Agent-based modeling: a systematic assessment of use cases and requirements for enhancing pharmaceutical research and development productivity.

A crisis continues to brew within the pharmaceutical research and development (R&D) enterprise: productivity continues declining as costs rise, despite ongoing, often dramatic scientific and technical advances. To reverse this trend, we offer various suggestions for both the expansion and broader adoption of modeling and simulation (M&S) methods. We suggest strategies and scenarios intended to enable new M&S use cases that directly engage R&D knowledge generation and build actionable mechanistic insight, thereby opening the door to enhanced productivity. What M&S requirements must be satisfied to access and open the door, and begin reversing the productivity decline? Can current methods and tools fulfill the requirements, or are new methods necessary? We draw on the relevant, recent literature to provide and explore answers. In so doing, we identify essential, key roles for agent-based and other methods. We assemble a list of requirements necessary for M&S to meet the diverse needs distilled from a collection of research, review, and opinion articles. We argue that to realize its full potential, M&S should be actualized within a larger information technology framework--a dynamic knowledge repository--wherein models of various types execute, evolve, and increase in accuracy over time. We offer some details of the issues that must be addressed for such a repository to accrue the capabilities needed to reverse the productivity decline

In silico, experimental, mechanistic model for extended-release felodipine disposition exhibiting complex absorption and a highly variable food interaction

The objective of this study was to develop and explore new, in silico experimental methods for deciphering complex, highly variable absorption and food interaction pharmacokinetics observed for a modified-release drug product. Toward that aim, we constructed an executable software analog of study participants to whom product was administered orally. The analog is an object- and agent-oriented, discrete event system, which consists of grid spaces and event mechanisms that map abstractly to different physiological features and processes. Analog mechanisms were made sufficiently complicated to achieve prespecified similarity criteria. An equation-based gastrointestinal transit model with nonlinear mixed effects analysis provided a standard for comparison. Subject-specific parameterizations enabled each executed analog's plasma profile to mimic features of the corresponding six individual pairs of subject plasma profiles. All achieved prespecified, quantitative similarity criteria, and outperformed the gastrointestinal transit model estimations. We observed important subject-specific interactions within the simulation and mechanistic differences between the two models. We hypothesize that mechanisms, events, and their causes occurring during simulations had counterparts within the food interaction study: they are working, evolvable, concrete theories of dynamic interactions occurring within individual subjects. The approach presented provides new, experimental strategies for unraveling the mechanistic basis of complex pharmacological interactions and observed variability

Generative Invertible Networks (GIN): Pathophysiology-Interpretable Feature Mapping and Virtual Patient Generation

Machine learning methods play increasingly important roles in pre-procedural planning for complex surgeries and interventions. Very often, however, researchers find the historical records of emerging surgical techniques, such as the transcatheter aortic valve replacement (TAVR), are highly scarce in quantity. In this paper, we address this challenge by proposing novel generative invertible networks (GIN) to select features and generate high-quality virtual patients that may potentially serve as an additional data source for machine learning. Combining a convolutional neural network (CNN) and generative adversarial networks (GAN), GIN discovers the pathophysiologic meaning of the feature space. Moreover, a test of predicting the surgical outcome directly using the selected features results in a high accuracy of 81.55%, which suggests little pathophysiologic information has been lost while conducting the feature selection. This demonstrates GIN can generate virtual patients not only visually authentic but also pathophysiologically interpretable

Oxygen-Vacancy-Induced Orbital Reconstruction of Ti Ions at the Interface of LaAlO3/SrTiO3 Heterostructures: A Resonant Soft-X-Ray Scattering Study

Resonant soft-x-ray scattering measurements have been performed to investigate interface electronic structures of (LaAlO3/SrTiO3) superlattices. Resonant scattering intensities at superlattice reflections show clear evidence of degeneracy lifting in t(2g) states of interface Ti ions. Polarization dependence of intensities indicates the energy of d(xy) states is lower by similar to 1 eV than two other t(2g) states. The energy splitting is insensitive to epitaxial strain. The orbital reconstruction is induced by oxygen vacancies and confined to the interface within two unit cells, indicating charge compensation at the polar interfaces. DOI: 10.1103/PhysRevLett.110.017401X112723Nsciescopu

Caring for Alaska Native prostate cancer survivors in primary care: a survey of Alaska Tribal Health System providers.

BACKGROUND: Little is known about the constraints of optimizing health care for prostate cancer survivors in Alaska primary care. OBJECTIVE: To describe the experiences and attitudes of primary care providers within the Alaska Tribal Health System (ATHS) regarding the care of prostate cancer survivors. DESIGN: In late October 2011, we emailed a 22-item electronic survey to 268 ATHS primary care providers regarding the frequency of Prostate Specific Antigen (PSA) monitoring for a hypothetical prostate cancer survivor; who should be responsible for the patient's life-long prostate cancer surveillance; who should support the patient's emotional and medical needs as a survivor; and providers' level of comfort addressing recurrence monitoring, erectile dysfunction, urinary incontinence, androgen deprivation therapy, and emotional needs. We used simple logistic regression to examine the association between provider characteristics and their responses to the survivorship survey items. RESULTS: Of 221 individuals who were successfully contacted, a total of 114 responded (52% response rate). Most ATHS providers indicated they would order a PSA test every 12 months (69%) and believed that, ideally, the hypothetical patient's primary care provider should be responsible for his life-long prostate cancer surveillance (60%). Most providers reported feeling either "moderately" or "very" comfortable addressing topics such as prostate cancer recurrence (59%), erectile dysfunction (64%), urinary incontinence (63%), and emotional needs (61%) with prostate cancer survivors. These results varied somewhat by provider characteristics including female sex, years in practice, and the number of prostate cancer survivors seen in their practice. CONCLUSIONS: These data suggest that most primary care providers in Alaska are poised to assume the care of prostate cancer survivors locally. However, we also found that large minorities of providers do not feel confident in their ability to manage common issues in prostate cancer survivorship, implying that continued access to specialists with more expert knowledge would be beneficial

Plant characteristics associated with widespread variation in eelgrass wasting disease

Seagrasses are ecosystem engineers of essential marine habitat. Their populations are rapidly declining worldwide. One potential cause of seagrass population declines is wasting disease, which is caused by opportunistic pathogens in the genus Labyrinthula. While infection with these pathogens is common in seagrasses, theory suggests that disease only occurs when environmental stressors cause immunosuppression of the host. Recent evidence suggests that host factors may also contribute to disease caused by opportunistic pathogens. In order to quantify patterns of disease, identify risk factors, and investigate responses to infection, we surveyed shoot density, shoot length, epiphyte load, production of plant defenses (phenols), and wasting disease prevalence in eelgrass Zostera marina across 11 sites in the central Salish Sea (Washington state, USA), a region where both wasting disease and eelgrass declines have been documented. Wasting disease was diagnosed by the presence of necrotic lesions, and Labyrinthula cells were identified with histology. Disease prevalence among sites varied from 6 to 79%. The probability of a shoot being diseased was higher in longer shoots, in patches of higher shoot density, and in shoots with higher levels of biofouling from epiphytes. Phenolic concentration was higher in diseased leaves. We hypothesize that this results from the induction of phenols during infection. Additional research is needed to evaluate whether phenols are an adaptive defense against Labyrinthula infection. The high site-level variation in disease prevalence emphasizes the potential for wasting disease to be causing some of the observed decline in eelgrass beds

Stall Inception in Low-Pressure Ratio Fans

A combined experimental and computational test program, with two low-pressure ratio aero-engine fans, has been used to identify the flow mechanisms at stall inception and the subsequent stall cell growth. The two fans have the same rotor tip clearance, annulus design, and downstream stators, but different levels of tip loading. The measurement data show that both the fans stall via spike-type inception, but that the growth of the stall cell and the final cell size is different in each fan. The computations, reproducing both the qualitative and quantitative behavior of the steady-state and transient measurements, are used to identify the flow mechanisms at the origin of stall inception. In one fan, spillage of tip leakage flow upstream of the leading edge plane is responsible. In the other, sudden growth of casing corner separation blockage leads to stall. These two mechanisms are in accord with the findings from core compressors. However, the transonic aerodynamics and the low hub-to-tip radius ratio of the fans lead to the following two findings: first, the casing corner separation is driven by shock-boundary layer interaction and second, the spanwise loading distribution of the fan determines whether the spike develops into full-span or part-span stall and both types of behavior are represented in the present work. Finally, the axial momentum flux of the tip clearance flow is shown to be a useful indicator of the leakage jet spillage mechanism. A simple model is provided that links the tip loading, stagger, and solidity with the tip clearance axial momentum flux, thereby allowing the aerodynamicist to connect, qualitatively, design parameters with the stall behavior of the fan.</jats:p

Tissue Tropism in Host Transcriptional Response to Members of the Bovine Respiratory Disease Complex.

Bovine respiratory disease (BRD) is the most common infectious disease of beef and dairy cattle and is characterized by a complex infectious etiology that includes a variety of viral and bacterial pathogens. We examined the global changes in mRNA abundance in healthy lung and lung lesions and in the lymphoid tissues bronchial lymph node, retropharyngeal lymph node, nasopharyngeal lymph node and pharyngeal tonsil collected at the peak of clinical disease from beef cattle experimentally challenged with either bovine respiratory syncytial virus, infectious bovine rhinotracheitis, bovine viral diarrhea virus, Mannheimia haemolytica or Mycoplasma bovis. We identified signatures of tissue-specific transcriptional responses indicative of tropism in the coordination of host's immune tissue responses to infection by viral or bacterial infections. Furthermore, our study shows that this tissue tropism in host transcriptional response to BRD pathogens results in the activation of different networks of response genes. The differential crosstalk among genes expressed in lymphoid tissues was predicted to be orchestrated by specific immune genes that act as 'key players' within expression networks. The results of this study serve as a basis for the development of innovative therapeutic strategies and for the selection of cattle with enhanced resistance to BRD

Rolling-joint design optimization for tendon driven snake-like surgical robots

The use of snake-like robots for surgery is a popular choice for intra-luminal procedures. In practice, the requirements for strength, flexibility and accuracy are difficult to be satisfied simultaneously. This paper presents a computational approach for optimizing the design of a snake-like robot using serial rolling-joints and tendons as the base architecture. The method optimizes the design in terms of joint angle range and tendon placement to prevent the tendons and joints from colliding during bending motion. The resulting optimized joints were manufactured using 3D printing. The robot was characterized in terms of workspace, dexterity, precision and manipulation forces. The results show a repeatability as low as 0.9mm and manipulation forces of up to 5.6N