Dimethyl fumarate in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Dimethyl fumarate (DMF) inhibits inflammasome-mediated inflammation and has been proposed as a treatment for patients hospitalised with COVID-19. This randomised, controlled, open-label platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing multiple treatments in patients hospitalised for COVID-19 (NCT04381936, ISRCTN50189673). In this assessment of DMF performed at 27 UK hospitals, adults were randomly allocated (1:1) to either usual standard of care alone or usual standard of care plus DMF. The primary outcome was clinical status on day 5 measured on a seven-point ordinal scale. Secondary outcomes were time to sustained improvement in clinical status, time to discharge, day 5 peripheral blood oxygenation, day 5 C-reactive protein, and improvement in day 10 clinical status. Between 2 March 2021 and 18 November 2021, 713 patients were enroled in the DMF evaluation, of whom 356 were randomly allocated to receive usual care plus DMF, and 357 to usual care alone. 95% of patients received corticosteroids as part of routine care. There was no evidence of a beneficial effect of DMF on clinical status at day 5 (common odds ratio of unfavourable outcome 1.12; 95% CI 0.86-1.47; p = 0.40). There was no significant effect of DMF on any secondary outcome

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Real-Time Collaborative Modeling across Language Workbenches - A Case on Jetbrains MPS and Eclipse Spoofax

Software tools known as language workbenches are used to define and deploy custom (domain-specific) languages for the purpose of modeling (specific parts) of a system of interest. Because system modeling is a practice that stands to benefit from real-time collaboration, technologies offering real-time collaborative mechanisms for language workbenches are starting to make an appearance. However, these collaboration technologies are generally limited to providing collaboration among clients of a single designated workbench. If the collaborating engineers wish to use different workbenches to work on the model, cross-platform support for collaborative modeling becomes a necessity. In this paper we propose Parsafix, a tool-based approach for achieving real-time collaboration between different language workbenches for users collaborating on models conforming to the same domain-specific language. We propose the main components and mechanisms that make up Parsafix, as well as the implementation of a prototype tool supporting those mechanisms. The prototype tool allows for collaboration between users of JetBrains MPS and Spoofax (within the Eclipse IDE), by making use of the IDEs' respective real-time collaboration technologies Modelix and Saros. A hands-on session is proposed to showcase the feasibility of having collaborative modeling across different language workbenches through Parsafix

The effect of Cicerfuran, an Arylbenzofuran from Cicer bijugum, and related Benzofurans and Stilbenes on Leishmania aethiopica, L. tropica and L. major

The effect of 3 arylbenzofurans and 7 stilbenes on the growth of Leishmania parasites and human monocytes was evaluated. Promastigotes from cultures of L. aethiopica, L. major and L. tropica were tested in the exponential phase of growth. All compounds were active at concentrations of 100 mu g/mL within 6 hours. The 2-hydroxylstibene showed activity at a concentration < 1 mu g/mL, with an LD50 of 3-5 mu g/mL after 48 hours of incubation. The most active compounds: cicerfuran, 2-hydroxy-2'-methyl4,5-methylenedioxystilbene, 2-hydroxy-2 -methoxy-4,5-methylenedioxystilbene and 2-hydroxystilbene had even stronger activity against the temperature-induced amastigotes of L. aethiopica, with the latter having the highest relative potency against all three species. Leishmanicidal activity seemed to be associated with the level of oxygen substitution in each compound. The ratio between leishmanicidal activity on promastigotes and toxicity to human cells suggested that the compounds could be considered as leishmanicidal drug leads