Resumo: A regurgitação mitral (RM) é uma doença frequente. A degeneração mixomatosa é a principal causa de RM primária em países desenvolvidos. Se não for corrigido, leva à disfunção ventricular e insuficiência cardíaca congestiva, com alta morbimortalidade. A cirurgia de reparo valvular é o tratamento recomendado na RM primária grave. Em pacientes com alto risco cirúrgico, as opções terapêuticas são limitadas. O surgimento do reparo percutâneo com plicatura dos segmentos é uma opção terapêutica alternativa, com bons resultados demonstrados. Apresentamos o caso clínico de um paciente doente por RM primária grave. Devido ao seu alto risco cirúrgico, optou-se pela correção percutânea com técnica “edge-to-edge”, com excelentes resultados clínicos e ecocardiográficos. Este é o primeiro caso publicado com a técnica em Uruguai.

Resumen: La insuficiencia mitral (IM) es una enfermedad frecuente. La degeneración mixomatosa es la principal causa de IM primaria en los países desarrollados. Si no se corrige, conduce a la disfunción ventricular y a la insuficiencia cardíaca congestiva, con elevada morbimortalidad. La cirugía de reparación valvular es el tratamiento recomendado en la IM primaria severa y sintomática. En los pacientes con alto riesgo quirúrgico las opciones terapéuticas son limitadas. El surgimiento de la reparación percutánea borde a borde ha permitido ofrecer alternativas terapéuticas para estos pacientes, y se han demostrado buenos resultados. Se presenta el caso clínico de un paciente añoso con IM primaria severa. Por su elevado riesgo quirúrgico se optó por realizar reparación percutánea con técnica borde a borde, con excelentes resultados clínicos y ecocardiográficos. Se trata del primer reporte de caso de estas características en nuestro país.

Summary: Mitral regurgitation (MR) is a common disease. Myxomatous degeneration is the main cause of primary MR in developed countries. If not corrected, it leads to ventricular dysfunction and congestive heart failure, with high morbidity and mortality. Valve repair surgery is the recommended treatment for severe and symptomatic primary MR. In patients with high surgical risk, therapeutic options are limited. The emergence of edge-to-edge percutaneous repair has made it possible to offer therapeutic alternatives for these patients, and good results have been demonstrated. We present the clinical case of an elderly patient with severe primary MR. Due to his high surgical risk, it was decided to perform percutaneous repair with edge-to-edge technique, with excellent clinical and echocardiographic results. It is the first case report of these characteristics in our country.

Abstract: This paper presents a prototype of an automobile driver assistance system based on YOLOv3. The system detects car types, traffic signs, and traffic lights in real-time and warns the driver accordingly. In the learning phase of the YOLO algorithm, the standard weights are learned first, followed by transfer learning to the objects of interest. The retraining phase uses 2,800 images obtained from the Internet of three countries of the real-life, and the testing phase uses real-time videos of Mexico City roads. In the validation phase, the proposed system achieves 95%, 37%, and 40% performance on the compiled dataset for the detection of road elements. The results obtained are comparable and in some cases better than those reported in previous works. Using a Raspberry Pi 4, the prototype was tested in real-life, generating visual and audible warnings for the driver, with an object recognition rate of 0.4 fps. A mean average precision (mAP) of 53% was reached by the proposed system. The experiments showed that the prototype achieved a poor recognition rate and required high computational processing for object recognition. However, YOLO is a model that can have good performance on low-resource hardware.

Abstract The objective of this work was to study the mean lethal concentration (LC50) and the biosorption capacity of heavy metals in isolated yeasts from Lake Junín and the Yanamate tailings facility. In both bodies of water were evaluated: pH, electrical conductivity, temperature, total dissolved solids (STD) and heavy metals by ICM-MS, according to the Environmental Quality Standards (ECA) of the Ministry of the Environment-MINAM of Peru. The physicochemical parameters evaluated in Lake Junín were higher than the maximum permissible limits (MPL) for the following metals: arsenic, cadmium, copper, chromium and lead. In the Yanamate tailings facility, the evaluated parameters were out of the LMP for type IV water ECAs: pH below 3 (acids), high electrical conductivities and high concentrations of heavy metals. From the sampled waters, yeasts were isolated in YPG medium at 10 ° C and 20 ° C. The LC50 of the Cr+6, Cu+2, Cd+2 and Hg+2 ions in Y. lipolytica AMJ3 were 0.24 mM, 1.34 mM, 0.54 mM y 7.5 0.04 mM in the order described; while the strain Y. lipolytica AMJ6 showed a LC50 of 1.06 mM, 1.42 mM, 0.49 mM y 0.05 mM in the same order. The biosorption capacity of the Cu+2 ion was 90% in the case of the AMJ3 strain, and 92% in the AMJ6 strain, at a concentration of 1.26 mM; likewise, the biosorption of the Cr+6 ion was close to 90% in both strains (AMJ3 and AMJ6) at concentrations of 0.24 mM and 0.96 mM, respectively. Nucleotide sequence analysis of AMJ3 and AMJ6 strains confirmed 100% identity in the Yarrowia lipolytica clade. These LC50 and biosorption capacity results indicate that the studied yeasts have potential in the bioremediation of water bodies and soils contaminated with heavy metals.

Resumen El objetivo del presente trabajo fue estudiar la concentración letal media (CL50) y la capacidad de biosorción de metales pesados en levaduras aisladas del Lago Junín y la relavera Yanamate. Se evaluaron en ambos cuerpos de agua: pH, conductividad eléctrica, temperatura, sólidos totales disueltos (STD) y metales pesados por ICM-MS, según los Estándares de Calidad Ambiental (ECA) del Ministerio del Ambiente-MINAM del Perú. Los parámetros fisicoquímicos evaluados en el Lago Junín fueron superiores a los límites máximos permisibles (LMP) para los siguientes metales: arsénico, cadmio, cobre, cromo y plomo. En la relavera Yanamate, los parámetros evaluados estuvieron fuera del LMP para los ECA de aguas tipo IV: pH inferiores a 3 (ácidos), altas conductividades eléctricas y elevadas concentraciones de metales pesados. A partir de las aguas muestreadas, se aislaron levaduras en medio YPG a 10 °C y 20 °C. La CL50 de los iones Cr+6, Cu+2, Cd+2 y Hg+2 en Y. lipolytica AMJ3 fue 0.24 mM, 1.34 mM, 0.54 mM y 7.5 0.04 mM en el orden descrito; en tanto la cepa Y. lipolytica AMJ6 mostró una CL50 de 1.06 mM, 1.42 mM, 0.49 mM y 0.05 mM en el mismo orden. La capacidad de biosorción del ion Cu+2 fue del 90% en el caso de la cepa AMJ3 y 92% en la cepa AMJ6, a una concentración de 1.26 mM; asimismo, la biosorción del ion Cr+6 fue cercana al 90% en ambas cepas (AMJ3 y AMJ6) a concentraciones de 0.24 mM y 0.96 mM, respectivamente. Los análisis de las secuencias nucleotídicas de las cepas AMJ3 y AMJ6 confirmaron una identidad del 100% en el clado de Yarrowia lipolytica. Los resultados obtenidos de CL50 y la capacidad de biosorción indican que las levaduras bajo estudio tienen potencial en la biorremediación de cuerpos de agua y suelos contaminados con metales pesados.

ABSTRACT Mycetoma is a neglected tropical disease (NTD) declared by the World Health Organization (WHO) in 2016. It is characterized by the progressive growth of nodules and granulomatous lesions on the legs, arms, and trunk. It is potentially disfiguring and causes disability or amputations in working-age people from marginalized areas. The causative agents can be fungi (eumycetoma) or actinobacteria (actinomycetoma), the latter being the most common in America and Asia. Nocardia brasiliensis is the most important causal agent of actinomycetoma in the Americas. Taxonomic problems have been reported when identifying this species, so this study aimed to detect the 16S rRNA gene variations in N. brasiliensis strains using an in silico enzymatic restriction technique. The study included strains from clinical cases of actinomycetoma in Mexico, isolated from humans and previously identified as N. brasiliensis by traditional methods. The strains were characterized microscopically and macroscopically, then subjected to DNA extraction and amplification of the 16S rRNA gene by PCR. The amplification products were sequenced, and consensus sequences were constructed and used for genetic identification and in silico restriction enzyme analysis with the New England BioLabs® NEBcutter program. All study strains were molecularly identified as N. brasiliensis; however, in silico restriction analysis detected a diversity in the restriction patterns that were finally grouped and subclassified into 7 ribotypes. This finding confirms the existence of subgroups within N. brasiliensis. The results support the need to consider N. brasiliensis as a complex species. NTD (NTD WHO (WHO 2016 legs arms trunk workingage working age areas eumycetoma (eumycetoma actinomycetoma, , (actinomycetoma) Asia Americas species S N technique Mexico methods macroscopically PCR sequenced BioLabs program however ribotypes 201 (actinomycetoma 20 2

RESUMO O cenário do treinamento cirúrgico está evoluindo rapidamente com o surgimento da inteligência artificial (IA) e sua integração na educação e simulação. Este artigo explora as aplicações e benefícios potenciais do treinamento cirúrgico assistido por IA, em particular o uso de modelos de linguagem avançados (MLAs), para aprimorar a comunicação, personalizar o feedback e promover o desenvolvimento de habilidades. Discutimos os avanços no treinamento baseado em simulação, ferramentas de avaliação impulsionadas por IA, sistemas de avaliação baseados em vídeo, plataformas de realidade virtual (RV) e realidade aumentada (RA), e o papel potencial dos MLAs na transcrição, tradução e resumo do feedback. Apesar das oportunidades promissoras apresentadas pela integração da IA, vários desafios devem ser abordados, incluindo precisão e confiabilidade, preocupações éticas e de privacidade, viés nos modelos de IA, integração com os sistemas de treinamento existentes, e treinamento e adoção de ferramentas assistidas por IA. Ao abordar proativamente esses desafios e aproveitar o potencial da IA, o futuro do treinamento cirúrgico pode ser remodelado para proporcionar uma experiência de aprendizado mais abrangente, segura e eficaz para os aprendizes, resultando em melhores resultados para os pacientes. IA (IA simulação MLAs, , (MLAs) comunicação habilidades vídeo RV (RV RA, RA (RA) transcrição abordados confiabilidade privacidade existentes abrangente aprendizes pacientes (MLAs (RA

ABSTRACT The landscape of surgical training is rapidly evolving with the advent of artificial intelligence (AI) and its integration into education and simulation. This manuscript aims to explore the potential applications and benefits of AI-assisted surgical training, particularly the use of large language models (LLMs), in enhancing communication, personalizing feedback, and promoting skill development. We discuss the advancements in simulation-based training, AI-driven assessment tools, video-based assessment systems, virtual reality (VR) and augmented reality (AR) platforms, and the potential role of LLMs in the transcription, translation, and summarization of feedback. Despite the promising opportunities presented by AI integration, several challenges must be addressed, including accuracy and reliability, ethical and privacy concerns, bias in AI models, integration with existing training systems, and training and adoption of AI-assisted tools. By proactively addressing these challenges and harnessing the potential of AI, the future of surgical training may be reshaped to provide a more comprehensive, safe, and effective learning experience for trainees, ultimately leading to better patient outcomes. . (AI simulation AIassisted assisted LLMs, , (LLMs) communication feedback development simulationbased based AIdriven driven tools videobased video systems VR (VR AR (AR platforms transcription translation addressed reliability concerns comprehensive safe trainees outcomes (LLMs

ABSTRACT Heavy metals released into the environment cause deterioration of environmental health. Their removal by biological means is a strategy under study. This research aimed to isolate and identify halophilic bacteria from saline-sodic soils and determine their tolerance to the metalloid As3+ and the heavy metals Cr6+, Hg2+, and Pb2+. The strains were grown on halophilic medium (HM), without and with the presence of each metal, at 10% NaCl, pH 8.0 ± 0.2, and 37 ºC. The strains with the highest tolerance to each metal were identified by 16S rRNA gene sequencing and phylogenetic analysis. The minimum inhibitory concentration (MIC) was subsequently determined. Seventy-five halophilic strains were isolated. The isolates with the highest tolerance were Salinicococcus spp. strains TX3SA-2MHG1 and TX3SA-4MHG1 [MIC (Hg2+) of 0.1 mmol/L]; Halomonas sp. strain TXO4B-1SG9 [MIC (Pb2+) of 7.0 mmol/L]; Nocardiopsis sp. strains TXO7B-1SG12 and TXV10-3SG5 [MIC (As3+) of 8.5 mmol/L], and Nocardiopsis sp. strain TXV7-8SG2 [MIC (As3+) of 27.25 mmol/L; MIC (Cr6+) 1250.0 mmol/L; MIC (Hg2+) 0.075 mmol/L and MIC (Pb2+) 7.5 mmol/L]. It was possible to obtain and identify isolates of halophilic metal tolerant bacteria.

RESUMEN Los metales pesados liberados en el ambiente causan el deterioro de la salud ambiental. Su eliminación por medios biológicos es una estrategia en estudio. El objetivo de esta investigación fue aislar e identificar bacterias halófilas a partir de suelos salino-sódicos y determinar su tolerancia al metaloide As3+ y a los metales pesados Cr6+, Hg2+ y Pb2+. Las cepas fueron cultivadas en medio halófilo (MH), sin y con la presencia de cada metal, al 10 % de NaCl, pH 8.0 ± 0.2 y 37 ºC. Las cepas que mostraron mayor tolerancia a cada metal se identificaron por análisis de secuenciación del gen del ARNr 16S y por análisis filogenético, posteriormente se determinó la concentración mínima inhibitoria (CMI). Se aislaron 75 cepas halófilas. Los aislados con mayor tolerancia fueron Salinicoccus spp. TX3SA-2MHG1 y TX3SA-4MHG1 [CMI (Hg2+) de 0.1 mmol/L]; Halomonas sp. TXO4B-1SG9 [CMI (Pb2+) de 7.0 mmol/L]; Nocardiopsis sp. TXO7B-1SG12 y TXV10-3SG5 [CMI (As3+) de 8. 5 mmol/L] y Nocardiopsis sp. TXV7-8SG2 [CMI (As3+) de 27.25 mmol/L; CMI (Cr6+) 1 250.0 mmol/L; CMI (Hg2+) 0.075 mmol/L y CMI (Pb2+) 7.5 mmol/L]. Fue posible obtener e identificar aislados de bacterias halófilas metalo-tolerantes.

Resumen Introducción: en Colombia las Guías de Práctica Clínica para el manejo del paciente con diabetes tipo 1 (DM1) y tipo 2 (DM2) no mencionan el uso del monitoreo de glucosa flash dado que dicho sistema no estaba disponible. El objetivo del presente trabajo fue establecer un grupo de recomendaciones sobre el uso del monitoreo intermitente flash en Colombia. Métodos: el grupo de expertos estuvo conformado por ocho médicos colombianos expertos en el manejo de pacientes con DM1 y DM2 de diversas ciudades de Colombia, una enfermera licenciada educadora en diabetes, una paciente con diagnóstico de DM1 y un experto metodológico. A través de Zoom Enterprise versión de la aplicación de videoconferencia Zoom (Zoom Video Communications, San Jose, California) el grupo generó las preguntas con metodología Metaplan. Posteriormente, se realizó una búsqueda sistemática de la literatura y análisis de la evidencia. Las recomendaciones se generaron mediante grupo nominal según el grado de evidencia y la formaleza de la recomendación siguiendo la metodología GRADE. Resultados: se generaron recomendaciones clínicas enfocadas a: a) paciente con diagnóstico de DM1 e hipoglucemia; b) paciente con diagnóstico de DM1 y mal control metabólico, c) paciente con diagnóstico de DM tipo 2 tratado con insulina, d) diabetes pregestacional, e) calidad de vida y f) uso intrahospitalario. Conclusiones: las recomendaciones clínicas del presente consenso orientan la toma de decisiones clínicas con respecto al uso de monitoreo intermitente flash en el paciente con diagnóstico de diabetes en diferentes escenarios clínicos. (Acta Med Colomb 2022; 47. DOI:https://doi.org/10.36104/amc.2022.2239).

Abstract Introduction: in Colombia, the Clinical Practice Guidelines for the treatment of patients with type 1 (DM1) and type 2 (DM2) diabetes do not mention the use of flash glucose monitoring, as this system was not available. The objective of this study was to establish a set of recommendations for the use of intermittent flash monitoring in Colombia. Methods: the group of experts consisted of eight Colombian physicians from different cities within Colombia, with expertise in the management of patients with DM1 and DM2; a certified diabetes nurse educator; a patient with DM1; and a methodological expert. Using the Zoom Enterprise video conferencing application (Zoom Video Communications, San Jose, California), the group generated questions through the Metaplan method, then carried out a systematic literature search and evidence review. The recommendations were made according to the degree of evidence and strength of the recommendation, following the GRADE method. Results: clinical recommendations were made for: a) patients with DM1 and hypoglycemia; b) patients with DM1 and poor metabolic control; c) patients with insulin-treated DM2; d) pregestational diabetes; e) quality of life; and f) inpatient use. Conclusions: this consensus's clinical recommendations guide clinical decision making with regard to the use of intermittent flash monitoring in patients with diabetes in various clinical settings. (Acta Med Colomb 2022; 47. DOI:https://doi.org/10.36104/amc.2022.2239).

RESUMEN La restauración de grandes preparaciones cavitarias clases II MOD es un escenario clínico de alta complejidad. Elegir correctamente una resina compuesta y planificar la secuencia de estratificación permitirá mejorar la adaptación de las masas de resina y controlar el estrés de contracción de polimerización. En el siguiente reporte de caso clínico, se expone el protocolo paso a paso para el uso combinado de una resina compuesta para estratificación de esmalte de alto índice de refracción para la restauración de los rebordes marginales perdidos y la superficie oclusal, junto a una resina compuesta bulk-fill de baja viscosidad para la reconstrucción dentinaria en un diente posterior con gran destrucción coronaria.

ABSTRACT The restoration of large class II MOD cavity preparations is a highly complex clinical scenario. Selecting correctly a composite resin and planning the stratification sequence will improve the adaptation of the composite resin masses and will control the polymerization shrinkage stress. In the following clinical case report, the step- by-step protocol of the combined use of an high-refractive-index enamel-like composite resin is shown for the restoration of lost marginal ridges and the occlusal surface, together with a low viscosity Bulk-Fill composite resin for dentine reconstruction in a highly damaged posterior tooth.

El artículo analiza los desafíos percibidos y las estrategias implementadas en cinco países de América Latina y el Caribe para garantizar la continuidad de los cuidados y el acceso a servicios de salud de mujeres, recién nacidos/as, niños/as y adolescentes durante la pandemia por COVID-19. El estudio corresponde a una evaluación rápida basada en entrevistas semi-estructuradas a informantes clave de países seleccionados por conveniencia: Colombia, Ecuador, Guatemala, Granada y República Dominicana. Se realizaron entrevistas con 23 informantes clave: (a) referentes de la toma de decisión a nivel nacional y/o subnacional, (b) referentes de servicios de salud, y (c) representantes de organizaciones de la sociedad civil, durante diciembre de 2020 y enero de 2021. Entre los hallazgos, al inicio de la pandemia se priorizó la atención del COVID-19, con medidas para limitar la afluencia de personas a los establecimientos de salud en los países involucrados, procediendo al cierre o limitación de consultas externas y restricción de horarios de atención. Para las mujeres, esto impactó en los servicios de planificación familiar y el acceso a métodos anticonceptivos, e implicó una reducción de los controles prenatales. Por esta desinstitucionalización de la atención, entre recién nacidos/as fue reportada una disminución de los controles pediátricos, una disminución de su vacunación oportuna y una detección tardía de patologías o problemas de crecimiento. Entre adolescentes, se señaló una fuerte restricción de los servicios de planificación familiar, la limitación de otros espacios amigables de consejería y dificultades para acceder a anticonceptivos. mujeres nacidosas nacidos as niñosas niños COVID19. COVID19 COVID 19. 19 COVID-19 semiestructuradas semi estructuradas conveniencia Colombia Ecuador Guatemala Dominicana 2 (a yo subnacional b (b c (c civil 202 2021 hallazgos COVID19, 19, involucrados anticonceptivos prenatales pediátricos crecimiento COVID1 1 COVID-1 20 COVID-

The article analyzes the perceived challenges and strategies implemented in five Latin American and Caribbean countries to ensure continuity of care and access to health services for women, newborns, children, and adolescents during the COVID-19 pandemic. The study corresponds to a quick assessment based on semi-structured interviews with key informants in countries selected by convenience: Colombia, Ecuador, Guatemala, Grenada, and the Dominican Republic. Interviews were conducted with 23 key informants: (a) decision makers at the national and/or subnational level, (b) healthcare professionals, and (c) representatives of civil society organizations; from December 2020 to January 2021. Among the findings, at the beginning of the pandemic, priority was given to the COVID-19 care, with measures to limit the flow of people to health facilities in the countries involved, closing or limiting outpatient visits and restricting care schedule. For women, this affected family planning services and access to contraceptive methods, implying a reduction in prenatal check-ups. As a result of this deinstitutionalization of care, among newborns, a decrease in pediatric check-ups, a decrease in timely immunization and late detection of pathologies or growth problems were reported. Among adolescents, a strong restriction of family planning services, the limitation of other friendly counseling spaces and difficulties in accessing contraceptives were observed. women newborns children COVID19 COVID 19 COVID-1 pandemic semistructured semi structured convenience Colombia Ecuador Guatemala Grenada Republic 2 (a andor level b (b professionals c (c organizations 202 2021 findings involved schedule methods checkups. checkups check ups. ups check-ups checkups, ups, reported observed COVID1 1 COVID- 20

O artigo analisa os desafios observados e as estratégias implementadas em cinco países da América Latina e do Caribe para garantir a continuidade do atendimento e o acesso aos serviços de saúde para mulheres, recém-nascidos/as, crianças e adolescentes durante a pandemia de COVID-19. O estudo é uma avaliação rápida baseada em entrevistas semiestruturadas com informantes-chave em países selecionados por conveniência: Colômbia, Equador, Guatemala, Granada e República Dominicana. Foram realizadas entrevistas com 23 informantes-chave: (a) tomadores de decisão em nível nacional e/ou subnacional, (b) prestadores de serviços de saúde e (c) representantes de organizações da sociedade civil; durante dezembro de 2020 e janeiro de 2021. Entre as conclusões encontrou-se que, no início da pandemia, foi dada prioridade à COVID-19, com medidas para limitar o fluxo de pessoas às instalações de saúde nos países envolvidos, fechando ou limitando as consultas ambulatoriais e restringindo o horário de atendimento. Para as mulheres, a medida impactou os serviços de planejamento familiar e o acesso à contracepção, significando uma redução nos check-ups pré-natais. Como resultado desta desinstitucionalização dos cuidados, uma diminuição dos check-ups pediátricos, uma diminuição das vacinações no período correto e uma detecção tardia de patologias ou problemas de crescimento foram relatados entre os/as recém-nascidos/as. Entre os adolescentes, foi observada uma restrição severa dos serviços de planejamento familiar, a limitação de acesso a espaços de aconselhamento amigável e dificuldades de acesso a contraceptivos. mulheres recémnascidos/as, recémnascidosas recém nascidos/as, nascidos recém-nascidos/as COVID19. COVID19 COVID 19. 19 COVID-19 informanteschave informantes chave conveniência Colômbia Equador Guatemala Dominicana 2 (a eou subnacional b (b c (c civil 202 2021 encontrouse encontrou se que COVID19, 19, envolvidos contracepção checkups check ups prénatais. prénatais pré natais. natais pré-natais cuidados pediátricos osas recémnascidos/as. nascidos/as. contraceptivos recémnascidos recémnascidos/as nascidosas nascidos/as COVID1 1 COVID-1 20 COVID-

The article analyzes the perceived challenges and strategies implemented in five Latin American and Caribbean countries to ensure continuity of care and access to health services for women, newborns, children, and adolescents during the COVID-19 pandemic. The study corresponds to a quick assessment based on semi-structured interviews with key informants in countries selected by convenience: Colombia, Ecuador, Guatemala, Grenada, and the Dominican Republic. Interviews were conducted with 23 key informants: (a) decision makers at the national and/or subnational level, (b) healthcare professionals, and (c) representatives of civil society organizations; from December 2020 to January 2021. Among the findings, at the beginning of the pandemic, priority was given to the COVID-19 care, with measures to limit the flow of people to health facilities in the countries involved, closing or limiting outpatient visits and restricting care schedule. For women, this affected family planning services and access to contraceptive methods, implying a reduction in prenatal check-ups. As a result of this deinstitutionalization of care, among newborns, a decrease in pediatric check-ups, a decrease in timely immunization and late detection of pathologies or growth problems were reported. Among adolescents, a strong restriction of family planning services, the limitation of other friendly counseling spaces and difficulties in accessing contraceptives were observed.

O artigo analisa os desafios observados e as estratégias implementadas em cinco países da América Latina e do Caribe para garantir a continuidade do atendimento e o acesso aos serviços de saúde para mulheres, recém-nascidos/as, crianças e adolescentes durante a pandemia de COVID-19. O estudo é uma avaliação rápida baseada em entrevistas semiestruturadas com informantes-chave em países selecionados por conveniência: Colômbia, Equador, Guatemala, Granada e República Dominicana. Foram realizadas entrevistas com 23 informantes-chave: (a) tomadores de decisão em nível nacional e/ou subnacional, (b) prestadores de serviços de saúde e (c) representantes de organizações da sociedade civil; durante dezembro de 2020 e janeiro de 2021. Entre as conclusões encontrou-se que, no início da pandemia, foi dada prioridade à COVID-19, com medidas para limitar o fluxo de pessoas às instalações de saúde nos países envolvidos, fechando ou limitando as consultas ambulatoriais e restringindo o horário de atendimento. Para as mulheres, a medida impactou os serviços de planejamento familiar e o acesso à contracepção, significando uma redução nos check-ups pré-natais. Como resultado desta desinstitucionalização dos cuidados, uma diminuição dos check-ups pediátricos, uma diminuição das vacinações no período correto e uma detecção tardia de patologias ou problemas de crescimento foram relatados entre os/as recém-nascidos/as. Entre os adolescentes, foi observada uma restrição severa dos serviços de planejamento familiar, a limitação de acesso a espaços de aconselhamento amigável e dificuldades de acesso a contraceptivos.

El artículo analiza los desafíos percibidos y las estrategias implementadas en cinco países de América Latina y el Caribe para garantizar la continuidad de los cuidados y el acceso a servicios de salud de mujeres, recién nacidos/as, niños/as y adolescentes durante la pandemia por COVID-19. El estudio corresponde a una evaluación rápida basada en entrevistas semi-estructuradas a informantes clave de países seleccionados por conveniencia: Colombia, Ecuador, Guatemala, Granada y República Dominicana. Se realizaron entrevistas con 23 informantes clave: (a) referentes de la toma de decisión a nivel nacional y/o subnacional, (b) referentes de servicios de salud, y (c) representantes de organizaciones de la sociedad civil, durante diciembre de 2020 y enero de 2021. Entre los hallazgos, al inicio de la pandemia se priorizó la atención del COVID-19, con medidas para limitar la afluencia de personas a los establecimientos de salud en los países involucrados, procediendo al cierre o limitación de consultas externas y restricción de horarios de atención. Para las mujeres, esto impactó en los servicios de planificación familiar y el acceso a métodos anticonceptivos, e implicó una reducción de los controles prenatales. Por esta desinstitucionalización de la atención, entre recién nacidos/as fue reportada una disminución de los controles pediátricos, una disminución de su vacunación oportuna y una detección tardía de patologías o problemas de crecimiento. Entre adolescentes, se señaló una fuerte restricción de los servicios de planificación familiar, la limitación de otros espacios amigables de consejería y dificultades para acceder a anticonceptivos.

Resumen: La COVID-19 ha provocado múltiples efectos en la salud física y mental de la población mundial. Desde la perspectiva psicosocial, este estudio propone comprender las representaciones sociales sobre la pandemia de la COVID-19 en estudiantes chilenos de educación superior. Los participantes fueron un total de 92 estudiantes. La recolección de los datos se realizó mediante un cuestionario de representaciones sociales, que incluyó las siguientes palabras estímulos: (a) COVID-19, (b) cuarentena, y (c) distanciamiento social. Los datos fueron analizados mediante análisis de redes semánticas naturales. Los resultados muestran que las categorías temáticas sobre la COVID-19 se relacionan principalmente con aspectos biológicos, emocionales y valorativos. Para la cuarentena y el distanciamiento social, las categorías temáticas se relacionan con aspectos emocionales y valorativos. Se discuten los resultados en función de la comprensión de las categorías de pensamiento que promueven el comportamiento en contexto de emergencia sanitaria.

Abstract: The COVID-19 has caused multiple effects on the physical and mental health of the world’s population. From the psychosocial perspective, this study proposes to understand the social representations about the COVID-19 pandemic of Chilean higher education students. The participants were a total of 92 Chilean higher education students. Data collection was carried out using a questionnaire of social representations, which included the following stimulus words: (a) COVID-19, (b) quarantine, and (c) social distancing. The data were analyzed using natural semantic network analysis. The results showed that the thematic categories of the COVID-19 are mainly related to biological, emotional and value aspects. For quarantine and social distancing, thematic categories are related to emotional and value aspects. The results are discussed based on the understanding of the categories of thought that promote behavior in the context of a health emergency.

Resumo: O COVID-19 provocou múltiplos efeitos na saúde física e mental da população mundial. A partir de uma perspectiva psicossocial, este estudo se propõe a compreender as representações sociais sobre a pandemia do COVID-19 de estudantes chilenos do ensino superior. Os participantes foram um total de 92 estudantes. A coleta de dados foi realizada por meio de um questionário de representações sociais, que incluiu as seguintes palavras estímulo: (a) COVID-19, (b) quarentena, e (c) distanciamento social. Os dados foram analisados por meio de análise de rede semântica natural. Os resultados mostram que as categorias temáticas sobre o COVID-19 estão relacionadas principalmente com aspectos biológicos, emocionais e apreciativos. Para quarentena e distanciamento social, as categorias temáticas estão relacionadas a aspectos emocionais e apreciativos. Os resultados são discutidos a partir da compreensão das categorias de pensamento que promovem o comportamento no contexto de uma emergência sanitária.

Resumen Objetivo. Reconstruir las teorías subjetivas de profesionales en trabajo social y psicología sobre la disciplina parental. Método. Es una investigación cualitativa con diseño descriptivo. Se realizaron entrevistas individuales a siete profesionales en trabajo social y siete en psicología de la cuarta región de Chile. El análisis de datos utilizó codificaciones mediante el software ATLAS.ti. Resultados. Se demostró que los consejos de disciplina parental se conforman por la formación profesional de pre y posgrado, la experiencia laboral en programas con familias y elementos personales relacionados con historia de vida y parentalidad. Es así que los consejos se basan principalmente en teorías subjetivas y profesionales que se relacionan con teorías formales. Se observan diferencias en los consejos que entregan ambas profesiones.

Abstract Objective. To reconstruct the subjective theories of social workers and psychologists regarding parental discipline. Method. The following research is qualitative, and it was carried out through a descriptive type of design. Individual interviews were conducted to seven social workers and seven psychologists from the fourth region of Chile. The analysis of the collected data was performed through the grounded theory using encodings from the ATLAS.ti. software. Results. It is shown that the pieces of advice regarding parental discipline are strongly influenced by the professional training, the working experience, and some personal elements and conceptions of the interviewed professionals. Some differences are observed regarding the pieces of advice provided from both professional perspectives.

Resumen Se caracterizan y analizan los parámetros de la fuente sísmica del sismo ocurrido el 27 de julio de 2018 a las 17:50:46 (hora UTC) en San Gabriel de Aserrí (latitud 9,788, longitud -84,101). Este tuvo una profundidad de 15 km y magnitud Ml 4,6. La distribución de la sismicidad localizada y solución de mecanismo focal (MF) indican que probablemente el evento ocurrió en una falla de corrimiento lateral derecho, con componente normal pequeña y rumbo NNW, alto ángulo de buzamiento ~77° e inclinación hacia el NE (strike 326°/dip 77°/rake -165°). Este MF concuerda con otros localizados en el área, el cual evidencia deformación transtensional en el antearco central del país, conocido como el Cinturón Deformado del Centro de Costa Rica (CDCCR). Registros de aceleración en las estaciones sísmicas (%g), permitieron identificar en la escala de Intensidad Modificada de Mercalli (IMM) intensidades instrumentales máximas de IV en comunidades como San Gabriel de Aserrí, San Pablo de León Cortés y San Marcos de Tarrazú.

Abstract In this research the seismic source parameters of the earthquake that occurred on July 27, 2018, at 17:50:46 (UTC time) in San Gabriel de Aserrí (latitude 9.788, longitude -84.101) are characterized and analyzed. The parameters show that the event had a depth of 15 km and Ml 4.6. The distribution of localized seismicity and a focal mechanism solution indicates that it probably occurred on a right-lateral strike-slip fault with a small normal component, strike NNW, high dip angle ~77°, dipping to the NE (strike 326 ° /dip 77 ° /slip -165°). The focal mechanism is consistent with those of previous seismicity located in the area and they indicate transtensional deformation in the central forearc of the country, known as the Central Costa Rica Deformed Belt. The instrumental intensities, obtained from the acceleration (% g) recorded in the seismic stations, allowed to identify in the Modified Mercalli Intensity scale (MMI) maximum instrumental intensities of IV in communities such as San Gabriel de Aserrí, San Pablo de León Cortés, and San Marcos de Tarrazú.