A Novel NOX Inhibitor Alleviates Parkinson's Disease Pathology in PFF-Injected Mice

Oxidative stress-mediated damage is often a downstream result of Parkinson's disease (PD), which is marked by sharp decline in dopaminergic neurons within the nigrostriatal regions of the brain, accounting for the symptomatic motor deficits in patients. Regulating the level of oxidative stress may present a beneficial approach in preventing PD pathology. Here, we assessed the efficacy of a nicotinamide adenine phosphate (NADPH) oxidase (NOX) inhibitor, an exogenous reactive oxygen species (ROS) regulator synthesized by Aptabio therapeutics with the specificity to NOX-1, 2 and 4. Utilizing N27 rat dopaminergic cells and C57Bl/6 mice, we confirmed that the exposures of alpha-synuclein preformed fibrils (PFF) induced protein aggregation, a hallmark in PD pathology. In vitro assessment of the novel compound revealed an increase in cell viability and decreases in cytotoxicity, ROS, and protein aggregation (Thioflavin-T stain) against PFF exposure at the optimal concentration of 10 nM. Concomitantly, the oral treatment alleviated motor-deficits in behavioral tests, such as hindlimb clasping, rotarod, pole, nesting and grooming test, via reducing protein aggregation, based on rescued dopaminergic neuronal loss. The suppression of NOX-1, 2 and 4 within the striatum and ventral midbrain regions including Substantia Nigra compacta (SNc) contributed to neuroprotective/recovery effects, making it a potential therapeutic option for PD.

Effects of dapagliflozin on cardiovascular and kidney events by baseline eGFR and UACR in patients with type 2 diabetes mellitus: a patient-level pooled analysis of DECLARE-TIMI 58 and DAPA-CKD trials

Background

The sodium glucose co-transporter 2 (SGLT2) inhibitor dapagliflozin reduced the risk of hospitalization for heart failure (HHF) or cardiovascular death (CVD) and the risk of kidney events in patients type 2 diabetes mellitus (T2DM) and high cardiovascular risk or chronic kidney disease in the DECLARE-TIMI 58 and DAPA-CKD trials. These events are more common at lower levels of kidney function. Combining data from the two trials creates an opportunity to examine the effect of dapagliflozin across the spectrum of baseline kidney function.

Purpose

To determine the effects of dapagliflozin on HHF/CVD and kidney endpoints across a broad range of kidney function in the combined dataset.

Methods

We conducted a post hoc analysis of pooled patient-level data from DECLARE and DAPA-CKD. The effects of dapagliflozin compared with placebo on HHF/CVD and kidney endpoints (defined as sustained eGFR decrease ≥40%, end-stage kidney disease, or renal death) were assessed in the combined cohorts and in subgroups of baseline eGFR (<45, 45-<60, 60-<90, ≥90 mL/min/1.73 m2) and urinary albumin:creatinine ratio (UACR) (<30, 30-<300, 300-<1000, ≥1000 mg/g).

Results

A total of 19,748 patients with T2DM were included. Median (IQR) follow up time was 4.1 (3.7–4.4) years. Median eGFR was 85 (65–95) mL/min/1.73 m2 and UACR 18.2 (7–135) mg/g. Overall, dapagliflozin reduced the risk of HHF/CVD by 18% (HR 0.82, 95% CI 0.73–0.92, p<0.001) and kidney endpoints by 40% (HR 0.60, 95% CI 0.52–0.69, p<0.001). Overall rates of HHF/CVD and kidney endpoints were higher with lower eGFR (p<0.001) and with higher UACR (p<0.001). There were consistent relative risk reductions in HHF/CVD and kidney events with dapagliflozin across eGFR (p-interaction 0.25 and 0.32, respectively, Figure 1) and UACR (p-interaction 0.29 and 0.83, respectively, Figure 2) subgroups. The absolute rate difference (ARD) with dapagliflozin for CVD/HHF ranged from 0.1 events per 1000 patient years in patients in normal categories of eGFR and UACR to 1.0–1.7 events in patients in the most abnormal categories. Likewise, the ARD for kidney events ranged from 0.2 events per 1000 patient years in the normal eGFR and UACR groups to 2.5–4.3 events in patients in the most abnormal categories.

Conclusion

In this pooled analysis of pts with T2DM, there was higher risk of HHF/CVD and kidney events with lower eGFR and higher UACR. Dapagliflozin consistently reduced these events regardless of baseline eGFR and UACR, with large absolute risk reductions in patients with lower eGFR and higher UACR.

Funding Acknowledgement

Type of funding sources: None.

Protein profiles of enzymatically isolated rumen epithelium in sheep fed a fibrous diet

BACKGROUND

The rumen wall plays a major role in efficient transfer of digested nutrients in the rumen to peripheral tissues through the portal venous system. Some of these substrates are metabolised in the epithelium during this process. To identify the specific proteins involved in these processes, we used proteomic technologies. Protein extracts were prepared from ventral rumen tissue of six sheep fed a fibrous diet at 1.5× maintenance energy requirements. Using a newly developed method, we were able to enzymatically isolate the epithelial cells from underlying tissue layers, thus allowing cytosol and membrane fractions to be independently analysed using liquid chromatography tandem mass spectrometry (LC MS/MS).

RESULTS

Using our procedure we identified 570 epithelial proteins in the Ovis aries sequence database. Subcellular locations were largely cytosolic (n = 221) and extracellular (n = 85). However, a quarter of the proteins identified were assigned to the plasma membrane or organelle membranes, some of which transport nutrients and metabolites. Of these 91 were transmembrane proteins (TMHMM), 27 had an N-terminal signal peptide (signalP) and TMHMM motif, 13 had a glycosylphosphatidylinositol (GPI) anchor and signalP sequence, 67 had beta (β) strands or 17 β strands and a transit peptide sequence, indicating the identified proteins were integral or peripheral membrane proteins. Subunits of the 5 protein complexes involved in mitochondrial cellular energy production were well represented. Structural proteins (15%), proteins involved in the metabolism of lipids and proteins (26%) and those with steroid or cytokine action were a feature of the proteome.

CONCLUSION

Our research has developed a procedure to isolate rumen epithelium proteins from the underlying tissue layers so that they may be profiled using proteomic technologies. The approach improves the number of proteins that can be profiled that are specific to the epithelium of the rumen wall. It provides new insights into the proteins of structural and nutritional importance in the rumen epithelium, that carry out nutrient transport and metabolism, cell growth and signalling.

Carbon and Fluorinated Carbon Materials for Fuel Cells

Carbon and fluorinated carbon materials are major constituents of phosphoric acid fuel cells and PEM fuel cells and the stability of these materials is critical for long life operation. Laboratory corrosion studies of separator plate materials were correlated with separator plate changes in commercial PAFC fuel cells. The addition of thin films of Teflon™ to the separator plates extends the life of the separator plates to 60,000+ hours through the formation of a temporary hydrophobic barrier. ESCA studies show the loss of hydrophobicity with time of PAFC electrodes to be a result of delamination of the Teflon from the carbon and not corrosion of the Teflon by phosphoric acid. The projected life of PAFC power plants has been confirmed by commercial operation of power plants for over 40,000 hours.

Abstract S6-10: Identification of a Novel Tumor Suppressor Network Reveals a Role for Proto-Oncogenic Receptor Tyrosine Kinases in Triple-Negative Breast Cancer

Breast cancer is a collection of diseases with distinct clinical behaviors and underlying genetic causes. Triple-negative breast cancer (TNBC) is a common subtype of breast cancer that confers a particularly poor prognosis and is refractory to current targeted therapies. Unfortunately, the molecular determinants driving this aggressive malignancy are poorly understood. Using an unbiased genetic screen, we have identified a novel tumor suppressor network that governs proliferation and transformation of TNBCs in vitro and in vivo. We define SECT21 as a core component in this network and a commonly inactivated tumor suppressor in TNBC. SECT21 is a potent suppressor of human mammary epithelial cell proliferation and transformation. SECT21 function is frequently compromised in human TNBCs by inactivating mutations, deletion, or loss of protein expression. Mechanistically, SECT21 is a tyrosine phosphatase that suppresses cellular transformation by interacting with and inhibiting several oncogenic receptor tyrosine kinases including HER2, EGFR, and PDGFR. Notably, the tumorigenic and metastatic potential of SECT21-deficient TNBCs is severely impaired by restoring SECT21 function or by inhibiting kinase targets of SECT21, suggesting that TNBCs are dependent on the proto-oncogenic tyrosine kinases constrained by SECT21. Collectively, these data identify SECT21 as a commonly inactivated tumor suppressor and provide a rationale for combinatorially targeting tyrosine kinases in TNBC and other cancers based on their profile of tyrosine phosphatase activity.

Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr S6-10.

Effect of insulin-like growth factor 1 receptor inhibitor on sensitization of head and neck cancer cells to cetuximab and methotrexate

6079

Background: Insulin-like growth factor 1 receptor (IGF1R) is highly expressed in head and neck squamous cell carcinoma (HNSCC) and IGF1R inhibitors have been shown to modulate sensitivity to selected chemotherapeutic agents and radiation. The combination effects of an IGF1R inhibitor, MK-0646, with cetuximab or cytotoxic agents that are commonly used in the treatment of recurrent and/or metastatic HNSCC were examined in cetuximab resistant and sensitive HNSCC cell lines. Methods: The cell lines, SCC1 and its cetuximab-resistant clone 1Cc8, were treated with MK-0646, cetuximab or methotrexate, and a combination of MK-0646 and each anti-cancer drug (MK-0646 was supplied by Merck & Co., Inc.). The effect of treatments on cell proliferation and anti-tumor activity was determined using MTS assay in vitro and in vivo using mouse xenografts generated from the cell lines. Overall changes in the gene and protein expressions with the treatments were determined by DNA microarrays and western blots. Results: The IGF1R inhibitor, MK-0646, showed high-sensitivity in vitro xenograft model in SCC1 as monotherapy and increased sensitivity to cetuximab in SCC1 and to methotrexate in 1Cc8 in combination. However, MK-0646 did not inhibit cell proliferation in vitro and in vivo in 1Cc8. The gene expression array and western blot analyses showed that MK-0646 decreased expression of AKT and dihydrofolate reductase (DHFR), a target of methotrexate. Increased expressions of AKT and DHFR have been shown to associate with cetuximab and methotrexate resistance as well as radiation resistance. Conclusions: The development of tolerance in response to the IGF1R inhibitor and cetuximab is common. Whereas IGF1R inhibitors may have little therapeutic impact in cetuximab resistant, the IGF1R inhibitor may modulate response to selected chemotherapeutic agents and to radiation. The IGF1R inhibitor appears to enhance cetuximab and methotrexate response, and modulates genes associated with radiation resistance thereby providing alternative regimens for recurrent and refractory HNSCC patients who have developed resistance to initial therapies.

No significant financial relationships to disclose.

The involvement of prolactin in avian molt: the effects of gender and breeding success on the timing of molt in Mute swans (Cygnus olor)

The aim of the study was to test the hypothesis that decreasing plasma prolactin stimulates or permits the initiation of avian molt. Changes in the concentration of plasma prolactin in Mute swans (Cygnus olor) were compared in non-breeding singletons and breeding pairs. In breeding swans, the onset of molt is delayed compared to non-breeders, and is delayed further in breeding males compared to their female partners. The seasonal decrease in prolactin in non-breeding birds of both sexes started at the end of May and was associated with the initiation of molt 4 weeks later. The decrease in plasma prolactin in incubating females was more pronounced, as a consequence of increased prolactin secretion associated with incubation behavior, but also started at end of May, and was associated the onset of molt 6 weeks later. In breeding males, plasma prolactin increased at the end of May when they started to care for their newly hatched cygnets. Correspondingly, prolactin began to decrease 3-5 weeks later in males than in females. These males started to molt in mid August, at least 4 weeks later than females. It is concluded that molt is related to decreasing plasma prolactin, and is inhibited when plasma prolactin is increasing or high.

Improving indoor air quality for poor families: a controlled experiment in Bangladesh

The World Health Organization's 2004 Global and Regional Burden of Disease Report estimates that acute respiratory infections from indoor air pollution (pollution from burning wood, animal dung, and other bio-fuels) kill a million children annually in developing countries, inflicting a particularly heavy toll on poor families in South Asia and Africa. This paper reports on an experiment that studied the use of different fuels in conjunction with different combinations of construction materials, space configurations, cooking locations, and household ventilation practices (use of doors and windows) as potentially-important determinants of indoor air pollution. Results from controlled experiments in Bangladesh were analyzed to test whether changes in these determinants can have significant effects on indoor air pollution. Analysis of the data shows, for example, that pollution from the cooking area is transported into living spaces rapidly and completely. Furthermore, it is important to factor in the interaction between outdoor and indoor air pollution. Hence, the optimal cooking location should take 'seasonality' in account. Among fuels, seasonal conditions seem to affect the relative severity of pollution from wood, dung, and other biomass fuels. However, there is no ambiguity about their collective impact. All are far dirtier than clean (LPG and Kerosene) fuels. The analysis concludes that if cooking with clean fuels is not possible, then building the kitchen with permeable construction material and providing proper ventilation in cooking areas will yield a better indoor health environment.

PRACTICAL IMPLICATIONS

Several village-level measures could significantly reduce IAP exposure in Bangladesh. All would require arrangements and the assert of male heads-of-household: negotiated bulk purchases of higher cost, cleaner fuels; purchase of more fuel-efficient stoves; peripheral location of cooking facilities; building the kitchen with permeable construction material; rotation of women in cooking roles, to reduce their exposure; and ventilation of smoke through a stack tall enough to disperse smoke over a relatively broad area. It is expected that village men and women will agree to these measures if they become convinced that IAP poses a serious risk to health, and their actions will significantly reduce the risk. The keys to success are effective public education about the sources and risks of IAP, and financial and technical assistance for changes in cooking arrangements.

Household interventions for prevention of domestic lead exposure in children

BACKGROUND

Lead poisoning is associated with physical, cognitive and neurobehavioral impairment in children and many household interventions to prevent lead exposure have been trialled.

OBJECTIVES

To determine the effectiveness of household interventions in preventing or reducing lead exposure in children as measured by reductions in blood lead levels and/or improvements in cognitive development.

SEARCH STRATEGY

Trials were identified through electronic searches of CENTRAL 2006 (Issue 1), MEDLINE 1966 to March 2006, and thirteen other electronic databases and contacting experts to find unpublished studies.

SELECTION CRITERIA

Randomised and quasi randomised trials of household educational or environmental interventions to prevent lead exposure in children where at least one standardised outcome measure was reported.

DATA COLLECTION AND ANALYSIS

Two reviewers independently reviewed all eligible studies for inclusion, assessed study quality and extracted data. Triallists were contacted to obtain missing information.

MAIN RESULTS

Twelve studies (2239 children) were included. All studies reported blood lead level outcomes and none reported on cognitive or neurobehavioural outcomes. Studies were subgrouped according to their intervention type. Meta-analysis of both continuous and dichotomous data was performed for subgroups where appropriate. Educational interventions were not effective in reducing blood lead levels (continuous: WMD 0.13, 95% CI -0.30, 0.56, I2 = 41.6; dichotomous >/= 10 microg/dL (>/= 0.48 micromol/l): RR 1.02 (95% CI 0.79, 1.30, I2 = 0); dichotomous >/= 15 microg/dL (>/=0.72 micromol/l): RR 0.60, 95% CI 0.33, 1.09, I2 = 0). Meta-analysis of the dichotomous data for the dust control subgroup found no evidence of effectiveness. The studies using soil abatement (removal and replacement) and combination intervention groups were not able to be meta-analysed due to substantial differences between studies.

AUTHORS' CONCLUSIONS

Currently there is no evidence of effectiveness for household interventions for education or dust control measures in reducing blood lead levels in children as a population health measure. There is insufficient evidence for soil abatement or combination interventions. Further trials are required to establish the most effective intervention for prevention of lead exposure. Key elements should include longer term follow up and measures of compliance as well as performing trials in developing countries and differing socio-economic groups in developed countries.

Indoor air quality for poor families: new evidence from Bangladesh

Poor households in Bangladesh depend heavily on wood, dung and other biomass fuels for cooking. This paper provides a detailed analysis of the implications for indoor air pollution (IAP), drawing on new 24-h monitoring data for respirable airborne particulates (PM10). A stratified sample of 236 households was selected in Dhaka and Narayanganj, with a particular focus on fuel use, cooking locations, structural materials, ventilation practices, and other potential determinants of exposure to IAP. At each household, PM10 concentrations in the kitchen and living room were monitored for a 24-h period during December, 2003-February, 2004. Concentrations of 300 microg/m3 or greater are common in our sample, implying widespread exposure to a serious health hazard. A regression analysis for these 236 households was then conducted to explore the relationships between PM10 concentrations, fuel choices and a large set of variables that describe household cooking and ventilation practices, structure characteristics and building materials. As expected, our econometric results indicate that fuel choice significantly affects indoor pollution levels: natural gas and kerosene are significantly cleaner than biomass fuels. However, household-specific factors apparently matter more than fuel choice in determining PM10 concentrations. In some biomass-burning households, concentrations are scarcely higher than in households that use natural gas. Our results suggest that cross-household variation is strongly affected by structural arrangements: cooking locations, construction materials, and ventilation practices. A large variation in PM10 was also found during the 24-h cycle within households. For example, within the 'dirtiest' firewood-using household in our sample, readings over the 24-h cycle vary from 68 to 4864 microg/m3. Such variation occurs because houses can recycle air very quickly in Bangladesh. After the midday meal, when ventilation is common, air quality in many houses goes from very dirty to reasonably clean within an hour. Rapid change also occurs within households: diffusion of pollution from kitchens to living areas is nearly instantaneous in many cases, regardless of internal space configuration, and living-area concentrations are almost always in the same range as kitchen concentrations. By implication, exposure to dangerous indoor pollution levels is not confined to cooking areas. To assess the broader implications for poor Bangladeshi households, we extrapolate our regression results to representative 600 household samples from rural, peri-urban and urban areas in six regions: Rangpur in the north-west, Sylhet in the north-east, Rajshahi and Jessore in the west, Faridpur in the center, and Cox's Bazar in the south-east. Our results indicate great geographic variation, even for households in the same per capita income group. This variation reflects local differences in fuel use and, more significantly, construction practices that affect ventilation. For households with per capita income <US Dollars 1.00/day, rural PM10 concentrations vary from 410 microg/m3 in Cox's Bazar to 202 microg/m3 in Faridpur. In urban areas, concentrations for such households differ by almost 100 microg/m3 between the highest areas, Jessore and Rajshahi, and the lowest, Sylhet. Practical Implications Our analysis suggests that poor families may not have to wait for clean fuels or clean stoves to enjoy significantly cleaner air. Within our sample household population, some arrangements are already producing relatively clean conditions, even when 'dirty' biomass fuels are used, such as simple changes in ventilation characteristics of housing (construction materials, space configurations, cooking locations and placement of doors and windows) and ventilation behavior (keeping doors and windows open after cooking). As these arrangements are already within the means of poor families, the scope for cost-effective improvements may be larger than is commonly believed.

Auditory integration training and other sound therapies for autism spectrum disorders: a systematic review

OBJECTIVES

To determine the effectiveness of auditory integration training (AIT) or other methods of sound therapy in people with autism spectrum disorders (ASD).

STUDY DESIGN

A systematic review was carried out of randomised controlled trials (RCTs) of adults or children with ASD. Meta-analysis was attempted.

RESULTS

Six RCTs of AIT, including one crossover trial, were identified, with a total of 171 participants aged 3-39 years. 17 different outcome measures were used, with only two outcome measures used by three or more studies. Meta-analysis was not possible owing to very high heterogeneity or presentation of data in unusable forms. Three studies did not show any benefit of AIT over control conditions. Three studies reported improvements at 3 months in the AIT group for total mean scores of the Aberrant Behaviour Checklist (ABC), which is of questionable validity. Of these, one study also reported improvements at 3 months in the AIT group for ABC subgroup scores. No significant adverse effects of AIT were reported.

CONCLUSION

At present there is not sufficient evidence to support its use.

What is soil organic matter worth?

The conservation and restoration of soil organic matter are often advocated because of the generally beneficial effects on soil attributes for plant growth and crop production. More recently, organic matter has become important as a terrestrial sink and store for C and N. We have attempted to derive a monetary value of soil organic matter for crop production and storage functions in three contrasting New Zealand soil orders (Gley, Melanic, and Granular Soils). Soil chemical and physical characteristics of real-life examples of three pairs of matched soils with low organic matter contents (after long-term continuous cropping for vegetables or maize) or high organic matter content (continuous pasture) were used as input data for a pasture (grass-clover) production model. The differences in pasture dry matter yields (non-irrigated) were calculated for three climate scenarios (wet, dry, and average years) and the yields converted to an equivalent weight and financial value of milk solids. We also estimated the hypothetical value of the C and N sequestered during the recovery phase of the low organic matter content soils assuming trading with C and N credits. For all three soil orders, and for the three climate scenarios, pasture dry matter yields were decreased in the soils with lower organic matter contents. The extra organic matter in the high C soils was estimated to be worth NZ$27 to NZ$150 ha(-1) yr(-1) in terms of increased milk solids production. The decreased yields from the previously cropped soils were predicted to persist for 36 to 125 yr, but with declining effect as organic matter gradually recovered, giving an accumulated loss in pastoral production worth around NZ$518 to NZ$1239 ha(-1). This was 42 to 73 times lower than the hypothetical value of the organic matter as a sequestering agent for C and N, which varied between NZ$22,963 to NZ$90,849 depending on the soil, region, discount rates, and values used for carbon and nitrogen credits.

Differential effects of everyday stress on the episodic memory test performances of young, mid-life, and older adults

This research explored the differential association of everyday stress with the episodic memory test performances of young, mid-life, and older adults. Participants included 98 community-dwelling adults ranging in age from 19-89 years. Everyday stress was assessed via the Perceived Stress Scale and the Elder Life Stress Inventory. A brief battery of episodic memory tasks was administered which included tests of Logical Memory, Verbal Paired Associates, Digit Symbol Substitution, and Digit Symbol Incidental Learning. Results suggest that everyday hassles and irritations as well as the accumulation of challenging life events may exacerbate age-related decline on episodic memory tests that require greater executive resources and more integrated and elaborative processing. The functional relationship between affective status and risk for dementia is discussed, and consideration of individual differences in everyday stress is suggested so as to allow more sensitive interpretation of episodic memory tests commonly used to discern mild cognitive impairment.

Sequencing and mapping hemoglobin gene clusters in the Australian model dasyurid marsupial Sminthopsis macroura

Comparing globin genes and their flanking sequences across many species has allowed globin gene evolution to be reconstructed in great detail. Marsupial globin sequences have proved to be of exceptional significance. A previous finding of a beta(beta)-like omega(omega) gene in the alpha(alpha) cluster in the tammar wallaby suggested that the alpha and beta cluster evolved via genome duplication and loss rather than tandem duplication. To confirm and extend this important finding we isolated and sequenced BACs containing the alpha and beta loci from the distantly related Australian marsupial Sminthopsis macroura. We report that the alpha gene lies in the same BAC as the beta-like omega gene, implying that the alpha-omega juxtaposition is likely to be conserved in all marsupials. The LUC7L gene was found 3' of the S. macroura alpha locus, a gene order shared with humans but not mouse, chicken or fugu. Sequencing a BAC contig that contained the S. macroura beta globin and epsilon globin loci showed that the globin cluster is flanked by olfactory genes, demonstrating a gene arrangement conserved for over 180 MY. Analysis of the region 5' to the S. macroura epsilon (epsilon) globin gene revealed a region similar to the eutherian LCR, containing sequences and potential transcription factor binding sites with homology to eutherian hypersensitive sites 1 to 5. FISH mapping of BACs containing S. macroura alpha and beta globin genes located the beta globin cluster on chromosome 3q and the alpha locus close to the centromere on 1q, resolving contradictory map locations obtained by previous radioactive in situ hybridization.

Auditory integration training and other sound therapies for autism spectrum disorders

BACKGROUND

Autism spectrum disorders (ASD) are a heterogeneous group of disorders encompassing Autistic Disorder, Asperger's Disorder, Semantic-Pragmatic disorder and Pervasive Developmental Disorder Not Otherwise Specified. Auditory integration therapy (AIT) was developed as a technique for improving abnormal sound sensitivity in individuals with behavioural disorders including autism. Other sound therapies bearing similarities to AIT include the Tomatis Method and Samonas Sound Therapy.

OBJECTIVES

To determine the effectiveness of AIT or other methods of sound therapy in individuals with ASD.

SEARCH STRATEGY

We searched the Cochrane Central Register of Controlled Trials (Cochrane Library Issue 2, 2003), MEDLINE (1966 - February 2002), EMBASE (1980 - February 2002), CINAHL (1982 - December 2001), PsycINFO (1887 - February 2002), ERIC (1965 - December 2001) and LILACS (1982 - March 2002). Reference lists of articles identified electronically were searched for further relevant publications.

SELECTION CRITERIA

Randomised controlled trials of adults or children with ASD. Treatment was auditory integration therapy (AIT) or other sound therapies involving listening to music modified by filtering and modulation. Control groups could be no treatment, waiting list, usual therapy or placebo equivalent. Outcomes sought were changes in core and associated features of ASD, auditory processing, quality of life and adverse events.

DATA COLLECTION AND ANALYSIS

All outcome data reported in included papers were continuous. Initial intention was to undertake meta-analyses using mean difference and standard deviation to take into account differences between treatment and control groups at baseline. These data were not available. Instead, point estimates and standard errors were calculated from t-test scores and post intervention means. Meta-analysis was attempted but deemed inappropriate at present.

MAIN RESULTS

No trials assessing sound therapies other than AIT were found. Six RCTs of AIT, including one cross-over trial, were identified with a total of 171 individuals aged 3-39 years. Four trials had fewer than 20 participants. Allocation concealment was inadequate for all of the studies. Seventeen different outcome measures were used. Only two outcomes were used by three or more studies: Aberrant Behaviour Checklist (ABC) (5) and Fisher's Auditory Problems Checklist (FAPC) (3). Meta-analysis was not possible due to very high heterogeneity (Aberrant Behaviour Checklist subscores), or presentation of data in unusable forms. Three studies (Bettison 1996, Zollweg 1997, Mudford 2000) did not demonstrate benefit of AIT over control conditions. The remaining trials (Veale 1993, Rimland 1995, Edelson 1999) reported improvements at 3 months for the AIT group based on improvements of total mean scores for the ABC, which is of questionable validity. Rimland 1995 also reported improvements at 3 months in the AIT group for ABC subgroup scores. No significant adverse effects of AIT were reported.

REVIEWER'S CONCLUSIONS

More research is needed to inform parents', carers' and practitioners' decision making about this therapy for individuals with autism spectrum disorders.

Antibiotics and surgery for vesicoureteric reflux: a meta-analysis of randomised controlled trials

AIMS

To evaluate the benefits and harms of treatments for vesicoureteric reflux in children.

METHODS

Meta-analyses of randomised controlled trials using a random effects model. Main outcome measures were incidence of urinary tract infection (UTI), new or progressive renal damage, renal growth, hypertension, and glomerular filtration rate.

RESULTS

Eight trials involving 859 evaluable children comparing long term antibiotics with surgical correction of reflux (VUR) and antibiotics (seven trials) and antibiotics compared with no treatment (one trial) were identified. Risk of UTI by 1-2 and 5 years was not significantly different between surgical and medical groups (relative risk (RR) by 2 years 1.07; 95% confidence interval (CI) 0.55 to 2.09, RR by 5 years 0.99; 95% CI 0.79 to 1.26). Combined treatment resulted in a 60% reduction in febrile UTI by 5 years (RR 0.43; 95% CI 0.27 to 0.70) but no concomitant significant reduction in risk of new or progressive renal damage at 5 years (RR 1.05; 95% CI 0.85 to 1.29). In one small study no significant differences in risk for UTI or renal damage were found between antibiotic prophylaxis and no treatment.

CONCLUSION

It is uncertain whether the identification and treatment of children with VUR confers clinically important benefit. The additional benefit of surgery over antibiotics alone is small at best. Assuming a UTI rate of 20% for children with VUR on antibiotics for five years, nine reimplantations would be required to prevent one febrile UTI, with no reduction in the number of children developing any UTI or renal damage.

Biomechanical analysis of the effect of varying suture pitch in tendon graft fixation

The purpose of this study was to biomechanically assess the effect of varying suture pitch on the holding power of the Krackow suture technique for tendon graft fixation. Seven pairs of rabbit Achilles tendons were sutured with single No. 5 Ti-Cron suture using the Krackow technique. One tendon from each pair was sutured using a 0.5-cm suture pitch (half-pitch group) while the contralateral tendon from each pair was sutured with a 1.0-cm suture pitch (one-pitch group). The tendons were loaded to failure using a servohydraulic materials test system at a loading rate of 0.5 mm/sec. There were no statistically significant differences noted in suture slippage at failure (1.58 cm for half pitch versus 1.45 cm for one pitch) or maximal force to failure (158.5 N for half pitch versus 168.2 N one pitch) between the two treatment groups. However, the construct with the 1-cm suture pitch was significantly stiffer than the construct with the 0.5-cm suture pitch, with stiffness values of 106.2 N/cm and 91.4 N/cm, respectively. The most common mechanism of failure was slippage of the suture at the first suture throw and tearing of the first knot through the most distal portion of the tendon. Four constructs failed by suture rupture, two from each experimental group.

Influenza vaccine effectiveness in preventing hospitalizations and deaths in persons 65 years or older in Minnesota, New York, and Oregon: data from 3 health plans

This study developed methods and determined the impact of influenza vaccination on elderly persons in 3 large health plans: Kaiser Permanente Northwest, HealthPartners, and Oxford Health Plans. Data for the 1996-1997 and 1997-1998 seasons were extracted from administrative databases. Subjects were health plan members > or = 65 years old. Comorbid conditions collected from the preceding year were used for risk adjustment with logistic regression. The virus-vaccine match was excellent for year 1 and fair for year 2. Both years, during peak and total periods, vaccination reduced all causes of death and hospitalization for pneumonia and influenza: hospitalizations were reduced by 19%-20% and 18%-24% for years 1 and 2, respectively, and deaths were reduced by 60%-61% and 35%-39% for the same periods. These results show that all elderly persons should be immunized annually for influenza. The methods used in this study are an efficient cost-effective way to study vaccine impact and similar questions.

Superconformal electrodeposition in submicron features

Superconformal electrodeposition is explained based on a local growth velocity that increases with coverage of a catalytic species adsorbed on the copper-electrolyte interface. For dilute concentration of the catalyst precursor in the electrolyte, local coverage in fine features changes more due to interface area change than by accumulation from the electrolyte, yielding superconformal growth. The model is supported by experiments and simulations of copper deposition in 350-100 nm wide features, helping to explain the influence of adsorbates on roughness evolution.

MADD victim impact panels and stages-of-change in drunk-driving prevention

OBJECTIVE

To assess the additional effects of Mothers Against Drunk Driving (MADD) Victim Impact Panels (VIPs) over the effects of a DWI (driving while intoxicated) school, on (1) moving individuals through the stages-of-change toward not drinking while driving and (2) drunk-driving recidivism.

METHOD

A randomized experiment with 813 (75% male) DWI offenders in New Mexico measured progress through the stages-of-change at pretest, posttest, 1-year follow-up and 2-year follow-up. In addition, drunk-driving recidivism over 2 years was measured from state driving records. Individuals were randomly assigned to a DWI school or a DWI school plus a MADD VIP.

RESULTS

No significant difference in movement through the stages-of-change, or in recidivism, occurred between respondents in the DWI-school-only treatment, and those in the DWI school plus VIP treatment.

CONCLUSIONS

There was no additional effect of the MADD VIP, a relatively emotional intervention, over that of the DWI school, a relatively informational approach, on DWI behavior (whether measured by stages-of-change or by DWI rearrest data) over the 2-year period following the two interventions.

An orphaned mammalian beta-globin gene of ancient evolutionary origin

Mammals possess multiple, closely linked beta-globin genes that differ in the timing of their expression during development. These genes have been thought to be derived from a single ancestral gene, by duplication events that occurred after the separation of the mammals and birds. We report the isolation and characterization of an atypical beta-like globin gene (omega-globin) in marsupials that appears to be more closely related to avian beta-globin genes than to other mammalian beta-globin genes, including those previously identified in marsupials. Phylogenetic analyses indicate that omega-globin evolved from an ancient gene duplication event that occurred before the divergence of mammals and birds. Furthermore, we show that omega-globin is unlinked to the previously characterized beta-globin gene cluster of marsupials, making this the first report of an orphaned beta-like globin gene expressed in a vertebrate.

Sequence and evolution of a hexamerin from the ant Camponotus festinatus

In the ant Camponotus festinatus, two different hexamerins accumulate stage-specifically during the late larval period and at various times in adults. These hexamerins serve as storage proteins and play important roles in brood nourishment and colony founding. We report an analysis of the cDNA sequence of C. festinatus hexamerin 2 (CfeHex2). The native protein contains 732 amino acids, which are moderately enriched in aromatic amino acids, aspartate and asparagine. Phylogenetic analyses show a close relationship of CfeHex2 to a putative toxin of the braconid wasp, Bracon hebetor. The divergence of Formicidae and Braconidae hexamerins was calculated to have begun 187 MYA, an estimate consistent with currently accepted phylogeny of insect orders.