Evaluation of patients treated by telemedicine in the beginning of the COVID-19 pandemic in São Paulo, Brazil: A non-randomized clinical trial preliminary study.

We performed a pilot open-label, non-randomized controlled clinical trial in a clinic in São Paulo, Brazil in the beginning of the COVID-19 pandemic. "This medical pilot project was carried out during the pandemic of a new and unknown agent. It was necessary to find a new and safe therapeutic approach for pathogens with high potential for severity and contamination. The repositioning of safe and accessible pre-existing and approved medications and the telemedicine approach improved treated covid patients' symptoms and reduced the risk of disease transmission. The emergency application of a new medical technology was the major limitation of the study. This innovative care model is a low-cost safe strategy, and we understand that applicability can be expanded to other regions in emergency situations." The 187 patients of the study (mean age of 37.6 ± 15,6 years) were divided into four groups: (1) asymptomatic, (2) mild symptoms, (3) moderate symptoms and (4) severe symptoms and were followed up for five days. A drug intervention was performed in group 3 and the patients of Group 4 were oriented to seek hospital care. Of all the patients, 23.0% were asymptomatic, 29.4% reported mild symptoms, 43.9% moderate symptoms and 3.7% severe symptoms. Three patients were hospitalized and discharged after recovery. Our results indicate that the use of telemedicine with diagnosis and drug treatment is a safe and effective strategy to reduce overload of health services and the exposure of healthcare providers and the population. The patients that initiated the treatment in the early stages of the disease presented satisfactory clinical response, reducing the need of face-to-face consultations and hospitalizations. The patients who followed the protocol treatment for COVID-19 with hydroxychloroquine and azithromycin for five days presented statistically significant improvement of clinical symptoms when compared to moderate patients who opted for not following the protocol (p < 0.05) and to all no treatment patients (p < 0.001).

Comparisons between the Neighboring States of Amazonas and Pará in Brazil in the Second Wave of COVID-19 Outbreak and a Possible Role of Early Ambulatory Treatment.

Brazil and many countries are now experiencing a second wave of the COVID-19 outbreak. The objective of this study is to compare results with statistical samples involving millions of people in the two largest neighboring states in Brazil, Amazonas and Pará, which in the first wave were similar but now show significant different results in combating COVID-19. During the first wave, in May 2020, the maximums of the 7-day average daily deaths per population of Amazonas and Pará were similar: 15.7 and 17.1 deaths per day per million people, respectively, which means a ratio 15.7/17.1 = 0.92 ≈ 1. Now, in the second wave of COVID-19 outbreak, Amazonas has entered a serious situation; meanwhile, Pará has presented a much smaller growth in the mortality. The accumulated mortality per population from 11 November 2020 to 15 March 2021 of Amazonas and Pará are 1645 and 296 deaths per million people, respectively. As 1645/296 = 5.55, Amazonas is presenting an accumulated mortality per population more than five times that of Pará. Future in-depth research can provide a grounded answer to explain this significant difference, nonetheless the explicit support of the Pará state government, after 21 May 2020, to early ambulatory treatment may have played some role on this result.

Production of high-purity cellulose, cellulose acetate and cellulose-silica composite from babassu coconut shells.

Lignocellulosic biomass has been widely studied as a source of cellulose- and related products, attracting the great interest of researchers dealing with renewable energy sources, vegetable waste recycling and biomaterials. In this work, the babassu coconut shells (epicarp and endocarp) were used for the achievement of products such as cellulose, cellulose acetate and cellulose-silica composite, which were chemically and structurally characterized by solid-state 13C nuclear magnetic resonance spectroscopy and scanning electron microscopy, among other techniques. As this precursor also naturally contains a significant amount of silica, a composite containing cellulose fibers mixed with amorphous silica particles (with rosette-like shape) was also produced. Finally, the possibility of synthesis of cellulose acetate was also demonstrated, illustrating the plethora of potential applications of this important lignocellulosic residue for the production of cellulose-based materials of high technological interest.

Recovery of latent fingermarks from brass cartridge cases: Evaluation of developers, analysis of surfaces and internal ballistic effects.

A study was undertaken wherein different fingermark developers were evaluated for the recovery of fingermarks from brass cartridge cases, besides the evaluation of factors such as firing effects and surface characterization of the cases. The latent fingermarks on α-brass plates, fired and unfired cartridge cases were deposited and aged for 1-14days before development with different developers. In order to mimic the fired cartridge case conditions, the brass plates were heated and examined at room temperature (RT), at 63 and at 200°C. The sequential treatment with cyanoacrylate, gun blue and fluorescent dye has been found to be the best among other developers for the recovery of latent fingermarks on brass surfaces including fired and unfired cartridge cases. Cartridge cases and other brass surfaces were also analyzed by surface characterization methods, including X-ray diffraction, scanning electronic microscopy, energy dispersive X-ray spectroscopy and metallographic examination. The tested surfaces correspond to α-phase brass Cu0.7Zn0.3 composition and have shown different surface morphologies (such as grain structure) and different levels of oxidation, even for cartridge cases obtained from the same batch. Due to this, the effectiveness of a given reagent for a specific brass surface is uncertain. Therefore, the application of the entire tested sequence of developers is strongly recommended. Further, the effects of firing on fingermarks on cartridge cases were examined, and the results indicated that the blowback of hot gases through the looseness between cartridge case and chamber wall of the firearm is the main cause responsible for deterioration of fingermarks during firing. Despite the recognized damage caused to fingermarks by the firing effects, good quality fingermarks were recovered from fired cartridge cases in which full fingermarks were intentionally deposited prior to firing. This indicates that the handling of the cartridges before and during the loading of the gun may have a strong influence on the quantity and quality of fingermarks, and that the firing itself is not the main responsible factor for the absence or low quality of fingermarks, as frequently reported in fired cartridge cases studies.

Comparison of practical techniques to develop latent fingermarks on fired and unfired cartridge cases.

We have tested some widely used and practical fingermark enhancement techniques such as powdering (regular powder dusting and magnetic powder application), cyanoacrylate fuming, fluorescent dying (basic yellow 40), gun blueing solutions and acidified hydrogen peroxide solutions. The results were evaluated and compared in order to establish best procedures on processing cartridge cases. The tests were performed on brass discs subjected to three different temperatures (room temperature, 63 and 200°C), and on fired and unfired cartridge cases. All the samples were processed after three different periods of time (24h, 7 days and 14 days) after deposition. The best results for both fired and unfired cartridge cases were obtained by the sequential application of cyanoacrylate, gun blueing solution and basic yellow 40. Some stages of the firing process were isolated in order to identify their effects over the final amount and quality of the remaining latent fingermarks on cartridge cases. Good state fingermarks were developed on unfired cartridge cases cycled through the gun, showing that friction inside the gun without firing does not cause significant damage to the fingermarks. On the other hand, fired cartridge cases are significantly affected by the firing effects, exhibiting low quality ridge details which are mainly located next to base. An unexpected phenomenon was observed on most of the brass discs heated to 200°C and developed with gun blueing solutions; they presented a reverse development compared to the expected one, with darkening of the ridges instead of the background.

A multiple-field (23)Na NMR study of sodium species in porous carbons.

The sodium environments in porous carbon materials prepared from NaOH activation of a char were investigated by means of multiple-field solid-state (23)Na NMR measurements, carried out at magnetic fields of 4.7, 8.45 and 14.1T, with single-pulse excitation and magic angle spinning (MAS). The recorded spectra showed a relatively featureless resonance with linewidth and peak shift strongly dependent on the magnetic field strength and on the hydration level of the samples. The existence of second-order quadrupolar effects was inferred, although the structural disorder and the mobile character associated with the Na environment precluded the direct observation of typical quadrupolar features in the MAS NMR spectra. The analysis of the spectra collected at multiple magnetic fields yielded the values of -2.8ppm for the isotropic chemical shift and 1.8MHz for the quadrupole coupling constant, which were interpreted as due to Na(+) ions bonded to oxygenated groups at the edges of the graphene planes within the carbon pore network.