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At least 19 records

Pivotal trial characteristics and types of endpoints used to support Food and Drug Administration rare disease drug approvals between 2013 and 2022

Background/aims Rare disease drug development faces unique challenges, such as genotypic and phenotypic heterogeneity within small patient populations and a lack of established outcome measures for conditions without previously successful drug development programs. These challenges complicate the process of selecting the appropriate trial endpoints and conducting clinical trials in rare diseases. In this descriptive study, we examined novel drug approvals for non-oncologic rare diseases by the U.S. Food and Drug Administration’s Center for Drug Evaluation and Research over the past decade and characterized key regulatory and trial design elements with a focus on the primary efficacy endpoint utilized as the basis of approval. Methods Using the Food and Drug Administration’s Data Analysis Search Host database, we identified novel new drug applications and biologics license applications with orphan drug designation that were approved between 2013 and 2022 for non-oncologic indications. From Food and Drug Administration review documents and other external databases, we examined characteristics of pivotal trials for the included drugs, such as therapeutic area, trial design, and type of primary efficacy endpoints. Differences in trial design elements associated with primary efficacy endpoint type were assessed such as randomization and blinding. Then, we summarized the primary efficacy endpoint types utilized in pivotal trials by therapeutic area, approval pathway, and whether the disease etiology is well defined. Results One hundred and seven drugs that met our inclusion criteria were approved between 2013 and 2022. Assessment of the 107 drug development programs identified 150 pivotal trials that were subsequently analyzed. The pivotal trials were mostly randomized (80%) and blinded (69.3%). Biomarkers (41.1%) and clinical outcomes (42.1%) were commonly utilized as primary efficacy endpoints. Analysis of the use of clinical trial design elements across trials that utilized biomarkers, clinical outcomes, or composite endpoints did not reveal statistically significant differences. The choice of primary efficacy endpoint varied by the drug’s therapeutic area, approval pathway, and whether the indicated disease etiology was well defined. For example, biomarkers were commonly selected as primary efficacy endpoints in hematology drug approvals (70.6%), whereas clinical outcomes were commonly selected in neurology drug approvals (69.6%). Further, if the disease etiology was well defined, biomarkers were more commonly used as primary efficacy endpoints in pivotal trials (44.7%) than if the disease etiology was not well defined (27.3%). Discussion In the past 10 years, numerous novel drugs have been approved to treat non-oncologic rare diseases in various therapeutic areas. To demonstrate their efficacy for regulatory approval, biomarkers and clinical outcomes were commonly utilized as primary efficacy endpoints. Biomarkers were not only frequently used as surrogate efficacy endpoints in accelerated approvals, but also in traditionally approved rare disease drugs. The choice of primary efficacy endpoints varied by therapeutic area, approval pathway, and understanding of disease etiology.

Hong, Kyungwan [Rare Diseases Team, Office of New ↗

Combining cross-pivot flexures to generate improved kinematically equivalent flexure systems

In this work, we show that new kinematic equivalents with improved performance of standard flexure elements can be systematically synthesized by combination of cross-pivot flexures. Cross-pivot flexures provide a unique feature of kinematic stability under both high loading and large displacement conditions which can be exploited to synthesize a range of kinematic equivalents to standard flexure elements which retain much greater stiffness, load capacity and range capacity than the traditional elements. Cross-pivot synthetic elements provide a means to expand the performance of a large range of flexure-based structures including motion stages, manufacturing equipment and optical systems. This could result in better data collection, smaller systems, and less distortion in operation.

42 ENGINEERING↗

A Data-Driven Pivot-Point-Based Time-Series Feeder Load Disaggregation Method

The load profile at a feeder-head is usually known to utility engineers while the nodal load profiles are not. However, the nodal load profiles are increasingly important for conducting time-series analysis in distribution systems. Therefore, in this paper, we present a pivot-point based, two-stage feeder load disaggregation algorithm using smart meter data. The two stages are load profile selection (LPS) and load profile allocation (LPA). In the LPS stage, a random load profile selection process is first executed to meet the load diversity requirement. Then, a few pairs of pivot points are selected as the matching targets. After that, a matching algorithm will run repetitively to select one load profile at a time for matching the reference load profile at the pivot points. In the LPA stage, the LPS selected load profiles are allocated to each load node on the feeder considering distribution transformer loading limits, load composition, and square-footage. The proposed method is validated using actual data collected in a North Carolina service area. Finally, simulation results show that the proposed method can generate a unique load shape for each load node while match the shape of their aggregated profile with the actual feeder head load profile.

42 ENGINEERING↗

Human protein synthesis requires aminoacyl-tRNA pivoting during proofreading

Abstract Rigorous studies have characterized the aa-tRNA selection mechanism in bacteria, which is essential for maintaining translational fidelity. Recent investigations have identified critical distinctions in humans, such as the requirement of subunit rolling and a tenfold slower proofreading step. Although these studies captured key intermediates involved in tRNA selection, they did not elucidate the transitions of aa-tRNA between intermediates. Through diverse structure-based simulations, we simulated 1856 aa-tRNA accommodation events into the human ribosomal A site. Here we show the requirement for a distinct ~30° pivoting of aa-tRNA about the anticodon stem within the accommodation corridor. This pivoting is crucial for navigating the crowded accommodation corridor, which becomes more constrained due to subunit rolling. Subunit rolling-dependent crowding increases the steric contributions of the accommodation corridor during aa-tRNA accommodation, consistent with the tenfold reduction in the rate of proofreading. Furthermore, we show that eEF1A interacts with the accommodating aa-tRNA through conserved basic residues, limiting premature aa-tRNA dissociation from the A site. These findings provide a structural description of the human aa-tRNA selection process and demonstrate that the aa-tRNA alignment relative to the ribosomal catalytic sites is a critical determinant of translational fidelity.

Science & Technology - Other Topics↗

Pivotal Role of Cloud‐Planetary Boundary Layer Coupling to Explain Contrasting Aerosol‐Cloud Relationships

The radiative effect of aerosol on cloud albedo via altering cloud droplet effective radius (r e ) is a major uncertainty in the Earth's climate system. Remote sensing studies have reported either negative or positive relationships between re and aerosol number concentration (N a ) or other aerosol proxies. However, there are much fewer in situ observational evidences and physical explanation remains elusive for the contrasting N a -r e relationships. Here we quantify the N a -r e relationship by using in situ aircraft measurements, together with a re decomposition method. Our analysis reveals that the cloud-planetary boundary layer (PBL) coupling plays a pivotal role on the N a -r e relationship. Quantitative r e decomposition indicates that the contrasting N a -r e relationships in two cloud-PBL coupling regimes result from different balances of four distinct aspects. The widely recognized number effect may be outweighed by the joint effects of the remaining three that have been rarely investigated and largely ignored in N a -r e parameterizations.

54 ENVIRONMENTAL SCIENCES↗

Rice NIN-LIKE PROTEIN 4 plays a pivotal role in nitrogen use efficiency

Nitrogen (N) is one of the key essential macronutrients that affects rice growth and yield. Inorganic N fertilizers are excessively used to boost yield and generate serious collateral environmental pollution. Therefore, improving crop N use efficiency (NUE) is highly desirable and has been a major endeavour in crop improvement. However, only a few regulators have been identified that can be used to improve NUE in rice to date. Here we show that the rice NIN-like protein 4 (OsNLP4) significantly improves the rice NUE and yield. Field trials consistently showed that loss-of-OsNLP4 dramatically reduced yield and NUE compared with wild type under different N regimes. In contrast, the OsNLP4 overexpression lines remarkably increased yield by 30% and NUE by 47% under moderate N level compared with wild type. Transcriptomic analyses revealed that OsNLP4 orchestrates the expression of a majority of known N uptake, assimilation and signalling genes by directly binding to the nitrate-responsive cis-element in their promoters to regulate their expression. Moreover, overexpression of OsNLP4 can recover the phenotype of Arabidopsis nlp7 mutant and enhance its biomass. Our results demonstrate that OsNLP4 plays a pivotal role in rice NUE and sheds light on crop NUE improvement.

54 ENVIRONMENTAL SCIENCES↗

A new upper bound for the growth factor in Gaussian elimination with complete pivoting

Abstract The growth factor in Gaussian elimination measures how large the entries of an LU factorization can be relative to the entries of the original matrix. It is a key parameter in error estimates, and one of the most fundamental topics in numerical analysis. We produce an upper bound of for the growth factor in Gaussian elimination with complete pivoting — the first improvement upon Wilkinson's original 1961 bound of .

Bisain, Ankit [Department of Mathematics Massachus↗

Inverters: A Pivotal Role in PV Generated Electricity

This presentation discusses the pivotal role inverters play in PV generated electricity. Topics include: the inverter as the center of the system--increasingly becoming the brain, with more features and capabilities (hybrid systems, safety, islanding, monitoring, etc.); increasing inverter-based generated electricity associated with many renewable energy sources; increased dependence for grid support and forming capability; communication within the grid and security increasingly required; increasing complexity leads to more chances to fail; as in most PV segments, there is cost reduction pressure, which makes it more challenging to keep the reliability high.

ENGINEERING,SOLAR ENERGY↗

Pivotal Roles of Triple Screening-Topological, Electrostatic, and Hydrodynamic-On Dynamics in Semidilute Polyelectrolyte Solutions

For semidilute polyelectrolyte solutions, it is generally assumed that topological, electrostatic, and hydrodynamic interactions are screened (called triple screening). Despite a large body of research focused on polyelectrolyte solutions, the concept of triple screening has never been rigorously verified. In this work, we test the concept by probing concentration fluctuations in aqueous solutions containing a well-studied polyelectrolyte, sodium poly(styrenesulfonate) (NaPSS) with neutron scattering, theory, and molecular dynamics simulations. Neutron spin–echo (NSE) and small-angle neutron scattering (SANS) data from semidilute solutions of NaPSS are presented at different polymer and salt (NaCl) concentrations. A combined theory for structure (J. Chem. Phys. 105, 5183 (1996)) and dynamics (J. Chem. Phys. 107, 2619 (1997)), which captures effects of hydrodynamic, topological, and electrostatic screening, is used to interpret the experimental results. Here, the theory quantitatively predicts the decay rate obtained from the NSE measurements while capturing the shape and concentration dependencies of the polyelectrolyte peak observed in the SANS spectra. Detailed comparisons of the theory and the experiments reveal that the wavevector-dependent decay rate of concentration fluctuations in semidilute solutions of polyelectrolytes is dictated by the screening of hydrodynamic, topological, and electrostatic interactions. This conclusion is corroborated by coarse-grained molecular dynamics simulations, executed without any hydrodynamic interactions, which fail to capture the correct wavevector dependence of the decay rate. These results highlight that the theories based on the concept of triple screening provide a quantitative framework for predicting a relation between the structure and dynamics of polyelectrolyte solutions.

37 INORGANIC, ORGANIC, PHYSICAL, AND ANALYTICAL CH↗

Combining Remotely Sensed Evapotranspiration and an Agroecosystem Model to Estimate Center‐Pivot Irrigation Water Use at High Spatio‐Temporal Resolution

Abstract Estimating irrigation water use accurately is critical for sustainable irrigation and studying terrestrial water cycle in irrigated croplands. However, irrigation is not monitored in most places, and current estimations of irrigation water use has coarse spatial and/or temporal resolutions. This study aims to estimate irrigation water use at the daily and field scale through the proposed model‐data fusion framework, which is achieved by particle filtering with two configurations (concurrent, CON, and sequential, SEQ) by assimilating satellite‐based evapotranspiration (ET) observations into an advanced agroecosystem model, ecosys . Two types of experiments using synthetic and real ET observations were conducted to study the efficacy of the proposed framework for estimating irrigation water use at the irrigated fields in eastern and western Nebraska, United States. The experiments using synthetic ET observations indicated that, for two major sources of uncertainties of ET difference between observations and model simulations, which are bias and noise, noise had larger impacts on degrading the estimation performance of irrigation water use than bias. For the experiments using real ET observations, monthly and annual estimations of irrigation water use matched well with farmer irrigation records, with Pearson correlation coefficient ( r ) around 0.80 and 0.50, respectively. Although detecting daily irrigation records was very challenging, our method still gave a good performance with RMSE, BIAS, and r around 2.90, 0.03, and 0.4 mm/d, respectively. Our proposed model‐data fusion framework for estimating irrigation water use at high spatio‐temporal resolution could contribute to regional water management, sustainable irrigation, and better tracking terrestrial water cycle.

Environmental Sciences & Ecology↗

Durability Research Is Pivotal for Perovskite Photovoltaics

Metal halide perovskite solar cells have shown promising power conversion efficiencies, but commercialization requires that decent durability is also demonstrated. Under normal operation, solar cells are subject to a complex combination of stressors, such as visible light, ultraviolet light, heat, humidity, mechanical stress and electric potential, which complicates the understanding of failure mechanisms. Existing stress tests do not act as a time machine. In new materials systems such as perovskite photovoltaics, the tests have no known relationship to field service. In this Perspective we recommend following a durability learning cycle that interleaves photovoltaic module engineering with field testing; accelerated testing; and preconditioning and performance engineering. We advocate for field testing to demonstrate real-world performance and identify field-relevant failure modes, and urge the community to develop accelerated and qualification tests that account for device metastability, variations in material composition and different/various processing methods. In conclusion, these practices are more difficult, but more important, than the simple pursuit of higher initial efficiencies.

14 SOLAR ENERGY↗

Pivotal role of organic adsorbates for the creation of catalytic sites during dry reforming of methane

Inadvertent factors can sometimes be crucial for synthesis of catalysts. The use of polyalcohols is common in the synthesis of heterogeneous catalysts. Interactions between alcohols and heterogeneous catalysts have been shown to induce surface reconstructions that greatly impact catalytic performance. Thus, traces of these alcohol functionalities on the as-synthesized catalysts, combined with heat treatment, could be critical in the generation of catalytic sites. Here, we show that during the synthesis of a Ni–Mo/MgO catalyst using a polyol process, residual ethylene glycol (EG) on the surface plays a significant role in the generation of catalytic sites for dry reforming of methane (DRM). The as-synthesized catalyst presents dispersed cationic Ni. Under DRM reaction conditions, the presence of EG, and H2 generated in situ, promote the generation of co-localized Ni–Mo nanoparticles (NPs). Greater amount of EG in the as-synthesized catalyst prevented sintering, leading to better catalyst stability and higher rates. If the residual EG remaining post-synthesis is removed through calcination, before conducting DRM, NiO NPs are formed and the material is completely inactive for catalyzing the reaction. When using a different support, denoted MgO*, EG also proved indispensable to generate active sites, although Ni–Mo co-localization was not evident, and a combination of DRM-related species was needed to activate the catalyst, not just H2. This work systematically uncovers how the interactions between organic adsorbates, the supported metals and the catalyst support dictate the creation of catalytic active sites.

Polo Garzon, Felipe [ORNL] (ORCID:0000000265076183↗