Furosemide Exposure and Prevention of Bronchopulmonary Dysplasia in Premature Infants.

OBJECTIVE: To evaluate the association between furosemide exposure and risk of bronchopulmonary dysplasia (BPD). STUDY DESIGN: This retrospective cohort study included infants (2004-2015) born at 23-29 weeks gestational age and 501-1249 g birth weight. We compared the demographic and clinical characteristics of infants exposed and not exposed to furosemide between postnatal day 7 and 36 weeks postmenstrual age. We examined the association between furosemide exposure and 2 outcomes: BPD and BPD or death. We performed multivariable probit regression models that included demographic and clinical variables in addition to 2 instrumental variables: furosemide exposure by discharge year, and furosemide exposure by site. RESULTS: Of 37 693 included infants, 19 235 (51%) were exposed to furosemide; these infants were more premature and had higher respiratory support. Of 33 760 infants who survived to BPD evaluation, 15 954 (47%) had BPD. An increase in the proportion of furosemide exposure days by 10 percentage points was associated with a decrease in both the incidence of BPD (4.6 percentage points; P = .001), and BPD or death (3.7 percentage points; P = .01). CONCLUSIONS: More days of furosemide exposure between postnatal day 7 and 36 weeks was associated with decreased risk of BPD and a combined outcome of BPD or death.

Role of buoyant flame dynamics in wildfire spread.

Large wildfires of increasing frequency and severity threaten local populations and natural resources and contribute carbon emissions into the earth-climate system. Although wildfires have been researched and modeled for decades, no verifiable physical theory of spread is available to form the basis for the precise predictions needed to manage fires more effectively and reduce their environmental, economic, ecological, and climate impacts. Here, we report new experiments conducted at multiple scales that appear to reveal how wildfire spread derives from the tight coupling between flame dynamics induced by buoyancy and fine-particle response to convection. Convective cooling of the fine-sized fuel particles in wildland vegetation is observed to efficiently offset heating by thermal radiation until convective heating by contact with flames and hot gasses occurs. The structure and intermittency of flames that ignite fuel particles were found to correlate with instabilities induced by the strong buoyancy of the flame zone itself. Discovery that ignition in wildfires is critically dependent on nonsteady flame convection governed by buoyant and inertial interaction advances both theory and the physical basis for practical modeling.

Summary of Workshop Large Outdoor Fires and the Built Environment.

Large outdoor fires present a risk to the built environment. Wildfires that spread into communities, referred to as Wildland-Urban Interface (WUI) fires, have destroyed communities throughout the world, and are an emerging problem in fire safety science. Other examples are large urban fires including those that have occurred after earthquakes. Research into large outdoor fires, and how to potentially mitigate the loss of structures in such fires, lags other areas of fire safety science research. At the same time, common characteristics between fire spread in WUI fires and urban fires have not been fully exploited. In this paper, an overview of the large outdoor fire risk to the built environment from each region is presented. Critical research needs for this problem in the context offire safety science are provided. The present paper seeks to develop the foundation for an international research needs roadmap to reduce the risk of large outdoor fires to the built environment.