Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Chitosan sodium benzoate complex as a hydrocolloid and its application for nutraceuticals

Hydrocolloids have been a potential use in food, nutraceuticals, and pharmaceuticals for their viscoelastic properties, such as thickening and gelling. The increasing demand for nutraceuticals and pharmaceuticals has led to the development of new hydrocolloids. Chitosan has been investigated for pharmaceutical excipient, drug delivery agent, and food applications could be a potential hydrocolloid. This study focuses on the physiochemical characterization of chitosan- sodium benzoate hydrocolloid using Fourier Transform Infrared Spectroscopy (FTIR), X-Ray Diffraction (XRD), Differential Scanning Calorimetry (DSC), and Thermogravimetric Analysis (TGA). From FTIR and XRD, evident changes were observed in the structure and crystallinity of chitosan- sodium benzoate from chitosan, sodium benzoate, and physical mixture. The thermal decomposition temperatures and weight losses were analyzed using DSC and TGA. In addition to that, antibacterial and antioxidant assays were evaluated

Chitosan sodium benzoate complex as a hydrocolloid and its application for nutraceuticals

Hydrocolloids have been a potential use in food, nutraceuticals, and pharmaceuticals for their viscoelastic properties, such as thickening and gelling. The increasing demand for nutraceuticals and pharmaceuticals has led to the development of new hydrocolloids. Chitosan has been investigated for pharmaceutical excipient, drug delivery agent, and food applications could be a potential hydrocolloid. This study focuses on the physiochemical characterization of chitosan- sodium benzoate hydrocolloid using Fourier Transform Infrared Spectroscopy (FTIR), X-Ray Diffraction (XRD), Differential Scanning Calorimetry (DSC), and Thermogravimetric Analysis (TGA). From FTIR and XRD, evident changes were observed in the structure and crystallinity of chitosan- sodium benzoate from chitosan, sodium benzoate, and physical mixture. The thermal decomposition temperatures and weight losses were analyzed using DSC and TGA. In addition to that, antibacterial and antioxidant assays were evaluated.</jats:p

On-off attack detection in trust model using intra-daily variability for the IoT

The growth of the internet of things (IoT) increases the need to develop the trust computational model for heterogeneous networks with various IoT devices. Trust models are considered as an effective tool to mitigate insider attacks induced by IoT devices. However, trust models are exposed to on-off attacks, in which devices randomly exhibit good and bad behaviors to avoid being categorized as low-trust devices. The objective of this work is to recognize the malicious devices executing on-off attacks in IoT applications. This paper introduces an on-off attack detection strategy for the trust computational model based on the non-parametric index named intra-daily variability (IV). IV indicates trust fragmentation which depends on the frequency and the transitions between periods of low and high trust values of a device. The higher value of IV indicates the occurrence of fragmented trust values and the lower value of IV indicates the occurrence of non-fragmented trust values. Experimental results show that the proposed model outperforms the baseline methods by increasing the on-off attack detection rate

Impact of Milk and Milk Product of Tamil Nadu

Sampling and analysis occur along the milk processing train: from collection at farm level, to intake at the diary plant, the processing steps, and the end products. Milk has a short shelf life; however, products such as milk powders have allowed a global industry to be developed. Quality control tests are vital to support activities for hygiene and food standards to meet regulatory and customer demands. Multiples of chemical and microbiological contamination tests are undertaken. Hazard analysis testing strategies are necessary, but some tests may be redundant; it is therefore vital to identify product optimization quality control strategies. The time taken to undergo testing and turnaround time are rarely measured. The dairy industry is a traditional industry with a low margin commodity. Industry 4.0 vision for dairy manufacturing is to introduce the aspects of operational excellence and implementation of information and communications technologies. The dairy industries’ reply to Industry 4.0 is represented predominantly by proactive maintenance and optimization of production and logistical chains, such as robotic milking machines and processing and packaging line automation reinforced by sensors for rapid chemical and microbial analysis with improved and real-time data management. This chapter reviews the processing trains with suggestions for improved optimization.</jats:p

Isolation of bacterial strains possessing nitrogen-fixation, phosphate and potassium-solubilization and their inoculation effects on sugarcane

161-170Inorganic nitrogen (N), phosphate (P) and potash (K) are the most influencing macro-nutrients for plant growth and microbial supplementation of these minerals through N2-fixation, P- and K-solubilization is gaining importance. In the present study, a macronutrient deficient (MD), N-free novel medium, supplemented with tri calcium phosphate (TCP as P- source) and Mica (as K- source) was used for isolation of microbes possessing nitrogen fixing, P- &amp; K solubilizing abilities. Samples of rhizosphere and non-rhizosphere soils, roots and leaves of sugarcane varieties (viz., Co 6304, Co 86032 and CoC 671) collected from Tamil Nadu, India were used for isolation. Totally, 8 individual nitrogen-fixing, phosphate- and potash-solubilizing bacterial strains were obtained. Nitrogen-fixing abilities of these isolates were confirmed by analyzing acetylene reduction (AR) activity and the presence of nif genes. P- and K- solubilizing activities were confirmed by cultivating these isolates in solid/liquid medium supplemented with insoluble forms of P and K. These isolates which produced growth hormone IAA, were in two groups as Roseateles terrae and Burkholderia gladioli, respectively based on the morphological, physiological, biochemical and 16S rDNA gene sequence analysis. Association between diazotrophic, P- and K-solubilizing R. terrae and B. gladioli with sugarcane has not been reported earlier. These isolates were tested for their growth-promoting abilities in sugarcane cultivated in pots, and the results showed that these isolates were able to increase the leaf chlorophyll, N content and total biomass. This study may encourage farmers to use single microbe for microbial supplementation of N, P and K instead of consortium of microbes wherein the compatibility between different microbes is often compromised