Early Termination of Cardiovascular Research Protocols

2021 ◽  
pp. 232-246
Author(s):  
Teresa Lynne Caples ◽  
Emily E. Anderson
2020 ◽  
Vol 134 (17) ◽  
pp. 2243-2262
Author(s):  
Danlin Liu ◽  
Gavin Richardson ◽  
Fehmi M. Benli ◽  
Catherine Park ◽  
João V. de Souza ◽  
...  

Abstract In the elderly population, pathological inflammation has been associated with ageing-associated diseases. The term ‘inflammageing’, which was used for the first time by Franceschi and co-workers in 2000, is associated with the chronic, low-grade, subclinical inflammatory processes coupled to biological ageing. The source of these inflammatory processes is debated. The senescence-associated secretory phenotype (SASP) has been proposed as the main origin of inflammageing. The SASP is characterised by the release of inflammatory cytokines, elevated activation of the NLRP3 inflammasome, altered regulation of acetylcholine (ACh) nicotinic receptors, and abnormal NAD+ metabolism. Therefore, SASP may be ‘druggable’ by small molecule therapeutics targeting those emerging molecular targets. It has been shown that inflammageing is a hallmark of various cardiovascular diseases, including atherosclerosis, hypertension, and adverse cardiac remodelling. Therefore, the pathomechanism involving SASP activation via the NLRP3 inflammasome; modulation of NLRP3 via α7 nicotinic ACh receptors; and modulation by senolytics targeting other proteins have gained a lot of interest within cardiovascular research and drug development communities. In this review, which offers a unique view from both clinical and preclinical target-based drug discovery perspectives, we have focused on cardiovascular inflammageing and its molecular mechanisms. We have outlined the mechanistic links between inflammageing, SASP, interleukin (IL)-1β, NLRP3 inflammasome, nicotinic ACh receptors, and molecular targets of senolytic drugs in the context of cardiovascular diseases. We have addressed the ‘druggability’ of NLRP3 and nicotinic α7 receptors by small molecules, as these proteins represent novel and exciting targets for therapeutic interventions targeting inflammageing in the cardiovascular system and beyond.


2012 ◽  
Vol 26 (4) ◽  
pp. 178-203 ◽  
Author(s):  
Francesco Riganello ◽  
Sergio Garbarino ◽  
Walter G. Sannita

Measures of heart rate variability (HRV) are major indices of the sympathovagal balance in cardiovascular research. These measures are thought to reflect complex patterns of brain activation as well and HRV is now emerging as a descriptor thought to provide information on the nervous system organization of homeostatic responses in accordance with the situational requirements. Current models of integration equate HRV to the affective states as parallel outputs of the central autonomic network, with HRV reflecting its organization of affective, physiological, “cognitive,” and behavioral elements into a homeostatic response. Clinical application is in the study of patients with psychiatric disorders, traumatic brain injury, impaired emotion-specific processing, personality, and communication disorders. HRV responses to highly emotional sensory inputs have been identified in subjects in vegetative state and in healthy or brain injured subjects processing complex sensory stimuli. In this respect, HRV measurements can provide additional information on the brain functional setup in the severely brain damaged and would provide researchers with a suitable approach in the absence of conscious behavior or whenever complex experimental conditions and data collection are impracticable, as it is the case, for example, in intensive care units.


2020 ◽  
Vol 26 (7) ◽  
pp. 1590-1609
Author(s):  
V.A. Rakhaev

Subject. The article addresses modernization of lending facilities under concession agreements. It is important for evaluating the terms of credit transactions, effectiveness of credit projects, and the concessionaire's ability to repay the loan. Objectives. The purpose is to review the current financing mechanism and underpin approaches to improving the credit facilities within concession agreements. Methods. The study rests on general scientific methods, like the systems and logical analysis and synthesis, principles of induction and deduction, financial calculation techniques. The analytical part employs the balance method, methods of financial coefficients and the method of technical and economic estimates. Results. I analyzed the financial structure and special characteristics of concession agreements, parameters of concessionaires’ activities; considered the types of risks inherent in bank lending under concession agreements, methods for their identification and mitigation; offered a mechanism of lending, including the structure of credit transactions, restrictions for the financial condition of concessionaires, additional requirements and penalties for their non-fulfillment. The findings can help banks define lending parameters for concession agreements. The provided recommendations may be useful for consideration by the authorities of the constituent entities of the Russian Federation. Conclusions. It is possible to reduce the risks of lending under concession contracts, if their terms and conditions are stable, and if the lost income of concessionaires is compensated in the event of early termination. Reasonable tariffs for works and services and increased revenue collection will promote this type of lending.


2013 ◽  
pp. 16-17
Author(s):  
David Grieve ◽  
Barbara McDermott ◽  
Emma Robinson ◽  
Melanie Madhani

1992 ◽  
Vol 262 (6) ◽  
pp. H1939-H1940 ◽  
Author(s):  
G. L. Freeman ◽  
J. T. Colston

In this paper we describe a simple pacing circuit which can be used to drive the heart over a wide range of rates. The circuit is an astable multivibrator, based on an LM555 integrated circuit. It is powered by a 9-V battery and is small enough for use in rabbits. The circuit is easily constructed and inexpensive, making it attractive for numerous applications in cardiovascular research.


2019 ◽  
Vol 39 (2) ◽  
pp. 141-150
Author(s):  
Nicola J. Stagg ◽  
Hanan N. Ghantous ◽  
Robert Roth ◽  
Kenneth L. Hastings

Nonclinical toxicology studies are conducted to characterize the potential toxicities and establish a safe starting dose for new drugs in clinical studies, but the question remains as to how predictable/translatable the nonclinical safety findings are to humans. In many cases, there is good concordance between nonclinical species and patients. However, there are cases for which there is a lack of predictivity or translatability that led to early termination of clinical studies due to unanticipated toxicities or early termination of programs before making it to the clinic due to unacceptable nonclinical toxicities assumed to be translatable. A few case examples of safety findings that are translatable versus safety findings that are not translatable and why they are not translateable were presented as a symposium at the 38th Annual Meeting of the American College of Toxicology in Palm Springs, California, and are discussed in this article.


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