Immediate-Type Hypersensitivity to Succinylated Corticosteroids

Background: Despite their frequent use, systemic corticosteroids have rarely elicited immediate-type reactions. Objective: We report two male patients, aged 26 and 70 years, respectively, with severe immediate-type hypersensitivity secondary to the administration of corticosteroids esterified with succinate. Methods: Skin tests, basophil activation tests and challenge tests were performed for diagnostic evaluation. Results: In both patients, immediate-type skin test reactions were found to methylprednisolone sodium hemisuccinate (MSH) and prednisolone sodium hemisuccinate (PSH). In contrast, nonsuccinylated corticosteroids (including methylprednisolone and prednisolone in one patient) yielded no test reactions. Basophils from one patient exhibited a stimulated expression of the activation marker CD63 upon in vitro incubation with PSH or hydrocortisone sodium succinate, but not with hydrocortisone. Skin tests and basophil activation tests were negative in controls. One patient was challenged with the incriminated drugs. He developed flush, conjunctivitis, tachycardia and dyspnea 2 min after injection of MSH, and dyspnea shortly after intravenous administration of PSH. Oral and intravenous challenge tests with nonsuccinylated corticosteroids were tolerated well by both patients. Conclusions: These case reports should alert clinicians to rare, but severe immediate-type reactions to corticosteroids, related to the succinate moiety in our patients. In case of allergic reactions to corticosteroids, it is mandatory to identify the causative agent and find safe alternatives. Copyright (C) 2010 S. Karger AG, Base

High order numerical simulation of sound generated by the Kirchhoff vortex

An improved high order finite difference method for low Mach number computational aeroacoustics (CAA) is described. The improvements involve the conditioning of the Euler equations to minimize numerical cancellation errors, and the use of a stable non-dissipative sixth-order central spatial interior scheme and a third-order boundary scheme. Spurious high frequency oscillations are damped by a third-order characteristic-based filter. The objective of this paper is to apply these improvements in the simulation of sound generated by the Kirchhoff vortex

Action-Effect Sharing Induces Task-Set Sharing in Joint Task Switching

A central issue in the study of joint task performance has been one of whether co-acting individuals perform their partner’s part of the task as if it were their own. The present study addressed this issue by using joint task switching. A pair of actors shared two tasks that were presented in a random order, whereby the relevant task and actor were cued on each trial. Responses produced action effects that were either shared or separate between co-actors. When co-actors produced separate action effects, switch costs were obtained within the same actor (i.e., when the same actor performed consecutive trials) but not between co-actors (when different actors performed consecutive trials), implying that actors did not perform their co-actor’s part. When the same action effects were shared between co-actors, however, switch costs were also obtained between co-actors, implying that actors did perform their co-actor’s part. The results indicated that shared action effects induce task-set sharing between co-acting individuals

The Roles of Action Selection and Actor Selection in Joint Task Settings

Studies on joint task performance have proposed that co-acting individuals co-represent the shared task context, which implies that actors integrate their co-actor’s task components into their own task representation as if they were all their own task. This proposal has been supported by results of joint tasks in which each actor is assigned a single response where selecting a response is equivalent to selecting an actor. The present study used joint task switching, which has previously shown switch costs on trials following the actor’s own trial (intrapersonal switch costs) but not on trials that followed the co-actor’s trial (interpersonal switch costs), suggesting that there is no task co-representation. We examined whether interpersonal switch costs can be obtained when action selection and actor selection are confounded as in previous joint task studies. The present results confirmed this prediction, demonstrating that switch costs can occur within a single actor as well as between co-actors when there is only a single response per actor, but not when there are two responses per actor. These results indicate that task co-representation is not necessarily implied even when effects occur across co-acting individuals and that how the task is divided between co-actors plays an important role in determining whether effects occur between co-actors

Effects of centrally administered etanercept on behaviour, histology and TNF-α expression in mice following a peripheral immune challenge

Background: Peripheral cytokines affect central nervous system (CNS) function, triggering anxiety and cognitive decline. Although peripheral blockade of tumor necrosis factor (TNF-α) by etanercept, has been effective in alleviating rheumatoid arthritis, it is yet unknown whether central blockade of TNF-α is beneficial for immune-challenged CNS function. This study investigated effects of central etanercept administration post-peripheral immune challenge, on behaviour and histology. Methods: 12-week-old C57BL/6 mice (n=40) were challenged with either LPS or saline, administered peripherally 24hr before being treated with etanercept or artificial CSF (aCSF), via intracerebroventricular injection. Mice underwent behavioural analyses for locomotion (open field test: OFT), memory (Y maze) and anxiety (elevated zero maze: EZM) 24hr post etanercept/aCSF treatment. Brain tissue was then collected to estimate number of hippocampal microglia and expression of Tnfa. Results: Acute systemic challenge with LPS decreased weight in mice at 24hr, and impaired locomotor activity. LPS significantly increased anxiety-like behaviour (2-way ANOVA: Interaction: P=0.096; Saline/LPS challenge: P=0.0006, aCSF/etanercept treatment: P=0.0008), which was reversed by etanercept and significantly reduced cognition in the Y Maze (Interaction: P=0.037, Saline/LPS challenge: P=0.31, aCSF/etanercept treatment: P=0.80), which was not reversed by etanercept. LPS challenge also increased Tnfa expression in the hippocampus (Interaction: F(1,13)=28.04, P=0.0001, Saline/LPS challenge: P=0.0003, aCSF/etanercept treatment: P=0.021) and etanercept treatment was effective in reducing this Tnfa expression (P=0.001). Etanercept also significantly reduced microglial numbers within the hippocampus, which were increased following LPS administration (2-way ANOVA: Interaction: P= 0.0041; Saline/LPS challenge: P<0.0001, etanercept/aCSF: P=0.08,). Conclusion: A single dose of etanercept was found to be effective in significantly decreasing anxiety, Tnfa expression and microglia numbers 48hr post-peripheral immune challenge. The present study suggests that there is effective cross-talk between peripheral and central immune systems. Additionally behavioural and biological changes caused by LPS challenge which may be mediated by TNF-α related central inflammation, were reversed by etanercept treatment

Data provenance tracking and reporting in a high-security digital research environment.

Objective To protect privacy, routinely-collected data are processed and anonymised by third parties before being used for research. However, the methods used to do this are rarely shared, leaving the resulting research difficult to evaluate and liable to undetected errors. Here, we present a provenance-based approach for documenting and auditing such methods. Approach We designed the Safe Haven Provenance (SHP) ontology for representing provenance information about data, users, and activities within high-security environments as knowledge graphs. The work was based on a case study of the Grampian Data Safe Haven (DASH) which holds and processes medical records for 600,000 people in Scotland. The SHP ontology was designed as an extension to the standard W3C PROV-O ontology. The auditing capabilities of our approach were evaluated against a set of transparency requirements through a prototype interactive dashboard. Results We demonstrated the ability of the SHP ontology to document the workflow within DASH: capturing the extraction and anonymisation process using a structured vocabulary of entities (e.g. datasets), activities (e.g. linkage, anonymisation) and agents (e.g. analysts, data owners). Two provenance reporting templates were designed following interviews with DASH staff and clinical researchers: 1) a detailed report for use within DASH for quality assurance, and 2) a summary report for researchers that was safe for public release. Using a prototype data-linkage project, we formalised queries for report generation, and demonstrated use of automated rules for error detection (e.g., data discrepancies) using the structure of the SHP knowledge graphs. All of the project outputs are available under an open-source license. Conclusions This project lays a foundation for more transparent high-quality research using public data for health care and innovation. The SHP ontology is extendible for different domains and potentially represents a key component for further automation of provenance capture and reporting in high-security research environments

How does reviewing the evidence change veterinary surgeons' beliefs regarding the treatment of ovine footrot? A quantitative and qualitative study

Footrot is a widespread, infectious cause of lameness in sheep, with major economic and welfare costs. The aims of this research were: (i) to quantify how veterinary surgeons’ beliefs regarding the efficacy of two treatments for footrot changed following a review of the evidence (ii) to obtain a consensus opinion following group discussions (iii) to capture complementary qualitative data to place their beliefs within a broader clinical context. Grounded in a Bayesian statistical framework, probabilistic elicitation (roulette method) was used to quantify the beliefs of eleven veterinary surgeons during two one-day workshops. There was considerable heterogeneity in veterinary surgeons’ beliefs before they listened to a review of the evidence. After hearing the evidence, seven participants quantifiably changed their beliefs. In particular, two participants who initially believed that foot trimming with topical oxytetracycline was the better treatment, changed to entirely favour systemic and topical oxytetracycline instead. The results suggest that a substantial amount of the variation in beliefs related to differences in veterinary surgeons’ knowledge of the evidence. Although considerable differences in opinion still remained after the evidence review, with several participants having non-overlapping 95% credible intervals, both groups did achieve a consensus opinion. Two key findings from the qualitative data were: (i) veterinary surgeons believed that farmers are unlikely to actively seek advice on lameness, suggesting a proactive veterinary approach is required (ii) more attention could be given to improving the way in which veterinary advice is delivered to farmers. In summary this study has: (i) demonstrated a practical method for probabilistically quantifying how veterinary surgeons’ beliefs change (ii) revealed that the evidence that currently exists is capable of changing veterinary opinion (iii) suggested that improved transfer of research knowledge into veterinary practice is needed (iv) identified some potential obstacles to the implementation of veterinary advice by farmers

A two-year participatory intervention project with owners to reduce lameness and limb abnormalities in working horses in Jaipur, India

Participatory methods are increasingly used in international human development, but scientific evaluation of their efficacy versus a control group is rare. Working horses support families in impoverished communities. Lameness and limb abnormalities are highly prevalent in these animals and a cause for welfare concern. We aimed to stimulate and evaluate improvements in lameness and limb abnormalities in horses whose owners took part in a 2-year participatory intervention project to reduce lameness (PI) versus a control group (C) in Jaipur, India.In total, 439 owners of 862 horses participated in the study. PI group owners from 21 communities were encouraged to meet regularly to discuss management and work practices influencing lameness and poor welfare and to track their own progress in improving these. Lameness examinations (41 parameters) were conducted at the start of the study (Baseline), and after 1 year and 2 years. Results were compared with control horses from a further 21 communities outside the intervention. Of the 149 horses assessed on all three occasions, PI horses showed significantly (P<0.05) greater improvement than C horses in 20 parameters, most notably overall lameness score, measures of sole pain and range of movement on limb flexion. Control horses showed slight but significantly greater improvements in four parameters, including frog quality in fore and hindlimbs.This participatory intervention succeeded in improving lameness and some limb abnormalities in working horses, by encouraging changes in management and work practices which were feasible within owners’ socioeconomic and environmental constraints. Demonstration of the potentially sustainable improvements achieved here should encourage further development of participatory intervention approaches to benefit humans and animals in other contexts