Corticosteroids for the common cold

BACKGROUND: The common cold is a frequent illness, which, although benign and self limiting, results in many consultations to primary care and considerable loss of school or work days. Current symptomatic treatments have limited benefit. Corticosteroids are an effective treatment in other upper respiratory tract infections and their anti‐inflammatory effects may also be beneficial in the common cold. This updated review has included one additional study. OBJECTIVES: To compare corticosteroids versus usual care for the common cold on measures of symptom resolution and improvement in children and adults. SEARCH METHODS: We searched Cochrane Central Register of Controlled Trials (CENTRAL 2015, Issue 4), which includes the Acute Respiratory Infections (ARI) Group's Specialised Register, the Database of Reviews of Effects (DARE) (2015, Issue 2), NHS Health Economics Database (2015, Issue 2), MEDLINE (1948 to May week 3, 2015) and EMBASE (January 2010 to May 2015). SELECTION CRITERIA: Randomised, double‐blind, controlled trials comparing corticosteroids to placebo or to standard clinical management. DATA COLLECTION AND ANALYSIS: Two review authors independently extracted data and assessed trial quality. We were unable to perform meta‐analysis and instead present a narrative description of the available evidence. MAIN RESULTS: We included three trials (353 participants). Two trials compared intranasal corticosteroids to placebo and one trial compared intranasal corticosteroids to usual care; no trials studied oral corticosteroids. In the two placebo‐controlled trials, no benefit of intranasal corticosteroids was demonstrated for duration or severity of symptoms. The risk of bias overall was low or unclear in these two trials. In a trial of 54 participants, the mean number of symptomatic days was 10.3 in the placebo group, compared to 10.7 in those using intranasal corticosteroids (P value = 0.72). A second trial of 199 participants reported no significant differences in the duration of symptoms. The single‐blind trial in children aged two to 14 years, who were also receiving oral antibiotics, had inadequate reporting of outcome measures regarding symptom resolution. The overall risk of bias was high for this trial. Mean symptom severity scores were significantly lower in the group receiving intranasal steroids in addition to oral amoxicillin. One placebo‐controlled trial reported the presence of rhinovirus in nasal aspirates and found no differences. Only one of the three trials reported on adverse events; no differences were found. Two trials reported secondary bacterial infections (one case of sinusitis, one case of acute otitis media; both in the corticosteroid groups). A lack of comparable outcome measures meant that we were unable to combine the data. AUTHORS' CONCLUSIONS: Current evidence does not support the use of intranasal corticosteroids for symptomatic relief from the common cold. However, there were only three trials, one of which was very poor quality, and there was limited statistical power overall. Further large, randomised, double‐blind, placebo‐controlled trials in adults and children are required to answer this question

Growing good crops of oats in Missouri

Revision of Bulletin 644.Cover title.Includes bibliographical references

Blending for student engagement: lessons learned for the MOOCs and beyond

The purpose of this ongoing, three-year action research study is to explore the digital challenges of student engagement in higher education within the experimental platform of blended learning. Research questions examine the role of digital innovation in supporting diverse learners, as well as building meaningful connections with technology for undergraduate teacher education students. Results from qualitative data collected through instructor journals and field notes and student mid-term and exit surveys during year one, indicate blended learning can be effective for modelling how to use technology to shift learners towards more active agency. The immediacy of the localised university classroom delivered a viable research setting for digital experimentation, while providing a significant lived experience for undergraduates to springboard their future technological practices with K–12 students. Four pedagogical opportunities for digital intentionality in virtual spaces emerged during data analysis and are shared as considerations for future innovation: (1) designing digital resources, (2) scaffolding student learning, (3) learner customisation, and (4) promoting the lived experience. Lessons learned could be effective in helping develop higher quality educational experiences for on-campus students, as well as scaffolding greater engagement in online formats involving more global populations (e.g., massive online open courses – MOOCs)

Corticosteroids for pain relief in sore throat: systematic review and meta-analysis

Objective To evaluate whether systemic corticosteroids improve symptoms of sore throat in adults and children

Renal denervation for the management of resistant hypertension

Renal sympathetic denervation (RSD) as a therapy for patients with resistant hypertension has attracted great interest. The majority of studies in this field have demonstrated impressive reductions in blood pressure (BP). However, these trials were not randomized or sham-controlled and hence, the findings may have been overinflated due to trial biases. SYMPLICITY HTN-3 was the first randomized controlled trial to use a blinded sham-control and ambulatory BP monitoring. A surprise to many was that this study was neutral. Possible reasons for this neutrality include the fact that RSD may not be effective at lowering BP in man, RSD was not performed adequately due to limited operator experience, patients’ adherence with their antihypertensive drugs may have changed during the trial period, and perhaps the intervention only works in certain subgroups that are yet to be identified. Future studies seeking to demonstrate efficacy of RSD should be designed as randomized blinded sham-controlled trials. The efficacy of RSD is in doubt, but many feel that its safety has been established through the thousands of patients in whom the procedure has been performed. Over 90% of these data, however, are for the Symplicity™ system and rarely extend beyond 12 months of follow-up. Long-term safety cannot be assumed with RSD and nor should it be assumed that if one catheter system is safe then all are. We hope that in the near future, with the benefit of well-designed clinical trials, the role of renal denervation in the management of hypertension will be established

Diet selection in the Coyote Canis latrans

The Coyote (Canis latrans) is one of the most studied species in North America with at least 445 papers on its diet alone. While this research has yielded excellent reviews of what coyotes eat, it has been inadequate to draw deeper conclusions because no synthesis to date has considered prey availability. We accounted for prey availability by investigating the prey selection of coyotes across its distribution using the traditional Jacobs’ index method, as well as the new iterative preference averaging (IPA) method on scats and biomass. We found that coyotes selected for Dall’s Sheep (Ovis dalli), White-tailed Deer (Odocoileus virginianus), Eastern Cottontail Rabbit (Sylvilagus floridanus), and California Vole (Microtus californicus), which yielded a predator-to-preferred prey mass ratio of 1:2. We also found that coyotes avoided preying on other small mammals, including carnivorans and arboreal species. There was strong concordance between the traditional and IPA method on scats, but this pattern was weakened when biomass was considered. General linear models revealed that coyotes preferred to prey upon larger species that were riskier to hunt, reflecting their ability to hunt in groups, and were least likely to hunt solitary species. Coyotes increasingly selected Mule Deer (O. hemionus) and Snowshoe Hare (Lepus americanus) at higher latitudes, whereas Black-tailed Jackrabbit (L. californicus) were increasingly selected toward the tropics. Mule Deer were increasingly selected at higher coyote densities, while Black-tailed Jackrabbit were increasingly avoided at higher coyote densities. Coyote predation could constrain the realized niche of prey species at the distributional limits of the predator through their increased efficiency of predation reflected in increased prey selection values. These results are integral to improved understandings of Coyote ecology and can inform predictive analyses allowing for spatial variation, which ultimately will lead to better understandings about the ecological role of the coyote across different ecosystems

Associations between changes in ferritin levels and susceptibility-weighted imaging filtered phase in patients with relapsing–remitting multiple sclerosis over 24weeks of therapy with subcutaneous interferon beta-1a three times weekly

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Is Point-of-Care testing feasible and safe in care homes in England? An exploratory usability and accuracy evaluation of a point-of-care polymerase chain reaction test for SARS-COV-2

Introduction Reliable rapid testing on COVID-19 is needed in care homes to reduce the risk of outbreaks and enable timely care. Point-of-care testing (POCT) in care homes could provide rapid actionable results. This study aimed to examine the usability and test performance of point of care polymerase chain reaction (PCR) for COVID-19 in care homes. Methods Point-of-care PCR for detection of SARS-COV2 was evaluated in a purposeful sample of four UK care homes. Test agreement with laboratory real-time PCR and usability and use errors were assessed. Results Point of care and laboratory polymerase chain reaction (PCR) tests were performed on 278 participants. The point of care and laboratory tests returned uncertain results or errors for 17 and 5 specimens respectively. Agreement analysis was conducted on 256 specimens. 175 were from staff: 162 asymptomatic; 13 symptomatic. 69 were from residents: 59 asymptomatic; 10 symptomatic. Asymptomatic specimens showed 83.3% (95% CI: 35.9%-99.6%) positive agreement and 98.7% negative agreement (95% CI: 96.2%-99.7%), with overall prevalence and bias-adjusted kappa (PABAK) of 0.965 (95% CI: 0.932 – 0.999). Symptomatic specimens showed 100% (95% CI: 2.5%-100%) positive agreement and 100% negative agreement (95% CI: 85.8%-100%), with overall PABAK of 1. No usability-related hazards emerged from this exploratory study. Conclusion Applications of point-of-care PCR testing in care homes can be considered with appropriate preparatory steps and safeguards. Agreement between POCT and laboratory PCR was good. Further diagnostic accuracy evaluations and in-service evaluation studies should be conducted, if the test is to be implemented more widely, to build greater certainty on this initial exploratory analysis