Background Most patients with allergic rhinitis consult in primary care. A simple test is needed to evaluate globally the severity of allergic rhinitis to assess the efficacy of treatment. Objective ...This study compared the responsiveness of visual analog scale (VAS) scores between baseline and treatment with the 2 gold-standard outcomes (symptom score and quality of life). Five hundred eighty-six subjects were included, all with allergic rhinitis caused by grass pollens and all seen in primary care. Methods A randomized, multicenter, open-label parallel study was designed to compare 2 therapeutic strategies in patients with allergic rhinitis. The disease-specific Rhinoconjunctivitis Quality of Life Questionnaire total score, the symptom score, and the VAS score (0-10 cm) were all self-assessed by the patient before and after 2 weeks of treatment. Receiver operating characteristic curves and cost function were used to assess VAS cutoff scores and to distinguish between patients with no clinical improvement and patients with improvement in symptoms, quality of life, or both. Results The optimal cutoff in VAS score change separating the patients without improvement from those with improvement is 0.30 cm. By using the cost of false-positive and false-negative results, a difference of more than 1 cm is significant. However, when patients show an improvement in both symptoms and Rhinoconjunctivitis Quality of Life Questionnaire scores, the median improvement on the VAS is 7 cm. Conclusions A VAS, when used for a global evaluation of rhinitis, is highly responsive to change during the treatment of a large number of patients in a cluster randomized pragmatic trial.
In this work, the use of magnetic induction (MI) to cross the air-water boundary is investigated. An analytical expression is derived for the magnetic field in air from a coil underwater and is ...validated with simulation results that also include the effect of the front-end. Specifically, the ratio of the induced voltage of the receiver over transmitter current is maximized for a given distance between small coils with a radius of 6.5 cm and it is found that an optimal frequency exists: for a distance between 10 and 100 m, the optimum frequency of operation decreases from 8000 down to 80 Hz. Experiments are performed in air and in sea-water tanks to verify the mutual inductance and end-to-end attenuation. The experiments agree with the theory for distances up to 1.6 m, after which a noise floor is reached. To increase the range, the use of passive repeaters is studied and a relay coil that transfers the energy to a receiver inside a magnetic shield is analyzed. When configured correctly, this relay can significantly enhance the receiver output voltage, as demonstrated through simulations, potentially increasing it by up to tenfold.
Allergic rhinitis (AR) impairs quality of life (QoL), sleep and work. The Allergic Rhinitis and its Impact on Asthma (ARIA) classification is widely used, but the impact of the different symptoms on ...QoL is not clear.
To describe characteristics of patients consulting in primary care for AR and to study the impact of AR symptoms and the ARIA classes on QoL.
A multicenter prospective observational cross-sectional study assessed the visual analogue scale (VAS) in the management of AR in 990 patients consulting general practitioners for AR. Patients were classified according to the four classes of ARIA. VAS, Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) and total symptom score (TSS) for nasal and non-nasal symptoms were evaluated. VAS and TSS measures were compared with RQLQ.
Mild intermittent rhinitis was diagnosed in 20% of patients, mild persistent rhinitis in 17%, moderate/severe intermittent rhinitis in 15% and moderate/severe persistent rhinitis in 48%. The presence of treatments did not affect VAS levels. Both severity and duration of rhinitis had an impact on QoL and VAS levels. Ocular symptoms (OR: 2.78, 95% CI: 1.965-3.939) including eyelid edema (OR: 2.07, 95% CI: 1.274-3.360) and asthenia (OR: 2.73, 95% CI: 1.922-3.877) had more impact on RQLQ than nasal obstruction (OR: 1.61, 95% CI: 1.078-2.405) and nasal pruritus (OR 1.45, 95% CI: 1.028-2.042). Sneezing and rhinorrhea did not impact RQLQ.
This study confirmed that ocular symptoms and, to a lesser degree, nasal obstruction and pruritus have a significant impact on QoL.
This article presents a channel state information acquisition approach based on a Markov chain process that exploits information from the physical environmental conditions, including the tide phase ...and flow. The method is intended to predict channel characteristics, including the gain, delay, and Doppler spread, as well as the standard deviation of intrapath delays in time-varying conditions. Specifically, the correlation between different oceanic processes and the acoustic channel characteristics is confirmed to define a set of tide-dependent states corresponding to a particular channel condition. Channel soundings from a 34-day sea trial conducted in Grand Passage, Nova Scotia, are used to derive the channel characteristics statistics. For this purpose, channel soundings measurements are applied to a parametric model of the propagation channel. The probabilistic parametric model forms a data set by characterizing the time-varying channel impulse response and describing the channel tapped-delay structure statistically as a function of different tide phases. The proposed Markov chain is driven by the measured channel data set and predicts the future channel characteristics one tide cycle ahead. To validate the accuracy of the proposed method, the predicted channel characteristics are compared to the channel measurements obtained in a 566-m channel in Grand Passage, Nova Scotia.
Following the emergency use authorization of the mRNA‐1273 vaccine on the 18th of December 2020, two mRNA vaccines are in current use for the prevention of coronavirus disease 2019 (COVID‐19). For ...both mRNA vaccines, the phase III pivotal trials excluded individuals with a history of allergy to vaccine components. Immediately after the initiation of vaccination in the United Kingdom, Canada, and the United States, anaphylactic reactions were reported. While the culprit trigger requires investigation, initial reports suggested the excipient polyethylene glycol 2000 (PEG‐2000)—contained in both vaccines as the PEG‐micellar carrier system—as the potential culprit. Surface PEG chains form a hydrate shell to increase stability and prevent opsonization. Allergic reactions to such PEGylated lipids can be IgE‐mediated, but may also result from complement activation‐related pseudoallergy (CARPA) that has been described in similar liposomes. In addition, mRNA‐1273 also contains tromethamine (trometamol), which has been reported to cause anaphylaxis to substances such as gadolinium‐based contrast media. Skin prick, intradermal and epicutaneous tests, in vitro sIgE assessment, evaluation of sIgG/IgM, and basophil activation tests are being used to demonstrate allergic reactions to various components of the vaccines.
Background
Grass pollen‐induced allergic rhinoconjunctivitis (AR) is very common worldwide. However, its symptoms may vary with the patient's age. The present study compared symptom profiles and ...quality of life (QoL) in children, adolescents and adults with grass pollen‐induced AR.
Methods
This was a four‐week, multicentre, observational study of children (aged 6–11), adolescents (12–17) and adults (18–65) consulting specialist physicians in France. The management of AR was at the physicians’ discretion. Participants regularly rated their symptoms (the rhinoconjunctivitis total symptom score (RTSS) and a visual analogue scale (VAS)) and QoL (the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ).
Results
A total of 806 patients (253 children, 250 adolescents and 303 adults, of whom 83.5% suffered from moderate‐to‐severe, persistent AR) provided data for at least the first 2 weeks of the study. Ocular pruritus (the most bothersome symptom in children (35%), adolescents (22%) and adults (16%)) was associated with poor QoL in all groups, whereas nasal obstruction and pruritus were associated with poor QoL in adolescents and children. Over 4 weeks, the weekly mean RTSS and VAS scores fell by around half. This change was associated with an improvement in the RQLQ scores. In all age groups, the VAS score was well correlated with the weekly mean RTSS score (Pearson's r: 0.79–0.88) and moderately correlated with the weekly mean RQLQ score (Pearson's r: 0.64–0.80).
Conclusions
In moderate‐to‐severe grass pollen‐induced AR, symptom perception differs in children vs. older patients. However, the assessments of treatment outcomes (using the RTSS, VAS and RQLQ) were similar in all age groups.
In this paper, a Media Access Control (MAC) protocol is investigated for multichannel underwater acoustic sensor networks and a distributed channel allocation scheme is proposed for acoustic nodes ...equipped with a multichannel bi-directional transceiver. To ensure that a minimum of one channel is allocated for each transmitter-receiver pair, a novel distributed channel allocation scheme, the High Coverage High Fairness (HCHF) algorithm, is proposed. The algorithm requires the exchange of channel sensing information among neighbor nodes at the beginning of each transmission time slot. To compare HCHF and existing schemes, various performance metrics are assessed including spectrum utilization, coverage, fairness, and control packet overhead. Simulation results indicate that the HCHF scheme can improve the coverage and fairness in comparison to other schemes without sacrificing much on the spectrum utilization. The performance improvement of HCHF is constrained by a higher control message overhead, since local packet exchange between neighbor nodes is required to share spectrum sensing information.
This article reports a fourth-order continuous-time (CT) delta-sigma modulator (DSM) that features a single-amplifier biquad, a passive integrator, and an active integrator. This simplifies the ...circuit to only two op-amps in comparison to four power-hungry op-amps used in a conventional fourth-order DSM. In addition to improving the power consumption, the proposed design also has more relaxed requirements for the gain-bandwidth product and the loop gain. A 4-bit flash analog-to-digital converter (ADC) and two feedback digital-to-analog converters (DACs) are employed in this design to implement a fully integrated CT DSM. By incorporating the passive network in front of the last active integrator, this design gives a better attenuation at high frequency, which decreases the possibility of instability caused by out-of-band high-frequency signals. The proposed design has a measured bandwidth of 2 MHz with a power consumption of only around 3 mW. The effective number of bits (ENOB) of the proposed CT-DSM is approximately 12.7 bits with a peak signal-to-noise and distortion ratio (SNDR) around 78 dB, and it also exhibits a good Schreier figure of merit on the order of 166 dB compared to the existing state of the art.
Background Allergic rhinitis represents a global health problem affecting 10% to 20% of the population. The Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines have been widely used to treat ...the approximately 500 million affected patients globally. Objective To develop explicit, unambiguous, and transparent clinical recommendations systematically for treatment of allergic rhinitis on the basis of current best evidence. Methods The authors updated ARIA clinical recommendations in collaboration with Global Allergy and Asthma European Network following the approach suggested by the Grading of Recommendations Assessment, Development and Evaluation working group. Results This article presents recommendations about the prevention of allergic diseases, the use of oral and topical medications, allergen specific immunotherapy, and complementary treatments in patients with allergic rhinitis as well as patients with both allergic rhinitis and asthma. The guideline panel developed evidence profiles for each recommendation and considered health benefits and harms, burden, patient preferences, and resource use, when appropriate, to formulate recommendations for patients, clinicians, and other health care professionals. Conclusion These are the most recent and currently the most systematically and transparently developed recommendations about the treatment of allergic rhinitis in adults and children. Patients, clinicians, and policy makers are encouraged to use these recommendations in their daily practice and to support their decisions.
Forest tree improvement helps provide adapted planting stock to ensure growth productivity, fibre quality and carbon sequestration through reforestation and afforestation activities. However, there ...is increasing doubt that conventional pedigree provides the most accurate estimates for selection and prediction of performance of improved planting stock. When the additive genetic relationships among relatives is estimated using pedigree information, it is not possible to take account of Mendelian sampling due to the random segregation of parental alleles. The use of DNA markers distributed genome-wide (multi-locus genotypes) makes it possible to estimate the realized additive genomic relationships, which takes account of the Mendelian sampling and possible pedigree errors. We reviewed a series of papers on conifer and broadleaf tree species in which both pedigree-based and marker-based estimates of genetic parameters have been reported. Using metadata analyses, we show that for heritability and genetic gains, the estimates obtained using only the pedigree information are generally biased upward compared to those obtained using DNA markers distributed genome-wide, and that genotype-by-environment (GxE) interaction can be underestimated for low to moderate heritability traits. As high-throughput genotyping becomes economically affordable, we recommend expanding the use of genomic selection to obtain more accurate estimates of genetic parameters and gains.
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