Diagnosis, Management, and Investigational Therapies for Food Allergies

Food allergies have increased in prevalence over the past 20 years, now becoming an important public health concern. Although there are no therapies currently available for routine clinical care, recent reports have indicated that immunotherapies targeting the mucosal immune system may be effective. Oral immunotherapy is conducted by administering small, increasing amounts of food allergen; it has shown promise for desensitizing individuals with peanut, egg, or milk allergies. Sublingual immunotherapy also desensitizes allergic patients to foods—2 major studies have examined the effects of sublingual immunotherapy in subjects with peanut allergies. We review the complex nature of IgE-mediated food allergies and the therapies being evaluated in clinical trials. We focus on the diagnosis and management of food allergies and investigational therapies

Update to the Vitamin C, Thiamine and Steroids in Sepsis (VICTAS) protocol: statistical analysis plan for a prospective, multicenter, double-blind, adaptive sample size, randomized, placebo-controlled, clinical trial.

BACKGROUND: Observational research suggests that combined therapy with Vitamin C, thiamine and hydrocortisone may reduce mortality in patients with septic shock. METHODS AND DESIGN: The Vitamin C, Thiamine and Steroids in Sepsis (VICTAS) trial is a multicenter, double-blind, adaptive sample size, randomized, placebo-controlled trial designed to test the efficacy of combination therapy with vitamin C (1.5 g), thiamine (100 mg), and hydrocortisone (50 mg) given every 6 h for up to 16 doses in patients with respiratory or circulatory dysfunction (or both) resulting from sepsis. The primary outcome is ventilator- and vasopressor-free days with mortality as the key secondary outcome. Recruitment began in August 2018 and is ongoing; 501 participants have been enrolled to date, with a planned maximum sample size of 2000. The Data and Safety Monitoring Board reviewed interim results at N = 200, 300, 400 and 500, and has recommended continuing recruitment. The next interim analysis will occur when N = 1000. This update presents the statistical analysis plan. Specifically, we provide definitions for key treatment and outcome variables, and for intent-to-treat, per-protocol, and safety analysis datasets. We describe the planned descriptive analyses, the main analysis of the primary end point, our approach to secondary and exploratory analyses, and handling of missing data. Our goal is to provide enough detail that our approach could be replicated by an independent study group, thereby enhancing the transparency of the study. TRIAL REGISTRATION: ClinicalTrials.gov, NCT03509350. Registered on 26 April 2018

Crater gradation in Gusev crater and Meridiani Planum, Mars

The Mars Exploration Rovers investigated numerous craters in Gusev crater and Meridiani Planum during the first ∼400 sols of their missions. Craters vary in size and preservation state but are mostly due to secondary impacts at Gusev and primary impacts at Meridiani. Craters at both locations are modified primarily by eolian erosion and infilling and lack evidence for modification by aqueous processes. Effects of gradation on crater form are dependent on size, local lithology, slopes, and availability of mobile sediments. At Gusev, impacts into basaltic rubble create shallow craters and ejecta composed of resistant rocks. Ejecta initially experience eolian stripping, which becomes weathering-limited as lags develop on ejecta surfaces and sediments are trapped within craters. Subsequent eolian gradation depends on the slow production of fines by weathering and impacts and is accompanied by minor mass wasting. At Meridiani the sulfate-rich bedrock is more susceptible to eolian erosion, and exposed crater rims, walls, and ejecta are eroded, while lower interiors and low-relief surfaces are increasingly infilled and buried by mostly basaltic sediments. Eolian processes outpace early mass wasting, often produce meters of erosion, and mantle some surfaces. Some small craters were likely completely eroded/buried. Craters \u3e100 m in diameter on the Hesperian-aged floor of Gusev are generally more pristine than on the Amazonian-aged Meridiani plains. This conclusion contradicts interpretations from orbital views, which do not readily distinguish crater gradation state at Meridiani and reveal apparently subdued crater forms at Gusev that may suggest more gradation than has occurred

Vascular pedicle width in acute lung injury: correlation with intravascular pressures and ability to discriminate fluid status

Abstract Introduction Conservative fluid management in patients with acute lung injury (ALI) increases time alive and free from mechanical ventilation. Vascular pedicle width (VPW) is a non-invasive measurement of intravascular volume status. The VPW was studied in ALI patients to determine the correlation between VPW and intravascular pressure measurements and whether VPW could predict fluid status. Methods This retrospective cohort study involved 152 patients with ALI enrolled in the Fluid and Catheter Treatment Trial (FACTT) from five NHLBI ARDS (Acute Respiratory Distress Syndrome) Network sites. VPW and central venous pressure (CVP) or pulmonary artery occlusion pressure (PAOP) from the first four study days were correlated. The relationships between VPW, positive end-expiratory pressure (PEEP), cumulative fluid balance, and PAOP were also evaluated. Receiver operator characteristic (ROC) curves were used to determine the ability of VPW to detect PAOP <8 mmHg and PAOP ≥18 mm Hg. Results A total of 71 and 152 patients provided 118 and 276 paired VPW/PAOP and VPW/CVP measurements, respectively. VPW correlated with PAOP (r = 0.41; P < 0.001) and less well with CVP (r = 0.21; P = 0.001). In linear regression, VPW correlated with PAOP 1.5-fold better than cumulative fluid balance and 2.5-fold better than PEEP. VPW discriminated achievement of PAOP <8 mm Hg (AUC = 0.73; P = 0.04) with VPW ≤67 mm demonstrating 71% sensitivity (95% CI 30 to 95%) and 68% specificity (95% CI 59 to 75%). For discriminating a hydrostatic component of the edema (that is, PAOP ≥18 mm Hg), VPW ≥72 mm demonstrated 61.4% sensitivity (95% CI 47 to 74%) and 61% specificity (49 to 71%) (area under the curve (AUC) 0.69; P = 0.001). Conclusions VPW correlates with PAOP better than CVP in patients with ALI. Due to its only moderate sensitivity and specificity, the ability of VPW to discriminate fluid status in patients with acute lung injury is limited and should only be considered when intravascular pressures are unavailable

The Grizzly, October 27, 1978

Bomberger Tower Razed • Homecoming Brings Crowning, Presentations • Self Study Continues • Hockey Ties Nation\u27s Best • No Tickets at Door • Campus Sunshine to Set? • Ravine Paradise Revisited • Portrait of the Professor: Randy Davidson • Letters to the Editor • Springsteen & Dylan: Poet Laureates or Veritable Zeroes? • Art is a Math is an Art is a Math... • Escher Takes On New Dimension • Commencement Speaker Announced • Plea From the Press • GM: Looking Good For \u2779 • Soccer Splits: 2-2 • Sports Profile: Don Paolicelli • Thin Clads Receive Treat • Swarthmore Superior In Homecoming Game • J.V.s Romp to Win • Hockey Returns Home • News in Brief: Fire Alarm Installations Near Completion; ProTheatre to Present The Good Doctor ; Art Exhibit to Open Soonhttps://digitalcommons.ursinus.edu/grizzlynews/1004/thumbnail.jp

The Grizzly, October 27, 1978

Bomberger Tower Razed • Homecoming Brings Crowning, Presentations • Self Study Continues • Hockey Ties Nation\u27s Best • No Tickets at Door • Campus Sunshine to Set? • Ravine Paradise Revisited • Portrait of the Professor: Randy Davidson • Letters to the Editor • Springsteen & Dylan: Poet Laureates or Veritable Zeroes? • Art is a Math is an Art is a Math... • Escher Takes On New Dimension • Commencement Speaker Announced • Plea From the Press • GM: Looking Good For \u2779 • Soccer Splits: 2-2 • Sports Profile: Don Paolicelli • Thin Clads Receive Treat • Swarthmore Superior In Homecoming Game • J.V.s Romp to Win • Hockey Returns Home • News in Brief: Fire Alarm Installations Near Completion; ProTheatre to Present The Good Doctor ; Art Exhibit to Open Soonhttps://digitalcommons.ursinus.edu/grizzlynews/1004/thumbnail.jp

B844: Checklist of the Vascular Plants of Maine Third Revision

This is the third revision of the Checklist of Vascular Plants of Maine. Like its predecessors, it lists all ferns and related plants, conifers, and flowering plants native and naturalized in Maine and records their county-level distribution in the state. The first Check- list (Ogden et al. 1948) was based on specimens in herbaria at the University of Maine (hereafter referred to as MAINE), Portland Society of Natural History, New England Botanical Club, Gray Herbarium of Harvard University, and the private collection of Glen D. Chamberlain of Presque Isle, Maine (now part of MAINE). Bean et al. (1966) revised the checklist to include additions to the flora and update the nomenclature to follow Fernald (1950). Richards et al. (1983) added many new state and county records in the second revision. The purpose of this revision is twofold. First, we have included many new county and state records. Since Richards et al. (1983) there has been considerable collecting in Maine, much of it directed at searching for new state and county records in relatively neglected regions of the state. Second, there have been numerous changes in the scientific names of Maine plants since Fernald (1950), the nomenclatural basis of Richards et al. (1983). We have largely followed Kartesz\u27s (1994) nomenclature (see Taxonomy and Nomenclature section). Recent work on rare plants and establishment of an official list of endangered and threatened plants in Maine (Dibble et al. 1989; Maine State Planning Office 1990) also motivate updating the known distribution and taxonomy of Maine\u27s flora.https://digitalcommons.library.umaine.edu/aes_bulletin/1121/thumbnail.jp

Stellar Spectroscopy in the Near-infrared with a Laser Frequency Comb

The discovery and characterization of exoplanets around nearby stars is driven by profound scientific questions about the uniqueness of Earth and our Solar System, and the conditions under which life could exist elsewhere in our Galaxy. Doppler spectroscopy, or the radial velocity (RV) technique, has been used extensively to identify hundreds of exoplanets, but with notable challenges in detecting terrestrial mass planets orbiting within habitable zones. We describe infrared RV spectroscopy at the 10 m Hobby-Eberly telescope that leverages a 30 GHz electro-optic laser frequency comb with nanophotonic supercontinuum to calibrate the Habitable Zone Planet Finder spectrograph. Demonstrated instrument precision <10 cm/s and stellar RVs approaching 1 m/s open the path to discovery and confirmation of habitable zone planets around M-dwarfs, the most ubiquitous type of stars in our Galaxy

The Returns to Criminal Capital

Human capital theory (Becker 1962; Mincer 1958; Schultz 1960; 1961) posits that individuals can increase their labor market returns through investments in education and training. This concept has been studied extensively across several disciplines. An analog concept of criminal capital, while the focus of speculation and limited empirical study, remains considerably less developed theoretically and methodologically. This paper offers a formal theoretical model of criminal capital indicators and tests for greater illegal wage returns using a sample of serious adolescent offenders, many of whom participate in illegal income-generating activities. Our results reveal that, consistent with human capital theory, there are important illegal wage premiums associated with investments in criminal capital, notably an increasing but declining marginal return to experience and a premium for specialization. Further, as in studies of legal labor markets, we find strong evidence that, if left unaccounted for, non-random sample selection causes severe bias in models of illegal wages. Theoretical and practical implications of these results, along with directions for future research, are discussed