A Canadian Critical Care Trials Group project in collaboration with the international forum for acute care trialists - Collaborative H1N1 Adjuvant Treatment pilot trial (CHAT): study protocol and design of a randomized controlled trial

Background

The Vaccine Assessment using Linked Data (VALiD) trial compared opt-in and opt-out parental consent for a population-based childhood vaccine safety surveillance program using data linkage. A subsequent telephone interview of all households enrolled in the trial elicited parental intent regarding the return or non-return of reply forms for opt-in and opt-out consent. This paper describes the rationale for the trial and provides an overview of the design and methods.

Methods/Design

Single-centre, single-blind, randomised controlled trial (RCT) stratified by firstborn status. Mothers who gave birth at one tertiary South Australian hospital were randomised at six weeks post-partum to receive an opt-in or opt-out reply form, along with information explaining data linkage. The primary outcome at 10 weeks post-partum was parental participation in each arm, as indicated by the respective return or non-return of a reply form (or via telephone or email response). A subsequent telephone interview at 10 weeks post-partum elicited parental intent regarding the return or non-return of the reply form, and attitudes and knowledge about data linkage, vaccine safety, consent preferences and vaccination practices. Enrolment began in July 2009 and 1,129 households were recruited in a three-month period. Analysis has not yet been undertaken. The participation rate and selection bias for each method of consent will be compared when the data are analysed.

Discussion

The VALiD RCT represents the first trial of opt-in versus opt-out consent for a data linkage study that assesses consent preferences and intent compared with actual opting in or opting out behaviour, and socioeconomic factors. The limitations to generalisability are discussed.

Trial registration

Australian New Zealand Clinical Trials Registry ACTRN12610000332022     

Significance of the initial state of the murine liver for the development of consequences after the combined action of the factors of different nature

The search of the most significant parameters of the liver initial state of mice Balb/c (males) for the development of the biological consequences under a combined action of the Tween-80 (0.3% solution) in the 10% solution of the aqueous acetone and X-rays at the doses of 4 and 5 Gy during one month after exposure was performed by means of the software program for the experimental data analysis. The study has shown both the absence of the same correlation relationships and the existence of two groups of relationships in terms of the coefficient correlation values under the alteration of the X-ray dose. The assumption has been made about different mechanisms underlying regulation of the biochemical process in the murine liver after the combined action of low-toxicity chemical agents at low doses and X-rays irradiation at sublethal doses, whose contribution to the development of effects of different factors depends on the radiation dose.     

Reaction of rat pulmonary macrophages to stimulation by zymosan

Female Wistar rats weighing 200-250 g received 0.1 mg/g of zymosan particles intravenously. 2 days later the foci consisting of accumulated mononuclears developed in the lungs. On day 5 after zymosan injection they assumed granulocyte-like appearance. This coincided with more than three-fold increase of interstitial lung macrophages over-loaded with colloidal carbon particles. The delivery of cells into alveolar space also increased two-fold on the 2nd and three-fold on the 5th day after stimulation due to an influx of monocyte-macrophage elements. The clearance rate of inert colloidal particles through mononuclear phagocyte system increased more than two-fold on the 2nd and three-fold on the 5th day following stimulation. The initial figures were restored by day 14. Thus, activated macrophages play an essential role in mononuclear infiltration of the lung. The specificity of infiltrate development may be evaluated by the cellular content of bronchoalveolar washouts.     

Effect of alcohol on the content of sex steroid receptors in the hypothalamus and hypophysis of male rats

In experimental dipsomania model (formation of physical dependence by method of intensive alcoholization) we have studied receptor binding of testosterone (T) and estradiol (E2) in the hypothalamus and pituitary body of mature male rats. Administration (at 10 and 16 h) of 25% ethanol-saline solution at a dose of 7.5 g/kg of body weight in the course of 5 days significantly decreased serum T level but did not change serum LH and FSH levels. Essential reduction of the nuclear androgen receptors in the preoptic-anterior hypothalamic area (POA), mediobasal hypothalamus (MBH) and adenohypophysis was noted in alcohol-treated rats. Unlike androgen receptors the number of the nuclear E2-binding sites in PaO was significantly increased in these males. Thus the results of the present paper demonstrate that multiple administration of ethanol stipulates deficit of serum T, androgen receptors in MBH and pituitary body that possibly results in separation of negative feedback mechanism between the gonads and pituitary body. Increase of specific binding of E2 to nuclear receptors in PoA might appear to explain feminization of alcohol-treated rats.     

Effect of hydrophobicity of yeast cell envelopes on the rate of methyl oleate autooxidation

The relationships between the antioxidant and antiperoxide properties and the lipid composition of yeast cell envelopes before and after interaction with a liquid culture medium was studied. Correlations between the hydrophobicity of cell envelopes, their lipid composition, and parameters of kinetic oxidation curves of model methyl oleate in the presence of lipids were found. Irrespective of the total lipid content in yeast cell envelopes, the preparations with a high antiperoxide activity of lipids exhibited a higher hydrophobicity and adsorbed lipophilic prooxidants from the medium more readily, whereas the preparations with a low antiperoxide activity were less hydrophobic and adsorbed predominantly lipophilic inhibitors. It was found that analysis of kinetic oxidation curves in toto provides the most comprehensive information on the physicochemical properties of lipids adsorbed from medium.     

Dependence of response reaction of root voles to low-intensity irradiation on initial state of the tissue antioxidant system

There has been studied the response of antioxidant (AO) reaction of the tissue system of the root voles Microtus oeconomus Pall., whose parents belonged to the populations long inhabiting the Republic Komi regions with different degrees of radioactive contamination, on an additional irradiation at low doses. Differences have been revealed in the phospholipid content, activity of AO defense, intensity of processes of lipid peroxidation (LPO) in tissues of the offspring of voles caught in the control and contaminated regions. It has been revealed that direction and degree of changes in the offspring tissues after the additional action are determined by the parameter value in the non-irradiated animal group. Intensity of the LPO processes in liver and brain was leveled after the long low-intensity irradiation. The obtained data and analysis of literature indicate that at predicting effects of chronic action of low doses of a damaging factor both in experiment and in the natural habitation, it is necessary to take into account initial characteristics of biological objects.     

Effects of short-term exposure to lithium on antiapoptotic Bcl-xL protein expression in cortex and hippocampus of rats after acute stress

The antiapoptotic protein Bcl-xL is involved in development of neurobiological resilience to stress; hence, the possibility of use of psychotropic drugs to increase its expression in brain in response to stress is of considerable interest. Lithium is a neurotropic drug widely used in psychiatry. In work, we studied effects of lithium administration (for 2 or 7 days) on the expression of Bcl-xL mRNA and protein in the hippocampi and cortices of rats subjected to stress that induced depression-like behavior in the animals. In contrast to the brain-derived neurotrophic factor (BDNF), whose expression decreased in the hippocampus in response to acute stress, stress increased the level of Bcl-xL mRNA in the hippocampus, but decreased it in the frontal cortex. Treatment of stressed animals with lithium for 2 or 7 days increased Bcl-xL protein levels 1.5-fold in the hippocampus, but it decreased them in the cortex. Therefore, Bcl-xL expression in the brain can be modulated by both stress and psychotropic drugs, and the effects of these factors are brain region-specific: both stress exposure and lithium administration activated Bcl-xL expression in the hippocampus and suppressed it in the frontal cortex. The activation of Bcl-xL expression in the hippocampus by lithium, demonstrated for the first time in this study, suggests an important role of this protein in the therapeutic effects of lithium in the treatment of stress-induced psychoemotional disorders.     

Reduced aggregation and improved specificity of G-rich oligodeoxyribonucleotides containing pyrazolo[3,4-d]pyrimidine guanine bases

Guanine (G)-rich oligodeoxyribonucleotides (ODNs) can form undesired complexes by self association through non-Watson–Crick interactions. These aggregates can compromise performance of DNA probes and make genetic analysis unpredictable. We found that the 8-aza-7-deazaguanine (PPG), a pyrazolo[3,4-d]pyrimidine analog, reduces guanine self association of G-rich ODNs. In the PPG heterocycle, the N-7 and C-8 atoms of G are interposed. This leaves the ring system with an electron density similar to G, but prevents Hoogsteen-bonding associated with N-7. ODNs containing multiple PPG bases were easily prepared using a dimethylformamidine-protected phosphoramidite reagent. Substitution of PPG for G in ODNs allowed formation of more stable DNA duplexes. When one or more PPGs were substituted for G in ODNs containing four or more consecutive Gs, G aggregation was eliminated. Substitution of PPG for G also improved discrimination of G/A, G/G and G/T mismatches in Watson–Crick hybrids. Use of PPG in fluorogenic minor groove binder probes was also explored. PPG prevented aggregation in MGB probes (MGB^TM is a trademark of Epoch Biosciences) and allowed use of G-rich sequences. An increased signal was observed in 5′-PPG probes due to reduced quenching of fluorescein by PPG. In summary, substitution of PPG for G enhances affinity, specificity, sensitivity and predictability of G-rich DNA probes.     

Influence of the antioxidant status on the characteristics of lipids in tissues of animals after acute irradiation with sublethal doses

The effect of the acute exposure to sublethal doses of X-rays on the interrelation between parameters of the lipid peroxidation regulatory system (lipid antioxidative activity, AOA; peroxide amount, lipid composition) was studied in liver, spleen and blood erythrocytes of CBA and SHK mice and rats within 1 month after irradiation. The reverse correlation between the lipid AOA values and the initial peroxide amount in lipids of the CBA mice spleen was found. The coefficient of the linear regression of this correlation for the exposed mice was 1.8-fold higher as compared with control. The correlative dependence between the ratio of the sums of the more readily to more poorly oxidizable phospholipid and the ratio of phosphatidyl choline to phosphatidyl ethanolamine content in phospholipids of liver and blood erythrocytes was revealed. The direction (the phospholipids of the rat liver) or the value of the linear regression coefficient of that correlation were different for groups of the exposed and control animals, especially in the blood erythrocytes. Thus, the different sensitivity of examined characteristics of lipids and the possibility of their normalization in the dependence on the lipid AOA value cause the conversion of the lipid peroxidation regulatory system in organs and blood erythrocytes of the exposed animals to the other scale of the functioning.     

Comparative analysis of the antioxidant system of mouse liver and blood during exposure to toxins, extracted from drinking water

A comparative analysis of the antioxidant system of mouse liver and blood was done during one month after a single per os administration of oil solutions of hexane--ether extracts from the drinking water sources with different proportions of benz(o)pyrene and polychlorbiphenyls. The absence of a linear dependence dose-effect on the extract concentration and a change in the scale and direction of interrelations between the parameters examined (the antioxidant activity of lipids, the content of peroxides, and the content of products interacting with 2-thiobarbituric acid) were revealed, indicating a high sensitivity and the absence of normalization of the antioxidant status in animal tissues.