Understanding an impact of patient enrollment pattern on predictability of central (unstratified) randomization in a multi-center clinical trial.

In a multi-center randomized controlled trial (RCT) with competitive recruitment, eligible patients are enrolled sequentially by different study centers and are randomized to treatment groups using the chosen randomization method. Given the stochastic nature of the recruitment process, some centers may enroll more patients than others, and in some instances, a center may enroll multiple patients in a row, for example, on a given day. If the study is open-label, the investigators might be able to make intelligent guesses on upcoming treatment assignments in the randomization sequence, even if the trial is centrally randomized and not stratified by center. In this paper, we use enrollment data inspired by a real multi-center RCT to quantify the susceptibility of two restricted randomization procedures, the permuted block design and the big stick design, to selection bias under the convergence strategy of Blackwell and Hodges (1957) applied at the center level. We provide simulation evidence that the expected proportion of correct guesses may be greater than 50% (i.e., an increased risk of selection bias) and depends on the chosen randomization method and the number of study patients recruited by a given center that takes consecutive positions on the central allocation schedule. We propose some strategies for ensuring stronger encryption of the randomization sequence to mitigate the risk of selection bias.

Asymmetric Synthesis of Functionalized α-Amino Acid Derivatives via the γ-Pyrone Carbaldimine-Based Organocatalytic Mannich Reaction.

A powerful synthetic strategy for the asymmetric synthesis of enantiomerically enriched γ-functionalized α-amino acid derivatives based on the highly stereoselective proline-catalyzed Mannich-type reaction of pre-prepared or in situ-generated γ-pyrone-derived aldimines with carbonyl compounds and subsequent transformations of multifunctional reaction products has been developed. A significant positive nonlinear effect was detected for the key organocatalytic reaction. The developed strategy was applied for facile gram-scale preparation of (S)-γ-oxonorvaline, used for site-specific modification of proteins, and both enantiomers of amycolatolide A recently isolated from the lichen-derived actinomycete Amycolatopsis sp. YIM 130923.

Selecting a randomization method for a multi-center clinical trial with stochastic recruitment considerations.

BACKGROUND: The design of a multi-center randomized controlled trial (RCT) involves multiple considerations, such as the choice of the sample size, the number of centers and their geographic location, the strategy for recruitment of study participants, amongst others. There are plenty of methods to sequentially randomize patients in a multi-center RCT, with or without considering stratification factors. The goal of this paper is to perform a systematic assessment of such randomization methods for a multi-center 1:1 RCT assuming a competitive policy for the patient recruitment process. METHODS: We considered a Poisson-gamma model for the patient recruitment process with a uniform distribution of center activation times. We investigated 16 randomization methods (4 unstratified, 4 region-stratified, 4 center-stratified, 3 dynamic balancing randomization (DBR), and a complete randomization design) to sequentially randomize n = 500 patients. Statistical properties of the recruitment process and the randomization procedures were assessed using Monte Carlo simulations. The operating characteristics included time to complete recruitment, number of centers that recruited a given number of patients, several measures of treatment imbalance and estimation efficiency under a linear model for the response, the expected proportions of correct guesses under two different guessing strategies, and the expected proportion of deterministic assignments in the allocation sequence. RESULTS: Maximum tolerated imbalance (MTI) randomization methods such as big stick design, Ehrenfest urn design, and block urn design result in a better balance-randomness tradeoff than the conventional permuted block design (PBD) with or without stratification. Unstratified randomization, region-stratified randomization, and center-stratified randomization provide control of imbalance at a chosen level (trial, region, or center) but may fail to achieve balance at the other two levels. By contrast, DBR does a very good job controlling imbalance at all 3 levels while maintaining the randomized nature of treatment allocation. Adding more centers into the study helps accelerate the recruitment process but at the expense of increasing the number of centers that recruit very few (or no) patients-which may increase center-level imbalances for center-stratified and DBR procedures. Increasing the block size or the MTI threshold(s) may help obtain designs with improved randomness-balance tradeoff. CONCLUSIONS: The choice of a randomization method is an important component of planning a multi-center RCT. Dynamic balancing randomization with carefully chosen MTI thresholds could be a very good strategy for trials with the competitive policy for patient recruitment.

Current trends and challenges in the analysis of marine environmental contaminants by isotope ratio mass spectrometry.

An increasing number of organic and inorganic pollutants are being detected in the marine environment, posing a severe threat to the ecosystem and human health, even in trace concentrations. Isotope ratio mass spectrometry (IRMS) is one of the critical methods for determining the origin and fate of environmental pollutants and characterising their transformation processes. It has been used for a relatively long time for ecological monitoring of some well-studied industrial hydrocarbons at contaminated sites. However, the method still faces many analytical challenges. This review provides a comprehensive overview of recent technical advances concerning IRMS analysis of various contaminants and discusses typical pitfalls encountered in marine environment analysis. Particular attention is given to the study of sampling techniques and sample preparation for examination, often the keys to successful research given the complexity of marine matrices and the diverse and numerous nature of contaminants. Prospects for developing IRMS to monitor pollution sources and pollutant transformation in the marine environment are outlined.

Sphingolipid Metabolism in Tumor Cells.

Sphingolipids are a diverse family of complex lipids typically composed of a sphingoid base bound to a fatty acid via amide bond. The metabolism of sphingolipids has long remained out of focus of biochemical studies. Recently, it has been attracting an increasing interest of researchers because of different and often multidirectional effects demonstrated by sphingolipids with a similar chemical structure. Sphingosine, ceramides (N-acylsphingosines), and their phosphorylated derivatives (sphingosine-1-phosphate and ceramide-1-phosphates) act as signaling molecules. Ceramides induce apoptosis and regulate stability of cell membranes and cell response to stress. Ceramides and sphingoid bases slow down anabolic and accelerate catabolic reactions, thus suppressing cell proliferation. On the contrary, their phosphorylated derivatives (ceramide-1-phosphate and sphingosine-1-phosphate) stimulate cell proliferation. Involvement of sphingolipids in the regulation of apoptosis and cell proliferation makes them critically important in tumor progression. Sphingolipid metabolism enzymes and sphingolipid receptors can be potential targets for antitumor therapy. This review describes the main pathways of sphingolipid metabolism in human cells, with special emphasis on the properties of this metabolism in tumor cells.

Analysis of Engineered Nanoparticles in Seawater Using ICP-MS-Based Technology: From Negative to Positive Samples.

A growing global emission of engineered nanoparticles (ENPs) into the aquatic environment has become an emerging safety concern that requires methods capable of identifying the occurrence and possibly determining the amounts of ENPs. In this study, we employed sector-field inductively coupled mass spectrometry to assess the presence of ENPs in coastal seawater samples collected from the Black Sea in regions suffering different anthropogenic impacts. Ultrafiltration through commercial 3 kDa membrane filters was shown to be feasible to separate the ENPs from the bulk seawater, and the subsequent ultrasound-mediated acidic dissolution makes the metals constituting the ENPs amenable to analysis. This procedure allowed the ENPs bearing Cu, Zn, V, Mo, and Sn to be for the first time quantitated in seashore surface water, their concentration ranging from 0.1 to 1.0 µg L-1 (as metal) and related to the presence of industry and/or urban stress. While these levels are decreased by natural dilution and possible sedimentation, the monitored ENPs remain measurable at a distance of 2 km from the coast. This can be attributed not only to local emission sources but also to some natural backgrounds.

Metal-Specific Response of High-Resolution ICP-MS for Proteins Binding to Gold Nanoparticles in Human Serum.

Metalloproteins have many different functions such as storage and transport of proteins, enzymes, signal transduction proteins, etc. Herein, for a selection of gold nanoparticles differing in shape, size, charge, and surface modification, the binding behavior in human serum was assessed with respect to metal-containing proteins. Our results based on sector-field ICP-MS measurements and a simple calculation algorithm indicate the possible involvement of proteins, incorporating Cu and Fe, in the formation of the biomolecular layer around the particle surface. Given that such binding encompasses a substantial amount of copper and iron within the serum proteome (>50%) at a calculated nanoparticle dose, it may result in depleting their biological functions and should be taken into account when selecting lead candidates with an improved biocompatibility.

Production of 6-l-[18F]Fluoro-m-tyrosine in an Automated Synthesis Module for 11C-Labeling.

6-l-[18F]Fluoro-m-tyrosine (6-l-[18F]FMT) represents a valuable alternative to 6-l-[18F]FDOPA which is conventionally used for the diagnosis and staging of Parkinson's disease. However, clinical applications of 6-l-[18F]FMT have been limited by the paucity of practical production methods for its automated production. Herein we describe the practical preparation of 6-l-[18F]FMT using alcohol-enhanced Cu-mediated radiofluorination of Bpin-substituted chiral Ni(II) complex in the presence of non-basic Bu4ONTf using a volatile iPrOH/MeCN mixture as reaction solvent. A simple and fast radiolabeling procedure afforded the tracer in 20.0 ± 3.0% activity yield within 70 min. The developed method was directly implemented onto a modified TracerLab FX C Pro platform originally designed for 11C-labeling. This method enables an uncomplicated switch between 11C- and 18F-labeling. The simplicity of the developed procedure enables its easy adaptation to other commercially available remote-controlled synthesis units and paves the way for a widespread application of 6-l-[18F]FMT in the clinic.

Preliminary Assessment of the Anti-inflammatory Activity of New Structural Honokiol Analogs with a 4'-O-(2-Fluoroethyl) Moiety and the Potential of Their 18F-Labeled Derivatives for Neuroinflammation Imaging.

Neolignans honokiol and 4'-O-methylhonokiol (MH) and their derivatives have pronounced anti-inflammatory activity, as evidenced by numerous pharmacological studies. Literature data suggested that cyclooxygenase type 2 (COX-2) may be a target for these compounds in vitro and in vivo. Recent studies of [11C]MPbP (4'-[11C]methoxy-5-propyl-1,1'-biphenyl-2-ol) biodistribution in LPS (lipopolysaccharide)-treated rats have confirmed the high potential of MH derivatives for imaging neuroinflammation. Here, we report the synthesis of four structural analogs of honokiol, of which 4'-(2-fluoroethoxy)-2-hydroxy-5-propyl-1, 1'-biphenyl (F-IV) was selected for labeling with fluorine-18 (T1/2 = 109.8 min) due to its high anti-inflammatory activity confirmed by enzyme immunoassays (EIA) and neuromorphological studies. The high inhibitory potency of F-IV to COX-2 and its moderate lipophilicity and chemical stability are favorable factors for the preliminary evaluation of the radioligand [18F]F-IV in a rodent model of neuroinflammation. [18F]F-IV was prepared with good radiochemical yield and high molar activity and radiochemical purity by 18F-fluoroethylation of the precursor with Boc-protecting group (15) with [18F]2-fluoro-1-bromoethane ([18F]FEB). Ex vivo biodistribution studies revealed a small to moderate increase in radioligand uptake in the brain and peripheral organs of LPS-induced rats compared to control animals. Pretreatment with celecoxib resulted in significant blocking of radioactivity uptake in the brain (pons and medulla), heart, lungs, and kidneys, indicating that [18F]F-IV is likely to specifically bind to COX-2 in a rat model of neuroinflammation. However, in comparison with [11C]MPbP, the new radioligand showed decreased brain uptake in LPS rats and high retention in the blood pool, which apparently could be explained by its high plasma protein binding. We believe that the structure of [18F]F-IV can be optimized by replacing the substituents in the biphenyl core to eliminate these disadvantages and develop new radioligands for imaging activated microglia.

How versatile is the use of ultrafiltration to study biointeractions of therapeutic metallodrugs?

For a representative number of approved or investigational anticancer metallodrugs varying in lipophilicity, unspecific adsorption onto ultracentrifugal filter units was studied. It was found that for fairly hydrophilic compounds, such as cisplatin and oxaliplatin, the binding to filters does not substantially affect their amount measured (by ICP-MS) after ultrafiltration (>95%). In the case of metal complexes with moderate lipophilicity (log P > -0.1), adsorption effects turn out to be substantial. This might impede using ultrafiltration for studying the transformations of such drugs in human serum, unless they are rapidly converted into the protein adducts. The adsorption-suppressing effect of proteins was proved for indazolium trans-[tetrachloridobis(1H-indazole)ruthenate(III)] whose recovery from the filters was 61 and 14% in free and HSA-bound form, respectively.

An ICP-MS-based assay for characterization of gold nanoparticles with potential biomedical use.

Most of potential diagnostic and therapeutic nanoparticles fail to reach clinical trials because assessment of their 'drug-like' properties is often overlooked during the discovery stage. This compromises the results of cell culture and animal experiments, making them insufficient to evaluate the lead candidates for testing on patients. In this study, we demonstrate the potential of high-resolution inductively coupled plasma mass spectrometry (ICP-MS) as a nanoparticle qualification tool. Using novel gold nanoparticles stabilized by N-heterocyclic carbenes as test nanoparticles, it was shown that important prerequisites for biomedical applications, such as resistance to the action of human serum milieu or reactivity toward serum biomolecules, can be reliably assessed by recording the signals of gold or sulfur isotopes. Implemented during the screening stage, the method would provide benefits in shortening timelines and reducing cost for selection and initial testing of medicinal nanoparticle candidates.

An isotope ratio mass spectrometry-based method for hydrogen isotopic analysis in sub-microliter volumes of water: Application for multi-isotope investigations of gases extracted from fluid inclusions.

RATIONALE: The study of multi-isotope systematics of fluid inclusions is of great importance for understanding of the sources and evolution of fluid phases in mantle rocks and ore deposits. The most appropriate technique for such investigations is a (stepwise) crushing method that is widely used for noble gases and nitrogen. However, because of the possible influence of mechanochemical reactions and back sorption, analyses of the isotope composition of water extracted by crushing from fluid inclusions are challenging. METHODS: An isotope ratio mass spectrometry (IRMS)-based method for hydrogen (and oxygen) isotopic analysis in sub-microliter volumes of water extracted from fluid inclusions by crushing is presented. The verification of the possible influence of adsorption processes and mechanochemical reactions on the results of isotope analysis was performed for the first time. For that a series of parallel analyses of hydrogen isotopic ratios from water inclusions in quartz applying physically different extraction methods (crushing and thermodecrepitation) was conducted. RESULTS: Four series of quartz aliquots were analyzed: three series extracting water by crushing (two series for δ2 H values and one for δ18 O values) and one by thermodecrepitation. The mean value for the crushing results is δ2 H = -85.3 ± 3.6 ‰ (1σ, n = 11), which coincides well with the thermodecrepitation data (-86.3 ± 2.0 ‰, 1σ, n = 5), suggesting that our methodological approach allows the influence of back sorption or mechanochemical reactions during the crushing experiment to be minimized. The reproducibility of the oxygen isotopic ratios is ±0.9 ‰ (1σ, n = 5). CONCLUSIONS: The conducted experiments have shown that the influence of back sorption or mechanochemical reactions during crushing on isotopic results is not crucial for our method. The developed IRMS-based method for hydrogen (and oxygen) isotopic analysis in sub-microliter volumes of water is well applicable for multi-isotope investigations of gases extracted from fluid inclusions. As an application a well-defined 40 Ar/36 Ar-δ2 H correlation in mantle rocks is presented for the first time.

Alcohol-Supported Cu-Mediated 18F-Fluorination of Iodonium Salts under "Minimalist" Conditions.

In the era of personalized precision medicine, positron emission tomography (PET) and related hybrid methods like PET/CT and PET/MRI gain recognition as indispensable tools of clinical diagnostics. A broader implementation of these imaging modalities in clinical routine is closely dependent on the increased availability of established and emerging PET-tracers, which in turn could be accessible by the development of simple, reliable, and efficient radiolabeling procedures. A further requirement is a cGMP production of imaging probes in automated synthesis modules. Herein, a novel protocol for the efficient preparation of 18F-labeled aromatics via Cu-mediated radiofluorination of (aryl)(mesityl)iodonium salts without the need of evaporation steps is described. Labeled aromatics were prepared in high radiochemical yields simply by heating of iodonium [18F]fluorides with the Cu-mediator in methanolic DMF. The iodonium [18F]fluorides were prepared by direct elution of 18F- from an anion exchange resin with solutions of the corresponding precursors in MeOH/DMF. The practicality of the novel method was confirmed by the racemization-free production of radiolabeled fluorophenylalanines, including hitherto unknown 3-[18F]FPhe, in 22-69% isolated radiochemical yields as well as its direct implementation into a remote-controlled synthesis unit.

Approaches to expanding the two-arm biased coin randomization to unequal allocation while preserving the unconditional allocation ratio.

The paper discusses three methods for expanding the biased coin randomization (BCR) to unequal allocation while preserving the unconditional allocation ratio at every step. The first method originally proposed in the contexts of BCR and minimization is based on mapping from an equal allocation multi-arm BCR. Despite the improvement proposed in this paper to ensure tighter adherence to the targeted unequal allocation, this method still distributes the probability mass at least as wide as the permuted block randomization (PBR). This works for smaller block sizes, but for larger block sizes, a tighter control of the imbalance in the treatment assignments is desired. The second method, which has two versions, allows to tighten the distribution of the imbalance compared with that achieved with the PBR. However, the distribution of the imbalance remains considerably wider than that of the brick tunnel randomization - the unequal allocation procedure with the tightest possible imbalance distribution among all allocation ratio preserving procedures with the same allocation ratio. Finally, the third method, the BCR with a preset proportion of maximal forcing, mimics the properties of the equal allocation BCR. With maximum forcing, it approaches the brick tunnel randomization, similar to how 1:1 BCR approaches 1:1 PBR with the permuted block size of 2 (the equal allocation procedure with the lowest possible imbalance) when the bias approaches 1. With minimum forcing, the BCR with a preset proportion of maximal forcing approaches complete randomization (similar to 1:1 BCR). Copyright © 2017 John Wiley & Sons, Ltd.

Simultaneous Introduction of Two Nitroxides in the Reaction: A New Approach to the Synthesis of Heterospin Complexes.

A new approach to the synthesis of multispin compounds has been developed, namely, the simultaneous introduction of two different stable nitroxides (nitronyl nitroxide and imino nitroxide) in a reaction with a metal ion. An important characteristic of the new method is that nitronyl nitroxide and imino nitroxide introduced in the reaction with the metal are the products of different series; i.e., the nitronyl nitroxide molecule differs from the imino nitroxide molecule not only in one additional oxygen molecule per molecule but also in another substituent in the side chain of the organic paramagnet. This possibility was demonstrated on the synthesis of multispin compounds [Ni2(A1)(L2)2(Piv)(MeOH)], [Ni2(L1)(A2)2(Piv)(H2O)], [Co2(A1)(L2)2(Piv)(MeOH)], and [Co3(L1)2(A2)2(Piv)2], in which Ln and An differ in the substituent in the phenyl ring. The number of multispin compounds that can be synthesized by the proposed method is almost unlimited. The heterospin complexes of transition metals with coordinated nitronyl nitroxide and imino nitroxide in one molecule contain energy-different exchange interaction channels that differ in both magnitude and sign, as confirmed by the quantum-chemical analysis of exchange channels in [Ni(B1)(B2)2](NO3)2. The series of mixed-radical complexes may include compounds with nontrivial magnetic properties such as [Co2(A1)(L2)2(Piv)(MeOH)], which experiences bulk magnetic ordering below 3.5 K.

Human snRNA genes use polyadenylation factors to promote efficient transcription termination.

RNA polymerase II transcribes both protein coding and non-coding RNA genes and, in yeast, different mechanisms terminate transcription of the two gene types. Transcription termination of mRNA genes is intricately coupled to cleavage and polyadenylation, whereas transcription of small nucleolar (sno)/small nuclear (sn)RNA genes is terminated by the RNA-binding proteins Nrd1, Nab3 and Sen1. The existence of an Nrd1-like pathway in humans has not yet been demonstrated. Using the U1 and U2 genes as models, we show that human snRNA genes are more similar to mRNA genes than yeast snRNA genes with respect to termination. The Integrator complex substitutes for the mRNA cleavage and polyadenylation specificity factor complex to promote cleavage and couple snRNA 3'-end processing with termination. Moreover, members of the associated with Pta1 (APT) and cleavage factor I/II complexes function as transcription terminators for human snRNA genes with little, if any, role in snRNA 3'-end processing. The gene-specific factor, proximal sequence element-binding transcription factor (PTF), helps clear the U1 and U2 genes of nucleosomes, which provides an easy passage for pol II, and the negative elongation factor facilitates termination at the end of the genes where nucleosome levels increase. Thus, human snRNA genes may use chromatin structure as an additional mechanism to promote efficient transcription termination in vivo.

Brick tunnel randomization and the momentum of the probability mass.

The allocation space of an unequal-allocation permuted block randomization can be quite wide. The development of unequal-allocation procedures with a narrower allocation space, however, is complicated by the need to preserve the unconditional allocation ratio at every step (the allocation ratio preserving (ARP) property). When the allocation paths are depicted on the K-dimensional unitary grid, where allocation to the l-th treatment is represented by a step along the l-th axis, l = 1 to K, the ARP property can be expressed in terms of the center of the probability mass after i allocations. Specifically, for an ARP allocation procedure that randomizes subjects to K treatment groups in w1 :⋯:wK ratio, w1 +⋯+wK =1, the coordinates of the center of the mass are (w1 i,…,wK i). In this paper, the momentum with respect to the center of the probability mass (expected imbalance in treatment assignments) is used to compare ARP procedures in how closely they approximate the target allocation ratio. It is shown that the two-arm and three-arm brick tunnel randomizations (BTR) are the ARP allocation procedures with the tightest allocation space among all allocation procedures with the same allocation ratio; the two-arm BTR is the minimum-momentum two-arm ARP allocation procedure. Resident probabilities of two-arm and three-arm BTR are analytically derived from the coordinates of the center of the probability mass; the existence of the respective transition probabilities is proven. Probability of deterministic assignments with BTR is found generally acceptable. Copyright © 2015 John Wiley & Sons, Ltd.

Intimate partner violence and ways of coping with stress: cross-sectional survey of female patients in Russian general practice.

BACKGROUND: Despite World Health Organization guidelines on health service responses to intimate partner violence (IPV) against women general practitioners (GPs) often overlook the problem. Training on IPV addresses GPs' barriers to asking women patients about abuse and responding appropriately. One of the barriers is stereotype of women as passive victims. Little is known about coping behaviour of women patients with a history of IPV. OBJECTIVES: The objectives are (i) to compare problem- and emotion-focused coping used by patients who have experienced IPV with those who have not; (ii) to examine whether greater coping resources (health, education, employment and income) would be associated with more problem-focused coping. METHODS: The Russian Ways of Coping Questionnaire was administered to every fifth woman who participated in a cross-sectional survey on IPV prevalence in 24 St Petersburg general practices. Linear regression was used (n = 159) to test associations between life-time IPV, coping resources and ways of coping. RESULTS: Mean problem-focused coping scores were 0.2-4.7 units higher in those patients who have experienced IPV compared with those who have not [95% confidence interval (CI): -4.2, 11.9; P = 0.16-0.92], while mean emotion-focused coping scores were 2.5-4.2 units higher (95% CI: -3.0, 11.0; P = 0.12-0.57). After adjustment for coping resources there was no evidence for an association between IPV and problem-focused coping. CONCLUSIONS: Patients who have experienced IPV use as much problem-focused and emotion-focused coping, as those patients who have not experienced IPV. These findings should be incorporated into training on IPV to address GPs' stereotypes towards patients who have experienced IPV.