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This study aimed to assess interrater agreement in lung ultrasound scores (LUS) among neonatologists with varying experience levels and an expert sonographer. A post hoc analysis was conducted on data from a prospective multicenter study involving 155 infants born <34 weeks' gestation, all with respiratory distress syndrome. A total of 629 lung scans were performed and video-recorded by 21 point-of-care sonographers, including both experienced (n = 7) and inexperienced (n = 14) evaluators. Subsequently, a blinded expert sonographer re-evaluated the assigned LUS values. The Cohen's kappa statistic for individual pulmonary field assessments ranged from 0.89 to 0.93, indicating nearly perfect agreement. The interclass correlation coefficient (ICC) confirmed excellent reliability on total LUS values, demonstrating similar performance of experienced (ICC = 0.92, 95% CI 0.90–0.94) and inexperienced sonographers (ICC = 0.93, 95% CI 0.92–0.94). This study underscores that lung ultrasound is easily learned, and LUS exhibits outstanding reproducibility, irrespective of the sonographer's level of experience. [ABSTRACT FROM AUTHOR]

The heterogeneous nature and widespread anthropogenic impacts on industrial water biotopes in the Trzuskawica S.A., pose challenges to biomonitoring of this habitat. Generally, the concentration of trace elements in the industrial water biotopes reflects the anthropogenic impacts. With X-ray fluorescence method (TXRF) in waters 17 elements:P,S,Cl,K,Ca,Ti,Cr, Mn,Fe,Ni,Cu,Zn,Br,Rb, Sr, Ba, Pb were revealed. High amounts of Ca, from 300 ppm to 198 ppm in May and from 999 ppm to 231 ppm in September 2015, was determined. A total of 36 diatoms were found in two reservoirs and drainage ditch, but only three taxa: Cymatopleura radiosa, Navicula upsaliensis and Nitzschia angustata were present in all 7 sampling sites. These species are known to be tolerant to organic pollution, eutrophication, and also characteristic for limestone waters. The results of CVA showed that dintoms in the water reservoir stocked with fish were distinguished by highest species richness. The relationships between diatoms and environmental variables confirm the positive correlation with the currently functioning industrial plant (despite the increased water temperature and large content of trace elements). Our results suggest that, though heterogeneity in both diatoms and selected elements in industrial waters, diatoms can be useful indicators of habitat conditions.

Element concentrations of K, Ca, Ti, Cr, Fe, Ni, Cu, Zn, Se, Br, Sr and Pb as well as the activity of natural radionuclides 210Pb and 226Ra in air were measured. The aerosol samples were collected during tropospheric and stratospheric aircraft flights over the Northeastern region of Poland, which is mostly an agricultural and wooded area. The air volumes were filtered using Petrianov filters at 1, 3, 6, 9, 12 and 15 km above the ground level by special equipment attached to a jet plane. Aircraft flights were provided from September 1997 to August 1998 in 5 separate sampling runs. The long sampling distances served as a good representation of mean aerosol composition and distribution. Concentrations of the same elements were also measured using stationary equipment near the ground level at the outskirts of Warsaw. The vertical profiles of element concentration were obtained and the elemental compositions for the tropospheric and stratospheric aerosols were compared with those from the near-ground level. Contribution of K, Ca, Ti and Fe, which are the main components of soil, in total mass of all detected ones was estimated. Relative concentrations of all measured elements, which show any differences in the composition of the aerosol were calculated. The results obtained confirm the fact that the stratospheric reservoir is observed in the bottom stratosphere. The XRF method based on molybdenum X-ray tube was used as an analytical tool in the determination of aerosols trace elements. The altitude distributions of radioactivity of 226Ra and 210Pb were determined using radiochemical methods. [Copyright &y& Elsevier]

Objective: There is growing evidence for the usefulness of the lung ultrasound score (LUS) in neonatal intensive care. We evaluated whether the LUS is predictive of outcomes in infants with respiratory distress syndrome (RDS)., Study Design: Neonates less than 34 weeks of gestational age were eligible for this prospective, multicenter cohort study. The outcomes of interest were the need for mechanical ventilation (MV) at <72 hours of life, the need for surfactant (SF), successful weaning from continuous positive airway pressure (CPAP), extubation readiness, and bronchopulmonary dysplasia. Lung scans were taken at 0 to 6 hours of life (Day 1), on Days 2, 3, and 7, and before CPAP withdrawal or extubation. Sonograms were scored (range 0-16) by a blinded expert sonographer. The area under the receiver operating characteristic curve (AUC) was used to estimate the prediction accuracy of the LUS., Results: A total of 647 scans were obtained from 155 newborns with a median gestational age of 32 weeks. On Day 1, a cutoff LUS of 6 had a sensitivity (Se) of 88% and a specificity (Sp) of 79% to predict the need for SF (AUC = 0.86), while a cutoff LUS of 7 predicted the need for MV at <72 hours of life (Se = 89%, Sp = 65%, AUC = 0.80). LUS acquired prior to weaning off CPAP was an excellent predictor of successful CPAP withdrawal, with a cutoff level of 1 (Se = 67%, Sp = 100%, AUC = 0.86)., Conclusion: The LUS has significant predictive ability for important outcomes in neonatal RDS., Key Points: · Lung ultrasound has significant prognostic abilities in neonatal RDS.. · Early sonograms (0-6 h of life) accurately predict the requirement for SF and ventilation.. · Weaning off CPAP is effective when the LUS (range 0-16) is less than or equal to 1.., Competing Interests: P.S., M.S., W.B., I.S-K., P.K., and R.B. received honoraria from Chiesi Poland for lecturing and participation on advisory boards. R.H. is employed by Chiesi Poland, the sponsor of the study. The remaining authors report no conflict of interest., (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).)

The use of fenoterol in the treatment of preterm labor is associated with the risk of many complications in the mother and the fetus. We present a case of a multipara treated with oral fenoterol due to threatening preterm labor 14 weeks. At 35 weeks of gestation the fetus was diagnosed with hypertrophic cardiomyopathy with severe impairment of the right ventricle. The only factor that might have caused such a state of the fetal circulatory system was fenoterol, used from 21 weeks of gestation. After the withdrawal of the fenoterol the fetal right ventricular function improved gradually. However fetal cardiac hypertrophy persisted until the birth at 39 weeks of gestation. Concentric hypertrophy of the right ventricular wall and interventricular septum were confirmed in the newborn.