PRIME

PRIME
  • 文章类型: Editorial
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  • 文章类型: Journal Article
    测序费用的减少促进了用于扩大的生物体阵列的参考基因组和蛋白质组的创建。然而,没有建立详细说明特定长度的生物体特异性基因组和蛋白质组序列的存储库,被称为kmers,存在于我们的知识中。在这篇文章中,我们介绍kmerDB,通过交互式网络界面访问的数据库,该界面以系统的方式从基因组和蛋白质组序列中提供基于kmer的信息。kmerDB目前包含202,340,859,107个碱基对和19,304,903,356个氨基酸,跨越54,039和21,865个参考基因组和蛋白质组,分别,以及6,905,362和149,305,183基因组和蛋白质组物种特异性序列,称为准素数。此外,我们提供了每个基因组和蛋白质组中缺失的5,186,757核酸和214,904,089肽序列的访问,称为素数。kmerDB具有用户友好的界面,提供各种搜索选项和过滤器,以便于解析和搜索。该服务可在www上获得。kmerdb.com.
    The decrease in sequencing expenses has facilitated the creation of reference genomes and proteomes for an expanding array of organisms. Nevertheless, no established repository that details organism-specific genomic and proteomic sequences of specific lengths, referred to as kmers, exists to our knowledge. In this article, we present kmerDB, a database accessible through an interactive web interface that provides kmer-based information from genomic and proteomic sequences in a systematic way. kmerDB currently contains 202,340,859,107 base pairs and 19,304,903,356 amino acids, spanning 54,039 and 21,865 reference genomes and proteomes, respectively, as well as 6,905,362 and 149,305,183 genomic and proteomic species-specific sequences, termed quasi-primes. Additionally, we provide access to 5,186,757 nucleic and 214,904,089 peptide sequences absent from every genome and proteome, termed primes. kmerDB features a user-friendly interface offering various search options and filters for easy parsing and searching. The service is available at: www.kmerdb.com.
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  • 文章类型: Journal Article
    背景:Aducanumab选择性地靶向β淀粉样蛋白(Aβ)的聚集形式,阿尔茨海默病(AD)的神经病理学标志。
    方法:PRIME是1b阶段,双盲,aducanumab的随机临床试验。在12个月的安慰剂对照期间,患有前驱AD或轻度AD痴呆的参与者被随机分配接受阿杜卡尼单抗或安慰剂治疗.在第56周,参与者可以注册长期扩展(LTE),所有参与者均接受了阿杜卡尼单抗治疗.主要终点是安全性和耐受性。
    结果:淀粉样蛋白相关影像学异常-水肿(ARIA-E)是最常见的不良事件。剂量滴定与ARIA-E发生率的降低有关。超过48个月,aducanumab以剂量和时间依赖性方式降低脑淀粉样蛋白水平.探索性终点表明在48个月内临床下降的减少持续受益。
    结论:在PRIME的LTE中,aducanumab的安全性保持不变。淀粉样蛋白斑块水平在接受aducanumab治疗的参与者中持续下降。
    结论:PRIME是1b阶段,双盲,aducanumab的随机临床试验。我们报告了PRIME的累积安全性和48个月疗效结果。淀粉样蛋白相关的影像学异常-水肿(ARIA-E)是最常见的不良事件(AE);61%的ARIA-E参与者无症状。剂量滴定与ARIA-E发生率的降低有关。Aducanumab以剂量和时间依赖性方式降低淀粉样β(Aβ)的水平。
    Aducanumab selectively targets aggregated forms of amyloid beta (Aβ), a neuropathological hallmark of Alzheimer\'s disease (AD).
    PRIME was a Phase 1b, double-blind, randomized clinical trial of aducanumab. During the 12-month placebo-controlled period, participants with prodromal AD or mild AD dementia were randomized to receive aducanumab or placebo. At week 56, participants could enroll in a long-term extension (LTE), in which all participants received aducanumab. The primary endpoint was safety and tolerability.
    Amyloid-related imaging abnormalities-edema (ARIA-E) were the most common adverse event. Dose titration was associated with a decrease in the incidence of ARIA-E. Over 48 months, aducanumab decreased brain amyloid levels in a dose- and time-dependent manner. Exploratory endpoints suggested a continued benefit in the reduction of clinical decline over 48 months.
    The safety profile of aducanumab remained unchanged in the LTE of PRIME. Amyloid plaque levels continued to decrease in participants treated with aducanumab.
    PRIME was a Phase 1b, double-blind, randomized clinical trial of aducanumab. We report cumulative safety and 48-month efficacy results from PRIME. Amyloid-related imaging abnormalities-edema (ARIA-E) were the most common adverse event (AE); 61% of participants with ARIA-E were asymptomatic. Dose titration was associated with a decrease in the incidence of ARIA-E. Aducanumab decreased levels of amyloid beta (Aβ) in a dose- and time-dependent manner.
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  • 文章类型: Journal Article
    背景:在先天性心脏手术中用于体外循环(CPB)的标准血液灌注可能具有电解质的非生理价值,葡萄糖,和乳酸。旁路前超滤(PBUF)可以使这些值在旁路开始之前更加生理和标准化。我们的目的是确定对血液原液(包括浓缩的红细胞和解冻的血浆)使用PBUF是否会使原液值更可预测和生理。此外,我们旨在评估PBUF的加入是否对结局指标有影响.
    方法:对2017年8月至2021年9月接受CPB心脏手术的年龄≤1岁的连续患者进行回顾性回顾。由于PBUF是在灌注者的自由裁量权下进行的,接受PBUF的患者的自然分组与那些没有发生的。电解质的差异,葡萄糖,在特定时间点使用分类变量的Fisher精确检验和连续变量的Wilcoxon秩和检验进行比较。还评估了临床结果。
    结果:在这两个队列中,手术时的中位年龄为3个月,47%的患者为女性;PBUF组的308/704(44%)和标准主要组的163/414(39%)存在至少一个术前危险因素.显示出更多葡萄糖生理值的PBUF电路的比例(318[45%]),钠(434,[62%]),钾(688[98%]),乳酸(612[87%])和渗透压(595[92%])显著高于葡萄糖的标准原路水平(8[2%]),钠(13[3%],钾(150[36%]),开始CPB前的乳酸(56[13%])和渗透压(23[6%])。两组之间的临床结果或主要不良事件发生率没有差异。
    结论:PBUF为电解质创造了标准化和更多的生理价值,葡萄糖,和开始旁路术前的乳酸,对院内结局无显著影响。
    BACKGROUND: A standard blood prime for cardiopulmonary bypass (CPB) in congenital cardiac surgery may possess non-physiologic values for electrolytes, glucose, and lactate. Pre-bypass Ultrafiltration (PBUF) can make these values more physiologic and standardized prior to bypass initiation. We aimed to determine if using PBUF on blood primes including packed red blood cells and thawed plasma would make prime values more predictable and physiologic. Additionally, we aimed to evaluate whether the addition of PBUF had an impact on outcome measures.
    METHODS: Retrospective review of consecutive patients ≤ 1 year of age undergoing an index cardiac operation on CPB between 8/2017 and 9/2021. As PBUF was performed at the perfusionists\' discretion, a natural grouping of patients that received PBUF vs. those that did not occur. Differences in electrolytes, glucose, and lactate were compared at specific time points using Fisher\'s exact test for categorical variables and the Wilcoxon rank sum test for continuous variables. Clinical outcomes were also assessed.
    RESULTS: In both cohorts, the median age at surgery was 3 months and 47% of patients were female; 308/704 (44%) of the PBUF group and 163/414 (39%) of the standard prime group had at least one preoperative risk factor. The proportion of PBUF circuits which demonstrated more physiologic values for glucose (318 [45%]), sodium (434, [62%]), potassium (688 [98%]), lactate (612 [87%]) and osmolality (595 [92%]) was significantly higher when compared to standard prime circuit levels for glucose (8 [2%]), sodium (13 [3%], potassium (150 [36%]), lactate (56 [13%]) and osmolality (23 [6%]) prior to CPB initiation. There were no differences in clinical outcomes or rates of major adverse events between the two cohorts.
    CONCLUSIONS: PBUF creates standardized and more physiologic values for electrolytes, glucose, and lactate before the initiation of bypass without significant impacts on in-hospital outcomes.
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  • 文章类型: Journal Article
    2000年,欧盟(EU)引入了孤儿药品立法,以激励罕见疾病药品的开发。孤儿药品委员会(COMP),负责评估孤儿申请(OD)的欧洲药品管理局委员会,在过去的几年中,在基因治疗领域的应用越来越多。这里,COMP对基因疗法在非肿瘤罕见疾病中的应用进行了描述性分析,关于(a)目标条件及其稀有性,(b)建议用于OD的基因治疗产品的特征,重点关注使用的向量类型,和(c)与赞助商和发展类型有关的监管方面,通过审查欧盟提供的可用框架的使用情况,如协议援助和PRIME。人们注意到,基因疗法是由来自不同背景的赞助商开发的。大多数目标条件是单基因的,最常见的是溶酶体疾病,患病率非常低。一般来说,腺相关病毒载体被用于递送转基因。最后,赞助商并不经常使用可能支持发展的激励措施,其原因尚不清楚。
    In 2000, the European Union (EU) introduced the orphan pharmaceutical legislation to incentivize the development of medicinal products for rare diseases. The Committee for Orphan Medicinal Products (COMP), the European Medicines Agency committee responsible for evaluation of applications for orphan designation (OD), received an increasing flow of applications in the field of gene therapies over the last years. Here, the COMP has conducted a descriptive analysis of applications regarding gene therapies in non-oncological rare diseases, with respect to (a) targeted conditions and their rarity, (b) characteristics of the gene therapy products proposed for OD, with a focus on the type of vector used, and (c) regulatory aspects pertaining to the type of sponsor and development, by examining the use of available frameworks offered in the EU such as protocol assistance and PRIME. It was noted that gene therapies are being developed by sponsors from different backgrounds. Most conditions being targeted are monogenic, the most common being lysosomal disorders, and with a very low prevalence. Generally, adeno-associated viral vectors were being used to deliver the transgene. Finally, sponsors are not frequently using the incentives that may support the development and the reasons for this are unclear.
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  • 文章类型: Journal Article
    情感启动效应的强度受各种因素的影响,包括黄金期的持续时间。令人惊讶的是,与长期素数相比,意识意识阈值附近的短期素数通常会产生更强的效果。错误归因效应理论表明,下意识素数不能为情感感归因于素数提供足够的认知处理时间。相反,被评估的中立目标被认为是情感体验。在日常的社交互动中,我们将目光从一张脸转移到另一张脸,通常只考虑每一张脸几秒钟。可以合理地假设在这种互动过程中没有发生情感启动。为了调查是否确实如此,参与者被要求对显示的人脸的效价进行逐一评分。每个面部图像同时充当目标(由先前的试验引发)和素数(用于下一次试验)。根据参与者的响应时间,图像通常显示大约1-2s。正如误判效应理论所预测的那样,中性目标不受积极情感启动的影响。然而,非中性目标表现出强大的启动效应,当先前看到的面孔在情绪上一致时,情绪上的面孔被认为更加消极或积极。这些结果表明,“正确的归因效应”调节了我们对面孔的感知,不断影响我们的社交互动。鉴于面孔在社交中的重要性,这些发现具有广泛的意义.
    The strength of the affective priming effect is influenced by various factors, including the duration of the prime. Surprisingly, short-duration primes that are around the threshold for conscious awareness typically result in stronger effects compared to long-duration primes. The misattribution effect theory suggest that subliminal primes do not provide sufficient cognitive processing time for the affective feeling to be attributed to the prime. Instead, the neutral target being evaluated is credited for the affective experience. In everyday social interactions, we shift our gaze from one face to another, typically contemplating each face for only a few seconds. It is reasonable to assume that no affective priming takes place during such interactions. To investigate whether this is indeed the case, participants were asked to rate the valence of faces displayed one by one. Each face image simultaneously served as both a target (primed by the previous trial) and a prime (for the next trial). Depending on the participant\'s response time, images were typically displayed for about 1-2 s. As predicted by the misattribution effect theory, neutral targets were not affected by positive affective priming. However, non-neutral targets showed a robust priming effect, with emotional faces being perceived as even more negative or positive when the previously seen face was emotionally congruent. These results suggest that a \"correct attribution effect\" modulates how we perceive faces, continuously impacting our social interactions. Given the importance of faces in social communication, these findings have wide-ranging implications.
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  • 文章类型: Journal Article
    目标:由于法属西印度群岛正面临持续的营养转变,2型糖尿病(T2DM)患病率增加,我们的研究旨在根据几种情况评估法国西印度成年人膳食模式的潜在变化对T2DM风险的影响.
    方法:我们在2013年对瓜德岛和马提尼卡成年人的代表性样本(n=1063)进行了一项关于饮食摄入的横断面多阶段抽样调查。从先前确定的当前饮食模式来看,我们使用了PRIME-糖尿病,比较风险评估模型,为了估计从“过渡”模式到“方便”模式的潜在转变的影响,“谨慎”,“和”传统“T2DM风险”。
    结果:饮食摄入量从“过渡”模式到“传统”模式的潜在转变降低了女性(-16%[-22;-10])和男性-14%[-21;-7])的T2DM风险,随着膳食摄入量向“谨慎”模式的转变(-23%[-29;-17]和-19%-23;-14],分别)。这些风险的降低主要是由于全谷物的增加,水果,绿叶蔬菜摄入量,土豆减少,红肉,加工肉类,和含糖饮料。膳食摄入量向“方便”模式的转变并不影响T2DM的风险。
    结论:为了遏制T2DM患病率的增加并减轻这种负担,一项公共卫生行动可能是针对过渡的成年人,并帮助他们转向与降低T2DM风险相关的饮食,作为谨慎或传统的饮食.
    OBJECTIVE: As the French West Indies are facing an ongoing nutrition transition with increasing type-2 diabetes mellitus (T2DM) prevalence, our study aimed to evaluate the effect of potential shifts in dietary patterns on T2DM risk in French West Indian adults according to several scenarios.
    METHODS: We used a cross-sectional multistage sampling survey on dietary intake conducted in 2013 on a representative sample of Guadeloupeans and Martinicans adults (n = 1063). From previously identified current dietary patterns, we used PRIME-Diabetes, a comparative risk assessment model, to estimate the effect of potential shifts from the \"transitioning\" pattern to the \"convenient,\" the \"prudent,\" and the \"traditional\" ones on T2DM risks.
    RESULTS: Potential shift in dietary intakes from the \"transitioning\" pattern to the \"traditional\" one reduced the T2DM risk in women (- 16% [- 22; - 10]) and in men - 14% [- 21; - 7]), as the shift in dietary intakes toward the \"prudent\" pattern (- 23% [- 29; - 17] and - 19% - 23; - 14], respectively). These risk reductions were mostly driven by increased whole grains, fruits, green leafy vegetable intakes, and decreases in potatoes, red meats, processed meats, and sugar-sweetened beverages. The shift in dietary intakes toward the \"convenient\" pattern did not affect the T2DM risks.
    CONCLUSIONS: To curb the increase in T2DM prevalence and reduce this burden, one public health action could be to target transitioning adults and help them to shift towards a diet associated with a reduced risk of T2DM as a prudent or a traditional diet.
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  • 文章类型: Journal Article
    在欧洲联盟(欧盟),先进治疗药物(ATMP)经过欧洲药品管理局(EMA)高级治疗委员会(CAT)的评估,以获得集中程序下的上市许可。由于ATMP的多样性和复杂性,需要对监管过程采取量身定制的方法,以确保每种产品的安全性和有效性。由于ATMP通常针对医疗需求未满足的严重疾病,行业和当局有兴趣通过优化和加快的监管途径及时为患者提供治疗。欧盟立法者和监管机构已经实施了各种工具,通过在早期阶段提供科学指导来支持创新药物的开发和授权,对小型开发商和罕见疾病产品的激励,加快营销授权申请的评估,不同类型的营销授权,并为具有孤儿药名称(ODD)和优先药(PRIME)计划的医药产品量身定制计划。自从ATMP的监管框架建立以来,20个产品已获得许可,15名孤儿药,和7由PRIME支持。本章讨论了欧盟ATMP的具体监管框架,并强调了以前的成功和剩余的挑战。
    In the European Union (EU), advanced therapy medicinal products (ATMPs) undergo evaluation by the European Medicines Agency\'s (EMA) Committee for Advanced Therapies (CAT) to obtain marketing authorization under the centralized procedure. Because of the diversity and complexity of ATMPs, a tailored approach to the regulatory process is required that needs to ensure the safety and efficacy of each product. Since ATMPs often target serious diseases with unmet medical need, the industry and authorities are interested in providing treatment to patients in a timely manner through optimized and expedited regulatory pathways. EU legislators and regulators have implemented various instruments to support the development and authorization of innovative medicines by offering scientific guidance at early stages, incentives for small developers and products for rare diseases, accelerated evaluation of marketing authorization applications, different types of marketing authorizations, and tailored programs for medicinal products with the orphan drug designation (ODD) and the Priority Medicines (PRIME) scheme. Since the regulatory framework for ATMPs was established, 20 products have been licenced, 15 with orphan drug designation, and 7 supported by PRIME. This chapter discusses the specific regulatory framework for ATMPs in the EU and highlights previous successes and remaining challenges.
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  • 文章类型: Journal Article
    未经证实:混合免疫与对2019年冠状病毒病(COVID-19)的更持久保护有关。我们描述了在接种疫苗和未接种疫苗的个体中严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染后的抗体反应。
    UNASSIGNED:在冠状病毒疗效试验盲期诊断的55例疫苗组COVID-19病例与55例安慰剂组COVID-19病例相匹配。在疾病第1天(DD1)和28天后(DD29)评估了对祖先菌株的假病毒中和抗体(nAb)活性以及对核衣壳和刺突抗原(祖先和相关变体[VOC])的结合抗体(bAb)反应。
    UNASSIGNED:主要分析集是在首次给药后至少57天使用COVID-19的46例疫苗病例和49例安慰剂病例。对于疫苗组病例,疾病发作后1个月,祖先的抗刺bAbs增加了1.88倍,虽然47%没有增加。DD29抗刺和抗核衣壳bAb的疫苗与安慰剂的几何平均值比分别为6.9和0.04。对于所有VOC,疫苗的DD29平均bAb水平高于安慰剂。DD1鼻病毒载量与疫苗组的bAb水平呈正相关。
    UNASSIGNED:在COVID-19之后,接种疫苗的参与者比未接种疫苗的参与者具有更高的水平和更大的抗尖峰bAb宽度和更高的nAb滴度。这些主要归因于初次免疫系列。
    UNASSIGNED: Hybrid immunity is associated with more durable protection against coronavirus disease 2019 (COVID-19). We describe the antibody responses following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in vaccinated and unvaccinated individuals.
    UNASSIGNED: The 55 vaccine arm COVID-19 cases diagnosed during the blinded phase of the Coronavirus Efficacy trial were matched with 55 placebo arm COVID-19 cases. Pseudovirus neutralizing antibody (nAb) activity to the ancestral strain and binding antibody (bAb) responses to nucleocapsid and spike antigens (ancestral and variants of concern [VOCs]) were assessed on disease day 1 (DD1) and 28 days later (DD29).
    UNASSIGNED: The primary analysis set was 46 vaccine cases and 49 placebo cases with COVID-19 at least 57 days post-first dose. For vaccine group cases, there was a 1.88-fold rise in ancestral antispike bAbs 1 month post-disease onset, although 47% had no increase. The vaccine-to-placebo geometric mean ratios for DD29 antispike and antinucleocapsid bAbs were 6.9 and 0.04, respectively. DD29 mean bAb levels were higher for vaccine vs placebo cases for all VOCs. DD1 nasal viral load positively correlated with bAb levels in the vaccine group.
    UNASSIGNED: Following COVID-19, vaccinated participants had higher levels and greater breadth of antispike bAbs and higher nAb titers than unvaccinated participants. These were largely attributable to the primary immunization series.
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  • 文章类型: Review
    美国食品和药物管理局和欧洲药品管理局(EMA)都有计划加快开发被确定为有可能满足未满足的医疗需求的产品:美国的突破性疗法(BT)和再生药物高级疗法指定计划以及EMA的优先药物(PRIME)计划。我们审查了通过这些计划提交的请求和指定的产品的共性和差异,旨在探索更好地支持全球发展的方法。在PRIME于2016年4月启动至2020年12月31日期间,向BT和PRIME计划提出了151项请求,各机构达成了一致的结果,批准或拒绝了近三分之二的案件(93/151,62%),就所研究产品的潜力提出了国际监管机构的类似观点。42(42/151,28%)产品获得了BT和PRIME,ThusfoundbybothAgenciestohavethepotentialtoaddressanunmetneedforaseriouscondition,因此,高效开发的产品将是非常可取的。努力更好地参与全球发展战略符合患者和公共卫生的最大利益。考虑到这一点,机构和赞助商应该利用现有的合作机会,比如平行的科学建议,并努力确定新的方法来支持全球开发未满足医疗需求的产品。
    The United States Food and Drug Administration and the European Medicines Agency (EMA) each have programs to expedite development of products identified as having potential to address unmet medical needs: the Breakthrough therapy (BT) and Regenerative Medicines Advanced Therapies designation programs in the US and the Priority Medicines (PRIME) scheme at EMA. We reviewed commonalities and differences in requests submitted and products designated through these programs, with the intent to explore ways to better support global development. During the period from PRIME\'s launch in April 2016 to 31 December 2020, 151 requests were made to both BT and PRIME programs and the agencies reached concordant outcomes to grant or deny requests for almost two thirds of the cases (93/151, 62%), suggesting similar perspectives across international regulators on the potential of the products under study. Forty-two (42/151, 28%) products were granted both BT and PRIME, thus found by both Agencies to have the potential to address an unmet need for a serious condition, and thereby products for which efficient development would be highly desirable. Working toward better engagement on global development strategies is in the best interests of patients and public health. With this in mind, Agencies and sponsors should take advantage of existing collaborative opportunities, such as parallel scientific advice, and work to identify fresh approaches to support global development of products for unmet medical needs.
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