Abstract Background Vitamin K antagonists (VKAs) are the recommended first-line treatment for left ventricular thrombus (LVT); however, direct oral anticoagulants (DOACs) have been considered an alternative therapy. Objectives To evaluate the efficacy and safety of DOACs compared with VKAs therapy in patients with LVT. Methods PubMed, Embase, and Cochrane were systematically searched for randomized clinical trials or cohort studies that compared DOACs versus VKAs for LVT. Risk ratios (RRs) were computed for binary endpoints, with 95% confidence intervals (95% CIs). Statistical significance was defined as p value < 0.05. Results A total of 4 randomized clinical trials and 29 cohort studies were included, with 4,450 patients assigned to either DOACs or VKAs. There was no significant difference between groups for stroke or systemic embolic (SSE) events (RR 0.84; 95% CI 0.65 to 1.07; p = 0.157), stroke (RR 0.73; 95% CI 0.48 to 1.11; p = 0.140), systemic embolic (SE) events (RR 0.69; 95% CI 0.40 to 1.17; p = 0.166), thrombus resolution (RR 1.05; 95% CI 0.99 to 1.11; p = 0.077), any bleeding (RR 0.78; 95% CI 0.60 to 1.00; p = 0.054), clinically relevant bleeding (RR 0.69; 95% CI 0.46 to 1.03; p = 0.066), minor bleeding (RR 0.73; 95% CI 0.43 to 1.23; p = 0.234), major bleeding (RR 0.87; 95% CI 0.42 to 1.80; p = 0.705), and all-cause mortality (RR 1.05; 95% CI 0.79 to 1.39; p = 0.752). Compared with VKAs, rivaroxaban significantly reduced SSE events (RR 0.35; 95% CI 0.16 to 0.91; p = 0.029) and SE events (RR 0.39; 95% CI 0.16 to 0.95; p = 0.037). Conclusions DOACs had a similar rate of thromboembolic and hemorrhagic events, as well as thrombus resolution, compared to VKAs in the treatment of LVTs. Rivaroxaban therapy had a significant reduction in thromboembolic events, compared to VKAs. (VKAs firstline first line LVT (LVT) however (DOACs PubMed Embase RRs (RRs endpoints 95 (95 CIs. CIs . CIs) 005 0 05 0.05 2 included 4450 450 4,45 (SSE RR 0.84 084 84 065 65 0.6 1.07 107 1 07 0.157, 0157 0.157 , 157 0.157) 0.73 073 73 048 48 0.4 1.11 111 11 0.140, 0140 0.140 140 0.140) (SE 0.69 069 69 040 40 1.17 117 17 0.166, 0166 0.166 166 0.166) 1.05 105 099 99 0.9 0.077, 0077 0.077 077 0.077) 0.78 078 78 060 60 1.00 100 00 0.054, 0054 0.054 054 0.054) 046 46 1.03 103 03 0.066, 0066 0.066 066 0.066) 043 43 1.23 123 23 0.234, 0234 0.234 234 0.234) 0.87 087 87 042 42 1.80 180 80 0.705, 0705 0.705 705 0.705) allcause all cause 079 79 0.7 1.39 139 39 0.752. 0752 0.752 752 0.752) 0.35 035 35 016 16 0.1 0.91 091 91 0.029 0029 029 0.39 039 0.95 095 0.037. 0037 0.037 037 0.037) LVTs (LVT 9 (9 0.0 445 45 4,4 0.8 08 8 06 6 0. 1.0 10 015 0.15 15 7 04 1.1 014 0.14 14 09 007 0.07 006 0.06 1.2 12 023 0.23 1.8 18 070 0.70 70 1.3 13 3 075 0.75 75 0.3 01 0.02 002 02 003 0.03 ( 44 4, 1. 0.2

Resumo Fundamento Os antagonistas da vitamina K (AVKs) são o tratamento de primeira linha recomendado para trombo ventricular esquerdo (TVE); entretanto, os anticoagulantes orais diretos (AODs) têm sido considerados uma terapia alternativa. Objetivos Avaliar a eficácia e a segurança dos AODs em comparação com a terapia com AVKs em pacientes com TVE. Métodos PubMed, Embase e Cochrane foram sistematicamente pesquisados em busca de ensaios clínicos randomizados ou estudos de coorte que comparassem AODs versus AVKs para TVE. As razões de risco (RR) foram calculadas para desfechos binários, com intervalos de confiança (IC) de 95%. A significância estatística foi definida como valor de p < 0,05. Resultados Foram incluídos um total de 4 ensaios clínicos randomizados e 29 estudos de coorte, com 4.450 pacientes designados para AODs ou AVKs. Não houve diferença significativa entre os grupos para acidente vascular cerebral ou eventos embólicos sistêmicos (AVC/EES) (RR 0,84; IC 95% 0,65 a 1,07; p = 0,157), acidente vascular cerebral (RR 0,73; IC 95% 0,48 a 1,11; p = 0,140), eventos embólicos sistêmicos (EES) (RR 0,69; IC 95% 0,40 a 1,17; p = 0,166), resolução do trombo (RR 1,05; IC 95% 0,99 a 1,11; p = 0,077), qualquer sangramento (RR 0,78; IC 95% 0,60 a 1,00; p = 0,054), sangramento clinicamente relevante (RR 0,69; IC 95% 0,46 a 1,03; p = 0,066), sangramento menor (RR 0,73; IC 95% 0,43 a 1,23; p = 0,234), sangramento maior (RR 0,87; IC 95% 0,42 a 1,80; p = 0,705) e mortalidade por todas as causas (RR 1,05; IC 95% 0,79 a 1,39; p = 0,752). Em comparação com AVKs, a rivaroxabana reduziu significativamente AVC/EES (RR 0,35; IC 95% 0,16 a 0,91; p = 0,029) e EES (RR 0,39; IC 95% 0,16 a 0,95; p = 0,037). Conclusões Os AODs tiveram uma taxa semelhante de eventos tromboembólicos e hemorrágicos, bem como de resolução do trombo, em comparação com os AVKs no tratamento de TVE. A terapia com rivaroxabana teve uma redução significativa nos eventos tromboembólicos, em comparação com os AVKs. (AVKs TVE (TVE) entretanto (AODs alternativa PubMed RR binários (IC 95 005 0 05 0,05 2 4450 450 4.45 AVCEES AVC (AVC/EES 0,84 084 84 065 65 0,6 1,07 107 1 07 0,157, 0157 0,157 , 157 0,157) 0,73 073 73 048 48 0,4 1,11 111 11 0,140, 0140 0,140 140 0,140) (EES 0,69 069 69 040 40 1,17 117 17 0,166, 0166 0,166 166 0,166) 1,05 105 099 99 0,9 0,077, 0077 0,077 077 0,077) 0,78 078 78 060 60 1,00 100 00 0,054, 0054 0,054 054 0,054) 046 46 1,03 103 03 0,066, 0066 0,066 066 0,066) 043 43 1,23 123 23 0,234, 0234 0,234 234 0,234) 0,87 087 87 042 42 1,80 180 80 0,705 0705 705 079 79 0,7 1,39 139 39 0,752. 0752 0,752 . 752 0,752) 0,35 035 35 016 16 0,1 0,91 091 91 0,029 0029 029 0,39 039 0,95 095 0,037. 0037 0,037 037 0,037) hemorrágicos (TVE 9 0,0 445 45 4.4 0,8 08 8 06 6 0, 1,0 10 015 0,15 15 7 04 1,1 014 0,14 14 09 007 0,07 006 0,06 1,2 12 023 0,23 1,8 18 0,70 070 70 1,3 13 3 075 0,75 75 0,3 01 0,02 002 02 003 0,03 44 4. 1, 0,2

ABSTRACT Objective: describe the process of translation and cross-cultural adaptation of the Mayo High Performance Team Scale into Brazilian Portuguese. Method: descriptive study of validation and cross-cultural adaptation of the scale, carried out virtually, following assumptions proposed by Beaton and collaborators. It had a sample of 40 experts, and carried out two rounds, one for validation and one for final assessment. Results: after following all translation steps, the scale was presented to the committee of experts who reached a consensus (IVC between 0.9 and 1.0) that there was no discrepancy, after evaluating the semantic, idiomatic, experiential and conceptual equivalences between the original scale and the translated version. Conclusion: The Brazilian Portuguese version of the MHPTS was adequately translated and validated, revealing excellent potential for use in clinical simulation contexts for multidisciplinary scenarios. Objective crosscultural cross cultural Method virtually collaborators 4 rounds assessment Results steps IVC 09 0 9 0. 1.0 10 1 discrepancy semantic idiomatic Conclusion validated scenarios 1.

RESUMO Objetivo: descrever o processo de tradução e adaptação transcultural da escala Mayo High Performance Team Scale para o português brasileiro. Método: estudo descritivo de validação e adaptação transcultural da escala, realizado de maneira virtual, seguindo pressupostos propostos por Beaton e colaboradores. Contou com uma amostra de 40 especialistas, e realizou duas rodadas, sendo uma de validação e uma de apreciação final. Resultados: após seguir todas as etapas de tradução a escala foi apresentada ao comitê de especialistas que chegou a um consenso (IVC entre 0,9 e 1,0) sobre não haver qualquer discrepância, após avaliação das equivalências semântica, idiomática, experiencial e conceitual entre a escala original e a versão traduzida. Conclusão: A versão em português brasileiro da MHPTS foi adequadamente traduzida e validada, revelando excelente potencial de utilização em contextos de simulação clínica para cenários multiprofissionais. Objetivo Método virtual colaboradores 4 rodadas final Resultados IVC 09 0 9 0, 1,0 10 1 discrepância semântica idiomática Conclusão validada multiprofissionais 1,

Resumen En este artículo analizamos significados producidos por estudiantes de educación secundaria durante el desarrollo de un escenario de investigación que ha implicado la inmersión en las distintas fases de un proceso de modelización matemática. El problema abordado se relaciona con el tránsito vehicular entre dos ciudades argentinas, y focalizamos en los aspectos que se vinculan con el desarrollo de una ciudadanía crítica, desde una perspectiva socio-crítica de la modelización. Apelamos a una metodología cualitativa de estudio de casos. El escenario ha resultado adecuado para proporcionar la oportunidad de que el estudiantado reflexione en torno al problema del mundo real. La familiaridad con la situación facilitó su conexión con los antecedentes de los estudiantes, que, a partir de establecer una intencionalidad, lograron ver significado en las acciones llevadas a cabo y aprender con otros. Consideramos que el estudiantado asume una actitud crítica, dado que presta atención y reacciona ante una situación que genera dificultades en las ciudades en las que reside. Para abordar su resolución, piensa de modo autónomo y toma decisiones equilibradas que son discutidas y justificadas en el seno de los grupos pequeños y también del curso completo. Señalamos como limitación del escenario montado que el debate generado en torno a las nociones matemáticas involucradas resultó insuficiente. matemática argentinas crítica sociocrítica socio casos real intencionalidad otros reside resolución completo insuficiente

Abstract In this article, we analyze meanings produced by high school students during the development of a landscape of investigation that involved immersion in the different phases of a mathematical modeling process. The problem addressed here is related to vehicular traffic between two Argentinian cities, and we focus on the aspects that are linked to the development of critical citizenship from a socio-critical perspective of modeling. We used a qualitative case study methodology. The scenario proved to be adequate for allowing students to reflect on the real-world problem. Familiarity with the situation facilitated its connection with the students' background, who, by developing an intentional mindset, were able to see meaning in the actions carried out and learn with others. We consider that the students assume a critical attitude, given that they pay attention and react to a situation that generates difficulties in the cities where they live. In order to address its resolution, they think autonomously and make balanced decisions that are discussed and justified within small groups as well as with the whole class. We point out, as a limitation of the scenario set up for this study, that the debate generated around the mathematical notions involved turned out to be insufficient. article process sociocritical socio methodology realworld real world background who mindset others attitude live resolution class insufficient

ABSTRACT C3 glomerulopathies are a rare group of glomerular diseases resulting from excessive activation of the alternative complement pathway. The pathogenesis involves genetic, acquired, or immunologic defects in regulators of the alternative complement pathway. Currently, these diseases have a chronic course with progression to end-stage renal disease in up to 50% of adult patients. We report a case of a young woman who presented with nephrotic syndrome and renal disfunction. During follow-up, the diagnosis of C3 glomerulopathy associated with complement factor I deficiency was established. After relapse of nephrotic proteinuria, immunosuppressive therapy with mycophenolate mofetil and glucocorticoid was added to supportive care. There is no disease-specific therapy for C3 glomerulopathies, and treatment is focused on reducing proteinuria and renal inflammation. Supportive treatment with ACE inhibitors or angiotensin receptor blockers is the first-line therapy. Immunosuppressive therapy with mycophenolate mofetil plus corticosteroids is associated with higher chances of clinical remission and lower risk of kidney failure. Complement targeting therapies, such as eculizumab, avacopan, danicopan, iptacopan, and pegcetacoplan, are being studied as potential new therapeutic options. This article highlights the need for more clinical trials to test new therapeutic agents, as well as to better understand the heterogeneity of the disease and its long-term outcomes.

Objetivo: mapear los instrumentos para la evaluación del riesgo de lesiones por presión en adultos en situación crítica en una unidad de terapia intensiva; identificar los indicadores de desempeño de los instrumentos y la apreciación de los usuarios con respecto al uso/limitaciones de los instrumentos. Método: scoping review. Para redactar el estudio se utilizó la extensión Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. La investigación se realizó mediante la herramienta de búsqueda EBSCOhost en 8 bases de datos, resultando 1846 estudios, de los cuales 22 conforman la muestra. Resultados: se identificaron dos grandes grupos de instrumentos: los generalistas [Braden, Braden (ALB), Emina, Norton-MI, RAPS y Waterlow]; y los específicos (CALCULATE, Cubbin & Jackson, EVARUCI, RAPS-ICU, Song & Choi, Suriaidi y Sanada y el índice COMHON). En cuanto al valor predictivo, EVARUCI y CALCULATE mostraron los mejores resultados de indicadores de desempeño. En cuanto a las apreciaciones/limitaciones señaladas por los usuarios, destaca la escala CALCULATE, seguida de la EVARUCI y la RAPS-ICU, aunque aún necesitan ajustes futuros. Conclusión: el mapeo mostró que las evidencias son suficientes para indicar uno o más instrumentos para la evaluación del riesgo de lesiones por presión en adultos críticos en una unidad de cuidados intensivos. Objetivo intensiva usolimitaciones uso limitaciones Método review MetaAnalyses Meta Analyses datos 184 estudios 2 muestra Resultados Braden, [Braden ALB, ALB , (ALB) Emina NortonMI, NortonMI Norton MI, MI Norton-MI Waterlow Waterlow] (CALCULATE Jackson RAPSICU, RAPSICU ICU, ICU RAPS-ICU Choi COMHON. COMHON . COMHON) predictivo apreciacioneslimitaciones apreciaciones futuros Conclusión intensivos 18 (ALB 1

Objective: to map the instruments for risk assessment of pressure ulcers in adults in critical situation in intensive care units; identify performance indicators of the instrument, and the appreciation of users regarding the instruments’ use/limitations. Method: a scoping review. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews in the writing of the study. We carried out the searches in the EBSCOhost search tool for 8 databases, resulting in 1846 studies, of which 22 studies compose the sample. Results: we identified two big instrument groups: generalist [Braden, Braden (ALB), Emina, Norton-MI, RAPS, and Waterlow]; and specific (CALCULATE, Cubbin & Jackson, EVARUCI, RAPS-ICU, Song & Choi, Suriaidi and Sanada, and COMHON index). Regarding the predictive value, EVARUCI and CALCULATE presented better results for performance indicators. Concerning appreciation/limitations indicated by users, we highlight the CALCULATE scale, followed by EVARUCI and RAPS-ICU, although they still need future adjustments. Conclusion: the mapping of the literature showed that the evidence is sufficient to indicate one or more instruments for the risk assessment of pressure ulcers for adults in critical situation in intensive care units. Objective units uselimitations use limitations use/limitations Method review MetaAnalyses Meta Analyses study databases 184 2 sample Results groups Braden, [Braden ALB, ALB , (ALB) Emina NortonMI, NortonMI Norton MI, MI Norton-MI RAPS Waterlow Waterlow] CALCULATE, (CALCULATE Jackson RAPSICU, RAPSICU ICU, ICU RAPS-ICU Choi Sanada index. index . index) value appreciationlimitations scale adjustments Conclusion 18 (ALB 1

Objetivo: mapear os instrumentos para avaliação do risco de lesões por pressão nos adultos em situação crítica em unidade de cuidados intensivos; identificar os indicadores de desempenho dos instrumentos e a apreciação dos utilizadores quanto ao uso/às limitações dos instrumentos. Método: scoping review. O Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews foi utilizado para a redação do estudo. A pesquisa foi realizada na ferramenta de busca EBSCOhost em oito bases de dados, resultando em 1846 estudos, dos quais 22 compõem a amostra. Resultados: identificaram-se dois grandes grupos de instrumentos: os genéricos [Braden, Braden (ALB), Emina, Norton-MI, RAPS e Waterlow]; e os específicos (CALCULATE, Cubbin & Jackson, EVARUCI, RAPS-ICU, Song & Choi, Suriaidi e Sanada e o índice de COMHON). Quanto ao valor preditivo, a EVARUCI e a CALCULATE apresentaram os melhores resultados de indicadores de desempenho. Em relação à apreciação/às limitações apontadas pelos utilizadores, destacam-se a escala CALCULATE, seguindo-se da EVARUCI e da RAPS-ICU, embora ainda necessitem de ajustes futuros. Conclusão: o mapeamento mostrou que as evidências são suficientes para indicar um ou mais instrumentos para avaliação do risco de lesões por pressão nos adultos em situação crítica em unidade de cuidados intensivos. Objetivo intensivos usoàs uso às Método review MetaAnalyses Meta Analyses estudo dados 184 estudos 2 amostra Resultados identificaramse identificaram se Braden, [Braden ALB, ALB , (ALB) Emina NortonMI, NortonMI Norton MI, MI Norton-MI Waterlow Waterlow] (CALCULATE Jackson RAPSICU, RAPSICU ICU, ICU RAPS-ICU Choi COMHON. COMHON . COMHON) preditivo apreciaçãoàs destacamse destacam seguindose seguindo futuros Conclusão 18 (ALB 1

RESUMEN La infección causada por el SARS-CoV-2, tuvo una repercusión negativa en la evolución clínica de un número importante de gestantes y puérperas en todo el mundo. Este trabajo tiene como objetivo, exponer los principales resultados de la organización del proceso de atención a la paciente obstétrica en el contexto de la pandemia por la COVID-19. Está basado en la organización y elementos fundamentales seguidos con las pacientes que ingresaron, por afecciones relacionadas con el aborto, embarazo o puerperio, con sospecha de COVID-19 o con RT-PCR para SARS-CoV-2 positivo, en el año 2020, y las positivas al SARS-CoV-2 en 2021, de las provincias La Habana, Mayabeque y Artemisa, que fueron atendidas en el Hospital Militar Central “Dr. Luis Díaz Soto”. Se tuvo en cuenta el total de casos ingresados, pacientes confirmadas, ingresos en unidad de cuidados intensivos obstétricos, en servicio de vigilancia intensiva obstétrica, y la evolución clínica Con la organización de la atención médica a las pacientes obstétricas con la COVID-19, se logró el cumplimiento de los protocolos establecidos y la integración multidisciplinaria en el seguimiento de los casos, lo cual contribuyó a la evolución favorable de la mayoría de las pacientes.

ABSTRACT The infection caused by SARS-CoV-2 had a negative impact on the clinical evolution of a significant number of pregnant and puerperal women worldwide. The aim of this work is to present the main results of the organization of the obstetric patient care process in the context of the COVID-19 pandemic. It is based on the organization and fundamental elements followed with the patients who were admitted, for conditions related to abortion, pregnancy or puerperium, with suspicion of COVID-19 or with positive RT-PCR for SARS-CoV-2, in the year 2020, and those positive to SARS-CoV-2 in 2021, from Havana, Mayabeque and Artemisa provinces, who were attended at the Central Military Hospital "Dr. Luis Díaz Soto". The total number of cases admitted, confirmed patients, admissions to the obstetric intensive care unit, obstetric intensive surveillance service, and clinical evolution were taken into account. With the organization of medical care for obstetric patients with COVID-19, compliance with established protocols and multidisciplinary integration in the follow-up of cases was achieved, which contributed to the favorable evolution of most patients.

Abstract Walter Benjamin published his influential essay ‘Critique of Violence’/‘Zur Kritik der Gewalt’ in 1921, and the work has troubled and provoked thinkers across disciplines for over a century now. This Forum gathers a group of scholars in philosophy, political science, international relations and legal studies to reflect on the actuality of Benjamin’s essay for contemporary critical theory. Melany Cruz, Kaveh Ghoreishi and Sara Minelli engage Benjamin on ‘divine violence.’ As Cruz notes, lynching in contemporary Mexico has become a recurrent phenomenon in nota roja outlets. Due to its brutality, perceptions of lynching have been reduced to a form of uncivilised and irrational crime. In opposition to this perspective, Cruz theorises the political dimension of the violence of lynching by drawing from Benjamin and argues that such violence symbolically and affectively dramatises the suspension of ‘mere life’ in which the communities enacting the lynchings are immersed in the current conditions of neoliberal Mexico. In this way, it is possible to claim that lynching, in Benjamin’s terms, constitutes a form of divine violence that has the capacity to reveal and communicate the need to end the fear- and anger-provoking condition of ‘mere life.’ In the second section, Ghoreishi and Minelli propose a reading of ‘divine’ as opposed to ‘mythical violence’ that brings out the radical elements of some contemporary struggles by interpreting some examples of strike which took place in Iranian Kurdistan (Rojhilat) in the last forty years. They understand the revolutionary ‘general strike’ considered by Benjamin as what Jesi has called a ‘suspension of time,’ bringing ‘normal’ economic and social relations to a halt. In this sense, the general strikes in Kurdistan can be said to bring the mythological temporality of oppression to an end. These struggles, in which new forms of collectivity have emerged and been experimented, should, therefore, be seen as anticipations of the ‘divine violence’ that puts an end to ‘mythical violence.’ Critique Violence/‘Zur ViolenceZur Violence /‘Zur Zur Gewalt 1921 now philosophy science Benjamins s theory violence. notes outlets brutality crime perspective mere life way terms fear angerprovoking anger provoking life. section mythical Rojhilat (Rojhilat years time, time ‘normal normal halt sense experimented should therefore 192 19 1

Resumo Walter Benjamin publicou seu influente ensaio ‘Crítica da Violência’ / ‘Zur Kritik der Gewalt’ em 1921, e o trabalho tem incomodado e provocado pensadores de várias disciplinas por mais de um século. Este Fórum reúne um grupo de estudiosos em filosofia, ciência política, relações internacionais e estudos jurídicos para refletir sobre a atualidade do ensaio de Benjamin para a teoria crítica contemporânea. Melany Cruz, Kaveh Ghoreishi e Sara Minelli envolvem Benjamin na ‘violência divina’. Como observa Cruz, o linchamento no México contemporâneo tornou-se um fenômeno recorrente nas mídias nota roja. Devido à sua brutalidade, as percepções do linchamento foram reduzidas a uma forma de crime incivilizado e irracional. Em oposição a essa perspectiva, Cruz teoriza a dimensão política da violência do linchamento ao se basear em Benjamin e argumenta que tal violência simbolicamente e afetivamente dramatiza a suspensão da ‘mera vida’ na qual as comunidades que realizam os linchamentos estão imersas nas condições atuais do México neoliberal. Dessa forma, é possível afirmar que o linchamento, nos termos de Benjamin, constitui uma forma de violência divina que tem a capacidade de revelar e comunicar a necessidade de acabar com a condição provocadora de medo e raiva da ‘mera vida’. Na segunda seção, Ghoreishi e Minelli propõem uma leitura do ‘divino’ em oposição à ‘violência mítica’ que destaca os elementos radicais de algumas lutas contemporâneas ao interpretar alguns exemplos de greve que ocorreram no Curdistão iraniano (Rojhilat) nos últimos quarenta anos. Eles entendem a ‘greve geral’ revolucionária considerada por Benjamin como o que Jesi chamou de ‘suspensão do tempo’, interrompendo as relações econômicas e sociais ‘normais’. Nesse sentido, as greves gerais no Curdistão podem ser ditas como encerrando a temporalidade mitológica da opressão. Essas lutas, nas quais novas formas de coletividade surgiram e foram experimentadas, devem, portanto, ser vistas como antecipações da ‘violência divina’ que põe fim à “violência mítica”. Crítica Violência Zur Gewalt 1921 século filosofia contemporânea divina. . tornouse tornou roja brutalidade irracional perspectiva mera vida neoliberal vida. seção ‘divino divino mítica Rojhilat (Rojhilat anos geral tempo, tempo , tempo’ ‘normais. normais ‘normais ‘normais’ sentido opressão experimentadas devem portanto mítica. mítica” 192 19 1

Abstract Insulin-like growth factor I (IGF-1) is the most important known growth factor for cartilage repair in horses. It promotes mitosis of chondrocytes, collagen II expression, and extra cellular matrix production. Osteoarthritis (OA) is the most common musculoskeletal condition that causes lameness and poor performance in sport horses. A total of 11 lame horses were clinically and radiographically evaluated, and all were confirmed to suffer a front metacarpophalangeal lameness by a positive flexion test, a low-4-point nerve block and an intraarticular block. Total protein, IGF-1, IL-6 and TNF( were determined by ELISA, demonstrating changes and different correlations between clinical condition, radiographic changes and degree of inflammation. All horses with joint associated pain and therefore associated lameness, demonstrated a significant increase of total protein (P<0.0001) and IGF-1 concentration (P<0.05). Concentrations of IL-6 and TNF( between controls and lame horses demonstrated significant differences (P<0.01 and P<0.001 respectively). Horses with less radiographic changes, demonstrated the highest IGF-1 expression in synovial fluid, and horses with more chronic OA conditions had very similar IGF-1 expression levels than control joints. In all lame joints, it was identified by Western blot a lighter isoform of IGF-1 (~7.5 kDa) which was inflammation related and it is the molecular weight of the mature peptide, and all control joints expressed a heavier isoform (~12 kDa). This finding could lead to new research for sequencing and targeting the isoform which is not expressed during an inflammatory process within a joint, and to have a better understanding of its role in the horse’s joint.

Resumen El factor de crecimiento similar a la insulina I (IGF-1) es el factor de crecimiento conocido más importante para la reparación del cartílago en caballos. Promueve la mitosis de los condrocitos, la expresión de colágeno II y la producción de matriz extracelular. La osteoartritis (OA) es la condición musculoesquelética más común que causa cojera y bajo rendimiento en caballos deportivos. Se evaluó clínica y radiográficamente un total de 11 caballos cojos, y se confirmó que todos sufrían una cojera metacarpofalángica frontal mediante una prueba de flexión positiva, un bloqueo nervioso en 4 puntos bajos y un bloqueo intraarticular. La proteína total, IGF-1, IL-6 y TNFα se determinaron por ELISA, lo que demostró cambios y diferentes correlaciones entre la condición clínica, los cambios radiográficos y el grado de inflamación. Todos los caballos con dolor asociado a las articulaciones y, por lo tanto, asociado a la cojera, mostraron un aumento significativo de la proteína total (P<0.0001) y la concentración de IGF-1 (P<0.05). Las concentraciones de IL-6 y TNFα entre los controles y los caballos cojos mostraron diferencias significativas (P<0.01 y P<0.001 respectivamente). Los caballos con menos cambios radiográficos mostraron la mayor expresión de IGF-1 en el líquido sinovial, y los caballos con condiciones de OA más crónicas tuvieron niveles de expresión de IGF-1 muy similares a los de las articulaciones de control. En todas las articulaciones cojas, se identificó por medio de Western blot una isoforma de IGF-1 más ligera (~ 7.5 kDa) que estaba relacionada con la inflamación y es el peso molecular del péptido maduro, y todas las articulaciones de control expresaron una isoforma más pesada (~ 12 kDa). Este hallazgo podría conducir a una nueva investigación para secuenciar y apuntar a la isoforma que no se expresa durante un proceso inflamatorio dentro de una articulación, y para tener una mejor comprensión de su papel en la articulación del caballo.

ABSTRACT: Brucellosis is a chronic contagious infectious zoonosis that affects the reproductive system of animals, causing economic and health losses. This study diagnosed Brucella spp. in commercial kennels, comparing PCR positivity in different biological samples (blood, semen, and vaginal secretion), as well as correlating these findings with reproductive indices. Hence, we analyzed dogs from kennels in the neighboring cities of Cuiabá and Várzea Grande/MT, Brazil. The reproductive histories of the animals were obtained and blood samples were collected from all animals (n=35); in addition, semen samples were collected from males (n=9) and vaginal swabs were collected from females (n=24) to perform polymerase chain reactions (PCR) for brucellosis. The findings indicated that vaginal swab PCR is an effective test to identify Brucella spp. For males, there were more positive results when testing blood samples, possibly because the male animals were at the beginning stage of infection. ABSTRACT losses spp blood, (blood secretion, secretion , secretion) indices Hence GrandeMT Grande MT Grande/MT Brazil n=35 n35 n 35 (n=35) addition n=9 n9 9 (n=9 n=24 n24 24 (n=24 (PCR brucellosis infection n=3 n3 3 (n=35 n= (n= n=2 n2 2 (n=2 (n=3 (n

RESUMO: A Brucelose é uma zoonose infectocontagiosa crônica que afeta o sistema reprodutivo dos animais, gerando prejuízos econômicos e sanitários. O objetivo do presente estudo foi diagnosticar a Brucella spp. em canis comerciais, comparando a positividade na PCR em diferentes amostras biológicas (sangue, sêmen e secreção vaginal) e correlacionar estes achados aos índices reprodutivos. Foram analisados cães provenientes de canis no município de Cuiabá e Várzea Grande/MT. Foi realizado o levantamento do histórico reprodutivo dos animais e em seguida, foi coletado o sangue em todos os animais (n=35), sendo sêmen nos machos (n=9) e swab vaginal (n=24) nas fêmeas para realização da técnica de Reação em Cadeia pela Polimerase (PCR) para brucelose. De acordo com os resultados, conclui-se que a PCR de swab vaginal é um teste efetivo para identificar Brucella spp., porém em machos, verifica-se que no sangue obtivemos mais positivos, possivelmente por estarem no início da infecção. RESUMO sanitários spp comerciais sangue, (sangue reprodutivos GrandeMT Grande MT Grande/MT seguida n=35, n35 n n=35 , 35 (n=35) n=9 n9 9 (n=9 n=24 n24 24 (n=24 (PCR brucelose resultados concluise conclui se verificase verifica positivos infecção n3 n=3 3 (n=35 n= (n= n=2 n2 2 (n=2 (n=3 (n

Resumen ANTECEDENTES: Durante el embarazo es más común el linfoma de Hodking que el no Hodking; afecta, en promedio, a mujeres de 30 años (18-44 años) y más. Suele diagnosticarse alrededor de las 28 semanas de embarazo y está documentado que puede llegarse al término. Los esquemas de tratamiento pueden iniciarse en el posparto inmediato o, incluso, antes. La incidencia mundial del linfoma no Hodking es de 0.8 por cada 100,000 mujeres; se desconoce la supervivencia durante el embarazo. CASO CLINICO: Paciente de 34 años, con antecedentes obstétricos de tres embarazos, una cesárea y un aborto y el embarazo actual en curso de las 29 semanas, referida de la ciudad de Colima debido a un reporte de BI-RADS 3 en el ultrasonido de mama y un nódulo mamario palpable, con evidencia de múltiples tumoraciones en la zona hepática, esplénica y peripancreática. La biopsia tomada de las zonas de la lesión reportó: linfoma de células B de alto grado de malignidad, con morfología blastoide y expresión de C-MYC y BCL2. Además, la paciente se encontró con: anemia, dolor abdominal, múltiples nódulos hepáticos y adenopatías abdominales. Se decidió la interrupción del embrazo a las 30 semanas, con la obtención de un recién nacido, sin complicaciones. Enseguida se inició el tratamiento con rituximab-etopósido-prednisolona-vincristina-ciclofosfamida-doxorrubicina (R-EPOCH) con adecuada adaptación por la paciente. CONCLUSION: Puesto que la información bibliográfica de linfoma y embarazo es escasa el caso aquí reportado es relevante por su aporte. La atención multidisciplinaria favorecerá siempre el pronóstico de las pacientes.

Abstract BACKGROUND: Hodking&apos;s lymphoma is more common during pregnancy than non-Hodking&apos;s lymphoma; it affects, on average, women aged 30 years (18-44 years) and older. It is usually diagnosed around 28 weeks of pregnancy and is documented to be carried to term. Treatment regimens can be initiated in the immediate postpartum period or even earlier. The worldwide incidence of non-Hodking&apos;s lymphoma is 0.8 per 100,000 women; survival during pregnancy is unknown. CLINICAL CASE: 34-year-old patient, with obstetric history of three pregnancies, one cesarean section and one abortion and the current pregnancy in progress at 29 weeks, referred from the city of Colima due to a report of BI-RADS 3 on breast ultrasound and a palpable breast nodule, with evidence of multiple tumors in the hepatic, splenic and peripancreatic area. Biopsy taken from the lesion areas reported: high grade malignant B-cell lymphoma, with blastoid morphology and expression of C-MYC and BCL2. In addition, the patient was found to have: anemia, abdominal pain, multiple hepatic nodules and abdominal adenopathies. It was decided to terminate the pregnancy at 30 weeks, with the delivery of an uncomplicated newborn. Rituximab-Etoposide, Prednisone, Vincristine, Cyclophosphamide, and Doxorubicin (R-EPOCH) therapy was started immediately with adequate adaptation by the patient. CONCLUSION: Since bibliographic information on lymphoma and pregnancy is scarce, the case reported here is relevant for its contribution. Multidisciplinary care will always favor the prognosis of patients.

Abstract The purpose of this study is to analyze how the video game industry has reinvented the way entertainment content is consumed during lockdown; specifically, we will study the case of Fortnite. The methodological approach is qualitative, supported by content analysis and discourse analysis of Spanish digital media articles and news. The results reveal three elements that favour innovation in the video game industry: the development of new content, in-game events, and added value in the players’ experience.

Resumen El propósito de este artículo es analizar cómo la industria del videojuego ha reinventado la manera de consumir contenido de entretenimiento en tiempos de confinamiento; en concreto, estudiamos el caso de Fortnite. El enfoque metodológico es de tipo cualitativo, apoyado en el análisis de contenido y el análisis del discurso de artículos y noticias procedentes de medios digitales españoles. Los resultados revelan tres factores que han propiciado la innovación en la industria: desarrollo de contenido novedoso, celebración de eventos in-game y valor agregado en la experiencia de los jugadores.

Resumo O objetivo deste artigo é analisar como a indústria de videogames reinventou a forma de consumir conteúdo de entretenimento em tempos de confinamento; Especificamente, estudamos o caso do Fortnite. A abordagem metodológica é qualitativa, apoiada pela análise de conteúdo e análise do discurso de artigos e notícias da mídia digital espanhola. Os resultados revelam três fatores que têm fomentado a inovação na indústria: desenvolvimento de novos conteúdos, realização de eventos in-game e valor agregado na experiência do jogador.

ABSTRACT Marine environments are the most studied habitats when addressing microplastic pollution. However, there are no standardized methodologies for this analysis, so methodologies are often adapted by researchers. This situation has raised doubts concerning the reliability and reproducibility of results that are related to the null or little use of measures to avoid cross-contamination. The objective of this work was to carry out a short review and analyze the different measures that have been reported in research articles for different marine habitats, published in the ScienceDirect database in 2020, to avoid cross-contamination during fieldwork and laboratory work. From the 115 analyzed articles, eight did not report measures at any stage, 61 took measures during sampling, and 98 did it in the processing stage. Even though most studies take steps to prevent cross-contamination, they do not specify the percentage of contamination avoided. However, from the concentrations of microplastics in the blanks and the total microplastic concentrations in the samples, we estimate that between 4.8 and 69 % of contamination is avoided in sampling and between 0.1 and 48.8 % in the laboratory. This shows the need to establish standards for sampling and sample processing, which must include measures regarding the marine environment studied and the stage addressed, as well as the minimum percentages that should be met for the data to be considered valid and reliable.

RESUMEN Los ambientes marinos destacan entre los hábitats estudiados para la contaminación por microplásticos. Sin embargo, no existen metodologías estandarizadas para su análisis por lo que a menudo se adaptan métodos propuestos por los investigadores. Esto ha generado dudas sobre la confiabilidad y reproducibilidad de los resultados, relacionadas con la nula o limitada utilización de medidas para evitar contaminación cruzada. El objetivo de este trabajo fue realizar una revisión corta y analizar las diferentes medidas que se han reportado en artículos de investigación de diferentes hábitats marinos, publicados en ScienceDirect en 2020, para evitar la contaminación cruzada durante los trabajos de campo y laboratorio. De un total de 115 trabajos, ocho no reportaron medidas, 61 tomaron medidas en los muestreos y 98 lo hicieron en el procesamiento de las muestras. Aun cuando la mayoría de los estudios adoptan medidas para evitar la contaminación cruzada, éstos no especifican el porcentaje de contaminación evitada. Sin embargo, a partir de las concentraciones de microplásticos en los blancos y las concentraciones totales de microplásticos en las muestras, estimamos que para el muestro se evita entre 4.8 y 69 % de contaminación y en el laboratorio de 0.1 a 48.8 %. Lo anterior muestra que es necesario establecer estándares para el muestreo y procesamiento de muestras, los cuales deben incluir las medidas que deben tomarse por ambiente estudiado y etapa abordada, así como los porcentajes mínimos que deben cumplirse para que los datos se consideren válidos y confiables.

Resumo Introdução e Objetivos: A prevalência da obesidade entre mulheres em idade fértil tem aumentado nos últimos anos, devendo ser considerada na escolha do método contracetivo. Estas mulheres apresentam maior risco de eventos tromboembólicos, sendo superior com a utilização de contraceção hormonal combinada (CHC). Por este motivo, algumas sociedades médicas não recomendam a utilização de CHC nas mulheres com obesidade classe 2 e 3. Este estudo tem como objetivo avaliar a terapêutica contracetiva nas mulheres obesas de classe 2 ou superior em nove Unidades de Saúde Familiar (USF’s) da região norte de Portugal. Tipo de Estudo: Estudo multicêntrico observacional retrospetivo transversal. População: Todas as mulheres em idade fértil (15-49 anos), com IMC ≥35 kg/m2, inscritas nas USF’s intervenientes e inseridas no programa de planeamento familiar (PF). Métodos: A amostra foi recolhida através da plataforma MIM@UF® e a identificação do método anticoncecional e antecedentes tromboembólicos através do processo clínico (SClínico®). Foram excluídas mulheres grávidas, mulheres sem consulta nos últimos cinco anos e mulheres com dados inválidos. Resultados: Da amostra inicial de 1063 mulheres, 123 foram excluídas. A idade média era 36,8 ± 8,8 anos e o IMC médio era 39,2 ± 4,0 kg/m2. Desta amostra, 36,2% (n=340) estavam sob progestativos (70,9% progestativo oral, 14,7% sistema intrauterino com levonorgestrel, 13,8% com implante progestativo, 0,6% com progestativo injetável); 27,7% (n=260) estavam sob CHC, 12,8% (n=120) estava sob métodos não hormonais (55,8% métodos de barreira; 37,5% dispositivo intrauterino de cobre; 6,7% métodos naturais); 6,4% (n=60) estavam com métodos permanentes e 17,0% não utilizavam método contracetivo (n=160). Nesta amostra, 2,2% (n=21) tinham antecedentes tromboembólicos. Conclusões: A CHC é o segundo método mais usado nas USF intervenientes, apesar do seu uso não estar recomendado. Dado o elevado risco de eventos tromboembólicos, é essencial implementar medidas corretivas para a melhoria do aconselhamento contracetivo nas consultas de PF.

Abstract Overview and Aims: The prevalence of obesity among fertile women has increased over the last few years and should be considered when choosing a contraceptive method. These women have a higher risk of thromboembolic events that increases with the use of combined hormonal contraception (CHC). Therefore, some medical societies do not recommend the use of CHC in women with class 2 obesity or higher. This study aims to assess the contraceptive methods used in women with class 2 obesity or higher in nine Primary Healthcare Units (PHU) in northern Portugal. Study Design: Multicentric retrospective, observational, cross-sectional study. Population: All women of reproductive age (between ages 15 and 49), with a BMI ≥ 35 kg/m2, enrolled in the intervening PHU and included in the family planning (FP) program. Methods: The sample was collected using the MIM@UF® database, obtaining the contraceptive method and thromboembolic history through the individual electronic medical record system, Sclínico®. Pregnant women, women without a medical appointment in the previous five years and women with invalid data were excluded. Results: From the initial sample of 1063 women, 123 were excluded. The mean age was 36.8 ± 8.8 years, the mean BMI was 39.2 ± 4.0 kg/m2. From the sample, 36.2% (n=340) were using progestogen (70.9% progestogen-only pill, 14.7% levonorgestrel intrauterine system, 13.8% progestogen-only implant, 0.6% progestogen-only injectables); 27.7% (n=260) were taking CHC; 12.8% (n=120) were with a non-hormonal methods (55.8% barrier methods; 37.5% copper intrauterine contraceptive device, 6.7% natural methods); 6.4% (n=60) were with permanent methods, 17.0% were not using any type of contraception (n=160). In this sample, 2,2% (n=21) had a thromboembolic event. Conclusions: CHC was the second most used method in the intervening FHU, although its use is not recommended. Given the high risk of thromboembolic events, it is essential to implement corrective measures to improve contraceptive counselling in FP consultations.

Resumen La valoración visual del paisaje ayuda a comprender las preferencias del mismo como un bien frágil y escaso, y a evaluar la percepción, aceptación y rechazo de los paisajes naturales, manejados y alterados. La valoración del paisaje, mediante el uso de indicadores eco-estéticos, permite evaluarlos desde su estructura y es una manera de afrontar las problemáticas de subjetividad observada en otros métodos. Si bien, los indicadores eco-estéticos han sido utilizados en la valoración de distintos paisajes, no han sido ampliamente aplicados en la evaluación de paisajes costeros. Este estudio tuvo como objetivo realizar la evaluación visual de la naturalidad y la complejidad del paisaje costero de la isla de Cozumel, México, a través de 2 indicadores ecoestéticos: el índice de etapa sucesional y el índice de diversidad de Shannon. Para evaluar la percepción del observador, se fotografiaron paisajes costeros de 4 etapas sucesionales, y distintos valores de diversidad. Las fotografías fueron proyectadas a 152 individuos, quienes puntuaron los paisajes de acuerdo con su preferencia. Las respuestas fueron analizadas por medio de pruebas no paramétricas. Los resultados evidenciaron una relación directa, positiva y estadísticamente significativa (P < 0.05) entre la preferencia y la naturalidad, pero no entre la preferencia y la diversidad. Se concluye que la naturalidad, medida a través del indicador de etapa sucesional, influye directamente sobre las preferencias del paisaje costero y puede ser usado para evaluar el efecto de las alteraciones al paisaje sobre las preferencias del observador.

Abstract The visual assessment of the landscape helps to understand the preferences of the landscape as a fragile and scarce asset, and to evaluate the perception, acceptance, and rejection of natural, managed and altered landscapes. The valuation of the landscape using eco-aesthetic indicators allows us to evaluate them from their structure, and it is a way of facing the problems of subjectivity observed in other methods. Although these eco-aesthetic indicators have been used in the assessment of different landscapes, they have not been widely applied in the assessment of coastal landscapes. The objective of this study was to carry out a visual evaluation of the naturalness and complexity of the coastal landscape of the Cozumel island, Mexico through 2 eco-aesthetic indicators: The successional stage index, and the Shannon diversity index. To evaluate the perception of the observer, coastal landscapes of 4 successional stages, and different levels of diversity, were photographed, and the photographs were projected to 152 individuals who scored the landscapes according to their preference. The responses were analyzed by means of non-parametric tests. The results show a direct, positive, and statistically significant (P < 0.05) relationship between preference and the naturalness, but not between preference and diversity. It is concluded that naturalness, measured through the ecological succession indicator, directly influences coastal landscape preferences, and can be used to evaluate the effect of landscape alterations on observer preferences.

RESUMEN Introducción: Las personas con un trasplante renal forman una población vulnerable para la infección por SARS-CoV-2, lo que las puede llevar a sufrir consecuencias psicológicas que aún no han sido estudiadas. Objetivos: Comparar la incidencia de ansiedad y el nivel de calidad de vida, en personas con un trasplante renal, que se han contagiado de SARS-CoV-2 frente a los que no se han contagiado; así como describir la incidencia de contagios y la mortalidad en la población a estudio. Material y Métodos: Estudio retrospectivo de cohortes prospectivas. Durante la segunda ola de la pandemia (del 1 de julio al 5 de diciembre de 2020) se compararon los datos de la cohorte de casos (n=22) y la cohorte de no casos (n=36) en cuanto a ansiedad estado y ansiedad rasgo (medidas con el STAI), la calidad de vida (medida mediante el KTQ) y la mortalidad, como variables de interés principales. Resultados: La población a estudio fue de 601 personas trasplantadas, con una edad media de 61.7 años (DE: 12.8), 61.9% (372) fueron hombres. Se infectaron de SARS-CoV-2 el 12.1% (73) y fallecieron 6.2% (37), siendo el 52.9% (18) por SARSCoV- 2. Esto supone una tasa de mortalidad del 2.9% y una tasa de letalidad del 24.7%. Durante la segunda ola se infectaron un 6.2% (37). La calidad de vida media fue de 4.1 (DE: 0.9). En los infectados la media fue 4.2 (DE: 0.8), y en los no infectados 4 (DE: 1). Mientras que la media de ansiedad fue de 49 (DE:24.3); siendo 54.6 (DE: 25.7) en los infectados y 45.4 (DE: 23.1) en no infectados. No se encontraron diferencias estadísticamente significativas. Conclusiones: Las personas con un trasplante renal tienen afectada su calidad de vida y presentan altos niveles de ansiedad, independientemente de si han pasado o no la infección por SARS-CoV-2.La tasa de mortalidad durante el periodo analizado fue baja, mientras que la letalidad fue alta y ambas disminuyeron de la primera a la segunda ola de la infección.

ABSTRACT Background: The consequences of SARSCoV- 2 infection on the mental health of kidney transplant recipients have not yet been investigated. Objectives: This study compares anxiety and quality of life in individuals with a kidney transplant who did or did not test positive for coronavirus. Design: Retrospective study of two prospective cohorts. Participants: Kidney transplant recipients under follow-up in a Spanish tertiary teaching hospital who tested positive for coronavirus (cases); and consecutive kidney recipients who had not suffered the infection (not-cases). Methods: Mortality and case fatality data were compared between the two cohorts for the two pandemic waves. For the second wave (July 1 to December 5, 2020), the data compared between cases (n=22) and not-cases (n=36) were state and trait anxiety (STAI), kidney transplant-related quality of life (KTQ), and mortality as the main outcome variables. Results: 601 transplanted persons of mean age 61.7 years (SD 12.8), 61.9% men. 12.1% (n=73) tested SARS-CoV-2-positive over the first two pandemic waves with a mortality of 2.9% and case fatality of 24.7%. Over the second wave, the mean quality of life score was 4.1 (SD 0.9) and the overall anxiety score was 49 (SD 24.3) for the two cohorts, which did not vary in terms of the impacts of these measures on the descriptive variables examined. Conclusions: Quality of life is invariably affected, and levels of anxiety are high regardless of whether or not they have had a SARS-CoV-2 infection. Over the period examined, mortality was low while coronavirus case fatality was high.