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The diversity of sustainable certifications raises questions about the credibility, intentions, and impacts of Voluntary Sustainability Standards (VSS) on Global Value Chains (GVC). Few studies show the impacts of VSS on different sustainable dimensions in sectors such as the non-timber forest product (NTFP) sector. This paper aims to investigate in the value chain of the most important NTFP in the Amazon, açaí, whether VSS contributes to sustainable outcomes in the Governance, Environmental, Economic, and Social dimensions. Using case studies in enterprises of the açaí chain and the use of tools and indicators was possible to generate information that is currently scarce for NTFPs in the Amazon from the VSS perspective. The results show that there is a great distance that the weakest links of the GVC (Micro, Small, and Medium Enterprises - MSMEs) must walk to adopt VSS and be inserted into the global market. The requirements are based on bureaucratic management activities, which are extraordinarily complex and involve many issues and indicators. The VSS lacks supplements that evaluate and validate the results reported by the companies as sustainable. Finally, the VSS is still far from ensuring an inclusive and fully sustainable chain by itself.

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This paper discusses the potential of an international agreement to ensure equitable vaccine distribution, addressing the failures witnessed during the COVID-19 pandemic. COVAX was unable to prevent vaccine monopolization and unequal distribution, which led to significant disparities in vaccination rates and avoidable deaths. Any future agreement on equitable vaccine distribution must address ethical and practical issues to ensure global health equity and access. The proposed agreement should recognize healthcare as a human right and consider vaccines beyond mere commodities, emphasizing the social responsibility of pharmaceutical companies to prioritize affordability, availability, and accessibility, particularly for low-income countries (LICs). Voluntary licensing agreements are suggested as a means to enhance access to essential medicines. The paper also outlines the necessity of international cooperation, with robust compliance mechanisms, to effectively enforce such an agreement and mitigate future health crises.

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BACKGROUND: This study delves into the States' accountability for health-related Sustainable Development Goal (SDG) indicators from 2016 to 2020. An analysis of Voluntary National Reviews (VNR) is employed as an instrument to scrutinize the alignment of States' indicators with the global indicator framework, shedding light on global health governance within the context of the 2030 Agenda and States' strategic prioritization. A curation of 60 health-related indicators from 195 VNRs, produced during the aforementioned period, is organized into thematic groups. RESULTS: Our results highlight a concerning discrepancy in the reporting frequency of various health-related themes. The findings reveal a paradoxical coexistence characterized by the concurrent strengthening and diminution of the global health governance articulated in the Agenda's global health governance. This manifests in the increased utilization and consistency of health-related indicators over the study years, coupled with an emphasis on infectious diseases and child and maternal health indicators. Conversely, a discernible governance decline is evidenced by the inadequate representation of health-related indicators in VNRs, notably within the domains of universal health coverage and health system indicators. Furthermore, High-Income States exhibit diminished accountability. CONCLUSIONS: The VNRs unveil a paradox wherein burgeoning technical capacity coexists with governance deficits, a phenomenon attributable to both statistical capabilities and political preferences. The prevalent use of proxy indicators in VNRs oversimplifies the presentation of official indicators, thereby compromising the aspirational goal of pioneering statistical innovations for measuring intricate issues in the SDGs. In light of our conceptualization of the 2030 Agenda's global health as a regime complex governance, we advocate for comprehensive investigations into each health regime cluster. This approach aims to unravel disputes, discern patterns, and elucidate States' preferences concerning specific thematic areas. Functioning as an accountability mechanism for the Agenda's governance, VNRs underscore States' adaptability and short-term learning capabilities, offering valuable insights for identifying harmful goal prioritization. The discretionary nature of indicator selection by States in the VNRs, enabled by the Agenda's proposition of a contextual adaptation of the SDGs and a blind eye to the guideline's request to review all SDG indicators, highlights a critical flaw in the VNR as an accountability mechanism.

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This study aimed to investigate the effects of chronic ß-alanine (ßA) plus acute sodium bicarbonate (SB) co-supplementation on neuromuscular fatigue during high-intensity intermittent efforts in swimming. Eleven regional and national competitive-level young swimmers performed a neuromuscular fatigue assessment before and immediately after two 20 × 25-m front crawl maximal efforts every 90 s, performed at pre- and post-4-week co-supplementation. Neuromuscular fatigue was evaluated by percutaneous electrical stimuli through the twitch interpolation technique on the triceps brachii and quadriceps femoris. Performance was defined by the mean time of the 20 efforts and blood samples to lactate concentrations were collected every four efforts. Participants supplemented 3.2-6.4 g·day-1 of chronic ßA or placebo (PL) during four weeks, and acute 0.3 g·kg-1 of SB or PL 60 min before the second assessment (allowing ßA+SB and PL+PL groups). No statistical changes were found in neuromuscular fatigue of triceps brachii. In the quadriceps femoris, a main effect of time was found in potentiated twitch delta values in pooled groups, showing a statistical increase of 19.01% after four weeks (Δ = 13.05 [0.35-25.75] N; p = 0.044), without time × group interactions. No statistical difference was found in the swimming performance. Blood lactate increased by 25.06% only in the ßA+SB group (Δ = 6.40 [4.62-8.18] mM; p Bonf < 0.001) after the supplementation period. In conclusion, 4-week ßA and SB co-supplementation were not able to reduce neuromuscular fatigue levels and improve performance in highintensity intermittent efforts, but statistically increased blood lactate levels.

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An experiment was carried out to assess the effect of the incorporation of sun-dried foliage of Brosimum alicastrum into rations based on hay of Megathyrsus maximus on intake, rumen fermentation, kinetics of passage, microbial nitrogen supply to the small intestine, apparent digestibility in Pelibuey hair sheep. Four rations were randomly allotted to four rumen-cannulated lambs (BW = 37.4 ± 4.9 kg) using a 4 × 4 Latin square design to assess the effect of increasing levels (0, 15, 30 and 45% DM basis) of foliage of Brosimum alicastrum on a basal ration of M. maximus. Organic matter intake and water consumption increased linearly (p < 0.01) with increasing levels of B. alicastrum in the ration. The rate and potential extent of rumen fermentation of OM and CP of B. alicastrum were 10.6%/h and 86.6% and 11.4%/h and 95.2%, respectively, but no effect (p > 0.05) was found on the potential rumen degradation of DM (40.2%) or on the rate of degradation of DM (0.033%/h) of M. maximus, although a positive effect was found in the rumen degradation rate of NDF (p < 0.05). VFA and ammonia concentration in the rumen and the rate of passage of solids and liquids through the rumen (k1) increased linearly (p < 0.01) with increasing levels of B. alicastrum. Rumen pH was not affected by the incorporation of B. alicastrum (p > 0.05). Microbial nitrogen supply to the small intestine (p < 0.001), apparent digestibility of dry matter (p < 0.01) and NDF (p < 0.05) of the rations were also significantly increased as a result of the incorporation of B. alicastrum foliage. Results from this experiment suggest that the foliage of Brosimum alicastrum can be readily incorporated at around 30% of the ration of dry matter in hair sheep with beneficial effects on feed intake, rate of passage and microbial N supply to the lower tract.

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The objective of this research was to evaluate how pregnancy and feeding regimens affect the feed intake, digestibility, and efficiency of microbial nitrogen (N) synthesis in beef cows. Forty-four multiparous Nellore cows, comprising 32 gestating and 12 non-gestating cows, with an average weight of 451 ± 10 kg, were assigned to either a HIGH (ad libitum) or LOW (limited feeding at 1.2 times maintenance based on the NRC) feeding regimen during the gestational period. The dry matter intake (DMI) in kg/d was significantly greater (P < 0.01) in HIGH-fed cows. The DMI reduced (P < 0.05) in proportion to the shrunk body weight (SBW) as days of pregnancy (DOP) increased. The interaction between feeding level and DOP was significant (P < 0.05) for the digestibility of dry matter (DM), organic matter (OM), N compounds, ether extract (EE), ash- and protein-free neutral detergent fiber (NDFap), gross energy (GE), and total digestible nutrients (TDN). Except for DM and TDN digestibility, there was a reduced nutrient digestibility as gestation progressed in HIGH-fed cows. In contrast, digestibility increased as a function of DOP in LOW-fed cows. Microbial N synthesis (g/day) was significantly higher in HIGH-fed cows (P < 0.001) compared to LOW-fed cows. The efficiency of microbial N production per g of N intake and kg of digestible OM intake was (P = 0.021) and tended (P = 0.051) to be greater in LOW-fed cows compared to HIGH-fed cows. In summary, HIGH-fed Nellore cows reduce feed intake and digestibility with advancing gestation, affecting feed utilization. In addition, LOW-fed cows, showed higher microbial protein synthesis efficiency, potentially making them more nutrient-efficient under challenging nutritional conditions.

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OBJECTIVE: This study examined the effectiveness of neuromuscular electrical stimulation (NMES) added to the exercise or superimposed on voluntary contractions on patient-reported outcomes measures (PROMs) in people with knee osteoarthritis (OA). METHODS: This systematic review was described according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Randomized controlled trials (RCTs) were obtained from a systematic literature search in five electronic databases (PubMed, PEDro, LILACS, EMBASE, and SPORTDiscus) in April 2022. We described the effects of intervention according to each PROMs (scores for Pain; Self-reported functional ability; Symptoms (hear clicking, swelling, catching, restricted range of motion, and stiffness); Daily living function; Sports function; and Quality of life) and used a random-effect model to examine the impact of NMES plus exercise on pain compared with exercise in people with knee OA. RESULTS: Six RCTs (n = 367) were included. In the qualitative synthesis, the systematic literature analysis showed improvement in pain after NMES plus exercise compared with exercise alone in three studies. The other three studies revealed no difference between groups in pain, although similar improvement after treatments. In the meta-analysis, NMES at a specific joint angle combined with exercise was not superior to exercise alone in pain management (standardized mean difference = -0.33, 95% CI = -1.05 to 0.39, p = 0.37). There was no additional effect of NMES on exercise on self-reported functional ability, stiffness, and physical function compared with exercise alone. In only one study, symptoms, activities of daily living, sports function, and quality of life improved after whole-body electrostimulation combined with exercise. CONCLUSION: This review found insufficient evidence for the effectiveness of NMES combined with exercise in treating knee OA considering PROMs. While pain relief was observed in some studies, more high-quality clinical trials are needed to support the use of NMES added to the exercise in clinical practice. Electrical stimulation in a whole-body configuration combined with exercise shows promise as an alternative treatment option.

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Objectives: Maternal physical activity may impact behavioral and electrophysiological aspects of brain function, with short- and long-term effects on pre- and postnatal neurodevelopment of the offspring. This study evaluated in the rat the effects of maternal voluntary physical activity (MVPA) on food intake and weight gain in the dams, as well as anxiety-like behavior, short-term memory and the brain excitability-related phenomenon known as cortical spreading depression (CSD) on the mother-pup dyad.Methods: Female Wistar rats (n=33) were individually housed in cages containing a running wheel for a 30-days adaptation period before mating. Rats were classified as inactive (I); active (A) or very active (VA) according to the distance spontaneously travelled daily. During gestation, the dams continued to have access to the running wheel. Mothers and their respective pups (1 pup per mother) were evaluated in the open field test (OFT), object recognition test (ORT), elevated plus maze test (EPMT) and the CSD propagation features.Results: MVPA was directly associated with increased food intake and weight gain during gestation, and maternal anxiolytic-like behavioral responses in the OFT. Pups from VA mothers showed a high discrimination index for shape recognition memory (ORT) and decreased propagation velocities of CSD, when compared with the inactive group.Discussion: The data suggest that MVPA during the gestational period induces neuroplasticity and may modulate the brain functions in the mother-infant dyad in the rat.

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Resumo Eutanásia voluntária ativa (EVA) e suicídio assistido (SA) são práticas de fim de vida que, embora permeadas de tabus e controvérsias, visam minimizar o sofrimento das pessoas com doenças incuráveis, preservando sua dignidade humana diante da morte. Neste artigo, objetivamos investigar a situação jurídico-normativa dessas práticas no Brasil, por meio de uma pesquisa documental qualitativa que buscou dados do período de 1981 a 2020 nos sites do Poder Legislativo Federal. Com base na proposta hermenêutica dialética, discutimos o percurso das decisões políticas sobre EVA, SA (e suas relações com a ortotanásia e cuidados paliativos) e os efeitos práticos de suas construções valorativas e morais para a autodeterminação das pessoas tanto no processo de morte quanto na sociedade.

Abstract Voluntary active euthanasia (VAE) and assisted suicide (AS) constitute end-of-life practices that aim to minimize the suffering of people with incurable diseases, preserving their human dignity in the face of death. However, taboos and controversies still surround them. This study aims to investigate the legal-normative status of these practices in Brazil via a qualitative documentary research with data from the Federal Legislative Power websites from 1981 and 2020. The dialectical hermeneutic proposal of this study discusses the path of political decisions on VAE, AS (and their relations with orthothanasia and palliative care), and the practical effects of their values and moral constructions on people's self-determination in the dying process and in society.

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Com o intuito de chegar aos motivos que levam pessoas à entrega voluntária, escolhemos a comarca do Rio de Janeiro, RJ - Brasil - como lócus privilegiado. O caminho metodológico utilizado para a presente pesquisa foi a análise documental sobre ações de destituição de poder familiar e extinção de poder familiar que tramitaram a partir da promulgação da Lei n. 13.509/17, com atenção especial ao contexto pandêmico. A partir de reflexões propostas por Ferreira e Lowenkron, a coleta e análise desses documentos foi realizada levando em conta que a produção, a escrita e a circulação dos autos são tecnologias de fabricação das realidades. A partir das multiplicidades de vozes sobre os motivos para a entrega voluntária, construímos três eixos de análise: (1) a impossibilidade do cuidado; (2) a recusa da maternidade, a resignação e a indiferença; e (3) a violência institucional.(AU)

This study sought to understand the reasons for "voluntary surrender" in the district of Rio de Janeiro, Brazil. We performed a document analysis of termination of parental rights actions and extinction of parental rights actions that took place after the promulgation of Law 13509/17, focusing on the context of the Covid-19 pandemic. Drawing on the reflections of Ferreira and Lowenkron, data collection and document analysis was performed bearing in mind that the production, writing and circulation of writs are reality manufacturing technologies. Based on the multiplicity of voices speaking about the motives, we defined three core themes of analysis: (1) the impossibility of care; (2) the refusal of motherhood, resignation and indifference; and (3) institutional violence.(AU)

Con el objetivo de llegar a los motivos que llevan a las personas a la "entrega voluntaria", elegimos la comarca de Río de Janeiro/RJ - Brasil como locus privilegiado. El camino metodológico fue el análisis documental sobre acciones de destitución de poder familiar y extinción de poder familiar que se tramitaron a partir de la promulgación de la Ley nº 13.509/17, con atención especial al contexto pandémico. A partir de reflexiones propuestas por Ferreira y Lowenkron, la colecta y análisis de esos documentos se realizó llevando en consideración que la producción, la redacción y la circulación de los autos son tecnologías de fabricación de las realidades. A partir de las multiplicidades de voces sobre los motivos, construimos tres ejes de análisis: (1) la imposibilidad del cuidado, (2) el rechazo de la maternidad, la resignación y la indiferencia y (3) la violencia institucional.(AU)

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ABSTRACT Introduction: The severe exercise intensity domain can be defined as the range of work rates or speeds over which VO2max can be elicited. Objectives: Our purpose was to determine if critical speed (running analog of critical power) identifies the lower boundary of the severe domain and to identify the upper boundary of the domain. Methods: Twenty-five individuals performed five running tests to exhaustion, each lasting > 2.5 min and < 16 min. The two-parameter speed vs time-to-exhaustion relationship generated values for critical speed and the three-parameter speed vs time-to-reach-VO2max relationship generated values for the threshold speed above which VO2max can be elicited. The relationships were solved to calculate the minimum time needed to elicit VO2max. Results: Critical speed (3.00 ± 0.38 m·s−1) and the threshold speed above which VO2max can be elicited (2.99 ± 0.37 m·s−1) were correlated (r = 0.83, p < 0.01) and did not differ (p = 0.70), confirming critical speed as the lower boundary of the severe domain. The minimum time needed to elicit VO2max (103 ± 7 s) and the associated highest speed at which VO2max can be elicited (4.98 ± 0.52 m·s−1) identified the upper boundary of the severe domain for these participants. Conclusion: The critical power concept, which requires no metabolic measurements, can be used to identify the lowest speed at which VO2max can be elicited. With addition of metabolic measurements, mathematical modeling can also identify the highest speed and shortest exercise duration at which VO2max can be elicited. Evidence Level I; Validating cohort study with good reference standards.

RESUMEN Introducción: El dominio de la intensidad del ejercicio severo se puede definir como el rango de ritmos o velocidades de trabajo sobre las que se puede obtener el VO2max. Objetivos: Nuestro propósito fue determinar si la velocidad crítica (funcionamiento analógico de potencia crítica) identifica el límite inferior del dominio severo e identificar el límite superior del dominio. Métodos: Veinticinco personas realizaron cinco pruebas de carrera hasta el agotamiento, cada una con una duración de > 2,5 min y <16 min. La relación de dos parámetros de velocidad frente a tiempo de agotamiento generó valores para la velocidad crítica y la relación de tres parámetros de velocidad frente a tiempo de alcance de VO2max generó valores para la velocidad umbral por encima del cual se puede obtener el VO2max. Las relaciones se resolvieron para calcular el tiempo mínimo necesario para obtener el VO2max. Resultados: La velocidad crítica (3,00 ± 0,38 m·s−1) y la velocidad umbral por encima de la cual se puede obtener el VO2max (2,99 ± 0,37 m·s−1) se correlacionaron (r = 0,83, p < 0,01) y no difirieron (p = 0,70), lo que confirma la velocidad crítica como el límite inferior del dominio severo. El tiempo mínimo necesario para obtener el VO2max (103 ± 7 s) y la velocidad más alta asociada a la que se puede obtener el VO2max (4,98 ± 0,52 m·s−1) identificaron el límite superior del dominio severo para estos participantes. Conclusión: El concepto de potencia crítica, que no requiere mediciones metabólicas, se puede utilizar para identificar la velocidad más baja a la que se puede obtener el VO2max. Con la adición de mediciones metabólicas, el modelado matemático también puede identificar la velocidad más alta y la duración más corta del ejercicio a la que se puede obtener VO2max. Nivel de Evidencia I; Estudio de cohortes con alto estándar de referencia.

RESUMO Introdução: O domínio de intensidade de exercício severo pode ser definido como a faixa de taxas de trabalho ou velocidades sobre as quais o VO2max pode ser obtido. Objetivos: Nosso propósito foi determinar se a velocidade crítica (execução analógica da potência crítica) identifica o limite inferior do domínio severo e identificar o limite superior do domínio. Métodos: Vinte e cinco indivíduos realizaram cinco testes de corrida até a exaustão, cada um com duração > 2,5 min e < 16 min. A relação velocidade de dois parâmetros contra tempo até a exaustão gerou valores para a velocidade crítica e a relação velocidade de três parâmetros contra tempo para alcançar o VO2max valores gerados para a velocidade limite acima da qual o VO2max pode ser obtido. As relações foram resolvidas para calcular o tempo mínimo necessário para eliciar o VO2max. Resultados: A velocidade crítica (3,00 ± 0,38 m·s−1) e a velocidade limite acima da qual o VO2max pode ser eliciado (2,99 ± 0,37 m·s−1) foram correlacionadas (r = 0,83, p < 0,01) e não diferiram (p = 0,70), confirmando a velocidade crítica como o limite inferior do domínio grave. O tempo mínimo necessário para eliciar o VO2max (103 ± 7 s) e a maior velocidade associada na qual o VO2max pode ser eliciado (4,98 ± 0,52 m·s−1) identificou o limite superior do domínio severo para esses participantes. Conclusão: O conceito de potência crítica, que não requer medidas metabólicas, pode ser usado para identificar a velocidade mais baixa em que o VO2max pode ser eliciado. Com a adição de medidas metabólicas, a modelagem matemática também pode identificar a velocidade mais alta e a duração mais curta do exercício em que o VO2max pode ser obtido. Nível de Evidência I; Estudo de coorte com alto padrão de referência.

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Introducción. Determinar el efecto de ocho semanas de entrenamiento por hiperpnea isocápnica voluntaria (HIV) sobre el costo energético asociado a la respiración (COB) reflejado en los cambios en la oxigenación de los músculos intercostales (∆SmO2-m. intercostales) inducida por ejercicio físico de intensidad incremental. Métodos. Doce participantes físicamente activos fueron entrenados durante ocho semanas de HIV 3 días x semana, 12 minutos, al 60% de ventilación voluntaria máxima (VVM). En la semana previa y posterior al entrenamiento HIV se realizó un test cardiopulmonar (CPET) de intensidad incremental en cicloergómetro, durante esta prueba se registró la ∆SmO2-m. intercostales mediante el dispositivo MOXY®. El efecto de HIV sobre la ∆SmO2-m. intercostales se analizó mediante la prueba two-way mixed ANOVA considerando los factores (fase × tarea). Resultados. ∆SmO2-m.intercostales fue significativamente menor a partir del 30% (­5,0±4,7%; p<0.01) hasta el 100% (­10,6±12,8%; p<0.01) de la tarea luego de ocho semanas de HIV. Además, se reportó un aumento de la presión inspiratoria máxima (PIM)=16,5±11,4 cmH2O (p<0.01); y de la resistencia muscular respiratoria=106,6±149,0 s (p<0.01). El tiempo total de ejercicio aumentó en 106,6±149,0 s (p=0.04), así como la carga total en 10,50± 10,12 vatios (p<0.01). Conclusión. El HIV disminuye el COB inducido por ejercicio incremental asociado a un incremento en la performance física y de los músculos respiratorios. En futuros estudios se sugiere estudiar esta estrategia de entrenamiento analítico de los músculos respiratorios en usuarios con limitación física relacionada al aumento prematuro del COB.

Background. Objetive. To determine the effect of eight weeks of voluntary isocapnic hyperpnea (VIH) training on cost of breathing (COB) as reflected by intercostales muscles deoxygenation (∆SmO2-m. intercostales) induced by incremental-intensity physical exercise. Methods. Twelve physically active participants underwent eight weeks of VIH training, three days a week, for 12 minutes each session, at 60% of maximal voluntary ventilation (MVV). In the week before and after VIH training, a cardiopulmonary test (CPET) of incremental intensity was performed on a cycloergometer. During this test, intercostal ∆SmO2-m.intercostales was recorded using the MOXY® device. The effect of VIH on ∆SmO2-m.intercostales were analyzed using a two-way mixed ANOVA test considering the factors (phase × task). Results. ∆SmO2-m.intercostales significantly decreased from 30% (­5.0±4.7%; p<0.01) to 100% (­10.6±12.8%; p<0.01) of the task after eight weeks of VIH. Additionally, an increase in maximal inspiratory pressure (MIP) of 16.5±11.4 cmH2O (p<0.01) and respiratory muscle endurance of 106.6±149.0 s (p<0.01) was reported. Total exercise time increased by 106.6±149.0 s (p=0.04), as well as total workload by 10.50±10.12 watts (p<0.01). Conclusion. VIH reduces COB induced by incremental exercise and is associated with increased physical and respiratory muscle performance. Future studies should explore this respiratory muscle training strategy for individuals with physical limitations related to a premature increase in COB.

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BACKGROUND: The pulmonary impairment in patients with bronchoconstriction induced by eucapnic voluntary hyperpnea(EVH) goes beyond the respiratory system, also impairing autonomic nervous modulation. This study aimed to evaluate the behavior of cardiac autonomic modulation in young asthmatics with and without EIB after the EVH test. RESEARCH DESIGN AND METHODS: A cross-sectional study design using 54 asthmatics(51.9% female), aged between 10 and 19 years, investigated with the EVH test. Forced expiratory volume in one second(FEV1) was measured at 5, 10, 15, and 30 min after EVH. Heart rate variability(HRV) measures of time were assessed pre and 30 min-post EVH. The diagnosis of Exercise-Induced bronchoconstriction with underlying clinical asthma(EIBA) was confirmed by a fall in FEV1 ≥10% compared to baseline. RESULTS: Thirty(55.5%) asthmatics had EIBA. Subjects with EIBA have reduced mean of the R-R intervals in relation to baseline until 15 minutes after EVH. Individuals without EIBA had increased parasympathetic activity compared to baseline(rMSSD) from 5 min after EVH(p < 0.05). This parasympathetic activity increase in relation to baseline was seen in individuals with EIBA after 25 minutes (rMSSD = 49.9 ± 5.3 vs 63.5 ± 7.2, p < 0.05). CONCLUSION: Young asthmatics with EIBA present a delay in the increase of the parasympathetic component after EVH when compared to asthmatics without EIBA.

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The effects of voluntary running on the skeletal muscle of rats with pulmonary arterial hypertension (PAH) were tested in the present study. PAH was induced in rats by a single injection of monocrotaline (MCT, 60 mg/kg). Rats in the sedentary hypertension (HS) group had their tolerance to physical exertion reduced throughout the experiment, while those in the sedentary control (SC), exercise control (EC), exercise hypertension (EH) and median exercise (EM) groups maintained or increased. Despite that, the muscular citrate synthase activity was not different between groups. The survival time was higher in the EH (32 days) than in the SH (28 days) (p = 0.0032). SH and EH groups showed a lower percentage of muscle fiber and a higher percentage of extracellular matrix compared to control groups (p < 0.0001). However, the EM and EH groups presented higher percentage of muscle fiber and lower percentage of extracellular matrix than SH group (p < 0.0001). Regarding muscular gene expression, the SH and EM groups showed a lower expression of PGC1-α (p = 0.0024) and a higher expression of VEGF (p = 0.0033) compared to SC, while PGC1-α was elevated in the EH. No difference between groups was found for the carbonylated protein levels (p > 0.05), while the TNF-α/IL-10 ratio was augmented in the EH (p = 0.0277). In conclusion, voluntary running augments the proportion of fiber and affects the gene expression of inflammatory and mitochondrial biogenesis' markers in the skeletal muscle of rats with MCT-induced PAH, which benefits their survival and tolerance to physical effort.

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Capitán, C. y Aragón, L.F. (2023). La sed ¿un mecanismo suficiente para lograr euhidratación?: una revisión narrativa. PENSAR EN MOVIMIENTO: Revista de Ciencias del Ejercicio y la Salud, 21(1), 1-16. El papel de la percepción de sed para mantener el balance hídrico ha sido ampliamente estudiado, tanto durante el ejercicio como después de este. Sin embargo, la forma de evaluarla y la eficacia de los instrumentos existentes son aún áreas que necesitan más investigación. El objetivo de esta revisión fue integrar, de forma general, la información disponible en la literatura sobre el funcionamiento del mecanismo de la sed como respuesta a la deshidratación durante y después del ejercicio. Se explican los mecanismos fisiológicos y las respuestas de estos durante y posterior al ejercicio; además, se describen los instrumentos disponibles en la literatura científica, sus debilidades y fortalezas, y se plantea una serie de preguntas que aún no tienen respuesta en el área. En esta revisión se presenta el aspecto teórico de los mecanismos de la sed, además, se discuten los estudios científicos que respaldan o refutan el comportamiento de estos mecanismos en el ejercicio. Finalmente, se hace un resumen de las principales conclusiones extraídas de la literatura científica sobre la sed como un mecanismo suficiente para prevenir la deshidratación tanto durante como después del ejercicio.

Capitán, C. y Aragón, L.F. (2023). Is thirst sufficient as a mechanism for achieving euhydration? a narrative review. PENSAR EN MOVIMIENTO: Revista de Ciencias del Ejercicio y la Salud, 21(1), 1-16. The role of thirst perception for keeping hydric balance, both during and after exercise, has been extensively studied. However, the way to assess it and the effectiveness of the existing instruments are areas that still require further research. The objective of this review is to integrate, in a general way, the information available in the literature on the functioning of the thirst mechanism as a response to dehydration during and after exercise. The physiological mechanisms and their responses during and after exercise are explained. In addition, a description of the instruments available in scientific literature is included, together with their weaknesses and strengths, and a series of as yet unanswered questions in this area are raised. This review presents the theoretical aspect of thirst mechanisms, and discusses the scientific studies that support or refute the behavior of these mechanisms in exercise. Finally, a summary is made of the major conclusions drawn from the scientific literature on thirst as a sufficient mechanism to prevent dehydration both during and after exercise.

Capitán, C. y Aragón, L.F. (2023). A sede é um mecanismo suficiente para alcançar a hidratação? uma revisão narrativa. PENSAR EN MOVIMIENTO: Revista de Ciencias del Ejercicio y la Salud, 21(1), 1-16. O papel da percepção da sede na manutenção do equilíbrio hídrico tem sido amplamente estudado, tanto durante quanto após o exercício. Entretanto, como avaliá-la e a eficácia dos instrumentos existentes ainda são áreas que necessitam de mais pesquisas. Esta revisão visou integrar, de forma geral, as informações disponíveis na literatura sobre o funcionamento do mecanismo da sede em resposta à desidratação durante e após o exercício. Ele explica os mecanismos fisiológicos e suas respostas durante e após o exercício, descreve os instrumentos disponíveis na literatura científica, seus pontos fracos e fortes, e levanta uma série de questões que permanecem sem resposta no campo. Esta revisão apresenta o aspecto teórico dos mecanismos da sede e discute os estudos científicos que respaldam ou refutam o comportamento desses mecanismos no exercício. Finalmente, é feito um resumo das principais conclusões extraídas da literatura científica sobre a sede como mecanismo suficiente para prevenir a desidratação tanto durante quanto após o exercício.

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Abstract The right to die is an international dilemma. Some countries and states already have laws regulating one of the most common applications of this right, the active voluntary euthanasia. The evidence from these countries highlights the importance of a bioethical framework to limit some of its applications. In this regard, the evaluation of attitudes towards euthanasia in medical personnel will allow to understand the attitudes of these professionals and how they can deal with such requests, whether this assisted death is decided by the patients or their surroundings. Consequently, the aim of this study was to develop a brief scale to evaluate attitudes, as well as to determine their significance according to the gender and seniority of the professionals in this situation. A double design strategy was followed. On the one hand, a psychometric design with an exploratory and confirmatory factor analysis and, on the other, a descriptive analytical design for the comparison of groups. A six-item scale (AE-PM) and two factors were extracted. The first focuses on attitudes towards euthanasia to alleviate suffering for medical reasons and the second one to alleviate the patient's emotional suffering. The scale (AHE-PM) is useful for the rapid exploration of attitudes towards euthanasia in physicians, a professional group with limited free time, who may also encounter relatively frequent requests for active voluntary euthanasia. The two factors obtained allow attitudes to be assessed from a bioethical perspective, providing information on the application under apparent medical justification and in situations based on the patient's subjective emotional suffering.

Resumen La eutanasia voluntaria activa se define como la petición de un paciente que quiere morir y la acción que es llevada a cabo por otra persona para provocar dicha muerte. El derecho a morir es un dilema sobre el que se debate a nivel internacional. Algunos países y estados ya cuentan con leyes que regulan una de las aplicaciones más comunes de este derecho. Los datos aportados por estos países ponen de manifiesto la importancia de un marco bioético que permita limitar algunas de sus aplicaciones. En este sentido, la evaluación de las actitudes hacia la eutanasia en personal médico permitirá conocer las actitudes de estos profesionales y cómo estos pueden enfrentarse a dichas solicitudes, o no, sea de muerte asistida por parte de los pacientes o su entorno. Además, se ha reportado en la bibliografía diferentes actitudes según la experiencia o el sexo de los trabajadores, por lo que es de relevancia su exploración diferencial. Por ello, el objetivo del presente trabajo un instrumento de evaluación de actitudes hacia la eutanasia diseñado y validado por y para profesionales médicos en ejercicio. En esta línea, los objetivos de este estudio son obtener una escala corta con propiedades psicométricas adecuadas, que proporcione información relevante sobre las actitudes hacia la eutanasia, así como la posible evaluación de algunas prácticas médicas relacionadas con ésta que pueden ser bioéticamente dudosas. La muestra estaba compuesta por 419 profesionales de la medicina procedentes de tres provincias del sur de España. Se siguió una doble estrategia en el diseño. Por un lado, un diseño psicométrico con un análisis factorial exploratorio y confirmatorio. Se dividió la muestra en dos submuestras aleatorias para realizar de forma paralela ambos análisis. Se utilizaron los estadísticos KMO, Bartlett, RMSEA, RMRS, CFI, NNFI, GFI y AGFI para explorar el ajuste de modelos. Po otro lado, se utilizó un diseño asociativo descriptivo para la comparación de grupos mediante la t de Student, ANOVA, Tukey y la prueba d de Cohen. Se extrae una escala de seis ítems (AE-PM) y dos factores. El primero de ellos está centrado en las actitudes hacia la eutanasia para aliviar el sufrimiento por cuestiones médicas y el segundo para aliviar el sufrimiento emocional del paciente. Respecto al estudio de las diferencias, no se observaron diferencias significativas según el sexo del profesional ni la antigüedad en la profesión. La escala (AHE-PM) es útil para la exploración rápida de las actitudes hacia la eutanasia en médicos, un grupo profesional con limitado tiempo libre que, además, puede encontrarse con relativa frecuencia ante solicitudes de eutanasia voluntaria activa. Los dos factores obtenidos permiten evaluar, por un lado, las actitudes desde una perspectiva bioética. Es de especial relevancia en estas situaciones el conocimiento de las actitudes del personal médico hacia la eutanasia, exponiéndolo a un dilema bioético y personal. La autoconciencia de estos profesionales sobre sus propias actitudes hacia la eutanasia y su adaptación a los códigos éticos vigentes podría minimizar el impacto generado por estas situaciones y, por tanto, mejorar la relación terapéutica y la calidad asistencial. Por otro lado, el instrumento aporta información sobre la posible recomendación de estas prácticas bajo aparente justificación médica y/o en situaciones basadas en el sufrimiento emocional subjetivo del paciente. Estudios previos indican que los profesionales se ven afectados emocionalmente cuando se enfrentan a los conceptos de muerte y eutanasia en pacientes terminales. En este sentido, la escala también podría servir de evaluación de actitudes y el trabajo en planes de prevención de salud laboral en los centros sanitarios.

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Privately protected areas (PPAs) are a potentially innovative conservation tool. Legal recognition is necessary for their success, especially where there are institutional challenges to nature conservation, such as in South America. Although PPAs have increased in South America since the early 2000s, there is a critical information gap pertaining to their legal frameworks. We analyzed the level of landowner commitment to and governmental support for PPAs across countries in South America that officially recognize PPAs. We analyzed the legal framework governing PPAs and reviewed literature on them. This process was done in English and Spanish. The information we gathered was validated by 16 conservation experts from 10 South American countries. Because Peru is 1 of only 2 South American countries where local communities create and manage PPAs, we studied Peruvian PPAs in more detail by examining official creation documents and interviewing 13 local conservation professionals. We found inadequate minimum duration of PPAs and vague guidelines for conducting economic activities within them and a lack of governmental support (e.g., financial and technical support) for PPAs. Support was limited to the exemption from rural property taxes, which are relatively low compared with countries outside South America. In Peru, PPAs run by individuals and communities needed different legal frameworks because they were created with different objectives and had different sizes and duration of commitments. The prompt improvement of legal frameworks across South America is necessary for PPAs to achieve their aim of being places for enduring nature conservation in the region.

Una revisión legal de la conservación voluntaria entierras privadas de América del Sur Resumen Las áreas protegidas privadas (APP) son una herramienta de conservación con potencial innovador. Para ser exitosas, las APP necesitan reconocimiento legal, especialmente cuando existen obstáculos institucionales para la conservación de la naturaleza, como sucede en América del Sur. Aunque las APP han aumentado en esta zona desde principios de la década del 2000, existe un vacío de información con respecto a sus marcos legales. Analizamos el nivel de compromiso de los terratenientes y el apoyo gubernamental hacia las APP en los países de América del Sur que reconocen de forma oficial las APP. Analizamos el encuadre legal que rige a las APP y revisamos la literatura existente sobre ellas; realizamos este proceso en inglés y en español. Dieciséis expertos de la conservación de diez países sudamericanos validaron la información recopilada. Ya que Perú es uno de los dos países de la zona en donde las comunidades locales crean y manejan las APP, nos enfocamos en sus APP y examinamos a detalle los documentos oficiales de creación y entrevistamos a 13 profesionales de la conservación locales. Encontramos una duración mínima inadecuada de las APP y directrices vagas para la realización de actividades dentro de ellas, así como una falta de apoyo gubernamental (p. ej.: apoyo económico y técnico). Este apoyo se limitaba a la exención de los impuestos sobre la propiedad rural, los cuales son relativamente bajos en comparación con los países fuera de América del Sur. En Perú, las APP a cargo de individuos y comunidades necesitaban diferentes encuadres legales porque fueron creados con diferentes objetivos y tenían diferentes tamaños y plazos para los compromisos. Se necesita una rápida mejora de los marcos legales en América del Sur para que las APP logren el objetivo de ser sitios para que perdure la conservación de la naturaleza en la región.

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Cardiovascular control is vulnerable to forced high sodium consumption during the per-inatal period, inducing programming effects, with anatomical and molecular changes at the kidney, brain, and vascular levels that increase basal and induce blood pressure. However, the program- ming effects of the natriophilia proper of the perinatal period on blood pressure control have not yet been elucidated. In order to evaluate this, we studied the effect of a sodium overload challenge (SO) on blood pressure response and kidney and brain gene expression in adult offspring exposed to voluntary hypertonic sodium consumption during the perinatal period (PM-NaCl group). Male PM-NaCl rats showed a more sustained increase in blood pressure after SO than controls (PM-Ctrol). They also presented a reduced number of glomeruli, decreased expression of TRPV1, and increased expression of At1a in the kidney cortex. The relative expression of heteronuclear vaso- pressin (AVP hnRNA) and AVP in the supraoptic nucleus was unchanged after SO in PM-NaCl in contrast to the increase observed in PM-Ctrol. The data indicate that the availability of a rich source of sodium during the perinatal period induces a long-term effect modifying renal, cardiovascular, and neuroendocrine responses implicated in the control of hydroelectrolyte homeostasis.

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While Chile's partial decriminalization of abortion in 2017 was a long overdue recognition of women's sexual and reproductive rights, nearly four years later the caseload remains well below expectations. This pattern is the product of standing barriers in access to abortion-related health services, especially at the primary care point of entry. This study seeks to identify and describe these barriers. The findings presented here were obtained through a qualitative, exploratory study based on 19 semi-structured interviews with relevant actors identified through non-random sampling and snowballing techniques. Coding was inductive and complemented by semantic content analysis. The authors find that the key barriers in primary care to accessing legal abortion are unfamiliarity with the law, insufficient practitioner training, intersectoral discrimination, and the stigma surrounding abortion. They conclude that the government needs to exercise its constitutional mandate as guarantor of public health and act promptly to safeguard and guarantee the abortion rights of Chilean women.

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ABSTRACT The article analyzes aspects of the change in the legal nature of private healthcare from "for-profit" to "non-profit" entities. It is an exploratory research, supported by the policy analysis framework, focusing on secondary data from the Cadastro Nacional de Estabelecimentos de Saúde (National Registry of Health Facilities - CNES) from 2012 to 2020 and a case study. The results show an increase in these entities in all regions of the country and evidence that they behave like profit-oriented entities. The change in legal nature hides a broader process of implicit commodification of healthcare services, encouraged by state policies and related to exemptions provided by law.

RESUMO O artigo analisa aspectos da mudança da natureza jurídica de instituições privadas de assistência à saúde, de estabelecimentos "com" para "sem" fins lucrativos. Trata-se de uma pesquisa exploratória, apoiada no referencial de análise de políticas, com foco em dados secundários, provenientes do Sistema de Cadastro Nacional de Estabelecimentos de Saúde (SCNES), de 2012 a 2020, e estudo de caso. Os resultados apresentam aumento dessas entidades em todas as regiões do país e evidências de que se comportam como estabelecimentos com fins lucrativos. A mudança de natureza jurídica oculta um processo mais amplo de mercantilização implícita dos serviços de saúde, incentivado por políticas estatais e relacionado às isenções previstas em lei.

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