carnitine). Subsequently, blood samples were collected from 15 randomly selected goats from each group on days 100, 115, 130, and 145 of pregnancy to quantify serum levels of β-HBA (beta-hydroxybutyrate) and NEFA (non-esterified fatty acids), alongside glucose levels. Dietary supplementation of L-carnitine did not exert a significant impact on blood glucose levels in the CAR50 and CAR100 groups, in comparison to the CON group, during the third trimester of pregnancy (P>0.05). Nevertheless, serum NEFA levels exhibited a noteworthy reduction in the CAR50 and CAR100 groups compared to the CON group on day 145 (P<0.01). Furthermore, no substantial fluctuations in mean NEFA and β-HBA levels were observed in the CAR100 group between days 100 and 145 of gestation (P>0.05). The body condition score exhibited consistent maintenance both within and between groups (P>0.05). To conclude, this study underscores the efficacy of dietary supplementation with L-carnitine in mitigating ketone and NEFA levels in pregnant goats, particularly when administered at a dosage of 100 mg/kg. Consequently, the integration of a standardized quantity of L-carnitine into the diet holds the potential to serve as a valuable preventive strategy for goats susceptible to pregnancy toxemia. Lcarnitine, Lcarnitine L carnitine, carnitine nutrition βoxidation β oxidation acids doses synchronization mating confirmation these 9 th follows CAR CAR5 50 (5 mgkg mg kg , L-carnitine) CAR10 (10 control Lcarnitine. . Subsequently 1 115 130 14 βHBA HBA betahydroxybutyrate beta hydroxybutyrate (beta-hydroxybutyrate nonesterified non esterified acids, acids) P>0.05. P005 P P>0.05 0 05 (P>0.05) Nevertheless P<0.01. P001 P<0.01 01 (P<0.01) Furthermore 10 conclude Consequently 5 ( CAR1 (1 11 13 P00 P>0.0 (P>0.05 P<0.0 (P<0.01 P0 P>0. (P>0.0 P<0. (P<0.0 P>0 (P>0. P<0 (P<0. P> (P>0 P< (P<0 (P> (P< (P

Abstract: The COVID-19 pandemic has become the main epidemiological crisis of the century, leading to the adoption of various self-care behaviors. The effectiveness of these preventive strategies depends on the adherence of the population. The objective was to establish predictors of adherence to self-care behaviors for the prevention of COVID-19 transmission in the Chilean population aged 18 and above. A non-probabilistic sample of 1,033 individuals completed a virtual questionnaire using a cross-sectional design. Self-report scales were used to assess risk perception, pro-care norms, and self-care behaviors against COVID-19. Using hierarchical multiple regressions, it was found that gender, risk perception, and pro-care norms against COVID-19 significantly and directly predicted the use of masks, hygiene behaviors, and social distancing. Age only predicted higher adherence to hygiene behaviors, and socioeconomic status only predicted the use of masks and social distancing. In all self-care behaviors, the interaction between risk perception and pro-care norms suggested that at low levels of pro-care norms, risk perception enhances the adoption of these behaviors. Based on these findings, it is suggested to develop strategies that promote self-care behaviors based on risk perception, considering variables such as gender, age, and socioeconomic status, through the creation and maintenance of pro-care norms that take into account the relationships between individuals and significant others in the perception of the positive evaluation of their health behaviors.

Resumen: La pandemia por la COVID-19 se ha transformado en la principal crisis epidemiológica del siglo, por lo que debieron adoptarse diversas conductas de autocuidado. La eficacia de estas estrategias preventivas depende de la adherencia que mantenga la población. El objetivo de este estudio fue establecer los predictores de la adherencia a las conductas de autocuidado para la prevención del contagio de la COVID-19 en población chilena mayor a 18 años. Una muestra no probabilística de 1.033 personas respondió un cuestionario virtual, bajo un diseño transversal. Se emplearon escalas de autoreporte sobre percepción de riesgo, normas procuidado y conductas de autocuidado contra la COVID-19. Utilizando regresiones múltiples jerárquicas, se encontró que el género, percepción de riesgo y normas procuidado contra la COVID-19 predijeron significativa y directamente el uso de mascarilla, conductas de higiene y distancia social, mientras que la edad solo predijo mayor adhesión a conductas de higiene y el estatus socioeconómico solo predijo el uso de mascarilla y distancia social. En todas las conductas de autocuidado la interacción entre percepción de riesgo y normas procuidado sugiere que a niveles bajos de norma procuidado, la percepción de riesgo potencia la adopción de estas conductas. A partir de estos hallazgos, se sugiere elaborar estrategias que promuevan conductas de autocuidado con base en la percepción de riesgo, considerando variables como el género, edad y estatus socioeconómico, a través de la creación y mantención de normas procuidado que consideren las relaciones entre el individuo y otros significativos en la percepción de la valoración positiva de sus conductas en salud.

Abstract Power distribution utilities effort to ensure the quality of energy to their consumers and the reliability of their power distribution system. It is necessary that maintenance activities are planned with the aim of maintaining or improving reliability indicators in supply to consumers. In this paper, a computational model based on integer nonlinear multiobjective programming is presented to improve the maintenance of equipment in the power distribution system. Since it is a reliability-centered approach, a probabilistic failure model is first used to obtain equipment reliability values at each time point through fuzzy inference. Three objective functions are optimized: i) minimizing maintenance cost, ii) minimizing failure frequency, and iii) maximizing equipment reliability. The optimization problem is also formed by three sets of constraints: i) individual and collective continuity indicators; ii) task execution time; and iii) maintenance limit for each type of equipment. Lichtenberg's algorithm is used to solve the model. A case study is performed for a feeder section consisting of twenty-eight distribution equipment. The results obtained using the Pareto constraints show scenarios that can help maintenance teams to make decisions and develop the preventive maintenance planning. Adding constraints on the duration and frequency of collective interruptions indicators improves the power quality of the distribution system; however, it requires an increase in investment by 36%. system paper reliabilitycentered centered approach inference optimized i cost ii iii Lichtenbergs Lichtenberg s twentyeight twenty eight planning however 36 36% 3

RESUMO O objetivo deste trabalho foi identificar o momento ótimo para substituição de um Harvester utilizado na colheita florestal, comparando diferentes métodos econômicos. A máquina florestal utilizada foi o Harvester John Deere modelo 1270D, com cabeçote modelo 270. O custo da máquina por hora trabalhada foi calculado pela soma dos custos fixos com os custos variáveis. Os métodos utilizados para determinação da substituição ótima da máquina foram o Custo Médio Total (CMT) e o Custo Anual Equivalente (CAE), que consideram funções discretas e o Ciclo Terminal e Cadeia de Substituição Constante, que consideram funções contínuas. Os quatro métodos utilizados diferiram entre si na indicação do momento ótimo de substituição do Harvester. O CMT, apesar de ser um método simples e conhecido, não conduziu a um resultado adequado (2 anos), pois, a substituição de uma máquina florestal é usualmente feita com um período maior de uso, com as atuais rotinas de manutenção preventivas e preditivas. Tal divergência é justificada devido aos elevados valores de aquisição e de custo operacional, além do método não considerar a variação do capital no tempo (a taxa de juros) e as receitas ou a produção do Harvester, o que impacta drasticamente a análise. O CAE, por utilizar a taxa de desconto, foi mais eficiente que o CMT e forneceu um resultado mais coerente com a realidade do setor florestal, sendo 6 anos. Além disso, é o método mais difundido nos estudos de substituição de máquinas e equipamentos, por ser simples, de fácil aplicação e eficiente. Já o método da Cadeia de Substituição forneceu um momento ótimo de substituição entre 7 e 8 anos, também coerente com a realidade das empresas do setor florestal que praticam a atividade de colheita florestal por um longo período. Portanto, este método pode ser considerado na tomada de decisão, por considerar as variáveis de custo e receita da máquina. A determinação da vida útil de uma máquina utilizada na colheita florestal, do ponto de vista econômico, ou o período em que ela executa suas atividades com menor custo operacional está diretamente relacionada com seu menor custo de produção, e no presente estudo, os métodos mais adequados para determinar o momento ótimo de substituição do Harvester foram o CAE e o método da Cadeia de Substituição. econômicos 1270D D 270 (CMT , (CAE) Constante contínuas conhecido 2 ( anos anos) pois uso preditivas juros análise desconto disso equipamentos Portanto decisão econômico estudo 27 (CAE

ABSTRACT This research sought to identify the ideal timeframe for replacing a Harvester, used in forest harvesting, employing a comparative evaluation of different economic methods. A John Deere 1270D harvester, equipped with a 270-model head was utilized in this study. The machine’s cost per hour worked was calculated by adding fixed costs with variable costs. The methods used to determine the machine’s optimal replacement time were: the Total Average Cost (TAC) and the Equivalent Annual Cost (EAC), which consider discrete functions, and the Terminal Cycle and Constant Chain Replacement, which consider continuous functions. The four methods differed in their indication of the optimal replacement time for the harvester. Although the TAC is a simple and well-known method, it did not yield an adequate result (2 years). This is because replacing a forest machine usually occurs over a longer period of use, with current preventive and predictive maintenance routines. This discrepancy arises from the high acquisition and operational costs, as well as the method’s failure to account for the variation of capital over time (interest rate) and the revenues or production of the harvester, which significantly affects the analysis. Utilizing the discount rate, the EAC proved to be more efficient than the TAC, yielding a result that is more aligned with the reality of the forest sector (6 years). Furthermore, it is the most widespread method in machine and equipment replacement studies due to its simplicity, ease of application, and efficiency. The Chain Replacement method provided an optimal replacement time between 7 and 8 years, also consistent with the reality of companies in the forest sector engaged in forest harvesting for an extended period. Therefore, this method can be considered in decision-making as it takes into account the cost and revenue variables of the machine. Determining the useful life of a machine used in forest harvesting from an economic perspective, or the period in which it performs its activities with the lowest operational cost, is directly related to its lowest production cost. In the present study, the most suitable methods to determine the optimal replacement time for the harvester were the EAC and the Chain Replacement method. Harvester D 270model model 270 study machines s (TAC EAC, , (EAC) functions wellknown known 2 ( years. years . years) use routines interest rate analysis 6 Furthermore simplicity application efficiency Therefore decisionmaking decision making perspective 27 (EAC

Abstract This paper presents an eyebolt structural fault detection system, based on the analysis of multiple electromagnetic parameters through a random forest classifier trained by both measurements and high-fidelity simulated signals. The proposed methodology is completely noninvasive and does not require the disassembly of the electrical infrastructure, allowing the live-line working. The obtained results show that the proposed multi-parameter strategy achieves high accuracy and increases the system’s capability of detecting faults, improving the efficiency of the operator’s preventive maintenance routines and, consequently, increasing the reliability of the power supply and energy distribution systems. system highfidelity fidelity signals infrastructure liveline live line working multiparameter multi parameter systems s faults operators operator consequently

Resumen La soledad individualista humana impele a vivir en pareja y a alcanzar complementariedad hombre/mujer, afecto y reci procidad. El periodismo científico de este artículo parafrasea el contenido de su bibliografía al revisar la elección de pareja, su satisfacción y complicaciones e instrucción preventiva de circunstancias que ocasionan ruptura. La falla -desde la elección-, desconoce los mecanismos entre razón e instinto sexual. El problema del amor no es ser amado sino desarrollar tal capacidad, pues lo extingue la inadaptación y monotonía. Se describe el acto elector/elegido y sus razones simultáneas: conscientes (homogeneidad/heterogeneidad del encuentro; emulación del modelo animal; tipo, dinámica vincular y redes sociales; aspectos sociodemográficos; ubicación geográfica y accesibilidad; compartición sexual y expectativas inmediatas/ futuras), e inconscientes (problemática electora, interacción diádica y antecedentes parentales; mecanismos de defensa, intercambio de disociaciones; idealización; reciprocidad negativa, lucha de poder, identificación proyectiva, búsqueda de aprecio por el otro; narcisismo, falso sí mismo, mecanis mos de dilación/evasión de responsabilidad, inseguridad, intrusión y colusión). Una pareja saludable, entiende/atiende la creación y mantenimiento del “nosotros”, elimina la lucha de poder y produce conciliación permanente. El acuerdo y comprensión tolerante son indispensables para una relación emocional satisfactoria, estable y duradera.

Abstract Human individualistic loneliness impels us to live as a couple and achieve complementarity between man and woman, af fection, and reciprocity. The science journalism of this article reviews the choice of partner, their satisfaction and complications, and preventive instruction of circumstances that cause rupture. The failure from the election ignores the mechanisms between reason and sexual instinct. The problem of love is not to be loved but to develop such a capacity, for it is extinguished by maladjustment and monotony. The voting/elected act and its simultaneous reasons are described: Conscious (homogeneity/heterogeneity of the encounter; emulation of the animal model; type, dynamic link and social networks; Sociodemographic aspects; sexual sharing and immediate/future expectations). Unconscious (electoral problems, dyadic interaction, and parental background; defense mechanisms, exchange of dissociations; idealization; negative reciprocity, power struggle, projective identification, search for appreciation for the other; narcissism, false self, mecha nisms of procrastination/evasion of responsibility, insecurity, intrusion, and collusion). A healthy couple, understands/at tends to the creation and maintenance of the “we”, eliminates the power struggle and produces permanent conciliation. Tolerant agreement and understanding are indispensable for a satisfying, stable, and lasting emotional relationship.

RESUMEN El aprendizaje conjunto es un término que se utiliza para referirse a los métodos que combinan varios algoritmos para tomar una decisión, generalmente en tareas de aprendizaje automático supervisado. En los últimos años la regresión logística, Support Vector Machine, la red neuronal y otros algoritmos de aprendizaje de máquinas se han utilizado en el diagnostico inteligente de fallas en maquinaria rotativa, sin embargo, cada algoritmo tiene sus ventajas y desventajas y pueden funcionar de distinta manera para un determinado conjunto de datos. En el presente artículo científico se proponen tres modelos de detección de fallas en cajas de engranajes bajo el enfoque de aprendizaje conjunto utilizando las técnicas de clasificación por votación mayoritaria, votación suave y apilamiento a través de las cuales se combinan las predicciones de varios estimadores a fin de mejorar la generalización y la robustez sobre un solo estimador. Para el desarrollo de los modelos especificados se utiliza un conjunto de datos de señales de falla de cajas de engranajes y cuatro técnicas de clasificación las cuales son: regresión logística, support vector machine, XGBoost y random forest. Los resultados finales de precisión de los modelos de votación mayoritaria y votación suave son 99.86% y 99.82% respectivamente, mientras que la precisión del modelo bajo el enfoque de apilamiento es de 99.85%. En comparación con los resultados de los clasificadores individuales, se demuestra que los modelos de aprendizaje conjunto compensan los errores cometidos por los clasificadores individuales y mejoran efectivamente la precisión de clasificación.

ABSTRACT Joint learning is a term used to refer to methods that combine several algorithms to make a decision, usually in supervised machine learning tasks. In recent years logistic regression, Support Vector Machine, neural network and other machine learning algorithms have been used in intelligent fault diagnosis in rotating machinery, however, each algorithm has its advantages and disadvantages and may perform differently for a given data set. In this scientific paper, three gearbox fault detection models are proposed under the ensemble learning approach using the majority voting, soft voting and stacking classification techniques through which the predictions of several estimators are combined in order to improve generalization and robustness over a single estimator. A data set of gearbox failure signals and four classification techniques are used to develop the specified models: logistic regression, support vector machine, XGBoost and random forest. The final accuracy results of the majority voting and soft voting models are 99.86% and 99.82% respectively, while the accuracy of the model under the stacking approach is 99.85%. Compared with the results of the individual classifiers, it is shown that the ensemble learning models compensate for the errors made by the individual classifiers and effectively improve the classification accuracy.

INTRODUCTION: Epidermolysis bullosa (EB) is a group of rare inherited disorders uniquely characterised by skin and, in some instances, mucosal blistering. In the most severe form of the disease, recessive dystrophic EB (RDEB), the blister-inducing split occurs below the lamina densa. Extensive scarring of the oral mucosa results in limited mouth opening, making speech and mastication difficult. At the same time, oral mucosal blisters often lead to patients restricting their diets to soft, and generally cariogenic, foods, and battling with oral hygiene practices. This results in poor plaque control, a high caries burden and complex dental management Aims and objectives: This paper presents a report on two siblings suffering from generalised RDEB affecting the oral cavity and their extensive dental treatment needs. Design/Methods: The siblings were referred to the University of Pretoria Oral Health Centre, complaining of painful teeth and oral mucosal discomfort. Their clinical features, dental condition and subsequent management are presented. RESULTS: Restricted mouth opening, limited personal plaque control and diets limited to soft, carbohydrate-rich foods because of oral mucosal discomfort, resulted in extensive dental decay that required multiple extractions CONCLUSION: The dental and anaesthetic management of patients with RDEB is complex and, due to the friable tissues, requires the most atraumatic care possible. Ideally, patients with this condition need to have early dental intervention where preventive programmes can be implemented to reduce the need for later extensive and complicated dental interventions. Maintenance of the patient's oral health is essential to ensure adequate nutrition, yet also reducing the consumption of soft cariogenic diets which increased their caries risk

ABSTRACT: The present investigation aimed to evaluate the type of maintenance and the types of machinery in four sawmills in the city of Jaén, the evaluation was carried out through the methodology of direct observation information collection through the data collection sheet instrument, In turn, the type of machinery used in the first transformation sawmill work was identified, with the technical characteristics of each machinery usually consisting of a brushcutter, band saw, circular table saw and a planer. The type of sawmill was classified according to its daily production, being the sawmill the parral, Santa Rosa and Casa Blanca in the category of small and the sawmill the union of very small; process diagrams were also elaborated according to the classification, resulting in two process diagrams; and the classification of maintenance in the studied sawmills is preventive and corrective; It was also determined that it is business-oriented for the La Unión, Santa Rosa and Casa Blanca sawmills and for the El Parral sawmill it is classified as oriented to business-followers.

RESUMEN: La presente investigación tuvo como objetivo clasificar el tipo de mantenimiento y describir el tipo de maquinarias en cuatro aserraderos en la ciudad de Jaén, la evaluación se realizó mediante la metodología de recopilación de información de observación directa mediante el instrumento de ficha de recolección de datos, a su vez se identifico el tipo de maquinaria usada en los trabajos de aserrío de primera transformación, siendo las características técnicas de cada maquinaria conformado usualmente por una desbrozadora, sierra cinta, sierra circular de mesa y una cepilladora. Se clasificó el tipo de aserradero según su producción diaria, siendo el aserradero el parral, santa rosa y casa blanca en categoría de pequeño y el aserradero la unión de muy pequeño; también se elaboraron diagramas de procesos según la clasificación dando como resultado dos diagramas de procesos; y la clasificación del mantenimiento en los aserraderos estudiados es de tipo preventivo y correctivo; también se determinó que es orientado a los negocios para los aserraderos la Unión, Santa Rosa y Casa Blanca y para el aserradero el parral se clasifica en orientado a los negocios - seguidores.

Resumen: Introducción. Los estudios de cohortes han sido fundamentales para describir la evolución de múltiples enfermedades. El Grupo de estudio Uruguayo de VIH, comenzó en 2018 el seguimiento de una cohorte de personas con VIH de diferentes prestadores de salud. Objetivo . Describir las características epidemiológicas y clínicas de las personas incluidas en la cohorte GeUVIH. Pacientes y métodos. Estudio descriptivo, observacional, multicéntrico transversal y prospectivo. Desde 1 de julio de 2018 hasta 31 de mayo de 2021. Se analizaron 795 personas con VIH de centros con consultas ambulatorias públicas y privadas de Montevideo-Uruguay. Resultados. Se analizaron 795. Relación hombre/ mujer 2 a 1. Mediana de edad 46 años. El 56,6% tenía entre 39 y 58 años. Motivaron al diagnóstico de VIH sobre todo controles en salud y enfermedades oportunistas. Al ingresar a la cohorte el 49% llevaba más de 10 años viviendo con VIH y el 25% estaba en estadio SIDA. El 98.4% estaban recibiendo antirretrovirales y de ellos 84% tenían carga viral indetectable. El 1,3% estaba co-infectado con el VHB y 3,9% con el VHC. Fallecieron 4 pacientes de la cohorte. Conclusiones. Se observó una población vinculada a los servicios de salud, que recibe TAR y es adherente. El envejecimiento de la población nos obliga a diagnosticar y tratar precozmente las comorbilidades. Se debe estimular el diagnóstico de VIH durante el control en salud y/o campañas preventivas. El mantenimiento de la cohorte prospectivamente dará información fundamental para la toma de decisiones.

Abstract: Introduction: cohort studies are essential to describe the evolution of multiple diseases. In 2018 the Uruguayan group for the study of HIV started to monitor a cohort of individuals infected with HIV in different health care Institutions. Objective: to describe the epidemiological and clinical characteristics of individuals included in an HIV cohort (GeUVIH). Patients and method: descriptive, observational, multi-transversal and prospective study. From July 1, 2018 to May 31, 2021. 795 individuals infected with HIV were analyzed in private and public outpatient consultations in Montevideo, Uruguay. Results: the case of 795 patients was analyzed. Men/women ratio was 2/1. Median age was 46 years old. 65.6% was between 39 and 58 years old. HIV diagnosis mainly resulted from health control and opportunistic diseases. Upon inclusion in the cohort group, 49% of patients had been living with HIV for over 10 years and were in the AIDS stage of infection. 98.3% were under antiretroviral treatment and in 84% of them viral load could not be detected. 1.3% of patients presented HIV-HIB coinfection and 3.9% HIV-HIC coinfection. 4 patients in the cohort died. Conclusions: the studied population was found to be related to the health care services, receiving antiretroviral therapy and showing good adherence to treatment. The aging of population makes it mandatory for the early diagnosis and treatment of comorbilities. Diagnosis of HIV must be encouraged in health care controls or preventive campaigns. The prospective maintenance of the cohort will provide key data for the making of decisions.

Resumo: Introdução: estudos de coorte têm sido essenciais para descrever a evolução de múltiplas doenças. O Grupo Uruguaio de Estudos de HIV começou a monitorar uma coorte de pessoas com HIV de diferentes prestadores de serviços de saúde em 2018. Objetivo: descrever as características epidemiológicas e clínicas das pessoas incluídas na coorte GeUVIH. Pacientes e métodos : estudo descritivo, observacional, multicêntrico, transversal e prospectivo. No período 1º de julho de 2018 a 31 de maio de 2021 foram analisadas 795 pessoas com HIV de unidades ambulatoriais públicas e privadas em Montevidéu-Uruguai. Resultados: foram incluídas 795 pessoas. A proporção homem/mulher foi 2 para 1, a mediana de idade 46 anos sendo que 56,6% tinham entre 39 e 58 anos. O diagnóstico do HIV foi motivado especialmente por controles de saúde e pela detecção de doenças oportunistas. Ao ingressar na coorte, 49% viviam com HIV há mais de 10 anos e 25% encontravam-se na fase de AIDS. 98,4% estavam recebendo antirretrovirais e 84% deles tinham carga viral indetectável. 1,3% estavam co-infectados com HBV e 3,9% com HCV. Quatro pacientes da coorte morreram. Conclusões: observou-se uma população vinculada aos serviços de saúde, que recebe TARV com adesão ao tratamento. O envelhecimento da população obriga-nos a diagnosticar e tratar precocemente as comorbilidades. O diagnóstico de HIV deve ser incentivado durante controles de saúde e/ou campanhas preventivas. Manter a coorte prospectivamente fornecerá informações essenciais para a tomada de decisões.

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Summary: The new Coronavirus SARS CoV-2 pandemic was declared at the beginning of March 2020 when the Uruguayan government appointed the National Contingency Plan for the COVID-19 disease caused by this virus. This plan included non-pharmacological preventive measures such as: hand hygiene, physical distancing, use of different types of masks according to the risk of who should wear them, in some periods, restrictions to mobility, educational activities or public shows, and movement by land, air or sea. Responsible freedom was strongly called for. In December 2020, the Vaccination Strategy was included as a primary prevention mechanism. On 3/1/2021, the COVID-19 2021 Vaccination Campaign began, it was non-mandatory, population-based, initially for people over 19 years of age, and for adolescents between 12 and 17 years of age and pregnant women since June. The National Honorary Scientific Advisory Group (GACH) together with the National Vaccine Advisory Committee (CNAV) of the Ministry of Public Health (MSP) that has vast experience in advising health authorities in scientific decisions on the introduction of vaccines, and an ad-Hoc Commission created for COVID-19 vaccines, brought together experts to advise on the vaccination strategy. The Honorary Commission for the Fight Against Tuberculosis and Prevalent Diseases (CHLA-EP), as the operational branch of the MSP’s Department of Immunizations, has participated with all stakeholders since December to implement the COVID-19 Population Vaccination Campaign without neglecting their tasks regarding the vaccination to prevent other infectious diseases. Methodology: a descriptive, retrospective study was carried out regarding the strategies implemented by the Immunization Operational Department (operational branch of the Ministry of Health’s Immunization Department), A. Calmette Laboratory, Honorary Commission, General Coordination and Administrative Departments between November, 2020 and July 2021. Data source: reports were issued or provided specially for this work by the Immunization Operational Department, A. Calmette Laboratory, by the Ministry of Public Health’s immunization Department, Human Resources, Material Resources, Support, Communication and Design Service, Peripheral Centers, Executive Board and General secretariat. Results: the results of the 4 periods are as follows: 1- Planning (Period November - December 2020), 2- Training, hiring of human resources and advice for the acquisition of qualitative and quantitative material resources (January - February 2021), 3- Opening of COVID-19 vaccination centers (Hubs), posts and launch of the COVID-19 Campaign (March 2021), 4- Overlap of the 2021 flu campaign (April-June) and maintenance of vaccine coverage (National Immunization Programme - PNI). 1- Planning: The characteristics of the different vaccines (dead virus vaccines, vector vaccines and in particular mRNA vaccines, with storage requirements of -70ºC, transfer and distribution requirements of -25ºC, and reconstitution and use of +2 + 8ºC) were taken into account in the different scenarios. Risk and costs analysis were performed. We interchanged data with different companies that provided this service, we participated in training activities with some of them, mainly in the design of a solid cold chain without failures (e.g. a Vac-Q-tec training activity). The transfer of vaccines to hubs, tertiary vaccination centers or peripheral vaccination centers was designed. The different destination site of the vaccines, the different possible scenarios were taken into account, both at local central level (Montevideo - Carrasco International Airport), but also at National level using the different air terminals. Similarly, strategies for the distribution of vaccines by land were planned involving different public or private actors based on the institutions’ experience, both regarding the vaccination campaign and in the PNI maintenance. We made a supply acquisition plan for the vaccine’s storage and distribution, for the vaccination itself, and for the purchase of supplies jointly with the Procurement Department of the Ministry of Economy and Executive Secretariat of the MSP. Six-people vaccination teams were created with clear roles and with the slogan of rapid, universal, free and safe vaccination for all. 2- Training: Courses and materials were organized for the staff to acquire updated knowledge about SARS CoV 2 and COVID-19, transmission mechanisms, use and planning of use of personal protective equipment (PPE) and of course, a detailed monitoring of the vaccines being developed. We carried out a thorough analysis of the vaccine companies to arrive in Uruguay, we focused on 3 of them (Pfizer BioNtech, CoronaVac, Oxford AZ). Training was carried out by roles (vaccinators, preppers, administrators, position referents, backups). Special emphasis was placed on the training of the care of the person to be vaccinated, registration of the vaccination act, end-to-end cold chain, disposal of used materials and filing out inspection forms. All the contents and materials were available on the Institution’s webpage. Human resources: human resources were allocated for the creation, signature and registration of the paperwork for 1,463 new contracts for teams across the country. These resources were allocated not only to vaccination itself, but also to actively participate in each of the vaccination posts. This meant that the work was multiplied by 6 for the tasks required during this period. The Department of Material Resources, went from packaging and distributing from 7 to 15 packages a month to 80 packages a month for each Peripheral/Vaccination Center. Material shipment quadrupled at the beginning of the campaign and it eventually grew by five and sixfold. Some of the key figures to highlight are: 3, 300,000 needle syringes, 8,800 liters of Eucalyptus Alcohol, 852,000 latex and nitrile gloves and 141,000 isolation gowns. 3. COVID-19 Vaccination Hubs, Posts and Campaigns. We gradually opened maximum response mass vaccination Hubs in Montevideo (8), Canelones (1) and Maldonado (1). Since it was had been decided to vaccinate 3 to 5 people every 15 minutes, the primary results at the Hospital de Clínicas Hub were 211,153 doses administered in 32 vaccination posts, and at Antel Arena Hub 615,637 doses were administered in its 15 vaccination posts. As of July 31, there were 144 COVID 19 vaccination posts throughout the national territory. The distribution was made nationwide: 3,229,320 Sinovac vaccine doses, 97,790 Oxford-Astra Zeneca vaccine doses, and 1,585,452 Pfizer-BioNtech vaccine doses. We devised 60 teams including a referent (identification, registration, control), a trainer, 2 vaccinators and vaccination driver for Homes for the Elderly at ELEPEM and people needing special care. They actively participated in the vaccination at ELEPEM, Shelters and Schools for Children with Special Needs and visited a total of 1679 Institutions and overall, 35,006 people were vaccinated. 4- Overlap of the 2021 flu campaign (April-June) and the maintenance of the COVID vaccine coverage (National Immunization Programme - PNI). Since 04/24/2021, the Anti-Flu Campaign began, and it overlapped the COVID-19 campaign described above, which meant reinforcing strategies and expanding actions to be able to carry out both campaigns simultaneously, always with the objective of maintaining the National Immunization Program. Vaccination was carried out at the ELEPEM, as it is performed annually by the commission and vaccination of COVID-19, influenza and PNI was performed on the territory. According to the data received on July 17 in the Ministry of Public Health Immunization Unit Report (week 12), there were 605,802 registered doses, of which at least 87,802 had been administered by the Institution. This difference regarding previous campaigns could have been caused by the intense work carried out during the COVID19 Vaccination Campaign. Within the framework of the inter-institutional activity “Barrio a Barrio” (Vaccination in all Neighborhoods), 7,225 people were vaccinated with the influenza vaccine at the CHLA-EP mobile vaccination bus in Montevideo. The CHLA-EP has contributed with logistics and vaccination with a 2-dose schedule for the 3 platforms and a booster dose for those who received virus vaccines. The CHLA-EP has contributed to achieving the target of the COVID-19 Vaccination Campaign between 1/3 and 8/29/21: 5,487,181 doses were applied, 2,065,269 people received 1 dose of vaccine and 2,496,290 of them received 2 doses and 333,662 have received booster doses. Conclusion: the planning, training, provision of human and material resources has enabled us to successfully carry out two historical simultaneous vaccination campaigns in hubs, vaccination centers, ELEPEM and all along the territory.

Resumo: A pandemia causada pela infecção pelo novo Coronavírus SARS CoV-2 determinou que no Uruguai no início de março de 2020 o governo elaborasse o Plano Nacional de Contingência para a doença COVID-19 causada por este vírus. Este plano incluía medidas preventivas não farmacológicas como: higiene das mãos, distanciamento físico, uso de diferentes tipos de máscaras dependendo do risco de quem as deve usar, em alguns períodos várias restrições à circulação de pessoas, atividades educativas ou espetáculos públicos e a trânsito por terra, ar ou mar). Foi feito um forte apelo à liberdade responsável. A partir de dezembro de 2020, decidiu-se incorporar uma Estratégia de Vacinação à prevenção primária. Em 01/03/2021 teve início a Campanha de Vacinação COVID-19 2021, não obrigatória, de base populacional, inicialmente para maiores de 18 anos e a partir de junho contempla adolescentes entre 12 e 17 anos e gestantes. O Grupo Honorário de Assessoramento Científico do Governo Nacional juntamente com a Comissão Nacional de Assessoramento de Vacinas (CNAV) do Ministério da Saúde Pública (MSP), que assessora autoridades de saúde em decisões científicas sobre a introdução de vacinas, e uma Comissão ad hoc criada para vacinas contra a COVID-19 reuniu especialistas do país para aconselhar sobre a estratégia de vacinação. A Comissão Honorária de Luta contra a Tuberculose e Doenças Prevalentes (CHLA-EP) como braço operacional do Departamento de Vacinação do MSP envolveu-se desde dezembro com todos os intervenientes na implementação da Campanha de Vacinação da População COVID-19, aliás de realizar as tarefas de vacinação para prevenir outras doenças infecciosas. Metodologia: foi realizado um estudo descritivo e retrospectivo das estratégias implementadas pelo Departamento Operacional de Imunizações (braço operacional do Departamento de Imunizações do MSP), Laboratório A. Calmette, Comissão Honorária, Coordenação Geral e departamentos administrativos: entre os meses de novembro de 2020 a julho de 2021. Fonte de dados: relatórios divulgados ou oferecidos especialmente para este trabalho pelo Departamento Operacional de Imunizações, Laboratório A. Calmette, Departamento de Imunizações do Ministério da Saúde Pública, Recursos Humanos, Recursos Materiais, Serviço de Apoio, Comunicação e Design, Centros Periféricos, Direção Executiva e Secretaria Geral. Resultados: são apresentados os resultados de 4 períodos: 1- Planejamento (novembro - dezembro de 2020), 2- Capacitação, contratação de recursos humanos e assessoria para aquisição de recursos materiais em qualidade e quantidade (janeiro - fevereiro de 2021), 3- Abertura de centros (Hubs), postos de vacinação COVID-19 e implementação da Campanha COVID-19 (março 2021), 4- Sobreposição da campanha da gripe 2021 (abril-junho 2021) e manutenção da cobertura vacinal (PNI) 1- Planejamento: As características das vacinas a receber eram vacinas de vírus mortos, vacinas vetoriais e em particular mRNA com requisitos de armazenamento de temperaturas de -70ºC, transferência e distribuição de -25ºC, e reconstituição e uso de +2 +8ºC nos diferentes cenários. Análise de risco e análise de custo foram realizadas. Realizaram-se intercâmbios com diferentes empresas que prestam este serviço, participando em ações de formação com algumas delas, essenciais na criação de uma cadeia de frio sólida e sem falhas (ex. ação de formação com Vac-Q-tec). Foi projetada a transferência de vacinas para os hubs, centros de vacinação terciários ou periféricos. Tendo em conta o local de chegada das vacinas, foram considerados os diferentes cenários possíveis, não só a nível central (Montevidéu - Aeroporto Internacional de Carrasco), mas também a nível nacional utilizando os diferentes terminais aéreas. Da mesma forma, foram planejadas estratégias de distribuição de vacinas por via terrestre envolvendo diferentes atores (públicos ou privados), com base na experiência da instituição, tanto na campanha de vacinação quanto na manutenção do PNI. A previsão de compra de insumos foi feita tanto para o armazenamento e distribuição da vacina, quanto para a própria vacinação, como também na tomada de decisão na compra de insumos, atuando em conjunto com o Departamento de Compras do Ministério da Economia e Gestão Secretário do MSP. Eles participaram da formação de equipes de 6 pessoas com funções especificas de vacinação com o slogan de vacinação rápida, universal, gratuita e segura. 2- Capacitação, contratação de recursos humanos e assessoria para aquisição de recursos materiais em qualidade e quantidade. Foram organizados cursos e materiais para que os funcionários adquirissem conhecimento atualizado sobre SARS CoV2 e COVID-19, mecanismos de transmissão, uso e planejamento de uso de equipamentos de proteção individual (EPI) e também para o acompanhamento minucioso das vacinas em desenvolvimento. Fizemos a análise minuciosa das possíveis vacinas candidatas para chegar ao Uruguai, e focamos em 3 delas (Pfizer BioNtech, CoronaVac, Oxford AZ). O treinamento foi realizado por funções (vacinadores, treinadores, administradores, posição de referência, backup). Foi dado especial destaque à formação no cuidado da pessoa a vacinar, registo do ato vacinal, rede de frio em todos os seus pontos, eliminação de materiais utilizados e preenchimento de fichas de controlo. Todos os conteúdos e materiais foram disponibilizados na página web da Instituição. Recursos humanos: funcionários foram alocados para a preparação, assinatura e registro de 1.463 novos contratos para complementar as equipes em todo o país, estes recursos humanos estiveram dedicados não apenas à vacinação em si, mas a participar ativamente de cada um dos postos de vacinação. Isso significou que o trabalho se multiplicou por 6 para as tarefas exigidas durante esse período. O Departamento de Recursos Materiais, passou de embalar e distribuir de 7 para 15 embalagens por mês, passando para 80 embalagens para cada Periférico/Centro de Vacinação. A remessa habitual de materiais se quadruplicou e no início da campanha aumentou cinco e seis vezes. Alguns dos números a destacar são: 3.300.000 seringas com agulha, 8.800 litros de álcool de eucalipto, 852.000 luvas de látex e nitrílica e 141.000 túnicas. 3. Abertura de centros e postos de vacinação COVID-19 e lançamento da Campanha COVID-19. Isso gerou progressivamente o estabelecimento de centros de resposta máxima (Hubs) (vacinação em massa) 8 em Montevidéu, um em Canelones e um em Maldonado. Já que decidiu-se vacinar de 3 a 5 pessoas a cada 15 minutos, no Hub. O Hospital de Clínicas administrou 211.153 doses em seus 32 postos de vacinação e na Arena Hub Antel foram administradas 615.637 doses em seus 15 postos de vacinação. Até 31 de julho, havia 144 postos de vacinação contra a COVID 19 habilitados em todo o território nacional. A distribuição foi realizada, 3.229 foram distribuídos em todo o país, 320 doses de vacina Sinovac, 97.790 doses de vacinas AstraZeneca e 1.585452 de vacina Pfizer. Participaram no treinamento de 60 equipes de referência (identificação, registo, controle), treinador, 2 vacinadores e motorista para vacinação em estabelecimentos de longa permanência para idosos (ELEPEM) e pessoas com situações especiais em albergues e escolas especiais, visitando um total de 1.679 Instituições e vacinando a 35.006 pessoas. 4- Sobreposição da campanha de gripe de 2021 (abril a junho de 2021) e manutenção da cobertura vacinal (PNI). A partir de 24/04/2021 teve início a Campanha da Gripe 2021, sobrepondo-se à campanha COVID-19 descrita, o que implicou o reforço de estratégias e ampliação das ações para poder cumprir ambas campanhas em paralelo, sempre com o objetivo de não descurar o Programa Nacional de Imunizações. Foi realizada a vacinação no ELEPEM, conforme anualmente realizada pela comissão e a vacinação no território das vacinas COVID-19, influenza e PNI. De acordo com os dados recebidos até 17 de julho no relatório da Unidade de Imunizações dos Ministérios da Saúde Pública (semana 12), foram registradas 605.802 doses, das quais pelo menos 87.802 doses foram administradas pela Instituição. Essa diferença em relação às campanhas anteriores pode ser atribuída ao intenso trabalho realizado na estratégia de Vacinação COVID19. No âmbito da atividade interinstitucional Bairro a Bairro, 7.225 pessoas foram vacinadas com a vacina contra gripe no celular do CHLAEP de Montevidéu. O CHLA-EP tem contribuído desde a logística e vacinação com um esquema de 2 doses para as 3 plataformas e uma dose de reforço para quem recebeu vacinas de vírus mortos. O CHLA-EP contribuiu para atingir os números da Campanha de Vacinação COVID-19 entre 1/3 e 29/8/21: 5.487.181 doses aplicadas, 2.065.269 pessoas que receberam 1 dose de vacina e delas 2.496.290 têm 2 doses e 333.662 receberam doses de reforço. Conclusões: O planejamento, capacitação, disponibilização de recursos humanos e materiais permitiram a realização de duas campanhas de vacinação coexistentes nos hubs, vacinatórios, ELEPEM e no território, o que pode ser considerado um processo bem sucedido e histórico.

Com base na incorporação da profilaxia pré-exposição (PrEP) como estratégia para a prevenção do HIV, e considerando a necessidade de compreender o uso da medicação entre jovens, o artigo analisa as narrativas de homens gays e mulheres transgênero da cidade de Belo Horizonte, Minas Gerais, Brasil, participantes no estudo PrEP1519. A pesquisa qualitativa, baseada na antropologia interpretativa, foi desenvolvida através de 10 entrevistas em profundidade com usuários de PrEP acompanhados durante pelo menos três meses entre outubro e novembro de 2019. Os resultados mostraram que o medicamento era visto como a principal motivação para participar no estudo e como estratégia combinada com o uso de preservativos, seja como prevenção adicional ou assumindo o papel principal. A medicação revelou sinais elaborados pelas performances de gênero e sua relação com outros medicamentos, principalmente a experiência de meninas trans em uso de hormonioterapia. Quanto à socialização do uso da PrEP, as narrativas mostraram que não havia segredo entre os casais, o que não significava a inexistência de estigma em relação à associação com HIV, principalmente no contexto virtual. No ambiente familiar, os participantes relatavam questões sobre a função preventiva da medicação e a natureza voluntária da participação no estudo. As narrativas dos jovens revelaram sentidos plurais atribuídos à medicação e ao seu uso social, compondo as performances tanto dos meninos quanto das meninas. Os sinais atribuídos à medicação indicaram que além da manutenção da saúde, a medicação melhora a vida e a liberdade sexual dos usuários.

Basado en la incorporación de la profilaxis previa a la exposición (PrEP) como una estrategia de prevención contra el VIH, y considerando la necesidad de entender el uso de medicación entre gente joven, este artículo analiza narrativas de hombres gais y mujeres transgénero de Belo Horizonte, Minas Gerais, Brasil, que participan en el estudio PrEP1519. Esta es una investigación cualitativa, basada en la antropología interpretativa, desarrollada por 10 entrevistas en profundidad con usuarios de PrEP, a quienes se les realizó un seguimiento durante al menos tres meses entre octubre y noviembre de 2019. Los resultados mostraron que la medicación fue considerada como la principal motivación de participar en el estudio y como una estrategia combinada con el uso de condones, ya sea como prevención adicional, o asumiendo el papel principal. La medicación reveló signos de estar construida por el desempeño del género y su relación con otros medicamentos, especialmente la experiencia de las chicas trans en la terapia hormonal. Respecto a la socialización del uso del PrEP, las narrativas mostraron que no había secretos entre las parejas, lo cual no significó que no existieran estigmas en la asociación con el VIH, principalmente en contexto virtual. En el ambiente familiar, se informó de cuestiones sobre la función preventiva de la medicación y la naturaleza voluntaria de participar en el estudio. Las narrativas de ellos jóvenes revelaron significados plurales de la medicación y su uso social, formando parte del desempeño tanto de los chicos como de las chicas. Los signos atribuidos a la medicación indicaron que además de mantener la salud, la medicación mejora la vida y la libertad sexual.

Based on the incorporation of pre-exposure prophylaxis (PrEP) as an HIV prevention strategy and considering the need to comprehend the use of medication among young people, this article analyzes narratives of gay men and transgender women from Belo Horizonte, Minas Gerais State, Brazil, participating in the PrEP1519 study. This is a qualitative research, based on the interpretative anthropology, developed by 10 in-depth interviews with PrEP users followed-up for at least three months between October and November 2019. The results showed that the drug was seen as the main motivation for participating in the study and as a strategy combined with the use of condoms, whether as additional prevention, or assuming the leading role. The medication revealed signs built by the gender performances and their relation to other medications, especially the experience of trans girls in hormonal therapy. Regarding the socialization of the use of PrEP, the narratives showed that there was no secret between the couples, which did not meant that stigmas on the association with HIV did not exist, mainly in the virtual context. In the family environment, they reported questions about the preventive function of the medication and the voluntary nature of the participation in the study. The youth’s narratives revealed plural meanings of the medication and its social use, composing both the boys’ and girls’ performances. The signs attributed to the medication indicated that in addition to maintenance of health, the medication improves life and sexual freedom.