A randomized, open-label, pragmatic study to assess reliever-triggered inhaled corticosteroid in African American/Black and Hispanic/Latinx adults with asthma: Design and methods of the PREPARE trial

BACKGROUND: Asthma prevalence, morbidity, and mortality disproportionately impact African American/Black (AA/B) and Hispanic/Latinx (H/L) communities. Adherence to daily inhaled corticosteroid (ICS), recommended by asthma guidelines in all but the mildest cases of asthma, is generally poor. As-needed ICS has shown promise as a patient-empowering asthma management strategy, but it has not been rigorously studied in AA/B or H/L patients or in a real-world setting. Design and Aim: The PeRson EmPowered Asthma RElief (PREPARE) Study is a randomized, open-label, pragmatic study which aims to assess whether a patient-guided, reliever-triggered ICS strategy called PARTICS (Patient-Activated Reliever-Triggered Inhaled CorticoSteroid) can improve asthma outcomes in AA/B and H/L adult patient populations. In designing and implementing the study, the PREPARE research team has relied heavily on advice from AA/B and H/L Patient Partners and other stakeholders. Methods: PREPARE is enrolling 1200 adult participants (600 AA/Bs, 600H/Ls) with asthma. Participants are randomized to PARTICS + Usual Care (intervention) versus Usual Care (control). Following a single in-person enrollment visit, participants complete monthly questionnaires for 15 months. The primary endpoint is annualized asthma exacerbation rate. Secondary endpoints include asthma control; preference-based quality of life; and days lost from work, school, or usual activities. Discussion: The PREPARE study features a pragmatic design allowing for the real-world assessment of a patient-centered, reliever-triggered ICS strategy in AA/B and H/L patients. Outcomes of this study have the potential to offer powerful evidence supporting PARTICS as an effective asthma management strategy in patient populations that suffer disproportionately from asthma morbidity and mortality

Risk of pneumonia in obstructive lung disease : A real-life study comparing extra-fine and fine-particle inhaled corticosteroids

The study received institutional support from Teva Pharmaceuticals Europe B.V. Teva did not contribute either in part or in whole, to the collection, analysis, or interpretation of study data, manuscript writing, or the decision to submit the manuscript for publication. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Peer reviewedPublisher PD

Preclinical Evaluation of Spatial Frequency Domain-Enabled Wide-Field Quantitative Imaging for Enhanced Glioma Resection

5-Aminolevelunic acid-induced protoporphyrin IX (PpIX) fluorescence-guided resection (FGR) enables maximum safe resection of glioma by providing real-time tumor contrast. However, the subjective visual assessment and the variable intrinsic optical attenuation of tissue limit this technique to reliably delineating only high-grade tumors that display strong fluorescence. We have previously shown, using a fiber-optic probe, that quantitative assessment using noninvasive point spectroscopic measurements of the absolute PpIX concentration in tissue further improves the accuracy of FGR, extending it to surgically curable low-grade glioma. More recently, we have shown that implementing spatial frequency domain imaging with a fluorescent-light transport model enables recovery of two-dimensional images of [PpIX], alleviating the need for time-consuming point sampling of the brain surface. We present first results of this technique modified for in vivo imaging on an RG2 rat brain tumor model. Despite the moderate errors in retrieving the absorption and reduced scattering coefficients in the subdiffusive regime of 14% and 19%, respectively, the recovered [PpIX] maps agree within 10% of the point [PpIX] values measured by the fiber-optic probe, validating its potential as an extension or an alternative to point sampling during glioma resection

Small-particle Inhaled Corticosteroid as First-line or Step-up Controller Therapy in Childhood Asthma

Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.Peer reviewedPublisher PD

Self-Efficacy and Openness to Experience as Antecedent of Study Engagement: An Exploratory Analysis

AbstractPrevious research provides evidence for the association between openness to experience (OTE) and study engagement (SI People who are open to experience could perceive demands as challenges through which they can learn and broaden tht resources promoting engagement. We hypothesized that self-efficacy will fully mediates the relationship of OTE and SE. A tw wave study was conducted with 37 students. The path analysis shows that self-efficacy fully mediates the relationship betwe OTE and SE both times. This suggests that when people are willing to experience new things, tend to be more engaged if th believe they are capable of overcome the event

eosinophil derived neurotoxin and clinical outcomes with mepolizumab in severe eosinophilic asthma

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Molecular Counterparts of Ultracompact HII Regions with Extended Envelopes

We carried out 13CO J=1-0, CS, and C34S J=2-1 and J=3-2 line observations of molecular clouds associated with 16 ultracompact (UC) HII regions with extended envelopes. The molecular clouds are the ones that give birth to rich stellar clusters and/or very massive (O7-O4) stars. Our data show that the clouds are very clumpy and of irregular morphology. They usually have much larger masses, velocity dispersions, and fractions of dense gas than molecular clouds that form early B or late O stars. This is compatible with earlier findings that more massive stars form in more massive cores. 13CO cores are in general associated with compact HII regions regardless of the presence of UC HII regions therein. In contrast, CS cores are preferentially associated with compact HII regions that contain UC HII regions. As with the fact that the compact HII regions containing UC HII regions are more compact than those not associated with UC HII regions, these indicate that the former may be in an earlier evolutionary phase than the latter. The diffuse extended envelopes of HII regions often develop in the direction of decreasing molecular gas density. Based on detailed comparison of molecular line data with radio continuum and recombination line data, the extended ionized envelopes are likely the results of champagne flows in at least 10 sources in our sample. Together these results appear to support a published suggestion that the extended emission around UC HII regions can be naturally understood by combining the champagne flow model with the hierarchical structure of molecular clouds. We discuss the implication of our results for the blister model of HII regions.Comment: 36 pages, including 30 figures, accepted for publication in Ap

Relation between eating evoked by lateral hypothalamic stimulation and tail pinch in different rat strains

The similarity between the behaviors evoked by tail pinch (TP) and electrical stimulation of the lateral hypothalamus (ESLH) has been noted by many investigators. Evidence is presented for a possible inverse relationship between the probability that ESLH would evoke eating and the readiness to eat in response to TP in six different rat populations (High and Low lines of the LC1 and LC2 Hebrew University Strains, Sprague--Dawley, and Long--Evans). Discussion of these results emphasizes differences in intensity between ESLH and TP stimulation and differences in emotionality among rat populations.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/24047/1/0000296.pd

Impact of botanical oils on polyunsaturated fatty acid metabolism and leukotriene generation in mild asthmatics

Background: Dietary supplementation with botanical oils that contain n-6 and n-3 eighteen carbon chain (18C)-PUFA such as γ linolenic acid (GLA, 18:3n-6), stearidonic acid (SDA, 18:4n-3) and α linolenic acid (ALA, 18:3n-3) have been shown to impact PUFA metabolism, alter inflammatory processes including arachidonic acid (AA) metabolism and improve inflammatory disorders. Methods: The diet of mild asthmatics patients was supplemented for three weeks with varying doses of two botanical seed oils (borage oil [Borago officinalis, BO] and echium seed oil [Echium plantagineum; EO]) that contain SDA, ALA and GLA. A three week wash out period followed. The impact of these dietary manipulations was evaluated for several biochemical endpoints, including in vivo PUFA metabolism and ex vivo leukotriene generation from stimulated leukocytes. Results: Supplementation with several EO/BO combinations increased circulating 20–22 carbon (20–22C) PUFAs, including eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA), and dihommo-gammalinolenic acid (DGLA), which have been shown to inhibit AA metabolism and inflammation without impacting circulating AA levels. BO/EO combinations also inhibited ex vivo leukotriene generation with some combinations attenuating cysteinyl leukotriene generation in stimulated basophils by >50% and in stimulated neutrophils by >35%. Conclusions: This study shows that dietary supplementation with BO/EO alters 20–22C PUFA levels and attenuates leukotriene production in a manner consistent with a reduction in inflammation