Broken Rotor Bar Detection Based on Steady-State Stray Flux Signals Using Triaxial Sensor with Random Positioning.

This paper investigates the detection of broken rotor bar in squirrel cage induction motors using a novel approach of randomly positioning a triaxial sensor over the motor surface. This study is conducted on two motors under laboratory conditions, where one motor is kept in a healthy state, and the other is subjected to a broken rotor bar (BRB) fault. The induced electromotive force of the triaxial coils, recorded over ten days with 100 measurements per day, is statistically analyzed. Normality tests and graphical interpretation methods are used to evaluate the data distribution. Parametric and non-parametric approaches are used to analyze the data. Both approaches show that the measurement method is valid and consistent over time and statistically distinguishes healthy motors from those with BRB defects when a reference or threshold value is specified. While the comparison between healthy motors shows a discrepancy, the quantitative analysis shows a smaller estimated difference in mean values between healthy motors than comparing healthy and BRB motors.

Bronchoalveolar lavage cytology in children with chronic unexplained cough and severely neurologically impaired children.

OBJECTIVE: We aimed to compare the cellular composition of bronchoalveolar lavage (BAL) fluids in children with chronic unexplained cough (group 1) and severely neurologically impaired children with chronic or recurrent respiratory problems (group 2) with the BAL cytology of children without pulmonary or systemic diseases (group 3). METHODS: Bronchoscopy with BAL fluid analysis was performed in all subjects. Children with respiratory symptoms underwent 24-hour multichannel intraluminal impedance monitoring. RESULTS: A significant difference was found between the groups in the total number of cells in BAL fluid cytology (191 [range, 24-12,747], 747 [range, 53-13,000], and 105 [range, 41-233] cells/µL, P = .015), in the percentage of neutrophils (21.2 [SD = 32.4], 49.4 [SD = 36.6], and 3.6 [SD = 2.4], P < .001), and in the percentage of lipid-laden macrophages (10.3 [SD = 11.4], 13.7 [SD = 15.8] and 0.44 [SD = 1.0], P < .001). CONCLUSION: The BAL fluid cytology provides useful data for determining the cause of chronic unexplained cough and chronic or recurrent respiratory problems in severely neurologically impaired children.

Diagnostic Utility of pH-MII Monitoring in Preschool Children with Recurrent Wheeze and Suspected Gastroesophageal Reflux Disease: A Prospective Study.

BACKGROUND: Recurrent wheezing and gastroesophageal reflux disease (GERD) are common in young children, with a suggested but challenging link between them. This study aimed to investigate the diagnostic value of pH-MII monitoring in preschool children with recurrent wheezing and evaluate GERD-related therapy effects. METHODS: Children under 6 years with recurrent wheeze were eligible. The pH-MII monitoring was conducted in those clinically suspected of GERD's involvement. Flexible bronchoscopy with bronchoalveolar lavage (BAL) was performed in severe cases. The primary outcome was the difference in wheezing episodes between proven GERD and non-GERD groups. Secondary outcomes included GERD therapy impact and predictive factors for wheezing reduction. RESULTS: Of 66 children (mean age 3.9 years), 71% had proven GERD on pH-MII. Compared to the non-GERD group, the GERD group had higher total, liquid, mixed, and gas reflux episodes, as well as more acidic and weakly acidic episodes. GERD treatment significantly reduced wheezing episodes. PPI (proton pump inhibitor) introduction was associated with ≥50% wheezing reduction. Children with GERD showed ≥50% wheezing reduction more frequently than those without GERD. PPI usage, higher total GER episodes, acidic episodes, and liquid and proximal episodes on MII predicted ≥50% wheezing reduction. No significant BAL differences were observed between GERD and non-GERD groups. CONCLUSIONS: The pH-MII monitoring is valuable in diagnosing GERD-related wheezing in preschool children. GERD therapy, particularly PPI usage, was associated with reduced wheezing episodes. The pH-MII parameters correlated with wheezing reduction, suggesting their potential predictive role. BAL did not differentiate between GERD and non-GERD cases.

Weakly Hard Real-Time Model for Control Systems: A Survey.

The concept of weakly hard real-time systems can be used to model real-time systems that may tolerate occasional deadline misses in a bounded and predictable manner. This model applies to many practical applications and is particularly interesting in the context of real-time control systems. In practice, applying hard real-time constraints may be too rigid since a certain amount of deadline misses is acceptable in some applications. In order to maintain system stability, limitations on the amount and distribution of violated deadlines need to be imposed. These limitations can be formally expressed as weakly hard real-time constraints. Current research in the field of weakly hard real-time task scheduling is focused on designing scheduling algorithms that guarantee the fulfillment of constraints, while aiming to maximize the total number of timely completed task instances. This paper provides an extensive literature review of the work related to the weakly hard real-time system model and its link to the field of control systems design. The weakly hard real-time system model and the corresponding scheduling problem are described. Furthermore, an overview of system models derived from the generalized weakly hard real-time system model is provided, with an emphasis on models that apply to real-time control systems. The state-of-the-art algorithms for scheduling tasks with weakly hard real-time constraints are described and compared. Finally, an overview of controller design methods that rely on the weakly hard real-time model is given.

Achromobacter xylosoxidans Purulent Bronchitis in a Previously Healthy Child: An Unexpected Consequence of COVID-19 Infection.

Achromobacter xylosoxidans is an aerobic, Gram-negative rod with a broad intrinsic and acquired antimicrobial resistance, usually isolated in patients with cystic fibrosis (CF), immunodeficiencies, or those undergoing invasive procedures. We report a case of a previously healthy 14-year-old girl who was hospitalized in our institution due to a prolonged, progressive cough and exertional dyspnea, which started after a mild viral respiratory tract infection. To elucidate the cause of her symptoms, a bronchoscopy was finally performed, showing bilateral purulent bronchitis caused by A. xylosoxidans, isolated from bronchoalveolar lavage (BAL) sample. Since the patient had positive serological testing for coronavirus disease 2019 (COVID-19), we concluded that it was the initial viral infection, although of a mild clinical course, the one that created favorable conditions for proliferation and further inflammation caused by A. xylosoxidans.

INVASIVE FUNGAL INFECTIONS IN CHILDREN TREATED FOR HEMATOLOGIC MALIGNANCIES - A FIVE-YEAR SINGLE CENTER EXPERIENCE.

Invasive fungal infections (IFI) are life-threatening complications of intensive chemotherapy treatment, with the incidence in pediatric patients ranging from 2% to 21%. In this article, we describe our 5-year experience of IFI in pediatric oncology patients and its clinical manifestations with radiological findings, treatment and outcome. A retrospective and descriptive survey of IFI in children with hematologic neoplasms was conducted at the Department of Oncology and Hematology, Zagreb Children's Hospital. Medical charts of children 0-17 years of age, of both sexes, treated for leukemias and lymphomas from January 2016 to December 2020 were reviewed. In a 5-year period, 60 patients were treated for hematologic malignancy, acute lymphoblastic leukemia (ALL) being the most prevalent diagnosis. IFI was verified in 9 (15%) children, predominantly in patients with ALL (75%). The specific causative agent was detected in one child, whereas other infections were classified as probable pulmonary aspergillosis. All the patients received standard prophylaxis with fluconazole and treatment with liposomal amphotericin B and voriconazole. The majority of our patients achieved recovery. IFI prevention, diagnosis and treatment remain a challenge. Uniform prophylaxis and therapy protocols, as well as environmental control are of vital importance for the development of better strategies in the prevention, early detection and treatment of IFI in pediatric hematology patients.

Raman and Photoluminescence Spectroscopy with a Variable Spectral Resolution.

Raman and photoluminescence (PL) spectroscopy are important analytic tools in materials science that yield information on molecules' and crystals' vibrational and electronic properties. Here, we show results of a novel approach for Raman and PL spectroscopy to exploit variable spectral resolution by using zoom optics in a monochromator in the front of the detector. Our results show that the spectral intervals of interest can be recorded with different zoom factors, significantly reducing the acquisition time and changing the spectral resolution for different zoom factors. The smallest spectral intervals recorded at the maximum zoom factor yield higher spectral resolution suitable for Raman spectra. In contrast, larger spectral intervals recorded at the minimum zoom factor yield the lowest spectral resolution suitable for luminescence spectra. We have demonstrated the change in spectral resolution by zoom objective with a zoom factor of 6, but the perspective of such an approach is up to a zoom factor of 20. We have compared such an approach on the prototype Raman spectrometer with the high quality commercial one. The comparison was made on ZrO2 and TiO2 nanocrystals for Raman scattering and Al2O3 for PL emission recording. Beside demonstrating that Raman spectrometer can be used for PL and Raman spectroscopy without changing of grating, our results show that such a spectrometer could be an efficient and fast tool in searching for Raman and PL bands of unknown materials and, thereafter, spectral recording of the spectral interval of interest at an appropriate spectral resolution.

Neglected tuberculous trochanteric bursitis in an adolescent girl: A case report and literature review.

Tuberculous trochanteric bursitis (TTB) is an extremely rare form of extrapulmonary tuberculosis. Due to a low clinical suspicion and poor collaboration among medical professionals, the diagnosis of TTB can be often delayed. In this report, we describe a case of neglected TTB in an adolescent girl that initially presented with right thigh swelling and fluctuance. The patient underwent repeated unsuccessful surgical treatment; however, dull pain and periodic wound drainage remained for eight years. Complete excision of fistula and trochanteric bursa and one year of oral antituberculous drug therapy led to complete recovery. This case report highlights tuberculosis as a diagnostic challenge, when rare localizations are affected. In addition, this report addresses several diagnostic pitfalls and reviews the literature regarding TTB in adolescent patients. Orthopedic surgeons need to consider TTB, when swelling, fluctuance or repeated wound drainage are present on the thigh.

The Role of Combined Multichannel Intraluminal Impedance-pH Monitoring in Infants with Brief, Resolved, Unexplained Events.

PURPOSE: Data on the relationship between gastroesophageal reflux (GER) and brief resolved unexplained events (BRUE) in infants is scarce. The aim of this study was to identify the characteristics of combined multichannel intraluminal impedance-pH (MII-pH) monitoring in infants who have experienced BRUE. METHODS: We conducted a prospective study of infants who were hospitalized on account of BRUE and required 24-hour MII-pH monitoring. RESULTS: Twenty-one infants (mean age, 4.7 months; range, 0.9-8.9 months; male/female, 11/10) participated in this study. BRUE symptoms associated with GER were found in 10 infants (47.6%). Based on the RI on pH-metry alone, only 7 (33.3%) infants were diagnosed with GERD. More than 100 GER episodes detected by MII were found in 10 (47.6%) infants. Nineteen percent of infants were diagnosed with GERD based on both pH and MII. CONCLUSION: Both acid and non-acid reflux seem to play a significant role in the pathogenesis of GER-related BRUE in infants.

Hallmarks of senescence and aging.

The complex process of biological aging, as an intrinsic feature of living beings, is the result of genetic and, to a greater extent, environmental factors and time. For many of the changes taking place in the body during aging, three factors are important: inflammation, immune aging and senescence (cellular aging, biological aging). Senescence is an irreversible form of long-term cell-cycle arrest, caused by excessive intracellular or extracellular stress or damage. The purpose of this cell-cycles arrest is to limit the proliferation of damaged cells, to eliminate accumulated harmful factors and to disable potential malignant cell transformation. As the biological age does not have to be in accordance with the chronological age, it is important to find specific hallmarks and biomarkers that could objectively determine the rate of age of a person. These biomarkers might be a valuable measure of physiological, i.e. biological age. Biomarkers should meet several criteria. For example, they have to predict the rate of aging, monitor a basic process that underlies the aging process, be able to be tested repeatedly without harming the person. In addition, biomarkers have to be indicators of biological processes, pathogenic processes or pharmacological responses to therapeutic intervention. It is considered that the telomere length is the weak biomarker (with poor predictive accuracy), and there is currently no reliable biomarker that meets all the necessary criteria.

Filaggrin and atopic march.

There is an increasing number of experimental, genetic and clinical evidence of atopic dermatitis expression as a pre-condition for later development of other atopic diseases such as asthma, food allergy and allergic rhinitis. Atopic dermatitis is a heterogeneous, recurrent childhood disease, also present in the adult age. It is increasingly attributed to systemic features and is characterized by immunological and skin barrier integrity and function dysregulation. To maintain the protective function of the skin barrier, in particular the maintenance of pH, hydration and antimicrobial functions, the filaggrin, among others, plays a significant role. Filaggrin is a multifunctional, histidine-rich, insoluble protein. The lack of filaggrin is associated with various cutaneous (e.g. ichthyosis vulgaris, allergic contact dermatitis) and non-cutaneous (e.g. diabetes, inflammatory conditions of the gastrointestinal tract) diseases and may be a result of genetic, immunological factors combined with environmental factors. In this review we summarised (emphasized) recent findings in understanding the role of filaggrin in atopic dermatitis and other diseases, participants in the atopic march.

Refugee Status as a Possible Risk Factor for Childhood Enuresis.

This study investigated the influence of refugee status on the occurrence of enuresis. It was performed among school children aged 6 to 11 years and their parents in the Vukovarsko-srijemska County (eastern Croatia), which had many displaced persons and refugees (mostly women and children) in the 1990s due to the wars in Croatia and Bosnia and Herzegovina. A specially designed questionnaire (about the child's age and gender, the child's enuresis history and that of the parents, and data on parental refugee status in childhood) was completed by one of the parents. Adequate data were collected for 3046 children. The prevalence of enuresis among the studied children was quite low (2.3%) but the prevalence distribution according to gender, the decline by age, and the higher odds ratio for paternal enuresis were in line with the results of other studies. The prevalence of parental enuresis in childhood was higher than their children's enuresis (mothers: 5.8%, fathers: 3.6%, p < 0.001), and significantly higher among parents who had been refugees (mothers: p = 0.001, fathers: p = 0.04). Parental refugee status had no influence on the children's enuresis. The results suggest that refugee status is a risk factor for the occurrence of enuresis in childhood.

Busulfan-Induced Lung Injury in Pediatric Oncology Patients-Review of the Literature with an Illustrative Case.

Background: Impaired lung function has been detected in up to 65% of all childhood cancer survivors. It is often caused by exposure to radiation therapy and various chemotherapeutics. The first cytotoxic drug ever identified as a causative agent of lung injury was busulfan, reported in the early 1960s. Signs and symptoms of busulfan lung are nonspecific and it is therefore difficult to differentiate the condition from pulmonary impairment caused by other pulmotoxic agents, infections, pulmonary metastases, graft-versus-host disease, or other noninfectious post-transplant complications involving the lungs. Methods: A case example is provided to illustrate the difficulties in management of busulfan-induced lung injury in children. A retrospective review of cases of busulfan-induced lung injury indexed in PubMed until March 2019 was performed. Inclusion criteria for articles was available in full text in English. Results: Impaired lung function caused by busulfan may become an increasing problem for young survivors. Conclusion: Newly developed dyspnea or subclinical damage detected on pulmonary function tests, indicating primarily restrictive disease, should always arouse suspicion of busulfan-induced lung injury in a child conditioned with busulfan, especially after excluding other leading culprits of pulmonary damage affecting oncology patients.

Combined multichannel intraluminal impedance-pH monitoring should be used to diagnose reflux-related otitis media with effusion in children.

AIM: This study investigated the diagnostic usefulness of combined multichannel intraluminal impedance-pH monitoring (MII-pH) in children with suspected reflux-related otitis media with effusion (OME) as existing data were scarce. METHODS: This was a prospective study that included children up to seven years of age who underwent MII-pH due to OME lasting more than three months. The study was conducted in the Children's Hospital Zagreb, Croatia, from January 2014 to August 2016. RESULTS: The study comprised 63 children (63% male) with a mean age of 4.7 years. Gastroesophageal reflux (GER) disease was detected by impedance in 22 (35%) of the children and by pH-metry in nine (14%). In children with OME, MII-pH found a median number of 24 proximal GER episodes, of which a median of nine was acidic and a median of 11 was weakly acidic. There was a significant positive correlation between the number of GER episodes and the presence of eosinophils in nasal swabs. CONCLUSION: Both acidic and weakly acidic refluxes seemed to play a significant role in the pathogenesis of OME. Localised nasal eosinophilia may serve as a marker of extraoesophageal reflux in children with suspected reflux-related OME.

ACUTE RESPIRATORY DISTRESS SYNDROME IN A FOUR-YEAR-OLD BOY WITH DIABETIC KETOACIDOSIS - CASE REPORT.

- Among many disease states as known initiators of acute respiratory distress syndrome (ARDS), diabetic ketoacidosis (DKA) is the rarest one. We present a 4-year-old boy with DKA as the first manifestation of insulin-dependent diabetes mellitus who developed ARDS, required tracheal intubation and mechanical ventilation, and survived without significant sequels. To improve survival of patients with ARDS as a complication of DKA, physicians should be aware of this rare pulmonary complication and its appropriate management.

Comparison of Obesity Prevalence and Dietary Intake in School-Aged Children Living in Rural and Urban Area of Croatia.

The aim of this study was to explore the differences in nutritional status and dietary intakes in 12~17 year-old children living in urban (Zagreb) and the rural (Sinj and Drnis) area of Croatia. A validated food frequency questionnaire was used to assess dietary intake. For each participant, body weight and body height were measured and bioelectrical impedance was used to estimate the body fat percentage. There was an overall of 310 children included: 105 (33.9%) from urban area and 205 (66.1%) from rural area; 191 (61.6%) were female with a mean age 14.9 (range 12~17) years. When adjusted for age and gender, there was no statistically significant difference in body mass index for age Z-scores between urban and rural parts (0.23±0.07 vs. 0.30±1.15; P=0.650) or in average daily energy intake (2,479.2±1,111.2 kcal vs. 2,338.2±920.2 kcal; P=0.702). There was a statistically significant difference in nutritional status between genders, with a higher percentage of boys being overweight or obese compared to girls. When combined, 'Fast food' and 'Snacks' were major contributors to the total energy intake for both areas. The mean contribution of 'Fast food' to total energy intake was significantly higher in the urban area. The prevalence of obesity among Croatian children is high and unrelated to the urban/rural setting, which could be partially explained by the high intake of 'Fast food' and 'Snacks'.

Growth of Children with Food Allergy
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BACKGROUND: The prevalence of food allergy in children is increasing worldwide. Strict avoidance of identified allergens from the diet is still the cornerstone of the management of food allergies. There are widespread concerns that food allergy and elimination diet may predispose children to nutrient deficiencies and growth failure. AIM: The aim of this paper was to review the current evidence on growth of children suffering from food allergy. Summarised is literature on the effects of the number and type of offending allergens, the child's age and affected organ system, as well as the importance of supervision by a dietician/nutritionist. CONCLUSION: Children suffering from food allergy are stunted at the time of diagnosis and during the elimination diets, irrespective whether or not their nutritional requirements were fulfilled, and/or were under the control of a dietician. This underscores the need for further studies to obtain more precise insight into and better understanding of the mechanisms contributing to growth failure in children suffering from food allergy.
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The Relationship Between Gastroesophageal Reflux and Chronic Unexplained Cough in Children.

The aim of this study was to assess the association between chronic cough and acid or weakly acid gastroesophageal reflux (GER) determined by 24-hour multichannel intraluminal impedance-pH monitoring and to assess whether the association is age dependent. Overall 150 children (mean age 7.5 years; range 0.3-18.0 years; male/female 90/60) were enrolled. Median of 87.5% (0% to 100%) of all cough episodes were associated with reflux; 9% (0% to 100%) with acidic and 60% (0% to 100%) with weakly acidic episodes. In 52 children (34.7%), all cough episodes were associated with GER (100% association). Children younger than 2 years had significantly higher number of cough episodes associated with total (P = .03) and weakly acidic GER (P = .01). Binary logistic regression confirmed that only increase in age decreases the risk for complete (100%) association between cough episode and GER. Cough is significantly associated with weakly acidic GER and children of younger age are at higher risk.

[Which tuberculin skin test hyperreactive child should be treated with -our experience]. / KOJIM PPD-HIPERREAKTORIMA TREBA DATI PROFILAKSU - NASA ISKUSTVA.

Since persons with latent tuberculosis infection (LTBI) represent a huge reservoir of potential tuberculosis (TB) disease, accurate diagnosis and treatment of LTBI is essential for TB control and eradication. The aim was to assess the diagnostic value of determination of interferon-gamma release assay in school children with hyperreactive tuberculin skin test (TST) reaction. A total of 120 BCG-vaccinated children were investigated due to a hyperreactive TST results. The QuantiFERON-TB Gold In-Tube test (QFT-GIT) was performed. Fifteen children (12.5%) had positive QFT-GIT and 105 (87.5%) children had negative QFT-GIT. There was no statistically significant difference in TST reaction (21.5 mm u QFT+ vs. 20.9 mm u QFT-group, p=0.458). The children with positive QFT-GIT had a statistically higher level of interferon-gamma (IFN-γ) than children with negative QFT-GIT. There were no statistically significant differences in concentrations of IFN-y either basic or upon stimulation with mitogen phytohemagglutinin. After isoniazid prophylaxis QFT-GIT remained positive in two children (p=0.019). In a difficult procedure for diagnosing LTBI in BCG-vaccinated children determination of IFN-γ could be the key factor in making decision whether to use preventive therapy or not.

Discordance Between Tuberculin Skin Test and Interferon-γ Release Assay in Children Younger Than 5 Years Who Have Been Vaccinated With Bacillus Calmette-Guérin.

BACKGROUND: Interferon-γ release assays (IGRAs) offer the possibility of improved detection of latent tuberculosis infection (LTBI). OBJECTIVE: To analyze discordant tuberculin skin testing (TST) and IGRA results in ethnic Croatian children as old as 5 years for whom there is documented exposure to an adult with active tuberculosis (TB) and who have been vaccinated with Bacillus Calmette-Guérin. METHODS: In specimens from our cohort individuals, we tested the performances of the QuantiFERON-TB Gold In-Tube (QFT-GIT) test and TST and analyzed discordant results. RESULTS: At the TST cutoff value of 10 mm or greater, the estimated prevalence of M. tuberculosis infection was 18.1% (31/171) using TST and 15.2% (26/171) using QFT-GIT. The results of these 2 tests showed an overall concordance of 87.7%. There was no evidence that subjects' age correlated with discordant results. CONCLUSIONS: The reasons for discordant results in young children are still unclear, which highlights the importance of further longitudinal studies to better understand the interpretation and any possible clinical implications of the results of these tests.