Impact of ATP-binding cassette, subfamily B, member 1 pharmacogenetics on tacrolimus-associated nephrotoxicity and dosage requirements in paediatric patients with liver transplant

Importance of the field: Tacrolimus is the most commonly used immunosuppressive agent following solid-organ transplantation in children. Its clinical use, however, is complicated by side effects (mainly nephrotoxicity), narrow therapeutic index and pharmacokinetic variability which can result in an increased risk of treatment failure or toxicity. Studies examining inter-individual differences in the expression of the ABCB1 (ATP-binding cassette, subfamily B, member 1) gene (which encodes the drug transporter, P-gp) and its genetic polymorphisms have attempted to elucidate variations in tacrolimus response and disposition in children.

The Bright Side of Manufacturing–Remanufacturing Conflict in a Decentralised Closed-Loop Supply Chain

Researchers and managers broadly agree that original equipment manufacturers (OEMs), which have opportunities to produce both new and remanufactured products, are better off by centrally controlling their manufacturing and remanufacturing activities. Thus, OEMs should not remanufacture used products until the remanufacturing cost is sufficiently low to overcome the negative impact of new product cannibalisation. In this paper, we present a contrasting view of the manufacturing–remanufacturing conflict: OEMs sometimes benefit from the decentralised control mode under which they ignore the internal cannibalisation rather than the remanufacturing option. We consider a decentralised closed-loop supply chain in which one OEM can purchase new components from one supplier to produce new products and collect used products from consumers to produce remanufactured products. The key feature of our model is that the OEM can select a centralised or decentralised control mode to manage its manufacturing and remanufacturing activities before the supplier prices the new component. In a steady state period setting, we analyse the players’ optimal decisions and compare the OEM's profits under centralised and decentralised control modes. Our analytic results reveal that the decentralised control within the OEM can outperform the centralised control when the cost structure of producing new and remanufactured products satisfies certain conditions. Finally, the key findings are distilled in a conceptual framework and its managerial implications are discussed.

The impact of personalised therapies on respiratory medicine

Stratified approaches to treating disease are very attractive, as efficacy is maximised by identifying responders using a companion diagnostic or by careful phenotyping. This approach will spare non-responders form potential side-effects. This has been pioneered in oncology where single genes or gene signatures indicate tumours that will respond to specific chemotherapies. Stratified approaches to the treatment of asthma with biological therapies are currently being extensively studied. In cystic fibrosis (CF), therapies have been developed that are targeted at specific functional classes of mutations. Ivacaftor, the first of such therapies, potentiates dysfunctional cystic fibrosis transmembrane conductance regulator (CFTR) protein Class III mutations and is now available in the USA and some European countries. Pivotal studies in patients with a G551D mutation, the most common Class III mutation, have demonstrated significant improvements in clinically important outcomes such as spirometry and exacerbations. Sweat chloride was significantly reduced demonstrating a functional effect on the dysfunctional CFTR protein produced by the G551D mutation. Symptom scores are also greatly improved to a level that indicates that this is a transformational treatment for many patients. This stratified approach to the development of therapies based on the functional class of the mutations in CF is likely to lead to new drugs or combinations that will correct the basic defect in many patients with CF. © ERS 2013.

Demand-side characterisation of the smart city for energy modelling.

This paper presents a new methodology for characterising the energy performance of buildings suitable for city-scale, top-down energy modelling. Building properties that have the greatest impact on simulated energy performance were identified via a review of sensitivity analysis studies. The methodology greatly simplifies the description of a building to decrease labour and simulation processing overheads. The methodology will be used in the EU FP7 INDICATE project which aims to create a master-planning tool that uses dynamic simulation to facilitate the design of sustainable, energy efficient smart cities.

Parkinson’s Is Time on Your Side? Evidence for Difficulties with Sensorimotor Synchronization

There is lack of consistent evidence as to how well PD patients are able to accurately time their movements across space with an external acoustic signal. For years, research based on the finger-tapping paradigm, the most popular paradigm for exploring the brain's ability to time movement, has provided strong evidence that patients are not able to accurately reproduce an isochronous interval [i.e., Ref. (1)]. This was undermined by Spencer and Ivry (2) who suggested a specific deficit in temporal control linked to emergent, rhythmical movement not event-based actions, which primarily involve the cerebellum. In this study, we investigated motor timing of seven idiopathic PD participants in event-based sensorimotor synchronization task. Participants were asked to move their finger horizontally between two predefined target zones to synchronize with the occurrence of two sound events at two time intervals (1.5 and 2.5 s). The width of the targets and the distance between them were manipulated to investigate impact of accuracy demands and movement amplitude on timing performance. The results showed that participants with PD demonstrated specific difficulties when trying to accurately synchronize their movements to a beat. The extent to which their ability to synchronize movement was compromised was found to be related to the severity of PD, but independent of the spatial constraints of the task.

Impact of energy-using product policies

Energy-using products (EuPs), such as domestic appliances, audio-visual and ICT equipment contribute significantly to CO2 emissions, both in the domestic and non-domestic sectors. Policies that encourage the use of more energy efficient products can therefore generate significant reductions in overall energy consumption and hence, CO2 emissions. To the extent that these policies cause an increase the average production cost of EuPs, they may impose economic costs on producers, or on consumers, or on both. In this theoretical paper, an adaptation of a simple vertical product differentiation model – in which products are characterised in terms of their quality and their energy consumption – is used to analyse the impact of the different EuP polices on product innovation and to assess the resultant economic impacts on producers and consumers. It is shown that whereas the imposition of a binding product standard for energy efficiency unambiguously reduces aggregate profit and increases the average market price in the absence of any learning effects, the introduction or strengthening of demand-side measures (such as energy labelling) may reduce, or increase, aggregate profit. Even in the case where the overall impact is unambiguously negative, the effects of product innovation and learning can be in either direction.

The impact of oligofructose on stimulation of gut hormones, appetite regulation and adiposity

Objective: To investigate the effect of nutrient stimulation of gut hormones by oligofructose supplementation on appetite, energy intake (EI), body weight (BW) and adiposity in overweight and obese volunteers. Methods: In a parallel, single-blind and placebo-controlled study, 22 healthy overweight and obese volunteers were randomly allocated to receive 30 g day−1 oligofructose or cellulose for 6 weeks following a 2-week run-in. Subjective appetite and side effect scores, breath hydrogen, serum short chain fatty acids (SCFAs), plasma gut hormones, glucose and insulin concentrations, EI, BW and adiposity were quantified at baseline and post-supplementation. Results: Oligofructose increased breath hydrogen (P < 0.0001), late acetate concentrations (P = 0.024), tended to increase total area under the curve (tAUC)420mins peptide YY (PYY) (P = 0.056) and reduced tAUC450mins hunger (P = 0.034) and motivation to eat (P = 0.013) when compared with cellulose. However, there was no significant difference between the groups in other parameters although within group analyses showed an increase in glucagon-like peptide 1 (GLP-1) (P = 0.006) in the cellulose group and a decrease in EI during ad libitum meal in both groups. Conclusions: Oligofructose increased plasma PYY concentrations and suppressed appetite, while cellulose increased GLP-1 concentrations. EI decreased in both groups. However, these positive effects did not translate into changes in BW or adiposity.

Compression Efficiency Analysis of Wyner-Ziv Video Coding with Motion Compensated Side Information Interpolation

The Wyner-Ziv video coding (WZVC) rate distortion performance is highly dependent on the quality of the side information, an estimation of the original frame, created at the decoder. This paper, characterizes the WZVC efficiency when motion compensated frame interpolation (MCFI) techniques are used to generate the side information, a difficult problem in WZVC especially because the decoder only has available some reference decoded frames. The proposed WZVC compression efficiency rate model relates the power spectral of the estimation error to the accuracy of the MCFI motion field. Then, some interesting conclusions may be derived related to the impact of the motion field smoothness and the correlation to the true motion trajectories on the compression performance.

An analysis of the impact of bus contention on the WCET in multicores

The use of multicores is becoming widespread inthe field of embedded systems, many of which have real-time requirements. Hence, ensuring that real-time applications meet their timing constraints is a pre-requisite before deploying them on these systems. This necessitates the consideration of the impact of the contention due to shared lowlevel hardware resources like the front-side bus (FSB) on the Worst-CaseExecution Time (WCET) of the tasks. Towards this aim, this paper proposes a method to determine an upper bound on the number of bus requests that tasks executing on a core can generate in a given time interval. We show that our method yields tighter upper bounds in comparison with the state of-the-art. We then apply our method to compute the extra contention delay incurred by tasks, when they are co-scheduled on different cores and access the shared main memory, using a shared bus, access to which is granted using a round-robin arbitration (RR) protocol.

Addressing software impact in the design of remote laboratories

Remote Laboratories or WebLabs constitute a first-order didactic resource in engineering faculties. However, in many cases, they lack a proper software design, both in the client and server side, which degrades their quality and academic usefulness. This paper presents the main characteristics of a Remote Laboratory, analyzes the software technologies to implement the client and server sides in a WebLab, and correlates these technologies with the characteristics to facilitate the selection of a technology to implement a WebLab. The results obtained suggest the adoption of a Service Oriented Laboratory Architecture-based approach for the design of future Remote Laboratories so that client-agnostic Remote Laboratories and Remote Laboratory composition are enabled. The experience with the real Remote Laboratory, WebLab-Deusto, is also presented.

(Un)ethical leadership, organizational identification and sensemaking: the BES case and its impact on employees

This paper provides an ongoing analysis to one of the biggest ethical and financial scandals in Portugal – Banco Espírito Santo (BES). BES was considered one of the three best banks but it went bankrupted and its employees were transferred to a new entity – Novo Banco. This study was conducted in order to provide an understanding of the employees’ side, which has been forgotten so far. An ethical scandal (sensebreaking) creates ambiguity and uncertainty which triggers new sensemaking processes in order to understand and derive meaning from the new reality. The methodology followed was semi-structured interviews to employees both from the branches and the central services. We found evidence that in organizations with strong identification, unethical behavior has a significant impact on followers’ – the new process of sensemaking is particularly important in this situation because employees suffer more from the disruption of their reality.

Impact of genetic SLC28 transporter and ITPA variants on ribavirin 21 serum level, hemoglobin drop and therapeutic response in patients with HCV infection

Background: T reatment o f chronic hepatitis C i s evolving, a nd direct acting antivirals ( DAAs) are now a dded to p egylated interferon-α ( Peg- INF-α) and ribavirin (RBV) for the treatment o f hepatitis C v irus ( HCV) genotype 1 infection. DAAs c ause d ifferent side effects and can even worsen RBV induced hemolytic anemia. T herefore, identifying host genetic d eterminants of R BV bioavailability and therapeutic e fficacy will remain crucial for individualized treatment. Recent d ata showed associations between R BV induced h emolytic anemia and genetic polymorphisms o f concentrative nucleoside transporters s uch as C NT3 (SLC28A3) and i nosine t riphosphatase (ITPA). T o analyze t he association of genetic variants of SLC28 transporters and ITPA with RBV induced hemolytic anemia and treatment o utcome. Methods: I n our study, 173 patients f rom t he S wiss Hepatitis C C ohort Study and 2 2 patients from Swiss Association for the Study of the Liver study 24 (61% HCV g enotype 1, 3 9% genotypes 2 o r 3) were analyzed for SLC28A2 single nucleotide p olymorphism (SNP) rs11854484, SLC28A3 rs56350726 and SLC28A3 rs10868138 as well as ITPA SNPs rs1127354 and rs7270101. RBV serum levels during treatment were measured in 49 patients. Results: SLC28A2 r s11854484 genotype TT was associated with significantly higher dosage- and body weight-adjusted RBV levels as compared to genotypes TC and CC (p=0.04 and p=0.02 at weeks 4 and 8, respectively). ITPA SNPs rs1127354 and rs7270101 were associated with h emolytic a nemia both in genotype as w ell as i n allelic a nalyses. SLC28A3 rs56350726 genotype TT (vs. AT/AA, RR=2.1; 95% CI 1.1-4.1) as well as the T allele (vs. A; RR=1.8, 95% CI 1.1-3.2) were associated with increased SVR rates. The combined analysis of overall ITPA activity and SLC28 v ariants together revealed n o significant a dditive effects on either treatment-related anemia or SVR. Conclusions: T he newly identified association between RBV serum levels a nd SLC28A2 rs11854484 genotype as well as the replicated association of ITPA and SLC28A3 g enetic p olymorphisms w ith RBV induced hemolytic anemia and treatment r esponse underpin the need for further studies on host genetic d eterminants of R BV bioavailability and therapeutic e fficacy f or individualized treatment of chronic hepatitis C.

Le cas du chapitre 11 de l'ALÉNA : son impact sur la capacité de l'État d'agir pour le bien public et de gérer le risque

Cet article présente le chapitre 11 de l’ALÉNA à titre de question d’actualité non seulement juridique mais également sociale et politique. Après avoir retracé son origine historique et expliqué la controverse qui y est relative ainsi que ses implications, l’auteur analyse l’impact du chapitre en posant trois questions: le chapitre 11 de l’ALÉNA a-t-il l’effet recherché ?  A-t-il des effets secondaires ?  Quelle est leur importance relative ?  Afin de combler une lacune dans la doctrine existante, une analyse globale des poursuites et des jugements déjà rendus est effectuée, tableaux de travail à l’appui, État par État.  Ceci permet de constater notamment que les États-Unis n’ont jamais été condamnés à payer des dommages-intérêts en vertu de ce chapitre alors que les entreprises américaines ont raflé la quasi-totalité des dommages-intérêts payés par le Canada et le Mexique.  Les entreprises canadiennes n’ont jamais obtenu de dommages-intérêts en vertu de ce chapitre.  On constate aussi que le Canada est actuellement l’État poursuivi pour le montant le plus élevé en vertu de ce chapitre et que les poursuites intentées contre le Canada se sont multipliées par quatre, ce qui n’augure pas bien de l’avenir.

Dietary supplement use and its impact on nutritional adequacy for British Columbia and Manitoba First Nations adults living on reserve.

Contexte: L'utilisation de suppléments alimentaires est répandue chez les populations américaines et canadiennes en général, mais on en sait peu sur la consommation de suppléments alimentaires dans la population autochtone canadienne. Objectif: L'objectif général de cette étude est de prendre en compte l'utilisation de suppléments alimentaires dans l'évaluation nutritionnelle des apports alimentaires des adultes des Premières nations vivant dans les réserves en Colombie-Britannique et Manitoba. Conception: Les données ont été recueillies par l’étude ‘First Nations Food, Nutrition, and Environment Study’ de 1103 (Colombie-Britannique) et 706 (Manitoba) adultes des Premières Nations âgés de 19 à 70 ans. L'étude a utilisé un rappel alimentaire des dernières 24 heures (avec un deuxième rappel pour un sous-échantillon) pour évaluer la diète alimentaire. L'utilisation de suppléments alimentaires et des antiacides ont été recueillis par un questionnaire de fréquence. En utilisant le logiciel SIDE pour tenir compte des variations intra-individuelles dans la prise alimentaire et la technique du bootstrap pour obtenir des estimations représentatives des différentes régions, l'utilisation de suppléments de la vitamine A, D, C et de calcium ont été intégrées aux estimations de la consommation alimentaire. Résultats: Environ 30% des adultes des Premières Nations de la Colombie-Britannique et seulement 13,2% des adultes des Premières Nations du Manitoba âgés entre 19-70 ans vivant dans les réserves ont déclaré utiliser au moins un supplément alimentaire durant les 30 jours précédents. Lors de l'examen des nutriments d'intérêt, un plus faible pourcentage de la population en a fait usage, de 14,8 à 18,5% en Colombie-Britannique et de 4,9 à 8% de la population du Manitoba. La prévalence de l'usage de tout supplément alimentaire était plus élevée chez les femmes que chez les hommes dans tous les groupes d'âge et augmente avec l'âge dans les deux sexes. La plus forte prévalence d'un apport insuffisant provenant de la nourriture a été observée pour la vitamine D et le calcium en Colombie-Britannique et Manitoba, variant de 75 à 100%, et de la vitamine A dans le Manitoba (73-96%). Après avoir examiné l'utilisation de suppléments alimentaires, plus des trois quarts des participants n’ont toujours pas réussi à répondre au besoin moyen estimatif pour ces nutriments. La vitamine C est l'oligo-élément avec le plus faible pourcentage sous le besoin moyen estimatif (avec au sans suppléments) pour la Colombie-Britannique et le Manitoba. Conclusion: La majorité des adultes des Premières nations de la Colombie-Britannique et du Manitoba, même après prise en compte de l'utilisation de suppléments alimentaires, avaient des apports en vitamines A, D et des apports de calcium sous les niveaux recommandés. L'utilisation de compléments alimentaires n'a pas contribué de façon significative à l'apport total en nutriments sélectionnés sauf pour la vitamine C dans certains groupes d'âge.

The Forgotten Side of Partisanship: Negative Party Identification in Four Anglo-American Democracies

Early studies of electoral behavior proposed that party identification could be negative as well as positive. Over time, though, the concept became mostly understood as a positive construct. The few studies that took negative identification into account tended to portray it as a marginal factor that went “hand-in-hand” with positive preferences. Recent scholarship in psychology reaffirms, however, that negative evaluations are not simply the bipolar opposite of positive ones. This article considers negative party identification from this standpoint, and evaluates its impact in recent national elections in Australia, Canada, New Zealand, and the United States. Our findings highlight the autonomous power of negative partisanship. They indicate as well that ideology has an influence on both positive and negative partisan identification.