Inclusion and exclusion in nutrigenetics clinical research: ethical & scientific challenges

Background/Aims: There are compelling reasons to ensure participation of ethnic minorities and populations of all ages worldwide in nutrigenetics clinical research. If findings in such research are valid for some individuals, groups, or communities, and not for others, then ethical questions of justice – and not only issues of methodology and external validity – arise. This paper aims to examine inclusion in nutrigenetics clinical research and its scientific and ethical challenges. Methods: 173 publications were identified through a systematic review of clinical studies in nutrigenetics published between 1998 and 2007 inclusively. Data such as participants' demographics as well as eligibility criteria were extracted. Results: There is no consistency in the way participants’ origins (ancestry, ethnicity or race) and ages are described in publications. A vast majority of the studies identified was conducted in North America and Europe and focused on “white” participants. Our results show that pregnant women (and fetuses), minors and the elderly (≥75 years old) remain underrepresented. Conclusion: Representativeness in nutrigenetics research is a challenging ethical and scientific issue. Yet, if nutrigenetics is to benefit whole populations and be used in public and global health agendas, fair representation, as well as clear descriptions of participants in publications are crucial.

Intrinsic test of independence in contingency tables

A condition needed for testing nested hypotheses from a Bayesian viewpoint is that the prior for the alternative model concentrates mass around the small, or null, model. For testing independence in contingency tables, the intrinsic priors satisfy this requirement. Further, the degree of concentration of the priors is controlled by a discrete parameter m, the training sample size, which plays an important role in the resulting answer regardless of the sample size. In this paper we study robustness of the tests of independence in contingency tables with respect to the intrinsic priors with different degree of concentration around the null, and compare with other “robust” results by Good and Crook. Consistency of the intrinsic Bayesian tests is established. We also discuss conditioning issues and sampling schemes, and argue that conditioning should be on either one margin or the table total, but not on both margins. Examples using real are simulated data are given

Derived control by compound and single stimuli in a matching-to-sample task in children

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Emotional stimuli reduce the attentional blink in sub-clinical anxious subjects. 'Los est??mulos emocionales reducen el parpadeo atencional (attentional blink) en sujetos con ansiedad subcl??nica'

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¿Qué factores inciden en la hospitalización de pacientes con cálculos ureterales menores a 10 mm en Fundación Santa Fe?

Debido a que el 12% de la población tendrá un cálculo en uréter hacia la mitad de su vida y a que las tasas de recurrencia en los que ya lo presentan son del 50% es necesario estudiar esta patología para aproximarse a un manejo adecuado en el servicio de urgencias. La literatura identifica un conjunto de factores que pueden contribuir a un cambio en el manejo médico. Objetivo: El objetivo de este estudio fue determinar los factores demográficos y clínicos asociados a manejo hospitalario en los pacientes con diagnóstico de cálculo ureteral menor de 10 mm. Métodos: Se diseñó un estudio de casos y controles no emparejados. Un caso fue definido como un paciente de 18 o más años con diagnóstico de urolitiasis con cálculo menor a 10 mm realizado por urotac que consultó (por primera vez para ese episodio) al servicio de urgencias de la Fundación Santa Fe de Bogotá entre el 1 de marzo de 2007 y 30 de abril de 2012. Se indagaron factores como edad, sexo, tamaño y localización del cálculo, respuesta a los analgésicos, evidencia de obstrucción e infección urinaria, además de otros antecedentes medicamentosos y clínicos. Se utilizó regresión logística no condicional bivariada y multivariada para evaluar la asociación entre tipo de manejo (hospitalario o ambulatorio) y las variables recolectadas, calculando odds ratio (OR) e intervalos de confianza al 95% (IC95%). Resultados: El riesgo de hospitalización se incrementó con: 1. La localización del cálculo en tercio superior o medio (OR=1.49; IC95%: 0.751-2.966) al comparar con el inferior, 2. El aumento del tamaño del cálculo (OR=1.49; IC95%: 0.751-2.966, por cada milímetro de incremento), y 3: Por la evidencia de obstrucción o infección urinaria y elevación de azoados. Por el contrario, hubo menos riesgo de hospitalización en aquellos pacientes con una respuesta analgésica apropiada en urgencias.

Eficacia y seguridad de la melatonina para el manejo de los trastornos del sueño en el autismo: meta-análisis

INTRODUCCIÓN: El 80% de los niños y adolescentes con trastornos del espectro autista (TEA) presenta algún trastorno del sueño, en cuya génesis al parecer intervienen alteraciones en la regulación de la melatonina. El objetivo de este metaanálisis fue determinar la eficacia y seguridad de la melatonina para el manejo de ciertos trastornos del sueño en niños con TEA. MÉTODOS: Tres revisores extrajeron los datos relevantes de los ensayos clínicos aleatorizados doble ciego de alta calidad publicados en bases de datos primarias, de ensayos clínicos, de revisiones sistemáticas y de literatura gris; además se realizó búsqueda en bola de nieve. Se analizaron los datos con RevMan 5.3. Se realizó un análisis del inverso de la varianza por un modelo de efectos aleatorios para las diferencias de medias de los desenlaces propuestos: duración del tiempo total, latencia de sueño y número de despertares nocturnos. Se evaluó la heterogeneidad interestudios con el parámetro I2 RESULTADOS: La búsqueda inicial arrojó 355 resultados, de los cuales tres cumplieron los criterios de selección. La melatonina resultó ser un medicamento seguro y eficaz para aumentar la duración total del sueño y disminuir la latencia de sueño en niños y adolescentes con TEA; hasta el momento la evidencia sobre el número de despertares nocturnos no es estadísticamente significativa. DISCUSIÓN: A la luz de la evidencia disponible, la melatonina es una elección segura y eficaz para el manejo de ciertos problemas del sueño en niños y adolescentes con TEA. Es necesario realizar estudios con mayores tamaños muestrales y comparados con otros medicamentos disponibles en el mercado.

Psychometric characteristics of the BRIEF scale for the assessment of executive functions in Spanish clinical population

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Sample size planning for multiple correlation : reply to Shieh (2013)

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Continuous Assessment through Objective Structured Clinical Examinations in Veterinary Clinical Propaedeutics

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Shifts in resident bird communities associated with cloud forest patch size in Central Veracruz, Mexico

Avian communities in cloud forests have high levels of endemism and are at major risk given the accelerated rate of habitat fragmentation. Nevertheless, the response of these communities to changes in fragment size remains poorly understood. We evaluated species richness, bird community density, community composition, and dominance as indicators of the response to fragment size in a fragmented cloud forest landscape in central Veracruz, Mexico. Medium-sized fragments had statistically higher than expected species richness and more even communities, which may be a reflection of the intermediate disturbance hypothesis, in which medium-sized fragments are exploited by both forest and disturbance-associated species. Bird density also reached higher values in medium-sized fragments, which may indicate a carrying capacity in this habitat. However, large cloud forest fragments had a distinct taxonomic and functional composition, attributable to an increased number of understory insectivore species and canopy frugivores. By comparison, omnivorous species associated with human-altered habitats were more abundant in smaller fragments. Hence, although medium-sized cloud forest fragments had higher species richness and high bird density, large forest tracts maintained a distinct avian community composition, particularly of insectivorous and frugivorous species. Furthermore, the underlying response to fragmentation can only be properly addressed when contrasting several community attributes, such as richness, density, composition, and species dominance. Therefore, cloud forest conservation should aim to preserve the remaining large forest fragments to maintain comprehensive avian communities and avoid local extinctions.

Analysis of ochres from Clearwell Caves: the role of particle size in determining colour

Three ochre samples (A (orange-red in colour), B (red) and C (purple)) from Clearwell Caves, (Gloucestershire, UK) have been examined using an integrated analytical methodology based on the techniques of IR and diffuse reflectance UV-visible-NIR spectroscopy, X-ray diffraction, elemental analysis by ICP-AES and particle size analysis. It is shown that the chromophore in each case is haematite. The differences in colour may be accounted for by (i) different mineralogical and chemical composition in the case of the orange ochre, where hi,,her levels of dolomite and copper are seen and (ii) an unusual particle size distribution in the case of the purple ochre. When the purple ochre was ground to give the same particle size distribution as the red ochre then the colours of the two samples became indistinguishable. An analysis has now been completed of a range of ochre samples with colours from yellow to purple from the important site of Clearwell Caves. (C) 2004 Elsevier B.V. All rights reserved.

Retrieval of effective ice crystal size in the infrared: sensitivity study and global measurements from TIROS-N Operational Vertical Sounder

The difference between cirrus emissivities at 8 and 11 μm is sensitive to the mean effective ice crystal size of the cirrus cloud, De. By using single scattering properties of ice crystals shaped as planar polycrystals, diameters of up to about 70 μm can be retrieved, instead of up to 45 μm assuming spheres or hexagonal columns. The method described in this article is used for a global determination of mean effective ice crystal sizes of cirrus clouds from TOVS satellite observations. A sensitivity study of the De retrieval to uncertainties in hypotheses on ice crystal shape, size distributions, and temperature profiles, as well as in vertical and horizontal cloud heterogeneities shows that uncertainties can be as large as 30%. However, the TOVS data set is one of few data sets which provides global and long-term coverage. Having analyzed the years 1987–1991, it was found that measured effective ice crystal diameters De are stable from year to year. For 1990 a global median De of 53.5 μm was determined. Averages distinguishing ocean/land, season, and latitude lie between 23 μm in winter over Northern Hemisphere midlatitude land and 64 μm in the tropics. In general, larger Des are found in regions with higher atmospheric water vapor and for cirrus with a smaller effective emissivity.