ABSTRACT Introduction: Transfusion of red blood cells is recurrent in cardiac surgery despite the well-established deleterious effects. Identifying patients with higher chances of requiring blood transfusion is essential to apply strategic preventive measures to reduce such chances, considering the restricted availability of this product. The most used risk scores to predict blood transfusion are the Transfusion Risk and Clinical Knowledge (TRACK) and Transfusion Risk Understanding Scoring Tool (TRUST). However, these scores were not validated for the Brazilian population. The objective of this study was to assess the accuracy of TRACK and TRUST scores in estimating the need for postoperative transfusion of red blood cell concentrates (TRBCC) after cardiac surgery. Methods: A clinical retrospective study was conducted using the database of a Brazilian reference service composed of patients operated between November 2019 and September 2021. Scores were compared using Mann-Whitney U test. Hosmer-Lemeshow goodness of fit test assessed calibration of the scores. Accuracy was assessed using the area under the receiver operating characteristic curve (AUC). All analyses considered a level of significance of 5%. The study was approved by the research ethics committee (CAAE 55577421.4.0000.5201). Results: This study assessed 498 patients. Only the TRACK score presented good calibration (P=0.238; TRUST P=0.034). AUC of TRACK was 0.678 (95% confidence interval 0.63 to 0.73; P<0.001), showing a significant accuracy. Conclusion: Between the scores analyzed, only the TRACK score showed a good calibration, but low accuracy, to predict postoperative TRBCC after cardiac surgery.

Abstract Paper aims Housing is pivotal in advancing the quality of life. This study investigates the impact of economic complexity on the housing deficit within the Brazilian states. Originality Several studies have investigated the significance of social policies and economic growth as explanatory factors for housing deficits. Our study sheds light on the importance of economic structure in facilitating improved housing conditions for individuals. Research method The Fixed Effects Driscoll Kraay (FE-DK) econometric model was employed, utilizing panel data encompassing 27 Brazilian federative units spanning 2009 to 2017. Main findings The primary finding of this research elucidates the role of economic complexity as a determining factor that significantly impacts the housing deficit within Brazilian states. In other words, an enhanced economic structure contributes to improved housing conditions for the population and fosters a higher quality of life. Implications for theory and practice Theoretically, this paper posits the existence of a novel determinant that elucidates the housing and housing deficit theory. Moreover, the study makes a substantive contribution by advocating for public policies to facilitate housing conditions and enhance social well-being within a developing country. It underscores the pivotal significance of the productive structure in driving the economic development of the nation.

ABSTRACT Introduction: Transfusion of red blood cells is recurrent in cardiac surgery despite the well-established deleterious effects. Identifying patients with higher chances of requiring blood transfusion is essential to apply strategic preventive measures to reduce such chances, considering the restricted availability of this product. The most used risk scores to predict blood transfusion are the Transfusion Risk and Clinical Knowledge (TRACK) and Transfusion Risk Understanding Scoring Tool (TRUST). However, these scores were not validated for the Brazilian population. The objective of this study was to assess the accuracy of TRACK and TRUST scores in estimating the need for postoperative transfusion of red blood cell concentrates (TRBCC) after cardiac surgery. Methods: A clinical retrospective study was conducted using the database of a Brazilian reference service composed of patients operated between November 2019 and September 2021. Scores were compared using Mann-Whitney U test. Hosmer-Lemeshow goodness of fit test assessed calibration of the scores. Accuracy was assessed using the area under the receiver operating characteristic curve (AUC). All analyses considered a level of significance of 5%. The study was approved by the research ethics committee (CAAE 55577421.4.0000.5201). Results: This study assessed 498 patients. Only the TRACK score presented good calibration (P=0.238; TRUST P=0.034). AUC of TRACK was 0.678 (95% confidence interval 0.63 to 0.73; P<0.001), showing a significant accuracy. Conclusion: Between the scores analyzed, only the TRACK score showed a good calibration, but low accuracy, to predict postoperative TRBCC after cardiac surgery.

Resumo: Vários estudos argumentam que a mecanização agrícola reduziu o emprego e os salários. No entanto, faltam estudos que analisem o emprego e a renda ao longo do tempo, principalmente comparando as atividades agrícolas. O argumento apresentado por este artigo é que a mudança estrutural no emprego - de trabalhadores não qualificados para qualificados, deve ser entendida por causa da diminuição geral do número de empregos. Este estudo tem como objetivo analisar a evolução do mercado de trabalho na lavoura canavieira e demais atividades agrícolas, de 1992 a 2015. Por meio da Pesquisa Nacional por Amostra de Domicílios (PNAD / IBGE), este artigo compara a cultura da cana-de-açúcar com outras lavouras brasileiras por meio de técnicas econométricas. Analisamos o procedimento e os modelos de Heckman com dados de painel de efeitos fixos, controlando as características não observáveis dos trabalhadores. Metodologicamente, nossas equações mostram convergência, uma vez que o procedimento de Heckman e a regressão combinada apresentam estimativas semelhantes. Note que a regressão de efeito fixo captura as mesmas tendências da técnica de Mínimos Quadrados Ordinários (MQO), usando o método de Heckman. Os principais resultados sugerem que o salário dos trabalhadores da cana-de-açúcar é maior do que o salário de outras safras, mesmo depois de controlar as características observáveis e regionais. Essa constatação é importante porque o setor sucroalcooleiro tem enfrentado críticas quanto ao baixo nível de emprego e renda devido ao processo de mecanização. Por fim, destacamos a diminuição do número de empregos não qualificados na cana-de-açúcar, o que exige intervenção de políticas para a melhora do capital humano no setor sucroalcooleiro.

Abstract: Several studies argue that agricultural mechanization has reduced employment and wages. However, there is a lack of studies analyzing employment and income over time, especially comparing the agricultural activities. Our major argument is the structural change in the employment - from un-skilled to skilled workers which has to be understood because of the overall decrease in the number of jobs. This study aims to analyze the labor market evolution in sugarcane farming and other agricultural activities, from 1992 to 2015. Using the National Household Sample Survey (PNAD/IBGE), we compared sugarcane and other Brazilian crops using econometrics techniques. We analyzed the Heckman's procedure and models with fixed effects panel data, controlling the unobservable characteristics of workers. Methodologically, our equations show convergence, since the Heckman procedure and pooled regression present similar estimates. We showed that fixed-effect regression captures the same trends of Ordinary Least Square (OLS) technique, using the Heckman method. Our main findings suggest that the wage of sugarcane workers is higher than wages in other crops, even after we control the observable and regional characteristics. This finding is important because the sugarcane sector has faced criticism regarding the low level of employment and income due to the mechanization process. Finally, we pointed out the decrease in unskilled jobs in sugarcane, which demands for policy intervention to improve the human capital in the sugarcane sector.

Abstract Background: Right valve diseases are not benign, the tricuspid regurgitation has a significant impact on morbidity and mortality of patients. Objectives: This study aimed to report the short-term results of tricuspid annuloplasty using the De Vega technique modified by Manuel Antunes. Methods: A descriptive-analytical study was performed to evaluate the results of the tricuspid valvuloplasty performed at the Instituto de Medicina Integral Professor Fernando Figueira between 2012 and 2017. Data were collected by reviewing charts and databases of the Department of Cardiology and Cardiovascular Surgery of the institution. Those with rheumatic diseases or infective endocarditis with tricuspid valve involvement, or reoperation of the tricuspid valve were excluded. Student's t-test and McNemar's were used for statistical analysis. A p-value < 0.05 was considered statistically significant. Results: A total of 87 patients were studied, most of them were women (56.3%). The most associated heart valve diseases were mitral regurgitation (27.6%) and aortic regurgitation (20.7%). There was a significant decrease in the degree of tricuspid regurgitation in the postoperative period, with 83.3% of patients with none or mild regurgitation and only 1.1% with severe regurgitation (p = 0.0077). Conclusions: In the current study, tricuspid valve annuloplasty using the modified De Vega technique was shown to be effective in the short term. Further studies are needed to evaluate the long-term results.

Abstract Paper aims to analyze the international flow of students - both from developed and underdeveloped countries - and to observe their significance for the productivity gains of the country of origin of these students. Originality The main contributions to the literature are the understanding of how student flows affect countries' economic growth, as well as to verify the systematic differences between the contribution of international student flows to economic growth between developed and underdeveloped countries. Research method This empirical study performed using a data set of 87 countries, during 2001-2012 yields results that are in accordance with previous literature, supporting the hypothesis of international student flows as a significant channel of R&D spillovers from developed countries. The paper used econometric models already tested by previous studies. Main findings The results show that BRICS countries may benefit more than other countries from such internationalization initiatives. Implications for theory and practice The mobility of international students is currently an important political issue in the world. These formal or informal links between agents from diverse countries result in an exchange of ideas, experiences and knowledge potentially generating new business opportunities for developing economies.

Resumo O crescimento econômico não é o único fator que explica o desenvolvimento humano. Nesse aspecto, índices sobre a qualidade de vida têm sido recorrentes na literatura. Entretanto, esses índices não analisam como a complexidade econômica é convertida em desenvolvimento humano. O objetivo deste artigo é mensurar a eficiência de países latino-americanos e asiáticos na conversão de complexidade econômica em desenvolvimento humano, entre 2010 e 2014. O método utilizado foi o Data Envelopment Analysis (DEA), por meio do Modelo de Retornos Variáveis à Escala (BCC) e Análise de Janela. Os resultados demonstraram que, em 2014, todos os países asiáticos foram eficientes, exceto China e Filipinas. Nesse ano, Cuba foi o país que mais serviu de benchmark para os países ineficientes. A análise em janela demonstrou que apenas Japão, Coréia do Sul e Singapura se mantiveram eficientes ao longo do tempo. Esse resultado confirma a hipótese inicial deste artigo: economias mais complexas são mais eficientes na geração de desenvolvimento humano.

Abstract Economic growth is not the only factor to explain human development. Therefore, many authors have prioritized studies to measure the Human Development Index. However, these indexes do not analyze how Economic Complexity can increase Human Development. This paper aimed to determine how efficiently nations from Latin America and Asia measure a country’s performance in converting Economic Complexity into Human Development, between 2010 and 2014. We used Data Envelopment Analysis (DEA), through the Variable Returns of Scale (VRS) Model and Window Analysis. Results showed that in 2014, all Asian countries, except China and the Philippines, were efficient; on the other hand Cuba was the benchmark for inefficient countries. Window Analysis showed Japan, South Korea and Singapore were efficient over time. This result confirms the initial hypothesis of this article: the more complex countries are the more efficiently they create Human Development.

Abstract Paper aims to measure the impact of Foreign Direct Investment (FDI) and Absorptive Capacity (AC) on productivity in Brazil. Originality no articles were found using the AC as moderator of FDI in Brazil. Research method the Malmquist Index was employed and the Feasible Generalized Least Squares (FGLS) model was chosen, which has greater robustness for correcting the heterocedasticity and autocorrelation. Main findings productivity is more impacted by FDI than Economic Complexity. There is a two-year time lag to the impact of the FDI on productivity. The interaction between FDI and AC becomes positive only when experience and schooling are controlled. The number of PhD employees was better as proxy for AC than R&D workers. Implications for theory and practice there was no positive relationship between productivity and the number of higher education professionals.

Abstract Embolization by a dislodged projectile is a rare complication that may occur in cases of gunshot cardiac injuries. We report a case of a firearm projectile cardiac injury that evolved, with dislocation of the projectile during cardiac surgery, into embolization of the right external carotid artery.

Objetivos: descrever uma técnica de encurtamento femoral associada a artroplastia total da anca numa doente com doença de desenvolvimento da anca bilateral tipo IV de Crowe. Métodos: doente de 62 anos, sexo feminino, com história conhecida de doença de desenvolvimento da anca bilateral não tratada. Clínica de coxalgia bilateral resistente ao tratamento conservador. Radiologia convencional confirmou sub luxação bilateral das ancas superior a 100%. Antecedentes de substituição articular com osteotomia subtrocantérica transversa. Posteriormente ralizada a artroplastia contralateral com encurtamento femoral pela técnica da Clínica Mayo. Resultados: o recuo conseguido de 25 meses para o procedimento de osteotomia sub trocantérica transversa e de 17 meses para a técnica da Clínica Mayo. Em ambos os atos cirúrgicos verificou-se uma correta execução técnica e não foram registadas complicações. Não foram observáveis no período de seguimento crítérios de ossificação heterotópica ou descolamento asséptico. O Harris Hip Score inicial situava-se em valores de 40 tendo evoluído após os dois procedimentos cirúrgicos para valores superiores a 80. A dor inicial descrita como severa e persistente melhorou para ligeira a ocasional. Conclusões: a substituição articular para as luxações altas (tipo IV de Crowe) implica com regularidade um encurtamento femoral para evitar uma lesão neurológica por estiramento. O procedimento de encurtamento subtrocantérico permite evitar a pseudartrose pós osteotomia de avanço do grande trocanter bem como a fragilização da musculatura abdutora. A técnica da Clínica Mayo acrescenta um superior contacto osso - osso no local da osteotomia e o ajuste intra operatório do comprimento do membro.

Objective: describe a surgical technique and to evaluate the results of cementless arthroplasty with a simultaneous subtrochanteric shortening osteotomy in a patient with bilateral Crowe type - IV developmental dysplasia of the hip. Methods: a 62 year old woman with a known history of untreated bilateral Developmental Displacement of the Hip. Pain and dysfunction resistants’ to nonoperative measures. Conventional radiology confirmed bilateral dislocation of the hips more than 100%. History of joint replacement with transverse subtrochanteric osteotomy at left hip. Subsequently right hip arthroplasty with femoral shortening osteotomy by Mayo Clinic technique. Results: the follow up period was 25 months for transverse sub trochanteric osteotomy procedure and 17 months for the Mayo Clinic technique. Both surgical acts occurred with proper technical execution, and there were no complications. Were not observed during follow-up criteria of heterotopic ossification or components loosening. The Harris Hip Score initial stood in values of 40 having evolved after the two surgical procedures for values greater than 80. The initial pain described as severe and persistent improved to mild or occasional. Conclusions: joint replacement for high dislocations (Crowe type IV) implies with regularly a shortening femoral osteotomy to prevent neurological damage by stretching the sciatic nerve. The procedure of sub trochanteric osteotomy allows prevent nonunion after advancement osteotomy of the greater trochanter as well as the weakening of the abductor muscles. The technique of Mayo Clinic adds a superior contact bone - bone at the osteotomy site and setting intraoperative limb length.

Objectivos: descrever uma técnica cirúrgica de artrodese C1-C2 numa doente com os odontoideum distópico com instabilidade atlanto-axial. Métodos: doente de 63 anos, sexo feminino, sem antecedentes traumáticos conhecidos. Início insidioso de radiculopatia bilateral irradiada aos membros superiores associada a dor cervical posterior. A radiologia convencional demonstrou os odontoideum com instabilidade atlanto-axial. A RMN confirmou o diagnóstico e evidenciou mielomalácia pelo nível. A Tomografia Computorizada pré operatória efetuou - se para confirmar a possibilidade da fixação aparafusada. Foi realizada a artrodese C1-C2 com parafusos poli-axiais em C1 às massas laterais e translaminares em C2 sendo o nível estabilizado por 2 barras longitudinais. Resultados: o recuo obtido foi de 20 meses. No acto cirúrgico verificou-se uma correcta execução técnica sem complicações neuro-vasculares. Não se registou falência de material ou instabilidade no período de seguimento estudado. A paciente referiu melhoria das queixas algicas no pós operatório imediato e resolução da sintomatologia neurológica aos 3 meses. Conclusões: a fixação translaminar cruzada em C2 é uma opção cirúrgica de baixo risco para fixação C1-C2 em doentes com instabilidade a esse nível e com taxas de fusão óssea da ordem dos 97%.

Objective: describe a surgical technique of C1-C2 arthrodesis in a patient with dystopic os odontoideum and atlantoaxial instability. Methods: a 63 - year - old woman without history of known trauma. Insidious onset of bilateral radiculopathy radiated to the upper limbs associated with posterior cervical pain. Conventional radiology demonstrated os odontoideum with atlanto-axial instability. MRI confirmed the diagnosis and showed the level of myelomalacia. The preoperative CT scan is mandatory to confirm the possibility of fixing screws. Arthrodesis was performed C1-C2 level with poly - axial screws. C1 screws were directed to lateral masses. For fixation of C2 the screws were place within the crossing laminas. Both structures were stabilized by two longitudinal bars. Results: the follow up period was 20 months. During surgery a correct implementation technique occurred without neuro - vascular complications. No hardware failure or instability was noted during the follow up period. The patient reported improvement of pain complaints in the immediate postoperative period andresolution of neurological symptoms at 3 months. Conclusions: atlantoaxial fixation with bilateral, crossing C-2 translaminar screws is a low-risk surgical option in patients with instability at this level and presents bone fusion rates of 97%.