Are You Still There? - A Lightweight Algorithm to Monitor Node Presence in Self-Configuring Networks

This paper is concerned with the analysis and redesign of a distributed algorithm to monitor the availability of nodes in self-configuring networks. The simple scheme to regularly probe a node ¿ "are you still there?" ¿ may easily lead to over- or underloading. The essence of the algorithm is therefore to automatically adapt the probing frequency. We show that a self-adaptive scheme to control the probe load, originally proposed as an extension to the UPnPTM (Universal Plug and Play) standard, leads to an unfair treatment of nodes: some nodes probe fast while others almost starve. An alternative distributed algorithm is proposed that overcomes this problem and that tolerates highly dynamic network topology changes. The algorithm is very simple and can be implemented on large networks of small computing devices such as mobile phones, PDAs, and so on

Improvement of developmental outcome between 24 and 36 months corrected age in very preterm infants

Aim: To study early developmental course in preschool-aged very preterm infants and its association with perinatal risk factors and test-taking behaviour. Methods: Children born <30 weeks gestation and/or <1000 g in the Academic Medical Center of Amsterdam were assessed at 24 and 36 months corrected age with the Dutch Bayley Scales of Infant Development-II (BSID-II-NL) and neurological examination. Linear regression analyses for developmental change were performed with perinatal risk factors. Results: One hundred and forty-six children, mean GA 28 weeks and mean birth weight 1043 g, participated. Mental and psychomotor scores improved significantly with 6 and 7 points, respectively, from 24 to 36 months (p <0.01). Mild to severe problems on at least one domain occurred less often at 36 (32%) compared to 24 months (63%) (p <0.01), using corrected scores. Mental improvement was associated with being born very small for gestational age or <28 weeks; psychomotor improvement was associated with not being treated with indomethacin. Difficult test behaviour occurred mostly at 24 months and was associated with non-optimal development at 36 months. Conclusion: Improved developmental outcome and test behaviour were found at 36 compared to 24 months in a cohort of very preterm children. Long-term outcome studies and retesting of behaviourally difficult children are recommende

Glutathione pegylated liposomal methylprednisolone administration after the early phase of status epilepticus did not modify epileptogenesis in the rat

It has been reported that glucocorticoids (GCs) can effectively control seizures in pediatric epilepsy syndromes, possibly by inhibition of inflammation. Since inflammation is supposed to be involved in epileptogenesis, we hypothesized that treatment with GCs would reduce brain inflammation and thereby modify epileptogenesis in a rat model for temporal lobe epilepsy, in which epilepsy gradually develops after electrically induced status epilepticus (SE).To prevent the severe adverse effects that are inevitable with long-term GC treatment, we used liposome nanotechnology (G-Technology®) to enhance the sustained delivery to the brain. Starting 4h after onset of SE, rats were treated with glutathione pegylated liposomal methylprednisolone (GSH-PEG liposomal MP) according to a treatment protocol (1× per week; 10mg/kg) that is effective in other models of neuroinflammation.Continuous electro-encephalogram (EEG) recordings revealed that SE duration and onset of spontaneous seizures were not affected by GSH-PEG liposomal MP treatment. The number and duration of spontaneous seizures were also not different between vehicle and GSH-PEG liposomal MP-treated animals. Six weeks after SE, brain inflammation, as assessed by quantification of microglia activation, was not reduced by GSH-PEG liposomal MP-treatment. Also, neuronal cell loss and mossy fiber sprouting were not affected.Our study shows that the selected GSH-PEG liposomal MP treatment regimen that was administered beyond the acute SE phase does not reduce brain inflammation and development of temporal lobe epilepsy

Impact of presence, level and closure of a stoma on growth in young children: A retrospective cohort study

Introduction A stoma will cause nutrients loss which could result in impaired growth. Impaired growth can negatively impact long-term development. This study aims to evaluate: 1) the effect of stomas on growth comparing small bowel stoma versus colostomy, 2) if early closure (within 6 weeks), proximal small bowel stoma (within 50 centimeters of Treitz), major small bowel resection (≥30 centimeters) or adequate sodium supplementation (urinary level ≤30mmol/L) influence growth. Methods Young children (≤3 years) treated with stomas between 1998-2018 were retrospectively identified. Growth was measured with weight-for-age Z-scores. Malnourishment was defined using the WHO-definition. Comparison between changes in Z-scores at creation, closure and a year following closure was done by Friedman-test with post-hoc-Wilcoxon-signed-rank-test or Wilcoxon-rank-sum-test when necessary. Results In the presence of a stoma in 172 children, 61% showed growth decline. Severe malnourishment was seen at time of stoma closure in 51% of the patients treated by small bowel stoma and 16% of those treated by colostomy. Within a year following stoma closure 67% showed a positive growth trend. Having a proximal small bowel stoma and undergoing major small bowel resection led to significantly lower Z-scores at closure. Adequate sodium supplementation and early closure didn't lead to significant changes in Z-scores. Conclusion Stomas have a negative impact on growth in the majority of children. This impact might be decreased by preventing small bowel stomas when possible, specifically proximal stomas, and limiting small bowel resection. Since stoma closure is essential in reversing the negative effect on growth, we opt that early closure might result in an early shift to catch-up growth

Effects of the Live Attenuated Measles-Mumps-Rubella Booster Vaccination on Disease Activity in Patients With Juvenile Idiopathic Arthritis A Randomized Trial:a randomized trial

Importance The immunogenicity and the effects of live attenuated measles-mumpsrubella (MMR) vaccination on disease activity in patients with juvenile idiopathic arthritis (JIA) are matters of concern, especially in patients treated with immunocompromising therapies. Objectives To assess whether MMR booster vaccination affects disease activity and to describe MMR booster immunogenicity in patients with JIA. Design, Setting, and Participants Randomized, multicenter, open-label clinical equivalence trial including 137 patients with JIA aged 4 to 9 years who were recruited from 5 academic hospitals in the Netherlands between May 2008 and July 2011. Intervention Patients were randomly assigned to receive MMR booster vaccination (n=68) or no vaccination (control group; n=69). Among patients taking biologics, these treatments were discontinued at 5 times their half-lives prior to vaccination. Main Outcomes and Measures Disease activity as measured by the Juvenile Arthritis Disease Activity Score (JADAS-27), ranging from 0 (no activity) to 57 (high activity). Disease activity in the year following randomization was compared between revaccinated patients and controls using a linear mixed model. A difference in JADAS-27 of 2.0 was the equivalence margin. Primary immunogenicity outcomes were seroprotection rates and MMR-specific antibody concentrations at 3 and 12 months. Results Of 137 randomized patients, 131 were analyzed in the modified intention-to-treat analysis, including 60 using methotrexate and 15 using biologics. Disease activity during complete follow-up did not differ between 63 revaccinated patients (JADAS-27, 2.8; 95% CI, 2.1-3.5) and 68 controls (JADAS-27, 2.4; 95% CI, 1.7-3.1), with a difference of 0.4 (95% CI, -0.5 to 1.2), within the equivalence margin of 2.0. At 12 months, seroprotection rates were higher in revaccinated patients vs controls (measles, 100% vs 92%[95% CI, 84%-99%]; mumps, 97%[95% CI, 95%-100%] vs 81% [95% CI, 72%-93%]; and rubella, 100% vs 94% [95% CI, 86%-100%], respectively), as were antibody concentrations against measles (1.63 vs 0.78 IU/mL; P=.03), mumps (168 vs 104 RU/mL; P=.03), and rubella (69 vs 45 IU/mL; P=.01). Methotrexate and biologics did not affect humoral responses, but low patient numbers precluded definite conclusions. Conclusion and Relevance Among children with JIA who had undergone primary immunization, MMR booster vaccination compared with no booster did not result in worse JIA disease activity and was immunogenic. Larger studies are needed to assess MMR effects in patients using biologic agents