Sexual attraction: sex-specific wiring of neural circuitry.

Two recent studies describe mechanisms by which sexually dimorphic responses to pheromones in the nematode worm Caenorhabditis elegans are driven by differences in the balance of neural circuits that control attraction and repulsion behaviors.

Reductions in hospital admissions and mortality rates observed after integrating emergency care: a natural experiment.

Objectives: Reducing emergency admissions is a priority for the NHS. A single hospital's emergency care system was reorganised with the principles of front-loaded investigations, integration of specialties, reduced duplication, earlier decision making by senior clinicians and a combined emergency assessment area. The authors relocated our Medical Assessment Unit into our emergency department in 2006.

Targeted left ventricular lead placement to guide cardiac resynchronization therapy: the TARGET study: a randomized, controlled trial.

Objectives: This study sought to assess the impact of targeted left ventricular (LV) lead placement on outcomes of cardiac resynchronization therapy (CRT).

Background: Placement of the LV lead to the latest sites of contraction and away from the scar confers the best response to CRT. We conducted a randomized, controlled trial to compare a targeted approach to LV lead placement with usual care.

Analysis of diagnostic confidence: application to data from a prospective randomized controlled trial of CT for acute abdominal pain.

Background: Changes in diagnostic confidence are used as a measure of a test's efficacy. There are several methods for analyzing such data, but it is unclear which are most robust.

Purpose: To compare analytical methods for assessing diagnostic confidence, applied to data from a prospective study of computed tomography (CT) for acute abdominal pain.

Tumor recurrence following liver transplantation for hepatocellular carcinoma: role of tumor proliferation status.

The selection of patients with hepatocellular carcinoma for liver transplantation is currently based on the size and number of tumors to minimize the risk of recurrence. These criteria measure tumor bulk but may not reflect tumor behavior accurately. A biological marker of tumor behavior could aid with patient selection further.

Hierarchical log linear analysis of admission blood parameters and clinical outcome following traumatic brain injury.

Purpose: Numerous statistical methods have been utilised to generate predictive models that identify clinical and biochemical parameters of prognostic value following traumatic brain injury. While these methods provide an accurate statistical description between these variables and outcome, they are difficult to interpret intuitively. Hierarchical log linear analysis can be utilised to present the complex interactions between these variables and outcome visually.

Early insulin therapy in very-low-birth-weight infants.

Background: Studies involving adults and children being treated in intensive care units indicate that insulin therapy and glucose control may influence survival. Hyperglycemia in very-low-birth-weight infants is also associated with morbidity and mortality. This international randomized, controlled trial aimed to determine whether early insulin replacement reduced hyperglycemia and affected outcomes in such neonates.

Assessing diagnostic confidence: a comparative review of analytical methods.

Rationale And Objectives: The ability of a test to influence diagnostic confidence is used as a measure of its efficacy. Our aim was to compare analytic methods that evaluate changes in confidence.

Materials And Methods: The approaches compared were "basic," "retained diagnoses," "Omary," "Tsushima," and "score-based" methods.

A randomized controlled trial of late conversion from calcineurin inhibitor (CNI)-based to sirolimus-based immunosuppression in liver transplant recipients with impaired renal function.

Renal impairment is common in patients after liver transplantation and is attributable in large part to the use of calcineurin inhibitor (CNI)-based immunosuppression. We sought to determine whether conversion to sirolimus-based immunosuppression was associated with improved renal function. In a single-center, randomized, controlled trial, 30 patients at least 6 months post liver transplantation were randomized to remain on CNI-based immunosuppression or to switch to sirolimus-based immunosuppression.

Implementing a decision-theoretic design in clinical trials: why and how?

This paper addresses two main questions: first, why should Bayesian and other innovative, data-dependent design models be put into practice and, secondly, given the past dearth of actual applications, how might one example of such a design be implemented in a genuine example trial? Clinical trials amalgamate theory, practice and ethics, but this last point has become relegated to the background, rather than taking often a more appropriate primary role. Trial practice has evolved but has its roots in R. A.

Fusidic acid-resistant Staphylococcus aureus (FRSA) carriage in patients with atopic eczema and pattern of prior topical fusidic acid use.

We questioned 62 dermatology outpatients with atopic eczema and Staphylococcus aureus colonisation regarding their use of topical preparations containing fusidic acid during the previous 6 months as well as the pattern of any such use. Recent exposure to topical fusidic acid was significantly correlated with the presence of fusidic acid-resistant S. aureus (FRSA) (P=0.

A randomized controlled trial of late conversion from CNI-based to sirolimus-based immunosuppression following renal transplantation.

Maintenance immunosuppression with calcineurin inhibitors (CNIs) following renal transplantation is associated with nephrotoxicity and accelerated graft loss. We aimed to assess whether conversion to sirolimus-based immunosuppression would affect the progression of renal impairment. In this single center, randomized controlled trial, 40 renal transplant recipients between 6 months and 8 years post-transplant were randomly assigned to remain on their CNI (cyclosporin or tacrolimus) or to switch to sirolimus.

Efficacy of enhanced evening light for advanced sleep phase syndrome.

This study tested whether a newly designed enhanced evening light therapy was well tolerated and effective in relieving symptoms of Advanced, Sleep Phase Syndrome (ASPS). Participants with self-reported ASPS symptoms were 47 older adults (21 men and 26 women, age 60-86). After baseline, participants underwent 28 consecutive days of either dim or enhanced intensity light treatment for 2-3 hr in the evening.

Clinical significance of renal function in hypertensive patients at high risk: results from the INSIGHT trial.

Background: Increasing evidence suggests renal involvement in hypertension-related cardiovascular and cerebrovascular complications. To assess this role of renal function in more detail, we studied the evolution of renal function and the relationship of renal function with mortality and morbidity in the Intervention as a Goal in Hypertension Treatment (INSIGHT) study.

Methods: The INSIGHT study was a double-blind, randomized, multicenter trial in patients with hypertension and at least 1 additional cardiovascular risk factor.

No association of sleep with total daily physical activity in normal sleepers.

The aim of two studies was to examine both between-subjects and within-subjects associations between daily amounts of physical activity and sleep in the home environment. Study 1 examined self-reported exercise durations and sleep diaries for 105 consecutive days in 31 college students who were normal sleepers. Between-subjects associations of mean exercise with mean sleep were assessed with Spearman rank-order correlations.

Outcomes with nifedipine GITS or Co-amilozide in hypertensive diabetics and nondiabetics in Intervention as a Goal in Hypertension (INSIGHT).

To investigate the impact of treatment on cardiovascular mortality and morbidity, we assessed outcomes in patients with hypertension and diabetes who received co-amilozide or nifedipine in the International Nifedipine GITS Study: Intervention as a Goal in Hypertension. Participants had to be 55 to 80 years of age, with hypertension (> or =150/95 or > or =160 mm Hg) and at least one additional cardiovascular risk factor. Patients received 30 mg nifedipine once daily or co-amilozide (25 mg hydrochlorothiazide and 2.

Evaluation of early abdominopelvic computed tomography in patients with acute abdominal pain of unknown cause: prospective randomised study.

Objectives: To evaluate the impact of early abdominopelvic computed tomography in patients with acute abdominal pain of unknown cause on length of hospital stay and accuracy of diagnosis.

Design: Randomised, prospective controlled trial.

Setting: Teaching hospital in England.