Investigating paediatric airways by non-bronchoscopic lavage: Normal cellular data

Background: Bronchoscopic bronchoalveolar lavage in children to investigate bronchia disorders such as asthtna has both ethical and procedural difficulties.


Objective: The aim of this study was to establish a standardized non-bronchoscopic method to perform bronchoalveolar lavage in children attending for elective surgery to obtain normal cellular data.


Methods: Bronchoalveolar lavage was performed on normal children (n= 55) by infusing saline (20 mL) through an 8 FG suction catheter passed after endotracheal intubation. Oxygen saturation, heart and respiratory rate were monitored during the bronchoalveolar lavage procedure. Cellular analysis and total protein estimation of the lavage fluid were performed. Epithelial lining fluid volume was calculated (n = 15) using the urea dilution method.


Results: The procedure was well tolerated by all children. Total cell count and differential cell count for children (macrophages 70.8 ± 2.3%, lymphocytes 3.8 ± 0.6%, neutrophils 5,7 ± 1.0%, eosinophils 0.14 ± 0.03%. epithelial cells 19.6 ± 2.1%, mast cells 0.21 ± 0.02%) were similar to those reported for adults. Age and sex comparisons revealed no differences between groups. The mean total protein recovered in the cell free supernatant was 49.72 ± 4.29 mg/L and epithelial lining fluid volume was 0.82 ± 0.11% of return lavageate.


Conclusion This method allows bronchoalveolar lavage to be performed safely and quickly on children attending for routine elective surgery. Using this method and taking the ‘window of opportunity’ of elective surgery, the presence or absence of airway inflammation could be studied in children with various patterns of asthma during relatively asymptomatic periods.

Observations of the initial 3D flow from a ship's propeller

The present paper was aimed at presenting the time-averaged velocity and turbulence intensity at the initial plane from a ship’s propeller. The flow characteristics of a ship’s propeller jet are of particular interest for the researchers investigating the jet induced seabed damage as documented in the previous studies. Laser Doppler Anemometry (LDA) measurements show that the axial component of velocity is the main contributor to the velocity magnitude at the initial plane of a ship’s propeller jet. The tangential component contributes to the rotation while the radial component which contributes to the diffusion, are the second and third largest contributors to the velocity magnitude. The maximum tangential and radial velocity components at the initial plane are approximately 82% and 14% of the maximum axial velocity component, respectively. The axial velocity distribution at the initial plane shows two peaked ridges with a low velocity core at the rotation axis. The turbulence intensity distribution shows a three-peaked profile at the initial plane.

Proton radiography of a shock-compressed target

In this paper we report on the radiography of a shock-compressed target using laser produced proton beams. A low-density carbon foam target was shock compressed by long pulse high-energy laser beams. The shock front was transversally probed with a proton beam produced in the interaction of a high intensity laser beam with a gold foil. We show that from radiography data, the density profile in the shocked target can be deduced using Monte Carlo simulations. By changing the delay between long and short pulse beams, we could probe different plasma conditions and structures, demonstrating that the details of the steep density gradient can be resolved. This technique is validated as a diagnostic for the investigation of warm dense plasmas, allowing an in situ characterization of high-density contrasted plasmas.

Spatiotemporal evolution of high-power relativistic laser pulses in electron-positron-ion plasmas

The spatiotemporal pulse dynamics of a high-power relativistic laser pulse interacting with an electron-positron-ion plasmas is investigated theoretically and numerically. The occurrence of pulse compression is studied. The dependence of the mechanism on the concentration of the background ions in electron positron plasma is emphasized.

Methods to increase response to postal and electronic questionnaires

Background: Postal and electronic questionnaires are widely used for data collection in epidemiological studies but non-response reduces the effective sample size and can introduce bias. Finding ways to increase response to postal and electronic questionnaires would improve the quality of health research. Objectives: To identify effective strategies to increase response to postal and electronic questionnaires. Search strategy: We searched 14 electronic databases to February 2008 and manually searched the reference lists of relevant trials and reviews, and all issues of two journals. We contacted the authors of all trials or reviews to ask about unpublished trials. Where necessary, we also contacted authors to confirm methods of allocation used and to clarify results presented. We assessed the eligibility of each trial using pre-defined criteria. Selection criteria: Randomised controlled trials of methods to increase response to postal or electronic questionnaires. Data collection and analysis: We extracted data on the trial participants, the intervention, the number randomised to intervention and comparison groups and allocation concealment. For each strategy, we estimated pooled odds ratios (OR) and 95% confidence intervals (CI) in a random-effects model. We assessed evidence for selection bias using Egger's weighted regression method and Begg's rank correlation test and funnel plot. We assessed heterogeneity among trial odds ratios using a Chi 2 test and the degree of inconsistency between trial results was quantified using the I 2 statistic. Main results: Postal We found 481 eligible trials.The trials evaluated 110 different ways of increasing response to postal questionnaires.We found substantial heterogeneity among trial results in half of the strategies. The odds of response were at least doubled using monetary incentives (odds ratio 1.87; 95% CI 1.73 to 2.04; heterogeneity P < 0.00001, I 2 = 84%), recorded delivery (1.76; 95% CI 1.43 to 2.18; P = 0.0001, I 2 = 71%), a teaser on the envelope - e.g. a comment suggesting to participants that they may benefit if they open it (3.08; 95% CI 1.27 to 7.44) and a more interesting questionnaire topic (2.00; 95% CI 1.32 to 3.04; P = 0.06, I 2 = 80%). The odds of response were substantially higher with pre-notification (1.45; 95% CI 1.29 to 1.63; P < 0.00001, I 2 = 89%), follow-up contact (1.35; 95% CI 1.18 to 1.55; P < 0.00001, I 2 = 76%), unconditional incentives (1.61; 1.36 to 1.89; P < 0.00001, I 2 = 88%), shorter questionnaires (1.64; 95%CI 1.43 to 1.87; P < 0.00001, I 2 = 91%), providing a second copy of the questionnaire at follow up (1.46; 95% CI 1.13 to 1.90; P < 0.00001, I 2 = 82%), mentioning an obligation to respond (1.61; 95% CI 1.16 to 2.22; P = 0.98, I 2 = 0%) and university sponsorship (1.32; 95% CI 1.13 to 1.54; P < 0.00001, I 2 = 83%). The odds of response were also increased with non-monetary incentives (1.15; 95% CI 1.08 to 1.22; P < 0.00001, I 2 = 79%), personalised questionnaires (1.14; 95% CI 1.07 to 1.22; P < 0.00001, I 2 = 63%), use of hand-written addresses (1.25; 95% CI 1.08 to 1.45; P = 0.32, I 2 = 14%), use of stamped return envelopes as opposed to franked return envelopes (1.24; 95% CI 1.14 to 1.35; P < 0.00001, I 2 = 69%), an assurance of confidentiality (1.33; 95% CI 1.24 to 1.42) and first class outward mailing (1.11; 95% CI 1.02 to 1.21; P = 0.78, I 2 = 0%). The odds of response were reduced when the questionnaire included questions of a sensitive nature (0.94; 95% CI 0.88 to 1.00; P = 0.51, I 2 = 0%). Electronic: We found 32 eligible trials. The trials evaluated 27 different ways of increasing response to electronic questionnaires. We found substantial heterogeneity among trial results in half of the strategies. The odds of response were increased by more than a half using non-monetary incentives (1.72; 95% CI 1.09 to 2.72; heterogeneity P < 0.00001, I 2 = 95%), shorter e-questionnaires (1.73; 1.40 to 2.13; P = 0.08, I 2 = 68%), including a statement that others had responded (1.52; 95% CI 1.36 to 1.70), and a more interesting topic (1.85; 95% CI 1.52 to 2.26). The odds of response increased by a third using a lottery with immediate notification of results (1.37; 95% CI 1.13 to 1.65), an offer of survey results (1.36; 95% CI 1.15 to 1.61), and using a white background (1.31; 95% CI 1.10 to 1.56). The odds of response were also increased with personalised e-questionnaires (1.24; 95% CI 1.17 to 1.32; P = 0.07, I 2 = 41%), using a simple header (1.23; 95% CI 1.03 to 1.48), using textual representation of response categories (1.19; 95% CI 1.05 to 1.36), and giving a deadline (1.18; 95% CI 1.03 to 1.34). The odds of response tripled when a picture was included in an e-mail (3.05; 95% CI 1.84 to 5.06; P = 0.27, I 2 = 19%). The odds of response were reduced when "Survey" was mentioned in the e-mail subject line (0.81; 95% CI 0.67 to 0.97; P = 0.33, I 2 = 0%), and when the e-mail included a male signature (0.55; 95% CI 0.38 to 0.80; P = 0.96, I 2 = 0%). Authors' conclusions: Health researchers using postal and electronic questionnaires can increase response using the strategies shown to be effective in this systematic review. Copyright © 2009 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.


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Near-surface temperature cycling of stone and its implications for scales of surface deterioration

Many previous studies into internal temperature gradients within stone have assumed smooth, exponential increases and decreases in sub-surface temperatures in response, for example, to diurnal patterns of heating and cooling and these have been used to explain phenomena such as large-scale contour scaling. This high-resolution experimental study, in which a porous limestone block was subjected to alternate surface heating and cooling using an infrared lamp, demonstrates that internal temperature gradients in response to short-term environmental cycles (measured in minutes) can in fact be complex and inconsistent. Results confirm the significance of very steep temperature/stress gradients within the outer 10 mm or less of exposed stone. Below this the data indicate complex patterns of temperature reversals, the amplitudes of which are attenuated with depth and which are influenced in their intensity and location by variations in the relative duration of heating and cooling phases. It is suggested that the reversals might represent ‘interference patterns’ between incoming and outgoing thermal waves, but whatever their origin they are potentially important because they occur within the zone in which many stone decay processes, especially salt weathering, operate. These processes invariably respond to temperature and moisture fluctuations, and short-term interruptions to insolation could, for example, trigger these fluctuations on numerous occasions over a day. In particular, the reversals occur at a scale that is commensurate with decay by multiple flaking and could indicate an underlying control on this previously little-researched pattern of weathering. In the context of this publication, however, the main lesson to be learned from this study is that differing scales of behaviour require different scales of enquiry.

Energy levels, radiative rates and electron impact excitation rates for transitions in H-like N VII, O VIII, F IX, Ne X and Na XI

We report calculations of energy levels, radiative rates and electron impact excitation rates for transitions in H-like N VII, O VIII, F IX, Ne X and Na XI. The general-purpose relativistic atomic structure package (grasp) is adopted for calculating energy levels and radiative rates, while the Dirac atomic R-matrix code (DARC) and the flexible atomic code (FAC) are used for determining the collision strengths and subsequently the excitation rates. Oscillator strengths, radiative rates and line strengths are listed for all E1, E2, M1 and M2 transitions among the lowest 25 levels of the above five ions. Collision strengths have been averaged over a Maxwellian velocity distribution, and the effective collision strengths so obtained are reported over a wide temperature range below 10(7) K. Additionally, lifetimes are also given for all the calculated energy levels of the above five ions.

Immunovirological Correlates in Human Rabies Treated With Therapeutic Coma

A 37-year-old woman was admitted to hospital and over the next 5 days developed a progressive encephalitis. Nuchal skin biopsy, analyzed using a Rabies TaqMan(C) PCR, demonstrated rabies virus RNA. She had a history in keeping with exposure to rabies whilst in South Africa, but had not received pre- or post-exposure prophylaxis. She was treated with a therapeutic coma according to the

Cold-formed steel sections with web openings subjected to web crippling under two-flange loading conditions - part I: Tests and finite element analysis

The results of 82 web crippling tests are presented, with 20 tests conducted on channel sections without web openings and 62 tests conducted on channel sections with web openings. The tests consider both end-two-flange and interior-two-flange loading conditions. In the case of the tests with web openings, the hole was located directly under the concentrated load. The concentrated load was applied through bearing plates; the effect of different bearing lengths is investigated. In addition, the cases of both flanges fastened and unfastened to the support is considered. A non-linear elasto-plastic finite element model is described, and the results compared against the laboratory test results; a good agreement was obtained in terms of both strength and failure modes.

Premiere of "Spaced Images with Noise and Lines" Performance at the Joinery, Dublin, at at Spatial Music Collective concert. Authors: Lyon, E. Keywords: (Spatial Audio, Electroacoustic Music, Computer Music, Algorithmic Music) Publication date: 07 Oct 2011

Performance at the Joinery, Dublin, at at Spatial Music Collective concert

Intra-uterine growth restriction and increased risk of hypertension in adult life: A follow-up study of 50-year-olds

OBJECTIVE:

To compare blood pressure between 50-year-old adults who were born at term (37-42 weeks of gestation) with intra-uterine growth restriction (IUGR; birth weight <10th centile) and a control group of similar age born at term without IUGR (birth weight =10th centile).

STUDY DESIGN:

Controlled comparative study.

METHODS:

Participants included 232 men and women who were born at the Royal Maternity Hospital, Belfast, a large regional maternity hospital in Northern Ireland, between 1954 and 1956. One hundred and eight subjects who were born with IUGR were compared with 124 controls with normal birth weight for gestation. The main outcome measures were systolic and diastolic blood pressure at approximately 50 years of age, measured according to European recommendations.

RESULTS:

The IUGR group had higher systolic and diastolic blood pressure than the control group: 131.5 [95% confidence interval (CI) 127.9-135.1] vs 127.1 (95% CI 124.3-129.2) mmHg and 82.3 (95% CI 79.6-85.0) vs 79.0 (95% CI 77.0-81.0) mmHg, respectively. After adjustment for gender, the differences between the groups were statistically significant: systolic blood pressure 4.5 (95% CI 0.3-8.7) mmHg and diastolic blood pressure 3.4 (95% CI 0.2-6.5) mmHg (both P < 0.05). More participants in the IUGR group were receiving treatment for high blood pressure compared with the control group [16 (15%) vs 11 (9%)], although this was not statistically significant. The proportion of subjects with blood pressure >140/90 mmHg or currently receiving antihypertensive treatment was 45% (n = 49) for the IUGR group, and 31% (n = 38) for the control group (odds ratio 1.9, 95% CI 1.1-3.3). Adjustment for potential confounders made little difference.

CONCLUSIONS:

IUGR is associated with higher blood pressure at 50 years of age. Individuals born with IUGR should have regular blood pressure screening and early treatment as required. Hypertension remains underdiagnosed and undertreated in adult life.

Rapid serological diagnosis of Helicobacter pylori:a need for caution and re-evaluation

Screening for Helicobacter pylori in dyspeptic patients may improve selectivity for gastroscopy. Rapid serological tests based on ELISA technique are cheap, readily available and simple to use in the clinical setting. However local evaluation is essential in order to validate these techniques. Fifty-six dyspeptic patients (aged less than 45 yr) had a rapid serological test (Helisal) performed prior to gastroscopy. At gastroscopy H. pylori status was assessed using culture and histology. The Helisal sensitivity was 80 per cent, specificity 82 per cent. Screening patients with the Helisal test would have missed 6 patients with peptic ulcer disease and 2 with oesophagitis. The Helisal test did not perform satisfactorily as a screening test in selection of patients for gastroscopy.