5,296 research outputs found

    Quantifying Isoniazid Levels in Small Hair Samples: A Novel Method for Assessing Adherence during the Treatment of Latent and Active Tuberculosis.

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    BackgroundTuberculosis (TB) is the leading cause of death from an infectious pathogen worldwide and the most prevalent opportunistic infection in people living with HIV. Isoniazid preventive therapy (IPT) reduces the incidence of active TB and reduces morbidity and mortality in HIV-infected patients independently of antiretroviral therapy. However, treatment of latent or active TB is lengthy and inter-patient variability in pharmacokinetics and adherence common. Current methods of assessing adherence to TB treatment using drug levels in plasma or urine assess short-term exposure and pose logistical challenges. Drug concentrations in hair assess long-term exposure and have demonstrated pharmacodynamic relevance in HIV.MethodsA large hair sample from a patient with active TB was obtained for assay development. Methods to pulverize hair and extract isoniazid were optimized and then the drug detected by liquid chromatography/ tandem mass spectrometry (LC/MS-MS). The method was validated for specificity, accuracy, precision, recovery, linearity and stability to establish the assay's suitability for therapeutic drug monitoring (TDM). Hair samples from patients on directly-observe isoniazid-based latent or active TB therapy from the San Francisco Department of Public Health TB clinic were then tested.ResultsOur LC/MS-MS-based assay detected isoniazid in quantities as low as 0.02ng/mg using 10-25 strands hair. Concentrations in spiked samples demonstrated linearity from 0.05-50ng/mg. Assay precision and accuracy for spiked quality-control samples were high, with an overall recovery rate of 79.5%. In 18 patients with latent or active TB on treatment, isoniazid was detected across a wide linear dynamic range.ConclusionsAn LC-MS/MS-based assay to quantify isoniazid levels in hair with performance characteristics suitable for TDM was developed and validated. Hair concentrations of isoniazid assess long-term exposure and may be useful for monitoring adherence to latent or active TB treatment in the setting of HIV

    Implementing Information System Innovations to Manage Biosecurity Issues in Australian Food NetChains

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    Tracking and tracing systems are being demanded by customers such as the major Australian supermarket chains, superior food service chains and globally in export markets such as the European Union and Asia. This includes the ability to track products as they move to downstream customers and to traceback where products have been sourced for feedback and to resolve problems. To continue to access these global premium priced markets Australian food organisations need to ensure they meet changing customer requirements. Traditionally information communication technologies to provide tracking and tracing systems have been set up for larger business and industry sectors that warrant the costs of development. Small business cannot always afford to invest in the infrastructure to establish through chain and industry wide netchain based systems. This problem is compounded where businesses are fragmented and spread over large geoographical areas even if they have similar requirements. An action learning approach was taken to identify what is needed in setting up tracking and tracing systems to address biosecurity issues in three small business based netchains (livestock 'A' and fruits 'B' and 'C'). In the livestock 'A' sector fears of a global pandemic has heightened the need for tracking and traceablity processes, combined with preventative actions and rigorous bio-security protocols (e.g. traceability of traffic properties). For fruit 'B' and 'C' movements of produce across state and national borders requires phytosanitary certification to provide assurance to minimize or eradicate the spread of diseases and pests. Concerns or delays in tracking and tracing can result in perishable produce becoming unsalable. A system was identified to suit small businesses and those in niche market industries. The system was based on deployment through the internet. The system had to link in with existing business information systems and business methods, be reliable, able to be tailored to address biosecurity issues and effective in meeting customer requirements. Results presented compare the use of the tracking and tracing system across the three different sectors (animal and horticultural products) and states of Australia. Findings are presented on what was learnt in the process including: identifying business in chains and networks to work collaboratively with; catalysts needed to get commitment to change; and support systems needed for successful implementation across multiple small businesses linked in netchains

    Long-term Economic Implications of Brexit

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    Over the long term (i.e. 10+ years), most economists predict that the decision to leave the EU will have a negative impact on trade, labour mobility and investment.To date studies have concentrated on the UK as a whole. At the same time, they have tended to focus on the aggregate economic impact, with little assessment of the different impacts by sector.This report closes this gap by providing an inter-regional and multi-sectoral analysis of Brexit on Scotland and the rest of the UK.To undertake this analysis we examine the geographical pattern of Scottish international exports and identify the sectors most exposed to any changing trading relationship with the EU. We then make use of an inter-regional macroeconomic model of Scotland and the rest of the UK to examine the long-term impact on the Scottish economy.Our conclusion is that under all modelled scenarios, Brexit is predicted to have a negative impact on Scotlandā€™s economy. Based on the modelling and assumptions set out in the report, over the long-term a reduced level of trade is expected to result in Scottish GDP being between 2% and 5% lower than would otherwise be the case. The range of impacts is driven by the nature of any post-Brexit relationship between the UK and the EU ā€“ the stronger the economic integration with the EU, the smaller the negative impact.We also find that the impact on Scotland, whilst significant, is estimated to be smaller than for the UK as a whole.Our modelling suggests that ultimately, the size of the relative impact by sector depends on a complex interplay between the EU-export intensity of sectoral sales and how responsive particular sectors are to changes in competitiveness. We recommend that focus is now given to sectors that have close trading links with the EU ā€“ e.g. food & drink and some manufacturing sectors ā€“ to fully understand the particular issues facing them on a product-by-product basis. However, we also find that other sectors which at first glance may not be thought as immediately at risk from a change in the UKā€™s relationship with the EU ā€“ e.g. professional services ā€“ should also be considered. This analysis makes clear that Brexit is not going to be straightforward

    Evaluation of Super Slow Way Programme 2015 - 2017 [Final Report]

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    Developing Collaborative & Social Arts Practice: The Heart of Glass Research Partnership 2014ā€”2017

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    This is a report based on the first three years of the Heart of Glass programme. It presents findings from a qualitative evaluation. In response to the idea that Creative People and Places (CPP) is an action research project, findings have been fed back to the Heart of Glass team iteratively throughout the first three years. In this report, we draw together those findings, presenting a series of detailed case studies of commissioned projects, interviews with key stakeholders and Heart of Glass staff
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