274 research outputs found

    Safety and efficacy of dexpramipexole in eosinophilic asthma (EXHALE): a randomized controlled trial

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    BACKGROUND: There is a need for new and effective oral asthma therapies. Dexpramipexole, an oral eosinophil-lowering drug, has not previously been studied in asthma. OBJECTIVE: We sought to evaluate the safety and efficacy of dexpramipexole in lowering blood and airway eosinophilia in subjects with eosinophilic asthma. METHODS: We performed a randomized, double-blind, placebo-controlled proof-of-concept trial in adults with inadequately controlled moderate to severe asthma and blood absolute eosinophil count (AEC) greater than or equal to 300/μL. Subjects were randomly assigned (1:1:1:1) to dexpramipexole 37.5, 75, or 150 mg BID (twice-daily) or placebo. The primary end point was the relative change in AEC from baseline to week 12. Prebronchodilator FEV1 week-12 change from baseline was a key secondary end point. Nasal eosinophil peroxidase was an exploratory end point. RESULTS: A total of 103 subjects were randomly assigned to dexpramipexole 37.5 mg BID (N = 22), 75 mg BID (N = 26), 150 mg BID (N = 28), or placebo (N = 27). Dexpramipexole significantly reduced placebo-corrected AEC week-12 ratio to baseline, in both the 150-mg BID (ratio, 0.23; 95% CI, 0.12-0.43; P < .0001) and the 75-mg BID (ratio, 0.34; 95% CI, 0.18-0.65; P = .0014) dose groups, corresponding to 77% and 66% reductions, respectively. Dexpramipexole reduced the exploratory end point of nasal eosinophil peroxidase week-12 ratio to baseline in the 150-mg BID (median, 0.11; P = .020) and the 75-mg BID (median, 0.17; P = .021) groups. Placebo-corrected FEV1 increases were observed starting at week 4 (nonsignificant). Dexpramipexole displayed a favorable safety profile. CONCLUSIONS: Dexpramipexole demonstrated effective eosinophil lowering and was well tolerated. Additional larger clinical trials are needed to understand the clinical efficacy of dexpramipexole in asthma

    Neutron and Photon Transport in Sea-Going Cargo Containers

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    Factors affecting sensing of small quantities of fissionable material in large sea-going cargo containers by neutron interrogation and detection of {beta}-delayed photons are explored. The propagation of variable-energy neutrons in cargos, subsequent fission of hidden nuclear material and production of the {beta}-delayed photons, and the propagation of these photons to an external detector are considered explicitly. Detailed results of Monte Carlo simulations of these stages in representative cargos are presented. Analytical models are developed both as a basis for a quantitative understanding of the interrogation process and as a tool to allow ready extrapolation of the results to cases not specifically considered here

    A Compton-vetoed germanium detector with increased sensitivity at low energies

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    The difficulty to directly detect plutonium in spent nuclear fuel due to the high Compton background of the fission products motivates the design of a Gamma detector with improved sensitivity at low energies. We have built such a detector by operating a thin high-purity Ge detector with a large scintillator Compton veto directly behind it. The Ge detector is thin to absorb just the low-energy Pu radiation of interest while minimizing Compton scattering of high energy radiation from the fission products. The subsequent scintillator is large so that forward scattered photons from the Ge detector interact in it at least once to provide an anti-coincidence veto for the Ge detector. For highest sensitivity, additional material in the line-of-sight is minimized, the radioactive sample is kept thin, and its radiation is collimated. We will discuss the instrument design, and demonstrate the feasibility of the approach with a prototype that employs two large CsI scintillator vetoes. Initial spectra of a thin Cs-137 calibration source show a background suppression of a factor of {approx}2.5 at {approx}100 keV, limited by an unexpectedly thick 4 mm dead layer in the Ge detector
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