Efeitos macroeconômicos da seguridade social num contexto de bônus demográfico: simulação de um modelo do ciclo da vida / Macroeconomic effects of social security in a demographic bonus context: simulating a life cycle model / Efectos macroeconómicos de la seguridad social en un contexto de bonos demográfico: simulación de un modelo de ciclo de vida

Esse artigo analisa o impacto de política fiscal e de seguridade social em presença de bônus demográfico num modelo de equilíbrio geral dinâmico com agentes se comportando de acordo com a hipótese do ciclo da vida. Permitindo uma estrutura demográfica não estacionária, sob a hipótese do ciclo da vida, o modelo teórico captura o impacto da política fiscal e de seguridade social sobre a distribuição de renda durante a fase de bônus demográfico. O método de análise se baseia em técnicas de economia computacional para simular choques demográficos a partir do equilíbrio estacionário do modelo. O crescimento provisório da parcela da população correspondente aos trabalhadores causa aumento da poupança e redução da taxa de juros. Já o estoque de capital segue uma trajetória em forma de U invertido, tal como sugerido na literatura. A políticas que elevam o grau de contribuição da seguridade social são ferramentas de estímulo ao consumo e à redistribuição da renda em favor dos aposentados. A principal contribuição do artigo é fornecer uma análise das implicações macroeconômicas do bônus demográfico a partir de um modelo teórico com fundamentos microeconômicos para as decisões de consumo e acumulação de ativos.

This paper analyzes the impact of fiscal and social security policies in the presence of demographic bonuses in a dynamic general equilibrium model with life cycle hypothesis. Based on the theoretical framework proposed by Gertler (1999), but allowing a non-stationary demographic structure, the context of the demographic bonus was captured to infer the impact of tax and social security policy on income distribution during the demographic bonus phase. The results of the simulations indicate that the temporary increase in the share of workers in the population generates an increase in savings and a reduction in interest rates, while the behavior of the capital stock in the economy showed that the trajectory is an inverted U shape, as already suggested in the literature. In addition, it was seen that policies increasing the degree of social security contribution are tools to stimulate consumption and income redistribution in favor of retirees. The contribution of the paper is the analysis of macroeconomics implications of a demographic dividend with investment and fully microfounded consumption decisions.

Este artículo analiza el impacto de la política fiscal y previsional ante la presencia de bonos demográficos en un modelo dinámico de equilibrio general con agentes comportándose según la hipótesis del ciclo de vida. Con base en el marco teórico propuesto por Gertler (1999), pero permitiendo una estructura demográfica no estacionaria, se capturó el contexto del bono demográfico para inferir sobre el impacto de la política fiscal y previsional sobre la distribución del ingreso durante la fase del bono demográfico. Los resultados de las simulaciones indican que el aumento temporal de la participación de los trabajadores en la población genera un aumento del ahorro y una reducción de las tasas de interés, mientras que el comportamiento del stock de capital en la economía mostró que la trayectoria es en forma de U invertida, como ya se ha sugerido en la literatura. Además, se observó que las políticas que aumentan el grado de cotización a la seguridad social son herramientas para estimular el consumo y la redistribución del ingreso a favor de los jubilados.

Thermodynamic bounds for existence of normal shock in compressible fluid flow in pipes

Abstract The present paper is concerned with the thermodynamic theory of the normal shock in compressible fluid flow in pipes, in the lights of the pioneering works of Lord Rayleigh and G. Fanno. The theory of normal shock in pipes is currently presented in terms of the Rayleigh and Fanno curves, which are shown to cross each other in two points, one corresponding to a subsonic flow and the other corresponding to a supersonic flow. It is proposed in this paper a novel differential identity, which relates the energy flux density, the linear momentum flux density, and the entropy, for constant mass flow density. The identity so obtained is used to establish a theorem, which shows that Rayleigh and Fanno curves become tangent to each other at a single sonic point. At the sonic point the entropy reaches a maximum, either as a function of the pressure and the energy density flux or as a function of the pressure and the linear momentum density flux. A Second Law analysis is also presented, which is fully independent of the Second Law analysis based on the Rankine-Hugoniot adiabatic carried out by Landau and Lifshitz (1959).

Impacto del cambio de programación en la incidencia acumulada de choques apropiados e inapropiados en portadores de cardiodesfibrilador automático implantable / Impact of programming change on the cumulative incidence of appropriate and inappropriate shocks in patients with implantable cardioverter defibrillator

Introducción: el cardiodesfibrilador automático implantable (DAI) ha impactado positivamente en el tratamiento de la muerte súbita cardíaca. Sin embargo, los choques, apropiados o inapropiados generan efectos adversos. Definir zonas para las terapias según la patología de base y utilizando rangos de frecuencia altos e intervalos de detección prolongados ha demostrado disminuir el número de terapias sin aumentar la mortalidad. En Uruguay no existen datos sobre el impacto de estos cambios de programación en la incidencia de choques, como tampoco se han evaluado predictores de tales acontecimientos. Método: cohorte retrospectiva observacional de 191 pacientes vivos con DAI en el período comprendido entre diciembre de 1991 y abril de 2016 en el Servicio de Electrofisiología de Casa de Galicia. El implante se realizó con criterio de prevención secundaria en el 82% de los casos; edad 55±16 años, con predominio del sexo masculino (78%). El 46% tenían fracción de eyección del ventrículo izquierdo (FEVI) >40% y 37% era portador de cardiopatía isquémica. Se asoció terapia de resincronización cardíaca (TRC) en 20%. A partir de enero de 2013 la programación se ajustó a las recomendaciones actuales y se aplicó a 75 pacientes (39%). A efectos de comparar la performance de la nueva estrategia con la tradicional, se determinó la densidad de incidencia de choques apropiados e inapropiados entre los 116 pacientes programados según la estrategia convencional y los 75 con la nueva estrategia y se calculó la razón de densidades de choques apropiados e inapropiados entre ambos grupos. Resultado: con una mediana de seguimiento de tres años, la incidencia acumulada de choques apropiados fue de 30,9% (IC95% 24,4%-37,9%) y de choques inapropiados 16,8% (IC95% 11,7%-22,8%) en el grupo entero. Con la programación tradicional los choques apropiados e inapropiados fueron de 40,5% y 23,3% respectivamente versus 16,0% y 6,7% cuando se utilizó la programación actual. Los factores predictores de choques inapropiados identificados fueron los choques apropiados (OR 4,66 IC95% 1,81-12 p=0,001) y la programación tradicional (OR 6,77 IC95% 1,77-25,9 p=0,005), mientras que para los choques apropiados fue la programación tradicional (OR 3,28 IC95% 1,46-7,38 p=0,002). El uso de TRC (OR 0,036 IC95% 0,01-0,3 p=0,002) constituyó un factor protector independiente. La incidencia de choques inapropiados se reduce 27,7% con la programación actual, mientras que la incidencia de choques apropiados se incrementa 18,0%. Conclusión: la incidencia acumulada de choques apropiados e inapropiados es frecuente en la población estudiada. La programación del dispositivo de acuerdo a las recomendaciones actuales se asoció significativamente a menor ocurrencia de choques inapropiados. La programación tradicional y los choques apropiados fueron predictores independientes de choques inapropiados mientras que el uso de TRC fue predictor negativo independiente para descargas apropiadas.

Introduction: implantable cardioverter defibrillator (ICD) has positively impacted the treatment of sudden cardiac death. However, appropriate or inappropriate shocks generate multiple adverse effects of diverse severity. Defining zones for therapies considering baseline pathology and using higher frequency ranges and longer detection times has been shown to decrease the number of therapies without increasing mortality. In Uruguay, there is no data on the impact of these programming changes on the incidence of appropriate and inappropriate shocks, nor have predictors of such events been evaluated. Method: observational retrospective cohort of 191 alive patients with ICD in the period from December 1991 to April 2016, at the Electrophysiology Service of Casa de Galicia. The implants were performedwith secondary prevention criteria in 82%. Mean age 55±16 y.o., predominantly male (78%). 46% of patientes had left ventricular ejection fraction (LVEF) >40% and 37% had ischemic heart disease. Cardiac resynchronization therapy (CRT) was associated in 20%. From 1/2013 the programming was adjusted to the current recommendations including 75 patients (39%). We considered the cumulative incidence of appropriate and inappropriate shocks and their association with programming through univariate analysis and binary logistic regression for the multivariate. We determined the incidence density and the density ratios between the two groups. Result: with a median follow-up of 3 years, the cumulative incidence of appropriate shocks was 31% (95% CI 24.4-37.9) and inappropriate shocks 17% (CI 95% 11.7-22.8%). With traditional programming, appropriate and inappropriate shocks were 40.5% and 23%, while with the new programming protocol it was 16% and 6.7% respectively. The predictors of inappropriate shocks identified were: appropriate shocks (OR 4.66 CI 95% 1.81-12 p=0.001) and traditional programming (OR 6.77 CI 95% 1.77-25.9 p = 0.005); For appropriate shocks the predictor was the traditional programming (OR 3.28 CI 95% 1.46-7.38 p = 0.002). The use of CRT (OR 0.036 IC95% 0.01-0.3 p = 0.002) was an independent protective factor. The incidence of inappropriate shocks is reduced by 27% with the current protocol while the incidence of appropriate shocks increases by 18%. Conclusion: the cumulative incidence of appropriate and inappropriate shocks is frequent in the studied population. The programming of the device according to current recommendations was significantly associated with less occurrence of inappropriate shocks. Traditional programming and appropriate shocks were independent predictors of inappropriate shocks while the use of CRT was independent predictor of appropriate discharges.

Oxidative stress parameters in juvenile brazilian flounder Paralichthys orbignyanus (Valenciennes, 1839) (Pleuronectiformes: Paralichthyidae) exposed to cold and heat shocks

The aim of this study was to determine oxidative stress parameters in the liver and gill of Brazilian flounder juveniles (307.0 ± 16.0 g and 30.0 ± 4.0 cm) submitted to different water temperature (17.1, 23.0 and 28.8ºC) for 72 h and maintained at salinity 25‰. After the acclimation of 7 days, in 23ºC, fish were transferred to 200 L tanks containing seawater (salinity 25‰) at 28.8ºC (heat shock), 17.1ºC (cold shock) or 23.0ºC (control), five replicates (five fish tank-1). The sampled collection occurred in 0 (pre-challenge), 3, 24, 48 and 72 h after temperature shock. Flounder exposed to 17.1ºC and 28.8ºC showed significantly higher TBARS levels and GST activity in the liver post-exposition (PE) in relation to the control (23ºC). CAT activity in liver present a significantly increase at 17.1ºC, in first 48 h, and subsequently decrease in 72 h PE in relation to 28.8ºC. The gills of flounder showed significantly higher TBARS levels, GST and CAT activity when submitted at 17.1 and 28.8ºC in relation to 23.0ºC. There were observed changes in lipid peroxidation levels (LPO), CAT and GST activities in the liver and gill of Brazilian flounder in response to reactive oxygen species (ROS) produced by thermal shocks.

O objetivo deste estudo foi determinar os parâmetros de estresse oxidativo no fígado e brânquias de juvenis de linguado (307,0 ± 16,0 g e 30,0 ± 4,0 cm) submetidos a diferentes temperaturas da água (17,1, 23,0 e 28,8ºC) por 72 h e mantidos na salinidade de 25‰. Após uma aclimatação de sete dias, em 23ºC, os peixes foram transferidos para tanques de 200 L contendo água do mar (salinidade 25‰) em 28,8ºC (choque quente), 17,1ºC (choque frio) ou 23,0ºC (controle), cinco repetições (cinco peixes/tanque). A coleta de amostras ocorreu em 0 (pré-exposição), 3, 24, 48 e 72 h após o choque térmico. O linguado exposto a 17,1ºC e 28,8ºC apresentaram um significante aumento dos níveis de TBARS e atividade da GST no fígado pós-exposição (PE) em relação ao controle (23ºC). A atividade da CAT no fígado apresentou um aumento significativo em 17,1ºC, nas primeiras 48 h, e subsequente diminuição em 72 h PE em relação a 28,8ºC. As brânquias do linguado apresentaram significante aumento dos níveis de TBARS e atividade da GST e CAT quando submetidos a 17,1ºC e 28,8ºC em relação a 23,0ºC. Foram observadas alterações nos níveis de peroxidação lipídica (LPO) e atividade de GST e CAT no fígado e brânquias de linguado em resposta as espécies reativas de oxigênio (ROS) produzidas pelo choque térmico.

Study of effects of donepezil and aspirin on working memory in rats using electroconvulsive shock model.

Background: Memory is the most common cognitive ability lost with dementia commonly seen in Alzheimer’s disease (AD). Donepezil was the first cholinesterase inhibitor to be licensed in UK for AD. There is preliminary evidence that aspirin decreases the risk and delays the onset of AD. Low dose aspirin users had numerically lower prevalence of Alzheimer’s dementia and had better cognitive function than non-users. Methods: Retention of conditioned avoidance response (CAR) was assessed by using repeated electroconvulsive shocks (ECS) in rats. Rats were divided into five groups: control (pretreated with distilled water), ECS (150 V, 50 Hz, with intensity of 210 mA for 0.5 sec) pretreated, combined aspirin (6.75 mg/kg) and pretreated ECS, combined donepezil (0.32 mg/kg) and pretreated ECS, combined aspirin, donepezil and pretreated ECS groups. Data were analyzed using the Chi-square test and ANOVA. Results: Findings show that administration of ECS daily for 8 days results in transient amnesia and disruption of retention of CAR. Aspirin and donepezil administration significantly increased the retention of CAR in comparison to ECS. However, aspirin failed to show an increase in the retention of CAR as compared to donepezil. The combination of the two drugs showed statistically significant increase in the retention of CAR than either of these drugs given alone. Conclusion: Neuroinflammation plays an important role in the pathophysiology of neurodegenerative disorder like AD. Combination of aspirin with donepezil increased the nootropic and neuroprotective effect of aspirin and thus may hold great clinical significance in such disorders.

Costs of Maternal Health-related Complications in Bangladesh.

This paper assesses both out-of-pocket payments for healthcare and losses of productivity over six months postpartum among women who gave birth in Matlab, Bangladesh. The hypothesis of the study objective is that obstetric morbidity leads women to seek care at which time out-of-pocket expenditure is incurred. Second, a woman may also take time out from employment or from doing her household chores. This loss of resources places a financial burden on the household that may lead to reduced consumption of usual but less important goods and use of other services depending on the extent to which a household copes up by using savings, taking loans, and selling assets. Women were divided into three groups based on their morbidity patterns: (a) women with a severe obstetric complication (n=92); (b) women with a less-severe obstetric complication (n=127); and (c) women with a normal delivery (n=483). Data were collected from households of these women at two time-points—at six weeks and six months after delivery. The results showed that maternal morbidity led to a considerable loss of resources up to six weeks postpartum, with the greatest financial burden of cost of healthcare among the poorest households. However, families coped up with loss of resources by taking loans and selling assets, and by the end of six months postpartum, the households had paid back more than 40% of the loans.

Terapia posimplante de cardiodesfibrilador como prevención primaria y secundaria de muerte súbita en la Fundación Abood Shaio: seguimiento a un año / Therapy after to the implant of cardioverter-defi brillator in the primary and secundary prevention of sudden death during the fi rst year of follow up in the a clinic of fourth level of complexity

Introducción: el implante de cardiodesfi briladores ha cambiado el pronóstico en la prevención primaria y secundaria en paciente con muerte súbita. Hay sufi ciente evidencia que soporta que las terapias del cardiodesfi brilador, antitaquicardia y choques; tienen impacto sobre la morbimortalidad de los pacientes portadores del mismo, además del efecto proarritmogénico. Objetivo: está por determinar cuál es la incidencia de terapias apropiadas e inapropiadas en nuestra población de pacientes portadores de cardiodesfi brilador por prevención primaria y secundaria de muerte súbita. Materiales y métodos: se describe una serie de casos de pacientes a quienes se les implantó un cardiodesfi brilador como prevención primaria y secundaria de muerte súbita en una institución de cuarto nivel de complejidad. Resultados: la incidencia de terapia delcardiodesfi brilador implantable posimplante en pacientes con prevención primaria y secundaria de muerte súbita al primer año de seguimiento fue 44%. La incidencia de terapia apropiada del cardiodesfi brilador posimplante en pacientes con prevención primaria de muerte súbita al primer año de seguimiento fue 26,3%.La incidencia de terapia apropiada del cardiodesfi brilador posimplante en pacientes con prevención secundariade muerte súbita al primer año de seguimiento fue 53%. La mitad de los pacientes posimplante decardiodesfi brilador implantable como prevención primaria o secundaria presentaron terapias apropiadasdurante el seguimiento a un año. Los pacientes que presentaron terapias inapropiadas durante el año deseguimiento posterior al primoimplante de cardiodesfi brilador fueron 36%. Conclusiones: la terapia posterioral implante de cardiodesfi brilador se presento casi en la mitad de los pacientes, siendo más frecuente enprevención secundaria. Estos episodios se pueden presentar en diferentes patologías y pueden ser apropiadose inapropiados. Las complicaciones del procedimiento pueden ser agudas y crónicas.

The implant of Cardioverter-Defi brillator has changes the pronostic in the primary and secondary prevention in the patients with suden death. There are a lot of evidence that supports that the therapies of the CDI (antitachycardia and shocks) have impact on the morbimortality of the patients with Implantable Cardioverter-Defi brillators, besides the effect proarritmogenic. Objective: It is for determining which is the incidence of appropriate and inappropriate therapies in our population of patients with Implantable Cardioverter-Defi brillators for primary and secondary prevention of sudden death. Materials and Methods: we describe a case series of patients with cardioverter-Defi brillator as the primary and secondary prevention of sudden death in a clinic of fourth level of complexity. Results: the incidence of therapy of the Implantable Cardioverter-Defi brillators after implant in patients with primary and secondary prevention of sudden death to the fi rst year of follow-up was 44%. The incidence of apropiate therapy of the Implantable Cardioverter-Defi brillators after implant in patients with primary prevention of sudden death to the fi rst year of follow-up was the 26.3%.

The incidence of apropiate therapy of the Implantable Cardioverter-Defi brillators after implant in patients with secondary prevention of sudden death to the fi rst year of follow-up was the 53%. The half of the patients with Implantable Cardioverter-Defi brillators afterimpant for primary prevention or secondary had apropiate therapies during the fi rst year of follow-up. 36% of the patients presented inappropriate therapies during the year of follow-up after fi rst implat of the Implantable Cardioverter-Defi brillators. Conclusions: the therapies after to the implant of cardioverter-Defi brillator were near to the half of the patients, being more frecuent in the secundary prevention. These events may be present in the different pathologies, and to be apropiate and inapropiate. The complications of procedure may be acutes and chronics.