Assessment of Consistency of Fixed Airflow Obstruction Status during Budesonide/Formoterol Treatment and Its Effects on Treatment Outcomes in Patients with Asthma

BackgroundThe consistency of fixed airflow limitation status during treatment in patients with asthma is unknown.ObjectiveThe objective of this study was to determine the consistency of fixed airflow obstruction (FAO) status during treatment and effects on treatment response.MethodsThis post hoc analysis from a 12-week study (NCT00652002) assessed patients aged 12 years or more with moderate-to-severe asthma randomized to twice-daily budesonide/formoterol (BUD/FM) via pressurized metered-dose inhaler (pMDI) 320/9 μg, BUD pMDI 320 μg, FM 9 μg via dry-powder inhaler, or placebo. FAO status was assessed postbronchodilator at screening and after study drug administration at weeks 2, 6, and 12 via the forced expiratory volume in 1 second to forced vital capacity (FEV1/FVC) ratio < lower limit of normal (LLN) (FAO+) or ≥ LLN (FAO−). Patients with persistent FAO− and FAO+ retained their screening FAO status at all visits. Patients with inconsistent FAO changed categories at least once during the study. Assessments included early withdrawal due to predefined worsening asthma events (PAEs), lung function, and symptoms.ResultsOf 386 patients, 29% had persistent FAO+, 31% inconsistent FAO, and 40% persistent FAO−. PAEs were lowest in the FAO− group overall and with BUD/FM treatment in patients with FAO+ and inconsistent FAO. Baseline demographics and treatment responses of the inconsistent FAO group were most similar to the FAO+ group. The greatest improvements in asthma control days and use of rescue medications were seen with BUD/FM treatment, regardless of FAO status.ConclusionsApproximately one third of patients with moderate-to-severe asthma in this study had inconsistent FAO, and their treatment responses were most similar to patients with FAO+. Regardless of FAO status, patients treated with BUD/FM experienced the most improved treatment responses and fewest withdrawals due to PAEs

Underwater remote skimming of slow sand filters for sustainable water production

Slow sand filters (SSF) are a simple water treatment technology providing an important alternative to conventional drinking water treatment. SSF are extensive in terms of carbon cost and chemical use but require a large land area and are complex to operate, as periodic cleaning is required to prevent filter clogging. Therefore, redundant SSF beds are required to enable water production to occur during long cleaning downtimes. Underwater skimming (UWS) is a cleaning innovation where the foulant layer (containing sand and particles) is removed using a skimmer consisting of a shrouded blade mounted on a vehicle platform. Sand, particles, and biofilm are skimmed prior to ex situ washing of the recovered sand. In this Viewpoint, we posit that the introduction of an in situ underwater skimmer operated remotely can substantially help to offset the aforementioned challenge of downtime, with its associated loss of production, enabling the technology to operate more efficiently and remain a pertinent and advantageous process option within modern water treatment facilities or possibly resource constrained settings. Otherwise, this resilient biotechnological process could be replaced by chemical and energy-intensive processes which increase the entropy of water treatment more than SSF. The anticipated benefits and challenges of UWS of SSF are discussed

Scientific and stakeholder evidence-based assessment:Ecosystem response to floating solar photovoltaics and implications for sustainability

Floating solar photovoltaic (FPV) installations are increasing globally. However, their interaction with the hosting water body and implications for ecosystem function is poorly understood. Understanding potential impacts is critical as water bodies provide many ecosystem services on which humans rely and are integral for delivering the United Nations Sustainable Development Goals (SDGs). Here, we used scientific evidence from a systematic review and stakeholder expertise, captured through an international survey and a workshop, alongside existing understanding of the role of water bodies in delivering ecosystem services and the SDGs. We found 22 evidence outcomes that indicated potential physical, chemical and biological impacts of FPV on water bodies. Assessment by stakeholders from across sectors indicated that reduced water evaporation is the greatest opportunity, whilst changes to water chemistry, including nitrification and deoxygenation, are the greatest threat. Despite these findings, FPV operators reported no observed water quality or ecosystem impacts. However, only 15% of respondents had performed water quality analysis; visual inspection alone cannot ascertain all water quality impacts. Based on the integration of these findings, we determined that FPV could impact nine ecosystem services. Furthermore, established linkages between ecosystem services and SDGs indicate the potential for impacts on eight SDGs, although whether the impact is positive or negative is likely to depend on FPV design and water body type. Our results further the understanding of the effects of FPVs on host water bodies and may help to ensure the anticipated growth in FPVs minimises threats and maximises opportunities, safeguarding overall sustainability

Floating solar panels on reservoirs impact phytoplankton populations:A modelling experiment

Floating solar photovoltaic (FPV) deployments are increasing globally as the switch to renewable energy intensifies, representing a considerable water surface transformation. FPV installations can potentially impact aquatic ecosystem function, either positively or negatively. However, these impacts are poorly resolved given the challenges of collecting empirical data for field or modelling experiments. In particular, there is limited evidence on the response of phytoplankton to changes in water body thermal dynamics and light climate with FPV. Given the importance of understanding phytoplankton biomass and species composition for managing ecosystem services, we use an uncertainty estimation approach to simulate the effect of FPV coverage and array siting location on a UK reservoir. FPV coverage was modified in 10 % increments from a baseline with 0 % coverage to 100 % coverage for three different FPV array siting locations based on reservoir circulation patterns. Results showed that FPV coverage significantly impacted thermal properties, resulting in highly variable impacts on phytoplankton biomass and species composition. The impacts on phytoplankton were often dependent on array siting location as well as surface coverage. Changes to phytoplankton species composition were offset by the decrease in phytoplankton biomass associated with increasing FPV coverage. We identified that similar phytoplankton biomass reductions could be achieved with less FPV coverage by deploying the FPV array on the water body's faster-flowing area than the central or slower flowing areas. The difference in response dependent on siting location could be used to tailor phytoplankton management in water bodies. Simulation of water body-FPV interactions efficiently using an uncertainty approach is an essential tool to rapidly develop understanding and ultimately inform FPV developers and water body managers looking to minimise negative impacts and maximise co-benefits

Floating solar panels on reservoirs impact phytoplankton populations: a modelling experiment

Floating solar photovoltaic (FPV) deployments are increasing globally as the switch to renewable energy intensifies, representing a considerable water surface transformation. FPV installations can potentially impact aquatic ecosystem function, either positively or negatively. However, these impacts are poorly resolved given the challenges of collecting empirical data for field or modelling experiments. In particular, there is limited evidence on the response of phytoplankton to changes in water body thermal dynamics and light climate with FPV. Given the importance of understanding phytoplankton biomass and species composition for managing ecosystem services, we use an uncertainty estimation approach to simulate the effect of FPV coverage and array siting location on a UK reservoir. FPV coverage was modified in 10% increments from a baseline with 0% coverage to 100% coverage for three different FPV array siting locations based on reservoir circulation patterns. Results showed that FPV coverage significantly impacted thermal properties, resulting in highly variable impacts on phytoplankton biomass and species composition. The impacts on phytoplankton were often dependent on array siting location as well as surface coverage. Changes to phytoplankton species composition were offset by the decrease in phytoplankton biomass associated with increasing FPV coverage. We identified that similar phytoplankton biomass reductions could be achieved with less FPV coverage by deploying the FPV array on the water body's faster-flowing area than the central or slower flowing areas. The difference in response dependent on siting location could be used to tailor phytoplankton management in water bodies. Simulation of water body-FPV interactions efficiently using an uncertainty approach is an essential tool to rapidly develop understanding and ultimately inform FPV developers and water body managers looking to minimise negative impacts and maximise co-benefits

Catching Element Formation In The Act

Gamma-ray astronomy explores the most energetic photons in nature to address some of the most pressing puzzles in contemporary astrophysics. It encompasses a wide range of objects and phenomena: stars, supernovae, novae, neutron stars, stellar-mass black holes, nucleosynthesis, the interstellar medium, cosmic rays and relativistic-particle acceleration, and the evolution of galaxies. MeV gamma-rays provide a unique probe of nuclear processes in astronomy, directly measuring radioactive decay, nuclear de-excitation, and positron annihilation. The substantial information carried by gamma-ray photons allows us to see deeper into these objects, the bulk of the power is often emitted at gamma-ray energies, and radioactivity provides a natural physical clock that adds unique information. New science will be driven by time-domain population studies at gamma-ray energies. This science is enabled by next-generation gamma-ray instruments with one to two orders of magnitude better sensitivity, larger sky coverage, and faster cadence than all previous gamma-ray instruments. This transformative capability permits: (a) the accurate identification of the gamma-ray emitting objects and correlations with observations taken at other wavelengths and with other messengers; (b) construction of new gamma-ray maps of the Milky Way and other nearby galaxies where extended regions are distinguished from point sources; and (c) considerable serendipitous science of scarce events -- nearby neutron star mergers, for example. Advances in technology push the performance of new gamma-ray instruments to address a wide set of astrophysical questions.Comment: 14 pages including 3 figure

Risk and safety requirements for diagnostic and therapeutic procedures in allergology : World Allergy Organization Statement

Peer reviewe

Hiring and maintaining community college presidents

Purpose of the study. Historically, community colleges have experienced difficulty in hiring and maintaining presidents. In 1985, one of every ten public community colleges searched for a new president. To compound this problem, the number of community colleges has increased thirty-seven percent in the past twenty years. The purpose of this study was to investigate the reasons why community colleges are experiencing difficulty in hiring and maintaining presidents. Procedures. The initial data for this study were collected from the Bulletin Board: Positions Available section of the Chronicle of Higher Education. Presidential positions advertised during calendar year 1987 in the Chronicle of Higher Education for colleges accredited by the North Central Association of Colleges and Schools were identified. College presidents currently holding those positions, as well as the respective governing board chairpersons, constituted the survey population. The survey-interview technique was the research method employed. To study the hiring and maintenance of presidents, a linear analysis was utilized. The position was analyzed by examining (1) position vacancy announcements, (2) use of consultants, (3) job descriptions, (4) goals and objectives, (5) performance evaluations, and (6) perceived qualities. Conclusions. (1) The position vacancy announcement adequately described the responsibilities of and the qualities needed in a president. (2) Fifty percent of the surveyed colleges used the services of a consultant. (3) A formal, written job description was not available or not well-documented by colleges. (4) Eighty-eight percent of the presidents were not required to submit formal goals and objectives. (5) In the absence of requirements for formal goals and objectives, a formal evaluation process was not developed and implemented. (6) The primary qualities sought in a president were leadership, communication, organization and experience. Summary. Governing boards should be cognizant of interdependence of the linear model as presented in this study. The systematic approach to hiring and maintaining community college presidents should increase position stability by reducing the transitory nature of the position, thereby enhancing college mission continuity

An experimental investigation into filter ripening: Contact filtration of lowland reservoir water

Pilot rapid gravity filters, treating lowland reservoir water, were operated to examine chemical, physical and biological influences on filter ripening. Ripening occurred if, after backwashing, filtrate turbidities showed an initial peak, then improvement to a minimum value. Backwashing using collapse pulsing prevented biological fouling of media, and ensured constant starting head losses for three years. Ripening was examined using sand roughing filtration and dual media contact filtration with pre-ozonation and iron (III) sulphate coagulation. Turbidity removal data from sand filters showed that ripening behaviour varied with seasonal changes in applied loading. Biological maturation of filter media over several months caused improved turbidity removals. Subsequently, ripened turbidity removals varied proportionally with water temperature. Within a filter run ripened turbidity removal was independent of load at constant flow rate, but varied inversely with flow rate. Dual media filters showed ripening behaviour in roughing and contact filtration modes. Iron dosing produced superior turbidity removals. A novel coagulation control method was devised, based on the shape of the filtrate turbidity curves. Ripening time varied inversely with coagulant dose, but higher doses caused turbidity breakthrough. A temporary initial overdose could control ripening. Pre-ozonation enhanced roughing and contact filtration, but did not change the time taken to achieve maximum removals. With contact filtration ripened removals were a fixed proportion of the applied turbidity in winter, but filtrate turbidity was independent of load in summer, achieving 0.2 NTU. Flow rates of 12, 17 and 22 m.h⁻¹ produced identical ripening curves, indicating a complex relationship between flow rate and particle capture. This was confirmed with data showing inconsistent relationships between turbidity, particle loading and ripening, and poorer ripening behaviour on longer filter runs. Further detailed particle size data were required. Six definitions of ripening were examined but none was satisfactory as ripening behaviour changed with chemical treatment and seasonal factors