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Regulation of Human Hydrolases and Its Implications in Pharmacokinetics and Pharmacodynamics [Special Section on New and Emerging Areas and Technologies in Drug Metabolism and Disposition, Part II]

Hydrolases represent an essential class of enzymes indispensable for the metabolism of various clinically essential medications. Individuals exhibit marked differences in the expression and activation of hydrolases, resulting in significant variability in the pharmacokinetics (PK) and pharmacodynamics (PD) of drugs metabolized by these enzymes. The regulation of hydrolase expression and activity involves both genetic polymorphisms and nongenetic factors. This review examines the current understanding of genetic and nongenetic regulators of six clinically significant hydrolases, including carboxylesterase (CES)-1 CES2, arylacetamide deacetylase (AADAC), paraoxonase (PON)-1 PON3, and cathepsin A (CTSA). We explore genetic variants linked to the expression and activity of the hydrolases and their effects on the PK and PD of their substrate drugs. Regarding nongenetic regulators, we focus on the inhibitors and inducers of these enzymes. Additionally, we examine the developmental expression patterns and gender differences in the hydrolases when pertinent information was available. Many genetic and nongenetic regulators were found to be associated with the expression and activity of the hydrolases and PK and PD. However, hydrolases remain generally understudied compared with other drug-metabolizing enzymes, such as cytochrome P450s. The clinical significance of genetic and nongenetic regulators has not yet been firmly established for the majority of hydrolases. Comprehending the mechanisms that underpin the regulation of these enzymes holds the potential to refine therapeutic regimens, thereby enhancing the efficacy and safety of drugs metabolized by the hydrolases.

SIGNIFICANCE STATEMENT

Hydrolases play a crucial role in the metabolism of numerous clinically important medications. Genetic polymorphisms and nongenetic regulators can affect hydrolases’ expression and activity, consequently influencing the exposure and clinical outcomes of hydrolase substrate drugs. A comprehensive understanding of hydrolase regulation can refine therapeutic regimens, ultimately enhancing the efficacy and safety of drugs metabolized by the enzymes.




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Simplified Method for Kinetic and Thermodynamic Screening of Cardiotonic Steroids through the K+-Dependent Phosphatase Activity of Na+/K+-ATPase with Chromogenic pNPP Substrate [Article]

The antitumor effect of cardiotonic steroids (CTS) has stimulated the search for new methods to evaluate both kinetic and thermodynamic aspects of their binding to Na+/K+-ATPase (IUBMB Enzyme Nomenclature). We propose a real-time assay based on a chromogenic substrate for phosphatase activity (pNPPase activity), using only two concentrations with an inhibitory progression curve, to obtain the association rate (kon), dissociation rate (koff), and equilibrium (Ki) constants of CTS for the structure-kinetics relationship in drug screening. We show that changing conditions (from ATPase to pNPPase activity) resulted in an increase of Ki of the cardenolides digitoxigenin, essentially due to a reduction of kon. In contrast, the Ki of the structurally related bufadienolide bufalin increased much less due to the reduction of its koff partially compensating the decrease of its kon. When evaluating the kinetics of 15 natural and semisynthetic CTS, we observed that both kon and koff correlated with Ki (Spearman test), suggesting that differences in potency depend on variations of both kon and koff. A rhamnose in C3 of the steroidal nucleus enhanced the inhibitory potency by a reduction of koff rather than an increase of kon. Raising the temperature did not alter the koff of digitoxin, generating a H (koff) of –10.4 ± 4.3 kJ/mol, suggesting a complex dissociation mechanism. Based on a simple and inexpensive methodology, we determined the values of kon, koff, and Ki of the CTS and provided original kinetics and thermodynamics differences between CTS that could help the design of new compounds.

SIGNIFICANCE STATEMENT

This study describes a fast, simple, and cost-effective method for the measurement of phosphatase pNPPase activity enabling structure-kinetics relationships of Na+/K+-ATPase inhibitors, which are important compounds due to their antitumor effect and endogenous role. Using 15 compounds, some of them original, this study was able to delineate the kinetics and/or thermodynamics differences due to the type of sugar and lactone ring present in the steroid structure.




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Factors Influencing the Central Nervous System (CNS) Distribution of the Ataxia Telangiectasia Mutated and Rad3-Related Inhibitor Elimusertib (BAY1895344): Implications for the Treatment of CNS Tumors [Metabolism, Transport, and Pharmacogenetics]

Glioblastoma (GBM) is a disease of the whole brain, with infiltrative tumor cells protected by an intact blood-brain barrier (BBB). GBM has a poor prognosis despite aggressive treatment, in part due to the lack of adequate drug permeability at the BBB. Standard of care GBM therapies include radiation and cytotoxic chemotherapy that lead to DNA damage. Subsequent activation of DNA damage response (DDR) pathways can induce resistance. Various DDR inhibitors, targeting the key regulators of these pathways such as ataxia telangiectasia mutated and Rad3-related (ATR), are being explored as radio- and chemosensitizers. Elimusertib, a novel ATR kinase inhibitor, can prevent repair of damaged DNA, increasing efficacy of DNA-damaging cytotoxic therapies. Robust synergy was observed in vitro when elimusertib was combined with the DNA-damaging agent temozolomide; however, we did not observe improvement with this combination in in vivo efficacy studies in GBM orthotopic tumor-bearing mice. This in vitro–in vivo disconnect was explored to understand factors influencing central nervous system (CNS) distribution of elimusertib and reasons for lack of efficacy. We observed that elimusertib is rapidly cleared from systemic circulation in mice and would not maintain adequate exposure in the CNS for efficacious combination therapy with temozolomide. CNS distribution of elimusertib is partially limited by P-glycoprotein efflux at the BBB, and high binding to CNS tissues leads to low levels of pharmacologically active (unbound) drug in the brain. Acknowledging the potential for interspecies differences in pharmacokinetics, these data suggest that clinical translation of elimusertib in combination with temozolomide for treatment of GBM may be limited.

SIGNIFICANCE STATEMENT

This study examined the disconnect between the in vitro synergy and in vivo efficacy of elimusertib/temozolomide combination therapy by exploring systemic and central nervous system (CNS) distributional pharmacokinetics. Results indicate that the lack of improvement in in vivo efficacy in glioblastoma (GBM) patient-derived xenograft (PDX) models could be attributed to inadequate exposure of pharmacologically active drug concentrations in the CNS. These observations can guide further exploration of elimusertib for the treatment of GBM or other CNS tumors.




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Validation of a Simplified Tissue-to-Reference Ratio Measurement Using SUVR to Assess Synaptic Density Alterations in Alzheimer Disease with [11C]UCB-J PET

Simplified methods of acquisition and quantification would facilitate the use of synaptic density imaging in multicenter and longitudinal studies of Alzheimer disease (AD). We validated a simplified tissue-to-reference ratio method using SUV ratios (SUVRs) for estimating synaptic density with [11C]UCB-J PET. Methods: Participants included 31 older adults with AD and 16 with normal cognition. The distribution volume ratio (DVR) using simplified reference tissue model 2 was compared with SUVR at short scan windows using a whole-cerebellum reference region. Results: Synaptic density was reduced in AD participants using DVR or SUVR. SUVR using later scan windows (60–90 or 70–90 min) was minimally biased, with the strongest correlation with DVR. Effect sizes using SUVR at these late time windows were minimally reduced compared with effect sizes with DVR. Conclusion: A simplified tissue-to-reference method may be useful for multicenter and longitudinal studies seeking to measure synaptic density in AD.




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Is the Clinical Application of CXCR4 Imaging in the Diagnosis and Management of Primary Aldosteronism Really Happening?




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Drug-Drug Interactions and Synergy: From Pharmacological Models to Clinical Application [Review Article]

This review explores the concept of synergy in pharmacology, emphasizing its importance in optimizing treatment outcomes through the combination of drugs with different mechanisms of action. Synergy, defined as an effect greater than the expected additive effect elicited by individual agents according to specific predictive models, offers a promising approach to enhance therapeutic efficacy while minimizing adverse events. The historical evolution of synergy research, from ancient civilizations to modern pharmacology, highlights the ongoing quest to understand and harness synergistic interactions. Key concepts, such as concentration-response curves, additive effects, and predictive models, are discussed in detail, emphasizing the need for accurate assessment methods throughout translational drug development. Although various mathematical models exist for synergy analysis, selecting the appropriate model and software tools remains a challenge, necessitating careful consideration of experimental design and data interpretation. Furthermore, this review addresses practical considerations in synergy assessment, including preclinical and clinical approaches, mechanism of action, and statistical analysis. Optimizing synergy requires attention to concentration/dose ratios, target site localization, and timing of drug administration, ensuring that the benefits of combination therapy detected bench-side are translatable into clinical practice. Overall, the review advocates for a systematic approach to synergy assessment, incorporating robust statistical analysis, effective and simplified predictive models, and collaborative efforts across pivotal sectors, such as academic institutions, pharmaceutical companies, and regulatory agencies. By overcoming critical challenges and maximizing therapeutic potential, effective synergy assessment in drug development holds promise for advancing patient care.

Significance Statement

Combining drugs with different mechanisms of action for synergistic interactions optimizes treatment efficacy and safety. Accurate interpretation of synergy requires the identification of the expected additive effect. Despite innovative models to predict the additive effect, consensus in drug-drug interactions research is lacking, hindering the bench-to-bedside development of combination therapies. Collaboration among science, industry, and regulation is crucial for advancing combination therapy development, ensuring rigorous application of predictive models in clinical settings.




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The 75-Year Anniversary of the Department of Physiology and Pharmacology at Karolinska Institutet--Examples of Recent Accomplishments and Future Perspectives [75th Anniversary Celebration Collection Special Section-Perspective]

Karolinska Institutet is a medical university encompassing 21 departments distributed across three departmental or campus groups. Pharmacological research has a long and successful tradition at the institute with a multitude of seminal findings in the areas of neuronal control of vasodilatation, cardiovascular pharmacology, neuropsychopharmacology, receptor pharmacology, and pharmacogenomics that resulted in, among many other recognitions, two Nobel prizes in Physiology and Medicine, one in 1970 to Ulf von Euler for his discovery of the processes involved in storage, release, and inactivation of neurotransmitters and the other in 1982 to Sune Bergström and Bengt Samuelsson for their work on prostaglandins and the discovery of leukotrienes. Pharmacology at Karolinska Institutet has over the last decade been ranked globally among the top 10 according to the QS World University Ranking. With the Department of Physiology and Pharmacology now celebrating its 75-year anniversary, we wanted to take this as an opportunity to showcase recent research achievements and how they paved the way for current activities at the department. We emphasize examples from preclinical and clinical research where the dpartment's integrative environment and robust infrastructure have successfully facilitated the translation of findings into clinical applications and patient benefits. The close collaboration between preclinical scientists and clinical researchers across various disciplines, along with a strong network of partnerships within the department and beyond, positions us to continue leading world-class pharmacological research at the Department of Physiology and Pharmacology for decades to come.

Significance Statement

Pharmacological research at Karolinska Institutet has a long and successful history. Given the 75-year anniversary of the Department of Physiology and Pharmacology, this perspective provides an overview of recent departmental achievements and future trajectories. For these developments, interdisciplinary and intersectoral collaborations and a clear focus on result translation are key elements to continue its legacy of world-leading pharmacological research.




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Differences in Cervical Spine Fractures in Patients Younger or Older Than 65 Years of Age: Implications for the Canadian C-Spine Rule [CLINICAL PRACTICE]

BACKGROUND AND PURPOSE:

There has been a distinction made in the 2001 Canadian C-Spine Rule regarding patients 65 and older and younger than 65 years of age as far as indications for cervical spine CT scanning. We sought to determine if there are differences in the symptoms, mechanisms of injury, fracture locations, and types that are still relevant in 2024.

MATERIALS AND METHODS:

The institutional review board approved this retrospective study of cervical spine CT emergency department results from 2 hospitals in our health system after reviewing 5 years of data in patients experiencing trauma. In addition to the primary variable of age (younger than 65 years and 65 years and older), we looked at injury mechanism, fracture types, sites, symptoms, and operative or medical treatments. Because the demographics of our home site is different from most towns in the United States, we provide race/ethnicity data.

RESULTS:

Of 21,986 cervical spine CTs, 190/9455 (2.0%) participants 65 years of age and older and 199/12,531 (1.6%) participants younger than 65 years of age had fractures (total, 389/21,986, 1.8%). There were more cases of falls from standing (106, 55.8%) and falls from a height (46, 4.2%) in those 65 years and older and this mechanism was associated with a higher risk of C1 and C2 fractures (52, 27.4%; and 78, 41.1%, respectively). Among the C1 fractures, anterior and posterior arch fractures predominated (37, 19.5%). For C2 fractures, types 2 and 3 odontoid fractures (39, 20.5%; and 12, 6.3%) were more common in the older cohort. Motor vehicle collisions were more common in the younger cohort (89, 44.7%), and they were associated with more C5–C7 fractures (47, 23.6%; 60, 30.2%; and 66, 33.2%, respectively) including the facets (49, 24.6%), spinous processes (31, 15.6%), and transverse processes (52, 26.1%). Overall, the rates of instability, surgical intervention, and asymptomatic fractures were similar in the 2 age groups.

CONCLUSIONS:

Cervical spine fractures appear in about 1.8% of the CT scans performed in a busy emergency department environment. Fractures in the elderly occur more commonly due to falls, are located at C1 and C2, and may involve ligamentous injuries. Younger patients incur trauma more commonly due to motor vehicle collisions, and they are more likely to affect the posterior elements, especially C5–C7. The differences in trends for fractures in the 65 years of age and older and younger than 65 years of age groups have persisted since the Canadian C-Spine Rule 1996–1998 data were collected.




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Improving Access to Disability Assessment for US Citizenship Applicants in Primary Care: An Embedded Neuropsychological Assessment Innovation [Innovations in Primary Care]




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Pulmonary complications of bone marrow transplantation

Bone marrow transplantation, now often known as haematopoietic stem cell transplantation (HSCT), is a complex choreographed procedure used to treat both acquired and inherited disorders of the bone marrow. It has proven invaluable as therapy for haematological and immunological disorders, and more recently in the treatment of metabolic and enzyme disorders. As the number of performed transplants grows annually, and with patients enjoying improved survival, a knowledge of both early and late complications of HSCT is essential for respiratory trainees and physicians in practice. This article highlights the spectrum of respiratory complications, both infectious and non-infectious, the timeline of their likely occurrence, and the approaches used for diagnosis and treatment, keeping in mind that more than one entity may occur simultaneously. As respiratory issues are often a leading cause of short- and long-term morbidity, consideration of a combined haematology/respiratory clinic may prove useful in this patient population.




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Palliative care in lung cancer: tumour- and treatment-related complications in lung cancer and their management

Palliative care pertains to the holistic multidimensional concept of "patient-centred" care. It is an interprofessional specialty, primarily aiming to improve quality of care for cancer patients and their families, from the time of diagnosis of malignant disease, over the continuum of cancer care, and extending after the patient's death to the period of bereavement to support the patient's family. There are various complex and frequently unmet needs of lung cancer patients and their families/caregivers, not only physical but also psychological, social, spiritual and cultural. Systematic monitoring of patients’ symptoms using validated questionnaires and patient-reported outcomes (PROs), on a regular basis, is highly encouraged and recommended in recent guidelines on the role of PRO measures in the continuum of cancer clinical care. It improves patient–physician communication, physician awareness of symptoms, symptom control, patient satisfaction, health-related quality of life and cost-effectiveness. This implies that all treating physicians should improve their skills in communication with lung cancer patients/relatives and become more familiar with this multidimensional assessment, repeatedly screening patients for palliative care needs. Therefore, they should receive education and training to develop palliative care knowledge, skills and attitudes. This review is dedicated to lung cancer palliative care essentials that should be within the competences of treating physicians, i.e. pneumologists/thoracic oncologists.




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Sega Sells Humankind Developer Amplitude Studios

Sega has sold Humankind and Endless developer Amplitude Studios to members of its internal team, announced the developer in a community post. This means the studio is now independent.

"Our studio is backed by strong and meaningful franchises and our team is committed to creating the best games possible," said Amplitude Studios founder Romain de Waubert de Genlis.

"With our extensive experiences in strategy game development and two exciting titles currently in progress, we are confident in our ability to deliver outstanding experience to players. This decision allows us to be more agile in our approach while continuing to shape the vision that has been ours from the very beginning, empowering us to push boundaries and be closer as ever of our community."

Sega in its own statement said: "Sega Europe has today announced the sale of Amplitude Studios following a management buyout from senior leaders and employees at the Parisian studio. The move will see Amplitude go back to its roots as an independent organisation and concludes the structural reforms that have been taking place in Sega’s European business.  

"The decision to part ways follows a period of close consultation between Sega Europe and Amplitude. As an independent studio once more, Amplitude will focus on its in-development projects and growing its own franchises, while Sega will continue to advance its strong and diverse stable of Japanese and Western IP. 

“Sega Europe acquired Amplitude in 2016, and together have released epic strategy titles like Endless Space 2 and Humankind, along with Endless Dungeon, the successor to 2014’s indie hit, Dungeon of the Endless.

"While Amplitude is no longer a part of the Sega family of studios, the two entities will continue to work together on the smooth transition of services and operations, ensuring minimum disruption for Amplitude employees and continuity of service for players of Amplitude games."

A life-long and avid gamer, William D'Angelo was first introduced to VGChartz in 2007. After years of supporting the site, he was brought on in 2010 as a junior analyst, working his way up to lead analyst in 2012 and taking over the hardware estimates in 2017. He has expanded his involvement in the gaming community by producing content on his own YouTube channel and Twitch channel. You can contact the author on Twitter @TrunksWD.

Full Article - https://www.vgchartz.com/article/463024/sega-sells-humankind-developer-amplitude-studios/




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How Star Trek-style replicators could lead to a food revolution

Our Future Chronicles column explores an imagined history of inventions and developments yet to come. This time, Rowan Hooper takes us to the early 2030s, when a technological step change enabled us to produce all the food we needed without the use of animals





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Video Friday: Zipline Delivers



Video Friday is your weekly selection of awesome robotics videos, collected by your friends at IEEE Spectrum robotics. We also post a weekly calendar of upcoming robotics events for the next few months. Please send us your events for inclusion.

ICRA@40: 23–26 September 2024, ROTTERDAM, NETHERLANDS
IROS 2024: 14–18 October 2024, ABU DHABI, UAE
ICSR 2024: 23–26 October 2024, ODENSE, DENMARK
Cybathlon 2024: 25–27 October 2024, ZURICH

Enjoy today’s videos!

Zipline has (finally) posted some real live footage of its new Platform 2 drone, and while it’s just as weird looking as before, it seems to actually work really well.

[ Zipline ]

I appreciate Disney Research’s insistence on always eventually asking, “okay, but can we get this to work on a real robot in the real world?”

[ Paper from ETH Zurich and Disney Research [PDF] ]

In this video, we showcase our humanoid robot, Nadia, being remotely controlled for boxing training using a simple VR motion capture setup. A remote user takes charge of Nadia’s movements, demonstrating the power of our advanced teleoperation system. Watch as Nadia performs precise boxing moves, highlighting the potential for humanoid robots in dynamic, real-world tasks.

[ IHMC ]

Guide dogs are expensive to train and maintain—if available at all. Because of these limiting factors, relatively few blind people use them. Computer science assistant professor Donghyun Kim and Ph.D candidate Hochul Hwang are hoping to change that with the help of UMass database analyst Gail Gunn and her guide dog, Brawny.

[ University of Massachusetts, Amherst ]

Thanks Julia!

The current paradigm for motion planning generates solutions from scratch for every new problem, which consumes significant amounts of time and computational resources. Our approach builds a large number of complex scenes in simulation, collects expert data from a motion planner, then distills it into a reactive generalist policy. We then combine this with lightweight optimization to obtain a safe path for real world deployment.

[ Neural MP ]

A nice mix of NAO and AI for embodied teaching.

[ Aldebaran ]

When retail and logistics giant Otto Group set out to strengthen its operational efficiency and safety, it turned to robotics and automation. The Otto Group has become the first company in Europe to deploy the mobile case handling robot Stretch, which unloads floor-loaded trailers and containers.

[ Boston Dynamics ]

From groceries to last-minute treats, Wing is here to make sure deliveries arrive quickly and safely. Our latest aircraft design features a larger, more standardized box and can carry a higher payload which came directly from customer and partner feedback.

[ Wing ]

It’s the jacket that gets me.

[ Devanthro ]

In this video, we introduce Rotograb, a robotic hand that merges the dexterity of human hands with the strength and efficiency of industrial grippers. Rotograb features a new rotating thumb mechanism, allowing for precision in-hand manipulation and power grasps while being adaptable. The robotic hand was developed by students during “Real World Robotics”, a master course by the Soft Robotics Lab at ETH Zurich.

[ ETH Zurich ]

A small scene where Rémi, our distinguished professor, is teaching chess to the person remotely operating Reachy! The grippers allow for easy and precise handling of chess pieces, even the small ones! The robot shown in this video is the Beta version of Reachy 2, our new robot coming very soon!

[ Pollen ]

Enhancing the adaptability and versatility of unmanned micro aerial vehicles (MAVs) is crucial for expanding their application range. In this article, we present a bimodal reconfigurable robot capable of operating in both regular quadcopter flight mode and a unique revolving flight mode, which allows independent control of the vehicle’s position and roll-pitch attitude.

[ City University Hong Kong ]

The Parallel Continuum Manipulator (PACOMA) is an advanced robotic system designed to replace traditional robotic arms in space missions, such as exploration, in-orbit servicing, and docking. Its design emphasizes robustness against misalignments and impacts, high precision and payload capacity, and sufficient mechanical damping for stable, controlled movements.

[ DFKI Robotics Innovation Center ]

Even the FPV pros from Team BlackSheep do, very occasionally, crash.

[ Team BlackSheep ]

This is a one-hour uninterrupted video of a robot cleaning bathrooms in real time. I’m not sure if it’s practical, but I am sure that it’s impressive, honestly.

[ Somatic ]





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The complicated role loneliness plays in 26 common health conditions

Loneliness was long thought to cause health conditions ranging from diabetes to cardiovascular disease, but new research paints a more nuanced picture




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Comment on Case Study: Premature Baby Overcomes Life-Threatening Complications by Blue Techker

<a href="https://bluetechker.com/" rel="nofollow ugc">Blue Techker</a> Nice post. I learn something totally new and challenging on websites




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Justin Hartley's Ex-Wife and Daughter Support Him As Chrishell Stause Split Plays Out on 'Selling Sunset'

The actor is getting some support from his ex-wife, Lindsay Hartley, and daughter, Bella.

[[ This is a content summary only. Visit my website for full links, other content, and more! ]]




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Essential Guide to Choosing the Best Lakeland Dry Ice Supplier for Your Business Needs

Dry ice is becoming an essential resource for various industries in Lakeland, Florida. Made from carbon dioxide in its solid form, dry ice sublimates directly into gas without leaving any liquid residue. This characteristic makes it a highly effective cooling solution, ideal for transporting perishable goods, supporting medical needs, and industrial cleaning. With the right […]

The post Essential Guide to Choosing the Best Lakeland Dry Ice Supplier for Your Business Needs appeared first on Chart Attack.




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‘Crime Patrol’ and ‘Splitsvilla’ actor Nitin Chauhaan dies at 35

Reports indicate that Chauhaan may have died by suicide, a claim supported by a social media post from his former co-star Vibhuti Thakur, who expressed her shock and sorrow over his untimely death




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Apple Arcade Weekly Round-Up: New Content and Feature Updates Are Now Live for TMNT Splintered Fate, Temple Run: Legends, Vampire Survivors, Simon’s Cat, and More

Following yesterday’s big Disney Dreamlight Valley update on Apple Arcade and other platforms, a few more notable games on Apple’s …






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Innovation Works opens grant application for hardware startups

The grant program provides hardware startups with reimbursement for working with local manufacturers.




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DoP rejects Aristo Pharma's review application for its multivitamin tablets

The Department of Pharmaceuticals (DoP) has upheld the retail price fixation of National Pharmaceutical Pricing Authority (NPPA) for Mumbai─based Aristo Pharmaceuticals for its multivitamin tablets with




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Oversimplification about integration of traditional & modern treatment systems creates confusion: Dr Kotecha

Oversimplification about integration of traditional and modern treatment systems often creates confusion among the stakeholders, and nobody understands the reality of the integration and what it is meant for, said Dr.




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The role of surface preparation in the application of hydrophilic and hydrophobic coatings

Joe Anderson, product and promotional marketing manager at Harland, explores the role of surface preparation in the application of hydrophilic and hydrophobic coatings.




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NPRA Malaysia trials new timelines for variation applications

<p>In May 2024, Malaysia’s National Pharmaceutical Regulatory Agency (NPRA) announced that it will trial new timelines for variation applications&nbsp;of registered pharmaceutical products and natural health supplements (TMHS).</p>




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NHS England lowers threshold for COVID-19 vaccination site applications

Community pharmacies able to administer up to 400 COVID-19 vaccines per week can now apply to become designated vaccination sites, NHS England has said.




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Retention metrics, simplified

[Originally posted on First Patient In]

In my experience, most clinical trials do not suffer from significant retention issues. This is a testament to the collaborative good will of most patients who consent to participate, and to the patient-first attitude of most research coordinators.

However, in many trials – especially those that last more than a year – the question of whether there is a retention issue will come up at some point while the trial’s still going. This is often associated with a jump in early terminations, which can occur as the first cohort of enrollees has been in the trial for a while.

It’s a good question to ask midstream: are we on course to have as many patients fully complete the trial as we’d originally anticipated?

However, the way we go about answering the question is often flawed and confusing. Here’s an example: a sponsor came to us with what they thought was a higher rate of early terminations than expected. The main problem? They weren't actually sure.

Here’s their data. Can you tell?

Original retention graph. Click to enlarge.
If you can, please let me know how! While this chart is remarkably ... full of numbers, it provides no actual insight into when patients are dropping out, and no way that I can tell to project eventual total retention.

In addition, measuring the “retention rate” as a simple ratio of active to terminated patients will not provide an accurate benchmark until the trial is almost over. Here's why: patients tend to drop out later in a trial, so as long as you’re enrolling new patients, your retention rate will be artificially high. When enrollment ends, your retention rate will appear to drop rapidly – but this is only because of the artificial lift you had earlier.

In fact, that was exactly the problem the sponsor had: when enrollment ended, the retention rate started dropping. It’s good to be concerned, but it’s also important to know how to answer the question.

Fortunately, there is a very simple way to get a clear answer in most cases – one that’s probably already in use by your  biostats team around the corner: the Kaplan-Meier “survival” curve.

Here is the same study data, but patient retention is simply depicted as a K-M graph. The key difference is that instead of calendar dates, we used the relative measure of time in the trial for each patient. That way we can easily spot where the trends are.


In this case, we were able to establish quickly that patient drop-outs were increasing at a relatively small constant rate, with a higher percentage of drops coinciding with the one-year study visit. Most importantly, we were able to very accurately predict the eventual number of patients who would complete the trial. And it only took one graph!







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En Banc: Federal Circuit Provides Guidance on Application of On-Sale Bar to Contract Manufacturers

Pharmaceutical and biotech companies breathed a sigh of relief Monday when the Federal Circuit unanimously ruled in a precedential opinion that the mere sale of manufacturing services to create embodiments of a patented product is not a “commercial sale” of the invention that triggers the on-sale bar of 35 U.S.C. § 102(b) (pre-AIA).[1]  The en banc opinion...… Continue Reading




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Understanding splines in the EFFECT statement

This SAS Usage Note illustrates fitting a model containing a spline effect in PROC GLIMMIX. It discusses the spline basis output, the interpretation of the output, how to use the spline model to make predictions, and how to use the LSMEANS and ESTIMATE statements to compute quantities of interest.




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Police probing deepfake nude photos of Singapore Sports School students; school meting out disciplinary actions

SINGAPORE – The police are investigating deepfake nude photos of Singapore Sports School (SSP) students that were created and spread by other students. In response to queries from The Straits Times, school principal Ong Kim Soon said SSP is “aware of the incident involving the creation and sharing of deepfake photos by our student-athletes”. “The school does not condone such harmful behaviour,” he said, adding that it has launched an investigation and lodged a police report. The police, in response to queries from ST, confirmed that a report was lodged and investigations are ongoing. A reader who identified himself as a parent of a victim had alerted ST in an e-mail on Nov 12 about the deepfake nude images that were being circulated. “Many parents of affected female students in Singapore Sports School are making police reports about deepfake nude photos of their daughters generated by male students from the school,” the parent said. When contacted, the parent said that female teachers were also targeted, and that the school has offered affected students counselling.




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Climate Change: Political Implications and Policy Response in Africa

The fourth session addressed the pressing issue of climate change and its political implications in Africa. This session highlighted the disproportionate impact of climate change effects on African nations and how governments are responding through policy measures. A significant focus of the discussion was placed on current climate financial models and the challenges to accessing funding for renewable energy and electrification projects in Africa. The study group counted with the presence of external expert speaker Ely Sandler, Fellow at the Belfer Center. Ely has worked as a senior consultant at the World Bank and previously at Morgan Stanley for nearly a decade. Policy proposals that Ely developed at Harvard were presented at COP27 and are now being adopted by the World Bank and UAE COP28 Presidency, with the hope of catalyzing trillions of dollars of green investment, in part through Article 6 of the Paris Agreement.






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GST Compliance Alert: Check and Rectify Past Claims Before November 2024

GST Returns which are to be filed in November month, those returns are very important as in this month you need to reconcile them thoroughly.




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TDS Applicability for an NRI

My client purchased a property from an NRI and we have deducted 20% Plus Cess and Surcharge. Later the TDS processed with defaults and intimated that the applicable rate is 30%. They have raised demand for short deduction.1.What is the actual rate of TDS when we are buying




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GST applicable on Car facility extended to employees when the amount of car lease incurred by the company is recovered from employees

The AAAR, Tamil Nadu in the case of M/s Faiveley Transport Rail Technologies India (P.) Ltd., In Re [A.R. Appeal No. 03/2024 AAAR dated July 10, 2024] upheld the ruling passed by AAR Tamil Nadu wherein it was ruled that GST would be applicable on Car facility extended to employees when the amount of




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Application of GST registration cancellation cannot be rejected based on scrutiny proceeding against Assessee for determining tax liability of past period

The Hon'ble Delhi High Court in the case of M/s Sanjay Sales India v. Principal Commissioner of Department of Trade and Taxes, Government of NCT, Delhi [Writ Petition (Civil) No. 10234 of 2024 dated July 26, 2024] held that the application for the cancellation of the GST registration cannot be denie




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Regarding applicability of head

If assessee had agriculture income in inheritance, then such agriculture land converted into non-agriculture land i.e. commercial land and make his sub plots and sale to others, so what is treatment of such income arise on sale whether capital gain applicable in such case or consider in PGBP, if considered in PGBP, then how to provide effect in that i.e. Treat as direct income under Trading account or treat as indirect income in P&L Account?




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you dont have to accomplish

Today on Toothpaste For Dinner: you dont have to accomplish


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'My dad’s beautiful brain started thinking': Karen neighbor insists HOA remove neighbor's boat from view, neighbor maliciously complies with her demands

Minding your business? This woman has never heard of such a thing. She's being a rather nosy neighbor, as u/Ok-One-3240 shared in their family's story of malicious compliance

Some people just can't help being busybodies. They have too much time on their hands, and they're going to make it everyone else's problem, too. This person shares that their family enjoyed living in a gated community, and they spent a good amount of time using their boat. Each weekend, they'd take the boat out for a few days, then store it again for the rest of the week. As long as the boat wasn't within view of the street, their local HOA had no problem with it. That's a common issue that people seem to have with their HOAs… who cares if you can see someone's boat? It's a pretty frivolous rule in the first place, and this person mentions that their HOA didn't really enforce the rule too strongly.

Then along comes this busybody neighbor who decides to make it her mission to bug the boat family. Read the whole dramatic story below. 

Up next, read about what happened when this 17-year-old babysat her aunt's kids and helped herself to a piece of cake… from a dessert that cost $90! 




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'His hand pauses in midair': Front desk attendant gets scolded for using his phone at work, instead he maliciously complies with company policy by wasting other precious office resources

No personal cell phones? Okay. This employee took his malicious compliance to the next level after getting scolded one too many times for using his cell phone on the job. 

I get it… It doesn't look good for a hotel receptionist to scroll memes while the line at the concierge starts to grow. Smacking your gum, rolling your eyes, and scrolling endlessly really isn't something you're supposed to be doing at work, but as many of us forget, our phones are actually super useful little tools. We've grown accustomed to traveling around all day with a tiny computer in our pocket that it's easy to let slip their more convenient functions. The front desk reception guy in our next tale knew all the ways his phone could help out clients, but after his manager got on his back about using his personal device on the clock, he decided to use the second language translating tool at his disposal. 

Keep scrolling to read how an employee turned a spiteful MC into a memorable guest experience when a traveler needed help with a quick translation.




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Tax-News.com: Italy To Extend VAT Split Payment Mechanism For B2G Supplies

On July 24, 2020, a Council Implementing Decision was published in the official journal of the European Union authorizing the extension of Italy's value-added tax split payment mechanism scheme, applicable to contracts with public sector entities.




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Tax-News.com: US IRS Announces TCJA Compliance Campaign

On May 1, 2020, the United States Internal Revenue Service Large Business and International Division announced a new compliance campaign focusing on the 2017 Tax Cuts and Jobs Act and the recently enacted Coronavirus Aid, Relief and Economic Security Act.




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Tax-News.com: UK Delays Overhaul To Tax Non-Compliance Penalties

HM Revenue and Customs is reforming late-filing and payment penalties to make them fairer and more consistent across taxes. The first stage of these reforms was set to come into effect early this year. However, on January 13, 2022, HMRC postponed the effective dates by nine months to one year.




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Nurses as Parents Exemplify Association Between Poor Sleep and Daily Stress: Study

Nurses who are parents are more susceptible than other groups to daily stress aggravated by sleep deprivation, revealed paper published in Journal of Sleep Research.




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Donation from WHO to Malawi: Medical Supplies Worth (Dollor) 9 Million

The government of Malawi has received a donation of various medical supplies, including drugs, valued at (Dollor) 9 million, from the World Health Organisation (WHO) to aid the country's public hospitals.