Topical analgesia for acute otitis media

BACKGROUND: Acute otitis media (AOM) is a spontaneously remitting disease of which pain is the most distressing symptom. Antibiotics are now known to have less benefit than previously assumed. Topical pain relief may be a satisfactory intervention for AOM sufferers and encourage clinicians to prescribe fewer antibiotics. OBJECTIVES: To assess the effectiveness of topical analgesia for AOM in adults and children. SEARCH METHODS: For this second update we searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2011, Issue 1), Ovid MEDLINE (2008 to February Week 1 2011), Ovid MEDLINE (In‐Process & Other Non‐Indexed Citations 10 February 2011), Ovid EMBASE (2008 to 2011 Week 05), EBSCO CINAHL (2008 to 4 February 2011) and Ovid AMED (2008 to April 2011). SELECTION CRITERIA: Double‐blind randomised controlled trials (RCTs) or quasi‐RCTs comparing an otic preparation with an analgesic effect (excluding antibiotics) versus placebo or an otic preparation with an analgesic effect (excluding antibiotics) versus any other otic preparation with an analgesic effect, in adults or children presenting at primary care settings with AOM without perforation. DATA COLLECTION AND ANALYSIS: Three review authors independently screened studies, assessed trial quality and extracted data. Attempts to obtain additional information from the trial authors of the included trials were unsuccessful. MAIN RESULTS: Five trials including 391 children aged three to 18 years met our criteria. Two studies (117 children) compared anaesthetic ear drops versus placebo immediately at diagnosis. All children received some form of oral pain relief. In all five studies it was clear that ear pain diminishes rapidly for most sufferers. Nevertheless there was a statistically significant difference in the proportion of children achieving a 50% reduction in pain in favour of anaesthetic drops 10 minutes after instillation (risk ratio (RR) 2.13, 95% confidence interval (CI) 1.19 to 3.80) and 30 minutes after instillation (RR 1.43, 95% CI 1.12 to 1.81) on the day AOM was diagnosed but not at 20 minutes (RR 1.24, 95% CI 0.88 to 1.74). Three trials (274 children) compared anaesthetic ear drops with naturopathic herbal ear drops. Naturopathic drops were favoured 15 and 30 minutes after instillation, one to three days after diagnosis, but the differences were not statistically significant. Only one trial looked at adverse reactions and found none. Overall the findings of this review are based on trial evidence that is at low or unclear risk of bias. AUTHORS' CONCLUSIONS: Evidence from five RCTs, only two of which addressed the most relevant question of primary effectiveness, provides limited evidence that ear drops are effective 30 minutes after administration in older children with AOM. Uncertainty exists as to the magnitude of this effect and more high‐quality studies are needed

Hydrography and dynamics of Port Foster, Deception Island, Antarctica

The circulation and water masses of Port Foster, Deception Island, were studied using conductivity-temperature-depth stations inside and outside the semi-enclosed bay and an array of bottom temperature sensors moored around the perimeter of the bay over two weeks in the summer of 2012. Inside Port Foster, the water column is divided into two layers separated by a temperature-forced, seasonal pycnocline at ~40–60 m. The circulation of the upper layer is in an anticlockwise direction, with mean geostrophic currents of ~0.04–0.10 ms^(-1). The lower layer, from ~60 m to the seabed, shows coastal-trapped waves travelling in a clockwise direction, possibly triggered by local wind gusts. Local sea ice melt in areas surrounding the underwater hot springs of Pendulum Cove appears as a fresh, warm anomaly down to 30 m

Fracaso electromecánico inducido por el ejercicio dinámico

Se investiga el fracaso muscular tras la realización de un ejercicio dinámico de alto esfuerzo, mediante la determinación de índices cuantitativos de función contráctil. Cincuenta adultos practican un test triangular en cicloergómetro bajo control ergoespirométrico, midiendo en el cuádriceps femoral la variación de la fuerza generada en la estimulación eléctrica (curva fuerzaflrecuencia), de lafierza máxima voluntaria y del umbral de intensidad y la cronaxia. Se observan distintos tipos de fatiga de origen periférico, cuya magnitud no depende de la intensidad del esfuerzo. La coincidencia del cambio de la fuerza tetánica, de la fuerza voluntaria y de la cronaxia apoya la responsabilidad del defecto excitatorio en la fatiga de alta frecuencia, la cual puede causar la detención del ejercicio. El límite de la aptitud debe referirse a una capacidad individual según la modificación de diversos parámetros, entre los cuales debe incluirse una exploración funcional muscularPeer Reviewe

Seed systems and crop genetic diversity in agroecosystems

Poster presented at the First Diversitas Open Science Conference. Oaxaca (Mexico), 9-12 Nov 200

Neuraminidase inhibitors for preventing and treating influenza in healthy adults and children

BACKGROUND: Neuraminidase inhibitors (NIs) are stockpiled and recommended by public health agencies for treating and preventing seasonal and pandemic influenza. They are used clinically worldwide. OBJECTIVES: To describe the potential benefits and harms of NIs for influenza in all age groups by reviewing all clinical study reports of published and unpublished randomised, placebo-controlled trials and regulatory comments. SEARCH METHODS: We searched trial registries, electronic databases (to 22 July 2013) and regulatory archives, and corresponded with manufacturers to identify all trials. We also requested clinical study reports. We focused on the primary data sources of manufacturers but we checked that there were no published randomised controlled trials (RCTs) from non-manufacturer sources by running electronic searches in the following databases: the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, MEDLINE (Ovid), EMBASE, Embase.com, PubMed (not MEDLINE), the Database of Reviews of Effects, the NHS Economic Evaluation Database and the Health Economic Evaluations Database. SELECTION CRITERIA: Randomised, placebo-controlled trials on adults and children with confirmed or suspected exposure to naturally occurring influenza. DATA COLLECTION AND ANALYSIS: We extracted clinical study reports and assessed risk of bias using purpose-built instruments. We analysed the effects of zanamivir and oseltamivir on time to first alleviation of symptoms, influenza outcomes, complications, hospitalisations and adverse events in the intention-to-treat (ITT) population. All trials were sponsored by the manufacturers. MAIN RESULTS: We obtained 107 clinical study reports from the European Medicines Agency (EMA), GlaxoSmithKline and Roche. We accessed comments by the US Food and Drug Administration (FDA), EMA and Japanese regulator. We included 53 trials in Stage 1 (a judgement of appropriate study design) and 46 in Stage 2 (formal analysis), including 20 oseltamivir (9623 participants) and 26 zanamivir trials (14,628 participants). Inadequate reporting put most of the zanamivir studies and half of the oseltamivir studies at a high risk of selection bias. There were inadequate measures in place to protect 11 studies of oseltamivir from performance bias due to non-identical presentation of placebo. Attrition bias was high across the oseltamivir studies and there was also evidence of selective reporting for both the zanamivir and oseltamivir studies. The placebo interventions in both sets of trials may have contained active substances. Time to first symptom alleviation. For the treatment of adults, oseltamivir reduced the time to first alleviation of symptoms by 16.8 hours (95% confidence interval (CI) 8.4 to 25.1 hours, P 1000) and nausea whilst on treatment (RD 4.15%, 95% CI 0.86 to 9.51); NNTH = 25 (95% CI 11 to 116). AUTHORS' CONCLUSIONS: Oseltamivir and zanamivir have small, non-specific effects on reducing the time to alleviation of influenza symptoms in adults, but not in asthmatic children. Using either drug as prophylaxis reduces the risk of developing symptomatic influenza. Treatment trials with oseltamivir or zanamivir do not settle the question of whether the complications of influenza (such as pneumonia) are reduced, because of a lack of diagnostic definitions. The use of oseltamivir increases the risk of adverse effects, such as nausea, vomiting, psychiatric effects and renal events in adults and vomiting in children. The lower bioavailability may explain the lower toxicity of zanamivir compared to oseltamivir. The balance between benefits and harms should be considered when making decisions about use of both NIs for either the prophylaxis or treatment of influenza. The influenza virus-specific mechanism of action proposed by the producers does not fit the clinical evidence

Measurement of the Resonant dμtd\mu t Molecular Formation Rate in Solid HD

Measurements of muon-catalyzed dt fusion ($d\mu t \to ^4He+n+\mu^-$) in solid HD have been performed. The theory describing the energy dependent resonant molecular formation rate for the reaction $\mu t$ + HD $\to [(d\mu t)pee]^*$ is compared to experimental results in a pure solid HD target. Constraints on the rates are inferred through the use of a Monte Carlo model developed specifically for the experiment. From the time-of- flight analysis of fusion events in 16 and 37 $\mu g\cdot cm^{-2}$ targets, an average formation rate consistent with 0.897$\pm$(0.046)$_{stat}\pm$ (0.166)$_{syst}$ times the theoretical prediction was obtained.Comment: 4 pages, 5 figure

Revealing the Dusty Warm Absorber in MCG--6-30-15 with the Chandra HETG

We present detailed evidence for a warm absorber in the Seyfert 1 galaxy MCG--6-30-15 and dispute earlier claims for relativistic O line emission. The HETG spectra show numerous narrow, unresolved (FWHM < 200 km/s) absorption lines from a wide range of ionization states of N, O, Mg, Ne, Si, S, Ar, and Fe. The O VII edge and 1s^2--1snp resonance line series to n=9 are clearly detected at rest in the AGN frame. We attribute previous reports of an apparently highly redshifted O VII edge to the 1s^2--1snp (n > 5) O VII resonance lines, and a neutral Fe L absorption complex. The shape of the Fe L feature is nearly identical to that seen in the spectra of several X-ray binaries, and in laboratory data. The implied dust column density agrees with that obtained from reddening studies, and gives the first direct X-ray evidence for dust embedded in a warm absorber. The O VIII resonance lines and weak edge are also detected, and the spectral rollover below 2 keV is explained by the superposition of numerous absorption lines and edges. We identify, for the first time, a KLL resonance in the O VI photoabsorption cross section, giving a measure of the O VI column density. The O VII (f) emission detected at the systemic velocity implies a covering fraction of ~5% (depending on the observed vs. time-averaged ionizing flux). Our observations show that a dusty warm absorber model is not only adequate to explain all the spectral features > 0.48 keV (< 26 \AA) the data REQUIRE it. This contradicts the interpretation of Branduardi-Raymont et al. (2001) that this spectral region is dominated by highly relativistic line emission from the vicinity of the black hole.Comment: 4.5 pages, 1 color figure, accepted (April 2001) for publication in ApJL, not many changes from the initial submission - updated/added some measuements for the O VII resonance series, and added a discussion about FeO2 grain

Neuronal deletion of GSK3beta increases microtubule speed in the growth cone and enhances axon regeneration via CRMP-2 and independently of MAP1B and CLASP2

BACKGROUND: In the adult central nervous system, axonal regeneration is abortive. Regulators of microtubule dynamics have emerged as attractive targets to promote axonal growth following injury as microtubule organization is pivotal for growth cone formation. In this study, we used conditioned neurons with high regenerative capacity to further dissect cytoskeletal mechanisms that might be involved in the gain of intrinsic axon growth capacity. RESULTS: Following a phospho-site broad signaling pathway screen, we found that in conditioned neurons with high regenerative capacity, decreased glycogen synthase kinase 3β (GSK3β) activity and increased microtubule growth speed in the growth cone were present. To investigate the importance of GSK3β regulation during axonal regeneration in vivo, we used three genetic mouse models with high, intermediate or no GSK3β activity in neurons. Following spinal cord injury, reduced GSK3β levels or complete neuronal deletion of GSK3β led to increased growth cone microtubule growth speed and promoted axon regeneration. While several microtubule-interacting proteins are GSK3β substrates, phospho-mimetic collapsin response mediator protein 2 (T/D-CRMP-2) was sufficient to decrease microtubule growth speed and neurite outgrowth of conditioned neurons and of GSK3β-depleted neurons, prevailing over the effect of decreased levels of phosphorylated microtubule-associated protein 1B (MAP1B) and through a mechanism unrelated to decreased levels of phosphorylated cytoplasmic linker associated protein 2 (CLASP2). In addition, phospho-resistant T/A-CRMP-2 counteracted the inhibitory myelin effect on neurite growth, further supporting the GSK3β-CRMP-2 relevance during axon regeneration. CONCLUSIONS: Our work shows that increased microtubule growth speed in the growth cone is present in conditions of increased axonal growth, and is achieved following inactivation of the GSK3β-CRMP-2 pathway, enhancing axon regeneration through the glial scar. In this context, our results support that a precise control of microtubule dynamics, specifically in the growth cone, is required to optimize axon regrowth

Population coding by globally coupled phase oscillators

A system of globally coupled phase oscillators subject to an external input is considered as a simple model of neural circuits coding external stimulus. The information coding efficiency of the system in its asynchronous state is quantified using Fisher information. The effect of coupling and noise on the information coding efficiency in the stationary state is analyzed. The relaxation process of the system after the presentation of an external input is also studied. It is found that the information coding efficiency exhibits a large transient increase before the system relaxes to the final stationary state.Comment: 7 pages, 9 figures, revised version, new figures added, to appear in JPSJ Vol 75, No.