Is there a rationale for including only patients already being treated with acetylcholinesterase inhibitors in a prodromal AD trial?

Prodromal AD clinical trial methodology is advancing rapidly. It is now possible to more accurately identify MCI patients with underlying AD pathology at an earlier stage of the disease through the use of amyloid imaging and CSF biomarkers. Measurement of decline in these early stage clinical trials using continuous clinical and cognitive outcome measures is conceptually more appealing and adds greater efficiency compared to the classical outcome of "conversion" to dementia used in prior MCI clinical trials. Nevertheless, the fact that many prodromal AD patients who are likely to be recruited to these early stage studies are not taking acetylcholinesterase inhibitors at the time of enrollment, but are poised to start taking them over a multi-year period of follow-up, is a potential confound that needs to be addressed.

Implementing Black Box Warnings (BBWs) in Health Information Systems: An Organizing Taxonomy Identifying Opportunities and Challenges

OBJECTIVE

To develop a practical approach for implementing clinical decision support (CDS) for medication black box warnings (BBWs) into health information systems (HIS).

METHODS

We reviewed all existing medication BBWs and organized them into a taxonomy that identifies opportunities and challenges for implementing CDS for BBWs into HIS.

RESULTS

Of the over 400 BBWs that currently exist, they can be organized into 4 categories with 9 sub-categories based on the types of information contained in the BBWs, who should be notified, and potential actions to that could be taken by the person receiving the BBW. Informatics oriented categories and sub-categories of BBWs include - interactions (13%) (drug-drug (4%) and drug-diagnosis (9%)), testing (21%) (baseline (9%) and on-going (12%)), notifications (29%) (drug prescribers (7%), drug dispensers (2%), drug administrators (9%), patients (10%), and third parties (1%)), and non-actionable (37%). This categorization helps identify BBWs for which CDS can be easily implemented into HIS today (such as drug-drug interaction BBWs), those that cannot be easily implemented into HIS today (such as non-actionable BBWs), and those where advanced and/or integrated HIS need to be in place to implement CDS for BBWs (such a drug dispensers BBWs).

CONCLUSIONS

HIS have the potential to improve patient safety by implementing CDS for BBWs. A key to building CDS for BBWs into HIS is developing a taxonomy to serve as an organizing roadmap for implementation. The informatics oriented BBWs taxonomy presented here identified types of BBWs in which CDS can be implemented easily into HIS currently (a minority of the BBWs) and those types of BBWs where CDS cannot be easily implemented today (a majority of BBWs).

Prohibitin is overexpressed in Huh-7-HCV and Huh-7.5-HCV cells harboring in vitro transcribed full-length hepatitis C virus RNA

Background

Currently, up-regulated proteins and apoptosis in hepatitis C is a hot topic in exploring the pathogenic mechanism of Heptitis C Virus(HCV). Some recent studies shows that prohibitin is overexpressed in cells expressing HCV core proteins, and up-regulated prohibitin is also found in human hepatoma cell line HCC-M, lung cancer, prostate cancer, and other cancers. Prohibitin is an important member of the membrane protein superfamily, and it plays a role of molecular chaperones in mitochondrial protein stability. Meanwhile, it has a permissive action on tumor growth or acts as an oncosuppressor. Based on our previously established the in vitro HCV cell-culture system (HCVcc), here we aimed to investigate the different expression profiles of prohibitin in Huh-7-HCV and Huh-7.5-HCV cells

Methods

The total cellular RNA of Huh-7, Huh-7.5, Huh-7-HCV and Huh-7.5-HCV cells were extracted, and then the first-strand cDNA was reversely transcribed. The expression of prohibitin at the mRNA level was assessed by real-time PCR with GAPDH as the control. Furthermore, the expression of prohibitin at the protein level was evaluated by western blot with GAPDH as an internal control.

Results

Our results of real-time PCR showed that the mRNA expression level of prohibitin in Huh-7-HCV cells was 2.09 times higher than that in Huh-7 cells, while, the mRNA level of prohibitin in Huh-7.5-HCV cells was 2.25 times higher than that in Huh-7.5 cells. The results of western blot showed that the protein expression level of prohibitin in Huh-7-HCV cells was 2.38 times higher than that in Huh-7 cells, while the protein expression of prohibitin in Huh-7.5-HCV cells was 2.29 times higher than that in Huh-7.5 cells.

Conclusions

The expression of prohibitin was relatively high in Huh-7-HCV and Huh-7.5-HCV cells harboring in vitro transcribed full-length HCV RNA.

Photocatalytic activities of Cd-doped ZnWO4 nanorods prepared by a hydrothermal process

The ZnWO(4) nanorods doped with cadmium ions have been successfully synthesized by a hydrothermal crystallization process. The products were characterized in detail by multiform techniques: X-ray diffraction (XRD), energy dispersive X-ray analysis (EDS), scanning electron microscopy (SEM), and transmission electron microscopy (TEM). The results of the photocatalytic degradation of rhodamine B (RhB) in aqueous solution showed that cadmium ions doping greatly improved the photocatalytic efficiency of ZnWO(4) nanorods. The Cd-doped ZnWO(4) nanorods with atomic ratio of Cd to Zn being 0.06 had the best activity in photo-degradation of RhB in aqueous solution under UV light irradiation, when the nanorods have prepared at pH 8.

Human Circulating Endorepellin LG3 Fragment and Breast Density: A Potential Combination with Screening Mammography in Women with Dense Breast

(Background) In vitro studies have reported that the endorepellin LG3 fragment (ERLG3F), which is matrix-derived endogenous anti-angiogenic factor, can be a circulating biomarker candidate for breast cancer. This study examined the plasma ERLG3F levels in breast cancer patients and normal healthy controls, and evaluated its potential roles as a screening biomarker for breast cancer (Methods) ERLG3F levels were determined by competitive ELISA in the plasmas from prospectively constructed independent cohorts (train and test set) from July 2006 to September 2007 for the Biomarker Discovery Project (funded by 21C Frontier Functional Proteomics Program of South Korea). The Breast Cancer Cohort (BC) (n=366) has plasmas drawn preoperatively; the Healthy Control Cohort (HC) (n=305), drawn when volunteers visited our Healthcare Center for medical check-up. Circulating ERLG3F, mammography, and the combining marker (CM) of both were evaluated for their performance of identifying breast cancer in the train set and verified again in the test set. (Results) Decreased ERLG3F levels were observed in the individual plasmas from BC compared to the HC. The decrease was significantly prominent in patients without axillary lymph node metastasis (negative vs. positive), young age (< 50 vs. ≥50 yr), and dense breast (mammographic density Gr 3 or 4 vs. 1 or 2). We used a cutoff level, which correspond to 2SD below the mean ERLG3F in total healthy controls. ERLG3F significantly improved the performance of mammography in distinguishing breast cancer cases from healthy controls, although it is less sensitive than mammography as a single marker. (Conclusion) We conclude that ERLG3F can be a useful diagnostic biomarker for breast cancer and its role can be even better when used for young women with dense breast for whom mammography is less helpful.

Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 3026.

NETWORKS, BIOLOGY AND SYSTEMS ENGINEERING: A CASE STUDY IN INFLAMMATION

Biological systems can be modeled as networks of interacting components across multiple scales. A central problem in computational systems biology is to identify those critical components and the rules that define their interactions and give rise to the emergent behavior of a host response. In this paper we will discuss two fundamental problems related to the construction of transcription factor networks and the identification of networks of functional modules describing disease progression. We focus on inflammation as a key physiological response of clinical and translational importance.

Validation of new ultrasound parameters for quantifying pelvic floor muscle contraction

OBJECTIVE

To determine the reliability and validity of new ultrasound parameters, measured in the polar coordinate system, for quantifying pelvic floor muscle action.

METHODS

This was a prospective study, from January 2005 to December 2007, in 209 women with urodynamic stress incontinence, to validate new ultrasound parameters for quantifying pelvic floor muscle contraction. The examination of each patient included intravaginal digital palpation of voluntary pelvic floor muscle contractility and an ultrasound assessment of the positions of the bladder neck and anorectal junction at rest and during pelvic floor muscle contraction. The position of the bladder neck was expressed by bladder neck angle and bladder neck distance from the lower border of the pubic symphysis, and the position of the anorectal junction was expressed by the levator hiatal angle and sagittal hiatal diameter. The vector lengths of the motion of the bladder neck and anorectal junction during pelvic floor muscle contraction were calculated from the positions at rest and during pelvic floor muscle contraction by mathematical formulae.

RESULTS

There was good inter- and intraobserver reliability of measurement of ultrasound parameters on stored volumes. During pelvic floor muscle contraction, elevated bladder neck distance and shortened sagittal hiatal diameter were valid parameters representing stronger pelvic floor muscle contractility, with shortened sagittal hiatal diameter having the best correlation (r = - 0.348, P < 0.001).

CONCLUSION

The methods used in this study appear to be reliable for quantifying pelvic floor muscle action. The bladder neck distance with respect to the lower border of the pubic symphysis and the sagittal hiatal diameter were both valid parameters reflecting PFM contractility.

4,4′-(Propane-1,3-diyl)dipiperidinium sulfate monohydrate

In the title compound, C₁₃H₂₈N₂²⁺·SO₄²⁻·H₂O, extensive hydrogen-bonding inter­actions between the protonated 4,4′-(propane-1,3-di­yl)dipiperidinium ions, the sulfate anions and the water mol­ecules lead to a three-dimensional pillared and layered structure with the 4,4′-(propane-1,3-di­yl)­dipiperidinium ions acting as the pillars.

1,4-Diazo-niabicyclo-[2.2.2]octane terephthalate

In the title compound, C₆H₁₄N²⁺·C₈H₄O₄²⁻, the protonated 1,4-diazo­niabicyclo­[2.2.2]octane cations and the deprotonated terephthalate anions are alternately linked by N—H⋯O hydrogen bonds into chains.