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Seizure frequency in intractable partial epilepsy: a statistical analysis.

We examined the seizure records of 13 patients (nine men and four women, ages 27-50 years) with intractable partial epilepsy, maintained with steady anti-epileptic drug dosages. Patients recorded daily seizure frequency on calendars. Periods of outpatient observation ranged from 99 to 1,710 days and the number of observed seizures ranged from 18 to over 400, with daily seizure rates of 0.1-4.3 per day. We used the quasi-likelihood regression model to examine the following four departures of the daily seizure counts from a Poisson (random) model: (1) linear increasing or decreasing time trends in expected seizure rates; (2) clustering, where the expected seizure rate on a given day depends on the number of seizures observed on the immediate prior days; (3) monthly cyclicity; and (4) increased variability (overdispersion). Linear time trends were seen in six patients (four increasing and two decreasing), clustering was seen in 10 patients, and a near-monthly cycle appeared in four patients (two of nine men and two of four women). A significant amount of extra variation (overdispersion) relative to a Poisson distribution was observed in all but one of the 13 patients. Departures from a Poisson (random) model appear more common in this population of patients with medically intractable epilepsy than is commonly recognized, and have clinical importance as well as implications for the design of clinical studies.

Adult

Monitoring tsetse fly populations. II. The effect of climate on trap catches of Glossina pallidipes.

In Part I it was shown that the sampling distribution of trap catches of tsetse flies, Glossina pallidipes Austen, at Nguruman, Kenya, using unbaited biconical traps follows a Poisson distribution. In this paper we examine the effect of humidity and temperature on day-to-day and seasonal variations in the trap catches. It is shown that the seasonal variation is significantly correlated with maximum daily temperature, the catches increasing with temperature when the maximum temperature is below 34 degrees C and decreasing with temperature when it is above 34 degrees C. The correlation between trap catches and relative humidity is not as good as the correlation with the maximum temperature, and the two together do not improve the fit to the trap catches. The day-to-day variation is significantly greater than the intrinsic variation due to the stochastic nature of the sampling process and for some traps it is correlated with temperature and humidity. An autoregressive model gives a half-life for the decay of departures from the mean of about 1 day and it is suggested that this indicates the movement of flies in response to animal movement or to climatic factors other than temperature or humidity. After removing the temperature dependent part of the seasonal variation and the autoregressive component of the data, the male and female catches are still significantly correlated.

Animals

Power and detectable risk of seven tests for standardized mortality ratios.

Power and minimum detectable risk are calculated for seven one-sided tests of standardized mortality ratios with Poisson-distributed events. Each test contrasts the number of observed deaths (D) with the number expected (E). Three tests use exact Poisson probabilities: 1) the exact test, which computes a p value as the probability of equaling or exceeding the number of observed events; 2) the optimal randomized exact test which, although not used in practice, serves as a standard for the other statistics; and 3) the exact "mid-p" procedure, which counts only one-half the probability of the observed event. The remaining four tests use normal approximations to the Poisson ("Z statistics"): 4) Z = magnitude of D-E/square root of E; 5) the Z statistic corrected for continuity, Z = (magnitude of D-E)-0.5)/square root of E; 6) a statistic based on a square root transformation, Z = 2(square root of D-square root of E); and 7) a statistic created by Byar, which, when D is greater than E, is Z = square root of 9D[1-1/(9D)-3 square root of D/E]. Power differences among these procedures with one-sided alpha of 0.05, 0.025, and 0.01 are small as long as four or more events are expected. If fewer than four events are expected, the uncorrected Z has unacceptably high type I error. Simple approximations to the power and detectable risk of these tests are evaluated and prove satisfactory. Differences in minimum detectable risk, actual and approximated, are slight for E of 2.0 or more.

Humans

Improved evaluation of binding of ligands to membranes containing several receptor-subtypes.

In order to evaluate accurately affinity characteristics and relative size of populations of receptor-subtypes in one system we analysed three relevant problems encountered in binding assays. Binding to receptors caused a decrease in the free ligand concentration (i.e. "depletion"). The neglect of depletion may lead to significant distortions of the estimates of affinity and size of receptor-subtype population when the concentrations of both receptor and ligand are of similar magnitude. The distortion is particularly marked when the affinity of a competing ligand is higher than the affinity of the radioligand. We present a formula that describes binding inhibition in a system with receptor-subtypes under conditions of depletion. Binding data usually exhibit heteroscedasticity (i.e. heterogeneous variance), which can not be neglected especially in a system with receptor heterogeneity. Assuming a log normal distribution of experimental errors and a Poisson distribution for errors due to radioactivity counting we derived a function for the transformation of binding data. Transformed data show homoscedasticity, as illustrated with experiments on membranes of guinea-pig lung using ICI 118,551 as inhibitor of 3H-(-)-bupranolol binding to beta 1- and beta 2-adrenoceptors. The hypothesis that affinity characteristics of receptor subtypes are independent of the tissue class can not be tested accurately by the use of standard methods because of interferences of errors between experiments. We propose a method to account for differences between experiments. Assuming invariance of affinity characteristics one is able to perform common fits of data from different tissue classes.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenergic beta-Antagonists

Exact calculation of probabilities of false positives and false negatives for low background counting.

The purpose of this paper is to demonstrate the derivation and use of exact formulas, and their algorithms, for calculating the probabilities alpha of Type I errors, and beta of Type II errors, for low blank total counts (Poisson-distributed). The calculations are carried out to examine the alpha and beta probabilities at low blank levels of the decision level (DL) and minimum detectable amount (MDA) formulations as adopted in the Health Physics Society Standard, "Performance Criteria for Radiobioassay." These formulations are consistent with those published by L.A. Currie, which have received wide acceptance in defining lower limits of detection (LLD). Although Currie's formulation was derived assuming a normal distribution in net counts, the behavior of the distribution of net counts at low count levels, which is a distribution of the difference between two Poisson variates, is such that the MDA formulation in the standard could be considered acceptable for the purpose of providing one simple formulation of MDA. The derivations in this note can also be useful in other problems involving differences in Poisson variates, such as those in certain population studies.

Background Radiation

Quantal analysis of transmitter release at an inhibitory synapse in the central nervous system of the leech.

The quantal nature of transmitter release has been analysed at central inhibitory synapses in the leech nervous system between an interneurone (HN) and a motoneurone (HE) that regulate the heartbeat. 1. Ganglia were bathed in leech Ringer fluid containing 20 mM-Mg and 1.8 mM-Ca and the membrane of the presynaptic HN interneurone was hyperpolarized by current injection. Under these conditions successive inhibitory potentials in the HE motoneurone, evoked by impulses in the HN interneurone, showed striking fluctuations in amplitude. 2. Assuming a Poisson distribution of the i.p.s.p.s and estimating the number of failures from the amplitude histograms of the observed responses, the mean size of the quantal unit was estimated as 0.25 +/- 0.015 mV (S.E. of mean, n = 26). When m, the mean number of quanta released per trial, was varied by changing the membrane potential of the presynaptic HN cell (Nicholls & Wallace, 1978), the experimentally observed amplitude distributions could be predicted by the Poisson theory. 3. An independent estimate of the unit size was obtained by noise analysis. A long subthreshold depolarizing pulse applied to the presynaptic HN interneurone evoked a sustained hyperpolarization of the HE motoneurone, apparently caused by an increase in the rate of on-going release of quanta by the HN cell terminals. From the mean change in membrane potential and the increase in variance, the size of the unit was calculated as 0.21 +/- 0.039 mV (S.E. of mean, n = 11). For ten pairs of cells an estimate of unit amplitude was made both from the Poisson analysis and the analysis of variance, again with good agreement. For these cells the estimated unit sizes were 0.24 +/- 0.023 mV (S.E. of mean, n = 10) from the failures and 0.21 +/- 0.043 m V (S.E. of mean, n = 10) from the noise. 4. A similar analysis was made of the inhibitory synaptic potentials evoked in one HN interneurone by stimulation of its contralateral homologue. Transmission again appeared to be qualtal; the mean unit amplitude from Poisson analysis was 0.31 +/- 0.022 mV (S.E. of mean, n = 19) and from the noise 0.29 +/- 0.027 mV (S.E. of mean, n = 3). 5. We conclude that transmitter is released from the terminals of the HN interneurone in quantal units that evoke miniature i.p.s.p.s of about 0.25 mV in the post-synaptic cells. Furthermore, modulation of transmission proudced by variation in the presynaptic resting potential and during presynaptic inhibition results from changes in the mean number of quanta released by each impulse.

Animals

Monitoring of genotoxic exposure of humans by the sister chromatid exchange test. Methodology and confounding factors.

During the last decades several in vitro assays for measurement of genotoxic exposure have been developed. Exposure of humans to genotoxic products in their workplaces and the environment may be evaluated by means of the sister chromatid exchange test (SCE), which visualize exchange of DNA material between sister chromatids of a chromosome. This thesis deals with the development of SCE methodology and screening of confounding factors to make the method useful in population monitoring of genotoxic exposure of chemicals in vivo. Human lymphocytes are cultured under standardized conditions. The cells are prepared for chromosome analysis by means of new-developed apparatuses treating 12 samples simultaneously. By this method the preparation is speeded up and breathing of glacial acetic acid is minimized. Slides are prepared and stained. The staining procedure includes irradiation of the slides with long wave UV light. The light source has been optimized with regard to simplicity and spectral distribution to fit the absorption spectrum of the dye bisbenzimid. The irradiation time and dose to produce distinct harlequin stained chromosomes has been found. Population screening demands analysis in microscope of a great number of chromosomes. The working time at microscope is long and improvement of ergonomics and automation to speed up the procedure was obtained by development of a special microscope which projects the picture of SCEs at table level. The scanning table was motorized. These changes gave excellent ergonomic proporties as fixed positions of the eyes and hands were avoided. The system is fast and flexible and may semiautomatically produce karyotypes. By pointing out SCEs the system automatically registers SCE number, cell coordinates, mitosis quality and perform statistics. The statistical model which best describe the distributions of SCE data has been analysed. This was a negative binomial distribution, which is close to the Poisson distribution. The transformation y = (S).5 + (S + 1).5 follows a normal distribution. Variances of the transformation of the sum of SCEs in 30 cells within subjects and between subjects have been calculated, and on that basis the demands to sample size have been calculated. To avoid to make false statements about a connection between an exposure and SCE a detailed knowledge of confounding factors is essential. Of endogenous factors gender, age, race, and heredity have been considered. Of these gender and age contribute to the variation in SCE. Very high SCE level has been found in healthy members of a family and such cases have to be excluded from exposure studies.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals

[Molecular weight distribution of polymeric DNA-products, formed upon the action of matrix enzymes].

Models of processive and distributive DNA synthesis and degradation catalysed by matrix enzymes were investigated. Distribution of polymer products dependent on the reaction model chosen, on the type of the matrix and on the enzyme-matrix initial concentration ratio were determined by methods of numerical modeling. Conditions were found where the scattering of the reaction polymer products was minimal. The homopolymer matrix choice of experimental condition may generate a distribution of product that obeys the Poisson distribution. Numerical investigations of polymerization (hydrolysis) processes showed that for a number of heteropolymer matrixes a distribution may exist with scattering much less than that for homopolymer matrixes. Conditions are found when processive and distributive models give different distributions of the reaction product.

Base Sequence

A statistical method for evaluating suicide clusters and implementing cluster surveillance.

The absence of any standard definition of suicide cluster events hinders understanding of the prevalence of the problem, hinders the development of appropriate public health responses to observed clusters, and ultimately hinders investigation of the mechanisms underlying contagious communication of suicidal behavior. The authors introduce a Poisson mixture model for assessing potential clusters of adolescent suicide, apply that model to the monthly incidence rates of adolescent suicide for one populous US county over the last 11 years, and generate 99% tolerance limits with 95% confidence for the number of suicides which may occur by chance within specific intervals of time in that county. The suicide incidence data showed a remarkable fit to a single Poisson distribution, suggesting it is not unreasonable to consider the cases as randomly-distributed and independent events. The authors conclude that there is no evidence that adolescent suicides occurred in clusters in the place and in the time frame under study, and recommend the Poisson mixture model for ascertaining clusters as well as implementing cluster surveillance.

Adolescent

[Chiasma distribution in the lampbrush chromosomes of the chicken Gallus gallus domesticus: hot spots of recombination and their possible role in proper dysjunction of homologous chromosomes at the first meiotic division].

Chiasma distribution in the lambrush chromosomes of the chicken Gallus gallus domesticus was studied. The data of the authors show that the general pattern of chiasmata in the interstitional region of chromosomes corresponds to the Poisson distribution. However, in the telomeric and subtelomeric regions of all chicken macrochromosomes one can see chiasma as a rule. In the half of 140 microchromosomes from 24 different oocytes, there are also the telomeric chiasmata. On the basis of this observation, it may be predicted that there are hot spots of recombination near or into the telomeric GC-rich heterochromatic bands of chicken chromosomes. We suggest that these hot spots of recombination near the telomeres are a necessary facility for not only macrochromosomes but all microchromosomes as well to have at least one chiasma. The constant presence of at least one chiasma in a bivalent in needed for correct disjunction of homologous chromosomes at the first meiotic division.

Animals

CANEST: a microcomputer program for estimating cancer in a cohort.

Certain diseases and symptoms carry an overrepresentation of cancer. To be able to measure the strength of such an association it is necessary to be able to predict cancer development in the group being observed. A computer program for computers running under the MS DOS operating system has been developed for this purpose. The program is written in the CLIPPER programming language. The estimates are based on incidence and prevalence data from the Swedish Cancer Registry for the years 1958 to 1986. The program also computes confidence intervals based on the Poisson distribution. The results can be printed out or exported to other programs for further analysis.

Cohort Studies

An empirical Bayes formulation of cohort models in cancer epidemiology.

This paper concerns the incidence rates of malignant skin melanoma for several age-sex groups and time periods in three geographic regions, uses a method of cohort analysis and employs a two-stage random effects model. The first stage entails the assumption that the within-region variation in the frequency of disease incidence for a fixed age-sex-cohort group has a Poisson distribution with mean proportional to the population at risk. The second stage, after adjusting for age and sex, entails the assumption that the between-region geographic variation in the logarithm of the true incidence rate has a prior distribution with parameters estimated by the method of maximum likelihood. After adjusting for age effects, we estimate random geographic-specific cohort effects for each sex with use of an empirical Bayes method and compare the results with the usual multiplicative Poisson model that assumes fixed geographic-specific cohort effects for each sex. This comparison shows that the method presented here provides more stable estimates of geographic-specific cohort effects, and in addition the random effects model describes these data more adequately.

Adult

Sister chromatid exchange frequency in breast cancer cases.

Sister chromatid exchange (SCE) were studied in 22 patients with breast cancer (i.e., four stage II; 12 stage III, six stage IV) and 10 normal healthy females as age-matched controls. The data obtained in these cases followed a Poisson distribution. An apparent increase in the average rate of SCE/cell was observed with the advancing stage of breast cancer.

Breast Neoplasms

Paraplegic pressure sore frequency versus circulation measurements.

Paraplegic subjects (N = 34) were examined to determine the association of pressure sore history with respect to ankle pressure ratio and buttocks cutaneous plethysmographic harmonic persistence. No relationship was found between pressure sore history and ankle pressure ratio. No significant difference in ankle pressure ratios exists for those who have a pressure sore history as compared to those who have not experienced a pressure sore in 5 years. Those subjects with a diminished buttocks circulation harmonic persistence are more likely to have experienced one or more pressure sores than those subjects with normal circulation characteristics. A Poisson distribution analysis of multiple pressure sore occurrence suggests that repeated pressure sores are unlikely to arise as the result of chance.

Ankle

The distribution of transposable elements within and between chromosomes in a population of Drosophila melanogaster. I. Element frequencies and distribution.

Data were collected on the distribution of nine families of transposable elements among second and third chromosomes isolated from a natural population of Drosophila melanogaster, by means of in situ hybridization of element probes to polytene chromosomes. It was found that the copy numbers per chromosome in the distal sections of the chromosome arms followed a Poisson distribution. Elements appeared to be distributed randomly along the distal sections of the chromosome arms. There was no evidence for linkage disequilibrium in the distal sections of the chromosomes, but some significant disequilibrium was detected in proximal regions. There were many significant correlations between different element families with respect to the identity of the sites that were occupied in the sample. There were also significant correlations between families with respect to sites at which elements achieved relatively high frequencies. Element frequencies per chromosome band were generally low in the distal sections, but were higher proximally. These results are discussed in the light of models of the population dynamics of transposable elements. It is concluded that they provide strong evidence for the operation of a force or forces opposing transpositional increase in copy number. The data suggest that the rate of transposition per element per generation is of the order of 10(-4), for the elements included in this study.

Animals

Selectivity for temporal characteristics of sound and interaural time difference of auditory midbrain neurons in the grassfrog: a system theoretical approach.

The selectivity for temporal characteristics of sound and interaural time difference (ITD) was investigated in the torus semicircularis (TS) of the grassfrog. Stimuli were delivered by means of a closed sound system and consisted of binaurally presented Poisson distributed condensation clicks, and pseudo-random (RAN) or equidistant (EQU) click trains of which ITD was varied. With RAN and EQU trains, 86% of the TS units demonstrated a clear selectivity for ITD. Most commonly, these units had monotonically increasing ITD-rate functions. In general, units responding to Poisson clicks, responded also to RAN and EQU trains. One category of units which showed strong time-locking had comparable selectivities for ITD with both stimulus ensembles. A second category of units showed a combined selectivity for temporal structure and ITD. These units responded exclusively to EQU trains in a nonsynchronized way. From the responses obtained with the Poisson click ensemble so-called Poisson system kernels were determined, in analogy to the Wiener-Volterra functional expansion for nonlinear systems. The kernel analysis was performed up to second order. Contralateral (CL) first order kernels usually had positive or combinations of positive and negative regions, indicating that the contralateral ear exerted an excitatory or combined excitatory-inhibitory influence upon the neural response. Ipsilateral (IL), units were characterized by first order kernels which were not significantly different from zero, or kernels in which a single negative region was present. A large variety of CL second order kernels has been observed whereas rarely IL second order kernels were encountered. About 35% of the units possessed nonzero second order cross kernels, which indicates that CL and IL neural processes are interacting in a nonlinear way. Units demonstrating a pronounced selectivity for ITD, were generally characterized by positive CL combined with negative IL first order kernels. Findings suggested that, in the grassfrog, neural selectivity for ITD mainly is established by linear interaction of excitatory and inhibitory processes originating from the CL and IL ear, respectively. Units exhibiting strong time-locking to Poisson clicks and RAN and EQU trains had significantly shorter response latencies than moderately time-locking units. In the first category of units, a substantial higher number of nonzero first and second order kernels was observed. It was concluded that nonlinear response properties, as observed in TS units, most likely have to be ascribed to nonlinear characteristics of neural components located in the auditory nervous system peripheral to the torus semicircularis.

Acoustic Stimulation

Temporal distribution of seizures in epilepsy.

A major problem in epileptology is why a seizure occurs at a particular moment in time. An initial step in solving this problem is a detailed analysis of the temporal distribution of seizures. Using methods and theories of stochastic processes, seizure patterns in a group of epileptic outpatients were examined for stationarity, randomness, dependency and periodicity in a prospective study. Sixteen of the 21 seizure diaries included in the study showed stationarity; 2 were non-stationary and 3 inconclusive. Eleven of the 16 stationary diaries were non-Poisson (P less than 0.005), indicating that in the majority of patients seizures did not occur randomly. The most frequently encountered phenomenon was seizure clustering. Clustering was considered when the diaries fulfilled all three criteria: (1) a positive R-test (P less than 0.001); (2) deviation from the fitted Poisson distribution towards clustering; and (3) the feature of an autoregressive process in the autocorrelogram plot. Dependency between seizure events was demonstrated in 8 of the 16 stationary diaries, computing first order transition probabilities. A detailed analysis of seizure occurrence is a major step towards a better understanding of the mechanisms underlying seizure precipitation. This is exemplified by our finding of a relation between seizure frequency and the menstrual cycle.

Adolescent

Fragile sites and statistics.

A simple and reliable statistical method is proposed to distinguish real fragile sites from the casual accumulation of aberrations that can occur as a consequence of random distribution. It is based on a study of the expected random distribution, assumed to be equal to a Poisson distribution, with the expected value of events per band as the mean.

Chromosome Fragile Sites