Tests Of The Effect Of Treatment In Stratified Cluster Randomization Trials

It is becoming increasingly common for epidemiologists to consider randomizing intact social units (e.g. families, schools, communities) rather than individuals in experimental trials. Reasons are diverse, but include administrative convenience, a desire to reduce the effect of treatment contamination and the need to avoid ethical issues that might otherwise arise. Dependencies among cluster members typical of such designs must be considered when determining sample size and analysing the resulting data.;The primary focus of this thesis is on comparisons of tests of the effect of treatment in trials where clusters are randomly assigned to treatment groups after stratifying on cluster-level baseline risk factors (e.g. cluster size). Particular attention is paid to the analysis of binary outcome data.;Tests of the effect of treatment for such trials range in complexity from adaptations of standard statistical methods performed using the cluster as the unit of analysis to extensions of logistic regression adjusted for clustering. The validity of such extensions was shown to be assured if the average correlation among cluster members is fixed. This assumption can be relaxed by using robust variance estimators. Test statistics using these different approaches were shown to be asymptotically equivalent when there is no variability in cluster size.;Simulation studies were used to examine the small sample properties of test statistics assuming an average cluster size of 100 subjects and either two or four strata. These simulation studies indicated that exact permutation tests should be used to make inferences about the effect of treatment if there are 20 or fewer clusters per treatment group. Approximate test statistics using cluster-level analyses or extensions of the Mantel-Haenszel test statistic are appropriate if there are more than 20 clusters per treatment group. Valid rejection rates for methods using robust variance estimates can not be assured even if there are 40 clusters per treatment group. There is little need to employ such techniques, however, since the simulation studies also showed that typical violations of the common correlation assumption have no effect on the validity or power of test statistics

Activation of mating type genes by transposition in Saccharomyces cerevisiae

Yeast Saccharomyces cerevisiae may express an a or alpha mating type. These cells types may be interconverted as a consequence of heritable genetic alteractions at the mating type locus (MAT). According to the more general controlling element model [Oshima, U. & Takano, I. (1971) Genetics 67, 327--335] and the specific cassette model [Hicks, J., Strathern, J. & Herskowitz, I. (1977) in DNA Insertion Elements, Plasmids and Episomes, eds. Bukhari, A. I., Shapiro, J.A. & Adhya, S. L.(Cold Spring Harbor Laboratory, Cold Spring Harbor, NY), pp. 457--462], the regulatory information required for switching the MAT locus exists at two other loosely linked loci, HMa and HMalpha. Specifically, the HMa and HMalpha loci are proposed to carry silent alpha and silent a genes, respectively. According to these models, switching occurs when a replica of a silent gene replaces the resident information at the mating type locus and is thereby expressed. These models predict that mutations at the silent ("storage") loci would generate defective MAT loci subsequent to the switching process. Therefore, the behavior of HMalpha mutants during the mating type interconversion was investigated. The results demonstrate that defective MATa alleles are generated by switching the MATalpha locus in HMalpha mutants. Thus, the genetic information from HMalpha is transposed to the mating type locus. These results provide genetic evidence in support of these models

Photoluminescence and photoluminescence excitation studies of lateral size effects in Zn_{1-x}Mn_xSe/ZnSe quantum disc samples of different radii

Quantum disc structures (with diameters of 200 nm and 100 nm) were prepared from a Zn_{0.72}Mn_{0.28}Se/ZnSe single quantum well structure by electron beam lithography followed by an etching procedure which combined dry and wet etching techniques. The quantum disc structures and the parent structure were studied by photoluminescence and photoluminescence excitation spectroscopy. For the light-hole excitons in the quantum well region, shifts of the energy positions are observed following fabrication of the discs, confirming that strain relaxation occurs in the pillars. The light-hole exciton lines also sharpen following disc fabrication: this is due to an interplay between strain effects (related to dislocations) and the lateral size of the discs. A further consequence of the small lateral sizes of the discs is that the intensity of the donor-bound exciton emission from the disc is found to decrease with the disc radius. These size-related effects occur before the disc radius is reduced to dimensions necessary for lateral quantum confinement to occur but will remain important when the discs are made small enough to be considered as quantum dots.Comment: LaTeX2e, 13 pages, 6 figures (epsfig

Comparison of Zn_{1-x}Mn_xTe/ZnTe multiple-quantum wells and quantum dots by below-bandgap photomodulated reflectivity

Large-area high density patterns of quantum dots with a diameter of 200 nm have been prepared from a series of four Zn_{0.93}Mn_{0.07}Te/ZnTe multiple quantum well structures of different well width (4 nm, 6 nm, 8 nm and 10 nm) by electron beam lithography followed by Ar+ ion beam etching. Below-bandgap photomodulated reflectivity spectra of the quantum dot samples and the parent heterostructures were then recorded at 10 K and the spectra were fitted to extract the linewidths and the energy positions of the excitonic transitions in each sample. The fitted results are compared to calculations of the transition energies in which the different strain states in the samples are taken into account. We show that the main effect of the nanofabrication process is a change in the strain state of the quantum dot samples compared to the parent heterostructures. The quantum dot pillars turn out to be freestanding, whereas the heterostructures are in a good approximation strained to the ZnTe lattice constant. The lateral size of the dots is such that extra confinement effects are not expected or observed.Comment: 23 pages, LaTeX2e (amsmath, epsfig), 7 EPS figure

Multidrug-resistance proteins are weak tumor associated antigens for colorectal carcinoma

<p>Abstract</p> <p>Background</p> <p>Multidrug resistance (MDR) is a clinically, highly relevant phenomenon. Under chemotherapy many tumors show an increasing resistance towards the applied substance(s) and to a certain extent also towards other agents. An important molecular cause of this phenomenon is an increased expression of transporter proteins. The functional relationship between high expression levels and chemotherapy resistance makes these MDR and MRP (MDR related protein) proteins to interesting therapeutic targets. We here wanted to systematically analyze, whether these proteins are tumor specific antigens which could be targeted immunologically.</p> <p>Results</p> <p>Using the reverse immunology approach, 30 HLA-A2.1 restricted MDR and MRP derived peptides (MDP) were selected. Stimulated T cell lines grew well and mainly contained activated CD8⁺cells. Peptide specificity and HLA-A2.1 restriction were proven in IFN-γ-ELISpot analyses and in cytotoxicity tests against MDP loaded target cells for a total of twelve peptides derived from MDR-1, MDR-3, MRP-1, MRP-2, MRP-3 and MRP-5. Of note, two of these epitopes are shared between MDR-1 and MDR-3 as well as MRP-2 and MRP-3. However, comparably weak cytotoxic activities were additionally observed against HLA-A2.1⁺tumor cells even after upregulation of MDR protein expression by <it>in vitro </it>chemotherapy.</p> <p>Conclusions</p> <p>Taken together, these data demonstrate that human T cells can be sensitised towards MDPs and hence, there is no absolute immunological tolerance. However, our data also hint towards rather low endogenous tumor cell processing and presentation of MDPs in the context of HLA-A2.1 molecules. Consequently, we conclude that MDR and MRP proteins must be considered as weak tumor specific antigens-at least for colorectal carcinoma. Their direct contribution to therapy-failure implies however, that it is worth to further pursue this approach.</p

Fostering Leadership Capacity in Three South Carolina High Schools: An Exploratory Study

Some states include fostering teacher leadership in principal evaluations, so principals need to provide opportunities and mentor or coach their staffs to assume leadership roles. Yet, less is known about the specific ways principals develop the leadership capacities of others. In this exploratory study we examined how principals in three South Carolina high schools intentionally fostered the capacities of leaders to enhance their schools’ organizational capacities. Our research questions were: 1) How are emerging leaders identified and selected by their principals? 2) How do principals foster leadership capacity in these leaders? Data collected for this multi-site qualitative study consisted of artifacts and semi-structured 60-90 minute interviews. All interviews were transcribed and analyzed by the research team inductively and deductively using NVivo 10. Our findings indicated that principals selected leaders who: indicated a desire to go into formal leadership roles; had good interpersonal skills and rapport with students and parents; demonstrated persistence and willingness; were effective teachers; had strong personalities; and had a particular skill or knowledge. Our findings for the second question indicate that principals fostered leadership by: mentoring and coaching others to leadership; scaffolding opportunities to lead; and trusting leaders to make the right decision

Immunomodulation of Skin Repair: Cell-Based Therapeutic Strategies for Skin Replacement (A Comprehensive Review)

The immune system has a crucial role in skin wound healing and the application of specific cell-laden immunomodulating biomaterials emerged as a possible treatment option to drive skin tissue regeneration. Cell-laden tissue-engineered skin substitutes have the ability to activate immune pathways, even in the absence of other immune-stimulating signals. In particular, mesenchymal stem cells with their immunomodulatory properties can create a specific immune microenvironment to reduce inflammation, scarring, and support skin regeneration. This review presents an overview of current wound care techniques including skin tissue engineering and biomaterials as a novel and promising approach. We highlight the plasticity and different roles of immune cells, in particular macrophages during various stages of skin wound healing. These aspects are pivotal to promote the regeneration of nonhealing wounds such as ulcers in diabetic patients. We believe that a better understanding of the intrinsic immunomodulatory features of stem cells in implantable skin substitutes will lead to new translational opportunities. This, in turn, will improve skin tissue engineering and regenerative medicine applications. Keywords: biomaterials; chronic wounds; immunomodulation; intrinsic immune cell signals; regenerative medicine; skin substitutes; skin tissue engineering; wound healing