A patient preference study that evaluated fluticasone furoate and mometasone furoate nasal sprays for allergic rhinitis

Background: Corticosteroid nasal sprays are the mainstay of treatment for allergic rhinitis. These sprays have sensory attributes such as scent and/or odor, taste and aftertaste, and run down the throat and/or the nose, which, when unpleasant, can affect patient preference for, and compliance with, treatment. Objective: This study examined patient preference for fluticasone furoate nasal spray (FFNS) or mometasone furoate nasal spray (MFNS) based on their sensory attributes after administration in patients with allergic rhinitis. Methods: This was a multicenter, randomized, double-blind, cross-over study. Patient preferences were determined by using three questionnaires (Overall Preference, Immediate Attributes, and Delayed Attributes). Results: Overall, 56% of patients stated a preference for FFNS versus 32% for MFNS (p _ 0.001); the remaining 12% stated no preference. More patients stated a preference for FFNS versus MFNS for the attributes of “less drip down the throat” (p _ 0.001), “less run out of the nose” (p _ 0.05), “more soothing” (p _ 0.05), and “less irritating” (p _ 0.001). More patients responded in favor of FFNS versus MFNS for the immediate attributes, “run down the throat” (p _ 0.001), and “run out of the nose” (p _ 0.001), and, in the delayed attributes, “run down the throat” (p _ 0.001), “run out of the nose” (p _ 0.01), “presence of aftertaste” (p _ 0.01), and “no nasal irritation” (p _ 0.001). Conclusion: Patients with allergic rhinitis preferred FFNS versus MFNS overall and based on a number of individual attributes, including “less drip down the throat,” “less run out of the nose,” and “less irritating.” Greater preference may improve patient adherence and thereby improve symptom management of the patient’s allergic rhinitis

Assessing the impact of peat erosion on growing season CO2 fluxes by comparing erosional peat pans and surrounding vegetated haggs (article)

This is the author accepted manuscript. The final version is available from International Mire Conservation Group and International Peat Society via the DOI in this record.The research data supporting this publication are openly available from the University of Exeter's institutional repository at: https://doi.org/10.24378/exe.1143.Peatlands are recognised as an important but vulnerable ecological resource. Understanding the effects of existing damage, in this case erosion, enables more informed land management decisions to be made. Over the growing seasons of 2013 and 2014 photosynthesis and ecosystem respiration were measured using closed chamber techniques within vegetated haggs and erosional peat pans in Dartmoor National Park, southwest England. Below-ground total and heterotrophic respiration were measured and autotrophic respiration estimated from the vegetated haggs. The mean water table was significantly higher in the peat pans than in the vegetated haggs; because of this, and the switching from submerged to dry peat, there were differences in vegetation composition, photosynthesis and ecosystem respiration. In the peat pans photosynthetic CO2 uptake and ecosystem respiration were greater than in the vegetated haggs and strongly dependent on the depth to water table (r2>0.78, p<0.001). Whilst in the vegetated haggs, photosynthesis and ecosystem respiration had the strongest relationships with normalised difference vegetation index (NDVI) (r2=0.82, p<0.001) and soil temperature at 15 cm depth (r2=0.77, p=0.001). Autotrophic and total below-ground respiration in the vegetated haggs varied with soil temperature; heterotrophic respiration increased as water tables fell. An empirically derived net ecosystem model estimated that over the two growing seasons both the vegetated haggs (29 and 20 gC m 2; 95 % confidence intervals of -570 to 762 and -873 to 1105 gC m-2) and the peat pans (7 and 8 gC m 2; 95 % confidence intervals of -147 to 465 and -136 to 436 gC m 2) were most likely net CO2 sources. This study suggests that not only the visibly degraded bare peat pans but also the surrounding vegetated haggs are losing carbon to the atmosphere, particularly during warmer and drier conditions, highlighting a need for ecohydrological restoration.MomentaSouth West Water (SWW)Dartmoor National Park Authorit

Drain blocking has limited short-term effects on greenhouse gas fluxes in a Molinia caerulea dominated shallow peatland (article)

This is the final version. Available on open access from Elsevier via the DOI in this recordThe dataset associated with this article is available in ORE at https://doi.org/10.24378/exe.2723Drained peatlands dominated by purple moor grass (Molinia caerulea) are widespread in the UK and Western Europe. Although substantial carbon stores may be present in these peatlands, in this degraded state they are not currently acting as carbon sinks. Therefore, M.caerulea dominated peatlands have been identified as potential sites for ecohydrological restoration to tackle the current climate emergency. However, at present little is known about whether ditch blocking can raise water tables and promote the recovery of bog plant species, and the subsequent effects on carbon sequestration in these peatlands. To investigate the potential for restoration, we measured changes in water table depth, vegetation composition, photosynthesis at 1000 μmol Photons m−2 s−1 (PG1000), ecosystem respiration (REco) and partitioned below-ground respiration in two M.caerulea dominated peatlands in which drainage ditches had been blocked located in Exmoor National Park, southwest England. Measurements were made in two headwater catchments at ⅛, ¼ and ½ of the distance between adjacent drainage ditches at four control-restored paired sites, during the growing seasons pre- (2012) and post- (2014, 2016 & 2018) restoration. Restoration had a small but significant (p = 0.009) effect on water table depths however, this did not result in a significant change in vegetation composition (p > 0.350). Ecosystem respiration increased in both the control and restored locations following restoration however, this increase was significantly smaller (p = 0.010) at the restored locations, possibly due to a similarly reduced increase in photosynthesis, although this change was not significant (p = 0.116). Below-ground respiration showed no significant changes following restoration. This research illustrates how degraded these shallow peatlands are, and raises concerns that ditch blocking alone may not bring about the high and stable water tables required to perturb the existing Molinia caerulea-dominated ecosystem and substantially alter the carbon balance. Additional restoration measures may be required.South West Water (SWW)University of ExeterTechnology Strategy Board CouncilNatural Environment Research Council (NERC

Prostate cancer risk: associations with ultraviolet radiation, tyrosinase and melanocortin-1 receptor genotypes

Exposure to ultraviolet radiation may reduce prostate cancer risk, suggesting that polymorphism in genes that mediate host pigmentation will be associated with susceptibility to this cancer. We studied 210 prostate cancer cases and 155 controls to determine whether vitamin D receptor (VDR, Taql and Fokl variants), tyrosinase (TYR, codon 192 variant) and melanocortin-1 receptor (MC1R, Arg151Cys, Arg160Trp, Val92Met, Asp294His and Asp84Glu variants) genotypes are associated with risk. UV exposure was determined using a questionnaire. MC1R Arg160/Arg160 homozygotes were at increased risk (P = 0.027, odds ratio = 1.94) while TYR A2/A2 homozygotes were at reduced risk of prostate cancer (P = 0.033, odds ratio = 0.48). These associations remained significant after correction for UV-exposure. Stratification of cases and controls by quartiles of exposure, showed that the protective effect of TYR A1A2 (P = 0.006, odds ratio 0.075) and A2A2 (P = 0.003, odds ratio 0.055) was particularly strong in subjects who had received the greatest exposure. Our data show for the first time, that allelism in genes linked with skin pigment synthesis is associated with prostate cancer risk possibly because it mediates the protective effects of UV. Importantly, susceptibility is associated with an interaction between host predisposition and exposure. © 2001 Cancer Research Campaign  http://www.bjcancer.co

Nyquist method for Wigner-Poisson quantum plasmas

By means of the Nyquist method, we investigate the linear stability of electrostatic waves in homogeneous equilibria of quantum plasmas described by the Wigner-Poisson system. We show that, unlike the classical Vlasov-Poisson system, the Wigner-Poisson case does not necessarily possess a Penrose functional determining its linear stability properties. The Nyquist method is then applied to a two-stream distribution, for which we obtain an exact, necessary and sufficient condition for linear stability, as well as to a bump-in-tail equilibrium.Comment: 6 figure

Potentially Inappropriate Prescribing in Australian Nursing Home Residents with Advanced Dementia: A Substudy of the IDEAL Study

© 2018, Mary Ann Liebert, Inc. Background: Prescribing medications for nursing home residents with advanced dementia should focus on optimizing function and comfort, reducing unnecessary harms and aligning care goals with a palliative approach. Objective: The aim of the study was to estimate the proportion of Australian nursing home residents with advanced dementia receiving potentially inappropriate medications, and identify those most commonly prescribed and factors associated with their use. Design: Data were collected through retrospective audit of medication charts. Setting/Subjects: Two hundred eighteen nursing home residents with advanced dementia from 20 nursing homes participated in a cluster-randomized controlled trial of case conferencing (the IDEAL Study) from June 2013 to December 2014. Measurements: Inappropriate drug use was defined as medications classified as "never appropriate" by the Palliative Excellence in Alzheimer Care Efforts (PEACE) program criteria. Generalized linear mixed models were used to identify variables predicting use of "never" appropriate medications. Results: Over a quarter (n = 65, 30%) of residents received at least one medication classed as "never" appropriate, the most common being lipid-lowering agents (n = 38, 17.4%), antiplatelet agents (n = 18, 8.3%), and acetylcholinesterase inhibitors (n = 16, 7.3%). Residents who had been at the nursing home for ≤10 months (odds ratio [OR] 5.60, 95% confidence interval [CI] 1.74-18.06) and 11-21 months (OR 5.41, 95% CI 1.67-17.75) had significantly greater odds of receiving a never appropriate medication compared with residents who had been at the nursing home for >5 years. Conclusions: Use of potentially inappropriate medications in Australian nursing home residents with advanced dementia is common. A greater understanding of the rationale that underpins prescribing of medications is required

HumanMethylation450K array–identified biomarkers predict tumour recurrence/progression at initial diagnosis of high-risk non-muscle Invasive bladder cancer

Background: High-risk non-muscle invasive bladder cancer (HR-NMIBC) is a clinically unpredictable disease. Despite clinical risk estimation tools, many patients are undertreated with intra-vesical therapies alone, whereas others may be over-treated with early radical surgery. Molecular biomarkers, particularly DNA methylation, have been reported as predictive of tumour/patient outcomes in numerous solid organ and haematologic malignancies; however, there are few reports in HR-NMIBC and none using genome-wide array assessment. We therefore sought to identify novel DNA methylation markers of HR-NMIBC clinical outcomes that might predict tumour behaviour at initial diagnosis and help guide patient management. Patients and methods: A total of 21 primary initial diagnosis HR-NMIBC tumours were analysed by Illumina HumanMethylation450 BeadChip arrays and subsequently bisulphite Pyrosequencing. In all, 7 had not recurred at 1 year after resection and 14 had recurred and/or progressed despite intra-vesical BCG. A further independent cohort of 32 HR-NMIBC tumours (17 no recurrence and 15 recurrence and/ or progression despite BCG) were also assessed by bisulphite Pyrosequencing. Results: Array analyses identified 206 CpG loci that segregated non-recurrent HR-NMIBC tumours from clinically more aggressive recurrence/progression tumours. Hypermethylation of CpG cg11850659 and hypomethylation of CpG cg01149192 in combination predicted HRNMIBC recurrence and/or progression within 1 year of diagnosis with 83% sensitivity, 79% specificity, and 83% positive and 79% negative predictive values. Conclusions: This is the first genome-wide DNA methylation analysis of a unique HR-NMIBC tumour cohort encompassing known 1-year clinical outcomes. Our analyses identified potential novel epigenetic markers that could help guide individual patient management in this clinically unpredictable diseas

Delocalization of states in two component superlattices with correlated disorder

Electron and phonon states in two different models of intentionally disordered superlattices are studied analytically as well as numerically. The localization length is calculated exactly and we found that it diverges for particular energies or frequencies, suggesting the existence of delocalized states for both electrons and phonons. Numerical calculations for the transmission coefficient support the existence of these delocalized states.Comment: RevTeX, 12 pages, 2 PS figures adde