Protesting or Justifying? A Latent Class Model for Contingent Valuation with Attitudinal Data

This article develops a latent class model for estimating willingness-to-pay for public goods using simultaneously contingent valuation (CV) and attitudinal data capturing protest attitudes related to the lack of trust in public institutions providing those goods. A measure of the social cost associated with protest responses and the consequent loss in potential contributions for providing the public good is proposed. The presence of potential justification biases is further considered, that is, the possibility that for psychological reasons the response to the CV question affects the answers to the attitudinal questions. The results from our empirical application suggest that psychological factors should not be ignored in CV estimation for policy purposes, allowing for a correct identification of protest responses. JEL codes: C35, C85, Q51

Freedom is a place. Ruth Wilson Gilmore e a Geografia Abolicionista

Ruth Wilson Gilmore, geógrafa estadunidense, é diretora do Center for Place, Culture and Politics (CPCP), e professora nos departamentos “Earth and Environmental Sciences”, “Africana Studies” and “American Studies” da City University of New York (CUNY – Graduate Center). Reconhecida como uma das intelectuais mais proeminentes da atualidade, dedica seu pensamento e militância ao entendimento e recusa do capitalismo racial, propondo caminhos cotidianos rumo a futuros libertários. Por meio de um rigoroso trabalho comprometido com a Tradição Radical Negra ela estrutura sua pesquisa-militante, e ampara-se em leituras de mundo que possibilitam a formação e transformação da consciência.Ruth Wilson Gilmore, an US geographer, is the director of the Center for Place, Culture, and Politics (CPCP) and a professor in the department of Earth and Environmental Sciences, Africana  Studies,  and  American  Studies  at  the  City  University  of  New  York  (CUNY–  The  Graduate Center).She is recognized as one of the most prominent intellectuals of our time. She dedicates her thought and activism to understanding and rejecting racial capitalism, proposing everyday paths towards  liberatory  futures.  Through  rigorous  work  committed  to  the  Black  Radical  Tradition,  she  structures  her  research-activism  and  relies  on  worldviews  that  enable  the  formation  and  transformation of consciousness

Trichotillomania: a good response to treatment with N-acetylcysteine

Trichotillomania is considered a behavioral disorder and is characterized by the recurring habit of pulling one's hair, resulting in secondary alopecia. It affects 1% of the adult population, and 2 to 4.4% of psychiatric patients meet the diagnostic criteria. It can occur at any age and is more prevalent in adolescents and females. Its occurrence in childhood is not uncommon and tends to have a more favorable clinical course. The scalp, eyebrows and eyelashes are the most commonly affected sites. Glutamate modulating agents, such as N-acetylcysteine, have been shown to be a promising treatment. N-acetylcysteine acts by reducing oxidative stress and normalizing glutaminergic transmission. In this paper, we report a case of trichotillomania with an excellent response to N-acetylcysteine.Univ Fed Sao Paulo, Dept Cosmetol, Trichol Outpatient Clin, Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Dept Cosmetol, Trichol Outpatient Clin, Sao Paulo, SP, BrazilWeb of Scienc

Conidial heads (Fruiting Bodies) as a hallmark for histopathological diagnosis of angioinvasive aspergillosis

Aspergillosis is a mycosis that afflicts immunocompetent and immunocompromised hosts; among the former it exhibits different clinical pictures, and among the latter the infection renders an invasive form of the disease. The histologic diagnosis of invasive aspergillosis is somewhat challenging mostly because of some morphological similarities between other fungi. However, when present, the conidial heads are pathognomonic of aspergillosis. The authors present the case of a 68-year-old woman who was submitted to autologous hematopoietic stem cell transplantation in the pursuit of multiple myeloma treatment. The post-transplantation period was troublesome with the development of severe neutropenia, human respiratory syncytial virus pneumonia, and disseminated aspergillosis, which was suspected because of a positive serum galactomannan antigen determination, and resulted in a fatal outcome. The autopsy findings showed diffuse alveolar damage associated with angioinvasive pulmonary aspergillosis with numerous hyphae and conidial heads in the lung parenchyma histology. The authors call attention to the aid of autopsy in confirming the diagnosis of this deep mycosis, since only the research of the galactomannan antigen may be insufficient and uncertain due to its specificity and of the possibility of false-positive result

Fluoride rinse effect on retention of Caf2 formed on enamel/dentine by fluoride application

Calcium fluoride-like materials ("CaF2") formed on dental surfaces after professional fluoride application are unstable in the oral environment but can be retained longer with a daily NaF mouthrinse. We tested the effect of twice daily 0.05% NaF rinses on the retention of "CaF2" formed on enamel and dentine after applying acidulated phosphate fluoride (APF). "CaF2" formed on enamel/dentine by APF application significantly decreased after exposure to artificial saliva and the 0.05% NaF rinse was ineffective to avoid this reduction. These findings suggest that the combination of APF and 0.05% NaF is not clinically relevant, either for caries or dental hypersensitivity.Calcium fluoride-like materials ("CaF2") formed on dental surfaces after professional fluoride application are unstable in the oral environment but can be retained longer with a daily NaF mouthrinse. We tested the effect of twice daily 0.05% NaF rinses on the retention of "CaF2" formed on enamel and dentine after applying acidulated phosphate fluoride (APF). "CaF2" formed on enamel/dentine by APF application significantly decreased after exposure to artificial saliva and the 0.05% NaF rinse was ineffective to avoid this reduction. These findings suggest that the combination of APF and 0.05% NaF is not clinically relevant, either for caries or dental hypersensitivity3011

Conidial heads (Fruiting Bodies) as a hallmark for histopathological diagnosis of angioinvasive aspergillosis

Aspergillosis is a mycosis that afflicts immunocompetent and immunocompromised hosts; among the former it exhibits different clinical pictures, and among the latter the infection renders an invasive form of the disease. The histologic diagnosis of invasive aspergillosis is somewhat challenging mostly because of some morphological similarities between other fungi. However, when present, the conidial heads are pathognomonic of aspergillosis. The authors present the case of a 68-year-old woman who was submitted to autologous hematopoietic stem cell transplantation in the pursuit of multiple myeloma treatment. The post-transplantation period was troublesome with the development of severe neutropenia, human respiratory syncytial virus pneumonia, and disseminated aspergillosis, which was suspected because of a positive serum galactomannan antigen determination, and resulted in a fatal outcome. The autopsy findings showed diffuse alveolar damage associated with angioinvasive pulmonary aspergillosis with numerous hyphae and conidial heads in the lung parenchyma histology. The authors call attention to the aid of autopsy in confirming the diagnosis of this deep mycosis, since only the research of the galactomannan antigen may be insufficient and uncertain due to its specificity and of the possibility of false-positive result

Costs in the Treatment of Schizophrenia in Adults Receiving Atypical Antipsychotics: An 11-Year Cohort in Brazil

Background: Schizophrenia is associated with significant economic burden. In Brazil, antipsychotics drugs, outpatient and hospital services are provided by the Brazilian National Health System for patients with schizophrenia. However, there are few studies that capture the cost of managing these patients within the Brazilian NHS. This is important to appraise different management approaches within universal healthcare systems. Objective: Describe the costs associated with the treatment of schizophrenia in adults receiving atypical antipsychotics in Brazil from 2000 to 2010 through real world data. Methods: We integrated three national databases for adult patients with schizophrenia receiving one or more atypical antipsychotics. Only direct medical costs were assessed as the perspective is a public payer. A multivariate log-linear regression model was performed to evaluate associations between costs and clinical and demographic variables. Results: 174,310 patients with schizophrenia were identified with mean (± SD) annual costs of USD 1,811.92 ± 284.39 per patient. Atypical antipsychotics accounted for 79.7% of the total cost, with a mean (± SD) annual cost per patient of USD 1,578.74 ± 240.40. Mean (± SD) annual costs per patient of psychiatric hospitalization were USD 2,482.90 ± 302.92 and outpatient psychiatric care was USD 862.96 ± 160.18. Olanzapine was used by 47.7% of patients and represented 62.8% of the total cost of atypical antipsychotics. Patients who used clozapine had the highest mean annual cost per patient regarding outpatient psychiatric care and psychiatric hospitalization. Conclusions: Atypical antipsychotics were responsible for the majority of the schizophrenia treatment cost, and psychiatric hospitalization costs were the highest mean annual cost per patient. As a result, authorities should ensure good quality of use of atypical antipsychotic and encourage outpatient psychiatric care over psychiatric hospitalization where possible

Progression of mitral regurgitation in rheumatic valve disease : role of left atrial remodeling

Introduction: Mitral regurgitation (MR) is the most common valve abnormality in rheumatic heart disease (RHD) often associated with stenosis. Although the mechanism by which MR develops in RHD is primary, longstanding volume overload with left atrial (LA) remodeling may trigger the development of secondary MR, which can impact on the overall progression of MR. This study is aimed to assess the incidence and predictors of MR progression in patients with RHD. Methods: Consecutive RHD patients with non-severe MR associated with any degree of mitral stenosis were selected. The primary endpoint was a progression of MR, which was defined as an increase of one grade in MR severity from baseline to the last follow-up echocardiogram. The risk of MR progression was estimated accounting for competing risks. Results: The study included 539 patients, age of 46.2 ± 12 years and 83% were women. At a mean follow-up time of 4.2 years (interquartile range [IQR]: 1.2–6.9 years), 54 patients (10%) displayed MR progression with an overall incidence of 2.4 per 100 patient-years. Predictors of MR progression by the Cox model were age (adjusted hazard ratio [HR] 1.541, 95% CI 1.222–1.944), and LA volume (HR 1.137, 95% CI 1.054–1.226). By considering competing risk analysis, the direction of the association was similar for the rate (Cox model) and incidence (Fine-Gray model) of MR progression. In the model with LA volume, atrial fibrillation (AF) was no longer a predictor of MR progression. In the subgroup of patients in sinus rhythm, 59 had an onset of AF during follow-up, which was associated with progression of MR (HR 2.682; 95% CI 1.133–6.350). Conclusions: In RHD patients with a full spectrum of MR severity, progression of MR occurs over time is predicted by age and LA volume. LA enlargement may play a role in the link between primary MR and secondary MR in patients with RHD

UMA VISÃO GERAL SOBRE AS COMPLICAÇÕES NO TRATAMENTO PÓS-OPERATÓRIO DE CANCER RENAL.

Introduction: Renal cancer poses significant challenges in contemporary medical practice, and understanding its diverse facets is crucial. This review aims to provide a comprehensive overview by examining the diagnostic and therapeutic approach to renal cancer, considering various perspectives and relevant findings in the literature. Methods: The review adopted a comprehensive approach, carefully analyzing and synthesizing scientific articles. Using descriptors such as "Renal Cancer," "Nephrectomy," "Renal Cell Carcinoma," "Immunohistochemistry," and "Targeted Therapies," the search was conducted on BVS, PubMed, and Scopus platforms in Portuguese and English. Out of 227 initial records, 18 relevant articles were selected and subjected to detailed analysis. Results: The analysis revealed a remarkable evolution in the approach to renal cancer over time. Early detection emerged as crucial in reducing morbidity and mortality. Histological differentiation between subtypes, such as clear cell and papillary carcinoma, became fundamental for effective therapeutic strategies. The incorporation of biomarkers and targeted therapies points to promising advances in precision medicine. Conclusion: This review highlights the complexity of renal cancer, emphasizing the importance of early detection, histological understanding, and advances in personalized medicine. Commitment to individualized treatments, coordinated research, and awareness are crucial to enhancing effectiveness and quality of life for patients. The path toward a more precise and effective approach continues, with personalized medicine outlining a promising future in tackling renal cancer.Introdução: O câncer renal apresenta desafios significativos na prática médica contemporânea, sendo vital compreender suas diversas facetas. Esta revisão visa proporcionar uma visão abrangente, examinando a abordagem diagnóstica e terapêutica do câncer renal, considerando perspectivas variadas e achados relevantes na literatura. Métodos: A revisão adotou uma abordagem abrangente, analisando e sintetizando criteriosamente artigos científicos. Utilizando descritores como "Câncer Renal", "Nefrectomia", "Carcinoma de Células Renais", "Imuno-histoquímica" e "Terapias Alvo", a busca foi conduzida nas plataformas BVS, PubMed e Scorpus, em português e inglês. Dos 227 registros iniciais, 18 artigos relevantes foram selecionados e submetidos a uma análise detalhada. Resultados: A análise revelou uma evolução marcante na abordagem do câncer renal ao longo do tempo. A detecção precoce emergiu como crucial na redução da morbidade e mortalidade. A diferenciação histológica entre os subtipos, como carcinoma de células claras e papilífero, tornou-se fundamental para estratégias terapêuticas eficazes. A incorporação de biomarcadores e terapias-alvo aponta para avanços promissores na medicina de precisão. Conclusão: Esta revisão destaca a complexidade do câncer renal, enfatizando a importância da detecção precoce, compreensão histológica e avanços na medicina personalizada. O comprometimento com tratamentos individualizados, pesquisa coordenada e conscientização são cruciais para aprimorar a eficácia e qualidade de vida dos pacientes. O caminho rumo a uma abordagem mais precisa e eficaz continua, com a medicina personalizada delineando um futuro promissor no enfrentamento do câncer renal