Multi-Stakeholder Processes and Innovation Systems towards Science for impact

Multi_stakeholder processes (MSPs) have become an important phenomena in the work of many of the Science Groups and knowledge units of Wageningen UR. To realise ‘science for impact’ it is increasingly recognized that stakeholder engagement is a critical element. Much remains to be understood about their role and effectiveness in a wider context of politics, governance and societal change. There is clearly value to be gained from the efforts of Wageningen UR wide sharing and critical reflection processes. The CD&IC programme, Wageningen International, hosted a Critical Reflection Day, building on existing and past initiatives such as Own experiences, the Transition lab and deepening of Communities of Practice of action learning and ‘Telen met Toekomst’. The Critical Reflection Day was part of the three_week international course on 'Facilitating Multi_stakeholder Processes and Social Learning' attended by some 30 participants from all over the world. They facilitated and actively took part in the Critical Reflection Da

The influence of pregnancy on the pharmacokinetic properties of artemisinin combination therapy (ACT): a systematic review

Pregnancy has been reported to alter the pharmacokinetic properties of anti-malarial drugs, including the different components of artemisinin-based combination therapy (ACT). However, small sample sizes make it difficult to draw strong conclusions based on individual pharmacokinetic studies. The aim of this review is to summarize the evidence of the influence of pregnancy on the pharmacokinetic properties of different artemisinin-based combinations. A PROSPERO-registered systematic review to identify clinical trials that investigated the influence of pregnancy on the pharmacokinetic properties of different forms of ACT was conducted, following PRISMA guidelines. Without language restrictions, Medline/PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, LILACS, Biosis Previews and the African Index Medicus were searched for studies published up to November 2015. The following components of ACT that are currently recommend by the World Health Organization as first-line treatment of malaria in pregnancy were reviewed: artemisinin, artesunate, dihydroartemisinin, lumefantrine, amodiaquine, mefloquine, sulfadoxine, pyrimethamine, piperaquine, atovaquone and proguanil. The literature search identified 121 reports, 27 original studies were included. 829 pregnant women were included in the analysis. Comparison of the available studies showed lower maximum concentrations (Cmax) and exposure (AUC) of dihydroartemisinin, the active metabolite of all artemisinin derivatives, after oral administration of artemether, artesunate and dihydroartemisinin in pregnant women. Low day 7 concentrations were commonly seen in lumefantrine studies, indicating a low exposure and possibly reduced efficacy. The influence of pregnancy on amodiaquine and piperaquine seemed not to be clinically relevant. Sulfadoxine plasma concentration was significantly reduced and clearance rates were higher in pregnancy, while pyrimethamine and mefloquine need more research as no general conclusion can be drawn based on the available evidence. For atovaquone, the available data showed a lower maximum concentration and exposure. Finally, the maximum concentration of cycloguanil, the active metabolite of proguanil, was significantly lower, possibly compromising the efficacy. These findings suggest that reassessment of the dose of the artemisinin derivate and some components of ACT are necessary to ensure the highest possible efficacy of malaria treatment in pregnant women. However, for most components of ACT, data were insufficient and extensive research with larger sample sizes will be necessary to identify the exact influences of pregnancy on the pharmacokinetic properties of different artemisinin-based combinations. In addition, different clinical studies used diverse study designs with various reported relevant outcomes. Future pharmacokinetic studies could benefit from more uniform designs, in order to increase quality, robustness and effectiveness. CRD42015023756 (PROSPERO

Magnetostratigraphy-based astronomical tuning of the early Pliocene lacustrine sediments of Ptolemais (NW Greece) and bed-to-bed correlation with the marine record

Continental deposits from the early Pliocene lacustrine Ptolemais basin in NW Greece display rhythmical alternations of lignite and marl beds. Three parallel sections from this area are studied using magnetostratigraphy and cyclostratigraphy. The presence of the greater part of the Gilbert Chron enables the recognition of astronomical periodicities in the succession. Especially the precessional influence is evident, as it determines the lithological cycles. The continental Ptolemais composite section is correlated to the most recent astronomical time scale and thus to the marine reference section: the Rossello composite from Sicily [C.G. Langereis, F.J. Hilgen, The Rossello composite: a Mediterranean and global reference section for the Early to early Late Pliocene, Earth Planet. Sci. Lett. 104 (1991) 211-225] on a bed-to-bed scale. It is concluded that lignite corresponds to an insolation minimum (beige layer in the Rossello composite), and marl to an insolation maximum (grey layer in the Rossello composite). This implies a precipitation increase during insolation maxima in early Pliocene continental Greece. Ó 1998 Elsevier Science B.V. All rights reserved