Specific Trigger Research Articles

Surface modification of tungsten disulfide nanosheets by pH/temperature sensitive polymers for NIR-triggered drug delivery

Stimuli-responsive polymers are attractive nanocarriers for cancer drug delivery due to their biodegradability and precise control of the release of an anti-cancer drug in response to specific triggers. Herein, the tungsten disulfide nanosheet was modified by pH and thermo-responsive polymer as the novel nanocarrier. The physicochemical characteristics of nanoadsorbent were studied by X-ray diffraction, Fourier transform infrared, field emission-scanning electron microscopy, and thermal gravitational analysis. The maximum adsorption capacity in optimal conditions for flutamide with nanoadsorbent (C0 = 20 mg L−1, pH = 5, contact time = 15 min, stirring speed = 500 rpm, and temperature = 25 °C) was obtained 2.43 mg g−1. The Langmuir equilibrium isotherm and the pseudo-second-order kinetic model fit the adsorption mechanism very well. Around 75.26 % of the drug was released from nanocarrier in simulated human fluid at 6 h and 91.48 % in simulated cancer fluid at 45 °C. The near laser irradiation-triggered effective and controllable release of the loaded drug under near laser irradiation is successfully confirmed. Drug releasing 94.77 % under near laser irradiation within 30 min, which was roughly four folds of that without near laser irradiation. Cytotoxicity/cell viability assays using MTT were carried out for samples in PC-3 prostate cancer cells. Based on the cell viability assay on the PC-3 prostate cancer cell line, the drug loaded pH/thermo-responsive nanocarrier indicated better cytotoxic activity than the free drug. According to these results, it is very promising that pH/thermo-responsive nanocarrier can be used as an effective drug delivery system.

Versatile Weight Attack via Flipping Limited Bits.

Many attack paradigms against deep neural networks have been well studied, such as the backdoor attack in the training stage and the adversarial attack in the inference stage. In this article, we study a novel attack paradigm, the bit-flip based weight attack, which directly modifies weight bits of the attacked model in the deployment stage. To meet various attack scenarios, we propose a general formulation including terms to achieve effectiveness and stealthiness goals and a constraint on the number of bit-flips. Furthermore, benefitting from this extensible and flexible formulation, we present two cases with different malicious purposes, i.e., single sample attack (SSA) and triggered samples attack (TSA). SSA which aims at misclassifying a specific sample into a target class is a binary optimization with determining the state of the binary bits (0 or 1); TSA which is to misclassify the samples embedded with a specific trigger is a mixed integer programming (MIP) with flipped bits and a learnable trigger. Utilizing the latest technique in integer programming, we equivalently reformulate them as continuous optimization problems, whose approximate solutions can be effectively and efficiently obtained by the alternating direction method of multipliers (ADMM) method. Extensive experiments demonstrate the superiority of our methods.

Auditory cortical functioning in individuals with misophonia: an electrophysiological investigation.

Misophonia is characterized by a reduced tolerance for specific sound triggers. This aspect has been relatively underexplored in audiology, with limited research from the audiological angle. Our primary objective is to compare the auditory late latency response (ALLR) findings between individuals with misophonia and those without it. A study compared individuals with significant misophonia to a healthy control group. Thirty misophonia participants were categorized into mild and moderate-to-severe groups based on their Amsterdam Misophonia Scale scores. The latency and amplitude of auditory response peaks were analyzed across the groups using the ALLR. Statistical tests included Shapiro-Wilk for data normality, one-way ANOVA for group differences, and Bonferroni post hoc analysis for detailed variation sources. The result showed a significant difference in latency of P1 and N1 peaks (p < 0.05) of ALLR between the groups in both ears. This suggests a deficit in auditory processing at the cortical level in individuals with misophonia. Our study substantiates the potential utility of the ALLR as a valuable instrument for evaluating misophonia, particularly from the audiological standpoint.

A Temporal Chrominance Trigger for Clean-Label Backdoor Attack Against Anti-Spoof Rebroadcast Detection

We propose a stealthy clean-label video backdoor attack against Deep Learning (DL)-based models aiming at detecting a particular class of spoofing attacks, namely video rebroadcast attacks. The injected backdoor does not affect spoofing detection in normal conditions, but induces a misclassification in the presence of a specific triggering signal. The proposed backdoor relies on a temporal trigger altering the average chrominance of the video sequence. The backdoor signal is designed by taking into account the peculiarities of the Human Visual System (HVS) to reduce the visibility of the trigger, thus increasing the stealthiness of the backdoor. To force the network to look at the presence of the trigger in the challenging clean-label scenario, we choose the poisoned samples used for the injection of the backdoor following a so-called Outlier Poisoning Strategy (OPS). According to OPS, the triggering signal is inserted in the training samples that the network finds more difficult to classify. The effectiveness of the proposed backdoor attack and its generality are validated experimentally on different datasets and anti-spoofing rebroadcast detection architectures.

Examined The Relationship Between Travel Anxiety and Destination Choice: Implications for Tourism Marketing: A Qualitative Study

This qualitative study examined the relationship between travel anxiety and destination choice, specifically focusing on its implications for tourism marketing. Through in-depth interviews with individuals who have experienced travel anxiety, the study explored their past experiences and decision-making processes when selecting destinations. Participants were selected through purposive sampling, ensuring diverse travel anxiety levels and demographic backgrounds. Data analysis followed a thematic approach, using past tense verbs to capture participants' retrospective perspectives on their travel anxiety experiences. The findings revealed that travel anxiety significantly influenced destination choices, with various factors contributing to decision-making processes. Past tense verbs were employed to describe participants' experiences, emotions, and coping mechanisms during their previous travel experiences. These verbs highlighted the nuanced nature of travel anxiety and provided valuable insights into the specific triggers and manifestations of anxiety in different travel contexts. The implications for tourism marketing were identified through the lens of the findings. Strategies were proposed to address and alleviate travel anxiety, targeting specific stages of the decision-making process. Tourism marketers can tailor their marketing efforts to better accommodate and support individuals with travel anxiety, ultimately enhancing their overall travel experiences by comprehending the complex relationship between destination selection and travel anxiety. This study adds to the growing body of research on travel anxiety by shedding light on people's individual experiences and providing tourism marketers with practical implications. The long-term effects of marketing interventions on reducing travel anxiety and increasing destination satisfaction should be the subject of additional research.

Food-Dependent Exercise-Induced Anaphylaxis: A Distinct Form of Food Allergy-An Updated Review of Diagnostic Approaches and Treatments.

Food-dependent exercise-induced allergic reactions (FDEIA) represent a distinct clinical phenomenon where symptoms arise during exercise following the consumption of specific trigger foods, with the most severe manifestation being anaphylaxis-a condition distinct from typical exercise-induced or food-induced anaphylaxis. In FDEIA, patients can either exercise or tolerate specific foods separately without experiencing any allergic reactions. Diagnosis relies on patient history and provocation testing, requiring rigorous implementation within a supervised hospital environment. Positive symptoms and clinical signs during testing confirm FDEIA, while negative outcomes do not preclude its presence. Exercise stands as the primary trigger, followed by nonsteroidal anti-inflammatory drugs (NSAIDs) and alcohol. The utilization of various protocols for food cofactor challenges to confirm FDEIA yields differing diagnostic outcomes. We highlight the updated concept of food cofactor challenges, incorporating protocols reported in the literature, and summarize current recommendations and comprehensive management approaches for FDEIA patients.

Distinct Food Triggers for Migraine, Medication Overuse Headache and Irritable Bowel Syndrome.

Irritable bowel syndrome (IBS) is an under-diagnosed common health problem that impairs quality of life. Migraine and IBS are comorbid disorders that are triggered by foods. We aim to investigate IBS frequency in medication overuse headache (MOH) patients and identify food triggers and food avoidance behavior. Participants who completed the cross-sectional, observational and online survey were included (n = 1118). Demographic data, comorbid disorders, medications used, presence of headache, the diagnostic features of headache and IBS, migraine related subjective cognitive symptoms scale (MigSCog), consumption behavior of patients regarding 125 food/food additives and food triggers were asked about in the questionnaire. Migraine and MOH diagnoses were made in 88% and 30.7% of the participants, respectively. Non-steroidal anti-inflammatory drugs (NSAIDs) were the main overused drug (89%) in MOH patients. IBS symptoms were present in 35.8% of non-headache sufferers, 52% of migraine patients and 65% of MOH patients. Specific food triggers for MOH patients were dopaminergic and frequently consumed as healthy foods such as banana, apple, cherry, apricot, watermelon, olive, ice cream and yogurt. MigSCog scores were significantly higher in episodic migraine and MOH patients when IBS symptoms coexisted. The frequency of IBS was higher in MOH patients compared to migraine patients. Coexistence of IBS seems to be a confounding factor for cognitive functions. MOH specific triggers were mostly dopaminergic foods, whereas migraine specific food triggers were mostly histaminergic and processed foods. Personalized diets focusing on food triggers and interference with leaky gut must be integrated to MOH and migraine treatment to achieve sustainable management of these disorders.

Political icon and role model: Dimensions of the perceived ‘Greta effect’ among climate activists as aspects of contemporary social movement leadership

The 2019 Fridays For Future global climate strikes were extraordinary protest mobilisations in many respects, both in terms of size, age composition and the absence of a specific external triggering event. To properly understand it, one must account for Greta Thunberg's leadership role in the mobilisation – the ‘Greta effect’. We contribute to such an account by linking the ‘Greta effect’ on individual mobilisation to theories of political iconicity and political role models. Empirically, we use unique data from two waves of international surveys of participants in European Fridays For Future protests – on 15 March and 20–27 September 2019 – demonstrating that the perceived individual impact of Greta differs considerably among those who were mobilised in climate strikes. Through multilevel regression analysis, we furthermore show that (a) young women were especially prone to have been inspired and mobilised by Thunberg as a role model and (b) subjectively assessed mobilising influence by ‘Greta’ – in her capacity as a political icon – is positively related to protest participants’ instrumental motivation, sense of solidarity and collective identity. We argue that our results contribute to a better understanding of informal social movement leadership in contemporary political mobilisations.

SGBA: A stealthy scapegoat backdoor attack against deep neural networks

Outsourced deep neural networks have been demonstrated to suffer from patch-based trojan attacks, in which an adversary poisons the training sets to inject a backdoor in the obtained model so that regular inputs can be still labeled correctly while those carrying a specific trigger are falsely given a target label. Due to the severity of such attacks, many backdoor detection and containment systems have recently, been proposed for deep neural networks. One major category among them are various model inspection schemes, which hope to detect backdoors before deploying models from non-trusted third-parties. In this paper, we show that such state-of-the-art schemes can be defeated by a so-called Scapegoat Backdoor Attack, which introduces a benign scapegoat trigger in data poisoning to prevent the defender from reversing the real abnormal trigger. In addition, it confines the values of network parameters within the same variances of those from clean model during training, which further significantly enhances the difficulty of the defender to learn the differences between legal and illegal models through machine-learning approaches. Our experiments on 3 popular datasets show that it can escape detection by all five state-of-the-art model inspection schemes. Moreover, this attack brings almost no side-effects on the attack effectiveness and guarantees the universal feature of the trigger compared with original patch-based trojan attacks.

THE POWER OF SPOKEN LANGUAGE: UNDERSTANDING COMMUNICATION APPREHENSION AND ENGLISH LANGUAGE ANXIETY AMONG KIAS DEGREE STUDENTS

Communication apprehension is characterized by the anxiety or fear individuals experience during interpersonal communication. In the context of foreign language learning, this apprehension can significantly impact learners' ability to effectively acquire, use, and master the language. Despite its importance, there remains a scarcity of studies exploring communication apprehension as a key contributor to anxiety, especially in language learning. This study focuses on examining communication apprehension as one of the four components known to trigger anxiety in foreign language learning. Specifically, the research targets KIAS degree students. The findings of this study contribute to the existing literature by delving into foreign language anxiety from the perspective of KIAS degree students. The research identifies anxiety-inducing situations and offers recommendations for educational interventions to address communication apprehension. Notably, the study reveals that these students feel uncomfortable or anxious in various situations, particularly when required to speak in English during impromptu tasks. By identifying specific triggers of anxiety, the research highlights the factors that hinder language learning progress among these students. This valuable knowledge can guide educators in developing appropriate instructional approaches and creating a supportive classroom environment. It is crucial for educators to pay special attention to learners struggling with communication anxiety, fostering a friendly and secure learning space where these students can confidently practice their language skills. This supportive environment plays a significant role in building their confidence and self-esteem, effectively alleviating unnecessary anxieties. Thus, this study sheds light on the significance of communication apprehension as a crucial factor influencing anxiety in foreign language learning among KIAS degree students. The findings underscore the importance of addressing this issue and designing tailored interventions to accommodate the unique challenges faced by these learners. Ultimately, by providing a supportive and inclusive learning environment, educators can empower the students to excel in their foreign language acquisition journey and enhance the overall language learning experience.

Bacterial respiratory inhibition triggers dispersal of Pseudomonas aeruginosa biofilms.

Pseudomonas aeruginosa grows as a biofilm under many environmental conditions, and the bacterium can disperse from biofilms via highly regulated, dynamic processes. However, physiologic triggers of biofilm dispersal remain poorly understood. Based on prior literature describing dispersal triggered by forms of starvation, we tested bacterial respiratory inhibitors for biofilm dispersal in two models resembling chronic airway infections. Our underlying hypothesis was that respiratory inhibitors could serve as a model for the downstream effects of starvation. We used two experimental conditions. In the first condition, biofilms were grown and dispersed from the surface of airway epithelial cells, and the second condition was a model where biofilms were grown on glass in cell culture media supplemented with host-relevant iron sources. In both biofilm models, the respiratory inhibitors potassium cyanide and sodium azide each triggered biofilm dispersal. We hypothesized that cyanide-induced dispersal was due to respiratory inhibition rather than signaling via an alternative mechanism, and, indeed, if respiration was supported by overexpression of cyanide-insensitive oxidase, dispersal was prevented. Dispersal required the activity of the cyclic-di-GMP regulated protease LapG, reinforcing the role of matrix degradation in dispersal. Finally, we examined the roles of individual phosphodiesterases, previously implicated in dispersal to specific triggers, and found signaling to be highly redundant. Combined deletion of the phosphodiesterases dipA, bifA, and rbdA was required to attenuate the dispersal phenotype. In summary, this work adds insight into the physiology of biofilm dispersal under environmental conditions in which bacterial respiration is abruptly limited. IMPORTANCE The bacterium Pseudomonas aeruginosa grows in biofilm communities that are very difficult to treat in human infections. Growing as a biofilm can protect bacteria from antibiotics and the immune system. Bacteria can leave a biofilm through a process called "dispersal." Dispersed bacteria seed new growth areas and are more susceptible to killing by antibiotics. The triggers for biofilm dispersal are not well understood, and if we understood dispersal better it might lead to the development of new treatments for infection. In this paper, we find that inhibiting P. aeurginosa's ability to respire (generate energy) can trigger dispersal from a biofilm grown in association with human respiratory epithelial cells in culture. The dispersal process requires a protease which is previously known to degrade the biofilm matrix. These findings give us a better understanding of how the biofilm dispersal process works so that future research can discover better ways of clearing bacteria growing in biofilms.

Validation of a Reduced Set of High-Performance Triggers for Identifying Patient Safety Incidents with Harm in Primary Care: TriggerPrim Project.

The aim of the study was to construct and validate a reduced set of high-performance triggers for identifying adverse events (AEs) via electronic medical records (EMRs) review in primary care (PC). This was a cross-sectional descriptive study for validating a diagnostic test. The study included all 262 PC centers of Madrid region (Spain). Patients were older than 18 years who attended their PC center over the last quarter of 2018. The randomized sample was n = 1797. Main measurements were as follows: ( a ) presence of each of 19 specific computer-identified triggers in the EMR and ( b ) occurrence of an AE. To collect data, EMR review was conducted by 3 doctor-nurse teams. Triggers with statistically significant odds ratios for identifying AEs were selected for the final set after adjusting for age and sex using logistic regression. The sensitivity (SS) and specificity (SP) for the selected triggers were: ≥3 appointments in a week at the PC center (SS = 32.3% [95% confidence interval {CI}, 22.8%-41.8%]; SP = 92.8% [95% CI, 91.6%-94.0%]); hospital admission (SS = 19.4% [95% CI, 11.4%-27.4%]; SP = 97.2% [95% CI, 96.4%-98.0%]); hospital emergency department visit (SS = 31.2% [95% CI, 21.8%-40.6%]; SP = 90.8% [95% CI, 89.4%-92.2%]); major opioids prescription (SS = 2.2% [95% CI, 0.0%-5.2%]; SP = 99.8% [95% CI, 99.6%-100%]); and chronic benzodiazepine treatment in patients 75 years or older (SS = 14.0% [95% CI, 6.9%-21.1%]; SP = 95.5% [95% CI, 94.5%-96.5%]).The following values were obtained in the validation of this trigger set (the occurrence of at least one of these triggers in the EMR): SS = 60.2% (95% CI, 50.2%-70.1%), SP = 80.8% (95% CI, 78.8%-82.6%), positive predictive value = 14.6% (95% CI, 11.0%-18.1%), negative predictive value = 97.4% (95% CI, 96.5%-98.2%), positive likelihood ratio = 3.13 (95% CI, 2.3-4.2), and negative likelihood ratio = 0.49 (95% CI, 0.3-0.7). The set containing the 5 selected triggers almost triples the efficiency of EMR review in detecting AEs. This suggests that this set is easily implementable and of great utility in risk-management practice.

Nature and nurture: understanding phenotypic variation in inborn errors of immunity.

The overall disease burden of pediatric infection is high, with widely varying clinical outcomes including death. Among the most vulnerable children, those with inborn errors of immunity, reduced penetrance and variable expressivity are common but poorly understood. There are several genetic mechanisms that influence phenotypic variation in inborn errors of immunity, as well as a body of knowledge on environmental influences and specific pathogen triggers. Critically, recent advances are illuminating novel nuances for fundamental concepts on disease penetrance, as well as raising new areas of inquiry. The last few decades have seen the identification of almost 500 causes of inborn errors of immunity, as well as major advancements in our ability to characterize somatic events, the microbiome, and genotypes across large populations. The progress has not been linear, and yet, these developments have accumulated into an enhanced ability to diagnose and treat inborn errors of immunity, in some cases with precision therapy. Nonetheless, many questions remain regarding the genetic and environmental contributions to phenotypic variation both within and among families. The purpose of this review is to provide an updated summary of key concepts in genetic and environmental contributions to phenotypic variation within inborn errors of immunity, conceptualized as including dynamic, reciprocal interplay among factors unfolding across the key dimension of time. The associated findings, potential gaps, and implications for research are discussed in turn for each major influencing factor. The substantial challenge ahead will be to organize and integrate information in such a way that accommodates the heterogeneity within inborn errors of immunity to arrive at a more comprehensive and accurate understanding of how the immune system operates in health and disease. And, crucially, to translate this understanding into improved patient care for the millions at risk for serious infection and other immune-related morbidity.

Intrinsic and extrinsic regulation of rhabdomyolysis susceptibility by Tango2.

Rhabdomyolysis is a clinical emergency characterized by severe muscle damage, resulting in the release of intracellular muscle components, which leads to myoglobinuria and, in severe cases, acute kidney failure. Rhabdomyolysis is caused by genetic factors linked to increased disease susceptibility in response to extrinsic triggers. Recessive mutations in TANGO2 result in episodic rhabdomyolysis, metabolic crises, encephalopathy and cardiac arrhythmia. The underlying mechanism contributing to disease onset in response to specific triggers remains unclear. To address these challenges, we created a zebrafish model of Tango2 deficiency. Here, we demonstrate that the loss of Tango2 in zebrafish results in growth defects, early lethality and increased susceptibility of skeletal muscle defects in response to extrinsic triggers, similar to TANGO2-deficient patients. Using lipidomics, we identified alterations in the glycerolipid pathway in tango2 mutants, which is critical for membrane stability and energy balance. Therefore, these studies provide insight into key disease processes in Tango2 deficiency and have increased our understanding of the impacts of specific defects on predisposition to environmental triggers in TANGO2-related disorders.

Factors associated with internalizing and externalizing symptoms in a clinical sample of youth with misophonia

Misophonia is an often chronic condition characterized by strong, unpleasant emotional reactions when exposed to specific auditory or visual triggers. While not currently defined within existing classification systems, and not clearly fitting within the framework of extant psychiatric conditions, misophonia has historically been studied most frequently within the context of obsessive-compulsive and related disorders. Internalizing and externalizing psychiatric symptoms are common in misophonia, but specific factors that confer risk for these symptoms remain unknown. The present cross-sectional study examined whether sensory sensitivity and cognitive emotion regulation facets are associated with co-occurring internalizing and externalizing symptoms in 102 youth with misophonia aged 8–17 years (Nfemales = 69). Participants completed self-report assessments of misophonia severity, sensory sensitivity, cognitive emotion regulation, and emotional-behavioral functioning. In the final model, controlling for all variables, multiple linear regression analyses revealed that sensory sensitivity and age were significant predictors of internalizing symptoms, while sensory sensitivity and the other-blame cognitive emotion regulation facet were significant predictors of externalizing symptoms. Further, findings demonstrated that the positive reappraisal cognitive emotion regulation facet moderated the effect of misophonia severity on internalizing symptoms. Results highlight a strong, consistent relation between sensory sensitivities (beyond sound sensitivity) and psychiatric symptoms in misophonic youth. Further research is necessary to determine mechanisms and clinical variables impacting internalizing and externalizing symptoms within youth with misophonia.

Epithelial-Mesenchymal Transition Mechanisms in Chronic Airway Diseases: A Common Process to Target?

Epithelial-to-mesenchymal transition (EMT) is a reversible process, in which epithelial cells lose their epithelial traits and acquire a mesenchymal phenotype. This transformation has been described in different lung diseases, such as lung cancer, interstitial lung diseases, asthma, chronic obstructive pulmonary disease and other muco-obstructive lung diseases, such as cystic fibrosis and non-cystic fibrosis bronchiectasis. The exaggerated chronic inflammation typical of these pulmonary diseases can induce molecular reprogramming with subsequent self-sustaining aberrant and excessive profibrotic tissue repair. Over time this process leads to structural changes with progressive organ dysfunction and lung function impairment. Although having common signalling pathways, specific triggers and regulation mechanisms might be present in each disease. This review aims to describe the various mechanisms associated with fibrotic changes and airway remodelling involved in chronic airway diseases. Having better knowledge of the mechanisms underlying the EMT process may help us to identify specific targets and thus lead to the development of novel therapeutic strategies to prevent or limit the onset of irreversible structural changes.

Chronic Urticaria and Angioedema: Masqueraders and Misdiagnoses.

Chronic urticaria is a common condition presenting with intensely pruritic wheals. Although individual lesions resolve within 24 hours, by definition, chronic urticaria lasts for a duration of at least 6 weeks. Both spontaneous and inducible forms exist. In the spontaneous variant, chronic urticaria occurs in the absence of clearly identifiable triggers. In chronic inducible urticaria, specific triggers may include dermatographism, cholinergic (heat), cold, exercise, delayed pressure, and solar. Extensive laboratory evaluation for chronic spontaneous urticaria is not required unless indicated by clinical history or physical examination. Angioedema describes sudden onset of localized edema involving the deep layers of the skin and submucosal tissues. It can be seen in isolation or in conjunction with chronic urticaria. Angioedema typically resolves slower than wheals, taking up to 72 hours or longer. Histamine- and bradykinin-mediated forms exist. Both chronic urticaria and angioedema have many mimics, and a broad range of differential diagnoses should be considered. Importantly, an incorrect diagnosis may have significant implications for the additional investigation, treatment, and prognosis of the affected patient. The aim of this article is to discuss the characteristics of chronic urticaria and angioedema, and an approach to the investigation and diagnosis of their mimics.

Severe Anaphylactic Reactions to Home Doses of Oral Immunotherapy for Food Allergy.

Severe anaphylactic reactions to home doses may occur during food allergy oral immunotherapy (OIT). To study the rate and risk factors for such reactions. We studied all patients aged greater than 3.5 years who completed OIT in a single center between April 2010 and January 2020. All home epinephrine-treated reactions (HETRs) were identified. High-grade HETRs (HG-HETRs) were defined as HETRs involving respiratory (SpO2 of 94% or less), cardiovascular (low blood pressure), or central nervous system impairment (loss of consciousness). We investigated the rate and risk factors for HG-HETRs. A total of 1,637 OIT treatments were studied: milk (880), peanut (346), tree nuts (221), sesame (115), and egg (75). Of 390 identified HETRs, 30 HG-HETRs occurred during 27 treatments (1.65% of all treatments). Nearly all (26 of 30) were during milk OIT in patients with house dust mite (HDM) sensitization and asthma (26 of 30 each). Of the 30 patients with HG-HETRs, 21 recovered with one or two epinephrine treatments, but nine (0.55% of all treatments) did not respond to a second dose of epinephrine and were deemed to have refractory anaphylaxis. Three patients required intensive care unit admission and three received epinephrine drip, but none required ventilatory support. Risk factors for HG-HETRs included milk OIT (P= .031), asthma (P= .02) and HDM sensitization (P= .02). No specific triggers for HG-HETR were identified. Of patients with HG-HETRs, 25.9% were fully desensitized, including the four non-milk treated patients; 22.2% were partially desensitized; and 51.9% failed. High-grade HETRs are uncommon, particularly refractory anaphylactic reactions to home OIT doses. Although milk OIT, asthma, and HDM sensitization are the main risk factors for such reactions, identification of patients who are at risk is challenging.

Inhibitory control towards angry stimuli in patients with binge eating disorder: a pilot study

BackgroundEmotion regulation theories and the negative urgency concept assume that negative mood increases binge eating. Negative emotions are considered as a trigger for binge eating, while binge eating itself is regarded as an impulsive behavior and should thus be increased within the negative urgency concept. Anger might be a specific negative emotion triggering binge eating in patients with binge eating disorder (BED). We investigated how inhibitory control as one main factor of impulsivity is influenced by anger stimuli in patients with BED and two control groups.MethodsWe compared patients with BED (N = 20) with normal-weight healthy control participants (NW-CG, N = 20) and BMI-matched overweight and obese control participants (BMI-CG, N = 18). We used the emotional Stop Signal task (eSST) to investigate inhibitory control, where we presented angry facial expressions in comparison with neutral facial expressions as emotional stimuli.ResultsAll participants showed decreased inhibitory control in the angry versus neutral condition, i.e., a faster Stop Signal Reaction Time and a lower percentage of correct reactions. However, no significant group differences emerged in terms of performance. Performance in the eSST did not correlate with negative urgency, disorder- or emotion-related characteristics.ConclusionsThe current pilot study does not deliver evidence for decreased inhibitory control towards angry stimuli in patients with BED, as we detected a general and not disorder-related effect in all participants that might represent the conjunction of inhibitory control and anger. A direct mood induction technique might have led to different results. Further research in healthy and clinical groups is needed.

Chemical and Photophysical Triggers for the Reduction of Pt(IV) Prodrugs for Anticancer Therapy

AbstractPlatinum(II) complexes are used in approximately 50% of chemotherapeutic treatments worldwide. Despite their undoubtful clinical success, these compounds are associated with severe side effects and poor tumor selectivity. To overcome these drawbacks, the development of platinum(IV) molecular prodrugs and nanoparticle formulations that remain stable and therapeutically inactive in a biological environment, but could be quickly reduced into the therapeutically active analogs through a specific trigger have been thought. Within this article, the mechanisms for chemical and photophysical triggers for the activation of platinum(IV) prodrugs have been critically reviewed.