| 61. |
- Kliest, Tessa, et al.
(författare)
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Clinical trials in pediatric ALS: a TRICALS feasibility study
- 2022
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Ingår i: Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration. - : Taylor & Francis Group. - 2167-8421 .- 2167-9223. ; 23:7-8, s. 481-488
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Tidskriftsartikel (refereegranskat)abstract
- Background: Pediatric investigation plans (PIPs) describe how adult drugs can be studied in children. In 2015, PIPs for Amyotrophic Lateral Sclerosis (ALS) became mandatory for European marketing-authorization of adult treatments, unless a waiver is granted by the European Medicines Agency (EMA).Objective: To assess the feasibility of clinical studies on the effect of therapy in children (<18 years) with ALS in Europe.Methods: The EMA database was searched for submitted PIPs in ALS. A questionnaire was sent to 58 European ALS centers to collect the prevalence of pediatric ALS during the past ten years, the recruitment potential for future pediatric trials, and opinions of ALS experts concerning a waiver for ALS.Results: Four PIPs were identified; two were waived and two are planned for the future. In total, 49 (84.5%) centers responded to the questionnaire. The diagnosis of 44,858 patients with ALS was reported by 46 sites; 39 of the patients had an onset < 18 years (prevalence of 0.008 cases per 100,000 or 0.087% of all diagnosed patients). The estimated recruitment potential (47 sites) was 26 pediatric patients within five years. A majority of ALS experts (75.5%) recommend a waiver should apply for ALS due to the low prevalence of pediatric ALS.Conclusions: ALS with an onset before 18 years is extremely rare and may be a distinct entity from adult ALS. Conducting studies on the effect of disease-modifying therapy in pediatric ALS may involve lengthy recruitment periods, high costs, ethical/legal implications, challenges in trial design and limited information.
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| 62. |
- Klimek, Ludger, et al.
(författare)
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In-vivo diagnostic test allergens in Europe : A call to action and proposal for recovery plan-An EAACI position paper
- 2020
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Ingår i: Allergy. European Journal of Allergy and Clinical Immunology. - : Wiley. - 0105-4538 .- 1398-9995. ; 75:9, s. 2161-2169
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Tidskriftsartikel (refereegranskat)abstract
- Diagnostic allergens are defined as medicinal products in the EU. Marketing authorization by national authorities is necessary; however, diagnostic allergens are not homogeneously regulated in different EU member states. Allergen manufacturers argue with increasing costs forcing them to continuously reduce the diagnostic allergen portfolios offered to allergists. In contrast, EAACI and national European Allergy Societies see the need for the availability of a wide range of high‐quality diagnostic allergens for in vivo diagnosis of IgE‐mediated allergies not only covering predominant but also less frequent allergen sources. In a recent EAACI task force survey, the current practice of allergy diagnosis was shown to rely on skin tests as first option in almost 2/3 of all types of allergic diseases and in 90% regarding respiratory allergies.With the need to ensure the availability of high‐quality diagnostic allergens in the EU, an action plan has been set up by EAACI to analyse the current regulatory demands in EU member states and to define possible solutions stated in this document: (a) simplification of authorization for diagnostic allergens; (b) specific regulation of special types of diagnostic allergens; (c) new models beyond the current model of homologous groups; (d) simplification of pharmacovigilance reporting; (e) reduction of regulation fees for diagnostic allergens; (f) reimbursement for diagnostic allergens.Joining forces of allergists, manufacturers and authorities are of high importance to ensure remaining relevant allergens in the EU markets to facilitate a sustainable and comprehensive service for the diagnosis and treatment of allergic diseases.
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| 63. |
- Kraemer, Bernhard K., et al.
(författare)
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Tacrolimus-Based, Steroid-Free Regimens in Renal Transplantation : 3-Year Follow-Up of the ATLAS Trial
- 2012
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Ingår i: Transplantation. - 0041-1337 .- 1534-6080. ; 94:5, s. 492-498
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Tidskriftsartikel (refereegranskat)abstract
- Background. Long-term use of corticosteroids is associated with considerable morbidity, including cardiovascular and metabolic adverse effects. Methods. This study evaluated the long-term efficacy and safety of two steroid-free regimens compared with a triple immunosuppressive therapy in renal transplant recipients. This was a 3-year follow-up to a 6-month, open-label, randomized, multicenter study. Results. Data from 3 years were available for 421 (93.3%) of 451 patients in the original intent-to-treat population (143 tacrolimus/basiliximab [Tac/Bas], 139 tacrolimus/mycophenolate mofetil [Tac/MMF], and 139 tacrolimus/MMF/steroids [triple therapy]). In the time interval from 6 months to 3 years after transplantation, the incidence of biopsy-proven acute rejection was low and similar (Tac/Bas, 2.1%; Tac/MMF, 2.2%; triple therapy, 2.2%); Most rejection episodes occurred during the first 6 months of the study. Graft survival was high (Kaplan-Meier estimates: 92.7%, 92.5%, and 92.5%), as was patient survival (93.1%, 96.4%, and 97.0%). There were 10 graft losses (n=2, 4, and 4) and 12 patient deaths (n=5, 2, and 5). Renal function was well preserved throughout the study and similar between groups. There was a trend toward improved cardiovascular risk factors in the Tac/Bas group, including reduced total and low-density lipoprotein cholesterol and lower new-onset insulin use. There were no between-group differences in the incidence or type of adverse events. Conclusion. Higher rates of acute rejection early in treatment were seen with the steroid-free regimens, but this did not translate into poorer long-term outcomes, such as graft and patient survival and renal function. A trend for a more favorable cardiovascular risk profile was observed for steroid-free immunosuppression with Tac/Bas.
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| 64. |
- Krämer, Bernhard K., et al.
(författare)
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Tacrolimus combined with two different corticosteroid-free regimens compared with a standard triple regimen in renal transplantation : one year observational results
- 2010
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Ingår i: Clinical Transplantation. - : Wiley. - 0902-0063 .- 1399-0012. ; 24:1, s. E1-E9
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Tidskriftsartikel (refereegranskat)abstract
- Side effects of steroid use have led to efforts to minimize their use in transplantation. Two corticosteroid-free regimens were compared with a triple immunosuppressive therapy. Data from the original intent-to-treat (ITT) population (153 tacrolimus/basiliximab [Tac/Bas], 151 tacrolimus/MMF [Tac/MMF], and 147 tacrolimus/MMF/steroids [control]) were analyzed in a 12-month follow-up. Percentage of graft survival were 92.8%, 95.4%, and 95.9% (KM estimates 89.9%, 95.3%, 95.9%), percentage of surviving patients were 98.7%, 98.0%, and 100% (KM estimates 95.9%, 92.8%, and 100%). During months 7-12, graft loss occurred in 3 Tac/Bas, 2 Tac/MMF, and zero control patients, patient deaths in 1 Tac/Bas, 2 Tac/MMF, and zero control, and biopsy-proven acute rejection episodes in 4 Tac/Bas, 3 Tac/MMF, and zero control. Mean serum creatinine at month 12 was 141.9 +/- 69.6 muM, 144.0 +/- 82.1 muM, and 134.5 +/- 71.2 muM (ns). New-onset insulin use in previously non-diabetic patients at month 12 was 1/138, 6/127, and 4/126. Patient and graft survival as well as renal function at 12 months were not different between patient groups, despite considerably higher rates of acute rejection occurring within the first six months after transplantation in both steroid-free patient groups. Tac/Bas therapy might offer benefits in terms of a trend for a more favorable cardiovascular risk profile.
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| 65. |
- Lagrange, A. -M., et al.
(författare)
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A narrow, edge-on disk resolved around HD 106906 with SPHERE
- 2016
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Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 586
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Tidskriftsartikel (refereegranskat)abstract
- Context. HD 106906AB is the only young binary system so far around which a planet has been imaged and a debris disk has been shown to exist, thanks to a strong IR excess. As such, it represents a unique opportunity for studying the dynamics of young planetary systems. Aims. We aim at further investigating the close (tens of au scales) environment of the HD 106906AB system. Methods. We used the extreme adaptive-optics-fed, high-contrast imager SPHERE that has recently been installed on the VLT to observe HD 106906. Both the IRDIS imager and the Integral Field Spectrometer were used. Results. We discovered a highly inclined, ring-like disk at a distance of 65 au from the star. The disk shows a strong brightness asymmetry with respect to its semi-major axis. It shows a smooth outer edge, compatible with ejection of small grains by the stellar radiation pressure. We show furthermore that the planet's projected position is significantly above the PA of the disk. Given the determined disk inclination, it is not excluded, however, that the planet could still orbit within the disk plane if at a large separation (2000 3000 au). We identified several additional point sources in the SPHERE /IRDIS field of view that appear to be background objects. We compare this system with other debris disks sharing similarities, and we briefly discuss the present results in the framework of dynamical evolution.
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| 66. |
- Langlois, M., et al.
(författare)
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First scattered light detection of a nearly edge-on transition disk around the T Tauri star RY Lupi
- 2018
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Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 614
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Tidskriftsartikel (refereegranskat)abstract
- Context. Transition disks are considered sites of ongoing planet formation, and their dust and gas distributions could be signposts of embedded planets. The transition disk around the T Tauri star RY Lup has an inner dust cavity and displays a strong silicate emission feature. Aims. Using high-resolution imaging we study the disk geometry, including non-axisymmetric features, and its surface dust grain, to gain a better understanding of the disk evolutionary process. Moreover, we search for companion candidates, possibly connected to the disk. Methods. We obtained high-contrast and high angular resolution data in the near-infrared with the VLT/SPHERE extreme adaptive optics instrument whose goal is to study the planet formation by detecting and characterizing these planets and their formation environments through direct imaging. We performed polarimetric imaging of the RY Lup disk with IRDIS (at 1.6 mu m), and obtained intensity images with the IRDIS dual-band imaging camera simultaneously with the IFS spectro-imager (0.9-1.3 mu m). Results. We resolved for the first time the scattered light from the nearly edge-on circumstellar disk around RY Lup, at projected separations in the 100 au range. The shape of the disk and its sharp features are clearly detectable at wavelengths ranging from 0.9 to 1.6 mu m. We show that the observed morphology can be interpreted as spiral arms in the disk. This interpretation is supported by in-depth numerical simulations. We also demonstrate that these features can be produced by one planet interacting with the disk. We also detect several point sources which are classified as probable background objects.
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| 67. |
- Langlois, M., et al.
(författare)
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The SPHERE infrared survey for exoplanets (SHINE) : II. Observations, data reduction and analysis, detection performances, and initial results
- 2021
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Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 651
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Tidskriftsartikel (refereegranskat)abstract
- Context. In recent decades, direct imaging has confirmed the existence of substellar companions (exoplanets or brown dwarfs) on wide orbits (>10 au) around their host stars. In striving to understand their formation and evolution mechanisms, in 2015 we initiated the SPHERE infrared survey for exoplanets (SHINE), a systematic direct imaging survey of young, nearby stars that is targeted at exploring their demographics.Aims. We aim to detect and characterize the population of giant planets and brown dwarfs beyond the snow line around young, nearby stars. Combined with the survey completeness, our observations offer the opportunity to constrain the statistical properties (occurrence, mass and orbital distributions, dependency on the stellar mass) of these young giant planets.Methods. In this study, we present the observing and data analysis strategy, the ranking process of the detected candidates, and the survey performances for a subsample of 150 stars that are representative of the full SHINE sample. Observations were conducted in a homogeneous way between February 2015 and February 2017 with the dedicated ground-based VLT/SPHERE instrument equipped with the IFS integral field spectrograph and the IRDIS dual-band imager, covering a spectral range between 0.9 and 2.3 μm. We used coronographic, angular, and spectral differential imaging techniques to achieve the best detection performances for this study, down to the planetary mass regime.Results. We processed, in a uniform manner, more than 300 SHINE observations and datasets to assess the survey typical sensitivity as a function of the host star and of the observing conditions. The median detection performance reached 5σ-contrasts of 13 mag at 200 mas and 14.2 mag at 800 mas with the IFS (YJ and YJH bands), and of 11.8 mag at 200 mas, 13.1 mag at 800 mas, and 15.8 mag at 3 as with IRDIS in H band, delivering one of the deepest sensitivity surveys thus far for young, nearby stars. A total of sixteen substellar companions were imaged in this first part of SHINE: seven brown dwarf companions and ten planetary-mass companions.These include two new discoveries, HIP 65426 b and HIP 64892 B, but not the planets around PDS70 that had not been originally selected for the SHINE core sample. A total of 1483 candidates were detected, mainly in the large field of view that characterizes IRDIS. The color-magnitude diagrams, low-resolution spectrum (when available with IFS), and follow-up observations enabled us to identify the nature (background contaminant or comoving companion) of about 86% of our subsample. The remaining cases are often connected to crowded-field follow-up observations that were missing. Finally, even though SHINE was not initially designed for disk searches, we imaged twelve circumstellar disks, including three new detections around the HIP 73145, HIP 86598, and HD 106906 systems.Conclusions. Nowadays, direct imaging provides a unique opportunity to probe the outer part of exoplanetary systems beyond 10 au to explore planetary architectures, as highlighted by the discoveries of: one new exoplanet, one new brown dwarf companion, and three new debris disks during this early phase of SHINE. It also offers the opportunity to explore and revisit the physical and orbital properties of these young, giant planets and brown dwarf companions (relative position, photometry, and low-resolution spectrum in near-infrared, predicted masses, and contrast in order to search for additional companions). Finally, these results highlight the importance of finalizing the SHINE systematic observation of about 500 young, nearby stars for a full exploration of their outer part to explore the demographics of young giant planets beyond 10 au and to identify the most interesting systems for the next generation of high-contrast imagers on very large and extremely large telescopes.
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| 68. |
- Lee, Teresa, et al.
(författare)
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Ataxin-2 intermediate-length polyglutamine expansions in European ALS patients
- 2011
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Ingår i: Human Molecular Genetics. - : Oxford University Press (OUP). - 0964-6906 .- 1460-2083. ; 20:9, s. 1697-1700
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Tidskriftsartikel (refereegranskat)abstract
- Amyotrophic lateral sclerosis (ALS) is a fatal adult-onset neurodegenerative disease primarily affecting motor neurons. We recently identified intermediate-length polyglutamine (polyQ) expansions (27-33 Qs) in ataxin 2 as a genetic risk factor for sporadic ALS in North American ALS patients. To extend these findings, we assessed the ataxin 2 polyQ repeat length in 1294 European ALS patients and 679 matched healthy controls. We observed a significant association between polyQ expansions and ALS (>30 Qs; P= 6.2 × 10(-3)). Thus, intermediate-length ataxin 2 polyQ repeat expansions are associated with increased risk for ALS also in the European cohort. The specific polyQ length cutoff, however, appears to vary between different populations, with longer repeat lengths showing a clear association. Our findings support the hypothesis that ataxin 2 plays an important role in predisposing to ALS and that polyQ expansions in ataxin 2 are a significant risk factor for the disease.
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| 69. |
- Li, Wantong, et al.
(författare)
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Contrasting Drought Propagation Into the Terrestrial Water Cycle Between Dry and Wet Regions
- 2023
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Ingår i: Earth's Future. - 2328-4277. ; 11:7
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Tidskriftsartikel (refereegranskat)abstract
- Drought's intensity and duration have increased in many regions over the last decades. However, the propagation of drought-induced water deficits through the terrestrial water cycle is not fully understood at a global scale. Here we study responses of monthly evaporation (ET) and runoff to soil moisture droughts occurring between 2001 and 2015 using independent gridded datasets based on machine learning-assisted upscaling of satellite and in-situ observations. We find that runoff and ET show generally contrasting drought responses across climate regimes. In wet regions, runoff is strongly reduced while ET is decoupled from soil moisture decreases and enhanced by sunny and warm weather typically accompanying soil moisture droughts. In drier regions, ET is reduced during droughts due to vegetation water stress, while runoff is largely unchanged as precipitation deficits are typically low in these regions and ET decreases are buffering runoff reductions. While these water flux drought responses are controlled by the large-scale climate regimes, they are additionally modulated by local vegetation characteristics. Land surface models capture the observed water cycle responses to drought in the case of runoff, but not for ET where the ET deficit (surplus) is overestimated (underestimated), related to a misrepresentation of the general soil moisture-evaporation interplay. In summary, our study illustrates how the joint analysis of machine learning-enhanced Earth observations can advance the understanding of global eco-hydrological processes, as well as the validation of land surface models.
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| 70. |
- Ligi, R., et al.
(författare)
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Investigation of the inner structures around HD 169142 with VLT/SPHERE
- 2018
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Ingår i: Monthly notices of the Royal Astronomical Society. - : Oxford University Press (OUP). - 0035-8711 .- 1365-2966. ; 473:2, s. 1774-1783
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Tidskriftsartikel (refereegranskat)abstract
- We present observations of the Herbig Ae star HD 169142 with the VLT/SPHERE instruments InfraRed Dual-band Imager and Spectrograph (IRDIS) (K1K2 and H2H3 bands) and the Integral Field Spectrograph (IFS) (Y, J and H bands). We detect several bright blobs at similar to 180 mas separation from the star, and a faint arc-like structure in the IFS data. Our reference differential imaging (RDI) data analysis also finds a bright ring at the same separation. We show, using a simulation based on polarized light data, that these blobs are actually part of the ring at 180 mas. These results demonstrate that the earlier detections of blobs in the H and K-S bands at these separations in Biller et al. as potential planet/substellar companions are actually tracing a bright ring with a Keplerian motion. Moreover, we detect in the images an additional bright structure at similar to 93 mas separation and position angle of 355 degrees, at a location very close to previous detections. It appears point-like in the YJ and K bands but is more extended in the H band. We also marginally detect an inner ring in the RDI data at similar to 100 mas. Follow-up observations are necessary to confirm the detection and the nature of this source and structure.
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