Utility of a single adjusting compartment: a novel methodology for whole body physiologically-based pharmacokinetic modelling

<p>Abstract</p> <p>Background</p> <p>There are various methods for predicting human pharmacokinetics. Among these, a whole body physiologically-based pharmacokinetic (WBPBPK) model is useful because it gives a mechanistic description. However, WBPBPK models cannot predict human pharmacokinetics with enough precision. This study was conducted to elucidate the primary reason for poor predictions by WBPBPK models, and to enable better predictions to be made without reliance on complex concepts.</p> <p>Methods</p> <p>The primary reasons for poor predictions of human pharmacokinetics were investigated using a generic WBPBPK model that incorporated a single adjusting compartment (SAC), a virtual organ compartment with physiological parameters that can be adjusted arbitrarily. The blood flow rate, organ volume, and the steady state tissue-plasma partition coefficient of a SAC were calculated to fit simulated to observed pharmacokinetics in the rat. The adjusted SAC parameters were fixed and scaled up to the human using a newly developed equation. Using the scaled-up SAC parameters, human pharmacokinetics were simulated and each pharmacokinetic parameter was calculated. These simulated parameters were compared to the observed data. Simulations were performed to confirm the relationship between the precision of prediction and the number of tissue compartments, including a SAC.</p> <p>Results</p> <p>Increasing the number of tissue compartments led to an improvement of the average-fold error (AFE) of total body clearances (CL_tot) and half-lives (T_1/2) calculated from the simulated human blood concentrations of 14 drugs. The presence of a SAC also improved the AFE values of a ten-organ model from 6.74 to 1.56 in CL_tot, and from 4.74 to 1.48 in T_1/2. Moreover, the within-2-fold errors were improved in all models; incorporating a SAC gave results from 0 to 79% in CL_tot, and from 14 to 93% in T_1/2of the ten-organ model.</p> <p>Conclusion</p> <p>By using a SAC in this study, we were able to show that poor prediction resulted mainly from such physiological factors as organ blood flow rate and organ volume, which were not satisfactorily accounted for in previous WBPBPK models. The SAC also improved precision in the prediction of human pharmacokinetics. This finding showed that the methodology of our study may be useful for functionally reinforcing a WBPBPK model.</p

Recovery and Enrichment of Phosphorus from the Nitric Acid Extract of Dephosphorization Slag

A method for the recovery and enrichment of the phosphate from dephosphorization slag was examined. First, the elution of aqueous phosphate from dephosphorization slag using aqueous HNO3 was examined using both the batch and flow methods. With the batch method, 82% of the dephosphorization slag could be dissolved within 30 min using 1.0 mol/L HNO3, indicating that the batch method could be used for mass processing to extract phosphorus in the bulk phase, but all components contained in the slag were unselectively dissolved. In contrast, by using 0.05 mol/L HNO3 via the flow method, 22% of the slag was dissolved in 100 min giving a more selective dissolution of phosphate from the slag compared with the batch method, which indicated that this method would be incompatible with mass processing for the purpose of extracting phosphorus in the bulk phase. In order to remove the Fe-species in the aqueous solution obtained by the batch method using 1.0 mol/L HNO3, which has been referred to as the “slag solution,” it was necessary to add calcium hydroxyapatite (CaHAp) to the slag solution. The optimal conditions for the removal of Fe-species using CaHAp were observed at a solution pH of ca. 1.5, which resulted in 100% removal of the Fe-species after 4 h. When the pH of the slag solution was adjusted to 7.0 after removing the Fe species, a pale pink solid sample was precipitated. The amounts of phosphate in the slag solution and in the pink solid were 3.5 and 42.0 mol%, respectively, indicating that the treatment suggested in the present study could be used for the recovery and enrichment of phosphate, that is, phosphorous, from dephosphorization slag

Recovery of the Phosphorus from the Nitric Acid Extract of Powder Collected in a Bag Filter during the Recycling of Used Fluorescence Tubes

During the recovery of phosphorus from the powder collected in a bag filter during the recycling of used fluorescence tubes (bag-powder), the batch method with aqueous HNO3 was used to examine the elution behavior of aqueous phosphate contained in the bag-powder. The main components of the bag-powder included Ca2+, PO4 3- and Y3+ along with Si4+, Sr2+ and lanthanide cations such as La3+ and Ce4+. Therefore, it seemed possible that, with the selective dissolution of Ca2+ and PO4 3- from the bag-powder, these lanthanide cations in the residue could be enriched. With the batch method, most of the phosphate in the bag-powder was dissolved within 0.2 min using 1.0 mol/L HNO3. The dissolution behavior of calcium cation was similar to that of the phosphate. In contrast, the dissolution of yttrium, the content of which was the highest among the lanthanide cations in the bag-powder, was increased with the dissolution times, reaching complete dissolution after 24 h. The Sr2+, La3+ and Si4+ in the bag-powder, however, did not dissolve under the same conditions. Although Ca2+, PO4 3- and Y3+ were the main components in the nitric acid extract, Y3+ was separated as YPO4 at pH = 4.0, while Ca2+ and PO4 3- were separated as calcium phosphates at pH= 7.0. These results revealed that the separation of calcium phosphates, YPO4 and some residue was possible, and resulted in the enrichment of lanthanide cations along with the recovery of phosphorus from the bag-powder. Using the present technique, 91% of the P in the bag-powder was recovered

Pathway to psychiatric care in Japan: A multicenter observational study

<p>Abstract</p> <p>Background</p> <p>This study examines pathways to psychiatric care in Japan using the same method as the collaborative study carried out in 1991 under the auspices of the World Health Organization.</p> <p>Methods</p> <p>Thirteen psychiatric facilities in Japan were involved. Of the 228 patients who contacted psychiatric facilities with any psychiatric illness, eighty four visiting psychiatric facilities for the first time were enrolled. Pathways to psychiatric care, delays from the onset of illness to treatment prior to reaching psychiatrists were surveyed.</p> <p>Results</p> <p>Thirty three patients (39.4%) directly accessed mental health professionals, 32 patients (38.1%) reached them via general hospital, and 13 patients (15.5%) via private practitioners. The patients who consulted mental health professionals as their first carers took a longer time before consulting psychiatrists than the patients who consulted non-mental health professionals as their first carers. The patients who presented somatic symptoms as their main problem experienced longer delay from the onset of illness to psychiatric care than the patients who complained about depressive or anxiety symptoms. Prior to the visit to mental health professionals, patients were rarely informed about their diagnosis and did not receive appropriate treatments from their physicians. Private practitioners were more likely to prescribe psychotropics than physicians in general hospitals, but were less likely to inform their patients of their diagnosis.</p> <p>Conclusion</p> <p>This first pathway to psychiatric care study in Japan demonstrated that referral pathway in Japan heavily relies on medical resources. The study indicates possible fields and gives indications, underlining the importance of improving skills and knowledge that will facilitate the recognition of psychiatric disorders presenting with somatic and depressive symptoms in the general health care system and by private practitioners.</p

Breastfeeding history and metabolic syndrome in parous women

Objective The aim of the present study was to investigate the associations between breastfeeding and the prevalence of metabolic syndrome in community-dwelling parous women and to clarify whether the associations depend on age. Methods The present cross-sectional study included 11,118 women, aged 35–69 years. Participants’ longest breastfeeding duration for one child and their number of breastfed children were assessed using a self-administered questionnaire, and their total breastfeeding duration was approximated as a product of the number of breastfed children and the longest breastfeeding duration. The longest and the total breastfeeding durations were categorized into none and tertiles above 0 months. Metabolic syndrome and cardiovascular risk factors (obesity, hypertension, dyslipidemia, and hyperglycemia) were defined as primary and secondary outcomes, respectively. Associations between breastfeeding history and metabolic syndrome or each cardiovascular risk factor were assessed using multivariable unconditional logistic regression analysis. Results Among a total of 11,118 women, 10,432 (93.8%) had ever breastfed, and 1,236 (11.1%) had metabolic syndrome. In participants aged <55 years, an inverse dose–response relationship was found between the number of breastfed children and the prevalence of metabolic syndrome; multivariable-adjusted odds ratios for 1, 2, 3, and ≥4 breastfed children were 0.60 (95% confidence interval [CI]: 0.31 to 1.17), 0.50 (95% CI: 0.29 to 0.87), 0.44 (95% CI: 0.24 to 0.84), and 0.35 (95% CI: 0.14 to 0.89), respectively. The longest and total breastfeeding durations of longer than 0 months were also associated with lower odds of metabolic syndrome relative to no breastfeeding history in participants aged <55 years. In contrast, all measures of breastfeeding history were not significantly associated with metabolic syndrome and cardiovascular risk factors in participants aged ≥55 years old. Conclusions Breastfeeding history may be related to lower prevalence of metabolic syndrome in middle-aged parous women

Association between plasma levels of homocysteine, folate, and vitamin B12, and dietary folate intake and hypertension in a cross-sectional study

There are few studies examining the association between homocysteine (Hcy) level and the risk of hypertension with consideration for folate and vitamin B12 as related to Hcy level. We simultaneously examined the associations of plasma levels of Hcy, folate, and vitamin B12, and dietary folate intake with the prevalence of hypertension. Participants included 1046 men and 1033 women (mean age ± standard deviation: 56.0 ± 8.9 years) in the Japan Multi-Institutional Collaborative Cohort Study. Dietary folate intake was estimated using a validated food frequency questionnaire. Hypertension was defined based on measured blood pressure and use of antihypertensive medication. A total of 734 participants (35.3%) had hypertension. Multivariate-adjusted odds ratios of hypertension for the highest quartile group of Hcy were 2.36 (95% CI 1.41–3.96) in men and 1.86 (95% CI 1.11–3.11) in women, as compared with the lowest group (P for trend = 0.014 and 0.005, respectively). Dietary folate intake was not correlated with hypertension in both men and women (P for trend = 0.099 and 0.703, respectively). Plasma vitamin B12 was positively associated with hypertension only in women (P for trend = 0.027). Plasma Hcy level was positively linked with hypertension after controlling for covariates, including folate and vitamin B12

Association Between PSCA Variants and Duodenal Ulcer Risk

Background: While duodenal ulcer (DU) and gastric cancer (GC) are both H. pylori infection-related diseases, individuals with DU are known to have lower risk for GC. Many epidemiological studies have identified the PSCA rs2294008 T-allele as a risk factor of GC, while others have found an association between the rs2294008 C-allele and risk of DU and gastric ulcer (GU). Following these initial reports, however, few studies have since validated these associations. Here, we aimed to validate the association between variations in PSCA and the risk of DU/GU and evaluate its interaction with environmental factors in a Japanese population. Methods: Six PSCA SNPs were genotyped in 584 DU cases, 925 GU cases, and 8,105 controls from the Japan Multi-Institutional Collaborative Cohort (J-MICC). Unconditional logistic regression models were applied to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the association between the SNPs and risk of DU/GU. Results: PSCA rs2294008 C-allele was associated with per allele OR of 1.34 (95% CI, 1.18–1.51; P = 2.28 × 10−6) for the risk of DU. This association was independent of age, sex, study site, smoking habit, drinking habit, and H. pylori status. On the other hand, we did not observe an association between the risk of GU and PSCA SNPs. Conclusions: Our study confirms an association between the PSCA rs2294008 C-allele and the risk of DU in a Japanese population