Resumo: O ruído ambiental é um poluente atmosférico urbano nas metrópoles. O objetivo deste estudo foi identificar a associação entre a exposição diferencial ao ruído ambiental e a qualidade do sono em adultos. Trata-se de um estudo transversal com amostragem aleatória estratificada de residências conforme duas categorias de exposição (alta [≥ 65dBA] e baixa [≤ 50dBA]), de acordo com o mapa do ruído urbano. Foram selecionadas pessoas maiores de 18 anos, que dormiam e moravam o maior tempo no local durante os últimos seis meses, e foram excluídas pessoas em tratamento de distúrbios mentais ou de comunicação. Foi utilizado um questionário autoaplicável para coletar as características sociodemográficas, clínicas, de estilo de vida, de exposição ao ruído e de qualidade subjetiva do sono (Índice da Qualidade do Sono de Pittsburgh). A análise estatística incluiu testes qui-quadrado e correlações de Spearman, e foi utilizado um modelo de regressão de Poisson com variância robusta. As análises foram realizadas no Stata v12. Foram incluídos 221 participantes, 53,4% do sexo feminino, com idade média de 57 anos (IIQ: 35-67), 52,9% trabalhadores e 45,9% com formação universitária. Foi observado que 47,5% dos participantes tinham alguma patologia subjacente. Os residentes de locais com alta exposição ao ruído tiveram uma maior prevalência de 13% de qualidade de sono ruim em comparação com aqueles de locais com baixa exposição (RP = 1,13; IC95%: 0,99-1,28). O ruído ambiental afeta a qualidade do sono, mas fatores como sensibilidade ao ruído, duração da exposição, variáveis sociodemográficas, hábitos de vida e distúrbios de saúde mental determinam a forma e a magnitude com que o ruído afeta a qualidade do sono.

Resumen: El ruido ambiental es un contaminante urbano del aire en metrópolis. Nuestro objetivo fue determinar la asociación entre exposición diferencial a ruido ambiental y calidad del sueño de adultos. Se realizó estudio de corte transversal con muestreo aleatorio estratificado de viviendas según dos categorías de exposición (alta [≥ 65dBA] y baja [≤ 50dBA]), de acuerdo con mapa a priori de ruido de la ciudad. Se seleccionó personas con 18 o más años, que durmieran y residieran el mayor tiempo posible en la vivienda los últimos seis meses y, se excluyó a personas con tratamiento de alteraciones mentales o de la comunicación. Se utilizó un cuestionario auto diligenciado para medir las características sociodemográficas, clínicas, de estilo de vida, de exposición a ruido, y de calidad subjetiva del sueño (Índice de Calidad de Sueño de Pittsburgh). El análisis estadístico incluyó contrastes mediante chi cuadrado, correlaciones de Spearman y se estructuró un modelo de regresión de Poisson con varianza robusta. Los análisis se realizaron en Stata v12. Se incluyeron 221 participantes, 53,4% mujeres con edad mediana de 57 años (RIC: 35-67), 52,9% trabajadores y 45,9% con formación universitaria. El 47,5% de las personas tenía alguna patología de base. Los residentes en la zona de alta exposición presentaron 13% más prevalencia de mala calidad del sueño comparado con la zona de baja (RP = 1,13; IC95%: 0,99-1,28). El ruido ambiental altera la calidad del sueño, sin embargo, existen factores tales como la sensibilidad al ruido, la duración de la exposición, variables sociodemográficas, hábitos de vida y alteraciones en salud mental que modulan la manera y magnitud en que el ruido afecta dicha calidad del sueño.

Abstract: Environmental noise is an urban air pollutant in metropolises. This study aimed to identify the association between differential exposure to environmental noise and sleep quality in adults. This cross-sectional study used stratified random sampling of households according to two noise exposure categories (high [≥ 65dBA] and low [≤ 50dBA]), as specified by the urban noise map. People aged over 18 years, who slept and spent most of their time in the place during the last six months were selected, and people undergoing treatment for mental or communication disorders were excluded. A self-administered questionnaire was used to collect sociodemographic, clinical, lifestyle, noise exposure, and subjective sleep quality characteristics (Pittsburgh Sleep Quality Index). Statistical analysis included chi-squared tests and Spearman’s correlations, and a Poisson regression model with robust variance was used. The analyses were performed in Stata v12. A total of 221 participants were included, 53.4% female, with a mean age of 57 years (IQR: 35-67), 52.9% workers and 45.9% with higher education. It was observed that 47.5% of the participants had some underlying pathology. Residents of places with high noise exposure had a 13% higher prevalence of poor sleep quality compared to those in places with low exposure (PR = 1.13; 95%CI: 0.99-1.28). Although affecting sleep quality, the ways and extent with which environmental noise affects individuals seems to be influenced by noise sensitivity, length of exposure, sociodemographic variables, lifestyle habits, and mental health disorders.

ABSTRACT The flowers of Agave americana, characterized by their yellow to greenish color, are highly attractive to various pollinators, including bats, insects, and birds. These pollinators consume a large portion of the energy that the plant has accumulated throughout its life, making these flowers a viable food alternative. This study aims to determine the antioxidant and polyphenolic behavior of the preserved flower of black cabuya (Agave americana), a still little-known food option in Ecuadorian cuisine. The samples were subjected to a rigorous process that included drying, grinding, and ultrasoundassisted extraction, followed by analysis using the FRAP and Folin-Ciocalteu methods. The results indicated a significant polyphenol content, with 868.5 mg/kg, and a remarkable antioxidant capacity, reaching 65,000 mg/kg. These findings suggest that the preserved flower of Agave americana could be a healthy food option. Additionally, they highlight the importance of conducting future researchon phytochemicals present in unconventional foods to expand scientific knowledge and diversify Ecuadorian and global cuisine.

RESUMEN Las flores del Agave americana, caracterizadas por su color amarillo a verdoso, son altamente atractivas para diversos polinizadores, incluyendo murciélagos, insectos y aves. Estos polinizadores consumen gran parte de la energía que la planta ha acumulado a lo largo de su vida, lo que hace que estas flores se presenten como una alternativa alimentaria viable. Este estudio tiene como objetivo determinar el comportamiento antioxidante y polifenólico de la conserva de flor de cabuya negra (Agave americana), una opción alimentaria aún poco conocida en la gastronomía ecuatoriana. Las muestras fueron sometidas a un riguroso proceso que incluyó secado, trituración y extracción asistida por ultrasonido, seguido de análisis mediante los métodos FRAP y Folin-Ciocalteu. Los resultados indicaron un contenido significativo de polifenoles, con 868,5 mg/kg, y una notable capacidad antioxidante, alcanzando 65000 mg/kg. Estos hallazgos sugieren que la conserva de flor de Agave americana podría ser una opción alimentaria saludable. Además, destacan la importancia de realizar futuras investigaciones sobre fitoquímicos presentes en alimentos no convencionales, con el fin de expandir el conocimiento científico y diversificar la gastronomía ecuatoriana y mundial.

Abstract: The relationship between fiscal decentralization and the extraction of income by private agents is a constant element in the debates on territorial institutional design. Theoretical literature makes ambiguous predictions about this relationship, and it has been little studied empirically. An econometric model is estimated for a panel of data from 73 developing countries for the years 1996-2019. In general, the evidence found regarding the role of spending decentralization in a lower perception of corruption is consistent. However, a decentralization of income is related to greater corruption. In this way, possible accountability systems appear independent of the generation of own resources and transfer systems are highlighted in the control of public spending.

Resumen: La relación entre la descentralización fiscal y la extracción de rentas por parte de agentes privados es un elemento constante en los debates pertinentes al diseño institucional territorial. La literatura teórica hace predicciones ambiguas respecto de esta relación, y ha sido poco estudiada empíricamente. Se estima un modelo econométrico para un panel de datos de 73 países en desarrollo para 1996-2019. En general, es consistente la evidencia encontrada respecto del papel de la descentralización del gasto en una menor percepción de la corrupción. Sin embargo, una descentralización del ingreso se relaciona con una mayor corrupción. De este modo, aparecen posibles sistemas de rendición de cuentas independientes de la generación de recursos propios y se resaltan a los sistemas de transferencias en el control del gasto público.

Abstract The presence of humans frequently modifies the behavior of animals, particularly their foraging patterns, compromising energetic demands. The fiddler crab Leptuca leptodactyla inhabits mangroves with high degrees of anthropogenic influence. Thus, we tested if populations living in highly anthropized mangroves respond differently from those living in more protected areas. We predict that individuals from touristy areas will be more tolerant to humans and will resume their activities sooner after disturbance. To do so, we conducted an experiment that consisted in the approach of an observer to the burrows, recording the response of individuals to the stimuli. The experiment took place in July 2022, in Ubatuba, São Paulo, Brazil. We analysed the duration and latency of various behaviors of a total of 80 adult males from two populations (high and low anthropogenic influence). Contrary to our predictions, individuals from the anthropized population were less tolerant, spending more time inside their burrows and taking longer to resume their activities. Therefore, fiddler crabs were not habituated to human presence. These results help us understand the learning process in invertebrates and their ability to select stimuli, contributing to understanding the impacts of human-wildlife interactions. animals patterns demands influence Thus disturbance so stimuli 2022 Ubatuba Paulo Brazil 8 . influence) predictions Therefore humanwildlife wildlife interactions 202 20 2

Resumen La alfalfa (Medicago sativa) es originaria de Asia Central, esta leguminosa se siembra en todo México, contribuye a la regeneración de la fertilidad del suelo, además, su elevado contenido de proteínas y aminoácidos ayuda a la reducción de costos de producción de carne y leche. El objetivo del presente trabajo fue valuar diferentes densidades de siembra y la efectividad del extracto a base de exudados de alfalfa sobre plántulas de Arabidopsis thaliana (L.) Heynh. Se empleó semilla de alfalfa variedad San Miguelito y Belleza Verde. La siembra se estableció en cajas Petri en el Tecnológico Nacional de México Campus Roque en noviembre de 2018. Se utilizaron tres densidades de siembra 3, 6 y 9 kg ha-1. Todas las variables se sometieron a un análisis de varianza y una comparación de medias, con el paquete SAS 9.0. El desarrollo radicular de la alfalfa fue afectado por la densidad de siembra, en particular al desarrollo de raíces laterales y presencia de pelos radicales, no así para la longitud de la raíz. La densidad de siembra con mayor desarrollo radicular fue con los 9 kg ha-1. Los exudados de la alfalfa presentaron un efecto antagónico muy marcado sobre Arabidopsis thaliana al reducir su crecimiento, este efecto fue más alto para la densidad de 9 kg ha-1. Una concentración de 50% o más de exudados de alfalfa disminuye el crecimiento hasta llegar a la muerte de esta Arabidopsis thaliana.

Abstract Alfalfa (Medicago sativa) is native to Central Asia, this legume is sown throughout Mexico, contributes to the regeneration of soil fertility, in addition, its high content of proteins and amino acids helps reduce costs of meat and milk production. The objective of this study was to evaluate different sowing densities and the effectiveness of the extract based on alfalfa exudates on seedlings of Arabidopsis thaliana (L.) Heynh. Seeds of the alfalfa varieties San Miguelito and Belleza Verde were used. Sowing was established in Petri dishes at the National Technological Institute of Mexico, Roque campus in November 2018. Three sowing densities, 3, 6 and 9 kg ha-1, were used. All variables were subjected to an analysis of variance and a comparison of means, with the SAS 9.0 package. The sowing density affected the root development of alfalfa, in particular the development of lateral roots and the presence of root hairs, but not the root length. The sowing density with the highest root development was with 9 kg ha-1. The exudates of alfalfa presented a very marked antagonistic effect on Arabidopsis thaliana by reducing its growth, this effect was higher for the density of 9 kg ha-1. A concentration of 50% or more of alfalfa exudates slows the growth until death of this Arabidopsis thaliana.

Resumen Introducción: Alrededor del 50% de los pacientes hos pitalizados por injuria cerebral adquirida grave requie ren traqueostomía y cuidados a largo plazo. El objetivo principal de este estudio fue describir la evolución de enfermos con injuria cerebral adquirida grave (ICAg) traqueostomizados que ingresaron a rehabilitación. Se cundariamente se estudió el fracaso de la decanulación y la supervivencia a los 12 meses del alta. Métodos: estudio cuantitativo observacional prospec tivo de centro único. Se incorporó al estudio, de forma prospectiva y consecutiva, usuarios mayores de 18 años, traqueostomizados posterior a ICAg ingresados a un cen tro de rehabilitación entre abril de 2018 y marzo de 2020. Resultados: se incluyeron para el análisis 50 pacien tes. La estancia en el centro fue de 203 (RIQ 93-320) días. Al alta de la institución, 32 (64%) pacientes pudieron ser decanulados exitosamente. El tiempo transcurrido desde el ingreso al centro hasta la decanulación fue de 49 (12-172) días. No se observó fracaso de la decanula ción. La mortalidad a los 12 meses de seguimiento fue de 32%, cinco (16%) de los 32 pacientes que pudieron ser decanulados y 11 (61%) de los 18 que no lograron la decanulación fallecieron dentro de los 12 meses de seguimiento. La relación entre la decanulación y la mortalidad a los 12 meses de seguimiento resultó esta dísticamente significativa (p = 0.002). Discusión: La supervivencia global fue relativamente elevada, el proceso de decanulación resulta relevante ya que puede tener impacto en la supervivencia a largo plazo.

Abstract Introduction: About 50% of patients hospitalized for severe acquired brain injury require tracheostomy, and many of them need long-term care. The main objective of this study was to describe the evolution of patients with severe acquired brain injury (sABI) tracheotomized who entered rehabilitation. Secondarily, mortality re lated to the success or failure of decannulation and survival at 12 months of discharge were studied. Methods: A single-center prospective observational quantitative study. Users over 18 years of age were recruited prospectively and consecutively, tracheosto mized after sABI, and admitted to a rehabilitation center between April 2018 and March 2020. Results: Fifty patients were included for analysis. The stay in the center was 203 (RIQ 93-320) days. At discharge to the institution, 32 (64%) patients managed to be successfully decannulated. The median number of days from admission to the center to decannulation was 49 (12-172). No decannulation failure was observed. Mortality at 12 months follow-up was 32%, five (16%) of the 32 patients who managed to be decannulated, and 11 (61%) of 18 who failed to achieve decannulation died within 12 months of follow-up. The relationship between decannulation success and mortality at 12 months of follow-up was statistically significant (p= 0.002). Discussion: Addressing the decannulation process early and properly guided is relevant as it may impact long-term survival.

RESUMEN Introducción: La enseñanza en enfermería debe transitar desde una perspectiva tradicionalista, centrada en el docente, a un enfoque que esté centrado al estudiante. Esto último promueve el aprendizaje autónomo, donde el docente actúa como mediador, no como fuente de conocimiento. Objetivo: Identificar la necesidad de usar guías y videos de simulación clínica para el aprendizaje autónomo de estudiantes de enfermería de la Universidad de Cundinamarca. Materiales y Métodos: Investigación bajo el paradigma positivista, de diseño descriptivo, con enfoque cuantitativo, de corte transversal, durante el primer trimestre de 2020. Población 376. Se realizó un muestreo intencional no probabilístico, conformado por 95 estudiantes de enfermería. Los datos se obtuvieron mediante una encuesta autoadministrada y anónima. Se realizó una evaluación descriptiva de los datos. Resultados: El 75 % de los estudiantes demostró un nivel alto de necesidad de usar guías y videos para su aprendizaje autónomo, consideran un mayor grado de seguridad y claridad al realizar procedimientos en las prácticas simuladas, 62 % aseguró que es una herramienta pertinente para el aprendizaje de enfermería. Conclusiones: Se demostró alta necesidad de guías y videos de simulación clínica para el aprendizaje autónomo en estudiantes de enfermería. Estos recursos fomentan la motivación, seguridad y habilidades para el cuidado, reduciendo riesgos en prácticas clínicas. La actualización periódica es crucial para garantizar su utilidad e innovación.

ABSTRACT Introduction: Nursing teaching must move from a traditionalist teacher-centered perspective to a student-centered approach. The latter promotes autonomous learning where the teacher acts as a mediator, but not as a source of knowledge. Objective: To identify the need to use clinical simulation guides and videos for the autonomous learning of nursing students at the University of Cundinamarca. Material and Methods: Research under the positivist paradigm, with a descriptive design and a quantitative cross-sectional approach conducted during the first quarter of 2020 on a population of 376 students. An intentional non-probabilistic sampling made up of 95 nursing students was carried out. The data were obtained through a self-administered and anonymous survey. A descriptive evaluation of the data was performed. Results: The results show that 75% of the students demonstrated a high level of need to use guides and videos for their autonomous learning; they considered that the procedures carried out in simulated practices provided greater degree of safety and clarity; in addition, 62% assured that it is a relevant tool for nursing learning. Conclusions: A high need to use clinical simulation guides and videos for autonomous learning in nursing students was demonstrated. These resources promote motivation, safety, and caregiving skills, reducing risks in clinical practices. Regular updating is crucial to ensure their usefulness and innovation.

RESUMEN Introducción: Actualmente los contagios por el virus del SARS-CoV-2 supera los 600 millones de casos en el mundo. Objetivo: Aislar y caracterizar el virus SARS-CoV-2 causante de la COVID-19 a inicios de la pandemia en el Perú. Materiales y métodos: Se realizó el aislamiento viral a partir de 20 muestras de hisopado nasal y faríngeo positivas a SARS-CoV-2 por RT-PCR. El aislamiento se realizó en las líneas celulares Vero ATCC CCL-81 y Vero E6, evaluando el efecto citopático, la presencia del virus por RT-PCR, inmunofluorescencia indirecta (IFI) y posterior identificación por secuenciación genómica. Posteriormente, uno de los aislamientos de mayor circulación fue seleccionado y denominado cepa prototipo (PE/B.1.1/28549/2020), realizándose 10 pasajes sucesivos en células Vero ATCC CCL-81 para evaluar la dinámica de mutaciones. Resultados: Se observaron 11 aislamientos de virus por efecto citopático confirmándose por RT-PCR e IFI, de los cuales 6 fueron secuenciados identificándose los linajes B.1, B.1.1, B.1.1.1 y B.1.205, según el comité Pango de los genomas. La cepa prototipo corresponde a la variante B.1.1 y el análisis de las secuencias de los pasajes sucesivos mostró mutaciones a nivel de la proteína de la espiga (S) del virus, sin variación en la identidad del linaje. Conclusiones: Se aislaron 4 linajes en la línea celular Vero ATCC CCL-81. Los subcultivos en la misma línea celular muestran mutaciones en la proteína de la espiga, lo que indica mayor adaptabilidad a la célula hospedera y variación de la patogenicidad in vitro, comportamiento que le permite tener más éxito de supervivencia.

ABSTRACT Introduction: Currently, infections caused by the SARS-CoV-2 virus exceed 600 million cases in the world. Objective: Isolation and characterization of the SARS-CoV-2 virus causing COVID-19 at the beginning of the pandemic in Peru. Materials and methods: Twenty nasal and pharyngeal swab samples were isolated from SARS-CoV-2 using two cell lines, Vero ATCC CCL-81 and Vero E-6; virus identification was performed by RT-PCR and the onset of cytopathic effect (CPE) was evaluated by indirect immunofluorescence and subsequent identification by genomic sequencing. One of the most widely circulating isolates were selected and named the prototype strain (PE/B.1.1/28549/2020). Then 10 successive passages were performed on Vero ATCC CCL-81 cells to assess mutation dynamics. Results: We detected 11 virus isolates by cytopathic effect, and subsequently confirmed by RT-PCR and indirect immunofluorescence. Of these, six were sequenced and identified as the lineages B.1, B.1.1, B.1.1.1, and B.1.205 according to the Pango lineage nomenclature. The prototype strain corresponded to lineage B.1.1. The analysis of the strains from the successive passages showed mutations mainly at in the spike (S) protein of the virus without variation in the identity of the lineage. Conclusions: Four lineages were isolated in the Vero ATCC CCL-81 cell line. Subcultures in the same cell line show mutations in the spike protein indicating greater adaptability to the host cell and variation in pathogenicity in vitro, a behavior that allows it to have more survival success.

Abstract Introduction Intraoperative fluid therapy in cytoreductive surgery with hyperthermic intraperitoneal chemotherapy plays an important role in postoperative morbidity. Studies have found an association between overload fluid therapy and increased postoperative complications, advising restrictive intraoperative fluid therapy. Our objective in this study was to compare the morbidity associated with restrictive versus non-restrictive intraoperative fluid therapy. Methods Retrospective analysis of a database collected prospectively in the Anesthesiology Service of Virgen del Rocío Hospital, from December 2016 to April 2019. One hundred and six patients who underwent complete cytoreductive surgery and hyperthermic intraperitoneal chemotherapy were divided into two cohorts according to Fluid Therapy received 1. Restrictive ≤ 9 mL.kg-1.h-1 (34 patients), 2. Non-restrictive ≥ 9 mL.kg-1.h-1 (72 patients). Percentage of major complications (Clavien-Dindo grade III-IV) and length hospital stay were the main outcomes variables. Results Of the 106 enrolled patients, 68.9% were women; 46.2% had ovarian cancer, 35.84% colorectal cancer, and 7.5% peritoneal cancer. The average fluid administration rate was 11 ± 3.58 mL.kg-1.h-1. The restrictive group suffered a significantly higher percentage of Clavien-Dindo grade III-IV complications (35.29%) compared with the non-restrictive group (15.27%) (p= 0.02). The relative risk associated with restrictive therapy was 1.968 (95% confidence interval: 1.158-3.346). We also found a significant difference for hospital length of stay, 20.91 days in the restrictive group vs 16.19 days in the non-restrictive group (p= 0.038). Conclusions Intraoperative fluid therapy restriction below 9 mL.kg-1.h-1 in cytoreductive surgery with hyperthermic intraperitoneal chemotherapy was associated with a higher percentage of major postoperative complications.

RESUMEN La pandemia por el nuevo coronavirus denominado SARS-CoV-2 plantea retos sin precedentes en la atención de la salud. Entre ellos se cuenta el aumento en los casos de delirium. La enfermedad grave por SARS-CoV-2, COVID-19, tiene vulnerabilidades comunes con el delirium y produce alteraciones en órganos como el pulmón o el cerebro, entre otros, que tienen potencial para precipitar el trastorno mental; de hecho, este puede ser la primera manifestación de la infección, antes de la fiebre, el malestar general, la tos o las alteraciones respiratorias. Está ampliamente sustentado que el delirium incrementa la morbilidad y la mortalidad de quienes lo padecen durante una hospitalización, por lo que se debe buscar activamente para realizar las intervenciones pertinentes. Ante la ausencia de evidencia sobre el abordaje del delirium en el contexto de la COVID-19, se elaboró este consenso sobre tres aspectos fundamentales: diagnóstico, tratamiento no farmacológico y tratamiento farmacológico, en pacientes ingresados en el hospital general. El documento contiene recomendaciones sobre uso sistemático de herramientas diagnósticas, cuándo hospitalizar al paciente con delirium, la aplicación de acciones no farmacológicas dentro de las restricciones que impone la COVID-19 y la utilización de antipsicóticos teniendo en cuenta los efectos secundarios más relevantes y las interacciones farmacológicas.

ABSTRACT The pandemic caused by the new coronavirus named SARS-CoV-2 poses unprecedented challenges in the health care. Among them is the increase in cases of delirium. The severe SARS-CoV-2 disease, COVID-19, has common vulnerabilities with delirium and produces alterations in organs such as the lungs or the brain, among others, which have the potential to trigger the mental disorder. In fact, delirium may be the first manifestation of the infection, before fever, general malaise, cough or respiratory disturbances. It is widely supported that delirium increases the morbidity and mortality in those who suffer from it during hospitalization, so it should be actively sought to carry out the relevant interventions. In the absence of evidence on the approach to delirium in the context of COVID-19, this consensus was developed on three fundamental aspects: diagnosis, non-pharmacological treatment and pharmacological treatment, in patients admitted to the general hospital. The document contains recommendations on the systematic use of diagnostic tools, when to hospitalize the patient with delirium, the application of non-pharmacological actions within the restrictions imposed by COVID-19, and the use of antipsychotics, taking into account the most relevant side effects and pharmacological interactions.

Abstract: This paper analyses public policies concerning sustainability in Brazil, Chile, Colombia, and Mexico; and examines their contribution to the transformation of the productivity practices towards circular economy (CE). The findings allow for a distinction among three fields: renewable energy and energy transition, sustainable production and consumption, and waste management. This paper points out elements for formulation of public policies directed towards CE, such as the need for stability and normative clarity to handle actions from active participators; the creation of taxes and economic/financial incentives to industrial updating processes and making of profit out of externalities; the formation and training of human capital to align business’ goals with sustainable practices; and both the education and sensitization of the population that drive policies dissemination.

Resumen: Este trabajo analiza las políticas públicas de sostenibilidad de Brasil, Chile, Colombia y México y su contribución a la transformación productiva hacia una economía circular (EC). Los hallazgos permiten distinguir políticas públicas en tres campos: energías renovables y transición energética, producción y consumo sostenible, y gestión de residuos. El artículo aporta elementos en la formulación de políticas públicas dirigidas a la implementación de la EC, tales como: la necesidad de estabilidad y claridad normativa para manejar las acciones de los participantes activos; la creación de incentivos fiscales, económicos y financieros para los procesos de actualización industrial y el aprovechamiento de las externalidades; la formación y capacitación del capital humano para alinear los objetivos comerciales con prácticas sostenibles; así como la educación y la sensibilización de la población que impulsen la difusión de las políticas.

Resumo: O estudo da fadiga em ambiente subaquático é dificultado pois envolve diversas variáveis, muitas delas estão relacionadas à interação do material com o meio em que está submetido. Em testes de fadiga em ambiente aquoso foi constatado o aparecimento de bolhas que se desprendem da região da ponta da trinca durante o ensaio, porém, até o momento a literatura não havia relatado esse fenômeno. Buscando a repetibilidade, este trabalho apresenta parâmetros de ensaio que promovam o desprendimento de bolhas, facilitando seu estudo e compreensão. Corpos de prova do tipo C(T) fabricados em aço ASTM A36 foram ensaiados em ambiente subaquático sob uma variação de carga constante (ΔP) de 5kN e frequência de 30Hz. Os desprendimentos das bolhas durante os ensaios foram registrados com uma câmera de alta velocidade (captura de 1000fps). Os resultados indicam que as primeiras bolhas desprendidas durante o ensaio são menores e aumentam de volume com o aumento do comprimento da trinca, chegando a um diâmetro médio máximo e após isso ocorre diminuição e supressão do fenômeno ao se aproximar do final do ensaio. A ocorrência foi associada à fragilização por hidrogênio, com existência já comprovada nesse tipo de ensaio

Abstract: The study of fatigue in an underwater environment is difficult because it involves several variables, many of them are related to the interaction of the material with the environment in which it is submitted. In fatigue tests in an aqueous environment, the appearance of bubbles that detach from the crack tip region during the test was observed, however, until now the literature had not reported this phenomenon. Seeking repeatability, this work presents test parameters that promote the detachment of bubbles, facilitating their study and understanding. Type C(T) specimens made of ASTM A36 steel were tested in an underwater environment under a constant load variation (ΔP) of 5kN and frequency of 30Hz. The detachments of the bubbles during the tests were recorded with a high-speed camera (capture of 1000fps). The results indicate that the first bubbles released during the test are smaller and increase in volume with increasing crack length, reaching a maximum average diameter and after that, there is a decrease and suppression of the phenomenon when approaching the end of the test. The occurrence was associated with hydrogen embrittlement, with proven existence in this type of test

Resumo A hiperuricemia é comum na doença renal crônica (DRC) e pode estar presente em até 50% dos pacientes que se apresentam para diálise. A hiperuricemia pode ser secundária ao comprometimento da taxa de filtração glomerular (TFG) que ocorre na DRC. No entanto, ela também pode preceder o desenvolvimento da doença renal e mesmo prever uma DRC incidente. Estudos experimentais de modelos hiperuricêmicos descobriram que tanto o ácido úrico solúvel quanto o cristalino podem causar danos renais significativos, caracterizados por isquemia, fibrose tubulointersticial e inflamação. Entretanto, a maioria dos estudos de randomização Mendeliana falhou em demonstrar uma relação causal entre o ácido úrico e a DRC, e os ensaios clínicos têm apresentado resultados variáveis. Aqui sugerimos explicações potenciais para os achados clínicos e genéticos negativos, incluindo o papel do ácido úrico cristalino, do ácido úrico intracelular e da atividade da xantina oxidase na lesão renal mediada por ácido úrico. Propomos ensaios clínicos futuros, bem como um algoritmo para o tratamento de hiperuricemia em pacientes com DRC.

Abstract Hyperuricemia is common in chronic kidney disease (CKD) and may be present in 50% of patients presenting for dialysis. Hyperuricemia can be secondary to impaired glomerular filtration rate (GFR) that occurs in CKD. However, hyperuricemia can also precede the development of kidney disease and predict incident CKD. Experimental studies of hyperuricemic models have found that both soluble and crystalline uric acid can cause significant kidney damage, characterized by ischemia, tubulointerstitial fibrosis, and inflammation. However, most Mendelian randomization studies failed to demonstrate a causal relationship between uric acid and CKD, and clinical trials have had variable results. Here we suggest potential explanations for the negative clinical and genetic findings, including the role of crystalline uric acid, intracellular uric acid, and xanthine oxidase activity in uric acid-mediated kidney injury. We propose future clinical trials as well as an algorithm for treatment of hyperuricemia in patients with CKD.

RESUMEN Objetivo: describir las prácticas farmacológicas y no farmacológicas para el delirium, realizadas por residentes de psiquiatría y psiquiatras en Colombia. Métodos: encuesta anónima basada en el consenso de expertos del Comité de Psiquiatría de Enlace de la Asociación Colombiana de Psiquiatría y en la literatura. Enviada por correo electrónico a los adscritos a la asociación. Resultados: Participaron 101 clínicos. Las medidas preventivas no farmacológicas como psi-coeducación, corrección de problemas sensoriales o higiene del sueno son realizadas por el 70% o más. Solo cerca de uno de cada 10 hace parte de algún programa multicomponente preventivo institucional. La prescripción preventiva de fármacos fue menor del 20%. Respecto al tratamiento no farmacológico, más del 75% hace corrección de dificultades sensoriales, control de estímulos y reorientación. Nadie indicó que en su centro la atención esté organizada para potenciar el tratamiento no farmacológico. El 17,8% no usa fármacos en el tratamiento. Los que los usan prefieren haloperidol o quetiapina, especialmente en casos hiperactivos o mixtos. Conclusiones: Las prácticas de los encuestados coinciden con las de otros expertos en el mundo. En general, las acciones no farmacológicas son iniciativas individuales, lo que evidencia la necesidad de que las instituciones colombianas de salud se comprometan con el abordaje del delirium, especialmente cuando su prevalencia y consecuencias son indicadores de calidad en la atención.

ABSTRACT Objective: To describe pharmacological and non-pharmacological practices for delirium, carried out by psychiatry residents and psychiatrists in Colombia. Methods: An anonymous survey was conducted based on the consensus of experts of the Liaison Psychiatry Committee of the Asociación Colombiana de Psiquiatría [Colombian Psychiatric Association] and on the literature review. It was sent by email to the association members. Results: 101 clinicians participated. Non-pharmacological preventive measures such as psychoeducation, correction of sensory problems or sleep hygiene are performed by 70% or more. Only about 1 in 10 participants are part of an institutional multi-component prevention programme. The preventive prescription of drugs was less than 20%. Regarding non-pharmacological treatment, more than 75% recommend correction of sensory difficulties, control of stimuli and reorientation. None of the participants indicated that the care at their centres is organised to enhance non-pharmacological treatment. 17.8% do not use medication in the treatment of delirium. Those who use it prefer haloperidol or quetiapine, particularly in hyperactive or mixed motor subtypes. Conclusions: The practices of the respondents coincide with those of other experts around the world. In general, non-pharmacological actions are individual initiatives, which demonstrates the need in Colombian health institutions to commit to addressing delirium, in particular when its prevalence and consequences are indicators of quality of care.