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El criterio (juicio o consulta) de expertos, en las últimas décadas, ha sido ampliamente utilizado en las investigaciones cualitativas, puede decirse que para muchos investigadores constituye la "regla de oro" para validar sus hallazgos. El propósito del artículo consistió en proponer un procedimiento para el procesamiento estadístico de los datos cuando se emplea una extensión del método convencional del criterio de expertos, para establecer la validez, consistencia y fiabilidad en los hallazgos científicos. El mismo fue aplicado en la toma de decisiones de una de las tres dimensiones de la variable de los componentes del ejercicio problémico interdisciplinario del proceso de enseñanza-aprendizaje. En el proceso investigativo se utilizaron métodos empíricos como la revisión de documentos, la encuesta y el criterio de expertos. Los tests estadísticos aplicados arrojaron significación estadística (P < 0.05 hasta P < 0.001) entre las comparaciones y/o asociaciones realizadas. Los hallazgos encontrados demostraron, al aplicar el procedimiento, una aproximación hacia la validez, consistencia y fiabilidad de los resultados científicos.

O julgamento de especialistas (julgamento ou consulta) tem sido, nas últimas décadas, amplamente utilizado em pesquisas qualitativas, indiscutivelmente o "padrão ouro" para muitos pesquisadores validarem suas descobertas. O objetivo do artigo foi propor um procedimento para o processamento estatístico de dados ao usar uma extensão do método convencional de julgamento de especialistas para estabelecer validade, consistência e confiabilidade em descobertas científicas. Ele foi aplicado na tomada de decisão de uma das três dimensões dos componentes variáveis do exercício interdisciplinar de solução de problemas do processo de ensino-aprendizagem. Métodos empíricos, como análise de documentos, pesquisa e julgamento de especialistas, foram usados no processo de pesquisa. Os testes estatísticos aplicados mostraram significância estatística (P < 0,05 a P < 0,001) entre as comparações e/ou associações feitas. Os resultados demonstraram, ao aplicar o procedimento, uma abordagem voltada para a validade, a consistência e a confiabilidade dos resultados científicos.

In recent decades, expert judgment has been widely used in qualitative research, and it can be said that for many researchers it constitutes the "golden rule" for validating their findings. The purpose of the article was to propose a procedure for the statistical processing of data when an extension of the conventional method of expert judgment is used to establish the validity, consistency and reliability of scientific findings. It was applied in the decision making of one of the three dimensions of the variable of the components of the interdisciplinary problem-solving exercise of the teaching-learning process. Empirical methods such as document review, survey and expert judgment were used in the research process. The statistical tests applied showed statistical significance (P < 0.05 to P < 0.001) among the comparisons and/or associations made. The findings found demonstrated, when applying the procedure, an approach towards the validity, consistency and reliability of the scientific results.

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BACKGROUND: Since spring 2020, the SARS-CoV-2 virus has spread worldwide, causing dramatic global consequences in terms of medical, care, economic, cultural and bioethical dimensions. Although the resulting conflicts initially appeared to be quite similar in most countries, a closer look reveals a country-specific intensification and differentiation of issues. Our study focused on understanding and highlighting bioethical conflicts that were triggered, exposed or intensified by the COVID-19 pandemic in low and middle-income countries (LMICs) and high-income countries (HICs). METHODS: We conducted qualitative interviews with 39 ethics experts from 34 countries (Argentina, Australia, Austria, Brazil, Canada, Colombia, Denmark, Ecuador, Ethiopia, France, Germany, India, Italy, Israel, Japan, Kyrgyzstan, Mexico, Nigeria, Oman, Pakistan, Paraguay, Poland, Romania, Russia, Singapore, South Korea, Spain, Sweden, South Africa, Tunisia, Türkiye, United-Kingdom, United States of America, Zambia) from November 2020 to March 2021. We analysed the interviews using qualitative content analysis. RESULTS: The scale of the bioethical challenges between countries differed, as did coping strategies for meeting these challenges. Data analysis focused on: a) Resource scarcity in clinical contexts: Scarcity of medical resources led to the need to prioritize the care of some COVID-19 patients in clinical settings globally. Because this entails the postponement of treatment for other patients, the possibility of serious present or future harm to deprioritized patients was identified as a relevant issue. b) Health literacy: The pandemic demonstrated the significance of health literacy and its influence on the effective implementation of health measures. c) Inequality and vulnerable groups: The pandemic highlighted the context-sensitivity and intersectionality of the vulnerabilities of women and children in LMICs and the aged in HICs. d) Conflicts surrounding healthcare professionals: The COVID-19 outbreak underscored the tough working conditions for nurses and other health professionals, raising awareness of the need for reform. CONCLUSION: The pandemic exposed pre-existing structural problems in LMICs and HICs. Without neglecting individual contextual factors in the observed countries, we created a mosaic of different voices of experts in bioethics across the globe, drawing attention to the need for international solidarity in the context of a global crisis.

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This document constitutes the third and last part of the Third Argentine Consensus on the Management of Bipolar Disorders carried out by the Argentine Association of Biological Psychiatry (AAPB). Continuing with the initial objective, this section of the Consensus on the Management of Bipolar Disorders is focused on the management of bipolar disorders in special populations. This section constitutes a comprehensive review and expert consideration of the scientific evidence on: a) the management of bipolar disorders in treatment-resistant patients; b) the management of bipolar disorder in childhood and adolescence; c) the management of bipolar disorders in women during their perinatal period and, d) the management of bipolar disorders in older adults.

Este documento constituye la tercera y última parte del Tercer Consenso Argentino sobre el Manejo de los Trastornos Bipolares llevada a cabo por la Asociación Argentina de Psiquiatría Biológica (AAPB). Siguiendo con el objetivo propuesto por el comité de expertos, en la actual versión del Consenso sobre el manejo de los trastornos bipolares, esta sección está enfocada al abordaje de los Trastornos Bipolares en situaciones especiales. Esto configura una revisión exhaustiva de la evidencia científica  sobre: a) el manejo de los trastornos bipolares en pacientes resistentes al tratamiento, b) el manejo de los trastornos bipolares en la mujer en el período perinatal, c) el manejo del trastorno bipolar en la etapa infantojuvenil y d) el manejo de los trastornos bipolares en los adultos mayores.

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This document constitutes the second section B of the Third Argentine Consensus on the Management of Bipolar Disorders, focused on synthesizing the most updated evidence on therapeutic approaches for adult patients. The scope of this section is to provide therapeutic recommendations for managing bipolar disorders in adults, (i) acute mania (ii) bipolar depression (iii) mixed stated (iv) suicidality and (vi) psychological interventions. In addition, the current manuscript outlines the assessment and management of side effects of pharmacotherapeutic treatments.

Este documento constituye la segunda parte B del Tercer Consenso Argentino sobre el Manejo de los Trastornos Bipolares llevada a cabo por la Asociación Argentina de Psiquiatría Biológica (AAPB). Siguiendo con el direccionamiento iniciado en el parte 2A sobre el tratamiento integral de los trastornos bipolares, esta sección se ha enfocado en sintetizar la evidencia más actualizada sobre abordajes terapéuticos para pacientes adultos. El alcance de esta sección es proporcionar recomendaciones terapéuticas para el manejo de los trastornos bipolares en adultos, (i) manía aguda, (ii) depresión bipolar, (iii) estado mixto, (iv) el suicidio en el trastorno bipolar, (v) intervenciones psicológicas. Además, el presente manuscrito aborda la evaluación y el manejo de los efectos secundarios de los tratamientos farmacoterapéuticos.

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The Palmares Environmental Protection Area covers almost 90% of Paty do Alferes Atlantic Forest with great biodiversity. This work aimed to research about the knowledge local specialists have about medicinal plants in order to describe the relationship between home gardens and the conservation of biodiversity and local knowledge. 107 ethnospecies were reported belonging to 37 botanical families, Asteraceae the most abundant and a majority of native species. The highest RCF species were Plectranthus barbatus and the highest RI was obtained for Plantago australis/P. guilleminiana. Plants were cited mainly for the treatment of illness related to digestive system and the highest FIC was about the use of plants related to eye diseases. Local experts mainly cited plants for low complexity health problems. Home gardens, as the main collection site, contribute to minimizing anthropic pressure and extractivism, which favours a sustainable relationship within the APA, at least regarding to medicinal plants.

El Área de Protección Ambiental de Palmares cubre casi el 90% de la Mata Atlántica de Paty do Alferes con una gran biodiversidad. Este trabajo tuvo como objetivo investigar el conocimiento que los especialistas locales tienen sobre las plantas medicinales con el fin de describir la relación entre los huertos familiares y la conservación de la biodiversidad y el conocimiento local. Se reportaron 107 etnoespecies pertenecientes a 37 familias botánicas, Asteraceae la más abundante y la mayoría de las especies nativas. Las especies de RCF más altas fueron Plectranthus barbatus y la IR más alta se obtuvo para Plantago australis/P. guilleminiana. Las plantas se citaron principalmente para el tratamiento de enfermedades relacionadas con el sistema digestivo y el FIC más alto fue sobre el uso de plantas relacionadas con enfermedades oculares. Los expertos locales citaron principalmente las plantas por problemas de salud de baja complejidad. Los huertos familiares, como principal sitio de acopio, contribuyen a minimizar la presión antrópica y el extractivismo, lo que favorece una relación sustentable dentro de la APA, al menos en lo que respecta a las plantas medicinales.

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This document constitutes the second section A of the Third Argentine Consensus on the Management of Bipolar Disorders, focused on synthesizing the most updated evidence on therapeutic approaches for adult patients. The aim of this section (2A) is to provide therapeutic recommendations for managing bipolar disorders in adults. In addition, the scope of this current manuscript outlines recommendations on the use of treatment guidelines, levels of evidence available to support these recommendations, general considerations for the treatment of bipolar disorders, the so-called pseudoresistance and adherence to treatment, general considerations on psychological therapies, as well as long term treatment of bipolar disorders.

Este documento corresponde a la segunda parte del Tercer Consenso Argentino sobre el manejo de los trastornos bipolares, enfocada en sintetizar la evidencia actualizada sobre los abordajes terapéuticos de esta patología en los pacientes adultos. Siguiendo la metodología descripta en la primera parte del Consenso, el panel de expertos realizó una exhaustiva revisión de la bibliografía y, como consecuencia de un posterior debate sobre la información disponible, se generó esta sección A del segundo documento que abarca el tratamiento integral de las personas adultas que padecen este trastorno. Durante la etapa de debate y discusión de estas guías, se decidió incorporar algunos puntos que estimamos serán de gran utilidad para el equipo interdisciplinario encargado del manejo de pacientes con trastornos bipolares.  En tal sentido, en la sección A de la segunda parte de este documento, se podrán encontrar las recomendaciones generales para el uso de las guías de tratamiento, los niveles de evidencia disponibles para sustentar las recomendaciones, las consideraciones generales del tratamiento de los trastornos bipolares, el fenómeno de pseudorresistencia y adherencia al tratamiento, las consideraciones generales sobre el abordaje psicológico, así como el tratamiento a largo plazo de los trastornos bipolares.

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Resumen Objetivo: El siguiente trabajo científico analiza, desde un enfoque socio-histórico con énfasis en la historia social de los saberes y personas expertas, el XIV Congreso Panamericano de Educación Física realizado en Costa Rica en 1993. Analiza al evento como un espacio de sociabilidad, circulación de saberes, legitimación de ciertos sujetos expertos, e influencia y poder de algunas organizaciones internacionales. Teniendo en cuenta ello, la finalidad del artículo es examinar los saberes, personas expertas y organizaciones que validaron ciertos sentidos verdaderos sobre cómo conceptualizar el amplio universo de la cultura física, la educación física y los deportes. Material y métodos: Para llevar a cabo el análisis hermenéutico, en el marco de una metodología cualitativa, se ha focalizado la atención interpretativa en diversas fuentes documentales, entre las que se destacan las memorias e informes del congreso, la prensa escrita, las exposiciones centrales, las ponencias generales y las memorias vinculadas a otros congresos panamericanos. Asimismo, se han realizado un conjunto de entrevistas semiestructuradas. El análisis ha articulado el ''texto'' junto con las condiciones históricas de producción e interacción del universo indagado. Resultados y conclusiones: Entre las conclusiones, se identifica al congreso como un espacio en el que la disciplina educativa fue interpelada a través de diversos saberes, destacándose los biomédicos, los pedagógicos, los didácticos y los sociológicos. Asimismo, el congreso visibilizó a ciertos sujetos expertos internacionales y a importantes instituciones transnacionales vinculadas al heterogéneo campo de la cultura física.

Abstract Objective: From a socio-historical approach with emphasis on the social history of knowledge and experts, the following scientific work analyzes the XIV Pan American Congress of Physical Education held in Costa Rica in 1993. The paper analyzes the event as a space for sociability, knowledge circulation, legitimation of certain experts, influence, and power of some international organizations. Based on this analysis, the article aims to examine the knowledge, experts, and organizations that validated certain true meanings on how to conceptualize the vast universe of physical culture, physical education, and sports. Material and methods: To conduct the hermeneutical analysis within the framework of a qualitative methodology. Interpretive attention has been focused on various documentary sources, such as memoirs and reports of the congress, the written press, the central exhibitions, the general lectures, and the memories related to other Pan American congresses. Likewise, a set of semi-structured interviews have been carried out. The analysis has articulated the ''text'' with the historical conditions of production and interaction of the investigated universe. Results and conclusion: Among the conclusions, the congress is identified as a space in which the educational discipline was questioned through various types of knowledge, highlighting the biomedical, pedagogical, didactic, and sociological ones. In addition, the congress made visible certain international experts and important transnational institutions linked to the heterogeneous field of physical culture.

Resumo Objetivo: Este trabalho científico analisa, a partir de uma abordagem sócio-histórica com ênfase na história social do conhecimento e dos especialistas, o XIV Congresso Pan-Americano de Educação Física realizado na Costa Rica em 1993. Analisa o evento como espaço de sociabilidade, circulação de saberes, legitimação de certos especialistas, influência e poder de algumas organizações internacionais. O objetivo desse artigo é examinar os saberes, especialistas e organizações que validaram certos significados verdadeiros sobre como conceituar o amplo universo da cultura física, da educação física e do esporte. Material e métodos: Para realizar a análise hermenêutica, a partir de uma metodologia qualitativa, a atenção interpretativa tem-se centrado em várias fontes documentais, entre as quais se destacam as memórias e relatórios do congresso, a imprensa escrita, as exposições centrais, as conferências gerais, e as memórias relacionadas a outros congressos panamericanos. Da mesma forma, foi realizado um conjunto de entrevistas semiestruturadas. A análise articulou o ''texto'' às condições históricas de produção e interação do universo investigado. Resultados e conclusão: Dentre as conclusões, o congresso é identificado como um espaço em que a disciplina educacional foi interpretada por meio de diversos saberes, destacando-se o biomédico, o pedagógico, o didático e o sociológico. Da mesma forma, o congresso tornou visíveis alguns especialistas internacionais e importantes instituições transnacionais vinculadas ao heterogêneo campo da cultura física.

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Introducción: En muchas investigaciones científicas de las Ciencias Sociales, es usual la aplicación del método de consulta a expertos con el fin de validar escalas, enfoques, proyecciones, políticas y otros temas para la adopción de decisiones fundamentadas, aunque se constata su empleo parcial, indiscriminado e incorrecto. Objetivo: Fundamentar la necesidad de aplicar el método de consulta a expertos en tres niveles para determinar: la competencia de los expertos; la fiabilidad del instrumento empleado y el consenso entre los expertos sobre el tema abordado. Material y Métodos: Se realizó una sistematización de documentos relacionados con el empleo del método de consulta de expertos en la investigación científica, tesis de doctorado y maestría, artículos, monografías y otras publicaciones. Se aplicaron pruebas estadísticas no paramétricas. Resultados: Se constata que la aplicación del método de consulta a expertos siguiendo los procedimientos adecuados, permite elevar el rigor metodológico y su contribución en la investigación científica. Conclusiones: El método de consulta a expertos constituye una herramienta eficaz en la investigación científica siempre que se aplique con el rigor requerido(AU)

Introduction: The method for expert consultation is commonly applied to scientific research conducted in the Social Sciences to validate scales, approaches, planning, politics, and other matters in decision making; however, its incorrect, indiscriminate, and partial use is confirmed. Objective: To validate the need to apply the method for expert consultation at three levels in order to determine: the competence of experts; the reliability of the instrument used; and the consensus among experts on the topic approached. Material and Methods: Systematization of documents related to the use of the method for expert consultation in scientific research, master´s and doctoral theses, articles, monographs, and other publications. Non-parametric statistical tests were applied. Results: It is confirmed that the application of the method for expert consultation following the appropriate procedures allows for an increase in the methodological rigor and a contribution to scientific research. Conclusions: The method for expert consultation is an effective tool in scientific research provided that it is rigorously applied(AU)

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The Third Argentine Consensus on the management of bipolar disorders (TB) is an initiative of the Argentine Association of Biological Psychiatry (AAPB). As a reference document, this consensus pursues two main objectives: on the one hand, to summarize and systematize the best available evidence on the comprehensive management of this pathology; on the other, to provide a useful, up-to-date instrument for psychiatrists, multidisciplinary teams dedicated to mental health, and government agencies. During a period of approximately six months of work -that is, from May to October 2022- a committee of experts made up of 18 professionals and representatives of the three most important Psychiatry and Mental Health associations in Argentina (that is, the AAPB, the Argentine Association of Psychiatrists, AAP, and the Association of Argentine Psychiatrists, APSA) have focused on updating the information regarding TB. Finally, this document was prepared as a result of an exhaustive review of the bibliography published to date, which was strategically divided into three parts: the first deals with the generalities of TB; the second deals with the comprehensive treatment of the pathology; finally, the third analyzes TB in the context of special situations.

El Tercer Consenso Argentino sobre el manejo de los Trastornos Bipolares (TB) es una iniciativa de la Asociación Argentina de Psiquiatría Biológica (AAPB). Como documento de referencia, este consenso persigue dos objetivos principales: por un lado, resumir y sistematizar la mejor evidencia disponible sobre el manejo integral de esta patología; por el otro, proporcionar un instrumento útil y actualizado a psiquiatras, a equipos multidisciplinarios abocados a la salud mental y a organismos gubernamentales. Durante un período de aproximadamente seis meses de trabajo -desde mayo a octubre de 2022- un comité de expertos integrado por 18 profesionales y por representantes de las tres asociaciones de Psiquiatría y Salud Mental más importantes de la Argentina: la AAPB, la Asociación Argentina de Psiquiatras, (AAP) y la Asociación de Psiquiatras Argentinos (APSA), se abocaron a actualizar la información respecto de los TB. Finalmente, y como resultado de una exhaustiva revisión de la bibliográfica publicada hasta la actualidad, se confeccionó este documento que fue dividido estratégicamente en tres partes: la primera versa acerca de las generalidades del TB; la segunda aborda el  tratamiento integral de la patología; y, por último, la tercera analiza los TB en el contexto de situaciones especiales.

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Introducción: Una de las tareas básicas en las investigaciones es la realización de herramientas con contenidos acordes con el tema que se desea estudiar, lo cual puede solucionarse mediante los criterios de expertos, que permiten la confección de instrumentos confiables y su aplicabilidad en las ciencias biomédicas. Objetivo: Describir los resultados del proceso de selección de expertos para la validación teórica de los instrumentos utilizados en la estrategia de superación profesional de los cirujanos en el periodo preoperatorio mediato. Métodos: Se realizó un estudio cualitativo y cuantitativo en el Hospital General Docente Dr. Juan Bruno Zayas Alfonso de Santiago de Cuba, desde diciembre de 2019 hasta marzo de 2021. El universo estuvo constituido por 25 expertos, a quienes se les aplicó el test de autovaloración y el método Delphi. Resultados: Se halló que 17 (68,0 %) doctores en ciencias obtuvieron coeficiente de competencia alto y 6 (24,0 %) medio, los cuales fueron seleccionados para validar los instrumentos y el programa docente de la investigación. Los expertos consideraron que en dichos instrumentos existió suficiencia claridad, coherencia y relevancia. A pesar de que no alcanzaron la calificación máxima, todos obtuvieron entre 3 y 4 puntos, por lo que no se realizaron cambios en los ítems. Conclusiones: La validación del contenido de los instrumentos sirvió para fortalecer las herramientas utilizadas en la investigación, la experiencia en la actividad profesional y en la función científico - investigativa.

Introduction: One of the basic tasks in the investigations is the realization of tools with contents according to the topic that is wanted to study, which can be solved by means of the experts criteria that allow the making of reliable instruments and their implementation in the biomedical sciences. Objective: To describe the results of the experts selection process for the theoretical validation of the instruments used in the strategy of the surgeons professional training during the mediate preoperative period. Methods: A qualitative and quantitative study was carried out at Dr. Juan Bruno Zayas Alfonso Teaching General Hospital in Santiago de Cuba, from December, 2019 to March, 2021. The universe was constituted by 25 experts to whom the self-appraisal test and Delphi method were applied. Results: It was found that 17 (68.0 %) doctors in science obtained high competence coefficient and 6 (24.0 %) mean competence coefficient, which were selected to validate the instruments and the teaching program of investigation. The experts considered that in this instruments existed sufficiency, clarity, coherence and relevance. Although they didn't reach the maximum qualification, all of them obtained between 3 and 4 points, reason why changes in the items were not carried out. Conclusion: The validation of the instruments content was good to strengthen the tools used in the investigation, the experience in the professional activity and in the scientist - investigative function.

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Neste artigo, analisamos o impacto das epidemias em duas cidades portuguesas ­ a capital, Lisboa, e a cidade do Porto, nodo de uma rede comercial intensa, de meados do século XIX até ao final da primeira década do século XX. Sendo ambas cidades portuárias de um país europeu, periférico, mas com um vasto império colonial, a prevenção e a aplicação de medidas de combate às epidemias, foram, e continuam a ser, fundamentais na gestão, muitas vezes precária, das crises sanitárias. Não temos dúvidas que as reflexões que estes dois casos de estudo nos proporcionam podem ser facilmente recuperadas e readaptadas para a análise da pandemia global daCOVID-19. Podemos usar a investigação histórica sobre a forma como temos lidado, enquanto sociedade, com as epidemias e pandemias para melhor atravessarmos os actuais momentos de incerteza e de espanto e definirmos acções futuras que sejam eficazes na alteração das condições que levaram a, em pleno século XXI, parar o mundo. Se é, naturalmente, impossível prever datas e contornos exactos da ocorrência das próximas epidemias, é possível criar as condições locais, nacionais e globais, tanto ao nível ambiental e social, como institucional e político para que lhes possamos responder com muito maior eficácia. Mais que reagir, teremos que ser capazes de antecipar.

In this article we analyze the impact of epidemics in two Portuguese cities ­ Lisbon, the capital city, and the city of Porto, the hub of an intense commercial network ­ from mid-19th century to the end of the first decade of the 20th century. As port cities of a peripheral European country with a vast colonial empire, the prevention and application of measures to combat epidemics were fundamental in the, often precarious, management of health crises. They still are. We argue that the reflections provided by these two case studies can be easily recovered as guides in the analysis of the present global COVID-19 pandemic. Historical research on how societies have dealt with epidemics and pandemics in the past help to understand current moments of uncertainty and astonishment, and to outline effective future actions to avoid the adverse conditions that put the whole world to a halt, in 2020. Of course, it is impossible to predict the exact dates and contours of the occurrence of the next epidemics, but it is necessary to create the local, national and global conditions, both at the environmental and social, as well as institutional and political levels, which will enable us to respond to them effectively. More than react, we need to anticipate.

En este artículo analizamos el impacto de las epidemias en dos ciudades portuguesas ­ Lisboa y Oporto, nodos de una red comercial intensa ­ desde mediados de siglo XIX hasta finales de la primera década de siglo XX. Siendo ambas ciudades portuarias y de un país europeo periférico,pero con un vasto imperio colonial, la prevención y aplicación de medidas para combatir las epidemias fueron (y continúan siendo) fundamentales en la gestión (muchas veces precaria) de las crisis sanitarias. No tenemos duda que las reflexiones que estos dos casos nos proporcionan pueden ser fácilmente recuperadas y adaptadas para el análisis de la pandemia de COVID-19. Podemos usar la investigación histórica sobre la forma como hemos lidiado, en cuanto sociedad, con las epidemias y pandemias para atravesar, de la mejor manera posible, los momentos actuales de incertidumbre y de desconcierto, y poder definir efectivas acciones futuras que puedan alterar las condiciones que llevaron a parar el mundo en pleno siglo XXI. Si bien es naturalmente imposible prever las fechas y devenires exactos de los acontecimientos de las próximas epidemias, es posible crear las condiciones locales, nacionales y globales, tanto a nivel ambiental y social, como institucional y político, para que podamos responder con mucha más eficacia. Más que actuar, tenemos que ser capaces de anticipar.

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Radical prostatectomy is a commonly adopted treatment for localized/locally advanced prostate cancer in men with a life expectancy of ten years or more. Robotic-assisted radical prostatectomy (RARP) is comparable to open radical prostatectomy on cancer control and complication rates; however, new evidence suggests that RARP may have better functional outcomes, especially with respect to urinary incontinence and erectile dysfunction. Some of the surgical steps of RARP are not adequately described in published literature and, as such, may have an impact on the final outcomes of the procedure. We organized a Brazilian experts' panel to evaluate best practices in RARP. The confection of the recommendations broadly involved: selection of the experts; establishment of working groups; systematic review of the literature and elaboration of a questionnaire; and construction of the final text with the approval of all participants. The participants reviewed the publications in English from December 2019 to February 2020. A one-round Delphi technique was employed in 188 questions. Five reviewers worked on the final recommendations using consensual and non-consensual questions. We found 59.9% of questions with greater than 70% agreement that were considered consensual. Non-consensual questions were reported according to the responses. The recommendations were based on evidence-based literature and individual perceptions adapted to the Brazilian reality, although some issues remain controversial. We believe that these recommendations may help urologists involved in RARP and hope that future discussions on this surgical procedure may evolve over the ensuing years.

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School mathematics comprises a diversity of concepts whose cognitive complexity is still poorly understood, a chief example being fractions. These are typically taught in middle school, but many students fail to master them, and misconceptions frequently persist into adulthood. In this study, we investigate fraction comparison, a task that taps into both conceptual and procedural knowledge of fractions, by looking at performance of highly mathematically skilled young adults. Fifty-seven Chilean engineering undergraduate students answered a computerized fraction comparison task, while their answers and response times were recorded. Task items were selected according to a number of mathematically and/or cognitively relevant characteristics: (a) whether the fractions to be compared shared a common component, (b) the numerical distance between fractions, and (c) the applicability of two strategies to answer successfully: a congruency strategy (a fraction is larger if it has larger natural number components than another) and gap thinking (a fraction is larger if it is missing fewer pieces than another to complete the whole). In line with previous research, our data indicated that the congruency strategy is inadequate to describe participants' performance, as congruent items turned out to be more difficult than incongruent ones when fractions had no common component. Although we hypothesized that this lower performance for congruent items would be explained by the use of gap thinking, this turned out not to be the case: evidence was insufficient to show that the applicability of the gap thinking strategy modulated either participants' accuracy rates or response times (although individual-level data suggest that there is an effect for response times). When fractions shared a common component, instead, our data display a more complex pattern that expected: an advantage for congruent items is present in the first experimental block but fades as the experiment progresses. Numerical distance had an effect in fraction comparison that was statistically significant for items without common components only. Altogether, our results from experts' reasoning reveal nuances in the fraction comparison task with respect to previous studies and contribute to future models of reasoning in this task.

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En la actualidad se enfatiza el enfoque universal para abordar situaciones de interés mundial en ámbitos tales como educación, economía y salud. Esto requiere indicadores transversales que posibiliten comparaciones adecuadas. En el área de la salud esto es especialmente relevante para comprender, conocer y responder problemas sanitarios que trascienden las fronteras. La mayoría de los instrumentos de evaluación en salud han sido desarrollados en idioma anglosajón, lo que requiere de un proceso de Adaptación Transcultural (AT) para ser utilizados en países de habla hispana. La AT va más allá de la mera traducción; tiene etapas y requiere componentes específicos para asegurar la validez y confiabilidad del instrumento al ser aplicado en poblaciones con diferente cultura y/o idioma. El presente artículo tiene por objetivo revisar la relevancia de la adaptación transcultural de instrumentos en salud, los componentes y recomendaciones generales del proceso, así como también algunos conceptos claves como la equivalencia, el rol del comité de expertos y la prueba piloto del instrumento adaptado. Se describe el desarrollo histórico de este proceso, evidencia de su uso y desafíos actuales. Finalmente se insta a la revisión de los documentos referenciados para quienes deseen ahondar en los recursos disponibles que lo guían.

Nowadays the use of a universal approach is emphasized to address issues of world level interest in the areas of education, economy and health, among others. This requires cross-sectional indicators that allow adequate comparisons. In the health area this is especially relevant to gain knowledge, understanding and responses of health problems that transcend borders. Most health assessment instruments have been developed in Anglo-Saxon cultures and languages, which require a process of Transcultural Adaptation (TA) to be used in Spanish-speaking countries. TA means not only translation; it has steps and requires specific components to ensure the validity and reliability of the instrument when applied to populations with different culture and/or languages. The objective of this article is to review the relevance of cross-cultural adaptation of health instruments, the components and general recommendations of the process as well as some key concepts such as equivalence, the role of the expert committee and the pilot testing of the adapted instrument. It describes the historical development of this process, evidence of its use and current challenges. Finally, the reviewing of the referenced documents is recommended for those who wish to gain more knowledge in the available resources that guide this process.

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En junio de 2019 comenzó a aplicarse el nuevo Código Procesal Penal Federal, que adopta como sistema de enjuiciamiento el modelo acusatorio. Este modelo implementa la oralidad, la inmediatez, la contradicción y la publicidad como guías de los procesos judiciales. En este sistema el rol de los peritos juega un papel fundamental para el que deben estar preparados. (AU)

In June 2019, the new Federal Criminal Procedure Code began to be used, which adopts the adversarial model as a system of prosecution. This model implements orality, immediacy, contradiction and publicity as guides to judicial processes. In this system the role of the experts plays a fundamental role for which they must be prepared. (AU)

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Introducción: La creciente diversidad de problemas asociados al consumo de drogas ha vuelto imprescindible el desarrollo de metodologías para el diagnóstico de su expresión local a nivel sanitario y social. Objetivo: Validación de la Guía metodológica para la elaboración de Diagnósticos Locales de problemas asociados al uso de drogas. Métodos: Se realizó una consulta a expertos sobre la metodología considerada, en enero de 2016. Se utilizó el Google Form para la administración del formulario de encuesta con preguntas cerradas y abiertas. Las respuestas cerradas fueron procesadas con los recursos estadísticos del Google Form y las abiertas fueron codificadas para análisis de contenido simple de los discursos mediante el programa Atlas-ti 6.2. Resultados: Se consultó a una muestra de veinte expertos de ocho países y ocho disciplinas diferentes con inscripciones académicas múltiples en países sudamericanos y extraregionales. En virtud de las opiniones mayoritarias y consensuales de los expertos, la guía fue validada y reconocida como un instrumento valioso para el desarrollo de diagnósticos locales. Conclusiones: Se considera que la metodología estudiada constituye en la actualidad la mejor opción para la realización de un diagnóstico local de los problemas sanitarios asociados al uso de drogas en una pequeña localidad(AU)

Introduction: The growing diversity of problems associated with drugs use has become essential to the development of methodologies for the diagnosis of their local expression at the health and social levels. Objective: To validate the Methodological Guide for the elaboration of local diagnoses of problems associated to drugs use. Methods: It was conducted a consultation to experts on the considered methodology in January, 2016. It was used Google Form for the management of a survey form with closed and open questions. The closed answers were processed with the statistical resources of Google Form and the open were coded for analysis of simple content of the speeches by the Atlas-ti 6.2. program. Results: It was consulted a sample of 20 experts from eight countries and eight different academic disciplines with inscriptions in South American and out of the region countries. Under the majority and consensual opinions of the experts, the guide was validated and recognized as a valuable instrument for the development of local assessments. Conclusions: It is considered that the methodology studied currently represents the best option for the implementation of a local diagnosis of health problems associated with the use of drugs in a small town(AU)

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Introducción: El experto es figura clave en la evaluación de manuscritos científicos. Objetivo: Valorar las percepciones de expertos de revistas biomédicas cubanas en relación con características y habilidades que deben considerarse en la revisión de manuscritos. Métodos: Investigación descriptiva (septiembre 2013-diciembre 2014) realizada como parte del proyecto de culminación del curso para editores impartido por la Editorial Ciencias Médicas. El grupo analizado estuvo constituido por 57 árbitros. Para su selección se tuvo en cuenta el criterio del director de la revista. La recogida de información se realizó a través de un cuestionario que exploró variables sociodemográficas y relacionadas con el proceso de evaluación. Los datos se ingresaron en una base de datos creada al efecto con el programa SPSS versión 15.0 en español. Resultados: Las características identificadas con mayor porcentaje de respuestas e importancia indispensable fueron: actitud ética y responsable: 45 árbitros (82 por ciento) y actualizado en el tema a evaluar 42 expertos (76 por ciento). Las habilidades, con iguales condiciones fueron, detectar errores graves de forma y contenido: 42 expertos (76 por ciento) y ser éticos en sus críticas 38 expertos (69 por ciento). Otras particularidades profesionales, como ser objetivos en el dictamen y detectar errores metodológicos que afectan la calidad del texto, respectivamente, alcanzaron porcentajes menores. Conclusiones: Los expertos reconocen aspectos fundamentales para la evaluación de los manuscritos, lo que podría influir en el resultado positivo de su labor siempre que lo asuman y apliquen en su práctica, con énfasis en aquellas características profesionales que tuvieron menores porcentajes de reconocimiento(AU)

Introduction: Experts are a key factor in the assessment of scientific manuscripts. Objective: To assess the perception of Cuban biomedical journal's experts in relation with the characteristics and skills that must be taken into account in the review of manuscripts. Methods: Descriptive research (September 2013-December 2014) carried out as part of the final project in the Course for Editors given by the Medical Sciences Publishing House (Editorial de Ciencias Médicas). The assessed group was formed by 57 referees. It was taken into account the opinion of the journal´s directors for their selection. Data collection was carried out by a questionnaire that explored socio-demographic variables related with the assessment process. Data were submitted in a database created with SPSS program, version 15.0 in Spanish. Results: The characteristics identified with a higher percentage of answers and essential importance were: ethical and responsible attitude: 45 referees (82 percent); and there were updated in the assessed topic 42 experts (76 percent). The skills with the same conditions were: to detect serious mistakes of form and content: 42 experts (76 percent) and to be ethical in their critics: 38 experts (69 percent). Other professional particularities as being objective in the report and to detect methodological mistakes that affect the quality of the text had lower percentages. Conclusions: Experts can recognize essential aspects for the assessment of manuscripts, which can influence in the positive result of their work as far as they assume it and use it practically emphasizing in those professional characteristics that had lower percentages of acknowledgement(AU)

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The reconstruction of positron emission tomography data is a difficult task, particularly at low count rates because Poisson noise has a significant influence on the statistical uncertainty of positron emission tomography (PET) measurements. Prior information is frequently used to improve image quality. In this paper, we propose the use of a field of experts to model a priori structure and capture anatomical spatial dependencies of the PET images to address the problems of noise and low count data, which make the reconstruction of the image difficult. We reconstruct PET images by using a modified MXE algorithm, which minimizes a objective function with the cross-entropy as a fidelity term, while the field of expert model is incorporated as a regularizing term. Comparisons with the expectation maximization algorithm and a iterative method with a prior penalizing relative differences showed that the proposed method can lead to accurate estimation of the image, especially with acquisitions at low count rate.

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Today, there is growing interest in the automatic classification of a variety of tasks, such as weather forecasting, product recommendations, intrusion detection, and people recognition. "Mixture-of-experts" is a well-known classification technique; it is a probabilistic model consisting of local expert classifiers weighted by a gate network that is typically based on softmax functions, combined with learnable complex patterns in data. In this scheme, one data point is influenced by only one expert; as a result, the training process can be misguided in real datasets for which complex data need to be explained by multiple experts. In this work, we propose a variant of the regular mixture-of-experts model. In the proposed model, the cost classification is penalized by the Shannon entropy of the gating network in order to avoid a "winner-takes-all" output for the gating network. Experiments show the advantage of our approach using several real datasets, with improvements in mean accuracy of 3-6% in some datasets. In future work, we plan to embed feature selection into this model.

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Species distribution models (SDMs) estimate the geographical distribution of species although with several limitations due to sources of inaccuracy and biases. Empirical tests arose as the most important steps in scientific knowledge to assess the efficiency of model predictions, which are poorly rigorous in SDMs. A good approach to the empirical distribution (ED) of a species can be obtained from comprehensive empirical knowledge, that is, well-understood distributions gathered from large amount of data generated with appropriate spatial and temporal samples coverage. The aims of this study were to (a) compare different SDMs predictions with an ED; and (b) evaluate if fuzzy global matching (FGM) could be used as an index to compare SDMs predictions and ED. Six algorithms with 5 and 20 variables were used to assess their accuracy in predicting the ED of the venomous snake Bothrops alternatus (Viperidae). Its entire distribution is known, thanks to thorough field surveys across Argentina, with 1,767 records. ED was compared with SDMs predictions using Map Comparison Kit. SDMs predictions showed important biases in all methods used, from 70% sub-estimation to 40% over-estimation of ED. BIOCLIM predicted ≈31% of B. alternatus ED. DOMAIN predicted 99% of ED, but over-estimated 40% of the area. GLM with five variables calculated 75% of ED, while Genetic Algorithm for Rule-set Prediction showed ≈60% of ED; the last two presenting overpredictions in areas with favorable climatic conditions but not inhabited by the species. MaxEnt and RF were the only methods to detect isolated populations in the southern distribution of B. alternatus. Although SDMs proved useful in making predictions about species distribution, predictions need validation with expert maps knowledge and ED. Moreover, FGM showed a good performance as an index with values similar to True Skill Statistic, so that it could be used to relate ED and SDMs predictions.