ANÁLISE ECONÔMICA DA CITRICULTURA DE ROSÁRIO DO SUL/RS: UM ENFOQUE SOBRE A ADOÇÃO DE PROGRAMAS DE CERTIFICAÇÃO SOCIOAMBIENTAL

The fruit sector is one of the most important segments of agribusiness in Brazil. In addition to its high profitability and expressive use of hand labor, the fruit stands out as an important alternative to the increase in Brazilian exports of agricultural products. The new market demands reflect the adoption of certification seals that prove the quality and healthiness of the product, the consumer is assured of a safe food whose production respects the environment and the worker. In Rio Grande do Sul, the culture began to be implemented from the year 2000 when several municipalities in the region received funds from the federal government, especially the Rosary South, through the Program for Fruit of the southern half being a beneficiary of the company Citrusul. This article aims to analyze the characteristics of production and marketing of the company, in addition to identifying the possible benefits of a future adoption of environmental certification programs in the citrus industry in the municipality. This article builds on the literature review and as a way to obtain the information necessary to construct this study, we sought through interviews and case study. The study showed that adoption of certification seals would bring the opportunity to access markets more noble and demanding, since the company is already working to have fruit of excellent quality. However, due to the volume of its current production, it is believed that the high costs for registration need not bring a financial return for such an investment.http://dx.doi.org/10.5902/223611708803O setor frutícola é um dos mais importantes segmentos do agronegócio do Brasil. Além da sua elevada rentabilidade e expressiva utilização de mão-de-obra, a fruticultura destaca-se como uma importante alternativa para o aumento das exportações brasileiras de produtos agrícolas. As novas exigências do mercado refletem na adoção de selos de certificação que comprovam a qualidade e sanidade do produto, o consumidor tem a garantia de um alimento seguro, cuja produção respeita o meio ambiente e o trabalhador. No Rio Grande do Sul, a cultura começou a ser implantada a partir do ano de 2000 quando diversos municípios da região receberam recursos do governo federal, sobretudo, Rosário do Sul, através do Programa de Fruticultura da Metade Sul, sendo uma das beneficiárias a empresa Citrusul. Este artigo tem como objetivo analisar as características de produção e comercialização da empresa, além de identificar os possíveis benefícios de uma futura adoção de programas de certificações socioambientais no setor de citros do município. O estudo foi arquitetado a partir de uma revisão bibliográfica e através de entrevistas para obter informações primárias sobre o assunto. O trabalho mostrou que adoção de selos de certificação traria a oportunidade de acesso a mercados mais nobres e exigentes, uma vez que a empresa já trabalha para ter frutas de excelente qualidade. No entanto, devido ao volume de sua produção atual, acredita-se que os altos custos para seu registro não trazem retorno financeiro necessário para tal investimento

ENFOQUE À LEGISLAÇÃO BRASILEIRA E EUROPEIA SOBRE A INDICAÇÃO GEOGRÁFICA

http://dx.doi.org/10.5902/2236117013045adoção da indicação geográfica (IG) está associada com a tradição do conhecimento e do alimento. Tendo-se em vista que os estudos nessa temática são ainda muito recentes e escassos no Brasil, objetivou-se realizar uma revisão da literatura sobre as legislações e normatizações existentes no Brasil e na Europa sobre indicação geográfica. Utilizou-se o método qualitativo, através de um estudo descritivo e com utilização da pesquisa bibliográfica. Observa-se que as preocupações com indicações geográficas são mais antigas nos países da União Europeia e que a legislação europeia traz uma forte regulamentação sobre o assunto. No Brasil, essa visão trazida pela indicação geográfica ainda é muito recente e caminha para uma maior valorização e regulamentação dos produtos dessa natureza. Conclui-se as IGs trazem contribuições extremamente positivas para as economias locais e para o dinamismo regional, proporcionando o real significado de criação de valor, atuando como uma espécie de certificação com atributos definidos, garantindo seu enquadramento às normas pré-estabelecidas

APPROACH TO THE BRAZILIAN AND EUROPEAN LEGISLATION ON GEOGRAPHICAL INDICATION

The adoption of the Geographical Indication (GI) is associated with the tradition of knowledge and food. Bearing in mind that the studies on this topic are still very recent and scarce in Brazil aimed to conduct a literature review of existing law sand norms in Brazil and in Europe on the aspect of geographical indication. We used the qualitative method, through a descriptive study and using the literature search. It is observed that concerns about Geographical Indications are the oldest in the countries of the European Union, and European legislation brings strong regulation son the subject. In Brazil this vision brought by the Geographical Indication is still very recent and walks to a greater appreciation and regulation of such products. It follows GIs bring extremely positive contributions to local economies and to regional dynamics, providing the real meaning of value creation, acting as a kind of certification with defined attributes, ensuring their consistency with prescribed standards. A adoção da indicação geográfica (IG) está associada com a tradição do conhecimento e do alimento. Tendo-se em vista que os estudos nessa temática são ainda muito recentes e escassos no Brasil, objetivou-se realizar uma revisão da literatura sobre as legislações e normatizações existentes no Brasil e na Europa sobre indicação geográfica. Utilizou-se o método qualitativo, através de um estudo descritivo e com utilização da pesquisa bibliográfica. Observa-se que as preocupações com indicações geográficas são mais antigas nos países da União Europeia e que a legislação europeia traz uma forte regulamentação sobre o assunto. No Brasil, essa visão trazida pela indicação geográfica ainda é muito recente e caminha para uma maior valorização e regulamentação dos produtos dessa natureza. Conclui-se as IGs trazem contribuições extremamente positivas para as economias locais e para o dinamismo regional, proporcionando o real significado de criação de valor, atuando como uma espécie de certificação com atributos definidos, garantindo seu enquadramento às normas pré-estabelecidas

New concepts in the treatment of hepatocellular carcinoma

Hepatocellular carcinoma (HCC) is the third most common cause of cancer-related death and occurs mainly in the context of chronic liver disease at cirrhosis stage. The Barcelona Clinic Liver Cancer classification, first established in 1999, is the most commonly used staging system for HCC in Western countries that link tumor burden, liver function and performance status with prognosis and therapeutic management. Since the first publication of this classification, it has been implemented in several clinical guidelines and recent major therapeutic advances in the management of HCC have modified the therapeutic landscape of HCC. Accordingly, an updated version was recently published in 2022, incorporating an expert clinical decision-making component and the concept of treatment stage migration. This update also introduces the positive results of recent randomized clinical trials, and introduces atezolizumab/bevacizumab (A/B) as a first-line combination regimen for patients with advanced HCC. Finally, the complexity of the management of patients with HCC highlights the need for a multidisciplinary approach including input from hepatology, surgery, radiology, medical oncology, and radiation oncology.SCOPUS: re.jinfo:eu-repo/semantics/publishe

Fragility index of positive phase II and III randomised clinical trials of treatments for hepatocellular carcinoma (2002–2022)

Background &amp; Aims: The fragility index (FI), i.e., theminimum number of best survivors reassigned to the control group required to revert the statistically significant result of a clinical trial to non-significant, is a metric to evaluate the robustness of randomized controlled trials (RCTs). We aimed to assess the FI in the field of HCC. Methods: This is a retrospective analysis of phase 2 and 3 RCTs for the treatment of HCC published between 2002 and 2022. We included two-arm studies with 1:1 randomization and significant positive results for a primary time-to-event endpoint for the FI calculation, which involves the iterative addition of a best survivor from the experimental group to the control group, until positive significance (p <0,05, Log-rank test) is lost. Results: We identified 51 phase 2 and 3 positive RCTs, of which 29 (57%) were eligible for fragility index calculation. After reconstruction of the Kaplan-Meier curves, 25/29 studies remained significant, among which the analysis was performed. The median (interquartile range (IQR)) FI was 5 (2-10) and Fragility Quotient (FQ) was 3% (1%-6%). Ten trials (40%) had a FI of 2 or less. FI was positively correlated to the blind assessment of the primary endpoint (median FI 9 with blind assessment versus 2 without, p = 0.01), the number of reported events in the control arm (RS = 0.45, p = 0.02) and to impact factor (RS = 0.58, p = 0.003). Conclusions: Several phases 2 and 3 RCTs in HCC have a low fragility index, underlying the limited robustness on the conclusion of their superiority over control treatments. The fragility index might provide an additional tool to assess the robustness of clinical trial data in HCC. Impact and implications: The fragility index is a method to assess robustness of a clinical trial and is defined the minimum number of best survivors reassigned to the control group required to revert the statistically significant result of a clinical trial to non-significant. Among 25 randomised controlled trials in HCC, the median fragility index was 5, and 10 trials among 25 (40%) had a fragility index of 2 or less, indicating an important fragility

Is it necessary to perform a morphological assessment for an esophageal motility disorder? A retrospective descriptive study

International audienc

Determinants of survival after lung transplantation in telomerase-related gene mutation carriers: A retrospective cohort.

Carriers of germline telomerase-related gene (TRG) mutations can show poor prognosis, with an increase in common hematological complications after lung transplantation (LT) for pulmonary fibrosis. The aim of this study was to describe the outcomes after LT in recipients carrying a germline TRG mutation and to identify the predictors of survival. In a multicenter cohort of LT patients, we retrospectively reviewed those carrying pathogenic TRG variations (n = 38; TERT, n = 23, TERC, n = 9, RTEL1, n = 6) between 2009 and 2018. The median age at LT was 54 years (interquartile range [IQR] 46-59); 68% were male and 71% had idiopathic pulmonary fibrosis. During the diagnosis of pulmonary fibrosis, 28 (74%) had a hematological disease, including eight with myelodysplasia. After a median follow-up of 26 months (IQR 15-46), 38 patients received LT. The overall post-LT median survival was 3.75 years (IQR 1.8-NA). The risk of death after LT was increased for patients with myelodysplasia (HR 4.1 [95% CI 1.5-11.5]) or short telomere (HR 2.2 [1.0-5.0]) before LT. After LT, all patients had anemia, 66% had thrombocytopenia, and 39% had neutropenia. Chronic lung allograft dysfunction frequency was 29% at 4 years. The present findings support the use of LT in TRG mutation carriers without myelodysplasia. Hematological evaluation should be systematically performed before LT

Determinants of survival after lung transplantation in telomerase-related gene mutation carriers: A retrospective cohort.

Carriers of germline telomerase-related gene (TRG) mutations can show poor prognosis, with an increase in common hematological complications after lung transplantation (LT) for pulmonary fibrosis. The aim of this study was to describe the outcomes after LT in recipients carrying a germline TRG mutation and to identify the predictors of survival. In a multicenter cohort of LT patients, we retrospectively reviewed those carrying pathogenic TRG variations (n = 38; TERT, n = 23, TERC, n = 9, RTEL1, n = 6) between 2009 and 2018. The median age at LT was 54 years (interquartile range [IQR] 46-59); 68% were male and 71% had idiopathic pulmonary fibrosis. During the diagnosis of pulmonary fibrosis, 28 (74%) had a hematological disease, including eight with myelodysplasia. After a median follow-up of 26 months (IQR 15-46), 38 patients received LT. The overall post-LT median survival was 3.75 years (IQR 1.8-NA). The risk of death after LT was increased for patients with myelodysplasia (HR 4.1 [95% CI 1.5-11.5]) or short telomere (HR 2.2 [1.0-5.0]) before LT. After LT, all patients had anemia, 66% had thrombocytopenia, and 39% had neutropenia. Chronic lung allograft dysfunction frequency was 29% at 4 years. The present findings support the use of LT in TRG mutation carriers without myelodysplasia. Hematological evaluation should be systematically performed before LT

Liver disease in germline mutations of telomere-related genes: Prevalence, clinical, radiological, pathological features, outcome, and risk factors

International audienceBackground and aim: Germline mutations of telomere-related genes (TRG) induce multiorgan dysfunction, and liver-specific manifestations have not been clearly outlined. We aimed to describe TRG mutations-associated liver diseases. Approach and results: Retrospective multicentre analysis of liver disease (transaminases>30 IU/L and/or abnormal liver imaging) in patients with TRG mutations. Main measurements were characteristics, outcomes, and risk factors of liver disease in a TRG mutations cohort. The prevalence of liver disease was compared to a community-based control group (n=1190) stratified for age and matched 1:3 for known risk factors of liver disease. Among 132 patients with TRG mutations, 95 (72%) had liver disease, with associated lung, blood, skin, rheumatological and ophthalmological TRG diseases in 82%, 77%, 55%, 39%, and 30% of cases, respectively. Liver biopsy was performed in 52/95 patients, identifying porto-sinusoidal vascular disease (PSVD) in 48%, and advanced fibrosis/cirrhosis in 15%. After a follow-up of 21 months (12-54), ascites, hepato-pulmonary syndrome, variceal bleeding, and hepatocellular carcinoma occurred in 14%, 13%, 13%, and 2% of cases, respectively. Five-year liver transplantation-free survival was 69%. A FIB-4 score ≥3·25 and ≥1 risk factor for cirrhosis were associated with poor liver transplantation-free survival. Liver disease was more frequent in patients with TRG mutations than in the paired control group (80/396, (20%)), OR 12.9 (CI95% 7.8-21.3, p <0.001). Conclusions: TRG mutations significantly increase the risk of developing liver disease. Although symptoms may be mild they may be associated with severe disease. PSVD and cirrhosis were the most frequent lesions suggesting that the mechanism of action is multifactorial