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

The ecology of black files (Diptera: Simuliidae) in the Scottish Highlands in relation to control

SIGLEAvailable from British Library Document Supply Centre- DSC:DX171426 / BLDSC - British Library Document Supply CentreGBUnited Kingdo

Exsudação radicular de glyphosate por Brachiaria decumbens e seus efeitos em plantas de eucalipto Radicular exudation of glyphosate by Brachiaria decumbens and its effects on eucalypt plant

Plantas de eucalipto com sintomas de intoxicação por glyphosate são comuns em áreas em que esse herbicida é usado. Uma das possíveis formas de contato com glyphosate é por meio da exsudação radicular do produto, por plantas daninhas tratadas, e subseqüente absorção pelas plantas de eucalipto. Objetivou-se com este trabalho avaliar a exsudação de glyphosate por Brachiaria decumbens e seus efeitos sobre plantas de eucalipto, por meio da aplicação de 14C-glyphosate misturado à calda de pulverização do produto comercial. Mudas de dois clones de eucalipto (UFV05 e UFV06) foram cultivadas em consórcio com Brachiaria decumbens (capim-braquiária), em vasos contendo dois tipos de solo: um arenoso e outro argiloso. Aos 35 dias após o transplantio das mudas, foram aplicados na braquiária 50 µL da mistura de 14C-glyphosate com a formulação comercial de glyphosate Scout®, utilizando-se uma microsseringa de precisão. Aos 2, 8, 16 e 24 dias após aplicação, as plantas de eucalipto foram coletadas e fracionadas em ápice primário, ápices secundários, folhas e raízes, sendo processadas de acordo com metodologia usual para determinação da radioatividade. Não foram observados sintomas de intoxicação por glyphosate nas plantas de eucalipto, em nenhuma das avaliações realizadas. Entretanto, o 14C-glyphosate foi encontrado em todas as plantas de eucalipto avaliadas, independentemente do solo, do clone e da época de avaliação, em maior concentração em plantas cultivadas no solo arenoso. Os resultados evidenciam a exsudação radicular do glyphosate e/ou de seus metabólitos pela braquiária e subseqüente absorção, via raízes, pelas plantas de eucalipto, em concentrações inferiores às necessárias para causar intoxicação na cultura.<br>Eucalypt plants commonly present symptoms of intoxication in areas where glyphosate is used. One possible way of contamination is through radicular exudation of glyphosate by the treated weed and later, plant absorption. This study aimed to evaluate glyphosate exudation by Brachiaria decumbens and its effects on eucalypt plants when 14C-glyphosate, mixed to the solution of the commercial product Scout® was applied. Seedlings of two eucalypt clones (UFV05 and UFV06) were cultivated in pots, intercropped with Brachiaria decumbens, on two types of soil (clayey and sandy). At 35 days after transplantation, 50 µL of the mixture was applied on brachiaria by using a precision micro-syringe. After application, 2, 8, 16 and 24 days, samples of eucalypt plants were collected and fractioned in the primary apices, secondary apices, leaves and roots, following the usual methodology to determine radioactivity. Symptoms of intoxication were not observed in any eucalypt plant evaluation. However, 14C-glyphosate was found in all plants, regardless of the soil type, clone or evaluation time, with the highest concentration being found in the sandy soil. Results show radicular exudation of glyphosate by B. decumbens and its absorption by eucalypt plants through roots. However, concentrations lower than necessary may cause crop intoxication