Multiple imputation methods for bivariate outcomes in cluster randomised trials.

Missing observations are common in cluster randomised trials. The problem is exacerbated when modelling bivariate outcomes jointly, as the proportion of complete cases is often considerably smaller than the proportion having either of the outcomes fully observed. Approaches taken to handling such missing data include the following: complete case analysis, single-level multiple imputation that ignores the clustering, multiple imputation with a fixed effect for each cluster and multilevel multiple imputation. We contrasted the alternative approaches to handling missing data in a cost-effectiveness analysis that uses data from a cluster randomised trial to evaluate an exercise intervention for care home residents. We then conducted a simulation study to assess the performance of these approaches on bivariate continuous outcomes, in terms of confidence interval coverage and empirical bias in the estimated treatment effects. Missing-at-random clustered data scenarios were simulated following a full-factorial design. Across all the missing data mechanisms considered, the multiple imputation methods provided estimators with negligible bias, while complete case analysis resulted in biased treatment effect estimates in scenarios where the randomised treatment arm was associated with missingness. Confidence interval coverage was generally in excess of nominal levels (up to 99.8%) following fixed-effects multiple imputation and too low following single-level multiple imputation. Multilevel multiple imputation led to coverage levels of approximately 95% throughout. © 2016 The Authors. Statistics in Medicine Published by John Wiley & Sons Ltd

Reduction in jejunal fluid absorption in vivo through distension and cholinergic stimulation not attributable to enterocyte secretion

Jejunal fluid absorption in vivo was reduced by distension and by hydrostatic pressure and further declined on adding E. coli STa enterotoxin but no net fluid secretion was detected. Luminal atropine reduced pressure mediated reductions in fluid absorption to normal values but intravenous hexamethonium was without effect. A neural component to inhibition of absorption by pressure (though not stretch) may be mediated by axon reflexes within cholinergic neurons.Perfusion of cholinergic compounds also reduced net fluid absorption but did not cause secretion. In order to show that these actions were not secretory processes stimulated by cholinergic compounds that offset normal rates of absorption, these compounds were tested for their ability to cause net secretion in loops that were perfused with solutions in which choline substituted for sodium ion. In addition, these perfusates additionally contained E. coli STa enterotoxin or EIPA (ethyl-isopropyl-amiloride) to minimize absorption.In these circumstances, where it might be expected to do so if it were acting through a secretory rather than an absorptive mechanism, carbachol did not cause net fluid secretion. Cholinergic stimulation and pressure induced distension are thought to reduce net fluid absorption through inducing secretion but are found only to reduce fluid absorption.In conclusion, distension and cholinergic stimulation of the small intestine are two further circumstances in which fluid secretion is assumed to explain their action on fluid movement, as required by the enterocyte secretion model of secretion but, which like STa enterotoxin, instead are only able to reduce fluid absorption. This casts further doubt on the widespread validity of the enterocyte secretion model for fluid appearance in the lumen in diarrhoeal diseases

Preliminary archaeoentomological analyses of permafrost-preserved cultural layers from the pre-contact Yup’ik Eskimo site of Nunalleq, Alaska : implications, potential and methodological considerations

Acknowledgements Site excavation and samples collection were conducted by archaeologists from the University of Aberdeen, with the help of archaeologists and student excavators from the University of Aberdeen University of Alaska Fairbanks and Bryn Mawr College, Kuskokwim Campus, College of Rural Alaska and residents of Quinhagak and Mekoryuk. This study is funded through AHRC grant to the project ‘Understanding Cultural Resilience and Climate Change on the Bering Sea through Yup’ik Ecological Knowledge, Lifeways, Learning and Archaeology’ to Rick Knecht, Kate Britton and Charlotta Hillderal (University of Aberdeen; AH/K006029/1). Thanks are due to Qanirtuuq Inc. and Quinhagak, Alaska for sampling permissions and to entomologists working at the CNC in Ottawa for allowing access to reference collections of beetles, lice and fleas. Yves Bousquet, Ales Smetana and Anthony E. Davies are specially acknowledged for their help with the identification of coleopteran specimens. Finally, we would also like to thank Scott Elias for useful comments on the original manuscript.Peer reviewedPublisher PD

Characterisation and in vitro antimicrobial potential of liposome encapsulated silver ions against Candida albicans

Liposomes are biocompatible, biodegradable, controlled delivery systems with the ability to encapsulate both lipophilic and hydrophilic compounds, including metal ions. Liposome encapsulated Ag(+) (lipo-Ag(+)), prepared by reverse-phase evaporation, was used as a controlled delivery system against Candida albicans. Characterisation of the lipo-Ag(+) indicated that the multilamellar vesicles with diameters ranging between ≈ 0.5 and 5.0 μm showed potential as a controlled delivery system to consistently deliver Ag(+) to C. albicans. Results from inductively coupled plasma (ICP) analysis showed higher association of cell bound Ag(+) at 15 mins post exposure when compared to unencapsulated Ag(+). Scanning electron microscopy (SEM) and transmission electron microscopy (TEM) indicate detrimental effects of Ag(+) on C. albicans cell structure. These effects along with the ICP results also correlate with previously reported time kill experiment observations

Multiple imputation for IPD meta-analysis: allowing for heterogeneity and studies with missing covariates.

Recently, multiple imputation has been proposed as a tool for individual patient data meta-analysis with sporadically missing observations, and it has been suggested that within-study imputation is usually preferable. However, such within study imputation cannot handle variables that are completely missing within studies. Further, if some of the contributing studies are relatively small, it may be appropriate to share information across studies when imputing. In this paper, we develop and evaluate a joint modelling approach to multiple imputation of individual patient data in meta-analysis, with an across-study probability distribution for the study specific covariance matrices. This retains the flexibility to allow for between-study heterogeneity when imputing while allowing (i) sharing information on the covariance matrix across studies when this is appropriate, and (ii) imputing variables that are wholly missing from studies. Simulation results show both equivalent performance to the within-study imputation approach where this is valid, and good results in more general, practically relevant, scenarios with studies of very different sizes, non-negligible between-study heterogeneity and wholly missing variables. We illustrate our approach using data from an individual patient data meta-analysis of hypertension trials. © 2015 The Authors. Statistics in Medicine Published by John Wiley & Sons Ltd

Transient Ionospheric Upflow Driven by Poleward Moving Auroral forms Observed During the Rocket Experiment for Neutral Upwelling 2 (RENU2) Campaign

This study examines cumulative effects of a series of poleward moving auroral forms on ion upflow and downflow. These effects are investigated using an ionospheric model with inputs derived from the Rocket Experiment for Neutral Upwelling 2 (RENU2) sounding rocket campaign. Auroral precipitation inputs are constrained by all‐sky imager brightness values resulting in significant latitudinal structuring in simulated ionospheric upflows due to transient forcing. For contrast, a case with steady forcing generates almost double the O+ upflow transport through 1,000 km when compared to poleward moving auroral form‐like structures. At high altitudes, model results show a spread in upflow response time dependent on ion mass, with molecular ions responding slower than atomic ions by several minutes. While the modeled auroral precipitation is not strong enough to accelerate ions to escape velocities, source populations available for higher‐altitude energization processes are greatly impacted by variable forcing exhibited by the RENU2 event.Key PointsImager data provide realistic transient forcing constraints for model inputs to simulate observations from a high‐latitude rocket flightTransient forcing deposits energy over a wider latitudinal region but less energy in any specific locationModeling a sequence of poleward moving auroral forms with realistic spatiotemporal variability generates significant latitudinal structuringPeer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/150562/1/grl59002.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/150562/2/grl59002-sup-0001-Text_SI-S01.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/150562/3/grl59002_am.pd

Life path analysis: scaling indicates priming effects of social and habitat factors on dispersal distances

1. Movements of many animals along a life-path can be separated into repetitive ones within home ranges and transitions between home ranges. We sought relationships of social and environmental factors with initiation and distance of transition movements in 114 buzzards Buteo buteo that were marked as nestlings with long-life radio tags. 2. Ex-natal dispersal movements of 51 buzzards in autumn were longer than for 30 later in their first year and than 35 extra-natal movements between home ranges after leaving nest areas. In the second and third springs, distances moved from winter focal points by birds that paired were the same or less than for unpaired birds. No post-nuptial movement exceeded 2 km. 3. Initiation of early ex-natal dispersal was enhanced by presence of many sibs, but also by lack of worm-rich loam soils. Distances travelled were greatest for birds from small broods and with relatively little short grass-feeding habitat near the nest. Later movements were generally enhanced by the absence of loam soils and short grassland, especially with abundance of other buzzards and probable poor feeding habitats (heathland, long grass). 4. Buzzards tended to persist in their first autumn where arable land was abundant, but subsequently showed a strong tendency to move from this habitat. 5. Factors that acted most strongly in ½-km buffers round nests, or round subsequent focal points, usually promoted movement compared with factors acting at a larger scale. Strong relationships between movement distances and environmental characteristics in ½-km buffers, especially during early ex-natal dispersal, suggested that buzzards became primed by these factors to travel far. 6. Movements were also farthest for buzzards that had already moved far from their natal nests, perhaps reflecting genetic predisposition, long-term priming or poor habitat beyond the study area

Anti-nausea effects and pharmacokinetics of ondansetron, maropitant and metoclopramide in a low-dose cisplatin model of nausea and vomiting in the dog: a blinded crossover study

Nausea is a subjective sensation which is difficult to measure in non-verbal species. The aims of this study were to determine the efficacy of three classes of antiemetic drugs in a novel low dose cisplatin model of nausea and vomiting and measure change in potential nausea biomarkers arginine vasopressin (AVP) and cortisol. A four period cross-over blinded study was conducted in eight healthy beagle dogs of both genders. Dogs were administered 18 mg/m2 cisplatin intravenously, followed 45 min later by a 15 min infusion of either placebo (saline) or antiemetic treatment with ondansetron (0.5 mg/kg; 5-HT3 antagonist), maropitant (1 mg/kg; NK1 antagonist) or metoclopramide (0.5 mg/kg; D2 antagonist). The number of vomits and nausea associated behaviours, scored on a visual analogue scale, were recorded every 15 min for 8 h following cisplatin administration. Plasma samples were collected to measure AVP, cortisol and antiemetic drug concentrations

Adenovirus: an emerging factor in red squirrel Sciurus vulgaris conservation

1. Adenovirus is an emerging threat to red squirrel Sciurus vulgaris conservation, but confirming clinically significant adenovirus infections in red squirrels is challenging. Rapid intestinal autolysis after death in wild animals frequently obscures pathology characteristic of the disease in animals found dead. 2. We review the available literature to determine current understanding of both subclinical and clinically significant adenovirus infections in free-living wild and captive red squirrel populations. 3. Benefits of scientific testing for adenovirus incorporating both transmission electron microscopy (TEM) and polymerase chain reaction (PCR) technologies are compared and contrasted. We favour viral particle detection using TEM in animals exhibiting enteropathy at post-mortem and the use of PCR to detect subclinical cases where no enteric abnormalities are observed. 4. Adenoviral infections associated with re-introduction studies are evaluated by examination of sporadic cases in wild populations and of data from captive collections used to service such studies. 5. The paucity of data available on adenovirus infection in grey squirrel Sciurus carolinensis populations is documented, and we highlight that although subclinical virus presence is recorded in several locations in Great Britain and in Italy, no clinically significant disease cases have been detected in the species thus far. 6. Current speculation about potential interspecific infection between sciurids and other woodland rodents such as wood mice Apodemus sylvaticus is examined. Where subclinical adenovirus presence has been detected in sympatric populations using the same point food sources, husbandry methods may be used to diminish the potential for cross-infection. 7. Our findings highlight the importance of controlling disease in red squirrel populations by using clearly defined scientific methods. In addition, we propose hypothetical conservation benefits of restricting contact rates between red squirrels and sympatric grey squirrels and of limiting competition from other woodland rodent species