Cardiac remodeling is defined as a group of molecular, cellular and interstitial changes that manifest clinically as changes in size, mass, geometry and function of the heart after injury. The process results in poor prognosis because of its association with ventricular dysfunction and malignant arrhythmias. Here, we discuss the concepts and clinical implications of cardiac remodeling, and the pathophysiological role of different factors, including cell death, energy metabolism, oxidative stress, inflammation, collagen, contractile proteins, calcium transport, geometry and neurohormonal activation. Finally, the article describes the pharmacological treatment of cardiac remodeling, which can be divided into three different stages of strategies: consolidated, promising and potential strategies.

Some fear that the profit‐maximizing orientation of private entrepreneurs conflicts with societal goals expected in the provision of complex public services. Received contractual theories advocate that private involvement in public services will result in cost reductions at the expense of quality. Using prisons as our empirical context, we benefit from an event involving the outsourcing and subsequent statization of correctional facilities in Brazil. Triangulating between quantitative and qualitative information, we do not find evidence of quality deterioration in outsourced prisons and suggest that a key mechanism driving this result is the presence of public supervisors closely working on‐site with private entrepreneurs in a hybrid governance fashion. We then deliver a set of new propositions that move beyond hazard considerations to examine how the combination of heterogeneous public and private capabilities might yield learning and spillover effects unattainable through pure government management or full‐fledged privatization. Copyright © 2013 Strategic Management Society.

Fatty acids are the main substrates used by mitochondria to provide myocardial energy under normal conditions. During heart remodeling, however, the fuel preference switches to glucose. In the earlier stages of cardiac remodeling, changes in energy metabolism are considered crucial to protect the heart from irreversible damage. Furthermore, low fatty acid oxidation and the stimulus for glycolytic pathway lead to lipotoxicity, acidosis, and low adenosine triphosphate production. While myocardial function is directly associated with energy metabolism, the metabolic pathways could be potential targets for therapy in heart failure.

Background/AimsExperimental and clinical studies have shown the direct toxic effects of cigarette smoke (CS) on the myocardium, independent of vascular effects. However, the underlying mechanisms are not well known.MethodsWistar rats were allocated to control (C) and cigarette smoke (CS) groups. CS rats were exposed to cigarette smoke for 2 months.ResultsAfter that morphometric, functional and biochemical parameters were measured. The echocardiographic study showed enlargement of the left atria, increase in the left ventricular systolic volume and reduced systolic function. Within the cardiac metabolism, exposure to CS decreased beta hydroxy acyl coenzyme A dehydrogenases and citrate synthases and increased lactate dehydrogenases. Peroxisome proliferator-activated receptor alpha (PPARα) and peroxisome proliferator-activated receptor gamma coactivator 1 alpha (PGC-1α) were expressed similarly in both groups. CS increased serum lipids and myocardial triacylglycerols (TGs). These data suggest that impairment in fatty acid oxidation and the accumulation of cardiac lipids characterize lipotoxicity. CS group exhibited increased oxidative stress and decreased antioxidant defense. Finally, the myocyte cross-sectional area and active Caspase 3 were increased in the CS group.ConclusionThe cardiac remodeling that was observed in the CS exposure model may be explained by abnormalities in energy metabolism, including lipotoxicity and oxidative stress.

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A visão predominante na teoria econômica é que organizações de propriedade difusa e complexas apresentam melhor desempenho se forem separados os direitos ao lucro residual das decisões de gestão. Nos países de economia desenvolvida, os modelos de governança corporativa das cooperativas agropecuárias de propriedade difusa e complexas, tal como já informado pela literatura econômica, promovem a desvinculação dos cooperados da gestão da empresa. Em contraposição, no Brasil, embora não haja estudos sistemáticos sobre o tema, evidências pontuais indicam que essas organizações concentram a propriedade e decisões de gestão. A possível divergência entre os modelos de governança utilizados nos diferentes países revela a necessidade de mensuração do grau de separação entre propriedade e decisão de gestão em cooperativas agropecuárias brasileiras, tarefa a que se dedica este artigo. A partir de dados coletados junto a 77 cooperativas agropecuárias, identificou-se que diferentes modelos de governança coexistem no Brasil. Embora grande parcela de cooperativas tenha governança concentrada, há um grupo que já adota modelos de governança que promovem a separação parcial de jure ou de facto entre propriedade e decisão de gestão. Esses resultados revelam a necessidade de pesquisas futuras voltadas a identificar os determinantes da variabilidade de modelos de governança nas cooperativas brasileiras.
Contract and Organizational theories establish that complex organizations with diffuse ownership, such as agriculture cooperatives, should benefit from the separation of ownership and decision control. In developed economies, such as the USA and Canada, these organizations, aligned with the theoretical proposition, adopt governance models that promote the separation of ownership and decision rights. However, in Brazil, despite the lack ofquantitative studies that measure governance separation, anecdotal evidence suggests that ownership and decisions rights are concentrated in Brazilian cooperatives. By means of a survey with 77 Brazilian agricultural cooperatives, this paper measures the degree of de jure and de facto separation of ownership and decision control, providing new evidences on the governance models observed in different countries. Different models coexist in Brazil, i.e., although the majority of agricultural cooperatives concentrate ownership and decision rights, a significant proportion organize themselves consistently with the theoretical proposition, adopting the American models of agricultural cooperatives. Further research is required in order to address the determinants of the variety of governance models in Brazil

Background/Aims: Experimental studies suggest that vitamin A plays a role in regulating cardiac structure and function. We tested the hypothesis that cardiac vitamin A deficiency is associated with adverse myocardial remodeling in young adult rats. Methods: Two groups of young female rats, control (C - n = 29) and tissue vitamin A deficient (RVA - n = 31), were subjected to transthoracic echocardiography exam, isolated rat heart study and biochemical study. Results: The RVA rats showed a reduced total vitamin A concentration in both the liver and heart [vitamin A in heart, µmol/kg (C = 0.95 ± 0.44 and RVA = 0.24 ± 0.16, p = 0.01)] with the same serum retinol levels (C = 0.73 ± 0.29 µmol/L e RVA = 0.62 ± 0.17 µmol/L, p = 0.34). The RVA rats showed higher left ventricular diameters and reduced systolic function. The RVA rats also demonstrated increased lipid hydroperoxide/total antioxidant capacity ratio and cardiac levels of IFN-γ and TNF-α but not of metalloproteinase (MMP)-2 and -9 activity. On the other hand, the RVA rats had decreased levels of β-hydroxyacylcoenzyme A dehydrogenase and lactate dehydrogenase. Conclusions: Tissue vitamin A deficiency stimulated cardiac remodeling and ventricular dysfunction. Additionally, the data support the involvement of oxidative stress, energy metabolism, and cytokine production in this remodeling process.

Hybrid governance, Public supervision, Prisons, Implicit contracts, L33,