158 research outputs found
The experience of âmedicine companionsâ to support adherence to antiretroviral therapy: quantitative and qualitative data from a trial population in Uganda
Good adherence is critical for antiretroviral therapy (ART) in sub-Saharan Africa. We report on the characteristics of medicine companions (MCs) chosen by Ugandan patients enrolling on ART, and on how MCs were chosen, and what roles they played. Baseline data on MCs of 1453 participants in a randomized controlled trial comparing facility and home-based delivery of ART in Jinja, Uganda were analyzed. Textual data on experience with MCs were collected through in-depth interviews among a subsample of 40 trial participants equally divided by sex and trial arm. Significantly more women (71%) than men (29%) were recruited. The majority (75%) of women participants were either widowed (51%) or separated or divorced (24%), whereas most of the men (66%) were married. Women were most likely to choose a child as their MC while men were most likely to choose their spouse; 41% of women chose an MC under 21 compared with only 14% of men. Only 31% of married women chose their husband, compared with 66% of married men who chose their wife. Qualitative interviews suggested MCs proved useful for reminding and other supportive tasks in the first three months but were generally less essential by six months and beyond. Convenience, reliability, and trust were key considerations in choosing an MC. Children provided the only alternative for many unmarried women, but even some married women felt children made more reliable MCs than husbands. Participants who had disclosed their serostatus usually received drug-taking reminders from multiple household members. One participant in the qualitative sample with poor family relations delayed starting treatment due to unwillingness to identify an MC. MCs were generally welcome and useful in supporting early adherence. However, disclosure to an MC should not be a condition of obtaining treatment
Disposition of docosahexaenoic acid-paclitaxel, a novel taxane, in blood: in vitro and clinical pharmacokinetic studies
PURPOSE: Docosahexaenoic acid-paclitaxel is as an inert prodrug composed
of the natural fatty acid DHA covalently linked to the C2'-position of
paclitaxel (M. O. Bradley et al., Clin. Cancer Res., 7: 3229-3238, 2001).
Here, we examined the role of protein binding as a determinant of the
pharmacokinetic behavior of DHA-paclitaxel. EXPERIMENTAL DESIGN: The blood
distribution of DHA-paclitaxel was studied in vitro using equilibrium
dialysis and in 23 cancer patients receiving the drug as a 2-h i.v.
infusion (dose, 200-1100 mg/m(2)). RESULTS: In vitro, DHA-paclitaxel was
found to bind extensively to human plasma (99.6 +/- 0.057%). The binding
was concentration independent (P = 0.63), indicating a nonspecific,
nonsaturable process. The fraction of unbound paclitaxel increased from
0.052 +/- 0.0018 to 0.055 +/- 0.0036 (relative increase, 6.25%; P = 0.011)
with an increase in DHA-paclitaxel concentration (0-1000 microg/ml),
suggesting weakly competitive drug displacement from protein-binding
sites. The mean (+/- SD) area under the curve of unbound paclitaxel
increased nonlinearly with dose from 0.089 +/- 0.029 microg.h/ml (at 660
mg/m(2)) to 0.624 +/- 0.216 microg.h/ml (at 1100 mg/m(2)), and was
associated with the dose-limiting neutropenia in a maximum-effect model
(R(2) = 0.624). A comparative analysis indicates that exposure to
Cremophor EL and unbound paclitaxel after DHA-paclitaxel (at 1100 mg/m(2))
is similar to that achieved with paclitaxel on clinically relevant dose
schedules. CONCLUSIONS: Extensive binding to plasma proteins may explain,
in part, the unique pharmacokinetic profile of DHA-paclitaxel described
previously with a small volume of distribution ( approximately 4 liters)
and slow systemic clearance ( approximately 0.11 liters/h)
Gelijke behandeling: oordelen en commentaar 2004
bookFDR De bescherming van fundamentele rechten in een integrerend Europa ou
Taenia solium Cysticercosis, Irian Jaya, Indonesia
Centers for Disease Control and Prevention, Toni, Wandra ; Akira, Ito ; Hiroshi, Yamasaki ; Thomas, Suroso ; Sri S. Margono, Emerging Infectious Diseases, 9(7), 2003, 884-885.
publishe
Grain Surface Models and Data for Astrochemistry
AbstractThe cross-disciplinary field of astrochemistry exists to understand the formation, destruction, and survival of molecules in astrophysical environments. Molecules in space are synthesized via a large variety of gas-phase reactions, and reactions on dust-grain surfaces, where the surface acts as a catalyst. A broad consensus has been reached in the astrochemistry community on how to suitably treat gas-phase processes in models, and also on how to present the necessary reaction data in databases; however, no such consensus has yet been reached for grain-surface processes. A team of âŒ25 experts covering observational, laboratory and theoretical (astro)chemistry met in summer of 2014 at the Lorentz Center in Leiden with the aim to provide solutions for this problem and to review the current state-of-the-art of grain surface models, both in terms of technical implementation into models as well as the most up-to-date information available from experiments and chemical computations. This review builds on the results of this workshop and gives an outlook for future directions
The Sound Generated by Mid-Ocean Ridge Black Smoker Hydrothermal Vents
Hydrothermal flow through seafloor black smoker vents is typically turbulent and vigorous, with speeds often exceeding 1 m/s. Although theory predicts that these flows will generate sound, the prevailing view has been that black smokers are essentially silent. Here we present the first unambiguous field recordings showing that these vents radiate significant acoustic energy. The sounds contain a broadband component and narrowband tones which are indicative of resonance. The amplitude of the broadband component shows tidal modulation which is indicative of discharge rate variations related to the mechanics of tidal loading. Vent sounds will provide researchers with new ways to study flow through sulfide structures, and may provide some local organisms with behavioral or navigational cues
Investigations of the Mars Upper Atmosphere with ExoMars Trace Gas Orbiter
The Martian mesosphere and thermosphere, the region above about 60 km, is not the primary target of the ExoMars 2016 mission but its Trace Gas Orbiter (TGO) can explore it and address many interesting issues, either in-situ during the aerobraking period or remotely during the regular mission. In the aerobraking phase TGO peeks into thermospheric densities and temperatures, in a broad range of latitudes and during a long continuous period. TGO carries two instruments designed for the detection of trace species, NOMAD and ACS, which will use the solar occultation technique. Their regular sounding at the terminator up to very high altitudes in many different molecular bands will represent the first time that an extensive and precise dataset of densities and hopefully temperatures are obtained at those altitudes and local times on Mars. But there are additional capabilities in TGO for studying the upper atmosphere of Mars, and we review them briefly. Our simulations suggest that airglow emissions from the UV to the IR might be observed outside the terminator. If eventually confirmed from orbit, they would supply new information about atmospheric dynamics and variability. However, their optimal exploitation requires a special spacecraft pointing, currently not considered in the regular operations but feasible in our opinion. We discuss the synergy between the TGO instruments, specially the wide spectral range achieved by combining them. We also encourage coordinated operations with other Mars-observing missions capable of supplying simultaneous measurements of its upper atmosphere
A review of diagnostic and functional imaging in headache
The neuroimaging of
headache patients has revolutionised
our understanding of the pathophysiology
of primary headaches and provided
unique insights into these syndromes.
Modern imaging studies
point, together with the clinical picture,
towards a central triggering
cause. The early functional imaging
work using positron emission
tomography shed light on the genesis
of some syndromes, and has
recently been refined, implying that
the observed activation in migraine
(brainstem) and in several trigeminal-autonomic headaches (hypothalamic
grey) is involved in the pain
process in either a permissive or
triggering manner rather than simply
as a response to first-division nociception
per se. Using the advanced
method of voxel-based morphometry,
it has been suggested that there
is a correlation between the brain
area activated specifically in acute
cluster headache â the posterior
hypothalamic grey matter â and an
increase in grey matter in the same
region. No structural changes have
been found for migraine and medication
overuse headache, whereas
patients with chronic tension-type
headache demonstrated a significant
grey matter decrease in regions
known to be involved in pain processing.
Modern neuroimaging thus
clearly suggests that most primary
headache syndromes are predominantly
driven from the brain, activating
the trigeminovascular reflex and
needing therapeutics that act on both
sides: centrally and peripherally
Orbital Observations of Dust Lofted by Daytime Convective Turbulence
Over the past several decades, orbital observations of lofted dust have revealed the importance of mineral aerosols as a climate forcing mechanism on both Earth and Mars. Increasingly detailed and diverse data sets have provided an ever-improving understanding of dust sources, transport pathways, and sinks on both planets, but the role of dust in modulating atmospheric processes is complex and not always well understood. We present a review of orbital observations of entrained dust on Earth and Mars, particularly that produced by the dust-laden structures produced by daytime convective turbulence called âdust devilsâ. On Earth, dust devils are thought to contribute only a small fraction of the atmospheric dust budget; accordingly, there are not yet any published accounts of their occurrence from orbit. In contrast, dust devils on Mars are thought to account for several tens of percent of the planetâs atmospheric dust budget; the literature regarding martian dust devils is quite rich. Because terrestrial dust devils may temporarily contribute significantly to local dust loading and lowered air quality, we suggest that martian dust devil studies may inform future studies of convectively-lofted dust on Earth
Measurement of the cross section for isolated-photon plus jet production in pp collisions at âs=13 TeV using the ATLAS detector
The dynamics of isolated-photon production in association with a jet in protonâproton collisions at a centre-of-mass energy of 13 TeV are studied with the ATLAS detector at the LHC using a dataset with an integrated luminosity of 3.2 fbâ1. Photons are required to have transverse energies above 125 GeV. Jets are identified using the anti- algorithm with radius parameter and required to have transverse momenta above 100 GeV. Measurements of isolated-photon plus jet cross sections are presented as functions of the leading-photon transverse energy, the leading-jet transverse momentum, the azimuthal angular separation between the photon and the jet, the photonâjet invariant mass and the scattering angle in the photonâjet centre-of-mass system. Tree-level plus parton-shower predictions from Sherpa and Pythia as well as next-to-leading-order QCD predictions from Jetphox and Sherpa are compared to the measurements
- âŠ