Navigating Disease-Modifying Treatments for Alzheimer's Disease: Focusing on Medications in Phase 3 Clinical Trials.

Over the past 18 months, there has been scrutiny and controversy over the U.S. Food and Drug Administration's accelerated approval of aducanumab, a novel monoclonal antibody to treat Alzheimer's disease and prevent disease progression. As clinicians, educators, and advocates for our patients and caregivers impacted daily by this debilitating illness, this approval reinforces the need to maintain vigilance and awareness about emerging agents. The intent of the current article is to highlight some of the medications in Phase 3 clinical trials and share resources and updates on disease-modifying agents and their unique pharmacology. [Journal of Gerontological Nursing, 49(1), 6-10.].

Biomechanical evaluation of peak reverse torque (PRT) in a dynamic compression plate-screw construct used in a goat tibia segmental defect model.

BACKGROUND: Peak reverse torque (PRT) is a valid method to evaluate implants' secondary stability in the healing bone. The secondary stability is achieved by the implant over time and it has been positively correlated with the implants' osseointegration level. In other words, peak reverse torque is the force required to break the bone-implant interface. The purpose of this study was to compare the peak reverse torque for the self-tapping and non-self-tapping screws used in a dynamic compression plate-screw-bone construct after 60 days of loading when used to stabilize 2.5-cm defects in the tibia of goats. The second objective was to compare the peak removal torque of the screws placed in the different positions to evaluate the impact of construct biomechanics on implants osseointegration. RESULTS: In total, 176 non-self-tapping screws and 66 self-tapping screws were used to fix the 8-holes dynamic compression plates to the bones. The screws were placed in the tibiae from proximal (position sites 1,2, 3) to distal (position sites 4,5,6) and were removed 60 days post-implantation. The animals remained weight-bearing throughout the study period. The screws placed in the proximal diaphysis had significantly less peak reverse torque than screws placed in the distal diaphysis in both groups (p < 0.05). The peak reverse torque resistance was also significantly less for the non-self-tapping screws as compared with the self-tapping screws (p < 0.05). The intracortical fractures in the trans-cortex occurred significantly more frequently during the placement of non-self-tapping screws (p < 0.05) as compared with self-tapping screws (p < 0.05). CONCLUSIONS: Based on these results, we concluded that self-tapping screws may be expected to maintain a more stable bone-implant interface during the first 60 days of loading as compared with non-self-tapping screws. This should be a consideration for orthopedic surgeons and scientists using bone plates to stabilize non-load sharing fractures when a stable plate-screw-bone interface is needed to ensure prolonged stability.

Assessment of biometric tools for quantitative gait analysis in Holstein calves.

OBJECTIVE: To assess biometric tools for gait analysis in healthy calves by use of pressure mat sensors, a handheld algometer, and serial circumferential measurements of selected joints. ANIMALS: 20 six- to eight-week-old healthy male Holstein calves. PROCEDURES: Calves were evaluated over a 4-day period. Gait analysis was performed by training calves to walk over a pressure-sensitive mat, which recorded quantitative measurements. An algometer was applied perpendicular to each joint until an aversion response was observed or a preset limit of 50 N/cm(2) was obtained. Circumference measurements of the carpal and tarsal joints were obtained by the application of a flexible measuring tape to defined areas of each limb. Variability between joint circumference measurements and pressure mat variables were analyzed with a standard least squares means model. Algometer measurements were dichotomized, and logistic regression was used to assess the probability that a calf reacted to algometer-applied pressure. RESULTS: 1 calf was removed from the study because of lameness. Mean carpal and tarsal joint circumference measurements were reliable and consistent among calves. Algometry results suggested that healthy calves were more sensitive to pressure applied to the elbow and stifle joints, compared with pressure applied to the carpal, tarsal, and metacarpophalangeal or metatarsophalangeal joints. Pressure mat variables of stance time and stride velocity varied greatly among calves, whereas impulse and maximum forces varied little. CONCLUSIONS AND CLINICAL RELEVANCE: Findings can serve as reference points for other studies and be used for comparison with results for calves with lameness or altered gaits.

Assessment of a commercially available point-of-care assay for the measurement of bovine cardiac troponin I concentration.

OBJECTIVE: To assess a commercially available point-of-care assay for measurement of bovine cardiac troponin I (cTnI) concentration in blood and plasma samples. SAMPLE: Prepared bovine plasma standard samples with known concentrations (0 to 1.0 ng/mL) of cTnI and blood and plasma samples obtained from 28 healthy 2.5-month-old Holstein calves. PROCEDURES: Coefficients of variation were calculated for concentrations of cTnI in prepared standards determined with the point-of-care assay, and values were compared with the known concentrations. The cTnI concentrations in blood samples obtained from calves determined with the point-of-care assay were compared with cTnI concentrations in plasma samples obtained from those animals determined with a validated immunoassay. RESULTS: The coefficients of variation of cTnI concentrations determined for prepared standards by use of the point-of-care assay were low (< 20%) for standards with cTnI concentrations ≥ 0.025 ng/mL. The blood cTnI concentrations determined with the point-of-care assay were not significantly different from the plasma cTnI concentrations determined with the validated immunoassay. CONCLUSIONS AND CLINICAL RELEVANCE: Results of this study indicated the point-of-care assay had high precision for determination of cTnI concentrations in most evaluated prepared bovine plasma standard samples. The point-of-care assay may be useful for determination of circulating concentrations of cTnI in cattle.