Anti-IL-4R versus Anti-IL-5/5R after Anti-IL-5/5R failure in asthma: an emulated target trial.

BACKGROUND: Switching biologics is now common practice in severe eosinophilic asthma. After insufficient response to anti-interleukin 5 or 5 receptor (anti-IL-5/5R), the optimal switch between an anti-IL-4R monoclonal antibody (mAb) (inter-class) or another anti-IL-5/5R drug (intra-class) remains unknown. OBJECTIVE: We compared the effectiveness of these two strategies on asthma control in patients with severe eosinophilic asthma and insufficient response to an anti-IL-5/5R mAb. METHODS: We emulated a target randomized trial using observational data from the RAMSES Cohort. Eligible patients were switched to an anti-IL-4R mAb or another anti-IL-5/5R drug after insufficient response to an anti-IL-5/5R mAb. The primary outcome was the change in Asthma Control Test (ACT) score at 6 months. RESULTS: Among the 2046 patients in the cohort, 151 were included in the study: 103 switched to an anti-IL-4R mAb and 48 to another anti-IL-5/5R. At 6 months, the difference in ACT score improvement was not statistically significant (mean difference groups, 0.82 [-0.47,2.10], p=0.213). The inter-class group exhibited greater cumulative reduction in oral corticosteroids dose (Pinter-intra -1.05g [-1.76, -0.34], p=0.041). The inter-class group had a better effect, although not significantly, on reducing exacerbations (Δinter-intra -0.37 [-0.77, 0.02], p=0.124) and increasing lung function (FEV1) (126.8 ml [-12.7, 266.4], p=0.124). CONCLUSION: After anti-IL-5/5R mAb insufficient response, switching to dupilumab demonstrated similar improvement in ACT scores compared to intra-class switching. However, it appeared more effective in reducing oral corticosteroid use. Larger studies are warranted to confirm these results.

Removal of Cr(VI) from Aqueous Solutions Using Amino-Functionalized Carbon Nanospheres Adsorbents.

Carbon nanospheres were prepared and functionalized with carboxyl acid groups (CNS-CA), then reacted with 3-aminopropyltriethoxysilane to introduce amino groups onto the surface (CNS-NH2) by post-synthesis grafting. CNS-NH2 was acidified in order to convert the amino groups (-NH2) into ammonium moieties (). Various techniques such as N2 physisorption, X-ray diffraction, Fourier transform infrared spectroscopy, Raman spectroscopy, thermogravimetry, X-ray photoelectron spectroscopy, and transmission electron microscopy were used to characterize the nanospheres. The removal of chromium ions from aqueous solution using was investigated. Factors influencing the uptake of Cr(VI) ions such as solution pH, adsorbent dose, and initial Cr(VI) ion concentration were investigated. Equilibrium adsorption data fitted the Langmuir model very well. The adsorption maximum capacity of Cr(VI) was found to be 52.38 mg/g. The reusability of results indicated that it can be reused five times successfully without loss of adsorption capacity.

Severe asthma care trajectories: the French RAMSES cohort.

Background: The French RAMSES study is an observational prospective multicentre real-life cohort including severe asthmatic subjects. The objective of the study was to compare the characteristics of patients, in terms of phenotype and asthma care trajectories, between those managed by tertiary referral centres (TRCs) or secondary care centres (SCCs). Methods: Patients were prospectively recruited and enrolled for a 5-year follow-up. Patients' characteristics were analysed at inclusion and compared between TRCs and SCCs. Results: 52 centres (24 TRCs and 28 SCCs) included 2046 patients: 1502 (73.4%) were included by a TRC and 544 (26.6%) by a SCC. Patients were mainly women (62%), 53±15 years old, 67% with Asthma Control Test <20; at inclusion, 14% received oral corticosteroids (OCS) and 66% biologics. Compared with the SCC group, the TRC group had more frequent comorbidities and lower blood eosinophil counts (262 versus 340 mm-3; p=0.0036). OCS and biologics use did not differ between groups, but patients in the TRC group benefited more frequently from an educational programme (26% versus 18%; p=0.0008) and received more frequently two or more sequential lines of biologics (33% versus 24%; p=0.0105). In-depth investigations were more frequently performed in the TRC group (allergy tests: 74% versus 62%; p<0.0001; exhaled nitric oxide fraction: 56% versus 21%; p<0.0001; induced sputum: 6% versus 3%; p=0.0390). Conclusions: Phenotypes and care trajectories differed in the RAMSES cohort between SCCs and TRCs, probably related to different levels of asthma severity and differences in medical resources and practices among centres. This highlights the need for standardisation of severe asthma care.

Enhanced reactivity of the CuO-Fe2O3 intimate heterojunction for the oxidation of quinoline yellow dye (E104).

This research work describes the degradation of quinoline yellow (QY) in aqueous solutions by the heterogeneous Fenton and photo-Fenton processes in the presence of CuO/Fe2O3 photocatalyst. CuO/Fe2O3 derived from LDH structure was synthesized by the co-precipitation method. The physiochemical characteristics of CuO/Fe2O3 were described by XRD, TEM/SEM, BET surface area, and FTIR techniques. The effects of pH, H2O2 concentration, dye concentration, catalyst dose, reaction temperature, and reusability of catalyst on the QY decolorization efficiency were studied. The results indicated that a complete removal of QY was achieved within 150 min, when the H2O2 and QY concentrations were 27.6 mM and 100 mg/L, respectively. The rate constants for QY removal by the heterogeneous Fenton system were calculated, and the experimental data were found to fit the pseudo-first order model. Under optimal conditions, the rate constants were, respectively, 0.02032 and 0.01715 min-1 for the photo-Fenton and Fenton systems; this means that the addition of light has not a noticeable effect.

A Definitive Prognostication System for Patients With Thoracic Malignancies Diagnosed With Coronavirus Disease 2019: An Update From the TERAVOLT Registry.

INTRODUCTION: Patients with thoracic malignancies are at increased risk for mortality from coronavirus disease 2019 (COVID-19), and a large number of intertwined prognostic variables have been identified so far. METHODS: Capitalizing data from the Thoracic Cancers International COVID-19 Collaboration (TERAVOLT) registry, a global study created with the aim of describing the impact of COVID-19 in patients with thoracic malignancies, we used a clustering approach, a fast-backward step-down selection procedure, and a tree-based model to screen and optimize a broad panel of demographics and clinical COVID-19 and cancer characteristics. RESULTS: As of April 15, 2021, a total of 1491 consecutive eligible patients from 18 countries were included in the analysis. With a mean observation period of 42 days, 361 events were reported with an all-cause case fatality rate of 24.2%. The clustering procedure screened 73 covariates in 13 clusters. A further multivariable logistic regression for the association between clusters and death was performed, resulting in five clusters significantly associated with the outcome. The fast-backward step-down selection procedure then identified the following seven major determinants of death: Eastern Cooperative Oncology Group-performance status (ECOG-PS) (OR = 2.47, 1.87-3.26), neutrophil count (OR = 2.46, 1.76-3.44), serum procalcitonin (OR = 2.37, 1.64-3.43), development of pneumonia (OR = 1.95, 1.48-2.58), C-reactive protein (OR = 1.90, 1.43-2.51), tumor stage at COVID-19 diagnosis (OR = 1.97, 1.46-2.66), and age (OR = 1.71, 1.29-2.26). The receiver operating characteristic analysis for death of the selected model confirmed its diagnostic ability (area under the receiver operating curve = 0.78, 95% confidence interval: 0.75-0.81). The nomogram was able to classify the COVID-19 mortality in an interval ranging from 8% to 90%, and the tree-based model recognized ECOG-PS, neutrophil count, and c-reactive protein as the major determinants of prognosis. CONCLUSIONS: From 73 variables analyzed, seven major determinants of death have been identified. Poor ECOG-PS was found to have the strongest association with poor outcome from COVID-19. With our analysis, we provide clinicians with a definitive prognostication system to help determine the risk of mortality for patients with thoracic malignancies and COVID-19.

Elaboration and characterization of photobiocomposite beads, based on titanium (IV) oxide and sodium alginate biopolymer, for basic blue 41 adsorption/photocatalytic degradation.

This study provides the preparation and profound characterization of an eco-friendly photobiocomposite beads named, titanium (IV) oxide/calcium alginate (TiO2/CaAlg), and the examination of their effectiveness for Basic Blue 41 (BB 41) adsorption/ photocatalytic degradation using sunlight like a renewable energy source. Chemical and physical characteristics of pure TiO2, pure CaAlg and TiO2/CaAlg beads were investigated using; X-ray diffraction (XRD), UV-visible diffuse reflectance spectra (UV-Vis DRS), scanning electron microscopy (SEM), attenuated total reflection spectroscopy (ATR), X-Ray photoelectron spectrometer (XPS), thermogravimetry (TGA) derivative thermogravimetry (DTG) and differential scanning calorimetry (DSC) analysis. Kinetic and isotherm models were evaluated using the non-linear model fitting analysis method. Effect of experimental parameters such as solution initial pH, BB 41 initial concentration, photobiocomposite dose on the BB 41 adsorption/photocatalytic degradation was investigated. Recycling capacity of TiO2/CaAlg photobiocomposite beads was tested. Results show that TiO2/CaAlg photobiocomposite is promising material for the BB 41 adsorption/photocatalytic degradation.

Sulfaquinoxaline oxidation by UV-C activated sodium persulfate: Degradation kinetics and toxicological evaluation.

This study evaluates the efficiency of sulfate radicals used in advanced oxidation process in water treatment. The targeted pollutant is an antibiotic, sulfaquinoxaline (SQ-Na) sodium, widely used in the veterinary field. The results show a degradation of SQ-Na until 90% after 300 min of irradiation at optimal sodium persulfate (SPS) concentration (200 mg/L). Degradation of the antibiotic obeys a pseudo-first-order kinetics when the concentration of sulfate radicals ranging from 0 to 240 mg/L. The decomposition of SQ-Na via the UV/SPS method is favored significantly under acidic conditions but becomes slow at neutral pH and almost inhibited under alkaline conditions. The contribution of the sulfate radicals alone and of both radicals hydroxyl and sulfate on the SQ-Na degradation is evaluated at 69% and 80%, respectively. Toxicity tests with Sinapis alba and Daphnia magna on treated samples, before and after irradiation, indicate the formation of new by-products more toxic during the treatment process. PRACTITIONER POINTS: SQ-Na was significantly degraded (90%) under UV/SPS system. SQ-Na decay exhibited a pseudo-first-order kinetics. SQ-Na was completely degraded via UV/SPS process under acidic conditions. The shoot growth appears to be more sensitive to oxidation by-products toxicity than root growth. Ineffectiveness in eliminating the ecotoxicity.

Photodegradation of organic pollutants in water and green hydrogen production via methanol photoreforming of doped titanium oxide nanoparticles.

Novel nanomaterials based on doped TiO2 nanoparticles with different morphological, textural and band-gap properties have been synthesized using scalable methods. The influence of synthetic parameters such as titanium source (titanium(IV) isopropoxide and titanium(IV) butoxide), doping quantity (0%, 2% or 5% Zn), acidic solution for the hydrolysis reaction (ascorbic acid, nitric acid) and calcination temperatures (500°C and 600°C) was simultaneously investigated. The obtained nanomaterials were characterized by different methods and photocatalytic tests of methylene blue (MB) degradation under UV-light were conducted to determine their activity. The results revealed that the synthesized nanomaterials are porous aggregates with very high crystallinity and are mainly composed of the anatase phase; although their physical properties vary depending on the different synthetic parameters employed. These changes are able to modify the apparent rate constant of the degradation of MB up to one order of magnitude, indicating, substantial changes in their photoactivity. Hybrid materials TiO2-Pd nanoparticles have also been prepared, characterized and tested for hydrogen production using photocatalytic methanol reforming where supported palladium nanoparticles acted as co-catalyst. Furthermore, the hybrid materials TiO2-Pd nanoparticles were studied in photocatalytic tests of methylene blue degradation under visible LED-light. The results obtained in the production of hydrogen from the photocatalytic reforming of methanol by hybrid materials suggest that the reported hybrid systems could be suitable photocatalysts for future sustainable hydrogen production upon tuning of the morphological, textural and band gap energy properties to allow processes to be carried out under visible light.