Efficacy of the TMPRSS2 inhibitor camostat mesilate in patients hospitalized with Covid-19-a double-blind randomized controlled trial.

BACKGROUND: The trans-membrane protease serine 2 (TMPRSS2) is essential for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) cell entry and infection. Efficacy and safety of TMPRSS2 inhibitors in patients with coronavirus disease 2019 (Covid-19) have not been evaluated in randomized trials. METHODS: We conducted an investigator-initiated, double-blind, randomized, placebo-controlled multicenter trial in patients hospitalized with confirmed SARS-CoV-2 infection from April 4, to December 31, 2020. Within 48 h of admission, participants were randomly assigned in a 2:1 ratio to receive the TMPRSS2 inhibitor camostat mesilate 200 mg three times daily for 5 days or placebo. The primary outcome was time to discharge or clinical improvement measured as ≥2 points improvement on a 7-point ordinal scale. Other outcomes included 30-day mortality, safety and change in oropharyngeal viral load. FINDINGS: 137 patients were assigned to receive camostat mesilate and 68 to placebo. Median time to clinical improvement was 5 days (interquartile range [IQR], 3 to 7) in the camostat group and 5 days (IQR, 2 to 10) in the placebo group (P = 0·31). The hazard ratio for 30-day mortality in the camostat compared with the placebo group was 0·82 (95% confidence interval [CI], 0·24 to 2·79; P = 0·75). The frequency of adverse events was similar in the two groups. Median change in viral load from baseline to day 5 in the camostat group was -0·22 log10 copies/mL (p <0·05) and -0·82 log10 in the placebo group (P <0·05). INTERPRETATION: Under this protocol, camostat mesilate treatment was not associated with increased adverse events during hospitalization for Covid-19 and did not affect time to clinical improvement, progression to ICU admission or mortality. ClinicalTrials.gov Identifier: NCT04321096. EudraCT Number: 2020-001200-42.

[Christmas article: Possible link between face mask position and touching of face].

INTRODUCTION: The author of this original article has noted, that some face masks are only covering the chin, and these masks are touched infrequently. In the study, it has been investigated, if users of chin masks touch their face less than users of mouth or mouth-and-nose masks. METHODS: Ten waiters in cafés have been observed for half an hour each, and the numbers of face or mask touching have been registered. RESULTS: The study found three persons, who mainly used chin masks and touched the face rarely. CONCLUSION: Due to a limited number of observations, the result was not significant. FUNDING: none. TRIAL REGISTRATION: none.

Modeling of received signals from annular array ultrasound transducers due to extended reflectors.

This paper describes a computationally efficient numerical technique for calculating the received signal from a broadband annular array transducer operating in pulse-echo mode, due to a specified reflector. The technique is referred to as the Diffraction Response from Extended Area Method (DREAM) and operates by tessellating the reflector into planar tiles with a dimension of several wavelengths (at the highest frequency of interest) and finding the contribution from a given tile by a temporal low-pass filtering rather than spatial integration. In particular, this paper formulates the theory for the DREAM for tessellation into triangular tiles and demonstrates the improved performance with triangular tiles relative to square tiles. This paper also analyzes the mean square error of the received signal as a function of the diameters of the transmitting and the receiving transducers and the radial position and orientation of the tile. Based on this, a set of rules for the optimal tile size is developed. The power of the modeling technique is demonstrated by calculating the received signal from an annular array transducer due to three given extended reflectors in which the effect of the focal point location on the received signal is readily demonstrated.