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To assess whether high-dose coronavirus disease (COVID-19) convalescent plasma (CCP) transfusion may benefit patients with severe COVID-19, we conducted a multicenter randomized trial in Brazil. Patients with severe COVID-19 who were within 10 days of initial symptom onset were eligible. Patients in the CCP group received 3 daily doses of CCP (600 mL/d) in addition to standard treatment; control patients received standard treatment only. Primary outcomes were death rates at days 30 and 60 of study randomization. Secondary outcomes were ventilator-free days and hospital-free days. We enrolled 107 patients: 36 CCP and 71 control. At day 30, death rates were 22% for CCP and 25% for the control group; at day 60, rates were 31% for CCP and 35% for control. Needs for invasive mechanical ventilation and durations of hospital stay were similar between groups. We conclude that high-dose CCP transfused within 10 days of symptom onset provided no benefit for patients with severe COVID-19.

Summary: Background: Administration of convalescent plasma may serve as an adjunct to supportive treatment to prevent COVID-19 progression and death. We aimed to evaluate the efficacy and safety of 2 volumes of intravenous convalescent plasma (CP) with high antibody titers for the treatment of severe cases of COVID-19. Methods: We conducted a Bayesian, randomized, open-label, multicenter, controlled clinical trial in 7 Brazilian hospitals. Adults admitted to hospital with positive RT-PCR for SARS-CoV2, within 10 days of the symptom onset, were eligible. Patients were randomly assigned (1:1:1) to receive standard of care (SoC) alone, or in combination with 200 mL (150–300 mL) of CP (Low-volume), or 400 mL (300–600 mL) of CP (High-volume); infusion had to be performed within 24 h of randomization. Randomization was centralized, stratified by center. The primary outcome was the time until clinical improvement up to day 28, measured by the WHO ten-point scale, assessed in the intention-to-treat population. Interim and terminal analyses were performed in a Bayesian framework. Trial registered at ClinicalTrials.gov: NCT04415086. Findings: Between June 2, 2020, and November 18, 2020, 129 patients were enrolled and randomly assigned to SoC (n = 42), Low-volume (n = 43) or High-volume (n = 44) CP. Donors presented a median titer of neutralizing antibodies of 1:320 (interquartile range, 1:160 to 1:1088). No evidence of any benefit of convalescent plasma was observed, with Bayesian estimate of 28-day clinical improvement of 72.7% (95%CI, 58.8 to 84.7) in the SoC versus 64.1% (95%ci, 53.8 to 73.7) in the pooled experimental groups (mean difference of -8.7%, 95%CI, -24.6 to 8.2). There was one case of cutaneous mild allergic reaction related to plasma transfusion and one case of suspected transfusion-related acute lung injury but deemed not to be related to convalescent plasma infusion. Interpretation: In this prospective, randomized trial of adult hospitalized patients with severe COVID-19, convalescent plasma was not associated with clinical benefits. Funding: Brazilian Ministry of Science, Technology and Innovation, Fundação de Amparo à Pesquisa do Estado de São Paulo.

El presente escrito gira en torno al problema de la moral y el posconflicto, y del papel de la escuela en la construcción de un sujeto que rompa dos herencias, que han impedido la modernidad en nuestro presente colombiano: una moral pastoral-escolástica y el fracaso de la moral formal moderna liberal. Ante los cuales se propone desde la educación una ética de sí mismo, en la consolidación de unas subjetividades radicalmente distintas hasta ahora. Por ello dicho ejercicio del desarrollo humano que rescate las autonomías comunitarias con el acompañamiento de lo pedagógico, puestas de cara al momento del proceso de paz y particularmente al posconflicto hace un llamado del retorno a lo comunitario, como aquellos procesos singulares de tejer propuestas venidas de lo cotidiano, de lo local, que generadas desde lógicas del sentir, restituyan comunidades constructoras de sus propios destinos, donde no tengan cabida lógicas racionales que sólo miden el impacto del avance tecnológico científico, donde se olvida el sentido de tener una existencia en libertad y convivencia mutua de lo humano con la naturaleza, lo cual quizás obligue a reconstruir formas de pensar donde la palabra este en coherencia con lo que se dice y de hace.

Os bancos de sangue de cordão umbilical e placentário foram criados a partir da comprovação de que o sangue de cordão umbilical e placentário (SCUP) é uma fonte rica em células progenitoras hematopoéticas (CPH) e alternativa às células provenientes da medula óssea para transplante, fato que gerou o interesse pelo armazenamento das células nele contidas. A legislação brasileira distingue bancos para uso alogênico não aparentado (públicos) e para uso exclusivamente autólogo (privados). Por sua vez, o armazenamento de SCUP para uso familiar (doação dirigida) pode ser realizado em bancos de sangue de cordão umbilical e placentário públicos, serviços de hemoterapia ou centros de transplante, quando há um membro da família do nascituro com doença diagnosticada e que necessite de transplante de CPH como tratamento. Apesar de a legislação ser clara, a Anvisa tem identificado o interesse sobre a possibilidade da liberação de unidades de SCUP, armazenadas em bancos autólogos, para a utilização de outrem, familiar, além do recém-nascido beneficiário. O objetivo do trabalho visa promover a reflexão sobre uma possível modificação dos parâmetros legais nacionais que regem os bancos de SCUP autólogo, tornando-os bancos com vistas ao uso familiar, por meio da exposição dos principais elementos relacionados ao tema. O estudo analisou os critérios técnico-sanitários legais para regulamentação dos bancos; descreveu as características das CPH de diversas fontes e tipos de doação para transplante; contextualizou a relação com os princípios da Bioética; avanços sobre terapia e pesquisas relativas às CPH; e discutiu possíveis riscos envolvidos no processo.Umbilical cord blood banks have been created worldwide after the discovery that umbilical cord blood (UCB) is a rich source of Hematopoietic Stem Cells (HSC) and an alternative to HSC from bone marrow for allogeneic transplantation. According to Brazilian legislation, banks for allogeneic use (government services) and exclusively autologous use (private services) can be created in the country. The storage of UCB units for direct donation (family use) can occur in public cord blood banks, hemotherapy services and transplant centers when there is a specific need to treat a known patient that is a member of the newborn's family. Even with the legislation being quite clear about the creation of cord blood banks and distribution of UCB units, ANVISA has identified an interest, demonstrated by the population and regulated sector, in the possibility of releasing UCB units, stored in autologous cord blood banks, with the purpose of clinical applicability to another family member other than the newborn owner of the cells. The objective of this study is to promote a discussion on a possible alteration in the legal parameters that support the implementation of autologous cord blood banks, towards the constitution of private banks for family use, pointing out the main issues. The study analyzed the technical and legal criteria related to cord blood banks, described the characteristics of HSC from different sources and types of transplant donations and procedures; discussed concerns related to Bioethical principles, current and potential clinical HSC applications, and possibly risks and benefits.

Based on a new approach to symmetries of the fundamental interactions we deal, in this paper, with the electroweak interactions of leptons. We show that the coupling constants, arising in the way leptons are coupled to intermediate bosons, can be understood as parameters associated to the breakdown of SU(2) and parity symmetries. The breakdown of both symmetries is characterized by a new parameter (the asymetry parameter) of the electroweak interactions. This parameter gives a measure of the strength of breakdown of symmetries. We analyse the behaviour of the theory for three values of this parameter. The most relevant value is the one for which only the electromagnetic interactions do not break parity (the maximally allowed left-right asymetric theory). Maximamally allowed parity asymmetry is a requirement that is met for a value of Weinberg's theta-angle that is quite close to the experimental value of this parameter.Com base em uma formulação nova para simetrias das interações fundamentais nós lidamos, neste trabalho, com interações eletrofracas de leptons. Mostramos que as constantes do acoplamento, associadas aos acoplamentos de bósons intermediários, podem ser entendidas como parâmetros associados à quebra de simetrias SU(2) e paridade. A quebra de ambas as simetrias é caracterizada por um parâmetro novo (o parâmetro de assimetria) das interações eletrofracas. Este parâmetro dá uma medida da intensidade com que a simetria é quebrada. Analisamos o comportamento da teoria para três valores deste parâmetro. O valor mais relevante é aquele para o qual apenas as interações eletromagnéticas não quebram a paridade (a teoria assimétrica esquerda-direita permitida da maneira máxima). A assimetria máxima permitida é uma exigência que leva a um ângulo de Weinberg cujo valor é próximo daquele observado experimentalmente.

The antigens recognised by mAb US5 specific to 53 kDa glycoprotein (gp 53) in T. spiralis L-1 muscle larvae (TSL1) antigens, mAb US9 specific to gp 53 in TSL1 from all encapsulated species and mAb US4 specific to a tyvelose containing tetrasaccharide present in TSL1, were investigated in crude extracts from muscle larvae of T. spiralis, T. nativa and T. britovi by 2D-electrophoresis and western-blot. At least four proteins of different pI were recognised by mAb US5 on T. spiralis antigens. Recognition profile of mAb US9 on T. spiralis antigens exhibited some variation with regard to that of the US5. Polymorphism was apparent in gp 53. High reactivity was shown by the mAb US4 with the three species.

While ontic structural realism (OSR) has been a central topic in contemporary philosophy of science, the relation between OSR and the concept of emergence has received little attention. We will argue that OSR is fully compatible with emergentism. The denial of ontological emergence requires additional assumptions that, strictly speaking, go beyond OSR. We call these physicalist closure assumptions. We will explain these assumptions and show that they are independent of the central commitments of OSR and inconsistent with its core goals. Recognizing the compatibility of OSR and ontological emergence may contribute to the solution of ontological puzzles in physics while offering new ways to achieve the goals that advocates of OSR set for their view., Author(s): João L. Cordovil [sup.1], Gil C. Santos [sup.1], John Symons [sup.2] Author Affiliations: (1) grid.9983.b, 0000 0001 2181 4263, Centro de Filosofia das Ciências da Universidade de Lisboa, Departamento [...]