Resumen En este trabajo se realizó una aproximación biogeográfica para identificar nodos panbiogeográficos y evaluar los patrones de diversidad espacial de los gasterópodos continentales mexicanos. Un total de 86 nodos individuales y un nodo generalizado fueron identificados para los gasterópodos continentales. La mayoría de las celdas mostraron valores bajos de diversidad, con excepción de 3 cuyos valores de diversidad fueron mayores a 10% y que pueden considerarse como puntos de alta diversidad. Por otro lado, a pesar de los diferentes ambientes, los caracoles terrestres y acuáticos mostraron similitudes en sus patrones de distribución tanto espaciales como temporales.

Abstract This study used a biogeographic approach to identify panbiogeographic nodes and evaluate the spatial diversity patterns of the Mexican continental gastropods. A total of 86 individual nodes and one generalized node were identified for the continental gastropods. Most grid cells showed low diversity values, except for 3 cells with diversity values greater than 10%, which can be considered hotspots. On the other hand, despite the different environments, land and freshwater snails showed similar historical and spatial distribution patterns.

Abstract Introduction: The presence of mild to moderate pericardial effusion after cardiac surgery is common and oral medical therapy is usually able to treat it. Larger effusions are less frequent and surgical intervention is usually necessary. However, there are some rare cases of large effusions that are recurrent even after intervention and become challenging to treat. Methods: We describe the case of a patient submitted to coronary artery bypass grafting (CABG) without any intraoperative complications, who was regularly discharged from the hospital. She was referred to our emergency department twice after surgery with large pericardial effusion that was drained. Even after those two interventions and with adequate oral medication, the large effusion recurred. Results: During follow-up, the patient had her symptoms resolved, with no need for further hospital admission. Her echocardiograms after the last intervention showed no pericardial effusion. The present surgical technique demonstrated to be easy to perform, thus it should be considered as a treatment option for these rare cases of large and repetitive effusions, which do not respond to the traditional methods. Conclusions: In challenging cases of recurrent and large pericardial effusions, the pericardial-peritoneal window is an alternative surgical technique that brings clinical improvement and diminishes the risk of cardiac tamponade. Introduction necessary However Methods CABG (CABG complications drained medication recurred Results followup, followup follow up, up follow-up resolved admission perform methods Conclusions pericardialperitoneal peritoneal tamponade

Abstract Since the beginning of the coronavirus disease (COVID-19) pandemic, in March 2020, the number of people infected with COVID-19 worldwide increases continuously. Brazil is being followed with great concern in the international media, as it can, very soon, be the epicenter of the pandemic. Initial surgical data suggest that patients who acquire COVID-19 in the perioperative period are prone to a higher morbidity and mortality, however, evidence in cardiac surgery is still scarce. This article aims to aggregate to the growing evidence suggesting that perioperative infection with severe acute respiratory syndrome coronavirus 2 contributes to a more morbid evolution of the case.

Resumo: O surgimento do novo coronavírus SARS-CoV-2 está desafiando seriamente a comunidade médica em praticamente todo o mundo. A pneumonia no COVID-19 tem características peculiares e pode ser estudada por ultrassom pulmonar. A ultrassonografia permite identificar o comportamento da infecção e sua progressão na beira do leito do paciente. A técnica evoluiu consideravelmente nos últimos anos em relação aos seus aspectos teóricos e operacionais. Consequentemente, sua aplicação clínica tornou-se suficientemente conhecida e generalizada no contexto do paciente crítico. Sugerimos a identificação de quatro padrões na ultrassonografia pulmonar, o que permite uma melhor caracterização da doença. Devido à demanda atual por serviços de saúde, o conhecimento e a aplicação da ultrassonografia pulmonar são altamente relevantes. Esta revisão inclui uma abordagem prática e fornece um resumo das evidências para o uso e a interpretação do ultrassom pulmonar.

Abstract: The emergence of the novel coronavirus (SARS-CoV-2) is seriously challenging the medical community virtually the entire world. Pneumonia in COVID-19 has peculiar characteristics and can be studied by lung ultrasound. The ultrasound allows identifying the behavior of the infection and its progression at the bedside of the patient. The technique has evolved considerably in recent years in terms of its theoretical and operational aspects. Consequently, its clinical application has become sufficiently known and generalized in the context of the critically ill patient. We suggest the identification of 4 patterns on lung ultrasound which allow a better characterization of the disease. Due to the current demand for health services, the knowledge and application of lung ultrasound is highly relevant. This review includes a pragmatic approach and provides a summary of the evidence for the use and interpretation of lung ultrasound.

Resumen: El surgimiento del nuevo coronavirus SARS-CoV-2 está desafiando seriamente a la comunidad médica en prácticamente todo el mundo. La neumonía causada por COVID-19 tiene características peculiares y puede estudiarse mediante ultrasonografía pulmonar. La ecografía permite identificar el comportamiento de la infección y su progresión al lado de la cama del paciente. La técnica ha evolucionado considerablemente en los últimos años en lo que respecta a sus aspectos teóricos y operativos. En consecuencia, su aplicación clínica ha llegado a ser suficientemente conocida y generalizada en el contexto del paciente críticamente enfermo. Sugerimos la identificación de cuatro patrones en el ultrasonido pulmonar, los cuales permiten una mejor caracterización de la enfermedad. Debido a la sobredemanda de los servicios de salud en la actualidad, el conocimiento y aplicación de la ecografía pulmonar resulta de gran relevancia. Esta revisión incluye un enfoque práctico y proporciona un resumen de la evidencia para el uso e interpretación del ultrasonido pulmonar.

ABSTRACT The present study was carried out between the months of August and September of 2019, in Ribera Miguel Hidalgo Community of Copainala Municipality, Chiapas, Mexico. For this, tests related to some physical, mechanical and chemical variables were carried out, with the objective of evaluating these parameters and determining the quality of the fruits for a later study of shelf life. Polar and equatorial diameters of the fruits were obtained, which ranged from 1.56 to 1.61 cm and from 2.05 to 1.72 cm, respectively and the green fruits showed the largest diameters. The weight ranged from 3.27 to 4.03 g on average, therefore, according to their morphology, they are considered small fruits and of low quality. The best OSH values were recorded in green fruits with an average of 10.35 º Brix. Similarly occurred with the pH, where an average value of 4.43 was observed, while red fruits had a higher percentage of citric acid with 1.75%. The material that could cause less damage to the fruits during transportation and post-harvest handling is plastic, since it has a relatively low coefficient of friction of 0.66 and 0.64.

RESUMEN El presente estudio se llevó a cabo entre los meses de agosto y septiembre del 2019, en la comunidad Ribera Miguel Hidalgo del municipio de Copainalá, Chiapas, México. Para ello se realizaron ensayos relacionados con algunas variables físicas, mecánicas y químicas, con el objetivo de evaluar estos parámetros y determinar la calidad de los frutos para un posterior estudio de la vida en anaquel. Dentro de los principales resultados obtenidos se destacan el diámetros polar y ecuatorial de los frutos los que oscilaron desde 1,56 a 1,61 cm y de 2,05 a 1,72 cm respectivamente, siendo los frutos de color verde los de mayores diámetros. El peso osciló entre 3,27 a 4,03 g como promedio, razón por la cual se consideran frutos pequeños y de baja calidad desde su morfología. Los mejores valores de SST se registraron en los frutos de color verde con un promedio de 10,35 ºBrix, así mismo ocurrió en el pH con un valor promedios de 4,43, mientras que los frutos rojos presentaron mayor porcentaje de ácido cítrico con 1,75%. El material que menos daños pudiera ocasionar a los frutos durante la transportación y manipulación poscosecha es el plástico, por presentar un coeficiente de fricción relativamente bajo de 0,66 y 0,64.

Resumen La especiación es un proceso con múltiples factores que actúan a diferentes escalas de espacio y tiempo. La segregación de nichos tróficos es un proceso que ha promovido la diversificación en cíclidos en entornos lacustres, pero en el caso de los ríos no está claro. Herichthys es un género de cíclidos cuya distribución es la más boreal en América, el cual comprende 12 especies actualmente reconocidas, la mayoría microendémicas y solo dos con una amplia distribución. En el presente trabajo, se analizó el contenido estomacal y las morfologías de la mandíbula faríngea inferior de las especies del género para compararlas y evaluar su posible papel en la diversificación del grupo. La dieta en dichas especies es muy variada e incluyó tanto especies que pueden ser consideradas omnívoras como especialistas. Se encontraron valores bajos del índice de solapamiento alimentario (índice de Pianka) en las especies simpátricas microendémicas, mientras que en las especies ampliamente distribuidas el índice fue muy variable. El análisis de morfometría geométrica de la mandíbula faríngea inferior permite discriminar dos formas principales, una que incluye la especie piscívora y otra que incluye a los otros grupos alimentarios. Los resultados encontrados en este estudio sugieren que la segregación de nicho trófico es un factor que promueve claramente la diversificación dentro del género Herichthys, aunque se deben realizar estudios adicionales para comprender completamente el proceso de especiación en este grupo de peces neotropicales.

Abstract Speciation is a multifactorial process with factors acting at different scales of space and time. Trophic niche segregation has promoted the diversification of cichlids fishes in lentic (lacustrine) environments, whether this is also the case in lotic (riverine) systems remains unknown. Herichthys is the genus of cichlids with the most boreal distribution in the Americas comprising 12 currently recognized species, most micro-endemic and only two with a wide distribution. In the present work, we analyzed the stomach content and lower pharyngeal jaw morphologies of the species of the genus to evaluate the possible role of feeding ecology in the diversification of the group. Trophic strategies varied widely, including omnivores, piscivores, invertivores, molluskivores, detritivores, herbivores and algivores. Low values of Pianka's index of niche overlap were found in the sympatric micro-endemic species, while in the widely distributed species the indices ranged from low to very high. The analysis of lower pharyngeal jaw morphologies allowed discriminating a shape associated with piscivorous species from other foraging groups. The results of this study suggest that trophic niche segregation is a factor that could promotes diversification within the genus Herichthys although additional studies need to be performed to fully understand the speciation process in this group of Neotropical cichlid fishes.

Abstract This paper presents a controller performance that is develop employing an adaptive B-spline neural network algorithm for adjusting the rotor speed of the permanent magnet synchronous motor. It includes a comparative analysis with three control strategies: conventional proportional integral, sliding mode and fuzzy logic. Also, gives a systematic way to determine the optimal control gains and improve the tracking error performance. A methodology for the adaptive controller and its training procedure are explained. The efficacy of the proposed method is analyzed using time simulations where the motor is subjected to disturbances and reference changes. The proposed control technique exhibits the best performance because it can adapt to every condition, demanding low computational effort for an on-line operation and considering the system nonlinearities.

Resumen En este trabajo se presenta el desempeño de un controlador adaptativo utilizando una red neuronal B-spline para ajustar la velocidad del rotor del motor síncrono de imanes permanentes. El análisis incluye una comparación de tres estrategias de control convencionales y no lineales: control proporcional integral, modos deslizantes y lógica difusa. Además, se proporciona una forma sistemática de determinar las ganancias óptimas del controlador para mejorar el desempeño del error de seguimiento. Dentro del trabajo se explica el diseño del controlador adaptativo y la metodología para realizar su entrenamiento. La eficiencia del controlador propuesto se demuestra mediante simulaciones en el tiempo donde el motor se somete a diferentes perturbaciones y cambios en el valor de la señal de referencia. El análisis de los resultados muestra que la técnica de control propuesta exhibe mejor rendimiento porque puede adaptarse a todas las condiciones operativas, presentando un bajo esfuerzo computacional para una operación en línea y considerando las no linealidades del sistema.

Abstract Currently there is a progressive increase in the prevalence of diabetes in a referred for cardiovascular surgery. Benefits of glycemic management (< 180 mg/dL) in diabetic patients compared to patients without diabetes in perioperative cardiac surgery. The purpose of this study is to present recommendations based on international evidence and adapted to our clinical practice for the perioperative management of hyperglycemia in adult patients with and without diabetes undergoing cardiovascular surgery. This update is based on the latest current literature derived from articles and guidelines regarding perioperative management of diabetic patients to cardiovascular surgery.

Abstract The loss of stored grains is a problem for farmers. Sitophilus zeamais Motschulsky, is the main pest in stored corn. The objective of the study was to determine the bioinsecticidal properties of pulverized vegetables recognized by producers of the Nueva and Rosario, Copainalá, Chiapas, Mexico, from September 2015 to April 2016. A completely randomized design was used, with 25 treatments, an absolute control and one chemical (aluminum phosphide) with three repetitions. In the laboratory, five plant species were evaluated as pulverized. R. communis L. at 4% generated the highest mortality (53.3%). C. ambrosioides L. at 1% and R. communis L. at 3 and 5% with repellence index (0.95) were the best. In stored corn, the best treatment of the laboratory test was evaluated; for mortality there were no significant differences between treatments. The percentage of germinated corn is not affected by the application of powders. R. comunis L. presented statistically similar results in damaged grain than aluminum phosphide. The weight loss of the grain was 0.97 kg. It can be concluded that castor spray has effects of mortality at 4% and repellency at 3 and 5% in laboratory conditions. While in storage conditions there were no differences which could be due to the loss of effectiveness of the active metabolites of castor, the germinative power of corn seeds is not affected by the application of the spray of R. communis L.

Resumen La pérdida de granos almacenados es un problema para los agricultores. Sitophilus zeamais Motschulsky, es la principal plaga en maíz almacenado. El objetivo del estudio fue determinar las propiedades bioinsecticidas de vegetales pulverizados reconocidos por productores de la Nueva y el Rosario, Copainalá, Chiapas, México, de septiembre 2015 a abril 2016. Se utilizó un diseño completamente al azar, con 25 tratamientos, un testigo absoluto y uno químico (fosfuro de aluminio) con tres repeticiones. En laboratorio se evaluaron cinco especies vegetales como pulverizados. R. communis L. al 4% genero la mortalidad mayor (53.3%). C. ambrosioides L. al 1% y R. communis L. al 3 y 5% con índice de repelencia (0.95) fueron los mejores. En maíz almacenado se evaluó el mejor tratamiento de la prueba en laboratorio; para mortalidad no se presentó diferencias significativas entre tratamientos. El porcentaje de maíz germinado no se ve afectado por la aplicación de pulverizados. R. comunis L. presentó resultados estadísticamente similares en grano dañado que el fosfuro de aluminio. La pérdida de peso del grano fue de 0.97 kg. Se puede concluir que el pulverizado de higuerilla tiene efectos de mortalidad al 4% y repelencia al 3 y 5% en condiciones de laboratorio. Mientras que en condiciones de almacenamiento no existieron diferencias lo cual pudo deberse a la perdida de efectividad de los metabolitos activos de higuerilla, el poder germinativo de las semillas de maíz no se ve afectado por la aplicación del pulverizado de R. communis L.

Abstract Introduction: Most risk stratification scores used in surgery do not include external and non-technical factors as predictors of morbidity and mortality. Objective: The present study aimed to translate and adapt transculturally the Brazilian version of the Disruptions in Surgery Index (DiSI) questionnaire, which was developed to capture the self-perception of each member of the surgical team regarding the disruptions that may contribute to error and obstruction of safe surgical flow. Methods: A universalist approach was adopted to evaluate the conceptual equivalence of items and semantics, which included the following stages: (1) translation of the questionnaire into Portuguese; (2) back translation into English; (3) panel of experts to draft the preliminary version; and (4) pre-test for evaluation of verbal comprehension by the target population of 43 professionals working in cardiothoracic surgery. Results: The questionnaire was translated into Portuguese and its final version with 29 items obtained 89.6% approval from the panel of experts. The target population evaluated all items as easy to understand. The mean overall clarity and verbal comprehension observed in the pre-test reached 4.48 ± 0.16 out of the maximum value of 5 on the psychometric Likert scale. Conclusion: Based on the methodology used, the experts' analysis and the results of the pre-test, it is concluded that the essential stages of translation and cross-cultural adaptation of DiSI to the Portuguese language were satisfactorily fulfilled in this study.

Abstract Introduction: Advances in modern medicine have led to people living longer and healthier lives. Frailty is an emerging concept in medicine yet to be explored as a risk factor in cardiac surgery. When it comes to CABG surgery, randomized controlled clinical trials have primarily focused on low-risk (ROOBY, CORONARY), elevated-risk (GOPCABE) or high-risk patients (BBS), but not on frail patients. Therefore, we believe that off-pump CABG could be an important technique in patients with limited functional capacity to respond to surgical stress. In this study, the authors introduce the new national, multicenter, randomized, controlled trial "FRAGILE", to be developed in the main cardiac surgery centers of Brazil, to clarify the potential benefit of off-pump CABG in frail patients. Methods: FRAGILE is a two-arm, parallel-group, multicentre, individually randomized (1:1) controlled trial which will enroll 630 patients with blinded outcome assessment (at 30 days, 6 months, 1 year, 2 years and 3 years), which aims to compare adverse cardiac and cerebrovascular events after off-pump versus on-pump CABG in pre-frail and frail patients. Primary outcomes will be all-cause mortality, acute myocardial infarction, cardiac arrest with successful resuscitation, low cardiac output syndrome/cardiogenic shock, stroke, and coronary reintervention. Secondary outcomes will be major adverse cardiac and cerebrovascular events, operative time, mechanical ventilation time, hyperdynamic shock, new onset of atrial fibrillation, renal replacement therapy, reoperation for bleeding, pneumonia, length of stay in intensive care unit, length of stay in hospital, number of units of blood transfused, graft patency, rate of complete revascularization, neurobehavioral outcomes after cardiac surgery, quality of life after cardiac surgery and costs. Discussion: FRAGILE trial will determine whether off-pump CABG is superior to conventional on-pump CABG in the surgical treatment of pre-frail and frail patients. Trial registration: ClinicalTrials.gov, ID: NCT02338947. Registered on August 29th 2014; last updated on March 21st 2016.

ResumenLa estructura y composición de las comunidades son determinadas por procesos evolutivos y ecológicos que se manifiestan en señales de diversidad, abundancia y la relación de especies. El análisis de la relación de especies que coexisten ha recibido atención como una herramienta para identificar los procesos que influyen en la composición de una comunidad dentro de un hábitat particular. En este estudio, evaluamos si la composición genética de bacterias microbialíticas depende de acontecimientos al azar vs factores biológicos/ abióticos. Este estudio se basa en un conjunto de datos genéticos de dos regiones hipervariables (V5 y V6) de gen 16S rRNA generados previamente de nueve comunidades de microbialitos distribuidos en el Noreste, Centro y Sureste de México, recolectados en mayo y junio 2009. Los datos genéticos de los filos más abundantes (Proteobacteria, Planctomycetes, Verrucomicrobia, Bacteroidetes y Cyanobacteria) fueron analizados para determinar la estructura filogenética de la comunidad y de cada filo por separado. Para el análisis conjunto, el índice NTI de Webb mostró valores positivos y significativos en las nueve comunidades analizadas, en donde los valores oscilaron entre 31.5 en Pozas Azules I y 57.2 en el Canal Pirata en Bacalar; en contraste, los valores del índice NRI fueron positivos y significativos en seis de las nueve comunidades analizadas con valores oscilando desde 18.1 en Pozas Azules I hasta 45.1 en Río Mezquites. Por otro lado, en la comparación de cada filo individual, el índice NTI fue positivo y significativo en todos los grupos excepto en Cyanobacteria, en donde valores positivos y significativos fueron encontrados sólo en tres localidades; finalmente, el índice NRI fue significativo sólo en unas cuantas de las comparaciones realizadas. Los resultados sugieren que el filtrado del hábitat es el proceso principal que determina la estructura filogenética de las comunidades bacterianas asociadas a microbialitos con la excepción de las cianobacterias en donde diferentes linajes pueden contribuir a la formación y crecimiento del microbialito.

Abstract:Community structure and composition are dictated by evolutionary and ecological assembly processes which are manifested in signals of, species diversity, species abundance and species relatedness. Analysis of species coexisting relatedness, has received attention as a tool to identify the processes that influence the composition of a community within a particular habitat. In this study, we tested if microbialite genetic composition is dependent on random events versus biological/abiotical factors. This study was based on a large genetic data set of two hypervariable regions (V5 and V6) from previously generated barcoded 16S rRNA amplicons from nine microbialite communities distributed in Northeastern, Central and Southeastern Mexico collected in May and June of 2009. Genetic data of the most abundant phyla (Proteobacteria, Planctomycetes, Verrucomicrobia, Bacteroidetes, and Cyanobacteria) were investigated in order to state the phylogenetic structure of the complete communities as well as each phylum. For the complete dataset, Webb NTI index showed positive and significant values in the nine communities analysed, where values ranged from 31.5 in Pozas Azules I to 57.2 in Bacalar Pirate Channel; meanwhile, NRI index were positive and significant in six of the nine communities analysed with values ranging from 18.1 in Pozas Azules I to 45.1 in Río Mesquites. On the other hand, when comparing each individual phylum, NTI index were positive and significant in all groups, except in Cyanobacteria for which positive and significant values were only found in three localities; finally, NRI index was significant in only a few of the comparisons performed. The results suggest that habitat filtering is the main process that drives phylogenetic structure in bacterial communities associated to microbialites with the exception of Cyanobacteria where different lineages can contribute to microbialite formation and growth. Rev. Biol. Trop. 64 (3): 10571065. Epub 2016 September 01.

Abstract. Permanent magnet synchronous motors have been widely used in variable speed drives; however, the control scheme must ensure high requirements of dynamic performance. In this work, a comparative analysis of a synchronous motor response with four control strategies-conventional proportional integral, sliding mode, fuzzy logic, and neural networks-is exposed. The motor model and the current controller are described; this allows the control laws design. In addition, a nonlinear observer for estimating the rotor speed and load torque is designed. The performance of each driver is analyzed using time simulations where the motor is subjected to disturbances and reference changes. The proposed control technique using neural networks exhibits the best performance because it can adapt to every condition, demanding low computational effort for an online operation and considering the system nonlinearities.

Resumen. Los motores síncronos de imanes permanentes se han utilizado ampliamente en aplicaciones de velocidad variable de alta precisión, sin embargo, el esquema de control debe cumplir con altas exigencias de desempeno dinâmico. En este trabajo se realiza un análisis comparativo de la respuesta de un motor síncrono con cuatro estrategias de control: convencional proporcional integral, modos deslizantes, lógica difusa y redes neuronales. Se describe el modelo del motor, el regulador de corriente y se realiza el diseño del control. Además, se utiliza un observador no lineal para la estimación de la velocidad del rotor y el par de carga. El desempeno de cada controlador se analiza mediante simulaciones en el tiempo donde el motor se somete a diversas perturbaciones y cambios de referencia. La técnica de control propuesta mediante redes neuronales exhibe el mejor desempeno debido a que puede adaptarse a cada condición, demandando bajo costo computacional para una operación en línea y considerando las no linealidades del sistema.

ResumoFundamento:Escores de risco para cirurgia cardíaca não podem continuar sendo neglicenciados.Objetivo:Avaliar o desempenho do Age, Creatinine and Ejection Fraction Score (ACEF Score) na predição de mortalidade dos pacientes submetidos à cirurgia de revascularização miocárdica e/ou valvar eletiva, e compará-lo a outros escores.Métodos:Estudo de coorte prospectivo no banco de um centro terciário brasileiro. Foram avaliados 2.565 pacientes operados de maneira eletiva entre maio de 2007 e julho de 2009. Para uma análise mais detalhada, o desempenho do ACEF Score foi comparado ao do InsCor e ao do EuroSCORE por meio de testes de correlação, calibração e discriminação.Resultados:Os pacientes foram estratificados em leve, moderado e grave para todos os modelos. A calibração foi inadequada para o ACEF Score (p = 0,046) e adequada para o InsCor (p = 0,460) e o EuroSCORE (p = 0,750). Na discriminação, a área abaixo da curva ROC apresentou-se questionável para o ACEF Score (0,625) e apropriada para o InsCor (0,744) e o EuroSCORE (0,763).Conclusão:Embora simples e prático, o ACEF Score, ao contrário do InsCor e do EuroSCORE, não se mostrou acurado para predizer mortalidade nos pacientes submetidos à cirurgia de revascularização miocárdica e/ou valvar eletiva em centro terciário brasileiro. (Arq Bras Cardiol. 2015; [online].ahead print, PP.0-0)

AbstractBackground:Risk scores for cardiac surgery cannot continue to be neglected.Objective:To assess the performance of “Age, Creatinine and Ejection Fraction Score” (ACEF Score) to predict mortality in patients submitted to elective coronary artery bypass graft and/or heart valve surgery, and to compare it to other scores.Methods:A prospective cohort study was carried out with the database of a Brazilian tertiary care center. A total of 2,565 patients submitted to elective surgeries between May 2007 and July 2009 were assessed. For a more detailed analysis, the ACEF Score performance was compared to the InsCor’s and EuroSCORE’s performance through correlation, calibration and discrimination tests.Results:Patients were stratified into mild, moderate and severe for all models. Calibration was inadequate for ACEF Score (p = 0.046) and adequate for InsCor (p = 0.460) and EuroSCORE (p = 0.750). As for discrimination, the area under the ROC curve was questionable for the ACEF Score (0.625) and adequate for InsCor (0.744) and EuroSCORE (0.763).Conclusion:Although simple to use and practical, the ACEF Score, unlike InsCor and EuroSCORE, was not accurate for predicting mortality in patients submitted to elective coronary artery bypass graft and/or heart valve surgery in a Brazilian tertiary care center. (Arq Bras Cardiol. 2015; [online].ahead print, PP.0-0)