Few studies have discussed the reasons for pharmacological undertreatment of Acute Coronary Syndrome (ACS).
To determine the frequency and reasons for the non-administration and suspension of ...medications during in-hospital treatments of ACS in the Strategy of Registry of Acute Coronary Syndrome (ERICO) study.
The present study analyzed the medical charts of the 563 participants in the ERICO study to evaluate the frequency and reasons for the non-administration and/or suspension of medications. Logistic regression models were built to analyze if sex, age ≥65 years of age, educational level, or ACS subtype were associated with (a) the non-administration of ≥1 medications; and (b) the non-administration or suspension of ≥1 medications. The significance level was set at 5%.
This study's sample included 58.1% males, with a median of 62 years of age. In 183 (32.5%) participants, ≥1 medications were not administered, while in 288 (51.2%), ≥1 medications were not administered or were suspended. The most common reasons were the risk of bleeding (aspirin, clopidogrel, and heparin), heart failure (beta blockers), and hypotension (angiotensin-converting enzyme inhibitors and angiotensin receptor blockers). Individuals aged ≥65 (odds ratio OR:1.51; 95% confidence interval 95% CI:1.05-2.19) and those with unstable angina (OR:1.72; 95% CI:1.07-2.75) showed a higher probability for the non-administration of ≥1 medication. Considering only patients with myocardial infarction, being ≥65 years of age was associated with both the non-administration and the non-administration or suspension of ≥1 medication.
Non-administration or suspension of ≥1 medication proved to be common in this ERICO study. Individuals of ≥65 years of age or with unstable angina showed a higher probability of the non-administration of ≥1 medication and may be undertreated in this scenario. (Arq Bras Cardiol. 2020; 115(5):830-839).
Historically, carbon dioxide emissions from transport have been a globally discussed and analyzed problem. The adoption of flex fuel vehicles designed to run ethanol–gasoline blends is important to ...mitigate these emissions. The main purpose of this paper is to analyze the impact of the ethanol–gasoline price ratio on different vehicle models, and discuss the opportunities to increase ethanol consumption from this perspective. Our analysis shows that the use of a unique fuel economy ratio for all flex–fuel vehicles in the country significantly reduces the opportunity of some customers to purchase hydrous ethanol. The paper also discusses possible actions to provide adequate information that may increase the possibility of fuelling vehicles with a high-level ethanol blend.
Several empirical results on time series indicate that combining forecasts is, on average, better than selecting a single winning forecasting model. The success of the combination approach depends on ...how well the combination weights can be determined. Focusing on convex combinations – linear combinations with forecast weights constrained to be non-negative and to sum to unity – this paper proposes a new weight generation framework called Neural Expert Weighting (NEW). The framework generates dynamic weighting models based on neural networks, both relaxing in-sample performance dependence and abstracting statistical complexity. Assessed with 15 time series divided into two case studies – petroleum products and NN3 forecasting competition – the NEW models presented promising results.
The worldwide COVID-19 pandemic caused by the coronavirus SARS-CoV-2 urgently demands novel direct antiviral treatments. The main protease (M
) and papain-like protease (PL
) are attractive drug ...targets among coronaviruses due to their essential role in processing the polyproteins translated from the viral RNA. In this study, we virtually screened 688 naphthoquinoidal compounds and derivatives against M
of SARS-CoV-2. Twenty-four derivatives were selected and evaluated in biochemical assays against M
using a novel fluorogenic substrate. In parallel, these compounds were also assayed with SARS-CoV-2 PL
. Four compounds inhibited M
with half-maximal inhibitory concentration (IC
) values between 0.41 μM and 9.0 μM. In addition, three compounds inhibited PL
with IC
ranging from 1.9 μM to 3.3 μM. To verify the specificity of M
and PL
inhibitors, our experiments included an assessment of common causes of false positives such as aggregation, high compound fluorescence, and inhibition by enzyme oxidation. Altogether, we confirmed novel classes of specific M
and PL
inhibitors. Molecular dynamics simulations suggest stable binding modes for M
inhibitors with frequent interactions with residues in the S1 and S2 pockets of the active site. For two PL
inhibitors, interactions occur in the S3 and S4 pockets. In summary, our structure-based computational and biochemical approach identified novel naphthoquinonal scaffolds that can be further explored as SARS-CoV-2 antivirals.
The worldwide COVID-19 pandemic caused by the coronavirus SARS-CoV-2 urgently demands novel direct antiviral treatments. The main protease (Mpro) and papain-like protease (PLpro) are attractive drug ...targets among coronaviruses due to their essential role in processing the polyproteins translated from the viral RNA. In this study, we virtually screened 688 naphthoquinoidal compounds and derivatives against Mpro of SARS-CoV-2. Twenty-four derivatives were selected and evaluated in biochemical assays against Mpro using a novel fluorogenic substrate. In parallel, these compounds were also assayed with SARS-CoV-2 PLpro. Four compounds inhibited Mpro with half-maximal inhibitory concentration (IC50) values between 0.41 μM and 9.0 μM. In addition, three compounds inhibited PLpro with IC50 ranging from 1.9 μM to 3.3 μM. To verify the specificity of Mpro and PLpro inhibitors, our experiments included an assessment of common causes of false positives such as aggregation, high compound fluorescence, and inhibition by enzyme oxidation. Altogether, we confirmed novel classes of specific Mpro and PLpro inhibitors. Molecular dynamics simulations suggest stable binding modes for Mpro inhibitors with frequent interactions with residues in the S1 and S2 pockets of the active site. For two PLpro inhibitors, interactions occur in the S3 and S4 pockets. In summary, our structure-based computational and biochemical approach identified novel naphthoquinonal scaffolds that can be further explored as SARS-CoV-2 antivirals.
In recent years, we have witnessed the emergence of Shared Sensor Networks (SSNs) as a core component of cyber-physical systems for diverse applications. As Wireless Sensor and Actuator Networks ...(WSANs) design starts shifting from application-specific platforms to shared system infrastructures, a pressing research challenge is security. In scenarios involving unprotected hostile outdoor areas, SSNs are prone to different types of attacks that can compromise reliability, integrity, and availability of the sensor data traffic and sensor lifetime as well. In this work we propose a Dynamic Security System to be applied in the shared sensor network context. Its basic feature is the nodes neighborhood monitoring and collaboration (through the use of the Byzantine algorithm) to identify an attack and enhance security. The proposed security system is dynamic since it is able to manage the availability, integrity, and confidentiality of multiple applications according to the current execution context. It is also resilient, since it is able to support the continuous network operation even in the presence of malicious or faulty nodes. Its resilience is achieved for the capacity of gathering information from several nodes, thus inferring the countermeasures using context information.
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In this study, we developed and validated a chromatographic method by High-performance Liquid Chromatography coupled to Diode-Array Ultraviolet Detector for quantification of ...acetaminophen in small volumes of plasma. This analytical method is particularly suitable for studies of gastric emptying time and pharmacokinetics in small rodents. Orally administered acetaminophen is promptly and completely absorbed in the intestines, with negligible absorption from the stomach. Owing to these kinetic features, acetaminophen can be used to study gastric emptying. The newly-validated analytical method was employed to investigate whether plants used as anti-dyspeptics in the Brazilian traditional medicine affect the gastric emptying. Lyophilized aqueous extracts from leaves of Baccharis trimera (Less) DC., Asteraceae (carqueja), Maytenus ilicifolia Mart. Ex Reissek, Celastraceae (espinheira-santa) and Lippia alba (Mill.) N.E.Br. ex Britton & P. Wilson, Verbenaceae (erva-cidreira) were administered by gavage to female Wistar rats 30min before a single oral dose of acetaminophen (50mg/kg). L. alba extract (50mg/kg) did not alter acetaminophen plasma concentration versus time curve an indication that it has no effect on gastric emptying. Extracts of B. trimera (50mg/kg) and M. ilicifolia (30 and 50mg/kg, but not 10mg/kg), however, slightly delayed gastric emptying. M. ilicifolia given by intraperitoneal route (30mg/kg) also retarded gastric emptying. In conclusion, the newly-validated analytical method is adequate for studying the effects of medicinal plants on gastric emptying.
Competition is a relevant element in any open economy. Public policies are necessary to induce economic efficiency and to create conditions to preserve or stimulate a competitive environment. This ...paper aims to assess the competitiveness of hydrous ethanol price in a period of political, social and economic crises, in 15 Brazilian state capitals between the years 2012 and 2019. We compared the ethanol–gasoline price ratio behavior in two different periods, before and after the import parity price policy implemented by Petrobras in 2016. Mann–Whitney and Levene’s tests, two non-parametric statistical methods, were applied to verify significant changes between these periods. The implementation of changes in Petrobras’ pricing policy from 2016 onwards caused a statistically significant increase in the ratio coefficient of variation in two-thirds of the distribution market and more than the half of analyzed retail markets. Second, overall, the cities that showed statistically significant changes in the median and coefficient of variation in the distribution market price ratio were followed by the retail market. Our findings suggest that government interventions in the fuel and byproduct final selling prices to distributors negatively impact competition between companies that are part of the fuel distribution and retail chain, also affecting the sale of biofuels in Brazil and discouraging the initiatives to use renewable fuels to reduce the emission of pollutants.
Waste frying oil has been used to optimize the production of biodiesel. Biodiesel was prepared through sodium ethoxide catalyzed methanolysis from the transesterification of recycled waste frying ...oil. Optimization of the transesterification reaction for biodiesel production was carried out by means of statistical analyses using ANOVA. The optimum conditions for reaction were the following: a oil−methanol mole ratio of 1:9, temperature of 50 °C, catalyst mass fraction of 0.9 %, and reaction time of 40 min, which enabled a yield of 98.7 % determined by gas chromatography/mass spectrometry (GC/MS) analysis. The density and viscosity of biodiesel/diesel blends have been determined as a function of composition at several temperatures.
La miositis por cuerpos de inclusión (MCI) es una patología poco común que se presenta en individuos mayores de 50 años y con mayor frecuencia en hombres; sin embargo, los síntomas pueden empezar 20 ...años antes de su diagnóstico. Hasta un 30% de los casos de miopatías inflamatorias pueden ser de MCI y su prevalencia varía en los diferentes países y grupos étnicos. Clínicamente se manifiesta como debilidad lentamente progresiva proximal y distal. En este artículo se presenta un caso de una paciente de 78 años con antecedentes previos de diabetes mellitus tipo 2, hipertensión arterial, e hipotiroidismo, con cuadro de 18 meses de evolución consistente en debilidad de miembros inferiores, incapacidad para subir y bajar escaleras, limitación en la marcha, acompañado de disestesias. Se realizó la medición de la creatin quinasa (CK) y su valor inicial fue 7820, la electromiografía y neuroconducciones mostraron polineuropatia axonal motora en las cuatro extremidades y miopatía inflamatoria. Se trató con glucorticoides a dosis de 1 mg/kg y después de seis meses de tratamiento no se observó mejoría. Se decide tomar biopsia muscular que mostró miopatía por cuerpos de inclusión, lo que explicó la falla terapéutica inicial. Este caso es interesante desde el punto de vista clínico, ya que no es frecuente la elevación de la CK en los niveles que presentó la paciente y por las múltiples comorbilidades asociadas.
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