Metabolismo socioeconômico (MSE)

O metabolismo socioeconômico (MSE) é uma perspectiva teórica e metodológica que tem a pretensão de entender as relações entre as sociedades e a natureza, no sentido de qualificação e quantificação dos impactos biofísicos advindos da apropriação dos seus recursos energéticos e materiais, liberação de resíduos e rejeitos, e efeitos sinérgicos dessas atividades como consequência da ação humana. Partindo dessa abordagem, o presente estudo analisa a inter-relação entre o MSE e economia ecológica (EE), verificando que existe uma convergência teórico-metodológica entre ambas as abordagens. Metodologicamente, o estudo constituiu de um levantamento documental, analisando pesquisas acadêmicas teóricas e aplicadas sobre a temática. Os resultados demonstram que o MSE pode contribuir metodologicamente para a análise de dados e informações na EE, sobretudo na análise macroeconômica, segmento que vem ganhando relevância na última década.The socioeconomic metabolism (SEM) is a theoretical and methodological perspective that pretends to understand the interrelations between nature and society by quantifying and qualifying the biophysical impacts arising from the appropriation of energy and material resources provided by the environment. Based onthis approach, the present study analyses the connections between SEM and ecological economics (EE), indicating that there is a theoretical-methodological convergence between these two approaches. Methodologically, the study consisted of a documentary survey, analysing the academic and applied researches on the subject. The results demonstrated that SEM can be used for an analysis of data and information in EE, especially in the emergent field of ecological macroeconomics

MARCAÇÃO, DISPERSÃO E CAPACIDADE DE PARASITISMO DE Cotesia flavipes (CAMERON) (HYMENOPTERA: BRACONIDAE)

The objective of this study was to evaluate the biological aspects of C. flavipes your markup, and the development of a methodology for adult capture. Sugarcane borers fed on artificial diet containing the dyes SudanRed 7B and Solvent Blue 35 in concentrations of 200 and 400 ppm, vegetable oil at 200 and 400 ppm and without oil. Later, the caterpillars were parasitized in the above treatments. Evaluated the period between parasitism and the emergence of the larvae (egg-larval), the pupation, the weight of the masses and pupae, sex ratio, adult longevity and marking. After the setting of the dye / marker suitable concentration for adult C. flavipes, we evaluated the dispersibility and parasitism of adult females under field conditions. We used the Dunnett test for the variables related to the development of larvae, pupae and adults of C. flavipes and the GLM procedure for analysis of variance and the LSMEANS to fit the media in each factor tested. Set up The SudanRed 7B dye at a concentration of 200 ppm is the best dye / concentration to mark the larval parasitoid C. flavipes after developed the methodology for capturing C. flavipes, which associated with marking, allowed evaluating the flight capacity by distance and capture these individuals accurately. It was defined bottle trap 600 as the best pet for evaluation capture and parasitism. The maximum flight distance field in individuals was 17 meters, and the captured number was increased up to five meters.O objetivo deste trabalho foi avaliar os aspectos biológicos de C. flavipese sua marcação, além do desenvolvimento de uma metodologia para captura de adultos. Lagartas de D. saccharalis alimentadas com dieta artificial contendo os corantes SudanRed 7B e Solvent Blue 35 nas concentrações de 200 e 400 ppm, óleo vegetal a 200 e 400 ppm e sem óleo. Posteriormente, as lagartas foram parasitadas nos tratamentos supracitados. Avaliou-se o período entre o parasitismo e a emergência das larvas (ovo-larval), a empupação, o peso das massas e das pupas, razão sexual, longevidade dos adultos e marcação. Após a definição do corante/concentração adequado para marcar adultos de C. flavipes, avaliou-se a capacidade de dispersão e parasitismo das fêmeas adultas em condições de campo. Utilizou-se o teste de Dunnett para as variáveis relacionadas ao desenvolvimento de larvas, pupas e adultos de C. flavipes e o procedimento de GLM para análise de variância e o LSMEANS para ajustar as medias em cada fator testado. Definiu-se o corante SudanRed 7B na concentração de 200 ppm é o melhor corante/concentração para marcar o parasitoide larval C. flavipes, após desenvolvida a metodologia para captura de C. flavipes, que associadas à marcação, permitiram avaliar a capacidade de voo pela distância e captura desses indivíduos com precisão. Foi definida a armadilha de garrafa pet 600 como a melhor para avaliação de captura e parasitismo. A distância máxima de voo de indivíduos em campo foi de 17 metros, sendo que o maior número capturado foi até cinco metros

Predictors of rescue percutaneous coronary intervention after pharmacoinvasive strategy in women

AbstractBackgroundPharmacoinvasive therapy (PIT) is feasible in patients with acute myocardial infarction with ST-segment elevation (STEMI) when timely primary percutaneous coronary intervention (PCI) is unavailable. In this study, we compared women who underwent successful reperfusion PIT with those who required rescue PCI, to identify potential predictors of thrombolytic failure.MethodsFrom January 2010 to November 2014, 327 consecutive women with STEMI were referred to a tertiary hospital, 206 after successful thrombolysis (63%) and 121 who required rescue PCI. The groups were compared regarding demographic, clinical and angiographic outcomes, and clinical (TIMI, GRACE, and ZWOLLE CADILLAC) and bleeding (CRUSADE) risk scores. A multivariate logistic regression model was used to identify predictors of thrombolytic failure.ResultsThere was no significant difference between the demographic characteristics or the medical history of the groups. Rescue PCI group had significantly higher values of the evaluated scores. Clinical hospital complications and mortality (2.5% vs. 22.0%; p < 0.0001) were more frequent in rescue PCI group. The independent variables associated with rescue PCI were pain-to-needle time > 3h (OR: 3.07, 95%CI: 1.64 to 5.75; p < 0.0001), ZWOLLE score (OR: 1.25; 95%CI: 1.14 to 1.37; p = 0.0001) and creatinine clearance (OR: 1.009, 95%CI: 1.0 to 1.02; p = 0.04).ConclusionsWomen with STEMI who underwent PIT and who required rescue PCI had significantly higher mortality compared to those who achieved initial success of PIT with elective PCI. Pain-to-needle time > 3h, ZWOLLE score and creatinine clearance were independent predictors of the need for rescue PCI

Global variation in diabetes diagnosis and prevalence based on fasting glucose and hemoglobin A1c

Fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) are both used to diagnose diabetes, but these measurements can identify different people as having diabetes. We used data from 117 population-based studies and quantified, in different world regions, the prevalence of diagnosed diabetes, and whether those who were previously undiagnosed and detected as having diabetes in survey screening, had elevated FPG, HbA1c or both. We developed prediction equations for estimating the probability that a person without previously diagnosed diabetes, and at a specific level of FPG, had elevated HbA1c, and vice versa. The age-standardized proportion of diabetes that was previously undiagnosed and detected in survey screening ranged from 30% in the high-income western region to 66% in south Asia. Among those with screen-detected diabetes with either test, the age-standardized proportion who had elevated levels of both FPG and HbA1c was 29-39% across regions; the remainder had discordant elevation of FPG or HbA1c. In most low- and middle-income regions, isolated elevated HbA1c was more common than isolated elevated FPG. In these regions, the use of FPG alone may delay diabetes diagnosis and underestimate diabetes prevalence. Our prediction equations help allocate finite resources for measuring HbA1c to reduce the global shortfall in diabetes diagnosis and surveillance

Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults

Background Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. Methods We used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5–19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI &lt;18·5 kg/m2) and obesity (BMI ≥30 kg/m2). For school&#x2;aged children and adolescents, we report thinness (BMI &lt;2 SD below the median of the WHO growth reference) and obesity (BMI &gt;2 SD above the median). Findings From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in 11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and 140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%) with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and 42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents, the increases in double burden were driven by increases in obesity, and decreases in double burden by declining underweight or thinness. Interpretation The combined burden of underweight and obesity has increased in most countries, driven by an increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesit

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure &lt;= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt

Global variations in diabetes mellitus based on fasting glucose and haemogloblin A1c

Fasting plasma glucose (FPG) and haemoglobin A1c (HbA1c) are both used to diagnose diabetes, but may identify different people as having diabetes. We used data from 117 population-based studies and quantified, in different world regions, the prevalence of diagnosed diabetes, and whether those who were previously undiagnosed and detected as having diabetes in survey screening had elevated FPG, HbA1c, or both. We developed prediction equations for estimating the probability that a person without previously diagnosed diabetes, and at a specific level of FPG, had elevated HbA1c, and vice versa. The age-standardised proportion of diabetes that was previously undiagnosed, and detected in survey screening, ranged from 30% in the high-income western region to 66% in south Asia. Among those with screen-detected diabetes with either test, the agestandardised proportion who had elevated levels of both FPG and HbA1c was 29-39% across regions; the remainder had discordant elevation of FPG or HbA1c. In most low- and middle-income regions, isolated elevated HbA1c more common than isolated elevated FPG. In these regions, the use of FPG alone may delay diabetes diagnosis and underestimate diabetes prevalence. Our prediction equations help allocate finite resources for measuring HbA1c to reduce the global gap in diabetes diagnosis and surveillance.peer-reviewe

Dispersão de machos de Diatraea saccharalis (Fabricius) (Leipdoptera: Crambidae) em cana-de-açúcar

A broca-da-cana, Diatraea saccharalis (Fabr.), é a uma das pragas mais importantes da cana-de-açúcar no Brasil. Para o sucesso na utilização de plantas geneticamente modificadas visando o controle deste inseto, faz-se necessário conhecer sua dispersão. Estudos da dinâmica de vôo também podem ajudar na compreensão do comportamento do inseto, e de suas interações ecológicas. O estudo da dispersão de D. saccharalis foi possível através da marcação, liberação e captura dos machos adultos. A marcação foi realizada por meio da incorporação de corante lipossolúvel à dieta das larvas. As armadilhas de feromônio foram dispostas nos talhões de cana-de-açúcar nos sentidos norte, sul, leste e oeste, circundando o ponto de liberação. Os resultados obtidos mostram que mais de 45 % dos machos marcados capturados permaneceram nas áreas mais próximas ao ponto de liberação. Fatores climáticos como a temperatura, umidade relativa, velocidade do vento e precipitação não interferem decisivamente na captura dos machos liberados e dos machos do campo. A direção do vento exerce um papel fundamental na dispersão de D. saccharalis, uma vez que a maioria dos insetos voou a favor do vento. O modelo mais adequado para explicar a relação entre a distância de vôo e o número de indivíduos capturados é dado por y = a2/(1+(2a1,8bx))2,6. Com isso, para o manejo de resistência de D. saccharalis em cultivos de cana-de-açúcar geneticamente modificada expressando proteínas de Bacillus thuringiensis Berliner, deve se manter no máximo 800 m de distância entre as áreas de refúgioThe sugarcane borer, Diatraea saccharalis (Fabr.), is one of the most important sugarcane pests in Brazil. For a successful utilization of genetically modified crops aiming at the control of this insect, it is necessary to know its dispersal. Studies of flight dynamics can also help understand the insect’s behavior and its ecological interactions. The study of D. saccharalis dispersal was possible through labeling, releasing and capturing adult males. Labeling was performed by incorporating oil soluble dyes into the larval diet. The pheromone traps were placed in a sugarcane field following the cardinal directions (North, South, East, West) around the release site. The results showed that more than 45 % of the labeled males were captured closer to the release site. Climatic factors such as temperature, relative humidity, wind speed and rain do not affect decisively in the release or wild males capture. The wind direction is important in D. saccharalis dispersal, once the majority of insects flew towards the wind. The most adequate model to explain the relationship between flight distance and number of captured insects is y = a2/(1+(2a1,8bx))2,6. Thus, for resistance management of D. saccharalis in genetically modified sugarcane expressing Bacillus thuringiensis Berliner proteins, the refugia sites should be kept at most 800 m apar

Marcação, voo tutorado e dispersão de Anticarsia gemmatalis (Hübner) (Lepidoptera: Erebidae) e Chrysodeixis includens (Walker) (Lepidoptera: Noctuidae)

O uso de plantas Bt no controle de pragas possui riscos quanto à seleção de indivíduos resistentes. Por isso, a adoção de áreas de refúgio é crucial para minimizar a evolução da resistência. E para planejar a disposição e a distância entre essas áreas deve-se conhecer a dispersão dos insetos. Assim, o primeiro objetivo deste trabalho foi marcar Anticarsia gemmatalis (Hübner) (Lepidoptera: Erebidae) e Chrysodeixis includens (Walker) (Lepidoptera: Noctuidae) por meio de corantes lipossolúveis para definir o melhor corante-concentração a ser utilizados em estudos de dispersão. O segundo objetivo foi avaliar os efeitos da idade, do sexo e da cópula no voo tutorado, e o reflexo desses cenários na reprodução e no manejo de resistência, para, com isso, realizar estudos de dispersão de adultos de A. gemmatalis em soja. Os corantes azul (Solvent Blue 35) e vermelho (Sudan Red 7B) nas concentrações de 100 e 400 ppm diluídos em óleo foram testados. Verificou-se que o corante Sudan Red 7B a 400 ppm pode ser utilizado na marcação de A. gemmatalis, mas não para C. includens. Avaliou-se o voo tutorado e a reprodução de fêmeas e machos, copulados ou não com 2, 4 e 6 dias após a emergência. Constatou-se que diversas características relacionadas ao voo e à reprodução de A. gemmatalis reforçam a estratégia de refúgio estruturado em soja Bt, o que pode desacelerar o desenvolvimento de populações resistentes no campo. Avaliou-se a dispersão por meio da liberação e captura. Utilizaram-se armadilhas luminosas na captura dos insetos, distribuídas nos sentidos norte, sul, leste e oeste, e espaçadas a 150 m entre si até a distância máxima de 900 m. Mais de 10% dos adultos de A. gemmatalis estudados puderam voar mais de 800 m. Consequentemente, propõe-se que as áreas de refúgio em soja Bt sejam espaçadas a até 800 m de distância entre si, visando a diminuição da frequência dos indivíduos resistentes no campoThe use of Bt crops to control pests may cause environmental risks mainly due to selection of resistant individuals. Therefore, the use of refuge areas is crucial to minimize the evaluation of resistance. However, dispersal of target insects should be understood to properly plan the locations of these areas. Thus, the first objective of this study was to mark Anticarsia gemmatalis (Hübner) (Lepidoptera: Erebidae) and Chrysodeixis includens (Walker) (Lepidoptera: Noctuidae) by oil-soluble dyes in order to establish the best concentration to be used in dispersal studies. The second objective was to evaluate the effects of age, sex, and copulation on tethered flight and their implication of these scenarios on reproduction and resistance management as well as to carry out dispersal studies of A. gemmatalis adults in soybean. The blue (Solvent Blue 35) and red (Sudan Red 7B) dyes at 100 and 400 ppm concentrations diluted in oil were tested. It was noticed that the Sudan Red 7B at 400 ppm can be used for marking A. gemmatalis, but not for C. includens. We evaluated the tethered flight and reproduction of females and males, mated and unmated with 2, 4, and 6 days after emergence. Results indicated that several characteristics related to flight and reproduction of A. gemmatalis support the structured refuge strategy for Bt soybean, which can slow down the development of resistant populations in the field. Dispersal of insects was also evaluated through the release and capture. Light traps were used to capture the insects and were distributed 150 m apart in the North, South, East and West directions. The farthest light trap was located 900 m from the release site. More than 10% of A. gemmatalis adults could fly more than 800 m. Consequently, it is proposed that refuge areas in Bt soybeans should be spaced up to 800 m away from each other, aiming to reduce the frequency of resistant individuals in the fiel