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Strange C, Tkacz J, Schinkel J, et al. Int J Chron Obstruct Pulmon Dis. 2023;18:2245–2256. The authors have advised that there are errors in the 95% CI interval values on page 2248. Results, Baseline and Follow-Up Exacerbation Rates, sentence 3, the text “Relative rates of total exacerbations for prompt were 0.76, 95% CI: (0.72 – 0.79) and 0.66, 95% CI: (0.63 – 0.69) versus delayed and very delayed” should read “Relative rates of total exacerbations for prompt were 0.76, 95% CI: (0.69 – 0.83) and 0.66, 95% CI: (0.60 – 0.72) versus delayed and very delayed”. Results, Baseline and Follow-Up Exacerbation Rates, sentence 5, the text “Relative rates of severe exacerbations for prompt were 0.75 (95% CI: 0.67-0.90) and 0.38 (95% CI: 0.29-0.47) versus delayed and very delayed” should read “Relative rates of severe exacerbations for prompt were 0.75 (95% CI: 0.45-1.15) and 0.38 (95% CI: 0.22-0.55) versus delayed and very delayed”. The authors apologize for these errors and confirm that the overarching interpretation of the results and conclusions of the study remain consistent with the originally published article and no other text or figures are affected.

Charlie Strange,1 Joseph Tkacz,2 Jill Schinkel,2 Benjamin Lewing,2 Barnabie Agatep,2 Sean Swisher,3 Sushma Patel,3 Devechio Edwards,3 Daniel R Touchette,4 Edward Portillo,5 Norbert Feigler,3 Michael Pollack3 1College of Medicine, The Medical University of South Carolina, Charleston, SC, USA; 2Data Solutions, Inovalon, Bowie, MD, USA; 3BioPharmaceuticals Medical, AstraZeneca, Wilmington, DE, USA; 4College of Pharmacy - Pharmacy Systems Outcomes and Policy, University of Illinois Chicago, Chicago, IL, USA; 5Pharmacy Practice & Translational Research Division, University of Wisconsin-Madison, Madison, WI, USACorrespondence: Michael Pollack, BioPharmaceuticals Medical, AstraZeneca, 1800 Concord Pike, Bldg A1C, Wilmington, DE, 19850, USA, Tel +1 302-886-1253, Email michael.pollack1@astrazeneca.comPurpose: Triple therapy to prevent exacerbations from chronic obstructive pulmonary disease (COPD) is associated with improved health compared to single and dual-agent therapy in some populations. This study assessed the benefits of prompt administration of budesonide/glycopyrrolate/formoterol fumarate (BGF) following a COPD exacerbation.Patients and methods: EROS was a retrospective analysis of people with COPD using the MORE2 Registry®. Inclusion required ≥ 1 severe, ≥ 2 moderate, or ≥ 1 moderate exacerbation while on other maintenance treatment. Within 12 months following the index exacerbation, ≥ 1 pharmacy claim for BGF was required. Primary outcomes were the rate of COPD exacerbations and healthcare costs for those that received BGF promptly (within 30 days of index exacerbation) versus delayed (31– 180 days) and very delayed (181– 365 days). The effect of each 30-day delay in initiation of BGF was estimated using a multivariable negative binomial regression model.Results: 2409 patients were identified: 434 prompt, 1187 delayed, and 788 very delayed. The rate (95% CI) of total exacerbations post-index increased as time to BGF initiation increased: prompt 1.52 (1.39– 1.66); delayed 2.00 (1.92– 2.09); and very delayed 2.30 (2.20– 2.40). Adjusting for patient characteristics, each 30-day delay in receiving BGF was associated with a 5% increase in the average number of subsequent exacerbations (rate ratio, 95% CI: 1.05, 1.01– 1.08; p< 0.05). Prompt initiation of BGF was also associated with lower post-index annualized COPD-related costs (&dollar;5002 for prompt vs &dollar;7639 and &dollar;8724 for the delayed and very delayed groups, respectively).Conclusion: Following a COPD exacerbation, promptly initiating BGF was associated with a reduction in subsequent exacerbations and reduced healthcare utilization and costs.Keywords: COPD, triple therapy, exacerbations, delayed therapy, budesonide/glycopyrrolate/formoterol fumarate

Joseph Tkacz,1 Kristin A Evans,1 Daniel R Touchette,2 Edward Portillo,3 Charlie Strange,4 Anthony Staresinic,5 Norbert Feigler,5 Sushma Patel,5 Michael Pollack5 1Life Sciences, IBM Watson Health, Cambridge, MA, USA; 2Center for Pharmacoepidemiology and Pharmacoeconomic Research, University of Illinois College of Pharmacy, Chicago, IL, USA; 3Pharmacy Practice Division, University of Wisconsin-Madison School of Pharmacy, Madison, WI, USA; 4Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, Medical University of South Carolina, Charleston, SC, USA; 5BioPharmaceuticals, US Medical Affairs, AstraZeneca, Wilmington, DE, USACorrespondence: Michael Pollack, AstraZeneca, 1800 Concord Pike, Wilmington, DE, 19850, USA, Tel +1 302 377 4911, Email michael.pollack1@astrazeneca.comPurpose: Patients with chronic obstructive pulmonary disease (COPD) may experience moderate (requiring outpatient care) or severe (requiring hospitalization) disease exacerbations. Guidelines recommend escalation from dual to triple therapy (inhaled corticosteroid + long-acting beta agonist + long-acting muscarinic antagonist) after two moderate or one severe exacerbation in a year. This study examined whether prompt initiation of triple therapy lowers risk of future exacerbations and reduces healthcare costs, compared to delayed/very delayed triple therapy after an exacerbation.Patients and Methods: This retrospective observational study of US healthcare claims included patients ≥ 40 years old with COPD who initiated triple therapy (1/1/2011– 3/31/2020) after ≥ 2 moderate or ≥ 1 severe exacerbation in the prior year. The earliest of the second moderate or first severe exacerbation was the index date. Patients were stratified by triple therapy timing: prompt (≤ 30 days post-index), delayed (31– 180 days), very delayed (181– 365 days). COPD exacerbations, all-cause and COPD-related healthcare utilization and costs were assessed during 12 months post-index (follow-up). Multivariable regression estimated the effect of each 30-day delay in triple therapy on the odds of exacerbations, number of exacerbations, and costs during follow-up, controlling for patient characteristics.Results: A total of 24,770 patients were included: 7577 prompt, 9676 delayed, 7517 very delayed. Each 30-day delay of triple therapy was associated with 11% and 7% increases in the odds of any exacerbation and a severe exacerbation, respectively (odds ratio [95% CI]: 1.11 [1.10– 1.13] and 1.07 [1.05– 1.08]), a 4.3% (95% CI: 3.9– 4.6%) increase in the number of exacerbations, a 1.8% (95% CI: 1.3– 2.3%) increase in all-cause costs, and a 2.1% (95% CI: 1.6– 2.6%) increase in COPD-related costs during follow-up.Conclusion: Promptly initiating triple therapy after two moderate or one severe exacerbation is associated with decreased morbidity and economic burden in COPD. Proactive disease management may be warranted to prevent future exacerbations and lower costs among patients with COPD.Keywords: costs, discharge, hospitalization, utilization

Environmental context: Cobalt is a technologically critical element due to its uses in the green energy transition, but its cycling is poorly constrained in surface environments. We determined the form of cobalt in naturally enriched soils and found that it is commonly associated with manganese as mixed oxide nanoparticles. These findings demonstrate that the behaviour of critical elements such as cobalt in the environment is in part governed at the nanoscale. Rationale: Cobalt (Co) faces increasing demand for use in batteries and alloys, but its environmental behaviour in terrestrial surface environments is poorly constrained. This study analyses cobalt regolith mineralogy and nanoparticulate phase transitions to address this knowledge gap. Methodology: We studied Co-enriched environments across six localities and four distinct deposit types in arid and semi-arid Australian regolith environments to analyse its environmental behaviour. We used a combination of single particle inductively coupled plasma–mass spectrometry (SP ICP-MS) and synchrotron X-ray techniques (fluorescence microscopy, X-ray flouresence microscopy and X-ray absorption spectroscopy). Results: We discovered the presence of Co oxide-based nanoparticles in soils surrounding cobalt-rich rocks at all of our studied locations, to our knowledge the first detection of terrestrial Co oxide-based nanoparticles. The extractable concentration of Co in the nanoparticles varied from 0.7 ng of nanoparticulate Co per gram of soil (ng Co g–1), up to 1390 ng Co g–1, the latter soil containing 1 × 109 extractable Co-based nanoparticles per gram of soil. Discussion: Nanoparticulate cobalt was typically closely associated with manganese (Mn) in the form of natural Co–Mn oxide phases, with only two of the studied locations not showing a close Co–Mn association. We discuss the environmental drivers that may facilitate formation of Co–Mn oxide nanoparticles. Our study suggests that Co may be more mobile in surface environments than previously thought, with Co–Mn oxide nanoparticles found around all four analysed types of Co-rich outcrops. Environmental context.  Cobalt is a technologically critical element due to its uses in the green energy transition, but its cycling is poorly constrained in surface environments. We determined the form of cobalt in naturally enriched soils and found that it is commonly associated with manganese as mixed oxide nanoparticles. These findings demonstrate that the behaviour of critical elements such as cobalt in the environment is in part governed at the nanoscale. (Photograph by O. P. Missen, 11 July 2022.) [ABSTRACT FROM AUTHOR]

Combining Carbon Capture and Storage (CCS) with producing competitive secondary raw materials is key to decarbonizing industry and reducing resource extraction. Biogas upgrading to biomethane stand out as an alternative, but a significant gap remains in integrating this process within a circular economy framework. This issue has been recently addressed by a process that integrates biogas upgrading via caustic absorption with the production of Precipitated Calcium Carbonate (PCC) and the recovery of sodium hydroxide from waste brine solution using membrane technologies. The profitability of this approach depends on the quality of the PCC, a critical factor that this work addresses. By characterizing PCC is determined whether trace compounds in biogas contaminate the PCC and potentially affect its commercial value. It also examines the CO 2 absorption process and analyzes the aqueous samples from the filtration phase of the PCC slurry. Results confirm the high purity of PCC obtained from biogas treatment using Raman spectroscopy, X-Ray Diffraction (XRD), and Scanning Electron Microscopy (SEM). The analyses show that the PCC is pure calcium carbonate, mainly in the stable calcite form, with a typical tetrahedral morphology and no detectable impurities. Characterization of aqueous solutions revealed organic trace compounds from biogas, with TOC concentrations of 9.7 (± 6.4) and 16.0 (± 8) mg C/l. Silicon measurements showed similar concentrations in the absorbent solution and filtrated PCC slurry. Additionally, ammonia escapes as gas, and hydrogen sulfide in the biogas likely contributed to sulfate salt formation. Analysis of the CO₂ absorption shows a first-order reaction with OH-, where the amount of CO₂ absorbed (46.3–50.0 g) closely matches the theoretical value of 48 g. The study reveals that most of the biogas impurities dissolve into the aqueous solution, being crucial for future studies and downstream membrane treatments, and the PCC is unaffected by these impurities with a purity suitable for commercial applications. • Integrating CCS with secondary raw materials for sustainable industry decarbonization. • Biogas upgrading via caustic absorption enhances circular economy integration. • Novel process combines biogas upgrading with calcium carbonate production profitably. • PCC characterization confirms its commercial suitability despite biogas impurities. • Biogas impurities dissolve into aqueous solution, crucial for downstream treatments. [ABSTRACT FROM AUTHOR]