36 research outputs found
When should grain be marketed?
Cover title.Includes bibliographical references
When to market grain
Cover title.This circular is a revision of Circular 516
Efficacy and safety of baricitinib or ravulizumab in adult patients with severe COVID-19 (TACTIC-R): a randomised, parallel-arm, open-label, phase 4 trial
Background
From early in the COVID-19 pandemic, evidence suggested a role for cytokine dysregulation and complement activation in severe disease. In the TACTIC-R trial, we evaluated the efficacy and safety of baricitinib, an inhibitor of Janus kinase 1 (JAK1) and JAK2, and ravulizumab, a monoclonal inhibitor of complement C5 activation, as an adjunct to standard of care for the treatment of adult patients hospitalised with COVID-19.
Methods
TACTIC-R was a phase 4, randomised, parallel-arm, open-label platform trial that was undertaken in the UK with urgent public health designation to assess the potential of repurposing immunosuppressants for the treatment of severe COVID-19, stratified by a risk score. Adult participants (aged ≥18 years) were enrolled from 22 hospitals across the UK. Patients with a risk score indicating a 40% risk of admission to an intensive care unit or death were randomly assigned 1:1:1 to standard of care alone, standard of care with baricitinib, or standard of care with ravulizumab. The composite primary outcome was the time from randomisation to incidence (up to and including day 14) of the first event of death, invasive mechanical ventilation, extracorporeal membrane oxygenation, cardiovascular organ support, or renal failure. The primary interim analysis was triggered when 125 patient datasets were available up to day 14 in each study group and we included in the analysis all participants who were randomly assigned. The trial was registered on ClinicalTrials.gov (NCT04390464).
Findings
Between May 8, 2020, and May 7, 2021, 417 participants were recruited and randomly assigned to standard of care alone (145 patients), baricitinib (137 patients), or ravulizumab (135 patients). Only 54 (39%) of 137 patients in the baricitinib group received the maximum 14-day course, whereas 132 (98%) of 135 patients in the ravulizumab group received the intended dose. The trial was stopped after the primary interim analysis on grounds of futility. The estimated hazard ratio (HR) for reaching the composite primary endpoint was 1·11 (95% CI 0·62–1·99) for patients on baricitinib compared with standard of care alone, and 1·53 (0·88–2·67) for ravulizumab compared with standard of care alone. 45 serious adverse events (21 deaths) were reported in the standard-of-care group, 57 (24 deaths) in the baricitinib group, and 60 (18 deaths) in the ravulizumab group.
Interpretation
Neither baricitinib nor ravulizumab, as administered in this study, was effective in reducing disease severity in patients selected for severe COVID-19. Safety was similar between treatments and standard of care. The short period of dosing with baricitinib might explain the discrepancy between our findings and those of other trials. The therapeutic potential of targeting complement C5 activation product C5a, rather than the cleavage of C5, warrants further evaluation
Assumption without representation: the unacknowledged abstraction from communities and social goods
We have not clearly acknowledged the abstraction from unpriceable “social goods” (derived from
communities) which, different from private and public goods, simply disappear if it is attempted to
market them. Separability from markets and economics has not been argued, much less established.
Acknowledging communities would reinforce rather than undermine them, and thus facilitate
the production of social goods. But it would also help economics by facilitating our understanding
of – and response to – financial crises as well as environmental destruction and many social problems,
and by reducing the alienation from economics often felt by students and the public
Factors affecting success of farm loans : a study of lending experience in seven counties in east-central Illinois, 1917-1933
Cover title."Based on a thesis submitted by Joseph Ackerman to the Graduate School of the University of Illinois, January, 1938, in partial fulfillment of the requirements for the degree of doctor of philosophy in economics."--P. 459.Includes bibliographical references
Prices of Illinois farm products, 1931-1934
Cover title.Includes bibliographical references
Prices of Illinois farm products from 1921 to 1929
Cover title.Includes bibliographical references