Quantifying an aquifer nitrate budget and future nitrate discharge using field data from streambeds and well nests

Novel groundwater sampling (age, flux, and nitrate) carried out beneath a streambed and in wells was used to estimate (1) the current rate of change of nitrate storage, dSNO3 /dt, in a contaminated unconfined aquifer, and (2) future [NO3–]FWM (the flow-weighted mean nitrate concentration in groundwater discharge) and fNO3 (the nitrate flux from aquifer to stream). Estimates of dSNO3 /dt suggested that at the time of sampling (2013) the nitrate storage in the aquifer was decreasing at an annual rate (mean = –9 mmol/m2yr) equal to about one-tenth the rate of nitrate input by recharge. This is consistent with data showing a slow decrease in the [NO3–] of groundwater recharge in recent years. Regarding future [NO3–]FWM and fNO3 , predictions based on well data show an immediate decrease that becomes more rapid after ~5 years before leveling out in the early 2040s. Predictions based on streambed data generally show an increase in future [NO3–]FWM and fNO3 until the late 2020s, followed by a decrease before leveling out in the 2040s. Differences show the potential value of using information directly from the groundwater—surface water interface to quantify the future impact of groundwater nitrate on surface water quality. The choice of denitrification kinetics was similarly important; compared to zero-order kinetics, a first-order rate law levels out estimates of future [NO3–]FWM and fNO3 (lower peak, higher minimum) as legacy nitrate is flushed from the aquifer. Major fundamental questions about nonpoint-source aquifer contamination can be answered without a complex numerical model or long-term monitoring program

Dupilumab significantly modulates pain and discomfort in patients with atopic dermatitis : a post hoc analysis of 5 randomized clinical trials

Background Pain is a frequent symptom of atopic dermatitis (AD). Objectives The aims of the study were to evaluate the effects of dupilumab on pain/discomfort in AD and to determine whether pain correlates with other outcomes. Methods This was a post hoc analysis of 5 randomized, placebo-controlled clinical trials in which adults with chronic AD received placebo or dupilumab 300 mg every 2 weeks or once weekly with and without topical corticosteroids. Proportions of patients with no pain/discomfort on this dimension of the 5-dimension EuroQoL (EQ-5D) at week 16 (all trials) and week 52 (CHRONOS) were compared between placebo and dupilumab. Correlations were evaluated between pain/discomfort and signs and symptoms of AD. Results Among 2632 evaluated patients, 72.9% to 83.1% reported at least moderate pain/discomfort at baseline. Higher proportions treated with dupilumab reported no pain/discomfort at week 16 relative to placebo; risk differences ranged from 22.3% (95% confidence interval = 11.5%–33.1%) to 42.2% (95% confidence interval = 26.6%–57.8%, all P ≤ 0.0001), with similar effects observed at week 52. Correlations at baseline of pain/discomfort with signs and symptoms of AD were low to moderate. Conclusions Pain/discomfort, present in a substantial proportion of patients with moderate-to-severe AD, was significantly reduced by dupilumab treatment. Given the low-to-moderate correlations with other AD symptoms at baseline, pain likely represents a distinct AD symptom. Trial Registration: ClinicalTrials.gov identifiers NCT01859988, NCT02277743, NCT02277769, NCT02260986, and NCT02755649

A-CD estrogens. I. substituent effects, hormone potency, and receptor subtype selectivity in a new family of flexible estrogenic compounds

Long-term use of estrogen supplements by women leads to an increased risk of breast and uterine cancers. Possible mechanisms include metabolism of estradiol and compounds related to tumor-initiating quinones, and ligand-induced activation of the estrogen receptors ERα and ERβ which can cause cancer cell proliferation, depending on the ratio of receptors present. One therapeutic goal would be to create a spectrum of compounds of variable potency for ERα and ERβ, which are resistant to quinone formation, and to determine an optimum point in this spectrum. We describe the synthesis, modeling, binding affinities, hormone potency, and a measure of quinone formation for a new family of A-CD estrogens, where the A-C bond is formed by ring coupling. Some substituents on the A-ring increase hormone potency, and one compound is much less quinone-forming than estradiol. These compounds span a wide range of receptor subtype selectivities and may be useful in hormone replacement therapy

Sevikar (R): Combination therapy for the treatment of hypertension

Hypertension is a highly prevalent disease and one of the most important modifiable risk factors for cardiovascular disease. Hypertension remains the leading cause of mortality and the third largest cause of disability in both developed and developing countries. Although recent guidelines and advisory statements are recommending lower thresholds and goals for antihypertensive treatment, approximately two thirds of patients do not achieve the goals. In the United States only 36.8% of hypertensive patients achieve the goal o