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

The magnitude of educational disadvantage amongst indigenous minority groups in Australia.

Indigenous groups are amongst the most disadvantaged minority groups in the developed world. This paper examines the educational disadvantage of indigenous Australians by assessing academic performance at a relatively early age. We find that, by the age of 10, indigenous Australians are substantially behind non-indigenous Australians in academic achievement. Their relative performance deteriorates further over the next 2 years. School and locality do not appear to be important determinants of the indigenous to non-indigenous achievement gap. However, geographic remoteness, indigenous ethnicity and language use at home have a marked influence on educational achievement. A current focus of Australian indigenous policy is to increase school resources. Our results suggest that this will not eliminate indigenous educational disadvantage on its own

International expert workshop on the analysis of the economic and public health impacts of air pollution: workshop summary.

Forty-nine experts from 18 industrial and developing countries met on 6 September 2001 in Garmisch-Partenkirchen, Germany, to discuss the economic and public health impacts of air pollution, particularly with respect to assessing the public health benefits from technologies and policies that reduce greenhouse gas (GHG) emissions. Such measures would provide immediate public health benefits, such as reduced premature mortality and chronic morbidity, through improved local air quality. These mitigation strategies also allow long-term goals--for example, reducing the buildup of GHG emissions--to be achieved alongside short-term aims, such as immediate improvements in air quality, and therefore benefits to public health. The workshop aimed to foster research partnerships by improving collaboration and communication among various agencies and researchers; providing a forum for presentations by sponsoring agencies and researchers regarding research efforts and agency activities; identifying key issues, knowledge gaps, methodological shortcomings, and research needs; and recommending activities and initiatives for research, collaboration, and communication. This workshop summary briefly describes presentations made by workshop participants and the conclusions of three separate working groups: economics, benefits transfer, and policy; indoor air quality issues and susceptible populations; and development and transfer of dose-response relationships and exposure models in developing countries. Several common themes emerged from the working group sessions and subsequent discussion. Key recommendations include the need for improved communication and extended collaboration, guidance and support for researchers, advances in methods, and resource support for data collection, assessment, and research

The UV Properties of the Narrow Line Quasar I Zwicky 1

I Zw 1 is the prototype narrow line quasar. We report here the results of our study of the UV emission of I Zw 1 using a high S/N (50-120) spectrum obtained with the HST FOS. The following main new results are obtained: 1. The Mg II and Al III doublets are partially/fully resolved. The measured doublet ratios verify theoretical predictions that the lines are thermalized in the BLR. 2. A weak associated UV absorption system is detected in N~V, and possibly also in C IV and Lya, suggesting an outflow with a velocity of 1870 km/s and velocity dispersion <300 km/s. 3. Lines from ions of increasing ionization level show increasing excess blue wing flux, and an increasing line peak velocity shift, reaching a maximum blueshift of about 2000 km/s for He II 1640. This may indicate an out-flowing component in the BLR, where the ionization level increases with velocity, and which is visible only in the approaching direction. The highest velocity part of this outflow may produce the associated UV absorption system. 4. The small C III] 1909 EW, and the small C III] 1909/Lya and C III] 1909/Si III] 1892 flux ratios indicate a typical BLR density of 10^11, i.e. about an order of magnitude larger than implied by C III] 1909 in most quasars. A BLR component of a higher density is implied by the EW and doublet ratio of the Al III 1857 doublet. 5. Prominent Fe II UV 191 emission is seen, together with weaker line emission at 1294 and 1871 A. These three features have been proposed as evidence for significant Lya pumping of the 8-10 eV levels of Fe II. 6. Significant Fe III emission is present. The Fe III UV 34 and UV 48 multiplets are clearly resolved, and Fe III UV 1, UV 47, UV 50, and UV 68 may also be present. (Shortened version)Comment: 28 pages, 1 table and 7 figures included. Uses aas2pp4.sty. Scheduled for the Astrophysical Journal November 10, 1997 issue, Vol. 48

Chromosome Conformation Capture Carbon Copy (5C): a massively parallel solution for mapping interactions between genomic elements

Physical interactions between genetic elements located throughout the genome play important roles in gene regulation and can be identified with the Chromosome Conformation Capture (3C) methodology. 3C converts physical chromatin interactions into specific ligation products, which are quantified individually by PCR. Here we present a high-throughput 3C approach, 3C-Carbon Copy (5C), that employs microarrays or quantitative DNA sequencing using 454-technology as detection methods. We applied 5C to analyze a 400-kb region containing the human beta-globin locus and a 100-kb conserved gene desert region. We validated 5C by detection of several previously identified looping interactions in the beta-globin locus. We also identified a new looping interaction in K562 cells between the beta-globin Locus Control Region and the gamma-beta-globin intergenic region. Interestingly, this region has been implicated in the control of developmental globin gene switching. 5C should be widely applicable for large-scale mapping of cis- and trans- interaction networks of genomic elements and for the study of higher-order chromosome structure

Molecular Dynamics Simulations

A tutorial introduction to the technique of Molecular Dynamics (MD) is given, and some characteristic examples of applications are described. The purpose and scope of these simulations and the relation to other simulation methods is discussed, and the basic MD algorithms are described. The sampling of intensive variables (temperature T, pressure p) in runs carried out in the microcanonical (NVE) ensemble (N= particle number, V = volume, E = energy) is discussed, as well as the realization of other ensembles (e.g. the NVT ensemble). For a typical application example, molten SiO2, the estimation of various transport coefficients (self-diffusion constants, viscosity, thermal conductivity) is discussed. As an example of Non-Equilibrium Molecular Dynamics (NEMD), a study of a glass-forming polymer melt under shear is mentioned.Comment: 38 pages, 11 figures, to appear in J. Phys.: Condens. Matte

Multicenter prevalence of anaphylaxis in clinic-based oral food challenges

Background Although previous single-center studies report the rate of anaphylaxis for oral food challenges (OFCs) as 9% to 11%, little is known regarding the epidemiology of clinical OFCs across multiple centers in the United States. Objective To examine the epidemiology, symptoms, and treatment of clinical low-risk OFCs in the nonresearch setting. Methods Data were obtained from 2008 to 2013 through a physician survey in 5 food allergy centers geographically distributed across the United States. Allergic reaction rates and the association of reaction rates with year, hospital, and demographics were determined using a linear mixed model. Meta-analysis was used to pool the proportion of reactions and anaphylaxis with inverse-variance weights using a random-effects model with exact confidence intervals (CIs). Results A total of 6,377 OFCs were performed, and the pooled estimate of anaphylaxis was 2% (95% CI, 1%-3%). The rate of allergic reactions was 14% (95% CI, 13%-16%) and was consistent during the study period (P = .40). Reaction rates ranged from 13% to 33%. Males reacted 16% more frequently than females (95% CI, 4%-37.5%; P = .04). Foods challenged in 2013 varied geographically, with peanut as the most challenged food in the Northeast, Midwest, and West and egg as the most challenged in the South. Conclusion As the largest national survey of allergic reactions of clinical open OFCs in a nonresearch setting in the United States, this study found that performing clinical nonresearch open low-risk OFCs results in few allergic reactions, with 86% of challenges resulting in no reactions and 98% without anaphylaxis