Applying interval stability concept to empirical model of middle Pleistocene transition.

Interval stability is a novel method for the study of complex dynamical systems, allowing for the estimation of their stability to strong perturbations. This method describes how large perturbation should be to disrupt the stable dynamical regime of the system (attractor). In our work, interval stability is used for the first time to study the properties of a real natural system: to analyze the stability of the earth's climate system during the last 2.6×106 years. The main abrupt shift in global climate during this period is the middle Pleistocene transition (MPT), which occurred about 1×106 years ago as a change of the periodicity of glacial cycles from 41 to 100 kyr. On the basis of the empirical nonlinear stochastic model proposed in our recent work, we demonstrate that the global climate stability to any perturbations decreases throughout the Pleistocene period (including the MPT), enhancing its response to fast (with a millennial scale or less) internal disturbances.

Flavone inspired discovery of benzylidenebenzofuran-3(2H)-ones (aurones) as potent inhibitors of human protein kinase CK2.

In this work, we describe the design, synthesis and SAR studies of 2-benzylidenebenzofuran-3-ones (aurones), a new family of potent inhibitors of CK2. A series of aurones have been synthesized. These compounds are structurally related to the synthetic flavones and showed nanomolar activities towards CK2. Biochemical tests revealed that 20 newly synthesized compounds inhibited CK2 with IC50 values in the nanomolar range. Further property-based optimization of aurones was performed, yielding a series of CK2 inhibitors with enhanced lipophilic efficiency. The most potent compound 12m (BFO13) has CLipE = 4.94 (CLogP = 3.5; IC50 = 3.6 nM) commensurable with the best known inhibitors of CK2.

Long-term tolerability, immunogenicity and efficacy of Nuwiq® (human-cl rhFVIII) in children with severe haemophilia A.

INTRODUCTION: Nuwiq® (human-cl rhFVIII, simoctocog alfa) is a 4th generation recombinant human FVIII, without chemical modification or fusion with any other protein, produced in a human cell line. AIM/METHODS: This study (GENA-13) was an extension of the GENA-03 study in which previously treated children aged 2-12 years with severe haemophilia A received Nuwiq® prophylaxis for ≥6 months. GENA-13 examined long-term tolerability, immunogenicity and efficacy of Nuwiq® prophylaxis in children. RESULTS: Of 59 patients enrolled in GENA-03, 49 continued Nuwiq® prophylaxis in GENA-13 for a median (range) of 30.0 (9.5-52.0) months. No patient withdrew due to drug-related adverse events or developed inhibitors. Only 2 of 20 518 infusions were associated with possibly related adverse events (dyspnoea, fever). The estimated annualized bleeding rate (ABR) was 0.67 (95% CI: 0.44, 1.02) for spontaneous and 2.88 (95% CI: 1.86, 4.46) for all bleeds. Younger children (2-5 years) had lower ABRs than children aged 6-12 years. Annualized bleeding rates were reduced in GENA-13 vs GENA-03, especially for spontaneous bleeds in younger children (71% reduction; ABR ratio 0.29 [95% CI: 0.11, 0.74]). Nuwiq® efficacy was rated as excellent/good in the treatment of 83.0% of 305 evaluated breakthrough bleeds. Surgical prophylaxis with Nuwiq® was rated as excellent for all 17 assessed procedures. CONCLUSION: Long-term treatment with Nuwiq® for the prevention of bleeds in children with severe haemophilia A was well tolerated, effective and reduced spontaneous bleeding by up to 70% compared with GENA-03.

Low incidence of factor VIII inhibitors in previously untreated patients with severe haemophilia A treated with octanate® : Final report from a prospective study.

INTRODUCTION: Octanate® is a human, plasma-derived, von Willebrand factor-stabilized coagulation factor VIII (FVIII) concentrate with demonstrated haemostatic efficacy in previously treated patients with haemophilia A. AIM: This prospective, open-label study aimed to assess the immunogenicity of octanate® in previously untreated patients (PUPs). METHODS: The study monitored development of FVIII inhibitors in 51 PUPs. Tolerability, viral safety, FVIII recovery and efficacy of octanate® for the prevention and treatment of bleeds and in surgical procedures were also assessed. RESULTS: Five (9.8%) of the 51 patients developed inhibitors during the study, 4 of which (7.8%) were high titre. Three inhibitor cases (5.9%) were considered clinically relevant; 2 were transient inhibitors that disappeared during regular octanate® treatment without a change in dose or treatment frequency. Amongst 45 patients with FVIII:C <1% at baseline and who received ≥20 exposure days (EDs) or had <20 EDs but developed an inhibitor, inhibitor incidence was 11.1% (6.7% clinically relevant). All clinically relevant inhibitors developed within 20 EDs of on-demand treatment. No inhibitors developed in PUPs receiving prophylaxis. All patients who developed inhibitors had either intron 22 inversions or large deletions. Irrespective of the reason for administration, haemostatic efficacy was rated as "excellent" in 99.6% of all infusions (4700 of 4717 infusions), and no complications were reported in 23 surgical procedures. Mean incremental in vivo recovery was 2.0%/IU/kg (±0.7) and 1.9%/IU/kg (±0.5) for the first and second assessments, respectively. Tolerability was rated "very good" in 99.9% of infusions. CONCLUSION: In PUPs with severe haemophilia A, octanate® demonstrated haemostatic efficacy with a low rate of inhibitor development.

Immunogenicity, efficacy and safety of Nuwiq® (human-cl rhFVIII) in previously untreated patients with severe haemophilia A-Interim results from the NuProtect Study.

INTRODUCTION: Nuwiq® (Human-cl rhFVIII) is a fourth generation recombinant FVIII, produced in a human cell line, without chemical modification or protein fusion. No inhibitors developed in studies with Nuwiq® in 201 previously treated patients with haemophilia A (HA). The immunogenicity, efficacy and safety of Nuwiq® in previously untreated patients (PUPs) with severe HA are being assessed in the ongoing NuProtect study. METHODS: The study, conducted across 38 centres worldwide, is evaluating 110 true PUPs of all ages and ethnicities enrolled for study up to 100 exposure days (EDs) or 5 years maximum. The primary objective is to assess the immunogenicity of Nuwiq® (inhibitor activity ≥0.6 BU) using the Nijmegen-modified Bethesda assay at a central laboratory. RESULTS: Data for 66 PUPs with ≥20 EDs from a preplanned interim analysis were analysed. High-titre (HT) inhibitors developed in 8 of 66 patients after a median of 11.5 EDs (range 6-24). Five patients developed low-titre inhibitors (4 transient). The cumulative incidence (95% confidence interval) was 12.8% (4.5%, 21.2%) for HT inhibitors and 20.8% (10.7%, 31.0%) for all inhibitors. During inhibitor-free periods, median annualized bleeding rates during prophylaxis were 0 for spontaneous bleeds and 2.40 for all bleeds. Efficacy was rated as "excellent" or "good" in treating 91.8% of bleeds. Efficacy of surgical prophylaxis was "excellent" or "good" for 8 (89%) procedures and "moderate" for 1 (11%). No tolerability concerns were evident. CONCLUSION: These interim data show a cumulative incidence of 12.8% for HT inhibitors and convincing efficacy and tolerability in PUPs treated with Nuwiq® .

Fluorinated graphene suspension for inkjet printed technologies.

The possibility to control the size of the flakes of graphene suspension in the course of their fluorination in an aqueous hydrofluoric acid solution was demonstrated. The effect of the suspension composition, the fluorination time, temperature and thermal stress on the fragmentation process was investigated. The corrugation of suspension flakes, which occurs at fluorination due to a difference in the constants of graphene and fluorographene lattices, leads to the appearance of nonuniform mechanical stresses. The fact that the flake size after fragmentation is determined by the size of corrugation allows the assumption that the driving force of fragmentation is this mechanical stress. This assumption is confirmed by the break of the corrugated layers from flakes under thermal stress. Moreover, fluorination treatment at elevated temperatures (∼70 °C) significantly accelerates the fragmentation process. Suspensions of fluorinated graphene with nanometer size flakes are of interest for the development of 2D ink-jet printing technologies and production of thermally and chemically stable dielectric films for nanoelectronics. The printed fluorinated graphene films on silicon and flexible substrates have been demonstrated and the charges in metal-insulator-semiconductor structures have been estimated as the ultra low values of (0.5-2) × 10(10) cm(-2).

First prospective report on immune tolerance in poor risk haemophilia A inhibitor patients with a single factor VIII/von Willebrand factor concentrate in an observational immune tolerance induction study.

INTRODUCTION/BACKGROUND: Development of neutralizing inhibitors against factor VIII (FVIII) is a major complication of haemophilia A treatment. AIM: The ongoing, international, open-label, uncontrolled, observational immune tolerance induction (ObsITI) study evaluates ITI, the standard of care in patients with inhibitors. PATIENTS/METHODS: Forty-eight prospective patients in this interim analysis received a single plasma-derived, von Willebrand factor-stabilized, FVIII concentrate (pdFVIII/VWF) for ITI. According to recommended Bonn protocol, 'low responders' at ITI start (<5 BU) received 50-100 IU FVIII kg(-1) daily, or every other day; 'high responders' (≥5 BU) received 100 IU FVIII kg(-1) every 12 h. RESULTS: Forty of 48 patients (83.3%), had at least one risk factor for poor ITI-prognosis at ITI start (i.e. age ≥7 years, >2 years since inhibitor diagnosis, inhibitor titre ≥10 BU at the start of ITI, or prior ITI failure). Nonetheless, 34 patients (70.8%) achieved complete success, 3 (6.3%) partial success, 1 (2.1%) partial response; ITI failed in 10 patients (20.8%), all with poor prognosis factors. All six low responders achieved complete success. ITI outcome was significantly associated with inhibitor titre level at ITI start (P = 0.0068), number of poor prognosis factors for ITI success (P = 0.0187), monthly bleeding rate during ITI (P = 0.0005) and peak inhibitor titre during ITI (P = 0.0007). Twenty-two of 35 high responder patients (62.9%) with ≥1 poor prognosis factor achieved complete success. CONCLUSION: Treatment with a single pdFVIII/VWF concentrate, mainly according to the Bonn protocol, resulted in a high ITI success rate in haemophilia A patients with inhibitors and poor prognosis for ITI success.

Novel, human cell line-derived recombinant factor VIII (Human-cl rhFVIII, Nuwiq® ) in children with severe haemophilia A: efficacy, safety and pharmacokinetics.

INTRODUCTION: Nuwiq® (Human-cl rhFVIII) is a new-generation recombinant factor VIII (rFVIII) protein, without chemical modification or fusion to any other protein, produced in a human cell line. AIM/METHODS: This prospective, open-label, multinational phase III study assessed the efficacy and safety of Human-cl rhFVIII in 59 previously treated patients (PTPs) with severe haemophilia A aged 2-12 years (2-5 [N = 29]; 6-12 [N = 30]) during standard prophylaxis (≥50 exposure days and ≥6 months). Efficacy in treating breakthrough bleeds and during surgical prophylaxis was also assessed. RESULTS: An initial pharmacokinetic assessment (N = 13 per age subgroup) demonstrated comparable results with the one-stage and chromogenic assays. Mean (SD) half-life was 11.9 (5.4) and 13.1 (2.6) hours in children aged 2-5 years and 6-12 years respectively (one-stage assay). Prophylactic efficacy, based on mean monthly bleeding rate, was 'excellent' or 'good' in 91.5% of children for all bleeds and in 96.6% of children for spontaneous bleeds. Mean (SD) annualized bleeding rate was 4.12 (5.22) [median 1.9] for all bleeds, 1.50 (3.32) [median 0] for spontaneous bleeds and 2.34 (3.54) [median 1.57] for traumatic bleeds. There were no major, life-threatening bleeds. Efficacy was 'excellent' or 'good' in the treatment of 82.4% of breakthrough bleeds. Overall efficacy during five major surgeries was rated as 'excellent'. There were no FVIII inhibitors or treatment-related serious adverse events. CONCLUSION: These results in paediatric PTPs indicate that Human-cl rhFVIII is effective for the prevention and treatment of bleeds.

Fluorinated graphene dielectric films obtained from functionalized graphene suspension: preparation and properties.

In the present study, we have examined the interaction between a suspension of graphene in dimethylformamide and an aqueous solution of hydrofluoric acid, which was found to result in partial fluorination of suspension flakes. A considerable decrease in the thickness and lateral size of the graphene flakes (up to 1-5 monolayers in thickness and 100-300 nm in diameter) with increasing duration of fluorination treatment is found to be accompanied by a simultaneous transition of the flakes from the conducting to the insulating state. Smooth and uniform insulating films with a roughness of ∼2 nm and thicknesses down to 20 nm were deposited from the suspension on silicon. The electrical and structural properties of the films suggest their use as insulating elements in thin-film nano- and microelectronic device structures. In particular, it was found that the films prepared from the fluorinated suspension display rather high breakdown voltages (field strength of (1-3) × 10(6) V cm(-1)), ultralow densities of charges in the film and at the interface with the silicon substrate in metal-insulator-semiconductor structures (∼(1-5) × 10(10) cm(-2)). Such excellent characteristics of the dielectric film can be compared only to well-developed SiO2 layers. The films from the fluorinated suspension are cheap, practically feasible and easy to produce.

[Elimination of the activating influence of emotional stress on hemostasis mild hypothermia action].

The state of the hemostatic system in the psycho-emotional and hypothermia in rats. It is shown that the psycho-emotional impact is accompanied by a hypercoagulable. "Clean" effect of hypothermia is characterized by the activation of anticoagulation and fibrinolysis. Thus, we have shown that the general hypothermia in the aquatic environment has a more pronounced effect on the hemostatic system than the psycho-emotional impact.

Results from a large multinational clinical trial (guardian™3) using prophylactic treatment with turoctocog alfa in paediatric patients with severe haemophilia A: safety, efficacy and pharmacokinetics.

Recombinant factor VIII (rFVIII) products provide a safe and efficacious replacement therapy for prophylaxis and treatment of bleeding episodes in patients with severe haemophilia A. This multinational, open-label, non-controlled trial investigated the safety, efficacy and pharmacokinetics (PK) of turoctocog alfa, a new rFVIII product, in a paediatric population. The primary objective was to evaluate safety. A total of 31 younger children (0-5 years) and 32 older children (6-11 years), with ≥ 50 exposure days to any factor VIII (FVIII) product and no history of inhibitors, received prophylaxis with turoctocog alfa (25-50 IU kg(-1) every second day or 25-60 IU kg(-1) three times weekly). PK assessments of turoctocog alfa and the patients' previous FVIII product were performed in 28 patients. Mean exposure to turoctocog alfa was 60 exposure days per patient. This corresponds to approximately 4.5 months in the trial. None of the patients developed inhibitors (≥ 0.6 BU) and no safety concerns were raised. A total of 120 bleeding episodes (95%) were controlled with 1-2 infusions of turoctocog alfa. Based on patient reports, the success rate (defined as 'excellent' or 'good' haemostatic response) for treatment of bleeding episodes was 92%. Overall, the median annualized bleeding rate was 3.0 (interquartile range: 8.5) bleeds patient(-1) year(-1) . PK parameters were comparable between the two age groups. In conclusion, the present large global clinical trial showed that turoctocog alfa was safe, effective in treatment of bleeding episodes and had a prophylactic effect in paediatric patients.

[Peculiarities of hemostasis reactivity under stress load in persons with different degree of physical training].

Healthy young persons with different degrees of physical training have been impacted with exposure to a stress (a single physical exercise). It caused unidirectional hypercoagulative shifts and activation of anticoagulant and fibrinolytic blood systems. It was shown that changes of the untrained individuals' haemostatic parameters could be adjusted with adaptogen preliminary administration. The adaptogen administration in trained individuals resulted in disadaptive shifts in the haemostatic system. These contradictory changes indicate different levels of subject's adaptive potential.

[Hemostasis changes and their correction by adaptogen].

The paper presents an investigation into the changes in the hemostasis system of rats during extreme exercises. It has been observed that a single two-hour swimming exercise and an eight-hour imposed running in the treadbahn are accompanied by the expressed shifts in hypercoagulation with the signs of thrombinemia. On the background of the decrease in the anticoagulative and fibrinolytic activity it creates a serious threat of intravascular blood coagulation. The preliminary thirty-day course of extractum Eleutherococci eliminated the signs of intravascular blood coagulation.

Efficacy and safety of OCTANINE F in children with haemophilia B.

OCTANINE F is a high-purity blood clotting factor IX concentrate that has been shown to be effective and safe in adults with haemophilia B. At present, there are no prospective clinical study data on FIX replacement therapy in young children. The primary objective of this trial was to investigate the immunogenicity of OCTANINE F in children aged <6 years with haemophilia B. Secondary objectives were to assess the efficacy, viral safety and tolerability of OCTANINE F in this patient population. Twenty-five children aged <6 years with moderate or severe haemophilia B, including six who were previously untreated and 13 who had less than previous 50 exposure days were assigned to prophylactic or on-demand treatment with OCTANINE F over a 12- to 24-month period. Immunogenicity was assessed at baseline, during the treatment period and at the end of treatment by monitoring the levels of inhibitor. OCTANINE F was not associated with the development of an inhibitor in any patient during the study; all patients had a FIX inhibitor level of <0.4 Bethesda units (BU) for all samples taken throughout the study. The efficacy of OCTANINE F was rated as excellent in 96.4% of 499 bleeding episodes and tolerability was rated as very good in 97% of 1684 injections. OCTANINE F was shown to be effective and well tolerated in children aged <6 years with moderate or severe haemophilia B, including previously untreated patients, with no reported cases of FIX inhibitors or thrombotic events.

[Effect of eleutherococcus on hemostasis in immobilized rats].

The influence of a chronic (30 days) administration of an eleutherococcus extract on the haemostatic system state was studied in immobilized rats. A 3-h immobilization of untreated animals is accompanied by hypercoagulation and thrombinemia signs on the background of downregulation of the anticoagulant and fibrinolytic activity, which leads to a risk of thrombosis. Preliminary 30-day course of eleutherococcus uptake prevents the immobilization-induced thrombosis in rats.

[Blood vessels of the pancreatic islets in different portions of the adult human pancreas]. / Krovenosnye sosudy pankreaticheskikh ostrovkov v razlichnykh otdelakh podzheludochnoi zhelezy u vzroslogo cheloveka.

The pancreatic islets and their blood vessels have been studied in the head, the body and the tail of the human pancreas. The following methods have been applied: injection, histological and quantitative estimation, graphic and plastic reconstruction. A rather great variability in the form of the pancreatic islets has been stated, with presence of one--two peculiar processes in large islets. In different parts of the pancreatic gland, relative volume of the endocrine parenchyma has been stated to be statistically greater (2.16 +/- 0.45%) in the caudal portion than in the head of the gland (1.31 +/- 0.26%). In every pancreatic islet an afferent arterial vessel is described, two types of its branching are determined: magistral and scattered. Relative volume of the pancreatic islets and morpho-functional coefficient reflecting the ratio of the capillary surface area to the volume of the islet capillaries in different parts of the pancreatic gland have been estimated.