Flawed Studies Research Articles

The Cult of the Modern: Trans-Mediterranean France and the Construction of French Modernity by Gavin Murray-Miller

Reviews 227 a “Western” entity for categorizing Arabs and French banlieue Muslims who partake in same-sex relations as homosexual, thereby imposing a Western homo-hetero binary that transforms sexual practices into identities on a group of people who presumably do share the same perspective. Both authors, however, ignore that many Arabs and banlieue Muslims who engage in same-sex relations do adopt a corresponding sexual identity. Mack goes so far as to excuse violence committed against gay banlieusards and places the blame on both the French equivalent of the Gay International and gay Muslims who adopt the homo-hetero binary.Yet, Mack’s thesis is unsubstantiated; he has not done any fieldwork among gay Muslims in the banlieue. Perhaps the author ought to have asked the “clandestine” why they remain “clandestine,” rather than uncritically adopting Massad’s central claims about the Gay International and the Arab World. In a book largely about gay Muslims, Mack does not bring up cases of actual,“ordinary”gay Muslims.The only gay Muslim association in France,Homosexuels musulmans de France (HM2F), receives only a fleeting mention in Mack’s book. Therefore , despite the timeliness of the topic, Sexagon is ultimately a conceptually and methodologically flawed study on gay Muslims in the banlieue. University of Manchester Adi S. Bharat Murray-Miller, Gavin. The Cult of the Modern: Trans-Mediterranean France and the Construction of French Modernity. Lincoln: UP of Nebraska, 2017. ISBN 9780 -8032-9064-8. Pp. 336. Murray-Miller first traces the key ideological concepts of la France transméditerran éenne and modernity in France before and after the Second Empire, which was “constitutive of the social relations and political projects that assumed shape over the course of the nineteenth century” (7). The author examines modernity as a “decentered and diasporic community extending across national and spatial frontiers” (45), modernity as it was imagined by elites in post-revolutionary France with the onset of colonial conquests, the Algerian colonization during the nineteenth century and the colonial logic anchored in the belief in France’s mission civilisatrice and the perfectibility of mankind. He goes on to outline Napoléon III’s imperial civilization rhetoric, the“political culture of modernity”(80), populist and modernizing strategies and policies (colonial exhibitions, technological innovations, infrastructure improvements , industrial exhibitions and urban renovation in France and Algeria), used to legitimize his Coup d’état. The pax Napoléon “constituted the germ of transMediterranean civilizing mission” (64) which justified the use of violence against opponents. Chapter 3 examines debates on nationalité, unité, and nativism, the emperor’s politique de nationalité and its “penchant to represent the modernizing impulses of colonialism as a trans-Mediterranean program of national revival and nation-building” (95), in particular through its politique indigène and the creation of Arab Offices in Algeria as examples of French modernization efforts. The author also discusses the politicization of the Second Empire’s divisive education policies, debates over secular and religious instruction, the role of education as a tool of pacification and sociability in Algeria and student activism in France. He analyzes the links between Positivism and republicanism, the emergence of scientific republicanism and a new liberalism and heated debates surrounding the complex concepts of liberty, Positivism, democracy, Bonapartist modernity and authoritarianism, and acceptable forms of postrevolutionary republican democracy advocated by“young”republicans (181). He also discusses the challenges to“forge a national and democratic polity”(193) in rural France and the need for decentralization and the development of the press as a means of socialization and politicization of the rural population in particular. He maps the transformation of the“Algerian question into a national one”(212), that is the appropriation by the colons of the terms of republican modernization to the colony. Murray-Miller convincingly demonstrates that“Nation and Empire, France and North Africa became central to the articulation of the new social imaginary that modernity anticipated” (251). This meticulously researched and intellectually stimulating study focuses primarily on continental France (not so much, as indicated by the title, on France’s colonies and trans-Mediterranean relations, with the exception of the final chapter). The author makes excellent use of historical source materials—though all of them originate from prominent...

Sexagon: Muslims, France, and the Sexualization of National Culture by Mehammed Amadeus Mack

likely have reached a diverse readership, according to Kay. Bestiary readers could have included lay brothers or schoolboys learning Latin, as well as university students, and highly literate readers. Whereas Kay states that there is “no direct evidence” that bestiaries were read by women (15), she notes the likelihood of medieval aristocratic women having access to the vernacular bestiaries and therefore refers in her work to the readers of Latin bestiaries as “he” and to the readers of vernacular bestiaries as “she.” Exceedingly well researched and organized, and richly illustrated with twentyeight color plates and numerous black-and-white reproductions from illuminated bestiary manuscripts, Kay’s close readings of bestiary texts, images, and parchment will be of tremendous interest to students and scholars from a wide range of disciplines, including medieval studies, manuscript studies, animal studies, and skin studies. Northern Arizona University Erika E. Hess Mack, Mehammed Amadeus. Sexagon: Muslims, France, and the Sexualization of National Culture. NewYork: Fordham UP, 2017. ISBN 978-0-8232-7461-1. Pp. 318. The title suggests that the boundaries of Frenchness are increasingly defined by attitudes to LGBT issues and feminism. Mack contends that French Muslims, who can no longer be excluded on the grounds of linguistic non-assimilation, are now subjected to a “sexual” citizenship test. Immigrants and their descendants are only considered French if they adhere to “long-standing French values” on gender and sexuality. A central contention of this book is that, while French Muslim banlieusards are chastised for their regressive views on gender and sexuality, and while queer French Muslim banlieusards are criticized by activists for not “coming out,” the banlieue can be a site of dissident queer culture. This hypothesized“local”queer culture, according to Mack, is ignored by an “imperialistic” Parisian gay center that adheres to a hetero-homo binary and privileges a linear coming-out narrative. For Mack, the homonationalism and sexual nationalism of the gay center ignores banlieue queer cultures and, especially, queer banlieusards’ “nongendered virility” and “chosen homosexual clandestinity” (23). Both terms, however, lack conceptual clarity. In particular, Mack’s notion of “chosen homosexual clandestinity” suggests that gay Muslim men in the banlieue choose to be“discreet”and actively reject the Parisian gay center’s imperative to come out. Mack considers that these gay men remain in the closet, not out of fear of discrimination, harassment, or reprisals, but out of choice. Clandestinity, then, would be a free choice that is willingly adopted by banlieue gay Muslims. Mack appears to have implicitly taken Joseph Massad’s main argument in Desiring Arabs and transposed it onto the French context. The Gay International here is replaced by a vague Parisian gay center and the Arab World by the French banlieue. Many of the same critiques that one could make of Desiring Arabs can also be made of Mack’s book. Both criticize 226 FRENCH REVIEW 91.3 Reviews 227 a “Western” entity for categorizing Arabs and French banlieue Muslims who partake in same-sex relations as homosexual, thereby imposing a Western homo-hetero binary that transforms sexual practices into identities on a group of people who presumably do share the same perspective. Both authors, however, ignore that many Arabs and banlieue Muslims who engage in same-sex relations do adopt a corresponding sexual identity. Mack goes so far as to excuse violence committed against gay banlieusards and places the blame on both the French equivalent of the Gay International and gay Muslims who adopt the homo-hetero binary.Yet, Mack’s thesis is unsubstantiated; he has not done any fieldwork among gay Muslims in the banlieue. Perhaps the author ought to have asked the “clandestine” why they remain “clandestine,” rather than uncritically adopting Massad’s central claims about the Gay International and the Arab World. In a book largely about gay Muslims, Mack does not bring up cases of actual,“ordinary”gay Muslims.The only gay Muslim association in France,Homosexuels musulmans de France (HM2F), receives only a fleeting mention in Mack’s book. Therefore , despite the timeliness of the topic, Sexagon is ultimately a conceptually and methodologically flawed study on gay Muslims in the banlieue. University of Manchester Adi S. Bharat Murray-Miller, Gavin. The Cult...

Ayurveda: Controversies and the Need for Integration with Mainstream Medicine

Ayurveda has often been labeled a pseudoscience due to a lack of understanding regarding its principles, which are difficult to translate into mainstream medical terminology. Furthermore, there have been controversies due to a few biased and flawed studies that claim some of the metals it uses are toxic and cause other side effects.1,2 The lack of randomized, controlled trials has only increased the public’s distrust. This paper attempts to address these challenges by introducing the concepts of Ayurveda and comparing it with mainstream medicine in order to bring to the readers’ notice the pros and cons of both forms of medicine. The paper begins with an analysis of the different approaches in the understanding and treatment of a disease in Ayurveda and mainstream medicine. This is followed by studies supporting the efficacy of the herbs used in Ayurveda. Next, the use of metals in Ayurveda and its purity is discussed. Finally, this paper mentions the lack of quality control and regulations in Ayurveda and the steps being taken to address this issue. The paper concludes with an argument for the integration of Ayurveda into mainstream medicine.

Is partial behaviour a plausible explanation for the unavailability of the ICMJE disclosure form of an author in a BMJ journal?

This case study about the ethical behaviour in the field of scholarly publishing documents an exception on the rule for research articles in the medical journal BMJ Open that ICMJE disclosure forms of authors must be made available on request. The ICMJE, the International Committee of Medical Journal Editors, has developed these forms for the disclosure of conflicts of interest for authors of medical publications. The case refers to the form of the corresponding author of an article in BMJ Open on retraction notices (Moylan and Kowalczuk, 2016). The corresponding author is a member of the council of COPE, the Committee on Publication Ethics. I will argue that the unavailability of the form relates to personal conflicts of interest with the corresponding author about my efforts to retract a fatally flawed study on the breeding biology of the Basra Reed Warbler Acrocephalus griseldis . I describe my attempts to get the form and I will argue that its unavailability can be attributed to partial behaviour by BMJ, the publisher of BMJ Open . This study complements other sources reporting ethical issues at COPE.

Improving the detection of fluorescent tracer dyes in groundwater investigations

Groundwater tracing with fluorescent tracer dyes is a valuable tool in many remediation projects. Three of four common dyes can be used concurrently, effectively separated, and their concentrations quantified if modern laboratory instruments and appropriate protocols are used. Unfortunately, investigators often overestimate the amount of introduced dye likely to be detected, use too little dye because of these estimates and concern that colored water might be detectable off-site, and place sampling reliance solely on grab samples of water. The common result is flawed studies that identify only some of the points to which the dyed water flows. Results are quantitatively compared for monitoring sites during periods where both water samples and granular activated carbon samplers (referred to as carbon samplers) were used. The results demonstrate that carbon samplers are superior to water samples for detecting the presence of the fluorescent tracer dyes evaluated. A technically sound and cost-effective strategy is to place primary sampling reliance on carbon samplers for detecting the presence of the dyes and secondary reliance on grab samples of water for determining dye concentrations when they are greater than the detection limits.

Valproate used during pregnancy: What should be done?

BackgroundSodium valproate can cause serious developmental disorders in unborn babies if taken while pregnant, especially in the first trimester.AimTo review recent literature and advice or treatment for women who have or are using valproate whilst pregnant.DesignLiterature review.MethodsLiterature review using Pubmed with search terms: ‘bipolar’; ‘pregnant’; ‘valproate’ and following up references.ResultsThere are several small methodologically flawed studies that attempt to address this question and will be reprised. Three key population register studies found high rates of malformations. A retrospective study of longer-term outcomes found high rates of developmental issues. There are several relevant treatment guidelines, including from the National Institute for Health and Clinical Excellence (NICE). There is a 40% risk of developmental disorder, a 10% risk of congenital malformations and a 3% risk of IQ deterioration.ConclusionsAvoid valproate in women of childbearing age if at all possible, and consider effective contraception if used. If already pregnant then consider, with involvement from the patient, stopping or minimizing the dose of sodium valproate. Assess the risks and benefits of using sodium valproate during pregnancy versus stopping the treatment for the first trimester as symptoms of the disorder may return. Seek advice from a perinatal psychiatrist. Add 5 mg of folic acid daily for the remainder of the pregnancy.Disclosure of interestThe authors have not supplied their declaration of competing interest.

From Reproducibility to Translation in Neurodegenerative Disease.

Despite tremendous investment and preclinical success in neurodegenerative disease, effective disease-altering treatments for patients have remained elusive. One highly cited reason for this discrepancy is flawed animal study design and reporting. If this can be broadly remedied, reproducibility of preclinical studies will improve. However, without concurrent efforts to improve generalizability, these improvements may not translate effectively from animal experiments to more complex human neurodegenerative diseases. Mechanistic and phenotypic variability of neurodegenerative disease is such that most models are only able to interrogate individual aspects of complex phenomena. One approach is to consider animals as models of individual targets rather than as models of individual diseases and to migrate the concept of predictive validity from the individual model to the body of experiments that demonstrate translatability of a target. Both exploratory and therapeutic preclinical studies are dependent upon study design methods that promote rigor and reproducibility. However, the body of evidence that is needed to demonstrate efficacy in therapeutic studies is substantially broader than that needed for exploratory studies. In addition to requiring rigor within individual experiments, convincing evidence for therapeutic potential must assess the relationships between model choice, intended goal of the intervention, pharmacologic criteria, and integration of biomarker data with outcome measures that are clinically relevant to humans. It is conceivable that proof-of-concept studies will migrate to cell-based systems and that animal systems will be increasingly reserved for more distal translational purposes. If this occurs, it is likely to prompt reexamination of what the term "translational" truly means.

In pursuit of truth: A critical examination of meta-analyses of cognitive behavior therapy

Objective: Three recent meta-analyses have made the claim, albeit with some caveats, that cognitive-behavioral treatments (CBT) are superior to other psychotherapies, in general or for specific disorders (e.g., social phobia). Method: The purpose of the present article was to examine four issues in meta-analysis that mitigate claims of CBT superiority: (a) effect size, power, and statistical significance, (b) focusing on disorder-specific symptom measures and ignoring other important indicators of psychological functioning, (c) problems inherent in classifying treatments provided in primary studies into classes of treatments, and (d) the inclusion of problematic trials, which biases the results, and the exclusion of trials that fail to find differences among treatments. Results: When these issues are examined, the effects demonstrating the superiority of CBT are small, nonsignificant for the most part, limited to targeted symptoms, or are due to flawed primary studies. Conclusion: Meta-analytic evidence for the superiority of CBT in the three meta-analysis are nonexistent or weak.

The sleeper effect between psychotherapy orientations: a strategic argument of sustainability of treatment effects at follow-up.

OBJECTIVE: Three recent meta-analyses have made the claim, albeit with some caveats, that cognitive-behavioral treatments (CBT) are superior to other psychotherapies, in general or for specific disorders (e.g., social phobia). METHOD: The purpose of the present article was to examine four issues in meta-analysis that mitigate claims of CBT superiority: (a) effect size, power, and statistical significance, (b) focusing on disorder-specific symptom measures and ignoring other important indicators of psychological functioning, (c) problems inherent in classifying treatments provided in primary studies into classes of treatments, and (d) the inclusion of problematic trials, which biases the results, and the exclusion of trials that fail to find differences among treatments. RESULTS: When these issues are examined, the effects demonstrating the superiority of CBT are small, nonsignificant for the most part, limited to targeted symptoms, or are due to flawed primary studies. CONCLUSION: Meta-analytic evidence for the superiority of CBT in the three meta-analysis are nonexistent or weak

The efficacy and safety of Fufangdanshen tablets (Radix Salviae miltiorrhizae formula tablets) for mild to moderate vascular dementia: a study protocol for a randomized controlled trial.

BackgroundVascular dementia (VaD) is the second most common subtype of dementia after Alzheimer's disease (AD). Currently, there are no medications approved for treating patients with VaD. Fufangdanshen (FFDS) tablets (Radix Salviae miltiorrhizae formula tablets) are a traditional Chinese medicine that has been reported to improve memory. However, the existing evidence for FFDS tablets in clinical practice derives from methodologically flawed studies. To further investigate the safety, tolerability, and efficacy of FFDS tables in the treatment of mild to moderate VaD, we designed and reported the methodology for a 24-week randomized, double-blind, parallel, multicenter study.Methods/designThis ongoing study is a double-blind, randomized, parallel placebo-controlled trial. A total of 240 patients with mild to moderate VaD will be enrolled. After a 2-week run-in period, the eligible patients will be randomized to receive either three FFDS or placebo tablets three times per day for 24 weeks, with a follow-up 12 weeks after the last treatment. The primary efficacy measurement will be the Alzheimer’s Disease Assessment Scale-cognitive subscale (ADAS-cog) and the Clinician Interview-Based Impression of Change (CIBIC-plus). The secondary efficacy measurements will include the Mini Mental State Examination (MMSE) and activities of daily living (ADL). Adverse events will also be reported.DiscussionThis randomized trial will be the first rigorous study on the efficacy and safety of FFDS tablets for treating cognitive symptoms in patients with VaD using a rational design.Trial registrationClinicalTrials.gov: NCT01761227. Registered on 2 January 2013.

Antifibrinolytics (lysine analogues) for the prevention of bleeding in people with haematological disorders.

Background Patients with haematological disorders are frequently at risk of severe or life-threatening bleeding as a result of thrombocytopenia. This is despite the routine use of prophylactic platelet transfusions (PlTx) to prevent bleeding once the platelet count falls below a certain threshold. PlTx are not without risk and adverse events may be life-threatening. A possible adjunct to prophylactic PlTxs is the use of antifibrinolytics, specifically the lysine analogues tranexamic acid (TXA) and epsilon aminocaproic acid (EACA). Objectives To determine the efficacy and safety of antifibrinolytics (lysine analogues) in preventing bleeding in patients with haematological disorders. Search methods We searched for randomised controlled trials (RCTs) in the Cochrane Central Register of Controlled Trials (CENTRAL Issue 12, 2012), MEDLINE (1948 to 10 January 2013), EMBASE (1980 to 10 January 2013), CINAHL (1982 to 10 January 2013), PubMed (e-publications only) and the Transfusion Evidence Library (1980 to January 2013). We also searched several international and ongoing trial databases to 10 January 2013 and citation-tracked relevant reference lists. Selection criteria RCTs involving patients with haematological disorders, who would routinely require prophylactic platelet transfusions to prevent bleeding. We only included trials involving the use of the lysine analogues TXA and EACA. Data collection and analysis Two authors independently screened all electronically derived citations and abstracts of papers, identified by the review search strategy, for relevancy. Two authors independently assessed the full text of all potentially relevant trials for eligibility, completed the data extraction and assessed the studies for risk of bias using The Cochrane Collaboration's 'Risk of bias' tool. We requested missing data from one author but the data were no longer available. The outcomes are reported narratively: we performed no meta-analyses because of the heterogeneity of the available data. Main results Of 470 articles initially identified, 436 were excluded on the basis of the title and abstract. We reviewed 34 full-text articles from which four studies reported in five articles were eligible for inclusion. We did not identify any RCTs which compared TXA with EACA. We did not identify any ongoing RCTs. One cross-over TXA study (eight patients) was excluded from the outcome analysis because data from this study were at a high risk of bias. Data from the other three studies were all at unclear risk of bias due to lack of reporting of study methodology. Three studies (two TXA (12 to 56 patients), one EACA (18 patients)) reported in four articles (published 1983 to 1995) were included in the narrative review. All three studies compared the drug with placebo. All studies reported bleeding, but it was reported in different ways. All three studies suggested antifibrinolytics reduced the risk of bleeding. The first study showed a difference in average bleeding score of 42 in placebo (P) versus three (TXA). The second study only showed a difference in bleeding episodes during consolidation chemotherapy, with a mean of 2.6 episodes/patient (standard deviation (SD) 2.2) (P) versus a mean of 1.1 episodes/patient (SD 1.4) (TXA). The third study reported bleeding on 50% of days at risk (P) versus bleeding on 31% of days at risk (EACA). Two studies (68 patients) reported thromboembolism and no events occurred. All three studies reported a reduction in PlTx usage. The first study reported a difference of 222 platelet units (P) versus 69 platelet units (TXA). The second study only showed a difference in total platelet usage during consolidation chemotherapy, with a mean of 9.3 units (SD 3.3) (P) versus 3.7 (SD 4.1) (TXA). The third study reported one PlTx every 10.5 days at risk (P) versus one PlTx every 13.3 days at risk (EACA). Two studies reported red cell transfusion requirements and one study found a reduction in red cell transfusion usage. One study reported death due to bleeding as an outcome measure and none occurred. Only one study reported adverse events of TXA as an outcome measure and none occurred. None of the studies reported on the following pre-specified outcomes: overall mortality, adverse events of transfusion, disseminated intravascular coagulation (DIC) or quality of life (QoL). Authors' conclusions Our results indicate that the evidence available for the use of antifibrinolytics in haematology patients is very limited. The only available data suggest that TXA and EACA may be useful adjuncts to platelet transfusions so that platelet use, and the complications associated with their use, can be reduced. However, the trials were too small to assess whether antifibrinolytics increased the risk of thromboembolic events. Large, high-quality RCTs are required before antifibrinolytics can be demonstrated to be efficacious and safe in widespread clinical practice.

The Conflicting Evidence of Three-dimensional Displays in Laparoscopy: A Review of Systems Old and New.

To describe studies evaluating 3 generations of three-dimensional (3D) displays over the course of 20 years. Most previous studies have analyzed performance differences during 3D and two-dimensional (2D) laparoscopy without using appropriate controls that equated conditions in all respects except for 3D or 2D viewing. Databases search consisted of MEDLINE and PubMed. The reference lists for all relevant articles were also reviewed for additional articles. The search strategy employed the use of keywords "3D," "Laparoscopic," "Laparoscopy," "Performance," "Education," "Learning," and "Surgery" in appropriate combinations. Our current understanding of the performance metrics between 3D and 2D laparoscopy is mostly from the research with flawed study designs. This review has been written in a qualitative style to explain in detail how prior research has underestimated the potential benefit of 3D displays and the improvements that must be made in future experiments comparing 3D and 2D displays to better determine any advantage of using one display or the other. Individual laparoscopic performance in 3D may be affected by a multitude of factors. It is crucial for studies to measure participant stereoscopic ability, control for system crosstalk, and use validated measures of performance.

Effect of Topical Administration of Fractions and Isolated Molecules from Plant Extracts on Skin Wound Healing: A Systematic Review of Murine Experimental Models.

Background and Purpose. Skin wound healing is a dynamic process driven by molecular events responsible for the morphofunctional repair of the injured tissue. In a systematic review, we analyzed the relevance of plant fractions and isolates on skin wound healing. By revising preclinical investigations with murine models, we investigated if the current evidence could support clinical trials. Methods. Studies were selected in the MEDLINE/PubMed and Scopus databases according to the PRISMA statement. All 32 identified studies were submitted to data extraction and the methodological bias was investigated according to ARRIVE strategy. Results. The studies demonstrated that plant fractions and isolates are able to modulate the inflammatory process during skin wound healing, being also effective in attenuating the oxidative tissue damage in the scar tissue and stimulating cell proliferation, neoangiogenesis, collagen synthesis, granulation tissue expansion, reepithelialization, and the wound closure rate. However, we identified serious methodological flaws in all studies, such as the high level of reporting bias and absence of standardized experimental designs, analytical methods, and outcome measures. Conclusion. Considering these limitations, the current evidence generated from flawed methodological animal studies makes it difficult to determine the relevance of herbal medicines to treat skin wounds and derails conducting clinical studies.

Throwaway Children: The Tragic Consequences of a False Narrative

Truth be told, we are afraid for our children and we are afraid of our children. The intersection of these disparate thoughts has produced a perfect storm. We have created increasingly harsh sex offender registration schemes to protect our children from sexual abuse. At the same time, fear of our children ensnares and punishes them under the very same laws that were designed to protect them. Yet, what compels action is premised on a false narrative that includes flawed studies on recidivism rates and misguided case decisions that embraced these findings. In this article, I explore the inherently unfair and deeply flawed practice of mandatory lifetime registration for children who commit sex offenses. Examination reveals two fallacies in a system that condemns children to lifetime monitoring: the breadth of its ensnarement, and the presumption of a child’s continued sexual predatory behavior. Fueled by emotional rhetoric, both are tightly bound in a fundamentally false narrative that is unnecessary and wholly damaging for the child registrant. The utility of an overly-simplified registration scheme comes with a hefty price tag: the acknowledgement that mandatory lifetime registration captures and shatters the lives of many non-dangerous children. It is a price tag we should no longer be willing to bear. In the face of overwhelming statistical evidence to the contrary, we must commit to changing the false narrative that children who commit sex offenses are presumed to become sexually dangerous adults. We must commit to replacing it with a narrative that acknowledges that recidivism rates are low and that mandatory lifetime registration is both unnecessary and devastating.

Neutrophil CD64 expression is not a useful biomarker for detecting serious bacterial infections in febrile children at the emergency department

Background CD64 is expressed on the surface membrane of neutrophils (nCD64) in the presence of bacterial infection. Although initial studies in intensive care settings have been promising, only two small, methodologically flawed studies have been performed in feverish children presenting to the emergency departement (ED), both of which were showing a moderate diagnostic value of nCD64 to detect a serious bacterial infection (SBI). This study aimed to determine the diagnostic value of nCD64 in children presenting with fever to the ED for detecting SBI. Methods In this prospective observational multi-centre study previously healthy children aged 1 month–16 years with fever, presenting to the ED of two hospitals in the Netherlands in 2011–2012 were included. Standardised information on clinical features were collected and nCD64 and CRP were measured routinely. Multivariable logistic regression was used to determine the discriminative ability to detect SBI (ROC-area) of nCD64 compared with CRP. Diagnostic performance measures including sensitivity, specificity and likelihood ratios were calculated. Results In 392 children (45%) with both CRP and nCD64 determined, 52 children (13%) had an SBI. The AUC of the ROC curve for CD64 was 0.62 (95% CI = 0.54–0.70) and 0.75 (95% CI = 0.67-0.83) for CRP. Neither duration of fever nor deviated vital signs influenced the diagnostic performance of nCD64. Conclusion NCD64 expression has poor discriminative value to detect children with an SBI in a general population of febrile children at the ED. It has no superior value compared to CRP in this setting, neither in total nor in sub-populations.

Advances in the Prevention of Infection-Related Preterm Birth

Infection-related preterm birth (PTB) is more common at early gestational ages and is associated with major neonatal mortality and morbidity. Abnormal genital tract microflora in early pregnancy predicts late miscarriage and early PTB. Accordingly, it is logical to consider antibiotics as an intervention. Unfortunately, the conclusions of systematic reviews and meta-analyses (SR&MAs) carried out in an attempt to explain the confusion over the heterogeneity of individual studies are flawed by the fact that undue reliance was placed on studies which: (a) had a suboptimal choice of antibiotic (mainly metronidazole) or used antibiotics not recommended for the treatment of bacterial vaginosis (BV) or BV-related organisms; (b) used antibiotics too late in pregnancy to influence outcome (23–27 weeks); and (c) included women whose risk of PTB was not due to abnormal genital tract colonization and hence unlikely to respond to antibiotics. These risks included: (a) previous PTB of indeterminate etiology; (b) low weight/body mass index; or (c) detection of fetal fibronectin, ureaplasmas, Group B streptococcus or Trichomonas vaginalis). While individual studies have found benefit of antibiotic intervention for the prevention of PTB, in meta-analyses these effects have been negated by large methodologically flawed studies with negative results. As a result, many clinicians think that any antibiotic given at any time in pregnancy to any woman at risk of PTB will cause more harm than good. Recently, a more focused SR&MA has demonstrated that antibiotics active against BV-related organisms, used in women whose risk of PTB is due to abnormal microflora, and used early in pregnancy before irreversible inflammatory damage has occurred, can reduce the rate of PTB. This review presents those data, the background and attempts to explain the confusion using new information from culture-independent molecular-based techniques. It also gives guidance on the structure of putative future antibiotic intervention studies.

Flawed studies: EMA confirms recommendation to suspend drugs

Flawed studies: EMA confirms recommendation to suspend drugs

A reanalysis of mouse ENCODE comparative gene expression data

Recently, the Mouse ENCODE Consortium reported that comparative gene expression data from human and mouse tend to cluster more by species rather than by tissue. This observation was surprising, as it contradicted much of the comparative gene regulatory data collected previously, as well as the common notion that major developmental pathways are highly conserved across a wide range of species, in particular across mammals. Here we show that the Mouse ENCODE gene expression data were collected using a flawed study design, which confounded sequencing batch (namely, the assignment of samples to sequencing flowcells and lanes) with species. When we account for the batch effect, the corrected comparative gene expression data from human and mouse tend to cluster by tissue, not by species.

A reanalysis of mouse ENCODE comparative gene expression data.

Recently, the Mouse ENCODE Consortium reported that comparative gene expression data from human and mouse tend to cluster more by species rather than by tissue. This observation was surprising, as it contradicted much of the comparative gene regulatory data collected previously, as well as the common notion that major developmental pathways are highly conserved across a wide range of species, in particular across mammals. Here we show that the Mouse ENCODE gene expression data were collected using a flawed study design, which confounded sequencing batch (namely, the assignment of samples to sequencing flowcells and lanes) with species. When we account for the batch effect, the corrected comparative gene expression data from human and mouse tend to cluster by tissue, not by species.

A Study of Flaws in Delivering Programming languages and to impart programming logic in a reasonable approach

One of the important objectives of computer science (programming) education is to develop fundamental proficiency in the area of computer programming. Knowledge of programming is so important that almost all computer science programs include it in their curriculum. This important subject is widely reported as being challenging for novices especially in the very beginning early lessons. Study on bilingual language instructions shows that use of native language instructions help students to understand the subject better and use of secondary language instructions increase their social context of choice. When a learner learns through a language other than the mother tongue, learner faces problems because his task becomes two-fold. The first is that the learner has to make sense of the instructional tasks, which are presented in the second language or an interactive manner, and the second is Learner has to get linguistic competence that is required for effective learning to take place.