In preterm infants, chronic lung disease (CLD) is associated with an increased risk for cerebral palsy (CP). However, systemic postnatal corticosteroid therapy to prevent or treat CLD, although ...effective in improving lung function, may cause CP. The objective of this study was to determine the effect of systemic postnatal corticosteroid treatment on death and CP and to assess any modification of effect arising from risk for CLD.
Randomized, controlled trials of postnatal corticosteroid therapy for prevention or treatment of CLD in preterm infants that reported rates of both mortality and CP were reviewed and their data were synthesized. Twenty studies with data on 1721 randomized infants met eligibility criteria. The relationship between the corticosteroid effect on the combined outcome, death or CP, and the risk for CLD in control groups was analyzed by weighted meta-regression.
Among all infants who were randomized, a significantly higher rate of CP after corticosteroid treatment (typical risk difference RD: 0.05; 95% confidence interval CI: 0.02, 0.08) was partly offset by a nonsignificant reduction in mortality (typical RD: -0.02; 95% CI: -0.06 to 0.02). Consequently, there was no significant effect of corticosteroid treatment on the combined rate of mortality or CP (typical RD: 0.03; 95% CI: -0.01 to 0.08). However, on meta-regression, there was a significant negative relationship between the treatment effect on death or CP and the risk for CLD in control groups. With risks for CLD below 35%, corticosteroid treatment significantly increased the chance of death or CP, whereas with risks for CLD exceeding 65%, it reduced this chance.
The effect of postnatal corticosteroids on the combined outcome of death or CP varies with the level of risk for CLD.
Detailed field mapping combined with a petrologic and geochemical investigation of the Zedong terrane within the Yarlung Tsangpo suture zone provides insights to the evolution of now mostly subducted ...portions of Tethys during the Late Jurassic. The terrane is dominated by volcanic rocks of shoshonitic affinity, which were erupted in a submarine oceanic island arc setting. The volcanic island arc was built on a basement of oceanic crust, and the shoshonites locally overlie a thin section of pillowed island arc tholeiites and red ribbon–bedded radiolarian cherts. Geochemistry of the shoshonites suggests that their development occurred in a setting analogous to that of Late Miocene to Early Pliocene Fiji and was associated with an arc rifting. We speculate that this event may have been a far‐field response to developments associated with Gondwana breakup.
Celotno besedilo
Dostopno za:
BFBNIB, DOBA, IZUM, KILJ, NMLJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
The Liverpool Telescope is one of the world’s premier facilities for time domain astronomy. The time domain landscape is set to radically change in the coming decade, with synoptic all-sky surveys ...such as LSST providing huge numbers of transient detections on a nightly basis; transient detections across the electromagnetic spectrum from other major facilities such as SVOM, SKA and CTA; and the era of ‘multi-messenger astronomy’, wherein astrophysical events are detected via non-electromagnetic means, such as neutrino or gravitational wave emission. We describe here our plans for the Liverpool Telescope 2: a new robotic telescope designed to capitalise on this new era of time domain astronomy. LT2 will be a 4-metre class facility co-located with the Liverpool Telescope at the Observatorio del Roque de Los Muchachos on the Canary island of La Palma. The telescope will be designed for extremely rapid response: the aim is that the telescope will take data within 30 seconds of the receipt of a trigger from another facility. The motivation for this is twofold: firstly it will make it a world-leading facility for the study of fast fading transients and explosive phenomena discovered at early times. Secondly, it will enable large-scale programmes of low-to-intermediate resolution spectral classification of transients to be performed with great efficiency. In the target-rich environment of the LSST era, minimising acquisition overheads will be key to maximising the science gains from any follow-up programme. The telescope will have a diverse instrument suite which is simultaneously mounted for automatic changes, but it is envisaged that the primary instrument will be an intermediate resolution, optical/infrared spectrograph for scientific exploitation of transients discovered with the next generation of synoptic survey facilities. In this paper we outline the core science drivers for the telescope, and the requirements for the optical and mechanical design.
Since 1999, independently derived geophysical and geological models have been published arguing for an intra-oceanic subduction system along essentially the entire width of the India–Eurasia ...collision belt. This idea conflicts with earlier proposals, where in the eastern part of the convergence zone Neotethyan mid-ocean ridge-generated lithosphere directly north of the Indian craton was consumed beneath Eurasia in Tibet in an Andean-type plate configuration. New palaeomagnetic data are reported from three Barremian–Aptian (∼
120 Ma) sequences of chert, siliceous mudstones and volcaniclastic rocks. These rocks form the uppermost part of the Dazhuqu supra-subduction zone ophiolite terrane, which crop out along substantial portions of the India–Eurasia (=
Yarlung Tsangpo) suture zone in southern Tibet. The declination data provide little regionally-useful tectonic information; they are dominated by local rotations, presumably related to the Dazhuqu terrane's initial obduction onto the India plate in the Palaeocene and subsequent movement(s) as India later collided and indented into Eurasia. The inclination data are, however, useful because they yield consistent sub-equatorial formation sites (2.7 °S
±
3.0°, 7.9 °N
±
2.7°, 1.4 °N
±
5.7°), which correspond with the location of the Neotethyan intra-oceanic subduction system inferred from the seismic tomographic data. At the time these Dazhuqu terrane rocks formed, the intra-Tethyan subduction zone would have been about 2500 km south of Eurasia.
Mapping the dynamics of immune cell populations over time or disease‐course is key to understanding immunopathogenesis and devising putative interventions. We present TrackSOM, a novel method for ...delineating cellular populations and tracking their development over a time‐ or disease‐course cytometry datasets. We demonstrate TrackSOM‐enabled elucidation of the immune response to West Nile Virus infection in mice, uncovering heterogeneous subpopulations of immune cells and relating their functional evolution to disease severity. TrackSOM is easy to use, encompasses few parameters, is quick to execute, and enables an integrative and dynamic overview of the immune system kinetics that underlie disease progression and/or resolution.
...comprehensive smoke-free air laws in public buildings have been estimated to result in a saving of $10 billion annually in health-care costs by eliminating exposure to second-hand smoke.9 Reducing ...sodium in the food supply to 1500 mg per day could result in $26·2 billion in US health-care savings annually.10 Community-based programmes to increase physical activity, improve nutrition, and prevent smoking can provide a return on investment of $5·60 for every dollar spent within 5 years.11 The cost of implementing prevention programmes in low-income and middle-income countries is less than $0·40 per person and a package of public health behavioural interventions is projected to cost only $0·70 per person in China, for example, far less than projected costs of NCDs.5,12 Further investments in research, development, and evaluation of new approaches to mitigate the effects of NCDs are also needed to ensure effective investment of resources by public and private entities.
On 15–17 February 2008, a CME with an approximately circular cross section was tracked through successive images obtained by the Heliospheric Imager (HI) instrument onboard the STEREO-A spacecraft. ...Reasoning that an idealised flux rope is cylindrical in shape with a circular cross-section, best fit circles are used to determine the radial width of the CME. As part of the process the radial velocity and longitude of propagation are determined by fits to elongation-time maps as 252±5 km/s and 70±5° respectively. With the longitude known, the radial size is calculated from the images, taking projection effects into account. The radial width of the CME, S (AU), obeys a power law with heliocentric distance, R, as the CME travels between 0.1 and 0.4 AU, such that S=0.26 R0.6±0.1. The exponent value obtained is compared to published studies based on statistical surveys of in situ spacecraft observations of ICMEs between 0.3 and 1.0 AU, and general agreement is found. This paper demonstrates the new opportunities provided by HI to track the radial width of CMEs through the previously unobservable zone between the LASCO field of view and Helios in situ measurements.
Summary
Background
Wet dressings combined with topical corticosteroids are beneficial for patients with generalized and refractory dermatosis; however, to our knowledge, serum levels after topical ...corticosteroid absorption during intensive therapy have not been reported previously.
Aim
To examine serum levels of triamcinolone acetonide (TAC) after topical corticosteroid application during intensive wet‐dressing therapy.
Methods
We performed a retrospective study of adult patients admitted for inpatient wet‐dressing therapy from 7 November 2015 to 24 June 2016. Data were collected on sex, age, body surface area, TAC serum levels, number of wet‐dressing changes after 24 and 48 h, and type of wet dressing.
Results
In total, 29 patients (14 men, 15 women) were assessed. Median interquartile range (IQR) age was 57 years (51.5–67.0 years) and involved body surface area was 1.98 m2 (1.88–2.15) m2. Before the 24‐hour blood draw, patients had received 1–3 dressing changes. Median (IQR) TAC level at 24 h was 0.33 µg/dL (0.20–0.58 µg/dL), with no significant difference noted between the number of dressing changes and TAC serum level. At 48 h, results of a serum TAC test were available for 22 patients with 2–6 dressing changes. Mean (IQR) serum level was 0.30 µg/dL (0.30–0.87 µg/dL). For each additional dressing change, there was an estimated 0.21 µg/dL increase in TAC serum level (95% CI 0.11–0.31; P < 0.001). TAC serum level was not significantly associated with sex, age, body surface area or dressing type.
Conclusions
Intensive, inpatient wet‐dressing therapy is associated with detectable TAC serum levels. However, we suspect that topical TAC has a primarily local therapeutic effect on the skin.
Transplant units are exploring strategies to increase the availability of donor kidneys. The use of en-bloc kidney transplantation (EBKT) from paediatric donors represents one potential solution. We ...present our long-term experience with paediatric EBKT among adult recipients.
Twenty-three paediatric to adult EBKTs were performed by the Irish National Kidney Transplant Service between 1990 and 2016. The primary outcome variable was long-term en-bloc allograft survival rate. Secondary outcome variables were incidence of allograft thrombosis, incidence of delayed graft function, overall patient survival and serum creatinine at most recent follow-up. Outcomes were compared to single kidney transplant recipients from the same time period.
Mean donor age was 1.8 ± 0.97 years (range: 7 months to 3 years). Recipient age was 46 ± 12 years. Mean follow-up was 133 ± 64 months (range: 36–264). Overall graft survival was 100%, 91% and 80% after 1, 5 and 10 years respectively, compared to 92%, 79% and 61% in single kidney transplant recipients (p = 0.04). There were 5 cases of allograft failure, 3 due to death from unrelated causes. Median time to graft failure was 108 months (range: 36–172). Mean serum creatinine was 72.6 ± 21.6 μmol/l after the follow-up period. There were no cases of graft thrombosis or delayed graft function. Overall survival was 96.4%, 88.0%, 76.23% and 50.5% at 1, 5, 10 and 20 years respectively.
En-bloc paediatric kidney transplantation is associated with excellent long-term allograft and patient survival and is a feasible strategy for increasing the transplant donor pool in carefully selected recipients.
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