Objective: Childhood maltreatment (CM) is a significant risk factor for the development and severity of bipolar disorder (BD) with increased risk of suicide attempts (SA). This study evaluated whether a machine learning algorithm could be trained to predict if a patient with BD has a history of CM or previous SA based on brain metabolism measured by positron emission tomography. Methods: Thirty-six euthymic patients diagnosed with BD type I, with and without a history of CM were assessed using the Childhood Trauma Questionnaire. Suicide attempts were assessed through the Mini International Neuropsychiatric Interview (MINI-Plus) and a semi-structured interview. Resting-state positron emission tomography with 18F-fluorodeoxyglucose was conducted, electing only grey matter voxels through the Statistical Parametric Mapping toolbox. Imaging analysis was performed using a supervised machine learning approach following Gaussian Process Classification. Results: Patients were divided into 18 participants with a history of CM and 18 participants without it, along with 18 individuals with previous SA and 18 individuals without such history. The predictions for CM and SA were not significant (accuracy = 41.67%; p = 0.879). Conclusion: Further investigation is needed to improve the accuracy of machine learning, as its predictive qualities could potentially be highly useful in determining histories and possible outcomes of high-risk psychiatric patients. Objective (CM (BD SA. . (SA) Methods Thirtysix Thirty six I Questionnaire MINIPlus MINI Plus (MINI-Plus semistructured semi structured interview Restingstate Resting state 18Ffluorodeoxyglucose Ffluorodeoxyglucose 18F fluorodeoxyglucose F conducted toolbox Classification Results 1 it 41.67% 4167 41 67 0.879. 0879 0.879 0 879 0.879) Conclusion highrisk high (SA 41.67 416 4 6 087 0.87 87 41.6 08 0.8 8 41. 0.

ABSTRACT Economic instability scenarios and reduction in charcoal consumption, such as those that occurred in 2009 and 2016, affect production and result in the maintenance of eucalyptus forests and an increase in the rotation age. The objective of this work was to evaluate the quality of wood from four Eucalyptus clones (clones 1, 2, 3, and 4) at the ages of 108 and 120 months and the charcoal produced in a rectangular kiln. We evaluated the heart/sapwood ratio, basic density, dry mass per hectare.year, and chemical composition . The carbonizations were performed in a rectangular kiln (210 m³ of wood). We determined the gravimetric yield and the charcoal properties: density, particle size and percentage of fines, friability index, proximate analysis, and mass of charcoal produced per hectare.year. We verified the significant effect of clones on basic density and dry mass, whose variations were from 494 to 589 kg m-3 and 12.47 to 23.34 ton.ha-1, respectively. The charcoal yield did not differ among clones (34.1%), while the yield of semicarbonized wood varied from 3.2% (clone 4) to 10.7% (clone 3). The particle size of 65% of the charcoal volume of clones 1 and 3 was greater than 30 mm, and 49.5% of clones 2 and 4. We found medium mechanical resistance for charcoal from all four clones. The apparent density ranged from 356 to 458 kg.m-3, with the highest average value for clone 3. We found the highest charcoal production for clones 1 and 2, 7.5 tons per hectare.year. The fixed carbon did not vary among clones (76.92%). The wood properties of the Eucalyptus clones at ages 108 and 120 months are suitable for charcoal production for metallurgical use. Clones 1 (a hybrid of E. urophylla x E. grandis) and 3 (a hybrid of E. urophylla x E. camaldulensis) stood out from the others. consumption 200 2016 age 4 10 12 heartsapwood heart sapwood ratio hectareyear hectare year hectare.year 210 (21 m wood. wood) fines index analysis 49 58 m3 m- 1247 47 12.4 2334 23 34 23.3 ton.ha1, tonha1 tonha ton.ha ton ha ton.ha-1 respectively 34.1%, 341 34.1% , (34.1%) 32 3.2 107 7 10.7 3) 65 mm 495 5 49.5 35 45 kg.m3, kgm3 kgm kg.m kg.m-3 75 7. 76.92%. 7692 76.92% 76 92 (76.92%) use E grandis camaldulensis others 20 201 21 (2 124 12. 233 23. ha1 ton.ha1 ton.ha- 34.1 (34.1% 10. 6 49. kg.m3 kg.m- 769 76.92 9 (76.92% ( 34. (34.1 76.9 (76.92 (34. 76. (76.9 (34 (76. (3 (76 (7

RESUMO Cenários de instabilidade econômica e redução do consumo de carvão vegetal, como as ocorridas em 2009 e 2016, afetam a produção deste insumo, resultando na manutenção das florestas de eucalipto e aumento da idade de corte. O objetivo deste trabalho foi avaliar a qualidade da madeira de quatro clones de Eucalyptus (clones 1, 2, 3 e 4) com idades entre 108 e 120 meses e do carvão vegetal produzido em forno retangular. Para caracterização da madeira, foram avaliadas a relação cerne/alburno, densidade básica, massa seca por hectare.ano e composição química. As carbonizações foram realizadas em forno retangular, com capacidade de 210 m³ de madeira, e determinaram-se o rendimento gravimétrico e as propriedades do carvão vegetal: densidade do carvão vegetal, granulometria e porcentagem de finos, índice de friabilidade, análise imediata, além da massa de carvão produzida por hectare.ano. Verificou-se efeito significativo dos clones na densidade básica e massa seca, com valores de 494 a 589 kg m-3 e 12,47 a 23,34 ton.ha-1, respectivamente. O rendimento médio em carvão vegetal não diferiu entre os clones e foi igual a 34,1%, enquanto o rendimento em atiço variou de 3,2% para o clone 4 a 10,7% para o clone 3. Os clones 1 e 3 apresentaram em média 65% do volume de carvão vegetal na maior faixa granulométrica (>30 mm), enquanto os clones 2 e 4 tiveram 49,5% nessa granulometria. O carvão vegetal dos quatro clones foi de média resistência e a densidade aparente variou de 356 a 458 kg.m-3, com maior valor para o clone 3. Os clones 1 e 2 apresentaram a maior produção de carvão vegetal, 7,5 toneladas por hectare.ano. O carbono fixo não variou entre os clones, apresentando média igual a 76,92%. Os clones de Eucalyptus nas idades de 108 e 120 meses apresentam propriedades da madeira adequadas para a produção de carvão vegetal, alcançando rendimento gravimétrico e qualidade satisfatórios para uso metalúrgico, destacando-se os clones 1 (híbrido de E. urophylla x E. grandis) e 3 (híbrido de E. urophylla x E. camaldulensis). 200 2016 insumo corte 10 12 retangular cernealburno cerne alburno cerne/alburno hectareano hectare ano química 21 m determinaramse determinaram se finos friabilidade imediata Verificouse Verificou 49 58 m3 m- 1247 47 12,4 2334 23 34 23,3 ton.ha1, tonha1 tonha ton.ha ton ha ton.ha-1 respectivamente 341 34,1% 32 3,2 107 7 10,7 65 >30 30 (>3 mm, mm , mm) 495 5 49,5 35 45 kg.m3, kgm3 kgm kg.m 3, kg.m-3 75 7, 7692 76 92 76,92% metalúrgico destacandose destacando híbrido E grandis camaldulensis. camaldulensis . camaldulensis) 20 201 124 12, 233 23, ha1 ton.ha1 ton.ha- 34,1 10, 6 >3 (> 49, kg.m3 kg.m- 769 9 76,92 34, > ( 76,9 76,

Abstract Background Cognitive dysfunction (CD) is a widespread manifestation in adult systemic lupus erythematosus (SLE) patients, but this subject is rarely examined in patients with childhood-onset SLE (cSLE). This study aimed to assess the frequency of CD, its associations with lupus clinical manifestations and its impact on the health-related quality of life (HRQL) in young adult cSLE patients. Methods We evaluated 39 cSLE patients older than 18 years. They underwent a rheumatologic evaluation and extensive neuropsychological assessment, encompassing all cognitive domains described by the American College of Rheumatology. HRQL was assessed with the WHOOQOL-BREEF, General Activities of Daily Living Scale (GADL) and Systemic Lupus Erythematosus-specific quality-of-life instrument (SLEQOL). The activity of SLE was evaluated with the modified sle disease activity index (sledai-2k). Results Impairment in at least one cognitive domain was found in 35 (87.2%) patients. The most compromised domains were attention (64.1%), memory (46.2%), and executive functions (38.5%). Patients with cognitive impairment were older, had more accumulated damage and had worse socioeconomic status. Regarding the association between cognitive dysfunction and HRQL, memory impairment was correlated with worse environmental perception and a worse relationship with the treatment. Conclusion In this study, the frequency of CD in cSLE patients was as high as that in the adult SLE population. CD can significantly impact the response of cSLE patients to treatment, justifying preventive measures in the care of this population. (CD (SLE childhoodonset childhood onset cSLE. . (cSLE) healthrelated health related (HRQL 3 1 years assessment Rheumatology WHOOQOLBREEF, WHOOQOLBREEF WHOOQOL BREEF, BREEF WHOOQOL-BREEF GADL (GADL Erythematosusspecific Erythematosus specific qualityoflife SLEQOL. SLEQOL (SLEQOL) sledai2k. sledai2k sledaik sledai 2k k (sledai-2k) 87.2% 872 87 2 (87.2% 64.1%, 641 64.1% , 64 (64.1%) 46.2%, 462 46.2% 46 (46.2%) 38.5%. 385 38.5% 38 5 (38.5%) status treatment population (cSLE (SLEQOL (sledai-2k 87.2 8 (87.2 64.1 6 (64.1% 46.2 4 (46.2% 38.5 (38.5% 87. (87. 64. (64.1 46. (46.2 38. (38.5 (87 (64. (46. (38. (8 (64 (46 (38 ( (6 (4 (3

Abstract Objective: To identify and assess the current evidence available about the costs of managing hospitalized pediatric patients diagnosed with Respiratory Syncytial Virus (RSV) and Parainfluenza Virus Type 3 (PIV3) in upper-middle-income countries. Methods: The authors conducted a systematic review across seven key databases from database inception to July 2022. Costs extracted were converted into 2022 International Dollars using the Purchasing Power Parity-adjusted. PROSPERO identifier: CRD42020225757. Results: No eligible study for PIV3 was recovered. For RSV, cost analysis and COI studies were performed for populations in Colombia, China, Malaysia, and Mexico. Comparing the total economic impact, the lowest cost per patient at the pediatric ward was observed in Malaysia ($ 347.60), while the highest was in Colombia ($ 709.66). On the other hand, at pediatric ICU, the lowest cost was observed in China ($ 1068.26), while the highest was in Mexico ($ 3815.56). Although there is no consensus on the major cost driver, all included studies described that the medications (treatment) consumed over 30% of the total cost. A high rate of inappropriate prescription drugs was observed. Conclusion: The present study highlighted how RSV infection represents a substantial economic burden to health care systems and to society. The findings of the included studies suggest a possible association between baseline risk status and expenditures. Moreover, it was observed that an important amount of the cost is destinated to treatments that have no evidence or support in most clinical practice guidelines. Objective (RSV PIV (PIV3 uppermiddleincome upper middle income countries Methods 202 Parityadjusted. Parityadjusted Parity adjusted. adjusted Parity-adjusted identifier CRD42020225757 CRD Results recovered impact $ ( 347.60, 34760 347.60 , 347 60 347.60) 709.66. 70966 709.66 . 709 66 709.66) hand ICU 1068.26, 106826 1068.26 1068 26 1068.26) 3815.56. 381556 3815.56 3815 56 3815.56) driver treatment (treatment 30 Conclusion society expenditures Moreover guidelines (PIV 20 CRD4202022575 3476 347.6 34 6 7096 709.6 70 10682 1068.2 106 2 38155 3815.5 381 5 CRD420202257 347. 709. 7 1068. 10 3815. 38 CRD42020225 1 CRD4202022 CRD420202 CRD42020 CRD4202 CRD420 CRD42 CRD4

ABSTRACT The identity study has long been gaining new paradigms, even generating identity crises. The aim of the study was to find publications on this theme in Brazilian studies, with the intention of discussing the process of (re)construction of the identity of the Physical Education Teacher. A narrative review of the literature was carried out, to discuss along with the themes of conceptual identity theory, contributions to the construction of teacher identity, and the identity of the physical education teacher. Given the findings, it is worth saying that the current scenario requires a more reflective debate on the direction and development of the professional identity of the physical education teacher. In relation to scientific literature, there is still much to be studied, as it was possible to identify some limitations in studies on identity, such as, for example, the lack of consensus on the definition and conceptualization of the identity of the physical education teacher, which may hinder comparison and generalization of future results. It is hoped that researchers and public and private organizations will pay attention to the necessary care regarding teacher training, as well as any professional development, and that these findings will gain space in discussions related to the professional identity of the physical education teacher. paradigms crises reconstruction re Teacher out theory studied example results training

RESUMO O estudo identitário por muito tempo vem ganhando novos paradigmas, gerando inclusive crises identitárias. O objetivo do estudo foi encontrar publicações desta temática em estudos brasileiros, com a pretensão de discutir o processo de (re)construção da identidade do Professor de Educação Física. Foi realizada uma revisão narrativa da literatura, para discutir junto as temáticas da Teoria conceituais da identidade, Contributos para a construção da identidade do professor, e a identidade do professor de Educação Física. Face aos achados, vale dizer que o cenário atual requer um debate mais reflexivo sobre o direcionamento e desenvolvimento da identidade profissional do professor de Educação Física. Em relação a literatura científica, ainda há muito a ser estudado, pois foi possível identificar algumas limitações nos estudos sobre identidade, como por exemplo, a falta de consenso sobre a definição e conceituação da identidade do professor de Educação Física, que podem dificultar a comparação e generalização de futuros resultados. Espera-se que pesquisadores e organizações públicas a privadas, se atentem aos cuidados necessários quanto à formação do docente, assim para qualquer desenvolvimento profissional, e que esses achados ganhem espaços nas discussões relacionadas a identidade profissional do professor de Educação Física. paradigmas identitárias brasileiros reconstrução re Física científica estudado exemplo resultados Esperase Espera privadas docente

Resumen En Nuevo León, México, se decretaron tres áreas naturales protegidas (ANP) para conservar a Cynomys mexicanus; sin embargo, las actividades agropecuarias continúan dentro de estas áreas, aunado a la carencia de información sobre la condición de su hábitat. En este estudio se evaluó la salud del pastizal y la producción de biomasa de las tres áreas (la Trinidad, la Hediondilla y Llano la Soledad) para determinar su funcionalidad. La salud del ecosistema de La Hediondilla estuvo deteriorada, y su zona núcleo presentó el estado funcional más crítico; además, presentó la mayor producción de biomasa (0.53 Mg/ha-1) debido al cambio de uso de suelo y la vegetación invasora. Las actividades productivas en el Llano La Soledad son básicamente ganaderas, y aunque la producción de biomasa fue menor (0.14 Mg/ha-1), presentó las mejores condiciones de salud, ya que toda su superficie es de uso restringido. La salud deteriorada del pastizal es una amenaza para Cynomys mexicanus y la biodiversidad de su ecosistema.

Abstract In Nuevo Leon, Mexico, three protected natural areas (PNA) have been declared to conserve Cynomys mexicanus; however, agricultural activities are still present within these areas, in conjunction with a lack of information related to their habitat condition. In this study, grassland health and biomass production were evaluated in three protected areas (la Trinidad, la Hediondilla and Llano la Soledad) to determine their functionality. The ecosystem health of La Hedionadilla was deteriorated, and its core zone showed the most critical functional status; additionally, it showed the highest annual production of biomass (0.53 Mg/ha-1) due to land-use change and invasive vegetation. The productive activities in Llano La Soledad are mainly dedicated to cattle raising, and although the biomass production was lower (0.14 Mg/ha-1), it showed the best health condition because its surface is restricted. The deteriorated health of grassland is a threat to Cynomys mexicanus and the biodiversity of its ecosystem.

Suicide is a global public health problem that causes the loss of more than 800,000 lives each year, principally among young people. In Brazil, the average mortality rate attributable to suicide is approximately 5.23 per 100,000 population. Although many guidelines have been published for the management of suicidal behavior, to date, there are no recent guidelines based on the principles of evidence-based medicine that apply to the reality of suicide in Brazil. The objective of this work is to provide key guidelines for managing patients with suicidal behavior in Brazil. This project involved 11 Brazilian psychiatry professionals selected by the Psychiatric Emergencies Committee (Comissão de Emergências Psiquiátricas) of the Brazilian Psychiatric Association for their experience and knowledge in psychiatry and psychiatric emergencies. For the development of these guidelines, 79 articles were reviewed (from 5,362 initially collected and 755 abstracts). In this review, we present definitions, risk and protective factors, assessments, and an introduction to the Safety Plan. Systematic review registry number: CRD42020206517

This article continues our presentation of the Brazilian Psychiatric Association guidelines for the management of patients with suicidal behavior, with a focus on screening, intervention, postvention, prevention, and promotion. For the development of these guidelines, we conducted a systematic review of the MEDLINE (via PubMed), Cochrane Database of Systematic Reviews, Web of Science, and SciELO databases for research published from 1997 to 2020. Systematic reviews, clinical trials, and cohort/observational studies on screening, intervention, and prevention in suicidal behavior were included. This project involved 14 Brazilian psychiatry professionals and 1 psychologist selected by the Psychiatric Emergencies Committee of the Brazilian Psychiatric Association for their experience and knowledge in psychiatry and psychiatric emergencies. Publications were evaluated according to the 2011 Oxford Center for Evidence-Based Medicine (OCEBM) Levels of Evidence Classification. Eighty-five articles were reviewed (of 5,362 initially collected and 755 abstracts on the drug approach). Forms of screening, intervention, and prevention are presented. The intervention section presents evidence for psychotherapeutic and drug interventions. For the latter, it is important to remember that each medication is effective only for specific groups and should not replace treatment protocols. We maintain our recommendation for the use of universal screening plus intervention. Although the various studies differ in terms of the populations evaluated and several proposals are presented, there is already significant evidence for certain interventions. Suicidal behavior can be analyzed by evidence-based medicine protocols. Currently, the best strategy is to combine several techniques through the Safety Plan. Nevertheless, further research on the topic is needed to elucidate some approaches with particular potential for intervention and prevention. Systematic review registry number: CRD42020206517

ABSTRACT The objective of the actual research is to analyze the theoretical bases about problem-based learning as an active methodology for the teaching of natural sciences in Cuban Higher Education. With the descriptors learning based on problems, learning by discovery and construction, learning based on projects and challenges, a bibliographic review was carried out in which original and review articles published between 2000 and 2020 were considered. The search was carried out in the databases of SciELO and Google academic data from April to June 2020. It is concluded that it is pertinent to assume this methodology by the teacher, since it is specified in a teaching management focused on student-centered learning, therefore, it is necessary to continue investigating in this area and proceed to the development and application of instruments that allow them to be evaluated reliably and effectively.

RESUMEN El objetivo del presente estudio está dirigido a analizar los presupuestos teóricos acerca del aprendizaje basado en problemas como metodología activa para la enseñanza de las ciencias naturales en la Educación Superior cubana. Se realizó una revisión bibliográfica en la que se consideraron artículos originales y de revisión publicados entre 2000 y 2020 a partir de los descriptores aprendizaje basado en problemas, aprendizaje por descubrimiento y construcción, aprendizaje basado en proyectos y en retos. La búsqueda fue realizada en las bases de datos SciELO y Google académico de abril a junio de 2020, en función del establecimiento de los presupuestos teóricos y metodológicos de una investigación desarrollada en el Departamento de Química de la Facultad de Ciencias Aplicadas perteneciente a la Universidad de Camagüey Ignacio Agramonte Loynaz. Se concluye que resulta pertinente asumir por parte del profesor esta metodología, ya que se concreta en una gestión docente enfocada en el aprendizaje centrado en el estudiante, por consiguiente, es necesario seguir investigando en esta temática y proceder al desarrollo y la aplicación de instrumentos que permitan evaluarla de modo fiable y eficaz.

Resumen En el caso de personas con limitación motriz de miembros superiores, los gestos faciales son la principal forma de comunicarse con el mundo. Sin embargo, las interfaces actuales basadas en gestos no tienen en cuenta la reducción de movilidad que la mayoría de las personas con limitación motriz experimentan durante sus periodos de recuperación. Como alternativa para superar esta limitación, se presenta una interfaz humana-computador basada en técnicas de visión por computador sobre dos tipos de imagen: la imagen del rostro capturada mediante webcam y la captura de pantalla de una aplicación de escritorio en primer plano. La primera imagen es utilizada para detectar, seguir y estimar la pose del rostro con el fin de desplazar y ejecutar comandos con el cursor; la segunda imagen es utilizada para lograr que los desplazamientos del cursor sean realizados a zonas específicas de interacción de la aplicación de escritorio. La interfaz es programada totalmente en Python 3.6 utilizando bibliotecas de código abierto y se ejecuta en segundo plano dentro del sistema operativo Windows. El desempeño de la interfaz se evalúa con videos de personas utilizando cuatro comandos de interacción con la aplicación WhatsApp versión de escritorio. Se encontró que la interfaz puede operar con varios tipos de iluminación, fondos, distancias a la cámara, posturas y velocidades de movimiento; la ubicación y el tamaño de la ventana de WhatsApp no afecta la efectividad de la interfaz. La interfaz opera a una velocidad de 1 Hz y utiliza el 35 % de la capacidad de un procesador Intel Core i5 y 1,5 GB de RAM para su ejecución lo que permite concebir esta solución en equipos de cómputo personales.

Abstract People with reduced upper-limb mobility depend mainly on facial gestures to communicate with the world; nonetheless, current facial gesture-based interfaces do not take into account the reduction in mobility that most people with motor limitations experience during recovery periods. This study presents an alternative to overcome this limitation, a human-computer interface based on computer vision techniques over two types of images: images of the user’s face captured by a webcam and screenshots of a desktop application running on the foreground. The first type is used to detect, track, and estimate gestures, facial patterns in order to move and execute commands with the cursor, while the second one is used to ensure that the cursor moves to specific interaction areas of the desktop application. The interface was fully programmed in Python 3.6 using open source libraries and runs in the background in Windows operating systems. The performance of the interface was evaluated with videos of people using four interaction commands in WhatsApp Desktop. We conclude that the interface can operate with various types of lighting, backgrounds, camera distances, body postures, and movement speeds; and the location and size of the WhatsApp window does not affect its effectiveness. The interface operates at a speed of 1 Hz and uses 35 % of the capacity a desktop computer with an Intel Core i5 processor and 1.5 GB of RAM for its execution; therefore, this solution can be implemented in ordinary, low-end personal computers.

Resumen: Introducción: la pandemia provocada por el SARS-CoV-2 genera un importante desafío para el sistema sanitario y especialmente para la Medicina Intensiva. Es necesario prepararse en múltiples aspectos. Además, considerar plausible una demanda extraordinaria de camas críticas que puede llevar a un desbalance entre las necesidades clínicas y la disponibilidad efectiva de los recursos sanitarios. Objetivos: realizar un análisis bioético para brindar una orientación en la atención a los pacientes críticos. Objetivos específicos: 1) Analizar los principios bioéticos fundamentales en este contexto. 2) Apoyar a los clínicos en la toma de decisiones difíciles. 3) Hacer explícitos los criterios de asignación de recursos. 4) Definir líneas de acción ante un posible escenario de “desastre sanitario”. Método: la SUMI ha generado un ámbito de trabajo colectivo cuyo método de trabajo fue la deliberación. En la documentación se utiliza la revisión bibliográfica y los protocolos ya existentes. Resultados: el trabajo plantea un análisis teórico documentado sobre los principios bioéticos involucrados en el contexto de pandemia, sobre los escenarios de demanda asistencial y sobre la fundamentación para un cambio en los criterios éticos ante un escenario de saturación del sistema. Conclusión: se plantean recomendaciones prácticas para: 1) Toma de decisiones de ingreso y egreso en demanda controlada. 2) Criterios de acción ante el aumento de la demanda estableciendo definiciones de los diferentes escenarios. 3) Recomendaciones para aplicar en un escenario de saturación del sistema.

Summary: Introduction: the pandemic caused by SARS-CoV2 constitutes a significant challenge for the health system, and especially for Critical Care Units, so we need to prepare in many aspects. Likewise, we need to consider there could be an extraordinary demand for beds in critical care units, what would lead to an imbalance between clinical needs and the effective availability of health resources. Objectives: the study aims to perform a bioethical analysis that could provide guidelines for the assistance of patients in critical care. Specific objectives: 1) to analyse the main bioethical principles in this context, 2) to support clinicians in the making of difficult decisions, 3) to make the resource allocation criteria specific, 4) to define action lines upon a potential “health’s disastrous” scenario Method: the Uruguayan Society of Intensive Care has generated a space for collective work based on discussion processes. Documents include a bibliographic review and the existing protocols. Results: the study presents a theoretical analysis that is backed up by the bioethical principles involved in the pandemic context on the scenarios of demand for assistance and, by the arguments calling for a change in the ethical criteria upon the saturation of the health system. Conclusion: practical recommendations are made: 1) for the making of decisions about admission and discharge in a controlled demand. 2) to define action criteria upon an increase in demand, clearly defining the different scenarios, 3) to apply upon the saturation of the health system.

Resumo: Introdução: a pandemia causada pelo SARS-CoV2 gera um importante desafio para o sistema de saúde e principalmente para a Medicina Intensiva. É preciso se preparar em vários aspectos. Além disso, considera plausível uma demanda extraordinária por leitos críticos, que pode levar a um desequilíbrio entre as necessidades clínicas e a disponibilidade efetiva de recursos de saúde. Objetivos: realizar uma análise bioética para orientar o cuidado ao paciente crítico. Objetivos específicos: 1) Analisar os princípios bioéticos fundamentais neste contexto, 2) Apoiar os médicos na tomada de decisões difíceis, 3) Tornar explícitos os critérios de alocação de recursos, 4) Definir linhas de ação perante um possível cenário de " desastre de saúde ". Métodos: a SUMI gerou um ambiente de trabalho coletivo cujo método de trabalho era deliberativo. A documentação usa a revisão da literatura e os protocolos existentes. Resultados: o trabalho propõe uma análise teórica documentada sobre os princípios bioéticos envolvidos no contexto da Pandemia, sobre os cenários da demanda de saúde e sobre os fundamentos para uma mudança de critérios éticos em um cenário de saturação do sistema. Conclusão: são propostas recomendações práticas para: 1) tomada de decisão para admissão e alta sob demanda controlada. 2) critérios de atuação frente ao aumento da demanda, estabelecendo definições dos diferentes cenários. 3) recomendações a serem aplicadas em um cenário de saturação do sistema.

Resumen En diciembre de 2019 se detectó por primera vez en China la existencia del SARS-CoV2, causante de la enfermedad COVID-19. El virus rápidamente se propagó por Europa y Asia, tardándose un par de meses antes de llegar a América Latina. Se ha demostrado que los pacientes que desarrollan una enfermedad severa y que tienen mayor riesgo de mortalidad por COVID-19 son aquellos con edades avanzadas y que presentan por lo menos una enfermedad crónica, incluyendo el cáncer. Debido a lo anterior, surgen muchas dudas en el grupo de profesionales encargados de brindar tratamiento a pacientes con cáncer durante la pandemia, pues se debe equilibrar el riesgo-beneficio de proveer tratamiento a pacientes que se encuentran de base con un riesgo incrementado para tener manifestaciones severas por COVID-19. En este consenso planteamos recomendaciones para los profesionales en hematología que brindan tratamiento a pacientes que padecen de algún tipo de linfoma, con el fin de aclarar el panorama clínico durante la pandemia.

Abstract The existence of SARS-CoV2, the cause of COVID 19 disease, was detected for the first time in China in December 2019. The virus quickly spread across Europe and Asia, taking a couple months to reach Latin America. It has been shown that elderly patients and those with chronic diseases, including cancer, have a higher risk of mortality from COVID-19. Consequently, many doubts arise in the group of health professionals responsible for treating patients with cancer during the pandemic, as they must balance the risk-benefit of delivering treatment to patients with an increased risk for severe manifestations resulting from COVID-19. In this consensus we propose recommendations for hematology professionals who provide treatment to patients suffering from some type of lymphoma, with the aim of clarifying the clinical picture during the pandemic.

Resumen La enfermedad por COVID-19 fue detectada a finales de 2019 en Wuhan, China. Debido a su rápida propagación fue declarada emergencia sanitaria de forma inicial y luego de identificar casos fuera de China con transmisión autóctona y caracterizado por una mortalidad considerablemente alta en países como Italia y España, fue declarada pandemia por la Organización Mundial de la Salud. Se ha evidenciado que los pacientes mayores y con antecedentes de enfermedades crónicas incluido el cáncer desarrollan una enfermedad severa, presentando mayor riesgo de mortalidad por SARS-CoV2/ COVID-19. Lo anterior es por supuesto especialmente importante en el manejo de pacientes con Mieloma Múltiple (MM), generando en el personal Médico nuevos desafíos, oportunidades de mejora y aprendizajes, que aporten al análisis riesgo-beneficio del tratamiento inmunodepresor en este tipo de patologías. El consenso tiene como objetivo brindar orientación sobre el manejo de pacientes con MM en estos momentos donde el profesional de la salud requiere información para llevar a cabo terapias eficientes en el cuidado del paciente.

Abstract COVID-19 disease was detected in late 2019 in Wuhan, China. Due to its rapid spread, it was initially declared a health emergency, but after cases with indigenous transmission were identified outside China, characterized by considerably high mortality in countries such as Italy and Spain, it was declared a pandemic by the World Health Organization. It has been shown that elderly patients with a history of chronic diseases, including cancer, develop a severe disease, presenting a higher risk of mortality from SARS-CoV2 / COVID-19. This becomes especially important in the management of patients with Multiple Myeloma (MM), generating new challenges, opportunities for improvement and learning opportunities in the health professionals, which will contribute to the risk-benefit analysis of immunosuppressive treatment for this type of pathology. The consensus aims to provide guidance for the management of patients with MM in these times when the health professional requires information to deliver efficient therapies in patient care.

Abstract The aim of the present study was to determine the floristic composition of the sarcocaule scrub of the Sonoran desert in an area of 800 ha within an ejidal property located in the limits of the city of La Paz, Southern Baja California. Sampling was carried out during the rainy season (September-November 2018) and at the end of the dry season (May-August 2019), using 20 quadrants of 5 m × 5 m. 29 species of 1 634 individuals were identified, between the two seasons and the variables of height and crown diameter of each specimen by species were considered, in order to determine abundance (A r ), dominance (D r ), frequency (F r ), importance value index (IVI) and the Shannon index for species diversity (H´) and the Margalef index for species richness (S´). During the rainy season, Jatropha cinerea is observed as the dominant species D r = 7.15 % and with the highest IVI (10.7 %) and Turnera diffusa as the most abundant with A r = 3.2. On the other hand, for the dry season, Prosopis articulata is the dominant species D r = 9.29 and with the highest IVI (12.51 %) and Mammillaria armillata as the most abundant, with A r = 4.56. The indices of H' and S' during the rainy season were 3.36 and 8.09, respectively, with a difference between them (p≤0.05) when compared with those of the dry season (2.88 and 4.88, respectively), due to the absence of species and decrease in the number of individuals, than in the wet season.

Resumen El objetivo del presente estudio fue determinar la composición florística del matorral sarcocaule del desierto sonorense en un área de 800 ha dentro de una propiedad ejidal ubicada en los límites de la ciudad de La Paz, Baja California Sur. El muestreo se realizó durante la época de lluvias (septiembre-noviembre de 2018) y a finales de la épocade sequía (mayo-agosto de 2019), por medio de 20 cuadrantes de 5 m × 5 m. Se identificaron 29 especies de 1 634 individuos, entre las dos temporadas y se consideraron las variables de altura y diámetro de copa de cada ejemplar por especie, para determinar abundancia (A r ), dominancia (D r ), frecuencia (F r ), índice de valor de importancia (IVI) y los índices de Shannon para la diversidad de especies (H´) e índice de Margalef para la riqueza de especies (S´). Durante la época de lluvias, se observó a Jatropha cinerea como dominante D r =7.15 % y con mayor IVI (10.7 %); Turnera diffusa fue la más abundante con A r =3.2. En cambio, para la temporada seca, fue Prosopis articulata la especie dominante D r =9.29 y con mayor IVI (12.51 %); Mammillaria armillata fue la más abundante, con A r =4.56. Los índices de (H’) y (S’) durante la época de lluvias fueron 3.36 y 8.09, respectivamente, con diferencia entre ellos (p≤0.05) al compararlos con los de la temporada seca (2.88 y 4.88, respectivamente), debido a la ausencia de taxones y disminución del número de individuos, en relación con la época húmeda.