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The INBUILD trial investigated the efficacy and safety of nintedanib versus placebo in patients with progressive fibrosing interstitial lung diseases (ILDs) other than idiopathic pulmonary fibrosis (IPF). We aimed to establish the effects of nintedanib in subgroups based on ILD diagnosis., info:eu-repo/semantics/published

Objectives To evaluate the effect of timing and appropriateness of antibiotics administration on mortality in patients diagnosed with sepsis according to the Sepsis-3 definition. Methods This prospective cohort study was conducted in patients diagnosed with sepsis according to the Sepsis-3 definition at the emergency department of Korea University Ansan Hospital from January 2016 to January 2019. The time to antibiotics was defined as the time in hours from emergency department arrival to the first antibiotic administration. Cox proportional hazards regression analysis was used to estimate the association between time to antibiotics and 7-, 14- and 28-day mortality. Results Of 482 patients enrolled onto this study, 203 (42.1%) of 482 and 312 (64.7%) of 482 were diagnosed with septic shock and high-grade infection respectively. The median time to receipt of antibiotic therapy was 115 minutes. Antibiotics were administered within 3 and 6 hours in 340 (70.4%) of 482 and 450 (93.2%) of 482 patients respectively. Initial appropriate empirical antibiotics were administered in 375 (77.8%) of 482 patients. The time to and appropriateness of the initial antibiotics were not associated with 7-, 14- and 28-day mortality in multivariate analysis. The Sequential Organ Failure Assessment (SOFA) score (adjusted hazard ratio (aHR) 1.229, 95% confidence interval (CI) 1.093–1.381, p 0.001) and initial lactate levels (aHR 1.128, 95% CI 1.034–1.230, p 0.007), Charlson comorbidity index (aHR 1.115, 95% CI 1.027–1.210, p 0.014), 2-hour lactate level (aHR 1.115, 95% CI 1.027–1.210, p 0.009) and SOFA score (aHR 1.077, 95% CI 1.013–1.144, p 0.018) affected 7-, 14- and 28-day mortality respectively. Subgroup analysis with septic shock, bacteraemia and high-grade infection did not affect mortality rates. Conclusions Time to receipt of antibiotics may not affect the prognosis of patients with sepsis if a rapid and well-trained resuscitation is combined with appropriate antibiotic administration within a reasonable time.

BACKGROUND Idiopathic pulmonary fibrosis (IPF) and chronic obstructive pulmonary disease (COPD) share common risk factors. They could therefore be expressed in a single patient. However, the prevalence, clinical characteristics and prognosis of individuals with comorbid IPF and COPD are not known. METHOD From 2003 to 2007, the Korean Interstitial Lung Disease Study Group created a register for idiopathic interstitial pneumonia using 2002 ATS/ERS (American Thoracic Society/European Respiratory Society) criteria. Of the 1546 IPF patients assessed, 143 had decreased lung function consistent with COPD (IPF-COPD). COPD was diagnosed based on age (≥40 years) and pulmonary function (forced expiratory volume in 1 sec [FEV1]/forced vital capacity [FVC] ratio RESULTS The median age of the IPF-COPD group was 71.0 years (interquartile range 66.0-76.0); most patients were male (88.1%). FVC (%) was significantly higher in the IPF-COPD group; however, FEV1 (%) was significantly lower in the IPF-COPD group (P CONCLUSION The prevalence of IPF-COPD was estimated to be ∼9.2% among all IPF patients; prognosis of patients with IPF-COPD was not worse than those with IPF alone. .

SETTING Korea is an intermediate-burden country with high rates of tuberculosis (TB) drug resistance. OBJECTIVE To evaluate the performance of the GenoType® MTBDRplus (MTBDR) assay in diagnosing drug-resistant TB in routine practice in Korea. DESIGN The MTBDR assay was performed on 428 samples, and the results were retrospectively compared with the results of conventional drug susceptibility testing (DST). The interval between treatment and diagnosis of drug resistance was also compared. RESULTS The sensitivity, specificity and positive and negative predictive values of the MTBDR assay were respectively 96.6%, 98.9%, 93.4% and 99.5% for the detection of rifampicin (RMP) resistance; 93.8%, 98.3%, 92.7% and 98.6% for isoniazid (INH) resistance; and 91.1%, 99.2%, 99.4% and 98.7% for multidrug-resistant TB (MDR-TB). The median interval between the start of anti-tuberculosis chemotherapy and the reporting of results was 88.9 days for conventional DST and 19.8 days for MTBDR using clinical specimens. CONCLUSION The specificity of the MTBDR assay in detecting MDR-TB was very high, although the sensitivity in detecting INH resistance and MDR-TB was not optimal (

Transfusion-associated iron overload is often observed in patients with haematological malignancies. We analysed the effect of iron overload, indicated by high serum ferritin level, on the mobilization of CD34(+) peripheral blood stem cells (PBSCs). We evaluated the association between the serum ferritin level prior to PBSC collection and the number of CD34(+) cells collected through leukapheresis in 51 patients with various haematological malignancies. Patients with serum ferritin level over 1000 ng mL(-1) were defined as high-ferritin group. Comparing the good (or =1 x 10(6) per kg CD34(+) cells) and poor (1 x 10(6) per kg CD34(+) cells) mobilizing groups, there was no difference in disease status, previous chemotherapies and white blood cell count at the first day of apheresis. However, there was a significant difference in the median units of red blood cell transfused between the good and poor mobilizer (2 vs. 8 units; P = 0.012). Serum ferritin level was notably higher in the poor mobilizer (1670 +/- 1320 ng mL(-1)) compared with the good mobilizer (965 +/- 705 ng mL(-1), P = 0.035). The cumulative number of CD34(+) cells per kg collected during the whole procedure was significantly lower in the high-ferritin group (5.5 +/- 4.7 x 10(6) per kg vs. 13.1 +/- 9.1 x 10(6) per kg, P = 0.01). Multivariate analysis revealed that serum ferritin level remained as an independent predictive factor for poor PBSC mobilization. Our study indicated that transfusion-associated iron overload is a predictive factor for poor PBSC mobilization. Iron chelation therapy prior to apheresis may be required to collect sufficient numbers of PBSCs in the iron overload patients.

Regenerative flow compressors (RFCs) are rotodynamic machines capable of producing high heads at very low flowrates. They have very low specific speed and share some of the characteristics of positive displacement machines such as a roots blower, but without the problems of lubrication and wear. They can produce heads equivalent to that of several centrifugal stages from a single rotor with comparable tip speed. The compression process is usually not regarded as efficient. Typically they produce efficiency of less than 50 per cent but still they have found many applications because they allow the use of fluid dynamic compressors in place of positive displacement compressors for duties requiring high heads at low flowrates. There are very few mathematical models in the literature that explain the behaviour of regenerative turbomachines and predict the performance. Most of these models assumed incompressible flow, thus limiting their use to only pumps and blowers. Moreover, they needed extensive experimental support for performance prediction. Hence, it is very interesting from an industrial point of view to find efficient theoretical means that are able to forecast regenerative compressor performances, using easy to find geometric and fluid dynamic parameters. A compressible flow theory is thus presented for the first time in this paper to describe complex three-dimensional corkscrew flow patterns in regenerative compressors. Conventional RFC were designed with radial, non-radial or semicircular impeller blades. In the present investigation, the authors have discussed RFCs with aerofoil blades and an annular flow channel containing a core to direct circulating flow to the blades with a minimum amount of losses. The effects of various geometric elements on the performance of RFCs are studied. All the major sources of losses in blade and channel region are identified. Governing equations for the flow in the compressor are derived and a performance prediction code based on governing equations and loss models is developed. Theoretical performance results are compared with published test data on aerofoil blade RFCs. Based on sensitivity analysis from the code, design changes are suggested for performance improvement.

This paper descried the teaching background using ESP in higher vocational college and indicated three disadvantages existed in current teaching process. It discussed how to improve ESP teaching quality through using web-based ESP method on strengthening listening and oral skills, accelerating materials development, building up a ESP corpus, ensuring personalized studies and enhancing ESP professional quality.

Aim To assess initial and follow-up CT findings of invasive pulmonary aspergillosis (IPA) in solid organ transplant (SOT) recipients using new diagnostic criteria, and to compare initial CT findings of survivors with those of patients who died. Materials and methods Forty-six adult SOT patients who met the 2008 EORTC/MSG criteria for proven or probable invasive pulmonary aspergillosis were assessed. Initial CT findings of the 21 survivors and 15 patients who died of IPA-related causes were compared using the internationally recognized thoracic glossary of terms. The extents of the largest lesions in each of 18 surviving were measured and changes of those lesions were recorded. Results Consolidation or mass was the most common finding, observed in 33 of 46 patients (72%), followed by large nodules (59%), ground-glass opacity (50%), and infarcted consolidation (48%). Consolidation or mass was significantly less frequent in survivors than in patients who died (62% versus 93%). Cavitation was more common (43% versus 13%), and significantly smaller (7.5 cm 2 versus 19 cm 2 , p = 0.014) in survivors. Follow-up CT in survivors showed that the halo sign resolved rapidly within 4 weeks. The extent of consolidation, infarcted consolidation, and internal low-density area decreased gradually with time to reduce to half the size in 3 weeks. Large nodules persisted for the first 7 days (84%), followed by slow regression. Conclusion Consolidation or mass is the most common CT finding of IPA in SOT recipients. Absence of consolidation or mass and presence of small cavities may be associated with better prognosis. The time for resolution of each pattern after treatment varies.

Group C rotavirus (GpC RV) causes sporadic cases and outbreaks of acute diarrhoea in humans worldwide, but has not been detected among children in South Korea. The present study aimed to detect GpC RV among children hospitalized with gastroenteritis in South Korea and to perform a molecular characterization of GpC RV strains. From November 2003 to January 2006, 434 faecal samples were collected from children

Outlines a design methodology for synthesizing control systems for a class of SISO (single-input single-output) systems to guarantee a nonovershooting nominal step response in addition to satisfying standard feedback requirements such as robust stability, disturbance rejection, and sensitivity reduction. Compensators can be synthesized for SISO, stable, and minimum-phase plants with significant plant variations. The basic idea of the technique is to appropriately locate the closed-loop poles with respect to fixed and added zeros. An example illustrating the design procedure is presented. >

Hantaan virus was serially passaged in the brains of suckling rats. Vaccine inactivated with formalin was prepared from the suckling rat brains and the antigenic potency of the vaccine was determined by enzyme-linked immunosorbent assay (ELISA). Mice immunized with the vaccine were protected when challenged with live Hantaan virus. The antibody responses of 456 vaccinees given inactivated Hantaan virus vaccine against hemorrhagic fever with renal syndrome (HFRS) were then studied. Subcutaneous injection of the vaccine was better than intramuscular injection for production of antibodies in humans. Optimal immunogenic dose of the vaccine given subcutaneously to humans was 5,120 ELISA antigen units. Of 456 vaccinees, immunization of 336 with two doses of vaccine at one month interval resulted in 99% seroconversion by indirect immunofluorescent antibody tests. The vaccine was safe and only minimum side effects were observed. The efficacy of this vaccine against HFRS in the endemic areas of HFRS remains to be determined.