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OBJECTIVES:. Data on cardiac arrest survivors from developing countries are scarce. This study investigated clinical characteristics associated with in-hospital mortality in resuscitated patients following cardiac arrest in Brazil. DESIGN:. Retrospective analysis of prospectively collected data. SETTING:. Ninety-two general ICUs from 55 hospitals in Brazil between 2014 and 2015. PATIENTS:. Adult patients with cardiac arrest admitted to the ICU. INTERVENTIONS:. None. MEASUREMENTS AND MAIN RESULTS:. We analyzed 2,296 patients (53% men; median 67 yr (interquartile range, 54–79 yr]). Eight-hundred patients (35%) had a primary admission diagnosis of cardiac arrest suggesting an out-of-hospital cardiac arrest; the remainder occurred after admission, comprising an in-hospital cardiac arrest cohort. Overall, in-hospital mortality was 83%, with only 6% undergoing withholding/withdrawal-of-life support. Random-effects multivariable Cox regression was used to assess associations with survival. After adjusting for age, sex, and severity scores, mortality was associated with shock (adjusted odds ratio, 1.25 [95% CI, 1.11–1.39]; p < 0.001), temperature dysregulation (adjusted odds ratio for normothermia, 0.85 [95% CI, 0.76–0.95]; p = 0.007), increased lactate levels above 4 mmol/L (adjusted odds ratio, 1.33 [95% CI, 1.1–1.6; p = 0.009), and surgical or cardiac cases (adjusted odds ratio, 0.72 [95% CI, 0.6–0.86]; p = 0.002). In addition, survival was better in patients with probable out-of-hospital cardiac arrest, unless ICU admission was delayed (adjusted odds ratio for interaction, 1.63 [95% CI, 1.21–2.21]; p = 004). CONCLUSIONS:. In a large multicenter cardiac arrest cohort from Brazil, we found a high mortality rate and infrequent withholding/withdrawal of life support. We also identified patient profiles associated with worse survival, such as those with shock/hypoperfusion and arrest secondary to nonsurgical admission diagnoses. Our findings unveil opportunities to improve postarrest care in developing countries, such as prompt ICU admission, expansion of the use of targeted temperature management, and implementation of shock reversal strategies (i.e., early coronary angiography), according to modern guidelines recommendations.

The presence of women in the university and in research can be considered a position of resistance, since the female gender faces several problems to be present in these and other spaces of power. As a way of breaking the silence in the face of some gender issues, this article presents the results of a didactic intervention developed for the curricular component of History and Philosophy of Science, in the Postgraduate Program in Science and Mathematics Teaching at a Brazilian Federal University. The article aims to discuss issues that cross gender diversity in different spaces, especially in academics and schools. The emerging categories presented in this text were based on the records of classes and questionnaires carried out by the teachers enrolled in the curricular component developed from the Content Analysis. The results allow us to understand that the proposed activity had its objective achieved in terms of promoting the discussion about gender, in different spaces. It was also evident that the academic environment is not yet a representative space, and also that the silence and the outbursts of professors on issues involving representativeness and diversity denote the importance of spaces for information, training and reflection in initial and continuing education at school and in society as a whole. [ABSTRACT FROM AUTHOR]

This paper exploits the decomposition structure of the large-scale hydrothermal generation expansion planning problem with an integrated modified Benders Decomposition and Progressive Hedging approach. We consider detailed and realistic data from the Brazilian power system to represent hourly chronological constraints based on typical days per month and year. Also, we represent the multistage stochastic nature of the optimal hydrothermal operational policy through co-optimized linear decision rules for individual reservoirs. Therefore, we ensure investment decisions compatible with a nonanticipative (implementable) operational policy. To solve the large-scale optimization problem, we propose an improved Benders Decomposition method with multiple instances of the master problem, each of which strengthened by primal cuts and new Benders cuts generated by each master’s trial solution. Additionally, our new approach allows using Progressive Hedging penalization terms for accelerating the convergence of the method. We show that our method is 60% faster than the benchmark. Finally, the consideration of a nonanticipative operational policy can save 7.64% of the total cost (16.18% of the investment costs) and significantly improve spot price profiles. [ABSTRACT FROM AUTHOR]

This article analyses the institute of popular initiative foreseen in the 1988 Brazilian Constitution. Based on an historical approach, we identify some formal and informal experiences related to the implementation of popular initiatives in the country. We argue that this direct democracy mechanism was embraced in an austere fashion by the Brazilian Political Charter, thus neutralizing its democratic potentiality and power control. As a practical result, we show that there is a clear tendency of utilizing popular initiative as a way of expanding repressive policies in the political and penal field. From another perspective, the informal initiatives implemented over time indicate a democratic insufficiency of the institute demanding a debate on new institutional arrangements. [ABSTRACT FROM AUTHOR]

Purpose: To compare the endothelial coverage of different stents in porcine carotid arteries. Research problem: How effective are polyurethane stents (PU) and PU + rapamycin (PU + RAPA) compared to bare-metal stents on endothelial coverage by neointima in pigs after 28 days?, Methods: The methodology had two phases for an interventional, experimental, prospective study, with three Moura pigs, 12 weeks old and weighing between 19 and 22.5 kg. In phase I, eight stents were implanted in carotid arteries; three stents coated with PU, three coated with PU + RAPA, and two without coating. After 28 days, phase II was carried out, consisting of euthanasia, removal of the stents, to evaluate the exposed area of the stent struts, and the percentage of endothelialization through optical microscopy and scanning electron microscopy., Results: The eight stents implanted with ultrasound sizing and post-dilation with a larger diameter balloon were analyzed by Doppler ultrasound, intravascular ultrasound, and angiography after 28 days., Conclusions: This study showed complete endothelial coverage by the endoluminal neointima of the stent struts, good integration and coverage with the arterial wall, with no exposed struts showing the presence of intimal hyperplasia (whitish tissue).