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

Correlation between Subjective Nasal Patency and Intranasal Airflow Distribution

Objectives (1) Analyze the relationship between intranasal airflow distribution and subjective nasal patency in healthy and nasal airway obstruction (NAO) cohorts using computational fluid dynamics (CFD). (2) Determine whether intranasal airflow distribution is an important objective measure of airflow sensation that should be considered in future NAO virtual surgery planning. Study Design Cross-sectional. Setting Academic tertiary medical center and academic dental clinic. Subjects and Methods Three-dimensional models of nasal anatomy were created based on computed tomography scans of 15 patients with NAO and 15 healthy subjects and used to run CFD simulations of nasal airflow and mucosal cooling. Subjective nasal patency was quantified with a visual analog scale (VAS) and the Nasal Obstruction Symptom Evaluation (NOSE). Regional distribution of nasal airflow (inferior, middle, and superior) was quantified in coronal cross sections in the narrowest nasal cavity. The Pearson correlation coefficient was used to quantify the correlation between subjective scores and regional airflows. Results Healthy subjects had significantly higher middle airflow than patients with NAO. Subjective nasal patency had no correlation with inferior and superior airflows but a high correlation with middle airflow (|r| = 0.64 and |r| = 0.76 for VAS and NOSE, respectively). Anterior septal deviations tended to shift airflow inferiorly, reducing middle airflow and reducing mucosal cooling in some patients with NAO. Conclusion Reduced middle airflow correlates with the sensation of nasal obstruction, possibly due to a reduction in mucosal cooling in this region. Further research is needed to elucidate the role of intranasal airflow distribution in the sensation of nasal airflow

Lyapunov conditions for differentiability of Markov chain expectations: The absolutely continuous case

We consider a family of Markov chains whose transition dynamics are affected by model parameters. Understanding the parametric dependence of (complex) performance measures of such Markov chains is often of significant interest. The derivatives of the performance measures w.r.t. the parameters play important roles, for example, in numerical optimization of the performance measures, and quantification of the uncertainties in the performance measures when there are uncertainties in the parameters from the statistical estimation procedures. In this paper, we establish conditions that guarantee the differentiability of various types of intractable performance measures---such as the stationary and random horizon discounted performance measures---of general state space Markov chains and provide probabilistic representations for the derivatives

Suppression of mitochondrial respiration through recruitment of p160 myb binding protein to PGC-1α : modulation by p38 MAPK

The transcriptional coactivator PPAR gamma coactivator 1 α (PGC-1α) is a key regulator of metabolic processes such as mitochondrial biogenesis and respiration in muscle and gluconeogenesis in liver. Reduced levels of PGC-1α in humans have been associated with type II diabetes. PGC-1α contains a negative regulatory domain that attenuates its transcriptional activity. This negative regulation is removed by phosphorylation of PGC-1α by p38 MAPK, an important kinase downstream of cytokine signaling in muscle and β-adrenergic signaling in brown fat. We describe here the identification of p160 myb binding protein (p160MBP) as a repressor of PGC-1α. The binding and repression of PGC-1α by p160MBP is disrupted by p38 MAPK phosphorylation of PGC-1α. Adenoviral expression of p160MBP in myoblasts strongly reduces PGC-1α's ability to stimulate mitochondrial respiration and the expression of the genes of the electron transport system. This repression does not require removal of PGC-1α from chromatin, suggesting that p160MBP is or recruits a direct transcriptional suppressor. Overall, these data indicate that p160MBP is a powerful negative regulator of PGC-1α function and provide a molecular mechanism for the activation of PGC-1α by p38 MAPK. The discovery of p160MBP as a PGC-1α regulator has important implications for the understanding of energy balance and diabetes

Guarantees and Capital Infusions in Response to Financial Crises C: U.S. 2009 Stress Test

When President Obama took office in 2009, the Treasury focused on restarting bank lending and repairing the ability of the banking system as a whole to perform the role of credit intermediation. In order to do so, the Treasury needed to raise public confidence that banks had sufficient buffers to withstand even a very adverse economic scenario, especially given heightened uncertainty surrounding the outlook of the U.S. economy and potential losses in the banking system. The Supervisory Capital Assessment Program (SCAP)—the so-called “stress tests”—sought to rigorously measure the resilience of the largest bank holding companies. Those found to have insufficient buffers were able to raise funds from the private sector, and if unable to do so, the Capital Assistance Program (CAP) would capitalize the firm with public capital. surroundin

Time--Splitting Schemes and Measure Source Terms for a Quasilinear Relaxing System

Several singular limits are investigated in the context of a $2 \times 2$ system arising for instance in the modeling of chromatographic processes. In particular, we focus on the case where the relaxation term and a $L^2$ projection operator are concentrated on a discrete lattice by means of Dirac measures. This formulation allows to study more easily some time-splitting numerical schemes

Dark Matter Scaling Relations

We establish the presence of a dark matter core radius, for the first time in a very large number of spiral galaxies of all luminosities. Contrary to common opinion we find that the sizes of these cores and the " DM core problem" are bigger for more massive spirals. As a result the Burkert profile provides an excellent mass model for dark halos around disk galaxies. Moreover, we find that the spiral dark matter core densities $\rho_{0}$ and core radii $r_{0}$ lie in the same scaling relation $\rho_{0}=4.5\times 10^-2 (r_{0}/kpc)^{-2/3} M_{\odot}pc^{-3}$ of dwarf galaxies with core radii upto ten times more smaller.Comment: 4 pages, 4 figures, Accepted for Publication in Apj Let

A role for ATP Citrate Lyase in cell cycle regulation during myeloid differentiation

Differentiation of myeloid progenitor cells into macrophages is accompanied by increased PU.1 concentration and increasing cell cycle length, culminating in cell cycle arrest. Induction of PU.1 expression in a cultured myeloid cell line expressing low PU.1 concentration results in decreased levels of mRNA encoding ATP-Citrate Lyase (ACL) and cell cycle arrest. ACL is an essential enzyme for generating acetyl-CoA, a key metabolite for the first step in fatty acid synthesis and for histone acetylation. We hypothesized that ACL may play a role in cell cycle regulation in the myeloid lineage. In this study, we found that acetyl-CoA or acetate supplementation was sufficient to rescue cell cycle progression in cultured BN cells treated with an ACL inhibitor or induced for PU.1 expression. Acetyl-CoA supplementation was also sufficient to rescue cell cycle progression in BN cells treated with a fatty acid synthase (FASN) inhibitor. We demonstrated that acetyl-CoA was utilized in both fatty acid synthesis and histone acetylation pathways to promote proliferation. Finally, we found that Acly mRNA transcript levels decrease during normal macrophage differentiation from bone marrow precursors. Our results suggest that regulation of ACL activity is a potentially important point of control for cell cycle regulation in the myeloid lineage

The dynamics of Abell 2634

We have amassed a large sample of velocity data for the cluster of galaxies Abell 2634 which contains the wide-angle tail (WAT) radio source 3C 465. Robust indicators of location and scale and their confidence intervals are used to determine if the cD galaxy, containing the WAT, has a significant peculiar motion. We find a cD peculiar radial velocity of 219 plus or minus 98 km s(exp -1). Further dynamical analyses, including substructure and normality tests, suggest that A 2634 is an unrelaxed cluster whose radio source structure may be bent by the turbulent gas of a recent cluster-subcluster merger