bluuebunny/crossref_metadata_2025 huggingface dataset:
P23 Evaluation of exposure to vancomycin in neonates with current dosing approaches
Authors: Dao K , Guidi M , Andre P , Giannoni E , Fuchs A , Pfister M , Buclin T , Csajka C
Published: May 2019

Background

Several neonatal dosing recommendations for vancomycin are found in the literature, variably based on age, renal function and body weight. Still there is no consensus regarding optimal initial dosing in term or preterm neonates. Our objective was to evaluate and compare how current dosing approaches perform with respect to target plasma concentration attainment, using a comprehensive population PK model of vancomycin developed in a large cohort of neonates.

Methods

A single-compartment, linear elimination population pharmacokinetic model incorporating postmenstrual age, kidney function and body weight as covariates was elaborated using NONMEM®, based on 1848 vancomycin concentration values measured in 405 neonates during routine TDM. The model was then used to simulate the distribution of vancomycin concentrations resulting from 20 dosing guidelines identified in the literature. Proportions of patients within and above target exposure were used as a performance measure of each dosing regimen, defining target as AUC24/MIC ratio of 400–700 h and trough concentration of 10–20 mg/L, both on days 1 and 7 of treatment.

Results

Only 2 out of 20 current dosing recommendations (Neonatal Formulary 7 and Neofax® meningitis regimens) ensured target attainment in about 60% of neonates on both days 1 and 7. Most other guidelines produced below-target exposure in a large fraction of patients (22–97%), except two that frequently produced overexposure (55–66%).

Conclusion

A majority of currently used vancomycin dosing regimens proposed in the literature failed to ensure target attainment in at least 60% of neonates. It is important that concentration exposure associated with best chances of therapeutic success is promptly reached, in particular in neonatal units having a high prevalence of coagulase negative Staphylococci. We recommend electing an effective dosage regimen, with a loading dose, to ensure early target attainment in a majority of patients. Subsequent therapeutic concentration monitoring remains warranted to further individualize vancomycin dosage and optimize exposure in all patients.

Disclosure(s)

Nothing to disclose
P29 A smartphone application to monitor nausea in pediatric cancer patients during chemotherapy
Authors: Eliasen A , Abildtoft MK , Krogh NS , Brok JS , Mathiasen R , Schmiegelow K , Dalhoff KP
Published: May 2019

Background

Nausea is a common and distressing side effect for children in chemotherapy. Antiemetic recommendations are based on limited literature and prospective evaluation of antiemetic efficacy is required. Smartphone applications (apps) may collect patient-reported outcomes with precision and effectiveness1. We developed a smartphone app to track nausea in pediatric cancer patients during chemotherapy.

Methods

Medical researchers, pediatric oncologists and software engineers worked synergistically in the development. We translated the validated Pediatric Nausea Assessment Tool to score nausea severity2. We conducted three rounds of patient-feedback and modification.

Results

The app has a definition module where the child centers the attention to the concept of nausea. The child can then express nausea severity with four faces and the child’s own definition of nausea is incorporated in the question2. The app includes a notification system to ensure high response rates. All participants felt that the app was user-friendly, intuitive and that time spent was acceptable.

Conclusion

The app is a user-friendly tool to assess nausea in pediatric cancer patients that can ease future pediatric antiemetic trials.

References

Stone AA, Shiffman S, Schwartz JE, et al. Patient compliance with paper and electronic diaries. Control Clin Trials 2003 Apr;24(2):182–99.

Dupuis LL, Taddio A, Kerr EN, et al. Development and validation of the pediatric nausea assessment tool for use in children receiving antineoplastic agents. Pharmacotherapy 2006;26:1221–31.

Disclosure(s)

Nothing to disclose
P30 Limited sampling strategies to predict valganciclovir exposure in kidney transplanted children
Authors: Benyoub N , Facchin A , Magreault S , Jacqz-Aigrain E , Elie V
Published: May 2019

Background

Ganciclovir and its pro-drug, valganciclovir, are anti-viral drugs used in cytomegalovirus infections treatment in kidney transplanted children. Both present a high pharmacokinetic variability requiring dosage individualization and Therapeutic Drug Monitoring to ensure optimal therapeutic exposure. This retrospective monocentric study aimed to develop a Limited Sampling Strategy (LSS) predicting Area Under the Curve (AUC0-24h) reducing the number of blood samples to improve and facilitate kidney transplanted children medical care.

Methods

Pediatric kidney transplanted children treated with valganciclovir were included. Rich pharmacokinetic data from ganciclovir plasmatic dosages (sampling times at 0h, 1h, 2h, 4h, 8h, 12 h and 24 h) were collected between February 2005 and November 2018. Ganciclovir exposures at steady-state (AUC0-24h) were calculated using the trapezoidal method. The LSS was developed using a multilinear regression approach to predict AUC0-24h. The overall patients population was divided into two groups for model development and validation purposes.

Results

129 patients were included: 46 girls and 83 boys, mean age at transplantation was 11.3years ± 5.1. Multilinear regression models were developed on 85 pharmacokinetic profiles (85 patients, mean AUC0-24h=64µg.h/mL ± 27, creatinine clearance=72.4 mL/min per 1.73 m2) and validated on an independent group of 73 pharmacokinetic profiles (44 patients). Regressions based on samples collected at 0, 2, 4 h (R=0.946) or 0, 2, 8 h (R=0.968) presented the best AUC0-24h predictive performances (RMSE=7.5 and 6.6, MAE=5.7 and 4.8 respectively) with an average difference between reference and predicted AUC0-24h of -0.52 and 0.67µg.h/mL respectively.

Conclusions

To date, this is the largest cohort of valganciclovir treated pediatric transplanted children used to develop a LSS. This LSS allows to accurately predict ganciclovir AUC0-24h in pediatric transplanted patients using 3 pharmacokinetic blood samples at 0h, 2h, and 4 h post-dose. Beside other Bayesian estimators developed in the literature, this multilinear regression can be easily implemented into daily practice facilitating patients care.

Disclosure(s)

Nothing to disclose
P38 Identification of Nifurtimox metabolites in urine of pediatric Chagas disease patients by UHPLC-MS/MS
Authors: Pérez Montilla CA , Moroni S , González N , Moscatelli G , Altcheh JM , García Bournissen F
Published: May 2019

Background

Nifurtimox (NFX) is one of the only 2 available drugs for the treatment of Chagas disease, a parasitic disease endemic to Latin America. In spite of widespread use of this medication, little is known regarding its metabolism, particularly in children.

The objective of this study was to develop a method to identify NFX metabolites in human samples, and apply it to the discovery of NFX metabolites in urine from pediatric patients undergoing treatment for Chagas disease.

Methods

Urine was collected from 12 pediatric patients and 8 healthy volunteers (controls), and anonymized before analysis. Informed consent was obtained from all participants. Samples were aliquoted, deproteinized with ACN (BNZ as internal standard) and centrifuged in cold. 10% of supernatant in water was injected into a 1.8 µm C18 column and chromatographed in 3.5 min under a water/ACN gradient at 0.4 mL/min in a Shimadzu Nexera X2 UHPLC equipment. Species were positively ionized by a Turbo IonSpray source. Metabolites were identified and characterized by an ABSciex 6500 QTRAP spectrometer through Enhanced-Mass-Screening (EMS), Neutral-Loss (NL), Precursor-Ion (PREC), Enhanced-Product-Ion (EPI) and MS3 experiments. For chromatographic monitoring, parameters were optimized and the three most intense Multiple-Reaction-Monitoring (MRM) transitions were selected.

Results

Denitrated NFX conjugated with cysteine (M1) and N-acetyl-cysteine (M2), as well as other phase I metabolites like saturated nitrile (M3), hydroxyamide (M4), carboxylic acid (M5) or aldehyde (M6) were identified in most samples. The final MS/MS detection method was high reproducible and sensitive for all metabolites.

Conclusions

We found the main NFX metabolites in pediatric urine using a fast MS/MS method that can allow us to efficiently study the role of NFX and its metabolites in pediatric treatment response and the adverse drug reactions, and in combination with PK/PD experiments will facilitate future clinical trials, and possibly develop new therapeutic drug monitoring strategies.

Reference

The research was carried out in the Translational Research Unit (IMIPP-CONICET), located in the Buenos Aires Children´s Hospital ‘Dr. Ricardo Gutiérrez’, and financed by the Fund for Scientific and Technological Research (FONCyT, Project BID-PICT 2015–0168).

Disclosure(s)

Nothing to disclose
P43 Pharmacokinetics and target attainment of antibiotics in critically ill children – a systematic review of current literature
Authors: Hartman S , Brüggemann R , Orriëns L , Dia N , Schreuder M , de Wildt S
Published: May 2019

Background

Pharmacokinetics (PK) are severely altered in critically ill patients due to changes in volume of distribution (Vd) and/or drug clearance (Cl). To what extent this affects the PK of antibiotics in critically children is largely unknown. We aimed to identify gaps in current knowledge and to compare published PK parameters and target attainment of antibiotics in critically ill children to healthy children and critically ill adults.

Methods

Systematic literature search in PubMed, EMBASE and Web of Science. Articles were labelled as relevant when they included information on PK of antibiotics in critically ill, non-neonatal, pediatric patients. Extracted PK-parameters included Vd, Cl, trough concentrations, AUC, probability of target attainment, and elimination half-life.

Results

45 relevant articles were identified. Studies focusing on vancomycin were most prevalent (15/45). Other studies included data on penicillins, cephalosporins, carbapenems and aminoglycosides, but data on ceftriaxone, ceftazidime, penicillin and metronidazole could not be found. Critically ill children generally show a larger Vd and higher Cl than healthy children and critically ill adults. Reduced target attainment was described in critically ill children for multiple antibiotics, including amoxicillin, piperacillin, cefotaxime, vancomycin, gentamicin, teicoplanin, amikacin and daptomycin. 32/45 articles included information on both Vd and Cl, but a dosing advice was given in only 18 articles.

Conclusion

The majority of studies focus on agents where therapeutic drug monitoring is applied, while other antibiotics lack data altogether. The larger Vd and higher Cl that is observed in critically ill children might warrant a higher dose or extended infusions of antibiotics in this patient population to increase target attainment. Studies frequently fail to provide a dosing advice for this patient population, even if the necessary information is available. Our study shows gaps in current knowledge and encourages future researchers to provide dosing advice for special populations whenever possible.

Disclosure(s)

Nothing to disclose
P46 Spontaneous reporting of suspected adverse drug reactions by children and young people: past, present and future
Authors: King C , Bhoombla N , Clarke J , Morgan V , Preston J , Ainsworth J , Hanson A , Hawcutt D
Published: May 2019

Background

UK patients of all ages can contribute to the Medicines and Healthcare Regulatory Agency (MHRA) Yellow Card scheme (YCS), reporting suspected adverse drug reactions (ADRs). Children’s and young people’s (CYPs) contribution to, and awareness of, the YCS is not known.

Methods

Suspected ADR reports received by the MHRA from 01/01/2008 to 29/11/2018 were examined. Prospective data from CYP and parents in paediatric outpatients were collected as part of the QUestionnaire study about Adverse Drug ReAcTions In Children (QUADRATIC) study (IRAS 242352).

Results

CYP contributed 2.3% of YCS reports for patients < 19 years. Patients from age 10 years old have contributed YCS reports, and CYP reports are increasing annually. Reports from CYP contain different suspected medications and reactions compared to YCS for all patients age < 19 years. Common CYP generated reports prioritiseadolescent vaccinations (Human papilloma virus most reported, n=69), oral contraceptives, acne medication, anti-infectives, and antidepressants.Common CYP generated reports identified depression, anxiety and suicidal ideation, which were not amongst common reports about CYP. Amongst CYP (n=50) attending outpatients, the YCS was not known to any CYP. The YCS was known to 16.3% of parents (8/49) interviewed. From this population of patients with a chronic illness, with high rates of drug therapy, 68 suspected ADRs were identified overall.

Conclusion

CYP contribute to YCS, with distinct patterns of suspected medications and reactions. Awareness of the YCS appears poor, particularly in populations you would expect to have a greater level of knowledge and understanding about medicines.

Disclosure(s)

Nothing to disclose
P58 Development of JUNIORMED – the Austrian paediatric pharmacopoeia
Authors: Lagler F , Hofbauer P , Danninger L , Hattinger B , Aichberger M , Mursch-Edlmayr U , Sperl W
Published: May 2019

Background

Despite the regulatory measures to improve the availability of medicines for new-borns, infants and children, extemporaneous preparations are often necessary to cover the needs of these patients. In Austria the prescription of magistral medicines is more common (approx. 3,4% of all prescriptions) than in the European average (1,9%)1, yet a paediatric pharmacopoeia which sets standards for the preparation and use of extemporaneous preparations was missing so far.

Methods

The project was mutually conducted by the Austrian Chamber of Pharmacists, Austrian Society for Pediatric and Adolescent Medicine and the Austrian Society of General Practice/Family Medicine and funded by the Austrian Federal Ministry of Education, Science and Research (BMWFW-97.160/0001-C1/9/2015). 9.000 community and hospital pharmacists, paediatricians, dermatologists and general practitioners have been invited to submit commonly prescribed paediatric preparations. In a five step approach all submissions were assessed for completeness, pharmaceutical and medical correctness as well as level of evidence by the involved expert board (1 paediatric pharmacologist, 1 paediatrician, 4 pharmacists) and additional 10 external consultants covering 7 organ systems. Only preparations fulfilling the quality criteria for recommendation have been included in the compendium.

Results

1500 preparations have been submitted by 780 pharmacists, 227 general practitioners, 165 paediatricians and 3 dermatologists. 1175 were applicable for further assessment and 177 were recommended and included in the monograph compendium after assessment of correctness and level of evidence. These fell into 7 organ systems, namely 60 medicines for skin, 34 for the gastro intestinal tract, 20 for the respiratory system, 19 for CNS, 18 for ENT, 16 for circulation and kidneys, 10 for eyes.

Conclusion

This project is an example of successful inter-professional cooperation with the aim to improve the quality of magistral formulations for children. The high number of excluded preparations underlines the need for quality control and standardisation.

Reference

Hofbauer P. 19. GD Jahrestagung, 18. März 2015 in Berlin.

Disclosure(s)

Nothing to disclose
Dopamine dysregulation syndrome induced by proxy
Authors: Reis Carneiro Diogo , Sousa Mário , Morgadinho Ana , Januário Cristina
Published: May 2019

Dopamine dysregulation syndrome is a rare complication of Parkinson’s disease (PD) treatment. We present a 70-year-old woman with a long-standing PD and a clinical picture compatible with dopaminergic dysregulation, which was ultimately revealed to be induced by her companion. Patient’s exuberant choreiform dyskinesia led to a potential financial advantage when performed outside the hospital but excessive dopamine intake also occurred during hospital admission, without any obvious reward for the abuser. Even in cases where there is no place for a definitive diagnosis, deceptive behaviours must be identified as their management is based on psychological and social support in parallel to the adjustment of PD therapy.
Fatal colchicine intoxication by ingestion ofGloriosa superbatubers
Authors: Gunasekaran Karthik , Mathew Divya Elizabeth , Sudarsan Thomas Isaiah , Iyyadurai Ramya
Published: May 2019

Gloriosa superbais an ornamental herb, wildly found in the tropics especially in the southern parts of India and Sri Lanka. All parts of the plants are toxic, especially the tuberous rhizomes in view of their high content of colchicines and its derivatives. We report a case of fatal ingestion of the tubers ofG. superba, with an intention of deliberate self harm, leading to systemic coagulopathy and progressive multiple organ dysfunctions. The patient was managed with intralipid rescue therapy, plasmapheresis, haemodialysis and intensive care. The ease of availability makes plant poisons, a common method of deliberate self-harm in South India. This report reiterates the need for clinician’s awareness of common toxidromes associated with plant poisons.
Wake up call for collegiate athlete sleep: narrative review and consensus recommendations from the NCAA Interassociation Task Force on Sleep and Wellness
Authors: Kroshus Emily , Wagner Jessica , Wyrick David , Athey Amy , Bell Lydia , Benjamin Holly J , Grandner Michael A , Kline Christopher E , Mohler Jessica M , Roxanne Prichard J , Watson Nathaniel F , Hainline Brian
Published: May 2019

Sleep is an important determinant of collegiate athlete health, well-being and performance. However, collegiate athlete social and physical environments are often not conducive to obtaining restorative sleep. Traditionally, sleep has not been a primary focus of collegiate athletic training and is neglected due to competing academic, athletic and social demands. Collegiate athletics departments are well positioned to facilitate better sleep culture for their athletes. Recognising the lack of evidence-based or consensus-based guidelines for sleep management and restorative sleep for collegiate athletes, the National Collegiate Athletic Association hosted a sleep summit in 2017. Members of the Interassociation Task Force on Sleep and Wellness reviewed current data related to collegiate athlete sleep and aimed to develop consensus recommendations on sleep management and restorative sleep using the Delphi method. In this paper, we provide a narrative review of four topics central to collegiate athlete sleep: (1) sleep patterns and disorders among collegiate athletes; (2) sleep and optimal functioning among athletes; (3) screening, tracking and assessment of athlete sleep; and (4) interventions to improve sleep. We also present five consensus recommendations for colleges to improve their athletes’ sleep.
Determinants of anxiety in elite athletes: a systematic review and meta-analysis
Authors: Rice Simon M , Gwyther Kate , Santesteban-Echarri Olga , Baron David , Gorczynski Paul , Gouttebarge Vincent , Reardon Claudia L , Hitchcock Mary E , Hainline Brian , Purcell Rosemary
Published: May 2019

Objective

To identify and quantify determinants of anxiety symptoms and disorders experienced by elite athletes.

Design

Systematic review and meta-analysis.

Data sources

Five online databases (PubMed, SportDiscus, PsycINFO, Scopus and Cochrane) were searched up to November 2018 to identify eligible citations.

Eligibility criteria for selecting studies

Articles were included if they were published in English, were quantitative studies and measured a symptom-level anxiety outcome in competing or retired athletes at the professional (including professional youth), Olympic or collegiate/university levels.

Results and summary

We screened 1163 articles; 61 studies were included in the systematic review and 27 of them were suitable for meta-analysis. Overall risk of bias for included studies was low. Athletes and non-athletes had no differences in anxiety profiles (d=−0.11, p=0.28). Pooled effect sizes, demonstrating moderate effects, were identified for (1) career dissatisfaction (d=0.45; higher anxiety in dissatisfied athletes), (2) gender (d=0.38; higher anxiety in female athletes), (3) age (d=−0.34; higher anxiety for younger athletes) and (4) musculoskeletal injury (d=0.31; higher anxiety for injured athletes). A small pooled effect was found for recent adverse life events (d=0.26)—higher anxiety in athletes who had experienced one or more recent adverse life events.

Conclusion

Determinants of anxiety in elite populations broadly reflect those experienced by the general population. Clinicians should be aware of these general and athlete-specific determinants of anxiety among elite athletes.
Attention-deficit/hyperactivity disorder in elite athletes: a narrative review
Authors: Han Doug Hyun , McDuff David , Thompson Donald , Hitchcock Mary E , Reardon Claudia L , Hainline Brian
Published: May 2019

Attention-deficit/hyperactivity disorder (ADHD) is a common brain developmental disorder in the general population that may be even more prevalent in elite athletes in certain sports. General population studies of ADHD are extensive and have reported on prevalence, symptoms, therapeutic and adverse effects of treatment and new clinical and research findings. However, few studies have reported on prevalence, symptoms and treatments of ADHD in elite athletes. This narrative review summarises the literature on symptoms, comorbidities, effects of ADHD on performance and management options for elite athletes with ADHD. The prevalence of ADHD in student athletes and elite athletes may be 7%–8%. The symptoms and characteristics of ADHD play a role in athletes’ choice of a sport career and further achieving elite status. Proper management of ADHD in elite athletes is important for safety and performance, and options include pharmacologic and psychosocial treatments.
Mental health in elite athletes: International Olympic Committee consensus statement (2019)
Authors: Reardon Claudia L , Hainline Brian , Aron Cindy Miller , Baron David , Baum Antonia L , Bindra Abhinav , Budgett Richard , Campriani Niccolo , Castaldelli-Maia João Mauricio , Currie Alan , Derevensky Jeffrey Lee , Glick Ira D , Gorczynski Paul , Gouttebarge Vincent , Grandner Michael A , Han Doug Hyun , McDuff David , Mountjoy Margo , Polat Aslihan , Purcell Rosemary , Putukian Margot , Rice Simon , Sills Allen , Stull Todd , Swartz Leslie , Zhu Li Jing , Engebretsen Lars
Published: May 2019

Mental health symptoms and disorders are common among elite athletes, may have sport related manifestations within this population and impair performance. Mental health cannot be separated from physical health, as evidenced by mental health symptoms and disorders increasing the risk of physical injury and delaying subsequent recovery. There are no evidence or consensus based guidelines for diagnosis and management of mental health symptoms and disorders in elite athletes. Diagnosis must differentiate character traits particular to elite athletes from psychosocial maladaptations.

Management strategies should address all contributors to mental health symptoms and consider biopsychosocial factors relevant to athletes to maximise benefit and minimise harm. Management must involve both treatment of affected individual athletes and optimising environments in which all elite athletes train and compete. To advance a more standardised, evidence based approach to mental health symptoms and disorders in elite athletes, an International Olympic Committee Consensus Work Group critically evaluated the current state of science and provided recommendations.
Individual free fatty acids have unique associations with inflammatory biomarkers, insulin resistance and insulin secretion in healthy and gestational diabetic pregnant women
Authors: Chen Xinhua , Stein T Peter , Steer Robert A , Scholl Theresa O
Published: May 2019

Objective

We investigated the relationships of maternal circulating individual free fatty acids (FFA) with insulin resistance, insulin secretion and inflammatory biomarkers during mid-pregnancy.

Research design and methods

The data were drawn from a prospective cohort of generally healthy pregnant women (n=1368, African-American 36%, Hispanic 48%, Caucasian 16%) in Camden, NJ. We quantitatively determined 11 FFAs, seven cytokine/adipokine, homeostatic model assessment of insulin resistance (HOMA-IR) and C-peptide levels from the fasting blood samples that were collected at 16 weeks of gestation. Multivariate analyses were performed along with separate analyses for each individual FFA.

Results

High HOMA-IR (p<0.001) and C-peptide (p<0.0001) levels were positively associated with a twofold to fourfold increased risk for developing gestational diabetes mellitus (GDM). Negative relationships were found with specific FFAs (molecular percentage, palmitoleic, oleic, linolenic, myristic acids) and HOMA-IR and C-peptide levels (p<0.01 to p<0.0001). In contrast, palmitic, stearic, arachidonic, dihomo-γ-linolenic (DGLA) and docosahexaenoic acids were positively associated with HOMA-IR and C-peptide (p<0.01 to p<0.0001). The individual FFAs also predicted cytokine/adipokine levels. For example, women who had elevated DGLA (highest quartile) were twice as (adjusted OR 2.06, 95% CI 1.42 to 2.98) likely to have higher interleukin (IL)-8 (p<0.0001) levels. Conversely, women with high palmitoleic, oleic, and linolenic acid levels had reduced odds (≥2-fold, p<0.01 to p<0.001) for having higher IL-8, IL-6 or tumor necrosis factor-alpha levels.

Conclusion

Our results suggest that maternal individual FFAs uniquely affect insulin resistance and secretion. The effects are either direct or indirect via modulation of the inflammatory response. Modifying the composition of FFAs may help in reducing the risk of GDM.
Vaginal herb use andChlamydia trachomatisinfection: cross-sectional study among women of various ethnic groups in Suriname
Authors: Van der Helm Jannie J , Schim van der Loeff Maarten Franciscus , de Vries Esther , van der Veer Charlotte , Grünberg Antoon W , Mans Dennis , de Vries Henry J C
Published: May 2019

Objective

Vaginal steam baths with herb leaves (herb use) is practised by some Surinamese women. We assessed herb use among women from the five most prevalent ethnic groups, and if herb use is associated withChlamydia trachomatisinfection.

Setting

Participants were recruited at a sexually transmitted infection (STI) clinic and a family planning clinic (FP) in Paramaribo, Suriname.

Participants

1040 women were included subsequently, comprising the following ethnic groups: Creole (26.7%), Hindustani (24.6%), Javanese (15.7%), Maroon (13.3%) and mixed descent (19.7%).

Methods

Nurses collected a questionnaire and vaginal swabs for nucleic acid amplificationC. trachomatistesting.

Primary outcomes

Determinants of vaginal herb use andC. trachomatisinfection via univariable and multivariable logistic regression.

Results

Herb use was most common among Maroon (68.8%) and Creole women (25.2%). In multivariable analysis including only Maroon and Creole women, determinants significantly associated with vaginal herb use were (OR; 95% CI): Maroon ethnic descent (5.33; 3.26 to 8.71 vs Creole), recruitment at the STI clinic (2.04; 1.24 to 3.36 vs FP), lower education levels (3.80; 1.68 to 8.57 lower vs higher, and 2.02; 0.90 to 4.51 middle vs higher). Lower age and recruitment at the STI clinic were associated withC. trachomatisinfection, but not vaginal herb use.

Conclusion

In Suriname, vaginal herb use is common among Maroon and Creole women. Education, ethnic group and recruitment site were determinants for herb use. Vaginal herb use was not a determinant ofC. trachomatisinfection. Future research should focus on the effect of herb use on the vaginal microbiome and mucosal barrier.
Physical heaviness of work and sitting at work as predictors of mortality: a 26-year follow-up of the Helsinki Birth Cohort Study
Authors: Mikkola Tuija M , von Bonsdorff Mikaela B , Salonen Minna K , Kautiainen Hannu , Ala-Mursula Leena , Solovieva Svetlana , Viikari-Juntura Eira , Eriksson Johan G
Published: May 2019

Objectives

To examine the relationships of late-career physical heaviness of work and sitting at work with mortality. A national-level job exposure matrix was used to determine the occupation-specific level of physical heaviness and sitting.

Design

Prospective cohort study between years 1990 and 2015.

Setting

Community.

Participants

5210 men and 4725 women from the Helsinki Birth Cohort Study with an occupational code at baseline (ages 45–57 years).

Primary and secondary outcome measures

Total, cardiovascular (International Classification of Diseases 10th Revision I00–I99), cancer (C00–C97) and external (S00–Y84) mortality.

Results

The exposures, physical heaviness and sitting had a non-linear, inverse relationship. During the 26-year follow-up, 1536 men and 759 women died. Among men, physical heaviness of work was positively associated and sitting at work was negatively associated with all-cause, cardiovascular and external cause mortality but they were not associated with cancer mortality. The HRs for men in the highest quartile of physical heaviness of work compared with men in the lowest quartile were 1.54 (1.31–1.80) for all-cause mortality, 1.70 (1.30–2.23) for cardiovascular mortality and 3.18 (1.75–5.78) for external cause mortality (adjusted for age and years of education). Compared with the lowest quartile, the HRs for the highest quartile of sitting at work among men were 0.71 (0.61–0.82) for all-cause mortality, 0.59 (0.45–0.77) for cardiovascular mortality and 0.38 (0.22–0.66) for external cause mortality. In women, neither physical heaviness of work nor sitting at work was associated with mortality.

Conclusions

Men in physically heavy work at their late-work career are at higher risk of death than men in physically light work.
Patient-reported outcomes after surgical and non-surgical treatment of proximal hamstring avulsions in middle-aged patients
Authors: Pihl Elsa , Skoldenberg Olof , Nasell Hans , Jonhagen Sven , Kelly Pettersson Paula , Hedbeck Carl Johan
Published: May 2019

Objectives

In the literature on proximal hamstring avulsions, only two studies report the outcomes of non-surgically treated patients. Our objective was to compare subjective recovery after surgical and non-surgical treatment of proximal hamstring avulsions in a middle-aged cohort.

Methods

We included 47 patients (33 surgically and 14 non-surgically treated) with a mean (SD) age of 51 (±9) years in a retrospective cohort study. Follow-up time mean (SD) of 3.9 (±1.4) years. The outcome variables were the Lower Extremity Functional Scale (LEFS) and questions from the Proximal Hamstring Injury Questionnaire. Outcome variables were adjusted in regression models for gender, age, American Society of Anestesiologits (ASA) classification and MRI findings at diagnosis.

Results

The baseline characteristics showed no differences except for the MRI result, in which the surgically treated group had a larger proportion of tendons retracted ≥ 2 cm. The mean LEFS score was 74 (SD±12) in the surgically treated cohort and 72 (SD±16) in the non-surgically treated cohort. This was also true after adjusting for confounders. The only difference in outcome at follow-up was the total hours performing physical activity per week, p=0.02; surgically treated patients reported 2.5 hours or more (5.2 vs 2.7).

Conclusion

This study on middle-aged patients with proximal hamstring avulsions was unable to identify any difference in patient-reported outcome measures between surgically and non-surgically treated patients. The vast majority of patients treated surgically had complete proximal hamstring avulsions with ≥ 2 cm of retraction. We conclude that to obtain an evidence-based treatment algorithm for proximal hamstring avulsions studies of higher scientific level are needed.
Some observations on BWIM data collected in Manitoba
Authors: Algohi B. , Bakht B. , Khalid H. , Mufti A. , Regehr J.
Published: May 2019

Three highway bridges in the Canadian province of Manitoba are being monitored continuously not only for their long-term performance but also for bridge weighing-in-motion (BWIM). Data collected for the BWIM study has led to some observations that have far-reaching consequences about the design and evaluation loads for highway bridges. This paper presents the well-known concept of equivalent base length, Bm, as a useful tool for comparing trucks with different axle weight and spacing configurations as they influence load effects in all bridges. It is discussed that the statistics of gross vehicle weights (GVWs), W, collected over a one-month period is not significantly different from that for the GVW data collected over a longer period. A rational method concludes that the value of W for the CL-W Truck, the design live load specified by the Canadian Highway Bridge Design Code, is 555 kN for Manitoba. The observed truck data in Manitoba presented on the W–Bm space is found to be similar to that collected in the Canadian province of Ontario more than four decades ago. It was also found that the multi-presence factors, accounting for the presence of side-by-side trucks in two-lane bridges, specified in North American bridge design and evaluation codes are somewhat conservative.
Stanniocalcin-1 and -2 effects on glucose and lipid metabolism in white adipose tissue from fed and fasted rats
Authors: Sarapio Elaine , De Souza Samir K. , Model Jorge F.A. , Trapp Marcia , Da Silva Roselis S.M.
Published: May 2019

Stanniocalcin-1 and -2 belong to a family of molecules that exhibit both paracrine and autocrine effects in mammalian cells. Human stanniocalcin-1 (hSTC-1) is expressed in a wide range of tissues, including white adipose tissue. In fed rats, hSTC-1 increases carbon flux from glucose to lipids in retroperitoneal white adipose tissue. Human stanniocalcin-2 (hSTC-2) is expressed in almost all tissues and regulates various biological processes. The aim of this work was to study the action of hSTC-1 and hSTC-2 in the lipid and glucose metabolism of epididymal white adipose tissue (eWAT) in rats in different nutritional states. This study shows for the first time an opposite effect of hSTC-1 and hSTC-2 on glyceride-glycerol generation from glucose in eWAT of fed rats. hSTC-1 stimulated the storage of triacylglycerol in eWAT in the postprandial period, increasing glucose uptake and glyceride-glycerol generation from14C-glucose. hSTC-2 decreased triacylglycerol synthesis, reducing glyceride-glycerol generation from14C-glucose, direct phosphorylation of glycerol, and fatty acid synthesis from14C-glucose in eWAT of fed rats. However, both hormones increased glucose uptake in fed and fasting states. These findings provide evidence for a direct role of hSTC-1 and hSTC-2 in the regulation of lipid and glucose metabolism in eWAT of rats.
Identifying multiple vulnerable areas of infrastructure network under global connectivity measure
Authors: Wang Ke , Li Yong , Wu Jun
Published: May 2019

Infrastructure networks provide significant services for our society. Nevertheless, high dependence on physical infrastructures makes infrastructure networks vulnerable to disasters or intentional attacks which being considered as geographically related failures that happened in specific geographical locations and result in failures of neighboring network components. To provide comprehensive network protection against failures, vulnerability of infrastructure network needs to be assessed with various network performance measures. However, when considering about multiple vulnerable areas, available researches just employ measure of total number of affected edges while neglecting edges’ different topologies. In this paper, we focus on identifying multiple vulnerable areas under global connectivity measure: Size Ratio of the Giant Component (SRGC). Firstly, Deterministic Damage Circle Model and Multiple Barycenters Method are presented to determine damage impact and location of damage region. For solving the HP-hard problem of identifying multiple optimal attacks, we transform the problem into combinational optimization problem and propose a mixed heuristic strategy consisted of both Greedy Algorithm and Genetic Algorithm to attain the optimal solution. We obtain numerical results for real-world infrastructure network, thereby demonstrating the effectiveness and applicability of the presented strategy and algorithms. The distinctive results of SRGC indicate the necessity and significance of considering global connectivity measure in assessing vulnerability of infrastructure networks.
An adaptive discrete particle swarm optimization for influence maximization based on network community structure
Authors: Tang Jianxin , Zhang Ruisheng , Yao Yabing , Zhao Zhili , Chai Baoqiang , Li Huan
Published: May 2019

As an important research field of social network analysis, influence maximization problem is targeted at selecting a small group of influential nodes such that the spread of influence triggered by the seed nodes will be maximum under a given propagation model. It is yet filled with challenging research topics to develop effective and efficient algorithms for the problem especially in large-scale social networks. In this paper, an adaptive discrete particle swarm optimization (ADPSO) is proposed based on network topology for influence maximization in community networks. According to the framework of ADPSO, community structures are detected by label propagation algorithm in the first stage, then dynamic encoding mechanism for particle individuals and discrete evolutionary rules for the swarm are conceived based on network community structure for the meta-heuristic optimization algorithm to identify the allocated number of influential nodes within different communities. To expand the seed nodes reasonably, a local influence preferential strategy is presented to allocate the number of candidate nodes to each community according to its marginal gain. The experimental results on six social networks demonstrate that the proposed ADPSO can achieve comparable influence spread to CELF in an efficient way.
Immersed boundary-lattice Boltzmann simulation of a rotating flat plate interacting with laminar flows
Authors: Wang Zhikai , Yao Xiongliang
Published: May 2019

To make an insight into the interaction characteristics of a flat plate rotating in laminar flows, the immersed boundary (IB)-lattice Boltzmann (LB) method combined with the multiple-relaxation-time (MRT) collision model in two dimensions is presented. Furthermore, an implicit velocity-correction IB method is proposed to deal with the interface of moving solid boundary interacting with fluid flows. Two valuable sub-issues are particularly highlighted in the research. One is the multiple-relaxation-time immersed boundary-lattice Boltzmann (MRT-IB-LB) implementation of the fluid-structure interface enforcing the nonslip boundary condition, and the other is the effects of rotating velocities associated with aspect ratios on the plate interacting with the flows. The model is validated with the benchmark case: the flow around a cylinder asymmetrically placed in a channel. Then the effects of different rotating velocities and aspect ratios are researched. With the increasing of aspect ratios, the vortex shedding frequency increases and the multiple dominant frequencies of the hydrodynamic force occur. The formed vortices are driven downstream and amalgamated into the dominant vortices in the biased flow. The average values of hydrodynamic forces can be enlarged by increasing aspect ratio. Additionally, the drag coefficient can be decreased but the lift coefficient is increased by increasing the rotating velocity.
Study of structural, electrical, optical and magnetic properties of Hexaferrite–Polyaniline nanocomposites
Authors: Ajmal Muhammad , Islam M. U.
Published: May 2019

Y-type hexagonal ferrite (CaBaCo2Ga[Formula: see text]Fe[Formula: see text]O[Formula: see text]) was synthesized by sol–gel technique. The ferrite–polymer composites (1−x)CaBaCo2Ga[Formula: see text]Fe[Formula: see text]O[Formula: see text]+(x)polyaniline (x=0.25, 0.50, 0.75, 1) namely PF1, PF2, PF3 and polyaniline (PANI) were synthesized by in situ polymerization. The synthesized samples were characterized by XRD, SEM, electrical and dielectric measurements, optical and magnetic studies. XRD pattern reveals a broad peak of polyaniline which is an indication of amorphous nature of PANI. Room-temperature resistivity increases from 2.14 × 101 [Formula: see text]cm to 2.78 × 10[Formula: see text]cm as ferrite content increases due to resistive behavior of the ferrite particles dispersed in the PANI matrix. The value of dielectric constant decreases at fixed frequency with increasing concentration of ferrite filler which is predominantly due to exchange of electrons between Fe[Formula: see text] and Fe[Formula: see text] ions that ultimately results in enhancement of electric polarization and conductivity. The optical bandgap increases with increasing amount of ferrite in the composites. The saturation magnetization and remanence increase with the increase of ferrite filler amount in PANI matrix whereas coercivity decreases. The decrease in coercivity and increase in saturation magnetization are related to Brown’s relation. The present nanocomposite samples may be the best candidates for electromagnetic shielding.
Learned versus Handcrafted Features for Person Re-identification
Authors: Chahla C. , Snoussi H. , Abdallah F. , Dornaika F.
Published: May 2019

Person re-identification is one of the indispensable elements for visual surveillance. It assigns consistent labeling for the same person within the field of view of the same camera or even across multiple cameras. While handcrafted feature extraction is certainly one way of approaching this problem, in many cases, these features are becoming more and more complex. Besides, training a deep convolutional neural network (CNN) from scratch is difficult because it requires a large amount of labeled training data and a great deal of expertise to ensure proper convergence. This paper explores the following three main strategies for solving the person re-identification problem: (i) using handcrafted features, (ii) using transfer learning based on a pre-trained deep CNN (trained for object categorization) and (iii) training a deep CNN from scratch. Our experiments consistently demonstrated that: (1) The handcrafted features may still have favorable characteristics and benefits especially in cases where the learning database is not sufficient to train a deep network. (2) A fully trained Siamese CNN outperforms handcrafted approaches and the combination of pre-trained CNN with different re-identification processes. (3) Moreover, our experiments demonstrated that pre-trained features and handcrafted features perform equally well. These experiments have also revealed the most discriminative parts in the human body.
Mössbauer rotor experiment as new proof of general relativity: Rigorous computation of the additional effect of clock synchronization
Authors: Corda Christian
Published: May 2019

We received an Honorable Mention at the Gravity Research Foundation 2018 Awards for Essays on Gravitation by showing that a correct general relativistic interpretation of the Mössbauer rotor experiment represents a new, strong and independent proof of Einstein’s general theory of relativity (GTR). Here, we correct a mistake which was present in our previous computations on this important issue by deriving a rigorous computation of the additional effect of clock synchronization. Finally, we show that some recent criticisms on our general relativistic approach to the Mössbauer rotor experiment are incorrect, by ultimately confirming our important result.
Elasto-Plastic Analysis of Steel Framed Structures Based on Rigid Body Rule and Plastic-Hinge Concept
Authors: Yang Y. B. , Chen Zhao-Hui , Tao Y. C. , Li Y. F. , Liao M. M.
Published: May 2019

Aimed at its elegance, the rigid-body-based procedure for geometric nonlinear analysis is extended to including the plastic-hinge concept for elasto-plastic analysis of framed structures. To this end, the rigid body test for initially stressed elements is first briefed, followed by derivation of the tangent stiffness of the 2D elasto-plastic beam element using the initial and full yield surfaces to consider gradual yielding of the cross-section. Of theoretical importance, the tangent and geometric stiffnesses are jointly tested by the rigid body rule for initially stressed elements. The above concepts are contained in the global and local strategies, respectively, for tracing the load–deflection curves and for performing the trial-and-error iterations. The former can deal with the formation of multi plastic hinges, in addition to multi-critical points, whereas the latter is strongly rooted in the rigid body rule and thus is free of fictitious forces (source of slow convergence). The accuracy and efficiency of the solutions obtained are confirmed by comparison with the existing ones. In conclusion, the procedure proposed in its entity makes the elasto-plastic analysis simpler and faster. The more complicated the problem is, the greater the saving in computation time using the proposed procedure. Since only minimal mathematical operations are required, this procedure has the potential of being widely accepted by structural engineers in routine analysis.
KINETOSTATIC ANALYSIS FOR FOUR-BAR LINKAGE MECHANISM OF PROSTHETIC KNEE JOINT
Authors: LIU XUHUI , GUO TIANTIAN , ZHANG JIAHAO , YANG GUANG , SUN LUCHAN , LUO QIWEN , QIU YE
Published: May 2019

In this paper, a mathematical model of four-bar linkage mechanism is built to investigate the prosthetic knee joint, by means of the bar group method, and the motion of the prosthetic knee joint is simulated by motion analysis software. In the state of motion of the four linkage mechanism, to the moving component of the mechanism, the relationship between the moving displacement, velocity and acceleration are obtained. On the basis of the above investigation, dynamic statics analysis for the moving component of four-bar linkage mechanism are completed by the ‘D’Alembert principle. The research results show that, with the change of the rotating angle of the active part, the counter-force of rotating pair and the balance torque on active component are all changeable, which will provide a theoretical basis for the design of prosthetic knee joint mechanism with longer life and better damping effect.