Development of a Consensus Statement for the Definition, Diagnosis, and Treatment of Acute Exacerbations of Idiopathic Pulmonary Fibrosis Using the Delphi Technique.

© 2015, The Author(s).Introduction: There is a lack of agreed and established guidelines for the treatment of acute exacerbations of idiopathic pulmonary fibrosis (AE-IPF). This reflects, in part, the limited evidence-base underpinning the management of AE-IPF. In the absence of high-quality evidence, the aim of this research was to develop a clinician-led consensus statement for the definition, diagnosis and treatment of AE-IPF. Methods: A literature review was conducted to obtain published material on the definition and treatment of AE-IPF. The results of this review were circulated to an online panel of clinicians for review. Statements were then shared with ten expert respiratory clinicians who regularly treat patients with IPF. A Delphi technique was then used to develop a consensus statement for the definition, diagnosis and treatment of AE-IPF. During the first round of review, clinicians rated the clarity of each statement, the extent to which the statement should be included and provided comments. In two subsequent rounds of review, clinicians were provided with the group median inclusion rating for each statement, and any revised wording of statements to aid clarity. Clinicians were asked to repeat the clarity and inclusion ratings for the revised statements. Results: The literature review, online panel discussion, and face-to-face meeting generated 65 statements covering the definition, diagnosis, and management of AE-IPF. Following three rounds of blind review, 90% of clinicians agreed 39 final statements. These final statements included a definition of AE-IPF, approach to diagnosis, and treatment options, specifically: supportive measures, use of anti-microbials, immunosuppressants, anti-coagulants, anti-fibrotic therapy, escalation, transplant management, and long-term management including discharge planning. Conclusion: This clinician-led consensus statement establishes the ‘best practice’ for the management and treatment of AE-IPF based on current knowledge, evidence, and available treatments. Funding: Boehringer Ingelheim Ltd., Bracknell, West Berkshire, UK

Numerical prediction of cavitation erosion in cavitating flow

In this study bubble behavior in cavitating flow is analyzed and prediction of cavitation erosion in 2D cavitating flow around ClarkY 11.7 % hydrofoil at several cavitation is performed by impact pressure induced by bubble collapse. Our numerical method predicts that the impact energy is small if variation of cavitating flow is small and that the position of peak impact energy moves downstream with the decrease in cavitation number until the maximum sheet cavity length becomes larger than chord length. When the maximum sheet cavity length becomes larger than chord length, there are not obvious peak values and relatively weak erosion occurs. And it is found that high impact pressures are mainly induced by bubbles in a cloud and in the vicinity of sheet cavity termination during a cloud collapse. Therefore large impact energy occurs when the cloud cavity collapses near the hydrofoil, the sheet cavity termination is on the hydrofoil and the number of bubble is large in these cavities.http://deepblue.lib.umich.edu/bitstream/2027.42/84264/1/CAV2009-final67.pd

Administration of isoferulic acid improved the survival rate of lethal influenza virus pneumonia in mice.

BACKGROUND: Isoferulic acid (IFA) is a main active ingredient of the rhizoma of Cimicifuga beracleifolia, which is used frequently in Japanese traditional medicine as an anti-inflammatory drug. It has been revealed that IFA inhibits the production of macrophage inflammatory protein-2 (MIP-2), which is a murine counterpart of the chemokine family that may contribute to the pathogenesis of inflammatory diseases through the chemotactic activity for inflammatory and immune effector cells. AIM OF THE STUDY: In this study, we investigated the therapeutic effect of IFA on the progression of lethal influenza virus pneumonia in mice by comparison with that of dexamethasone (DX), a potent inhibitor for various inflammatory cytokines including MIP-2. METHODS: Mice were infected by intranasal inoculation of influenza virus under ether anesthesia. The IFA or DX was given by oral administration once daily for 4 days after infection. After infection, the survival rate and the change in body weight were daily monitored. RESULTS: IFA administration markedly improved the survival rate and body weight loss of influenza virus-infected mice in a suitable dose range (0.5 mg/day). However, DX administration did not show a beneficial effect at any dose. CONCLUSION: These data suggested that IFA is a novel tool not only for the intervention therapy, but also for the studies on the pathogenesis of influenza virus-induced pneumonia

Magnetic Phases of Frustrated Ferromagnetic Spin-Trimer System Gd_3_Ru_4_Al_12_ With a Distorted Kagome Lattice Structure

The magnetization and specific heat measurements have been performed on single-crystalline Gd_3_Ru_4_Al_12_ with a distorted Kagome lattice structure. This spin system is regarded as an antiferromagnetic triangular lattice of XY like Heisenberg model at low temperatures. The magnetic phase diagrams indicate the existence of frustration and Z_2_ degeneracy. The magnetization and specific heat imply the successive phase transitions with partial disorder and a T-shaped spin structure in the ground state.Comment: 14 pages, 19 figure

Symmetry characterization of eigenstates in opal-based photonic crystals

The complete symmetry characterization of eigenstates in bare opal systems is obtained by means of group theory. This symmetry assignment has allowed us to identify several bands that cannot couple with an incident external plane wave. Our prediction is supported by layer-KKR calculations, which are also performed: the coupling coefficients between bulk modes and externally excited field tend to zero when symmetry properties mismatch.Comment: 7 pages, 5 figures, submitted to Physical Review

Inhibitory effect of ferulic acid and isoferulic acid on the production of macrophage inflammatory protein-2 in response to respiratory syncytial virus infection in RAW264.7 cells.

We investigated the effect of ferulic acid (FA) and isoferulic acid (IFA), which are the main active components of the rhizoma of Cimicifuga heracleifolia (CH), an anti-inflammatory drug used frequently in Japanese traditional medicine, on the production of macrophage inflammatory protein-2 (MIR-2) in a murine macrophage cell line, RAW264.7, in response to respiratory syncytial virus (RSV) infection. Following the exposure of cells to RSV for 20h, the MIP-2 level in condition medium was increased to about 20 ng/ml, although this level in mock-infected cells was negligible. In the presence of either FA or IFA, RSV-infected cells reduced MIP-2 production in a dose-dependent manner. These data suggest that FA and IFA might be responsible, at least in part, for the anti-inflammatory drug effect of CH extract through the inhibition of MIP-2 production