ARIA 2016 : Care pathways implementing emerging technologies for predictive medicine in rhinitis and asthma across the life cycle

European Innovation Partnership on Active and Healthy Ageing Reference Site MACVIA-France, EU Structural and Development Fund Languedoc-Roussillon, ARIA.Peer reviewedPublisher PD

Comparing the rates of absorption and weight loss during a desorption test using near infrared spectroscopy

The importance of determining skin hydration has over the years prompt the development of many instruments and methods, specifically designed to assess this parameter or water contents especially in the stratum corneum, and have greatly matured to suit different anatomical sites and measure multiple attributes. Of those, Near Infrared Spectroscopy (NIRS) has gained wide interest as a precise, safe, fast and noninvasive technique for determining skin hydration due to its high sensitivity to hydrogen bonding and ability to measure the amount of water in skin directly using the intensities of overtone and combination bands of OH and HOH water bonds occurring in the NIR region, that are good indicators of the state of skin hydration. This paper reports near infrared spectrophotometric measurements using a highly sophisticated spectrophotometer in the region of 1000-2500 nm to study the water uptake and dehydration properties of skin in vitro using samples of porcine skin. Initial results of pure liquid water and skin samples have clearly displayed the prominent bands associated with water content, and desorption tests have been able to verify changes in these bands associated with water content, although a clear correlation between the rates of weight loss and absorbance loss at various hydration periods has not yet been established. These preliminary results are expected to further explain the relationship between water and skin, and its role within, in hope to aid the future development of a portable instrument based on near infrared spectroscopy that would be capable of directly measuring skin hydration and/or water content in a fast and noninvasive manner

Alteration of superconductivity of suspended carbon nanotubes by deposition of organic molecules

We have altered the superconductivity of a suspended rope of single walled carbon nanotubes, by coating it with organic polymers. Upon coating, the normal state resistance of the rope changes by less than 20 percent. But superconductivity, which on the bare rope shows up as a substantial resistance decrease below 300 mK, is gradualy suppressed. We correlate this to the suppression of radial breathing modes, measured with Raman Spectroscopy on suspended Single and Double-walled carbon nanotubes. This points to the breathing phonon modes as being responsible for superconductivity in carbon nanotubes

Allergen immunotherapy for allergic asthma: protocol for a systematic review

Background: The European Academy of Allergy and Clinical Immunology (EAACI) is in the process of developing the EAACI Guidelines for Allergen Immunotherapy (AIT) for Allergic Asthma. We seek to critically assess the effectiveness, cost-effectiveness and safety of AIT in the management of allergic asthma. Methods: We will undertake a systematic review, which will involve searching international biomedical databases for published, in progress and unpublished evidence. Studies will be independently screened against pre-defined eligibility criteria and critically appraised using established instruments. Data will be descriptively and, if possible and appropriate, quantitatively synthesised. Discussion: The findings from this review will be used to inform the development of recommendations for EAACI’s Guidelines on AIT

Investigation of photoplethysmographic signals and blood oxygen saturation values on healthy volunteers during cuff-induced hypoperfusion using a multimode PPG/SpO2 sensor

Photoplethysmography (PPG) is a technique widely used to monitor volumetric blood changes induced by cardiac pulsations. Pulse oximetry uses the technique of PPG to estimate arterial oxygen saturation values (SpO2). In poorly perfused tissues, SpO2 readings may be compromised due to the poor quality of the PPG signals. A multimode finger PPG probe that operates simultaneously in reflectance, transmittance and a combined mode called “transreflectance”’ was developed, in an effort to improve the quality of the PPG signals in states of hypoperfusion. Experiments on 20 volunteers were conducted to evaluate the performance of the multimode PPG sensor and compare the results with a commercial transmittance pulse oximeter. A brachial blood pressure cuff was used to induce artificial hypoperfusion. Results showed that the amplitude of the transreflectance AC PPG signals were significantly different (p\0.05) than the AC PPG signals obtained from the other two conventional PPG sensors (reflectance and transmittance). At induced brachial pressures between 90 and 135 mmHg, the reflectance finger pulse oximeter failed 25 times (failure rate 42.2 %) to estimate SpO2 values, whereas the transmittance pulse oximeter failed 8 times (failure rate 15.5 %). The transreflectance pulse oximeter failed only 3 times (failure rate 6.8 %) and the commercial pulse oximeter failed 17 times (failure rate 29.4 %)

Microbial ligand costimulation drives neutrophilic steroid-refractory asthma

Funding: The authors thank the Wellcome Trust (102705) and the Universities of Aberdeen and Cape Town for funding. This research was also supported, in part, by National Institutes of Health GM53522 and GM083016 to DLW. KF and BNL are funded by the Fonds Wetenschappelijk Onderzoek, BNL is the recipient of an European Research Commission consolidator grant and participates in the European Union FP7 programs EUBIOPRED and MedALL. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Peer reviewedPublisher PD

Multicentre, non-interventional study to assess the profile of patients with uncontrolled rhinitis prescribed a novel formulation of azelastine hydrochloride and fluticasone propionate in a single spray in routine clinical practice in the UK

OBJECTIVE: The aims of this study were (1) to characterise the type of patient prescribed MP-AzeFlu (Dymista, a novel formulation of azelastine hydrochloride, fluticasone propionate and excipients in a single spray) in real life in the UK and physicians' reasons for prescribing it and (2) to quantify the personal and societal burden of allergic rhinitis (AR) in the UK prior to MP-AzeFlu prescription. DESIGN, SETTING AND PARTICIPANTS: This multicentre, non-interventional study enrolled patients (n=193) with moderate-to-severe AR and acute symptoms who were eligible to receive treatment with MP-AzeFlu according to its licensed indications. Information was gathered on patient demographics, AR history and symptom severity, symptomatology and AR treatments in the previous calendar year (prior to MP-AzeFlu prescription). Physicians also recorded the number of previous AR visits, specific reasons for these visits and their reason for prescribing MP-AzeFlu. RESULTS: Most patients had seasonal AR either alone (10.4%) or in combination with perennial AR (35.2%), but many had AR of unknown origin (35.8%). Prior to MP-AzeFlu prescription, patients reported troublesome symptoms (78.2%) and sleep disturbance (64.8%), with congestion considered the most bothersome (54.4%) and ocular symptoms reported by 68.4% of patients. The most frequent reason for MP-AzeFlu prescription was that other therapies were not sufficient in the past (78.8%) or not sufficient to treat acute symptoms (16.1%). 79.3% of patients reported using ≥2 AR therapies in the past year. An average of 1.6 (SD 1.9) doctor visits due to AR were reported prior to MP-AzeFlu prescription. CONCLUSIONS: In the UK, MP-AzeFlu was prescribed for individuals (≥12 years) with moderate/severe AR irrespective of (1) previous AR treatment (mono or multiple), (2) previous or likely treatment failure, (3) phenotype, (4) number of previous physician visits for AR and (5) for the relief of both acute symptoms and in anticipation of allergen exposure

The comparative study between endourological and minimally invasive treatment of reno-ureteral lithiasis

Universitatea de Stat de Medicină şi Farmacie „Nicolae Testemiţanu”, Chişinău, Republica MoldovaIntroduction. Lithic urological obstruction is ranked 3rd among urological diseases worldwide, following renal infectious pathologies and prostate pathologies. At the national level, it is the most prevalent urological disease. Aim of study. The aim of this study is to compare the benefits, efficacy, and potential complications of endourological and minimally invasive methods for treating reno-ureteral lithiasis. Methods and materials. A retrospective descriptive study was conducted on a group of 148 patients with reno-ureteral lithiasis who were treated at the urology clinic of IMSP SCM "Sfânta Treime'' between January 2023 and July 2023. The first study group included 59 patients (39.8%) who were treated with semi-rigid ureteroscopy . Of these, 37 patients had 1/3 middle ureteral lithiasis and 22 patients had lithiasis of the juxtavesical segment. The second group consisted of 89 patients (60.2%) with pyelocalyceal lithiasis who were treated with NLP (percutaneous nephrolithotomy). The study also utilized statistical methods, clinical and paraclinical examinations, including laboratory tests (complete blood count, urinalysis, blood biochemistry analysis, uroculture, coagulogram), as well as other instrumental investigations such as conventional imaging methods (SRVR, renal USG, IUR, retrograde ureteropyelography). In some cases, more complex imaging methods were used, such as abdominal CT,spectrometric analysis of the removed stones to evaluate the appropriate treatment approach for each patient. Results. The criteria used to analyze the results of the study were the success rate, number of failures, type of anesthesia, time of stone removal, and complications and their management. The study included 148 patients (96 men and 52 women) between the ages of 19 and 78, with a median age of 46 ± 10.7. In the first group, the "stone free" rate was 70%, with an intervention time of 25-40 minutes using local anesthesia and no associated complications. In the second group, the "stone free" rate was 87%. However, due to factors such as excess weight, volume and location of the kidney stones, and access to the stone, the intervention time was longer at 45 minutes to 1 hour and 30 minutes, with spinal or general anesthesia. There were also secondary complications, including 3 cases of exacerbation of chronic pyelonephritis and 7 cases of subcapsular renal hematomas. The patients with hematomas were closely monitored and did not require additional surgical intervention. Conclusion. The most effective treatment for renal stones is NLP. Compared to semi-rigid ureteroscopy, NLP has a higher success rate in completely removing the stones due to its more precise targeting. With semi-rigid ureteroscopy, it can be challenging to capture all the fragmented stone pieces. Additionally, the use of a ureteroscope to access the stones through the urinary tract results in a quicker recovery time, lower complication rates, shorter hospital stays, and faster return to work for the patient compared to NLP treatment. following renal infectious pathologies and prostate pathologies. A t the national level, it is the most prevalent urological disease. Aim of study. The aim of this study is to compare the benefits, efficacy, and potential complications of endourological and minimally invasive methods for treating reno-ureteral lithiasis. Methods and materials. A retrospective descriptive study was conducted on a group of 148 patients with reno-ureteral lithiasis who were treated at the urology c linic of IMSP SCM "Sfânta Treime'' between January 2023 and July 2023. The first study group included 59 patient s (39.8%) who were treated with semi-rigid ureteroscopy . Of these, 37 patients had 1/3 middle ureteral lithiasis and 22 patients had lithiasis of the juxtavesical segment. The sec ond group consisted of 89 patients (60.2%) with pyelocalyceal lithiasis who were treated with NLP (perc utaneous nephrolithotomy). The study also utilized statistical methods, clinical and paraclinical examinations, including laboratory tests (complete blood count, urinalysis, blood biochemistry analysis, uroculture, coagulogram), as well as other instrumental investigations such as conventional imaging methods (SRVR, renal USG, IUR, retrograde ureteropyelography). In some cases, more complex imagin g methods were used, such as abdominal CT,spectrometric analysis of the removed stones to eva luate the appropriate treatment approach for each patient. Results. The criteria used to analyze the results of the study were the success rat e, number of failures, type of anesthesia, time of stone removal, and complication s and their management. The study included 148 patients (96 men and 52 women) between the ages of 19 and 78, wit h a median age of 46 ± 10.7. In the first group, the "stone free" rate was 70%, with an intervention time of 25-40 minutes using local anesthesia and no associated complications. In the second gro up, the "stone free" rate was 87%. However, due to factors such as excess weight, volume and location o f the kidney stones, and access to the stone, the intervention time was longer at 45 minutes to 1 hour and 30 minutes, with spinal or general anesthesia. There were also secondary complications, including 3 cases of exacerbation of chronic pyelonephritis and 7 cases of subcapsular renal hematoma s. The patients with hematomas were closely monitored and did not require additional surgical intervention. Conclusion. The most effective treatment for renal stones is NLP. Com pared to semi-rigid ureteroscopy, NLP has a higher success rate in completely rem oving the stones due to its more precise targeting. With semi-rigid ureteroscopy, it can be challengi ng to capture all the fragmented stone pieces. Additionally, the use of a ureteroscope to access the stones through the urinary tract results in a quicker recovery time, lower complication rates, shorter hospital st ays, and faster return to work for the patient compared to NLP treatment

A Stochastic Search on the Line-Based Solution to Discretized Estimation

Recently, Oommen and Rueda [11] presented a strategy by which the parameters of a binomial/multinomial distribution can be estimated when the underlying distribution is nonstationary. The method has been referred to as the Stochastic Learning Weak Estimator (SLWE), and is based on the principles of continuous stochastic Learning Automata (LA). In this paper, we consider a new family of stochastic discretized weak estimators pertinent to tracking time-varying binomial distributions. As opposed to the SLWE, our proposed estimator is discretized , i.e., the estimate can assume only a finite number of values. It is well known in the field of LA that discretized schemes achieve faster convergence speed than their corresponding continuous counterparts. By virtue of discretization, our estimator realizes extremely fast adjustments of the running estimates by jumps, and it is thus able to robustly, and very quickly, track changes in the parameters of the distribution after a switch has occurred in the environment. The design principle of our strategy is based on a solution, pioneered by Oommen [7], for the Stochastic Search on the Line (SSL) problem. The SSL solution proposed in [7], assumes the existence of an Oracle which informs the LA whether to go “right” or “left”. In our application domain, in order to achieve efficient estimation, we have to first infer (or rather simulate ) such an Oracle. In order to overcome this difficulty, we rather intelligently construct an “Artificial Oracle” that suggests whether we are to increase the current estimate or to decrease it. The paper briefly reports conclusive experimental results that demonstrate the ability of the proposed estimator to cope with non-stationary environments with a high adaptation rate, and with an accuracy that depends on its resolution. The results which we present are, to the best of our knowledge, the first reported results that resolve the problem of discretized weak estimation using a SSL-based solution

Dietary intake and risk of asthma in children and adults : protocol for a systematic review and meta-analysis

Background: Diet has been proposed to modulate the risk of asthma in children and adults. An increasing body of epidemiological studies have been published in the last year investigating the association between dietary intake and asthma. As part of the Evidence-Based Clinical Practice Guideline Task Force on 'Lifestyle Interventions in Allergy and Asthma' funded by the European Academy of Allergy and Clinical Immunology, we will use a systematic approach to review the evidence from published scientific literature on dietary intake and asthma in children and adults. Methods: This systematic review will be carried out following the PRISMA guidelines. The protocol has been published in PROSPERO (CRD42016036078). We will review the evidence from epidemiological studies in children (from the age of 2 years) and adults and dietary intake of foods and nutrients. Discussion: The findings from this review will be used as a reference to inform guideline recommendations.Peer reviewe