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This study partially replicated the research of Cook, Kwak, Hoffman, & Loftus where they examined post-event activities that induces subjects to pick a wrong person in a forced choice identification procedure. The goal was to investigate if providing a neither option to a match to sample task increases the accuracy of responding. Subjects were asked to study three faces for 10 seconds, after which they were asked to pick out the faces in a forced choice setting where two other faces were presented. Later the subjects were asked to pick out faces in a setting in which they could use a neither option. Results indicated that a generalization effect occurs when identifying faces and the effect is seen as subjects choosing the wrong face. This suggests that when using faces with some similar features in a lineup setting the procedure may cause the subject to pick the wrong person.

Over the past few decades, Cluster Randomized Trials (CRT) have become a design of choice in many research areas. One of the most critical issues in planning a CRT is to ensure that the study design is sensitive enough to capture the intervention effect. The assessment of power and sample size in such studies is often faced with many challenges due to several methodological difficulties. While studies on power and sample size for cluster designs with one and two levels are abundant, the evaluation of required sample size for three-level designs has been generally overlooked. First, the nesting effect introduces more than one intracluster correlation into the model. Second, the variance structure of the estimated treatment difference is more complicated. Third, sample size results required for several levels are needed. In this work, we developed sample size and power formulas for the three-level data structures based on the generalized linear mixed model approach. We derived explicit and general power and sample size equations for detecting a hypothesized effect on continuous Gaussian outcomes and binary outcomes. To confirm the accuracy of the formulas, we conducted several simulation studies and compared the results. To establish a connection between the theoretical formulas and their applications, we developed a SAS user-interface macro that allowed the researchers to estimate sample size for a three-level design for different scenarios. These scenarios depend on which randomization level is assigned and whether or not there is an interaction effect.

Master of Science / Department of Statistics / Christopher Vahl / Sample size estimation is generally based on assumptions made during the planning stage of a clinical trial. Often, there is limited information available to estimate the initial sample size. This may result in a poor estimate. For instance, an insufficient sample size may not have the capability to produce statistically significant results, while an over-sized study will lead to a waste of resources or even ethical issues in that too many patients are exposed to potentially ineffective treatments. Therefore, an interim analysis in the middle of a trial may be worthwhile to assure that the significance level is at the nominal level and/or the power is adequate to detect a meaningful treatment difference. In this report, the impact of sample size re-estimation on the type I error rate for the continuous end-point in a clinical trial with two treatments is evaluated through a simulation study. Two sample size estimation methods are taken into consideration: blinded and partially unblinded. For the blinded method, all collected data for two groups are used to estimate the variance, while only data from the control group are used to re-estimate the sample size for the partially unblinded method. The simulation study is designed with different combinations of assumed variance, assumed difference in treatment means, and re-estimation methods. The end-point is assumed to follow normal distribution and the variance for both groups are assumed to be identical. In addition, equal sample size is required for each group. According to the simulation results, the type I error rates are preserved for all settings.

Master of Science / Department of Statistics / Christopher I. Vahl / Estimation of sample size is an important and critical procedure in the design of clinical trials. A trial with inadequate sample size may not produce a statistically significant result. On the other hand, having an unnecessarily large sample size will definitely increase the expenditure of resources and may cause a potential ethical problem due to the exposure of unnecessary number of human subjects to an inferior treatment. A poor estimate of the necessary sample size is often due to the limited information at the planning stage. Hence, the adjustment of the sample size mid-trial has become a popular strategy recently. In this work, we introduce two methods for sample size re-estimation for trials with a binary endpoint utilizing the interim information collected from the trial: a blinded method and a partially unblinded method. The blinded method recalculates the sample size based on the first stage’s overall event proportion, while the partially unblinded method performs the calculation based only on the control event proportion from the first stage. We performed simulation studies with different combinations of expected proportions based on fixed ratios of response rates. In this study, equal sample size per group was considered. The study shows that for both methods, the type I error rates were preserved satisfactorily.

Os antimicrobianos, especialmente a classe das fluoroquinolonas (FQs), são utilizados em grandes quantidades na medicina humana e veterinária. Uma atenção especial deve ser dada à ocorrência desses fármacos em diferentes matrizes ambientais, devido a potencialidade de propagação da resistência bacteriana. As principais fontes dessa contaminação são os esgoto industrial, urbanos, esgoto sanitário de hospital e de fazendas que utilizam antibióticos com finalidades veterinárias. Após a ingestão, os antimicrobianos são excretados na sua forma inalterada e, devido a baixa eficiência dos sistemas convencionais de tratamento de esgoto, são eventualmente liberados para o meio aquático. Diferentes métodos têm sido desenvolvidos para a determinação de FQs em amostras aquosas diversas, tais como esgoto sanitário , água de abastecimento, águas superficiais e esgoto sanitário de hospital. A maior parte dessas amostras ambientais é complexa e exige uma série de etapas de preparo, limpeza e pré-concentração; de maneira que, nos últimos anos, extensos esforços têm sido feitos para o desenvolvimento de novas técnicas de preparo de amostra que reduzam o tempo, trabalho, consumo de solvente e que permitam melhor desempenho do processo analítico. Nesse estudo foram desenvolvidos dois métodos de extração - a extração em fase sólida (SPE ) e a microextração por sorvente empacotado (MEPS) - sendo a separação, identificação e quantificação feitos por HPLC-MS/MS. Os métodos foram avaliados e validados segundo os parâmetros: precisão, exatidão, recuperação, linearidade, limite de detecção (LD), limite de quantificação (LQ), seletividade, efeito matriz, eficiência total do processo e robustez. Posteriormente, foi feita aplicação dos métodos desenvolvidos para investigação de FQs em águas superficiais e amostra de esgoto coletadas em diferentes pontos da cidade de São Carlos-SP. Os métodos apresentaram valores de recuperação maiores que 80% para as FQs estudadas, e valores de exatidão e precisão menores que 30% . A comparação entre as técnicas de extração desenvolvidas permitiu listar vantagens e desvantagens particulares de cada técnica. Além do menor consumo de solventes e volume de amostras, valores insignificantes de efeito matriz foram alcançados para a técnica MEPS; no entanto a SPE, devido ao seu maior fator de concentração, permitiu a quantificação de duas fluoroquinolonas em amostra de esgoto doméstico e detecção das mesmas em amostra de rio. / Antimicrobials, particularly the fluoroquinolones (FQs) class, are widely used in human and veterinary medicine. Particular attention must be given to the occurrence of these drugs in different environmental matrices, due to the potential spread of bacterial resistance. Effluents from industries, residential districts, hospitals and animal farms are the main sources of contamination by antibiotics. After ingestion, the antimicrobials are excreted in its unchanged form. Due to the low efficiency of conventional wastewater treatments, these antimicrobials are eventually released into the aquatic environment. Several methods have been developed for the determination of FQs in different water samples, such as municipal wastewater, tap water, river water, and hospital sewage. Most of these environmental samples is complex and requires a number of preparation steps, cleaning and preconcentration. For this reason, recently, extensive efforts have been made to develop new techniques for sample preparation in order to reduce: time, number of steps, solvent consumption and achieve better performance on the analytical process. This work describes the development of two methods of extraction - by solid phase extraction (SPE) and microextraction by packed sorbent (MEPS) - and separation, identification and quantification by HPLC-MS/MS. These methods were evaluated and validated by studying the following parameters: accuracy, precision, recovery, linearity, limit of detection (MDL), limit of quantification (MQL), selectivity, matrix effect, process efficiency and robustness. These methods were subsequently applied for FQs investigation in surface water and sewage sample collected at different points in the city of Sao Carlos/SP, Brazil. The methods recoveries achieved values greater than 80% for the studied FQS and the accuracy and precision values were satisfactory when compared to the values acceptable by regulatory agencies such as EPA and AOAC. A comparison between the extraction techniques developed allowed listing advantages and disadvantages of each particular technique. Besides the lowest solvent consumption and volume of samples, negligible values of matrix effects were achieved for MEPS technique. However, SPE, due to its higher pre-concentration, allowed the quantification of two fluoroquinolones in a sample of sewage and the detection in river sample.

A presença de antibióticos no ambiente evidencia o problema do descarte inadequado de resíduos farmacêuticos e da ineficiência dos atuais sistemas de tratamento de resíduos. Como consequência a essa contaminação há a possibilidade de resistência microbiana e de outros efeitos nocivos, ainda não completamente compreendidos, sobre a fauna e flora aquática. O presente trabalho teve como um dos objetivos desenvolver métodos de preparo de amostra e análise para avaliar o potencial de um reator anaeróbio de leito fixo para a remoção de sulfonamidas de matrizes complexas, além de investigar possíveis resíduos dessa classe em diversos compartimentos ambientais da cidade de São Carlos. Para isso, métodos utilizando extração em fase sólida (SPE) e cromatografia líquida (LC) foram desenvolvidos em associação à análise por espectrometria de massas. Os resultados mostraram que o reator utilizado consegue remover satisfatoriamente o composto investigado, podendo ser, futuramente, uma alternativa aos tratamentos convencionais. Tais resultados foram obtidos a partir do desenvolvimento e validação de um método utilizando detecção por um analisador híbrido do tipo quadrupolo-tempo de voo (SPE-LC-QTOF). Outro método, baseado em SPE-LC-QTRAP (analisador híbrido quadrupolo-aprisionador de íons linear), foi validado visando mostrar que existe contaminação por sulfonamidas e trimetoprima em águas de córregos coletadas em algumas regiões da cidade. Tal objetivo foi atingindo, permitindo inclusive a comparação entre as figuras de mérito obtidas durante a validação dos métodos, que indicou que os analisadores (e os sistemas utilizados, em geral) possuem diferenças significativas que influem em parâmetros como o efeito de matriz, os limites de quantificação e a sensibilidade.<br/> Paralelamente aos métodos convencionais, alternativas de preparo e análise que reduziam a necessidade de grandes volumes de amostra e solventes também foram desenvolvidos. A associação de técnicas miniaturizadas de preparo de amostra e análise permitiu que limites de detecção comparáveis aos dos métodos utilizando SPE fossem atingidos, utilizando, inclusive, o analisador do tipo tempo de voo. Dessa forma, um novo escopo de aplicações usufruindo das características deste último analisador poderá ser desenvolvido a partir da melhor pré-concentração proporcionada pelas estratégias de miniaturização estudadas. / The presence of antibiotics in the environment demonstrates the problem of improper drug disposal and inefficiency of the current water treatment systems. As a result of this contamination, there is the possibility of microbial resistance and other harmful effects, not totally understood, on the aquatic flora and fauna. The present study aimed to develop methods for sample preparation and analysis in order to evaluate the potential of an anaerobic fixed bed reactor for removing sulfonamides from complex matrices and, in addiction, to investigate the presence of this class of contaminants in various environmental compartments of São Carlos. For this, methods using solid phase extraction (SPE) and liquid chromatography (LC), were developed in association with the analysis by mass spectrometry . The results showed that the reactor used can satisfactorily remove the compound investigated and may be, in future, an alternative to conventional treatments. These results were obtained from the development and validation of a method based on solid phase extraction associated with liquid chromatography coupled to mass spectrometry using a hybrid quadrupole-time of flight (SPE-LC-QTOF) analyzer. Another method that was also developed and validated, based on SPE-LC-QTRAP (hybrid quadrupole-linear ion trap), was useful to show that there is contamination by sulfonamides and trimethoprim in water collected from rivers in some areas of the town. This objective was achieved, inclusive allowing the comparison between the figures of merit obtained during the methods validation, which indicated that the analyzers (and the systems used, in general) have significant differences which that affect parameters as matrix effect and quantification limits.<br/> In parallel with the conventional methods, alternatives of sample preparation and analysis that reduced the need of large volumes of sample and solvent were also developed.<br/> The association of miniaturized techniques of sample preparation and analysis allowed detection limits comparable to that of methods using SPE, even using small volumes of sample and solvent and a less sensitive mass analyzer. Thus, a new scope of applications, taking advantage of the characteristics of the QTOF, can be developed from the higher pre-concentration provided by the strategies studied in this work.

The Centers for Disease Control and Prevention deemed the increase in overdose fatalities, due to the use of opioids, an “opioid epidemic” in the United States. Heroin, fentanyl, and other synthetic opioids are commonly abused and are contributing to the opioid epidemic. In 2016, the Drug Enforcement Administration temporarily placed three fentanyl analogs (beta-hydroxythiofentanyl, butyryl fentanyl, and furanyl fentanyl) under Schedule I due to their imminent threat to public health. These drugs elicit analgesic effects similar to heroin making them desirable drugs to abuse. Novel fentanyl analogs and designer opioids are expected to become more prominent in forensic casework in the near future as the opioid epidemic continues. These drugs can be seen in forensic seized drug and urine casework samples either alone or mixed with other drugs of abuse. It is therefore necessary to have an efficient methodology to identify these new compounds. Currently, gas chromatography-mass spectrometry (GC/MS) is used to identify drugs of abuse and is considered the “gold standard” in forensic casework. However, analysis times can often range from 15 to 60 minutes in length. Another drawback is the need for spectral library matching, which requires analytical reference materials for identification. Therefore, the identification of novel fentanyl analogs and designer drugs is limited until a reference material becomes available. In this study, direct sample analysis time-of-flight mass spectrometry (DSA-TOFMS) was evaluated to provide rapid identification of fentanyl and other synthetic opioids in seized drug and urine casework samples. DSA is a direct ambient ionization source, which requires no chromatography and minimal sample preparation. TOFMS is a high resolution mass spectrometer that uses collision-induced dissociation (CID) to produce precursor ion and characteristic fragmentation ions, which provide additional structural and molecular formula information, allowing for the identification of compounds without a reference material. The analytes explored in this study include: heroin, 6-monoacetylmorphine (6-MAM), morphine, fentanyl, norfentanyl, 4-anilino-N-phenethylpiperidine (4-ANPP), acetyl fentanyl, beta-hydroxythiofentanyl, butyryl fentanyl, furanyl fentanyl, valeryl fentanyl, AH-7921, U-47700, buprenorphine, norbuprenorphine, desomorphine, MT-45, W-15, and W-18. Direct sample analysis time-of flight mass spectrometry (DSA-TOFMS) is a novel instrumentation that could be utilized in the forensic sciences field to qualitatively identify illicit substances in casework samples. In this study, 19 compounds of interest containing heroin, fentanyl, fentanyl analogs, and other synthetic opioids were evaluated using DSA-TOFMS. DSA-TOFMS abbreviated the workload of the analysis and was utilized to provide precursor ion and characteristic fragmentation ions within an analysis time of 20 seconds. Certified reference standards were used to optimize instrumentation settings, to determine precursor ions and characteristic fragmentation ions, and to determine the limit of detection of the instrument. A carryover study determined there were no persisting ions present when entering the capillary inlet between runs. A repeatability study revealed the DSA-TOFMS repeated results within the acceptable criteria range of above 500 counts and within 10ppm error 93% (10ppm) and 83% (1ppm). Forensic seized drug casework samples were evaluated with DSA-TOFMS and qualitatively identified. Out of the 64 samples, 89% were qualitatively identified as heroin, 4% were qualitatively identified as fentanyl, 1% was qualitatively identified as heroin and fentanyl, 3% were qualitatively identified as acetyl fentanyl, and 3% were qualitatively identified as furanyl fentanyl. The casework samples containing furanyl fentanyl were considered “true unknown unknown samples,” as the Maine Health and Environmental Testing Laboratory gas chromatography-mass spectrometry library did not have a spectrum to use for the identification of these samples. Forensic urine casework samples were evaluated with DSA-TOFMS. Samples previously confirmed to contain compounds of interest were prepared using minimal sample preparation technique (filtered using 0.45 microns syringe filters and diluted (1:10) with LC/MS grade water). Analysis displayed the limitations of DSA-TOFMS as only twelve of the forty compounds of interest were present and only three of the twelve were within the acceptable criteria range. DSA-TOFMS is a fast and reliable technique with minimal sample preparation for forensic seized drug samples. However, the concentration in complex matrixes, such as urine and blood, were unable to be qualitatively identified using this sample preparation method by DSA-TOFMS.

Os antimicrobianos, especialmente a classe das fluoroquinolonas (FQs), são utilizados em grandes quantidades na medicina humana e veterinária. Uma atenção especial deve ser dada à ocorrência desses fármacos em diferentes matrizes ambientais, devido a potencialidade de propagação da resistência bacteriana. As principais fontes dessa contaminação são os esgoto industrial, urbanos, esgoto sanitário de hospital e de fazendas que utilizam antibióticos com finalidades veterinárias. Após a ingestão, os antimicrobianos são excretados na sua forma inalterada e, devido a baixa eficiência dos sistemas convencionais de tratamento de esgoto, são eventualmente liberados para o meio aquático. Diferentes métodos têm sido desenvolvidos para a determinação de FQs em amostras aquosas diversas, tais como esgoto sanitário , água de abastecimento, águas superficiais e esgoto sanitário de hospital. A maior parte dessas amostras ambientais é complexa e exige uma série de etapas de preparo, limpeza e pré-concentração; de maneira que, nos últimos anos, extensos esforços têm sido feitos para o desenvolvimento de novas técnicas de preparo de amostra que reduzam o tempo, trabalho, consumo de solvente e que permitam melhor desempenho do processo analítico. Nesse estudo foram desenvolvidos dois métodos de extração - a extração em fase sólida (SPE ) e a microextração por sorvente empacotado (MEPS) - sendo a separação, identificação e quantificação feitos por HPLC-MS/MS. Os métodos foram avaliados e validados segundo os parâmetros: precisão, exatidão, recuperação, linearidade, limite de detecção (LD), limite de quantificação (LQ), seletividade, efeito matriz, eficiência total do processo e robustez. Posteriormente, foi feita aplicação dos métodos desenvolvidos para investigação de FQs em águas superficiais e amostra de esgoto coletadas em diferentes pontos da cidade de São Carlos-SP. Os métodos apresentaram valores de recuperação maiores que 80% para as FQs estudadas, e valores de exatidão e precisão menores que 30% . A comparação entre as técnicas de extração desenvolvidas permitiu listar vantagens e desvantagens particulares de cada técnica. Além do menor consumo de solventes e volume de amostras, valores insignificantes de efeito matriz foram alcançados para a técnica MEPS; no entanto a SPE, devido ao seu maior fator de concentração, permitiu a quantificação de duas fluoroquinolonas em amostra de esgoto doméstico e detecção das mesmas em amostra de rio. / Antimicrobials, particularly the fluoroquinolones (FQs) class, are widely used in human and veterinary medicine. Particular attention must be given to the occurrence of these drugs in different environmental matrices, due to the potential spread of bacterial resistance. Effluents from industries, residential districts, hospitals and animal farms are the main sources of contamination by antibiotics. After ingestion, the antimicrobials are excreted in its unchanged form. Due to the low efficiency of conventional wastewater treatments, these antimicrobials are eventually released into the aquatic environment. Several methods have been developed for the determination of FQs in different water samples, such as municipal wastewater, tap water, river water, and hospital sewage. Most of these environmental samples is complex and requires a number of preparation steps, cleaning and preconcentration. For this reason, recently, extensive efforts have been made to develop new techniques for sample preparation in order to reduce: time, number of steps, solvent consumption and achieve better performance on the analytical process. This work describes the development of two methods of extraction - by solid phase extraction (SPE) and microextraction by packed sorbent (MEPS) - and separation, identification and quantification by HPLC-MS/MS. These methods were evaluated and validated by studying the following parameters: accuracy, precision, recovery, linearity, limit of detection (MDL), limit of quantification (MQL), selectivity, matrix effect, process efficiency and robustness. These methods were subsequently applied for FQs investigation in surface water and sewage sample collected at different points in the city of Sao Carlos/SP, Brazil. The methods recoveries achieved values greater than 80% for the studied FQS and the accuracy and precision values were satisfactory when compared to the values acceptable by regulatory agencies such as EPA and AOAC. A comparison between the extraction techniques developed allowed listing advantages and disadvantages of each particular technique. Besides the lowest solvent consumption and volume of samples, negligible values of matrix effects were achieved for MEPS technique. However, SPE, due to its higher pre-concentration, allowed the quantification of two fluoroquinolones in a sample of sewage and the detection in river sample.

A presença de antibióticos no ambiente evidencia o problema do descarte inadequado de resíduos farmacêuticos e da ineficiência dos atuais sistemas de tratamento de resíduos. Como consequência a essa contaminação há a possibilidade de resistência microbiana e de outros efeitos nocivos, ainda não completamente compreendidos, sobre a fauna e flora aquática. O presente trabalho teve como um dos objetivos desenvolver métodos de preparo de amostra e análise para avaliar o potencial de um reator anaeróbio de leito fixo para a remoção de sulfonamidas de matrizes complexas, além de investigar possíveis resíduos dessa classe em diversos compartimentos ambientais da cidade de São Carlos. Para isso, métodos utilizando extração em fase sólida (SPE) e cromatografia líquida (LC) foram desenvolvidos em associação à análise por espectrometria de massas. Os resultados mostraram que o reator utilizado consegue remover satisfatoriamente o composto investigado, podendo ser, futuramente, uma alternativa aos tratamentos convencionais. Tais resultados foram obtidos a partir do desenvolvimento e validação de um método utilizando detecção por um analisador híbrido do tipo quadrupolo-tempo de voo (SPE-LC-QTOF). Outro método, baseado em SPE-LC-QTRAP (analisador híbrido quadrupolo-aprisionador de íons linear), foi validado visando mostrar que existe contaminação por sulfonamidas e trimetoprima em águas de córregos coletadas em algumas regiões da cidade. Tal objetivo foi atingindo, permitindo inclusive a comparação entre as figuras de mérito obtidas durante a validação dos métodos, que indicou que os analisadores (e os sistemas utilizados, em geral) possuem diferenças significativas que influem em parâmetros como o efeito de matriz, os limites de quantificação e a sensibilidade.<br/> Paralelamente aos métodos convencionais, alternativas de preparo e análise que reduziam a necessidade de grandes volumes de amostra e solventes também foram desenvolvidos. A associação de técnicas miniaturizadas de preparo de amostra e análise permitiu que limites de detecção comparáveis aos dos métodos utilizando SPE fossem atingidos, utilizando, inclusive, o analisador do tipo tempo de voo. Dessa forma, um novo escopo de aplicações usufruindo das características deste último analisador poderá ser desenvolvido a partir da melhor pré-concentração proporcionada pelas estratégias de miniaturização estudadas. / The presence of antibiotics in the environment demonstrates the problem of improper drug disposal and inefficiency of the current water treatment systems. As a result of this contamination, there is the possibility of microbial resistance and other harmful effects, not totally understood, on the aquatic flora and fauna. The present study aimed to develop methods for sample preparation and analysis in order to evaluate the potential of an anaerobic fixed bed reactor for removing sulfonamides from complex matrices and, in addiction, to investigate the presence of this class of contaminants in various environmental compartments of São Carlos. For this, methods using solid phase extraction (SPE) and liquid chromatography (LC), were developed in association with the analysis by mass spectrometry . The results showed that the reactor used can satisfactorily remove the compound investigated and may be, in future, an alternative to conventional treatments. These results were obtained from the development and validation of a method based on solid phase extraction associated with liquid chromatography coupled to mass spectrometry using a hybrid quadrupole-time of flight (SPE-LC-QTOF) analyzer. Another method that was also developed and validated, based on SPE-LC-QTRAP (hybrid quadrupole-linear ion trap), was useful to show that there is contamination by sulfonamides and trimethoprim in water collected from rivers in some areas of the town. This objective was achieved, inclusive allowing the comparison between the figures of merit obtained during the methods validation, which indicated that the analyzers (and the systems used, in general) have significant differences which that affect parameters as matrix effect and quantification limits.<br/> In parallel with the conventional methods, alternatives of sample preparation and analysis that reduced the need of large volumes of sample and solvent were also developed.<br/> The association of miniaturized techniques of sample preparation and analysis allowed detection limits comparable to that of methods using SPE, even using small volumes of sample and solvent and a less sensitive mass analyzer. Thus, a new scope of applications, taking advantage of the characteristics of the QTOF, can be developed from the higher pre-concentration provided by the strategies studied in this work.