Flexible selection of a single treatment incorporating short-term endpoint information in a phase II/III clinical trial

Seamless phase II/III clinical trials in which an experimental treatment is selected at an interim analysis have been the focus of much recent research interest. Many of the methods proposed are based on the group sequential approach. This paper considers designs of this type in which the treatment selection can be based on short-term endpoint information for more patients than have primary endpoint data available. We show that in such a case, the familywise type I error rate may be inflated if previously proposed group sequential methods are used and the treatment selection rule is not specified in advance. A method is proposed to avoid this inflation by considering the treatment selection that maximises the conditional error given the data available at the interim analysis. A simulation study is reported that illustrates the type I error rate inflation and compares the power of the new approach with two other methods: a combination testing approach and a group sequential method that does not use the short-term endpoint data, both of which also strongly control the type I error rate. The new method is also illustrated through application to a study in Alzheimer's disease. © 2015 The Authors. Statistics in Medicine Published by John Wiley & Sons Ltd.

Energy consistent discontinuous Galerkin methods for a quasi-incompressible diffuse two phase flow model

We design consistent discontinuous Galerkin finite element schemes for the approximation of a quasi-incompressible two phase flow model of Allen–Cahn/Cahn–Hilliard/Navier–Stokes–Korteweg type which allows for phase transitions. We show that the scheme is mass conservative and monotonically energy dissipative. In this case the dissipation is isolated to discrete equivalents of those effects already causing dissipation on the continuous level, that is, there is no artificial numerical dissipation added into the scheme. In this sense the methods are consistent with the energy dissipation of the continuous PDE system.

Process analysis of trauma-focused cognitive behavioural therapy for individuals with schizophrenia

Objective. Therapeutic alliance, modality, and ability to engage with the process of therapy have been the main focus of research into what makes psychotherapy successful. Individuals with complex trauma histories or schizophrenia are suggested to be more difficult to engage and may be less likely to benefit from therapy. This study aimed to track the in-session ‘process’ of working alliance and emotional processing of trauma memories for individuals with schizophrenia. Design. The study utilized session recordings from the treatment arm of an open randomized clinical trial investigating trauma-focused cognitive behavioural therapy (TF-CBT) for individuals with schizophrenia (N = 26). Method. Observer measures of working alliance, emotional processing, and affect arousal were rated at early and late phases of therapy. Correlation analysis was undertaken for process measures. Temporal analysis of expressed emotions was also reported. Results. Working alliance was established and maintained throughout the therapy; however, agreement on goals reduced at the late phase. The participants appeared to be able to engage in emotional processing, but not to the required level for successful cognitive restructuring. Conclusion. This study undertook novel exploration of process variables not usually explored in CBT. It is also the first study of process for TF-CBT with individuals with schizophrenia. This complex clinical sample showed no difficulty in engagement; however, they may not be able to fully undertake the cognitive–emotional demands of this type of therapy. Clinical and research implications and potential limitations of these methods are considered.

Interim analyses and sequential designs in phase III studies

Recruitment of patients to a clinical trial usually occurs over a period of time, resulting in the steady accumulation of data throughout the trial's duration. Yet, according to traditional statistical methods, the sample size of the trial should be determined in advance, and data collected on all subjects before analysis proceeds. For ethical and economic reasons, the technique of sequential testing has been developed to enable the examination of data at a series of interim analyses. The aim is to stop recruitment to the study as soon as there is sufficient evidence to reach a firm conclusion. In this paper we present the advantages and disadvantages of conducting interim analyses in phase III clinical trials, together with the key steps to enable the successful implementation of sequential methods in this setting. Examples are given of completed trials, which have been carried out sequentially, and references to relevant literature and software are provided.

Stopping rules for phase II studies

This paper, the second in a series of three papers concerned with the statistical aspects of interim analyses in clinical trials, is concerned with stopping rules in phase II clinical trials. Phase II trials are generally small-scale studies, and may include one or more experimental treatments with or without a control. A common feature is that the results primarily determine the course of further clinical evaluation of a treatment rather than providing definitive evidence of treatment efficacy. This means that there is more flexibility available in the design and analysis of such studies than in phase III trials. This has led to a range of different approaches being taken to the statistical design of stopping rules for such trials. This paper briefly describes and compares the different approaches. In most cases the stopping rules can be described and implemented easily without knowledge of the detailed statistical and computational methods used to obtain the rules.

The combined influences of westerly phase of the quasi biennial oscillation and 11-year solar maximum conditions on the Northern Hemisphere extratropical winter circulation

The combined influences of the westerly phase of the quasi-biennial oscillation (QBO-W) and solar maximum (Smax) conditions on the Northern Hemisphere extratropical winter circulation are investigated using reanalysis data and Center for Climate System Research/National Institute for Environmental Studies chemistry climate model (CCM) simulations. The composite analysis for the reanalysis data indicates strengthened polar vortex in December followed by weakened polar vortex in February–March for QBO-W during Smax (QBO-W/Smax) conditions. This relationship need not be specific to QBO-W/Smax conditions but may just require strengthened vortex in December, which is more likely under QBO-W/Smax. Both the reanalysis data and CCM simulations suggest that dynamical processes of planetary wave propagation and meridional circulation related to QBO-W around polar vortex in December are similar in character to those related to Smax; furthermore, both processes may work in concert to maintain stronger vortex during QBO-W/Smax. In the reanalysis data, the strengthened polar vortex in December is associated with the development of north–south dipole tropospheric anomaly in the Atlantic sector similar to the North Atlantic oscillation (NAO) during December–January. The structure of the north–south dipole anomaly has zonal wavenumber 1 (WN1) component, where the longitude of anomalous ridge overlaps with that of climatological ridge in the North Atlantic in January. This implies amplification of the WN1 wave and results in the enhancement of the upward WN1 propagation from troposphere into stratosphere in January, leading to the weakened polar vortex in February–March. Although WN2 waves do not play a direct role in forcing the stratospheric vortex evolution, their tropospheric response to QBO-W/Smax conditions appears to be related to the maintenance of the NAO-like anomaly in the high-latitude troposphere in January. These results may provide a possible explanation for the mechanisms underlying the seasonal evolution of wintertime polar vortex anomalies during QBO-W/Smax conditions and the role of troposphere in this evolution.

Cacao swollen shoot virus in Nigeria: analysis of a pathogen and its vectors

Cacao swollen shoot virus (CSSV) causes the Cacao swollen shoot virus disease (CSSVD) and significantly reduces production in West African cacao. This study characterised the current status of the disease in the major cacao growing States in Nigeria and attempted a clarification on the manner of CSSV transmission. Two separate field surveys and sample collections were conducted in Nigeria in summer 2012 and spring 2013. PCR-based screening of cacao leaf samples and subsequent DNA sequencing showed that the disease continues to persist in Ondo and Oyo States and in new cacao sites in Abia, Akwa Ibom, Cross River and Edo States. Mealybug samples collected were identified using a robust approach involving environmental scanning electron microscopy, histology and DNA barcoding, which highlighted the importance of integrative taxonomy in the study. The results show that the genus Planococcus (Planococcus citri (Risso) and/or Planococcus minor (Maskell)) was the most abundant vector (73.5%) at the sites examined followed by Formicococcus njalensis (Laing) (19.0 %). In a laboratory study, the feeding behaviour of Pl. citri, Pseudococcus longispinus (Targioni-Tozzetti) and Pseudococcus viburni (Signoret) on cacao were investigated using electrical penetration graph (EPG) analysis. EPG waveforms reflecting intercellular stylet penetration (C), extracellular salivation (E1e), salivation in sieve elements (E1), phloem ingestion (E2), derailed stylet mechanics (F), xylem ingestion (G) and non-probing phase (Np) were analysed. Individual mealybugs exhibited marked variation within species and significantly differed (p ≤ .05) between species for E1e and E1. PCR-based assessments of the retention time for CSSV in viruliferous Pl. citri, Ps. longispinus and Ps. viburni fed on a non-cacao diet showed that CSSV was still detectable after 144 hours. These unusually long durations for a pathogen currently classified as a semi-persistent virus have implications for the design of non-malvaceous barrier crops currently being considered for the protection of new cacao plantings.

Phase transitions of cassava starch dispersions prepared with glycerol solutions

The aim of this work was to study the glass transition, the glass transition of the maximally freeze-concentrated fractions, the ice melting and the gelatinization phenomenon in dispersions of starch prepared using glycerol- water solutions. The starch concentration was maintained constant at 50 g cassava starch/100 g starch dispersions, but the concentration of the glycerol solutions was variable (C-g= 20, 40, 60, 80 and 100 mass/mass%). The phase transitions of these dispersions were studied by calorimetric methods, using a conventional differential scanning calorimeter (DSC) and a more sensitive equipment (micro-DSC). Apparently, in the glycerol diluted solutions (20 and 40%), the glycerol molecules interacted strongly with the glucose molecules of starch. While in the more concentrated glycerol domains (C-g> 40%), the behaviour was controlled by migration of water molecules from the starch granules, due to a hypertonic character of glycerol, which affected all phase transitions.

Non-stationary frequency analysis of extreme daily rainfall in Sao Paulo, Brazil

This work is an assessment of frequency of extreme values (EVs) of daily rainfall in the city of Sao Paulo. Brazil, over the period 1933-2005, based on the peaks-over-threshold (POT) and Generalized Pareto Distribution (GPD) approach. Usually. a GPD model is fitted to a sample of POT Values Selected With a constant threshold. However. in this work we use time-dependent thresholds, composed of relatively large p quantities (for example p of 0.97) of daily rainfall amounts computed from all available data. Samples of POT values were extracted with several Values of p. Four different GPD models (GPD-1, GPD-2, GPD-3. and GDP-4) were fitted to each one of these samples by the maximum likelihood (ML) method. The shape parameter was assumed constant for the four models, but time-varying covariates were incorporated into scale parameter of GPD-2. GPD-3, and GPD-4, describing annual cycle in GPD-2. linear trend in GPD-3, and both annual cycle and linear trend in GPD-4. The GPD-1 with constant scale and shape parameters is the simplest model. For identification of the best model among the four models WC used rescaled Akaike Information Criterion (AIC) with second-order bias correction. This criterion isolates GPD-3 as the best model, i.e. the one with positive linear trend in the scale parameter. The slope of this trend is significant compared to the null hypothesis of no trend, for about 98% confidence level. The non-parametric Mann-Kendall test also showed presence of positive trend in the annual frequency of excess over high thresholds. with p-value being virtually zero. Therefore. there is strong evidence that high quantiles of daily rainfall in the city of Sao Paulo have been increasing in magnitude and frequency over time. For example. 0.99 quantiles of daily rainfall amount have increased by about 40 mm between 1933 and 2005. Copyright (C) 2008 Royal Meteorological Society

Multivariate analysis of the energy cycle of the South American rainy season

The South American (SA) rainy season is studied in this paper through the application of a multivariate Empirical Orthogonal Function (EOF) analysis to a SA gridded precipitation analysis and to the components of Lorenz Energy Cycle (LEC) derived from the National Centers for Environmental Prediction (NCEP) reanalysis. The EOF analysis leads to the identification of patterns of the rainy season and the associated mechanisms in terms of their energetics. The first combined EOF represents the northwest-southeast dipole of the precipitation between South and Central America, the South American Monsoon System (SAMS). The second combined EOF represents a synoptic pattern associated with the SACZ (South Atlantic convergence zone) and the third EOF is in spatial quadrature to the second EOF. The phase relationship of the EOFs, as computed from the principal components (PCs), suggests a nonlinear transition from the SACZ to the fully developed SAMS mode by November and between both components describing the SACZ by September-October (the rainy season onset). According to the LEC, the first mode is dominated by the eddy generation term at its maximum, the second by both baroclinic and eddy generation terms and the third by barotropic instability previous to the connection to the second mode by September-October. The predominance of the different LEC components at each phase of the SAMS can be used as an indicator of the onset of the rainy season in terms of physical processes, while the existence of the outstanding spectral peaks in the time dependence of the EOFs at the intraseasonal time scale could be used for monitoring purposes. Copyright (C) 2009 Royal Meteorological Society

Bayesian analysis and constraints on kinematic models from union SNIa

The kinematic expansion history of the universe is investigated by using the 307 supernovae type Ia from the Union Compilation set. Three simple model parameterizations for the deceleration parameter ( constant, linear and abrupt transition) and two different models that are explicitly parametrized by the cosmic jerk parameter ( constant and variable) are considered. Likelihood and Bayesian analyses are employed to find best fit parameters and compare models among themselves and with the flat Lambda CDM model. Analytical expressions and estimates for the deceleration and cosmic jerk parameters today (q(0) and j(0)) and for the transition redshift (z(t)) between a past phase of cosmic deceleration to a current phase of acceleration are given. All models characterize an accelerated expansion for the universe today and largely indicate that it was decelerating in the past, having a transition redshift around 0.5. The cosmic jerk is not strongly constrained by the present supernovae data. For the most realistic kinematic models the 1 sigma confidence limits imply the following ranges of values: q(0) is an element of [-0.96, -0.46], j(0) is an element of [-3.2,-0.3] and z(t) is an element of [0.36, 0.84], which are compatible with the Lambda CDM predictions, q(0) = -0.57 +/- 0.04, j(0) = -1 and z(t) = 0.71 +/- 0.08. We find that even very simple kinematic models are equally good to describe the data compared to the concordance Lambda CDM model, and that the current observations are not powerful enough to discriminate among all of them.

Early Phase of Allergic Airway Inflammation in Diabetic Rats: Role of Insulin on the Signaling Pathways and Mediators

Background: Allergic lung inflammation is impaired in diabetic rats and is restored by insulin treatment. In the present study we investigated the effect of insulin on the signaling pathways triggered by allergic inflammation in the lung and the release of selected mediators. Methods: Diabetic male Wistar rats (alloxan, 42 mg/kg, i.v., 10 days) and matching controls were sensitized by s.c. injections of ovalbumin (OA) in aluminium hydroxide, 14 days before OA (1 mg/0.4 ml) or saline intratracheal challenge. A group of diabetic rats were treated with neutral protamine Hagedorn insulin (NPH, 4 IU, s.c.), 2 h before the OA challenge. Six hours after the challenge, bronchoalveolar lavage (BAL) was performed for mediator release and lung tissue was homogenized for Western blotting analysis of signaling pathways. Results: Relative to non-diabetic rats, the diabetic rats exhibited a significant reduction in OA-induced phosphorylation of the extracellular signal-regulated kinase (ERK, 59%), p38 (53%), protein kinase B (Akt, 46%), protein kinase C (PKC)-alpha (63%) and PKC-delta (38%) in lung homogenates following the antigen challenge. Activation of the NF-kappa B p65 subunit and phosphorylation of I kappa B alpha were almost suppressed in diabetic rats. Reduced expression of inducible nitric oxide synthase (iNOS, 32%) and cyclooxygenase-2 (COX-2, 46%) in the lung homogenates was also observed. The BAL concentration of prostaglandin (PG)-E(2), nitric oxide (NO) and interleukin (IL)-6 was reduced in diabetic rats (74%, 44% and 65%, respectively), whereas the cytokine-induced neutrophil chemoattractant (CINC)-2 concentration was not different from the control animals. Treatment of diabetic rats with insulin completely or partially restored all of these parameters. This protocol of insulin treatment only partially reduced the blood glucose levels. Conclusion: The data presented show that insulin regulates MAPK, PI3K, PKC and NF-kappa B pathways, the expression of the inducible enzymes iNOS and COX-2, and the levels of NO, PGE(2) and IL-6 in the early phase of allergic lung inflammation in diabetic rats. It is suggested that insulin is required for optimal transduction of the intracellular signals that follow allergic stimulation. Copyright (C) 2010 S. Karger AG, Basel

Phase portraits of quadratic polynomial vector fields having a rational first integral of degree 3

In this paper, we classify all the global phase portraits of the quadratic polynomial vector fields having a rational first integral of degree 3. (C) 2008 Elsevier Ltd. All rights reserved.

Chaotic phase synchronization and desynchronization in an oscillator network for object selection

Object selection refers to the mechanism of extracting objects of interest while ignoring other objects and background in a given visual scene. It is a fundamental issue for many computer vision and image analysis techniques and it is still a challenging task to artificial Visual systems. Chaotic phase synchronization takes place in cases involving almost identical dynamical systems and it means that the phase difference between the systems is kept bounded over the time, while their amplitudes remain chaotic and may be uncorrelated. Instead of complete synchronization, phase synchronization is believed to be a mechanism for neural integration in brain. In this paper, an object selection model is proposed. Oscillators in the network representing the salient object in a given scene are phase synchronized, while no phase synchronization occurs for background objects. In this way, the salient object can be extracted. In this model, a shift mechanism is also introduced to change attention from one object to another. Computer simulations show that the model produces some results similar to those observed in natural vision systems.

Many-body energy decomposition of hydrogen-bonded glycine clusters in gas-phase

A detailed analysis of the many-body contribution to the interaction energies of the gas-phase hydrogen-bonded glycine clusters, (Gly)(N), N = 1-4 is presented. The energetics of the hydrogen-bonded dimer, trimer and tetramer complexes have been analyzed using density-functional theory. The magnitude of the two-through four-body energy terms have been calculated and compared. The relaxation energy and the two-body energy terms are the principal contributors to the total binding energy. Four-body contribution is negligible. However, the three-body contribution is found to be sizable and the formation of the cyclic glycine trimer presents geometric strains that make it less favorable. (C) 2010 Elsevier B.V. All rights reserved.