Abstract Background This study examines the association of standard-of-care systemic lupus erythematosus (SLE) medications with key outcomes such as low disease activity attainment, flares, damage accrual, and steroid-sparing, for which there is current paucity of data. Methods The Asia Pacific Lupus Collaboration (APLC) prospectively collects data across numerous sites regarding demographic and disease characteristics, medication use, and lupus outcomes. Using propensity score methods and panel logistic regression models, we determined the association between lupus medications and outcomes. Results Among 1707 patients followed over 12,689 visits for a median of 2.19 years, 1332 (78.03%) patients achieved the Lupus Low Disease Activity State (LLDAS), 976 (57.18%) experienced flares, and on most visits patients were taking an anti-malarial (69.86%) or immunosuppressive drug (76.37%). Prednisolone, hydroxychloroquine and azathioprine were utilised with similar frequency across all organ domains; methotrexate for musculoskeletal activity. There were differences in medication utilisation between countries, with hydroxychloroquine less frequently, and calcineurin inhibitors more frequently, used in Japan. More patients taking leflunomide, methotrexate, chloroquine/ hydroxychloroquine, azathioprine, and mycophenolate mofetil/mycophenolic acid were taking ≤ 7.5 mg/day of prednisolone (compared to > 7.5 mg/day) suggesting a steroid-sparing effect. Patients taking tacrolimus were more likely (Odds Ratio [95% Confidence Interval] 13.58 [2.23-82.78], p = 0.005) to attain LLDAS. Patients taking azathioprine (OR 0.67 [0.53-0.86], p = 0.001) and methotrexate (OR 0.68 [0.47-0.98], p = 0.038) were less likely to attain LLDAS. Patients taking mycophenolate mofetil were less likely to experience a flare (OR 0.79 [0.64-0.97], p = 0.025). None of the drugs was associated with a reduction in damage accrual. Conclusions This study suggests a steroid-sparing benefit for most commonly used standard of care immunosuppressants used in SLE treatment, some of which were associated with an increased likelihood of attaining LLDAS, or reduced incidence of flares. It also highlights the unmet need for effective treatments in lupus. standardofcare (SLE attainment flares accrual steroidsparing, steroidsparing steroid sparing, sparing APLC (APLC characteristics use models 170 12689 12 689 12,68 219 2 19 2.1 years 133 78.03% 7803 78 03 (78.03% LLDAS , (LLDAS) 97 57.18% 5718 57 18 (57.18% antimalarial anti malarial 69.86% 6986 69 86 (69.86% 76.37%. 7637 76.37% . 76 37 (76.37%) Prednisolone domains countries frequently Japan leflunomide chloroquine mofetilmycophenolic mycophenolic 75 7 5 7. mgday mg day compared effect Odds 95% 95 [95 Interval 1358 13 58 13.5 2.2382.78, 2238278 2.23 82.78 23 82 [2.23-82.78] 0.005 0005 0 005 OR 067 67 0.6 0.530.86, 053086 0.53 0.86 53 [0.53-0.86] 0.001 0001 001 068 68 0.470.98, 047098 0.47 0.98 47 98 [0.47-0.98] 0.038 0038 038 079 79 0.7 0.640.97, 064097 0.64 0.97 64 [0.64-0.97] 0.025. 0025 0.025 025 0.025) treatment 17 1268 1 12,6 21 2. 78.03 780 (78.03 (LLDAS 9 57.18 571 (57.18 69.86 698 6 8 (69.86 763 76.37 3 (76.37% [9 135 13. 2382 2.2382.78 223827 223 2.2 8278 82.7 [2.23-82.78 0.00 000 00 06 0. 530 0.530.86 05308 053 0.5 086 0.8 [0.53-0.86 470 0.470.98 04709 047 0.4 098 0.9 4 [0.47-0.98 0.03 003 07 640 0.640.97 06409 064 097 [0.64-0.97 002 0.02 02 126 12, 78.0 (78.0 57.1 (57.1 69.8 (69.8 76.3 (76.37 [ 238 2.2382.7 22382 22 827 82. [2.23-82.7 0.0 0.530.8 0530 05 08 [0.53-0.8 0.470.9 0470 04 09 [0.47-0.9 0.640.9 0640 [0.64-0.9 78. (78. 57. (57. 69. (69. 76. (76.3 2.2382. 2238 [2.23-82. 0.530. [0.53-0. 0.470. [0.47-0. 0.640. [0.64-0. (78 (57 (69 (76. 2.2382 [2.23-82 0.530 [0.53-0 0.470 [0.47-0 0.640 [0.64-0 (7 (5 (6 (76 2.238 [2.23-8 [0.53- [0.47- [0.64- ( [2.23- [0.53 [0.47 [0.64 [2.23 [0.5 [0.4 [0.6 [2.2 [0. [2. [0 [2

RESUMEN A raíz del COVID-19, las Competencias Digitales (CD) y la Gestión Directiva (GD) han adquirido una gran relevancia en el ámbito educativo; por tal motivo, el objetivo fue determinar la influencia de las CD y la GD en el Desempeño Docente (DD). La metodología fue cuantitativa, de diseño causal correlacional, de corte transaccional y con una muestra de 101 educadores. La aplicación de la encuesta permitió la recolección de datos que, al procesarse estadísticamente, arrojaron un valor de significancia de 0,008 < 0,05 y un coeficiente de Nagelkerke de 17,8%, lo que permitió concluir que, las CD y la GD influyen positiva y significativamente en el DD; así como en todas sus dimensiones (preparación para el aprendizaje, enseñanza para el aprendizaje, participación en la gestión de la escuela articulada a la comunidad y el desarrollo de la profesionalidad y la identidad docente.

RESUMO Como resultado da COVID-19, as Competências Digitais (CD) e a Gestão Diretiva (DM) adquiriram grande relevância no campo educacional; por essa razão, o objetivo foi determinar a influência das CD e da DM no Desempenho Docente (DT). A metodologia foi quantitativa, com um desenho correlacional causal, transacional e com uma amostra de 101 educadores. A aplicação da pesquisa permitiu a coleta de dados que, quando tratados estatisticamente, produziram um valor de significância de 0,008 < 0,05 e um coeficiente de Nagelkerke de 17,8%, o que levou à conclusão de que a CD e a GD têm influência positiva e significativa no DT, bem como em todas as suas dimensões (preparação para a aprendizagem, ensino para a aprendizagem, participação na gestão escolar articulada à comunidade e desenvolvimento do profissionalismo e da identidade docente).

ABSTRACT As a result of COVID-19, Digital Competencies (DC) and Directive Management (DM) have acquired great relevance in the educational field; for this reason, the objective was to determine the influence of DC and DM on Teaching Performance (TD). The methodology was quantitative, with a causal correlational design, transactional and with a sample of 101 educators. The application of the survey allowed the collection of data that, when statistically processed, yielded a significance value of 0.008 < 0.05 and a Nagelkerke coefficient of 17.8%, which allowed concluding that, DC and DG have a positive and significant influence on DD; as well as in all its dimensions (preparation for learning, teaching for learning, participation in school management articulated to the community and the development of professionalism and teacher identity.

RESUMO OBJETIVO Caracterizar o perfil sociodemográfico e analisar as características migratórias dos integrantes dos Programas de Residência em Medicina de Família e Comunidade em 2020 no Brasil. MÉTODOS O estudo segue um delineamento observacional transversal de natureza quantitativa a partir da perspectiva dos integrantes dos Programas de Residência em Medicina de Família e Comunidade. Foram desenvolvidos questionários adaptados para cada grupo participante, aplicados por meio de plataforma on-line. RESULTADOS A maioria dos participantes é do sexo feminino e de cor branca. A maioria dos supervisores e preceptores foi residente de Programas de Residência em Medicina de Família e Comunidade, contudo, há alguns que não são especialistas na área. A maior parte dos participantes está vinculada às capitais ou regiões metropolitanas. Em relação à fixação, 41,1% dos supervisores e 73,1% dos preceptores estão vinculados a um programa no mesmo município onde foram residentes. Para a maioria dos médicos residentes, o local da residência coincide com o local de nascimento e/ou graduação (57,4%), sendo que 48,5% estão no mesmo local de graduação. CONCLUSÕES A pesquisa reforça a necessidade de políticas de promoção da migração de residentes para Programas de Residência em Medicina de Família e Comunidade fora das capitais e regiões metropolitanas, bem como estimula a fixação dos egressos formados fora dos grandes centros urbanos para que eles possam contribuir com a distribuição e com o provimento de médicos onde ainda é necessário.

ABSTRACT OBJECTIVE To describe the sociodemographic profile and analyze the migratory characteristics of the members of the Residency Programs in Family Medicine in 2020 in Brazil. METHODS The study follows a cross-sectional observational design of a quantitative nature from the perspective of the members of the Residency Programs in Family Medicine. Questionnaires adapted for each participating group were developed, applied through an online platform. RESULTS Most participants are female and white. Most supervisors and preceptors were residents of Residency Programs in Family Medicine, however, there are some who are not specialists in the field. Most participants are based in capitals or metropolitan regions. In relation to retention, 41.1% of supervisors and 73.1% of preceptors are affiliated to a program in the same municipality where they lived. For most resident physicians, the place of residence coincides with the place of birth and/or graduation (57.4%), and 48.5% are in the same place of graduation. CONCLUSIONS The research reinforces the need for policies to promote the migration of residents to Residency Programs in Family Medicine outside capital cities and metropolitan regions, as well as encouraging the retention of graduates trained outside large urban centers so that they can contribute to distribution and provision of doctors where they are still needed.

RESUMO OBJETIVO Caracterizar o perfil sociodemográfico e analisar as características migratórias dos integrantes dos Programas de Residência em Medicina de Família e Comunidade em 2020 no Brasil. MÉTODOS O estudo segue um delineamento observacional transversal de natureza quantitativa a partir da perspectiva dos integrantes dos Programas de Residência em Medicina de Família e Comunidade. Foram desenvolvidos questionários adaptados para cada grupo participante, aplicados por meio de plataforma on-line. RESULTADOS A maioria dos participantes é do sexo feminino e de cor branca. A maioria dos supervisores e preceptores foi residente de Programas de Residência em Medicina de Família e Comunidade, contudo, há alguns que não são especialistas na área. A maior parte dos participantes está vinculada às capitais ou regiões metropolitanas. Em relação à fixação, 41,1% dos supervisores e 73,1% dos preceptores estão vinculados a um programa no mesmo município onde foram residentes. Para a maioria dos médicos residentes, o local da residência coincide com o local de nascimento e/ou graduação (57,4%), sendo que 48,5% estão no mesmo local de graduação. CONCLUSÕES A pesquisa reforça a necessidade de políticas de promoção da migração de residentes para Programas de Residência em Medicina de Família e Comunidade fora das capitais e regiões metropolitanas, bem como estimula a fixação dos egressos formados fora dos grandes centros urbanos para que eles possam contribuir com a distribuição e com o provimento de médicos onde ainda é necessário.

ABSTRACT OBJECTIVE To describe the sociodemographic profile and analyze the migratory characteristics of the members of the Residency Programs in Family Medicine in 2020 in Brazil. METHODS The study follows a cross-sectional observational design of a quantitative nature from the perspective of the members of the Residency Programs in Family Medicine. Questionnaires adapted for each participating group were developed, applied through an online platform. RESULTS Most participants are female and white. Most supervisors and preceptors were residents of Residency Programs in Family Medicine, however, there are some who are not specialists in the field. Most participants are based in capitals or metropolitan regions. In relation to retention, 41.1% of supervisors and 73.1% of preceptors are affiliated to a program in the same municipality where they lived. For most resident physicians, the place of residence coincides with the place of birth and/or graduation (57.4%), and 48.5% are in the same place of graduation. CONCLUSIONS The research reinforces the need for policies to promote the migration of residents to Residency Programs in Family Medicine outside capital cities and metropolitan regions, as well as encouraging the retention of graduates trained outside large urban centers so that they can contribute to distribution and provision of doctors where they are still needed.

Abstract The article analyzes socio-community inclusion practices of groups of people with psychosocial disabilities, generated in doing and feeling in their collective occupations, from the dialogues that take place with social institutions. A qualitative methodology was used, with a critical approach. The information was collected through discussion groups, which made it possible to collect speeches from the participants of two groups of people with mental disabilities, corresponding to the communes of Penco and Concepción, in the Biobío Region (Chile); discourses that were coded, analyzed, categorized and interpreted. Among the most relevant results obtained, differences and tensions are evident in the ways of understanding and proceeding towards inclusion, since institutions tend to maintain hierarchical relationships, while groups tend to have more democratic and participatory practices. Regarding the conclusions, it is possible to visualize that the human rights of people with mental disabilities are materialized in a field of collective occupations, daily actions in everyday contexts, and social conflict.

Resumen El artículo analiza, prácticas de inclusión socio comunitaria, de agrupaciones de personas con discapacidad psicosocial, generadas en el hacer y sentir en sus ocupaciones colectivas, a partir de los diálogos que se producen con las instituciones sociales. Se empleó una metodología cualitativa, con enfoque crítico. La información fue recolectada mediante grupos de discusión, lo que permitió recoger discursos de los participantes de dos agrupaciones de personas con discapacidad psicosocial, correspondientes a las comunas de Penco y Concepción, de la Región del Biobío (Chile); discursos que fueron codificados, analizados, categorizados e interpretados. Entre los resultados más relevantes obtenidos, se evidencian diferencias y tensiones en las formas de comprender y proceder hacia la inclusión, pues las instituciones tienden a mantener relaciones jerárquicas, mientras que las agrupaciones propenden a prácticas más democráticas y participativas. Con respecto a las conclusiones, es posible visualizar que los derechos humanos de las personas con discapacidad psicosocial se materializan en un campo de ocupaciones colectivas, de acciones diarias en contextos cotidianos y de conflicto social.

ABSTRACT Zinc (Zn) is an essential nutrient for plants, however, there are still few studies related to this nutrient in Paraguay. The aim of this experiment was to evaluate the effect of the application of Zn on wheat, corn and sesame crops in two soils of different textures. The experiment was carried out in a greenhouse, in pots with 5 kg of soil, between February 2017 and January 2018. The experimental design used was completely randomized with a bifactorial arrangement, with 5 repetitions. The factors evaluated were: Factor 1, soil textures (sandy and clay loam) and Zn doses (0, 10, 20, 40 and 80 mg kg-1 of Zn) applied before sowing wheat and corn, evaluating the residual effect of Zn in sesame. The Zn level in the soil and in the tissue, the plant height and the dry matter weight were determined. The soil texture did not influence the Zn content in the soil and in the leaf tissue of the plants. The zinc content in the soil and the Zn concentration in the tissue increased linearly with the higher dose of Zn applied. Plant height was affected by soil texture in the three crops and dry matter production in grasses. Zn increased the plant height of wheat and corn, but not that of sesame. Dry matter and plant height of wheat and corn increased in sandy soil, not so in sesame. Corn and wheat showed a significant effect on growth parameters depending on the Zn doses applied to the sandy soil. Dry matter production suffered interaction between soil and Zn doses in wheat and corn. The application of Zn allows the increase of its levels in the soil and plant tissue, but not always in the production of dry matter.

RESUMEN El zinc (Zn) es un nutriente esencial para las plantas, sin embargo, aún existen escasos estudios de fertilización relacionados a este nutriente en Paraguay. El objetivo de este experimento fue evaluar el efecto de la aplicación de Zn sobre los cultivos de trigo, maíz y sésamo en dos suelos de diferentes texturas. La investigación fue realizada en ambiente controlado, en macetas con 5 kg de suelo, entre febrero de 2017 a enero de 2018. El diseño experimental utilizado fue completamente al azar con arreglo bifactorial, con 5 repeticiones. Los factores evaluados fueron: Factor 1, texturas de suelo (franco arenosa y arcillosa) y dosis de Zn (0, 10, 20, 40 y 80 mg kg-1 de Zn) aplicados antes de la siembra del trigo y maíz, evaluando el efecto residual del Zn en el sésamo. Se determinó el nivel de Zn en el suelo y en el tejido, la altura de planta y el peso de materia seca. La textura del suelo no influyó en el contenido de Zn en el suelo y en el tejido foliar de las plantas. El contenido de zinc en el suelo y la concentración de Zn en el tejido aumentaron en forma lineal a mayor dosis de Zn aplicada. La altura de planta fue afectada por la textura del suelo en los tres cultivos y la producción de materia seca en las gramíneas. El Zn aumentó la altura de planta de trigo y maíz, no así la del sésamo. La materia seca y la altura de planta del trigo y maíz aumentaron en el suelo arenoso, no así en el sésamo. El maíz y el trigo presentaron efecto significativo en parámetros de crecimiento en función a las dosis de Zn aplicadas en el suelo arenoso. La producción de materia seca sufrió interacción entre suelo y dosis de Zn en el trigo y maíz. La aplicación de Zn permite el aumento de los niveles de este en el suelo y en el tejido de las plantas, pero no siempre en la producción de materia seca.

Abstract In Mexico, healthy lifestyle has a low prevalence. The importance of a healthy lifestyle lies in avoiding the emergence of a chronic non-communicable disease. Thus, university administrative personnel are a vulnerable population due to working conditions that prevent them from having a healthy lifestyle, so it is necessary to analyze psychological variables that can explain how to promote and develop a healthy lifestyle. The purposes of this study were to identify relationships among lifestyle (LS) and positive psychological functioning (PPF) and their differences by gender in the administrative staff; a cross-sectional and correlational study was conducted. University administrative staff (n = 102), were recruited using the snowball sampling method, forming a non-probabilistic sample, completed the Fantastic Lifestyle Questionnaire and the Positive Psychological Functioning Scale. LS has a statistically significant correlation with PPF (r = .355, p = .001); in addition, it is worth pointing out that showing a low level of PPF implies a lower probability of having a healthy LS (Ψ = 28.333, 4.965 - 161.675). Results suggest the relevance of interventions to develop psychological resources in people seeking the adoption of a healthy LS.

Resumen En México, el estilo de vida saludable tiene una baja prevalencia. La importancia de un estilo de vida saludable radica en evitar la aparición de una enfermedad crónica no transmisible. Así, el personal administrativo universitario es una población vulnerable debido a las condiciones laborales que les impiden tener un estilo de vida saludable, por lo que es necesario analizar las variables psicológicas que pueden explicar cómo promoverlo y desarrollarlo. Los propósitos de este estudio fueron identificar las relaciones entre el estilo de vida (EV) y el funcionamiento psicológico positivo (FPP) y sus diferencias por sexo en personal administrativo universitario para lo cual se realizó un estudio transversal y correlacional. El personal administrativo universitario (n = 102) reclutado mediante el método de muestreo de bola de nieve, completó el Cuestionario de Estilo de Vida Fantástico y la Escala de Funcionamiento Psicológico Positivo. El EV presentó una correlación estadísticamente significativa con el FPP (r = .355, p = .001); además, vale la pena señalar que tener un bajo nivel de FPP implica una menor probabilidad de tener un EV saludable (Ψ = 28.333, 4.965 - 161.675). Los resultados sugieren la relevancia de las intervenciones para desarrollar recursos psicológicos en personas que buscan la adopción de un EV saludable.

Abstract The objective of this study was to analyze the impact on the use of ICT for the development of their academic activities in the modality of online classes at the University of Guayaquil, in times of the COVID-19 pandemic, a global health crisis that includes Ecuador. This research was in the field and its design was not cross-sectional. The information was collected through a questionnaire of different types of questions, the reliability of this instrument was made through Cronbach's Alpha coefficient, the results of the surveys were processed with the Excel program and presented in frequency tables. The population used was 2,138 teachers and 57,567 students from the 17 faculties of the University of Guayaquil. The sample was non-probabilistic or directed, with a total of 246 teachers and 276 students. The results indicate that, for the teachers who participated in the study, the use of Information and Communication Technologies (ICT) is of utmost importance for the development of teaching, especially in virtual classes. However, they consider that training processes in the use of these technologies should be improved. It is concluded that both teachers and students recognize that they cannot separate technologies from the teaching - learning process, but adequate training of digital skills is essential for their use and maximum use.

Resumen El objetivo de este estudio fue analizar el impacto en el uso de las TIC para el desarrollo de sus actividades académicas en la modalidad de clases en línea de la Universidad de Guayaquil, en tiempo de pandemia por el COVID-19, crisis de salud global que incluye al Ecuador. Esta investigación fue de campo y su diseño no experimental transversal. La información se recolectó a través de un cuestionario de preguntas de diferentes tipos, la confiabilidad de este instrumento se hizo a través del coeficiente Alfa de Cronbach, los resultados de las encuestas se procesaron con el programa Excel y se presentaron en tablas de frecuencia. La población utilizada fue de 2138 docentes y 57567 estudiantes de las 17 facultades de la Universidad de Guayaquil. La muestra fue de tipo no probabilística o dirigida, con un total de 246 docentes y 276 de estudiantes. Los resultados indican que, para los docentes que participaron en el estudio, el uso de Tecnologías de Información y Comunicación (TIC) son de suma importancia para el desarrollo de la docencia, especialmente en las clases virtuales. Sin embargo, consideran que deben mejorarse los procesos de capacitación en el uso de estas tecnologías. Se concluye que tanto docentes y estudiantes reconocen que no pueden separar las tecnologías del proceso enseñanza - aprendizaje, pero es clave una adecuada capacitación de las competencias digitales para su uso y máximo aprovechamiento.

Abstract The objective of this study is to identify the relation between academic self-efficacy, academic social support and school well-being with academic performance, as well as comparing these variables by gender. Participants were 304 undergraduate students from the Centro Universitario de los Valles, with a mean age of 20.91 years (SD = 2.74). Academic self-efficacy, academic social support and school well-being were statistically correlated with academic performance and it was identified that having low and medium academic self-efficacy represents a lower probability of achieving satisfactory academic performance. Women have better academic performance and better school well-being compared to men. The relevance of this study is that it shows the feasibility of carrying out interventions that promote the development of self-efficacy in university students in the blended mode.

Resumen El objetivo de este estudio es identificar la relación de la autoeficacia académica, el apoyo social académico y el bienestar escolar con el rendimiento académico, además de comparar estas variables por sexo. Se realizó un estudio cuantitativo, correlacional y transversal en el que se aplicaron la Escala de Autoeficacia en Conductas Académicas, la Escala de Apoyo Social Académico y la Escala de Bienestar en Contexto Académico. Con base en un muestreo no probabilístico de conveniencia participaron 304 estudiantes de licenciatura de una universidad del occidente de México, 175 mujeres y 129 hombres con una media de edad de 20.82 (DE = 2.46) y 21.02 (DE = 3.10), respectivamente. La autoeficacia académica, el apoyo social académico y el bienestar escolar correlacionaron significativamente con el rendimiento académico y se identificó que es menos probable lograr un rendimiento académico satisfactorio cuando se cuenta con una autoeficacia académica baja y media. Las mujeres tienen un mejor rendimiento académico y un mayor bienestar escolar con relación a los hombres. La relevancia de este estudio radica en que muestra la factibilidad para realizar intervenciones que propicien el desarrollo de la autoeficacia en estudiantes universitarios en la modalidad semipresencial.

ABSTRACT OBJECTIVE To characterize recent HIV infections among newly diagnosed men who have sex with men and transgender women in Tijuana. METHODS Limiting Antigen (LAg)-Avidity testing was performed to detect recent HIV infection within a cohort of newly-diagnosed men who have sex with men and transgender women in Tijuana. Logistic regression was used to determine characteristics associated with recent infection. A partial transmission network was inferred using HIV-1 pol sequences. Tamura-Nei 93 genetic distances were measured between all pairs of sequences, and the network was constructed by inferring putative transmission links (genetic distances ≤ 1.5%). We assessed whether recent infection was associated with clustering within the inferred network. RESULTS Recent infection was detected in 11% (22/194) of newly-diagnosed participants. Out of the participants with sequence data, 60% (9/15) with recent infection clustered compared with 31% (43/139) with chronic infection. Two recent infections belonged to the same cluster. In adjusted analyses, recent infection was associated with years of residence in Tijuana (OR = 1.5; 95%CI 1.01–1.09), cocaine use (past month) (OR = 8.50; 95%CI 1.99–28.17), and ever experiencing sexual abuse (OR = 2.85; 95%CI 1.03–7.85). DISCUSSION A total of 11% of men newly diagnosed with HIV who have sex with men and transgender women in Tijuana were recently infected. The general lack of clustering between participants with recent infection suggests continued onward HIV transmission rather than an outbreak within a particular cluster.

ABSTRACT OBJECTIVE To characterize recent HIV infections among newly diagnosed men who have sex with men and transgender women in Tijuana. METHODS Limiting Antigen (LAg)-Avidity testing was performed to detect recent HIV infection within a cohort of newly-diagnosed men who have sex with men and transgender women in Tijuana. Logistic regression was used to determine characteristics associated with recent infection. A partial transmission network was inferred using HIV-1 pol sequences. Tamura-Nei 93 genetic distances were measured between all pairs of sequences, and the network was constructed by inferring putative transmission links (genetic distances ≤ 1.5%). We assessed whether recent infection was associated with clustering within the inferred network. RESULTS Recent infection was detected in 11% (22/194) of newly-diagnosed participants. Out of the participants with sequence data, 60% (9/15) with recent infection clustered compared with 31% (43/139) with chronic infection. Two recent infections belonged to the same cluster. In adjusted analyses, recent infection was associated with years of residence in Tijuana (OR = 1.5; 95%CI 1.01–1.09), cocaine use (past month) (OR = 8.50; 95%CI 1.99–28.17), and ever experiencing sexual abuse (OR = 2.85; 95%CI 1.03–7.85). DISCUSSION A total of 11% of men newly diagnosed with HIV who have sex with men and transgender women in Tijuana were recently infected. The general lack of clustering between participants with recent infection suggests continued onward HIV transmission rather than an outbreak within a particular cluster.

Resumo: O estudo teve como objetivo avaliar os efeitos no médio prazo da hospitalização nos primeiros 48 meses sobre o desenvolvimento de transtornos psiquiátricos aos 6 e 11 anos de idade entre membros de uma coorte de nascimentos em um país de renda média. Analisamos os dados de uma coorte de nascimentos de 2004 (N = 4.231) na cidade de Pelotas, Rio Grande do Sul, Brasil. Foi investigada a frequência da hospitalização aos 12, 24 e 48 meses de vida. Quando as crianças tinham 6 e 11 anos de idade, os transtornos psiquiátricos foram investigados com o Development and Well-Being Assessment. Usamos a regressão logística para ajustar os potenciais fatores de confusão. A frequência global de hospitalização durante os primeiros 48 meses de vida foi 33,1% (IC95%: 31,4; 34,7). Entre as crianças que tinham sido hospitalizadas, 25,6% (IC95%: 24,1; 27,1), 4,7% (IC95%: 4,0; 5,5) e 2,8% (IC95%: 2,3; 3,5) foram internadas 1, 2 ou ≥ 3 vezes durante o período, respectivamente. Depois de ajustar para os potencias fatores de confusão, as chances de apresentar qualquer transtorno psiquiátrico aos 6 e 11 anos de idade foram mais altas em crianças que haviam sido hospitalizadas nos primeiros 48 meses de vida, com OR de 1,50 (IC95%: 1,19; 1,88) e 1,63 (IC95%: 1,28; 2,07), respectivamente. Nossos resultados corroboram a hipótese de que a hospitalização na primeira infância tem efeito sobre a saúde mental posterior. São necessárias medidas preventivas para minimizar as experiências negativas de crianças com história de hospitalização na infância.

Abstract: This study aimed to evaluate the medium-term effects that hospitalization in the first 48 months of life has on the development of psychiatric disorders at 6 and 11 years of age among individuals in a birth cohort in a middle-income country. We analyzed data from a 2004 birth cohort (N = 4,231) in the city of Pelotas, Rio Grande do Sul State, Brazil. The frequency of hospitalization was investigated at 12, 24 and 48 months of life. When the children were 6 and 11 years old, psychiatric disorders were investigated with the Development and Well-Being Assessment. We used logistic regression to adjust for potential confounders. The overall frequency of hospitalization during the first 48 months of life was 33.1% (95%CI: 31.4; 34.7). Among the hospitalized children 25.6% (95%CI: 24.1; 27.1), 4.7% (95%CI: 4.0; 5.5) and 2.8% (95%CI: 2.3; 3.5) were hospitalized 1, 2 or ≥ 3 times during this period, respectively. After adjustment for potential confounders, the chance of presenting any psychiatric disorder at 6 and 11 years of age was higher for the children who had been hospitalized during the first 48 months of life than for those who had not, with OR of 1.50 (95%CI: 1.19; 1.88) and 1.63 (95%CI: 1.28; 2.07), respectively. Our results support the hypothesis that hospitalization in the early stages of life has an effect on the subsequent mental health of children. Preventive measures are needed in order to minimize the negative experiences of children who are hospitalized during infancy.

Resumen: Este estudio tuvo como meta evaluar los efectos a medio plazo que tiene una hospitalización durante los primeros 48 meses de vida en el desarrollo de trastornos psiquiátricos entre los 6 y 11 años de edad, con individuos en una cohorte de nacimientos en un país de renta media. Analizamos los datos de una cohorte de nacimientos de 2004 (N = 4.231) en la ciudad de Pelotas, Rio Grande do Sul, Brasil. Se investigó una frecuencia de hospitalización a los 12, 24 y 48 meses de vida. Cuando los niños tenían entre 6 y 11 años de edad, se investigaron los trastornos psiquiátricos con una evaluación sobre desarrollo y bienestar. Se usó regresión logística para ajustar potenciales factores de confusión. La frecuencia general de hospitalización durante los primeros 48 meses de vida fue de un 33,1% (95%CI: 31,4; 34,7). Entre los niños hospitalizados un 25,6% (95%CI: 24,1; 27,1), 4,7% (95%CI: 4,0; 5,5) y 2,8% (95%CI: 2,3; 3,5) estuvieron hospitalizados 1, 2 o ≥ 3 veces durante este período, respectivamente. Tras ajustar los factores de confusión, la oportunidad de presentar cualquier trastorno psiquiátrico entre los 6 y 11 años de edad fue mayor para los niños que habían sido hospitalizados durante los primeros 48 meses de vida, respecto a quienes no lo habían estado, con un OR de 1,50 (95%CI: 1,19; 1,88) y 1,63 (95%CI: 1,28; 2,07), respectivamente. Nuestros resultados avalan la hipótesis de que la hospitalización en estadios tempranos de la vida tuvo un efecto en la futura salud mental de los niños. Son necesarias medidas preventivas, con el fin de minimizar las experiencias negativas de los niños que habían sido hospitalizados durante la infancia.

Resumo: O estudo teve como objetivo avaliar os efeitos no médio prazo da hospitalização nos primeiros 48 meses sobre o desenvolvimento de transtornos psiquiátricos aos 6 e 11 anos de idade entre membros de uma coorte de nascimentos em um país de renda média. Analisamos os dados de uma coorte de nascimentos de 2004 (N = 4.231) na cidade de Pelotas, Rio Grande do Sul, Brasil. Foi investigada a frequência da hospitalização aos 12, 24 e 48 meses de vida. Quando as crianças tinham 6 e 11 anos de idade, os transtornos psiquiátricos foram investigados com o Development and Well-Being Assessment. Usamos a regressão logística para ajustar os potenciais fatores de confusão. A frequência global de hospitalização durante os primeiros 48 meses de vida foi 33,1% (IC95%: 31,4; 34,7). Entre as crianças que tinham sido hospitalizadas, 25,6% (IC95%: 24,1; 27,1), 4,7% (IC95%: 4,0; 5,5) e 2,8% (IC95%: 2,3; 3,5) foram internadas 1, 2 ou ≥ 3 vezes durante o período, respectivamente. Depois de ajustar para os potencias fatores de confusão, as chances de apresentar qualquer transtorno psiquiátrico aos 6 e 11 anos de idade foram mais altas em crianças que haviam sido hospitalizadas nos primeiros 48 meses de vida, com OR de 1,50 (IC95%: 1,19; 1,88) e 1,63 (IC95%: 1,28; 2,07), respectivamente. Nossos resultados corroboram a hipótese de que a hospitalização na primeira infância tem efeito sobre a saúde mental posterior. São necessárias medidas preventivas para minimizar as experiências negativas de crianças com história de hospitalização na infância.

Abstract: This study aimed to evaluate the medium-term effects that hospitalization in the first 48 months of life has on the development of psychiatric disorders at 6 and 11 years of age among individuals in a birth cohort in a middle-income country. We analyzed data from a 2004 birth cohort (N = 4,231) in the city of Pelotas, Rio Grande do Sul State, Brazil. The frequency of hospitalization was investigated at 12, 24 and 48 months of life. When the children were 6 and 11 years old, psychiatric disorders were investigated with the Development and Well-Being Assessment. We used logistic regression to adjust for potential confounders. The overall frequency of hospitalization during the first 48 months of life was 33.1% (95%CI: 31.4; 34.7). Among the hospitalized children 25.6% (95%CI: 24.1; 27.1), 4.7% (95%CI: 4.0; 5.5) and 2.8% (95%CI: 2.3; 3.5) were hospitalized 1, 2 or ≥ 3 times during this period, respectively. After adjustment for potential confounders, the chance of presenting any psychiatric disorder at 6 and 11 years of age was higher for the children who had been hospitalized during the first 48 months of life than for those who had not, with OR of 1.50 (95%CI: 1.19; 1.88) and 1.63 (95%CI: 1.28; 2.07), respectively. Our results support the hypothesis that hospitalization in the early stages of life has an effect on the subsequent mental health of children. Preventive measures are needed in order to minimize the negative experiences of children who are hospitalized during infancy.

Resumen: Este estudio tuvo como meta evaluar los efectos a medio plazo que tiene una hospitalización durante los primeros 48 meses de vida en el desarrollo de trastornos psiquiátricos entre los 6 y 11 años de edad, con individuos en una cohorte de nacimientos en un país de renta media. Analizamos los datos de una cohorte de nacimientos de 2004 (N = 4.231) en la ciudad de Pelotas, Rio Grande do Sul, Brasil. Se investigó una frecuencia de hospitalización a los 12, 24 y 48 meses de vida. Cuando los niños tenían entre 6 y 11 años de edad, se investigaron los trastornos psiquiátricos con una evaluación sobre desarrollo y bienestar. Se usó regresión logística para ajustar potenciales factores de confusión. La frecuencia general de hospitalización durante los primeros 48 meses de vida fue de un 33,1% (95%CI: 31,4; 34,7). Entre los niños hospitalizados un 25,6% (95%CI: 24,1; 27,1), 4,7% (95%CI: 4,0; 5,5) y 2,8% (95%CI: 2,3; 3,5) estuvieron hospitalizados 1, 2 o ≥ 3 veces durante este período, respectivamente. Tras ajustar los factores de confusión, la oportunidad de presentar cualquier trastorno psiquiátrico entre los 6 y 11 años de edad fue mayor para los niños que habían sido hospitalizados durante los primeros 48 meses de vida, respecto a quienes no lo habían estado, con un OR de 1,50 (95%CI: 1,19; 1,88) y 1,63 (95%CI: 1,28; 2,07), respectivamente. Nuestros resultados avalan la hipótesis de que la hospitalización en estadios tempranos de la vida tuvo un efecto en la futura salud mental de los niños. Son necesarias medidas preventivas, con el fin de minimizar las experiencias negativas de los niños que habían sido hospitalizados durante la infancia.

ABSTRACT TiO2 is a semiconductor widely used in heterogeneous photocatalysis processes for water decontamination. Several studies indicate that ordered nanostructures in anatase phase improve the photocatalytic properties with respect to other morphologies and crystal structures of TiO2. The aim of the present work is to evaluate the influence of different thermal treatments on the structural integrity and crystal structure of the nanotubular TiO2 coatings synthesized by the anodic oxidation technique. A solution of 0.6% w/w ammonium fluoride and 3.5% w/w water in ethylene glycol was used as the electrolyte for the oxidation. A direct current was used at a constant voltage of 45 V during 2 h. After the anodic oxidation, thermal treatments of 2 h and 4 h at 450, 550 and 650 °C with a heating ramp of 10 ºC/min were performed. Morphology and crystalline structure of the coatings were characterized by scanning electron microscopy and X-ray diffraction, respectively. TiO2 coatings of nanotubes about 85 nm inner diameter, 18 nm wall thick and 7 ?m in length (mean value) were obtained. The nanotubes maintained their structural integrity without changes in the dimensions with the applied thermal treatments. However, the morphology of the walls of the nanotubes was modified with the time and temperature of the thermal treatments, evidencing the formation of anatase crystals. Even on the coatings thermally treated at 550 °C, nanocrystalline anatase deposits on the outside wall of the nanotubes were observed. Regarding the crystal structure, the coatings were amorphous previously to the thermal treatments and were crystalline in anatase phase after thereof, indicating the anatase stabilization even up to 650 °C, temperature at which the rutile phase appeared.

RESUMEN El TiO2 es un semiconductor ampliamente utilizado en el proceso de fotocatálisis heterogénea para la descontaminación de aguas. Diversos estudios indican que las estructuras ordenadas de nanotubos en fase anatasa mejoran las propiedades fotocatalíticas del material con respecto a otras morfologías y estructuras de TiO2. El objetivo del presente trabajo es evaluar la influencia de diferentes tratamientos térmicos sobre la integridad y estructura cristalina de recubrimientos nanotubulares de TiO2 obtenidos mediante la técnica de oxidación anódica. Para la oxidación se utilizó como electrolito una solución de 0,6% p/p de fluoruro de amonio y 3,5% p/p de agua en etilenglicol. Se hizo circular corriente continua a un voltaje constante de 45 V durante 2 h. Luego de la oxidación anódica, se realizaron tratamientos térmicos de 2 h y 4 h a 450, 550 y 650 °C, con rampa de calentamiento de 10 ºC/min. Se caracterizó la morfología y la estructura cristalina de los recubrimientos mediante microscopía electrónica de barrido y difracción de rayos X, respectivamente. Se obtuvieron recubrimientos nanotubulares de TiO2 de 85 nm de diámetro interior, 18 nm de espesor de pared y 7 ?m de longitud (valores promedio), que mantuvieron su integridad estructural sin cambio en las dimensiones con los tratamientos térmicos aplicados. Sin embargo, la morfología de las paredes de los nanotubos se fue modificando con el tiempo y la temperatura de los tratamientos térmicos, evidenciándose la formación de cristales de anatasa. Incluso a partir de 550 ºC se observaron depósitos nanocristalinos de anatasa sobre la cara exterior de la pared de los nanotubos. En cuanto a la estructura cristalina, los recubrimientos resultaron amorfos previamente a los tratamientos térmicos y cristalinos en fase anatasa luego de los mismos, indicando la estabilización de esta fase incluso hasta los 650 ºC, temperatura a la que apareció la fase rutilo.

ABSTRACT Titanium dioxide is one of the most used materials in heterogeneous photocatalysis due to its commercial availability, low cost, chemical stability, low toxicity and high photocatalytic activity. One of the most efficient and economical methods to obtain TiO2 coatings is the plasma electrolytic oxidation. In this anodization process, a direct current is circulated between a cathode and an anode immersed in an electrolyte solution, at a high voltage that induces the formation of spark discharges on the surface of the anode. In the present work, porous TiO2 coatings were obtained by plasma electrolytic oxidation, using 1 M sulfuric acid as the electrolyte, a Pt cathode, titanium Grade 2 as the anode and a maximum current density of 3250 A m-2. The influence of voltage (90-180 V) and surface finishing (with and without metallographic polishing) on the morphology and crystalline structure was studied. The temporal evolution of voltage and current density were recorded. The morphology of the oxides was observed by scanning electron microscopy, and the crystalline phases were determined by grazing incidence X-ray diffraction. The curves of current density and voltage showed behaviors characteristic of galvanostatic-potenciostatic grown of anodic oxides, with fluctuations as the result of the spark discharge condition. Micrographs of the oxides showed pores with an average diameter between 60 and 160 nm, which increased at higher voltages. The diffractograms showed the presence of the anatase and rutile phases of TiO2, with a decrease in the anatase fraction at the higher voltages. No influence of surface finishing was observed on the morphology and crystallinity of the coatings. The synthesized oxides show favorable characteristics as potential materials for heterogeneous photocatalytic processes.

RESUMEN El TiO2 es uno de los materiales más utilizados en el proceso de fotocatálisis heterogénea debido a su disponibilidad comercial, bajo costo, baja toxicidad y elevada actividad fotocatalítica. Uno de los métodos más eficientes y económicos para obtener recubrimientos de TiO2 es la oxidación electrolítica por plasma. Durante este proceso de anodización, se hace circular corriente continua entre el ánodo y el cátodo inmersos en una solución de electrolito, a voltajes elevados que inducen la formación de arcos eléctricos (spark discharge) en la superficie del ánodo. En el presente trabajo se sintetizaron recubrimientos porosos de TiO2 por oxidación electrolítica por plasma, empleando ácido sulfúrico 1 M como electrolito, cátodo de Pt, titanio Grado 2 como ánodo y una densidad de corriente máxima de 3250 A m-2. Se estudió la influencia del voltaje (90-180 V) y el acabado superficial del ánodo (con y sin pulido metalográfico) sobre la morfología y estructura cristalina de los recubrimientos. Se registró la evolución temporal de la densidad de corriente y el voltaje. La morfología de los óxidos se observó por microscopía electrónica de barrido. Las fases cristalinas se determinaron por difracción de rayos X con incidencia rasante. Las curvas de la densidad de corriente y el voltaje en función del tiempo muestran un comportamiento característico del crecimiento galvanostático-potenciostático de óxidos anódicos, con fluctuaciones propias del fenómeno de spark discharge. Las micrografías de los óxidos mostraron poros con un diámetro promedio 60-160 nm, que aumentó con el voltaje. Los difractogramas indicaron la presencia de las fases anatasa y rutilo del TiO2, con disminución de la fracción anatasa con el incremento del voltaje. No se observó influencia del acabado superficial sobre la morfología y la cristalinidad de los recubrimientos. Los óxidos sintetizados presentan características favorables como material de potencial aplicación en procesos de fotocatálisis heterogénea.