63 research outputs found
Changements comportementaux et neuro-anatomiques suite à un entrainement aérobie chez les individus atteints de la maladie de Parkinson
La maladie de Parkinson (MP) est la deuxieÌme maladie neurodeÌgeÌneÌrative la plus reÌpandue au Canada et dans dâautres pays industrialiseÌs. Cette pathologie se caracteÌrise par des symptoÌmes moteurs tels que les tremblements de repos, la rigiditeÌ musculaire, la difficulteÌ aÌ initier les gestes volontaires et la lenteur dans lâexeÌcution des mouvements (i.e., akineÌsie et bradykineÌsie). Des symptoÌmes non moteurs, tels que des troubles cognitifs, de sommeil et autres sont eÌgalement couramment rencontreÌs.
LâactiviteÌ physique sâest montreÌe jusquâaÌ ce jour un compleÌment inteÌressant aux traitements pharmacologiques et neurochirurgicaux existants pour soulager les symptoÌmes de la MP. Cependant, malgreÌ les connaissances acquises jusquâaÌ preÌsent concernant lâimpact de lâexercice physique chez les personnes atteintes de cette maladie, il est possible de constater que plusieurs questions demeurent encore sans reÌponse ou peu eÌlucideÌes. Le preÌsent travail sâinseÌre donc dans un immense projet de recherche qui a pour but de combler certaines de ces lacunes. Plus preÌciseÌment, lâobjectif principal de cette theÌse est dâeÌvaluer les effets dâun entrainement de type aeÌrobie chez une population atteinte de la MP sur les parameÌtres de marche, la mobiliteÌ du membre supeÌrieur et les structures anatomiques ceÌreÌbrales. Un second objectif est dâobserver les relations existantes entre ces trois composantes, et dâautres parameÌtres tels que lâameÌlioration des capaciteÌs aeÌrobies, les fonctions exeÌcutives et les capaciteÌs dâapprentissage dâune nouvelle seÌquence motrice.
Vingt adultes en bonne santeÌ et 19 personnes atteintes de la MP ont participeÌ aÌ un programme dâentraiÌnement de 3 mois sur veÌlo stationnaire, aÌ raison de 3 seÌances par semaine durant lesquelles la dureÌe (20 aÌ 40 minutes) et lâintensiteÌ (60% aÌ 80% de la freÌquence cardiaque maximale) eÌtaient augmenteÌes de façon progressive. Plusieurs mesures telles que le patron de la
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marche, la mobiliteÌ du membre supeÌrieur, les fonctions exeÌcutives, lâapprentissage dâune taÌche motrice, les capaciteÌs aeÌrobies (VO2 pic), les symptoÌmes moteurs de la MP et quelques meÌtriques provenant de donneÌes dâimagerie par reÌsonance magneÌtique ont eÌteÌ acquises avant et apreÌs le programme dâexercice.
Les reÌsultats ont permis de deÌmontrer quâun entraiÌnement de 3 mois sur veÌlo stationnaire est beÌneÌfique pour les gens atteints de la MP. En effet, ce type dâexercice permet dâaugmenter la cadence et la vitesse marche. Il est eÌgalement possible de reÌduire la force antagoniste, en plus dâameÌliorer la propagation du signal neuromusculaire antagoniste, ameÌliorant globalement la mobiliteÌ du membre supeÌrieur. Finalement, un exercice aeÌrobie de 3 mois permettre eÌgalement dâaugmenter le volume de certaines structures ceÌreÌbrales, tel que le globus pallidus.
Ce projet de recherche est parmi les premiers aÌ deÌmontrer lâefficaciteÌ dâun programme dâentraiÌnement aeÌrobie sur veÌlo stationnaire pour ameÌliorer les parameÌtres de la marche et la mobiliteÌ du membre supeÌrieur. Cette eÌtude est eÌgalement la premieÌre aÌ investiguer les effets de lâexercice sur les structures ceÌreÌbrales de personnes atteintes de la MP et ainsi essayer de comprendre les meÌcanismes qui sont sous-jacents aux ameÌliorations des symptoÌmes moteurs et non-moteurs suite aÌ un programme dâactiviteÌ physique dâintensiteÌ modeÌreÌe aÌ eÌleveÌe. Nous croyons que les reÌsultats obtenus aideront les speÌcialistes de lâactiviteÌ physique aÌ offrir une prescription dâexercice adapteÌe et varieÌe pour la population de gens atteints de la maladie de Parkinson.Parkinsonâs disease (PD) is the second most common neurodegenerative disease in Canada and other industrialized countries. The pathology is characterized by motor symptoms such as resting tremor, muscle rigidity, difficulty in initiating voluntary gestures and slowness in the execution of movements (i.e. bradykinesia). Non-motor symptoms, such as cognitive impairment, sleep disorders and others are commonly encountered.
To date, physical activity has been an interesting complement to existing pharmacological and neurosurgical treatments to relieve the symptoms of PD. However, despite the knowledge gained so far about the impact of physical exercise in patients with the disease, it is possible to note that many questions remain unanswered or unclear. This work is part of a larger research project that aims to fill some of theses gaps. More specifically, the main objective of this thesis is to evaluate the effects of an aerobic training in a population with PD on walking parameters, upper limb mobility and anatomical brain structures. A second objective is to observe the relationships existing between these three components, and with other parameters such as the improvement of aerobic capacities, the executive functions and the learning capacities of a new motor skill.
20 healthy adults and 19 persons with PD participated in a 3-month stationary recumbent bicycle training program, with 3 sessions per week during which the duration (20 to 40 minutes) and intensity (60 to 80%) were increased gradually. Several measures such as walking pattern, upper limb function, executive functions, learning of a new motor skill, aerobic capacities (VO2 peak), motor symptoms of PD and magnetic resonance imaging were acquired before and after the exercise program.
The results showed that a 3-month training on stationary bike is beneficial for people with PD. Indeed, this type of exercise can increase the cadence and walking speed. It is also possible
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to reduce the antagonist force, in addition to improve the propagation of this neuromuscular signal, generally improving the mobility of the upper limb. Finally, an aerobic exercise of 3 months can also increase the volume of certain brain structures, such as globus pallidus.
This research project is among the first to demonstrate the effectiveness of a stationary bicycle aerobic exercise program to improve gait parameters and upper limb function in persons with PD. This study is also the first to investigate the effects of exercise on the brain structures of these patients and to try to understand the mechanisms that underlie improvements in motor and non-motor symptoms following a moderate to high intensity exercise program. We believe that the results obtained will help physical activity specialists to provide a more tailored and varied exercise prescription for people living with Parkinsonâs disease
Racines citoyennes : la communautĂ© locale au coeur de la transition Ă©cologique Lâimpact des initiatives climatiques locales et citoyennes Ă MontrĂ©al
Dans les villes, un nombre croissant de citoyens met en place de maniĂšre indĂ©pendante des initiatives pour faire face aux changements climatiques, tels que des projets de verdissement, dâagriculture urbaine ou dâĂ©nergies alternatives. Cet article cherche Ă comprendre comment les acteurs citoyens locaux contribuent Ă la gouvernance climatique urbaine par le biais dâexpĂ©rimentations sociales et environnementales de petite Ă©chelle. Ă partir de lâĂ©tude de cas du quartier Rosemont-La Petite-Patrie Ă MontrĂ©al (Canada) portant sur huit initiatives, cette recherche se base sur un cadre thĂ©orique combinant les expĂ©rimentations de gouvernance climatique et la thĂ©orie de transition sociotechnique. Lâaccumulation et lâinfl uence de telles initiatives peuvent contribuer Ă redĂ©fi nir les enjeux urbains et dĂ©montrer la faisabilitĂ© et lâacceptabilitĂ© de solutions simples afi n de mieux eff ectuer une transition urbaine face aux changements climatiques. En sâappuyant sur leur rĂ©seau social mais aussi sur leurs objectifs et leur savoir-faire, les militants urbains Ă©tablissent leur lĂ©gitimitĂ© en tant quâacteurs capables de proposer des alternatives Ă lâadministration municipale. LesrĂ©sultats de la recherche montrent Ă©galement que ces initiatives locales refl Ăštent le pouvoir grandissant des modes dâaction collectifs informels. En effet, par le biais des actions locales «vertes», les citoyens produisent des retombĂ©es directes, concrĂštes, simples et axĂ©es sur leur bĂ©nĂ©fi ce personnel. Ce faisant, ils construisent de nouveaux Ă©cosystĂšmes basĂ©s sur divers partenariats. Il sâagit dâun modĂšle alternatif innovant face aux modes actuels de consommation des ressources et Ă la maniĂšre dont est socialement gĂ©rĂ©e la crise climatique Ă partir dâun paradigme façonnĂ© par le capitalisme et le nĂ©olibĂ©ralisme.Within urban areas, a growing number of citizens independently set up initiatives to face climate change, such as greening, urban agriculture or alternative energy projects. This paper seeks to understand how local citizensâactors contribute to urban climate governance through small-scale social and environmental experiments. Based on a Montreal (Canada) neighbourhood Rosemont-La Petite-Patrie case study of eight initiatives, the research is based on a theoretical framework combining climate governance experiments and sociotechnical transition theory. The accumulation and infl uence of such initiatives can contribute to redefine urban issues and demonstrate the feasibility and acceptability of simple solutions in order to implement an urban transition in face of climate change. Using their social network but also their objectives and know-how, urban activists establish their legitimacy as stakeholders who can propose alternatives to the municipal government. Results of the study also show that such local experiments refl ect the growing power of informal collective modes of action. Indeed, through local âgreenâ actions, citizens produce impacts that are immediate, concrete, simple and âpersonal-benefit-oriented.â By doing so, they build new ecosystems made of various partnerships. Th is off ers an innovative alternative model in the face of the current ways of consuming resources and about how we socially deal with the climate crisis under a paradigm shaped by capitalism and neoliberalism
Preterm Birth: An Inflammatory Syndrome, Not Just A Myometrial Disorder
Preterm birth (PTB) is the leading cause of neonatal mortality and morbidity. Although the severity of neonatal outcomes is inversely correlated with gestational age, all PTBs can lead to potentially life-threatening neonatal outcomes and major lifelong health complications. Because advances in neonatal care have substantially decreased neonatal mortality, the incidence of PTB and its complications is unabatedly rising. PTB currently affects more than 10% of births worldwide, with similar numbers in developed countries. Correspondingly, improving neonatal outcome is a key objective of the World Health Organization. The recently approved (in Europe) tocolytics drug, Atosiban, used to prolong preterm gestation, has not been shown to improve neonatal outcome, nor have other tocolytic agents used in clinic. Thus, PTB remains an unmet medical need. Recent evidence shows that most, if not all, PTBs are associated with (overt or occult) inflammatory processes in gestational tissues, independent of infection. Pro- inflammatory cytokines are produced from maternal and fetal cells in response to sterile or infectious stressors. These seem to orchestrate a multi-tissue response including myometrial contractility, cervical ripening, and weakening/rupture of fetal membranes, leading to the onset of preterm labor. This integrated system might have been conserved through mammalian evolution due to increased maternal and/or fetal survival when gestation is terminated in specific settings, such as infection. Hence, inflammation may be a common pathway to the numerous aetiologies of PTB. Most importantly, recent evidence suggests that inflammation is transmitted to the fetus, thereby inducing organ injuries that may underlie the development of major neonatal diseases. Targeting inflammation prenatally instead of myometrial contraction could be a more successful and safe approach for the management of PTB, as suggested by recent animal studies.Â
Résumé
La naissance preÌmatureÌe est la principale cause de mortaliteÌ et de morbiditeÌ neÌonatale. Bien que la seÌveÌriteÌ des issus neÌonataux soit inversement correÌleÌe avec lâaÌge gestationnel aÌ la naissance, toutes les naissances preÌmatureÌes peuvent mener aÌ des issus neÌonataux potentiellement mortels et aÌ des complications avec reÌpercussions sâeÌchelonnant sur toute la vie. EÌtant donneÌ que la mortaliteÌ neÌonatale a consideÌrablement diminueÌe avec les reÌcentes avanceÌes en neÌonatalogie, lâincidence de la naissance preÌmatureÌe et de ses complications sont en hausse. La naissance preÌmatureÌe affecte preÌsentement plus de 10% des naissances aÌ travers le monde, avec des taux similaires dans les pays deÌveloppeÌs. ConseÌquemment, dâameÌliorer lâissu neÌonatal est un objectif cleÌ de lâOrganisation Mondiale de la SanteÌ. Le tocolytique Atosiban reÌcemment approuveÌ (en Europe) pour prolonger les gestations preÌ- matureÌes nâa pas deÌmontreÌ dâefficaciteÌ pour ameÌliorer les issus neÌonataux, tout comme les autres tocolytiques utiliseÌs en clinique, et la naissance preÌmatureÌe demeure un besoin meÌdical non-atteint. Des donneÌes reÌcentes deÌmontrent que la plupart, sinon toutes les naissances preÌmatureÌes sont associeÌes avec des processus inflammatoires (francs ou silencieux) dans les tissus gestationnels, indeÌpendamment de lâinfection. Les cytokines pro-inflammatoires sont produites dans les cellules maternelles et fĆtales en reÌponse aÌ des stresseurs steÌriles ou infectieux, et semblent orchestrer une reÌponse multi-tissulaire incluant la contractiliteÌ myomeÌtriale, la preÌparation cervicale, et lâaffaiblissement/rupture des membranes fĆtales, menant au commencement du travail preÌterme. Ce systeÌme inteÌgreÌ pourrait avoir eÌteÌ conserveÌ durant lâeÌvolution mammifeÌre aÌ cause dâune survie accrue de la meÌre et/ou du fĆtus lorsque la gestation est termineÌe dans un contexte speÌcifique, comme lâinfection. Donc, lâinflammation pourrait constituer une voie commune finale pour les nombreuses causes de la naissance preÌmatureÌe. De façon importante, des donneÌes reÌcentes sug- geÌrent que cette inflammation est transmise au fĆtus et en retour induit des dommages aux organes qui pourraient sous-tendre le deÌveloppement de maladies neÌonatales majeures. De cibler lâinflammation en preÌnatal plutoÌt que les contractions myomeÌtriales pourrait constituer une approche seÌcuritaire et plus efficace, comme suggeÌreÌ par de reÌcentes eÌtudes animales.Â
Ăvaluation de la lisibilitĂ© et de la fluiditĂ© de lâĂ©criture manuelle dâĂ©lĂšves franco-quĂ©bĂ©cois de 1re et 2e annĂ©e du primaire
Contexte. Au QuĂ©bec, les difficultĂ©s dâĂ©criture manuelle et leur impact fonctionnel constituent le principal motif de rĂ©fĂ©rence en ergothĂ©rapie pour les enfants en milieu scolaire. Pour Ă©valuer le rendement de lâĂ©criture manuelle, plusieurs critĂšres peuvent ĂȘtre utilisĂ©s, tels que la lisibilitĂ© et la fluiditĂ©. Toutefois, aucune valeur de rĂ©fĂ©rence nâexiste pour situer et comparer correctement la lisibilitĂ© et la fluiditĂ© de lâĂ©criture manuelle auprĂšs dâenfants franco-quĂ©bĂ©cois.
Objectif. LâĂ©tude visait Ă dĂ©velopper un guide dâĂ©valuation de la lisibilitĂ© de lâĂ©criture manuelle, Ă dĂ©terminer des valeurs de rĂ©fĂ©rence de la lisibilitĂ© et de la fluiditĂ© pour des enfants francophones et Ă comparer les scores entre les filles et les garçons.
MĂ©thodologie. Il sâagit dâune analyse secondaire de donnĂ©es provenant dâune Ă©tude descriptive transversale rĂ©alisĂ©e auprĂšs dâĂ©lĂšves de 1re et de 2e annĂ©e du primaire. Les valeurs de rĂ©fĂ©rence de la lisibilitĂ© et de la fluiditĂ© ont Ă©tĂ© calculĂ©es Ă partir dâĂ©chantillons provenant de tĂąches en copie de prĂšs et Ă lâaide du guide dĂ©veloppĂ© dans la prĂ©sente Ă©tude.
RĂ©sultats. Les critĂšres du guide dâĂ©valuation de la lisibilitĂ© offrent une excellente fidĂ©litĂ© inter-juges pour la 1re annĂ©e du primaire et une bonne fidĂ©litĂ© interjuges pour la 2e annĂ©e. De plus, des valeurs de rĂ©fĂ©rence ont Ă©tĂ© obtenues pour la lisibilitĂ© et la fluiditĂ©. Une diffĂ©rence significative entre les scores de lisibilitĂ© des filles et des garçons de 2e annĂ©e a Ă©tĂ© relevĂ©e.
ConsĂ©quences. Le guide dâĂ©valuation et les valeurs de rĂ©fĂ©rence amĂ©liorent la rigueur de lâĂ©valuation ergothĂ©rapique de lâĂ©criture manuelle des enfants franco-quĂ©bĂ©cois, et ce, grĂące Ă des critĂšres observables et mesurables bien dĂ©finis.
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Background. In Quebec, handwriting difficulties and their functional impacts are the main reason for referral of children to occupational therapy for children in school settings. To evaluate handwriting performance, several criteria can be used such as legibility and accuracy. However, there are no norms to properly compare handwriting legibility and accuracy among French-speaking children in Québec.
Purpose. The purpose of the study was to develop a handwriting legibility assessment guide, to develop norms for legibility and accuracy for francophone children, and to compare scores between boys and girls.
Methods. This is a secondary analysis of data from a cross-sectional descriptive study of grade 1 and grade 2 students. Norms for legibility and accuracy were calculated from close-copy tasks samples and using the guide developed in this study.
Findings. The criteria used in the handwriting legibility assessment guide offer excellent inter-rater reliability for grade 1 students and good inter-rater reliability for grade 2 students. Norms were also obtained for legibility and fluency. There was a significant difference between the legibility score of grade 2 boys and girls.
Consequences. The assessment guide and norms increase the rigour of the occupational therapy evaluation of handwriting for Quebec francophone children, using well-defined observable and measurable criteria
Ăvaluation de la lisibilitĂ© et de la fluiditĂ© de lâĂ©criture manuelle dâĂ©lĂšves franco-quĂ©bĂ©cois de 1re et 2e annĂ©e du primaire
Contexte. Au QuĂ©bec, les difficultĂ©s dâĂ©criture manuelle et leur impact fonctionnel constituent le principal motif de rĂ©fĂ©rence en ergothĂ©rapie pour les enfants en milieu scolaire. Pour Ă©valuer le rendement de lâĂ©criture manuelle, plusieurs critĂšres peuvent ĂȘtre utilisĂ©s, tels que la lisibilitĂ© et la fluiditĂ©. Toutefois, aucune valeur de rĂ©fĂ©rence nâexiste pour situer et comparer correctement la lisibilitĂ© et la fluiditĂ© de lâĂ©criture manuelle auprĂšs dâenfants franco-quĂ©bĂ©cois.
Objectif. LâĂ©tude visait Ă dĂ©velopper un guide dâĂ©valuation de la lisibilitĂ© de lâĂ©criture manuelle, Ă dĂ©terminer des valeurs de rĂ©fĂ©rence de la lisibilitĂ© et de la fluiditĂ© pour des enfants francophones et Ă comparer les scores entre les filles et les garçons.
MĂ©thodologie. Il sâagit dâune analyse secondaire de donnĂ©es provenant dâune Ă©tude descriptive transversale rĂ©alisĂ©e auprĂšs dâĂ©lĂšves de 1re et de 2e annĂ©e du primaire. Les valeurs de rĂ©fĂ©rence de la lisibilitĂ© et de la fluiditĂ© ont Ă©tĂ© calculĂ©es Ă partir dâĂ©chantillons provenant de tĂąches en copie de prĂšs et Ă lâaide du guide dĂ©veloppĂ© dans la prĂ©sente Ă©tude.
RĂ©sultats. Les critĂšres du guide dâĂ©valuation de la lisibilitĂ© offrent une excellente fidĂ©litĂ© inter-juges pour la 1re annĂ©e du primaire et une bonne fidĂ©litĂ© interjuges pour la 2e annĂ©e. De plus, des valeurs de rĂ©fĂ©rence ont Ă©tĂ© obtenues pour la lisibilitĂ© et la fluiditĂ©. Une diffĂ©rence significative entre les scores de lisibilitĂ© des filles et des garçons de 2e annĂ©e a Ă©tĂ© relevĂ©e.
ConsĂ©quences. Le guide dâĂ©valuation et les valeurs de rĂ©fĂ©rence amĂ©liorent la rigueur de lâĂ©valuation ergothĂ©rapique de lâĂ©criture manuelle des enfants franco-quĂ©bĂ©cois, et ce, grĂące Ă des critĂšres observables et mesurables bien dĂ©finis.
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Background. In Quebec, handwriting difficulties and their functional impacts are the main reason for referral of children to occupational therapy for children in school settings. To evaluate handwriting performance, several criteria can be used such as legibility and accuracy. However, there are no norms to properly compare handwriting legibility and accuracy among French-speaking children in Québec.
Purpose. The purpose of the study was to develop a handwriting legibility assessment guide, to develop norms for legibility and accuracy for francophone children, and to compare scores between boys and girls.
Methods. This is a secondary analysis of data from a cross-sectional descriptive study of grade 1 and grade 2 students. Norms for legibility and accuracy were calculated from close-copy tasks samples and using the guide developed in this study.
Findings. The criteria used in the handwriting legibility assessment guide offer excellent inter-rater reliability for grade 1 students and good inter-rater reliability for grade 2 students. Norms were also obtained for legibility and fluency. There was a significant difference between the legibility score of grade 2 boys and girls.
Consequences. The assessment guide and norms increase the rigour of the occupational therapy evaluation of handwriting for Quebec francophone children, using well-defined observable and measurable criteria
The epithelial barrier: The gateway to allergic, autoimmune, and metabolic diseases and chronic neuropsychiatric conditions
Since the 1960 s, our health has been compromised by exposure to over 350,000 newly introduced toxic substances, contributing to the current pandemic in allergic, autoimmune and metabolic diseases. The "Epithelial Barrier Theory" postulates that these diseases are exacerbated by persistent periepithelial inflammation (epithelitis) triggered by exposure to a wide range of epithelial barrier-damaging substances as well as genetic susceptibility. The epithelial barrier serves as the body's primary physical, chemical, and immunological barrier against external stimuli. A leaky epithelial barrier facilitates the translocation of the microbiome from the surface of the afflicted tissues to interepithelial and even deeper subepithelial locations. In turn, opportunistic bacterial colonization, microbiota dysbiosis, local inflammation and impaired tissue regeneration and remodelling follow. Migration of inflammatory cells to susceptible tissues contributes to damage and inflammation, initiating and aggravating many chronic inflammatory diseases. The objective of this review is to highlight and evaluate recent studies on epithelial physiology and its role in the pathogenesis of chronic diseases in light of the epithelial barrier theory
Swiss public health measures associated with reduced SARS-CoV-2 transmission using genome data
Genome sequences from evolving infectious pathogens allow quantification of case introductions and local transmission dynamics. We sequenced 11,357 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) genomes from Switzerland in 2020 - the sixth largest effort globally. Using a representative subset of these data, we estimated viral introductions to Switzerland and their persistence over the course of 2020. We contrasted these estimates with simple null models representing the absence of certain public health measures. We show that Switzerland's border closures de-coupled case introductions from incidence in neighboring countries. Under a simple model, we estimate an 86-98% reduction in introductions during Switzerland's strictest border closures. Furthermore, the Swiss 2020 partial lockdown roughly halved the time for sampled introductions to die out. Last, we quantified local transmission dynamics once introductions into Switzerland occurred, using a phylodynamic model. We found that transmission slowed 35-63% upon outbreak detection in summer 2020, but not in fall. This finding may indicate successful contact tracing over summer before overburdening in fall. The study highlights the added value of genome sequencing data for understanding transmission dynamics
Sr/Ca ratios and oxygen isotopes from sclerosponges: Temperature history of the Carribean mixed layer and thermocline during the Little Ice Age
We investigate aragonitic skeletons of the Caribbean sclerosponge Ceratoporella nicholsoni from Jamaica,
20 m below sea level (mbsl), and Pedro Bank, 125 mbsl. We use d18O and Sr/Ca ratios as temperature proxies to
reconstruct the Caribbean mixed layer and thermocline temperature history since 1400 A.D. with a decadal time
resolution. Our age models are based on U/Th dating and locating of the radiocarbon bomb spike. The modern
temperature difference between the two sites is used to tentatively calibrate the C. nicholsoni Sr/Ca thermometer.
The resulting calibration points to a temperature sensitivity of Sr/Ca in C. nicholsoni aragonite of about
-0.1 mmol/mol/K. Our Sr/Ca records reveal a pronounced warming from the early 19th to the late 20th century,
both at 20 and 125 mbsl. Two temperature minima in the shallow water record during the late 17th and early
19th century correspond to the Maunder and Dalton sunspot minima, respectively. Another major cooling
occurred in the late 16th century and is not correlatable with a sunspot minimum. The temperature contrast
between the two sites decreased from the 14th century to a minimum in the late 17th century and subsequently
increased to modern values in the early 19th century. This is interpreted as a long-term deepening and
subsequent shoaling of the Caribbean thermocline. The major trends of the Sr/Ca records are reproduced in both
specimens but hardly reflected in the d18O records
Eliciting Dose and Safety Outcomes From a Large Dataset of Standardized Multiple Food Challenges
Background: Food allergy prevalence has continued to rise over the past decade. While studies have reported threshold doses for multiple foods, large-scale multi-food allergen studies are lacking. Our goal was to identify threshold dose distributions and predictors of severe reactions during blinded oral food challenges (OFCs) in multi-food allergic patients.Methods: A retrospective chart review was performed on all Stanford-initiated clinical protocols involving standardized screening OFCs to any of 11 food allergens at 7 sites. Interval-censoring survival analysis was used to calculate eliciting dose (ED) curves for each food. Changes in severity and ED were also analyzed among participants who had repeated challenges to the same food.Results: Of 428 participants, 410 (96%) had at least one positive challenge (1445 standardized OFCs with 1054 total positive challenges). Participants undergoing peanut challenges had the highest ED50 (29.9 mg), while those challenged with egg or pistachio had the lowest (7.07 or 1.7 mg, respectively). The most common adverse event was skin related (54%), followed by gastrointestinal (GI) events (33%). A history of asthma was associated with a significantly higher risk of a severe reaction (hazard ratio [HR]: 2.37, 95% confidence interval [CI]: 1.36, 4.13). Higher values of allergen-specific IgE (sIgE) and sIgE to total IgE ratio (sIgEr) were also associated with higher risk of a severe reaction (1.49 [1.19, 1.85] and 1.84 [1.30, 2.59], respectively). Participants undergoing cashew, peanut, pecan, sesame, and walnut challenges had more severe reactions as ED increased. In participants who underwent repeat challenges, the ED did not change (p = 0.66), but reactions were more severe (p = 0.02).Conclusions: Participants with a history of asthma, high sIgEr, and/or high values of sIgE were found to be at higher risk for severe reactions during food challenges. These findings may help to optimize food challenge dosing schemes in multi-food allergic, atopic patients, specifically at lower doses where the majority of reactions occur.Trials Registration Number: ClinicalTrials. gov number NCT03539692; https://clinicaltrials.gov/ct2/show/NCT03539692
Erratum to: Allergen immunotherapy for IgE-mediated food allergy: protocol for a systematic review
Unfortunately this article [1] was published with an error in the Funding section. The BM4SIT project is not acknowledged. This section should be corrected to the below: Funding EAACI and the BM4SIT project (Grant Number 601763) in the European Unionâs Seventh Framework Programme FP7
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