Monitoring growth in asthmatic children treated with high dose inhaled glucocorticoids does not predict adrenal suppression

Aims: To determine whether routine outpatient monitoring of growth predicts adrenal suppression in prepubertal children treated with high dose inhaled glucocorticoid.

Methods: Observational study of 35 prepubertal children (aged 4–10 years) treated with at least 1000 µg/day of inhaled budesonide or equivalent potency glucocorticoid for at least six months. Main outcome measures were: changes in HtSDS over 6 and 12 month periods preceding adrenal function testing, and increment and peak cortisol after stimulation by low dose tetracosactrin test. Adrenal suppression was defined as a peak cortisol 500 nmol/l.

Results: The areas under the receiver operator characteristic curves for a decrease in HtSDS as a predictor of adrenal insufficiency 6 and 12 months prior to adrenal testing were 0.50 (SE 0.10) and 0.59 (SE 0.10). Prediction values of an HtSDS change of –0.5 for adrenal insufficiency at 12 months prior to testing were: sensitivity 13%, specificity 95%, and positive likelihood ratio of 2.4. Peak cortisol reached correlated poorly with change in HtSDS ( = 0.23, p = 0.19 at 6 months; = 0.33, p = 0.06 at 12 months).

Conclusions: Monitoring growth does not enable prediction of which children treated with high dose inhaled glucocorticoids are at risk of potentially serious adrenal suppression. Both growth and adrenal function should be monitored in patients on high dose inhaled glucocorticoids. Further research is required to determine the optimal frequency of monitoring adrenal function.

EMI Suppression in an Aircraft Cooling Vent

Digital avionics systems are increasingly under threat from external electromagnetic interference (EMI). The same avionics systems require a thermal cooling mechanism and one method of providing this is to mount an air vent on the body of the aircraft. For the first time, a nacelle-mounted air vent that may expose the flight critical full authority digital engine controller (FADEC) to high intensity radiated fields (HIRF) is examined. The reflection/transmission characteristics of the vent are reported and the current shielding method employed is shown to provide a low shielding level (5 dB at 18 GHz). A new design has been proposed, providing over 100 dB of attenuation at 18 GHz. To the authors' knowledge this is the first time this shielding method has been applied to aircraft air vents.

Optimisation of source/drain extension region profile for suppression of short channel effects in sub-50 nm DG SOI MOSFETs with high- k gate dielectrics

Novel technology dependent scaling parameters i.e. spacer to gradient ratio and effective channel length (Leff) are proposed for source/drain engineered DG MOSFET, and their significance in minimizing short channel effects (SCES) in high-k gate dielectrics is discussed in detail. Results show that a high-k dielectric should be associated with a higher spacer to gradient ratio to minimise SCEs The analytical model agrees with simulated data over the entire range of spacer widths, doping gradients, high-k gate dielectrics and effective channel lengths.

Suppression of multiple ionization of atomic ions in intense ultrafast laser pulses

The interaction of an intense laser field with a beam of atomic ions has been investigated experimentally for the first time. The ionization dynamics of Ar+ ions and Ar neutrals in a 60 fs, 790 nm laser pulse have been compared and contrasted at intensities up to 10(16) W cm (-2). Our results show that nonsequential ionization from an Ar+ target is strongly suppressed compared with that from the corresponding neutral target. We have also observed for the first time the strong field ionization of high lying target metastable levels in the Ar+ beam.

Inverse Class-E Amplifier With Transmission-Line Harmonic Suppression

This paper reports on the design methodology and experimental characterization of the inverse Class-E power amplifier. A demonstration amplifier with excellent second and third harmonic-suppression levels has been designed, constructed, and measured. The circuit fabricated using a 1.2-min gate-width GaAs MESFET is shown to be able to deliver 22-dBm output power at 2.3 GHz. The amplifier achieves a peak power-added efficiency of 64 % and drain efficiency of 69 %, and exhibits 11.6 dB power gain when operated from a 3-V supply voltage. Comparisons of simulated and measured results are given with good agreement between them being obtained. Experimental results are presented for the amplifier's response to Gaussian minimum shift keying modulation, where a peak error vector modulation value of 0.6% is measured.