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The Tenth International Conference on trichinellosis, organized by the International Commission on Trichinellosis, gathered together 147 scientists from 34 countries. The 173 presentations ranged over most aspects of this parasitic zoonosis: history, epidemiology, speciation, biology, immunology, biochemistry, human and animal pathology, new diagnostic methods and control.
BACKGROUND: There is controversy about which dialytic modality should be used for the treatment of acute renal failure (ARF) in the intensive care unit. We performed a systematic review and meta-analysis to determine the relative risks (RRs) of mortality and renal recovery associated with intermittent hemodialysis (IHD) therapy compared with continuous renal replacement therapy (CRRT) in critically ill adults with ARF. METHODS: Four databases (MEDLINE, Cochrane Library, Database of Abstracts and Reviews, and Science Citation Index), hand searching of conference proceedings and journals, manual review of bibliographies from identified articles, and contact with experts were used. All randomized trials (published or unpublished in any language) that compared mortality between intermittent and continuous treatments were eligible. Trials for which an RR for mortality could not be calculated or with multiple experimental interventions were excluded. Data were extracted separately by two authors and recorded on a standardized form. Disagreements were resolved by consensus. RESULTS: Six eligible trials were identified; four of these provided data on renal outcomes. RR (mortality) for IHD was 0.96 (95% confidence interval [CI], 0.85 to 1.08; P = 0.50), RR (renal death) was 1.02 (95% CI, 0.89 to 1.17; P = 0.78), and RR (dialysis dependence) in survivors was 1.19 (95% CI, 0.62 to 2.27; P = 0.60; all compared with continuous therapy). Several sensitivity analyses did not change these results. Of the outcomes studied, the risk for dialysis dependence in survivors would be most sensitive to the addition of new trials. CONCLUSIONS: In comparison to IHD therapy, CRRT does not improve survival or renal recovery in unselected critically ill patients with ARF. Future studies should focus on well-defined subgroups of such patients using lessons learned from the trials in this meta-analysis. The high cost of chronic dialysis therapy and the relative instability of the RR for dialysis dependence suggest that future trials also should evaluate differences in renal recovery between dialytic modalities.
BACKGROUND: Many randomized trials have now evaluated the effects of calcimimetics in patients with chronic kidney disease and secondary hyperparathyroidism (SHPT) on standard therapy with vitamin D and/or phosphate binders. We conducted a meta-analysis to evaluate outcomes of therapy with these novel agents. METHODS: MEDLINE, EMBASE, the Cochrane Controlled Trials Register, and conference proceedings were searched for randomized controlled trials evaluating any calcimimetic against placebo or another agent in predialysis or dialysis patients with chronic kidney disease. Data were extracted for all relevant patient-centered and surrogate outcomes. Analysis was by means of a random-effects model, and results are expressed as relative risk or weighted mean difference (WMD) with 95% confidence intervals (CIs). RESULTS: Eight trials (1,429 patients) were identified that compared a calcimimetic agent plus standard therapy with placebo plus standard therapy. End-of-treatment values for parathyroid hormone (4 trials; 1,278 patients; WMD, -290.49 pg/mL; 95% CI, -359.91 to -221.07), serum calcium (3 trials; 1,201 patients; WMD, -0.85 mg/dL; 95% CI, -1.14 to -0.56), serum phosphorus (3 trials; 1,195 patients; WMD, -0.29 mg/dL; 95% CI, -0.50 to -0.08), and calcium x phosphorus product (3 trials; 1,194 patients; WMD, -7.90 mg2/dL2; 95% CI, -10.25 to -5.54) were significantly lower with calcimimetic therapy compared with placebo. No significant effects on patient-based end points were shown. CONCLUSION: Calcimimetic treatment of patients with SHPT leads to significant improvements in biochemical parameters that observational studies have associated with increased mortality, cardiovascular risk, and osteitis fibrosa, but patient-based benefits have not yet been shown. For patients with SHPT, the benefits of calcimimetics over standard therapy remain uncertain until additional randomized trials become available.
BACKGROUND: Acute kidney injury is common in critically ill patients. Fenoldopam mesylate is a potent dopamine A-1 receptor agonist that increases blood flow to the renal cortex and outer medulla. Because there is uncertainty about the benefits of fenoldopam in such a setting, we performed a systematic review of randomized controlled trials of intensive care unit patients or those undergoing major surgery. METHODS: BioMedCentral, CENTRAL, PubMed, and conference proceedings were searched (updated October 2005). Investigators and external experts were contacted. Two unblinded reviewers selected randomized controlled trials that used fenoldopam in the prevention or treatment of acute kidney injury in postoperative or intensive care patients. Studies involving the prevention of contrast nephropathy or containing duplicate data were excluded from analysis. Two reviewers independently abstracted patient data, treatment characteristics, and outcomes. RESULTS: A total of 1,290 patients from 16 randomized studies were included in the analysis. Pooled estimates showed that fenoldopam consistently and significantly reduced the risk for acute kidney injury (odds ratio [OR], 0.43; 95% confidence interval [CI], 0.32 to 0.59; P < 0.001), need for renal replacement therapy (OR, 0.54; 95% CI, 0.34 to 0.84; P = 0.007), and in-hospital death (OR, 0.64; 95% CI, 0.45 to 0.91; P = 0.01). These benefits were associated with shorter intensive care unit stay (weighted mean difference, -0.61 days; 95% CI, -0.99 to -0.23; P = 0.002). Sensitivity analyses, tests for small-study bias, and heterogeneity assessment further confirmed the main analysis. CONCLUSION: This analysis suggests that fenoldopam reduces the need for renal replacement and mortality in patients with acute kidney injury. A large, multicenter, appropriately powered trial will need to be performed to confirm these results.
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BACKGROUND: Fenfluramine-derivative diet pills were withdrawn from the market in 1997 because of an association with valvular regurgitation, but subsequent estimates of the prevalence of this condition have varied widely. We systematically reviewed evidence regarding the prevalence of valvular disease after fenfluramine exposure. METHODS: We searched multiple databases with multiple search terms. Conference proceedings from 1997 onward were searched by index. Authors of eligible studies were contacted to identify unpublished works. Selection criteria were liberally determined. Ten of the identified 11 articles met these criteria. Reviewers assessed the studies' methodologic quality by use of a standard form to evaluate selection, attrition, performance, and detection bias. The studies were analyzed in 2 groups on the basis of length of exposure (<90 days or >90 days). The Mantel-Haenszel method was used to summarize data. Quantitative and qualitative tests for heterogeneity were performed. Tests for publication bias were also done. RESULTS: Tests for heterogeneity were nonsignificant after removing 1 outlier trial. The pooled prevalence of valvular regurgitation meeting Food and Drug Administration criteria (at least mild aortic regurgitation or at least moderate mitral regurgitation) among patients treated for >90 days was 12.0% compared with 5.9% for the unexposed group (prevalence odds ratio 2.2, 95% CI 1.7-2.7). The combined analyses also identified a small but statistically significant increase in mitral regurgitation not previously identified by individual studies (exposed 3.5%, unexposed 1.8%, prevalence odds ratio 1.6, 95% CI 1.05-2.3). Among patients exposed for <90 days, a trend toward more regurgitation was not statistically significant by either combined Food and Drug Administration criteria (exposed 6.8%, unexposed 5.8%, prevalence odds ratio 1.4, 95% CI 0.8-2.4) or by individual valve. CONCLUSIONS: These data indicate that fenfluramine-associated valvular regurgitation is less common than initially reported, but still present in 1 of 8 patients treated for >90 days.
BACKGROUND: Although many catheter-related bloodstream infections (CR-BSIs) are preventable, measures to reduce these infections are not uniformly implemented. OBJECTIVE: To update an existing evidenced-based guideline that promotes strategies to prevent CR-BSIs. DATA SOURCES: The MEDLINE database, conference proceedings, and bibliographies of review articles and book chapters were searched for relevant articles.Studies Included: Laboratory-based studies, controlled clinical trials, prospective interventional trials, and epidemiological investigations. OUTCOME MEASURES: Reduction in CR-BSI, catheter colonization, or catheter-related infection. SYNTHESIS: The recommended preventive strategies with the strongest supportive evidence are education and training of healthcare providers who insert and maintain catheters; maximal sterile barrier precautions during central venous catheter insertion; use of a 2% chlorhexidine preparation for skin antisepsis; no routine replacement of central venous catheters for prevention of infection; and use of antiseptic/antibiotic impregnated short-term central venous catheters if the rate of infection is high despite adherence to other strategies (i.e. education and training, maximal sterile barrier precautions and 2% chlorhexidine for skin antisepsis). CONCLUSION: Successful implementation of these evidence-based interventions can reduce the risk for serious catheter-related infection.
The Primary Health Care Research Evaluation and Development (PHCRED) program in Australia aims to build research capacity in primary health care. In South Australia, the program (PHCRED-SA) has addressed skill building in dissemination of research findings by providing support for peer reviewed publication. The support included comprehensive advice and feedback for novice and inexperienced researchers and writers in the publication process of the program's 2003 Conference Proceedings. This paper describes the South Australian experience of supporting novice researchers in research dissemination by applying the PHCRED-SA capacity building support model.
OBJECTIVES: To determine by systematic review the prevalence of genital chlamydial infection in Australia between 1997 and 2004. METHODS: Electronic literature databases, reference lists, and conference proceedings were searched and health agencies and jurisdictions were contacted for published and unpublished reports. Studies were eligible if they offered a diagnostic nucleic acid amplification test to consecutive individuals presenting during the study period. As a summary measure of the available data, mean prevalence rates, weighted by sample size and irrespective of participant age, were calculated for the population sub-groups. RESULTS: 40 studies of 50 populations and 40,587 individuals met the inclusion criteria, but only one of these was population-based. The use of non-systematic methodologies prevented an assessment of time trends and a statistical comparison of population sub-groups. The mean overall prevalence of genital chlamydial infection was 4.6% (95% CI 4.4-4.8%), reflecting over-sampling of high-risk groups. The mean community-based rates were 7.5% (95% CI 6.4-8.6%) and 8.7% (95% CI 7.9-9.7%) for Indigenous men and women, and 1.5% (95% CI 1.1-1.9%) and 1.4% (95% CI 0.9-2.0%) for non-Indigenous men and women. The overall mean estimates for other groups were 3.3% (95% CI 3.0-3.7%) for female attendees of sexual health and related clinics, 5.6% (95% CI 4.9-6.4%) for adolescents and young adults, 3.3% (95% CI 2.8-3.9%) for sex workers, and 1.6% (95% CI 1.2-2.0%) for urethral infection in men who have sex with men. Clinic-based estimates were generally, although not consistently, higher than community-based estimates. There is no serial population-based data for sexually active young men and women, but the available age-specific rates suggest under-ascertainment by the routine surveillance systems. CONCLUSIONS: The prevalence of genital chlamydial infection in Indigenous Australians and young adults is unacceptably high and quality epidemiological studies are urgently required to supplement the routinely collected national notification data.
Let X be a smooth projective variety admitting an algebraic vector field V with exactly one zero and a holomorphic C(*)-action lambda so that the condition dlambda(t).V = t(p)V holds for all t in C(*). The purpose of this note is to report on a product formula for the Poincaré polynomial of X which specializes to the classical identity [Formula: see text] when X is the flag variety of a semisimple complex Lie group. A surprising corollary is that the second Betti number of such an X is the multiplicity of largest weight of the linear C(*)-action on the tangent space of X at the sink of lambda. We discuss several examples, including a construction of the rational Fano 3-folds A'(22) and B(5) which is due to Konarski [Konarski, J. (1989) in C.M.S. Conference Proceedings, ed. Russell, P. (Am. Math. Soc., Providence, RI), in press].
This paper is a summary of several papers published in different journals and conference proceedings. The contents deal with the incidence of load related musculoskeletal illness of female workers exposed to various workloads. Furthermore, the changes in workload due to improved workplace design and the effect on the incidence of musculoskeletal illness was evaluated. The sick-leave due to musculoskeletal illness was reduced from 5.3% to 3.1% and the reduction in turn-over from 30.1% to 7.6%. The cost and the benefits of this ergonomic intervention were analysed, and showed that an investment of NOK. 350,000 produced total savings of NOK. 3,200,000. Postural load was assessed by recording electromyography (EMG) on the upper part of musculus trapezius, postural angles of the upper arm and flexion/extension of the head and back. A quantitative relationship was found between the static trapezius load and the development of musculoskeletal sick-leave, related to the length of employment. Indications were found that certain factors were associated with reduced incidence of musculoskeletal illness. These were: increasing the number and total duration of trapezius load below 1% to 2% MVC (Maximum Voluntary Contraction); reducing the magnitude of flexion angle of the upper arm in the sagittal plane and distributing the work between flexors and extensors; and a more dynamic work pattern of the upper arm. The relationship between postural load and musculoskeletal injury was studied in comparable groups of female workers with respect to age, working hours per day and time of employment. Psychosocial problems, spare time activities and living habits of the workers did not show any significant differences across the groups. The results from this study indicate that: the static trapezius load must be kept at a minimum; a median arm flexion should be less than 15 degrees and a median arm abduction less than 10 degrees. These values seem roughly to approach an acceptable arm position; and a forward median flexion of the back of less than 20 degrees seems not to lead to a higher rate of low back pain for workers with long periods of employment.
Dr Jackson's concerns about citing non-peer-reviewed studies in the New Zealand Veterinary Journal (NZVJ) are shared by the editors and Editorial Board and have provoked considerable discussion about our policy and practice in this regard. Independent peer review remains a central part of the quality control process applied to the publication of scientific literature and is embraced by the NZVJ. All papers published in the NZVJ are scrutinised by the editors and Editorial Board, and those considered suitable are sent to two or three expert referees. In 2002, these comprised 195 people, of whom 36% were resident overseas. In addition, each paper is allocated a Guardian, a member of the Editorial Board specifically responsible for ensuring the adequacy of the peer-review process and providing an additional perspective regarding the quality of the paper. Papers are only accepted for publication after authors have satisfactorily addressed the issues raised by referees, Guardians and the Editor and sometimes by the Editorial Board. Thus, in addition to peer review, key quality-control roles are exercised at multiple points in the publication process by the Editor and Editorial Board to ensure the effectiveness, impartiality and integrity of the peer-review and editorial processes. Citation of data published in non-peer-reviewed sources in the NZVJ is discouraged but not precluded, in recognition of publications such as Surveillance and annual conference proceedings of New Zealand Veterinary Association (NZVA) special interest branches and the New Zealand Society of Animal Production as first repositories of disease reports and trial data often of substantial value and relevance to the scientific community. Many do not progress into the peer reviewed literature for reasons other than lack of quality and would otherwise be very difficult to access. As Dr Jackson points out, a substantial body of data generated in the deer industry has not yet appeared in peer-reviewed scientific journals, yet circulates widely in that industry. Considerable discussion preceded the permission granted authors to cite non-peer-reviewed studies to the extent evident in the December 2002 issue which was dedicated to feature review articles on the health and welfare of farmed deer. The proceedings of the annual seminars of the Deer Branch of the NZVA contain one of the most comprehensive records of studies on the nutrition, health and welfare of farmed deer available in the world. It was considered that the benefits of including discussion of these studies and exposing them to critical review outweighed the risks elaborated by Dr Jackson. However, the concerns raised by Dr Jackson and others prompted the Editorial Board to review the NZVJ's policy in this regard, which is now as follows: - Authors are specifically encouraged to cite peer-reviewed references wherever possible and particularly discouraged from citing their own publications in non-peer-reviewed sources. - Referees are specifically requested to scrutinise the use of non peer-reviewed references and make recommendations regarding alternatives or omission. - The Editor requests that authors: justify the use of non-peer-reviewed references; avoid the use of non-peer-reviewed citations more than 2 years old and; clearly distinguish references to nonpeer-reviewed references in the text of their papers, using qualifying statements such as preliminary data or non-peer-reviewed reportsetc. By limiting but not precluding citation of non-peer-reviewed studies, exposing them to specific scrutiny during the peer-review and editorial processes and by distinguishing them from peer-reviewed sources in the body of articles we aim to minimise the dangers of appearing to legitimise non-peer-reviewed data without losing the information value contained in some of these reports. There are many benefits of publishing in quality peer-reviewed journals such as the NZVJ, not least of which is the almost inevitable improvement in the quality and rigour of manuscripts after peer-review and the greatly increased opportunity for recognition and citation of peer-reviewed studies by others. Peer-reviewed journals remain the most widely accepted and established medium for communication and preservation of high-quality science. Authors and industry sectors that choose not to publish in peer-reviewed journals arguably limit the recognition and true progress of their science.
An investigation was made as to whether studies have found journal clubs for physicians in training to be effective for improving patient. care, teaching critical appraisal skills, improving reading habits, increasing knowledge of clinical epidemiology and biostatistics, and increasing the use of medical literature in clinical practice. A literature search was undertaken using 10 databases and retrieval systems and hand searches of journals, conference proceedings and personal files. The rigor of studies meeting the inclusion criteria was analyzed using a protocol based on methods established by the Cochrane Collaboration. One randomized controlled trial found an improvement in knowledge of clinical epidemiology and biostaristics, reading habits, and the use of medical literature in practice, but no improvement in critical appraisal skills. Six less methodologically rigorous studies found possible improvement in critical appraisal skills. It is concluded that journal clubs may improve knowledge of clinical epidemiology and biostatistics, reading habits, and the use of medical literature in practice. A multi-center, randomized controlled trial of journal clubs is needed to assess whether journal clubs improve critical appraisal skills.
In the past 75 years, articles in Research Quarterly for Exercise and Sport (RQES) have contributed to the understanding of the role physical activity plays in the health of individuals and populations. Articles have described laboratory and community research studies in humans and animals, presented reviews of topics and conference proceedings, and presented forums for discussion about current topics in physical activity and health. The articles reflect the growth of the profession from basic inquiry, about physiological responses to exercise (and the development of physical fitness methods and standards), to studies of the effects of exercise on physical fitness and health in various population subgroups. This evolution in RQES reflects the well recognized paradigm shift toward public health concerns for physical activity and health outcomes.
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CONCLUSIONS: The role of cognition in tinnitus is difficult to ignore. First, tinnitus is likely to disrupt cognitive functioning, and there are some indications that tinnitus patients have impaired capacity to perform certain cognitive tasks. Second, evidence is emerging that tinnitus patients show cognitive bias in the way they handle information. Such information processing style suggests either depressive functioning, or anxious vigilance, or both. Finally, self-report measures of tinnitus distress all require conscious recollection of how tinnitus is perceived and the consequences of tinnitus. Such reports necessitate cognitive capacity. OBJECTIVES: To review the literature on the interface between cognitive function and tinnitus, with special regard to the role of different levels of information processing. MATERIALS AND METHODS: A selective systematic literature search was conducted using the search engines of Medline and Psychological Abstracts, and by hand search of conference proceedings. RESULTS: There are yet relatively few published studies on cognitive functioning in tinnitus patients. Most research has been conducted by a few separate research groups. However, the available studies clearly implicate an important role of cognitive processes at different levels from basic cognitive function to more conscious appraisal of the consequences of tinnitus. Finally, a tentative model of the road from tinnitus generation to annoyance via cognitive function is suggested.
Arguably, the richest source of knowledge (as opposed to fact and data collections) about biology and biotechnology is captured in natural-language documents such as technical reports, conference proceedings and research articles. The automatic exploitation of this rich knowledge base for decision making, hypothesis management (generation and testing) and knowledge discovery constitutes a formidable challenge. Recently, a set of technologies collectively referred to as knowledge discovery in text (KDT) has been advocated as a promising approach to tackle this challenge. KDT comprises three main tasks: information retrieval, information extraction and text mining. These tasks are the focus of much recent scientific research and many algorithms have been developed and applied to documents and text in biology and biotechnology. This article introduces the basic concepts of KDT, provides an overview of some of these efforts in the field of bioscience and biotechnology, and presents a framework of commonly used techniques for evaluating KDT methods, tools and systems.