45 research outputs found
The bronchodilator response in preschool children: A systematic review
BACKGROUND: The bronchodilator response (BDR) is frequently used to support diagnostic and therapeutic decision-making for children who wheeze. However, there is little evidence-based guidance describing the role of BDR testing in preschool children and it is unclear whether published cut-off values, which are derived from adult data, can be applied to this population. METHODS: We searched MEDLINE, EMBASE, Web of Science, and Cochrane databases (inception-September 2015) for studies reporting response to a bronchodilator in healthy preschool children, response following placebo inhalation, and the diagnostic efficacy of BDR compared with a clinical diagnosis of asthma/recurrent wheezing. FINDINGS: We included 14 studies. Thirteen studies provided BDR data from healthy preschool children. Two studies reported response to placebo in preschool children with asthma/recurrent wheezing. Twelve studies compared BDR measurements from preschool children with asthma/recurrent wheeze to those from healthy children and seven of these studies reported diagnostic efficacy. Significant differences between the BDR measured in healthy preschool children compared with that in children with asthma/recurrent wheeze were demonstrated in some, but not all studies. Techniques such as interrupter resistance, oscillometry, and plethysmography were more consistently successfully completed than spirometry. Between study heterogeneity precluded determination of an optimum technique. INTERPRETATION: There is little evidence to suggest spirometry-based BDR can be used in the clinical assessment of preschool children who wheeze. Further evaluation of simple alternative techniques is required. Future studies should recruit children in whom airways disease is suspected and should evaluate the ability of BDR testing to predict treatment response
The interaction in nuclear matter from a study of the reactions
The pion-production reactions were studied on
, , , and nuclei at an incident pion energy
of =283 MeV. Pions were detected in coincidence using the CHAOS
spectrometer. The experimental results are reduced to differential cross
sections and compared to both theoretical predictions and the reaction phase
space. The composite ratio between the
invariant masses on nuclei and on the nucleon is also presented. Near the
threshold pion pairs couple to when produced in
the reaction channel. There is a marked near-threshold
enhancement of which is consistent with theoretical
predictions addressing the partial restoration of chiral symmetry in nuclear
matter. Furthermore, the behaviour of is well
described when the restoration of chiral symmetry is combined with standard
P-wave renormalization of pions in nuclear matter. On the other hand, nuclear
matter only weakly influences , which displays a flat
behaviour throughout the energy range regardless of .Comment: 30 pages, 16 figures, PS format, accepted for publication in Nucl.
Phys
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Real-world effectiveness of airway clearance techniques in children with cystic fibrosis
Data Availability Statement - The study protocol is published open access. De-identified participant data are hosted in a secure DRE through GOSH DRIVE (www.goshdrive.com). Access to the data, data dictionary and informed consent forms through the DRE is available with permission from the corresponding author.Background Cystic fibrosis (CF) is commonly characterised by thick respiratory mucus. From diagnosis, people with CF are prescribed daily physiotherapy, including airway clearance techniques (ACTs). ACTs consume a large proportion of treatment time, yet the efficacy and effectiveness of ACTs are poorly understood. This study aimed to evaluate associations between the quality and quantity of ACTs and lung function in children and young people with CF. Methods Project Fizzyo, a longitudinal observational cohort study in the UK, used remote monitoring with electronic pressure sensors attached to four different commercial ACT devices to record real-time, breath-by-breath pressure data during usual ACTs undertaken at home over 16 months in 145 children. ACTs were categorised either as conformant or not with current ACT recommendations based on breath pressure and length measurements, or as missed treatments if not recorded. Daily, weekly and monthly associations between ACT category and lung function were investigated using linear mixed effects regression models adjusting for clinical confounders. Results After exclusions, 45 224 ACT treatments (135 individuals) and 21 069 days without treatments (141 individuals) were analysed. The mean±SD age of participants was 10.2±2.9 years. Conformant ACTs (21%) had significantly higher forced expiratory volume in 1 s (FEV1) (mean effect size 0.23 (95% CI 0.19–0.27) FEV1 % pred per treatment) than non-conformant (79%) or missed treatments. There was no benefit from non-conformant or missed treatments and no significant difference in FEV1 between them (mean effect size 0.02 (95% CI −0.01–0.05) FEV1 % pred per treatment). Conclusions ACTs are beneficial when performed as recommended, but most people use techniques that do not improve lung function. Work is needed to monitor and improve ACT quality and to increase the proportion of people doing effective airway clearance at home.UK Research and Innovation
MR/T041285/1
Rosetrees Trust
M712
Cystic Fibrosis Trust
CEA010
Great Ormond Street Hospital for Children
Higher Education Funding Council for England
KEI2017–01–04
Hospital for Sick Children
University College London
Partners Awar
Determination of the Gamow-Teller Quenching Factor from Charge Exchange Reactions on 90Zr
Double differential cross sections between 0-12 degrees were measured for the
90Zr(n,p) reaction at 293 MeV over a wide excitation energy range of 0-70 MeV.
A multipole decomposition technique was applied to the present data as well as
the previously obtained 90Zr(p,n) data to extract the Gamow-Teller (GT)
component from the continuum. The GT quenching factor Q was derived by using
the obtained total GT strengths. The result is Q=0.88+/-0.06 not including an
overall normalization uncertainty in the GT unit cross section of 16%.Comment: 11 papes, 4 figures, submitted to Physics Letters B (accepted),
gzipped tar file, changed content
Gamow-Teller strength distributions for nuclei in pre-supernova stellar cores
Electron-capture and -decay of nuclei in the core of massive stars
play an important role in the stages leading to a type II supernova explosion.
Nuclei in the f-p shell are particularly important for these reactions in the
post Silicon-burning stage of a presupernova star. In this paper, we
characterise the energy distribution of the Gamow-Teller Giant Resonance (GTGR)
for mid-fp-shell nuclei in terms of a few shape parameters, using data obtained
from high energy, forward scattering (p,n) and (n,p) reactions. The energy of
the GTGR centroid is further generalised as function of nuclear
properties like mass number, isospin and other shell model properties of the
nucleus. Since a large fraction of the GT strength lies in the GTGR region, and
the GTGR is accessible for weak transitions taking place at energies relevant
to the cores of presupernova and collapsing stars, our results are relevant to
the study of important -capture and -decay rates of arbitrary,
neutron-rich, f-p shell nuclei in stellar cores. Using the observed GTGR and
Isobaric Analog States (IAS) energy systematics we compare the coupling
coefficients in the Bohr-Mottelson two particle interaction Hamiltonian for
different regions of the Isotope Table.Comment: Revtex, 28 pages +7 figures (PostScript Figures, uuencoded, filename:
Sutfigs.uu). If you have difficulty printing the figures, please contact
[email protected]. Accepted for publication in Phys. Rev. C, Nov 01,
199
General properties of the pion production reaction in nuclear matter
The pion production reaction on was
studied at incident pion energies of = 240, 260, 280, 300, and
320 MeV. The experiment was performed using the pion-channel at TRIUMF,
and multiparticle events, () and
(), were detected with the CHAOS spectrometer. Results
are reported in the form of both differential and total cross sections, and are
compared to theoretical predictions and the reaction phase space. The present
investigation of the T-dependence of the
reaction complements earlier examinations of the A-dependence of the reaction,
which was measured using , , , , , and
targets at 280 MeV. Some general properties of the
pion-induced pion production reaction in nuclear matter will be presented,
based on the combined results of the two studies.Comment: 23 pages, Latex, accepted for publication in Nucl. Phys.
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Quantity and quality of airway clearance in children and young people with cystic fibrosis
Supplementary materials are online at: https://www.sciencedirect.com/science/article/pii/S1569199322006865#sec0016 .Children and young people with CF (CYPwCF) get advice about using positive expiratory pressure (PEP) or oscillating PEP (OPEP) devices to clear sticky mucus from their lungs. However, little is known about the quantity (number of treatments, breaths, or sets) or quality (breath pressures and lengths) of these daily airway clearance techniques (ACTs) undertaken at home. This study used electronic pressure sensors to record real time breath-by-breath data from 145 CYPwCF (6–16y) during routine ACTs over 2 months. ACT quantity and quality were benchmarked against individual prescriptions and accepted recommendations for device use. In total 742,084 breaths from 9,081 treatments were recorded. Individual CYPwCF maintained consistent patterns of ACT quantity and quality over time. Overall, 60% of CYPwCF did at least half their prescribed treatments, while 27% did fewer than a quarter. About 77% of pre-teens did the right number of daily treatments compared with only 56% of teenagers. CYPwCF usually did the right number of breaths. ACT quality (recommended breath length and pressure) varied between participants and depended on device. Breath pressures, lengths and pressure-length relationships were significantly different between ACT devices. PEP devices encouraged longer breaths with lower pressures, while OPEP devices encouraged shorter breaths with higher pressures. More breaths per treatment were within advised ranges for both pressure and length using PEP (30–31%) than OPEP devices (1–3%). Objective measures of quantity and quality may help to optimise ACT device selection and support CYPwCF to do regular effective ACTs.Project Fizzyo was supported by the UCL Rosetrees Stoneygate prize (M712), a Cystic Fibrosis Trust Clinical Excellence and Innovation Award (CEA010), A UCL Partners award and the HEFCE Higher Education Innovation Fund (KEI2017–01–04). HD was funded by the CF Trust Youth Activity Unlimited SRC and an NIHR GOSH BRC internship. All work at UCL GOSICH is supported by the NIHR GOSH BRC
Precision Pion-Proton Elastic Differential Cross Sections at Energies Spanning the Delta Resonance
A precision measurement of absolute pi+p and pi-p elastic differential cross
sections at incident pion laboratory kinetic energies from T_pi= 141.15 to
267.3 MeV is described. Data were obtained detecting the scattered pion and
recoil proton in coincidence at 12 laboratory pion angles from 55 to 155
degrees for pi+p, and six angles from 60 to 155 degrees for pi-p. Single arm
measurements were also obtained for pi+p energies up to 218.1 MeV, with the
scattered pi+ detected at six angles from 20 to 70 degrees. A flat-walled,
super-cooled liquid hydrogen target as well as solid CH2 targets were used. The
data are characterized by small uncertainties, ~1-2% statistical and ~1-1.5%
normalization. The reliability of the cross section results was ensured by
carrying out the measurements under a variety of experimental conditions to
identify and quantify the sources of instrumental uncertainty. Our lowest and
highest energy data are consistent with overlapping results from TRIUMF and
LAMPF. In general, the Virginia Polytechnic Institute SM95 partial wave
analysis solution describes our data well, but the older Karlsruhe-Helsinki PWA
solution KH80 does not.Comment: 39 pages, 22 figures (some with quality reduced to satisfy ArXiv
requirements. Contact M.M. Pavan for originals). Submitted to Physical Review
results in nuclei
The Crystal Ball () collaboration at has recently presented results
regarding a study of the reaction on and , using a nearly 4 detector. Similar results, but for the
reaction on , , ,
and , have been published earlier by the collaboration at
. In this Brief Report a comparison of the results of the two
measurements is made, which shows that the and data share relevant
common features. In particular, the increase in strength as a function of A
seen in the near-threshold invariant mass spectra reported by the
group, is also seen in the CB data, when the results from
the two groups are compared in a way which accounts for the different
acceptances of the two experiments.Comment: 7 pages, 1 figure, accepted for publication in Phy. Rev. C - Brief
Repor
pi+- p differential cross sections at low energies
Differential cross sections for pi- p and pi+ p elastic scattering were
measured at five energies between 19.9 and 43.3 MeV. The use of the CHAOS
magnetic spectrometer at TRIUMF, supplemented by a range telescope for muon
background suppression, provided simultaneous coverage of a large part of the
full angular range, thus allowing very precise relative cross section
measurements. The absolute normalisation was determined with a typical accuracy
of 5 %. This was verified in a simultaneous measurement of muon proton elastic
scattering. The measured cross sections show some deviations from phase shift
analysis predictions, in particular at large angles and low energies. From the
new data we determine the real part of the isospin forward scattering
amplitude.Comment: 13 pages, 5 figures. To appear in PL