Developing therapeutic strategies for prevention of neonatal herpes : antivirals and microbicides
Bibliographic record
Abstract
Genital herpes is a sexually transmitted disease affecting many women of childbearing age. Recurrences during childbirth can result in transmission to the neonate. The current strategy to prevent neonatal herpes has focused on the use of suppressive acyclovir therapy in late pregnancy. Issues pertaining to the safety, efficacy, and cost-effectiveness of this treatment were evaluated in our investigation. To examine the potential myelosuppressive effects of acyclovir use in late pregnancy, a clinical trial protocol was developed and implemented. A lack of enrolment in this placebo-controlled study led to inconclusive results. However, quantitative analysis of cord blood samples from the same patients revealed that although adequate blood levels are achieved with most patients at delivery, a longer duration of labor was correlated with lower levels. Inadequate levels of acyclovir could result in reactivation and viral shedding, thus endangering the neonate. Therefore, issues of noncompliance and vomiting during labor need to be addressed. For this investigation, a sensitive and rapid analytical assay with small volume requirements was developed and validated for the detection of acyclovir in plasma using capillary electrophoresis technology. With solid phase extraction and ultraviolet detection, the limit of quantification and the limit of detection was 20 ng/ml and 5.5 ng/ml, respectively. Suppressive acyclovir use in pregnancy was demonstrated to be cost-effective in a Canadian context, with most of the savings due to the avoidance of caesarean sections. This therapy was found to be especially cost effective in women with greater than 6 recurrences per year. Finally, the use of dendrimers as vaginal microbicides was proposed as an alternative strategy for the prevention of neonatal herpes. In vitro studies demonstrated that this class of compounds acts on both early and late stages of herpes simplex virus replication, making it a suitable candidate as an adjunct to existing oral antiviral therapy.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".