Reducing the Individual Carbon Impact of Video Streaming: A Seven-Week Intervention Using Information, Goal Setting, and Feedback

This online intervention study examined whether system- and action-related information alone, together with goal setting, or together with goal setting and feedback helps people change their video streaming activities in a pro-environmental way. The participants (N = 92) documented their video streaming activities for one week prior to the intervention (week 1), three weeks after the onset of the intervention (weeks 2-4), and in a follow-up period two weeks later (week 7). A reduction of greenhouse gas emissions associated with video streaming was observed over the course of the intervention, together with reduced streaming durations and lowered resolution settings across all groups. There were no differences between the groups. It appears that as regards video streaming, information combined with self-monitoring has considerable potential to change individual behaviour and its associated ecological impact.

Aerosol Impacts on Water Relations of Camphor (Cinnamomum camphora)

Major parts of anthropogenic and natural aerosols are hygroscopic and deliquesce at high humidity, particularly when depositing to leaf surfaces close to transpiring stomata. Deliquescence and subsequent salt creep may establish thin, extraordinary pathways into the stomata, which foster stomatal uptake of nutrients and water but may also cause stomatal liquid water loss by wicking. Such additional water loss is not accompanied by a wider stomatal aperture with a larger CO₂ influx and hypothetically reduces water use efficiency (WUE). Here, the possible direct impacts of aerosols on physical and physiological parameters of camphor (Cinnamomum camphora) were studied (i) in a greenhouse experiment using aerosol exclusion and (ii) in a field study in Taiwan, comparing trees at two sites with different aerosol regimes. Scanning electron microscopy (SEM) images showed that leaves grown under aerosol exclusion in filtered air (FA) were lacking the amorphous, flat areas that were abundant on leaves grown in ambient air (AA), suggesting salt crusts formed from deliquescent aerosols. Increasing vapor pressure deficit (VPD) resulted in half the Ball-Berry slope and double WUE for AA compared to FA leaves. This apparent contradiction to the wicking hypothesis may be due to the independent, overcompensating effect of stomatal closure in response to VPD, which affects AA more than FA stomata. Compared to leaves in a more polluted region in the Taiwanese Southwest, NaCl aerosols dominated the leaf surface conditions on mature camphor trees in Eastern Taiwan, while the considerably lower contact angles and the 2.5 times higher minimum epidermal conductances might have come from organic surfactants. Interpretations of SEM images from leaf surface microstructures should consider amorphous areas as possible indicators of aerosol deposition and other hygroscopic material. The amount and type of the material determine the resulting impacts on plant water relations, together with the surrounding atmosphere and ecophysiological traits.

Optimal sampling locations to reduce uncertainty in contamination extent in water distribution systems

Drinking water utilities rely on samples collected from the distribution system to provide assurance of water quality. If a water contamination incident is suspected, samples can be used to determine the source and extent of contamination. By determining the extent of contamination, the percentage of the population exposed to contamination, or areas of the system unaffected can be identified. Using water distribution system models for this purpose poses a challenge because significant uncertainty exists in the contamination scenarios (e.g., injection location, amount, duration, customer demands, contaminant characteristics). This article outlines an optimization framework to identify strategic sampling locations in water distribution systems. The framework seeks to identify the best sampling locations to quickly determine the extent of the contamination while considering uncertainty with respect to the contamination scenarios. The optimization formulations presented here solve for multiple optimal sampling locations simultaneously and efficiently, even for large systems with a large uncertainty space. These features are demonstrated in two case studies.

Hot under the collar: A 14-year association between temperature and violent behavior across 436 U.S. counties

OBJECTIVES

Violent behavior is influenced by individual and societal characteristics, but the role of environmental factors is less understood. Our aims were to use national-level data to identify the association between criminal behavior and short-term temperature conditions, including the departure of daily temperatures from normal conditions.

METHODS

We conducted a multi-stage hierarchical time-series model across 436 U.S. counties and 14-years representing 100.4 million people to investigate the association between daily mean temperature and daily mean temperatures departing from normal conditions with violent and non-violent crime counts. First-stage comparisons were made within counties to control for population and geographic heterogeneities, while a second stage combined estimates. We evaluated differences in risk based on county sociodemographic characteristics and estimated non-linear exposure-response relationships.

RESULTS

We observed a total of 9.0 million violent crimes and 20.9 million non-violent property crimes between 2000 through 2013. We estimated that each 10 °C increase in daily temperature or daily departure from long-term normal temperatures were associated with 11.92% (95% PI: 11.57, 12.27) and 10.37% (95% PI: 10.05, 10.69) increase in the risk of violent crime, respectively. Similar, but lower in magnitude trends, were observed for property crime risks. We found that crime risk plateaus and decreases at high daily temperatures, but for temperatures departing from normal, the association with crime increased linearly. Seasonal variations showed that anomalously warm temperatures days during cool months had the greatest risk.

CONCLUSIONS

Our study revealed an association between higher temperatures and high departure from normal temperatures with both violent and non-violent crime risk, regardless of community-type. However, our findings on seasonal and daily trends suggest that daily mean temperature may impact crime by affecting routine activities and behavior, as opposed to a temperature-aggression relationship. These results may advance public response and planning to prevent violent behavior.

Agricultural adjuvants may impair leaf transpiration and photosynthetic activity

Adjuvants such as surfactants are commonly incorporated into agrochemical formulations to enhance the biological efficiency of foliar sprays by improving the wetting behavior of the spray and/or the penetration of the active ingredients into the leaf tissues. Penetration accelerating adjuvants are known to increase the cuticular permeability and may alter the cuticular barrier to water loss. However, none or very little emphasis has been given to the impacts of adjuvants on crop water balance or drought tolerance, a very important factor affecting crop performance under water scarcity. Two model crops with strongly varying leaf traits, kohlrabi (Brassica oleracea) and apple (Malus domestica) seedlings were grown in controlled environments. Three adjuvants with varying solubility in the cuticle, i.e. octanol-water partition coefficients (logKow) were selected: rapeseed methyl ester (RME) and the surfactants alkyl polyglycoside (APG) and polyoxyethylated tallow amine (POEA). The higher the logKow of the adjuvant, the stronger was the increase of minimum epidermal conductance (g_min, an essential parameter describing plant drought tolerance). However, such effects depended on the physio-chemical properties of the leaf surface. In comparison to kohlrabi, the adjuvant effects on g_min of apple leaves were relatively weak. The increase of g_min was associated with a decrease in contact angle and with an alteration of the wax microstructure. Furthermore, POEA affected photochemical efficiency of kohlrabi leaves. Some adjuvants could have a temporal influence on transpirational water loss and g_min. At repeated applications, they might alter the effective water use and possibly reduce drought tolerance of some horticultural crops.

How does the VPD response of isohydric and anisohydric plants depend on leaf surface particles?

Atmospheric vapour pressure deficit (VPD) is the driving force for plant transpiration. Plants have different strategies to respond to this 'atmospheric drought'. Deposited aerosols on leaf surfaces can interact with plant water relations and may influence VPD response. We studied transpiration and water use efficiency of pine, beech and sunflower by measuring sap flow, gas exchange and carbon isotopes, thereby addressing different time scales of plant/atmosphere interaction. Plants were grown (i) outdoors under rainfall exclusion (OD) and in ventilated greenhouses with (ii) ambient air (AA) or (iii) filtered air (FA), the latter containing <1% ambient aerosol concentrations. In addition, some AA plants were sprayed once with 25 mM salt solution of (NH4 )2 SO4 or NaNO3 . Carbon isotope values (δ(13) C) became more negative in the presence of more particles; more negative for AA compared to FA sunflower and more negative for OD Scots pine compared to other growth environments. FA beech had less negative δ(13) C than AA, OD and NaNO3 -treated beech. Anisohydric beech showed linearly increasing sap flow with increasing VPD. The slopes doubled for (NH4 )2 SO4 - and tripled for NaNO3 -sprayed beech compared to control seedlings, indicating decreased ability to resist atmospheric demand. In contrast, isohydric pine showed constant transpiration rates with increasing VPD, independent of growth environment and spray, likely caused by decreasing gs with increasing VPD. Generally, NaNO3 spray had stronger effects on water relations than (NH4 )2 SO4 spray. The results strongly support the role of leaf surface particles as an environmental factor affecting plant water use. Hygroscopic and chaotropic properties of leaf surface particles determine their ability to form wicks across stomata. Such wicks enhance unproductive water loss of anisohydric plant species and decrease CO2 uptake of isohydric plants. They become more relevant with increasing number of fine particles and increasing VPD and are thus related to air pollution and climate change. Wicks cause a deviation from the analogy between CO2 and water pathways through stomata, bringing some principal assumptions of gas exchange theory into question.

Genetic risk variants for dyslexia on chromosome 18 in a German cohort

Dyslexia is characterized by impaired reading and spelling. The disorder has a prevalence of about 5% in Germany, and a strong hereditary component. Several loci are thought to be involved in the development of dyslexia. Scerri et al. identified eight potential dyslexia-associated single nucleotide polymorphisms (SNPs) in seven genes on chromosome 18 in an English-speaking population. Here, we present an association analysis that explores the relevance of these SNPs in a German population comprising 388 dyslexia cases and 364 control cases. In case-control analysis, three nominal SNP associations were replicated. The major alleles of NEDD4L-rs12606138 and NEDD4L-rs8094327 were risk associated [odds ratio (OR) = 1.35, 95% confidence interval (CI) = 1.0-1.7, P-value = 0.017 and OR = 1.39, 95% CI = 1.1-1.7, P-value = 0.007, respectively], and both SNPs were in strong linkage disequilibrium (r(2)  = 0.95). For MYO5B-rs555879, the minor allele was risk associated (OR = 1.31, 95% CI = 1.1-1.6, P-value = 0.011). The combined analysis of SNP sets using set enrichment analysis revealed a study-wide significant association for three SNPs with susceptibility for dyslexia. In summary, our results substantiate genetic markers in NEDD4L and MYO5B as risk factors for dyslexia and provide first evidence that the relevance of these markers is not restricted to the English language.

Simulation of H2 distribution and combustion in LWR containments using Lumped Parameter Codes

This article focuses on the validation of the Lumped Parameter (LP) computer codes COCOSYS and ASTEC in the field of containment phenomena during severe accidents. The release of hydrogen (H2) as an open jet from the primary circuit into the containment might cause atmospheric H2-stratifications which in turn may result in an ignitable atmospheric mixture. If this mixture is ignited, the integrity of the containment can be endangered due to the pressure and temperature rise, resulting from the combustion process. The emphasis of the paper lies on these three phenomena referring to possible successive phases of a loss of coolant accident.

A new approach to assess atmospheric nitrogen deposition by way of standardized exposition of mosses

A standardized method of moss exposition for assessing variations in nitrogen deposition was tested in the western part of Germany. Six pleurocarpous moss species were transplanted to two sites differing in their deposition rates but being comparable as to their climatic conditions. The mosses were exposed in standardized containers over a period of 12 months; the focus of interest was the effect of N deposition on nitrogen content and on (15)N natural abundance (delta(15)N-values). Within the first nine months only trends could be observed. However, after one year all species tested showed significantly higher N concentrations at the highly polluted site. Besides, more negative delta(15)N-values possibly reflecting the higher ammonium input were detected at this site. Surprisingly, most of the plants though being kept in plastic containers without a favourable substratum did not show any conspicuous deficiency symptoms. The potential advantages of a standardized moss exposition for N monitoring purposes are discussed. It is concluded that the method presented here can yield significant results in particular if the number of testing sites is increased.

Nitrogen content, 15N natural abundance and biomass of the two pleurocarpous mosses Pleurozium schreberi (Brid.) Mitt. and Scleropodium purum (Hedw.) Limpr. in relation to atmospheric nitrogen deposition

The suitability of the two pleurocarpous mosses Pleurozium schreberi and Scleropodium purum for assessing spatial variation in nitrogen deposition was investigated. Sampling was carried out at eight sites in the western part of Germany with bulk deposition rates ranging between 6.5 and 18.5 kg N ha(-1) yr(-1). In addition to the effect of deposition on the nitrogen content of the two species, its influence on 15N natural abundance (delta15N values) and on productivity was examined. Annual increases of the mosses were used for all analyses. Significant relationships between bulk N deposition and nitrogen content were obtained for both species; delta15N-values reflected the ratio of NH4-N to NO3-N in deposition. A negative effect of nitrogen input on productivity, i.e. decreasing biomass per area with increasing N deposition due to a reduction of stem density, was particularly evident with P. schreberi. Monitoring of N deposition by means of mosses is considered an important supplement to existing monitoring programs. It makes possible an improved spatial resolution, and thus those areas that receive high loads of nitrogen are more easily discernible.

Quantification of stomatal uptake of ionic solutes using a new model system

Evidence for stomatal uptake of solutes by leaves without the application of surfactants or pressure has recently been provided (Eichert et al., 1998). In the present study, experimental conditions were refined in that the water potential was held at <0 on the physiologically inner side of the epidermal strips (ES) by use of a ceramic plate or the proper mesophyll of the plant. The penetrated substances were immobilized on the inner side by ion exchange membranes. The influence of humidity, light, stomatal density, and re-wetting on the uptake of anions (fluorescein) and cations (Fe(3+)) was investigated, using leaves of Allium porrum, Commelina communis and Sedum telephium. Uptake increased with humidity, stomatal aperture and stomatal density. It was restricted to stomatal areas, and was especially high below the rims of drying droplets. Again, penetration of stomatal pores was observed. Uptake was strongly correlated with the number of penetrated stomata, although usually less than 10% of the stomata contributed to uptake. The number of stomata that had been penetrated was highly variable, increasing extremely significantly with the number of repeated drying/ wetting cycles. These results indicate that stomatal uptake can be a major pathway for the foliar uptake of ionic solutes. It is a dynamic process, depending on environmental conditions and history of the residues on the leaf, aspects that had been neglected in previous concepts.

The prostaglandin E2 EP1 receptor mediates pain perception and regulates blood pressure

The lipid mediator prostaglandin E2 (PGE2) has diverse biological activity in a variety of tissues. Four different receptor subtypes (EP1-4) mediate these wide-ranging effects. The EP-receptor subtypes differ in tissue distribution, ligand-binding affinity, and coupling to intracellular signaling pathways. To identify the physiological roles for one of these receptors, the EP1 receptor, we generated EP1-deficient (EP1-/-) mice using homologous recombination in embryonic stem cells derived from the DBA/1lacJ strain of mice. The EP1-/- mice are healthy and fertile, without any overt physical defects. However, their pain-sensitivity responses, tested in two acute prostaglandin-dependent models, were reduced by approximately 50%. This reduction in the perception of pain was virtually identical to that achieved through pharmacological inhibition of prostaglandin synthesis in wild-type mice using a cyclooxygenase inhibitor. In addition, systolic blood pressure is significantly reduced in EP1 receptor-deficient mice and accompanied by increased renin-angiotensin activity, especially in males, suggesting a role for this receptor in cardiovascular homeostasis. Thus, the EP1 receptor for PGE2 plays a direct role in mediating algesia and in regulation of blood pressure.

[Postoperative analgesic effect after intra-articular morphine or ropivacaine following knee arthroscopy - a prospective randomized, doubleblinded study]

INTRODUCTION

Recent studies for postoperative pain relief after arthroscopy by intraarticular morphine or bupivacaine showed controversial results. The aim of the study was to evaluate the analgesic effect of intraarticular morphine and ropivacaine.

METHODS

135 patients were randomized into 9 groups (n=15) after standardized knee-arthroscopy. They received either 1 mg or 5 mg morphine or 150 mg ropivacaine or a combination of 5 mg morphine and 75 mg ropivacaine. Drains were opened either after 10 or 30 minutes. A control-group received isotonic saline. Pain was assesed 1 h and 4 h after surgery, at 8 pm on the day of the operation and at 8am and 4 pm the following two days by a VAS scale. Tramadol consumption as rescue medication was registred.

RESULTS

Ropivacaine showed the best pain relief after surgery. After 24 h the pain intensity approximated in all groups and after 48 h there was no difference. Tramadol consumption was highest in the control group and lowest in the ropivacaine group (p<0,05). Ropivacaine showed better pain reduction than morphine. An influence of the time, when drains were opened, could only be demostrated for the 75 mg ropivacain combination group.

CONCLUSION

Intraarticular ropivacaine following elective knee-arthroscopy reduces postoperative analgetic consumption significantly and improves patient comfort.

Virucidal and chlamydicidal activities of eye drops with povidone-iodine liposome complex

Povidone-iodine (PVP-I) is a broad-spectrum microbicide with in vitro activity against bacteria, viruses, fungi and protozoans. A 5% solution of PVP-I proved to be highly effective in ophthalmic surgery for the prophylaxis of endophthalmitis. For the antiseptic treatment of eye infections a novel application form of PVP-I has been developed by using a PVP-I liposome complex which demonstrated an excellent antimicrobial efficacy. In this study it could be shown that the novel liposomal formulations containing 2.5 or 5% PVP-I were as active as the aqueous solution against herpes simplex virus type 1, adenovirus type 8, coxsackievirus A9 and Chlamydia trachomatis in cell culture referring to equal PVP-I concentrations. Long-term cytotoxicity experiments demonstrated a moderate cytotoxicity for both formulations with a better tolerability of the liposomal PVP-I formulation compared with the aqueous solution. There is no evidence for a genotoxic activity of these agents.

Financial and organizational determinants of hospital diversification into subacute care

OBJECTIVE

To examine the financial, market, and organizational determinants of hospital diversification into subacute inpatient care by acute care hospitals in order to guide hospital managers in undertaking such diversification efforts.

STUDY SETTING

All nongovernment, general, acute care, community hospitals that were operating during the years 1985 through 1991 (3,986 hospitals in total).

DATA SOURCES

Cross-sectional, time-series data were drawn from the American Hospital Association's (AHA) Annual Survey of Hospitals, the Health Care Financing Administration's (HCFA) Medicare Cost Reports, a latitude and longitude listing for all community hospital addresses, and the Area Resource File (ARF) published in 1992, which provides county level environmental variables.

STUDY DESIGN

The study is longitudinal, enabling the specification of temporal patterns in conversion, causal inferences, and the treatment of right-censoring problems. The unit of analysis is the individual hospital.

KEY FINDINGS

Significant differences were found in the average level of subacute care offered by investor-owned versus tax-exempt hospitals. After controlling for selection bias, financial performance, risk, size, occupancy, and other variables, IO hospitals offered 31.3 percent less subacute care than did NFP hospitals. Financial performance and risk are predictors of IO hospitals' diversification into subacute care, but not of NFP hospitals' activities in this market. Resource availability appears to expedite expansion into subacute care for both types of hospitals.

CONCLUSIONS

Investment criteria and strategy differ between investor-owned and tax-exempt hospitals.

The synergism between SO2 oxidation and manganese leaching on spruce needles--a chamber experiment

Four year old spruce (Picea abies (L.) Karst.) seedlings were planted in sand pots and supplied with nutrient solution. Three groups were formed, differing only in manganese nutrition (0.5 ppm, 2.5 ppm, 12.5 ppm, respectively). After three months, five individuals of each group were transferred to a dew chamber. For the next seven weeks the trees were sprayed in the evenings, the relative humidity overnight was kept high and the droplets were collected directly from the needles in the mornings. The trees were sprayed with HNO3 (pH 3.4) during the first three weeks to reduce the natural buffering capacity of the needles. After this time, the trees were sprayed with KCl (1 mM) solution, and NaHSO3 was added to the chamber resulting in SO2 concentrations usually between 50 and 150 microg m(-3). Needles and water samples were analysed. Foliar Ca seemed to be only a short-time buffer even under optimal Ca supply. A highly significant influence of managanese supply on manganese in needles and droplets was observed, as well as on sulphate, H+ and calcium concentrations in the droplets. The SO2 flux to trees treated with 12.5 ppm Mn was about twice as high as to trees treated with 0.5 ppm Mn. The conclusion is that this is due to a synergism between manganese leaching and catalysis of the SO2 oxidation by the leached Mn2+ ions. The results suggest a positive feedback between (moderate) acidification of soils and SO2 and NH3 inputs to terrestrial ecosystems.

Gaining insight into a complex organelle, the phagosome, using two-dimensional gel electrophoresis

Phagosomes are the organelles formed de novo in a variety of cells by the internalization of large particulate materials, including a wide range of pathogenic microorganisms. We present here a systematic approach that can be used to study the polypeptide composition of phagosomes/phagolysosomes and to yield analytical information on the characteristics of their proteins. A density shift approach was used to isolate pure preparations of phagosomes filled with low density latex beads from mouse J774 and human U937 macrophages. High resolution two-dimensional (2-D) gel electrophoresis was performed to generate a map of the overall [35S]methionine-labeled protein profile of the isolated phagosomes. The resulting map showed the minimal presence of over 200 polypeptides, indicating the complexity of this organelle. Comigration experiments showed that several phagosome polypeptides, among them several known proteins, are shared by the two species. Extraction with Triton X-114 and sodium carbonate was performed to distinguish between membrane and soluble proteins, and sensitivity to a panel of proteases was measured to identify proteins exposed on the cytoplasmic face of the phagosome membrane. The general value of the 2-D gel approach in the mapping of organelle proteins is discussed.

Nursing/pharmacy interface: a TQM project

W. Edwards Deming's seven-step quality improvement process provided a sequential pathway to facilitate problem-solving allowing the pharmacy and nursing departments to formulate a systems perspective rather than an individual point of view. Both departments identified problems with the Medication Administration Record and defined three key outcomes needed to signify process improvement.

Trauma-hemorrhage and resuscitation in the mouse: effects on cardiac output and organ blood flow

Although mice are widely used for the study of immune consequences of hemorrhage, the changes of cardiac output (CO) and blood flow (BF) in response to trauma and hemorrhage in this species have not been well defined. To study this, nonheparinized C3H/HeN mice (n = 6 per group) underwent laparotomy (i.e., trauma induced), were bled to a mean arterial pressure of 35 mmHg, and maintained for 90 min by withdrawing more blood or returning Ringer lactate. The animals were then resuscitated with four times the volume of maximal bleedout in the form of Ringer lactate over 60 min. Sham-operated mice underwent the same procedure but were neither bled nor resuscitated. At the end of hemorrhage, 60 min postresuscitation, or corresponding time after sham operation, CO and BF were determined by radioactive microspheres. Results indicate that CO and BF decreased significantly at the end of hemorrhage. Resuscitation, however, restored CO and BF in various organs except the brain and skeletal muscle. Despite this, 9 of 16 mice died within 6 days postresuscitation, whereas none of sham mice died (n = 16 per group in this additional study). Therefore, we have developed a nonheparinized model of trauma-hemorrhage and resuscitation in mice that is associated with late mortality. Furthermore, the microsphere technique provides a reliable method for assessing CO and BF in mice. Thus it may be possible to study the correlation between cardiovascular and immunologic alterations under such conditions.

Measurement of hepatic blood flow after severe hemorrhage: lack of restoration despite adequate resuscitation

Although Ringer lactate (RL) is routinely used for resuscitation, it is not known whether the volume of RL that restores cardiac output after severe hemorrhagic shock also restores the depressed effective hepatic blood flow (EHBF). To study this, a 5-cm midline laparotomy was performed in rats (i.e., trauma induced), and the animals were then bled to and maintained at a mean arterial pressure of 40 mmHg until 40% of maximum bleedout volume was returned in the form of RL. Animals were then resuscitated with four or five times the volume of maximum bleedout with RL. EHBF was determined during hemorrhage and at various intervals thereafter by an in vivo indocyanine green (ICG) clearance technique and corrected by the appropriate hepatic extraction ratio for ICG. Cardiac output was determined by ICG dilution, and hepatic microvascular blood flow (HMBF) was measured with laser Doppler flowmetry. In addition, hepatic blood flow was assessed by using radioactive microspheres. Results indicate that resuscitation markedly improved but did not restore the depressed EHBF after trauma and hemorrhagic shock despite the fact that cardiac output was restored. Similar changes in EHBF, HMBF, and hepatic blood flow as determined by microspheres were observed, suggesting that the in vivo ICG clearance is a reliable method to assess effective hepatic perfusion. Thus the lack of restoration of EHBF may be responsible for the subsequent hepatocellular dysfunction after trauma and severe hemorrhage.

Analysis of intraocularly applied silicone oils of various origins

Complications during the intraocular use of silicone oil can be caused by two factors: first, mechanical interaction with the surrounding tissue and, second, the physiochemical properties of the oil itself. The properties of 14 oils of various origins in clinical use were investigated: 12 of the 14 oils contained various amounts of low-molecular-weight components (cyclosiloxanes and molecules with a molecular weight of less than 2,400), which are able to diffuse into the surrounding tissue and may incite toxic or inflammatory reactions. Some of the samples had a ten-fold lower volume resistivity than others, an indicator of the presence of ionic impurities, such as catalyst remnants, which may also be responsible for adverse reactions.

Chest radiographs of near-drowned children

From 1972 through 1983 there were 10 near-drowned children (7 boys and 3 girls) aged 1 to 4 years, treated as inpatients at the Children's Hospital of the Medical Academy Dresden. Three of them showed a severe aspiration pneumonia which in one case was complicated by bilateral pneumothoraces. In a further five children there were radiological signs of pulmonary oedema. Only in two children were the X-ray pictures of the chest normal.