Shifts in clinical trial application rates over time indicate if the attractiveness of a country or region for the conduct of clinical trials is growing or decreasing. The purpose of this ...observational study was to track changes in drug trial application patterns across several EU countries in order to analyze the medium-term impact of the EU Clinical Trials Directive 2001/20/EC on the conduct of drug trials.
Rates of Clinical Trial Applications (CTA) for studies with medicinal products in those six countries in the EU, which authorize on average more than 500 trials per year, were analyzed. Publicly available figures on the number of annually submitted CTA, the distribution of trials per phase and the type of sponsorship were tracked; missing data were provided by national drug agencies.
Since 2001, the number of CTA in Italy and Spain increased significantly (5.0 and 2.5% average annual growth). For Italy, the gain was driven by a strong increase of applications from academic trial sponsors; Spain's growth was due to a rise in trials run by commercial sponsors. The Netherlands, Germany, France and the UK saw a decline (1.9, 2.3, 3.0 and 5.3% average annual diminution; significant (P < 0.05) except for Germany) in clinical drug trials. The decrease in the UK was caused by a sharp fall in academic trial activities. Across the six analyzed countries, no EU-wide trial-phase-specific patterns or trends were observed.
The EU Clinical Trials Directive 2001/20/EC did not achieve the harmonization of clinical trial requirements across Europe. Rather, it resulted in the leveling of clinical trial activities caused by a continuing decrease in CTA rates in the Netherlands, Germany, France and the UK. Southern European countries, Italy and Spain, benefited to some extent from policy changes introduced by the Directive. In Italy's case, national funding measures helped to considerably promote the conduct of non-commercial trials. On the other hand, the EU Directive-driven transition from liberal policy environments, based on non-explicit trial approval through notifications, towards red-taped processes of trial authorization, contributed to the decreases in trial numbers in Germany and the UK. In the latter case, national research governance concerns had a share in the country's marked decline. However, different EU member states successfully developed best practices, which a new European legislation should take into consideration to resume Europe's attractiveness and international competitiveness for the conduct of clinical trials.
Osteogenesis imperfecta (OI) is a heterogenous group of heritable connective tissue disorders characterized by high bone fragility due to low bone mass and impaired bone material properties. Atypical ...type VI OI is an extremely rare and severe form of bone dysplasia resulting from a loss-of-function mutation (p.S40L) in IFITM5/BRIL,the causative gene of OI type V and decreased osteoblast secretion of pigment epithelium-derived factor (PEDF), as in OI type VI. It is not yet known which alterations at the material level might lead to such a severe phenotype. We therefore characterized bone tissue at the micrometer level in a novel heterozygous Ifitm5/BRIL p.S42L knock-in murine model at 4 and 8 weeks of age.
We evaluated in female mice, total body size, femoral and lumbar bone mineral density (BMD) by dual-energy X-ray absorptiometry. In the femoral bone we examined osteoid deposition by light microscopy, assessed bone histomorphometry and mineralization density distribution by quantitative backscattered electron imaging (qBEI). Osteocyte lacunae were examined by qBEI and the osteocyte lacuno-canalicular network by confocal laser scanning microscopy. Vasculature was examined indirectly by qBEI as 2D porosity in cortex, and as 3D porosity by micro-CT in third trochanter. Collagen orientation was examined by second harmonic generation microscopy. Two-way ANOVA was used to discriminate the effect of age and genotype.
Ifitm5/BRIL p.S42L female mice are viable, do not differ in body size, fat and lean mass from wild type (WT) littermates but have lower whole-body, lumbar and femoral BMD and multiple fractures.
The average and most frequent calcium concentration, CaMean and CaPeak, increased with age in metaphyseal and cortical bone in both genotypes and were always higher in Ifitm5/BRIL p.S42L than in WT, except CaMean in metaphysis at 4 weeks of age. The fraction of highly mineralized bone area, CaHigh, was also increased in Ifitm5/BRIL p.S42L metaphyseal bone at 8 weeks of age and at both ages in cortical bone. The fraction of lowly mineralized bone area, CaLow, decreased with age and was not higher in Ifitm5/BRIL p.S42L, consistent with lack of hyperosteoidosis on histological sections by visual exam. Osteocyte lacunae density was higher in Ifitm5/BRIL p.S42L than WT, whereas canalicular density was decreased. Indirect measurements of vascularity revealed a higher pore density at 4 weeks in cortical bone of Ifitm5/BRIL p.S42L than in WT and at both ages in the third trochanter. Importantly, the proportion of bone area with disordered collagen fibrils was highly increased in Ifitm5/BRIL p.S42L at both ages.
Despite normal skeletal growth and the lack of a collagen gene mutation, the Ifitm5/BRIL p.S42L mouse shows major OI-related bone tissue alterations such as hypermineralization of the matrix and elevated osteocyte porosity. Together with the disordered lacuno-canalicular network and the disordered collagen fibril orientation, these abnormalities likely contribute to overall bone fragility.
•Ifitm5/BRIL pS42L mice, a model for atypical OI type VI, shows high bone fragility.•Bone material properties were evaluated in mutants and WT at 4 and 8 weeks of age.•Vascularity and osteocyte density decreased with age and were higher in mutants.•Osteocyte canalicular density increased with age and was lower in mutants.•At both ages, mutants show hypermineralization and disordered collagen orientation.
Recent studies pointed to a high ice nucleating activity (INA) in the Arctic sea surface microlayer (SML). However, related chemical information is still sparse. In the present study, INA and free ...glucose concentrations were quantified in Arctic SML and bulk water samples from the marginal ice zone, the ice-free ocean, melt ponds, and open waters within the ice pack. T 50 (defining INA) ranged from −17.4 to −26.8 °C. Glucose concentrations varied from 0.6 to 51 μg/L with highest values in the SML from the marginal ice zone and melt ponds (median 16.3 and 13.5 μg/L) and lower values in the SML from the ice pack and the ice-free ocean (median 3.9 and 4.0 μg/L). Enrichment factors between the SML and the bulk ranged from 0.4 to 17. A positive correlation was observed between free glucose concentration and INA in Arctic water samples (T 50(°C) = (−25.6 ± 0.6) + (0.15 ± 0.04)·Glucose(μg/L), R P = 0.66, n = 74). Clustering water samples based on phytoplankton pigment composition resulted in robust but different correlations within the four clusters (R P between 0.67 and 0.96), indicating a strong link to phytoplankton-related processes. Since glucose did not show significant INA itself, free glucose may serve as a potential tracer for INA in Arctic water samples.
Exceedingly high levels of PM2.5 with complex chemical composition occur frequently in China. It has been speculated
whether anthropogenic PM2.5 may significantly contribute to ice-nucleating ...particles (INP). However, few studies have focused on the
ice-nucleating properties of urban particles. In this work, two ice-nucleating droplet arrays have been used to determine the
atmospheric number concentration of INP (NINP) in the range from −6 to −25 ∘C in Beijing. No
correlations between NINP and either PM2.5 or black carbon mass concentrations were found, although both
varied by more than a factor of 30 during the sampling period. Similarly, there were no correlations between NINP and
either total particle number concentration or number concentrations for particles with diameters >500 nm. Furthermore,
there was no clear difference between day and night samples. All these results indicate that Beijing air pollution did not increase or
decrease INP concentrations in the examined temperature range above values observed in nonurban areas; hence, the background INP
concentrations might not be anthropogenically influenced as far as urban air pollution is concerned, at least in the examined
temperature range.
Number
concentrations of ice-nucleating particles (NINP) in the Arctic
were derived from ground-based filter samples. Examined samples had been
collected in Alert (Nunavut, northern Canadian ...archipelago on Ellesmere
Island), Utqiaġvik, formerly known as Barrow (Alaska), Ny-Ålesund
(Svalbard), and at the Villum Research Station (VRS; northern Greenland). For
the former two stations, examined filters span a full yearly cycle. For VRS,
10 weekly samples, mostly from different months of one year, were included.
Samples from Ny-Ålesund were collected during the months from March until
September of one year. At all four stations, highest concentrations were
found in the summer months from roughly June to September. For those stations
with sufficient data coverage, an annual cycle can be seen. The spectra of
NINP observed at the highest temperatures, i.e., those obtained
for summer months, showed the presence of INPs that nucleate ice up to
−5 ∘C. Although the nature of these highly ice-active INPs could
not be determined in this study, it often has been described in the
literature that ice activity observed at such high temperatures originates
from the presence of ice-active material of biogenic origin. Spectra observed
at the lowest temperatures, i.e., those derived for winter months, were on
the lower end of the respective values from the literature on Arctic INPs or
INPs from midlatitude continental sites, to which a comparison is presented
herein. An analysis concerning the origin of INPs that were ice active at
high temperatures was carried out using back trajectories and satellite
information. Both terrestrial locations in the Arctic and the adjacent sea
were found to be possible source areas for highly active INPs.
Osteocytes are terminally differentiated osteoblasts embedded within the bone matrix and key orchestrators of bone metabolism. However, they are generally not characterized by conventional bone ...histomorphometry because of their location and the limited resolution of light microscopy. OI is characterized by disturbed bone homeostasis, matrix abnormalities and elevated bone matrix mineralization density. To gain further insights into osteocyte characteristics and bone metabolism in OI, we evaluated 2D osteocyte lacunae sections (OLS) based on quantitative backscattered electron imaging in transiliac bone biopsy samples from children with OI type I (n = 19) and age-matched controls (
= 24). The OLS characteristics were related to previously obtained, re-visited histomorphometric parameters. Moreover, we present pediatric bone mineralization density distribution reference data in OI type I (
= 19) and controls (
= 50) obtained with a field emission scanning electron microscope. Compared to controls, OI has highly increased OLS density in cortical and trabecular bone (+50.66%, +61.73%; both
< 0.001), whereas OLS area is slightly decreased in trabecular bone (-10.28%;
= 0.015). Correlation analyses show a low to moderate, positive association of OLS density with surface-based bone formation parameters and negative association with indices of osteoblast function. In conclusion, hyperosteocytosis of the hypermineralized OI bone matrix associates with abnormal bone cell metabolism and might further impact the mechanical competence of the bone tissue.
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