RESUMO Este estudo foca no desempenho de vacas para produção de carne, criadas nos pântanos do Paraguai, examinando cinco genótipos bovinos; Brahman, Brangus, Nelore, bem como duas raças locais em risco de extinção. O principal objetivo é identificar e classificar variáveis fenotípicas que incluem variáveis sanguíneas, clínicas, de pelagem e saúde, demonstrando ligação causal com o peso vivo das vacas analisadas. Inicialmente, foram identificadas correlações elevadas entre diferentes variáveis incluídas neste estudo, e, então, utilizando técnicas avançadas de aprendizado de máquina e a aplicação de explicações aditivas de Shapley (SHAP), foi proporcionado um entendimento mais profundo dos fatores fortemente associados à adaptabilidade nestes ambientes, e, portanto, o respectivo desempenho zootécnico. A associação entre o componente genotípico bovino ligado à estação do ano mostrou ser o fator influente mais predominante sobre o peso vivo bovino. Variáveis como comprimento do pelo, hematócrito, fosfatase, fósforo, creatina phosphokinase, creatinina, proteína, cortisol, cálcio e a presença de endoparasitas foram destacadas, demonstrando sua importância hierárquica para a seleção animal. Os modelos de ML são ferramentas eficazes para estabelecer hierarquias de relevância em multivariáveis fenotípicas complexas, o que é crucial em programas de melhoramento genético em diferentes espécies zootécnicas, bem como em ambientes especiais e específicos, como os pântanos. carne Paraguai bovinos Brahman Brangus Nelore extinção sanguíneas clínicas saúde analisadas Inicialmente então SHAP, SHAP , (SHAP) portanto zootécnico pelo hematócrito fosfatase fósforo phosphokinase creatinina proteína cortisol destacadas animal complexas zootécnicas específicos (SHAP

ABSTRACT This study focuses on the performance of cows for meat production raised in the wetlands of Paraguay, examining five cattle genotypes: Brahman, Brangus, and Nelore, as well as two local breeds at risk of extinction. The main objective is to identify and rank phenotypic variables, including blood, clinical, hair, and health variables, demonstrating causal linkage with the live weight of the cows analyzed. Initially, high correlations were identified between different variables included in this study; then, using advanced Machine learning (ML) techniques and the application of Shapley additive explanations (SHAP), a deeper understanding was provided of the factors strongly associated with adaptability in these environments, and, therefore, the respective zootechnical performance. The association between cattle genotypic components linked with the season of the year proved to be the most influential factor on cattle live weight. Variables such as hair length, hematocrit, phosphatase, phosphorus, creatine phosphokinase, creatinine, protein, cortisol, calcium, and the presence of endoparasites were highlighted, demonstrating their hierarchical importance for animal selection. ML models are effective tools for establishing hierarchies of relevance in complex phenotypic multivariable, which is crucial in breeding programs for different zootechnical species and in special and specific environments like wetlands. Paraguay genotypes Brahman Brangus Nelore extinction blood clinical analyzed Initially then (ML SHAP, SHAP , (SHAP) therefore length hematocrit phosphatase phosphorus phosphokinase creatinine protein cortisol calcium highlighted selection multivariable (SHAP

Resumo: Desde a década de 1960, uma série de pesquisas tem questionado a capacidade das escolas para igualar os níveis de aprendizagem entre alunos de diferentes origens sociais. Apesar da diversidade de programas e políticas que buscaram equalizar as diferenças, pesquisas em diversos contextos constataram repetidamente que as diferenças não apenas persistem, mas são reproduzidas nas escolas. Este artigo aborda o problema de uma perspectiva um pouco diferente: seu objetivo é identificar práticas e atitudes de estudantes e docentes associadas a diferenças no desempenho escolar entre estudantes de condição social e econômica mais baixa no Brasil e na Argentina. O objetivo não é entender os mecanismos que reproduzem as diferenças entre os estratos, mas sim aqueles que geram maior desempenho relativo entre os estudantes com menos recursos. Para isso, foi realizada uma análise comparativa dos resultados do teste PISA de 2018 por meio de modelos estatísticos multivariados. Essa análise mostrou que determinados fatores, como a empatia docente, a motivação e perseverança estudantil ou as modalidades de estudo, estão associados ao desempenho. Mas também mostrou que a magnitude da associação varia de acordo com o contexto. Esses resultados contribuem para a elaboração de políticas educacionais que buscam aumentar o desempenho em estratos desfavorecidos, indicando algumas condições que podem favorecê-lo, mas também alertando sobre as dificuldades de extrapolar resultados entre contextos de forma acrítica

Abstract: Since the 1960s, a vast array of studies has questioned the ability of schools to equalize learning levels among students from different social backgrounds. Despite various programs and policies aimed at reducing these disparities, research in diverse contexts has repeatedly found that not only do these differences persist, but they are also reproduced within the school system. This article approaches the issue from a slightly different perspective: its objective is to identify practices and attitudes of students and teachers that are associated with differences in school performance among students from lower socioeconomic backgrounds in Brazil and Argentina. The focus is not on understanding the mechanisms that perpetuate differences between social strata, but rather on identifying those that lead to higher relative achievements among students with fewer resources. A comparative analysis of the 2018 PISA test results was conducted using multivariate statistical models. This analysis revealed that certain factors, such as teacher empathy, student motivation and perseverance, and study methods, are associated with academic performance. However, it also showed that the strength of these associations varies depending on the context. These findings contribute to the design of educational policies aimed at improving performance in disadvantaged groups by highlighting conditions that may foster better outcomes, while also cautioning against uncritically extrapolating results across different contexts

Resumen: Desde la década de 1960 en adelante una extensa serie de estudios ha puesto en duda la capacidad de la escuela para igualar los niveles de aprendizaje entre estudiantes de distinto origen social. Pese a la diversidad de programas y políticas que han buscado igualar las diferencias, distintas investigaciones en diversos contextos han encontrado una y otra vez que las diferencias no solo persisten, sino que se reproducen en la escuela. En este artículo se aborda el problema desde una óptica ligeramente diferente: su objetivo es identificar prácticas y actitudes de estudiantes y docentes asociadas a las diferencias de desempeño escolar entre estudiantes de menor nivel económico social en Brasil y Argentina. No se busca comprender los mecanismos que reproducen las diferencias entre estratos, sino aquellos que generan mayores logros relativos en los estudiantes con menos recursos. Se realizó para ello un análisis comparativo de los resultados de las pruebas PISA del 2018 mediante modelos estadísticos multivariados. Este análisis mostró que ciertos factores, como la empatía docente, la motivación y perseverancia estudiantil o las modalidades de estudio se asocian al desempeño. Pero también evidenció que la magnitud de la asociación varía con el contexto. Estos resultados aportan al diseño de políticas educativas que procuren incrementar el desempeño en estratos desfavorecidos, al indicar algunas condiciones que pueden favorecerlo, pero advirtiendo también sobre las dificultades de extrapolar resultados entre contextos de manera acrítica

RESUMEN Introducción: la salud mental es crucial para el bienestar y el rendimiento académico de los estudiantes universitarios. Los estudiantes de Kinesiología y Fisioterapia enfrentan desafíos únicos que pueden afectar su salud mental. Objetivo: determinar la frecuencia de trastornos mentales comunes en estudiantes de kinesiología y fisioterapia de la Universidad Nacional de Asunción. Metodología: se trata de un estudio observacional, descriptivo y transversal. La muestra no probabilística estuvo compuesta por 150 estudiantes de Kinesiología y Fisioterapia de la Universidad Nacional de Asunción. Se recogieron datos sociodemográficos, académicos, ocupacionales, de estilo de vida y psicopatológicos mediante la Escala de Depresión, Ansiedad y Estrés - 21 (DASS-21). El análisis se realizó mediante Jamovi con regresión logística binomial multivariada. Resultados: la frecuencia de depresión, ansiedad y estrés fue del 61,3 %, 72 % y 54,7 %, respectivamente. Los factores importantes para la depresión incluyeron ser un estudiante irregular, trabajar y no realizar actividad física. Para la ansiedad, fueron significativos ser estudiante irregular y ser mujer. Respecto al estrés, se encontraron relevantes ser estudiante irregular, trabajar y no realizar actividad física. Los modelos resultantes tuvieron clasificaciones correctas del 90,2 %, 88 % y 72 % para depresión, ansiedad y estrés, respectivamente. Conclusión: Este estudio reveló una alta frecuencia de depresión, ansiedad y estrés entre estudiantes de kinesiología y fisioterapia, lo que se asoció significativamente con irregularidad académica, empleo y falta de actividad física. Estos hallazgos subrayan la necesidad de implementar estrategias de intervención y programas de apoyo que aborden estos factores de riesgo para promover la salud mental y el bienestar de los futuros profesionales de la salud.

ABSTRACT Introduction: mental health is crucial for university students’ well-being and academic performance. Kinesiology and Physical Therapy students face unique challenges that can affect their mental health. Objective: to determine the frequency of common mental disorders in kinesiology and physical therapy students at the Universidad Nacional de Asunción. Methodology: this was an observational and descriptive cross-sectional study. The nonprobabilistic sample included 150 Kinesiology and Physiotherapy students from the Universidad Nacional de Asunción. Sociodemographic, academic, occupational, lifestyle, and psychopathological data were collected using the Depression, Anxiety and Stress Scale - 21 (DASS-21). The analysis was performed using Jamovi with multivariate binomial logistic regression. Results: the frequency of depression, anxiety, and stress was 61.3 %, 72 %, and 54.7 %, respectively. The significant factors for depression included being an irregular student, working, and not engaging in physical activity. For anxiety, being an irregular student and being a woman were significant. Regarding stress, being an irregular student, working, and not engaging in physical activity were found to be relevant. The resulting models had correct classifications of 90.2 %, 88 %, and 72 % for depression, anxiety, and stress, respectively. Conclusion: this study revealed a high frequency of depression, anxiety, and stress among kinesiology and physical therapy students, which was significantly associated with academic irregularity, employment, and a lack of physical activity. These findings underscore the need to implement intervention strategies and support programs that address these risk factors in order to promote the mental health and well-being of future health professionals.

Resumen La presión arterial media es un indicador indirecto del grado de perfusión orgánica, la cual podría variar en pacientes con y sin diabetes mellitus-2. El objetivo fue determinar las diferencias y riesgo de alteraciones en la presión arterial media de adultos con y sin diabetes mellitus-2 de la población peruana según datos de la encuesta demográfica de salud familiar. Se realizó un estudio observacional, analítico, retrospectivo y transversal;. Los datos provinieron de la encuesta demográfica y de salud familiar-2022 (ENDES-2022), se incluyó adultos diabéticos y no diabéticos. Las variables fueron: presión arterial media, diabetes mellitus-2, sexo y se incluyeron las variables: edad, consumo de alcohol, nivel educativo e índice de masa corporal para el análisis multivariado. Se realizó la prueba de Chi-cuadrado de Pearson, la prueba T student para muestras independientes, Odds Ratio crudo y ajustado mediante regresión logística binaria. El promedio de presión arterial media en diabéticos fue de 94,81 y 93,52 mmHg en la primera y segunda medición y en no diabéticos de 89,18 y 88,02 mmHg. La presión arterial media alta fue más frecuente en diabéticos que en no diabéticos; En el modelo logístico, incluyendo las variables sexo y edad, los diabéticos tuvieron un riesgo 2 veces mayor que los no diabéticos de alteraciones en la presión arterial media tanto en la primera como en la segunda medición. En conclusión, la diabetes mellitus-2 incrementa la presión arterial media y representa un factor de riesgo para la elevación de la presión arterial media en la población peruana.

Abstract Mean arterial pressure is an indirect indicator of the degree of organ perfusion, which could vary in diabetics and non-diabetics. The objective of this research was to determine the differences and risk of alterations in the mean arterial pressure of adults with and without diabetes mellitus-2 of the Peruvian population according to data from the family health demographic survey. An observational, analytical, retrospective and cross-sectional study was carried out. The data came from the demographic and family health survey-2022 (ENDES-2022). Diabetic and non-diabetic adults were included. The variables were mean arterial pressure, diabetes mellitus-2, sex, and the variables age, alcohol consumption, educational level, and body mass index were included for multivariate analysis. Pearson's Chi-square test, student's T test for independent samples, crude Odds Ratio and adjusted by binary logistic regression were performed. The mean arterial pressure in diabetics was 94.81 and 93.52 mmHg in the first and second measurements, and in non-diabetics it was 89.18 and 88.02 mmHg. High mean arterial pressure was more frequent in diabetics than in non-diabetics. In the logistic model, including the variables sex and age, diabetics had a risk twice as high as non-diabetics for alterations in mean arterial pressure in both the first and second measurements. In conclusion, diabetes mellitus-2 increases mean arterial pressure and represents a risk factor for elevated mean arterial pressure in the Peruvian population.

Abstract Introduction: Cardiovascular disease is an important cause of death among patients with chronic kidney disease (CKD). Valve calcification is a predictor of cardiovascular mortality and coronary artery disease. Objective: To assess heart valve disease frequency, associated factors, and progression in CKD patients. Methods: We conducted a retrospective study on 291 CKD patients at Hospital das Clínicas de Pernambuco. Inclusion criteria were age ≥ 18 with CKD and valve disease, while those on conservative management or with missing data were excluded. Clinical and laboratory variables were compared, and patients were categorized by dialysis duration (<5 years; 5–10 years; >10 years). Statistical tests, including chi-square, Fisher’s exact, ANOVA, and Kruskal-Wallis, were employed as needed. Simple and multivariate binary regression models were used to analyze valve disease associations with dialysis duration. Significance was defined as p < 0.05. Results: Mitral valve disease was present in 82.5% (240) of patients, followed by aortic valve disease (65.6%; 86). Over time, 106 (36.4%) patients developed valve disease. No significant association was found between aortic, pulmonary, mitral, or tricuspid valve disease and dialysis duration. Secondary hyperparathyroidism was the sole statistically significant factor for mitral valve disease in the regression model (OR 2.59 [95% CI: 1.09–6.18]; p = 0.031). Conclusion: CKD patients on renal replacement therapy exhibit a high frequency of valve disease, particularly mitral and aortic valve disease. However, no link was established between dialysis duration and valve disease occurrence or progression. Introduction CKD. . (CKD) Objective factors Methods 29 Pernambuco 1 excluded compared <5 5 (< years 510 10 5–1 >1 years. years) tests chisquare, chisquare chi square, square chi-square Fishers Fisher s exact ANOVA KruskalWallis, KruskalWallis Kruskal Wallis, Wallis Kruskal-Wallis needed 005 0 05 0.05 Results 825 82 82.5 240 (240 65.6% 656 65 6 (65.6% 86. 86 86) time 36.4% 364 36 4 (36.4% pulmonary OR 259 2 59 2.5 95% 95 [95 CI 1.09–6.18 109618 09 1.09–6.18] 0.031. 0031 0.031 031 0.031) Conclusion However (CKD ( 51 5– > 00 0.0 8 82. 24 (24 65.6 (65.6 36.4 3 (36.4 25 2. 9 [9 1.09–6.1 10961 003 0.03 03 0. (2 65. (65. 36. (36. [ 1.09–6. 1096 (65 (36 1.09–6 109 (6 (3 1.09– 1.09 1.0 1.

Resumo Introdução: Doenças cardiovasculares são uma causa significativa de morte em pacientes com Doença Renal Crônica (DRC). A calcificação valvar é preditor de mortalidade cardiovascular e doença arterial coronariana. Objetivo: Avaliar a frequência, fatores associados e progressão de valvopatias em pacientes com DRC. Métodos: Coorte retrospectiva com 291 pacientes ambulatoriais no Hospital das Clínicas de Pernambuco. Inclusão: ≥18 anos com DRC e valvopatia; exclusão: tratamento conservador ou dados incompletos. Variáveis clínicas e laboratoriais foram comparadas e categorizadas por tempo de terapia dialítica (TTD): <5 anos, 5–10 anos, >10 anos. Foram aplicados os testes Qui-quadrado, exato de Fisher, ANOVA, Kruskal-Wallis. Associação entre valvopatia e TTD foi avaliada por regressão binária. Significância foi definida como p < 0,05. Resultados: A valvopatia mitral foi encontrada em 82,5% (240) dos casos, seguida da aórtica (65,6%; 86). Houve progressão da doença valvar em 106 (36,4%) pacientes. Não houve associação entre valvopatias aórtica, pulmonar, mitral ou tricúspide e TTD. Hiperparatireoidismo secundário foi a única variável explicativa significativa na regressão para valvopatia mitral (OR 2,59 [IC95%: 1,09–6,18]; p = 0,031). Conclusão: Encontramos alta frequência de valvopatias, especialmente mitral e aórtica, aem pacientes com DRC. Não houve associação entre TTD e valvopatia. Introdução . (DRC) coronariana Objetivo Métodos 29 Pernambuco Inclusão 18 ≥1 exclusão incompletos (TTD) 5 510 10 5–1 >1 Quiquadrado, Quiquadrado Qui quadrado, quadrado Qui-quadrado Fisher ANOVA KruskalWallis. KruskalWallis Kruskal Wallis. Wallis Kruskal-Wallis binária 005 0 05 0,05 Resultados 825 82 82,5 240 (240 casos 65,6% 656 65 6 (65,6% 86. 86 86) 36,4% 364 36 4 (36,4% pulmonar OR 259 2 59 2,5 IC95% IC95 IC [IC95% 1,09–6,18 109618 1 09 1,09–6,18] 0,031. 0031 0,031 031 0,031) Conclusão (DRC ≥ (TTD 51 5– > 00 0,0 8 82, 24 (24 65,6 (65,6 36,4 3 (36,4 25 2, IC9 [IC95 1,09–6,1 10961 003 0,03 03 0, (2 65, (65, 36, (36, [IC9 1,09–6, 1096 ( (65 (36 [IC 1,09–6 109 (6 (3 1,09– 1,09 1,0 1,

Abstract Objective: Periventricular-intraventricular hemorrhage is the most common type of intracranial bleeding in newborns, especially in the first 3 days after birth. Severe periventricular-intraventricular hemorrhage is considered a progression from mild periventricular-intraventricular hemorrhage and is often closely associated with severe neurological sequelae. However, no specific indicators are available to predict the progression from mild to severe periventricular-intraventricular in early admission. This study aims to establish an early diagnostic prediction model for severe PIVH. Method: This study was a retrospective cohort study with data collected from the MIMIC-III (v1.4) database. Laboratory and clinical data collected within the first 24 h of NICU admission have been used as variables for both univariate and multivariate logistic regression analyses to construct a nomogram-based early prediction model for severe periventricular-intraventricular hemorrhage and subsequently validated. Results: A predictive model was established and represented by a nomogram, it comprised three variables: output, lowest platelet count and use of vasoactive drugs within 24 h of NICU admission. The model’s predictive performance showed by the calculated area under the curve was 0.792, indicating good discriminatory power. The calibration plot demonstrated good calibration between observed and predicted outcomes, and the Hosmer-Lemeshow test showed high consistency (p = 0.990). Internal validation showed the calculated area under a curve of 0.788. Conclusions: This severe PIVH predictive model, established by three easily obtainable indicators within the NICU, demonstrated good predictive ability. It offered a more user-friendly and convenient option for neonatologists. Objective Periventricularintraventricular Periventricular intraventricular newborns birth periventricularintraventricular periventricular sequelae However Method MIMICIII MIMIC III v1.4 v14 v v1 4 (v1.4 database 2 nomogrambased nomogram based validated Results output models s 0792 0 792 0.792 power outcomes HosmerLemeshow Hosmer Lemeshow p 0.990. 0990 0.990 . 990 0.990) 0788 788 0.788 Conclusions ability userfriendly user friendly neonatologists v1. (v1. 079 79 0.79 099 0.99 99 078 78 0.78 (v1 07 7 0.7 09 0.9 9 (v 0.

Abstract Objective: To analyze the prevalence evolution of Guthrie, hearing, and eye screening testing among newborns in Brazil, between 2013 and 2019, according to demographic and socioeconomic characteristics. Methods: This is a cross-sectional study with data from 5231 infants from the Pesquisa Nacional de Saude (PNS), in 2013, and 6637 infants, in 2019, for the Guthrie test, hearing, and red reflex tests. The authors analyzed the outcomes according to the region of residence, self-reported color/race, having health insurance, and per capita household income. By using bivariate and multivariate Poisson regression models, the prevalence ratios and their respective 95 % Confidence Intervals (CI95%) were calculated for each year. Results: In 2013, Guthrie test, hearing, and red reflex tests were performed in 96.5 % (95%CI 95,8;97,0), 65.8 % (95%CI 63,9;67,7), and 60.4 % (95%CI 58,5;62,3) of infants, respectively. In 2019, the prevalence was 97.8 % (95%CI 97,3;98,2) in the Guthrie test, 81.6 % (95%CI 80,3;82,9) in the hearing test, and 78.6 % (95%CI 77,1;79,9) in the red reflex test. The testing frequency was higher among residents of the Southeast and South regions of Brazil, among infants whose mother or guardian was white, had health insurance, and was in the higher income strata; and the most evident differences were in the eye and hearing testing. Conclusions: The coverage inequalities according to the region of residence, income, and having health insurance highlight the need to use strategies that enable exams to be carried out, with more information about their importance, encompassing actions from primary care, prenatal care to the puerperium, aiming at universal access and equity. Objective Brazil 201 2019 characteristics Methods crosssectional cross sectional 523 PNS, PNS , (PNS) 663 test residence selfreported self reported colorrace color race color/race models 9 CI95% CI95 CI (CI95% year Results 965 96 5 96. 95%CI 95CI 95,897,0, 958970 95,8 97,0 8 97 0 95,8;97,0) 658 65 65. 63,967,7, 639677 63,9 67,7 63 67 7 63,9;67,7) 604 60 4 60. 58,562,3 585623 58,5 62,3 58 62 3 58,5;62,3 respectively 978 97. 97,398,2 973982 97,3 98,2 98 2 97,3;98,2 816 81 6 81. 80,382,9 803829 80,3 82,9 80 82 80,3;82,9 786 78 78. 77,179,9 771799 77,1 79,9 77 1 79 77,1;79,9 white strata Conclusions out importance puerperium equity 20 52 (PNS 66 CI9 (CI95 897 95,897,0 95897 958 95, 970 97, 95,8;97,0 967 63,967,7 63967 639 63, 677 67, 63,9;67,7 562 58,562, 58562 585 58, 623 62, 58,5;62, 398 97,398, 97398 973 982 98, 97,3;98, 382 80,382, 80382 803 80, 829 82, 80,3;82, 179 77,179, 77179 771 77, 799 79, 77,1;79, (CI9 89 95,897, 9589 95,8;97, 63,967, 6396 63,9;67, 56 58,562 5856 58,5;62 39 97,398 9739 97,3;98 38 80,382 8038 80,3;82 17 77,179 7717 77,1;79 (CI 95,897 95,8;97 63,967 63,9;67 58,56 58,5;6 97,39 97,3;9 80,38 80,3;8 77,17 77,1;7 95,89 95,8;9 63,96 63,9;6 58,5; 97,3; 80,3; 77,1; 95,8; 63,9;

Abstract Objective: Reliably prediction models for coronary artery abnormalities (CAA) in children aged > 5 years with Kawasaki disease (KD) are still lacking. This study aimed to develop a nomogram model for predicting CAA at 4 to 8 weeks of illness in children with KD older than 5 years. Methods: A total of 644 eligible children were randomly assigned to a training cohort (n = 450) and a validation cohort (n = 194). The least absolute shrinkage and selection operator (LASSO) analysis was used for optimal predictors selection, and multivariate logistic regression was used to develop a nomogram model based on the selected predictors. Area under the receiver operating characteristic curve (AUC), calibration curves, Hosmer-Lemeshow test, Brier score, and decision curve analysis (DCA) were used to assess model performance. Results: Neutrophil to lymphocyte ratio, intravenous immunoglobulin resistance, and maximum baseline z-score ≥ 2.5 were identified by LASSO as significant predictors. The model incorporating these variables showed good discrimination and calibration capacities in both training and validation cohorts. The AUC of the training cohort and validation cohort were 0.854 and 0.850, respectively. The DCA confirmed the clinical usefulness of the nomogram model. Conclusions: A novel nomogram model was established to accurately assess the risk of CAA at 4–8 weeks of onset among KD children older than 5 years, which may aid clinical decisionmaking. Objective (CAA (KD lacking Methods 64 n 450 194. 194 . 194) (LASSO AUC, , (AUC) curves HosmerLemeshow Hosmer Lemeshow test score (DCA performance Results ratio resistance zscore z 25 2 2. cohorts 0854 0 854 0.85 0850 850 0.850 respectively Conclusions 48 4– decisionmaking 6 45 19 (AUC 085 85 0.8 1 08 0.

BACKGROUND. Adolescent girls and young women (AGYW) remain vulnerable to HIV, with a higher incidence rate than their male counterparts. OBJECTIVES. To determine the prevalence of and factors associated with HIV testing among AGYW in South Africa (SA). METHODS. A cross-sectional design was used to analyse the South Africa Demographic and Health Survey 2016. Only sexually active AGYW aged 15 - 24 years residing in SA at the time of the survey were included. Descriptive statistics were used to analyse baseline sociodemographic characteristics. Univariate and multivariate logistic regression models were used to determine factors associated with HIV testing. Statistical significance was set at p<0.05, and all analyses were adjusted using survey weights to account for unequal selection probabilities. RESULTS. The overall prevalence of HIV testing among sexually active AGYW was 85.2% (95% confidence interval (CI) 83.0 - 87.1). The AGYW who had a history of pregnancy (adjusted odds ratio (aOR) 4.47; 95% CI 2.90 - 6.89), were employed (aOR 3.29; 95% CI 1.75 - 6.21), belonged to a middle wealth index (aOR 1.80; 95% CI 1.04 - 3.10), had knowledge about mother-to-child transmission of HIV (aOR 3.29; 95% CI 2.26 - 4.79), had visited a health facility during the past 12 months (aOR 2.93; 95% CI 2.09 - 4.10), or had secondary/tertiary education (aOR 2.04; 95% CI 1.04 - 3.99) had higher odds of HIV testing. CONCLUSION. The study identified an unmet need for HIV testing among sexually active AGYW in SA, especially adolescent girls aged 15 - 19 years. Increasing knowledge about HIV testing, adolescent-friendly services and other offsite strategies are therefore important for this particular key population.

Resumo Introdução: A resistência muscular do corpo superior (UBME) e a capacidade aeróbica (AC) são componentes essenciais da aptidão física. Baixos níveis desses componentes estão relacionados a doenças cardiovasculares. Propósito: Avaliar a associação entre os níveis de UBME e AC em estudantes universitários de cultura física. Metodologia: Estudo transversal analítico realizado com 192 estudantes (169 homens, 23 mulheres; idade média 20 anos). Todos os participantes do estudo assinaram consentimento por escrito. UBME foi a variável dependente avaliada pelo teste de flexão de braço, e AC foi a principal variável independente avaliada pelo teste de corrida de vaivém de 20 m. Para analisar diferenças por sexo e semestre acadêmico, foram aplicados testes exatos de Fischer, t de Student e U de MannWhitney. Análises descritivas, bivariadas e multivariadas foram realizadas usando modelos de regressão logística. Resultados: 82,29 % dos participantes apresentaram níveis saudáveis de UBME. Respeitando o semestre acadêmico, os estudantes tiveram uma probabilidade maior de ter níveis saudáveis de UBME conforme os semestres aumentavam (OR: 1,23, IC 95 %: 1,06 a 1,44, p = 0,007). Em relação à AC, 58,33 % dos participantes registraram níveis saudáveis. Após ajuste por sexo, idade, nível socioeconômico e semestre acadêmico, o consumo máximo de oxigênio (VO2max) foi associado a níveis saudáveis de UBME (OR: 1,157, IC 95 %: 1,071 - 1,249, p <0,001). Conclusões: Os estudantes tiveram uma probabilidade maior de apresentar níveis saudáveis de UBME conforme os semestres de estudo aumentaram, e aqueles com um VO2max mais alto tiveram maior probabilidade de ter níveis saudáveis de UBME.

Abstract Introduction: Upper-body muscular endurance (UBME) and aerobic capacity (AC) are essential components of physical fitness. Low levels of these components are related to cardiovascular disease. Purpose: To assess the association between UBME and AC levels in college students of physical culture. Methodology: Analytical cross-sectional study carried out in 192 students (169 men, 23 women; median age 20 years). Every participant of the study signed written consent. UMBE was the dependent variable assessed by the push-up test, and AC was the main independent variable assessed using the 20 m shuttle run test. To analyze differences by sex, and academic semester, Fischer exact, Student's T, and U Mann-Whitney tests were applied. Descriptive, as well as bivariate and multivariate analysis, were realized using logistic regression models. Results: 82.29 % of participants had healthy levels of UBME. Respecting the academic semester, students had a higher probability of having healthy levels of UBME as semesters increased (OR: 1.23, 95 % CI: 1.06 to 1.44, p = 0.007). Concerning AC, 58.33 % of participants registered healthy levels. After adjusting by sex, age, socioeconomic level, and academic semester, maximum oxygen consumption (VO2max), was associated with healthy levels of UBME (OR: 1.157, CI 95 %: 1.O71 - 1.249, p=<0.001). Conclusions: Students had a higher probability of presenting healthy levels of UBME as semesters of study increased, and those with a higheVO2max were more likely to have healthy levels of UBME.

Resumen Introducción: La fuerza resistencia de miembros superiores (FRMS) y la capacidad aeróbica (CA) son componentes esenciales de la condición física. Bajos niveles de estos componentes están relacionados con la enfermedad cardiovascular. Propósito: El objetivo de este estudio fue evaluar la asociación entre los niveles de FRMS y la CA en estudiantes universitarios de cultura física. Metodología: Estudio transversal analítico realizado en 192 estudiantes (169 hombres, 23 mujeres; mediana de edad, 20 años). Cada participante firmó el consentimiento informado. FRMS fue la variable dependiente y se valoró con la prueba de flexiones de brazo, y la CA fue la variable independiente y se evaluó usando la prueba de ida y vuelta de 20 m. Para analizar las diferencias por sexo y semestre académico, fueron utilizadas las pruebas exacta de Fischer, T de Student y U de Mann-Whitney. Se realizaron análisis descriptivos, bivariados y múltiples, usando modelos de regresión logística. Resultados: El 82.29 % de los participantes registraron niveles saludables de FRMS. Respecto al semestre académico, se evidenció una probabilidad más alta de tener niveles saludables de FRMS al incrementarse los semestres de estudio (OR: 1.23, 95 % CI: 1.06 to 1.44, p = 0.007). En lo concerniente a la CA, el 58.33 % de los participantes registro niveles saludables. Después de realizar ajustes por sexo, edad, nivel socioeconómico y semestre académico, el consumo máximo de oxígeno (VO2máx), estuvo asociado con niveles saludables de FRMS (OR: 1.157, CI 95 % 1.O71 - 1.249, p=<0.001). Conclusiones: Los participantes presentaron una mayor probabilidad de tener niveles saludables de FRMS, a medida que incrementaron los semestres de estudio, y aquellos con niveles de VO2máx más alto, fueron más proclives a tener niveles saludables de FRMS.

Resumen: México ocupa el primer lugar en obesidad infantil en el mundo, por lo que resulta importante identificar variables asociadas al consumo alimentario. El objetivo del presente trabajo fue establecer si la forma en que el consumo de alimentos se modifica en función de las normas sociales alimentarias y la publicidad alimentaria que recibe la población infantil escolar. Se diseñó un estudio multivariado predictivo utilizando sistemas de lógica difusa tipo dos de intervalo (IT2 FLS), y comparando su ajuste con modelos convencionales, como la regresión lineal múltiple (RLM). Se trabajó con las respuestas emitidas por 196 niños en un estudio previo y almacenadas en una base de datos, seleccionando solo las que correspondieron a las variables de interés para el estudio. Las normas sociales a evitar, el número de comidas y la compra de alimentos por la publicidad alimentaria permitieron predecir el consumo alimentario de los niños mediante IT2 FLS. En RLM las horas de comidas tuvo mayor capacidad predictiva que el número de comidas. El IT2 FLS proporcionó un mayor coeficiente de determinación (R2 = 0.649), que el de la RLM (R2 = 0.370). El consumo alimentario, al ser un fenómeno multicausal y complejo, puede ser mejor predicho al utilizar métodos de análisis que manejen de forma más flexible la incertidumbre, como lo hace la IT2 FLS.

Abstract: Mexico ranks first in childhood obesity in the world, so it is important to identify variables associated with food consumption. The objective of this work was to establish whether the way in which food consumption is modified depending on social food norms and food advertising received by school children. A predictive multivariate study was designed using interval type two fuzzy logic systems (IT2 FLS), and comparing its fit with conventional models, such as multiple linear regression (RLM). We worked with the responses issued by 196 children in a previous study and stored in a database, selecting only those that corresponded to the variables of interest for the study. The social norms to avoid, the number of meals and the purchase of food through food advertising made it possible to predict children’s food consumption through IT2 FLS. In RLM, mealtimes had a greater predictive capacity than the number of meals. The IT2 FLS provided a higher coefficient of determination (R2 = 0.649) than that of the RLM (R2 = 0.370). Food consumption, being a multicausal and complex phenomenon, can be better predicted by using analysis methods that manage uncertainty more flexibly, as the IT2 FLS does.

Abstract Objective: Analyze socio-environmental factors related to the cumulative incidence of leishmaniasis at the cantonal level in Costa Rica from 2018 to 2021. Materials and methods: Observational, ecological, cantonal, descriptive-analytical study. A spatial analysis is carried out through choropleth maps, Moran Index and Local Spatial Association Index. Bivariate and multivariate negative binomial regression models are carried out. Results: Two multivariate models are developed: Multivariate model A: the variables educational dimension and access to information behave as protective factors. Model B: the percentage of households lacking decent shelter, sex ratio, percentage of Afro-descendant population and percentage of poor households act as risk factors. Conclusions: It is observed that the cantons with the highest cumulative incidence of leishmaniasis were those located mainly in the Caribbean and southern areas. Socioenvironmental factors related to the cantonal standardized cumulative incidence of leishmaniasis in Costa Rica from 2018 to 2021 are identified. It is possible to determine the presence of clusters of high spatial autocorrelation between the variables identified in this research as protective factors educational dimension, access to information and risk factors percentage of households lacking decent shelter, sex ratio, percentage of population Afrodescendant, and percentage of poor households mainly in cantons located in the Caribbean area and southern part of the country, as well as clusters of low spatial autocorrelation in cantons in the center of the country.

Resumen Objetivo: Analizar factores socioambientales relacionados con la incidencia acumulada de leishmaniasis a nivel cantonal en Costa Rica del año 2018 al 2021. Materiales y métodos: Estudio de tipo observacional, ecológico, a nivel cantonal, descriptivo-analítico. Se realiza un análisis espacial por medio de mapas coropléticos, Índice de Moran e Índice Local de Asociación Espacial. Se llevan a cabo modelos de regresión binomial negativa bivariado y multivariado. Resultados: Se desarrollan dos modelos multivariados: Modelo multivariado A, las variables dimensión educativa y acceso a información se comportan como factores protectores. Modelo B, el porcentaje de hogares con carencia de albergue digno, razón de masculinidad, porcentaje de población afrodescendiente y porcentaje de hogares pobres, actúan como factores de riesgo. Conclusiones: Se observa que los cantones con mayor incidencia acumulada de leishmaniasis fueron los localizados principalmente en el caribe y zona sur. Se identifican factores socioambientales relacionados con la incidencia acumulada estandarizada cantonal de leishmaniasis en Costa Rica del año 2018 al 2021. Es posible determinar clústeres de autocorrelación espacial alta entre las variables identificadas en esta pesquisa como factores protectores, dimensión educativa, acceso a la información y de riesgo, porcentaje de hogares con carencia de albergue digno, razón de masculinidad, porcentaje de población afrodescendiente, y porcentaje de hogares pobres principalmente en cantones ubicados en la zona del caribe y zona sur del país, así como clústeres de autocorrelación espacial baja en cantones del centro del país.

ABSTRACT Background: Osteoarthritis is a frequent rheumatic disease. Some single-nucleotide polymorphisms of the gene associated with fat mass and obesity are associated with increased body mass index and knee osteoarthritis. Objective: The objective of this study was to analyze the association of single nucleotide polymorphism rs1477196 of the fat mass and obesity gene with primary knee osteoarthritis. Methods: This observational and cross-sectional study included 347 Mexican participants. We performed the genotypification analysis with TaqMan® probe C_2031262_10 for rs1477196 (Thermo Fisher Scientific). Multivariate analysis included covariables such as age, type 2 diabetes, obesity, and postmenopause. Results: Type 2 diabetes, obesity, and postmenopause were associated with primary knee osteoarthritis in female participants. We did not find an association between rs1477196 and obesity. In the codominant and dominant genetic models, rs1477196 was significantly associated with primary knee osteoarthritis only in the female group, including in the model adjusted by other covariables (odds ratio = 2.517; 1.035-6.123; p = 0.042 and odds ratio = 2.387; 1.054-5.407; p = 0.037, respectively). The interaction between rs1477196 and obesity was significantly associated with primary knee osteoarthritis in female participants (p = 0.039 and p = 0.043). Conclusions: Our findings suggest that the rs1477196 variant of the fat and obesity mass gene may be associated with the risk of primary knee osteoarthritis in women.

Problem: Preterm birth is the leading cause of death and can result in significant long-term loss of physical and psychological capacity among survivors.Background: An estimated 15 million babies are born preterm every year. Prediction models based on machine learning methods have reported promising results.Aims: To identify risk factors associated with preterm birth and to develop and validate a prediction model for this outcome in a Brazilian birth cohort.Methods: Cross-sectional study of all births that occurred in Ribeirão Preto-SP and of one in three births that occurred in São Luís-MA, Brazil, in 2010. Questionnaires were applied to obtain pregnancy-related data. Multivariate adaptive regression splines were used to determine the independent variables. Preterm birth, defined as birth before 37 weeks gestational age, was the dependent variable. A random forest model was developed and its performance was evaluated by ROC analysis.Findings: The preterm birth rates were 12.7% (RP) and 14.1% (SL). The prediction and validation accuracies of the RF-based model were 91.3% and 85.5% respectively. The model can be applied starting in the third month of gestation and is more effective in identifying preterm infants with GA&lt;31 weeks and 6 days (AUC=0.98).Discussion: It was possible to build a prediction model based on easily accessible low-cost data, without the need for complementary tests, providing results similar to those of other studies.Conclusions: Previous preterm birth and prenatal care were determinants. The use of an application for individualized patient monitoring an early stage can have positive effects on the quality of life of mother and child.

ABSTRACT Introduction: Myocardial infarction continues with high mortality rates, from 4.6% to 13.1%. There are predictive risk stratification models, such as the Grace Score, which does not include glycemia as a variable. Patients hospitalized for myocardial infarction with hyperglycemia on admission may have higher mortality, in ST elevated and non-elevated infarcts. Objectives: The objective of this review is to identify and systematize the evidence on hyperglycemia on admission as a biomarker of mortality and heart failure in acute myocardial infarction. Materials and Methods: The search was carried out in the MEDLINE database including the MeSH terms hyperglycemia and hospital mortality or heart failure in myocardial infarction, selecting 12 articles. Results: Hospital mortality was calculated in 11 articles, in 9 of them a significant association was found between hyperglycemia and hospital mortality, both in the bivariate and multivariate analysis, and in 2 articles this association was not demonstrated. For in-hospital mortality, the results of 11 articles included in this review were synthesized. The frequency of occurrence of heart failure was determined in 11 articles, finding a higher frequency in 9 of them. For in-hospital mortality, the results of 11 articles included in this review were synthesized and analyzed, in 8 the analysis was performed in non-diabetics, obtaining OR: 4.15, IC 95% (2.853-6.035), in 3 for diabetics obtaining OR 2.365 IC 95% (1.778- 3,146) and in 6 for the total population finding OR 3,314 (2,910-3,774). Conclusions: Hyperglycemia on admission is associated with increased mortality and frequency of occurrence of heart failure during hospitalization for myocardial infarction, with evidence of moderate quality.

RESUMEN Introducción: El infarto de miocardio continúa con altas tasas de mortalidad, desde 4.6 % hasta 13.1 %. Existen modelos predictivos de estratificación de riesgo, como el Score Grace, que no incluye la glicemia como variable. Los pacientes hospitalizados por infarto de miocardio con hiperglicemia al ingreso pueden tener mayor mortalidad, en infarto ST elevado y no elevado. Objetivo: Identificar y sistematizar la evidencia sobre hiperglicemia al ingreso como biomarcador de mortalidad y de insuficiencia cardiaca en infarto de miocardio. Materiales y Métodos: La búsqueda se realizó en la base de datos Medline, se incluyeron los términos MeSH hiperglicemia y mortalidad hospitalaria o insuficiencia cardiaca en infarto de miocardio y se seleccionaron 12 artículos. Resultados: La mortalidad hospitalaria se calculó en 11 artículos; en 9 de ellos se encontró asociación significativa entre hiperglicemia y mortalidad hospitalaria; en el análisis bivariado y en el multivariado y en dos artículos, no se demostró dicha asociación. En 11, se determinó la frecuencia de aparición de insuficiencia cardiaca y se encontró mayor frecuencia en nueve de ellos. Para mortalidad hospitalaria, se sintetizaron y analizaron los resultados de 11 artículos incluidos en esta revisión; en ocho, se realizó el análisis en no diabéticos y se obtuvo OR: 4,15, IC 95 % (2,853-6,035); en tres, para diabéticos, OR 2,365 IC 95 % (1,778-3,146) y en 6, para población total, OR 3,314 (2,910-3,774). Conclusiones: Hiperglicemia al ingreso está asociada a mayor mortalidad y frecuencia de aparición de insuficiencia cardiaca durante la hospitalización por infarto de miocardio con evidencia de moderada calidad.