This article reports the SMART analyses of four failed sepsis investigations.

Methods: Databases from the E5 antiendotoxin antibody, North American Sepsis Trial (NORASEPT) and NORASEPT II anti-tumor necrosis factor antibody (TNFMAb), interleukin (IL)-1ra, and platelet-activation factor acetylhydrolase (PAF-AH) sepsis clinical trials were evaluated with SMART using multivariate logistic regression. From baseline data, within each study, mortality prediction models were Cyclosporin A built separately for the placebo and active drug populations. Subjects among whom each drug’s effects were greatest were then identified by excluding from efficacy analysis subjects predicted by SMART to survive on placebo or to expire on

active drug. Finally, prerandomization data from patients in each study were entered into SMART models, and placebo or active drug treatment effects were evaluated for parent populations and SMART cohorts.

Results: E5-consensus

mortality: 27.4% placebo, 26.2% E5; SMART mortality: 17.1% placebo, 8.0% E5 (p < 0.01). NORASEPT-consensus mortality; 33.4% placebo, 29.5% TNFMAb; SMART mortality: 47.2% placebo, 34.7% SRT1720 TNFMAb (p = 0.03). IL-1ra-consensus mortality: 33.9% placebo, 29.8% IL-1ra; SMART mortality: 55.6% placebo, 34.9% IL-1ra (p < 0.001). PAF-AH-consensus mortality: 22.4% placebo, 23.9% PAF-AH; SMART mortality: 17.7% placebo, 28.9% PAF-AH (p = 0.039).

Conclusions: Using prerandomization clinical trial data, SMART identifies septic patients whose host-inflammatory responses can benefit from specific drugs. SMART also predicts ineffective drugs and patients whom they might harm.”
“Combination of anaerobic-aerobic sequencing Screening Library cell line processes result in both anaerobic color removal and aerobic aromatic amine removal during the treatment of dye-containing wastewaters. The aim of the present study was to gain more insight into the competitive biochemical reactions between sulfate and azo dye in the presence of glucose as electron donor source. For this aim, anaerobic-aerobic sequencing batch reactor fed with a simulated textile effluent including Remazol Brilliant Violet 5R (RBV 5R)

azo dye was operated with a total cycle time of 12 h including anaerobic (6 h) and aerobic cycles (6 h). Microorganism grown under anaerobic phase of the reactor was exposed to different amounts of competitive electron acceptor (sulfate). Performance of the anaerobic phase was determined by monitoring color removal efficiency, oxidation reduction potential, color removal rate, chemical oxygen demand (COD), color, specific anaerobic enzyme (azo reductase) and aerobic enzyme (catechol 1,2-dioxygenase), and formation of aromatic amines. The presence of sulfate was not found to significantly affect dye decolorization. Sulfate and azo dye reductions took place simultaneously in all operational conditions and increase in the sulfate concentration generally stimulated the reduction of RBV 5R.