Oral food challenges: Special considerations.

OBJECTIVE: To reinforce special considerations when offering and conducting oral food challenges (OFCs). DATA SOURCES: Published studies and reviews. STUDY SELECTIONS: Studies concerning OFCs and their conduct. RESULTS: Multiple OFC protocols for various clinical situations and foods were reviewed. CONCLUSION: OFCs are used for the definitive diagnosis of food allergy. Risk and benefit assessment guide the OFC procedure. The conduct of OFCs is influenced by multiple factors, including age, food, and goal of the challenge.

Estimating the Vertical Structure of Weather-Induced Mission Costs for Small UAS.

The performance of small uninhabited aerial systems (UAS) is very sensitive to the atmospheric state. Improving awareness of the environment and its impact on mission performance is important to enabling greater autonomy for small UAS. A modeling system is proposed that allows a small UAS to build a model of the atmospheric state using computational resources available onboard the aircraft and relate the atmospheric state to the cost of completing a mission. In this case, mission cost refers to the energy required per distance traveled. The system can use in situ observations made by the aircraft, but can also incorporate observations from other aircraft and sensors. The modeling system is demonstrated in a flight test aboard a small UAS and validated against radiosondes and numerical weather model analyses. The test demonstrates that the modeling system can represent the atmospheric state and identifies times where significant error exists between the state expected by the numerical weather model and that observed. Transformation of the atmospheric state into a mission performance cost identifies cases where the mission performance cost predicted by a numerical weather model differs from that observed by more than 30%.

Online Aerial Terrain Mapping for Ground Robot Navigation.

This work presents a collaborative unmanned aerial and ground vehicle system which utilizes the aerial vehicle's overhead view to inform the ground vehicle's path planning in real time. The aerial vehicle acquires imagery which is assembled into a orthomosaic and then classified. These terrain classes are used to estimate relative navigation costs for the ground vehicle so energy-efficient paths may be generated and then executed. The two vehicles are registered in a common coordinate frame using a real-time kinematic global positioning system (RTK GPS) and all image processing is performed onboard the unmanned aerial vehicle, which minimizes the data exchanged between the vehicles. This paper describes the architecture of the system and quantifies the registration errors between the vehicles.

Manifesto for a healthy and health-creating society.

Brexit and the troubled state of the NHS call for re-thinking the UK's approach to health. The EU referendum vote reveals deep social divisions as well as presenting the country with important decisions and negotiations about the future. At the same time, health problems are growing; the NHS faces severe financial constraints and appears to lurch from crisis to crisis, with leaving the European Union likely to exacerbate many problems including staffing issues across the whole sector. However, new scientific developments and digital technology offer societies everywhere massive and unprecedented opportunities for improving health. It is vital for the country that the NHS is able to adopt these discoveries and see them translated into improved patient care and population health, but also that the UK benefits from its capabilities and strengths in these areas.

Tolerance of a high-protein baked-egg product in egg-allergic children.

BACKGROUND: Egg allergy is one of the most common immunoglobulin E (IgE)-mediated food allergies. Extensively heating egg has been found to decrease its allergenicity and 64% to 84% of children allergic to egg have been found to tolerate baked-egg products. Because there is no reliable method for predicting baked-egg tolerance, oral food challenges remain the gold standard. Prior studies have reported on baked-egg challenges using up to 2.2 g of egg white (EW) protein. OBJECTIVE: To establish whether children with egg allergy would pass a baked-egg challenge to a larger amount of egg protein and the potential criteria for predicting the likelihood of baked-egg tolerance. METHODS: A chart review was conducted of all patients 6 months to 18 years of age with egg allergy who underwent oral baked-egg challenges at Children's Medical Center Dallas over a 2-year period. Challenges were conducted in the clinic with a 3.8-g baked-egg product. RESULTS: Fifty-nine of 94 patients (63%) tolerated the 3.8-g baked-egg product. The presence of asthma (P < .01), EW skin prick test (SPT; P < .01) reactive wheal, and EW-specific IgE level (P = .02) correlated with baked-egg reactivity, whereas ovomucoid-specific IgE level did not. The positive predictive value approached 66% at an EW SPT reactive wheal of 10 mm and 60% for an EW-specific IgE level of 8 kUA/L. CONCLUSION: Most subjects with egg allergy tolerated baked egg. This study is the first to use 3.8 g of EW protein for the challenges. The EW SPT wheal diameter and EW-specific IgE levels were the best predictors of baked-egg tolerance.

Osteology of the basal hadrosauroid Eolambia caroljonesa (Dinosauria: Ornithopoda) from the Cedar Mountain Formation of Utah.

BACKGROUND: Eolambia caroljonesa is known from copious remains from the lower Cenomanian Mussentuchit Member of the Cedar Mountain Formation in eastern Utah; however, the taxon has been only briefly described. Thus, we present herein a complete osteological description of Eolambia. METHODOLOGY/PRINCIPAL FINDINGS: The description of Eolambia presented here is based upon the holotype partial skeleton (CEUM 9758), paratype partial skull (CEUM 5212), and abundant disarticulated elements from two bonebeds that contain juvenile individuals. These remains allow the skeletal anatomy of Eolambia to be documented almost fully and a revised diagnosis to be proposed. CONCLUSIONS/SIGNIFICANCE: The description provided here facilitates comparisons between Eolambia and other iguanodontians and allows Eolambia to be coded for additional characters in phylogenetic analyses. The close affinity between Eolambia and Probactrosaurus gobiensis from the Early Cretaceous of China supports previous hypotheses of faunal interchange between Asia and North America in the early Late Cretaceous.

A new troodontid theropod dinosaur from the lower Cretaceous of Utah.

BACKGROUND: The theropod dinosaur family Troodontidae is known from the Upper Jurassic, Lower Cretaceous, and Upper Cretaceous of Asia and from the Upper Jurassic and Upper Cretaceous of North America. Before now no undisputed troodontids from North America have been reported from the Early Cretaceous. METHODOLOGY/PRINCIPAL FINDINGS: Herein we describe a theropod maxilla from the Lower Cretaceous Cedar Mountain Formation of Utah and perform a phylogenetic analysis to determine its phylogenetic position. The specimen is distinctive enough to assign to a new genus and species, Geminiraptor suarezarum. Phylogenetic analysis places G. suarezarum within Troodontidae in an unresolved polytomy with Mei, Byronosaurus, Sinornithoides, Sinusonasus, and Troodon+(Saurornithoides+Zanabazar). Geminiraptor suarezarum uniquely exhibits extreme pneumatic inflation of the maxilla internal to the antorbital fossa such that the anterior maxilla has a triangular cross-section. Unlike troodontids more closely related to Troodon, G. suarezarum exhibits bony septa between the dental alveoli and a promaxillary foramen that is visible in lateral view. CONCLUSIONS/SIGNIFICANCE: This is the first report of a North American troodontid from the Lower Cretaceous. It therefore contributes to a fuller understanding of troodontid biogeography through time. It also adds to the known dinosaurian fauna of the Cedar Mountain Formation.

In vitro and in vivo endochondral bone formation models allow identification of anti-angiogenic compounds.

A major obstacle in the study of angiogenesis and the testing of new agents with anti-angiogenic potential has been the lack of experimental models with predictive in vivo value. We describe here the combined use of in vitro and in vivo angiogenesis models that are based on endochondral bone development. This approach led to the identification of a new inhibitor of matrix metalloprotease (MMP) activity that inhibits neovascularization in vitro and in vivo while osteoclast invasion, which occurs simultaneously during bone development, remained unaffected. In contrast, the broad-spectrum MMP-inhibitor marimastat inhibited both in vitro angiogenesis and osteoclastogenesis dose-dependently but displayed severe toxic side effects in vivo. The combined use of these experimental models may, therefore, facilitate the discovery of mechanisms underlying angiogenesis and lead to identification of new pharmacological compounds with clinical efficacy and appropriate selectivity in the treatment of angiogenesis-dependent disorders like arthritis and cancer.

Inhibition of alveolar bone loss by matrix metalloproteinase inhibitors in experimental periodontal disease.

Periodontal disease is characterized by excessive host collagenase resulting in loss of gingival and periodontal ligament collagen and adjacent alveolar bone. Intragingival endotoxin injection induces a model of periodontal disease characterized by rapid bone loss with biochemical features similar to that of naturally occurring adult periodontitis. CH1766, a peptide with a zinc binding moeity which fits into the active site of the enzyme, and CH6631, a hydroxamic acid derivative with aryl-substituted sulphonamide residues, are inhibitors of matrix metalloproteinases (MMPIs) with differing inhibitory profiles as characterized by in vitro assays. In this study, endotoxin was injected into the gingivae of rats which were then treated orally with either 3 mg/kg or 30 mg/kg of one of the two inhibitory compounds. The gingival tissues were assessed for collagenase and gelatinase activity, plus three different pro-inflammatory cytokines. In addition, alveolar bone height in defleshed jaws was studied by computerized morphometric analysis and scanning electron microscopy. Both drugs reduced active and/or total MMP activity, in many cases to normal, and also partially normalized cytokine levels as well. A dose-response effect was seen with regard to amelioration of lipopolysaccharide-induced alveolar bone loss with both drugs. Other than studies with tetracyclines, this is the first report of beneficial effects of MMPIs in a model of periodontal disease, strongly suggesting that this class of agents could bring therapeutic benefit to patients with this disorder, and that periodontal disease can be used as a model to demonstrate in vivo efficacy of this class of drugs.