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Significant evidence supports the view that dopamine shapes learning by encoding reward prediction errors. However, it is unknown whether striatal targets receive tailored dopamine dynamics based on regional functional specialization. Here, we report wave-like spatiotemporal activity patterns in dopamine axons and release across the dorsal striatum. These waves switch between activational motifs and organize dopamine transients into localized clusters within functionally related striatal subregions. Notably, wave trajectories were tailored to task demands, propagating from dorsomedial to dorsolateral striatum when rewards are contingent on animal behavior and in the opponent direction when rewards are independent of behavioral responses. We propose a computational architecture in which striatal dopamine waves are sculpted by inference about agency and provide a mechanism to direct credit assignment to specialized striatal subregions. Supporting model predictions, dorsomedial dopamine activity during reward-pursuit signaled the extent of instrumental control and interacted with reward waves to predict future behavioral adjustments.
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Axônios/metabolismo , Comportamento Animal , Corpo Estriado/metabolismo , Dopamina/metabolismo , Recompensa , Animais , Feminino , Masculino , Camundongos , Camundongos MutantesRESUMO
Reinforcement learning inspires much theorizing in neuroscience, cognitive science, machine learning, and AI. A central question concerns the conditions that produce the perception of a contingency between an action and reinforcement-the assignment-of-credit problem. Contemporary models of associative and reinforcement learning do not leverage the temporal metrics (measured intervals). Our information-theoretic approach formalizes contingency by time-scale invariant temporal mutual information. It predicts that learning may proceed rapidly even with extremely long action-reinforcer delays. We show that rats can learn an action after a single reinforcement, even with a 16-min delay between the action and reinforcement (15-fold longer than any delay previously shown to support such learning). By leveraging metric temporal information, our solution obviates the need for windows of associability, exponentially decaying eligibility traces, microstimuli, or distributions over Bayesian belief states. Its three equations have no free parameters; they predict one-shot learning without iterative simulation.
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Reforço Psicológico , Animais , Ratos , Aprendizagem/fisiologia , Fatores de Tempo , Teorema de BayesRESUMO
The stem-loop 2 motif (s2m) in SARS-CoV-2 (SCoV-2) is located in the 3'-UTR. Although s2m has been reported to display characteristics of a mobile genomic element that might lead to an evolutionary advantage, its function has remained unknown. The secondary structure of the original SCoV-2 RNA sequence (Wuhan-Hu-1) was determined by NMR in late 2020, delineating the base-pairing pattern and revealing substantial differences in secondary structure compared to SARS-CoV-1 (SCoV-1). The existence of a single G29742-A29756 mismatch in the upper stem of s2m leads to its destabilization and impedes a complete NMR analysis. With Delta, a variant of concern has evolved with one mutation compared to the original sequence that replaces G29742 by U29742. We show here that this mutation results in a more defined structure at ambient temperature accompanied by a rise in melting temperature. Consequently, we were able to identify >90% of the relevant NMR resonances using a combination of selective RNA labeling and filtered 2D NOESY as well as 4D NMR experiments. We present a comprehensive NMR analysis of the secondary structure, (sub)nanosecond dynamics, and ribose conformation of s2m Delta based on heteronuclear 13C NOE and T 1 measurements and ribose carbon chemical shift-derived canonical coordinates. We further show that the G29742U mutation in Delta has no influence on the druggability of s2m compared to the Wuhan-Hu-1 sequence. With the assignment at hand, we identify the flexible regions of s2m as the primary site for small molecule binding.
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Conformação de Ácido Nucleico , RNA Viral , SARS-CoV-2 , SARS-CoV-2/genética , SARS-CoV-2/química , SARS-CoV-2/metabolismo , RNA Viral/genética , RNA Viral/química , RNA Viral/metabolismo , Sítios de Ligação , Espectroscopia de Ressonância Magnética/métodos , Regiões 3' não Traduzidas , Ligantes , Humanos , Mutação , COVID-19/virologia , Pareamento de Bases , Motivos de NucleotídeosRESUMO
We developed phyloBARCODER (https://github.com/jun-inoue/phyloBARCODER), a new web tool that can identify short DNA sequences to the species level using metabarcoding. phyloBARCODER estimates phylogenetic trees based on the uploaded anonymous DNA sequences and reference sequences from databases. Without such phylogenetic contexts, alternative, similarity-based methods independently identify species names and anonymous sequences of the same group by pairwise comparisons between queries and database sequences, with the caveat that they must match exactly or very closely. By putting metabarcoding sequences into a phylogenetic context, phyloBARCODER accurately identifies (i) species or classification of query sequences and (ii) anonymous sequences associated with the same species or even with populations of query sequences, with clear and accurate explanations. Version 1 of phyloBARCODER stores a database comprising all eukaryotic mitochondrial gene sequences. Moreover, by uploading their own databases, phyloBARCODER users can conduct species identification specialized for sequences obtained from a local geographic region or those of nonmitochondrial genes, e.g. ITS or rbcL.
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Código de Barras de DNA Taxonômico , Eucariotos , Filogenia , Eucariotos/genética , Eucariotos/classificação , Código de Barras de DNA Taxonômico/métodos , Software , Bases de Dados Genéticas , Internet , Bases de Dados de Ácidos NucleicosRESUMO
Great efforts have been made to develop precision medicine-based treatments using machine learning. In this field, where the goal is to provide the optimal treatment for each patient based on his/her medical history and genomic characteristics, it is not sufficient to make excellent predictions. The challenge is to understand and trust the model's decisions while also being able to easily implement it. However, one of the issues with machine learning algorithms-particularly deep learning-is their lack of interpretability. This review compares six different machine learning methods to provide guidance for defining interpretability by focusing on accuracy, multi-omics capability, explainability and implementability. Our selection of algorithms includes tree-, regression- and kernel-based methods, which we selected for their ease of interpretation for the clinician. We also included two novel explainable methods in the comparison. No significant differences in accuracy were observed when comparing the methods, but an improvement was observed when using gene expression instead of mutational status as input for these methods. We concentrated on the current intriguing challenge: model comprehension and ease of use. Our comparison suggests that the tree-based methods are the most interpretable of those tested.
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Oncologia , Neoplasias , Feminino , Humanos , Masculino , Neoplasias/genética , Algoritmos , Genômica , Aprendizado de MáquinaRESUMO
Traditional Randomized Controlled Trials often fall short in addressing the specific needs of clinical practice due to their one-size-fits-all treatment approaches. Sequential Multiple Assignment Randomized Trials (SMARTs) offer a dynamic and adaptive approach, allowing for multiple randomizations based on patient responses and evolving conditions. SMARTs enable personalized treatment pathways, such as in the trial for antiretroviral therapy (ART) in South Africa, which adjusts treatment based on patient outcomes. Despite these advantages, the use of SMARTs in infectious diseases remains limited. Greater adoption of SMARTs could promote more personalized treatment approaches, improve flexibility in response to public health needs, and enhance the effectiveness of interventions. However, challenges such as recruitment and increased expertise needed for more complex analyses must be addressed. Additionally, combining SMARTs with other adaptive designs could further improve the relevance and outcomes of clinical research.
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BACKGROUND: Taxonomic classification of reads obtained by metagenomic sequencing is often a first step for understanding a microbial community, but correctly assigning sequencing reads to the strain or sub-species level has remained a challenging computational problem. RESULTS: We introduce Mora, a MetagenOmic read Re-Assignment algorithm capable of assigning short and long metagenomic reads with high precision, even at the strain level. Mora is able to accurately re-assign reads by first estimating abundances through an expectation-maximization algorithm and then utilizing abundance information to re-assign query reads. The key idea behind Mora is to maximize read re-assignment qualities while simultaneously minimizing the difference from estimated abundance levels, allowing Mora to avoid over assigning reads to the same genomes. On simulated diverse reads, this allows Mora to achieve F1 scores comparable to other algorithms while having less runtime. However, Mora significantly outshines other algorithms on very similar reads. We show that the high penalty of over assigning reads to a common reference genome allows Mora to accurately infer correct strains for real data in the form of E. coli reads. CONCLUSIONS: Mora is a fast and accurate read re-assignment algorithm that is modularized, allowing it to be incorporated into general metagenomics and genomics workflows. It is freely available at https://github.com/AfZheng126/MORA .
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Algoritmos , Metagenômica , Metagenômica/métodos , Escherichia coli/genética , Análise de Sequência de DNA/métodos , Software , Metagenoma/genética , Genoma BacterianoRESUMO
We introduce single cell Proteoform imaging Mass Spectrometry (scPiMS), which realizes the benefit of direct solvent extraction and MS detection of intact proteins from single cells dropcast onto glass slides. Sampling and detection of whole proteoforms by individual ion mass spectrometry enable a scalable approach to single cell proteomics. This new scPiMS platform addresses the throughput bottleneck in single cell proteomics and boosts the cell processing rate by several fold while accessing protein composition with higher coverage.
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Espectrometria de Massas , Proteômica , Análise de Célula Única , Análise de Célula Única/métodos , Proteômica/métodos , Humanos , Espectrometria de Massas/métodos , Proteoma/análiseRESUMO
Photosystem II (PSII) is the water-splitting enzyme central to oxygenic photosynthesis. To drive water oxidation, light is harvested by accessory pigments, mostly chlorophyll (Chl) a molecules, which absorb visible light (400-700 nm). Some cyanobacteria facultatively acclimate to shaded environments by altering their photosynthetic machinery to additionally absorb far-red light (FRL, 700-800 nm), a process termed far-red light photoacclimation or FaRLiP. During far-red light photoacclimation, FRL-PSII is assembled with FRL-specific isoforms of the subunits PsbA, PsbB, PsbC, PsbD, and PsbH, and some Chl-binding sites contain Chls d or f instead of the usual Chl a. The structure of an apo-FRL-PSII monomer lacking the FRL-specific PsbH subunit has previously been determined, but visualization of the dimeric complex has remained elusive. Here, we report the cryo-EM structure of a dimeric FRL-PSII complex. The site assignments for Chls d and f are consistent with those assigned in the previous apo-FRL-PSII monomeric structure. All sites that bind Chl d or Chl f at high occupancy exhibit a FRL-specific interaction of the formyl moiety of the Chl d or Chl f with the protein environment, which in some cases involves a phenylalanine sidechain. The structure retains the FRL-specific PsbH2 subunit, which appears to alter the energetic landscape of FRL-PSII, redirecting energy transfer from the phycobiliprotein complex to a Chl f molecule bound by PsbB2 that acts as a bridge for energy transfer to the electron transfer chain. Collectively, these observations extend our previous understanding of the structure-function relationship that allows PSII to function using lower energy FRL.
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Aclimatação , Cianobactérias , Complexo de Proteína do Fotossistema II , Multimerização Proteica , Clorofila/metabolismo , Clorofila A/metabolismo , Cianobactérias/metabolismo , Cianobactérias/fisiologia , Luz , Fotossíntese , Complexo de Proteína do Fotossistema I/metabolismo , Complexo de Proteína do Fotossistema II/químicaRESUMO
BACKGROUND: At a global scale, the SARS-CoV-2 virus did not remain in its initial genotype for a long period of time, with the first global reports of variants of concern (VOCs) in late 2020. Subsequently, genome sequencing has become an indispensable tool for characterizing the ongoing pandemic, particularly for typing SARS-CoV-2 samples obtained from patients or environmental surveillance. For such SARS-CoV-2 typing, various in vitro and in silico workflows exist, yet to date, no systematic cross-platform validation has been reported. RESULTS: In this work, we present the first comprehensive cross-platform evaluation and validation of in silico SARS-CoV-2 typing workflows. The evaluation relies on a dataset of 54 patient-derived samples sequenced with several different in vitro approaches on all relevant state-of-the-art sequencing platforms. Moreover, we present UnCoVar, a robust, production-grade reproducible SARS-CoV-2 typing workflow that outperforms all other tested approaches in terms of precision and recall. CONCLUSIONS: In many ways, the SARS-CoV-2 pandemic has accelerated the development of techniques and analytical approaches. We believe that this can serve as a blueprint for dealing with future pandemics. Accordingly, UnCoVar is easily generalizable towards other viral pathogens and future pandemics. The fully automated workflow assembles virus genomes from patient samples, identifies existing lineages, and provides high-resolution insights into individual mutations. UnCoVar includes extensive quality control and automatically generates interactive visual reports. UnCoVar is implemented as a Snakemake workflow. The open-source code is available under a BSD 2-clause license at github.com/IKIM-Essen/uncovar.
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COVID-19 , Genoma Viral , SARS-CoV-2 , Fluxo de Trabalho , SARS-CoV-2/genética , Humanos , COVID-19/virologia , COVID-19/epidemiologia , Software , Reprodutibilidade dos TestesRESUMO
Monoclonal antibodies (mAbs) are biotherapeutics that have achieved outstanding success in treating many life-threatening and chronic diseases. The recognition of an antigen is mediated by the fragment antigen binding (Fab) regions composed by four different disulfide bridge-linked immunoglobulin domains. NMR is a powerful method to assess the integrity, the structure and interaction of Fabs, but site specific analysis has been so far hampered by the size of the Fabs and the lack of approaches to produce isotopically labeled samples. We proposed here an efficient in vitro method to produce [15N, 13C, 2H]-labeled Fabs enabling high resolution NMR investigations of these powerful therapeutics. As an open system, the cell-free expression mode enables fine-tuned control of the redox potential in presence of disulfide bond isomerase to enhance the formation of native disulfide bonds. Moreover, inhibition of transaminases in the S30 cell-free extract offers the opportunity to produce perdeuterated Fab samples directly in 1H2O medium, without the need for a time-consuming and inefficient refolding process. This specific protocol was applied to produce an optimally labeled sample of a therapeutic Fab, enabling the sequential assignment of 1HN, 15N, 13C', 13Cα, 13Cß resonances of a full-length Fab. 90% of the backbone resonances of a Fab domain directed against the human LAMP1 glycoprotein were assigned successfully, opening new opportunities to study, at atomic resolution, Fabs' higher order structures, dynamics and interactions, using solution-state NMR.
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Fragmentos Fab das Imunoglobulinas , Marcação por Isótopo , Ressonância Magnética Nuclear Biomolecular , Fragmentos Fab das Imunoglobulinas/química , Ressonância Magnética Nuclear Biomolecular/métodos , Marcação por Isótopo/métodos , Humanos , Sistema Livre de Células , Isótopos de Nitrogênio , Anticorpos Monoclonais/químicaRESUMO
Lesion-symptom studies in persons with aphasia showed that left temporoparietal damage, but surprisingly not prefrontal damage, correlates with impaired ability to process thematic roles in the comprehension of semantically reversible sentences (The child is hugged by the mother). This result has led to challenge the time-honored view that left prefrontal regions are critical for sentence comprehension. However, most studies focused on thematic role assignment and failed to consider morphosyntactic processes that are also critical for sentence processing. We reviewed and meta-analyzed lesion-symptom studies on the neurofunctional correlates of thematic role assignment and morphosyntactic processing in comprehension and production in persons with aphasia. Following the PRISMA checklist, we selected 43 papers for the review and 27 for the meta-analysis, identifying a set of potential bias risks. Both the review and the meta-analysis confirmed the correlation between thematic role processing and temporoparietal regions but also clearly showed the involvement of prefrontal regions in sentence processing. Exploratory meta-analyses suggested that both thematic role and morphosyntactic processing correlate with left prefrontal and temporoparietal regions, that morphosyntactic processing correlates with prefrontal structures more than with temporoparietal regions, and that thematic role assignment displays the opposite trend. We discuss current limitations in the literature and propose a set of recommendations for clarifying unresolved issues.
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As climatic variation re-shapes global biodiversity, understanding eco-evolutionary feedbacks during species range shifts is of increasing importance. Theory on range expansions distinguishes between two different forms: "pulled" and "pushed" waves. Pulled waves occur when the source of the expansion comes from low-density peripheral populations, while pushed waves occur when recruitment to the expanding edge is supplied by high-density populations closer to the species' core. How extreme events shape pushed/pulled wave expansion events, as well as trailing-edge declines/contractions, remains largely unexplored. We examined eco-evolutionary responses of a marine invertebrate (the owl limpet, Lottia gigantea) that increased in abundance during the 2014-2016 marine heatwaves near the poleward edge of its geographic range in the northeastern Pacific. We used whole-genome sequencing from 19 populations across >11 degrees of latitude to characterize genomic variation, gene flow, and demographic histories across the species' range. We estimated present-day dispersal potential and past climatic stability to identify how contemporary and historical seascape features shape genomic characteristics. Consistent with expectations of a pushed wave, we found little genomic differentiation between core and leading-edge populations, and higher genomic diversity at range edges. A large and well-mixed population in the northern edge of the species' range is likely a result of ocean current anomalies increasing larval settlement and high-dispersal potential across biogeographic boundaries. Trailing-edge populations have higher differentiation from core populations, possibly driven by local selection and limited gene flow, as well as high genomic diversity likely as a result of climatic stability during the Last Glacial Maximum. Our findings suggest that extreme events can drive poleward range expansions that carry the adaptive potential of core populations, while also cautioning that trailing-edge extirpations may threaten unique evolutionary variation. This work highlights the importance of understanding how both trailing and leading edges respond to global change and extreme events.
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Evolução Biológica , Mudança Climática , Animais , Fluxo Gênico , Dinâmica Populacional , Distribuição Animal , Variação GenéticaRESUMO
The escalating threat posed by antibiotic resistance is a global concern and underscores the need for new antibiotics. In this context, the recent discovery of evybactin, a nonribosomal depsipeptide antibiotic that selectively and potently inhibits the growth of M. tuberculosis, is particularly noteworthy. Here, we present the first total synthesis of this natural product, along with a revision of its assigned structure. Our studies revealed a disparity between the structure originally proposed for evybactin and its actual configuration. Specifically, the 3-methylhistidine residue present in the evybactin core macrocycle was found to be of the d-configuration rather than the previously assigned l-His(Me). Having addressed this, we further optimized our solid-phase synthetic route to provide access to evybactin on a multi-hundred-milligram scale. Access to such quantities will allow for more comprehensive studies with this promising antibiotic.
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We address a Bayesian two-stage decision problem in operational forestry where the inner stage considers scheduling the harvesting to fulfill demand targets and the outer stage considers selecting the accuracy of pre-harvest inventories that are used to estimate the timber volumes of the forest tracts. The higher accuracy of the inventory enables better scheduling decisions but also implies higher costs. We focus on the outer stage, which we formulate as a maximization of the posterior value of the inventory decision under a budget constraint. The posterior value depends on the solution to the inner stage problem and its computation is analytically intractable, featuring an NP-hard binary optimization problem within a high-dimensional integral. In particular, the binary optimization problem is a special case of a generalized quadratic assignment problem. We present a practical method that solves the outer stage problem with an approximation which combines Monte Carlo sampling with a greedy, randomized method for the binary optimization problem. We derive inventory decisions for a dataset of 100 Swedish forest tracts across a range of inventory budgets and estimate the value of the information to be obtained.
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Teorema de Bayes , Análise Custo-Benefício , Agricultura Florestal , Florestas , Método de Monte Carlo , Agricultura Florestal/economia , Agricultura Florestal/estatística & dados numéricos , Análise Custo-Benefício/métodos , Suécia , Modelos Estatísticos , HumanosRESUMO
A dynamic treatment regime (DTR) is a mathematical representation of a multistage decision process. When applied to sequential treatment selection in medical settings, DTRs are useful for identifying optimal therapies for chronic diseases such as AIDs, mental illnesses, substance abuse, and many cancers. Sequential multiple assignment randomized trials (SMARTs) provide a useful framework for constructing DTRs and providing unbiased between-DTR comparisons. A limitation of SMARTs is that they ignore data from past patients that may be useful for reducing the probability of exposing new patients to inferior treatments. In practice, this may result in decreased treatment adherence or dropouts. To address this problem, we propose a generalized outcome-adaptive (GO) SMART design that adaptively unbalances stage-specific randomization probabilities in favor of treatments observed to be more effective in previous patients. To correct for bias induced by outcome adaptive randomization, we propose G-estimators and inverse-probability-weighted estimators of DTR effects embedded in a GO-SMART and show analytically that they are consistent. We report simulation results showing that, compared to a SMART, Response-Adaptive SMART and SMART with adaptive randomization, a GO-SMART design treats significantly more patients with the optimal DTR and achieves a larger number of total responses while maintaining similar or better statistical power.
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Simulação por Computador , Ensaios Clínicos Controlados Aleatórios como Assunto , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto/estatística & dados numéricos , Ensaios Clínicos Controlados Aleatórios como Assunto/métodos , Projetos de Pesquisa , Modelos Estatísticos , Resultado do Tratamento , ViésRESUMO
Dynamic treatment regimes (DTRs) are sequences of decision rules that recommend treatments based on patients' time-varying clinical conditions. The sequential, multiple assignment, randomized trial (SMART) is an experimental design that can provide high-quality evidence for constructing optimal DTRs. In a conventional SMART, participants are randomized to available treatments at multiple stages with balanced randomization probabilities. Despite its relative simplicity of implementation and desirable performance in comparing embedded DTRs, the conventional SMART faces inevitable ethical issues, including assigning many participants to the empirically inferior treatment or the treatment they dislike, which might slow down the recruitment procedure and lead to higher attrition rates, ultimately leading to poor internal and external validities of the trial results. In this context, we propose a SMART under the Experiment-as-Market framework (SMART-EXAM), a novel SMART design that holds the potential to improve participants' welfare by incorporating their preferences and predicted treatment effects into the randomization procedure. We describe the steps of conducting a SMART-EXAM and evaluate its performance compared to the conventional SMART. The results indicate that the SMART-EXAM can improve the welfare of the participants enrolled in the trial, while also achieving a desirable ability to construct an optimal DTR when the experimental parameters are suitably specified. We finally illustrate the practical potential of the SMART-EXAM design using data from a SMART for children with attention-deficit/hyperactivity disorder.
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Projetos de Pesquisa , Criança , Humanos , Ensaios Clínicos Controlados Aleatórios como AssuntoRESUMO
Ion mobility spectrometry-mass spectrometry (IMS-MS) separates gas phase ions due to differences in drift time from which reproducible and analyte-specific collision cross section (CCS) values can be derived. Internally conducted in vitro and in vivo metabolism (biotransformation) studies indicated repetitive shifts in measured CCS values (CCSmeas) between parent drugs and their metabolites. Hence, the purpose of the present article was (i) to investigate if such relative shifts in CCSmeas were biotransformation-specific and (ii) to highlight their potential benefits for biotransformation studies. First, mean CCSmeas values of 165 compounds were determined (up to n = 3) using a travelling wave IMS-MS device with nitrogen as drift gas (TWCCSN2, meas). Further comparison with their predicted values (TWCCSN2, pred, Waters CCSonDemand) resulted in a mean absolute error of 5.1%. Second, a reduced data set (n = 139) was utilized to create compound pairs (n = 86) covering eight common types of phase I and II biotransformations. Constant, discriminative, and almost non-overlapping relative shifts in mean TWCCSN2, meas were obtained for demethylation (- 6.5 ± 2.1 Å2), oxygenation (hydroxylation + 3.8 ± 1.4 Å2, N-oxidation + 3.4 ± 3.3 Å2), acetylation (+ 13.5 ± 1.9 Å2), sulfation (+ 17.9 ± 4.4 Å2), glucuronidation (N-linked: + 41.7 ± 7.5 Å2, O-linked: + 38.1 ± 8.9 Å2), and glutathione conjugation (+ 49.2 ± 13.2 Å2). Consequently, we propose to consider such relative shifts in TWCCSN2, meas (rather than absolute values) as well for metabolite assignment/confirmation complementing the conventional approach to associate changes in mass-to-charge (m/z) values between a parent drug and its metabolite(s). Moreover, the comparison of relative shifts in TWCCSN2, meas significantly simplifies the mapping of metabolites into metabolic pathways as demonstrated.
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Cisteamina , Nitrogênio , Espectrometria de Massas/métodos , BiotransformaçãoRESUMO
INTRODUCTION: Mobile phone-based interventions show promise for smoking cessation but often face low engagement. This study assessed the feasibility and preliminary effectiveness of a 2-phase, multi-component mobile phone-based smoking cessation intervention for patients with chronic diseases. METHODS: This Sequential Multiple Assignment Randomized Trial (SMART) recruited smokers with chronic diseases from hospitals in Zhuhai, China. Participants received brief cessation advice and were randomized to personalized chat support (PCS, n=64) or group chat support (GCS, n=64) for 1 month. At 1-month, PCS non-responders (continuing smokers) were re-randomized to receive either multi-component optional support (MOS) or continued PCS for 2 months. GCS non-responders were re-randomized to receive PCS or continued GCS. Responders continued with their initial intervention for 2 months. Feasibility outcomes included eligibility, participation, retention, intervention engagement, and satisfaction. Preliminary effectiveness was assessed by abstinence rates among non-responders. RESULTS: Of 160 screened, 128 (all male, 46.1% aged≤39 years) participated. At 1-month, 51 and 53 non-responded to PCS and GCS, respectively. Of them, 26 were re-randomized to receive PCS-MOS and 26 to receive GCS-PCS. At 6-month, PCS-MOS showed a non-significant higher validated abstinence rate compared to PCS alone (11.5% vs. 4.2%, odds ratio [OR] 3.13, 95%CI 0.30-32.31, P=0.34), GCS-PCS showed a non-significant lower validated abstinence rate compared to GCS (0% vs. 11.1%, OR 0.50, 95%CI 0.15-1.67, P=0.26). CONCLUSIONS: This trial showed the feasibility of leveraging hospital visits as teachable opportunities and integrating mobile phone-based smoking cessation support into chronic disease management in China. Optional treatments alongside mobile support showed preliminary effectiveness.
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BACKGROUND: Comparing causal effect estimates obtained using observational data to those obtained from the gold standard (i.e., randomized controlled trials [RCTs]) helps assess the validity of these estimates. However, comparisons are challenging due to differences between observational data and RCT generated data. The unknown treatment assignment mechanism in the observational data and varying sampling mechanisms between the RCT and the observational data can lead to confounding and sampling bias, respectively. AIMS: The objective of this study is to propose a two-step framework to validate causal effect estimates obtained from observational data by adjusting for both mechanisms. MATERIALS AND METHODS: An estimator of causal effects related to the two mechanisms is constructed. A two-step framework for comparing causal effect estimates is derived from the estimator. An R package RCTrep is developed to implement the framework in practice. RESULTS: A simulation study is conducted to show that using our framework observational data can produce causal effect estimates similar to those of an RCT. A real-world application of the framework to validate treatment effects of adjuvant chemotherapy obtained from registry data is demonstrated. CONCLUSION: This study constructs a framework for comparing causal effect estimates between observational data and RCT data, facilitating the assessment of the validity of causal effect estimates obtained from observational data.