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Rationale: Inhaled nitric oxide (iNO) has been shown to result in benefits in moderate to vigorous physical activity (MVPA) in patients with fibrotic interstitial lung disease (f-ILD) receiving supplemental oxygen in two independent trials. Objective: This phase III randomized, double-blind, placebo-controlled study sought to validate the benefit of ambulatory iNO in patients with f-ILD requiring supplemental oxygen. Methods: Patients with f-ILD receiving supplemental long-term oxygen were randomized in a 1:1 fashion to iNO at 45 μg/kg ideal body weight per hour or placebo for 16 weeks. The primary outcome was the change from baseline to Week 16 in MVPA assessed by accelerometry. Secondary outcomes included overall activity, 6-minute-walk distance and patient-reported outcomes. Results: 145 patients were enrolled; 75 were assigned to receive iNO and 70 placebo. The changes from baseline in MVPA at 16 weeks were −9.2 min/d (standard error, 3.51) in the iNO45 group and −3.7 min/d (3.76) in the placebo group (difference, 5.5; P = 0.265). No statistically significant differences between the two treatment arms were found for any of the secondary outcomes. A subgroup analysis of patients with an intermediate or high probability of pulmonary hypertension on echocardiography did not demonstrate any benefit. The most common adverse events reported were respiratory tract infections, but the therapy was generally very well tolerated. Conclusions: There was no demonstrable benefit to iNO in patients with f-ILD receiving supplemental oxygen in daily physical activity assessed by actigraphy, a potential novel clinical trial endpoint. Clinical trial registered with (NCT 03267108). [ABSTRACT FROM AUTHOR]

In order to improve the wear and frictional behavior of the aluminum metal matrix composites, carbon nanotube, and fly ash were added as reinforcements. Powder metallurgy technique was used to fabricate the hybrid metal matrix composites. Experimentations were carried out using pin on disc type wear test rig. The analyzed experimental results showed that, in comparison to the pure aluminum and mono reinforcement combination, the wear loss and coefficient of friction of hybrid metal matrix composites were greatly reduced. It was noted that compared to pure aluminum wear loss was decreased to 89.58%, 86.97%, 83.3% by adding 0.25, 0.5, 0.75 wt% carbon nanotube (CNT), respectively. By the addition of 4, 8 and 16 wt% FA to pure Al wear loss was decreased to 83.85%, 89.58%, and 78.12%, respectively. It was also noted that compared to Al/8 wt% FA mono reinforced composites, wear loss was decreased to 77%, 71.26%, and 53.22% with the addition of 0.25, 0.5, 0.75 wt% CNT, respectively. With the addition of 4, 8, 16 wt% FA, wear loss decreased to 81%, 88%, and 75% over Al/0.25 wt% CNT composites, respectively. The microstructural study of the worn‐out surfaces revealed low abrasive and adhesive wear by the presence of carbon nanotubes and fly ash in aluminum metal matrix. The reinforcing mechanisms of the wear and frictional properties were also discussed. [ABSTRACT FROM AUTHOR]

Pulmonary hypertension (PH) associated with interstitial lung disease (ILD) is an attractive target for clinical trials of PH medications. There are many factors that need to be considered to prime such studies for success. The patient phenotype most likely to respond to the intervention requires weighing the extent of the parenchymal lung disease against the severity of the hemodynamic impairment. The inclusion criteria should not be too restrictive, thus enabling recruitment. The trial should be of sufficient duration to meet the chosen endpoint which should reflect how the patient feels, functions, or survives. This paper summarizes prior studies in PH-ILD and provides a framework of the type of studies to be considered. Inclusion criteria, clinical trial endpoints, and pharmacovigilance in the context of PH-ILD trials are also addressed. Through lessons learnt from prior studies, suggestions and guidance for future clinical trials in PH-ILD are also provided. [ABSTRACT FROM AUTHOR]

A 46-year-old man presented with worsening vision in the context of long-standing optic disc changes, bilateral sensorineural hearing loss, chronic aseptic meningitis, rash, arthralgia and raised inflammatory markers. The differential diagnoses of neoplasia, infection and inflammation are discussed. We highlight a condition that can present to adult neurologists, with successful diagnosis leading to targeted treatments that transform patient outcomes. This case was presented at the Association of British Neurologists Annual Meeting 2020 as a Clinicopathological Conference (CPC). [ABSTRACT FROM AUTHOR]

Immunohistochemical and immunogold labeling electron microscopy was utilized to determine the distribution and function of cysteine-rich intestinal protein (CRIP) in rat IEC-6 intestinal epithelial cell lines. Analysis of rats IEC-6 indicated the presence of CRIP in the cytoplasmic granules of Paneth cells and epithelium of the villus tip. Furthermore, CRIP was also detected in murine RAW 264.7 mononuclear macrophage cell lines indicating the role of the protein in mediating host defense and tissue differentiation.