A CFTR Potentiator in Patients with Cystic Fibrosis and the G551D Mutation

Background:<br/><br/>Increasing the activity of defective cystic fibrosis transmembrane conductance regulator (CFTR) protein is a potential treatment for cystic fibrosis. <br/><br/>Methods: <br/><br/>We conducted a randomized, double-blind, placebo-controlled trial to evaluate ivacaftor (VX-770), a CFTR potentiator, in subjects 12 years of age or older with cystic fibrosis and at least one G551D-CFTR mutation. Subjects were randomly assigned to receive 150 mg of ivacaftor every 12 hours (84 subjects, of whom 83 received at least one dose) or placebo (83, of whom 78 received at least one dose) for 48 weeks. The primary end point was the estimated mean change from baseline through week 24 in the percent of predicted forced expiratory volume in 1 second (FEV1). <br/><br/>Results: <br/><br/>The change from baseline through week 24 in the percent of predicted FEV1 was greater by 10.6 percentage points in the ivacaftor group than in the placebo group (P &lt; 0.001). Effects on pulmonary function were noted by 2 weeks, and a significant treatment effect was maintained through week 48. Subjects receiving ivacaftor were 55% less likely to have a pulmonary exacerbation than were patients receiving placebo, through week 48 (P &lt; 0.001). In addition, through week 48, subjects in the ivacaftor group scored 8.6 points higher than did subjects in the placebo group on the respiratory-symptoms domain of the Cystic Fibrosis Questionnaire-revised instrument (a 100-point scale, with higher numbers indicating a lower effect of symptoms on the patient's quality of life) (P &lt; 0.001). By 48 weeks, patients treated with ivacaftor had gained, on average, 2.7 kg more weight than had patients receiving placebo (P &lt; 0.001). The change from baseline through week 48 in the concentration of sweat chloride, a measure of CFTR activity, with ivacaftor as compared with placebo was -48.1 mmol per liter (P &lt; 0.001). The incidence of adverse events was similar with ivacaftor and placebo, with a lower proportion of serious adverse events with ivacaftor than with placebo (24% vs. 42%). <br/><br/>Conclusions: <br/><br/>Ivacaftor was associated with improvements in lung function at 2 weeks that were sustained through 48 weeks. Substantial improvements were also observed in the risk of pulmonary exacerbations, patient-reported respiratory symptoms, weight, and concentration of sweat chloride.

Production of a monoclonal antibody and its application in an optical biosensor based assay for the quantitative measurement of Pantothenic Acid (Vitamin B5) in foodstuffs

Pantothenicacid (PA), vitamin B5, is an essential B vitamin that may be fortified in food and as such requires robust and accurate methods of detection to meet compliance legislation. This study reports the production and characterisation of the first monoclonalantibody (MAb) specific for PA and the subsequent development of a surface plasmon resonance (SPR) biosensorassay for the quantification of PA. The developed assay was compared with an SPR based commercial kit which utilised a polyclonal antibody (PAb). Foodstuffs, including cereals (n = 43), infant formulas and baby food (n = 10) and fruit juices (n = 48) were analysed by both the MAb and PAb biosensorassays and comparison plots showed good correlation (R2 0.77���0.99). The results indicate that the MAb basedbiosensorassay is suitable for the measurement of PA in foodstuffs and has the added advantage of facilitating a constant, long term supply of identical antibody. Preliminary matrix studies suggest the MAb basedassay is an excellent candidate for further validation studies and routine quality assurance based analysis.

This is Not a Photo Opportunity: Verbal/Visual Struggle in Francophone Travel Narratives

This article explores the ethics and aesthetics of representing travel and intercultural encounter in textual and photographic forms. Taking as its starting point two textual accounts of journeys in the course of which photographic narratives were also produced, the article explores the possibilities and limitations of textuality and visuality and thus considers the implications of, or new opportunities afforded by, reading ��� and ultimately publishing ��� these narratives as iconotexts. Focusing on Pierre Loti's L'Inde (sans les Anglais) (1901) and Ella Maillart's Oasis interdites (1937), the article also offers an alternative perspective on writers whose work is commonly associated with an imperialist or exoticist discourse, with clich�� and one-dimensionality. As such, it aims to replace the monolithic, orientalist vision often attributed to these writers with ambiguity, ethical hesitation and a plurality of perspectives. Using these examples as a springboard, the article seeks to argue that verbal/visual mobility in narratives representing mobility contributes to resisting static, monolithic perceptions of other cultures. Using the work of British graffiti artist Banksy as a foil for exploring photography as cultural commodification and art as commodity, the article also seeks to engage with current debates in Humanities research on ekphrasis and iconotextuality and on the problematics of representing other cultures within an ethical and/or humanist frame.

Carotenoids and co-antioxidants in age-related maculopathy:design and methods

Age-related macular degeneration (AMD), is the leading cause of blind registration in the Western World among individuals 65 years or older. Early AMD, a clinical state without overt functional loss, is said to be present clinically when yellowish deposits known as drusen and/or alterations of fundus pigmentation are seen in the macular retina. Although the etiopathogenesis of AMD remains uncertain, there is a growing body of evidence in support of the view that cumulative oxidative damage plays a causal role. Appropriate dietary antioxidant supplementation is likely to be beneficial in maintaining visual function in patients with AMD, and preventing or delaying the progression of early AMD to late AMD. The Carotenoids in Age-Related Maculopathy (CARMA) Study is a randomized and double-masked clinical trial of antioxidant supplementation versus placebo in 433 participants with either early AMD features of sufficient severity in at least one eye or any level of AMD in one eye with late AMD (neovascular AMD or central geographic atrophy) in the fellow eye. The aim of the CARMA Study is to investigate whether lutein and zeaxanthin, in combination with co-antioxidants (vitamin C, E, and zinc), has a beneficial effect on visual function and/or prevention of progression from early to late stages of disease. The primary outcome is improved or preserved distance visual acuity at 12 months. Secondary outcomes include improved or preserved interferometric acuity, contrast sensitivity, shape discrimination ability, and change in AMD severity as monitored by fundus photography. This article outlines the CARMA Study design and methodology, including its rationale.

Identification of lesion components that influence visual function in age related macular degeneration

To explore the relation between lesion composition as assessed by fundus photography and fluorescein angiography with clinical measures of vision in eyes of patients with age related macular degeneration (AMD).

Heritability and Genome-Wide Association Study to Assess Genetic Differences between Advanced Age-Related Macular Degeneration Subtypes

PURPOSE: To investigate whether the 2 subtypes of advanced age-related macular degeneration (AMD), choroidal neovascularization (CNV), and geographic atrophy (GA) segregate separately in families and to identify which genetic variants are associated with these 2 subtypes. DESIGN: Sibling correlation study and genome-wide association study (GWAS). PARTICIPANTS: For the sibling correlation study, 209 sibling pairs with advanced AMD were included. For the GWAS, 2594 participants with advanced AMD subtypes and 4134 controls were included. Replication cohorts included 5383 advanced AMD participants and 15 240 controls. METHODS: Participants had the AMD grade assigned based on fundus photography, examination, or both. To determine heritability of advanced AMD subtypes, a sibling correlation study was performed. For the GWAS, genome-wide genotyping was conducted and 6 036 699 single nucleotide polymorphisms (SNPs) were imputed. Then, the SNPs were analyzed with a generalized linear model controlling for genotyping platform and genetic ancestry. The most significant associations were evaluated in independent cohorts. MAIN OUTCOME MEASURES: Concordance of advanced AMD subtypes in sibling pairs and associations between SNPs with GA and CNV advanced AMD subtypes. RESULTS: The difference between the observed and expected proportion of siblings concordant for the same subtype of advanced AMD was different to a statistically significant degree (P = 4.2��10(-5)), meaning that in siblings of probands with CNV or GA, the same advanced subtype is more likely to develop. In the analysis comparing participants with CNV to those with GA, a statistically significant association was observed at the ARMS2/HTRA1 locus (rs10490924; odds ratio [OR], 1.47; P = 4.3��10(-9)), which was confirmed in the replication samples (OR, 1.38; P = 7.4��10(-14) for combined discovery and replication analysis). CONCLUSIONS: Whether CNV versus GA develops in a patient with AMD is determined in part by genetic variation. In this large GWAS meta-analysis and replication analysis, the ARMS2/HTRA1 locus confers increased risk for both advanced AMD subtypes, but imparts greater risk for CNV than for GA. This locus explains a small proportion of the excess sibling correlation for advanced AMD subtype. Other loci were detected with suggestive associations that differ for advanced AMD subtypes and deserve follow-up in additional studies. FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found after the references.

The personality of ���aggressive��� and ���non-aggressive��� dog owners

The relationship between pet-keeping and owner personality has attracted considerable attention. Little focus, however, has been directed towards the personality of pet owners in relation to the type of pet owned. This study therefore explored the personality of pet owners in relation to the type of dog breed owned, focusing specifically on owners of breeds widely considered to be ���aggressive��� versus those more generally perceived as ���non-aggressive���. One hundred and forty seven owners of ���aggressive��� (German shepherd dogs, Rottweilers) or ���non-aggressive��� (Labrador retrievers, Golden retrievers) dog breeds completed the Eysenck Personality Questionnaire short scale. Breed of dog owned was significantly related to owners��� psychoticism scores, with people who kept ���aggressive��� dogs having significantly higher scores on this trait than owners of ���non-aggressive��� dogs. Dog breed ownership was not significantly related to neuroticism, extraversion or lie scale scores, although male owners of ���aggressive��� dogs were found to be significantly less neurotic than women who kept ���aggressive��� or ���non-aggressive��� dogs. Overall, findings suggest that there is a significant relationship between dog breed ownership and specific personality traits, with owners of breeds widely considered to be ���aggressive��� harbouring more psychotic tendencies than people who choose to keep dogs with a reputedly less aggressive temperament.

Design and Practice in Architectural Theory Education

Benefiting from design in theory learning is not common in architecture schools. The general practice is to design in studio and to theorise in lectures. In the undergraduate module History and Theory in Architecture II at Queen���s University Belfast, students attend interactive lectures, participate in reading group discussions, design TextObjects, and write essays. TextObjects contain textual, audio and/or graphic representations that highlight a single concept or a complex set of issues derived from readings. Students experiment with diverse media, such as filmmaking, photography, and graphic design, some of which they experience for the first time. Lectures and readings revolve around theories of architectural representation, media and communication, which are practiced through TextObjects. This is a new way to link theory and practice in architectural education. Through action research, this study analyses this innovative teaching method called TextObject, which brings design and practice into architectural theory education to stimulate students towards critical thinking. The pedagogical research of architectural theoretician Necdet Teymur (1992, 1996, 2002) underlies the study.

Cold, Hungry and Scared:Prison Films About the Troubles

The cinematic representations of the prison experience during the Northern Irish Troubles.

Secondary Outcomes in a Clinical Trial of Carotenoids with Coantioxidants versus Placebo in Early Age-Related Macular Degeneration

Purpose: To report the secondary outcomes in the Carotenoids with Coantioxidants in Age-Related Maculopathy trial. <br/> <br/>Design: Randomized double-masked placebo-controlled clinical trial (registered as ISRCTN 94557601). <br/> <br/>Participants: Participants included 433 adults 55 years of age or older with early age-related macular degeneration (AMD) in 1 eye and late-stage disease in the fellow eye (group 1) or early AMD in both eyes (group 2). <br/> <br/>Intervention: An oral preparation containing lutein (L), zeaxanthin (Z), vitamin C, vitamin E, copper, and zinc or placebo. Best-corrected visual acuity (BCVA), contrast sensitivity (CS), Raman spectroscopy, stereoscopic colour fundus photography, and serum sampling were performed every 6 months with a minimum follow-up time of 12 months. <br/> <br/>Main Outcome Measures: Secondary outcomes included differences in BCVA (at 24 and 36 months), CS, Raman counts, serum antioxidant levels, and progression along the AMD severity scale (at 12, 24, and 36 months). <br/> <br/>Results: The differential between active and placebo groups increased steadily, with average BCVA in the former being approximately 4.8 letters better than the latter for those who had 36 months of follow-up, and this difference was statistically significant (P = 0.04). In the longitudinal analysis, for a 1-log-unit increase in serum L, visual acuity was better by 1.4 letters (95% confidence interval, 0.3-2.5; P = 0.01), and a slower progression along a morphologic severity scale (P = 0.014) was observed. <br/> <br/>Conclusions: Functional and morphologic benefits were observed in key secondary outcomes after supplementation with L, Z, and coantioxidants in persons with early AMD. <br/> <br/>Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article. �� 2012 American Academy of Ophthalmology.

Screening tests for detecting open-angle glaucoma: systematic review and meta-analysis

<p>PURPOSE: To assess the comparative accuracy of potential screening tests for open angle glaucoma (OAG).</p><p>METHODS: Medline, Embase, Biosis (to November 2005), Science Citation Index (to December 2005), and The Cochrane Library (Issue 4, 2005) were searched. Studies assessing candidate screening tests for detecting OAG in persons older than 40 years that reported true and false positives and negatives were included. Meta-analysis was undertaken using the hierarchical summary receiver operating characteristic model.</p><p>RESULTS: Forty studies enrolling over 48,000 people reported nine tests. Most tests were reported by only a few studies. Frequency-doubling technology (FDT; C-20-1) was significantly more sensitive than ophthalmoscopy (30, 95% credible interval [CrI] 0-62) and Goldmann applanation tonometry (GAT; 45, 95% CrI 17-68), whereas threshold standard automated perimetry (SAP) and Heidelberg Retinal Tomograph (HRT II) were both more sensitive than GAT (41, 95% CrI 14-64 and 39, 95% CrI 3-64, respectively). GAT was more specific than both FDT C-20-5 (19, 95% CrI 0-53) and threshold SAP (14, 95% CrI 1-37). Judging performance by diagnostic odds ratio, FDT, oculokinetic perimetry, and HRT II are promising tests. Ophthalmoscopy, SAP, retinal photography, and GAT had relatively poor performance as single tests. These findings are based on heterogeneous data of limited quality and as such are associated with considerable uncertainty.</p><p>CONCLUSIONS: No test or group of tests was clearly superior for glaucoma screening. Further research is needed to evaluate the comparative accuracy of the most promising tests.</p>

Common variation near CDKN1A, POLD3 and SHROOM2 influences colorectal cancer risk.

We performed a meta-analysis of five genome-wide association studies to identify common variants influencing colorectal cancer (CRC) risk comprising 8,682 cases and 9,649 controls. Replication analysis was performed in case-control sets totaling 21,096 cases and 19,555 controls. We identified three new CRC risk loci at 6p21 (rs1321311, near CDKN1A; P = 1.14 �� 10(-10)), 11q13.4 (rs3824999, intronic to POLD3; P = 3.65 �� 10(-10)) and Xp22.2 (rs5934683, near SHROOM2; P = 7.30 �� 10(-10)) This brings the number of independent loci associated with CRC risk to 20 and provides further insight into the genetic architecture of inherited susceptibility to CRC.