An evaluation of a Bayesian method of dose escalation based on bivariate binary responses

Recently, various approaches have been suggested for dose escalation studies based on observations of both undesirable events and evidence of therapeutic benefit. This article concerns a Bayesian approach to dose escalation that requires the user to make numerous design decisions relating to the number of doses to make available, the choice of the prior distribution, the imposition of safety constraints and stopping rules, and the criteria by which the design is to be optimized. Results are presented of a substantial simulation study conducted to investigate the influence of some of these factors on the safety and the accuracy of the procedure with a view toward providing general guidance for investigators conducting such studies. The Bayesian procedures evaluated use logistic regression to model the two responses, which are both assumed to be binary. The simulation study is based on features of a recently completed study of a compound with potential benefit to patients suffering from inflammatory diseases of the lung.

Chaucer's presence in songes and sonettes

In an elegy to Wyatt published in Tottel’s Miscellany, Surrey claims that Wyatt ‘reft Chaucer the glory of his wit’. This statement, which both lauds and resists Chaucer, is a microcosm of the way Chaucer is treated throughout the Miscellany. In examining the collection’s paradoxical attitude to Chaucer, this essay focuses particularly on the Squire’s Tale, the Franklin’s Tale, Anelida and Arcite, the Legend of Good Women, and several short lyrics. In its interest in courtly love poetry and Petrarch, the Miscellany follows a trajectory in English poetry set by Chaucer. Its courtly verse is saturated with words, phrases, and tropes from his poetry. Rhyme royal, which he introduced into English poetry, is widely used. The Canterbury Tales has been fully assimilated and can be referred to allusively with the same confidence of the audience’s knowledge as is the case when referring to classical myth; in Wyatt’s ‘Myne owne Jhon Poins’, the speaker, disclaiming deceitfulness, says that he cannot ‘say that Pan/ Passeth Appollo in musike manifold:/ Praise syr Topas for a noble tale,/ And scorne the story that the knight tolde’ (lines 48-50). However, Chaucer’s poetry is also downplayed and contested in the Miscellany. ‘Truth’, the only poem of his which appears in the volume, is disingenuously placed in the ‘Uncertain Authors’ section. In addition, some of the most important elements of his work are strongly resisted in the Miscellany, either ignored, dismissed or challenged. These elements include Chaucer’s interest in variety of voice, his sympathetic engagement with women, particularly wronged women, and his interest in female speech and particularly female complaint. The Miscellany, by contrast, is dominated by male-voiced lyrics preoccupied with the pain inflicted on the lover by a lady who is frequently unfeeling, cruel, or faithless. Chaucer’s frequent focus on the cynical seduction and betrayal of female by male is reversed in the Miscellany, and the language and metaphors he uses to express male cruelty (e.g. the word ‘newfangleness’ and images of hooks, nets and traps) are usurped to describe the lady’s cruelty to the suffering lover. On occasion, poems in the Miscellany challenge specific Chaucerian texts; ‘On His Love Named White’ throws down a gauntlet to The Book of the Duchess, while two of Surrey’s poems implicitly take issue with the female falcon’s voice in the Squire’s Tale, giving the deceitful tercelet the opportunity to shout down the falcon’s charges. The essay thus shows that in many respects Tottel’s Miscellany is only superficially Chaucerian, and that it both passively and actively takes issue with Chaucer’s work.

High sensitivity recording of afferent nerve activity using ultra-compliant microchannel electrodes: an acutein vivovalidation

Neuroprostheses interfaced with transected peripheral nerves are technological routes to control robotic limbs as well as convey sensory feedback to patients suffering from traumatic neural injuries or degenerative diseases. To maximize the wealth of data obtained in recordings, interfacing devices are required to have intrafascicular resolution and provide high signal-to-noise ratio (SNR) recordings. In this paper, we focus on a possible building block of a three-dimensional regenerative implant: a polydimethylsiloxane (PDMS) microchannel electrode capable of highly sensitive recordings in vivo. The PDMS 'micro-cuff' consists of a 3.5 mm long (100 µm × 70 µm cross section) microfluidic channel equipped with five evaporated Ti/Au/Ti electrodes of sub-100 nm thickness. Individual electrodes have average impedance of 640 ± 30 kΩ with a phase angle of −58 ± 1 degrees at 1 kHz and survive demanding mechanical handling such as twisting and bending. In proof-of-principle acute implantation experiments in rats, surgically teased afferent nerve strands from the L5 dorsal root were threaded through the microchannel. Tactile stimulation of the skin was reliably monitored with the three inner electrodes in the device, simultaneously recording signal amplitudes of up to 50 µV under saline immersion. The overall SNR was approximately 4. A small but consistent time lag between the signals arriving at the three electrodes was observed and yields a fibre conduction velocity of 30 m s−1. The fidelity of the recordings was verified by placing the same nerve strand in oil and recording activity with hook electrodes. Our results show that PDMS microchannel electrodes open a promising technological path to 3D regenerative interfaces.

Late Quaternary hydrological dynamics in the Middle Kalahari: forcing and feedbacks

The Kalahari region has become a major source of Quaternary palaeoenvironmental data derived primarily from the analysis of geomorphological proxies of environmental change. One suite of data, from palaeolacustrine landforms, has recently provided a new record of major hydrological changes in the last 150 ka [Burrough, S. L., Thomas, D. S. G., Bailey, R. M., 2009. Mega-Lake in the Kalahari: A Late Pleistocene record of the Palaeolake Makgadikgadi system. Quaternary Science Reviews, in press.]. Here we present an improved analysis of the drivers and feedbacks of lake level change, utilising information from three main sources: data from the lake system itself, from analyses of other late Quaternary records within the region and from climate modelling. Simulations using the Hadley Centre coupled climate model, HadCM3, suggest that once triggered, the lake body was large enough to potentially affect both local and regional climates. Surface waters and their interactions with the climate are therefore an important component of environmental dynamics during the late Quaternary. Through its capacity to couple Middle Kalahari environments to distant forcing mechanisms and to itself force environmental change, we demonstrate that the existence or absence of megalake Makgadikgadi adds a new level of complexity to the interpretations of environmental proxy records in southern Africa's summer rainfall zone.

Pollination deficits in UK apple orchards

Apple production in the UK is worth over £100 million per annum and this production is heavily dependent on insect pollination. Despite its importance, it is not clear which insect pollinators carry out the majority of this pollination. Furthermore, it is unknown whether current UK apple production, in terms of both yield and quality, suffers pollination deficits and whether production value could be increased through effective management of pollination services. The present study set out to address some of these unknowns and showed that solitary bee activity is high in orchards and that they could be making a valuable contribution to pollination. Furthermore, fruit set and apple seed number were found to be suffering potential pollination deficits although these were not reflected in apple quality. Deficits could be addressed through orchard management practices to improve the abundance and diversity of wild pollinators. Such practices include provision of additional floral resources and nesting habitats as well as preservation of semi-natural areas. The cost effectiveness of such strategies would need to be understood taking into account the potential gains to the apple industry.

Regulation of cell migration in cancer: investigation into the regulation of cancer cell blebbing in the extracellular matrix

Cell migration is a highly coordinated process and any aberration in the regulatory mechanisms could result in pathological conditions such as cancer. The ability of cancer cells to disseminate to distant sites within the body has made it difficult to treat. Cancer cells also exhibit plasticity that makes them able to interconvert from an elongated, mesenchymal morphology to an amoeboid blebbing form under different physiological conditions. Blebs are spherical membrane protrusions formed by actomyosin-mediated contractility of cortical actin resulting in increased hydrostatic pressure and subsequent detachment of the membrane from the cortex. Tumour cells use blebbing as an alternative mode of migration by squeezing through preexisting gaps in the ECM, and bleb formation is believed to be mediated by the Rho-ROCK signaling pathway. However, the involvement of transmembrane water and ion channels in cell blebbing has not been examined. In the present study, the role of the transmembrane water channels, aquaporins, transmembrane ion transporters and lipid signaling enzymes in the regulation of blebbing was investigated. Using 3D matrigel matrix as an in vitro model to mimic normal extracellular matrix, and a combination of confocal and time-lapse microscopy, it was found that AQP1 knockdown by siRNA ablated blebbing of HT1080 and ACHN cells, and overexpression of AQP1-GFP not only significantly increased bleb size with a corresponding decrease in bleb numbers, but also induced bleb formation in non-blebbing cell lines. Importantly, AQP1 overexpression reduces bleb lifespan due to faster bleb retraction. This novel finding of AQP1-facilitated bleb retraction requires the activity of the Na+/H+ pump as inhibition of the ion transporter, which was found localized to intracellular vesicles, blocked bleb retraction in both cell lines. This study also demonstrated that a differential regulation of cell blebbing by AQP isoforms exists as knockdown of AQP5 had no effect on bleb formation. Data from this study also demonstrates that the lipid signaling PLD2 signals through PA in the LPA-LPAR-Rho-ROCK axis to positively regulate bleb formation in both cell lines. Taken together, this work provides a novel role of AQP1 and Na+/H+ pump in regulation of cell blebbing, and this could be exploited in the development of new therapy to treat cancer.

Voluntary facial displays of pain increase suffering in response to nociceptive stimulation

This study demonstrates that making a standardized pain face increases negative affect in response to nociceptive stimulation, even in the absence of social feedback. This suggests that exaggerated facial displays of pain, although often socially reinforced, may also have unintended aversive consequences.

Climate response to basin-scale warming and cooling of the North Atlantic Ocean

Using experiments with an atmospheric general circulation model, the climate impacts of a basin-scale warming or cooling of the North Atlantic Ocean are investigated. Multidecadal fluctuations with this pattern were observed during the twentieth century, and similar variations--but with larger amplitude--are believed to have occurred in the more distant past. It is found that in all seasons the response to warming the North Atlantic is strongest, in the sense of highest signal-to-noise ratio, in the Tropics. However there is a large seasonal cycle in the climate impacts. The strongest response is found in boreal summer and is associated with suppressed precipitation and elevated temperatures over the lower-latitude parts of North and South America. In August­-September-­October there is a significant reduction in the vertical shear in the main development region for Atlantic hurricanes. In winter and spring, temperature anomalies over land in the extratropics are governed by dynamical changes in circulation rather than simply reflecting a thermodynamic response to the warming or cooling of the ocean. The tropical climate response is primarily forced by the tropical SST anomalies, and the major features are in line with simple models of the tropical circulation response to diabatic heating anomalies. The extratropical climate response is influenced both by tropical and higher-latitude SST anomalies and exhibits nonlinear sensitivity to the sign of the SST forcing. Comparisons with multidecadal changes in sea level pressure observed in the twentieth century support the conclusion that the impact of North Atlantic SST change is most important in summer, but also suggest a significant influence in lower latitudes in autumn and winter. Significant climate impacts are not restricted to the Atlantic basin, implying that the Atlantic Ocean could be an important driver of global decadal variability. The strongest remote impacts are found to occur in the tropical Pacific region in June­-August and September­-November. Surface anomalies in this region have the potential to excite coupled ocean­atmosphere feedbacks, which are likely to play an important role in shaping the ultimate climate response.

Integrated Nitrogen CAtchment model (INCA) applied to a tropical catchment in the Atlantic Forest, Sao Paulo, Brazil

Stream-water flows and in-stream nitrate and ammonium concentrations in a small (36.7 ha) Atlantic Forest catchment were simulated using the Integrated Nitrogen in CAtchments (INCA) model version 1.9.4. The catchment, at Cunha, is in the Serra do Mar State Park, SE Brazil and is nearly pristine because the nearest major conurbations, Sao Paulo and Rio, are some 450 km distant. However, intensive farming may increase nitrogen (N) deposition and there are growing pressures for urbanisation. The mean-monthly discharges and NO3-N concentration dynamics were simulated adequately for the calibration and validation periods with (simulated) loss rates of 6.55 kg.ha(-1) yr(-1) for NO3-N and 3.85 kg.ha(-1) yr(-1) for NH4-N. To investigate the effects of elevated levels of N deposition in the future, various scenarios for atmospheric deposition were simulated; the highest value corresponded to that in a highly polluted area of Atlantic Forest in Sao Paulo City. It was found that doubling the atmospheric deposition generated a 25% increase in the N leaching rate, while at levels approaching the highly polluted Sao Paulo deposition rate, five times higher than the current rate, leaching increased by 240%, which would create highly eutrophic conditions, detrimental to downstream water quality. The results indicate that the INCA model can be useful for estimating N concentration and fluxes for different atmospheric deposition rates and hydrological conditions.

Public policy and foreign-based enterprises in Britain prior to the Second World War

This article examines the early evolution of British policy, prior to the Second World War. The British government adopted an ‘open’ policy towards foreign direct investment (FDI), despite periodic fears that some foreign acquisitions of UK firms in key sectors might be detrimental to the national interest, and a few ad hoc attempts to deal with particular instances of this kind. During the 1930s, when the inflow of foreign firms accelerated following Britain's adoption of general tariff protection, the government developed a sophisticated admissions policy, based on an assessment of the likely net benefit of each applicant to the British economy. Its limited regulatory powers were used to maximize the potential of immigrant firms for technology transfer, enhanced competition, industrial diversification, and employment creation (particularly in the depressed regions), while protecting British industries suffering from excess capacity.

Elevated levels of corticotrophin-releasing factor binding protein in the blood of patients suffering from arthritis and septicaemia and the presence of novel ligands in synovial fluid.

In view of the reported inflammatory effects of corticotrophin-releasing factor (CRF) and the associated regulatory elements in the gene of its binding protein (BP), we postulate that both BP as well as novel BP-ligands other than CRF may be involved in inflammatory disease. We have investigated BP in the blood of patients with arthritis and septicaemia and have attempted to identify CRF and other BP-ligands in synovial fluid. The BP was found to be significantly elevated in the blood of patients with rheumatoid arthritis and septicaemia. There was less BP-ligand and CRF in synovial fluid from patients with rheumatoid arthritis that from those with osteo- or psoriatic arthritis. There was at least 10-fold more BP-ligand than CRF in the fluid of all three groups of patients. A small amount of immunoreactive human (h)CRF, eluting in the expected position of CRF-41, was detected after high-pressure liquid chromatography of arthritic synovial fluid; however, the bulk of material with BP-ligand binding activity eluted earlier, suggesting that synovial fluid contained novel peptides that interacted with the BP. These results would suggest that the BP and its ligands could play an endocrine immunomodulatory role in inflammatory disease.

Priority setting in healthcare: from arbitrariness to societal values

This paper develops an account of the normative basis of priority setting in health care as combining the values which a given society holds for the common good of its members, with the universal provided by a principle of common humanity. We discuss national differences in health basket in Europe and argue that health care decision-making in complex social and moral frameworks is best thought of as anchored in such a principle by drawing on the philosophy of need. We show that health care needs are ethically ‘thick’ needs whose psychological and social construction can best be understood in terms of David Wiggins's notion of vital need: a person's need is vital when failure to meet it leads to their harm and suffering. The moral dimension of priority setting which operates across different societies’ health care systems is located in the demands both of and on any society to avoid harm to its members.

Stock measurement and regeneration policy approaches to ‘hardcore’ brownfield sites: England and Japan compared

This paper discusses key contextual differences and similarities in a comparative study on brownfield regeneration in England and Japan. Over the last decade, the regeneration of large-scale ‘flagship’ projects has been a primary focus in England, and previous research has discussed policy issues and key barriers at these sites. However, further research is required to explore specific barriers associated with problematic ‘hardcore’ sites suffering from long-term dereliction due to site-specific obstacles such as contamination and fragmented ownership. In comparison with England, brownfield regeneration is a relatively new urban agenda in Japan. Japan has less experience in terms of promoting redevelopment of brownfield sites at national level and the specific issues of ‘hardcore’ sites have been under-researched. The paper reviews and highlights important issues in comparing the definitions, national policy frameworks and the current stock of brownfields.

Microchannel electrode interfaces to assess bladder afferent activity

By placing axons into polymeric micro-channels hosting embedded electrodes the extracellular amplitude of action potentials is greatly increased, allowing for robust recording and noise suppression. We are developing such an electrode interface to record electrical activity from bladder afferents to restore bladder control in patients suffering from spinal cord injury. Here we describe our microchannel electrode interface in terms of design, microfabrication and electrode characteristics and report on in vivo bladder function after implantation of teased dorsal rootlets within microchannels.

“The suffering black male body and the threatened white female body": ambiguous bodies in Candyman

This article explores the roles of monster and victim as experienced through the body, and considers how the relationship between violence and the body affects the presentation of these roles through close analysis of performance in Candyman (Bernard Rose, 1992). I aim to demonstrate that commitment to such a detailed approach, offers a more intricate and rewarding critical interaction, reflecting the complexity of narrative film. Consideration of the particulars of performance is crucial, in its affect on our engagement with the performer and their physical presence. Through this attention I intend to demonstrate how the seemingly fixed role of monster is in fact more fluid than first apparent, that monster and victim can co-exist in the same body. Candyman’s physicality and the way it is presented foregrounds the oscillations between violence and suffering, the relationship between the body and the violence inflicted on and by it, ambiguities which are also found in the heroine’s development, thus enhancing the film’s striking preoccupation with the shifting parallels between monster and victim.