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

Anticancer effect of polyunsaturated fatty acid extracts from sardine fishes on human cancer cell lines

290-294Cytotoxic activity of polyunsaturated fatty acid extracts from two species of fishes, Sardinella longiceps and Sardinella fimbriata, were examined and compared. Cell lines of MCF-7 (breast cancer) and DU-145 (prostate cancer) were used to analyze the cytotoxicity of the PUFA extracts. Both cell lines were subjected to MTT Assay with extracts at working concentrations of 100, 200, 400, 800, 1000 μg/ml. Both extracts showed significant cytotoxic effects against both cell lines and a peak cytotoxicity of 85-90% was apparent. IC-50 values were calculated from the graphs and it was found that S. longiceps extracts had a slightly lower IC-50 value indicating that it is more potent even at a lower concentration as compared to extracts from S. fimbriata.</i

Call performance studies on the ATM forum UNI signalling implementations

10.1016/S0140-3664(99)00049-3Computer Communications225463-469COCO

Measurement of arteriolar blood volume in brain tumors using MRI without exogenous contrast agent administration at 7T

Neuro Imaging Researc

Planktonic food web structure at SSTF and PF in the Indian sector of the Southern Ocean during austral summer 2011

This study aims to describe the planktonic food web structure with respect to phytoplankton biomass (chlorophyll a ) and prevailing environmental conditions at the South Subtropical Front (SSTF) and the Polar Front (PF) in the Indian sector of the Southern Ocean. Sampling was carried out at each front for 72 hrs, at 6-hr intervals, during the austral summer 2011. Considerable variations were observed in the hydrography between these two fronts. A strong temperature minimum layer was observed at the PF. Although the surface primary production and chlorophyll a values showed similar trends at both the fronts, the water column values of these parameters showed major disparities. The phytoplankton composition also revealed marked difference between the fronts. A deep chlorophyll maximum concordant with the upper limit of the temperature minimum layer was prominent at the PF. The microzooplankton abundance at the SSTF was twice as high as at the PF. The mesozooplankton biovolume and population density also showed considerable variations between these fronts. Noticeable diel variations were observed in the surface mesozooplankton biovolumes at both the fronts and the copepod Pleuromamma gracilis showed active diel vertical migration at SSTF. Both the grazing and senescence indices showed significant variations between these fronts, suggesting a disparity in the ecological efficiency of the two regions. The variability observed in the plankton community structure with respect to the hydrography and the biological components measured suggests that a multivorous food web at the SSTF and a conventional food web at the PF prevailed during the period of study

Planktonic food web structure at SSTF and PF in the Indian sector of the Southern Ocean during austral summer 2011

This study aims to describe the planktonic food web structure with respect to phytoplankton biomass (chlorophyll a) and prevailing environmental conditions at the South Subtropical Front (SSTF) and the Polar Front (PF) in the Indian sector of the Southern Ocean. Sampling was carried out at each front for 72 hrs, at 6-hr intervals, during the austral summer 2011. Considerable variations were observed in the hydrography between these two fronts. A strong temperature minimum layer was observed at the PF. Although the surface primary production and chlorophyll a values showed similar trends at both the fronts, the water column values of these parameters showed major disparities. The phytoplankton composition also revealed marked difference between the fronts. A deep chlorophyll maximum concordant with the upper limit of the temperature minimum layer was prominent at the PF. The microzooplankton abundance at the SSTF was twice as high as at the PF. The mesozooplankton biovolume and population density also showed considerable variations between these fronts. Noticeable diel variations were observed in the surface mesozooplankton biovolumes at both the fronts and the copepod Pleuromamma gracilis showed active diel vertical migration at SSTF. Both the grazing and senescence indices showed significant variations between these fronts, suggesting a disparity in the ecological efficiency of the two regions. The variability observed in the plankton community structure with respect to the hydrography and the biological components measured suggests that a multivorous food web at the SSTF and a conventional food web at the PF prevailed during the period of study

Not Available

Not AvailableThe book provides meticulous, yet concise descriptions of viral, bacterial, fungal, parasitic and non-infectious diseases in an exhaustive number of fish and shrimp species. The book is designed as a comprehensive guide to the identification and treatment of both common and rare problems encountered in culture conditions. It is based on the methods currently followed by fish pathologists and laboratories and also includes early prevention, detection and treatment. The chapters cover essential information on the basic principles of disease causation, major diseases of cultured fish and shrimp, and standard operating procedures for prevention, control, diagnosis, treatment and quarantine. Health certification forms the key element of such control measures.Not Availabl