Resumo Um macho de Pteronura brasiliensis (Carnivora: Mustelidae) foi encontrado morto às margens do Rio Negro, no Pantanal do estado de Mato Grosso do Sul, município de Aquidauana. Dois carrapatos encontrados aderidos à sua pele foram identificados, morfologicamente, como uma ninfa de segundo ínstar de Ornithodoros rostratus (Argasidae) e um macho de Amblyomma sculptum (Ixodidae). Para complementar a identificação morfológica, esses espécimes de carrapatos foram submetidos à extração de DNA e testados por meio de ensaios de PCR, para confirmar a identidade molecular dos espécimes. Além disso, os extraídos dos carrapatos foram testados e revelaram-se negativos nos ensaios de PCR para todos os patógenos testados. Também foram examinados 30 lotes, compostos por 174 indivíduos de O. rostratus, depositados na Coleção Acari do Instituto Butantan, e encontramos material de quatro estados brasileiros, incluindo-se um lote contendo 2 machos e 2 fêmeas de Aquidauana, estado de Mato Grosso do Sul (MS), coletado do solo. Este foi, portanto, o primeiro registro de O. rostratus parasitando P. brasiliensis e o primeiro registro de localidade (Aquidauana). Da mesma forma, A. sculptum é comumente encontrado no Pantanal e relatado aqui, pela segunda vez, parasitando a ariranha, hospedeiro pouco estudado em relação a ectoparasitas.

Abstract A male of Pteronura brasiliensis (Carnivora: Mustelidae) was found dead on the banks of the Rio Negro, in the Pantanal wetlands of Mato Grosso do Sul state, Aquidauana municipality. Two ticks found attached to its skin were morphologically identified as a second-instar nymph of Ornithodoros rostratus (Argasidae) and a male of Amblyomma sculptum (Ixodidae). In order to complement the morphological identification, these tick specimens were subjected to DNA extraction, and tested using PCR assays to confirm the molecular identity the specimens. Also, the tick DNA samples were tested and were negative in the PCR assays for all the pathogens tested. We also examined 30 batches, consisting of 174 individuals of O. rostratus deposited in the Acari Collection of the Butantan Institute, and we found material from four Brazilian states, including one batch containing 2 males and 2 females from Aquidauana, of Mato Grosso do Sul state, collected from the soil. This was therefore the first record of O. rostratus parasitizing P. brasiliensis and the first locality record (Aquidauana). Likewise, A. sculptum is commonly found in the Pantanal and is reported here for the second time parasitizing the giant otter, which is a host little studied regarding the ectoparasites.

Abstract The incidence of premature birth has increased worldwide, unequally distributed by race/ethnicity. Racism generates economic inequalities, educational disparities, and differential access to health care, which increases the risk of preterm birth. Thus, this study aimed to evaluate the factors associated with preterm birth and racial and ethnic disparities in premature birth among pregnant women attending prenatal care at the Brazilian Unified Health System health units in the urban area of Santo Antônio de Jesus, Bahia, Brazil. This study used data from 938 pregnant women aged between 18 to 45 years within the NISAMI prospective cohort. Premature birth prevalence was 11.8%, with a higher prevalence among black than non-black women (12.9% versus 6.0%, respectively). Maternal age between 18 and 24 years was the only factor associated with premature birth. A higher risk of premature birth was found among black women than non-black women (RR 3.22; 95%CI 1.42-7.32). These results reveal the existence of racial and social inequalities in the occurrence of premature birth.

Resumo A incidência de parto prematuro tem aumentado em todo o mundo, distribuída de forma desigual por raça/etnia. O racismo gera desigualdades econômicas, disparidades educacionais e acesso diferenciado à saúde, o que aumenta o risco de parto prematuro. Assim, este estudo teve como objetivo avaliar os fatores associados à prematuridade e disparidades raciais e étnicas no parto prematuro entre gestantes atendidas durante o pré-natal em unidades de saúde do Sistema Único de Saúde na zona urbana de Santo Antônio de Jesus, Bahia, Brasil. Este estudo utilizou dados de 938 mulheres grávidas com idade entre 18 e 45 anos dentro da coorte prospectiva do NISAMI. A prevalência de prematuridade foi de 11,8%, sendo maior entre as negras do que entre as não negras (12,9% versus 6,0%, respectivamente). A idade materna entre 18 e 24 anos foi o único fator associado ao parto prematuro. Foi encontrado maior risco de prematuridade entre as mulheres negras do que entre as não negras (RR 3,22; IC95% 1,42-7,32). Esses resultados revelam a existência de desigualdades raciais e sociais na ocorrência do parto prematuro.

Biodiversity conservation is a complex and transdisciplinary problem that requires engagement and cooperation among scientific, societal, economic, and political institutions. However, historical approaches have often failed to bring together and address the needs of all relevant stakeholders in decision‐making processes. The Tropical Andes, a biodiversity hotspot where conservation efforts often conflict with socioeconomic issues and policies that prioritize economic development, provides an ideal model to develop and implement more effective approaches. In this study, we present a co‐design approach that mainstreams and improves the flow of biodiversity information in the Tropical Andes, while creating tailored outputs that meet the needs of economic and societal stakeholders. We employed a consultative process that brought together biodiversity information users and producers at the local, national, and regional levels through a combination of surveys and workshops. This approach identified priority needs and limitations of the flow of biodiversity information in the region, which led to the co‐design of user‐relevant biodiversity indicators. By leveraging the existing capacities of biodiversity information users and producers, we were able to co‐design multiple biodiversity indicators and prioritize two for full implementation ensuring that the data was findable, accessible, interoperable, and reusable based on the FAIR principles. This approach helped address limitations that were identified in the stakeholder engagement process, including gaps in data availability and the need for more accessible biodiversity information. Additionally, capacity‐building workshops were incorporated for all producers of biodiversity information involved, which aimed to not only improve the current flow of biodiversity information in the region but also facilitate its future sustainability. Our approach can serve as a valuable blueprint for mainstreaming biodiversity information and making it more inclusive in the future, especially considering the diverse worldviews, values, and knowledge systems between science, policy, and practice.

La conservación de la biodiversidad es un problema complejo y transdisciplinario que requiere el compromiso y la cooperación entre instituciones científicas, sociales, económicas y políticas. Sin embargo, los enfoques tradicionales/convencionales  a menudo no logran  reunir y abordar las necesidades de todos los actores relevantes en los procesos de toma de decisiones. Los Andes tropicales, un área clave  de biodiversidad donde los esfuerzos de conservación a menudo entran en conflicto con cuestiones socioeconómicas y políticas que priorizan el desarrollo económico, proporcionan un modelo ideal para desarrollar e implementar enfoques más efectivos. En este estudio, presentamos un enfoque co-diseño que integra y mejora el flujo de información sobre biodiversidad en los Andes tropicales, creando resultados personalizados que satisfacen las necesidades, tanto económicas como sociales, de las partes interesadas. Empleamos un proceso de consulta que reunió a usuarios y productores de información sobre biodiversidad a nivel local, nacional y regional, a través de encuestas y talleres. Este enfoque ha permitido identificar necesidades prioritarias y limitaciones del flujo de información sobre biodiversidad en la región; lo cual llevó al codiseño de indicadores de biodiversidad relevantes para los usuarios. Aprovechando las capacidades existentes de los usuarios y productores de información sobre biodiversidad, pudimos co-diseñar múltiples indicadores de biodiversidad y priorizar dos de estos para su implementación completa, asegurando que los datos sean localizables, accesibles, interoperables y reutilizables, según los principios FAIR. Este enfoque ayudó a abordar las limitaciones que se identificaron en el proceso de participación de las partes interesadas; incluidas las brechas en la disponibilidad de datos y la necesidad de información sobre biodiversidad más accesible. Además, se incorporaron talleres de desarrollo de capacidades para todos los productores de información sobre biodiversidad involucrados, los cuales apuntaron no sólo a mejorar el flujo actual de información sobre biodiversidad en la región, sino también facilitar su sostenibilidad futura. Nuestro enfoque puede servir como un modelo valioso para incorporar la información sobre biodiversidad y hacerla más inclusiva en el futuro; especialmente si consideramos las diversas perspectivas globales, valores y sistemas de conocimiento implicados en las interacciones entre  la ciencia, la política y su aplicación práctica.

A conservação da biodiversidade é um problema complexo e transdisciplinar que requer compromisso e cooperação entre instituições científicas, sociais, económicas e políticas. No entanto, as abordagens tradicionais/convencionais muitas vezes não conseguem reunir e responder às necessidades de todos os intervenientes relevantes nos processos de tomada de decisão. Os Andes tropicais, uma área chave para a biodiversidade onde os esforços de conservação entram frequentemente em conflito com questões socioeconómicas e políticas que dão prioridade ao desenvolvimento económico, fornecem um modelo ideal para desenvolver e implementar abordagens mais eficazes. Neste estudo, apresentamos uma abordagem de co-design que integra e melhora o fluxo de informações sobre biodiversidade nos Andes tropicais, criando resultados personalizados que atendem às necessidades, tanto econômicas quanto sociais, das partes interessadas. Empregamos um processo de consulta que reuniu usuários e produtores de informações sobre biodiversidade nos níveis local, nacional e regional, por meio de pesquisas e workshops. Esta abordagem permitiu identificar necessidades prioritárias e limitações do fluxo de informação sobre a biodiversidade na região; o que levou à concepção conjunta de indicadores de biodiversidade relevantes para os utilizadores. Aproveitando as capacidades existentes dos utilizadores e produtores de informação sobre biodiversidade, fomos capazes de conceber em conjunto vários indicadores de biodiversidade e priorizar dois deles para implementação total, garantindo que os dados sejam localizáveis, acessíveis, interoperáveis ​​e reutilizáveis, de acordo com os princípios FAIR. Esta abordagem ajudou a resolver as limitações identificadas no processo de envolvimento das partes interessadas; incluindo lacunas na disponibilidade de dados e a necessidade de informações mais acessíveis sobre biodiversidade. Além disso, foram incorporados workshops de capacitação para todos os produtores de informação sobre biodiversidade envolvidos, que visaram não só melhorar o fluxo actual de informação sobre biodiversidade na região, mas também facilitar a sua sustentabilidade futura. A nossa abordagem pode servir como um modelo valioso para incorporar informações sobre biodiversidade e torná-las mais inclusivas no futuro; especialmente se considerarmos as diversas perspectivas globais, valores e sistemas de conhecimento envolvidos nas interações entre ciência, política e sua aplicação prática.

ABSTRACT Objective: To report outcomes from the largest multicenter series of penile cancer patients undergoing video endoscopic inguinal lymphadenectomy (VEIL). Materials and Methods: Retrospective multicenter analysis. Authors of 21 centers from the Penile Cancer Collaborative Coalition-Latin America (PeC-LA) were included. All centers performed the procedure following the same previously described standardized technique. Inclusion criteria included penile cancer patients with no palpable lymph nodes and intermediate/high-risk disease and those with non-fixed palpable lymph nodes less than 4 cm in diameter. Categorical variables are shown as percentages and frequencies whereas continuous variables as mean and range. Results: From 2006 to 2020, 210 VEIL procedures were performed in 105 patients. Mean age was 58 (45-68) years old. Mean operative time was 90 minutes (60-120). Mean lymph node yield was 10 nodes (6-16). Complication rate was 15.7%, including severe complications in 1.9% of procedures. Lymphatic and skin complications were noted in 8.6 and 4.8% of patients, respectively. Histopathological analysis revealed lymph node involvement in 26.7% of patients with non-palpable nodes. Inguinal recurrence was observed in 2.8% of patients. 10y- overall survival was 74.2% and 10-y cancer specific survival was 84.8%. CSS for pN0, pN1, pN2 and pN3 were 100%, 82.4%, 72.7% and 9.1%, respectively. Conclusion: VEIL seems to offer appropriate long term oncological control with minimal morbidity. In the absence of non-invasive stratification measures such as dynamic sentinel node biopsy, VEIL emerged as the alternative for the management of non-bulky lymph nodes in penile cancer.

Resumen Introducción: La educación a distancia ha sido instau rada en múltiples universidades debido al contexto de la pandemia de COVID-19 y es discutido si presenta impactos positivos en el campo de Odontología. Objetivo: Identificar las actitudes y percepciones de los estudiantes de Odontología sobre la educación a distancia. Método: Estudio transversal comparativo que incluyó a estudiantes de la Facultad de Odontología de la Univer sidad Nacional Mayor de San Marcos (Lima, Perú). Se utilizó una escala de actitudes hacia el aprendizaje, un cuestionario de datos personales y preguntas abiertas. Los datos de la escala se presentaron como frecuencias relativas según respuesta global y puntuaciones prome dio. Estos datos se compararon con las características de los estudiantes. Resultados: Fueron encuestados 216 estudiantes, 120 (55.6 %) mujeres. El 34.7 % (n = 75) estuvo en desacuer do al afirmar que la educación a distancia es más eficaz que el aprendizaje presencial, el 24.5 % (n = 53) sí estuvo de acuerdo. Los varones estuvieron más satisfechos con la educación a distancia (3.91 ± 1.02); las puntuaciones de esta satisfacción fueron más elevadas para los estu diantes de primer y segundo año, así como para aquellos que cursaban asignaturas teóricas (3.94 ± 1.12). Los estudiantes que recibieron asignaturas teóricas, prácticas y clínicas evidenciaron bajas puntuaciones respecto a la pregunta “Creo que no he aprendido bien con la educa ción a distancia” (3.01 ± 0.12). Conclusiones: La mayoría de estudiantes de Odontología de una universidad pública peruana presentan actitudes de desacuerdo respecto a la eficacia de la educación a distancia sobre la educación presencial, principalmente por estudiantes de años superiores y aquellos que han llevado asignaturas teórico-prácticas y clínicas. La ma yoría de estudiantes sí recomienda el uso del modelo educativo a distancia para llevar asignaturas teóricas, que no demanden sesiones prácticas donde se desa rrollen habilidades psicomotrices y que se desarrolle una asignatura al día.

Abstract Introduction: Distance education has been instituted in multiple universities due to the context of the COVID-19 pandemic and it is debated whether it presents positive impacts in the field of Dentistry. Objective: To identify the attitudes and perceptions of dental students about distance education. Method: Cross-sectional comparative study that included students of the Faculty of Dentistry at the Universidad Nacional Mayor de San Marcos (Lima, Peru). A scale of attitudes toward learning, a personal data question naire, and open questions was used. The scale data were presented as relative frequencies according to global re sponse and average scores. These data were compared with the characteristics of the students. Results: 216 students were surveyed, and 120 (55.6 %) were female. 34.7% (n = 75) disagreed that distance edu cation is more effective than face-to-face learning, and 24.5% (n = 53) agreed. Males were more satisfied with distance education (3.91 ± 1.02); scores for this satisfac tion were higher for first and second-year students as well as for those taking theoretical subjects (3.94 ± 1.12). Students who received theoretical, practical, and clinical subjects evidenced low scores concerning the question “I think I have not learned well with distance education” (3.01 ± 0.12). Conclusions: The majority of dental students at a Peru vian public university present attitude of disagreement regarding the effectiveness of distance education over face-to-face education, mainly by students in higher years and those who have taken theoretical-practical and clini cal subjects. The majority of students do recommend the use of the distance education model to take theoretical subjects that do not require practical sessions where psychomotor skills are developed and where one subject per day is taken.

ABSTRACT This article analyzes the narratives and geographical imaginaries of the Anthropocene through an examination of two hydroelectric milestones in Argentine Patagonia: the construction of the Chocón-Cerros Colorados complex (1968-1977) and the Cóndor - Cliff-La Barrancosa dams (since 2013). Using the perspectives of Political Ecology and Latin American Ecofeminism, we problematize the energetic interconnections between work, nature, and development in Patagonia, where the Anthropocene has been characterized by the persistent imaginary of “Patagonia-energy” and its connotations of civilization and development. The analysis is based on short films produced by the government, businesses, and unions, as well as other artistic and activist-artist productions. Finally, this work also discusses a resistance movement that grew out of worker-led Choconazo protest in 1969, and has since expanded to include Indigenous and ecofeminist resistance movements against Terricide.

RESUMEN Este artículo analiza las narrativas e imaginarios geográficos del Antropoceno en torno a dos hitos hidroeléctricos en la Patagonia argentina: la construcción del complejo Chocón-Cerros Colorados (1968-1977) y las represas Cóndor Cliff-La Barrancosa (desde 2013). A partir de perspectivas de la Ecología Política y los Ecofeminismos Latinoamericanos, problematizamos los entrelazamientos energéticos entre trabajo, naturaleza y desarrollo en la Patagonia centrándonos en la hidroenergía. El análisis realizado, a partir de cortometrajes estatales, empresariales y sindicales y producciones artísticas y artivistas, permite identificar las condiciones situadas que caracterizan el Antropoceno en la Patagonia, marcado por el origen y persistencia del imaginario “Patagonia-energía” y su signo civilizatorio-desarrollista. Finalmente, ponemos de relieve un frente de resistencia en la región que se despliega desde la lucha obrera del Choconazo en 1969 a la resistencia indígena y los frentes ecofeministas actuales contra el Terricidio.

RESUMO Este artigo analisa as narrativas e os imaginários geográficos do Antropoceno em torno de dois marcos hidrelétricos na Patagônia argentina: a construção do complexo Chocón-Cerros Colorados (1968-1977) e as barragens Cóndor Cliff-La Barrancosa (desde 2013). A partir de perspectivas da Ecologia Política e dos Ecofeminismos Latino-Americanos, problematizamos os entrelaçamentos energéticos entre trabalho, natureza e desenvolvimento na Patagônia, com foco na hidroenergia. A análise, baseada em curtas-metragens estaduais, empresariais e sindicais e produções artístico/artivísticas, permite identificar as condições situadas que caracterizam o Antropoceno na Patagônia, marcado pela origem e persistência do imaginário “Patagônia-energia” e seu signo civilizatório-desenvolvimentista. Por fim, destacamos uma frente de resistência na região que se desenvolve desde a luta operária de Choconazo em 1969 até a resistência indígena e as atuais frentes ecofeministas contra o Terricídio.

Abstract Objective: To analyze the association between osteolysis at the prosthesis interfaces, as determined by magnetic resonance imaging (MRI) with multiacquisition variable-resonance image combination selective (MAVRIC-SL) sequences, and clinical severity after knee or hip arthroplasty, as well as to assess interobserver and intraobserver agreement on periprosthetic bone resorption. Materials and Methods: This was a cross-sectional study of 47 patients (49 joints) under postoperative follow-up after knee or hip arthroplasty, with chronic pain, between March 2019 and August 2020. All of the patients completed the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire. The component interfaces were evaluated and ordered into two groups: osseointegrated and osteolytic. Nonparametric tests were used. Results: There were significant differences between the two groups in terms of the mean WOMAC scores: total (p = 0.010); stiffness domain (p = 0.047); and function (p = 0.011) domains. There was substantial interobserver and intraobserver agreement for most analyses of the components. Conclusion: Periprosthetic osteolysis appears to be associated with clinical complaints of pain in the post-arthroplasty scenario, and MAVRIC-SL provides reproducible assessments. It could prove to be an important tool for orthopedists to use in the evaluation of challenging cases of chronic pain after arthroplasty.

Resumo Objetivo: Analisar associação entre osteólise nas interfaces protéticas por ressonância magnética com sequências MAVRIC-SL e a gravidade clínica dos pacientes submetidos a artroplastias de joelho ou quadril. Determinar concordância intraobservador e interobservador na reabsorção óssea peri-implante. Materiais e Métodos: Foi realizado estudo transversal entre março de 2019 e agosto de 2020, com 47 pacientes (49 articulações) em seguimento pós-operatório de artroplastias de joelho ou quadril, com dor crônica, que responderam ao questionário WOMAC. As interfaces dos componentes foram avaliadas e definiram dois grupos: osteointegrado e osteólise. Testes não paramétricos foram usados. Resultados: Houve diferença significativa na média do escore WOMAC entre os grupos (p = 0,010), assim como nos domínios rigidez (p = 0,047) e função (p = 0,011). Houve concordância substancial interobservador e intraobservador para a maioria dos componentes analisados. Conclusão: Osteólise periprótese parece estar associada com a queixa clínica de dor pós-artroplastia, com avaliação reprodutível pela MAVRIC-SL. Isto pode ser uma importante ferramenta para o ortopedista na avaliação de casos desafiadores de dor crônica pós-artroplastia.

ABSTRACT Objective: To determine the prevalence and factors associated with the physical rehabilitation of critically ill children in Brazilian pediatric intensive care units. Methods: A 2-day, cross-sectional, multicenter point prevalence study comprising 27 pediatric intensive care units (out of 738) was conducted in Brazil in April and June 2019. This Brazilian study was part of a large multinational study called Prevalence of Acute Rehabilitation for Kids in the PICU (PARK-PICU). The primary outcome was the prevalence of mobility provided by physical therapy or occupational therapy. Clinical data on patient mobility, potential mobility safety events, and mobilization barriers were prospectively collected in patients admitted for ≥ 72 hours. Results: Children under the age of 3 years comprised 68% of the patient population. The prevalence of therapist-provided mobility was 74%, or 277 out of the 375 patient-days. Out-of-bed mobility was most positively associated with family presence (adjusted odds ratios 3.31;95%CI 1.70 - 6.43) and most negatively associated with arterial lines (adjusted odds ratios 0.16; 95%CI 0.05 - 0.57). Barriers to mobilization were reported on 27% of patient-days, the most common being lack of physician order (n = 18). Potential safety events occurred in 3% of all mobilization events. Conclusion: Therapist-provided mobility in Brazilian pediatric intensive care units is frequent. Family presence was high and positively associated with out-of-bed mobility. The presence of physiotherapists 24 hours a day in Brazilian pediatric intensive care units may have a substantial impact on the mobilization of critically ill children.

RESUMO Objetivo: Determinar a prevalência e os fatores associados à reabilitação física de crianças em estado grave em unidades de terapia intensiva pediátrica brasileiras. Métodos: Realizou-se um estudo de prevalência pontual multicêntrico, transversal, de 2 dias, abrangendo 27 unidades de terapia intensiva pediátrica (do total de 738) no Brasil em abril e junho de 2019. Este estudo brasileiro fez parte de um grande estudo multinacional chamado Prevalence of Acute Rehabilitation for Kids in the PICU (PARK-PICU). O desfecho primário foi a prevalência de mobilidade proporcionada pela fisioterapia ou pela terapia ocupacional. Foram coletados prospectivamente dados clínicos sobre a mobilidade do paciente, possíveis eventos de segurança de mobilidade e barreiras de mobilização em pacientes admitidos por ≥ 72 horas. Resultados: As crianças com idade inferior a 3 anos eram 68% da população de pacientes. A prevalência de mobilidade fornecida pelo terapeuta foi de 74%, ou 277 dos 375 pacientes-dia. A mobilidade para fora do leito foi mais positivamente associada à presença de familiares (razão de chance ajustada de 3,31; IC95% 1,70 - 6,43) e mais negativamente associada às linhas arteriais (razão de chance ajustada de 0,16; IC95% 0,05 - 0,57). Foram relatadas barreiras à mobilização em 27% dos pacientes-dia, sendo a mais comum a falta de prescrição médica (n = 18). Registaram-se eventuais eventos de segurança em 3% de todos os eventos de mobilização. Conclusão: A mobilidade proporcionada pelo terapeuta nas unidades de terapia intensiva pediátrica brasileiras é frequente. A presença de familiares foi alta e positivamente associada à mobilidade para fora do leito. A presença de fisioterapeutas 24 horas por dia nas unidades de terapia intensiva pediátrica brasileiras pode exercer papel importante na mobilização de crianças em estado grave.

Resumen El VIH es una enfermedad crónica que afecta a los receptores CD4 del sistema inmunológico. El Tratamiento Antirretroviral (TARV) es vital para disminuir la carga viral, pero su éxito depende del grado de adherencia al mismo. El objetivo de este estudio fue revisar los factores asociados a la eficacia de las intervenciones psicológicas para incrementar la adherencia al TARV y agregar los hallazgos en estimaciones cuantitativas de su impacto en la adherencia. La revisión de la literatura fue realizada desde agosto de 2017 hasta abril de 2020 en PubMed, EBSCO y Springer Link, utilizando los siguientes criterios de elección de los estudios: (1) que estuvieran publicados en revistas indexadas con revisión por pares, (2) que fueran experimentales o cuasiexperimentales, (3) que emplearan técnicas para el incremento de la adherencia, (4) que estuvieran publicados en español o inglés, (5) que reportaran los estadísticos necesarios para el cálculo del tamaño de efecto. De los 15 estudios seleccionados (. total = 1669), se obtuvieron 38 tamaños del efecto. El cálculo de los tamaños de efecto individuales y global se realizó usando el programa Comprehensive Meta-Analysis (Biostat, 2011, v. 2.2.064). Todos los tamaños de efecto fueron calculados usando la diferencia estandarizada de medias y un modelo de efectos aleatorios. El tamaño de efecto global fue moderado (. = 0.56, . = 38, IC95 % = 0.39 - 0.72, . < .001), mostrando que las intervenciones fueron significativamente superiores al grupo de comparación. Debido a la alta heterogeneidad de los estudios (I. = 82.25), se analizaron 12 variables moderadoras, de las cuales 11 fueron significativas (. < .005). Los resultados del análisis de variables moderadoras indican un mayor efecto en el incremento de la adherencia al TARV en intervenciones con marcos teóricos basados en el apoyo social por pares y con metodologías adaptables a la vivencia cotidiana de la persona.

Abstract HIV is a chronic disease that affects the CD4 receptors of the immune system, so it is necessary for people with the virus to be under Antiretroviral Treatment (ART) to reduce the viral load in the body. The success of ART is related to adherence to treatment, understood as: the intake of antiretroviral drugs, follow-up of medical controls and implementation of healthy lifestyles. There are personal, social and health systems problems that prevent people from adhering to ART in an adequate way. This situation has become a public health problem because inappropriate taking of drugs often leads to drug resistance. In this way, it is necessary to implement effective psychological interventions aimed at increasing adherence to ART, to contribute to a better use of antiretrovirals and to the improvement of the quality of life of people with HIV. Accordingly, the objective was to review the factors associated with the efficacy of psychological interventions, to increase adherence to ART and to aggregate the findings in quantitative estimates of its impact on adherence. For this purpose, meta-analysis was used as a research technique that allows a quantitative analysis of results by calculating specific statistics. The literature search and review were carried out from August 2017 to May 2019 in the PubMed, Academic Search Complete (EBSCO Host) and Springer Link databases, for the identification of experimental studies that met the eligibility criteria (studies published in peer-reviewed indexed journals, experimental or quasi-experimental research, using techniques to increase adherence, published in Spanish and English and reporting the necessary statistics for effect size calculation). Of the 15 studies (total n = 1669) selected, 38 effect sizes were obtained. The calculation of the individual and global effect size was performed using the Comprehensive Meta-Analysis software (Biostat, 2011, v. 2.2.064). All the effect sizes were calculated using the standardized mean difference and a random effects model. To find out if individual effect sizes were homogeneous and therefore represent a similar measure of treatment efficacy, the Cochran Q homogeneity test was applied; based on this, the I. was calculated. Also, it was performed a publication bias calculation, the objective of which was to estimate the number of non-significant effect sizes that are required for a reduction of the global effect size to a smaller and non-significant one. The overall effect size was moderate (. = 0.56, . = 38, 95 % CI = 0.39 - 0.72, . < .001) and presented high heterogeneity (I. = 82.25). Twelve moderator variables were analyzed (year of publication, percentage of men, average age, measurement time, number of sessions / interactions, duration of sessions, total duration of intervention, economic remuneration for intervention, place where the intervention was carried out, type of intervention, intervention modality and adherence measurement), of which 11 were significant (all but intervention modality: individual vs. group therapy). The results suggest that the success of an intervention proposal to improve adherence to ART will be related to its ability to consider the components of the environment and the social situation in which the person with HIV develops, as well as their intrinsic characteristics in interaction with their context. Likewise, it is necessary to consider that the presence of adherence barriers should be treated specifically in young people and adults, as well as in men and women. Finally, it is more important to establish interventions aimed not only to increase adherence, but maintaining it, which is why it is considered necessary to propose studies aimed at maintaining adherence, as well as offering practical tools for people to make better decisions about their health.

ABSTRACT The main objective is to evaluate the ethnobotanical potential of forest species taking into consideration medicinal species. It is an innovative project, which applies a descriptive methodology, developed in situ, aimed at solving practical problems. The study reflects that 60% of the respondents are women, who are the ones who have the knowledge of the number of medicinal species and their ages range from 48 to 83 years. In addition to this, 30 forest and ruderal species were identified, after which guidelines were established for the conservation of these species.

RESUMEN El objetivo principal es evaluar el potencial etnobotánico de especies forestales tomando en consideración las especies medicinales. Es un proyecto de innovación, que aplica una metodología descriptiva, desarrollado in situ, encaminado a resolver problemas prácticos. Se reflejó en el estudio que el 60% de los encuestados son mujeres, quienes son las que tienen el conocimiento del número de especies medicinales y sus edades oscilan entre 48 y 83 años. A más de ello, se identificaron 30 especies forestales y ruderales, posterior a lo cual se establecieron lineamientos para la conservación de estas especies.

Abstract Purpose Several bedside clinical tests have been proposed to predict difficult tracheal intubation. Unfortunately, when used alone, these tests show less than ideal prediction performance. Some multivariate tests have been proposed considering that the combination of some criteria could lead to better prediction performance. The goal of our research was to compare three previously described multivariate models in a group of adult patients undergoing general anesthesia. Methods This study included 220 patients scheduled for elective surgery under general anesthesia. A standardized airway evaluation which included modified Mallampati class (MM), thyromental distance (TMD), mouth opening distance (MOD), head and neck movement (HNM), and jaw protrusion capacity was performed before anesthesia. Multivariate models described by El-Ganzouri et al., Naguib et al., and Langeron et al. were calculated using the airway data. After anesthesia induction, an anesthesiologist performed the laryngoscopic classification and tracheal intubation. The sensitivity, specificity, and receiver operating characteristic (ROC) curves of the models were calculated. Results The overall incidence of difficult laryngoscopic view (DLV) was 12.7%. The area under curve (AUC) for the Langeron, Naguib, and El-Ganzouri models were 0.834, 0.805, and 0.752, respectively, (Langeron > El-Ganzouri, p= 0.004; Langeron = Naguib, p= 0.278; Naguib = El-Ganzouri, p= 0.101). The sensitivities were 85.7%, 67.9%, and 35.7% for the Langeron, Naguib, and El-Ganzouri models, respectively. Conclusion The Langeron model had higher overall prediction performance than that of the El-Ganzouri model. Additionally, the Langeron score had higher sensitivity than the Naguib and El-Ganzouri scores, and therefore yielded a lower incidence of false negatives.

Resumen Introducción: La pandemia de COVID-19 ha afectado los procesos universitarios y las tesis no son una excepción. El cierre de las universidades y las sesiones virtuales han alterado el proceso de elaboración de una tesis. Objetivo: Identificar el impacto de la pandemia de COVID-19 en la elaboración, desarrollo y ejecución de la tesis de licenciatura. Método: Se diseñó un estudio descriptivo que incluyó a graduados de la facultad de Odontología de la Universidad Nacional Mayor de San Marcos (Lima-Perú). Se utilizó la técnica de la encuesta a través de un cuestionario con preguntas abiertas enviadas de forma virtual. Las categorías de análisis incluyeron: impacto en el desarrollo de la tesis, retos experimentados y las estrategias de afrontamiento. Resultados: Se encuestaron a 42 graduados, 55% fueron mujeres. El impacto fue percibido en la selección del tema de estudio, ejecución del proyecto de tesis, adquisición de recursos, procesos administrativos, coordinación con el asesor, adecuación a una nueva técnica investigativa, pérdida de motivación, interés en otros temas diferentes a la tesis y afectación a la salud mental. Los tesistas manifiestan que han aplicado algunas estrategias para afrontar el impacto de la pandemia, tales como: modificar su técnica investigativa, adecuar ambientes para la ejecución de experimentos in vitro y realizar reuniones más frecuentes con asesores y amigos de forma virtual. Conclusiones: La pandemia de COVID-19 ha afectado a los tesistas del pregrado de la facultad de Odontología. Este impacto ha afectado la selección del tema de estudio, ejecución del proyecto de tesis, adquisición de recursos y los procesos administrativos.

Abstract Introduction: The COVID-19 pandemic has affected university processes and theses are no exception. The closure of universities and virtual sessions has altered the process of preparing a thesis. Objective: Identify the impact of the COVID-19 pandemic on the preparation, development and execution of the undergraduate thesis. Method: A descriptive study was designed that included graduates of the Faculty of Dentistry of the Universidad Nacional Mayor de San Marcos (Lima-Peru). The survey technique was used through a questionnaire with virtual open questions. Analysis categories included: impact on thesis development, challenges experienced, and coping strategies. Results: 42 graduates were surveyed, 55% women. The impact was perceived in the selection of the study topic, execution of the thesis project, acquisition of resources, administrative processes, coordination with the thesis advisor, adaptation to a new investigative technique, loss of motivation, interest in topics other than the thesis and impact on mental health. Thesis students state that they have applied some strategies to face the impact of the pandemic: modify their investigative technique, adapt environments for the execution of in vitro experiments, more frequent meetings with advisers and friends in a virtual way. Conclusions: The COVID-19 pandemic has affected the undergraduate thesis of the Faculty of Dentistry. This impact has affected the selection of the study topic, execution of the thesis project, acquisition of resources and administrative processes.

Abstract The present study evaluated the actual rotational speed of three different endodontic motors compared to the values provided by the manufacturers. A total of three endodontic motors (X-Smart Plus, VDW.Silver, and iRoot) were tested at 400 rpm and 800 rpm and 2 N/cm2 torque. The kinematics of the devices was recorded by using a custom angle-measuring disc with a 50-mm diameter attached to the handpiece provided by the manufacturer, whereas their movement was captured by a high-speed camera at 2,400 frames per second, 800 x 800 pixel-resolution and distance of 0.3 m from the target object. Statistical analysis was performed at a significance level of 5%. At 400 rpm, the iRoot motor had a value of 17.94 rpm above that indicated by the manufacturer, which was significantly different from those of X-Smart Plus (5.20 rpm below that indicated by the manufacturer) and VDW.Silver (0.62 rpm above that indicated by the manufacturer) motors (P < 0.05). At 800 rpm, the iRoot motor had a value of 51.34 rpm below that indicated by the manufacturer, whereas the X-Smart Plus motor had a value of 13.00 rpm below that indicated by the manufacturer (P > 0.05). The VDW.Silver motor statistically differed from the iRoot and X-Smart Plus ones, showing a value of 1.68 rpm above that indicated by the manufacturer. In conclusion, the X-Smart Plus, VDW.Silver, and iRoot motors showed lower variations in the rotational speed values compared to those reported by their manufacturers. The endodontic motors presented different behaviors between them, with the VDW.Silver motor presents the most accurate values and the iRoot presents the most divergent values.

Resumo O presente estudo avaliou a real velocidade rotacional de três diferentes motores endodônticos comparados aos valores fornecidos pelos fabricantes. Um total de três motores endodônticos (X-Smart Plus, VDW.Silver e iRoot) foram testados a 400 rpm e 800 rpm e torque de 2 N/cm2. A cinemática dos dispositivos foi verificada utilizando-se um disco customizado de 50 mm de diâmetro acoplado ao contra ângulo fornecido pelo fabricante e o movimento foi capturado através de uma câmera ajustada em 2400 quadros por segundo com resolução de 800 x 800 pixels distante 0,3 m do objeto alvo. A análise estatística foi realizada com nível de significância de 5%. A 400 rpm, o motor iRoot apresentou 17,94 rpm acima do indicado pelo fabricante, sendo o valor significativamente diferente do X-Smart Plus (5,20 rpm abaixo do indicado pelo fabricante) e VDW.Silver (0.62 rpm acima do indicado pelo fabricante) (P > 0,05). A 800 rpm, iRoot apresentou 51.34 rpm abaixo do indicado pelo fabricante e X-Smart Plus 13,00 rpm abaixo do indicado pelo fabricante (P > 0,05). VDW.Silver foi estatisticamente diferente de iRoot e X-Smart Plus, apresentando 1,68 rpm acima do indicado pelo fabricante. Concluiu-se que os motores X-Smart Plus, VDW.Silver e iRoot apresentaram baixa variação na velocidade rotacional quando comparada ao fornecido pelo fabricante. Os motores endodônticos apresentaram diferentes comportamentos entre eles, sendo que o motor VDW.Silver apresentou valores mais acurados enquanto o iRoot foi o mais divergente.

RESUMEN El objetivo de este informe especial es presentar los avances en Latinoamérica sobre la regulación de la venta de productos médicos a través de internet y ofrecer orientación a las Autoridades Reguladoras Nacionales (ARN) en la planificación y ejecución de estrategias para la regulación y fiscalización del comercio electrónico de productos médicos. Se presentan los avances regulatorios y de programas, e iniciativas efectuadas por cuatro países de América Latina para el control de la venta de productos médicos a través de Internet, incluyendo revisiones complementarias de la literatura y de programas para el control del comercio electrónico de agencias de referencia. A partir de esta revisión, se proponen las siguientes líneas estratégicas: fortalecimiento del marco regulatorio y normativo; fortalecimiento de la capacidad fiscalizadora; colaboración con autoridades y otros actores clave nacionales e internacionales; y comunicación y sensibilización con la comunidad y los profesionales de salud. Cada una de estas estrategias deben ir acompañadas con acciones específicas, que pueden servir como orientaciones para las ARN de las Américas, y de países con contextos similares para el fortalecimiento de sus marcos regulatorios y la protección de los pacientes y consumidores.

RESUMO O objetivo deste relatório especial é apresentar os avanços na regulamentação da comercialização de produtos médicos pela internet na América Latina e oferecer orientações às Autoridades Reguladoras Nacionais (ARN) sobre planejamento e execução de estratégias de regulamentação e fiscalização do comércio eletrônico de produtos médicos. São apresentados avanços regulatórios e programáticos, bem como iniciativas realizadas por quatro países latino-americanos para controlar a venda de produtos médicos pela internet, incluindo revisões complementares da literatura e programas de controle do comércio eletrônico por agências reguladoras de referência. Com base nesta revisão, propõem-se as seguintes linhas estratégicas: fortalecimento do marco regulatório e normativo; fortalecimento da capacidade de fiscalização; colaboração com autoridades e outros atores-chave nacionais e internacionais; e comunicação e sensibilização da comunidade em geral e dos profissionais de saúde. Cada uma dessas estratégias deve ser acompanhada de ações específicas, que podem servir de diretrizes para as ARN das Américas – e de países com contextos semelhantes – para fortalecer seus marcos regulatórios e a proteção de pacientes e consumidores.

ABSTRACT The objective of this special report is to present the advances in Latin America on regulation of the online sale of medical products and to offer guidance to national regulatory authorities (NRAs) on planning and implementing strategies to regulate and oversee the e-commerce of medical products. The regulatory advances and the programs and initiatives implemented in four Latin American countries to control the online sale of medical products are presented, including complementary reviews of the literature and reviews of e-commerce control programs of agencies of reference. Based on this review, the following strategies are proposed: strengthening the regulatory and policy framework; strengthening the capacity for oversight; collaboration with national and international authorities and other key players; and communication and awareness-raising with the community and health care professionals. Each of these strategies should be accompanied by specific actions that can serve as guidelines for NRAs in the Americas and in countries with similar contexts, to strengthen their regulatory frameworks and patient and consumer protections.

Resumo Objetivo: Analisar associação entre osteólise nas interfaces protéticas por ressonância magnética com sequências MAVRIC-SL e a gravidade clínica dos pacientes submetidos a artroplastias de joelho ou quadril. Determinar concordância intraobservador e interobservador na reabsorção óssea peri-implante. Materiais e Métodos: Foi realizado estudo transversal entre março de 2019 e agosto de 2020, com 47 pacientes (49 articulações) em seguimento pós-operatório de artroplastias de joelho ou quadril, com dor crônica, que responderam ao questionário WOMAC. As interfaces dos componentes foram avaliadas e definiram dois grupos: osteointegrado e osteólise. Testes não paramétricos foram usados. Resultados: Houve diferença significativa na média do escore WOMAC entre os grupos (p = 0,010), assim como nos domínios rigidez (p = 0,047) e função (p = 0,011). Houve concordância substancial interobservador e intraobservador para a maioria dos componentes analisados. Conclusão: Osteólise periprótese parece estar associada com a queixa clínica de dor pós-artroplastia, com avaliação reprodutível pela MAVRIC-SL. Isto pode ser uma importante ferramenta para o ortopedista na avaliação de casos desafiadores de dor crônica pós-artroplastia.

Abstract Objective: To analyze the association between osteolysis at the prosthesis interfaces, as determined by magnetic resonance imaging (MRI) with multiacquisition variable-resonance image combination selective (MAVRIC-SL) sequences, and clinical severity after knee or hip arthroplasty, as well as to assess interobserver and intraobserver agreement on periprosthetic bone resorption. Materials and Methods: This was a cross-sectional study of 47 patients (49 joints) under postoperative follow-up after knee or hip arthroplasty, with chronic pain, between March 2019 and August 2020. All of the patients completed the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire. The component interfaces were evaluated and ordered into two groups: osseointegrated and osteolytic. Nonparametric tests were used. Results: There were significant differences between the two groups in terms of the mean WOMAC scores: total (p = 0.010); stiffness domain (p = 0.047); and function (p = 0.011) domains. There was substantial interobserver and intraobserver agreement for most analyses of the components. Conclusion: Periprosthetic osteolysis appears to be associated with clinical complaints of pain in the post-arthroplasty scenario, and MAVRIC-SL provides reproducible assessments. It could prove to be an important tool for orthopedists to use in the evaluation of challenging cases of chronic pain after arthroplasty.