Writing Committee for the REMAP-CAP Investigators IMPORTANCE The evidence for benefit of convalescent plasma for critically ill patients with COVID-19 is inconclusive.OBJECTIVE To determine whether convalescent plasma would improve outcomes for critically ill adults with COVID-19. DESIGN, SETTING, AND PARTICIPANTSThe ongoing Randomized, Embedded, Multifactorial, Adaptive Platform Trial for Community-Acquired Pneumonia (REMAP-CAP) enrolled and randomized 4763 adults with suspected or confirmed COVID-19 between March 9, 2020, and January 18, 2021, within at least 1 domain; 2011 critically ill adults were randomized to open-label interventions in the immunoglobulin domain at 129 sites in 4 countries. Follow-up ended on April 19, 2021. INTERVENTIONSThe immunoglobulin domain randomized participants to receive 2 units of high-titer, ABO-compatible convalescent plasma (total volume of 550 mL ± 150 mL) within 48 hours of randomization (n = 1084) or no convalescent plasma (n = 916). MAIN OUTCOMES AND MEASURESThe primary ordinal end point was organ support-free days (days alive and free of intensive care unit-based organ support) up to day 21 (range, −1 to 21 days; patients who died were assigned -1 day). The primary analysis was an adjusted bayesian cumulative logistic model. Superiority was defined as the posterior probability of an odds ratio (OR) greater than 1 (threshold for trial conclusion of superiority >99%). Futility was defined as the posterior probability of an OR less than 1.2 (threshold for trial conclusion of futility >95%). An OR greater than 1 represented improved survival, more organ support-free days, or both. The prespecified secondary outcomes included in-hospital survival; 28-day survival; 90-day survival; respiratory support-free days; cardiovascular support-free days; progression to invasive mechanical ventilation, extracorporeal mechanical oxygenation, or death; intensive care unit length of stay; hospital length of stay; World Health Organization ordinal scale score at day 14; venous thromboembolic events at 90 days; and serious adverse events. RESULTS Among the 2011 participants who were randomized (median age, 61 [IQR, 52 to 70] years and 645/1998 [32.3%] women), 1990 (99%) completed the trial. The convalescent plasma intervention was stopped after the prespecified criterion for futility was met. The median number of organ support-free days was 0 (IQR, -1 to 16) in the convalescent plasma group and 3 (IQR, -1 to 16) in the no convalescent plasma group. The in-hospital mortality rate was 37.3% (401/1075) for the convalescent plasma group and 38.4% (347/904) for the no convalescent plasma group and the median number of days alive and free of organ support was 14 (IQR, 3 to 18) and 14 (IQR, 7 to 18), respectively. The median-adjusted OR was 0.97 (95% credible interval, 0.83 to 1.15) and the posterior probability of futility (OR <1.2) was 99.4% for the convalescent plasma group compared with the no convalescent plasma group. The treatment effects were consistent across the primary outcome and the 11...

This study examined the prevalence of intimate partner violence in Jordan among a sample of 517 reproductive health clinic attendees. Intimate partner violence was measured using the World Health Organization's domestic violence questionnaire which was modified by the results of focus group discussions conducted in Amman. Estimation de la prévalence de la violence exercée par le partenaire intime en Jordanie RÉSUMÉ Cette étude portait sur la prévalence de la violence exercée par le partenaire intime en Jordanie sur un échantillon de 517 personnes fréquentant des centres de santé génésique. Cette violence a été mesurée au moyen du questionnaire sur la violence familiale de l'Organisation mondiale de la santé, qui a été modifié suite à des réunions de groupe de discussion tenues à Amman. Les pourcentages de femmes ayant subi au moins une forme de comportement autoritaire ou de violence depuis le mariage se décomposaient comme suit : comportement autoritaire, 97,2 % ; violence psychologique, 73,4 % ; violence physique, 31,2 % ; et violence sexuelle, 18,8 %. Les modifications apportées au questionnaire de l'OMS étaient nécessaires pour mesurer les comportements autoritaires et la violence psychologique en Jordanie. Il sera peut-être nécessaire de procéder à des modifications similaires aux fins de la réalisation de travaux de recherche dans la région.

Protein-DNA complexes were formed when nuclear extracts from embryogenic rice suspension cultures or maize embryos were incubated with an abscisic acid-VIVIPAROUS1 (VP1) response element (Em1a) from the Em promoter. Monoclonal antibodies generated to GF14, a 14-3-3 protein from plants, resulted in gel retardation of the Em1a-protein complexes. Antibodies generated to the C and N termini of GF14 detected protein isoforms in rice nuclear and cytoplasmic extracts, but no differences in distribution of the GF14 isoforms were recognized between the nucleus and cytoplasm or when abscisic acid-treated and untreated tissues were compared. When recombinant GF14 fusion proteins from rice were added to nuclear extracts, novel complexes were formed that required the dimerization domain of GF14. Chemical cross-linking showed that GF-14 interacted with the basic leucine zipper factor EmBP1, which binds specifically to Em1a, and with VP1, which transactivates Em through Em1a. GF14 proteins from rice were shown to interact with VP1 in yeast through the dimerization domain of GF14. Our results indicated that GF14 interacts with both site-specific DNA binding proteins (i.e., EmBP1) and tissue-specific regulatory factors (i.e., VP1) and may provide a structural link between VP1 and the Em1a transcriptional complex.

Objectives: To determine the use and costs of the principal out of hours health services in Buckinghamshire. Design: Prospective cross sectional survey and cost description of patient contacts with out of hours services. Setting: Buckinghamshire during March and April 1995. Subjects: General practices, accident and emergency departments, ambulance services, and community nursing services. Main outcome measure: Contacts with patients and cost of out of hours services. Results: 438 patient contacts/1000 population/year were recorded at an annual incremental cost of between £4.6m and £7.2m (depending on the costing of general practitioner services), for a population of 660 000. Of these contacts, 21 649 (45%) were with general practitioners. Night time contacts with all services diminished sharply after 10 pm. General practitioners considered that 40% of contacts were unnecessary or could have waited until morning. Over 70% of contacts were for upper respiratory tract infections, earache, gastroenteritis, and other minor ailments. Nursing care was predominantly for elderly people, and 33% of nursing contacts were to supervise medication. Accident and emergency care was predominately for young adults, especially men, and 41% of attendances were for medical conditions. Conclusions: New models such as multidisciplinary primary care centres with telephone advice lines and triaging are required to ensure high quality, cost effective care that is responsive to the needs of both consumers and professionals.

34The COVID-19 pandemic is straining public health systems worldwide and major non-35 pharmaceutical interventions have been implemented to slow its spread [1][2][3][4] . During the initial phase 36 of the outbreak the spread was primarily determined by human mobility 5,6 . Yet empirical evidence 37 on the effect of key geographic factors on local epidemic spread is lacking 7 . We analyse highly-38 resolved spatial variables for cities in China together with case count data in order to investigate 39 the role of climate, urbanization, and variation in interventions across China. Here we show that 40 the epidemic intensity of COVID-19 is strongly shaped by crowding, such that epidemics in dense 41cities are more spread out through time, and denser cities have larger total incidence. Observed 42 differences in epidemic intensity are well captured by a metapopulation model of COVID-19 that 43 explicitly accounts for spatial hierarchies. Densely-populated cities worldwide may experience more 44 prolonged epidemics. Whilst stringent interventions can shorten the time length of these local 45 epidemics, although these may be difficult to implement in many affected settings. 46 47 Main text identify drivers of local transmission in Chinese cities, with a focus on epidemic intensity among 68 provinces in China. 69 70To explore the impact of urbanization, temperature, and humidity, we used daily incidence data of 71 confirmed COVID-19 cases (date of onset) aggregated at the prefectural level (n = 293) in China. 72Prefectures are administrative units that typically have one urban center (Figure 1). We aggregate 73 individual level data that were collected from official government reports 18 . Epidemiological data in each 74 prefecture were truncated to exclude dates before the first and after the last day of reported cases. The 75 shape of epidemic curves varied between prefectures with some showing rapid rises and declines in cases 76 and others showing more prolonged epidemics (Figure 1A). We estimate epidemic intensity for each 77 prefecture from these data by calculating the inverse Shannon entropy of the distribution of incident 78 cases 9 . We define the incidence distribution "# for a given city to be the proportion of COVID-19 cases 79