Ajuste fino de un modelo de producción vocal para estimar el estrés de impacto utilizando un método metaheurístico

Introducción: En modelos de producción vocal que emplean estructuras de resorte-masa-amortiguador, la precisión en la determinación de coeficientes de amortiguamiento que se asemejen a las características fisiológicas de las cuerdas vocales es crucial, teniendo en cuenta posibles variaciones en la representación de la viscoelasticidad. Objetivo: Este estudio tiene como objetivo realizar un ajuste paramétrico de un modelo de producción vocal basado en un sistema de resorte-masa-amortiguador que incorpora interacción con la presión subglótica, con el fin de modelar de manera precisa las fuerzas de colisión ejercidas por las cuerdas vocales durante la fonación. Método: Se utilizó un algoritmo de búsqueda metaheurística para la síntesis paramétrica. El algoritmo se aplicó a los coeficientes de elasticidad c1 y c2, así como a los coeficientes de amortiguamiento ε1 y ε2, que se correlacionan directamente con las matrices de masa del modelo. Esto facilita el ajuste de la composición de las cuerdas para lograr un comportamiento fisiológico deseado. Resultados: El comportamiento del sistema vocal para cada ciclo de simulación se comparó con un estándar predefinido en condiciones normales. El algoritmo determinó el punto final de la simulación evaluando las discrepancias entre características clave de las señales obtenidas y las deseadas. Conclusión: El ajuste paramétrico permitió la aproximación del comportamiento fisiológico de la producción vocal, proporcionando estimaciones de las fuerzas de impacto experimentadas por las cuerdas vocales durante la fonación.

Introduction: In vocal production models employing spring-mass-damper frameworks, precision in determining damping coefficients that align with physiological vocal fold characteristics is crucial, accounting for potential variations in the representation of viscosity-elasticity properties. Objective: This study aims to conduct a parametric fitting of a vocal production model based on a mass-spring-damper system incorporating subglottic pressure interaction, with the purpose of accurately modeling the collision forces exerted by vocal folds during phonation. Method: A metaheuristic search algorithm was employed for parametric synthesis. The algorithm was applied to elasticity coefficients c1 and c2, as well as damping coefficients ε1 and ε2, which directly correlate with the mass matrices of the model. This facilitates the adjustment of fold composition to achieve desired physiological behavior. Results: The vocal system's behavior for each simulation cycle was compared to a predefined standard under normal conditions. The algorithm determined the simulation endpoint by evaluating discrepancies between key features of the obtained signals and the desired ones. Conclusion: Parametric fitting enabled the approximation of physiological vocal production behavior, providing estimates of the impact forces experienced by vocal folds during phonation.

Mining threats in high-level biodiversity conservation policies.

Amid a global infrastructure boom, there is increasing recognition of the ecological impacts of the extraction and consumption of construction minerals, mainly processed as concrete, including significant and expanding threats to global biodiversity. We investigated how high-level national and international biodiversity conservation policies address mining threats, with a special focus on construction minerals. We conducted a review and quantified the degree to which threats from mining these minerals are addressed in biodiversity goals and targets under the 2011-2020 and post-2020 biodiversity strategies, national biodiversity strategies and action plans, and the assessments of the Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services. Mining appeared rarely in national targets but more frequently in national strategies. Yet, in most countries, it was superficially addressed. Coverage of aggregates mining was greater than coverage of limestone mining. We outline 8 key components, tailored for a wide range of actors, to effectively mainstream biodiversity conservation into the extractive, infrastructure, and construction sectors. Actions include improving reporting and monitoring systems, enhancing the evidence base around mining impacts on biodiversity, and modifying the behavior of financial agents and businesses. Implementing these measures could pave the way for a more sustainable approach to construction mineral use and safeguard biodiversity.

Amenazas de la minería a las políticas de alto nivel para la conservación de la biodiversidad Resumen Enmedio del auge global del desarrollo de infraestructura, hay un mayor reconocimiento de los impactos ecológicos de la extracción y consumo de materiales para construcción, procesados predominantemente como concreto. Estos materiales representan amenazas significativas y en expansión para la biodiversidad global. Investigamos cómo son abordadas las amenazas de la minería por las políticas nacionales e internacionales de alto nivel para la conservación de la biodiversidad, con enfoque especial en los minerales para construcción. Realizamos una revisión exhaustiva y cuantificamos el grado en el cual son abordadas las amenazas de la extracción de estos minerales en los objetivos y metas para la biodiversidad bajo estrategias 2011­2020 y post 2020, las estrategias y planes de acción nacionales para la biodiversidad, y las evaluaciones de la Plataforma Intergubernamental Científico­normativa sobre Diversidad Biológica y Servicios de los Ecosistemas. La minería raramente apareció en los objetivos nacionales, pero fue más frecuente en las estrategias nacionales. Sin embargo, fue abordada superficialmente en la mayoría de los países. La cobertura de minería de agregados fue mayor que la cobertura de la minería de caliza. Describimos ocho componentes clave, adaptados para una amplia gama de actores, para incorporar eficazmente la conservación de la biodiversidad en los sectores extractivo, desarrollo de infraestructura y construcción. Las acciones incluyen la mejora de los sistemas de informes y monitoreo, el reforzamiento de la base de evidencias en torno a los impactos de la minería sobre la biodiversidad y la modificación del comportamiento de los agentes financieros y comerciales. La implementación de estas medidas podría allanar el camino para un enfoque más sostenible en el uso de minerales para la construcción y la salvaguarda de la biodiversidad.

Asociación de las características del ensayo con la publicación simultánea y su impacto en citas y menciones: un estudio transversal / Association of trial characteristics with simultaneous publication and its impact on citations and mentions: a cross-sectional study

Introducción y objetivos: Los ensayos clínicos aleatorizados a menudo se presentan en conferencias médicas y se publican al mismo tiempo o después. Los predictores de publicación simultánea y sus consecuencias no están determinados. Nuestro objetivo es caracterizar la práctica de la publicación simultánea, identificar sus predictores y evaluar su impacto. Métodos: En este estudio transversal se incluyeron ensayos clínicos aleatorizados presentados en sesiones de ciencia de última hora de importantes conferencias cardiovasculares desde 2015 hasta 2021. Se analizó la asociación entre las características del ensayo y el momento de la publicación. Se investigó el impacto de la publicación simultánea frente a la no simultánea en el número de citas a 1 año y menciones a 1 mes, así como en el total de citas y menciones en el seguimiento más largo observado. Resultados: De los 478 ensayos incluidos en el análisis, el 48,7% se publicó simultáneamente. Las publicaciones simultáneas tenían mayor probabilidad de presentarse en la sala principal de la conferencia (OR=6,09; IC95%, 1,34-36,92; p=0,029) y se caracterizaban por un tiempo de revisión más corto (OR=0,95; IC95%, 0,91-0,96; p<0,001). Las publicaciones simultáneas se asociaron con un mayor número de citas a 1 año (R2=43,81; IC95%, 23,89-63,73; p<0,001), menciones a 1 mes (R2=132,32; IC95%, 85,42-179,22; p<0,001) y total de citas (R2=222,89; IC95%, 127,98-317,80; p<0,001) en el seguimiento. Conclusiones: Los ensayos clínicos aleatorizados presentados en la sala principal de la conferencia y con un tiempo de revisión más corto tienen mayor probabilidad de publicarse simultáneamente. Las publicaciones simultáneas se asocian con más citas y menciones que las publicaciones no simultáneas. (AU)

Introduction and objectives: Randomized trials are often presented at medical conferences and published simultaneously or later. Predictors of simultaneous publication and its consequences are undetermined. Our aim was to characterize the practice of simultaneous publication, identify its predictors, and evaluate its impact. Methods: In this cross-sectional study, we included randomized trials presented at late-breaking science sessions of major cardiovascular conferences from 2015 to 2021. The association of trial characteristics with the timing of publication was analyzed. The impact of simultaneous vs nonsimultaneous publication was investigated on the number of 1-year citations and 1-month mentions, and the total citations and mentions at the longest observation follow-up. Results: Of 478 trials included in the analysis, 48.7% were published simultaneously. Simultaneous publications were more likely to be presented in the main conference room (OR, 6.09; 95%CI, 1.34-36.92; P=.029) and were characterized by a shorter review time (OR, 0.95; 95%CI, 0.91-0.96; P<.001). Simultaneous publications were associated with higher 1-year citations (R2, 43.81; 95%CI, 23.89-63.73; P<.001), 1-month mentions (R2, 132.32; 95%CI, 85.42-179.22; P<.001) and total citations (R2, 222.89; 95%CI, 127.98-317.80; P<.001). Conclusions: Randomized trials presented in the main conference room and with shorter review time were more likely to be published simultaneously. Simultaneous publications were associated with more citations and mentions than nonsimultaneous publications. (AU)

The effects of the COVID-19 pandemic on perceived stress among Romanian young adults: negative affect and avoidant coping as mediators / El impacto de la pandemia COVID-19 en el estrés percibido por jóvenes rumanos: los afectos negativos y las estrategias evasivas como mediadores

Antecedentes y objetivos: Aunque se consideraba que los jóvenes estaban menos expuestos a contraer una forma severa de la infección, los efectos que ellos más resintieron fueron los psicosociales. El presente artículo se propone comprobar el papel mediador de los afectos negativos y de las estrategias evasivas, primero en la relación entre el impacto de la pandemia COVID-19 y el estrés percibido, y luego entre la amenaza percibida y el estrés. Diseño: Se utilizó un diseño transversal. Métodos: Se empleó una muestra de 669 estudiantes de grado (18 - 28 años) durante la cuarta oleada de coronavirus, cuando la variante delta era la dominante. Resultados: Se observaron asociaciones positivas entre el impacto de la pandemia COVID-19 y el estrés percibido (r = .485; p<.001), por un lado, y entre la amenaza percibida y el estrés (r = .283; p< .001), por otro lado. Los datos estadísticos demuestran que los afectos negativos y las estrategias evasivas actúan como mediadores seriales (efecto indirecto = .3349, 95% CI, [.2858; .3852] / (efecto indirecto = .2072, 95% CI, [.1515; .2624]). Consecuentemente, el impacto de la pandemia COVID-19 (β = .137; 95% CI [.0019; .0045]) y la amenaza percibida (β = .069; 95% CI [.0007; .0046]) aumentan el estrés no sólo de manera directa, sino también indirecta, intensificando los afectos negativos. Esto genera una propensión hacia el uso específico de estrategias evasivas de afrontamiento. Conclusiones: El estudio subraya algunos mecanismos explicativos en cuanto a las relaciones entre variables que afectan la salud mental durante la pandemia COVID-19.(AU)

Background and objectives:Although young adults were considered to face a lower risk of severe coronavirus infection, they were at higher risk for adverse psychosocial effects. The aim of this study was to test the me-diating roles of negative affect and avoidant coping, firstly in the relation-ship between COVID-19 impact and perceived stress, and then in the rela-tionship between perceived coronavirus threat and perceived stress. Design:Cross-sectional design. Methods: We conducted the study on a sample of 669 university students (aged between 18-28), during the critical fourth wave, when the delta variant was the dominant strain. Results: The results indicate significant positive associations between the impact of COVID-19 and perceived stress (r = .485; p<.001), and between perceived corona-virus threat and perceived stress (r= .283; p<.001). Our findings demon-strate that negative affect and avoidant coping serially mediate these rela-tionships (total indirect effect = .3349, 95% CI, [.2858; .3852] / (total indi-rect effect = .2072, 95% CI, [.1515; .2624]). Thus, the impact of COVID-19 (β= .137; 95% CI [.0019; .0045]) and perceived coronavirus threat (β= .069; 95% CI [.0007; .0046]) induce an increase in stress not only directly, but also indirectly, through amplified negative affect, which in turn in-creases the specific-oriented use of avoidant coping strategies. Conclusions:Our results highlighted some new explanatory relationships between varia-bles that affect mental health during the COVID-19 pandemic.(AU)

Revisión Sistemática Sobre el Funcionamiento Familiar en Familias con un Hijo con una Enfermedad Poco Frecuente / Systematic Review on Family Functioning in Families of Children With Rare Diseases

El presente estudio es una revisión sistemática de las investigaciones realizadas sobre el funcionamiento familiar en familias con niños con una enfermedad poco frecuente. La búsqueda se realizó en las bases de datos Pubmed, EBSCO y Google Académico, siguiendo los lineamientos PRISMA. Luego de aplicar los criterios de inclusión y exclusión a los artículos 460 encontrados inicialmente, un total de 55 artículos conformaron la muestra final. A partir del análisis de los resultados se establecieron las siguientes temáticas abordadas en relación al funcionameinto familiar: impacto del diagnóstico; función y responsabilidades del cuidador; funcionamiento familiar; impacto en la esfera emocional; efectos en la vida conyugal y social; estrategias de afrontamiento; familia, cuidados y sistema de salud. Los hallazgos de este estudio pueden proporcionar una justificación para considerar los factores asociados al funcionamiento familiar al momento de dar el diagnóstico de una EPOF y pensar un tratamiento.(AU)

The present study is a systematic review of the research on family functioning in families who have a child with a rare disease. The research was carried out using the databases Pubmed, EBSCO, and Google Scholar, following PRISMA guidelines. After applying the inclusion and exclusion criteria to the 460 articles initially found, a total of 55 articles made up the final sample. The following topics regarding family functioning were identified: impact of diagnosis; caregiver’s role and responsibilities; family functioning; impact on the emotional sphere; effects on marital and social life; coping strategies; family, and care and health system. The results of this study may provide justification for considering factors associated with family functioning when diagnosing a rare disease and deciding on treatment.(AU)

Challenges and opportunities in human dimensions behind cat-wildlife conflict.

Because global anthropogenic activities cause vast biodiversity loss, human dimensions research is essential to forming management plans applicable to biodiversity conservation outside wilderness areas. Engaging public participation is crucial in this context to achieve social and environmental benefits. However, knowledge gaps remain in understanding how a balance between conservation and public demands can be reached and how complicated sociocultural contexts in the Anthropocene can be incorporated in conservation planning. We examined China's nationwide conflict between free-ranging cats (owned cats that are allowed to go outdoors or homeless cats living outdoors) and wildlife to examine how a consensus between compassion and biodiversity conservation can help in decision-making. We surveyed a random sample of people in China online. Over 9000 questionnaires were completed (44.2% response). In aggregate, respondents reported approximately 29 million free-ranging owned cats and that over 5 million domestic cats per year become feral in mainland China. Respondents who were cat owners, female, and religious were more likely to deny the negative impacts of cats on wildlife and ongoing management strategies and more supportive of stray cat shelters, adoption, and community-based fund raising than nonowners, male, and nonreligious respondents (p < 0.05). Free-ranging cat ownership and abandonment occurred less with owners with more knowledge of biodiversity and invasive species than with respondents with less knowledge of these subjects (p < 0.05). We recommend that cat enthusiasts and wildlife conservationists participate in community-based initiatives, such as campaigns to keep cats indoors. Our study provides a substantially useful framework for other regions where free-ranging cats are undergoing rapid expansion.

Retos y oportunidades de las dimensiones humanas detrás del conflicto entre gatos y fauna Resumen Debido a que las actividades antropogénicas globales causan una enorme pérdida de la biodiversidad, la investigación sobre las dimensiones humanas es esencial para generar planes de manejo aplicables a la conservación de la biodiversidad fuera de las áreas silvestres. Es muy importante lograr que el público participe en este contexto para obtener los beneficios sociales y ambientales. Sin embargo, todavía existen vacíos en el conocimiento sobre cómo lograr el balance entre la conservación y las demandas públicas y cómo incorporar los contextos socioculturales complejos del Antropoceno a la planeación de la conservación. Analizamos el conflicto nacional entre los gatos libres (gatos callejeros o gatos domésticos que se les permite salir) y la fauna en China para estudiar cómo un consenso entre la compasión y la conservación de la biodiversidad puede ayudar en la toma de decisiones. Encuestamos en línea a una muestra aleatoria de personas en China. Se completaron más de 9000 cuestionarios (44.2% de respuesta). En total, los respondientes reportaron un aproximado de 29 millones de gatos libres y que más de cinco millones de gatos domésticos se vuelven ferales al año en China. Quienes respondieron y son dueños de gatos, mujeres y religiosos tuvieron la mayor probabilidad de negar los impactos negativos de los gatos sobre la fauna y de las estrategias actuales de manejo y de mostrar más apoyo por los refugios de gatos abandonados, la adopción y de la recaudación de fondos comunitaria que quienes no son dueños, no son religiosos y son hombres (p < 0.05). La propiedad de gatos libres y el abandono ocurrieron menos con los dueños con más conocimiento sobre la biodiversidad y las especies invasoras que con los respondientes con menos conocimiento sobre estos temas (p < 0.05). Recomendamos que los aficionados a los gatos y los conservacionistas de la fauna participen en las iniciativas comunitarias; por ejemplo, campañas para mantener a los gatos dentro de casa. Nuestro estudio proporciona un marco sustancialmente útil para otras regiones en donde los gatos libres se encuentran en rápida expansión.

Evaluación del impacto de la obesidad en los resultados del trasplante renal / Does obesity really affect renal transplantation outcomes?

Introducción El trasplante renal es el tratamiento de elección para pacientes con enfermedad renal crónica (ERC) estadio 5. Alrededor de 60% de los pacientes con ERC presentan sobrepeso u obesidad en el momento del trasplante de riñón, y la obesidad postrasplante se da en 50% de los pacientes, con un aumento de peso de 10% en el primer año y un alto riesgo de mortalidad cardiovascular. La obesidad se asocia a un mayor riesgo de retraso de la función del injerto (RFI), rechazo agudo, complicaciones quirúrgicas, pérdida del injerto y mortalidad. El objetivo de este estudio es evaluar la evolución clínica de los pacientes obesos y con sobrepeso receptores de un trasplante renal, en términos de las complicaciones a corto y largo plazo asociadas a un mayor índice de masa corporal (IMC). Material y métodos Se realizó un estudio descriptivo, observacional y transversal con 104 pacientes sometidos a trasplante de riñón o páncreas-riñón entre marzo de 2017 y diciembre de 2020, con seguimiento hasta abril de 2021. Para el análisis comparativo, los pacientes se agruparon según el IMC. Resultados La edad media fue de 56,65 años, 60,6% varones y 39,4% mujeres. Los pacientes con sobrepeso experimentaron cirugías más prolongadas, más dehiscencia de la herida quirúrgica, RFI, hernias, proteinuria y un requerimiento mayor de biopsias renales. Por otro lado, los pacientes obesos presentaron más RFI, mayor número de biopsias renales requeridas, proteinuria, desarrollo de diabetes mellitus y fibrilación auricular, y necesitaron estancias hospitalarias más prolongadas. Conclusiones A pesar de la alta prevalencia de comorbilidad en la población con sobrepeso y/u obesidad, no se observó un empeoramiento en la supervivencia del paciente y/o del injerto. Sin embargo, es necesario un seguimiento más prolongado. (AU)

Introduction Kidney transplantation is the treatment of choice for patients with stage 5 chronic kidney disease (CKD). About 60% of CKD patients are overweight or obese at the time of kidney transplantation, and post-transplant obesity occurs in 50% of patients, with a weight gain of 10% in the first year and high risk of cardiovascular mortality. Obesity is associated with an increased risk of delayed graft function (DGF), acute rejection, surgical complications, graft loss and mortality. The aim of this study is to assess the clinical evolution of obese and overweight patients that have received a kidney transplant, based on short- and long-term complications associated with a higher BMI. Material and methods A descriptive, observational, cross-sectional study was conducted with 104 kidney or pancreas-kidney transplant patients between March 2017 and December 2020, with a follow-up until April 2021. For comparative analysis, patients were grouped according to BMI. Results Mean age was of 56.65 years, 60.6% male and 39.4% female. Overweight patients experienced prolonged surgeries, more surgical wound dehiscence, delayed graft function, hernias, proteinuria and more indications for renal biopsies. Additionally, obese patients displayed more DGF, indications for renal biopsies, proteinuria, development of diabetes mellitus, atrial fibrillation and needed prolonged hospital stays. Conclusions Despite a high prevalence of comorbidity in the overweight and/or obese population, we found no reduction in patient and/or graft survival. However, longer follow-up is needed. (AU)

Análisis bibliométrico de las revistas oficiales de sociedades de medicina interna en Europa / Bibliometric analysis of the official journals of internal medicine societies in Europe

Introducción La bibliometría evalúa la calidad de las revistas biomédicas. El objetivo de este estudio ha sido comparar los principales índices bibliométricos de las revistas oficiales de sociedades científicas de medicina interna en Europa. Material y métodos Se obtuvo información bibliométrica de las bases de datos Web of Science (WoS) y Scopus. Se analizaron tanto métricas de impacto (Journal Impact Factor [JIF], CiteScore) como normalizadas (Journal Citation Indicator [JCI], Normalized Eigenfactor, Source Normalized Impact per Paper [SNIP] y SCImago Journal Rank [SJR]) de las revistas para el año 2022, y se observó su evolución en la última década. Resultados Se evaluaron 23 revistas oficiales de 33 sociedades científicas. Ocho revistas estaban incluidas en WoS y 11 en Scopus. Las revistas mejor posicionadas en 2022 fueron: 1) European Journal of Internal Medicine, que ocupó el primer cuartil (Q1) de las métricas JIF, CiteScore y JCI, superando valores de uno en las métricas Normalized Eigenfactor y SNIP; 2) Internal and Emergency Medicine, en Q1 para las métricas CiteScore y JCI, y con valores >1 en las métricas Normalized Eigenfactor y SNIP; 3) Polish Archives of Internal Medicine, con Q1 en la métrica JCI; 4) Revista Clínica Española, con Q2 para las métricas JIF, CiteScore y JCI; y 5) Acta Medica Belgica, con Q2 en las métricas CiteScore y JCI. Estas revistas incrementaron sus métricas de impacto en los últimos 3 años, coincidiendo con la pandemia COVID. Conclusiones Cinco revistas oficiales de sociedades europeas de medicina interna, entre ellas Revista Clínica Española, cumplen altos estándares de calidad. (AU)

Introduction Bibliometrics evaluates the quality of biomedical journals. The aim of this study has been to compare the main bibliometric indexes of the official journals of scientific societies of internal medicine in Europe. Material and methods Bibliometric information was obtained from the Web of Science (WoS) and Scopus databases. Both impact metrics (Journal Impact Factor [JIF], CiteScore) and normalized metrics (Journal Citation Indicator [JCI], Normalized Eigenfactor, Source Normalized Impact per Paper [SNIP] and SCImago Journal Rank [SJR]) of the journals for the year 2022 were analyzed, and their evolution over the last decade was described. Results Twenty-three official journals from 33 scientific societies were evaluated. Eight journals were included in WoS and 11 in Scopus. The best positioned journals in 2022 were: 1) European Journal of Internal Medicine, which ranked in the first quartile (Q1) for JIF, CiteScore and JCI metrics, exceeding values of 1 in Normalized Eigenfactor and SNIP metrics; 2) Internal and Emergency Medicine, with Q1 for CiteScore and JCI metrics, and with values >1 in Normalized Eigenfactor and SNIP metrics; 3) Polish Archives of Internal Medicine, with Q1 for JCI metrics; 4) Revista Clínica Española, with Q2 for JIF, CiteScore and JCI metrics; and 5) Acta Medica Belgica, Q2 for CiteScore and JCI metrics. These journals increased their impact metrics in the last 3 years, in parallel with the COVID pandemic. Conclusions Five official journals of European Internal Medicine societies, including Revista Clínica Española, meet high quality standards. (AU)

Bibliometric analysis of the official journals of internal medicine societies in Europe.

INTRODUCTION: Bibliometrics evaluates the quality of biomedical journals. The aim of this study has been to compare the main bibliometric indexes of the official journals of scientific societies of Internal Medicine in Europe. MATERIAL AND METHODS: Bibliometric information was obtained from the Web of Science (WoS) and Scopus databases. Both impact metrics (Journal Impact Factor [JIF], CiteScore) and normalized metrics (Journal Citation Indicator [JCI], Normalized Eigenfactor, Source Normalized Impact per Paper [SNIP] and SCImago Journal Rank [SJR]) of the journals for the year 2022 were analyzed, and their evolution over the last decade was described. RESULTS: Twenty-three official journals from 33 scientific societies were evaluated. Eight journals were included in WoS and 11 in Scopus. The best positioned journals in 2022 were: 1) European Journal of Internal Medicine, which ranked in the first quartile (Q1) for JIF, CiteScore and JCI metrics, exceeding values of 1 in Normalized Eigenfactor and SNIP metrics; 2) Internal and Emergency Medicine, with Q1 for CiteScore and JCI metrics, and with values >1 in Normalized EigenFactor and SNIP metrics; 3) Polish Archives of Internal Medicine, with Q1 for JCI metrics; 4) Revista Clínica Española, with Q2 for JIF, CiteScore and JCI metrics; and 5) Acta Medica Belgica, with Q2 for CiteScore and JCI metrics. These journals increased their impact metrics in the last 3 years, in parallel with the COVID pandemic. CONCLUSIONS: Five official journals of European Internal Medicine societies, including Revista Clínica Española, meet high quality standards.

[Impact of care for victims of gender violence on the health professionals]. / Impacto de la atención a las víctimas de violencia de género en los y las profesionales de la salud.

Professionals who work with women victims of gender violence face difficult emotional situations, and it is important to be aware of the emotions and feelings that the attitudes and behaviour of victims and aggressors generate in them. These emotions can become barriers to communication and seriously affect the professional's relationship with victims. Furthermore, they can generate situations of sustained stress, lead to emotional exhaustion, and affect their health, life, and work performance. We describe the consequences, risk factors and warning signs, as well as protective or resilience factors, that are important to know, and we list the current challenges and some recommendations for professionals and management in order to help prevent such effects and improve professional performance without health risks.

Patient-journey of fibromyalgia patients: A scoping review / Patient-journey del paciente con fibromialgia: una revisión de alcance

Background: Fibromyalgia (FM) is a chronic disease characterized by widespread pain. Although much is known about this disease, research has focused on diagnosis and treatment, leaving aside factors related to patient's experience and the relationship with healthcare system. Objectives: The aim was to analyze the available evidence on the experience of FM patients from the first symptoms to diagnosis, treatment, and follow-up. Methods: A scoping review was carried out. Medline and the Cochrane Library were searched for original studies or reviews dealing with FM and focusing on “patient journey”. Results were organized using a deductive classification of themes. Results: Fifty-four articles were included in the qualitative synthesis. Five themes were identified: the patient journey, the challenge for the health systems, a complex doctor–patient relationship, the importance of the diagnosis, and the difficulty of standardizing the treatment. Conclusions: This scoping review confirms the negative impact of FM on the patient, their social environment, and health systems. It is necessary to minimize the difficulties encountered throughout the diagnosis and follow-up of patients with FM.(AU)

Antecedentes: La fibromialgia (FM) es una enfermedad crónica caracterizada por dolor generalizado. Aunque se sabe mucho de esta enfermedad, la investigación se ha centrado en el diagnóstico y el tratamiento, sin valorar la experiencia del paciente y la relación con el sistema. Objetivos: El objetivo fue analizar la evidencia sobre la experiencia de los pacientes con FM desde el inicio de los síntomas hasta el diagnóstico, el tratamiento y el seguimiento. Métodos: Se realizó una revisión de alcance. Se buscaron en Medline y en Cochrane Library estudios o revisiones sobre la FM y “patient journey”. Los resultados se clasificaron mediante deductiva de temas. Resultados: Se incluyeron 54 artículos en la síntesis cualitativa. Se identificaron cinco temas: el viaje del paciente, el reto para los sistemas sanitarios, la compleja relación médico-paciente, la importancia del diagnóstico, y la dificultad de estandarizar el tratamiento. Conclusiones: Esta revisión confirma el impacto negativo de la FM en pacientes, su entorno social y sistemas sanitarios. Es necesario minimizar las dificultades durante el diagnóstico y seguimiento de pacientes con FM.(AU)

Patient-journey of fibromyalgia patients: A scoping review.

BACKGROUND: Fibromyalgia (FM) is a chronic disease characterized by widespread pain. Although much is known about this disease, research has focused on diagnosis and treatment, leaving aside factors related to patient's experience and the relationship with healthcare system. OBJECTIVES: The aim was to analyze the available evidence on the experience of FM patients from the first symptoms to diagnosis, treatment, and follow-up. METHODS: A scoping review was carried out. Medline and the Cochrane Library were searched for original studies or reviews dealing with FM and focusing on "patient journey". Results were organized using a deductive classification of themes. RESULTS: Fifty-four articles were included in the qualitative synthesis. Five themes were identified: the patient journey, the challenge for the health systems, a complex doctor-patient relationship, the importance of the diagnosis, and the difficulty of standardizing the treatment. CONCLUSIONS: This scoping review confirms the negative impact of FM on the patient, their social environment, and health systems. It is necessary to minimize the difficulties encountered throughout the diagnosis and follow-up of patients with FM.

Rare earth elements as tracers of iron ore tailings on the Brazilian eastern continental shelf.

Iron ore tailings are stored in large dams and pose risks to the environment around the world. In Brazil, the rupture of these dams has become frequent and has generated environmental and social concern. Rare earth elements are good tracers of sediment sources and our results indicated chronic contamination of the seabed sediment from the marine region affected by the Fundão Dam tailings since 2015, including areas of environmental protection. This research, carried out between November 2018 and September 2021, with a database of 575 samples, showed a greater amount of contaminated material in the marine region adjacent to the Doce River mouth. Although data suggest prior mining contamination of the Doce River basin, the Fundão episode was an empirical and massive example of the environmental damage caused by these human activities over the centuries, showing that the impact remains in the shallow marine environments for years. Integr Environ Assess Manag 2024;20:179-188. © 2023 SETAC.

Os rejeitos de minério de ferro são armazenados em grandes barragens que trazem riscos ao meio ambiente em todo o mundo. No Brasil, o rompimento dessas barragens tem se tornado frequente e gerado preocupação ambiental e social. Elementos terras raras são bons marcadores de fontes sedimentares e nossos resultados indicaram uma contaminação crônica da região marinha afetada pelos rejeitos da barragem de Fundão, incluindo áreas de proteção ambiental. Esta pesquisa teve com 575 amostras analisadas entre os meses de novembro de 2018 e outubro de 2021, com a região marinha adjacente a foz do Rio Doce apresentando o maior grau de impacto. Embora os dados ressaltem a contaminação histórica da mineração na bacia do Rio Doce, o episódio do Fundão foi um exemplo empírico e massivo dos danos ambientais causados por essas atividades ao longo dos séculos, mostrando que o impacto permanece nos ambientes marinhos rasos por anos. Integr Environ Assess Manag 2024;20:179-188.

Does obesity really affect renal transplantation outcomes?

INTRODUCTION: Kidney transplantation is the treatment of choice for patients with stage 5 chronic kidney disease (CKD). About 60% of CKD patients are overweight or obese at the time of kidney transplantation, and post-transplant obesity occurs in 50% of patients, with a weight gain of 10% in the first year and high risk of cardiovascular mortality. Obesity is associated with an increased risk of delayed graft function (DGF), acute rejection, surgical complications, graft loss and mortality. The aim of this study is to assess the clinical evolution of obese and overweight patients that have received a kidney transplant, based on short- and long-term complications associated with a higher BMI. MATERIAL AND METHODS: A descriptive, observational, cross-sectional study was conducted with 104 kidney or pancreas-kidney transplant patients between March 2017 and December 2020, with a follow-up until April 2021. For comparative analysis, patients were grouped according to BMI. RESULTS: Mean age was of 56.65 years, 60.6% male and 39.4 % female. Overweight patients experienced prolonged surgeries, more surgical wound dehiscence, delayed graft function, hernias, proteinuria and more indications for renal biopsies. Additionally, obese patients displayed more DGF, indications for renal biopsies, proteinuria, development of diabetes mellitus, atrial fibrillation and needed prolonged hospital stays. CONCLUSIONS: Despite a high prevalence of comorbidity in the overweight and/or obese population, we found no reduction in patient and/or graft survival. However, longer follow-up is needed.

Threats to conservation from national security interests.

There is a growing trend of nation states invoking national security and emergency declarations to build state-sponsored infrastructure projects for border defense, energy production, and transportation. Established laws, regulations, and agreements for the protection of nature and cultural heritage within and between countries are becoming secondary to national security, compromising the function of protected areas, such as national parks, wilderness areas, and biosphere reserves that safeguard biodiversity, climate, and human health. We considered cases where decades-long multinational cross-border endangered species recovery programs have been jeopardized by waivers of environmental protection laws to facilitate rapid construction of border barriers that impede the movement and migration of animals, such as at the US-Mexico and Poland-Belarus borders. Renewable energy megaprojects, such as the Pinacate solar plant in Mexico, coupled with power transmission lines and road networks likewise cast a large footprint on the land and are being carried out with minimal to no environmental compliance under the guise of national security. National sovereignty likewise has been used as justification for bypassing laws to proceed with similar projects, such as Mexico's Dos Bocas refinery and Poland's Vistula Spit canal. Emphasis on security is also apparent in increasing military expenditure by the world's largest economies, which has created a mismatch with improvement in environmental policy stringency. Decisions to prioritize security can undermine democratic principles and environmental review protocols, trivialize humanity's dependence on functioning ecosystems, and contradict the United Nation's resolution on the human right to a healthy environment. Framing infrastructure projects as matters of national security also foments civil and political unrest by the labeling and casting of dissenters, including conservation scientists and environmental defenders, as antinational. World leaders must refrain from misusing extraordinary powers, adhere to laws and international agreements, and consult experts and local people before taking unilateral action on projects that affect ecological and human communities.

Amenazas para la conservación a partir de los intereses nacionales de seguridad Resumen En los países existe una tendencia creciente por invocar la seguridad nacional y las declaraciones de emergencia para construir infraestructuras financiadas por el estado para la defensa de las fronteras, producción de energía y transporte. Las leyes, regulaciones y acuerdos establecidos para la protección de la naturaleza y el patrimonio cultural dentro y entre los países se están relegando por la seguridad nacional, lo que compromete la función de las áreas protegidas (parques nacionales, áreas silvestres y reservas de la biósfera) que resguardan la biodiversidad, el clima y la salud humana. Consideramos los casos en donde se han puesto en peligro los programas longevos y multinacionales de recuperación de especies en peligro por las exenciones a las leyes de protección ambiental para facilitar la construcción rápida de barreras fronterizas que impiden el movimiento y la migración de animales, como es el caso de las fronteras entre EU y México y Polonia y Bielorrusia. Los megaproyectos de energía renovable, como la planta solar del Pinacate en México, en conjunto con las líneas de transmisión eléctrica y las redes de carreteras también dejan una gran huella sobre la tierra y se realizan con el mínimo o ningún cumplimiento bajo el aspecto de la seguridad nacional. La soberanía nacional también se ha usado para justificar la omisión de las leyes para proceder con proyectos similares, como la refinería de Dos Bocas en México y el canal Vistula Spit en Polonia. El énfasis sobre la seguridad también es evidente con el incremento del gasto militar de las mayores economías mundiales, lo que ha creado una desigualdad con las mejoras en la exigencia de la política ambiental. Las decisiones para priorizar la seguridad pueden debilitar los principios democráticos y los protocolos de revisión ambiental, banalizar la dependencia de la humanidad por los ecosistemas funcionales y contradecir la resolución de las Naciones Unidas sobre el derecho humano a un ambiente saludable. Cuando se denominan los proyectos de infraestructura como asuntos de seguridad nacional, también se fomenta el malestar civil y político al etiquetar como antinacionales a los disidentes, incluidos los defensores ambientales y los científicos de la conservación. Los líderes mundiales deben abstenerse de usar indebidamente los poderes extraordinarios, adherirse a las leyes y acuerdos internacionales y consultar con expertos y personas locales antes de actuar de forma unilateral en cuanto a proyectos que afectan las comunidades humanas y ecológicas.

Influence of pain prognosis and electrical stimulation modality on the amplitude of current elicited at sensory threshold in chronic lumbar pain sufferers / Influência do prognóstico para dor e da modalidade de estimulação elétrica na amplitude de corrente elicitada no limiar sensorial em lombálgicos crônicos

ABSTRACT BACKGROUND AND OBJECTIVES: Sensory function may be altered in chronic low back pain (CLBP), which may alter the perception of therapeutic currents. The aim of this study was to verify whether the risk of poor prognosis for CLBP pain influences the amplitude elicited at the sensory threshold (ST) in different modalities of neuromuscular electrical stimulation (NMES). METHODS: This is a quasi-experimental counterbalanced study with 40 subjects divided into four groups (n=10 each), according to the risk of poor prognosis for pain: no risk (control group - CG), low (LrG), medium (MrG), and high (HrG) risks. Four modalities of NMES were tested: two medium frequency currents (Aussie current [AC] and Russian current [RC]) and two low frequency currents (commonly known as functional electrical stimulation [FES]), with two phase durations of200 μs (FES_200) and 500 μs (FES_500), in the region of the lumbar multifidus muscles. All subjects were exposed to all current modalities with interval periods, and when the ST was reached, the amplitude of the current measured in mA was recorded. RESULTS: The currents that elicited the highest and lowest amplitude in the ST were FES_200 and AC, respectively. As for the risk of poor prognosis, the highest amplitudes were for the HrG and the lowest for the LrG. CONCLUSION: The amplitude of the current elicited in the ST tended to be higher among those with a higher risk of poor prognosis for pain and, among the currents, those of medium frequency elicited lower amplitudes.

RESUMO JUSTIFICATIVA E OBJETIVOS: A função sensorial é potencialmente alterada na presença de dor lombar crônica (DLC), o que pode alterar a percepção de passagem de correntes terapêuticas. O objetivo deste estudo foi verificar se o risco de mau prognóstico para DLC influencia a amplitude elicitada no limiar sensorial (LS) em diferentes modalidades de estimulação elétrica neuromuscular (EENM). MÉTODOS: Trata-se de um estudo quase-experimental contrabalanceado composto por 40 voluntários alocados em quatro grupos (n=10 cada), de acordo com o risco de mau prognóstico para dor: sem risco (grupo controle - GC), baixo risco (GBR), médio risco (GMR) e alto risco (GAR). Foram testadas quatro modalidades de EENM: duas correntes de média frequência (corrente Aussie [CA] e corrente Russa [CR]) e duas correntes de baixa frequência (comumente denominada estimulação elétrica funcional [FES]), com duas durações de fases 200 μs (FES_200) e 500 μs (FES_500) na região dos músculos multífidos lombares. Todos os voluntários foram submetidos a todas as modalidades de corrente, com períodos de intervalos, e ao ser atingido o LS, foi realizado o registro da amplitude da corrente medida em mA. RESULTADOS: As correntes que elicitaram a maior e a menor amplitude no LS foram, respectivamente, FES_200 e CA. Quanto ao risco de mau prognóstico, as maiores amplitudes foram do GAR e as menores do GBR. CONCLUSÃO: A amplitude da corrente elicitada no LS tendeu a ser mais alta entre aqueles com maior risco de mau prognóstico para dor e, dentre as correntes, aquelas de média frequência elicitaram amplitudes mais baixas.A amplitude da corrente elicitada no LS tendeu a ser mais alta entre aqueles com maior risco de mau prognóstico para dor e, dentre as correntes, aquelas de média frequência elicitaram amplitudes mais baixas.

Impact of a research-action on vaccination indicators in the state of Minas Gerais, Brazil / Impacto de uma pesquisa-ação nos indicadores vacinais em Minas Gerais

ABSTRACT OBJECTIVE Analyze the impact of the state research-action project on immunization indicators (vaccination coverage - VC, homogeneity of vaccination coverage - HVC, dropout rate - DR, and risk rating) before and after the intervention in municipalities and priority Regional Health Administrations/Regional Health Superintendencies (RHA/RHS). METHODS The state research-action project was a before-after community clinical trial conducted in 212 municipalities belonging to eight RHA/RHS in the state of Minas Gerais, Brazil. The study sample comprised RHA/RHS with a decreasing trend for routine vaccination coverage in children under one year from 2015 to 2020. This study used secondary VC and DR data from 10 immunobiologicals recommended for children younger than two years from January to December 2021 (pre-intervention period, prior to the state research-action project) and from January to December 2022 (post-intervention period). The categorical variables were presented in proportions, and initially, a comparison was made between those of DR, HVC, and the risk rating for the transmission of vaccine-preventable diseases, according to the two periods (2021 and 2022), using the McNemar test. RESULTS All immunization indicators increased after conducting the research-action project. In 2021, 80.66% of the state's municipalities had a risk rating for the transmission of vaccine-preventable diseases as "high and very high." In 2022, the value reduced to 68.40%. CONCLUSIONS Risk rating for the transmission of vaccine-preventable diseases is an important mechanism to assist managers in defining priorities. The state research-action project used a method that enabled the construction and execution of unique action plans for each municipality, directing the improvement of immunization indicators in the state.

RESUMO OBJETIVO Analisar o impacto do projeto estadual de pesquisa-ação nos indicadores de imunização (coberturas vacinais - CV, homogeneidade de cobertura vacinal - HCV, taxa de abandono - TA e classificação de risco) antes e após a intervenção em municípios e Gerências Regionais de Saúde/Superintendências Regionais de Saúde (GRS/SRS) prioritários. MÉTODOS O projeto estadual de pesquisa-ação foi um ensaio clínico comunitário, do tipo antes-depois, realizado em 212 municípios pertencentes a oito GRS/SRS do estado de Minas Gerais, Brasil. Compuseram a amostra do estudo as SRS/GRS com tendência decrescente para a cobertura vacinal de rotina em crianças menores de 1 ano, no período de 2015 a 2020. Neste estudo, foram utilizados dados secundários de CV e TA de 10 imunobiológicos recomendados para crianças menores de 2 anos, no período de janeiro a dezembro de 2021 (período pré-intervenção, anterior ao projeto estadual de pesquisa-ação) e de janeiro a dezembro de 2022 (período pós-intervenção). As variáveis categóricas foram apresentadas em proporções e, inicialmente, realizou-se a comparação entre as de TA, HCV e a classificação de risco para a transmissão de doenças imunopreveníveis, segundo os dois períodos (2021 e 2022), utilizando-se o teste McNemar. RESULTADOS Observou-se um aumento de todos os indicadores de imunização após a realização do projeto de pesquisa-ação. No ano de 2021, 80,66% dos municípios do estado tiveram a classificação de risco para transmissão de doenças imunopreveníveis como "alto e muito alto risco". Em 2022, o valor foi reduzido para 68,40%. CONCLUSÕES A classificação de risco para transmissão de doenças imunopreveníveis é um mecanismo importante para auxiliar os gestores na definição de prioridades. O projeto estadual de pesquisa-ação empregou um método que possibilitou a construção e a execução de planos de ação singulares a cada município, direcionando a melhoria dos indicadores de imunização no estado.

Repercussões psicossociais da pandemia da covid-19 para mães de crianças com transtorno do espectro autista / Psychosocial repercussions of the covid-19 pandemic for mothers of children with autism spectrum disorder / Repercusiones psicosociales de la pandemia de covid-19 en las madres de niños con trastorno del espectro autista

RESUMO Objetivo: compreender as repercussões psicossociais da pandemia da COVID-19 para mães de crianças com Transtorno do Espectro Autista. Método: estudo qualitativo, com a participação de 22 mães. Os dados foram coletados de maio a julho de 2022, no interior da Paraíba, Brasil, por meio de uma Dinâmica de Criatividade e Sensibilidade. A análise deu-se através do referencial teórico-analítico da análise de discurso francesa. Resultados: medo, ansiedade, angústia, preocupações assumiram um lugar central no movimento dialógico das mães. Diante das demandas e reconfigurações na rotina, houve uma sobrecarrega física, emocional e psicológica, com repercussões na vida materna. A solidão pôde ser evidenciada pela frágil ou inexistente rede de apoio durante o período pandêmico. Conclusão: o estudo pode subsidiar a reflexão sobre as repercussões da pandemia na vida de mães de crianças com autismo e viabilizar a elaboração de ações que priorizem a saúde mental, auxiliando-as na superação de momentos de adversidades.

ABSTRACT Objective: to understand the psychosocial repercussions of the COVID-19 pandemic for mothers of children with Autism Spectrum Disorder. Method: a qualitative study, with participation of 22 mothers. The data were collected from May to July 2022 in the inland of Paraíba, Brazil, through the Dynamics of Creativity and Sensitivity. The analysis took place through the theoretical-analytical framework of French discourse analysis. Results: fear, anxiety, anguish and concerns assumed a central place in the mothers' dialogical movement. Faced with the demands and reconfigurations in the routine, there was physical, emotional and psychological overload, with repercussions on maternal life. Loneliness can be seen in the weak or non-existent support network during the pandemic. Conclusion: the study can support reflection on the repercussions of the pandemic on the lives of mothers of children with autism and enable the development of actions that prioritize mental health, helping them to overcome moments of adversity.

RESUMEN Objetivo: comprender las repercusiones psicosociales de la pandemia de COVID-19 en las madres de niños con Trastorno del Espectro Autista. Método: estudio cualitativo, con la participación de 22 madres. Los datos fueron recolectados de mayo a julio de 2022, en el interior de Paraíba, Brasil, mediante una Dinámica de Creatividad y Sensibilidad. El análisis se realizó siguiendo el marco teórico-analítico del análisis del discurso francés. Resultados: el miedo, la ansiedad, la angustia y las preocupaciones ocuparon un lugar central en el movimiento dialógico de las madres. Ante las exigencias y reconfiguraciones de la rutina, las madres sufrieron una sobrecarga física, emocional y psicológica que afectó su vida. La soledad se puede ver en la débil o nula red de apoyo que tuvieron durante la pandemia. Conclusión: el estudio puede contribuir a la reflexión sobre las repercusiones de la pandemia en la vida de las madres de niños con autismo y posibilitar el desarrollo de acciones que prioricen la salud mental que las ayuden a superar momentos de adversidad.

A mercantilização anunciada da Pesquisa na Espanha dos anos 2000 / The announced commodification of Research in Spain in the 2000s

Resumo: Este artigo problematiza o processo de mercantilização universitária na Espanha, relacionando-o às tendências globais, mediante realização de pesquisa bibliográfica. Destaca o papel crucial desempenhado pela Agência Nacional de Avaliação da Qualidade e Acreditação (ANECA) e a imposição progressiva de fatores de impacto em periódicos científicos como expressão do fortalecimento do denominado capitalismo acadêmico e do trabalho digital nas universidades, no âmbito das reformas universitárias dos anos 2000.

Abstract: This article problematizes the process of university commodification in Spain, relating it to global trends, through bibliographic research. It highlights the crucial role played by the National Agency for Quality Evaluation and Accreditation (ANECA) and the progressive imposition of impact factors in scientific journals as an expression of the strengthening of academic capitalism and digital work in universities, within the framework of the university reforms of the 2000s.

Avaliação do impacto da implantação do novo sistema de informações da atenção primária à saúde nos registros de atendimentos e visitas domiciliares no Brasil / Evaluation of the impact of the implementation of the new primary health care information system on records of patient care and home visits in Brazil / Evaluación del impacto de la implantación del nuevo sistema de informaciones de la atención primaria de salud en los registros de atención y visitas domiciliarias en Brasil

Resumo: A substituição do Sistema de Informação da Atenção Básica (SIAB, 1998-2015), a partir de janeiro de 2016, pelo novo Sistema de Informação em Saúde para a Atenção Básica (SISAB) determinou novas formas de coleta, processamento e uso das informações, com possível impacto nos registros das atividades desenvolvidas na atenção primária à saúde no Brasil. O objetivo deste estudo foi avaliar o impacto da implantação do novo sistema de informação sobre registros de atendimentos de médicos e enfermeiros, e de visitas domiciliares de agentes comunitários de saúde (ACS) brasileiros entre 2007 e 2019. Para tal, utilizou-se uma abordagem bayesiana de modelo estrutural para séries temporais, com base em uma regressão difusa de espaço-estado. Ao longo do período de 2016 a 2019, foram registrados 463,47 milhões de atendimentos médicos, 210,61 milhões de atendimentos de enfermagem e 1,28 bilhão de visitas de ACS. Seguindo a tendência registrada antes da implantação, seriam esperados 598,86 milhões, 430,46 milhões e 1,5 bilhão de atendimentos de médicos, enfermeiros e visitas de ACS, respectivamente. Em termos relativos, houve um decréscimo de 25% nos atendimentos médicos, 51% nos atendimentos de enfermagem e 15% nas visitas de ACS quando comparado com o valor esperado pelo método bayesiano. O impacto negativo no registro de atendimentos e de visitas domiciliares identificado neste estudo, seja por dificuldade de adaptação ao novo sistema, seja por diminuição de registros indevidos, merece ser alvo de investigação para que se possa, de forma planejada, compreender e superar o desafio da melhoria do sistema de informação da atenção primária.

Abstract: The replacement of the Primary Care Information System (SIAB, 1998-2015), as of January 2016, by the new Health Information System for Primary Care (SISAB) determined new forms of collecting, processing, and using information, with a possible impact on the records of activities carried out in primary health care in Brazil. This study aimed to evaluate the implementation impact of the new information system on records of physicians' and nurses' patient care and home visits of community health workers (CHW) in Brazil from 2007 to 2019. To this end, a Bayesian structural time-series model approach was used, based on a diffuse state-space regression. From 2016 to 2019, 463.47 million physician care, 210.61 million nursing care, and 1.28 billion CHW visits were recorded. Following the trend recorded before the implementation, 598.86 million, 430.46 million, and 1.5 billion physician and nursing appointments and CHW visits would be expected, respectively. In relative terms, there was a decrease of 25% in physician care, 51% in nursing care, and 15% in CHW visits when compared to the value expected by the Bayesian method. The negative impact on the records of patient care and home visits identified in this study, whether due to difficulties in adapting to the new system or a reduction in improper records, must be investigated so that the challenge of improving the primary care information system can be understood and overcome in a planned way.

Resumen: La sustitución del Sistema de Información de la Atención Básica (SIAB, 1998-2015), desde enero de 2016, por el nuevo Sistema de Información en Salud para la Atención Básica (SISAB) estableció nuevas maneras para recolectar, procesar y utilizar las informaciones, con posibles impactos en los registros de las actividades desarrolladas en la atención primaria de salud en Brasil. El objetivo de este estudio fue evaluar el impacto de la implantación del nuevo sistema de información sobre los registros de atención de médicos y enfermeros y de visitas domiciliarias de agentes comunitarios de salud (ACS) en Brasil entre 2007 y 2019. Para eso, se utilizó un enfoque bayesiano de modelo estructural para series temporales basadas en una regresión difusa de espacio de estado. Entre los años 2016 y 2019, se registraron 463,47 millones de consultas médicas, 210,61 millones de consultas de enfermería y 1,28 mil millones de visitas de ACS. Siguiendo la tendencia registrada antes de la implantación, se esperarían 598,86 millones, 430,46 millones y 1,5 mil millones de consultas médicas y de enfermería y visitas de ACS respectivamente. En términos relativos, hubo una disminución del 25% en las consultas médicas, del 51% en las consultas de enfermería y del 15% en las visitas de ACS en comparación con el valor esperado por el método bayesiano. El impacto negativo en el registro de consultas y visitas domiciliarias identificado en este estudio, ya sea por dificultades en la adaptación al nuevo sistema o por la disminución de los registros indebidos, merece ser objeto de investigación para que se pueda, de manera planificada, comprender y superar el desafío continuo de mejorar el sistema de información de la atención primaria.