Design, conduct, and analyses of Breast International Group (BIG) 1-98: a randomized, double-blind, phase-III study comparing letrozole and tamoxifen as adjuvant endocrine therapy for postmenopausal women with receptor-positive, early breast cancer.

BACKGROUND: Aromatase inhibitors provide superior disease control when compared with tamoxifen as adjuvant therapy for postmenopausal women with endocrine-responsive early breast cancer. PURPOSE: To present the design, history, and analytic challenges of the Breast International Group (BIG) 1-98 trial: an international, multicenter, randomized, double-blind, phase-III study comparing the aromatase inhibitor letrozole with tamoxifen in this clinical setting. METHODS: From 1998-2003, BIG 1-98 enrolled 8028 women to receive monotherapy with either tamoxifen or letrozole for 5 years, or sequential therapy of 2 years of one agent followed by 3 years of the other. Randomization to one of four treatment groups permitted two complementary analyses to be conducted several years apart. The first, reported in 2005, provided a head-to-head comparison of letrozole versus tamoxifen. Statistical power was increased by an enriched design, which included patients who were assigned sequential treatments until the time of the treatment switch. The second, reported in late 2008, used a conditional landmark approach to test the hypothesis that switching endocrine agents at approximately 2 years from randomization for patients who are disease-free is superior to continuing with the original agent. RESULTS: The 2005 analysis showed the superiority of letrozole compared with tamoxifen. The patients who were assigned tamoxifen alone were unblinded and offered the opportunity to switch to letrozole. Results from other trials increased the clinical relevance about whether or not to start treatment with letrozole or tamoxifen, and analysis plans were expanded to evaluate sequential versus single-agent strategies from randomization. LIMITATIONS: Due to the unblinding of patients assigned tamoxifen alone, analysis of updated data will require ascertainment of the influence of selective crossover from tamoxifen to letrozole. CONCLUSIONS: BIG 1-98 is an example of an enriched design, involving complementary analyses addressing different questions several years apart, and subject to evolving analytic plans influenced by new data that emerge over time.

Virtual Communities of Practice: Design and Development of Support Platforms and Participation Fostering

Mestrado em Engenharia Informática - Área de Especialização em Sistemas Gráficos e Multimédia

SPf66 vaccine trial in Brazil: conceptual framework study design and analytical approach

This paper describes the study population and the study design of the phase III field trial of the SPf66 vaccine in Brazil. Assessment of validity and precision principles necessary for the appropriate evaluation of the protective effect of the vaccine are discussed, as well as the results of the preliminary analyses of the gathered data. The analytical approach for the estimation of the protective effect of the vaccine is presented. This paper provides the conceptual framework for future publications.

Design and evaluation of a solid sampler for the monitoring of airborne 1,6-hexamethylene diisocyanate (HDI) and its prepolymers in 2-component spray painting

An active, solvent-free solid sampler was developed for the collection of 1,6-hexamethylene diisocyanate (HDI) aerosol and prepolymers. The sampler was made of a filter impregnated with 1-(2-methoxyphenyl)piperazine contained in a filter holder. Interferences with HDI were observed when a set of cellulose acetate filters and a polystyrene filter holder were used; a glass fiber filter and polypropylene filter cassette gave better results. The applicability of the sampling and analytical procedure was validated with a test chamber, constructed for the dynamic generation of HDI aerosol and prepolymers in commercial two-component spray paints (Desmodur(R) N75) used in car refinishing. The particle size distribution, temporal stability, and spatial uniformity of the simulated aerosol were established in order to test the sample. The monitoring of aerosol concentrations was conducted with the solid sampler paired to the reference impinger technique (impinger flasks contained 10 mL of 0.5 mg/mL 1-(2-methoxyphenyl)piperazine in toluene) under a controlled atmosphere in the test chamber. Analyses of derivatized HDI and prepolymers were carried out by using high-performance liquid chromatography and ultraviolet detection. The correlation between the solvent-free and the impinger techniques appeared fairly good (Y = 0.979X - 0.161; R = 0.978), when the tests were conducted in the range of 0.1 to 10 times the threshold limit value (TLV) for HDI monomer and up to 60-mu-g/m3 (3 U.K. TLVs) for total -N = C = O groups.

The stomach cancer pooling (StoP) project: study design and presentation.

Gastric cancer affects about one million people per year worldwide, being the second leading cause of cancer mortality. The study of its etiology remains therefore a global issue as it may allow the identification of major targets, besides eradication of Helicobacter pylori infection, for primary prevention. It has however received little attention, given its comparatively low incidence in most high-income countries. We introduce a consortium of epidemiological investigations named the 'Stomach cancer Pooling (StoP) Project'. Twenty-two studies agreed to participate, for a total of over 9000 cases and 23 000 controls. Twenty studies have already shared the original data set. Of the patients, 40% are from Asia, 43% from Europe, and 17% from North America; 34% are women and 66% men; the median age is 61 years; 56% are from population-based case-control studies, 41% from hospital-based ones, and 3% from nested case-control studies derived from cohort investigations. Biological samples are available from 12 studies. The aim of the StoP Project is to analyze the role of lifestyle and genetic determinants in the etiology of gastric cancer through pooled analyses of individual-level data. The uniquely large data set will allow us to define and quantify the main effects of each risk factor of interest, including a number of infrequent habits, and to adequately address associations in subgroups of the population, as well as interaction within and between environmental and genetic factors. Further, we will carry out separate analyses according to different histotypes and subsites of gastric cancer, to identify potential different risk patterns and etiological characteristics.

Design and establishment of a biobank in a multicenter prospective cohort study of elderly patients with venous thromboembolism (SWITCO65+).

In the field of thrombosis and haemostasis, many preanalytical variables influence the results of coagulation assays and measures to limit potential results variations should be taken. To our knowledge, no paper describing the development and maintenance of a haemostasis biobank has been previously published. Our description of the biobank of the Swiss cohort of elderly patients with venous thromboembolism (SWITCO65+) is intended to facilitate the set-up of other biobanks in the field of thrombosis and haemostasis. SWITCO65+ is a multicentre cohort that prospectively enrolled consecutive patients aged ≥65 years with venous thromboembolism at nine Swiss hospitals from 09/2009 to 03/2012. Patients will be followed up until December 2013. The cohort includes a biobank with biological material from each participant taken at baseline and after 12 months of follow-up. Whole blood from all participants is assayed with a standard haematology panel, for which fresh samples are required. Two buffy coat vials, one PAXgene Blood RNA System tube and one EDTA-whole blood sample are also collected at baseline for RNA/DNA extraction. Blood samples are processed and vialed within 1 h of collection and transported in batches to a central laboratory where they are stored in ultra-low temperature archives. All analyses of the same type are performed in the same laboratory in batches. Using multiple core laboratories increased the speed of sample analyses and reduced storage time. After recruiting, processing and analyzing the blood of more than 1,000 patients, we determined that the adopted methods and technologies were fit-for-purpose and robust.

Design and implementation of a multipurpose reactor for scale-up studies

In the theoretical part, the different polymerisation catalysts are introduced and the phenomena related to mixing in the stirred tank reactor are presented. Also the advantages and challenges related to scale-up are discussed. The aim of the applied part was to design and implement an intermediate-sized reactor useful for scale-up studies. The reactor setting was tested making one batch of Ziegler–Natta polypropylene catalyst. The catalyst preparation with a designed equipment setting succeeded and the catalyst was analysed. The analyses of the catalyst were done, because the properties of the catalyst were compared to the normal properties of Ziegler–Natta polypropylene catalyst. The total titanium content of the catalyst was slightly higher than in normal Ziegler–Natta polypropylene catalyst, but the magnesium and aluminium content of the catalyst were in the normal level. By adjusting the siphonation tube and adding one washing step the titanium content of the catalyst could be decreased. The particle size of the catalyst was small, but the activity was in a normal range. The size of the catalyst particles could be increased by decreasing the stirring speed. During the test run, it was noticed that some improvements for the designed equipment setting could be done. For example more valves for the chemical feed line need to be added to ensure inert conditions during the catalyst preparation. Also nitrogen for the reactor needs to separate from other nitrogen line. With this change the pressure in the reactor can be kept as desired during the catalyst preparation. The proposals for improvements are presented in the applied part. After these improvements are done, the equipment setting is ready for start-up. The computational fluid dynamics model for the designed reactor was provided by cooperation with Lappeenranta University of Technology. The experiments showed that for adequate mixing with one impeller, stirring speed of 600 rpm is needed. The computational fluid dynamics model with two impellers showed that there was no difference in the mixing efficiency if the upper impeller were pumping downwards or upwards.

Design and analysis of a transversal-flux switched-reluctance-linear-machine pole-pair

The Switched Reluctance technology is probably best suited for industrial low-speed or zerospeed applications where the power can be small but the torque or the force in linear movement cases might be relatively high. Because of its simple structure the SR-motor is an interesting alternative for low power applications where pneumatic or hydraulic linear drives are to be avoided. This study analyses the basic parts of an LSR-motor which are the two mover poles and one stator pole and which form the “basic pole pair” in linear-movement transversal-flux switchedreluctance motors. The static properties of the basic pole pair are modelled and the basic design rules are derived. The models developed are validated with experiments. A one-sided one-polepair transversal-flux switched-reluctance-linear-motor prototype is demonstrated and its static properties are measured. The modelling of the static properties is performed with FEM-calculations. Two-dimensional models are accurate enough to model the static key features for the basic dimensioning of LSRmotors. Three-dimensional models must be used in order to get the most accurate calculation results of the static traction force production. The developed dimensioning and modelling methods, which could be systematically validated by laboratory measurements, are the most significant contributions of this thesis.

Design and formative evaluation of an information kiosk on cattle health for landless cattle owners

This paper describes and analyses the experience of designing, installing and evaluating a farmer-usable touch screen information kiosk on cattle health in a veterinary institution in Pondicherry. The contents of the kiosk were prepared based on identified demands for information on cattle health, arrived at through various stakeholders meetings. Information on these cattle diseases and conditions affecting the livelihoods of the poor was provided through graphics, text and audio back-up, keeping in mind the needs of landless and illiterate poor cattle owners. A methodology for kiosk evaluation based on the feedback obtained from kiosk facilitator, critical group reflection and individual users was formulated. The formative evaluation reveals the potential strength this ICT has in transferring information to the cattle owners in a service delivery centre. Such information is vital in preventing diseases and helps cattle owners to present and treat their animals at an early stage of disease condition. This in turn helps prevent direct and indirect losses to the cattle owners. The study reveals how an information kiosk installed at a government institution as a freely accessible source of information to all farmers irrespective of their class and caste can help in transfer of information among poor cattle owners, provided periodic updating, interactivity and communication variability are taken care of. Being in the veterinary centre, the kiosk helps stimulate dialogue, and facilitates demand of services based on the information provided by the kiosk screens.

Design and analysis of climate model experiments for the efficient estimation of anthropogenic signals

Presented herein is an experimental design that allows the effects of several radiative forcing factors on climate to be estimated as precisely as possible from a limited suite of atmosphere-only general circulation model (GCM) integrations. The forcings include the combined effect of observed changes in sea surface temperatures, sea ice extent, stratospheric (volcanic) aerosols, and solar output, plus the individual effects of several anthropogenic forcings. A single linear statistical model is used to estimate the forcing effects, each of which is represented by its global mean radiative forcing. The strong colinearity in time between the various anthropogenic forcings provides a technical problem that is overcome through the design of the experiment. This design uses every combination of anthropogenic forcing rather than having a few highly replicated ensembles, which is more commonly used in climate studies. Not only is this design highly efficient for a given number of integrations, but it also allows the estimation of (nonadditive) interactions between pairs of anthropogenic forcings. The simulated land surface air temperature changes since 1871 have been analyzed. The changes in natural and oceanic forcing, which itself contains some forcing from anthropogenic and natural influences, have the most influence. For the global mean, increasing greenhouse gases and the indirect aerosol effect had the largest anthropogenic effects. It was also found that an interaction between these two anthropogenic effects in the atmosphere-only GCM exists. This interaction is similar in magnitude to the individual effects of changing tropospheric and stratospheric ozone concentrations or to the direct (sulfate) aerosol effect. Various diagnostics are used to evaluate the fit of the statistical model. For the global mean, this shows that the land temperature response is proportional to the global mean radiative forcing, reinforcing the use of radiative forcing as a measure of climate change. The diagnostic tests also show that the linear model was suitable for analyses of land surface air temperature at each GCM grid point. Therefore, the linear model provides precise estimates of the space time signals for all forcing factors under consideration. For simulated 50-hPa temperatures, results show that tropospheric ozone increases have contributed to stratospheric cooling over the twentieth century almost as much as changes in well-mixed greenhouse gases.

Design and use of mobile technology in distance language education : Matching learning practices with technologies-in-practice

This thesis focuses on the adaptation of formal education to people’s technology- use patterns, theirtechnology-in-practice, where the ubiquitous use of mobile technologies is central. The research question is: How can language learning practices occuring in informal learning environments be effectively integrated with formal education through the use of mobile technology? The study investigates the technical, pedagogical, social and cultural challenges involved in a design science approach. The thesis consists of four studies. The first study systematises MALL (mobile-assisted language learning) research. The second investigates Swedish and Chinese students’ attitudes towards the use of mobile technology in education. The third examines students’ use of technology in an online language course, with a specific focus on their learning practices in informal learning contexts and their understanding of how this use guides their learning. Based on the findings, a specifically designed MALL application was built and used in two courses. Study four analyses the app use in terms of students’ perceived level of self-regulation and structuration. The studies show that technology itself plays a very important role in reshaping peoples’ attitudes and that new learning methods are coconstructed in a sociotechnical system. Technology’s influence on student practices is equally strong across borders. Students’ established technologies-in-practice guide the ways they approach learning. Hence, designing effective online distance education involves three interrelated elements: technology, information, and social arrangements. This thesis contributes to mobile learning research by offering empirically and theoretically grounded insights that shift the focus from technology design to design of information systems.

Design and Characterization of Silicone and Surfactant Based Systems for Topical Drug Delivery

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Distance software: design and analysis of distance sampling surveys for estimating population size

1. Distance sampling is a widely used technique for estimating the size or density of biological populations. Many distance sampling designs and most analyses use the software Distance. 2. We briefly review distance sampling and its assumptions, outline the history, structure and capabilities of Distance, and provide hints on its use. 3. Good survey design is a crucial prerequisite for obtaining reliable results. Distance has a survey design engine, with a built-in geographic information system, that allows properties of different proposed designs to be examined via simulation, and survey plans to be generated. 4. A first step in analysis of distance sampling data is modeling the probability of detection. Distance contains three increasingly sophisticated analysis engines for this: conventional distance sampling, which models detection probability as a function of distance from the transect and assumes all objects at zero distance are detected; multiple-covariate distance sampling, which allows covariates in addition to distance; and mark–recapture distance sampling, which relaxes the assumption of certain detection at zero distance. 5. All three engines allow estimation of density or abundance, stratified if required, with associated measures of precision calculated either analytically or via the bootstrap. 6. Advanced analysis topics covered include the use of multipliers to allow analysis of indirect surveys (such as dung or nest surveys), the density surface modeling analysis engine for spatial and habitat-modeling, and information about accessing the analysis engines directly from other software. 7. Synthesis and applications. Distance sampling is a key method for producing abundance and density estimates in challenging field conditions. The theory underlying the methods continues to expand to cope with realistic estimation situations. In step with theoretical developments, state-of- the-art software that implements these methods is described that makes the methods accessible to practicing ecologists.

Revisiting the Security of the ALRED Design and Two of Its Variants: Marvin and LetterSoup

The ALRED construction is a lightweight strategy for constructing message authentication algorithms from an underlying iterated block cipher. Even though this construction's original analyses show that it is secure against some attacks, the absence of formal security proofs in a strong security model still brings uncertainty on its robustness. In this paper, aiming to give a better understanding of the security level provided by different authentication algorithms based on this design strategy, we formally analyze two ALRED variants-the MARVIN message authentication code and the LETTERSOUP authenticated-encryption scheme,-bounding their security as a function of the attacker's resources and of the underlying cipher's characteristics.