144 research outputs found

    The Effect of Azithromycin on Ivermectin Pharmacokinetics—A Population Pharmacokinetic Model Analysis

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    This paper describes the use of a modeling and simulation approach to explore a reported pharmacokinetic interaction between two drugs (ivermectin and azithromycin), which along with albendazole, are being developed for combination use in neglected tropical diseases. This approach is complementary to more traditional pharmacokinetic and safety studies that need to be conducted to support combined use of different health interventions. A mathematical model of ivermectin pharmacokinetics was created and used to simulate multiple trials, and the probability of certain outcomes (very high peak blood ivermectin levels when given in combination) was determined. All simulated peak blood levels were within ranges known to be safe and well tolerated. Additional field studies are needed to confirm these findings

    Haemostatics in surgery and our experience in the enucleoresection of renal cell carcinoma

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    <p>Abstract</p> <p>Background</p> <p>30 patients, with T1 renal cell carcinomas (RCC) who underwent open enucleoresection of the tumour, were randomized to the use of a topical haemostatic agent (Floseal) or to an infrared-sapphire coagulator (ISC), to compare their efficacy in achieving haemostasis. Methods: Successful intra-operative haemostasis, intra- and post-operative bleeding, operative time, hospital discharge were evaluated.</p> <p>Results</p> <p>Statistically higher rates of successful haemostasis and shorter time-to-haemostasis (8,1 vs 12,9 min) were observed in the FloSeal group (p < 0.001 both). Patients operative time was not different between Group 1 vs 2 (58.7 ± 12 vs 62.4 ± 15; p > 0.05). The average blood loss during surgery was less (60 +/- 25.5 mL) for the FloSeal group than for the ISC group (85 +/- 40.5 mL) (p < 0.05). Postoperative blood loss was 25 +/- 5 mL and 40 +/- 45 mL for Floseal and ISC respectively, (p < 0.05). Length of the postoperative hospital discharge was 2.5 +/- 1.2 days for FloSeal group and 3.5 +/- 1.3 for the Group 2 (p < 0.05). No major immediate or delayed complications were observed in either Groups.</p> <p>Conclusions</p> <p>The use of Floseal and ISC offer a safe and efficacy haemostasis in the enucleoresection of RCC. Moreover, our results show a less intra-operative and post-operative blood loss as well as a shorter time to haemostasis of Floseal in respect to ISC.</p

    A question of fit:cultural and individual differences in interpersonal justice perceptions

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    This study examined the link between employees’ adult attachment orientations and perceptions of line managers’ interpersonal justice behaviors, and the moderating effect of national culture (collectivism). Participants from countries categorized as low collectivistic (N = 205) and high collectivistic (N = 136) completed an online survey. Attachment anxiety and avoidance were negatively related to interpersonal justice perceptions. Cultural differences did not moderate the effects of avoidance. However, the relationship between attachment anxiety and interpersonal justice was non-significant in the Southern Asia (more collectivistic) cultural cluster. Our findings indicate the importance of ‘fit’ between cultural relational values and individual attachment orientations in shaping interpersonal justice perceptions, and highlight the need for more non-western organizational justice research

    Knowledge systems, health care teams, and clinical practice: a study of successful change

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    Clinical teams are of growing importance to healthcare delivery, but little is known about how teams learn and change their clinical practice. We examined how teams in three US hospitals succeeded in making significant practice improvements in the area of antimicrobial resistance. This was a qualitative cross-case study employing Soft Knowledge Systems as a conceptual framework. The purpose was to describe how teams produced, obtained, and used knowledge and information to bring about successful change. A purposeful sampling strategy was used to maximize variation between cases. Data were collected through interviews, archival document review, and direct observation. Individual case data were analyzed through a two-phase coding process followed by the cross-case analysis. Project teams varied in size and were multidisciplinary. Each project had more than one champion, only some of whom were physicians. Team members obtained relevant knowledge and information from multiple sources including the scientific literature, experts, external organizations, and their own experience. The success of these projects hinged on the teams' ability to blend scientific evidence, practical knowledge, and clinical data. Practice change was a longitudinal, iterative learning process during which teams continued to acquire, produce, and synthesize relevant knowledge and information and test different strategies until they found a workable solution to their problem. This study adds to our understanding of how teams learn and change, showing that innovation can take the form of an iterative, ongoing process in which bits of K&I are assembled from multiple sources into potential solutions that are then tested. It suggests that existing approaches to assessing the impact of continuing education activities may overlook significant contributions and more attention should be given to the role that practical knowledge plays in the change process in addition to scientific knowledge

    Acoustic telemetry reveals strong spatial preferences and mixing during successive spawning periods in a partially migratory common bream population

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    Partial migration, whereby a population comprises multiple behavioural phenotypes that each have varying tendencies to migrate, is common among many animals. Determining the mechanisms by which these phenotypes are maintained is important for understanding their roles in population structure and stability. The aim here was to test for the temporal and spatial consistency of migratory phenotypes in a common bream Abramis brama (‘bream’) population, and then determine their social preferences and extent of mixing across three successive annual spawning periods. The study applied passive acoustic telemetry to track the movements of bream in the River Bure system of the Norfolk Broads, a lowland wetland comprising highly connected riverine and lacustrine habitats. Analyses revealed that individual migratory phenotype was highly consistent across the three years, but this was not predicted by fish sex or length at tagging. During the annual spawning periods, network analyses identified off-channel areas visited by both resident and migrant fish that, in non-spawning periods, were relatively independent in their space use. Within these sites, the co-occurrence of bream was non-random, with individuals forming more preferred and avoided associations than expected by chance. These associations were not strongly predicted by similarity in fish length, sex or behavioural phenotype, indicating that the resident and migrant phenotypes mixed during their annual spawning periods. The results suggested these different phenotypes, with spatially distinct resource use in non-spawning periods, comprised a single metapopulation, with this having important implications for the management of this wetland resource

    Sugarcane (Saccharum X officinarum): A Reference Study for the Regulation of Genetically Modified Cultivars in Brazil

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    Global interest in sugarcane has increased significantly in recent years due to its economic impact on sustainable energy production. Sugarcane breeding and better agronomic practices have contributed to a huge increase in sugarcane yield in the last 30 years. Additional increases in sugarcane yield are expected to result from the use of biotechnology tools in the near future. Genetically modified (GM) sugarcane that incorporates genes to increase resistance to biotic and abiotic stresses could play a major role in achieving this goal. However, to bring GM sugarcane to the market, it is necessary to follow a regulatory process that will evaluate the environmental and health impacts of this crop. The regulatory review process is usually accomplished through a comparison of the biology and composition of the GM cultivar and a non-GM counterpart. This review intends to provide information on non-GM sugarcane biology, genetics, breeding, agronomic management, processing, products and byproducts, as well as the current technologies used to develop GM sugarcane, with the aim of assisting regulators in the decision-making process regarding the commercial release of GM sugarcane cultivars

    Euclid preparation. TBD. Forecast impact of super-sample covariance on 3x2pt analysis with Euclid

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    Deviations from Gaussianity in the distribution of the fields probed by large-scale structure surveys generate additional terms in the data covariance matrix, increasing the uncertainties in the measurement of the cosmological parameters. Super-sample covariance (SSC) is among the largest of these non-Gaussian contributions, with the potential to significantly degrade constraints on some of the parameters of the cosmological model under study -- especially for weak lensing cosmic shear. We compute and validate the impact of SSC on the forecast uncertainties on the cosmological parameters for the Euclid photometric survey, obtained with a Fisher matrix analysis, both considering the Gaussian covariance alone and adding the SSC term -- computed through the public code PySSC. The photometric probes are considered in isolation and combined in the `3×\times2pt' analysis. We find the SSC impact to be non-negligible -- halving the Figure of Merit of the dark energy parameters (w0w_0, waw_a) in the 3×\times2pt case and substantially increasing the uncertainties on Ωm,0,w0\Omega_{{\rm m},0}, w_0, and σ8\sigma_8 for cosmic shear; photometric galaxy clustering, on the other hand, is less affected due to the lower probe response. The relative impact of SSC does not show significant changes under variations of the redshift binning scheme, while it is smaller for weak lensing when marginalising over the multiplicative shear bias nuisance parameters, which also leads to poorer constraints on the cosmological parameters. Finally, we explore how the use of prior information on the shear and galaxy bias changes the SSC impact. Improving shear bias priors does not have a significant impact, while galaxy bias must be calibrated to sub-percent level to increase the Figure of Merit by the large amount needed to achieve the value when SSC is not included.Comment: 22 pages, 13 figure

    The Long-Baseline Neutrino Experiment: Exploring Fundamental Symmetries of the Universe

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    Major update of previous version. This is the reference document for LBNE science program and current status. Chapters 1, 3, and 9 provide a comprehensive overview of LBNE's scientific objectives, its place in the landscape of neutrino physics worldwide, the technologies it will incorporate and the capabilities it will possess. 288 pages, 116 figuresMajor update of previous version. This is the reference document for LBNE science program and current status. Chapters 1, 3, and 9 provide a comprehensive overview of LBNE's scientific objectives, its place in the landscape of neutrino physics worldwide, the technologies it will incorporate and the capabilities it will possess. 288 pages, 116 figuresThe preponderance of matter over antimatter in the early Universe, the dynamics of the supernova bursts that produced the heavy elements necessary for life and whether protons eventually decay --- these mysteries at the forefront of particle physics and astrophysics are key to understanding the early evolution of our Universe, its current state and its eventual fate. The Long-Baseline Neutrino Experiment (LBNE) represents an extensively developed plan for a world-class experiment dedicated to addressing these questions. LBNE is conceived around three central components: (1) a new, high-intensity neutrino source generated from a megawatt-class proton accelerator at Fermi National Accelerator Laboratory, (2) a near neutrino detector just downstream of the source, and (3) a massive liquid argon time-projection chamber deployed as a far detector deep underground at the Sanford Underground Research Facility. This facility, located at the site of the former Homestake Mine in Lead, South Dakota, is approximately 1,300 km from the neutrino source at Fermilab -- a distance (baseline) that delivers optimal sensitivity to neutrino charge-parity symmetry violation and mass ordering effects. This ambitious yet cost-effective design incorporates scalability and flexibility and can accommodate a variety of upgrades and contributions. With its exceptional combination of experimental configuration, technical capabilities, and potential for transformative discoveries, LBNE promises to be a vital facility for the field of particle physics worldwide, providing physicists from around the globe with opportunities to collaborate in a twenty to thirty year program of exciting science. In this document we provide a comprehensive overview of LBNE's scientific objectives, its place in the landscape of neutrino physics worldwide, the technologies it will incorporate and the capabilities it will possess
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