Practical Considerations before Installing Ground-Based Geodetic Infrastructure for Integrated InSAR and cGNSS Monitoring of Vertical Land Motion.

Continuously operating Global Navigation Satellite Systems (cGNSS) can be used to convert relative values of vertical land motion (VLM) derived from Interferometric Synthetic Aperture Radar (InSAR) to absolute values in a global or regional reference frame. Artificial trihedral corner reflectors (CRs) provide high-intensity and temporally stable reflections in SAR time series imagery, more so than naturally occurring permanent scatterers. Therefore, it is logical to co-locate CRs with cGNSS as ground-based geodetic infrastructure for the integrated monitoring of VLM. We describe the practical considerations for such co-locations using four case-study examples from Perth, Australia. After basic initial considerations such as land access, sky visibility and security, temporary test deployments of co-located CRs with cGNSS should be analysed together to determine site suitability. Signal to clutter ratios from SAR imagery are used to determine potential sites for placement of the CR. A significant concern is whether the co-location of a deliberately designed reflecting object generates unwanted multipath (reflected signals) in the cGNSS data. To mitigate against this, we located CRs >30 m from the cGNSS with no inter-visibility. Daily RMS values of the zero-difference ionosphere-free carrier-phase residuals, and ellipsoidal heights from static precise point positioning GNSS processing at each co-located site were then used to ascertain that the CR did not generate unwanted cGNSS multipath. These steps form a set of recommendations for the installation of such geodetic ground-infrastructure, which may be of use to others wishing to establish integrated InSAR-cGNSS monitoring of VLM elsewhere.

Successful administration of a 1-day imported fire ant rush immunotherapy protocol.

BACKGROUND: Young children with a history of systemic reactions to imported fire ant (IFA) stings are at substantial risk of recurrent stings because of their maturational inability to practice appropriate avoidance techniques. OBJECTIVE: To present 3 cases in which patients 36 months or younger completed a 1-day rush immunotherapy (RIT) protocol with IFA whole-body extract (WBE). METHODS: The 1-day RIT protocol used for these patients was modified from the Wilford Hall 2-day rush protocol previously published. A 1:1 vol/vol maintenance vial consisted of 1 mL of IFA WBE and 9 mL of human serum albumin diluent in a 10-mL vial. RESULTS: All 3 patients had positive intradermal skin test results to IFA WBE. No systemic reactions occurred during the 1-day RIT. CONCLUSIONS: This case series provides data with which we can begin to assess the efficacy and safety of a 1-day IFA RIT protocol for the prevention of anaphylaxis in IFA allergic children. Further studies with larger numbers of patients are needed to confirm the findings.

Rates of retrieval of self-injectable epinephrine prescriptions: a descriptive report.

BACKGROUND: Some studies have demonstrated poor patient compliance with carrying and administering self-injectable epinephrine (SIE). No study has attempted to define the number or characteristics of patients who are prescribed SIE and subsequently do not retrieve the prescription. OBJECTIVES: To determine fill rates of SIE prescriptions and to provide a descriptive report of patients who do not fill those prescriptions. METHODS: This was a retrospective review of electronic medical records of patients prescribed SIE at a large military medical center in a 1-year period. Rates of prescription retrieval were determined, and patient demographic information was collected. Additional information recorded included the number of devices prescribed per prescription, the International Classification of Diseases, Ninth Revision, code associated with each prescription, and the ambulatory care setting associated with the patient encounter resulting in the prescription. Statistical analysis was performed using the chi2 test. RESULTS: There were 881 SIE prescriptions entered for 769 patients, and 630 patients (82%) filled at least 1 prescription. Individuals older than 55 years filled their SIE prescriptions more often than those 55 years and younger (P < .009), and prescriptions were filled more often from outpatient clinics compared with the emergency department (P < .01). There were no statistically significant differences in fill rates based on sex, active-duty military status, or diagnosis. CONCLUSIONS: Elderly patients and those receiving care in clinic settings are more likely to fill an SIE prescription. Determining why patients do not fill an SIE prescription may help focus patient education efforts.

Generalized cutaneous reactions to the anthrax vaccine: preliminary results of anthrax vaccine-specific cell mediated immunity and cytokine profiles.

Over two years, the Vaccine Adverse Event Reporting System reported that 0.042% of all anthrax vaccine (Biothrax, Bioport Corporation) doses administered were associated with cutaneous reactions, half of which were eczematous. This case series attempts to immunologically detail this eczematous reaction in four patients by measuring anthrax vaccine-specific cell mediated immunity (ASCMI), profiling TH1 and TH2 cytokine response to the anthrax vaccine in vitro, and analyzing of skin biopsy specimens. Results demonstrated that (1) ASCMI was variable and likely unrelated to this reaction; (2) a lack of TH1 cytokine response to anthrax vaccine may be associated with an increased risk of this eczematous reaction; and (3) skin biopsy findings were nonspecific but supportive of a clinical diagnosis of eczema. Future studies with more patients may yield data to further characterize the ASCMI response and cytokine profiles among patients with this type of reaction.

Multicolored Asian lady beetle hypersensitivity: a case series and allergist survey.

BACKGROUND: Multicolored Asian lady beetles (Harmonia axyridis) have been used as a biological control agent against crop-destroying aphids in the United States. Outside their natural habitat, H. axyridis seeks refuge in homes during fall and winter, leading to patient complaints and symptoms of rhinitis, wheezing, and urticaria on exposure to the beetles. OBJECTIVE: To gain a better understanding of the character and spectrum of allergic disease provoked by exposure to home-infesting lady beetles. METHODS: Eight patients with allergic symptoms suspected of being caused by H. axyridis and consistent with an IgE-mediated process were identified and interviewed. A whole-body extract from H. axyridis was prepared. Western blots using the patients' serum identified specific IgE antibodies in the extract. Through a novel technique, immunohistochemical analysis using beetle sections overlayed with patient serum was performed. A random survey of allergists from across the United States was also performed to evaluate experience with cases of lady beetle allergy. RESULTS: Western blots revealed IgE binding to 5 proteins with molecular weights of approximately 8.6, 21, 28, 31, and 75 kDa. Specific IgE bound to proteins localized in the beetle's mouth and leg areas. The allergist survey revealed positive responses in North Central, Mid-Atlantic and New England states. CONCLUSION: In 8 patients with allergic symptoms on exposure to high levels of lady beetles, specific IgE bound to proteins from H. axyridis. There was also an increased frequency of suspected cases of lady beetle allergy in endemic areas.