832 research outputs found

    Efficacy, safety, and tolerability of adjunctive brivaracetam for secondarily generalized tonic-clonic seizures: Pooled results from three Phase III studies

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    AbstractPurposeSecondarily generalized tonic-clonic seizures (SGTCS) are among the most devastating types of seizures, contributing to increased morbidity and mortality. Brivaracetam (BRV), a selective, high-affinity ligand for synaptic vesicle 2A (SV2A), has been shown to be useful for the adjunctive treatment of focal seizures. We sought to determine its specific efficacy in treating SGTCS.MethodsData were pooled from three Phase III studies (NCT00490035; NCT00464269; NCT01261325) of adults with focal seizures taking 1⿿2 antiepileptic drugs (AEDs) who received placebo or BRV 50⿿200mg/day without titration over a 12-week treatment period. We report efficacy and safety/tolerability data for the BRV therapeutic dose range (50⿿200 mg/day) in patients with focal seizures including baseline SGTCS.ResultsPatients (efficacy population, N=409) had been diagnosed with epilepsy for a mean±standard deviation duration of 22.2±13.1years. Baseline median SGTCS frequency was 3.0 per 28days. The majority (293, 71.6%) had failed ⿥2 AEDs prior to study enrollment. The median percent reduction from baseline in SGTCS frequency/28days was: placebo, 33.3%; BRV 50mg/day, 66.6% (p<0.001); BRV 100mg/day, 61.2% (p=0.002); and BRV 200mg/day, 82.1% (p<0.001). The ⿥50% responder rate for SGTCS was: placebo, 33.0%; BRV 50mg/day, 61.3% (p=0.003); BRV 100mg/day, 55.0% (p<0.001); and BRV 200mg/day, 64.0% (p<0.001). Freedom from SGTCS was achieved by: placebo, 14.8%; BRV 50mg/day, 22.6%; BRV 100mg/day, 31.0%; and BRV 200mg/day, 36.0% of patients. Time to first SGTCS during the treatment period was longer in patients receiving BRV than placebo (26days vs 8days, hazard ratio 0.55, p<0.001). In the SGTCS safety population (N=487), treatment-emergent adverse events (TEAEs) were reported by 60.6% of patients receiving placebo vs 65.0% of patients receiving BRV ⿥50mg/day. Serious TEAEs were reported by 3.1% placebo vs 3.9% BRV ⿥50mg/day. Discontinuations due to TEAEs were 3.9% placebo vs 6.3% BRV ⿥50mg/day.ConclusionsIn patients with drug-resistant focal seizures, adjunctive BRV is effective in reducing the frequency of SGTCS. Almost one-third (30.4%) of patients were rendered completely free of SGTCS during the 12-week treatment period when taking BRV ⿥50mg/day. BRV was well tolerated, with a TEAE profile consistent with that of the overall study population

    Rachis brittleness in a hybrid–parent barley (Hordeum vulgare) breeding germplasm with different combinations at the non‐brittle rachis genes

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    Two dominant, closely linked and complementary genes, Btr1 and Btr2, control rachis brittleness in barley. Recessive mutations in any of these genes turn the fragile rachis (brittle) into a tough rachis phenotype (non‐brittle). The cross of parents with alternative mutations in the btr genes leads to a brittle F1 hybrid that presents grain retention problems. We evaluated rachis fragility through a mechanical test and under natural conditions, in F1 crosses with different compositions at the btr genes. Brittleness was significantly higher in Btr1btr1Btr2btr2 crosses compared to hybrids and inbred parents carrying one of the mutations (btr1btr1Btr2Btr2/Btr1Btr1btr2btr2). This fact could jeopardize the efficient harvest of hybrids bearing alternative mutations, reducing the choice of possible crosses for hybrid barley breeding and hindering the exploitation of potential heterotic patterns. Furthermore, non‐brittle hybrids showed higher brittleness than inbreds, suggesting the presence of other dominant factors affecting the trait. In conclusion, this work encourages a deeper study of the genetic control of the rachis brittleness trait and urges the consideration of rachis tenacity as a target for hybrid barley breeding.This work was supported by the Spanish Ministry of Economy, Industry and Competitiveness grants RFP2015 00006‐00‐00, and RTA2012‐00033‐C03‐02, and by the contract “Iberia region hybrid barley variety development and understanding effects of adaptation genes in hybrids,” between CSIC and Syngenta Crop Protection AG, which included funding for MFC PhD scholarship

    Characterisation of machinable structural polymers in restorative dentistry

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    Objectives To characterise the mechanical properties of the machinable polymers Pekkton® (Cendres-Meteaux, Biel/Bienne, Switzerland), Lava Ultimate® (3MESPE, Seefeld, Germany), Vita Enamic® (Ivoclar Vivadent, Schaan, Liechtenstein) and the ceramic IPS e.Max Press® (Ivoclar Vivadent, Schaan, Liechtenstein). To determine the structural integrity of full coverage crowns fabricated from these materials. Methods The following tests were conducted: Biaxial flexural strength (BFS) using the piston on 3 balls jig (n = 10); Vickers Hardness (VH) 10 indentations per sample with 10 kg load & 20 s dwell time (n = 5); Hygroscopic Expansion Change (HEC) in artificial saliva over 68 days (n = 5). Structural Strength (SS) of teeth analogues (n = 20) restored with monolithic crowns from the four materials. Mean values and standard deviations for BFS, VH, HEC and SS tests were calculated and compared using one-way ANOVA with post-hoc Tukey’s test at a level of 5% significance. Results BFS: IPS e.Max Press® (317 MPa ± 37 MPa), Pekkton® (227 MPa ± 18 MPa), Lava Ultimate® (145 MPa ± 18 MPa) and Vita Enamic® (137 MPa ± 7 MPa) with a significance between groups of p < 0.0001. VH: IPS e.Max Press® (5064 MPa ± 131 MPa), Vita Enamic® (1976 MPa ± 12 MPa), Lava Ultimate® (924 MPa ± 27 MPa) and Pekkton® (445MPa ± 21 MPa) with a significance between groups of p < 0.0001. HEC (%vol change): Pekkton® (0.14% ± 0.14%), Vita Enamic® (0.38% ± 0.16%) and Lava Ultimate® (1.06% ± 0.17%). SS for full-coverage crowns: Pekkton® (2037 N ± 49 N no fracture), IPS e.Max Press® (1497 N ± 165 N), Lava Ultimate® (1476 N ± 142 N) and Vita Enamic® (1127 N ± 108 N). Significance The properties investigated suggest that full coverage monolithic PEKK crowns possess adequate mechanical and physical properties for use in the posterior region of the mouth. These results must be considered alongside other data including clinical studies

    (Re)constructing Dimensions

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    Compactifying a higher-dimensional theory defined in R^{1,3+n} on an n-dimensional manifold {\cal M} results in a spectrum of four-dimensional (bosonic) fields with masses m^2_i = \lambda_i, where - \lambda_i are the eigenvalues of the Laplacian on the compact manifold. The question we address in this paper is the inverse: given the masses of the Kaluza-Klein fields in four dimensions, what can we say about the size and shape (i.e. the topology and the metric) of the compact manifold? We present some examples of isospectral manifolds (i.e., different manifolds which give rise to the same Kaluza-Klein mass spectrum). Some of these examples are Ricci-flat, complex and K\"{a}hler and so they are isospectral backgrounds for string theory. Utilizing results from finite spectral geometry, we also discuss the accuracy of reconstructing the properties of the compact manifold (e.g., its dimension, volume, and curvature etc) from measuring the masses of only a finite number of Kaluza-Klein modes.Comment: 23 pages, 3 figures, 2 references adde

    Options to Reform the European Union Legislation on GMOs: Scope and Definitions

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    We discuss options to reform the EU genetically modified organisms (GMO) regulatory framework, make risk assessment and decision-making more consistent with scientific principles, and lay the groundwork for international coherence. The first in a three-part series, this article focuses on reform options related to the scope of the legislation and the GMO definition
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