Resumen Objetivo: cuantificar la incertidumbre asociada con la estimación del valor actual del ciclo económico. Metodología: se emplea el filtro de Baxter y King en una serie de tiempo ampliada con proyecciones, asumiendo caminata aleatoria, y se construyen intervalos de confianza para el ciclo de manera analítica y con bootstrap. Limitaciones: la calidad de los intervalos de confianza se deteriora en presencia de cambio estructural en la serie de tiempo. Originalidad: la originalidad subyace en proponer una metodología para determinar la fase actual del ciclo económico de manera conjunta con una cuantificación de la incertidumbre respecto a tal medición. Conclusión: para Costa Rica, el método propuesto conduce a estimaciones del ciclo económico menos sensibles a nuevos datos que lo obtenido con el filtro de Hodrick y Prescott, y simulaciones muestran que los intervalos de confianza propuestos proveen la confianza nominal especificada.

Abstract Objetive: To quantify the uncertainty associated to the estimation of the current value of the business cycle. Methodology: The Baxter and King filter is applied to an time series expanded with forecasts, assuming a random walk, and confidence intervals are build for the cyclical component both analytically and using bootstrap. Limitations: The quality of the confidence 1 intervals deteriorates when there is a structural break in the time series. Originality: The original contribution of this article is a proposed methodology to jointly determined the current phase of the business cycle and the uncertainty associated with such measurement. Conclusions: For Costa Rica, the proposed method provides estimations of the business cycle that are less sensitive to new data points than the Hodrick and Prescott filter, and simulations show that the proposed confidence intervals provide the specified nominal confidence.

Abstract: The Intensity-Duration-Frequency (IDF) curves are a way to visualize and represent extreme hydrometeorological rainfall events. In this article, an analysis of convective rainfall events recorded at the La Piedra Meteorological Station, Villa Clara, Cuba, was conducted. To develop IDF curves, the 2006-2019 time series was analyzed. A partial duration series was generated, including intervals from 20 minutes to 4320 minutes, subjected to an outlier detection process. The series was divided into two categories: one for durations ≤ 720 minutes and another for durations > 720 minutes. The resulting series underwent non-parametric tests to assess their independence, randomness, homogeneity, and seasonality. Subsequently, they were fitted to the Generalized Pareto probability distribution and to a parametric equation of the Montana model, and then the curves were plotted for return periods of 10, 50 and 100. The Montana model led to obtaining correlation coefficients greater than 0.90 compared to the other methods used, significantly improving the quality of the fit in both categories. This research provides information to understand and plan the management of intense climatic phenomena and adequate risk management in an area where such studies are lacking, facilitating access to crucial data essential in the design and execution of hydraulic engineering projects in the region.

Resumen: Las curvas de Intensidad-Duración-Frecuencia (IDF) son una manera de visualizar y representar los eventos hidrometeorológicos extremos de lluvia. En este artículo se llevó a cabo un análisis de eventos de lluvias convectivas registrados en la Estación Meteorológica La Piedra, Villa Clara, Cuba. Para desarrollar curvas IDF se analizó la serie temporal 2006-2019. Se generó una serie de duración parcial que incluyó intervalos de 20 minutos hasta 4320 minutos, sometiéndola a un proceso de detección de datos anómalos. La serie se dividió en dos categorías: una para duraciones ≤ 720 minutos y otra para duraciones > 720 minutos. Las series resultantes se sometieron a pruebas no paramétricas para evaluar su independencia, aleatoriedad, homogeneidad y estacionalidad. Posteriormente, se procedió a ajustarlas a la distribución probabilística Generalizada de Pareto y a una ecuación paramétrica del modelo de Montana. Luego se grafica la representación de las curvas para períodos de retorno de 10, 50 y 100 años. El modelo de Montana condujo a la obtención de coeficientes de correlación superiores a 0.90 y a los demás métodos utilizados, mejorando significativamente la calidad del ajuste en ambas categorías. Esta investigación aporta información para comprender y planificar la gestión de fenómenos climáticos intensos, así como para una adecuada gestión de riesgos en una zona donde no se cuenta con este tipo de estudios. Asimismo, facilita el acceso a datos cruciales que resultan fundamentales en el diseño y ejecución de proyectos de ingeniería hidráulica en la zona.

RESUMEN Objetivos. Determinar el requerimiento y tiempo para ventilación mecánica y Unidad de Cuidados Intensivos (UCI), hospitalización y tiempo de hospitalización, muerte y discapacidad de las variantes axonales del Síndrome de Guillain-Barré (SGB) en comparación con la variante aguda desmielinizante en pacientes de todas las edades. Materiales y métodos. Revisión sistemática que incluyó pacientes con SGB; la exposición fueron las variantes axonales y el comparador la polineuropatía desmielinizante inflamatoria aguda (AIDP) los desenlaces fueron el requerimiento y tiempo en ventilación mecánica (VM), requerimiento y tiempo en la UCI, tiempo de hospitalización, discapacidad y muerte. Se utilizó la escala NewCasttle-Ottawa (NOS) para evaluar el riesgo de sesgo. Se realizó un metaanálisis para calcular las diferencias de medias y los riesgos relativos (RR) con sus intervalos de confianza (IC) del 95% utilizando varianzas inversas y modelos de efectos aleatorios. Resultados. De los 3116 artículos encontrados, 46 cumplieron los criterios de selección. El tiempo en VM fue 7,42 días (IC95%: 0,36 a 1,48) y el tiempo de hospitalización fue 3,11 (IC95%: 0,73 a 5,49) días en las variantes axonales. Las variantes axonales tuvieron un RR de 0,47 (IC95%: 0,24 a 0,92) para el requerimiento de VM en adultos, pero en niños fue de 1,68 (IC95%: 1,25 a 2,25). Hubo una alta heterogeneidad estadística. Conclusiones. Las variantes axonales tienen en promedio mayor tiempo de VM y de hospitalización, en total y por subgrupos. Se observó un mayor requerimiento de VM para las variantes axonales en niños; mientras que en los adultos fue menor.

ABSTRACT Objectives. To determine the requirement and time to mechanical ventilation and Intensive Care Unit (ICU), hospitalization and hospitalization time, death and disability of the axonal variants of Guillain-Barré Syndrome (GBS) in comparison with the acute demyelinating variant in patients of all the ages. Materials and methods. The systematic review that included patients with GBS. The exposure variable was the axonal variants and the comparator was acute inflammatory demyelinating polyneuropathy (AIDP). The outcomes were the requirement and time on mechanical ventilation (MV), requirement and time in the ICU, hospitalization time, disability and death. The NewCasttle-Ottawa Scale (NOS) was used to assess risk of bias. A meta-analysis was conducted to calculate mean differences and relative risks (RR) with their 95% confidence intervals (CI) using inverse variances and random effects models. Results. Of the 3116 articles found, 46 met the selection criteria. The time on MV was 7.42 days (95% CI: 0.36 to 1.48) and the hospitalization time was 3.11 (95% CI: 0.73 to 5.49) days for the axonal variants. The axonal variants had a RR of 0.47 (95% CI: 0.24 to 0.92) for the requirement of MV in adults, but it was 1.68 (95% CI: 1.25 to 2.25) in children. There was a high statistical heterogeneity. Conclusions. Axonal variants showed, on average, longer MV and hospitalization time, overall and by subgroups. A high MV requirement was found for axonal variants in children; it was lower for adults.

Abstract Objective: To examine if the substitution of different screen time intervals with light physical activity (LPA), moderate to vigorous physical activity (MVPA) and sleep is associated with cardiovascular indicators and inflammatory markers in children. Methods: This is a cross-sectional study developed with 186 children aged between six and 11 years old from public schools in southern Brazil. CRF was measured with the 6-minute running and walking test, following the Brazil Sports Project procedures. The percentage of fat was evaluated through DXA. LPA and MVPA were measured using accelerometers. Sleep and screen time were assessed by questionnaires answered by parents. Leptin and C-reactive protein were measured by fasting blood collection. Systolic and diastolic blood pressure were determined through a digital sphygmomanometer. Isotemporal substitution models were used for statistical analysis. Results: Replacing 1 h of screen time with MVPA was associated with lower BMI, systolic and diastolic blood pressure, fat percentage, leptin, and C-reactive protein. When screen time was substituted for sleep time, lower waist circumference was observed. Regarding the substitution of 1 h of screen time with LPA, significant values were found only for leptin. Conclusion: The replacement of screen time with physical activities of different intensities and sleep time was associated with benefits in cardiovascular indicators and inflammatory markers in childhood. Objective , (LPA) (MVPA Methods crosssectional cross sectional 18 6minute minute 6 test procedures DXA accelerometers parents Creactive C reactive collection sphygmomanometer analysis Results BMI leptin observed Conclusion childhood (LPA

Abstract The aim of this study was to perform a systematic review (SR) of the therapeutic effect of ozonated oil for oral lesions treatment. A SR was conducted according to the PRISMA guidelines. The Medline (PubMed), Embase, Cochrane Library, Scielo and LILACS were investigated, together with manual searches, to extract all publications until December 2020, including randomized and non-randomized clinical trials reporting the effects of ozonated oils on the management of oral lesions when compared with other methods. The risk of bias (RoB) of the studies included were assessed by using the RoB 2 tool and ROBINS-I. After analyzing the titles and reading the abstracts, 1932 articles were excluded; the remaining 25 passed a full-text evaluation. Ultimately, 13 articles were included in this SR. There was heterogeneity of the results regarding healing times and intervals of ozonated oil application for the treatment of each type of oral lesion, but in general, there was a shorter healing time when ozonated oil was used as therapy, and no adverse effects were reported. Despite the limited information found and the lack of rigorous methodological standards for the use of ozonated oil on oral lesions, a positive effect was suggested. The findings indicated an advantage in terms of shorter healing times when compared with other conventional treatments. No adverse effects were reported, showing safety and reliability for patient’s treatment.

Resumen El objetivo de este estudio fue realizar una revisión sistemática (RS) del efecto terapéutico del aceite ozonizado sobre las lesiones orales. Se realizó una RS siguiendo las directrices PRISMA. Se realizaron búsquedas en Medline (PubMed), Embase, Cochrane Library, Scielo y LILACS, y búsquedas manuales, que abarcaron hasta diciembre de 2020, de ensayos clínicos aleatorizados y no aleatorizados que informaran sobre el efecto de los aceites ozonizados en el tratamiento de las lesiones orales en comparación con cualquier otro método. El riesgo de sesgo (RoB) de los estudios incluidos se evaluó mediante la herramienta RoB 2 y ROBINS-I. Tras analizar los títulos y leer los resúmenes, se excluyeron 1932 artículos; los 25 restantes pasaron una evaluación exhaustiva del texto completo. Finalmente, se incluyeron 13 artículos en esta RS. Hubo heterogeneidad de resultados en cuanto a los tiempos de cicatrización y los intervalos de aplicación del aceite ozonizado para el tratamiento de cada tipo de lesión oral, pero en general, hubo un menor tiempo de cicatrización cuando se utilizó el aceite ozonizado como terapia, y no se comunicaron efectos adversos. A pesar de la limitada información encontrada y de la falta de normas metodológicas rigurosas sobre el uso de aceite ozonizado en lesiones orales, se sugirió un efecto positivo del uso de aceite ozonizado para el tratamiento de lesiones orales. Los resultados indicaron una ventaja en términos de menor tiempo de curación en comparación con otros tratamientos convencionales; además, no se notificaron efectos adversos, por lo que se demostró una opción de tratamiento segura y fiable para los pacientes.

Resumen: El tránsito de avenidas por lo general es usado en el análisis y evaluación de inundaciones, sin embargo, ha sido poco estudiado en la extensión y determinación de caudales. Por ello, esta investigación tuvo por objetivo generar caudales aplicando un método simple de tránsito de avenidas conocido como Muskingum a nivel mensual, en la cuenca La Leche de Perú. Se escogió la cuenca en mención, pues en los últimos 40 años ha sufrido grandes inundaciones, viéndose afectada gran parte de la población, terrenos de cultivo e infraestructura local, por lo que se requiere abordar su estudio. La metodología fue del tipo aplicada y de diseño no experimental comparativo. Debido a que el tránsito de avenidas emplea los parámetros de proporcionalidad de volumen y ponderación del tránsito en intervalos de tiempo definido, se creyó conveniente usar indicadores estadísticos para optimizar la comparación de los caudales registrados en las estaciones hidrométricas y los hidrogramas de la simulación de un modelo hidrológico tipo precipitación-escorrentía para diferentes períodos de retorno, obteniéndose significativos resultados en cada caso, según la correlación de Pearson, el criterio de Schultz, el criterio de Nash-Sutcliffe, el error de balance de masas y la prueba t para dos muestras suponiendo varianzas iguales. Finalmente, se concluye que se pueden establecer caudales empleando el tránsito de avenidas con el método Muskingum en la cuenca La Leche, además pueden utilizarse en descargas simuladas donde se disponga de información meteorológica e hidrométrica.

Abstract: The flood routing is generally used in the analysis and evaluation of floods; however, it has been scarcely explored in the extent and determination of flows. Therefore, this research aimed to generate flows applying a simple method of flood routing known as Muskingum to monthly level, in the La Leche basin of Peru. The basin in question was chosen, since in the last 40 years it has suffered major floods, affecting a large part of the population, farmland and local infrastructure, which is why it is necessary to address its study. The methodology was of applied type and comparative non-experimental design. Due to the fact that the flood routing uses the parameters of proportionality of volume and weighting of routing in defined intervals of time, it was considered convenient to use statistical indicators to optimize the comparison of the flows registered in the hydrometric stations and the hydrographs of the simulation of a hydrological model rainfall-runoff type for different return periods, obtaining significant results in each case, according to the Pearson correlation, the Schultz criterion, the Nash-Sutcliffe criterion, the mass balance error and the t-test for two samples assuming equal variances. Finally, it is concluded that flows can be established using the flood routing with the Muskingum method in the La Leche basin, and can also be used in simulated discharges where meteorological and hydrometric information is available.

Abstract Introduction As 30 to 50% of deep venous thrombosis (DVT) cases remain idiopathic, an increased focus on hematologic variables may therefore reveal novel correlates of DVT. Very few studies have investigated the association of hematological parameters with DVT and the causal relationship between them is still to be elucidated. Therefore, we aimed to investigate the association between serial values of hematologic variables and DVT. Methods Complete blood count parameters were serially measured at baseline and then at approximately 3-month intervals for 12 months in 152 adults with the first episode of DVT and 152 age- and sex-matched controls. The odds ratio (OR) with the 95% confidence interval (95%CI) was calculated as a measure of association between hematological parameters and DVT. Results The red cell distribution width (RDW) was the only hematologic variable which showed an independent and consistent association with DVT at all time points (multivariable-adjusted OR [95%CI] 3.38 [1.28 - 8.91] at baseline, 2.24 [0.85 - 5.92] at 3 months and 2.12 [0.81 - 5.55] at 12 months for RDW > 14.0%). This association was higher for provoked DVT than unprovoked DVT and for DVT plus pulmonary embolism than DVT alone. No significant correlation was found between the high RDW and classical thrombotic risk factors, except malignancy. Conclusions We demonstrated an independent and consistent association of the high RDW with the first episode of DVT in adult patients. The study was probably underpowered to evaluate the association between the high RDW and recurrent DVT. Further large studies with long follow-up are needed to confirm this association. 50 (DVT idiopathic elucidated Therefore 3month month 1 15 age sexmatched sex matched controls (OR 95 95%CI 95CI CI (95%CI (RDW multivariableadjusted multivariable adjusted [95%CI 338 38 3.3 1.28 128 28 [1.2 8.91 891 8 91 224 2 24 2.2 0.85 085 0 85 [0.8 5.92 592 5 92 212 2.1 0.81 081 81 5.55 555 55 14.0%. 140 14.0% . 14 14.0%) alone factors malignancy patients followup follow up 9 33 3. 1.2 [1. 8.9 89 22 2. 0.8 08 [0. 5.9 59 21 5.5 14.0 1. [1 8. 0. [0 5. 14. [

Resumo Introdução: A trombocitemia essencial (TE) é uma condição pouco comum e assintomática na maioria dos casos. No entanto, podem surgir sintomas como cefaleias, síncope, vertigem, dor torácica, eritromelalgia e distúrbios visuais transitórios. Os eventos hemorrágicos e tromboembólicos são os grandes riscos desta patologia. O objetivo da partilha deste caso clínico é alertar para uma patologia rara que pode passar despercebida e causar eventos potencialmente graves. Descrição do caso: Sexo feminino, 43 anos, raça caucasiana, antecedentes de hepatite B crónica, sem antecedentes cirúrgicos nem medicação habitual, incluindo método contracetivo hormonal. Recorreu a consulta com queixas de enfartamento precoce, dispepsia e epigastralgia com três dias de evolução, negando alterações do trânsito intestinal, características das fezes, náuseas ou vómitos. Exame físico e endoscopia digestiva alta recente sem alterações de relevo. Foi consultado o estudo analítico que a utente realizava regularmente no hospital, verificando-se que o valor do número de plaquetas se encontrava consistentemente a rondar os 500.000/uL desde há três anos. Pediu-se ecografia abdominal que descrevia trombose parcial da veia porta e do seu ramo esquerdo. A doente foi medicada com enoxaparina 60 mg 12h/12 h. Foi realizado angio-TC abdominal, estudo pró-trombótico e estudo genético e iniciou varfarina 5 mg 1x/dia, inicialmente sobreposta com enoxaparina 60 mg 12/12h. O angio-TC viria a confirmar a trombose da veia porta e confirmou-se positiva a mutação JAK2 V617F. Assumido o diagnóstico de TE e iniciado tratamento citorredutor com hidroxiureia 500 mg em dias alternados. Comentário: Este caso chama a atenção pelo excesso de plaquetas secundário à TE, ainda que ligeiramente acima do valor de referência, ter originado uma trombose da veia porta. Pretende-se alertar os médicos de família para a importância de realizar um estudo atento, valorizando pequenas variações sustentadas fora dos intervalos da normalidade e fazer uma referenciação correta e atempada quando necessário.

Abstract Introduction: Essential thrombocythemia (ET) is an asymptomatic rare condition in most cases. Nonetheless, symptoms like headache, syncope, vertigo, thoracic pain, erythromelalgia, and transient visual disturbances may surge. The major concerns of this pathology are hemorrhagic and thromboembolic events. The aim of sharing this case report is to alert for the existence of this rare pathology that can go unnoticed and cause potentially serious events. Case description: Female, 43-year-old, Caucasian. Background of chronic B hepatitis, without surgical background nor usual medication, including the contraceptive pill. She appealed to a medical appointment with an early feeling of fullness when eating, dyspepsia, and epigastric pain in the last three days. She denied changes in intestinal habits, feces characteristics, nausea, or vomiting. Physical examination and recent upper endoscopic study were normal. The hospital medical record was examined, verifying that platelet levels were consistently rounding 500,000/uL for the past three years. An abdominal ultrasonography was requested, and it described a partial portal vein and left branch thrombosis. The patient started enoxaparin 60 mg every 12 hours. It was conducted an abdominal angiotomography, prothrombotic, and genetic study, including the JAK2 V617F mutation. The patient started warfarin 5 mg one time daily, initially overlaid with enoxaparin 60 mg 12h/12h. The abdominal angiotomography would confirm the portal vein thrombosis and the JAK2 V617F mutation study was positive. It was assumed the diagnosis of ET and was initiated cytoreductive therapy with hydroxyurea 500 mg on alternated days. Comment: This case report shows that the excessive platelet count, secondary to ET, even if slightly above the reference value, caused a portal vein thrombosis. We aim to alert family physicians to the importance of doing a careful study, valuing little sustained variations out of the normal intervals, and referring correctly and promptly when necessary.

Resumen La entomotoxicología forense, que analiza insectos necrófagos para detectar sustancias tóxicas, es crucial en la determinación de causas de muerte y la estimación del intervalo post-mortem. Este estudio se centró en Peckia intermutans (Walker) (Diptera: Sarcophagidae) como marcador para la detección de metanol, un alcohol potencialmente letal presente como adulterante en bebidas alcohólicas debido a su bajo costo y parecido con el etanol. Se desarrolló un método de cromatografía de gases-espectrometría de masas (HS-GC-MS) para detectar metanol y se estudió su efecto sobre el tiempo de desarrollo, supervivencia y morfología de las moscas de la carne. Las larvas se criaron en sustratos de hígado enriquecidos con metanol (300, 500 y 1000 mg/kg). Los resultados mostraron: el método desarrollado detectó metanol en todos los estadios; el metanol afectó el tiempo de desarrollo de las moscas; la supervivencia aumentó con una mayor concentración de metanol; y los cambios morfológicos fueron evidentes en el peso. Este estudio ofrece valiosa información sobre la investigación entomotoxicológica del Ecuador, por lo que se debe considerar los cambios morfológicos de P. intermutans para evitar estimaciones inexactas de los intervalos post-mortem.

Abstract Forensic entomotoxicology, which analyzes necrophagous insects to detect toxic substances, is crucial in determining causes of death and estimating the post-mortem interval. This study focused on Peckia intermutans (Walker) (Diptera: Sarcophagidae) as a marker for detecting methanol, a potentially lethal alcohol often added as an adulterant in alcoholic beverages due to its low cost and similarity to ethanol. A gas chromatography-mass spectrometry (HS-GC-MS) method was developed to detect methanol, and its effects on the development time, survival, and morphology of flesh flies were investigated. Larvae were reared on liver substrates enriched with methanol (300, 500, and 1000 mg/kg). Results showed: the developed method detected methanol in all instars; methanol affected the developmental time of the flies; survival increased with higher methanol concentration; and morphological changes were evident in weight. This study provides valuable information on entomotoxicological research in Ecuador, emphasizing the need to consider morphological changes in P. intermutans to avoid inaccurate estimations of post-mortem intervals.

Abstract Background: Prolongation of the PQ interval, generally associated with an atrioventricular conduction delay, may be related to changes in intraventricular impulse spreading. Objective: To assess, using body surface potential mapping (BSPM), the process of ventricular depolarization in athletes with prolonged PQ intervals at rest and after exercise. Methods: The study included 7 cross-country skiers with a PQ interval of more than 200 ms (Prolonged-PQ group) and 7 with a PQ interval of less than 200 ms (Normal-PQ group). The BSPM from 64 unipolar torso leads was performed before (Pre-Ex) and after the bicycle exercise test (Post-Ex). Body surface equipotential maps were analyzed during ventricular depolarization. The significance level was 5%. Results: Compared to Normal-PQ athletes, the first and second periods of the stable position of cardiac potentials on the torso surface were longer, and the formation of the “saddle” potential distribution occurred later, at Pre-Ex, in Prolonged-PQ athletes. At Post-Ex, the Prolonged-PQ group showed a shortening of the first and second periods of stable potential distributions and a decrease in appearance time of the “saddle” phenomenon relative to Pre-Ex (to the values near to those of the Normal-PQ group). Additionally, at Post-Ex, the first inversion of potential distributions and the total duration of ventricular depolarization in Prolonged-PQ athletes decreased compared to Pre-Ex and with similar values in Normal-PQ athletes. Compared to Normal-PQ athletes, the second inversion was longer at Pre-Ex and Post-Ex in Prolonged-PQ athletes. Conclusion: Prolonged-PQ athletes had significant differences in the temporal characteristics of BSPM during ventricular depolarization both at rest and after exercise as compared to Normal-PQ athletes. Background delay spreading Objective assess BSPM, , (BSPM) Methods crosscountry cross country 20 ProlongedPQ Prolonged NormalPQ Normal group. . 6 PreEx Pre Ex (Pre-Ex PostEx. PostEx Post (Post-Ex) 5 5% Results saddle “saddle later PreEx, Ex, PostEx, Additionally Conclusion (BSPM 2 (Post-Ex

Resumo Fundamento: O prolongamento do intervalo PQ, geralmente associado a um atraso na condução atrioventricular, pode estar relacionado a alterações na propagação do impulso intraventricular. Objetivo: Avaliar, por meio do mapeamento do potencial de superfície corporal (BSPM), o processo de despolarização ventricular em atletas com intervalos PQ prolongados em repouso e após o exercício. Métodos: O estudo incluiu 7 esquiadores cross-country com intervalo PQ superior a 200 ms (grupo PQ Prolongado) e 7 com intervalo PQ inferior a 200 ms (grupo PQ Normal). O BSPM de 64 derivações unipolares do tronco foi realizado antes (Pré-Ex) e após o teste ergométrico de bicicleta (Pós-Ex). Mapas equipotenciais da superfície corporal foram analisados durante a despolarização ventricular. O nível de significância foi de 5%. Resultados: Comparado com atletas com PQ Normal, o primeiro e o segundo períodos de posição estável dos potenciais cardíacos na superfície do tronco foram mais longos, e a formação da distribuição de potencial “sela” ocorreu mais tarde, no Pré-Ex, nos atletas com PQ Prolongado. No Pós-Ex, o grupo PQ Prolongado apresentou um encurtamento do primeiro e segundo períodos de distribuições de potencial estáveis e uma diminuição no tempo de aparecimento do fenômeno “sela” em relação ao Pré-Ex (para valores próximos aos do Normal -Grupo PQ). Além disso, no Pós-Ex, a primeira inversão das distribuições de potencial e a duração total da despolarização ventricular em atletas com PQ Prolongado diminuíram em comparação com o Pré-Ex e com valores semelhantes em atletas com PQ Normal. Em comparação com atletas com PQ Normal, a segunda inversão foi mais longa no Pré-Ex e Pós-Ex em atletas com PQ Prolongado. Conclusão: Atletas com PQ prolongado apresentaram diferenças significativas nas características temporais do BSPM durante a despolarização ventricular, tanto em repouso quanto após o exercício, em comparação com atletas com PQ normal. Fundamento atrioventricular intraventricular Objetivo Avaliar BSPM, , (BSPM) exercício Métodos crosscountry cross country 20 . Normal) 6 PréEx Pré Ex (Pré-Ex PósEx. PósEx Pós (Pós-Ex) 5 5% Resultados longos sela “sela tarde PréEx, Ex, PósEx, para Grupo PQ. PQ) disso Conclusão normal (BSPM 2 (Pós-Ex

RESUMEN Objetivo Describir las tendencias de la frecuencia de obesidad y su relación con algunos factores socioeconómicos en mujeres en edad fértil en el Perú. Material y métodos Estudio transversal de datos secundarios, analítico utilizando las bases de datos de la Encuesta Nacional Demográfica en Salud (ENDES) de los años 2005 a 2018. Se estimó la frecuencia de mujeres con obesidad para cada año y se las comparó mediante los intervalos de confianza al 95% (IC95%). Se comparó la magnitud de asociación de lugar, edad y paridad, lugar de residencia, grado de educación e índice de riqueza. Resultados Se observó un aumento de la obesidad en mujeres en edad fértil de 17,72% (IC95%: 16,24-19,32) en el 2005 a 32% (IC95%: 30,46-34,42) en el 2018. La prevalencia de obesidad tipo I aumentó de 9,07% (IC95% 8,09-10,16) en el año 2005 a 22,15% (IC95% 15,19-16,48) en el 2018. Se observó un aumento continuo en la prevalencia de obesidad tipo II de 2,34% (IC95% 1,84-3,05) a 7,29% (IC95% 3,75-4,52). En las mujeres que se encontraron embarazadas al momento de la entrevista se encontró una prevalencia de obesidad de 17,21% (IC95% 11,42-25,10) en el año 2005 llegando a 38,61% (IC95% 20,25-28,46) en el año 2018. Se encontró relación significativa de la posibilidad de ser obesa con la edad y la paridad. Conclusiones La prevalencia de obesidad en las mujeres en edad fértil en nuestro país es alta y continúa incrementando con el tiempo. La prevalencia incrementada se presenta igualmente en gestantes, incrementando las complicaciones materno-perinatales.

SUMMARY Objective To describe the trends in the frequency of obesity and its relationship with some socioeconomic factors in women of childbearing age in Peru. Methods Analytical cross-sectional study of secondary data, using the databases of the Encuesta Nacional Demográfica en Salud (ENDES) from 2005 to 2018. The frequency of women with obesity was estimated for each year and compared using the confidence intervals at 95% (95% CI). The magnitude of association was compared between place, age and parity, place of residence, level of education and wealth index. Results An increase in obesity was observed in women of childbearing age from 17.72% (95% CI: 16.24-19.32) in 2005 to 32% (95% CI: 30.46-34.42) in 2018. The prevalence of type I obesity increased from 9.07% (95% CI 8.09-10.16) in 2005 to 22.15% (95% CI 15.19-16.48) in 2018. It was observed a continuous increase in the prevalence of type II obesity from 2.34% (95% CI 1.84-3.05) to 7.29% (95% CI 3.75-4.52). In women who were pregnant at the time of the interview, a prevalence of obesity was found to be 17.21% (95% CI 11.42-25.10) in 2005, reaching 38.61% (95% CI 20.25). -28.46) in 2018. A significant relationship was found between the possibility of being obese with age and parity. Conclusions The prevalence of obesity in women of childbearing age in our country is high and continues to increase over time. The increased prevalence also occurs in pregnant women, increasing maternal-perinatal complications.

ABSTRACT BACKGROUND: Exclusive breastfeeding is recommended for the first six months, and mother’s age impact early weaning. Educational support and relevant information can increase breastfeeding rates. OBJECTIVE: To determine whether antenatal education enhances the maintenance, intention, and confidence in breastfeeding among adolescents. DESIGN AND SETTING: A prospective cohort study involving primiparous adolescents who gave birth at the Woman’s Hospital (CAISM), Universidade Estadual de Campinas, Brazil. METHODS: Adolescent mothers were categorized into two groups based on the location of prenatal care: those at the Woman’s Hospital (WH) who received antenatal education, and at the Primary Care (PC) who did not receive antenatal education. All adolescents received breastfeeding orientation during their postpartum hospital stay. The groups were compared using the Student’s t-test, Mann–Whitney U test, and chi-squared test. Log-binomial models were used to compare the groups at different time intervals. RESULTS: The study included 132 adolescents: 59 in the WH group and 73 in the PC group. Six months postpartum, adolescents in the WH group demonstrated higher engagement in breastfeeding (P < 0.005) and exclusive breastfeeding (P = 0.04) than PC group. PC group showed greater lack of confidence in breastfeeding (P = 0.02) and felt less prepared (P = 0.01). Notably, all WH adolescents reported a stronger desire to breastfeed after antenatal education. CONCLUSION: Antenatal education significantly improves the maintenance, intention, and confidence of breastfeeding among adolescents. This education approach can be implemented across all healthcare levels and should be made accessible to all women throughout the pregnancy and postpartum period. BACKGROUND mother s weaning rates OBJECTIVE maintenance intention SETTING Womans Woman CAISM, CAISM , (CAISM) Campinas Brazil METHODS care (WH (PC stay Students Student ttest, ttest t test t-test MannWhitney Mann Whitney chisquared chi squared Logbinomial Log binomial intervals RESULTS 13 5 7 P 0.005 0005 0 005 0.04 004 04 0.02 002 02 0.01. 001 0.01 . 01 0.01) Notably CONCLUSION period (CAISM 1 0.00 000 00 0.0 0.

ABSTRACT Objective: Evaluate whether the experience of the surgeon could reduce Ponseti treatment time, and a number of cast changes, and the evolution of the Pirani Score. Methods: 2 reference centers were evaluated. At Institution 1, 254 patients with idiopathic clubfoot (403 feet) were included, and at Institution 2, 32 patients (51 feet). At institution 1 (mentor), 3 intervals of 5 years each were analyzed. At the Institution 2 (trainee), 1 interval of 5 years was analyzed. Results: Patients treated by the mentor had fewer casts compared with the trainee (p < 0.001). At Institution 1, the three mentor intervals showed differences in the number of casts (p < 0.05). A statistically significant difference was observed only in the first mentor interval (2000 to 2005, average of 3.47 casts) compared with the 2 other intervals (2005 to 2010; average of 2.6 casts and 2011 to 2015; average of 2.79 casts; p < 0.0001). Pirani score decreases the most until the third clinic visit. Conclusion: The mentor’s greater expertise was associated with fewer casts and shorter time to obtain correction in isolated clubfoot, especially right after the first 5 years of practice. Progression of the Pirani score in both institutions occurs between the first and the third casts. Level of Evidence III; Therapeutic Study, Retrospective Comparative Study. Objective changes Score Methods evaluated 25 403 (40 feet included 51 (5 feet. . mentor, , (mentor) analyzed trainee, (trainee) Results 0.001. 0001 0.001 0 001 0.001) 0.05. 005 0.05 05 0.05) 2000 (200 2005 347 47 3.4 2010 26 6 2. 201 2015 279 79 2.7 0.0001. 00001 0.0001 0.0001) visit Conclusion mentors s practice III Study 40 (4 ( (mentor (trainee 000 0.00 00 0.0 200 (20 34 4 3. 20 27 7 0000 0.000 0. (2

RESUMO Objetivo: Avaliar se a experiência no Método Ponseti pode reduzir o tempo de tratamento e o número de gessos. Métodos: Na instituição 1 foram incluídos 254 pacientes com pé torto idiopático (403 pés) e na instituição 2, 32 pacientes (51 pés). Na instituição 1 (mentora) foram analisados 3 intervalos de 5 anos. Na instituição 2 (estagiária), foi analisado 1 intervalo de 5 anos. Resultados: Os pacientes tratados pelo mentor tiveram menos gessos em comparação aos tratados pelo estagiário (p < 0,001). Na Instituição 1, os três intervalos de mentores apresentaram diferenças no número de gessos até a correção dos pés (p < 0,05). Diferença estatisticamente significativa foi observada no primeiro intervalo do mentor (2000 a 2005, média 3,47 gessos) em comparação com os outros 2 intervalos (2005 a 2010; média 2,6 gessos e 2011 a 2015; média 2,79 gessos; p < 0,0001). O escore de Pirani diminui mais até a terceira consulta clínica. Conclusão: A maior expertise do mentor no Método Ponseti esteve associada ao menor número de gessos e ao menor tempo para correção do pé torto, principalmente logo após os primeiros 5 anos. A maior progressão do score de Pirani ocorre entre o primeiro e o terceiro gesso. Nível de Evidência III; Estudo Terapêutico, Estudo Comparativo Retrospectivo. Objetivo Métodos 25 403 (40 51 (5 pés. . mentora (mentora anos estagiária, estagiária , (estagiária) Resultados 0,001. 0001 0,001 0 001 0,001) 0,05. 005 0,05 05 0,05) 2000 (200 2005 347 47 3,4 2010 26 6 201 2015 279 79 2,7 0,0001. 00001 0,0001 0,0001) clínica Conclusão gesso III Terapêutico Retrospectivo 40 (4 ( (estagiária 000 0,00 00 0,0 200 (20 34 4 3, 20 27 7 0000 0,000 0, (2

We present the video analysis of the oblique launch of five Styrofoam balls into the air, highlighting the effect of the drag force. Graphs of the trajectories, position, and velocity coordinates as a function of time are obtained numerically using the fourth-order Runge-Kutta method (RK4) and superimposed on the experimental data and compared to the ideal case without drag force. The values of the drag coefficients used in the RK4 numerical calculation are compatible with those presented in the literature. Measurements of each system’s kinetic, gravitational potential and mechanical energies, as well the modulus of the work of the drag force were obtained as a function of time, showing that the reduction in mechanical energy is more pronounced in the intervals where the variation of the kinetic energy is greater. air trajectories position fourthorder fourth order RungeKutta Runge Kutta RK (RK4 literature systems system s energies greater (RK

Apresentamos a videoanálise do lançamento oblíquo de cinco bolas de isopor no ar, evidenciando o efeito da força de arrasto. Gráficos das trajetórias, das coordenadas de posição e velocidade em função do tempo são obtidas numericamente pelo método Runge-Kutta de quarta ordem (RK4) e superpostas aos dados experimentais, sendo também comparadas ao caso ideal sem força de arrasto. Os valores dos coeficientes de arrasto utilizados no cálculo numérico RK4 são compatíveis com aqueles apresentados na literatura. Foram obtidas as medidas das energias cinética, potencial gravitacional, mecânica e do módulo do trabalho da força de arrasto de cada sistema em função do tempo, mostrando que a redução da energia mecânica é mais pronunciada nos intervalos onde a variação da energia cinética é maior. ar trajetórias RungeKutta Runge Kutta RK (RK4 experimentais literatura gravitacional maior (RK

ABSTRACT Purpose: This study aims to compare the initial ocular discomfort symptoms resulting from trabeculectomy and Ahmed glaucoma valve implantation surgeries. Methods: A prospective comparative study was conducted. The evaluation of ocular discomfort employed a questionnaire designed to identify the frequency and severity of distinct symptoms: ocular pain, general discomfort, tearing, foreign body sensation, and burning. This questionnaire was administered prior to surgery as a baseline, and subsequently at 7, 30, and 90 days post-surgery. Simultaneously, the Ocular Surface Disease Index (OSDI) was applied at these same time intervals. Results: The study encompassed a total of 17 patients (9 undergoing trabeculectomy and 8 undergoing Ahmed glaucoma valve implantation). The Ahmed glaucoma valve implantation group exhibited higher tearing levels at baseline (p=0.038). However, no statistically significant differences in symptoms were observed between the two surgeries at 7 and 30 days post-surgery. At the 90-day mark following surgery, patients who had undergone trabeculectomy reported a significantly higher foreign body sensation (p=0.004). Although OSDI scores did not differ between groups at baseline, the trabeculectomy group showed significantly higher OSDI scores than the Ahmed glaucoma valve implantation group at 7, 30, and 90 days after surgery (p<0.05). Conclusion: Post-surgery, patients who had undergone trabeculectomy experienced increased foreign body sensation. Trabeculectomy appears to cause greater early postoperative ocular discomfort compared to the Ahmed glaucoma valve implantation group. Purpose Methods conducted pain burning 9 postsurgery. postsurgery post surgery. post-surgery Simultaneously (OSDI intervals Results 1 ( implantation. . implantation) p=0.038. p0038 p p=0.038 0 038 (p=0.038) However 3 90day day p=0.004. p0004 p=0.004 004 (p=0.004) p<0.05. p005 p<0.05 05 (p<0.05) Conclusion Postsurgery, Postsurgery Post Post-surgery p003 p=0.03 03 (p=0.038 p000 p=0.00 00 (p=0.004 p00 p<0.0 (p<0.05 p=0.0 (p=0.03 (p=0.00 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