BackgroundSSG&PM over 17 days is recommended as first line treatment for visceral leishmaniasis in eastern Africa, but is painful and requires hospitalization. Combination regimens including AmBisome and miltefosine are safe and effective in India, but there are no published data from trials of combination therapies including these drugs from Africa.MethodsA phase II open-label, non-comparative randomized trial was conducted in Sudan and Kenya to evaluate the efficacy and safety of three treatment regimens: 10 mg/kg single dose AmBisome plus 10 days of SSG (20 mg/kg/day), 10 mg/kg single dose AmBisome plus 10 days of miltefosine (2.5mg/kg/day) and miltefosine alone (2.5 mg/kg/day for 28 days). The primary endpoint was initial parasitological cure at Day 28, and secondary endpoints included definitive cure at Day 210, and pharmacokinetic (miltefosine) and pharmacodynamic assessments.ResultsIn sequential analyses with 49–51 patients per arm, initial cure was 85% (95% CI: 73–92) in all arms. At D210, definitive cure was 87% (95% CI: 77–97) for AmBisome + SSG, 77% (95% CI 64–90) for AmBisome + miltefosine and 72% (95% CI 60–85) for miltefosine alone, with lower efficacy in younger patients, who weigh less. Miltefosine pharmacokinetic data indicated under-exposure in children compared to adults.ConclusionNo major safety concerns were identified, but point estimates of definitive cure were less than 90% for each regimen so none will be evaluated in Phase III trials in their current form. Allometric dosing of miltefosine in children needs to be evaluated.Trial RegistrationThe study was registered with ClinicalTrials.gov, number NCT01067443
Nowadays, Green IoT-Based Agriculture plays an essential role in farming to improve the yield. Here, IoT devices are embedded in the farming equipment, which helps to enhance the irrigation and yield with minimum cost-cutting. Data security and privacy are major challenges in green IoT-related agriculture. Therefore, a secured system should create to maintain data confidentiality, authentication, integrity, availability, and privacy. This system uses the privacy-preserving data aggregation (PPDA) with a Fair access framework (FAF) that manages the data security. The data aggregation concept is used to protect the green IoT data from false data injection. The FAF utilizes the blockchain technique to grant, get, revoke and delegate access to the user. The developed security system can adapt the green IoT-based agriculture and provide confidentiality, which is done with the help of an enhanced ciphertext access control mechanism. This system resolves the security and privacy issues involved in the Green IoT-based agriculture, and the effectiveness of the system is evaluated using implementation results.
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