Comparative efficacy and tolerability of pharmacological interventions for attention-deficit/hyperactivity disorder in children, adolescents and adults: protocol for a systematic review and network meta-analysis

Introduction Attention-deficit/hyperactivity disorder (ADHD) is a major public health issue. Pharmacological treatments play an important role in the multimodal treatment of ADHD. Currently, there is a lack of up-to-date and comprehensive evidence on how available ADHD drugs compare and rank in terms of efficacy and tolerability, in children or adolescents as well as in adults. We will conduct a network meta-analysis (NMA), integrating direct and indirect comparisons from randomised controlled trials (RCTs), to rank pharmacological treatments for ADHD according to their efficacy and tolerability profiles. Methods and analysis We will search a broad range of electronic databases, including PubMed, MEDLINE, EMBASE, PsycINFO, ERIC and Web of Science, with no date or language restrictions. We will also search for unpublished studies using international clinical trial registries and contacting relevant drug companies. We will identify and include available parallel-group, cross-over and cluster randomised trials that compare methylphenidate, dexmethylphenidate, amphetamine derivatives (including lisdexamfetamine), atomoxetine, clonidine, guanfacine, bupropion or modafinil (as oral therapy) either with each other or to placebo, in children, adolescents or adults with ADHD. Primary outcomes will be efficacy (indicated by reduction in severity of ADHD core symptoms measured on a standardised scale) and tolerability (the proportion of patients who left a study early due to side effects). Secondary outcomes will be global functioning, acceptability (proportion of patients who left the study early by any cause) and changes in blood pressure and body weight. NMA will be conducted in STATA within a frequentist framework. The quality of RCTs will be evaluated using the Cochrane risk of bias tool, and the quality of the evidence will be assessed using the GRADE approach. Subgroup and sensitivity analyses will be conducted to assess the robustness of the findings. Ethics and dissemination No ethical issues are foreseen. Results from this study will be published in a peer-reviewed journal and possibly presented at relevant national and international conferences

A First Search for coincident Gravitational Waves and High Energy Neutrinos using LIGO, Virgo and ANTARES data from 2007

We present the results of the first search for gravitational wave bursts associated with high energy neutrinos. Together, these messengers could reveal new, hidden sources that are not observed by conventional photon astronomy, particularly at high energy. Our search uses neutrinos detected by the underwater neutrino telescope ANTARES in its 5 line configuration during the period January - September 2007, which coincided with the fifth and first science runs of LIGO and Virgo, respectively. The LIGO-Virgo data were analysed for candidate gravitational-wave signals coincident in time and direction with the neutrino events. No significant coincident events were observed. We place limits on the density of joint high energy neutrino - gravitational wave emission events in the local universe, and compare them with densities of merger and core-collapse events.Comment: 19 pages, 8 figures, science summary page at http://www.ligo.org/science/Publication-S5LV_ANTARES/index.php. Public access area to figures, tables at https://dcc.ligo.org/cgi-bin/DocDB/ShowDocument?docid=p120000

Moonraker: enceladus multiple flyby mission

Stars and planetary system

Antidepressants may work for people with major depression: where do we go from here?

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Risk taking by singing males

The distance at which an individual flees from a potential predator represents a measure of risk taking. If individuals are engaged in another activity that might affect fitness, trade-offs between the fitness benefits of flight and the other activity should determine the nearest distance of approach by a predator. In a comparative analysis of birds, flight distance represented a reliable measure of risk of predation by the sparrowhawk Accipiter nisus that increased with decreasing flight distance across species. To test the hypothesis that singing males adjusted their risk taking to the costs and benefits of early flight, we compared the flight distance of singing and nonsinging birds to an approaching human observing with a binocular. Singing birds on average fled at a greater distance than nonsinging birds, implying that singing birds took small risks. We used a standardized measure of difference in flight distance between singing and nonsinging individuals to investigate factors affecting interspecific variation in risk taking. Species that used more exposed song posts (sites used for singing) took smaller risks than species with less exposed song posts. Species that suffered from higher levels of parasitism as reflected by the prevalence of Plasmodium, but not by 3 other genera of blood parasites, took greater risks during singing compared with nonsinging activities. Likewise, species with high circulating levels of natural antibodies, and hence a history of natural selection caused by bacteria took relatively greater risks during singing than species with few natural antibodies. These findings suggest that risks taken by singing birds have been molded by natural and sexual selection, and that risk taking represents a compromise between the costs and benefits of flight from a potential predator