translational science

翻译科学
  • 文章类型: Journal Article
    听力学领域是听觉科学知识的集合,研究,和临床方法,技术,实践发生了很大变化。对心理学有更深刻的理解,认知,和行为相互作用导致越来越多的感兴趣的变量来衡量和跟踪诊断和康复过程。以技术为主导的临床实践变化,包括听力学,预示着采取行动的呼吁,以认识到自主性和机构对临床实践的作用和影响,订婚,和结果。响度模型的进展和新信息,耳鸣,心理声学,深度神经网络,机器学习,预测和自适应算法,和PREM/PROM使技术创新彻底改变了以下临床原则和实践:(i)评估,(ii)听力装置的装配和编程,(三)康复。这篇叙述性评论将考虑作为当代成人听力学实践中日益增长的基本要素的目的听力学的兴起如何影响基于知识和能力的新时代的听力学的原理和实践。哪些领域的知识增长了?新知识如何改变了临床听力学的优先事项?哪些技术创新与这些技术创新相结合来改变临床实践?作为健康和医学领域,听力损失现在在哪里定位?
    The field of audiology as a collection of auditory science knowledge, research, and clinical methods, technologies, and practices has seen great changes. A deeper understanding of psychological, cognitive, and behavioural interactions has led to a growing range of variables of interest to measure and track in diagnostic and rehabilitative processes. Technology-led changes to clinical practices, including teleaudiology, have heralded a call to action in order to recognise the role and impact of autonomy and agency on clinical practice, engagement, and outcomes. Advances in and new information on loudness models, tinnitus, psychoacoustics, deep neural networks, machine learning, predictive and adaptive algorithms, and PREMs/PROMs have enabled innovations in technology to revolutionise clinical principles and practices for the following: (i) assessment, (ii) fitting and programming of hearing devices, and (iii) rehabilitation. This narrative review will consider how the rise of teleaudiology as a growing and increasingly fundamental element of contemporary adult audiological practice has affected the principles and practices of audiology based on a new era of knowledge and capability. What areas of knowledge have grown? How has new knowledge shifted the priorities in clinical audiology? What technological innovations have been combined with these to change clinical practices? Above all, where is hearing loss now consequently positioned in its journey as a field of health and medicine?
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  • 文章类型: Journal Article
    跨专业研究设计课程使用真实的学习教学法将来自不同教育轨道的学生聚集在一起(博士,MD,MD/博士培训)从事跨专业的协作技能,以完成顶峰项目,美国国立卫生研究院(NIH)R21式赠款提案。课程,以团队科学的原则为基础,首先是领导力培训研讨会,向学生介绍跨专业团队环境的有效领导力和团队合作策略。我们在课程中使用了一些评估来监控领导力和团队动态。我们分析了三项评估(领导自我效能感测试,迭代团队合同和反思性论文),以更好地理解学生的学习经验。在领导力培训之前(前)和课程结束时(后)进行自我效能感测试;使用重复的方差分析对分数进行了分析。使用演绎和描述性方法对迭代团队合同进行了定性分析。反思性论文采用一般归纳法进行分析。9个团队的32名学生(23名医学博士;9名博士)参加了2017-2018年的课程。使用事后时间控制反应变化的自我效能感测试显示,在所有措施中,自我效能感的统计学显着提高。迭代契约的演绎定性分析显示了支持成功团队绩效的团队过程的证据;描述性分析映射了生产行为。在反思性文章中,九个团队中有七个团队积极地描述了他们的经历;例如,主题包括同情小组成员,复杂的沟通和协作工作流/风格。对于负面的经历,主题与基本交流有关,领导力培训的整合差和理论与实践的差距。这些发现证明了专注于教授团队科学实践的真实学习教学法的有用性。
    The Interprofessional Research Design course uses authentic learning pedagogy to bring together students from different education tracks (PhD, MD, MD/PhD training) to engage in interprofessional collaborative skills toward completion of a capstone project, a National Health Institutes (NIH) R21-style grant proposal. The course, underpinned by principles of team science, begins with a leadership training workshop to introduce students to effective leadership and teamwork strategies for interprofessional team environments. We used several assessments during the course to monitor leadership and team dynamics. We analyzed three assessments (leadership self-efficacy testing, iterative team contracts and reflective essays) to better understand students\' learning experiences. Self-efficacy testing was administered before leadership training (pre) and at the end of the course (post-then); scores were analyzed using a repeated repeated measures ANOVA. Iterative team contracts were analyzed qualitatively using both deductive and descriptive methods. Reflective essays were analyzed using a general inductive approach. Nine teams of 32 students (23 MD; 9 PhD) participated in the class over 2017-2018. Self-efficacy testing using post-then timing to control for response shift showed a statistically significant increase in self-efficacy across all measures. Deductive qualitative analysis of iterative contracting showed evidence of team processes which support successful team performance; and descriptive analysis mapped productive behaviors. In reflective essays, seven of the nine teams collectively described their experiences positively; e.g., themes included empathizing with group members, sophisticated communication and collaborative workflow/styles. For negative experiences, themes were related to basic communication, poor integration and the theory-practice gap of leadership training. These findings demonstrate the usefulness of an authentic learning pedagogy focused on teaching the practice of team science.
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  • 文章类型: Journal Article
    鉴定现有药物和新药物的作用机制对于开发用于治疗和商业用途的新化合物至关重要。在这里,我们提供了一种技术,通过分离突变细胞系来鉴定这些机制,这些突变细胞系显示出对使用盘基网柄菌REMI文库的药物诱导表型的抗性。这种方法提供了一种强大而快速的化学遗传筛选技术,使一种无偏见的方法能够识别控制药物敏感性的蛋白质和分子途径。导致耐药性的突变通常发生在靶蛋白中,从而鉴定药物和生物活性天然产物的特定蛋白靶标。在鉴定推定的分子靶标列表之后,可以分析用户选择的化合物靶标以确认和验证直接抑制作用。
    Identifying the mechanisms of action of existing and novel drugs is essential for the development of new compounds for therapeutic and commercial use. Here we provide a technique to identify these mechanisms through isolating mutant cell lines that show resistance to drug-induced phenotypes using Dictyostelium discoideum REMI libraries. This approach provides a robust and rapid chemical-genetic screening technique that enables an unbiased approach to identify proteins and molecular pathways that control drug sensitivity. Mutations that result in drug resistance often occur in target proteins thus identifying the specific protein targets for drugs and bioactive natural products. Following the identification of a list of putative molecular targets user selected compound targets can be analyzed to confirm and validate direct inhibitory effects.
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  • 文章类型: Journal Article
    心血管疾病被认为是全球死亡的主要原因;即使狗的死亡率很低,这些疾病在伴侣动物和人类中以相同的方式描述。本研究旨在设计一种有效的去细胞化方案,通过物理关联的犬心肌,化学,和酶法,评估所得的心肌细胞外基质的改变以获得合适的支架。收集了两个犬心脏;将样品切成±1cm2的碎片,在蒸馏水和1×PBS溶液中洗涤,然后在四种不同的脱细胞方案下进行治疗。十二烷基硫酸钠(SDS)1%7天+TritonX-1001%48小时(方案I);十二烷基硫酸钠(SDS)1%5天+TritonX-1001%48小时(方案II);胰蛋白酶0.05%在36°C下冷冻1小时-80°C过夜+十二烷基硫酸钠(SDS)1%3天,Triton-X-10048小时(方案III);0.05%胰蛋白酶在36°C下1小时+在-80°C下冷冻过夜+1%十二烷基硫酸钠(SDS)2天+1%Triton-X-10024小时(方案IV)。经过分析,方案I和II显示细胞内容物的去除和细胞外基质(ECM)内容物的保存,与第三和第四议定书不同,收回ECM并去除基质的基本要素。理论上,虽然方案I和II有相似的结果,方案II在保护细胞外基质的结构和成分方面脱颖而出,随着减少暴露于试剂的时间,使其成为开发犬心肌支架的推荐方案。
    Cardiovascular diseases are considered the leading cause of mortality globally; even with low mortality in dogs, such diseases are described in the same way in companion animals and humans. This study aimed to devise an effective decellularization protocol for the canine myocardium through the association of physical, chemical, and enzymatic methods, assessing resultant alterations in the myocardial extracellular matrix to obtain a suitable scaffold. Two canine hearts were collected; the samples were sectioned into ±1 cm2 fragments, washed in distilled water and 1× PBS solution, and followed by treatment under four distinct decellularization protocols. Sodium Dodecyl Sulfate (SDS) 1% 7 days + Triton X-100 1% for 48 h (Protocol I); Sodium Dodecyl Sulfate (SDS) 1% 5 days + Triton X-100 1% for 48 h (Protocol II); Trypsin 0.05% for 1 h at 36 °C + freezing -80 °C overnight + Sodium Dodecyl Sulfate (SDS) 1% for 3 days, Triton-X-100 for 48 h hours (Protocol III); 0.05% trypsin for 1 h at 36 °C + freezing at -80 °C overnight + 1% Sodium Dodecyl Sulfate (SDS) for 2 days + 1% Triton-X-100 for 24 h (Protocol IV). After analysis, Protocols I and II showed the removal of cellular content and preservation of extracellular matrix (ECM) contents, unlike Protocols III and IV, which retracted the ECM and removed essential elements of the matrix. In theory, although Protocols I and II have similar results, Protocol II stands out for the preservation of the architecture and components of the extracellular matrix, along with reduced exposure time to reagents, making it the recommended protocol for the development of a canine myocardial scaffold.
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  • 文章类型: Journal Article
    学术医学中心和大学推广计划仍然是不发达的合作者,尽管翻译科学和扩展之间有互补的目标。本案例研究详细介绍了密苏里大学(MU)扩展与参与办公室(MU扩展)和MU医学院之间创建全国独特的跨专业组织结构,以使用高接触社区促进全州范围的研究和教育发现健康方法。本文介绍了用于系统地计划的特定策略:1)新结构的创建和操作,2)工作程序化和制度化,3)可持续性。我们进一步概述了挑战和下一步。卫生外联政策和教育(HOPE)骨干组织办公室的发展汇集了五个部门的跨专业专业知识,并制定了共同的议程,以促进相辅相成的活动。希望有望为扩大MU的土地授予任务做出重大贡献,获得额外的赠款资金,促进密苏里州人的健康。
    Academic medical centers and university extension programs remain underdeveloped collaborators, despite the complementary objectives between translational science and extension. This case study details the creation of a nationally unique interprofessional organizational structure between the University of Missouri (MU) Office of Extension and Engagement (MU Extension) and the MU School of Medicine to accelerate statewide reach of research and education discoveries using high-touch community health approaches. This article describes specific strategies used to systematically plan for: 1) creation and operation of the new structure, 2) routinization and institutionalizing the work, and 3) sustainability. We further outline challenges and next steps. The development of the backbone organization office of Health Outreach Policy and Education (HOPE) brings together the interprofessional expertise of five units with a common agenda to advance mutually reinforcing activities. HOPE is poised to make significant contributions to amplify MU\'s land grant mission, garner additional grant funding, and advance the health of Missourians.
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  • 文章类型: Journal Article
    细胞外基质(ECM)支架和生物材料已经在各种不同的临床应用中广泛使用了数十年,并已植入全球数百万患者中。基于ECM的生物材料在软组织修复应用中已经特别成功,但是它们在其他临床应用(例如用于骨或神经组织的再生)中的效用还不太清楚。使用ECM生物材料的有益愈合结果是其生物相容性的结果,它们的生物物理特性和损伤后改变细胞行为的能力。由于成功的临床结果,有动机开发下一代ECM材料的配方,包括水凝胶,生物墨水,粉末,整个器官或组织支架。新型ECM制剂的持续开发以及对这些材料的积极研究兴趣确保了再生医学中未来临床转化和创新的大量可能性。下一代制剂ECM支架的临床转化面临可预测的挑战,如制造,可管理的监管途径,外科植入,以及应对这些挑战所需的成本。基于ECM的生物材料的现状,包括临床翻译,目前正在开发的新型制剂和疗法,本文综述了限制ECM生物材料临床转化的挑战。
    Extracellular Matrix (ECM) scaffolds and biomaterials have been widely used for decades across a variety of diverse clinical applications and have been implanted in millions of patients worldwide. ECM-based biomaterials have been especially successful in soft tissue repair applications but their utility in other clinical applications such as for regeneration of bone or neural tissue is less well understood. The beneficial healing outcome with the use of ECM biomaterials is the result of their biocompatibility, their biophysical properties and their ability to modify cell behavior after injury. As a consequence of successful clinical outcomes, there has been motivation for the development of next-generation formulations of ECM materials ranging from hydrogels, bioinks, powders, to whole organ or tissue scaffolds. The continued development of novel ECM formulations as well as active research interest in these materials ensures a wealth of possibilities for future clinical translation and innovation in regenerative medicine. The clinical translation of next generation formulations ECM scaffolds faces predictable challenges such as manufacturing, manageable regulatory pathways, surgical implantation, and the cost required to address these challenges. The current status of ECM-based biomaterials, including clinical translation, novel formulations and therapies currently under development, and the challenges that limit clinical translation of ECM biomaterials are reviewed herein.
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  • 文章类型: Journal Article
    在1980年代,猎户座制药公司,然后是北欧地区的中等制药公司,建立了抑制儿茶酚O-甲基转移酶(COMT)的药物开发计划。这种酶,在儿茶酚胺神经递质和具有儿茶酚结构的药物的失活中起着重要作用,因此,我们将其作为我们在本历史回顾中描述的创新转化和临床计划的目标。起点是推测外周作用的COMT抑制剂可能改善左旋多巴进入大脑。这对帕金森病(PD)的药物治疗具有潜在的重要意义。基本原理是左旋多巴更有效地递送到大脑可能允许减少左旋多巴的高治疗剂量并延长剂量间隔。结构-活动关系的阐明为entacapone的发现和发展铺平了道路,一种5-硝基儿茶酚,是一种有效和高度特异性的COMT抑制剂。III期临床试验的经验表明,entacapone,用作常规或控释左旋多巴制剂(也包括外周作用的多巴脱羧酶抑制剂)的辅助药物,增加的ON-时间和减少的OFF-时间和改善的临床状况的患者经历磨损,经常减少每日左旋多巴剂量。其中一些研究还发现,恩他卡朋改善了患者的生活质量,并且具有成本效益。随后,entacapone已与左旋多巴和卡比多巴合并成三联制剂(Stalevo®),为左旋多巴/多巴脱羧酶抑制剂治疗中剂量末运动波动不稳定的PD患者提供灵活方便的药物治疗。这篇评论为研究人员成功的药物开发计划提供了历史视角,这些研究人员在从探索性假设到注册药品的进展中发挥了核心作用。
    In the 1980s, Orion Pharma, then a mid-ranking Nordic area pharmaceutical company, established a drug development programme on the inhibition of catechol O-methyltransferase (COMT). This enzyme, which plays an important role in the inactivation of catecholamine neurotransmitters and drugs with a catechol structure, thus came under consideration as a target in the innovative translational and clinical programme we describe in this historical review. The starting point was the conjecture that a peripherally acting COMT inhibitor might improve entry of levodopa into the brain. This had potentially significant implications for the medical treatment of Parkinson\'s disease (PD). The rationale was that more efficient delivery of levodopa to the brain might allow the high therapeutic doses of levodopa to be reduced and the dose interval to be extended. Elucidation of structure-activity relations paved the way for the discovery and development of entacapone, a 5-nitrocatechol that was a potent and highly specific inhibitor of COMT. Experience in phase III clinical trials established that entacapone, used as an adjunct to regular or controlled-release levodopa preparations (also including a peripherally acting dopa-decarboxylase inhibitor), increased ON-time and reduced OFF-time and improved clinical condition in patients with PD experiencing wearing-off, often with a reduced daily levodopa dose. Several of these studies also identified that entacapone improved patients\' quality of life and was cost-effective. Subsequently, entacapone has been amalgamated into a triple-combination preparation (Stalevo®) with levodopa and carbidopa to create a flexible and convenient drug therapy for patients with PD who have end-of-dose motor fluctuations not stabilised on levodopa/dopa-decarboxylase inhibitor treatment. This review offers a historical perspective on a successful programme of drug development by researchers who played central roles in the progress from exploratory hypothesis to registered pharmaceutical product.
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  • 文章类型: Journal Article
    丝绸和丝绸衍生物已成为外科设备开发中的一种可能的替代品,提供机械强度,生物相容性,和环境可持续性。通过遵循PRISMA指南的系统审查,这项研究评估了丝素蛋白在临床前和临床环境中的应用,专注于其作为骨固定螺钉和钢板的作用。全面搜索产生了245项研究,其中33人接受全文审查,15人最终接受定性分析。这些发现强调了丝素蛋白的优异性能,包括其可调的降解速率和被治疗剂功能化的能力。体内和体外研究证明了其在增强骨愈合方面的功效,提供改善的骨固定结果,特别是颅面缺陷。丝素蛋白在生物降解和药物释放能力方面的显着属性强调了其增强患者护理的潜力。最终,丝素蛋白与外科手术的整合有望在患者预后和环境可持续性方面带来一场革命。它的多功能性,加上制造技术的不断进步,标志着它在医学领域被广泛接受的前景,可能在手术治疗中建立新的基准。进一步的研究有望巩固丝绸产品从基础科学到患者护理的转变,为广泛用于各种外科应用铺平了道路。
    Silk and silk derivatives have emerged as a possible alternative in surgical device development, offering mechanical strength, biocompatibility, and environmental sustainability. Through a systematic review following PRISMA guidelines, this study evaluated silk fibroin\'s application across pre-clinical and clinical settings, focusing on its role as screws and plates for osteofixation. A comprehensive search yielded 245 studies, with 33 subjected to full-text review and 15 ultimately included for qualitative analysis. The findings underscore silk fibroin\'s superior properties, including its tunable degradation rates and ability to be functionalized with therapeutic agents. In vivo and in vitro studies demonstrated its efficacy in enhancing bone healing, offering improved outcomes in osteofixation, particularly for craniofacial defects. Silk fibroin\'s remarkable attributes in biodegradation and drug release capabilities underscore its potential to enhance patient care. Ultimately, silk fibroin\'s integration into surgical practices promises a revolution in patient outcomes and environmental sustainability. Its versatility, coupled with the continuous progress in fabrication techniques, signals a promising horizon for its widespread acceptance in the medical field, potentially establishing a new benchmark in surgical treatment. Further research is expected to solidify the transition of silk products from basic science to patient care, paving the way for widespread use in various surgical applications.
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  • 文章类型: Journal Article
    N6-甲基腺苷(m6A)修饰,由甲基转移酶样3(METTL3)催化的真核信使RNA修饰,在干细胞命运决定中起着举足轻重的作用。颅骨的发育和维持是由颅骨缝合线协调的。组织蛋白酶K(CTSK)阳性的颅骨干细胞(CSC)有助于小鼠颅骨骨化。然而,在颅骨发育过程中,m6A修饰在调节Ctsk谱系细胞中的作用仍然难以捉摸。这里,我们显示METTL3与颅骨非破骨细胞Ctsk谱系细胞共定位,也与GLI1表达相关。在新生儿发育过程中,Ctsk谱系细胞中Mettl3的消耗延迟了缝合线的形成并减少了矿化。在成年期间维持,Ctsk+谱系细胞中Mettl3的丢失损害了颅骨形成,其特点是骨骼孔隙率增加,增强的骨髓腔,细胞轮廓不发达的骨细胞数量减少。甲基化RNA免疫沉淀测序和RNA测序数据的分析表明METTL3的缺失降低了Hedgehog(Hh)信号通路。通过交叉Sufufl/+等位基因或通过局部施用SAG21来恢复Hh信号通路部分地挽救了该异常。我们的数据表明,METTL3通过调节Hh信号通路调节支持颅骨骨形成的Ctsk+谱系细胞,为颅骨穹窿骨病的临床治疗提供新的见解。
    N6-methyladenosine (m6A) modification, a eukaryotic messenger RNA modification catalyzed by methyltransferase-like 3 (METTL3), plays a pivotal role in stem cell fate determination. Calvarial bone development and maintenance are orchestrated by the cranial sutures. Cathepsin K (CTSK)-positive calvarial stem cells (CSCs) contribute to mice calvarial ossification. However, the role of m6A modification in regulating Ctsk+ lineage cells during calvarial development remains elusive. Here, we showed that METTL3 was colocalized with cranial nonosteoclastic Ctsk+ lineage cells, which were also associated with GLI1 expression. During neonatal development, depletion of Mettl3 in the Ctsk+ lineage cells delayed suture formation and decreased mineralization. During adulthood maintenance, loss of Mettl3 in the Ctsk+ lineage cells impaired calvarial bone formation, which was featured by the increased bone porosity, enhanced bone marrow cavity, and decreased number of osteocytes with the less-developed cellular outline. The analysis of methylated RNA immunoprecipitation sequencing and RNA sequencing data indicated that loss of METTL3 reduced Hedgehog (Hh) signaling pathway. Restoration of Hh signaling pathway by crossing Sufufl/+ alleles or by local administration of SAG21 partially rescued the abnormity. Our data indicate that METTL3 modulates Ctsk+ lineage cells supporting calvarial bone formation by regulating the Hh signaling pathway, providing new insights for clinical treatment of skull vault osseous diseases.
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