Longitudinal analyses of correlated response efficiencies of fillet traits in Nile tilapia

Recent studies with Nile tilapia have shown divergent results regarding the possibility of selecting on morphometric measurements to promote indirect genetic gains in fillet yield (FY). The use of indirect selection for fillet traits is important as these traits are only measurable after harvesting. Random regression models are a powerful tool in association studies to identify the best time point to measure and select animals. Random regression models can also be applied in a multiple trait approach to analyze indirect response to selection, which would avoid the need to sacrifice candidate fish. Therefore, the aim of this study was to investigate the genetic relationships between several body measurements, weight and fillet traits throughout the growth period and to evaluate the possibility of indirect selection for fillet traits in Nile tilapia. Data were collected from 2042 fish and was divided into two subsets. The first subset was used to estimate genetic parameters, including the permanent environmental effect for BW and body measurements (8758 records for each body measurement, as each fish was individually weighed and measured a maximum of six times). The second subset (2042 records for each trait) was used to estimate genetic correlations and heritabilities, which enabled the calculation of correlated response efficiencies between body measurements and the fillet traits. Heritability estimates across ages ranged from 0.05 to 0.5 for height, 0.02 to 0.48 for corrected length (CL), 0.05 to 0.68 for width, 0.08 to 0.57 for fillet weight (FW) and 0.12 to 0.42 for FY. All genetic correlation estimates between body measurements and FW were positive and strong (0.64 to 0.98). The estimates of genetic correlation between body measurements and FY were positive (except for CL at some ages), but weak to moderate (−0.08 to 0.68). These estimates resulted in strong and favorable correlated response efficiencies for FW and positive, but moderate for FY. These results indicate the possibility of achieving indirect genetic gains for FW and by selecting for morphometric traits, but low efficiency for FY when compared with direct selection.     

Characteristics of consultants who hold distinction awards in England and Wales: database analysis with particular reference to sex and ethnicity

Objective To determine whether women, ethnic minorities, and particular specialties are discriminated against in the receipt of NHS distinction awards.Design Analysis of database of consultants eligible for distinction awards.Setting England and Wales, 2002.Main outcome measures Holding of B, A, and Aplus distinction awards, analysed for all awards, irrespective of when made, and for awards made in the last five years studied.Results Women and doctors from ethnic minorities were substantially under-represented among award holders when no account was taken of potential confounding factors. Differences diminished after multivariate analysis, but some remained significant. For example, the adjusted odds ratio of women holding awards compared with men was 0.69 (95% confidence interval 0.59 to 0.82) for any award and 1.37 (0.86 to 2.20) for Aplus awards; the odds ratio for any award for non-white doctors trained abroad compared with white doctors trained in the United Kingdom was 0.45 (0.37 to 0.56). In the last five years studied the adjusted ratio of women to men was 0.94 (0.79 to 1.10) for B awards and 1.54 (0.85 to 2.83) for Aplus awards. The adjusted ratio for non-white British trained consultants was 0.86 (0.62 to 1.17) for B awards and 1.20 (0.37 to 3.87) for Aplus awards; for non-white consultants trained abroad it was 0.68 (0.54 to 0.85) for B awards and 0.69 (0.15 to 3.10) for Aplus awards; and for white consultants trained abroad it was 0.70 (0.54 to 0.91) for B awards and 0.90 (0.38 to 2.15) for Aplus awards.Conclusion Historical under-representation in award holding by women and doctors from ethnic minorities was partly explained by time spent as a consultant. Recent awards showed no under-representation of women and no appreciable under-representation of ethnic minorities overall. However, doctors who trained abroad—both white and non-white—remained under-represented for B awards.     

Confidence intervals for genotype relative risks and allele frequencies from the case parent trio design for candidate-gene studies

OBJECTIVES: Confidence intervals for genotype relative risks, for allele frequencies and for the attributable risk in the case parent trio design for candidate-gene studies are proposed which can be easily calculated from the observed familial genotype frequencies. METHODS: Likelihood theory and the delta method were used to derive point estimates and confidence internals. We used Monte Carlo simulations to show the validity of the formulae for a variety of given modes of inheritance and allele frequencies and illustrated their usefulness by applying them to real data. RESULTS: Generally these formulae were found to be valid for 'sufficiently large' sample sizes. For smaller sample sizes the estimators for genotype relative risks tended to be conservative whereas the estimator for attributable risk was found to be anti-conservative for moderate to high allele frequencies. CONCLUSIONS: Since the proposed formulae provide quantitative information on the individual and epidemiological relevance of a genetic variant they might be a useful addition to the traditional statistical significance level of TDT results.     

The Significance of Spermatozoa in Victims of Sexual Offences

Factual information for the use of the doctor called upon to give evidence in court after examining the victim of an alleged sexual attack is considered on the basis of an extensive review of the literature and of years of experience by the staff of the Attorney-General''s Laboratory for Ontario. This experience emphasizes the need for immediate examination of fluid from the vaginal pool for motility of the spermatozoa and the need for a later examination for delayed bruising of the victim. Motile spermatozoa are found in the vagina for one-half to six hours, with an average time of three hours. Non-motile forms usually are found for seven to 12 hours, but exceptionally for 18 to 24 hours. Data relative to the survival of spermatozoa under various conditions are tabulated.     

湖南土家族的体质特征

以20至69岁的湖南土家族人为观察测量对象,根据1392人(男896,女496)的身高,1038人(男668,女370)的头部测量,364人(男235,女129)的五官测量和观察结果,分析该民族的体质特征,并与国内其他民族相比较。     

Resistance to selected organochlorin, organophosphate, carbamate and pyrethroid, in Spodoptera litura (Lepidoptera: Noctuidae) from Pakistan

The toxicity of the most commonly used insecticides of organochlorine, organophosphate, pyrethroid, and carbamate groups were investigated against Spodoptera litura (F.) (Lepidoptera: Noctuidae) populations collected for three consecutive years (2004-2006). For a chlorocyclodiene and pyrethroids tested, the resistance ratios compared with Lab-PK were in the range of 10- to 92-fold for endosulfan, 5- to 111-fold for cypermethrin, 2- to 98-fold for deltamethrin, and 7- to 86-fold for beta-cyfluthrin. For organophosphates and carbamates, resistance ratios were in the range of 3- to 169-fold for profenofos, 18- to 421-fold for chlorpyrifos, 3- to 160-fold for quinalphos, 6- to 126-fold for phoxim, 7- to 463-fold for triazophos, and 10- to 389-fold for methomyl and 16- to 200-fold for thiodicarb. Resistance ratios were generally low to medium for deltamethrin and beta-cyfluthrin and high to very high for endosulfan, cypermethrin, profenofos, chlorpyrifos, quinalphos, phoxim, triazophos, methomyl, or thiodicarb. Pairwise comparisons of the log LC50 values of insecticides tested for all the populations showed correlations among several insecticides, suggesting a cross-resistance mechanism. Integration of timely judgment of pest problem, delimiting growing of alternate crops such as arum, rotation of insecticides with new chemicals, and insect growth regulators in relation to integrated pest management could help in manageable control of this important pest.     

An Assessment Framework for Optimal FMS Effectiveness

Equipment failures in an FMS are significant to performance and can lead to costly, incorrect decisions. Fortunately, effectiveness measurement techniques can be mapped to clever modeling frameworks to help predict, track, and then improve upon the FMS performability or mission effectiveness, and improve maintenance. This article provides sources and guidelines for efficient and effective FMS modeling, a framework for applying the modeling to predict the impact on customers from their point of view, and a method for tying it all together for improving the FMS effectiveness. It is not enough to simply examine the working and failed states of an FMS or even to calculate common reliability metrics. It is necessary to consider the FMS as a whole, and that system includes the needs of the customer and the business. It is also necessary to be purposeful about the measures of performance selected and to support the measures of effectiveness. In this article, we present: a framework for considering customer needs in the measures of effectiveness for FMS; modeling approaches for solving for effectiveness measures; and an example to show how to apply it to an FMS, to improve it or plan for meeting specific customer needs.     

Fertilization and early cleavage in vitro of ageing bovine oocytes after maturation in culture

Bovine follicular oocytes cultured for 20 to 48 hours were inseminated with frozen thawed spermatozoa. Significantly higher penetration rates (94 to 100% vs 86 to 94%: P < 0.05) and proportions of polyspermy (35 to 78% vs 22 to 45%: P < 0.01) were obtained for oocytes cultured continuously for 24 hours with spermatozoa than for those separated from spermatozoa 8 hours after insemination. The most prominent effect of ageing of oocytes on early events of penetration was observed in the incidence of polyspermy rather than in the penetration rate and the proportion of pronuclear plus cleaved oocytes: the proportion of polyspermic oocytes significantly increased (P < 0.05) in oocytes inseminated after 28 to 48 hours of culture (36 to 78%) compared with those cultured for 20 to 24 hours (22 to 35%) for maturation. Culture experiments for early development of penetrated oocytes indicated that no significant differences were observed in the proportions of oocytes cleaved to the two- to four-cell stage 48 hours after insemination among those cultured for 20 to 40 hours for maturation. However, further cleavage to the four- to sixteen-cell stage 72 to 96 hours after insemination was greatly inhibited as ageing of oocytes proceeded from 28 hours in culture for maturation.     

美国花生微核心种质资源纯化系的引进与表型评价

花生种质资源是花生新品种选育和重要农艺性状遗传研究的基础材料。引进国外优异花生种质资源,并对其进行鉴定和评价对发掘优良花生种质、丰富我国花生资源遗传多样性以及合理利用种质资源进行遗传改良具有重要意义。本研究于2014-2015年连续2年在河北保定对104份引进的美国花生微核心种质资源纯化系进行了农艺性状考察和抗病性鉴定。鉴定结果表明,美国微核心种质纯化系多为匍匐型,主茎高变异范围为24.50~89.50 cm,侧枝长为39.37~99.23 cm,单株果数和单株果重分别为8.75~46.33个和8.49~29.54 g,百果重为80.76~216.72 g,单株粒数为18.25~58.00个,单株粒重为9.89~33.36 g,百仁重为25.52~74.18 g,出仁率为52.58%~76.08%。抗病性鉴定表明,部分美国微核心种质资源纯化系高抗褐斑病和网斑病,性状优良。该研究结果为花生新品种选育与遗传研究提供了优异材料和参考信息。     

Effect of predictor traits on accuracy of genomic breeding values for feed intake based on a limited cow reference population

The genomic breeding value accuracy of scarcely recorded traits is low because of the limited number of phenotypic observations. One solution to increase the breeding value accuracy is to use predictor traits. This study investigated the impact of recording additional phenotypic observations for predictor traits on reference and evaluated animals on the genomic breeding value accuracy for a scarcely recorded trait. The scarcely recorded trait was dry matter intake (DMI, n = 869) and the predictor traits were fat–protein-corrected milk (FPCM, n = 1520) and live weight (LW, n = 1309). All phenotyped animals were genotyped and originated from research farms in Ireland, the United Kingdom and the Netherlands. Multi-trait REML was used to simultaneously estimate variance components and breeding values for DMI using available predictors. In addition, analyses using only pedigree relationships were performed. Breeding value accuracy was assessed through cross-validation (CV) and prediction error variance (PEV). CV groups (n = 7) were defined by splitting animals across genetic lines and management groups within country. With no additional traits recorded for the evaluated animals, both CV- and PEV-based accuracies for DMI were substantially higher for genomic than for pedigree analyses (CV: max. 0.26 for pedigree and 0.33 for genomic analyses; PEV: max. 0.45 and 0.52, respectively). With additional traits available, the differences between pedigree and genomic accuracies diminished. With additional recording for FPCM, pedigree accuracies increased from 0.26 to 0.47 for CV and from 0.45 to 0.48 for PEV. Genomic accuracies increased from 0.33 to 0.50 for CV and from 0.52 to 0.53 for PEV. With additional recording for LW instead of FPCM, pedigree accuracies increased to 0.54 for CV and to 0.61 for PEV. Genomic accuracies increased to 0.57 for CV and to 0.60 for PEV. With both FPCM and LW available for evaluated animals, accuracy was highest (0.62 for CV and 0.61 for PEV in pedigree, and 0.63 for CV and 0.61 for PEV in genomic analyses). Recording predictor traits for only the reference population did not increase DMI breeding value accuracy. Recording predictor traits for both reference and evaluated animals significantly increased DMI breeding value accuracy and removed the bias observed when only reference animals had records. The benefit of using genomic instead of pedigree relationships was reduced when more predictor traits were used. Using predictor traits may be an inexpensive way to significantly increase the accuracy and remove the bias of (genomic) breeding values of scarcely recorded traits such as feed intake.     

Lineage effects and the index of dispersion of molecular evolution

Recent efforts to estimate the index of dispersion [R(t)] of molecular evolution-i.e., the ratio of the variance in the number of substitutions on a lineage to the mean number-have suffered from an inability to adjust the data for lineage effects. These effects may include the generation-time dependency of the rate of evolution or improper assumptions about the branching pattern of a phylogenetic tree. In the present paper a method for correcting for lineage effects in the estimation of R(t) is presented for trees made up of three species. The recent data published by Li et al. for 20 loci in three orders of mammals is examined, and the average R(t), corrected for lineage effects, is shown to be 7.75 for replacement substitutions and 3.3 for silent substitutions. Thus the high values reported earlier may not be dismissed as due to generation-time effects or improper assumptions about phylogenies. Computer simulations are presented to give confidence in the estimate for replacement substitutions but also to demonstrate that the estimate for silent substitutions is sensitive to corrections for multiple substitutions and is not as reliable. This work's implications for our understanding of the mechanism of molecular evolution are discussed, and the arguments in favor of the hypothesis that replacement substitutions are mostly selected while silent substitutions are mostly neutral is presented.     

Determination of gasoline range,diesel range,and mineral oil range organics in soils and water by flame lonization gas chromatography

This article describes a method for the determination of gasoline range, diesel range, and mineral oil range organics in soils and water. It represents the culmination of a series of efforts to go beyond typical GRO and DRO methodology currently available in the literature to include a quantitative determination of mineral oil organics having a boiling range up to C₄₄. It also is the result of an attempt to develop a cost‐effective method that enables the analyst to quantify three different types of hydrocarbon components in one GC run under conditions without a concentration step. Method performance is comparable to that of current protocols for GRO and DRO determinations and validated further by comparisons to certified standards and in‐house standards. Accuracy as percentage recovery for GRO in water is 82 to 84 and 91 to 92% for soils. Accuracy as percentage recovery for MRO in water is 84 to 102 and 75 to 80% for soils. Accuracy as percentage recovery for DRO in water is 78 to 100 and 71 to 90% for soils. Results from the analysis of in‐house standards and certified standards for DRO and MRO gave higher recoveries than was demonstrated in the MDL studies. The MDL for DRO in water is 31 mg/l and 14 mg/kg for soils. The MDL for GRO in water is 8 mg/l and 4 mg/kg for soils. For MRO in water, the MDL is 7 mg/l and for soils 10 mg/kg. Future proposed improvements to this method will involve updated software that will allow automatic blank subtraction, automatic calculation of surrogate recoveries and the automatic incorporation of dry weight factors in the final calculations for soils. In addition, a GRO method with a run time of only 24 min will be used routinely when only GRO analyses have to be performed.     

Duration of Last Attack in 998 Fatal Cases of Coronary Artery Disease and its Relation to Possible Cardiac Resuscitation

All the deaths attributed to coronary artery disease and occurring in Belfast during one year were studied.The frequency distributions of the cases by interval of time between onset of the last attack and death are given for those not admitted to hospital, for those admitted to hospital, and for those already in hospital for some other cause of illness.Sixty per cent. of all the deaths occurred outside hospital. This indicates that the problem of cardiac resuscitation in coronary artery disease is to a considerable extent an extra-hospital one.Twenty-seven per cent. of the men and 22% of the women died within 15 minutes, but the median period of survival was 3 hours 30 minutes for men and 6 hours 18 minutes for women.The median time interval from the onset of the attack to sending for medical aid was 1 hour 17 minutes for men and 1 hour 6 minutes for women, and from summoning medical aid to sending for the ambulance 59 minutes for men and 1 hour 26 minutes for women. Ninety-six per cent. of the ambulance journeys to the patient were accomplished in less than 20 minutes.It was found among men, but not among women, that the duration of survival tended to be longer in older patients and in second or subsequent attacks.Of the 596 who did not gain admission to hospital 229 (23% of all the 998 patients) were known to have survived for more than half an hour after the onset of the fatal attack; 182 (18%) survived for more than one hour; and 143 (14%) survived for more than two hours. It is among these that there would appear to be special scope for the cardiac ambulance, providing that medical aid is sought and the ambulance is summoned without delay.     

Different affinities of glycosaminoglycan oligosaccharides for monomeric and dimeric interleukin-8: a model for chemokine regulation at inflammatory sites

The binding of interleukin-8 (IL-8) to heparan sulfate (HS) proteoglycans on the surface of endothelial cells is crucial for the recruitment of neutrophils to an inflammatory site. Fluorescence anisotropy measurements yielded an IL-8 dimerization constant of 120 nM. The binding affinities, obtained by isothermal fluorescence titration, of size-defined heparin and HS oligosaccharides to the chemokine were found to depend on the oligomerization state of IL-8: high affinity was detected for monomeric and low affinity was detected for dimeric IL-8, referring to a self-regulatory mechanism for its chemoattractant effect. The highest affinity for monomeric IL-8 was detected for the HS octamer with a K(d) < 5 nM whereas the dissociation constants of dimeric IL-8 were found in the medium micromolar range. No indication for increasing affinities for monomeric IL-8 with increasing oligosaccharide chain length was found. Instead, a periodic pattern was obtained for the dissociation constants of the GAG oligosaccharides with respect to chain length, referring to optimum and least optimum chain lengths for IL-8 binding. GAG disaccharides were identified to be the minimum length for chemokine binding. Conformational changes of the dimeric chemokine, determined using CD spectroscopy, were detected only for the IL-8/HS complexes and not for heparin, pointing to an HS-induced activation of the chemokine with respect to receptor binding. Thermal unfolding of IL-8 yielded a single transition at 56 degrees C which was completely prevented by the presence of undigested HS or heparin, indicating structural stabilization, thereby prolonging the biological effect of the chemokine.     

Kinetics and equilibria for the reactions of coenzymes with wild type and the Y70F mutant of Escherichia coli aspartate aminotransferase.

The Y70F mutant of aspartate aminotransferase has reduced affinity for coenzymes compared to the wild type. The equilibrium dissociation constants for pyridoxamine phosphate (PMP) holoenzymes, KPMPdiss, were determined from the association and dissociation rate constants to be 1.3 nM and 30 nM for the wild type and mutant, respectively. This increase in KPMPdiss for Y70F is due to a 27-fold increase in the dissociation rate constant. Pyridoxal phosphate (PLP) association kinetics are complex, with three kinetic processes detectable for wild type and two for Y70F. A directly determined, accurate value of KPLPdiss for wild type enzyme has been difficult to obtain because of the low value of this constant. The values of KPLPdiss for the holoenzymes were determined indirectly through the measured values for KPMPdiss, glutamate-alpha-ketoglutarate half-reaction equilibrium constants, and the equilibrium constant for the transamination of PLP by glutamate catalyzed by Y70F. The values of KPLPdiss obtained by this procedure are 0.4 pM for wild type and 40 pM for Y70F. The increases in KPMPdiss and KPLPdiss for Y70F correspond to delta delta G values of 1.9 and 2.7 kcal/mol, respectively, and are directly attributed to the loss of the hydrogen bond from the phenolic hydroxyl group of Tyr70 to the coenzyme phosphate. The delta G for association of PLP with wild type enzyme is 4.7 kcal/mol more favorable than that for PMP.     

First cleavage of enucleated rat eggs following transplantation of karyoplast removed from pronuclear eggs stored at 2 to 6 degrees C for various durations

Pronuclear rat eggs were cultured for 24 to 48 hours at 37 degrees C after storage at 2 to 6 degrees C for 0 to 216 hours in medium. Very high proportions (89 to 97%) of eggs cleaved to the two-cell stage after storage for 0 to 48 hours. The proportion, however, decreased rapidly in eggs stored for 72 hours (60%), and eggs stored for more than 120 hours cleaved poorly. However, when male and female pronuclei from stored eggs were transplanted into enucleated fresh eggs, 92 to 100% of the fused eggs with karyoplast stored for 0 to 144 hours cleaved. Although the cleavage rate was reduced to 50% when karyoplast from eggs stored for 168 hours was transplanted, this reduction was not significant. Complete loss of cleaving ability was observed in fused eggs with the karyoplast stored for 216 hours. These results clearly indicate that the pronuclei of rat eggs can be stored for a longer period than the cytoplasm at low temperatures (2 to 6 degrees C).     

Selection of nematodes for zero cyst phenotypes with soybean

Definitive genetic studies of the soybean cyst nematode (Heterodera glycines)-soybean (Glycine max) relationship are complicated by the use of soybean lines with many genes for resistance to heterogeneous, amphimictic nematode populations. Inbreeding and artificial selection of cyst nematodes decreased their ability to form cysts on specific soybean lines assumed to have few genes for resistance. In the initial sib selection, single cysts were used to inoculate two-seedling units consisting of a seedling of one soybean line to evaluate the nematodes' ability to form cysts on it and a seedling of another line for comparison and maintenance of the nematode inbreds being developed. This method permitted some selection but was slow and labour-intensive. A better method of artificial selection for fewer cysts on specific soybean lines was to inbreed nematodes for about four generations, then to evaluate the inbreds for ability to form cysts on the soybean lines before selecting particular inbreds with poor ability to form cysts for the development of more inbreds. This increased the frequencies of specific nematode genes for avirulence or alleles for incompatibility with soybean lines containing the interacting [gene-for-gene] alleles for incompatibility (genes for resistance). The artificial selection apparently was for at least two nematode alleles for incompatibility since at least two soybean alleles were indicated in the segregation from crosses of soybean lines.     

Evaluation of Drugs for Treating Obesity

Criteria for the evaluation of new drugs to treat obesity are important as guides for designing clinical trials to test these agents. These criteria must be developed in relation to the realities of obesity, which is a chronic disease associated with morbidity and mortality that is increased by visceral fat deposits. The observation that patients regain weight after stopping drug treatment for obesity argues for the proposition that drugs work only when taken and NOT that the drugs are ineffective. The analogy between the development of treatments for obesity to those for the treatment of hypertension is used to highlight potential areas for new developments. Several features of an ideal drug for the treatment of obesity are suggested. Criteria for evaluating new drugs include both primary and secondary endpoints. The primary endpoint for an anti-obesity drug should be weight loss, possibly by category of success. Losses of total body fat or visceral fat might be alternative primary endpoints. Secondary endpoints include reduction in risk factors for associated diseases and improvement in the quality of life. In trials where vigorous placebo designs including highly aggressive behavior modification or very-low-calorie diets were used, it may be difficult or impossible to detect a response to a drug.     

Exclusion of deceased donors post-procurement of tissues

The EU Tissues and Cells Directive (2004/23/EC, 2006/17/EC, 2006/86/EC) (EUTCD) provides standards for quality and safety for all aspects of banking of tissues and cells for clinical applications. Commission Directive 2006/17/EC stipulates that the complete donor record with all the medical information is assessed for suitability before releasing tissues for clinical use. The aim of this study was to investigate the medical reasons for post-procurement donor exclusion, to identify the various potential sources for gathering information about donors’ medical and behavioural history and to evaluate their contribution to maximising the safety of donations. Information was collected from the Tissue Services (TS) records of 1000 consecutive deceased donors submitted to National Health Service Blood and Transplant (NHSBT) medical officers for authorisation for release for subsequent tissue processing and then for transplantation. Of the 1000 donors 60 (6%) were excluded because they did not fulfil the donor selection requirements of the EUTCD and NHSBT donor selection guidelines. The main reasons for medical exclusion were the presence of significant local or systemic infection in 32 donors (53% of those excluded for medical reasons) and a history of past or occult malignancy in 9 donors (15% of those excluded for medical reasons) which was not identified prior to procurement. The information leading to post-procurement exclusion was obtained from autopsy reports in 35 of the 60 excluded donors for medical reasons (58%) and from the general practitioner for 10 donors (17% of those excluded for medical reasons). In summary, careful evaluation of complete donor records reduces the potential risk of disease transmission by tissue allografts and ensures compliance with regulations and guidelines. The findings may lead to changes in donor selection policies with the aim of improving efficiency without compromising safety.     

New antiepileptic drugs: a systematic review of their efficacy and tolerability.

OBJECTIVES: To evaluate the efficacy and tolerability of the newly developed antiepileptic drugs gabapentin, lamotrigine, tiagabine, topiramate, vigabatrin, and zonisamide in patients with refractory partial epilepsy. DESIGN: Systematic review of published and unpublished randomised controlled trials of add-on treatment with new antiepileptic drugs. SUBJECTS: 20 published and eight unpublished trials representing 3883 patients with refractory partial epilepsy. MAIN OUTCOME MEASURES: Proportion of patients who (a) showed 50% or greater reduction in frequency of seizures (50% responders) and (b) withdrew from each study for any reason. RESULTS: Odds ratios (95% confidence intervals) relative to placebo for 50% responders were 2.29 (1.53 to 3.43) for gabapentin, 2.32 (1.47 to 3.68) for lamotrigine, 3.03 (2.01 to 4.58) for tiagabine, 4.22 (2.80 to 6.35) for topiramate, 3.68 (2.45 to 5.51) for vigabatrin, and 2.47 (1.36 to 4.47) for zonisamide. Odds ratios for withdrawal were 1.36 (0.75 to 2.49) for gabapentin, 1.19 (0.79 to 1.79) for lamotrigine, 1.81 (1.21 to 2.70) for tiagabine, 2.42 (1.43 to 4.11) for topiramate, 2.58 (1.26 to 5.27) for vigabatrin, and 5.70 (1.76 to 18.49) for zonisamide. Comparing results for each drug showed that all of the 95% confidence intervals overlapped, indicating that they were not significantly different in terms of efficacy and tolerability. CONCLUSIONS: All six drugs were significantly better than placebo at reducing frequency of seizures. These results do not allow an evidence based choice between these drugs as we have no conclusive indication of differences in efficacy or tolerability.