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 critical analysis of decision support systems research revisited: the rise of design science

In 2005 the Journal of Information Technology article ‘A critical analysis of decision support systems research’ analyzed 1020 decision support systems (DSS) articles from 1990 to 2003. Since 2003 business intelligence (BI) and business analytics have gained popularity in practice. In theory and research the period since 2003 has seen a change in the decision-making theory orthodoxy and the codification and acceptance of design science. To investigate the changes in the DSS field, a number of expectations were derived from previous literature analyses. These expectations were assessed using bibliometric content analysis. The article sample to 2010 now includes 1466 articles from 16 journals. The analysis of the expectations yields mixed results for the DSS field. On the negative side, there has been an overall decline in DSS publishing, the relevance of DSS research published in journals to IT professionals has declined, and the rigor of DSS research designs has not improved. On the positive side, there has been improvement in relevance to managers, grant funding of DSS research has increased, there has been a positive shift in judgment and decision-making foundations, BI publishing has increased, and group support systems publishing has reduced to a more balanced level. An important result from the analysis of the last 7 years of DSS research is the significant increase in DSS design-science research (DSR) to almost half of published articles. It is clear from the analysis that DSS is undergoing a transition from a field based on statistical hypothesis testing and conceptual studies to one where DSR is the most popular method

Composition and synthesis of raphide crystals and druse crystals in berries of Vitis vinifera L. cv. Cabernet Sauvignon: Ascorbic acid as precursor for both oxalic and tartaric acids as revealed by radiolabelling studies

Copyright © 2008 Australian Society of Viticulture and Oenology Inc.Biomineralisation in the fleshy pericarp of berries of Vitis vinifera L. gives rise to crystals of two distinct forms, viz. raphides and druses, which are found in exocarp and endocarp cells respectively. Druses have generally been considered as crystalline aggregates of calcium oxalate. However, the organic moiety of raphide crystals has been commonly accepted as tartrate, although we have found no analytical data to support that assumption. We now present TEM and X-ray powder diffraction analysis data showing that raphide crystals of V. vinifera berries are composed of calcium oxalate monohydrate. This work also established ascorbic acid as the biosynthetic precursor of both oxalic and tartaric acids. When ascorbic acid labelled with ¹⁴C at position 1 was introduced into berries via the rachis, 21% and 52% of the added radiolabel was recovered as oxalic and tartaric acids respectively. Purified crystals from the radiolabelled grape berries contained approximately 20% of the original radioactivity, further confirming the role of ascorbic acid in oxalic acid biosynthesis. To our knowledge, this is the first evidence to be published on the formation of oxalic and tartaric acids from ascorbic acid via two distinct pathways operating within the same physiological entity (organ).Seth Debolt, Jim Hardie, Steve Tyerman and Christopher M. For