Association between convalescent plasma treatment and mortality in COVID-19: a collaborative systematic review and meta-analysis of randomized clinical trials.

Funder: laura and john arnold foundationBACKGROUND: Convalescent plasma has been widely used to treat COVID-19 and is under investigation in numerous randomized clinical trials, but results are publicly available only for a small number of trials. The objective of this study was to assess the benefits of convalescent plasma treatment compared to placebo or no treatment and all-cause mortality in patients with COVID-19, using data from all available randomized clinical trials, including unpublished and ongoing trials (Open Science Framework, https://doi.org/10.17605/OSF.IO/GEHFX ). METHODS: In this collaborative systematic review and meta-analysis, clinical trial registries (ClinicalTrials.gov, WHO International Clinical Trials Registry Platform), the Cochrane COVID-19 register, the LOVE database, and PubMed were searched until April 8, 2021. Investigators of trials registered by March 1, 2021, without published results were contacted via email. Eligible were ongoing, discontinued and completed randomized clinical trials that compared convalescent plasma with placebo or no treatment in COVID-19 patients, regardless of setting or treatment schedule. Aggregated mortality data were extracted from publications or provided by investigators of unpublished trials and combined using the Hartung-Knapp-Sidik-Jonkman random effects model. We investigated the contribution of unpublished trials to the overall evidence. RESULTS: A total of 16,477 patients were included in 33 trials (20 unpublished with 3190 patients, 13 published with 13,287 patients). 32 trials enrolled only hospitalized patients (including 3 with only intensive care unit patients). Risk of bias was low for 29/33 trials. Of 8495 patients who received convalescent plasma, 1997 died (23%), and of 7982 control patients, 1952 died (24%). The combined risk ratio for all-cause mortality was 0.97 (95% confidence interval: 0.92; 1.02) with between-study heterogeneity not beyond chance (I2 = 0%). The RECOVERY trial had 69.8% and the unpublished evidence 25.3% of the weight in the meta-analysis. CONCLUSIONS: Convalescent plasma treatment of patients with COVID-19 did not reduce all-cause mortality. These results provide strong evidence that convalescent plasma treatment for patients with COVID-19 should not be used outside of randomized trials. Evidence synthesis from collaborations among trial investigators can inform both evidence generation and evidence application in patient care

Butterflies of the Cambrian benthos? Shield position in bradoriid arthropods

Mode of preservation and method of recovery strongly influences our understanding of the life habits of extinct organisms. Bradoriid arthropods were abundant, and diverse members of early Cambrian ecosystems and most life reconstructions display these animals with the two shields of the carapace open in a ‘butterfly’ configuration. This favoured reconstruction is largely based on the abundance of ‘crack-out’ specimens preserved in this position (e.g. Kunmingella from the early Cambrian of China). In contrast, large collections of acid processed bradoriids from the Arrowie Basin of South Australia (Cambrian Stage 3) are preserved with a narrow gape at the ventral margin or completely closed with the carapace folded along the dorsal midline. The relative abundance of conjoined, closed (or partially closed) specimens from the lower Cambrian Hawker Group succession suggests that at least some bradoriid taxa were capable of withdrawing appendages and tightly closing the shields, challenging the common view that the majority of bradoriids usually held their carapaces open in a ‘butterfly’ configuration during life. New data show that layers of the bradoriid carapace are continuous through the dorsal fold with no evidence for complex articulating structures as in ostracod hinges. The relatively pliable, sclerotized or lightly mineralized calcium phosphate composition of the carapace and the simple, flexible dorsal fold facilitated opening and closing of the shields. Despite not being closely related, ostracods share close biomechanical and ecological similarities with bradoriids. The evolution of more complex articulating hinge structures – together with well-developed musculature – in ostracods during the Early Ordovician, may have provided more efficient means for shield articulation and movement, thus promoting the ecological success of ostracods throughout the Phanerozoic.14 page(s

A Bounty of bradoriids -- biodiversity, biogeography and biostratigraphy of richly diverse lower Cambrian assemblages from South Australia

Systematic acid digestion of samples derived from 24 separate stratigraphic sections measured through thick carbonate dominated lower Cambrian successions in the Flinders Ranges (Arrowie Basin) reveals an unexpectedly rich diversity (c. 25 taxa) of well-preserved bradoriid arthropods. The new assemblages occur across a broad spectrum of biofacies including shallow water stromatolitic facies, archaeocyath-cryptalgal bioherms and carbonate slope facies. The oldest known bradoriid taxon (Liangshanella circumbolina) from East Gondwana occurs 20 m below the FAD of the zonal trilobite Abadiella huoi in the lower Cambrian Ajax and Wirrapowie limestones of the Flinders Ranges, South Australia. This occurrence suggests a lower Cambrian (Series 2, Stage 3) age for the earliest bradoriids in Australia. The recognition of distinct bradoriid assemblages associated with the Abadiella huoi (Atdabanian), Pararaia tatei, P. bunyerooensis and P. janeae (all Botoman) trilobite biozones in South Australia indicates great potential for future regional biostratigraphic correlation. An updated quantitative biogeographic analysis utilising new unpublished taxonomic data from the lower Cambrian of South Australia highlights the strong endemism displayed by early Cambrian bradoriid communities in East Gondwana -- but the presence of a few previously unreported cosmopolitan taxa strengthens the close faunal affinities with South China, Antarctica and Siberia.1 page(s

Shelly fossils from the lower Cambrian White Point Conglomerate, Kangaroo Island, South Australia

The lower Cambrian (Series 2) White Point Conglomerate (WPC) on Kangaroo Island, South Australia contains exoticclasts representing a diverse array of lithologies, including metamorphics, chert, sandstone, and abundant carbonates,notably archaeocyath-rich bioclastic limestone. Acetic acid digestion of the WPC bioclastic limestone clasts reveals adiverse shelly fauna. This assemblage includes abundant organophosphatic brachiopods such as Cordatia erinae Brockand Claybourn gen. et sp. nov., Curdus pararaensis, Eodicellomus elkaniformiis, Eohadrotreta sp. cf. E. zhenbaensis,Eoobolus sp., Kyrshabaktella davidii, and Schizopholis yorkensis. Additional shelly taxa include the solenopleurid trilobiteTrachoparia? sp., the tommotiids Dailyatia odyssei, Dailyatia decobruta Betts sp. nov., Kelanella sp., and Lapworthellafasciculata, spines of the bradoriid arthropod Mongolitubulus squamifer, and several problematica, such as Stoibostrombuscrenulatus and a variety of tubular forms. The upper age limit for the WPC is constrained by biostratigraphic data fromthe overlying Marsden Sandstone and Emu Bay Shale, which are no younger than the Pararaia janeae Trilobite Zone(Cambrian Series 2, Stage 4). The shelly fossil assemblage from the WPC limestone clasts indicates an upper Dailyatiaodyssei Zone (= Pararaia tatei to lower P. janeae trilobite zones), equivalent to the Atdabanian–early Botoman of theSiberian scheme. This contrasts with the previously suggested late Botoman age for the limestone clasts, based on the diversearchaeocyath assemblage. The minor age difference between the WPC and its fossiliferous limestone clasts suggestsrelatively rapid reworking of biohermal buildups during tectonically-active phases of deposition in the Stansbury Basin

Shelly fossils from the lower Cambrian White Point Conglomerate, Kangaroo Island, South Australia

The lower Cambrian (Series 2) White Point Conglomerate (WPC) on Kangaroo Island, South Australia contains exotic clasts representing a diverse array of lithologies, including metamorphics, chert, sandstone, and abundant carbonates, notably archaeocyath-rich bioclastic limestone. Acetic acid digestion of the WPC bioclastic limestone clasts reveals a diverse shelly fauna. This assemblage includes abundant organophosphatic brachiopods such as Cordatia erinae Brock and Claybourn gen. et sp. nov., Curdus pararaensis, Eodicellomus elkaniformiis, Eohadrotreta sp. cf. E. zhenbaensis, Eoobolus sp., Kyrshabaktella davidii, and Schizopholis yorkensis. Additional shelly taxa include the solenopleurid trilobite Trachoparia? sp., the tommotiids Dailyatia odyssei, Dailyatia decobruta Betts sp. nov., Kelanella sp., and Lapworthella fasciculata, spines of the bradoriid arthropod Mongolitubulus squamifer, and several problematica, such as Stoibostrombus crenulatus and a variety of tubular forms. The upper age limit for the WPC is constrained by biostratigraphic data from the overlying Marsden Sandstone and Emu Bay Shale, which are no younger than the Pararaia janeae Trilobite Zone (Cambrian Series 2, Stage 4). The shelly fossil assemblage from the WPC limestone clasts indicates an upper Dailyatia odyssei Zone (= Pararaia tatei to lower P. janeae trilobite zones), equivalent to the Atdabanian-early Botoman of the Siberian scheme. This contrasts with the previously suggested late Botoman age for the limestone clasts, based on the diverse archaeocyath assemblage. The minor age difference between the WPC and its fossiliferous limestone clasts suggests relatively rapid reworking of biohermal buildups during tectonically-active phases of deposition in the Stansbury Basin

sj-docx-1-aut-10.1177_13623613231213543 – Supplemental material for Community-guided, autism-adapted group cognitive behavioral therapy for depression in autistic youth (CBT-DAY): Preliminary feasibility, acceptability, and efficacy

Supplemental material, sj-docx-1-aut-10.1177_13623613231213543 for Community-guided, autism-adapted group cognitive behavioral therapy for depression in autistic youth (CBT-DAY): Preliminary feasibility, acceptability, and efficacy by Jessica M Schwartzman, Marissa C Roth, Ann V Paterson, Alexandra X Jacobs and Zachary J Williams in Autism</p

sj-docx-2-aut-10.1177_13623613231213543 – Supplemental material for Community-guided, autism-adapted group cognitive behavioral therapy for depression in autistic youth (CBT-DAY): Preliminary feasibility, acceptability, and efficacy

Supplemental material, sj-docx-2-aut-10.1177_13623613231213543 for Community-guided, autism-adapted group cognitive behavioral therapy for depression in autistic youth (CBT-DAY): Preliminary feasibility, acceptability, and efficacy by Jessica M Schwartzman, Marissa C Roth, Ann V Paterson, Alexandra X Jacobs and Zachary J Williams in Autism</p

A new lower Cambrian shelly fossil biostratigraphy for South Australia:Reply

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sj-docx-3-aut-10.1177_13623613231213543 – Supplemental material for Community-guided, autism-adapted group cognitive behavioral therapy for depression in autistic youth (CBT-DAY): Preliminary feasibility, acceptability, and efficacy

Supplemental material, sj-docx-3-aut-10.1177_13623613231213543 for Community-guided, autism-adapted group cognitive behavioral therapy for depression in autistic youth (CBT-DAY): Preliminary feasibility, acceptability, and efficacy by Jessica M Schwartzman, Marissa C Roth, Ann V Paterson, Alexandra X Jacobs and Zachary J Williams in Autism</p