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

Geodynamic significance of S-type granites in circum-Pacific orogens

In Phanerozoic circum-Pacific orogenic belts, most "post-collisional" S-type granites and associated high-temperature, low-pressure metamorphic complexes formed during early arc extension. The granites are part of a tripartite association consisting of (1) inboard S-type granite, (2) outboard oceanic arc, and (3) intervening, turbidite-filled backarc basin. S-type granites herald the formation of new outboard oceanic arc and extensional backarc systems, but thickening of a preexisting, sediment-dominated back-arc basin is a prerequisite for their generation. In these environments, S-type plutonism is triggered by renewal of arc magmatism following thickening, when hot basaltic magmas are intruded into the thickened backarc crust once slab retreat is reestablished. With ongoing extension during retreat, the crust becomes progressively thinned, the sedimentary contribution is diminished, and the granites lose their S-type character. Such tripartite associations involving S-type granite are probably diagnostic of repeated slab-retreat episodes, and the Jurassic U.S. cordillera might be an example

Design of Wear-Resistant Austenitic Steels for Selective Laser Melting

Type 316L stainless steel feedstock powder was modified by alloying with powders containing carbide/boride-forming elements to create improved wear-resistant austenitic alloys that can be readily processed by Selective Laser Melting. Fe-based alloys with high C, B, V, and Nb contents were thus produced, resulting in a microstructure that consisted of austenitic grains and a significant amount of hard carbides and borides. Heat treatments were performed to modify the carbide distribution and morphology. Optimal hard-phase spheroidization was achieved by annealing the proposed alloys at 1150 °C for 1 hour followed by water quenching. The total increase in hardness of samples containing 20 pct of C/B-rich alloy powder was of 82.7 pct while the wear resistance could be increased by a factor of 6