74 research outputs found
Dureza Rockwell da madeira de três espécies amazônicas submetidas a ensaios de apodrecimento acelerado
Tocilizumab in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial
Background:
In this study, we aimed to evaluate the effects of tocilizumab in adult patients admitted to hospital with COVID-19 with both hypoxia and systemic inflammation.
Methods:
This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. Those trial participants with hypoxia (oxygen saturation <92% on air or requiring oxygen therapy) and evidence of systemic inflammation (C-reactive protein ≥75 mg/L) were eligible for random assignment in a 1:1 ratio to usual standard of care alone versus usual standard of care plus tocilizumab at a dose of 400 mg–800 mg (depending on weight) given intravenously. A second dose could be given 12–24 h later if the patient's condition had not improved. The primary outcome was 28-day mortality, assessed in the intention-to-treat population. The trial is registered with ISRCTN (50189673) and ClinicalTrials.gov (NCT04381936).
Findings:
Between April 23, 2020, and Jan 24, 2021, 4116 adults of 21 550 patients enrolled into the RECOVERY trial were included in the assessment of tocilizumab, including 3385 (82%) patients receiving systemic corticosteroids. Overall, 621 (31%) of the 2022 patients allocated tocilizumab and 729 (35%) of the 2094 patients allocated to usual care died within 28 days (rate ratio 0·85; 95% CI 0·76–0·94; p=0·0028). Consistent results were seen in all prespecified subgroups of patients, including those receiving systemic corticosteroids. Patients allocated to tocilizumab were more likely to be discharged from hospital within 28 days (57% vs 50%; rate ratio 1·22; 1·12–1·33; p<0·0001). Among those not receiving invasive mechanical ventilation at baseline, patients allocated tocilizumab were less likely to reach the composite endpoint of invasive mechanical ventilation or death (35% vs 42%; risk ratio 0·84; 95% CI 0·77–0·92; p<0·0001).
Interpretation:
In hospitalised COVID-19 patients with hypoxia and systemic inflammation, tocilizumab improved survival and other clinical outcomes. These benefits were seen regardless of the amount of respiratory support and were additional to the benefits of systemic corticosteroids.
Funding:
UK Research and Innovation (Medical Research Council) and National Institute of Health Research
Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial
Background:
Many patients with COVID-19 have been treated with plasma containing anti-SARS-CoV-2 antibodies. We aimed to evaluate the safety and efficacy of convalescent plasma therapy in patients admitted to hospital with COVID-19.
Methods:
This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]) is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. The trial is underway at 177 NHS hospitals from across the UK. Eligible and consenting patients were randomly assigned (1:1) to receive either usual care alone (usual care group) or usual care plus high-titre convalescent plasma (convalescent plasma group). The primary outcome was 28-day mortality, analysed on an intention-to-treat basis. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936.
Findings:
Between May 28, 2020, and Jan 15, 2021, 11558 (71%) of 16287 patients enrolled in RECOVERY were eligible to receive convalescent plasma and were assigned to either the convalescent plasma group or the usual care group. There was no significant difference in 28-day mortality between the two groups: 1399 (24%) of 5795 patients in the convalescent plasma group and 1408 (24%) of 5763 patients in the usual care group died within 28 days (rate ratio 1·00, 95% CI 0·93–1·07; p=0·95). The 28-day mortality rate ratio was similar in all prespecified subgroups of patients, including in those patients without detectable SARS-CoV-2 antibodies at randomisation. Allocation to convalescent plasma had no significant effect on the proportion of patients discharged from hospital within 28 days (3832 [66%] patients in the convalescent plasma group vs 3822 [66%] patients in the usual care group; rate ratio 0·99, 95% CI 0·94–1·03; p=0·57). Among those not on invasive mechanical ventilation at randomisation, there was no significant difference in the proportion of patients meeting the composite endpoint of progression to invasive mechanical ventilation or death (1568 [29%] of 5493 patients in the convalescent plasma group vs 1568 [29%] of 5448 patients in the usual care group; rate ratio 0·99, 95% CI 0·93–1·05; p=0·79).
Interpretation:
In patients hospitalised with COVID-19, high-titre convalescent plasma did not improve survival or other prespecified clinical outcomes.
Funding:
UK Research and Innovation (Medical Research Council) and National Institute of Health Research
The Relationship of Certain Personal and Family Influences to Operator's Labor Earnings
Farm Management, Labor and Human Capital,
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Noncontact material testing using laser energy deposition and interferometry
A technique is described for the noncontact testing of materials using laser deposition to generate a stress pulse and interferometry to record the transient surface displacement. The dilatational wave speed can be measured and, in the particular case of rod or plate specimens, sufficient information can be obtained to evaluate the two elastic constants of an isotropic material. Several applications illustrating the advantages of the approach are summarized
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Acoustic velocity measurement across the diameter of a liquid metal column
Present techniques for measuring sound velocity in liquid metals have been limited by the use of transducers which cannot survive in extreme temperature conditions. These methods also require relatively long measurement times. An optical noncontacting method has been developed which may be used for extremely short experimental times and very high temperatures and pressures. This technique is being incorporated into an isobaric expansion apparatus in which a 1 mm diam wire sample in a high pressure argon gas environment is resistively heated to melt within a time period of only a few microseconds. Before instability of the liquid column occurs, thermal expansion, enthalpy, and temperature are measured. The addition of the sound velocity measurement permits a more complete determination of the thermophysical properties of the liquid metal
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Weld evaluation on spherical pressure vessels using holographic interferometry
Waist welds on spherical experimental pressure vessels have been evaluated under pressure using holographic interferometry. A coincident viewing and illumination optical configuration coupled with a parabolic mirror was used so that the entire weld region could be examined with a single hologram. Positioning the pressure vessel at the focal point of the parabolic mirror provides a relatively undistorted 360 degree view of the waist weld. Double exposure and real time holography were used to obtain displacement information on the weld region. Results are compared with radiographic and ultrasonic inspections
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Materials testing using laser energy deposition
A convenient method for determining the elastic constants of materials has been devised using the energy from a Q-switched neodymium-glass laser. Stress waves are induced in materials having circular rod or rectangular bar geometries by the absorption of energy from the laser. The wave transit times through the material are recorded with a piezoelectric transducer. Both dilatation and shear wave velocities are determined in a single test using an ultrasonic technique and these velocities are used to calculate the elastic constants of the material. A comparison of the constants determined for ten common engineering materials using this method is made with constants derived using the conventional ultrasonic pulse technique and agreement is shown to be about one percent in most cases. Effects of material geometry are discussed and surface damage to the material caused by laser energy absorption is shown
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