Likely country of origin in publications on randomised controlled trials and controlled clinical trials during the last 60 years

Background

The n-of-1 trial offers a more methodologically sound approach to determining optimum treatment for an individual patient than "trials of therapy" routinely conducted in clinical practice. However, such methodology is rarely used in the UK. This pilot study explores the acceptability of n-of-1 trials to patients in the UK.

Methods

Patients with osteoarthritis of the knee were recruited to their own 12-week n-of-1 trial comparing either two knee supports or an NSAID with simple analgesic. Patients were interviewed at the start and completion of their trial to explore reasons for participation, understanding of the trial design and experiences of participation. Daily diaries were completed to inform future treatment.

Results

Nine patients participated (5 supports, 4 drugs). Patients were keen to participate, believing that the trial may lead to personal gains such as improved symptom control and quality of life. However, recruitment to the pharmacological comparison was more difficult since this could also entail risk. All patients were eager to complete the trial, even when difficulties were encountered. Completing the daily diary provided some patients with greater insight into their condition, which allowed them to improve their self-management. The n-of-1 trial design was viewed as a 'logical' design offering an efficient method of reaching a personalised treatment decision tailored to suit individual needs and preferences.

Conclusion

This pilot study suggests that patients perceive the n-of-1 trial as an acceptable approach to the individualisation of treatment. In addition, further benefits over and above any gained from the interventions can be derived from involvement in such a study.     

Isolation and Identification of α,α-Trehalose and Glycerol from an Arctic Psychrotolerant Streptomyces sp. SB9 and their Possible Role in the Strain's Survival

Abstract

Streptomyces sp. strain SB9 was isolated from perm frost soil samples in Spitsbergen, Arctic Ocean; it grows in a temperature range between 4°C and 28°C. During the survey of biologically active metabolites biosynthesized by this strain, significant amounts of α,α-trehalose (1) and glycerol (2) were detected. The compounds were isolated from the mycelium, were chromatographically separated, and the structures were elucidated on the basis of MS and NMR measurements. A possible role of trehalose in cold adaptation of the strain was examined. It was determined that the mycelium of the strain cultivated at 4°C accumulated 5-fold higher amounts of trehalose in comparison with the cells cultivated at 28°C. The mesofilic reference strains, Streptomyces spectabilis NRRL 2494 and Streptomyces lividans TK64, accumulated 100-fold less trahalose than the psychrotolerant Streptomyces sp. SB9. High amounts of trehalose in the cells could be a reason for adaptation of the strain to life at Arctic conditions.     

Production of gluconic acid by Aspergillus niger immobilized on polyurethane foam

Production of gluconic acid by cells of Aspergillus niger immobilized on polyurethane foam was studied in repeated-batch shake-flask and bubble-column fermentations. For passive immobilization, various amounts of polyurethane foam and spore suspension were tested in order to obtain a suitable combination for optimal concentration of immobilized biomass. Immobilized cells were sucessfully reused with higher levels of product formation being maintained for longer period (65–70h) than free cells. The highest gluconic acid concentration of about 143 g l^–1 was reached on hydrol-based production medium with 0.3-cm³ foam cubes in the bubble column, where the effect of more suitable aeration and particle volume: medium volume ratio scheme was also investigated.