Vantagens comparativas e desempenho das exportações do setor pesqueiro brasileiro no mercado norte-americano

The objective of this study is to analyze the competitiveness of Brazilian exports of fish in the United States market from 2000 to 2008. To identify the products with revealed comparative advantage, and analyze the quality of expertise were used indicators of Revealed Comparative Advantage (RCA), Sales Performance (SP) and Quality of Expertise (QE). The results showed that the Brazilian fishing industry is in a great competitive situation in the U.S. market. The products in a state of withdrawal, and with missed opportunities (live fish and fish fillets) represent important business opportunities and investments in trade between Brazil and the United States.Key words: competitiveness, fish, United States, Brazil.O objetivo deste trabalho é analisar a competitividade das exportações brasileiras de pescado no mercado dos Estados Unidos no período de 2000 a 2008. Para identificar os produtos que apresentam vantagem comparativa revelada e analisar a qualidade de especialização, foram utilizados os indicadores de Vantagem Comparativa Revelada (VCR), Desempenho Comercial (DES) e Qualidade da Especialização (QE). Os resultados mostraram que o setor pesqueiro brasileiro está em situação competitiva ótima no mercado norte-americano. Os produtos em situação de retirada e com oportunidades perdidas (peixes vivos e filés de peixe) representam importantes oportunidades de negócios e investimentos no comércio entre o Brasil e os Estados Unidos.Palavras-chave: competitividade, pescado, Estados Unidos, Brasil

Development and validation of the MMCD score to predict kidney replacement therapy in COVID-19 patients

Abstract Background Acute kidney injury (AKI) is frequently associated with COVID-19, and the need for kidney replacement therapy (KRT) is considered an indicator of disease severity. This study aimed to develop a prognostic score for predicting the need for KRT in hospitalised COVID-19 patients, and to assess the incidence of AKI and KRT requirement. Methods This study is part of a multicentre cohort, the Brazilian COVID-19 Registry. A total of 5212 adult COVID-19 patients were included between March/2020 and September/2020. Variable selection was performed using generalised additive models (GAM), and least absolute shrinkage and selection operator (LASSO) regression was used for score derivation. Accuracy was assessed using the area under the receiver operating characteristic curve (AUC-ROC). Results The median age of the model-derivation cohort was 59 (IQR 47–70) years, 54.5% were men, 34.3% required ICU admission, 20.9% evolved with AKI, 9.3% required KRT, and 15.1% died during hospitalisation. The temporal validation cohort had similar age, sex, ICU admission, AKI, required KRT distribution and in-hospital mortality. The geographic validation cohort had similar age and sex; however, this cohort had higher rates of ICU admission, AKI, need for KRT and in-hospital mortality. Four predictors of the need for KRT were identified using GAM: need for mechanical ventilation, male sex, higher creatinine at hospital presentation and diabetes. The MMCD score had excellent discrimination in derivation (AUROC 0.929, 95% CI 0.918–0.939) and validation (temporal AUROC 0.927, 95% CI 0.911–0.941; geographic AUROC 0.819, 95% CI 0.792–0.845) cohorts and good overall performance (Brier score: 0.057, 0.056 and 0.122, respectively). The score is implemented in a freely available online risk calculator ( https://www.mmcdscore.com/ ). Conclusions The use of the MMCD score to predict the need for KRT may assist healthcare workers in identifying hospitalised COVID-19 patients who may require more intensive monitoring, and can be useful for resource allocation