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...
The debate surrounding the documentation of performance is principally concerned with the ephemerality of the live event, set against the stasis and 'death' that the archive is conventionally believed to represent. The advent of digital technology in live performance has complexified this still further, by altering the architecture, space and dimensionality of the live event. Time-delay, live motion capture, feedback loops, dancing avatars and images projected in and onto the space all conspire to generate a liminal zone between the virtual and the real, fracturing audience perception and subverting still further the already-contested notion that performance can in any way be repeatable or 'captured'. Telematics and immersive/interactive environments, such as virtual reality, also complicate what the performance is and where it resides: here it becomes a personal exchange, in an intimate space generated afresh between the artist/performer and each spectator/participant. As our experience of performance becomes ever more personalised it reinforces the notion that multiple truths must emerge from any performance event and validates individual memory as a site for 'documents' to reside. Digital technology here comes to the fore as a documentation medium as well as a performance device: it allows us to upload, disseminate and share personal perspectives on a performance event and to challenge the limiting linearity of bound text and film, navigating dynamically between documentobjects and playfully (re)performing the documentation each time we visit it.
This article tracks my exploration of the somatic practices as a postgraduate dance student, set against the background of my previous experience and my journey to this place through conventional dance training. Personal reflections and journal writings are combined with a more formal definition and discussion of the somatic practices and their application to dance training and performance, with particular reference to the Alexander Technique and Body-Mind Centering. What emerges is a personal record of the shifts in my thinking/moving that were necessary to realize fully what the somatic practices have to offer, both in dance and life. It also charts the struggle and frustrations as well as the delights and discoveries that I encountered in this rite of passage.
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