The cost of asthma medicines

Most adults and adolescents with asthma require a preventer inhaler. In Australia these patients are often prescribed a combination inhaler containing a corticosteroid and a long-acting beta 2 agonist. These combination inhalers increase the cost of treatment for patients and for government and may not provide extra benefit. Many patients can control their asthma using an inhaled corticosteroid alone for prevention of symptoms and flare-ups. Most of the benefits of inhaled corticosteroids are obtained at low doses. To achieve these benefits it is important to check that the patient is using their inhaler correctly and regularly. Shared decision making includes discussing the options for treatment. Offering a more affordable preventer regimen could aid adherence and lead to improved outcomes

Water management on claypan soils in the midwest

Irrigation scheduling with soil moisture monitoring devices provided the most efficient use of water on claypan soils. Corn was found to be particularly responsive to both drainage and irrigation with average yield increases of 80 bushels per acre over the seven year period of the experiment. Consequently, water management was found to be an important aspect of corn production. Hybrid selection was found to be important to maximize the benefits of water management. Soybeans were found to be less responsive to irrigation than corn. Also, soybeans were found to be more responsive to drainage during the growing season than corn. Soybean variety selection was found to be important to prevent lodging when irrigation was used. Surface drainage is an important practice in water management but irrigation was found to be necessary to prevent yield reduction particularly with corn, when top soil was removed during the construction needed for surface drainage.U.S. Geological SurveyU.S. Department of the InteriorOpe

Getting More From Your Maze: Examining Differences in Distractors

The present study examined the technical adequacy of maze-selection tasks constructed in 2 different ways: typical versus novel. We selected distractors for each measure systematically based on rules related to the content of the passage and the part of speech of the correct choice. Participants included 262 middle school students who were randomly assigned to 1 of the 2 maze formats. Scoring of the maze included both correct and correct-minus-incorrect scores. Students completed 3 criterion-reading tests: the Scholastic Reading Inventory, the AIMSweb R-Maze, and a high-stakes state assessment (the Missouri Assessment Program). Alternate-forms reliability was similar across maze formats; however, with regard to scoring procedure, reliability coefficients were consistently higher for correct than for correct-minus-incorrect scores. Validity coefficients were also similar across format with 1 exception: The coefficients for typical maze scores were stronger when compared with the Missouri Assessment Program scores than the coefficients for novel maze scores

Electric Field Effects on Graphene Materials

Understanding the effect of electric fields on the physical and chemical properties of two-dimensional (2D) nanostructures is instrumental in the design of novel electronic and optoelectronic devices. Several of those properties are characterized in terms of the dielectric constant which play an important role on capacitance, conductivity, screening, dielectric losses and refractive index. Here we review our recent theoretical studies using density functional calculations including van der Waals interactions on two types of layered materials of similar two-dimensional molecular geometry but remarkably different electronic structures, that is, graphene and molybdenum disulphide (MoS$_2$). We focus on such two-dimensional crystals because of they complementary physical and chemical properties, and the appealing interest to incorporate them in the next generation of electronic and optoelectronic devices. We predict that the effective dielectric constant ($\varepsilon$) of few-layer graphene and MoS$_2$ is tunable by external electric fields ($E_{\rm ext}$). We show that at low fields ($E_{\rm ext}^{}<0.01$ V/\AA) $\varepsilon$ assumes a nearly constant value $\sim$4 for both materials, but increases at higher fields to values that depend on the layer thickness. The thicker the structure the stronger is the modulation of $\varepsilon$ with the electric field. Increasing of the external field perpendicular to the layer surface above a critical value can drive the systems to an unstable state where the layers are weakly coupled and can be easily separated. The observed dependence of $\varepsilon$ on the external field is due to charge polarization driven by the bias, which show several similar characteristics despite of the layer considered.Comment: Invited book chapter on Exotic Properties of Carbon Nanomatter: Advances in Physics and Chemistry, Springer Series on Carbon Materials. Editors: Mihai V. Putz and Ottorino Ori (11 pages, 4 figures, 30 references

Deglacial Land-Ocean Linkages at the Alaskan Continental Margin in the Bering Sea

A marine sediment record from the central Bering Sea, spanning the last 20 thousand years (ka), was studied to unravel the depositional history with regard to terrigenous sediment supply and biogenic sedimentation. Methodic approaches comprised the inference of accumulation rates of siliciclastic and biogenic components, grain-size analysis, and (clay) mineralogy, as well as paleoclimatic modelling. Changes in the depositional history provides insight into land-ocean linkages of paleoenvironmental changes. During the finale of the Last Glacial Maximum, the depositional environment was characterized by hemipelagic background sedimentation. A marked change in the terrigenous sediment provenance during the late Heinrich 1 Stadial (15.7–14.5 ka), indicated by increases in kaolinite and a high glaciofluvial influx of clay, gives evidence of the deglaciation of the Brooks Range in the hinterland of Alaska. This meltwater pulse also stimulated the postglacial onset of biological productivity. Glacial melt implies regional climate warming during a time of widespread cooling on the northern hemisphere. Our simulation experiment with a coupled climate model suggests atmospheric teleconnections to the North Atlantic, with impacts on the dynamics of the Aleutian Low system that gave rise to warmer winters and an early onset of spring during that time. The late deglacial period between 14.5 and 11.0 ka was characterized by enhanced fluvial runoff and biological productivity in the course of climate amelioration, sea-level rise, seasonal sea-ice retreat, and permafrost thaw in the hinterland. The latter processes temporarily stalled during the Younger Dryas stadial (12.9-11.7 ka) and commenced again during the Preboreal (earliest Holocene), after 11.7 ka. High river runoff might have fertilized the Bering Sea and contributed to enhanced upper ocean stratification. Since 11.0 ka, advanced transgression has shifted the coast line and fluvial influence of the Yukon River away from the study site. The opening of the Bering Strait strengthened contour currents along the continental slope, leaving behind winnowed sand-rich sediments through the early to mid-Holocene, with non-deposition occurring since about 6.0 ka

Children’s rights online: challenges, dilemmas and emerging directions

In debates over internet governance, the interests of children figure unevenly, and only partial progress has been made in supporting children’s rights online globally. This chapter examines how the UN Convention on the Rights of the Child is helpful in mapping children’s rights to provision, protection and participation as they apply online as well as offline. However, challenges remain. First, opportunities and risks are positively linked, policy approaches are needed to resolve the potential conflict between protection on the one hand, and provision and participation on the other. Second, while parents may be relied on to some degree to balance their child’s rights and needs, the evidence suggests that a minority of parents are ill-equipped to manage this. Third, resolution is needed regarding the responsibility for implementing digital rights, since many governments prefer self-regulation in relation to internet governance. The chapter concludes by calling for a global governance body charged with ensuring the delivery of children’s rights

Sugarcane genes associated with sucrose content

<p>Abstract</p> <p>Background -</p> <p>Sucrose content is a highly desirable trait in sugarcane as the worldwide demand for cost-effective biofuels surges. Sugarcane cultivars differ in their capacity to accumulate sucrose and breeding programs routinely perform crosses to identify genotypes able to produce more sucrose. Sucrose content in the mature internodes reach around 20% of the culms dry weight. Genotypes in the populations reflect their genetic program and may display contrasting growth, development, and physiology, all of which affect carbohydrate metabolism. Few studies have profiled gene expression related to sugarcane's sugar content. The identification of signal transduction components and transcription factors that might regulate sugar accumulation is highly desirable if we are to improve this characteristic of sugarcane plants.</p> <p>Results -</p> <p>We have evaluated thirty genotypes that have different Brix (sugar) levels and identified genes differentially expressed in internodes using cDNA microarrays. These genes were compared to existing gene expression data for sugarcane plants subjected to diverse stress and hormone treatments. The comparisons revealed a strong overlap between the drought and sucrose-content datasets and a limited overlap with ABA signaling. Genes associated with sucrose content were extensively validated by qRT-PCR, which highlighted several protein kinases and transcription factors that are likely to be regulators of sucrose accumulation. The data also indicate that aquaporins, as well as lignin biosynthesis and cell wall metabolism genes, are strongly related to sucrose accumulation. Moreover, sucrose-associated genes were shown to be directly responsive to short term sucrose stimuli, confirming their role in sugar-related pathways.</p> <p>Conclusion -</p> <p>Gene expression analysis of sugarcane populations contrasting for sucrose content indicated a possible overlap with drought and cell wall metabolism processes and suggested signaling and transcriptional regulators to be used as molecular markers in breeding programs. Transgenic research is necessary to further clarify the role of the genes and define targets useful for sugarcane improvement programs based on transgenic plants.</p

Evidence-based guidelines for treating bipolar disorder: revised third edition recommendations from the British Association for Psychopharmacology

The British Association for Psychopharmacology guidelines specify the scope and targets of treatment for bipolar disorder. The third version is based explicitly on the available evidence and presented, like previous Clinical Practice Guidelines, as recommendations to aid clinical decision making for practitioners: it may also serve as a source of information for patients and carers, and assist audit. The recommendations are presented together with a more detailed review of the corresponding evidence. A consensus meeting, involving experts in bipolar disorder and its treatment, reviewed key areas and considered the strength of evidence and clinical implications. The guidelines were drawn up after extensive feedback from these participants. The best evidence from randomized controlled trials and, where available, observational studies employing quasi-experimental designs was used to evaluate treatment options. The strength of recommendations has been described using the GRADE approach. The guidelines cover the diagnosis of bipolar disorder, clinical management, and strategies for the use of medicines in short-term treatment of episodes, relapse prevention and stopping treatment.The use of medication is integrated with a coherent approach to psychoeducation and behaviour change

Dispersal of Group A Streptococcal Biofilms by the Cysteine Protease SpeB Leads to Increased Disease Severity in a Murine Model

Group A Streptococcus (GAS) is a Gram-positive human pathogen best known for causing pharyngeal and mild skin infections. However, in the 1980's there was an increase in severe GAS infections including cellulitis and deeper tissue infections like necrotizing fasciitis. Particularly striking about this elevation in the incidence of severe disease was that those most often affected were previously healthy individuals. Several groups have shown that changes in gene content or regulation, as with proteases, may contribute to severe disease; yet strains harboring these proteases continue to cause mild disease as well. We and others have shown that group A streptococci (MGAS5005) reside within biofilms both in vitro and in vivo. That is to say that the organism colonizes a host surface and forms a 3-dimensional community encased in a protective matrix of extracellular protein, DNA and polysaccharide(s). However, the mechanism of assembly or dispersal of these structures is unclear, as is the relationship of these structures to disease outcome. Recently we reported that allelic replacement of the streptococcal regulator srv resulted in constitutive production of the streptococcal cysteine protease SpeB. We further showed that the constitutive production of SpeB significantly decreased MGAS5005Δsrv biofilm formation in vitro. Here we show that mice infected with MGAS5005Δsrv had significantly larger lesion development than wild-type infected animals. Histopathology, Gram-staining and immunofluorescence link the increased lesion development with lack of disease containment, lack of biofilm formation, and readily detectable levels of SpeB in the tissue. Treatment of MGAS5005Δsrv infected lesions with a chemical inhibitor of SpeB significantly reduced lesion formation and disease spread to wild-type levels. Furthermore, inactivation of speB in the MGAS5005Δsrv background reduced lesion formation to wild-type levels. Taken together, these data suggest a mechanism by which GAS disease may transition from mild to severe through the Srv mediated dispersal of GAS biofilms