38 research outputs found

    Federation of Internet experimentation facilities: architecture and implementation

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    International audienceRealistic experimentation facilities are indispensable to accelerate the design of novel Future Internet systems. As many of these ground-breaking new applications and services cover multiple innovation areas, the need for these solutions to be tested on cross-domain facilities with both novel infrastructure technologies and newly emerging service platforms is rising. The Fed4FIRE project therefore aims at federatingotherwise isolated experimentation facilities in order to foster synergies between research communities. Currently the federation includes over 15 facilities from the Future Internet Research and Experiment (FIRE) initiative, covering wired, wireless and sensor networks, SDN and OpenFlow, cloud computing, smart city services,etc.This paper presents the architecture and implementation details of the federation, based on an extensive set of requirements coming from infrastructure owners, service providers and support communitie

    Retreatment for hepatitis C virus direct-acting antiviral therapy virological failure in primary and tertiary settings: The REACH-C cohort

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    Virological failure occurs in a small proportion of people treated for hepatitis C virus (HCV) with direct-acting antiviral (DAA) therapies. This study assessed retreatment for virological failure in a large real-world cohort. REACH-C is an Australian observational study (n = 10,843) evaluating treatment outcomes of sequential DAA initiations across 33 health services between March 2016 to June 2019. Virological failure retreatment data were collected until October 2020. Of 408 people with virological failure (81% male; median age 53; 38% cirrhosis; 56% genotype 3), 213 (54%) were retreated once; 15 were retreated twice. A range of genotype specific and pangenotypic DAAs were used to retreat virological failure in primary (n = 56) and tertiary (n = 157) settings. Following sofosbuvir/velpatasvir/voxilaprevir availability in 2019, the proportion retreated in primary care increased from 21% to 40% and median time to retreatment initiation declined from 294 to 152 days. Per protocol (PP) sustained virological response (SVR12) was similar for people retreated in primary and tertiary settings (80% vs 81%; p = 1.000). In regression analysis, sofosbuvir/velpatasvir/voxilaprevir (vs. other regimens) significantly decreased likelihood of second virological failure (PP SVR12 88% vs. 77%; adjusted odds ratio [AOR] 0.29; 95%CI 0.11–0.81); cirrhosis increased likelihood (PP SVR12 69% vs. 91%; AOR 4.26; 95%CI 1.64–11.09). Indigenous Australians had lower likelihood of retreatment initiation (AOR 0.36; 95%CI 0.15–0.81). Treatment setting and prescriber type were not associated with retreatment initiation or outcome. Virological failure can be effectively retreated in primary care. Expanded access to simplified retreatment regimens through decentralized models may increase retreatment uptake and reduce HCV-related mortality

    Selective Serotonin Reuptake Inhibitor (SSRI) Antidepressants in Pregnancy and Congenital Anomalies: Analysis of Linked Databases in Wales, Norway and Funen, Denmark

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    Background: Hypothesised associations between in utero exposure to selective serotonin reuptake inhibitors (SSRIs) and congenital anomalies, particularly congenital heart defects (CHD), remain controversial. We investigated the putative teratogenicity of SSRI prescription in the 91 days either side of first day of last menstrual period (LMP). Methods and Findings: Three population-based EUROCAT congenital anomaly registries- Norway (2004–2010), Wales (2000–2010) and Funen, Denmark (2000–2010)—were linked to the electronic healthcare databases holding prospectively collected prescription information for all pregnancies in the timeframes available. We included 519,117 deliveries, including foetuses terminated for congenital anomalies, with data covering pregnancy and the preceding quarter, including 462,641 with data covering pregnancy and one year either side. For SSRI exposures 91 days either side of LMP, separately and together, odds ratios with 95% confidence intervals (ORs, 95%CI) for all major anomalies were estimated. We also explored: pausing or discontinuing SSRIs preconception, confounding, high dose regimens, and, in Wales, diagnosis of depression. Results were combined in meta-analyses. SSRI prescription 91 days either side of LMP was associated with increased prevalence of severe congenital heart defects (CHD) (as defined by EUROCAT guide 1.3, 2005) (34/12,962 [0.26%] vs. 865/506,155 [0.17%] OR 1.50, 1.06–2.11), and the composite adverse outcome of 'anomaly or stillbirth' (473/12962, 3.65% vs. 15829/506,155, 3.13%, OR 1.13, 1.03–1.24). The increased prevalence of all major anomalies combined did not reach statistical significance (3.09% [400/12,962] vs. 2.67% [13,536/506,155] OR 1.09, 0.99–1.21). Adjusting for socio-economic status left ORs largely unchanged. The prevalence of anomalies and severe CHD was reduced when SSRI prescriptions were stopped or paused preconception, and increased when >1 prescription was recorded, but differences were not statistically significant. The dose-response relationship between severe CHD and SSRI dose (meta-regression OR 1.49, 1.12–1.97) was consistent with SSRI-exposure related risk. Analyses in Wales suggested no associations between anomalies and diagnosed depression. Conclusion: The additional absolute risk of teratogenesis associated with SSRIs, if causal, is small. However, the high prevalence of SSRI use augments its public health importance, justifying modifications to preconception care

    Developing waist-to-height ratio cut-offs to define overweight and obesity in children and adolescents

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    OBJECTIVE: The waist-to-height ratio (WHtR) assesses abdominal adiposity and has been proposed to be of greater value in predicting obesity-related cardiovascular health risks in children than BMI. The present study aims to develop WHtR cut-offs for overweight and obesity based on the 85th and 95th percentiles for the percentage body fat (%BF) in a cohort of children and adolescents. DESIGN: Waist circumference (WC), height, triceps and subscapular skinfolds were used to calculate WHtR and %BF. Correlations between WHtR and %BF and WHtR/mid-abdominal skinfold were made. Receiver-operating characteristic (ROC) curve analysis was used to select WHtR cut-offs to define overweight and obesity. Subjects were grouped by WHtR cut-offs, and mean values for anthropometry, blood lipids and blood pressure (BP) variables were compared. SETTING: Australian primary and secondary schools. SUBJECTS: A total of 2773 male (M) and female (F) subjects of the 1985 Australian Health and Fitness Survey, aged 8-16 years. RESULTS: Correlation coefficients between WHtR and %BF were M: r = 0·73, F: r = 0·60, P < 0·01 and WHtR/mid-abdominal skinfold were M: r = 0·78, F: r = 0·65, P < 0·01. WHtR of 0·46(M) and 0·45(F) best identified subjects with ≄85th percentile for %BF and 0·48(M) and 0·47(F) identified subjects with ≄95th percentile for %BF. When comparing the highest WHtR group to the lowest, both sexes had significantly higher means for weight, WC, %BF, TG (male subjects only), systolic BP (female subjects only) and lower means for HDL cholesterol (P < 0·05). CONCLUSIONS: WHtR is useful in clinical and population health as it identifies children with higher %BF at greater risk of developing weight-related CVD at an earlier age

    SSRI (NO6AB) exposures 91 days either side of LMP<sup>a</sup> and outcomes<sup>b</sup>based on signals: 3 countries.

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    <p>SSRI (NO6AB) exposures 91 days either side of LMP<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0165122#t003fn002" target="_blank"><sup>a</sup></a> and outcomes<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0165122#t003fn003" target="_blank"><sup>b</sup></a>based on signals: 3 countries.</p
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