Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial

SummaryBackground Azithromycin has been proposed as a treatment for COVID-19 on the basis of its immunomodulatoryactions. We aimed to evaluate the safety and efficacy of azithromycin in patients admitted to hospital with COVID-19.Methods In this randomised, controlled, open-label, adaptive platform trial (Randomised Evaluation of COVID-19Therapy [RECOVERY]), several possible treatments were compared with usual care in patients admitted to hospitalwith COVID-19 in the UK. The trial is underway at 176 hospitals in the UK. Eligible and consenting patients wererandomly allocated to either usual standard of care alone or usual standard of care plus azithromycin 500 mg once perday by mouth or intravenously for 10 days or until discharge (or allocation to one of the other RECOVERY treatmentgroups). Patients were assigned via web-based simple (unstratified) randomisation with allocation concealment andwere twice as likely to be randomly assigned to usual care than to any of the active treatment groups. Participants andlocal study staff were not masked to the allocated treatment, but all others involved in the trial were masked to theoutcome data during the trial. The primary outcome was 28-day all-cause mortality, assessed in the intention-to-treatpopulation. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936.Findings Between April 7 and Nov 27, 2020, of 16 442 patients enrolled in the RECOVERY trial, 9433 (57%) wereeligible and 7763 were included in the assessment of azithromycin. The mean age of these study participants was65·3 years (SD 15·7) and approximately a third were women (2944 [38%] of 7763). 2582 patients were randomlyallocated to receive azithromycin and 5181 patients were randomly allocated to usual care alone. Overall,561 (22%) patients allocated to azithromycin and 1162 (22%) patients allocated to usual care died within 28 days(rate ratio 0·97, 95% CI 0·87–1·07; p=0·50). No significant difference was seen in duration of hospital stay (median10 days [IQR 5 to >28] vs 11 days [5 to >28]) or the proportion of patients discharged from hospital alive within 28 days(rate ratio 1·04, 95% CI 0·98–1·10; p=0·19). Among those not on invasive mechanical ventilation at baseline, nosignificant difference was seen in the proportion meeting the composite endpoint of invasive mechanical ventilationor death (risk ratio 0·95, 95% CI 0·87–1·03; p=0·24).Interpretation In patients admitted to hospital with COVID-19, azithromycin did not improve survival or otherprespecified clinical outcomes. Azithromycin use in patients admitted to hospital with COVID-19 should be restrictedto patients in whom there is a clear antimicrobial indication

A Generic Revision Of The Entodontaceae (bryophyta: Musci), With Special Reference To The Evolutionary Importance Of Sporophytic Characters.

PhDBotanyUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/178620/2/7916675.pd

Brazilian Flora 2020: Leveraging the power of a collaborative scientific network

The shortage of reliable primary taxonomic data limits the description of biological taxa and the understanding of biodiversity patterns and processes, complicating biogeographical, ecological, and evolutionary studies. This deficit creates a significant taxonomic impediment to biodiversity research and conservation planning. The taxonomic impediment and the biodiversity crisis are widely recognized, highlighting the urgent need for reliable taxonomic data. Over the past decade, numerous countries worldwide have devoted considerable effort to Target 1 of the Global Strategy for Plant Conservation (GSPC), which called for the preparation of a working list of all known plant species by 2010 and an online world Flora by 2020. Brazil is a megadiverse country, home to more of the world's known plant species than any other country. Despite that, Flora Brasiliensis, concluded in 1906, was the last comprehensive treatment of the Brazilian flora. The lack of accurate estimates of the number of species of algae, fungi, and plants occurring in Brazil contributes to the prevailing taxonomic impediment and delays progress towards the GSPC targets. Over the past 12 years, a legion of taxonomists motivated to meet Target 1 of the GSPC, worked together to gather and integrate knowledge on the algal, plant, and fungal diversity of Brazil. Overall, a team of about 980 taxonomists joined efforts in a highly collaborative project that used cybertaxonomy to prepare an updated Flora of Brazil, showing the power of scientific collaboration to reach ambitious goals. This paper presents an overview of the Brazilian Flora 2020 and provides taxonomic and spatial updates on the algae, fungi, and plants found in one of the world's most biodiverse countries. We further identify collection gaps and summarize future goals that extend beyond 2020. Our results show that Brazil is home to 46,975 native species of algae, fungi, and plants, of which 19,669 are endemic to the country. The data compiled to date suggests that the Atlantic Rainforest might be the most diverse Brazilian domain for all plant groups except gymnosperms, which are most diverse in the Amazon. However, scientific knowledge of Brazilian diversity is still unequally distributed, with the Atlantic Rainforest and the Cerrado being the most intensively sampled and studied biomes in the country. In times of scientific reductionism, with botanical and mycological sciences suffering pervasive depreciation in recent decades, the first online Flora of Brazil 2020 significantly enhanced the quality and quantity of taxonomic data available for algae, fungi, and plants from Brazil. This project also made all the information freely available online, providing a firm foundation for future research and for the management, conservation, and sustainable use of the Brazilian funga and flora.Brazilian Biodiversity Information System (SiBBr)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Brazilian FAPsFundação de Amparo à Pesquisa do Estado do Rio de Janeiro (FAPERJ)Inst Pesquisas Jardim Bot Rio de Janeiro, Rio De Janeiro, BrazilUniv Fed Rio de Janeiro, Rio De Janeiro, BrazilEmpresa Brasileira Pesquisa Agropecuaria, Brasilia, DF, BrazilInst Bot Sao Paulo, Sao Paulo, BrazilUniv Estadual Feira de Santana, Feira De Santana, BA, BrazilKew, Royal Bot Gardens, Richmond, Surrey, EnglandUniv Estadual Paulista, Sao Paulo, SP, BrazilUniv Fed Minas Gerais, Belo Horizonte, MG, BrazilUniv Fed Sao Carlos, Sao Carlos, SP, BrazilUniv Fed Pernambuco, Recife, PE, BrazilUniv Sao Paulo, Sao Paulo, SP, BrazilUniv Fed Paraiba, Joao Pessoa, Paraiba, BrazilUniv Fed Bahia, Salvador, BA, BrazilUniv Fed Parana, Curitiba, Parana, BrazilUniv Brasilia, Brasilia, DF, BrazilUniv Nacl La Plata, La Plata, ArgentinaUniv Fed Mato Grosso, Cuiaba, MG, BrazilUniv Estado Bahia, Salvador, BA, BrazilUniv Fed Fluminense, Niteroi, RJ, BrazilInst Bot Darwinion, Acassuso, BA, BrazilConservatoire & Jardin Bot Ville Geneve, Pregny Chambesy, SwitzerlandUniv Calif Berkeley, Berkeley, CA USAUSDA, Miami, FL USAMuseu Paraense Emilio Goeldi, Belem, Para, BrazilUniv Nacl Autonoma Mexico, Mexico City, DF, MexicoIKIAM Univ Reg Amazon, Tena, EcuadorUniv Fed Sergipe, Sao Cristova, Sergipe, BrazilPrefeitura Municipal Cariacica ES, Cariacica, ES, BrazilInst Fed Educ Ciencia & Tecnol Ceara, Fortaleza, Ceara, BrazilUniv Santa Cecilia, Santos, SP, BrazilCtr Univ Fac Metropolitanas Unidas, Sao Paulo, SP, BrazilUniv Fed Maranhao, Sao Luis, Maranhao, BrazilUniv Fed Sao Paulo, Sao Paulo, SP, BrazilInst Nacl Mata Atlantica, Santa Teresa, BrazilUniv Estado Minas Gerais, Belo Horizonte, MG, BrazilUniv Estado Rio de Janeiro, Rio De Janeiro, BrazilUniv Estadual Campinas, Campinas, SP, BrazilUniv Fed Tocantins, Palmas, BrazilFac Guanambi, Guanambi, BrazilUniv Fed Alagoas, Maceio, Alagoas, BrazilUniv Fed Juiz de Fora, Juiz De Fora, MG, BrazilUniv Fed Vicosa, Vicosa, MG, BrazilUniv Fed Santa Catarina, Florianopolis, SC, BrazilUniv Estadual Sudoeste Bahia, Candeias, BA, BrazilUniv Fed Espirito Santo, Vitoria, BrazilUniv Fed Rio Grande do Sul, Porto Alegre, RS, BrazilUniv Fed Rural Pernambuco, Recife, PE, BrazilUniv Reg Blumenau, Blumenau, SC, BrazilUniv Estadual Santa Cruz, Ilheus, BA, BrazilInst Bot Nordeste, Corrientes, ArgentinaBot Staatssammlung Munchen, Munich, GermanyInst Amparo Ciencia Tecnol & Inovacao Roraima, Sao Paulo, SP, BrazilUniv Estadual Ctr Oeste Parana, Guarapuava, Parana, BrazilUniv Fed Mato Grosso do Sul, Campo Grande, MS, BrazilUniv Fed Pampa, Bage, RS, BrazilUniv Estadual Amazonas, Manaus, Amazonas, BrazilMarie Selby Bot Gardens, Sarasota, FL USAUniv Estadual Londrina, Londrina, Parana, BrazilUniv Fed Goias, Goiania, Go, BrazilUniv Fed Rio Grande do Norte, Natal, RN, BrazilFundacao Univ Fed Grande Dourados, Dourados, MS, BrazilPontificia Univ Catolica de Minas Gerais, Belo Horizonte, MG, BrazilUniv Estadual Rio Grande do Sul, Porto Alegre, RS, BrazilNew York Bot Garden, Bronx, NY USAUniv Aarhus, Aarhus, DenmarkUniv Estado Amazonas, Manaus, Amazonas, BrazilNat Hist Museum Wien, Vienna, AustriaInst Patrimonio Hist & Artist Nacl, Sitio Burle Marx, Rio De Janeiro, BrazilUniv Fed Campina Grande, Campina Grande, Paraiba, BrazilColumbia Univ, New York, NY 10027 USAMississippi State Univ, Mississippi State, MS USAInst Tecnol Vale, Belem, Para, BrazilUniv Fed Uberlandia, Uberlandia, MG, BrazilConsejo Nacl Invest Cient & Tecn, INIBIOMA, San Carlos De Bariloche, Rio Negro, ArgentinaUniv Estado Santa Catarina, Florianopolis, SC, BrazilMilwaukee Publ Museum, Milwaukee, WI USAUniv Cidade Sao Paulo, Sao Paulo, SP, BrazilPontificia Univ Catolica Rio de Grande, Belo Horizonte, MG, BrazilUniv Fed Pelotas, Pelotas, RS, BrazilInst Nacl de Pesquisas da Amazonia, Manaus, Amazonas, BrazilMinist Publ Estado Amazonas, Manaus, Amazonas, BrazilUniv Fed Ceara, Fortaleza, Ceara, BrazilUniv Fed Oeste Bahia, Barreiras, BrazilOhio Wesleyan Univ, Delaware, OH USAUniv Estadual Norte Fluminense, Rio De Janeiro, BrazilUniv Michigan, Ann Arbor, MI 48109 USAUniv Fed Amazonas, Manaus, Amazonas, BrazilUniv Fed Rural Rio de Janeiro, Rio De Janeiro, BrazilMuseo Argentino Ciencias Nat Bernardino Rivadavia, Buenos Aires, DF, ArgentinaUniv Tokyo, Tokyo 1138654, JapanRoyal Bot Garden Edinburgh, Edinburgh, Midlothian, ScotlandUniv Med Ctr Groningen, Groningen, NetherlandsUniv Fed Rural Amazonia, Belem, Para, BrazilInst Fed Farroupilha, Santa Maria, RS, BrazilUniv Estadual Vale Acarau, Sobral, Ceara, BrazilUniv Fed Reconcavo Bahia, Cruz Das Almas, BrazilSmithsonian Inst, Washington, DC 20560 USAUniv Fed Vales Jequitinhonha & Mucuri, Teofilo Otoni, MG, BrazilUniv Fed Sul Bahia, Itabuna, BrazilUniv Nacl Colombia, Bogota, ColombiaUniv Chile, Santiago, ChileUniv Caxias do Sul, Caxias Do Sul, RS, BrazilInst Fed Minas Gerais Campus Bambui, Bambui, MG, BrazilUniv Fed Triangulo Mineiro, Uberaba, MG, BrazilUniv Estacio Sa, Rio De Janeiro, BrazilThermo Fisher Sci, Waltham, MA USAUniv Estadual Maranhao, Sao Luis, Maranhao, BrazilUniv Estadual Mato Grosso, Caceres, MG, BrazilFac Marechal Rondon, Sao Manuel, SP, BrazilCalif Acad Sci, San Francisco, CA 94118 USAUniv Buenos Aires, Buenos Aires, DF, ArgentinaCtr Univ UNA, Belo Horizonte, MG, BrazilUniv Nacl Nordeste, Corrientes, ArgentinaUniv Fed Piaui, Teresina, BrazilInst Fed Piaui, Teresina, BrazilJardim Bot Cubatao, Cubatao, BrazilUniv Turku, Turku, FinlandUniv Nacl Cordoba, Cordoba, ArgentinaUniv Estadual Maringa, Maringa, Parana, BrazilJardim Bot Plantarum, Nova Odessa, SP, BrazilUniv Estadual Piaui, Teresina, BrazilUniv Fed Delta Parnaiba, Parnaiba, BrazilJardim Bot Brasilia, Brasilia, DF, BrazilInst Fed Educ Ciencia & Tecnol Para, Belem, Para, BrazilUniv Fed Vale Sao Francisco, Petrolina, BrazilJardim Bot Recife, Recife, PE, BrazilUniv Free State, Bloemfontein, South AfricaPrefeitura Municipal Mariana MG, Mariana, MG, BrazilPontificia Univ Catolica Rio de Janeiro, Rio De Janeiro, BrazilSecretaria Estadual Educ Rio de Janeiro, Rio De Janeiro, BrazilUniv Minnesota, Minneapolis, MN 55455 USAUniv Fed Sao Joao Del Rei, Sao Joao Del Rei, BrazilUniv Fed Estado Rio de Janeiro, Rio De Janeiro, BrazilUniv Estadual Paraiba, Campina Grande, Paraiba, BrazilUniv Laval, Quebec City, PQ G1K 7P4, CanadaUniv Fed Oeste Para, Santarem, Para, BrazilUniv Bayreuth, Bayreuth, GermanyUniv Fed Para, Belem, Para, BrazilSwedish Museum Nat Hist, Stockholm, SwedenUniv Fed Santa Maria, Santa Maria, RS, BrazilHillfield Strathallan Coll, Hamilton, ON, CanadaUniv Fed Integracao Latino Amer, Foz Do Iguacu, BrazilUniv Fed Rural Semi Arido, Mossoro, BrazilIPF Solucoes Florestais, Rio De Janeiro, BrazilUniv Tecnol Fed Parana, Curitiba, Parana, BrazilArboribus Consultoria & Planejamento Ambiental, Sao Paulo, SP, BrazilUniv Paris Saclay, CNRS, AgroParisTech, Paris, FranceUniv Fed Ouro Preto, Ouro Preto, MG, BrazilUniv Estadual Oeste Parana, Cascavel, Parana, BrazilFed Univ ABC, Santo Andre, SP, BrazilUniv Estadual Ceara, Fortaleza, Ceara, BrazilInst Fed Para, Belem, Para, BrazilInst Agron Campinas, Campinas, SP, BrazilInst Fed Bahia, Salvador, BA, BrazilUniv Utah, Salt Lake City, UT 84112 USAIowa State Univ, Iowa City, IA USAMuseu Nacl Hist Nat Paris, Paris, FranceUniv Nacl Rio Cuarto, Rio Cuarto, ArgentinaUniv Coimbra, Coimbra, PortugalInst Nacl Tecnol, Rio De Janeiro, BrazilUniv Fed Ciencias Saude Porto Alegre, Porto Alegre, RS, BrazilScientifik Consultoria Ltda, Sao Jose Dos Campos, SP, BrazilInst Fed Educ Ciencia & Tecnol Goias Campus Formo, Formosa, Goias, BrazilSecretaria Estadual Educ Cameta PA, Cameta, PA, BrazilInst Agron Pernambuco, Recife, PE, BrazilInst Fed Educ Ciencia & Tecnol Rio Grande do Sul, Rio Grande, RS, BrazilUniv Panama, Panama City, PanamaInst Anchietano Pesquisas, Sao Leopoldo, RS, BrazilCtr Univ Araguaia, Goiania, Go, BrazilUniv Mogi das Cruzes, Mogi Das Cruzes, SP, BrazilUniv Fed Acre, Rio Branco, BrazilMissouri Bot Garden, St Louis, MO USAInst Nacl Tecnol Agropecuaria, Buenos Aires, DF, ArgentinaRhein Friedrich Wilhelms Univ, Bonn, GermanyEastern Kentucky Univ, Richmond, KY USAMiami Univ, Oxford, OH 45056 USAUniv Vermont, Burlington, VT 05405 USAUniv Passo Fundo, Passo Fundo, RS, BrazilUniv Mayor San Andres, La Paz, BoliviaInst Invest Amazonia Peruana, Maynas, PeruField Museum Nat Hist, Chicago, IL USAUniv Fed Rondonia, Porto Velho, BrazilUniv Florida, Gainesville, FL 32611 USAUniv Gibraltar, Campus Europa Point, GibraltarMuseu Bot Municipal Curitiba, Curitiba, Parana, BrazilUniv Nilton Lins, Manaus, Amazonas, BrazilInst Pesquisas Cient & Tecnol Estado Amapa, Macapa, BrazilUniv Autonoma Madrid, Madrid, SpainBot Res Inst Texas, Ft Worth, TX USAInst Rech Dev, Marseille, FranceSecretaria Meio Ambiente & Infraestrutura RS Jard, Porto Alegre, RS, BrazilUniv Costa Rica, San Jose, Costa RicaUnilasalle Canoas, Canoas, BrazilCSIC, Real Jardin Bot, Madrid, SpainUniv Wisconsin, Madison, WI USAPrefeitura Cidade Rio de Janeiro, Rio De Janeiro, BrazilCtr Invest Cient Yucatan, Yucatan, MexicoUniv Fed Roraima, Boa Vista, Parana, BrazilInst Brasileiro Geog & Estat, Rio De Janeiro, BrazilUniv Nacl Mayor San Marcos, Lima, PeruInst Fed Educ Ciencia & Tecnol Mato Grosso, Cuiaba, BrazilUniv Estadual Ponta Grossa, Ponta Grossa, Parana, BrazilMaastricht Univ, Maastricht, NetherlandsUniv Pisa, Pisa, ItalyNat Hist Museum UK, London, EnglandInst Espanol Oceanog, Madrid, SpainUniv Antioquia, Medellin, Antioquia, ColombiaUniv Fed Rio Grande, Rio Grande, BrazilSenckenberg Res Inst Frankfurt M, Frankfurt, GermanyColorado Mesa Univ, Grand Junction, CO USAInst Chico Mendes Conservacao Biodiversidade, Brasilia, DF, BrazilUnited States Bot Garden, Washington, DC USAUniv Fed Lavras, Lavras, MG, BrazilNaturalis Biodivers Ctr Leiden, Leiden, NetherlandsInst Fed Goiano, Ceres, Go, BrazilUniv Arkansas, Fayetteville, AR 72701 USAUniv Franciscana, Santa Maria, RS, BrazilConnecticut State Univ, New Britain, CT USASecretaria Municipal Educ Vitoria ES, Vitoria, ES, BrazilLeibniz Ctr Agr Landscape Res, Muncheberg, GermanyFac Tecnol Estado Sao Paulo, Sao Paulo, BrazilUniv Simon Bolivar, Caracas, VenezuelaUniv Estadual Paulista, Sao Paulo, SP, Brazi