Explore the vast range of titles available.

Socioeconomic status (SES) is a strong determinant in the development of various diseases. We evaluated the relationship between SES and the incidence of chronic obstructive pulmonary disease (COPD) by using a community-based cohort data. Four-year follow-up data of 6341 adults (aged ≥ 40 years), who underwent serial pulmonary function test were analyzed. Incidence of COPD in the participants was defined as the absence of airflow obstruction compatible with COPD (pre-bronchodilator forced expiratory volume in 1 second/forced vital capacity ratio of <0.7) at baseline but documentation of airflow obstruction in serial testing. SES of patients was divided into quartiles according to household income and educational level. Multivariate logistic regression analyses were performed to estimate the association between SES and COPD incidence. A total of 280 (4.4%) patients developed COPD during the follow-up. The proportion of subjects with lowest education (elementary school) and lowest household income levels (1st quartile) was significantly higher in the COPD group than in the non-COPD group (37.9% vs 29.5%, p<0.011 and 48.4% vs 30.8%, p<0.001, respectively). Logistic regression analysis revealed that education level of elementary school was independently associated with COPD incidence after adjustment for sex, age, body mass index, white blood cell count, residence area, and occupation (odds ratio 1.879, 95% confidence interval 1.124-3.141, p=0.016). In the general population, educational level of elementary school was an independent risk factor for COPD among the components comprising SES. Our results indicate that the implementation of preventive strategies for COPD in those with low educational status could be beneficial.

Objectives To compare the diagnostic performance of digital tomosynthesis (DTS) and chest radiography for detecting airway abnormalities, using computed tomography (CT) as a reference. Materials and methods We evaluated 161 data sets from 149 patients (91 with and 70 without airway abnormalities) who had undergone radiography, DTS, and CT to detect airway problems. Radiographs and DTS were evaluated to localize and score the severity of the airway abnormalities, and to score the image quality using CT as a reference. Receiver operating characteristics (ROC), McNemar’s test, weighted kappa, and the paired t-test were used for statistical analysis. Results The sensitivity of DTS was higher (reader 1, 93.51 %; reader 2, 94.29 %) than chest radiography (68.83 %; 71.43 %) in detecting airway lesions. The diagnostic accuracy of DTS (90.91 %; 94.70 %) was also significantly better than that of radiography (78.03 %; 82.58 %, all p  < 0.05). DTS image quality was significantly better than chest radiography (1.83, 2.74; p  < 0.05) in the results of both readers. The inter-observer agreement with respect to DTS findings was moderate and superior when compared to radiography findings. Conclusions DTS is a more accurate and sensitive modality than radiography for detecting airway lesions that are easily obscured by soft tissue structures in the mediastinum. Key Points • Digital tomosynthesis offers new diagnostic options for airway lesions . • Digital tomosynthesis is more sensitive and accurate than radiography for airway lesions . • Digital tomosynthesis shows better image quality than radiography . • Assessment of lesion severity, via tomosynthesis is comparable to computed tomography .

Background Remote ischemic preconditioning (RIPC) and postconditioning (RpostC) have protective effects on ischemia and reperfusion injury. The effects have been reported to activate heme oxygenase-1 (HO-1) and attenuate nuclear factor kappa B (NF-κB) and subsequently reduce systemic inflammation. Ischemic preconditioning prevented inflammatory responses by modulating HO-1 expression in endotoxic shock model. Therefore, we investigated whether RpostC could have protective effects on lipopolysaccharide (LPS)-induced systemic inflammation. Methods The LPS-induced sepsis mice received LPS (20 mg/kg) intraperitoneally. Remote ischemic conditioning was induced with three 10-min ischemia/10-min reperfusion cycles of the right hind limbs using tourniquet before LPS injection (RIPC) or after LPS injection (RpostC). The effects of RIPC and RpostC were examined for the survival rate, serum cytokines, NF-κB, HO-1 and liver pathology in the LPS injected mice. Results Survival rate within 120 hours significantly increased in the LPS injected and remote ischemic conditioned mice than in LPS only injected mice (60-65% vs 5%, respectively, p < 0.01). Tumor necrosis factor-alpha (TNF-α), interleukin-1 beta (IL-1β) and interleukin-6 (IL-6) increased markedly in the LPS only injected mice, however, remote ischemic conditioning suppressed the changes (p < 0.05). Interleukin-10 (IL-10) level was significantly higher in the LPS injected and RpostC treated mice than in the LPS only injected mice ( p  = 0.014). NF-κB activation was significantly attenuated (p < 0.05) and HO-1 levels were substantially higher in the LPS injected and remote ischemic conditioned mice than in the LPS only injected mice. Neutrophil infiltration was significantly attenuated in the LPS injected and remote ischemic conditioned mice than in the only LPS injected mice (p < 0.05). Conclusions RpostC attenuated inflammatory responses and improved survival outcomes of mice with LPS-induced systemic inflammation. The mechanism may be caused by modifying NF-κB mediated expression of cytokines.

Polyhexamethylene guanidine phosphate (PHMG-p), a major ingredient of humidifier disinfectants, is known to induce inflammation, interstitial pneumonitis, and fibrosis in the lungs. While its histopathologic toxicities have been studied in rodents, research on pulmonary function test (PFT) changes following PHMG-p exposure is limited. This study aimed to investigate the acute and chronic effects, as well as the dose and time response, of PHMG-p on the lungs in mice using PFT and histopathologic examinations. In the single instillation model, mice received PHMG-p and were sacrificed at 2, 4, and 8 weeks. In the five-time instillation model, PHMG-p was administered five times at one-week intervals, and mice were sacrificed 10 weeks after the first instillation. Results showed that PHMG-p exposure reduced lung volume, increased resistance, and decreased compliance, indicating a restrictive ventilation defect. Histopathologic examination showed increases in lung inflammation and fibrosis scores. Changes in several lung volume and compliance parameters, as well as histopathology, were dose-dependent. Lung resistance and compliance parameters had significant correlations with lung inflammation and fibrosis scores. PHMG-p exposure in mice resulted in a restrictive ventilation defect with altered lung resistance and compliance, along with histopathologic lung inflammation and fibrosis.

Using energy‐saving electrochromic (EC) displays in smart devices for augmented reality makes cost‐effective, easily producible, and efficiently operable devices for specific applications possible. Prussian blue (PB) is a metal‐organic coordinated compound with unique EC properties that limit EC display applications due to the difficulty in PB micro‐patterning. This work presents a novel micro‐printing strategy for PB patterns using localized crystallization of FeFe(CN)6 on a substrate confined by the acidic‐ferric‐ferricyanide ink meniscus, followed by thermal reduction at 120 °C, thereby forming PB. Uniform PB patterns can be obtained by manipulating printing parameters, such as the concentration of FeCl3·K3Fe(CN)6, printing speed, and pipette inner diameter. Using a 0.1 M KCl (pH 4) electrolyte, the printed PB pattern is consistently and reversibly converted to Prussian white (CV potential range: −0.2–0.5 V) with 200 CV cycles. The PB‐based EC display with a navigation function integrated into a smart contact lens is able to display directions to a destination to a user by receiving GPS coordinates in real time. This facile method for forming PB micro‐patterns could be used for advanced EC displays and various functional devices. Meniscus‐guided micro‐printing of Prussian blue (PB) is realized by local crystallization of FeFe(CN)6 on a substrate confined with an ink meniscus followed by thermal reduction of Fe3+ ions. The printed PB pattern is reversibly converted to Prussian white by conducting cyclic voltammetry in KCl electrolyte. PB‐based electrochromic displays with a navigation function in a smart contact lens are demonstrated.

•Early enteral nutrition (EN) was related to decreased in-hospital mortality.•Adequate energy support was not related to decreased in-hospital mortality.•The contribution of EN versus parenteral nutrition was not related to in-hospital mortality.•EN can be recommended in the early stages of extracorporeal membrane oxygenation even when the energy intake from EN is small. There are concerns about adverse events related to early enteral nutrition (EN) in people receiving extracorporeal membrane oxygenation (ECMO). This was a retrospective study evaluating. This nutritional support of people receiving ECMO, factors that may confer benefits in outcomes. 60 adults on ECMO who survived for more than 48 h were enrolled in the study. We evaluated energy and protein intake and the associations of the timing, adequacy, and route of nutrition with in-hospital mortality. Thirty-three participants (55%) were successfully weaned off ECMO, and 30 (50%) survived. EN was initiated on day 2 of ECMO (interquartile range, 1–3), and the mean energy intake on day 7 of ECMO was 94.1% ± 41.8% of the energy requirement. Although early EN significantly decreased in-hospital mortality (hazard ratio, 0.413; 95% confidence interval, 0.174–0.984; P = 0.046), neither adequate energy intake (hazard ratio, 0.982; 95% confidence interval, 0.292–3.301; P = 0.977) nor EN-dominant nutritional support (hazard ratio, 0.394; 95% confidence interval, 0.138–1.128; P = 0.083) in the first week influenced survival. Although adequate nutritional support and EN-dominant nutritional support were not associated with changes in outcome, early EN was associated with reduced in-hospital mortality. Therefore, even when EN is not the dominant route of nutritional support, early EN may be recommended for better outcomes in people on ECMO.

Some genetic variants are associated with lung function decline and chronic obstructive pulmonary disease (COPD), but functional studies are necessary to confirm causality. We investigated the genetic susceptibility-associated lung function decline with or without COPD, using data from a community-based cohort (N = 8554). A genome-wide interaction study was conducted to identify the association between genetic variants and pulmonary function, and the way variants relate to lung impairment in accordance with smoking status and amount was examined. We further used a linear mixed model to examine the association and interaction to time effect. We found annual mean FEV 1 declines of 41.7 mL for men and 33.4 mL for women, and the annual rate of decline in FEV 1 was the fastest for current smokers. We also found a previously identified locus near FAM13A, the most significant SNPs from the results of two likelihood ratio tests for FEV 1 /FVC ( P  = 1.56 × 10 −10 ). These selected SNPs were located in the upstream region of FAM13A on chromosome 4 and had similar minor allele frequencies (MAFs). Furthermore, we found that certain SNPs tended to have lower FEV 1 /FVC values, and lung function decreased much faster with time interactions. The SNP most associated with lung function decline was the rs75679995 SNP on chromosome 7, and those SNPs located within the TAD of the DNAH11 region and the eQTL of rs9991425 revealed a higher expression of MFAP3L and AADAT genes ( P  = 2.28 × 10 −7 and 2.01 × 10 −6 , respectively). This is the first study to investigate gene–time interactions in lung function decline as a risk factor for COPD in the Korean population. In addition to replicating previously known signals for FAM13A, we identified two genomic regions (DNAH11, AADAT) that are potentially involved in gene–environment interactions, warranting further investigation to confirm their roles.

Although the routine use of alkali buffer is not recommended in patients with respiratory acidosis, some patients may benefit from its administration. A 42-year-old man was treated with venovenous extracorporeal membrane oxygenation (VV-ECMO) and continuous venovenous hemodiafiltration (CVVHDF) due to necrotizing pneumonia and emphysematous cystitis with Klebsiella pneumoniae. Although the sweep gas flow rate of the VV-ECMO was gradually reduced, he failed to wean off VV-ECMO due to respiratory acidosis, followed by tachycardia and tachypnea on the 63rd day of VV-ECMO. Therefore, we mixed sodium bicarbonate in the replacement fluid of CVVHDF for 5 days to avoid an intolerable decrease in blood pH after discontinuing the VV-ECMO sweep gas. When the serum bicarbonate concentration was >30 mmol/L and pH was maintained at >7.30 with a PCO2 of >60 mmHg, VV-ECMO was finally decannulated. Sodium bicarbonate buffer through the replacement of CVVHDF fluid facilitated VV-ECMO weaning in a patient with hypercapnic respiratory failure.

This study evaluates the association between the Eastern Cooperative Oncology Group Performance Status (ECOG-PS) and hospital mortality in general critically ill patients. This is a retrospective cohort study that analyzes prospective collected data from the Validation of Simplified acute physiology score 3 in Korean Intensive care unit study. The study population comprised patients who were consecutively admitted to participating intensive care units from July 1, 2010, to January 31, 2011. Univariate and multivariate logistic regression models were used to evaluate the effect of ECOG-PS on hospital mortality. A total of 3868 patients were included in the analysis. There was a significant trend for increasing hospital mortality as the ECOG-PS grade became higher (P < .001). There was a trend of increasing adjusted odds ratio for hospital mortality, with grade 1 of PS 1.4 (95% confidence intervals [CIs], 1.0-1.8), grade 2 of PS 2.0 (95% CIs, 1.5-2.7), grade 3 of PS 2.9 (95% CIs, 2.1-4.1), and grade 4 of PS 2.5 (95% CIs, 1.6-3.9). Also, there was a significant difference in all grades. Subgroup analysis showed a trend of increasing hospital mortality regardless of the presence of cancer. Preadmission PS, assessed with ECOG-PS in critically ill patients, has prognostic value in general critically ill patients.

The reported actual compliance for severe sepsis bundles was very low, suggesting the presence of barriers to their implementation. The purpose of this study was to assess the influence of full-time intensivist and nurse-to-patient ratio in Korean intensive care units (ICUs) on the implementation of the severe sepsis bundles and clinical outcome. A total of 251 patients with severe sepsis were enrolled from 28 adult ICUs during the July, 2009. We recorded the organizational characteristics of ICUs, patients' characteristics and clinical outcomes, and the compliance for severe sepsis bundles. Complete compliance with the resuscitation bundle and totally complete compliance with all element targets for resuscitation and management bundles were significantly higher in the ICU with full-time intensivist and a nurse-to-patient ratio of 1:2 (P < .05). The hazard ratio (HR) for hospital mortality was independently reduced by the presence of full-time intensivist (HR, 0.456; 95% confidence interval, 0.223-0.932), and a nurse-to-patient ratio of 1:2 was independently associated with a lower 28-day mortality (HR, 0.459; 95% confidence interval, 0.211-0.998). The full-time intensivist and the nurse-to-patient ratio had a substantial influence on the implementation of severe sepsis bundles and the mortalities of patients with severe sepsis.