La Economía Circular desde la perspectiva de la empresa estatal cubana: ¿ oportunidad o necesidad en la condiciones actuales? / The Circular Economy from the perspective of the Cuban state enterprise: ¿opportunity o necessity in current condition?

La Economía Circular (EC) se ha posicionado como una alternativa viable ante la insostenibilidad del modelo económico lineal. Hoy este constituye una temática que está en el centro del debate y de todas las agendas de gobierno y Cuba no puede ser la excepción. El presente artículo persigue como objetivo principal diagnosticar el estado de la economía circular en Cuba desde la perspectiva de las empresas estatales. En este sentido se parte de sistematizar las ventajas de la aplicación de modelos circulares en el país. Se particulariza en el estudio por sectores que han avanzado en la aplicación del paradigma circular y se concluye con una propuesta de acciones estratégicas a seguir para expandir las prácticas circulares en el país, las cuales son validadas según criterio de los principales usuarios responsables de su implementación a través de la técnica de IADOV

The Circular Economy (CE) has positioned itself as aviable alternative to the unsustainability of the linear economic model. Today this is an issue that is at the center of the debate and of all government agendas, and Cuba cannot be the exception. The main objective of this article is to diagnose the state of the circular economy in Cuba from the perspective of public enterprises. e study is particularized to analyze separately the advance of the different sectors in the application of the circular paradigm. It concludes with a proposal of strategic actions to be followed to expand circular practices in the country, which are validated according to the criteria of the main users responsible for their implementation through the IADOV technique

Pertinencia de la atención de la salud mental de conductores para lograr que sean competitivos

Fundamento: Cuidar la salud mental de los conductores de vehículos, es indispensable para que estos sean competitivos y para prevenir accidentes de tránsito, debido a que una de las causas de los accidentes, es la deficiente salud mental de los conductores. Objetivo: Determinar la pertinencia de la atención en salud mental de conductores de vehículos para evitar accidentes y para que sean competitivos. Métodos: La muestra fue de 219 conductores y cobradores de transporte terrestre en Trujillo, La Libertad, Perú; que contestaron el Test de Bienestar General-5, anteriormente aplicado en el Perú por otros investigadores, conformado por 5 preguntas compuestas. La prueba de Hipótesis nula (Ho) y alterna (Ha); se plantearon con una respecto al puntaje decisorio de 54,75 puntos. Resultados: Para las preguntas 2 y 4 se aprobó la hipótesis alterna con la indicación de que es pertinente la atención de salud mental para conductores para que puedan estar relajados; descansen bien e inicien el día sintiéndose sosegados. Para las preguntas 1, 3 y 5 se aceptó la hipótesis nula. Conclusiones: se percibe que los promedios más bajos se corresponden con las preguntas 2 y 4, entonces es pertinente la atención en salud mental para que los conductores de transporte público, puedan recibir asistencia psicológica para sentirse relajados y descansados. Para las demás preguntas se acepta la hipótesis nula.

Foundation: Taking care of the mental health of vehicle drivers is essential for them to be competitive and to prevent traffic accidents because one of the causes of accidents is the poor mental health of drivers. Objective: Determine the relevance of mental health care for vehicle drivers to avoid accidents and to make them competitive. Methods: The sample was 219 drivers and collectors of land transportation in Trujillo, La Libertad, Peru; who answered the General Well-being Test-5, previously applied in Peru by other researchers, made up of 5 composite questions. The null (Ho) and alternate (Ha) hypothesis test; were raised with a respect to the decisive score of 54.75 points. Results: For questions 2 and 4, the alternative hypothesis was approved with the indication that mental health care for drivers is pertinent so that they can be relaxed; also so that they rest well and start the day feeling well rested. For questions 1, 3 and 5, the null hypothesis was accepted. Conclusions: It is perceived that the lowest averages correspond to questions 2 and 4, then mental health care is pertinent for public transport drivers, so that they can receive psychological assistance to feel relaxed and rested. For the other questions, the null hypothesis is accepted.

Causas precipitantes de crisis hiperglicémicas agudas en pacientes internados en el Centro Médico Nacional - Hospital Nacional / Precipiting causes of acute hyperglycemic crisis in patients in the Centro Médico Nacional - Hospital Nacional

Introducción: las crisis hiperglicémicas agudas son las emergencias endocrinológicas más frecuentes en la práctica clínica y junto a la hipoglucemia se las describe como las complicaciones metabólicas agudas graves del paciente diabético. Objetivo: identificar las causas precipitantes de crisis hiperglicémicas agudas en pacientes internados en el Centro Médico - Hospital Nacional. Metodología: estudio observacional, descriptivo, de corte transversal de pacientes internados en el Centro Médico Hospital Nacional, durante el periodo de mayo 2021 a octubre del 2023. Los datos fueron obtenidos con la revisión de las fichas clínicas. Resultados: de los 100 pacientes evaluados, la crisis hiperglicémica aguda más frecuente fue la Cetoacidosis diabética (CAD) 53 %, seguida del Estado hiperosmolar hiperglicémico (EHH) 25 % y el estado mixto 22 %. Los desencadenantes más frecuentes fueron el abandono del tratamiento, debut de la enfermedad e infecciones. La mortalidad global fue del 12 %. Conclusión: la causa más frecuente de descompensación fueron el abandono del tratamiento, la diabetes de novo y procesos infecciosos.

Introduction: hyperglycemic crises are the most frequent endocrinological emergencies in clinical practice and, along with hypoglycemia, are described as serious acute metabolic complications in diabetic patients. Objective: to identify the precipiting causes of acute hyperglycemic crisis in hospitalized patients in the Centro Médico Nacional - Hospital National. Methodology: this was an observational, descriptive, cross -sectional study of patients hospitalized at the Centro Médico Nacional - Hospital National, from May 2021 to October 2023. The data were obtained from a review of the clinical records. Results: Of the 100 patients evaluated, the most frequent acute hyperglycemic crisis was diabetic ketoacidosis (CAD) 53 %, followed by the hyperglycemic hyperosmolar state (EHH) 25 % and the mixed state 22 %. The most frequent triggers were the abandonment of treatment, disease debut and infections. Global mortality was 12 %. Conclusion: the most frequent causes of decompensations were abandoning treatment, novo diabetes and infectious processes.

Availability of resources for paediatric hearing care in a South African province

Background: Unavailability of healthcare resources can lead to poor patient outcomes. The latter is true for infants with hearing loss and require early hearing detection and intervention (EHDI). Aim: To determine the availability and distribution of resources for EHDI in state hospitals in the Eastern Cape (EC) province, South Africa. Setting: Sixteen state hospitals (nine district, four regional and three tertiary hospitals). Methods: Descriptive cross-sectional survey completed between July 2022 and October 2022. Results: Thirteen hospitals had audiologists (n = 4) or speech therapists and audiologists (n = 9). Specific to equipment, 10 hospitals had a screening otoacoustic emissions or automated auditory brainstem response, 8 hospitals had diagnostic middle ear analysers and only 3 hospitals had diagnostic auditory brainstem response and/or auditory steady state response. Twelve hospitals did not have visual response audiometry (VRA) and 94% had no hearing aid verification systems. Budget allocations were uneven, with only 10 hospitals, i.e., 4 districts, all regional and 2 tertiary hospitals being allocated varying amounts. Subsequently, only 50% provided newborn hearing screening, 56% provided diagnostic evaluations and 14 hospitals fitted hearing aids. Conclusion: Results revealed a limited and uneven distribution of resources, which negatively impacted the provision of EHDI. Even distribution of healthcare resources and further research aimed at strengthening hearing health services is recommended as these could potentially improve equitable access to EHDI and the overall quality of healthcare provided. Contribution: This study highlights the need for even distribution of resources and strengthening of health systems, especially in the dawn of the National Health Insurance.

Challenges in the study of self-assembled aggregates in decoction of traditional Chinese medicine: A preliminary review / 药学学报

Decoction is the most commonly used dosage form in the clinical treatment of traditional Chinese medicine (TCM). During boiling, the violent movement of various active ingredients in TCM creates molecular forces such as hydrogen bonding, π-π stacking, hydrophobic interactions and electrostatic interactions, which results in the formation of self-assembled aggregates in decoction (SADs), including particles, gels, fibers, etc. It was found that SADs widely existed in decoction with biological activities superior to both effective monomers and their physical mixtures, providing a new idea to reveal the pharmacodynamic material basis of Chinese herbal medicine from the perspective of component interactions-phase structure. Recently, SADs have become a novel focus of research in TCM. This paper reviewed their relevant studies in recent years and found some issues to be concerned in the research, such as the polydispersity of decoction system, instability of active ingredient interactions during boiling, uncertainty of the aggregates self-assembly rules, and stability, purity, yield of the products. In this regard, some solutions and new ideas were presented for the integrated development and clinical application of SADs.

Exploration of Decision-Making Methods Based on Syndrome Differentiation by “Data-Knowledge” Dual-Driven Models： A Case Study of Gastric Precancerous State / 中医杂志

Data analysis models may assist the transmission of traditional Chinese medicine （TCM） experience and clinical diagnosis and treatment， and the possibility of constructing a “data-knowledge” dual-drive model was explored by taking gastric precancerous state as an example. Data-driven is to make clinical decisions around data analysis， and its syndrome-differentiation decision-making research relies on hidden structural models and partially observable Markov decision-making processes to identify the etiology of diseases， syndrome elements， evolution of pathogenesis， and syndrome differentiation protocols； knowledge-driven is to make use of data and information to promote decision-making and action processes， and its syndrome-differentiation decision-making research relies on convolutional neural networks to improve the accuracy of local disease identification and syndrome differentiation. The “data-knowledge” dual-driven model can make up for the shortcomings of single-drive numerical simulation accuracy， and achieve a balance between local disease identification and macroscopic syndrome differentiation. On the basis of previous research， we explored the construction method of diagnostic assisted decision-making platform for gastric precancerous state， and believed that the diagnostic and decision-making ability of doctors can be extended through the assistance of machines and algorithms. Meanwhile， the related research methods were integrated and the core features of gastric precancerous state based on TCM syndrome differentiation and endoscopic pathology diagnosis and prediction were obtained， and the elements of endoscopic pathology recognition based on TCM syndrome differentiation were explored， so as to provide ideas for the in-depth research and innovative application of cutting-edge data analysis technology in the field of intelligent TCM syndrome differentiation.

Efficacy and safety of paclitaxel albumin assisted platinum chemotherapy in the treatment of recurrent and metastatic cervical cancer based on tumor factors and inflammatory status / 中国临床药理学与治疗学

AIM: To investigate the efficacy and safety of paclitaxel albumin assisted platinum chemotherapy in the treatment of recurrent and metastatic cervical cancer based on tumor factors and inflammatory status. METHODS: A total of 100 patients with recurrent and metastatic cervical cancer in our hospital from January 2020 to January 2023 were randomly divided into two groups: 50 patients in the control group were treated with paclitaxel-assisted nedaplatin regimen, and 50 patients in the study group were treated with paclitaxel-assisted nedaplatin regimen. The short-term efficacy, tumor factors, inflammatory factors, relapse-metastasis related indexes, quality of life, functional status and adverse reactions were compared between the two groups. RESULTS: The total remission rate of the study group (72.00%) was higher than that of the control group (48.00%) (P0.05), but the total incidence of adverse reactions (12.00%) was lower than that of the control group (32.00%) (P<0.05). CONCLUSION: Paclitaxel albumin-assisted nedaplatin has a reliable effect in the treatment of recurrent and metastatic cervical cancer, which can further reduce the level of tumor factors, relieve inflammation, and has high safety.

Biological Connotation of Disease-stage-state of Hypertension in Concept of State-target Differentiation and Treatment From Perspective of Lipophagy / 中国实验方剂学杂志

Hypertension is a common chronic disease with elevated arterial pressure as the main clinical manifestation，which can cause lesions in important organs such as heart，brain and kidney. In recent years，the prevalence of hypertension has increased，and its incidence is also increasing year by year. Combining the theory of traditional Chinese medicine （TCM） with personal clinical experience，Academician TONG Xiaolin put forward the specific pathogenesis of "disease-stage-state" of hypertension based on the state-target theory. Lipophagy plays an important role in the pathogenesis of hypertension by interfering with lipid metabolism，atherosclerosis，arterial plaque formation，vascular remodeling，vascular endothelial injury and other aspects of hypertension. Through modern medical and biological research，on the one hand，it is believed that the dynamic pathological changes in lipophagy are closely related to the "stage" of hypertensive state-target differentiation and treatment，corresponding to the time points of disease occurrence and development in the three stages of hypertension. On the other hand，it is believed that lipophagy is an important microscopic manifestation of the "state" of hypertensive state-target differentiation and treatment. From the perspective of lipophagy，this paper discusses the biological connotation of the 'disease-stage-state' model of state-target differentiation and treatment of hypertension and draws on the modern medicine to understand the law of disease development，matching the macro differentiation and treatment of TCM and the micro physico-chemical indicators of modern medicine to achieve precise TCM treatment. This study provides new ideas for the early prevention and treatment of hypertension and its complications.

Research progress on brain functional near-infrared spectroscopy technology in the field of neonates / 中国当代儿科杂志

Functional near infrared spectroscopy (fNIRS) is an emerging neuroimaging tool that reflects the activity and function of brain neurons by monitoring changes in brain oxygen metabolism based on the neurovascular coupling mechanism. It is non-invasive and convenient, especially suitable for monitoring neonatal brain function. This article provides a comprehensive review of research related to the developmental patterns of brain networks concerning language, music, and emotions in neonates using fNIRS. It also covers brain network imaging in neonatal care, resting-state brain network connectivity patterns, and characteristics of brain functional imaging in disease states of neonates using fNIRS.

Baixos Níveis de Atividade Física e suas Associações com o Estado de Humor, Sonolência Diurna e Consumo Alimentar em Universitários / Low Levels of Physical Activity and its Associations with Mood State, Daytime Sleepiness and Food Consumption in University Students

O ingresso em um curso universitário leva a mudanças significativas no estilo de vida e na rotina do estudante, com impacto na prática de atividade física, saúde mental, hábitos de sono e hábitos alimentares. O objetivo do estudo foi verificar o nível de atividade física dos jovens universitários e suas associações com estado de humor, qualidade do sono e consumo alimentar. Trata-se de uma pesquisa de corte transversal, realizada com estudantes universitários do curso de Medicina de uma Instituição de Ensino Superior Pública. Realizou-se avaliação de medidas antropométricas, do nível de atividade física (NAF) por meio do acelerômetro GT3x (Actigraph), do consumo alimentar (inventário de 24h), e utilizando os questionários de BECK e BRUMs / POMS avaliou-se os distúrbios de sono e estado de humor. Utilizando o software SPSS realizou análise comparativa com teste t Student para grupos independentes, análise inferencial de correlação de Pearson e Regressão logística binária. Dos universitários analisados (n=75), 54,7% (n=41) eram do sexo masculino e, quando comparado com as mulheres, apresentaram maior nível de atividade física (NAF). Aproximadamente 1/3 de toda a amostra do estudo realizou menos de 300min de atividade física moderada/vigorosa. O perfil alimentar dos universitários não foi satisfatório. Verificou-se para ambos os sexos o Escore Total de POMS (Profile of Mood States) se associou com universitários que realizam menos de 300min de atividade física por semana. As mulheres têm 65% mais chances de apresentar Escala de Tensão (POMS) quando são menos ativas, e nos homens, a razão de chances é de aproximadamente três vezes maior de apresentar Confusão (BRUMS - Escala de Humor de Brunel). Conclui-se que os estudantes universitários do curso estudado, em sua maioria, foram insuficientemente ativos fisicamente e apresentam algumas alterações no estado de humor, sonolência diurna e um consumo alimentar insatisfatório.

Starting a university course leads to significant changes in the student's lifestyle and routine, with an impact on physical activity, mental health, sleeping habits and eating habits. The objective of the study was to verify the level of physical activity of young university students and its associations with mood, sleep quality and food consumption. This is a cross-sectional survey, carried out with university students studying Medicine at a Public Higher Education Institution. Anthropometric measurements, physical activity level (PAL) were assessed using the GT3x accelerometer (Actigraph), food consumption (24-hour inventory), and using the BECK and BRUMs / POMS questionnaires, health disorders were assessed. sleep and mood. Using SPSS software, comparative analysis was carried out with Student's t test for independent groups, Pearson correlation inferential analysis and binary logistic regression. Of the university students analyzed (n=75), 54.7% (n=41) were male and, when compared to women, they had a higher physical activity level (PAL). Approximately 1/3 of the entire study sample performed less than 300 minutes of moderate/vigorous physical activity. The dietary profile of university students was not satisfactory. For both sexes, the POMS Total Score (Profile of Mood States) was found to be associated with university students who perform less than 300 minutes of physical activity per week. Women are 65% more likely to present with Tension Scale (POMS) when they are less active, and in men, the odds ratio is approximately three times greater for presenting Confusion (BRUMS - Brunel Mood Scale). It is concluded that the majority of university students on the course studied were insufficiently physically active and presented some changes in mood, daytime drowsiness and unsatisfactory food consumption.

A systematic review and meta-analysis on abnormal posturing among brain injury patients / Uma revisão sistemática e metanálise sobre postura anormal entre pacientes com lesão cerebral

Abstract Background Abnormal motor posturing (AMP), exhibiting as decorticate, decerebrate, or opisthotonos, is regularly noticed among children and adults. Objective This systematic review and meta-analysis examined the risk factors and outcome of posturing among severe head and brain injury subjects. Methods Based on the inclusion and exclusion criteria and using MeSH terms: "decerebrate posturing", "opisthotonic posturing", "brain injury", and/or "cerebral injury" articles were searched on Scopus, PubMed, Science Direct, and google scholar databases. Observational studies, case series, and case reports were included. Results A total of 1953 studies were retrieved initially, and based on the selection criteria, 20 studies were finally selected for review and were analyzed for meta-analysis based on the mortality between the hematomas. The functional outcomes of this study are the risk factors, mortality rate and Glasgow Outcome Scale. Decerebrative patients were higher among the studies related to head injury surgeries. Males were mainly treated for decerebrate postures compared with the female subjects. Extradural hematoma and acute subdural hematoma with cerebral contusion were quite common in the surgical mass lesions. Conclusion The findings reported that the lesion types, the operative procedures, and the age of the decerebrating patients with brain injuries are the significant prognostic factors determining the survival outcomes.

Resumo Antecedentes Postura motora anormal (AMP), exibindo-se como decorticada, descerebrada ou opistótono, é regularmente observada entre crianças e adultos. Objetivo Esta revisão sistemática e metanálise examinou os fatores de risco e os resultados da postura entre indivíduos com lesões graves na cabeça e no cérebro. Métodos Com base nos critérios de inclusão e exclusão e usando termos MeSH: artigos sobre "postura descerebrada", "postura opistótona", "lesão cerebral" e/ou "lesão cerebral" foram pesquisados nas bases de dados Scopus, PubMed, Science Direct e Google Scholar. Foram incluídos estudos observacionais, séries de casos e relatos de casos. Resultados Um total de 1.953 estudos foram recuperados inicialmente e, com base nos critérios de seleção, 20 estudos foram finalmente selecionados para revisão e analisados para metanálise com base na mortalidade entre os hematomas. Os resultados funcionais deste estudo são os fatores de risco, taxa de mortalidade e Escala de Resultados de Glasgow. Os pacientes descerebrados foram maiores entre os estudos relacionados a cirurgias de traumatismo cranioencefálico. Os homens foram tratados principalmente para posturas descerebradas em comparação com as mulheres. Hematoma extradural e hematoma subdural agudo com contusão cerebral foram bastante comuns nas lesões de massa cirúrgica. Conclusão Os achados relataram que os tipos de lesões, os procedimentos operatórios e a idade dos pacientes descerebrados com lesões cerebrais são os fatores prognósticos significativos que determinam os resultados de sobrevivência.

Manda pra um, joga pra outro: a emergência sanitária da zika nas margens do Estado / Send it to one, throw it to another: the Zika health emergency on the margins of the State

Resumo Distantes temporalmente da declaração da emergência em saúde pública de importância internacional (ESPII) e emergência em saúde pública de importância nacional (ESPIN) provocada pela epidemia de zika, no ano de 2015, enunciamos a herança da emergência humanitária. Com base em uma pesquisa qualitativa, por meio de grupos focais realizados com profissionais de saúde e familiares das crianças afetadas epidemia de zika em Natal e Feira de Santana, buscamos discutir esse fenômeno de saúde pública pelas lentes da Antropologia do Estado. Concluímos que o não reconhecimento do Estado como uma instância encarnada no cotidiano das práticas por parte dos seus agentes locais leva à reprodução de práticas discriminatórias esvaziadas de sentido político e do reconhecimento de moralidades que permeiam as ausências nas ações de promoção de saúde e estratégias de reconhecimento e busca por estratégias para a garantia do direito à saúde.

Abstract Temporarily distant from the declaration of the Public Health Emergency of International Importance (ESPII) and Public Health Emergency of National Importance (ESPIN) caused by the Zika epidemic, in 2015, we enunciate the legacy of the humanitarian emergency. Based on qualitative research, through focus groups with health professionals and families of children affected by the Zika epidemic in Natal and Feira de Santana, we seek to discuss this public health phenomenon through the lens of State Anthropology. We conclude that the non-recognition of the State as an instance embodied in the daily practices of its local agents leads to the reproduction of discriminatory practices emptied of political sense and the recognition of moralities that permeate the absences in health promotion actions and recognition strategies, and search for methods to guarantee the right to health.

Contribuições da ética da alteridade para os estudos da deficiência: um estado da arte / Contribuciones de la ética de la alteridad a los estudios de discapacidad: un estado del arte / Contributions from the ethics of alterity to the disability studies: a state of art

RESUMO. O avanço de legislações nacionais e internacionais contribuiu para a reafirmação da dignidade e dos direitos fundamentais das pessoas com deficiência. Ainda assim, a efetiva participação sociocultural dessa população é prejudicada pelas barreiras discriminatórias impostas nos mais diversos âmbitos da sociedade. Faz-se necessário, portanto, promover reflexões sobre a 'cultura da normalidade', e sua consequente influência em situações de exclusão, opressão e discriminação dos sujeitos com deficiência. A presente pesquisa teve como objetivo analisar o conceito de deficiência na contemporaneidade sob a ótica da filosofia de Emmanuel Levinas, autor responsável por tecer críticas ao pensamento filosófico ocidental, principalmente às ações de exclusão e discriminação da alteridade dele decorrentes. Para tanto, utilizou-se o método do Estado da Arte, coletando-se 12 artigos, 11 dissertações e quatro teses. Os trabalhos foram categorizados de maneira quantitativo-descritiva e, posteriormente, analisados a partir da obra Totalidade e infinito e dos estudos contemporâneos sobre deficiência, ética e responsabilidade. Observou-se uma análise crítica dos trabalhos em relação às atuais ações e intervenções voltadas ao público com deficiência, denunciando sua insuficiência na garantia de direitos fundamentais. Constatou-se também a necessidade de substituição de concepções totalizantes e universalizantes das diferenças por perspectivas de reconhecimento do Outro e consideração da singularidade humana. Conclui-se que a Ética da Alteridade, proposta por Levinas, convida ao compromisso infinito do Mesmo para com o Outro, à ajuda sem espera de reciprocidade, fazendo-se, portanto, relevante nos campos político e acadêmico como princípio ético, teórico-prático e analítico para a interpretação de questões relativas à deficiência.

RESUMEN. El avance de la legislación nacional e internacional ha contribuido a reafirmar la dignidad y los derechos fundamentales de las personas con discapacidad. Todavia, la participación sociocultural efectiva de esta población se ve obstaculizada por las barreras discriminatorias impuestas en los más diversos ámbitos de la sociedad. Por tanto, es necesario promover reflexiones sobre la 'cultura de la normalidad' dominante, y su consecuente influencia en situaciones de exclusión, opresión y discriminación de sujetos con discapacidad. Esta investigación tuvo como objetivo analizar el concepto de discapacidad en la época contemporánea desde la perspectiva filosófica de Emmanuel Levinas, autor responsable de criticar el pensamiento filosófico occidental, especialmente las acciones de exclusión y discriminación de la alteridad que de él resultan. Para ello se utilizó el método del estado del arte, recogiendo 12 artículos, 11 disertaciones y 4 tesis. Las obras fueron categorizadas de manera cuantitativo-descriptiva y posteriormente analizadas a partir de la obra Totalidade e infinito y estudios contemporáneos sobre discapacidad, ética y responsabilidad. Se observó un análisis crítico de las obras en relación a las acciones e intervenciones actuales dirigidas al público con discapacidad, denunciando su insuficiencia en la garantía de los derechos fundamentales. También se señaló la necesidad de reemplazar las concepciones totalizadoras y universalizadoras de las diferencias por perspectivas de reconocimiento del Otro y consideración de la singularidad humana. Se concluye que la Ética de la Alteridad, propuesta por Levinas, invita a la implicación del Mismo hacia el Otro, para ayudar sin esperar a la reciprocidad, volviéndose, por tanto, relevante en los campos político y académico como un enfoque ético, teórico-práctico y marco analítico para la interpretación de las cuestiones relacionadas con la discapacidad.

ABSTRACT. The advancement of national and international laws has contributed to reassuring the dignity and fundamental rights of people with disabilities. Even so, the effective sociocultural participation of these people is jeopardized by discriminatory barriers imposed across multiple spheres of society. Therefore, it is necessary to promote reflections about 'normality culture' and its consequences in situations of exclusion, oppression, and discrimination of people with disabilities. This study aimed to analyze the contemporary concept of disability in the light of Emmanuel Levinas's philosophy, author responsible for criticizing Western philosophy affirming that the exclusion of alterity stems from it. To this end, a State of the Art analysis was done, and 12 papers, 11 master's theses, and 4 doctoral dissertations were found. The works were classified by quantitative characteristics and were later analyzed in the light of Levinas's major work, Totalidade e infinito, and the contemporary studies on disability, ethics, and responsibility. It was observed that the works had done critical analyses about governmental actions and interventions destined to people with disabilities, showing the insufficiency in ensuring fundamental rights of these people. We also identified the need to substitute conceptions that totalize and universalize the differences with perspectives that recognise the Other in its singularity. This article concludes that the Ethics of Alterity proposed by Levinas invites one to infinite commitment of the Self to the Other, who does not expect anything in return to the aid provided. Therefore, it is relevant to politics and the academic field as an ethical, theoretical, practical, and analytical principle to interpret questions relating to the field of disability studies.

Malaria in a vulnerable population living in quilombo remnant communities in the Brazilian Amazon: a cross-sectional study from 2005-2020

ABSTRACT Quilombo remnant communities are areas officially recognized by the Brazilian government as historical communities founded by formerly enslaved individuals. These communities are mostly located in the endemic areas of malaria in the Brazilian Amazon. We retrospectively described the prevalence of malaria among individuals living in 32 recognized quilombo remnant communities in the Baiao and Oriximina municipalities located in the Para State. The number of malaria cases and the Annual Parasitic Incidence (API) recorded by the Brazilian malaria surveillance system (SIVEP-Malaria) from January 2005 to December 2020 were analyzed. We found that all communities registered at least one case over the 16-year period, the most frequent parasitic species being Plasmodium vivax (76.1%). During this period, 0.44% (4,470/1,008,714) of the malaria cases registered in Para State were reported in these quilombo remnant communities, with frequencies of 10.9% (856/7,859) in Baiao municipality and 39.1% (3,614/9,238) in Oriximina municipality, showing that individuals living in these rural communities are exposed to malaria. These data indicate that effective surveillance requires improved measures to identify malaria transmission among vulnerable populations living in quilombo remnant communities in the Brazilian Amazon.

Angle-closure glaucoma associated with vitreous prolapse after neodymium-doped yttrium-aluminum-garnet laser posterior capsulotomy

ABSTRACT Capsulotomy with neodymium-doped yttrium--aluminum-garnet (Nd:YAG) laser is an effective treatment for posterior capsule opacification following cataract surgery. A wide opening of the posterior capsule associated with the ruptured anterior hyaloid can cause anterior chamber vitreous prolapse. Two patients who developed angle-closure glaucoma associated with vitreous prolapse following Nd:YAG laser posterior capsulotomy were successfully treated with antiglaucoma medication and peripheral iridotomies. Patient identification for potential risk factors and a careful postoperative follow-up are essential to avoid these serious complications.

Long-term evaluation of the efficacy and safety of Nd:YAG laser vitreolysis for symptomatic vitreous foaters / Avaliação de longo prazo da eficácia e segurança da vitreólise com Nd:YAG laser para moscas volantes sintomáticas

ABSTRACT Purpose: This study aimed to evaluate the long-term safety and efficacy of neodymium-doped yttrium aluminum garnet (Nd:YAG) vitreolysis for symptomatic vitreous floaters as it remains a controversial procedure due to insufficient robust evidence in the literature for the maintenance of the results and absence of adverse effects. Methods: This is an observational extension to the previously presented prospective, randomized, double-blind clinical trial. Eight of thirteen subjects who underwent vitreolysis with YAG laser returned for a late reevaluation, 18 months after the procedure, to evaluate the efficacy and safety of the procedure. Results: All patients maintained the improvement in symptomatology noted after the procedure, with 25% showing complete improvement and a similar proportion (37.5%) reporting significant or partial improvement. Objective improvement in opacity was similar to that found at 6 months follow-up. The NEI-VFQ 25 quality of life questionnaire showed no statistically significant difference in responses between the 6th and 18th month. No adverse effects were noted on clinical examination or reported by patients. Conclusion: Vitreolysis efficacy observed at 6 months of follow-up was maintained until the eighteenth month, with all patients reporting improvement from the pre-procedure state. No late adverse effects were noted. A larger randomized clinical trial is needed to confirm the safety of the procedure.

RESUMO Objetivos: Avaliar a segurança e eficácia a longo prazo da vitreólise com Nd:YAG laser para moscas volantes sintomáticas, uma vez que permanece como um procedimento controverso devido a falta de evidência científica robusta sobre a manutenção dos resultados e ocorrência de efeitos adversos. Métodos: Este estudo é uma extensão observacional de um ensaio clínico prospectivo, randomizado, duplo cego, previamente publicado. Oito de treze pacientes que foram submetidos a vitreólise com YAG laser foram acompanhados para uma reavaliação tardia, dezoito meses após o procedimento, para avaliar a eficácia e segurança do procedimento. Resultados: Todos os pacientes mantiveram a melhora na sintomatologia notada ao final do procedimento original, com 25% dos casos apresentando melhora completa, e uma proporção semelhante (37,5%) demonstrando melhora significativa ou parcial. A melhora objetiva na opacidade foi similar ao achado no seguimento original de 6 meses. O questionário de qualidade de vida NEI-VFQ 25 não demonstrou diferença estatisticamente significativa nas respostas entre o sexto e o décimo oitavo mês de acompanhamento. Nenhum efeito adverso foi notado no exame clínico ou reportado pelos pacientes. Conclusão: A eficácia da vitreólise observada ao sexto mês do acompanhamento foi mantida até o décimo oitavo mês, com todos os pacientes notando algum grau de melhora quando comparado ao estado pré procedimento. Nenhum efeito adverso tardio foi notado. Um ensaio clínico randomizado maior é necessário para confirmar a segurança do procedimento.

Spatial distribution of acute cases of Chagas disease reported from 2010 to 2020 in the State of Amazonas / Distribuição espacial dos casos agudos de doença de Chagas notificados de 2010 a 2020 no Estado da Amazônia / Distribución espacial de los casos agudos de enfermedad de Chagas notificados de 2010 a 2020 en el Estado Amazónico

This study aimed to investigate the epidemiology of acute cases of Chagas disease notified in the State of Amazonas between the period from 2010 to 2020. Data were obtained from the portal of the Sistema de Informação de Agravos de Notificação- SINAN, considering the number of cases per municipality of notification. 140 cases of Acute Chagas Disease were notified, distributed in 23 of the 62 municipalities of the State of Amazonas, 82 (59%) were male individuals, with a greater predominance in the age group of 20-39 years old, having 45 (32.1%) cases. As for the race/color variable, the highest number was among brown people with 101 (72.1%) notifications. The oral route prevailed as the main form of disease transmission with 93 (66.4%) records. Infection by the oral route of T. cruzi is the most important route of transmission of CD in the State of Amazonas, the occurrence of transmission is associated in most cases with the consumption of foods such as açaí juice and has been reported frequently over the years between municipalities.

este estudo se propôs a investigar a epidemiologia dos casos agudos de Doença de Chagas notificados no Estado do Amazonas no período de 2010 a 2020. Os dados foram obtidos no portal do Sistema de Informação de Agravos de Notificação - SINAN, considerando o número de casos por município de notificação. Foram notificados 140 casos de Doença de Chagas Aguda, distribuídos em 23 dos 62 municípios do Estado do Amazonas, 82 (59%) eram indivíduos do sexo masculino, com maior predominância na faixa etária de 20-39 anos de idade com 45 (32,1%) casos. Quanto a variável raça/cor, a maior registro foi entre pardos com 101(72,1%) notificações. A via oral, prevaleceu como a principal forma de transmissão da patologia com 93 (66,4%) registros. A infecção pela via oral do T. cruzi, é a mais importante via de transmissão de DC no Estado do Amazonas, a ocorrência da transmissão está associada na maioria das vezes ao consumo de alimentos como o suco de açaí, e tem sido reportada com frequência ao longo dos anos entre os municípios.

Este estudio tuvo como objetivo investigar la epidemiología de los casos agudos de la enfermedad de Chagas notificados en el Estado de Amazonas en el período de 2010 a 2020. Los datos fueron obtenidos del portal del Sistema de Información de Enfermedades de Notificación - SINAN, considerando el número de casos por municipio de notificación. Se notificaron 140 casos de Enfermedad de Chagas Aguda, distribuidos en 23 de los 62 municipios del Estado de Amazonas, 82 (59%) fueron individuos del sexo masculino, con mayor predominio en el grupo etario de 20 a 39 años con 45 (32,1%) casos. En cuanto a la variable raza/color, el mayor número fue entre los morenos con 101 (72,1%) notificaciones. La vía oral predominó como principal vía de transmisión de la enfermedad con 93 (66,4%) registros. La infección por vía oral de T. cruzi es la vía de transmisión más importante de la EC en el Estado de Amazonas, la ocurrencia de la transmisión está mayoritariamente asociada al consumo de alimentos como el jugo de açaí, y ha sido reportada con frecuencia a lo largo de los años entre municipios.

Comunicação pública da ciência e da saúde no pós-pandemia / Post-pandemic science and health public communication / Comunicación pública de la ciencia y de la salud tras la pandemia

A pandemia de covid-19 demonstrou a relevância da comunicação pública da saúde e da ciência, mas também evidenciou suas fragilidades. No Brasil, como em outras partes do mundo, a desinformação foi institucionalizada, com grave impacto na saúde dos cidadãos. Após a pandemia, coloca-se o desafio de estruturar políticas públicas de comunicação para combater a desinformação e de fortalecer a carreira de comunicador público como suporte a essas políticas. A mobilização de organizações da sociedade civil ligadas ao tema produziu um projeto de Lei Geral da Comunicação Pública que tramita na Câmara dos Deputados. Também permitiu incluir o estabelecimento de uma política de comunicação para o Sistema Único de Saúde entre as diretrizes aprovadas pela 17ª Conferência Nacional de Saúde

The covid-19 pandemic demonstrated the relevance of public health and science communication, but also highlighted its weaknesses. In Brazil, as in other parts of the world, disinformation has been institutionalized, with a serious impact on the health of citizens. After the pandemic, there is a challenge of structuring public communication policies to combat disinformation and to strengthen the career of public communicator to support these policies. The mobilization of civil society organizations linked to these issues produced a public communication bill which is currently discussed in the Chamber of Deputies. It also made it possible to include the establishment of a communication policy for the Unified Health System among the guidelines approved by the 17th National Health Conference

La pandemia de covid-19 demostró la relevancia de la comunicación pública de la salud y de la ciencia, pero también puso de relieve sus debilidades. En Brasil, como en otras partes del mundo, la desinformación ha sido institucionalizada, con un grave impacto en la salud de los ciudadanos. Después de la pandemia, queda el desafío de estructurar políticas públicas de comunicación para combatir la desinformación y también de estructurar la carrera de comunicador público para apoyar estas políticas. La movilización de organizaciones de la sociedad civil vinculadas al tema ha producido un proyecto de Ley General de Comunicación Pública que se encuentra en trámite en la Cámara de Diputados. También permitió incluir el establecimiento de una política de comunicación para el Sistema Único de Salud entre las directrices aprobadas por la XVII Conferencia Nacional de Salud

Statelessness of Children born to Venezuelan Parents in Colombia: Lawmaking without Convincing Policies

This article examines the Colombian legislation against statelessness issued due to the humanitarian emergency in Venezuela in recent years. There have been three waves of Venezuelan migration: the first, in 2005; the second, in 2017; and the last wave, from 2017 to the present day. For this analysis, it was used a qualitative socio-legal method adopting a descriptive approach. The paper affirms that, despite the efforts of Colombian entities to regulate the statelessness of minors born to Venezuelan parents, these regulations contain legal vacua due to a lack of communication between the different State bodies. Such void causes legal contradictions and legal uncertainty in the national system, and, subsequently, violates in a direct manner the fundamental rights of children born to Venezuelan migrants in Colombia.

En el presente artículo se analiza la legislación colombiana contra la apatridia expedida a raíz de la migración ocasionada por la emergencia humanitaria en Venezuela durante los últimos años. La migración venezolana se puede dividir en tres oleadas, la primera en el año de 2005, la segunda en el año de 2010 y la última desde el año de 2017 hasta la actualidad. Para la realización del presente artículo, se utilizó el método cualitativo de carácter sociojurídico con un enfoque descriptivo. Finalmente, se concluye que, a pesar del esfuerzo de las entidades colombianas por regular la apatridia de los menores hijos de padres venezolanos, dicha legislación presenta vacíos normativos por la falta de comunicación de los diferentes órganos del Estado. Dichos vacíos crean contradicciones, generan inseguridad jurídica en el ordenamiento nacional y, ulteriormente, violentan de manera directa los derechos fundamentales de los menores hijos de migrantes venezolanos nacidos en Colombia.

Este artigo analisa a legislação colombiana contra a apatridia emitida como resultado da migração causada pela emergência humanitária na Venezuela nos últimos anos. A migração venezuelana pode ser dividida em três ondas, a primeira em 2005, a segunda em 2010 e a última de 2017 até o presente. Para este artigo, usamos um método sociojurídico qualitativo com uma abordagem descritiva. Por fim, conclui-se que, apesar dos esforços das entidades colombianas para regulamentar a apatridia de menores nascidos de pais venezuelanos, essa legislação apresenta lacunas regulatórias devido à falta de comunicação entre os diferentes órgãos do Estado. Essas lacunas criam contradições, geram insegurança jurídica no sistema jurídico nacional e, consequentemente, violam diretamente os direitos fundamentais das crianças nascidas na Colômbia de migrantes venezuelanos.

Isquemia aguda por trombosis aórtica en COVID-19: A propósito de un caso

Objetivo: Presentar un caso de isquemia aguda por trombosis aórtica en paciente con infección por COVID-19 y exponer la importancia del diagnóstico y manejo oportuno. Introducción: El coronavirus (COVID-19) afecta principalmente al tracto respiratorio, pero presenta predisposición a fenómenos trombóticos y sus complicaciones, siendo una de las más graves la isquemia aguda por trombosis aórtica. Caso clínico: Paciente masculino de 68 años, que cursa con cuadro clínico de neumonía grave por COVID-19, presenta de forma concomitante episodio de trombosis aórtica aguda, resultando con isquemia aguda de extremidades inferiores. Se realizó trombectomía, post procedimiento y asociado a reperfusión, presentó paro cardiorrespiratorio con asistolia sostenida, falleciendo pese a maniobras de reanimación. Conclusión: Pese a las medidas de profilaxis con heparina de bajo peso molecular (HBPM), se deben sospechar y buscar las complicaciones tromboembólicas en pacientes que cursan con esta infección para dar un manejo oportuno y vigilar las complicaciones post quirúrgicas que pueden ser mortales.

Aim: To present a case of acute ischemia due to aortic thrombosis in a patient with COVID-19 infection and explain the importance of diagnosis and timely management. Introduction: The coronavirus (COVID-19) mainly affects the respiratory tract, but it has a predisposition to thrombotic phenomena and its complications, one of the most serious being acute ischemia due to aortic thrombosis. Clinical case: 68-year-old man, coronary heart disease with severe pneumonia due to COVID-19, presents aortic thrombosis, resulting in acute lower extremity ischemia. Thrombectomy was performed, post procedure and associated with reperfusion, presented cardiorespiratory arrest with sustained asystole, died despite resuscitation maneuvers. Conclusion: Despite prophylaxis measures with low molecular-weight heparins (LMWH), thromboembolic complications should be sought in patients with this infection to provide timely management and monitor post-surgical complications that can be fatal.