ABSTRACT This collaborative study between the University of Granma (UDG) in Cuba and the Technical University of Madrid (UPM) in Spain aimed to enhance sustainable rabbit meat production in vulnerable rural communities in eastern Cuba to contribute to food sovereignty. In partnership with the Agroindustrial Grains Company Fernando Echenique in Granma, a feed system based on staggered planting of proteinaceous plants and energy crops has been developed as an alternative to more expensive conventional feeds. Additionally, improvements have been made in reproductive management, and a genetic improvement program for animals has been implemented. The nutritional value and in vitro digestibility of these raw materials have been analyzed at UPM. Seminars addressing topics such as reproduction, nutrition, and genetic improvement in rabbit farming have also been conducted. This work presents the results obtained until June 2023, highlighting the achieved social, economic, and environmental benefits.

RESUMEN Este estudio entre la Universidad de Granma (UDG) en Cuba y la Universidad Politécnica de Madrid (UPM) en España pretendió aumentar la producción sostenible de carne de conejo en comunidades rurales vulnerables del oriente de Cuba, con el fin de contribuir a la soberanía alimentaria. Con la Empresa Agroindustrial de Granos Fernando Echenique de Granma, se ha desarrollado un sistema de alimentación basado en plantas proteicas escalonadas y cultivos energéticos en lugar de piensos convencionales más costosos. Además, se han realizado mejoras en el manejo reproductivo y en un programa de mejora genética de los animales. Se ha analizado el valor nutricional de estas materias primas y su digestibilidad in vitro en la UPM. También se han realizado seminarios abordando temas como la reproducción, nutrición y mejora genética en la cunicultura. Este trabajo presenta los resultados obtenidos hasta junio de 2023, destacando los beneficios sociales, económicos y medioambientales logrados.

ABSTRACT The union of theory and practice is crucial for equitable teaching, and flexible and effective strategies are required to ensure inclusion. The objective of this article was to propose strategies for the participation of students with disabilities in Physical Education classes. Twenty-two works focused on inclusion strategies for Physical Education were reviewed in the SciELO, Google Academic and Dialnet databases. Based on the results obtained, the systematization was carried out and strategies were designed to improve the learning experience and promote equality, including those that adapt to the curriculum and activities; those of teacher training and awareness; and, those with an inclusive culture and positive environment. It is concluded that educational inclusion is a complex process that demands changes in attitudes, methodologies and educational policies.

RESUMEN La unión de la teoría y la práctica es crucial para una enseñanza equitativa, además se requiere de estrategias flexibles y efectivas para asegurar la inclusión. El objetivo de este artículo fue proponer estrategias para la participación de estudiantes con discapacidad en las clases de Educación Física. Se revisaron 22 trabajos centrados en estrategias de inclusión para Educación Física en las bases de datos SciELO, Google Académico y Dialnet. A partir de los resultados obtenidos, se procedió a la sistematización y se diseñaron estrategias para mejorar la experiencia de aprendizaje y promover la igualdad, entre ellas las que se adaptan al currículo y actividades; las de formación y sensibilización docente; y, las de cultura inclusiva y ambiente positivo. Se concluye que la inclusión educativa es un proceso complejo que demanda cambios en actitudes, metodologías y políticas educativas.

RESUMO O casamento entre teoria e prática é crucial para o ensino equitativo, e são necessárias estratégias flexíveis e eficazes para garantir a inclusão. O objetivo deste artigo foi propor estratégias para a participação de alunos com deficiência nas aulas de educação física. Vinte e dois artigos com foco em estratégias de inclusão para a Educação Física foram revisados nas bases de dados SciELO, Google Scholar e Dialnet. Com base nos resultados obtidos, foram sistematizadas e elaboradas estratégias para melhorar a experiência de aprendizagem e promover a igualdade, incluindo aquelas adaptadas ao currículo e às atividades; treinamento e conscientização dos professores; e cultura inclusiva e ambiente positivo. Conclui-se que a inclusão educacional é um processo complexo que exige mudanças de atitudes, metodologias e políticas educacionais.

Abstract: Growth hormone (GH) is effective in improving height in several conditions. Objective: To describe the evolution of a group of children who received GH in a tertiary center between 2012-2022. Patients and Method: Descriptive, retrospective study. We analyzed the impact on height after GH use with Z-score according to etiology, age at onset and bone age. Patients under 15 years old at baseline and receiving GH for at least 12 months, with diagnoses of GH deficiency (GHD), idiopathic short stature (ISS), small for gestational age (SGA), SHOX Haploinsufficiency (SHOX) and Turner syndrome (TS) were included. Height was expressed as Z-score for age and sex, according to NCHS curves. Results: 145 children received GH. Sixty patients were excluded due to irregular administration, incomplete data, less than 12 months of GH, change of hospital, and associated comorbidities. Seventy-three patients were analyzed, 23 GHD, 15 ISS, 20 SGA, 9 SHOX and 6 TS patients. Significant improvement in height (Z-score for age and sex) was observed in SGA (1.4 ± 0.8 gain; p < 0.001), GHD (1.1 ± 1.0; p < 0.001), ISS (1.1 ± 0.8; p < 0.001) and SHOX (0.8 ± 0.7; p = 0.007) patients. In TS, a non-statistically significant improvement was observed (0.7 ± 0.8; p = 0.085). In GHD, onset before 3 years showed a gain of 1.9 ± 1.1, vs 0.7 ± 0.6 (p = 0.083) and in ISS onset with bone age less than 9 years increased it by 1.7 ± 0.5 vs 0.5 ± 0.5 (p < 0.001). Adverse events: 27/73 (37%) headache, 18/73 (24%) lower extremity pain, 1/73 (1.5%) dizziness, 1/73 (1.5%) scoliosis, 1/73 (1.5%) epiphysiolysis and 1/73 (1.5%) craniopharyngioma recurrence. Conclusions: Children with GHD, ISS, SHOX mutation and SGA significantly improved their height, highlighting in GHD and ISS the importance of early treatment. Treatment was well tolerated in the 5 groups analyzed.

Resumen: La hormona de crecimiento (GH) es efectiva para mejorar la estatura en varias condiciones. Objetivo: describir la evolución de un grupo de niños que recibieron GH en un centro terciario entre 2012-2022. Pacientes y Método: estudio descriptivo, retrospectivo. Se analizó el impacto en la talla después del uso de GH con puntaje Z según etiología, edad de inicio y edad ósea. Se incluyeron pacientes menores de 15 años al inicio del tratamiento y que recibieron GH por al menos 12 meses, con diagnósticos de déficit de GH (DHC), talla baja idiopática (TBI), pequeños para edad gestacional (PEG), Haploinsuficiencia SHOX (SHOX) y síndrome Turner (ST). La estatura se expresó como puntaje Z para edad y sexo, según curvas NCHS. Resultados: 145 niños recibieron GH. Se excluyeron 60 pacientes por administración irregular, datos incompletos, menos de 12 meses de GH, cambio de hospital, y comorbilidades asociadas. Se analizaron 73 pacientes, 23 DHC, 15 TBI, 20 PEG, 9 pacientes SHOX y 6 ST. Se observó una mejoría significativa en la estatura (puntaje Z para edad y sexo) en los pacientes PEG (ganancia de 1,4 ± 0,8; p < 0,001), DHC (1,1 ± 1,0; p < 0,001), TBI (1,1 ± 0,8; p < 0,001) y SHOX (0,8 ± 0,7; p = 0,007). En ST se observó una mejoría no estadísticamente significativa (0,7 ± 0,8; p = 0,085). En DHC, el inicio antes de los 3 años mostró una ganancia de 1,9 ± 1,1 vs. 0,7 ± 0,6 (p = 0,083) y en TBI el inicio con edad ósea menor a 9 años la aumentó en 1,7 ± 0,5 vs. 0,5 ± 0,5 (p < 0,001). Eventos adversos: 27/73 (37%) cefalea, 18/73 (24%) dolor en extremidades inferiores, 1/73 (1,5%) mareos, 1/73 (1,5%) escoliosis, 1/73 (1,5%) epifisiolisis y 1/73 (1,5%) recidiva craneofaringioma. Conclusiones: Los niños con DHC, TBI, mutación SHOX y PEG mejoraron significativamente su estatura, destacando en DHC y TBI la importancia del tratamiento precoz. El tratamiento fue bien tolerado en los 5 grupos analizados.

Resumo: Introdução: O uso de prednisona e reabilitação musculoesquelética e respiratória foi descrito no tratamento de pacientes com COVID-19 grave ou crítico. O papel destas intervenções e o momento ideal para o seu início não estão claramente estabelecidos. Este trabalho mostra os resultados da Unidade de Reabilitação Hospitalar do Banco de Seguro del Estado que implementou um programa abrangente de reabilitação e uso de corticosteroides na fase subaguda de pacientes graves ou críticos pós-COVID-19, com uma abordagem sistematizada, trabalhando de forma interdisciplinar e centrada no paciente. São relatados os achados na admissão, a necessidade de oxigênio, a escala de Barthel, os padrões tomográficos, o uso de corticosteroides, a resposta ao tratamento e as complicações. Os resultados desta abordagem sobre variáveis clínicas, respiratórias e funcionais são descritos. Material e métodos: Estudo descritivo e retrospectivo de pacientes pós-COVID-19 que completaram reabilitação na Unidade de Reabilitação do Hospital Banco de Seguros del Estado (URHBSE) no período de abril a agosto de 2021. Os dados foram obtidos dos prontuários de pacientes com posterior análise estatísticas usando PRISM (v8.2.1). Resultados: 84 pacientes completaram o programa de reabilitação. No momento da admissão na URHBSE, 55% apresentavam dependência total ou grave da escala de Barthel. 48% não conseguiam se mover. 89,2% necessitaram oxigênio com saturação média de 90,3 ± 4,8. 25% dos pacientes foram internados necessitando máscara com reservatório. Todos os pacientes que ingressaram no programa estavam na fase subaguda da doença (4 a 12 semanas) e receberam um plano de reabilitação abrangente e individualizado. O objetivo era alcançar uma situação funcional semelhante à que apresentavam antes da COVID-19. O tempo de permanência na URHBSE foi de 23,5±13,8 dias. A tomografia de tórax de alta resolução (TCAR) foi realizada em 76 pacientes (90,5%); os resultados foram patológicos em 96,1%. O vidro fosco predominou em 49,3% deles, a consolidação em 8,23% e o padrão fibroso em 30,13%. Alterações tomográficas “atípicas” de danos pós-COVID (derrame pleural, nódulos cavitados, cavidades apicais, etc.) foram detectadas em 11,8% dos exames tomográficos. Aspergilose pulmonar foi encontrada em 2,6% dos pacientes e tromboembolismo pulmonar em 6,6%. 44 pacientes (52,3%) receberam prednisona. Em 63,4% a oferta de oxigênio foi suspensa nos primeiros 15 dias após o início da mesma. Encontramos associação entre o padrão tomográfico em vidro fosco e a suspensão precoce da oferta de oxigênio desde o início da administração da prednisona (p = 0,047). Apesar do alto grau de colonização, mesmo naqueles que usaram prednisona, não observamos infecções. Em relação às variáveis respiratórias, só temos dados sobre a presença de dispneia nos primeiros 35 pacientes; destes, 83% apresentavam dispneia na admissão, enquanto apenas 17% a apresentavam na alta (p< 0,0001). Observou-se também diferenças significativas na necessidade de O2 entre a admissão e a alta (p< 0,0001) e no grau de dependência medido pela escala de Barthel, com 55% dos pacientes apresentando dependência total ou grave na admissão e apenas 3,4% na alta. Conclusões: As intervenções realizadas na fase subaguda da doença foram associadas a melhorias significativas nas variáveis de interesse clínico. São necessários mais estudos para definir o papel e o momento exato do início dos corticosteroides e da reabilitação neste grupo de pacientes.

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Abstract: Introduction: In patients with severe or critical COVID-19, the use of prednisone and musculoskeletal and respiratory rehabilitation has been described. The role of these interventions and the optimal time for their initiation are not clearly established. This study presents the results of the Rehabilitation Unit of the Banco de Seguro del Estado Hospital, which implemented a comprehensive rehabilitation program and the use of corticosteroids in the subacute stage of patients with severe or critical post-COVID-19, with a systematic approach, working interdisciplinary and centered on the person being treated. Findings at admission, oxygen requirement, Barthel scale, tomographic patterns, use of corticosteroids, their response, and complications are reported. The results of this approach on clinical, respiratory, and functional variables are described. Method: Descriptive, retrospective study of post-COVID-19 patients who completed rehabilitation at the Rehabilitation Unit of the Banco de Seguros del Estado Hospital (URHBSE) in the period April-August 2021. Data obtained from review of medical records, statistical analysis with PRISM (v8.2.1). Results: Eighty-four patients completed the rehabilitation program. Upon admission to the URHBSE, 55% had total or severe dependence on the Barthel scale. Forty-eight percent were unable to walk. Eighty-nine-point two percent required oxygen, with a mean saturation of 90.3 ± 4.8. Twenty-five percent of patients were admitted requiring a reservoir mask. All patients who entered the program were in the subacute phase of the disease (4 to 12 weeks) and received a comprehensive and individualized rehabilitation plan. The objective was to achieve a functional situation similar to what they had before COVID-19. The length of stay at the URHBSE was 23.5 ± 13.8 days. A total of 76 patients (90.5%) underwent high-resolution chest tomography (HRCT), which was pathological in 96.1% of cases. The predominant findings were ground-glass opacity in 49.3% of cases, consolidation in 8.23%, and a fibrosis-like pattern in 30.13%. “Non-typical” post-COVID damage tomographic alterations were detected (pleural effusion, cavitary nodules, apical cavities, etc.) in 11.8% of the tomographies. In 2 patients (2.6%), pulmonary aspergillosis was found, and in 6.6%, pulmonary thromboembolism. Forty-four patients (52.3%) received prednisone. In 63.4% of cases, oxygen supplementation was discontinued within the first 15 days from the start of prednisone. We found an association between the ground-glass opacity tomographic pattern and early discontinuation of oxygen supplementation from the start of prednisone (p = 0.047). Despite the high degree of colonization, we did not observe infections by colonizing microorganisms, even in those who used prednisone. Comparing admission and discharge, statistically significant differences were found in the following parameters: degree of dyspnea, oxygen requirement (only one patient was discharged with oxygen), saturation, degree of instrumentation (tracheostomy, nasogastric tube, etc.), and the Barthel dependency scale. Regarding respiratory variables, we only have data on the presence of dyspnea in the first 35 patients. Of these, 83% had dyspnea at admission, while only 17% had it at discharge (p < 0.0001). There were also significant differences in the oxygen requirement between admission and discharge (p < 0.0001) and in the degree of dependency measured on the Barthel scale. Fifty-five percent of patients had total or severe dependence at admission, compared to only 3.4% at discharge. Conclusions: The interventions carried out in the subacute stage of the disease were associated with significant improvements in clinical variables of interest. More studies are needed to define the role and the exact timing of the initiation of corticosteroids and rehabilitation in this group of patients.

ABSTRACT BACKGROUND: Ankle taping (AT) is effective in preventing ankle sprain injuries in most common sports and is employed in rehabilitation and prevention sports. OBJECTIVE: This study aimed to investigate the effectiveness of AT to restricting excessive frontal plane ankle movements in semi-professional basketball players throughout the training session. DESIGN AND SETTING: A cross-sectional study was performed at the Universidad Europea de Madrid. METHODS: Forty male and female semi-professional basketball players were divided into two groups. The ankle dorsiflexion range of motion (ROM) and interlimb asymmetries in a weight-bearing lunge position were evaluated at four time points: 1) with no tape, 2) before practice, at 30 min of practice, and 3) immediately after practice. RESULTS: In male basketball players, no differences were observed in the right and left ankles between the baseline and 30 min and between baseline and 90 min of assessment. In female athletes, significant differences were reported between baseline and pre-training assessments for the right ankle and also significant differences between baseline and 90 min in both ankles. CONCLUSIONS: Ankle taping effectively decreased the ankle dorsiflexion ROM in male and female basketball players immediately after application. However, ROM restriction was very low after 30 and 90 min, as assessed in a single basketball practice. Therefore, the classic taping method should be revised to develop new prophylactic approaches, such as the implementation of semi-rigid bracing techniques or the addition of active stripes during training or game pauses.

Resumo Este estudo teve como objetivo estimar a prevalência de alterações na autopercepção de saúde mental durante a pandemia de COVID-19 e seus fatores associados em quatro países da América Latina. Este é um estudo transversal de dados coletados de adultos em 2021 por meio da pesquisa Resposta Colaborativa à COVID-19 da Academia McDonnell na Universidade Washington em St. Louis (Estados Unidos). A amostra foi composta por 8.125 pessoas do Brasil, Colômbia, México e Chile. O estudo utilizou um modelo linear generalizado para uma variável de desfecho binário com uma conexão logística e efeitos fixos do país. No total, 2.336 (28,75%) pessoas consideraram ter sofrido alterações na autopercepção de saúde mental. Os desempregados (OR = 1,40; IC95%: 1,24-1,58), aqueles com qualidade de vida ruim/regular (OR = 5,03; IC95%: 4,01-6,31) e aqueles com alto nível socioeconômico (OR = 1,66; IC95%: 1,41-1,96) apresentaram maior risco de alterações na autopercepção de saúde mental do que aqueles com emprego em tempo integral, excelente qualidade e baixo nível socioeconômico. De acordo com o modelo de efeitos fixos, os brasileiros que viviam no país durante a pandemia, que discordavam das decisões do governo (OR = 2,05; IC95%: 1,74-2,42) e não confiavam em seu governo (OR = 2,10; IC95%: 1,74-2,42) apresentaram maior risco de alterações na autopercepção de saúde mental. Quase 30% dos entrevistados indicaram que a pandemia da COVID-19 alterou sua autopercepção de saúde mental. Esse desfecho estava associado a fatores políticos, sociodemográficos e de risco à saúde. Estes achados devem ajudar os formuladores de políticas a desenvolver intervenções comunitárias pós-pandemia.

Resumen Este estudio tuvo como objetivo estimar la prevalencia de alteraciones en la autopercepción de la salud mental durante la pandemia de COVID-19 y sus factores asociados en cuatro países de América Latina. Este es un estudio transversal de datos recopilados de adultos en el 2021 por medio de la investigación Respuesta Colaborativa a COVID-19 de la Academia McDonnell en la Universidad Washington en St. Louis (Estados Unidos). La muestra estuvo compuesta por 8.125 personas de Brasil, Colombia, México y Chile. El estudio utilizó un modelo lineal generalizado para una variable de desenlace binario con un enlace logístico y efectos fijos por país. En total, 2.336 (28,75%) personas consideraron que habían sufrido alteraciones en la autopercepción de la salud mental. Los desempleados (OR = 1,40; IC95%: 1,24-1,58), aquellos con calidad de vida mala/regular (OR = 5,03; IC95%: 4,01-6,31) y aquellos con alto nivel socioeconómico (OR = 1,66; IC95%: 1,41-1,96) presentaron mayor riesgo de alteraciones en la autopercepción de la salud mental que aquellos con empleo a tiempo completo, excelente calidad y bajo nivel socioeconómico. Según el modelo de efectos fijos, los brasileños que vivían en el país durante la pandemia y que no estuvieron de acuerdo con las decisiones del gobierno (OR = 2,05; IC95%: 1,74-2,42) y no confiaban en su gobierno (OR = 2,10; IC95%: 1,74-2,42) presentaron mayor riesgo de alteraciones en la autopercepción de la salud mental. Casi el 30% de los encuestados indicaron que la pandemia de COVID-19 alteró su autopercepción de la salud mental. Este desenlace se asoció con factores políticos, sociodemográficos y de riesgo a la salud. Estos hallazgos deben ayudar a los formuladores de políticas a desarrollar intervenciones comunitarias pospandémicas.

Abstract This study aimed to estimate the prevalence of alterations in self-perceived mental health during the COVID-19 pandemic and their associated factors in four Latin American countries. This is a cross-sectional study based on data collected from adults in 2021 through the Collaborative Response COVID-19 Survey by the MacDonnell Academy at Washington University in St. Louis (United States). The sample was composed of 8,125 individuals from Brazil, Colombia, Mexico, and Chile. A generalized linear model for a binary outcome variable with a logistic link and fixed country effects was used. There were 2,336 (28.75%) individuals who considered having suffered alterations in self-perceived mental health. Unemployed individuals (OR = 1.40; 95%CI: 1.24-1.58), those with bad/regular quality of life (OR = 5.03; 95%CI: 4.01-6.31), and those with high socioeconomic status (OR = 1.66; 95%CI: 1.41-1.96) had a higher risk of self-perceived mental health alterations than those with full-time employment, excellent quality, and low socioeconomic status. According to the fixed-effects model, Brazilians living in the country during the pandemic, who disagreed with their government’s decisions (OR = 2.05; 95%CI: 1.74-2.42) and lacked trust in their government (OR = 2.10; 95%CI: 1.74-2.42) had a higher risk of having self-perceived mental health alterations. Nearly 30% of respondents indicated that the COVID-19 pandemic altered their self-perceived mental health. This outcome was associated with political, sociodemographic, and health risk factors. These findings should help policymakers develop post-pandemic community interventions.

ABSTRACT Inadequate management of pasture soils in the Amazon has resulted in a predominance of degraded pastures. Considering the natural characteristics of this region can favor more appropriate strategies for sustainability, the objective of this study was to evaluate the differences in the chemical and physical attributes of pasture and forest soils in the Southern Amazon and to identify the most sensitive attributes of their fertility. Additionally, this study suggests appropriate management practices for sustainable pastures. Soil samples from the 0 to 0.20 m layer were analyzed to determine pH, exchangeable bases (calcium, magnesium, and potassium), exchangeable aluminum, potential acidity, phosphorus, organic carbon, bulk density, and texture. Pasture soils had a higher pH, calcium content, and bulk density than forest soils. However, the pasture soils had lower phosphorus and organic matter content. The soil organic carbon stocks were also lower in pasture soils, with levels 0.8 to 12 Mg ha-1 lower than in forest soils. The fertility attributes most sensitive to soil management in these pastures were phosphorus, pH, organic carbon, and bulk density. The lack of nutrients and soil and water conservation practices have contributed to the degradation of these pastures. Therefore, the recommended management for these pastures should aim to improve the organic matter content, reduce compaction, and replenish and cycle nutrients.

RESUMO O manejo inadequado de solos de pastagens na Amazônia resulta em predomínio de pastagens degradadas. Considerando as características naturais dessa região pode favorecer estratégias mais adequadas para sua sustentabilidade, o objetivo desse estudo foi avaliar as diferenças de atributos químicos e físicos de solos de pastagens e florestas no sul da Amazônia e identificar os atributos mais sensíveis de sua fertilidade. Além disso, sugerir práticas de manejo mais adequadas para essas pastagens em direção à sustentabilidade. Amostras de solo da camada de 0 a 0,20 m foram analisadas para determinação de pH, bases trocáveis (cálcio, magnésio e potássio), alumínio trocável, acidez potencial, fósforo, carbono orgânico, densidade aparente e textura. Os solos de pastagem tiveram maior pH, cálcio e densidade aparente do que os solos de floresta. No entanto, os solos de pastagem apresentaram menores teores de fósforo e matéria orgânica. Os estoques de carbono orgânico do solo também foram menores nas pastagens, com teores de 0,8 a 12 Mg ha-1 inferiores aos solos da floresta. Os atributos de fertilidade mais sensíveis ao manejo do solo nessas pastagens foram fósforo, pH, carbono orgânico e densidade aparente. A carência de nutrientes e de práticas de conservação do solo e da água têm contribuído para o estado de degradação dessas pastagens. Portanto, o manejo recomendado para essas pastagens deve visar a melhoria da matéria orgânica, redução da compactação, além da reposição e ciclagem de nutrientes.

Abstract: Growth hormone (GH) is effective in improving height in several conditions. Objective: To describe the evolution of a group of children who received GH in a tertiary center between 2012-2022. Patients and Method: Descriptive, retrospective study. We analyzed the impact on height after GH use with Z-score according to etiology, age at onset and bone age. Patients under 15 years old at baseline and receiving GH for at least 12 months, with diagnoses of GH deficiency (GHD), idiopathic short stature (ISS), small for gestational age (SGA), SHOX Haploinsufficiency (SHOX) and Turner syndrome (TS) were included. Height was expressed as Z-score for age and sex, according to NCHS curves. Results: 145 children received GH. Sixty patients were excluded due to irregular administration, incomplete data, less than 12 months of GH, change of hospital, and associated comorbidities. Seventy-three patients were analyzed, 23 GHD, 15 ISS, 20 SGA, 9 SHOX and 6 TS patients. Significant improvement in height (Z-score for age and sex) was observed in SGA (1.4 ± 0.8 gain; p < 0.001), GHD (1.1 ± 1.0; p < 0.001), ISS (1.1 ± 0.8; p < 0.001) and SHOX (0.8 ± 0.7; p = 0.007) patients. In TS, a non-statistically significant improvement was observed (0.7 ± 0.8; p = 0.085). In GHD, onset before 3 years showed a gain of 1.9 ± 1.1, vs 0.7 ± 0.6 (p = 0.083) and in ISS onset with bone age less than 9 years increased it by 1.7 ± 0.5 vs 0.5 ± 0.5 (p < 0.001). Adverse events: 27/73 (37%) headache, 18/73 (24%) lower extremity pain, 1/73 (1.5%) dizziness, 1/73 (1.5%) scoliosis, 1/73 (1.5%) epiphysiolysis and 1/73 (1.5%) craniopharyngioma recurrence. Conclusions: Children with GHD, ISS, SHOX mutation and SGA significantly improved their height, highlighting in GHD and ISS the importance of early treatment. Treatment was well tolerated in the 5 groups analyzed.

Resumen: La hormona de crecimiento (GH) es efectiva para mejorar la estatura en varias condiciones. Objetivo: describir la evolución de un grupo de niños que recibieron GH en un centro terciario entre 2012-2022. Pacientes y Método: estudio descriptivo, retrospectivo. Se analizó el impacto en la talla después del uso de GH con puntaje Z según etiología, edad de inicio y edad ósea. Se incluyeron pacientes menores de 15 años al inicio del tratamiento y que recibieron GH por al menos 12 meses, con diagnósticos de déficit de GH (DHC), talla baja idiopática (TBI), pequeños para edad gestacional (PEG), Haploinsuficiencia SHOX (SHOX) y síndrome Turner (ST). La estatura se expresó como puntaje Z para edad y sexo, según curvas NCHS. Resultados: 145 niños recibieron GH. Se excluyeron 60 pacientes por administración irregular, datos incompletos, menos de 12 meses de GH, cambio de hospital, y comorbilidades asociadas. Se analizaron 73 pacientes, 23 DHC, 15 TBI, 20 PEG, 9 pacientes SHOX y 6 ST. Se observó una mejoría significativa en la estatura (puntaje Z para edad y sexo) en los pacientes PEG (ganancia de 1,4 ± 0,8; p < 0,001), DHC (1,1 ± 1,0; p < 0,001), TBI (1,1 ± 0,8; p < 0,001) y SHOX (0,8 ± 0,7; p = 0,007). En ST se observó una mejoría no estadísticamente significativa (0,7 ± 0,8; p = 0,085). En DHC, el inicio antes de los 3 años mostró una ganancia de 1,9 ± 1,1 vs. 0,7 ± 0,6 (p = 0,083) y en TBI el inicio con edad ósea menor a 9 años la aumentó en 1,7 ± 0,5 vs. 0,5 ± 0,5 (p < 0,001). Eventos adversos: 27/73 (37%) cefalea, 18/73 (24%) dolor en extremidades inferiores, 1/73 (1,5%) mareos, 1/73 (1,5%) escoliosis, 1/73 (1,5%) epifisiolisis y 1/73 (1,5%) recidiva craneofaringioma. Conclusiones: Los niños con DHC, TBI, mutación SHOX y PEG mejoraron significativamente su estatura, destacando en DHC y TBI la importancia del tratamiento precoz. El tratamiento fue bien tolerado en los 5 grupos analizados.

Resumen Este trabajo estudia las principales innovaciones introducidas en el sistema político-electoral mexicano por tres reformas entre las décadas de 1940 y 1970, durante las administraciones de Manuel Ávila Camacho (1940-1946), Adolfo López Mateos (1958-1964) y José López Portillo (1976-1982). Nuestra hipótesis propone que, a diferencia de otras reformas electorales del período que va de la promulgación de la Constitución de 1917 a la reforma de 1977, estos tres momentos reformadores comportaron cambios constitucionales de un calado sin precedentes, en los que la oposición, aún sin una presencia significativa, logró introducir por distintas vías algunas de sus propuestas en la Cámara de Diputados. Estas tres reformas estuvieron además influenciadas, en mayor o menor grado, por el carácter propio del sexenio en el que fueron desarrolladas, lo que ayuda a explicar algunas de sus características.

Résumé Cet article étudie les principales innovations introduites dans le système politicoélectoral mexicain par trois réformes entre les années 1940 et 1970, sous les administrations de Manuel Ávila Camacho (1940-1946), Adolfo López Mateos (1958-1964) et José López Portillo. 1976-1982). Notre hypothèse propose que, contrairement à d’autres réformes électorales dans la période allant de la promulgation de la Constitution de 1917 à la réforme de 1977, ces trois moments de réforme ont conduit à des changements constitutionnels sans précédent, dans lesquels l’opposition, même sans présence significative, a réussi à introduire certaines de ses propositions à la Chambre des députés par différents voies. Ces trois réformes ont aussi été influencées, à un degré plus ou moins grand, par le caractère du sexennat au cours duquel elles ont été élaborées, ce qui contribue à expliquer certaines de leurs caractéristiques.

Summary This paper studies the main innovations introduced into the Mexican politicalelectoral system by three reforms between the 1940s and 1970s, during the administrations of Manuel Ávila Camacho (1940-1946), Adolfo López Mateos (1958-1964) and José López Portillo. (1976-1982). Our hypothesis proposes that, unlike other electoral reforms in the period from the promulgation of the 1917 Constitution to the 1977 reform, these three moments of reform led to unprecedented constitutional changes, in which the opposition, even without a significant presence and through various means, managed to introduce some of their proposals into the Chamber of Deputies. These three reforms were also influenced, to a greater or lesser degree, by the character of the six-year term in which they were developed, which helps to explain some of their characteristics.

RESUMEN Introducción y objetivos: El tratamiento de los pacientes con fibrilación auricular no valvular (FANV) que requieren implante de stents coronarios es un desafío. El objetivo del estudio fue investigar si el cierre de la orejuela izquierda (COI) podría ser una opción posible y beneficiosa para estos pacientes. Para ello, se analiza el impacto del COI más tratamiento antiagregante plaquetario (AP) en comparación con la combinación de anticoagulantes orales (ACO), incluidos los ACO directos, y tratamiento AP en los resultados a largo plazo de estos pacientes Métodos: Se analizaron los resultados de 207 pacientes con FANV sometidos consecutivamente a implante de stents coronarios. Recibieron ACO 146 pacientes (74 acenocumarol, 71 ACO de acción directa) y en 61 se realizó COI. La mediana de seguimiento fue de 35 meses. Los pacientes también recibieron tratamiento AP por prescripción de su cardiólogo. El estudio recibió la debida supervisión ética. Resultados: La edad (media: 75,7 años) y el antecedente de accidente vascular cerebral fueron similares en ambos grupos, aunque el grupo de COI presentó más características desfavorables (antecedente de enfermedad de las arterias coronarias [CHA2DS2-VASc], antecedente de hemorragias significativas [BARC ≥ 2] y HAS-BLED). La aparición de acontecimientos adversos graves (muerte, accidente vascular cerebral, accidente isquémico transitorio, hemorragia grave) y cardiovasculares graves (muerte de causa cardiaca, accidente vascular cerebral, accidente isquémico transitorio, infarto de miocardio) fue significativamente mayor en el grupo de ACO que en el de COI: 19,75 frente a 9,06% (HR = 2,18; p = 0,008) y 6,37 frente a 1,91% (HR = 3,34; p = 0,037), respectivamente. Conclusiones: La combinación de COI y tratamiento AP en pacientes con FANV conlleva mejor pronóstico clínico a largo plazo que el tratamiento con ACO y terapia AP, a pesar de las características basales desfavorables del grupo de COI.

ABSTRACT Introduction and objectives: The treatment of patients with non-valvular atrial fibrillation (NVAF) who need coronary stenting is challenging. The objective of the study was to determine whether left atrial appendage occlusion (LAAO) could be a feasible option and benefit these patients. To this end, we studied the impact of LAAO plus antiplatelet drugs vs oral anticoagulants (OAC) (including direct OAC) plus antiplatelet drugs in these patients' long-term outcomes. Methods: The results of 207 consecutive patients with NVAF who underwent coronary stenting were analyzed. A total of 146 patients were treated with OAC (75 with acenocoumarol, 71 with direct OAC) while 61 underwent LAAO. The median follow-up was 35 months. Patients also received antiplatelet therapy as prescribed by their cardiologist. The study received the proper ethical oversight. Results: Age (mean 75.7 years), and the past medical history of stroke were similar in both groups. However, the LAAO group had more unfavorable characteristics (history of coronary artery disease [CHA2DS2-VASc], and significant bleeding [BARC ≥ 2] and HAS-BLED). The occurrence of major adverse events (death, stroke/transient ischemic events, major bleeding) and major cardiovascular events (cardiac death, stroke/transient ischemic attack, and myocardial infarction) were significantly higher in the OAC group compared to the LAAO group: 19.75% vs 9.06% (HR, 2.18; P = .008) and 6.37% vs 1.91% (HR, 3.34; P = .037), respectively. Conclusions: In patients with NVAF undergoing coronary stenting, LAAO plus antiplatelet therapy produced better long-term outcomes compared to treatment with OAC plus antiplatelet therapy despite the unfavorable baseline characteristics of the LAAO group.

RESUMEN Introducción y objetivos: Se describen los resultados del Registro Radcong-21 del Grupo de Trabajo de Hemodinámica de la Sociedad Española de Cardiología Pediátrica y Cardiopatías Congénitas con el objetivo de analizar los datos, establecer parámetros de referencia actualizados y compararlos con otros registros. Métodos: Registro multicéntrico, observacional, transversal y retrospectivo de pacientes con cardiopatías congénitas tratados con cateterismo cardiaco en 2021. Cada sala de hemodinámica remite los últimos 100 casos realizados hasta enero de 2022. Análisis descriptivo de variables antropomórficas, procedimientos (agrupados por tipo y riesgo estimado de radiación [RER]), características técnicas y parámetros dosimétricos. Revisión adicional de todos los valores fuera del intervalo de confianza del 95% de la mediana. Resultados: Se analizaron 1.090 procedimientos en 11 salas de hemodinámica de 10 centros hospitalarios. De los pacientes, el 22,8% fueron < 1 año, el 60,7% entre 1 y 18 años, y el 16,4% > 18 años. Los valores del producto dosis-área (PDA)/kg y del PDA/kg/fluoroscopia fueron muy similares independientemente del tipo de sala, al igual que ocurre con la edad, el peso y el grupo RER en la mayor parte de las salas pediátricas. El PDA/kg fue superior en los grupos RER I y III comparado con otros países con registros y programas de mejora activos en este campo (un 78 y un 8,3%, respectivamente). Conclusiones: Se obtienen datos representativos de los parámetros dosimétricos por edad y procedimientos en los cateterismos cardiacos congénitos en España en el año 2021. El PDA/kg es el que tiene menor dispersión en la muestra total. Existen áreas de mejora en comparación con otros países con programas de optimización.

ABSTRACT Introduction and objectives: The results of the Radcong-21 Registry of the Spanish Society of Pediatric Cardiology and Congenital Heart Disease Working Group on Hemodynamics are described to analyze data, establish updated reference parameters, and compare them to other registries. Methods: Retrospective, cross-sectional, observational, multicenter registry of patients with congenital heart disease undergoing cardiac catheterization in 2021. Each cath lab sent the last 100 cases performed prior to January 2022. A descriptive analysis was conducted of anthropomorphic variables, procedural (grouped by type and radiation exposure categories [REC]) and technical characteristics, and dosimetric parameters with additional review of all values outside the 95%CI of the median. Results: A total of 1090 procedures performed in 11 cath lab of 10 hospital centers were analyzed. Age distribution: 22.8% < 1 year, 60.7% between 1-18 years, and 16.4% > 18 years. In dose area product (DAP)/Kg and DAP/Kg/fluoroscopy, the distribution was very similar regardless of the type of cath lab as is the case with most pediatric patients in terms of age, weight, and REC group. The DAP/Kg was higher in the REC I and III groups compared to other countries with registries and improvement programs in this area (78% and 8,3%, respectively). Conclusions: Representative data of dosimetric parameters by age and procedures in congenital cardiac catheterizations were obtained in Spain back in 2021. DAP/Kg is the parameter with the lowest dispersion in the sample. There is room for improvement compared to other countries with optimization programs in this area.

Abstract Background/Objective: Stroke knowledge is variable within and between countries. It is determined by school grade, geographical location, and language barriers. This study aims to evaluate the knowledge of stroke symptoms, risk factors, and treatment in a specific population in Mexico. Methods: We surveyed volunteer participants among the inhabitants of a medium-income condominium complex and employees of a pharmaceutical company located in Mexico City between 2016 and 2018. We collected information regarding knowledge of stroke definitions, symptoms, risk factor identification, and treatment. Results: We surveyed 499 participants at both sites, with a median age of 44 years (interquartile range 31-70) and mean years of education of 16.09 years (SD 3.67). The recognition of different definitions regarding stroke was highly heterogeneous, with "brain hemorrhage" and "stroke" being the most known. Among participants, 70% knew at least one stroke symptom. Out of four risk factors, a mean of 3 are identified when prompted, with dyslipidemia being the least acknowledged. While 70% of participants recognize stroke as treatable, only 12-25% know about intravenous thrombolysis. There was no significant difference in overall stroke knowledge between surveyed sites. Conclusions: Knowledge about stroke remains highly heterogeneous in our population. While the knowledge of the general presentation of stroke is higher than in other studies, probably due to the higher mean school education, the awareness of treatment options is low. New public education programs should consider including this information, because it may improve the proportion of cases treated promptly.

Resumen Introducción/Objetivo: El conocimiento de la enfermedad vascular cerebral (EVC) varía entre países y dentro de los mismos. Está determinado por la escolaridad, localización geográfica, barreras de lenguaje y más. Este estudio proporciona información reciente sobre este tema, a través de la medición del conocimiento sobre los síntomas de la EVC, factores de riesgo y tratamientos, en una población de la Ciudad de México. Métodos: Realizamos una entrevista a participantes voluntarios en un condominio de ingreso medio y a empleados de una empresa farmacéutica en Ciudad de México, entre 2016 y 2018. Recolectamos información acerca del conocimiento de definiciones de EVC, síntomas, factores de riesgo y tratamientos. Resultados: Realizamos 499 entrevistas entre ambos sitios, con mediana de edad de 44 años (interquartile range 31-70) y media de escolaridad de 16.09 años (SD 3.67). El reconocimiento de diferentes definiciones relacionadas a la EVC fue altamente heterogéneo, siendo "hemorragia cerebral" y "EVC" los más reconocidos. Adicionalmente, 70% reconoció al menos 1 síntoma de EVC. De 4 factores de riesgo, se identificaron una media de 3, siendo dislipidemia el menos reconocido. Aunque el 70% reconoce la EVC como tratable, sólo un 12-25% conoce la trombolisis intravenosa. No hubo diferencia significativa entre ambos sitios. Conclusiones: El conocimiento de la EVC permanece altamente heterogéneo en nuestra población. Mientras el conocimiento sobre la presentación de la EVC fue mayor a otros estudios, probablemente por una mayor escolaridad, el conocimiento del tratamiento es bajo. Los programas de educación deben considerar incluir esta información, ya que puede mejorar la proporción de casos tratados en tiempo oportuno.

Abstract The objective was to identify the strains, quantity and diversity of fungi present in tortillas of 14 corn breeds. The weight of the fungal complex (PCH) was determined and the identification of its fungi and characteristics of the grain (flotation index), nixtamal (nixtamal moisture and dough moisture) and tortilla (tortilla moisture at 24 and 48 hours). An analysis of variance was performed on the data. All variables presented significant differences (p < 0.05). For the PCH the highest statistically different averages were the Naltel de altura breed (0.69 g) and Arrocillos amarillo breed (0.68 g) per tortilla. The Chalqueño breed had the highest number of mushrooms in the complex (Aspergillus flavus, Mucor sp., Penicillium sp., Rhizopus oryzae, Acremonium sp. y Alternaria sp.) unlike the fungus Penicillium sp., the Conico breed was the second best and in Pepitilla only the Acremonium sp. fungus was identified. For the humidity of nixtamal and dough moisture, the Pepitilla breed obtained the best values with 49.7 and 60.9%, respectively. There were differences of 65.2% in the PCH between the races evaluated, with the highest and lowest weight being the tall Naltel and Chalqueño breeds, respectively.

Resumen El objetivo fue identificar las cepas, la cantidad y la diversidad de hongos presente en tortillas de 14 razas de maíz. Se determinó el peso del complejo de hongos (PCH) y la identificación de los hongos del mismo, así como características del grano (índice de flotación), nixtamal (humedad de nixtamal y humedad de masa) y tortilla (humedad de tortillo a las 24 y 48 h). A los datos se les realizó un análisis de varianza. Todas las variables presentaron diferencias significativas (p < 0.05). Para el PCH los mayores promedios estadísticamente diferente fueron las razas Naltel de altura (0.69 g) y Arrocillos amarillo (0.68 g) por tortilla. La raza Chalqueño tuvo el mayor número de hongos en el complejo (Aspergillus flavus, Mucor sp., Pen icilli um sp., Rh izopus oryzae, Acremonium sp. y Alternaría sp.); con diferencia del hongo Penicillium sp., la raza Cónico fue la segunda mejor, y en Pepitilla solo se identificó el hongo Acremonium sp. Para la humedad de nixtamal y de masa la raza Pepitilla obtuvo los mejores valores, con un 49.7 y 60.9%, respectivamente. Se tuvieron diferencias del 65.2% en el PCH entre las razas evaluadas, presentando el mayor y menor peso las razas Naltel de altura y Chalqueño, respectivamente.

Resumen: Antecedentes. La concurrencia de COVID-19 y padecimientos crónicos no transmisibles son capaces de deteriorar la calidad de vida relacionada con la salud (CVRS) de las personas, pero poco se ha investigado al respecto en México. Objetivo. Examinar la CVRS de pacientes recuperados de COVID-19, estratificados por su severidad clínica. Material y métodos. Encuesta transversal en 144 adultos mayores de 18 años, con diagnóstico confirmado de infección por SARS-CoV-2 en localidades de Sonora. La CVRS fue examinada mediante el cuestionario SF-36 y comparada de acuerdo con la gravedad de las manifestaciones clínicas. Resultados. 131 sujetos se clasificaron con COVID-19 no grave y 13 con un cuadro grave. La media global (76.4 ± 18.4) de la CVRS no fue estadísticamente diferente entre los pacientes agrupados por su severidad clínica; sin embargo, los pacientes con una comorbilidad tuvieron la menor puntuación (72.00 ± 20.74), especialmente los que padecen diabetes mellitus tipo 2 [DM2] (66.33 ± 23.75). También hubo menores puntajes en la función física (58.8 ± 29.6) y el dolor corporal (69.8 ± 20.2). Conclusiones. No se observó una diferencia significativa en la CVRS de pacientes de acuerdo con la severidad de las manifestaciones clínicas de COVID-19.

Abstract Introduction. The simultaneity of COVID-19 and chronic noncommunicable diseases can impair the health-related quality of life (HRQoL) of individuals, however, limited research has been conducted in Mexico in this regard. Objective. Examine the HRQoL of patients recovered from COVID-19, ranked by clinical severity. Methods. Cross-sectional survey of 144 adults over 18 years old, with a confirmed diagnosis of infection caused by SARS-CoV-2 in localities in Sonora. HRQoL was examined using the SF-36 questionnaire and compared according to severity of clinical manifestations. Results. 131 subjects were classified with non-severe COVID-19 and 13 as a severe case. The overall mean (76.4± 18.4) HRQoL was not statistically different between patients grouped by clinical severity; however, patients with a comorbidity had the lowest score (72.00 ± 20.74), especially those with type 2 diabetes (66.33 ± 23.75). There were also lower scores for physical function (58.8± 29.6) and body pain (69.8±20.2). Conclusions. There was no significant difference in HRQoL for patients according to the severity of clinical manifestations of COVID-19.

Resumen: El cultivo de naranja se produce principalmente en el estado de Veracruz. En los municipios de Martínez de la Torre y San Rafael operan dos de las tres empresas productoras de jugo de naranja más importantes de México. La generación de bagazo de naranja por parte de cada una de estas corporaciones oscila entre 112 500 - 187 500 toneladas por ciclo productivo. El manejo de grandes cantidades de bagazo de naranja es un problema económico y ambiental importante para esta zona de Veracruz. Las empresas productoras de jugo de la zona manejan el bagazo a través de tratamientos térmicos (deshidratación para alimentación animal y combustión para la generación de calor). No obstante, cuando la capacidad de manejo del bagazo se ve rebasada, las empresas optan por depositarlo en tiraderos a cielo abierto. Esto representa un riesgo de contaminación para el suelo, el agua y el aire debido a la putrefacción de la biomasa y la generación de lixiviados. El objetivo de este ensayo fue examinar las prácticas de manejo de bagazo de naranja empleadas por parte de las empresas productoras de jugo instaladas en la zona centro de Veracruz. Para ello, se llevó a cabo una revisión de literatura aunado con una estancia de vinculación con una de estas empresas para recabar datos de primera mano. Todas las estrategias de manejo presentan ventajas y desventajas económico-ambientales. Teóricamente, la alternativa más sostenible es la producción y aprovechamiento de gas natural a partir de la digestión anaerobia del bagazo. No obstante, es recomendable realizar un análisis de ciclo de vida de las estrategias de manejo de bagazo con el propósito de determinar que alternativa es la más adecuada en función de la rentabilidad económica, mitigación del impacto ambiental y eficiencia energética.

Summary: Orange cultivation occurs mainly in the State of Veracruz. In Martínez de la Torre and San Rafael municipalities, two of the three most important orange juice producing companies operate in Mexico. The orange bagasse generated by each of these corporations ranges from 112 500 - 187 500 tons per production cycle. Managing large orange bagasse quantities is a major economic and environmental problem for this area of Veracruz. The juice producing companies in the area handle bagasse through heat treatments (dehydration for animal feed and combustion for heat generation). However, when the bagasse handling capacity exceeds, companies choose to deposit it in open dumping sites, posing a risk of contaminating soil, water and air due to biomass putrefaction and leachate generation. Therefore, the objective of this trial is to examine the orange bagasse management practices utilized by the juice producing companies installed in the central area of Veracruz. For this purpose, a literature review was performed together with an internship with one of these companies to collect first-hand data. All management strategies have economic-environmental advantages and disadvantages. Theoretically, the most sustainable alternative is the production and use of natural gas from the bagasse anaerobic digestion. Nevertheless, a life cycle assessment of bagasse management strategies should be performed to determine which alternative is the most appropriate based on economic profitability, environmental impact mitigation and energy efficiency.