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

BACKGROUND: 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and all-cause mortality in patients with COVID-19, using data from all available randomized clinical trials, including unpublished and ongoing trials (Open Science Framework, https://doi.org/10.17605/OSF.IO/GEHFX ).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 Aggregated mortality data were extracted from publications or provided by investigators of unpublished trials and combined using the Hartung-Knapp-Sidik-Jonkman random effects model. We investigated the contribution of unpublished trials to the overall evidence. RESULTS: A total of 16,477 patients were included in 33 trials (20 unpublished with 3190 patients, 13 published with 13,287 patients). 32 trials enrolled only hospitalized patients (including 3 with only intensive care unit patients).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 (I(2) = 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 The RECOVERY trial had 69.8% and the unpublished evidence 25.3% of the weight in the meta-analysis.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

The building information modelling trajectory in facilities management: A review

There is a paucity of literature that examines building information modelling (BIM) for asset management within the architecture, engineering, construction and owner-operated (AECO) sector. This paper therefore presents a thorough review of published literature on the latest research and standards development that impact upon BIM and its application in facilities management (FM) during the operations and maintenance (O&M) phase of building usage. The purpose is to generate new ideas and provide polemic clarity geared to intellectually challenge readers from across a range of academic and industrial disciplines. The findings reveal that significant challenges facing the FM sector include the need for: greater consideration of long-term strategic aspirations; amelioration of data integration/interoperability issues; augmented knowledge management; enhanced performance measurement; and enriched training and competence development for facilities managers to better deal with the amorphous range of services covered by FM. Future work is also proposed in several key areas and includes: case studies to observe and report upon current practice and development; and supplementary research related to concepts of knowledge capture in relation to FM and the growing use of BIM for asset management

Less than equal? Community organisations and estate regeneration partnerships

SIGLEAvailable from British Library Document Supply Centre- DSC:q96/04213 / BLDSC - British Library Document Supply CentreGBUnited Kingdo

Towards a Circular Economy for End-of-Life Vehicles: A Comparative Study UK – Japan

As the European Directive on end-of-life vehicle (ELV) treatment has heavily influenced policies in many countries, car manufacturers need to reconsider the early phases of the product design to enable better ELV treatment. This paper proposes policy, technical and business recommendations to improve the reuse, recycling and recovery (RRR) rate of ELVs. A comparative analysis between the United Kingdom and Japan is undertaken, in which the two countries’ contextual background is described along with their RRR performance from a lifecycle perspective. Barriers and countermeasures to improve the RRR rates are discussed based upon mutual learning between the two countries