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2.
Sci Rep ; 14(1): 5981, 2024 03 12.
Artículo en Inglés | MEDLINE | ID: mdl-38472275

RESUMEN

Human physical activity (HPA), a fundamental physiological signal characteristic of bodily motion is of rapidly growing interest in multidisciplinary research. Here we report the existence of hitherto unidentified hierarchical levels in the temporal organization of HPA on the ultradian scale: on the minute's scale, passive periods are followed by activity bursts of similar intensity ('quanta') that are organized into superstructures on the hours- and on the daily scale. The time course of HPA can be considered a stochastic, quasi-binary process, where quanta, assigned to task-oriented actions are organized into work packages on higher levels of hierarchy. In order to grasp the essence of this complex dynamic behaviour, we established a stochastic mathematical model which could reproduce the main statistical features of real activity time series. The results are expected to provide important data for developing novel behavioural models and advancing the diagnostics of neurological or psychiatric diseases.


Asunto(s)
Ejercicio Físico , Modelos Teóricos , Humanos
3.
Nat Med ; 30(2): 435-442, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38365952

RESUMEN

Individuals with kidney failure undergoing hemodialysis are at elevated risk for thromboembolic events. Factor (F) XI, which is in the intrinsic pathway of coagulation, is emerging as an attractive target for new anticoagulants that may be safer than existing agents. Osocimab-an inhibitory FXIa antibody-is a potential treatment option for such patients. We conducted a phase 2b, double-blind, placebo-controlled trial, in which 704 participants (448 male, 256 female) with kidney failure undergoing hemodialysis were randomized to receive lower- or higher-dose osocimab or placebo. In total, 686 participants (436 male, 250 female) received treatment for ≤18 months (planned minimal treatment period of 6 months). The co-primary outcomes were clinically relevant bleeding (a composite of major and clinically relevant nonmajor bleeding) and a composite of the incidence of moderate, severe or serious adverse events. Clinically relevant bleeding occurred in 16/232 (6.9%) and 11/224 (4.9%) participants who received lower- and higher-dose osocimab, respectively, and in 18/230 participants (7.8%) who received a placebo. For the composite adverse event endpoint, incidences were 51%, 47% and 43% in the lower-dose osocimab, higher-dose osocimab and placebo groups, respectively. These results suggest that osocimab is associated with a low risk of bleeding and is generally well tolerated in this population; findings that require confirmation in larger trials. ClinicalTrials.gov identifier, NCT04523220 .


Asunto(s)
Anticuerpos Monoclonales Humanizados , Coagulación Sanguínea , Insuficiencia Renal , Humanos , Masculino , Femenino , Anticoagulantes , Hemorragia , Insuficiencia Renal/complicaciones , Insuficiencia Renal/terapia , Insuficiencia Renal/inducido químicamente , Diálisis Renal , Método Doble Ciego
4.
J Neurophysiol ; 130(2): 458-473, 2023 08 01.
Artículo en Inglés | MEDLINE | ID: mdl-37465880

RESUMEN

Stochastic resonance (SR) describes a phenomenon where an additive noise (stochastic carrier-wave) enhances the signal transmission in a nonlinear system. In the nervous system, nonlinear properties are present from the level of single ion channels all the way to perception and appear to support the emergence of SR. For example, SR has been repeatedly demonstrated for visual detection tasks, also by adding noise directly to cortical areas via transcranial random noise stimulation (tRNS). When dealing with nonlinear physical systems, it has been suggested that resonance can be induced not only by adding stochastic signals (i.e., noise) but also by adding a large class of signals that are not stochastic in nature that cause "deterministic amplitude resonance" (DAR). Here, we mathematically show that high-frequency, deterministic, periodic signals can yield resonance-like effects with linear transfer and infinite signal-to-noise ratio at the output. We tested this prediction empirically and investigated whether nonrandom, high-frequency, transcranial alternating current stimulation (tACS) applied to the visual cortex could induce resonance-like effects and enhance the performance of a visual detection task. We demonstrated in 28 participants that applying 80-Hz triangular-waves or sine-waves with tACS reduced the visual contrast detection threshold for optimal brain stimulation intensities. The influence of tACS on contrast sensitivity was equally effective to tRNS-induced modulation, demonstrating that both tACS and tRNS can reduce contrast detection thresholds. Our findings suggest that a resonance-like mechanism can also emerge when deterministic electrical waveforms are applied via tACS.NEW & NOTEWORTHY Our findings extend our understanding of neuromodulation induced by noninvasive electrical stimulation. We provide the first evidence showing acute online benefits of transcranial alternating current stimulation (tACS)triangle and tACSsine targeting the primary visual cortex (V1) on visual contrast detection in accordance with the resonance-like phenomenon. The "deterministic" tACS and "stochastic" high-frequency-transcranial random noise stimulation (tRNS) are equally effective in enhancing visual contrast detection.


Asunto(s)
Estimulación Transcraneal de Corriente Directa , Corteza Visual , Humanos , Percepción Visual/fisiología , Sensibilidad de Contraste , Ruido , Corteza Visual/fisiología
5.
Semin Arthritis Rheum ; 58: 152140, 2023 02.
Artículo en Inglés | MEDLINE | ID: mdl-36446256

RESUMEN

OBJECTIVES: Osteoarthritis (OA) is a complex disease comprising diverse underlying patho-mechanisms. To enable the development of effective therapies, segmentation of the heterogenous patient population is critical. This study aimed at identifying such patient clusters using two different machine learning algorithms. METHODS: Using the progression and incident cohorts of the Osteoarthritis Initiative (OAI) dataset, deep embedded clustering (DEC) and multiple factor analysis with clustering (MFAC) approaches, including 157 input-variables at baseline, were employed to differentiate specific patient profiles. RESULTS: DEC resulted in 5 and MFAC in 3 distinct patient phenotypes. Both identified a "comorbid" cluster with higher body mass index (BMI), relevant burden of comorbidity and low levels of physical activity. Both methods also identified a younger and physically more active cluster and an elderly cluster with functional limitations, but low disease impact. The additional two clusters identified with DEC were subgroups of the young/physically active and the elderly/physically inactive clusters. Overall pain trajectories over 9 years were stable, only the numeric rating scale (NRS) for pain showed distinct increase, while physical activity decreased in all clusters. Clusters showed different (though non-significant) trajectories of joint space changes over the follow-up period of 8 years. CONCLUSION: Two different clustering approaches yielded similar patient allocations primarily separating complex "comorbid" patients from healthier subjects, the latter divided in young/physically active vs elderly/physically inactive subjects. The observed association to clinical (pain/physical activity) and structural progression could be helpful for early trial design as strategy to enrich for patients who may specifically benefit from disease-modifying treatments.


Asunto(s)
Osteoartritis de la Rodilla , Humanos , Osteoartritis de la Rodilla/diagnóstico por imagen , Radiografía , Progresión de la Enfermedad , Dolor , Aprendizaje Automático , Fenotipo
6.
Neurology ; 96(12): e1595-e1607, 2021 03 23.
Artículo en Inglés | MEDLINE | ID: mdl-33597289

RESUMEN

OBJECTIVE: To assess long-term (2 years) effects of bimagrumab in participants with sporadic inclusion body myositis (sIBM). METHODS: Participants (aged 36-85 years) who completed the core study (RESILIENT [Efficacy and Safety of Bimagrumab/BYM338 at 52 Weeks on Physical Function, Muscle Strength, Mobility in sIBM Patients]) were invited to join an extension study. Individuals continued on the same treatment as in the core study (10 mg/kg, 3 mg/kg, 1 mg/kg bimagrumab or matching placebo administered as IV infusions every 4 weeks). The co-primary outcome measures were 6-minute walk distance (6MWD) and safety. RESULTS: Between November 2015 and February 2017, 211 participants entered double-blind placebo-controlled period of the extension study. Mean change in 6MWD from baseline was highly variable across treatment groups, but indicated progressive deterioration from weeks 24-104 in all treatment groups. Overall, 91.0% (n = 142) of participants in the pooled bimagrumab group and 89.1% (n = 49) in the placebo group had ≥1 treatment-emergent adverse event (AE). Falls were slightly higher in the bimagrumab 3 mg/kg group vs 10 mg/kg, 1 mg/kg, and placebo groups (69.2% [n = 36 of 52] vs 56.6% [n = 30 of 53], 58.8% [n = 30 of 51], and 61.8% [n = 34 of 55], respectively). The most frequently reported AEs in the pooled bimagrumab group were diarrhea 14.7% (n = 23), involuntary muscle contractions 9.6% (n = 15), and rash 5.1% (n = 8). Incidence of serious AEs was comparable between the pooled bimagrumab and the placebo group (18.6% [n = 29] vs 14.5% [n = 8], respectively). CONCLUSION: Extended treatment with bimagrumab up to 2 years produced a good safety profile and was well-tolerated, but did not provide clinical benefits in terms of improvement in mobility. The extension study was terminated early due to core study not meeting its primary endpoint. CLINICAL TRIAL REGISTRATION: Clinicaltrials.gov identifier NCT02573467. CLASSIFICATION OF EVIDENCE: This study provides Class IV evidence that for patients with sIBM, long-term treatment with bimagrumab was safe, well-tolerated, and did not provide meaningful functional benefit. The study is rated Class IV because of the open-label design of extension treatment period 2.


Asunto(s)
Anticuerpos Monoclonales Humanizados/uso terapéutico , Miositis por Cuerpos de Inclusión/tratamiento farmacológico , Accidentes por Caídas , Adulto , Anciano , Anciano de 80 o más Años , Método Doble Ciego , Femenino , Humanos , Masculino , Persona de Mediana Edad , Fuerza Muscular/efectos de los fármacos , Miositis por Cuerpos de Inclusión/complicaciones , Tiempo , Resultado del Tratamiento , Prueba de Paso
7.
Lancet Healthy Longev ; 2(5): e263-e274, 2021 05.
Artículo en Inglés | MEDLINE | ID: mdl-36098133

RESUMEN

BACKGROUND: Older adult patients (ie, those aged ≥60 years) undergoing surgery for hip fracture repair frequently experience loss of muscle mass and strength due to poor mobility and delayed functional recovery. No proven treatment is currently available to enhance recovery of physical function in this growing patient population. This study aimed to investigate whether bimagrumab, a human monoclonal antibody targeting activin type 2 receptors, can improve post-surgical recovery. METHODS: This multicentre, double-blind, randomised, parallel-group, placebo-controlled, phase 2a/b trial was done at 50 clinical research centres in 18 countries. Participants aged 60 years or older with a body-mass index of 15-35 kg/m2 who had undergone internal fixation or hemiarthroplasty for a proximal femoral fracture (confirmed by radiography) in the previous 6 weeks were eligible. Patients with a history of a high-energy subtrochanteric fracture or any other lower limb fracture in the past 6 months, or any major surgery of the lower limbs in the past 3 months were excluded. Participants were randomly assigned (2:1:2:2) via interactive response technology to receive intravenous treatment with placebo, bimagrumab 70 mg, bimagrumab 210 mg, or bimagrumab 700 mg every 4 weeks for 24 weeks. Participants, investigators, site personnel, and study sponsor personnel in participating countries were masked to treatment assignment. The primary endpoint was the change from baseline in total lean body mass, measured by dual-energy x-ray absorptiometry, at week 24 in the full analysis set, which included all randomised participants who had received at least one dose of the assigned treatment. Key secondary endpoints included changes in habitual gait speed (measured in m/s) and short physical performance battery score between baseline and 24 weeks. Safety and tolerability were assessed by recording adverse events and vital signs on weeks 4, 8, 12, 24, and 48, and by laboratory assessments and electrocardiography at the screening visit and on days 1, 84, and 168. Safety was assessed in all randomised participants who had received at least one dose of study drug, analysed according to treatment received. This study was registered with ClinicalTrials.gov, NCT02152761. FINDINGS: Between Sept 16, 2014, and Dec 15, 2017, 384 patients were screened, of whom 250 patients were enrolled and randomly assigned to the placebo group (n=72), the bimagrumab 70 mg group (n=34), the bimagrumab 210 mg group (n=69), or the bimagrumab 700 mg group (n=75). A total of 207 (83%) participants completed the 24-week treatment period. There was a significant absolute increase in lean body mass from baseline compared with placebo (0·2 kg [SD 2·0]) in the bimagrumab 210 mg group (1·9 kg [1·7]; p<0·0001) and in the bimagrumab 700 mg group 2·8 kg [2·2]; p<0·0001) but not in the bimagrumab 70 mg group (0·6 kg [SD 2·2]; significance not assessed). Changes in habitual gait speed and short physical performance battery scores between baseline and week 24 were not significantly different across the treatment groups, suggesting no enhancement of physical recovery with bimagrumab over placebo. Bimagrumab was safe and well tolerated. The most frequently reported treatment-emergent adverse events were falls (six [18%] of 34 participants in the bimagrumab 70 mg group; 12 [17%] of 69 participants in the bimagrumab 210 mg group; 14 [19%] of 75 participants in the bimagrumab 700 mg group; and 13 [18%] of 72 participants in the placebo group), muscle spasms (two [6%] in the bimagrumab 70 mg group; 17 [25%] in the bimagrumab 210 mg group; 12 [16%] in the bimagrumab 700 mg group; and six [8%] in the placebo group), and arthralgia (five [15%] in the bimagrumab 70 mg group; six [9%] in the bimagrumab 210 mg group; nine [12%] in the bimagrumab 700 mg group; and five [7%] in the placebo group). Six deaths were reported during the study, none of which were considered by investigators as related to the study drug. INTERPRETATION: Bimagrumab treatment for 24 weeks led to dose-dependent, significant increases in lean body mass in older patients recovering from hip fracture surgery when compared with placebo. However, no functional benefit was observed in recovery of mobility or lower extremity function following bimagrumab treatment compared with placebo. FUNDING: Novartis Pharma.


Asunto(s)
Anticuerpos Monoclonales Humanizados , Anticuerpos Monoclonales , Receptores de Activinas , Anciano , Anticuerpos Bloqueadores/uso terapéutico , Anticuerpos Monoclonales/efectos adversos , Anticuerpos Monoclonales Humanizados/uso terapéutico , Método Doble Ciego , Humanos
8.
Biosensors (Basel) ; 10(8)2020 Aug 09.
Artículo en Inglés | MEDLINE | ID: mdl-32784841

RESUMEN

An improved method for fluctuation-enhanced sensing (FES) is introduced. We enhanced the old binary fingerprinting method, where the fingerprint bit values were ±1, by introducing ternary fingerprint bits utilizing a reference odor. In the ternary method, the fingerprint bit values are -1, 0, and +1, where the 0 value stands for the situation where the slope of the spectrum is identical to that of the reference odor. The application of the reference odor spectrum makes the fingerprint relative to the reference. The ternary nature and the reference feature increase the information entropy of the fingerprints. The method is briefly illustrated by sensing bacterial odor in cow manure isolates.


Asunto(s)
Odorantes/análisis , Bacterias , Monitoreo del Ambiente , Estiércol/microbiología , Estructura Molecular
9.
Neurology ; 95(14): e1971-e1978, 2020 10 06.
Artículo en Inglés | MEDLINE | ID: mdl-32690797

RESUMEN

OBJECTIVE: To assess the long-term safety and tolerability and to monitor benefits of extended use of bimagrumab in individuals with sporadic inclusion body myositis (sIBM) who completed a single-dose core study. METHODS: In this multicenter, open-label extension study, 10 adults received bimagrumab 10 mg/kg IV every 4 weeks up to 2 years (104 weeks). Safety (primary endpoint) was assessed by recording adverse events (AEs). Clinical benefits were assessed by changes from baseline in thigh muscle volume (TMV), lean body mass (LBM), 6-minute walk distance (6MWD), handgrip, and quadriceps strength. RESULTS: Participants had a mean age of 70.1 (SD 10.4) years. All participants (n = 10) discontinued the treatment due to early termination of the study (n = 7) or AEs (n = 3; myocardial infarction, esophageal carcinoma, and dementia, none of which were treatment related). The most common AEs were muscle spasms and falls (both 9 of 10, 90%), followed by diarrhea (6 of 10, 60%) and acne and skin eruption (both 5 of 10, 50%). At weeks 8 and 16, mean TMV increased from baseline by 4.1% (SD 4.3%) and 4.5% (SD 6.3%). Mean LBM increased from baseline and was sustained at 6.9% (SD 3.9%) at week 76. Means of 6MWD showed a progressive decline from baseline to week 76, during which there was a modest numerical increase in handgrip strength and no significant changes in quadriceps strength. CONCLUSIONS: Long-term treatment up to 2 years with bimagrumab had a good safety profile and was well tolerated in individuals with sIBM. An increase in muscle mass was noted on a group level; however, there was no evidence of clinical improvement. CLINICALTRIALSGOV IDENTIFIER: NCT02250443. CLASSIFICATION OF EVIDENCE: This study provides Class IV evidence that for patients with sIBM, long-term bimagrumab treatment was safe and well tolerated and did not lead to functional improvement.


Asunto(s)
Anticuerpos Monoclonales Humanizados/uso terapéutico , Miositis por Cuerpos de Inclusión/tratamiento farmacológico , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Fuerza Muscular/efectos de los fármacos , Tiempo , Resultado del Tratamiento
10.
Horm Behav ; 124: 104777, 2020 08.
Artículo en Inglés | MEDLINE | ID: mdl-32439347

RESUMEN

Neuropeptide oxytocin (OT) is involved in the regulation of social and non-social behaviour. The central nucleus of amygdala (CeA), part of the limbic system, plays an important role in learning, memory, anxiety and reinforcing mechanisms. CeA has been shown to be rich in OT receptors in rodents. Our previous findings indicated that OT in the rat CeA has a dose dependent rewarding and anxiolytic effect. The aim of our present study was to examine in the CeA the possible interaction of OT and D2 dopamine (DA) receptor antagonist Sulpiride on reinforcement in place preference test and on anxiety in elevated plus maze test. Wistar rats were microinjected bilaterally with 10 ng OT. In different group of animals 4 µg D2 DA receptor antagonist was applied. Other animals received D2 DA receptor antagonist 15 min before 10 ng OT treatment or vehicle solution into the CeA. Rats receiving 10 ng OT spent significantly longer time in the treatment quadrant during the test session in conditioned place preference test. Prior treatment with D2 DA receptor antagonist blocked the rewarding effects of OT. Antagonist in itself did not influence the time rats spent in the treatment quadrant. In elevated plus maze test, rats receiving 10 ng OT spent significantly longer time on the open arms. Prior treatment with D2 DA receptor antagonist blocked the effects of OT. Our results show that DA system plays a role in positive reinforcing and anxiolytic effects of OT because D2 DA receptor antagonist can block these actions.


Asunto(s)
Ansiolíticos/farmacología , Oxitocina/farmacología , Receptores de Dopamina D2/fisiología , Conducta Espacial/efectos de los fármacos , Amígdala del Cerebelo/efectos de los fármacos , Amígdala del Cerebelo/metabolismo , Animales , Ansiedad/tratamiento farmacológico , Conducta Animal/efectos de los fármacos , Condicionamiento Clásico/efectos de los fármacos , Antagonistas de los Receptores de Dopamina D2/farmacología , Miedo/efectos de los fármacos , Reacción Cataléptica de Congelación/efectos de los fármacos , Masculino , Aprendizaje por Laberinto/efectos de los fármacos , Ratas , Ratas Wistar , Receptores de Dopamina D1/metabolismo , Receptores de Dopamina D2/metabolismo , Receptores de Oxitocina/metabolismo , Receptores de Oxitocina/fisiología , Refuerzo en Psicología , Recompensa , Sulpirida/farmacología
11.
J Org Chem ; 85(22): 14763-14771, 2020 Nov 20.
Artículo en Inglés | MEDLINE | ID: mdl-32216341

RESUMEN

The asymmetric catalytic P-H addition of racemic secondary phosphines to electrophilic α-diazoesters via P*-N bond formation is disclosed for the first time. Interaction between the diazoester and the palladium catalyst resulted in the unusually enhanced electrophilic ability of the terminal nitrogen in the diazo functionality, as opposed to the commonly expected formation of a metal carbene by nitrogen elimination. Further derivatization of the generated phosphinic hydrazones provided access to enantioenriched P-stereogenic diarylphosphinates via a simple transformation.

12.
Front Cardiovasc Med ; 7: 608193, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33585581

RESUMEN

Aims: The restoration of coronary circulation plays a crucial role in treating ST-segment elevation myocardial infarction (STEMI), however successful reperfusion with primary percutaneous coronary intervention (PPCI) may induce life-threatening arrhythmias. The relation between myocardial electrical instability, as a background factor in reperfusion arrhythmia, and magnesium administered periprocedurally is still questionable. Several randomized clinical trials have been conducted predominantly in the thrombolysis era. Due to the contradictory results of these studies, there is little evidence of the potential preventive effect of magnesium on reperfusion arrhythmias. The aim of our study is to review and meta-analytically analyze data from all studies published so far in the PPCI era, comparing STEMI patients who have undergone primary PCI and received either magnesium or a placebo before the reperfusion procedure. Methods and Results: Our meta-analysis follows the points in the PRISMA protocol and, meets all of their criteria. We conducted a search in five scientific databases using the following keyword combination: (myocardial infarction OR myocardial injury OR acute coronary syndrome OR acs OR stemi) AND magnesium. The 7,295 collected publications were filtered with the Endnote program by title, abstract and full-text based on predefined criteria. A statistical analysis was performed on three randomized-controlled trials using three common parameters, involving 336 patients Trial sequential analysis (TSA) was applied to assess the risk of random error associated with sparse data and multiple testing which can affect cumulative meta-analysis. The incidence of ventricular tachycardias (VTs) was not significantly increased in the non-magnesium control group. (OR: 1.36; CI: 0.619; -2.986, P = 0.263). For the ejection fraction (EF), a non-significant decrease was observed in the magnesium group by weighted mean difference calculation. (WMD: 7.262, 95% CI: -0.238; 0.053; P = 0.057). There was significant decrease in the infarct zone wall motion index (IZWMSI) in the magnesium treatment group. (WMD: 0.384, 95% CI: -0.042; 0.811, P = 0.015). Based on the TSA assessments, the results of all parameters are not significant, objectively demonstrating the lack of reasonable data pertaining to our question. Conclusions: The preventive effect of magnesium on reperfusion arrhythmia associated with primary PCI can still be considered contradictory based on previous studies. In our study, we found, that magnesium is ineffective with a very weak evidence, due to the small number of patients and the biases of the included studies, and a well-designed clinical trial is needed in this area, based on the TSA.

13.
Chem Commun (Camb) ; 55(73): 10936-10939, 2019 Sep 10.
Artículo en Inglés | MEDLINE | ID: mdl-31441914

RESUMEN

A metal-free tandem double hydrophosphination of extended conjugated indandiones has been established. Mechanistic investigations confirmed the consecutive manner of the nucleophilic addition reaction. Complexation of the generated keto-diphosphine resulted in the formation of an unexpected tridentate bridging ligand with an anionic P,O-bidentate and a neutral P-monodentate coordination mode on two palladium units. In the presence of an external chiral auxiliary, the coordinated diphosphines could be separated into their enantiomeric forms.

14.
Int J Rehabil Res ; 41(3): 251-257, 2018 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-29889116

RESUMEN

The aim of this study was to determine changes in clinical and biomechanical measures of spasticity after administering galvanic vestibular stimulation in patients with a complete spinal cord injury (SCI). The spasticity in the lower limbs was assessed using the Modified Ashworth Scale and the pendulum test in seven SCI patients (grade A on the ASIA Impairment Scale) before (0), immediately after (0), and at 5 and 30 min after the real versus sham galvanic vestibular stimulation (15 s each, anode over the right mastoid). Overall, the changes in spasticity were not significantly different between the real and sham galvanic vestibular stimulation. However, the Modified Ashworth Scale and the pendulum test indicated a reduction in spasticity in two out of seven patients. The results suggest that galvanic vestibular stimulation may modify spasticity in some patients with complete SCI, presumably through the residual vestibulospinal influences. Future studies should determine clinical and neurophysiological profiles of responders versus nonresponders and optimize parameters of galvanic vestibular stimulation.


Asunto(s)
Terapia por Estimulación Eléctrica , Extremidad Inferior/fisiopatología , Espasticidad Muscular/rehabilitación , Traumatismos de la Médula Espinal/fisiopatología , Nervio Vestibular/fisiología , Núcleos Vestibulares/fisiología , Humanos , Espasticidad Muscular/fisiopatología
15.
J Cachexia Sarcopenia Muscle ; 8(5): 727-734, 2017 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-28905498

RESUMEN

BACKGROUND: Patients experiencing disuse atrophy report acute loss of skeletal muscle mass which subsequently leads to loss of strength and physical capacity. In such patients, especially the elderly, complete recovery remains a challenge even with improved nutrition and resistance exercise. This study aimed to explore the clinical potential of bimagrumab, a human monoclonal antibody targeting the activin type II receptor, for the recovery of skeletal muscle volume from disuse atrophy using an experimental model of lower extremity immobilization. METHODS: In this double-blind, placebo-controlled trial, healthy young men (n = 24; mean age, 24.1 years) were placed in a full-length cast of one of the lower extremities for 2 weeks to induce disuse atrophy. After cast removal, subjects were randomized to receive a single intravenous (i.v.) dose of either bimagrumab 30 mg/kg (n = 15) or placebo (n = 9) and were followed for 12 weeks. Changes in thigh muscle volume (TMV) and inter-muscular adipose tissue (IMAT) and subcutaneous adipose tissue (SCAT) of the thigh, maximum voluntary knee extension strength, and safety were assessed throughout the 12 week study. RESULTS: Casting resulted in an average TMV loss of -4.8% and comparable increases in IMAT and SCAT volumes. Bimagrumab 30 mg/kg i.v. resulted in a rapid increase in TMV at 2 weeks following cast removal and a +5.1% increase above pre-cast levels at 12 weeks. In comparison, TMV returned to pre-cast level at 12 weeks (-0.1%) in the placebo group. The increased adiposity of the casted leg was sustained in the placebo group and decreased substantially in the bimagrumab group at Week 12 (IMAT: -6.6%, SCAT: -3.5%). Knee extension strength decreased by ~25% in the casted leg for all subjects and returned to pre-cast levels within 6 weeks after cast removal in both treatment arms. Bimagrumab was well tolerated with no serious or severe adverse events reported during the study. CONCLUSIONS: A single dose of bimagrumab 30 mg/kg i.v. safely accelerated the recovery of TMV and reversal of accumulated IMAT following 2 weeks in a joint-immobilizing cast.


Asunto(s)
Anticuerpos Bloqueadores/uso terapéutico , Anticuerpos Monoclonales/uso terapéutico , Composición Corporal/efectos de los fármacos , Músculo Esquelético/efectos de los fármacos , Músculo Esquelético/patología , Atrofia Muscular/tratamiento farmacológico , Atrofia Muscular/patología , Muslo , Adolescente , Adulto , Anticuerpos Bloqueadores/farmacología , Anticuerpos Monoclonales/farmacología , Anticuerpos Monoclonales Humanizados , Moldes Quirúrgicos/efectos adversos , Femenino , Humanos , Imagen por Resonancia Magnética/métodos , Masculino , Fuerza Muscular/efectos de los fármacos , Músculo Esquelético/diagnóstico por imagen , Atrofia Muscular/etiología , Tamaño de los Órganos , Resultado del Tratamiento , Adulto Joven
16.
Calcif Tissue Int ; 99(3): 310-21, 2016 09.
Artículo en Inglés | MEDLINE | ID: mdl-27167138

RESUMEN

Bimagrumab (BYM338) is a novel fully human monoclonal antibody that exerts strong promyogenic effects on skeletal muscle by blocking activin type II receptors (ActRII). We investigated whether such blockade of ActRII by bimagrumab manifests any detrimental effect on outcomes of bone healing in a rat fibula osteotomy model. Animals (n = 150) were divided into 11 groups and received weekly treatment with either bimagrumab (10 or 100 mg/kg) or vehicle. Progression and outcomes of bone healing were assessed by lateral radiographs in vivo as well as by peripheral quantitative computed tomography (pQCT), 4-point bending test, and microscopic examination of the excised fibula at Day 29 or later. The radiographic progression of bone healing showed no significant differences between treatment groups in any comparative setting. In 3-month-old animals, pQCT revealed slightly reduced immature callus size and bone mineral content in bimagrumab-treated animals compared with vehicle-treated animals at Day 29 (p < 0.05). There were, however, no differences in mature callus size, bone mineral density, or biomechanical competency. The aforementioned effects on immature callus size were not present when the treatment was initiated 4 weeks post osteotomy or when treating 6-month-old animals. In summary, these findings suggest that there is no major impact of ActRII blockade on overall fracture healing, and delayed treatment initiation can bypass the small and transient effect of the therapy on immature callus formation observed in younger animals. Verification of these findings in humans is the subject of an ongoing clinical trial on elderly hip fracture patients.


Asunto(s)
Receptores de Activinas/efectos de los fármacos , Anticuerpos Bloqueadores/farmacología , Anticuerpos Monoclonales/farmacología , Densidad Ósea/efectos de los fármacos , Peroné/efectos de los fármacos , Fracturas Óseas/tratamiento farmacológico , Receptores de Activinas/metabolismo , Animales , Anticuerpos Monoclonales Humanizados , Fenómenos Biomecánicos/efectos de los fármacos , Callo Óseo/efectos de los fármacos , Curación de Fractura/efectos de los fármacos , Masculino , Osteotomía/métodos , Ratas Sprague-Dawley
17.
Cogn Neurodyn ; 9(4): 459-62, 2015 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-26157518

RESUMEN

Even a single neuron may be able to produce significant lognormal features in its firing statistics due to noise in the charging ion current. A mathematical scheme introduced in advanced nanotechnology is relevant for the analysis of this mechanism in the simplest case, the integrate-and-fire model with white noise in the charging ion current.

18.
Int J Rehabil Res ; 37(1): 22-8, 2014 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-23820295

RESUMEN

Improvement in gait abilities is one of the important goals of stroke rehabilitation. The Walkaround is a new postural assistance device for gait training, which allows an early start for gait training. This device provides body postural support (BPS) and trunk orientation by means of a lumbar belt that is connected to a powered rolling walker. We conducted a randomized, single-blinded, 4-week clinical trial of 22 subacute stroke patients with a follow-up period of 6 months. Patients were divided into two identically sized groups: the treatment group (BPS), which was assisted by the Walkaround, and the control (CON) group, which was assisted by conventional means (cane, therapist) during gait training. The objective of the study was to assess whether the Walkaround is more effective than conventional assistance during gait training. The outcome measures were as follows: Barthel index, Fugl-Meyer score for the lower extremities, Berg balance test, and gait speed. Changes in the outcome measures were significant for the Berg balance score after 6 months in both groups and in gait speed among the BPS group at the end of therapy and after 6 months (P<0.05) compared with the same outcome measures at the beginning of the trial. Significant differences were found in gait speed and Berg balance test scores after 4 weeks and in gait speed after 6 months (P<0.05) between the BPS and the CON groups. The results suggest that added postural support by the Walkaround led to limited yet significant changes in gait speed and balance control.


Asunto(s)
Trastornos Neurológicos de la Marcha/rehabilitación , Rehabilitación/instrumentación , Robótica , Rehabilitación de Accidente Cerebrovascular , Caminata , Bastones , Terapia Combinada , Terapia por Estimulación Eléctrica/instrumentación , Diseño de Equipo , Hemiplejía/rehabilitación , Humanos , Limitación de la Movilidad , Método Simple Ciego
19.
Artículo en Inglés | MEDLINE | ID: mdl-29732044

RESUMEN

Noise-based logic is a practically deterministic logic scheme inspired by the randomness of neural spikes and uses a system of uncorrelated stochastic processes and their superposition to represent the logic state. We briefly discuss various questions such as (i) What does practical determinism mean? (ii) Is noise-based logic a Turing machine? (iii) Is there hope to beat (the dreams of) quantum computation by a classical physical noise-based processor, and what are the minimum hardware requirements for that? Finally, (iv) we address the problem of random number generators and show that the common belief that quantum number generators are superior to classical (thermal) noise-based generators is nothing but a myth.

20.
PLoS One ; 8(11): e81103, 2013.
Artículo en Inglés | MEDLINE | ID: mdl-24303033

RESUMEN

A method to quantify the error probability at the Kirchhoff-law-Johnson-noise (KLJN) secure key exchange is introduced. The types of errors due to statistical inaccuracies in noise voltage measurements are classified and the error probability is calculated. The most interesting finding is that the error probability decays exponentially with the duration of the time window of single bit exchange. The results indicate that it is feasible to have so small error probabilities of the exchanged bits that error correction algorithms are not required. The results are demonstrated with practical considerations.


Asunto(s)
Seguridad Computacional , Modelos Teóricos , Humanos
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