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NASA NTRS2012

NASA Thesaurus: Hierarchical Listing with Definitions; Rotated Term Display - Volumes 1 and 2

The NASA Thesaurus contains the authorized subject terms by which the documents in the NASA STI Databases are indexed and retrieved. The scope of this controlled vocabulary includes not only aerospace engineering, but all supporting areas of engineering and physics, the natural space sciences (astronomy, astrophysics, planetary science), Earth sciences, and to some extent, the biological sciences. Volume 1 - Hierarchical Listing With Definitions contains over 18,400 subject terms, 4,300 definitions, and more than 4,500 USE cross references. The Hierarchical Listing presents full hierarchical structure for each term along with 'related term' lists, and can serve as an orthographic authority. Volume 2 - Rotated Term Display is a ready-reference tool which provides over 52,700 additional 'access points' to the thesaurus terminology. It contains the postable and nonpostable terms found in the Hierarchical Listing arranged in a KWIC (key-word-in-context) index.

Source record↗

NASA NTRS2000

Proposed Definitions of Some Technical Terms Frequently Used in Microwave Radiometry for Remote Sensing

The use of microwave radiometry for remote sensing is a relatively young field. As a result, there are no standard definitions of many frequently used technical terms; a lot of which are conventional usages carried-over from optical remote sensing, and a lot more are shared with electrical or microwave engineering. Sometimes the divergent notions and assumptions originating from a different field may cause ambiguity or confusions. It is proposed that we establish a list of frequently used terms, together with their 'standard' definitions and hope that they will gradually gain general acceptance by the remote sensing community. It would be even more useful if the IEEE community can set up a standard committee of sort to develop and maintain the standards. To minimize the effort, the existing terms should be kept or reinterpreted as much as possible. For example, the term 'Instantaneous Field of View' (IFOV), originally coming from the optical remote sensing field, is now appearing in microwave remote sensing literature frequently. The IFOV refers to the 'beam width' or the 'diameter' of the beam's geometrical projection on earth surface. Since the definition of 'beam width' is different for an optical system versus a microwave antenna, the use of IFOV in microwave radiometry needed to be clarified. Also, the meaning of the IFOV will be different depending upon whether the beam is scanning or not, and how the scanning takes place, e.g. 'continuous scanning' vs 'stare-and-step scan.' From this one term alone, it is clear that more subtle meanings must be spell out in detail and a 'standard' definition would help in understanding and comparing systems and data in the literature. A selected list of terms with their suggested definitions will be discussed in this presentation.

Shiue, James C.↗

NASA NTRS2005

Source Term Model for Steady Micro Jets in a Navier-Stokes Computer Code

A source term model for steady micro jets was implemented into a non-proprietary Navier-Stokes computer code, OVERFLOW. The source term models the mass flow and momentum created by a steady blowing micro jet. The model is obtained by adding the momentum and mass flow created by the jet to the Navier-Stokes equations. The model was tested by comparing with data from numerical simulations of a single, steady micro jet on a flat plate in two and three dimensions. The source term model predicted the velocity distribution well compared to the two-dimensional plate using a steady mass flow boundary condition, which was used to simulate a steady micro jet. The model was also compared to two three-dimensional flat plate cases using a steady mass flow boundary condition to simulate a steady micro jet. The three-dimensional comparison included a case with a grid generated to capture the circular shape of the jet and a case without a grid generated for the micro jet. The case without the jet grid mimics the application of the source term. The source term model compared well with both of the three-dimensional cases. Comparisons of velocity distribution were made before and after the jet and Mach and vorticity contours were examined. The source term model allows a researcher to quickly investigate different locations of individual or several steady micro jets. The researcher is able to conduct a preliminary investigation with minimal grid generation and computational time.

Waithe, Kenrick A.↗

NASA NTRS2015

The Use of Absolute-Value Terms in Regression Modeling of Multi-Piece Force Balances

Different aspects of the use of absolute-value terms in regression models of the electrical outputs of multi-piece force balance calibration data are discussed. First, characteristics of a variety of regression model term combinations with absolute-value terms are reviewed that are currently used in the aerospace testing community to fit the gage outputs of a balance. Then, a semi-empirical test is presented that quantifies bidirectional characteristics of the balance bridge outputs. Several diagnostic methods are discussed to assess the severity of near-linear dependencies between regressors of models with absolute-value terms. In particular, connections between the linear, absolute-value, quadratic, signed quadratic, and cubic terms are studied in greater detail. Data from an automated calibration of NASAs MK29B force balance are used to illustrate the most important observations and results. Rules of thumb that variance-inflation factors be less than 10 must be relaxed when using absolute-value terms to describe bidirectional balances.

calibration analysis↗

DOE OSTI2021

Long-term hydrological, biogeochemical, and climatological data from Walker Branch Watershed, East Tennessee, USA

In 1967, the original Walker Branch Watershed (WBW) project was established to study elemental cycling and mass balances in a relatively unimpacted watershed. Over the next 50+ years, findings from additional experimental studies and long-term observations on WBW advanced understanding of catchment hydrology, biogeochemistry, and ecology and established WBW as a seminal site for catchment science. The 97.5-ha WBW is located in East Tennessee, USA, on the U.S. Department of Energy's Oak Ridge Reservation. Vegetation on the watershed is characteristic of an eastern deciduous, second-growth forest. The watershed is divided into two subcatchments: the West Fork (38.4 ha) and the East Fork (59.1 ha). Headwater streams draining these subcatchments are fed by multiple springs, and thus flow is perennial. Stream water is high in base cations due to weathering of dolomite bedrock and nutrient concentrations are low. Long-term observations of climate, hydrology, and biogeochemistry include daily (1969–2014) and 15-min (1994–2014) stream discharge and annual runoff (1969–2014); hourly, daily, and annual rainfall (1969–2012); daily climate and soil temperature (1993–2010); and weekly stream water chemistry (1989–2013). These long-term datasets are publicly available on the WBW website (https://walkerbranch.ornl.gov/long-term-data/). While collection of these data has ceased, related long-term measurements continue through the National Ecological Observatory Network (NEON), where WBW is the core terrestrial and aquatic site in the Appalachian and Cumberland Plateau region (NEON's Domain 7) of the United States. These long-term datasets have been and will continue to be important in evaluating the influence of climatic and environmental drivers on catchment processes.

54 ENVIRONMENTAL SCIENCES↗

DOE OSTI2020

Improving Long-term Monitoring of Contaminated Groundwater at Sites where Attenuation-based Remedies are Deployed

This study presents an effective approach to tackle the challenge of long-term monitoring of contaminated groundwater sites where remediation leaves residual contamination in the subsurface. Traditional long-term monitoring of contaminated groundwater sites focuses on measuring contaminant concentrations and is applicable to sites where contaminant mass is removed or degraded to a level below the regulatory standard. The traditional approach is less effective at sites where risk from metals or radionuclides continues to exist in the subsurface after remedial goals are achieved. We propose a long-term monitoring strategy for this type of waste site that focuses on measuring the hydrological and geochemical parameters that control attenuation or remobilization of contaminants while de-emphasizing contaminant-concentration measurements. Furthermore, we demonstrate how this approach would be more effective than traditional long-term monitoring, using a site in South Carolina, USA, where groundwater is contaminated by several radionuclides. A comprehensive enhanced attenuation remedy has been implemented at the site to minimize discharge of contamination to surface water. The immobilization of contaminants occurs in three locations by manipulation of hydrological and geochemical parameters, as well as by natural attenuation processes. Deployment of our proposed long-term monitoring strategy will combine subsurface and surface measurements using spectroscopic tools, geophysical tools, and sensors to monitor the parameters controlling contaminant attenuation. The advantage of this approach is that it will detect the potential for contaminant remobilization from engineered and natural attenuation zones, allowing potential adverse changes to be mitigated before contaminant attenuation is reversed.

12 MANAGEMENT OF RADIOACTIVE AND NON-RADIOACTIVE W↗

DOE OSTI2021

Determining the leading-order contact term in neutrinoless double β decay

We present a method to determine the leading-order (LO) contact term contributing to the nn → ppe - e - amplitude through the exchange of light Majorana neutrinos. Our approach is based on the representation of the amplitude as the momentum integral of a known kernel (proportional to the neutrino propagator) times the generalized forward Compton scattering amplitude n ( p 1 ) n ( p 2 ) W + ( k ) → \( p\left({p}_1^{\prime}\right)p\left({p}_2^{\prime}\right){W}^{-}(k) \) , in analogy to the Cottingham formula for the electromagnetic contribution to hadron masses. We construct model-independent representations of the integrand in the low- and high-momentum regions, through chiral EFT and the operator product expansion, respectively. We then construct a model for the full amplitude by interpolating between these two regions, using appropriate nucleon factors for the weak currents and information on nucleon-nucleon ( NN ) scattering in the 1 S 0 channel away from threshold. By matching the amplitude obtained in this way to the LO chiral EFT amplitude we obtain the relevant LO contact term and discuss various sources of uncertainty. We validate the approach by computing the analog I = 2 NN contact term and by reproducing, within uncertainties, the charge-independence-breaking contribution to the 1 S 0 NN scattering lengths. While our analysis is performed in the \( \overline{\mathrm{MS}} \) scheme, we express our final result in terms of the scheme-independent renormalized amplitude \( {\mathcal{A}}_{\nu}\left(\left|\mathbf{p}\right|,\left|\mathbf{p}^{\prime}\right|\right) \) at a set of kinematic points near threshold. We illustrate for two cutoff schemes how, using our synthetic data for \( {\mathcal{A}}_{\nu } \) , one can determine the contact-term contribution in any regularization scheme, in particular the ones employed in nuclear-structure calculations for isotopes of experimental interest.

73 NUCLEAR PHYSICS AND RADIATION PHYSICS↗

DOE OSTI2020

Alaskan carbon-climate feedbacks will be weaker than inferred from short-term experiments

Climate warming is occurring fastest at high latitudes. Based on short-term field experiments, this warming is projected to stimulate soil organic matter decomposition, and promote a positive feedback to climate change. We show here that the tightly coupled, nonlinear nature of high-latitude ecosystems implies that short-term (<10 year) warming experiments produce emergent ecosystem carbon stock temperature sensitivities inconsistent with emergent multi-decadal responses. We first demonstrate that a well-tested mechanistic ecosystem model accurately represents observed carbon cycle and active layer depth responses to short-term summer warming in four diverse Alaskan sites. We then show that short-term warming manipulations do not capture the non-linear, long-term dynamics of vegetation, and thereby soil organic matter, that occur in response to thermal, hydrological, and nutrient transformations belowground. Our results demonstrate significant spatial heterogeneity in multi-decadal Arctic carbon cycle trajectories and argue for more mechanistic models to improve predictive capabilities.

54 ENVIRONMENTAL SCIENCES↗

DOE OSTI2021

Lack of long-term effect of coarse woody debris dam restoration on ecosystem functioning and water quality in Coastal Plain streams

Coarse woody debris (CWD) addition is a restoration technique that has been used to reduce effects of landscape disturbance on instream habitat. However, efficacy of this technique for improving ecosystem condition is not well established, in part because monitoring designed to evaluate long-term efficacy is rare. We assessed the effectiveness of CWD additions in disturbed Coastal Plain streams at Fort Benning Military Installation, Georgia, USA, 14 y after initial restoration. In October 2003, 4 disturbed streams received CWD additions (restored streams), and 4 streams were left as unrestored controls. Pre-restoration (2001–2003) and post-restoration (2003–2006) monitoring of nutrient uptake, stream metabolism, and water-quality variables revealed 1) minimal change in water-quality variables, 2) increased stream metabolism and nutrient-uptake rates immediately following restoration, and 3) decreased metabolism and uptake over the remainder of the 3-y post-restoration period. We returned to these streams in 2017 and 2018, measured the same variables, and found minimal long-term effects of restoration on water quality, nutrient uptake, and whole-stream metabolism indicators; however, streamwater pH decreased in all streams 14 y after restoration, and there was a weak treatment × period interaction, indicating that CWD additions may decrease pH in the long term. Further, we found few relationships between watershed disturbance and water-quality variables and ecosystem function metrics, although some relationships were apparent during certain seasons and years. Furthermore, our study is one of the few that have assessed the long-term effects of CWD additions, or any other stream-restoration technique, on ecosystem function. These long-term assessments may be necessary to determine if restorations are a good use of limited resources.

54 ENVIRONMENTAL SCIENCES↗

DOE OSTI2021

Source term method for binary neutron stars initial data

The initial condition problem for a binary neutron star system requires a Poisson equation solver for the velocity potential with a Neumann-like boundary condition on the surface of the star. Difficulties that arise in this boundary value problem are: (a) the boundary is not known a priori, but constitutes part of the solution of the problem; (b) various terms become singular at the boundary. In this work, we present a new method to solve the fluid Poisson equation for irrotational/spinning binary neutron stars. The advantage of the new method is that it does not require complex fluid surface fitted coordinates and it can be implemented in a Cartesian grid, which is a standard choice in numerical relativity calculations. This is accomplished by employing the source term method proposed by Towers, where the boundary condition is treated as a jump condition and is incorporated as additional source terms in the Poisson equation, which is then solved iteratively. The issue of singular terms caused by vanishing density on the surface is resolved with an additional separation that shifts the computation boundary to the interior of the star. We present two-dimensional tests to show the convergence of the source term method, and we further apply this solver to a realistic three-dimensional binary neutron star problem. By comparing our solution with the one coming from the initial data solver cocal, we demonstrate agreement to approximately 1%. We report our method can be used in other problems with non-smooth solutions like in magnetized neutron stars.

79 ASTRONOMY AND ASTROPHYSICS↗

DOE OSTI2024

Multi-scale impacts of climate change on hydropower for long-term water-energy planning in the contiguous United States

Climate change impacts on watersheds can potentially exacerbate water scarcity issues where water serves multiple purposes including hydropower. The long-term management of water and energy resources is still mostly approached in a siloed manner at different basins or watersheds, failing to consider the potential impacts that may concurrently affect many regions at once. There is a need for a large-scale hydropower modeling framework that can examine climate impacts across adjoining river basins and balancing authorities (BAs) and provide a periodic assessment at regional to national scales. Expanding from our prior assessment only for the United States (US) federal hydropower plants, we enhance and extend two regional hydropower models to cover over 85% of the total hydropower nameplate capacity and present the first contiguous US-wide assessment of future hydropower production under Coupled Model Intercomparison Project phase 6’s high-end Shared Socioeconomic Pathway 5-8.5 emission scenario using an uncertainty-aware multi-model ensemble approach. We present regional hydropower projections, using both BA regions and US Hydrologic Subregions (HUC4s), to consistently inform the energy and water communities for two future periods—the near-term (2020–2039) and the mid-term (2040–2059) relative to a historical baseline period (1980–2019). We find that the median projected changes in annual hydropower generation are typically positive—approximately 5% in the near-term, and 10% in the mid-term. However, since the risk of regional droughts is also projected to increase, future planning cannot overly rely on the ensemble median, as the potential of severe hydropower reductions could be overlooked. The assessment offers an ensemble of future hydropower generation projections, providing regional utilities and power system operators with consistent data to develop drought scenarios, design long duration storage and evaluate energy infrastructure reliability under intensified inter-annual and seasonal variability.

13 HYDRO ENERGY↗

DOE OSTI2025

Post-composing ontology terms for efficient phenotyping in plant breeding

Abstract Ontologies are widely used in databases to standardize data, improving data quality, integration, and ease of comparison. Within ontologies tailored to diverse use cases, post-composing user-defined terms reconciles the demands for standardization on the one hand and flexibility on the other. In many instances of Breedbase, a digital ecosystem for plant breeding designed for genomic selection, the goal is to capture phenotypic data using highly curated and rigorous crop ontologies, while adapting to the specific requirements of plant breeders to record data quickly and efficiently. For example, post-composing enables users to tailor ontology terms to suit specific and granular use cases such as repeated measurements on different plant parts and special sample preparation techniques. To achieve this, we have implemented a post-composing tool based on orthogonal ontologies providing users with the ability to introduce additional levels of phenotyping granularity tailored to unique experimental designs. Post-composed terms are designed to be reused by all breeding programs within a Breedbase instance but are not exported to the crop reference ontologies. Breedbase users can post-compose terms across various categories, such as plant anatomy, treatments, temporal events, and breeding cycles, and, as a result, generate highly specific terms for more accurate phenotyping.

Mathematical & Computational Biology↗

DOE OSTI2022

Substrate availability and not thermal acclimation controls microbial temperature sensitivity response to long-term warming

Microbes are responsible for cycling carbon (C) through soils, and predicted changes in soil C stocks under climate change are highly sensitive to shifts in the mechanisms assumed to control the microbial physiological response to warming. Two mechanisms have been suggested to explain the long-term warming impact on microbial physiology: microbial thermal acclimation and changes in the quantity and quality of substrates available for microbial metabolism. Yet studies disentangling these two mechanisms are lacking. To resolve the drivers of changes in microbial physiology in response to long-term warming, we sampled soils from 13- and 28-year-old soil warming experiments in different seasons. We performed short-term laboratory incubations across a range of temperatures to measure the relationships between temperature sensitivity of physiology (growth, respiration, carbon use efficiency, and extracellular enzyme activity) and the chemical composition of soil organic matter. We observed apparent thermal acclimation of microbial respiration, but only in summer, when warming had exacerbated the seasonally-induced, already small dissolved organic matter pools. Irrespective of warming, greater quantity and quality of soil carbon increased the extracellular enzymatic pool and its temperature sensitivity. We propose that fresh litter input into the system seasonally cancels apparent thermal acclimation of C-cycling processes to decadal warming. Our findings reveal that long-term warming has indirectly affected microbial physiology via reduced C availability in this system, implying that earth system models including these negative feedbacks may be best suited to describe long-term warming effects on these soils.

59 BASIC BIOLOGICAL SCIENCES↗

DOE OSTI2024

Seasonality and longer-term development generate temporal dynamics in the Populus microbiome

ABSTRACT Temporal variation in community composition is central to our understanding of the assembly and functioning of microbial communities, yet the controls over temporal dynamics for microbiomes of long-lived plants, such as trees, remain unclear. Temporal variation in tree microbiomes could arise primarily from seasonal (i.e., intra-annual) fluctuations in community composition or from longer-term changes across years as host plants age. To test these alternatives, we experimentally isolated temporal variation in plant microbiome composition using a common garden and clonally propagated plants, and we used amplicon sequencing to characterize bacterial/archaeal and fungal communities in the leaf endosphere, root endosphere, and rhizosphere of two Populus spp. over four seasons across two consecutive years. Microbial community composition differed among seasons and years (which accounted for up to 21% of the variation in microbial community composition) and was correlated with seasonal dissimilarity in climatic conditions. However, microbial community dissimilarity was also positively correlated with time, reflecting longer-term compositional shifts as host trees aged. Together, our findings demonstrate that temporal patterns in tree microbiomes arise from both seasonal fluctuations and longer-term changes, which interact to generate unique seasonal patterns each year. In addition to shedding light on two important controls over the assembly of plant microbiomes, our results also suggest future studies of tree microbiomes should account for background temporal dynamics when testing the drivers of spatial patterns in microbial community composition and temporal responses of plant microbiomes to environmental change. IMPORTANCE Microbiomes are integral to the health of host plants, but we have a limited understanding of the factors that control how the composition of plant microbiomes changes over time. Especially little is known about the microbiome of long-lived trees, relative to annual and non-woody plants. We tested how tree microbiomes changed between seasons and years in poplar (genus Populus ), which are widespread and ecologically important tree species that also serve as important biofuel feedstocks. We found the composition of bacterial, archaeal, and fungal communities differed among seasons, but these seasonal differences depended on year. This dependence was driven by longer-term changes in microbial composition as host trees developed across consecutive years. Our findings suggest that temporal variation in tree microbiomes is driven by both seasonal fluctuations and longer-term (i.e., multiyear) development.

59 BASIC BIOLOGICAL SCIENCES↗

DOE OSTI2022

Unstructured clinical notes within the 24 hours since admission predict short, mid & long-term mortality in adult ICU patients

Mortality prediction for intensive care unit (ICU) patients is crucial for improving outcomes and efficient utilization of resources. Accessibility of electronic health records (EHR) has enabled data-driven predictive modeling using machine learning. However, very few studies rely solely on unstructured clinical notes from the EHR for mortality prediction. In this work, we propose a framework to predict short, mid, and long-term mortality in adult ICU patients using unstructured clinical notes from the MIMIC III database, natural language processing (NLP), and machine learning (ML) models. Depending on the statistical description of the patients’ length of stay, we define the short-term as 48-hour and 4-day period, the mid-term as 7-day and 10-day period, and the long-term as 15-day and 30-day period after admission. We found that by only using clinical notes within the 24 hours of admission, our framework can achieve a high area under the receiver operating characteristics (AU-ROC) score for short, mid and long-term mortality prediction tasks. The test AU-ROC scores are 0.87, 0.83, 0.83, 0.82, 0.82, and 0.82 for 48-hour, 4-day, 7-day, 10-day, 15-day, and 30-day period mortality prediction, respectively. We also provide a comparative study among three types of feature extraction techniques from NLP: frequency-based technique, fixed embedding-based technique, and dynamic embedding-based technique. Lastly, we provide an interpretation of the NLP-based predictive models using feature-importance scores.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2021

Resolving Conflicting Physical and Biochemical Feedbacks to Climate in Response to Long-Term Warming

The goal of the research was to increase our understanding of the microbial mechanisms that control soil organic matter decay in the context of a changing climate. We hypothesized that a major source of carbon respired after long-term soil warming is recalcitrant soil C mineralized by microbes. We found that long-term warming was associated with decreased fungal communities but not bacterial communities, with bacterial communities in organic horizon soils significantly affected by warming. Molecular analysis indicated that this community shift was towards a more oligotrophic community, consistent with previously observed decreased in soil organic matter quality and quantity. We further hypothesized that low labile C resulting from long-term warming has selected for a microbial community that is better able to mineralize recalcitrant C. Analysis of soil communities and individual isolates physiology showed that long-term warming caused bacteria to have increased potential lignolytic activitiy as well as increased carbohydrate degradation potential. This increased ability to degrade recalcitrant soil organic matter is suggested as a mechanism for accelerated soil carbon loss with long-term warming. Soil warming was shown to have little change in transcriptional activity or proteins levels of the enzymes related to recalcitrant C, and little change in the temperature sensitivity of enzyme activity.

54 ENVIRONMENTAL SCIENCES↗

DOE OSTI2023

SAM Code Development for Source Term Modeling in Fluoride-salt-cooled High-temperature Reactors

The SAM code is under development and supported by DOE-NE’s Nuclear Energy Advanced Modeling and Simulation program as a modern system-level modeling and simulation tool for advanced non-light water reactor safety analyses. These advanced reactor concepts incorporate novel and improved approaches to achieve safety and economic feasibility. Many concepts leverage higher operating temperatures for improved efficiency with a variety of coolants and structural materials to support those needs. Such design choices may also pose unique radiological source term risks. There are continuous efforts to incorporate new physics and phenomena relevant to advanced reactor concepts, including capabilities to enable system-level source term modeling. The Pebble-Bed Fluoride-salt-cooled High-temperature Reactor (PB-FHR) is a promising candidate among advanced nuclear reactor concepts with its improved passive safety characteristics and high thermal efficiency. In addition to past efforts to support the development and utilization of SAM for PB-FHR safety analysis, the species transport modeling capabilities in SAM have been extended to simulate source term phenomena in concepts like the PB-FHR. The PB-FHR concept utilizes pebble-form TRISO fuel and FLiBe salt coolant to provide robust barriers to the release of almost all fission products and radiological source terms. However, tritium poses a unique radiological risk due to its significant production from neutron interactions with 6 Li and 9 Be in the FLiBe as well as its high mobility at elevated temperatures where it can permeate through structural metals. Secondly, the use of graphite at elevated temperatures poses the risk of oxidation damage to any structural components or fuel pebbles that are exposed to accidental air ingress. This report summarizes progress made in modeling these phenomena in SAM, which leverages the system-level multi-physics thermal hydraulic simulation to support an effective engineering-scale source term modeling capability. A tritium transport model is developed to simulate the various transport pathways in FHR and MSR concepts and is presented through verification and validation examples as well as demonstrations simulating experimental test loops and reference plant FHR models. A graphite oxidation model is also introduced to calculate local oxidation rates and is presented with initial validation results.

22 GENERAL STUDIES OF NUCLEAR REACTORS↗

DOE OSTI2023

Neonatal respiratory support strategies—short and long-term respiratory outcomes

Mechanical ventilation (MV), although life-saving, is associated with chronic respiratory morbidity in both preterm and term born infants. New ventilation modes have been developed with the aim of minimising lung injury. These include invasive and non-invasive respiratory support strategies, techniques for less invasive surfactant administration (LISA) and closed-loop automated oxygen control (CLAC) systems. Increasingly, newborn infants with signs of respiratory distress are stabilised on continuous positive airway pressure (CPAP) and receive LISA. Early CPAP when compared to mechanical ventilation reduced the incidence of BPD and respiratory morbidity at 18 to 22 months corrected age. Nasal intermittent positive pressure ventilation reduced treatment failure rates compared to CPAP, but not bronchopulmonary dysplasia (BPD). LISA compared with intubation and surfactant delivery reduced BPD, but there is no evidence from randomised trials regarding long-term respiratory and neurodevelopmental outcomes. Synchronisation of positive pressure inflations with the infant's respiratory efforts used with volume targeting should be applied for infants requiring intubation as this strategy reduces BPD. A large RCT with long term follow up data demonstrated that prophylactic high frequency oscillatory ventilation (HFOV) improved respiratory and functional outcomes at school age, but those effects were not maintained after puberty. CLAC systems appear promising, but their effect on long term clinical outcomes has not yet been explored in randomised trials. Further studies are required to determine the role of newer ventilation modes such as neurally adjusted ventilator assist (NAVA). All such respiratory support strategies should be tested in randomised controlled trials powered to assess long-term outcomes.

Kaltsogianni, Ourania↗