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OBJECTIVE To determine if increased mortality could be detected with the administration of ceftriaxone and IV calcium in infants through an analysis of a large repository of electronic health records. METHODS Patients were split into 3 groups: 1) neonates, 2) infants, and 3) infants RESULTS A total of 259,149 infants were identified. Of 79,038 neonates, the proportion of patients that received ceftriaxone and IV calcium within 48 hours who died was 3.8%, compared with 1.95% (IV calcium), 0.3% (ceftriaxone), 1.54% (IV fluids), and 2.03% (parenteral nutrition). For 102,456 infants, the proportions of deaths were 5.47% (ceftriaxone and IV calcium within 48 hours), 0.45% (IV calcium), 0.15% (ceftriaxone), 0.39% (IV fluids), and 5.5% (parenteral nutrition). Multivariate analysis showed increased odds of death in infants who received ceftriaxone and IV calcium within 48 hours, regardless of age, and propensity score–matched analysis showed a more than 2-fold increased risk for death. CONCLUSIONS The increased risk for death following ceftriaxone and IV calcium administration was noted not only in neonates, but among older infants as well.

Purpose To design and implement a chemotherapy stewardship process to optimize the location of chemotherapy administration in an effort to decrease the number of inappropriate inpatient anticancer regimen administrations and decrease institutional costs associated with inpatient administration. Summary As the costs of anticancer agents continue to rise, it is crucial that multidisciplinary efforts are aimed at managing anticancer medication utilization; this is especially important for high-cost medications, medications whose use requires increased monitoring due to safety concerns, and medications that do not exert effects quickly and, as such, can be more appropriately administered in the outpatient setting. It is imperative that pharmacists play a role in managing chemotherapy medication utilization, as pharmacists provide expertise in formulary management, a vast knowledge of financial impact and reimbursement processes, and clinical knowledge that can help predict the expected effectiveness and adverse effects of each anticancer regimen. Our institution sought to develop and implement a multidisciplinary chemotherapy stewardship program targeting the optimization of site of anticancer agent administration with a goal of decreasing both cost and inappropriate utilization of high-cost, high-risk anticancer agents. Conclusion Implementation of a chemotherapy stewardship service may decrease the number of inappropriate inpatient anticancer regimen administrations and decrease inpatient resource use, thereby decreasing costs to institutions. The concept of a chemotherapy stewardship process was well received by multidisciplinary healthcare colleagues, and a collaborative approach should be used to design and implement such processes.

Transiting Exoplanet Survey Satellite (TESS) observations show CD−28° 1974 to be a gravity(g)-mode-dominated hybrid pulsating subdwarf B (sdBV) star. It shows 13 secure periods that form an ℓ = 1 asymptotic sequence near the typical period spacing. Extraordinarily, these periods lie between 1500 and 3300 s, whereas typical $\ell = 1\, g$ modes in sdBV stars occur between 3300 and 10 000 s. This indicates a structure somewhat different from typical sdBV stars. CD−28° 1974 has a visually close F/G main-sequence companion 1.33 arcsec away, which may be a physical companion. Gaia proper motions indicate a comoving pair with the same distance. A reanalysis of Ultraviolet and Visual Echelle Spectrograph (UVES) spectra failed to detect any orbital motion and the light curve shows no reflection effect or ellipsoidal variability, making an unseen close companion unlikely. The implication is that CD−28° 1974 has become a hot subdwarf via single star or post-merger evolution.

OBJECTIVES Pentamidine is an antifungal that is used alternatively to sulfamethoxazole-trimethoprim for the prophylaxis and treatment of Pneumocystis jirovecii pneumonia (PJP). The primary objective of this study was to assess the tolerability of aerosolized versus intravenous pentamidine for PJP prophylaxis in pediatric, adolescent, and young adult immunosuppressed patients. Secondary objectives included comparing pentamidine formulation reaction to dosing frequency and diagnosis. METHODS This retrospective chart review used electronic medical record (EMR) data from patients at a tertiary care pediatric teaching institution from January 1, 2014, to January 1, 2017. Information used from the EMR included pentamidine dosing, ordering, and laboratory values. Inclusion criteria consisted of patients with a cancer diagnosis, hematopoietic stem cell transplant (HSCT) recipients, and renal transplant recipients who received pentamidine for PJP prophylaxis. RESULTS Ninety-six patients met inclusion criteria, of which 31 received aerosolized pentamidine. Ten of the 96 patients experienced a drug-related reaction to either aerosolized or intravenous pentamidine (p = 0.134). Nine of 10 patients who experienced a reaction received intravenous pentamidine versus 1 patient who received aerosolized pentamidine (p = 0.132). In those patients who reacted to pentamidine there was a higher incidence of reactions after subsequent administration (p = 0.039) and in patients with a blood cancer diagnosis (p = 0.042). CONCLUSIONS Data suggest that patients who receive aerosolized pentamidine may tolerate therapy better compared to intravenous administration. Additional studies involving larger numbers of pediatric, adolescent, and young adult patients are needed for stronger statistically significant clinical differences in tolerability of aerosolized versus intravenous pentamidine.

We processed and analysed K2 observations of the pulsating subdwarf-B (sdBV) stars UY Sex and V1405 Ori. We detect 97 p-mode pulsations in UY Sex while we discover V1405 Ori to be a rare rich hybrid pulsator with over 100 p-mode pulsations and 19 g-mode pulsations. We detect frequency multiplets, which we use to identify pulsation modes as well as determine rotation periods. For UY Sex, we find a rotation period of the envelope of 24.6 ± 3.5 d and for V1405 Ori, we find a rotation period of 0.555 ± 0.029 d for the p modes and a marginal detection of 4.2 ± 0.4 d for the g modes. We discover that V1405 Ori is unique among sdBV stars observed to date. It is a rich hybrid pulsator, allowing us to simultaneously probe the envelope and interior; its frequency multiplets indicate V1405 Ori to be rotating differentially with the core rotating more slowly than the envelope, and it is also in a short-period binary (0.398 d) with an envelope that is nearly but not quite tidally locked. For both stars, we have obtained spectroscopic follow-up observations and examine combining them with Gaia parallaxes and archival photometry to determine fundamental properties. Our derived masses are inconsistent with spectroscopy and previous determinations and indicate problems with the methodology.

Clinical therapeutics during pregnancy typically focuses on maternal or fetal disease with only passing attention to the placenta as a potential target. This chapter briefly reviews the history of targeting the placenta for therapeutics and offers some thoughts on current and future opportunities for treating the placenta.

We present photometric and spectroscopic analyses of gravity (g-mode) long-period pulsating hot subdwarf B (sdB) stars. We perform a detailed asteroseismic and spectroscopic analysis of five pulsating sdB stars observed with {\it TESS} aiming at the global comparison of the observations with the model predictions based on our stellar evolution computations coupled with the adiabatic pulsation computations. We apply standard seismic tools for mode identification, including asymptotic period spacings and rotational frequency multiplets. We calculate the mean period spacing for $l = 1$ and $l = 2$ modes and estimate the errors by means of a statistical resampling analysis. For all stars, atmospheric parameters were derived by fitting synthetic spectra to the newly obtained low-resolution spectra. We have computed stellar evolution models using {\tt LPCODE} stellar evolution code, and computed $l = 1$ g-mode frequencies with the adiabatic non-radial pulsation code {\tt LP-PUL}. Derived observational mean period spacings are then compared to the mean period spacings from detailed stellar evolution computations coupled with the adiabatic pulsation computations of g-modes. The atmospheric parameters derived from spectroscopic data are typical of long-period pulsating sdB stars with the effective temperature ranging from 23\,700\,K to 27\,600\,K and surface gravity spanning from 5.3\,dex to 5.5\,dex. In agreement with the expectations from theoretical arguments and previous asteroseismological works, we find that the mean period spacings obtained for models with small convective cores, as predicted by a pure Schwarzschild criterion, are incompatible with the observations. We find that models with a standard/modest convective boundary mixing at the boundary of the convective core are in better agreement with the observed mean period spacings and are therefore more realistic., Comment: Accepted for publication in A&A

We present an overview of eclipsing systems of the HW-Virginis type, based on space observations from the TESS Mission. We perform a detailed analysis of the properties of AA Dor, which was monitored for almost a full year. This excellent time-series dataset permitted us to search for both stellar pulsations and eclipse timing variations. In addition, we used the high-precision trigonometric parallax from Gaia Early Data Release 3 to make an independent determination of the fundamental stellar parameters. No convincing pulsations were detected down to a limit of 76 parts per million, however we detected one peak with false alarm probability of 0.2%. 20 sec cadences being collected during Year 3 should confirm or reject our detection. From eclipse timing measurements we were able to confirm that the orbital period is stable, with an upper limit to any period change of 5.75 $\cdot$ 10$^{-13}$ s/s. The apparent offset of the secondary eclipse is consistent with the predicted R{\o}mer delay when the primary mass is that of a canonical extended horizontal branch star. Using parallax and a spectral energy distribution corroborates that the mass of the primary in AA Dor is canonical, and its radius and luminosity is consistent with an evolutionary state beyond core helium burning. The mass of the secondary is found to be at the limit of hydrogen burning., Comment: published in the MNRAS

We report the discovery of four new pulsating subdwarf B (sdBV) stars from Campaign 7 of the Kepler spacecraft's K2 mission. EPICs 215776487, 217280630, 218366972, and 218717602 are all gravity (g)-mode pulsators and we also detect two pressure (p)-mode pulsations in EPIC 218717602. We detect asymptotic l=1 sequences in all four stars, allowing us to identify nearly all of the g modes. We detect evenly-spaced frequency multiplets in EPIC 218717602, from which we determine a rotation period near seven days. Spectroscopic observations determine that EPIC 218366972, is in a 5.92d binary with most likely a white dwarf companion of canonical mass while the others have no detected companions. As we detect no multiplets in EPIC 218366972, it is added to the growing list of subsynchronously rotating stars. With 40 Kepler-detected sdBV stars and a growing number of TESS publications, we update an examination of the group properties to provide direction for models. We notice a correlation between effective temperature and period of maximum pulsation amplitude, at least for g-mode pulsations, and update the previously-observed effective temperature-rotation period relation., Comment: 20 pages, 12 figures, 1 large table at the end. Accepted for publication in MNRAS

We report results of our analysis of the Kepler superaperture LC data of the open cluster NGC 6791 to search for pulsating sdB stars. We checked all pixels and we found only three sdB stars to be pulsating, KIC 2569576 (B3), KIC 2438324 (B4), and KIC 2437937 (B5). These stars were known to be pulsators before, though we extended data coverage detecting more frequencies and features in their amplitude spectra, i.e. new multiplets and more complete period spacing sequences that we used for identifying geometry of the pulsation modes. The multiplet splittings were also used to derive rotation periods. The remaining known sdBs do not show any pulsation-related light variation down to our detection thresholds. We analysed already existing spectroscopic observations taken with the HECTOSPEC at the MMT telescope in Smithsonian Arizona and with the Gemini Multi-Object Spectrograph at the Gemini North telescope, and fitted atmospheric parameters using the Balmer lines. Four stars, B3 – B6, show atmospheric parameters that are consistent with g-mode dominated sdBs. We detected hints of radial velocity variability in B3, B5, and B6, indicating these three stars may be in binaries.

Three major classes of natural products (NPs) for medicinal purposes or improving wellbeing are generally available in the US: conventional drugs of herbal origin, botanical drugs, and dietary supplements (DSs). Consumer consumption of DSs is growing annually. The U.S. FDA regulates conventional and botanical drugs for safety and efficacy; however, DSs are minimally regulated.This article will: i) highlight the importance of NP as a significant source of prescription drugs; ii) discuss differences in the regulation of conventional drugs of NP product, botanical drugs, and DSs; iii) discuss the safety and efficacy of DSs and iv) make recommendations for improvement of safety for minimally regulated NPs.Toxicities associated with the use of NPs, including vitamins and DSs, are mainly due to excessive use and interactions with conventional drug(s) and may represent challenges for clinicians. Conventional and botanical-based prescription drugs are rarely associated with unknown toxicities. However, DSs are minimally regulated and can produce severe adverse effects. We believe that clinical pharmacologists can have a role in developing criteria for DS safety analysis. There is also the potential for a standardized NP stewardship program(s) and the development of NP policies and practices nationally and globally.

We report on the detection of pulsations of three pulsating subdwarf B stars observed by the TESS satellite and our results of mode identification in these stars based on an asymptotic period relation. SB 459 (TIC 067584818), SB 815 (TIC 169285097) and PG 0342+026 (TIC 457168745) have been monitored during single sectors resulting in 27 days coverage. These datasets allowed for detecting, in each star, a few tens of frequencies, which we interpreted as stellar oscillations. We found no multiplets, though we partially constrained mode geometry by means of period spacing, which recently became a key tool in analyses of pulsating subdwarf B stars. Standard routine that we have used allowed us to select candidates for trapped modes that surely bear signatures of non-uniform chemical profile inside the stars. We have also done statistical analysis using collected spectroscopic and asteroseismic data of previously known subdwarf B stars along with our three stars. Making use of high precision trigonometric parallaxes from the Gaia mission and spectral energy distributions we converted atmospheric parameters to stellar ones. Radii, masses and luminosities are close to their canonical values for extreme horizontal branch stars. In particular, the stellar masses are close to the canonical one of 0.47 M$_\odot$ for all three stars but uncertainties on the mass are large. The results of the analyses presented here will provide important constrains for asteroseismic modelling., 16 pages, 13 figures

Effective drug therapy to optimally influence disease requires an understanding of a drug's pharmacokinetic, pharmacodynamic, and pharmacogenomic interrelationships. In pediatrics, age is a continuum that can and does add variability in drug disposition and effect. This article addresses the many important factors that influence drug disposition and effect relative to age. What is known about the influence of maturation on the processes of drug absorption, distribution, metabolism, excretion, and drug receptor dynamics are outlined. Our state of understanding of many of these factors remains in flux, however, and only with additional study will we be able to better anticipate and model drug-response relationships across the age continuum. Being able to continuously improve our care of the ill pediatric patient while simultaneously being able to accurately determine the utility of new drugs and chemical entities in this population requires our enhanced understanding of these disposition characteristics. ispartof: JOURNAL OF CLINICAL PHARMACOLOGY vol:58 issue:10 pages:S10-S25 ispartof: location:England status: published

We present an analysis of two pulsating subdwarf B stars PHL 457 and EQ Psc observed during the K2 mission. The K2 light curves of both stars show variation consistent with irradiation of a cooler companion by the hot subdwarf. They also show higher frequency oscillations consistent with pulsation. Using new spectroscopic data, we measured the radial velocity, effective temperature, surface gravity, and helium abundance of both hot subdwarfs as a function of orbital phase. We confirm the previously published spectroscopic orbit of PHL 457, and present the first spectroscopic orbit of EQ Psc. The orbital periods are 0.313 and 0.801 d, respectively. For EQ Psc, we find a strong correlation between Teff and orbital phase, due to contribution of light from the irradiated companion. We calculated amplitude spectra, identified significant pulsation frequencies, and searched for multiplets and asymptotic period spacings. By means of multiplets and period spacing, we identified the degrees of several pulsation modes in each star. The g-mode multiplets indicate subsynchronous core rotation with periods of 4.6 d (PHL 457) and 9.4 d (EQ Psc). We made spectral energy disctribution (SED) fits of PHL 457 and EQ Psc using available broad-band photometry and Gaia data. While the SED of PHL 457 shows no evidence of a cool companion, the SED for EQ Psc clearly shows an infrared (IR) access consistent with a secondary with a temperature of about 6800 K and a radius of 0.23 R⊙. This is the first detection of an IR access in any sdB + dM binary.

HD4539 (alias PG0044+097 or EPIC220641886) is a bright (V=10.2) long-period V1093 Her-type subdwarf B (sdB) pulsating star that was observed by the Kepler spacecraft in its secondary (K2) mission. We use the K2 light curve (78.7 days) to extract 169 pulsation frequencies, 124 with a robust detection. Most of these frequencies are found in the low-frequency region typical of gravity (g-)modes, but some higher frequencies corresponding to pressure (p-)modes are also detected. Therefore HD4539 is a hybrid pulsator and both the deep and surface layers of the star can potentially be probed through asteroseismology. The lack of any frequency splitting in its amplitude spectrum suggests that HD4539 has a rotation period longer than the K2 run and/or that it is seen pole-on. From asymptotic period spacing we see many high-degree modes, up to l=12, in the spectrum of HD4539, with amplitudes as low as a few ppm. A large fraction of these modes can be identified and for ~29% of them we obtain a unique and robust identification corresponding to l, 13 pages, Accepted for publication in MNRAS

Improving 511 keV photon detection sensitivity is a common goal for positron emission tomography system designers. One attractive approach to increase sensitivity is recovering events that are normally rejected. The kinematics of Compton scattering can be used to recover the line of response through direction difference angle (DDA). The uncertainty of DDA is determined by the energy and spatial resolution of a system. In this work, we evaluated the performance of small animal CZT-based positron emission tomography systems with energy resolution of 1%, 4%, and 6% and different spatial resolution based on prior work for guiding new design efforts. Designs with energy resolution limited by counting statistics and by electronic noise were considered. The influence of modifying the conventional energy window and uncertainty of DDA was investigated. For a system with 4% energy resolution and limited by electronic noise, the figure of merit of noise equivalent count increases by 65% as the lower energy bound increases from 471 keV to 493 keV. If the system-wide energy resolution becomes worse than 4% of the full width half maximum at 511 keV, going to a pixel size finer than 1 mm has very limited effect in reducing total angular uncertainty. For a system with 1% energy resolution, as the spatial resolution improves from 1 mm to 0.5 mm, the contrast-to-noise ratio increases by 9%.

KIC 10001893 is a V1093 Her type pulsating subdwarf-B star, which was observed extensively by the Kepler spacecraft. It was a part of the survey searching for compact pulsators in the Kepler field of view. An amplitude spectrum of the star demonstrates a rich content of g-modes between 102 and 496 {\mu}Hz as well as a few p-modes above 2000 {\mu}Hz. In total, we found 110 frequencies. The g-mode region contains 104 frequencies, while the p-mode region contains just six, altogether indicating the hybrid nature of KIC 10001893. The main goal of our analysis was to identify the detected modes and to find some features, which will significantly help modeling of the star. We found no multiplets, which points at a pole-on orientation, however, we defined modal degrees and relative radial orders using asymptotic period spacing. Eventually, we assigned 32 dipole l = 1 and 18 quadrupole l = 2 modes. The most remarkable feature we found are trapped modes, which are clearly seen in a reduce period diagram. It is the first time that three trapped modes are detected in one pulsating sdB star. Since the more trapped modes we find, the better sounding of the stellar interior we can do, this feature provides important constraints on the physical structure of the star. Mode trapping is likely caused by the He-H transition region and therefore it provides crucial constraints for making realistic theoretical models of hot subdwarfs.

Background: This study examined the degree to which individuals’ sense of self-determination and internal locus of control might be suitable constructs to study in relation to fine arts participation in adults with complex developmental disabilities.Method: Thirty-four participants in fine arts programs and eight non-participants, all with disabilities involving neuromuscular impairment and varying degrees of cognitive impairment, completed measures of locus of control and of sense of self-determination.Results: No significant differences on quantitative measures were found among high users, low users or non-users of arts programming. Qualitative results suggest that fine arts participants, relative to non-participants, are more likely to de-emphasize “luck” in favor of effort and ambition in attributions about their circumstances and accomplishments.Conclusion: While quantitative findings did not suggest a relationship between either self-determination or locus of control and arts participation, ...

Differences in physiology related to young or old age and/or organ system impairment alter the absorption, distribution, metabolism, and excretion of many medications and consequently their effectiveness and toxicity. This module discusses common alterations in medication use and dosage that are required in the pediatric age group, in the elderly, and in patients with renal or hepatic disease.

CdZnTe single crystals grown with the traveling heater method have been specifically engineered to support high-flux x-ray photon counting applications. Pixelated detector devices absorb hardened $120~\mathrm {kV}_{\mathrm {p}}$ fluxes up to $10^{8}~\mathrm {photons}/(\mathrm {mm}^{2.}\mathrm {sec})$ without any sign of electric field polarization at room temperature (23-28) °C. It is shown that detector functionality can be verified using photon counting electronics even under conditions of strong pulse pile-up. A non-paralyzable counting model satisfactory describes the average output count rate of the detector-electronics system as a function of the absorbed flux. Good pixel-to-pixel count rate uniformity can be achieved.

The Best Pharmaceuticals for Children Act of 2002 mandated that the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) carries out critical reviews of the gaps in knowledge and unmet needs regarding safe and effective pharmacologic treatment of infants, children, and adolescents in a broad range of disease areas. In 2012, NICHD selected diabetes mellitus as one of the pediatric disorders for review. Dr. William V. Tamborlane was named chair, and Dr. Linda DiMeglio, vice-chair, of the Diabetes Working Group. Together with Dr. George Giacoia of NICHD, they assembled a distinguished group of medical experts in childhood diabetes, including clinicians/clinical investigators from leading academic centers and from industry and representatives from the U.S. Food and Drug Administration (FDA), the European Medicines Agency (EMA), and the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), to carry out this review. It is very important to note that the views expressed in this article, as well as in other reports from the Diabetes Working Group, are the personal views of the authors and may not be understood or quoted as being made on behalf of or reflecting the position of the FDA or EMA or any of the organizations or pharmaceutical companies represented in our working group. As shown in Supplementary Table 1, the large Diabetes Working Group was divided into five committees: Type 1 Diabetes (T1D): Therapeutics, Type 2 Diabetes (T2D): Therapeutics, T1D: Natural History and Biomarkers, T2D: Natural History and Biomarkers, and Diabetes Pharmacology. The consensus of the T2D Therapeutics Committee was that its efforts should address the crisis in care that clinicians face in treating this disorder in adolescents. Despite a plethora of new drug classes and new agents within each class that have been approved for use in adults with T2D, in …

Recent progress with Cadmium Zinc Telluride (CZT) radiation sensors grown by the traveling heater method (THM) at Kromek is reported. Large volume monolithic pixelated detectors, 40×40×15 mm3 have been fabricated with good initial gamma spectroscopy response (< 2.5% energy resolution at 662 keV at room temperature without correction). After depth of interaction (DOI) correction, detector performance with < 1% energy resolution at 662 keV at room temperature has been obtained on pixelated 22×22×15 mm3 CZT detector. For medical imaging applications, 20×20×6 mm3 pixelated detectors exhibits < 3% energy resolution at 122 keV without correction. These results have been achieved via our proprietary THM crystal growth in combination with our robust device fabrication technique. Examples of progress in other areas of CZT development for gamma spectroscopy and imaging applications such as 40×40×5 mm3 cross-strip device for PET and Kromek’s general-purpose SPECT camera will also be presented.

We analysed recent K2 data of the short-period eclipsing binary system HW Vir, which consists of a hot subdwarf-B type primary with an M-dwarf companion. We determined the mid-times of eclipses, calculated O-C diagrams, and an average shift of the secondary minimum. Our results show that the orbital period is stable within the errors over the course of the 70 days of observations. Interestingly, the offset from mid-orbital phase between the primary and the secondary eclipses is found to be 1.62 s. If the shift is explained solely by light-travel time, the mass of the sdB primary must be 0.26 M-circle dot, which is too low for the star to be core-helium burning. However, we argue that this result is unlikely to be correct and that a number of effects caused by the relative sizes of the stars conspire to reduce the effective light-travel time measurement. After removing the flux variation caused by the orbit, we calculated the amplitude spectrum to search for pulsations. The spectrum clearly shows periodic signal from close to the orbital frequency up to 4600 mu Hz, with the majority of peaks found below 2600 mu Hz. The amplitudes are below 0.1 part-per-thousand, too low to be detected with ground-based photometry. Thus, the high-precision data from the Kepler spacecraft has revealed that the primary of the HW Vir system is a pulsating sdBV star. We argue that the pulsation spectrum of the primary in HW Vir differs from that in other sdB stars due to its relatively fast rotation that is (nearly) phase-locked with the orbit.

Aim Osteoporosis is a significant clinical problem in persons with moderate to severe cerebral palsy (CP), causing fractures with minimal trauma. Over the past decade, most studies examining osteoporosis and CP have been cross-sectional in nature, focused exclusively on children and adolescents and only involving one evaluation of bone mineral density (BMD). The purpose of this study was to assess BMD in a group including adults with CP, and changes in each individual's BMD over a 5- to 6-year period. Method The study group included 40 residents of a long-term care facility aged 6 to 26 years at the time of their initial evaluation. Twenty-one patients (52.5%) were male, 35 (88%) were white, and 38 (95%) were in Gross Motor Function Classification System level V. BMD was assessed by dual-energy X-ray absorptiometry on the right and left distal femurs for three distinct regions of interest. Results Five residents had a fracture that occurred during the study period; this represented a fracture rate of 2.1% per year in the study group. Longitudinally, annualized change in the median BMD was 0.7% to 1.0% per year in the different regions of the distal femur, but ranged widely among the study group, with both increases and decreases in BMD. Increase in BMD over time was negatively correlated with age and positively correlated with change in weight. Interpretation Changes in BMD over time in profoundly involved persons with CP can range widely, which is important to recognize when evaluating potential interventions to improve BMD. Age and changes in body weight appear the most relevant factors.

This article has been accepted for publication in Monthly notices of the Royal Astronomical Society ©: 2018 Royal Astronomical Society. Published by Oxford University Press on behalf of the Royal Astronomical Society. All rights reserved. The version of record Reed, M.D., Armbrecht, E.L., Telting, J.H., Baran, A.S., Østensen, R., Blay, P., ... Jeffery, C.S. (2018). K2 Campaign 5 observations of pulsating subdwarf B stars: Binaries and super-Nyquist frequencies. Monthly notices of the Royal Astronomical Society, 474(4), 5186-5198 is available online at: https://doi.org/10.1093/mnras/stx3133. We report the discovery of three pulsating subdwarf B stars in binary systems observed with the Kepler space telescope during Campaign 5 of K2. EPIC 211696659 (SDSS J083603.98+155216.4) is a g-mode pulsator with a white dwarf companion and a binary period of 3.16 d. EPICs 211823779 (SDSS J082003.35+173914.2) and 211938328 (LB 378) are both p-mode pulsators with main-sequence F companions. The orbit of EPIC 211938328 is long (635 ± 146 d) while we cannot constrain that of EPIC 211823779. The p modes are near the Nyquist frequency and so we investigate ways to discriminate super- from sub-Nyquist frequencies. We search for rotationally induced frequency multiplets and all three stars appear to be slow rotators with EPIC 211696659 subsynchronous to its orbit.

V391 Peg (alias HS2201+2610) is a subdwarf B (sdB) pulsating star that shows both p- and g-modes. By studying the arrival times of the p-mode maxima and minima through the O-C method, in a previous article the presence of a planet was inferred with an orbital period of 3.2 yr and a minimum mass of 3.2 M_Jup. Here we present an updated O-C analysis using a larger data set of 1066 hours of photometric time series (~2.5x larger in terms of the number of data points), which covers the period between 1999 and 2012 (compared with 1999-2006 of the previous analysis). Up to the end of 2008, the new O-C diagram of the main pulsation frequency (f1) is compatible with (and improves) the previous two-component solution representing the long-term variation of the pulsation period (parabolic component) and the giant planet (sine wave component). Since 2009, the O-C trend of f1 changes, and the time derivative of the pulsation period (p_dot) passes from positive to negative; the reason of this change of regime is not clear and could be related to nonlinear interactions between different pulsation modes. With the new data, the O-C diagram of the secondary pulsation frequency (f2) continues to show two components (parabola and sine wave), like in the previous analysis. Various solutions are proposed to fit the O-C diagrams of f1 and f2, but in all of them, the sinusoidal components of f1 and f2 differ or at least agree less well than before. The nice agreement found previously was a coincidence due to various small effects that are carefully analysed. Now, with a larger dataset, the presence of a planet is more uncertain and would require confirmation with an independent method. The new data allow us to improve the measurement of p_dot for f1 and f2: using only the data up to the end of 2008, we obtain p_dot_1=(1.34+-0.04)x10**-12 and p_dot_2=(1.62+-0.22)x10**-12 ..., Comment: 13 pages, 11 figures, accepted for publication in Astronomy and Astrophysics

The ECH system on DIII-D is continuing to be upgraded, while simultaneously being operated nearly daily for plasma experiments. The latest major hardware addition is a new 117.5 GHz gyrotron, which generated 1.7 MW for short pulses during factory testing. A new gyrotron control system based on Field Programmable Gate Array (FPGA) technology with very high speed system data acquisition has significantly increased the flexibility and reliability of individual gyrotron operation. We have improved the performance of the fast mirror scanning, both by increasing the scan speeds and by adding new algorithms for controlling the aiming using commands generated by the Plasma Control System (PCS). The system is used for transport studies, ELM control, current profile control, non-inductive current generation, suppression of MHD modes, startup assist, plasma density control, and other applications. A program of protective measures, which has been in place for more than two years, has eliminated damage to hardware and diagnostics caused by overdense operation. Other activities not directly related to fusion research have used the ECH system to test components, study methods for improving production of semiconductor junctions and materials, and test the feasibility of using ground based microwave systems to power satellites into orbit.

Although obesity is prevalent among children in the United States, pharmacokinetic (PK) data for obese children are limited. Clindamycin is a commonly used antibiotic that may require dose adjustment in obese children due to its lipophilic properties. We performed a clindamycin population PK analysis using data from three separate trials. A total of 420 samples from 220 children, 76 of whom had a body mass index greater than or equal to the 95th percentile for age, were included in the analysis. Compared to other metrics, total body weight (TBW) was the most robust measure of body size. The final model included TBW and a sigmoidal maturation relationship between postmenstrual age (PMA) and clearance (CL): CL (liters/hour) = 13.8 × (TBW/70) 0.75 × [PMA 2.83 /(39.5 2.83 +PMA 2.83 )]; volume of distribution ( V ) was associated with TBW, albumin (ALB), and alpha-1 acid glycoprotein (AAG): V (liters) = 63.6 × (TBW/70) × (ALB/3.3) −0.83 × (AAG/2.4) −0.25 . After accounting for differences in TBW, obesity status did not explain additional interindividual variability in model parameters. Our findings support TBW-based dosing for obese and nonobese children.

We report a new subdwarf B (sdB) pulsator, PG1142-037, discovered during the first full-length campaign of K2, the two-gyro mission of the Kepler space telescope. Fourteen periodicities have been detected between 0.9 and 2.5 hours with amplitudes below 0.35 ppt. We have been able to associate all of the pulsations with low-degree, ell, 11 pages, 9 figures, accepted for publication in Monthly Notices of the Royal Astronomical Society

We report the discovery of two new pulsating subdwarf B (sdB) stars in the open cluster NGC 6791 using data from the Kepler spacecraft. Three sdB stars were observed for one month in short-cadence (1 min) mode and three months in long-cadence (30 min) mode during Quarter 11 (fall 2011). The stars have Kepler Input Catalogue numbers of 2437937, 2569576 and 2569583 with previous designations of B5, B3 and B6, respectively. Another sdB star exists in the cluster and it is also known to be a pulsator. We also obtained Nordic Optical Telescope spectra to update effective temperatures, surface gravities and helium abundances and compare the spectroscopic properties of all four stars on a uniform model grid. We detect four periodicities between 0.9 and 2.4 h in B3 above a detection limit of 0.53 parts per thousand (ppt) and nine periodicities between 1.1 and 2.2 h in B5 above a detection limit of 0.37 ppt. No pulsations were detected in B6 to the detection threshold of 0.29 ppt. The long-cadence data were less useful as few observations are obtained per pulsation period, yet they do indicate that the pulsations are variable from month to month. The spacings between the pulsation periods are similar to other g-mode pulsating sdB stars observed by Kepler, indicating that the periodicities can be associated witquals; 1 modes. A fit to the periods give spacings of 234.6 ± 0.6 and 242.6 ± 1.5 s for B3 and B5, respectively.

We present our analyses of 15 months of Kepler data on KIC 10139564. We detected 57 periodicities with a variety of properties not previously observed all together in one pulsating subdwarf B star. Ten of the periodicities were found in the low-frequency region, and we associate them with nonradial g-modes. The other periodicities were found in the high-frequency region, which are likely p-modes. We discovered that most of the periodicities are components of multiplets with a common spacing. Assuming that multiplets are caused by rotation, we derive a rotation period of 25.6(1.8) days. The multiplets also allow us to identify the pulsations to an unprecedented extent for this class of pulsator. We also detect l

We have used 605 days of photometric data from the Kepler spacecraft to study KIC 6614501, a close binary system with an orbital period of 0.15749747(25) days (3.779939 hours), that consists of a low-mass subdwarf B (sdB) star and a white dwarf. As seen in many other similar systems, the gravitational field of the white dwarf produces an ellipsoidal deformation of the sdB which appears in the light curve as a modulation at two times the orbital frequency. The ellipsoidal deformation of the sdB implies that the system has a maximum inclination of ~40 degrees, with i \approx 20 degrees being the most likely. The orbital radial velocity of the sdB star is high enough to produce a Doppler beaming effect with an amplitude of 432 \pm 5 ppm, clearly visible in the folded light curve. The photometric amplitude that we obtain, K1 = 85.8 km/s, is ~12 per cent less than the spectroscopic RV amplitude of 97.2 \pm 2.0 km/s. The discrepancy is due to the photometric contamination from a close object at about 5 arcsec North West of KIC 6614501, which is difficult to remove. The atmospheric parameters of the sdB star, Teff = 23 700 \pm 500 K and log g = 5.70 \pm 0.10, imply that it is a rare object below the Extreme Horizontal Branch (EHB), similar to HD 188112 (Heber et al. 2003). The comparison with different evolutionary tracks suggests a mass between ~0.18 and ~0.25 Msun, too low to sustain core helium burning. If the mass was close to 0.18-0.19 Msun, the star could be already on the final He-core WD cooling track. A higher mass, up to ~0.25 Msun, would be compatible with a He-core WD progenitor undergoing a cooling phase in a H-shell flash loop. A third possibility, with a mass between ~0.32 and ~0.40 Msun, can not be excluded and would imply that the sdB is a "normal" (but with an unusually low mass) EHB star burning He...

Diuretics are administered routinely to sick neonates for the treatment of multiple clinical disorders, including edema, hypertension, congestive heart failure/cardiovascular disease, bronchopulmonary dysplasia, and renal dysfunction. Choosing the safest and most effective regimen of diuretic therapy for both the term and preterm neonate requires thoughtful consideration of several factors. Such factors include an understanding of each drug’s pharmacologic principles and safety and efficacy profiles as well as outside considerations such as clinically relevant drug interactions and available formulations, among others. This article focuses on the pharmacokinetic and pharmacodynamic characteristics of each of the most commonly employed diuretics in the neonatal population and the factors that may influence the infant’s overall response to therapy.

We report on extended photometry of two pulsating sdB stars in close binaries. For both cases, we use rotational splitting of the pulsation frequencies to show that the sdB component rotates much too slowly to be in synchronous rotation. We use a theory of tidal interaction in binary stars to place limits on the mass ratios that are independent of estimates based on the radial velocity curves. The companions have masses below 0.26 M\odot. The pulsation spectra show the signature of high-overtone g-mode pulsation. One star, KIC 11179657, has a clear sequence of g-modes with equal period spacings as well as several periodicities that depart from that trend. KIC 02991403 shows a similar sequence, but has many more modes that do not fit the simple pattern.

PG 1351+489 is one of the 20 DBVs ― pulsating helium-atmosphere white dwarf stars ― known and has the simplest power spectrum for this class of star, making it a good candidate to study cooling rates. We report accurate period determinations for the main peak at 489.334 48 s and two other normal modes using data from the Whole Earth Telescope (WET) observations of 1995 and 2009. In 2009, we detected a new pulsation mode and the main pulsation mode exhibited substantial change in its amplitude compared to all previous observations. We were able to estimate the star's rotation period, of 8.9 h, and discuss a possible determination of the rate of period change of (2.0 ± 0.9) x 10 ―13 s s ―1 , the first such estimate for a DBV.

PG 2303+243 is a cool DA variable (also called ZZ Ceti) star with a rich pulsation spectrum and variable amplitudes. A mini-campaign involving six observatories yielded time-resolved photometric measurements of PG 2303+243 during the period 2004 September 5-20. A duty cycle of 35 per cent was achieved. We detected 24 possible independent frequencies, their amplitudes and phases for future mode identification. We confirm the occurrence of short-term amplitude and frequency variations. Our analysis suggests an l = 1 rotational splitting around 8.4 μHz, implying a rotation period of 16.5 h.

We present results from the final six months of a survey to search for pulsations in white dwarfs and hot subdwarf stars with the Kepler spacecraft. Spectroscopic observations are used to separate the objects into accurate classes, and we explore the physical parameters of the subdwarf B (sdB) stars and white dwarfs in the sample. From the Kepler photometry and our spectroscopic data, we find that the sample contains 5 new pulsators of the V1093 Her type, one AM CVn type cataclysmic variable, and a number of other binary systems. This completes the survey for compact pulsators with Kepler. No V361 Hya type of short-period pulsating sdB stars were found in this half, leaving us with a total of one single multiperiodic V361 Hya and 13 V1093 Her pulsators for the full survey. Except for the sdB pulsators, no other clearly pulsating hot subdwarfs or white dwarfs were found, although a few low-amplitude candidates still remain. The most interesting targets discovered in this survey will be observed throughout the remainder of the Kepler Mission, providing the most long-term photometric datasets ever made on such compact, evolved stars. Asteroseismic investigations of these datasets will be invaluable in revealing the interior structure of these stars, and will boost our understanding of their evolutionary history.

We present five new pulsating subdwarf B (sdB) stars discovered by the Kepler spacecraft during the asteroseismology survey phase. We perform time-series analysis on the nearly continuous month-long Kepler datasets of these 5 objects; these datasets provide nearly alias-free time-series photometry at unprecedented precision. Following an iterative prewhitening process we derive the pulsational frequency spectra of these stars, separating out artefacts of known instrumental origin. We find that these new pulsating sdB stars are multiperiodic long-period pulsators of the V1093 Her type, with the number of periodicities ranging from 8 (KIC8302197) to 53 (KIC11558725). The frequencies and amplitudes are typical of g-mode pulsators of this type. We do not find any evidence for binarity in the five stars from their observed pulsation frequencies. As these are g-mode pulsators, we briefly looked for period spacings for mode identification, and found average spacings about 260s and 145s. This may indicate l=1 and 2 patterns. Some modes may show evidence of rotational splitting. These discoveries complete the list of compact pulsators found in the survey phase. Of the 13 compact pulsators, only one star was identified as a short-period (p-mode) V361Hya pulsator, while all other new pulsators turned out to be V1093 Her class objects. Among the latter objects, two of them seemed to be pure V1093 Her while the others show additional low amplitude peaks in the p-mode frequency range, suggesting their hybrid nature. Authenticity of these peaks will be tested with longer runs currently under analysis.