Heterogeneity in allergic rhinitis: explained by inducible mechanistic traits?

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LIQUID XENON FILLED WIRE CHAMBERS FOR MEDICAL IMAGINGAPPLICATIONS

In 1968, Luis Alvarez suggested that a high-resolution multiwire particle detector could be developed using a thin layer of liquified noble gas as the detection medium. After key problems in chamber construction, purification, and readout had been solved, a spatial resolution of 15 {micro} rms was demonstrated. Work is in progress to build high-resolution chambers and measure their properties for particle physics experiments at high-energy accelerators. The liquid xenon multiwire chamber also has potential in nuclear medicine for imaging isotope distributions with an unprecedented combination of gamma-ray detection efficiency and spatial resolution. A preliminary 24-wire chamber has been constructed; this chamber detects 280-keV gamma rays with 65% efficiency and 4-mm FWHM spatial resolution. Initial images of point and distributed sources are very promising, and the liquid purity can be maintained for periods exceeding several days

HIGH-RESOLUTION LIQUID-FILLED MULTI-WIRE CHAMBERS FOR USE INHIGH-ENERGY BEAMS

The authors describe experiments with liquid-xenon-filled wire chambers operating in the proportional mode and the difficulty of achieving useful gain when the anode wires have a spacing < 1 mm. As a result, they have largely turned our attention to chambers with closely spaced wires operated in the ionization mode. They have previously demonstrated a spatial resolution of 15 {micro} rms in this mode, using a 5-wire chamber and a collimated alpha source. They describe the construction of two small high-resolution test chambers to be filled with liquid argon, krypton, or xenon. The chambers consist of two flat cathodes 1 to 2.5 mm apart with a wire plane between them. The wire plane is an array of 24 wires, 5 {micro} in diameter, spaced on 20-{micro} centers, and a charge amplifier is attached to each wire. The space resolution (expected rms < 20 {micro}), time resolution (expected rms < 50 ns), and efficiency will be measured in an accelerator beam. Chambers of this type with only a few hundred wires have sufficient area to cover nearly every beam at NAL

The influence of preferred place of birth on the course of pregnancy and labor among healthy nulliparous women: a prospective cohort study

__Abstract__ BACKGROUND: Most studies on birth settings investigate the association between planned place of birth at the start of labor and birth outcomes and intervention rates. To optimize maternity care it also is important to pay attention to the entire process of pregnancy and childbirth. This study explores the association between the initial preferred place of birth and model of care, and the course of pregnancy and labor in low-risk nulliparous women in the Netherlands. METHODS: As part of a Dutch prospective cohort study (2007-2011), we compared medical indications during pregnancy and birth outcomes of 576 women who initially preferred a home birth (n = 226), a midwife-led hospital birth (n = 168) or an obstetrician-led hospital birth (n = 182). Data were obtained by a questionnaire before 20 weeks of gestation and by medical records. Analyses were performed according to the initial preferred place of birth. RESULTS: Low-risk nulliparous women who preferred a home birth with midwife-led care were less likely to be diagnosed with a medical indication during pregnancy compared to women who preferred a birth with obstetrician-led care (OR 0.41 95% CI 0.25-0.66). Preferring a birth with midwife-led care - both at home and in hospital - was associated with lower odds of induced labor (OR 0.51 95% CI 0.28-0.95 respectively OR 0.42 95% CI 0.21-0.85) and epidural analgesia (OR 0.32 95% CI 0.18-0.56 respectively OR 0.34 95% CI 0.19-0.62) compared to preferring a birth with obstetrician-led care. In addition, women who preferred a home birth were less likely to experience augmentation of labor (OR 0.54 95% CI 0.32-0.93) and narcotic analgesia (OR 0.41 95% CI 0.21-0.79) compared to women who preferred a birth with obstetrician-led care. We observed no significant association between preferred place of birth and mode of birth. CONCLUSIONS: Nulliparous women who initially preferred a home birth were less likely to be diagnosed with a medical indication during pregnancy. Women who initially preferred a birth with midwife-led care - both at home and in hospital - experienced lower rates of interventions during labor. Although some differences can be attributed to the model of care, we suggest that characteristics and attitudes of women themselves also play an important role

Modulating local airway immune responses to treat allergic asthma: lessons from experimental models and human studies

With asthma affecting over 300 million individuals world-wide and estimated to affect 400 million by 2025, developing effective, long-lasting therapeutics is essential. Allergic asthma, where Th2-type immunity plays a central role, represents 90% of child and 50% of adult asthma cases. Research based largely on animal models of allergic disease have led to the generation of a novel class of drugs, so-called biologicals, that target essential components of Th2-type inflammation. Although highly efficient in subclasses of patients, these biologicals and other existing medication only target the symptomatic stage of asthma and when therapy is ceased, a flare-up of the disease is often observed. Therefore, it is suggested to target earlier stages in the inflammatory cascade underlying allergic airway inflammation and to focus on changing and redirecting the initiation of type 2 inflammatory responses against allergens and certain viral agents. This focus on upstream aspects of innate immunity that drive development of Th2-type immunity is expected to have longer-lasting and disease-modifying effects, and may potentially lead to a cure for asthma. This review highlights the current understanding of the contribution of local innate immune elements in the development and maintenance of inflammatory airway responses and discusses available leads for successful targeting of those pathways for future therapeutics.Pathogenesis and treatment of chronic pulmonary disease

Magnet system for the time projection chamber at PEP

A superconducting solenoid with a conductive bore tube is under construction for use with the time projection chamber (TPC) detector at PEP. It will be a uniform induction of 1.5 T over a 6.3 m/sup 3/ volume. Its stored energy will be 11 MJ while maintaining a radiation thickness of 0.3 radiation lengths for the coil package. The coil will operate at a current density of 7 x 10/sup 8/ Am/sup -2/ and it will be cooled by force flow two phase helium in a tube. The final design details are given here

Prevalence of Frailty in European Emergency Departments (FEED): an international flash mob study

Introduction Current emergency care systems are not optimized to respond to multiple and complex problems associated with frailty. Services may require reconfiguration to effectively deliver comprehensive frailty care, yet its prevalence and variation are poorly understood. This study primarily determined the prevalence of frailty among older people attending emergency care. Methods This cross-sectional study used a flash mob approach to collect observational European emergency care data over a 24-h period (04 July 2023). Sites were identified through the European Task Force for Geriatric Emergency Medicine collaboration and social media. Data were collected for all individuals aged 65 + who attended emergency care, and for all adults aged 18 + at a subset of sites. Variables included demographics, Clinical Frailty Scale (CFS), vital signs, and disposition. European and national frailty prevalence was determined with proportions with each CFS level and with dichotomized CFS 5 + (mild or more severe frailty). Results Sixty-two sites in fourteen European countries recruited five thousand seven hundred eighty-five individuals. 40% of 3479 older people had at least mild frailty, with countries ranging from 26 to 51%. They had median age 77 (IQR, 13) years and 53% were female. Across 22 sites observing all adult attenders, older people living with frailty comprised 14%. Conclusion 40% of older people using European emergency care had CFS 5 + . Frailty prevalence varied widely among European care systems. These differences likely reflected entrance selection and provide windows of opportunity for system configuration and workforce planning

Factors Associated with Revision Surgery after Internal Fixation of Hip Fractures

Background: Femoral neck fractures are associated with high rates of revision surgery after management with internal fixation. Using data from the Fixation using Alternative Implants for the Treatment of Hip fractures (FAITH) trial evaluating methods of internal fixation in patients with femoral neck fractures, we investigated associations between baseline and surgical factors and the need for revision surgery to promote healing, relieve pain, treat infection or improve function over 24 months postsurgery. Additionally, we investigated factors associated with (1) hardware removal and (2) implant exchange from cancellous screws (CS) or sliding hip screw (SHS) to total hip arthroplasty, hemiarthroplasty, or another internal fixation device. Methods: We identified 15 potential factors a priori that may be associated with revision surgery, 7 with hardware removal, and 14 with implant exchange. We used multivariable Cox proportional hazards analyses in our investigation. Results: Factors associated with increased risk of revision surgery included: female sex, [hazard ratio (HR) 1.79, 95% confidence interval (CI) 1.25-2.50; P = 0.001], higher body mass index (fo