Oral bioavailability and drug/carrier particulate systems

The oral route remains the preferred route of administration to ensure patient satisfaction and compliance. However, new chemical entities may exhibit low bioavailability after oral administration because of poor stability within the gastrointestinal tract, poor solubility in gastrointestinal fluids, low mucosal permeability, and/or extensive first-pass metabolism. Consequently, these new drug substances cannot be further developed using conventional oral formulations. This issue is addressed by an innovative approach based on the entrapment of drug molecules in drug/carrier assembling systems. The carrier materials are lipids, naturally occurring polymers or synthetic polymers, which are considered as nontoxic and biocompatible materials. Drug entrapment is intended to protect drug substances against degradation by gastrointestinal fluids. Fine drug/carrier particle size ensures increased drug dissolution rates. Carriers and particle supramolecular organization can be designed to enhance drug absorption through the intestinal epithelium and lymphatic transport. Promising preclinical results have been obtained with model drugs like paclitaxel, insulin, calcitonin, or cyclosporin. Attention has focused on mucoadhesive carriers like chitosan that favor an intimate and extended contact between drugs and intestinal cells, thus enhancing absorption. Addition of ligands such as lectins improves intestinal drug absorption through specific binding of the carrier to intestinal cell carbohydrates. In conclusion, drug/carrier particulate systems are an attractive and exciting drug delivery strategy for highly potent drug substances unsuitable for oral use. Further evidence will determine whether this approach has marked therapeutic benefits over conventional drug formulations and is compatible with large-scale industrial production and stringent registration requirements. Producing highly effective particulate systems requiring low-complexity manufacturing processes is therefore an ongoing challenge

Fine Selmer Groups and Isogeny Invariance

We investigate fine Selmer groups for elliptic curves and for Galois representations over a number field. More specifically, we discuss Conjecture A, which states that the fine Selmer group of an elliptic curve over the cyclotomic extension is a finitely generated $\mathbb{Z}_p$-module. The relationship between this conjecture and Iwasawa's classical $\mu=0$ conjecture is clarified. We also present some partial results towards the question whether Conjecture A is invariant under isogenies.Comment: 20 page

Synthesis and structural characterization of a mimetic membrane-anchored prion protein

During pathogenesis of transmissible spongiform encephalopathies (TSEs) an abnormal form (PrPSc) of the host encoded prion protein (PrPC) accumulates in insoluble fibrils and plaques. The two forms of PrP appear to have identical covalent structures, but differ in secondary and tertiary structure. Both PrPC and PrPSc have glycosylphospatidylinositol (GPI) anchors through which the protein is tethered to cell membranes. Membrane attachment has been suggested to play a role in the conversion of PrPC to PrPSc, but the majority of in vitro studies of the function, structure, folding and stability of PrP use recombinant protein lacking the GPI anchor. In order to study the effects of membranes on the structure of PrP, we synthesized a GPI anchor mimetic (GPIm), which we have covalently coupled to a genetically engineered cysteine residue at the C-terminus of recombinant PrP. The lipid anchor places the protein at the same distance from the membrane as does the naturally occurring GPI anchor. We demonstrate that PrP coupled to GPIm (PrP-GPIm) inserts into model lipid membranes and that structural information can be obtained from this membrane-anchored PrP. We show that the structure of PrP-GPIm reconstituted in phosphatidylcholine and raft membranes resembles that of PrP, without a GPI anchor, in solution. The results provide experimental evidence in support of previous suggestions that NMR structures of soluble, anchor-free forms of PrP represent the structure of cellular, membrane-anchored PrP. The availability of a lipid-anchored construct of PrP provides a unique model to investigate the effects of different lipid environments on the structure and conversion mechanisms of PrP

Assessment and management of anxiety disorders in children and adolescents

Anxiety disorders in childhood and adolescence are extremely common and are often associated with lifelong psychiatric disturbance. Consistent with DSM-5 and the extant literature, this review concerns the assessment and treatment of specific phobias, separation anxiety disorder, generalised anxiety disorder, social anxiety disorder, panic disorder and agoraphobia. Evidence-based psychological treatments (cognitive behaviour therapy; CBT) for these disorders have been developed and investigated, and in recent years promising low-intensity versions of CBT interventions have been proposed that offer a means to increase access to evidence-based treatments. There is some evidence of effectiveness of pharmacological treatments for anxiety disorders in children and young people, however, routine prescription is not recommended due to concerns about potential harm

Evaluation of Chemotherapeutic Outcomes for Thymic Carcinoma Patients

Background and Hypothesis: Thymic Epithelial Tumors are uncommon tumors of the anterior mediastinum composed of thymomas and thymic carcinomas (TC). TC’s are known to have worse disease outcomes and lower rates of survival in comparison to thymomas and are suspected to have lower response rates to chemotherapy as well. As these tumors are rare, little data exists assessing the true efficacy of chemotherapeutic regimens for TC patients. Due to this lack of data, and that the Indiana University Health Simon Cancer Center treats a high percentage of TET patients, a database of these patients covering a variety different disease characteristics and treatments has been established. We hypothesize, upon evaluation of this database, response rates to anthracycline based regimens (PAC) will be superior to non-anthracycline based regimens (i.e., PE, Carbo/Taxol) for TC patients. Methods: In this project, a collection of patients seen by Dr. Patrick Loehrer and/or Dr. Kenneth Kesler was acquired, and a database was created using these patients in RedCap. Once established, we evaluated patient medical records in Cerner and entered data related to disease characteristics and treatments. These patients were then analyzed accordingly to evaluate chemotherapy response rates. Results: The database yielded 123 instances of chemotherapy treatment for TC. Of which, the most popular treatments were PAC and Carbo/Taxol. The data suggests that PAC generates a higher response rate (65.5%) than other therapies (Carbo/Taxol: 27.6%, PE: 58.3%, etc.). Therefore, there is evidence that anthracycline based regimens may be more effective at generating response rates in comparison to non-anthracycline based regimens. Conclusion and Potential Impact: This project will help elucidate the effectiveness of recommended systemic therapies for thymic carcinoma patients from one of the largest TET databases constructed. Ultimately, we hope that with clarity of the effectiveness of treatment, this can serve as a reliable reference for evidence-based medicine for the care of TC patients

Fungal vaccines and immunotherapeutics: current concepts and future challenges

Purpose of review The remarkable advances in modern medicine have paradoxically resulted in a rapidly expanding population of immunocompromised patients displaying extreme susceptibility to life-threatening fungal infections. There are currently no licensed vaccines, and the prophylaxis and therapy of fungal infections in at-risk individuals remains challenging, contributing to undesirable mortality and morbidity rates. The design of successful antifungal preventive approaches has been hampered by an insufficient understanding of the dynamics of the host-fungus interaction and the mechanisms that underlie heterogenous immune responses to vaccines and immunotherapy. Recent findings Recent advances in proteomics and glycomics have contributed to the identification of candidate antigens for use in subunit vaccines, novel adjuvants, and delivery systems to boost the efficacy of protective vaccination responses that are becoming available, and several targets are being exploited in immunotherapeutic approaches. Summary We review some of the emerging concepts as well as the inherent challenges to the development of fungal vaccines and immunotherapies to protect at-risk individuals.ThisworkwassupportedbytheNorthernPortugal Regional Operational Programme (NORTE 2020), under the Portugal 2020 Partnership Agreement, through the European Regional Development Fund (FEDER) (NORTE-01-0145-FEDER-000013), and the Fundação para a Ciência e Tecnologia (FCT) (contracts IF/00735/ 2014 to A.C., and SFRH/BPD/96176/2013 to C.C).info:eu-repo/semantics/publishedVersio

Behavioural activation by mental health nurses for late-life depression in primary care: a randomized controlled trial

Background: Depressive symptoms are common in older adults. The effectiveness of pharmacological treatments and the availability of psychological treatments in primary care are limited. A behavioural approach to depression treatment might be beneficial to many older adults but such care is still largely unavailable. Behavioural Activation (BA) protocols are less complicated and more easy to train than other psychological therapies, making them very suitable for delivery by less specialised therapists. The recent introduction of the mental health nurse in primary care centres in the Netherlands has created major opportunities for improving the accessibility of psychological treatments for late-life depression in primary care. BA may thus address the needs of older patients while improving treatment outcome and lowering costs.The primary objective of this study is to compare the effectiveness and cost-effectiveness of BA in comparison with treatment as usual (TAU) for late-life depression in Dutch primary care. A secondary goal is to explore several potential mechanisms of change, as well as predictors and moderators of treatment outcome of BA for late-life depression. Methods/design: Cluster-randomised controlled multicentre trial with two parallel groups: a) behavioural activation, and b) treatment as usual, conducted in primary care centres with a follow-up of 52 weeks. The main inclusion criterion is a PHQ-9 score > 9. Patients are excluded from the trial in case of severe mental illness that requires specialized treatment, high suicide risk, drug and/or alcohol abuse, prior psychotherapy, change in dosage or type of prescribed antidepressants in the previous 12 weeks, or moderate to severe cognitive impairment. The intervention consists of 8 weekly 30-min BA sessions delivered by a trained mental health nurse. Discussion: We expect BA to be an effective and cost-effective treatment for late-life depression compared to TAU. BA delivered by mental health nurses could increase the availability and accessibility of non-pharmacological treatments for late-life depression in primary care. Trial registration: This study is retrospectively registered in the Dutch Clinical Trial Register NTR6013on August 25th 2016. © 2017 The Author(s)

A survey of diamagnetic probes for copper(2+) binding to the prion protein. H-1 NMR solution structure of the palladium(2+) bound single octarepeat

The prion protein (PrPC) is a copper binding cell surface glycoprotein which when misfolded causes transmissible spongiform encephalopathies. The cooperative binding of Cu2+ to an unstructured octarepeat sequence within PrPC causes profound folding of this region. The use of NMR to determine the solution structure of the octarepeat region of PrP with Cu2+ bound has been hampered by the paramagnetic nature of the Cu2+ ions. Using NMR we have investigated the binding of candidate diamagnetic replacement ions, to the octarepeat region of PrP. We show that Pd2+ forms diamagnetic complexes with the peptides HGGG, HGGGW and QPHGGGWGQ with 1 : 1 stoichiometry The H-1 NMR spectra indicate that these peptides are in slow-exchange between free and bound Pd2+ on the chemical-shift time-scale. We demonstrate that the Pd-peptide complex forms slowly with a time taken to reach half-maximal signal of 3 hours. Other candidate metal ions, Ni2+, Pt2+ and Au3+, were investigated but only the Pd2+ complexes gave resolvable H-1 NMR spectra. We have determined the solution structure of the QPHGGGWGQ-Pd 1 : 1 complex using 71 NOE distance restraints. A backbone RMSD of 0.30 angstrom was observed over residues 3 to 7 in the final ensemble. The co-ordinating ligands consist of the histidine imidazole side chain N epsilon, the amide N of the second and third glycines with possibly H2O as the fourth ligand. The co-ordination geometry differs markedly from that of the HGGGW-Cu crystal structure. This survey of potential replacement metal ions to Cu2+ provides insight into the metal specificity and co-ordination chemistry of the metal bound octarepeats

The makewaves tsunami tests and their relevance to tsunami engineering and risk management

MAKEWAVES is an international multi-partner collaborative project bringing together nine academic institutions and two commercial consultancies. The objective of the collaboration is to develop experimental data and associated numerical modelling on tsunami inundation and interaction with boulders, buildings, natural and engineered barriers, towards the development of new internationally accepted guidance for structural codes and standards. Using a pneumatic tsunami simulator (TS) developed jointly by HR Wallingford and UCL the team conducted experiments between November 2022 and April 2023 within a highly instrumented 100m long flume. The TS is capable of simulating realistic trough and crest-led tsunami waves at 1:50, including traces from the The TS is capable of generating very long trough and crest-led waves, and can reproduce at 1:50 scale waves from real life events such as the Mercator trace from the 2004 Indian Ocean event and the and 2011 Tohoku tsunamis. The TS capability has been further extended to include bore-waves. The characteristics of the waves are controlled by adjusting the flow rate and total volume of water drawn in and discharged by the TS. The experimental campaign is was subdivided into discrete research areas, each aimed at furthering knowledge on how different tsunami wave characteristics affect their interaction with manmade and natural structures environments. These include tests aimed at understanding: (1) how roughness representative of coastal forests and mangroves affects tsunami inundation characteristics, (2) how tsunami interact with boulders (3) the effectiveness of offshore breakwaters as tsunami barriers (4) how structural loads and foundation scour are affected by building permeability. This paper presents an overview of the tests conducted and some of the important early observations made that are relevant to future engineering standards and to tsunami disaster management