Improving the use of G-CSF during chemotherapy using physiological mathematical modelling : a quantitative systems pharmacology approach

La diminution des doses administrées ou même la cessation complète d'un traitement chimiothérapeutique est souvent la conséquence de la réduction du nombre de neutrophiles, qui sont les globules blancs les plus fréquents dans le sang. Cette réduction dans le nombre absolu des neutrophiles, aussi connue sous le nom de myélosuppression, est précipitée par les effets létaux non spécifiques des médicaments anti-cancéreux, qui, parallèlement à leur effet thérapeutique, produisent aussi des effets toxiques sur les cellules saines. Dans le but d'atténuer cet impact myélosuppresseur, on administre aux patients un facteur de stimulation des colonies de granulocytes recombinant humain (rhG-CSF), une forme exogène du G-CSF, l'hormone responsable de la stimulation de la production des neutrophiles et de leurs libération dans la circulation sanguine. Bien que les bienfaits d'un traitement prophylactique avec le G-CSF pendant la chimiothérapie soient bien établis, les protocoles d'administration demeurent mal définis et sont fréquemment déterminés ad libitum par les cliniciens. Avec l'optique d'améliorer le dosage thérapeutique et rationaliser l'utilisation du rhG-CSF pendant le traitement chimiothérapeutique, nous avons développé un modèle physiologique du processus de granulopoïèse, qui incorpore les connaissances actuelles de pointe relatives à la production des neutrophiles des cellules souches hématopoïétiques dans la moelle osseuse. À ce modèle physiologique, nous avons intégré des modèles pharmacocinétiques/pharmacodynamiques (PK/PD) de deux médicaments: le PM00104 (Zalypsis®), un médicament anti-cancéreux, et le rhG-CSF (filgrastim). En se servant des principes fondamentaux sous-jacents à la physiologie, nous avons estimé les paramètres de manière exhaustive sans devoir recourir à l'ajustement des données, ce qui nous a permis de prédire des données cliniques provenant de 172 patients soumis au protocol CHOP14 (6 cycles de chimiothérapie avec une période de 14 jours où l'administration du rhG-CSF se fait du jour 4 au jour 13 post-chimiothérapie). En utilisant ce modèle physio-PK/PD, nous avons démontré que le nombre d'administrations du rhG-CSF pourrait être réduit de dix (pratique actuelle) à quatre ou même trois administrations, à condition de retarder le début du traitement prophylactique par le rhG-CSF. Dans un souci d'applicabilité clinique de notre approche de modélisation, nous avons investigué l'impact de la variabilité PK présente dans une population de patients, sur les prédictions du modèle, en intégrant des modèles PK de population (Pop-PK) des deux médicaments. En considérant des cohortes de 500 patients in silico pour chacun des cinq scénarios de variabilité plausibles et en utilisant trois marqueurs cliniques, soient le temps au nadir des neutrophiles, la valeur du nadir, ainsi que l'aire sous la courbe concentration-effet, nous avons établi qu'il n'y avait aucune différence significative dans les prédictions du modèle entre le patient-type et la population. Ceci démontre la robustesse de l'approche que nous avons développée et qui s'apparente à une approche de pharmacologie quantitative des systèmes (QSP). Motivés par l'utilisation du rhG-CSF dans le traitement d'autres maladies, comme des pathologies périodiques telles que la neutropénie cyclique, nous avons ensuite soumis l'étude du modèle au contexte des maladies dynamiques. En mettant en évidence la non validité du paradigme de la rétroaction des cytokines pour l'administration exogène des mimétiques du G-CSF, nous avons développé un modèle physiologique PK/PD novateur comprenant les concentrations libres et liées du G-CSF. Ce nouveau modèle PK a aussi nécessité des changements dans le modèle PD puisqu’il nous a permis de retracer les concentrations du G-CSF lié aux neutrophiles. Nous avons démontré que l'hypothèse sous-jacente de l'équilibre entre la concentration libre et liée, selon la loi d'action de masse, n'est plus valide pour le G-CSF aux concentrations endogènes et mènerait en fait à la surestimation de la clairance rénale du médicament. En procédant ainsi, nous avons réussi à reproduire des données cliniques obtenues dans diverses conditions (l'administration exogène du G-CSF, l'administration du PM00104, CHOP14). Nous avons aussi fourni une explication logique des mécanismes responsables de la réponse physiologique aux deux médicaments. Finalement, afin de mettre en exergue l’approche intégrative en pharmacologie adoptée dans cette thèse, nous avons démontré sa valeur inestimable pour la mise en lumière et la reconstruction des systèmes vivants complexes, en faisant le parallèle avec d’autres disciplines scientifiques telles que la paléontologie et la forensique, où une approche semblable a largement fait ses preuves. Nous avons aussi discuté du potentiel de la pharmacologie quantitative des systèmes appliquées au développement du médicament et à la médecine translationnelle, en se servant du modèle physio-PK/PD que nous avons mis au point.

Using blogs to enhance the capacity of mathematical communication in High School

The aim of this investigation is to analyze the use of the blog as an educational resource for the development of the mathematical communication in secondary education. With this aim, four aspects are analyzed: organization of mathematical thinking through communication; communication of mathematical thinking; analysis and evaluation of the strategies and mathematical thought of others; and expression of mathematical ideas using mathematical language. The research was conducted from a qualitative approach on an exploratory level, with the case study method of 4 classrooms of second grade of secondary education in a private school in Lima. The observational technique of 20 publications in the blog of the math class was applied; a study of a focal group with a sample of 9 students with different levels of academic performance; and an interview with the academic coordinator of the school was conducted. The results show that the organization of mathematical thinking through communication is carried out in the blog in a written, graphical and oral way through explanations, schemes and videos. Regarding communication of mathematical thinking, the blog is used to describe concepts, arguments and mathematical procedures with words and examples of the students. The analysis and evaluation of the strategies and mathematical thinking is performed through comments and debates about the publications. It was also noted that the blog does not facilitate the use of mathematical language to express mathematical ideas, since it does not allow direct writing of symbols nor graphic representation.

Mathematical Modeling to Assess the Drivers of the Recent Emergence of Typhoid Fever in Blantyre, Malawi

BACKGROUND: Multiyear epidemics of Salmonella enterica serovar Typhi have been reported from countries across eastern and southern Africa in recent years. In Blantyre, Malawi, a dramatic increase in typhoid fever cases has recently occurred, and may be linked to the emergence of the H58 haplotype. Strains belonging to the H58 haplotype often exhibit multidrug resistance and may have a fitness advantage relative to other Salmonella Typhi strains.

METHODS: To explore hypotheses for the increased number of typhoid fever cases in Blantyre, we fit a mathematical model to culture-confirmed cases of Salmonella enterica infections at Queen Elizabeth Central Hospital, Blantyre. We explored 4 hypotheses: (1) an increase in the basic reproductive number (R0) in response to increasing population density; (2) a decrease in the incidence of cross-immunizing infection with Salmonella Enteritidis; (3) an increase in the duration of infectiousness due to failure to respond to first-line antibiotics; and (4) an increase in the transmission rate following the emergence of the H58 haplotype.

RESULTS: Increasing population density or decreasing cross-immunity could not fully explain the observed pattern of typhoid emergence in Blantyre, whereas models allowing for an increase in the duration of infectiousness and/or the transmission rate of typhoid following the emergence of the H58 haplotype provided a good fit to the data.

CONCLUSIONS: Our results suggest that an increase in the transmissibility of typhoid due to the emergence of drug resistance associated with the H58 haplotype may help to explain recent outbreaks of typhoid in Malawi and similar settings in Africa.

Investigating high-achieving sixth grade students' erroneous answers on the angle concept in Yozgat

The angle concept is a multifaceted concept having static and dynamic definitions. The static definition of the angle refers to “the space between two rays” or “the intersection of two rays at the same end point” (Mitchelmore & White, 1998), whereas the dynamic definition of the angle concept highlights that the size of angle is the amount of rotation in direction (Fyhn, 2006). Since both definitions represent two diverse situations and have unique limitations (Henderson & Taimina, 2005), students may hold misconceptions about the angle concept. In this regard, the aim of this research was to explore high achievers’ knowledge regarding the definition of the angle concept as well as to investigate their erroneous answers on the angle concept.

104 grade 6 students drawn from four well-established elementary schools of Yozgat, Turkey were participated in this research. All participants were selected via a purposive sampling method and their mathematics grades were 4 or 5 out of 5, and. Data were collected through four questions prepared by considering the learning competencies set out in the grade 6 curriculum in Turkey and the findings of previous studies whose purposes were to identify students’ misconceptions of the angle concept. The findings were analyzed by two researchers, and their inter-rater agreement was calculated as 0.91, or almost perfect. Thereafter, coding discrepancies were resolved, and consensus was established.

The angle concept is a multifaceted concept having static and dynamic definitions.The static definition of the angle refers to “the space between two rays” or“the intersection of two rays at the same end point” (Mitchelmore & White, 1998), whereas the dynamicdefinition of the angle concept highlights that the size of angle is the amountof rotation in direction (Fyhn, 2006). Since both definitionsrepresent two diverse situations and have unique limitations (Henderson & Taimina, 2005), students may holdmisconceptions about the angle concept. In this regard, the aim of thisresearch was to explore high achievers’ knowledge regarding the definition ofthe angle concept as well as to investigate their erroneous answers on theangle concept.

New Method Based on the UNIFAC–VISCO Model for the Estimation of Ionic Liquids Viscosity Using the Experimental Data Recommended by Mathematical Gnostics

The viscosity of ionic liquids (ILs) has been modeled as a function of temperature and at atmospheric pressure using a new method based on the UNIFAC–VISCO method. This model extends the calculations previously reported by our group (see Zhao et al. J. Chem. Eng. Data 2016, 61, 2160–2169) which used 154 experimental viscosity data points of 25 ionic liquids for regression of a set of binary interaction parameters and ion Vogel–Fulcher–Tammann (VFT) parameters. Discrepancies in the experimental data of the same IL affect the quality of the correlation and thus the development of the predictive method. In this work, mathematical gnostics was used to analyze the experimental data from different sources and recommend one set of reliable data for each IL. These recommended data (totally 819 data points) for 70 ILs were correlated using this model to obtain an extended set of binary interaction parameters and ion VFT parameters, with a regression accuracy of 1.4%. In addition, 966 experimental viscosity data points for 11 binary mixtures of ILs were collected from literature to establish this model. All the binary data consist of 128 training data points used for the optimization of binary interaction parameters and 838 test data points used for the comparison of the pure evaluated values. The relative average absolute deviation (RAAD) for training and test is 2.9% and 3.9%, respectively.

New methods for movement technique development in cross-country skiing using mathematical models and simulation

This Licentiate Thesis is devoted to the presentation and discussion of some new contributions in applied mathematics directed towards scientific computing in sports engineering. It considers inverse problems of biomechanical simulations with rigid body musculoskeletal systems especially in cross-country skiing. This is a contrast to the main research on cross-country skiing biomechanics, which is based mainly on experimental testing alone. The thesis consists of an introduction and five papers. The introduction motivates the context of the papers and puts them into a more general framework. Two papers (D and E) consider studies of real questions in cross-country skiing, which are modelled and simulated. The results give some interesting indications, concerning these challenging questions, which can be used as a basis for further research. However, the measurements are not accurate enough to give the final answers. Paper C is a simulation study which is more extensive than paper D and E, and is compared to electromyography measurements in the literature. Validation in biomechanical simulations is difficult and reducing mathematical errors is one way of reaching closer to more realistic results. Paper A examines well-posedness for forward dynamics with full muscle dynamics. Moreover, paper B is a technical report which describes the problem formulation and mathematical models and simulation from paper A in more detail. Our new modelling together with the simulations enable new possibilities. This is similar to simulations of applications in other engineering fields, and need in the same way be handled with care in order to achieve reliable results. The results in this thesis indicate that it can be very useful to use mathematical modelling and numerical simulations when describing cross-country skiing biomechanics. Hence, this thesis contributes to the possibility of beginning to use and develop such modelling and simulation techniques also in this context.

Mathematical methods for the configuration of transportation systems with a focus on continuous and modular matrix conveyors

The lack of flexibility in logistic systems currently on the market leads to the development of new innovative transportation systems. In order to find the optimal configuration of such a system depending on the current goal functions, for example minimization of transport times and maximization of the throughput, various mathematical methods of multi-criteria optimization are applicable. In this work, the concept of a complex transportation system is presented. Furthermore, the question of finding the optimal configuration of such a system through mathematical methods of optimization is considered.

Mathematical modeling of the diffusion of magnetic particles in a ferrofluid seal under magnetic and centrifugal forces

Otto-von-Guericke-Universität Magdeburg, Fakultät für Mathematik, Dissertation, 2016

Residence Time Distribution (Rtd) Associated with Statistical Weighted Moments to Fit Mathematical Models Using In Industrial Systems Diagnosis

This work presents a computational, called MOMENTS, code developed to be used in process control to determine a characteristic transfer function to industrial units when radiotracer techniques were been applied to study the unit´s performance. The methodology is based on the measuring the residence time distribution function (RTD) and calculate the first and second temporal moments of the tracer data obtained by two scintillators detectors NaI positioned to register a complete tracer movement inside the unit. Non linear regression technique has been used to fit various mathematical models and a statistical test was used to select the best result to the transfer function. Using the code MOMENTS, twelve different models can be used to fit a curve and calculate technical parameters to the unit.

The use of mathematical modelling in fire safety engineering

Fire is a form of uncontrolled combustion which generates heat, smoke, toxic and irritant gases. All of these products are harmful to man and account for the heavy annual cost of 800 lives and £1,000,000,000 worth of property damage in Britain alone. The new discipline of Fire Safety Engineering has developed as a means of reducing these unacceptable losses. One of the main tools of Fire Safety Engineering is the mathematical model and over the past 15 years a number of mathematical models have emerged to cater for the needs of this discipline. Part of the difficulty faced by the Fire Safety Engineer is the selection of the most appropriate modelling tool to use for the job. To make an informed choice it is essential to have a good understanding of the various modelling approaches, their capabilities and limitations. In this paper some of the fundamental modelling tools used to predict fire and evacuation are investigated as are the issues associated with their use and recent developments in modelling technology.

Monitoring Infection Risk for Air and Soil Borne Fungal Plant Pathogens using Antibody and DNA Techniques and Mathematical Models describing Environmental Parameters

Economic losses resulting from disease development can be reduced by accurate and early detection of plant pathogens. Early detection can provide the grower with useful information on optimal crop rotation patterns, varietal selections, appropriate control measures, harvest date and post harvest handling. Classical methods for the isolation of pathogens are commonly used only after disease symptoms. This frequently results in a delay in application of control measures at potentially important periods in crop production. This paper describes the application of both antibody and DNA based systems to monitor infection risk of air and soil borne fungal pathogens and the use of this information with mathematical models describing risk of disease associated with environmental parameters.

A Haptic System for Depicting Mathematical Graphics for Students with Visual Impairments

When teaching students with visual impairments educators generally rely on tactile tools to depict visual mathematical topics. Tactile media, such as embossed paper and simple manipulable materials, are typically used to convey graphical information. Although these tools are easy to use and relatively inexpensive, they are solely tactile and are not modifiable. Dynamic and interactive technologies such as pin matrices and haptic pens are also commercially available, but tend to be more expensive and less intuitive. This study aims to bridge the gap between easy-to-use tactile tools and dynamic, interactive technologies in order to facilitate the haptic learning of mathematical concepts. We developed an haptic assistive device using a Tanvas electrostatic touchscreen that provides the user with multimodal (haptic, auditory, and visual) output. Three methodological steps comprise this research: 1) a systematic literature review of the state of the art in the design and testing of tactile and haptic assistive devices, 2) a user-centered system design, and 3) testing of the system’s effectiveness via a usability study. The electrostatic touchscreen exhibits promise as an assistive device for displaying visual mathematical elements via the haptic modality.

The Control of a Mathematical Analog of a Tentacle

A 2-dimensional dynamic analog of squid tentacles was presented. The tentacle analog consists of a multi-cell structure, which can be easily replicated to a large scale. Each cell of the model is a quadrilateral with unit masses at the corners. Each side of the quadrilateral is a spring-damper system in parallel. The spring constants are the controls for the system. The dynamics are subject to the constraint that the area of each quadrilateral must remain constant. The system dynamics was analyzed, and various equilibrium points were found with different controls. Then these equilibrium points were further determined experimentally, demonstrated to be asymptotically stable. A simulation built in MATLAB was used to find the convergence rates under different controls and damping coefficients. Finally, a control scheme was developed and used to drive the system to several configurations observed in real tentacle.