RESUMO
Public policies, incentives, and infrastructure are top-down instruments that can align stakeholders' roles and expectations for Circular Economy (CE) transitions, but it is crucial to analyse the possible effects of such instruments before implementation. This research investigates the Brazilian Industrial Agreement for Electrical and Electronic Equipment (BIAEEE) that governs the responsibilities and targets for nationwide collection and treatment of Waste from Electrical and Electronic Equipment (WEEE). A system dynamics simulation model is adapted for the use of smartphones in Brazil, and interventions focused on the collection of end-of-life products are examined against the BIAEEE targets. Twelve policy scenarios investigate three aspects of EEE collection: coverage increase, distribution of collection points and rewards. All scenarios show improvement in the EEE collection, but only one meets the BIAEEE targets. This research demonstrates how modelling and simulation can inform strategic decision-making in public policies for CE transitions.
Assuntos
Resíduo Eletrônico , Gerenciamento de Resíduos , Brasil , Resíduo Eletrônico/análise , Eletrônica , Política Pública , ReciclagemRESUMO
The Doppler-derived Tei index has been reported to be clinically useful in assessing global right ventricular function. It could increase in response to combinations of increased pulmonary artery pressure and/or ventricular dysfunction. We compared the Tei index with invasive measurements of right ventricular function during acute pulmonary hypertension. Right and left ventricular pressures, pulmonary and aortic pressures, pulmonary flow and right ventricular volume by sonomicrometry were measured in six anaesthetized sheep. Graded pulmonary arterial hypertension was induced by a mechanical occlusion maneuver. Pressure-volume loops were generated during preload reduction through caval occlusion. Epicardial echocardiograms were also performed. Invasive indexes including preload recruitable stroke work, ventricular diastolic time constant and stiffness constant, and cardiac output were assessed, as were noninvasive echocardiographic indexes including Tei index and E/A ratio. The right ventricular pressure-volume loop became rectangular, with well-defined isovolumic phases. The slope of preload recruitable stroke work was increased significantly during pulmonary pressure of 30 mm Hg. The ventricular time constant showed a significant increase with no change of chamber stiffness during pulmonary pressure of 35 mm Hg. Concomitantly, the Tei index increased significantly from 0.06+/-0.03 to 0.31+/-0.06, together with the shortening of the ejection time and a decrease of the E/A ratio (P<0.05). Thus, the right ventricular Tei index was noted to be affected by acute graded afterload increase. The alteration in invasive measurements of systolic and diastolic function makes the Tei index a sensitive indicator of right ventricular dysfunction in the settings of acute pulmonary hypertension.
Assuntos
Técnicas de Diagnóstico Cardiovascular , Ecocardiografia Doppler , Hipertensão Pulmonar/fisiopatologia , Função Ventricular Direita , Doença Aguda , Animais , Pressão Sanguínea , Volume Sanguíneo , Débito Cardíaco , Diástole , Elasticidade , Artéria Pulmonar/fisiopatologia , Sensibilidade e Especificidade , Ovinos , Volume Sistólico , Fatores de TempoRESUMO
Los enfermos portadores de atresia pulmonar con septum intraventricular intacto tiene una mala evolución con o sin tratamiento quirúrgico. Los mejores resultados operatorios se obtiene en aquellos casos con un ventrículo derecho de tamaño aceptable, con pocos sinusoides intramiocardicos y en ausencia de disfunción significativa de la válvula tricúspide. Presentmos cinco casos de atresia pulmonar con septum intraventricular intacto asociados a disfución de la válvula tricúspide. Este grupo de enfermos tiene un comportamiento clínico a aquellos sin displasia de la válvula tricúspide. Tanto la ecocardiografía como la angiocardiografía son necesarios para el diagnóstico diferencial. La combinación de fístula sístemico-pulmonar con valvulotomía cuando es posible, así como la reconstrucción de la vía de salida del ventrículo derecho están indicadas en la corrección quirúrgica del defecto. El cambio valvular tricuspideo se vuelve necesario en algunos casos
Assuntos
Humanos , Recém-Nascido , Lactente , Pré-Escolar , Anomalia de Ebstein , Septos Cardíacos/anormalidades , Valva TricúspideRESUMO
Revisamos el cuadro clínico y la evolución a largo plazo de 14 casos de atresia tricuspídea asociada a atresia pulmonar. Con la finalidad de delinear la desición terapeútica analizamos los hallazgos electrocardiográficos, homodinámicos y anatómicos. En este grupo de atresias tricuspídeas, el cuadro clínico depende del tamaño del conducto arterioso. Es frecuente sin embargo que exista pobre tolerancia a la malformación y esta se comporta como las cardiopatías con oligohemia pulmonar (cianosis desde el nacimiento y crisis de hipoxia). Si tomamos en consideración la edad de estos pacientes el procedimiento quirúrgico inicial debe ser la fístula de Blalock-Taussig modificada. La técnica de Fontn y sus variantes deben ser consideradas como una alteración en niños mayores