Crescimento e produtividade de alface sob diferentes tipos de cobertura do solo

No Brasil, a alface é a principal hortaliça produzida e comercializada, carecendo, contudo, de tecnologias para otimizar a produção e garantir a sustentabilidade ambiental em áreas agrícolas. Objetivou-se com este trabalho verificar o efeito de diferentes coberturas do solo no crescimento, produtividade de plantas de alface e na temperatura do solo. O delineamento experimental utilizado foi em blocos casualizados, com seis tratamentos e cinco repetições. Os tratamentos estudados consistiram de tipos de cobertura do solo, sendo: cobertura com material vegetal (CVe), polietileno preto (0,020 mm) (PPt), polietileno prata (0,020 mm) (PPr), polietileno branco (0,020 mm) (PBr), polietileno transparente (0,100 mm) (PTr) e solo sem cobertura (Testemunha - T). As variáveis analisadas foram: massa fresca total, número e massa fresca de folhas comerciais, massa fresca de raiz, diâmetro da cabeça e produtividade. Foi realizado o monitoramento da temperatura do solo durante toda condução da cultura. As coberturas com polietilenos prata, branco e preto foram estatisticamente iguais e superiores às demais coberturas para todas as características agronômicas avaliadas na alface. A temperatura do solo foi influenciada pelos tipos de cobertura. Em relação ao solo descoberto, a temperatura do solo aumentou nos tratamentos com coberturas plásticas, e diminuiu no tratamento com cobertura vegetal morta

Endothelial biomarkers in critically-ill COVID-19 patients: potential predictors of the need for dialysis

Introduction: To evaluate the function of vascular biomarkers to predict need for hemodialysis in critically-ill patients with COVID-19. Methods: This is a prospective study with 58 critically-ill patients due to COVID-19 infection. Laboratory tests in general and vascular biomarkers, such as VCAM-1, Syndecan-1, Angiopoietin-1 and Angiopoeitin-2 were quantified on intensive care unit (ICU) admission. Results: There was a 40% death rate. VCAM and Ang-2/Ang-1 ratio on ICU admission were associated with need for hemodialysis. Vascular biomarkers (VCAM-1, Syndecan-1, angiopoetin-2/ anogiopoetin-1 ratio) were predictors of death and their cut-off values were useful to stratify patients with a worse prognosis. In the multivariate cox regression analysis with adjusted models, VCAM-1 [O.R. 1.13 (C.I. 95%: 1.01 - 1.27); p= 0.034] and Ang-2/Ang-1 ratio [O.R. 4.87 (C.I.95%: 1.732 - 13.719); p= 0.003] were associated with need for dialysis. Conclusion: Vascular biomarkers, mostly VCAM-1 and Ang-2/Ang-1 ratio, showed better efficiency to predict need for hemodialysis in critically-ill COVID-19 patients

Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants.

BACKGROUND: Hypertension can be detected at the primary health-care level and low-cost treatments can effectively control hypertension. We aimed to measure the prevalence of hypertension and progress in its detection, treatment, and control from 1990 to 2019 for 200 countries and territories. METHODS: We used data from 1990 to 2019 on people aged 30-79 years from population-representative studies with measurement of blood pressure and data on blood pressure treatment. We defined hypertension as having systolic blood pressure 140 mm Hg or greater, diastolic blood pressure 90 mm Hg or greater, or taking medication for hypertension. We applied a Bayesian hierarchical model to estimate the prevalence of hypertension and the proportion of people with hypertension who had a previous diagnosis (detection), who were taking medication for hypertension (treatment), and whose hypertension was controlled to below 140/90 mm Hg (control). The model allowed for trends over time to be non-linear and to vary by age. FINDINGS: The number of people aged 30-79 years with hypertension doubled from 1990 to 2019, from 331 (95% credible interval 306-359) million women and 317 (292-344) million men in 1990 to 626 (584-668) million women and 652 (604-698) million men in 2019, despite stable global age-standardised prevalence. In 2019, age-standardised hypertension prevalence was lowest in Canada and Peru for both men and women; in Taiwan, South Korea, Japan, and some countries in western Europe including Switzerland, Spain, and the UK for women; and in several low-income and middle-income countries such as Eritrea, Bangladesh, Ethiopia, and Solomon Islands for men. Hypertension prevalence surpassed 50% for women in two countries and men in nine countries, in central and eastern Europe, central Asia, Oceania, and Latin America. Globally, 59% (55-62) of women and 49% (46-52) of men with hypertension reported a previous diagnosis of hypertension in 2019, and 47% (43-51) of women and 38% (35-41) of men were treated. Control rates among people with hypertension in 2019 were 23% (20-27) for women and 18% (16-21) for men. In 2019, treatment and control rates were highest in South Korea, Canada, and Iceland (treatment >70%; control >50%), followed by the USA, Costa Rica, Germany, Portugal, and Taiwan. Treatment rates were less than 25% for women and less than 20% for men in Nepal, Indonesia, and some countries in sub-Saharan Africa and Oceania. Control rates were below 10% for women and men in these countries and for men in some countries in north Africa, central and south Asia, and eastern Europe. Treatment and control rates have improved in most countries since 1990, but we found little change in most countries in sub-Saharan Africa and Oceania. Improvements were largest in high-income countries, central Europe, and some upper-middle-income and recently high-income countries including Costa Rica, Taiwan, Kazakhstan, South Africa, Brazil, Chile, Turkey, and Iran. INTERPRETATION: Improvements in the detection, treatment, and control of hypertension have varied substantially across countries, with some middle-income countries now outperforming most high-income nations. The dual approach of reducing hypertension prevalence through primary prevention and enhancing its treatment and control is achievable not only in high-income countries but also in low-income and middle-income settings. FUNDING: WHO

Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants

Background Hypertension can be detected at the primary health-care level and low-cost treatments can effectively control hypertension. We aimed to measure the prevalence of hypertension and progress in its detection, treatment, and control from 1990 to 2019 for 200 countries and territories. Methods We used data from 1990 to 2019 on people aged 30-79 years from population-representative studies with measurement of blood pressure and data on blood pressure treatment. We defined hypertension as having systolic blood pressure 140 mm Hg or greater, diastolic blood pressure 90 mm Hg or greater, or taking medication for hypertension. We applied a Bayesian hierarchical model to estimate the prevalence of hypertension and the proportion of people with hypertension who had a previous diagnosis (detection), who were taking medication for hypertension (treatment), and whose hypertension was controlled to below 140/90 mm Hg (control). The model allowed for trends over time to be non-linear and to vary by age. Findings The number of people aged 30-79 years with hypertension doubled from 1990 to 2019, from 331 (95% credible interval 306-359) million women and 317 (292-344) million men in 1990 to 626 (584-668) million women and 652 (604-698) million men in 2019, despite stable global age-standardised prevalence. In 2019, age-standardised hypertension prevalence was lowest in Canada and Peru for both men and women; in Taiwan, South Korea, Japan, and some countries in western Europe including Switzerland, Spain, and the UK for women; and in several low-income and middle-income countries such as Eritrea, Bangladesh, Ethiopia, and Solomon Islands for men. Hypertension prevalence surpassed 50% for women in two countries and men in nine countries, in central and eastern Europe, central Asia, Oceania, and Latin America. Globally, 59% (55-62) of women and 49% (46-52) of men with hypertension reported a previous diagnosis of hypertension in 2019, and 47% (43-51) of women and 38% (35-41) of men were treated. Control rates among people with hypertension in 2019 were 23% (20-27) for women and 18% (16-21) for men. In 2019, treatment and control rates were highest in South Korea, Canada, and Iceland (treatment >70%; control >50%), followed by the USA, Costa Rica, Germany, Portugal, and Taiwan. Treatment rates were less than 25% for women and less than 20% for men in Nepal, Indonesia, and some countries in sub-Saharan Africa and Oceania. Control rates were below 10% for women and men in these countries and for men in some countries in north Africa, central and south Asia, and eastern Europe. Treatment and control rates have improved in most countries since 1990, but we found little change in most countries in sub-Saharan Africa and Oceania. Improvements were largest in high-income countries, central Europe, and some upper-middle-income and recently high-income countries including Costa Rica, Taiwan, Kazakhstan, South Africa, Brazil, Chile, Turkey, and Iran. Interpretation Improvements in the detection, treatment, and control of hypertension have varied substantially across countries, with some middle-income countries now outperforming most high-income nations. The dual approach of reducing hypertension prevalence through primary prevention and enhancing its treatment and control is achievable not only in high-income countries but also in low-income and middle-income settings. Copyright (C) 2021 World Health Organization; licensee Elsevier

Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants

Background Hypertension can be detected at the primary health-care level and low-cost treatments can effectively control hypertension. We aimed to measure the prevalence of hypertension and progress in its detection, treatment, and control from 1990 to 2019 for 200 countries and territories. Methods We used data from 1990 to 2019 on people aged 30–79 years from population-representative studies with measurement of blood pressure and data on blood pressure treatment. We defined hypertension as having systolic blood pressure 140 mm Hg or greater, diastolic blood pressure 90 mm Hg or greater, or taking medication for hypertension. We applied a Bayesian hierarchical model to estimate the prevalence of hypertension and the proportion of people with hypertension who had a previous diagnosis (detection), who were taking medication for hypertension (treatment), and whose hypertension was controlled to below 140/90 mm Hg (control). The model allowed for trends over time to be non-linear and to vary by age. Findings The number of people aged 30–79 years with hypertension doubled from 1990 to 2019, from 331 (95% credible interval 306–359) million women and 317 (292–344) million men in 1990 to 626 (584–668) million women and 652 (604–698) million men in 2019, despite stable global age-standardised prevalence. In 2019, age-standardised hypertension prevalence was lowest in Canada and Peru for both men and women; in Taiwan, South Korea, Japan, and some countries in western Europe including Switzerland, Spain, and the UK for women; and in several low-income and middle-income countries such as Eritrea, Bangladesh, Ethiopia, and Solomon Islands for men. Hypertension prevalence surpassed 50% for women in two countries and men in nine countries, in central and eastern Europe, central Asia, Oceania, and Latin America. Globally, 59% (55–62) of women and 49% (46–52) of men with hypertension reported a previous diagnosis of hypertension in 2019, and 47% (43–51) of women and 38% (35–41) of men were treated. Control rates among people with hypertension in 2019 were 23% (20–27) for women and 18% (16–21) for men. In 2019, treatment and control rates were highest in South Korea, Canada, and Iceland (treatment >70%; control >50%), followed by the USA, Costa Rica, Germany, Portugal, and Taiwan. Treatment rates were less than 25% for women and less than 20% for men in Nepal, Indonesia, and some countries in sub-Saharan Africa and Oceania. Control rates were below 10% for women and men in these countries and for men in some countries in north Africa, central and south Asia, and eastern Europe. Treatment and control rates have improved in most countries since 1990, but we found little change in most countries in sub-Saharan Africa and Oceania. Improvements were largest in high-income countries, central Europe, and some upper-middle-income and recently high-income countries including Costa Rica, Taiwan, Kazakhstan, South Africa, Brazil, Chile, Turkey, and Iran. Interpretation Improvements in the detection, treatment, and control of hypertension have varied substantially across countries, with some middle-income countries now outperforming most high-income nations. The dual approach of reducing hypertension prevalence through primary prevention and enhancing its treatment and control is achievable not only in high-income countries but also in low-income and middle-income settings

Crescimento e produtividade de alface sob diferentes tipos de cobertura do solo

No Brasil, a alface é a principal hortaliça produzida e comercializada, carecendo, contudo, de tecnologias para otimizar a produção e garantir a sustentabilidade ambiental em áreas agrícolas. Objetivou-se com este trabalho verificar o efeito de diferentes coberturas do solo no crescimento, produtividade de plantas de alface e na temperatura do solo. O delineamento experimental utilizado foi em blocos casualizados, com seis tratamentos e cinco repetições. Os tratamentos estudados consistiram de tipos de cobertura do solo, sendo: cobertura com material vegetal (CVe), polietileno preto (0,020 mm) (PPt), polietileno prata (0,020 mm) (PPr), polietileno branco (0,020 mm) (PBr), polietileno transparente (0,100 mm) (PTr) e solo sem cobertura (Testemunha - T). As variáveis analisadas foram: massa fresca total, número e massa fresca de folhas comerciais, massa fresca de raiz, diâmetro da cabeça e produtividade. Foi realizado o monitoramento da temperatura do solo durante toda condução da cultura. As coberturas com polietilenos prata, branco e preto foram estatisticamente iguais e superiores às demais coberturas para todas as características agronômicas avaliadas na alface. A temperatura do solo foi influenciada pelos tipos de cobertura. Em relação ao solo descoberto, a temperatura do solo aumentou nos tratamentos com coberturas plásticas, e diminuiu no tratamento com cobertura vegetal morta

Crescimento e produtividade de alface sob diferentes tipos de cobertura do solo

No Brasil, a alface é a principal hortaliça produzida e comercializada, carecendo, contudo, de tecnologias para otimizar a produção e garantir a sustentabilidade ambiental em áreas agrícolas. Objetivou-se com este trabalho verificar o efeito de diferentes coberturas do solo no crescimento, produtividade de plantas de alface e na temperatura do solo. O delineamento experimental utilizado foi em blocos casualizados, com seis tratamentos e cinco repetições. Os tratamentos estudados consistiram de tipos de cobertura do solo, sendo: cobertura com material vegetal (CVe), polietileno preto (0,020 mm) (PPt), polietileno prata (0,020 mm) (PPr), polietileno branco (0,020 mm) (PBr), polietileno transparente (0,100 mm) (PTr) e solo sem cobertura (Testemunha - T). As variáveis analisadas foram: massa fresca total, número e massa fresca de folhas comerciais, massa fresca de raiz, diâmetro da cabeça e produtividade. Foi realizado o monitoramento da temperatura do solo durante toda condução da cultura. As coberturas com polietilenos prata, branco e preto foram estatisticamente iguais e superiores às demais coberturas para todas as características agronômicas avaliadas na alface. A temperatura do solo foi influenciada pelos tipos de cobertura. Em relação ao solo descoberto, a temperatura do solo aumentou nos tratamentos com coberturas plásticas, e diminuiu no tratamento com cobertura vegetal morta

XV Jornada de Investigación

La XV Jornada de Investigación en 2024 convocó a 815 asistentes con la presentación de 8 conferencias principales, 90 pósters y 56 ponencias, alrededor de los diferentes ejes temáticos: a) “Derecho, cultura y sociedad”, b) “Desarrollo humano y sostenible” y c) “Gestión de la tecnología al servicio de la sociedad”. Estos trabajos abordaron temas de actualidad, por ejemplo, la inteligencia artificial (IA) y sus aportes para el desarrollo de diferentes disciplinas, robótica, derechos humanos, salud mental y aspectos políticos y culturales en comunidades vulnerables. Asimismo, la investigación-creación fue uno de los escenarios más importantes a destacar como una forma de aportar a la sociedad del conocimiento en favor del desarrollo cultural y artístico de nuestro país. La visualización de los resultados de investigación sigue siendo un fin importante de la XV Jornada de Investigación, con la presentación de resultados de manera clara y accesible que facilita la comprensión y la aplicación de los productos de investigación por parte de un público más amplio. Esta transparencia es esencial para construir confianza y asegurar que el conocimiento generado tenga un impacto real y positivo en la sociedad. Como un reconocimiento al esfuerzo de todos y cada uno de sus participantes, se publican las Memorias de la XV Jornada de Investigación, en las que se recopilan los valiosos aportes al conocimiento científico de conferencistas, ponentes y todos los participantes.. (Tomado de la fuente).Quinta ediciónEJE TEMÁTICO I: DERECHO, CULTURA Y SOCIEDAD Mascotas de apoyo emocional. Trazar el camino hacia una ciberseguridad integral: fusionar conocimientos para proteger el mundo digital. Políticas desarrolladas por los Gobiernos colombianos (2018-2024) con miras al cumplimiento del Objetivo de Desarrollo Sostenible 2 Hambre cero. Cómo el método comparativo logra potenciar los principios del aprendizaje basado en problemas por medio del estudio de caso. Beneficios del régimen de insolvencia de persona natural no comerciante y los vacíos jurídicos que permean la normatividad vigente. Impacto del Acuerdo de Facilitación del Comercio en Colombia: diversificación exportadora y desempeño logístico. La reja como delimitador del espacio público. El papel de los derechos humanos en la protección de la cultura de los indígenas en Colombia como minoría cultural. Análisis de las estrategias de guerra híbrida utilizadas por grupos armados ilegales en Colombia. La comunidad wayuu frente a la escasez de agua en La Guajira causada por la minería. Interpretaciones sobre la vulneración de derechos a menores durante el conflicto armado entre Israel y Palestina. Responsabilidad legal frente a las decisiones adoptadas por sistemas de inteligencia artificial en Colombia. Los desafíos de la ciberseguridad para la privacidad de los datos personales: análisis sobre la inteligencia artificial y sus repercusiones en el derecho. La influencia de la inteligencia artificial en la toma de decisiones judiciales. Aplicación del principio de oportunidad en el sistema penal acusatorio colombiano: ¿ha logrado reducir la carga procesal y mejorar la eficiencia del sistema? Sostenibilidad en Singapur: conectar con los Objetivos de Desarrollo Sostenible. Retos éticos y jurídicos de la inteligencia artificial en la Unión Europea y Colombia. Criminalidad y populismo punitivo: indagación sobre el cuidado de la esfera pública y la fragilidad de la libertad. Libertad y justicia social en la filosofía positivista y antipositivista latinoamericana. La globalización económica y su impacto en la positivización del derecho interno. Discurso histórico e inteligencia artificial. La novena de Navidad y la religiosidad popular en Colombia. Estudiosidad, cultura académica y centralidad de la persona: desafíos para la educación de calidad y la construcción de convivencia. El Darién: un desafío estatal para la protección de derechos humanos de migrantes irregulares. Desarrollo de una plataforma tecnológica para el empoderamiento de mujeres empresarias en América Latina a través de Agora Partnerships. Manufacturar la educación con inteligencia artificial y las implicaciones en el aprendizaje: un enfoque desde la perspectiva de John Biggs. Suelo portable: una estrategia para la vivienda prefabricada en Colombia. Enseñanza y aprendizaje de la proporcionalidad usando elementos de la cultura de Paz de Río (Colombia). Perspectivas sobre el linchamiento social entre las personas que conviven en el mercado mayorista de Corabastos. Construcción de identidad de la comunidad ballroom en las houses de Bogotá. ¿En qué medida la crisis migratoria entre Bielorrusia y la Unión Europea de 2021 puede ser conceptualizada como un referente de guerra híbrida? Zonas verdes y arborización en Bogotá: el fracaso de las políticas ambientales, el estado actual y el papel del derecho constitucional. EJE TEMÁTICO II: DESARROLLO HUMANO Y SOSTENIBLE. ¿Cómo las soluciones basadas en la naturaleza mejoran las cualidades sociales y ecológicas de Estocolmo a Bogotá? Configuración urbana del territorio a partir de indicadores de sostenibilidad urbana para territorios informales: caso de estudio Unidad de Planeamiento Zonal (UPZ) San Isidro Patios y Pardo Rubio en la localidad de Chapinero en Bogotá. El workaholism. Validación cognitiva de una intervención cognitivo-conductual en el dolor oncológico pediátrico. Tiempo de calidad y desarrollo afectivo: caso de Matilda Wormwood. Alteraciones del apego en adopciones. Influencia de los estilos de crianza en la ideación suicida de niños, niñas y adolescentes: estrategias para su intervención. Depresión y funcionalidad motora y su relación con el deterioro cognoscitivo en población colombiana mayor de 60 años. Nicotina: droga de alto impacto lesivo. Aplicaciones de tecnologías nucleares para el desarrollo sostenible en Colombia. Burnout y estrategias de afrontamiento en trabajadores de la salud. La moda pronta: afectaciones ambientales y transformación hacia la moda sostenible en Colombia. Estrategias integradas para la conservación de ecosistemas en ciudades: un enfoque en los Objetivos de Desarrollo Sostenible 14 y 15. Explorar las interacciones de las escaleras como elemento: adaptabilidad y singularidad. Parque Nacional Natural Sumapaz: territorio sostenible entre la comunidad y la naturaleza. Reconocimiento e identificación de los espacios intermediarios en Bogotá. Una revisión bibliométrica sobre videojuegos y procesos cognitivos: tendencias y avances. Conexión vital: un viaje visual por la región del Magdalena Medio. Entrenamiento de habilidades comunicativas a través de agentes conversacionales: una revisión de alcance. Cambios en el funcionamiento del almacén episódico en escenarios 2D, 2.5D y 3D. Implementación del modelo ADDIE para la identificación del riesgo por inundación en la Escuela Normal Superior Sor Josefa del Castillo y Guevara de Chiquinquirá (Boyacá, Colombia). Diferencias en la regulación emocional en niños y niñas según los estilos de crianza. Calidad de vida laboral desde la interacción líder-colaborador. Griefbots: retos de la inteligencia artificial en tiempos del duelo digital. Sumapaz en perspectiva: desarrollo sostenible, gestión cultural y zonas de reserva campesina. La arquitectura raizal en San Andrés y Providencia: entre la tradición y la modernización. Tejidos espaciales del Chocó: un viaje a través de las interacciones en la vivienda tradicional. Aportes de la educación ambiental para la construcción de territorios sostenibles en América Latina. EJE TEMÁTICO III: GESTIÓN Y TECNOLOGÍA AL SERVICIO DE LA SOCIEDAD. Humedal Juan Amarillo. Compromiso comunitario y aprendizaje: el camino hacia una sociedad más unida desde la perspectiva del Semillero Politeia. Textiwall: uso de residuos textiles en arquitectura. Cambridge Analytica: el caso de Donald Trump en las elecciones presidenciales de 2016. Alternativas de fabricación y construcción digital: desarrollo de procesos de flexibilidad por medio del diseño de prototipos básicos en la vivienda social sostenible. Tendencias de consumo en el metaverso: impacto en las decisiones económicas del sector textil. Modelo de seguridad con un enfoque holístico para aplicaciones móviles de entidades financieras en Colombia. Estrategias de sostenibilidad en la vivienda asociadas a las dinámicas del agua en San Andrés (Colombia). Mediciones de cantidades físicas con el uso de sensores móviles. Identificación de herramientas tecnológicas en psicología clínica: retos y oportunidades. Robot sumo RC. Integración de la robótica y la metodología aprendizaje basado en proyectos para potenciar el pensamiento creativo en la resolución de problemas de ingeniería. Modelado del efecto corona y su efecto en la propagación de sobretensiones en líneas de transmisión e interferencia en las bandas de comunicaciones. Consideraciones éticas, técnicas y teóricas en el desarrollo de aplicaciones móviles en salud mental: una mirada interdisciplinaria. Validación de un modelo de fabricación digital para vivienda social de un TRL 4 a un TRL 6. Dinámica laboral en el modelaje webcam desde la pandemia de covid-19: análisis desde el consultorio jurídico. Horizonte IA: cambio y tendencias en telecomunicaciones. Modelo de inteligencia artificial que alerta sobre los impactos de maremotos en zonas costeras de Colombia. Algoritmos de machine learning aplicados a la evaluación docente y a la deserción estudiantil. Implementación de un sistema automatizado para el cobro de comisiones bancarias por uso de pasarelas de pago a clientes empresariales en el Banco de Occidente. Recorrido virtual de la Universidad Católica de Colombia Sede Claustro para la inducción de estudiantes y docentes. Propuesta de herramienta web para la aproximación del cálculo de bodegaje en procesos de mudanzas. Prototipo de un flujo de trabajo en KNIME para el emparejamiento y limpieza de información científica y tecnológica en Knowten. Desarrollo de un videojuego interactivo como herramienta lúdica para niños con trastorno del espectro autista. Estrategias de eficiencia del agua en las edificaciones de las islas de San Andrés, Providencia y Santa Catalina. Proyecto cartilla de entrenamiento cognitivo para adultos mayores: intervención para el mejoramiento de los procesos atencionales. Pruebas cognitivas tradicionales y digitalizadas para evaluar la atención: ¿son comparables? Elevar los estándares del proceso de secado del café: rumbo a una producción más rentable. Módulo didáctico de telecomunicaciones punto a punto por señales de microondas. Educación en la era digital: navegar los desafíos y las oportunidades de las redes sociales digitales. El uso de ChatGPT afecta la propiedad intelectual y los derechos de autor. Análisis de la relación entre variables clave y la rotación de personal en un contexto laboral específico: un enfoque metodológico de Anova y Six Sigma

Implementation of a Brazilian Cardioprotective Nutritional (BALANCE) Program for improvement on quality of diet and secondary prevention of cardiovascular events: A randomized, multicenter trial

Background: Appropriate dietary recommendations represent a key part of secondary prevention in cardiovascular disease (CVD). We evaluated the effectiveness of the implementation of a nutritional program on quality of diet, cardiovascular events, and death in patients with established CVD. Methods: In this open-label, multicenter trial conducted in 35 sites in Brazil, we randomly assigned (1:1) patients aged 45 years or older to receive either the BALANCE Program (experimental group) or conventional nutrition advice (control group). The BALANCE Program included a unique nutritional education strategy to implement recommendations from guidelines, adapted to the use of affordable and regional foods. Adherence to diet was evaluated by the modified Alternative Healthy Eating Index. The primary end point was a composite of all-cause mortality, cardiovascular death, cardiac arrest, myocardial infarction, stroke, myocardial revascularization, amputation, or hospitalization for unstable angina. Secondary end points included biochemical and anthropometric data, and blood pressure levels. Results: From March 5, 2013, to Abril 7, 2015, a total of 2534 eligible patients were randomly assigned to either the BALANCE Program group (n = 1,266) or the control group (n = 1,268) and were followed up for a median of 3.5 years. In total, 235 (9.3%) participants had been lost to follow-up. After 3 years of follow-up, mean modified Alternative Healthy Eating Index (scale 0-70) was only slightly higher in the BALANCE group versus the control group (26.2 ± 8.4 vs 24.7 ± 8.6, P <.01), mainly due to a 0.5-serving/d greater intake of fruits and of vegetables in the BALANCE group. Primary end point events occurred in 236 participants (18.8%) in the BALANCE group and in 207 participants (16.4%) in the control group (hazard ratio, 1.15; 95% CI 0.95-1.38; P =.15). Secondary end points did not differ between groups after follow-up. Conclusions: The BALANCE Program only slightly improved adherence to a healthy diet in patients with established CVD and had no significant effect on the incidence of cardiovascular events or death. © 2019 The Author