Quantitative response in ion mobility spectrometry with atmospheric pressure chemical ionization in positive polarity as a function of moisture and temperature.

Response of an ion mobility spectrometer at ambient pressure was quantitatively determined for fourteen chemicals from five chemical families spanning a range of proton affinities and temperature from 30 to 175 °C with moisture from 1 to 1 × 104 ppmv in purified air. Peak intensities, drift times and reduced mobility coefficients were determined for hydrated protons from a63Ni ion source and for protonated monomers and proton bound dimers of alcohols, aldehydes, acetates, ketones, and organophosphates. These measurements permitted the determination of response factors with atmospheric pressure chemical ionization and the influence of moisture and temperature on APCI response with correlation to computational models of hydration values. The formation of protonated monomers and proton bound dimers was described by heats of formation for a displacement reaction of water on H+(H2O)n by an analyte vapor and favorably matched results from density functional theory (DFT) with the 6-311 + G(dp) basis set. Response factors worsened with increased moisture and decreased temperature for compounds of medium, and more so, of low proton affinities. Findings here provide a broad measure and understanding for quantitative response in ion mobility spectrometers for substances for combinations of moisture and temperature.

Differential Mobility Spectrometry of Ketones in Air at Extreme Levels of Moisture.

The performance of a differential mobility spectrometer was characterized at ambient pressure and ten values of water vapor concentration, from 1.0 × 102 to 1.7 × 104 ppm using a homologous series of seven ketones from acetone to 2-dodecanone. Dispersion plots at 30 °C with separation fields from 35 to 123 Td exhibited increased alpha functions for the hydrated proton, protonated monomers, and proton bound dimers with increased moisture levels. Increases in the level of moisture were accompanied by decreased quantitative response with progressive suppression in the formation of the proton bound dimer first and then protonated monomer. Product ions for 2-octanone at 7 ppb were not observed above a moisture level of 4.0 × 103 ppm, establishing a limit for observation of analyte ion formation. The observation limit increased from 1.1 × 103 ppm for acetone to 5.7 × 103 ppm for 2-dodecanone. These findings demonstrate that ketones can be determined with a differential mobility spectrometry (DMS) analyzer near room temperature in the presence of elevated levels of moisture expected with the use of membrane inlets or headspace sampling of surface or ground waters. Moisture levels entering this DMS analyzer employed as an environmental monitor should be kept at 1.0 × 103 ppm or below and quantitative studies for individual ketones should be made at a fixed moisture level.

Temporal and spatial occlusion of advanced visual information constrains movement (re)organization in one-handed catching behaviors.

Dynamic interceptive actions are performed under severe spatial and temporal constraints. Here, behavioral processes underpinning anticipation in one-handed catching were examined using novel technology to implement a spatial and temporal occlusion design. Video footage of an actor throwing a ball was manipulated to create four temporal and five spatial occlusion conditions. Data from twelve participants' hand kinematics and gaze behaviors were recorded while attempting to catch a projected ball synchronized with the video footage. Catching performance decreased with earlier occlusion of the footage. Movement onset of the catching hand and initiation of visual ball tracking emerged earlier when footage of the thrower was occluded at a later time point in the throwing action. Spatial occlusion did not affect catching success, although movement onset emerged later when increased visual information of the actor was occluded. Later movement onset was countered by greater maximum velocity of the catching hand. Final stages of action (e.g., grasping action of the hand) remained unchanged across both spatial and temporal conditions suggesting that later phases of the action were organized using ball flight information. Findings highlighted the importance of maintaining information-movement coupling during performance of interceptive actions, since movement behaviors were continuously (re)organized using kinematic information from a thrower's actions and ball flight information.

Population Pharmacokinetic/Pharmacodynamic Modeling of Tumor Size Dynamics in Pembrolizumab-Treated Advanced Melanoma.

Pembrolizumab is a potent immune-modulating antibody active in advanced melanoma, as demonstrated in the KEYNOTE-001, -002, and -006 studies. Longitudinal tumor size modeling was pursued to quantify exposure-response relationships for efficacy. A mixture model was first developed based on an initial dataset from KEYNOTE-001 to describe four patterns of tumor growth and shrinkage. For subsequent analyses, tumor size measurements were adequately described by a single consolidated model structure that captured continuous tumor size with a combination of growth and regression terms, as well as a fraction of tumor responsive to therapy. This revised model structure provided a framework to efficiently evaluate the impact of covariates and pembrolizumab exposure. Both models indicated that exposure to the drug was not a significant predictor of tumor size response, demonstrating that the dose range evaluated (2 and 10 mg/kg every 3 weeks) is likely near or at the plateau of maximal response.

Model-Based Characterization of the Pharmacokinetics of Pembrolizumab: A Humanized Anti-PD-1 Monoclonal Antibody in Advanced Solid Tumors.

Pembrolizumab, a potent antibody against programmed death 1 (PD-1) receptor, has shown robust antitumor activity and manageable safety in patients with advanced solid tumors. Its pharmacokinetic (PK) properties were analyzed with population PK modeling using pooled data from the KEYNOTE-001, -002, and -006 studies of patients with advanced melanoma, non-small cell lung cancer (NSCLC), and other solid tumor types. Pembrolizumab clearance was low and the volume of distribution small, as is typical for therapeutic antibodies. Identified effects of sex, baseline Eastern Cooperative Oncology Group performance status, measures of renal and hepatic function, tumor type and burden, and prior ipilimumab treatment on pembrolizumab exposure were modest and lacked clinical significance. Furthermore, simulations demonstrated the model has robust power to detect clinically relevant covariate effects on clearance. These results support the use of the approved pembrolizumab dose of 2 mg/kg every 3 weeks without dose adjustment in a variety of patient subpopulations.

Disease Systems Analysis of Bone Mineral Density and Bone Turnover Markers in Response to Alendronate, Placebo, and Washout in Postmenopausal Women.

A previously established mechanism-based disease systems model for osteoporosis that is based on a mathematically reduced version of a model describing the interactions between osteoclast (bone removing) and osteoblast (bone forming) cells in bone remodeling has been applied to clinical data from women (n = 1,379) receiving different doses and treatment regimens of alendronate, placebo, and washout. The changes in the biomarkers, plasma bone-specific alkaline phosphatase activity (BSAP), urinary N-telopeptide (NTX), lumbar spine bone mineral density (BMD), and total hip BMD, were linked to the underlying mechanistic core of the model. The final model gave an accurate description of all four biomarkers for the different treatments. Simulations were used to visualize the dynamics of the underlying network and the natural disease progression upon alendronate treatment and discontinuation. These results complement the previous applications of this mechanism-based disease systems model to data from various treatments for osteoporosis.

Application of a Systems Pharmacology-Based Placebo Population Model to Analyze Long-Term Data of Postmenopausal Osteoporosis.

Osteoporosis is a progressive bone disease characterized by decreased bone mass resulting in increased fracture risk. The objective of this investigation was to test whether a recently developed disease systems analysis model for osteoporosis could describe disease progression in a placebo-treated population from the Early Postmenopausal Intervention Cohort (EPIC) study. First, we qualified the model using a subset from the placebo arm of the EPIC study of 222 women who had similar demographic characteristics as the 149 women from the placebo arm of the original population. Second, we applied the model to all 470 women. Bone mineral density (BMD) dynamics were changed to an indirect response model to describe lumbar spine and total hip BMD in this second population. This updated disease systems analysis placebo model describes the dynamics of all biomarkers in the corresponding datasets to a very good approximation; a good description of an individual placebo response will be valuable for evaluating treatments for osteoporosis.

(De)synchronization of advanced visual information and ball flight characteristics constrains emergent information-movement couplings during one-handed catching.

Advance visual information of a projection action and ball flight information is important for organizing dynamic interceptive actions like catching. However, how the central nervous system (CNS) manages the relationship between advance visual information and emerging ball flight information in regulating behavior is less well understood. Here, we sought to examine the extent that advance visual information to the CNS constrains regulation of catching actions by synchronizing and desynchronizing its relationship with ball trajectory characteristics. Novel technology was used to present video footage of an actor throwing a ball at three different speeds, integrated with information from a real ball projected by a machine set to the three speeds. The technology enabled three synchronized and six desynchronized conditions between advance visual information and subsequent ball flight trajectories. Catching performance, kinematic data from the catching hand and gaze behaviors were recorded. Findings revealed that desynchronization of video images of ball projection shaped emergent catching behaviors. Footage of slower throws, paired with faster ball projection speeds, caused catching performance decrements. Timing in early phases of action was organized by the CNS to match the advance visual information presented. In later phases, like the grasp, ball flight information constraints adapted and regulated behaviors. Gaze behaviors showed increased ball projection speed resulted in participants tracking the ball for a smaller percentage of ball flight. Findings highlighted the role of the two visual systems in perception and action, implicating the importance of coupling advanced visual information and ball flight to regulate emergent movement coordination tendencies during interceptive behaviors.

Implementation of quantitative and systems pharmacology in large pharma.

Quantitative and systems pharmacology concepts and tools are the foundation of the model-informed drug development paradigm at Merck for integrating knowledge, enabling decisions, and enhancing submissions. Rigorous prioritization of modeling and simulation activities has enabled key drug development decisions and led to a high return on investment through significant cost avoidance. Critical factors for the successful implementation, examples on impact on decision making with associated return of investment, and drivers for continued success are discussed.

An integrated ball projection technology for the study of dynamic interceptive actions.

Dynamic interceptive actions, such as catching or hitting a ball, are important task vehicles for investigating the complex relationship between cognition, perception, and action in performance environments. Representative experimental designs have become more important recently, highlighting the need for research methods to ensure that the coupling of information and movement is faithfully maintained. However, retaining representative design while ensuring systematic control of experimental variables is challenging, due to the traditional tendency to employ methods that typically involve use of reductionist motor responses such as buttonpressing or micromovements. Here, we outline the methodology behind a custom-built, integrated ball projection technology that allows images of advanced visual information to be synchronized with ball projection. This integrated technology supports the controlled presentation of visual information to participants while they perform dynamic interceptive actions. We discuss theoretical ideas behind the integration of hardware and software, along with practical issues resolved in technological design, and emphasize how the system can be integrated with emerging developments such as mixed reality environments. We conclude by considering future developments and applications of the integrated projection technology for research in human movement behaviors.

The development of evidence-informed physical activity guidelines for adults with spinal cord injury.

OBJECTIVES: To systematically develop evidence-informed physical activity guidelines to improve physical fitness in people with spinal cord injury (SCI). SETTING: This study was conducted in Canada. METHODS: The Appraisal of Guidelines, Research and Evaluation II guideline development protocol was used to develop exercise guidelines to improve physical capacity and muscular strength. The evidence base for the guideline development process consisted of a systematic review and quality appraisal of research examining the effects of exercise on physical fitness among people with SCI. A multidisciplinary expert panel deliberated the evidence and generated the guidelines. Pilot testing led to refinement of the wording and presentation of the guidelines. RESULTS: The expert panel generated the following guidelines: for important fitness benefits, adults with a SCI should engage in (a) at least 20 min of moderate to vigorous intensity aerobic activity two times per week and (b) strength training exercises two times per week, consisting of three sets of 8-10 repetitions of each exercise for each major muscle group. CONCLUSION: People with SCI, clinicians, researchers and fitness programmers are encouraged to adopt these rigorously developed guidelines.

Rifampin's acute inhibitory and chronic inductive drug interactions: experimental and model-based approaches to drug-drug interaction trial design.

We studied the time course for the reversal of rifampin's effect on the pharmacokinetics of oral midazolam (a cytochrome P450 (CYP) 3A4 substrate) and digoxin (a P-glycoprotein (P-gp) substrate). Rifampin increased midazolam metabolism, greatly reducing the area under the concentration-time curve (AUC(0-∞)). The midazolam AUC(0-∞) returned to baseline with a half-life of ~8 days. Rifampin's effect on the AUC(0-3 h) of digoxin was biphasic: the AUC(0-3 h) increased with concomitant dosing of the two drugs but decreased when digoxin was administered after rifampin. Digoxin was found to be a weak substrate of organic anion-transporting polypeptide (OATP) 1B3 in transfected cells. Although the drug was transported into isolated hepatocytes, it is not likely that this transport was through OATP1B3 because the transport was not inhibited by rifampin. However, rifampin did inhibit the P-gp-mediated transport of digoxin with a half-maximal inhibitory concentration (IC(50)) below anticipated gut lumen concentrations, suggesting that rifampin inhibits digoxin efflux from the enterocyte to the intestinal lumen. Pharmacokinetic modeling suggested that the effects on digoxin are consistent with a combination of inhibitory and inductive effects on gut P-gp. These results suggest modifications to drug-drug interaction (DDI) trial designs.

A comparison of the ion chemistry for mono-substituted toluenes and anilines by three methods of atmospheric pressure ionization with ion mobility spectrometry.

Ion mobility spectra for a series of mono-substituted toluenes and a series of mono-substituted anilines were obtained using three different methods of atmospheric pressure ionization including photoionization, chemical ionization from a (63)Ni source, and chemical ionization from a corona discharge source. The product ion peak intensities were measured as functions of analyte concentration at 323 K in a purified air atmosphere. Two, and sometimes three, product ion peaks were observed in spectra from chemical ionization with the (63)Ni source and it is suggested that the major peak, due to the protonated molecule, arose in both series by proton transfer from H3O+(H2O)n. The second peak with diminished intensity and longer drift time than the protonated molecule can be seen with the toluenes and was understood to be the NO+ adduct, formed from the reactant ion NO+(H2O)n. Electron transfer from the anilines to the latter ion yields the molecular ions, identified by having the same reduced mobility coefficients as the molecular ions produced by photoionization. The structure of these product ions was determined by investigations using the coupling of ion mobility spectrometry with atmospheric pressure photoionization and mass spectrometry (APPI-IMS-MS). The relative abundances of both the NO+ adducts with the toluenes and the molecular ions with the anilines are enhanced with a corona discharge source where relatively more NO+(H2O)n is produced than in a (63)Ni source. Ab initio calculations show that only the protonated anilines of all the product ions are significantly hydrated with 1 ppm(v) of moisture in the supporting atmosphere of the ion mobility spectrometer.

Pharmacokinetics of raltegravir in individuals with UGT1A1 polymorphisms.

Raltegravir is a human immunodeficiency virus-1 (HIV-1) integrase strand transfer inhibitor metabolized by glucuronidation via UDP-glucuronosyltransferase 1A1 (UGT1A1). In this study, 30 subjects with a UGT1A1*28/*28 genotype (associated with decreased activity of UGT1A1) and 27 UGT1A1*1/*1 control subjects (matched by race, age, gender, and body mass index) received a single 400-mg dose of raltegravir after fasting. No serious adverse experiences were reported, and there were no discontinuations due to adverse experiences. The geometric mean ratio (GMR) (UGT1A1*28/*28 to UGT1A1*1/*1) and 90% confidence interval (CI) were 1.41 (0.96, 2.09) for raltegravir area under the concentration-time curve (AUC(0-infinity)), 1.40 (0.86, 2.28) for maximum plasma concentration (C(max)), and 1.91 (1.43, 2.55) for concentration at the 12-h time point (C(12 h)). No clinically important differences in time to maximum concentration (T(max)) or half-life were observed. Plasma concentrations of raltegravir are modestly higher in individuals with the UGT1A1*28/*28 genotype than in those with the UGT1A1*1/*1 genotype. This increase is not clinically significant, and therefore no dose adjustment of raltegravir is required for individuals with the UGT1A1*28/*28 genotype.

Raltegravir thorough QT/QTc study: a single supratherapeutic dose of raltegravir does not prolong the QTcF interval.

Raltegravir is a novel HIV-1 integrase inhibitor with potent in vitro activity (IC(95) = 31 nM in 50% human serum). A double-blind, randomized, placebo-controlled, double-dummy, 3-period, single-dose crossover study was conducted; subjects received single oral doses of 1600 mg raltegravir, 400 mg moxifloxacin, and placebo. The upper limit of the 2-sided 90% confidence interval for the QTcF interval placebo-adjusted mean change from baseline of raltegravir was less than 10 ms at every time point. For the raltegravir and placebo groups, there were no QTcF values >450 ms or change from baseline values >30 ms. A mean C(max) of approximately 20 muM raltegravir was attained, approximately 4-fold higher than the C(max) at the clinical dose. Moxifloxacin demonstrated an increase in QTcF at the 2-, 3-, and 4-hour time points. Administration of a single supratherapeutic dose of raltegravir does not prolong the QTcF interval. A single supratherapeutic dose design may be appropriate for crossover thorough QTc studies.

Safety, tolerability, and pharmacokinetics of raltegravir after single and multiple doses in healthy subjects.

Raltegravir is a novel human immunodeficiency virus-1 integrase inhibitor with potent in vitro activity (95% inhibitory concentration (IC95)=33 nM in 50% human serum). Three double-blind, randomized, placebo-controlled, pharmacokinetic, safety, and tolerability studies were conducted: (1) single-dose escalation study (10-1,600 mg), (2) multiple-dose escalation study (100-800 mg q12 h x 10 days), and (3) single-dose female study (400 mg). Raltegravir was rapidly absorbed with a terminal half-life (t1/2) approximately 7-12 h. Approximately 7-14% of raltegravir was excreted unchanged in urine. Area under the curve (AUC)(0-infinity) was similar between male and female subjects. After multiple-dose administration, steady state was achieved within 2 days; there was little to modest accumulation of raltegravir. Trough levels were >33 nM for dose levels of 100 mg and greater. Raltegravir is generally well tolerated at doses of up to 1,600 mg/day given for up to 10 days and exhibits a pharmacokinetic profile supportive of twice-daily dosing with multiple doses of 100 mg and greater achieving trough levels >33 nM.

Mobility resolution and mass analysis of ions from ammonia and hydrazine complexes with ketones formed in air at ambient pressure.

Protonated ammonia and hydrazines (MH(+)) form complexes with ketones and the differences in masses and mobilities of the resulting ions, MH(+)(ketone)(n), are sufficient for separation in an ion mobility spectrometer at ambient pressure. The highest mass ion for any of the protonated molecules is obtained when the ketone is present at elevated concentrations in the supporting atmosphere of both the source and drift regions of the spectrometer so that an ion maintains a discrete composition and mobility. The sizes of the ion-molecule complexes were found to depend on the number of H atoms on the protonated nitrogen atom--four for ammonia, three for hydrazine, two for monomethylhydrazine, and one for 1,1-dimethylhydrazine, and the drift times of these ions were proportional to the size of the ion-molecule complex. Unexpected side products, including protonated hydrazones and azines, and associated ketone clusters, were isolated to a single drift tube containing ceramic parts and could not, from CID studies, be attributed to gas-phase ion chemistry. These findings illustrate that mobility resolution of ions in IMS and IMS/MS experiments can be enhanced through chemical modification of the supporting gas atmosphere without changes in the core ion.

Characterization of nelfinavir binding to plasma proteins and the lack of drug displacement interactions.

OBJECTIVES: To determine the characteristics of the binding of nelfinavir and active M8 to alpha1-acid glycoprotein (AAG) and human serum albumin (HSA), and to examine the displacement effects of drugs binding extensively to AAG (ritonavir and saquinavir) or to HSA (salicylic acid and valproic acid). METHODS: Free drugs were separated by equilibrium dialysis after incubation with human plasma or purified plasma proteins and after co-incubation with potential displacers. Association constants were estimated from double-reciprocal plots of the data. RESULTS: Nelfinavir and M8 free fractions [fractions of unbound drug (fus)] were 0.42+/-0.08% (mean+/-standard deviation) and 0.64+/-0.07%, respectively. For the two analytes, respectively, association constants were 7.25 x 10(7)/m and 3.33 x 10(7)/m for AAG and 1.11 x 10(6)/m and 7.92 x 10(5)/m for HSA. Nelfinavir fu in an AAG solution was significantly (P < 0.01) increased by the addition of ritonavir or saquinavir, whereas it was unaltered by addition of these drugs to whole plasma. Similarly, fu in an HSA solution was significantly increased (P < 0.01) by the addition of salicylic acid or valproic acid, whereas there was no difference in the free fraction in plasma. CONCLUSIONS: The affinity of nelfinavir for human plasma proteins was higher than that of M8, and both nelfinavir and M8 showed higher affinity to AAG than to HSA. The free fraction of nelfinavir was not affected by drugs that bind extensively to AAG or albumin when these drugs were added to whole plasma in combination, suggesting a compensatory effect of alternate binding proteins.

Exaggerated respiratory chemosensitivity and association with SaO2 level at 3568 m in obesity.

To investigate whether obesity is associated with alterations in respiratory chemosensitivity, we compared the ventilatory response to hypoxia (HVR) and hypercapnia (HCVR) in 9 obese men (BMI: 37.0+/-4.3 kg m(-2)) and 10 lean men (BMI: 25.8+/-4.8 kg m(-2)). HVR (DeltaVE, L min(-1) per DeltaSaO2, %) was measured by a progressive isocapnic hypoxia technique, and HCVR (DeltaVE/DeltaPETCO2, L min(-1)Torr(-1)) was measured by a progressive hypercapnic method. HCVR, was greater (p<0.001) in the obese men (2.68+/-0.78) than in the lean men (1.4+/-0.45) as was HVR (p<0.05) (1.26+/-0.65 versus 0.71+/-0.43, respectively). The difference (DeltaSaO2, 4.30+/-3.69 and 10.54+/-3.45 in the lean and obese men, respectively, p<0.01) between daytime (86+/-1 and 86+/-1%) and nighttime SaO2 (81+/-3 and 76+/-4%) at a simulated altitude of 3658 m was significantly (p<0.05) correlated with both HVR (r=0.51) and HCVR (r=0.48). These results suggest that chemosensitivity in mildly obese men is increased, not blunted. Furthermore, otherwise healthy, obese individuals have the potential for significant desaturation during sleep at high altitude possibly due to exaggerated sleep-disordered breathing.