A method of automated detection of onset and termination of rhythmic muscle activity in electromyograms (EMGs) is presented. A threshold level in the EMG is computed, such that amplitudes in the EMG signal exceeding this level indicate muscle activity. The threshold level is determined using a statistical criterion based on the amplitude distribution of the entire EMG signal. The working of the method is illustrated with EMG signals recorded from chewing muscles. EMG signals with a good as well as a worse signal-to-noise ratio are presented. The method can be used for any EMG signal containing cyclic bursts of activity and thus may be applied in studies on rhythmic movements, such as chewing, walking and breathing. An automated method of EMG burst detection has the advantage that large amounts of EMG data can be easily and objectively processed.

In Ethiopia, as elsewhere in Africa, the boundaries of political belonging have always shifted. They continue to do so. Since the 1995 constitution, in a both peculiar and complex manner, ethnicity has been included in the apparatus of rights and practices, with often far-reaching consequences for Ethiopian nation-building. Since 1991, citizenship in Ethiopia can hardly be discussed without reference to the post-1991 ethnofederal system, which was the result of the restructuring of domestic politics based on ethnolinguistic criteria. This reformation of the administrative landscape altered interethnic relations, and although justified as an answer to an age-old national question about belonging, and a guarantor for interethnic peace and justice, problems have abounded. In this article, we analyze Ethiopian citizenship in the wider context of global debates on “cultural citizenship.” We examine the bifurcated Ethiopian approach to national and regional citizenship and the language of cultural rights in a historical perspective both as continued subject-making as well as a form of claims-making. Focusing on citizenship and the powers that manifest social boundaries through cultural ascription, we circumvent both the instrumentalist and primordialist gaze on ethnicity and multiculturalism. Ethnicity appears as a reservoir and idiom of political appropriation within an evolving system of state-subject relations that has left the status of citizenship unresolved.

BackgroundVoriconazole pharmacokinetics (PK) have been studied in paediatric studies and described by popu-lation pharmacokinetic modelling.1 Using the currently approved intravenous (IV) dosing regimen,2,3 paediatric patients provided 30 trough samples resulting in a ob-served median (range) of 1.2 (0.11–17.4) mg/L.1 This illustrates the highly variable pharmacokinetic (PK) pro-file of voriconazole in children. The aim of this case series is to evaluate the effectiveness of dosing guidelines in combination with routine therapeutic drug monitoring (TDM) to achieve therapeutic serum concentrations of voriconazole in young cancer patients (age 0–6 years old).MethodsAt the VUmc, paediatric patients are treated using TDM. Voriconazole plasma concentrations are monitored and dosing regimens are individualised, aiming at trough levels of 1–6 mg/L depending on the location of the Asper-gillus. A case series of 4 children (age 0–6 years) is presented.ResultsHighly variable voriconazole exposure (n=4) were observed. Case 1 Boy, 13 months, acute myeloid leukaemia: Loading dose 9 mg/kg tid (IV), maintenance 8 mg/kg tid (IV) [2] resulted in supratherapeutic levels, hepatic toxicity and circulatory insufficiency. Root cause: CYP2C inhibition by previous prophylactic Itraconazole treatment. Itraconazole has a half-life time up to two days. Therapeutic voriconazole levels achieved at 6 mg/kg tid (IV); Case 2 Boy, 5 years, acute lymphatic leukaemia: Doses varying between 7 mg/kg tid IV and 11 mg/kg tid IV during 4 months of IV therapy. Highly variable trough concentrations varying from 0.10–13.3 mg/L; 65% within the target range of 2–6 mg/L for cerebral Aspergillus: Case 3 Girl, 7 months, mixed phenotype acute leukaemia: Load-ing dose 6 mg/kgbid (IV), maintenance 9 mg/kgbid (PO) resulted in subtherapeutic trough levels (0.1–0.2 mg/L), possibly due to high first pass metabolism. Case 4 Girl, 5 years, acute lymphatic leukaemia: Loading dose 10 mg/kgbid (PO), high maintenance dose of 23 mg/kgbid (PO) re-sulted in therapeutic levels. Higher doses of 30 mg/kgbid resulted in a more than dose-proportional increase of ex-posure (trough level 22 mg/L), suggesting non-linear PK.ConclusionVoriconazole PK is highly variable in pedi-atric cancer patients, which can only partly be attributed to drug interactions and co-morbidities. A starting dose of 18 mg/kg (IV) is recommended and could be adminis-tered as 6 mg/kg tid (IV).2 Intensive TDM (at least twice weekly) and daily in-depth status reviews are recom-mended to achieve therapeutic drug levels.

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