The Current Role of Viability Imaging to Guide Revascularization and Therapy Decisions in Patients With Heart Failure and Reduced Left Ventricular Function

This review describes the current evidence and controversies for viability imaging to direct revascularization decisions and the impact on patient outcomes. Balancing procedural risks and possible benefit from revascularization is a key question in patients with heart failure of ischemic origin (IHF). Different stages of ischemia induce adaptive changes in myocardial metabolism and function. Viable but dysfunctional myocardium has the potential to recover after restoring blood flow. Modern imaging techniques demonstrate different aspects of viable myocardium; perfusion (single-photon emission computed tomography [SPECT], positron emission tomography [PET], cardiovascular magnetic resonance [CMR]), cell metabolism (PET), cell membrane integrity and mitochondrial function (201Tl and 99mTc-based SPECT), contractile reserve (stress echocardiography, CMR) and scar (CMR). Observational studies suggest that patients with IHF and significant viable myocardium may benefit from revascularization compared with medical treatment alone but that in patients without significant viability, revascularization appears to offer no survival benefit or could even worsen the outcome. This was not supported by 2 randomized trials (Surgical Treatment for Ischemic Heart Failure [STICH] and PET and Recovery Following Revascularization [PARR] -2) although post-hoc analyses suggest that benefit can be achieved if decisions had been strictly based on viability imaging recommendations. Based on current evidence, viability testing should not be the routine for all patients with IHF considered for revascularization but rather integrated with clinical data to guide decisions on revascularization of high-risk patients with comorbidities.Peer reviewe

Discussão sobre a regularização da piscicultura brasileira: da produção à comercialização.

Introdução. Regularização de projetos aquícolas. Regularização de projetos aquícolas. Exemplos da abertura de empresa rural em outros países. Registro de Aquicultor e Licença de Aquicultor. Espécies cultiváveis. Exemplos de permissão de espécies exóticas para cultivo em outros países. Resumo do processo de regularização das pisciculturas em águas da União. Licenciamento ambiental de projetos de piscicultura. Particularidades do licenciamento em viveiros escavados, barragem e PCH e águas Estaduais. Custos do processo de regularização da área aquícola no Brasil. Exemplos internacionais sobre a regularização das áreas produtivas. Outorga de direito de uso de recursos hídricos para a piscicultura. Exemplos internacionais sobre cessão de uso das áreas produtivas. Regularização da produção. Incentivos para a produção. Tarifa da energia elétrica. Contribuição previdenciária. Regularização na comercialização. Despesca e Abate. Transporte. Guia de trânsito animal e outros documentos. Problemas causados pela falta de Inspeção Sanitária. Registros de estabelecimentos de processamento de pescado. SISB - Uma opção. Considerações Finais. Referências. Anexo 1 - Referências de interesse

Chapitre 7. Le développement des pôles industriels halieutiques en Amérique latine

RésuméLe développement des pêches industrielles en Amérique latine est récent et les grands pôles halieutiques de la région ont été formés en général après 1960. 60 % des 23,8 millions de tonnes de poissons pêchés en 1995 dans la région correspondent à 35 grands pôles halieutiques, les plus productifs étant situés au long du littoral Pacifique Sud. Déjà, deux de ces pôles sont essentiellement aquacoles. L'aquaculture constitue en effet un des grands enjeux du secteur halieutique latino-américain du début du xxie siècle, tout comme le développement de la pêche hauturière, en particulier dans les eaux antarctiques, et la croissance accélérée des marchés régionaux. Afin de mieux comprendre l'évolution historique de ce secteur, qui dispose d'un énorme potentiel de développement, on étudiera en particulier le cas du pôle halieutique de Rio de Janeiro. ResumenEl desarrollo de la pesca industrial en América Latina es reciente y los grandes polos pesqueros en general fueron formados después de 1960. El 60 % de los 23,8 millones de toneladas de pescados producidas en 1995 en la región se encuentran concentradas en 35 grandes polos pesqueros de los cuales los más productivos están situados a lo largo del litoral Pacífico Sur. Dos de estos polos son esencialmente acuícolas. La acuicultura constituye efectivamente uno de los puntos claves del desarrollo pesquero latino-americano en este início de siglo xxi, así como la pesca de altura, particularmente en las aguas antárticas, y el crecimiento acelerado de los mercados regionales. Con el propósito de entender mejor la evolución histórica de este sector, que cuenta todavía con un enorme potential de desarrollo, aprofundizaremos el caso del polo pesquero de Rio de Janeiro

Une méthode pour déterminer le sous-ensemble optimal d'attributs pour la classification orientée objet d'images satellitaires

International audienceIn GEOBIA, remote sensing experts benefit from a large spectrum of characteristics to interpret images (spectral information, texture, geometry, spatial relations, etc). However, the quality of a classification is not always increased by inserting a higher number of features. The experts are then used to define classification rules based on a laborious "trial-and-error" process. In this paper, we propose a methodology to automatically determine an optimal subset of features for discriminating features. This process assumes that a reference land cover map is available. The method consists in ranking the features according to their potential for discriminating two classes. This task was performed thanks to the Support Vector Machine-Ranking Feature Extraction (SVM-RFE) algorithm. Then, it consists in training and validating a classification algorithm (SVM), with an increasing number of features: first only the best-ranked feature is included in the classifier, then the two best-ranked features, etc., until all the N features are included. The objective is to analyze how the quality of the classification evolves according to the numbers of features used. The optimal subset of features is finally determined through the analysis of the Akaike information criterion. The methodology was tested on two classes of pastures in a study area located in the Amazon. Two features were considered as sufficient to discriminate both classes

Une méthode pour déterminer le sous-ensemble optimal d'attributs pour la classification orientée objet d'images satellitaires

International audienceIn GEOBIA, remote sensing experts benefit from a large spectrum of characteristics to interpret images (spectral information, texture, geometry, spatial relations, etc). However, the quality of a classification is not always increased by inserting a higher number of features. The experts are then used to define classification rules based on a laborious "trial-and-error" process. In this paper, we propose a methodology to automatically determine an optimal subset of features for discriminating features. This process assumes that a reference land cover map is available. The method consists in ranking the features according to their potential for discriminating two classes. This task was performed thanks to the Support Vector Machine-Ranking Feature Extraction (SVM-RFE) algorithm. Then, it consists in training and validating a classification algorithm (SVM), with an increasing number of features: first only the best-ranked feature is included in the classifier, then the two best-ranked features, etc., until all the N features are included. The objective is to analyze how the quality of the classification evolves according to the numbers of features used. The optimal subset of features is finally determined through the analysis of the Akaike information criterion. The methodology was tested on two classes of pastures in a study area located in the Amazon. Two features were considered as sufficient to discriminate both classes