Efficacy and safety of empagliflozin in glycogen storage disease type Ib: Data from an international questionnaire

Purpose: This paper aims to report collective information on safety and efficacy of empagliflozin drug repurposing in individuals with glycogen storage disease type Ib (GSD Ib). Methods: This is an international retrospective questionnaire study on the safety and efficacy of empagliflozin use for management of neutropenia/neutrophil dysfunction in patients with GSD Ib, conducted among the respective health care providers from 24 countries across the globe. Results: Clinical data from 112 individuals with GSD Ib were evaluated, representing a total of 94 treatment years. The median age at start of empagliflozin treatment was 10.5 years (range = 0-38 years). Empagliflozin showed positive effects on all neutrophil dysfunction-related symptoms, including oral and urogenital mucosal lesions, recurrent infections, skin abscesses, inflammatory bowel disease, and anemia. Before initiating empagliflozin, most patients with GSD Ib were on G-CSF (94/112; 84%). At the time of the survey, 49 of 89 (55%) patients previously treated with G-CSF had completely stopped G-CSF, and another 15 (17%) were able to reduce the dose. The most common adverse event during empagliflozin treatment was hypoglycemia, occurring in 18% of individuals. Conclusion: Empagliflozin has a favorable effect on neutropenia/neutrophil dysfunction-related symptoms and safety profile in individuals with GSD Ib. Keywords: GSD Ib; Glycogen storage disease type Ib; Neutropenia; SGLT2 inhibitors; SLC37A

"Phenomenal Conservatism" - Ch 2 of Seemings and Epistemic Justification

In this chapter I introduce and analyse the tenets of phenomenal conservatism, and discuss the problem of the nature of appearances. After that, I review the asserted epistemic merits phenomenal conservatism and the principal arguments adduced in support of it. Finally, I survey objections to phenomenal conservatism and responses by its advocates. Some of these objections will be scrutinised and appraised in the next chapters

Rubber friction: role of the flash temperature

When a rubber block is sliding on a hard rough substrate, the substrate asperities will exert time-dependent deformations of the rubber surface resulting in viscoelastic energy dissipation in the rubber, which gives a contribution to the sliding friction. Most surfaces of solids have roughness on many different length scales, and when calculating the friction force it is necessary to include the viscoelastic deformations on all length scales. The energy dissipation will result in local heating of the rubber. Since the viscoelastic properties of rubber-like materials are extremely strongly temperature dependent, it is necessary to include the local temperature increase in the analysis. At very low sliding velocity the temperature increase is negligible because of heat diffusion, but already for velocities of order 0.01 m/s the local heating may be very important. Here I study the influence of the local heating on the rubber friction, and I show that in a typical case the temperature increase results in a decrease in rubber friction with increasing sliding velocity for v > 0.01 m/s. This may result in stick-slip instabilities, and is of crucial importance in many practical applications, e.g., for the tire-road friction, and in particular for ABS-breaking systems.Comment: 22 pages, 27 figure

Metacognition as Evidence for Evidentialism

Metacognition is the monitoring and controlling of cognitive processes. I examine the role of metacognition in ‘ordinary retrieval cases’, cases in which it is intuitive that via recollection the subject has a justified belief. Drawing on psychological research on metacognition, I argue that evidentialism has a unique, accurate prediction in each ordinary retrieval case: the subject has evidence for the proposition she justifiedly believes. But, I argue, process reliabilism has no unique, accurate predictions in these cases. I conclude that ordinary retrieval cases better support evidentialism than process reliabilism. This conclusion challenges several common assumptions. One is that non-evidentialism alone allows for a naturalized epistemology, i.e., an epistemology that is fully in accordance with scientific research and methodology. Another is that process reliabilism fares much better than evidentialism in the epistemology of memory

Science's immunity to moral refutation

Our moral convictions cannot, on the face of it, count in evidence against scientific claims with which they happen to conflict. Moral anti-realists of whatever stripe can explain this easily: science is immune to moral refutation because moral discourse is defective as a trustworthy source of true and objective judgments. Moral realists, they can add, are unable to explain this immunity. After describing how anti-realists might implement this reasoning, the paper argues that the only plausible realist comeback turns on the practical nature of moral reasoning. This comeback, however, places significant constraints on the structure of evidence for moral judgments. These constraints cannot be met by coherentist defenders of reflective-equilibrium methodology or by anyone sympathetic to bottom-up, case-driven foundationalism, including those who claim we have perceptual or perception-like access to moral truths. Unfortunately for realists in these categories, alternative realism-friendly accounts of science’s apparent moral immunity are unpromising. These neither explain nor explain away our unwillingness to infer an is from an ought, as Hume might have put it. Science’s apparent immunity to moral refutation therefore poses a serious problem for any realist unhappy with top-down, theory-driven conceptions of the structure of moral evidence

100 years of inherited metabolic disorders in Austria-A national registry of minimal birth prevalence, diagnosis, and clinical outcome of inborn errors of metabolism in Austria between 1921 and 2021

Inherited metabolic disorders (IMDs) are a heterogeneous group of rare disorders characterized by disruption of metabolic pathways. To date, data on incidence and prevalence of IMDs are limited. Taking advantage of a functioning network within the Austrian metabolic group, our registry research aimed to update the data of the "Registry for Inherited Metabolic Disorders" started between 1985 and 1995 with retrospectively retrieved data on patients with IMDs according to the Society for the Study of Inborn Errors of Metabolism International Classification of Diseases 11 (SSIEM ICD11) catalogue. Included in this retrospective register were 2631 patients with an IMD according to the SSIEM ICD11 Classification, who were treated in Austria. Thus, a prevalence of 1.8/10 000 for 2020 and a median minimal birth prevalence of 16.9/100 000 (range 0.7/100 000-113/100 000) were calculated for the period 1921 to February 2021. We detected a male predominance (m:f = 1.2:1) and a mean age of currently alive patients of 17.6 years (range 5.16 months-100 years). Most common diagnoses were phenylketonuria (17.7%), classical galactosaemia (6.6%), and biotinidase deficiency (4.2%). The most common diagnosis categories were disorders of amino acid and peptide metabolism (819/2631; 31.1%), disorders of energy metabolism (396/2631; 15.1%), and lysosomal disorders (395/2631; 15.0%). In addition to its epidemiological relevance, the "Registry for Inherited Metabolic Disorders" is an important tool for enhancing an exchange between care providers. Moreover, by pooling expertise it prospectively improves patient treatment, similar to pediatric oncology protocols. A substantial requirement for ful filling this goal is to regularly update the registry and provide nationwide coverage with inclusion of all medical specialties

Belief, Credence and Statistical Evidence

According to the Rational Threshold View, a rational agent believes p if and only if her credence in p is equal to or greater than a certain threshold. One of the most serious challenges for this view is the problem of statistical evidence: statistical evidence is often not sufficient to make an outright belief rational, no matter how probable the target proposition is given such evidence. This indicates that rational belief is not as sensitive to statistical evidence as rational credence. The aim of this paper is twofold. First, we argue that, in addition to playing a decisive role in rationalizing outright belief, non-statistical evidence also plays a preponderant role in rationalizing credence. More precisely, when both types of evidence are present in a context, non-statistical evidence should receive a heavier weight than statistical evidence in determining rational credence. Second, based on this result, we argue that a modified version of the Rational Threshold View can avoid the problem of statistical evidence. We conclude by suggesting a possible explanation of the varying sensitivity to different types of evidence for belief and credence based on the respective aims of these attitudes

DNA Barcoding the Geometrid Fauna of Bavaria (Lepidoptera): Successes, Surprises, and Questions

BACKGROUND: The State of Bavaria is involved in a research program that will lead to the construction of a DNA barcode library for all animal species within its territorial boundaries. The present study provides a comprehensive DNA barcode library for the Geometridae, one of the most diverse of insect families. METHODOLOGY/PRINCIPAL FINDINGS: This study reports DNA barcodes for 400 Bavarian geometrid species, 98 per cent of the known fauna, and approximately one per cent of all Bavarian animal species. Although 98.5% of these species possess diagnostic barcode sequences in Bavaria, records from neighbouring countries suggest that species-level resolution may be compromised in up to 3.5% of cases. All taxa which apparently share barcodes are discussed in detail. One case of modest divergence (1.4%) revealed a species overlooked by the current taxonomic system: Eupithecia goossensiata Mabille, 1869 stat.n. is raised from synonymy with Eupithecia absinthiata (Clerck, 1759) to species rank. Deep intraspecific sequence divergences (>2%) were detected in 20 traditionally recognized species. CONCLUSIONS/SIGNIFICANCE: The study emphasizes the effectiveness of DNA barcoding as a tool for monitoring biodiversity. Open access is provided to a data set that includes records for 1,395 geometrid specimens (331 species) from Bavaria, with 69 additional species from neighbouring regions. Taxa with deep intraspecific sequence divergences are undergoing more detailed analysis to ascertain if they represent cases of cryptic diversity

Oppositional COMT Val158Met effects on resting state functional connectivity in adolescents and adults

© 2014, The Author(s).Prefrontal dopamine levels are relatively increased in adolescence compared to adulthood. Genetic variation of COMT (COMT Val158Met) results in lower enzymatic activity and higher dopamine availability in Met carriers. Given the dramatic changes of synaptic dopamine during adolescence, it has been suggested that effects of COMT Val158Met genotypes might have oppositional effects in adolescents and adults. The present study aims to identify such oppositional COMT Val158Met effects in adolescents and adults in prefrontal brain networks at rest. Resting state functional connectivity data were collected from cross-sectional and multicenter study sites involving 106 healthy young adults (mean age 24 ± 2.6 years), gender matched to 106 randomly chosen 14-year-olds. We selected the anterior medial prefrontal cortex (amPFC) as seed due to its important role as nexus of the executive control and default mode network. We observed a significant age-dependent reversal of COMT Val158Met effects on resting state functional connectivity between amPFC and ventrolateral as well as dorsolateral prefrontal cortex, and parahippocampal gyrus. Val homozygous adults exhibited increased and adolescents decreased connectivity compared to Met homozygotes for all reported regions. Network analyses underscored the importance of the parahippocampal gyrus as mediator of observed effects. Results of this study demonstrate that adolescent and adult resting state networks are dose-dependently and diametrically affected by COMT genotypes following a hypothetical model of dopamine function that follows an inverted U-shaped curve. This study might provide cues for the understanding of disease onset or dopaminergic treatment mechanisms in major neuropsychiatric disorders such as schizophrenia and attention deficit hyperactivity disorder