Problems in design of stroke treatment trials

Critical evaluation of the literature was use to identify remediable flaws in the design of clinical trials of stroke treatment. Trials of dexamethasone, dextran, and glycerol were reviewed. Available studies have in common major weaknesses in case selection (failure to exclude arteriolar strokes due to hemorrhage or lacunar infarction), and failure to estimate required sample size. Problems of case selection can be avoided with computerized tomography; the sample size required to show superiority of active treatment over placebo can be estimated using standard formulas. Prognostic stratification is suggested as a method of overcoming problems of unbalanced allocation. Further studies with improved design are required to evaluate the prospects for medical limitation of cerebral infarct size. © 1982 American Heart Association, Inc

Quasiperiodic graphs: structural design, scaling and entropic properties

A novel class of graphs, here named quasiperiodic, are constructed via application of the Horizontal Visibility algorithm to the time series generated along the quasiperiodic route to chaos. We show how the hierarchy of mode-locked regions represented by the Farey tree is inherited by their associated graphs. We are able to establish, via Renormalization Group (RG) theory, the architecture of the quasiperiodic graphs produced by irrational winding numbers with pure periodic continued fraction. And finally, we demonstrate that the RG fixed-point degree distributions are recovered via optimization of a suitably defined graph entropy

WOODLAND POND SALAMANDER ABUNDANCE IN RELATION TO FOREST MANAGEMENT AND ENVIRONMENTAL CONDITIONS IN NORTHERN WISCONSIN

Woodland ponds are important landscape features that help sustain populations of amphibians that require this aquatic habitat for successful reproduction. Species abundance patterns often reflect site-specific differences in hydrology, physical characteristics, and surrounding vegetation. Large-scale processes such as changing land cover and environmental conditions are other potential drivers influencing amphibian populations in the Upper Midwest, but little information exists on the combined effects of these factors. We used Blue-spotted (Ambystoma laterale Hallowell) and Spotted Salamander (A. maculatum Shaw) monitoring data collected at the same woodland ponds thirteen years apart to determine if changing environmental conditions and vegetation cover in surrounding landscapes influenced salamander movement phenology and abundance. Four woodland ponds in northern Wisconsin were sampled for salamanders in April 1992-1994 and 2005-2007. While Bluespotted Salamanders were more abundant than Spotted Salamanders in all ponds, there was no change in the numbers of either species over the years. However, peak numbers of Blue-spotted Salamanders occurred 11.7 days earlier (range: 9-14 days) in the 2000s compared to the 1990s; Spotted Salamanders occurred 9.5 days earlier (range: 3 - 13 days). Air and water temperatures (April 13- 24) increased, on average, 4.8 oC and 3.7 oC, respectively, between the decades regardless of pond. There were no discernible changes in canopy openness in surrounding forests between decades that would have warmed the water sooner (i.e., more light penetration). Our finding that salamander breeding phenology can vary by roughly 10 days in Wisconsin contributes to growing evidence that amphibian populations have responded to changing climate conditions by shifting life-cycle events. Managers can use this information to adjust monitoring programs and forest management activities in the surrounding landscape to avoid vulnerable amphibian movement periods. Considering direct and indirect stressors such as changing habitat and environmental conditions simultaneously to better understand trends in space and time can help improve monitoring programs for this taxa, which is at major risk of continued declines

Post-training load-related changes of auditory working memory: An EEG study

Working memory (WM) refers to the temporary retention and manipulation of information, and its capacity is highly susceptible to training. Yet, the neural mechanisms that allow for increased performance under demanding conditions are not fully understood. We expected that post-training efficiency in WM performance modulates neural processing during high load tasks. We tested this hypothesis, using electroencephalography (EEG) (N = 39), by comparing source space spectral power of healthy adults performing low and high load auditory WM tasks. Prior to the assessment, participants either underwent a modality-specific auditory WM training, or a modality-irrelevant tactile WM training, or were not trained (active control). After a modality-specific training participants showed higher behavioral performance, compared to the control. EEG data analysis revealed general effects of WM load, across all training groups, in the theta-, alpha-, and beta-frequency bands. With increased load theta-band power increased over frontal, and decreased over parietal areas. Centro-parietal alpha-band power and central beta-band power decreased with load. Interestingly, in the high load condition a tendency toward reduced beta-band power in the right medial temporal lobe was observed in the modality-specific WM training group compared to the modality-irrelevant and active control groups. Our finding that WM processing during the high load condition changed after modality-specific WM training, showing reduced beta-band activity in voice-selective regions, possibly indicates a more efficient maintenance of task-relevant stimuli. The general load effects suggest that WM performance at high load demands involves complementary mechanisms, combining a strengthening of task-relevant and a suppression of task-irrelevant processing

Cluster randomised trials in the medical literature: two bibliometric surveys

Background: Several reviews of published cluster randomised trials have reported that about half did not take clustering into account in the analysis, which was thus incorrect and potentially misleading. In this paper I ask whether cluster randomised trials are increasing in both number and quality of reporting. Methods: Computer search for papers on cluster randomised trials since 1980, hand search of trial reports published in selected volumes of the British Medical Journal over 20 years. Results: There has been a large increase in the numbers of methodological papers and of trial reports using the term 'cluster random' in recent years, with about equal numbers of each type of paper. The British Medical Journal contained more such reports than any other journal. In this journal there was a corresponding increase over time in the number of trials where subjects were randomised in clusters. In 2003 all reports showed awareness of the need to allow for clustering in the analysis. In 1993 and before clustering was ignored in most such trials. Conclusion: Cluster trials are becoming more frequent and reporting is of higher quality. Perhaps statistician pressure works

Sample size calculations for cluster randomised controlled trials with a fixed number of clusters

Background\ud Cluster randomised controlled trials (CRCTs) are frequently used in health service evaluation. Assuming an average cluster size, required sample sizes are readily computed for both binary and continuous outcomes, by estimating a design effect or inflation factor. However, where the number of clusters are fixed in advance, but where it is possible to increase the number of individuals within each cluster, as is frequently the case in health service evaluation, sample size formulae have been less well studied. \ud \ud Methods\ud We systematically outline sample size formulae (including required number of randomisation units, detectable difference and power) for CRCTs with a fixed number of clusters, to provide a concise summary for both binary and continuous outcomes. Extensions to the case of unequal cluster sizes are provided. \ud \ud Results\ud For trials with a fixed number of equal sized clusters (k), the trial will be feasible provided the number of clusters is greater than the product of the number of individuals required under individual randomisation ($n_i$) and the estimated intra-cluster correlation ($\rho$). So, a simple rule is that the number of clusters ($\kappa$) will be sufficient provided: \ud \ud $\kappa$ > $n_i$ x $\rho$\ud \ud Where this is not the case, investigators can determine the maximum available power to detect the pre-specified difference, or the minimum detectable difference under the pre-specified value for power. \ud \ud Conclusions\ud Designing a CRCT with a fixed number of clusters might mean that the study will not be feasible, leading to the notion of a minimum detectable difference (or a maximum achievable power), irrespective of how many individuals are included within each cluster. \ud \u

Impact of CONSORT extension for cluster randomised trials on quality of reporting and study methodology : review of random sample of 300 trials, 2000-8

Peer reviewedPublisher PD

Influence of Climate Change and Postdelisting Management on Long‐term Population Viability of the Conservation‐reliant Kirtland\u27s Warbler

Rapid global climate change is resulting in novel abiotic and biotic conditions and in‐ teractions. Identifying management strategies that maximize probability of long‐term persistence requires an understanding of the vulnerability of species to environmen‐ tal changes. We sought to quantify the vulnerability of Kirtland\u27s Warbler (Setophaga kirtlandii), a rare Neotropical migratory songbird that breeds almost exclusively in the Lower Peninsula of Michigan and winters in the Bahamian Archipelago, to pro‐ jected environmental changes on the breeding and wintering grounds. We devel‐ oped a population‐level simulation model that incorporates the influence of annual environmental conditions on the breeding and wintering grounds, and parameter‐ ized the model using empirical relationships. We simulated independent and addi‐ tive effects of reduced breeding grounds habitat quantity and quality, and wintering grounds habitat quality, on population viability. Our results indicated the Kirtland\u27s Warbler population is stable under current environmental and management condi‐ tions. Reduced breeding grounds habitat quantity resulted in reductions of the stable population size, but did not cause extinction under the scenarios we examined. In contrast, projected large reductions in wintering grounds precipitation caused the population to decline, with risk of extinction magnified when breeding habitat quan‐ tity or quality also decreased. Our study indicates that probability of long‐term per‐ sistence for Kirtland\u27s Warbler will depend on climate change impacts to wintering grounds habitat quality and contributes to the growing literature documenting the importance of considering the full annual cycle for understanding population dynam‐ ics of migratory species

Geometric and dynamic perspectives on phase-coherent and noncoherent chaos

Statistically distinguishing between phase-coherent and noncoherent chaotic dynamics from time series is a contemporary problem in nonlinear sciences. In this work, we propose different measures based on recurrence properties of recorded trajectories, which characterize the underlying systems from both geometric and dynamic viewpoints. The potentials of the individual measures for discriminating phase-coherent and noncoherent chaotic oscillations are discussed. A detailed numerical analysis is performed for the chaotic R\"ossler system, which displays both types of chaos as one control parameter is varied, and the Mackey-Glass system as an example of a time-delay system with noncoherent chaos. Our results demonstrate that especially geometric measures from recurrence network analysis are well suited for tracing transitions between spiral- and screw-type chaos, a common route from phase-coherent to noncoherent chaos also found in other nonlinear oscillators. A detailed explanation of the observed behavior in terms of attractor geometry is given.Comment: 12 pages, 13 figure