RESUMO Objetivo: Analisar a associação entre a participação em exercícios físicos relacionados ao fitness (EFRF) e a insatisfação com a imagem corporal (IIC) em adolescentes e avaliar a interação entre os exercícios físicos e o estado nutricional nesta associação. Métodos: Estudo transversal realizado em 2015 com 799 adolescentes (10 a 16 anos) de 14 escolas públicas de Curitiba (PR), Brasil. A IIC foi avaliada por meio do Body Shape Questionnaire e da Escala de Silhuetas. A participação em EFRF foi avaliada pelo Questionário de Atividade Física para Adolescentes e classificada em “não pratica”, “pratica ≤300 minutos/semana” e “pratica >300 minutos/semana”. As regressões de Poisson e logística multinomial, ajustadas por sexo, maturação sexual e estado nutricional, analisaram a associação entre EFRF e IIC. Resultados: A prevalência de IIC foi de 28,3%; 52,4% dos adolescentes queriam reduzir a silhueta e 48,7% não praticavam a EFRF. Adolescentes que praticavam EFRF >300 minutos/semana tiveram prevalência 28% maior para algum nível de IIC (razão de prevalência — RP 1,28; intervalo de confiança de 95% — IC95% 1,08–1,52) e chance 46% menor de querer reduzir silhuetas (OR 0,54; 95IC% 0,35–0,82), comparados aos não praticantes. Não houve interação entre os EFRF e o estado nutricional na associação com IIC. Conclusões: Os adolescentes que praticam EFRF >300 minutos/semana estão mais propensos a apresentar algum nível de IIC e têm menores chances de reportar o desejo de aumentar silhuetas, independentemente do estado nutricional. Objetivo (EFRF (IIC Métodos 201 79 10 (1 1 anos PR, PR , (PR) Brasil Silhuetas pratica, pratica pratica” 300 ≤30 minutossemana minutos semana >30 minutos/semana. . multinomial sexo Resultados 28,3% 283 28 3 524 52 4 52,4 487 48 7 48,7 razão 1,28 128 95 IC95 IC 1,08–1,52 108152 08 46 OR 0,54 054 0 54 95IC 0,35–0,82, 035082 0,35–0,82 35 82 0,35–0,82) praticantes Conclusões 20 ( (PR 30 ≤3 >3 28,3 2 5 52, 48, 1,2 12 9 IC9 1,08–1,5 10815 0,5 05 03508 0,35–0,8 8 ≤ > 28, 1, 1,08–1, 1081 0, 0350 0,35–0, 1,08–1 108 035 0,35–0 1,08– 03 0,35– 1,08 0,35 1,0 0,3

ABSTRACT Objective: The aim of this study was to analyze the association between participation in fitness-related exercises (FRE) and body image dissatisfaction (BID) in adolescents and evaluate the interaction between physical exercise and nutritional status in this association. Methods: A cross-sectional study was conducted in 2015 involving 799 adolescents (10–16 years old) from 14 public schools in Curitiba (PR), Brazil. BID was assessed using the Body Shape Questionnaire and the Silhouette Scale. The FRE was classified as “does not practice,” “practices ≤300 min/week,” and “practices >300 min/week” by the Physical Activity Questionnaire for Adolescents. Poisson and multinomial logistic regressions, adjusted for sex, sexual maturation, and nutritional status analyzed the association of FRE and BID. Results: The BID prevalence was 28.3%; 52.4% of the adolescents wanted to reduce their silhouettes; and 48.7% did not practice FRE. Adolescents who practiced FRE >300 min/week had a 28% higher prevalence for some level of BID (PR 1.28; 95%CI 1.08–1.52) and a 46% lower chance of wanting to reduce silhouettes (OR 0.54; 95%CI 0.35–0.82), compared to nonpractitioners. There was no interaction between FRE and nutritional status in association with BID. Conclusions: The adolescents who practice FRE >300 min/week are likely to have some level of BID and are less likely to report the desire to increase their silhouettes, regardless of their nutritional status. Objective fitnessrelated fitness related (FRE (BID Methods crosssectional cross sectional 201 79 10–16 1016 10 16 (10–1 old 1 PR, PR , (PR) Brazil Scale does practice, practices 300 ≤30 min/week, minweek min week >30 regressions sex maturation Results 28.3% 283 28 3 524 52 4 52.4 487 48 7 48.7 1.28 128 95CI CI 95 1.08–1.52 108152 08 46 OR 0.54 054 0 54 0.35–0.82, 035082 0.35–0.82 35 82 0.35–0.82) nonpractitioners Conclusions 20 10–1 101 (10– 30 ≤3 >3 28.3 2 5 52. 48. 1.2 12 9 1.08–1.5 10815 0.5 05 03508 0.35–0.8 8 10– (10 ≤ > 28. 1. 1.08–1. 1081 0. 0350 0.35–0. (1 1.08–1 108 035 0.35–0 ( 1.08– 03 0.35– 1.08 0.35 1.0 0.3

ABSTRACT: The aim of this article is to present different legal strategies for the financial sustainability of Colombian biobanks. For that purpose, this work criticizes the sale of human biological samples as a means for sustainability, and proposes different legal alternatives based on, among others, the compensation for the costs associated with the maintenance of the biobank, services of sample collection for third parties or political commitment on the part of the State.

RESUMEN. El objetivo de este artículo es presentar posibles estrategias jurídicas para la sostenibilidad financiera de los biobancos en Colombia. Para tal propósito, critica la posibilidad de comercializar muestras biológicas humanas mediante contratos onerosos y estudia algunas alternativas de sostenimiento basadas, por ejemplo, en la compensación económica por los costos asociados al mantenimiento, el servicio de colección de muestras a terceros o el compromiso político por parte del Estado.

Abstract Introduction: Health promotion is fundamental to help people to acquire personal skills, abilities, and behaviors that facilitate the acquisition of a healthy lifestyle. Objective: To analyze what qualitative evidence indicates about the perception of health promotion by adults and health professionals to contribute to lifestyle changes. Methodology: We used qualitative metasynthesis and metadata analysis with Sandelowski and Barros's proposal in descriptive or interpretative primary studies from 2008 to 2019, considering the perceptions of adults and health professionals regarding health promotion and lifestyle. Different databases, descriptors such as health promotion, healthy behaviors, healthy lifestyle, nursing and qualitative research and Boolean operators AND, OR, with various possible combinations, were used. Quantitative articles, pediatric population and people with health problems were excluded. Ten articles were analyzed according to Lincoln and Guba's scientific rigor criteria. Results: People perceived the macro and micro social context and some barriers in the implementation of health promotion actions by health personnel, which directly influenced behavioral changes. Health professionals recognized health promotion as a mediation strategy between people and their environment to influence the adoption of a healthy lifestyle. Conclusions: Health promotion remains an ideal strategy to encourage actions for the benefit of people's health.

Abstrato Introdução: ¿ Introdução: A promoção da saúde é essencial para ajudar as pessoas a adquirir competências, habilidades e comportamentos pessoais que facilitem a aquisição de um estilo de vida saudável. Objetivo: ¿ Explorar o que as evidências qualitativas sobre a percepção da promoção da saúde de adultos e profissionais de saúde indicam para contribuir para a modificação do estilo de vida. Metodologia: Metássíntese qualitativa com análise de metadados proposta por Sandelowski e Barroso, em estudos primários descritivos ou interpretativos de 2008 a 2019, considerando percepções de adultos e profissionais de saúde sobre promoção da saúde e estilo de vida, utilizando diferentes bases de dados, descritores e booleanos: promoção da saúde, comportamentos saudáveis, estilo de vida saudável, adultos e pesquisas qualitativas, em diversas combinações possíveis, com AND e OR, excluindo artigos quantitativos, população pediátrica e pessoas com problemas de saúde, foram analisados 10 artigos segundo os critérios de rigor científico de Lincoln e Guba. Resultados: As pessoas perceberam o contexto macro e microssocial e algumas barreiras na implementação de ações de promoção da saúde pelos profissionais de saúde que influenciaram diretamente nas mudanças comportamentais. Os profissionais de saúde reconheceram a promoção da saúde como uma estratégia de mediação entre as pessoas e o seu ambiente para influenciar a adoção de um estilo de vida saudável. Conclusões: A promoção da saúde continua sendo uma estratégia ideal para incentivar ações que beneficiem a saúde das pessoas.

Resumen Introducción: La promoción de la salud es primordial para modificar que las personas adquieran aptitudes, habilidades y comportamientos personales que faciliten la adquisición de un estilo de vida saludable. Objetivo: Explorar que señala la evidencia cualitativa sobre percepción de la promoción de la salud de personas adultas y profesionales de la salud para contribuir a modificar el estilo de vida. Metodología: Metasíntesis cualitativa, análisis de metadatos con propuesta de Sandelowski y Barroso, en estudios primarios descriptivos o interpretativos de 2008 a 2019, considerando las percepciones de personas adultas y profesionales de la salud con respecto a la promoción de la salud y estilo de vida, empleando diferentes bases de datos, descriptores y boleanos: promoción de la salud, conductas saludables, estilo de vida saludable, adulto e investigación cualitativa, en diversas combinaciones posibles, con AND y OR, excluyendo artículos cuantitativos, población pediátrica y personas con problemas de salud, se analizaron 10 artículos según criterios de rigor científico de Lincoln y Guba. Resultados: Las personas percibieron el contexto macro y microsocial y algunas barreras en la implementación de acciones de promoción de la salud por parte del personal de salud que influyó directamente en los cambios de conducta. Los profesionales de la salud reconocieron la promoción de la salud como una estrategia de mediación entre las personas y su entorno para incidir en la adopción de un estilo de vida saludable. Conclusiones: La promoción de la salud sigue siendo una estrategia idónea para incentivar acciones en beneficio de la salud de las personas.

Abstract This integrative review aims to identify the mental health care measures that were produced during the COVID-19 pandemic. This research was conducted on three databases (SciELO, PubMed, and LILACS) with the following descriptors in Portuguese, English, and Spanish: “SAÚDE MENTAL” or “SALUD MENTAL” or “MENTAL HEALTH” AND “COVID-19” from 2020 to 2021. In total, 3,451 articles were found, 43 of which were analyzed. Most measures were digital, stemmed from public institutions, focused on the local perspective, and were integrated with the public health care system. This study discusses the models of care in mental health based on measures to cope with the COVID-19 pandemic. It also discusses the Brazilian health care system, reiterating its resilience. In conclusion, digital measures occurred most often. This study suggest the evaluation of the accessibility of this mental health care model for most vulnerable groups. Finally, this research reinforces the importance of the Brazilian health care system for public health and access to information to cope with the COVID-19 pandemic. COVID19 COVID 19 COVID-1 pandemic SciELO, SciELO (SciELO PubMed LILACS Portuguese English Spanish SAÚDE MENTAL SALUD HEALTH “COVID-19 202 2021 total 3451 3 451 3,45 found 4 analyzed institutions perspective resilience conclusion often groups Finally COVID1 1 COVID- “COVID-1 20 345 45 3,4 “COVID- 2 34 3, “COVID

Resumo A presente revisão integrativa tem por objetivo identificar os arranjos de cuidado em saúde mental que foram implementados no enfrentamento à pandemia de COVID-19. Realizou-se busca em três bases de dados (SciELO, PubMed e LILACS), em português, inglês e espanhol, com os descritores “SAÚDE MENTAL” or “SALUD MENTAL” or “MENTAL HEALTH” AND “COVID-19”, no período de 2020 a 2021. Foram encontrados 3.451 artigos, sendo 43 selecionados para análise. Em relação ao cuidado em saúde mental, os principais arranjos identificados foram os digitais, de natureza pública, desenvolvidos na esfera municipal e com integração com a rede de saúde. Os modelos de cuidado em saúde mental para o enfrentamento da pandemia são discutidos a partir dos tipos de arranjo produzidos nesse contexto sanitário emergencial e crítico. Apresenta-se, ainda, um recorte da realidade encontrada no Sistema Único de Saúde (SUS), reiterando sua resiliência. Concluiu-se que os arranjos digitais foram os mais usados e que há necessidade de investigar a acessibilidade deste modelo para populações com maior vulnerabilidade social. Reafirma-se a importância do SUS para o enfrentamento da COVID-19 e no acesso a informações de saúde. COVID19. COVID19 COVID 19. 19 Realizouse Realizou se SciELO, SciELO (SciELO LILACS, LILACS , LILACS) português espanhol SAÚDE MENTAL SALUD HEALTH COVID19, “COVID-19” 202 2021 3451 3 451 3.45 artigos 4 análise pública crítico Apresentase, Apresentase Apresenta se, Apresenta-se ainda SUS, (SUS) resiliência Concluiuse Concluiu social Reafirmase Reafirma COVID-1 COVID1 1 “COVID-19 20 345 45 3.4 (SUS COVID- “COVID-1 2 34 3. “COVID- “COVID

Abstract Objective: To estimate the prevalence of vitamin D deficiency and severe deficiency in children and adolescents, in a large Brazilian sample. Methodology: Results of 413,988 25(OH)D measurements in children and adolescents aged 0 to 18 years collected between 01/2014 and 10/2018 were obtained from the database of a Clinical Laboratory. In this population, 25 hydroxyvitamin D concentrations below 20 ng/mL are considered deficient, and below 12 ng/mL as severe deficiency. All measurements were performed by immunoassay and the results were distributed by gender, age group, seasonality, and latitude. Results: The mean of 25(OH)D levels was 29.2 ng/mL with a standard deviation of 9.2 ng/mL. Of the total samples, 0.8% had a concentration < 12 ng/mL, and 12.5% of the samples had a concentration < 20 ng/mL, with a higher prevalence in females. Children under 2 years of age had the lowest prevalence. The effects of latitude and seasonality were quite evident. In samples of female adolescents from the southern region in winter, 36% of vitamin D deficiency and 5% of severe deficiency were found. Conclusion: In this large number of measurements of 25(OH)D in children and adolescents, 12.5% had a deficiency and 0.8% had severe deficiency. A greater deficiency was observed among adolescents, especially females, which raises questions about the need for supplementation during this period of life. Objective sample Methodology 413988 413 988 413,98 25OHD OHD OH 1 012014 01 2014 01/201 102018 10 2018 10/201 Laboratory population ngmL ng mL deficient gender group 292 29 29. 92 9 9. 08 8 0.8 125 5 12.5 females evident winter 36 found Conclusion life 41398 41 98 413,9 01201 201 01/20 10201 10/20 0. 12. 3 4139 4 413, 0120 01/2 1020 10/2 012 01/ 102 10/

RESUMEN Las infecciones por el VSR en constituyen una causa importante de morbilidad, hospitalización, ausentismo escolar y laboral, así como de mortalidad, en el mundo, así como en el Paraguay.En la actualidad, existen herramientas para la prevención del VSR. En el año 2012, el Paraguay, ha incorporado el palivizumab (MedImmune, EE. UU.), anticuerpo monoclonal, producido por tecnología de DNA recombinante. Este anticuerpo se administra en 5 dosis, cada 30 días y está indicado en lactantes nacidos prematuros y aquellos con trastornos cardiopulmonares. Por otro lado, actualmente se cuenta con una nueva herramienta para la prevención del VSR. El anticuerpo monoclonal de vida media prolongada Nirsevimab, específico para la conformación de prefusión de la proteína F, aprobado por EMA y FDA. Este monoclonal, está indicado para la prevención de las Infecciones respiratorias agudas bajas, causada por VSR en recién nacidos y lactantes nacidos durante o al ingresar a su primera temporada de VSR, en prematuros y lactantes hasta los 24 meses de edad que siguen siendo vulnerables a la enfermedad grave por VSR durante su segunda temporada de VSR. Luego de analizar la situación epidemiológica del VSR en el país así como la evidencia de eficacia, eficiencia y efectividad de este monoclonal; instituciones académicas, sociedades científicas, organizaciones no gubernamentales y gubernamentales se reunieron y elaboraron un consenso interinstitucional para la prevención de las infecciones por VSR, sugiriendo la incorporación del Nirsevimab, en menores de 12 meses de edad antes de su primera temporada de VSR y en reemplazo del Palivizumab, debido a que el nuevo monoclonal tiene el potencial de cambiar el panorama de las infecciones por VSR en el lactante y producir un impacto en la reducción la mortalidad y morbilidad infantil; reduciendo la carga al sistema de salud, en lo que se refiere a la disminución de la ocupación de camas hospitalarias tanto en sala como en unidades de cuidados intensivos, así como la disminución de la carga para los cuidadores, médicos y proveedores de atención médica y la mortalidad infantil.

ABSTRACT Respiratory syncytial virus (RSV) infections constitute a significant cause of morbidity, hospitalization, school and work absenteeism, as well as mortality worldwide, including in Paraguay. Currently, tools for RSV prevention are available. In 2012, Paraguay approved the use of palivizumab (MedImmune, USA), a monoclonal antibody produced through recombinant DNA technology. This antibody is administered in 5 doses, every 30 days and is indicated in infants born prematurely and those with cardiopulmonary disorders. Furthermore, a novel tool for RSV prevention has recently become available. Nirsevimab, a long-acting monoclonal antibody specific to the prefusion conformation of the F protein, has been approved by both the European Medicines Agency (EMA) and the Food and Drug Administration (FDA). This monoclonal antibody is indicated for the prevention of acute lower respiratory tract infections caused by RSV in newborns and infants born during or entering their first RSV season, as well as in premature infants and infants up to 24 months of age who remain vulnerable to severe RSV disease during their second RSV season. After analyzing the epidemiological situation of RSV in our country and evaluating the evidence of efficacy, efficiency, and effectiveness of this monoclonal antibody, academic institutions, scientific societies, and non-governmental and governmental organizations developed consensus guidelines on a new prevention alternative for the prevention of RSV infections, suggesting the incorporation of Nirsevimab in children under 12 months of age before their first RSV season and replacing Palivizumab. The new monoclonal has the potential to change the panorama of RSV infections in infants and produce an impact on the reduction of infant mortality and morbidity reducing the burden on the health system by decreasing hospital bed occupancy both in wards and in intensive care units, as well as the decrease in the burden on caregivers, physicians and health care providers.

ABSTRACT: The purpose of this article is to identify mechanisms that can be applicable at the national level to promote the development of cinema in Ecuador. First, it starts with a documentary review on the development of film production in Ibero-America from its beginnings to the present, including the case of Ecuador. The paper then identifies strategies and initiatives that have been implemented in the region to promote film production at the local level. Based on this collection of information, which includes interviews with experts related to the medium, a series of mechanisms are outlined that could be applied in the future in Ecuador to boost its level of film production and its impact on the market. ABSTRACT First IberoAmerica Ibero America present information medium market

RESUMEN: El presente trabajo tiene por finalidad identificar mecanismos que puedan ser aplicables a nivel nacional para fomentar el desarrollo del cine en el Ecuador. Primero, se parte de una revisión documental sobre el desarrollo de la producción cinematográfica en Iberoamérica desde sus inicios hasta la actualidad, incluyendo el caso de Ecuador. Después se identifican estrategias e iniciativas que se han dado en la región para fomentar la producción de películas a nivel local. Y a partir de esta recolección de información, que incluye entrevistas a expertos relacionados al medio, se esbozan una serie de mecanismos que se podrían aplicar a futuro en el Ecuador, para potenciar su nivel de producción cinematográfica y su impacto en el mercado. RESUMEN Ecuador Primero actualidad local información medio mercado

Abstract Medical communication skills are treated as innate abilities, without the need for training and evaluation. However, they play a very important role in the doctor-patient relationship. Communication deficits are a cause of dissatisfaction and litigation. Quality communication is associated with greater adherence to proposed procedures and increases patient satisfaction and safety. Effective communication is particularly important in Gynecology-Obstetrics and justifies specific training. Formal teaching of communication skills should be included at all levels of medical education, just like technical-scientific skills.

Resumo As capacidades comunicacionais dos médicos são tratadas como habilidades inatas, sem a necessidade de treino e avaliação. Desempenham, no entanto, um papel da maior importância na relação médico-doente. Os déficits de comunicação são causa de descontentamento e motivo de litigância. A comunicação de qualidade está associada a maior adesão aos procedimentos propostos, aumenta a satisfação e segurança do doente. A comunicação eficaz assume particular acutilância em Ginecologia-Obstetrícia e justifica que seja objeto de treino específico. O ensino formal da competência em comunicação deve ser incluído em todos os níveis da educação médica, à semelhança das competências técnico-científicas.

Abstract Introduction: Autoimmune hepatitis (AIH) has a spectrum of symptoms ranging from asymptomatic disease to acute severe hepatitis, chronic hepatitis, and decompensated cirrhosis. The acute presentation is not rare and could represent genuine acute AIH (GAAIH) or acute exacerbation of chronic autoimmune hepatitis. We aimed to identify the prevalence, clinical features, and prognostic factors associated with GAAIH and compare these cases with acute exacerbation of chronic AIH. Methods: This cross-sectional observational study evaluated patients with acute AIH presentation, defined as total bilirubin >5 times the upper limit of normality (xULN) and/or alanine aminotransferase >10 xULN, and no prior history of liver disease. Histology findings of acute disease defined GAAIH. Bivariate analyses were performed to identify factors associated with the GAAIH, when compared with acute exacerbation of chronic AIH. Results: Seventy-two patients with acute presentation of AIH were included and six (8.3%) of them presented GAAIH. Comparative analysis between patients with GAAIH and patients with acute exacerbation of chronic AIH revealed that prothrombin activity (96% [74-100] vs. 61% [10-100]; p = 0.003) and albumin levels (3.9 ± 0.2 g/dL vs. 3.4 ± 0.5 g/dL; p < 0.001) were higher in patients with GAAIH. The International Autoimmune Hepatitis Group score was higher in patients with acute exacerbation of chronic AIH (18.5 [8-23] vs. 16.5 [15-17]; p = 0.010). Compared to 15.2% of acute exacerbation of chronic AIH, complete therapeutic response to treatment was achieved in 67.7% of cases with GAAIH (p = 0.018). Conclusions: GAAIH was rare (8.3%), and patients with this presentation exhibited more preserved liver function tests, suggesting that most cases presenting with loss of function are acute exacerbation of chronic AIH. Additionally, patients with GAAIH had a better complete therapeutic response, suggesting a more preserved liver function at presentation, and early diagnosis has a positive therapeutic implication.

Resumo Introdução: A hepatite autoimune (HAI) apresenta um espectro de sintomas que varia de doença assintomática a hepatite aguda grave, hepatite crónica e cirrose descompensada. A apresentação aguda não é rara e pode representar hepatite autoimune aguda genuína (HAIAG) ou exacerbação aguda de hepatite autoimune crónica (EAHAIC). O nosso objetivo foi identificar a prevalência, caraterísticas clínicas e fatores prognósticos associados à HAIAG, e comparar esses casos com EAHAIC. Métodos: Estudo observacional, transversal, incluindo doentes com apresentação aguda de HAI, definida como bilirrubina total > 5 vezes o limite superior da normalidade (xLSN) e/ou ALT > 10 xLSN, e sem história prévia de doença hepática. HAIAG foi definida pela presença de achados histológicos de doença aguda. Análises bivariadas foram realizadas para identificar fatores associados à HAIAG, quando comparado com o EAHAIC. Resultados: Foram incluídos setenta e dois doentes com apresentação agu-da de HAI, dos quais seis (8.3%) com HAIAG. A análise comparativa entre doentes com HAIAG e doentes com EAHAIC mostrou que a atividade de protrombina (96%(74-100) versus 61% (10-100; p=0.003) e os níveis de albumina (3,9 ± 0,2 g/dL vs. 3,4 ± 0,5 g/dL; p < 0,001) foram significativamente mais elevados em pacientes com HAIAG. O score do Grupo Internacional de Hepatite Autoimune foi mais elevado em doentes com EAHAIC (18.5 (8-23) versus 16.5 (15-17); p=0.010). A resposta terapêutica completa ao tratamento foi alcançada em 66.7% dos casos de HAIAG (vs. 15,2% na EAHAIC, p=0,018). Conclusões: A HAIAG é rara (8.3%), e os doentes com esta apresentação mostraram testes de função hepática mais preservados, sugerindo que a maioria dos casos com perda de função são EAHAIC. Além disso, os doentes com HAIAG tiveram maior taxa de resposta terapêutica completa, sugerindo que uma função hepática mais preservada na apresentação e o diagnóstico precoce tem uma implicação terapêutica positiva.

ABSTRACT Foundation: atherosclerosis is a disease of multifactorial origin that is aggravated as a result of an adverse environment and unhealthy lifestyles. Evidence confirms its onset from the earliest stages of life. Objective: to describe the presence of early atherosclerotic lesions in the aortas of deceased fetuses and neonates born to hypertensive mothers. Method: a descriptive cross-sectional study was carried out that included fetuses older than 22 weeks and deceased neonates born to hypertensive mothers, who underwent autopsy in the pathological anatomy department of the Eusebio Hernández Pérez Gynecobstetric University Hospital, in the period between January 2021 and December 2022, with a total of 18. The following data were collected in the medical records: sex of the deceased, gestational age at the time of delivery, postpartum weight, maternal age, and history of arterial hypertension (chronic or gestational). The 18 aortas (thoracic and abdominal) of the selected deceased were analyzed. Results: of the total number of deceased studied, 70.6 % presented early atherosclerotic lesions, characterized by thickening of the intima as a cushion, presence of lymphocytes in the intima or in the arterial wall close to it and/or macrophages. In some cases, one of these histological variants was observed and in others a combination of two or three. Conclusions: early atherosclerotic lesions are present in the aortas of the majority of the fetuses and neonates studied, with a predominance in those with gestational hypertension.

RESUMEN Fundamento: la aterosclerosis es una enfermedad de origen multifactorial que se agrava a consecuencia de un medio ambiente adverso y de estilos de vida no saludables. Las evidencias confirman su inicio desde las etapas más tempranas de la vida. Objetivo: describir la presencia de lesiones ateroscleróticas tempranas en las aortas de fetos y neonatos fallecidos hijos de madres hipertensas. Método: se realizó un estudio descriptivo de tipo transversal que incluyó a los fetos mayores de 22 semanas y neonatos fallecidos hijos de madres hipertensas, a quienes se les realizó autopsia en el departamento de anatomía patológica, del Hospital Universitario Ginecobstétrico Eusebio Hernández Pérez, en el período comprendido entre enero del 2021 hasta diciembre 2022, con un total de 18. Se recogieron los siguientes datos en las historias clínicas: sexo del fallecido, edad gestacional en el momento del parto, peso postparto, edad materna y antecedentes de hipertensión arterial (crónica o gestacional). Se analizaron las 18 aortas (torácicas y abdominales) de los fallecidos seleccionados. Resultados: del total de fallecidos estudiados el 70,6 % presentó lesiones ateroscleróticas tempranas, caracterizadas por engrosamiento de la íntima a modo de cojinete, presencia de linfocitos en la íntima o en la pared arterial cercana a ella y/o macrófagos. En algunos casos se observó una de estas variantes histológicas y en otros la combinación de dos o tres. Conclusiones: las lesiones ateroscleróticas tempranas están presentes en las aortas de la mayoría de los fetos y neonatos estudiados, con predominio en las que presentaban hipertensión gestacional.

Abstract The Saman tree (Samanea saman) is a native species with a significant and economic importance in Costa Rica due to its high-quality wood and versatile range of uses. It is ability to compete with other reforestation species and suits specific niche markets increses its value. This research aimed to develop a methodology of in vitro culture for cenízaro, as a key tool for breeding and germplasm conservation programs in Costa Rica. Experiments were focused on using greenhouse-reproduced material, both inside and outside of a microtunnel environment. Two disinfectant agents, sodium hypochlorite (NaClO) and mercury chloride (HgCl2), were assessed at varying concentrations and exposure durations. In vitro establishment success rates for material from the microtunnel greenhouse were less than 12.5 %. Conversely, material from outside the microtunnel showed remarkable in vitro establishment rates, surpassing 72.3 %. The most effective disinfection treatment for achieving contamination free shoots involved an incubation in 1 % v/v NaClO for 20 minutes, yielding the highest percentage of contamination-free shoots, corresponding to 85.47 %. As for apex disinfection, employing a 0.2 % (w/v) HgCl2 for 5 minutes proved optimal, resulting in 100 % establishment of explants devoid of contaminants.

Resumen El cenízaro (Samanea saman), es una especie nativa de Costa Rica, de reconocido valor económico por la calidad de la madera y la variedad de usos; estas características le permiten competir con otras especies usadas para reforestación, con el fin de generar productos dirigidos a mercados selectos. El objetivo de esta investigación fue desarrollar una metodología para el establecimiento in vitro de cenízaro como herramienta biotecnológica para un programa de mejoramiento genético y conservación de germoplasma en Costa Rica. El ensayo se estableció a partir de material reproducido en invernadero, tanto en microtúnel como fuera de este. Posteriormente, se evaluaron dos agentes desinfectantes, hipoclorito de sodio (NaClO) y cloruro de mercurio (HgCl2), en diferentes concentraciones y tiempos de exposición. Se obtuvieron porcentajes de establecimiento in vitro inferiores al 12,5 % al emplear material proveniente del invernadero microtúnel; mientras que, el material proveniente fuera del microtúnel, presentó porcentajes de establecimiento in vitro superiores a 72,3 %. La desinfección con hipoclorito de sodio (NaClO) al 1 % v/v durante 20 minutos presentó el mayor porcentaje de nudos libres de contaminación y correspondiente al 85,47 %. Por otro lado, la desinfección de ápices con cloruro de mercurio (HgCl2) al 0,2 % p/v durante 5 minutos, presentó el mayor porcentaje de ápices libres de contaminación (100 %).

Abstract Rich in fiber and bioactive compounds, roselle calyx decoction residues offer opportunities in food processing. This study sought to develop a directly expanded snack with a mixture of corn and roselle calyx decoction residues, optimizing its physical qualities. It was conducted in 2023, using the response surface methodology with three factors and three responses. The directly expanded snack showed expansion index values between 1.75 to 2.64, bulk density of 0.15 to 0.38 g cm-3 and firmness of 6.8 to 19.6 N, with attractive purple-lilac shades. The regression models were adequate and using the desirability method, optimal conditions (OT= 132.3 °C, SS= 240 rpm) and roselle inclusion level (J= 12.4%) were determined for an optimized directly expanded snack. It was concluded that the inclusion of up to 12.4% of roselle calyx allowed obtaining snacks with excellent physical characteristics.

Resumen Los residuos de decocción cáliz de jamaica, ricos en fibra y compuestos bioactivos, ofrecen oportunidades en la elaboración de alimentos. Este estudio buscó desarrollar una botana directamente expandida con mezcla de maíz y residuos de decocción cáliz de jamaica, optimizando sus cualidades físicas. Se realizó en el año 2023, empleando la metodología de superficie de respuesta con tres factores y tres respuestas. La botana directamente expandida, mostraron valores de índice de expansión entre 1.75 a 2.64, densidad aparente de 0.15 a 0.38 g cm-3 y firmeza de 6.8 a 19.6 N, con tonalidades morado-lila atractivas. Los modelos de regresión fueron adecuados y mediante el método de deseabilidad, se determinaron condiciones óptimas (TS= 132.3 °C, VT= 240 rpm) y nivel de inclusión de jamaica (J= 12.4%) para una botana directamente expandida optimizada. Se concluyó que la inclusión de hasta un 12.4% de cáliz de jamaica permitió obtener botanas con excelentes características físicas.

RESUMEN Objetivo: Realizar una adaptación transcultural y validación del cuestionario de creencias de miedo y evitación (FABQ, por sus siglas en inglés) para sujetos argentinos con dolor lumbar (DL) y reportar las propiedades psicométricas de confiabilidad, validez e interpretabilidad. Materiales y métodos: Se realizó un estudio observacional, prospectivo y longitudinal. Se incluyeron de forma consecutiva residentes argentinos hispanohablantes mayores de 18 años con DL. El estudio comprendió una fase de adaptación, seguida de una fase de validación. Los sujetos fueron evaluados el día de su admisión al estudio (T1) y 48 a 72 horas después (T2). Se utilizó una escala global de cambio como anclaje externo para evaluar la estabilidad clínica. Resultados: Fueron elegibles 74 sujetos. La media de la puntuación total del FABQ fue de 50,24 (DE 20,64). La consistencia interna (alfa de Cronbach) fue de 0,85 (IC 95 % 0,79 - 0,91). La confiabilidad test-retest fue aceptable, con un coeficiente de correlación intraclase de 0,765 (IC 95 % 0,61 - 0,86). El error estándar de medición fue de 4,85 puntos, y el cambio mínimo detectable (95 %) fue de 13,45. La mediana de tiempo para que los sujetos completen el cuestionario fue de 3,86 minutos (RIQ 3,44 - 4,85), y la media de tiempo para puntuarlo fue de 24,40 segundos (DE 13,77). No se observó efecto suelo o techo. Conclusión: El FABQ en su versión argentina es un cuestionario válido, confiable y viable para evaluar las creencias de miedo y evitación en sujetos con DL.

ABSTRACT Objective: To perform a cross-cultural adaptation and validation of the Fear and Avoidance Beliefs Questionnaire (FABQ) for Argentine subjects with low back pain (LBP) and to report the psychometric properties of reliability, validity, and interpretability. Materials and method: An observational, prospective, and longitudinal study was conducted. Spanish-speaking Argentine residents aged 18 years or older with LBP were consecutively included. The study comprised an adaptation phase followed by a validation phase. Subjects were evaluated on the day of study admission (T1) and 48 to 72 hours later (T2). A global change scale was used as an external anchor to assess clinical stability. Results: Seventy-four subjects were eligible. The mean FABQ total score was 50.24 (SD 20.64). The internal consistency (Cronbach’s alpha) was 0.85 (95 % CI 0.79 - 0.91). Test-retest reliability was acceptable, with an intraclass correlation coefficient of 0.765 (95 % CI 0.61 - 0.86). The standard error of measurement was 4.85 points, and the minimum detectable change (95 %) was 13.45. The median time for subjects to complete the questionnaire was 3.86 minutes (IQR 3.44 - 4.85), and the mean time to score it was 24.40 seconds (SD 13.77). No floor or ceiling effect was found. Conclusion: The Argentine version of the FABQ is a valid, reliable, and feasible questionnaire for assessing fear and avoidance beliefs in subjects with LBP.

RESUMEN Antecedentes: Las condiciones climáticas en los países tropicales, ejercen un efecto significativo, sobre la producción de leche. Objetivo: Analizar las condiciones climáticas en la Empresa Pecuaria Genética Los Naranjos y su posible relación con el comportamiento de la producción de leche a 305 días. Materiales y métodos: Se dispuso de una base de datos de 12 625 registros de producción de leche, de vacas que tuvieron sus partos entre los años 2002 -2020 que se correspondieron con 7 711 animales. Se contó con los registros mensuales de la temperatura mínima (Tmin), media (Tmed) y máxima (Tmáx) en 0C, humedad relativa (HR) en % y se generó el índice temperatura-humedad (ITH), y a partir de este se realizó el cálculo de la Carga Calórica Acumulada (CCA) de los tres meses antes del parto. Además, se estimaron las heredabilidades (h2) y las correlaciones genéticas (rg) para las diferentes CCA. Resultados: Las medias generales obtenidas fueron: PL305: 1 624,45 ± 360.40 (kg/lactancia), ITH 76,34± 18,70 y CCA 229,21± 128,5. Todas las fuentes de variación estudiadas influyeron en forma significativa en la producción de leche a 305 días. Las h2 variaron entre 0,25 y 0,38 y las rg fueron todas positivas y más altas para los grupos de CCA más próximos. Conclusiones: Hubo relación inversa entre el ITH y la CCA con la producción de leche. Se evidencia la variabilidad genética aditiva para los diferentes grupos de CCA y las rg fueron positivas denotando cierta variabilidad genética para la adaptación al stress climático.

ABSTRACT Background: Climatic conditions in tropical countries have a significant effect on milk production. Aim: Analyze the climatic conditions at the Los Naranjos Genetic Livestock Company and its possible relationship with the behavior of milk production at 305 days. Materials and methods: A database of 12,625 milk production records was available, from cows that gave birth between the years 2002 -2020, which corresponded to 7,711 animals. There were monthly records of the minimum temperature (Tmin), average (Tmed) and maximum (Tmax) at 0C, relative humidity (RH) in % and the temperature-humidity index (ITH) was generated, and from this the performed the calculation of the Accumulated Caloric Load (CCA) for the three months before delivery. In addition, heritabilities (h2) and genetic correlations (rg) were estimated for the different CCAs. Results: The general means obtained were: PL305: 1 624.45 ± 360.40 (kg/lactation), ITH 76.34 ± 18.70 and CCA 229.21 ± 128.5. All sources of variation studied significantly influenced milk production at 305 days. The h2 ranged between 0.25 and 0.38 and the rgs were all positive and higher for the closer CCA groups. Conclusions: There was an inverse relationship between ITH and CCA with milk production. Additive genetic variability is evident for the different CCA groups and the rg were positive denoting certain genetic variability for adaptation to climatic stress.

RESUMEN El estilo de crianza se refiere a la manera en la cual los padres ejercen su influencia en la formación y el crecimiento del niño. Del estilo aplicado que fundamentalmente puede ser democrático, autoritario o permisivo, depende en gran medida la salud emocional de ese individuo en crecimiento. En Paraguay, tradicionalmente la figura de los padres se visualiza como el autoritario. El objetivo de esta investigación fue identificar la percepción social sobre estilos de crianzas de los hijos en Paraguay, en el año 2023. El diseño fue cuantitativo, descriptivo, de corte transversal, aplicado a una población de 313 personas, mediante un muestreo no probabilísticos por conveniencia, con el método de la encuesta, a través de un cuestionario difundido por las redes sociales. Entre los principales resultados se evidenció: 69% fueron mujeres; 48.2% con procedencia de Asunción y de 41.9% Central; 84% son de formación universitaria; 60.4% no tienen bajo su responsabilidad a un niño; el estilo predominante en Paraguay según los participantes fue el autoritario con 39%, seguido del permisivo con 29.1%, el democrático con 17.2% y el negligente con 14.7%. El 44.7% sufrió alguna forma de violencia como método de educación; 19.5% ha aplicado alguna forma de violencia en la crianza; 91.7% no está de acuerdo con dichas prácticas; 68.1% considera que la crianza autoritaria puede generar traumas y 83.7% que genera más miedo que respeto. Si la persona pudiese elegir el modelo predominante en Paraguay, el 77.6% optaría por un estilo democrático. Se concluye que el estilo de crianza predominante es el autoritario y que las prácticas de violencia hacia las personas son frecuentes.

ABSTRACT Parenting style refers to the way in which parents exert their influence on the formation and growth of the child. The emotional health of the growing individual depends to a great extent on the style applied, which can be democratic, authoritarian or permissive. In Paraguay, traditionally the parental figure is visualized as authoritarian. The objective of this research was to identify the social perception of parenting styles in Paraguay in the year 2023. The design was quantitative, descriptive, cross-sectional, applied to a population of 313 people, through a non-probabilistic sampling by convenience, with the survey method, through a questionnaire disseminated through social networks. Among the main results were: 69% were women; 48.2% were from Asunción and 41.9% from Central Paraguay; 84% had university education; 60.4% did not have a child under their responsibility; the predominant style in Paraguay according to the participants was authoritarian with 39%, followed by permissive with 29.1%, democratic with 17.2% and negligent with 14.7%. A total 44.7% suffered some form of violence as a method of education; 19.5% have applied some form of violence in upbringing; 91.7% do not agree with such practices; 68.1% consider that authoritarian upbringing can generate traumas and 83.7% that it generates more fear than respect. If a person could choose the predominant model in Paraguay, 77.6% would opt for a democratic style. It is concluded that the predominant parenting style is authoritarian and that violent practices towards people are frequent.