Missing steps in a staircase: a qualitative study of the perspectives of key stakeholders on the use of adaptive designs in confirmatory trials

Background Despite the promising benefits of adaptive designs (ADs), their routine use, especially in confirmatory trials, is lagging behind the prominence given to them in the statistical literature. Much of the previous research to understand barriers and potential facilitators to the use of ADs has been driven from a pharmaceutical drug development perspective, with little focus on trials in the public sector. In this paper, we explore key stakeholders’ experiences, perceptions and views on barriers and facilitators to the use of ADs in publicly funded confirmatory trials. Methods Semi-structured, in-depth interviews of key stakeholders in clinical trials research (CTU directors, funding board and panel members, statisticians, regulators, chief investigators, data monitoring committee members and health economists) were conducted through telephone or face-to-face sessions, predominantly in the UK. We purposively selected participants sequentially to optimise maximum variation in views and experiences. We employed the framework approach to analyse the qualitative data. Results We interviewed 27 participants. We found some of the perceived barriers to be: lack of knowledge and experience coupled with paucity of case studies, lack of applied training, degree of reluctance to use ADs, lack of bridge funding and time to support design work, lack of statistical expertise, some anxiety about the impact of early trial stopping on researchers’ employment contracts, lack of understanding of acceptable scope of ADs and when ADs are appropriate, and statistical and practical complexities. Reluctance to use ADs seemed to be influenced by: therapeutic area, unfamiliarity, concerns about their robustness in decision-making and acceptability of findings to change practice, perceived complexities and proposed type of AD, among others. Conclusions There are still considerable multifaceted, individual and organisational obstacles to be addressed to improve uptake, and successful implementation of ADs when appropriate. Nevertheless, inferred positive change in attitudes and receptiveness towards the appropriate use of ADs by public funders are supportive and are a stepping stone for the future utilisation of ADs by researchers.

Selenium supplementation of lactating dairy cows: effects on milk production and total selenium content and speciation in blood, milk and cheese

Forty-multiparous Holstein cows were used in a 16-wk continuous design study to determine the effects of either selenium (Se) source, selenized yeast (SY) (derived from a specific strain of Saccharomyces cerevisiae CNCM I-3060 Sel-Plex®) or sodium selenite (SS), or inclusion rate of SY on Se concentration and speciation in blood, milk and cheese. Cows received ad libitum a TMR with 1:1 forage:concentrate ratio on a dry matter (DM) basis. There were four diets (T1-T4) which differed only in either source or dose of Se additive. Estimated total dietary Se for T1 (no supplement), T2 (SS), T3 (SY) and T4 (SY) was 0.16, 0.30, 0.30 and 0.45 mg/kg DM, respectively. Blood and milk samples were taken at 28 day intervals and at each time point there were positive linear effects of SY on Se concentration in blood and milk. At day 112 blood and milk Se values for T1-T4 were 177, 208, 248, 279 ± 6.6 and 24, 38, 57, 72 ± 3.7 ng/g fresh material, respectively and indicate improved uptake and incorporation of Se from SY. While selenocysteine (SeCys) was the main selenised amino acid in blood its concentration was not markedly affected by treatment, but the proportion of total Se as selenomethionine (SeMet) increased with increasing inclusion rate of SY. In milk, there were no marked treatment effects on SeCys content, but Se source had a marked effect on the proportion of total Se as SeMet. At day 112 replacing SS (T2) with SY (T3) increased the SeMet concentration of milk from 36 to 111 ng Se/g and its concentration increased further to 157 ng Se/g as the inclusion rate of SY increased further (T4) to provide 0.45 mg Se/kg TMR. Neither Se source nor inclusion rate effected the keeping quality of milk. At day 112, milk from T1, T2, and T3 was made into a hard cheese and Se source had a marked effect on total Se and the proportion of total Se comprised as either SeMet or SeCys. Replacing SS (T2) with SY (T3) increased total Se, SeMet and SeCys content from 180 to 340 ng Se/g, 57 to 153 ng Se/g and 52 to 92 ng Se/g, respectively. Key words: dairy cow, milk and cheese, selenomethionine, selenocysteine, milk keeping quality

Consumer acceptance, valuation of and attitudes towards genetically modified food: Review and implications for food policy

An increasing set of evidence has been reported on how consumers could potentially react to the introduction of genetically modified food. Studies typically contain some empirical evidence and some theoretical explanations of the data, however, to date limited effort has been posed on systematically reviewing the existing evidence and its implications for policy. This paper contributes to the literature by bringing together the published evidence on the behavioural frameworks and evidence on the process leading to the public acceptance of genetically modified (GM) food and organisms (GMOs). In doing so, we employ a set of clearly defined search tools and a limited number of comprehensive key words. The study attempts to gather an understanding of the published findings on the determinants of the valuation of GM food - both in terms of willingness to accept and the willing-to-pay a premium for non-GM food, trust with information sources on the safety and public health and ultimate attitudes underpinning such evidence. Furthermore, in the light of such evidence, we formulate some policy strategies to deal with public uncertainly regarding to GMOs and, especially GM food. (c) 2007 Elsevier Ltd. All rights reserved.

Life histories of music service histories, the past in inductees' present

This article discusses inductee music service teachers (to 25 years of age). It explores how their lives, as perceived, shape current identities in teaching and result in several career problems. Respondents were drawn from a comprehensive life history study of 28 Local Education Authority employees. Of this larger cohort, four were age 25 years and below, and the remaining 24 teachers made retrospective comments. Data were collected and analysed between October 2002 and March 2004. Principal findings suggest that schooling failed to address these educators' needs as musical learners; key childhood experiences were external of schools. This often resulted in an idealistic trajectory, in teenage years, towards an occupation as a performer. An occupation in music education was entirely disregarded. Consequently, inductees now consider training experiences an inappropriate platform for their professional lives. Managing group teaching and children's behaviour engenders considerable anxiety. Music service work is also deemed a transient state of affairs. There are implications for training, retention and professional development.

Principles and calibration of solid phase microextraction fibre (passive sampler) for measurements of airflow and air infiltration in dwellings

Tracer gas techniques have been the most appropriate experimental method of determining airflows and ventilation rates in houses. However, current trends to reduce greenhouse gas effects have prompted the need for alternative techniques, such as passive sampling. In this research passive sampling techniques have been used to demonstrate the potential to fulfil these requirements by using solutions of volatile organic compounds (VOCs) and solid phase microextraction (SPME) fibres. These passive sampling techniques have been calibrated against tracer gas decay techniques and measurements from a standard orifice plate. Two constant sources of volatile organic compounds were diffused into two sections of a humidity chamber and sampled using SPME fibres. From a total of four SPME fibres (two in each section), reproducible results were obtained. Emission rates and air movement from one section to the other were predicted using developed algorithms. Comparison of the SPME fibre technique with that of the tracer gas technique and measurements from an orifice plate showed similar results with good precision and accuracy. With these fibres, infiltration rates can be measured over grab samples in a time weighted averaged period lasting from 10 minutes up to several days. Key words: passive samplers, solid phase microextraction fibre, tracer gas techniques, airflow, air infiltration, houses.

La comunicazione interculturale

The chapter is about Intercultural communication in Italy (seen from both a sociolinguistic and a pragmatic perspective), and it is structured into four different sections: “Key words/concept”, “Theoretical background”, “Good practice” and “Exercises”. Although based on the most recent research on Intercultural communication, it is addressed to both specialists/scholars and non specialists, as it is meant not only to outline new approaches and interpretations, but also to be regarded as a possible resource by civil servants and operators working with migrants. It is included in a book sponsored by the “Forum Internazionale ed Europeo di Ricerche sull’Immigrazione” (International and European Forum on Migration Research), which gathers contributions on policy, housing, education, health, employment and communication, and it has been widely adopted as a text book in Italian universities and by public institutions.

Does SMS text messaging help or harm adults’ knowledge of standard spelling?

The recent increase in short messaging system (SMS) text messaging, often using abbreviated, non-conventional ‘textisms’ (e.g. ‘2nite’), in school-aged children has raised fears of negative consequences of such technology for literacy. The current research used a paradigm developed by Dixon and Kaminska, who showed that exposure to phonetically plausible misspellings (e.g. ‘recieve’) negatively affected subsequent spelling performance, though this was true only with adults, not children. The current research extends this work to directly investigate the effects of exposure to textisms, misspellings and correctly spelledwords on adults’ spelling. Spelling of a set of key words was assessed both before and after an exposure phase where participants read the same key words, presented either as textisms (e.g. ‘2nite’), correctly spelled (e.g. ‘tonight’) or misspelled (e.g. 'tonite’)words. Analysis showed that scores decreased from pre- to post-test following exposure to misspellings, whereas performance improved following exposure to correctly spelled words and, interestingly, to textisms. Data suggest that exposure to textisms, unlike misspellings, had a positive effect on adults’ spelling. These findings are interpreted in light of other recent research suggesting a positive relationship between texting and some literacy measures in school-aged children.

The acrylamide problem: a plant and agronomic science issue.

Acrylamide, a chemical that is probably carcinogenic in humans and has neurological and reproductive effects, forms from free asparagine and reducing sugars during high-temperature cooking and processing of common foods. Potato and cereal products are major contributors to dietary exposure to acrylamide and while the food industry reacted rapidly to the discovery of acrylamide in some of the most popular foods, the issue remains a difficult one for many sectors. Efforts to reduce acrylamide formation would be greatly facilitated by the development of crop varieties with lower concentrations of free asparagine and/or reducing sugars, and of best agronomic practice to ensure that concentrations are kept as low as possible. This review describes how acrylamide is formed, the factors affecting free asparagine and sugar concentrations in crop plants, and the sometimes complex relationship between precursor concentration and acrylamide-forming potential. It covers some of the strategies being used to reduce free asparagine and sugar concentrations through genetic modification and other genetic techniques, such as the identification of quantitative trait loci. The link between acrylamide formation, flavour, and colour is discussed, as well as the difficulty of balancing the unknown risk of exposure to acrylamide in the levels that are present in foods with the well-established health benefits of some of the foods concerned. Key words: Amino acids, asparagine, cereals, crop quality, food safety, Maillard reaction, potato, rye, sugars, wheat.

Adaptive evolution of four microcephaly genes and the evolution of brain size in anthropoid primates

The anatomical basis and adaptive function of the expansion in primate brain size have long been studied; however, we are only beginning to understand the genetic basis of these evolutionary changes. Genes linked to human primary microcephaly have received much attention as they have accelerated evolutionary rates along lineages leading to humans. However, these studies focus narrowly on apes, and the link between microcephaly gene evolution and brain evolution is disputed. We analyzed the molecular evolution of four genes associated with microcephaly (ASPM, CDK5RAP2, CENPJ, MCPH1) across 21 species representing all major clades of anthropoid primates. Contrary to prevailing assumptions, positive selection was not limited to or intensified along the lineage leading to humans. In fact we show that all four loci were subject to positive selection across the anthropoid primate phylogeny. We developed clearly defined hypotheses to explicitly test if selection on these loci was associated with the evolution of brain size. We found positive relationships between both CDK5RAP2 and ASPM and neonatal brain mass and somewhat weaker relationships between these genes and adult brain size. In contrast, there is no evidence linking CENPJ and MCPH1 to brain size evolution. The stronger association of ASPM and CDK5RAP2 evolution with neonatal brain size than with adult brain size is consistent with these loci having a direct effect on prenatal neuronal proliferation. These results suggest that primate brain size may have at least a partially conserved genetic basis. Our results contradict a previous study that linked adaptive evolution of ASPM to changes in relative cortex size; however, our analysis indicates that this conclusion is not robust. Our finding that the coding regions of two widely expressed loci has experienced pervasive positive selection in relation to a complex, quantitative developmental phenotype provides a notable counterexample to the commonly asserted hypothesis that cisregulatory regions play a dominant role in phenotypic evolution. Key words: ASPM, MCPH1, CDK5RAP2, CENPJ, brain, neurogenesis, primates.

Do variations in substitution rates and male mutation bias correlate with life-history traits? A study of 32 mammalian genomes

Life-history traits vary substantially across species, and have been demonstrated to affect substitution rates. We compute genomewide, branch-specific estimates of male mutation bias (the ratio of male-to-female mutation rates) across 32 mammalian genomes and study how these vary with life-history traits (generation time, metabolic rate, and sperm competition). We also investigate the influence of life-history traits on substitution rates at unconstrained sites across a wide phylogenetic range. We observe that increased generation time is the strongest predictor of variation in both substitution rates (for which it is a negative predictor) and male mutation bias (for which it is a positive predictor). Although less significant, we also observe that estimates of metabolic rate, reflecting replication-independent DNA damage and repair mechanisms, correlate negatively with autosomal substitution rates, and positively with male mutation bias. Finally, in contrast to expectations, we find no significant correlation between sperm competition and either autosomal substitution rates or male mutation bias. Our results support the important but frequently opposite effects of some, but not all, life history traits on substitution rates. KEY WORDS: Generation time, genome evolution, metabolic rate, sperm competition.

Ventilation in a street canyon under diurnal heating conditions

To study the thermal effects on airflow in a street canyon under real heating conditions (due to diurnal solar radiation), a one-way static approach combining an urban canopy model and CFD is proposed in this paper. An urban canopy model was developed to calculate the individual temperatures of surfaces in the street canyon. The calculated surface temperature may be used as a thermal boundary for CFD simulation. The reliability of this model was validated against a field experiment in Harbin, China. Using the coupling calculation method, the wind flow and air exchange process inside an idealized street canyon was studied. The simulation results show that the thermal effect has significant impacts on the transfer process in the street canyon, especially when the approaching wind is weak. Under a real diurnal thermal forcing, the flow structure within the street canyon changes from one primary vortex to two counter-rotating vortices. The change of transfer process, induced by the buoyancy force, was determined by the thermal condition of all surfaces rather than a single one. Key words: thermal effect, street canyon, numerical simulation, transfer process, diurnal heating.

Comparative biology of mammalian telomeres: hypotheses on ancestral states and the roles of telomeres in longevity determination

Progressive telomere shortening from cell division (replicative aging) provides a barrier for human tumor progression. This program is not conserved in laboratory mice, which have longer telomeres and constitutive telomerase. Wild species that do ⁄ do not use replicative aging have been reported, but the evolution of different phenotypes and a conceptual framework for understanding their uses of telomeres is lacking. We examined telomeres ⁄ telomerase in cultured cells from > 60 mammalian species to place different uses of telomeres in a broad mammalian context. Phylogeny-based statistical analysis reconstructed ancestral states. Our analysis suggested that the ancestral mammalian phenotype included short telomeres (< 20 kb, as we now see in humans) and repressed telomerase. We argue that the repressed telomerase was a response to a higher mutation load brought on by the evolution of homeothermy. With telomerase repressed, we then see the evolution of replicative aging. Telomere length inversely correlated with lifespan, while telomerase expression co-evolved with body size. Multiple independent times smaller, shorter-lived species changed to having longer telomeres and expressing telomerase. Trade-offs involving reducing the energetic ⁄ cellular costs of specific oxidative protection mechanisms (needed to protect < 20 kb telomeres in the absence oftelomerase) could explain this abandonment of replicative aging. These observations provide a conceptual framework for understanding different uses of telomeres in mammals, support a role for human-like telomeres in allowing longer lifespans to evolve, demonstrate the need to include telomere length in the analysis of comparative studies of oxidative protection in the biology of aging, and identify which mammals can be used as appropriate model organisms for the study of the role of telomeres in human cancer and aging. Key words: evolution of telomeres; immortalization; telomerase; replicative aging; senescence.