Lifeboat Foundation

Findings In this bayesian randomized clinical trial that included 403 patients and was stopped early after results from another trial were released, treatment with a 7-day fixed-dose course of hydrocortisone or shock-dependent dosing of hydrocortisone, compared with no hydrocortisone, resulted in 93% and 80% probabilities of superiority, respectively, with regard to the odds of improvement in organ support–free days within 21 days.

Objective To determine whether hydrocortisone improves outcome for patients with severe COVID-19.

Design, Setting, and Participants An ongoing adaptive platform trial testing multiple interventions within multiple therapeutic domains, for example, antiviral agents, corticosteroids, or immunoglobulin. Between March 9 and June 17, 2020, 614 adult patients with suspected or confirmed COVID-19 were enrolled and randomized within at least 1 domain following admission to an intensive care unit (ICU) for respiratory or cardiovascular organ support at 121 sites in 8 countries. Of these, 403 were randomized to open-label interventions within the corticosteroid domain. The domain was halted after results from another trial were released. Follow-up ended August 12, 2020.

Continue reading “Effect of Hydrocortisone on Mortality and Organ Support in Patients With Severe COVID-19: The REMAP-CAP COVID-19 Corticosteroid Domain Randomized Clinical Trial” »

A new report claims to have the scoop on Chevrolet’s in-development high-performance off-road pickup, which could be called ZR2 instead of ZRX.

Providence, R.I. — The federal government has told states to prepare for a coronavirus vaccine to be ready to distribute by Nov. 1.

The timeline raised concern among public health experts about an “October surprise” — a vaccine approval driven by political considerations ahead of a presidential election, rather than science.

In a letter to governors dated Aug. 27, Robert Redfield, director of the U.S. Centers for Disease Control and Prevention, said states “in the near future” will receive permit applications from McKesson Corp., which has contracted with CDC to distribute vaccines to places including state and local health departments and hospitals.

Medical experts say coronavirus COVID-19 and Ebola outbreaks show that robotic medicine can help fight infectious disease, but the goal needs to be applications in everyday health care.

When we came out of the financial crisis of 2008, cloud computing kicked into high gear and started to become a pervasive, transformational technology. The current COVID-19 crisis could provide a similar inflection point for AI applications. While the implications of AI continue to be debated on the world stage, the rapid onset of a global health crisis and concomitant recession will accelerate its impact.

Times of crisis bring rapid change. Efforts to harness AI technologies to discover new drugs – either vaccine or treatment – have kicked into hyperdrive. Startups are racing to find solutions and established companies are forming partnerships with academia to find a cure. Other companies are researching existing drugs for their potential applicability. AI is proving a useful tool for dramatically reducing the time needed to identify potential drug candidates, possibly saving years of research. AI uses already put into action are screening for COVID-19 symptoms, decision support for CT scans, and automating hospital operations. A variety of healthcare functions have started to be performed by robots, from diagnosis to temperature monitoring.

Whatever the new normal becomes in the aftermath of the current crisis, it’s apparent that AI will be an even larger part of the technology landscape going forward — and not only for healthcare.

As the coronavirus spreads around the world, the urgency of being able to scale up a vaccine is even more critical.

Delays in production can occur at any point in time, from timely receipt and testing of raw materials, to characterization of the drug substance, to quality testing and release.

Automation technologies can help both speed up the manufacturing process and make the process safer and more efficient by reducing manual errors.

Authorities in Spain have invested in robots to automate the testing of citizens for the Covid-19 coronavirus.

Using the spin precession of Bose-condensed 87Rb atoms as a clock, direct measurements are made of the time required for Rb atoms to quantum tunnel through a classically impenetrable barrier.

The brain is an inherently dynamic system, and much work has focused on the ability to modify neural activity through both local perturbations and changes in the function of global network ensembles. Network controllability is a recent concept in network neuroscience that purports to predict the influence of individual cortical sites on global network states and state changes, thereby creating a unifying account of local influences on global brain dynamics. While this notion is accepted in engineering science, it is subject to ongoing debates in neuroscience as empirical evidence linking network controllability to brain activity and human behavior remains scarce. Here, we present an integrated set of multimodal brain–behavior relationships derived from fMRI, diffusion tensor imaging, and online repetitive transcranial magnetic stimulation (rTMS) applied during an individually calibrated working memory task performed by individuals of both sexes. The modes describing the structural network system dynamics showed direct relationships to brain activity associated with task difficulty, with difficult-to-reach modes contributing to functional brain states in the hard task condition. Modal controllability (a measure quantifying the contribution of difficult-to-reach modes) at the stimulated site predicted both fMRI activations associated with increasing task difficulty and rTMS benefits on task performance. Furthermore, fMRI explained 64% of the variance between modal controllability and the working memory benefit associated with 5 Hz online rTMS. These results therefore provide evidence toward the functional validity of network control theory, and outline a clear technique for integrating structural network topology and functional activity to predict the influence of stimulation on subsequent behavior.

SIGNIFICANCE STATEMENT The network controllability concept proposes that specific cortical nodes are able to steer the brain into certain physiological states. By applying external perturbation to these control nodes, it is theorized that brain stimulation is able to selectively target difficult-to-reach states, potentially aiding processing and improving performance on cognitive tasks. The current study used rTMS and fMRI during a working memory task to test this hypothesis. We demonstrate that network controllability correlates with fMRI modulation because of working memory load and with the behavioral improvements that result from a multivisit intervention using 5 Hz rTMS. This study demonstrates the validity of network controllability and offers a new targeting approach to improve efficacy.