What's new in the diagnosis and management of food allergy in children?

This article reviews the recent advances in the diagnosis and management of IgE mediated food allergy in children. It will encompass the emerging technology of component testing; moves to standardization of the allergy food challenge; permissive diets which allow for inclusion of extensively heated food allergens with allergen avoidance; and strategies for accelerating tolerance and food desensitization including the use of adjuvants for specific tolerance induction

Variability and uncertainty in empirical ground-motion prediction for probabilistic hazard and risk analyses

© The Author(s) 2015.The terms aleatory variability and epistemic uncertainty mean different things to people who routinely use them within the fields of seismic hazard and risk analysis. This state is not helped by the repetition of loosely framed generic definitions that actually inaccurate. The present paper takes a closer look at the components of total uncertainty that contribute to ground-motion modelling in hazard and risk applications. The sources and nature of uncertainty are discussed and it is shown that the common approach to deciding what should be included within hazard and risk integrals and what should be pushed into logic tree formulations warrants reconsideration. In addition, it is shown that current approaches to the generation of random fields of ground motions for spatial risk analyses are incorrect and a more appropriate framework is presented

The potential application of artificial intelligence for diagnosis and management of glaucoma in adults

BACKGROUND: Glaucoma is the most frequent cause of irreversible blindness worldwide. There is no cure, but early detection and treatment can slow the progression and prevent loss of vision. It has been suggested that artificial intelligence (AI) has potential application for detection and management of glaucoma. SOURCES OF DATA: This literature review is based on articles published in peer-reviewed journals. AREAS OF AGREEMENT: There have been significant advances in both AI and imaging techniques that are able to identify the early signs of glaucomatous damage. Machine and deep learning algorithms show capabilities equivalent to human experts, if not superior. AREAS OF CONTROVERSY: Concerns that the increased reliance on AI may lead to deskilling of clinicians. GROWING POINTS: AI has potential to be used in virtual review clinics, telemedicine and as a training tool for junior doctors. Unsupervised AI techniques offer the potential of uncovering currently unrecognized patterns of disease. If this promise is fulfilled, AI may then be of use in challenging cases or where a second opinion is desirable. AREAS TIMELY FOR DEVELOPING RESEARCH: There is a need to determine the external validity of deep learning algorithms and to better understand how the 'black box' paradigm reaches results

Allergic gastroenteritis hospital admission time trends in Australia and New Zealand

AIM: Recent epidemiological studies indicate increases in hospital food allergy-related anaphylaxis admission rates in Australian and New Zealand. The aim of the study was to examine whether non-IgE-mediated food allergy might have increased in parallel. METHODS: We analysed childhood hospital admissions rates by ICD 10 codes for allergic gastroenteritis (AG) and infective gastroenteritis in Australia and New Zealand between June 1998 and July 2014. RESULTS: In Australia, most AG-related admissions (73%) occurred in those aged <1 year and increased by 7.3%/year (95% confidence interval (CI) 5.5-9.3, P < 0.0001) from 6.8 to 26.5/10(5) population. Similar trends were observed for New Zealand; 81% of admissions occurred in those aged <1 year and increased by 9.4%/year (95% CI 5.5-9.3, P < 0.0001) from 7.2 to 30.7/10(5) population. By contrast there were no significant changes in AG-related admission rates in the older patients and infective gastroenteritis admissions fell in both countries in those aged <1 year; Australia by 4.4%/year (95% CI 4.3-4.6, P < 0.0001) and in New Zealand by 5.8%/year (95% CI 5.4-6.2, P < 0.0001). CONCLUSION: We observed a fourfold increase in AG-related admission rates in two countries with known high rates of IgE-mediated food allergy/anaphylaxis. If confirmed by other studies, it will be of interest to determine if factors thought to contribute to the increase in IgE-mediated food allergy might also play a role in non-IgE-mediated gastroenterological food allergy syndromes

Increased rate of D1 repair in coral symbionts during bleaching is insufficient to counter accelerated photo-inactivation

We dissect the primary photo-inactivation and the counteracting metabolic repair rates in fragments of the scleractinian coral, Pocillopora damicornis, subjected to a combined stress of a shift to elevated temperature (from 26°C to 32°C) and increased light (from 200 μmol photons m-2 s-1 to 400 μmol photons m-2 s-1) to induce bleaching. During the bleaching treatment the dinoflagellate symbionts showed a 5.5-fold acceleration in their photosystem II (PSII) repair rate constant, demonstrating that they maintain strong metabolic capacity to clear and replace photo-damaged D1 protein at the elevated temperature and light conditions. Nevertheless, the symbionts concurrently suffered a seven-fold increase in the rate constant for PSII photo-inactivation. This rapid photo-inactivation exceeded the PSII repair capacity, therefore tipping the symbionts, and by implication the symbiosis, into net photo-inhibition. Increased photo-inactivation in hospite, rather than an inhibition of PSII repair, is the principle trigger for net photo-inhibition under bleaching conditions. © 2011, by the American Society of Limnology and Oceanography, Inc

Clustering in surgical trials : database of intracluster correlations

PMID: 22217216 [PubMed - indexed for MEDLINE] PMCID: PMC3311136 Free PMC ArticlePeer reviewedPublisher PD

Rapid photoprotection in sea-ice diatoms from the East Antarctic pack ice

Photoinhibition and D1 protein re-synthesis were investigated in bottom-dwelling sea-ice microalgal communities from the East Antarctic pack ice during early spring. Bottom-dwelling sea-ice microalgal communities were dominated by diatoms that exhibited rapid photoprotection when exposed to a range of different light levels (10 μmol photons m-2 s -1, 50 μmol photons m-2 s-1, 100 μmol photons m-2 s-1, and 200 μmol photons m-2 s-1). Photosynthetic capacity of photosystem II (PSII) dropped significantly over 3 h under 200 μmol photons m-2 s-1, but largely recovered when placed in a low-light environment (10 μmol photons m-2 s-1) for an additional 3 h. PSII repair rates increased with increasing irradiance, and the D1-protein pool remained steady even under high light (200 μmol photons m-2 s-1). Sea-ice diatoms showed a low intrinsic susceptibility to photoinactivation of PSII across all the light treatments, and a strong and irradiance-dependent induction of nonphotochemical quenching, which did not depend upon chloroplast protein synthesis, was also seen. These highly plastic organisms, once thought to be adapted to shade, are in fact well equipped to withstand rapid and relatively large changes in light at low temperatures with minimal long-term effect on their photosynthetic machinery. © 2010, by the American Society of Limnology and Oceanography, Inc