Scientific misconduct. How prevalent is fraud? That's a million-dollar question

How often does scientific misconduct occur? There seems to be no consensus on the answer, although a range of estimates were presented at a conference called last month by a key federal watchdog agency to announce a $1 million grants program to investigate the prevalence of fraud, data fabrication, plagiarism, and other questionable practices in science. The 8-year-old Office of Research Integrity hopes to support studies gauging the frequency of misconduct and assessing efforts to raise ethical standards.

Clinical trials. Planned Ritalin trial for tots heads into uncharted waters

U.S. scientists are gearing up for a major clinical trial intended to measure the effects of a popular but controversial drug used to treat attention deficit hyperactivity disorder, methylphenidate (Ritalin), on a previously untested population--children aged 3 to 6. But in doing so, they are running up against ethical concerns about using young subjects in clinical trials. The scientists involved in the study admit that they are concerned about the drug's effect on the children's still-developing personalities and brains, as well as their inability to give informed consent. But they believe that such trials are the only way to answer concerns about rising use of the drug among this population.

Clinical trials. Enforcers halt NIH study called less risky than outdoor play

How much risk should healthy children face in a research experiment? The answer can land even the best clinicians in hot water, especially if they read the rules differently from the government officials who must enforce them.

Genetic testing. Families sue hospital, scientist for control of Canavan gene

A successful partnership between parents and a scientist to combat a deadly genetic disease has dissolved into a bitter legal battle over the commercial tests used to identify people with dangerous mutations in their genes. The lawsuit, filed on 30 October in Chicago federal court, is the latest dispute in the growing controversy over who controls and who benefits from human genetics research.

Drugs. Reinventing an ancient cure for malaria

As drug resistance renders cheap antimalarials ineffective, a promising candidate has emerged from an overlooked source: Asia. Used as herbal remedies in China for 2000 years, artemisinins haven't yet been approved for clinical use in Western countries. But abundant clinical data show that a water-soluble form called artesunate knocks down the number of parasites in the blood faster than any other drug does.

Malaria. A renewed assault on an old and deadly foe

After languishing for decades in the scientific backwaters, malaria research is suddenly being swept into the mainstream. Money is beginning to pour in from international finance and aid organizations, giving researchers who have been doggedly pursuing an intractable foe with limited resources the means to follow new leads. But on the ground, the disease is unyielding, and the current weapons are losing their effectiveness. In a series of related stories, Science explores the World Health Organization's crusade that aims to cut malaria mortality in half over the next 10 years, conditions on the front lines of clinical research in Africa, the challenges that have slowed development of a so-far elusive vaccine, renewed interest in a Chinese herbal remedy that could aid in the fight against drug-resistant malaria, progress in attacking the Plasmodium parasite through its genome, and the dream of building a malaria-proof mosquito.

Genomics. Public-private project to deliver mouse genome in 6 months

Research on the mouse genome lurched into the fast lane last week, as private donors joined the U.S. government to step on the gas. A public-private consortium announced on 6 October that it's kicking $58 million into a new fund that will pay to sequence the DNA of the "black six" (C57BL/6J) strain of laboratory mouse. The consortium aims to produce a draft version of the genome by the end of February.

Neuroscience. A ruckus over releasing images of the human brain

A plan to have scientists deposit functional magnetic resonance images of the brain in a public center at Dartmouth College as a condition of publication has drawn a flurry of objections. Brain scientists warn that if the project goes forward as planned, it could compromise the privacy of research subjects, get tangled up in technical knots, and rob authors of the credit they deserve. A new task force is attempting to elicit a consensus and draft a set of data-sharing guidelines supported by the entire field.

Six-month success of intracoronary stenting for anomalous coronary arteries associated with myocardial ischemia

Fourteen patients with anomalous coronary arteries associated with objective evidence of myocardial ischemia, a group at increased risk for cardiac events, were successfully stented. This led to 6-month patency and resolution of the ischemia, which was confirmed angiographically and by stress imaging studies.

Epidemiology. Duke study faults overuse of stimulants for children

Some experts are growing concerned that Ritalin, a stimulant of the central nervous system used to calm a type of fidgety behavior called "attention-deficit hyperactivity disorder" (ADHD), is overused. Most psychiatrists think, however, that stimulants are being underprescribed, because too many cases of ADHD are going untreated. Now, an authoritative study published in this month's Journal of the American Academy of Child and Adolescent Psychiatry shows that Ritalin is being given to many children who don't fit the diagnosis of ADHD, while others who do are not receiving the drug.

A Sinister Plot or Victim of Politics?

When the Bush Administration proposed a "violence initiative" 8 years ago, it touched off a battle over racism and psychiatry. In particular, a proposed meeting on the genetics of crime sparked accusations that it was part of a government conspiracy to dope up inner city kids on psychoactive drugs.

The shots heard 'round the world

The massacre at Columbine High School last year unleashed a torrent of fresh concern over the threat that violence poses to society. It also energized a government research effort to understand and prevent violence. Ironically, this flurry of activity comes at a time when youth violence, as reflected in crime statistics, is in decline.

Bioterrorism. DOD retreats on plan for anthrax vaccine

Anthrax bacterium, once the deadly scourge of goat-hair workers, has become the bane of the U.S. defense establishment. Without infecting a single soldier, it has created a logistical headache for the Pentagon, as military contractors have fallen far short of supplying a vaccine that will protect all troops and be acceptable to health authorities. Last week military officials were forced to beat a hasty retreat in their current efforts, raising the hackles of legislators who already had serious doubts about the program.

Scientific publishing. Publish and perish in the Internet world

When 120 leaders in publishing and biomedicine met here last week to talk about the Internet's effect on scholarly journals, it didn't take long for disagreements to surface. Participants clashed over two very different visions of the future--one predicting that private firms will continue to produce the most reliable and readable journals, the other that scientists will soon abandon traditional journals and share results directly with other researchers on the Internet.

Patent disputes. Biotech giants butt heads over cancer drug

On 8 June, Chiron challenged Genentech's patent on an important new breast cancer drug called Herceptin and sued for a share of the profits. Chiron's 4-page complaint, filed in the federal district court in Sacramento, California, accuses Genentech of "willful, wanton, and deliberate" infringement of one of its patents. The case is being closely watched in the biotech industry not just because of the money at stake but also because it involves one of the first therapies to emerge from the burgeoning field of cancer genetics

Human genome. Rival genome sequencers celebrate a milestone together

At a White House ceremony on 26 June, two scientific groups, one funded by the government and the other privately funded, announced that they have generated a nearly complete readout of the 3.1 or so billion nucleotides in the human genome. The White House ceremony was more than a celebration; it was also designed to heal a split in the research community. The ceremony brought together leaders of the rival groups in a kind of truce, cooling off a competition that had grown intense in recent months.

Clinical trials. Harvard's Koski to lead human subjects office

As Congress steps up oversight of human clinical trials, the Administration is getting a high-level manager of its own to watch out for the interests of volunteers in U.S.-financed research. As expected, Secretary of Health and Human Services (HHS) Donna Shalala last week named anesthesiologist E. Greg Koski, 50, to run a new HHS Office for Human Research Protections.

Disease Group Invests in Do-It-Yourself Drugs

On 31 May, the Cystic Fibrosis (CF) Foundation of Bethesda, Maryland, announced that it will invest at least $30 million in a small biotech firm, Aurora Biosciences of San Diego, to identify compounds that might prove useful in treating CF. This project, fueled initially by a donation of $20 million from the Bill and Melinda Gates Foundation, marks a new departure in the growing trend of patient groups taking charge of biomedical research.

Low-dose continuous-infusion ceftazidime monotherapy in low-risk febrile neutropenic patients

One hundred and thirty-five cancer patients admitted with low-risk neutropenic fever received a low-dose schedule of ceftazidime as infusional monotherapy over a total of 180 episodes. Ceftazidime was administered as a 1-g bolus followed by a continuous infusion of 2 g per day. In this patient population the ceftazidime was both practical and well tolerated. Sixty-eight percent of patients responded with clinical improvement and complete resolution of fever within 48 h. Overall, 95% of patients responded, although 18% subsequently required antibiotic modification for persistent fever. Only 5% of episodes were considered failures due to clinical deterioration, and over the study period there was only 1 fatality due to respiratory failure. The median duration of hospitalisation was only 4 days (2-20). In conclusion, monotherapy with low-dose infusional ceftazidime appears safe and highly effective in this low-risk population of neutropenic patients and may reduce antibiotic costs appreciably.

Ten-year survival in advanced malignant melanoma following treatment with interferon and vindesine

A 31-year-old man with malignant melanoma of his right popliteal fossa was treated in 1987 with surgical excision followed by local radiotherapy. Eight months later, he presented with recurrence in the right inguinal lymph nodes, which were resected and followed by radiotherapy to the groin. Ten months later, he developed liver metastases and was treated with vindesine (12 months) and interferon-alpha-2a (30 months) resulting in complete remission which has been maintained for over 10 years. This interesting case report, with brief review of literature, is presented here.

Identification of factors that disrupt negative air pressurization of respiratory isolation rooms

OBJECTIVES

To investigate the airflow characteristics of respiratory isolation rooms (IRs) and to evaluate the use of visible smoke as a monitoring tool.

METHODS

Industrial hygienists from the New York State Department of Health evaluated 140 designated IRs in 38 facilities within New York State during 1992 to 1998. The rooms were located in the following settings: hospitals (59%), correctional facilities (40%), and nursing homes (1%). Each room was tested with visible smoke for directional airflow into the patient room (ie, negative air pressure relative to adjacent areas). Information was obtained on each facility's policies and procedures for maintaining and monitoring the operation of the IRs.

RESULTS

Inappropriate outward airflow was observed in 38% of the IRs tested. Multiple factors were associated with outward airflow direction, including ventilation systems not balanced (54% of failed rooms), shared anterooms (14%), turbulent airflow patterns (11%), and automated control system inaccuracies (10%). Of the 140 tested rooms, 38 (27%) had either electrical or mechanical devices to monitor air pressurization continuously. The direction of airflow at the door to 50% (19/38) of these rooms was the opposite of that indicated by the continuous monitors at the time of our evaluations. The inability of continuous monitors to indicate the direction of airflow was associated with instrument limitations (74%) and malfunction of the devices (26%). In one facility, daily smoke testing by infection control staff was responsible for identifying the malfunction of a state-of-the-art computerized ventilation monitoring and control system in a room housing a patient infectious with drug-resistant tuberculosis.

CONCLUSION

A substantial percentage of IRs did not meet the negative air pressure criterion. These failures were associated with a variety of characteristics in the design and operation of the IRs. Our findings indicate that a balanced ventilation system does not guarantee inward airflow direction. Devices that continuously monitor and, in some cases, control the pressurization of IRs had poor reliability. This study demonstrates the utility of using visible smoke for testing directional airflow of IRs, whether or not continuous monitors are used. Institutional tuberculosis control pro grams should include provisions for appropriate monitoring and maintenance of IR systems on a frequent basis, including the use of visible smoke.