Solid Waste Generated by Amazon and Tapajós River Vessels: An Environmental Education Activity

Given the lack of research on solid waste generated by vessels and often incorrectly discarded, it became clear the need for a new methodological approach focusing on the knowledge of this theme. Thus this study was conducted focusing on the process of awareness of users of a vessel that made the route that traveled the Amazon River and Tapajós, using an environmental awareness activity, with results and immediate observations. From this, the waste was quantified before and after the interventions, which occurred from the clarification of the environment, solid waste generation, natural resources, water, among others. The research took place aboard a vessel that connects Manaus-AM to Alenquer-PA, evaluating the before and after the intervention. Given this, it is verified that the evaluation process achieved positive results in the minimization of solid waste generated, ensuring that the study has immediate effect, but the intervention measures need time for consolidation, given the responsibility of environmental education, which needs different approaches, under different eyes and with depth of knowledge, even if it requires a long-term process. Therefore, the importance of this type of activity is verified, aiming at the correct destination of the solid waste generated, in any circumstance, mainly in vessels, in different rivers, considering the condition of this natural resource. In addition, user awareness and education through environmental education is mandatory to better understand the impacts caused by different changes over time and needs to be an effective tool to ensure the success of habit transformation processes and quality improvement of life

REVISITANDO A PROSPECT THEORY: SERIAM OS CONTADORES MAIS RACIONAIS?

The Prospect Theory, psychological theory of decision making developed by Amos Tversky and Daniel Kahneman, shows that humans are more risk averse in a situation of gains than losses, which those researchers called Framing Effect, dwelling, therefore, the heuristics (beliefs) of the individual catalyst phenomenon. Carvalho Junior (2009) states that the human being is not fully rational decision to make, especially in business environment. Since Miranda et al. (2010) concluded that possess knowledge in accounting help agents make better investment decisions in the presence of sunk costs. From this, we constructed the problem of this research: the formal learning accounting minimizes cognitive biases caused by framing effect on decisions that involve financial risk? We analyzed the responses of 222 subjects, asked to answer three questions, which suggested a financial risk (loss scenario) and a risk-free (gain setting), and a self-assessment of the respondent. The academic backgrounds, and Accounting, focused primarily on business and economics, with education ranging from undergraduate to current holders of the title of Doctor. The collected data were treated statistically using the SPSS software v. 16. Alternative to the main hypothesis of this study were also analyzed three other hypotheses, which evaluated the framing effect might be affected, respectively, by gender, by education or age of the individuals surveyed. Based on these results, it was not possible in any case reject the null hypothesis for each variable "dummy" which leads to the conclusion, considering the sample, none of those variables that significantly influence the behavior of those statistical respondents surveyed. A Prospect Theory, teoria psicológica de tomada de decisões desenvolvida por Amos Tversky e Daniel Kahneman, apresenta que o ser humano é mais avesso ao risco em situação de ganhos do que de perdas, o que aqueles pesquisadores denominaram de efeito framing, residindo, portanto, nas heurísticas (crenças) individuais o catalisador do fenômeno. Carvalho Junior (2009) afirma que o ser humano não é totalmente racional ao tomar decisão, notadamente em ambiente empresarial. Já Miranda et al. (2010) concluem que possuir conhecimentos em ciências contábeis ajudaria os agentes a tomarem melhores decisões de investimento, na presença de sunk costs. A partir disso, construiu-se o problema desta pesquisa: o aprendizado formal de contabilidade minimiza os vieses cognitivos provocados pelo efeito framing em decisões que envolvam risco financeiro? Foram analisadas as respostas de 222 indivíduos, solicitados a responder três questões, uma que sugeria risco financeiro (cenário de perda) e uma livre de risco (cenário de ganho), e uma de autoavaliação do respondente. As formações acadêmicas, além de Contabilidade, se concentravam principalmente em Administração e Economia, com escolaridade variando de graduação em curso até possuidores do título de Doutor. Os dados coletados receberam tratamento estatístico com a utilização do software SPSS v. 16. Subsidiariamente à principal hipótese deste estudo, foram analisadas ainda outras três hipóteses, que avaliavam se o efeito framing poderia ser afetado, respectivamente, pelo gênero, pelo nível de escolaridade ou pela idade dos indivíduos pesquisados. Com base nos resultados obtidos, não foi possível em nenhum dos casos rejeitar a hipótese nula de cada uma das variáveis dummy o que induz à conclusão, considerando-se a amostra analisada, que nenhuma daquelas variáveis influenciaria de maneira significativamente estatística o comportamento daqueles respondentes pesquisados

Melatonin and the cardiovascular system in animals: systematic review and meta-analysis

Melatonin, a hormone released by the pineal gland, demonstrates several effects on the cardiovascular system. Herein, we performed a systematic review and meta-analysis to verify the effects of melatonin in an experimental model of myocardial infarction. We performed a systematic review according to PRISMA recommendations and reviewed MEDLINE, Embase, and Cochrane databases. Only articles in English were considered. A systematic review of the literature published between November 2008 and June 2019 was performed. The meta-analysis was conducted using the RevMan 5.3 program provided by the Cochrane Collaboration. In total, 858 articles were identified, of which 13 were included in this review. The main results of this study revealed that melatonin benefits the cardiovascular system by reducing infarct size, improving cardiac function according to echocardiographic and hemodynamic analyses, affords antioxidant effects, improves the rate of apoptosis, decreases lactate dehydrogenase activity, enhances biometric analyses, and improves protein levels, as analyzed by western blotting and quantitative PCR. In the meta-analysis, we observed a statistically significant decrease in infarct size (mean difference [MD], -20.37 [-23.56, -17.18]), no statistical difference in systolic pressure (MD, -1.75 [-5.47, 1.97]), a statistically significant decrease in lactate dehydrogenase in animals in the melatonin group (MD, -4.61 [-6.83, -2.40]), and a statistically significant improvement in the cardiac ejection fraction (MD, -8.12 [-9.56, -6.69]). On analyzing potential bias, we observed that most studies presented a low risk of bias; two parameters were not included in the analysis, and one parameter had a high risk of bias. Melatonin exerts several effects on the cardiovascular system and could be a useful therapeutic target to combat various cardiovascular diseases

O estado da arte sobre escoamentos em quedas sucessivas em canais com o fundo em degraus

Apresenta-se uma revisão da literatura sobre os escoamentos em quedas sucessivas, assim como a respeito de escoamentos sobre um degrau. Foram analisadas metodologias para a previsão do alcance do jato, alturas características dos escoamentos, energia dissipada e eficiência de reoxigenação. As equações foram comparadas entre si e com dados experimentais, fornecendo informações sobre desvios, concordâncias, divergências e lacunas de conhecimento devido à falta de dados. Concluiu-se não haver concordância entre as metodologias para o cálculo da energia dissipada por um degrau e para o alcance do jato. Para mais de um degrau, não há consenso sobre a previsão da ocorrência do regime estudado e seus sub-regimes. Há lacunas sobre o cálculo da energia dissipada e poucos estudos sobre a reaeração. Tais lacunas e potenciais avanços sobre o tema conduziram, no presente trabalho, à proposição de uma equação para a energia dissipada e uma equação para o cálculo da eficiência da reaeração

Diretriz sobre Diagnóstico e Tratamento da Cardiomiopatia Hipertrófica – 2024

Hypertrophic cardiomyopathy (HCM) is a form of genetically caused heart muscle disease, characterized by the thickening of the ventricular walls. Diagnosis requires detection through imaging methods (Echocardiogram or Cardiac Magnetic Resonance) showing any segment of the left ventricular wall with a thickness > 15 mm, without any other probable cause. Genetic analysis allows the identification of mutations in genes encoding different structures of the sarcomere responsible for the development of HCM in about 60% of cases, enabling screening of family members and genetic counseling, as an important part of patient and family management. Several concepts about HCM have recently been reviewed, including its prevalence of 1 in 250 individuals, hence not a rare but rather underdiagnosed disease. The vast majority of patients are asymptomatic. In symptomatic cases, obstruction of the left ventricular outflow tract (LVOT) is the primary disorder responsible for symptoms, and its presence should be investigated in all cases. In those where resting echocardiogram or Valsalva maneuver does not detect significant intraventricular gradient (> 30 mmHg), they should undergo stress echocardiography to detect LVOT obstruction. Patients with limiting symptoms and severe LVOT obstruction, refractory to beta-blockers and verapamil, should receive septal reduction therapies or use new drugs inhibiting cardiac myosin. Finally, appropriately identified patients at increased risk of sudden death may receive prophylactic measure with implantable cardioverter-defibrillator (ICD) implantation.La miocardiopatía hipertrófica (MCH) es una forma de enfermedad cardíaca de origen genético, caracterizada por el engrosamiento de las paredes ventriculares. El diagnóstico requiere la detección mediante métodos de imagen (Ecocardiograma o Resonancia Magnética Cardíaca) que muestren algún segmento de la pared ventricular izquierda con un grosor > 15 mm, sin otra causa probable. El análisis genético permite identificar mutaciones en genes que codifican diferentes estructuras del sarcómero responsables del desarrollo de la MCH en aproximadamente el 60% de los casos, lo que permite el tamizaje de familiares y el asesoramiento genético, como parte importante del manejo de pacientes y familiares. Varios conceptos sobre la MCH han sido revisados recientemente, incluida su prevalencia de 1 entre 250 individuos, por lo tanto, no es una enfermedad rara, sino subdiagnosticada. La gran mayoría de los pacientes son asintomáticos. En los casos sintomáticos, la obstrucción del tracto de salida ventricular izquierdo (TSVI) es el trastorno principal responsable de los síntomas, y su presencia debe investigarse en todos los casos. En aquellos en los que el ecocardiograma en reposo o la maniobra de Valsalva no detecta un gradiente intraventricular significativo (> 30 mmHg), deben someterse a ecocardiografía de esfuerzo para detectar la obstrucción del TSVI. Los pacientes con síntomas limitantes y obstrucción grave del TSVI, refractarios al uso de betabloqueantes y verapamilo, deben recibir terapias de reducción septal o usar nuevos medicamentos inhibidores de la miosina cardíaca. Finalmente, los pacientes adecuadamente identificados con un riesgo aumentado de muerte súbita pueden recibir medidas profilácticas con el implante de un cardioversor-desfibrilador implantable (CDI).A cardiomiopatia hipertrófica (CMH) é uma forma de doença do músculo cardíaco de causa genética, caracterizada pela hipertrofia das paredes ventriculares. O diagnóstico requer detecção por métodos de imagem (Ecocardiograma ou Ressonância Magnética Cardíaca) de qualquer segmento da parede do ventrículo esquerdo com espessura > 15 mm, sem outra causa provável. A análise genética permite identificar mutações de genes codificantes de diferentes estruturas do sarcômero responsáveis pelo desenvolvimento da CMH em cerca de 60% dos casos, permitindo o rastreio de familiares e aconselhamento genético, como parte importante do manejo dos pacientes e familiares. Vários conceitos sobre a CMH foram recentemente revistos, incluindo sua prevalência de 1 em 250 indivíduos, não sendo, portanto, uma doença rara, mas subdiagnosticada. A vasta maioria dos pacientes é assintomática. Naqueles sintomáticos, a obstrução do trato de saída do ventrículo esquerdo (OTSVE) é o principal distúrbio responsável pelos sintomas, devendo-se investigar a sua presença em todos os casos. Naqueles em que o ecocardiograma em repouso ou com Manobra de Valsalva não detecta gradiente intraventricular significativo (> 30 mmHg), devem ser submetidos à ecocardiografia com esforço físico para detecção da OTSVE.   Pacientes com sintomas limitantes e grave OTSVE, refratários ao uso de betabloqueadores e verapamil, devem receber terapias de redução septal ou uso de novas drogas inibidoras da miosina cardíaca. Por fim, os pacientes adequadamente identificados com risco aumentado de morta súbita podem receber medida profilática com implante de cardiodesfibrilador implantável (CDI)

Diretriz da Sociedade Brasileira de Cardiologia sobre Diagnóstico e Tratamento de Pacientes com Cardiomiopatia da Doença de Chagas

This guideline aimed to update the concepts and formulate the standards of conduct and scientific evidence that support them, regarding the diagnosis and treatment of the Cardiomyopathy of Chagas disease, with special emphasis on the rationality base that supported it.  Chagas disease in the 21st century maintains an epidemiological pattern of endemicity in 21 Latin American countries. Researchers and managers from endemic and non-endemic countries point to the need to adopt comprehensive public health policies to effectively control the interhuman transmission of T. cruzi infection, and to obtain an optimized level of care for already infected individuals, focusing on diagnostic and therapeutic opportunistic opportunities.   Pathogenic and pathophysiological mechanisms of the Cardiomyopathy of Chagas disease were revisited after in-depth updating and the notion that necrosis and fibrosis are stimulated by tissue parasitic persistence and adverse immune reaction, as fundamental mechanisms, assisted by autonomic and microvascular disorders, was well established. Some of them have recently formed potential targets of therapies.  The natural history of the acute and chronic phases was reviewed, with enhancement for oral transmission, indeterminate form and chronic syndromes. Recent meta-analyses of observational studies have estimated the risk of evolution from acute and indeterminate forms and mortality after chronic cardiomyopathy. Therapeutic approaches applicable to individuals with Indeterminate form of Chagas disease were specifically addressed. All methods to detect structural and/or functional alterations with various cardiac imaging techniques were also reviewed, with recommendations for use in various clinical scenarios. Mortality risk stratification based on the Rassi score, with recent studies of its application, was complemented by methods that detect myocardial fibrosis.  The current methodology for etiological diagnosis and the consequent implications of trypanonomic treatment deserved a comprehensive and in-depth approach. Also the treatment of patients at risk or with heart failure, arrhythmias and thromboembolic events, based on pharmacological and complementary resources, received special attention. Additional chapters supported the conducts applicable to several special contexts, including t. cruzi/HIV co-infection, risk during surgeries, in pregnant women, in the reactivation of infection after heart transplantation, and others.     Finally, two chapters of great social significance, addressing the structuring of specialized services to care for individuals with the Cardiomyopathy of Chagas disease, and reviewing the concepts of severe heart disease and its medical-labor implications completed this guideline.Esta diretriz teve como objetivo principal atualizar os conceitos e formular as normas de conduta e evidências científicas que as suportam, quanto ao diagnóstico e tratamento da CDC, com especial ênfase na base de racionalidade que a embasou. A DC no século XXI mantém padrão epidemiológico de endemicidade em 21 países da América Latina. Investigadores e gestores de países endêmicos e não endêmicos indigitam a necessidade de se adotarem políticas abrangentes, de saúde pública, para controle eficaz da transmissão inter-humanos da infecção pelo T. cruzi, e obter-se nível otimizado de atendimento aos indivíduos já infectados, com foco em oportunização diagnóstica e terapêutica. Mecanismos patogênicos e fisiopatológicos da CDC foram revisitados após atualização aprofundada e ficou bem consolidada a noção de que necrose e fibrose sejam estimuladas pela persistência parasitária tissular e reação imune adversa, como mecanismos fundamentais, coadjuvados por distúrbios autonômicos e microvasculares. Alguns deles recentemente constituíram alvos potenciais de terapêuticas. A história natural das fases aguda e crônica foi revista, com realce para a transmissão oral, a forma indeterminada e as síndromes crônicas. Metanálises recentes de estudos observacionais estimaram o risco de evolução a partir das formas aguda e indeterminada e de mortalidade após instalação da cardiomiopatia crônica. Condutas terapêuticas aplicáveis aos indivíduos com a FIDC foram abordadas especificamente. Todos os métodos para detectar alterações estruturais e/ou funcionais com variadas técnicas de imageamento cardíaco também foram revisados, com recomendações de uso nos vários cenários clínicos. Estratificação de risco de mortalidade fundamentada no escore de Rassi, com estudos recentes de sua aplicação, foi complementada por métodos que detectam fibrose miocárdica. A metodologia atual para diagnóstico etiológico e as consequentes implicações do tratamento tripanossomicida mereceram enfoque abrangente e aprofundado. Também o tratamento de pacientes em risco ou com insuficiência cardíaca, arritmias e eventos tromboembólicos, baseado em recursos farmacológicos e complementares, recebeu especial atenção. Capítulos suplementares subsidiaram as condutas aplicáveis a diversos contextos especiais, entre eles o da co-infecção por T. cruzi/HIV, risco durante cirurgias, em grávidas, na reativação da infecção após transplante cardíacos, e outros.    Por fim, dois capítulos de grande significado social, abordando a estruturação de serviços especializados para atendimento aos indivíduos com a CDC, e revisando os conceitos de cardiopatia grave e suas implicações médico-trabalhistas completaram esta diretriz.&nbsp

The complete genome sequence of Chromobacterium violaceum reveals remarkable and exploitable bacterial adaptability

Chromobacterium violaceum is one of millions of species of free-living microorganisms that populate the soil and water in the extant areas of tropical biodiversity around the world. Its complete genome sequence reveals (i) extensive alternative pathways for energy generation, (ii) ≈500 ORFs for transport-related proteins, (iii) complex and extensive systems for stress adaptation and motility, and (iv) wide-spread utilization of quorum sensing for control of inducible systems, all of which underpin the versatility and adaptability of the organism. The genome also contains extensive but incomplete arrays of ORFs coding for proteins associated with mammalian pathogenicity, possibly involved in the occasional but often fatal cases of human C. violaceum infection. There is, in addition, a series of previously unknown but important enzymes and secondary metabolites including paraquat-inducible proteins, drug and heavy-metal-resistance proteins, multiple chitinases, and proteins for the detoxification of xenobiotics that may have biotechnological applications

Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to <90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], >300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of <15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P<0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P<0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years

REVISITANDO A PROSPECT THEORY: SERIAM OS CONTADORES MAIS RACIONAIS?

The Prospect Theory, psychological theory of decision making developed by Amos Tversky and Daniel Kahneman, shows that humans are more risk averse in a situation of gains than losses, which those researchers called Framing Effect, dwelling, therefore, the heuristics (beliefs) of the individual catalyst phenomenon. Carvalho Junior (2009) states that the human being is not fully rational decision to make, especially in business environment. Since Miranda et al. (2010) concluded that possess knowledge in accounting help agents make better investment decisions in the presence of sunk costs. From this, we constructed the problem of this research: the formal learning accounting minimizes cognitive biases caused by framing effect on decisions that involve financial risk? We analyzed the responses of 222 subjects, asked to answer three questions, which suggested a financial risk (loss scenario) and a risk-free (gain setting), and a self-assessment of the respondent. The academic backgrounds, and Accounting, focused primarily on business and economics, with education ranging from undergraduate to current holders of the title of Doctor. The collected data were treated statistically using the SPSS software v. 16. Alternative to the main hypothesis of this study were also analyzed three other hypotheses, which evaluated the framing effect might be affected, respectively, by gender, by education or age of the individuals surveyed. Based on these results, it was not possible in any case reject the null hypothesis for each variable "dummy" which leads to the conclusion, considering the sample, none of those variables that significantly influence the behavior of those statistical respondents surveyed. A Prospect Theory, teoria psicológica de tomada de decisões desenvolvida por Amos Tversky e Daniel Kahneman, apresenta que o ser humano é mais avesso ao risco em situação de ganhos do que de perdas, o que aqueles pesquisadores denominaram de efeito framing, residindo, portanto, nas heurísticas (crenças) individuais o catalisador do fenômeno. Carvalho Junior (2009) afirma que o ser humano não é totalmente racional ao tomar decisão, notadamente em ambiente empresarial. Já Miranda et al. (2010) concluem que possuir conhecimentos em ciências contábeis ajudaria os agentes a tomarem melhores decisões de investimento, na presença de sunk costs. A partir disso, construiu-se o problema desta pesquisa: o aprendizado formal de contabilidade minimiza os vieses cognitivos provocados pelo efeito framing em decisões que envolvam risco financeiro? Foram analisadas as respostas de 222 indivíduos, solicitados a responder três questões, uma que sugeria risco financeiro (cenário de perda) e uma livre de risco (cenário de ganho), e uma de autoavaliação do respondente. As formações acadêmicas, além de Contabilidade, se concentravam principalmente em Administração e Economia, com escolaridade variando de graduação em curso até possuidores do título de Doutor. Os dados coletados receberam tratamento estatístico com a utilização do software SPSS v. 16. Subsidiariamente à principal hipótese deste estudo, foram analisadas ainda outras três hipóteses, que avaliavam se o efeito framing poderia ser afetado, respectivamente, pelo gênero, pelo nível de escolaridade ou pela idade dos indivíduos pesquisados. Com base nos resultados obtidos, não foi possível em nenhum dos casos rejeitar a hipótese nula de cada uma das variáveis dummy o que induz à conclusão, considerando-se a amostra analisada, que nenhuma daquelas variáveis influenciaria de maneira significativamente estatística o comportamento daqueles respondentes pesquisados

Simulation of soil carbon changes due to conventional systems in the semi-arid region of Brazil: adaptation and validation of the century model

Soils play an important role on the global carbon cycle, but conventional land use practices generate negative impact by reducing soil organic carbon (SOC) content. Studies regarding the use of mathematical models on the magnitude of such impacts are scarce in semi-arid regions, but they are essential to broaden the understanding of the effects of cropping systems and help in proposing more rational land use alternatives. However, mathematical models (e.g. Century) must be previously calibrated and validated to present satisfactory results. Therefore, the aim of the present study was to validate the Century model for simulating SOC dynamics in areas of native vegetation and estimating SOC stocks on the adoption of agricultural systems in the semi-arid region of Brazil with a previous calibrated model. The study was carried out in three soil types (Quartzipsamments, Psamments and Ultisol), located in the state of Alagoas, north-eastern Brazil, adopting conventional (with minimal use of machinery) agricultural land-use practices under rainfed conditions. Simulations consisted of validating the model with previously calibrated parameters from another area of the Brazilian semi-arid region. The results showed that the model proved to be effective in simulating SOC dynamics in areas of native vegetation in the semi-arid region of Alagoas (PBIAS ranging from 20 to −9%); however, it needs further adjustment for satisfactory SOC simulation in agricultural/pasture systems. The results showed that conventional systems of agricultural crops and pasture in the semi-arid region of Brazil lead to losses (2673 g C m−2 in native vegetation to 1960 g C m−2 in conventional systems) between 22% and 35%, (PBIAS variating −9 to 49%) and that SOC stocks reach a new steady state between 30 and 40 years after conversion from native vegetation into agriculture (ranging from 24 to 42% in different soil types)