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1.
Front Mol Biosci ; 11: 1399225, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38962283

RESUMO

Periostin is a matricellular protein encoded by the POSTN gene that is alternatively spliced to produce ten different periostin isoforms with molecular weights ranging from 78 to 91 kDa. It is known to promote fibrillogenesis, organize the extracellular matrix, and bind integrin-receptors to induce cell signaling. As well as being a key component of the wound healing process, it is also known to participate in the pathogenesis of different diseases including atopic dermatitis, asthma, and cancer. In both health and disease, the functions of the different periostin isoforms are largely unknown. The ability to precisely determine the isoform profile of a given human sample is fundamental for characterizing their functional significance. Identification of periostin isoforms is most often carried out at the transcriptional level using RT-PCR based approaches, but due to high sequence homogeneity, identification on the protein level has always been challenging. Top-down proteomics, where whole proteins are measured by mass spectrometry, offers a fast and reliable method for isoform identification. Here we present a fully developed top-down mass spectrometry assay for the characterization of periostin splice isoforms at the protein level.

2.
Transl Psychiatry ; 14(1): 277, 2024 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-38965230

RESUMO

The mechanisms contributing to alcohol use disorder (AUD) are complex and the orexigenic peptide ghrelin, which enhances alcohol reward, is implied as a crucial modulator. The major proportion of circulating ghrelin is however the non-octanoylated form of ghrelin, des-acyl ghrelin (DAG), whose role in reward processes is unknown. As recent studies show that DAG decreases food intake, we hypothesize that DAG attenuates alcohol-related responses in animal models. Acute and repeated DAG treatment dose-dependently decreased alcohol drinking in male and female rats. In these alcohol-consuming male rats, repeated DAG treatment causes higher levels of dopamine metabolites in the ventral tegmental area, an area central to reward processing. The role of DAG in reward processing is further supported as DAG prevents alcohol-induced locomotor stimulation, reward in the conditioned place preference paradigm, and dopamine release in the nucleus accumbens in male rodents. On the contrary, DAG does not alter the memory of alcohol reward or affect neurotransmission in the hippocampus, an area central to memory. Further, circulating DAG levels are positively correlated with alcohol drinking in female but not male rats. Studies were conducted in attempts to identify tentative targets of DAG, which currently are unknown. Data from these recombinant cell system revealed that DAG does not bind to either of the monoamine transporters, 5HT2A, CB1, or µ-opioid receptors. Collectively, our data show that DAG attenuates alcohol-related responses in rodents, an effect opposite to that of ghrelin, and contributes towards a deeper insight into behaviors regulated by the ghrelinergic signaling pathway.


Assuntos
Consumo de Bebidas Alcoólicas , Dopamina , Grelina , Núcleo Accumbens , Recompensa , Área Tegmentar Ventral , Animais , Grelina/farmacologia , Grelina/metabolismo , Masculino , Ratos , Feminino , Dopamina/metabolismo , Área Tegmentar Ventral/metabolismo , Área Tegmentar Ventral/efeitos dos fármacos , Núcleo Accumbens/metabolismo , Núcleo Accumbens/efeitos dos fármacos , Etanol/farmacologia , Etanol/administração & dosagem , Humanos , Hipocampo/metabolismo , Hipocampo/efeitos dos fármacos , Ratos Sprague-Dawley
3.
BMJ Lead ; 2024 Jul 11.
Artigo em Inglês | MEDLINE | ID: mdl-38991736

RESUMO

BACKGROUND: Academic institutions benefit from researchers adopting leadership positions and, subsequently, leadership development programmes are of increasing importance. Despite this, no evaluation of the evidence basis for leadership development programmes for healthcare researchers has been conducted. In this study, the authors reviewed leadership development programmes for healthcare researchers and aimed to identify their impact and the factors which influenced this impact. METHODS: The authors searched MEDLINE, EMBASE, CINAHL and PsycINFO between January 2000 and January 2023 for evaluations of leadership development programmes with healthcare researchers. The authors synthesised results through exploratory meta-analysis and meta-aggregation and used the Medical Education Research Study Quality Instrument (MERSQI) and Joanna Briggs Institute (JBI) Checklist for Qualitative Studies to identify higher-reliability studies. RESULTS: 48 studies met inclusion criteria, of which approximately half (22) met the criteria for higher reliability. The median critical appraisal score was 10.5/18 for the MERSQI and 3.5/10 for the JBI. Common causes of low study quality appraisal related to study design, data analysis and reporting. Evaluations principally consisted of questionnaires measuring self-assessed outcomes. Interventions were primarily focused on junior academics. Overall, 163/168 categorised programme outcomes were positive. Coaching, experiential learning/project work and mentoring were associated with increased organisational outcomes. CONCLUSION: Educational methods appeared to be more important for organisational outcomes than specific educational content. To facilitate organisational outcomes, educational methods should include coaching, project work and mentoring. Programmes delivered by external faculty were less likely to be associated with organisational outcomes than those with internal or mixed faculty, but this needs further investigation. Finally, improving evaluation design will allow educators and evaluators to more effectively understand factors which are reliably associated with organisational outcomes of leadership development.

4.
Biochim Biophys Acta Proteins Proteom ; 1872(5): 141031, 2024 Jul 06.
Artigo em Inglês | MEDLINE | ID: mdl-38977230

RESUMO

Periostin is a matricellular protein known to be alternatively spliced to produce ten isoforms with a molecular weight of 78-91 kDa. Within the extracellular matrix, periostin attaches to cell surfaces to induce signaling via integrin-binding and actively participates in fibrillogenesis, orchestrating the arrangement of collagen in the extracellular environment. In atopic diseases such as atopic dermatitis (AD) and asthma, periostin is known to participate in driving the disease-causing type 2 inflammation. The periostin isoforms expressed in these diseases and the implication of the alternative splicing events are unknown. Here, we present two universal assays to map the expression of periostin isoforms at the mRNA (RT-qPCR) and protein (PRM-based mass spectrometry) levels. We use these assays to study the splicing profile of periostin in AD lesions as well as in in vitro models of AD and asthma. In these conditions, periostin displayed overexpression with isoforms 3 and 5 standing out as highly overexpressed. Notably, isoforms 9 and 10 exhibited a divergent pattern relative to the remaining isoforms. Isoforms 9 and 10 are often overlooked in periostin research and this paper presents the first evidence of their expression at the protein level. This underlines the necessity to include isoforms 9 and 10 in future research addressing periostin splice isoforms. The assays presented in this paper hold the potential to improve our insight into the splicing profile of periostin in tissues and diseases of interest. The application of these assays to AD lesions and in vitro models demonstrated their potential for identifying isoforms of particular significance, warranting a further in-depth investigation.

5.
Front Pediatr ; 12: 1281599, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38993324

RESUMO

Background: Sleep plays a vital role in the well-being of children and adolescents. Researchers have identified adverse childhood experiences (ACEs) as an important factor associated with poor sleep among adolescents. The objective of this study was to examine the mediating role of family resilience on the association between ACEs and insufficient sleep among adolescents in the United States. Methods: Data for this study came from the 2018-2019 National Survey of Children's Health (N = 28,097). The outcome variable in this study was insufficient sleep, and the main explanatory variable was exposure to ACEs. The mediating variable was family resilience. Data were analyzed using binary logistic regression. Results: Based on parent reports, one in five (22.4%) adolescents did not meet the recommended sleep hours on an average night. About half of the adolescents had no ACEs, 24.2% had one ACE, and 14.6% had three or more ACEs. Controlling for the effect of other factors and family resilience, the odds of having insufficient sleep were 1.63 times higher for children exposed to three or more ACEs (AOR = 1.63, 95% CI = 1.30-2.05). Family resilience partially mediates the association between exposure to ACEs and insufficient sleep. Each additional increase in family resilience decreased the odds of having insufficient sleep by a factor of 12% (AOR = 0.88, 95% CI = 0.86-0.91). Conclusions: Family resilience partially mediated exposure to ACEs on insufficient sleep. There are modifiable factors that may improve sleep outcomes among adolescents who have been exposed to adversity. Future research can help elucidate findings and establish the directionality of this association.

6.
Cortex ; 178: 141-156, 2024 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-39002454

RESUMO

Aleksandr Luria repeatedly emphasised the importance of emotions and the right hemisphere in his neuropsychological writings. It is surprising, therefore, that Luria's most influential book, The Working Brain, appears to lack an explicit section on these topics. This is especially notable because of a comment in the book's English-language Introduction, by Karl Pribram, referencing Luria's thoughts about precisely this material. Remarkably, it seems that Luria did write such an explicit chapter, in the original Russian edition. However, in the English-language version, the relevant sections were separated, embedded elsewhere without chapter headings, and altered, presumably following an explicit translation decision. The present paper tracks the nature of these changes and, 50 years later, presents the material for the first time translated and reunited in English, as Luria intended. After the translation, we offer a brief commentary, on the ways in which Luria's ideas were in some respects prescient, and in other respects less well-informed about the brain basis of emotions and the right hemisphere. This reunification offers an interesting time capsule on the opinions of one of neuropsychology's greatest minds, on a topic which Luria admits had, at the time, only a modest empirical foundation.

7.
Front Neurol ; 15: 1384494, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38846038

RESUMO

Purpose: Neuroglial tumors are frequently associated with pharmacorefractory epilepsies. However, comprehensive knowledge about long-term outcomes after epilepsy surgery and the main prognostic factors for outcome is still limited. We sought to evaluate long-term outcomes and potential influencing factors in a large cohort of patients who underwent surgery for neuroglial tumors in a single-center setting. Methods: The study analyzed the outcomes of 107 patients who underwent epilepsy surgery for neuroglial tumors between 2001 and 2020 at the Department of Epileptology, University Hospital Bonn, in Germany. The outcomes were evaluated using Engel classification. Differences in outcome related to potential prognostic factors were examined using the Chi2-test, Fisher's exact test and sign test. Additionally, stepwise logistic regression analysis was employed to identify independent prognostic factors. Results: Complete seizure freedom (Engel Class IA) was achieved in 75% of the operated patients at 12 months, and 56% at the last follow-up visit (70.4 ± 6.2 months, median: 40 months). Completeness of resection was a crucial factor for both 12-month follow-up outcomes and the longest available outcomes, whereas lobar tumor localization, histology (ganglioglioma vs. dysembryoplastic neuroepithelial tumor), history of bilateral tonic-clonic seizures prior to surgery, invasive diagnostics, side of surgery (dominant vs. non-dominant hemisphere), age at epilepsy onset, age at surgery, and epilepsy duration did not consistently impact postsurgical outcomes. Among temporal lobe surgeries, patients who underwent lesionectomy and lesionectomy, including hippocampal resection, demonstrated similar outcomes. Conclusion: Neuroglial tumors present as excellent surgical substrates in treating structural epilepsy. To achieve an optimal postsurgical outcome, a complete lesion resection should be pursued whenever possible.

8.
PLoS One ; 19(6): e0305638, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38935696

RESUMO

BACKGROUND: Obesity is associated with locality and alcohol use; however, less is known about how the interaction of these two factors may compound the risk of obesity among adolescents. OBJECTIVES: This study examines the relationship between alcohol use and obesity among adolescents from rural and urban areas in the United States. METHODS: Data came from a sample of American adolescents aged 12-17 years from the National Survey on Drug Use and Health (2015-2019; n = 39,489). Obesity was regressed on age, sex, race/ethnicity, income, cigarette smoking, locality, and alcohol use, with an interaction term to examine locality x alcohol use. Predicted probabilities were plotted to assess the interaction. RESULTS: Compared to adolescents from urban areas, those from rural areas had 1.35 times higher odds of being obese (95% CI 1.25, 1.47). Predicted probabilities indicated that the probability of being obese was higher for rural adolescents at lower levels of drinking, up to about 40 drinks in the past 12 months. CONCLUSIONS: Findings suggest rural-urban differences at the intersection of alcohol use and obesity could depend on the frequency of use, but overall adolescents from rural areas may be more at risk.


Assuntos
Consumo de Bebidas Alcoólicas , População Rural , População Urbana , Humanos , Adolescente , População Rural/estatística & dados numéricos , Masculino , Feminino , População Urbana/estatística & dados numéricos , Estados Unidos/epidemiologia , Consumo de Bebidas Alcoólicas/epidemiologia , Criança , Obesidade/epidemiologia , Obesidade Infantil/epidemiologia , Fatores de Risco
9.
Biomedicines ; 12(6)2024 Jun 20.
Artigo em Inglês | MEDLINE | ID: mdl-38927583

RESUMO

Glioblastoma multiforme (GBM) is one of the most aggressive forms of brain tumor, characterized by a daunting prognosis with a life expectancy hovering around 12-16 months. Despite a century of relentless research, only a select few drugs have received approval for brain tumor treatment, largely due to the formidable barrier posed by the blood-brain barrier. The current standard of care involves a multifaceted approach combining surgery, irradiation, and chemotherapy. However, recurrence often occurs within months despite these interventions. The formidable challenges of drug delivery to the brain and overcoming therapeutic resistance have become focal points in the treatment of brain tumors and are deemed essential to overcoming tumor recurrence. In recent years, a promising wave of advanced treatments has emerged, offering a glimpse of hope to overcome the limitations of existing therapies. This review aims to highlight cutting-edge technologies in the current and ongoing stages of development, providing patients with valuable insights to guide their choices in brain tumor treatment.

10.
Nat Commun ; 15(1): 4783, 2024 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-38839776

RESUMO

Ribosomes translate the genetic code into proteins. Recent technical advances have facilitated in situ structural analyses of ribosome functional states inside eukaryotic cells and the minimal bacterium Mycoplasma. However, such analyses of Gram-negative bacteria are lacking, despite their ribosomes being major antimicrobial drug targets. Here we compare two E. coli strains, a lab E. coli K-12 and human gut isolate E. coli ED1a, for which tetracycline exhibits bacteriostatic and bactericidal action, respectively. Using our approach for close-to-native E. coli sample preparation, we assess the two strains by cryo-ET and visualize their ribosomes at high resolution in situ. Upon tetracycline treatment, these exhibit virtually identical drug binding sites, yet the conformation distribution of ribosomal complexes differs. While K-12 retains ribosomes in a translation-competent state, tRNAs are lost in the vast majority of ED1a ribosomes. These structural findings together with the proteome-wide abundance and thermal stability assessments indicate that antibiotic responses are complex in cells and can differ between different strains of a single species, thus arguing that all relevant bacterial strains should be analyzed in situ when addressing antibiotic mode of action.


Assuntos
Antibacterianos , Escherichia coli , Ribossomos , Tetraciclina , Ribossomos/metabolismo , Ribossomos/efeitos dos fármacos , Antibacterianos/farmacologia , Escherichia coli/efeitos dos fármacos , Escherichia coli/genética , Escherichia coli/metabolismo , Tetraciclina/farmacologia , Microscopia Crioeletrônica , RNA de Transferência/metabolismo , RNA de Transferência/genética , Humanos , Sítios de Ligação , Biossíntese de Proteínas/efeitos dos fármacos , Escherichia coli K12/efeitos dos fármacos , Escherichia coli K12/genética , Escherichia coli K12/metabolismo
11.
Br J Pharmacol ; 2024 Jun 17.
Artigo em Inglês | MEDLINE | ID: mdl-38886096

RESUMO

BACKGROUND AND PURPOSE: The cannabinoid CB1 receptor has a well-established role in appetite regulation. Drugs antagonizing central CB1 receptors, most notably rimonabant, induced weight loss and improved the metabolic profile in obese individuals but were discontinued due to psychiatric side effects. However, metabolic benefits were only partially attributable to weight loss, implying a role for peripheral receptors, and peripherally restricted CB1 receptor antagonists have since been of interest. Herein, we describe the evaluation of the peripherally restricted potent CB1 receptor inverse agonists TM38837 and TM39875, with acidic functionality, which were administered daily to diet-induced obese (DIO) mice for 5 weeks at doses for which CNS-mediated effects were minimal. EXPERIMENTAL APPROACH: Compounds were tested in dose-response in acute studies to compare efficacy (gastric transport) and extent of CNS exposure (hypothermia and satiety sequence) to demonstrate peripheral restriction and select doses for the subsequent chronic DIO study. KEY RESULTS: TM38837 but not TM39875 produced considerable (26%) weight loss, linked to a sustained reduction in food intake, together with improvements in plasma markers of inflammation and glucose homeostasis. Pharmacokinetic analysis indicated high plasma and low brain levels for both compounds with high liver levels for TM38837 (but not TM39875) due to hepatic uptake. CONCLUSION AND IMPLICATIONS: Weight loss and metabolic benefits of TM38837 are likely not CNS-mediated but could be linked to enhanced liver exposure, which implicates intracellular CB1 receptors in hepatocytes as a possible driver of obesity and co-morbidities.

12.
Artigo em Inglês | MEDLINE | ID: mdl-38905012

RESUMO

BACKGROUND: Prescription drug monitoring programs (PDMPs) have been widely adopted as a tool to address the prescription opioid epidemic in the United States. PDMP integration and mandatory use policies are 2 approaches states have implemented to increase use of PDMPs by prescribers. While the effectiveness of these approaches is mixed, it is unclear what factors motivated states to implement them. This study examines whether opioid dispensing, adverse health outcomes, or other non-health-related factors motivated implementation of these PDMP approaches. METHODS: Time-to-event analysis was performed using lagged state-year covariates to reflect values from the year prior. Extended Cox regression estimated the association of states' rates of opioid dispensing, prescription opioid overdose deaths, and neonatal opioid withdrawal syndrome with implementation of PDMP integration and mandatory use policies from 2009 to 2020, controlling for demographic and economic factors, state government and political factors, and prior opioid policies. RESULTS: In our main model, prior opioid dispensing (HR 2.31, 95% CI 1.17, 4.57), neonatal opioid withdrawal syndrome hospitalizations (HR 1.55, 95% CI 1.09, 2.19), and number of prior opioid policies (HR 2.13, 95% CI 1.13, 4.00) were associated with mandatory use policies. Prior prescription opioid overdose deaths (HR 1.21, 95% CI 1.08, 1.35) were also associated with mandatory use policies in a model that did not include opioid dispensing or neonatal opioid withdrawal syndrome. No study variables were associated with implementation of PDMP integration. CONCLUSION: Understanding state-level factors associated with implementing PDMP approaches can provide insights into factors that motivate the adoption of future public health interventions.

13.
ACS Pharmacol Transl Sci ; 7(6): 1823-1838, 2024 Jun 14.
Artigo em Inglês | MEDLINE | ID: mdl-38898945

RESUMO

Coibamide A (CbA) is a cyanobacterial lariat depsipeptide that selectively inhibits multiple secreted and integral membrane proteins from entering the endoplasmic reticulum secretory pathway through binding the alpha subunit of the Sec61 translocon. As a complex peptide-based macrocycle with 13 stereogenic centers, CbA is presumed to adopt a conformationally restricted orientation in the ligand-bound state, resulting in potent antitumor and antiangiogenic bioactivity. A stereochemical structure-activity relationship for CbA was previously defined based on cytotoxicity against established cancer cell lines. However, the ability of synthetic isomers to inhibit the biosynthesis of specific Sec61 substrates was unknown. Here, we report that two less toxic diastereomers of CbA, [L-Hiv2]-CbA and [L-Hiv2, L-MeAla11]-CbA, are pharmacologically active Sec61 inhibitors. Both compounds inhibited the expression of a secreted reporter (Gaussia luciferase), VEGF-A, and a Type 1 membrane protein (VCAM1), while [L-Hiv2]-CbA also decreased the expression of ICAM1 and BiP/GRP78. Analysis of 43 different chemokines in the secretome of SF-268 glioblastoma cells revealed different inhibitory profiles for the two diastereomers. When the cytotoxic potential of CbA compounds was compared against a panel of patient-derived glioblastoma stem-like cells (GSCs), Sec61 inhibitors were remarkably toxic to five of the six GSCs tested. Each ligand showed a distinct cytotoxic potency and selectivity pattern for CbA-sensitive GSCs, with IC50 values ranging from subnanomolar to low micromolar concentrations. Together, these findings highlight the extreme sensitivity of GSCs to Sec61 modulation and the importance of ligand stereochemistry in determining the spectrum of inhibited Sec61 client proteins.

14.
Artigo em Inglês | MEDLINE | ID: mdl-38702217

RESUMO

BACKGROUND AND PURPOSE: Renal impairment (RI) confers adverse prognosis in myeloma; its reversal and avoidance of dialysis are crucial. We investigated whether serum free light chain (SFLC) measurements can predict renal outcome, to enable change in therapy to optimize prognosis and avoid dialysis. PATIENTS AND METHODS: We investigated 36 myeloma patients (17 newly diagnosed [ND]; 19 relapsed refractory [RR]; with median of 5 prior lines) with eGFR 15-40 ml/min treated with carfilzomib (Cfz)-dexamethasone to determine whether SFLC kinetics can predict renal outcomes, and assess efficacy and tolerability. RESULTS: The change in involved SFLC at Cycle 2 Day 1 was significantly correlated with renal function; for every one log10 reduction in involved SFLC, eGFR increased by 9.0-15.0 mL/min at cycles 2-4, with SFLC reduction of 54%-78%. At a median follow-up of 30.6 months, renal outcomes were favorable-CRrenal 25%, MRrenal 36%. Disease responses (ND 100%, RR 75%), progression-free survival (ND 32.2 months, RR 11.1 months) and overall survival (ND not reached, RR 42.0 months) were comparable to patients without RI. There was significant toxicity, including Cfz-related cardiac impairment of 20% within a cohort with high co-morbidity, and a high incidence of infections. CONCLUSION: We propose that one log10 reduction in involved SFLC at Cycle 2 Day 1 is an appropriate target for reducing the risk of dialysis in myeloma patients with RI; below this threshold patients may benefit from a change in therapy. While Cfz-dexamethasone achieved favorable renal and disease outcomes, toxicity can be significant in this vulnerable cohort.

15.
Heliyon ; 10(9): e30739, 2024 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-38765175

RESUMO

Metallic contaminants in Andean water resources influenced by mining activities poses risks to aquatic ecosystems and a challenge to regulatory agencies responsible for environmental compliance. In this study, the Ecological Risk Assessment (ERA) framework was adapted to assess dissolved heavy metal concentrations at 283 surface water monitoring stations near to six mining projects during the dry and wet seasons. Reports from OEFA-Peru on Early Environmental Assessment (EEA) were used to apply various criteria and non-parametric statistical tests. They included ecological, ecotoxicological, chemical, and regulatory factors. The main goal of this research was to identify, analyze, characterize, and compare the risks present at different trophic levels. These levels were categorized as T1 (Microalgae), T2 (Zooplankton and Benthic invertebrates), and T3 (Fish). Individual risk (IR) was estimated using the quotient model, while total risk (TR) was assessed using the additive probability rule. Rainbow trout (Oncorhynchus mykiss), representing trophic level T3, showed the highest sensitivity to Fe and Cu. Statistical tests ranked the IR as Fe > Cu > Zn > Mn > Pb (p < 0.01). The TR was more prevalent during the wet season compared to the dry season (p < 0.01). Notably, around 50 % of the monitoring stations (n = 142) were classified as high risk, and 9 % (n = 13) showed extremely high-risk values for Cu and Fe. The adapted ERA framework demonstrated great effectiveness in identifying critical points of metal contamination in high Andean aquatic ecosystems under mining influence. However, specialized studies are suggested that allow the sources of pollution to be associated with specific regulatory actions.

16.
J Pharm Technol ; 40(3): 152-157, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38784024

RESUMO

Objective: The objective of the study is to highlight the role and safety of romosozumab in patients at high risk of fractures in primary care. Data Sources: A systemic database search of PubMed/MEDLINE, ClinicalTrials.gov, and Cochrane Library was conducted for articles with keywords romosozumab, osteoporosis, and safety between inception and July 2022. Study Selection and Data Extraction: Phase 3 trials in patients with osteoporosis were included. Data results from these trials were utilized for assessment. Data Synthesis: Romosozumab decreased vertebral fracture incidence by 73% at 12 months (P < 0.001) in osteoporotic postmenopausal women compared with placebo. In an active-controlled fracture study in postmenopausal women with osteoporosis at high risk of fracture, a 48% lower risk of new vertebral fracture was observed at 24 months in the romosozumab-alendronate group (P < 0.001) compared with alendronate group. In a study comparing romosozumab with teriparatide in postmenopausal women with osteoporosis at high risk of fracture, 2.6% of the mean percentage change from baseline in the total hip (TH) areal bone mineral density (BMD) was observed with romosozumab, while teriparatide led -0.6% of change (P < 0.0001). Romosozumab significantly increased the mean percentage change from baseline in the lumbar spine (LS) and total hip (TH) BMD than placebo in men with osteoporosis (LS, 12.1% vs 1.2%; TH, 2.5% vs -0.5%; P < 0.001). Serious cardiovascular events were observed in the romosozumab compared with alendronate (2.5% vs 1.9%; odds ratio [OR] = 1.31; 95% confidence interval [CI] = 0.85-2.00) in postmenopausal women, and placebo (4.9% vs 2.5%) in men with osteoporosis. Relevance to Patient Care and Clinical Practice: This review discusses the role of romosozumab in patients with high fracture risk and its safety in primary care. Conclusions: Primary care physicians should consider romosozumab for patients at high fracture risk who are intolerant or have not responded to other pharmacological treatment. Further studies are needed to clarify the safety of cardiovascular events.

17.
Surg Endosc ; 38(6): 3448-3454, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38698258

RESUMO

BACKGROUND: In primarily unresectable liver tumors, ALPPS (Associating Liver Partition and Portal Vein Ligation for Staged hepatectomy) may offer curative two-stage hepatectomy trough a fast and extensive hypertrophy. However, concerns have been raised about the invasiveness of the procedure. Full robotic ALPPS has the potential to reduce the postoperative morbidity trough a less invasive access. The aim of this study was to compare the perioperative outcomes of open and full robotic ALPPS. METHODS: The bicentric study included open ALPPS cases from the University Hospital Zurich, Switzerland and robotic ALPPS cases from the University of Modena and Reggio Emilia, Italy from 01/2015 to 07/2022. Main outcomes were intraoperative parameters and overall complications. RESULTS: Open and full robotic ALPPS were performed in 36 and 7 cases. Robotic ALPPS was associated with less blood loss after both stages (418 ± 237 ml vs. 319 ± 197 ml; P = 0.04 and 631 ± 354 ml vs. 258 ± 53 ml; P = 0.01) as well as a higher rate of interstage discharge (86% vs. 37%; P = 0.02). OT was longer with robotic ALPPS after both stages (371 ± 70 min vs. 449 ± 81 min; P = 0.01 and 282 ± 87 min vs. 373 ± 90 min; P = 0.02). After ALPPS stage 2, there was no difference for overall complications (86% vs. 86%; P = 1.00) and major complications (43% vs. 39%; P = 0.86). The total length of hospital stay was similar (23 ± 17 days vs. 26 ± 13; P = 0.56). CONCLUSION: Robotic ALPPS was safely implemented and showed potential for improved perioperative outcomes compared to open ALPPS in an experienced robotic center. The robotic approach might bring the perioperative risk profile of ALPPS closer to interventional techniques of portal vein embolization/liver venous deprivation.


Assuntos
Hepatectomia , Neoplasias Hepáticas , Veia Porta , Procedimentos Cirúrgicos Robóticos , Humanos , Hepatectomia/métodos , Procedimentos Cirúrgicos Robóticos/métodos , Masculino , Feminino , Veia Porta/cirurgia , Ligadura/métodos , Neoplasias Hepáticas/cirurgia , Pessoa de Meia-Idade , Idoso , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Resultado do Tratamento , Tempo de Internação/estatística & dados numéricos , Perda Sanguínea Cirúrgica/estatística & dados numéricos , Duração da Cirurgia , Estudos Retrospectivos
18.
bioRxiv ; 2024 May 09.
Artigo em Inglês | MEDLINE | ID: mdl-38766019

RESUMO

Breast cancer brain metastases (BCBM) are a significant cause of mortality and are incurable. Thus, identifying BCBM targets that reduce morbidity and mortality is critical. BCBM upregulate Stearoyl-CoA Desaturase (SCD), an enzyme that catalyzes the synthesis of monounsaturated fatty acids, suggesting a potential metabolic vulnerability of BCBM. In this study, we tested the effect of a brain-penetrant clinical-stage inhibitor of SCD (SCDi), on breast cancer cells and mouse models of BCBM. Lipidomics, qPCR, and western blot were used to study the in vitro effects of SCDi. Single-cell RNA sequencing was used to explore the effects of SCDi on cancer and immune cells in a BCBM mouse model. Pharmacological inhibition of SCD markedly reshaped the lipidome of breast cancer cells and resulted in endoplasmic reticulum stress, DNA damage, loss of DNA damage repair, and cytotoxicity. Importantly, SCDi alone or combined with a PARP inhibitor prolonged the survival of BCBM-bearing mice. When tested in a syngeneic mouse model of BCBM, scRNAseq revealed that pharmacological inhibition of SCD enhanced antigen presentation by dendritic cells, was associated with a higher interferon signaling, increased the infiltration of cytotoxic T cells, and decreased the proportion of exhausted T cells and regulatory T cells in the tumor microenvironment (TME). Additionally, pharmacological inhibition of SCD decreased engagement of immunosuppressive pathways, including the PD-1:PD-L1/PD-L2 and PVR/TIGIT axes. These findings suggest that SCD inhibition could be an effective strategy to intrinsically reduce tumor growth and reprogram anti-tumor immunity in the brain microenvironment to treat BCBM.

19.
Nano Lett ; 24(22): 6553-6559, 2024 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-38775731

RESUMO

New approaches such as selective area growth (SAG), where crystal growth is lithographically controlled, allow the integration of bottom-up grown semiconductor nanomaterials in large-scale classical and quantum nanoelectronics. This calls for assessment and optimization of the reproducibility between individual components. We quantify the structural and electronic statistical reproducibility within large arrays of nominally identical selective area growth InAs nanowires. The distribution of structural parameters is acquired through comprehensive atomic force microscopy studies and transmission electron microscopy. These are compared to the statistical distributions of the cryogenic electrical properties of 256 individual SAG nanowire field effect transistors addressed using cryogenic multiplexer circuits. Correlating measurements between successive thermal cycles allows distinguishing between the contributions of surface impurity scattering and fixed structural properties to device reproducibility. The results confirm the potential of SAG nanomaterials, and the methodologies for quantifying statistical metrics are essential for further optimization of reproducibility.

20.
Environ Sci Technol ; 58(16): 6964-6977, 2024 Apr 23.
Artigo em Inglês | MEDLINE | ID: mdl-38602491

RESUMO

The rapid reduction in the cost of renewable energy has motivated the transition from carbon-intensive chemical manufacturing to renewable, electrified, and decarbonized technologies. Although electrified chemical manufacturing technologies differ greatly, the feasibility of each electrified approach is largely related to the energy efficiency and capital cost of the system. Here, we examine the feasibility of ammonia production systems driven by wind and photovoltaic energy. We identify the optimal regions where wind and photovoltaic electricity production may be able to meet the local demand for ammonia-based fertilizers and set technology targets for electrified ammonia production. To compete with the methane-fed Haber-Bosch process, electrified ammonia production must reach energy efficiencies of above 20% for high natural gas prices and 70% for low natural gas prices. To account for growing concerns regarding access to water, geospatial optimization considers water stress caused by new ammonia facilities, and recommendations ensure that the identified regions do not experience an increase in water stress. Reducing water stress by 99% increases costs by only 1.4%. Furthermore, a movement toward a more decentralized ammonia supply chain driven by wind and photovoltaic electricity can reduce the transportation distance for ammonia by up to 76% while increasing production costs by 18%.


Assuntos
Amônia , Energia Renovável , Fertilizantes , Eletricidade , Vento
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