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Michael Weekes

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Nick K. Jones1,2*, Lucy Rivett1,2*, Chris Workman3, Mark Ferris3, Ashley Shaw1, Cambridge COVID-19 Collaboration1,4, Paul J. Lehner1,4, Rob Howes5, Giles Wright3, Nicholas J. Matheson1,4,6¶, Michael P. Weekes1,7¶1 Cambridge University NHS Hospitals Foundation Trust, Cambridge, UK2 Clinical Microbiology & Public Health Laboratory, Public Health England, Cambridge, UK3 Occupational Health and Wellbeing, Cambridge Biomedical Campus, Cambridge, UK4 Cambridge Institute of Therapeutic Immunology & Infectious Disease, University of Cambridge, Cambridge, UK5 Cambridge COVID-19 Testing Centre and AstraZeneca, Anne Mclaren Building, Cambridge, UK6 NHS Blood and Transplant, Cambridge, UK7 Cambridge Institute for Medical Research, University of Cambridge, Cambridge, UK*Joint first authorship¶Joint last authorshipCorrespondence: UK has initiated mass COVID-19 immunisation, with healthcare workers (HCWs) given early priority because of the potential for workplace exposure and risk of onward transmission to patients. The UK’s Joint Committee on Vaccination and Immunisation has recommended maximising the number of people vaccinated with first doses at the expense of early booster vaccinations, based on single dose efficacy against symptomatic COVID-19 disease.1-3At the time of writing, three COVID-19 vaccines have been granted emergency use authorisation in the UK, including the BNT162b2 mRNA COVID-19 vaccine (Pfizer-BioNTech). A vital outstanding question is whether this vaccine prevents or promotes asymptomatic SARS-CoV-2 infection, rather than symptomatic COVID-19 disease, because sub-clinical infection following vaccination could continue to drive transmission. This is especially important because many UK HCWs have received this vaccine, and nosocomial COVID-19 infection has been a persistent problem.Through the implementation of a 24 h-turnaround PCR-based comprehensive HCW screening programme at Cambridge University Hospitals NHS Foundation Trust (CUHNFT), we previously demonstrated the frequent presence of pauci- and asymptomatic infection amongst HCWs during the UK’s first wave of the COVID-19 pandemic.4 Here, we evaluate the effect of first-dose BNT162b2 vaccination on test positivity rates and cycle threshold (Ct) values in the asymptomatic arm of our programme, which now offers weekly screening to all staff.Vaccination of HCWs at CUHNFT began on 8th December 2020, with mass vaccination from 8th January 2021. Here, we analyse data from the two weeks spanning 18thto 31st January 2021, during which: (a) the prevalence of COVID-19 amongst HCWs remained approximately constant; and (b) we screened comparable numbers of vaccinated and unvaccinated HCWs. Over this period, 4,408 (week 1) and 4,411 (week 2) PCR tests were performed from individuals reporting well to work. We stratified HCWs <12 days or > 12 days post-vaccination because this was the point at which protection against symptomatic infection began to appear in phase III clinical trial.226/3,252 (0·80%) tests from unvaccinated HCWs were positive (Ct<36), compared to 13/3,535 (0·37%) from HCWs <12 days post-vaccination and 4/1,989 (0·20%) tests from HCWs ≥12 days post-vaccination (p=0·023 and p=0·004, respectively; Fisher’s exact test, Figure). This suggests a four-fold decrease in the risk of asymptomatic SARS-CoV-2 infection amongst HCWs ≥12 days post-vaccination, compared to unvaccinated HCWs, with an intermediate effect amongst HCWs <12 days post-vaccination.A marked reduction in infections was also seen when analyses were repeated with: (a) inclusion of HCWs testing positive through both the symptomatic and asymptomatic arms of the programme (56/3,282 (1·71%) unvaccinated vs 8/1,997 (0·40%) ≥12 days post-vaccination, 4·3-fold reduction, p=0·00001); (b) inclusion of PCR tests which were positive at the limit of detection (Ct>36, 42/3,268 (1·29%) vs 15/2,000 (0·75%), 1·7-fold reduction, p=0·075); and (c) extension of the period of analysis to include six weeks from December 28th to February 7th 2021 (113/14,083 (0·80%) vs 5/4,872 (0·10%), 7·8-fold reduction, p=1x10-9). In addition, the median Ct value of positive tests showed a non-significant trend towards increase between unvaccinated HCWs and HCWs > 12 days post-vaccination (23·3 to 30·3, Figure), suggesting that samples from vaccinated individuals had lower viral loads.We therefore provide real-world evidence for a high level of protection against asymptomatic SARS-CoV-2 infection after a single dose of BNT162b2 vaccine, at a time of predominant transmission of the UK COVID-19 variant of concern 202012/01 (lineage B.1.1.7), and amongst a population with a relatively low frequency of prior infection (7.2% antibody positive).5This work was funded by a Wellcome Senior Clinical Research Fellowship to MPW (108070/Z/15/Z), a Wellcome Principal Research Fellowship to PJL (210688/Z/18/Z), and an MRC Clinician Scientist Fellowship (MR/P008801/1) and NHSBT workpackage (WPA15-02) to NJM. Funding was also received from Addenbrooke’s Charitable Trust and the Cambridge Biomedical Research Centre. We also acknowledge contributions from all staff at CUHNFT Occupational Health and Wellbeing and the Cambridge COVID-19 Testing Centre.

Guangming Wang

and 4 more

Tam Hunt

and 1 more

Tam Hunt [1], Jonathan SchoolerUniversity of California Santa Barbara Synchronization, harmonization, vibrations, or simply resonance in its most general sense seems to have an integral relationship with consciousness itself. One of the possible “neural correlates of consciousness” in mammalian brains is a combination of gamma, beta and theta synchrony. More broadly, we see similar kinds of resonance patterns in living and non-living structures of many types. What clues can resonance provide about the nature of consciousness more generally? This paper provides an overview of resonating structures in the fields of neuroscience, biology and physics and attempts to coalesce these data into a solution to what we see as the “easy part” of the Hard Problem, which is generally known as the “combination problem” or the “binding problem.” The combination problem asks: how do micro-conscious entities combine into a higher-level macro-consciousness? The proposed solution in the context of mammalian consciousness suggests that a shared resonance is what allows different parts of the brain to achieve a phase transition in the speed and bandwidth of information flows between the constituent parts. This phase transition allows for richer varieties of consciousness to arise, with the character and content of that consciousness in each moment determined by the particular set of constituent neurons. We also offer more general insights into the ontology of consciousness and suggest that consciousness manifests as a relatively smooth continuum of increasing richness in all physical processes, distinguishing our view from emergentist materialism. We refer to this approach as a (general) resonance theory of consciousness and offer some responses to Chalmers’ questions about the different kinds of “combination problem.”  At the heart of the universe is a steady, insistent beat: the sound of cycles in sync…. [T]hese feats of synchrony occur spontaneously, almost as if nature has an eerie yearning for order. Steven Strogatz, Sync: How Order Emerges From Chaos in the Universe, Nature and Daily Life (2003) If you want to find the secrets of the universe, think in terms of energy, frequency and vibration.Nikola Tesla (1942) I.               Introduction Is there an “easy part” and a “hard part” to the Hard Problem of consciousness? In this paper, we suggest that there is. The harder part is arriving at a philosophical position with respect to the relationship of matter and mind. This paper is about the “easy part” of the Hard Problem but we address the “hard part” briefly in this introduction.  We have both arrived, after much deliberation, at the position of panpsychism or panexperientialism (all matter has at least some associated mind/experience and vice versa). This is the view that all things and processes have both mental and physical aspects. Matter and mind are two sides of the same coin.  Panpsychism is one of many possible approaches that addresses the “hard part” of the Hard Problem. We adopt this position for all the reasons various authors have listed (Chalmers 1996, Griffin 1997, Hunt 2011, Goff 2017). This first step is particularly powerful if we adopt the Whiteheadian version of panpsychism (Whitehead 1929).  Reaching a position on this fundamental question of how mind relates to matter must be based on a “weight of plausibility” approach, rather than on definitive evidence, because establishing definitive evidence with respect to the presence of mind/experience is difficult. We must generally rely on examining various “behavioral correlates of consciousness” in judging whether entities other than ourselves are conscious – even with respect to other humans—since the only consciousness we can know with certainty is our own. Positing that matter and mind are two sides of the same coin explains the problem of consciousness insofar as it avoids the problems of emergence because under this approach consciousness doesn’t emerge. Consciousness is, rather, always present, at some level, even in the simplest of processes, but it “complexifies” as matter complexifies, and vice versa. Consciousness starts very simple and becomes more complex and rich under the right conditions, which in our proposed framework rely on resonance mechanisms. Matter and mind are two sides of the coin. Neither is primary; they are coequal.  We acknowledge the challenges of adopting this perspective, but encourage readers to consider the many compelling reasons to consider it that are reviewed elsewhere (Chalmers 1996, Griffin 1998, Hunt 2011, Goff 2017, Schooler, Schooler, & Hunt, 2011; Schooler, 2015).  Taking a position on the overarching ontology is the first step in addressing the Hard Problem. But this leads to the related questions: at what level of organization does consciousness reside in any particular process? Is a rock conscious? A chair? An ant? A bacterium? Or are only the smaller constituents, such as atoms or molecules, of these entities conscious? And if there is some degree of consciousness even in atoms and molecules, as panpsychism suggests (albeit of a very rudimentary nature, an important point to remember), how do these micro-conscious entities combine into the higher-level and obvious consciousness we witness in entities like humans and other mammals?  This set of questions is known as the “combination problem,” another now-classic problem in the philosophy of mind, and is what we describe here as the “easy part” of the Hard Problem. Our characterization of this part of the problem as “easy”[2] is, of course, more than a little tongue in cheek. The authors have discussed frequently with each other what part of the Hard Problem should be labeled the easier part and which the harder part. Regardless of the labels we choose, however, this paper focuses on our suggested solution to the combination problem.  Various solutions to the combination problem have been proposed but none have gained widespread acceptance. This paper further elaborates a proposed solution to the combination problem that we first described in Hunt 2011 and Schooler, Hunt, and Schooler 2011. The proposed solution rests on the idea of resonance, a shared vibratory frequency, which can also be called synchrony or field coherence. We will generally use resonance and “sync,” short for synchrony, interchangeably in this paper. We describe the approach as a general resonance theory of consciousness or just “general resonance theory” (GRT). GRT is a field theory of consciousness wherein the various specific fields associated with matter and energy are the seat of conscious awareness.  A summary of our approach appears in Appendix 1.  All things in our universe are constantly in motion, in process. Even objects that appear to be stationary are in fact vibrating, oscillating, resonating, at specific frequencies. So all things are actually processes. Resonance is a specific type of motion, characterized by synchronized oscillation between two states.  An interesting phenomenon occurs when different vibrating processes come into proximity: they will often start vibrating together at the same frequency. They “sync up,” sometimes in ways that can seem mysterious, and allow for richer and faster information and energy flows (Figure 1 offers a schematic). Examining this phenomenon leads to potentially deep insights about the nature of consciousness in both the human/mammalian context but also at a deeper ontological level.

Susanne Schilling*^

and 9 more

Jessica mead

and 6 more

The construct of wellbeing has been criticised as a neoliberal construction of western individualism that ignores wider systemic issues including increasing burden of chronic disease, widening inequality, concerns over environmental degradation and anthropogenic climate change. While these criticisms overlook recent developments, there remains a need for biopsychosocial models that extend theoretical grounding beyond individual wellbeing, incorporating overlapping contextual issues relating to community and environment. Our first GENIAL model \cite{Kemp_2017} provided a more expansive view of pathways to longevity in the context of individual health and wellbeing, emphasising bidirectional links to positive social ties and the impact of sociocultural factors. In this paper, we build on these ideas and propose GENIAL 2.0, focusing on intersecting individual-community-environmental contributions to health and wellbeing, and laying an evidence-based, theoretical framework on which future research and innovative therapeutic innovations could be based. We suggest that our transdisciplinary model of wellbeing - focusing on individual, community and environmental contributions to personal wellbeing - will help to move the research field forward. In reconceptualising wellbeing, GENIAL 2.0 bridges the gap between psychological science and population health health systems, and presents opportunities for enhancing the health and wellbeing of people living with chronic conditions. Implications for future generations including the very survival of our species are discussed.  

Mark Ferris

and 14 more

IntroductionConsistent with World Health Organization (WHO) advice [1], UK Infection Protection Control guidance recommends that healthcare workers (HCWs) caring for patients with coronavirus disease 2019 (COVID-19) should use fluid resistant surgical masks type IIR (FRSMs) as respiratory protective equipment (RPE), unless aerosol generating procedures (AGPs) are being undertaken or are likely, when a filtering face piece 3 (FFP3) respirator should be used [2]. In a recent update, an FFP3 respirator is recommended if “an unacceptable risk of transmission remains following rigorous application of the hierarchy of control” [3]. Conversely, guidance from the Centers for Disease Control and Prevention (CDC) recommends that HCWs caring for patients with COVID-19 should use an N95 or higher level respirator [4]. WHO guidance suggests that a respirator, such as FFP3, may be used for HCWs in the absence of AGPs if availability or cost is not an issue [1].A recent systematic review undertaken for PHE concluded that: “patients with SARS-CoV-2 infection who are breathing, talking or coughing generate both respiratory droplets and aerosols, but FRSM (and where required, eye protection) are considered to provide adequate staff protection” [5]. Nevertheless, FFP3 respirators are more effective in preventing aerosol transmission than FRSMs, and observational data suggests that they may improve protection for HCWs [6]. It has therefore been suggested that respirators should be considered as a means of affording the best available protection [7], and some organisations have decided to provide FFP3 (or equivalent) respirators to HCWs caring for COVID-19 patients, despite a lack of mandate from local or national guidelines [8].Data from the HCW testing programme at Cambridge University Hospitals NHS Foundation Trust (CUHNFT) during the first wave of the UK severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic indicated a higher incidence of infection amongst HCWs caring for patients with COVID-19, compared with those who did not [9]. Subsequent studies have confirmed this observation [10, 11]. This disparity persisted at CUHNFT in December 2020, despite control measures consistent with PHE guidance and audits indicating good compliance. The CUHNFT infection control committee therefore implemented a change of RPE for staff on “red” (COVID-19) wards from FRSMs to FFP3 respirators. In this study, we analyse the incidence of SARS-CoV-2 infection in HCWs before and after this transition.

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Most recent documents

Kurt Bjorkman R

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Objective: Diagnosis of Aortic arch (AoA) anatomy is critical for planning cardiac surgery/intervention and in diagnosing associated congenital heart defects. AoA sidedness is traditionally diagnosed with echocardiography as being contralateral to the direction of the first brachiocephalic artery in suprasternal view, but this method can be challenged by numerous anatomic variants and clinical conditions. The objective of this study was to assess feasibility of trachea visualization with echocardiography in pediatric patients, and using this landmark to identify AoA sidedness and potential for double aortic arch (DAA). Methods: A prospective study was performed on patients <18 years old who were undergoing Chest CT/MRI to serve as gold standard for confirming AoA anatomy. A right-to-left echocardiographic sagittal sweep was performed from the suprasternal notch and used to categorize 1) Left AoA = right SVC-trachea-AoA, 2) Right AoA= SVC-AoA-trachea, 3) DAA = SVC-AoA-trachea-AoA. The proportion of successful sweeps and diagnostic accuracy were calculated. Results: 100 consecutive patients were scanned (44% female; median age of 8.8 yr, range 2d–17.9 yr; median BSA 1.14 m 2, range 0.2–2.7; right AOA in 4%). Diagnosis of AoA sidedness was possible in 97% (95% CI: 94–100%, p < 0.01) and correct in 100% when the trachea was seen. Conclusion: Tracheal imaging with echo is reliable, easy, and reproducible method in patients of various sizes and levels of acuity to define AoA sidedness.
Does changing mindsets change the brain? Indeed, it does! This study explains how. Via a comprehensive review of the research literature, the study explores the complex link between mindset and neuroscience, focusing on how it affects cognitive functioning and personal growth. The study provides an overview of mindset, including fixed and growth mindsets, and delves into neuroscience, examining its fundamental ideas, cerebral regions, neuroplasticity, and connection to mindset. The study examines the influence of mindset on cognitive functions like memory, attention, and decision-making, as well as the neural mechanisms underpinning mindset and brain activity. It also analyzes the interrelationship between mindset and emotional regulation, examining the neural foundations of emotional regulation and its impact on mindset, resilience, and stress response. The study discusses mindset interventions in relation to neuroplasticity, presenting techniques for developing a growth mindset in light of neuroscientific data proving their efficacy. It also discusses the long-term impacts of mindset interventions on the structure and functionality of the brain. The implications of mindset and neuroscience are discussed within different settings, including learning, academic achievement, motivation, success, and career advancement. The report concludes by outlining prospective directions for future research and application, emphasizing the need to understand the influence of mindset and neuroscience on social development and individual growth. The results are influential upon professional development plans, instructional methods, and intervention procedures, eventually enabling people to adopt growth mindsets and fully reach their cognitive potential.

Jaehee Lee

and 1 more

We fabricate a synaptic device employing a TiO2 channel highly responsive to optical stimuli and incorporating a dual-gate dielectric, one of which facilitates charge trapping at the interface. Unlike conventional synaptic transistors responding to only a single type of stimulus such as optical or electrical stimulation, our device stands out by simulating synaptic behavior by integrating both optical and electrical stimuli. These distinctive attributes enable us to elicit excitatory postsynaptic current via optical and inhibitory postsynaptic currents through electrical stimulation. Notably, the lifetime of the optical synaptic behaviors was approximately 12 times longer than that of the electrical stimulation. Additionally, employing the paired-pulse facilitation index, distinct time constants are computed corresponding to the rapid and slow phases, mirroring a pattern akin to that observed in a bio-synapse. We establish a nonlinearity factor v = 7.21×10-4 through short-term plasticity to long-term plasticity transition, demonstrating remarkable linearity. We achieve 2048 analog states characterized by exceptional linearity. Finally, we replicate human depression, known as seasonal affective disorder, by employing electrical stimulation to emulate feelings of melancholy. Subsequently, we replicate light therapy for seasonal affective disorder by incorporating light stimulation. This outcome signifies a promising pathway for future investigations into emulating human brain activity.

Catherine Qin

and 6 more

Introduction: National lockdown was implemented to slow down the COVID-19 outbreak. This paper aims to compare the epidemiology of paediatric orthopaedic trauma presentation, management and outcomes during the lockdown period with the matched pre-pandemic period in 2019. Methods: This was a retrospective cohort study. All patients aged 0 - 18 years who required trauma unit management during the school closure period (18 March – 25 May 2020) were included. Cases for the matched period in 2019 were analysed for comparison. Patient demographics, mechanism and anatomic location of injury, management, and follow-up were assessed. Results: 286 and 575 injuries were observed in 2020 and 2019, respectively. In 2020, we observed a 50.3% fall in paediatric trauma presentation. There was a significant reduction in the average age at presentation by more than one year (p < 0.001). Sports-related injuries decreased significantly (n=16 5.6% vs n=127 22.1%; p<0.001). Proportion of ride on injuries increased significantly (n=63 22% vs n=61 10.6%; p<0.0001). Non-accidental injury concerns rose significantly (n=9 3.1% vs n=4 0.7%; p=0.01). There was a proportional increase in upper limb injuries (64.3% vs 58.4%) and proportional reduction in lower limb injuries (32.1% vs 35.5%). Use of conservative management increased. Telephone follow-up rose significantly (23% vs 6%; p < 0.001). Re-presentation rate increased significantly (1.4% vs 0.2%; p = 0.04). Conclusion: There was a reduction in paediatric trauma presentation and the average age at presentation during lockdown. This change was accompanied by a shift in mechanism and anatomic location of injury, management, and follow-up.

Fatih Bal

and 1 more

The use of artificial intelligence (AI) techniques in agriculture has reached a critical point, and classification studies utilizing machine learning (ML) methods for agricultural products are being conducted intensively. However, these studies face challenges in creating balanced datasets, which can significantly impact the performance of proposed methods and lead to confusing results. In this study, we address this challenge by creating a dataset comprising data from 7 species of date palm (Phoenix dactylifera L.) and 2 species of pistachio fruit (Pistacia vera L). Our objective is to evaluate the performance of ML methods on this dataset and explore the effectiveness of the Synthetic Minority Over-Sampling Technique (SMOTE) for improving classification accuracy. Initially, we performed classification on the original dataset using popular ML methods. Among these methods, the POLY-SVM model exhibited the best performance with an accuracy ratio of 92.95%. However, we observed limitations in the classification results due to the unbalanced distribution of data among different classes. To address this issue, we applied the SMOTE technique for over-sampling, which effectively balanced the data distribution. The POLY-SVM model, when trained on the dataset after SMOTE over-sampling, achieved a significantly improved classification accuracy of 98.64%. Furthermore, our proposed model demonstrated enhanced sub-classification performance, particularly for fruit species. In conclusion, this study highlights the challenges posed by unbalanced data distribution in agricultural product classification studies using ML methods. By utilizing the SMOTE technique for data over-sampling, we successfully addressed this challenge and improved classification accuracy.
Aims: Conduct a systematic review of case reports and case series regarding the development of acute abdomen following vaccination with COVID-19, to describe in detail the possible association, the clinical and demographic characteristics. Methods: Case report studies and case series regarding the development of acute abdomen following COVID-19 vaccination were included. Systematic review studies, literature, letters to the editor, brief comments, etc. were excluded. PubMed, Scopus, EMBASE, and Web of Science databases were searched until June 15, 2023. The Joanna Brigs Institute tool was used to assess risk of bias and study quality. Descriptive data were expressed as frequency, median, mean, and standard deviation. Results: Seventeen clinical case studies were identified and 17 patients with acute abdomen associated with COVID-19 vaccination were evaluated, including: acute appendicitis (n=3), acute pancreatitis (n=9), diverticulitis (n=1), cholecystitis (n=2) and colitis (n=2). The most associated COVID-19 vaccine was Pfizer-BioNTech (mRNA) with 64.71 %. The majority of cases acute abdomen was after the first dose (52.94 %). All patients responded objectively to medical (88.34 %) and surgical (11.76 %) treatment and were discharged within a few weeks. There were no cases of death. Conclusions: Acute abdomen is a rare complication of great interest in the medical and surgical practice of COVID-19 vaccination, our study reviewed based on a small sample of patients, therefore it is recommended to conduct future observational studies and fully elucidate the mechanisms by which this association occurs.

Gang Yu

and 5 more

Glioma refers to a highly prevalent type of brain tumor that is strongly associated with a high mortality rate. During the treatment process of the disease, it is particularly important to accurately perform segmentation of the glioma from Magnetic Resonance Imaging (MRI). However, existing methods used for glioma segmentation usually rely solely on either local or global features and perform poorly in terms of capturing and exploiting critical information from tumor volume features. Herein, we propose a local and global dual transformer with an attentional supervision U-shape network called DTASUnet, which is purposed for glioma segmentation. First, we built a pyramid hierarchical encoder based on 3D shift local and global transformers to effectively extract the features and relationships of different tumor regions. We also designed a 3D channel and spatial attention supervision module to guide the network, allowing it to capture key information in volumetric features more accurately during the training process. The experimental results show that DTASUnet exhibited superior or competitive performance compared to other state-of-the-art algorithms. In the BraTS 2018 validation set, the average Dice scores of DTASUnet for the tumor core (TC), whole tumor (WT), and enhancing tumor (ET) regions were 0.845, 0.905, and 0.808, respectively. For the BraTS 2020 validation set, the average Dice scores of TC, WT, and ET were 0.844, 0.906, and 0.790, respectively. These results demonstrate that DTASUnet has utility in assisting clinicians with determining the location of gliomas to facilitate more efficient and accurate brain surgery and diagnosis.

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Gizem Koken

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Background: Food-induced immediate response of the esophagus (FIRE) is a new phenomenon that has been described in eosinophilic esophagitis (EoE) patients. It is suspected when unpleasant symptoms occur suddenly on contact of the triggering food with the esophageal surface and recur with repeated exposures. It can often be mistaken for pollen-food allergy syndrome (PFAS) and solid food dysphagia. Data on FIRE is limited to one survey study and case reports, and there are no screening studies conducted on either adults or children with EoE. In this study, we aimed to screen children aged ≥7 years old with EoE for FIRE. Methods: Demographic data were collected from medical records. A questionnaire about FIRE was applied to all participants. Skin prick tests (SPTs) were done on suspected patients to identify the triggering foods. FIRE is defined as suitable clinical symptoms with suspected food allergen exposure. Results: Seventy-eight patients (74.4% male, median age: 13.5 years) were included. Unpleasant and recurrent symptoms distinct from dysphagia with specific foods were reported in %16.7 of the patients, all of whom had concomitant allergic rhinitis (AR). The symptoms described by almost all patients were oropharyngeal itching and tingling (PFAS: 15.3%) excluding only one patient reporting retrosternal narrowing and pressure after specific food consumption (FIRE: 1.2%). Conclusions: Although definitive conclusions regarding the true prevalence of FIRE cannot be made, it does not seem to be common as PFAS. However, it deserves questioning particularly in the presence of concurrent AR and/or PFAS in children with EoE.

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