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Description of physical activity in children with juvenile idiopathic arthritis using accelerometry.

OBJECTIVES: Juvenile idiopathic arthritis (JIA) can lead to functional impotence and reduced physical activity (PA) in patients. The objective of this study was to monitor the daily PA of children aged 6-18 years with JIA using accelerometry based on disease activity and individual abilities, and to compare this with age recommendations. METHODS: Patients volunteering for the study wore an accelerometer for 7 consecutive days; data were evaluated using a wGT3X ActiGraph™. The 2010 World Health Organization (WHO) recommendations were used for comparison. RESULTS: We collected accelerometry data for 24 patients of the University Hospital Center (UHC) of Besançon. Only two patients did not reach the recommendations of moderate-to-vigorous PA (MVPA). Time spent in MVPA was negatively correlated with age, BMI, number of joints with active arthritis, JADAS score, and visual analogue pain assessment (VAPA). Patients with active disease, those with upper extremity pain, and female patients had significantly lower PA scores. CONCLUSIONS: Almost all of the patients of the UHC of Besançon who accepted the study reached the WHO recommendations. Having an active disease, having painful upper limbs, or being a girl is associated with decreased PA.

Long-term outcome in patients with juvenile dermatomyositis: A case series.

BACKGROUND: Follow-up of juvenile dermatomyositis (JDM) patients has demonstrated the impact of the disease on several organs in the long term. OBJECTIVE: As there is little information on the long-term outcome of JDM, we aimed to assess long-term outcomes in a series of JDM patients. METHODS: After selection of JDM patients, a consultation with a dermatologist and a rheumatologist was held for each patient. Cutaneous, muscle, and disease damage was assessed using different validated scores including the abbreviated Cutaneous Assessment Tool (aCAT), 8-muscle Manual Muscle Testing (MMT8), Childhood Myositis Assessment Scale (CMAS), Myositis Damage Index (MDI), Childhood Health Assessment Questionnaire (CHAQ), and Health Assessment Questionnaire (HAQ). Long-term disease outcomes were recorded including growth and pubertal development, educational and vocational achievement, and development of comorbidities. RESULTS: Seven patients were included in the study. After a mean follow-up of 14.9±8.8 years, the mean aCAT score was 0.57±1.4 and only one patient had a positive aCAT activity score. The mean aCAT damage score was 1.4±1.3 and five (71%) patients had a score of ≥1. Five (71.4%) patients had normal muscle strength with an MMT8 score of >72, and none had severe muscle weakness (MMT8 ≤32, and CMAS<35). The mean total extent of damage according to the MDI was ≥1 in five (71%) patients and mainly involved the skin. Two (29%) patients had mild disability according to the CHAQ/HAQ disability index. In terms of quality of life, no patient had a score of<40 (1 SD below the mean for healthy controls). CONCLUSIONS: Based on validated cutaneous and musculoskeletal scores, our study demonstrated the good functional outcomes of JDM at long-term follow-up.

Heat-acclimatization and pre-cooling: a further boost for endurance performance?

To determine if pre-cooling (PC) following heat-acclimatization (HA) can further improve self-paced endurance performance in the heat, 13 male triathletes performed two 20-km cycling time-trials (TT) at 35 °C, 50% relative humidity, before and after an 8-day training camp, each time with (PC) or without (control) ice vest PC. Pacing strategies, physiological and perceptual responses were assessed during each TT. PC and HA induced moderate (+10 ± 18 W; effect size [ES] 4.4 ± 4.6%) and very large (+28 ± 19 W; ES 11.7 ± 4.1%) increases in power output (PO), respectively. The overall PC effect became unclear after HA (+4 ± 14 W; ES 1.4 ± 3.0%). However, pacing analysis revealed that PC remained transiently beneficial post-HA, i.e., during the first half of the TT. Both HA and PC pre-HA were characterized by an enhanced PO without increased cardio-thermoregulatory or perceptual disturbances, while post-HA PC only improved thermal comfort. PC improved 20-km TT performance in unacclimatized athletes, but an 8-day HA period attenuated the magnitude of this effect. The respective converging physiological responses to HA and PC may explain the blunting of PC effectiveness. However, perceptual benefits from PC can still account for the small alterations to pacing noted post-HA.

Trace formula for dielectric cavities. II. Regular, pseudointegrable, and chaotic examples.

Dielectric resonators are open systems particularly interesting due to their wide range of applications in optics and photonics. In a recent paper [Phys. Rev. E 78, 056202 (2008)] the trace formula for both the smooth and the oscillating parts of the resonance density was proposed and checked for the circular cavity. The present paper deals with numerous shapes which would be integrable (square, rectangle, and ellipse), pseudointegrable (pentagon), and chaotic (stadium), if the cavities were closed (billiard case). A good agreement is found between the theoretical predictions, the numerical simulations, and experiments based on organic microlasers.

Random matrix ensembles associated with lax matrices.

A method to generate new classes of random matrix ensembles is proposed. Random matrices from these ensembles are Lax matrices of classically integrable systems with a certain distribution of momenta and coordinates. The existence of an integrable structure permits us to calculate the joint distribution of eigenvalues for these matrices analytically. Spectral statistics of these ensembles are quite unusual and in many cases give rigorously new examples of intermediate statistics.

Glucuronidation of the mycotoxins alternariol and alternariol-9-methyl ether in vitro: chemical structures of glucuronides and activities of human UDP-glucuronosyltransferase isoforms.

Alternariol (AOH) and alternariol-9-methyl ether (AME) are major toxins produced by fungi of the genus Alternaria and are frequently found in various food items. Because AOH has three hydroxyl groups and AME two, the formation of various glucuronides must be expected. When AOH was incubated with hepatic and intestinal microsomes from rats, pigs and humans in the presence of uridine diphosphate glucuronic acid, two glucuronides were detected and tentatively identified as AOH-3-O-glucuronide and AOH-9-O-glucuronide. Under the same conditions, AME yielded predominantly AME-3-O-glucuronide and only small amounts of AME-7-O-glucuronide. The activities of all microsomes for the glucuronidation of AOH and AME were in the same range. Nine out of ten recombinant human UDP-glucuronosyltransferases (UGTs) were able to glucuronidate AOH, and eight out of ten UGTs had activity for AME. These data suggest that AOH and AME are readily glucuronidated in hepatic and extrahepatic tissues, implying that glucuronidation constitutes a major metabolic pathway in the disposition of these mycotoxins.

Trace formula for dielectric cavities: general properties.

The construction of the trace formula for open dielectric cavities is examined in detail. Using the Krein formula it is shown that the sum over cavity resonances can be written as a sum over classical periodic orbits for the motion inside the cavity. The contribution of each periodic orbit is the product of the two factors. The first is the same as in the standard trace formula and the second is connected with the product of reflection coefficients for all points of reflection with the cavity boundary. Two asymptotic terms of the smooth resonance counting function related with the area and the perimeter of a convex cavity are derived. The coefficient of the perimeter term differs from the one for closed cavities due to unusual high-energy asymptotics of the S matrix for the scattering on the cavity. Corrections to the leading semi-classical formula are briefly discussed. Obtained formulas agree well with numerical calculations for circular dielectric cavities.

Correlation between urine ketones (acetoacetate) and capillary blood ketones (3-beta-hydroxybutyrate) in hyperglycaemic patients.

AIMS: To facilitate the transition from urine ketones (acetoacetate) to capillary blood ketones (3-beta-hydroxybutyrate), we studied the correlation between these two tests. METHODS: Retrospective study of all patients with blood glucose greater than or equal to 2.5 g/l on arrival in the Emergency Department. We studied the correlation between urine ketones (Clinitek 50, Bayer) and capillary blood ketones (Optium, Abbott). We then compared the relative risks (RR) of ketoacidosis and hospitalization associated with each of these tests. RESULTS: In 33 months, 529 adult patients with both urine and blood testing for ketones were enrolled (ketoacidosis 8%, admission rate 49%). Urine ketones scored as +, ++ and +++ corresponded to median capillary blood ketone levels of 0.5 mmol/l (IQR: 0.1-0.9), 0.7 mmol/l (IQR: 0.2-1.8) and 3 mmol/l (IQR: 1.4-5.2), respectively. RRs of ketoacidosis or hospitalization associated with blood ketones greater than or equal to 3 mmol/l were higher than those associated with +++ urine ketones: 74 (95% confidence interval [CI]: 48-88) and 2.9 (95% CI: 2.5-3) versus 31 (95% CI: 18-45) and 2 (95% CI: 1.7-2.1), respectively. CONCLUSIONS: In hyperglycaemic patients in the Emergency Department, a good correlation was observed between urine ketones and capillary blood ketones for low values, but a poor correlation was observed for high values. Either test can therefore be used to exclude ketosis, but the capillary blood ketones test is more accurate to confirm ketoacidosis.

First experimental observation of superscars in a pseudointegrable barrier billiard.

With a perturbation body technique intensity distributions of the electric field strength in a flat microwave billiard with a barrier inside up to mode numbers as large as about 700 were measured. A method for the reconstruction of the amplitudes and phases of the electric field strength from those intensity distributions has been developed. Recently predicted superscars have been identified experimentally and--using the well-known analogy between the electric field strength and the quantum mechanical wave function in a two-dimensional microwave billiard--their properties determined.

Structure of wave functions of pseudointegrable billiards.

Wave functions of pseudointegrable plane polygonal billiards are investigated. It is demonstrated that they have clear structures (superscars) related with families of classical periodic orbits which do not disappear at large energy.

Spectral statistics of a quantum interval-exchange map.

Curious spectral properties of an ensemble of random unitary matrices appearing naturally in the quantization of a simple interval-exchange map are investigated. It is demonstrated that, under certain conditions on map parameters, local spectral statistics of this ensemble tends to the semi-Poisson distribution with arbitrary integer or half-integer level repulsion at small distances depending on time-reversal symmetry of the map.

Nearest-neighbor distribution for singular billiards.

The exact computation of the nearest-neighbor spacing distribution P(s) is performed for a rectangular billiard with a pointlike scatterer inside for periodic and Dirichlet boundary conditions, and it is demonstrated that when s-->infinity this function decreases exponentially. Together with the results of Bogomolny, Gerland, and Schmit [Phys. Rev. E 63, 036206 (2001)], it proves that spectral statistics of such systems is of intermediate type characterized by level repulsion at small distances and exponential fall-off of the nearest-neighbor distribution at large distances. The calculation of the nth nearest-neighbor spacing distribution P(n)(s) and its asymptotics is performed as well for any boundary conditions.

Percolation model for nodal domains of chaotic wave functions.

Nodal domains are regions where a function has definite sign. In [] it is conjectured that the distribution of nodal domains for quantum eigenfunctions of chaotic systems is universal. We propose a percolationlike model for description of these nodal domains which permits us to calculate all interesting quantities analytically, agrees well with numerical simulations, and due to the relation to percolation theory opens the way to deeper understanding of the structure of chaotic wave functions.

Singular statistics.

We consider the statistical distribution of zeros of random meromorphic functions whose poles are independent random variables. It is demonstrated that correlation functions of these zeros can be computed analytically, and explicit calculations are performed for the two-point correlation function. This problem naturally appears in, e.g., rank-1 perturbation of an integrable Hamiltonian and, in particular, when a delta-function potential is added to an integrable billiard.

Diffractive corrections in the trace formula for polygonal billiards

We derive contributions to the trace formula for the spectral density accounting for the role of diffractive orbits in two-dimensional polygonal billiards. In polygons, diffraction typically occurs at the boundary of a family of trajectories. In this case the first diffractive correction to the contribution of the family to the periodic orbit expansion is of order of that of an isolated orbit, and gives the first sqrt[Planck's over 2pi] correction to the leading semiclassical term. Keller's geometrical theory of diffraction is inadequate for treating these corrections and we develop an alternative approximation based on Kirchhoff's theory. Numerical checks show that our procedure allows reduction of the typical semiclassical error by about two orders of magnitude. The method permits treatment of the related problem of flux-line diffraction with the same degree of accuracy.

Gaussian unitary ensemble statistics in a time-reversal invariant microwave triangular billiard

The spectrum of a chaotic two-dimensional quantum billiard with threefold symmetry has been studied in an experiment with a superconducting microwave cavity. In total 622 eigenvalues were identified experimentally and compared with numerical calculations. The statistical analysis of the data shows that Gaussian unitary ensemble statistics can be observed for a spectrum of a time-reversal invariant system.

Spectral statistics of chaotic systems with a pointlike scatterer

The statistical properties of a Hamiltonian H0 perturbed by a localized scatterer are considered. We prove that if H0 describes a bounded chaotic motion, the universal part of the spectral statistics is not changed by the perturbation. This is done first within the random matrix model. Then it is shown by semiclassical techniques that the result is due to a cancellation between diagonal diffractive and off-diagonal periodic-diffractive contributions. The compensation is a very general phenomenon encoding the semiclassical content of the optical theorem.

Experimental versus numerical eigenvalues of a Bunimovich stadium billiard: a comparison.

We compare the statistical properties of eigenvalue sequences for a gamma=1 Bunimovich stadium billiard. The eigenvalues have been obtained in two ways: one set results from a measurement of the eigenfrequencies of a superconducting microwave resonator (real system), and the other set is calculated numerically (ideal system). We show influence of mechanical imperfections of the real system in the analysis of the spectral fluctuations and in the length spectra compared to the exact data of the ideal system. We also discuss the influence of a family of marginally stable orbits, the bouncing ball orbits, in two microwave stadium billiards with different geometrical dimensions.