A survey study of index food‐related allergic reactions and anaphylaxis management

Background:  Initial food‐allergic reactions are often poorly recognized and under‐treated. Methods:  Parents of food‐allergic children were invited to complete an online questionnaire, designed with Kids with Food Allergies Foundation , about their children’s first food‐allergic reactions resulting in urgent medical evaluation. Results:  Among 1361 reactions, 76% (95% CI 74–79%) were highly likely to represent anaphylaxis based on NIAID/FAAN criteria. Only 34% (95% CI 31–37%) of these were administered epinephrine. In 56% of these, epinephrine was administered by emergency departments; 20% by parents; 9% by paramedics; 8% by primary care physicians; and 6% by urgent care centers. In 26% of these, epinephrine was given within 15 min of the onset of symptoms; 54% within 30 min; 82% within 1 h; and 93% within 2 h. Factors associated with a decreased likelihood of receiving epinephrine for anaphylaxis included age <12 months, milk and egg triggers, and symptoms of abdominal pain and/or diarrhea. Epinephrine was more likely to be given to asthmatic children and children with peanut or tree nut ingestion prior to event. Post‐treatment, 42% of reactions likely to represent anaphylaxis were referred to allergists, 34% prescribed and/or given epinephrine auto‐injectors, 17% trained to use epinephrine auto‐injectors, and 19% given emergency action plans. Of patients treated with epinephrine, only half (47%) were prescribed epinephrine auto‐injectors. Conclusions:  Only one‐third of initial food‐allergic reactions with symptoms of anaphylaxis were recognized and treated with epinephrine. Fewer than half of patients were referred to allergists. There is still a need to increase education and awareness about food‐induced anaphylaxis.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/93515/1/pai1315.pd

Black Holes and Massive Remnants

This paper revisits the conundrum faced when one attempts to understand the dynamics of black hole formation and evaporation without abandoning unitary evolution. Previous efforts to resolve this puzzle assume that information escapes in corrections to the Hawking process, that an arbitrarily large amount of information is transmitted by a planckian energy or contained in a Planck-sized remnant, or that the information is lost to another universe. Each of these possibilities has serious difficulties. This paper considers another alternative: remnants that carry large amounts of information and whose size and mass depend on their information content. The existence of such objects is suggested by attempts to incorporate a Planck scale cutoff into physics. They would greatly alter the late stages of the evaporation process. The main drawback of this scenario is apparent acausal behavior behind the horizon.Comment: 16 pages + 3 Fig

Thermal history of the string universe

Thermal history of the string universe based on the Brandenberger and Vafa's scenario is examined. The analysis thereby provides a theoretical foundation of the string universe scenario. Especially the picture of the initial oscillating phase is shown to be natural from the thermodynamical point of view. A new tool is employed to evaluate the multi state density of the string gas. This analysis points out that the well-known functional form of the multi state density is not applicable for the important region $T \leq T_H$, and derives a correct form of it.Comment: 39 pages, no figures, use revtex.sty, aps.sty, aps10.sty & preprint.st

Mapping with Sparse Local Sensors and Strong Hierarchical Priors

The paradigm case for robotic mapping assumes large quantities of sensory information which allow the use of relatively weak priors. In contrast, the present study considers the mapping problem in environments where only sparse, local sensory information is available. To compensate for these weak likelihoods, we make use of strong hierarchical object priors. Hierarchical models were popular in classical blackboard systems but are here applied in a Bayesian setting and novelly deployed as a mapping algorithm. We give proof of concept results, intended to demonstrate the algorithm’s applicability as a part of a tactile SLAM module for the whiskered SCRATCHbot mobile robot platform

The Intrinsic Fundamental Group of a Linear Category

We provide an intrinsic definition of the fundamental group of a linear category over a ring as the automorphism group of the fibre functor on Galois coverings. If the universal covering exists, we prove that this group is isomorphic to the Galois group of the universal covering. The grading deduced from a Galois covering enables us to describe the canonical monomorphism from its automorphism group to the first Hochschild-Mitchell cohomology vector space.Comment: Final version, to appear in Algebras and Representation Theor

Farmers as experts: interpreting the "hidden" messages of participatory video across African contexts

Recent scholarship has contributed important insights into the political dynamics inherent in the process of making and showing participatory videos (PV). As a research method and an instrument for social change, participatory video has both potential and limitations for overturning the power dynamics embedded within research and in development processes. This paper focuses on experiences of incorporating participatory video in land management projects in four countries in Africa. Along with other participatory methods, the videos represented an effort to include community perspectives and objectives into the research process. Analysis of PV has largely focused on examining the tensions and contradictions involved in the process of making participatory videos. There has been less focus on the content of the videos themselves and what it might suggest for empowerment, voice and representation. This paper attempts to address this gap by examining the implications of the narratives that emerge in five different videos. On the surface, the participants appear to repeat dominant national and global narratives about land degradation. However, the fact that farmers present themselves as experts on these topics and the ways in which they appropriate and reconfigure the dominant narratives, can be seen as an act of empowerment. In this way, they preclude the need for external intervention on how to manage their resources

"More than just a medical student”: a mixed methods exploration of a structured volunteering programme for undergraduate medical students

Background As a result of the COVID-19 pandemic Imperial College School of Medicine developed a structured volunteering programme involving 398 medical students, across eight teaching hospitals. This case study aims to illuminate the experiences of volunteers, mechanisms of learning and draw lessons for future emergencies and curriculum improvements. Methods Using an illuminative approach to evaluation we invited all volunteers and supervisors to complete a mixed-methods survey. This gathered nominal demographic information and qualitative data related to motivations, experiences, insights into learning, processual and contextual factors. Qualitative responses were coded, thematically organised, and categorised into an overarching framework. Mann-Whitney U tests determined whether volunteers’ overall rating of the experience varied according to demographic features and modulating factors. Spearman’s rank correlation assessed the relationship between aspects of induction and supervision, and overall volunteering rating. Follow up interviews were carried out with students to check back findings and co-create conclusions. Results Modulating factors identified through thematic analysis include altruistic motivation, engaged induction and supervision, feeling valued, having responsibility and freedom from the formal curriculum. Statistically significant positive correlations are identified between volunteers overall rating and being a year 1 or 2 student, ability to discuss role and ask questions during induction, being male, and having regular meetings and role support from supervisors. Qualitatively reported impacts include improved wellbeing, valuable contribution to service and transformative learning. Transformative learning effects included reframing of role within the multidisciplinary team, view of effective learning and view of themselves as competent clinicians. The number of weeks, number of shifts per week, and the role the volunteers performed, did not significantly impact experiences. Conclusions While acknowledging the uniqueness of the situation presented by the first wave COVID-19, we suggest the features of a successful service-learning programme include: a learner-centred induction, engaged and appreciative supervisors, and the entrustment of students with meaningful work with reciprocal benefits to services. Programmes in similar settings may find that 1) volunteering is best appreciated in years 1 or 2, 2) students with altruistic motivations and meaningful work may flourish without formal outcomes and assessments, and 3) that female volunteers may experience emergency learning differently to men

Sulphur chemistry in the envelopes of massive young stars

The sulphur chemistry in nine regions in the earliest stages of high-mass star formation is studied through single-dish submillimeter spectroscopy. The line profiles indicate that 10-50% of the SO and SO2 emission arises in high-velocity gas, either infalling or outflowing. For the low-velocity gas, excitation temperatures are 25 K for H2S, 50 K for SO, H2CS, NS and HCS+, and 100 K for OCS and SO2, indicating that most observed emission traces the outer parts (T<100 K) of the molecular envelopes, except high-excitation OCS and SO2 lines. Abundances in the outer envelopes, calculated with a Monte Carlo program, using the physical structures of the sources derived from previous submillimeter continuum and CS line data, are ~10^-8 for OCS, ~10^-9 for H2S, H2CS, SO and SO2, and ~10^-10 for HCS+ and NS. In the inner envelopes (T>100 K) of six sources, the SO2 abundance is enhanced by factors of ~100-1000. This region of hot, abundant SO2 has been seen before in infrared absorption, and must be small, <~ 0.2 arcsec (180 AU radius). The derived abundance profiles are consistent with models of envelope chemistry which invoke ice evaporation at T~100$ K. Shock chemistry is unlikely to contribute. A major sulphur carrier in the ices is probably OCS, not H2S as most models assume. The source-to-source abundance variations of most molecules by factors of ~10 do not correlate with previous systematic tracers of envelope heating. Without observations of H2S and SO lines probing warm (>~ 100 K) gas, sulphur-bearing molecules cannot be used as evolutionary tracers during star formation.Comment: Accepted by A&A, 14 pages, 5 figure