Initial results of secukinumab drug survival in patients with psoriasis: A multicentre daily practice cohort study

Interleukin 17-antagonist secukinumab demonstrated high efficacy for treatment of psoriasis in randomized controlled trials. However, performance in daily practice may differ from trials. Drug survival is a comprehensive outcome covering effectiveness and safety, suitable for analyses of daily practice. The aim of this study was to evaluate drug survival of secukinumab in a daily practice psoriasis cohort. Data were collected from 13 hospitals. Drug survival was analysed using Kaplan–Meier survival curves, split for reason of discontinuation. In total, 196 patients were included (83% biologic experienced). Overall, 12 and 18 months drug survival of secukinumab was 76% and 67%, respectively, and was mostly determined by ineffectiveness. There was a trend towards shorter drug survival in women and in biologic experienced patients. Thirteen percent of patients experienced at least one episode of fungal infection. This is one of the first studies of drug survival of secukinumab in patients with psoriasis treated in daily practice

The Introduction of Bioptic Driving in the Netherlands

Background: In many US states, people with moderately reduced visual acuity (eg, 20/50–20/200) can legally drive with the aid of a small, spectacle-mounted (“bioptic”) telescope.We conducted a demonstration project to assess the viability of implementing bioptic driving in the Netherlands. In this article, we describe the framework of the project from conception through to realization of our primary objective—the introduction of bioptic driving as a legal option for visually impaired people in the Netherlands. Methods: The project was based on bioptic driving programs in the United States, which were adapted to fit into current driving training and assessment practices in the Netherlands. The project convened a consortium of organizations including the Netherlands Bureau of Driving Skills Certificates, service organizations for the visually impaired, and research departments at universities investigating driving and vision. All organizations were educated about bioptic driving and participating professionals were trained in their specific aspects of the project. Media publicity led to significant interest and helped recruitment that enabled the screening and selection of potential participants. Outcomes: The project demonstrated that people with moderately reduced visual acuity can be trained to achieve an adequate level of proficient and safe driving (as assessed by the local official driving licensing professionals) when using a bioptic telescope for the road conditions in the Netherlands. Based on the successful project outcomes, a request was made to the minister to allow bioptic driving in the Netherlands. This request has been accepted; the legal procedures for implementation are in process

3-D contrast enhanced ultrasound imaging of an in vivo chicken embryo with a sparse array and deep learning based adaptive beamforming

3-D contrast enhanced ultrasound enables better visualization of inherently 3-D vascular geometries compared to an intersecting plane. Additionally, it would allow the application of motion correction techniques for all directions. Both contrast detection and motion correction work better on high-frame rate data. However high-frame rate 3-D ultrasound imaging with dense matrix arrays is challenging to realize. Sparse arrays alleviate some of the limitations in cable count and data rate that fully populated arrays encounter, but their increased level of secondary lobes negatively impacts image contrast. Meanwhile the use of unfocused transmit beams needed to achieve high-frame rates negatively impacts resolution. Here we propose to use adaptive beamforming by deep learning (ABLE) to improve the image quality of contrast enhanced ultrasound images acquired with a sparse spiral array. We train the neural network on simulated data and evaluate simulated images and in vivo images of an ex ovo chicken embryo. ABLE improved resolution compared to delay-and-sum (DAS) and spatial coherence (SC) beamforming on the simulated and in vivo data. The qualitative improvements persist after histogram matching, indicating that the image quality improvement of the ABLE images was not purely due to dynamic range stretching. Green Open Access added to TU Delft Institutional Repository ‘You share, we take care!’ – Taverne project https://www.openaccess.nl/en/you-share-we-take-care Otherwise as indicated in the copyright section: the publisher is the copyright holder of this work and the author uses the Dutch legislation to make this work public.ImPhys/Imaging PhysicsImPhys/Medical Imagin

A Demonstration Project on Driving with Reduced Visual Acuity and a Bioptic Telescope System in the Netherlands

Background: In Europe, driving a passenger car is prohibited if binocular best corrected visual acuity (BCVA) is below 0.5 (20/40). Some US states allow people with reduced visual acuity to use a bioptic telescope system when driving. The aim of our study is to introduce a bioptic telescope system for driving in the Netherlands and to investigate whether it enables people with reduced visual acuity to gain sufficient practical fitness to drive in a European setting. Results:Out of 378 persons who applied for information following media attention for the project, 160 candidates volunteered to participate. Based on the available information, 36 subjects (binocular BCVA: 0.16–0.5 [20/125–20/40]) were invited for assessment (vision, mobility, cognitive function, and driving skills). Of these, 16 did not meet the inclusion criteria and 2 decided not to participate. The remaining 18 subjects were trained in the use of a monocular bioptic telescope (3×magnification). They all completed the predriving training successfully and received driving lessons from specialized professional driving instructors. Eventually, 9 subjects passed the official on-road test of practical fitness to drive, 7 were excluded after a number of driving lessons, and another 2 withdrew on their own initiative. Conclusion: This is the first study in Europe to prepare subjects with reduced visual acuity to drive with the use of a bioptic telescope system. About 55% of the preselected subjects fulfilled all inclusion criteria. Half of the subjects who entered the bioptic training program passed the official fitness to drive test, demonstrating that they could drive smoothly and safely in Dutch traffic using a bioptic telescope system.