Stepwise confidence intervals for monotone dose-response studies

Summary .   In dose–response studies, one of the most important issues is the identification of the minimum effective dose (MED), where the MED is defined as the lowest dose such that the mean response is better than the mean response of a zero-dose control by a clinically significant difference. Dose–response curves are sometimes monotonic in nature. To find the MED, various authors have proposed step-down test procedures based on contrasts among the sample means. In this article, we improve upon the method of Marcus and Peritz (1976, Journal of the Royal Statistical Society, Series B 38 , 157–165) and implement the dose–response method of Hsu and Berger (1999, Journal of the American Statistical Association 94 , 468–482) to construct the lower confidence bound for the difference between the mean response of any nonzero-dose level and that of the control under the monotonicity assumption to identify the MED. The proposed method is illustrated by numerical examples, and simulation studies on power comparisons are presented.     

A note on Shirley's nonparametric test for comparing several dose levels with a zero-dose control

Shirley (1977, Biometrics 33, 386-389) proposed a nonparametric version of Williams' test for determining the lowest dose level at which there is evidence of a toxic effect. A modification of Shirley's procedure is now proposed, which improves its power.     

Nonparametric inference for the cumulative incidence function of a competing risk,with an emphasis on confidence bands in the presence of left‐truncation

Motivated by a study on pregnancy outcome, a computationally simple resampling procedure for nonparametric analysis of the cumulative incidence function of a competing risk is investigated for left‐truncated data. We also modify the original procedure to producing the more desirable Greenwood‐type variance estimates. These approaches are used to construct simultaneous confidence bands of the cumulative incidence functions which is otherwise hampered by the complicated nature of the covariance process. Simulation results and a real data example are provided.     

Ultraviolet radiation-induced erythema in human skin

We have evaluated UVR-induced erythema in previously unexposed buttock skin of volunteers of skin types I, II, III, and IV. Studies were done with solar-simulated radiation (SSR), UVB, and UVAI and we determined the just perceptible minimal erythema dose (MED) and, in some cases, quantified erythema with a reflectance device. The results show that there is a trend for increased SSR MED with skin type, with the MED of skin type IV being approximately twice that of skin type I, a smaller difference than one might have expected. However, there is a very considerable overlap of MED between skin types which shows that MED is a very poor indictor of skin type. Quantitative dose-response and time course studies with SSR and UVAI showed broadly similar responses when comparable MED-based exposures were given. We used our data to test the new concept of the standard erythema dose (SED) with two different erythema action spectra, and confirmed that the SED approach works with the different UVR sources that we studied.     

基于药物毒性反应等级的Up-and-Down设计

Ⅰ期临床试验主要关心毒性,通常划分毒性为五个水平．简单起见,同时兼顾伦理问题,Ⅰ期临床试验通常采用up-and-down序贯设计(例如BCDⅠ,BCDⅡ,K-in-a-row,Narayana,Improved Narayana)．然而,在分配剂量水平时,该设计没有区分已经试验了的病人的严重毒性水平等级,从而有可能分配给病人更高毒性的剂量水平．因此,本文提出了基于药物毒性等级确定最大耐受剂量的up-and-down设计方法,并进一步研究了该设计方法在各种变化的剂量—毒性关系下的运作特征,并且和标准的up-and-down设计作模拟比较,结果表明该设计方法对Ⅰ期临床试验设计的剂量建议具有重要意义．     

Fitting nonlinear and constrained generalized estimating equations with optimization software

In this article, we present an estimation approach for solving nonlinear constrained generalized estimating equations that can be implemented using object-oriented software for nonlinear programming, such as nlminb in Splus or fmincon and lsqnonlin in Matlab. We show how standard estimating equation theory includes this method as a special case so that our estimates, when unconstrained, will remain consistent and asymptotically normal. To illustrate this method, we fit a nonlinear dose-response model with nonnegative mixed bound constraints to clustered binary data from a developmental toxicity study. Satisfactory confidence intervals are found using a nonparametric bootstrap method when a common correlation coefficient is assumed for all the dose groups and for some of the dose-specific groups.     

Minimal Erythema Dose (MED) Testing

Ultraviolet radiation (UV) therapy is sometimes used as a treatment for various common skin conditions, including psoriasis, acne, and eczema. The dosage of UV light is prescribed according to an individual''s skin sensitivity. Thus, to establish the proper dosage of UV light to administer to a patient, the patient is sometimes screened to determine a minimal erythema dose (MED), which is the amount of UV radiation that will produce minimal erythema (sunburn or redness caused by engorgement of capillaries) of an individual''s skin within a few hours following exposure. This article describes how to conduct minimal erythema dose (MED) testing. There is currently no easy way to determine an appropriate UV dose for clinical or research purposes without conducting formal MED testing, requiring observation hours after testing, or informal trial and error testing with the risks of under- or over-dosing. However, some alternative methods are discussed.     

Development of sequential multiple comparison procedure for dose response test

We propose a multiple comparison procedure to identify the minimum effective dose level by sequentially comparing each dose level with the zero dose level in the dose finding test. If we can find the minimum effective dose level at an early stage in the sequential test, it is possible to terminate the procedure in the dose finding test after a few group observations up to the dose level. Thus, the procedure is viable from an economical point of view when high costs are involved in obtaining the observations. In the procedure, we present an integral formula to determine the critical values for satisfying a predefined type I familywise error rate. Furthermore, we show how to determine the required sample size in order to guarantee the power of the test in the procedure. In practice, we compare the power of the test and the required sample size for various configurations of the population means in simulation studies and adopt our sequential procedure to the dose response test in a case study.     

Anesthesia of boma-captured Lichtenstein's hartebeest (Sigmoceros lichtensteinii) with a combination of thiafentanil,medetomidine, and ketamine

A dose range was determined for anesthesia of recently boma-captured Lichtenstein's hartebeest (Sigmoceros lichtensteinii) (n = 13) with the synthetic opiate thiafentanil (THIA) (formerly called A3080) combined with medetomidine (MED) and ketamine (KET) in the Kasungu National Park, Malawi on 4 to 5 September 1999. The dose range of 11-29 micrograms/kg THIA (mean +/- SD = 21 +/- 4 micrograms/kg) combined with 5-10 mg/kg MED (8 +/- 1 micrograms/kg) plus 0.7-1.4 mg/kg KET (1.1 +/- 0.2 mg/kg) was found to be safe and effective for the field conditions associated with this study. The anesthesia produced by this drug combination was very predictable and characterized by a short induction time (3:34 +/- 1:20 min:sec), good muscle relaxation, and acceptable physiologic parameters for anesthesia periods ranging from 22:30-35:00 min:sec (31:14 +/- 2:50). Within the range of doses used in this study, times to onset of initial effects and recumbency were not dependent on THAI, MED, or KET doses. Anesthesia was rapidly and completely reversed by intravenous injections of naltrexone at 30 times the THAI dosage (0.69 +/- 0.19 mg/kg) and atipamezole at about four times the MED dosage (38 +/- 14 micrograms/kg). There was no residual effect from ketamine noted following reversal of THIA and MED and no mortality or morbidity was associated with this anesthetic regimen.     

Kernel estimates of dose response

A nonparametric method for analyzing quantal response data from an indirect bioassay experiment is proposed. Kernel estimates of the dose-response curve are used to develop approximate confidence intervals for (i) the optimal combination dose of a drug with therapeutic effects at low doses and toxic effects at high doses, and (ii) the lethal dose levels of a toxic chemical. This nonparametric procedure was implemented on real and simulated data. The confidence interval for problem (i) has high coverage probabilities when the dose-response curve is symmetric about the optima. However, the coverage probabilities are adversely affected by asymmetry about the optima and consequently are not reliable unless the sample sizes are large. The use of kernel estimators with higher-order kernels may alleviate this sensitivity to asymmetry. The confidence interval for problem (ii) has high coverage probabilities robust with respect to the shape or symmetry of the underlying dose-response curve.     

烟粉虱MEAM1和MED成虫在辣椒上传播番茄褪绿病毒的特性

【目的】分析与比较烟粉虱Bemisia tabaci MEAM1和MED成虫在辣椒Capsicum annuum植株上对番茄褪绿病毒(tomato chlorosis virus, ToCV)的传播差异,解析媒介昆虫-病毒-寄主植物间的互作关系,为田间辣椒上ToCV防治提供参考。【方法】利用烟粉虱MEAM1和MED成虫及ToCV cDNA侵染性克隆,对烟粉虱MEAM1和MED成虫在辣椒植株上获取和传播ToCV的能力进行比较,同时比较烟粉虱MEAM1和MED成虫在健康和携带ToCV辣椒植株上的取食偏好。【结果】在感染ToCV的辣椒植株上接虫后96 h内,烟粉虱MEAM1和MED成虫体内病毒积累量逐渐增加,MED成虫获毒速度和病毒积累量均大于MEAM1成虫的,MED成虫获毒量是MEAM1成虫的1.74倍;MED成虫在辣椒植株上的传毒量明显高于MEAM1成虫,传毒量平均相差9倍,且MED成虫传毒率比MEAM1成虫高29%。MEAM1和MED成虫对健康和感染ToCV的辣椒植株的取食偏好相似,都明显倾向于取食被ToCV侵染的辣椒植株。【结论】烟粉虱MED成虫在辣椒植株上获取、传播ToCV的能力均...     

Using semiparametric‐mixed model and functional linear model to detect vulnerable prenatal window to carcinogenic polycyclic aromatic hydrocarbons on fetal growth

Prenatal exposure to carcinogenic polycyclic aromatic hydrocarbons (c‐PAHs) through maternal inhalation induces higher risk for a wide range of fetotoxic effects. However, the most health‐relevant dose function from chronic gestational exposure remains unclear. Whether there is a gestational window during which the human embryo/fetus is particularly vulnerable to PAHs has not been examined thoroughly. We consider a longitudinal semiparametric‐mixed effect model to characterize the individual prenatal PAH exposure trajectory, where a nonparametric cyclic smooth function plus a linear function are used to model the time effect and random effects are used to account for the within‐subject correlation. We propose a penalized least squares approach to estimate the parametric regression coefficients and the nonparametric function of time. The smoothing parameter and variance components are selected using the generalized cross‐validation (GCV) criteria. The estimated subject‐specific trajectory of prenatal exposure is linked to the birth outcomes through a set of functional linear models, where the coefficient of log PAH exposure is a fully nonparametric function of gestational age. This allows the effect of PAH exposure on each birth outcome to vary at different gestational ages, and the window associated with significant adverse effect is identified as a vulnerable prenatal window to PAHs on fetal growth. We minimize the penalized sum of squared errors using a spline‐based expansion of the nonparametric coefficient function to draw statistical inferences, and the smoothing parameter is chosen through GCV.     

Evaluating decision rules for nitrogen fertilization

It is important, both for farmer profit and for the environment, to correctly dose nitrogen fertilizer for crop growth. Fertilizer recommendations are embodied in decision rules, which give a recommended dose of nitrogen (N) as a function of information available at the time the decision is made. In this paper, we first propose a criterion for evaluating decision rules. The proposed criterion is the expectation of the objective function when the decision rule is implemented. The major problem here is the estimation of this criterion. Two estimators are considered, a model-based and a nonparametric estimator. A simulation study shows that, in essentially all cases, the nonparametric estimator is better or no worse than the model-based estimator. The bias in the nonparametric estimator is always very small.     

高脂饮食诱导肝脏MED1特异性敲除小鼠呈高胆固醇血症

为研究肝脏MED1对脂质代谢的影响,以肝脏MED1特异性敲除（MED1ΔLiv）小鼠为模型,对其进行基因型鉴定,H&E染色观察肝脏组织学变化,免疫组织化学染色检测肝脏MED1蛋白表达|高脂饲料（脂肪含量为60%）饲喂小鼠,并分别在0、1、2 和4 周动态检测血浆胆固醇和甘油三酯及血糖水平. 结果显示,与MED1fl/fl小鼠相比,MED1ΔLiv 小鼠仅肝脏MED1 mRNA表达水平显著降低,其它组织表达无明显变化. 高脂饲喂1 周和2 周,MED1ΔLiv小鼠血浆总胆固醇水平显著升高（P<0.01）|普通或高脂饲料饲喂状态下,与MED1fl/fl小鼠相比,MED1ΔLiv 小鼠血糖水平均显著降低（P<0.05）. 短期给予高脂饲料可诱导MED1ΔLiv 小鼠呈现高胆固醇血症,提示MED1在胆固醇代谢中发挥重要调控作用.     

A two-stage stepwise estimation procedure

Summary .   This article proposes a two-stage simultaneous confidence procedure for the comparisons of k pairs of population means, without using multiplicity adjustment of more than two populations. The proposed procedure can be broadly applied to parametric or nonparametric models. It is robust and versatile because its derivation only utilizes a partitioning approach in conjunction with a bivariate adjustment, without any assumption on the underlying distribution. To elucidate the application, the proposed procedure is intertwined with the estimation of the therapeutic window of a drug. It provides confidence limits for the efficacy and the toxicity of the effective doses, highest ineffective dose, safe doses, and lowest unsafe dose, simultaneously. Such estimation information facilitates follow-up studies in clinical trials. As an illustrative example, the new procedure is applied to analyze a data set on molecular cancer therapeutics regarding the apoptotic killing effects of different chemical compounds on two leukemia cell lines.