Determinants of inspiratory muscle function in healthy children

AbstractBackgroundChildren are affected by disorders that have an impact on the respiratory muscles. Inspiratory muscle function can be assessed by means of the noninvasive tension–time index of the inspiratory muscles (TTImus). Our objectives were to identify the determinants of TTImus in healthy children and to report normal values of TTImus in this population.MethodsWe measured weight, height, upper arm muscle area (UAMA), and TTImus in 96 children aged 6–18 years. The level and frequency of aerobic activity was assessed by questionnaire.ResultsTTImus was significantly lower in male subjects (0.095 ± 0.038, mean ± SD) compared with female subjects (0.126 ± 0.056) (p = 0.002). TTImus was significantly lower in regularly exercising (0.093 ± 0.040) compared with nonexercising subjects (0.130 ± 0.053) (p < 0.001). TTImus was significantly negatively related to age (r = −0.239, p = 0.019), weight (r = −0.214, p = 0.037), height (r = −0.355, p < 0.001), and UAMA (r = −0.222, p = 0.030). Multivariate logistic regression analysis revealed that height and aerobic exercise were significantly related to TTImus independently of age, weight, and UAMA. The predictive regression equation for TTImus in male subjects was TTImus = 0.228 − 0.001 × height (cm), and in female subjects it was TTImus = 0.320 − 0.001 × height (cm) .ConclusionGender, age, anthropometry, skeletal muscularity, and aerobic exercise are significantly associated with indices of inspiratory muscle function in children. Normal values of TTImus in healthy children are reported

Health-promoting properties of bioactive peptides derived from milk proteins in infant food : a review

Peer reviewedPublisher PD

Predictors of outcome of prematurely born infants with pulmonary interstitial emphysema

Aim: To determine how oxygenation, ventilation efficiency and tidal volume requirements changed with the development of pulmonary interstitial emphysema (PIE) and whether in affected patients a composite gas exchange index predicted death or bronchopulmonary dysplasia (BPD). Methods: Infants who developed PIE from 2010 to 2016 were identified. The oxygenation index (OI), ventilation efficiency index (VEI), ventilation to perfusion ratio and inspiratory tidal volume were calculated before radiological evidence of PIE (pre-PIE) and at the worst PIE radiographic appearance (PIE-worst). Results: Thirty infants, median (IQR) gestational age of 24.6 (24.3–26.7) weeks were assessed. Their age at pre-PIE was 11 (6–19) days and 23 (13–42) days at PIE-worst. Compared to pre-PIE, at PIE-worst, the OI was higher [14.5 (10.7–19.2) vs 4.8 (3.1–6.1), respectively, p 11.4 at PIE-worst predicted death or BPD with 80% sensitivity and 100% specificity. Conclusion: Development of PIE was associated with poorer oxygenation and ventilation efficiency despite increased tidal volumes. The OI at PIE-worst predicted death or BPD

Prediction of bronchopulmonary dysplasia by the chest radiographic thoracic area on day one in infants with exomphalos:Prediction of BPD in infants with exomphalos

Objectives: To determine if infants with exomphalos had abnormal antenatal lung growth as indicated by lower chest radiographic thoracic areas (CRTA) on day one compared to controls and whether the CRTA could predict the development of bronchopulmonary dysplasia (BPD). Methods: Infants with exomphalos cared for between January 2004 and January 2023 were included. The controls were term, newborn infants ventilated for absent respiratory drive at birth, without lung disease and had no supplemental oxygen requirement by 6 h of age. The radiographs were imported as digital image files by Sectra PACS software (Sectra AB, Linköping, Sweden). Free-hand tracing of the perimeter of the thoracic area was undertaken and the CRTA calculated by the software. Results: Sixty-four infants with exomphalos and 130 controls were included. Infants with exomphalos had a lower median (IQR) CRTA (1,983 [1,657-2,471] mm2) compared to controls (2,547 [2,153-2,932] mm2, p&lt;0.001). Following multivariable regression analysis, infants with exomphalos had lower CRTAs compared to controls (p=0.001) after adjusting for differences in gestational age and male sex. In the exomphalos group, the CRTAs were lower in those who developed BPD (n=14, 1,530 [1,307-1,941] mm2) compared to those who did not (2,168 [1,865-2,672], p&lt;0.001). Following multivariable regression analysis, the CRTA was associated with BPD development (p=0.021) after adjusting for male sex and gestational age. Conclusions: Lower CRTAs on day one in the exomphalos infants compared to the controls predicted BPD development.</p

Fast, accurate, and reliable detection of damage in aircraft composites by advanced synergistic infrared thermography and phased array techniques

This paper presents an advanced methodology for the detection of damage in aircraft composite materials based on the sensor fusion of two image-based non-destructive evaluation techniques. Both of the techniques, phased-array ultrasonics and infra-red thermography, are benchmarked on an aircraft-grade painted composite material skin panel with stringers. The sensors systems for carrying out the inspections have been developed and miniaturized for being integrated on a vortex-robotic platform inspector, in the framework of a larger research initiative, the Horizon-2020 ‘CompInnova’ project

ERS International Congress 2021: highlights from the Paediatric Assembly

In this review, Early Career Members of the European Respiratory Society (ERS) and the Chairs of the ERS Assembly 7: Paediatrics present the highlights in paediatric respiratory medicine from the ERS International Congress 2021. The eight scientific Groups of this Assembly cover respiratory physiology and sleep, asthma and allergy, cystic fibrosis (CF), respiratory infection and immunology, neonatology and intensive care, respiratory epidemiology, bronchology, and lung and airway development. We here describe new developments in lung function testing and sleep-disordered breathing diagnosis, early life exposures affecting pulmonary function in children and effect of COVID-19 on sleep and lung function. In paediatric asthma, we present the important role of the exposome in asthma development, and how biologics can provide better outcomes. We discuss new methods to assess distal airways in children with CF, as some details remain blind when using the lung clearance index. Moreover, we summarise the new ERS guidelines for bronchiectasis management in children and adolescents. We present interventions to reduce morbidity and monitor pulmonary function in newborns at risk of bronchopulmonary dysplasia and long-term chronic respiratory morbidity of this disease. In respiratory epidemiology, we characterise primary ciliary dyskinesia, identify early life determinants of respiratory health and describe the effect of COVID-19 preventive measures on respiratory symptoms. Also, we describe the epidemiology of interstitial lung diseases, possible consequences of tracheomalacia and a classification of diffuse alveolar haemorrhage in children. Finally, we highlight that the characterisation of genes and pathways involved in the development of a disease is essential to identify new biomarkers and therapeutic targets