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The genetic consequences of the subdivision of populations are regarded as significant to long-term evolution, and research has shown that the scale and speed at which this is now occurring is critically reducing the adaptive potential of most species which inhabit human-impacted landscapes. Here, we provide a rare and, to our knowledge, the first analysis of this process while it is happening and demonstrate a method of evaluating the effect of mitigation measures such as fauna crossings. We did this by using an extensive genetic data set collected from a koala population which was intensely monitored during the construction of linear transport infrastructure which resulted in the subdivision of their population. First, we found that both allelic richness and effective population size decreased through the process of population subdivision. Second, we predicted the extent to which genetic drift could impact genetic diversity over time and showed that after only 10 generations the resulting two subdivided populations could experience between 12% and 69% loss in genetic diversity. Lastly, using forward simulations we estimated that a minimum of eight koalas would need to disperse from each side of the subdivision per generation to maintain genetic connectivity close to zero but that 16 koalas would ensure that both genetic connectivity and diversity remained unchanged. These results have important consequences for the genetic management of species in human-impacted landscapes by showing which genetic metrics are best to identify immediate loss in genetic diversity and how to evaluate the effectiveness of any mitigation measures.
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Variación Genética , Phascolarctidae , Animales , Humanos , Phascolarctidae/genética , Ecosistema , Conservación de los Recursos Naturales/métodos , Flujo Genético , Genética de PoblaciónRESUMEN
AIMS: To explore perceptions of useful routine consultations with diabetologists from the perspective of adults with type 1 diabetes, including preferences for discussing psychosocial issues. METHODS: We conducted semi-structured interviews in 2018/2019 with 33 people with type 1 diabetes (age 22-75 years, 20 men and 13 women, median diabetes duration 25 years) recruited from two diabetes clinics in the capital region of Denmark. Interviews were audio recorded, transcribed verbatim and analysed using thematic text condensation. RESULTS: Achieving a useful consultation was perceived as a shared responsibility between people with diabetes and diabetologists. Participants' perspectives of what constitutes a useful consultation and expectations for both consultation and diabetologist varied in relation to perceptions of (1) the interaction between the person with diabetes and diabetologist, including being prepared, being honest, experiencing good rapport and preferring a partnership with the diabetologist or 'keeping it clinical' and (2) the diabetologist's approach to diabetes care, including providing up-to-date knowledge and listening and showing understanding. CONCLUSIONS: Both content and style of diabetes consultations need to be adapted to the individual person with type 1 diabetes. People with diabetes have an important role in expressing their needs and preferences related to both content and style. Diabetologists need to be aware of and attentive to the many individual needs and expectations among people with diabetes, including the desire and need to discuss psychosocial issues. Dialogue tools for preparation and in consultations may enable people with diabetes to voice their needs and expectations and diabetologists to juggle these diversities.
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Diabetes Mellitus Tipo 1/terapia , Relaciones Médico-Paciente , Médicos , Investigación Cualitativa , Derivación y Consulta/organización & administración , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto JovenRESUMEN
Some studies suggest that prenatal infection increases risk of autism spectrum disorders (ASDs). This study was undertaken in a prospective cohort in Norway to examine whether we could find evidence to support an association of the prenatal occurrence of fever, a common manifestation of infection, with ASD risk. Prospective questionnaires provided maternal exposure data; case status was established from clinical assessments and registry linkages. In a large, prospectively ascertained cohort of pregnant mothers and their offspring, we examined infants born ⩾32 weeks for associations between fever exposure in each trimester and ASD risk using logistic regression. Maternal exposure to second-trimester fever was associated with increased ASD risk, adjusting for presence of fever in other trimesters and confounders (adjusted odds ratio (aOR), 1.40; 95% confidence interval, 1.09-1.79), with a similar, but nonsignificant, point estimate in the first trimester. Risk increased markedly with exposure to three or more fever episodes after 12 weeks' gestation (aOR, 3.12; 1.28-7.63). ASD risk appears to increase with maternal fever, particularly in the second trimester. Risk magnified dose dependently with exposure to multiple fevers after 12 weeks' gestation. Our findings support a role for gestational maternal infection and innate immune responses to infection in the pathogenesis of at least some cases of ASD.
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Trastorno del Espectro Autista/etiología , Trastorno Autístico/etiología , Adulto , Femenino , Fiebre/complicaciones , Ligamiento Genético , Edad Gestacional , Humanos , Inmunidad Innata/inmunología , Lactante , Recién Nacido , Infecciones/complicaciones , Masculino , Exposición Materna , Madres , Noruega , Oportunidad Relativa , Embarazo , Segundo Trimestre del Embarazo/fisiología , Efectos Tardíos de la Exposición Prenatal , Estudios Prospectivos , Sistema de Registros , Factores de Riesgo , Encuestas y CuestionariosRESUMEN
Clinicians and other decision makers in healthcare use results from clinical trials to inform practice. Interpretation of clinical trial results can be challenging, as weaknesses in trial design, data collection, analysis or reporting, can compromise the usefulness of results. A good working knowledge of clinical trial design is essential to expertly interpret and determine the validity and generalizability of the results. This manuscript will give a brief overview of clinical trial design including the strengths and limitations of various approaches. The focus will be on confirmatory clinical trials.
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Ensayos Clínicos como Asunto , Proyectos de Investigación , Ensayos Clínicos Adaptativos como Asunto , Estudios de Equivalencia como Asunto , Humanos , Ensayos Clínicos Controlados Aleatorios como AsuntoRESUMEN
AIMS: The aim of this study was to identify the most efficient sampling method for quantitative PCR-based detection of airborne human norovirus (NoV). METHODS AND RESULTS: A comparative experiment was conducted in an aerosol chamber using aerosolized murine norovirus (MNV) as a surrogate for NoV. Sampling was performed using a nylon (NY) filter in conjunction with four kinds of personal samplers: Gesamtstaubprobenahme sampler (GSP), Triplex-cyclone sampler (TC), 3-piece closed-faced Millipore cassette (3P) and a 2-stage NIOSH cyclone sampler (NIO). In addition, sampling was performed using the GSP sampler with four different filter types: NY, polycarbonate (PC), polytetrafluoroethylene (PTFE) and gelatine (GEL). The sampling efficiency of MNV was significantly influenced by both sampler and filter type. The GSP sampler was found to give significantly (P < 0·05) higher recovery of aerosolized MNV than 3P and NIO. A higher recovery was also found for GSP compared with TC, albeit not significantly. Finally, recovery of aerosolized MNV was significantly (P < 0·05) higher using NY than PC, PTFE and GEL filters. CONCLUSIONS: The GSP sampler combined with a nylon filter was found to be the best method for personal filter-based sampling of airborne NoV. SIGNIFICANCE AND IMPACT OF THE STUDY: The identification of a suitable NoV air sampler is an important step towards studying the association between exposure to airborne NoV and infection.
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Aerosoles/análisis , Microbiología del Aire , Monitoreo del Ambiente/métodos , Norovirus/aislamiento & purificación , Monitoreo del Ambiente/instrumentación , Humanos , Norovirus/clasificación , Norovirus/genéticaRESUMEN
UNLABELLED: A fraction of HIV-1 patients are able to generate broadly neutralizing antibodies (bNAbs) after 2 to 4 years of infection. In rare occasions such antibodies are observed close to the first year of HIV-1 infection but never within the first 6 months. In this study, we analyzed the neutralization breadth of sera from 157 antiretroviral-naive individuals who were infected for less than 1 year. A range of neutralizing activities was observed with a previously described panel of six recombinant viruses from five different subtypes (M. Medina-Ramirez et al., J Virol 85:5804-5813, 2011, http://dx.doi.org/10.1128/JVI.02482-10). Some sera were broadly reactive, predominantly targeting envelope epitopes within the V2 glycan-dependent region. The neutralization breadth was positively associated with time postinfection (P = 0.0001), but contrary to what has been reported for chronic infections, no association with the viral load was observed. Notably, five individuals within the first 6 months of infection (two as early as 77 and 96 days postinfection) showed substantial cross-neutralization. This was confirmed with an extended panel of 20 Env pseudoviruses from four different subtypes (two in tier 3, 14 in tier 2, and four in tier 1). Sera from these individuals were capable of neutralizing viruses from four different subtypes with a geometric mean 50% infective dose (ID50) between 100 and 800. These results indicate that induction of cross-neutralizing responses, albeit rare, is achievable even within 6 months of HIV-1 infection. These observations encourage the search for immunogens able to elicit this kind of response in preventive HIV-1 vaccine approaches. IMPORTANCE: There are very few individuals able to mount broadly neutralizing activity (bNA) close to the first year postinfection. It is not known how early in the infection cross-neutralizing responses can be induced. In the present study, we show that bNAbs, despite being rare, can be induced much earlier than previously thought. The identification of HIV-1-infected patients with these activities within the first months of infection and characterization of these responses will help in defining new immunogen designs and neutralization targets for vaccine-mediated induction of bNAbs.
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Anticuerpos Neutralizantes/sangre , Anticuerpos Neutralizantes/inmunología , Epítopos/inmunología , Anticuerpos Anti-VIH/sangre , Infecciones por VIH/inmunología , VIH-1/inmunología , Adulto , Estudios Transversales , Mapeo Epitopo , Epítopos/química , Femenino , Anticuerpos Anti-VIH/inmunología , Infecciones por VIH/virología , VIH-1/fisiología , Humanos , Masculino , Pruebas de Neutralización , Polisacáridos/inmunología , Factores de Tiempo , Carga ViralRESUMEN
Myalgic encephalomyelitis/chronic fatigue syndrome is an unexplained debilitating disorder that is frequently associated with cognitive and motor dysfunction. We analyzed cerebrospinal fluid from 32 cases, 40 subjects with multiple sclerosis and 19 normal subjects frequency-matched for age and sex using a 51-plex cytokine assay. Group-specific differences were found for the majority of analytes with an increase in cases of CCL11 (eotaxin), a chemokine involved in eosinophil recruitment. Network analysis revealed an inverse relationship between interleukin 1 receptor antagonist and colony-stimulating factor 1, colony-stimulating factor 2 and interleukin 17F, without effects on interleukin 1α or interleukin 1ß, suggesting a disturbance in interleukin 1 signaling. Our results indicate a markedly disturbed immune signature in the cerebrospinal fluid of cases that is consistent with immune activation in the central nervous system, and a shift toward an allergic or T helper type-2 pattern associated with autoimmunity.
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Citocinas/análisis , Citocinas/inmunología , Síndrome de Fatiga Crónica/inmunología , Síndrome de Fatiga Crónica/metabolismo , Adulto , Estudios de Casos y Controles , Quimiocina CCL11/inmunología , Quimiocina CCL11/metabolismo , Citocinas/líquido cefalorraquídeo , Femenino , Humanos , Interleucina-17 , Interleucina-1beta , Masculino , Persona de Mediana Edad , Esclerosis Múltiple/líquido cefalorraquídeo , Esclerosis Múltiple/inmunología , Esclerosis Múltiple/metabolismoRESUMEN
Inhalation of aerosolised medications are the mainstay of treatment for a number of chronic lung diseases and have several advantages over systemically-administered medications. These include more rapid onset of action for drugs such as ß-adrenergic agonists when compared with oral medication, high luminal doses for inhaled antibiotics when used to treat endobronchial infection, and an improved therapeutic index compared with systemic delivery for these and other classes of drugs such as corticosteroids. The use of aerosolised drugs to treat patients whose tracheas are intubated is less well established, in part because systemic delivery via the intravenous route can be a simpler alternative for many drugs. Consequently, research in this area is largely limited to a number of in vitro studies and very few clinical trials. Unfortunately, a lack of focus in this area has resulted in a number of practices which at best are ineffective, and at worst dangerous for the patient. Although there have been some attempts to re-invigorate research in order to improve delivery systems, current devices are, to a great extent, based on long-standing technology developed more than 50 years ago. In this review, we explore current knowledge and provide guidance as to when and how the inhaled route may be of value when treating patients whose tracheas are intubated, and we set out the challenges facing those attempting to advance the topic. We conclude by reviewing current areas of interest that may lead to more effective and widespread use of aerosols in the treatment of intubated patients.
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Aerosoles , Ventilación no Invasiva/métodos , Preparaciones Farmacéuticas/administración & dosificación , Respiración Artificial/métodos , Administración por Inhalación , Adolescente , Niño , Preescolar , Humanos , Lactante , Nebulizadores y VaporizadoresRESUMEN
AIM: Pridopidine, a new oral drug for treatment of patients with motor symptoms associated with Huntington's Disease (HD) is currently under development. In steady-state conditions, pridopidine elimination is mediated primarily through renal excretion. This study evaluated single dose and steady-state pharmacokinetics (PK) of a daily dose of pridopidine in subjects with mild and moderate renal impairment and matched healthy subjects. METHODS: Subjects with mild renal impairment (n = 12), moderate impairment (n = 12), or their matched healthy controls (n = 25) participated in this study. Subjects received a single dose of pridopidine (45 mg) on day 1 and a multiple dose cycle of 45 mg once daily on days 5-18. Blood and urine samples were collected on days 1 and 18 for PK analysis. RESULTS: Mild renal impairment did not affect the PK of pridopidine whilst an increase in exposure was seen in subjects with moderate renal impairment. Subjects with moderate impairment showed reduced plasma clearance (by 44%) and had 68% higher AUC (90% CI 1.22, 2.30) and 26% higher Cmax (90% CI 1.02, 1.56) values than those with normal renal function at steady-state. Pridopidine was safe and well tolerated in healthy subjects and in subjects with mild and moderate renal impairment. CONCLUSIONS: Mild renal impairment has no impact on exposure to pridopidine while moderately impaired renal function resulted in higher pridopidine concentrations.
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Enfermedad de Huntington/tratamiento farmacológico , Enfermedades Renales , Piperidinas/farmacocinética , Adolescente , Adulto , Anciano , Citocromo P-450 CYP2D6/genética , Relación Dosis-Respuesta a Droga , Femenino , Alemania , Humanos , Enfermedad de Huntington/complicaciones , Enfermedades Renales/sangre , Enfermedades Renales/complicaciones , Enfermedades Renales/orina , Pruebas de Función Renal , Masculino , Persona de Mediana Edad , Piperidinas/sangre , Piperidinas/orina , Índice de Severidad de la Enfermedad , Adulto JovenRESUMEN
Age-related impairments in the default network (DN) have been related to disruptions in connecting white matter tracts. We hypothesized that the local correlation between DN structural and functional connectivity is negatively affected in the presence of global white matter injury. In 125 clinically normal older adults, we tested whether the relationship between structural connectivity (via diffusion imaging tractography) and functional connectivity (via resting-state functional MRI) of the posterior cingulate cortex (PCC) and medial prefrontal frontal cortex (MPFC) of the DN was altered in the presence of white matter hyperintensities (WMH). A significant correlation was observed between microstructural properties of the cingulum bundle and MPFC-PCC functional connectivity in individuals with low WMH load, but not with high WMH load. No correlation was observed between PCC-MPFC functional connectivity and microstructure of the inferior longitudinal fasciculus, a tract not passing through the PCC or MPFC. Decoupling of connectivity, measured as the absolute difference between structural and functional connectivity, in the high WMH group was related to poorer executive functioning and memory performance. These results suggest that such decoupling may reflect reorganization of functional networks in response to global white matter pathology and may provide an early marker of clinically relevant network alterations.
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Giro del Cíngulo/anatomía & histología , Giro del Cíngulo/fisiología , Corteza Prefrontal/anatomía & histología , Corteza Prefrontal/fisiología , Sustancia Blanca/anatomía & histología , Sustancia Blanca/fisiología , Anciano , Anciano de 80 o más Años , Mapeo Encefálico , Imagen de Difusión Tensora , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Vías Nerviosas/anatomía & histología , Vías Nerviosas/fisiología , Pruebas NeuropsicológicasRESUMEN
Norovirus outbreaks occur frequently in Denmark and it can be difficult to establish whether apparently independent outbreaks have the same origin. Here we report on six outbreaks linked to frozen raspberries, investigated separately over a period of 3 months. Norovirus from stools were sequence-typed; including extended sequencing of 1138 bp encompassing the hypervariable P2 region of the capsid gene. Norovirus was detected in 27 stool samples. Genotyping showed genotype GI.Pb_GI.6 (polymerase/capsid) with 100% identical sequences. Samples from five outbreaks were furthermore identical over the variable capsid P2 region. In one outbreak at a hospital canteen, frozen raspberries was associated with illness by cohort investigation (relative risk 6·1, 95% confidence interval 3·2-11). Bags of raspberries suspected to be the source were positive for genogroup I and II noroviruses, one typable virus was genotype GI.6 (capsid). These molecular investigations showed that the apparently independent outbreaks were the result of one contamination event of frozen raspberries. The contaminated raspberries originated from a single producer in Serbia and were originally not considered to belong to the same batch. The outbreaks led to consultations and mutual visits between producers, investigators and authorities. Further, Danish legislation was changed to make heat-treatment of frozen raspberries compulsory in professional catering establishments.
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Infecciones por Caliciviridae/epidemiología , Brotes de Enfermedades , Enfermedades Transmitidas por los Alimentos/epidemiología , Gastroenteritis/epidemiología , Norovirus/genética , ARN Viral/análisis , Dinamarca/epidemiología , Alimentos Congelados/envenenamiento , Humanos , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Rubus/envenenamiento , Análisis de Secuencia de ARNRESUMEN
This study quantified the per cent contribution of water chemistry to otolith chemistry using enriched stable isotopes of strontium ((86) Sr) and barium ((137) Ba). Euryhaline barramundi Lates calcarifer, were reared in marine (salinity 40), estuarine (salinity 20) and freshwater (salinity 0) under different temperature treatments. To calculate the contribution of water to Sr and Ba in otoliths, enriched isotopes in the tank water and otoliths were quantified and fitted to isotope mixing models. Fulton's K and RNA:DNA were also measured to explore the influence of fish condition on sources of element uptake. Water was the predominant source of otolith Sr (between 65 and 99%) and Ba (between 64 and 89%) in all treatments, but contributions varied with temperature (for Ba), or interactively with temperature and salinity (for Sr). Fish condition indices were affected independently by the experimental rearing conditions, as RNA:DNA differed significantly among salinity treatments and Fulton's K was significantly different between temperature treatments. Regression analyses did not detect relations between fish condition and per cent contribution values. General linear models indicated that contributions from water chemistry to otolith chemistry were primarily influenced by temperature and secondly by fish condition, with a relatively minor influence of salinity. These results further the understanding of factors that affect otolith element uptake, highlighting the necessity to consider the influence of environment and fish condition when interpreting otolith element data to reconstruct the environmental histories of fish.
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Peces/fisiología , Membrana Otolítica/química , Salinidad , Agua/química , Animales , Bario/análisis , Ambiente , Modelos Lineales , Isótopos de Estroncio/análisis , TemperaturaRESUMEN
Partial-post Laplace barriers have been postulated as a means to allow electrowetting transport and geometrical reshaping of fluids, followed by the preservation of fluid geometry after the electrowetting voltage is removed. Reported here is the first investigation of Laplace barriers with the arrayed electrodes and splitting/merging transport functions for an electrowetting lab-on-a-chip. Laplace barriers optimized for 500 × 500 µm(2) electrodes and 78 µm channel height are shown to provide geometrical control of fluid shape down to radii of curvature of ~70 µm. The Laplace barriers increase the splitting volume error, but with proper electrical control, the average error in the split volume is reduced to 5%. Improved programmable fluid storage in droplets or reservoirs and continuous channel flow are also shown. This work confirms the potential benefits of Laplace barriers for lab-on-a-chip and also reveals the unique challenges and operation requirements for Laplace barriers in lab-on-a-chip applications.
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We have previously identified an unknown cell type in the gills of Murray cod affected with chronic ulcerative dermatopathy (CUD), a condition that causes severe erosion of epidermis surrounding cephalic and lateral line sensory canals. The condition arises in aquaculture facilities that utilize groundwater, with the cause of the condition suggested to be an unknown contaminant(s). Light and transmission electron microscopy were used to characterize and quantify the unknown cells in CUD-affected Murray cod. The cells were identified as rodlet cells and were characterized by their oval or round shape, basally located nucleus, thick fibrillar capsule surrounding the cell, and multiple rodlet sacs containing a central electron-dense core within the cell. Rodlet cells were present in the gills, kidney and intestine of non-CUD-affected and CUD-affected Murray cod; however, differences in the numbers were observed between the groups of fish. A significantly greater number of rodlet cells were observed in the gills and collecting ducts of CUD-affected fish. This is the first report of rodlet cells in Murray cod, and we suggest that the increased rodlet cell numbers in CUD-affected Murray cod may be in response to unknown water contaminant(s) present in the groundwater that give rise to CUD.
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Enfermedades de los Peces/patología , Branquias/patología , Intestinos/patología , Riñón/patología , Perciformes , Enfermedades de la Piel/veterinaria , Animales , Enfermedades de los Peces/etiología , Branquias/ultraestructura , Intestinos/ultraestructura , Riñón/ultraestructura , Microscopía Electrónica de Transmisión/veterinaria , Enfermedades de la Piel/patologíaRESUMEN
BACKGROUND: Increased white matter hyperintensity (WMH) volume visible on MRI is a common finding in Alzheimer's disease (AD). We hypothesized that WMH in preclinical AD is associated with the presence of advanced vessel amyloidosis manifested as microhemorrhages (MCH). OBJECTIVES: 1) To assess the relationship between baseline WMH volume and baseline MCH. 2) To assess the relationship between longitudinal WMH accumulation and last MRI MCH during the double-blind phase of the A4 trial. DESIGN: A multicenter, randomized, double-blind, placebo-controlled, Phase 3 study comparing solanezumab with placebo given as infusions once every 4 weeks over 4.5 years in subjects with preclinical AD, defined as having evidence of elevated brain amyloid before the stage of clinically evident cognitive impairment, with an optional open-label extension period. SETTING: Anti-Amyloid Treatment in Asymptomatic Alzheimer's Disease (A4) study. PARTICIPANTS: A sample of 1157 cognitively unimpaired older adults (mean age = 71.9 years [SD = 4.8 years], 59% women, 59% APOE ε4 carriers). MEASUREMENTS: A linear regression model was used to assess the impact of baseline MCH amount (0, 1, 2+) on WMH volume. A linear mixed-effects model was used to assess the impact of last MRI MCH on longitudinal WMH. All models were corrected for age, sex, grey matter volume, cortical amyloid PET, APOE ε4 status, and treatment group. RESULTS: Baseline WMH volume was greater in individuals with more than one MCH compared to those with no MCH (t=4.8, p<0.001). The longitudinal increase in WMH amongst individuals with one (t=2.3, p=0.025) and more than one MCH (t=6.7, p<0.001) at the last MRI was greater than those with no MCH. CONCLUSION: These results indicate a strong association between WMH and MCH, a common manifestation of cerebral amyloid angiopathy and ARIA-H. These results suggest that increased WMH volume may represent an early sign of vessel amyloidosis, likely prior to the emergence of MCH.
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Enfermedad de Alzheimer , Anticuerpos Monoclonales Humanizados , Imagen por Resonancia Magnética , Sustancia Blanca , Humanos , Enfermedad de Alzheimer/patología , Enfermedad de Alzheimer/diagnóstico por imagen , Enfermedad de Alzheimer/tratamiento farmacológico , Femenino , Masculino , Anciano , Sustancia Blanca/patología , Sustancia Blanca/diagnóstico por imagen , Sustancia Blanca/efectos de los fármacos , Método Doble Ciego , Anticuerpos Monoclonales Humanizados/uso terapéutico , Síntomas ProdrómicosRESUMEN
BACKGROUND: Stronger resting-state functional connectivity of the default mode and frontoparietal control networks has been associated with cognitive resilience to Alzheimer's disease related pathology and neurodegeneration in smaller cohort studies. OBJECTIVES: We investigated whether these networks are associated with longitudinal CR to AD biomarkers of beta-amyloid (Aß). DESIGN: Longitudinal mixed. SETTING: The Anti-Amyloid Treatment in Asymptomatic Alzheimer's Disease (A4) study and its natural history observation arm, the Longitudinal Evaluation of Amyloid Risk and Neurodegeneration (LEARN) study. PARTICIPANTS: A sample of 1,021 cognitively unimpaired older adults (mean age = 71.2 years [SD = 4.7 years], 61% women, 42% APOEε4 carriers, 52% Aß positive). MEASUREMENTS: Global cognitive performance (Preclinical Alzheimer's Cognitive Composite) was assessed over an average 5.4 year follow-up period (SD = 2 years). Cortical Aß and functional connectivity (left and right frontoparietal control and default mode networks) were estimated from fMRI and PET, respectively, at baseline. Covariates included baseline age, APOEε4 carrier status, years of education, adjusted gray matter volume, head motion, study group, cumulative treatment exposure, and cognitive test version. RESULTS: Mixed effects models revealed that functional connectivity of the left frontoparietal control network moderated the negative effect of Aß on cognitive change (p = .025) such that stronger connectivity was associated with reduced Aß-related cognitive decline. CONCLUSIONS: Our results demonstrate a potential protective effect of functional connectivity in preclinical AD, such that stronger connectivity in this network is associated with slower Aß-related cognitive decline.
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Enfermedad de Alzheimer , Péptidos beta-Amiloides , Disfunción Cognitiva , Lóbulo Frontal , Imagen por Resonancia Magnética , Lóbulo Parietal , Humanos , Femenino , Masculino , Anciano , Péptidos beta-Amiloides/metabolismo , Lóbulo Parietal/diagnóstico por imagen , Estudios Longitudinales , Lóbulo Frontal/diagnóstico por imagen , Tomografía de Emisión de Positrones , Síntomas Prodrómicos , Red Nerviosa/diagnóstico por imagen , Red Nerviosa/fisiopatologíaRESUMEN
Pridopidine is being developed for the treatment of impaired motor function associated with Huntington's disease and belongs to a new class of compounds known as dopidines, which act as dopaminergic stabilizers. In vitro studies have shown that pridopidine is a substrate for the P450 cytochrome 2D6 enzyme (CYP2D6), and clinical data show that the half-life of pridopidine is different following single dosing versus at steady state. To further investigate the pharmacokinetic profile of pridopidine and to establish whether dose adjustment is needed in poor CYP2D6 metabolizers, a single-centre, open-label, multiple-dose study in healthy volunteers was performed. In total, 24 extensive CYP2D6 metabolizers (EMs) and 12 poor CYP2D6 metabolizers (PMs) were enrolled. Both groups received 45 mg pridopidine twice daily (b.i.d.). Plasma samples were taken during the first day of b.i.d. dosing (Day 1) and at steady state, following 14 days of b.i.d. dosing. At Day 1, total exposure in PMs was almost three times higher than those in EMs (AUC0-∞ = 11,192 and 3,782 h·ng/mL, respectively; PM/EM ratio = 2.96; p < 0.001). However, at steady state, PMs and EMs had comparable exposure due to a reduction in pridopidine elimination in EMs over time. Thus, at steady-state peak (C max) and total (AUC0-24) exposures were only 1.24 and 1.29 times higher, respectively, in PMs than EMs. These results support that pridopidine is a CYP2D6 auto-inhibitor. Pridopidine was well tolerated in both EMs and PMs. The slightly higher exposure level in PMs at steady state does not indicate a need for dose adjustment or genotyping for CYP2D6 metabolizer status.
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Citocromo P-450 CYP2D6/metabolismo , Dopaminérgicos/farmacocinética , Piperidinas/farmacocinética , Administración Oral , Adulto , Análisis de Varianza , Área Bajo la Curva , Citocromo P-450 CYP2D6/genética , Dinamarca , Dopaminérgicos/administración & dosificación , Dopaminérgicos/efectos adversos , Dopaminérgicos/sangre , Esquema de Medicación , Femenino , Genotipo , Semivida , Humanos , Masculino , Tasa de Depuración Metabólica , Persona de Mediana Edad , Modelos Biológicos , Farmacogenética , Fenotipo , Piperidinas/administración & dosificación , Piperidinas/efectos adversos , Piperidinas/sangreRESUMEN
A modified Padé approximant is used to construct an equation of state, which has the same large-density asymptotic behavior as the model fluid being described, while still retaining the low-density behavior of the virial equation of state (virial series). Within this framework, all sequences of rational functions that are analytic in the physical domain converge to the correct behavior at the same rate, eliminating the ambiguity of choosing the correct form of Padé approximant. The method is applied to fluids composed of "soft" spherical particles with separation distance r interacting through an inverse-power pair potential, φ = ε(σ∕r)(n), where ε and σ are model parameters and n is the "hardness" of the spheres. For n < 9, the approximants provide a significant improvement over the 8-term virial series, when compared against molecular simulation data. For n ≥ 9, both the approximants and the 8-term virial series give an accurate description of the fluid behavior, when compared with simulation data. When taking the limit as n â ∞, an equation of state for hard spheres is obtained, which is closer to simulation data than the 10-term virial series for hard spheres, and is comparable in accuracy to other recently proposed equations of state. By applying a least square fit to the approximants, we obtain a general and accurate soft-sphere equation of state as a function of n, valid over the full range of density in the fluid phase.
RESUMEN
Measuring individual feed nutrient concentration is common practice for field dairy nutritionists. However, accurately measuring nutrient digestibility and using digestion values in total digestible nutrients models is more challenging. Our objective was to determine if in vivo apparent total-tract nutrient digestibility measured with a practical approach was related to commercial milk production parameters. Total mixed ration and fecal samples were collected from high-producing cows in pens on 39 commercial dairies and analyzed at a commercial feed and forage testing laboratory for nutrient concentration and 120-h indigestible NDF (iNDF) content using the Combs-Goeser in vitro digestion technique. The 120-h iNDF was used as an internal marker to calculate in vivo apparent nutrient digestibilities. Two samples were taken from each dairy and were separated in time by at least 3 wk. Samples were targeted to be taken within 7d of Dairy Herd Improvement (DHI) herd testing. Approved DHI testers measured individual cow milk weights as well as fat and protein concentrations. Individual cow records were averaged by pen corresponding to the total mixed ration and fecal samples. Formulated diet and dry matter intake (DMI) records for each respective pen were also collected. Mixed model regression analysis with dairy specified as a random effect was used to relate explanatory variables (diet nutrient concentrations, formulated DMI, in vivo apparent nutrient digestibilities, and fecal nutrient concentrations) to milk production measures. Dry matter intake, organic matter (OM) digestibility, fecal crude protein (CP) concentration, and fecal ether extract concentration were related to milk, energy-corrected milk, and fat yields. Milk protein concentration was related to CP digestibility, and milk protein yield was related to DMI, OM digestibility, CP digestibility, and ether extract digestibility. Although many studies have related DMI and OM digestibility to milk production under controlled experimental settings, very few have related practical in vivo measures to milk production. By documenting the practical OM digestibility relationship with milk production, nutritionists and scientists may have confidence in this approach for measuring diet performance and collecting nutritional data for commercial dairies.