The use of Multiple Breath Washout for Assessing Cystic Fibrosis in Infants

INTRODUCTION: Lung Clearance Index, measured using the multiple breath washout (MBW) technique, may be a useful test in infants with Cystic Fibrosis (CF). However, the requirement for specialised equipment and a number of important technical and methodological considerations relevant to testing in infants have complicated matters, and to date prevented its widespread translatability in this age group. Areas covered: We review the current status of infant MBW testing in CF, focusing on Lung Clearance Index. This includes a review of recent developments in the field relevant to testing methodology in the infant population, use in evaluating lung disease in CF in infancy, and the associated challenges which remain. Expert commentary: The challenges of infant MBW are not limited to those associated with testing equipment, but also gaps in our understanding regarding the interpretation of MBW indices in infants. This includes their relationship to underlying physiology and pathology, and tracking over time. Recent advances in understanding and improving the infant MBW test set up (including both hardware and software) relevant to infants will greatly progress the field

The Elephant Trunk Nebula and the Trumpler 37 cluster: Contribution of triggered star formation to the total population of an HII region

Rich young stellar clusters produce HII regions whose expansion into the nearby molecular cloud is thought to trigger the formation of new stars. However, the importance of this mode of star formation is uncertain. This investigation seeks to quantify triggered star formation (TSF) in IC 1396A (a.k.a., the Elephant Trunk Nebula), a bright rimmed cloud (BRC) on the periphery of the nearby giant HII region IC 1396 produced by the Trumpler 37 cluster. X-ray selection of young stars from Chandra X-ray Observatory data is combined with existing optical and infrared surveys to give a more complete census of the TSF population. Over 250 young stars in and around IC 1396A are identified; this doubles the previously known population. A spatio-temporal gradient of stars from the IC 1396A cloud toward the primary ionizing star HD 206267 is found. We argue that the TSF mechanism in IC 1396A is the radiation-driven implosion process persisting over several million years. Analysis of the X-ray luminosity and initial mass functions indicates that >140 stars down to 0.1 Msun were formed by TSF. Considering other BRCs in the IC 1396 HII region, we estimate the TSF contribution for the entire HII region exceeds 14-25% today, and may be higher over the lifetime of the HII region. Such triggering on the periphery of HII regions may be a significant mode of star formation in the Galaxy.Comment: Accepted for publication in MNRAS; 28 pages, 18 figure

The bronchodilator response in preschool children: A systematic review

BACKGROUND: The bronchodilator response (BDR) is frequently used to support diagnostic and therapeutic decision-making for children who wheeze. However, there is little evidence-based guidance describing the role of BDR testing in preschool children and it is unclear whether published cut-off values, which are derived from adult data, can be applied to this population. METHODS: We searched MEDLINE, EMBASE, Web of Science, and Cochrane databases (inception-September 2015) for studies reporting response to a bronchodilator in healthy preschool children, response following placebo inhalation, and the diagnostic efficacy of BDR compared with a clinical diagnosis of asthma/recurrent wheezing. FINDINGS: We included 14 studies. Thirteen studies provided BDR data from healthy preschool children. Two studies reported response to placebo in preschool children with asthma/recurrent wheezing. Twelve studies compared BDR measurements from preschool children with asthma/recurrent wheeze to those from healthy children and seven of these studies reported diagnostic efficacy. Significant differences between the BDR measured in healthy preschool children compared with that in children with asthma/recurrent wheeze were demonstrated in some, but not all studies. Techniques such as interrupter resistance, oscillometry, and plethysmography were more consistently successfully completed than spirometry. Between study heterogeneity precluded determination of an optimum technique. INTERPRETATION: There is little evidence to suggest spirometry-based BDR can be used in the clinical assessment of preschool children who wheeze. Further evaluation of simple alternative techniques is required. Future studies should recruit children in whom airways disease is suspected and should evaluate the ability of BDR testing to predict treatment response

Controlling the pests with the help of plants in organic vineyards

The capability of plants of increasing the ecosystem resistance to pests and invasive species is a well-known ecosystem service. However, monocultures (including vineyards) do not exploit the potential of plant diversity. The aims of this research are to develop new viticultural systems based on increased plant diversity within (e.g., cover crops) and/or around (e.g., hedges, vegetation spots, edgings) vineyards by planting selected plant species for the control of arthropods, soil-borne pests (oomycetes, fungi, nematodes), and foliar pathogens. In order to control pests, plants species can either i) repel arthropod pests, ii) attract arthropod pests to a trap crop or iii) attract and/or conserve beneficials. An extensive systematic literature was performed to identify plant species suitable for repelling or attracting target pests - Lobesia botrana Den & Schiff or conserving and promoting beneficials (including parasitoids, such as ichneumonids, braconids and general predators, such as carabid beetles, ladybirds, hoverflies and spiders). Here we present the results of this literature review

Cooperation between expert knowledge and data mining discovered knowledge: Lessons learned

Expert systems are built from knowledge traditionally elicited from the human expert. It is precisely knowledge elicitation from the expert that is the bottleneck in expert system construction. On the other hand, a data mining system, which automatically extracts knowledge, needs expert guidance on the successive decisions to be made in each of the system phases. In this context, expert knowledge and data mining discovered knowledge can cooperate, maximizing their individual capabilities: data mining discovered knowledge can be used as a complementary source of knowledge for the expert system, whereas expert knowledge can be used to guide the data mining process. This article summarizes different examples of systems where there is cooperation between expert knowledge and data mining discovered knowledge and reports our experience of such cooperation gathered from a medical diagnosis project called Intelligent Interpretation of Isokinetics Data, which we developed. From that experience, a series of lessons were learned throughout project development. Some of these lessons are generally applicable and others pertain exclusively to certain project types

Study of the thermal behavior of the aluminium dust stabilized with gypsum

[ES]El polvo de aluminio (pAl) es un residuo peligroso procedente de la metalurgia secundaría del aluminio. Con objeto de reducir la reactividad del mismo, en el CENIM se ha desarrollado un proceso de estabilización/solidificación mediante su fraguado con yeso. En este trabajo se presenta el estudio del comportamiento térmico del pAl estabilizado con el yeso, con el fin de establecer la influencia del residuo en las reacciones de hidratación/deshidratación del yeso durante el proceso del fraguado, a saber: deshidratación parcial del sulfato calcico dihidrato, deshidratación del hemihidrato, deshidratación del hidróxido de aluminio y transformación de anhidrita soluble en anhidrita insoluble. Asimismo se ha estudiado la cinética asociada a cada una de las reacciones anteriormente mencionadas mediante Calorimetría Diferencial de Barrido.[EN]The aluminium dust is a hazardous waste from the secondary aluminium remelting industry. A stabilization/solidification process was developed at CENIM with the aim of decreasing its reactivity. Gypsum was used as a binder material. Tliis work summarizes the study of the thermal behavior of the aluminium dust stabilized with gypsum, in order to establish the influence of the residue in the reactions of hydration/dehydration of the gypsum during the hardening process, namely: partial dehydration of calcium sulphate dihydrate, dehydration of calcium sulphate hemi'hydrate, dehydration of aluminium hydroxide and anhydrite soluble/anhydrite insoluble transformation. The activation energy associated to all those reactions was determined by Differential Scanning Calorimetry.Los autores agradecen a la Consejería de Educación de la Comunidad de Madrid la financiación del proyecto (07M/0136/2000) y a la empresa Recuperación y Reciclaje Román por el apoyo a esta investigación.Peer reviewe

GLI equations improve interpretation of FEV1 decline among patients with cystic fibrosis

No abstract for this research letter

Whole-genome sequencing and epidemiological analysis do not provide evidence for cross-transmission of mycobacterium abscessus in a cohort of pediatric cystic fibrosis patients

Mycobacterium abscessus has emerged as a major pathogen in cystic fibrosis (CF) patients and has been associated with poor clinical outcomes, particularly following lung transplant. We investigated the acquisition of this bacterium in a cohort of pediatric CF patients

Clinical Applications of Pediatric Pulmonary Function Testing: Lung Function in Recurrent Wheezing and Asthma

Pulmonary function testing remains the gold standard for the diagnosis and management of wheezing disorders in older children and adults. Although wheezing disorders are among the most common clinical problems in pediatrics, most young children and toddlers cannot perform most of the currently clinically available pulmonary function tests. In this article, we review the different types of pulmonary function tests available and discuss the applicability and utility in the different age groups with specific reference to suitability in the diagnosis and management of wheezing disorders.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/90475/1/ped-2E2010-2E0060.pd