New light on an old syndrome: Role of Api g 7 in mugwort pollen-related celery allergy.

BACKGROUND: Celery root is known to cause severe allergic reactions in patients sensitized to mugwort pollen. OBJECTIVE: We studied clinically well-characterized patients with celery allergy by IgE testing with a comprehensive panel of celery allergens to disentangle the molecular basis of what is known as the celery-mugwort syndrome. METHODS: Patients with suspected food allergy to celery underwent a standardized interview. Main inclusion criteria were a positive food challenge with celery or an unambiguous case history of severe anaphylaxis. IgE to celery allergens (rApi g 1.01, rApi g 1.02, rApi g 2, rApi g 4, nApi g 5, rApi g 6, rApi g 7) and to mugwort allergens (rArt v 1, rArt v 3, rArt v 4) were determined. IgE levels ≥0.35 kUA/L were regarded positive. RESULTS: Seventy-nine patients with allergy to celery were included. Thirty patients had mild oral or rhinoconjunctival symptoms, and 49 had systemic reactions. Sixty-eight percent had IgE to celery extract, 80% to birch pollen, and 77% to mugwort pollen. A combination of Api g 1.01, 1.02, 4, 5, and 7 increased the diagnostic sensitivity for celery allergy to 92%. The lipid transfer proteins Api g 2 and Api g 6 were not relevant in our celery-allergic population. IgE to Api g 7, detected in 52% of patients, correlated closely (r = 0.86) to Art v 1 from mugwort pollen. Eleven of 12 patients with monosensitization to Api g 7 were IgE negative to celery extract. The odds ratio for developing a severe anaphylactic reaction rather than only mild oral symptoms was about 6 times greater (odds ratio, 5.87; 95% confidence interval, 1.08-32.0; P = .0410) for Api g 7-sensitized versus -nonsensitized subjects. CONCLUSION: There is an urgent need for routine diagnostic tests to assess sensitization to Api g 7, not only to increase test sensitivity but also to identify patients at risk of a severe allergic reaction to celery.

IgE to cyclophilins in pollen-allergic children: Epidemiologic, clinical, and diagnostic relevance of a neglected panallergen.

BACKGROUND: Cyclophilins are ubiquitous panallergens whose epidemiologic, diagnostic, and clinical relevance is largely unknown and whose sensitization is rarely examined in routine allergy practice. OBJECTIVE: We investigated the epidemiologic, diagnostic, and clinical relevance of cyclophilins in seasonal allergic rhinitis and its comorbidities. METHODS: We examined a random sample of 253 (25%) of 1263 Italian children with seasonal allergic rhinitis from the Panallergens in Pediatrics (PAN-PED) cohort with characterized disease phenotypes. Nested studies of sensitization prevalence, correlation, and allergen extract inhibition were performed in patients sensitized to birch pollen extract but lacking IgE to Bet v 1/2/4 (74/1263) or with highest serum level of IgE to Bet v 1 (26/1263); and in patients with sensitization to various extracts (ragweed, mugwort, pellitory, Plantago, and plane tree), but not to their respective major allergenic molecule, profilins, and polcalcins. IgE to cyclophilin was detected with recombinant Bet v 7, and extract inhibition tests were performed with the same rBet v 7. RESULTS: IgE to rBet v 7 was detected in 43 (17%) of 253 patients. It was associated with asthma (P < .028) and oral allergy syndrome (P < .017) in univariate but not multivariate analysis adjusted for IgE to profilins (Phl p 12), PR-10s (Bet v 1), and lipid transfer proteins (Pru p 3). IgE to rBet v 7 was also highly prevalent (47/74, 63%) among patients with unexplained sensitization to birch pollen extract. In patients with unexplained sensitization to ragweed, mugwort, pellitory, Plantago and plane tree pollen, the levels of IgE to those extracts correlated with the levels of IgE to rBet v 7, and they were also significantly inhibited by rBet v 7 (inhibition range 45%-74%). CONCLUSIONS: IgE sensitization to cyclophilin is frequent in pollen-allergic patients living in temperate areas and can produce "false" positive outcomes in skin prick and IgE tests to pollen extracts. Molecular diagnostic guidelines should include this panallergen family.

Characterization of a 7 kDa pollen allergen belonging to the gibberellin-regulated protein family from three Cupressaceae species.

BACKGROUND: Severe allergy to fruits mediated by a 7 kDa allergen belonging to the gibberellin-regulated protein (GRP) family is known to be associated with Cupressaceae pollinosis. OBJECTIVE: To identify and characterize Cupressaceae pollen allergens involved in GRP-related fruit allergy. METHODS: Pru p 7-related proteins from pollen of Cupressus sempervirens, Juniperus ashei and Cryptomeria japonica were identified using a rabbit anti-Pru p 7 antiserum, purified chromatographically and sequenced by mass spectrometry and bioinformatic comparisons. The C sempervirens protein was produced as a recombinant allergen in Pichia pastoris. IgE antibody binding to pollen GRP proteins was analysed in a peach allergic (n = 54) and a cypress pollen allergic (n = 88) patient population from southern France using ImmunoCAP. RESULTS: In each of the three Cupressaceae species studied, a 7 kDa pollen protein related to Pru p 7 was identified and found to comprise an amino acid sequence of 63 residues in length, 92%-98% identical to each other and 67%-68% identical to Pru p 7. The C sempervirens, J ashei and C japonica GRP allergens have been officially recognized by the WHO/IUIS Allergen Nomenclature Sub-Committee and named Cup s 7, Jun a 7 and Cry j 7, respectively. Recombinant Cup s 7 showed IgE antibody binding capacity comparable to that of the purified natural allergen. Among 51 peach allergic subjects sensitized to Pru p 7, substantially higher levels of IgE to Cup s 7 than to Pru p 7 were found. Further, the pollen protein was able to completely outcompete IgE binding to Pru p 7, while the reverse competition effect was modest, consistent with primary sensitization by the pollen allergen. CONCLUSION AND CLINICAL RELEVANCE: Pru p 7-related pollen allergens from three Cupressaceae species have been characterized and may become useful for the identification of pollinosis patients at risk of developing severe fruit allergy.

Parental reactions, distress, and sense of coherence after prenatal versus postnatal diagnosis of complex congenital heart disease.

INTRODUCTION: A diagnosis of congenital heart disease (CHD) in offspring triggers psychological distress in parents. Results of previous studies have been inconsistent regarding the psychological impact of a prenatal versus a postnatal diagnosis. The aim of this study was to evaluate the influence of the time of diagnosis on levels of parental distress. METHODS: Pregnant women and their partners with a fetus diagnosed with complex CHD, parents of children with postnatally diagnosed CHD, and pregnant women and their partners with uncomplicated pregnancies were invited to participate. Data were collected during pregnancy and 2-6 months after delivery using the Hospital Anxiety and Depression Scale, sense of coherence, life satisfaction, and Dyadic Adjustment Scale. RESULTS: During pregnancy, the prenatal group scored lower sense of coherence compared to controls (p=0.044). Postnatally the prenatal group scored lower on sense of coherence compared to the postnatal group and controls (p=0.001; p=0.001). Postnatally, the prenatal and postnatal groups had higher levels of anxiety compared to controls (p=0.025; p=0.0003). Life satisfaction was lower in the prenatal group compared to that in the postnatal group and in controls (p=0.000; p=0.0004). CONCLUSION: Parents with a prenatal diagnosis of CHD in offspring report a low sense of coherence already during pregnancy which decreased further at follow-up. The same group reported a lower satisfaction with life compared to parents of a child with postnatal diagnosis of CHD and parents of a healthy child. This motivates further efforts to improve counselling and support during pregnancy and for parents after a prenatal diagnosis.

A Systems-Based Risk Assessment Framework for Intentional Electromagnetic Interference (IEMI) on Critical Infrastructures.

Modern infrastructures are becoming increasingly dependent on electronic systems, leaving them more vulnerable to electrical surges or electromagnetic interference. Electromagnetic disturbances appear in nature, e.g., lightning and solar wind; however, they may also be generated by man-made technology to maliciously damage or disturb electronic equipment. This article presents a systematic risk assessment framework for identifying possible, consequential, and plausible intentional electromagnetic interference (IEMI) attacks on an arbitrary distribution network infrastructure. In the absence of available data on IEMI occurrences, we find that a systems-based risk assessment is more useful than a probabilistic approach. We therefore modify the often applied definition of risk, i.e., a set of triplets containing scenario, probability, and consequence, to a set of quadruplets: scenario, resource requirements, plausibility, and consequence. Probability is "replaced" by resource requirements and plausibility, where the former is the minimum amount and type of equipment necessary to successfully carry out an attack scenario and the latter is a subjective assessment of the extent of the existence of attackers who possess the motivation, knowledge, and resources necessary to carry out the scenario. We apply the concept of intrusion areas and classify electromagnetic source technology according to key attributes. Worst-case scenarios are identified for different quantities of attacker resources. The most plausible and consequential of these are deemed the most important scenarios and should provide useful decision support in a countermeasures effort. Finally, an example of the proposed risk assessment framework, based on notional data, is provided on a hypothetical water distribution network.

Advanced image analysis verifies geometry performance of micro-milling systems.

Accurate dimensional measurement of micro-milled items is a challenge and machine specifications do not include operational parameters in the workshop. Therefore, a verification test that shows the machine's overall geometrical performance over its working area would help machine users in the assessment and adjustment of their equipment. In this study, we present an optical technique capable of finding micro-milled features at submicron uncertainty over working areas >10 cm2. The technique relies on an ultra-precision measurement microscope combined with advanced image analysis to get the center of gravity of milled cross-shaped features at subpixel levels. Special algorithms had to be developed to handle the disturbing influence of burr and milling marks. The results show repeatability, reproducibility, and axis straightness for three micro-milling facilities and also discovered an unknown 2 µm amplitude undulation in one of them.

A population-based study of animal component sensitization, asthma, and rhinitis in schoolchildren.

BACKGROUND: Animal sensitization is a major determinant of asthma in children. Component-resolved studies of unselected pediatric populations are lacking. The aim was to describe sensitization to animal components and the association with asthma and rhinitis in animal-sensitized schoolchildren. METHODS: A random sample of 696 children (11-12 years) from a Swedish population-based cohort was tested for sensitization to cat, dog, and horse dander using ImmunoCAP. Sera from animal-sensitized children were further analyzed by microarray including three allergen components from cat, four from dog, and two from horse. The parents completed an expanded ISAAC questionnaire. RESULTS: Of 259 animal-sensitized children (≥0.1 kUA /l), 51% were sensitized to all three, 23% to two, and 25% to one species. Current asthma and asthma symptoms following contact with cats were associated with co-sensitization to Fel d 1 and Fel d 4. This association was seen already at moderate-level sensitization (1-15 ISU) to Fel d 4, at which level most children were sensitized to Fel d 1, as well. In dog-sensitized children, the majority was sensitized to more than one dog component, and co-sensitization to Can f 5 and Can f 1/f 2 conferred the greatest risk for asthma. Sensitization to the highly cross-reactive serum albumins was uncommon and not associated with asthma. CONCLUSIONS: Among schoolchildren in northern Sweden, where mite allergy is uncommon, furry animals were the primary perennial sensitizers. Asthma was associated with higher levels of component sensitization, and sensitization to more than one component from the same animal conferred the greatest risk.

Perspectives of mid-infrared optical coherence tomography for inspection and micrometrology of industrial ceramics.

Optical coherence tomography (OCT) is a promising tool for detecting micro channels, metal prints, defects and delaminations embedded in alumina and zirconia ceramic layers at hundreds of micrometers beneath surfaces. The effect of surface roughness and scattering of probing radiation within sample on OCT inspection is analyzed from the experimental and simulated OCT images of the ceramic samples with varying surface roughnesses and operating wavelengths. By Monte Carlo simulations of the OCT images in the mid-IR the optimal operating wavelength is found to be 4 µm for the alumina samples and 2 µm for the zirconia samples for achieving sufficient probing depth of about 1 mm. The effects of rough surfaces and dispersion on the detection of the embedded boundaries are discussed. Two types of image artefacts are found in OCT images due to multiple reflections between neighboring boundaries and inhomogeneity of refractive index.

Accurate and automated image segmentation of 3D optical coherence tomography data suffering from low signal-to-noise levels.

Optical coherence tomography (OCT) has proven to be a useful tool for investigating internal structures in ceramic tapes, and the technique is expected to be important for roll-to-roll manufacturing. However, because of high scattering in ceramic materials, noise and speckles deteriorate the image quality, which makes automated quantitative measurements of internal interfaces difficult. To overcome this difficulty we present in this paper an innovative image analysis approach based on volumetric OCT data. The engine in the analysis is a 3D image processing and analysis algorithm. It is dedicated to boundary segmentation and dimensional measurement in volumetric OCT images, and offers high accuracy, efficiency, robustness, subpixel resolution, and a fully automated operation. The method relies on the correlation property of a physical interface and effectively eliminates pixels caused by noise and speckles. The remaining pixels being stored are the ones confirmed to be related to the target interfaces. Segmentation of tilted and curved internal interfaces separated by ∼10 µm in the Z direction is demonstrated. The algorithm also extracts full-field top-view intensity maps of the target interfaces for high-accuracy measurements in the X and Y directions. The methodology developed here may also be adopted in other similar 3D imaging and measurement technologies, e.g., ultrasound imaging, and for various materials.

Fast and accurate metrology of multi-layered ceramic materials by an automated boundary detection algorithm developed for optical coherence tomography data.

Optical coherence tomography (OCT) is useful for materials defect analysis and inspection with the additional possibility of quantitative dimensional metrology. Here, we present an automated image-processing algorithm for OCT analysis of roll-to-roll multilayers in 3D manufacturing of advanced ceramics. It has the advantage of avoiding filtering and preset modeling, and will, thus, introduce a simplification. The algorithm is validated for its capability of measuring the thickness of ceramic layers, extracting the boundaries of embedded features with irregular shapes, and detecting the geometric deformations. The accuracy of the algorithm is very high, and the reliability is better than 1 µm when evaluating with the OCT images using the same gauge block step height reference. The method may be suitable for industrial applications to the rapid inspection of manufactured samples with high accuracy and robustness.

Sensitization to Cor a 9 and Cor a 14 is highly specific for a hazelnut allergy with objective symptoms in Dutch children and adults.

BACKGROUND: Component-resolved diagnosis has been shown to improve the diagnosis of food allergy. OBJECTIVE: We sought to evaluate whether component-resolved diagnosis might help to identify patients at risk of objective allergic reactions to hazelnut. METHOD: A total of 161 hazelnut-sensitized patients were included: 40 children and 15 adults with objective symptoms on double-blind, placebo-controlled food challenges (DBPCFCs) and 24 adults with a convincing objective history were compared with 41 children and 41 adults with no or subjective symptoms on DBPCFCs (grouped together). IgE levels to hazelnut extract and single components were analyzed with ImmunoCAP. RESULTS: IgE levels to hazelnut extract were significantly higher in children with objective than with no or subjective symptoms. In 13% of children and 49% of adults with hazelnut allergy with objective symptoms, only sensitization to rCor a 1.04 was observed and not to other water-soluble allergens. Sensitization to rCor a 8 was rare, which is in contrast to rCor a 1. Sensitization to nCor a 9, rCor a 14, or both was strongly associated with hazelnut allergy with objective symptoms. By using adapted cutoff levels, a diagnostic discrimination between severity groups was obtained. IgE levels to either nCor a 9 of 1 kUA/L or greater or rCor a 14 of 5 kUA/L or greater (children) and IgE levels to either nCor a 9 of 1 kUA/L or greater or rCor a 14 of 1 kUA/L or greater (adults) had a specificity of greater than 90% and accounted for 83% of children and 44% of adults with hazelnut allergy with objective symptoms. CONCLUSION: Sensitization to Cor a 9 and Cor a 14 is highly specific for patients with objective symptoms in DBPCFCs as a marker for a more severe hazelnut allergic phenotype.

Supernova dust destruction in the magnetized turbulent ISM.

Dust in the interstellar medium (ISM) is critical to the absorption and intensity of emission profiles used widely in astronomical observations, and necessary for star and planet formation. Supernovae (SNe) both produce and destroy ISM dust. In particular the destruction rate is difficult to assess. Theory and prior simulations of dust processing by SNe in a uniform ISM predict quite high rates of dust destruction, potentially higher than the supernova dust production rate in some cases. Here we show simulations of supernova-induced dust processing with realistic ISM dynamics including magnetic field effects and demonstrate how ISM inhomogeneity and magnetic fields inhibit dust destruction. Compared to the non-magnetic homogeneous case, the dust mass destroyed within 1 Myr per SNe is reduced by more than a factor of two, which can have a great impact on the ISM dust budget.

Optical coherence tomography for quality assessment of embedded microchannels in alumina ceramic.

Large-scale and cost-effective manufacturing of ceramic micro devices based on tape stacking requires the development of inspection systems to perform high-resolution in-process quality control of embedded manufactured cavities, metal structures and defects. With an optical coherence tomography (OCT) system operating at 1.3 µm and a dedicated automated line segmentation algorithm, layer thicknesses can be measured and laser-machined channels can be verified in alumina ceramics embedded at around 100 µm depth. Monte Carlo simulations are employed to analyze the abilities of OCT in imaging of the embedded channels. The light scattering parameters required as input data for simulations are evaluated from the integrating sphere measurements of collimated and diffuse transmittance spectra using a reconstruction algorithm based on refined diffusion approximation approach.

Involvement of Can f 5 in a case of human seminal plasma allergy.

BACKGROUND: The existence of IgE binding to dog dander extract without IgE antibodies against the described dog allergens (Can f 1, 2, 3 and 4) implies the presence of other dog allergens yet to be identified. Recently, an IgE-binding protein was isolated from dog urine and identified as prostatic kallikrein; it has been named Can f 5. Cross-reactivity between a dog dander allergen and human prostate-specific antigen (PSA) has been described. The aim of this study was to identify the dog dander allergen that presents cross-reactivity with PSA and demonstrate its clinical relevance in our patient with human seminal plasma allergy. METHODS: SDS-PAGE immunoblotting and inhibition tests were performed. Mass spectrometry was carried out to identify the protein involved in the allergy reactions. RESULTS: SDS-PAGE immunoblotting-inhibition with an IgE-binding protein from dog prostatic secretion showed total IgE binding inhibition to a 28-kDa IgE-reactive band identified as PSA. The electroeluted protein from dog prostatic secretion was identified by mass spectrometry as Can f 5. IgE immunoblotting of human seminal plasma incubated with the serum of the patient revealed two IgE-binding bands (28 and 32.7 kDa). Both SDS-PAGE immunoblotting inhibition assays, with human seminal plasma or purified PSA in solid phase, showed complete IgE binding inhibition when the serum of the anaphylactic patient was preincubated with dog dander extract or recombinant Can f 5. CONCLUSIONS: The dog dander allergen that shows cross-reactivity with human PSA has been characterized and turns out to be the recently described Can f 5. We demonstrated the clinical relevance of this cross-reactivity in a patient.

Afterpains: a comparison between active and expectant management of the third stage of labor.

BACKGROUND: Management of the third stage of labor, the period following the birth of the infant until delivery of the placenta, is crucial. Active management using synthetic oxytocin has been advocated to decrease blood loss. It has been suggested, but not studied, that oxytocin may increase afterpains. The aim of this study was to compare women's experience of pain intensity when the third stage of labor was managed actively and expectantly and their experience of afterpains. METHODS: A single-blind, randomized, controlled trial was performed at two delivery units in Sweden in a population of healthy women with normal, singleton pregnancies, gestational age of 34 to 43 weeks, cephalic presentation, and expected vaginal delivery. Women (n=1,802) were randomly allocated to either active management or expectant management of the third stage of labor. Afterpains were assessed by Visual Analog Scale (VAS) and the Pain-o-Meter (POM-WDS) 2 hours after delivery of the placenta and the day after childbirth. RESULTS: At 2 hours after childbirth, women in the actively managed group had lower VAS pain scores than expectantly managed women (p=0.014). Afterpains were scored as more intense the day after, compared with 2 hours after, childbirth in both groups. Multiparas scored more intense afterpains, compared with primiparas, irrespective of management (p<0.001). CONCLUSIONS: Active management of the third stage of labor does not provoke more intense afterpains than expectant management.

Exploring nine simultaneously occurring transients on April 12th 1950.

Nine point sources appeared within half an hour on a region within [Formula: see text] 10 arcmin of a red-sensitive photographic plate taken in April 1950 as part of the historic Palomar Sky Survey. All nine sources are absent on both previous and later photographic images, and absent in modern surveys with CCD detectors which go several magnitudes deeper. We present deep CCD images with the 10.4-m Gran Telescopio Canarias, reaching brightness [Formula: see text] mag, that reveal possible optical counterparts, although these counterparts could equally well be just chance projections. The incidence of transients in the investigated photographic plate is far higher than expected from known detection rates of optical counterparts to e.g. flaring dwarf stars, Fast Radio Bursts, Gamma Ray Bursts or microlensing events. One possible explanation is that the plates have been subjected to an unknown type of contamination producing mainly point sources with of varying intensities along with some mechanism of concentration within a radius of [Formula: see text] 10 arcmin on the plate. If contamination as an explanation can be fully excluded, another possibility is fast (t [Formula: see text] s) solar reflections from objects near geosynchronous orbits. An alternative route to confirm the latter scenario is by looking for images from the First Palomar Sky Survey where multiple transients follow a line.

Derivations that enable the testing of fetal urine production as a method of fetal surveillance.

PURPOSE: To calculate the measurement error of the hourly fetal urine production rate (HFUPR) and evaluate the implication of different methods for measuring the HFUPR, i.e. ellipsoid versus sum-of-cylinders method. METHODS: The calculation was based on sonographic documentation of the increased bladder volumes during the filling phase, the bladder volume measurement error and the number and time points of bladder image capture. RESULTS: The probability of a false pathological reading was excluded (0%) with the sum-of-cylinders method for gestational ages of ≥30 weeks. With the ellipsoid method, the risk was higher. The maximum changes which could be exclusively explained by measurement error were four to five times greater with the ellipsoid method compared with the sum-of-cylinders method. CONCLUSIONS: The present paper illustrates a careful evaluation of the HFUPR measurement error and the implications of using different ultrasound methods for bladder volume estimations.