Fluticasone Propionate Orally Disintegrating Tablet (APT-1011) for Eosinophilic Esophagitis: Randomized Controlled Trial.

Topical steroids are effective treatments for eosinophilic esophagitis (EoE). The FLUTE (Fluticasone in EoE) trial evaluated safety and efficacy of APT-1011 (fluticasone propionate oral disintegrating tablet) vs placebo for treatment of EoE. In this randomized, double-blind, placebo-controlled, dose-finding, phase 2b trial, 106 adults with EoE received 1 of 4 APT-1011 doses or placebo for a 12-week induction period and 40 weeks of maintenance. Primary outcome was histologic response (≤6 eosinophils per high-power field) at Week 12. Secondary outcomes included endoscopic features and dysphagia frequency. Histologic response rates were 0% for placebo, 80% for APT-1011 3 mg twice daily (BID), 67% for 3 mg at bedtime (HS), 86% for 1.5 mg BID, 48% for 1.5 mg HS (P < .001 for all groups vs placebo). At Week 12, mean Edema/Rings/Exudates/Furrows/Strictures (EoE Endoscopic Reference Score) total score (max, 9.0) improved from 4.5 to 2.3 for 3 mg BID, 5.3 to 2.1 for 3 mg HS, 4.6 to 1.7 for 1.5 mg BID, 5.3 to 2.9 for 1.5 mg HS vs 5.2 to 4.5 for placebo. Mean dysphagia frequency over 14 days improved from baseline to Week 12 with all active groups improving more than placebo. Improvements were sustained to Week 52. APT-1011 was safe and well-tolerated, with higher incidence of candidiasis noted at the higher twice daily doses. APT-1011 dosing regimens were superior for histologic and endoscopic responses, and for reduction in dysphagia frequency vs placebo. Based on the symptom improvement and assessment of adverse events together with the histologic response rate, 3 mg once daily at bedtime dose showed the most favorable risk-benefit profile. gov, Number: NCT03191864

Threats to agriculture at the extensive and intensive margins : economic analyses of selected land-use issues in the U.S. West and British Columbia

Key Words Agriculture-environment interactions, economic modelling, sage grouse, yellow starthistle, urban-rural fringe, Geographic Information Systems (GIS), farmland conservation, direct marketing Agricultural land uses are frequently challenged by competing land demands for urban uses and for nature. Decisions made by private operators at the natural (extensive) and urban (intensive) margins of land use may not be socially desirable due to the externalities and public goods associated with agricultural land use and production. The objective of this research is to inform and determine the economic implications of land use policies and decisions in two agricultural systems – (1) rangeland of the arid U.S. west, and (2) the urban fringe of British Columbia, Canada – where competition for land use and associated spillovers threaten long-term agricultural sustainability. This research uses econometric methods and Geographic Information Systems (GIS) to accomplish this goal. At the extensive margin, we address an issue where wildlife conservation interests challenge agricultural range uses in Nevada and another where invasive weeds reduce grazing productivity in California. We investigate the factors influencing the decline of greater sage grouse (Centrocercus urophasianus) populations and, using regression analysis, find that annual weather variations are dominant. Still there is some evidence that cattle grazing negatively affects sage grouse populations. We assess agricultural losses and damages due to yellow starthistle (Centaurea solstitialis L.) by using a survey administered to ranchers. Data collected included infestation rates, loss of forage quality and control efforts. Total state-wide losses of livestock forage value are calculated at 6-7% of the annual harvested pasture value. Further, at the intensive margin, this research explores the economic implications of the Agricultural Land Reserve (ALR) in southwestern British Columbia. GIS technology is used to assemble spatial data of farmland near the city of Victoria. Hedonic models determine spatial, farm type and ALR protection impacts on farmland prices from 1974 through 2008, incorporating a total of 2211 parcel sales into the analysis. We find that ALR zoning reduced protected land prices over time, even though prices were impacted more by urban than agricultural production factors. Next, we analyze ALR exclusion applications from 1974 through 2006 using a logit regression model of re-zoning decisions, and find that, although approvals became more likely over time, agricultural capability is a key determinant in exclusion decisions. Finally, we explore the impact of niche- and direct-marketing on farm economic sustainability. Among farms surveyed, the majority (>80%) of farm area was devoted to vegetable and berry production, and more than 50% of total sales took place on-farm. Production intensity (gross revenue per unit of land) is positively related to recent farm investments, crop diversity, and greenhouse or nursery operations; and negatively related to university education, female operators, farm area and agri-tourism. Results suggest that direct marketing could improve long-term agricultural sustainability in this region

Farmland Protection and Agricultural Land Values at the Urban-Rural Fringe: British Columbia's Agricultural Land Reserve

Farmland conservation policies typically use zoning and differentiated taxes to prevent urban development of farmland, but little is known about the effectiveness of these policies. This study adds to current knowledge by examining the impact of British Columbia's Agricultural Land Reserve (ALR), established in 1973, which severely restricts subdivision and nonagricultural uses for more than 4.7 million hectares of farmland. To determine the extent to which the ALR preserves farmland by reducing or removing the development option, a multilevel hedonic pricing model is used to estimate the impact of land use, geographic, and zoning characteristics on farmland value near the capital city of Victoria on Vancouver Island. Using sales data from 1974 through 2008, the model demonstrates a changing ALR impact over time that varies considerably by improved and unimproved land types. In 2008, landowners paid 19% less for the typical improved farmland parcel within the ALR versus that outside it. This suggests that would-be developers expect permanency in the zoning law, and prefer non-ALR zoned land. However, ALR land that is unimproved has a premium of 55%, suggesting that this land is more valuable for agriculture than for development. Farmland located closer to the city or the commuting highway commands a premium if it has a residence on it, with a residence also explaining why smaller agricultural properties sell at higher prices. However, it appears that zoning by itself is insufficient to protect farmland; other policies likely need to be implemented in conjunction with zoning to protect agricultural land

Farmland Protection and Agricultural Land Values at the Urban-Rural Fringe: British Columbia's Agricultural Land Reserve

Farmland conservation policies typically use zoning and differentiated taxes to prevent urban development of farmland, but little is known about the effectiveness of these policies. This study adds to current knowledge by examining the impact of British Columbia's Agricultural Land Reserve (ALR), established in 1973, which severely restricts subdivision and nonagricultural uses for more than 4.7 million hectares of farmland. To determine the extent to which the ALR preserves farmland by reducing or removing the development option, a multilevel hedonic pricing model is used to estimate the impact of land use, geographic, and zoning characteristics on farmland value near the capital city of Victoria on Vancouver Island. Using sales data from 1974 through 2008, the model demonstrates a changing ALR impact over time that varies considerably by improved and unimproved land types. In 2008, landowners paid 19% less for the typical improved farmland parcel within the ALR versus that outside it. This suggests that would-be developers expect permanency in the zoning law, and prefer non-ALR zoned land. However, ALR land that is unimproved has a premium of 55%, suggesting that this land is more valuable for agriculture than for development. Farmland located closer to the city or the commuting highway commands a premium if it has a residence on it, with a residence also explaining why smaller agricultural properties sell at higher prices. However, it appears that zoning by itself is insufficient to protect farmland; other policies likely need to be implemented in conjunction with zoning to protect agricultural land

Determinants of Threatened Sage Grouse in Northeastern Nevada

We examined potential human determinants of observed declines in greater sage grouse (Centrocercus urophasianus) populations in Elko County, Nevada. Although monitoring of sage grouse has occurred for decades, monitoring levels have not been consistent. This article contributes to the literature by normalizing grouse counts by the annual effort to count them, performing regression analyses to explain the resulting normalized data, and correcting for sample selectivity bias that arises from years when counts were not taken. Our findings provide some evidence that cattle-grazing contributes to a reduction in sage grouse populations, but this result should be interpreted with caution because our data do not include indications about the timing and precise nature of grazing practices. Annual variations in weather appear to be a major determinant after statistically controlling for human interactions with the landscape, suggesting that climate change is a key potential long-run threat to this species

Determinants of Threatened Sage Grouse in Northeastern Nevada

We examined potential human determinants of observed declines in greater sage grouse (Centrocercus urophasianus) populations in Elko County, Nevada. Although monitoring of sage grouse has occurred for decades, monitoring levels have not been consistent. This article contributes to the literature by normalizing grouse counts by the annual effort to count them, performing regression analyses to explain the resulting normalized data, and correcting for sample selectivity bias that arises from years when counts were not taken. Our findings provide some evidence that cattle-grazing contributes to a reduction in sage grouse populations, but this result should be interpreted with caution because our data do not include indications about the timing and precise nature of grazing practices. Annual variations in weather appear to be a major determinant after statistically controlling for human interactions with the landscape, suggesting that climate change is a key potential long-run threat to this species

Farmland Preservation Verdicts - Rezoning Agricultural Land in British Columbia

The Agricultural Land Reserve (ALR) in British Columbia (BC), Canada, is a provincial zoning scheme designed to protect agricultural land from development. Since 1973, landowners have not been permitted to use ALR land for nonagricultural purposes, prompting some to seek recovery of development option value by applying for exclusion from the ALR. Using Geographic Information System (GIS) technology and a binary choice (logit) model, this study examines factors that impact the acceptance of ALR exclusion applications. With data from two regions in southwestern BC, we find that applications are more likely to be approved when the land is closer to the major highway, has a smaller parcel size, consists of a smaller portion of the total parcel area, or has poorer quality soils. Therefore, as intended by public policy, agricultural capability is a key determinant in exclusion decisions, retaining properties of greater agricultural value in the ALR. Even though public opinion has suggested otherwise, the political party in power at the time of the decision was only a weak factor, mostly moderated by the number of applications in a given year. A spatial-effects model found no evidence of spatial autocorrelation, supporting the conclusions drawn from the nonspatial model estimations