Predictores de cambio en la función ventricular izquierda posterior a implante valvular aórtico transcateter comparado con reemplazo valvular aórtico quirúrgico en el hospital universitario fundación Cardioinfantil instituto de cardiología – Bogotá

Objetivos: Identificar predictores de recuperación de la función ventricular izquierda y comparar los hallazgos ecocardiográficos en pacientes con estenosis aórtica crítica sometidos a reemplazo quirúrgico de la válvula aórtica (RVA) o implantación de válvula aórtica transcatéter (TAVI). Métodos: Cuarenta y cuatro pacientes tratados con RVA se compararon con 34 pacientes con TAVI, los datos ecocardiográficos fueron retrospectivamente obtenidos antes de la intervención y previo al alta. Resultados: Se analizaron retrospectivamente pacientes tratados en la FCI - IC desde 2009 - 2015 (n = 78 pacientes, con una media de edad 70,29 ± 11,63, EuroSCORE logístico 3,75 (3-8,55) en RVA y 20,4 (15 , 47-23,32) en TAVI. Ambos grupos mostraron una disminución en los gradientes de la válvula aórtica, más en pacientes de TAVI, con un gradiente transaórtico pico (24,5 vs 18,5, p = 0,001) y medio (14 vs 10, p = 0,002) En comparación con RVA, TAVI presentó un mayor número de pacientes con insuficiencia aórtica paravalvular (47,1% frente a 2,3% p = 0.000). En total, el 61,5% presentó mejoría precoz de la función ventricular, el predictor en severo compromiso de la función del ventrículo izquierdo fue un alto índice de masa ventricular izquierda. Conclusiones: La implantación transcatéter de válvula aórtica es una alternativa al reemplazo quirúrgico de la válvula aórtica en pacientes con estenosis aórtica y alto riesgo quirúrgico. La recuperación postoperatoria precoz de la función ventricular izquierda en pacientes con severo compromiso de la función ventricular estuvo asociada a alto índice de masa ventricular izquierda.

Does connectivity add value to commercial real estate? The case of managed and conventional offices

This research is a preliminary study which examines the impact of connectivity on value in the managed office and conventional office sectors. The research is based on an extensive literature review, online survey and case studies carried out during 2005. The research shows, for the first time in the UK, how connectivity can increase value in office buildings, and how technology is priced in the market place.

Effect of different bleaching systems on the ultrastructure of bovine dentin

The aim of this study was to evaluate in vitro the effect of different in-office bleaching systems on the surface morphology of bovine dentin. Thirty tooth fragments measuring 4 x 4mm, containing enamel and dentin, were obtained from the crowns of extracted bovine incisors. Samples were subjected to simulated intracoronal bleaching techniques using conventional (Opalescence Endo (R) and Whiteness Super Endo (R)) and light-activated systems (Opalescence Xtra (R) and Whiteness HP Maxx (R)). Controls were treated with either sodium perborate mixed with 10% hydrogen peroxide or no bleaching agent. The samples were observed under SEM and the recorded images were evaluated for topographic alterations. The ultrastructural alterations of dentin observed in this study varied greatly between groups according to the products used. Higher pH products (Whiteness HP Maxx (R) and Opalescence Xtra (R)) associated with in-office techniques yielded better maintenance of dentin ultrastructure. Apparently, both low pH and hydrogen peroxide oxidation play a role in altering the ultrastructure of dentin during internal dental bleaching. The use of alkaline products with reduced time of application (in-office techniques) may decrease such morphological alterations.

Administração pública federal: propostas para o fortalecimento do controle sobre os atos praticados e o respectivo combate à corrupção

The characteristics of the Brazilian historic context, under which the predominant social relations have developed, have led to a process of income concentration and to the political power of the dominant classes. The slavery abolishment hasn't guaranteed the people the rights secured to privileged citizens in general. Such practices were observed during historic process as the low level literacy shown by the census of 1920, the political domination of oligarchies and the military coup, all as determining factors in process of political power concentration. The social indicators and the corruption are extremely unfavorable to our country, but we wonder if that happens only in underdeveloped societies. It is possible that even the American society, even the most developed societies, under the democratic capitalism, can suffer negative consequences of some corruption in the capitalism system. Our observations have led to the perception that all democratic society must be regulated by the State in order to preserve the stability of the system. It has also been observed that it is necessary more effective popular participation in order to neutralize economic groups¿ pressure. It has also become evident the necessity of reduction of commissioned office in the federal public administration. And, finally, it is fundamental to propose an amendment to the construction that allows the Public Ministry to have access to any bank, fiscal or telephonic information of anyone that is in office: It should be called "The Law of Moral Transparency". Those proposals will only be possible if there is massive popular participation and we hope that they express our people¿s will in order to appose to those who act only to obtain private benefits.

Atração de investimentos como instrumento de política industrial: o caso do ceará no período 1985-2002

This paper aims to assess the performance of credit and fiscal mechanisms in attracting industrial investment to the state of Ceará during 1985-2002, a period characterized by the political and administrative continuity which begun with the implementation of the so-called "Plan of Changes", during the term in office of former state governor Tasso Jereissati. In order to accomplish that, a survey was conducted of the state's credit, fiscal and infrastructure incentive mechanisms, industrial policy and the period's political context, as well as data from the Department of Industry and Commerce and on the economic performance of the state of Ceará. Over 700 industrial businesses were found to have been attracted into the state by means of the Industrial Investment Attraction Program, which amounted to a process of industry expansion while the country as a whole was going through a period of deindustrialization. The analysis points out that, if on one hand, the industrialization model then adopted was able to generate economic growth, on the other hand, it increased income concentration and could not drive industry into the less developed areas across the state's interior, as expected by Ceará's state government officials.

Electoral rules, political competition and fiscal spending: regression discontinuity evidence from brazilian municipalities

We exploit a discontinuity in Brazilian municipal election rules to investigate whether political competition has a causal impact on policy choices. In municipalities with less than 200,000 voters mayors are elected with a plurality of the vote. In municipalities with more than 200,000 voters a run-off election takes place among the top two candidates if neither achieves a majority of the votes. At a first stage, we show that the possibility of runoff increases political competition. At a second stage, we use the discontinuity as a source of exogenous variation to infer causality from political competition to fiscal policy. Our second stage results suggest that political competition induces more investment and less current spending, particularly personnel expenses. Furthermore, the impact of political competition is larger when incumbents can run for reelection, suggesting incentives matter insofar as incumbents can themselves remain in office.

Three essays on local demand for public services

Local provision of public services has the positive effect of increasing the efficiency because each locality has its idiosyncrasies that determine a particular demand for public services. This dissertation addresses different aspects of the local demand for public goods and services and their relationship with political incentives. The text is divided in three essays. The first essay aims to test the existence of yardstick competition in education spending using panel data from Brazilian municipalities. The essay estimates two-regime spatial Durbin models with time and spatial fixed effects using maximum likelihood, where the regimes represent different electoral and educational accountability institutional settings. First, it is investigated whether the lame duck incumbents tend to engage in less strategic interaction as a result of the impossibility of reelection, which lowers the incentives for them to signal their type (good or bad) to the voters by mimicking their neighbors’ expenditures. Additionally, it is evaluated whether the lack of electorate support faced by the minority governments causes the incumbents to mimic the neighbors’ spending to a greater extent to increase their odds of reelection. Next, the essay estimates the effects of the institutional change introduced by the disclosure on April 2007 of the Basic Education Development Index (known as IDEB) and its goals on the strategic interaction at the municipality level. This institutional change potentially increased the incentives for incumbents to follow the national best practices in an attempt to signal their type to voters, thus reducing the importance of local information spillover. The same model is also tested using school inputs that are believed to improve students’ performance in place of education spending. The results show evidence for yardstick competition in education spending. Spatial auto-correlation is lower among the lame ducks and higher among the incumbents with minority support (a smaller vote margin). In addition, the institutional change introduced by the IDEB reduced the spatial interaction in education spending and input-setting, thus diminishing the importance of local information spillover. The second essay investigates the role played by the geographic distance between the poor and non-poor in the local demand for income redistribution. In particular, the study provides an empirical test of the geographically limited altruism model proposed in Pauly (1973), incorporating the possibility of participation costs associated with the provision of transfers (Van de Wale, 1998). First, the discussion is motivated by allowing for an “iceberg cost” of participation in the programs for the poor individuals in Pauly’s original model. Next, using data from the 2000 Brazilian Census and a panel of municipalities based on the National Household Sample Survey (PNAD) from 2001 to 2007, all the distance-related explanatory variables indicate that an increased proximity between poor and non-poor is associated with better targeting of the programs (demand for redistribution). For instance, a 1-hour increase in the time spent commuting by the poor reduces the targeting by 3.158 percentage points. This result is similar to that of Ashworth, Heyndels and Smolders (2002) but is definitely not due to the program leakages. To empirically disentangle participation costs and spatially restricted altruism effects, an additional test is conducted using unique panel data based on the 2004 and 2006 PNAD, which assess the number of benefits and the average benefit value received by beneficiaries. The estimates suggest that both cost and altruism play important roles in targeting determination in Brazil, and thus, in the determination of the demand for redistribution. Lastly, the results indicate that ‘size matters’; i.e., the budget for redistribution has a positive impact on targeting. The third essay aims to empirically test the validity of the median voter model for the Brazilian case. Information on municipalities are obtained from the Population Census and the Brazilian Supreme Electoral Court for the year 2000. First, the median voter demand for local public services is estimated. The bundles of services offered by reelection candidates are identified as the expenditures realized during incumbents’ first term in office. The assumption of perfect information of candidates concerning the median demand is relaxed and a weaker hypothesis, of rational expectation, is imposed. Thus, incumbents make mistakes about the median demand that are referred to as misperception errors. Thus, at a given point in time, incumbents can provide a bundle (given by the amount of expenditures per capita) that differs from median voter’s demand for public services by a multiplicative error term, which is included in the residuals of the demand equation. Next, it is estimated the impact of the module of this misperception error on the electoral performance of incumbents using a selection models. The result suggests that the median voter model is valid for the case of Brazilian municipalities.

Liberar ou não liberar, eis a questão: estudo de caso de ensino em administração pública

O presente Estudo de Caso trata da realização de obra no mercado de uma Prefeitura e a liberação do processo administrativo para realização de procedimento licitatório. Apresenta o conflito existente entre o Secretário de Obras e o Subsecretário de Planejamento e Orçamento na condução das determinações do chefe do poder executivo. O Prefeito Municipal recém-eleito decidiu iniciar reforma com expansão do mercado popular no município de Três Barras. Com esta finalidade, solicitou ao Secretário de Obras o projeto arquitetônico com previsão inicial de custos para que se iniciasse o processo licitatório de imediato, de modo a não atrasar a inauguração do novo mercado prevista para o primeiro ano de mandato. O subsecretário de planejamento e orçamento precisa tomar a decisão de liberar ou não o processo já que há a necessidade de atendimento dos requisitos técnicos e legais que considerava necessários. O presente caso pode ser trabalho dentro do seguinte tema: Gestão do Planejamento e Orçamentária.

The Limits of political compromise: debt ceilings and political competition

We study the desirability of limits on the public debt and of political competition in an economy where political parties alternate in office. Due to rent-seeking motives, incumbents have an incentive to set public expenditures above the socially optimal level. Parties cannot commit to future policies, but they can forge a political compromise where each party curbs excessive spending when in office if it expects future governments to do the same. In contrast to the received literature, we find that strict limits on government borrowing can exacerbate political-economy distortions by rendering a political compromise unsustainable. This tends to happen when political competition is limited. Conversely, a tight limit on the public debt fosters a compromise that yields the efficient outcome when political competition is vigorous, saving the economy from immiseration. Our analysis thus suggests a legislative tradeoff between restricting political competition and constraining the ability of governments to issue debt.

Cabinet composition and assessment of a multiparty presidential system

This doctoral dissertation provides a detailed analysis of the Brazilian cabinet according to the concepts of a multiparty presidential system. Appointing politicians as ministers is one of the most important coalition-building tools and has been widely used by minority presidents. This dissertation will therefore analyze the high-level Brazilian national bureaucracy between 1995 and 2014. It argues that the ministries – or departments – are not equal, and that allied parties therefore take into account the different characteristics of a ministry when demanding positions as a patronage strategy or for use as other kinds of political assets. After reviewing the literature on the theme, followed by a comparative analysis of the Brazilian, Chilean, Mexican, and Guatemalan cabinets, all the Brazilian ministries will be weighed and ranked on a scale that is able to measure their political importance and attractiveness. This rank takes into account variables such as the budgetary power, the ability to spend money according the ministers’ will, the ability to hire new employees, the ministries’ influence over other governmental agents such as companies, agencies, and so on, the ministers’ tenure in office. Finally, a proxy is provided that seeks to identify the normative power a department may hold. All of these characteristics will then be taken into account in considering the representatives’ opinion, thus helping to ascertain whether the cabinet appointment has been coalescent among the several parties that belong to the president’s coalition.

Uma janela tropical: análise do desempenho luminoso de ambientes com aberturas sombreadas para o clima de Natal/RN

This master thesis introduces assessment procedures of daylighting performance in office rooms with shaded opening, recommendations for Natal-RN (Latitude 05,47' S, Longitude 35,11' W). The studies assume the need of window exterior shading in hot and humid climate buildings. The daylighting performance analyses are based on simulated results for three levels of illuminance (300,500 e 1000 lux) between 08h00 e 16h00, in rooms with 2,80 m height, 6 m large and 4 m, 6 m e 8 m depths, with a centered single opening, window wall ratio (20%, 40% e 60%), four orientations (North, East, South and West), and two types of sky (clear and partially cloudy). The sky characteristics were statistically determined based on hourly data from INPE-CRN solar and daylighting weather station. The lighting performance is resulted from dynamic computer simulation of 72 models using Troplux 3.12. The simulation results were assessed using a new parameter to quantify the use of interior daylighting, the useful percentage of daylight (PULN), which corresponds to the time fraction with satisfactory light, in accordance with the illuminance design. The passive zone depths are defined based on the PULN. Despite the failures of illuminance data from the weather station, the analyses ratified the high potential of daylighting for shaded rooms. The most influential variables on the lighting performance are the opening size and the illuminance of design, while the orientation is a little influential

Educação tecnológica e pré-sal: necessidades e urgências

The purpose of this dissertation is whether the demand for manpower trained in technical school for the sector of Oil and Gas (O&G) is in balance with the offer of that training in the Brazilian education system. The methodology used to obtain such information was based on School Census 2000 and 2008 where data were worked out in order to clarify the numbers of enrollments in secondary technical level demanded by the sector of O&G. The demand for manpower with that qualification as a data source was the 2010-2014 Business Plan Program for Mobilization of the National Oil and Natural Gas (PROMINP). This Program identified the future demand for manpower for the Sector of the O&G until 2014 where the occupational categories are mapped prerequisite training and experience. In order to better understand the object of this study was dome a review of the literature with regard to technical education in Brazil but also the importance of the education to economic growth and the peculiarities of the oil economy in different countries possessors of those mines, or that is, developed and underdeveloped countries. Analysis showed that enrollment in technical education in Brazil had a significant increase between the dates 2000 and 2008. It also don´t bring balance with the characteristic of the dynamics of the productive sectors of the economy mainly due to heating of the economy before the global growth especially in the Construction Industry as well as in the Oil and Natural Gas Engineering and a Naval account of the discovery of oil in the Pre-Salt. Another important aspect is that one of the major problems of qualification of manpower in Brazil is due to a bad quality of the student´s school and high school which makes difficult a good performance in office work and also this ability to learn new functions. The rapprochement between the supply of the education system and the demand for manpower with training mid-level technical support for the sector O&G showed that most technical courses demanded or had no enrollment in 2008, had few enrollment in 15 states with demand expect to occur and those enrollment were unevenly distributed among states. The analysis therefore signalize the needed of a public policy that enables the adequacy of the education system (Secondary Technical Education) to Sector of O&G in terms of enrollment and its distribution between the oil producing states and in relation to technical expertise offered

Estimulação transcraniana por corrente contínua e a flutuação de força em idosas durante exercício isométrico

The fluctuacion force has been increasingly used in studies with elderly as a good predictor of performance and functionality of the motor. However, most analyzes the fluctuation of force in one session. Thus, identifying the minimum amount of sessions needed for familiarization with the fluctuation strength in isometric exercise become relevant. Furthermore, to investigate the effects of applying transcranial direct current stimulation (tDCS) associated with regular exercise on rates fluctuation task force is extremely important. In the first experiment, volunteers were subjected to a protocol marked by a familiarization session to establish the parameters of VCM and eight sessions with intensity of 30% MVC in office. It was observed that two familiarization sessions are required so there is a fluctuation stabilizing force. In experiment II, subjects performed an isometric contraction before and after applying tDCS (cathode, anode and sham) applied to M1. ETCC anodic effectively contributed to reducing the fluctuation of force during isometric exercise in the elderly, while the cathodic caused the increased levels of strength fluctuation. It was concluded that there is a need to implement a familiarization protocol with at least two sessions to avoid possible misunderstandings of measurements in tests of fluctuacion force. Besides that tDCS interfered with the behavior of the oscillations of force, with cathodic promoting increased fluctuation strength and anodic contributed to greater stability, demonstrating the potential of this technique neuromodulation associated with exercise as rehabilitation tools

Fator de decisão na adoção de um sistema de micro-cogeração de energia a gás natural :um estudo em Hotéis três estrelas

The natural gas perform a essential paper, not only in primary sectors of energy, but also in others sectors of economy. The use natural gas will have expansion in Brazil, motivated by governmental decision to increase the participation of this fuel in the Brazilian energy matrix from 4% to 12% up until 2010. in order to reach the objective related to increase the consumption of natural gas in the energy matrix and to propose solutions to attend the electric requirements of heart and refrigeration, using natural gas as primary power plant. This thesis has a main objective to analysis the perception of businessmen of hotel sector about the feasability of investment with micro-cogeneration system by natural gas in their hotel in turistic sector, in Natal/RN. It s show a case for the hotels selected analyzing the actual knowledge of businessmen about alternative of new technology in generation of owner energy. There was make a interview using a standard form researching information about this topic. In this interview has shown 4 (four) canaries for businessmen with different configurations of investment in micro-cogeneration. Two of this canaries uses the project finance like option to make fasible this projects. The resulteis showed who businessmen has insecurity to make decision to put in office alone, or with a local company, and perhaps with a national company to perform for a alternative energy system, justifying, the alone feasability and without information by local businessmen. Apart from that, they are receptive for a option to put in office in micro-cogeneration configured in the settings using project finance