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.     

The adaptor protein FADD and the initiator caspase-8 mediate activation of NF-��B by TRAIL

Besides inducing apoptosis, tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) activates NF-κB. The apoptosis signaling pathway of TRAIL is well characterized involving TRAIL receptors, Fas-associated protein with death domain (FADD) and caspase-8. In contrast, the molecular mechanism of TRAIL signaling to NF-κB remains controversial. Here, we characterized the receptor–proximal mediators of NF-κB activation by TRAIL. Deletion of the DD of TRAIL receptors 1 and 2 revealed that it is essential in NF-κB signaling. Because FADD interacts with the TRAIL receptor DD, FADD was tested. RNAi-mediated knockdown of FADD or FADD deficiency in JURKAT T-cell leukemia cells decreased or disabled NF-κB signaling by TRAIL. In contrast, TRAIL-induced activation of NF-κB was maintained upon loss of receptor interacting protein 1 (RIP1) or knockdown of FLICE-like inhibitory protein (FLIP). Exogenous expression of FADD rescued TRAIL-induced NF-κB signaling. Loss-of-function mutations of FADD within the RHDLL motif of the death effector domain, which is required for TRAIL-induced apoptosis, abrogated FADD''s ability to recruit caspase-8 and mediate NF-κB activation. Accordingly, deficiency of caspase-8 inhibited TRAIL-induced activation of NF-κB, which was rescued by wild-type caspase-8, but not by a catalytically inactive caspase-8 mutant. These data establish the mechanism of TRAIL-induced NF-κB activation involving the TRAIL receptor DD, FADD and caspase-8, but not RIP1 or FLIP. Our results show that signaling of TRAIL-induced apoptosis and NF-κB bifurcates downstream of caspase-8.     

Microbial Analysis of Bite Marks by Sequence Comparison of Streptococcal DNA

Bite mark injuries often feature in violent crimes. Conventional morphometric methods for the forensic analysis of bite marks involve elements of subjective interpretation that threaten the credibility of this field. Human DNA recovered from bite marks has the highest evidentiary value, however recovery can be compromised by salivary components. This study assessed the feasibility of matching bacterial DNA sequences amplified from experimental bite marks to those obtained from the teeth responsible, with the aim of evaluating the capability of three genomic regions of streptococcal DNA to discriminate between participant samples. Bite mark and teeth swabs were collected from 16 participants. Bacterial DNA was extracted to provide the template for PCR primers specific for streptococcal 16S ribosomal RNA (16S rRNA) gene, 16S–23S intergenic spacer (ITS) and RNA polymerase beta subunit (rpoB). High throughput sequencing (GS FLX 454), followed by stringent quality filtering, generated reads from bite marks for comparison to those generated from teeth samples. For all three regions, the greatest overlaps of identical reads were between bite mark samples and the corresponding teeth samples. The average proportions of reads identical between bite mark and corresponding teeth samples were 0.31, 0.41 and 0.31, and for non-corresponding samples were 0.11, 0.20 and 0.016, for 16S rRNA, ITS and rpoB, respectively. The probabilities of correctly distinguishing matching and non-matching teeth samples were 0.92 for ITS, 0.99 for 16S rRNA and 1.0 for rpoB. These findings strongly support the tenet that bacterial DNA amplified from bite marks and teeth can provide corroborating information in the identification of assailants.     

Phosphorylation of the Peptidoglycan Synthase PonA1 Governs the Rate of Polar Elongation in Mycobacteria

Cell growth and division are required for the progression of bacterial infections. Most rod-shaped bacteria grow by inserting new cell wall along their mid-section. However, mycobacteria, including the human pathogen Mycobacterium tuberculosis, produce new cell wall material at their poles. How mycobacteria control this different mode of growth is incompletely understood. Here we find that PonA1, a penicillin binding protein (PBP) capable of transglycosylation and transpeptidation of cell wall peptidoglycan (PG), is a major governor of polar growth in mycobacteria. PonA1 is required for growth of Mycobacterium smegmatis and is critical for M. tuberculosis during infection. In both cases, PonA1’s catalytic activities are both required for normal cell length, though loss of transglycosylase activity has a more pronounced effect than transpeptidation. Mutations that alter the amount or the activity of PonA1 result in abnormal formation of cell poles and changes in cell length. Moreover, altered PonA1 activity results in dramatic differences in antibiotic susceptibility, suggesting that a balance between the two enzymatic activities of PonA1 is critical for survival. We also find that phosphorylation of a cytoplasmic region of PonA1 is required for normal activity. Mutations in a critical phosphorylated residue affect transglycosylase activity and result in abnormal rates of cell elongation. Together, our data indicate that PonA1 is a central determinant of polar growth in mycobacteria, and its governance of cell elongation is required for robust cell fitness during both host-induced and antibiotic stress.     

Enamel Ultrastructure in Fossil Cetaceans (Cetacea: Archaeoceti and Odontoceti)

The transition from terrestrial ancestry to a fully pelagic life profoundly altered the body systems of cetaceans, with extreme morphological changes in the skull and feeding apparatus. The Oligocene Epoch was a crucial time in the evolution of cetaceans when the ancestors of modern whales and dolphins (Neoceti) underwent major diversification, but details of dental structure and evolution are poorly known for the archaeocete-neocete transition. We report the morphology of teeth and ultrastructure of enamel in archaeocetes, and fossil platanistoids and delphinoids, ranging from late Oligocene (Waitaki Valley, New Zealand) to Pliocene (Caldera, Chile). Teeth were embedded in epoxy resin, sectioned in cross and longitudinal planes, polished, etched, and coated with gold palladium for scanning electron microscopy (SEM) observation. SEM images showed that in archaeocetes, squalodontids and Prosqualodon (taxa with heterodont and nonpolydont/limited polydont teeth), the inner enamel was organized in Hunter-Schreger bands (HSB) with an outer layer of radial enamel. This is a common pattern in most large-bodied mammals and it is regarded as a biomechanical adaptation related to food processing and crack resistance. Fossil Otekaikea sp. and delphinoids, which were polydont and homodont, showed a simpler structure, with inner radial and outer prismless enamel. Radial enamel is regarded as more wear-resistant and has been retained in several mammalian taxa in which opposing tooth surfaces slide over each other. These observations suggest that the transition from a heterodont and nonpolydont/limited polydont dentition in archaeocetes and early odontocetes, to homodont and polydont teeth in crownward odontocetes, was also linked to a marked simplification in the enamel Schmelzmuster. These patterns probably reflect functional shifts in food processing from shear-and-mastication in archaeocetes and early odontocetes, to pierce-and-grasp occlusion in crownward odontocetes, with the implication of less demanding feeding biomechanics as seen in most extant odontocetes.     

Blinded Sample Size Recalculation for Normally Distributed Outcomes Using Long‐ and Short‐term Data

Clinical trials are often planned with high uncertainty about the variance of the primary outcome variable. A poor estimate of the variance, however, may lead to an over‐ or underpowered study. In the internal pilot study design, the sample variance is calculated at an interim step and the sample size can be adjusted if necessary. The available recalculation procedures use the data of those patients for sample size recalculation that have already completed the study. In this article, we consider a variance estimator that takes into account both the data at the endpoint and at an intermediate point of the treatment phase. We derive asymptotic properties of this estimator and the relating sample size recalculation procedure. In a simulation study, the performance of the proposed approach is evaluated and compared with the procedure that uses only long‐term data. Simulation results demonstrate that the sample size resulting from the proposed procedure shows in general a smaller variability. At the same time, the Type I error rate is not inflated and the achieved power is close to the desired value.     

Identification of a gene negatively affecting antibiotic production and morphological differentiation in Streptomyces coelicolor A3(2)

SC7A1 is a cosmid with an insert of chromosomal DNA from Streptomyces coelicolor A3(2). Its insertion into the chromosome of S. coelicolor strains caused a duplication of a segment of ca. 40 kb and delayed actinorhodin antibiotic production and sporulation, implying that SC7A1 carried a gene negatively affecting these processes. The subcloning of SC7A1 insert DNA resulted in the identification of the open reading frame SCO5582 as nsdA, a gene negatively affecting Streptomyces differentiation. The disruption of chromosomal nsdA caused the overproduction of spores and of three of four known S. coelicolor antibiotics of quite different chemical types. In at least one case (that of actinorhodin), this was correlated with premature expression of a pathway-specific regulatory gene (actII-orf4), implying that nsdA in the wild-type strain indirectly repressed the expression of the actinorhodin biosynthesis cluster. nsdA expression was up-regulated upon aerial mycelium initiation and was strongest in the aerial mycelium. NsdA has DUF921, a Streptomyces protein domain of unknown function and a conserved SXR site. A site-directed mutation (S458A) in this site in NsdA abolished its function. Blast searching showed that NsdA homologues are present in some Streptomyces genomes. Outside of streptomycetes, NsdA-like proteins have been found in several actinomycetes. The disruption of the nsdA-like gene SCO4114 had no obvious phenotypic effects on S. coelicolor. The nsdA orthologue SAV2652 in S. avermitilis could complement the S. coelicolor nsdA-null mutant phenotype.