Deficiencia de ferritina en gestantes colombianas y factores sociodemográficos asociados / Ferritin deficiency in colombian pregnant women and associated sociodemographic factors / Deficiencia de ferritina en gestantes colombianas y factores sociodemográficos asociados

Objetivo: la ferritina es importante en el almacenamiento de hierro intracelular, en una forma soluble no tóxica. Sus niveles en la gestación se la relacionan con la salud de la madre y con su descendencia. El objetivo es escribir los niveles séricos de ferritina y prevalencia de déficit de ferritina, así como los factores sociodemográficos asociados en gestantes de Colombia. Metodología: estudio transversal; análisis secundario de la Encuesta de Situación Nutricional de Colombia, 2015. Se evaluaron en 1.234 embarazadas con edades entre 12 y 48 años: sus características sociodemográficas y antropométricas, la distribución de los niveles séricos y la prevalencia de déficit de ferritina. Para estimar la asociación entre las diferentes variables sociodemográficas y los niveles séricos, o la prevalencia de déficit de ferritina, se utilizaron modelos de regresión multivariables. Resultados: la prevalencia de deficiencia de ferritina fue de 44.5 % (IC 95 % 40.1 % a 49.0 %), los niveles séricos de ferritina oscilaron entre 4 µg/L y 295,7 µg/L, con un promedio de 29.3 µg/L (IC 95 % 26,5 µg/L-32.2 µg/L). Las gestantes del segundo (OR (OR 2.19 IC 95 % 1.50 a 3.19) y tercer trimestre (OR 3.84 IC 95 % 2.68 a 5.50), aquellas que residen en la región Atlántica (OR 2.18 IC 95 % 1.25 a 3.82) y en la región Orinoquia (OR 2.41 IC 95 %1.19 a 4.88), mostraron asociación con el déficit de ferritina. Conclusión: se halló alta prevalencia en el déficit de ferritina en gestantes colombianas.

Introduction: Ferritin is important in the storage of intracellular iron, in a non-toxic soluble form. Its levels during pregnancy are related to the health of the mother and her offspring. Objective: To describe the serum ferritin levels and the prevalence of ferritin deficiency, and the associated sociodemographic factors in pregnant women in Colombia. Methodology: Cross-sectional study; secondary analysis of the Nutritional Situation Survey of Colombia, 2015. The following were evaluated in 1,234 pregnant women aged between 12 and 48 years: their sociodemographic and anthropometric characteristics, the distribution of serum levels, and the prevalence of ferritin deficiency. To estimate the association between the different sociodemographic variables and serum levels, or the prevalence of ferritin deficiency, multivariate regression models were used. Results: The prevalence of ferritin deficiency was 44.5% (95% CI 40.1% to 49.0%), serum ferritin levels ranged from 4 µg/L to 295.7 µg/L, with a average of 29.3 µg/L (95% CI 26.5 µg/L - 32.2 µg/L). Pregnant women in the second (OR (OR 2.19 95% CI 1.50 to 3.19) and third trimester (OR 3.84 95% CI 2.68 to 5.50), those residing in the Atlantic region ( OR 2.18 95% CI 1.25 to 3.82) and in the Orinoquia region (OR 2.41 95% CI 1.19 to 4.88), showed an association with ferritin deficiency. Conclusion: A high prevalence of ferritin deficiency was found in Colombian pregnant women.

Consistency of information on the provision of water fluoridation in Brazil / Consistência das informações sobre a provisão da fluoretação da água no Brasil

ABSTRACT Objective: This study aimed to assess the consistency of data regarding the provision of fluoridation in Brazilian municipalities with water supply systems. Methods: Official data from the National Basic Sanitation Survey and the National Information System on Sanitation for 2017 were compared. Results: Out of 5,570 municipalities in Brazil, 4,546 (81.6%) had water supply systems. The agreement between data sources was 84%, with a Kappa of 0.668, indicating substantial agreement. However, the estimates of fluoridation provision exhibited an average discrepancy of 8.1 percentage points, ranging from 1.2 points in the Central-West region to 21.4 points in the Northeast region. Conclusion: To address these inconsistencies, it is essential to enhance information sources, ensuring more reliable data for health, sanitation authorities, and society at large.

RESUMO Objetivo: Avaliar a consistência dos dados sobre a provisão de fluoretação em municípios brasileiros com sistemas de abastecimento de água. Métodos: Foram comparados os dados da Pesquisa Nacional de Saneamento Básico e do Sistema Nacional de Informações sobre Saneamento referentes a 2017. Resultados: De 5.570 municípios no Brasil, 4.546 (81,6%) possuíam sistemas de água. A concordância entre as fontes foi de 84%, com Kappa de 0,668, indicando substancial concordância. Entretanto, as estimativas de provisão divergiram em média 8,1 pontos percentuais, variando de 1,2 ponto na região Centro-Oeste a 21,4 pontos na região Nordeste. Conclusão: Para superar essa inconsistência, é fundamental aprimorar as fontes de informação, garantindo dados mais confiáveis para as autoridades de saúde, saneamento e para a sociedade em geral.

Choroidal macrovascular and capillary alterations in eyes with idiopathic epiretinal membranes

ABSTRACT Purpose: To evaluate the choroidal vascular alterations and effect of surgical treatment in the setting of idiopathic epiretinal membranes. Methods: The structure of the choroid was studied in 33 patients with unilateral idiopathic epiretinal membrane using optical coherence tomography with enhanced depth imaging and optical coherence tomography angiography. Eyes with epiretinal membrane underwent 25-gauge vitrectomy with epiretinal membrane and internal limiting membrane peeling. The choroidal vascularity index, Haller layer/choroidal thickness ratio, and choriocapillaris flow density were used to evaluate changes in choroidal structure after surgery and compare with the healthy fellow eyes. Results: The choroidal vascularity index and Haller layer/choroidal thickness ratio of the eyes with epiretinal membrane were higher than those of the fellow eyes at baseline (p=0.009 and p=0.04, respectively) and decreased postoperatively compared with preoperative values (p=0.009 and p=0.001, respectively). The choriocapillaris flow of eyes with epiretinal membrane was lower than that of the fellow eyes at baseline (p=0.001) and increased after surgery compared with the preoperative value (p=0.04). The choroidal vascularity index, Haller layer/choroidal thickness ratio, and choriocapillaris flow values of the healthy fellow eyes were comparable at baseline and final visit. In eyes with epiretinal membrane, the final choroidal vascularity index correlated with the final choriocapillaris flow (r=-0.749, p=0.008) in the multivariate analysis. Conclusion: Idiopathic epiretinal membrane appears to affect the choroidal structure with increased choroidal vascularity index and Haller layer/choroidal thickness ratio and decreased choriocapillaris flow. These macrovascular (choroidal vascularity index and Haller layer/choroidal thickness) and microvascular (choriocapillaris flow) alterations appear to be relieved by surgical treatment of the epiretinal membranes.

Comparison between the ion-specific electrode and SPADNS methods for analysis of fluoride concentration in the water supply

The maintenance of adequate fluoride (F) concentration in the public water supply is fundamental for ensuring that the community use of F can reach the maximum benefit for caries control and minimum risk for dental fluorosis. Thus, surveillance systems must use accurate and valid analytical methods to determine F concentration and, according to the literature, give preference to the ion-specific electrode (F- ISE) analysis. Aim: The objective of this study was to compare the accuracy of the ISE and SPADNS methods in the determination of the F concentration in the same water sample. Methods: Duplicate water samples were taken from 30 sampling sites in the municipality of Maringá, state of Paraná, monthly for 12 months, totaling 276 samples. An aliquot was analyzed by the FOP-UNICAMP Oral Biochemistry laboratory, using the F- ISE method, and the other one, by the SANEPAR laboratory in Maringá/PR, using the SPADNS method. Descriptive analysis and Pearson's correlation test were applied, with a significant level of p<0.05. Results: Results were expressed as ppm F (mg F/L), and a very strong positive correlation (r= 0.91; p<0.001) was detected between the two methods of analysis. Conclusion: Our findings suggest that the determination of f luoride concentration in water can be made with accuracy by the SPADNS method, a standardized analysis protocol

Relationship between food environment, social isolation and diet quality in Brazil / Relación entre el entorno alimentario, el aislamiento social y calidad de la dieta en Brasil. Introducción

Introduction. The COVID-19 pandemic has impacted diet quality in differentways. In this context, community, organizational and consumer nutrition environments can influence the eating pattern. Objective. The purpose of this study was to identify how quarantine during the COVID-19 pandemic changed the diet in Brazil. Materials and methods. A natural experiment organized into experimental (social-isolated group - SIG) and control groups (non-isolated group - CG) was conducted with data collection from an online survey at the beginning of the pandemic (T0) and in the less restrictive period of 2020 (T1). Pre-post improvements in diet quality (IDQ) were determined for the SIG and CG. Intro-intergroup changes were tested using the Mann­Whitney and Wilcoxon signed rank tests. The intervention effect was estimated using crude and adjusted difference- indifference in multilevel regression analysis accounting for repeated measures. Results. A sample of 565 Brazilian adults answered the questionnaire at T0 and T1. IDQ was favored twice or more by attitudes such as buying food directly from farmers/street markets, reducing requests for food delivery, and increasing time spent on eating activities and the frequency of cooking. The isolated group had no IDQ at T1, whereas the no isolated group, who worsened diet quality (6.1%) at T0, improved it at T1 (4.8%). Conclusions. The restrictive quarantine forced the non-isolated population to have an experience comparable to a food desert, negatively affecting their diet(AU)

COVID-19 ha impactado la calidad de la dieta de diferentes maneras. Los entornos comunitarios, organizacionales y nutricionales de los consumidores pueden influir en los patrones dietéticos. Objetivo. el objetivo de este estudio fue identificar cómo la cuarentena durante la pandemia de COVID-19 cambió la dieta en Brasil. Materiales y métodos. Se realizó un experimento natural organizado en grupos experimental (grupo socialmente aislado - SIG) y control (grupo no aislado - GC) con datos recolectados en una encuesta en línea al inicio de la pandemia (T0) y en el momento menos restrictivo de 2020 (T1). Se determinaron mejoras pre-post en la calidad de la dieta (IDQ) para SIG y GC. Los cambios intra-intergrupo se probaron utilizando las pruebas de rangos con signos de Mann-Whitney y Wilcoxon. El efecto de la intervención se estimó utilizando diferencias crudas y ajustadas en el análisis de regresión multinivel, teniendo en cuenta medidas repetidas. Resultados. Una muestra de 565 adultos brasileños respondió el cuestionario en T0 y T1. IDQ se vio favorecido dos o más veces por actitudes como comprar alimentos directamente de los agricultores/mercados callejeros, reducir los pedidos de entrega de alimentos y aumentar el tiempo dedicado a las actividades alimentarias y la frecuencia de cocinar. El grupo aislado no mostró IDQ en T1, mientras que el grupo no aislado, que tenía peor calidad de la dieta (6,1%) en T0, mejoró en T1 (4,8%). Conclusiones. La cuarentena restrictiva obligó a la población no aislada a tener una experiencia comparable a un desierto alimentario, afectando negativamente su dieta(AU)

Caracterización de la oferta de medicamentos en la República Argentina / Characterization of the drug supply in Argentina

Resumen Introducción : Conocer las características del mercado farmacéutico permite obtener información sensible para entender la oferta, la demanda y el acceso de la pobla ción a los medicamentos. Con el objetivo de aportar da tos primarios respecto a la comercialización de fármacos en Argentina, se desarrolló la siguiente investigación. Métodos : Se trata de un estudio descriptivo cuanti tativo-cualitativo transversal del mercado farmacéutico argentino, tomando en cuenta 30 años de información oficial aportada por la Agencia Reguladora Nacional (ANMAT). Resultados : Se identificaron 216 laboratorios (182 nacionales) productores/importadores de medicamentos, 53 distribuidores y 479 droguerías (establecimientos de distribución de medicamentos al por mayor). Se detectó una alta concentración de la comercialización, agrupán dose el 90% de la misma, en solo 5 intermediarios. En el país existen actualmente 6670 productos/certificados, cantidad que fluctuó a lo largo de los últimos 30 años. Seis laboratorios son dueños de entre 116 y 208 certifica dos. El 84% de estos productos provienen de laboratorios nacionales, 5002 son monofármacos, mientras que el 83% se comercializa bajo un nombre de fantasía. Las tres principales indicaciones a las que se destina el registro de medicamentos en la Argentina son enfermedades del aparato digestivo, sistema nervioso, e infecciosas; el 58% es comercializado como formulaciones orales. Discusión : el presente trabajo muestra que el mer cado farmacéutico argentino tiene una participación mayoritaria de capitales nacionales, existiendo gran concentración en pocas empresas productoras y distri buidoras. Los productos son mayormente monodrogas comercializadas en forma oral y ofrecidas por su nombre de fantasía.

Abstract Introduction : Knowing the characteristics of the phar maceutical market allows obtaining sensitive informa tion to understand the supply, demand and access of the population to medicines. In order to provide primary data regarding the marketing of drugs in Argentina, the following research was performed. Method : This is a cross-sectional quantitative-quali tative descriptive study of the Argentine pharmaceutical market, taking into account 30 years of official information provided by the National Regulatory Agency (ANMAT). Results : Two hundred and sixteen laboratories (182 national) drug producers/importers, 53 distributors and 479 drugstores (wholesale drug distribution establishments) were identified. A high concentration of market ing was detected, grouping 90% in only 5 intermediaries. There are currently 6670 products/certificates in the country, an amount that fluctuated over the last 30 years. Six laboratories are owners of between 116 and 208 certificates; 84% of these products come from na tional laboratories, 5002 are mono-drugs, while 83% are marketed under a fancy name. The three main indica tions for which the registration of drugs in Argentina is intended are diseases of digestive system, nervous system and infectious diseases; 58% of the marketed products consist of oral formulations. Discussion : Based on data provided by this study, it is possible to assert that the Argentinian pharmaceutical market has a majority share of national capital, with a great concentration in a few pharmaceutical companies and distributors. The products are mostly available as non-combined drugs, in their oral form, and available by their brand names.

THE IMPACT OF SUPPLY CHAIN MANAGEMENT PRACTICES ON PRODUCTIVITY

The purpose of the study is to test the impact of supply chain management practices on productivity of the organisation. Additionally, investigated the relationship between supply chain management practices and organisational productivity. The type of research used is descriptive in nature.. The study was conducted on the basis of various factors like risk management, process, delivery and planning and how organisational productivity can be improved through these factors of supply chain management practices. The paper revealed that there is a relationship between supply chain management practices and organisational productivity. It also revealed that there is an impact of supply chain management practices on organisational productivity. As far as the researcher is aware,this paper is rst to investigate the impact of supply chain management practices on organisational productivity with factors like quality management, inventory management and transportation and the researcher has done the study on different factors like risk management, planning, process and delivery

SEMICONDUCTOR INDUSTRY IN INDIA- USHERING ITS WAY INTO A NEW ERA

This paper focuses on the current state of the semiconductor industry at the global level as well as in India. With semiconductor chips emerging as the new gold, its demand is highest now than it was ever before. The demand for semiconductor chips in India is said to reach a gure of whopping US 110 billion dollars by 2030. In recent years, this industry has witnessed a crunch in its supply due to supply-side and demand-side constraints. This paper sheds light on the causes of these limits. Moreover, many countries are acquainted with this industry's scope in the future. India recognizes its dependence on countries like China for semiconductors. So, it aims to become a manufacturing hub for this industry and not just remain a fabless industry. However, India is encountering hurdles in this process. With this perception, this study has tried to explore India's initiatives in this direction. Keeping in mind India's vision of Aatmanirbhar Bharat, it seems like it's a long and rough road ahead to make the semiconductor industry in India, a self-reliant industry. This analytical study infers that overcoming these obstacles is going to become increasingly onerous.

Captadores de niebla y recolección de agua en un ecosistema de páramo colombiano

Los captadores de niebla son usados para interceptar agua contenida en la niebla y abastecer de agua a comunidades que habitan en lugares donde este recurso escasea. Se evaluó el uso de captadores de niebla para la captación de agua en un área ubicada en el páramo Pan de Azúcar, Duitama-Boyacá. Se instalaron 60 captadores de niebla, 24 de ellos, con dispositivos para medir los volúmenes de agua interceptados. Los volúmenes de agua captados, se midieron en periodos de 24 horas, por 26 días, durante un año y se usó el modelo geométrico para diferenciar el agua proveniente de la niebla. La precipitación registrada fue mayor a la reportada en la literatura. La precipitación mensual osciló entre 51 y 1198 mm y la temperatura media mensual entre los 6 y 8 °C. Los volúmenes de agua promedio colectados por los 24 captadores de niebla estuvieron entre los 0,02 Lm-2dia-1 hasta los 4,4Lm-2dia-1. Los aportes de agua provenientes de la niebla oscilaron entre los 0,02 y 1,77 mmdía-1. La dirección del viento no afectó la captación de agua y aún se presenta incertidumbre al separar el aporte real de agua proveniente de la niebla a partir de la lluvia orográfica, lo cual, sigue siendo un desafío en los ecosistemas de páramo, por lo que se debe ampliar la investigación, para mejorar los diseños y las eficiencias de los captadores de niebla.

Fog collectors are used to intercept water contained in fog and supply water to communities that live in places where this resource is scarce. We evaluated the use of mist collectors to collect water in an area located in the Pan de Azúcar paramo, Duitama-Boyacá. We installed 60 mist collectors, 24 of them with devices to measure the volumes of water intercepted. The volumes of water captured were measured in periods of 24 hours for 26 days during one year and we used the geometric model to differentiate the water from the fog. The recorded precipitation was higher than that reported in the literature. Monthly rainfall ranged between 51 and 1198mm and mean monthly temperature ranged between 6 and 8°C. The average volumes of water collected by the fog collectors were below 0.5Lm-2day-1 with a maximum of 4.4Lm-2day-1. The contributions of water from the mist ranged between 0.02 and 1.77 mmday-1. The direction of the wind did not affect the capture of water and there is still uncertainty when separating the real contribution of water from the fog from the orographic rain, which continues to be a challenge in the paramo ecosystems, for which it is necessary to expand research, to improve the designs and efficiencies of fog collectors.

Environmental Laws Vs Energy Laws: A Comparative Analysis

Environmental laws and energy laws have always been a topic of debate among policymakers, legal scholars, and environmentalists. While environmental laws aim to protect the environment and natural resources, energy laws are designed to ensure a reliable and secure energy supply. The Indian government has implemented several laws and policies to protect the environment and promote renewable energy in recent years. This paper provides a comparative analysis of environmental laws and energy laws generally as well as in India to understand the effectiveness of the legal framework governing these areas and identify areas where improvements can be made. The Environmental Protection Act, Wildlife Protection Act, and Water (Prevention and Control of Pollution) Act are the major environmental laws in India, while the Electricity Act, National Tariff Policy, and National Electricity Policy govern the energy sector. Despite the efforts made by the government, India still faces several environmental and energy challenges, including air pollution, water pollution, deforestation, high cost of renewable energy, and limited availability of energy storage solutions. The paper highlights the need for the Indian government to take bold steps to enforce environmental laws and promote renewable energy to ensure a sustainable and secure energy future for its citizens while protecting the environment for future generations. The paper concludes that both environmental laws and energy laws are important for ensuring a sustainable future, and that there is a need to strike a balance between the two.

Determinación social del consumo de frutas y verduras en Florida (Valle del Cauca, Colombia) / Social Determinants of Fruit and Vegetable Consumption in Florida, Valle del Cauca ­ Colombia / Determinação social do consumo de frutas e verduras na Flórida, Valle del Cauca, Colômbia

Introducción: el consumo de frutas y verduras como proceso protector de la salud se ha analizado principalmente desde la perspectiva de los estilos de vida individuales; sin embargo, procesos de tipo estructural como los modelos de producción de alimentos y las políticas de alimentación determinan su producción, disponibilidad y acceso. Se planteó como objetivo analizar los procesos de determinación social del con- sumo de frutas y verduras en el municipio de Florida (Valle del Cauca, Colombia). Materiales y métodos: estudio cualitativo, tipo estudio de caso, con enfoque de determinación social. Incluyó revisión documental de políticas alimentarias y grupos de discusión con actores clave; el análisis de contenido permitió explicitar mensajes y discursos. Resultados: en la dimensión general, resaltan como procesos críticos de determinación, que limitan la producción y el acceso de frutas y verduras, el uso y tenencia inequitativa de la tierra y la explotación de las fuentes hídricas, y unas políticas que desde la lógica de libre mercado reducen cada vez más las estrategias locales de autosostenimiento y autoconsumo. En la dimensión particular, el conflicto armado (como proceso crítico adverso) y los ejercicios de soberanía alimentaria (como proceso crítico favorable al consumo de frutas y verduras). Conclusiones: la política alimentaria nacional y local reconoce, de manera discursiva, las determinaciones sociales de la seguridad alimentaria, pero en la práctica privilegia estrategias focalizadas y contingentes que no apuntan a la solución de condiciones estructurales que limitan la producción, disponibilidad, acceso y, por ende, el consumo de frutas y verduras

Introduction: Fruit and vegetable consumption as a preventive health measure depends mainly on the perspective of individual lifestyle. The structural processes such as food production models and food policies determine their production, availability, and access. This study aimed to analyze the social determinants of fruit and vegetable consumption in the municipality of Florida, Valle del Cauca, Colombia. Materials and Methods: This is a qualitative case study using a social determination approach. This study includes a documentary review of food policies and discussion groups among key stakeholders. A content analysis was conducted to allow an explicit analysis of the messages and speeches. Results: In the general dimension, deemed as critical processes of determination, the unequal use and possession of land and the exploitation of water sources and policies, from the logic of the free market, increasingly reduce the local strategies for self-support and self-consumption and limit the production and access of fruits and vegetables. In the particular dimension, a critical adverse process includes the armed conflict. However, the exercise of food sovereignty favors the consumption of fruits and vegetables. Conclusion: Food policy at the national and local level discursively recognizes the social determinants of food security; however, in practice, contingent strategies that do not aim at addressing the structural conditions that limit produc- tion, availability, access and, therefore, the consumption of fruits and vegetables, should be evaluated.

Introdução: o consumo de frutas e verduras como processo de proteção à saúde tem sido analisado principalmente na perspectiva dos estilos de vida individuais, porém processos estruturais como modelos de produção de alimentos e políticas alimentares determinam sua produção, disponibilidade e acesso; o objetivo do estudo foi analisar os processos de determinação social do consumo de frutas e verduras no município da Flórida, Valle del Cauca, Colômbia. Materiais e métodos: estudo qualitativo, do tipo estudo de caso, com enfoque na determinação social; incluiu uma revisão documental de políticas alimentares e grupos de discussão com atores-chave; a análise de conteúdo permitiu explicitar mensagens e discursos. Resultados: na dimensão geral, destacam-se o uso e posse desigual da terra e a exploração dos recursos hídricos como processos determinantes críticos que limitam a produção e o acesso a frutas e verduras; e políticas que, baseadas na lógica do livre mercado, reduzem cada vez mais as estratégias locais de autossustentabilidade e autoconsumo. Na dimensão particular, destaca-se o conflito armado como processo crítico adverso, e o exercício da soberania alimentar, como processo crítico favorável ao consumo de frutas e verduras. Conclusões: a política alimentar a nível nacional e local reconhece, de forma discursiva, as determinações sociais da segurança alimentar, mas na prática privilegia estratégias focalizadas e contingentes que não visam resolver condições estruturais que limitam a produção, a disponibilidade, o acesso e, portanto, o consumo de frutas e verduras.

Quantitative Measurements of Macular and Optic Nerve Head Blood Flow Parameters Following Cataract Surgery in Eye Department, Red Cross Tertiary General Hospital, Athens, Greece

Objective: To evaluate the effect of uncomplicated cataract surgery on macular and optic nerve head blood flow with Optical Coherence Tomography Angiography (OCT-A). Retinal vascular changes and macular vessel remodeling following cataract surgery is an area of interest, as the effect, cause and duration of such changes remain debatable.Setting: Eye Department, Red Cross Tertiary General Hospital, Athens, Greece.Methods: In this study, we recruited cataract surgery candidates who had regular post operative visits and underwent longitudinal OCT-A examinations before and after surgery.Results: Macular vessel density increased in the post operative visits both in the superficial (SCP) and deep capillary network (DCP) (P<0.001) and showed a persistent effect over 3 months follow-up. Macular thickness increased over the first postoperative month, but returned to preoperative values at 3 months. Foveal avascular zone (FAZ) measurements and vessel density at radial peripapillary capillaries (RPC) were unaffected.Conclusions: OCT-A enables a quantitative analysis of blood flow by regular patient monitoring. In this study, we found that after cataract surgery, macular blood flow increased significantly. The reason for this could be attributed to post operative inflammatory process or vascular remodeling due to change in retinal metabolic demands.

Da produção aos impactos na saúde e no ambiente: uma análise dos sistemas alimentares de Brasil, Colômbia e Panamá / From production to impacts on health and the environment: an analysis of food systems in Brazil, Colombia and Panama

Resumo O objetivo deste artigo é descrever os principais componentes dos sistemas alimentares de Brasil, Colômbia e Panamá. Revisão narrativa de literatura dos anos 2000 a 2022, ancorada no conceito de sistemas alimentares do Comitê de Segurança Alimentar Mundial. Nos três países, predomina um sistema de produção agroindustrial, monocultura, uso de agrotóxicos e exploração dos recursos naturais. A área ocupada por produtores familiares é reduzida. As redes multinacionais de supermercados dominam a distribuição dos alimentos, essencialmente nos grandes centros urbanos, apesar da crescente busca por modelos alternativos. Nota-se avanços na regulamentação da rotulagem de alimentos (Colômbia e Brasil) e na tributação de bebidas açucaradas (Panamá). Os sistemas alimentares predominantes nesses países geram importante e negativo impacto ambiental, favorecem o consumo de alimentos ultraprocessados, a elevada prevalência de obesidade e doenças crônicas não transmissíveis e o aumento da fome, violando o direito humano à alimentação adequada.

Abstract The scope of this article is to describe the main components of the food systems of Brazil, Colombia and Panama. It involved a narrative review of the literature from 2000 to 2022, based on the concept of food systems proposed by the Committee on World Food Security. A system of agro-industrial production, monoculture, use of pesticides and exploitation of natural resources predominates in all three countries, and the area occupied by family farmers is reduced. Multinational supermarket chains dominate food distribution, essentially in large urban centers, despite the increasing search for alternative models. Advances have been made in food labeling regulation (Colombia and Brazil) and in the taxation of sugar-sweetened beverages (Panama). The predominant food systems in these countries generate a significant and negative environmental impact, favor the consumption of ultra-processed foods, high prevalence of obesity and chronic non-transmissible diseases and increase in hunger, violating the human right to adequate food.

A efetividade social e a concessão do saneamento à iniciativa privada: o caso do leilão da CEDAE no Rio de Janeiro, Brasil / Social effectiveness and private sanitation concessions: the CEDAE auction in Rio de Janeiro, Brazil

Resumo A alteração no marco legal do saneamento (Lei 14.026, de 15 de julho de 2020) passou a exigir licitação no Brasil, mesmo nos casos de prestação do serviço de saneamento antes delegada pelos municípios às companhias estaduais, mediante contrato de programa. O objetivo foi identificar os atores que se beneficiaram com a mudança na lei e observar a efetividade social do processo de desestatização, que ocorreu em abril de 2021 com o leilão dos serviços de abastecimento de água e esgotamento sanitário prestados pela Companhia Estadual de Águas e Esgotos do Rio de Janeiro (CEDAE) em 35 municípios do estado. Adotou-se a análise exploratória de dados secundários e a metodologia da integração sistêmica, que possibilita identificar o papel e a atuação de atores sociais na concessão dos serviços operados pela CEDAE no Rio de Janeiro. Concluiu-se que os governos federal, estadual e municipais, o Banco Nacional de Desenvolvimento Econômico e Social e grupos privados ganharam com as concessões, mas quanto à efetividade social dos serviços, observou-se que é menor a proporção de população de baixa renda com redes de afastamento do esgoto sanitário nos municípios do estado operados pela iniciativa privada e que as tarifas praticadas são em média maiores ao comparar com os municípios que participaram do leilão.

Abstract Changes in the regulatory and legal framework for Brazil's water and sanitation sector (Law 14,026, July 15, 2020) require competitive bidding for service contracts, even in cases where the provision of services was previously delegated to state-owned utilities under program contracts. The aim of this study was to identify the actors who benefited from these changes to the legislation and assess the social effectiveness of the privatization of water supply and sewerage services in the state of Rio de Janeiro by investigating the auction of services provided by the public utility CEDAE in four blocks comprising 35 municipalities in April 2021. We conducted an exploratory analysis of secondary data and used the systemic integration method to identify the main actors involved in the concession process and the role they played. It is concluded that federal, state, and municipal governments, the Brazilian Development Bank, and the concessionaires have gained from the concessions, while the percentage of low-income populations connected to the sewage collection or drainage network is lower and tariffs are higher in municipalities served by the private sector when compared to the municipalities encompassed by the auction.

Acute and chronic changes in porcine rete mirabile after embolization with the Menox system: angiographic and histopathological analyses / Alterações angiográficas e histopatológicas agudas e crônicas da rete mirabile no modelo suíno com sistema embólico líquido Menox

Abstract Objective: To evaluate acute and chronic changes seen on angiographic and histopathological studies of porcine rete mirabile, comparing those treated with the Menox liquid embolic system (LES) and those treated with the Onyx LES. Materials and Methods: Five pigs, each weighing approximately 35 kg, were submitted to rete mirabile embolization under general anesthesia and fluoroscopic guidance, with the Menox LES or Onyx LES. Four animals were treated with the Menox LES and underwent cerebral angiography, followed by euthanasia, at 1, 30, 60, and 90 days after embolization. One animal was treated with the Onyx LES underwent the same procedures at 30 days after embolization. In a subsequent histopathological analysis, we compared the Menox LES and Onyx LES in terms of the acute and chronic changes observed. Results: We observed no significant changes in blood pressure, heart rate, or electrocardiographic parameters that could be attributed to the super-selective infusion of dimethyl sulfoxide or the Menox embolic agent. Fluoroscopy showed adequate material opacity, appropriate progression to the center of the rete mirabile and complete unilateral embolization. Microcatheters were uneventfully detached from the embolized nidus. We observed mild to moderate intravascular and extravascular inflammatory responses, without histological evidence of necrotizing arteritis. There were no adverse neurovascular events. Conclusion: The Menox LES appears to be safe and effective, as well as being apparently equivalent to the Onyx LES in terms of the postprocedure angiographic and histopathological findings.

Resumo Objetivo: Avaliar as alterações angiográficas e histopatológicas agudas e crônicas em rete mirabile suína tratadas com o Menox liquid embolic system (LES) e comparar essas alterações com a embolização com Onyx LES. Materiais e Métodos: A embolização da rete mirabile com Menox LES e Onyx LES foi realizada em cinco suínos pesando cerca de 35 kg sob anestesia geral e orientação fluoroscópica. Quatro animais tratados com Menox LES foram submetidos a angiografia cerebral seguida de eutanásia após 1, 30, 60 e 90 dias e um animal tratado com Onix LES foi submetido ao mesmo procedimento após 30 dias. A análise histopatológica subsequente para alterações agudas e crônicas avaliou o desempenho do Menox LES comparado ao Onyx LES. Resultados: Não foram observadas alterações significativas atribuíveis à infusão superseletiva de dimetilsulfóxido ou Menox nos parâmetros de pressão arterial, frequência cardíaca ou eletrocardiograma. A fluoroscopia mostrou opacidade adequada do material, progressão adequada para o centro da rete mirabile e embolização unilateral completa. Os microcateteres foram retirados do nidus embolizado sem complicações. Observou-se resposta inflamatória intravascular e extravascular leve a moderada, sem indício histológico de arterite necrosante. Nenhum dos casos apresentou eventos neurovasculares adversos. Conclusão: A injeção de Menox LES mostrou-se segura e eficaz, além de ser equivalente ao Onyx LES em relação aos achados angiográficos e histopatológicos pós-procedimento.

Effect of long working hours on work-related musculoskeletal disorders among operation and maintenance workers of power supply enterprises / 环境与职业医学

Background Long working hours is harmful to the physical and mental health of occupational groups, and should receive active attention. Objective To evaluate the current status of long working hours among operation and maintenance workers of power supply enterprises, and explore its effects on work-related musculoskeletal disorders (WMSDs) of the population. Methods From March to June 2021, a cross-sectional survey was conducted among 1433 operation and maintenance workers from 10 power supply enterprises in Jilin Province, Shandong Province, and Tianjin Municipality using cluster sampling. A total of 1433 copies of revised Mus-culoskeletal Disorders Questionnaire were distributed, 1343 questionnaires were recovered, and the recovery rate was 93.72%. The questionnaire included general information, personal health behaviors, weekly working hours, work-related factors, and musculoskeletal pain or discomfort in nine body parts in the past 12 months. χ2 test and multiple logistic regression models were used to investigate the relationships between long working hours (>40 h per week) and WMSDs. Results The average age of the workers was (39.42±9.89) years, and the average work experience was 11.00 (5.00, 21.00) years. There were 1158 males (86.22%) and 185 females (13.78%). The average weekly working hours of the workers were (47.98±11.35) h, and the proportion of long working hours (>40 h per week) was 61.06% (820/1343). The proportions of long working hours were higher among the workers with characteristics of male, power distribution, shift work, often/very often long-time standing, often/very often holding awkward postures, often handling heavy objects, limited space to operate, long-time neck tilting backward, keeping arms above shoulders, frequent elbow bending, repeating knee movement every minute, and repeating lower limb or foot movement every minute (all P<0.05). The prevalence rate of WMSDs was 81.53% (1095/1343) among the workers. The results of multiple logistic regression showed that after adjusting education, smoking, exercise, awkward postures, often handling heavy objects, limited space to operate, long-time heavy trunk bending, long-time neck tilting backward, and keeping arms above shoulders, compared with working ≤40 h per week, the risk of WMSDs among workers working >49 h per week was higher (OR=1.406, 95%CI: 1.011-1.955). Conclusion Long working hours is prominent among operation and maintenance workers of power supply enterprises, and increases the risk of reporting WMSDs.

Neck and shoulder pain among operation and maintenance workers of selected power supply enterprises / 环境与职业医学

Background Power grid is a basic industry of national economy. The occupational health problems among operation and maintenance workers in this industry have become increasingly prominent in recent years, and they should receive enough attention. Objective To estimate the prevalence of work-related musculoskeletal disorders (WMSDs) of neck and shoulder among operation and maintenance workers of power supply enterprises, and analyze related influencing factors. Methods From March to June 2021, a total of 1433 operation and maintenance worker from 10 power supply enterprises in three provinces of North China were selected as research subjects using cluster sampling method. A revised Musculoskeletal Disorders Questionnaire was used to investigate the prevalence and ergonomic factors of neck and shoulder pain in the past year. χ2 test and logistic regression model were used to explore influencing factors of neck and shoulder pain among operation and maintenance workers. Results A total of 1343 valid questionnaires were recovered and the effective recovery rate was 93.72%. The neck pain prevalence was 66.0% (886 cases) and the shoulder pain prevalence was 54.1% (727 cases). The multiple logistic regression analysis results showed that often/very often long-time sitting (OR=1.864, 95%CI: 1.236-2.811; OR=1.659, 95%CI: 1.091-2.524), sometimes holding awkward postures (OR=1.695, 95%CI: 1.294-2.219; OR=1.596, 95%CI: 1.218-2.092), often/very often holding awkward postures (OR=2.416, 95%CI: 1.618-3.607; OR=2.058, 95%CI: 1.405-3.015), long-time slight neck tilting forward (OR=1.327, 95%CI: 1.023-1.722; OR=1.571, 95%CI: 1.221-2.022), long-time elbows bending (OR=1.327, 95%CI: 1.023-1.722; OR=1.506, 95%CI: 1.112-2.040) and department or team staff shortages (OR=1.578, 95%CI: 1.153-2.161; OR=1.831, 95%CI: 1.320-2.539) were associated with higher neck and shoulder pain prevalence rates. While exercise (OR=0.630, 95%CI: 0.492-0.809; OR=0.707, 95%CI: 0.557-0.899) was associated with lower neck and shoulder pain prevalence rates. Doing same work every day (OR=1.704, 95%CI: 1.305-2.225) was associated with a higher neck pain prevalence rate. Awkward postures with ineffectual force (OR=1.808, 95%CI: 1.226-2.665) and often keeping arms above shoulders (OR=1.424, 95%CI: 1.017-1.992) were associated with a higher shoulder pain prevalence rate. Conclusion The prevalence rates of neck and shoulder pian are high among operation and maintenance workers of power supply enterprises in selected three provinces of North China, and the main associated factors include individual factors, awkward work postures, and labor organization.

Prevalence of work-related musculoskeletal disorders and its influencing factors among workers involving climbing task in power supply enterprises / 环境与职业医学

Background Operation and maintenance work in the power grid industry often involving climbing, manual handling, and poor postures causing serious problems like work-related musculoskeletal disorders (WMSDs). The influencing factors of WMSDs are not very clear, but the problem has been widely concerned in this industry. Objective To understand the prevalence and influencing factors of WMSDs among climbing task-involved workers in power supply enterprises. Methods Using a cross-sectional design, a total of 702 workers involving climbing task from 10 power supply enterprises in Jilin Province, Tianjin Municipality, and Shandong province were selected as study subjects using cluster sampling. The Musculoskeletal Disorders Questionnaire which was revised by Lei Yang was used to estimate the prevalence and identify related factors of WMSDs. \begin{document}$ {\chi

Excess Oxygen Supply for Different Time Periods Affect Energy Metabolism in Rat Alveolar Epithelial Type Ⅱ Cells / 中国医学科学院学报

Objective To observe the effect of excess oxygen supply for different time periods on the mitochondrial energy metabolism in alveolar epithelial type Ⅱ cells. Methods Rat RLE-6TN cells were assigned into a control group (21% O2 for 4 h) and excess oxygen supply groups (95% O2 for 1,2,3,and 4 h,res-pectively).The content of adenosine triphosphate (ATP),the activity of mitochondrial respiratory chain complex V,and the mitochondrial membrane potential were determined by luciferase assay,micro-assay,and fluorescent probe JC-1,respectively.Real-time fluorescence quantitative PCR was employed to determine the mRNA levels of NADH dehydrogenase subunit 1 (ND1),cytochrome b (Cytb),cytochrome C oxidase subunit I (COXI),and adenosine triphosphatase 6 (ATPase6) in the core subunits of mitochondrial respiratory chain complexes Ⅰ,Ⅲ,Ⅳ,and Ⅴ,respectively. Results Compared with the control group,excess oxygen supply for 1,2,3,and 4 h down-regulated the mRNA levels of ND1 (q=24.800,P<0.001;q=13.650,P<0.001;q=9.869,P<0.001;q=20.700,P<0.001),COXI (q=16.750,P<0.001;q=10.120,P<0.001;q=8.476,P<0.001;q=14.060,P<0.001),and ATPase6 (q=22.770,P<0.001;q=15.540,P<0.001;q=12.870,P<0.001;q=18.160,P<0.001).Moreover,excess oxygen supply for 1 h and 4 h decreased the ATPase activity (q=9.435,P<0.001;q=11.230,P<0.001) and ATP content (q=5.615,P=0.007;q=5.029,P=0.005).The excess oxygen supply for 2 h and 3 h did not cause significant changes in ATPase activity (q=0.156,P=0.914;q=3.197,P=0.116) and ATP content (q=0.859,P=0.557;q=1.273,P=0.652).There was no significant difference in mitochondrial membrane potential among the groups (F=0.303,P=0.869). Conclusion Short-term excess oxygen supply down-regulates the expression of the core subunits of mitochondrial respiratory chain complexes and reduces the activity of ATPase,leading to the energy metabolism disorder of alveolar epithelial type Ⅱ cells.

Analysis of the shortage of drugs in national centralized volume-based procurement and countermeasures and suggestions / 中国药房

OBJECTIVE To analyze the situation and causes of the shortage of drugs in centralized volume-based procurement， and to put forward countermeasures and suggestions for optimizing centralized procurement rules and improving the drug shortage supply guarantee system. METHODS The shortage data of the first five batches of centralized purchasing drugs during January 2019 and December 2021 were collected from the Shortage Database of Chinese medicine economic information； descriptive statistical analysis was performed for shortage frequency， varieties and reasons. RESULTS & CONCLUSIONS After the first five batches of centralized volumetric procurement policy landed， the frequency of drug shortage reported for selected specifications and selected enterprises increased significantly， mainly drug shortage of selected enterprises. The shortage of some varieties from selected enterprises in the short term was obvious， and most of them were commonly used clinical drugs. The occurrence of drug shortages was affected by various links such as the production， circulation and use， and the main reasons were shortage or monopoly of raw materials. In order to ensure the drugs supply， the government should scientifically assess the risk of production interruption of enterprises， further optimize centralized procurement rules， improve the reporting system for drug shortages， and attach importance to the supply of key drugs； in addition， hospitals should take a variety of measures within the scopes of policies to flexibly respond to drug shortages so as to avoid delaying the treatment of patients.