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1.
Genome Res ; 31(9): 1602-1613, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34404692

RESUMO

Important clues about natural selection can be gleaned from discrepancies between the properties of segregating genetic variants and of mutations accumulated experimentally under minimal selection, provided the mutational process is the same in the laboratory as in nature. The base-substitution spectrum differs between C. elegans laboratory mutation accumulation (MA) experiments and the standing site-frequency spectrum, which has been argued to be in part owing to increased oxidative stress in the laboratory environment. Using genome sequence data from C. elegans MA lines carrying a mutation (mev-1) that increases the cellular titer of reactive oxygen species (ROS), leading to increased oxidative stress, we find the base-substitution spectrum is similar between mev-1, its wild-type progenitor (N2), and another set of MA lines derived from a different wild strain (PB306). Conversely, the rate of short insertions is greater in mev-1, consistent with studies in other organisms in which environmental stress increased the rate of insertion-deletion mutations. Further, the mutational properties of mononucleotide repeats in all strains are different from those of nonmononucleotide sequence, both for indels and base-substitutions, and whereas the nonmononucleotide spectra are fairly similar between MA lines and wild isolates, the mononucleotide spectra are very different, with a greater frequency of A:T → T:A transversions and an increased proportion of ±1-bp indels. The discrepancy in mutational spectra between laboratory MA experiments and natural variation is likely owing to a consistent (but unknown) effect of the laboratory environment that manifests itself via different modes of mutability and/or repair at mononucleotide loci.


Assuntos
Caenorhabditis elegans , Laboratórios , Alelos , Animais , Caenorhabditis elegans/genética , Mutação , Estresse Oxidativo/genética
2.
Support Care Cancer ; 32(6): 335, 2024 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-38727834

RESUMO

PURPOSE: The Multinational Association of Supportive Care in Cancer (MASCC)/European Society of Medical Oncology (ESMO) Patient Antiemetic Guideline Committee aimed to (1) adapt the updated evidence-based, clinical guidelines to patient-centered antiemetic guidelines and (2) develop patient education materials and statements. METHODS: The MASCC 2023 Patient Antiemetic Guidelines were created and reviewed by antiemetic experts and patient advocates by incorporating the 2023 MASCC/ESMO antiemetic guidelines into patient-friendly language. Patient Education Statements were developed based on current literature and by utilizing an expert modified Delphi consensus (≥ 75% agreement). Patient advocate/focus group input and patient survey results were further integrated into Patient-Centered Antiemetic Guidelines and Education Statements. RESULTS: Patient-Centered Antiemetic Guidelines were created using patient-friendly language and visual slides. Patient-friendly language was also utilized to communicate the Educational Statements. Key content categories identified for the Educational Statements included the following: nausea/vomiting definitions, causes, risk factors, categories, complications, accompanying symptoms, prophylactic antiemetic treatment, general management, when to call/what to ask the healthcare team, what caregivers can do, and available resources. All identified content met the ≥ 75% expert agreement threshold. Fifteen (15) items demonstrated 100% agreement, 11 items achieved ≥ 90% agreement, and three content items demonstrated 80 ~ 82% agreement. CONCLUSIONS: The inaugural MASCC 2023 Patient Antiemetic Guidelines can help patients and caregivers understand the prevention of nausea and vomiting related to their cancer treatment. Educational Statements provide further patient information. Educating patients on how to utilize guideline antiemetics and the education statements can contribute improvements in the control of anticancer treatment-related nausea and vomiting.


Assuntos
Antieméticos , Consenso , Medicina Baseada em Evidências , Náusea , Neoplasias , Educação de Pacientes como Assunto , Assistência Centrada no Paciente , Vômito , Humanos , Antieméticos/uso terapêutico , Antieméticos/administração & dosagem , Vômito/prevenção & controle , Náusea/prevenção & controle , Educação de Pacientes como Assunto/métodos , Educação de Pacientes como Assunto/normas , Neoplasias/complicações , Assistência Centrada no Paciente/métodos , Técnica Delphi , Guias de Prática Clínica como Assunto
3.
J Insect Sci ; 23(6)2023 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-38055948

RESUMO

Because nontarget, beneficials, like insect pollinators, may be exposed unintentionally to insecticides, it is important to evaluate the impact of chemical controls on the behaviors performed by insect pollinators in field trials. Here we examine the impact of a portable mosquito repeller, which emits prallethrin, a pyrethroid insecticide, on honey bee foraging and recruitment using a blinded, randomized, paired, parallel group trial. We found no significant effect of the volatilized insecticide on foraging frequency (our primary outcome), waggle dance propensity, waggle dance frequency, and feeder persistency (our secondary outcomes), even though an additional deposition study confirmed that the treatment device was performing appropriately. These results may be useful to consumers that are interested in repelling mosquitos, but also concerned about potential consequences to beneficial insects, such as honey bees.


Assuntos
Abelhas , Comportamento Animal , Culicidae , Inseticidas , Piretrinas , Animais , Comunicação Animal , Comportamento Apetitivo/efeitos dos fármacos , Abelhas/efeitos dos fármacos , Comportamento Animal/efeitos dos fármacos , Repelentes de Insetos/farmacologia , Inseticidas/farmacologia , Piretrinas/farmacologia
4.
Nat Mater ; 20(5): 701-710, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33542471

RESUMO

Endosomal escape remains a fundamental barrier hindering the advancement of nucleic acid therapeutics. Taking inspiration from natural phospholipids that comprise biological membranes, we report the combinatorial synthesis of multi-tailed ionizable phospholipids (iPhos) capable of delivering messenger RNA or mRNA/single-guide RNA for gene editing in vivo. Optimized iPhos lipids are composed of one pH-switchable zwitterion and three hydrophobic tails, which adopt a cone shape in endosomal acidic environments to facilitate membrane hexagonal transformation and subsequent cargo release from endosomes. Structure-activity relationships reveal that iPhos chemical structure can control in vivo efficacy and organ selectivity. iPhos lipids synergistically function with various helper lipids to formulate multi-component lipid nanoparticles (called iPLNPs) for selective organ targeting. Zwitterionic, ionizable cationic and permanently cationic helper lipids enable tissue-selective mRNA delivery and CRISPR-Cas9 gene editing in spleen, liver and lungs (respectively) following intravenous administration. This rational design of functional phospholipids demonstrates substantial value for gene editing research and therapeutic applications.


Assuntos
Sistemas CRISPR-Cas , Membrana Celular/metabolismo , Sistemas de Liberação de Medicamentos , Edição de Genes , Fosfolipídeos , RNA Mensageiro , Administração Intravenosa , Animais , Linhagem Celular , Feminino , Camundongos , Especificidade de Órgãos , Fosfolipídeos/química , Fosfolipídeos/farmacologia , RNA Mensageiro/química , RNA Mensageiro/farmacologia
5.
Mol Pharm ; 19(11): 3973-3986, 2022 11 07.
Artigo em Inglês | MEDLINE | ID: mdl-36154076

RESUMO

Within the field of lipid nanoparticles (LNPs) for RNA delivery, the focus has been mainly placed on organ level delivery, which can mask cellular level effects consequential to therapeutic applications. Here, we studied a pair of LNPs with similar physical properties and discovered how the chemistry of the ionizable amino lipid can control the endogenous LNP identity, affecting cellular uptake in the liver and altering therapeutic outcomes in a model of liver cancer. Although most LNPs accumulate in the liver after intravenous administration (suggesting that liver delivery is straightforward), we observed an unexpected behavior when comparing two similar LNP formulations (5A2-SC8 and 3A5-SC14 LNPs) that resulted in distinct RNA delivery within the organ. Despite both LNPs possessing similar physical properties, ability to silence gene expression in vitro, strong accumulation within the liver, and a shared pKa of 6.5, only 5A2-SC8 LNPs were able to functionally deliver RNA to hepatocytes. Factor VII (FVII) activity was reduced by 87%, with 5A2-SC8 LNPs carrying FVII siRNA (siFVII), while 3A5-SC14 LNPs carrying siFVII produced baseline FVII activity levels comparable to the nontreatment control at a dosage of 0.5 mg/kg. Protein corona analysis indicated that 5A2-SC8 LNPs bind apolipoprotein E (ApoE), which can drive LDL-R receptor-mediated endocytosis in hepatocytes. In contrast, the surface of 3A5-SC14 LNPs was enriched in albumin but depleted in ApoE, which likely led to Kupffer cell delivery and detargeting of hepatocytes. In an aggressive MYC-driven liver cancer model relevant to hepatocytes, 5A2-SC8 LNPs carrying let-7g miRNA were able to significantly extend survival up to 121 days. Since disease targets exist in an organ- and cell-specific manner, the clinical development of RNA LNP therapeutics will require an improved understanding of LNP cellular tropism within organs. The results from our work illustrate the importance of understanding the cellular localization of RNA delivery and incorporating further checkpoints when choosing nanoparticles beyond biochemical and physical characterization, as small changes in the chemical composition of LNPs can have an impact on both the biofate of LNPs and therapeutic outcomes.


Assuntos
Neoplasias Hepáticas , Nanopartículas , Humanos , Lipídeos/química , Nanopartículas/química , RNA Interferente Pequeno , Apolipoproteínas E , Neoplasias Hepáticas/tratamento farmacológico , Neoplasias Hepáticas/genética , Resultado do Tratamento
6.
J Am Chem Soc ; 143(50): 21321-21330, 2021 12 22.
Artigo em Inglês | MEDLINE | ID: mdl-34878786

RESUMO

Polymers represent a promising therapeutic platform for extrahepatic messenger RNA (mRNA) delivery but are hampered by low in vivo efficacy due to polyplex serum instability and inadequate endosomal escape following systemic administration. Here, we report the rational design and combinatorial synthesis of zwitterionic phospholipidated polymers (ZPPs) via cationic polymer postmodification by alkylated dioxaphospholane oxides to deliver mRNA to spleen and lymph nodes in vivo. This modular postmodification approach readily produces tunable zwitterionic species for serum resistance and introduces alkyl chains simultaneously to enhance endosomal escape, thereby transforming deficient cationic polymers to efficacious zwitterionic mRNA carriers without the need to elaborately synthesize functional monomers. ZPPs mediated up to 39 500-fold higher protein expression than their parent cationic counterparts in vitro and enabled efficacious mRNA delivery selectively in spleen and lymph nodes following intravenous administration in vivo. This zwitterionic phospholipidation methodology provides a versatile and generalizable postmodification strategy to introduce zwitterions into the side chains of cationic polymers, extending the utility of cationic polymer families for precise mRNA delivery and demonstrating substantial potential for immunotherapeutic applications.


Assuntos
Linfonodos/metabolismo , Fosfolipídeos/química , Polímeros/química , RNA Mensageiro/metabolismo , Baço/metabolismo , Animais , Cátions/química , Endossomos/metabolismo , Técnicas de Transferência de Genes , Camundongos , Camundongos Endogâmicos C57BL , RNA Mensageiro/química
7.
Proc Natl Acad Sci U S A ; 115(7): 1424-1432, 2018 02 13.
Artigo em Inglês | MEDLINE | ID: mdl-29382745

RESUMO

Two foundational questions about sustainability are "How are ecosystems and the services they provide going to change in the future?" and "How do human decisions affect these trajectories?" Answering these questions requires an ability to forecast ecological processes. Unfortunately, most ecological forecasts focus on centennial-scale climate responses, therefore neither meeting the needs of near-term (daily to decadal) environmental decision-making nor allowing comparison of specific, quantitative predictions to new observational data, one of the strongest tests of scientific theory. Near-term forecasts provide the opportunity to iteratively cycle between performing analyses and updating predictions in light of new evidence. This iterative process of gaining feedback, building experience, and correcting models and methods is critical for improving forecasts. Iterative, near-term forecasting will accelerate ecological research, make it more relevant to society, and inform sustainable decision-making under high uncertainty and adaptive management. Here, we identify the immediate scientific and societal needs, opportunities, and challenges for iterative near-term ecological forecasting. Over the past decade, data volume, variety, and accessibility have greatly increased, but challenges remain in interoperability, latency, and uncertainty quantification. Similarly, ecologists have made considerable advances in applying computational, informatic, and statistical methods, but opportunities exist for improving forecast-specific theory, methods, and cyberinfrastructure. Effective forecasting will also require changes in scientific training, culture, and institutions. The need to start forecasting is now; the time for making ecology more predictive is here, and learning by doing is the fastest route to drive the science forward.


Assuntos
Ecologia/educação , Ecologia/métodos , Teorema de Bayes , Mudança Climática , Ecologia/tendências , Ecossistema , Previsões , Humanos , Modelos Teóricos
8.
Angew Chem Int Ed Engl ; 60(11): 5848-5853, 2021 03 08.
Artigo em Inglês | MEDLINE | ID: mdl-33305471

RESUMO

Lipid nanoparticles (LNPs) represent the leading concept for mRNA delivery. Unsaturated lipids play important roles in nature with potential for mRNA therapeutics, but are difficult to access through chemical synthesis. To systematically study the role of unsaturation, modular reactions were utilized to access a library of 91 amino lipids, enabled by the synthesis of unsaturated thiols. An ionizable lipid series (4A3) emerged from in vitro and in vivo screening, where the 4A3 core with a citronellol-based (Cit) periphery emerged as best. We studied the interaction between LNPs and a model endosomal membrane where 4A3-Cit demonstrated superior lipid fusion over saturated lipids, suggesting its unsaturated tail promotes endosomal escape. Furthermore, 4A3-Cit significantly improved mRNA delivery efficacy in vivo through Selective ORgan Targeting (SORT), resulting in 18-fold increased protein expression over parent LNPs. These findings provide insight into how lipid unsaturation promotes mRNA delivery and demonstrate how lipid mixing can enhance efficacy.


Assuntos
Lipídeos/química , Nanopartículas/química , RNA Mensageiro/genética , Animais , Endossomos/química , Endossomos/metabolismo , Técnicas de Transferência de Genes , Lipídeos/administração & dosagem , Camundongos , Camundongos Endogâmicos C57BL , Estrutura Molecular , Nanopartículas/administração & dosagem , Nanopartículas/metabolismo , RNA Mensageiro/administração & dosagem , RNA Mensageiro/química
9.
Mol Pharm ; 17(5): 1575-1585, 2020 05 04.
Artigo em Inglês | MEDLINE | ID: mdl-32267707

RESUMO

In this work, a series of linear-dendritic poly(ethylene glycol) (PEG) lipids (PEG-GnCm) were synthesized through a strategy using sequential aza- and sulfa-Michael addition reactions. The effect of modulating the hydrophobic domain of linear-dendritic PEG lipids was systematically investigated for in vitro and in vivo small RNA delivery as the surface-stabilizing component of 5A2-SC8 dendrimer lipid-based nanoparticles (DLNPs). The lipid alkyl lengths (C8, C12, and C16) and dendrimer generations (G1, G2, and G3) were altered to create PEG-GnCm with different physical properties and anchoring potential. The tail chemical structure of PEG-GnCm did not affect the formulation of 5A2-SC8 DLNPs, including the nanoparticle size, RNA encapsulation, and stability. However, the tail chemical structure did dramatically affect the RNA delivery efficacy of the formed 5A2-SC8 DLNPs with different PEG-GnCm. First-generation PEG lipids (PEG-G1C8, PEG-G1C12, and PEG-G1C16) and a second-generation PEG lipid (PEG-G2C8) formed 5A2-SC8 DLNPs that could deliver siRNAs effectively in vitro and in vivo. 5A2-SC8 DLNPs formulated with second-generation PEG lipids (PEG-G2C12 and PEG-G2C16) and all three third-generation PEG lipids (PEG-G3C8, PEG-G3C12, and PEG-G3C16) lost the ability to deliver siRNA effectively in vitro and in vivo. Overall, we determined that the hydrophobic domain chemical structure of linear-dendritic poly(ethylene glycol) lipids affected the RNA delivery of DLNPs by impacting the escape of 5A2-SC8 DLNPs from endosomes at early cell incubation times, thereby indicating how PEG lipid anchoring and chemical structure can modulate in vitro and in vivo siRNA delivery efficacies.


Assuntos
Dendrímeros/química , Sistemas de Liberação de Medicamentos , Lipídeos/química , Nanopartículas/química , Polietilenoglicóis/química , RNA Interferente Pequeno/administração & dosagem , Animais , Células HeLa , Humanos , Interações Hidrofóbicas e Hidrofílicas , Camundongos , Camundongos Endogâmicos C57BL , RNA Interferente Pequeno/química
10.
Yale J Biol Med ; 93(2): 283-289, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32607089

RESUMO

Mitragyna speciosa, otherwise known as kratom, is a plant in the coffee family (Rubiaceae) native to Southeast Asia and Thailand whose leaves have been shown to cause opioid-like and stimulant responses upon ingestion. The major pharmacologically active compounds present in kratom, mitragynine and 7-hydroxymitragynine (7-HMG), are both indole alkaloids and are responsible for its opioid-like activity. While kratom is most commonly known for its affinity for mu-opioid receptors, research has shown one of its active components has effects on the same receptors to which some antipsychotics bind, such as D2 dopamine, serotonin (5-HT2C and 5-HT7), and alpha-2 adrenergic receptors displaying possible indications of kratom to be used as both antipsychotics and antidepressants. Although studies to evaluate this effect are still lacking, several online and in-person surveys note relief of depression and anxiety symptoms among those who consume kratom products, and in fact identify it as a common reason for consumption. This then highlights the dire need for further research to be conducted on kratom, its mechanism of action and the constituents that elicit these antidepressant, anxiolytic, and antipsychotic properties.


Assuntos
Antidepressivos/farmacologia , Antipsicóticos/farmacologia , Sintomas Comportamentais/tratamento farmacológico , Mitragyna , Produtos Biológicos/farmacologia , Humanos , Alcaloides Indólicos/farmacologia , Receptores Opioides , Alcaloides de Triptamina e Secologanina/farmacologia , Resultado do Tratamento
11.
Mol Pharm ; 16(10): 4089-4103, 2019 10 07.
Artigo em Inglês | MEDLINE | ID: mdl-31487183

RESUMO

Many pharmaceutical drugs in the marketplace and discovery pipeline suffer from poor aqueous solubility, thereby limiting their effectiveness for oral delivery. The use of an amorphous solid dispersion (ASD), a mixture of an active pharmaceutical ingredient and a polymer excipient, greatly enhances the aqueous dissolution performance of a drug without the need for chemical modification. Although this method is versatile and scalable, deficient understanding of the interactions between drugs and polymers inhibits ASD rational design. This current Review details recent progress in understanding the mechanisms that control ASD performance. In the solid-state, the use of high-resolution theoretical, computational, and experimental tools resolved the influence of drug/polymer phase behavior and dynamics on stability during storage. During dissolution in aqueous media, novel characterization methods revealed that ASDs can form complex nanostructures, which maintain and improve supersaturation of the drug. The studies discussed here illustrate that nanoscale phenomena, which have been directly observed and quantified, strongly affect the stability and bioavailability of ASD systems, and provide a promising direction for optimizing drug/polymer formulations.


Assuntos
Química Farmacêutica , Composição de Medicamentos , Preparações Farmacêuticas/química , Polímeros/química , Disponibilidade Biológica , Cristalização , Estabilidade de Medicamentos , Excipientes , Humanos , Solubilidade
12.
Heredity (Edinb) ; 120(1): 1-12, 2018 01.
Artigo em Inglês | MEDLINE | ID: mdl-29234171

RESUMO

Androdioecious Caenorhabditis have a high frequency of self-compatible hermaphrodites and a low frequency of males. The effects of mutations on male fitness are of interest for two reasons. First, when males are rare, selection on male-specific mutations is less efficient than in hermaphrodites. Second, males may present a larger mutational target than hermaphrodites because of the different ways in which fitness accrues in the two sexes. We report the first estimates of male-specific mutational effects in an androdioecious organism. The rate of male-specific inviable or sterile mutations is ⩽5 × 10-4/generation, below the rate at which males would be lost solely due to those kinds of mutations. The rate of mutational decay of male competitive fitness is ~ 0.17%/generation; that of hermaphrodite competitive fitness is ~ 0.11%/generation. The point estimate of ~ 1.5X faster rate of mutational decay of male fitness is nearly identical to the same ratio in Drosophila. Estimates of mutational variance (VM) for male mating success and competitive fitness are not significantly different from zero, whereas VM for hermaphrodite competitive fitness is similar to that of non-competitive fitness. Two independent estimates of the average selection coefficient against mutations affecting hermaphrodite competitive fitness agree to within two-fold, 0.33-0.5%.


Assuntos
Caenorhabditis elegans/genética , Aptidão Genética/genética , Organismos Hermafroditas/genética , Mutação , Animais , Caenorhabditis elegans/fisiologia , Comportamento Competitivo , Feminino , Organismos Hermafroditas/fisiologia , Masculino , Modelos Genéticos , Seleção Genética , Razão de Masculinidade , Comportamento Sexual Animal
13.
J Foot Ankle Surg ; 57(3): 509-513, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29685561

RESUMO

Traditional rebalancing techniques, such as capsulotomies and capsulorrhaphies, are commonly performed during complex hammertoe and lesser metatarsal osteotomy procedures involving metatarsophalangeal joint (MTPJ) contractures; however, floating toes, digital instability, and malalignment are concerns. We critically analyzed the outcomes after anatomic reconstruction of the plantar plate and collateral ligaments compared with those after traditional rebalancing techniques. A case-control study was conducted of 54 patients who had undergone surgical correction of lesser MTPJ imbalances due to complex hammertoe deformities (power 80%, type I error = 0.05). Cases were defined as consecutive patients treated with anatomic plantar plate and collateral ligament reconstruction. Controls had undergone traditional lesser MTPJ rebalancing and were matched to cases by age, gender, follow-up duration (minimum 12 months), and concomitant procedures of the same lesser ray. Multivariate logistic regression demonstrated that patients treated with anatomic reconstruction had greater digital stability (negative dorsal drawer and negative paper pull-out test findings) at final follow-up examination compared with the controls. American College of Foot and Ankle Surgeons (ACFAS) forefoot module scores were greater in the anatomic group in all domains (p ≤ .05). Controls had greater postoperative radiographic MTPJ angles than the cases, with no differences detected between the 2 groups in visual analog scale scores or proximal interphalangeal joint angles. The importance of restoration of the plantar plate and collateral ligament integrity as a digital stabilizer is generally accepted but has not been well studied. We found that anatomic reconstruction yielded greater digital stability, greater ACFAS Forefoot module scores, and better radiographic MTPJ alignment than controls. Additional studies are warranted to assess the long-term viability of anatomic lesser MTPJ reconstruction.


Assuntos
Tratamento Conservador/métodos , Síndrome do Dedo do Pé em Martelo/cirurgia , Articulação Metatarsofalângica/cirurgia , Osteotomia/métodos , Placa Plantar/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Adulto , Idoso , Estudos de Casos e Controles , Feminino , Síndrome do Dedo do Pé em Martelo/diagnóstico por imagem , Síndrome do Dedo do Pé em Martelo/reabilitação , Humanos , Instabilidade Articular/prevenção & controle , Modelos Lineares , Modelos Logísticos , Masculino , Articulação Metatarsofalângica/diagnóstico por imagem , Articulação Metatarsofalângica/fisiopatologia , Pessoa de Meia-Idade , Análise Multivariada , Placa Plantar/fisiopatologia , Cuidados Pós-Operatórios/métodos , Prognóstico , Radiografia/métodos , Recuperação de Função Fisiológica , Medição de Risco , Resultado do Tratamento
14.
J Foot Ankle Surg ; 57(1): 2-6, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29037925

RESUMO

The reliable evaluation of osseous consolidation after hindfoot osteotomy can be difficult. Concomitant hindfoot osteotomies often dictate the advancement of weightbearing, and radiographs are the mainstay imaging tool owing to cost, efficiency, and radiation exposure. Understanding the radiographic parameters that can be used to reliably determine osseous healing is paramount. However, currently, no reliable or validated method is available to determine osseous healing of hindfoot osteotomies in irregular bones of the foot. The purpose of the present study was to develop a radiographic healing scoring system that would enhance the diagnostic healing assessment after elective calcaneal osteotomy. We adapted existing orthopedic scales validated for healing in the leg for application in the irregular bones of the foot. A total of 168 cases were evaluated by 6 blinded assessors to test the interrater reliability of subjective healing assessment compared with the proposed scoring system. The radiographs were classified by postoperative period: ≤4 weeks, 5 to 12 weeks, and >12 weeks. The proposed scale had high interrater reliability but was burdensome. Using a priori item reduction protocols, a limited 6-item scale further improved internal consistency and reduced the burden. The result was excellent interrater reliability (α = 0.98, standard deviation 0.02, 95% confidence interval 0.91 to 0.96) among all assessors when using the scoring scale compared with unacceptable reliability (α = 0.438) for subjective osteotomy healing. The reliability of our system appeared superior to that of subjective assessment of osseous healing alone, even in the absence of clinical correlates after osteotomy of the calcaneus.


Assuntos
Calcâneo/diagnóstico por imagem , Calcâneo/cirurgia , Procedimentos Cirúrgicos Eletivos/métodos , Osteotomia/métodos , Radiografia/métodos , Parafusos Ósseos , Estudos de Coortes , Técnica Delphi , Feminino , Seguimentos , Humanos , Masculino , Variações Dependentes do Observador , Osteogênese , Osteotomia/instrumentação , Estudos Prospectivos , Reprodutibilidade dos Testes , Resultado do Tratamento , Suporte de Carga
15.
J Foot Ankle Surg ; 57(5): 924-930, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29891128

RESUMO

Common corrective osteotomies used in flexible flatfoot deformity reconstruction include Cotton and Evans osteotomies, which require structural graft to maintain correction. Auto-, allo-, and xenografts are associated with a number of limitations, including disease transmission, rejection, donor site morbidity, technical challenges related to graft fashioning, and graft resorption. Porous titanium is a synthetic substance designed to address these flaws; however, few studies have been reported on the efficacy, safety, and long-term outcomes. A multicenter retrospective cohort of 63 consecutive preconfigured porous titanium wedges (PTWs) used in flexible flatfoot reconstructions from June 1, 2009 to June 30, 2015 was evaluated. The primary outcome measure was the pre- to postdeformity correction efficacy. The secondary outcomes included maintenance of correction at a minimum follow-up point of 12 months, complications, graft incorporation, and graft safety profile. Multivariate linear regression found a statistically significant improvement in all radiographic parameters from preoperatively to the final weightbearing radiographs (calcaneocuboid 18.850 ± 4.020 SE, p < .0001; Kite's, 7.810 ± 3.660 SE, p = .04; Meary's 13.910 ± 3.100 SE, p = .0001; calcaneal inclination, 5.550 ± 2.140 SE, p = .015). When restricted to patients with >4 years of follow-up data, maintenance of correction appeared robust in all 4 measurements, demonstrating a lack of bone or graft resorption. No patients were lost to follow-up, no major complications or implant explantation or migration occurred, and all implants were incorporated. Minor complications included hardware pain from plates over grafts (8%), 1 case of scar neuritis, and a 5% table incidence of transfer pain associated with the PTWs. These results support the use of PTWs for safety and degree and maintenance of correction in flatfoot reconstruction.


Assuntos
Pé Chato/cirurgia , Fixadores Internos , Osteotomia/instrumentação , Titânio , Adolescente , Adulto , Criança , Desenho de Equipamento , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Porosidade , Estudos Retrospectivos , Resultado do Tratamento , Adulto Jovem
16.
Langmuir ; 33(43): 12244-12253, 2017 10 31.
Artigo em Inglês | MEDLINE | ID: mdl-28985465

RESUMO

Nanoparticle (NP) clusters with diameters ranging from 20 to 100 nm are reversibly assembled from 5 nm gold (Au) primary particles coated with glutathione (GSH) in aqueous solution as a function of pH in the range of 5.4 to 3.8. As the pH is lowered, the GSH surface ligands become partially zwitterionic and form interparticle hydrogen bonds that drive the self-limited assembly of metastable clusters in <1 min. Whereas clusters up to 20 nm in size are stable against cluster-cluster aggregation for up to 1 day, clusters up to 80 nm in size can be stabilized over this period via the addition of citrate to the solution in equal molarity with GSH molecules. The cluster diameter may be cycled reversibly by tuning pH to manipulate the colloidal interactions; however, modest background cluster-cluster aggregation occurs during cycling. Cluster sizes can be stabilized for at least 1 month via the addition of PEG-thiol as a grafted steric stabilizer, where PEG-grafted clusters dissociate back to starting primary NPs at pH 7 in fewer than 3 days. Whereas the presence of excess citrate has little effect on the initial size of the metastable clusters, it is necessary for both the cycling and dissociation to mediate the GSH-GSH hydrogen bonds. In summary, these metastable clusters exhibit significant characteristics of equilibrium self-limited assembly between primary particles and clusters on time scales where cluster-cluster aggregation is not present.

17.
Langmuir ; 33(11): 2837-2848, 2017 03 21.
Artigo em Inglês | MEDLINE | ID: mdl-28282137

RESUMO

Blends of hydroxypropyl methylcellulose acetate succinate (HPMCAS) and dodecyl (C12)-tailed poly(N-isopropylacrylamide) (PNIPAm) were systematically explored as a model system to dispense the active ingredient phenytoin by rapid dissolution, followed by the suppression of drug crystallization for an extended period. Dynamic and static light scattering revealed that C12-PNIPAm polymers, synthesized by reversible addition-fragmentation chain-transfer polymerization, self-assembled into micelles with dodecyl cores in phosphate-buffered saline (PBS, pH 6.5). A synergistic effect on drug supersaturation was documented during in vitro dissolution tests by varying the blending ratio, with HPMACS primarily aiding in rapid dissolution and PNIPAm maintaining supersaturation. Polarized light and cryogenic transmission electron microscopy experiments revealed that C12-PNIPAm micelles maintain drug supersaturation by inhibiting both crystal nucleation and growth. Cross-peaks between the phenyl group of phenytoin and the isopropyl group of C12-PNIPAm in 2D 1H nuclear Overhauser effect (NOESY) spectra confirmed the existence of drug-polymer intermolecular interactions in solution. Phenytoin and polymer diffusion coefficients, measured by diffusion-ordered NMR spectroscopy (DOSY), demonstrated that the drug-polymer association constant increased with increasing local density of the corona chains, coincident with a reduction in C12-PNIPAm molecular weight. These findings demonstrate a new strategy for exploiting the versatility of polymer blends through the use of self-assembled micelles in the design of advanced excipients.


Assuntos
Metilcelulose/análogos & derivados , Polímeros/química , Acrilamidas/química , Resinas Acrílicas/química , Excipientes/química , Interações Hidrofóbicas e Hidrofílicas , Metilcelulose/química , Micelas , Fenitoína/química
18.
Biochim Biophys Acta Gen Subj ; 1861(12): 3257-3262, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28943300

RESUMO

BACKGROUND: Ferritins are ubiquitous multi-subunit iron storage and detoxification proteins that play a critical role in iron homeostasis. Ferrous ions that enter the protein's shell through hydrophilic channels are rapidly oxidized at dinuclear centers on the H-subunit before transfer to the protein's cavity for storage. The mechanisms of iron loading have been extensively studied, but little is known about iron mobilization. Fe(III) reduction can occur via rapid reduction by suitable reducing agents followed by chelation of Fe(II) ions or via direct and slow Fe(III) chelation. Here, the iron release kinetics from ferritin by FMNH2 in the presence of various chaotropic agents are studied and their in-vivo physiological significance discussed. METHODS: The iron release kinetics from horse and human ferritins by FMNH2 were monitored at 522nm where the Fe(II)-bipyridine complex absorbs. The experiments were performed in the presence of different concentrations of three chaotropic agents, urea, guanidine HCl, and triton. RESULTS AND CONCLUSIONS: Under our experimental conditions, iron reductive mobilization by the non-enzymatic FMN/NAD(P)H system is limited by the concentration of FMNH2 and is independent on the type or amount of chaotropes present. Diffusion of FMNH2 through the ferritin pores is an unlikely mechanism for ferritin iron reduction. An iron mobilization mechanism involving rapid electron transfer through the protein shell is discussed. GENERAL SIGNIFICANCE: Caution must be exercised when interpreting the kinetics of iron mobilization from ferritin using the FMN/NAD(P)H system. The kinetics are highly dependent on the amount of dissolved oxygen and the concentration of reagents used.


Assuntos
Ferritinas/química , Mononucleotídeo de Flavina/farmacologia , Hidroquinonas/farmacologia , Ferro/química , Animais , Transporte de Elétrons , Guanidina/farmacologia , Cavalos , Humanos , Cinética , Octoxinol/farmacologia , Oxirredução , Ureia/farmacologia
19.
J Acoust Soc Am ; 138(1): 65-73, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-26233007

RESUMO

A recent study from our laboratory assessed vowel identification in cochlear implant (CI) users, using full /dVd/ syllables and partial (center- and edges-only) syllables with duration cues neutralized [Donaldson, Rogers, Cardenas, Russell, and Hanna (2013). J. Acoust. Soc. Am. 134, 3021-3028]. CI users' poorer performance for partial syllables as compared to full syllables, and for edges-only syllables as compared to center-only syllables, led to the hypotheses (1) that CI users may rely strongly on vowel duration cues; and (2) that CI users have more limited access to dynamic spectral cues than steady-state spectral cues. The present study tested those hypotheses. Ten CI users and ten young normal hearing (YNH) listeners heard full /dVd/ syllables and modified (center- and edges-only) syllables in which vowel duration cues were either preserved or eliminated. The presence of duration cues significantly improved vowel identification scores in four CI users, suggesting a strong reliance on duration cues. Duration effects were absent for the other CI users and the YNH listeners. On average, CI users and YNH listeners demonstrated similar performance for center-only stimuli and edges-only stimuli having the same total duration of vowel information. However, three CI users demonstrated significantly poorer performance for the edges-only stimuli, indicating apparent deficits of dynamic spectral processing.


Assuntos
Implantes Cocleares , Sinais (Psicologia) , Fonética , Percepção da Fala/fisiologia , Estimulação Acústica , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Acústica da Fala , Fatores de Tempo , Adulto Jovem
20.
IEEE Trans Nucl Sci ; 2015: 2036-2042, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26755832

RESUMO

Advances in fabrication techniques, electronics, and mechanical cooling systems have given rise to germanium detectors suitable for biomedical imaging. We are developing a small-animal SPECT system that uses a double-sided Ge strip detector. The detector's excellent energy resolution may help to reduce scatter and simplify processing of multi-isotope imaging, while its ability to measure depth of interaction has the potential to mitigate parallax error in pinhole imaging. The detector's energy resolution is <1% FWHM at 140 keV and its spatial resolution is approximately 1.5 mm FWHM. The prototype system described has a single-pinhole collimator with a 1-mm diameter and a 70-degree opening angle with a focal length variable between 4.5 and 9 cm. Phantom images from the gantry-mounted system are presented, including the NEMA NU-2008 phantom and a hot-rod phantom. Additionally, the benefit of energy resolution is demonstrated by imaging a dual-isotope phantom with 99mTc and 123I without cross-talk correction.

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