A progestin isn’t a progestin: dienogest for endometriosis as a blueprint for future research – Review as a contribution for discussion -

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Michael Oettel ◽  
Hans Joachim Zentel ◽  
Klaus Nickisch
Keyword(s):  
Dose Range ◽  
Research Review ◽  
Future Research ◽  
Combination Therapies ◽  
Medical Needs ◽  
Drug Classes ◽  
Pharmacodynamic Profile ◽  
Therapeutic Principles ◽  
Relevant Dose ◽  
Signal Cascades

AbstractThe different etiopathogenetic mechanisms and the diversity of clinical features of endometriosis has not yet allowed to identify a causal pharmacological monotherapy satisfying the unresolved medical needs in this important female disease. Therefore, despite the search for new therapeutic principles for the indication, the strategy of gradual optimization of established therapeutic principles should not be disregarded.In the case of progestins, the fact that each compound has its own, specific profile may allow to study the therapeutic relevance of the various signal cascades influenced by their receptors.Using the example of the progestin dienogest, the different genomic and non-genomic mechanisms of action are discussed. It is pharmacodynamic profile is unique compared to other progestins.In light of the emerging multitude of pathomechanisms in endometriosis, a monotherapy may not be possible, and then the search for broad spectrum compounds or combination therapies with dual or multiple mode of action in a clinically relevant dose range might be considered. The progestogenic action may greatly benefit from, by way of example, additional anti-inflammatory and/or anti-fibrotic and/or pro-apoptotic activities. Such a strategy could lead to new drug classes.

Identification of Distinct Etiologies across Prescription Misuse and Illicit Drug Use: Opioids and Stimulants Compared

2020 ◽  
Author(s):  
Genevieve Fullerton Dash ◽  
Nicholas G. Martin ◽  
Arpana Agrawal ◽  
Michael Lynskey ◽  
Wendy S. Slutske
Keyword(s):  
Illicit Drugs ◽  
Genetic Influence ◽  
Prescription Opioid ◽  
Future Research ◽  
Opioid Use ◽  
Stimulant Use ◽  
Drug Classes ◽  
Illicit Use ◽  
Prescription Opioid Misuse ◽  
Illicit Opioid Use

Background. Drug classes are grouped based on their chemical and pharmacological properties, but prescription and illicit drugs differ in other important ways. Opioid and stimulant classes contain prescription and illicit forms differentially associated with salient risk factors (common route of administration, legality), making them useful comparators for examining the potential differences in the etiological influences on (mis)use of prescription and illicit drugs. Methods. 2,410 individual Australian twins (Mage=31.77 [SD=2.48]; 67% women) were interviewed about prescription misuse and illicit use of opioids and stimulants. Univariate and bivariate biometric models partitioned variances and covariances into additive genetic, shared environmental, and unique environmental influences across drug types. Results. Variation in the propensity to misuse prescription opioids was primarily attributable to genes (37%) and unique environment (59%). Illicit opioid use was attributable to shared (71%) and unique (29%) environment. Prescription stimulant misuse was primarily attributable to genes (78%) and unique environment (21%). Illicit stimulant use was influenced by genes (48%), and shared (29%) and unique environment (23%). There was evidence for genetic influence common to both stimulant types, but limited evidence for genetic influence common to both opioid types. Conclusions. Prescription opioid misuse may share little genetic influence with illicit opioid use. Future research may consider avoiding unitary drug classifications, particularly when examining genetic influences.

120 The Experience of Housing Need Amongst Families Caring for Children with Medical Complexity: A Qualitative Study

2021 ◽  
Vol 26 (Supplement_1) ◽  
pp. e85-e88
Author(s):  
Clara Moore ◽  
Kara Grace Hounsell ◽  
Arielle Zahavi ◽  
Danielle Arje ◽  
Natalie Weiser ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Future Research ◽  
Complex Care ◽  
Housing Situation ◽  
Children With Medical Complexity ◽  
Trade Off ◽  
Housing Preferences ◽  
Medical Needs ◽  
Medical Complexity ◽  
The Impact

Abstract Primary Subject area Complex Care Background Caregivers of children with medical complexity (CMC) face many financial, social and emotional stressors related to their child’s medical condition(s). Previous research has demonstrated that financial stress among this population can have an impact on their housing situation. Families of CMC may face other unique housing challenges such as disability accommodations in the home and housing space and layout. Objectives The primary aim of this study was to explore families’ perspectives and experiences of housing need, and its relationship to their child’s health status as it pertains to CMC. Design/Methods We conducted a qualitative study using semi-structured interviews to identify themes surrounding families of CMC’s experiences of housing need. Parents of CMC were recruited through purposive sampling from the Complex Care Program at a tertiary pediatric health sciences centre. Recruitment ceased when thematic saturation was reached, as determined by consensus of the research team. Interviews were recorded, transcribed verbatim, coded, and analyzed using thematic analysis. Results Twenty parents completed the interview, of whom 89% were mothers and 42% identified a non-English language as their first language. Two major themes and five subthemes (in parentheses) were identified: 1) the impact of health on housing (housing preferences, housing possibilities, housing outcome as a trade-off) and 2) the impact of housing on health (health of the caregiver, health of the child). Some parents reported that their child’s medical needs resulted in specific preferences regarding the location and layout of their home. Parents also indicated that their caregiving role often affected their income and home ownership status, which in turn, affected their housing possibilities. Thus, the housing situation (location and layout of the home) was often the result of a trade-off between the parent’s housing preferences and possibilities. Conclusion Housing is a recognized social determinant of health. We found that among CMC, health also appears to be a significant determinant of housing as families reported that the health of their child impacted their housing preferences and the options available to them (possibilities). To support the health of CMC and their families, policies targeting improved access to subsidized housing, improved sources of funding and regulations allowing families who rent to make accessibility changes are vital. Future research should investigate the impact of household income on housing need and identify interventions to support appropriate housing for CMC.

scholarly journals Reconstruction of Ovine Trachea with a Biomimetic Composite Biomaterial

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Wojciech Ścierski ◽  
Grażyna Lisowska ◽  
Grzegorz Namysłowski ◽  
Maciej Misiołek ◽  
Jan Pilch ◽  
...  
Keyword(s):  
Carbon Fiber ◽  
Carbon Fibers ◽  
Nonwoven Fabric ◽  
Woven Fabric ◽  
Future Research ◽  
Histological Structure ◽  
Tracheal Reconstruction ◽  
Medical Needs ◽  
Forms Of Carbon

The aim of this study was to evaluate a novel composite material for tracheal reconstruction in an ovine model. A polymer containing various forms of carbon fibers (roving, woven, and nonwoven fabric) impregnated with polysulfone (PSU) was used to create cylindrical tracheal implants, 3 cm in length and 2.5 cm in diameter. Each implant, reinforced with five rings made of PSU-impregnated carbon-fiber roving, had three external layers made of carbon-fiber woven fabric and the inner layer formed of carbon-fiber nonwoven fabric. The inner surface of five implants was additionally coated with polyurethane (PU), to promote migration of respiratory epithelium. The implants were used to repair tracheal defects (involving four tracheal rings) in 10 sheep (9-12 months of age; 40-50 kg body weight). Macroscopic and microscopic characteristics of the implants and tracheal anastomoses were examined 4 and 24 weeks after implantation. At the end of the follow-up period, outer surfaces of the implants were covered with the tissue which to various degree resembled histological structure of normal tracheal wall. In turn, inner surfaces of the prostheses were covered only with vascularized connective tissue. Inner polyurethane coating did not improve the outcomes of tracheal reconstruction and promoted excessive granulation, which contributed to moderate to severe stenosis at the tracheal anastomoses. The hereby presented preliminary findings constitute a valuable source of data for future research on a tracheal implant being optimally adjusted for medical needs.

scholarly journals Questions of Culture in Distance Learning: A Research Review

2009 ◽  
Vol 10 (3) ◽  
Author(s):  
Sedef Uzuner
Keyword(s):  
Distance Learning ◽  
Linguistically Diverse ◽  
Past Research ◽  
Cultural Dimensions ◽  
Asynchronous Learning ◽  
Research Review ◽  
Future Research ◽  
Learning Networks ◽  
Methodological Issues ◽  
Communities Of Learners

This paper reviews past research that focused on questions of culture in distance learning. Of specific interest are the studies that examined the influence of culture on students’ learning and engagement in asynchronous learning networks (ALNs). The purpose of this review is three-fold: to present the state of knowledge concerning the questions of culture in distance learning, to highlight important methodological issues that past research has left unresolved, and to provide practical insights into teaching culturally and linguistically diverse online communities of learners. For these purposes, 27 studies are examined and the findings are reported under the following categories: What do studies focusing on questions of culture in distance learning tell us? What implications do they suggest for practice and future research? Also, the paper provides methodological insights for researchers who wish to investigate the cultural dimensions of distance learning in future studies.

scholarly journals Visual factors and dyslexia: A research review

2010 ◽  
Vol 69 (2) ◽  
Author(s):  
S. O. Wajuihian ◽  
K. S. Naidoo
Keyword(s):  
Academic Performance ◽  
Causal Relationship ◽  
Research Review ◽  
Future Research ◽  
Eye Care ◽  
Psychological Literature ◽  
Poor Academic Performance ◽  
The Relationship

Eye care professionals have long been involved with vision and learning, and receive referrals from teachers, psychologists and other professionals who seek advice about whether vision problems may contribute to, or be responsible for, poor academic performance.  This is particularly the case when dealing with the relationship between vision and dyslexia, which has been a subject of controversy in optometric, ophthalmologic, educational and psychological literature. Ophthalmologists and optometrists in particular, hold different views on the association of dyslexia and vision, and there has been much debate regarding any causal relationship between them.  The results of studies that investigated the vision functions in dyslexic populations remain inconclusive.  This review is intended to provide an overview of studies to date and makes recommendation to guide future research.  (S AfrOptom 2010 69(2) 58-68)

scholarly journals Safety and Pharmacokinetic Characterization of Nacubactam, a Novel β-Lactamase Inhibitor, Alone and in Combination with Meropenem, in Healthy Volunteers

2020 ◽  
Vol 64 (5) ◽  
Author(s):  
Navita L. Mallalieu ◽  
Erica Winter ◽  
Scott Fettner ◽  
Katie Patel ◽  
Elke Zwanziger ◽  
...  
Keyword(s):  
Dose Range ◽  
Drug Dose ◽  
Test Results ◽  
Safety Test ◽  
Class D ◽  
Apparent Relationship ◽  
Dose Study ◽  
Relevant Dose ◽  
Lactamase Inhibitor

ABSTRACT Nacubactam is a novel β-lactamase inhibitor with dual mechanisms of action as an inhibitor of serine β-lactamases (classes A and C and some class D) and an inhibitor of penicillin binding protein 2 in Enterobacteriaceae. The safety, tolerability, and pharmacokinetics of intravenous nacubactam were evaluated in single- and multiple-ascending-dose, placebo-controlled studies. Healthy participants received single ascending doses of nacubactam of 50 to 8,000 mg, multiple ascending doses of nacubactam of 1,000 to 4,000 mg every 8 h (q8h) for up to 7 days, or nacubactam of 2,000 mg plus meropenem of 2,000 mg q8h for 6 days after a 3-day lead-in period. Nacubactam was generally well tolerated, with the most frequently reported adverse events (AEs) being mild to moderate complications associated with intravenous access and headache. There was no apparent relationship between drug dose and the pattern, incidence, or severity of AEs. No clinically relevant dose-related trends were observed in laboratory safety test results. No serious AEs, dose-limiting AEs, or deaths were reported. After single or multiple doses, nacubactam pharmacokinetics appeared linear, and exposure increased in an approximately dose-proportional manner across the dose range investigated. Nacubactam was excreted largely unchanged into urine. Coadministration of nacubactam with meropenem did not significantly alter the pharmacokinetics of either drug. These findings support the continued clinical development of nacubactam and demonstrate the suitability of meropenem as a potential β-lactam partner for nacubactam. (The studies described in this paper have been registered at ClinicalTrials.gov under NCT02134834 [single ascending dose study] and NCT02972255 [multiple ascending dose study].)

scholarly journals SGLT2 Inhibitors and Kidney Outcomes in Patients with Chronic Kidney Disease

2020 ◽  
Vol 9 (9) ◽  
pp. 2723 ◽  
Author(s):  
Swetha R. Kanduri ◽  
Karthik Kovvuru ◽  
Panupong Hansrivijit ◽  
Charat Thongprayoon ◽  
Saraschandra Vallabhajosyula ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Pressure Control ◽  
Future Research ◽  
Diabetic Patients ◽  
Special Focus ◽  
Combination Therapies ◽  
Positive Effects ◽  
Treatment Naïve ◽  
Progression Of Kidney Disease ◽  
End Stage

Globally, diabetes mellitus is a leading cause of kidney disease, with a critical percent of patients approaching end-stage kidney disease. In the current era, sodium-glucose co-transporter 2 inhibitors (SGLT2i) have emerged as phenomenal agents in halting the progression of kidney disease. Positive effects of SGLT2i are centered on multiple mechanisms, including glycosuric effects, tubule—glomerular feedback, antioxidant, anti-fibrotic, natriuretic, and reduction in cortical hypoxia, alteration in energy metabolism. Concurrently, multiple kidney and cardiovascular outcome studies have reported remarkable advantages of SGLT2i including mortality benefits. Additionally, the superiority of combination therapies (SGLT2I along with metformin/DDP-4 Inhibitors) in treatment-naïve diabetic patients is further looked into with potential signal towards glycemic and blood pressure control. Reported promising results initiate a gateway for future research targeting kidney outcomes with combination therapies as an initial approach. In the current paper, we summarize leading cardiovascular and kidney outcome trials in patients with type 2 diabetes, the role of SGLT2i in non-diabetic proteinuric kidney disease, and the potential mechanisms of action of SGLT2i with special focus on combination therapy as an initial therapeutic approach in treatment-naïve diabetic patients.

scholarly journals Use of directed acyclic graphs (DAGs) to identify confounders in applied health research: review and recommendations

2020 ◽  
Author(s):  
Peter W G Tennant ◽  
Eleanor J Murray ◽  
Kellyn F Arnold ◽  
Laurie Berrie ◽  
Matthew P Fox ◽  
...  
Keyword(s):  
Health Research ◽  
Web Of Science ◽  
Directed Acyclic Graphs ◽  
Causal Effects ◽  
Research Review ◽  
Future Research ◽  
Substantial Variation ◽  
Acyclic Graphs ◽  
Confounding Variables ◽  
Applied Health Research

Abstract Background Directed acyclic graphs (DAGs) are an increasingly popular approach for identifying confounding variables that require conditioning when estimating causal effects. This review examined the use of DAGs in applied health research to inform recommendations for improving their transparency and utility in future research. Methods Original health research articles published during 1999–2017 mentioning ‘directed acyclic graphs’ (or similar) or citing DAGitty were identified from Scopus, Web of Science, Medline and Embase. Data were extracted on the reporting of: estimands, DAGs and adjustment sets, alongside the characteristics of each article’s largest DAG. Results A total of 234 articles were identified that reported using DAGs. A fifth (n = 48, 21%) reported their target estimand(s) and half (n = 115, 48%) reported the adjustment set(s) implied by their DAG(s). Two-thirds of the articles (n = 144, 62%) made at least one DAG available. DAGs varied in size but averaged 12 nodes [interquartile range (IQR): 9–16, range: 3–28] and 29 arcs (IQR: 19–42, range: 3–99). The median saturation (i.e. percentage of total possible arcs) was 46% (IQR: 31–67, range: 12–100). 37% (n = 53) of the DAGs included unobserved variables, 17% (n = 25) included ‘super-nodes’ (i.e. nodes containing more than one variable) and 34% (n = 49) were visually arranged so that the constituent arcs flowed in the same direction (e.g. top-to-bottom). Conclusion There is substantial variation in the use and reporting of DAGs in applied health research. Although this partly reflects their flexibility, it also highlights some potential areas for improvement. This review hence offers several recommendations to improve the reporting and use of DAGs in future research.

The Research Review of Remote Sensing Survey on Geological Landscape Tourism Resources

2013 ◽  
Vol 726-731 ◽  
pp. 4705-4708 ◽  
Author(s):  
Wei Luo ◽  
Ling Mao ◽  
Bao Li Liu ◽  
Zhi Wu Yan
Keyword(s):  
Remote Sensing ◽  
Dynamic Change ◽  
Resource Planning ◽  
Research Review ◽  
Future Research ◽  
Research Issues ◽  
Remote Sensing Technology ◽  
Sensing Technology ◽  
Tourism Resources ◽  
Space Layout

Geological landscape is a kind of important tourism resources whose survey is the forerunner of tourism resource planning and development. The application of remote sensing technology develops a revolution of investigation method of geological landscape tourism resources. By analyzing domestic and international investigations and researches of remote sensing of geological landscape tourism resources, this paper considers that remote sensing technology is mainly applied to the investigation of regional geological environment background. The macro characteristics of regional geological landscape tourism resources such as resources area, type identification, dynamic change, space layout, formation lithology, topography distribution are hot research issues, and the analysis and measurement of micro characteristic values of regional geological landscape tourism resources is an important direction of future research.

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