The coronavirus disease 2019 (COVID-19) pandemic has impacted healthcare systems worldwide. Multiple reports on thromboembolic complications related to COVID-19 have been published, and researchers ...have described that people with COVID-19 are at high risk for developing venous thromboembolism (VTE). Anticoagulants have been used as pharmacological interventions to prevent arterial and venous thrombosis, and their use in the outpatient setting could potentially reduce the prevalence of vascular thrombosis and associated mortality in people with COVID-19. However, even lower doses used for a prophylactic purpose may result in adverse events such as bleeding. It is important to consider the evidence for anticoagulant use in non-hospitalised people with COVID-19.
To evaluate the benefits and harms of prophylactic anticoagulants versus active comparators, placebo or no intervention, or non-pharmacological interventions in non-hospitalised people with COVID-19.
We used standard, extensive Cochrane search methods. The latest search date was 18 April 2022.
We included randomised controlled trials (RCTs) comparing prophylactic anticoagulants with placebo or no treatment, another active comparator, or non-pharmacological interventions in non-hospitalised people with COVID-19. We included studies that compared anticoagulants with a different dose of the same anticoagulant. We excluded studies with a duration of under two weeks.
We used standard Cochrane methodological procedures. Our primary outcomes were all-cause mortality, VTE (deep vein thrombosis (DVT) or pulmonary embolism (PE)), and major bleeding. Our secondary outcomes were DVT, PE, need for hospitalisation, minor bleeding, adverse events, and quality of life. We used GRADE to assess the certainty of the evidence.
We included five RCTs with up to 90 days of follow-up (short term). Data were available for meta-analysis from 1777 participants. Anticoagulant compared to placebo or no treatment Five studies compared anticoagulants with placebo or no treatment and provided data for three of our outcomes of interest (all-cause mortality, major bleeding, and adverse events). The evidence suggests that prophylactic anticoagulants may lead to little or no difference in all-cause mortality (risk ratio (RR) 0.36, 95% confidence interval (CI) 0.04 to 3.61; 5 studies; 1777 participants; low-certainty evidence) and probably reduce VTE from 3% in the placebo group to 1% in the anticoagulant group (RR 0.36, 95% CI 0.16 to 0.85; 4 studies; 1259 participants; number needed to treat for an additional beneficial outcome (NNTB) = 50; moderate-certainty evidence). There may be little to no difference in major bleeding (RR 0.36, 95% CI 0.01 to 8.78; 5 studies; 1777 participants; low-certainty evidence). Anticoagulants probably result in little or no difference in DVT (RR 1.02, 95% CI 0.30 to 3.46; 3 studies; 1009 participants; moderate-certainty evidence), but probably reduce the risk of PE from 2.7% in the placebo group to 0.7% in the anticoagulant group (RR 0.25, 95% CI 0.08 to 0.79; 3 studies; 1009 participants; NNTB 50; moderate-certainty evidence). Anticoagulants probably lead to little or no difference in reducing hospitalisation (RR 1.01, 95% CI 0.59 to 1.75; 4 studies; 1459 participants; moderate-certainty evidence) and may lead to little or no difference in adverse events (minor bleeding, RR 2.46, 95% CI 0.90 to 6.72; 5 studies, 1777 participants; low-certainty evidence). Anticoagulant compared to a different dose of the same anticoagulant One study compared anticoagulant (higher-dose apixaban) with a different (standard) dose of the same anticoagulant and reported five relevant outcomes. No cases of all-cause mortality, VTE, or major bleeding occurred in either group during the 45-day follow-up (moderate-certainty evidence). Higher-dose apixaban compared to standard-dose apixaban may lead to little or no difference in reducing the need for hospitalisation (RR 1.89, 95% CI 0.17 to 20.58; 1 study; 278 participants; low-certainty evidence) or in the number of adverse events (minor bleeding, RR 0.47, 95% CI 0.09 to 2.54; 1 study; 278 participants; low-certainty evidence). Anticoagulant compared to antiplatelet agent One study compared anticoagulant (apixaban) with antiplatelet agent (aspirin) and reported five relevant outcomes. No cases of all-cause mortality or major bleeding occurred during the 45-day follow-up (moderate-certainty evidence). Apixaban may lead to little or no difference in VTE (RR 0.36, 95% CI 0.01 to 8.65; 1 study; 279 participants; low-certainty evidence), need for hospitalisation (RR 3.20, 95% CI 0.13 to 77.85; 1 study; 279 participants; low-certainty evidence), or adverse events (minor bleeding, RR 2.13, 95% CI 0.40 to 11.46; 1 study; 279 participants; low-certainty evidence). No included studies reported on quality of life or investigated anticoagulants compared to a different anticoagulant, or anticoagulants compared to non-pharmacological interventions.
We found low- to moderate-certainty evidence from five RCTs that prophylactic anticoagulants result in little or no difference in major bleeding, DVT, need for hospitalisation, or adverse events when compared with placebo or no treatment in non-hospitalised people with COVID-19. Low-certainty evidence indicates that prophylactic anticoagulants may result in little or no difference in all-cause mortality when compared with placebo or no treatment, but moderate-certainty evidence indicates that prophylactic anticoagulants probably reduce the incidence of VTE and PE. Low-certainty evidence suggests that comparing different doses of the same prophylactic anticoagulant may result in little or no difference in need for hospitalisation or adverse events. Prophylactic anticoagulants may result in little or no difference in risk of VTE, hospitalisation, or adverse events when compared with antiplatelet agents (low-certainty evidence). Given that there were only short-term data from one study, these results should be interpreted with caution. Additional trials of sufficient duration are needed to clearly determine any effect on clinical outcomes.
The use of copper as an antimicrobial agent has a long history and has gained renewed interest in the context of the COVID-19 pandemic. In this study, the authors investigated the antimicrobial ...properties of an alloy composed of copper with a small percentage of silver (Cu-0.03% wt.Ag). The alloy was tested against various pathogens, including
,
,
,
, and the H1N1 virus, using contact exposure tests. Results showed that the alloy was capable of inactivating these pathogens in two hours or less, indicating its strong antimicrobial activity. Electrochemical measurements were also performed, revealing that the small addition of silver to copper promoted a higher resistance to corrosion and shifted the formation of copper ions to higher potentials. This shift led to a slow but continuous release of Cu
ions, which have high biocidal activity. These findings show that the addition of small amounts of silver to copper can enhance its biocidal properties and improve its effectiveness as an antimicrobial material.
The copper alloy UNS-C27200 is a binary brass, composed of 38wt%Zn, beeing one of the most used in the industry. The union of Cu-Zn alloys by conventional welding by fusion in thin plates presents ...several challenges. The Friction Stir Welding (FSW) process performs the union of two, or more materials, through a rotating tool that travels throughout the welding region. One the great advantages of FSW is working below the melting point of the material, which reduces the change in the microstructure and properties of the material, when compared to conventional welding processes. Due to the lack of research on FSW process in lap brass joints with thin thicknesses, the present work aims to expand these studies in order to contribute to future research. Eight conditions were evaluated, varying rotation and welding speed. In the best results by visual inspection, analyzes of microstructure, temperature, microhardness and mechanical strength were performed. The better welding results were obtained with ω=1050 rpm and ν=20 mm/min. There was reduction of approximately 50% between Stir Zone and Base metal. The mechanical strength was affected by the pin hole resulting from the process. The microstructure revealed a homogeneous mixture in the stir zone and no defects were detected.
The welding of metallic materials by the Friction Stir Welding (FSW) method is a very attractive process for preserving their characteristics, especially for copper and its alloys that require high ...heat input and present many distortions by traditional methods. However, it is a great challenge to produce welds free of defects and maintain or improve their mechanical properties. In the current literature data on FSW parameters for copper and its alloys are scarce. In this study, tests were performed with a combination of four tool rotations (750, 850, 950, 1050 rev.min-1) and two welding speeds (20 and 60 mm.min-1), maintaining the tool inclination angle in 3° and waiting time of 5 seconds. The objective of this work is to analyze the microstructure and mechanical performance of lap joints of the UNS C19400 alloy joined by FSW. The process temperature was monitored to trace the heating profile of the process, in addition to microhardness and shear strength tests, in addition to optical microscopy for analysis. The joints welded by the parameters Ω 950 rev.mm-1 �� 20mm.min-1 obtained a mechanical performance of 73% compared to the characteristics of the base metal and despite the appearance of volumetric defects at the microstructural level, the metallurgical transformations of recovery and recrystallization of the grains observed in the microstructure played a key role in the result.
The combination of visible-light and tris(trimethylsilyl)silane promoting intramolecular reductive cyclization protocol for the synthesis of functionalized indolines and 2,3-dihydrobenzofurans has ...been developed. The transformations occur in the absence of transition metal and additional photocatalyst. In addition, quantum yield (
) was determined and electron paramagnetic resonance spectroscopy was performed to better understand the reaction pathway.
The Brazilian northeast is known to have sedimentary areas that contain minerals with anomalous concentrations of naturally occurring radioactive material (NORM). This characteristic can contribute ...to the elevation of natural radiation in the air, soil, and groundwater. Due to the inefficiency of drinking water distribution in this region, the use of water from wells has become essential for the population. Therefore, the objective of this research was to monitor the concentration of 238U and 232Th associated with biomonitoring with the species of mollusc Biomphalaria glabrata in waters of residential artesian wells, used for domestic consumption, in the municipalities of Abreu e Lima and São José do Sabugi, Brazil. To check the concentration of 238U and 232Th, ICP-MS was used. For biomonitoring, ecotoxicity techniques such as embryotoxicity and genotoxicity were used. The monitoring results confirmed high concentrations of natural uranium in one of the residential artesian wells, the data being above the limit allowed by the Ministry of Health of Brazil, whose study reference is the World Health Organization (WHO). The results of the bioassays showed embryotoxicity, with malformations and deaths in the exposed organisms being observed. The comet assay showed that groundwater caused changes in the mollusc's DNA, indicating genotoxicity. The bioassays suggest that embryotoxicity and genotoxicity were caused mainly by the high concentration of natural uranium. Therefore, the bioindicator B. glabrata was shown to be sensitive to the toxic effects of anomalous concentrations of NORM present in groundwater.
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•The presence of large concentration of natural uranium was found in one of the residential artesian wells in this study.•Genotoxicity caused by natural uranium was positive for the mollusc Biomphalaria glabrata.•Occurred Embryotoxicity caused by natural uranium to the embryos of Biomphalaria glabrata.•The mollusc of the species Biomphalaria glabrata proved to be a bioindicator sensitive to NORM.
Studying species interactions in nature often requires elaborated logistics and intense fieldwork. The difficulties in such task might hinder our ability to answer questions on how biotic ...interactions change with the environment. Fortunately, a workaround to this problem lies within scientific collections.
For some animals, the inspection of preserved specimens can reveal the scars of past antagonistic encounters, such as predation attempts. A common defensive behaviour that leaves scars on animals is autotomy, the loss of a body appendage to escape predation. By knowing the collection site of preserved specimens, it is possible to assess the influence of organismal biology and the surrounding environment in the occurrence of autotomy.
We gathered data on tail loss for 8189 preserved specimens of 33 snake and 11 amphisbaenian species to investigate biological and environmental correlates of autotomy in reptiles. We applied generalized linear mixed effect models to evaluate whether body size, sex, life‐stage, habitat use, activity pattern, biome, tropicality, temperature and precipitation affect the probability of tail loss in limbless reptiles.
We observed autotomy in 23.6% of examined specimens, with 18.7% of amphisbaenian and 33.4% of snake specimens showing tail loss. The probability of tail loss did not differ between snakes and amphisbaenians, but it was higher among large‐sized specimens, particularly in adults and females. Chance of tail loss was higher for diurnal and arboreal species, and among specimens collected in warmer regions, but it was unaffected by biome, precipitation, and tropicality.
Autotomy in limbless reptiles was affected by size‐dependent factors that interplay with ontogeny and sexual dimorphism, although size‐independent effects of life‐stage and sex also shaped behavioural responses to predators. The increase in probability of tail loss with verticality and diurnality suggests a risk‐balance mechanism between species habitat use and activity pattern. Although autotomy is more likely in warmer regions, it seems unrelated to seasonal differences in snakes and amphisbaenians activity. Our findings reveal several processes related to predator–prey interactions involving limbless reptiles, demonstrating the importance of scientific collections to unveil ecological mechanisms at different spatio‐temporal scales.
Research shows how scientific collections are useful to get around costs and logistics of the intense fieldwork required for the study of biotic interactions in nature. In using more than 8 K specimens deposited across 61 collections, the authors show how species biology and environment help explain tail loss in limbless reptiles.
The present work develops a simplified computational methodology to predict brackets’ mechanical behavior to support mooring systems’ fairleads under maximum environmental loads. The methodology ...consists of estimating environmental loads in Campos’s basin (Brazil) using standards available in the literature and applying them to determine the stress distribution in the brackets’ solid domain using a code based on the Finite Element Method. The brackets studied here are composed of AH36 steel plates. Six different geometric configurations for the brackets considering thinner plates than those ordinarily employed in the existent brackets of the P-66 Petrobras oil production platform were studied. Theoretical recommendations about geometric configurations to reduce the von Mises maximum stress in brackets’ plates were determined in the light of constructal design. The results proved the importance of the geometric investigation in this problem. For instance, for the accidental limit state (ALS) the best configuration leads to a mechanical performance two times superior to that reached for the worst one, which had a maximum stress superior to the yielding limit. Moreover, the best designs for the superior and inferior brackets in the ALS have different configurations.
However, the process of cleaning the material using acid pickling generates hazardous metal-rich acid residue that is harmful to the environment and expensive to dispose of. Therefore, this study ...aimed to recover the acid pickling residue from the Cu0.69Zn0.26Ni0.05 alloy. By using an economically viable and surfactant-free one-pot coprecipitation hydrothermal process, a ZnO-rich microcomposite material was obtained, which had a high recovery yield of 20 g/L by reusing residual water in a cyclic process. The material's composition was confirmed through electronic and crystalline characterizations determined by UV-Vis, Photoluminescence, FTIR, XRD, and XPS. Moreover, the morphological characterization showed that the wurtzite ZnO grows on the CuO surface, forming rod-like structures with high surface areas, as observed through SEM and TEM analysis. The microstructure exhibits favorable properties that enable the degradation of a pollutant model in an aqueous solution, as well as the inactivation of multidrug-resistant bacteria. Unlike other works in the literature, the creation of a valuable product from a harmful residue did not require complex metal separation steps. These promising results bode well for the development of functional materials based on green economy principles, thereby facilitating large-scale treatment of industrial metallurgy residues.
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•Recovering metal from a realistic metallurgic acid-pickling wastewater.•One-pot coprecipitation methodology allowed a high recovery yield of 20 g/L.•Wurtzite ZnO grows as rods on the CuO surface, forming high surface areas.•Composite material presents favorable photocatalytic and antibacterial properties.•Circular economy concepts applicable to large-scale metallurgy.
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