Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Litter fall production and decomposition in a fragment of secondary Atlantic Forest of São Paulo, sp, southeastern Brazil

Litter fall consists of all organic material deposited on the forest floor, being of extremely important for the structure and maintenance of the ecosystem through nutrient cycling. This study aimed to evaluate the production and decomposition of litter fall in a secondary Atlantic forest fragment of secondary Atlantic Forest, at the Guarapiranga Ecological Park, in São Paulo, SP. The litter samples were taken monthly from May 2012 to May 2013. To assess the contribution of litter fall forty collectors were installed randomly within an area of 0.5 ha. The collected material was sent to the laboratory to be dried at 65 °C for 72 hours, being subsequently separated into fractions of leaves, twigs, reproductive parts and miscellaneous, and weighed to obtain the dry biomass. Litterbags were placed and tied close to the collectors to estimate the decomposition rate in order to evaluate the loss of dry biomass at 30, 60, 90, 120 and 150 days. After collection, the material was sent to the laboratory to be dried and weighed again. Total litter fall throughout the year reached 5.7 Mg.ha-1.yr-1 and the major amount of the material was collected from September till March. Leaves had the major contribution for total litter fall (72%), followed by twigs (14%), reproductive parts (11%) and miscellaneous (3%). Reproductive parts had a peak during the wet season. Positive correlation was observed between total litter and precipitation, temperature and radiation (r = 0.66, p<0.05; r = 0.76, p<0.05; r = 0.58, p<0.05, respectively). The multiple regression showed that precipitation and radiation contributed significantly to litter fall production. Decomposition rate was in the interval expected for secondary tropical forest and was correlated to rainfall. It was concluded that this fragment of secondary forest showed a seasonality effect driven mainly by precipitation and radiation, both important components of foliage renewal for the plant community and that decomposition was in an intermediate rate

Litter fall production and decomposition in a fragment of secondary Atlantic Forest of São Paulo, sp, southeastern Brazil

Litter fall consists of all organic material deposited on the forest floor, being of extremely important for the structure and maintenance of the ecosystem through nutrient cycling. This study aimed to evaluate the production and decomposition of litter fall in a secondary Atlantic forest fragment of secondary Atlantic Forest, at the Guarapiranga Ecological Park, in São Paulo, SP. The litter samples were taken monthly from May 2012 to May 2013. To assess the contribution of litter fall forty collectors were installed randomly within an area of 0.5 ha. The collected material was sent to the laboratory to be dried at 65 °C for 72 hours, being subsequently separated into fractions of leaves, twigs, reproductive parts and miscellaneous, and weighed to obtain the dry biomass. Litterbags were placed and tied close to the collectors to estimate the decomposition rate in order to evaluate the loss of dry biomass at 30, 60, 90, 120 and 150 days. After collection, the material was sent to the laboratory to be dried and weighed again. Total litter fall throughout the year reached 5.7 Mg.ha-1.yr-1 and the major amount of the material was collected from September till March. Leaves had the major contribution for total litter fall (72%), followed by twigs (14%), reproductive parts (11%) and miscellaneous (3%). Reproductive parts had a peak during the wet season. Positive correlation was observed between total litter and precipitation, temperature and radiation (r = 0.66, p<0.05; r = 0.76, p<0.05; r = 0.58, p<0.05, respectively). The multiple regression showed that precipitation and radiation contributed significantly to litter fall production. Decomposition rate was in the interval expected for secondary tropical forest and was correlated to rainfall. It was concluded that this fragment of secondary forest showed a seasonality effect driven mainly by precipitation and radiation, both important components of foliage renewal for the plant community and that decomposition was in an intermediate rate

Relatos desde el acontecimiento: las marcas en la piel de la maestra y el maestro Tomo 2

208 p. Tomo1 128 p. Tomo2 Libro electrónicoTomo 1 • Presentación 7. • Prólogo 10. • ¿Qué es el Colectivo Pensamiento Pedagógico Contemporáneo? 16. • Problematizaciones sobre “niñez” 25. • Problematizaciones sobre “infancia” 92. • Apuestas metodológicas y didácticas 123. • Concepciones bisagra: entre filosofía PARA niños y filosofía para SER niños 172. • Epílogo 199. Tomo 2 • Presentación • Línea de Infancia 9. • Línea de Corporeidad 71.primera edicio

Resumos em andamento - Educação

Resumos em andamento - Educaçã

Resumos em andamento - Educação

Resumos em andamento - Educaçã

A Transcript Finishing Initiative for Closing Gaps in the Human Transcriptome

We report the results of a transcript finishing initiative, undertaken for the purpose of identifying and characterizing novel human transcripts, in which RT-PCR was used to bridge gaps between paired EST clusters, mapped against the genomic sequence. Each pair of EST clusters selected for experimental validation was designated a transcript finishing unit (TFU). A total of 489 TFUs were selected for validation, and an overall efficiency of 43.1% was achieved. We generated a total of 59,975 bp of transcribed sequences organized into 432 exons, contributing to the definition of the structure of 211 human transcripts. The structure of several transcripts reported here was confirmed during the course of this project, through the generation of their corresponding full-length cDNA sequences. Nevertheless, for 21% of the validated TFUs, a full-length cDNA sequence is not yet available in public databases, and the structure of 69.2% of these TFUs was not correctly predicted by computer programs. The TF strategy provides a significant contribution to the definition of the complete catalog of human genes and transcripts, because it appears to be particularly useful for identification of low abundance transcripts expressed in a restricted set of tissues as well as for the delineation of gene boundaries and alternatively spliced isoforms

Characterisation of microbial attack on archaeological bone

As part of an EU funded project to investigate the factors influencing bone preservation in the archaeological record, more than 250 bones from 41 archaeological sites in five countries spanning four climatic regions were studied for diagenetic alteration. Sites were selected to cover a range of environmental conditions and archaeological contexts. Microscopic and physical (mercury intrusion porosimetry) analyses of these bones revealed that the majority (68%) had suffered microbial attack. Furthermore, significant differences were found between animal and human bone in both the state of preservation and the type of microbial attack present. These differences in preservation might result from differences in early taphonomy of the bones. © 2003 Elsevier Science Ltd. All rights reserved