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BACKGROUND: Elderly people have multiple comorbidities that often require treatment with multiple medications. Having strategies to lessen the risks associated with pharmacological interactions and potentially inadequate prescribing (PIP) is of major importance. The STOPP- START criteria are useful in identifying PIP along with other tools, such as LASA (look alike/sound alike) drugs and high-risk medications (HRM). OBJECTIVE: We aimed to clinically and sociodemographically characterize the population with PIP according to the STOPP-START criteria in hospitalized elderly patients over 6 months in a third-level hospital in Colombia, South America. We also aimed to calculate the prevalence of PIP, LASA drugs and HRM and to identify other problems related with medication. Finally, we proposed an algorithm for the identification of PIP in this population. METHODS AND MATERIALS: This was a descriptive, cross-sectional study in hospitalized patients older than 60 years during the first semester of 2021 to identify PIP according to STOPP- START criteria. An analysis of clinical and sociodemographic variables was conducted, as well as the construction of an algorithm to identify PIP in the elderly in a semiautomated way. Data were collected and analyzed using the software SPSS 2021, using descriptive statistics and measures of central tendency. RESULTS: The prevalence of PIP in the study population was 25%. Furthermore, 60% of patients had one problem related to medication, and 27% used at least one LASA drug or HRM. CONCLUSION: This study allows one to characterize, for the first time, the Colombian population prone to PIP, as well as the construction of an algorithm that identifies PIP in a semiautomated way.

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Healthy sleep is defined by the combination of adequate duration, good quality, and regular timing. In children, sleep thus depends on the interplay of individual, parental, organizational, community, and social variables, but only a few studies have addressed this issue in a comprehensive way nationwide. Using the Uruguayan nationally representative survey (Nutrition, Child Development, and Health Survey, Encuesta de Nutrición, Desarrollo Infantil y Salud, ENDIS), we present the first epidemiological characterization of chronobiological and sleep parameters in Latin American children. On average, Uruguayan urban children (n = 2437; 5-10-years old) showed quite late chronotypes (MSFsc = 03:53 ± 1:07), moderate misalignment (SJL = 1.0 ± 0.9 h), and adequate sleep duration (SDweek = 9.9 ± 1.0 h). Further, we show the substantial influence of school shift schedules on children's circadian typology and sleep patterns. Our results show that children attending the morning school shift have a higher risk of sleep problems than afternoon-school shift ones. The chronotype and sleep were earlier in morning-school shift children than in children attending the afternoon school shift. However, morning-school shift children had stronger misalignment, shorter sleep on school days, and a higher risk of chronic sleep deficit and non-healthy circadian misalignment (even worse in late chronotypes) than afternoon-shift children. This evidence points to the need of evaluating policies to reorganize school start times to prevent the negative effects that early schooling seems to have on children's sleep health, which has been neglected so far.

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Due to the slow growth rate of anammox bacteria, enriched sludge is required for the rapid start-up of anammox-based reactors. However, it is still unclear if long-term stored anammox sludge (SAS) is an effective source of inoculum to accelerate reactor start-up. This study explored the reactivation of long-term SAS and developed an efficient protocol to reduce the start-up period of an anammox reactor. Although stored for 13 months, a low level of the specific anammox activity of 28 mg N/g VSS/d was still detected. Experimental Phase 1 involved the direct application of SAS to an upflow sludge bed reactor (USB) operated for 90 d under varying conditions of hydraulic retention time and nitrogen concentrations. In Phase 2, batch runs were executed prior to the continuous operation of the USB reactor. The biomass reactivation in the continuous flow reactor was unsuccessful. However, the SAS was effectively reactivated through a combination of batch runs and continuous flow feed. Within 75 days, the anammox process achieved a stable rate of nitrogen removal of 1.3 g N/L/day and a high nitrogen removal efficiency of 84.1 ± 0.2%. Anammox bacteria (Ca. Brocadia) abundance was 37.8% after reactivation. These overall results indicate that SAS is a feasible seed sludge for faster start-up of high-rate mainstream anammox reactors.

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En la provincia Pinar del Río, en los últimos cinco años se ha notado cierto descenso de los rendimientos de los corredores de distancias cortas. Entre uno de los aspectos que incide en ello figura el pobre aprovechamiento de la arrancada. Esta investigación se realizó con el objetivo de analizar del comportamiento, en la arrancada de la carrera de 100 metros planos de los velocistas escolares categoría 12-15 años de la Escuela de Iniciación Deportiva de Pinar del Río. En la actualidad, se procura personalizar el tipo de arrancada a las características específicas de cada atleta, local para garantizar un aprovechamiento óptimo de sus características antropométricas, potencia muscular, distancia de carrera y ubicación en la pista. El estudio se llevó a cabo con los ocho atletas de la categoría 12-15 años, sexo masculino, matriculados en el área de velocidad en la Escuela de Iniciación Deportiva de Pinar del Río. Se realizó una revisión documental del proceso de entrenamiento de la arrancada baja que se lleva a cabo en los velocistas escolares, además de aplicar otros métodos empíricos como: la observación a los entrenamientos, la medición y la técnica de encuesta. Los resultados arrojados muestran que existen factores en el proceso de entrenamiento que atentan contra el éxito competitivo de estos atletas; esto genera necesidad de organizar acciones en un orden secuencial, lógica que permitan su perfeccionamiento en base al ajuste a los cambios de la condición de estos sujetos.

Na província de Pinar del Río, nos últimos cinco anos, notou-se uma certa diminuição no desempenho dos corredores de curta distância. Um dos aspectos que afeta isso é o mau aproveitamento da largada. Esta pesquisa foi realizada com o objetivo de analisar o comportamento na largada da corrida de 100 metros rasos de velocistas escolares da categoria 12-15 anos da Escola de Iniciação Esportiva Pinar del Río. Atualmente, são feitos esforços para personalizar o tipo de largada às características específicas de cada atleta local para garantir o aproveitamento ideal de suas características antropométricas, potência muscular, distância de corrida e localização na pista. O estudo foi realizado com oito atletas da categoria 12 a 15 anos, do sexo masculino, matriculados na área de velocidade da Escola de Iniciação Esportiva Pinar del Río. Foi realizada uma revisão documental do processo de treinamento low start realizado em velocistas escolares, além de aplicar outros métodos empíricos como: observação ao treinamento, medição e técnica de levantamento. Os resultados mostram que existem fatores no processo de treinamento que ameaçam o sucesso competitivo desses atletas; Isso gera a necessidade de organizar as ações em uma ordem sequencial e lógica que permita seu aprimoramento a partir do ajuste às mudanças na condição desses sujeitos.

SUMMARY In the Pinar del Río province, in the last five years a certain decrease in the performance of short distance runners has been noted. One of the aspects that affects this is the poor use of the start. This research was carried out with the objective of analyzing the behavior at the start of the 100-meter dash race of school sprinters in the 12-15-year category of the Pinar del Río Sports Initiation School. Currently, efforts are made to personalize the type of start to the specific characteristics of each local athlete to guarantee optimal use of their anthropometric characteristics, muscular power, race distance and location on the track. The study was carried out with eight athletes in the 12-15-year-old category, male, enrolled in the speed area at the Pinar del Río Sports Initiation School. A documentary review of the low start training process carried out in school sprinters was carried out, in addition to applying other empirical methods such as: observation to training, measurement and survey technique. The results show that there are factors in the training process that threaten the competitive success of these athletes; this generates the need to organize actions in a sequential, logical order that allows their improvement based on adjustment to changes in the condition of these subjects.

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Circadian rhythms are entrained by external factors such as sunlight and social cues, but also depend on internal factors such as age. Adolescents exhibit late chronotypes, but worldwide school starts early in the morning leading to unhealthy sleep habits. Several studies reported that adolescents benefit from later school start times. However, the effect of later school start time on different outcomes varies between studies, and most previous literature only takes into consideration the social clock (i.e. local time of school starting time) but not the solar clock (e.g. the distance between school start time and sunrise). Thus, there is an important gap in the literature: when assessing the effect of a school start time on chronotype and sleep of adolescents at different locations and/or seasons, the solar clock might differ and, consistently, the obtained results. For example, the earliest school start time for adolescents has been suggested to be 08:30 hours, but this school start time might correspond to different solar times at different times of the year, longitudes and latitudes. Here, we describe the available literature comparing different school start times, considering important factors such as geographic position, nationality, and the local school start time and its distance to sunrise. Then, we described and contrasted the relative role of both social and solar clocks on the chronotype and sleep of adolescents. As a whole, we point and discuss a gap in literature, suggesting that both clocks are relevant when addressing the effect of school start time on adolescents' chronotype and sleep.

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INTRODUCTION: Unplanned peritoneal dialysis (PD) is an important option for chronic kidney disease (CKD) patients requiring kidney replacement therapy urgently as it offers the convenience of home-based therapy. The objective of this study was to assess the Brazilian urgent-start PD program in three different dialysis centers where there is shortage of hemodialysis (HD) beds. METHODS: This prospective, multicentric cohort study included incident patients with stage 5 CKD and no permanent vascular access established who started urgent PD between July 2014 and July 2020 in three different hospitals. Urgent-start PD was defined as initiation of treatment up to 72 h after catheter placement. Patients were followed up from catheter insertion and assessed according to mechanical and infectious complications related to PD, patients, and technique survival. RESULTS: Over 6 years, 370 patients were included in all three study centers. Mean patient age was 57.8 ± 16.32 years. Diabetic kidney disease was the main underlying condition (35.1%) and uremia was the main cause for dialysis indication (81.1%). Concerning complications related to PD, 24.3% had mechanical complications, 27.3% had peritonitis, 28.01% had technique failure, and 17.8% died. On logistic regression, hospitalization (p = 0.003) and exit site infection (p = 0.002) were identified as predictors of peritonitis, while mechanical complications (p = 0.004) and peritonitis (p < 0.001) were identified as predictors of technique failure and switching to HD. Age (p < 0.001), hospitalization (p = 0.012), and bacteremia (p = 0.021) were observed to predict death. The number of patients on PD increased at least 140% in all three participating centers. CONCLUSION: PD is a feasible option for patients starting dialysis in an unplanned manner and may be a useful tool for reducing shortage of HD beds.

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Aerobic granular sludge (AGS) is a self-aggregated microorganism consortium with pollutant removal properties. The aim of this work is to study and review the application of aerobic granules for water treatment with special focus on new applications and methodologies. Carbon-nitrogen containing pollutants are the classic targets of AGS technology. Carbon and nitrogen removal of AGS are classified as a biodegradation process. More recently, the AGS granules have been studied as sorbent materials for wastewater treatment. In particular, the sorption of cationic pollutants has been studied through biosorption and bioaccumulation mechanisms without distinguishing when one or the other process is involved. AGS conformation made them suitable for complex wastewater treatment. Indeed, several studies have demonstrated the removal of polyvalent cationic pollutants even with higher capacity than conventional sorbent materials. However, this was achieved almost exclusively for synthetic substrates, with single cation evaluation and using in some cases only qualitative measures. For successful industrial AGS application in complex substrates, it is necessary to evaluate and demonstrate the technology in real industrial conditions and reduce the currently long start-up times which limits its utility. Two new strategies have been proposed: autoinducer molecules and the production of artificial granular from common active sludge with commercial alginate. Finally, the increase of research on AGS cations assimilation properties will allow a new point of view, where granules will be materials for the recovery of valuable metals from industrial wastewater streams.

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Introducción: las prescripciones potencialmente inapropiadas en ancianos es un hecho común, tanto en el ámbito comunitario como hospitalario, dada su frecuencia elevada de comorbilidad grave y polifarmacia, y conlleva importantes repercusiones clínicas y económicas. Objetivo: determinar la prevalencia de polifarmacia y de prescripción de medicamentos potencialmente no apropiados en adultos mayores. Métodos: se realizó un estudio analítico transversal, de series de casos, en adultos mayores hospitalizados en el hogar de ancianos "Lidia Doce Sánchez" de Bayamo entre 1ro de septiembre de 2018 al 1ro de septiembre de 2019. La información se obtuvo del análisis de las historias clínicas y la aplicación de los criterios de STOPP/START. El análisis de los datos se realizó mediante estadística descriptiva, se utilizaron pruebas de contrastación de hipótesis y se determinó la razón de prevalencia para determinar los factores asociados. Resultados: fueron frecuentes los pacientes con edades iguales o superiores a 75 años; del sexo masculino; con grado de instrucción primaria; con estado civil soltero y desnutrido. El promedio de comorbilidades por paciente fue de 4,2 ± 2,5; encontrándose como las principales afecciones las enfermedades cardiovasculares. La polifarmacia fue frecuente. La relación de riesgo frente a las potenciales prescripciones inadecuadas de medicamentos es con la edad avanzada, nivel de instrucción baja, comorbilidad, malnutrición y polimedicación. Las potenciales omisiones en la prescripción relacionan con la edad avanzada. Las potenciales interacciones medicamentosas aumentan su probabilidad de presentación con edad avanzada, un nivel bajo de instrucción, la desnutrición, la comorbilidad y la polimedicación. Conclusiones: se constató elevada polifarmacia y prescripción de medicamentos potencialmente no apropiados en los adultos mayores.

Introduction: potentially inappropriate prescription in the elderly is a common occurrence, both in the community and hospital settings, given its high frequency of severe comorbidity and polypharmacy, and has significant clinical and economic repercussions. Objective: to determine the prevalence of polypharmacy and the prescription of potentially inappropriate medications in older adults. Methods: a cross-sectional analytical study of case series was carried out in older adults hospitalized in the "Lidia Doce Sánchez" nursing home in Bayamo between September 1, 2018 and September 1, 2019. The information was obtained from the analysis of clinical records and the application of the STOPP/START criteria. The analysis of the data was carried out through descriptive statistics, hypothesis contrast tests were used and the prevalence ratio was determined to determine the associated factors. Results: patients with ages equal to or greater than 75 years were frequent; of the male sex; with a primary education degree; with single marital status and malnourished. The average number of comorbidities per patient was 4.2 ± 2.5; being found as the main affections cardiovascular diseases. Polypharmacy was frequent. The risk relationship against potential inappropriate drug prescriptions is with advanced age, low level of education, comorbidity, malnutrition and polypharmacy. The potential omissions in the prescription are related to advanced age. Potential drug interactions increase the probability of presentation with advanced age, low level of education, malnutrition, comorbidity and polypharmacy. Conclusions: high polypharmacy and prescription of potentially inappropriate medications were found in older adults.

Introdução: prescrições potencialmente inadequadas em idosos é uma ocorrência comum, tanto na comunidade quanto no hospital, dada a sua alta frequência de comorbidades graves e polifarmácia, e acarreta importantes repercussões clínicas e econômicas. Objetivo: determinar a prevalência de polifarmácia e prescrição de medicamentos potencialmente inapropriados em idosos. Métodos: foi realizado um estudo transversal analítico de série de casos em idosos hospitalizados no lar de idosos "Lidia Doce Sánchez", em Bayamo, entre 1º de setembro de 2018 e 1º de setembro de 2019. As informações foram obtidas a partir da análise dos prontuários e da aplicação dos critérios STOPP/START. A análise dos dados foi realizada por meio de estatística descritiva, teste de hipóteses e razão de prevalência foi determinada para determinar os fatores associados. Resultados: pacientes com 75 anos ou mais foram frequentes; macho; com o ensino fundamental; com estado civil solteiro e desnutrido. O número médio de comorbidades por paciente foi de 4,2 ± 2,5; sendo encontradas como principais afecções as doenças cardiovasculares. A polifarmácia era frequente. A razão de risco para potenciais prescrições inadequadas de medicamentos é com idade avançada, baixa escolaridade, comorbidade, desnutrição e polimedicação. As possíveis omissões na prescrição referem-se à idade avançada. Potenciais interações medicamentosas aumentam sua probabilidade de se apresentar com idade avançada, baixo nível de escolaridade, desnutrição, comorbidade e polimedicação. Conclusões: alta polifarmácia e prescrição de medicamentos potencialmente inapropriados foram encontrados em idosos.

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Background: Patients with end-stage kidney disease (ESKD) who start unplanned dialysis therapy are more likely to be treated with hemodialysis (HD) using a central venous catheter, which has been associated with a greater risk of infections and other complications, as well as with a higher long-term risk of death. Urgent-start PD is an alternative that has been suggested as an option for starting dialysis in these cases, with potentially better patient outcomes. However, the definition of urgent-start PD is not homogeneous, and no study, to our knowledge, has compared clinical outcomes among urgent start, early start, and conventional start of PD. In this study, we aimed to compare these types of initiation of dialysis therapy in terms of a composite outcome of patient survival and technique failure. Methods: This is a retrospective, multicenter, cohort study, involving data from 122 PD clinics in Brazil. We used the following: Urgent-start groups refer to patients who initiated PD within 72 h after the PD catheter insertion; early-start groups are those starting PD from 72 h to 2 weeks after the catheter insertion; and conventional-start groups are those who used the PD catheter after 2 weeks from its insertion. We analyzed the composite endpoint of all causes of patient's mortality and technique failure (within the initial 90 days of PD therapy) using the following three different statistical models: multivariate Cox, Fine and Gay competing risk, and a multilevel model. Results: We included 509 patients with valid data across 68 PD clinics. There were 38 primary outcomes, comprising 25 deaths and 13 technique failures, with a total follow-up time of 1,393.3 months. Urgent-start PD had no association with the composite endpoint in all three models. Conclusion: Unplanned PD seems to be a safe and feasible option for treatment for patients with non-dialysis ESKD in urgent need of dialysis.

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La diálisis peritoneal (DP), es una terapia costo efectiva, poco utilizada a nivel mundial. DP de inicio urgente es definido como el inicio de terapia en pacientes incidentes, inmediatamente después o antes de las dos semanas de haber sido colocado un catéter para DP crónica en pacientes con insuficiencia renal crónica con indicación de diálisis de urgencia, comparado con el inicio convencional después de dos semanas. El objetivo fue revisar la información actual sobre la DP de inicio urgente. Se realizó una búsqueda en PubMed, The Cochrane Library y SciELO. Se incluyeron 12 artículos publicados hasta el 31 de octubre de 2021. Se encontró una baja incidencia de pacientes que ingresan a DP, más aún la DP de inicio urgente. No se encontró diferencia significativa que justifique la espera para utilizar el catéter implantado, pudiendo evitar la hemodiálisis en urgencia dialítica. Un metaanálisis con 16 estudios (2953 pacientes) concluye que la DP de inicio urgente comparada con la de inicio convencional no aumentó la muerte de cualquier causa (1 ECA: RR 1,49, IC 95%: 0,87 a 2,53; 7 estudios de cohortes: RR 1,89, IC 95%: 1,07 a 3,3; 1 estudio de casos y controles: RR 0,90, IC 95%: 0,27 a 3,02). Otro metaanálisis con 6 estudios (1242 pacientes) reporta certeza muy baja en la mortalidad (RR: 1,25, IC 95%: 0,92 a 1,69; I2=0%, p=0,99), complicaciones mecánicas con mayor prevalencia de fugas (RR: 6,72, IC 95%: 2,11 a 21,32; I2=0%, p=0,60), y no hubo diferencia en complicaciones infecciosas entre los dos grupos. (RR: 1,36, IC 95%: 0,90 a 2,05, p=0,14). Se concluye que, no existe diferencia significativa entre la DP de inicio urgente y la de inicio convencional, en la sobrevida del paciente ni en la sobrevida de la técnica. La comunidad nefrológica debe considerar a la DP de inicio urgente como una opción de terapia en pacientes que requieran diálisis de urgencia.

SUMMARY Peritoneal dialysis (PD) is a cost-effective therapy, little used worldwide. Urgent start PD is defined as the start of therapy in incident patients, immediately after or before two weeks after having placed a catheter for chronic PD in patients with chronic renal failure with indication of urgency dialysis, compared with the conventional start after two weeks. The objective was to review the current information on urgent start PD. A search was performed in PubMed, The Cochrane Library and SciELO. A total of 12 articles published up to October 31, 2021, were included. A low incidence of patients admitted to PD was found, even more so in urgent start PD. No significant differences were found that justify waiting to use the implanted catheter, thus avoiding hemodialysis in dialysis urgency. A meta-analysis with 16 studies (2953 patients) concluded that urgent start PD compared with conventional start did not increase death from any cause (1 RCT: RR 1.49, CI 95%: 0.87 to 2.53; 7 cohort studies: RR 1.89, CI 95%: 1.07 to 3.3, 1 case control study: RR 0.90, CI 95%: 0.27 to 3.02). Another meta-analysis with 6 studies (1242 patients) reports very low certainty in mortality (RR: 1.25, CI 95%: 0.92 to 1.69; I2=0%, p=0.99), mechanical complications with higher prevalence of leaks (RR: 6.72, CI 95%: 2.11 to 21.32; I2=0%, p=0.60), and there was no difference in infectious complications between the two groups. (RR: 1.36, CI 95%: 0.90 to 2.05, p=0.14). It is concluded that there is no significant difference between urgent start PD and conventional start, in patient survival or in the survival of the technique. The nephrology community should consider urgent start PD as a therapy option in patients requiring urgency dialysis.

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OBJECTIVE: We tested the effect of later school start time (LSST) by 1 hour during 1 week on sleep, sleepiness, and mood profile using within-subject design. DESIGN: A within-subject 3-weeks-long interventional study. A baseline week with school starting at 7:30 AM (week A), followed by an intervention week with school starting at 8:30 AM (week B), and a recovery week with school start time back to 7:30 AM (week C). Mixed model for repeated measures analysis was applied to test for the LSST effect between weeks. SETTING: A private high school with high level of socioeconomic status. PARTICIPANTS: Forty-eight adolescents from 3 different high school years. MEASUREMENTS: Participants were invited to wear actigraphs continuously during the 3 experimental weeks. Somnolence was obtained every school day twice, at arrival and before departure of school. Sleep quality and mood profile were evaluated by standard measures by the end of each school week, resulting in 3 repeated measures for each variable. RESULTS: Thirty-eight adolescents completed the study. Adolescents woke up later during week B (7:42 ± 00:30) in comparison to weeks A (6:54 ± 00:12) and C (6:46 ± 00:15) (p < .001), with no significant change on sleep onset between weeks (p = .657), resulting in a longer sleep duration in week B (p < .001). Significant improvements on sleepiness and mood profile were also reported during week B. CONCLUSIONS: Starting school later was effective in improving multiple aspects from sleep patterns, subjective sleepiness, and mood profile.

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In Brazil, vaccination has always cut across party political and ideological lines, which has delayed its start and brought the whole process into disrepute. Such divergences put the immunization of the population in the background and create additional hurdles beyond the pandemic, mistrust and scepticism over vaccines. We conduct a mathematical modelling study to analyse the impacts of late vaccination along with slowly increasing coverage, as well as how harmful it would be if part of the population refused to get vaccinated or missed the second dose. We analyse data from confirmed cases, deaths and vaccination in the state of Rio de Janeiro in the period between 10 March 2020 and 27 October 2021. We estimate that if the start of vaccination had been 30 days earlier, combined with efforts to drive vaccination rates up, about 31 657 deaths could have been avoided. In addition, the slow pace of vaccination and the low demand for the second dose could cause a resurgence of cases as early as 2022. Even when reaching the expected vaccination coverage for the first dose, it is still challenging to increase adherence to the second dose and maintain a high vaccination rate to avoid new outbreaks.

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INTRODUCTION: Early school start times adversely influence adolescents' sleep duration. Late school start times and remote learning are associated with longer sleep durations. We leveraged a highly variable school schedule adopted after the first SARS-CoV-2 wave in Uruguay to study the influence of a hybrid mode of instruction (in-person/remote) with irregular school start times on adolescents' sleep. METHODS: Objective sleep on school nights (120 observations) was determined using accelerometry recordings of 15 high-school students (3 males 15-17 years old). We used mixed-effects regressions to explore the influence of the mode of instruction (in-person/remote) and school start time on adolescents' sleep patterns (onset, end, and duration). RESULTS: An irregular individual regime of 2-6 school days per week, either in-person or remote, and with irregular start times (range: 07:30-12:00) were observed during the studied period. Remote learning delayed sleep end by 48 ± 9 min and increased sleep duration by 36 ± 12 min. In addition, 1 h delay in school start time delayed sleep end in 36 ± 4 min and increased sleep duration in 34 ± 5 min. CONCLUSIONS: A strong linear association of the mode of instruction and the school start time with participants' sleep was observed: Only waking time was associated with both school start time and mode of instruction, and sleep duration increased when students were taught remotely and when school started later. These results add evidence to the effectiveness of delaying school start time to improve adolescents' sleep. However, these efforts may not overcome the influence of a very late circadian orientation, as observed in Uruguayan adolescents.

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ABSTRACT In a sprint start, the athlete takes up a position with their hands just behind a line, arms vertical, feet generally placed about a shoe length apart, and the hips rising above the line of the head. Mistakes in this position influence the execution of the low-sprint start, and can drastically influence the initial running speed and acceleration achieved by the athlete. Common mistakes occur due to the misconception that athletes must also lean forward, bringing the shoulders ahead of their hands and putting pressure on them. A standard approach to identify sprint start mistakes is to use a stick or weighted string to drop down from the shoulders. The effective implementation of this approach depends on the coach's experience and remains a significant challenge. In this study, a three-dimensional motion capture system with the Vicon® Plug-in-Gait model was used to characterize the kinematic parameters that influence the execution of low-sprint start in six high-performance athletes. The main kinematic parameters are reaction time, stride length, and stride time. The obtained results demonstrate the potential utility of a three-dimensional motion capture system to assess the kinematic parameters of low-sprint start in high-performance athletes.

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Incremental peritoneal dialysis (PD) is characterized as less than a "standard dose" PD prescription. Compared to standard treatment, it has many potential advantages, including better preservation of residual renal function, a lower risk of peritonitis, and a decreased care delivery burden while reducing the environmental impact and economic cost. Unplanned PD can be defined when treatment starts up to 14 days after catheter insertion and is recognized as a safe and feasible clinical approach. In this perspective paper, we briefly discuss both strategies and share our experience and clinical routine in managing incremental PD after unplanned initiation.

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Prothrombin time (PT) and the activated partial thromboplastin time (aPTT) are useful tools for the diagnosis and monitoring of coagulation disorders in Veterinary Medicine. Our objectives were: to establish reference intervals (RI) for PT and a PTT for the dog using the Start®4 (Stago), to compare the obtained RI with literature; to evaluate the effects of gender and age on the coagulation profile. Plasma samples of 122 healthy dogs (57 males; 65 females) aged between 4 months and 18 years, divided into three age groups (0-2 years old; 3-10 years old; > 10 years old) and grouped in to males and females were analysed. The RI were estimated following the ASVCP guidelines with the Reference Value Advisor software. The RI were: PT 6.7'' to 10.8''; aPTT 9.0'' to 14.8''. PT was significantly higher in females than in males. Dogs aged 10 years or older have significantly higher mean aPTT times than younger dogs. RI comparison showed a considerable percentage of cases outside the reference RI of the literature (PT - 79.3%; aPTT - 77.1%), demonstrating the need of each laboratory to calculate its own RI. The RI established in this study are applicable for the coagulation profile assessment in dogs.

O tempo de protrombina (TP) e o tempo de tromboplastina parcial ativada (TTPa) são ferramentas úteis para o diagnóstico e monitorização das alterações da coagulação em Medicina Veterinária. Os objetivos deste estudo foram: estabelecer intervalos de referência (IR) para TP e TTPa para o cão utilizando o Start®4 (Stago), de modo a comparar os IR obtidos com a literatura; avaliar os efeitos do sexo e da idade no perfil da coagulação. Foram usadas amostras de plasma de 122 cães saudáveis (57 machos; 65 fêmeas) com idades entre quatro meses e 18 anos, divididos em três grupos (0-2 anos; 3-10 anos; > 10 anos) e agrupados em machos e fêmeas. Os IR foram calculados seguindo as diretrizes da ASVCP com o software Reference Value Advisor. Os IR obtidos foram: PT 6,7 '' a 10,8 ''; TTPa 9,0 '' a 14,8 ''. O TP foi significativamente maior nas fêmeas do que nos machos. Os cães com 10 anos ou mais apresentaram tempos médios de TTPa significativamente maiores do que cães mais jovens. A comparação de IR mostrou uma percentagem considerável de casos fora do IR de referência da literatura (TP - 79,3%; TTPa - 77,1%), confirmando a necessidade de cada laboratório calcular seu próprio IR. Os IR estabelecidos neste estudo são aplicáveis na avaliação do perfil hemostático em cães.

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Este artigo se fundamenta na articulação entre (1) ferramentas teóricas fornecidas em curso de aperfeiçoamento em psicologia do colaborador e (2) experiências de atuação clínica em um projeto de psicanálise aplicada para assistência aos colaboradores de uma instituição hospitalar. O trabalho é permeado pela questão de como sustentar a prática clínica de orientação psicanalítica na instituição. Neste sentido, argumenta-se que é possível encontrar na psicanálise lacaniana bases para formalizar a experiência de atendimento aos colaboradores. Especificamente, no enquadre do início do tratamento analítico - da sondagem diagnóstica em Freud, e das entrevistas preliminares em Lacan. A articulação tangencia o problema da "entrada" e da "inserção" do psicólogo que estabelece na psicanálise aplicada a efetividade de sua atuação em instituição hospitalar.

Cet article s'appuie sur l'articulation entre (1) des outils théoriques dispensés dans un cours de perfectionnement en psychologie du personnel, et (2) des expériences de pratique clinique dans un projet de psychanalyse appliquée pour assister les employés d'un établissement hospitalier. La question de ce travail est de savoir comment soutenir la pratique clinique d'orientation psychanalytique au sein de cette institution hospitalière. En ce sens, on avance qu'il est possible de trouver, dansla psychanalyse lacanienne, des bases pour formaliser l'expérience d'assistance des collaborateurs. Plus précisément, dans le cadre du début du traitement analytique du sondage diagnostic de Freud, ainsi que dans les entretiens préliminaires de Lacan. L'articulation touche au problème de "l'entrée" et de "l'insertion" du psychologue qui établit dans la psychanalyse appliquée l'efficacité de sa performance dans un établissement hospitalier.

This article is based on the articulation between (1) theoretical tools provided by a course in employee psychology and (2) experiences of clinical practice in an applied psychoanalysis project to assist the employees of a hospital institution. The work is permeated by the question of how to sustain the psychoanalytically oriented clinical practice in the institution. Therefore, it is argued that it is possible to find in Lacanian psychoanalysis bases to formalize the experience of assisting personnel. Specifically, within the frame of the beginning of the analytic treatment - of the diagnostic investigation in Freud, and in the preliminary interviews in Lacan. The study analyses the problem of "entry" and "insertion" of the psychologist who establishes the effectiveness of his performance in applied psychoanalysis at a hospital institution.

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In cycling, there is a body of evidence that supports that an all-out start strategy is superior to an even-pacing strategy, but it is unknown whether an all-out start strategy is superior to a self-paced strategy. In the present study, we investigated the effects of three different pacing strategies on 4-km cycling time trial performance. After preliminary trials (familiarization trials and a baseline 4-km cycling time trial), in a randomized and counterbalanced order, twelve male cyclists (32.3±7.2 years old, maximum rate of O2 uptake (V̇O2peak) 4.3±0.4 L/min) completed: 1) a self-paced 4-km cycling time trial; 2) an all-out start (∼10 s), followed by maintenance of the average baseline trial power for the first km and self-paced cycling for the remaining trial (all-out+mean); and 3) an all-out start (∼10 s), followed by a power 5% above the average baseline trial power for the first km and self-paced cycling for the remaining trial (all-out+5%mean). Although there was a significant interaction between power and distance (P=0.001) with different power distribution profiles throughout the trial, there was no significant difference (P=0.99) between the three strategies for overall exercise performance (self-paced 379.8±13.9 s, all-out+mean 380.0±16.0 s, and all-out+5%mean 380.2±11.5 s). Oxygen uptake, rating of perceived effort, and heart rate were also similar across the pacing strategies. Different all-out start strategies did not confer additional benefits to performance compared to a self-paced strategy.

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Despite being among the world's leaders in scientific output, Brazil ranks 66th among countries in the production of reagents and supplies needed for state-of-the-art scientific analyses. The production of needed reagents and equipment for experimental analyses and patient diagnostics is sorely lacking within Brazil and explicit in this pandemic period caused by SARS-CoV-2. A significant fraction of resources from Brazilian funding agencies is now being transferred to companies in other countries for the purchase of essential scientific-related products. Is this sustainable? Therefore it is necessary to draw the attention of all the world and Brazilian society about this situation.

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Promoter annotation is an important task in the analysis of a genome. One of the main challenges for this task is locating the border between the promoter region and the transcribing region of the gene, the transcription start site (TSS). The TSS is the reference point to delimit the DNA sequence responsible for the assembly of the transcribing complex. As the same gene can have more than one TSS, so to delimit the promoter region, it is important to locate the closest TSS to the site of the beginning of the translation. This paper presents TSSFinder, a new software for the prediction of the TSS signal of eukaryotic genes that is significantly more accurate than other available software. We currently are the only application to offer pre-trained models for six different eukaryotic organisms: Arabidopsis thaliana, Drosophila melanogaster, Gallus gallus, Homo sapiens, Oryza sativa and Saccharomyces cerevisiae. Additionally, our software can be easily customized for specific organisms using only 125 DNA sequences with a validated TSS signal and corresponding genomic locations as a training set. TSSFinder is a valuable new tool for the annotation of genomes. TSSFinder source code and docker container can be downloaded from http://tssfinder.github.io. Alternatively, TSSFinder is also available as a web service at http://sucest-fun.org/wsapp/tssfinder/.

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