SWAT-1: The effectiveness of a 'site visit' intervention on recruitment rates in a multi-centre randomised trial

Background: Recruitment rates in multi-centre randomised trials often fall below target recruitment rates, causing problems for study outcomes. The Studies Within A Trial (SWAT) Programme, established by the All-Ireland Hub for Trials Methodology Research in collaboration with the Medical Research Council Network of Hubs in the United Kingdom and others, is developing methods for evaluating aspects of trial methodology through the conduct of research within research. A recently published design for a SWAT-1 provides a protocol for evaluating the effect of a site visit by the principal investigator on recruitment in multi-centre trials.

Methods: Using the SWAT-1 design, the effect of a site visit, with the sole purpose of discussing trial recruitment, on recruitment rates in a large multicentre trial in the Republic of Ireland was evaluated. A controlled before and after intervention comparison was used, where the date of the site visit provides the time point for the intervention, and for the comparison to control sites. Site A received the intervention. Site B and Site C acted as the controls. Z-scores for proportions were calculated to determine within site recruitment differences. Odds ratios and 95% confidence intervals were calculated to determine between site recruitment differences.

Results: Recruitment rates were increased in Site A post-intervention (17% and 14% percentage point increases at 1 and 3 months, respectively). No differences in recruitment occurred in Site B or in Site C. Comparing between site differences, at 3 months post-intervention, a statistically significant difference was detected in favour of higher recruitment in Site A (34% versus 25%; odds ratio 1.57, 95% confidence interval 1.09 to 2.26).

Conclusions: This is the first reported example of a study in the SWAT programme.. It provides evidence that a site visit, combined with a scheduled meeting, increases recruitment in a clinical trial. Using this example, other researchers might be encouraged to consider conducting a similar study, allowing the findings of future SWAT-1s to be compared and combined, so that higher level evidence on the effect of a site visit by the principal investigator can be obtained.

Investigation into the effect of molybdenum-site substitution on the performance of Sr2Fe1.5Mo0.5O6-δ for intermediate temperature solid oxide fuel cells

In this paper, niobium doping is evaluated as a means of enhancing the electrochemical performance of a Sr₂Fe_1.5Mo_0.5O_6-δ (SFM) perovskite structure cathode material for intermediate temperature solid oxide fuel cells (IT-SOFCs) applications. As the radius of Nb approximates that of Mo and exhibits +4/+5 mixed valences, its substitution is expected to improve material performance. A series of Sr₂Fe_1.5Mo_0.5-xNb_xO_6-δ (x = 0.05, 0.10, 0.15, 0.20) cathode materials are prepared and the phase structure, chemical compatibility, microstructure, electrical conductivity, polarization resistance and power generation are systematically characterized. Among the series of samples, Sr₂Fe_1.5Mo_0.4Nb_0.10O_6-δ (SFMNb_0.10) exhibits the highest conductivity value of 30 S cm^-1 at 550°C, and the lowest area specific resistance of 0.068 Ω cm² at 800°C. Furthermore, an anode-supported single cell incorporating a SFMNb_0.10 cathode presents a maximum power density of 1102 mW cm^-2 at 800°C. Furthermore no obvious performance degradation is observed over 15 h at 750°C with wet H₂(3% H₂O) as fuel and ambient air as the oxidant. These results demonstrate that SFMNb shows great promise as a novel cathode material for IT-SOFCs.

Investigation into the effect of Fe-site substitution on the performance of Sr2Fe1.5Mo0.5O6-δ anodes for SOFCs

Ni-substituted Sr₂Fe_1.5-xNi_xMo_0.5O_6-δ (SFNM) materials have been investigated as anode catalysts for intermediate temperature solid oxide fuel cells. Reduced samples (x = 0.05 and 0.1) maintained the initial perovskite structure after reduction in H₂, while metallic nickel particles were detected on the grain surface for x = 0.2 and 0.3 using transmission electron microscopy. Temperature programmed reduction results indicate that the stable temperature for SFNM samples under reduction conditions decreases with Ni content. In addition, X-ray photoelectron spectroscopy analysis suggests that the incorporation of Ni affects the conductivity of SFNM through changing the ratios of Fe³⁺/Fe²⁺ and Mo⁶⁺/Mo⁵⁺. Sr₂Fe_1.4Ni_0.1Mo_0.5O_6-δ shows the highest electrical conductivity of 20.6 S cm^-1 at 800 °C in H₂. The performance of this anode was further tested with electrolyte-supported cells, giving 380 mW cm^-2 at 750 °C in H₂, hence demonstrating that Ni doping in the B-site is beneficial for Sr₂Fe_1.5Mo_0.5O_6-δ anode performance. 

Chronology of the site of Grotte du Renne, Arcy-sur-Cure, France: implications for Neanderthal symbolic behaviour

Higham et al (2010) published a large series of new dates from the key French Palaeolithic site of the Grotte du Renne at Arcy-sur-Cure. The site is important because it is one of only two sites in Europe in which Châtelperronian lithic remains co-occur with Neanderthal human remains. A large series of dates from the Mousterian, Châtelperronian, Aurignacian and Gravettian levels of the site was obtained. The 14C results showed great variability, which Higham et al (2010) interpreted as most likely to be due to mixing of archaeological material in the site. In contrast, Caron et al (2011) suggested that the site stratigraphy is well preserved and that the problem with the variability in the radiocarbon ages was due to unremoved contamination in the dated bone. In this paper we address their critique of the original Higham et al (2010) paper

Continuing the fight in reducing the risk of surgical site infections in the perioperative environment

Assessing risk has become part of the process of supporting patients andmaintaining safety in the healthcare setting. The risk of healthcare associatedinfections (HCAIs) has long been well documented and surgical site infection (SSI)is recognised as one of the most prevalent (Tanner & Khan 2008, Wilson 2013a).

Delineation of within-site terroir effects using soil and vine water measurements in Riesling vineyards within the Niagara Peninsula

The major focus of this dissertation was to explain terroir effects that impact wine varietal character and to elucidate potential determinants of terroir by testing vine water status (VWS) as the major factor of the terroir effect. It was hypothesized that consistent water status zones could be identified within vineyard sites, and, that differences in vine performance, fruit composition and wine sensory attributes could be related to VWS. To test this hypothesis, ten commercial Riesling vineyards representative of each Vintners Quality Alliance sub-appellation were selected. Vineyards were delineated using global positioning systems and 75 to 80 sentinel vines per vineyard were geo-referenced for data collection. During the 2005 to 2007 growing seasons, VWS measurements [midday leaf water potential ('l')] were collected from a subset of these sentinel vines. Data were collected on soil texture and composition, soil moisture, vine performance (yield components, vine size) and fruit composition. These variables were mapped using global information system (GIS) software and relationships between them were elucidated. Vines were categorized into "low" and "high" water status regions within each vineyard block and replicate wines were made from each. Many geospatial patterns and relationships were spatially and temporally stable within vineyards. Leaf'l' was temporally stable within vineyards despite different weather conditions during each growing season. Generally, spatial relationships between 'l', soil moisture, vine size, berry weight and yield were stable from year to year. Leaf", impacted fruit composition in several vineyards. Through sorting tasks and multidimensional scaling, wines of similar VWS had similar sensory properties. Descriptive analysis further indicated that VWS impacted wine sensory profiles, with similar attributes being different for wines from different water status zones. Vineyard designation had an effect on wine profiles, with certain sensory and chemical attributes being associated from different subappellations. However, wines were generally grouped in terms of their regional designation ('Lakeshore', 'Bench', 'Plains') within the Niagara Peninsula. Through multivariate analyses, specific sensory attributes, viticulture and chemical variables were associated with wines of different VWS. Vine water status was a major contributor to the terroir effect, as it had a major impact on vine size, berry weight and wine sensory characteristics.

Development of designed site-directed pseudopeptide-peptido-mimetic immunogens as novel minimal subunit-vaccine candidates for malaria

Synthetic vaccines constitute the most promising tools for controlling and preventing infectious diseases. When synthetic immunogens are designed from the pathogen native sequences, these are normally poorly immunogenic and do not induce protection, as demonstrated in our research. After attempting many synthetic strategies for improving the immunogenicity properties of these sequences, the approach consisting of identifying high binding motifs present in those, and then performing specific changes on amino-acids belonging to such motifs, has proven to be a workable strategy. In addition, other strategies consisting of chemically introducing non-natural constraints to the backbone topology of the molecule and modifying the a-carbon asymmetry are becoming valuable tools to be considered in this pursuit. Non-natural structural constraints to the peptide backbone can be achieved by introducing peptide bond isosters such as reduced amides, partially retro or retro-inverso modifications or even including urea motifs. The second can be obtained by strategically replacing L-amino-acids with their enantiomeric forms for obtaining both structurally site-directed designed immunogens as potential vaccine candidates and their Ig structural molecular images, both having immunotherapeutic effects for preventing and controlling malaria.

Reproductive Consequences of Nest Site Use in Fork-tailed Storm-Petrels in the Aleutian Islands, Alaska: Potential Lasting Effects of an Introduced Predator

We examined the reproductive consequences of differential nest site use in Fork-tailed Storm-Petrels (Oceanodroma furcata) in the Aleutian Islands, Alaska, where birds on islands where foxes were introduced nest in rocky substrate rather than in typical soil habitat. We investigated how physical and microclimatic nest site characteristics influenced storm-petrel breeding success 20 years after fox removal. We then examined whether those nest site characteristics that affected success were related to the amount of rock that composed the nest. In both years of our study, nest temperature had the strongest influence on chick survival and overall reproductive success, appearing in all the top models and alone explaining 14–35% of the variation in chick survival. The relationship between reproductive success and nest temperature was positive in both years, with higher survival in warmer nests. In turn, the best predictor of nest temperature was the amount of rock that composed the site. Rockier nests had colder average temperatures, which were driven by lower daily minimum temperatures, compared to nests with more soil. Thus, the rockiness of the nest site appeared to affect chick survival and overall reproductive success through its influence on nest temperature. This study suggests that the use of rocky nest sites, presumed to be a result of historic predation from introduced foxes, could decrease breeding success in this recovering population, and thus be a long-lasting effect of introduced predators.

Joined-up archaeology at Old Scatness, Shetland: thin section analysis of the site and hinterland

Excavations on the multi-period settlement at Old Scatness, Shetland have uncovered a number of Iron Age structures with compacted, floor-like layers. Thin section analysis was undertaken in order to investigate and compare the characteristics of these layers. The investigation also draws on earlier analyses of the Iron Age agricultural soil around the settlement and the midden deposits that accumulated within the settlement, to create a 'joined-up' analysis which considers the way material from the settlement was used and then recycled as fertiliser for the fields. Peat was collected from the nearby uplands and was used for fuel and possibly also for flooring. It is suggested that organic-rich floors from the structures were periodically removed and the material was spread onto the fields as fertilisers. More organic-rich material may have been used selectively for fertiliser, while the less organic peat ash was allowed to accumulate in middens. Several of the structures may have functioned as byres, which suggests a prehistoric plaggen system.

Grassland leafhoppers (Hemiptera: Auchenorrhyncha) as indicators of habitat condition - a comparison of between-site and between-year differences in assemblage composition

The Auchenorrhyncha (leafhoppers) show great potential as indicators of grassland habitat quality, which would make them useful as a conservation tool. However, they are known to have labile populations. The relative importance of site identity and the year of sampling in the composition of leafhopper assemblages on chalk grassland are assessed for two sets of sites sampled twice. The study included a total of 95 sites (one set of 54, the other of 41), and demonstrated that for both sets the vegetation community and geographical location had high explanatory value, while the influence of year was small. The conclusion is that, notwithstanding population fluctuations, the leafhopper assemblages are a good indicator of habitat quality, and represent a potentially valuable tool in grassland conservation and restoration.

Proteomic analysis of the site specificity of glycation and carboxymethylation of ribonuclease

Proteomic analysis using electrospray liquid chromatography-mass spectrometry (ESI-LC-MS) has been used to compare the sites of glycation (Amadori adduct formation) and carboxymethylation of RNase and to assess the role of the Amadori adduct in the formation of the advanced glycation end-product (AGE), N-is an element of-(carboxymethyl)lysine (CIVIL). RNase (13.7 mg/mL, 1 mM) was incubated with glucose (0.4 M) at 37 degreesC for 14 days in phosphate buffer (0.2 M, pH 7.4) under air. On the basis of ESI-LC-MS of tryptic peptides, the major sites of glycation of RNase were, in order, K41, K7, K1, and K37. Three of these, in order, K41, K7, and K37 were also the major sites of CIVIL formation. In other experiments, RNase was incubated under anaerobic conditions (1 mM DTPA, N-2 purged) to form Amadori-modified protein, which was then incubated under aerobic conditions to allow AGE formation. Again, the major sites of glycation were, in order, K41, K7, K1, and K37 and the major sites of carboxymethylation were K41, K7, and K37. RNase was also incubated with 1-5 mM glyoxal, substantially more than is formed by autoxidation of glucose under experimental conditions, but there was only trace modification of lysine residues, primarily at K41. We conclude the following: (1) that the primary route to formation of CIVIL is by autoxidation of Amadori adducts on protein, rather than by glyoxal generated on autoxidation of glucose; and (2) that carboxymethylation, like glycation, is a site-specific modification of protein affected by neighboring amino acids and bound ligands, such as phosphate or phosphorylated compounds. Even when the overall extent of protein modification is low, localization of a high proportion of the modifications at a few reactive sites might have important implications for understanding losses in protein functionality in aging and diabetes and also for the design of AGE inhibitors.

Automatic prediction of functional site regions in low-resolution protein structures

World-wide structural genomics initiatives are rapidly accumulating structures for which limited functional information is available. Additionally, state-of-the art structural prediction programs are now capable of generating at least low resolution structural models of target proteins. Accurate detection and classification of functional sites within both solved and modelled protein structures therefore represents an important challenge. We present a fully automatic site detection method, FuncSite, that uses neural network classifiers to predict the location and type of functionally important sites in protein structures. The method is designed primarily to require only backbone residue positions without the need for specific side-chain atoms to be present. In order to highlight effective site detection in low resolution structural models FuncSite was used to screen model proteins generated using mGenTHREADER on a set of newly released structures. We found effective metal site detection even for moderate quality protein models illustrating the robustness of the method.