Treadmill desks: A 1‐year prospective trial

Objective: Sedentariness is associated with weight gain and obesity. A treadmill desk is the combination of a standing desk and a treadmill that allow employees to work while walking at low speed. Design and Methods: The hypothesis was that a 1‐year intervention with treadmill desks is associated with an increase in employee daily physical activity (summation of all activity per minute) and a decrease in daily sedentary time (zero activity). Employees (n = 36; 25 women, 11 men) with sedentary jobs (87 ± 27 kg, BMI 29 ± 7 kg/m², n = 10 Lean BMI < 25 kg/m², n = 15 Overweight 25 < BMI < 30 kg/m², n = 11 Obese BMI > 30 kg/m²) volunteered to have their traditional desk replaced with a treadmill desk to promote physical activity for 1 year. Results: Daily physical activity (using accelerometers), work performance, body composition, and blood variables were measured at Baseline and 6 and 12 months after the treadmill desk intervention. Subjects who used the treadmill desk increased daily physical activity from baseline 3,353 ± 1,802 activity units (AU)/day to, at 6 months, 4,460 ± 2,376 AU/day (P < 0.001), and at 12 months, 4,205 ± 2,238 AU/day (P < 0.001). Access to the treadmill desks was associated with significant decreases in daily sedentary time (zero activity) from at baseline 1,020 ± 75 min/day to, at 6 months, 929 ± 84 min/day (P < 0.001), and at 12 months, 978 ± 95 min/day (P < 0.001). For the whole group, weight loss averaged 1.4 ± 3.3 kg (P < 0.05). Weight loss for obese subjects was 2.3 ± 3.5 kg (P < 0.03). Access to the treadmill desks was associated with increased daily physical activity compared to traditional chair‐based desks; their deployment was not associated with altered performance. For the 36 participants, fat mass did not change significantly, however, those who lost weight (n = 22) lost 3.4 ± 5.4 kg (P < 0.001) of fat mass. Weight loss was greatest in people with obesity. Conclusions: Access to treadmill desks may improve the health of office workers without affecting work performance.     

Comparison of design strategies for a three‐arm clinical trial with time‐to‐event endpoint: Power,time‐to‐analysis,and operational aspects

To optimize resources, randomized clinical trials with multiple arms can be an attractive option to simultaneously test various treatment regimens in pharmaceutical drug development. The motivation for this work was the successful conduct and positive final outcome of a three‐arm randomized clinical trial primarily assessing whether obinutuzumab plus chlorambucil in patients with chronic lympocytic lymphoma and coexisting conditions is superior to chlorambucil alone based on a time‐to‐event endpoint. The inference strategy of this trial was based on a closed testing procedure. We compare this strategy to three potential alternatives to run a three‐arm clinical trial with a time‐to‐event endpoint. The primary goal is to quantify the differences between these strategies in terms of the time it takes until the first analysis and thus potential approval of a new drug, number of required events, and power. Operational aspects of implementing the various strategies are discussed. In conclusion, using a closed testing procedure results in the shortest time to the first analysis with a minimal loss in power. Therefore, closed testing procedures should be part of the statistician's standard clinical trials toolbox when planning multiarm clinical trials.     

Effects of prenatal exposure to a 50‐Hz magnetic field on one‐trial passive avoidance learning in 1‐day‐old chicks

We investigated memory impairment in newly hatched chicks following in ovo exposure to a 50‐Hz magnetic field (MF) of 2 mT (60 min/day) on embryonic days 12–18. Isolated and paired chicks were used to test the effect of stress during training, and memory retention was tested at 10, 30, and 120 min, following exposure to a bitter‐tasting bead (100% methylanthranilate). Results showed that memory was intact at 10 min in both isolated and paired chicks with or without MF exposure. However, while isolated chicks had good memory retention levels at 30 and 120 min, those exposed to MF did not. The results suggest a potential disruption of memory formation following in ovo exposure to MF, with this effect only evident in the more stressed, isolated chicks. Bioelectromagnetics 31:150–155, 2010. © 2009 Wiley‐Liss, Inc.     

Sample size determination for testing nonequality under a three‐treatment two‐period incomplete block crossover trial

To reduce the lengthy duration of a crossover trial for comparing three treatments, the incomplete block design has been often considered. A sample size calculation procedure for testing nonequality between either of the two experimental treatments and a placebo under such a design is developed. To evaluate the performance of the proposed sample size calculation procedure, Monte Carlo simulation is employed. The accuracy of the sample size calculation procedure developed here is demonstrated in a variety of situations. As compared with the parallel groups design, a substantial proportional reduction in the total minimum required sample size in use of the incomplete block crossover design is found. A crossover trial comparing two different doses of formoterol with a placebo on the forced expiratory volume is applied to illustrate the use of the sample size calculation procedure.     

Beneficial effect of Burdock complex on asymptomatic Helicobacter pylori‐infected subjects: A randomized,double‐blind placebo‐controlled clinical trial

Background

Burdock complex (BC) constitutes of burdock (Arctium lappa), angelica (Angelica sinensis), gromwell (Lithospermum erythrorhizon), and sesame (Sesamum indicum) oil, which are commonly used in traditional Chinese medicine (TCM) for treating various disorders. This study intended to examine the anti‐H. pylori activity of BC on AGS cell model as well as in asymptomatic H. pylori‐infected subjects.

Materials and Methods

AGS cell incubated with H. pylori and treated with BC to evaluate the minimum inhibition concentration (MIC), cell viability (MTT) anti‐adhesion activity, and inflammatory markers. In case of clinical trial, H. pylori‐positive subjects (urea breath test [UBT] >10%, n = 36) were enrolled and requested to intake BC (n = 19) or placebo (n = 17) for 8 weeks. Antioxidant capacity, total phenol, UBT, inflammatory markers were analyzed at the initial, 4th, 8th, and 10th weeks. Moreover, the endoscopic examination was carried out on baseline and 10th week.

Results

In vitro studies showed that BC treatment significantly inhibited (P < .05) the inflammatory markers and adhesion of H. pylori to AGS cell. However, H. pylori‐infected subject ingested with BC for 8 weeks significantly decreased (P < .05) the UBT value, inflammatory markers with improved antioxidant activity, and phenolic levels as compared to placebo. Also, consumption of BC considerably healed the ulcer wound.

Conclusion

Overall, the BC could attenuate H. pylori infection by inhibiting H. pylori adhesion and subsequent inflammatory response on the gastric epithelial cell (AGS) as well as clinically ameliorated UBT, antioxidant capacity, and alleviated inflammation to display its anti‐H. pylori activity.     

Near‐natural methods promote restoration of species‐rich grassland vegetation—revisiting a road verge trial after 9 years

The present loss of species‐rich grasslands makes it vital to restore these valuable habitat types, including novel habitat variants such as road verges. Due to the lack of knowledge on long‐term outcomes of restoration initiatives, well‐designed studies comparing different restoration methods are needed. In this study, we examined fine‐scale vegetation recovery patterns over 9 years in a field experiment with several near‐natural restoration methods (adding local seed mixtures, transferring hay from local grasslands using hard or light raking, and natural regeneration) in a road verge. We compared this to standard revegetation (hydroseeding species‐poor commercial seed mixtures). We found major temporal changes in vegetation restored by local seed or hay transfer, before it gradually became more similar to the donor grasslands and seed mixtures, which served as references for the experiment. Natural (spontaneous) regeneration with seed dispersal from surroundings gave similar results, whereas areas revegetated using standard methods became more dissimilar to the reference sites during the study period. The main variation in species composition reflected the contrast between local donor grasslands and seed mixtures and the species‐poor early successional grasslands. We conclude that near‐natural methods (hay transfer and seeding) successfully restored species‐rich grassland, including road verges. This study underlines the importance of comparing several treatments over a sufficiently long period to assess their success in restoring species‐rich grassland.     

Time‐to‐event continual reassessment method incorporating treatment cycle information with application to an oncology phase I trial

Delayed dose limiting toxicities (i.e. beyond first cycle of treatment) is a challenge for phase I trials. The time‐to‐event continual reassessment method (TITE‐CRM) is a Bayesian dose‐finding design to address the issue of long observation time and early patient drop‐out. It uses a weighted binomial likelihood with weights assigned to observations by the unknown time‐to‐toxicity distribution, and is open to accrual continually. To avoid dosing at overly toxic levels while retaining accuracy and efficiency for DLT evaluation that involves multiple cycles, we propose an adaptive weight function by incorporating cyclical data of the experimental treatment with parameters updated continually. This provides a reasonable estimate for the time‐to‐toxicity distribution by accounting for inter‐cycle variability and maintains the statistical properties of consistency and coherence. A case study of a First‐in‐Human trial in cancer for an experimental biologic is presented using the proposed design. Design calibrations for the clinical and statistical parameters are conducted to ensure good operating characteristics. Simulation results show that the proposed TITE‐CRM design with adaptive weight function yields significantly shorter trial duration, does not expose patients to additional risk, is competitive against the existing weighting methods, and possesses some desirable properties.