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

Automatic Registration of Aerial Image and Digital Map for Detection of Earthquake Damaged Areas

Abstract. In this paper, we propose an automatic detection method of the areas damaged by an earthquake. We use aerial images that are taken before and after the earthquake. To detect the damaged areas, we register these two aerial images. It is difficult to register two aerial images by using only the image information, and hence, we use digital map for registering them. First each aerial image is registered to the digital map by using the perspective transformation. Then we detect damaged areas by computing the differences between the registered images. The damaged areas can be detected automatically and correctly by our method.

Simple Method for Preparing Superhydrophobic Paper: Spray-Deposited Hydrophobic Silica Nanoparticle Coatings Exhibit High Water-Repellency and Transparency

Superhydrophobic and transparent coatings are deposited onto paper by spraying alcohol suspensions of SiO₂ nanoparticles. Superhydrophobicity depends on the aggregation states of nanoparticles, which are determined by the type of alcohol used in the suspensions. The superhydrophobicity of the paper is maintained after touching the paper with a bare finger

Hard and Glossy-Colored Films Composed of Micropatterned Organic Dots and Electrodeposited Honeycomb-Shaped Nickel Walls

This paper proposes a novel approach for the preparation of colored films with a metallic luster and high hardness. The colored organic films were patterned as microdots by photolithography, and then honeycomb-shaped Ni walls were electrodeposited between the micropatterning. The organic/inorganic composite films showed the hardest grade in a pencil hardness test and high durability in wear resistance tests because the honeycomb-shaped Ni walls protected the colored organic dots

Simple Method for Preparing Superhydrophobic Paper: Spray-Deposited Hydrophobic Silica Nanoparticle Coatings Exhibit High Water-Repellency and Transparency

Superhydrophobic and transparent coatings are deposited onto paper by spraying alcohol suspensions of SiO₂ nanoparticles. Superhydrophobicity depends on the aggregation states of nanoparticles, which are determined by the type of alcohol used in the suspensions. The superhydrophobicity of the paper is maintained after touching the paper with a bare finger