Plant stem cell extract from Coffea canephora shows antioxidant, anti-inflammatory, and skin regenerative properties mediated by suppression of nuclear factor-κB

Plant cell cultures have become a promising production platform of bioactive compounds for biomedical and cosmetic uses in the last decades. However, the success so far has been limited. The study aimed to evaluate the effectiveness of this unique biotechnology process to obtain a bioactive stem cell extract of Coffea canephora (SCECC) with antioxidant, anti-inflammatory, and regenerative properties. Total phenolic and flavonoid contents were determined in the SCECC by spectrophotometry. The chemical composition of the extracts was characterized by mass spectrometry. Antioxidant activity was evaluated using the colorimetric methods of free radical scavenging 2,2'-azinobis-3-ethylbenzothiazoline-6-sulfonic acid (ABTS) and the ferric reducing ability of plasma (FRAP). The anti-inflammatory activity was determined in lipopolysaccharide-stimulated RAW 264.7 macrophages through the production of superoxide anion (O2•-), nitric oxide (NO), tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and the activity of nuclear factor kappa B (NF-κB). Moreover, the ability of SCECC to stimulate the proliferation and migration of fibroblasts was assessed. Five compounds were tentatively identified, two flavonoids, two phenolic acids, and one sugar. High phenolic content and antioxidant activity were observed in the SCECC. SCECC promoted the proliferation and migration of fibroblasts and suppressed the pro-inflammatory mediators O2•-, NO, TNF-α, and IL-6 in a dose-dependent manner. Moreover, SCECC inhibited the NF-κB transcription factor. Therefore, we obtained evidence that the extract from C. canephora stem cells can be used as a natural agent against skin damage. Hence, it could be of interest in cosmetics for preventing skin aging.

Measurement of the N170 during facial neuromuscular electrical stimulation (fNMES)

BACKGROUND

Studies on facial feedback effects typically employ props or posed facial expressions, which often lack temporal precision and muscle specificity.

NEW METHOD

Facial Neuromuscular Electrical Stimulation (fNMES) allows for a controlled influence of contractions of facial muscles, and may be used to advance our understanding of facial feedback effects, especially when combined with Electroencephalography (EEG). However, electrical stimulation introduces significant interference that can mask underlying brain dynamics. Whether established signal processing methods can allow for a reduction of said interference whilst retaining effects of interest, remains unexplored.

RESULTS

We addressed these questions focusing on the classic N170 visual evoked potential, a face-sensitive brain component: 20 participants viewed images of houses, and of sad, happy, and neutral faces. On half of the trials, fNMES was delivered to bilateral lower-face muscles during the presentation of visual stimuli. A larger N170 amplitude was found for faces relative to houses. Interestingly, this was the case both without and during fNMES, regardless of whether the fNMES artefact was removed or not. Moreover, sad facial expressions elicited a larger N170 amplitude relative to neutral facial expressions, both with and without fNMES.

COMPARISON WITH EXISTING METHODS

fNMES offers a more precise way of manipulating proprioceptive feedback from facial muscles, which affords greater diversity in experimental design for studies on facial feedback effects.

CONCLUSIONS

We show that the combining of fNMES and EEG can be achieved and may serve as a powerful means of exploring the impact of controlled proprioceptive inputs on various types of cognitive processing.

Fatty acid composition of vegetable oil blend and in vitro effects of pharmacotherapeutical skin care applications

Vegetable oils have been used for a plethora of health benefits by their incorporation in foods, cosmetics, and pharmaceutical products, especially those intended for skin care. This study aimed to investigate the cutaneous benefits of a vegetable oil blend (VOB) formulation and its fatty acid composition. The anti-inflammatory activity was studied in macrophages of RAW 264.7 cells by investigating the release of nitric oxide (NO), superoxide anion generation (O₂^-), tumor necrosis factor-alpha (TNF-α), and interleukin 6 (IL-6). ABTS cation radical scavenging capacity assay, ferric reducing antioxidant potential (FRAP), 2,2-diphenyl-1-picrylhydrazyl (DPPH), and NO free radical scavenging assays were used to evaluate the antioxidant activity. VOB was tested for its ability to stimulate fibroblast proliferation and migration using the scratch assay, and antibacterial activity by the microdilution test. The fatty acid profile of a freshly prepared VOB formulation was determined by gas chromatography before and after accelerated stability testing. Chemical composition of VOB revealed the presence of oleic acid (C18:1n-9; 63.3%), linoleic acid (C18:2n-6; 4.7%), and linolenic acid (C18:3n-6; 5.1%) as major mono- and polyunsaturated fatty acids. No changes in the organoleptic characteristics and fatty acid composition were observed after the accelerated stability test. VOB 100 µg/mL reduced the healing time by increasing the total number of cells in the wounded area by 43.0±5.1% compared to the negative control group. VOB also suppressed the pro-inflammatory TNF-α and IL-6 cytokines, and NO and O₂^- production in lipopolysaccharide-stimulated macrophage cells. In conclusion, the VOB formulation contributed to the improvement of current therapeutic strategies for cutaneous applications in skin care.

Die Wertigkeit der hepatobiliären Funktionsszintigraphie mit 99mTc-Diaethyl-IDA

99mTc-DAIDA ist anderen cholotropen Radiopharmazeutika überlegen. Wie radiochromatographische Untersuchungen mit verschiedenen Systemen zeigten, wird es unverändert von den Leberparenchymzellen als Anion in die Galle sezcrniert.

Nach Prüfung an einem hepatogastroenterologisch selektierten Krankengut (n = 45) ergaben sich bei lebergesunden Probanden für die hepatobiliären Funktionsparameter Tmax. T/2, Gallenblasen- und Darmerscheinungszeit folgende Werte (x ± s): 15,5 ± 5,2 min), 30,8 ± 8,2 min, 13,5 ± 6,1 min, und 22,0 ± 10,8 min. Die nach Vergleich verschiedener Bestimmungsregionen und Berechnungsarten ermittelte Clearance betrug in dieser Gruppe 323,8 ± 145,8 ml/min x 1,73 m2 (x ± s); die mit der hepatobiliären Elimination konkurrierende renale Ausscheidung während 5 1 min p. i. belief sich auf 5,15% der injizierten Gesamtaktivität.

Die Werte der einzelnen Zeitparameter wie auch der Anteil der Nieren bei der 99mTc-DAIDA-Ausscheidung erhöhten sich in der Gruppe der Patienten mit intrahepatischem Ikterus deutlich, in der Gruppe mit sonstigen Leberzellschäden nur geringfügig. Bei Patienten mit extrahepatischem Ikterus war eine Bestimmung der verschiedenen Leberfunktionsgrößen nicht möglich. Aufgrund der großen Variationsbreite innerhalb der einzelnen Gruppen blieben diese Parameter im Einzelfall ohne diagnostische Relevanz.

Die hepatobiliäre Sequenzszintigraphie mit 99mTc-DAIDA scheint ihr Indikationsgebiet in der funktionsmorphologischen Diagnostik zu finden.

[Operative therapy of external rectal prolapse with a stapler]

External rectal prolapse is a rare condition, which is more common in old and multimorbid women. In recent years five surgical methods have become established from among the multitude of operative procedures which have been described. One of the most recent techniques is perineal stapled prolapse resection (PSP) which is described in this article. After complete eversion of the rectal prolapse it is resected into 2 halves using a linear cutter by incisions at 3 o'clock and 9 o'clock lithotomy positions, followed by stepwise resection with a curved cutter along the ventral and dorsal circumference. There is low evidence for the treatment of external rectal prolapse. For PSP only case series exist with results that are similar to those from other techniques; however, comparative studies are nearly completely lacking. The PSP is a relatively new surgical technique for the treatment of external rectal prolapse. It is a safe surgical procedure. Due to the lack of evidence it should remain reserved for old and/or multimorbid patients.

Neutrophilic superoxide production can assess pharmacological and pharmacogenetic β-adrenoreceptor effects

Asthma can be controlled well in most patients by inhaled β-adrenoreceptor (β2 AR) agonists and steroids. Poor response to β2 AR agonists is difficult to predict, especially in young children and by lung function testing, which may be affected by multiple influences. As an alternative approach, we analyzed ex vivo neutrophilic superoxide inhibition in response to β2 AR stimulation. In 60 healthy volunteers, this assay was unaffected by sex, age, smoking, atopy or asthma status. Furthermore, we assessed effects of genetic variants in β2 AR by sequencing the ADRB2 gene in our cohort and relating genotypes to β2 AR-mediated neutrophilic superoxide inhibition. Gly16Arg genotypes correlated with minor decrease in overall adrenoresponse in this small study population. Taken together, ex vivo testing of the β2 AR response in human neutrophils represents a robust tool with good signal-to-noise ratio at physiological β2 AR agonist concentrations, and this assay may be useful to complement future pharmacogenetic studies in asthma.

Subglacial Lake Whillans microbial biogeochemistry: a synthesis of current knowledge

Liquid water occurs below glaciers and ice sheets globally, enabling the existence of an array of aquatic microbial ecosystems. In Antarctica, large subglacial lakes are present beneath hundreds to thousands of metres of ice, and scientific interest in exploring these environments has escalated over the past decade. After years of planning, the first team of scientists and engineers cleanly accessed and retrieved pristine samples from a West Antarctic subglacial lake ecosystem in January 2013. This paper reviews the findings to date on Subglacial Lake Whillans and presents new supporting data on the carbon and energy metabolism of resident microbes. The analysis of water and sediments from the lake revealed a diverse microbial community composed of bacteria and archaea that are close relatives of species known to use reduced N, S or Fe and CH4 as energy sources. The water chemistry of Subglacial Lake Whillans was dominated by weathering products from silicate minerals with a minor influence from seawater. Contributions to water chemistry from microbial sulfide oxidation and carbonation reactions were supported by genomic data. Collectively, these results provide unequivocal evidence that subglacial environments in this region of West Antarctica host active microbial ecosystems that participate in subglacial biogeochemical cycling.

Bortezomib Treatment can Overcome Glucocorticoid Resistance in Childhood B-cell Precursor Acute Lymphoblastic Leukemia Cell Lines

BACKGROUND

The response to initial glucocorticoid (gc) treatment is a reliable stratification factor in childhood acute lymphoblastic leukemia (ALL) and may predict the response to multi-agent chemotherapy. In a former study we detected that the valosin-containing protein (VCP, cdc48), a member of the ubiquitin proteasome degradation system (UPS), is altered in gc-resistant leukemic cells suggesting that the associated pathways might be involved in chemotherapy resistance in childhood ALL.

METHODS

Human B-cell precursor leukemia cell lines, gc-resistant MHH-cALL-2 and gc-sensitive MHH-cALL-3, were treated with prednisolone and various concentrations of bortezomib. Viability and apoptosis rates were determined.

RESULTS

Both cell lines showed a dose-dependent increase in caspase activity after bortezomib single treatment. The gc-sensitive cells showed an additive effect after combined treatment with prednisolone and bortezomib. In contrast, both cell lines showed a reduced viability and enhanced propidium iodide positivity after combined treatment as determined by flow cytometry. Western blot analyses of poly-(ADP-ribose) polymerase 1 (PARP-1) suggested that combined treatment promote necrotic cleavage of PARP-1 in gc-resistant cells. Furthermore, after prednisolone treatment the UPS associated proteins VCP and NFκB-inhibitor IκBα were differentially modulated in gc-resistant cells.

CONCLUSIONS

The proteasome inhibitor bortezomib seems to sensitize gc-resistant childhood ALL cells for prednisolone-induced cell death.

Determination of Ciprofloxacin in Pharmaceutical Formulations Using HPLC Method with UV Detection

A simple, specific, accurate and rapid reversed phase high performance liquid chromatographic method was validated for the determination of the content of ciprofloxacin in three pharmaceuticals forms: generic, similar and compounded. The results of the validation showed that the method was highly efficient for quantification of ciprofloxacin in the matrices evaluated. The recovery rates were between 97.4 to 104.3 %, and the relative standard deviations were lower than 5 % for repeatability, and lower than 5.15 % for intermediate precision. The limits of detection, quantification and practical, were 0.11, 0.35 and 1.56 μg/ml, respectively. All compounded samples were approved with in the quality control; however, one generic and one similar sample presented above allowed level.

Evidence-based toxicology for the 21st century: opportunities and challenges

The Evidence-based Toxicology Collaboration (EBTC) was established recently to translate evidence-based approaches from medicine and health care to toxicology in an organized and sustained effort. The EBTC held a workshop on "Evidence-based Toxicology for the 21st Century: Opportunities and Challenges" in Research Triangle Park, North Carolina, USA on January 24-25, 2012. The presentations largely reflected two EBTC priorities: to apply evidence-based methods to assessing the performance of emerging pathway-based testing methods consistent with the 2007 National Research Council report on "Toxicity Testing in the 21st Century" as well as to adopt a governance structure and work processes to move that effort forward. The workshop served to clarify evidence-based approaches and to provide food for thought on substantive and administrative activities for the EBTC. Priority activities include conducting pilot studies to demonstrate the value of evidence-based approaches to toxicology, as well as conducting educational outreach on these approaches.

Hsa-mir-124-3 CpG island methylation is associated with advanced tumours and disease recurrence of patients with clear cell renal cell carcinoma

Background:

Whether methylation of the microRNA (mir)-124-3 CpG island is of relevance for the clinical course of a solid cancer and whether it shows association with clinicopathology or survival of patients with renal cell cancer (RCC) is not known as yet.

Methods:

In a cross-sectional study, relative methylation of mir-124-3 was measured in 111 RCC samples and 77 paired normal appearing tissues using quantitative methyl-specific PCR. Results were statistically compared with tumour histology, clinicopathological parameters and disease recurrence.

Results:

We found tumour-specific hypermethylation of mir-124-3 in samples of RCCs with clear cell histology (ccRCC) compared with paired normal appearing tissues (P<0.0001). Methylation was significantly increased in tumours with state of advanced disease (P<0.0001). Higher relative methylation was associated with worse recurrence-free survival in both univariate (hazard ratio=9.37; P=0.0005) as well as bivariate Cox regression analyses considering age, sex, diameter of tumours and state of advanced disease, metastasis and lymph node metastases as covariates (hazard ratios=5.9–18.2; P-values of 0.0003–0.008).

Conclusion:

We identified mir-124-3 CpG islands (CGI) methylation as a relevant epigenetic mark for ccRCC thus underlining the need for functional studies of potentially affected signalling pathways in kidney tumour models. Methylation of mir-124-3 is suggested as an independent prognosticator for ccRCC.

Rationale for the tinnitus retraining therapy trial

The Tinnitus Retraining Therapy Trial (TRTT) is a National Institutes of Health-sponsored, multi-centered, placebo-controlled, randomized trial evaluating the efficacy of tinnitus retraining therapy (TRT) and its component parts, directive counseling and sound therapy, as treatments for subjective debilitating tinnitus in the military. The TRTT will enroll 228 individuals at an allocation ratio of 1:1:1 to: (1) directive counseling and sound therapy using conventional sound generators; (2) directive counseling and placebo sound generators; or (3) standard of care as administered in the military. Study centers include a Study Chair's Office, a Data Coordinating Center, and six Military Clinical Centers with treatment and data collection standardized across all clinics. The primary outcome is change in Tinnitus Questionnaire (TQ) score assessed longitudinally at 3, 6, 12, and 18-month follow-up visits. Secondary outcomes include: Change in TQ sub-scales, Tinnitus Handicap Inventory, Tinnitus Functional Index, and TRT interview visual analog scale; audiometric and psychoacoustic measures; and change in quality of life. The TRTT will evaluate TRT efficacy by comparing TRT (directive counseling and conventional sound generators) with standard of care; directive counseling by comparing directive counseling plus placebo sound generators versus standard of care; and sound therapy by comparing conventional versus placebo sound generators. We hypothesize that full TRT will be more efficacious than standard of care, directive counseling and placebo sound generators more efficacious than standard of care, and conventional more efficacious than placebo sound generators in habituating the tinnitus awareness, annoyance, and impact on the study participant's life.

Prototype of an auto-calibrating, context-aware, hybrid brain-computer interface

We present the prototype of a context-aware framework that allows users to control smart home devices and to access internet services via a Hybrid BCI system of an auto-calibrating sensorimotor rhythm (SMR) based BCI and another assistive device (Integra Mouse mouth joystick). While there is extensive literature that describes the merit of Hybrid BCIs, auto-calibrating and co-adaptive ERD BCI training paradigms, specialized BCI user interfaces, context-awareness and smart home control, there is up to now, no system that includes all these concepts in one integrated easy-to-use framework that can truly benefit individuals with severe functional disabilities by increasing independence and social inclusion. Here we integrate all these technologies in a prototype framework that does not require expert knowledge or excess time for calibration. In a first pilot-study, 3 healthy volunteers successfully operated the system using input signals from an ERD BCI and an Integra Mouse and reached average positive predictive values (PPV) of 72 and 98% respectively. Based on what we learned here we are planning to improve the system for a test with a larger number of healthy volunteers so we can soon bring the system to benefit individuals with severe functional disability.

What comparative effectiveness research is needed? A framework for using guidelines and systematic reviews to identify evidence gaps and research priorities

The authors developed and tested a framework for identifying evidence gaps and prioritizing comparative effectiveness research by using a combination of clinical practice guidelines and systematic reviews. In phase 1 of the project, reported elsewhere, 45 clinical questions on the management of primary open-angle glaucoma were derived from practice guidelines and prioritized by using a 2-round Delphi survey of clinicians. On the basis of the clinicians' responses, 9 questions were classified as high-priority. In phase 2, reported here, systematic reviews that addressed the 45 clinical questions were identified. The reviews were classified as at low, high, or unclear risk of bias, and evidence gaps (in which no systematic review was at low risk of bias) were identified. The following comparative effectiveness research agenda is proposed: Two of the 9 high-priority questions require new primary research (such as a randomized, controlled trial) and 4 require a new systematic review. The utility and limitations of the framework and future adaptations are discussed.

Setting priorities for comparative effectiveness research: a case study using primary open-angle glaucoma

OBJECTIVE

To test the feasibility of a framework for prioritizing new comparative effectiveness research (CER) questions related to management of primary open-angle glaucoma (POAG) using practice guidelines and a survey of clinicians.

DESIGN

Cross-sectional survey.

PARTICIPANTS

Members of the American Glaucoma Society (AGS).

METHODS

We restated as an answerable clinical question each recommendation in the 2005 American Academy of Ophthalmology Preferred Practice Patterns (PPPs) regarding the management of POAG. We asked members of the AGS to rank the importance of each clinical question, on a scale of 0 (not important at all) to 10 (very important), using a 2-round Delphi survey conducted online between April and September 2008. Respondents had the option of selecting "no judgment" or "research has already answered this question" to each question in lieu of the 0 to 10 rating. We used the ratings assigned by the Delphi respondents to determine the importance of each clinical question.

MAIN OUTCOME MEASURES

Ranking of importance of each clinical question.

RESULTS

We derived 45 clinical questions from the POAG PPPs. Of the 620 AGS members invited to participate in the survey, 169 completed the Round 1 survey; 105 of 169 also completed Round 2. We observed 4 response patterns to the individual questions. Nine clinical questions were ranked as the most important: 4 questions on medical intervention, 4 questions on filtering surgery, and 1 question on adjustment of therapy.

CONCLUSIONS

Our theoretical model for priority setting for CER questions is a feasible and pragmatic approach that merits testing in other medical settings.

Assessment of risk of bias among pediatric randomized controlled trials

OBJECTIVE

The goal was to assess the risk of bias among pediatric, randomized, controlled trials (RCTs) reported in 8 high-impact journals.

METHODS

We searched PubMed for all pediatric RCTs reported between July 1, 2007, and June 30, 2008, in 8 journals with high impact factors. Using Cochrane Collaboration methods for risk assessment, we evaluated all reports for risk of bias according to domain (ie, randomized sequence generation, allocation concealment, masking, incomplete outcome data, selective outcome reporting, and other). We used multiple logistic regression to test for associations between the presence of a high risk of bias according to domain and funding source, intervention type, trial registration, and multicenter status.

RESULTS

Industry-funded RCTs were more likely to show a high risk of bias for sequence generation, compared with government-funded RCTs (adjusted odds ratio [aOR]: 6.1 [95% confidence interval [CI]: 1.70- 21.89]), and behavioral/educational trials were more likely to show a high risk of bias for sequence generation (aOR: 2.8 [95% CI: 1.06-7.36]) and allocation concealment (aOR: 4.09 [95% CI: 1.69-9.90]), compared with drug trials. Registered trials were less likely to have a high risk of bias for sequence generation, compared with nonregistered trials (aOR: 0.33 [95% CI: 0.15-0.71]).

CONCLUSIONS

Overall, we found a large proportion of pediatric RCT reports with a high risk of bias for sequence generation and allocation concealment. Factors associated with a high risk of bias included industry funding and assessment of behavioral/educational interventions, whereas trial registration was associated with a lower risk of bias.

STARR with Contour Transtar: prospective multicentre European study

OBJECTIVE

The stapled transanal rectal resection (STARR) in patients with defecation disorders is limited by the shape and capacity of the circular stapler. A new device has been recently developed, the Contour Transtar stapler, in order to improve the safety and effectiveness of the STARR technique. The study has been designed to confirm this declaration.

METHOD

From January to June 2007 a prospective European multicentre study of consecutive patients with defecation disorder caused by internal rectal prolapse underwent the new STARR technique. The assessment of perioperative morbidity and functional outcome after 6 weeks, 3 and 12 months was documented by different scores.

RESULTS

In all 75 patients, median age 64, the Transtar procedure was performed with 9% intraoperative difficulties, 7% postoperative complications and no mortality. The mean reduction of the ODS score was -15.6 (95%-CI: -17.3 to -13.8, P < 0.0001), mean reduction of SSS was -12.6 (95%-CI: -14.2 to -11.2; P < 0.0001). 41% stated improvement of their continence status by CCF score, only 4 patients (5%) had deterioration.

CONCLUSION

The Transtar procedure is technically demanding, with good functional results similar to the conventional STARR.

High gamma mapping using EEG

High gamma (HG) power changes during motor activity, especially at frequencies above 70 Hz, play an important role in functional cortical mapping and as control signals for BCI (brain-computer interface) applications. Most studies of HG activity have used ECoG (electrocorticography) which provides high-quality spatially localized signals, but is an invasive method. Recent studies have shown that non-invasive modalities such as EEG and MEG can also detect task-related HG power changes. We show here that a 27 channel EEG (electroencephalography) montage provides high-quality spatially localized signals non-invasively for HG frequencies ranging from 83 to 101 Hz. We used a generic head model, a weighted minimum norm least squares (MNLS) inverse method, and a self-paced finger movement paradigm. The use of an inverse method enables us to map the EEG onto a generic cortex model. We find the HG activity during the task to be well localized in the contralateral motor area. We find HG power increases prior to finger movement, with average latencies of 462 ms and 82 ms before EMG (electromyogram) onset. We also find significant phase-locking between contra- and ipsilateral motor areas over a similar HG frequency range; here the synchronization onset precedes the EMG by 400 ms. We also compare our results to ECoG data from a similar paradigm and find EEG mapping and ECoG in good agreement. Our findings demonstrate that mapped EEG provides information on two important parameters for functional mapping and BCI which are usually only found in HG of ECoG signals: spatially localized power increases and bihemispheric phase-locking.

Innovative technique for the closure of rectovaginal fistula using Surgisis mesh

BACKGROUND

The aim of this prospective study was to analyse the efficacy of Surgisis mesh for closure of rectovaginal fistulas. Prospective data were collected from two centres.

METHODS

All patients with a rectovaginal fistula who underwent definitive surgery using Surgisis mesh were prospectively enrolled in this study. Inclusion criteria included a rectovaginal fistula in the lower two-thirds of the rectovaginal septum. Surgery was performed with a standardized technique including combined transrectal and transvaginal excision of the rectovaginal fistula with transvaginal placement of the mesh. Success was defined as closure of both internal and external (perianal and vaginal) openings, absence of drainage without further intervention, and no abscess formation.

RESULTS

Over a period of 16 months, a total of 21 mesh procedures were performed in two centres. The mean age of the patients was 47 years (18-59 years). Of the 21 patients, 18 (86%) had recurrent rectovaginal fistula, and the mean number of prior attempts was 2.3 (0-8). The majority of patients (nine) had Crohn's disease-associated fistula, followed by six with iatrogenic fistula, two with radiation-induced fistula, two with obstetric injury-induced fistula, and two with idiopathic fistula. The mesh procedure was performed under faecal diversion in eight patients (38%). The mean operative time was 38 min; no intraoperative morbidity occurred. Patients were discharged from hospital on day 4. After a mean follow-up of 12 months (range, 3-18 months), the overall success rate after primary mesh procedure was 71% (15/21; 6 patients had failure or recurrence). All patients with failure or recurrence were reoperated upon. Out of these six patients who were reoperated upon, four had definite healing (75%). Among the eight patients who had faecal diversion, four (50%) had reversal of their stoma.

CONCLUSION

The preliminary success rate for this innovative technique using Surgisis mesh for the closure of rectovaginal fistulas is promising. Further studies are needed to assess the definite role of this novel technique in comparison to traditional surgical procedures.

Self-initiation of EEG-based brain-computer communication using the heart rate response

Self-initiation, that is the ability of a brain-computer interface (BCI) user to autonomously switch on and off the system, is a very important issue. In this work we analyze whether the respiratory heart rate response, induced by brisk inspiration, can be used as an additional communication channel. After only 20 min of feedback training, ten healthy subjects were able to self-initiate and operate a 4-class steady-state visual evoked potential-based (SSVEP) BCI by using one bipolar ECG and one bipolar EEG channel only. Threshold detection was used to measure a beat-to-beat heart rate increase. Despite this simple method, during a 30 min evaluation period on average only 2.9 non-intentional switches (heart rate changes) were detected.

Simultaneous Determination of B-Group Vitamins in Enriched Brazilian Dairy Products

In addition to serving as good natural sources of vitamin B(2), milk and milk products are currently being enriched with the vitamins B(1), B(2), B(6), and nicotinamide in Brazil. The objective of this research was to evaluate the levels of enrichment of these products according to their availability in supermarkets in the Campinas (SP, Brazil) region. The separation of the vitamins was carried out on a C 18 column with gradient elution with acetonitrile and aqueous phase. Detection of vitamins was effected in the ultraviolet region and quantification by an external standard. The levels of vitamin B(2) determined in powdered whole milk, skimmed milk powder, and one brand of flavored lactic beverage, were practically double those stated on the packages. The same occurred with vitamins B(6) and PP (nicotinic acid + nicotinamide), when determined in the same lactic beverage and with vitamin B(6), determined in acidified milk. The high levels of vitamin B(2), naturally present in whole milk, and the predominance of the free form, allowed for the determination of this vitamin in non-enriched milk.

Handsearching versus electronic searching to identify reports of randomized trials

BACKGROUND

Systematic reviewers need to decide how best to reduce bias in identifying studies for their review. Even when journals are indexed in electronic databases, it can still be difficult to identify all relevant studies reported in these journals. Over 1700 journals have been or are being handsearched within The Cochrane Collaboration to identify reports of controlled trials in order to help address these problems.

OBJECTIVES

To review systematically empirical studies, which have compared the results of handsearching with the results of searching one or more electronic databases to identify reports of randomized trials.

SEARCH STRATEGY

Studies were sought from The Cochrane Methodology Register (The Cochrane Library, Issue 2, 2002), MEDLINE (1966 to Week 1 July 2002), EMBASE (1980 to Week 25 2002), AMED (1985 to June 2002), BIOSIS (1985 to June 2002), CINAHL (1982 to June 2002), LISA (1969 to July 2002) and PsycINFO (1972 to May 2002). Researchers who may have carried out relevant studies were contacted.

SELECTION CRITERIA

A research study was considered eligible for this review if it compared handsearching with searching one or more electronic databases to identify reports of randomized trials.

DATA COLLECTION AND ANALYSIS

The main outcome measure was the number of reports of randomized trials identified by handsearching as compared to electronic searching. Data were extracted on the electronic database searched, the complexity of electronic search strategy used, the characteristics of the journal reports identified, and the type of trial report identified.

MAIN RESULTS

Thirty-four studies were included. Handsearching identified between 92% to 100% of the total number of reports of randomized trials found in the various comparisons in this review. Searching MEDLINE retrieved 55%, EMBASE 49% and PyscINFO 67%. The retrieval rate of the electronic database varied depending on the complexity of the search. The Cochrane Highly Sensitive Search Strategy (HSSS) identified 80% of the total number of reports of randomized trials found, searches categorised as 'complex' (including the Cochrane HSSS) found 65% and 'simple' found 42%. The retrieval rate for an electronic search was higher when the search was restricted to English language journals; 62% versus 39% for journals published in languages other than English. When the search was restricted to full reports of randomized trials, the retrieval rate for an electronic search improved: a complex search strategy (including the Cochrane HSSS) retrieved 82% of the total number of such reports of randomized trials.

AUTHORS' CONCLUSIONS

Handsearching still has a valuable role to play in identifying reports of randomized trials for inclusion in systematic reviews of health care interventions, particularly in identifying trials reported as abstracts, letters and those published in languages other than English, together with all reports published in journals not indexed in electronic databases. However, where time and resources are limited, searching an electronic database using a complex search (or the Cochrane HSSS) will identify the majority of trials published as full reports in English language journals, provided, of course, that the relevant journals have been indexed in the database.

Study of On-Line Adaptive Discriminant Analysis for EEG-Based Brain Computer Interfaces

A study of different on-line adaptive classifiers, using various feature types is presented. Motor imagery brain computer interface (BCI) experiments were carried out with 18 naive able-bodied subjects. Experiments were done with three two-class, cue-based, electroencephalogram (EEG)-based systems. Two continuously adaptive classifiers were tested: adaptive quadratic and linear discriminant analysis. Three feature types were analyzed, adaptive autoregressive parameters, logarithmic band power estimates and the concatenation of both. Results show that all systems are stable and that the concatenation of features with continuously adaptive linear discriminant analysis classifier is the best choice of all. Also, a comparison of the latter with a discontinuously updated linear discriminant analysis, carried out in on-line experiments with six subjects, showed that on-line adaptation performed significantly better than a discontinuous update. Finally a static subject-specific baseline was also provided and used to compare performance measurements of both types of adaptation.