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The selection of appropriate outcomes is crucial when designing clinical trials in order to compare the effects of different interventions directly. For the findings to influence policy and practice, the outcomes need to be relevant and important to key stakeholders including patients and the public, health care professionals and others making decisions about health care. It is now widely acknowledged that insufficient attention has been paid to the choice of outcomes measured in clinical trials. Researchers are increasingly addressing this issue through the development and use of a core outcome set, an agreed standardised collection of outcomes which should be measured and reported, as a minimum, in all trials for a specific clinical area.Accumulating work in this area has identified the need for guidance on the development, implementation, evaluation and updating of core outcome sets. This Handbook, developed by the COMET Initiative, brings together current thinking and methodological research regarding those issues. We recommend a four-step process to develop a core outcome set. The aim is to update the contents of the Handbook as further research is identified.  相似文献   
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Abstract
The gall-forming scale insect Callococcus leptospermi was studied in the field to determine its life history and method of distribution on the host plant, Leptospermum sp., previously L. juniperinum (Sm.) Domin (prickly tea tree, Myrtaceae). This paper complements earlier taxonomic studies on C. leptospermi. Until now the adult female has provided most of the available data on the species. Newly described stages include the second instar male, the third instar assumed female and the adult male. The sexually dimorphic first instar and adult female are redescribed. Callococcus leptospermi is ovoviviparous. It is dispersed by migration of second instar larvae from the parent gall to new feeding sites.  相似文献   
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Abstract: A shift in pH from 7.4 to 7.8 in the incubation solution caused a 3.4-fold increase in the free glutamine content of mouse cerebral astrocytes that were incubated with glutamate (100 μ M ) and ammonium (100 μ M ). This large and reversible steady-state increase in glutamine content was accompanied by smaller transient increases in the following: (a) net formation of glutamine; (b) clearance of glutamate from the incubation solution; and (c) glutamate content. The content of glutamine was reduced markedly by omission of either glutamate or ammonium from the incubation solution, or by inhibition of glutamine synthetase activity with methionine sulfoximine. The rate at which glutamine was exported from the astrocytes was unaffected by the pH change. The effects of pH on the concentration of free ammonia or on glutamate uptake do not appear to mediate the increase in glutamine content. Uptake of exogenous glutamine was little affected by the pH change. Therefore, possible mediation of the effect by an increase in intracellular pH must be considered. The response to altered pH described here may provide a cellular basis for the increased level of brain glutamine observed in hyperammonemia.  相似文献   
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Evolutionary arms-races between avian brood parasites and their hosts have typically resulted in some spectacular adaptations, namely remarkable host ability to recognize and reject alien eggs and, in turn, sophisticated parasite egg mimicry. In a striking contrast to hosts sometimes rejecting even highly mimetic eggs, the same species typically fail to discriminate against highly dissimilar parasite chicks. Understanding of this enigma is still hampered by the rarity of empirical tests - and consequently evidence - for chick discrimination. Recent work on Australian host-parasite systems (Gerygone hosts vs. Chalcites parasites), increased not only the diversity of hosts showing chick discrimination, but also discovered an entirely novel host behavioural adaptation. The hosts do not desert parasite chicks (as in all previously reported empirical work) but physically remove living parasites from their nests. Here, I briefly discuss these exciting findings and put them in the context of recent empirical and theoretical work on parasite chick discrimination. Finally, I review factors responsible for a relatively slow progress in this research area and suggest most promising avenues for future research.  相似文献   
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Background  

Bovine viral diarrhoea virus (BVDV) is an important pathogen in cattle. The ability of the virus to cross the placenta during early pregnancy can result in the birth of persistently infected (PI) calves. These calves shed the virus during their entire lifespan and are the key transmitters of infection. Consequently, identification (and subsequent removal) of PI animals is necessary to rapidly clear infected herds from the virus. The objective of this study was to evaluate the suitability of a commercial Erns-capture ELISA, in comparison to the indirect immunoperoxidase test (IPX), for routine diagnostic detection of BVDV within a control programme. In addition, the effect of passive immunity and heat-inactivation of the samples on the performance of the ELISA was studied.  相似文献   
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Medicago truncatula is a member ofMedicago sect.Spirocarpos, in which all 34 species have coiled fruit, usually tightly coiled, that permanently retain the seeds. A variant ofM. truncatula from Libya is unique for the species in possessing very loosely coiled fruits, and is here recognized as a new forma,M. truncatula f.laxicycla E. Small. In germination tests of a number of species ofMedicago, the unusual Libyan variant proved to be the only one in which rapid and simultaneous germination of most of the seeds occurred while still within a fruit. The loose coiling of the fruit of the Libyan variety appears to facilitate water entry and seedling escape. Its rapid germination might adapt it to respond quickly to intermittently available moisture, but at the cost of abandoning the strategy of intermittent germination adopted by other populations ofMedicago sect.Spirocarpos.  相似文献   
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