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This paper presents a literature review of research undertaken on the out-of-plane behaviour of masonry infilled frames. This paper also discusses the effects of bidirectional loads, openings, slenderness, boundary conditions etc. As numerous researchers have reported, these effects play a crucial role in achieving arching action cause, as they can bypass or limit its effectiveness. Namely, arching action leads to additional compressive forces which resist traversal ones. This is confirmed by inertial force methods of testing, while the same cannot be claimed for inter-storey drift or dynamical methods. It is to be acknowledged that most experimental tests were carried out using inertial force methods, mostly with the use of airbags. In contrast, only a few were undertaken with dynamical methods and just two with inter-storey drift methods. It was found that inertial force and inter-storey drift methods differ widely. In particular, inertial force methods damage the infill, leaving the frame more or less intact. Conversely, drift heavily damages the frame, while infill only slightly. Openings were investigated, albeit with contrasting results. Namely, in all cases, it was found that openings do lower the deformational but not all load-bearing capacities. Furthermore, analytical models have shown contrasting results between themselves and with experimental data. Models’ stabilities were checked with single- and multi-variable parametric analysis from which governing factors, influences of frame and other parameters were identified.

Within the scope of literature, the influence of openings within the infill walls that are bounded by a reinforced concrete frame and excited by seismic drift forces in both in- and out-of-plane direction is still uncharted. Therefore, a 3D micromodel was developed and calibrated thereafter, to gain more insight in the topic. The micromodels were calibrated against their equivalent physical test specimens of in-plane, out-of-plane drift driven tests on frames with and without infill walls and openings, as well as out-of-plane bend test of masonry walls. Micromodels were rectified based on their behavior and damage states. As a result of the calibration process, it was found that micromodels were sensitive and insensitive to various parameters, regarding the model’s behavior and computational stability. It was found that, even within the same material model, some parameters had more effects when attributed to concrete rather than on masonry. Generally, the in-plane behavior of infilled frames was found to be largely governed by the interface material model. The out-of-plane masonry wall simulations were governed by the tensile strength of both the interface and masonry material model. Yet, the out-of-plane drift driven test was governed by the concrete material properties.

The behaviour of masonry infilled RC frames, with and without openings, subjected to both in-plane (IP) and out-of-plane (OoP) shear loading, indicates the most unfavourable shear (seismic) design condition. A series of calibrated computational micromodels of previously tested 1/2.5 scaled single-bay and single-story RC frames with masonry infill walls, were employed to investigate the effect of openings of various type, size and position, on structure’s shear resistance under different IP and OoP load combinations. The load combination was characterised by an angle α of the IP (or OoP) resultant force, ranging from 0° to 90°. Considered were walls with centrically or eccentrically positioned door or window opening, of an opening to wall area ratio Ao/Ai = 0.1–0.3, walls without openings, and frame without wall i.e. bare frame. A total of 252 models were considered. The obtained behaviour revealed the specific load resisting mechanisms and accompanying failure modes. The IP–OoP shear resistance interaction curves and surfaces were constructed with regard to load direction α and opening to wall area ratio Ao/Ai. Considering these criteria, the IP–OoP shear resistance estimation functions were derived in order to improve the existing shear (seismic) design methodologies of masonry infilled RC frames.

Various connective tissue diseases tend to affect specific organs, lungs being the organ with the most serious repercussions and consequences. The diagnosis of interstitial lung disease makes the treatment more difficult and worsens long-term prognosis and overall survival. Positive results from the registration studies of nintedanib led to approval of the drug for the treatment of idiopathic pulmonary fibrosis and chronic fibrosing interstitial lung diseases in connective tissue diseases. After registration, real-world data on the use of nintedanib are being collected in everyday clinical practise. The objective of the study was to collect and analyse real world experience gathered after the registration of nintedanib for the treatment of CTD-ILD and to show if the positive results collected from a homogeneous and “representative” study population can be applied to everyday clinical practice. We are presenting a retrospective observational case-series study of patients treated with nintedanib from the three largest Croatian centers specialised in the treatment of connective tissue diseases with interstitial lung diseases. Stabilisation or improved of lung function tests was reported in 68% of patients when changes in predicted FVC were observed and in 72% of patients when changes in DLco were analysed. Almost all of the reported patients (98%) were treated with nintedanib as an add-on drug to immunosuppressants. The most common side-effects were gastrointestinal symptoms and abnormal liver function tests in less extent. Our real-world data confirm the tolerability, efficacy and similar side-effects of nintedanib as reported in pivotal trials. Key Points• Interstitial lung disease is a common manifestation of several connective tissue diseases and its progressive fibrosing phenotype contributes to high mortality rate and many unmet needs regarding the treatment remain.• Registration studies of nintedanib obtained sufficient data and positive results to support approval of the drug.• Real-world evidence from our CTD-ILD centres confirm the clinical trial data regarding efficacy, tolerability and safety of nintedanib.

ECMO is rarely used in children with acute leukemia due to possible complications.We describe a 3.5-year-old boy with acute myeloid leukemia (AML) who required extracorporeal membrane oxygenation (ECMO) support due to severe acute respiratory distress syndrome (ARDS) and septic shock.At the age of 2 years, he was diagnosed with T-cell lymphoblastic lymphoma and he received treatment according to EURO-LB 02 protocol. At the end of the maintenance therapy leukocytosis with anemia and thrombocytopenia occurred. Bone marrow aspiration showed suspicion of myeloid neoplasm.Second bone marrow aspiration, which was sent to a foreign hematologic center, confirmed AML. Because of the previous lymphoma which started with eosinophilia, and unusual occurrence of AML early after, immature lymphoid/myeloid neoplasm with eosinophilia was suspected. AML induction treatment was started, with a plan to proceed to allogenic hematopoietic stem cell transplantation (HSCT) after chemotherapy, because of poor prognosis. The patient received AIE part of the AML-BFM 2012 protocol without serious complications, but on the 9th day of the HAM part of the protocol septic shock developed. The patient deteriorated and was transferred to the Pediatric Intensive Care Unit. A chest X-ray showed extensive infiltrative shading. Pseudomonas aeruginosa was isolated in blood culture. Further development of respiratory failure with ARDS and progression of the septic shock required intubation, mechanical ventilation and inotropes. However, conventional therapy was insufficient so central veno-arterial ECMO was indicated and performed. The ECMO was continued for22 days. Three days after the ECMO discontinuation he was extubated and respiratory and hemodynamically stable. Bone marrow aspiration after the ECMO treatment showed complete remission so the decision to proceed to HSCT without further chemotherapy was made. Allogeneic HSCT from a matched unrelated donor with myeloablative conditioning was performed 40 days after ECMO discontinuation. Three weeks after HSCT acute skin GVHD grade II responded well to corticosteroid treatment together with cyclosporine. Four weeks after the HSCT steroid-resistant liver GVHD developed but responded well to mini extracorporeal photopheresis (ECP). Five months after HSCT patient is in good condition, with good engraftment, in complete remission, and without GVHD.In our patient, ECMO support provided survival of septic shock and pneumonia with ARDS, and treatment with allogenic HSCT provided survival of high-risk leukemia with poor prognosis.