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Abstract Background Surfactant is a well-established therapy for preterm neonates affected by respiratory distress syndrome (RDS). The goals of different methods of surfactant administration are to reduce the duration of mechanical ventilation and the severity of bronchopulmonary dysplasia (BPD); however, the optimal administration method remains unknown. This study compares the effectiveness of the INtubate-RECruit-SURfactant-Extubate (IN-REC-SUR-E) technique with the less-invasive surfactant administration (LISA) technique, in increasing BPD-free survival of preterm infants. This is an international unblinded multicenter randomized controlled study in which preterm infants will be randomized into two groups to receive IN-REC-SUR-E or LISA surfactant administration. Methods In this study, 382 infants born at 24+0–27+6 weeks’ gestation, not intubated in the delivery room and failing nasal continuous positive airway pressure (nCPAP) or nasal intermittent positive pressure ventilation (NIPPV) during the first 24 h of life, will be randomized 1:1 to receive IN-REC-SUR-E or LISA surfactant administration. The primary outcome is a composite outcome of death or BPD at 36 weeks’ postmenstrual age. The secondary outcomes are BPD at 36 weeks’ postmenstrual age; death; pulse oximetry/fraction of inspired oxygen; severe intraventricular hemorrhage; pneumothorax; duration of respiratory support and oxygen therapy; pulmonary hemorrhage; patent ductus arteriosus undergoing treatment; percentage of infants receiving more doses of surfactant; periventricular leukomalacia, severe retinopathy of prematurity, necrotizing enterocolitis, sepsis; total in-hospital stay; systemic postnatal steroids; neurodevelopmental outcomes; and respiratory function testing at 24 months of age. Randomization will be centrally provided using both stratification and permuted blocks with random block sizes and block order. Stratification factors will include center and gestational age (24+0 to 25+6 weeks or 26+0 to 27+6 weeks). Analyses will be conducted in both intention-to-treat and per-protocol populations, utilizing a log-binomial regression model that corrects for stratification factors to estimate the adjusted relative risk (RR). Discussion This trial is designed to provide robust data on the best method of surfactant administration in spontaneously breathing preterm infants born at 24+0–27+6 weeks’ gestation affected by RDS and failing nCPAP or NIPPV during the first 24 h of life, comparing IN-REC-SUR-E to LISA technique, in increasing BPD-free survival at 36 weeks’ postmenstrual age of life. Trial registration ClinicalTrials.gov NCT05711966. Registered on February 3, 2023.

Respiratory health in children is essential for general wellbeing and healthy development in the short and long term. It is well known that many respiratory diseases in adulthood have their origins in early life, and therefore research on prevention of respiratory diseases and management of children with respiratory diseases will benefit patients during the full life course. Scientific and clinical advances in the field of respiratory health are moving at a fast pace. This article summarises some of the highlights in paediatric respiratory medicine presented at the hybrid European Respiratory Society (ERS) International Congress 2023 which took place in Milan (Italy). Selected sessions are summarised by Early Career Members of the Paediatrics Assembly (Assembly 7) under the supervision of senior ERS officers, and cover a wide range of research areas in children, including respiratory physiology and sleep, asthma and allergy, cystic fibrosis, respiratory infection and immunology, neonatology and intensive care, respiratory epidemiology and bronchology.

The article examines the gender politics of populist parties in two countries historically marked by cultural traditionalism – Italy and Spain. It defines and compares the articulation of gender issues cross-nationally and intra-ideologically to understand how populist parties contest the politics of gender in the two countries. Drawing on computer-assisted qualitative content analyses of programmatic documents, it assesses the framing and salience of gender by the populist radical left (the Spanish Podemos) and right (Lega and Fratelli d'Italia in Italy; VOX in Spain), while also accounting for an ideologically ambiguous populist party (the Italian Movimento 5 Stelle). It concludes ascertaining the different salience of gender politics among Italian and Spanish populist parties and evinces multiple axes of programmatic proximity and distance – not only cross-nationally, but also intra-ideologically among parties akin. [ABSTRACT FROM AUTHOR]

Since the beginning of the pandemic, while progressive movements have mainly focused on social inequalities exacerbated by the sanitary emergency, a number of protests emerged and quickly became visible that initially targeted the policies taken to reduce contagion and subsequently focused on the vaccine and vaccination. In the attempt to account for the rapid development of these protests, social scientists have mostly turned to classical approaches used in the analysis of far-right organizations and sects, looking at broad transformations in society or at fear and a sense of insecurity at the individual level. In this article, we build upon a social movement approach to look at the main characteristics of the protests against anti-contagion measures. From a theoretical point of view, we point to the importance of disentangling the specific waves happening within broader protest cycles. Empirically, focusing on the Italian case, we present a novel development in protest event analysis looking at the specific forms of action, the actors involved, and their claims in two waves of contention during the pandemic in Italy, between 2020 and 2021.

A new methodology to improve the sensitivity to new physics contributions to the Standard Model processes at LHC is presented. A Variational AutoEncoder trained on Standard Model processes is used to identify Effective Field Theory contributions as anomalies. While the output of the model is supposed to be very similar to the inputs for Standard Model events, it is expected to deviate significantly for events generated through new physics processes. The reconstruction loss can then be used to select a signal enriched region which is by construction independent of the nature of the chosen new physics process. In order to improve further the discrimination power, an adversarial layer is introduced with a cross entropy term added to the loss function, optimizing at the same time the reconstruction of the input variables of the Standard Model and classification of new physics processes. This procedure ensures that the model is optimized for discrimination, with a small price in terms of model dependency to physics process. In this work I will discuss in detail the above-mentioned method using generator level Vector Boson Scattering events produced at LHC assuming an integrated luminosity of 350/fb.

This study investigated the relationship between three respiratory support approaches on lung volume recruitment during the first 2 h of postnatal life in preterm lambs. We estimated changes in lung aeration, measuring respiratory resistance and reactance by oscillometry at 5 Hz. We also measured intratracheal pressure in subsets of lambs. The first main finding is that sustained inflation (SI) applied noninvasively (Mask SI; n = 7) or invasively [endotracheal tube (ETT) SI; n = 6] led to similar rapid lung volume recruitment (∼6 min). In contrast, Mask continuous positive airway pressure (CPAP) without SI (n = 6) resuscitation took longer (∼30–45 min) to reach similar lung volume recruitment. The second main finding is that, in the first 15 min of postnatal life, the Mask CPAP without SI group closed their larynx during custom ventilator-driven expiration, leading to intratracheal positive end-expiratory pressure of ∼17 cmH2O (instead of 8 cmH2O provided by the ventilator). In contrast, the Mask SI group used the larynx to limit inspiratory pressure to ∼26 cmH2O (instead of 30 cmH2O provided by the ventilator). These different responses affected tidal volume, being larger in the Mask CPAP without SI group [8.4 mL/kg; 6.7–9.3 interquartile range (IQR)] compared to the Mask SI (5.0 mL/kg; 4.4–5.2 IQR) and ETT SI groups (3.3 mL/kg; 2.6–3.7 IQR). Distinct physiological responses suggest that spontaneous respiratory activity of the larynx of preterm lambs at birth can uncouple pressure applied by the ventilator to that applied to the lung, leading to unpredictable lung pressure and tidal volume delivery independently from the ventilator settings. NEW & NOTEWORTHY: We compared invasive and noninvasive resuscitation on lambs at birth, including or not sustained inflation (SI). Lung volume recruitment was faster in those receiving SI. During noninvasive resuscitation, larynx modulation reduced tracheal pressure from that applied to the mask in lambs receiving SI, while it led to increased auto-positive end-expiratory pressure and very large tidal volumes in lambs not receiving SI. Our results highlight the need for individualizing pressures and monitoring tidal volumes during resuscitation at birth. [ABSTRACT FROM AUTHOR]

This review has been prepared by the Early Career Members and Chairs of the European Respiratory Society (ERS) Assembly 7: Paediatrics. We here summarise the highlights of the advances in paediatric respiratory research presented at the ERS International Congress 2022. The eight scientific groups of this Assembly cover a wide range of research areas, including respiratory physiology and sleep, asthma and allergy, cystic fibrosis (CF), respiratory infection and immunology, neonatology and intensive care, respiratory epidemiology, bronchology, and lung and airway developmental biology. Specifically, we report on abstracts presented at the congress on the effect of high altitude on sleep, sleep disorders, the hypoxic challenge test, and measurements of ventilation inhomogeneity. We discuss prevention of preschool wheeze and asthma, and new asthma medications. In children with CF, we describe how to monitor the effect of CF transmembrane conductance regulator modulator therapy. We present respiratory manifestations and chronic lung disease associated with common variable immunodeficiency. Furthermore, we discuss how to monitor respiratory function in neonatal and paediatric intensive care units. In respiratory epidemiology, we present the latest news from population-based and clinical cohort studies. We also focus on innovative and interventional procedures for the paediatric airway, such as cryotherapy. Finally, we stress the importance of better understanding the molecular mechanisms underlying normal and abnormal lung development.

Since the outbreak of the Covid-19 pandemic, progressive social movements have been engaged in an incredibly intense period of contestation. Confronted with the unprecedented extent of the crisis, the current wave of mobilization brought together both older and newer actors, bridging generations and movement sectors, building on past experiences of previous mobilizations while also innovating in important ways. The Covid-19 pandemic provides an opportunity to contextualize the role of past mobilizations in contemporary struggles, singling out continuities and innovation in the forms of resistance, collective frames, and organizational models. This paper focuses on the framing of health rights and analyzes the emergence of care as a bridging frame in the movement campaigns developed during the Covid-19 crisis. In examining the processes of cross-temporal diffusion, it considers the legacy of the Global Justice Movement and its offspring in the current mobilization in Italy. Through the analysis of key documents produced by social movements triangulated with in-depth interviews with activists, we observe the ways in which some collective frames migrate from past mobilizations to new ones, and are adapted through the reactivation of old organizational networks and the emergence of new organizations. [ABSTRACT FROM AUTHOR]