A practical approach to a multi-level analysis with a sparse binary outcome within a large surgical trial

Objectives: To assess the potential source of variation that surgeon may add to patient outcome in a clinical trial of surgical procedures. Methods: Two large (n = 1380) parallel multicentre randomized surgical trials were undertaken to compare laparoscopically assisted hysterectomy with conventional methods of abdominal and vaginal hysterectomy; involving 43 surgeons. The primary end point of the trial was the occurrence of at least one major complication. Patients were nested within surgeons giving the data set a hierarchical structure. A total of 10% of patients had at least one major complication, that is, a sparse binary outcome variable. A linear mixed logistic regression model (with logit link function) was used to model the probability of a major complication, with surgeon fitted as a random effect. Models were fitted using the method of maximum likelihood in SAS((R)). Results: There were many convergence problems. These were resolved using a variety of approaches including; treating all effects as fixed for the initial model building; modelling the variance of a parameter on a logarithmic scale and centring of continuous covariates. The initial model building process indicated no significant 'type of operation' across surgeon interaction effect in either trial, the 'type of operation' term was highly significant in the abdominal trial, and the 'surgeon' term was not significant in either trial. Conclusions: The analysis did not find a surgeon effect but it is difficult to conclude that there was not a difference between surgeons. The statistical test may have lacked sufficient power, the variance estimates were small with large standard errors, indicating that the precision of the variance estimates may be questionable.

A multi level analysis on pollination-related policies

The paper explores pollination from a multi level policy perspective and analyses the institutional fit and inter play of multi-faceted pollination-related policies. First, it asks what the major policies are that frame pollination at the EU level. Second, it explores the relationship between the EU policies and localised ways of understanding pollination. Addressed third is how the concept of ecosystem services can aid in under- standing the various ways of framing and governing the situation. The results show that the policy systems affecting pollination are abundant and that these systems create different kinds of pressure on stakeholders, at several levels of society. The local-level concerns are more about the loss of pollination services than about loss of pollinators. This points to the problem of fit between local activity driven by economic reasoning and biodiversity-driven EU policies. Here we see the concept of ecosystem services having some potential, since its operationalisation can combine economic and environmental considerations. Further- more, the analysis shows how, instead of formal institutions, it seems that social norms, habits, and motivation are the key to understanding and developing effective and attractive governance measures.

A multi-level analytical approach for detection and visualization of intracellular NO production and nitrosation events using diaminofluoresceins

Diaminofluoresceins are widely used probes for detection and intracellular localization of NO formation in cultured/isolated cells and intact tissues. The fluorinated derivative, 4-amino-5-methylamino-2′,7′-difluorofluorescein (DAF-FM), has gained increasing popularity in recent years due to its improved NO-sensitivity, pH-stability, and resistance to photo-bleaching compared to the first-generation compound, DAF-2. Detection of NO production by either reagent relies on conversion of the parent compound into a fluorescent triazole, DAF-FM-T and DAF-2-T, respectively. While this reaction is specific for NO and/or reactive nitrosating species, it is also affected by the presence of oxidants/antioxidants. Moreover, the reaction with other molecules can lead to the formation of fluorescent products other than the expected triazole. Thus additional controls and structural confirmation of the reaction products are essential. Using human red blood cells as an exemplary cellular system we here describe robust protocols for the analysis of intracellular DAF-FM-T formation using an array of fluorescence-based methods (laser-scanning fluorescence microscopy, flow cytometry and fluorimetry) and analytical separation techniques (reversed-phase HPLC and LC-MS/MS). When used in combination, these assays afford unequivocal identification of the fluorescent signal as being derived from NO and are applicable to most other cellular systems without or with only minor modifications.

Multi-level Input Fusion in multi-modal systems

Context-aware multimodal interactive systems aim to adapt to the needs and behavioural patterns of users and offer a way forward for enhancing the efficacy and quality of experience (QoE) in human-computer interaction. The various modalities that constribute to such systems each provide a specific uni-modal response that is integratively presented as a multi-modal interface capable of interpretation of multi-modal user input and appropriately responding to it through dynamically adapted multi-modal interactive flow management , This paper presents an initial background study in the context of the first phase of a PhD research programme in the area of optimisation of data fusion techniques to serve multimodal interactivite systems, their applications and requirements.

A multi-level probabilistic neural network

Based on the idea of an important cluster, a new multi-level probabilistic neural network (MLPNN) is introduced. The MLPNN uses an incremental constructive approach, i.e. it grows level by level. The construction algorithm of the MLPNN is proposed such that the classification accuracy monotonically increases to ensure that the classification accuracy of the MLPNN is higher than or equal to that of the traditional PNN. Numerical examples are included to demonstrate the effectiveness of proposed new approach.

Disentangling multi-level systems: averaging, correlations and memory

We consider two weakly coupled systems and adopt a perturbative approach based on the Ruelle response theory to study their interaction. We propose a systematic way of parameterizing the effect of the coupling as a function of only the variables of a system of interest. Our focus is on describing the impacts of the coupling on the long term statistics rather than on the finite-time behavior. By direct calculation, we find that, at first order, the coupling can be surrogated by adding a deterministic perturbation to the autonomous dynamics of the system of interest. At second order, there are additionally two separate and very different contributions. One is a term taking into account the second-order contributions of the fluctuations in the coupling, which can be parameterized as a stochastic forcing with given spectral properties. The other one is a memory term, coupling the system of interest to its previous history, through the correlations of the second system. If these correlations are known, this effect can be implemented as a perturbation with memory on the single system. In order to treat this case, we present an extension to Ruelle's response theory able to deal with integral operators. We discuss our results in the context of other methods previously proposed for disentangling the dynamics of two coupled systems. We emphasize that our results do not rely on assuming a time scale separation, and, if such a separation exists, can be used equally well to study the statistics of the slow variables and that of the fast variables. By recursively applying the technique proposed here, we can treat the general case of multi-level systems.

Aligning business and IT from multi-level learning perspectives

Business and IT alignment is increasingly acknowledged as a key for organisational performance. However, alignment research lack to mechanisms that enable for on-going process with multi-level effects. Multi-level learning allows on-going effectiveness through development of the organisation and improved quality of business and IT strategies. In particular, exploration and exploitation enable effective process of alignment across dynamic multi-level of learning. Hence, this paper proposes a conceptual framework that links multi-level learning and business-IT strategy through the concept of exploration and exploitation, which considers short-term and long-term alignment together to address the challenges of strategic alignment faced in sustaining organisational performance.

Plant-symbiotic fungi as chemical engineers: multi-genome analysis of the Clavicipitaceae reveals dynamics of alkaloid Loci

The fungal family Clavicipitaceae includes plant symbionts and parasites that produce several psychoactive and bioprotective alkaloids. The family includes grass symbionts in the epichloae clade (Epichloë and Neotyphodium species), which are extraordinarily diverse both in their host interactions and in their alkaloid profiles. Epichloae produce alkaloids of four distinct classes, all of which deter insects, and some—including the infamous ergot alkaloids—have potent effects on mammals. The exceptional chemotypic diversity of the epichloae may relate to their broad range of host interactions, whereby some are pathogenic and contagious, others are mutualistic and vertically transmitted (seed-borne), and still others vary in pathogenic or mutualistic behavior. We profiled the alkaloids and sequenced the genomes of 10 epichloae, three ergot fungi (Claviceps species), a morning-glory symbiont (Periglandula ipomoeae), and a bamboo pathogen (Aciculosporium take), and compared the gene clusters for four classes of alkaloids. Results indicated a strong tendency for alkaloid loci to have conserved cores that specify the skeleton structures and peripheral genes that determine chemical variations that are known to affect their pharmacological specificities. Generally, gene locations in cluster peripheries positioned them near to transposon-derived, AT-rich repeat blocks, which were probably involved in gene losses, duplications, and neofunctionalizations. The alkaloid loci in the epichloae had unusual structures riddled with large, complex, and dynamic repeat blocks. This feature was not reflective of overall differences in repeat contents in the genomes, nor was it characteristic of most other specialized metabolism loci. The organization and dynamics of alkaloid loci and abundant repeat blocks in the epichloae suggested that these fungi are under selection for alkaloid diversification. We suggest that such selection is related to the variable life histories of the epichloae, their protective roles as symbionts, and their associations with the highly speciose and ecologically diverse cool-season grasses.

Multi-level planning for semi-autonomous vehicles in traffic scenarios based on separation maximization

The planning of semi-autonomous vehicles in traffic scenarios is a relatively new problem that contributes towards the goal of making road travel by vehicles free of human drivers. An algorithm needs to ensure optimal real time planning of multiple vehicles (moving in either direction along a road), in the presence of a complex obstacle network. Unlike other approaches, here we assume that speed lanes are not present and that different lanes do not need to be maintained for inbound and outbound traffic. Our basic hypothesis is to carry forward the planning task to ensure that a sufficient distance is maintained by each vehicle from all other vehicles, obstacles and road boundaries. We present here a 4-layer planning algorithm that consists of road selection (for selecting the individual roads of traversal to reach the goal), pathway selection (a strategy to avoid and/or overtake obstacles, road diversions and other blockages), pathway distribution (to select the position of a vehicle at every instance of time in a pathway), and trajectory generation (for generating a curve, smooth enough, to allow for the maximum possible speed). Cooperation between vehicles is handled separately at the different levels, the aim being to maximize the separation between vehicles. Simulated results exhibit behaviours of smooth, efficient and safe driving of vehicles in multiple scenarios; along with typical vehicle behaviours including following and overtaking.

Mid-Holocene monsoons: a multi-model analysis of the inter-hemispheric differences in the responses to orbital forcing and ocean feedbacks

The response of monsoon circulation in the northern and southern hemisphere to 6 ka orbital forcing has been examined in 17 atmospheric general circulation models and 11 coupled ocean–atmosphere general circulation models. The atmospheric response to increased summer insolation at 6 ka in the northern subtropics strengthens the northern-hemisphere summer monsoons and leads to increased monsoonal precipitation in western North America, northern Africa and China; ocean feedbacks amplify this response and lead to further increase in monsoon precipitation in these three regions. The atmospheric response to reduced summer insolation at 6 ka in the southern subtropics weakens the southern-hemisphere summer monsoons and leads to decreased monsoonal precipitation in northern South America, southern Africa and northern Australia; ocean feedbacks weaken this response so that the decrease in rainfall is smaller than might otherwise be expected. The role of the ocean in monsoonal circulation in other regions is more complex. There is no discernable impact of orbital forcing in the monsoon region of North America in the atmosphere-only simulations but a strong increase in precipitation in the ocean–atmosphere simulations. In contrast, there is a strong atmospheric response to orbital forcing over northern India but ocean feedback reduces the strength of the change in the monsoon although it still remains stronger than today. Although there are differences in magnitude and exact location of regional precipitation changes from model to model, the same basic mechanisms are involved in the oceanic modulation of the response to orbital forcing and this gives rise to a robust ensemble response for each of the monsoon systems. Comparison of simulated and reconstructed changes in regional climate suggest that the coupled ocean–atmosphere simulations produce more realistic changes in the northern-hemisphere monsoons than atmosphere-only simulations, though they underestimate the observed changes in precipitation in all regions. Evaluation of the southern-hemisphere monsoons is limited by lack of quantitative reconstructions, but suggest that model skill in simulating these monsoons is limited.

A multi-model analysis of the role of the ocean on the African and Indian monsoon during mid-Holocene

We investigate the role of the ocean feedback on the climate in response to insolation forcing during the mid-Holocene (6,000 year BP) using results from seven coupled ocean–atmosphere general circulation models. We examine how the dipole in late summer sea-surface temperature (SST) anomalies in the tropical Atlantic increases the length of the African monsoon, how this dipole structure is created and maintained, and how the late summer SST warming in the northwest Indian Ocean affects the monsoon retreat in this sector. Similar mechanisms are found in all of the models, including a strong wind evaporation feedback and changes in the mixed layer depth that enhance the insolation forcing, as well as increased Ekman transport in the Atlantic that sharpens the Atlantic dipole pattern. We also consider changes in interannual variability over West Africa and the Indian Ocean. The teleconnection between variations in SST and Sahelian precipitation favor a larger impact of the Atlantic dipole mode in this region. In the Indian Ocean, the strengthening of the Indian dipole structure in autumn has a damping effect on the Indian dipole mode at the interannual time scale

Landscape change in central Latvia since the Iron Age: multi-proxy analysis of the vegetation impact of conflict, colonization and economic expansion during the last 2000 years

This study represents the first detailed multi-proxy palaeoenvironmental investigation associated with a Late Iron Age lake-dwelling site in the eastern Baltic. The main objective was to reconstruct the environmental and vegetation dynamics associated with the establishment of the lake-dwelling and land-use during the last 2,000 years. A lacustrine sediment core located adjacent to a Late Iron Age lake-dwelling, medieval castle and Post-medieval manor was sampled in Lake Āraiši. The core was dated using spheroidal fly-ash particles and radiocarbon dating, and analysed in terms of pollen, non-pollen palynomorphs, diatoms, loss-on-ignition, magnetic susceptibility and element geochemistry. Associations between pollen and other proxies were statistically tested. During ad 1–700, the vicinity of Lake Āraiši was covered by forests and human activities were only small-scale with the first appearance of cereal pollen (Triticum and Secale cereale) after ad 400. The most significant changes in vegetation and environment occurred with the establishment of the lake-dwelling around ad 780 when the immediate surroundings of the lake were cleared for agriculture, and within the lake there were increased nutrient levels. The highest accumulation rates of coprophilous fungi coincide with the occupation of the lake-dwelling from ad 780–1050, indicating that parts of the dwelling functioned as byres for livestock. The conquest of tribal lands during the crusades resulted in changes to the ownership, administration and organisation of the land, but our results indicate that the form and type of agriculture and land-use continued much as it had during the preceding Late Iron Age.

The late Roman field army in Northern Britain? Mobility, material culture and multi-isotope analysis at Scorton (N. Yorks)

At Hollow Banks Quarry, Scorton, located just north of Catterick (N Yorks.), a highly unusual group of 15 late Roman burials was excavated between 1998 and 2000. The small cemetery consists of almost exclusively male burials, dated to the fourth century. An unusually large proportion of these individuals was buried with crossbow brooches and belt fittings, suggesting that they may have been serving in the late Roman army or administration and may have come to Scorton from the Continent. Multi-isotope analyses (carbon, nitrogen, oxygen and strontium) of nine sufficiently well-preserved individuals indicate that seven males, all equipped with crossbow brooches and/or belt fittings, were not local to the Catterick area and that at least six of them probably came from the European mainland. Dietary (carbon and nitrogen isotope) analysis only of a tenth individual also suggests a non-local origin. At Scorton it appears that the presence of crossbow brooches and belts in the grave was more important for suggesting non-British origins than whether or not they were worn. This paper argues that cultural and social factors played a crucial part in the creation of funerary identities and highlights the need for both multi-proxy analyses and the careful contextual study of artefacts.

Multi-criteria analysis and the resolution of sustainable development dilemmas: a stakeholder management approach

We demonstrate that stakeholder-oriented multi-criteria analysis (MCA) can adequately address a variety of sustainable development dilemmas in decision-making, especially when applied to complex project evaluations involving multiple objectives and multiple stakeholder groups. Such evaluations are typically geared towards satisfying simultaneously private economic goals, broader social objectives and environmental targets. We show that, under specific conditions, a variety of stakeholder-oriented MCA approaches may be able to contribute substantively to the resolution or improved governance of societal conflicts and the pursuit of the public good in the form of sustainable development. We contrast the potential usefulness of these stakeholder-oriented approaches – in terms of their ability to contribute to sustainable development – with more conventional MCA approaches and social cost–benefit analysis.

A comparison of three different models for estimating relative risk in meta-analysis of clinical trials under unobserved heterogeneity

We focus on the comparison of three statistical models used to estimate the treatment effect in metaanalysis when individually pooled data are available. The models are two conventional models, namely a multi-level and a model based upon an approximate likelihood, and a newly developed model, the profile likelihood model which might be viewed as an extension of the Mantel-Haenszel approach. To exemplify these methods, we use results from a meta-analysis of 22 trials to prevent respiratory tract infections. We show that by using the multi-level approach, in the case of baseline heterogeneity, the number of clusters or components is considerably over-estimated. The approximate and profile likelihood method showed nearly the same pattern for the treatment effect distribution. To provide more evidence two simulation studies are accomplished. The profile likelihood can be considered as a clear alternative to the approximate likelihood model. In the case of strong baseline heterogeneity, the profile likelihood method shows superior behaviour when compared with the multi-level model. Copyright (C) 2006 John Wiley & Sons, Ltd.