Comorbid Conditions in Idiopathic Pulmonary Fibrosis: Recognition and Management.

Idiopathic pulmonary fibrosis (IPF), a fibrosing interstitial pneumonia of unknown etiology, primarily affects older adults and leads to a progressive decline in lung function and quality of life. With a median survival of 3-5 years, IPF is the most common and deadly of the idiopathic interstitial pneumonias. Despite the poor survivorship, there exists substantial variation in disease progression, making accurate prognostication difficult. Lung transplantation remains the sole curative intervention in IPF, but two anti-fibrotic therapies were recently shown to slow pulmonary function decline and are now approved for the treatment of IPF in many countries around the world. While the approval of these therapies represents an important first step in combatting of this devastating disease, a comprehensive approach to diagnosing and treating patients with IPF remains critically important. Included in this comprehensive assessment is the recognition and appropriate management of comorbid conditions. Though IPF is characterized by single organ involvement, many comorbid conditions occur within other organ systems. Common cardiovascular processes include coronary artery disease and pulmonary hypertension (PH), while gastroesophageal reflux and hiatal hernia are the most commonly encountered gastrointestinal disorders. Hematologic abnormalities appear to place patients with IPF at increased risk of venous thromboembolism, while diabetes mellitus (DM) and hypothyroidism are prevalent metabolic disorders. Several pulmonary comorbidities have also been linked to IPF, and include emphysema, lung cancer, and obstructive sleep apnea. While the treatment of some comorbid conditions, such as CAD, DM, and hypothyroidism is recommended irrespective of IPF, the benefit of treating others, such as gastroesophageal reflux and PH, remains unclear. In this review, we highlight common comorbid conditions encountered in IPF, discuss disease-specific diagnostic modalities, and review the current state of treatment data for several key comorbidities

Complete Constant Mean Curvature surfaces and Bernstein type Theorems in M2×R\mathbb{M}^2\times \mathbb{R}

In this paper we study constant mean curvature surfaces $\Sigma$ in a product space, $\mathbb{M}^2\times \mathbb{R}$, where $\mathbb{M}^2$ is a complete Riemannian manifold. We assume the angle function \nu = \meta{N}{\partial_t} does not change sign on $\Sigma$. We classify these surfaces according to the infimum $c(\Sigma)$ of the Gaussian curvature of the projection of $\Sigma$. When $H \neq 0$ and $c(\Sigma)\geq 0$, then $\Sigma$ is a cylinder over a complete curve with curvature 2H. If H=0 and $c(\Sigma) \geq 0$, then $\Sigma$ must be a vertical plane or $\Sigma$ is a slice $\mathbb{M}^2 \times {t}$, or $\mathbb{M}^2 \equiv \mathbb{R}^2$ with the flat metric and $\Sigma$ is a tilted plane (after possibly passing to a covering space). When $c(\Sigma)\sqrt{-c(\Sigma)} /2$, then $\Sigma$ is a vertical cylinder over a complete curve of $\mathbb{M}^2$ of constant geodesic curvature $2H$. This result is optimal. We also prove a non-existence result concerning complete multi-graphs in $\mathbb{M}^2\times \mathbb{R}$, when $c(\mathbb{M}^2)<0$

Seamless metal-clad fiber-reinforced organic matrix composite structures and process for their manufacture

A metallic outer sleeve is provided which is capable of enveloping a hollow metallic inner member having continuous reinforcing fibers attached to the distal end thereof. The inner member is then introduced into outer sleeve until inner member is completely enveloped by outer sleeve. A liquid matrix member is then injected into space between inner member and outer sleeve. A pressurized heat transfer medium is flowed through the inside of inner member, thereby forming a fiber reinforced matrix composite material. The wall thicknesses of both inner member and outer sleeve are then reduced to the appropriate size by chemical etching, to adjust the thermal expansion coefficient of the metal-clad composite structure to the desired value. thereby forming a fiber reinforced matrix composite material. The wall thicknesses of both inner member and outer sleeve are then reduced to the appropriate size by chemical etching, to adjust the thermal expansion coefficient of the metal-clad composite structure to the desired value. The novelty of this invention resides in the development of a efficient method of producing seamless metal clad fiber reinforced organic matrix composite structures

The atmospheric effects of stratospheric aircraft: A topical review

In the late 1960s the aircraft industry became interested in developing a fleet of supersonic transports (SSTs). Between 1972 and 1975, the Climatic Impact Assessment Program (CIAP) studied the possible environmental impact of SSTs. For environmental and economic reasons, the fleet of SSTs was not developed. The Upper Atmosphere Research Program (UARP) has recently undertaken the responsibility of directing scientific research needed to assess the atmospheric impact of supersonic transports. The UARP and the High-Speed Research Program asked Harold Johnston to review the current understanding of aircraft emissions and their effect on the stratosphere. Johnston and his colleagues have recently re-examined the SST problem using current models for stratospheric ozone chemistry. A unique view is given here of the current scientific issues and the lessons learned since the beginning of CIAP, and it links the current research program with the assessment process that began two years ago

The Dynamics of the One-Dimensional Delta-Function Bose Gas

We give a method to solve the time-dependent Schroedinger equation for a system of one-dimensional bosons interacting via a repulsive delta function potential. The method uses the ideas of Bethe Ansatz but does not use the spectral theory of the associated Hamiltonian

The use of shake cultures of Neurospora for growth experiments

The use of shake cultures of Neurospora for growth experiment

Medical Command and Control in Sea-Based Operations

During World War II it took the Navy and Marine Corps years to confirm and refine their prewar doctrine for amphibious attack. The labor began with the first U.S. landings at Guadalcanal in August 1942; the resulting doc- trine, organization, tactics, and techniques were subsequently used by the Army in Europe. Early operations in both theaters highlighted the enormous difficul- ties associated with essential medical elements, and it was not until late 1944, perhaps 1945, that these problems were adequately solved