Abstract Objective: The aim of this study was to assess the risk factors associated with 30-day hospital readmissions after a cholecystectomy. Methods: We conducted a case–control study, with data obtained from UC-Christus from Santiago, Chile. All patients who underwent a cholecystectomy between January 2015 and December 2019 were included in the study. We identified all patients readmitted after a cholecystectomy and compared them with a randomized control group. Univariate and multivariate analyses were conducted to identify risk factors. Results: Of the 4866 cholecystectomies performed between 2015 and 2019, 79 patients presented 30-day hospital readmission after the surgical procedure (1.6%). We identified as risk factors for readmission in the univariate analysis the presence of a solid tumor at the moment of cholecystectomy (OR = 7.58), high pre-operative direct bilirubin (OR = 2.52), high pre-operative alkaline phosphatase (OR = 3.25), emergency admission (OR = 2.04), choledocholithiasis on admission (OR = 4.34), additional surgical procedure during the cholecystectomy (OR = 4.12), and post-operative complications. In the multivariate analysis, the performance of an additional surgical procedure during cholecystectomy was statistically significant (OR = 4.24). Conclusion: Performing an additional surgical procedure during cholecystectomy was identified as a risk factor associated with 30-day hospital readmission.

Resumen Objetivo: El objetivo de este estudio fue evaluar los factores de riesgo asociados al reingreso hospitalario en los primeros 30 días post colecistectomía. Métodos: Estudio de casos-controles con datos obtenidos del Hospital Clínico de la UC-Christus, Santiago, Chile. Se incluyeron las colecistectomías realizadas entre los años 2015-2019. Se consideraron como casos aquellos pacientes que reingresaron en los 30 primeros días posterior a una colecistectomía. Se realizó un análisis univariado y multivariado de diferentes posibles factores de riesgo. Resultados: De un total de 4866 colecistectomías, 79 pacientes presentaron reingreso hospitalario. Los resultados estadísticamente significativos en el análisis univariado fueron; tumor sólido al momento de la colecistectomía (OR = 7.58) bilirrubina directa preoperatoria alterada (OR = 2.52), fosfatasa alcalina preoperatoria alterada (OR = 3.25), ingreso de urgencia (OR = 2.04), coledocolitiasis al ingreso (OR = 4.34) realización de otros procedimientos (OR = 4.12) y complicaciones postoperatorias. En el análisis multivariado sólo la realización de otro procedimiento durante la colecistectomía fue estadísticamente significativa (OR = 4.24). Conclusión: La realización de otros procedimientos durante la colecistectomía es un factor de riesgo de reingreso hospitalario en los 30 días posteriores a la colecistectomía.

RESUMO A aplicação do Treinamento de Habilidades Sociais no contexto universitário pode ser eficaz para a redução do estresse percebido pelos estudantes. Assim, o objetivo do presente artigo foi descrever, no formato de um estudo de caso único, o processo terapêutico de um Treinamento de Habilidades Sociais realizado com uma estudante de Psicologia, apresentando dados referentes à eficácia da intervenção. As avaliações pré e pós-teste foram feitas com os seguintes instrumentos: Inventário de Habilidades Sociais 2 (IHS2-Del-Prette), Escala de Estresse Percebido (PSS-14), entrevistas e diário de campo. Contatou-se o aprimoramento de habilidades sociais como recusar e fazer pedidos, lidar com críticas e expor desagrado e solicitar mudança de comportamento do outro, e redução dos níveis de estresse com base em dados qualitativos e quantitativos, com manutenção desses resultados no follow-up de seis semanas. Concluiu-se que o Treinamento de Habilidades Sociais realizado possibilitou a melhora da experiência na universidade para a participante. estudantes Assim descrever único Psicologia intervenção pósteste pós teste instrumentos IHS2DelPrette, IHS2DelPrette IHSDelPrette IHS2 Del Prette , IHS (IHS2-Del-Prette) PSS14, PSS14 PSS 14 (PSS-14) campo Contatouse Contatou se pedidos outro quantitativos followup follow up semanas Concluiuse Concluiu participante DelPrette (IHS2-Del-Prette PSS1 1 (PSS-14 (PSS-1 (PSS- (PSS

ABSTRACT The application of Social Skills Training in the university context can be effective in reducing the stress perceived by students. Therefore, the objective of this article was to describe, in the format of a single case study, the therapeutic process of a Social Skills Training carried out with a Psychology student, also presenting data regarding the effectiveness of the intervention. Pre- and post-test assessments were performed using the following instruments: Social Skills Inventory 2 (IHS2-Del-Prette), Perceived Stress Scale (PSS-14), interviews and field diary. It was possible to verify the improvement of social skills such as refusing and making requests, dealing with criticism and exposing displeasure and requesting a change in the other’s behavior, and reduction of stress levels based on qualitative and quantitative data, with maintenance of these results in the follow-up of six weeks. It was concluded that the Social Skills Training carried out enabled the participant to improve her university experience. students Therefore describe study student intervention Pre posttest post test instruments IHS2DelPrette, IHS2DelPrette IHSDelPrette IHS2 Del Prette , IHS (IHS2-Del-Prette) PSS14, PSS14 PSS 14 (PSS-14) diary requests others other s behavior followup follow up weeks experience DelPrette (IHS2-Del-Prette PSS1 1 (PSS-14 (PSS-1 (PSS- (PSS

RESUMEN La aplicación del entrenamiento de Habilidades Sociales en el contexto universitario puede ser eficaz para la disminución del estrese percibido por los estudiantes. Delante eso, el objetivo del presente artículo fue describir, en el molde de un estudio de caso único, el proceso terapéutico de un entrenamiento de Habilidades Sociales realizado con una estudiante de Psicología, que presentaba, también, datos referentes a la eficacia de la intervención. Las evaluaciones antes y e después de la prueba se hicieron con los siguientes instrumentos: Inventario de Habilidades Sociales 2 (IHS2-Del-Prette), Escala de Estrese Percibido (PSS-14), entrevistas y diario de campo. Fue posible constatar el perfeccionamiento de habilidades sociales como recusar y hacer pedidos, lidiar con críticas y exponer desagrado y solicitar cambio de comportamiento del otro, y reducción de los niveles de estrese con base en datos cualitativos y cuantitativos, con manutención de esos resultados en elfollow-upde seis semanas. Se concluye que el Entrenamiento de Habilidades Sociales realizado posibilitó la mejora de la experiencia en la universidad para la participante. estudiantes eso describir único Psicología presentaba también intervención instrumentos IHS2DelPrette, IHS2DelPrette IHSDelPrette IHS2 Del Prette , IHS (IHS2-Del-Prette) PSS14, PSS14 PSS 14 (PSS-14) campo pedidos otro cuantitativos elfollowupde elfollow upde semanas participante DelPrette (IHS2-Del-Prette PSS1 1 (PSS-14 (PSS-1 (PSS- (PSS

Abstract The sedimentary basins in the Continental Rift of Southeastern Brazil (CRSB) provide an opportunity for ichnological analyses due to its well-known facies relationships and paleoenvironmental interpretations. This study reports invertebrate trace fossils from the Neogene fluvial deposits (Floriano Formation) and applies integrated ichnological and facies analyses to reconstruct the environmental conditions recorded in this lithostratigraphic unit. Fieldworks revealed a rich ichnofauna in the Floriano Formation, whose facies associations have been interpreted as indicative of meandering river environments. Four sedimentary facies were identified, including bioturbated sandstone, horizontally stratified sandstone, laminated sandstone, and mudstone. Six ichnogenera were identified, Arenicolites, Beaconites, Camborygma, Palaeophycus, Skolithos, and Taenidium. Those ichnogenera occur as Skolithos, Taenidium, and Beaconites ichnocoenoses. The Skolithos ichnocoenosis is primarily represented within sand bar deposits, indicating arthropod colonization in abandoned channels. The Taenidium ichnocoenosis, which is observed within mudstone layers and presents Camborygma burrows, suggests transitional environments between aquatic and subaerial conditions, locally with high water table levels. The Beaconites ichnocoenosis indicates changes in substrate consistency associated with progressive desiccation and extended exposure time. Therefore, the identified ichnocoenoses, combined with the analysis of physical sedimentary structures, suggest generally humid conditions during colonization by invertebrates of the meandering river deposits of the Floriano Formation. CRSB (CRSB wellknown well known interpretations Formation unit sandstone Arenicolites Palaeophycus ichnocoenoses channels burrows levels time Therefore structures

Abstract Background A meta-analysis of randomized controlled trials has suggested a bidirectional relationship between sleep problems and mental health issues. Despite these findings, there is limited conclusive evidence on the relationship between sleep quality, depression, anxiety, and burnout. Objective The current study aimed to evaluate the relationships between sleep quality symptoms, anxiety, depression, and burnout in samples of adult individuals from two Latin American countries, Peru and El Salvador, through network analysis and to identify key symptoms that reinforce the correlation and intensify the syndromes. Methods A total of 1012 individuals from El Salvador and Peru participated, with an average age of 26.5 years (SD = 9.1). Symptom networks were constructed for both countries based on data from the Jenkins Sleep Scale, Patient Health Questionnaire-2, General Anxiety Disorder-2, and a single burnout item. Results The results indicated that Depressed Mood, Difficulty Falling Asleep, and Nervousness were the most central symptoms in a network in the participating countries. The strongest conditional associations were found between symptoms belonging to the same construct, which were similar in both countries. Thus, there is a relationship between Nervousness and Uncontrollable Worry, Anhedonia and Depressed Mood, and Nighttime Awakenings and Difficulty in Staying Asleep. It was observed that burnout is a bridge symptom between both countries and presents stronger conditional associations with Tiredness on Awakening, Depressed Mood, and Uncontrollable Worry. Other bridge symptoms include a Depressed Mood and Nervousness. The network structure did not differ between the participants from Peru and El Salvador. Conclusion The networks formed by sleep quality, anxiety, depression, and burnout symptoms play a prominent role in the comorbidity of mental health problems among the general populations of Peru and El Salvador. The symptombased analytical approach highlights the different diagnostic weights of these symptoms. Treatments or interventions should focus on identifying central and bridge symptoms. metaanalysis meta issues findings depression anxiety syndromes 101 participated 265 26 5 26. SD 9.1. 91 9.1 . 9 1 9.1) Scale Questionnaire2, Questionnaire2 Questionnaire 2, 2 Questionnaire-2 Disorder2, Disorder2 Disorder Disorder-2 item Asleep construct Thus Worry Awakening 10 9. Questionnaire- Disorder-

Resumo Este artigo propõe uma metodologia de análise das capacidades institucionais de enfrentamento das mudanças climáticas em âmbito municipal e metropolitano. A metodologia foi aplicada na Região Metropolitana de São Paulo (RMSP), utilizando os dados relativos a Meio Ambiente e Gestão de Riscos, da Pesquisa Nacional de Informações Municipais do IBGE (Munic), edições de 2013, 2017 e 2020. Os resultados indicam perda consistente das capacidades institucionais de enfrentamento das mudanças climáticas entre 2013 e 2020. Há uma diferença considerável no padrão dessa perda quando a análise incide separadamente sobre a capacidade institucional para lidar com os temas da gestão ambiental e da gestão de riscos de desastres. metropolitano RMSP, RMSP , (RMSP) Riscos Munic, Munic (Munic) 201 2020 desastres (RMSP (Munic 20 202 2

Abstract This article proposes a methodology of analysis of the institutional capabilities that are employed to cope with climate change at the municipal and metropolitan levels. The methodology was applied to the São Paulo Metropolitan Region using Environmental and Disaster Risk Management data, collected by the Brazilian Institute of Geography and Statistics (IBGE) through the National Survey of Municipal Information (MUNIC), years 2013, 2017, and 2020. The results indicate that municipal institutions consistently lost capabilities to cope with climate change between 2013 and 2020. There is a considerable difference in the pattern of this loss when the analysis focuses separately on institutional capacity to deal with environmental management and with disaster risk management. levels data IBGE (IBGE MUNIC, MUNIC , (MUNIC) 2017 2020 201 (MUNIC 202 20 2

ABSTRACT Mural endocarditis is an uncommon form of intracardiac infection affecting the non valvular endocardium that can present with complications similar to valvular infective endocarditis. Echocardiography is recommended to confirm the diagnosis when there is a high index of suspicion. Regarding treatment, there is limited evidence about therapeutic strategies in mural endocarditis, however in most reported cases it is recommended to initiate targeted antibiotic therapy associated with early surgical intervention. The following is a clinical case of a 74-year-old male patient with systemic embolic phenomena, in whom a transesophageal echocardiogram documented mural endocarditis in the apex of the left ventricle associated with Staphylococcus aureus bacteremia. This case highlights the importance of a detailed echocardiographic assessment of the cardiac valves and chambers when infective endocarditis is suspected.

RESUMEN La endocarditis mural es una forma infrecuente de infección intracardiaca que afecta al endocardio no valvular que pue- de presentarse con complicaciones similares a la endocarditis infecciosa valvular. Se recomienda la ecocardiografía para confirmar el diagnóstico cuando exista un alto índice de sospecha. Con respecto al tratamiento, existe evidencia limitada acerca de las estrategias terapéuticas en la endocarditis mural, sin embargo en la mayoría de casos reportados se recomienda iniciar antibioticoterapia dirigida asociado a una intervención quirúrgica precoz. A continuación, se presenta un caso clínico de un paciente masculino de 74 años con fenómenos embólicos sistémicos, en quien se documenta por ecocardiograma transesofágico una endocarditis mural en ápex del ventrículo izquierdo asociado a una bacteriemia por Staphylococcus aureus. Este caso pone de manifiesto la importancia de una valoración ecocardiográfica detallada de las válvulas y cámaras cardíacas ante la sospecha de una endocarditis infecciosa.

Resumen Introducción: Las especies de Mesochorus se encuentran en todo el mundo y los miembros de este género son principalmente hiperparasitoides de las familias Ichneumonoidea y Tachinidae. Objetivos: Describir las especies de Mesochorus costarricenses obtenidas de orugas y en menor medida por trampas Malaise. Métodos: Las especies se diagnosticaron mediante el uso de código de barra molecular por COI del ADNmt, inspección morfológica y datos del huésped. Se proporciona un conjunto de imágenes y datos de los huéspedes (planta, oruga y parasitoide primario) para cada especie. Resultados: Se encontró un total de 158 nuevas especies de Mesochorus. Sharkey es la autoridad taxonómica para todas las especies. Conclusiones: Se demuestra una aplicación práctica del código de barras de ADN que se puede aplicar a grandes cantidades de especies de insectos neotropicales no descritas para grupos hiperdiversos.

Abstract Introduction: Species of Mesochorus are found worldwide and members of this genus are primarily hyperparasitoids of Ichneumonoidea and Tachinidae. Objectives: To describe species of Costa Rican Mesochorus reared from caterpillars and to a lesser extent Malaise-trapped. Methods: The species are diagnosed by COI mtDNA barcodes, morphological inspection, and host data. A suite of images and host data (plant, caterpillar, and primary parasitoid) are provided for each species. Results: A total of 158 new species of Mesochorus. Sharkey is the taxonomic authority for all. Conclusions: This demonstrates a practical application of DNA barcoding that can be applied to the masses of undescribed neotropical insect species in hyperdiverse groups.

Resumen La alfalfa (Medicago sativa) es originaria de Asia Central, esta leguminosa se siembra en todo México, contribuye a la regeneración de la fertilidad del suelo, además, su elevado contenido de proteínas y aminoácidos ayuda a la reducción de costos de producción de carne y leche. El objetivo del presente trabajo fue valuar diferentes densidades de siembra y la efectividad del extracto a base de exudados de alfalfa sobre plántulas de Arabidopsis thaliana (L.) Heynh. Se empleó semilla de alfalfa variedad San Miguelito y Belleza Verde. La siembra se estableció en cajas Petri en el Tecnológico Nacional de México Campus Roque en noviembre de 2018. Se utilizaron tres densidades de siembra 3, 6 y 9 kg ha-1. Todas las variables se sometieron a un análisis de varianza y una comparación de medias, con el paquete SAS 9.0. El desarrollo radicular de la alfalfa fue afectado por la densidad de siembra, en particular al desarrollo de raíces laterales y presencia de pelos radicales, no así para la longitud de la raíz. La densidad de siembra con mayor desarrollo radicular fue con los 9 kg ha-1. Los exudados de la alfalfa presentaron un efecto antagónico muy marcado sobre Arabidopsis thaliana al reducir su crecimiento, este efecto fue más alto para la densidad de 9 kg ha-1. Una concentración de 50% o más de exudados de alfalfa disminuye el crecimiento hasta llegar a la muerte de esta Arabidopsis thaliana.

Abstract Alfalfa (Medicago sativa) is native to Central Asia, this legume is sown throughout Mexico, contributes to the regeneration of soil fertility, in addition, its high content of proteins and amino acids helps reduce costs of meat and milk production. The objective of this study was to evaluate different sowing densities and the effectiveness of the extract based on alfalfa exudates on seedlings of Arabidopsis thaliana (L.) Heynh. Seeds of the alfalfa varieties San Miguelito and Belleza Verde were used. Sowing was established in Petri dishes at the National Technological Institute of Mexico, Roque campus in November 2018. Three sowing densities, 3, 6 and 9 kg ha-1, were used. All variables were subjected to an analysis of variance and a comparison of means, with the SAS 9.0 package. The sowing density affected the root development of alfalfa, in particular the development of lateral roots and the presence of root hairs, but not the root length. The sowing density with the highest root development was with 9 kg ha-1. The exudates of alfalfa presented a very marked antagonistic effect on Arabidopsis thaliana by reducing its growth, this effect was higher for the density of 9 kg ha-1. A concentration of 50% or more of alfalfa exudates slows the growth until death of this Arabidopsis thaliana.

RESUMO Em espécies fruteiras, é essencial considerar o gerenciamento da distribuição da luz nas copas das plantas, pois a quantidade de energia solar absorvida pode influenciar na qualidade dos frutos. Diante disso, os objetivos deste estudo foram: (i) analisar as variações das trocas gasosas ao longo do dia; (ii) identificar a densidade de fluxo de fótons fotossinteticamente ativos (PPFD) que promove maior fluorescência da clorofila e maior taxa de transporte de elétrons em mudas de jaboticaba. O delineamento experimental foi inteiramente casualizado, sendo os tratamentos compostos por 18 densidades de fluxo de fótons fotossinteticamente ativos (0; 25; 50; 75; 100; 125; 150; 175; 200; 400; 600; 800; 1.000; 1.200; 1.400; 1.600; 1.800 e 2.000 μmol m-2 s-1) e três horários de avaliação ao longo do dia (08:00, 12:00 e 16:00 h). Foram utilizadas seis repetições, considerando duas plantas por parcela útil. Trocas gasosas e fluorescência da clorofila a de P. peruviana foram alterados em virtude da PPFD e das condições ambientais ao longo do dia. A alta PPFD (1.384,6 μmol m-2 s-1) e temperatura do ar (39,74 °C) no horário de 12 horas favoreceu as trocas gasosas dessa espécie. O aumento da PPFD até 1.000 µmol m-2 s-1 influenciou positivamente as trocas gasosas e fluorescência da clorofila a de P. peruviana. fruteiras frutos disso i (i ii (ii (PPFD jaboticaba casualizado 1 0 (0 25 50 75 100 125 150 175 200 400 600 800 1000 000 1.200 1200 1.400 1400 1.600 1600 1800 1.80 2000 2 2.00 m2 m m- s1 s 0800, 0800 08 00, 00 (08:00 12:0 16 16:0 h. h . h) repetições útil P 1.384,6 13846 384 6 (1.384, 39,74 3974 39 74 (39,7 °C C espécie 1.00 s- ( 5 7 10 15 17 20 40 60 80 1.20 120 1.40 140 1.60 160 180 1.8 2.0 080 (08:0 12: 16: 1.384, 1384 38 (1.384 39,7 397 3 (39, 1.0 4 8 1.2 1.4 14 1.6 1. 2. (08: 1.384 138 (1.38 39, (39 (08 1.38 13 (1.3 (3 1.3 (1. (1

ABSTRACT In fruit species, the amount of solar energy absorbed can influence fruit quality; hence, ensuring optimal light distribution management in the canopy of plants is essential. Therefore, the objectives of this study were (i) to analyze the variations in gas exchange through the day and (ii) identify the photosynthetically active photon flux density (PPFD) that promotes higher chlorophyll fluorescence and electron transport rate in jaboticaba seedlings. The experimental design was completely randomized, with treatments consisting of 18 photosynthetic photon flux densities and three evaluations throughout the day. Six replicates were used, with two plants per plot. Gas exchange and chlorophyll a fluorescence in P. peruviana were altered due to fluctuating photosynthetic photon flux density (0; 25; 50; 75; 100; 125; 150; 175; 200; 400; 600; 800; 1,000; 1,200; 1,400; 1,600; 1,800; and 2,000 μmol m-2 s-1) and environmental conditions throughout the day (8:00 a.m., 12:00 and 4:00 p.m.). The higher PPFD (1,384.6 μmol m-2 s-1) and air temperature (39.74 °C) at noon (12:00 p.m.) favored gas exchange in this species. An increase in PPFD of up to 1,000 μmol m-2 s-1 positively influenced the gas exchange and chlorophyll a fluorescence of P. peruviana. species quality hence essential Therefore i (i ii (ii (PPFD seedlings randomized 1 used plot P 0 (0 25 50 75 100 125 150 175 200 400 600 800 1000 000 1,200 1200 1,400 1400 1,600 1600 1,800 1800 2000 2 2,00 m2 m m- s1 s 8 00 (8:0 am a.m. 12 12:0 4 4:0 p.m.. pm p.m. . p 1,384.6 13846 384 6 (1,384. 39.74 3974 39 74 (39.7 °C C (12:0 1,00 s- ( 5 7 10 15 17 20 40 60 80 1,20 120 1,40 140 1,60 160 1,80 180 2,0 (8: a.m 12: 4: p.m 1,384. 1384 38 (1,384 39.7 397 3 (39. (12: 1,0 1,2 1,4 14 1,6 16 1,8 2, (8 1,384 138 (1,38 39. (39 (12 1, 1,38 13 (1,3 (3 (1 1,3 (1,

ABSTRACT Introduction: Variegate porphyria (VP) is a rare disease, resulting from mutation of the protoporphyrinogen oxidase (PPOX) enzyme gene, and it is characterized by cutaneous manifestations and acute neuro-visceral symptoms. Case report: We describe the case of a 21-year-old woman from Peruvian highlands. The patient came to the emergency department for abdominal pain, quadriparesis and reddish urine. The patient also presented the syndrome of inappropriate secretion of antidiuretic hormone (SIADH), motor neuropathy and respiratory failure. These clinical features were diagnosed as consequence of a porphyria crisis. The specific diagnosis was made with an elevated urinary porphobilinogen level (185.7 mg/24hours) and genetic analysis, which showed a rare pathogenic variant of the PPOX gene (nucleotide change: c.78C>A and protein change: p.Cys26*). The patient required intensive care until the administration of specific treatment with hemin. Conclusion: We report a case of VP with a pathogenic variant in the PPOX gene.

RESUMEN Introducción: La porfiria variegada (PV) es una enfermedad rara, resultante de la mutación del gen de la enzima protoporfirinógeno oxidasa (PPOX), se caracteriza por manifestaciones cutáneas y síntomas neuroviscerales agudos. Reporte de caso: Describimos el caso de una mujer de 21 años de la sierra peruana. La paciente acudió al servicio de urgencias por dolor abdominal, cuadriparesia y orina rojiza. La paciente también presentó el síndrome de secreción inapropiada de hormona antidiurética (SIADH), neuropatía motora e insuficiencia respiratoria. Estas características clínicas fueron diagnosticadas como consecuencia de una crisis de porfiria. El diagnóstico específico se realizó con un nivel elevado de porfobilinógeno en orina (185,7 mg/24horas) y el análisis genético, evidenció un rara variante patogénica del gen PPOX (cambio de nucleótido: c.78C>A y consecuentemente cambio de proteína: p.Cys26*). La paciente requirió cuidados intensivos hasta la administración de un tratamiento específico con hemina. Conclusion: Reportamos un caso de VP con una rara variante mutagénica en el gen PPOX.

RESUMO Nesta pesquisa, foi estudado o impacto ambiental do sistema UASB/Biofiltro Anaeróbio (reator anaeróbio de manta de lodo — UASB/BFA) + wetland construído do tipo floating (WCF) + wetland construído de fluxo vertical-célula de combustível microbiana (WCFV-CCM) + filtro misto com suporte reativo (FLR), aplicado para remediação em escala piloto de efluentes urbanos em um campus universitário. Foram feitos cenários de propostas de mudanças das configurações da estação de tratamento de efluente (ETE) (Cenários 2 e 3). O sistema do Cenário 1 foi operado em pulsos, com aplicação de 2,9 m3 de efluente de campus universitário semanalmente. A energia necessária para o bombeamento na unidade em escala piloto (Cenário 1) e para a potencial aplicação com fluxo por escoamento (Cenário 2) foi inventariada, considerando materiais de construção e processamento, especialmente com o controle de carga poluente nos efluentes líquidos e atmosféricos. O software SimaPro 8.0.4 foi utilizado, tendo como unidade funcional 2,9 m3 semana-1 de efluente e fluxo de referência de 20 anos. Os resultados demonstraram que os materiais da construção do sistema contribuíram com 84,8% (em pontuação única — Pt), e a operação do sistema do Cenário 2 contribuiu com 15,2%, sem o uso de energia elétrica para o bombeamento. Já o Cenário 3 mostrou que a substituição dos tanques de fibra de vidro por tanques de fibrocimento poderia ajudar a reduzir os impactos ambientais na fase de construção do sistema em até 58,6% em termos de uso de energia e até 80% nas emissões de poluentes carcinogênicos. pesquisa UASBBiofiltro UASB Biofiltro reator UASB/BFA UASBBFA BFA WCF (WCF verticalcélula vertical célula WCFVCCM WCFV CCM (WCFV-CCM FLR, FLR , (FLR) ETE (ETE Cenários 3. . 3) pulsos 29 9 2, m semanalmente inventariada processamento atmosféricos 804 8 0 4 8.0. utilizado semana1 semana semana- anos 848 84 84,8 Pt, Pt Pt) 152 15 15,2% 586 58 6 58,6 80 carcinogênicos (FLR 8.0 84, 15,2 5 58, 8. 15,

ABSTRACT This research studied the environmental impact of the UASB/anaerobic biofilter system (anaerobic sludge blanket reactor — UASB/ABF) + floating-type constructed wetland (FCW) + vertical flow constructed wetland — microbial fuel cell (FVCW-MFC) + mixed filter with reactive support (MFRS), applied for pilot-scale remediation of urban effluents on a university campus. Scenarios for proposed changes to the settings of the wastewater treatment plant (WTP) were made (Scenarios 2 and 3). The Scenario 1 system was operated in pulses, with the application of 2.9 m3 of university campus effluent per week. Energy required for pumping in the pilot scale unit (Scenario 1) and for potential application with runoff flow (Scenario 2) were inventoried, considering materials for construction and processing, especially with the control of pollutant load in liquid and atmospheric effluents. The SimaPro 8.0.4 software was used, with a functional unit of 2.9 m3 week-1 of effluent and a reference flow of 20 years. The results showed a contribution of 84.8% (in single score — Pt) for the system's construction materials, as well as 15.2% for the operation of the Scenario 2 system, without the use of electricity for pumping. Scenario 3, on the other hand, showed that replacing fiberglass tanks with fiber cement tanks could help reduce environmental impacts during the construction phase of the system by up to 58.6% in terms of energy use and up to 80% in emissions of carcinogenic pollutants. UASBanaerobic UASB anaerobic UASB/ABF UASBABF ABF floatingtype floating type FCW (FCW FVCWMFC FVCW MFC (FVCW-MFC MFRS, MFRS , (MFRS) pilotscale WTP (WTP 3. 3 . 3) pulses 29 9 2. m week inventoried processing 804 8 0 4 8.0. used week1 week- years 848 84 84.8 Pt systems s 152 15 15.2 hand 586 58 6 58.6 80 pollutants (MFRS 8.0 84. 15. 5 58. 8.

RESUMO Introdução: O objetivo deste estudo foi apresentar uma revisão sistemática e metanálise para comparar os efeitos de dois modelos de intervenção de treinamento sobre o consumo excessivo de oxigênio pós-exercício (EPOC) em indivíduos saudáveis em treinamento, e o objetivo secundário foi entender se o consumo de oxigênio depois de exercício realmente pode proporcionar ajuda substancial. Objetivo: Elaborar uma revisão de metanálise para comparar um modelo de treinamento de duas intervenções (experimental: treinamento intervalado de alta intensidade, e controle: contínuo de intensidade moderada) e o efeito sobre o EPOC total em indivíduos saudáveis. Participantes: Os 17 estudos foram considerados de boa qualidade metodológica e baixo risco de viés. Métodos: As buscas bibliográficas foram realizadas nos bancos de dados eletrônicos sem restrição de ano de publicação. Os descritores usados foram obtidos em MeSH (PubMed) e DeCS (Descritores em Ciências da Saúde da BIREME). Resultados: Os achados do presente estudo mostraram uma tendência (modelo de efeitos aleatórios: 0,87, IC 95% [0,35;1,38], I ² = 73%, p < 0,01) de aumento do EPOC quando as medidas foram realizadas depois de treinamento intervalado de alta intensidade. Conclusões: Nosso estudo concentrou-se na análise dos resultados de alta e moderada intensidade no consumo de oxigênio depois do exercício. Apesar da crescente popularidade do treinamento intervalado de alta intensidade, descobrimos que os benefícios agudos e crônicos permanecem limitados. Entendemos que a falta de um protocolo e variáveis padronizadas de treinamento fornecem consenso limitado para determinar a magnitude do EPOC. Sugerimos que estudos experimentais longitudinais podem fornecer conclusões mais robustas. Outro fator de confusão nos estudos investigados foi a magnitude (tempo em minutos) das medidas do VO2na avaliação do EPOC. Os tempos de medição variaram de 60 a 720 min. Estudos longitudinais e projetos experimentais controlados facilitariam medições mais precisas e números corretos de indivíduos forneceriam tamanhos de efeito precisos. Nível de evidência II; Revisão sistemáticabde Estudos.

ABSTRACT Introduction: The objective of this study was to present a systematic review and meta-analysis to compare total excess post-exercise oxygen consumption (EPOC) for two training intervention models in healthy individuals, and the secondary objective was to understand whether oxygen consumption after exercise could really promote a meaningful help. Design: To design a meta-analysis review to compare two training intervention models (experimental: high-intensity interval training; and control: continuous moderate-intensity) and their effects on total EPOC in healthy individuals. Participants: Seventeen studies were considered to be of good methodological quality and with a low risk of bias. Methods: Literature searches were performed using the electronic databases with no restriction on year of publication. The keywords used were obtained by consulting Mesh Terms (PubMed) and DeCS (BIREME Health Science Descriptors). Results: The present study findings showed a tendency (random-effects model: 0.87, 95%-CI [0.35,1.38], I2=73%, p<0.01) to increase EPOC when measured following high-intensity interval training. Conclusions: Our study focused on the analysis of high- and moderate-intensity oxygen uptake results following exercise. Despite the growing popularity of high-intensity interval training, we found that the acute and chronic benefits remain limited. We understand that the lack of a standard protocol and standard training variables provides limited consensus to determine the magnitude of the EPOC. We suggest that longitudinal experimental studies may provide more robust conclusions. Another confounding factor in the studies investigated was the magnitude (time in minutes) of VO2 measurements when assessing EPOC. Measurement times ranged from 60 min to 720 min. Longitudinal studies and controlled experimental designs would facilitate more precise measurements and correct subject numbers would provide accurate effect sizes. Systematic reviewb of Level II studies.

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ABSTRACT The Pan American Health Organization’s Revolving Fund for Access to Vaccines (the Revolving Fund) is a shared pool of funds for the procurement of vaccines, syringes, and cold-chain equipment for the Member States of the Organization. With a view to evaluating the results obtained during the Revolving Fund’s operation and analyzing its contributions to achievements in immunization, a review was conducted of historical documents and grey literature related to the Fund’s history and current processes, as well as data from platforms fed by countries’ annual reports, with reference to growth indicators, burden of vaccine-preventable diseases, introduction of new vaccines in the Region of the Americas, and lessons learned. In its 43 years of operation, the Revolving Fund has grown and contributed to the introduction of new vaccines, and the Region has made rapid progress in the field of immunization. However, several countries and territories in the Region have not yet introduced certain vaccines due to their high cost and the economic impact of sustainably administering them. The requirement to obtain the lowest possible price and to set a uniform price for all participating Member States has been instrumental in the Revolving Fund’s contribution to the vaccination goals of national immunization programs, and for timely planning of demand, accompanied by technical advice. An interprogrammatic approach and the planning of auxiliary inputs are key to the success of the programs. Pandemic preparedness, regional vaccine production, and the protection of national budgets for sustainable procurement of high-cost vaccines are current and future challenges.

RESUMO O Fundo Rotativo para Acesso a Vacinas (FR) da Organização Pan-Americana de Saúde é um fundo comum de capital e compra conjunta de vacinas, seringas e equipamento da cadeia de frio para os Estados Membros da Organização. Com o objetivo de avaliar os resultados obtidos durante sua operação e analisar sua contribuição para os êxitos da imunização, procedeu-se a uma revisão de documentos históricos e da literatura cinzenta relacionados à história do FR e revisaram-se os processos atuais, os dados de plataformas alimentadas pelos relatórios anuais dos países, os indicadores de crescimento, a carga de doenças imunopreveníveis, a introdução de novas vacinas na Região das Américas e as lições aprendidas. Constatou-se que, em seus 43 anos de operação, o FR cresceu e contribuiu para a introdução de novas vacinas e a região avançou com rapidez no campo da imunização. Entretanto, vários países e territórios da região ainda não introduziram determinadas vacinas em razão dos altos preços e do impacto econômico de manter sua administração. A cláusula do menor preço disponível e do preço uniforme para todos os Estados Membros participantes foi fundamental para a contribuição do FR para as metas de vacinação dos programas nacionais de imunização, bem como para o planejamento oportuno da demanda acompanhado pela assessoria técnica. A abordagem interprogramática e o planejamento de insumos auxiliares são necessários para o êxito dos programas. A preparação para pandemias, a produção regional de vacinas e a proteção dos orçamentos nacionais para a compra de vacinas de alto custo e sua sustentabilidade ainda constituem desafios atuais e futuros.

RESUMEN El Fondo Rotatorio para el acceso a las vacunas (FR) de la Organización Panamericana de la Salud es un fondo común de capital y compra mancomunada de vacunas, jeringas y equipo de cadena de frío para los Estados Miembros de la Organización. Con el objetivo de evaluar los resultados obtenidos durante su funcionamiento y analizar su contribución a los logros de inmunización, se llevó a cabo una revisión de documentos históricos y literatura gris relacionados con la historia del FR, y se revisaron los procesos actuales, los datos de plataformas alimentadas por los informes anuales de los países, los indicadores de crecimiento, la carga de enfermedades prevenibles por vacunación, la introducción de nuevas vacunas en la Región de las Américas, y lecciones aprendidas. Se encontró que, en sus 43 años de funcionamiento, el FR ha crecido y ha contribuido a la introducción de nuevas vacunas, y que la Región ha avanzado de manera acelerada en el ámbito de las inmunizaciones. Sin embargo, varios países y territorios de la Región todavía no han introducido ciertas vacunas debido a sus altos precios y al impacto económico del mantenimiento de su administración. La cláusula del precio más bajo posible y del precio uniforme para todos los Estados Miembros participantes ha sido fundamental para la contribución del FR a las metas de vacunación de los programas nacionales de inmunización, así como para la planeación oportuna de la demanda acompañada por la asesoría técnica. El abordaje interprogramático y la planeación de insumos auxiliares son necesarios para el éxito de los programas. La preparación ante pandemias, la producción regional de vacunas y la protección de presupuestos nacionales para la compra de vacunas de alto costo y su sostenibilidad constituyen aún retos en el presente y el futuro.