20 research outputs found

    An adaptive phase II/III safety and efficacy randomized controlled trial of single day or three-day fixed-dose albendazole-ivermectin co-formulation versus albendazole for the treatment of Trichuris trichiura and other STH infections. ALIVE trial protocol

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    18 pĂĄginas, 2 tablas, 1 figura.Background: Soil-transmitted helminths (STH) are targeted for control through mass drug-administration campaigns to prevent morbidity affecting at-risk groups in endemic regions. Although broadly successful, the use of albendazole and mebendazole achieved variable progress, with deficiencies against Trichuris trichiura and a predictable low efficacy against Strongyloides stercoralis. Novel drug combinations offer a potential solution, providing they can be delivered safely and maintain efficacy against all STH species. Here we present the protocol of a clinical trial to evaluate a fixed-dose combination (FDC) tablet containing albendazole and ivermectin that will be compared against albendazole against STH. Methods: An adaptive phase II/III randomized controlled trial will be undertaken in STH endemic sites in Ethiopia, Kenya and Mozambique to evaluate an oral FDC of 400 mg albendazole and either 9- or 18 mg ivermectin. FDC will be administered as a single dose or single doses over three-consecutive days and assessed against a single dose of 400 mg albendazole. In the phase II trial, 126 T. trichiura-infected children weighting 15 to 45 kg will be treated in a dose-escalation manner to determine safety objectives. In the phase III trial, 1097 participants aged 5 to 18 years old infected with T. trichiura, hookworm and S. stercoralis will be recruited to determine safety and efficacy. The trial will be open-label with blinded outcome assessors. Cure rate measured 21-days after-treatment in duplicate Kato-Katz is the primary efficacy outcome. Secondary objectives include efficacy evaluation by quantitative polymerase chain reaction (PCR) as an outcome measurement, description of pharmacokinetic parameters, palatability and acceptability evaluations, and monitoring of anthelmintic resistance. Conclusions: This trial with registrational goals seeks to evaluate an innovative fixed-dose combination of albendazole and ivermectin co-formulated tablets, with the goal of providing an anthelmintic regimen with improved efficacy and spectrum of coverage against STH. ClinicalTrials.gov registration: NCT05124691 (18/11/2021)

    Revisiting diffusion models: portuguese integrated management Systems evolution

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    This paper aims to update and report the diffusion and forecasting models of Portuguese integrated management systems (IMSs) encompassing the ISO 9001, ISO 14001 and OHSAS 18001 standards (QES). A research method similar to that described by Cabecinhas et al. [1] was adopted. Data concerning the evolution of the amount of multiple MSs in Portugal (ranging from 1999 to 2016) was retrieved from a periodical Portuguese publication (BarĂłmetro da Certificação). The evolutionary behavior of the number of MSs over the years was studied adopting both the Gompertz and the Simple Logistic models. The results obtained by fitting the data to these models were dissected enabling a forecast for the forthcoming years. In opposition to the results of the original study (based on a higher percentage of extrapolated data) the data seem to be properly fitted by the Simple Logistic model. Similarly to the conclusions of the original study the diffusion throughout the years of the number of MSs presents an S-shaped behavior and the Gompertz model predicts a higher amount of IMSs at the saturation level (which is in line with the original conclusions).The authors would like to thank the collaboration of several certification entities. This work has been supported by FCT – Fundação para a CiĂȘncia e Tecnologia within the Project Scope: UID/CEC/00319/2019. MĂłnica Cabecinhas is supported by FCT Doctorate Grant Reference SFRH/BD/131932/2017. Pedro Domingues is supported by FCT Post-Doc Grant Reference SFRH/BPD/103322/2014

    Cherenkov Telescope Array Contributions to the 35th International Cosmic Ray Conference (ICRC2017)

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    List of contributions from the Cherenkov Telescope Array Consortium presented at the 35th International Cosmic Ray Conference, July 12-20 2017, Busan, Korea.Comment: Index of Cherenkov Telescope Array conference proceedings at the ICRC2017, Busan, Kore

    Safety of primary anastomosis following emergency left sided colorectal resection: an international, multi-centre prospective audit.

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    This is the peer reviewed version of the following article: group, T. E. S. o. C. c. (2018). "Safety of primary anastomosis following emergency left sided colorectal resection: an international, multi-centre prospective audit." Colorectal Disease 20(S6): 47-57., which has been published in final form at https://doi.org/10.1111/codi.1437. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived VersionsINTRODUCTION: Some evidence suggests that primary anastomosis following left sided colorectal resection in the emergency setting may be safe in selected patients, and confer favourable outcomes to permanent enterostomy. The aim of this study was to compare the major postoperative complication rate in patients undergoing end stoma vs primary anastomosis following emergency left sided colorectal resection. METHODS: A pre-planned analysis of the European Society of Coloproctology 2017 audit. Adult patients (> 16 years) who underwent emergency (unplanned, within 24 h of hospital admission) left sided colonic or rectal resection were included. The primary endpoint was the 30-day major complication rate (Clavien-Dindo grade 3 to 5). RESULTS: From 591 patients, 455 (77%) received an end stoma, 103 a primary anastomosis (17%) and 33 primary anastomosis with defunctioning stoma (6%). In multivariable models, anastomosis was associated with a similar major complication rate to end stoma (adjusted odds ratio for end stoma 1.52, 95%CI 0.83-2.79, P = 0.173). Although a defunctioning stoma was not associated with reduced anastomotic leak (12% defunctioned [4/33] vs 13% not defunctioned [13/97], adjusted odds ratio 2.19, 95%CI 0.43-11.02, P = 0.343), it was associated with less severe complications (75% [3/4] with defunctioning stoma, 86.7% anastomosis only [13/15]), a lower mortality rate (0% [0/4] vs 20% [3/15]), and fewer reoperations (50% [2/4] vs 73% [11/15]) when a leak did occur. CONCLUSIONS: Primary anastomosis in selected patients appears safe after left sided emergency colorectal resection. A defunctioning stoma might mitigate against risk of subsequent complications

    CTA Contributions to the 34th International Cosmic Ray Conference (ICRC2015)

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    List of contributions from the CTA Consortium presented at the 34th International Cosmic Ray Conference, 30 July - 6 August 2015, The Hague, The Netherlands.Comment: Index of CTA conference proceedings at the ICRC2015, The Hague (The Netherlands). v1: placeholder with no arXiv links yet, to be replaced once individual contributions have been all submitted; v2: final with arXiv links to all CTA contributions and full author lis
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