bluuebunny/crossref_metadata_2025_split huggingface dataset:
P39 Establishment of the swiss database for dosing medicinal products in pediatrics
Authors: Giger E , Glauser A , Panis D , Tilen R , Berger C 
Published: May 2019

BackgroundDrug therapy in children is challenging. Due to the lack of licensed drugs for paediatric use, off-label or unlicensed prescription is frequent. To improve quality and safety of prescription of medicinal products for children in Switzerland, the requirement to create and continuously run a national database was added in the revision of the therapeutic products act (TPA Art. 67a). The task of operating the database was given to SwissPedDose, an association representing eight Swiss children’s hospitals, the Swiss Society of Paediatrics (SGP) and the Swiss Association of Public Health Administration and Hospital Pharmacists (GSASA).MethodsSubstances used in three therapeutic areas ‘general paediatrics’, ‘infectious diseases’ and ‘neonatology’ are selected according to their frequency of use in the eight participating hospitals. Dosage data of substance-indication pairs are requested from the hospital pharmacists. Based on these data and literature review a dosage suggestion consisting of substance, indication, route of administration, dose, daily repetitions and, if applicable, additional remarks is then elaborated by a specialised pharmacist of SwissPedDose. This suggestion is then discussed by experienced physicians delegated from the eight clinics. The elaboration, discussion and agreement on a national dosage recommendation takes place and is documented in an online platform specially programmed for this structured harmonisation process. Once an agreement has been achieved, the national dosage recommendation is sent to the eight participating clinics and published in a free accessible public database.ResultsAs of December 31st 2018, 195 dosage recommendations for children including 87 indications and 54 substances have been harmonised and published and are available for medical professionals on https://swisspeddose.ch/database.ConclusionThe goal of published recommendations for 100 substances by March 2021 is feasible to reach due to interprofessional collaboration. SwissPedDose may thus contribute to a more efficient and safe use of drugs prescribed to children in Switzerland.Disclosure(s)Source of Funding: Project funded by the Federal Office of Public Health. Conflict of interest: None, for all listed authors.
P51 A combined experimental approach to assess intestinal drug absorption in early childhood
Authors: Kiss M , Nicolaï J , Heuvel JJMW van den , Mbasu R , Botden SM , Koenderink JB , Russel FGM , Ungell A-L , de Wildt SN 
Published: May 2019

BackgroundDrug transporters and metabolizing enzymes located in the epithelial lining of the intestine limit or enhance systemic drug exposure. During child development, the abundance and activity of these transporters and enzymes - determining how fast and how much of a drug is being absorbed into the circulation - changes from birth to adolescence. As most drugs given to children are taken by mouth, the aim of this project is to study the abundance and activity of transporters and metabolizing enzymes, involved in the intestinal absorption of drugs.MethodsThe ex vivo Ussing chamber with pediatric small intestinal tissue is applied to evaluate intestinal drug absorption and metabolism.1 Transport and metabolism of a selection of drug molecules is assessed across these tissues by sampling the donor and receiver compartment at different intervals and sample analysis by LC-MS/MS. Viability, functionality and integrity of the tissues are monitored using electrophysiological parameters (dP, R, I). Ussing chamber experiments are combined with a targeted proteomics approach to quantify drug transporter and metabolizing enzyme abundance in these tissues.ResultsAn Using chamber method has been successfully set up using both adult and pediatric intestinal tissue. To date samples from three children of different ages have been evaluated and show promising results. Tissue from the same patients has been stored for proteomics analysis.ConclusionThe Ussing method presents an innovative, feasible approach to study active intestinal transport in children. Further studies are now underway to elucidate age-related variation in intestinal transport and metabolism.ReferenceSjöberg Å, Lutz M, Tannergren C, Wingolf C, Borde A, Ungell AL:Comprehensive study on regional human intestinal permeability and prediction of fraction absorbed of drugs using the Ussing chamber technique. Eur J Pharm Sci 2013 Jan 23;48(1–2):166–80.Disclosure(s)The collaboration project is financed by the Ministry of Economic Affairs by means of the PPP Allowance made available by the Top Sector Life Sciences & Health to stimulate public-private partnerships. Johan Nicolaï, Richard Mbasu and Anna-Lena Ungell are employees of UCB Biopharma SPRL.
P54 KIDS-STEP: a swiss multi-centre RCT on effectiveness of adjunct betamethasone therapy in hospitalised children with community acquired pneumonia
Authors: Kohns Vasconcelos M , Santoro R , Coslovsky M , van den Anker J , Bielicki JA 
Published: May 2019

BackgroundThe incidence of community-acquired pneumonia (CAP) in young children is high (20- 30/1000 child-years) and is associated with a high rate of hospitalisation (around 10/1000 child-years). In adults, a benefit of adjunct corticosteroids on time to clinical stability and hospital discharge has been observed and confirmed in systematic reviews and meta-analyses. In contrast, only few small trials have addressed the potential impact of oral steroid treatment in CAP during childhood. The purpose of this study is to concurrently evaluate whether adjunct treatment with corticosteroids in children hospitalised with CAP is more effective in terms of the proportion of children reaching clinical stability and whether such adjunct treatment is no worse in terms of CAP relapse.MethodsChildren in KIDS-STEP1 receive either oral betamethasone or oral placebo dosed once daily for two consecutive days. We include 700 children from age 1 weighing at least 7 kilograms and up to a body weight of 35 kilograms and age below 10 years hospitalised for CAP using a clinical diagnosis.Co-primary outcomes are(a) The proportion of children clinically stable at 48 hours after randomisation. (b) The proportion of children with CAP-related readmission within 28 days after randomization. Secondary outcomes will be captured to further evaluate the efficacy and safety of adjunct oral steroids in the management of childhood CAP, including proportion of children experiencing solicited side effects of the trial treatment and/or serious adverse events, time to hospital discharge after index hospitalisation in days, time away from routine child care and away from work (for parents) in days up to 28 days after randomisation and total antibiotic exposure in days up to 28 days after randomisation.ResultsEnrolment started in November 2018 and is currently proceeding at approximately 1 participant per participating hospital per week.ReferencesStudy registration: BASEC - EKNZ 2018–00563Disclosure(s)Nothing to disclose
Recreational and ergogenic substance use and substance use disorders in elite athletes: a narrative review
Authors: McDuff David , Stull Todd , Castaldelli-Maia João Mauricio , Hitchcock Mary E , Hainline Brian , Reardon Claudia L 
Published: May 2019

Background
Substances from various classes may be used for recreational purposes, self-treatment or to boost performance. When substance use shifts from occasional to regular, heavy or hazardous use, positive and negative effects can develop that vary by substance class and athlete. Regular use of recreational or performance enhancing substances can lead to misuse, sanctions or use disorders.

Objective
To review the prevalence, patterns of use, risk factors, performance effects and types of intervention for all classes of recreational and performance enhancing substances in elite athletes by sport, ethnicity, country and gender.

Methods
A comprehensive search was conducted to identify studies that compared the prevalence and patterns of substance use, misuse and use disorders in elite athletes with those of non-athletes and provided detailed demographic and sport variations in reasons for use, risk factors and performance effects for each main substance class.

Results
Alcohol, cannabis, tobacco (nicotine) and prescribed opioids and stimulants are the most commonly used substances in elite athletes, but generally used at lower rates than in non-athletes. In contrast, use/misuse rates for binge alcohol, oral tobacco, non-prescription opioids and anabolic-androgenic steroids are higher among athletes than non-athletes, especially in power and collision sports. Cannabis/cannabinoids seem to have replaced nicotine as the second most commonly used substance.

Conclusions
Substance use in elite athletes varies by country, ethnicity, gender, sport and competitive level. There are no studies on substance use disorder prevalence in elite male and female athletes and few studies with direct comparison groups.
Occurrence of mental health symptoms and disorders in current and former elite athletes: a systematic review and meta-analysis
Authors: Gouttebarge Vincent , Castaldelli-Maia João Mauricio , Gorczynski Paul , Hainline Brian , Hitchcock Mary E , Kerkhoffs Gino M , Rice Simon M , Reardon Claudia L 
Published: May 2019

ObjectivesTo present an overview of the existing epidemiological evidence regarding the occurrence of mental health symptoms and disorders among current and former elite athletes.DesignSystematic review and meta-analysis.Data sourcesFive electronic databases were searched from inception to November 2018: PubMed (MEDLINE), SportDiscus via EBSCO, PSycINFO via ProQuest, Scopus and Cochrane.Eligibility criteria for selecting studiesWe included original quantitative studies that were written in English, were conducted exclusively among current or former elite athletes, and presented incidence or prevalence rates of symptoms of mental disorders.ResultsTwenty-two relevant original studies about mental health symptoms and disorders among current elite athletes were included: they presented data especially on symptoms of distress, sleep disturbance, anxiety/depression and alcohol misuse. Meta-analyses comprising 2895 to 5555 current elite athletes showed that the prevalence of mental health symptoms and disorders ranged from 19% for alcohol misuse to 34% for anxiety/depression. Fifteen relevant original studies about mental health symptoms and disorders among former elite athletes were included: they similarly presented data especially about symptoms of distress, sleep disturbance, anxiety/depression and alcohol misuse. Meta-analyses comprising 1579 to 1686 former elite athletes showed that the prevalence of mental health symptoms and disorders ranged from 16% for distress to 26% for anxiety/depression.ConclusionsOur meta-analyses showed that the prevalence of mental health symptoms and disorders ranged from 19% for alcohol misuse to 34% for anxiety/depression for current elite athletes, and from 16% for distress to 26% for anxiety/depression for former elite athletes.
Mental health symptoms and disorders in Paralympic athletes: a narrative review
Authors: Swartz Leslie , Hunt Xanthe , Bantjes Jason , Hainline Brian , Reardon Claudia L 
Published: May 2019

Objectives
This narrative review summarises the literature on the mental health of Paralympic athletes, explores possible reasons for the paucity of research in this area and suggests directions for future research.

Methods
A systematic search of PubMed, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, SPORTDiscus, Scopus, and Cochrane databases was conducted using search terms related to disability, sport and mental health.

Results
The search yielded 665 publications. Of these, 129 were duplicates, resulting in 536 publications identified for initial screening. A total of 72 publications were to be relevant at initial screening. Only seven publications addressed Paralympic athletes specifically. Of these papers, three included measures of depression and three included measures of anxiety. In the studies that were not concerned with mental health symptoms or disorders, the focus of enquiry included identity and self, stress, and well-being.

Conclusion
Most of the studies reviewed are small in scale, and there are almost no comparative data on Paralympic versus Olympic athletes. There is a paucity of data on rates of mental health symptoms and disorders in this population and the factors that might contribute to poor mental health among elite athletes with disabilities. We propose that stereotypes about people with disabilities—and the disability rights movement’s rightful reaction to these stereotypes—have created barriers to mental health research among Paralympic athletes. There is a need for enquiry into the differential stressors experienced by Paralympic athletes, including trauma, transition out of sport, sport and personhood, and the potential for disability sport to promote psychological health.
Impact of a structured, group-based running programme on clinical, cognitive and social function in youth and adults with complex mood disorders: a 12-week pilot study
Authors: Keating Laura E , Becker Suzanna , McCabe Katie , Whattam Jeff , Garrick Laura , Frey Benicio N , Sassi Roberto B , McKinnon Margaret C 
Published: May 2019

BackgroundIndividuals with mood disorders often report lingering health-related quality of life (HRQOL) and social and cognitive impairments even after mood symptoms have improved. Exercise programmes improve mood symptoms in patients, but whether exercise improves functional outcomes in patients with difficult-to-treat mood disorders remains unknown.DesignWe evaluated the impact of a 12-week structured running programme on cognitive, social and quality-of-life outcomes in participants with difficult-to-treat mood disorders.MethodsIn a prospective, open-label study, patients referred to the St Joseph’s Healthcare HamiltonTeam Unbreakablerunning programme for youth and adults with mood disorders completed a comprehensive assessment battery before and after the 12-week exercise intervention.ResultsWe collected preintervention and postintervention data from 18 participants who improved on the general health, vitality, role of emotions, social functioning and mental health (all p≤0.01) HRQOL subscales. Performance improved on cognitive tests that assessed working memory and processing speed (p≤0.04); there were no improvements in complex executive functioning tasks. Regression analyses indicated that younger age, shorter illness duration and reduced bodily pain predicted social and cognitive outcomes.ConclusionParticipation in a group-based, structured running programme was associated with improved HRQOL and social and cognitive function.
Improving risk stratification in heart failure with preserved ejection fraction by combining two validated risk scores
Authors: Boralkar Kalyani Anil , Kobayashi Yukari , Moneghetti Kegan J , Pargaonkar Vedant S , Tuzovic Mirela , Krishnan Gomathi , Wheeler Matthew T , Banerjee Dipanjan , Kuznetsova Tatiana , Horne Benjamin D , Knowlton Kirk U , Heidenreich Paul A , Haddad Francois 
Published: May 2019

IntroductionThe Intermountain Risk Score (IMRS) was developed and validated to predict short-term and long-term mortality in hospitalised patients using demographics and commonly available laboratory data. In this study, we sought to determine whether the IMRS also predicts all-cause mortality in patients hospitalised with heart failure with preserved ejection fraction (HFpEF) and whether it is complementary to the Get with the Guidelines Heart Failure (GWTG-HF) risk score or N-terminal pro-B-type natriuretic peptide (NT-proBNP).Methods and resultsWe used the Stanford Translational Research Integrated Database Environment to identify 3847 adult patients with a diagnosis of HFpEF between January 1998 and December 2016. Of these, 580 were hospitalised with a primary diagnosis of acute HFpEF. Mean age was 76±16 years, the majority being female (58%), with a high prevalence of diabetes mellitus (36%) and a history of coronary artery disease (60%). Over a median follow-up of 2.0 years, 140 (24%) patients died. On multivariable analysis, the IMRS and GWTG-HF risk score were independently associated with all-cause mortality (standardised HRs IMRS (1.55 (95% CI 1.27 to 1.93)); GWTG-HF (1.60 (95% CI 1.27 to 2.01))). Combining the two scores, improved the net reclassification over GWTG-HF alone by 36.2%. In patients with available NT-proBNP (n=341), NT-proBNP improved the net reclassification of each score by 46.2% (IMRS) and 36.3% (GWTG-HF).ConclusionIMRS and GWTG-HF risk scores, along with NT-proBNP, play a complementary role in predicting outcome in patients hospitalised with HFpEF.
Temporal Trend of Non-Invasive Method Capacity for Early Detection of Metabolic Syndrome in Children and Adolescents: A Bayesian Multilevel Analysis of Pseudo-Panel Data
Authors: Arsang-Jang Shahram , Kelishadi Roya , Esmail Motlagh Mohammad , Heshmat Ramin , Mansourian Marjan 
Published: May 2019

<b><i>Background:</i></b> The aim of this study was to examine the ability of Noninvasive methods to early predictions of metabolic syndrome (MetS) among children and adolescents from 2003 to 2016. <b><i>Methods:</i></b> This was a repeated cross-sectional study based on 24,409 Iranian children and adolescents. The variables included anthropometric measures, serum lipid profiles, hypertension, and MetS. The receiver operating characteristic regression and Bayesian multilevel modeling conducted on data to comparison the power of anthropometric measures to early prediction of cardiometabolic risk factors. <b><i>Results:</i></b> The tri-ponderal body shape index (TBSI) in females and waist circumference (WC) percentile in males yielded a greater ability to predict lipid profiles and hypertension than the rest of anthropometric factors. The TBSI (β = 6.24, 95% credible interval [95% Crl] 3.9–8.7) followed by the WC percentile (β = 4.43, 95% Crl 3.5–5.4) were considered the better predictors of MetS compared with the body mass index (BMI), tri-ponderal mass index (TMI), WC, waist-to-height ratio, and WC to height<sup>5</sup> in adolescents. The TBSI with Youden index J (JI) = 0.85 was significantly more accurate than the BMI (JI = 0.73), and TMI (JI = 0.7) for classifying individuals with MetS and in healthy groups. The predictability of early MetS was consistent for both TBSI and WC components throughout the study period. <b><i>Conclusions:</i></b> The TBSI including, both BMI and WC components, predicts MetS and cardiometabolic risk factors more accurately than BMI or WC alone in females. The TBSI ability was higher than other anthropometric factors for screening MetS and cardiometabolic risk factors among adolescents.
The Global Compact for Migration: Lessons for the Unity of EU Representation
Authors: Melin Pauline 
Published: May 2019

Abstract
In December 2018, the Global Compact for Migration was first adopted at the Marrakesh intergovernmental conference to be later endorsed as an UN General Assembly Resolution in New York. From an EU perspective, what started out as a common project to manage migration globally, not to say externally, became a fiasco for the unity of EU representation on the international scene. Unlike the negotiations of international agreements which are framed by the procedure set out in Article 218 TFEU, the negotiations of international soft law do not benefit from a clear legal framework. The Court of Justice has given some indications on the procedural and institutional aspects relevant for the negotiations of international soft law instruments in the Council v. Commission (C-660/13) case but many uncertainties remain. The purpose of this article is to draw lessons from the negotiation process of the Global Compact for the unity of EU representation.
Spatially Continuous Characterization of Forest Canopy Structure and Subcanopy Irradiance Derived from Handheld Radiometer Surveys
Authors: Mazzotti Giulia , Malle Johanna , Barr Sarah , Jonas Tobias 
Published: May 2019

Abstract
Small-scale variations in radiative transfer through forest canopies are strongly linked to canopy structural heterogeneity. To date, upscaling of radiative transfer parameterizations developed at the point scale is hampered by (i) poor representation of canopy structure variability and (ii) limited spatially explicit subcanopy irradiance data to assess the performance of radiative transfer schemes at typical resolutions of land surface models. This study presents a novel approach for efficient in situ characterization of canopy structure and subcanopy irradiance over large spatial extents. The method involves a handheld radiometer assembly mounted on a motorized gimbal developed for nonstationary continuous measurements of shortwave and longwave radiation along forest transects. In combination with radiation and temperature data from a stationary reference station, spatially resolved estimates of sky-view fraction, canopy transmissivity, and longwave enhancement could be obtained. Under favorable meteorological conditions, validation against sky-view fraction data from hemispherical photographs yielded an RMSE of 0.03 (i.e., 3%). Irradiance measurements under heterogeneous canopy cover revealed strong spatial coherence between longwave radiation enhancement, shortwave radiation attenuation, and sky-view fraction on overcast days. Under clear-sky conditions, however, sun flecks caused highly variable shortwave radiation transmissivity patterns. This study demonstrates the potential of handheld radiometer surveys to deliver valuable spatially distributed datasets of collocated canopy structure and subcanopy irradiance which can be used (i) as reference data for alternative approaches to derive canopy structure parameters, (ii) to improve modeling of subcanopy radiation across a wide range of canopy distributions, and (iii) to support respective model upscaling efforts.
Uncertainty Quantification of Density and Stratification Estimates with Implications for Predicting Ocean Dynamics
Authors: Manderson A. , Rayson M. D. , Cripps E. , Girolami M. , Gosling J. P. , Hodkiewicz M. , Ivey G. N. , Jones N. L. 
Published: May 2019

AbstractWe present a statistical method for reconstructing continuous background density profiles that embeds incomplete measurements and a physically intuitive density stratification model within a Bayesian hierarchal framework. A double hyperbolic tangent function is used as a parametric density stratification model that captures various pycnocline structures in the upper ocean and offers insight into several density profile characteristics (e.g., pycnocline depth). The posterior distribution is used to quantify uncertainty and is estimated using recent advances in Markov chain Monte Carlo sampling. Temporally evolving posterior distributions of density profile characteristics, isopycnal heights, and nonlinear ocean process models for internal gravity waves are presented as examples of how uncertainty propagates through models dependent on the density stratification. The results show 0.95 posterior interval widths that ranged from 2.5% to 4% of the expected values for the linear internal wave phase speed and 15%–40% for the nonlinear internal wave steepening parameter. The data, collected over a year from a through-the-column mooring, and code, implemented in the software package Stan, accompany the article.