Survival analysis in clinical trials: past developments and future directions

The field of survival analysis emerged in the 20th century and experienced tremendous growth during the latter half of the century. The developments in this field that have had the most profound impact on clinical trials are the Kaplan-Meier (1958, Journal of the American Statistical Association 53, 457-481) method for estimating the survival function, the log-rank statistic (Mantel, 1966, Cancer Chemotherapy Report 50, 163-170) for comparing two survival distributions, and the Cox (1972, Journal of the Royal Statistical Society, Series B 34, 187-220) proportional hazards model for quantifying the effects of covariates on the survival time. The counting-process martingale theory pioneered by Aalen (1975, Statistical inference for a family of counting processes, Ph.D. dissertation, University of California, Berkeley) provides a unified framework for studying the small- and large-sample properties of survival analysis statistics. Significant progress has been achieved and further developments are expected in many other areas, including the accelerated failure time model, multivariate failure time data, interval-censored data, dependent censoring, dynamic treatment regimes and causal inference, joint modeling of failure time and longitudinal data, and Baysian methods.     

Prediction from an integrated regression equation: a forestry application

Models to depict the tapering of a tree bole abound in the literature of forest science, and such models are widely used in forestry practice. One important use is the integration of a taper equation to predict the volume of the tree bole. The statistical properties of volume prediction from an integrated taper equation have been obscure. Based on the statistical characteristics of a taper model for the bole's cross-sectional area, we derive the first two moments of the volume predictor and the prediction error. Bias from the integration is nil. The importance of a reasonable model of the error structure is demonstrated.     

Sex differential nectar secretion in protandrous Alstroemeria aurea (Alstroemeriaceae): is production altered by pollen removal and receipt?

We examined diurnal and nocturnal nectar secretion across sexual stages in protandrous Alstroemeria aurea, a bumble bee-pollinated herb with long-lived flowers native to the southern Andes. We found the following patterns: (1) most nectar was produced diurnally and (2) three times more sugar was secreted during the male than female phase, not only because the male phase lasted longer but also because the rate of nectar production was higher. This 3:1 ratio in nectar production matched the ratio of the minimum number of bumble bee visits required on average to saturate male (pollen removal) vs. female (seed set) functions. Standing crop of nectar, on the other hand, did not differ greatly between male- and female- stage flowers left open to visitors, because the high-production male-phase flowers were visited more frequently than female- phase flowers. In an experiment concurrent with the repeated nectar sampling of individual flowers over their life-span, we removed pollen from anthers or deposited pollen on stigmas by hand. Neither treatment, designed to mimic effects of visits by Alstroemeria's native bumble bee pollinator, affected nectar production. The absence of plasticity in nectar secretion in relation to pollination events may reflect a low cost of nectar production, or may result from developmental constraints related to the evolution of the synchronous protandry that characterizes A. aurea.     

Sample size re‐estimation in clinical trials

Adaptive clinical trials are becoming very popular because of their flexibility in allowing mid‐stream changes of sample size, endpoints, populations, etc. At the same time, they have been regarded with mistrust because they can produce bizarre results in very extreme settings. Understanding the advantages and disadvantages of these rapidly developing methods is a must. This paper reviews flexible methods for sample size re‐estimation when the outcome is continuous.     

Modifying the Bank Erosion Hazard Index (BEHI) Protocol for Rapid Assessment of Streambank Erosion in Northeastern Ohio

Understanding the source of pollution in a stream is vital to preserving, restoring, and maintaining the stream’s function and habitat it provides. Sediments from highly eroding streambanks are a major source of pollution in a stream system and have the potential to jeopardize habitat, infrastructure, and stream function. Watershed management practices throughout the Cleveland Metroparks attempt to locate and inventory the source and rate the risk of potential streambank erosion to assist in formulating effect stream, riparian, and habitat management recommendations. The Bank Erosion Hazard Index (BEHI), developed by David Rosgen of Wildland Hydrology is a fluvial geomorphic assessment procedure used to evaluate the susceptibility of potential streambank erosion based on a combination of several variables that are sensitive to various processes of erosion. This protocol can be time consuming, difficult for non-professionals, and confined to specific geomorphic regions. To address these constraints and assist in maintaining consistency and reducing user bias, modifications to this protocol include a “Pre-Screening Questionnaire”, elimination of the Study Bank-Height Ratio metric including the bankfull determination, and an adjusted scoring system. This modified protocol was used to assess several high priority streams within the Cleveland Metroparks. The original BEHI protocol was also used to confirm the results of the modified BEHI protocol. After using the modified assessment in the field, and comparing it to the original BEHI method, the two were found to produce comparable BEHI ratings of the streambanks, while significantly reducing the amount of time and resources needed to complete the modified protocol.     

Mutations within a human IgG2 antibody form distinct and homogeneous disulfide isomers but do not affect Fc gamma receptor or C1q binding

Human IgG2 antibodies may exist in at least three distinct structural isomers due to disulfide shuffling within the upper hinge region. Antibody interactions with Fc gamma receptors and the complement component C1q contribute to immune effector functions. These interactions could be impacted by the accessibility and structure of the hinge region. To examine the role structural isomers may have on effector functions, a series of cysteine to serine mutations were made on a human IgG2 backbone. We observed structural homogeneity with these mutants and mapped the locations of their disulfide bonds. Importantly, there was no observed difference in binding to any of the Fc gamma receptors or C1q between the mutants and the wild‐type IgG2. However, differences were seen in the apparent binding affinity of these antibodies that were dependent on the selection of the secondary detection antibody used.     

Functional indicators of stream health: a river‐basin approach

1. The efficacy of leaf‐litter decomposition, sediment respiration, biofilm biomass, growth, chlorophyll a concentration and the autotrophic index (biofilm ash‐free dry mass/chlorophyll a) and fungal biomass for detecting human‐induced change was evaluated using 24 references and 15 disturbed stream sites located in central Portugal. 2. Decomposition rates of alder (Alnus glutinosa) and oak (Quercus robur) leaves and sediment respiration rates were effective in discriminating impairment. Decomposition was negatively correlated with abiotic factors, such as ammonium and nitrite concentrations, connectivity and alterations in the hydrological regime, and positively correlated with nitrate concentration and oxygen concentration. Sediment respiration rates were correlated with organic contamination, land use and morphological changes. 3. Growth rates of biofilm, concentration of chlorophyll a and the autotrophic index, although 41–73% higher at disturbed compared to reference sites, were not significantly different. These three variables were significantly correlated with total organic carbon, oxygen concentration, pH, nitrite and the presence of dams. Fungal biomass on leaves and biofilm biomass on natural substrata did not differ between reference and disturbed sites. 4. Our findings lend support to the use of functional variables like decomposition and sediment respiration in monitoring and when used together with structural variables should give a more holistic measure of stream health.     

Redox potential of the Rieske iron-sulfur protein: Quantum-chemical and electrostatic study

Quantum-chemical study of structures, energies, and effective partial charge distribution for several models of the Rieske protein redox center is performed in terms of the B3LYP density functional method in combination with the broken symmetry approach using three different atomic basis sets. The structure of the redox complex optimized in vacuum differs markedly from that inside the protein. This means that the protein matrix imposes some stress on the active site resulting in distortion of its structure. The redox potentials calculated for the real active site structure are in a substantially better agreement with the experiment than those calculated for the idealized structure. This shows an important role of the active site distortion in tuning its redox potential. The reference absolute electrode potential of the standard hydrogen electrode is used that accounts for the correction caused by the water surface potential. Electrostatic calculations are performed in the framework of the polarizable solute model. Two dielectric permittivities of the protein are employed: the optical permittivity for calculation of the intraprotein electric field, and the static permittivity for calculation of the dielectric response energy. Only this approach results in a reasonable agreement of the calculated and experimental redox potentials.     

A lead dependent ischemic episodes detection strategy using Hermite functions

In this work a new strategy for automatic detection of ischemic episodes is proposed. A new measure for ST deviation based on the time–frequency analysis of the ECG and the use of a reduced set of Hermite basis functions for T wave and QRS complex morphology characterization, are the key points of the proposed methodology.Usually, ischemia manifests itself in the ECG signal by ST segment deviation or by QRS complex and T wave changes in morphology. These effects might occur simultaneously. Time–frequency methods are especially adequate for the detection of small transient characteristics hidden in the ECG, such as ST segment alterations. A Wigner–Ville transform-based approach is proposed to estimate the ST shift. To characterize the alterations in the T wave and the QRS morphologies, each cardiac beat is described by expansions in Hermite functions. These demonstrated to be suitable to capture the most relevant morphologic characteristics of the signal. A lead dependent neural network classifier considers, as inputs, the ST segment deviation and the Hermite expansion coefficients. The ability of the proposed method in ischemia episodes detection is evaluated using the European Society of Cardiology ST–T database. A sensitivity of 96.7% and a positive predictivity of 96.2% reveal the capacity of the proposed strategy to perform ischemic episodes identification.