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1.
Trends Genet ; 38(12): 1228-1252, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-35945076

RESUMO

The rearing of farmed animals is a vital component of global food production systems, but its impact on the environment, human health, animal welfare, and biodiversity is being increasingly challenged. Developments in genetic and genomic technologies have had a key role in improving the productivity of farmed animals for decades. Advances in genome sequencing, annotation, and editing offer a means not only to continue that trend, but also, when combined with advanced data collection, analytics, cloud computing, appropriate infrastructure, and regulation, to take precision livestock farming (PLF) and conservation to an advanced level. Such an approach could generate substantial additional benefits in terms of reducing use of resources, health treatments, and environmental impact, while also improving animal health and welfare.


Assuntos
Criação de Animais Domésticos , Gado , Animais , Humanos , Gado/genética , Bem-Estar do Animal , Genômica , Genoma/genética
2.
Nat Mater ; 23(5): 680-687, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38366155

RESUMO

Hybrid organic/inorganic materials have contributed to solve important challenges in different areas of science. One of the biggest challenges for a more sustainable society is to have active and stable catalysts that enable the transition from fossil fuel to renewable feedstocks, reduce energy consumption and minimize the environmental footprint. Here we synthesize novel hybrid materials where an amorphous oxide coating with embedded organic ligands surrounds metallic nanocrystals. We demonstrate that the hybrid coating is a powerful means to create electrocatalysts stable against structural reconstruction during the CO2 electroreduction. These electrocatalysts consist of copper nanocrystals encapsulated in a hybrid organic/inorganic alumina shell. This shell locks a fraction of the copper surface into a reduction-resistant Cu2+ state, which inhibits those redox processes responsible for the structural reconstruction of copper. The electrocatalyst activity is preserved, which would not be possible with a conventional dense alumina coating. Varying the shell thickness and the coating morphology yields fundamental insights into the stabilization mechanism and emphasizes the importance of the Lewis acidity of the shell in relation to the retention of catalyst structure. The synthetic tunability of the chemistry developed herein opens new avenues for the design of stable electrocatalysts and beyond.

3.
J Am Chem Soc ; 146(15): 10708-10715, 2024 Apr 17.
Artigo em Inglês | MEDLINE | ID: mdl-38579275

RESUMO

Atomic layer deposition (ALD) is a method to grow thin metal oxide layers on a variety of materials for applications spanning from electronics to catalysis. Extending ALD to colloidally stable nanocrystals promises to combine the benefits of thin metal oxide coatings with the solution processability of the nanocrystals. However, challenges persist in applying this method, which relate to finding precursors that promote the growth of the metal oxide while preserving colloidal stability throughout the process. Herein, we introduce a colloidal ALD method to coat nanocrystals with amorphous metal oxide shells using metal and oxygen precursors that act as colloidal stabilizing ligands. Our scheme involves metal-amide precursors modified with solubilizing groups and oleic acid as the oxygen source. The growth of the oxide is self-limiting and proceeds in a layer-by-layer fashion. Our protocol is generalizable and intrinsically scalable. Potential applications in display, light detection, and catalysis are envisioned.

4.
Malar J ; 23(1): 168, 2024 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-38812003

RESUMO

BACKGROUND: The recent reduction in malaria burden in Côte d'Ivoire is largely attributable to the use of long-lasting insecticidal nets (LLINs). However, this progress is threatened by insecticide resistance and behavioral changes in Anopheles gambiae sensu lato (s.l.) populations and residual malaria transmission, and complementary tools are required. Thus, this study aimed to assess the efficacy of the combined use of LLINs and Bacillus thuringiensis israelensis (Bti), in comparison with LLINs. METHODS: This study was conducted in the health district of Korhogo, northern Côte d'Ivoire, within two study arms (LLIN + Bti arm and LLIN-only arm) from March 2019 to February 2020. In the LLIN + Bti arm, Anopheles larval habitats were treated every fortnight with Bti in addition to the use of LLINs. Mosquito larvae and adults were sampled and identified morphologically to genus and species using standard methods. The members of the An. gambiae complex were determined using a polymerase chain reaction technique. Plasmodium infection in An. gambiae s.l. and malaria incidence in local people was also assessed. RESULTS: Overall, Anopheles spp. larval density was lower in the LLIN + Bti arm 0.61 [95% CI 0.41-0.81] larva/dip (l/dip) compared with the LLIN-only arm 3.97 [95% CI 3.56-4.38] l/dip (RR = 6.50; 95% CI 5.81-7.29; P < 0.001). The overall biting rate of An. gambiae s.l. was 0.59 [95% CI 0.43-0.75] biting/person/night in the LLIN + Bti arm against 2.97 [95% CI 2.02-3.93] biting/person/night in LLIN-only arm (P < 0.001). Anopheles gambiae s.l. was predominantly identified as An. gambiae sensu stricto (s.s.) (95.1%, n = 293), followed by Anopheles coluzzii (4.9%; n = 15). The human-blood index was 80.5% (n = 389) in study area. EIR was 1.36 infected bites/person/year (ib/p/y) in the LLIN + Bti arm against 47.71 ib/p/y in the LLIN-only arm. Malaria incidence dramatically declined from 291.8‰ (n = 765) to 111.4‰ (n = 292) in LLIN + Bti arm (P < 0.001). CONCLUSIONS: The combined use of LLINs with Bti significantly reduced the incidence of malaria. The LLINs and Bti duo could be a promising integrated approach for effective vector control of An. gambiae for elimination of malaria.


Assuntos
Anopheles , Bacillus thuringiensis , Mosquiteiros Tratados com Inseticida , Larva , Malária , Controle de Mosquitos , Côte d'Ivoire/epidemiologia , Animais , Anopheles/efeitos dos fármacos , Anopheles/fisiologia , Larva/efeitos dos fármacos , Malária/prevenção & controle , Malária/transmissão , Controle de Mosquitos/métodos , Mosquiteiros Tratados com Inseticida/estatística & dados numéricos , Feminino , Mosquitos Vetores/efeitos dos fármacos , Humanos , Masculino , Adolescente , Pré-Escolar , Adulto Jovem , Criança , Adulto
5.
BMC Nephrol ; 25(1): 255, 2024 Aug 08.
Artigo em Inglês | MEDLINE | ID: mdl-39118047

RESUMO

BACKGROUND: The optimisation of patients in primary care is a prime opportunity to manage patient care within the community and reduce the burden of referrals on secondary care. This paper presents a quality improvement clinical programme taking place within an NHS Primary Care Network as part of the wider Leicester Leicestershire Rutland integrated chronic kidney disease programme. METHOD: Patients are optimised to guidelines from the National Institute for Health and Care Excellence, by a primary care clinical team who are supported by nephrology consultants and nephrology pharmacists. Multidisciplinary team meetings take place with secondary care specialists and primary care staff. Learning is passed to the community clinicians for better patient treatment locally. RESULTS: A total of 526 patients were reviewed under this project.The total number of referrals to secondary care which were discharged following first outpatient appointment, reduced from 42.9% to 10%. This reduction of 32.9% represents the optimisation of patient cases through this quality improvement project. Patients can be optimised and managed within the community, reducing the number of unnecessary referrals to secondary care. CONCLUSION: This programme has the potential to offer significant improvement in patient outcomes when expanded to a larger patient base. Medicine management and the use of clinical staff are optimised in both primary and secondary care.


Assuntos
Atenção Primária à Saúde , Melhoria de Qualidade , Insuficiência Renal Crônica , Humanos , Insuficiência Renal Crônica/terapia , Encaminhamento e Consulta , Equipe de Assistência ao Paciente
6.
ScientificWorldJournal ; 2024: 9945354, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39026597

RESUMO

Poor agricultural soil management practices and water use optimisation in irrigation are major challenges facing crop production in Senegal. To address these problems, a factorial experiment was conducted in 2021 and 2022 to investigate the effects of biochar on tomato growth and yield in sandy loam soil under different irrigation levels. Treatments included three biochar treatments (B2 = 30 t·ha-1, B1 = 15 t·ha-1, and B0 = 0 t·ha-1) and three irrigation levels (full irrigation, W0 = 8 L·m-2·day-1; medium deficit irrigation, W1 = 6 L·m-2·day-1, which is 75% of W0; and deficit irrigation, W2 = 4 L·m-2·day-1, 50% of W0). The results showed that using biochar at 30 t·ha-1 significantly (P < 0.05) reduced the bulk density of the soil by up to 8.3% under W1. In addition, biochar at 15 t·ha-1 and 30 t·ha-1 enhanced, regardless of the amount of water applied, the growth of tomato plants by at least 14% compared to that in the B0 treatment. Furthermore, the tomatoes' yields in biochar treatments B1 (12.58 t·ha-1) and B2 (12.45 t·ha-1) under W2 were greater than those under B0 (9.27 t·ha-1) under full irrigation. The combinations of biochar and the lowest irrigation water level (W2 and B1 or W2 and B2) can therefore allow a water economy of up to 50% of full irrigation without compromising yield. Our study concluded that biochar could sustainably reduce agricultural water consumption while increasing yields. To further understand the influence of biochar on sandy loam soil, more research is needed on its effects on soil moisture content at permanent wilting points and field capacity.


Assuntos
Irrigação Agrícola , Carvão Vegetal , Solo , Solanum lycopersicum , Solanum lycopersicum/crescimento & desenvolvimento , Solo/química , Irrigação Agrícola/métodos , Senegal , Água , Agricultura/métodos
7.
J Am Chem Soc ; 145(14): 8189-8197, 2023 Apr 12.
Artigo em Inglês | MEDLINE | ID: mdl-36996442

RESUMO

Colloidal nanocrystals (NCs) are ideal materials for a variety of applications and devices, which span from catalysis and optoelectronics to biological imaging. Organic chromophores are often combined with NCs as photoactive ligands to expand the functionality of NCs or to achieve optimal device performance. The most common methodology to introduce these chromophores involves ligand exchange procedures. Despite their ubiquitous nature, ligand exchanges suffer from a few limitations, which include reversible binding, restricted access to binding sites, and the need for purification of the samples, which can result in loss of colloidal stability. Herein, we propose a methodology to bypass these inherent issues of ligand exchange through the growth of an amorphous alumina shell by colloidal atomic layer deposition (c-ALD). We demonstrate that c-ALD creates colloidally stable composite materials, which comprise NCs and organic chromophores as photoactive ligands, by trapping the chromophores around the NC core. As representative examples, we functionalize semiconductor NCs, which include PbS, CsPbBr3, CuInS2, Cu2-xX, and lanthanide-based upconverting NCs, with polyaromatic hydrocarbons (PAH) ligands. Finally, we prove that triplet energy transfer occurs through the shell and we realize the assembly of a triplet exciton funnel structure, which cannot be obtained via conventional ligand exchange procedures. The formation of these organic/inorganic hybrid shells promises to synergistically boost catalytic and multiexcitonic processes while endowing enhanced stability to the NC core.

8.
J Chem Phys ; 159(12)2023 Sep 28.
Artigo em Inglês | MEDLINE | ID: mdl-38127375

RESUMO

We report a method to predict equilibrium concentration profiles of hard ellipses in nonuniform fields, including multiphase equilibria of fluid, nematic, and crystal phases. Our model is based on a balance of osmotic pressure and field mediated forces by employing the local density approximation. Implementation of this model requires development of accurate equations of state for each phase as a function of hard ellipse aspect ratio in the range k = 1-9. The predicted density profiles display overall good agreement with Monte Carlo simulations for hard ellipse aspect ratios k = 2, 4, and 6 in gravitational and electric fields with fluid-nematic, fluid-crystal, and fluid-nematic-crystal multiphase equilibria. The profiles of local order parameters for positional and orientational order display good agreement with values expected for bulk homogeneous hard ellipses in the same density ranges. Small discrepancies between predictions and simulations are observed at crystal-nematic and crystal-fluid interfaces due to limitations of the local density approximation, finite system sizes, and uniform periodic boundary conditions. The ability of the model to capture multiphase equilibria of hard ellipses in nonuniform fields as a function of particle aspect ratio provides a basis to control anisotropic particle microstructure on interfacial energy landscapes in diverse materials and applications.

9.
J Chem Phys ; 159(7)2023 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-37602803

RESUMO

PbS semiconductor nanocrystals (NCs) have been heavily explored for infrared optoelectronics but can exhibit visible-wavelength quantum-confined optical gaps when sufficiently small (⌀ = 1.8-2.7 nm). However, small PbS NCs traditionally exhibited very broad ensemble absorption linewidths, attributed to poor size-heterogeneity. Here, harnessing recent synthetic advances, we report photophysical measurements on PbS ensembles that span this underexplored size range. We observe that the smallest PbS NCs pervasively exhibit lower brightness and anomalously accelerated photoluminescence decays-relative to the idealized photophysical models that successfully describe larger NCs. We find that effects of residual ensemble size-heterogeneity are insufficient to explain our observations, so we explore plausible processes that are intrinsic to individual nanocrystals. Notably, the anomalous decay kinetics unfold, surprisingly, over hundreds-of-nanosecond timescales. These are poorly matched to effects of direct carrier trapping or fine-structure thermalization but are consistent with non-radiative recombination linked to a dynamic surface. Thus, the progressive enhancement of anomalous decay in the smallest particles supports predictions that the surface plays an outsized role in exciton-phonon coupling. We corroborate this claim by showing that the anomalous decay is significantly remedied by the installation of a rigidifying shell. Intriguingly, our measurements show that the anomalous aspect of these kinetics is insensitive to temperature between T = 298 and 77 K, offering important experimental constraint on possible mechanisms involving structural fluctuations. Thus, our findings identify and map the anomalous photoluminescence kinetics that become pervasive in the smallest PbS NCs and call for targeted experiments and theory to disentangle their origin.

10.
Heart Fail Clin ; 19(3): 357-377, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-37230650

RESUMO

The aging population is rising at record pace worldwide. Along with it, a steep increase in the prevalence of atrial fibrillation and heart failure with preserved ejection fraction is to be expected. Similarly, both atrial functional mitral and tricuspid regurgitation (AFMR and AFTR) are increasingly observed in daily clinical practice. This article summarizes all current evidence regarding the epidemiology, prognosis, pathophysiology, and therapeutic options. Specific attention is addressed to discern AFMR and AFTR from their ventricular counterparts, given their different pathophysiology and therapeutic needs.


Assuntos
Fibrilação Atrial , Doenças das Valvas Cardíacas , Insuficiência da Valva Mitral , Humanos , Idoso , Insuficiência da Valva Mitral/epidemiologia , Insuficiência da Valva Mitral/etiologia , Doenças das Valvas Cardíacas/complicações , Doenças das Valvas Cardíacas/epidemiologia , Fibrilação Atrial/epidemiologia , Átrios do Coração , Prognóstico
11.
Eur Respir J ; 59(6)2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-34764182

RESUMO

BACKGROUND: In allergic bronchopulmonary aspergillosis (ABPA), prolonged nebulised antifungal treatment may be a strategy for maintaining remission. METHODS: We performed a randomised, single-blind, clinical trial in 30 centres. Patients with controlled ABPA after 4-month attack treatment (corticosteroids and itraconazole) were randomly assigned to nebulised liposomal amphotericin-B or placebo for 6 months. The primary outcome was occurrence of a first severe clinical exacerbation within 24 months following randomisation. Secondary outcomes included the median time to first severe clinical exacerbation, number of severe clinical exacerbations per patient, ABPA-related biological parameters. RESULTS: Among 174 enrolled patients with ABPA from March 2015 through July 2017, 139 were controlled after 4-month attack treatment and were randomised. The primary outcome occurred in 33 (50.8%) out of 65 patients in the nebulised liposomal amphotericin-B group and 38 (51.3%) out of 74 in the placebo group (absolute difference -0.6%, 95% CI -16.8- +15.6%; OR 0.98, 95% CI 0.50-1.90; p=0.95). The median (interquartile range) time to first severe clinical exacerbation was longer in the liposomal amphotericin-B group: 337 days (168-476 days) versus 177 days (64-288 days). At the end of maintenance therapy, total immunoglobulin-E and Aspergillus precipitins were significantly decreased in the nebulised liposomal amphotericin-B group. CONCLUSIONS: In ABPA, maintenance therapy using nebulised liposomal amphotericin-B did not reduce the risk of severe clinical exacerbation. The presence of some positive secondary outcomes creates clinical equipoise for further research.


Assuntos
Aspergilose Broncopulmonar Alérgica , Anfotericina B/efeitos adversos , Antifúngicos/uso terapêutico , Aspergilose Broncopulmonar Alérgica/tratamento farmacológico , Aspergillus , Humanos , Método Simples-Cego
12.
Rev Neurol (Paris) ; 178(4): 347-354, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34565624

RESUMO

INTRODUCTION: Non-motor fluctuations (NMF) in Parkinson's disease (PD) remain poorly recognized but have a high impact on patients' quality of life. The lack of assessment tools limits our understanding of NMF, compromising appropriate management. Our objective was to validate a hetero-questionnaire for NMF in PD patients at different stages of the disease: without treatment, without motor fluctuations, with motor fluctuations. METHODS: We included patients in 15 centers in France. Our questionnaire, NMF-Park, resulted from previous studies, allowing us to identify the more pertinent NMF for evaluation. Patients reported the presence (yes or no) of 22 selected NMF, and their link with dopaminergic medications. The assessment was repeated at one and two years to study the progression of NMF. We performed a metrological validation of our questionnaire. RESULTS: We included 255 patients (42 without treatment, 88 without motor fluctuations and 125 with motor fluctuations). After metrological validation, three dimensions of NMF were found: dysautonomic; cognitive; psychiatric. The sensory/pain dimension described in the literature was not statistically confirmed by our study. DISCUSSION: Our questionnaire was validated according to clinimetric standards, for different stages of PD. It was clinically coherent with three homogeneous dimensions. It highlighted a link between fatigue, visual accommodation disorder, and cognitive fluctuations; and the integration of sensory/pain fluctuations as part of dysautonomic fluctuations. It focused exclusively on NMF, which is interesting considering the described differences between non-motor and motor fluctuations. CONCLUSION: Our study validated a hetero-questionnaire of diagnosis for NMF for different stages of PD.


Assuntos
Doença de Parkinson , Disautonomias Primárias , Humanos , Dor , Doença de Parkinson/terapia , Qualidade de Vida , Inquéritos e Questionários
13.
Lancet Oncol ; 22(12): 1752-1763, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34793718

RESUMO

BACKGROUND: The primary analysis of the phase 3 NETTER-1 trial showed significant improvement in progression-free survival with 177Lu-Dotatate plus long-acting octreotide versus high-dose long-acting octreotide alone in patients with advanced midgut neuroendocrine tumours. Here, we report the prespecified final analysis of overall survival and long-term safety results. METHODS: This open-label, randomised, phase 3 trial enrolled patients from 41 sites in eight countries across Europe and the USA. Patients were 18 years and older with locally advanced or metastatic, well differentiated, somatostatin receptor-positive midgut neuroendocrine tumours (Karnofsky performance status score ≥60) and disease progression on fixed-dose long-acting octreotide. Patients were randomly assigned (1:1) via an interactive web-based response system to intravenous 177Lu-Dotatate 7·4 GBq (200 mCi) every 8 weeks (four cycles) plus intramuscular long-acting octreotide 30 mg (177Lu-Dotatate group) or high-dose long-acting octreotide 60 mg every 4 weeks (control group). The primary endpoint of progression-free survival has been previously reported; here, we report the key secondary endpoint of overall survival in the intention-to-treat population. Final overall survival analysis was prespecified to occur either after 158 deaths or 5 years after the last patient was randomised, whichever occurred first. During long-term follow-up, adverse events of special interest were reported in the 177Lu-Dotatate group only. This trial is registered with ClinicalTrials.gov, NCT01578239. FINDINGS: From Sept 6, 2012, to Jan 14, 2016, 231 patients were enrolled and randomly assigned for treatment. The prespecified final analysis occurred 5 years after the last patient was randomly assigned (when 142 deaths had occurred); median follow-up was 76·3 months (range 0·4-95·0) in the 177Lu-Dotatate group and 76·5 months (0·1-92·3) in the control group. The secondary endpoint of overall survival was not met: median overall survival was 48·0 months (95% CI 37·4-55·2) in the 177Lu-Dotatate group and 36·3 months (25·9-51·7) in the control group (HR 0·84 [95% CI 0·60-1·17]; two-sided p=0·30). During long-term follow-up, treatment-related serious adverse events of grade 3 or worse were recorded in three (3%) of 111 patients in the 177Lu-Dotatate group, but no new treatment-related serious adverse events were reported after the safety analysis cutoff. Two (2%) of 111 patients given 177Lu-Dotatate developed myelodysplastic syndrome, one of whom died 33 months after randomisation (this person was the only the only reported 177Lu-Dotatate treatment-related death). No new cases of myelodysplastic syndrome or acute myeloid leukaemia were reported during long-term follow-up. INTERPRETATION: 177Lu-Dotatate treatment did not significantly improve median overall survival versus high-dose long-acting octreotide. Despite final overall survival not reaching statistical significance, the 11·7 month difference in median overall survival with 177Lu-Dotatate treatment versus high-dose long-acting octreotide alone might be considered clinically relevant. No new safety signals were reported during long-term follow-up. FUNDING: Advanced Accelerator Applications, a Novartis company.


Assuntos
Quimiorradioterapia/mortalidade , Neoplasias do Sistema Digestório/mortalidade , Tumores Neuroendócrinos/mortalidade , Octreotida/análogos & derivados , Octreotida/uso terapêutico , Compostos Organometálicos/uso terapêutico , Idoso , Antineoplásicos Hormonais/uso terapêutico , Neoplasias do Sistema Digestório/patologia , Neoplasias do Sistema Digestório/terapia , Relação Dose-Resposta a Droga , Feminino , Seguimentos , Humanos , Masculino , Tumores Neuroendócrinos/patologia , Tumores Neuroendócrinos/terapia , Prognóstico , Compostos Radiofarmacêuticos/uso terapêutico , Taxa de Sobrevida
14.
Mol Cell Biochem ; 476(11): 4133-4137, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34312783

RESUMO

Chronic kidney disease (CKD) is a renal dysfunction that can lead to high rates of mortality and morbidity, particularly when coupled with late diagnosis. CKD has become a major health problem due to its challenging detection at early stages when clear symptoms are yet to be presented. Thus, CKD is likely to be identified when the substantive conditions of the disease are manifest. In order to address the development of the disease and provide necessary treatments at the initial stage, the investigation of new biomarkers and metabolites associated with early detection of CKD are needed. Identified metabolites could be used to confirm the presence of the disease, obtain information on its mechanism and facilitate the development of novel pharmaceutical treatments. Such metabolites may be detected from biofluids and tissues using a range of analytical techniques. There are a number of metabolites that have been identified by mass spectrometry at high sensitivities, whilst the detection of metabolites directly from biofluids using NMR could present a more rapid way to expand our understanding of this disease. This review is focused on NMR-based metabolomics associated with CKD in humans and animals.


Assuntos
Saúde Única , Insuficiência Renal Crônica/diagnóstico , Animais , Biomarcadores/análise , Diagnóstico Precoce , Humanos , Espectroscopia de Ressonância Magnética/métodos , Espectrometria de Massas/métodos , Metabolômica/métodos , Insuficiência Renal Crônica/metabolismo , Insuficiência Renal Crônica/terapia
15.
Eur Heart J ; 41(45): 4321-4328, 2020 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-33221855

RESUMO

AIMS: The aim of this study was to define the natural history of patients with mitral annular calcification (MAC)-related mitral valve dysfunction and to assess the prognostic importance of mean transmitral pressure gradient (MG) and impact of concomitant mitral regurgitation (MR). METHODS AND RESULTS: The institutional echocardiography database was examined from 2001 to 2019 for all patients with MAC and MG ≥3 mmHg. A total of 5754 patients were stratified by MG in low (3-5 mmHg, n = 3927), mid (5-10 mmHg, n = 1476), and high (≥10 mmHg, n = 351) gradient. The mean age was 78 ± 11 years, and 67% were female. MR was none/trace in 32%, mild in 42%, moderate in 23%, and severe in 3%. Primary outcome was all-cause mortality, and outcome models were adjusted for age, sex, and MAC-related risk factors (hypertension, diabetes, coronary artery disease, chronic kidney disease). Survival at 1, 5, and 10 years was 77%, 42%, and 18% in the low-gradient group; 73%, 38%, and 17% in the mid-gradient group; and 67%, 25%, and 11% in the high-gradient group, respectively (log-rank P < 0.001 between groups). MG was independently associated with mortality (adjusted HR 1.064 per 1 mmHg increase, 95% CI 1.049-1.080). MR severity was associated with mortality at low gradients (P < 0.001) but not at higher gradients (P = 0.166 and 0.372 in the mid- and high-gradient groups, respectively). CONCLUSION: In MAC-related mitral valve dysfunction, mean transmitral gradient is associated with increased mortality after adjustment for age, sex, and MAC-related risk factors. Concomitant MR is associated with excess mortality in low-gradient ranges (3-5 mmHg) but gradually loses prognostic importance at higher gradients, indicating prognostic utility of transmitral gradient in MAC regardless of MR severity.


Assuntos
Calcinose , Doenças das Valvas Cardíacas , Insuficiência da Valva Mitral , Idoso , Idoso de 80 Anos ou mais , Calcinose/diagnóstico por imagem , Feminino , Doenças das Valvas Cardíacas/complicações , Doenças das Valvas Cardíacas/diagnóstico por imagem , Humanos , Masculino , Valva Mitral/diagnóstico por imagem , Insuficiência da Valva Mitral/diagnóstico por imagem , Prognóstico , Resultado do Tratamento
16.
Invest New Drugs ; 38(6): 1796-1806, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32451663

RESUMO

The attrition rate of anticancer drugs during the clinical development remains very high. Interspecies extrapolation of anticancer drug pharmacodynamics (PD) could help to bridge the gap between preclinical and clinical settings and to improve drug development. Indeed, when combined with a physiologically-based-pharmacokinetics (PBPK) approach, PD interspecies extrapolation could be a powerful tool for predicting drug behavior in clinical trials. The present study aimed to explore this field for anticipating the clinical efficacy of a new Bcl-2 inhibitor, S 55746, for which dose ranging studies in xenografted mice and clinical data from a phase 1 trial involving cancer patients were available. Different strategies based on empirical or more mechanistic assumptions (based on PBPK-PD modelling) were developped and compared: the Rocchetti approach (ROC); the Orthogonal Rocchetti approach (oROC), a variant of ROC based on an orthogonal regression; the Consistent across species approach, bringing out an efficacy parameter assumed to be consistent across species; and the Scaling species-specific parameters approach, assuming the concentration-efficacy link is the same in mice as in humans, after allometric scaling. Empirical approaches (ROC and oROC) gave similar predictive performances and seemed to overestimate the active S 55746 dose compared to mechanistic approaches, while strategies elaborated from semi-mechanistic concepts and PBPK-PD modelling did not seem to be invalidated by clinical efficacy data. Also, empirical methods only predict a single dose level for the subsequent clinical studies, whereas mechanism-based strategies are more informative about the dose response relationship, highlighting the potential interest of such approaches in drug development.


Assuntos
Antineoplásicos/administração & dosagem , Modelos Biológicos , Neoplasias/tratamento farmacológico , Proteínas Proto-Oncogênicas c-bcl-2/antagonistas & inibidores , Administração Oral , Animais , Anti-Infecciosos/administração & dosagem , Antineoplásicos/sangue , Antineoplásicos/farmacocinética , Feminino , Humanos , Camundongos SCID , Neoplasias/sangue , Neoplasias/metabolismo , Neoplasias/patologia , Especificidade da Espécie , Pesquisa Translacional Biomédica/métodos
17.
Anticancer Drugs ; 31(3): 216-222, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31977567

RESUMO

Accessible prognostic tools are needed to individualize treatment of neuroendocrine tumors (NETs). Data suggest neutrophil/lymphocyte ratios (NLRs) have prognostic value in some solid tumors, including NETs. In the randomized double-blind CLARINET study (NCT00353496; EudraCT 2005-004904-35), the somatostatin analog lanreotide autogel/depot increased progression-free survival (PFS) compared with placebo in patients with inoperable or metastatic intestinal and pancreatic NETs (grades 1-2, Ki-67 < 10%). The exploratory post-hoc analyses presented here evaluated the prognostic value of NLR in the CLARINET study cohort, in the context of and independently from treatment. Kaplan-Meier PFS plots were generated for patients with available NLR data, in subgroups based on NLR values, and 24-month survival rates were calculated. P values and hazard ratios for prognostic effects were generated using Cox models. 31216222 Baseline characteristics were balanced between lanreotide autogel/depot 120 mg (n = 100) and placebo (n = 101) arms. Irrespective of treatment, raw 24-month PFS rates were comparable across subgroups based on NLR tertiles [37.3% (low), 38.8% (middle), 38.8% (high); n = 67 per group] and NLR cutoff of 4 [38.1% (NLR ≤ 4; n = 176), 40.0% (NLR > 4; n = 25)]. Furthermore, NLRs were not prognostic in Cox models, irrespective of subgroups used. The therapeutic effect of lanreotide autogel/depot 120 mg was independent of NLRs (P > 0.1). These exploratory post-hoc analyses in patients with advanced intestinal and pancreatic NETs contrast with previous data suggesting NLR has prognostic potential in NETs. This may reflect the inclusion of patients with lower-grade tumors or use of higher NLR cutoff values in the current analysis.


Assuntos
Linfócitos , Tumores Neuroendócrinos/mortalidade , Neutrófilos , Neoplasias Pancreáticas/mortalidade , Idoso , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Tumores Neuroendócrinos/sangue , Neoplasias Pancreáticas/sangue , Prognóstico , Modelos de Riscos Proporcionais
18.
Eur J Nutr ; 59(2): 661-669, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30806774

RESUMO

PURPOSE: The aim of this study was to investigate the effects of creatine supplementation on muscle wasting in Walker-256 tumor-bearing rats. METHODS: Wistar rats were randomly assigned into three groups (n = 10/group): control (C), tumor bearing (T), and tumor bearing supplemented with creatine (TCr). Creatine was provided in drinking water for a total of 21 days. After 11 days of supplementation, tumor cells were implanted subcutaneously into T and TCr groups. The animals' weight, food and water intake were evaluated along the experimental protocol. After 10 days of tumor implantation (21 total), animals were euthanized for inflammatory state and skeletal muscle cross-sectional area measurements. Skeletal muscle components of ubiquitin-proteasome pathways were also evaluated using real-time PCR and immunoblotting. RESULTS: The results showed that creatine supplementation protected tumor-bearing rats against body weight loss and skeletal muscle atrophy. Creatine intake promoted lower levels of plasma TNF-α and IL-6 and smaller spleen morphology changes such as reduced size of white pulp and lymphoid follicle compared to tumor-bearing rats. In addition, creatine prevented increased levels of skeletal muscle Atrogin-1 and MuRF-1, key regulators of muscle atrophy. CONCLUSION: Creatine supplementation prevents skeletal muscle atrophy by attenuating tumor-induced pro-inflammatory environment, a condition that minimizes Atrogin-1 and MuRF-1-dependent proteolysis.


Assuntos
Carcinoma 256 de Walker/metabolismo , Creatina/farmacologia , Suplementos Nutricionais , Inflamação/prevenção & controle , Atrofia Muscular/prevenção & controle , Proteólise/efeitos dos fármacos , Animais , Creatina/administração & dosagem , Modelos Animais de Doenças , Masculino , Músculo Esquelético/efeitos dos fármacos , Ratos , Ratos Wistar , Transdução de Sinais/efeitos dos fármacos
19.
Int J Mol Sci ; 21(7)2020 Apr 05.
Artigo em Inglês | MEDLINE | ID: mdl-32260582

RESUMO

Lysosomal storage disorders (LSDs) are predominantly very rare recessive autosomal neurodegenerative diseases.Sphingolipidoses, a sub-group of LSDs, result from defects in lysosomal enzymes involved in sphingolipid catabolism, and feature disrupted storage systems which trigger complex pathogenic cascades with other organelles collaterally affected. This process leads to cell dysfunction and death, particularly in the central nervous system. One valuable approach to gaining insights into the global impact of lysosomal dysfunction is through metabolomics, which represents a discovery tool for investigating disease-induced modifications in the patterns of large numbers of simultaneously-analysed metabolites, which also features the identification of biomarkers Here, the scope and applications of metabolomics strategies to the investigation of sphingolipidoses is explored in order to facilitate our understanding of the biomolecular basis of these conditions. This review therefore surveys the benefits of applying 'state-of-the-art' metabolomics strategies, both univariate and multivariate, to sphingolipidoses, particularly Niemann-Pick type C disease. Relevant limitations of these techniques are also discussed, along with the latest advances and developments. We conclude that metabolomics strategies are highly valuable, distinctive bioanalytical techniques for probing LSDs, most especially for the detection and validation of potential biomarkers. They also show much promise for monitoring disease progression and the evaluation of therapeutic strategies and targets.


Assuntos
Metabolômica/métodos , Doença de Niemann-Pick Tipo C/metabolismo , Biomarcadores/análise , Humanos , Espectroscopia de Ressonância Magnética/métodos , Espectroscopia de Ressonância Magnética/normas , Espectrometria de Massas/métodos , Espectrometria de Massas/normas , Metabolômica/normas , Doença de Niemann-Pick Tipo C/genética , Doença de Niemann-Pick Tipo C/patologia , Esfingolipídeos/análise , Esfingolipídeos/metabolismo
20.
Angew Chem Int Ed Engl ; 59(46): 20480-20484, 2020 11 09.
Artigo em Inglês | MEDLINE | ID: mdl-32743891

RESUMO

The ligands L1 and L2 form trinuclear self-assembled complexes with Cu2+ (i.e. [(L1 )2 Cu3 ]6+ or [(L2 )2 Cu3 ]6+ ) both of which act as a host to a variety of anions. Inclusion of long aliphatic chains on these ligands allows the assemblies to extract anions from aqueous media into organic solvents. Phosphate can be removed from water efficiently and highly selectively, even in the presence of other anions.

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