Prediction of disease progression, treatment response and dropout in chronic obstructive pulmonary disease (COPD).

Drug development in chronic obstructive pulmonary disease (COPD) has been characterised by unacceptably high failure rates. In addition to the poor sensitivity in forced expiratory volume in one second (FEV1), numerous causes are known to contribute to this phenomenon, which can be clustered into drug-, disease- and design-related factors. Here we present a model-based approach to describe disease progression, treatment response and dropout in clinical trials with COPD patients

Prediction of lung exposure to anti-tubercular drugs using plasma pharmacokinetic data: implications for dose selection

The development of novel candidate molecules for tuberculosis remains challenging, as drug distribution into the target tissue is not fully characterised in preclinical models of infection. Often antitubercular human dose selection is derived from pharmacokinetic data in plasma. Here, we explore whether whole-body physiologically-based pharmacokinetic (PBPK) modelling enables the prediction of lung exposure to anti-tubercular drugs in humans. Whole-body PBPK models were developed for rifampicin, isoniazid, pyrazinamide, and ethambutol using plasma data in mice as basis for the prediction of lung exposure. Model parameters were subsequently used to extrapolate disposition properties from mouse and determine lung:plasma ratio in humans. Model predictions were compared to biopsy data from patients. Predictions were deemed adequate if they fell within two-fold range of the observations. The concentration vs time profiles in lung were adequately predicted in mice. Isoniazid and pyrazinamide lung exposures were predicted to be comparable to plasma levels, whereas ethambutol lung exposure was predicted to be higher than in plasma. Lung:plasma ratio in humans could be reasonably predicted from preclinical data, but was highly dependent on the distribution model. This analysis showed that plasma pharmacokinetics may be used in conjunction with PBPK modelling to derive lung tissue exposure in mice and humans during early lead optimisation phase. However, the impact of uncertainty in predicted tissue exposure due to distribution should be always investigated through a sensitivity analysis when only plasma data is available. Despite these limitations, insight into lung tissue distribution represents a critical step for the dose rationale in tuberculosis patients

Dynamic anti-plane sliding of dissimilar anisotropic linear elastic solids

The stability of steady, dynamic, anti-plane slipping at a planar interface between two dissimilar anisotropic linear elastic solids is studied. The solids are assumed to possess a plane of symmetry normal to the slip direction, so that in-plane displacements and normal stress changes on the slip plane do not occur. Friction at the interface is assumed to follow a rate and state dependent law with velocity-weakening behavior in the steady state. The stability to spatial perturbations of the form exp(ikx_1), where k is the wavenumber and x_1 is the coordinate along the interface is studied. The critical wavenumber magnitude, |k|_cr, above which there is stability and the corresponding phase velocity, c, of the neutrally stable mode are obtained from the stability analysis. Numerical plots showing the dependence of |k|_cr and c on the unperturbed sliding velocity, V_o, are provided for various bi-material combinations of practical interest

Predictors of seizure outcomes in children with tuberous sclerosis complex and intractable epilepsy undergoing resective epilepsy surgery: an individual participant data meta-analysis.

ObjectiveTo perform a systematic review and individual participant data meta-analysis to identify preoperative factors associated with a good seizure outcome in children with Tuberous Sclerosis Complex undergoing resective epilepsy surgery.Data sourcesElectronic databases (MEDLINE, EMBASE, CINAHL and Web of Science), archives of major epilepsy and neurosurgery meetings, and bibliographies of relevant articles, with no language or date restrictions.Study selectionWe included case-control or cohort studies of consecutive participants undergoing resective epilepsy surgery that reported seizure outcomes. We performed title and abstract and full text screening independently and in duplicate. We resolved disagreements through discussion.Data extractionOne author performed data extraction which was verified by a second author using predefined data fields including study quality assessment using a risk of bias instrument we developed. We recorded all preoperative factors that may plausibly predict seizure outcomes.Data synthesisTo identify predictors of a good seizure outcome (i.e. Engel Class I or II) we used logistic regression adjusting for length of follow-up for each preoperative variable.ResultsOf 9863 citations, 20 articles reporting on 181 participants were eligible. Good seizure outcomes were observed in 126 (69%) participants (Engel Class I: 102(56%); Engel class II: 24(13%)). In univariable analyses, absence of generalized seizure semiology (OR = 3.1, 95%CI = 1.2-8.2, p = 0.022), no or mild developmental delay (OR = 7.3, 95%CI = 2.1-24.7, p = 0.001), unifocal ictal scalp electroencephalographic (EEG) abnormality (OR = 3.2, 95%CI = 1.4-7.6, p = 0.008) and EEG/Magnetic resonance imaging concordance (OR = 4.9, 95%CI = 1.8-13.5, p = 0.002) were associated with a good postoperative seizure outcome.ConclusionsSmall retrospective cohort studies are inherently prone to bias, some of which are overcome using individual participant data. The best available evidence suggests four preoperative factors predictive of good seizure outcomes following resective epilepsy surgery. Large long-term prospective multicenter observational studies are required to further evaluate the risk factors identified in this review

Application of machine learning in combination with mechanistic modeling to predict plasma exposure of small molecules

Prediction of a new molecule’s exposure in plasma is a critical first step toward understanding its efficacy/toxicity profile and concluding whether it is a possible first-in-class, best-in-class candidate. For this prediction, traditional pharmacometrics use a variety of scaling methods that are heavily based on pre-clinical pharmacokinetic (PK) data. We here propose a novel framework based on which preclinical exposure prediction is performed by applying machine learning (ML) in tandem with mechanism-based modeling. In our proposed method, a relationship is initially established between molecular structure and physicochemical (PC)/PK properties using ML, and then the ML-driven PC/PK parameters are used as input to mechanistic models that ultimately predict the plasma exposure of new candidates. To understand the feasibility of our proposed framework, we evaluated a number of mechanistic models (1-compartment, physiologically based pharmacokinetic (PBPK)), PBPK distribution models (Berezhkovskiy, PK-Sim standard, Poulin and Theil, Rodgers and Rowland, and Schmidt), and PBPK parameterizations (using in vivo, or in vitro clearance). For most of the scenarios tested, our results demonstrate that PK profiles can be adequately predicted based on the proposed framework. Our analysis further indicates some limitations when liver microsomal intrinsic clearance (CLint) is used as the only clearance pathway and underscores the necessity of investigating the variability emanating from the different distribution models when providing PK predictions. The suggested approach aims at earlier exposure prediction in the drug development process so that critical decisions on molecule screening, chemistry design, or dose selection can be made as early as possible

Lattice Resistance and Peierls Stress in Finite-size Atomistic Dislocation Simulations

Atomistic computations of the Peierls stress in fcc metals are relatively scarce. By way of contrast, there are many more atomistic computations for bcc metals, as well as mixed discrete-continuum computations of the Peierls-Nabarro type for fcc metals. One of the reasons for this is the low Peierls stresses in fcc metals. Because atomistic computations of the Peierls stress take place in finite simulation cells, image forces caused by boundaries must either be relaxed or corrected for if system size independent results are to be obtained. One of the approaches that has been developed for treating such boundary forces is by computing them directly and subsequently subtracting their effects, as developed by V. B. Shenoy and R. Phillips [Phil. Mag. A, 76 (1997) 367]. That work was primarily analytic, and limited to screw dislocations and special symmetric geometries. We extend that work to edge and mixed dislocations, and to arbitrary two-dimensional geometries, through a numerical finite element computation. We also describe a method for estimating the boundary forces directly on the basis of atomistic calculations. We apply these methods to the numerical measurement of the Peierls stress and lattice resistance curves for a model aluminum (fcc) system using an embedded-atom potential.Comment: LaTeX 47 pages including 20 figure

Kidney involvement in the Schnitzler syndrome, a rare disease

The Schnitzler syndrome (SS) is a rare and underdiagnosed entity that associates a chronic urticarial rash, monoclonal IgM (or sometimes IgG) gammopathy and signs and symptoms of systemic inflammation. During the past 45 years, the SS has evolved from an elusive little-known disorder to the paradigm of a late-onset acquired auto-inflammatory syndrome. Though there is no definite proof of its precise pathogenesis, it should be considered as an acquired disease involving abnormal stimulation of the innate immune system, which can be reversed by the interleukin-1 receptor antagonist anakinra. It clearly expands our view of this group of rare genetic diseases and makes the concept of auto-inflammation relevant in polygenic acquired diseases as well. Increasing numbers of dermatologists, rheumatologists, allergologists, haematologists and, more recently, nephrologists, recognize the SS. The aim of this review is to focus on kidney involvement in the SS. Although the literature regarding kidney involvement in the SS is very poor it can be severe, as in our own case here reported, leading us to recommend the systematic search for nephropathy markers in the SS

Physiologically based pharmacokinetic modeling of tacrolimus for food-drug and CYP3A drug-drug-gene interaction predictions

The immunosuppressant and narrow therapeutic index drug tacrolimus is metabolized mainly via cytochrome P450 (CYP) 3A4 and CYP3A5. For its pharmacokinetics (PK), high inter- and intra-individual variability can be observed. Underlying causes include the effect of food intake on tacrolimus absorption as well as genetic polymorphism in the CYP3A5 gene. Furthermore, tacrolimus is highly susceptible to drug–drug interactions, acting as a victim drug when coadministered with CYP3A perpetrators. This work describes the development of a whole-body physiologically based pharmacokinetic model for tacrolimus as well as its application for investigation and prediction of (i) the impact of food intake on tacrolimus PK (food–drug interactions [FDIs]) and (ii) drug–drug(−gene) interactions (DD[G]Is) involving the CYP3A perpetrator drugs voriconazole, itraconazole, and rifampicin. The model was built in PK-Sim® Version 10 using a total of 37 whole blood concentration–time profiles of tacrolimus (training and test) compiled from 911 healthy individuals covering the administration of tacrolimus as intravenous infusions as well as immediate-release and extended-release capsules. Metabolism was incorporated via CYP3A4 and CYP3A5, with varying activities implemented for different CYP3A5 genotypes and study populations. The good predictive model performance is demonstrated for the examined food effect studies with 6/6 predicted FDI area under the curve determined between first and last concentration measurements (AUClast) and 6/6 predicted FDI maximum whole blood concentration (Cmax) ratios within twofold of the respective observed ratios. In addition, 7/7 predicted DD(G)I AUClast and 6/7 predicted DD(G)I Cmax ratios were within twofold of their observed values. Potential applications of the final model include model-informed drug discovery and development or the support of model-informed precision dosing

Citizens AND HYdrology (CANDHY): conceptualizing a transdisciplinary framework for citizen science addressing hydrological challenges

Widely available digital technologies are empowering citizens who are increasingly well informed and involved in numerous water, climate, and environmental challenges. Citizen science can serve many different purposes, from the "pleasure of doing science" to complementing observations, increasing scientific literacy, and supporting collaborative behaviour to solve specific water management problems. Still, procedures on how to incorporate citizens' knowledge effectively to inform policy and decision-making are lagging behind. Moreover, general conceptual frameworks are unavailable, preventing the widespread uptake of citizen science approaches for more participatory cross-sectorial water governance. In this work, we identify the shared constituents, interfaces, and interlinkages between hydrological sciences and other academic and non-academic disciplines in addressing water issues. Our goal is to conceptualize a transdisciplinary framework for valuing citizen science and advancing the hydrological sciences. Joint efforts between hydrological, computer, and social sciences are envisaged for integrating human sensing and behavioural mechanisms into the framework. Expanding opportunities of online communities complement the fundamental value of on-site surveying and indigenous knowledge. This work is promoted by the Citizens AND HYdrology (CANDHY) Working Group established by the International Association of Hydrological Sciences (IAHS)