239 research outputs found

    Changes in the characteristics of new drug applications for the treatment and prevention of diabetes mellitus

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    Thesis (S.M.)--Massachusetts Institute of Technology, Dept. of Civil and Environmental Engineering; and, (S.M.)--Massachusetts Institute of Technology, Engineering Systems Division, Technology and Policy Program, 2007.Includes bibliographical references (p. 99-102).Efforts in managing diabetes, including the medical advances in novel therapies and public health policies of disease control and prevention, have not reduced the disease prevalence since 1990s. I analyze this phenomenon from the technology and policy viewpoints underlying diabetes treatment and prevention, in order to control and manage the disease in a cost-benefit balanced manner. The innovative performance of the antidiabetic drug therapy is investigated by analyzing the fifteen New Drug Applications (NDAs) of the antidiabetics approved by the US Food and Drug Administration since the early 1990s. I examine the characteristics of the clinical trials supporting NDAs and observe how the complexity of clinical trials has changed over time. Nine out of the twenty-five selected indicators are found to exhibit an increasing trend of complexity. The trend is more pronounced in the oral antiglycemics group (seven indicators) than the subcutaneous group (two indicators). Interestingly, this trend in increasing complexity in clinical trials is generally consistent with that of the increasing R&D costs in the pharmaceutical industry, possibly account for the declining innovative performance of the industry over the time period under investigation. A system dynamics approach is applied to assess current public health policies in diabetes control and prevention.(cont.) The benefit of system thinking is to avoid potential policy resistance by identifying the problematic characteristics of the system, such as time-delays, feedback, and structure of stocks and flows. For diabetes management, the public health system can be considered a "dynamic-complex" system in terms of current policy made by the National Diabetes Control and Prevention Program. Despite providing earlier and expanded screening as well as improved availability and accessibility of treatment for diabetes, the policy results in the increase of prevalence. More undiagnosed people are diagnosed, thus increasing the incidence, whereas people already diagnosed prolong their lifespan due to the better and more accessible medical care. A future successful chronic disease management program should systematically integrate the efforts from both the treatment and prevention perspectives.by Hsiao-Lan Sharon Lin.S.M

    Spatially resolved velocity maps of halo gas around two intermediate-redshift galaxies

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    Absorption-line spectroscopy of multiply-lensed QSOs near a known foreground galaxy provides a unique opportunity to go beyond the traditional one-dimensional application of QSO probes and establish a crude three-dimensional map of halo gas around the galaxy that records the line-of-sight velocity field at different locations in the gaseous halo. Two intermediate-redshift galaxies are targeted in the field around the quadruply-lensed QSO HE 0435−1223 at redshift z = 1.689, and absorption spectroscopy along each of the lensed QSOs is carried out in the vicinities of these galaxies. One galaxy is a typical, star-forming L* galaxy at z = 0.4188 and projected distance of ρ = 50 kpc from the lensing galaxy. The other is a super-L* barred spiral at z = 0.7818 and ρ = 33 kpc. Combining known orientations of the quadruply-lensed QSO to the two foreground galaxies with the observed Mg ii λλ2796, 2803 absorption profiles along individual QSO sightlines has for the first time led to spatially resolved kinematics of tenuous halo gas on scales of 5–10 kpc at z > 0.2. A Mg ii absorber is detected in every sightline observed through the haloes of the two galaxies, and the recorded absorber strength is typical of what is seen in previous close QSO–galaxy pair studies. While the multisightline study confirms the unity covering fraction of Mg ii absorbing gas at ρ < 50 kpc from star-forming discs, the galaxies also present two contrasting examples of complex halo gas kinematics. Different models, including a rotating disc, collimated outflows and gaseous streams from either accretion or tidal/ram-pressure stripping, are considered for comparisons with the absorption-line observations, and infalling streams/stripped gas of width ≳10 kpc are found to best describe the observed gas kinematics across multiple sightlines. In addition, the observed velocity dispersion between different sightlines offers a crude estimate of turbulence in the Mg ii absorbing halo gas. The observations presented here demonstrate that multiple-QSO probes enable studies of spatially resolved gas kinematics around distant galaxies, which provide key insights into the physical nature of circumgalactic gas beyond the nearby Universe

    The Multi-Epoch Nearby Cluster Survey: type Ia supernova rate measurement in z~0.1 clusters and the late-time delay time distribution

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    We describe the Multi-Epoch Nearby Cluster Survey (MENeaCS), designed to measure the cluster Type Ia supernova (SN Ia) rate in a sample of 57 X-ray selected galaxy clusters, with redshifts of 0.05 < z < 0.15. Utilizing our real time analysis pipeline, we spectroscopically confirmed twenty-three cluster SN Ia, four of which were intracluster events. Using our deep CFHT/Megacam imaging, we measured total stellar luminosities in each of our galaxy clusters, and we performed detailed supernova detection efficiency simulations. Bringing these ingredients together, we measure an overall cluster SN Ia rate within R_{200} (1 Mpc) of 0.042^{+0.012}_{-0.010}^{+0.010}_{-0.008} SNuM (0.049^{+0.016}_{-0.014}^{+0.005}_{-0.004} SNuM) and a SN Ia rate within red sequence galaxies of 0.041^{+0.015}_{-0.015}^{+0.005}_{-0.010} SNuM (0.041^{+0.019}_{-0.015}^{+0.005}_{-0.004} SNuM). The red sequence SN Ia rate is consistent with published rates in early type/elliptical galaxies in the `field'. Using our red sequence SN Ia rate, and other cluster SNe measurements in early type galaxies up to z1z\sim1, we derive the late time (>2 Gyr) delay time distribution (DTD) of SN Ia assuming a cluster early type galaxy star formation epoch of z_f=3. Assuming a power law form for the DTD, \Psi(t)\propto t^s, we find s=-1.62\pm0.54. This result is consistent with predictions for the double degenerate SN Ia progenitor scenario (s\sim-1), and is also in line with recent calculations for the double detonation explosion mechanism (s\sim-2). The most recent calculations of the single degenerate scenario delay time distribution predicts an order of magnitude drop off in SN Ia rate \sim 6-7 Gyr after stellar formation, and the observed cluster rates cannot rule this out.Comment: 35 pages, 14 figures, ApJ accepte

    Frequency Dependent Alterations in Regional Homogeneity of Baseline Brain Activity in Schizophrenia

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    Low frequency oscillations are essential in cognitive function impairment in schizophrenia. While functional connectivity can reveal the synchronization between distant brain regions, the regional abnormalities in task-independent baseline brain activity are less clear, especially in specific frequency bands. Here, we used a regional homogeneity (ReHo) method combined with resting-state functional magnetic resonance imaging to investigate low frequency spontaneous neural activity in the three different frequency bands (slow-5:0.01–0.027 Hz; slow-4:0.027–0.08 Hz; and typical band: 0.01–0.08 Hz) in 69 patients with schizophrenia and 62 healthy controls. Compared with controls, schizophrenia patients exhibited decreased ReHo in the precentral gyrus, middle occipital gyrus, and posterior insula, whereas increased ReHo in the medial prefrontal cortex and anterior insula. Significant differences in ReHo between the two bands were found in fusiform gyrus and superior frontal gyrus (slow-4> slow-5), and in basal ganglia, parahippocampus, and dorsal middle prefrontal gyrus (slow-5> slow-4). Importantly, we identified significant interaction between frequency bands and groups in the inferior occipital gyrus and caudate body. This study demonstrates that ReHo changes in schizophrenia are widespread and frequency dependent

    Microbiota Modulate Behavioral and Physiological Abnormalities Associated with Neurodevelopmental Disorders

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    Neurodevelopmental disorders, including autism spectrum disorder (ASD), are defined by core behavioral impairments; however, subsets of individuals display a spectrum of gastrointestinal (GI) abnormalities. We demonstrate GI barrier defects and microbiota alterations in the maternal immune activation (MIA) mouse model that is known to display features of ASD. Oral treatment of MIA offspring with the human commensal Bacteroides fragilis corrects gut permeability, alters microbial composition, and ameliorates defects in communicative, stereotypic, anxiety-like and sensorimotor behaviors. MIA offspring display an altered serum metabolomic profile, and B. fragilis modulates levels of several metabolites. Treating naive mice with a metabolite that is increased by MIA and restored by B. fragilis causes certain behavioral abnormalities, suggesting that gut bacterial effects on the host metabolome impact behavior. Taken together, these findings support a gut-microbiome-brain connection in a mouse model of ASD and identify a potential probiotic therapy for GI and particular behavioral symptoms in human neurodevelopmental disorders

    Comprehensive linkage and linkage heterogeneity analysis of 4344 sibling pairs affected with hypertension from the Family Blood Pressure Program

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    Linkage analyses of complex, multifactorial traits and diseases, such as essential hypertension, have been difficult to interpret and reconcile. Many published studies provide evidence suggesting that different genes and genomic regions influence hypertension, but knowing which of these studies reflect true positive results is challenging. The reasons for this include the diversity of analytical methods used across these studies, the different samples and sample sizes in each study, and the complicated biological underpinnings of hypertension. We have undertaken a comprehensive linkage analysis of 371 autosomal microsatellite markers genotyped on 4,334 sibling pairs affected with hypertension from five ethnic groups sampled from 13 different field centers associated with the Family Blood Pressure Program (FBPP). We used a single analytical technique known to be robust to interpretive problems associated with a lack of completely informative markers to assess evidence for linkage to hypertension both within and across the ethnic groups and field centers. We find evidence for linkage to a number of genomic regions, with the most compelling evidence from analyses that combine data across field center and ethnic groups (e.g., chromosomes 2 and 9). We also pursued linkage analyses that accommodate locus heterogeneity, which is known to plague the identification of disease susceptibility loci in linkage studies of complex diseases. We find evidence for linkage heterogeneity on chromosomes 2 and 17. Ultimately our results suggest that evidence for linkage heterogeneity can only be detected with large sample sizes, such as the FBPP, which is consistent with theoretical sample size calculations. Genet. Epidemiol . 2007. © 2007 Wiley-Liss, Inc.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/56011/1/20202_ftp.pd

    Discovery of 90 Type Ia supernovae among 700,000 Sloan spectra: the Type-Ia supernova rate versus galaxy mass and star-formation rate at redshift ~0.1

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    Using a method to discover and classify supernovae (SNe) in galaxy spectra, we find 90 Type Ia SNe (SNe Ia) and 10 Type II SNe among the ~700,000 galaxy spectra in the Sloan Digital Sky Survey Data Release 7 that have VESPA-derived star-formation histories (SFHs). We use the SN Ia sample to measure SN Ia rates per unit stellar mass. We confirm, at the median redshift of the sample, z = 0.1, the inverse dependence on galaxy mass of the SN Ia rate per unit mass, previously reported by Li et al. (2011b) for a local sample. We further confirm, following Kistler et al. (2011), that this relation can be explained by the combination of galaxy "downsizing" and a power-law delay-time distribution (DTD; the distribution of times that elapse between a hypothetical burst of star formation and the subsequent SN Ia explosions) with an index of -1, inherent to the double-degenerate progenitor scenario. We use the method of Maoz et al. (2011) to recover the DTD by comparing the number of SNe Ia hosted by each galaxy in our sample with the VESPA-derived SFH of the stellar population within the spectral aperture. In this galaxy sample, which is dominated by old and massive galaxies, we recover a "delayed" component to the DTD of 4.5 +/- 0.6 (statistical) +0.3 -0.5 (systematic) X 10^-14 SNe Msun^-1 yr^-1 for delays in the range > 2.4 Gyr. The mass-normalized SN Ia rate, averaged over all masses and redshifts in our galaxy sample, is R(Ia,M,z=0.1) = 0.10 +/- 0.01 (statistical) +/- 0.01 (systematic) SNuM, and the volumetric rate is R(Ia,V,z=0.1) = 0.247 +0.029 -0.026 (statistical) +0.016 -0.031 (systematic) X 10^-4 SNe yr^-1 Mpc^-3. This rate is consistent with the rates and rate evolution from other recent SN Ia surveys, which together also indicate a ~t^-1 DTD.Comment: MNRAS accepted. 20 pages, 12 figures, 5 tables. Revised following referee report. A full version of figure 8 can be found at http://www.astro.tau.ac.il/~orgraur/Graur_SDSS_SNe_full.pd

    Identified single-nucleotide polymorphisms and haplotypes at 16q22.1 increase diabetic nephropathy risk in Han Chinese population

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    Abstract Background Diabetic nephropathy (DN) has become one of the most common causes of end-stage renal disease (ESRD) in many countries, such as 44.5% in Taiwan. Previous studies have shown that there is a genetic component to ESRD. Studies attempting to determine which genetic variants are related to DN in Han Chinese are limited. A case–control study was conducted to identify DN susceptibility variants in Han Chinese patients with type 2 diabetes. Results We included 574 unrelated type 2 diabetes patients (217 DN cases and 357 controls), who were genotyped using Illumina HumanHap550-Duo BeadChip. In single-SNP association tests, the SNPs rs11647932, rs11645214, and rs6499323 located at 16q22.1 under the additive-effect disease model were significantly associated with an approximately 2-fold increased risk of DN. In haplotype association tests, identified haplotypes located in the chromosome 16q22.1 region (containing ST3GAL2, COG4, SF3B3, and IL34 genes) raised DN risk. The strongest association was found with haplotype rs2288491-rs4985534-rs11645214 (C-C-G) (adjusted odds ratio [AOR] 1.93, 95% confidence interval [CI] 1.83-2.03, p = 6.25 × 10−7), followed by haplotype rs8052125-rs2288491-rs4985534-rs11645214 (G-C-C-G) (AOR 1.92, 95% CI 1.82-2.02, p = 6.56 × 10−7), and haplotype rs2303792-rs8052125-rs2288491-rs4985534-rs11645214 (A-G-C-C-G) (AOR 1.91, 95% CI 1.81-2.01, p = 1.15 × 10−6). Conclusions Our results demonstrate that the novel SNPs and haplotypes located at the 16q22.1 region may involve in the biological pathways of DN in Han Chinese patients with type 2 diabetes. This study can provide new insights into the etiology of DN.http://deepblue.lib.umich.edu/bitstream/2027.42/109508/1/12863_2014_Article_113.pd
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