Community indicators: a framework for observing and supporting community activity on Cloudworks

Cloudworks (Cloudworks.ac.uk) is a social networking site designed for sharing, finding and discussing learning and teaching ideas and experiences. Design and development of the site has been based on an iterative analysis, development and implementation approach, underpinned by ongoing research and evaluation. To this end, we have been seeking to establish strategies to enable us to systematically position transactions and emerging patterns of activity on the site so that we can more reliably use the empirical evidence we have gathered (Galley, 2009a, Galley 2009b, Alevizou et al., 2010a, Conole et al, 2010). In this paper we will introduce a framework we have developed for observing and supporting community development on the site. In building our framework we have used empirical evidence gathered from the site, then related it to the literature from a range of disciplines concerned with professional and learning communities. We link research relating to distance learning communities with studies into Computer Mediated Communication (CMC), self-organising communities on the web, and wider research about the nature of learning organisations and continuous professional development. We argue that this framework can be used to capture the development of productive communities in the space (i.e. how far cohesive, productive groups can be said to be emerging or not) and also help focus futur

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

Volumetric wear assessment of retrieved metal-on-metal hip prostheses and the impact of measurement uncertainty

In hip replacement the use of hard bearing materials, which have been shown to have lower wear rates than traditional metal-UHMWPE couples, has been encouraged in an effort to extend component life-in-service. With a view to further extending this period of joint activity metal-on-metal hip resurfacings have been development which allow for implantation into younger and more active patients. However, these bearings have recently been the subject of a MHRA device alert due to unexplained hip pain and reported soft tissue reactions and indeed are under investigation having been shown to exhibit high failure rates. This has highlighted the need for a traceable metrological approach to the quantification and characterisation of in vivo wear as currently there is no standard dedicated to the measurement of such wear. This study is the first to develop a comprehensive method for measuring the wear geometry of retrieved bearings whilst also assessing and quantifying both the magnitude and effect of the three-dimensional measurement uncertainty on the measurement process as a whole. This study shows that the magnitude of the expanded measurement uncertainty is an important, and until now overlooked, factor and that a statement of uncertainty is vital in measuring retrieved components as a means of comparison between studies and as a measure of confidence in measurement data. Based on the results of this study, it is recommended that care be taken when performing wear measurements on retrieved bearings. Factors such as point pitch and scan line separation can have a great effect on the likely uncertainty of the obtained measurement result and indeed the uncertainty of the measurement can be of the same order as the wear being measured