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- Axfors, Cathrine, et al.
(författare)
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Association between convalescent plasma treatment and mortality in COVID-19 : a collaborative systematic review and meta-analysis of randomized clinical trials
- 2021
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Ingår i: BMC Infectious Diseases. - : BioMed Central (BMC). - 1471-2334. ; 21:1
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Forskningsöversikt (refereegranskat)abstract
- 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and all-cause mortality in patients with COVID-19, using data from all available randomized clinical trials, including unpublished and ongoing trials (Open Science Framework, ). 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 Aggregated mortality data were extracted from publications or provided by investigators of unpublished trials and combined using the Hartung-Knapp-Sidik-Jonkman random effects model. We investigated the contribution of unpublished trials to the overall evidence. Results: A total of 16,477 patients were included in 33 trials (20 unpublished with 3190 patients, 13 published with 13,287 patients). 32 trials enrolled only hospitalized patients (including 3 with only intensive care unit patients).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 The RECOVERY trial had 69.8% and the unpublished evidence 25.3% of the weight in the meta-analysis.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.
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| 2. |
- Seitz, Arne, et al.
(författare)
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Proof of concept study for fuselage boundary layer ingesting propulsion
- 2021
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Ingår i: Aerospace. - : MDPI AG. - 2226-4310. ; 8:1, s. 1-65
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Tidskriftsartikel (refereegranskat)abstract
- Key results from the EU H2020 project CENTRELINE are presented. The research activities undertaken to demonstrate the proof of concept (technology readiness level-TRL 3) for the so-called propulsive fuselage concept (PFC) for fuselage wake-filling propulsion integration are discussed. The technology application case in the wide-body market segment is motivated. The developed performance bookkeeping scheme for fuselage boundary layer ingestion (BLI) propulsion integration is reviewed. The results of the 2D aerodynamic shape optimization for the bare PFC configuration are presented. Key findings from the high-fidelity aero-numerical simulation and aerodynamic validation testing, i.e., the overall aircraft wind tunnel and the BLI fan rig test campaigns, are discussed. The design results for the architectural concept, systems integration and electric machinery pre-design for the fuselage fan turbo-electric power train are summarized. The design and performance implications on the main power plants are analyzed. Conceptual design solutions for the mechanical and aerostructural integration of the BLI propulsive device are introduced. Key heuristics deduced for PFC conceptual aircraft design are presented. Assessments of fuel burn, NOx emissions, and noise are presented for the PFC aircraft and benchmarked against advanced conventional technology for an entry-into-service in 2035. The PFC design mission fuel benefit based on 2D optimized PFC aero-shaping is 4.7%.
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