Minas Gerais e o Brasil diante das opções de integração econômica

-Este projeto tem por objetivo construir um indicador de atividade econômica de alta freqüência, com periodicidade diária, para a cidade de Juiz de Fora a partir de dados de resíduos sólidos, coletados junto da Empresa Municipal Demlurb. Esse indicador preenche uma lacuna de índices de acompanhamento do desempenho econômico da cidade, com baixíssimo custo para a sua elaboração. A idéia desse índice baseia-se no fato de haver uma forte correlação positiva entre a produção de resíduos sólidos e a atividade econômica. Os resultados mostram que houve uma ligeira tendência de crescimento

IGF-1R and Leptin Expression Profile and the Effects of Metformin Treatment on Metabolic and Endocrine Parameters in PCOS Mice

We aim to assess the effects of metformin treatment on metabolic and endocrine parameters and genes expression related to the insulin-responsive pathway in polycystic ovary syndrome (PCOS). This study comprises twenty-eight obese mice divided into three metformin-treated groups for seven and twenty days and eight nonobese and nontreated ones. We found a significant decrease in glycemia after metformin treatment at days seven and twenty. However, we did not observe differences in body weight measurement. Histologically, after twenty days we observed follicular development with regression of androgenic effects. Levels of IGF-1R protein expression were low after twenty days of treatment, but LEP proteins showed an overexpression in the ovarian stroma. We assessed the IGF-1R and LEP mRNAs levelsdata showed a significant overexpression of LEP after seven days of treatment, while the IGF-1R was downregulated. Metformin therapy seems to exert a beneficial effect on histological and anovulatory features, reducing follicular number and pyknosis formation, possibly involved in the reversion of androgenic stimulus. Expression of IGF-1 and LEPR indicates a relevant role in androgenic features reversion present in PCOS, hormonal equilibrium, body weight regulation, and glucose metabolism, therefore, under phenotype obesity and infertility regulation in this model.Univ Fed Sao Paulo UNIFESP, EPM, Dept Obstet & Gynecol, Climacter Sect, 66 Embau St,Vila Clementino, BR-04039060 Sao Paulo, SP, BrazilUniv Sao Paulo, Sch Med, Dept Obstet & Gynecol, Lab Mol & Struct Gynecol, 455 Dr Arnaldo Ave,Room 4121,Cerqueira Cesar, BR-01246903 Sao Paulo, SP, BrazilUniv Fed Sao Paulo UNIFESP, EPM, Morphol Dept, Hist & Biol Struct Div, 740 Botucatu St,Vila Clementino, BR-04023009 Sao Paulo, SP, BrazilUniv Ctr United Metropolitan Coll, 1239 Santo Amaro Ave,Vila Nova Conceicao, BR-04505001 Sao Paulo, SP, BrazilUniv Fed Sao Paulo UNIFESP, EPM, Dept Obstet & Gynecol, Climacter Sect, 66 Embau St,Vila Clementino, BR-04039060 Sao Paulo, SP, BrazilUniv Fed Sao Paulo UNIFESP, EPM, Morphol Dept, Hist & Biol Struct Div, 740 Botucatu St,Vila Clementino, BR-04023009 Sao Paulo, SP, BrazilWeb of Scienc

Leisure time physical activity and cardio-metabolic health: results from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

Background-—Although increasing effort has been devoted to the promotion of a healthy lifestyle such as leisure time physical activity for cardio-metabolic health, specific evidence supporting health policy remains sparse, particularly in those ethnically diverse populations where cardio-metabolic diseases are reaching epidemic proportion and yet are grossly understudied. Methods and Results-—We conducted a cross-sectional analysis of the baseline data from 10 585 participants aged 35 to 74 free of cardiovascular diseases in the Brazilian Longitudinal Study of Adult Health. Leisure time physical activity status was defined by the American Heart Association and the World Health Organization recommendations (≥150 min/week moderate activities or 75 min/week vigorous activities). In total, 1183 (21%) women and 1387 (29%) men were active. After accounting for covariates, the favorable effects of leisure time physical activity on cardio-metabolic parameters were evident. Specifically, the average blood pressure, heart rate, and Framingham Risk Score for cardiovascular diseases of the active were significantly lower within each sex. The ORs comparing the active versus the inactive women were 0.78 (95% CI: 0.66–0.92) for hypertension and 0.78 (95% CI: 0.65– 0.93) for cardiovascular diseases in 10 years. Among men, the ORs were 0.75 (95% CI: 0.65–0.87) for hypertension and 0.73 (95% CI: 0.61–0.87) for diabetes. The 10-year risk of cardiovascular diseases was significantly lower among the active men with a 33% reduction (OR=0.67, 95% CI: 0.57–0.78). Conclusions-—We observed beneficial effects of leisure time physical activity on cardio-metabolic health in this large Brazilian population that are consistent with studies in North America and Europe

Diversity and ethics in trauma and acute care surgery teams: results from an international survey

Background Investigating the context of trauma and acute care surgery, the article aims at understanding the factors that can enhance some ethical aspects, namely the importance of patient consent, the perceptiveness of the ethical role of the trauma leader, and the perceived importance of ethics as an educational subject. Methods The article employs an international questionnaire promoted by the World Society of Emergency Surgery. Results Through the analysis of 402 fully filled questionnaires by surgeons from 72 different countries, the three main ethical topics are investigated through the lens of gender, membership of an academic or non-academic institution, an official trauma team, and a diverse group. In general terms, results highlight greater attention paid by surgeons belonging to academic institutions, official trauma teams, and diverse groups. Conclusions Our results underline that some organizational factors (e.g., the fact that the team belongs to a university context or is more diverse) might lead to the development of a higher sensibility on ethical matters. Embracing cultural diversity forces trauma teams to deal with different mindsets. Organizations should, therefore, consider those elements in defining their organizational procedures. Level of evidence Trauma and acute care teams work under tremendous pressure and complex circumstances, with their members needing to make ethical decisions quickly. The international survey allowed to shed light on how team assembly decisions might represent an opportunity to coordinate team member actions and increase performance

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Omecamtiv mecarbil in chronic heart failure with reduced ejection fraction, GALACTIC‐HF: baseline characteristics and comparison with contemporary clinical trials

Aims: The safety and efficacy of the novel selective cardiac myosin activator, omecamtiv mecarbil, in patients with heart failure with reduced ejection fraction (HFrEF) is tested in the Global Approach to Lowering Adverse Cardiac outcomes Through Improving Contractility in Heart Failure (GALACTIC‐HF) trial. Here we describe the baseline characteristics of participants in GALACTIC‐HF and how these compare with other contemporary trials. Methods and Results: Adults with established HFrEF, New York Heart Association functional class (NYHA) ≥ II, EF ≤35%, elevated natriuretic peptides and either current hospitalization for HF or history of hospitalization/ emergency department visit for HF within a year were randomized to either placebo or omecamtiv mecarbil (pharmacokinetic‐guided dosing: 25, 37.5 or 50 mg bid). 8256 patients [male (79%), non‐white (22%), mean age 65 years] were enrolled with a mean EF 27%, ischemic etiology in 54%, NYHA II 53% and III/IV 47%, and median NT‐proBNP 1971 pg/mL. HF therapies at baseline were among the most effectively employed in contemporary HF trials. GALACTIC‐HF randomized patients representative of recent HF registries and trials with substantial numbers of patients also having characteristics understudied in previous trials including more from North America (n = 1386), enrolled as inpatients (n = 2084), systolic blood pressure < 100 mmHg (n = 1127), estimated glomerular filtration rate < 30 mL/min/1.73 m2 (n = 528), and treated with sacubitril‐valsartan at baseline (n = 1594). Conclusions: GALACTIC‐HF enrolled a well‐treated, high‐risk population from both inpatient and outpatient settings, which will provide a definitive evaluation of the efficacy and safety of this novel therapy, as well as informing its potential future implementation

O CUSTO DE TRANSPORTE COMO BARREIRA AO COMÉRCIO NA INTEGRAÇÃO ECONÔMICA: O CASO DO NORDESTE

O foco da estratégia de integração do governo brasileiro nos últimos anos está na tentativa de acordos de integração econômica externa tanto em negociações Norte-Sul quanto Sul-Sul. Contudo, tais negociações – quer no âmbito da Rodada de Doha, quer no âmbito de blocos regionais (Alca, Mercosul etc.) – enfrentam sérias dificuldades para a sua concretização, além de uma extrema morosidade. Em vista disso, a opção da integração econômica interna pode ser uma saída para esse impasse no sentido de ser uma fonte de ganhos de bem-estar social e de promoção de eqüidade regional. Essa opção depende apenas da disposição do governo brasileiro e a lógica da estratégia de uma integração interna baseia-se na redução dos custos de transporte, entendidos como sendo uma barreira ao comércio interestadual. Uma comparação dos resultados da integração econômica interna com a externa, tendo como foco a economia do Nordeste, mostra-se relevante nesse momento. Para simular opções de integração econômica, foi elaborado o modelo BRASIL-SPACE, um modelo EGAE para análise de políticas de integração econômica no país e com destaque para a economia do Nordeste. Esse modelo incorpora explicitamente os custos de transporte como uma barreira de comércio. A estrutura teórica do modelo está desenvolvida para as cinco macroregiões brasileiras e cinco regiões externas (Nafta, Ásia, União Européia com 25 membros, a Alcsa composta pelos países sul-americanos e o resto do mundo). O modelo compreende três fatores de produção, a saber, mão-de-obra, capital humano e outros fatores. Foram simulados diversos experimentos controlados de políticas de integração econômica tanto externa quanto interna com o objetivo de se analisar quais são as melhores opções de integração abertas ao País e para o Nordeste, avaliadas sob o prisma da eficiência econômica e da eqüidade regional

Avaliação econômica do tráfico de drogas no Estado do Acre

The decision of an individual to migrate to the criminal economic activity of the drug trade is influenced by a set of social and economic characteristics. Therefore, it is believed that drug trafficking is related to the practice of other crimes, the purpose of this paper is the production of information that serve as input to actions of public and private agents that aim to combat the crime. In general, the objective of this paper is to make a socioeconomic assessment of the crime of drug trafficking in the state of Acre. Specifically, it aims: i) to conduct an economic and financial analysis of drug trafficking, and ii) to identify what factors are common among people who migrate to such criminal activity. Thus, it was found that the individual considers of great risk the drug trafficking activity, however, its high profitability makes it attractive.A decisão de um indivíduo em migrar para a atividade econômica criminosa do tráfico de drogas é influenciada por um conjunto de características econômicas e sociais. Diante disso, levando-se em conta que o tráfico de drogas está relacionado à prática de uma grande quantidade de outros crimes, a proposta deste trabalho consiste na produção de informações que sirvam de subsídio para ações de agentes públicos e privados que visem combater a criminalidade. De forma geral, o objetivo deste trabalho consiste em fazer uma avaliação socioeconômica do crime de tráfico de drogas no Estado do Acre. Especificamente, pretende-se: i) realizar uma análise econômica e financeira do tráfico de drogas e, ii) identificar quais são os fatores comuns entre as pessoas que migram para esta atividade criminosa. Assim, pôde-se constatar que o indivíduo considera a atividade do tráfico de drogas de grande risco, contudo, sua alta lucratividade a torna atrativa

PRODUTIVIDADE DO CAFÉ EM MINAS GERAIS: UMA ANÁLISE ESPACIAL

O objetivo do trabalho é analisar a produtividade média do café nas 66 microrregiões do Estado de Minas Gerais nos anos de 2000 e 2004 através da análise espacial dos dados. O auxílio de instrumentos de análise exploratória de dados espaciais (AEDE) permitirá uma visualização de possíveis autocorrelações espaciais existentes em relação à eficiência produtiva das microrregiões e seu comportamento ao longo dos anos em questão