Mefloquine pharmacokinetics and mefloquine-artesunate effectiveness in Peruvian patients with uncomplicated Plasmodium falciparum malaria

<p>Abstract</p> <p>Background</p> <p>Artemisinin-based combination therapy (ACT) is recommended as a means of prolonging the effectiveness of first-line malaria treatment regimens. Different brands of mefloquine (MQ) have been reported to be non-bioequivalent; this could result in sub-therapeutic levels of mefloquine with decreased efficacy. In 2002, mefloquine-artesunate (MQ-AS) combination therapy was adopted as the first-line treatment for uncomplicated <it>Plasmodium falciparum </it>malaria in the Amazon region of Peru. Although MQ resistance has yet to be reported from the Peruvian Amazon, it has been reported from other countries in the Amazon Region. Therefore, continuous monitoring is warranted to ensure that the first-line therapy remains efficacious. This study examines the <it>in vivo </it>efficacy and pharmacokinetic parameters through Day 56 of three commercial formulations of MQ (Lariam^®, Mephaquin^®, and Mefloquina-AC^®Farma) given in combination with artesunate.</p> <p>Methods</p> <p>Thirty-nine non-pregnant adults with <it>P. falciparum </it>mono-infection were randomly assigned to receive artesunate in combination with either (1) Lariam, (2) Mephaquin, or (3) Mefloquina AC. Patients were assessed on Day 0 (with blood samples for pharmacokinetics at 0, 2, 4, and 8 hours), 1, 2, 3, 7, and then weekly until day 56. Clinical and parasitological outcomes were based on the standardized WHO protocol.</p> <p>Whole blood mefloquine concentrations were determined by high-performance liquid chromatography and pharmacokinetic parameters were determined using non-compartmental analysis of concentration versus time data.</p> <p>Results</p> <p>By day 3, all patients had cleared parasitaemia except for one patient in the AC Farma arm; this patient cleared by day 4. No recurrences of parasitaemia were seen in any of the 34 patients. All three MQ formulations had a terminal half-life of 14–15 days and time to maximum plasma concentration of 45–52 hours. The maximal concentration (C_max) and interquartile range was 2,820 ng/ml (2,614–3,108) for Lariam, 2,500 ng/ml (2,363–2,713) for Mephaquin, and 2,750 ng/ml (2,550–3,000) for Mefloquina AC Farma. The pharmacokinetics of the three formulations were generally similar, with the exception of the C_maxof Mephaquin which was significantly different to that of Lariam (<it>p </it>= 0.04).</p> <p>Conclusion</p> <p>All three formulations had similar pharmacokinetics; in addition, the pharmacokinetics seen in this Peruvian population were similar to reports from other ethnic groups. All patients rapidly cleared their parasitaemia with no evidence of recrudescence by Day 56. Continued surveillance is needed to ensure that patients continue to receive optimal therapy.</p

Academic language socialisation in high school writing conferences

This study examines multilingual high school writers’ individual talk with their teachers in two advanced English language development classes to observe how such talk shapes linguistically diverse adolescents’ writing. Addressing adolescent writers’ language socialization through microethnographic discourse analysis, the author argues that teachers’ oral responses during writing conferences can either scaffold or deter students’ socialization into valued ways of using academic language for school writing. She suggests what forms of oral response provide scaffolding and what forms might limit multilingual adolescent learners’ academic literacy. Constructive interactions engaged students in dialogue about their writing, and students included content or phrasing from the interaction in their texts. Unhelpful interactions failed to foster students’ language development in observable ways. Although teachers attempted to scaffold ideas and language, they often did not guide students’ discovery of appropriate forms or points. These interactions represent restrictive academic language socialization: while some students did create academic texts, they learned little about academic language use

Analytical modelling and analysis of thermal behavior for series resistance of solar cell

In this paper, the analysis of the nonlinear and complex modelling of a solar cell is addressed, to study its thermal behaviour. From literature it is well known that the output power of a solar cell monotonically decreases with the temperature; here, we investigate the specific expression based on derivation of current and power to simplify the equation model. Thus, applying the specific expression of the series resistance, we analyze the relation characteristics between the power and the temperature. Moreover, we aim to present a method to determine the specific theoretical expression of the series resistance with combination of parallel parasitic resistances. The analytical model equation is tested and compared with experimental results to add validity to the model

Efficient Hybrid Amorphous Silicon/Organic Tandem Solar Cells Enabled by Near-Infrared Absorbing Nonfullerene Acceptors

Monolithically stacked tandem solar cells present opportunities to absorb more of the sun's radiation while reducing the degree of energetic loss through thermalization. In these applications, the bandgap of the tandem's constituent subcells must be carefully adjusted so as to avoid competition for photons. Organic photovoltaics based on nonfullerene acceptors (NFAs) have recently exploded in popularity owing to the ease with which their electrical and optical properties can be tuned through chemistry. Here, highly complementary and efficient 2-terminal tandem solar cells are reported based on a wide bandgap amorphous silicon absorber, and a narrow bandgap NFA bulk-heterojunction with power conversion efficiencies (PCEs) exceeding 15%. Interface engineering of this tandem device allows for high PCEs across a wide range of light intensities both above and below “1 sun.” Furthermore, the addition of an inorganic silicon subcell enhances the operational stability of the tandem by reducing the light-stress experienced by the bulk heterojunction, resolving a long-standing stumbling block in organic photovoltaic research