Síndrome de Torsades de Pointes: análise de casos: Torsades de Pointes Syndrome: case analysis

A Síndrome de Torsades de Pointes (TdP) é uma taquiarritmia ventricular polimórfica de pacientes com um intervalo QT longo congênito ou induzido por fármacos, cujo eletrocardiograma possui aspecto de “torção das pontas” e os sinais e sintomas característicos são síncope, palpitação ou mesmo evolução para fibrilação ventricular e morte súbita. O sexo mais frequentemente acometido é o feminino, o diagnóstico se baseia no eletrocardiograma e o tratamento preconizado é o sulfato de magnésio (MgSO4) intravenoso, a correção dos distúrbios eletrolíticos, principalmente a hipocalemia e o tratamento da causa base, na TdP farmacoinduzida. O objetivo do estudo é analisar os casos de Síndrome de Torsades de Pointes em pacientes com alterações do intervalo QT no eletrocardiograma. Trata-se de uma revisão bibliográfica integrativa, do tipo quantitativa, que utilizou as plataformas do PubMed, SciELO e Cochrane Library como bases de dados para seleção dos artigos, todos na língua inglesa. Foram utilizadas literaturas publicadas com recorte temporal de 2017 a 2022. De acordo com as literaturas analisadas, conclui-se que a TdP é uma taquiarritmia ventricular polimórfica com um mau prognóstico se não tratada precocemente com o MgSO4 intravenoso e, por ter diversas etiologias, é primordial que o diagnóstico preciso seja estabelecido de forma rápida, devido ao alto índice de mortalidade. Pacientes portadores da síndrome do QT longo congênita, bradicardia sinusal e bloqueio atrioventricular de 1º grau possuem predisposição para o desenvolvimento de TdP. Observa-se escassez na literatura a respeito das formas adequadas de prevenção da TdP, já que muitos pacientes que participam das triagens, muitas das vezes inefetivas, adquirem a síndrome após o uso de drogas que a predispõem, com prolongamento do intervalo QT, ou não sabem que possuem uma SQTL pré-existente, obrigatória para o desenvolvimento da TdP

Soil chemical attributes and performance of crops in rotation or consortium with cover crops in an agroforestry system

Submitted by JÚLIO HEBER SILVA ([email protected]) on 2017-05-02T19:22:23Z No. of bitstreams: 2 Tese - Everton Martins Arruda - 2017.pdf: 2805056 bytes, checksum: 9654a11adbf9a0979a8dd38886147f92 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5)Approved for entry into archive by Luciana Ferreira ([email protected]) on 2017-05-03T11:57:43Z (GMT) No. of bitstreams: 2 Tese - Everton Martins Arruda - 2017.pdf: 2805056 bytes, checksum: 9654a11adbf9a0979a8dd38886147f92 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5)Made available in DSpace on 2017-05-03T11:57:43Z (GMT). No. of bitstreams: 2 Tese - Everton Martins Arruda - 2017.pdf: 2805056 bytes, checksum: 9654a11adbf9a0979a8dd38886147f92 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2017-03-09Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPESThe presence of an arboreal component, such as in agroforestry systems, can promote a better balance of tropical ecological processes, allowing agricultural exploration in vertical and horizontal landscape profiles. This, together with the inclusion of single or intercropped cover crops in the agroforestry understory can increase the beneficial effects through interaction among species, favoring greater nutrient accumulation and cycling. Therefore, the objective of this research was to evaluate the soil chemical attributes and the performance of agricultural species and cover crops in rotation/consortium in an agroforestry system in the cerrado region of Goiás. The research was carried out between 2012 and 2016, in the city of Goiânia-Goiás, in an agroforestry system implanted in an 8- year-old Baru forest (Dipteryx alata V.). Soil from the experimental area was classified as typical dystrophic Red Latosol. The experimental design was randomized complete block (RCB), with four replications. Cover plants were cultivated singly: Pigeon pea (Cajanus cajan); Stylosanthes cv. Campo Grande (Stylosanthes macrocephala - 20% and Stylosanthes capitata - 80%); Massai grass (Panicum maximum) and intercropped: Pigeon pea+ Massai grass and Stylosanthes + Massai grass, in addition to an area under spontaneous vegetation (control treatment). We evaluated soil chemical fertility and dry phytomass productivity and macronutrient accumulations by cover crops, quality and yield of corn silage grown in rotation with the cover plants, relative index of chlorophylls and growth of Banana trees cultivated in consortium with the cover plants, in addition to the growth of the Baru trees during this period (height, diameter at breast height and crown diameter). The Campo Grande Stylosanthes increased the calcium contents, pH values and sum of bases in the soil solution at depth 0-10 cm after two years of cultivation. However, Massai grass, alone, increased potassium levels at depth 0-10 and 10-20 cm in the same cultivation year. The dry matter yield of silage maize was similar among the residual straw of Pigeon pea, Massai grass, and Stylosanthes + Massai grass cultivars. However, cultivation with residual Stylosanthes increased the crude protein percentage. The growth in height of the banana trees at 6 and 12 months was higher in consortium with Massai grass when compared to the area maintained with spontaneous vegetation. The incremental increase in height of Baru trees only increased after two years through the residual Campo Grande Stylosanthes. The highest productivity of dry phytomass was obtained from Massai grass, alone. The accumulations of nitrogen, phosphorus, calcium and sulfur were similar among Massai grass alone, Stylosanthes alone, and Massai grass + Stylosanthes consortium. However, potassium and magnesium accumulations were only higher in the aerial part of the Massai grass, alone.A presença do componente arbóreo, como em sistemas agroflorestais, pode promover maior equilíbrio dos processos ecológicos tropicais, possibilitando uma exploração agrícola em perfis verticais e horizontais da paisagem. Isto, aliado a inserção de plantas de cobertura solteiras ou consorciadas nos sub-bosque agroflorestal pode aumentar os efeitos benéficos pela interação entre as espécies, favorecendo maior acúmulo e ciclagem de nutrientes. Com isso, o objetivo desta pesquisa foi avaliar os atributos químicos do solo e o desempenho de espécies agrícolas e plantas de coberturas em rotação/consórcio em sistema agroflorestal na região do cerrado goiano. A pesquisa foi realizada entre os anos de 2012 e 2016, na cidade de Goiânia-Goiás, em um sistema agroflorestal implantado em uma floresta de barueiros (Dipteryx alata V.) com 8 anos de idade. O solo da área experimental foi classificado como Latossolo Vermelho distrófico típico. O delineamento experimental foi em blocos casualizados (DBC), com quatro repetições. As plantas de cobertura foram cultivadas solteiras: feijão guandu (Cajanus cajan); estilosantes cv. campo grande (Stylosanthes macrocephala - 20% e Stylosanthes capitata - 80%); capim massai (Panicum maximum) e consorciadas: feijão guandu + massai e estilosantes + massai, além de uma área mantida sob vegetação espontânea (tratamento controle). Foram avaliados os atributos de fertilidade química do solo, a produtividade de fitomassa seca e os acúmulos de macronutrientes pelas plantas de cobertura, a qualidade e a produtividade do milho para silagem cultivado em rotação as plantas de cobertura, o índice relativo de clorofilas e o crescimento de bananeiras cultivado em consórcio com as plantas de cobertura, além do crescimento das árvores de barueiros durante este período (altura, diâmetro a altura do peito e diâmetro de copa). O estilosantes campo grande aumenta os teores de cálcio, valores de pH e soma de bases na solução do solo na profundidade 0-10 cm após dois anos de cultivo. Todavia, o capim massai solteiro aumenta os teores de potássio na profundidade 0-10 e 10-20 cm no mesmo ano de cultivo. A produtividade de matéria seca de milho para silagem é semelhante entre os cultivos com residual de palhada de estilosantes, feijão guandu, massai e estilosantes + massai, entretanto, o cultivo com residual de estilosantes aumenta o percentual de proteína bruta. O crescimento em altura das bananeiras aos 6 e 12 meses é maior no consórcio com capim massai quando comparado à área mantida com vegetação espontânea. O incremento de crescimento em altura das árvores de barueiros é aumentado somente após dois anos através do residual de estilosantes campo grande. A maior produtividade de fitomassa seca é obtida como capim massai solteiro. Os acúmulos de nitrogênio, fósforo, cálcio e enxofre são semelhantes entre o capim massai solteiro, o estilosantes solteiro e o consórcio estilosantes + massai, entretanto os acúmulos de potássio e magnésio somente são superiores na parte aérea do capim massai solteiro

Monitoring of soil physical properties and cane sugar yield for different tillage systems

This study evaluated the behavior of soil physical properties in growing plant sugarcane and ratoon cane in a Typic Haplustox soil under different tillage systems. The experiment was done in the Cerrado region, at Usina Jalles Machado, in 2009, with sugarcane variety CTC 02. The experimental design was randomized blocks (RBD), and soil total porosity, macroporosity, microporosity and bulk density were measured in split plots 6 x 2 (soil preparation as the factor plot, and planting dates as subplot factors), in four replications. The evaluations were done within each soil layer (0-0.2, 0.2-0.4 and 0.4-0.6 m). The other variables were evaluated in 6 x 3 split-plot factorial (where soil preparation was the factor in the plots, and soil layers the subplot factor), with four replications. The treatments were the types of tillage: 1. Moldboard + drying + Harrow; 2. Ripper + Harrow; 3. Desiccation + Direct furrowing; 4. Desiccation Ripper + Direct furrowing; 5. Stubble trasher + Ripper; 6. Stubble trasher + Harrow + Moldboard + Harrow. Sugar cane productivity, total porosity, macroporosity, microporosity, bulk density and resistance to penetration were evaluated, in the year of plant cane and second ratoon year. The geometric mean diameter and aggregate distribution in classes 4-2, 2-1, 1-0.5, 0.5-0.25 and <0.25 mm, soil organic matter, water dispersible clay and flocculation index, were evaluated only in ratoon cane. All evaluations were performed at 0-0.2, 0.2-0.4 and 0.4-0.6 m. The results were submitted to ANOVA and the averages compared by the Tukey test (P<0.05). The system of direct furrowing had the greatest macroporosity and total porosity in the layer 0-0.2 m. Decrease in macroporosity and total porosity, as well as increases in density values in the layer 0.4 to 0.6 m were observed in ratoon cane. Soil resistance to penetration was greater in the layer 0.2-0.4 m. The system furrowing directly showed the smallest values of clay dispersed in water, while the system of Stubble trasher + Harrow + moldboard + Harrow, the greatest values. Greater levels of soil organic matter were found in the 0-0.2 m layer in the system directly furrowing. Greater values of geometric mean diameter and aggregate size classes between 4-2 mm were found the 0-0.2 m layer in systems direct furrowing and direct furrowing + ripper. The greatest yield was obtained with use of the moldboard plow + Harrow and Stubble trasher + Harrow + moldboard + Harrow; however, the system with direct furrowing, besides contributing for better soil physical quality, productivity values were very close to systems with joint use of the moldboard plow.Fundação de Amparo a Pesquisa do Estado de Minas GeraisMestre em AgronomiaO objetivo deste trabalho foi avaliar o comportamento dos atributos físicos do solo em cultivo de cana-planta e cana-soca em Latossolo Vermelho Amarelo distrófico argiloso sob diferentes sistemas de preparo de solo. O experimento foi implantado na região do cerrado, na Usina Jalles Machado em 2009, em área de reforma de canavial, variedade CTC 02. O delineamento experimental utilizado foi em blocos casualizados (DBC), sendo a porosidade total, macroporosidade, microporosidade e densidade do solo avaliadas em esquema de parcelas subdivididas 6 x 2 (com o preparo de solo, o fator de parcela e as épocas de cultivo, os fatores de subparcela), em quatro repetições, sendo as avaliações realizadas dentro de cada camada de solo (0-0,2; 0,2-0,4 e 0,4-0,6m) de forma isolada. As demais variáveis foram avaliadas em esquema fatorial 6 x 3 com parcelas subdivididas (sendo os fatores de parcela, os preparo de solos e os fatores de subparcela, as camadas), em quatro repetições. Os tratamentos foram os tipos de preparo de solo: 1. Dessecação + Arado de Aiveca + Grade; 2. Subsolador + Grade; 3. Dessecação + Sulcação Direta; 4. Dessecação + Subsolador + Sulcação direta; 5. Destruidor de Soqueira + Subsolador; 6. Destruidor de Soqueira + Grade + Arado de Aiveca + Grade. Foi avaliada a produtividade da cana-de-açúcar, á porosidade total, macroporosidade, microporosidade, densidade do solo e resistência do solo a penetração, no ano de cana-planta e segundo ano de cana-soca. O diâmetro médio geométrico e a distribuição dos agregados em classes de 4-2; 2-1; 1-0,5; 0,5-0,25 e <0,25mm, matéria orgânica do solo, argila dispersa em água e índice de floculação, somente em cana-soca. Todas avaliações foram realizadas nas camadas de 0-0,2; 0,2-0,4 e 0,4-0,6m. Os resultados foram submetidos à análise de variância e ao teste de Tukey (P<0,05). O sistema de sulcação direta apresentou maiores valores de macroporosidade e porosidade total na camada de 0-0,2m. Foi observada redução na macroporosidade e porosidade total, assim como aumentos nos valores de densidade do solo na camada de 0,4 0,6m em cana-soca. A resistência do solo á penetração foi maior na camada de 0,2-0,4m. O sistema sulcação direta apresentou os menores valores de Argila dispersa em água, já o sistema destruidor de soqueiras + grade + arado de aiveca + grade, os maiores valores. Os maiores níveis de matéria orgânica do solo foram encontrados na camada de 0-0,2m no sistema sulcação direta. Na camada de 0-0,2m foi verificado os maiores valores de Diâmetro médio geométrico e classes de agregados entre 4-2mm, em sistemas sulcação direta e subsolador + sulcação direta. A maior produtividade foi encontrada com uso de arado de aiveca + grade e destruidor de soqueiras + grade + arado de aiveca + grade, todavia, o sistema com sulcação direta, além de ter contribuído para melhor qualidade física do solo, proporcionou valores de produtividade muito próximos aos sistemas com uso em comum de arado de aiveca

Parcelamento da adubação nitrogenada na cultura da rúcula

The parceling of nitrogen fertilization may increase the use of the nutrient by the plants, Evaluated the effect of parceling nitrogen fertilization on the development and productivity of arugula. The study was conducted in the year 2017 in a greenhouse in the municipality of Nova Mutum-MT. An entirely randomized design (DIC) was used, with five treatments and four repetitions. The treatments consisted of the N-fertilizer application modes, being: T1) witness (without N, T2) 100% of N-applied at planting; T3) 17.64% of N at planting + one cover with 82.36%; T4) 17.64% of N at planting + two covers of 41.17%; T5) 17.64% of N at planting + three covers with 27.41%. The following were evaluated: plant height, number of total leaves, number of commercial leaves, green and dry mass of the roots, and green and dry mass of the aerial part of the arugula plants. The use of split nitrogen fertilization in arugula culture positively affects the production of fresh and dry matter. With the cultivation characteristics mentioned in this study, it is recommended that the nitrogen fertilizer be spread over three cover crops for the arugula crop to obtain a greater production.O parcelamento da adubação nitrogenada poderá aumentar o uso do nutriente pelas plantas, Avaliou o efeito do parcelamento da adubação nitrogenada no desenvolvimento e produtividade da rúcula. O estudo foi realizado no ano de 2017 em casa de vegetação no município de Nova Mutum-MT. Foi utilizado o delineamento inteiramente casualizado (DIC), sendo cinco tratamentos e quatro repetições. Os tratamentos foram constituídos pelos modos de aplicação de N-fertilizante, sendo: T1) testemunha (sem N, T2) 100% do N-aplicado no plantio; T3) 17,64% de N no plantio + uma cobertura com 82,36%; T4) 17,64% de N no plantio + duas coberturas de 41,17%; T5) 17,64% de N no plantio + três cobertura com 27,41%. Avaliaou: a altura de plantas, número de folhas totais, número de folhas comerciais, massa verde e seca das raízes, além da massa verde e seca da parte aérea das plantas de rúcula. O uso do parcelamento da adubação nitrogenada na cultura da rúcula afeta de forma positiva a produção de matéria fresca e seca. Com as características de cultivo mencionadas no referido trabalho, recomenda-se o parcelamento da adubação nitrogenada em três coberturas na cultura da rúcula para obtenção de uma maior produção

SPNeoDeath: a demographic and epidemiological dataset having infant, mother, prenatal care and childbirth data related to births and neonatal deaths in São Paulo city Brazil - 2012-2018

SPNeodeath dataset includes births and deaths of infants during the neonatal period from São Paulo city between 2012 and 2018, containing more than 1.4 million records. The dataset was created from SINASC and SIM Brazilian information systems for births and deaths respectively. SINASC comprises information about demographic and epidemiological data for the infant, mother, prenatal care and childbirth. SIM collects information about mortality, and it is used as the basis for the calculation of vital statistics, such as neonatal mortality rate. SIM was only used to label records from SINASC, when the death happened until 28 days of life. SPNeodeath has 23 variables with socioeconomic maternal condition features, maternal obstetrics features, newborn related features and previous care related features, besides a label feature describing if the subject survived, or not, after 28 days of life. In order to build the dataset, DBF files were downloaded from DATASUS ftp repository and converted to CSV format, the R programming language, and then the CSV files were processed using Python programming language. Features with incorrect values and unknowing information were removed32CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICO - CNPQ443774/2018-8This research was supported by Bill & Melinda Gates Foundation (Process no: OPP1201970) and Ministry of Health of Brazil, through the National Council for Scientific and Technological Development (CNPq) (Process no: 443774/2018-8). It was also supported by NVIDIA, that donated a GPU XP Titan used by the research tea

SOIL CHEMICAL ATTRIBUTES AND CORN PRODUCTIVITY GROWN ON LEGUME STUBBLE IN AGROFORESTRY SYSTEMS

<div><p>ABSTRACT Leguminous species can improve nutrient cycling and chemical quality of Oxisols, resulting in higher productivity of intercropped crops. Thus, this research aimed to evaluate the decomposition rate and nutrient accumulation in legume stubble, as well as its contribution to soil chemical attributes, the growth of baru trees (Dipteryx alata Vogel), and yield of intercropped maize in an agroforestry system. The experiment was developed during the crop years of 2010-2011 and 2011-2012, in Goiás State, Brazil. The experimental design was a randomized block with five replicates. Leguminous species consisted of sunn hemp (Crotalaria juncea), jack bean (Canavalia ensiformis), pigeon pea (Cajanus cajan), Stylosanthes (Stylosanthes macrocephala - 20% and Stylosanthes capitata - 80%), and spontaneous vegetation (control treatment). The decomposition rates of legume and spontaneous vegetation residues remained unchanged in the agroforestry system. Sunn hemp, jack bean, and Stylosanthes plants are advantageous options for total accumulation of nutrients. However, sunn hemp grown as straw cover for next crop seasons increases the available phosphorus levels in the soil and productivity of maize cobs. With this coverage, maize productivity values were up to 24% higher than were those with maize growing on spontaneous vegetation, besides having no effect on the growth of baru trees.</p></div

Towards neonatal mortality risk classification: a data-driven approach using neonatal, maternal, and social factors

Infant mortality is an important health measure in a population as a crude indicator of the poverty and socioeconomic level. It also shows the availability and quality of health services and medical technology in a specific region. Although improvements have been observed in the last decades, the implementation of actions to reduce infant mortality is still a concern in many countries. To address such an important problem, this paper proposes a new support decision approach to classify newborns according to their neonatal mortality risk. Using features related to mother, newborn, and socio-demographic, we model the problem using a data-driven classification model able to provide the probability of a newborn dying until days of life. More than a theoretical study, decision support tools as the one proposed here is relevant in countries in development as Brazil, because it aims at identifying risky neonates that may die to raise the attention of medical practitioners so that they can work harder to reduce the overall neonatal mortality. Overcoming an AUC of 96%, the proposed method is able to provide not just the probability of death risk but also an explicable interpretation of most important features for model decision, which is paramount in public health applications. Furthermore, we provide an extensive analysis across different rounds of experiments, including an analysis of pre and post partum features influence over data-driven model. Finally, different from previously conducted studies which rely on databases with less than 100,000 samples, our model takes advantage from a new proposed database, constructed using more than 1,400,000 samples comprising births and deaths extracted from public records in São Paulo-Brazil from 2012 to 201820CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICO - CNPQ443774/2018–8We thank the Bill and Melinda Gates Foundation (Process # OPP1201970), the Brazilian Ministry of Health through the National Council for Scientific and Technological Development (CNPq) (Process # 443774/2018–8) by financial support. It was also supported by NVIDIA, which donated a GPU XP Titan used by the research team. We thank also the editor and anonymous reviewers for their insightful comments, which improved the content of the manuscrip

Might Heterostyly Underlie Spider Occurrence on Inflorescences? A Case Study of Palicourea rigida (Rubiaceae), a Common Shrub from Brazilian Cerrado

We carried out a research on the Palicourea rigida (Rubiaceae) inflorescences, a distylous shrub of Brazilian Cerrado. Our objective was to compare the inflorescence architectural complexity and its quality in the two floral morphs and search for any relationship with spider occurrence. In order to assess the quality of inflorescence resources, we quantified the nectar volume and its sugar concentration and the number of fruits and flowers (intact and aborted) for both inflorescence morphs with and without spiders. For the architectural heterogeneity, we quantified floral structures and inflorescence levels of branching. Spider occurrence was higher in longistylous inflorescences than in brevistylous ones. The sampled spiders were classified into the guilds ambushers, jumpers, or orb-weavers. Ambushers, jumpers, and total richness were much higher among longistylous inflorescences. We found no difference between morphs neither in volume or nectar concentration nor in amount of fruits and flowers. However, longistylous inflorescences presented greater architectural heterogeneity than brevistylous ones. Therefore, we suggested that architectural heterogeneity is an important factor underlying the occurrence of cursorial spiders on P. rigida inflorescences, which possibly arose from the relationship between refuge availability and inflorescence architecture

Economic viability of Phaseolus vulgaris (BRS Estilo) production in irrigated system in a function of application of leaf boron

Foliar fertilization may be a viable strategy to boron supply in irrigated cropping systems with common beans (Phaseolus vulgaris), since it prevent B leaching. The aim of this work was to evaluate the economic viability and physiological parameters of the common beans production in irrigated cropping systems using sources and increasing foliar boron doses. A field experiment was carried out using an experimental block design in a factorial scheme 2 × 5 × 3, with two sources of B (boric acid and borax) and five doses: 0 (control), 2, 4, 6 e 8 kg ha−1, with three repetitions. Foliar B applications were performed at 40 days after seeds germination, in pre-flowering stage. Physiological process (transpiration, stomatal conductance, CO2 internal concentration, net photosynthesis, and relative chlorophyll index), B level in leaves and grain yield were measured. These data were used to determine the economic viability of B fertilization in common beans. Both boric acid and borax increased B levels in common beans leaves. Borax affected some physiological process reducing stomatal conductance and increasing net photosynthesis. Using borax, the highest net photosynthesis was observed at a rate of 4 kg ha−1, while the boric acid increased net photosynthesis linearly after increasing B doses application. An enhance of 311 kg ha−1 in the grain yield was observed using borax related to the control (without B application); however, grain yield decreased linearly after application of increasing B doses, as boric acid. Comparing the economic viability of sources and doses of B, the highest profitability is obtained using borax at a rate of 4 kg ha−1, which promoting a differential profit of US$534.44 per hectare compared to common beans cropping without B