RESUMEN
INTRODUCTION: Skin blanching assay has been established as a surrogate method for assessing bioequivalence of topical corticosteroids. This study aimed to apply the skin blanching assay to evaluate the bioequivalence of a test desonide cream (T) compared with the reference Desonide® (R) using Chinese skins. Additionally, the pharmacokinetics and safety profiles were also assessed. METHODS: By detecting the degree of skin blanching under different dose duration in a pilot dose-duration-response study, the area under the observed effect-time curve (AUEC) and half of the maximum effect (ED50) was calculated. Based on this, the skin color of different time points after a dose duration of ED50, D1 (0.5×ED50) and D2 (2×ED50) were detected as a pharmacodynamic indicator to compare between test and reference creams. A single-center, single-dose, randomized, open-label, two-cycle crossover pharmacokinetic studies were designed to make sure the exposure of tested formulations was not higher than that of the reference formulations. Subjects experiencing adverse events (AEs) were monitored and utilized for safety analysis. RESULTS: These studies involved twelve subjects for the dose-duration-response study, 100 subjects for the bioequivalence study, and twelve subjects for pharmacokinetic study. The results showed that the population ED50 was 0.88±0.45 h, the mean ratio of area under effective curve (AUEC0-24h) of test and reference preparations was 0.95, with a 90% confidence interval as 88.09%-101.72%, indicating the bioequivalence of the test formulation and Desonide®. The maximum concentration (Cmax) and exposure (AUC0-t) of T and R were 20.8 ± 11.5 pg/mL versus 19.7 ± 10.1 pg/mL, respectively, and 451.04 ± 363.65 pgâh/mL versus 541.47 ± 581.41 pgâh/mL, respectively. The systemic exposure of a single dose of the test cream was not higher than that of the reference preparation. All of the volunteers experienced grade 1 adverse events (AEs), suggesting that single administration of the test desonide cream is well tolerated in the Chinese healthy population. CONCLUSIONS: This study demonstrated the applicability of skin blanching assay in Chinese skins and established the bioequivalence of test and reference desonide creams.
RESUMEN
Single-atom catalysts (SACs) with unitary active sites hold great promise for realizing high selectivity toward a single product in the CO2 electroreduction reaction (CO2RR). However, achieving high Faradaic efficiency (FE) of multielectron products like methane on SACs is still challenging. Herein, we report a pressure-regulating strategy that achieves 83.5 ± 4% FE for the CO2-to-CH4 conversion on the asymmetric Cu-N2 sites, representing one of the best CO2-to-CH4 performances. Elevated CO2 pressure was demonstrated as an efficient way to inhibit the hydrogen evolution reaction via promoting the competing adsorption of reactant CO2, regardless of the nature of the active sites. Meanwhile, the asymmetric Cu-N2 structure could endow the Cu sites with stronger electronic coupling with *CO, thus suppressing the desorption of *CO and facilitating the following hydrogenation of *CO to *CHO. This work provides a synergetic strategy of the pressure-induced reaction environment regulating and the electronic structure modulating for selective CO2RR toward targeted products.
RESUMEN
Low-energy consumption seawater electrolysis at high current density is an effective way for hydrogen production, however the continuous feeding of seawater may result in the accumulation of Cl-, leading to severe anode poisoning and corrosion, thereby compromising the activity and stability. Herein, CoFeAl layered double hydroxide anodes with excellent oxygen evolution reaction activity are synthesized and delivered stable catalytic performance for 350 hours at 2 A cm-2 in the presence of 6-fold concentrated seawater. Comprehensive analysis reveals that the Al3+ ions in electrode are etched off by OH- during oxygen evolution reaction process, resulting in M3+ vacancies that boost oxygen evolution reaction activity. Additionally, the self-originated Al(OH)n- is found to adsorb on the anode surface to improve stability. An electrode assembly based on a micropore membrane and CoFeAl layered double hydroxide electrodes operates continuously for 500 hours at 1 A cm-2, demonstrating their feasibility in brine electrolysis.
RESUMEN
Commercial alkaline water electrolysers typically operate at 80 °C to minimize energy consumption. However, NiFe-based catalysts, considered as one of the most promising candidates for anode, encounter the bottleneck of high solubility at such temperatures. Herein, we discover that the dissolution of NiFe layered double hydroxides (NiFe-LDH) during operation not only leads to degradation of anode itself, but also deactivates cathode for water splitting, resulting in decay of overall electrocatalytic performance. Aiming to suppress the dissolution, we employed oxyanions as inhibitors in electrolyte. The added phosphates to the electrolyte inhibit the loss of NiFe-LDH active sites at 400â mA cm-2 to 1/3 of the original amount, thus reducing the rate of performance decay by 25-fold. Furthermore, the usage of borates, sulfates, and carbonates yields similar results, demonstrating the reliability and universality of the active site dissolution inhibitor, and its role in elevated water electrolysis.
RESUMEN
BACKGROUND AND OBJECTIVE: Clinical pharmacological modeling and statistical analysis software is an essential basic tool for drug development and personalized drug therapy. The learning curve of current basic tools is steep and unfriendly to beginners. The curve is even more challenging in cases of significant individual differences or measurement errors in data, resulting in difficulties in accurately estimating pharmacokinetic parameters by existing fitting algorithms. Hence, this study aims to explore a new optimized parameter fitting algorithm that reduces the sensitivity of the model to initial values and integrate it into the CPhaMAS platform, a user-friendly online application for pharmacokinetic data analysis. METHODS: In this study, we proposed an optimized Nelder-Mead method that reinitializes simplex vertices when trapped in local solutions and integrated it into the CPhaMAS platform. The CPhaMAS, an online platform for pharmacokinetic data analysis, includes three modules: compartment model analysis, non-compartment analysis (NCA) and bioequivalence/bioavailability (BE/BA) analysis. Our proposed CPhaMAS platform was evaluated and compared with existing WinNonlin. RESULTS: The platform was easy to learn and did not require code programming. The accuracy investigation found that the optimized Nelder-Mead method of the CPhaMAS platform showed better accuracy (smaller mean relative error and higher R2) in two-compartment and extravascular administration models when the initial value was set to true and abnormal values (10 times larger or smaller than the true value) compared with the WinNonlin. The mean relative error of the NCA calculation parameters of CPhaMAS and WinNonlin was <0.0001 %. When calculating BE for conventional, high-variability and narrow-therapeutic drugs. The main statistical parameters of the parameters Cmax, AUCt, and AUCinf in CPhaMAS have a mean relative error of <0.01% compared to WinNonLin. CONCLUSIONS: In summary, CPhaMAS is a user-friendly platform with relatively accurate algorithms. It is a powerful tool for analysing pharmacokinetic data for new drug development and precision medicine.
Asunto(s)
Algoritmos , Programas Informáticos , Modelos Teóricos , Preparaciones Farmacéuticas , Proyectos de InvestigaciónRESUMEN
Seawater electrolysis offers a renewable, scalable, and economic means for green hydrogen production. However, anode corrosion by Cl- pose great challenges for its commercialization. Herein, different from conventional catalysts designed to repel Cl- adsorption, we develop an atomic Ir catalyst on cobalt iron layered double hydroxide (Ir/CoFe-LDH) to tailor Cl- adsorption and modulate the electronic structure of the Ir active center, thereby establishing a unique Ir-OH/Cl coordination for alkaline seawater electrolysis. Operando characterizations and theoretical calculations unveil the pivotal role of this coordination state to lower OER activation energy by a factor of 1.93. The Ir/CoFe-LDH exhibits a remarkable oxygen evolution reaction activity (202 mV overpotential and TOF = 7.46 O2 s-1) in 6 M NaOH+2.8 M NaCl, superior over Cl--free 6 M NaOH electrolyte (236 mV overpotential and TOF = 1.05 O2 s-1), with 100% catalytic selectivity and stability at high current densities (400-800 mA cm-2) for more than 1,000 h.
RESUMEN
Monoclonal antibody drugs targeting proprotein convertase kwashiorkor type 9 (PCSK9) have recently demonstrated remarkable success in lipid-lowering therapies. Specifically, antibodies derived from immunoglobulin G1 (IgG1, alirocumab) and IgG2 (evolocumab) have been successfully utilized for this purpose. Recently, a novel recombinant fully human anti-PCSK9 monoclonal antibody, originally derived from IgG4 and designated as SAL003, was developed. This study aimed to explore the pharmacokinetics, efficacy, and safety of SAL003 in both single and multiple administrations. The investigation included both healthy individuals and individuals with hyperlipidemia. To comprehensively grasp the pharmacokinetic (PK) and pharmacodynamic (PD) attributes of SAL003, this study employed population PK-PD (popPK-PD) and mechanistic systems pharmacology (MSP) modeling. These models were employed for predicting low-density lipoprotein cholesterol (LDLc) concentrations and appropriate dosages across diverse potential clinical scenarios. The research results indicated that SAL003 demonstrated comparable pharmacokinetic properties to evolocumab, exhibited notable effectiveness in reducing lipid levels, and was confirmed to be safe and well-tolerated in both healthy individuals and individuals with hyperlipidemia. Notably, SAL003 displayed differing effectiveness between patients and healthy populations. This discrepancy was observed in the popPK-PD model, with a positive population influence on Emax, and the MSP model, indicating elevated PCSK9 clearance and LDLr-related LDLc clearance in the healthy group. Simulation results from the popPK-PD and MSP models indicated a dosage of 140 mg of Q4W and 420 mg of Q8W for phase II/III clinical trials. Reducing the drug dose or extending the dosing intervals may result in treatment failure. Additionally, the simultaneous use of statins led to elevated PCSK9 levels and intensified fluctuations in steady-state LDLc levels during SAL003 treatment.
RESUMEN
Electrocatalytic CO2 reduction (ECR) to high value-added chemicals is an excellent method to attenuate the impact of greenhouse effect caused by CO2. At the same time, multicarbon products (C2+) get extensive attention in view of their relatively high energy density and market price. At present, Cu is an important metal electrocatalyst to convert CO2 into multicarbon products (e.g. ethylene, ethanol, and n-propanol); however, its poor selectivity impedes its practical application. It is well-known that the Cu(100) crystal facet can enhance the selectivity toward multicarbon products among different Cu crystal facets. Herein, the Cu nanoparticles were firstly prepared using the inductive effect of different gases (CO2, CO, Ar, N2, and air) during the Cu electrodeposition processes, in which the CO2-induced Cu catalyst (Cu-CO2) showed the largest normalized content of the Cu(100) crystal facet and the highest C2+ faradaic efficiency of 69% at a current density of 80 mA cm-2 in ECR. Subsequently, the different CO2 pressures during the Cu electrodepositions were studied to reveal the optimal CO2 pressure in the CO2-induced Cu synthesis for improved Cu(100) content as well as C2+ faradaic efficiency. Finally, density functional theory (DFT) calculations confirmed that CO2 molecules preferred to get adsorbed on the Cu(100) crystal facet, which resulted in not only the presence of dominant Cu(100) during the CO2-induced Cu synthesis but also the good electrocatalytic performance in ECR.
RESUMEN
BACKGROUND: Nilaparvata lugens (brown planthopper; BPH) is a significant rice pest in Asia, causing substantial yield losses. Pyramiding BPH resistance genes with diverse resistance traits into rice cultivars is an effective strategy for pest management. However, the response of pyramiding combinations to environmental changes remains unclear. To address this knowledge gap, we investigated three pyramiding rice lines (BPH2 + 32, BPH9 + 32, and BPH18 + 32) in the context of varying climate change conditions, ensuring sufficient N. lugens-rice interactions. Thus, we set three environmental conditions [30/25 °C (day/night) with 500 ppm CO2 concentration, 32/27 °C (day/night) with 600 ppm CO2 concentration, and 35/30 °C (day/night) with 1000 ppm CO2 concentration]. RESULTS: All three pyramiding rice lines maintained the insect resistant ability under the three environmental settings. In particular, the BPH18 + 32 rice line exhibited stronger antibiotic and antixenosis effects against N. lugens. In addition, BPH18 + 32 rice line had better shoot resilience under N. lugens infestation, whereas the performance of the other two selected pyramiding rice lines varied. Thus, although BPH2, BPH9, and BPH18 represent three alleles at the same locus, their resistance levels against N. lugens may vary under distinct climate change scenarios, as evidenced by the performance of N. lugens on the three pyramiding rice lines. CONCLUSION: Our findings indicate that all three tested pyramiding rice lines maintained their insect resistance in the face of diverse climate change scenarios. However, these lines exhibited varied repellent responses and resilience capacities in response to climate change. Thus, the combination of pyramiding genes needs to be considered for future breeding programs. © 2023 Society of Chemical Industry.
Asunto(s)
Hemípteros , Oryza , Animales , Oryza/genética , Dióxido de Carbono , Cambio Climático , Fitomejoramiento , Hemípteros/genéticaRESUMEN
Simultaneous electrochemical reduction of nitrite and carbon dioxide (CO2 ) under mild reaction conditions offers a new sustainable and low-cost approach for urea synthesis. However, the development of urea electrosynthesis thus far still suffers from low selectivity due to the high energy barrier of * CO formation and the subsequent CâN coupling. In this work, a highly active dendritic Cu99 Ni1 catalyst is developed to enable the highly selective electrosynthesis of urea from co-reduction of nitrite and CO2 , reaching a urea Faradaic efficiency (FE) and production rate of 39.8% and 655.4 µg h-1 cm-2 , respectively, at -0.7 V versus reversible hydrogen electrode (RHE). In situ Fourier-transform infrared spectroscopy (FT-IR) measurements together with density functional theory (DFT) calculations demonstrate that Ni doping into Cu can significantly enhance the adsorption energetics of the key reaction intermediates and facilitate the CâN coupling. This work not only provides a new strategy to design efficient electrocatalysts for urea synthesis but also offers deep insights into the mechanism of CâN coupling during the co-reduction of nitrite and CO2 .
RESUMEN
BACKGROUND: Gay geosocial networking apps, also known as "gay apps," have gained increasing popularity in the men who have sex with men (MSM) community. Certain sexuality traits and gay app use are both associated with high-risk sexual behaviors among MSM. However, little is known about the underlying mechanism of such relationships. OBJECTIVE: Based on the uses and gratifications theory, this study aimed to test the mediation effect of gay app use on the relationship between sexuality traits (sexual compulsivity and sexual sensation seeking) and high-risk sexual behaviors (multiple sexual partners and unprotected anal intercourse) among MSM. METHODS: A cross-sectional, multicenter study was conducted in Wuhan and Changsha, China, from August to October 2020. A representative sample of 402 MSM was recruited through respondent-driven sampling. A self-administered web-based structured questionnaire was used to collect data on sociodemographic information, high-risk sexual behaviors, gay app use, sexual compulsivity, and sexual sensation seeking. Path analysis was conducted to assess the mediation effect. RESULTS: Our study revealed that 67.42% (n=271) of MSM used gay apps for seeking potential sexual partners, with 37.06% (n=149) of them engaging in unprotected anal intercourse, and 45.42% (n=218) of them having multiple sexual partners. Of the participants, 17.16% (n=69) reported significant sexual compulsivity, while 29.10% (n=117) reported significant sexual sensation seeking. Notably, gay app usage partially mediated the relationship between sexual compulsivity and multiple sexual partners but fully mediated the relationship between sexual compulsivity and unprotected anal intercourse. Furthermore, gay app usage partially mediated the relationship between sexual sensation seeking and multiple sexual partners but fully mediated the relationship between sexual sensation seeking and unprotected anal intercourse. CONCLUSIONS: High-risk sexual behaviors are common among MSM. Most MSM rely on gay apps to find sexual partners, which, when combined with higher levels of sexual compulsivity and sexual sensation seeking, can increase the likelihood of engaging in high-risk sexual behaviors. Therefore, interventions aimed at reducing these behaviors among MSM should focus on addressing the use of gay apps, while also considering the influence of their sexuality traits on gay app use.
Asunto(s)
Aplicaciones Móviles , Minorías Sexuales y de Género , Masculino , Humanos , Homosexualidad Masculina , Análisis de Mediación , Estudios Transversales , Sexualidad , ChinaRESUMEN
The exposure to ticagrelor (BRILINTA) is higher in the East Asian population compared with the White population, thus, East Asians have an increased risk of bleeding. We developed a population pharmacokinetic (PopPK) model of ticagrelor based on a randomized 3 × 3 crossover study in healthy subjects. The area under the concentration-time curve (AUC) of Chinese patients with acute coronary syndrome was simulated based on this model. Following this, eight machine learning (ML) methods were used to construct bleeding risk models. Variables included in the final bleeding risk model were age, hypertension, body weight, AUC, drinking status, calcium channel blockers, antidiabetic medications, ß-blockers, peripheral vascular disease, diabetes, transient ischemic attack, sex, and proton pump inhibitor. In terms of F1 scores and area under the curve of receiver operating characteristic curve (ROC-AUC), the Random Forest model performed best among all models, with an F1 score of 0.73 and ROC-AUC of 0.81. Moreover, the PopPK model and ML algorithm were used to bridge the real-world data to build a bleeding risk prediction model based on drug exposure and clinical information. Using this model, a ticagrelor regimen that is associated with a lower risk of bleeding in individuals can be obtained. This model should be further validated prospectively in clinical settings.
Asunto(s)
Síndrome Coronario Agudo , Inhibidores de Agregación Plaquetaria , Ticagrelor , Humanos , Síndrome Coronario Agudo/tratamiento farmacológico , China/epidemiología , Estudios Cruzados , Hemorragia/inducido químicamente , Hemorragia/epidemiología , Inhibidores de Agregación Plaquetaria/efectos adversos , Ticagrelor/efectos adversos , Resultado del Tratamiento , Ensayos Clínicos Controlados Aleatorios como Asunto , Masculino , FemeninoRESUMEN
The direct seawater electrolysis at high current density and low overpotential affords an effective strategy toward clean and renewable hydrogen fuel production. However, the severe corrosion of anode as a result of the saturation of Cl- upon continuous seawater feeding seriously hamper the electrolytic process. Herein, cobalt ferricyanide / cobalt phosphide (CoFePBA/Co2 P) anodes with Cap/Pin structure are synthesized, which stably catalyze alkaline saturated saline water oxidation at 200-2000â mA cm-2 over hundreds of hours without corrosion. Together with the experimental findings, the molecular dynamics simulations reveal that PO4 3- and Fe(CN)6 3- generated by the electrode play synergistic role in repelling Cl- via electrostatic repulsion and dense coverage, which reduced Cl- adsorption by nearly 5-fold. The novel anionic synergy endow superior corrosion protection for the electrode, and is expected to promote the practical application of saline water electrolysis.
RESUMEN
PURPOSE: This study aimed to assess the pharmacokinetics, safety, and efficacy of GM1 in healthy Chinese subjects and patients with multiple myeloma. METHODS: The data used in this study was derived from two dose-escalation trials: GM1-101, involving 70 healthy subjects, and GM1-201, which included 160 multiple myeloma patients. Population pharmacokinetics (PopPK) analysis was conducted on a subset of 90 participants using a nonlinear mixed-effects approach, and potential covariates were explored quantitatively. Observations of any abnormalities in vital signs, physical examinations, laboratory tests, and electrocardiograms during the study period, along with any spontaneously reported and directly observed adverse events, were documented for safety evaluation. Furthermore, neurotoxicity scales were used to assess the efficacy of GM1 as a prophylaxis for chemotherapy-induced peripheral neuropathy and to perform exposure-response analyses in conjunction with pharmacokinetic parameters. RESULTS: A one-compartment model with first-order elimination best characterized the pharmacokinetics of GM1. The clearance and volume of distribution, as estimated by the final model, were 0.0942 L/h and 3.27 L for GM1-A, and 0.0714 L/h and 2.82 L for GM1-B, respectively. Covariates such as sex, body weight, and albumin significantly influenced pharmacokinetic parameters, yet the variation in steady-state exposure between subjects and reference subjects was less than 45% within their 90% confidence interval. Adverse reactions related to GM1 occurred in 20 (28.6%) and 57 (35.6%) subjects in the GM1-101 and GM1-201 cohorts, respectively. The changes in TNSc and FACT-Ntx scores from baseline at the end of periods 4 and 6 were lower in each GM1 dose group compared to the blank control group. The 400 mg dose group of GM1 displayed greater effectiveness than other dose groups. However, exposure-response analysis revealed no significant modification in efficacy with increasing GM1 exposure. CONCLUSIONS: This study provides the first population pharmacokinetic analysis of GM1. GM1 exhibits a favorable safety profile among healthy subjects and patients with multiple myeloma. GM1 proved effective in mitigating chemotherapy-induced peripheral neuropathy, but this study observed no significant correlation between its efficacy and exposure. TRIAL REGISTRATION NUMBERS: ChiCTR2000041283 and ChiCTR2000041283.
Asunto(s)
Antineoplásicos , Mieloma Múltiple , Enfermedades del Sistema Nervioso Periférico , Humanos , Gangliósido G(M1) , Voluntarios Sanos , Mieloma Múltiple/tratamiento farmacológico , Enfermedades del Sistema Nervioso Periférico/inducido químicamente , Antineoplásicos/efectos adversosRESUMEN
Developing highly efficient hydrogen oxidation reaction (HOR) electrocatalysts in alkaline media is of great significance for anion exchange membrane fuel cells (AEMFCs). Herein, we report an efficient Ru-doped hexagonal tungsten trioxide (Ru-WO3) HOR electrocatalyst through a hydrothermal strategy. The prepared Ru-WO3 electrocatalyst exhibits enhanced HOR performance with a 6.1 times higher exchange current density and better durability than commercial Pt/C. Structural characterizations and theoretical calculations reveal that the uniformly distributed Ru was modulated by oxygen defects and the electron transfer from O to Ru modulated the H* adsorption of Ru sites. In addition, plenty of W sites can serve as hydroxyl adsorption sites to accelerate the HOR kinetics. This work not only provides an efficient HOR catalyst in alkaline media, but also promotes the fundamental understanding of the effect of modulation on the adsorption of H* and *OH in tungsten oxides with a relatively low oxidation state by Ru doping, broadening the range of HOR catalysts to Ru-doped metal oxides.
RESUMEN
Electrocatalytic two-electron water oxidation affords a promising approach for distributed production of H2O2 using electricity. However, it suffers from the trade-off between the selectivity and high production rate of H2O2 due to the lack of suitable electrocatalysts. In this study, single atoms of Ru were controllably introduced into titanium dioxide to produce H2O2 through an electrocatalytic two-electron water oxidation reaction. The adsorption energy values of OH intermediates could be tuned by introducing Ru single atoms, offering superior H2O2 production under high current density. Notably, a Faradaic efficiency of 62.8% with an H2O2 production rate of 24.2 µmol min-1 cm-2 (>400 ppm within 10 min) was achieved at a current density of 120 mA cm-2. Consequently, herein, the possibility of high-yield H2O2 production under high current density was demonstrated and the importance of regulating intermediate adsorption during electrocatalysis was evidenced.
RESUMEN
Electrochemical reduction of nitrite (NO2 - ) offers an energy-efficient route for ammonia (NH3 ) synthesis and reduction of the level of nitrite, which is one of the major pollutants in water. However, the near 100 % Faradaic efficiency (FE) has yet to be achieved due to the complicated reduction route with several intermediates. Here, we report that carbon dioxide (CO2 ) can enhance the nitrite electroreduction to ammonia on copper nanowire (Cu NW) catalysts. In a broad potential range (-0.7â¼-1.3â V vs. RHE), the FE of nitrite to ammonia is close to 100 % with a 3.5-fold increase in activity compared to that obtained without CO2. In situ Raman spectroscopy and density functional theory (DFT) calculations indicate that CO2 acts as a catalyst to facilitate the *NO to *N step, which is the rate determining step for ammonia synthesis. The promotion effect of CO2 can be expanded to electroreduction of other nitro-compounds, such as nitrate to ammonia and nitrobenzene to aniline.
RESUMEN
Developing highly active, durable, and cost-effective electrocatalysts for the oxygen evolution reaction (OER) is of prime importance in proton exchange membrane (PEM) water electrolysis techniques. Ru-based catalysts have high activities but always suffer from severe fading and dissolution issues, which cannot satisfy the stability demand of PEM. Herein, a series of iridium-doped yttrium ruthenates pyrochlore catalysts is developed, which exhibit better activity and much higher durability than commercial RuO2 , IrO2 , and most of the reported Ru or Ir-based OER electrocatalysts. Typically, the representative Y2 Ru1.2 Ir0.8 O7 OER catalyst demands a low overpotential of 220 mV to achieve 10 mA cm-2 , which is much lower than that of RuO2 (300 mV) and IrO2 (350 mV). In addition, the catalyst does not show obvious performance decay or structural degradation over a 2000 h stability test. EXAFS and XPS co-prove the reduced valence state of ruthenium and iridium in pyrochlore contributes to the improved activity and stability. Density functional theory reveals that the potential-determining steps barrier of OOH* formation is greatly depressed through the synergy effect of Ir and Ru sites by balancing the d band center and oxygen intermediates binding ability.
RESUMEN
Background: Warfarin is an effective treatment for thromboembolic disease but has a narrow therapeutic index, and dosage can differ tremendously among individuals. The study aimed to develop an individualized international normalized ratio (INR) model based on time series anticoagulant data and simulate individualized warfarin dosing. Methods: We used a long short-term memory (LSTM) network to develop an individualized INR model based on data from 4,578 follow-up visits, including clinical and genetic factors from 624 patients whom we enrolled in our previous randomized controlled trial. The data of 158 patients who underwent valvular surgery and were included in a prospective registry study were used for external validation in the real world. Results: The prediction accuracy of LSTM_INR was 70.0%, which was much higher than that of MAPB_INR (maximum posterior Bayesian, 53.9%). Temporal variables were significant for LSTM_INR performance (51.7 vs. 70.0%, P < 0.05). Genetic factors played an important role in predicting INR at the onset of therapy, while after 15 days of treatment, we found that it might unnecessary to detect genotypes for warfarin dosing. Using LSTM_INR, we successfully simulated individualized warfarin dosing and developed an application (AI-WAR) for individualized warfarin therapy. Conclusion: The results indicate that temporal variables are necessary to be considered in warfarin therapy, except for clinical factors and genetic factors. LSTM network may have great potential for long-term drug individualized therapy. Trial Registration: NCT02211326; www.chictr.org.cn:ChiCTR2100052089.