502 research outputs found

    West Nile virus (WNv) human vaccine : from research to vaccination

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    This project will educate readers about the West Nile virus (WNv), and the vaccine research approaches currently underway. A narrative review used an instrument to synthesize WNv vaccine research studies, into an easy to understand format. Results indicated the instrument had a high magnitude of reliability (r = 0.90, p<0.0001). The size and frequency of future epidemics of the rare occurrence WNv is uncertain. Research for a WNv vaccine for humans is a responsible public health initiative. The rationale for preplanning a vaccination program is discussed as a future application of this research. The public expects preventative and therapeutic solutions to infectious diseases, and the project's conclusion indicates that for WNv this can be achieved

    Dose rationale and pharmacokinetics of dexmedetomidine in mechanically ventilated new-borns : impact of design optimisation

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    Purpose: There is a need for alternative analgosedatives such as dexmedetomidine in neonates. Given the ethical and practical difficulties, protocol design for clinical trials in neonates should be carefully considered before implementation. Our objective was to identify a protocol design suitable for subsequent evaluation of the dosing requirements for dexmedetomidine in mechanically ventilated neonates. Methods: A published paediatric pharmacokinetic model was used to derive the dosing regimen for dexmedetomidine in a first-in-neonate study. Optimality criteria were applied to optimise the blood sampling schedule. The impact of sampling schedule optimisation on model parameter estimation was assessed by simulation and re-estimation procedures for different simulation scenarios. The optimised schedule was then implemented in a neonatal pilot study. Results: Parameter estimates were more precise and similarly accurate in the optimised scenarios, as compared to empirical sampling (normalised root mean square error: 1673.1% vs. 13,229.4% and relative error: 46.4% vs. 9.1%). Most importantly, protocol deviations from the optimal design still allowed reasonable parameter estimation. Data analysis from the pilot group (n = 6) confirmed the adequacy of the optimised trial protocol. Dexmedetomidine pharmacokinetics in term neonates was scaled using allometry and maturation, but results showed a 20% higher clearance in this population compared to initial estimates obtained by extrapolation from a slightly older paediatric population. Clearance for a typical neonate, with a post-menstrual age (PMA) of 40 weeks and weight 3.4 kg, was 2.92 L/h. Extension of the study with 11 additional subjects showed a further increased clearance in pre-term subjects with lower PMA. Conclusions: The use of optimal design in conjunction with simulation scenarios improved the accuracy and precision of the estimates of the parameters of interest, taking into account protocol deviations, which are often unavoidable in this event-prone population

    Paired measurement of urinary creatinine in neonates based on a Jaffe and an enzymatic IDMS-traceable assay

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    BACKGROUND: Urinary creatinine can be quantified by Jaffe or enzymatic assays and is commonly used as denominator of urinary excretion of electrolytes or protein. Paired analysis in pediatric and adult samples documented inter-assay differences (up to 80%). We verified the interchangeability of two IDMS-traceable assays (Jaffe and enzymatic) for neonatal urine and report on neonatal urinary creatinine values using these IDMS-traceable methods. METHODS: Creatinine was measured in 84 neonatal urine samples from 46 neonates by an IDMS traceable Jaffe and enzymatic assay (Roche Diagnostics, Cobas c702 module). Creatinine values, differences in urinary creatinine and clinical characteristics were described and covariates of between assay difference were explored (Wilcoxon, Bland-Altman, correlation, multiple regression). RESULTS: Median Jaffe and enzymatic urinary creatinine concentrations were 9.25 (range 3.7-42.2) and 9.15 (range 3.8-42.9) mg/dL respectively, resulting in a median difference of 0.08 (SD 0.6, range −2.4 to 0.96) mg/dL. In a multiple regression model, urinary enzymatic creatinine concentration (r = 0.45) and postnatal age (r = −0.59) remained independent variables of the difference between both assays (r(2) adj = 0.45). CONCLUSIONS: The tested IDMS-traceable assays showed interchangeable in heterogeneous neonatal urine samples. Using these assays, neonatal urinary creatinine showed 5–20 fold lower values than those observed in children or adults with a significant negative correlation with postnatal age

    Towards an agroecological viticulture: advances and challenges

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    To improve its sustainability, viticulture should increase the provision of ecosystem services to decrease its use of inputs and the resulting environmental impact while maintaining high socio-economic performance. Soil functions in relation with their physical, chemical and biological properties can be regulated by proper soil surface management. Cover crops deliver ecosystem services such as protection of soils, better water infiltration and nitrogen fixation. Yet to avoid trade-off between provision of services and production of grapes, the management of cover crops should adapt to climate variations and to the yield objective. Pest and diseases can be regulated by various technical levers, including the control of the grape vegetative development. The assessment of damages due to pests and disease and of their consequences on yield losses is a key component of the design of alternative strategies of crop protection. This knowledge provides clues for designing management strategies with low pesticide use and high agro-ecological performance. A French national network of experiments has quantified the reduction of pesticide use with decision support systems, biocontrol or resistant varieties. To go further the challenge is now to design agroecological vineyards that combine innovations in management, and also in spatial organization at field, farm and landscape scales

    EPTRI Belgian Joint Research Unit : harmonisation and concertation of paediatric research in Belgium to ensure better and safer healthcare for children

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    We want to put the excellent translational paediatric research in Belgium on the ESFRI national roadmap in order to participate in the European Paediatric Translational Research Infrastructure (EPTRI) project. Therefore, we are in the preparatory phase to form a Belgian national EPTRI Joint Research Unit (JRU). Academic research organisations and hospitals from both regions, Flanders and Wallonia are currently involved. The Belgian JRU partners will gather complementary scientific and technological competencies in the different EPTRI thematic research platforms: 1. Paediatric medicines discovery: with different types of “in vitro” paediatric models, placental and umbilical cord and 3D organoid cell cultures from paediatric samples and juvenile animal models such as the rabbit BPD model, juvenile Göttingen minipig, juvenile conventional pig model and developmental zebrafish model; 2. Paediatric biomarkers and biosamples: identification, characterisation and validation of the biomarkers used as prognostic tools, safety markers and diagnostic tools in paediatric diseases; 3. Developmental pharmacology: including PK (bioavaibility/bioequivalence) studies, Population PKPD analysis and PK/PD modelling; 4. Paediatric medicines formulations and medical devices: including regulatory knowledge of paediatric medical devices. The partners will ensure a strong liaison with other RI’s such as the BBMRI-ERIC for paediatric biobanking and the IMI conect4children network paediatric clinical trials. We propose an integrated paediatric research system that links together EPTRI Belgium with landmark RIs, conect4children and the many paediatric clinical research networks and institutions that provide services to paediatric research. This integrated system can provide: expertise, experienced facilities and practical support for pre-clinical and clinical paediatric research in Belgium and Europe. Sharing understanding of patients’ needs and concerted efforts in paediatric research will further enhance the health of children

    The Impact of Caesarean Delivery on Paracetamol and Ketorolac Pharmacokinetics: A Paired Analysis

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    Pharmacokinetics is a first, but essential step to improve population-tailored postoperative analgesia, also after Caesarean delivery. We therefore aimed to quantify the impact of caesarean delivery on the pharmacokinetics of intravenous (iv) paracetamol (2 g, single dose) and iv ketorolac tromethamine (30 mg, single dose) in 2 cohorts eachof 8 women at caesarean delivery and to compare these findings with postpartum to quantify intrapatient changes. We documented a higher median paracetamol clearance at delivery when compared to 10–15 weeks postpartum (11.7 to 6.4 L/h·m2, P < 0.01), even after correction for weight-related changes. Similar conclusions were drawn for ketorolac: median clearance was higher at delivery with a subsequent decrease (2.03 to 1.43 L/h·m2, P < 0.05) in postpartum (17–23 weeks). These differences likely reflect pregnancy- and caesarean-delivery-related changes in drug disposition. Moreover, postpartum paracetamol clearance was significantly lower when compared to estimates published in healthy young volunteers (6.4  versus  9.6 L/h·m2), while this was not the case for ketorolac (1.43  versus  1.48 L/h·m2). This suggests that postpartum is another specific status in young women that merits focused, compound-specific pharmacokinetic evaluation

    Impact of enantiomer-specific changes in pharmacokinetics between infants and adults on the target concentration of racemic ketorolac– a pooled analysis

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    Aims Ketorolac is a non-steroidal anti-inflammatory racemic drug with analgesic effects only attributed to its S-enantiomer. The aim of this study is to quantify enantiomer-specific maturational pharmacokinetics (PK) of ketorolac and investigate if the contribution of both enantiomers to the total ketorolac concentration remains equal between infants and adults or if a change in target racemic concentration should be considered when applied to infants. Methods Data were pooled from 5 different studies in adults, children, and infants, with 1020 plasma concentrations following single intravenous ketorolac administration. An allometry-based enantiomer-specific population PK model was developed with NONMEM 7.3. Simulations were performed in typical adults and infants to investigate differences in S- and R-ketorolac exposure. Results S- and R-ketorolac PK were best described with a 3- and a 2-compartment model respectively. The allometry-based PK parameters accounted for changes between populations. No maturation function of ketorolac clearance could be identified. All model parameters were estimated with adequate precision (relative standard errorPeer reviewe

    Genome2D: a visualization tool for the rapid analysis of bacterial transcriptome data

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    Genome2D is a Windows-based software tool for visualization of bacterial transcriptome and customized datasets on linear chromosome maps constructed from annotated genome sequences. Genome2D facilitates the analysis of transcriptome data by using different color ranges to depict differences in gene-expression levels on a genome map. Such output format enables visual inspection of the transcriptome data, and will quickly reveal transcriptional units, without prior knowledge of expression level cutoff values. The compiled version of Genome2D is freely available for academic or non-profit use from
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