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

Developing an analytical framework for estimating food security indicators in the United Arab Emirates: A review

Rapid population growth, climate change, limited natural resources, and the COVID-19 pandemic contribute to increased global hunger, necessitating intensive efforts to ensure food security and nutrition (FSN). Previous FSN approaches covered some dimensions, but not all, resulting in significant gaps in food security indicators. The Gulf Cooperation Council (GCC) and the Middle East and North Africa (MENA) regions have received less attention in food security studies, thus far necessitating considerable effort to develop an appropriate analytical framework. This study reviewed articles and international reports of FSN indicators, drivers and policies, methods, and models and extracted the challenges and gaps from the global and UAE contexts. The UAE and the world have gaps in FSN drivers, indicators, and methods, necessitating potential solutions to meet future challenges such as rapid population growth, pandemics, and limited natural resources. As a result, we created a newly developed analytical framework that addresses the shortcomings of previous approaches such as sustainable food systems developed by FAO and the Global Food Security Index (GFSI) and covers all aspects of food security. Gaps in knowledge in FSN drivers and policies, indicators, big data, methods, and models were considered in the developed framework, which has specific advantages. The novel developed framework addresses all food security dimensions (access, availability, stability, and utilization), ensuring poverty reduction, food security, and nutrition security while outperforming previous approaches (i.e., FAO and GFSI). The developed framework could be used successfully not only in the UAE and MENA, but also, globally, helping to solve food insecurity and malnutrition for future generations. The scientific community and policymakers should disseminate such solutions to address global food insecurity and ensure nutrition for future generations in the face of rapid population growth, limited natural resources, climate change, and spreading pandemics

Development of smart energy monitoring using NB-IOT and cloud

IoT-based applications are growing in popularity nowadays because they offer effective answers to numerous current problems. In this research, With the aim of decreasing human efforts for monitoring the power units and increasing users' knowledge of excessive electricity usage, an IoT-based electric metre surveillance system utilising an Android platform has been developed. With the help of an Arduino Uno and an optical sensor, the electric analyser pulse is captured. To reduce human mistake and the expense of energy usage, a low-cost wireless network of sensors for digital energy metres is implemented alongside a smartphone application that can autonomously read the metre of the unit. In this research, an intelligent power monitoring system with effective communication modules has been developed to make wise use of the electricity. The controller, NB-IoT connection module, and cloud are the three main components of an IOT-based smart energy metre system. The controller is essential for maintaining the functionality of each component. This solution reduces the need for human involvement in electricity maintenance by connecting energy metres to the cloud using an NB-IoT communication module. The IoT-based metre reading system in the proposed work is created to monitor and analyse the metre reading, and the service provider can cut off the source of electricity whenever the customer fails to pay the monthly bill. It also eliminates the need for human intervention, provides accurate metre reading, and guards against billing errors. The proposed SPM improves the overall accuracy ranges of 7.42, 27.83, and 20% better than DR, OREM, and SLN respectively

A Note on Pushdown Automata Systems

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