Association of renin–angiotensin system blockers with COVID-19 diagnosis and prognosis in patients with hypertension: a population-based study

COVID-19; Angiotensin receptor blockers; HypertensionCOVID-19; Bloqueadores de los receptores de angiotensina; HipertensiónCOVID-19; Bloquejadors dels receptors d'angiotensina; HipertensióBackground The effect of renin–angiotensin system (RAS) blockade either by angiotensin-converting enzyme inhibitors (ACEis) or angiotensin-receptor blockers (ARBs) on coronavirus disease 2019 (COVID-19) susceptibility, mortality and severity is inadequately described. We examined the association between RAS blockade and COVID-19 diagnosis and prognosis in a large population-based cohort of patients with hypertension (HTN). Methods This is a cohort study using regional health records. We identified all individuals aged 18–95 years from 87 healthcare reference areas of the main health provider in Catalonia (Spain), with a history of HTN from primary care records. Data were linked to COVID-19 test results, hospital, pharmacy and mortality records from 1 March 2020 to 14 August 2020. We defined exposure to RAS blockers as the dispensation of ACEi/ARBs during the 3 months before COVID-19 diagnosis or 1 March 2020. Primary outcomes were: COVID-19 infection and severe progression in hospitalized patients with COVID-19 (the composite of need for invasive respiratory support or death). For both outcomes and for each exposure of interest (RAS blockade, ACEi or ARB) we estimated associations in age-, sex-, healthcare area- and propensity score-matched samples. Results From a cohort of 1 365 215 inhabitants we identified 305 972 patients with HTN history. Recent use of ACEi/ARBs in patients with HTN was associated with a lower 6-month cumulative incidence of COVID-19 diagnosis {3.78% [95% confidence interval (CI) 3.69–3.86%] versus 4.53% (95% CI 4.40–4.65%); P < 0.001}. In the 12 344 patients with COVID-19 infection, the use of ACEi/ARBs was not associated with a higher risk of hospitalization with need for invasive respiratory support or death [OR = 0.91 (0.71–1.15); P = 0.426]. Conclusions RAS blockade in patients with HTN is not associated with higher risk of COVID-19 infection or with a worse progression of the disease.The study was partially funded by ‘CIBER de Epidemiología y Salud Pública (CIBERESP)’

Translocation of pesticides in coconut palm by endotherapy with the addition of different adjuvants

Commercial pesticides were selected, mixed and applied in coconut stems (Cocos nucifera Linn.) by endotherapy with various adjuvants. Tissue samples from the coconut stem were collected at different heights and days, and subjected to extraction and analysis by modified QuEChERS (“Quick, Easy, Cheap, Effective, Rugged and Safe") and UHPLC-MS/MS (ultra-high-performance liquid chromatography–tandem mass spectrometry). The translocations of 3-hydroxy-carbofuran, carbendazim, carbofuran, difenoconazole, imidacloprid, thiabendazole, thiamethoxam, thiophanate-methyl and spirodiclofen, using salts, citric acid and organosilicones as adjuvants, were evaluated and compared 2 and 30 days after the applications. The results showed that each pesticide had a different translocation profile, modified by the presence of the adjuvants. The most significant modifications were obtained using organosilicones, which enhanced the translocation process by 40% for most pesticides, followed by acidification (30%) and the addition of salts (22%).

MANEJO NUTRICIONAL DE MATRIZES SUÍNAS

A nutrição de uma matriz, interfere em todo seus desempenho produtivo e reprodutivo, Para obter um controle de condição corporal da matriz no período de gestação, é utilizada técnica de Escore de Condição Corporal, que consiste em ajustar a quantidade de alimento fornecido a matriz de acordo com o seu peso metabólico. Neste estudo, foram reajustadas as dietas das fêmeas em gestação, de acordo com oECC, visando padronizar a condição corporal das fêmeas gestantes

Dual Career of the U-23 Spanish Canoeing Team

We would like to thank the Royal Spanish Canoeing Federation, their coaches and paddlers for the time they have dedicated to making this study a success. In particular, to María Corbera Muñoz. We would also like to thank Maria Repice for her help with the English version of this manuscript.Canoeing is one of the sport disciplines that brings great success to Spain in international competitions and Olympic Games (of the 17 medals won in Rio in 2016, four were in this sport, including three gold). However, the journey to become an elite athlete coincides in time with the challenge of pursuing an academic education, which often involves making difficult choices in the training-university dichotomy. The aim of this research was to ascertain how the Spanish under-23 calm water canoeing team perceives their athletic and academic careers. The present study was carried out with the Spanish under-23 flat water canoeing team, the step prior to competition at the highest level. The study sample comprised the whole population, namely the entire national team, made up of 21 athletes (11 women and 10 men) with a mean age of 20.57 ± 2.64 years and 10.00 ± 3.49 years of experience. These athletes are usually based at La Cartuja High Performance Center (Seville) and combine their sports activity with studying toward a university degree. A double qualitative and quantitative methodology was used. For the first of these, an interview script was elaborated based on the theoretical model by Wylleman et al. (2013). Applicable consents were requested from the Spanish Royal Canoeing Federation, coaches and paddlers. Interviews were carried out with each athlete twice: at the beginning and at the end of the season/academic year, which were recorded and subsequently tabulated and analyzed. Concerning quantitative methodology, the ESTPORT dual career questionnaire validated by Sánchez-Pato et al. (2016) was used. The results show that for all the paddlers canoeing is very important. It is typically complicated for them to attend classes, and subject planning is usually based on their training schedules. In the second/last part of the course, it is stressful for these athletes to combine both activities and some drop out of school. During the course, though, they appreciate having another activity that allows them to escape from the training routine. In addition, they miss not having an academic tutor to guide and advise them. These student-athletes are aware that their sport causes them to miss out on many moments with family and friends due to training or competing. However, at present this is offset, largely because of their high level of performance, which makes it easier for them to obtain scholarships that provide economic support

Randomized elimination and prolongation of ACE inhibitors and ARBs in coronavirus 2019 (REPLACE COVID) Trial Protocol

Severe acute respiratory syndrome coronavirus 2 (SARS- CoV- 2), the virus responsible for coronavirus disease 2019 (COVID- 19), is associated with high incidence of multiorgan dysfunction and death. Angiotensin- converting enzyme 2 (ACE2), which facilitates SARS- CoV- 2 host cell entry, may be impacted by angiotensin- converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs), two commonly used antihypertensive classes. In a multicenter, international randomized controlled trial that began enrollment on March 31, 2020, participants are randomized to continuation vs withdrawal of their long- term outpatient ACEI or ARB upon hospitalization with COVID- 19. The primary outcome is a hierarchical global rank score incorporating time to death, duration of mechanical ventilation, duration of renal replacement or vasopressor therapy, and multiorgan dysfunction severity. Approval for the study has been obtained from the Institutional Review Board of each participating institution, and all participants will provide informed consent. A data safety monitoring board has been assembled to provide independent oversight of the project.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/163400/2/jch14011_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/163400/1/jch14011.pd

Baseline characteristics of patients in the reduction of events with darbepoetin alfa in heart failure trial (RED-HF)

&lt;p&gt;Aims: This report describes the baseline characteristics of patients in the Reduction of Events with Darbepoetin alfa in Heart Failure trial (RED-HF) which is testing the hypothesis that anaemia correction with darbepoetin alfa will reduce the composite endpoint of death from any cause or hospital admission for worsening heart failure, and improve other outcomes.&lt;/p&gt; &lt;p&gt;Methods and results: Key demographic, clinical, and laboratory findings, along with baseline treatment, are reported and compared with those of patients in other recent clinical trials in heart failure. Compared with other recent trials, RED-HF enrolled more elderly [mean age 70 (SD 11.4) years], female (41%), and black (9%) patients. RED-HF patients more often had diabetes (46%) and renal impairment (72% had an estimated glomerular filtration rate &#60;60 mL/min/1.73 m2). Patients in RED-HF had heart failure of longer duration [5.3 (5.4) years], worse NYHA class (35% II, 63% III, and 2% IV), and more signs of congestion. Mean EF was 30% (6.8%). RED-HF patients were well treated at randomization, and pharmacological therapy at baseline was broadly similar to that of other recent trials, taking account of study-specific inclusion/exclusion criteria. Median (interquartile range) haemoglobin at baseline was 112 (106–117) g/L.&lt;/p&gt; &lt;p&gt;Conclusion: The anaemic patients enrolled in RED-HF were older, moderately to markedly symptomatic, and had extensive co-morbidity.&lt;/p&gt

Hyperoxemia and excess oxygen use in early acute respiratory distress syndrome : Insights from the LUNG SAFE study

Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Concerns exist regarding the prevalence and impact of unnecessary oxygen use in patients with acute respiratory distress syndrome (ARDS). We examined this issue in patients with ARDS enrolled in the Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study. Methods: In this secondary analysis of the LUNG SAFE study, we wished to determine the prevalence and the outcomes associated with hyperoxemia on day 1, sustained hyperoxemia, and excessive oxygen use in patients with early ARDS. Patients who fulfilled criteria of ARDS on day 1 and day 2 of acute hypoxemic respiratory failure were categorized based on the presence of hyperoxemia (PaO2 > 100 mmHg) on day 1, sustained (i.e., present on day 1 and day 2) hyperoxemia, or excessive oxygen use (FIO2 ≥ 0.60 during hyperoxemia). Results: Of 2005 patients that met the inclusion criteria, 131 (6.5%) were hypoxemic (PaO2 < 55 mmHg), 607 (30%) had hyperoxemia on day 1, and 250 (12%) had sustained hyperoxemia. Excess FIO2 use occurred in 400 (66%) out of 607 patients with hyperoxemia. Excess FIO2 use decreased from day 1 to day 2 of ARDS, with most hyperoxemic patients on day 2 receiving relatively low FIO2. Multivariate analyses found no independent relationship between day 1 hyperoxemia, sustained hyperoxemia, or excess FIO2 use and adverse clinical outcomes. Mortality was 42% in patients with excess FIO2 use, compared to 39% in a propensity-matched sample of normoxemic (PaO2 55-100 mmHg) patients (P = 0.47). Conclusions: Hyperoxemia and excess oxygen use are both prevalent in early ARDS but are most often non-sustained. No relationship was found between hyperoxemia or excessive oxygen use and patient outcome in this cohort. Trial registration: LUNG-SAFE is registered with ClinicalTrials.gov, NCT02010073publishersversionPeer reviewe

The Development of Shared Liking of Representational but not Abstract Art in Primary School Children and Their Justifications for Liking

This Document is Protected by copyright and was first published by Frontiers. All rights reserved. It is reproduced with permissionUnderstanding how aesthetic preferences are shared among individuals, and its developmental time course, is a fundamental question in aesthetics. It has been shown that semantic associations, in response to representational artworks, overlap more strongly among individuals than those generated by abstract artworks and that the emotional valence of the associations also overlaps more for representational artworks. This valence response may be a key driver in aesthetic appreciation. The current study tested predictions derived from the semantic association account in a developmental context. Twenty 4-, 6-, 8- and 10-year-old children (n = 80) were shown 20 artworks (10 representational, 10 abstract) and were asked to rate each artwork and to explain their decision. Cross-observer agreement in aesthetic preferences increased with age from 4–8 years for both abstract and representational art. However, after age 6 the level of shared appreciation for representational and abstract artworks diverged, with significantly higher levels of agreement for representational than abstract artworks at age 8 and 10. The most common justifications for representational artworks involved subject matter, while for abstract artworks formal artistic properties and color were the most commonly used justifications. Representational artwork also showed a significantly higher proportion of associations and emotional responses than abstract artworks. In line with predictions from developmental cognitive neuroscience, references to the artist as an agent increased between ages 4 and 6 and again between ages 6 and 8, following the development of Theory of Mind. The findings support the view that increased experience with representational content during the life span reduces inter-individual variation in aesthetic appreciation and increases shared preferences. In addition, brain and cognitive development appear to impact on art appreciation at milestone ages.Internal QR Grant to the first three authors, University of Chester