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

A simple automated system for hall effect measurements

This project deals with the development of a computer interfacing technique for the study of Hall effect. A stepper motor with resolution of 0.1 mm was used to move a pair of permanent magnet backward and forward against the sample. The General Purpose Interface Bus (GPIB) card together with a digital nanovoltmeter and teslameter using serial port siri RS232, interface were used to measure the potential difference and magnetic field strength, respectively. Hall effect for YBa2Cu3-xTixO7-δ system (x=0.00, 0.01, 0.03 and 0.05) showed positive sign Hall coefficient showing that the material is a hole type carrier at room temperature. Parameters such as Hall coefficient and charge carrier concentration were also display on the front panel of Lab View programmin

Optical properties of lithium borate glass (Li2O)x (B2O3)1-x

A series of (Li2O)x(B2O3)1-x has been synthesized with mole fraction x=0.10, 0.15,0.20,0.25 and 0.30 mol% using melt quenching method. The structure of the glass system was determined by FTIR and X-ray diffraction. The density and molar volume were determined and the density increases with Li2O content whereas molar volume decreases with Li2O. Refractive index of glass samples were measured by ellipsometer. Refractive index increases with increase of Li2O. The absorption spectra of the studied glass showed that position of fundamental absorption edge shifts to longer wavelength with Li2O. Optical band gap varies from 0.10 to 2.22 eV and Urbach energy varies from 2.91 to 1.55 eV. The variation in optical band gap and Urbach energy were due to the variation in the glass structure

The 2nd aic Unsyiah and 8th IMT-GT uninet biosciences conference 2012

xi, 445 hlm. : ilus. ; tab. ; 28 cm

Examinations of mechanical, and shielding properties of CeO2 reinforced B2O3–ZnF2–Er2O3–ZnO glasses for gamma-ray shield and neutron applications

The glass system 75B2O3 - 4.5ZnF2 – 0.5 Er2O3–(20−x) ZnO- x CeO2, x = (0 ≤ x ≤ 1 mol. %) was manufactured using a melt quenching process, with CeO2 substituted for ZnO in the glass matrix in concentrations ranging from 0 to 1 mol %. The Makishima–Mackenzie model and sound wave velocity measurements were used to evaluate the mechanical parameters and elastic characteristics of the examined glass system, respectively. The results showed that increasing CeO2 doping ratio from 0 to 1 mol% increased density, sound velocities, elastic properties, and microhardness from 5.80 to 9.01 GPa. Phy-X/PSD software was employed to assess the effect of replacing ZnO with CeO2 on shielding capacity. The obtained results revealed that replacing ZnO with CeO2 enhances shielding characteristics and the manufactured glass may be useful in shielding applications

High prevalence of toxigenic and nontoxigenic clostridium difficile strains in Malaysia

Accumulating evidence shows a high prevalence of Clostridium difficile in Southeast Asia associated with a range of clinical presentations. However, severe infections are rarely reported. We investigated C. difficile infection (CDI) across four hospitals in Kuala Lumpur and Kota Bharu, Malaysia. Enzyme immunoassays for glutamate dehydrogenase (GDH) and toxin A or B were performed on diarrheal stool specimens collected from patients in 2015 and 2016. Specimens were also cultured and isolates of C. difficile characterized by PCR ribotyping and detection of toxin genes. In total, 437 specimens were collected and fecal toxin was detected in 3.0%. A further 16.2% of specimens were GDH positive and toxin negative. After culture, toxigenic strains were isolated from 10.3% and nontoxigenic strains from 12.4% of specimens. The most prevalent PCR ribotypes (RTs) were RT 017 (20.0%) and RT 043 (10.0%). The high prevalence of RT 017 and nontoxigenic strains in Malaysia and in neighboring Thailand and Indonesia suggests that they localize to the region of Southeast Asia, with an implication that they may mediate the burden of CDI in the region