Serum Creatinine and Tacrolimus Assessment With VAMS Finger-Prick Microsampling: A Diagnostic Test Study

Rationale & Objective: Kidney transplant recipients require frequent venipunctures. Microsampling methods that use a finger-prick draw of capillary blood, like volumetric absorptive microsamplers (VAMS), have the potential to reduce the pain, inconvenience, and volume of blood loss associated with venipuncture. This study aimed to provide diagnostic accuracy using VAMS for measurement of tacrolimus and creatinine compared to gold standard venous blood in adult kidney transplant recipients. Study Design: Diagnostic test study. Prospective blood samples for measurement of tacrolimus and creatinine were collected using Mitra VAMS and venipuncture immediately before and 2 hours after tacrolimus dosing. Setting & Participants: A convenience sample of 40 adult kidney transplant participants in the outpatient setting. Tests Compared: Method comparison was assessed by Passing-Bablok regression and Bland-Altman analysis. The predictive performance of VAMS measurement compared to venipuncture was also assessed through estimation of the median prediction error and median absolute percentage prediction error. Results: A total of 74 tacrolimus samples and 70 creatinine samples were analyzed from 40 participants. Passing-Bablok regression showed a systematic difference between VAMS and venipuncture when measuring tacrolimus and creatinine with a slope of 1.08 (95% CI, 1.03-1.13) and a slope of 0.65 (95% CI, 0.6-0.7), respectively. These values were then corrected for the systematic difference. When used for Bland-Altman analysis, corrected values of tacrolimus and creatinine showed a bias of -0.1 μg/L and 0.04 mg/dL, respectively. Tacrolimus (corrected) and creatinine (corrected) microsampling values when compared to corresponding venipuncture values met median prediction error and median absolute percentage prediction error predefined acceptability limits of <15%. Limitations: This study was conducted in a controlled environment using a trained nurse to collect VAMS samples. Conclusions: In this study, VAMS was used to reliably measured tacrolimus and creatinine. This represents a clear opportunity for more frequent and less invasive sampling for patients

Влияние термомеханической обработки на структуру, механические и трибологические свойства композитов Al-Si-Sn

Исследование влияния режима спекания порошковых прессовок, а также последующей их деформационной обработки методом горячего доуплотнения и равноканального углового прессования (РКУП) на результирующую структуру, механические и трибологические свойства композитов (Al-Si)-40Sn.Investigation of the effect of sintering regimes of powder compacts, as well as their deformation treatment by hot doping and equal-channel angular pressing (ECAP) on the resulting structure, mechanical and tribological properties of composites (Al-Si)-40Sn

Проектирование автоматизированной групповой замерной установки при разработке Макарьевского месторождения нефти на проточном-1 лицензионном участке недр Томской области

В данной дипломной работе произведено обоснование оптимальной конфигурации и проектирование автоматизированной группой замерной установки для системы сбора продукции эксплуатационных скважин в рамках прогноза эффективности разработки Макарьевского месторождения Томской области.In this graduation work the study of the optimal configuration and design of automated group measuring system for the collection system of production wells within the forecast development efficiency Makar deposits of Tomsk region

Технологические решения для строительства эксплуатационной наклонно-направленной скважины глубиной 2850 метров на Игольско-Таловом нефтяном месторождении (Томская область)

Объектом работы эффективный являются эксплуатационная работы скважина для добычи нефти. Цель работы - продуктивный разработка техники и конструкция технологии бурения буровой эксплуатационной скважины технологии глубиной 2850 метров на Игольско-Тaловом месторождении. Работа разработка выполнена по сроки геологическим материалам Игольско-Тaлового месторождения.Ob"yekt raboty effektivnyy - ekspluatatsionnaya rabota skvazhina dlya dobychi nefti. Tselevaya rabota - produktivnaya razrabotka i razrabotka tekhnologiy bureniya burovoy ekspluatatsionnoy skvazhiny tekhnologii glubinoy 2850 metrov na Igol'sko-Talovom mestorozhdenii. Rabota razrabotka po pogodnym geologicheskim materialam Igol'sko-Talovogo mestorozhdeniya

Innovation systems, institutional change and the new knowledge market: implications for third world agricultural development

This paper uses a simplified version of classical information theory to improve understanding of the dynamic potential of innovation systems in developing countries with a special focus on issues of agricultural poverty. Using examples drawn from emergent knowledge markets in industrialised countries, the paper suggests that such an analytical approach focuses attention directly on the types of institutional reforms necessary to improve the effectiveness of Third World agricultural R&D. Contrast is made with more conventional approaches that take institutional structures as given and focus more on factors such as price regimes, policy weaknesses and political will. The paper argues that so great now are the problems in this area (particularly in Sub-Saharan Africa) that there is a clear need for institutional reform to accompany relevant technological changes. In the absence of such reform innovative (and hence economic) potential is likely to be compromised

The interactions of age, genetics, and disease severity on tacrolimus dosing requirements after pediatric kidney and liver transplantation

Purpose: In children, data on the combined impact of age, genotype, and disease severity on tacrolimus (TAC) disposition are scarce. The aim of this study was to evaluate the effect of these covariates on tacrolimus dose requirements in the immediate post-transplant period in pediatric kidney and liver recipients. Methods: Data were retrospectively collected describing tacrolimus disposition, age, CYP3A5 and ABCB1 genotype, and pediatric risk of mortality (PRISM) scores for up to 14 days post-transplant in children receiving liver and renal transplants. Initial TAC dosing was equal in all patients and adjusted using therapeutic drug monitoring. We determined the relationship between covariates and tacrolimus disposition. Results: Forty-eight kidney and 42 liver transplant recipients (median ages 11.5 and 1.5 years, ranges 1.5-17.7 and 0.05-14.8 years, respectively) received TAC post-transplant. In both transplant groups, younger children (<5 years) needed higher TAC doses than older children [kidney: 0.15 (0.07-0.35) vs. 0.09 (0.02-0.20) mg/kg/12h, p = 0.046, liver: 0.12 (0.04-0.32) vs. 0.09 (0.01-0.18) mg/kg/12h, p