The effect of high-dose fluticasone propionate and budesonide on lung function and asthma exacerbations in patients with severe asthma

AbstractThe purpose of this study was to investigate the comparative efficacy and safety of equal doses of inhaled fluticasone propionate (FP) and inhaled budesonide (BUD) using their respective dry powder inhalers in a population of severe asthmatics requiring high doses of inhaled corticosteroid. This double-blind double-dummy parallel-group study compared the effects of 24 weeks of treatment with FP (2000 μg daily via a Diskhaler® inhaler; Glaxo Wellcome, Evreux, France) and BUD (2000 μg daily via a Turbuhaler® inhaler; Astra Pharmaceuticals, Rijswijka, Netherlands) on lung function and asthma exacerbations in 395 patients with asthma.FP was statistically significantly superior to BUD with respect to the percentage of symptom-free days (P = 0·02), the incidence of days free from rescue bronchodilator usage (P = 0·02) and the distribution of change in peak expiratory flow (PEF) expressed as a percentage of the predicted PEF (P = 0·04). During the treatment period FP was statistically significantly superior to BUD for change in forced expiratory volume in 1 sec (FEV1) at 8, 16 and 24 weeks, change in the median daytime symptom score during weeks 5–16, for incidence of symptomfree days and incidence of days free from rescue bronchodilator usage during weeks 17–24. There was no significant difference between FP and BUD with respect to the number of patients experiencing one or more asthma exacerbation (33·8 and 28·4% of patients, respectively). There was, however, evidence that the exacerbations were clinically less severe in patients treated with FP, in that the time to resolution was quicker (11·0 vs. 14·7 days; P = 0·035), mean duration of all exacerbations (for an individual patient) tended to be shorter (18·5 vs. 23·6 days; P = 0·12), the time off work was reduced (4·2 vs. 7·6 days; P = 0·012) and the lowest PEF recorded during the exacerbation was higher (301 vs. 263 1 min−1; P = 0·07). There were no clinically relevant differences in the safety (serum cortisol levels, markers of bone turnover, adverse events) of FP and BUD at these microgram equivalent doses.The patients recruited into this study, in retrospect, probably had no need for such high doses of inhaled corticosteroid but, irrespective of this, FP at microgram equivalent doses showed evidence of superior efficacy to BUD with respect to lung function and severity of asthma exacerbations without producing any greater adverse systemic effect

Landform evolution in the headwaters area of Araguaia river (Mato Grosso and Goiás states, Brazil).

Editors: Francisco Gutiérrez, Mateo Gutiérrez, Gloria Desir, Jesús Guerrero, Pedro Lucha, Cinta Marín, José María García-Ruiz

Interaction of surface acoustic waves with a two-dimensional electron gas in the presence of spin splitting of the Landau bands

The absorption and variation of the velocity of a surface acoustic wave of frequency $f$= 30 MHz interacting with two-dimensional electrons are investigated in GaAs/AlGaAs heterostructures with an electron density $n=(1.3 - 2.8) \times 10^{11} cm^{-2}$ at $T$=1.5 - 4.2 K in magnetic fields up to 7 T. Characteristic features associated with spin splitting of the Landau level are observed. The effective g factor and the width of the spin-split Landau bands are determined: $g^* \simeq 5$ and $A$=0.6 meV. The greater width of the orbital-split Landau bands (2 meV) relative to the spin-split bands is attributed to different shielding of the random fluctuation potential of charged impurities by 2D electrons. The mechanisms of the nonlinearities manifested in the dependence of the absorption and the velocity increment of the SAW on the SAW power in the presence of spin splitting of the Landau levels are investigated.Comment: Revtex 5 pages + 5 EPS Figures, v.2 - minor corrections in text and pic

Three dimensional graphics station for computer integrated manufacturing research

Issued as Final report, Project no. E-25-69

Influence of myocardial oxygen demand on the coronary vascular response to arterial blood gas changes in humans

It remains unclear if the human coronary vasculature is inherently sensitive to changes in arterial PO2 and PCO2 or if coronary vascular responses are the result of concomitant increases in myocardial O2 consumption/demand (MVO2). We hypothesized that the coronary vascular response to PO2 and PCO2 would be attenuated in healthy men when MVO2 was attenuated with β1-adrenergic receptor blockade. Healthy men (n=11; age: 25 {plus minus} 1 years) received intravenous esmolol (β1-adrenergic receptor antagonist) or volume-matched saline in a double-blind, randomized, crossover study, and were exposed to poikilocapnic hypoxia, isocapnic hypoxia, and hypercapnic hypoxia. Measurements made at baseline and following 5-min of steady state at each gas manipulation included left anterior descending coronary blood velocity (LADV; Doppler echocardiography), heart rate and arterial blood pressure. LADV values at the end of each hypoxic condition were compared between esmolol and placebo. Rate pressure product (RPP) and left-ventricular mechanical energy (MELV) were calculated as indices of MVO2. All gas manipulations augmented RPP, MELV, and LADV but only RPP and MELV were attenuated (4-18%) following β1-adrenergic receptor blockade (P<0.05). Despite attenuated RPP and MELV responses, β1-adrenergic receptor blockade did not attenuate the mean LADV vasodilatory response when compared to placebo during poikilocapnic hypoxia (29.4{plus minus}2.2 vs. 27.3{plus minus}1.6 cm/s) and isocapnic hypoxia (29.5{plus minus}1.5 vs. 30.3{plus minus}2.2 cm/s). Hypercapnic hypoxia elicited a feed-forward coronary dilation that was blocked by β1-adrenergic receptor blockade. These results indicate a direct influence of arterial PO2 on coronary vascular regulation that is independent of MVO2

The ABCD (Agriculture Biologique, Conseil et Développement), a French professional degree in organic farming, consulting and development

The creation of a professional degree in organic farming, known as an ABCD, is the result of the desire to provide training at the national level that is supported by the agriculture sector and that brings together the know-how of universities and higher education institutions specialised in agronomy and those of a network of teaching establishments specialised in technical education in the field. This degree aims at forming agents and advisors capable of working in a wide range of fields such as production, processing, distribution, control-certification and marketing. It is mainly intended for adults interested in career development and students who would like to further their education. Four training sites are involved and all teaching is done through a virtual digital university using information and communication technologies

Observation and assessment of model retrievals of surface exchange components over a row canopy using directional thermal data

Land surface temperature is an essential climate variable that can serve as a proxy for detecting water deficiencies in croplands and wooded areas. Its measurement can however be influenced by anisotropic properties of surface targets leading to occurrence of directional effects on the signal. This may lead to an incorrect interpretation of thermal measurements. In this study, we perform model assessments and check the influence of thermal radiation directionality using data over a vineyard. To derive the overall directional surface temperatures, elemental values measured by individual cameras were aggregated according to the respective cover fractions/weights in viewing direction. Aggregated temperatures from the turbid model were compared to corresponding temperatures simulated by the 3D DART radiative transfer model. The reconstructed temperatures were then used in surface-energy-balance (SEB) simulations to assess the impact of the Sun-target-sensor geometry on retrievals. Here, the pseudo-isotropic Soil-Plant-Atmosphere-Remote-Sensing-of-Evapotranspiration (SPARSE) dual-source model together with the non-isotropic version (SPARSE4), were used. Both schemes were able to retrieve overall fluxes satisfactorily, confirming a previous study. However, the sensitivity (of flux and component temperature estimates) of the schemes to viewing direction was tested for the first time using reconstructed sets of directional thermal data to force the models. Degradation (relative to nadir) in flux retrieval cross-row was observed, with better consistency along rows. Overall, it was nevertheless shown that SPARSE4 is less influenced by the viewing direction of the temperature than SPARSE, particularly for strongly off-nadir viewing. Some directional/asymmetrical artefacts are however not well reproduced by the simple Radiative Transfer Methods (RTM), which can then manifest in and influence the subsequent thermal-infrared-driven SEB modelling.This work was supported by the ALTOS project (PRIMA 2018 - Section 2), with grants provided by ANR via the agreement n°ANR-18-PRIM-0011-02 as well as the CNES/TOSCA program for the TRISHNA project. First author acknowledges the financial support of his PhD from CNES and Région Occitanie. The field experiments were carried out in the context of the HiLiaise and ESA WineEO projects. Joan Boldu (proprietor) and David Tous (SafSampling) are also acknowledged for allowing/providing access to the site and other site related data. Nicolas Lauret’s help with preparation of the DART mock-ups is appreciated.info:eu-repo/semantics/publishedVersio