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PKRD: a pharmacokinetic program for least-squares and bayesian analysis of repeated-dose pharmacokinetic curves.

A microcomputer program is presented which analyses multiple-dose pharmacokinetic curves using either a least-squares nonlinear analysis or a bayesian fit. The least-squares subroutine is designed to fit retrospective pharmacokinetic curves and can generate the so-called population pharmacokinetic parameters using the Standard Two-Stage method. The bayesian subroutine can instead be used prospectively to individualise the dosage regimen of a patient based on the concentrations measured in the initial phases of the drug treatment. All the pharmacokinetic subroutines of the program use the one-compartment model with either constant-rate intravenous infusion or oral route with zero-order absorption. The program was tested in a series of ten bone marrow transplantation patients treated with cyclosporine. The least-squares estimates of the one-compartment parameters, calculated by the program, were compared with those generated by the SIMKIN program.

Adolescent↗

A new apparatus for studying feeding and drinking in the mouse.

The quantity of powder food consumed by individual mice was gauged with a newly developed apparatus that includes a specialized feeding station, an electric scale, and an interface to a computer that records the weight of the powder food jar. Using the measurements that exceeded the cutoff value, that is, the threshold between a mouse feeding or drinking event and scale noise, the reconstructed data were presented as the daily pattern of feeding and drinking in time resolution of 9 to 30 min. In this system, the ratio of noise to total consumption value was less than 4%. The fractal structure and fitting curve of this time series data were also analyzed by the nonlinear least-squares method, combined with the maximum entropy method. These analyses demonstrated that the mouse feeding event has circadian and ultradian periodicity. This apparatus and system are useful tools in studying the daily feeding pattern of mice.

Algorithms↗

Phenobarbital adsorption from simulated intestinal fluid, U.S.P., and simulated gastric fluid, U.S.P., by two activated charcoals.

Adsorption of phenobarbital from simulated intestinal and gastric fluids by two activated charcoals was studied. Adsorption isotherm data were analyzed by the linearized Langmuir equation and by nonlinear least-squares regression employing both Langmuir and Freundlich models. These analyses indicated differences in the capacities of the two charcoals for phenobarbital which could not be completely explained by surface-area considerations.

Adsorption↗

Increased oral ganciclovir bioavailability in HIV-infected patients with chronic diarrhoea and wasting syndrome--a population pharmacokinetic study.

AIMS: Despite a lack of data, the antiviral agent ganciclovir is not indicated in AIDS patients with diarrhoea because of its presumed poor oral bioavailability. To assess the effect of diarrhoea on ganciclovir intestinal absorption, we conducted a pharmacokinetic study in 42 HIV-infected patients categorized into three groups: A, HIV stage A and B (n = 15); B, AIDS stage C (n = 13); C, AIDS with chronic diarrhoea and wasting syndrome (n = 14). METHODS: Each patient was evaluated for nutritional (body mass index, albumin, transferrin serum levels), inflammatory (haptoglobin, orosomucoid), immunological (CD4 count, plasma viral load) and intestinal (D-xylose test, faecal fat and nitrogen output, intestinal permeability) status. Ganciclovir (1 g) was administered orally to fasted patients. Six blood samples were collected over 24 h. Serum was analysed for ganciclovir by h.p.l.c. Population pharmacokinetic analysis was performed using a nonlinear mixed effects modelling program, MP2. RESULTS: Mean intestinal permeability (lactulose/mannitol urinary ratio) was increased in group C (0.2) compared with group A (0.05) and B (0.1) patients. Drug concentration-time profiles were best described by a two-compartment model. Apparent oral clearance (CL/F) and central volume of distribution (V1/F) were influenced by clinical status (group). For groups A and B combined, final parameter estimates of CL/F and V1/F were 256 +/- 98 l h(-1) and 1320 +/- 470 l, respectively. Final parameter estimates for group C were 118 +/- 108 l h(-1) and 652 +/- 573 l for CL/F and V1/F, respectively. The 95% confidence intervals on differences between A and B combined and C were statistically significant ([ + 70, + 206] for CL/F, and [+ 314, + 1022] for V1/F). Compared with groups A and B, ganciclovir CL/F was significantly decreased in group C patients. CONCLUSIONS: AIDS patients with diarrhoea and severe disease may benefit from ganciclovir therapy, but a dose adjustment may be required according to their digestive and immunological status.

Acquired Immunodeficiency Syndrome↗

Comments on article "Applying mode-of-action and pharmacokinetic considerations in contemporary cancer risk assessments: an example with trichloroethylene" by Clewell and Andersen.

In their 2004 article, Clewell and Andersen provide their perspective on the application of mode-of-action (MOA) and pharmacokinetic considerations in contemporary cancer risk assessment using trichloroethylene (TCE) as a case example. TCE is a complex chemical toxicologically, with multiple metabolites, multiple sites of observed toxicity, and multiple potential MOAs. As scientists who are responsible for revising the U.S. Environmental Protection Agency's draft risk assessment of TCE, we welcome input of the quality to which the Agency is held accountable. However, in our view, Clewell and Andersen do not present a sufficiently current, complete, accurate, and transparent review of the pertinent scientific literature. In particular, their article would need to incorporate substantial recently published scientific information, better support its conclusions about MOA and choice of linear or nonlinear dose-response extrapolation, and increase its transparency as to quantitative analyses in order to make a significant contribution to the scientific discussion of TCE health risks.

Animals↗

Prediction of gentamicin concentrations in neonates and infants using a Bayesian pharmacokinetic model.

This study retrospectively characterized population-based pharmacokinetic parameters for gentamicin in neonates and young infants, and evaluated the predictive performance of these parameters in a Bayesian forecasting program. Population parameter estimates were determined from the serum concentration-time data of 19 neonates and infants using a one-compartment open infusion model and nonlinear least-squares regression analysis. Univariate and multiple stepwise linear regression analyses were used to determine significant relationships between demographic characteristics and gentamicin pharmacokinetic parameters. Creatinine clearance and postnatal age were the most significant predictors of weight-standardized gentamicin clearance (model r2 = 0.86). The relationships between patient characteristics and population-based parameters were incorporated into the one-compartment Bayesian forecasting model. A second group of 17 neonates and infants receiving 35 courses of gentamicin therapy were used to evaluate the predictive performance of the population-based parameters and a Bayesian forecasting model. The population parameters provided accurate prediction of steady state gentamicin concentrations throughout multiple courses of therapy within the same patient. Bayesian forecasting further minimized the mean prediction error (bias) once a set of steady state peak and trough serum gentamicin concentrations became available (peak concentrations: -0.062 vs. -0.273 mg/l; trough concentrations: -0.006 vs. -0.161 mg/l). The mean absolute error (accuracy) was similar for the two sets of parameters. The observed accuracy of both the population parameters and Bayesian forecasting suggests that monitoring of serum gentamicin concentrations can be kept to minimum in neonates and infants.

Aging↗

Heritability of clinical mastitis incidence and relationships with sire transmitting abilities for somatic cell score, udder type traits, productive life, and protein yield.

The objective of this study was to determine the relationships among daughter clinical mastitis during first and second lactations and sire transmitting abilities for somatic cell score, udder type traits, productive life, and protein yield. Data on clinical mastitis during first lactation were available for 1795 daughters (in six Pennsylvania herds, one Minnesota herd, and one Nebraska herd) of 283 Holstein sires. Data on clinical mastitis during second lactation were available for 1055 of these daughters. A total of 479 cows had 864 clinical episodes during first lactation, and 230 cows had 384 clinical episodes during second lactation. Clinical mastitis incidence and the total number of clinical episodes during each lactation were regressed on herd-season of calving (a classification variable), age at first calving, lactation length, and sire transmitting abilities taken one at a time. Linear effects, nonlinear effects, and odds ratios were estimated for sire transmitting abilities. Separate analyses were conducted on dependent variables that considered clinical mastitis from: all organisms, coagulase-negative staphylococci, coliform species, streptococci other than Streptococcus agalactiae, and the most common environmental organisms (coliform species and streptococci other than Streptococcus agalactiae). Heritability of clinical mastitis ranged from 0.01 to 0.42. Daughters of sires that transmit the lowest somatic cell score had the lowest incidence of clinical mastitis and the fewest clinical episodes during first and second lactations. Daughters of sires that transmit longer productive life, shallower udders, deeper udder cleft, and strongly attached fore udders had either fewer clinical episodes or lower clinical mastitis incidence during first and second lactations. The incidence of clinical mastitis and the number of clinical episodes per lactation may be reduced by selection for lower somatic cell score, longer productive life, shallower udders, deeper udder cleft, or strongly attached fore udders.

Animals↗

[Clinical significance of calculating the coefficients of Lyapunov in the objective assessment of dysphonia].

Measurement of the vibration instability by means of jitter in cases of dysphonia fails to take into account certain features of the vocal signal, such as modulation or bitonatily. These abnormalities appear in jitter measurements as instability, without allowing any differentiation from random instability (to give 'true' instability). The authors suggest the use of the coefficient of Lyapunov, a measurement which is used for nonlinear dynamics. The vocal product of 179 normal and dysphonic subjects has been analysed. The coefficient of Lyapunov and the jitter were measured during the stable period of a sustained 'a' vowel. For the coefficient of Lyapunov, the authors used the algorythm which has been published previously [Giovanni et al, J. Voice 1999;13:341-354]. The measurements were compared with the perceptive analysis of the reading voice by a panel, and divided into four grade (G0 to G3). The coefficient of Lyapunov appeared to be more relevant than the jitter in distinguishing the various perceived grades. Precise recognition of the grade was obtained in 46% using the coefficient of Lyapunov as against only 36% using jitter. The addition of this new index to the existing puriparametric methods of voice analysis seems to be promising.

Acoustics↗

Effect of shear stress on intrinsic CHO culture state and glycosylation of recombinant tissue-type plasminogen activator protein.

Shear stress in suspension culture was investigated as a possible manipulative parameter for the control of glycosylation of the recombinant tissue-type plasminogen activator protein (r-tPA) produced by recombinant Chinese hamster ovary (CHO) cell culture, grown in protein-free media. Resulting fractions of partially glycosylated, Type II, and fully glycosylated, Type I, r-tPA protein were monitored as a direct function of the shear characteristics of the culture environment. The shear-induced response of CHO culture to levels of low shear stress, where exponential growth was not obtained, and to higher levels of shear stress, which resulted in extensive cell death, were examined through manipulation of the bioreactor stirring velocity. Both apparent and intrinsic cell growth, metabolite consumption, byproduct and r-tPA production, and r-tPA glycosylation, from a variable site-occupancy standpoint, were monitored throughout. Kinetic analyses revealed a shear-stress-induced alteration of cellular homeostasis resulting in a nonlinear dependency of metabolic yield coefficients and an intrinsic cell lysis kinetic constant on shear stress. Damaging levels of shear stress were used to investigate the shear dependence of cell death and lysis, as well as the effects on the intrinsic growth rate of the culture. Kinetic models were also developed on the basis of the intrinsic state of the culture and compared to traditional models. Total r-tPA production was maximized under moderate shear conditions, as was the viable CHO cell density of the culture. However, Type II r-tPA production and the fraction of Type II glycoform production ratio was maximized under damaging levels of shear stress. Analyses of biomass production yield coefficients coupled with a plug-flow reactor model of glycan addition in the endoplasmic reticulum (ER) were used to propose an overall mechanism of decreased r-tPA protein site-occupancy glycosylation with increasing shear stress. Decreased residence time of r-tPA in the ER as a result of increased protein synthesis related to shear protection mechanisms is proposed to limit contact of site Asn184 with the membrane-bound oligosaccharyltransferase enzyme in the ER.

Animals↗

Nonlinear characteristics of heart rate time series: influence of three recumbent positions in patients with mild or severe coronary artery disease.

The aim of this study was to investigate the nonlinear characteristics of heart rate variability (HRV) for three recumbent positions: the supine, left lateral and right lateral decubitus positions. Recently, using a linear analyses method (for time and frequency domains), the effect of the right lateral decubitus position on vagal modulation has been found to increase parasympathetic activity and decrease sympathetic modulation. Little is known about the nonlinear dynamics of HRV for the three recumbent positions. Therefore, we studied the correlation dimension (CD), the largest Lyapunov exponent (LLE), the sample entropy (SampEn), the approximate entropy (ApEn) and the exponent alpha of the 1/falpha power spectrum as nonlinear characteristics of HRV. In response to the right lateral decubitus position, the CD, LLE, SampEn and ApEn increased significantly in both coronary artery disease (CAD) and control groups. In the linear analyses, the normalized high-frequency power (nHF) increased in the right lateral decubitus position. The CD, LLE, ApEn and SampEn correlated positively to the nHF. The alpha exponent did not correlate to either linear measure or CD, but correlated negatively to LLE, ApEn and SampEn. Among the three recumbent positions, it was found that the right lateral decubitus position can increase the complexity of the human physiological system and the vagal modulation of the cardiac autonomic nervous system the most.

Algorithms↗

A nonlinear rheological assessment of muscle recovery from eccentric stretch injury.

PURPOSE: To better understand the mechanical behavior of healing skeletal muscle; specifically the tissue's response after acute eccentric stretch injury. METHODS: Rabbit tibialis anterior (TA) muscle tendon units were subjected to an in vivo single stretch (eccentric) injury and mechanically evaluated (constant rate elongation to failure) at 1, 3, and 7 d postinjury. In addition to a traditional linear analysis (linear stiffness and failure load), an existing nonlinear rheological model was modified to interpret the experimental load-to-failure data. The models' performance were evaluated and discussed. RESULTS: No significant injury effect was observed, either within or between groups, across the 7-d healing interval, using the linear analysis. However, interpretation of the data using our nonlinear phenomenological model identified significant changes in mechanical behavior that went undetected by linear analyses. Percent differences, between injured and contralateral control limbs, of model parameter estimates were analyzed. Nonparametric statistical analysis illustrated significant changes in the first-order stiffness (k1) throughout the 7-d healing interval. Model simulations using mean values of each parameter revealed increased low-load tissue compliance after injury, with a decrease in linear slope that recovered steadily toward control values by day 7. At 7 d postinjury, virtually no differences were observed between injured and sham control tissues. CONCLUSIONS: Our findings suggest that acute eccentric injury increases the muscle's compliance 24 h after injury, with a steady recovery to uninjured values by the 7th day, yet these changes went undetected by linear analysis. Therefore, nonlinear analysis is necessary to recognize valuable information contained in the low-load region and to quantify important biomechanical phenomena of stretch-injured healing skeletal muscle.

Animals↗

Data visualisation and manifold mapping using the ViSOM.

The self-organising map (SOM) has been successfully employed as a nonparametric method for dimensionality reduction and data visualisation. However, for visualisation the SOM requires a colouring scheme to imprint the distances between neurons so that the clustering and boundaries can be seen. Even though the distributions of the data and structures of the clusters are not faithfully portrayed on the map. Recently an extended SOM, called the visualisation-induced SOM (ViSOM) has been proposed to directly preserve the distance information on the map, along with the topology. The ViSOM constrains the lateral contraction forces between neurons and hence regularises the interneuron distances so that distances between neurons in the data space are in proportion to those in the map space. This paper shows that it produces a smooth and graded mesh in the data space and captures the nonlinear manifold of the data. The relationships between the ViSOM and the principal curve/surface are analysed. The ViSOM represents a discrete principal curve or surface and is a natural algorithm for obtaining principal curves/surfaces. Guidelines for applying the ViSOM constraint and setting the resolution parameter are also provided, together with experimental results and comparisons with the SOM, Sammon mapping and principal curve methods.

Algorithms↗

Spatial and spatio-temporal patterns in a cell-haptotaxis model.

We investigate a cell-haptotaxis model for the generation of spatial and spatio-temporal patterns in one dimension. We analyse the steady state problem for specific boundary conditions and show the existence of spatially hetero-geneous steady states. A linear analysis shows that stability is lost through a Hopf bifurcation. We carry out a nonlinear multi-time scale perturbation procedure to study the evolution of the resulting spatio-temporal patterns. We also analyse the model in a parameter domain wherein it exhibits a singular dispersion relation.

Animals↗

Analysis of Ca++-dependent gain changes in PDE activation in vertebrate rod phototransduction.

PURPOSE: Recent biochemical and physiological data point to the existence of one or more Ca++-mediated feedback mechanisms modulating gain at stages early in the vertebrate phototransduction cascade, i.e., prior to activation of cGMP-phosphodiesterase (PDE). The present study is a computational analysis that combines quantitative optimization to key data with a qualitative evaluation of each candidate model's ability to capture "signature" features of representative rod responses obtained under a broad range of dark- (DA) and light-adapted (LA) conditions. The primary data motivating the analyses were the two-flash data of Murnick & Lamb. These data exhibited strikingly nonlinear behavior: the period of complete photocurrent saturation (Tsat) in response to a Test flash was reduced substantially when preceded by a less-intense saturating Pre-flash. Depending on the delay between Pre- and Test flashes, the change in Tsat (DTsat) could exceed the magnitude of the delay, and could be reduced by as much as approximately 50%, corresponding to a large reduction in gain by a factor of 10-15. The overall goal of the study was to evaluate what model structure(s) were commensurate with both the Murnick & Lamb data and the salient qualitative features of rod responses obtained under a broad range of DA and LA conditions. METHODS: Three candidate models were quantitatively optimized to the Murnick & Lamb saturated toad rod flash responses and, simultaneously, to a set of sub-saturated flash responses. Using the parameters from these optimizations, each candidate model was then used to simulate a suite of DA and LA responses. RESULTS: The analyses showed that: (1) Within the context of a model with Ca++ feedback onto rhodopsin (R*) lifetime (tR), the salient features of the Murnick & Lamb data can only be accounted for if the rate-limiting step is not the Ca++-sensitive step in the early cascade reactions, i.e., if PDE* lifetime, and not tR, is rate-limiting. (2) With tR rate-limiting, the model cannot account for DTsat exceeding the delay. (3) The Ca++-dependent reduction in tR required to effect the large gain is incommensurate with the empirical dynamics of dim-flash responses. (4) Regardless of which reaction is rate-limiting, a model using solely modulation of R* lifetime puts strong constraints on the domain of biochemical parameters commensurate with the large gain changes Murnick & Lamb observed. (5) The analyses show that, in principle, the Murnick & Lamb data can be accounted for when tR is both rate-limiting and Ca++-sensitive if, in addition to the feedback onto tR, there is an earlier, stronger Ca++ feedback that does not affect R* inactivation kinetics (e.g., gain at R* activation or transducin (T*) activation). (6) Ca++-modulation of R* activation or T* activation as the sole early gain mechanism can also account for the Murnick & Lamb data, but fails to predict the data of Matthews, and can thus be rejected along with any model of comparable form. CONCLUSIONS: The results imply that the Murnick & Lamb data per se are insufficient to rule out rate-limitation by (Ca++-sensitive) R* lifetime; evaluation of a broader set of responses is required. The analyses illustrate the importance of evaluating candidate models in relation to sets of data obtained under the broadest possible range of DA and LA conditions. The analyses are aided by the presence of reproducible signature, qualitative features in the data since these tend to constrain the domain of acceptable model structures and/or parameter sets. Some implications for vertebrate photoreceptor light-adaptation are discussed.

3',5'-Cyclic-GMP Phosphodiesterases↗

Information-integration category learning in patients with striatal dysfunction.

Information-integration category learning was examined in patients with Parkinson's disease (PD) and in healthy control participants in 2 different conditions. In the linear condition, optimal categorization required a nonverbalizable linear integration of information from the 2 stimulus dimensions, whereas in the nonlinear condition, a nonlinear integration of information was required. Each participant completed 600 trials in each condition and was given corrective feedback following each trial. Results indicated that PD patients were not impaired in the linear condition across all trials, whereas the same patients were impaired in the nonlinear condition, but only later in training. The authors conducted model-based analyses to identify participants who used an information-integration approach, and a comparison of the accuracy rates of those individuals further revealed a specific deficit in information-integration category learning in patients with PD. These findings suggest that the striatum may be particularly involved in information-integration category learning when the rule is highly complex.

Aged↗

Indices of whole-body and central adiposity for evaluating the metabolic load of obesity.

BACKGROUND: To assess the relative metabolic load or risk imposed by fatness, fat mass (FM) is commonly expressed as a proportion of weight (% fat), while central adiposity is assessed using the ratio of triceps (TRI) to subscapular (SUBS) skinfolds. The statistical validity of these indices, defined as independence of the index from its denominator, has received inadequate evaluation. OBJECTIVE: To critically examine commonly used obesity indices, and to propose more appropriate approaches. DESIGN: Cross-sectional studies. SUBJECTS: In total, 148 infants; 2195 adult men aged 18 y. METHODS: log-log regression analysis was used to explore the relationships between FM and weight (WT) or fat-free mass (FFM) (adults), and between TRI and SUBS (infants and adults). RESULTS: The simple indices FM/WT, FM/FFM, TRI/SUBS and SUBS/TRI remained related to their denominators, showing their rankings of individuals to be biased by size or fatness. The appropriate power (p) by which to raise the denominator was determined from regression analyses, and differed from unity in all cases. Both skinfold ratios showed a nonlinear relationship with their denominators. CONCLUSION: Simple indices for evaluating whole-body or central adiposity are statistically flawed, and remain influenced by size or fatness of the subject. The index FM/WT is conceptually flawed because FM appears in both numerator and denominator, and the index FM/FFM(p) is preferable. Skinfold ratios are also problematic, and to evaluate central adiposity SUBS alone, or SUBS/FFM(p), may represent more appropriate approaches. These issues should be investigated in other studies in order to address possible influences of age, ethnicity, gender and nutritional status.

Adipose Tissue↗

Hydrogen bonding and dynamics of methanol by high-pressure diamond-anvil cell NMR.

Liquid methanol at densities up to rhorho(0) = 1.7 was studied by NMR in a specially designed diamond-anvil cell. Methyl and hydroxyl resonances have been separately observed at pressures to 43 kbars which exceeds equilibrium freezing pressure of methanol. The chemical shift difference between methyl and hydroxyl protons increases nonlinearly with increasing density, indicating a noticeable decrease in hydrogen bond length. The analyses of spin-lattice relaxation rates of both hydroxyl and methyl protons indicate that compression enhances intermolecular proton exchange and selectively reduces motion of the hydroxyl protons. Collectively these observations reveal that hydrogen bonding interaction in liquid methanol noticeably increases with compression, inhibiting the liquid-solid transition even above the freezing pressure.

Journal Article↗

Air pollution and hospital admissions for cardiovascular disease in Tucson.

Several recent studies have reported associations between short-term changes in both inhalable particles (PM10) and carbon monoxide and cardiovascular hospital admissions. Here, I seek to replicate those findings in a location where sulfur dioxide concentrations are low and poorly correlated with PM10, and where PM10 concentrations peak in the winter when ozone is lowest. This setting allows the opportunity to separate the effects of different air pollutants. I constructed daily counts of admissions to all hospitals in Tucson, AZ, for cardiovascular disease (International Classification of Diseases, 9th revision, codes 390-429) for persons age 65 years and older. I analyzed these admission counts in a Poisson regression, on temperature, humidity, day of the week indicators, and air pollution. I removed long wavelength patterns using a nonparametric smooth function of day of study. I used regression splines to model possible nonlinearities in the dependence of hospital admissions on weather. I then examined sensitivity analyses to control for weather. Both PM10 and carbon monoxide were associated with increased risk of cardiovascular hospital admissions. Admissions increased by 2.75% [95% confidence limits (CL) = 0.52%, 5.04%] for an interquartile range increase (23 micrograms per m3) in PM10 and by 2.79% (95% CL = 0.51%, 5.41%) for an interquartile range increase (1.66 parts per million) in carbon monoxide. These associations were independent and additive. In contrast, I saw little association with sulfur dioxide [increase of 0.14% (95% CL = -1.3%, 1.6%) for an interquartile range increase in exposure], ozone [increase of 0.54% (95% CL = -2.3%, 3.45%)], or nitrogen dioxide [increase of 0.69% (95% CL = -2.3%, 3.8%)]. The air pollution associations were insensitive to control for a potential interaction between temperature and humidity and to control for temperature and humidity on more than 1 day.

Aged↗