Acute lung injury in paediatric intensive care: course and outcome

Introduction: Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) carry a high morbidity and mortality (10-90%). ALI is characterised by non-cardiogenic pulmonary oedema and refractory hypoxaemia of multifactorial aetiology [1]. There is limited data about outcome particularly in children. Methods This retrospective cohort study of 85 randomly selected patients with respiratory failure recruited from a prospectively collected database represents 7.1% of 1187 admissions. They include those treated with High Frequency Oscillation Ventilation (HFOV). The patients were admitted between 1 November 1998 and 31 October 2000. Results: Of the 85, 49 developed acute lung injury and 47 had ARDS. There were 26 males and 23 females with a median age and weight of 7.7 months (range 1 day-12.8 years) and 8 kg (range 0.8-40 kg). There were 7 deaths giving a crude mortality of 14.3%, all of which fulfilled the Consensus I [1] criteria for ARDS. Pulmonary occlusion pressures were not routinely measured. The A-a gradient and PaO2/FiO2 ratio (median + [95% CI]) were 37.46 [31.82-43.1] kPa and 19.12 [15.26-22.98] kPa respectively. The non-survivors had a significantly lower PaO2/FiO2 ratio (13 [6.07-19.93] kPa) compared to survivors (23.85 [19.57-28.13] kPa) (P = 0.03) and had a higher A-a gradient (51.05 [35.68-66.42] kPa) compared to survivors (36.07 [30.2-41.94]) kPa though not significant (P = 0.06). Twenty-nine patients (59.2%) were oscillated (Sensormedics 3100A) including all 7 non-survivors. There was no difference in ventilation requirements for CMV prior to oscillation. Seventeen of the 49 (34.7%) were treated with Nitric Oxide including 5 out of 7 non-survivors (71.4%). The median (95% CI) number of failed organs was 3 (1.96-4.04) for non-survivors compared to 1 (0.62-1.62) for survivors (P = 0.03). There were 27 patients with isolated respiratory failure all of whom survived. Six (85.7%) of the non-survivors also required cardiovascular support.Conclusion: A crude mortality of 14.3% compares favourably to published data. The A-a gradient and PaO2/FiO2 ratio may be of help in morbidity scoring in paediatric ARDS. Use of Nitric Oxide and HFOV is associated with increased mortality, which probably relates to the severity of disease. Multiple organ failure particularly respiratory and cardiac disease is associated with increased mortality. ARDS with isolated respiratory failure carries a good prognosis in children

Ultra-high-resolution observations of circumstellar K I and C2 around the post-AGB star HD 56126

We have used the Ultra-High-Resolution Facility (UHRF) at the AAT, operating at a resolution of 0.35 km s−1 (FWHM), to observe K I and C2 absorption lines arising in the circumstellar environment of the post-AGB star HD 56126. We find three narrow circumstellar absorption components in K I, two of which are also present in C2. We attribute this velocity structure to discrete shells resulting from multiple mass-loss events from the star. The very high spectral resolution has enabled us to resolve the intrinsic linewidths of these narrow lines for the first time, and we obtain velocity dispersions (b-values) of 0.2–0.3 km s−1 for the K I components, and 0.54 ± 0.03 km s−1 for the strongest (and best defined) C2 component. These correspond to rigorous kinetic temperature upper limits of 211 K for K I and 420 K for C2, although the b-value ratio implies that these two species do not co-exist spatially. The observed degree of rotational excitation of C2 implies low kinetic temperatures (Tk ≈10 K) and high densities (n ≈ 106 to 107 cm−3) within the shell responsible for the main C2 component. Given this low temperature, the line profiles then imply either mildly supersonic turbulence or an unresolved velocity gradient through the shell

On the distance to M1-67

The interstellar Na I D2 absorption spectrum of 209 BAC, the WN 8 central star of M1 - 67, shows a total velocity extent of 60 km/s. This is consistent with the spread of gas velocities expected from galactic rotation, provided 209 BAC is at a distance of 4-5 kpc, implying that it is a massive population I WN 8 star surrounded by a stellar ejecta nebula. If M1 - 67 was a planetary nebula at a distance of only 0.5-1 kpc, the velocity extent of the Na I absorption line should be 5-6 times smaller than that observed. It is suggested that similar observations should be obtained of We 21, recently discovered by Duerbeck and Reipurth (1990) to be a WN 8 star in a ringlike nebula

Ultra-high-resolution measurements of the intrinsic line profiles of interstellar C2 towards ζ Ophiuchi and HD 169454

We have used the Ultra-High-Resolution Facility at the Anglo-Australian Telescope (AAT), operating at a resolution of 0.35 km s−1 (FWHM), to measure the intrinsic profiles of the Q(2) and Q(4) lines of the (2-0) Phillips band of interstellar C2 towards ζ Oph and HD 169454. The C2 lines were found to be very narrow, with intrinsic velocity dispersions (b-values) in the range 0.25−0.71 km s−1. In the case of ζ Oph, two velocity components (separation 1.10 ± 0.17 km s−1) have been resolved, and found to have rather different linewidths and rotational excitation temperatures. In the case of HD 169454, the data are consistent with a single velocity component, but the well-defined b-value (0.59 + 0.04 km s−1) and low kinetic temperature would then imply supersonic turbulent velocities. One way to avoid this conclusion is to postulate the existence of unresolved velocity structure (or a velocity gradient) within the cloud

The distance to the WN8 star We 21

A high-resolution spectrum of the interstellar Na D lines toward We 21 shows a total velocity extent of about 95 km/s, extending from -65 to +30 km/s in the LSR velocity frame. In this line-of-sight the positive velocities can arise only from beyond the solar circle, and this suggests that We 21 lies in the far part of the Carina spiral arm, at a distance of about 11.5 kpc. Contrary to the conclusions of Duerbeck and Reipurth (1990), We 21 appears to be a massive Population I WN8 star surrounded by a stellar ejecta bubble, and not a PN central star

Mitochondrial DNA Diversity in Mennonite Communities from the Midwestern United States

We examined mitochondrial DNA (mtDNA) variation in six Mennonite communities from Kansas (Goessel, Lone Tree, Garden View, Meridian, and Garden City) and Nebraska (Henderson) to determine their genetic structure and its relationship to population history. Mitochondrial DNA haplogroup and haplotype information were obtained from blood samples from 118 individuals. Molecular genetic variation was analyzed using diversity measures, neutrality test statistics, spatial analysis of molecular variance (SAMOVA), and multidimensional scaling plots. The Mennonite samples exhibited eight western European mtDNA haplogroups: H, HVO, I, J, K, T, U, and X. Comparable to other populations of European descent, haplogroup H was the most frequent in all six communities and ranged from 35% in Lone Tree to 75% in Old Order Mennonites from Garden City. Fifty-eight different mtDNA haplotypes were found in these groups with only one shared among all six populations. Haplotype diversities varied from 0.81 in Goessel to 0.96 in Henderson and Garden View. Multivariate statistical analysis of these populations indicates that these Anabaptist communities formed new congregations by fissioning along familial lines. Population subdivision of these communities into congregations supports previously documented patterns of fission-fusion. These haploid molecular data provide a more accurate reflection of biological relationships between midwestern Mennonite communities than evidence based on classical genetic markers

High resolution observations of interstellar Na I and Ca II towards the Scorpius OB1 association

Observations of Na I and Ca II in absorption toward 22 stars in the Sco OB1 region, obtained at resolution R = 100,000 with a coude echelle spectrograph and 3.3-m camera on the 1.9-m telescope at Mt. Stromlo Observatory during 1986, are reported. The data are presented in extensive tables and graphs and analyzed in detail. Features discussed include (1) strong absorption at heliocentric velocities between 0 and -20 km/sec, (2) sharp discrete components with blueshifted velocities of up to -50 km/sec, and (3) some absorption at positive heliocentric velocities up to +20 km/sec. The (Na I)/(Ca II) ratios are found to be 4-200 for component (1), near 1 for component (2), and 0.4 or less for component (3

Detection of a variable interstellar absorption component towards δ Orionis A

Observations of δ Ori A made with the UHRF in its highest resolution mode (R≈900 000) have revealed the presence of a cool (Tk⩽350 K) variable absorption component at a heliocentric velocity of +21.3 km s−1. The component is detected in Na I D1, where clear hyperfine splitting is seen, and Ca II K. Comparison of our data with existing spectra suggests that the component has consistently increased in strength from 1966 to 1994, and subsequently reduced in intensity by 1999. Following a discussion of the possible origins of this component it is concluded that an interstellar, rather than circumstellar, origin is most likely. This is one of very few detections of variable interstellar absorption reported in the literature, and we suggest an origin within filamentary material associated with the expanding H I shell surrounding the Orion-Eridanus superbubble

Search for the hero: an investigation into the sports heroes of British sports fans

This is an initial study into British sports fans’ heroes. A questionnaire was sent to 95 students (average age ¼ 19.75) to identify their sporting hero, the hero’s sport and nationality and the reasons for this choice. Football was the most common source of sports heroes, identified by 49% of participants with a sporting hero. The majority (60%, N ¼ 48) of heroes chosen by participants were British, with David Beckham the most popular choice. Differences were observed between the gender of participants, gender of hero chosen and the reasons for choosing the hero. The most common reason for selecting a hero was a personal trait rather than skill, while in the questionnaire a category of Local Affiliation was added to those suggested by previous work. It was concluded that to become a hero athletes should combine skill with devotion to family, charity work and a place in popular culture

An ultra-high-resolution study of the interstellar medium towards Orion

We report ultra-high-resolution observations graphic of Na I, Ca II, K I, CH and CH+ for interstellar sightlines towards 12 bright stars in Orion. These data enable the detection of many more absorption components than previously recognized, providing a more accurate perspective on the absorbing medium. This is especially so for the line of sight to the Orion nebula, a region not previously studied at very high resolution. Model fits have been constructed for the absorption-line profiles, providing estimates for the column density, velocity dispersion and central velocity for each constituent velocity component. A comparison between the absorption occurring in sightlines with small angular separations has been used, along with comparisons with other studies, to estimate the line-of-sight velocity structures. Comparisons with earlier studies have also revealed temporal variability in the absorption-line profile of ζ Ori, highlighting the presence of small-scale spatial structure in the interstellar medium on scales of ≈10 au. Where absorption from both Na0 and K0 is observed for a particular cloud, a comparison of the velocity dispersions measured for each of these species provides rigorous limits on both the kinetic temperature and turbulent velocity prevailing in each cloud. Our results indicate the turbulent motions to be subsonic in each case