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1.
Chaos ; 34(4)2024 Apr 01.
Article in English | MEDLINE | ID: mdl-38658052

ABSTRACT

We present a study on the spatiotemporal pattern underlying the climate dynamics in various locations spread over India, including the Himalayan region, coastal region, and central and northeastern parts of India. We try to capture the variations in the complexity of their dynamics derived from temperature and relative humidity data from 1948 to 2022. By estimating the recurrence-based measures from the reconstructed phase space dynamics using a sliding window analysis on the data sets, we study the climate variability in different spatial locations. The study brings out the variations in the complexity of the underlying dynamics as well as their heterogeneity across the locations in India. We find almost all locations indicate shifts to more irregular and stochastic dynamics for temperature data around 1972-79 and shifts back to more regular dynamics beyond 2000. These patterns correlate with reported shifts in the climate and Indian Summer Monsoon related to strong and moderate El Niño-Southern Oscillation events and confirm their associated regional variability.

2.
Chaos ; 34(4)2024 Apr 01.
Article in English | MEDLINE | ID: mdl-38658051

ABSTRACT

We integrate machine learning approaches with nonlinear time series analysis, specifically utilizing recurrence measures to classify various dynamical states emerging from time series. We implement three machine learning algorithms: Logistic Regression, Random Forest, and Support Vector Machine for this study. The input features are derived from the recurrence quantification of nonlinear time series and characteristic measures of the corresponding recurrence networks. For training and testing, we generate synthetic data from standard nonlinear dynamical systems and evaluate the efficiency and performance of the machine learning algorithms in classifying time series into periodic, chaotic, hyperchaotic, or noisy categories. Additionally, we explore the significance of input features in the classification scheme and find that the features quantifying the density of recurrence points are the most relevant. Furthermore, we illustrate how the trained algorithms can successfully predict the dynamical states of two variable stars, SX Her and AC Her, from the data of their light curves. We also indicate how the algorithms can be trained to classify data from discrete systems.

3.
Biophys J ; 121(18): 3542-3561, 2022 09 20.
Article in English | MEDLINE | ID: mdl-35765244

ABSTRACT

Cationic nanocarriers offer a promising solution to challenges in delivering drugs to negatively charged connective tissues, such as to articular cartilage for the treatment of osteoarthritis (OA). However, little is known about the effects that cationic macromolecules may have on the mechanical properties of cartilage at high interstitial concentrations. We utilized arginine-rich cationic peptide carriers (CPCs) with varying net charge (from +8 to +20) to investigate the biophysical mechanisms of nanocarrier-induced alterations to cartilage biomechanical properties. We observed that CPCs increased the compressive modulus of healthy bovine cartilage explants by up to 70% and decreased the stiffness of glycosaminoglycan-depleted tissues (modeling OA) by 69%; in both cases, the magnitude of the change in stiffness correlated with the uptake of CPC charge variants. Next, we directly measured CPC-induced osmotic deswelling in cartilage tissue due to shielding of charge repulsions between anionic extracellular matrix constituents, with magnitudes of reductions between 36 and 64 kPa. We then demonstrated that electrostatic interactions were required for CPC-induced stiffening to occur, evidenced by no observed increase in tissue stiffness when measured in hypertonic bathing salinity. We applied a non-ideal Donnan osmotic model (under triphasic theory) to separate bulk modulus measurements into Donnan and non-Donnan components, which further demonstrated the conflicting charge-shielding and matrix-stiffening effects of CPCs. These results show that cationic drug carriers can alter tissue mechanical properties via multiple mechanisms, including the expected charge shielding as well as a novel stiffening phenomenon mediated by physical linkages. We introduce a model for how the magnitudes of these mechanical changes depend on tunable physical properties of the drug carrier, including net charge, size, and spatial charge distribution. We envision that the results and theory presented herein will inform the design of future cationic drug-delivery systems intended to treat diseases in a wide range of connective tissues.


Subject(s)
Cartilage, Articular , Drug Carriers , Animals , Arginine , Cations/chemistry , Cattle , Drug Carriers/chemistry , Glycosaminoglycans , Models, Biological , Peptides/chemistry
4.
J Assoc Physicians India ; 70(5): 11-12, 2022 May.
Article in English | MEDLINE | ID: mdl-35598134

ABSTRACT

India shoulders a heavy burden of diabetes mellitus (DM), the management of which is suboptimal globally.& Objectives: Insulin Management: Practical Aspects in Choice of Therapy (IMPACT) survey was designed to gain insight into the ground (in-clinic) reality of DM management by physicians in India. METHODS: A survey consisting of 12 multiple-choice questions was conducted by SurveyMonkey® , focusing on practice profile, patient profile, and other aspects of DM management. RESULTS: The survey included 2424 physicians. Majority of them were general physicians (58.5%) followed by diabetologists (31.1%). Most (49.2%) of the respondents specified that the ideal time for a DM consultation is 15 min. However, 73.4% of them provided consultation of <10& min because of heavy patient load. Nearly half of the respondents reported that their patients consumed a diet with carbohydrate content of 60% to 80%, and 79.4% of them admitted that <50% of their patients adhered to dietary advice. About 73.5% of the respondents believed controlling fasting plasma glucose (FPG) level alone would not adequately control postprandial plasma glucose (PPG) level, and 93.0% of them preferred an insulin therapy at the initiation that controls both FPG and PPG levels. CONCLUSION: Limited consultation time, high-carbohydrate diet, and a need for choosing insulin regimens that provide control for both PPG and FPG levels are some ground realities of DM management in India. These realities need to be factored in while choosing treatment options to achieve the desired glycemic control and improve the status of diabetes care.


Subject(s)
Blood Glucose , Diabetes Mellitus, Type 2 , Diabetes Mellitus, Type 2/drug therapy , Glycated Hemoglobin/analysis , Humans , Hypoglycemic Agents/therapeutic use , Insulin/therapeutic use , Postprandial Period , Surveys and Questionnaires
5.
Curr Opin Rheumatol ; 33(1): 94-109, 2021 01.
Article in English | MEDLINE | ID: mdl-33229973

ABSTRACT

PURPOSE OF REVIEW: Osteoarthritis is associated with severe joint pain, inflammation, and cartilage degeneration. Drugs injected directly into intra-articular joint space clear out rapidly providing only short-term benefit. Their transport into cartilage to reach cellular targets is hindered by the tissue's dense, negatively charged extracellular matrix. This has limited, despite strong preclinical data, the clinical translation of osteoarthritis drugs. Recent work has focused on developing intra-joint and intra-cartilage targeting drug delivery systems (DDS) to enable long-term therapeutic response, which is presented here. RECENT FINDINGS: Synovial joint targeting hybrid systems utilizing combinations of hydrogels, liposomes, and particle-based carriers are in consideration for pain-inflammation relief. Cartilage penetrating DDS target intra-cartilage constituents like aggrecans, collagen II, and chondrocytes such that drugs can reach their cellular and intra-cellular targets, which can enable clinical translation of disease-modifying osteoarthritis drugs including gene therapy. SUMMARY: Recent years have witnessed significant increase in both fundamental and clinical studies evaluating DDS for osteoarthritis. Steroid encapsulating polymeric microparticles for longer lasting pain relief were recently approved for clinical use. Electrically charged biomaterials for intra-cartilage targeting have shown promising disease-modifying response in preclinical models. Clinical trials evaluating safety of viral vectors are ongoing whose success can pave the way for gene therapy as osteoarthritis treatment.


Subject(s)
Drug Delivery Systems/methods , Osteoarthritis/drug therapy , Aggrecans/administration & dosage , Animals , Cartilage, Articular/metabolism , Chondrocytes/metabolism , Extracellular Matrix/metabolism , Genetic Therapy/methods , Humans , Inflammation/drug therapy , Injections, Intra-Articular/methods , Nanoparticles/administration & dosage , Pain/drug therapy , Steroids/administration & dosage , Synovial Membrane/metabolism
6.
Lung ; 199(1): 21-27, 2021 02.
Article in English | MEDLINE | ID: mdl-33423072

ABSTRACT

INTRODUCTION: E-cigarette or vaping product use associated lung injury (EVALI) has been an important health risk in both children and adults. The pathophysiology of EVALI is not well understood. However, it is speculated that certain substances such as Vitamin E Acetate (VEA), particularly in marijuana containing vape cartridges may result in lung injury and lead to respiratory dysfunction. EVALI is often seen in the absence of infections, but it has been found to be associated with both fungal and bacterial infections. Like EVALI, nontuberculous mycobacteria (NTM) pulmonary disease is also on the rise, but is primarily reported in immunocompromised individuals. Here, we present three immunocompetent individuals wherein pulmonary NTM infection co-occurred with vaping. METHODS: Medical information including patient history, laboratory, and radiograph reports were abstracted from electronic medical records from participating institutions located in the Bronx, NY, Philadelphia, PA, and Lexington, KY. RESULTS: All three cases were otherwise immunocompetent individuals with a significant history of vaping either nicotine and/or marijuana containing products. The pathogens isolated include Mycobacterium avium complex, M. xenopi, and M. gordonae. All three patients were treated for NTM. CONCLUSION: There is little reported on the association between vaping and NTM. It is possible that vaping may have rendered these individuals to be more susceptible to NTM colonization and infection. The possible mechanisms of vaping lung injury and pulmonary NTM are discussed.


Subject(s)
Electronic Nicotine Delivery Systems , Lung Diseases/microbiology , Mycobacterium Infections, Nontuberculous/chemically induced , Vaping/adverse effects , Adolescent , Adult , Antitubercular Agents/therapeutic use , Asthma/complications , Female , Humans , Immunocompetence , Lung/diagnostic imaging , Lung Diseases/diagnosis , Lung Diseases/drug therapy , Male , Mycobacterium Infections, Nontuberculous/diagnosis , Mycobacterium Infections, Nontuberculous/drug therapy , Nontuberculous Mycobacteria , Retrospective Studies , Tomography, X-Ray Computed , Young Adult
7.
Chaos ; 30(12): 123106, 2020 Dec.
Article in English | MEDLINE | ID: mdl-33380014

ABSTRACT

We present an integrated approach to analyze the multi-lead electrocardiogram (ECG) data using the framework of multiplex recurrence networks (MRNs). We explore how their intralayer and interlayer topological features can capture the subtle variations in the recurrence patterns of the underlying spatio-temporal dynamics of the cardiac system. We find that MRNs from ECG data of healthy cases are significantly more coherent with high mutual information and less divergence between respective degree distributions. In cases of diseases, significant differences in specific measures of similarity between layers are seen. The coherence is affected most in the cases of diseases associated with localized abnormality such as bundle branch block. We note that it is important to do a comprehensive analysis using all the measures to arrive at disease-specific patterns. Our approach is very general and as such can be applied in any other domain where multivariate or multi-channel data are available from highly complex systems.


Subject(s)
Bundle-Branch Block , Electrocardiography , Heart , Humans
8.
Chaos ; 30(4): 043104, 2020 Apr.
Article in English | MEDLINE | ID: mdl-32357668

ABSTRACT

We report the emergence of stable amplitude chimeras and chimera death in a two-layer network where one layer has an ensemble of identical nonlinear oscillators interacting directly through local coupling and indirectly through dynamic agents that form the second layer. The nonlocality in the interaction among the dynamic agents in the second layer induces different types of chimera-related dynamical states in the first layer. The amplitude chimeras developed in them are found to be extremely stable, while chimera death states are prevalent for increased coupling strengths. The results presented are for a system of coupled Stuart-Landau oscillators and can, in general, represent systems with short-range interactions coupled to another set of systems with long-range interactions. In this case, by tuning the range of interactions among the oscillators or the coupling strength between two types of systems, we can control the nature of chimera states and the system can also be restored to homogeneous steady states. The dynamic agents interacting nonlocally with long-range interactions can be considered as a dynamic environment or a medium interacting with the system. We indicate how the second layer can act as a reinforcement mechanism on the first layer under various possible interactions for desirable effects.

9.
Emerg Radiol ; 27(5): 495-501, 2020 Oct.
Article in English | MEDLINE | ID: mdl-32462343

ABSTRACT

PURPOSE: E-cigarette or vaping product use associated lung injury (EVALI) has received national attention as an epidemic resulting in cases of significant morbidity and mortality. We aim to present the clinical and imaging findings in adolescents with pulmonary symptoms from suspected EVALI. METHODS: Chest radiographs and CTs of adolescents (< 19 years) with acute pulmonary symptoms and history of vaping were reviewed by two radiologists in consensus. Clinical presentation and laboratory data were derived from the electronic medical records including pulmonary function tests (PFTs). RESULTS: Eleven patients were identified (9 male, mean 16.6 years). The most common presentation was progressive, subacute respiratory distress with abdominal pain. All but one of the patients tested positive for tetrahydrocannabinol. Chest radiograph features were notable for interstitial pattern of opacities (91%) and basilar abnormalities (82%). CT features were notable for ground-glass opacities (89%), interstitial opacities (78%), and subpleural sparing (67%). Eight patients underwent PFTs. Six had diffusing capacity measurement, which demonstrated impaired diffusion in 3 (50%). All patients received supportive treatment with supplemental oxygen and corticosteroids. CONCLUSION: Adolescents with suspected EVALI commonly present with subacute respiratory distress with abdominal pain. Imaging findings include ground-glass opacities, subpleural sparing, and basilar opacities, most consistent with organizing pneumonia or hypersensitivity pneumonitis. Recognition of the common imaging findings may have significant patient management implications, especially if the diagnosis is not suspected clinically. The lung function effects of vaping are consistent with mildly reduced airflow, which improves on follow-up testing, and reduced diffusion capacity, which, concerningly, does not improve.


Subject(s)
Electronic Nicotine Delivery Systems , Lung Injury/diagnostic imaging , Lung Injury/etiology , Tomography, X-Ray Computed , Vaping/adverse effects , Abdominal Pain/etiology , Adolescent , Female , Humans , Male , Radiography, Thoracic
10.
Chaos ; 29(3): 033119, 2019 Mar.
Article in English | MEDLINE | ID: mdl-30927860

ABSTRACT

The interplay between time scales and structural properties of complex networks of nonlinear oscillators can generate many interesting phenomena, like amplitude death, cluster synchronization, frequency synchronization, etc. We study the emergence of such phenomena and their transitions by considering a complex network of dynamical systems in which a fraction of systems evolves on a slower time scale on the network. We report the transition to amplitude death for the whole network and the scaling near the transitions as the connectivity pattern changes. We also discuss the suppression and recovery of oscillations and the crossover behavior as the number of slow systems increases. By considering a scale free network of systems with multiple time scales, we study the role of heterogeneity in link structure on dynamical properties and the consequent critical behaviors. In this case with hubs made slow, our main results are the escape time statistics for loss of complete synchrony as the slowness spreads on the network and the self-organization of the whole network to a new frequency synchronized state. Our results have potential applications in biological, physical, and engineering networks consisting of heterogeneous oscillators.

11.
Chaos ; 29(11): 113112, 2019 Nov.
Article in English | MEDLINE | ID: mdl-31779354

ABSTRACT

Close binary stars are binary stars where the component stars are close enough such that they can exchange mass and/or energy. They are subdivided into semidetached, overcontact, or ellipsoidal binary stars. A challenging problem in the context of close binary stars is their classification into these subclasses based solely on their light curves. Conventionally, this is done by observing subtle features in the light curves like the depths of adjacent minima, which is tedious when dealing with large datasets. In this work, we suggest the use of machine learning algorithms applied to quantifiers derived from recurrence networks to differentiate between classes of close binary stars. We show that overcontact binary stars occupy a region different from semidetached and ellipsoidal binary stars in a plane of characteristic path length and average clustering coefficient, computed from their recurrence networks. We use standard clustering algorithms and report that the clusters formed correspond to the standard classes with a high degree of accuracy.

12.
Clin Proteomics ; 13: 7, 2016.
Article in English | MEDLINE | ID: mdl-27030792

ABSTRACT

BACKGROUND: N-1-(Deoxyfructosyl) valine (DFV) ß-hemoglobin (ß-Hb), commonly referred as HbA1c, is widely used diagnostic marker in diabetes, believed to provide glycemic status of preceding 90-120 days. However, the turnover of hemoglobin is about 120 days, the DFV-ß-Hb, an early and reversible glycation product eventually may undergo irreversible advanced glycation modifications such as carboxymethylation or carboxyethylation. Hence quantification of N-1-(carboxymethyl) valine (CMV) and N-1-(carboxyethyl) valine (CEV) peptides of ß-Hb would be useful in assessing actual glycemic status. RESULTS: Fragment ion library for synthetically glycated peptides of hemoglobin was generated by using high resolution-accurate mass spectrometry (HR/AM). Using parallel reaction monitoring, deoxyfructosylated, carboxymethylated and carboxyethylated peptides of hemoglobin were quantified in clinical samples from healthy control, pre-diabetes, diabetes and poorly controlled diabetes. For the first time, we report N-1-ß-valine undergoes carboxyethylation and mass spectrometric quantification of CMV and CEV peptides of ß-hemoglobin. Carboxymethylation was found to be the most abundant modification of N-1-ß-valine. Both CMV-ß-Hb and CEV-ß-Hb peptides showed better correlation with severity of diabetes in terms of fasting glucose, postprandial glucose and microalbuminuria. CONCLUSIONS: This study reports carboxymethylation as a predominant modification of N-1-ß-valine of Hb, and quantification of CMV-ß-Hb and CEV-ß-Hb could be useful parameter for assessing the severity of diabetes.

13.
J Math Biol ; 69(6-7): 1773-800, 2014 Dec.
Article in English | MEDLINE | ID: mdl-24384697

ABSTRACT

Dengue viral infections show unique infection patterns arising from its four serotypes, (DENV-1,2,3,4). Its effects range from simple fever in primary infections to potentially fatal secondary infections. We analytically and numerically analyse virus dynamics and humoral response in a host during primary and secondary dengue infection for long periods using micro-epidemic models. The models presented here incorporate time delays, antibody dependent enhancement, a dynamic switch and a correlation factor between different DENV serotypes. We find that the viral load goes down to undetectable levels within 7-14 days as is observed for dengue infection, in both cases. For primary infection, the stability analysis of steady states shows interesting dependence on the time delay involved in the production of antibodies from plasma cells. We demonstrate the existence of a critical value for the immune response parameter, beyond which the infection gets completely cured. For secondary infections with a different serotype, the homologous antibody production is enhanced due to the influence of heterologous antibodies. The antibody production is also controlled by the correlation factor, which is a measure of similarities between the different DENV serotypes involved. Our results agree with clinically observed humoral responses for primary and secondary infections.


Subject(s)
Antibodies, Viral/immunology , Dengue Virus/immunology , Dengue/immunology , Immunity, Humoral/immunology , Models, Immunological , Humans , Numerical Analysis, Computer-Assisted , Viral Load/immunology
14.
ACS Omega ; 9(23): 24907-24915, 2024 Jun 11.
Article in English | MEDLINE | ID: mdl-38882103

ABSTRACT

The role of protein glycation in the pathogenesis of diabetes has been well established. Akin to proteins, free amino acids and other small-molecule amines are also susceptible to glycation in hyperglycemic conditions and may have a role in the pathogenesis of the disease. However, information about glycation of free amino acids and other small-molecule amines is relatively obscure. In the quest to discover small-molecule glycated amines in the plasma, we have synthesized glycated amino acids, glycated creatine, and glycated urea, and by using a high-resolution accurate mass spectrometer, a mass spectral library was developed comprising the precursor and predominant fragment masses of glycated amines. Using this information, we report the discovery of the glycation of free lysine, arginine, and leucine/isoleucine from the plasma of diabetic patients. This has great physiological significance as glycation of these amino acids may create their deficiency and affect vital physiological processes such as protein synthesis, cell signaling, and insulin secretion. Also, these glycated amino acids could serve as potential markers of diabetes and its complications. While other amines, such as creatinine and urea, accumulate in the plasma and act as biomarkers of diabetic nephropathy. For the first time, we report the detection of glycated urea in diabetic plasma, which is confirmed by matching the precursor and fragment masses with the in vitro synthesized glycated urea by using 12C6 and 13C6-glucose. Further, we quantified glycated urea detected in two forms, monoglycated urea (MGU) and diglycated urea (DGU), by a targeted mass spectrometric approach in the plasma of healthy, diabetic, and diabetic nephropathy subjects. Both MGU and DGU showed a positive correlation with clinical parameters, such as blood glucose and HbA1c. Given that urea gets converted to glycated urea in hyperglycemic conditions, it is crucial to quantify MGU and DGU along with the urea for the diagnosis of diabetic nephropathy and study their physiological role in diabetes.

15.
Biomater Sci ; 12(3): 634-649, 2024 Jan 30.
Article in English | MEDLINE | ID: mdl-38047368

ABSTRACT

Exosomes have emerged as a promising tool for the delivery of drugs and genetic materials, owing to their biocompatibility and non-immunogenic nature. However, challenges persist in achieving successful oral delivery due to their susceptibility to degradation in the harsh gastrointestinal (GI) environment and impeded transport across the mucus-epithelium barrier. To overcome these challenges, we have developed high-purity bovine milk exosomes (mExo) as a scalable and efficient oral drug delivery system, which can be customized by incorporating hydrophilic and zwitterionic motifs on their surface. In our study, we observed significantly improved transport rates by 2.5-4.5-fold in native porcine intestinal mucus after the introduction of hydrophilic and zwitterionic surface modifications, as demonstrated by transwell setup and fluorescence recovery after photobleaching (FRAP) analysis. Remarkably, mExo functionalized by a block peptide (BP), consisting of cationic and anionic amino acids arranged in blocks at the two ends, demonstrated superior tolerability in the acidic gastric environment (with a protein recovery rate of 84.8 ± 7.7%) and exhibited a 2.5-fold increase in uptake by intestinal epithelial cells. Furthermore, both mExo and mExo-BP demonstrated successful intracellular delivery of functional siRNA, resulting in up to 65% suppression of the target green fluorescence protein (GFP) gene expression at a low dose of siRNA (5 pmol) without causing significant toxicity. These findings highlight the immense potential of modifying mExo with hydrophilic and zwitterionic motifs for effective oral delivery of siRNA therapies.


Subject(s)
Exosomes , Nanoparticles , Animals , Swine , Milk , Exosomes/metabolism , Drug Delivery Systems/methods , Peptides/metabolism , RNA, Small Interfering/metabolism , Permeability , Mucus/metabolism , Administration, Oral , Drug Carriers/chemistry , Nanoparticles/chemistry
16.
J Mater Chem B ; 12(30): 7384-7400, 2024 Jul 31.
Article in English | MEDLINE | ID: mdl-38946491

ABSTRACT

Topical treatment of vitreoretinal diseases remains a challenge due to slow corneal uptake and systemic clearance. Exosomes are emerging nanocarriers for drug delivery due to biocompatibility and cellular targeting properties. To apply them for retinal targeting via the topical route, exosomes must traverse various ocular barriers including the cornea, lens, vitreous humor (VH), and the retina itself. Here we engineered high-purity milk-derived exosomes by anchoring arginine-rich cationic motifs via PEG2000 lipid insertion on their surface. Modification enabled exosomes to use weak-reversible electrostatic interactions with anionic glycosaminoglycan (GAG) and water content of the tissue to enhance their transport rate and retention. Addition of cationic motifs neutralized the anionic surface charge of exosomes (-24 to -2 mV) without impacting size or morphology. Cationic-motif-modified exosomes exhibited two-fold faster steady state diffusivity through bovine corneas compared to unmodified exosomes. Fluorescence recovery after photobleaching confirmed that cationic-motif-modified exosomes can diffuse through VH without steric hindrance. In healthy VH, cationic-motif-modified exosomes demonstrated stronger binding resulting in three-fold lower average diffusivity that enhanced by six-fold in 50% GAG-depleted VH recapitulating advanced liquefaction. Cationic-motif-modified exosomes penetrated through the full-thickness of porcine retinal explants resulting in ten-fold higher uptake in photoreceptors and three-fold greater transfection with encapsulated eGFP mRNA compared to unmodified exosomes. Cationic-motif-modified exosomes are safe to use as they did not adversely affect the mechanical swelling properties of the cornea or lens nor impact retinal cell viability. Cationic-motif-modified exosomes, therefore, offer themselves as a cell-free nanocarrier platform for gene delivery to retinal photoreceptors potentially via the topical route.


Subject(s)
Exosomes , RNA, Messenger , Animals , Exosomes/chemistry , Exosomes/metabolism , Cattle , RNA, Messenger/genetics , RNA, Messenger/metabolism , Cations/chemistry , Photoreceptor Cells, Vertebrate/metabolism
17.
Small Methods ; : e2301443, 2024 Apr 12.
Article in English | MEDLINE | ID: mdl-38607953

ABSTRACT

Gene therapy has the potential to facilitate targeted expression of therapeutic proteins to promote cartilage regeneration in osteoarthritis (OA). The dense, avascular, aggrecan-glycosaminoglycan (GAG) rich negatively charged cartilage, however, hinders their transport to reach chondrocytes in effective doses. While viral vector mediated gene delivery has shown promise, concerns over immunogenicity and tumorigenic side-effects persist. To address these issues, this study develops surface-modified cartilage-targeting exosomes as non-viral carriers for gene therapy. Charge-reversed cationic exosomes are engineered for mRNA delivery by anchoring cartilage targeting optimally charged arginine-rich cationic motifs into the anionic exosome bilayer by using buffer pH as a charge-reversal switch. Cationic exosomes penetrated through the full-thickness of early-stage arthritic human cartilage owing to weak-reversible ionic binding with GAGs and efficiently delivered the encapsulated eGFP mRNA to chondrocytes residing in tissue deep layers, while unmodified anionic exosomes do not. When intra-articularly injected into destabilized medial meniscus mice knees with early-stage OA, mRNA loaded charge-reversed exosomes overcame joint clearance and rapidly penetrated into cartilage, creating an intra-tissue depot and efficiently expressing eGFP; native exosomes remained unsuccessful. Cationic exosomes thus hold strong translational potential as a platform technology for cartilage-targeted non-viral delivery of any relevant mRNA targets for OA treatment.

18.
J Pak Med Assoc ; 63(6): 788-91, 2013 Jun.
Article in English | MEDLINE | ID: mdl-23901690

ABSTRACT

Diabetes and dyslipidaemia are two common comorbid conditions encountered in clinical practice. This review discusses the screening, investigations, non-pharmacological and pharmacological management of dyslipidaemia in type 2, type 1, and pre-diabetes, with a view to improving cardiovascular outcomes. The paper highlights certain simple dos and don'ts which may be useful for our cultural and clinical setting.


Subject(s)
Diabetes Mellitus/epidemiology , Diabetes Mellitus/therapy , Dyslipidemias , Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use , Physical Therapy Modalities , Dyslipidemias/complications , Dyslipidemias/epidemiology , Dyslipidemias/therapy , Global Health , Humans , Morbidity/trends
19.
Children (Basel) ; 10(10)2023 Oct 11.
Article in English | MEDLINE | ID: mdl-37892338

ABSTRACT

Sleep disordered breathing (SDB) in children with neuromuscular disease (NMD) is more prevalent compared to the general population, and often manifests as sleep-related hypoventilation, sleep-related hypoxemia, obstructive sleep apnea, central sleep apnea, and/or disordered control of breathing. Other sleep problems include, sleep fragmentation, abnormal sleep architecture, and nocturnal seizures in certain neuromuscular diseases. The manifestation of sleep disordered breathing in children depends on the extent, type, and progression of neuromuscular weakness, and in some instances, may be the first sign of a neuromuscular weakness leading to diagnosis of an NMD. In-lab diagnostic polysomnography (PSG) remains the gold standard for the diagnosis of sleep disordered breathing in children, but poses several challenges, including access to many children with neuromuscular disease who are non-ambulatory. If SDB is untreated, it can result in significant morbidity and mortality. Hence, we aimed to perform a comprehensive review of the literature of SDB in children with NMD. This review includes pathophysiological changes during sleep, clinical evaluation, diagnosis, challenges in interpreting PSG data using American Academy of Sleep (AASM) diagnostic criteria, management of SDB, and suggests areas for future research.

20.
ACS Nano ; 17(7): 6649-6663, 2023 04 11.
Article in English | MEDLINE | ID: mdl-36989423

ABSTRACT

Cartilage tissue exhibits early degenerative changes with onset of osteoarthritis (OA). Early diagnosis is critical as there is only a narrow time window during which therapeutic intervention can reverse disease progression. Computed tomography (CT) has been considered for cartilage imaging as a tool for early OA diagnosis by introducing radio-opaque contrast agents like ioxaglate (IOX) into the joint. IOX, however, is anionic and thus repelled by negatively charged cartilage glycosaminoglycans (GAGs) that hinders its intra-tissue penetration and partitioning, resulting in poor CT attenuation. This is further complicated by its short intra-tissue residence time owing to rapid clearance from joints, which necessitates high doses causing toxicity concerns. Here we engineer optimally charged cationic contrast agents based on cartilage negative fixed charge density by conjugating cartilage targeting a cationic peptide carrier (CPC) and multi-arm avidin nanoconstruct (mAv) to IOX, such that they can penetrate through the full thickness of cartilage within 6 h using electrostatic interactions and elicit similar CT signal with about 40× lower dose compared to anionic IOX. Their partitioning and distribution correlate strongly with spatial GAG distribution within healthy and early- to late-stage arthritic bovine cartilage tissues at 50-100× lower doses than other cationic contrast agents used in the current literature. The use of contrast agents at low concentrations also allowed for delineation of cartilage from subchondral bone as well as other soft tissues in rat tibial joints. These contrast agents are safe to use at current doses, making CT a viable imaging modality for early detection of OA and staging of its severity.


Subject(s)
Cartilage, Articular , Osteoarthritis , Rats , Animals , Cattle , Contrast Media/therapeutic use , Cartilage, Articular/diagnostic imaging , Tomography, X-Ray Computed/methods , Ioxaglic Acid/therapeutic use , Cations , Osteoarthritis/diagnostic imaging , Early Diagnosis
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