Relações familiares entre binacionais em tempos de pandemia = Family relationships of binational couples in times of pandemic

- DOI: https://doi.org/10.46901/revistadadpu.i15.p47-6

Extrafiscalidade como Instrumento de Implementação das Políticas Públicas: ICMS Ecológico E IVA Social

This work aims a study on the tax extrafiscality as a tool for providing public policies, which is seen as a trigger for the economic, social and environmental development. To prove such premise, it will be studied two taxes that were used for extrafiscal purposes in an attempt to correct and adjust the existing problems in their areas, which are: the tax on circulation and Ecological services, tax’s Brazilian assured by the Federal Constitution of Brazil, and Social Value Added Tax, which is a tax that exists in some European countries as well whose focus is on the consumer relations. O presente trabalho visa realizar um estudo acerca da extrafiscalidade tributária como instrumento propiciador das políticas públicas, hoje vista como implementadora do desenvolvimento econômico, social e ambiental. Para comprovar tal premissa, estudar-se-á dois impostos que foram utilizados em sua função extrafiscal, para tentar corrigir e regular os problemas existentes em seus territórios, quais sejam: o Imposto sobre Circulação de Mercadorias e Serviços - Ecológico, um imposto brasileiro previsto na Constituição da República Federativa do Brasil, e o Imposto sobre o Valor Acrescentado Social, um imposto existente em alguns países Europeus que incide sobre as relações de consumo

As jurisprudências dos tribunais brasileiros sobre isenções tributárias para pessoas com visão monocular

Analisamos a jurisprudência dos tribunais brasileiros sobre isenções tributárias para pessoas com visão monocular, abordando inicialmente a importância do tema na atualidade e demonstrando os direitos e os limites éticos da atuação do legislador quanto a discriminação em relação as deficiências graves e pessoas sem deficiência. Para tanto, efetuamos a análise da normativa nacional, internacional e da jurisprudência produzida nos tribunais, como direito comparado, sobre as possibilidades de reservas nas cotas de empregos, e com impossibilidade de concessão de isenção tributárias. Também observamos que a jurisprudência pátria faz entendimentos discriminatórios entre casos diferentes, uma vez que a visão monocular é uma deficiência de perda de um dos órgãos duplos, não gerando incapacidade total (invalidez). A partir dessas observações, identificou-se que as pessoas com visão monocular possuem desvantagens em relação às de visão plena para conseguir ingresso no mercado de trabalho, merecendo assim, a tutela do Estado para concorrerem nas vagas reservadas para pessoas com deficiência. Contudo, aegundo a Lei n.º 8.989/1995, com a redação dada pela Lei n.º 10.690/2003, que regulamenta o direito à isenção do IPI (Imposto sobre Produtos Industrializados), a visão monocular não se enquadra como deficiência visual. Identificou-se que pessoas com visão monocular merecem o acesso ao emprego através das vagas reservadas pelas cotas. Contudo, concluímos também que essas pessoas, por terem condições de trabalhar, não apresentam, segundo o Estado, condições para obtenção de determinadas isenções tributárias

As jurisprudências dos tribunais brasileiros sobre isenções tributárias para pessoas com visão monocular

Analisamos a jurisprudência dos tribunais brasileiros sobre isenções tributárias para pessoas com visão monocular, abordando inicialmente a importância do tema na atualidade e demonstrando os direitos e os limites éticos da atuação do legislador quanto a discriminação em relação as deficiências graves e pessoas sem deficiência. Para tanto, efetuamos a análise da normativa nacional, internacional e da jurisprudência produzida nos tribunais, como direito comparado, sobre as possibilidades de reservas nas cotas de empregos, e com impossibilidade de concessão de isenção tributárias. Também observamos que a jurisprudência pátria faz entendimentos discriminatórios entre casos diferentes, uma vez que a visão monocular é uma deficiência de perda de um dos órgãos duplos, não gerando incapacidade total (invalidez). A partir dessas observações, identificou-se que as pessoas com visão monocular possuem desvantagens em relação às de visão plena para conseguir ingresso no mercado de trabalho, merecendo assim, a tutela do Estado para concorrerem nas vagas reservadas para pessoas com deficiência. Contudo, aegundo a Lei n.º 8.989/1995, com a redação dada pela Lei n.º 10.690/2003, que regulamenta o direito à isenção do IPI (Imposto sobre Produtos Industrializados), a visão monocular não se enquadra como deficiência visual. Identificou-se que pessoas com visão monocular merecem o acesso ao emprego através das vagas reservadas pelas cotas. Contudo, concluímos também que essas pessoas, por terem condições de trabalhar, não apresentam, segundo o Estado, condições para obtenção de determinadas isenções tributárias

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

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

A implantação do IVA no Brasil: oportunidades e dificuldades de contexto

Dissertação de Mestrado Em Direito, apresentada à Faculdade de Direito da Universidade de Coimbr

NEOTROPICAL XENARTHRANS: a data set of occurrence of xenarthran species in the Neotropics

Xenarthrans—anteaters, sloths, and armadillos—have essential functions for ecosystem maintenance, such as insect control and nutrient cycling, playing key roles as ecosystem engineers. Because of habitat loss and fragmentation, hunting pressure, and conflicts with domestic dogs, these species have been threatened locally, regionally, or even across their full distribution ranges. The Neotropics harbor 21 species of armadillos, 10 anteaters, and 6 sloths. Our data set includes the families Chlamyphoridae (13), Dasypodidae (7), Myrmecophagidae (3), Bradypodidae (4), and Megalonychidae (2). We have no occurrence data on Dasypus pilosus (Dasypodidae). Regarding Cyclopedidae, until recently, only one species was recognized, but new genetic studies have revealed that the group is represented by seven species. In this data paper, we compiled a total of 42,528 records of 31 species, represented by occurrence and quantitative data, totaling 24,847 unique georeferenced records. The geographic range is from the southern United States, Mexico, and Caribbean countries at the northern portion of the Neotropics, to the austral distribution in Argentina, Paraguay, Chile, and Uruguay. Regarding anteaters, Myrmecophaga tridactyla has the most records (n = 5,941), and Cyclopes sp. have the fewest (n = 240). The armadillo species with the most data is Dasypus novemcinctus (n = 11,588), and the fewest data are recorded for Calyptophractus retusus (n = 33). With regard to sloth species, Bradypus variegatus has the most records (n = 962), and Bradypus pygmaeus has the fewest (n = 12). Our main objective with Neotropical Xenarthrans is to make occurrence and quantitative data available to facilitate more ecological research, particularly if we integrate the xenarthran data with other data sets of Neotropical Series that will become available very soon (i.e., Neotropical Carnivores, Neotropical Invasive Mammals, and Neotropical Hunters and Dogs). Therefore, studies on trophic cascades, hunting pressure, habitat loss, fragmentation effects, species invasion, and climate change effects will be possible with the Neotropical Xenarthrans data set. Please cite this data paper when using its data in publications. We also request that researchers and teachers inform us of how they are using these data

Effect of SGLT2 Inhibitors on Stroke and Atrial Fibrillation in Diabetic Kidney Disease: Results From the CREDENCE Trial and Meta-Analysis

BACKGROUND AND PURPOSE: Chronic kidney disease with reduced estimated glomerular filtration rate or elevated albuminuria increases risk for ischemic and hemorrhagic stroke. This study assessed the effects of sodium glucose cotransporter 2 inhibitors (SGLT2i) on stroke and atrial fibrillation/flutter (AF/AFL) from CREDENCE (Canagliflozin and Renal Events in Diabetes With Established Nephropathy Clinical Evaluation) and a meta-analysis of large cardiovascular outcome trials (CVOTs) of SGLT2i in type 2 diabetes mellitus.METHODS: CREDENCE randomized 4401 participants with type 2 diabetes mellitus and chronic kidney disease to canagliflozin or placebo. Post hoc, we estimated effects on fatal or nonfatal stroke, stroke subtypes, and intermediate markers of stroke risk including AF/AFL. Stroke and AF/AFL data from 3 other completed large CVOTs and CREDENCE were pooled using random-effects meta-analysis.RESULTS: In CREDENCE, 142 participants experienced a stroke during follow-up (10.9/1000 patient-years with canagliflozin, 14.2/1000 patient-years with placebo; hazard ratio [HR], 0.77 [95% CI, 0.55-1.08]). Effects by stroke subtypes were: ischemic (HR, 0.88 [95% CI, 0.61-1.28]; n=111), hemorrhagic (HR, 0.50 [95% CI, 0.19-1.32]; n=18), and undetermined (HR, 0.54 [95% CI, 0.20-1.46]; n=17). There was no clear effect on AF/AFL (HR, 0.76 [95% CI, 0.53-1.10]; n=115). The overall effects in the 4 CVOTs combined were: total stroke (HRpooled, 0.96 [95% CI, 0.82-1.12]), ischemic stroke (HRpooled, 1.01 [95% CI, 0.89-1.14]), hemorrhagic stroke (HRpooled, 0.50 [95% CI, 0.30-0.83]), undetermined stroke (HRpooled, 0.86 [95% CI, 0.49-1.51]), and AF/AFL (HRpooled, 0.81 [95% CI, 0.71-0.93]). There was evidence that SGLT2i effects on total stroke varied by baseline estimated glomerular filtration rate (P=0.01), with protection in the lowest estimated glomerular filtration rate (<45 mL/min/1.73 m2]) subgroup (HRpooled, 0.50 [95% CI, 0.31-0.79]).CONCLUSIONS: Although we found no clear effect of SGLT2i on total stroke in CREDENCE or across trials combined, there was some evidence of benefit in preventing hemorrhagic stroke and AF/AFL, as well as total stroke for those with lowest estimated glomerular filtration rate. Future research should focus on confirming these data and exploring potential mechanisms. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT02065791