RESUMEN Introducción: Durante el acto de la prescripción se deben relacionar los conocimientos de la terapéutica con los principios de la bioética para contribuir al uso racional de medicamentos. En el artículo se analiza el cumplimiento de los principios bioéticos relacionados con las prescripciones de medicamentos por los médicos generales integrales del municipio Santiago de Cuba. Métodos: Se realizó un estudio descriptivo transversal con una muestra de médicos generales integrales en el que se emplearon métodos teóricos, empíricos y matemáticos estadísticos, así como la triangulación metodológica. Se consideró como variable el cumplimiento de los principios bioéticos relacionados con las prescripciones de medicamentos y cinco indicadores que fueron valorados mediante encuesta, entrevista y observación del desempeño. Resultados: Se encontró que los médicos generales integrales alcanzaron un nivel alto de cumplimiento de los principios bioéticos relacionados con las prescripciones de medicamentos con un valor de media ponderada de 2,94. La valoración de la frecuencia de realización de los indicadores evidenció que tres de ellos fueron considerados del nivel alto, dos de nivel medio y ninguno de nivel bajo. Discusión: los resultados fueron confrontados con otros estudios y se confirma que los médicos generales integrales en Cuba por su formación humanista cumplen con la mayoría de los principios bioéticos en su desempeño profesional.

ABSTRACT Introduction: During the act of prescription, therapeutic knowledge must be related to the principles of bioethics to contribute to the rational use of medications. The article analyzes compliance with bioethical principles related to medication prescriptions by comprehensive general practitioners of the Santiago de Cuba municipality. Methods: A cross-sectional descriptive study was carried out with a sample of comprehensive general practitioners in which theoretical, empirical and mathematical statistical methods were used, as well as methodological triangulation. Compliance with bioethical principles related to medication prescriptions and five indicators that were assessed through a survey, interview and performance observation were considered as variables. Results: It was found that comprehensive general practitioners reached a high level of compliance with bioethical principles related to medication prescriptions with a weighted mean value of 2.94. The assessment of the frequency of carrying out the indicators showed that three of them were considered high level, two medium level and none low level. Discussion: the results were compared with con studies and it is confirmed that comprehensive general practitioners in Cuba, due to their humanistic training, comply with most of the bioethical principles in their professional performance.

RESUMEN Fundamento la infección por SARS-CoV-2 es la enfermedad emergente más importante del presente siglo. En dicho contexto, el Grupo de las Industrias Biotecnológica y Farmacéutica Cubanas (BioCubaFarma) creó alternativas terapéuticas para combatir la COVID-19, entre ellas el uso de Jusvinza, la cual forma parte del protocolo utilizado en el país. Objetivo determinar la resolutividad terapéutica de Jusvinza en pacientes confirmados de COVID-19. Métodos se realizó un estudio descriptivo, durante el periodo de enero a septiembre de 2021, en el Hospital Militar Dr. Joaquín Castillo Duany, de Santiago de Cuba. El universo estuvo constituido por 166 confirmados de COVID-19, a quienes se administró Jusvinza. Se analizaron algunas variables clínicas (estado clínico, enfermedades no transmisibles asociadas, progresión clínica), epidemiológicas (edad, sexo) y farmacológicas (resolutividad, duración en días). Se utilizó una planilla de vaciamiento de datos, los cuales fueron tomados de las historias clínicas. Resultados la morbimortalidad por COVID-19 fue superior en el sexo masculino, asociado a comorbilidades y edad mayor de 60 años; el sexo femenino resultó el de mayor resolutividad al tratamiento con Jusvinza (71,7 %), la cual incrementó su porcentaje en ausencia de enfermedades crónicas no transmisibles asociadas (81,4 %). Los pacientes de alto riesgo fueron los de más baja mortalidad (15,8 %). Conclusiones la resolutividad en pacientes confirmados de COVID-19 tratados con Jusvinza fue más elevada en casos de alto riesgo que en graves y críticos.

ABSTRACT Foundation SARS-CoV-2 infection is the most important emerging disease of this century. In this context, the Cuban Biotechnology and Pharmaceutical Industries Group (BioCubaFarma) created therapeutic alternatives to combat COVID-19, including the use of Jusvinza, which is part of the protocol used in the country. Objective to determine the Jusvinza therapeutic resolution in confirmed COVID-19 patients. Methods a descriptive study carried out from January to September 2021, at the Dr. Joaquín Castillo Duany Military Hospital, in Santiago de Cuba. The universe consisted of 166 confirmed COVID-19 cases, to whom Jusvinza was administered. Some clinical variables (clinical status, associated non-communicable diseases, clinical progression), epidemiological (age, sex) and pharmacological (resolving, duration in days) were analyzed. A data extraction form was used, which was taken from the medical records. Results morbidity and mortality from COVID-19 was higher in males, related to comorbidities and age over 60 years; The female sex was the one with the greatest response to treatment with Jusvinza (71.7%), which increased its percentage in the absence of associated chronic non-communicable diseases (81.4%). High-risk patients had the lowest mortality (15.8%). Conclusions resolution in confirmed COVID-19 patients treated with Jusvinza was higher in high-risk cases than in severe and critical cases.

Resumen Objetivo Comprender los desafíos enfrentados por la educación permanente para lograr mejorar la calidad y la seguridad del paciente en un hospital público sometido a acreditación hospitalaria. Métodos Estudio descriptivo, transversal y con enfoque cualitativo. Se realizaron entrevistas semiestructuradas a 22 profesionales, con duración promedio de 22 minutos, que luego se analizaron e interpretaron mediante el análisis de contenido temático de Bardin. Se utilizaron los softwares Iramuteq para el análisis de corpus textual y BioEstat 5.3 para el análisis del perfil de los participantes. La recopilación de datos se llevó a cabo en junio de 2022, después de la aprobación de los Comités de Ética en Investigación. Resultados Se aplicó el análisis de clasificación jerárquica descendente, generado por Iramuteq. Se obtuvieron tres categorías: Desafíos de la educación permanente mediante el proceso de mejora continua, Educación permanente para la promoción de la calidad y de la seguridad del paciente en el contexto de la acreditación hospitalaria, y Estrategias educativas para la mejora de la calidad y la seguridad del paciente. Conclusión Se identificaron desafíos inherentes a las acciones de educación permanente en salud, tales como resistencia a cambios de cultura, adherencia a las actividades, alta rotación de profesionales y dificultad de autorizar al equipo de enfermería para participar en las actividades relacionadas con la demanda de trabajo. hospitalaria descriptivo cualitativo 2 minutos Bardin 53 5 3 5. participantes 2022 Investigación descendente categorías continua salud cultura trabajo 202 20

Abstract Objective To understand the challenges faced in terms of permanent education in health, for achieving quality improvements and patient safety at a public hospital undergoing hospital accreditation. Methods This was a descriptive, cross-sectional study with a qualitative approach. Semi-structured interviews were conducted with 22 professionals, lasting an average of 22 minutes. The interviews were subsequently analyzed and interpreted using Bardin’s thematic content analysis. The software Iramuteq was used to analyze the textual corpus, and BioEstat 5.3 was used to analyze the profile of the participants. The data collection took place in June 2022, following approval by the Research Ethics Committees. Results The descending hierarchical classification analysis, generated by Iramuteq, was applied, resulting in three categories: Challenges of Permanent Education through the Continuous Improvement Process, Permanent Education for the Promotion of Quality and Patient Safety in the Context of Hospital Accreditation, and Educational Strategies for Improving Quality and Patient Safety. Conclusion Challenges inherent to the actions of permanent education in health were identified, such as resistance to cultural change, adherence to activities, high turnover of professionals, and difficulty in releasing the nursing team to participate in activities, due to work demand. accreditation descriptive crosssectional cross sectional approach Semistructured Semi structured 2 professionals minutes Bardins Bardin s analysis corpus 53 5 3 5. participants 2022 Committees applied categories Process Accreditation identified change activities demand 202 20

Resumo Objetivo Compreender os desafios enfrentados pela educação permanente para o alcance da melhoria da qualidade e da segurança do paciente em um hospital público submetido à acreditação hospitalar. Métodos Estudo descritivo, transversal e com abordagem qualitativa. Realizaram-se entrevistas semiestruturadas com 22 profissionais, durando, em média, 22 minutos, as quais posteriormente foram analisadas e interpretadas por meio da análise de conteúdo temática de Bardin. Adotaram-se os softwares Iramuteq para a análise de corpus textual, e o BioEstat 5.3, para análise do perfil dos participantes. A coleta de dados ocorreu em junho de 2022, após aprovação nos Comitês de Ética em Pesquisa. Resultados Aplicou-se a análise de classificação hierárquica descendente, gerada pelo Iramuteq. Obtiveram-se três categorias: Desafios da Educação Permanente mediante o Processo de Melhoria Contínua; Educação Permanente para a Promoção da Qualidade e da Segurança do Paciente no Contexto da Acreditação Hospitalar; e Estratégias Educativas para a Melhoria da Qualidade e da Segurança do Paciente. Conclusão Identificaram-se desafios inerentes às ações de educação permanente em saúde, tais como resistência à mudança de cultura, adesão às atividades, alta rotatividade de profissionais e dificuldade para liberação da equipe de enfermagem para participar das atividades relacionadas à demanda de trabalho. hospitalar descritivo qualitativa Realizaramse Realizaram se 2 durando média minutos Bardin Adotaramse Adotaram textual 53 5 3 5.3 participantes 2022 Pesquisa Aplicouse Aplicou descendente Obtiveramse Obtiveram categorias Contínua Hospitalar Identificaramse Identificaram saúde cultura trabalho 5. 202 20

Abstract This study verified the effect of the combination of preheated hydrofluoric acid/silane/electric current in the adhesion of the resin cement to ceramic. IPS E.max Press ceramic discs embedded in PVC rigid tubes were divided into four groups associating preheated hydrofluoric acid and silane applied with electrical current (n=10): Ha+S (Heated acid + silane); Ha+S+Ec (Heated acid + silane + electrical current); A+S (Acid + silane) and A+S+Ec (Acid + silano + electrical current). Resin cement/ceramic samples were stored in water at 37°C for 24h. After storage, they were submitted to the microshear test, fracture analysis, and contact angle at 24h or after thermocycling (10,000 cycles/5-55ºC). Bond strength data were evaluated by two-way ANOVA. For comparison between evaluation times (24h or thermocycling) was applied unpaired t-test. A significance post-hoc test of p=0.05 was assumed for analyses and graphs (GraphPad Prism 9.0 software). At 24h, the microshear strength showed similar values between Ha+S, Ha+S+Ec, and A+S+Ec groups, while A+S showed the lowest value with a statistical difference. After thermocycling, Ha+S and Ha+S+Ec were similar, as well as A+S and A+S+Ec. There was a significant difference in all groups comparing 24h (highest value) with after thermocycling (lowest value). Adhesive fracture was predominant in all groups and evaluation times. Ha+S and A+S groups showed higher contact angle values compared to the Ha+S+Ec and A+S+Ec with lower values. In conclusion, the association of preheated hydrofluoric acid/silane applied or not with electric current promoted different microshear strength values, fracture types, and contact angles in the resin cement/ceramic bond. acidsilaneelectric Emax E max n=10 n10 n 10 (n=10) HaS Ha S Heated HaSEc Ec current) AS Acid ASEc current. . cementceramic 37C C 37 h storage analysis 10,000 10000 000 (10,00 cycles/555ºC. cycles555ºC cyclesºC cycles/5 55ºC cycles 5 ºC cycles/5-55ºC) twoway two way ANOVA ttest. ttest t test. t-test posthoc post hoc p005 p 0 05 p=0.0 GraphPad 90 9 9. software. software software) highest value. conclusion acidsilane types bond n=1 n1 1 (n=10 3 10,00 1000 00 (10,0 555ºC cycles/555ºC cycles5 cycles/ cycles/5-55ºC p00 p=0. n= (n=1 10,0 100 (10, p0 p=0 (n= 10, (10 p= (n (1 (

Resumo Este estudo verificou o efeito da combinação ácido fluorídrico pré-aquecido/silano/corrente elétrica na adesão do cimento resinoso à cerâmica. Os discos cerâmicos IPS E.max Press embutidos em tubos rígidos de PVC foram separados em quatro grupos associando ácido fluorídrico pré-aquecido e silano aplicado com corrente elétrica (n=10): Ha+S (ácido aquecido + silano); Ha+S+Ec (Ácido aquecido + silano + corrente elétrica); A+S (Ácido + silano) e A+S+EC (Ácido + silano + corrente elétrica). Amostras de cimento resinoso/cerâmica foram armazenadas em água a 37°C por 24 horas. Após o armazenamento foram submetidas ao ensaio de micro cisalhamento, análise de fratura e ângulo de contato no período de 24 horas ou após termociclagem (10.000 ciclos/5-55ºC). Os dados de resistência de união foram avaliados por ANOVA dois fatores. Para comparação entre os tempos de avaliação (24 horas ou termociclagem) foi aplicado o teste t não pareado. Foi assumida significância de 5% para análises e gráficos (software GraphPad Prism 9.0). Em 24 horas, a resistência ao micro cisalhamento apresentou valores similares entre os grupos Ha+S, Ha+S+Ec e A+S+Ec, enquanto A+S apresentou menor valor com diferença estatística. Após a termociclagem, Ha+S e Ha+S+Ec foram similares, assim como A+S e A+S+Ec. Houve diferença significativa em todos os grupos comparando 24 horas (maior valor) com após termociclagem (menor valor). A fratura adesiva foi predominante em todos os grupos e tempos de avaliação. Os grupos Ha+S e A+S apresentaram maiores valores de ângulos de contato comparados aos grupos Ha+S+Ec e A+S+Ec com valores menores. Em conclusão, a associação ácido fluorídrico pré-aquecido/silano aplicado com corrente elétrica promoveu diferentes valores de resistência ao micro cisalhamento, tipos de fratura e ângulos de contato na adesão do cimento resinoso à cerâmica. préaquecido/silano/corrente préaquecidosilanocorrente pré aquecido/silano/corrente cerâmica Emax E max préaquecido n=10 n10 n 10 (n=10) HaS Ha S HaSEc Ec Ácido elétrica) AS ASEC EC elétrica. . resinosocerâmica 37C C 37 2 10.000 10000 000 (10.00 ciclos/555ºC. ciclos555ºC ciclosºC ciclos/5 55ºC ciclos 5 ºC ciclos/5-55ºC) fatores (2 pareado software 9.0. 90 9.0 9 0 9.0) ASEc estatística maior valor. menores conclusão préaquecido/silano préaquecidosilano aquecido/silano aquecidosilanocorrente n=1 n1 1 (n=10 3 10.00 1000 00 (10.0 555ºC ciclos/555ºC ciclos5 ciclos/ ciclos/5-55ºC ( 9. aquecidosilano n= (n=1 10.0 100 (10. (n= 10. (10 (n (1

The microwave-assisted interesterification of babassu oil with methyl, ethyl and butyl acetates was carried out via acid catalysis, using sulfuric, phosphoric, methanesulfonic and acetic acids for the production of biodiesel with triacetin as an additive. Dielectric measurements in the range of 0.3 to 13 GHz of pure reactants and reactions media lead to a clear understanding of the interaction between the medium and microwave irradiation, allowing achieving optimal conditions in terms of microwave power, kind and catalyst concentration, reactant molar ratios, and temperatures. Using ethyl acetate, reactions were carried out at various oil to acetate molar ratio (1:12 to 1:72) using sulfuric acid (0.5% m/mT) as a catalyst. For 1:60 molar ratio, the experiments were carried out with 0.5 to 2% m/mT sulfuric acid. The kind of catalyst and the applied microwave power to mass ratio were investigated using H3PO4, CH3COOH and CH3SO3H. The best catalytic activities were achieved with H2SO4 and CH3SO3H. It was found that under microwave or conventional heating the reactivity follows the ethyl→methyl→butyl trend. The best results were achieved using ethyl acetate with H2SO4 which yields 91.1% biodiesel and 18.3% triacetin in 120 min under microwave heating while using CH3SO3H yields 80.1% biodiesel and 11.2% triacetin. microwaveassisted assisted methyl catalysis phosphoric additive 03 0 3 0. 1 irradiation concentration ratios temperatures 112 12 (1:1 172 72 1:72 0.5% 05 5 (0.5 mmT m mT 160 60 1:6 2 H3PO4 HPO H PO CHCOOH CH COOH CHSOH SO HSO H2SO ethylmethylbutyl trend 911 91 91.1 183 18 18.3 801 80 80.1 11 11.2 (1: 17 7 1:7 (0. 16 6 1: H3PO 9 91. 18. 8 80. 11. (1 (0 (

Resumen: En el Ecuador, el acceso a Internet es considerado un servicio básico desde el 2015; sin embargo, apenas el 60% de su población tiene acceso al mismo. El 70% de los ecuatorianos que viven en la zona urbana cuentan con Internet mientras que en la zona rural solo el 38%. En este sentido, el objetivo de este trabajo fue diseñar e implementar un sistema de transmisión de texto e imagen a través de la radio FM tradicional basado en la tecnología data-over-sound para que pueda ser utilizado como una herramienta para reducir la brecha digital de las zonas rurales. Se construyeron un prototipo transmisor y otro receptor, se codificaron los datos aplicando la técnica de modulación BPSK y se enviaron a diferentes tasas de transmisión 4800, 9600, 19200, 76800 y 11500 bits por segundo (bps). Para evaluar el funcionamiento del dispositivo, se midió la tasa de error definida como la relación entre el número de bits trasmitidos y el de recibidos. Como resultado, se obtuvo una tasa de error mínima de 58% a una velocidad de 4800 bps y máxima de 61.25% a 115200 bps, así mismo, el sistema permitió enviar imágenes de hasta 256 píxeles. A diferencia de otros trabajos relacionados, esta propuesta no solo que superará por mucho la distancia de cobertura si no que puede ser implementada sobre una infraestructura de radiodifusión existente para llegar con la información a los sectores más vulnerables

Abstract: In Ecuador, Internet access has been considered an essential service since 2015; however, only 60% of its population has access. 70% of Ecuadorians in urban areas have Internet access, whereas only 38% in rural areas do. In this sense, this work aimed to design and implement a text and image transmission system through traditional FM radio based on data-over-sound technology so that it can be used as a tool to reduce the digital divide in rural areas. A transmitter and a receiver prototype were built, and the data was encoded using the BPSK modulation technique and sent at different transmission rates: 4800, 9600, 19200, 76800, and 11500 bits per second (bps). The error rate was measured to evaluate the operation of the device, defined as the ratio between the number of bits transmitted and the number of bits received. As a result, a minimum error rate of 58% was obtained at a speed of 4800 bps and a maximum of 61.25% at 115200 bps; likewise, the system allowed images of up to 256 pixels to be sent. Unlike other related works, this proposal will not only exceed the coverage distance but can also be implemented on an existing broadcasting infrastructure to reach the most vulnerable.

Abstract This study aimed to verify the association between voice handicaps, physical inactivity, and job dissatisfaction among public school teachers in Minas Gerais, Brazil. An epidemiological, cross-sectional web survey study was performed to do this. The data compilation relevant to this survey was amassed between October 26 and December 31, 2021. A total of 1782 teachers participated in this study. The outcome variable used was the Voice Handicap Index 10 (VHI-10), which makes it possible to quantify the individual’s perception of vocal alteration. The higher the result, the greater the voice handicap perceived by the subject. In addition to sociodemographic and occupational aspects, physical activity was evaluated by the International Physical Activity Questionnaire (IPAQ) in its short form. The level of job satisfaction was expressed through the simple validated question: “Are you satisfied with your job?”. The multivariate statistical analysis was Poisson regression with robust variance. Voice handicap was present in 20.2% of the teachers and was associated with being female (PR = 1.32; CI95%: 1.03-1.70), teaching time (PR = 1.26; CI95%: 1.26-1.04), job dissatisfaction (PR = 1.96; CI95%: 1.59-2.42) and physical inactivity (PR = 1.24; CI95%: 1.00-1.52). The study was carried out at the beginning of the teachers’ return to in-school classes and found that a fifth reported a perception of voice handicap, pointing to the need for greater attention to the work environment and the importance of physical activity for voice health.

Resumo O objetivo deste estudo foi verificar a associação entre desvantagem vocal e variáveis inatividade física e insatisfação no trabalho entre professores da rede pública de Minas Gerais, Brasil. Trata-se de estudo epidemiológico, transversal do tipo websurvey. Participaram do estudo 1782 professores. A coleta de dados ocorreu entre 26 de outubro e 31 de dezembro de 2021. A variável desfecho foi o Índice de Desvantagem Vocal 10 (IDV-10) que possibilita quantificar a percepção do indivíduo sobre sua alteração vocal. Quanto maior o resultado, maior a desvantagem vocal percebida pelo sujeito. Além dos aspectos sociodemográficos e ocupacionais, foi avaliada a atividade física pelo Questionário Internacional de Atividade Física (IPAQ), em sua forma curta e a satisfação no trabalho por meio da pergunta já validada: “Você está satisfeito com o seu trabalho?”. A análise estatística multivariada foi a regressão de Poisson com variância robusta. A desvantagem vocal esteve presente em 20.2% dos professores e apresentou associação com o sexo feminino (RP = 1.32; IC95%: 1.03-1.70) o tempo de docência (RP = 1.26; IC95%: 1.26-1.04), a insatisfação no trabalho (RP = 1.96; IC95%: 1.59-2.42) e a inatividade física (RP = 1.24; IC95%: 1.00-1.52). No estudo realizado no início do retorno dos professores às aulas presenciais verificou que um quinto referiu percepção de desvantagem vocal apontando para a necessidade de maior atenção ao ambiente de trabalho e sobre a importância da atividade física para a saúde da voz.

Abstract Objective: To determine the prevalence of HIV in individuals by analyzing the influence of social determinants and sexual risk behaviors, in order to estimate the crude and adjusted risks of being HIV positive in the municipality of Solidaridad, state of Quintana Roo, Mexico. Method and Materials: A cross-sectional study was conducted in the municipality of Solidaridad, Quintana Roo, Mexico. Third and fourth generation HIV rapid tests were performed. Descriptive statistics, measures of association (OR and 95 % CI) and p value were calculated for each stratum. Logistic regression models were performed to determine the risk factors associated with being HIV positive in the tests. Results: The sample consisted of 4,800 people, of whom 3,030 were men (63.12%); the mean age was 32.6 years (SD 14.96). The variables included in the multivariate model for being HIV positive are: men who have sex with men with OR=61.20, age 30-39 years OR=1.72, having anal sex OR=2.21, and as a protective factor having health service OR =0.42. Conclusions: This study confirms already known social determinants such as being male and being in economically active age and sexual practices such as: having anal sex and men with men. Being entitled to health services was shown to be the only protective factor.

Resumen Objetivo: Determinar la prevalencia de VIH en personas analizando la influencia de los determinantes sociales y las conductas sexuales de riesgo, para estimar los riesgos crudos y ajustados para ser VIH positivo en el municipio Solidaridad, estado de Quintana Roo, México. Método y Materiales: Se realizó un estudio transversal en el municipio de Solidaridad, Quintana Roo, México. Se realizaron pruebas rápidas de VIH de tercera y cuarta generación. Se calcularon las estadísticas descriptivas, las medidas de asociación (OR e IC del 95 %) y el valor de p para cada estrato. Se realizaron modelos de regresión logística para determinar los factores de riesgo asociados con ser VIH positivo en las pruebas. Resultados: La muestra estuvo compuesta por 4,800 personas de las cuales; 3,030 hombres (63.12%); la edad promedio fue de 32.6 años (D.E. 14.96). Las variables incluidas en el modelo multivariado para ser VIH positivo son: hombres que tienen sexo con hombres con OR=61.20, edad 30-39 años OR=1.72, tener sexo anal OR=2.21, y como factor protector contar con servicio de salud OR =0.42. Conclusiones: Este estudio confirma determinantes sociales ya conocidos como el ser hombre y estar en edad económicamente activa y prácticas sexuales como: el tener sexo anal y hombres con hombres. Contar con derechohabiencia se muestra como único factor protector.

Resumen Introducción La pandemia de COVID-19 provocó el cese de las actividades académicas desde el formato presencial al confinamiento de las clases virtuales, de las que poco se ha estudiado sobre su efecto en la salud mental. Objetivo Determinar los niveles de depresión, ansiedad y estrés en estudiantes de medicina de México y Colombia durante la pandemia de COVID-19; además de comparar depresión, ansiedad y estrés por género, nivel educativo y país. Método Se realizó un estudio transversal con 426 estudiantes de medicina. Los datos se recopilaron mediante una encuesta en línea que contenía el cuestionario DASS-21. Resultados Las puntuaciones generales de depresión, ansiedad y estrés fueron 6.7 ± 1.2, 8.8 ± 1.2 y 5.6 ± 1.2, respectivamente. Las mujeres tuvieron puntajes generales significativamente más altos para depresión (.24-fold increase), ansiedad (.25-fold increase) y estrés (.40-fold increase). El riesgo de ansiedad y estrés por año escolar mostró que los años básicos se asociaron con puntajes más altos que los estudiantes en años los avanzados (.25 y .38-fold increase). Para las mujeres, cursar años básicos mostró un mayor riesgo de depresión en comparación con los estudiantes varones (.38-fold increase). Por último, los estudiantes mexicanos tuvieron un mayor riesgo de depresión y ansiedad (p ≤ .022 y p ≤ .004, respectivamente) pero no de estrés (p ≤ .402) en comparación con los estudiantes Colombianos. Discusión y conclusión Se observó ansiedad y depresión significativas en estudiantes de medicina mexicanos y colombianos. Los factores asociados a un mayor riesgo de depresión y ansiedad fueron; ser estudiante en años básicos además de ser mujer.

Abstract Introduction The COVID-19 pandemic caused the cessation of academic activities from the face-to-face format to confinement and virtual classes, in which little is studied about its effect on mental health. Objective Determine levels of depression, anxiety, and stress in medical students in Mexico and Colombia during the COVID-19 pandemic. Furthermore, depression, anxiety, and stress were compared by gender, education status, and country. Method A cross-sectional study was carried out with 426 medical students. Data was collected using an online survey containing the Depression, Anxiety, Stress Scale (DASS-21) questionnaire. Results Overall scores for depression, anxiety, and stress were 6.7 ± 1.2, 8.8 ± 1.2, and 5.6 ± 1.2, respectively. Females had significantly higher overall scores for depression (.24-fold increase), anxiety (.25-fold increase), and stress (.40-fold increase) than males (p ≤ .01). The risk for anxiety and stress by school year showed that basic years were associated with higher scores than advanced years (.25 and .38-fold increase, respectively). For females, starting medical school did show an increased risk of depression when compared to male students in their basic years (.38-fold increase). Lastly, students from Mexico had an increased risk for depression and anxiety (p ≤ .022 and p ≤ .004, respectively) but not for stress (p ≤ .402), when compared to students from Colombia. Discussion and conclusion Significant anxiety and depression were observed in medical students from Mexico and Colombia. Factors associated with an increased risk of depression and anxiety are students in their basic years as well as being female.

Pasteurella multocida is a gram-negative coccobacillus bacterium found as a commensal in the oropharynx of domestic animals such as cats and dogs and some farm animals. Soft tissue infections and occasionally bacteremia in immunocompromised patients with direct contact with animals are described. We report a 61 year old male with a history of scratches and close contact with domestic cats, with a septic shock originating from a pulmonary focus, requiring mechanical ventilation and vasopressors. Blood cultures disclosed the presence of Pasteurella multocida. He responded successfully to antimicrobials.

ABSTRACT Introduction: Diabetes mellitus should be approached from a holistic approach, where the motivational affective functioning of patients suffering from it is considered. Objective: To determine the motivational affective characteristics in chronic diabetic patients. Methods: A descriptive exploratory study was carried out with a mixed research paradigm, where quantitative and qualitative analyzes were integrated. Responding to this approach, the sample was made up of 10 chronic diabetic subjects, not intending that the findings derived from their study were generalized to the population, but yes, due to their inductive nature, they reflected the perspective of the person experiencing the phenomenon under study. For the research, the psychological analysis of the clinical history, the RAMDI (S), the Dembo-Rubinstein Scale, the Phrase Completion Test, the Composition Technique, as well as the semi-structured interview were applied. Results: Awareness of the disease was found, showing an adequate assessment of it, accompanied by an emotional commitment and personal elaboration in their reflections, where their experiences and life experiences are combined, and giving an emotional-motivational orientation to their behavior. Conclusions: The health category appears as a central and hierarchical motive in these subjects, but despite this, not everyone manages to regulate their behavior in an effective and healthy way.

RESUMEN Introducción : La diabetes mellitus, debe abordarse desde un enfoque holístico, donde se considere el funcionamiento afectivo motivacional de los pacientes que la padecen. Objetivo: Determinar las particularidades afectivo motivacionales en pacientes diabéticos crónicos. Métodos: Se realizó un estudio exploratorio descriptivo con un paradigma de investigación mixto, donde se integraron los análisis cuantitativo y cualitativo. La muestra quedó conformada por 10 sujetos diabéticos crónicos, no se pretendió que los hallazgos derivados de su estudio fuesen generalizados a la población, pero sí, por su carácter inductivo, reflejaran la perspectiva de aquel que vivencia el fenómeno objeto de estudio. Para la pesquisa se aplicó el análisis psicológico de la historia clínica, el RAMDI (S), la Escala Dembo -Rubinstein, el test de completamiento de frases, la técnica de la composición, así como la entrevista semiestructurada. Resultados: Se constató conciencia de la enfermedad, se manifestó una adecuada valoración de la misma, acompañado de un compromiso afectivo y una elaboración personal en sus reflexiones, donde se conjugan sus vivencias y experiencias de vida, que da una orientación afectivo-motivacional a su comportamiento. Conclusiones: La categoría salud aparece como un motivo central y jerárquico en estos sujetos, pero a pesar de esto no todos logran regular su comportamiento de una manera efectiva y saludable.

Abstract We critically analyzed clinical trials performed with chloroquine (CQ) and hydroxychloroquine (HCQ) with or without macrolides during the first wave of COVID-19 and discussed the design and limitations of peer-reviewed studies from January to July 2020. Seventeen studies were eligible for the discussion. CQ and HCQ did not demonstrate clinical advantages that justified their inclusion in therapeutic regimens of free prescription for treatment or prophylactic purposes, as suggested by health authorities, including in Brazil, during the first wave. Around August 2020, robust data had already indicated that pharmacological effects of CQ, HCQ and macrolides as anti-SARS-CoV-2 molecules were limited to in vitro conditions and largely based on retrospective trials with low quality and weak internal validity, which made evidence superficial for decision-making. Up to that point, most randomized and nonrandomized clinical trials did not reveal beneficial effects of CQ or HCQ with or without macrolides to reduce lethality, rate of intubation, days of hospitalization, respiratory support/mechanical ventilation requirements, duration, type and number of symptoms, and death and were unsuccessful in increasing virus elimination and/or days alive in hospitalized or ambulatory patients with COVID-19. In addition, many studies have demonstrated that side effects are more common in CQ-or HCQ-treated patients. (CQ (HCQ COVID19 COVID 19 COVID-1 peerreviewed peer reviewed 2020 discussion purposes authorities Brazil antiSARSCoV2 antiSARSCoV anti SARS CoV 2 anti-SARS-CoV- validity decisionmaking. decisionmaking decision making. making decision-making point lethality intubation hospitalization supportmechanical support mechanical requirements duration symptoms andor COVID19. 19. addition CQor HCQtreated treated COVID1 1 COVID- 202 anti-SARS-CoV 20

ABSTRACT The present theoretical paper aimed to present pedagogical principles of constructivist-oriented teaching practices in team sports (TS). Specifically, the research sought to situate constructivism as a conceptual perspective to guide the teaching and learning in TS, presenting three general principles and fourteen adjacent principles, their definitions, and possible practical applications. General principles include: (1) facilitating the active construction of knowledge; (2) facilitating meaningful learning (personal relevance); and (3) facilitating social participation (cooperation). The pedagogical principles presented here constitute a matrix to guide empirical research on the teaching of TS in the context of professional training and practice in Physical Education and may aid in the TS's planning and intervention. constructivistoriented constructivist oriented TS. . (TS) Specifically definitions applications include 1 (1 knowledge 2 (2 personal relevance relevance) 3 (3 cooperation. cooperation (cooperation) TSs s intervention (TS ( (cooperation

RESUMO O objetivo deste ensaio teórico foi apresentar princípios pedagógicos das práticas de ensino orientadas ao construtivismo nos Jogos Esportivos Coletivos (JEC). Especificamente, buscou-se situar o construtivismo enquanto perspectiva conceitual para orientar o processo de ensino e aprendizagem dos JEC, apresentando três princípios gerais e 14 princípios adjacentes, suas definições e possibilidades de aplicação prática. Os princípios gerais incluem: 1) facilitar a construção ativa do conhecimento; 2) facilitar a aprendizagem significativa (relevância pessoal); e 3) facilitar a participação (cooperação) social. Os princípios pedagógicos ora apresentados constituem uma matriz para orientar a investigação empírica sobre o ensino dos JEC no âmbito da formação e atuação profissional em Educação Física, assim como podem auxiliar no planejamento e intervenção nos JEC. teorico teo rico . (JEC) Especificamente buscouse buscou se 1 adjacentes prática incluem conhecimento 2 relevância pessoal pessoal) 3 cooperação (cooperação social Física (JEC

ABSTRACT The diagnosis of congenital toxoplasmosis presents limitations and therefore new options are necessary. The analysis of amniotic fluid by real-time PCR has already proved effective for confirmation of fetal infection. However, its performance in other biological samples is not clear yet. The aim of this study is to better understand the role of real-time PCR in the blood of the mother and newborn as well as in the amniotic fluid and placenta in the diagnosis of congenital toxoplasmosis. This is a descriptive cohort study of pregnant women with toxoplasmosis followed up in Rio de Janeiro, Brazil. Real-time PCR was performed in samples of maternal blood, amniotic fluid, placenta, and blood of newborns. In addition, histopathological examination of placentas was performed, and data collected from babies were collected. 116 pregnant women were followed up and 298 samples were analyzed. One (0.9%) pregnant woman presented positive PCR in the blood, 3 (3.5%) in the amniotic fluid, 1 (2.3%) in the placenta and no newborn had positive PCR in the blood. Histopathological study was suggestive of toxoplasmosis infection in 24 (49%) placentas. Six (5.2%) newborns were diagnosed with congenital toxoplasmosis, and only cases with positive PCR in the amniotic fluid had correlation of the PCR result with the diagnosis of congenital infection. Both maternal and blood samples of new-borns and placenta did not prove to be promising in the diagnosis of congenital toxoplasmosis. Further studies are needed to evaluate the real role of molecular diagnosis in other biological materials rather than the amniotic fluid. necessary realtime time However yet Janeiro Brazil Realtime Real addition 11 29 analyzed 0.9% 09 0 9 (0.9% 3.5% 35 5 (3.5% 2.3% 23 2 (2.3% 49% 49 (49% 5.2% 52 (5.2% borns 0.9 (0.9 3.5 (3.5 2.3 (2.3 4 (49 5.2 (5.2 0. (0. 3. (3. 2. (2. (4 5. (5. (0 (3 (2 ( (5