Catch-up alveolarization in ex-preterm children: evidence from (3)He magnetic resonance

RATIONALE Histologic data from fatal cases suggest that extreme prematurity results in persisting alveolar damage. However, there is new evidence that human alveolarization might continue throughout childhood and could contribute to alveolar repair. OBJECTIVES To examine whether alveolar damage in extreme-preterm survivors persists into late childhood, we compared alveolar dimensions between schoolchildren born term and preterm, using hyperpolarized helium-3 magnetic resonance. METHODS We recruited schoolchildren aged 10-14 years stratified by gestational age at birth (weeks) to four groups: (1) term-born (37-42 wk; n = 61); (2) mild preterm (32-36 wk; n = 21); (3) extreme preterm (<32 wk, not oxygen dependent at 4 wk; n = 19); and (4) extreme preterm with chronic lung disease (<32 wk and oxygen dependent beyond 4 wk; n = 18). We measured lung function using spirometry and plethysmography. Apparent diffusion coefficient, a surrogate for average alveolar dimensions, was measured by helium-3 magnetic resonance. MEASUREMENTS AND MAIN RESULTS The two extreme preterm groups had a lower FEV1 (P = 0.017) compared with term-born and mild preterm children. Apparent diffusion coefficient was 0.092 cm(2)/second (95% confidence interval, 0.089-0.095) in the term group. Corresponding values were 0.096 (0.091-0.101), 0.090 (0085-0.095), and 0.089 (0.083-0.094) in the mild preterm and two extreme preterm groups, respectively, implying comparable alveolar dimensions across all groups. Results did not change after controlling for anthropometric variables and potential confounders. CONCLUSIONS Alveolar size at school age was similar in survivors of extreme prematurity and term-born children. Because extreme preterm birth is associated with deranged alveolar structure in infancy, the most likely explanation for our finding is catch-up alveolarization.

My patient is thrombocytopenic! Is (s)he? Why? And what shall I do? A practical approach to thrombocytopenia

Solving the riddle of a thrombocytopenic patient is a difficult and fascinating task. The spectrum of possible aetiologies is wide, ranging from an in vitro artefact to severe treatment-resistant thrombocytopenic bleeding conditions, or even life-threatening prothrombotic states. Moreover, thrombocytopenia by itself does not protect from thrombosis and sometimes a patient with a low platelet count requires concomitant antithrombotic treatment as well. In order to identify and treat the cause and the effects of the thrombocytopenia, you have to put together several pieces of information, solving a unique jig-jaw puzzle. The present work is not a textbook article about thrombocytopenia, rather a collection of differential diagnostic thoughts, treatment concepts, and some basic knowledge, that you can retrieve when facing your next thrombocytopenic patient. Enjoy reading it, but most importantly enjoy taking care of patients with a low platelet count. I bet the present work will assist you in this challenging and rewarding clinical task.

Groundwater age distributions at a public drinking water supply well field derived from multiple age tracers (⁸⁵Kr, ³H/³He, and ³⁹Ar)

Groundwater age is a key aspect of production well vulnerability. Public drinking water supply wells typically have long screens and are expected to produce a mixture of groundwater ages. The groundwater age distributions of seven production wells of the Holten well field (Netherlands) were estimated from tritium-helium (3H/3He), krypton-85 (85Kr), and argon-39 (39Ar), using a new application of a discrete age distribution model and existing mathematical models, by minimizing the uncertainty-weighted squared differences of modeled and measured tracer concentrations. The observed tracer concentrations fitted well to a 4-bin discrete age distribution model or a dispersion model with a fraction of old groundwater. Our results show that more than 75 of the water pumped by four shallow production wells has a groundwater age of less than 20 years and these wells are very vulnerable to recent surface contamination. More than 50 of the water pumped by three deep production wells is older than 60 years. 3H/3He samples from short screened monitoring wells surrounding the well field constrained the age stratification in the aquifer. The discrepancy between the age stratification with depth and the groundwater age distribution of the production wells showed that the well field preferentially pumps from the shallow part of the aquifer. The discrete groundwater age distribution model appears to be a suitable approach in settings where the shape of the age distribution cannot be assumed to follow a simple mathematical model, such as a production well field where wells compete for capture area.

Die richtige Mitte : als Widerlegungsschrift d. vorläufigen Bemerkungen d. Herren Doctoren Heß u. Creizenach zu d. Schrift d. Herrn Dr. Paulus

von M. J. B. M. S.

Justice to the Jew : the story of what he has done to the world

by Madison C. Peters

Arukh he-ḥadash

bearb. von Gustaf H. Dalman

Ha- Paliṭ ... peleṭat sofrim u-sefarim peletat bat Yehudah : ṿe-nilṿeh elaṿ eizeh heʿarot ... me-et ... Shneʾur Zaḳś

me-et Yom Ṭov Lipman Tsunts

Or Meʾir : kolel reshimat sifre Yiśraʾel, kitve yad ṿe-nidpasim, ha-nimtsaʾim be-vet otsar sefarim ha-gadol shel ... Meʾir Zultsberger be-Filadelfya; ʿim heʿarot, maʾamarim ṿe-shirim mi-kitve yad shonim ...

me-et Efrayim Deinard

Šraibn an di wirdign miṭglidr zemṭlichr leblichn und wohlṭheṭign ḥavērût gemîlût-ḥasādîm be-kōl haq-qehillôt haq-qedôšôt

fon Joel Bril

Dāvār ṭōv : ʿal šemî šēm haq-qôdeš ... di teḥine reṭ nur fun roš he-šone we-jom kiper biz noch hošaine-rabe

Digitalisat der Ausg. [Fürth], [1756/57] [i.e. circa 1840]

Dize šine teḥine zolin di waibr zogin an roš he-šone we-jom kiper in ʿalēnû le-šabbēaḥ ...

Digitalisat der Ausg. [S.l.], [circa 1800?]

Ein šeine maiśe wos es hoṭ zich giṭrofin in der Liṭa un Okreine : ... weṭ men zehn wi es hoṭ zich gfirṭ miṭ r. Jehuda he-Ḥasid ...

Digitalisat der Ausg. [S.l.], 1848