Asthma-Related Outcomes in Patients Initiating Extrafine Ciclesonide or Fine-Particle Inhaled Corticosteroids

Dirkje S. Postma,Richard Dekhuijzen,Thys van der Molen,Richard J. Martin,Wim van Aalderen,Nicolas Roche,Theresa W. Guilbert,Elliot Israel,Daniela van Eickels,Javaria Mona Khalid,Ron M.C. Herings,Jetty 대한천식알레르기학회 2017 Allergy, Asthma & Immunology Research Vol.9 No.2

Purpose: Extrafine-particle inhaled corticosteroids (ICS) have greater small airway deposition than standard fine-particle ICS. We sought to compare asthma-related outcomes after patients initiated extrafine-particle ciclesonide or fine-particle ICS (fluticasone propionate or non-extrafine beclomethasone). Methods: This historical, matched cohort study included patients aged 12-60 years prescribed their first ICS as ciclesonide or fineparticle ICS. The 2 cohorts were matched 1:1 for key demographic and clinical characteristics over the baseline year. Co-primary endpoints were 1-year severe exacerbation rates, risk-domain asthma control, and overall asthma control; secondary endpoints included therapy change. Results: Each cohort included 1,244 patients (median age 45 years; 65% women). Patients in the ciclesonide cohort were comparable to those in the fineparticle ICS cohort apart from higher baseline prevalence of hospitalization, gastroesophageal reflux disease, and rhinitis. Median (interquartile range) prescribed doses of ciclesonide and fine-particle ICS were 160 (160-160) μg/day and 500 (250-500) μg/day, respectively (P<0.001). During the outcome year, patients prescribed ciclesonide experienced lower severe exacerbation rates (adjusted rate ratio [95% CI], 0.69 [0.53-0.89]), and higher odds of risk-domain asthma control (adjusted odds ratio [95% CI], 1.62 [1.27-2.06]) and of overall asthma control (2.08 [1.68-2.57]) than those prescribed fine-particle ICS. The odds of therapy change were 0.70 (0.59-0.83) with ciclesonide. Conclusions: In this matched cohort analysis, we observed that initiation of ICS with ciclesonide was associated with better 1-year asthma outcomes and fewer changes to therapy, despite data suggesting more difficult-to-control asthma. The median prescribed dose of ciclesonide was one-third that of fine-particle ICS.

The Horizontal Branch Population of NGC 1851 as Revealed by the Ultraviolet Imaging Telescope (UVIT)

Subramaniam, Annapurni,Sahu, Snehalata,Postma, Joseph E.,Cô,té,, Patrick,Hutchings, J. B.,Darukhanawalla, N.,Chung, Chul,Tandon, S. N.,Rao, N. Kameswara,George, K.,Ghosh, S. K.,Girish, V.,M American Astronomical Society 2017 The Astronomical journal Vol.154 No.6

<P>We present the UV photometry of the globular cluster NGC 1851 using images acquired with the Ultraviolet Imaging Telescope (UVIT) onboard the ASTROSAT satellite. Point-spread function fitting photometric data derived from images in two far-UV (FUV) filters and one near-UV (NUV) filter are used to construct color-magnitude diagrams (CMDs), in combination with HST and ground-based optical photometry. In the FUV, we detect only the bluest part of the cluster horizontal branch (HB); in the NUV, we detect the full extent of the HB, including the red HB, blue HB, and a small number of RR Lyrae stars. UV variability was detected in 18 RR Lyrae stars, and three new variables were also detected in the central region. The UV/optical CMDs are then compared with isochrones of different age and metallicity (generated using Padova and BaSTI models) and synthetic HB (using helium-enhanced Y2 models). We are able to identify two populations among the HB stars, which are found to have either an age range of 10-12. Gyr, or a range in Y-ini of 0.23-0.28, for a metallicity of [Fe/H] = -1.2 to -1.3. These estimations from the UV CMDs are consistent with those from optical studies. The almost-complete sample of the HB stars tends to show a marginal difference in spatial/azimuthal distribution among the blue and red HB stars. Thus, this study showcases the capability of UVIT, with its excellent resolution and large field of view, to study the hot stellar population in Galactic globular clusters.</P>

Experimental evaluation of RAFT-based Poly(<i>N</i>-isopropylacrylamide) (PNIPAM) kinetic hydrate inhibitors

Park, Juwoon,Kim, Hyunho,da Silveira, Kelly Cristine,Sheng, Qi,Postma, Almar,Wood, Colin D.,Seo, Yutaek Elsevier 2019 Fuel Vol.235 No.-

<P><B>Abstract</B></P> <P>As the oil and gas industry produces hydrocarbons from deeper waters and colder regions the issue of hydrate formation becomes more serious. As a result, hydrate inhibition has focused on kinetic hydrate inhibitors (KHI) and anti-agglomerants (AA) as an alternative to the existing approaches which involves injecting vast quantities of thermodynamic inhibitors. In this research, we evaluated the effect of different architectures (linear and branched) of poly(<I>N</I>-isopropylacrylamide) (PNIPAM) polymers synthesized using reversible addition−fragmentation chain-transfer (RAFT) polymerization. Unlike non-reversible deactivation radical polymerisation (RDRP) synthetic routes this generates accurately controlled KHI candidates with target molecular weight, narrow molecular weight distributions and controlled architecture, so that the effect on hydrate inhibition can be more accurately assessed. The RAFT-based polymers (linear and branched) were compared to a commercially available linear PNIPAM synthesized <I>via</I> non-RDRP radical polymerization and control groups (pure water, PVP, and Luvicap). The hydrate experiments were performed in a high pressure autoclave with continuous cooling under different cooling rates (0.25 K/min, 0.033 K/min, and 0.017 K/min). In addition, a cold restart was simulated using constant subcooling. The results regarding subcooling temperature, onset time, and hydrate fraction with resistance-to-flow were compared to known KHIs. These revealed that a linear PNIPAM-MacroRAFT polymer delayed the hydrate nucleation with similar performance to known KHIs (eg., PVP and Luvicap). However, a branched polymer showed the best performance in terms of hydrate fraction and resistance-to-flow among all of the systems tested in this study. These data provide valuable information regarding linear and branched PNIPAM-MacroRAFT polymers by demonstrating their ability to delay hydrate formation but also in preventing hydrate agglomeration. These findings confirm that polymer architecture can effect hydrate inhibition.</P> <P><B>Highlights</B></P> <P> <UL> <LI> RAFT polymerization was applied to generate architecturally defined KHIs. </LI> <LI> Linear and branched PNIPAM were fully evaluated while varying the cooling rate. </LI> <LI> Our results suggest a possible new mechanism for managing hydrate formation with a branched PNIPAM. </LI> <LI> This study provided a better understanding of the architecture-property effect on hydrate prevention. </LI> </UL> </P>

Dual-Energy CT Angiography Improves Accuracy of Spot Sign for Predicting Hematoma Expansion in Intracerebral Hemorrhage

Michaël T.J. Peeters,Kim J.D. de Kort,Rik Houben,Wouter J.P. Henneman,Robert J. van Oostenbrugge,Julie Staals,Alida A. Postma 대한뇌졸중학회 2021 Journal of stroke Vol.23 No.1

Background and Purpose: Spot sign (SS) on computed tomography angiography (CTA) is associated with hematoma expansion (HE) and poor outcome after intracerebral hemorrhage (ICH). However, its predictive performance varies across studies, possibly because differentiating hyperdense hemorrhage from contrast media is difficult. We investigated whether dual-energy-CTA (DE-CTA),which can separate hemorrhage from iodinated contrast, improves the diagnostic accuracy of SS for predicting HE. Methods: Primary ICH patients undergoing DE-CTA (both arterial as well as delayed venous phase) and follow-up computed tomography were prospectively included between 2014 and 2019. SS was assessed on both arterial and delayed phase images of the different DE-CTA datasets, i.e., conventional-like mixed images, iodine images, and fusion images. Diagnostic accuracy of SS for prediction of HE was determined on all datasets. The association between SS and HE, and between SS and poor outcome (modified Rankin Scale at 3 months ≥3) was assessed with multivariable logistic regression, using the dataset with highest diagnostic accuracy. Results: Of 139 included patients, 47 showed HE (33.8%). Sensitivity of SS for HE was 32% (accuracy 0.72) on conventional-like mixed arterial images which increased to 76% (accuracy 0.80) on delayed fusion images. Presence of SS on delayed fusion images was independently associated with HE (odds ratio [OR], 17.5; 95% confidence interval [CI], 6.14 to 49.82) and poor outcome (OR, 3.84;95% CI, 1.16 to 12.73). Conclusions: Presence of SS on DE-CTA, in particular on delayed phase fusion images, demonstrates higher diagnostic performance in predicting HE compared to conventional-like mixed imaging, and it is associated with poor outcome.