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Background and Objective: Corticosteroids are commonly used for the treatment of acute exacerbation of idiopathic pulmonary fibrosis (AE‐IPF); however, the optimal initial dose of corticosteroids remains uncertain due to a lack of sufficient evidence. We evaluated whether the administration of a pulse dose of corticosteroids resulted in improved survival outcomes compared with conventional non‐pulse dose of corticosteroids. Methods: We retrospectively analysed 238 patients with AE‐IPF treated with corticosteroids at a tertiary referral hospital between January 2013 and December 2021. Based on whether a pulse dose of corticosteroids (methylprednisolone of ≥250 mg/day or equivalent) was administered within 7 days of hospitalization for AE‐IPF, the patients were divided into the pulse and non‐pulse regimen groups. The survival outcomes were compared between the two groups using multivariable regression and propensity score‐matched analyses. Results: Among the 238 patients, 59 patients received pulse dose of corticosteroids, whereas 179 patients received conventional non‐pulse dose of corticosteroids. After adjusting for the confounding factors related to the baseline clinical and radiographic severity, compared with the conventional non‐pulse regimen, the pulse regimen of corticosteroids did not reduce the risk of mortality at the 3‐month (aHR 0.84, 95% CI 0.45–1.38) or 12‐month (aHR 0.96, 95% CI 0.60–1.25) follow‐ups. Propensity score‐matched analysis revealed similar results. Conclusion: The survival outcomes of patients with AE‐IPF who received a pulse dose of corticosteroids did not differ from those of patients who received conventional non‐pulse dose of corticosteroids. Further prospective studies are required to establish the optimal initial dose of corticosteroids for the treatment of AE‐IPF. A pulse dose of corticosteroids did not improve survival outcome of acute exacerbation of IPF when compared with conventional non‐pulse dose of corticosteroids. [ABSTRACT FROM AUTHOR]

This study revealed that patients with IPF have a higher cancer incidence risk than matched controls without IPF. Physicians should be aware of this risk when treating patients with IPF. Background and objective: IPF shares common risk factors and has pathogenic similarities with cancer. However, limited population‐based data are available on cancer risk among patients with IPF. Herein, we investigated whether IPF is associated with an increased risk for cancer incidence from a nationwide database in South Korea. Methods: In this population‐based cohort study, patients with IPF were enrolled from 2009 to 2014, and matched controls were randomly selected at a control‐to‐case ratio of 3:1. In both groups, individuals diagnosed with any malignancy before the index date were excluded. The incidence rates of cancer were measured as the number of events per 1000 person‐years. Multivariable Cox regression models were used to assess the cancer incidence risk. Results: This study included 25 241 patients with IPF and 75 723 matched controls. The overall cancer incidence in patients with IPF was 29.0 cases per 1000 person‐years, and it was significantly higher in the IPF group than in the non‐IPF group (HR, 2.09; 95% CI, 1.96–2.16). Lung cancer showed the highest HR (5.89; 95% CI, 5.40–6.42), followed by lymphoma, skin, uterine cervical, multiple myeloma, thyroid, leukaemia, pancreatic, liver and prostate cancer. Moreover, adjustment for the effects of smoking and other cancer‐associated covariates had little effect on the HR of overall and specific cancers. Conclusion: The cancer incidence risk was higher in the IPF group than in the non‐IPF group. Therefore, healthcare providers should be aware of this risk when treating patients with IPF. [ABSTRACT FROM AUTHOR]

The device lifetime of phosphor mediated TADF OLED, which is composed of three different type of materials such as host, phosphorescence, and TADF emitters in EML, was systematically investigated by a multi‐scale approach from quantum mechanics simulation to kinetic Monte Carlo simulation. The quantum chemical simulations to estimate the chemical stability of materials in atomic scale were clearly showed that the photo‐ or electro‐chemical stability in excited state was good qualitative correlation with device lifetime. From the results, we could figure out the crucial parameters that strongly related with the lifetime of blue TADF devices. Then, the device simulations based on kinetic Monte Carlo method were performed to understand excitonic dynamic. Based on the understanding about both a role of phosphorescence and a mechanism of energy transfer through emitters in EML, we found out that a concentration of triplet exciton around TADF emitters could be a dominant origin of the short lifetime even if TADF would have a sufficient stability condition we expect, and should be reduce to prevent the excitonic stress such as triplet‐triplet annihilation and triplet‐polaron quenching, resulting in the degradation of emitters. Consequently, this work suggests the simultaneous co‐optimization of both the device and its component material, for deep blue OLED device with a longer lifetime. [ABSTRACT FROM AUTHOR]

Firefly bioluminescence has been widely studied due to its high quantum yield and its broad range of color modulation, but debates on the origin of its color modulation and the exact chemical form of the emitter are still ongoing. Herein, the keto‐enolate transformation of the oxyluciferin–luciferase complex is investigated using quantum mechanics/molecular mechanics (QM/MM) free energy simulations. We find that the free energy profile of this transformation largely depends on the protonation state of the phenoxy oxygen in oxyluciferin. Although the keto‐enolate transformation can be facilitated by protonation of this oxygen atom, the overall transformation is still unlikely and only the keto form will predominantly exist along our hypothesized reaction path. Nevertheless, we show with additional calculations with a modestly modified protein electric field that the energetics of the transformation can be heavily modulated with the protein electrostatics. This suggests that carefully modeling the protein–ligand interaction is key to understanding the reaction mechanism of the firefly bioluminescence and that it is not yet appropriate to completely rule out the possibility of having enolate participation. [ABSTRACT FROM AUTHOR]

Background: Although the choice between stereotactic ablative radiotherapy (SABR) and lobectomy for early‐stage non‐small cell lung cancer (NSCLC) has been debated for years, the two procedures have not yet been directly compared in a randomized trial. We conducted a virtual randomized phase III trial stratified by age to compare the effectiveness of lobectomy and SABR for medically operable patients with stage IA (AJCC eighth) NSCLC using the Markov model analysis. Methods: A Markov model was developed to simulate a cohort of patients aged 45–85 years with stage IA NSCLC who had undergone either lobectomy or SABR and were followed up for their remaining lifetime. Each virtual patient was randomly assigned to undergo lobectomy or SABR, and 10 000 patients were allocated to each group. All estimates of the variables were obtained by a systematic review of published articles. Results: The lobectomy group showed a better life expectancy than the SABR group, in patients under 75 years of age. However, no statistically significant difference was seen in patients 75 years or older. The predicted life expectancy was 9.43 and 8.70 years in 75‐year‐old patients in the lobectomy and SABR groups, respectively. However, the 95%CI for the difference in life expectancy between the two groups was ‐ 0.06–1.50 years (P = 0.0689). Conclusions: The Markov model showed no statistically significant difference in the expected overall survival in stage IA NSCLC patients who were older than 75 years and had undergone SABR or lobectomy. [ABSTRACT FROM AUTHOR]

Purpose We developed an adverse events (AEs) reporting form for Korean folk medicine. Methods The first version of the form was developed and tested in the clinical setting for spontaneous reporting of AEs. Additional revisions to the reporting form were made based on collected data and expert input. Results We developed an AEs reporting form for Korean folk medicine. The items of this form were based on patient information, folk medicine properties, and AEs. For causality assessment, folk medicine properties such as classification, common and vernacular names, scientific name, part used, harvesting time, storage conditions, purchasing route, product licensing, prescription, persons with similar exposure, any remnant of raw natural products collected from the patient, and cautions or contraindications were added. Conclusions This is the first reporting form for AEs that incorporates important characteristics of Korean folk medicine. This form would have an important role in reporting adverse events for Korean folk medicine. © 2016 The Authors. Pharmacoepidemiology and Drug Safety Published by John Wiley & Sons Ltd. [ABSTRACT FROM AUTHOR]

Background and objective There are limited data regarding serum activin-A as a biomarker for sepsis. We examined whether serum activin-A concentration could predict sepsis severity and prognosis in the management of critically ill patients with sepsis. Methods The subjects were adult patients suspected of having sepsis and admitted to intensive care unit (ICU) from January 2013 to March 2014. Serum activin-A concentration was measured in blood sampled within 48 h after ICU admission. The primary and secondary outcomes were the diagnostic value of serum activin-A concentration as a biomarker of sepsis and the prognostic value for predicting the clinical outcomes of sepsis, respectively. Results One hundred and thirty patients who had clinically suspected sepsis were included. Most (66.2%) were male; their median age was 65 years, and their Acute Physiology and Chronic Health Evaluation II score was 22.3. Serum activin-A concentration tended to increase with sepsis severity and differed significantly between those with non-sepsis and severe sepsis and between those with severe sepsis and septic shock. The risks of sepsis, severe sepsis and septic shock were significantly higher in patients with a serum activin-A concentration of 251, 319 and 432 pg/mL or greater, respectively. Serum activin-A concentration was significantly associated with the Acute Physiology and Chronic Health Evaluation II score, Sequential Organ Failure Assessment score, Charlson comorbidity index and ICU mortality. Conclusion Serum activin-A was a predictor of sepsis severity and a prognostic marker in critically ill patients with sepsis. Serum activin-A concentration in the early phase of sepsis was associated with prognostic indexes on ICU admission and with ICU mortality. [ABSTRACT FROM AUTHOR]

Background and Aims The solitary pulmonary nodule ( SPN) is a common clinical problem usually detected incidentally during screening tests for lung cancer. Video-assisted thoracoscopic surgery ( VATS) is performed for diagnosing SPNs when there are technical difficulties with transthoracic needle aspiration biopsy or bronchoscopic biopsy, inconclusive biopsy results, or when there is a high suspicion of malignancy. This study aimed to identify factors that can reduce unnecessary VATS for the diagnosis of SPNs. Methods We retrospectively analysed patients with SPNs ( n = 107) who had undergone diagnostic VATS at Seoul National University Hospital from January 2007 to December 2008. Clinical and radiological parameters were evaluated to compare benign and malignant SPNs. Results Benign SPNs were diagnosed in 31 patients (29.0%). The most common reason for patients to undergo a diagnostic VATS was a history of malignancy. The most common histological findings in patients with benign SPNs were non-specific inflammatory lesions (29.0%) and tuberculosis (16.1%). The presence of respiratory symptoms was significantly associated with benign diseases [ P = 0.004, odds ratio ( OR) 0.189, 95% confidence interval ( CI) 0.060-0.590], and part-solid nodules were significantly related to malignancy ( P = 0.026, OR 6.34, 95% CI 1.248-32.169). Conclusion Approximately 30% of SPNs resected by VATS were benign. Although we did not identify a definite factor for predicting benign disease or malignancy, the presence of respiratory symptoms was related to benign disease, and part-solid nodules were associated with malignancy. [ABSTRACT FROM AUTHOR]

ABSTRACT Background and objective: Vitamin D deficiency has been reported to be associated with the development of active tuberculosis (TB), but many discrepancies exist among studies. The aims of this study were to compare the frequency of vitamin D deficiency in a Korean population of TB patients and control subjects, and to monitor the changes in vitamin D levels during TB treatment. Methods: Patients with newly diagnosed TB were prospectively enrolled. In addition, healthy volunteers or patients with diseases other than TB were enrolled as controls. Baseline serum 25-hydroxyvitamin D (25-OHD) levels were measured in both groups and compared. In the TB patients, measurements of serum 25-OHD were repeated 1 month after the initiation of treatment and again after completion of treatment. Results: In total, 116 patients with TB and 86 control subjects were recruited. The median 25-OHD concentration was not different in TB patients at diagnosis (13.9 ng/mL; interquartile range (IQR) 8.80-21.8) compared with control subjects (13.2 ng/mL; IQR 9.6-19.3) ( P = 0.97). The frequency of vitamin D deficiency (≤10 ng/mL) was also not different in TB patients (36.2%) compared with controls (27.3%) ( P = 0.21). In TB patients, the median 25-OHD concentration decreased significantly during treatment, to 12.5 ng/mL at 1 month and 11.0 ng/mL on completion of treatment ( P = 0.01). Conclusions: Vitamin D levels do not appear to be associated with the development of TB in the Korean population. The median 25-OHD concentration decreased after treatment for TB. [ABSTRACT FROM AUTHOR]