Background
With the lack of effective therapy, chemoprevention, and vaccination against SARS-CoV-2, focusing on the immediate repurposing of existing drugs gives hope of curbing the COVID-19 pandemic. A recent unbiased genomics-guided tracing of the SARS-CoV-2 targets in human cells identified vitamin D among the three top-scoring molecules manifesting potential infection mitigation patterns. Growing pre-clinical and epidemiological observational data support this assumption. We hypothesized that vitamin D supplementation may improve the prognosis of COVID-19. The aim of this trial is to compare the effect of a single oral high dose of cholecalciferol versus a single oral standard dose on all-cause 14-day mortality rate in COVID-19 older adults at higher risk of worsening.
Methods
The COVIT-TRIAL study is an open-label, multicenter, randomized controlled superiority trial. Patients aged ≥ 65 years with COVID-19 (diagnosed within the preceding 3 days with RT-PCR and/or chest CT scan) and at least one worsening risk factor at the time of inclusion (i.e., age ≥ 75 years, or SpO2 ≤ 94% in room air, or PaO2/FiO2 ≤ 300 mmHg), having no contraindications to vitamin D supplementation, and having received no vitamin D supplementation > 800 IU/day during the preceding month are recruited. Participants are randomized either to high-dose cholecalciferol (two 200,000 IU drinking vials at once on the day of inclusion) or to standard-dose cholecalciferol (one 50,000 IU drinking vial on the day of inclusion). Two hundred sixty participants are recruited and followed up for 28 days. The primary outcome measure is all-cause mortality within 14 days of inclusion. Secondary outcomes are the score changes on the World Health Organization Ordinal Scale for Clinical Improvement (OSCI) scale for COVID-19, and the between-group comparison of safety. These outcomes are assessed at baseline, day 14, and day 28, together with the serum concentrations of 25(OH)D, creatinine, calcium, and albumin at baseline and day 7.
Discussion
COVIT-TRIAL is to our knowledge the first randomized controlled trial testing the effect of vitamin D supplementation on the prognosis of COVID-19 in high-risk older patients. High-dose vitamin D supplementation may be an effective, well-tolerated, and easily and immediately accessible treatment for COVID-19, the incidence of which increases dramatically and for which there are currently no scientifically validated treatments.
Trial registration
ClinicalTrials.govNCT04344041. Registered on 14 April 2020
Trial status
Recruiting. Recruitment is expected to be completed in April 2021.
-We report the experimental observation of the bifurcation at the origin of localization of the deformation in a granular material submitted to uniaxial compression. We present a quantitative characterization of the heterogeneity in the strain field repartition allowing to evidence objectively the existence of a bifurcation initiating the shear bands formation process. We show that this bifurcation is supercritical and has no clear signature on the stress-strain curve. At the bifurcation, a symetry breaking occurs characterized by the emergence of a well-defined orientation corresponding to the Mohr-Coulomb angle. Yet, plasticity is still diffuse and the shear band extension is of the order of the sample width. While loading proceeds, the shear band narrows until it reaches, after the peak of the stress-strain curve, a stationary width.
We present a thorough study of the plastic response of a granular material progressively loaded. We study experimentally the evolution of the plastic field from a homogeneous one to a heterogeneous one and its fluctuations in terms of incremental strain. We show that the plastic field can be decomposed in two components evolving on two decoupled strain increment scales. We argue that the slowly varying part of the field can be identified with the so-called fluidity field introduced recently to interpret the rheological behavior of amorphous materials. This fluidity field progressively concentrates along a macroscopic direction corresponding to the Mohr-Coulomb angle.
<p class="Abstract">Accurate load forecasting helps stabilize the system by triggering the appropriate actions if needed such as planning for emergency dispatch and load switching for short-term solution and building or upgrading facilities for long-term solution. The Short Term Load Forecasting (STLF) provides information for utilities’ system planners so that they can come up with a short-term solution to protect the transmission and distribution systems and to better serve the customers. This article provides a way of accurately predicting one-hour-ahead load of a utility company located in the North America region (hereafter this utility will be referred to as NAUC) based on Adaptive Neuro-Fuzzy Inference System (ANFIS). The inputs to the ANFIS are the next-hour temperature, next-hour dew point, day of the week, hour of the day, and the current-hour load. The output is the next-hour load of the entire system. The ANFIS based method can accurately predict the next-hour load to an accuracy of 2.5%.</p>
Abstract. We present an experimental investigation of the formation of shear bands in a granular sample submitted to a biaxial test. Our principal result is the direct observation of the bifurcation at the origin of the localization process in the material. At the bifurcation, the shear band is spatially extended: we observe a breaking of symmetry without any sudden localization of the deformation in a narrow band. Our work thus allows to clearly distinguish different phenomena: bifurcation which is a ponctual event which occurs before the peak, localization which is a process that covers a range of deformation of several percents during which the peak occurs and finally stationary shear bands which are well-defined permanent structures that can be observed at the end of the localization process, after the peak.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.