IMPORTANCE: It is unknown whether angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs) have a positive, neutral, or negative effect on clinical outcomes in ...patients with coronavirus disease 2019 (COVID-19). OBJECTIVE: To determine whether discontinuation compared with continuation of ACEIs or ARBs changed the number of days alive and out of the hospital through 30 days. DESIGN, SETTING, AND PARTICIPANTS: A randomized clinical trial of 659 patients hospitalized in Brazil with mild to moderate COVID-19 who were taking ACEIs or ARBs prior to hospitalization (enrolled: April 9-June 26, 2020; final follow-up: July 26, 2020). INTERVENTIONS: Discontinuation (n = 334) or continuation (n = 325) of ACEIs or ARBs. MAIN OUTCOMES AND MEASURES: The primary outcome was the number of days alive and out of the hospital through 30 days. Secondary outcomes included death, cardiovascular death, and COVID-19 progression. RESULTS: Among 659 patients, the median age was 55.1 years (interquartile range IQR, 46.1-65.0 years), 14.7% were aged 70 years or older, 40.4% were women, and 100% completed the trial. The median time from symptom onset to hospital admission was 6 days (IQR, 4-9 days) and 27.2% of patients had an oxygen saturation of less than 94% of room air at baseline. In terms of clinical severity, 57.1% of patients were considered mild at hospital admission and 42.9% were considered moderate. There was no significant difference in the number of days alive and out of the hospital in patients in the discontinuation group (mean, 21.9 days SD, 8 days) vs patients in the continuation group (mean, 22.9 days SD, 7.1 days) and the mean ratio was 0.95 (95% CI, 0.90-1.01). There also was no statistically significant difference in death (2.7% for the discontinuation group vs 2.8% for the continuation group; odds ratio OR, 0.97 95% CI, 0.38-2.52), cardiovascular death (0.6% vs 0.3%, respectively; OR, 1.95 95% CI, 0.19-42.12), or COVID-19 progression (38.3% vs 32.3%; OR, 1.30 95% CI, 0.95-1.80). The most common adverse events were respiratory failure requiring invasive mechanical ventilation (9.6% in the discontinuation group vs 7.7% in the continuation group), shock requiring vasopressors (8.4% vs 7.1%, respectively), acute myocardial infarction (7.5% vs 4.6%), new or worsening heart failure (4.2% vs 4.9%), and acute kidney failure requiring hemodialysis (3.3% vs 2.8%). CONCLUSIONS AND RELEVANCE: Among patients hospitalized with mild to moderate COVID-19 and who were taking ACEIs or ARBs before hospital admission, there was no significant difference in the mean number of days alive and out of the hospital for those assigned to discontinue vs continue these medications. These findings do not support routinely discontinuing ACEIs or ARBs among patients hospitalized with mild to moderate COVID-19 if there is an indication for treatment. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04364893
•Methyl-paraben can be fully mineralized by electrolysis with diamond anodes.•UV irradiation has a positive effect on the mineralization of methyl-paraben.•Neither persulfate nor hypochlorite can ...fully explain the results of electrolysis.•Significant differences are observed in the results of chloride and sulfate media.
In this work, the electrochemical oxidation of methyl paraben (MeP) with diamond electrodes is studied. Results point out that this preservative can be easily removed from wastewater, either in sulfate or chloride media. Pollutant removal is faster in chloride media due to the chlorination of the molecule. However, mineralization is faster in sulfate media. Current density does not have a clear influence on the efficiency, explained by a mediated oxidation control of the process. Irradiation by UV light produces a synergistic effect on the process, which is greater in sulfate than in chloride media, a behavior that could be initially understood in terms of the formation of sulfate and chloride radicals. However, chemical tests showed that persulfate is not active for the oxidation of MeP neither in dark conditions nor under UV irradiation and that hypochlorite is active in the chlorination of the MeP molecule but not in the mineralization. Consequently, these results can be better explained considering the oxidizing effect of ozone and hydrogen peroxide, which are produced during the electrolysis on the surface of diamond, and that within the reaction conditions undertaken, are unstable and decompose to hydroxyl radicals. Regarding electrolysis in chloride media, although chlorates or perchlorates are produced, UV light significantly delays the appearance of both species.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Abstract Background Agriculture in South America (SA) had a great expansion in the last decades and weed control changed accordingly with region and crop practices. Objective The objective of this ...review is to present the history of herbicide use and discuss the main changes in weed management in SA. Methods Herbicide use quantities were obtained from official institutions and commercial organizations in Argentina, Brazil, Chile, Paraguay and Uruguay. Data were summarized per active ingredient, herbicide mode of action or crop. The evolution of the cultivated area of the main crops in each country, and the crop and weed management associated to it were considered to discuss the importance and the consequences of the main herbicides used. Results In 2019 the most used herbicides in Brazil were glyphosate, 2,4-D, atrazine, paraquat and diuron representing 62, 15, 7, 5 and 2% of the total amount used. In Argentina, the increasing selection of herbicide resistant populations (4 cases/year), resulted in utilization of older chemistries. Weed control in Uruguay is traditionally benefited from crop/pasture rotations but recently is also facing problems of continuous cropping systems. Agriculture in Chile is more diverse, but similar patterns and problems of herbicide use are present. Conclusions Intensification of agriculture, no-tillage, glyphosate resistant crops, and herbicide resistant weeds were the most important drivers of herbicide use changes in SA. Integrated weed management is unpostponable to provide sustainable increasing food production in SA.
Pd/C, Au/C and PdAu/C electrocatalysts with different atomic ratios prepared using electron beam irradiation were tested for glycerol electrooxidation in single alkaline direct glycerol fuel cell ...(ADGFC). X-ray diffractograms (XRD) of PdAu/C electrocatalysts showed the presence of Pd (fcc) and Au (fcc) phases. Cyclic voltammetry (CV) and chronoamperometry showed that PdAu/C electrocatalyst with Pd:Au atomic ratio of 50:50 demonstrated superior activity for glycerol electrooxidation, at room temperature. In situ Fourier transform infrared spectroscopy by attenuated total reflectance (ATR-FTIR) experiments were performed for the electrocatalysts, identifying oxalate, glycerate ion, 1,3-dihydroxy-2-propanone, glyceraldehyde and glycolate as products of glycerol electrooxidation. Experiments with single ADGFC were carried out from 50 to 90 ºC, using Pd/C electrocatalyst; the best performance was obtained at 80 ºC.
Reported herein is the architecture for a nonvolatile n-type memory paper field-effect transistor. The device was built via the hybrid integration of natural cellulose fibers (pine and eucalyptus ...fibers embedded in resin with ionic additives), which act simultaneously as substrate and gate dielectric, using passive and active semiconductors, respectively, as well as amorphous indium zinc and gallium indium zinc oxides for the gate electrode and channel layer, respectively. This was complemented by the use of continuous patterned metal layers as source/drain electrodes.
Objectives: To evaluate respiratory muscle strength (RMS) in a sample composed exclusively of healthy sedentary individuals and to compare with predicted values, to investigate the relationship ...between maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) and age, weight and height, and propose predictive equations of MIP and MEP for this population. Methods: Subjects were 140 healthy and sedentary individuals: 70 males (55c20 years) and 70 females (54c21 years), separated into groups according to age. The RMS was obtained with an aneroid vacuum manometer (c300 cmH sub(2)O). Results: There was a significant reduction in RMS with increasing age (ANOVA one-way, p<0.05). Moreover, the RMS values decreased significantly from age 40 compared to the predicted values (Student t test, p<0.05). There were also significant correlations of RMS with age, weight and height (Pearson correlation, p<0.05). The predictive equations using linear regression for maximal respiratory pressures according to sex showed that age in males and females and weight in females influenced the prediction of the MIP and MEP values. Conclusions: Our results showed that age and anthropometric characteristics influence RMS values. In addition, the RMS values were lower compared to the predicted values from age 40 because the sample was composed exclusively of sedentary individuals. In this context, we propose equations to predict the MIP and MEP values exclusively for healthy, sedentary individuals from 20 to 89 years of age.Original Abstract: Objetivos: Avaliar a forca muscular respiratoria (FMR) em uma amostra composta apenas por individuos sedentarios saudaveis e comparar com os valores preditos; correlacionar os valores de pressao inspiratoria maxima (Plmax) e expiratoria maxima (PEmax) com a idade, peso e altura, e propor equacoes preditivas de Plmax e PEmax para essa populacao. Metodos: Foram selecionados 140 individuos saudaveis e sedentarios, sendo 70 homens (55c20 anos) e 70 mulheres (54c21 anos) que foram separados em grupos de acordo com a idade. A FMR foi obtida por meio de um manovacuometro aneroide (c300 cmH sub(2)O). Resultados: Foi verificada reducao significativa da FMR com o avancar da idade (ANOVA one-way, p<0,05). Alem disso, os valores de FMR foram significativamente menores em relacao aos valores preditos a pattir dos 40 anos (Teste t de Student, p<0,05). Tambem foram observadas correlacoes significativas da FMR com a idade, peso e altura (correlacao de Pearson, p<0,05). Quando realizadas as equacoes preditivas por meio de regressao linear para as pressoes respiratorias maximas em cada genero, verificou-se que a idade em ambos os sexos e o peso para as mulheres exerceram influencia na predicao dos valores de Plmax e PEmax. Conclusoes: Os resuitados mostraram que a idade e as caracteristicas antropometricas exercem influencia nos valores de FMR. Os valores de FMR foram menores em relacao aos valores preditos devido ao fato de a amostra ser composta exclusivamente por sujeitos sedentarios. Neste contexto, propoem-se equacoes para predizer os valores de Plmax e PEmax exclusivamente para individuos saudaveis sedentarios de 20 a 89 anos. Artigo registrado na Australian New Zealand Clinical Trials Registry (ANZCTR) sob o numero ACTRN12608000511336.
Real-time 3-dimensional echocardiography allows a comprehensive evaluation of left ventricular outflow tract (LVOT) obstruction in patients with hypertrophic cardiomyopathy. The anterior segment of ...the anterior mitral leaflet is essential in the development of the LVOT pressure gradient.
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