On the preservation of fibre direction during axisymmetric hyperelastic mass-growth of a finite fibre-reinforced tube

Several types of tube-like fibre-reinforced tissue, including arteries and veins, different kinds of muscle, biological tubes as well as plants and trees, grow in an axially symmetric manner that preserves their own shape as well as the direction and, hence, the shape of their embedded fibres. This study considers the general, three-dimensional, axisymmetric mass-growth pattern of a finite tube reinforced by a single family of fibres growing with and within the tube, and investigates the influence that the preservation of fibre direction exerts on relevant mathematical modelling, as well on the physical behaviour of the tube. Accordingly, complete sets of necessary conditions that enable such axisymmetric tube patterns to take place are initially developed, not only for fibres preserving a general direction, but also for all six particular cases in which the fibres grow normal to either one or two of the cylindrical polar coordinate directions. The implied conditions are of kinematic character but are independent of the constitutive behaviour of the growing tube material. Because they hold in addition to, and simultaneously with standard kinematic relations and equilibrium equations, they describe growth by an overdetermined system of equations. In cases of hyperelastic mass-growth, the additional information they thus provide enable identification of specific classes of strain energy densities for growth that are admissible and, therefore, suitable for the implied type of axisymmetric tube mass-growth to take place. The presented analysis is applicable to many different particular cases of axisymmetric mass-growth of tube-like tissue, though admissible classes of relevant strain energy densities for growth are identified only for a few example applications. These consider and discuss cases of relevant hyperelastic mass-growth which (i) is of purely dilatational nature, (ii) combines dilatational and torsional deformation, (iii) enables preservation of shape and direction of helically growing fibres, as well as (iv) plane fibres growing on the cross-section of an infinitely long fibre-reinforced tube. The analysis can be extended towards mass-growth modelling of tube-like tissue that contains two or more families of fibres. Potential combination of the outlined theoretical process with suitable data obtained from relevant experimental observations could lead to realistic forms of much sought strain energy functions for growth

Association of trial registration with the results and conclusions of published trials of new oncology drugs

<p>Abstract</p> <p>Background</p> <p>Registration of clinical trials has been introduced largely to reduce bias toward statistically significant results in the trial literature. Doubts remain about whether advance registration alone is an adequate measure to reduce selective publication, selective outcome reporting, and biased design. One of the first areas of medicine in which registration was widely adopted was oncology, although the bulk of registered oncology trials remain unpublished. The net influence of registration on the literature remains untested. This study compares the prevalence of favorable results and conclusions among published reports of registered and unregistered randomized controlled trials of new oncology drugs.</p> <p>Methods</p> <p>We conducted a cross-sectional study of published original research articles reporting clinical trials evaluating the efficacy of drugs newly approved for antimalignancy indications by the United States Food and Drug Administration (FDA) from 2000 through 2005. Drugs receiving first-time approval for indications in oncology were identified using the FDA web site and Thomson Centerwatch. Relevant trial reports were identified using PubMed and the Cochrane Library. Evidence of advance trial registration was obtained by a search of clinicaltrials.gov, WHO, ISRCTN, NCI-PDQ trial databases and corporate trial registries, as well as articles themselves. Data on blinding, results for primary outcomes, and author conclusions were extracted independently by two coders. Univariate and multivariate logistic regression identified associations between favorable results and conclusions and independent variables including advance registration, study design characteristics, and industry sponsorship.</p> <p>Results</p> <p>Of 137 original research reports from 115 distinct randomized trials assessing 25 newly approved drugs for treating cancer, the 54 publications describing data from trials registered prior to publication were as likely to report statistically significant efficacy results and reach conclusions favoring the test drug (for results, OR = 1.77; 95% CI = 0.87 to 3.61) as reports of trials not registered in advance. In multivariate analysis, reports of prior registered trials were again as likely to favor the test drug (OR = 1.29; 95% CI = 0.54 to 3.08); large sample sizes and surrogate outcome measures were statistically significant predictors of favorable efficacy results at p < 0.05. Subgroup analysis of the main reports from each trial (n = 115) similarly indicated that registered trials were as likely to report results favoring the test drug as trials not registered in advance (OR = 1.11; 95% CI = 0.44 to 2.80), and also that large trials and trials with nonstringent blinding were significantly more likely to report results favoring the test drug.</p> <p>Conclusions</p> <p>Trial registration alone, without a requirement for full reporting of research results, does not appear to reduce a bias toward results and conclusions favoring new drugs in the clinical trials literature. Our findings support the inclusion of full results reporting in trial registers, as well as protocols to allow assessment of whether results have been completely reported.</p

Effects of alirocumab on types of myocardial infarction: insights from the ODYSSEY OUTCOMES trial

Aims  The third Universal Definition of Myocardial Infarction (MI) Task Force classified MIs into five types: Type 1, spontaneous; Type 2, related to oxygen supply/demand imbalance; Type 3, fatal without ascertainment of cardiac biomarkers; Type 4, related to percutaneous coronary intervention; and Type 5, related to coronary artery bypass surgery. Low-density lipoprotein cholesterol (LDL-C) reduction with statins and proprotein convertase subtilisin–kexin Type 9 (PCSK9) inhibitors reduces risk of MI, but less is known about effects on types of MI. ODYSSEY OUTCOMES compared the PCSK9 inhibitor alirocumab with placebo in 18 924 patients with recent acute coronary syndrome (ACS) and elevated LDL-C (≥1.8 mmol/L) despite intensive statin therapy. In a pre-specified analysis, we assessed the effects of alirocumab on types of MI. Methods and results  Median follow-up was 2.8 years. Myocardial infarction types were prospectively adjudicated and classified. Of 1860 total MIs, 1223 (65.8%) were adjudicated as Type 1, 386 (20.8%) as Type 2, and 244 (13.1%) as Type 4. Few events were Type 3 (n = 2) or Type 5 (n = 5). Alirocumab reduced first MIs [hazard ratio (HR) 0.85, 95% confidence interval (CI) 0.77–0.95; P = 0.003], with reductions in both Type 1 (HR 0.87, 95% CI 0.77–0.99; P = 0.032) and Type 2 (0.77, 0.61–0.97; P = 0.025), but not Type 4 MI. Conclusion  After ACS, alirocumab added to intensive statin therapy favourably impacted on Type 1 and 2 MIs. The data indicate for the first time that a lipid-lowering therapy can attenuate the risk of Type 2 MI. Low-density lipoprotein cholesterol reduction below levels achievable with statins is an effective preventive strategy for both MI types.For complete list of authors see http://dx.doi.org/10.1093/eurheartj/ehz299</p

Effect of alirocumab on mortality after acute coronary syndromes. An analysis of the ODYSSEY OUTCOMES randomized clinical trial

Background: Previous trials of PCSK9 (proprotein convertase subtilisin-kexin type 9) inhibitors demonstrated reductions in major adverse cardiovascular events, but not death. We assessed the effects of alirocumab on death after index acute coronary syndrome. Methods: ODYSSEY OUTCOMES (Evaluation of Cardiovascular Outcomes After an Acute Coronary Syndrome During Treatment With Alirocumab) was a double-blind, randomized comparison of alirocumab or placebo in 18 924 patients who had an ACS 1 to 12 months previously and elevated atherogenic lipoproteins despite intensive statin therapy. Alirocumab dose was blindly titrated to target achieved low-density lipoprotein cholesterol (LDL-C) between 25 and 50 mg/dL. We examined the effects of treatment on all-cause death and its components, cardiovascular and noncardiovascular death, with log-rank testing. Joint semiparametric models tested associations between nonfatal cardiovascular events and cardiovascular or noncardiovascular death. Results: Median follow-up was 2.8 years. Death occurred in 334 (3.5%) and 392 (4.1%) patients, respectively, in the alirocumab and placebo groups (hazard ratio [HR], 0.85; 95% CI, 0.73 to 0.98; P=0.03, nominal P value). This resulted from nonsignificantly fewer cardiovascular (240 [2.5%] vs 271 [2.9%]; HR, 0.88; 95% CI, 0.74 to 1.05; P=0.15) and noncardiovascular (94 [1.0%] vs 121 [1.3%]; HR, 0.77; 95% CI, 0.59 to 1.01; P=0.06) deaths with alirocumab. In a prespecified analysis of 8242 patients eligible for ≥3 years follow-up, alirocumab reduced death (HR, 0.78; 95% CI, 0.65 to 0.94; P=0.01). Patients with nonfatal cardiovascular events were at increased risk for cardiovascular and noncardiovascular deaths (P<0.0001 for the associations). Alirocumab reduced total nonfatal cardiovascular events (P<0.001) and thereby may have attenuated the number of cardiovascular and noncardiovascular deaths. A post hoc analysis found that, compared to patients with lower LDL-C, patients with baseline LDL-C ≥100 mg/dL (2.59 mmol/L) had a greater absolute risk of death and a larger mortality benefit from alirocumab (HR, 0.71; 95% CI, 0.56 to 0.90; Pinteraction=0.007). In the alirocumab group, all-cause death declined wit h achieved LDL-C at 4 months of treatment, to a level of approximately 30 mg/dL (adjusted P=0.017 for linear trend). Conclusions: Alirocumab added to intensive statin therapy has the potential to reduce death after acute coronary syndrome, particularly if treatment is maintained for ≥3 years, if baseline LDL-C is ≥100 mg/dL, or if achieved LDL-C is low. Clinical Trial Registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT01663402

Advancing brain network models to reconcile functional neuroimaging and clinical research

Functional magnetic resonance imaging (fMRI) captures information on brain function beyond the anatomical alterations that are traditionally visually examined by neuroradiologists. However, the fMRI signals are complex in addition to being noisy, so fMRI still faces limitations for clinical applications. Here we review methods that have been proposed as potential solutions so far, namely statistical, biophysical and decoding models, with their strengths and weaknesses. We especially evaluate the ability of these models to directly predict clinical variables from their parameters (predictability) and to extract clinically relevant information regarding biological mechanisms and relevant features for classification and prediction (interpretability). We then provide guidelines for useful applications and pitfalls of such fMRI-based models in a clinical research context, looking beyond the current state of the art. In particular, we argue that the clinical relevance of fMRI calls for a new generation of models for fMRI data, which combine the strengths of both biophysical and decoding models. This leads to reliable and biologically meaningful model parameters, which thus fulfills the need for simultaneous interpretability and predictability. In our view, this synergy is fundamental for the discovery of new pharmacological and interventional targets, as well as the use of models as biomarkers in neurology and psychiatry

Probabilistic ensemble simplified fuzzy ARTMAP for sonar target differentiation

This Study investigates the processing of sonar signals with ensemble neural networks for robust recognition of simple objects such as plane, corner and trapezium surface. The ensemble neural networks can differentiate the target objects with high accuracy. The simplified fuzzy ARTMAP (SFAM) and probabilistic ensemble simplified fuzzy ARTMAP (PESFAM) are compared in terms of classification accuracy. The PESFAM implements an accurate and effective probabilistic plurality voting method to combine outputs from multiple SFAM classifiers. Five benchmark data sets have been used to evaluate the applicability of the proposed ensemble SFAM network. The PESFAM achieves good accuracy based on the twofold cross-validation results. In addition, the effectiveness of the proposed ensemble SFAM is delineated in sonar target differentiation. The experiments demonstrate the potential of PESFAM classifiers in offering an optimal solution to the data-ordering problem of SFAM implementation and also as an intelligent classification tool in mobile robot application

Text-dependent speaker recognition using wavelets and neural networks

An intelligent system for text-dependent speaker recognition is proposed in this paper. The system consists of a wavelet-based module as the feature extractor of speech signals and a neural-network-based module as the signal classifier. The Daubechies wavelet is employed to filter and compress the speech signals. The fuzzy ARTMAP (FAM) neural network is used to classify the processed signals. A series of experiments on text-dependent gender and speaker recognition are conducted to assess the effectiveness of the proposed system using a collection of vowel signals from 100 speakers. A variety of operating strategies for improving the FAM performance are examined and compared. The experimental results are analyzed and discussed.<br /

A hybrid neural network classifier combining ordered fuzzy ARTMAP and the dynamic decay adjustment algorithm

This paper presents a novel conflict-resolving neural network classifier that combines the ordering algorithm, fuzzy ARTMAP (FAM), and the dynamic decay adjustment (DDA) algorithm, into a unified framework. The hybrid classifier, known as Ordered FAMDDA, applies the DDA algorithm to overcome the limitations of FAM and ordered FAM in achieving a good generalization/performance. Prior to network learning, the ordering algorithm is first used to identify a fixed order of training patterns. The main aim is to reduce and/or avoid the formation of overlapping prototypes of different classes in FAM during learning. However, the effectiveness of the ordering algorithm in resolving overlapping prototypes of different classes is compromised when dealing with complex datasets. Ordered FAMDDA not only is able to determine a fixed order of training patterns for yielding good generalization, but also is able to reduce/resolve overlapping regions of different classes in the feature space for minimizing misclassification during the network learning phase. To illustrate the effectiveness of Ordered FAMDDA, a total of ten benchmark datasets are experimented. The results are analyzed and compared with those from FAM and Ordered FAM. The outcomes demonstrate that Ordered FAMDDA, in general, outperforms FAM and Ordered FAM in tackling pattern classification problems.<br /