Science and society: genetic counselling and customary consanguineous marriage

Consanguineous marriage is customary in many societies, but leads to an increased birth prevalence of infants with severe recessive disorders. It is therefore often proposed that consanguineous marriage should be discouraged on medical grounds. However, several expert groups have pointed out that this proposal is inconsistent with the ethical principles of genetic counselling, overlooks the social importance of consanguineous marriage and is ineffective. Instead, they suggest that the custom increases the possibilities for effective genetic counselling, and recommend a concerted effort to identify families at increased risk, and to provide them with risk information and carrier testing when feasible.     

Robust and efficient design of experiments for the Monod model

In this paper the problem of designing experiments for the Monod model, which is frequently used in microbiology, is studied. The model is defined implicitly by a differential equation and has numerous applications in microbial growth kinetics, environmental research, pharmacokinetics, and plant physiology. The designs presented so far in the literature are local optimal designs, which depend sensitively on a preliminary guess of the unknown parameters, and are for this reason in many cases not robust with respect to their misspecification. Uniform designs and maximin optimal designs are considered as a strategy to obtain robust and efficient designs for parameter estimation. In particular, standardized maximin D- and E-optimal designs are determined and compared with uniform designs, which are usually applied in these microbiological models. It is demonstrated that maximin optimal designs are substantially more efficient than uniform designs. Parameter variances can be decreased by a factor of two by simply sampling at optimal times during the experiment. Moreover, the maximin optimal designs usually provide the possibility for the experimenter to check the model assumptions, because they have more support points than parameters in the Monod model.     

The expected efficiencies of some methods of selection of components for inter-genotypic mixtures

Summary The gains in yields of mixtures expected to follow various methods of selection of components from populations of randomly constituted mixtures are formulated in terms of a statistical model and a model of first-order inter-plant competition. The types of selection investigated include that among whole mixtures and among groups or individual components on a within-mixture or unrestricted basis, or on the basis of the yields of sets of mixtures to which the group or individual is common. In all cases the sizes of mixture used for selection and for measurement of gain may differ. While evaluation of components in groups or whole mixtures allows selection for component interactions, gains are lower overall because of the reduction in variance caused by grouping. Gains due to interaction are lost if the components are pooled after selection, as in a population improvement programme. Individual selection carries some risk of negative gains, but these are reduced if assessment is made on an unrestricted rather than within-mixture basis. When second and higher order competitive interactions are absent, monoculture assessment is expected to be an efficient means of selection of components for binary and tertiary mixtures.     

Do Embryos Have Interests? Why Embryos Are Identical to Future Persons but Not Harmed by Death

Are embryos deserving of moral consideration in our actions? A standard view suggests that embryos are considerable only if they have interests. One argument for embryonic interests contends that embryos are harmed by death because they are deprived of valuable future lives as adult persons. Some have challenged this argument on the grounds that embryos aren’t identical to adults: either due to the potential for embryos to twin or because we do not exist until the fetus develops consciousness. These arguments fail to show that embryos do not have future adult lives. There is a better reason to think that embryos cannot have interests; namely, because they are not capable of having desires. Others have held this view but have not sufficiently justified it. The justification lies in the fact that the capacity for desires is necessary to make sense of the normativity of interests.     

N-estimation from retrospectively ascertained events with applications to AIDS.

It is a common sampling scheme in retrospective studies that the data set includes only individuals who satisfy a certain sampling criterion. In this paper we consider the situation when the sampling criterion is a specified event, and assume that an earlier event can be retrospectively identified given the occurrence of the specified event. A semiparametric method, which is a compromise between nonparametric and parametric methods, is employed for the estimation of the expected number of the specified events (namely, the N-estimation) occurring in arbitrarily given intervals. A number of statistical properties of the estimates are developed. Due to the limitation of semiparametric models, our estimates should be regarded as conservative estimates since in general they underestimate the actual number of the specified events. This type of limitation, however, cannot be avoided with nonparametric or semiparametric models. Applications to acquired immunodeficiency syndrome (AIDS) cases are considered. The blood transfusion AIDS cases reported to the Centers for Disease Control are analyzed in detail.     

Health care as a right, fairness and medical resources

Our intention in the following is to use the WHO declaration as a basis for considering the allocation of resources in health care. We shall first argue that most of the criteria suggested as grounds for fair allocation of scarce medical resources have their difficulties if one tries to apply them one by one to medical practices. We shall then go on to claim that, if we take the right of all human beings to health or health care even moderately seriously, increasing the resources would in most cases be more ethical than attempting to allocate them 'fairly'.     

Linked Cross Sectional Schemes for Estimating Growth of Children

For estimation of growth, the efficiency of linked cross sectional scheme has been compared with pure longitudinal and cross sectional schemes. The relevant estimation theory has been developed and the expressions for the optimum estimators alongwith their variances have been derived. It has been observed that for estimation of growth, the linked cross-sectional scheme has been observed to be less efficient as compared to pure longitudinal scheme but more efficient than pure cross-sectional scheme.     

Parsimony and explanatory power

Parsimony can be related to explanatory power, either by noting that each additional requirement for a separate origin of a feature reduces the number of observed similarities that can be explained as inheritance from a common ancestor; or else by applying Popper’s formula for explanatory power together with the fact that parsimony yields maximum likelihood trees under No Common Mechanism (NCM). Despite deceptive claims made by some likelihoodists, most maximum likelihood methods cannot be justified in this way because they rely on unrealistic background assumptions. These facts have been disputed on the various grounds that ad hoc hypotheses of homoplasy are explanatory, that they are not explanatory, that character states are ontological individuals, that character data do not comprise evidence, that unrealistic theories can be used as background knowledge, that NCM is unrealistic, and that likelihoods cannot be used to evaluate explanatory power. None of these objections is even remotely well founded, and indeed most of them do not even seem to have been meant seriously, having instead been put forward merely to obstruct the development of phylogenetic methods. © The Willi Hennig Society 2008.     

Detection of Nonrandom Association of Alleles from the Distribution of the Number of Heterozygous Loci in a Sample

The distribution of the number of heterozygous loci in two randomly chosen gametes or in a random diploid zygote provides information regarding the nonrandom association of alleles among different genetic loci. Two alternative statistics may be employed for detection of nonrandom association of genes of different loci when observations are made on these distributions: observed variance of the number of heterozygous loci (s2k) and a goodness-of-fit criterion (X2) to contrast the observed distribution with that expected under the hypothesis of random association of genes. It is shown, by simulation, that s2k is statistically more efficient than X2 to detect a given extent of nonrandom association. Asymptotic normality of s2k is justified, and X2 is shown to follow a chi-square (chi 2) distribution with partial loss of degrees of freedom arising because of estimation of parameters from the marginal gene frequency data. Whenever direct evaluations of linkage disequilibrium values are possible, tests based on maximum likelihood estimators of linkage disequilibria require a smaller sample size (number of zygotes or gametes) to detect a given level of nonrandom association in comparison with that required if such tests are conducted on the basis of s2k. Summarization of multilocus genotype (or haplotype) data, into the different number of heterozygous loci classes, thus, amounts to appreciable loss of information.     

Effect of nitrogen fertilization and cropping on the composition and amount of the soil-organic-matter extracted with formic acid

Summary A calcareous meadow soil was treated with urea at three levels in pots with and without a crop of maize. Results showed no significant change in the amounts or composition of the first organic-matter fraction (extracted with 98% formic acid), but urea addition caused significant decrease (at 5% level) in the yield and nitrogen of the second fraction (extracted with hydrofluoric acid). As expected the yields and nitrogen contents of the maize crop grown for seven weeks generally increased with increasing rates of nitrogen fertilization.     

Modelling studies to estimate the prevalence of foot-and-mouth disease carriers after reactive vaccination

Foot-and-mouth disease (FMD) is a highly contagious and economically significant viral disease of cloven-hoofed animals. Vaccination can be used to help restrict the spread of the infection, but evidence must be provided to show that the infection has been eradicated in order to regain the FMD-free status. While serological tests have been developed, which can identify animals that have been infected regardless of vaccination status, it is vital to know the probable prevalence of herds with FMD carriers and the within-herd prevalence of those carriers in order to design efficient post-epidemic surveillance strategies that establish freedom from disease. Here, we present the results of a study to model the expected prevalence of carriers after application of emergency vaccination and the impact of this on the sensitivity of test systems for their detection. Results showed that the expected prevalence of carrier-containing herds after reactive vaccination is likely to be very low, approximately 0.2%, and there will only be a small number of carriers, most likely one, in the positive herds. Therefore, sensitivity for carrier detection can be optimized by adopting an individual-based testing regime in which all animals in all vaccinated herds are tested and positive animals rather than herds are culled.     

Test‐compatible confidence intervals for adaptive two‐stage single‐arm designs with binary endpoint

Inference after two‐stage single‐arm designs with binary endpoint is challenging due to the nonunique ordering of the sampling space in multistage designs. We illustrate the problem of specifying test‐compatible confidence intervals for designs with nonconstant second‐stage sample size and present two approaches that guarantee confidence intervals consistent with the test decision. Firstly, we extend the well‐known Clopper–Pearson approach of inverting a family of two‐sided hypothesis tests from the group‐sequential case to designs with fully adaptive sample size. Test compatibility is achieved by using a sample space ordering that is derived from a test‐compatible estimator. The resulting confidence intervals tend to be conservative but assure the nominal coverage probability. In order to assess the possibility of further improving these confidence intervals, we pursue a direct optimization approach minimizing the mean width of the confidence intervals. While the latter approach produces more stable coverage probabilities, it is also slightly anti‐conservative and yields only negligible improvements in mean width. We conclude that the Clopper–Pearson‐type confidence intervals based on a test‐compatible estimator are the best choice if the nominal coverage probability is not to be undershot and compatibility of test decision and confidence interval is to be preserved.     

Sequential sampling: a novel method in farm animal welfare assessment

Lameness in dairy cows is an important welfare issue. As part of a welfare assessment, herd level lameness prevalence can be estimated from scoring a sample of animals, where higher levels of accuracy are associated with larger sample sizes. As the financial cost is related to the number of cows sampled, smaller samples are preferred. Sequential sampling schemes have been used for informing decision making in clinical trials. Sequential sampling involves taking samples in stages, where sampling can stop early depending on the estimated lameness prevalence. When welfare assessment is used for a pass/fail decision, a similar approach could be applied to reduce the overall sample size. The sampling schemes proposed here apply the principles of sequential sampling within a diagnostic testing framework. This study develops three sequential sampling schemes of increasing complexity to classify 80 fully assessed UK dairy farms, each with known lameness prevalence. Using the Welfare Quality herd-size-based sampling scheme, the first ‘basic’ scheme involves two sampling events. At the first sampling event half the Welfare Quality sample size is drawn, and then depending on the outcome, sampling either stops or is continued and the same number of animals is sampled again. In the second ‘cautious’ scheme, an adaptation is made to ensure that correctly classifying a farm as ‘bad’ is done with greater certainty. The third scheme is the only scheme to go beyond lameness as a binary measure and investigates the potential for increasing accuracy by incorporating the number of severely lame cows into the decision. The three schemes are evaluated with respect to accuracy and average sample size by running 100 000 simulations for each scheme, and a comparison is made with the fixed size Welfare Quality herd-size-based sampling scheme. All three schemes performed almost as well as the fixed size scheme but with much smaller average sample sizes. For the third scheme, an overall association between lameness prevalence and the proportion of lame cows that were severely lame on a farm was found. However, as this association was found to not be consistent across all farms, the sampling scheme did not prove to be as useful as expected. The preferred scheme was therefore the ‘cautious’ scheme for which a sampling protocol has also been developed.     

The Social Value Requirement Reconsidered

It is widely assumed that it is ethical to conduct research with human subjects only if the research has social value. There are two standard arguments for this view. The allocation argument claims that public funds should not be devoted to research that lacks social value. The exploitation avoidance argument claims that subjects are exploited if research has no social value. The primary purpose of this article is to argue that these arguments do not succeed. The allocation argument has little relevance to commercial research. Social value is not necessary to avoid exploitation if subjects benefit from participation. Although the standard arguments for a social value requirement do not succeed, that view might be justified in a different way. It might be justified by appeal to the importance of social trust or the integrity of physician investigators. It is possible but doubtful that these arguments succeed.     

Therapeutic aerosols in children.

The use and variety of drugs administered to children as inhaled aerosols is increasing, but little is known about how much drug reaches the lung and how it is distributed there in different age groups. In this article the reasons for measuring aerosol deposition in children are discussed and the potential methods for doing this described. Of the methods available, only the use of radiolabelled aerosols gives accurate information on total lung deposition and distribution. The potential risk of the radiation exposure required for these measurements varies with the age of the child but seems to be small. Properly designed studies are expected to clarify the factors affecting lung deposition in children and identify methods of inhalation associated with efficient and predictable delivery of the drug. Measurements of radioaerosol deposition may therefore be justified in children when this information is expected to lead to improvements in the effectiveness or safety of their treatment.     

Efficiency of haplotype frequency estimation when nuclear family information is included

In genetic studies the haplotype structure of the regarded population is expected to carry important information. Experimental methods to derive haplotypes, however, are expensive and none of them has yet become standard methodology. On the other hand, maximum likelihood haplotype estimation from unphased individual genotypes may incur inaccuracies. We therefore investigated the relative efficiency of haplotype frequency estimation when nuclear family information is included compared to estimation from experimentally derived haplotypes. Efficiency was measured in terms of variance ratios of the estimates. The variances were derived from the binomial distribution for experimentally derived haplotypes, and from the Fisher information matrix corresponding to the general likelihood function of the haplotype frequency parameters, including family information. We subsequently compared these variance ratios to the variance ratios for the case of estimation from individual genotypes. We found that the information gained from a single child compensates missing phase information to a high degree, resulting in estimates almost as reliable as those derived from observed haplotypes. Thus, if children have already been genotyped for other reasons, it is highly recommendable to include them into the estimation. If child information is not already present, it depends on the number of loci and the haplotype diversity if it is useful to genotype a single child just to reduce phase ambiguity. In general, if the number of loci is less than or equal to three or if the number of haplotypes with a frequency >5% is less than or equal to four, haplotype estimation from individuals is quite good already and the improvement gained from a single child can not compensate the genotyping effort for it. On the other hand, under scenarios with many loci and high haplotype diversity, haplotype frequency estimation from trios can be more efficient than haplotype frequency estimation from individuals also on a per genotype base.     

Antibiotic resistance as a tragedy of the commons: An ethical argument for a tax on antibiotic use in humans

To the extent that antibiotic resistance (ABR) is accelerated by antibiotic consumption and that it represents a serious public health emergency, it is imperative to drastically reduce antibiotic consumption, particularly in high‐income countries. I present the problem of ABR as an instance of the collective action problem known as ‘tragedy of the commons’. I propose that there is a strong ethical justification for taxing certain uses of antibiotics, namely when antibiotics are required to treat minor and self‐limiting infections, such as respiratory tract infections, in otherwise healthy individuals. Taxation would allow a reduction in consumption (given certain behavioural economics assumptions) and/or ensure that individuals internalize or compensate for their contribution to the erosion of the common good of antibiotic effectiveness. I suggest that revenue from the tax could be used to fund conservation and innovation strategies. Taxation might be a coercive policy, especially for certain individuals, but the ethical case for coercive policies is very strong when the good to be preserved is important enough and when they force individuals to do something they have a moral obligation to do anyway. I argue that, in the case of mild and self‐limiting infections, individuals have a moral duty of easy rescue and a moral duty of fairness to make their contribution to the preservation of the common good of antibiotic effectiveness by foregoing antibiotics. I also suggest that taxing antibiotics in such cases is an all things considered ethically justified policy even if it would introduce inequalities in access to healthcare.     

Huntington's disease. Contribution of clinical and epidemiological data to genetic counseling

From a regional survey (northwestern part of France 3,9 millions population) and from recent publications, the authors described clinical and epidemiologic aspects useful for genetic counselling. Besides the chronic chorea, the other clinical features justified the denomination "Huntington's disease". Misdiagnosis is frequent especially if the familial disorder is unknown. A prevalence of 50 X 10(-6) corresponds to 2750 choreics and 14.000 at risk descendants in France. Interfamilial heterogeneity is described from mean age of death which is 54.2 for the whole study: one third of families of late onset, around fifty (mean age of death: 64.6), one third of early onset, around thirty (mean age of death: 44.6). The 17 juvenile and infantile cases of the survey belong to this last group. The influence of gene-transmitters sex is more obvious if two generations are taken in account with a preponderance of fathers and grand-fathers in the early onset group and, to a lesser degree, of mothers and grand-mothers in the late onset group. The authors criticize the preclinical detection tests and, from attitudes of families, underline the ethical problems for the future predictive tests by genetic markers. The role of lay organisations is all the more important.