Clinical determinants of early parasitological response to ACTs in African patients with uncomplicated falciparum malaria: a literature review and meta-analysis of individual patient data.

BACKGROUND: Artemisinin-resistant Plasmodium falciparum has emerged in the Greater Mekong sub-region and poses a major global public health threat. Slow parasite clearance is a key clinical manifestation of reduced susceptibility to artemisinin. This study was designed to establish the baseline values for clearance in patients from Sub-Saharan African countries with uncomplicated malaria treated with artemisinin-based combination therapies (ACTs). METHODS: A literature review in PubMed was conducted in March 2013 to identify all prospective clinical trials (uncontrolled trials, controlled trials and randomized controlled trials), including ACTs conducted in Sub-Saharan Africa, between 1960 and 2012. Individual patient data from these studies were shared with the WorldWide Antimalarial Resistance Network (WWARN) and pooled using an a priori statistical analytical plan. Factors affecting early parasitological response were investigated using logistic regression with study sites fitted as a random effect. The risk of bias in included studies was evaluated based on study design, methodology and missing data. RESULTS: In total, 29,493 patients from 84 clinical trials were included in the analysis, treated with artemether-lumefantrine (n = 13,664), artesunate-amodiaquine (n = 11,337) and dihydroartemisinin-piperaquine (n = 4,492). The overall parasite clearance rate was rapid. The parasite positivity rate (PPR) decreased from 59.7 % (95 % CI: 54.5-64.9) on day 1 to 6.7 % (95 % CI: 4.8-8.7) on day 2 and 0.9 % (95 % CI: 0.5-1.2) on day 3. The 95th percentile of observed day 3 PPR was 5.3 %. Independent risk factors predictive of day 3 positivity were: high baseline parasitaemia (adjusted odds ratio (AOR) = 1.16 (95 % CI: 1.08-1.25); per 2-fold increase in parasite density, P <0.001); fever (>37.5 °C) (AOR = 1.50 (95 % CI: 1.06-2.13), P = 0.022); severe anaemia (AOR = 2.04 (95 % CI: 1.21-3.44), P = 0.008); areas of low/moderate transmission setting (AOR = 2.71 (95 % CI: 1.38-5.36), P = 0.004); and treatment with the loose formulation of artesunate-amodiaquine (AOR = 2.27 (95 % CI: 1.14-4.51), P = 0.020, compared to dihydroartemisinin-piperaquine). CONCLUSIONS: The three ACTs assessed in this analysis continue to achieve rapid early parasitological clearance across the sites assessed in Sub-Saharan Africa. A threshold of 5 % day 3 parasite positivity from a minimum sample size of 50 patients provides a more sensitive benchmark in Sub-Saharan Africa compared to the current recommended threshold of 10 % to trigger further investigation of artemisinin susceptibility.

Fanon, F. (1961), Les damnés de la terre, Paris, Editions Maspero. (Ressenya)

Resenya de l'obra de Fanon, F. (1961), Les damnés de la terre, París, Éditions Maspero. Edición consultada: Los condenados de la tierra, Navarra, Txalaparta, 1999, 251 pp. Con Prefacio de Jean-Paul Sartre, fechado en setiembre de 1961.

Extração no ponto nuvem de compostos orgânicos homólogos e isômeros

In this work, the feasibility of employing micelle-mediated extraction for selective separation of homologous or isomeric organic compounds is demonstrated. Firstly, the main parameters controlling extraction performances, such as surfactant concentration and temperature were varied. A Scheffé-type experimental design was demonstrated as a novel and useful method to characterize the various experimental factors. At each point selected in the two-phase domain and for a given solute, extraction percentage (E%), concentration ratio, phase volume ratio, and equilibrium partition coefficient (K C) were determined. The values of E% and K C decrease in the following order: phenol > 1-phenylethanol ~ 2-phenylethanol > benzyl alcohol.

Regime Switching Models for Electricity Time Series that Capture Fat Tailed Distributions

In the power market, electricity prices play an important role at the economic level. The behavior of a price trend usually known as a structural break may change over time in terms of its mean value, its volatility, or it may change for a period of time before reverting back to its original behavior or switching to another style of behavior, and the latter is typically termed a regime shift or regime switch. Our task in this thesis is to develop an electricity price time series model that captures fat tailed distributions which can explain this behavior and analyze it for better understanding. For NordPool data used, the obtained Markov Regime-Switching model operates on two regimes: regular and non-regular. Three criteria have been considered price difference criterion, capacity/flow difference criterion and spikes in Finland criterion. The suitability of GARCH modeling to simulate multi-regime modeling is also studied.

Liberdade dramática: ética e literatura na escrita de Sartre

Este artigo pretende investigar, nos romances de Jean-Paul Sartre, a tessitura entre forma literária, investigação filosófica e escolha ética implicada no trabalho do escritor.

Crescimento em diâmetro do tronco das árvores de Eucalyptus grandis W. Hill. ex. Maiden e relação com as variáveis climáticas e fertilização mineral

Este trabalho teve como objetivo avaliar o incremento em diâmetro do tronco de árvores de Eucalyptus grandis por 24 meses e sua relação com as variáveis climáticas e fertilização mineral. As árvores foram plantadas no espaçamento de 3 x 2 m e fertilizadas com potássio e sódio (plantio, 6 e 12 meses). Foram selecionadas 20 árvores de eucalipto por tratamento, de acordo com a distribuição de área basal do povoamento e instaladas faixas dendrométricas na altura do DAP. Os resultados indicaram efeito da sazonalidade climática no incremento em diâmetro do tronco das árvores, com períodos de máximo e de mínimo crescimento e uma defasagem (lag) de 28 dias, em função da resposta da atividade cambial às variações climáticas. A aplicação de potássio em relação ao sódio e controle promoveu maior taxa de incremento acumulado do tronco das árvores, com valores de 4,14; 3,28; e 3,08 cm, respectivamente.