Perceptual consequences of online group speech treatment for individuals with Parkinson's disease: A pilot study case series

PURPOSE

We examined perceptual changes in the domains of ease of understanding, naturalness, and speech severity, as well as changes in self-perceptions of voice disability, following an online group speech treatment program for people with Parkinson's disease (PD) conducted during the COVID-19 pandemic.

METHOD

Seven speakers with hypokinetic dysarthria associated with PD participated in a university and community-based online group speech program for 10 weeks. Speech recordings occurred remotely 1 week before and 1 week after the online program. Thirty naïve listeners rated ease of understanding, naturalness, and speech severity based on the speech recordings. Speakers' self-perceptions of voice disability were also obtained at both time points.

RESULT

Individual analysis of the speech data showed that for most speakers with dysarthria, ease of understanding and perceptions of severity were rated the same or better pre- to post-treatment. Naturalness, however, was only perceived to be the same or better post-treatment in three out of seven speakers. Over half of the speakers reported improvements in their self-perception of voice disability.

CONCLUSION

This pilot study highlighted the individual variability among speakers with dysarthria and the potential of online group speech treatment to maintain and/or improve speech function in this population.

Ketamine produces no detectable long-term positive or negative effects on cognitive flexibility or reinforcement learning of male rats

RATIONALE

Patients with major depressive disorder (MDD) often experience abnormalities in behavioral adaptation following environmental changes (i.e., cognitive flexibility) and tend to undervalue positive outcomes but overvalue negative outcomes. The probabilistic reversal learning task (PRL) is used to study these deficits across species and to explore drugs that may have therapeutic value. Selective serotonin-reuptake inhibitors (SSRIs) have limited effectiveness in treating MDD and produce inconsistent effects in non-human versions of the PRL. As such, ketamine, a novel and potentially rapid-acting therapeutic, has begun to be examined using the PRL. Two previous studies examining the effects of ketamine in the PRL have shown conflicting results and only examined short-term effects of ketamine.

OBJECTIVE

This experiment examined PRL performance across a 2-week period following a single exposure to a ketamine dose that varied across groups.

METHODS

After five sessions of PRL training, groups of rats received an injection of either 0, 10, 20 or 30 mg/kg ketamine. One-hour post-injection, rats engaged in the PRL, and subsequently sessions continued daily for 2 weeks. Traditional behavioral and computational reinforcement learning-derived measures were examined.

RESULTS

Results showed that ketamine had acute effects 1-h post-injection, including a significant decrease in the value of the punishment learning rate. Beyond 1 h, ketamine produced no detectable improvements nor decrements in performance across 2 weeks.

CONCLUSION

Overall, the present results suggest that the range of ketamine doses examined do not have long-term positive or negative effects on cognitive flexibility or reward processing in healthy rats as measured by the PRL.

¿Notas La Diferencia? [Do You Hear the Difference?]: Perceptual Consequences of Intensive Voice Treatment in Spanish Speakers With Parkinson's Disease

PURPOSE

The primary objective of this study was to explore the effects of intensive voice-focused treatment on speech parameters in Spanish speakers with dysarthria associated with Parkinson's disease (PD) as perceived by naïve listeners.

METHOD

Fifteen Spanish speakers with dysarthria associated with PD received the Lee Silverman Voice Treatment (LSVT LOUD) for a month. Voice and speech recordings were conducted pretreatment, posttreatment, and at a 1-month follow-up. Thirty naïve adult listeners rated the perceptual dimensions of ease of understanding (EoU), resonance, articulatory precision, prosody, and voice quality from sentences extracted from an emotional monologue on a visual analogue scale.

RESULTS

EoU, resonance, articulatory precision, and voice quality significantly improved pre- to posttreatment, but gains were not maintained at follow-up. Speech severity was a significant source of variance in mean listener response for all perceptual dimensions, although the interaction between speech severity and time was only significant for resonance and voice quality.

CONCLUSIONS

LSVT LOUD may be beneficial to improve perceptual speech domains affected by PD in Spanish speakers with dysarthria. Its impact on the different speech subsystems may reflect a universal distribution of effects when directly targeting the glottal source. Language-specific contributions of each perceptual domain to speech intelligibility should be explored in further research to determine linguistically sensitive treatment targets.

Acoustic Predictors of Ease of Understanding in Spanish Speakers With Dysarthria Associated With Parkinson's Disease

PURPOSE

The purpose of this study was to examine selected baseline acoustic features of hypokinetic dysarthria in Spanish speakers with Parkinson's disease (PD) and identify potential acoustic predictors of ease of understanding in Spanish.

METHOD

Seventeen Spanish-speaking individuals with mild-to-moderate hypokinetic dysarthria secondary to PD and eight healthy controls were recorded reading a translation of the Rainbow Passage. Acoustic measures of vowel space area, as indicated by the formant centralization ratio (FCR), envelope modulation spectra (EMS), and articulation rate were derived from the speech samples. Additionally, 15 healthy adults rated ease of understanding of the recordings on a visual analogue scale. A multiple linear regression model was implemented to investigate the predictive value of the selected acoustic parameters on ease of understanding.

RESULTS

Listeners' ease of understanding was significantly lower for speakers with dysarthria than for healthy controls. The FCR, EMS from the first 10 s of the reading passage, and the difference in EMS between the end and the beginning sections of the passage differed significantly between the two groups of speakers. Findings indicated that 67.7% of the variability in ease of understanding was explained by the predictive model, suggesting a moderately strong relationship between the acoustic and perceptual domains.

CONCLUSIONS

Measures of envelope modulation spectra were found to be highly significant model predictors of ease of understanding of Spanish-speaking individuals with hypokinetic dysarthria associated with PD. Articulation rate was also found to be important (albeit to a lesser degree) in the predictive model. The formant centralization ratio should be further examined with a larger sample size and more severe dysarthria to determine its efficacy in predicting ease of understanding.

Disulfide re-bridging reagents for single-payload antibody-drug conjugates

Numerous antibody-drug conjugate (ADC) linker technologies exist for the synthesis of ADCs with drug-to-antibody ratios (DARs) being an even integer (typically 2, 4 or 8). However, ADCs with odd-integer DARs are significantly harder to synthesise. Here, we report the synthesis of ADCs loaded with a single warhead, using TetraDVP linkers which simultaneously re-bridge all four interchain disulfides of an IgG1 antibody.

Peroxide-cleavable linkers for antibody-drug conjugates

Antibody-drug conjugates containing peroxide-cleavable arylboronic acid linkers are described, which target the high levels of reactive oxygen species (ROS) in cancer. The arylboronic acid linkers rapidly release a payload in the presence of hydrogen peroxide, but remain stable in plasma. Anti-HER2 and PD-L1 peroxide-cleavable ADCs exhibited potent cytotoxicity in vitro.

Antibody dual-functionalisation enabled through a modular divinylpyrimidine disulfide rebridging strategy

Herein we report the development of a methodology for the dual-functionalisation of IgG antibodies. This is accomplished through the combination of disulfide rebridging divinylpyrimidine technology, with bicyclononyne and methylcyclopropene handles to facilitate sequential SPAAC and IEDDA reactions. Advantageously, the strategy does not require metal catalysis and avoids the need for purification between functionalisation steps.

All-in-one disulfide bridging enables the generation of antibody conjugates with modular cargo loading

Antibody-drug conjugates (ADCs) are valuable therapeutic entities which leverage the specificity of antibodies to selectively deliver cytotoxins to antigen-expressing targets such as cancer cells. However, current methods for their construction still suffer from a number of shortcomings. For instance, using a single modification technology to modulate the drug-to-antibody ratio (DAR) in integer increments while maintaining homogeneity and stability remains exceptionally challenging. Herein, we report a novel method for the generation of antibody conjugates with modular cargo loading from native antibodies. Our approach relies on a new class of disulfide rebridging linkers, which can react with eight cysteine residues, thereby effecting all-in-one bridging of all four interchain disulfides in an IgG1 antibody with a single linker molecule. Modification of the antibody with the linker in a 1 : 1 ratio enabled the modulation of cargo loading in a quick and selective manner through derivatization of the linker with varying numbers of payload attachment handles to allow for attachment of either 1, 2, 3 or 4 payloads (fluorescent dyes or cytotoxins). Assessment of the biological activity of these conjugates demonstrated their exceptional stability in human plasma and utility for cell-selective cytotoxin delivery or imaging/diagnostic applications.

Automatic Assessment of Intelligibility in Noise in Parkinson’s Disease: A Validation Method (Preprint)

Background

Most individuals with Parkinson disease (PD) experience a degradation in their speech intelligibility. Research on the use of automatic speech recognition (ASR) to assess intelligibility is still sparse, especially when trying to replicate communication challenges in real-life conditions (ie, noisy backgrounds). Developing technologies to automatically measure intelligibility in noise can ultimately assist patients in self-managing their voice changes due to the disease.

Objective

The goal of this study was to pilot-test and validate the use of a customized web-based app to assess speech intelligibility in noise in individuals with dysarthria associated with PD.

Methods

In total, 20 individuals with dysarthria associated with PD and 20 healthy controls (HCs) recorded a set of sentences using their phones. The Google Cloud ASR API was used to automatically transcribe the speakers’ sentences. An algorithm was created to embed speakers’ sentences in +6-dB signal-to-noise multitalker babble. Results from ASR performance were compared to those from 30 listeners who orthographically transcribed the same set of sentences. Data were reduced into a single event, defined as a success if the artificial intelligence (AI) system transcribed a random speaker or sentence as well or better than the average of 3 randomly chosen human listeners. These data were further analyzed by logistic regression to assess whether AI success differed by speaker group (HCs or speakers with dysarthria) or was affected by sentence length. A discriminant analysis was conducted on the human listener data and AI transcriber data independently to compare the ability of each data set to discriminate between HCs and speakers with dysarthria.

Results

The data analysis indicated a 0.8 probability (95% CI 0.65-0.91) that AI performance would be as good or better than the average human listener. AI transcriber success probability was not found to be dependent on speaker group. AI transcriber success was found to decrease with sentence length, losing an estimated 0.03 probability of transcribing as well as the average human listener for each word increase in sentence length. The AI transcriber data were found to offer the same discrimination of speakers into categories (HCs and speakers with dysarthria) as the human listener data.

Conclusions

ASR has the potential to assess intelligibility in noise in speakers with dysarthria associated with PD. Our results hold promise for the use of AI with this clinical population, although a full range of speech severity needs to be evaluated in future work, as well as the effect of different speaking tasks on ASR.

Divinylpyrimidine reagents generate antibody-drug conjugates with excellent in vivo efficacy and tolerability

The development of divinylpyrimidine (DVP) reagents for the synthesis of antibody-drug conjugates (ADCs) with in vivo efficacy and tolerability is reported. Detailed structural characterisation of the synthesised ADCs was first conducted followed by in vitro and in vivo evaluation of the ADCs' ability to safely and selectively eradicate target-positive tumours.

Rapid and robust cysteine bioconjugation with vinylheteroarenes

Methods for residue-selective and stable modification of canonical amino acids enable the installation of distinct functionality which can aid in the interrogation of biological processes or the generation of new therapeutic modalities. Herein, we report an extensive investigation of reactivity and stability profiles for a series of vinylheteroarene motifs. Studies on small molecule and protein substrates identified an optimum vinylheteroarene scaffold for selective cysteine modification. Utilisation of this lead linker to modify a number of protein substrates with various functionalities, including the synthesis of a homogeneous, stable and biologically active antibody-drug conjugate (ADC) was then achieved. The reagent was also efficient in labelling proteome-wide cysteines in cell lysates. The efficiency and selectivity of these reagents as well as the stability of the products makes them suitable for the generation of biotherapeutics or studies in chemical biology.

A dual-enzyme cleavable linker for antibody-drug conjugates

A novel enzyme cleavable linker for antibody-drug conjugates is reported. The 3-O-sulfo-β-galactose linker is cleaved sequentially by two lysosomal enzymes - arylsulfatase A and β-galactosidase - to release the payload in targeted cells. An α-HER2 antibody-drug conjugate synthesised using this highly hydrophilic dual-cleavable linker exhibited excellent cytotoxicity and selectivity.

Site-selective modification strategies in antibody-drug conjugates

Antibody-drug conjugates (ADCs) harness the highly specific targeting capabilities of an antibody to deliver a cytotoxic payload to specific cell types. They have garnered widespread interest in drug discovery, particularly in oncology, as discrimination between healthy and malignant tissues or cells can be achieved. Nine ADCs have received approval from the US Food and Drug Administration and more than 80 others are currently undergoing clinical investigations for a range of solid tumours and haematological malignancies. Extensive research over the past decade has highlighted the critical nature of the linkage strategy adopted to attach the payload to the antibody. Whilst early generation ADCs were primarily synthesised as heterogeneous mixtures, these were found to have sub-optimal pharmacokinetics, stability, tolerability and/or efficacy. Efforts have now shifted towards generating homogeneous constructs with precise drug loading and predetermined, controlled sites of attachment. Homogeneous ADCs have repeatedly demonstrated superior overall pharmacological profiles compared to their heterogeneous counterparts. A wide range of methods have been developed in the pursuit of homogeneity, comprising chemical or enzymatic methods or a combination thereof to afford precise modification of specific amino acid or sugar residues. In this review, we discuss advances in chemical and enzymatic methods for site-specific antibody modification that result in the generation of homogeneous ADCs.

Photocatalytic methods for amino acid modification

This tutorial review introduces photocatalysis for amino acid modification and summarises recent advances in the field.

Expeditious Total Synthesis of Hemiasterlin through a Convergent Multicomponent Strategy and Its Use in Targeted Cancer Therapeutics

Hemiasterlin is an antimitotic marine natural product with reported sub-nanomolar potency against several cancer cell lines. Herein, we describe an expeditious total synthesis of hemiasterlin featuring a four-component Ugi reaction (Ugi-4CR) as the key step. The convergent synthetic strategy enabled rapid access to taltobulin (HTI-286), a similarly potent synthetic analogue. This short synthetic sequence enabled investigation of both hemiasterlin and taltobulin as cytotoxic payloads in antibody-drug conjugates (ADCs). These novel ADCs displayed sub-nanomolar cytotoxicity against HER2-expressing cancer cells, while showing no activity against antigen-negative cells. This study demonstrates an improved synthetic route to a highly valuable natural product, facilitating further investigation of hemiasterlin and its analogues as potential payloads in targeted therapeutics.

OXTR rs53576 Variation with Breast and Nipple Pain in Breastfeeding Women

BACKGROUND

Thirty percent of women who seek professional breastfeeding support require assistance with ongoing breast and nipple pain and < 50% of women report resolution of their pain. It is unknown if there is a molecular risk for ongoing breast and nipple pain during breastfeeding. Aim -To evaluate associations among breast and nipple pain sensitivity and candidate pain sensitivity single-nucleotide polymorphisms [SNPs], (COMT rs6269, rs4633, rs4818, rs4680 and OXTR rs2254298, rs53576) in breastfeeding women. Design - A secondary analysis of a pilot randomized controlled trial of a pain self-management intervention conducted over 6 weeks postpartum. Setting and Participants - Sixty women were recruited from two hospital settings after birth. Methods - All participants underwent standardized mechanical somatosensory testing for an assessment of pain sensitivity and provided baseline buccal swabs for genetic analysis. At 1, 2, and 6 weeks postpartum, women self-reported breast and nipple pain severity using a visual analogue scale. Results - Women with the minor allele OXTR rs53576 reported 8.18-fold higher breast and nipple pain severity over time. For every 1-unit increase in Mechanical detection threshold and windup ratio, women reported 16.51-fold and 4.82-fold higher breast and nipple pain severity respectively. Six women with the OXTR rs2254298 minor allele reported allodynia. Conclusion - The presence of OXTR alleles in women with enhanced pain sensitivity suggests a phenotype of genetic risk for ongoing breast and nipple with potential for pain-associated breastfeeding cessation. Somatosensory testing identified women who reported higher breast and nipple pain during the first weeks of breastfeeding.

General dual functionalisation of biomacromolecules via a cysteine bridging strategy

Site-selective modification of peptides and proteins has resulted in the development of a host of novel tools for the study of cellular systems or the synthesis of enhanced biotherapeutics. There is a need for useful methodologies that enable site-selective modification of native peptides or proteins, which is even more prevalent when modification of the biomolecule with multiple payloads is desired. Herein, we report the development of a novel dual functional divinylpyrimidine (dfDVP) platform that enables robust and modular modification of peptides, antibody fragments and antibodies. These biomacromolecules could be easily functionalised with a range of functional payloads (e.g. fluorescent dyes, cytotoxic warheads or cell-penetrating tags). Importantly, the dual functionalised peptides and antibodies demonstrated exquisite bioactivity in a range of in vitro cellular assays, showcasing the enhanced utility of these bioactive conjugates.

Characterization of intentional lurasidone ingestions using the United States National Poison Data System

Introduction: The ziprasidone analogue lurasidone is approved for the treatment of schizophrenia and bipolar disorder for adults and children older than 10 years. Small studies and case reports suggest lurasidone overdose is not generally associated with major adverse effects, but no large sample has been published.Objective: To describe intentional lurasidone overdoses reported to poison centers.Methods: Retrospective analysis of single-substance intentional lurasidone ingestions from the National Poison Data System (NPDS) from 2011 to 2018.Results: There were 1753 single-substance intentional overdoses. Average age was 28.6 years (SD = 13.3 years) and 1199 (68.4%) of patients were female. Most cases (86.6%) were coded as suspected suicide. Regarding final management site, 1143 (65.2%) were discharged or admitted to psychiatric facilities; 328 (18.8%) were admitted, half of whom were admitted to critical care units (CCUs). Major effect was coded in 12 (0.7%), moderate effect in 259 (14.8%), minor effect in 531 (30%), and no effect in 614 (35%). There were no deaths. For cases for which dose information was available, there was not a statistically significant difference between median doses when analyzed by clinical effect. Most common adverse effects were drowsiness (449, 25.6%), tachycardia (254, 14.5%), vomiting (121, 6.9%), and hypertension (115, 6.6%). Most cases had either no therapy reported, or therapy was recommended by the poison center but confirmed not to have been administered (1010, 57.6%). Of the 164 patients admitted to CCUs, 80 (48.8%) received either no therapy or intravenous fluids alone.Discussion: These data suggest major effects are uncommon from lurasidone overdose. Despite a high rate of admission to CCUs, a substantial proportion received no critical therapies.Conclusions: This report demonstrates intentional lurasidone overdoses reported to poison centers generally have a favorable clinical course.

Total synthesis and biological evaluation of simplified aplyronine analogues as synthetically tractable anticancer agents

The aplyronines are a family of highly cytotoxic marine natural products with potential application in targeted cancer chemotherapy. To address the severe supply issue, function-oriented molecular editing of their macrolactone scaffold led to the design of a series of simplified aplyronine analogues. Enabled by a highly convergent aldol-based route, the total synthesis of four analogues was achieved, with a significant improvement in step economy versus previous compounds, and their cancer cell growth inhibition in the HeLa cell line was determined. The modular strategy presented offers a means for significantly shortening their chemical synthesis to facilitate the continued development of this promising class of anticancer agent.

Sulfatase-cleavable linkers for antibody-drug conjugates

Antibody-drug conjugates (ADCs) are a class of targeted drug delivery agents combining the cell-selectivity of monoclonal antibodies (mAbs) and the cytotoxicity of small molecules. These two components are joined by a covalent linker, whose nature is critical to the efficacy and safety of the ADC. Enzyme-cleavable dipeptidic linkers have emerged as a particularly effective ADC linker type due to their ability to selectively release the payload in the lysosomes of target cells. However, these linkers have a number of drawbacks, including instability in rodent plasma and their inherently high hydrophobicity. Here we show that arylsulfate-containing ADC linkers are cleaved by lysosomal sulfatase enzymes to tracelessly release their payload, while circumventing the instability problems associated with dipeptide-linkers. When incorporated with trastuzumab and the highly potent monomethyl auristatin E (MMAE) payload, the arylsulfate-containing ADC 2 and ADC 3 were more cytotoxic than the non-cleavable ADC 4 against HER2-positive cells, while maintaining selectivity over HER2-negative cells. We propose that the stability, solubility and synthetic tractability of our arylsulfate linkers make them an attractive new motif for cleavable ADC linkers, with clear benefits over the widely used dipeptidic linkers.

Efficient and selective antibody modification with functionalised divinyltriazines

We have developed a highly efficient disulfide rebridging strategy for the modification of antibodies with substituted divinyltriazine linkers.

Indo-West Pacific species of Trachinotus with spots on their sides as adults, with description of a new species endemic to the Marquesas Islands (Teleostei: Carangidae)

Diagnoses, comparisons, photographs and distribution maps are given for three previously described Indo-West Pacific species of Trachinotus that develop spots on their sides as adults. A new species, Trachinotus macrospilus, is described from the Marquesas Islands where it is endemic and the only species of the genus present. It differs from the other spotted Indo-West Pacific species most noticeably in having adults with only one or two large spots on each side, the largest spot larger than the iris diameter, and in having no large spot positioned above the pectoral fin. An identification key is given for all Indo-West Pacific species of Trachinotus and a molecular phylogeny, including 16 of the 20 valid species of Trachinotus is presented. A neotype is designated for Scomber botla Shaw, 1803.

Targeted covalent inhibitors of MDM2 using electrophile-bearing stapled peptides

Herein, we describe the development of a novel staple with an electrophilic warhead to enable the generation of stapled peptide covalent inhibitors of the p53-MDM2 protein-protein interaction (PPI). The peptide developed showed complete and selective covalent binding resulting in potent inhibition of p53-MDM2 PPI.

Toolbox of Diverse Linkers for Navigating the Cellular Efficacy Landscape of Stapled Peptides

Stapled peptides have great potential as modulators of protein-protein interactions (PPIs). However, there is a vast landscape of chemical features that can be varied for any given peptide, and identifying a set of features that maximizes cellular uptake and subsequent target engagement remains a key challenge. Herein, we present a systematic analysis of staple functionality on the peptide bioactivity landscape in cellular assays. Through application of a "toolbox" of diversified dialkynyl linkers to the stapling of MDM2-binding peptides via a double-click approach, we conducted a study of cellular uptake and p53 activation as a function of the linker. Minor changes in the linker motif and the specific pairing of linker with peptide sequence can lead to substantial differences in bioactivity, a finding which may have important design implications for peptide-based inhibitors of other PPIs. Given the complexity of the structure-activity relationships involved, the toolbox approach represents a generalizable strategy for optimization when progressing from in vitro binding assays to cellular efficacy studies.

A general approach for the site-selective modification of native proteins, enabling the generation of stable and functional antibody-drug conjugates

Antibody-drug conjugates (ADCs) are a class of targeted therapeutics that utilize the specificity of antibodies to selectively deliver highly potent cytotoxins to target cells. Although recent years have witnessed significant interest in ADCs, problems remain with the standard linkage chemistries used for cytotoxin-antibody bioconjugation. These typically (1) generate unstable constructs, which may lead to premature cytotoxin release, (2) often give a wide variance in drug-antibody ratios (DAR) and (3) have poor control of attachment location on the antibody, resulting in a variable pharmacokinetic profile. Herein, we report a novel divinylpyrimidine (DVP) linker platform for selective bioconjugation via covalent re-bridging of reduced disulfide bonds on native antibodies. Model studies using the non-engineered trastuzumab antibody validate the utility of this linker platform for the generic generation of highly plasma-stable and functional antibody constructs that incorporate variable biologically relevant payloads (including cytotoxins) in an efficient and site-selective manner with precise control over DAR. DVP linkers were also used to efficiently re-bridge both monomeric and dimeric protein systems, demonstrating their potential utility for general protein modification, protein stabilisation or the development of other protein-conjugate therapeutics.

Correction: A general approach for the site-selective modification of native proteins, enabling the generation of stable and functional antibody-drug conjugates

[This corrects the article DOI: 10.1039/C8SC04645J.].

Macrocyclisation and functionalisation of unprotected peptides via divinyltriazine cysteine stapling

We report a novel divinyltriazine linker for the stapling of two cysteine residues to form macrocyclic peptides from their unprotected linear counterparts. The stapling reaction occurred rapidly under mild conditions on a range of unprotected peptide sequences. The resulting constrained peptides displayed greater stability in a serum stability assay when compared to their linear counterparts.

Effect of Overencapsulation on the Disintegration and Dissolution of Licensed Formulations for Blinding in Randomized Controlled Trials

Overencapsulation is a technique used to conceal tablet products for blinding in randomized controlled trials. A tablet is inserted in an opaque capsule shell with backfill excipient to prevent rattling. Regulatory authorities require evidence that such modification does not materially alter drug release to approve their use in trials. The objective of this study was to assess impact of overencapsulation on disintegration and dissolution of 4 immediate-release drug products (penicillin V, gemfibrozil, ciprofloxacin, and furosemide). Each unmodified tablet was compared to 3 overencapsulated tablets with differing backfill excipient (colloidal silica, lactose monohydrate, or microcrystalline cellulose). All 12 overencapsulated tablets met disintegration and dissolution acceptance criteria. Dissolution acceptance was dependent on apparatus as only 4/12 formulations met specifications using the rotating basket compared to 12/12 using the rotating paddle. Significant differences in release were observed at early time points (T₅-T₁₅). No correlation was observed between aqueous solubility and release, although dissolution of the lipophilic drug gemfibrozil was least impacted by overencapsulation. There was evidence that type/quantity of backfill delays release at early time points. These findings indicate that under the specified conditions, overencapsulated formulations of 4 drugs, 1 from each class of the Biopharmaceutics Classification System, met compendial requirements for release testing.

Protein modification via alkyne hydrosilylation using a substoichiometric amount of ruthenium(ii) catalyst

Transition metal catalysis has emerged as a powerful strategy to expand synthetic flexibility of protein modification. Herein, we report a cationic Ru(ii) system that enables the first example of alkyne hydrosilylation between dimethylarylsilanes and O-propargyl-functionalized proteins using a substoichiometric amount or low-loading of Ru(ii) catalyst to achieve the first C-Si bond formation on full-length substrates. The reaction proceeds under physiological conditions at a rate comparable to other widely used bioorthogonal reactions. Moreover, the resultant gem-disubstituted vinylsilane linkage can be further elaborated through thiol-ene coupling or fluoride-induced protodesilylation, demonstrating its utility in further rounds of targeted modifications.

IL-10 Gene Polymorphisms and Self-Medication With Over-the-Counter Nonsteroidal Anti-Inflammatory Drugs

Background:

Genetic influences on self-medication with over-the-counter (OTC) drugs merit investigation. For example, patients frequently use OTC nonsteroidal anti-inflammatory drugs (NSAIDs) to treat inflammation, but the inflammatory response is also affected by endogenous cytokines whose production varies across polymorphisms of their encoding genes. In the case of interleukin 10 (IL-10), literature suggests that a single nucleotide polymorphism (SNP) in the promoter region of the cytokine’s gene (-1082 A > G [rs1800896]) influences production with higher levels associated with G variant alleles.

Objective:

To demonstrate the feasibility of researching the role of genetics in self-medication by using existing national survey data to evaluate a possible association between OTC NSAID use and genotype at the -1082 SNP of the IL-10 gene.

Methods:

Statistical analyses were performed using data from 6,309 participants in the Third National Health and Nutrition Examination Survey (NHANES III).

Results:

OTC NSAID use (aspirin or ibuprofen) in the previous month was significantly more common among persons with AG or GG genotypes at the -1082 SNP. Odds of use consistently increased relative to the number of G alleles. This trend remained statistically significant (odds ratio = 1.14 per additional G allele, p = .02, 95% confidence interval [1.02, 1.27]) after adjustment for confounding.

Conclusions:

Analysis of population-based genetic data suggests an association between a common self-medication behavior and a specific genetic polymorphism. These findings broadly demonstrate that NHANES data provide opportunities to investigate such associations and specifically imply that potential interrelationships among OTC NSAID use, IL-10 genotype, and IL-10 cytokine levels deserve further study.

Taxonomic revision of the South American catfish genus Ageneiosus (Siluriformes: Auchenipteridae) with the description of four new species

The catfish genus Ageneiosus in the exclusively Neotropical family Auchenipteridae is revised. Species of Ageneiosus are widely distributed in all major South American continental drainages except the São Francisco River basin and small rivers along the Brazilian east coast. The taxonomic revision was based on examination of available type specimens, additional museum material and comparisons of original descriptions. A suite of morphometric, meristic and qualitative characters of internal and external anatomy were used to diagnose valid species and determine synonyms. Thirteen valid species are recognized in the genus Ageneiosus, some of which are widely distributed across South America. Ageneiosus pardalis is the only trans-Andean species in the genus. Ageneiosus polystictus and Ageneiosus uranophthalmus are more widely distributed than previously reported. Ageneiosus marmoratus is a junior synonym of Ageneiosus inermis. Ageneiosus dentatus is a valid species and its name is removed from the synonymy of Ageneiosus ucayalensis. Four new species are described: Ageneiosus akamai, Ageneiosus apiaka, Ageneiosus intrusus and Ageneiosus lineatus, all from the Amazon River basin. A dichotomous key for all 13 valid species of Ageneiosus species is provided.

One-year outcomes after successful chronic total occlusion percutaneous coronary intervention: The impact of dissection re-entry techniques

We aimed to determine clinical outcomes 1 year after successful chronic total occlusion (CTO) PCI and, in particular, whether use of dissection and re-entry strategies affects clinical outcomes. Hybrid approaches have increased the procedural success of CTO percutaneous coronary intervention (PCI) but longer-term outcomes are unknown, particularly in relation to dissection and re-entry techniques. Data were collected for consecutive CTO PCIs performed by hybrid-trained operators from 7 United Kingdom (UK) centres between 2012 and 2014. The primary endpoint (death, myocardial infarction, unplanned target vessel revascularization) was measured at 12 months along with angina status. One-year follow up data were available for 96% of successful cases (n = 805). In total, 85% of patients had a CCS angina class of 2-4 prior to CTO PCI. Final successful procedural strategy was antegrade wire escalation 48%; antegrade dissection and re-entry (ADR) 21%; retrograde wire escalation 5%; retrograde dissection and re-entry (RDR) 26%. Overall, 47% of CTOs were recanalized using dissection and re-entry strategies. During a mean follow up of 11.5 ± 3.8 months, the primary endpoint occurred in 8.6% (n = 69) of patients (10.3% (n = 39/375) in DART group and 7.0% (n = 30/430) in wire-based cases). The majority of patients (88%) had no or minimal angina (CCS class 0 or 1). ADR and RDR were used more frequently in more complex cases with greater disease burden, however, the only independent predictor of the primary endpoint was lesion length. CTO PCI in complex lesions using the hybrid approach is safe, effective and has a low one-year adverse event rate. The method used to recanalize arteries was not associated with adverse outcomes. © 2017 Wiley Periodicals, Inc.

Dynamic Spatial Simulation Modeling of the Population — Environment Matrix in the Ecuadorian Amazon

This research uses multithematic and spatially explicit data combined from a longitudinal socioeconomic and demographic survey conducted in 1990 and 1999, GIS coverages of resource endowments and geographic accessibility, and a classified Landsat Thematic Mapper (TM) satellite time series. The goal was to combine such data with expert knowledge, a set of analytic results, and dynamic modeling approaches to describe, explain, and explore the causes and consequences of land use and cover change (LUCC) in the northern Oriente region of the Ecuadorian Amazon. First, a cellular automaton (CA) model representing LUCC was developed using a time series of remotely sensed Landsat TM images for a 90 000-ha intensive study area within the region and calibrated using alternative images from the time series. The classified images were linked to spatially referenced biophysical and socioeconomic coverages used as input data, and then combined with ‘rules’ derived from empirical analyses. Second, the CA model was used in dynamic simulations to explore LUCC as both causes and consequences of (a) road development, (b) agricultural extensification and land abandonment, (c) major shifts in world markets and crop prices, and (d) urban expansion of the central city within the region. Finally, complexity theory was explored within the spatial and temporal dynamics associated with population – environment interactions, particularly, deforestation, urbanization, and subsistence and commercial cultivation of agricultural crops on lands made accessible by petroleum-company-built roads and the corresponding in-migration of spontaneous colonists beginning in the late 1960s. This research contributes to the study of population – environment interactions in a frontier environment, and examines how dynamic and complex systems can be modeled using CA-based spatial simulations.

Climate Shocks and Migration: An Agent-Based Modeling Approach

This is a study of migration responses to climate shocks. We construct an agent-based model that incorporates dynamic linkages between demographic behaviors, such as migration, marriage, and births, and agriculture and land use, which depend on rainfall patterns. The rules and parameterization of our model are empirically derived from qualitative and quantitative analyses of a well-studied demographic field site, Nang Rong district, Northeast Thailand. With this model, we simulate patterns of migration under four weather regimes in a rice economy: 1) a reference, 'normal' scenario; 2) seven years of unusually wet weather; 3) seven years of unusually dry weather; and 4) seven years of extremely variable weather. Results show relatively small impacts on migration. Experiments with the model show that existing high migration rates and strong selection factors, which are unaffected by climate change, are likely responsible for the weak migration response.

Intracardiac impedance response during acute AF internal cardioversion using novel rectilinear and capacitor-discharge waveforms

Intracardiac impedance (ICI) is a major determinant of success during internal cardioversion of atrial fibrillation (AF). However, there have been few studies that have examined the dynamic behaviour of atrial impedance during internal cardioversion in relation to clinical outcome. In this study, voltage and current waveforms captured during internal cardioversion of acute AF in ovine models using novel radiofrequency (RF) generated low-tilt rectilinear and conventional capacitor-discharge based shock waveforms were retrospectively analysed using a digital signal processing algorithm to investigate the dynamic behaviour of atrial impedance during cardioversion. The algorithm was specifically designed to facilitate the simultaneous analysis of multiple impedance parameters, including: mean intracardiac impedance (Z M), intracardiac impedance variance (ICIV) and impedance amplitude spectrum area (IAMSA) for each cardioversion event. A significant reduction in ICI was observed when comparing two successive shocks of increasing energy where cardioversion outcome was successful. In addition, ICIV and IAMSA variables were found to inversely correlate to the magnitude of energy delivered; with a stronger correlation found to the former parameter. In conclusion, ICIV and IAMSA have been evidenced as two key dynamic intracardiac impedance variables that may prove useful in better understanding of the cardioversion process and that could potentially act as prognostic markers with respect to clinical outcome.

Impact of proctoring on success rates for percutaneous revascularisation of coronary chronic total occlusions

OBJECTIVE

To assess the impact of proctoring for chronic total occlusion (CTO) percutaneous coronary intervention (PCI) in six UK centres.

METHODS

We retrospectively analysed 587 CTO procedures from six UK centres and compared success rates of operators who had received proctorship with success rates of the same operators before proctorship (pre-proctored) and operators in the same institutions who had not been proctored (non-proctored). There were 232 patients in the pre-proctored/non-proctored group and 355 patients in the post-proctored group. Complexity was assessed by calculating the Japanese CTO (JCTO) score for each case.

RESULTS

CTO PCI success was greater in the post-proctored compared with the pre-proctored/non-proctored group (77.5% vs 62.1%, p<0.0001). In more complex cases where JCTO≥2, the difference in success was greater (70.7% vs 49.5%, p=0.0003). After proctoring, there was an increase in CTO PCI activity in centres from 2.5% to 3.5%, p<0.0001 (as a proportion of total PCI), and the proportion of very difficult cases with JCTO score ≥3 increased from 15.3% (35/229) to 29.7% (105/354), p<0.0001.

CONCLUSIONS

Proctoring resulted in an increase in procedural success for CTO PCI, an increase in complex CTO PCI and an increase in total CTO PCI activity. Proctoring may be a valuable way to improve access to CTO PCI and the likelihood of procedural success.

Revision of Tympanopleura Eigenmann (Siluriformes: Auchenipteridae) with description of two new species

The Neotropical catfish genus Tympanopleura, previously synonymized within Ageneiosus, is revalidated and included species are reviewed. Six species are recognized, two of which are described as new. Tympanopleura is distinguished from Ageneiosus by having an enlarged gas bladder not strongly encapsulated in bone; a prominent pseudotympanum consisting of an area on the side of the body devoid of epaxial musculature where the gas bladder contacts the internal coelomic wall; short, blunt head without greatly elongated jaws; and smaller adult body size. Species of Tympanopleura are distinguished from each other on the basis of unique meristic, morphometric, and pigmentation differences. Ageneiosus melanopogon and Tympanopleura nigricollis are junior synonyms of Tympanopleura atronasus. Tympanopleura alta is a junior synonym of Tympanopleura brevis. A lectotype is designated for T. brevis. Ageneiosus madeirensis is a junior synonym of Tympanopleura rondoni. Tympanopleura atronasus, T. brevis, T. longipinna, and T. rondoni are relatively widespread in the middle and upper Amazon River basin. Tympanopleura cryptica is described from relatively few specimens collected in the upper portion of the Amazon River basin in Peru and the middle portion of that basin in Brazil. Tympanopleura piperata is distributed in the upper and middle Amazon River basin, as well as in the Essequibo River drainage of Guyana.

Changing crops in response to climate: virtual Nang Rong, Thailand in an agent based simulation

The effects of extended climatic variability on agricultural land use were explored for the type of system found in villages of northeastern Thailand. An agent based model developed for the Nang Rong district was used to simulate land allotted to jasmine rice, heavy rice, cassava, and sugar cane. The land use choices in the model depended on likely economic outcomes, but included elements of bounded rationality in dependence on household demography. The socioeconomic dynamics are endogenous in the system, and climate changes were added as exogenous drivers. Villages changed their agricultural effort in many different ways. Most villages reduced the amount of land under cultivation, primarily with reduction in jasmine rice, but others did not. The variation in responses to climate change indicates potential sensitivity to initial conditions and path dependence for this type of system. The differences between our virtual villages and the real villages of the region indicate effects of bounded rationality and limits on model applications.

An investigation of the association between omega 3 FA and bone mineral density among older adults: results from the National Health and Nutrition Examination Survey years 2005–2008

SUMMARY

The relation of omega 3 fatty acids (n-3 FA) with bone mineral density (BMD) was assessed among adults >60 years; NHANES data (2005-2008). The association of dietary n-3 FA with measures of hip BMD was equivocal, but n-3 FA supplement use was significantly associated with higher spine BMD - a finding that deserves further study.

INTRODUCTION

Associations between polyunsaturated fatty acids and bone mineral density are not well understood.

PURPOSE

To evaluate the cross-sectional relation between dietary omega 3 fatty acid intake (specifically docosahexaenoic acid, eicosapentaenoic acid, and octadecatetraenoic) and BMD at the hip and spine among older adults.

METHODS

Omega 3 FA intake (g/day) was assessed from two 24-h recalls using the National Health and Nutrition Examination Survey (NHANES, in 2005-2008); and omega 3 FA supplement use (yes/no) via questionnaire. Multivariable regression models were developed to explain variance in femoral neck, total femur, and lumbar spine BMD among 2,125 men and women over 60 years.

RESULTS

Mean age was 70 years. In adjusted models, dietary omega 3 FA were marginally associated with greater femoral neck BMD (p = 0.0505), but not with total femur BMD (p = 0.95) or lumbar spine BMD (p = 0.74). Omega 3 supplement use was significantly positively associated with lumbar spine BMD (p = 0.005) but not with femoral neck or total femur BMD.

CONCLUSIONS

Dietary intakes of omega 3 FA were marginally associated with femoral neck BMD; however, omega 3 supplement use was significantly associated with higher lumbar spine BMD in older adults. These results emphasize the need for assessment of total omega 3 intakes (diet and supplements) to provide a greater range of intake and a more accurate picture of the relation between omega 3 FA and BMD.

Dietary acid load is associated with lower bone mineral density in men with low intake of dietary calcium

High dietary acid load (DAL) may be detrimental to bone mineral density (BMD). The objectives of the study were to: (1) evaluate the cross-sectional relation between DAL and BMD; and (2) determine whether calcium intake modifies this association. Men (n = 1218) and women (n = 907) aged ≥60 years were included from the National Health and Nutrition Examination Survey 2005-2008. Nutrient intake from 2, 24-hour recalls was used to calculate net endogenous acid production (NEAP) and potential renal acid load (PRAL) (mEq/d). PRAL was calculated from dietary calcium (PRALdiet ) and diet + supplemental calcium (PRALtotal ). Tests for linear trend in adjusted mean BMD of the hip and lumbar spine were performed across energy-adjusted NEAP and PRAL quartiles. Modification by calcium intake (dietary or total) above or below 800 mg/d was assessed by interaction terms. Overall, mean age was 69 ± 0.3 years. Among women, there was no association between NEAP and BMD. PRALdiet was positively associated with proximal femur BMD (p trend = 0.04). No associations were observed with PRALtotal at any BMD site (p range, 0.38-0.82). Among men, no significant associations were observed between BMD and NEAP or PRAL. However, an interaction between PRALdiet and calcium intake was observed with proximal femur BMD (p = 0.08). An inverse association between PRALdiet and proximal femur BMD was detected among men with <800 mg/d dietary calcium (p = 0.02); no associations were found among men with ≥800 mg/d (p = 0.98). A significant interaction with PRALtotal was not observed. In conclusion, when supplemental calcium is considered, there is no association between DAL and BMD among adults. Men with low dietary calcium showed an inverse relation with PRAL at the proximal femur; in women no interaction was observed. This study highlights the importance of calcium intake in counteracting the adverse effect of DAL on bone health. Further research should determine the relation between DAL and change in BMD with very low calcium intake.

Soy proteins and isoflavones reduce interleukin-6 but not serum lipids in older women: a randomized controlled trial

Soy foods contain several components, notably, isoflavones and amino acids, that may improve cardiovascular health. We evaluated the long-term effect of soy protein and/or soy isoflavones supplementation on serum lipids and inflammatory markers using a 1-year randomized, double-blind, placebo-control, clinical trial in 131 healthy ambulatory women older than 60 years. We hypothesized that soy protein, in combination with isoflavones, would have the largest positive effect on coronary heart disease risk factors (serum lipids and inflammatory markers) compared with either intervention alone and that, within groups receiving isoflavones, equol producers would have more positive effects on coronary heart disease risk factors than nonequol producers. After a 1-month baseline period, participants were randomized into 1 of 4 intervention groups: soy protein (18 g/d) and isoflavone tablets (105 mg/d isoflavone aglycone equivalents), soy protein and placebo tablets, control protein and isoflavone tablets, or control protein and placebo tablets. T Tests were used to assess differences between equol and nonequol producers. Ninety-seven women completed the trial. Consumption of protein powder and isoflavone tablets did not differ among groups, and compliance with study powder and tablets was 79% and 90%, respectively. After 1 year, in the entire population, there were either no or little effects on serum lipids and inflammatory markers, regardless of treatment group. Equol producers, when analyzed separately, had significant improvements in total cholesterol/high-density lipoprotein and low-density lipoprotein/high-density lipoprotein ratios (-5.9%, P = .02; -7.2%, P = .04 respectively). Soy protein and isoflavone (either alone or together) did not impact serum lipids or inflammatory markers. Therefore, they should not be considered an effective intervention to prevent cardiovascular disease because of lipid modification in healthy late postmenopausal women lacking the ability to produce equol.

Design of an Agent-Based Model to Examine Population-Environment Interactions in Nang Rong District, Thailand

The design of an Agent-Based Model (ABM) is described that integrates Social and Land Use Modules to examine population-environment interactions in a former agricultural frontier in Northeastern Thailand. The ABM is used to assess household income and wealth derived from agricultural production of lowland, rain-fed paddy rice and upland field crops in Nang Rong District as well as remittances returned to the household from family migrants who are engaged in off-farm employment in urban destinations. The ABM is supported by a longitudinal social survey of nearly 10,000 households, a deep satellite image time-series of land use change trajectories, multi-thematic social and ecological data organized within a GIS, and a suite of software modules that integrate data derived from an agricultural cropping system model (DSSAT - Decision Support for Agrotechnology Transfer) and a land suitability model (MAXENT - Maximum Entropy), in addition to multi-dimensional demographic survey data of individuals and households. The primary modules of the ABM are the Initialization Module, Migration Module, Assets Module, Land Suitability Module, Crop Yield Module, Fertilizer Module, and the Land Use Change Decision Module. The architecture of the ABM is described relative to module function and connectivity through uni-directional or bi-directional links. In general, the Social Modules simulate changes in human population and social networks, as well as changes in population migration and household assets, whereas the Land Use Modules simulate changes in land use types, land suitability, and crop yields. We emphasize the description of the Land Use Modules - the algorithms and interactions between the modules are described relative to the project goals of assessing household income and wealth relative to shifts in land use patterns, household demographics, population migration, social networks, and agricultural activities that collectively occur within a marginalized environment that is subjected to a suite of endogenous and exogenous dynamics.

Land Suitability Modeling using a Geographic Socio-Environmental Niche-Based Approach: A Case Study from Northeastern Thailand

Understanding the pattern-process relations of land use/land cover change is an important area of research that provides key insights into human-environment interactions. The suitability or likelihood of occurrence of land use such as agricultural crop types across a human-managed landscape is a central consideration. Recent advances in niche-based, geographic species distribution modeling (SDM) offer a novel approach to understanding land suitability and land use decisions. SDM links species presence-location data with geospatial information and uses machine learning algorithms to develop non-linear and discontinuous species-environment relationships. Here, we apply the MaxEnt (Maximum Entropy) model for land suitability modeling by adapting niche theory to a human-managed landscape. In this article, we use data from an agricultural district in Northeastern Thailand as a case study for examining the relationships between the natural, built, and social environments and the likelihood of crop choice for the commonly grown crops that occur in the Nang Rong District - cassava, heavy rice, and jasmine rice, as well as an emerging crop, fruit trees. Our results indicate that while the natural environment (e.g., elevation and soils) is often the dominant factor in crop likelihood, the likelihood is also influenced by household characteristics, such as household assets and conditions of the neighborhood or built environment. Furthermore, the shape of the land use-environment curves illustrates the non-continuous and non-linear nature of these relationships. This approach demonstrates a novel method of understanding non-linear relationships between land and people. The article concludes with a proposed method for integrating the niche-based rules of land use allocation into a dynamic land use model that can address both allocation and quantity of agricultural crops.