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

SummaryBackground Azithromycin has been proposed as a treatment for COVID-19 on the basis of its immunomodulatoryactions. We aimed to evaluate the safety and efficacy of azithromycin in patients admitted to hospital with COVID-19.Methods In this randomised, controlled, open-label, adaptive platform trial (Randomised Evaluation of COVID-19Therapy [RECOVERY]), several possible treatments were compared with usual care in patients admitted to hospitalwith COVID-19 in the UK. The trial is underway at 176 hospitals in the UK. Eligible and consenting patients wererandomly allocated to either usual standard of care alone or usual standard of care plus azithromycin 500 mg once perday by mouth or intravenously for 10 days or until discharge (or allocation to one of the other RECOVERY treatmentgroups). Patients were assigned via web-based simple (unstratified) randomisation with allocation concealment andwere twice as likely to be randomly assigned to usual care than to any of the active treatment groups. Participants andlocal study staff were not masked to the allocated treatment, but all others involved in the trial were masked to theoutcome data during the trial. The primary outcome was 28-day all-cause mortality, assessed in the intention-to-treatpopulation. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936.Findings Between April 7 and Nov 27, 2020, of 16 442 patients enrolled in the RECOVERY trial, 9433 (57%) wereeligible and 7763 were included in the assessment of azithromycin. The mean age of these study participants was65·3 years (SD 15·7) and approximately a third were women (2944 [38%] of 7763). 2582 patients were randomlyallocated to receive azithromycin and 5181 patients were randomly allocated to usual care alone. Overall,561 (22%) patients allocated to azithromycin and 1162 (22%) patients allocated to usual care died within 28 days(rate ratio 0·97, 95% CI 0·87–1·07; p=0·50). No significant difference was seen in duration of hospital stay (median10 days [IQR 5 to >28] vs 11 days [5 to >28]) or the proportion of patients discharged from hospital alive within 28 days(rate ratio 1·04, 95% CI 0·98–1·10; p=0·19). Among those not on invasive mechanical ventilation at baseline, nosignificant difference was seen in the proportion meeting the composite endpoint of invasive mechanical ventilationor death (risk ratio 0·95, 95% CI 0·87–1·03; p=0·24).Interpretation In patients admitted to hospital with COVID-19, azithromycin did not improve survival or otherprespecified clinical outcomes. Azithromycin use in patients admitted to hospital with COVID-19 should be restrictedto patients in whom there is a clear antimicrobial indication

Air Pollution Tolerance Index for Selected Species of Plants in Roadside Highways at Allahabad, Uttar Pradesh, India

In recent years air pollution is one of the biggest problems in the world. Owing to the transboundary dispersion of contaminants around the world, air pollution has its own peculiarities. In a much planned urban setup industrial pollution takes a backseat and cooler admission takes the president's as the major cause of urban air pollution in the present investigation your pollution torrents index was calculated for various plant species growing around the Allahabad Highway. Five plants available commonly in all locations were selected for the present research namely Azadirachta indica (Neem), Delonix regia (Gulmohar), Saraca asoca (Ashok), Ficus benghalensis (Bargad), Ficus religiosa (Pepal). Using normal procedures, ascorbic acid, leaf extract pH, overall chlorophyll, relative water content and air quality tolerance index were analysed. Both plants tested in both areas have been shown to be pollution-sensitive, varying from 02.29 to 12.53. No pollution tolerant organisms studied were found. The maximum value of pH was 7.8 found in Neem tree spp. (Azadirachta indica) in Rewa Road (NH-35) and the minimum value of pH was 5.9 found in Gulmohar tree spp. (Delonix regia) in Varanasi Road (NH-19), The maximum value of RWC (89.99 %) found in Ashok tree spp. (Saraca asoca) and the minimum value of RWC (58.64 %) found in Neem tree spp. (Azadirachta indica) in Mirzapur Road site (NH-76). The maximum value of Total Chlorophyll Content was 1.55 mg/g found in Ashok tree spp. (Saraca asoca) in Mirzapur Road (NH-76) and the minimum value of Total Chlorophyll Content was 0.71 mg/g found in Bargad tree spp. (Ficus benghalensis) in Control Site and Rewa Road (NH-35). The maximum value of Ascorbic Acid (1.07 mg/g) found in Ashok tree spp. (Saraca asoca) in Rewa Road site (NH-35) and the minimum value of Ascorbic Acid (0.39 mg/g) found in Pepal tree spp. (Ficus religiosa) in Mirzapur Road site (NH-76) The variance may be due to alternative biochemical parameters being reflected. Plant can filter the air through aerial elements especially through their twigs stem leaves air pollution management is the better manage by the afforestation program. Air pollution tolerance index (APTI) is an intrinsic quality of tree to control air pollution problem which is currently of major concern of local urban locality. The trees having higher tolerance index rate or tolerant towards air pollution and can be used as a major component to reduce air pollution whereas the tree having less tolerance index can be an indicator to know the rate of air pollution. Hence, it is essential to protect the plants

Application of remote sensing-based spectral variability hypothesis to improve tree diversity estimation of seasonal tropical forest considering phenological variations

Global decline in biodiversity warrants its systematic monitoring in space and time. Remote sensing derived Rao’s Q index has been proposed as a proxy for species diversity yet its scope for seasonal tropical forest is untested. The study assessed the influence of phenology on Rao’s Q index derived using multi-date Sentinel-2 NDVI to estimate tree diversity. Plot level vegetation inventory data (n = 61) was used to estimate tree diversity (Shannon-Wiener index (H')) of Nandhaur landscape in North-West Himalayan foothills. Rao’s Q index and H' showed lower correlation at the landscape level than individual forest types. Rao’s Q index based on NDVI observed higher correlation with H', especially during the leaf flushing period. NDVI-based multi-dimensional Rao’s Q index offered better performance for dry deciduous (R2 =0.69) followed by moist deciduous forest. The present approach can be used for estimating tree diversity, especially in seasonal tropical forests