How best to capture the respiratory consequences of prematurity?

Chronic respiratory morbidity is a common complication of premature birth, generally defined by the presence of bronchopulmonary dysplasia, both clinically and in trials of respiratory therapies. However, recent data have highlighted that bronchopulmonary dysplasia does not correlate with chronic respiratory morbidity in older children born preterm. Longitudinally evaluating pulmonary morbidity from early life through to childhood provides a more rational method of defining the continuum of chronic respiratory morbidity of prematurity, and offers new insights into the efficacy of neonatal respiratory interventions. The changing nature of preterm lung disease suggests that a multimodal approach using dynamic lung function assessment will be needed to assess the efficacy of a neonatal respiratory therapy and predict the long-term respiratory consequences of premature birth. Our aim is to review the literature regarding the long-term respiratory outcomes of neonatal respiratory strategies, the difficulties of assessing dynamic lung function in infants, and potential new solutions

Automatic semigroups

AbstractThe area of automatic groups has been one in which significant advances have been made in recent years. While it is clear that the definition of an automatic group can easily be extended to that of an automatic semigroup, there does not seem to have been a systematic investigation of such structures. It is the purpose of this paper to make such a study.We show that certain results from the group-theoretic situation hold in this wider context, such as the solvability of the word problem in quadratic time, although others do not, such as finite presentability. There are also situations which arise in the general theory of semigroups which do not occur when considering groups; for example, we show that a semigroup S is automatic if and only if S with a zero adjoined is automatic, and also that S is automatic if and only if S with an identity adjoined is automatic. We use this last result to show that any finitely generated subsemigroup of a free semigroup is automatic

Surgical management of pulmonary artery sling in children

ObjectivesPulmonary artery (PA) sling is a rare vascular anomaly associated with congenital tracheal stenosis. The natural history is poor and these patients often require early surgical intervention. We describe our experience with repair of this condition.MethodsFrom 1984 to 2011, 21 patients with PA sling underwent repair at the Royal Children's Hospital (median age, 5.9 months). PA sling was associated with compression of the trachea in all patients. Tracheal surgery was required in 12 (57.1%) patients. All patients had an echocardiogram, and concomitant repair of coexisting cardiac anomalies was performed in 6 (28.6%, 6/21) patients.ResultsOperative mortality was 14.3% (3/21), occurring at 19 days, 4.4 months, and 5 months after surgery. Operative mortality for the first 10 years was 22.2% (1984-1993; 2/9), the next 10 years was 14.3% (1994-2003; 1/7), and 0% for the most recent 7 years (2004-2011; 0/5). All deaths occurred in patients requiring tracheal repair (25%, 3/12). No deaths have occurred since 2004 with introduction of the slide tracheoplasty technique. One (5.6%, 1/18) late death occurred at 8 months after repair. After tracheal repair, intervention for excessive granulations and tracheomalacia was necessary in 6 (50%, 6/12) patients. Median follow-up was 8 years (mean, 8.6 ± 6.4 years; range, 5 months to 20.6 years), and all survivors (100%, 17/17) remain asymptomatic.ConclusionsChildren with PA sling who do not require tracheal surgery have excellent outcomes. Mortality is determined by the need for tracheal surgery. However, with the advent of the slide tracheoplasty technique, mortality can be reduced. Survival beyond 1 year after surgery offers excellent prognosis

Contact Investigation of Children Exposed to Tuberculosis in South East Asia: A Systematic Review

Background. Screening of children who are household contacts of tuberculosis (TB) cases is universally recommended but rarely implemented in TB endemic setting. This paper aims to summarise published data of the prevalence of TB infection and disease among child contacts in South East Asia. Methods. Search strategies were developed to identify all published studies from South East Asia of household contact investigation that included children (0–15 years). Results. Eleven studies were eligible for review. There was heterogeneity across the studies. TB infection was common among child contacts under 15 years of age (24.4–69.2%) and was higher than the prevalence of TB disease, which varied from 3.3% to 5.5%. Conclusion. TB infection is common among children that are household contacts of TB cases in South East Asia. Novel approaches to child contact screening and management that improve implementation in South East Asia need to be further evaluated

Actin-myosin–based contraction is responsible for apoptotic nuclear disintegration

Membrane blebbing during the apoptotic execution phase results from caspase-mediated cleavage and activation of ROCK I. Here, we show that ROCK activity, myosin light chain (MLC) phosphorylation, MLC ATPase activity, and an intact actin cytoskeleton, but not microtubular cytoskeleton, are required for disruption of nuclear integrity during apoptosis. Inhibition of ROCK or MLC ATPase activity, which protect apoptotic nuclear integrity, does not affect caspase-mediated degradation of nuclear proteins such as lamins A, B1, or C. The conditional activation of ROCK I was sufficient to tear apart nuclei in lamin A/C null fibroblasts, but not in wild-type fibroblasts. Thus, apoptotic nuclear disintegration requires actin-myosin contractile force and lamin proteolysis, making apoptosis analogous to, but distinct from, mitosis where nuclear disintegration results from microtubule-based forces and from lamin phosphorylation and depolymerization

Paracetamol use in early life and asthma: prospective birth cohort study

Objective To determine if use of paracetamol in early life is an independent risk factor for childhood asthma

A multicenter study on chronic cough in children: Burden and etiologies based on a standardized management pathway

Background: While the burden of chronic cough in children has been documented, etiologic factors across multiple settings and age have not been described. In children with chronic cough, we aimed (1) to evaluate the burden and etiologies using a standar

Sex differences in procedural and clinical outcomes following rotational atherectomy

Aim: Evaluate sex differences in procedural net adverse clinical events and long‐term outcomes following rotational atherectomy (RA). Methods and Results: From August 2010 to 2016, 765 consecutive patients undergoing RA PCI were followed up for a median of 4.7 years. 285 (37%) of subjects were female. Women were older (mean 76 years vs. 72 years; p < .001) and had more urgent procedures (64.6 vs. 47.3%; p < .001). Females received fewer radial procedures (75.1 vs. 85.1%; p < .001) and less intravascular imaging guidance (16.8 vs. 25.0%; p = .008). After propensity score adjustment, the primary endpoint of net adverse cardiac events (net adverse clinical events: all‐cause death, myocardial infarction, stroke, target vessel revascularization plus any procedural complication) occurred more often in female patients (15.1 vs. 9.0%; adjusted OR 1.81 95% CI 1.04–3.13; p = .037). This was driven by an increased risk of procedural complications rather than procedural major adverse cardiac events (MACE). Specifically, women were more likely to experience coronary dissection (4.6 vs. 1.3%; p = .008), cardiac tamponade (2.1 vs. 0.4%; p = .046) and significant bleeding (BARC ≥2: 5.3 vs. 2.3). Despite this, overall MACE‐free survival was similar between males and females (adjusted HR 1.03; 95% CI 0.80–1.34; p = .81). Procedural complications during RA were associated with almost double the incidence of MACE at long‐term follow‐up (HR 1.92; 95% CI 1.34–2.77; p < .001). Conclusion: Women may be at greater risk of procedural complications following rotational atherectomy. These include periprocedural bleeding episodes and coronary perforation leading to cardiac tamponade. Despite this, the adjusted overall long‐term survival free of major adverse cardiac events was similar between males and females

Ghosts of NEID's Past

The NEID spectrograph is a R $\sim$ 120,000 resolution fiber-fed and highly stabilized spectrograph for extreme radial velocity (RV) precision. It is being commissioned at the 3.5 m WIYN telescope in Kitt Peak National Observatory with a desired instrumental precision of better than 30 \cms{}. NEID's bandpass of 380 -- 930 nm enables the simultaneous wavelength coverage of activity indicators from the Ca HK lines in the blue to the Ca IR triplet in the IR. In this paper we will present our efforts to characterize and mitigate optical ghosts in the NEID spectrograph during assembly, integration and testing, and highlight several of the dominant optical element contributors such as the cross dispersion prism and input optics. We shall present simulations of the 2-D spectrum and discuss the predicted ghost features on the focal plane, and how they may impact the RV performance for NEID. We also present the mitigation strategy adopted for each ghost which may be applied to future instrument designs. This work will enable other instrument builders to potentially avoid some of these issues, as well as outline mitigation strategies.Comment: Conference Proceeding from SPIE Astronomical Telescopes + Instrumentation (2020): 12 page