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

Life, Death, and IQ: It\u27s Much More than Just a Score: Understanding and Utilizing Forensic Psychological and Neuropsychological Evaluations in Atkins Intellectual Disability/Mental Retardation Cases

This article highlights best practices for assessing MR and ID in capital cases with an emphasis on Atkins trial preparation and potential problems the authors have noted through experience. These best practices in Atkins hearings concern issues for the lawyers, forensic psychologists, and neuropsychologists, which include: 1. Practice effects and IQ testing 2. Consistency of IQ scores over time 3. Flynn Effect 4. Malingering versus cognitive suboptimal effort 5. Lack of records indicating pre-age 18 diagnosis of MR/ID 6. Retrospective assessment of adaptive behaviors 7. Death row trends of increasing IQ over the years while incarcerated 8. Maladaptive behaviors versus symptoms of conduct disorder and antisocial personality disorder 9. There need be no nexus between an Atkins finding of mental retardation and the adaptive behavioral aspects of criminal and homicidal behavior 10. Potential bias of collateral informants 11. Cultural issues inherent in IQ and adaptive testing 12. Considering the utilization of different experts within a particular case, i.e., assessment of adaptive functioning versus assessment of intelligence 13. Videotaping assessments 14. Litigation strategies expanding MR/ID findings. Due to the length requirement of this article, some of these issues will be addressed and not to the extent of their respected complexities

Geodesic Warps by Conformal Mappings

In recent years there has been considerable interest in methods for diffeomorphic warping of images, with applications e.g.\ in medical imaging and evolutionary biology. The original work generally cited is that of the evolutionary biologist D'Arcy Wentworth Thompson, who demonstrated warps to deform images of one species into another. However, unlike the deformations in modern methods, which are drawn from the full set of diffeomorphism, he deliberately chose lower-dimensional sets of transformations, such as planar conformal mappings. In this paper we study warps of such conformal mappings. The approach is to equip the infinite dimensional manifold of conformal embeddings with a Riemannian metric, and then use the corresponding geodesic equation in order to obtain diffeomorphic warps. After deriving the geodesic equation, a numerical discretisation method is developed. Several examples of geodesic warps are then given. We also show that the equation admits totally geodesic solutions corresponding to scaling and translation, but not to affine transformations

How do Changes in Family Role Status Impact Employees? An empirical investigation

Purpose – Despite the proliferation of work–family research, a thorough understanding of family role status changes (e.g. the gaining of elder or child caregiving responsibilities) remain under-theorized and under-examined. The purpose of this paper is to conceptualize various forms of family role status changes and examine the ways in which these changes influence various employee outcomes. Design/methodology/approach – Data were collected as part of the work–family health study. Using a longitudinal, three-wave study with two-time lags of 6 months (n = 151 family role status changes; n = 392 individuals with family role stability), this study uses one-way analysis of variance to compare mean differences across groups and multilevel modeling to examine the predictive effects of family role status changes. Findings Overall, experiences of employees undergoing a family role status change did not differ significantly from employees whose family role status remained stable over the same 12-month period. Separation/divorce predicted higher levels of family-to-work conflict. Originality/value The work raises important considerations for organizational science and human resource policy research to better understand the substantive effects of family role status changes on employee well-being

The Early Evolution of Magnetar Rotation I: Slowly Rotating "Normal" Magnetars

In the seconds following their formation in core-collapse supernovae, "proto"-magnetars drive neutrino-heated magneto-centrifugal winds. Using a suite of two-dimensional axisymmetric MHD simulations, we show that relatively slowly rotating magnetars with initial spin periods of $P_{\star0}=50-500$ ms spin down rapidly during the neutrino Kelvin-Helmholtz cooling epoch. These initial spin periods are representative of those inferred for normal Galactic pulsars, and much slower than those invoked for gamma-ray bursts and super-luminous supernovae. Since the flow is non-relativistic at early times, and because the Alfv\'en radius is much larger than the proto-magnetar radius, spindown is millions of times more efficient than the typically-used dipole formula. Quasi-periodic plasmoid ejections from the closed zone enhance spindown. For polar magnetic field strengths $B_0\gtrsim5\times10^{14}$ G, the spindown timescale can be shorter than than the Kelvin-Helmholtz timescale. For $B_0\gtrsim10^{15}$ G, it is of order seconds in early phases. We compute the spin evolution for cooling proto-magnetars as a function of $B_0$, $P_{\star0}$, and mass ($M$). Proto-magnetars born with $B_0$ greater than $\simeq1.3\times10^{15}\,{\rm\,G}\,(P_{\star0}/{400\,\rm\,ms})^{-1.4}(M/1.4\,{\rm M}_\odot)^{2.2}$ spin down to periods $> 1$ s in just the first few seconds of evolution, well before the end of the cooling epoch and the onset of classic dipole spindown. Spindown is more efficient for lower $M$ and for larger $P_{\star0}$. We discuss the implications for observed magnetars, including the discrepancy between their characteristic ages and supernova remnant ages. Finally, we speculate on the origin of 1E 161348-5055 in the remnant RCW 103, and the potential for other ultra-slowly rotating magnetars.Comment: 16 pages, 10 figure

High-sensitivity measurement of diverse vascular plant-derived biomarkers in high-altitude ice cores

Author Posting. © American Geophysical Union, 2009. This article is posted here by permission of American Geophysical Union for personal use, not for redistribution. The definitive version was published in Geophysical Research Letters 36 (2009): L13501, doi:10.1029/2009GL037643.Semi-volatile organic compounds derived from burned and fresh vascular plant sources and preserved in high-altitude ice fields were detected and identified through use of recently developed analytical tools. Specifically, stir bar sorptive extraction and thermal desorption coupled with gas chromatography/time-of-flight mass spectrometry allowed measurement of multiple biomarkers in small sample volumes (≤30 ml). Among other compounds of interest, several diterpenoids, which suggest inputs from conifers and conifer burning, were identified in post-industrial era and older Holocene ice from the Sajama site in the Bolivian Andes, but not in a glacial period sample, consistent with aridity changes. Differences in biomarker assemblages between sites support the use of these compounds as regionally constrained recorders of vegetation and climate change. This study represents the first application of these analytical techniques to ice core research and the first indication that records of vegetation fires may be reconstructed from diterpenoids in ice.This project was supported in part by NSF-OCE (0402533), and NSF-EAR (0094475)