Clinical outcome of adding long-acting β-agonists to inhaled corticosteroids

AbstractCurrent asthma management guidelines state that where a patient is receiving a lowto moderate dose of inhalated corticosteroids and is still experiencing symptoms the dose of corticosteroid should be increased and, if necessary, a long-acting bronchodilator should be added. Many studies have now shown that the addition of a β2-agonist with long-acting properties is more effective at controlling asthma symptoms than increasing the doe of corticosteriod alone. The Formoterol and Corticosteroid Establishing Therapy (FACET) study was a 12-month study comparing excerbation rates in patients treated with budesonide (100 μg or 400 μg) twice daily, alone vs. treatment with budesonide (100 μg or 400 μg) twice daily plus formoterol 9 μg twice daily (delivered dose) (I). The addition of formoterol of reduced the rates of mild and severe exacerbations compared with budesonide alone, with the lowest rates seen in patients receiving high-dose budesonide and formoterol. There was no difference in the profile of exacerbations in any groups, indicating formoterol does not mask any signs of inflammation. The addition of formotereol to budesonide was also shown to result in improved lung function (as measured by peak expiratory flow rate and forced expiratory volume in I second), night-time awakeningsaand the use of as-needed medication when compared with an increase in the dose of budesonide. In all cases, increasing the dose of budesonide and addition of formoterol resulted in the most improvement and a significant increase in quality of life, measured by Asthma Quality of Life Questionnaire (AQLQ), was noted In conclusion, the addition of formoterol to established treatment with inhaled corticosteroids provides superior asthma control compared with an increase in the dose of corticosteroid alone

Relationships Between COVID-19 Infection Rates, Healthcare Access, Socioeconomic Status, and Cultural Diversity

The COVID-19 pandemic has had a disproportionate impact on racial and ethnic minority groups, with high infection rates throughout those communities. There are a complex set of factors that account for COVID-19 disparities. Focusing on infection and death rates alone without also examining health equity, underestimates the true impact of the pandemic. To gain a more clear understanding of COVID-19’s impact in these communities, we analyzed the relationship between state COVID-19 infection rates with social determinants of health: cultural diversity, health care access, and socioeconomic status. Our approach to identifying this relationship was to estimate infection rates by fitting John Hopkins COVID-19 data to an SIR compartmental model commonly used in epidemiology to model infectious disease. These infection rates were then analyzed as a function of state indices with regard to healthcare access, and socioeconomic status, as well as measures of each states cultural diversity. Nationally we do not see a relationship between COVID-19 infection and removal rates to cultural diversity, healthcare access, and socioeconomic status during the time period. However an analysis of states with the highest and lowest infection rates show that more culturally diverse states had higher infection rates during this time period. In addition, states that ranked low in healthcare access had infections an order of magnitude larger than states with good healthcare access. Alternatively, states grouped by low and high socioeconomic status had similar infection rates

Comment on the power law in rheological equations

In conformity with the principle of shear reversal, it is proposed that the power law index in the Cross equation relating steady state viscosity to shear rate in semisolid alloy slurries should have a value of 4/3, which is independent of alloy system and the fraction solid

Anoxic nitrification in marine sediments

Nitrate peaks are found in pore-water profiles in marine sediments at depths considerably below the conventional zone of oxic nitrification. These have been interpreted to represent nonsteady- state effects produced by the activity of nitrifying bacteria, and suggest that nitrification occurs throughout the anoxic sediment region. In this study, ΣNO3 peaks and molecular analysis of DNA and RNA extracted from anoxic sediments of Loch Duich, an organic-rich marine fjord, are consistent with nitrification occurring in the anoxic zone. Analysis of ammonia oxidiser 16S rRNA gene fragments amplified from sediment DNA indicated the abundance of autotrophic ammonia-oxidising bacteria throughout the sediment depth sampled (40 cm), while RT-PCR analysis indicated their potential activity throughout this region. A large non-steady-state pore-water ΣNO3 peak at ~21 cm correlated with discontinuities in this ammonia-oxidiser community. In addition, a subsurface nitrate peak at ~8 cm below the oxygen penetration depth, correlated with the depth of a peak in nitrification rate, assessed by transformation of 15N-labelled ammonia. The source of the oxidant required to support nitrification within the anoxic region is uncertain. It is suggested that rapid recycling of N is occurring, based on a coupled reaction involving Mn oxides (or possibly highly labile Fe oxides) buried during small-scale slumping events. However, to fully investigate this coupling, advances in the capability of high-resolution pore-water techniques are required

Breeding and larval rearing of the milkfish Chanos chanos (Pisces: Chanidae)

Contribution No. 11 of the Aquaculture Department, Southeast Asian Fisheries Development Center, P.O. Box 256, Iloilo City 5901, Philippines.Two sexually maturing female milkfish were captured in April 1977 and induced to spawn by means of acetone-dried Pacific salmon pituitary powder. The eggs were fertilized and incubated and the resultant young reared to 74-day old, 11 cm long fingerlings. Newly fertilized eggs averaged 1.16 mm in diameter and each had a narrow perivitelline space containing several cortical granules which disappeared within a few minutes. The yolk was slightly yellowish, devoid of oil globules and very finely granulated. Embryonic development was very similar to that of other pelagic fish eggs and hatching occurred between 35 to 36 hr at a salinity of 32 ppt and a temperature range of 28.4-29.2°C.This study was partially supported through a grant to the SEAFDEC Aquaculture Department by the International Development Research Centre of Canada, under Project No. 3-P-74-0146

Interlaced particle systems and tilings of the Aztec diamond

Motivated by the problem of domino tilings of the Aztec diamond, a weighted particle system is defined on $N$ lines, with line $j$ containing $j$ particles. The particles are restricted to lattice points from 0 to $N$, and particles on successive lines are subject to an interlacing constraint. It is shown that marginal distributions for this particle system can be computed exactly. This in turn is used to give unified derivations of a number of fundamental properties of the tiling problem, for example the evaluation of the number of distinct configurations and the relation to the GUE minor process. An interlaced particle system associated with the domino tiling of a certain half Aztec diamond is similarly defined and analyzed.Comment: 17 pages, 4 figure

Dexamethasone inhibits ozone-induced gene expression of macrophage inflammatory protein-2 in rat lung

AbstractTo address the potential role of the chemokine macrophage inflammatory protein-2 (MIP-2) in airway inflammation, we examined whether MIP-2 may play a role in ozone-induced neutrophilic inflammation of airways and its modulation by dexamethasone in rat lung. Following ozone exposure, MIP-2 mRNA expression in the lung peaked at 2 h after exposure and slowly declined thereafter. Dexamethasone suppressed ozone-induced MIP-2 mRNA expression and neutrophil accumulation in the lung. We suggest that the MIP-2 mRNA induction may switch on the neutrophilic influx observed in this model of lung inflammation. Furthermore, the MIP-2 expression is regulated by dexamethasone which may represent one of the mechanisms by which glucocorticoids exert their potent anti-inflammatory properties

Deficits in mitochondrial spare respiratory capacity contribute to the neuropsychological changes of alzheimer’s disease

Alzheimer’s disease (AD) is diagnosed using neuropsychological testing, supported by amyloid and tau biomarkers and neuroimaging abnormalities. The cause of neuropsychological changes is not clear since they do not correlate with biomarkers. This study investigated if changes in cellular metabolism in AD correlate with neuropsychological changes. Fibroblasts were taken from 10 AD patients and 10 controls. Metabolic assessment included measuring total cellular ATP, extracellular lactate, mitochondrial membrane potential (MMP), mitochondrial respiration and glycolytic function. All participants were assessed with neuropsychological testing and brain structural MRI. AD patients had significantly lower scores in delayed and immediate recall, semantic memory, phonemic fluency and Mini Mental State Examination (MMSE). AD patients also had significantly smaller left hippocampal, left parietal, right parietal and anterior medial prefrontal cortical grey matter volumes. Fibroblast MMP, mitochondrial spare respiratory capacity (MSRC), glycolytic reserve, and extracellular lactate were found to be lower in AD patients. MSRC/MMP correlated significantly with semantic memory, immediate and delayed episodic recall. Correlations between MSRC and delayed episodic recall remained significant after controlling for age, education and brain reserve. Grey matter volumes did not correlate with MRSC/MMP. AD fibroblast metabolic assessment may represent an emergent disease biomarker of AD

Educating a global workforce?

In the public rhetoric, at least, education is the answer to most, if not all, the questions raised by the global knowledge-based economy. In this chapter we begin an examination of what education promises the global workforce, and what the global workforce, and the knowledgebased economy, might reasonably ask of education. Different perspectives on the knowledgebased economy imply different constructions of ‘knowledge’. Workers are characterised within these frameworks as ‘knowledge workers’ (an elite), or, perhaps, ‘knowledgeable workers’ (the non-elite majority) and questions arise around what they are required to learn, to know, and to be able to do. The global knowledge-based economy produces profound challenges to workrelated education at every level. While these challenges manifest themselves in uniquely local ways at specific local sites, they are produced, and must be addressed, in contexts that are uncompromisingly global. If work-related education is to contribute to positive outcomes for people and for local communities we (workers, corporations, educators, researchers, policy makers, politicians and international organisations) must find new ways to pay attention to the ways in which a workforce in the knowledge-based economy can be understood to be ‘global’ as well as ‘local’, and what workers need to be able to know and be able to do to move across and within these spatial and temporal domains