Altered skin microbiome, inflammation, and JAK/STAT signaling in Southeast Asian ichthyosis patients.

BACKGROUND: Congenital ichthyosis (CI) is a collective group of rare hereditary skin disorders. Patients present with epidermal scaling, fissuring, chronic inflammation, and increased susceptibility to infections. Recently, there is increased interest in the skin microbiome; therefore, we hypothesized that CI patients likely exhibit an abnormal profile of epidermal microbes because of their various underlying skin barrier defects. Among recruited individuals of Southeast Asian ethnicity, we performed skin meta-genomics (i.e., whole-exome sequencing to capture the entire multi-kingdom profile, including fungi, protists, archaea, bacteria, and viruses), comparing 36 CI patients (representing seven subtypes) with that of 15 CI age-and gender-matched controls who had no family history of CI. RESULTS: This case-control study revealed 20 novel and 31 recurrent pathogenic variants. Microbiome meta-analysis showed distinct microbial populations, decreases in commensal microbiota, and higher colonization by pathogenic species associated with CI; these were correlated with increased production of inflammatory cytokines and Th17- and JAK/STAT-signaling pathways in peripheral blood mononuclear cells. In the wounds of CI patients, we identified specific changes in microbiota and alterations in inflammatory pathways, which are likely responsible for impaired wound healing. CONCLUSIONS: Together, this research enhances our understanding of the microbiological, immunological, and molecular properties of CI and should provide critical information for improving therapeutic management of CI patients.

Cyclopropanation of Alkenes with Halodiazirines as Halocarbene Precursors in Continuous Flow.

The cyclopropanation reaction of alkenes with photolytically-generated chlorocarbenes from chlorodiazirines is reported as an effective way to prepare substituted 3-chloro-3-aryl-cyclopropanes. This practical and efficient approach allows the synthesis of various 3-chloro-3-aryl-cyclopropanes (32 examples) in continuous flow in 5-minute residence time under light-emitting diode (LED) irradiation. The conditions using 380 nm LED irradiation were successfully extended to the synthesis of substituted 3-bromo-3-aryl-cyclopropanes (3 examples).

CinNapht AIE(E)gens for selective imaging of lipid droplets.

This article describes the synthesis and photophysical properties of Aggregation-Induced Emission (enhancement) luminogens derivated from CinNaphts dyes. These fluorophores can be obtained in good yields in a single SNAr step of a fluorinated CinNapht derivative by incorporating hindered aromatic amines. They exhibit AIE(E) behavior associated with solid-state fluorescence covering an emission range from 563 to 722 nm. One carbazole derivative demonstrates a remarkable efficiency in imaging lipid droplets in living cells through an original photophysical mechanism.

A novel sonoelectrochemical approach for preparing of ZnO nanoparticles.

A novel, rapid, and facile method for one-step sonoelectrochemical synthesis of zinc oxide nanoparticles (UEZ) was introduced in this study. The optimum operating parameters have been selected at a voltage of 7.5 V, KCl concentration of 0.5 M, and the reaction time of 60 min. The as-prepared UEZ were characterized by XRD, SEM, and HRTEM. It was found that the UEZ has a hexagonal wurtzite structure with high crystalline quality, good purity, a size range of 30-100 nm, and good photocatalytic degradation of methylene blue. This work provides a facile route for large-scale synthesizing ZnO nanoparticles via anodization.

Prevalence of obstructive sleep apnea in patients with chronic obstructive pulmonary disease in Vietnam.

PURPOSE: Chronic obstructive pulmonary disease and obstructive sleep apnea are two common respiratory diseases. Chronic obstructive pulmonary disease patients co-morbid with obstructive sleep apnea are associated with increased cardiovascular adverse events, frequent acute exacerbations, and higher mortality. Only a few studies on obstructive sleep apnea among patients with chronic obstructive pulmonary disease are available in Vietnam. The study aims to determine the prevalence of obstructive sleep apnea in patients with chronic obstructive pulmonary disease in Vietnam. METHODS: This is a cross-sectional study in patients with chronic obstructive pulmonary disease at multi-sites in Vietnam: the People's Hospital of Gia Dinh, Bach Mai Hospital, Phoi Viet Clinics, and Lam Dong Medical College using type 3 sleep monitoring device at sleep labs to diagnose obstructive sleep apnea in all study participants. RESULTS: Two hundred seventy-eight patients with chronic obstructive pulmonary disease were enrolled. Among the patients, 93.2% were male, with an average age of 66.9 ± 9.3 and a BMI of 21.9 ± 3.8 kg/m2; 82.0% were symptomatic including 44.6% in group B and 37.4% in group D with average post-FEV1 of 49.8 ± 18.3% predicted values. One hundred seventeen patients (42.1%) with chronic obstructive pulmonary disease presented obstructive sleep apnea defined by AHI ≥ 15 events/h. CONCLUSIONS: The prevalence of obstructive sleep apnea in patients with chronic obstructive pulmonary disease in Vietnam was 42.1% for an AHI of ≥ 15 events/h.

Investigation of Urinary Metabolites of Organophosphate Esters in Hanoi, Vietnam: Assessment Exposure and Estimated Daily Intake.

In recent years, organophosphate esters (OPEs) have become one of the most common additives in various consumer products worldwide, therefore the exposure and impact of OPEs on human health are drawing a lot of attention. In this study, three metabolites of OPEs including bis(1,3-dichloro-2-propyl) phosphate (BDCIPP), diphenyl phosphate (DPhP) and diethyl phosphate (DEP) were investigated in first-morning void urine samples taken from a population (age range: 3-76 years old) in Hanoi, Vietnam. The most dominant urinary OPE metabolite was DEP with the geometric mean of specific gravity adjust (SG-adjusted) concentration were 1960 ng mL-1 and detected frequency (DF) of 98%. Followed by DPhP (8.01 ng mL-1, DF: 100%) and BDCIPP (2.18 ng mL-1, DF: 51%). The results indicated that gender and age might have associations with the OPE metabolites variation in urine samples. The levels of OPE metabolites in urine samples from females were slightly higher than in males. An increase in age seems to have an association with a decrease in DPhP levels in urine. Exposure doses of parent OPEs were evaluated from the unadjusted urinary concentration of corresponding OPE metabolite. The estimated exposure doses of triethyl phosphate (TEP) (mean: 534,000 ng kg-1 d-1) were significantly higher than its corresponding reference dose, suggesting the high potential risk from the current exposure doses of TEP to human health. The results of this work provided the initial information on the occurrence of three OPE metabolites in urine from Hanoi, Vietnam and estimated exposure dose of corresponding parent OPEs.

Comparison of Machine Learning Algorithms for Heartbeat Detection Based on Accelerometric Signals Produced by a Smart Bed.

This work aims to compare the performance of Machine Learning (ML) and Deep Learning (DL) algorithms in detecting users' heartbeats on a smart bed. Targeting non-intrusive, continuous heart monitoring during sleep time, the smart bed is equipped with a 3D solid-state accelerometer. Acceleration signals are processed through an STM 32-bit microcontroller board and transmitted to a PC for recording. A photoplethysmographic sensor is simultaneously checked for ground truth reference. A dataset has been built, by acquiring measures in a real-world set-up: 10 participants were involved, resulting in 120 min of acceleration traces which were utilized to train and evaluate various Artificial Intelligence (AI) algorithms. The experimental analysis utilizes K-fold cross-validation to ensure robust model testing across different subsets of the dataset. Various ML and DL algorithms are compared, each being trained and tested using the collected data. The Random Forest algorithm exhibited the highest accuracy among all compared models. While it requires longer training time compared to some ML models such as Naïve Bayes, Linear Discrimination Analysis, and K-Nearest Neighbour Classification, it keeps substantially faster than Support Vector Machine and Deep Learning models. The Random Forest model demonstrated robust performance metrics, including recall, precision, F1-scores, macro average, weighted average, and overall accuracy well above 90%. The study highlights the better performance of the Random Forest algorithm for the specific use case, achieving superior accuracy and performance metrics in detecting user heartbeats in comparison to other ML and DL models tested. The drawback of longer training times is not too relevant in the long-term monitoring target scenario, so the Random Forest model stands out as a viable solution for real-time ballistocardiographic heartbeat detection, showcasing potential for healthcare and wellness monitoring applications.

Factors associated with hepatitis B knowledge among people of Vietnamese ethnicity in Australia.

Despite high hepatitis B (HBV) prevalence among people of Vietnamese ethnicity in Australia and elsewhere, there is limited research on levels of HBV knowledge and factors associated with such knowledge. The aim of this study was to examine HBV knowledge and associated demographic and attitudinal factors among people of Vietnamese ethnicity in Australia. People of Vietnamese ethnicity (n = 966) were recruited through community events and social media groups to complete online surveys measuring HBV knowledge, attitudes towards HBV, levels of mistrust in Western medicine, and demographic characteristics. Findings of this study indicate that levels of knowledge are mixed, with gaps in knowledge related to transmission and treatment of the virus. Those with greater knowledge of HBV tended to be older, have higher levels of formal education, have been tested for HBV, and know someone living with HBV. Those with lower levels of knowledge tended to have more negative attitudes towards the virus and greater levels of mistrust in Western medicine. Given that health literacy is connected to effective communication from health providers, we suggest that there is a need for the development of health promotion and education resources targeted at people of Vietnamese ethnicity and translated into Vietnamese. We propose that such resources be developed in consultation with Vietnamese communities and health providers to ensure that they are culturally appropriate and sensitive to people of Vietnamese ethnicity living in Australia.

Proportion and number of cancer cases and deaths attributable to behavioral risk factors in Vietnam.

Identifying modifiable risk factors that contribute to cancer is essential in setting up preventive strategies. Therefore, this study aimed to estimate the number and proportion of cancer cases and deaths attributable to five behavior-related risk factors-tobacco smoking, second-hand smoking, alcohol consumption, high body mass index and insufficient physical activity in Vietnam in 2020. Population attributable fractions were calculated for relationships of risk factors and cancer types based on sufficient evidence according to IARC or strong evidence according to WCRF/AICR. Relative risks were retrieved from meta-analyses where possible. Prevalence of risk factors was obtained from the most current available nationally representative population surveys in Vietnam. Cancer cases and deaths were obtained from GLOBOCAN 2020. An estimated 40.5% of all cancer cases in men (39 924 cases) and 7.8% in women (6542 cases) were attributable to these risk factors. The proportions of cancer deaths attributable to these risk factors were 44.0% in men (32 807 cases) and 8.9% in women (4235 cases). Tobacco smoking was the leading cause of cancer cases and deaths in men, followed by alcohol consumption and high BMI. In women, high BMI accounted for the highest proportion of cancer cases and second-hand smoking accounted for the highest proportion of cancer deaths. Lung and upper aerodigestive tract cancer cases and deaths could have been reduced at least by half if these risk factors had been eliminated. To reduce cancer incidence and mortality, preventive actions focusing on tobacco control are likely to have the most significant impact, especially in men.

Cation diffusion facilitator proteins of Beta vulgaris reveal diversity of metal handling in dicotyledons.

Manganese (Mn), iron (Fe), and zinc (Zn) are essential for diverse processes in plants, but their availability is often limiting or excessive. Cation diffusion facilitator (CDF) proteins have been implicated in the allocation of those metals in plants, whereby most of our mechanistic understanding has been obtained in Arabidopsis. It is unclear to what extent this can be generalized to other dicots. We characterized all CDFs/metal tolerance proteins of sugar beet (Beta vulgaris spp. vulgaris), which is phylogenetically distant from Arabidopsis. Analysis of subcellular localization, substrate selectivities, and transcriptional regulation upon exposure to metal deficiencies and toxicities revealed unexpected deviations from their Arabidopsis counterparts. Localization and selectivity of some members were modulated by alternative splicing. Notably, unlike in Arabidopsis, Mn- and Zn-sequestrating members were not induced in Fe-deficient roots, pointing to differences in the Fe acquisition machinery. This was supported by low Zn and Mn accumulation under Fe deficiency and a strikingly increased Fe accumulation under Mn and Zn excess, coinciding with an induction of BvIRT1. High Zn load caused a massive upregulation of Zn-BvMTPs. The results suggest that the employment of the CDF toolbox is highly diverse amongst dicots, which questions the general applicability of metal homeostasis models derived from Arabidopsis.

Assembling Vertical Nanogap Arrays with Nanoentities for Highly Sensitive Electrical Biosensing.

Nanogap biosensors have emerged as promising platforms for detecting and measuring biochemical substances at low concentrations. Although the nanogap biosensors provide high sensitivity, low limit of detection (LOD), and enhanced signal strength, it requires arduous fabrication processes and costly equipment to obtain micro/nanoelectrodes with extremely narrow gaps in a controlled manner. In this work, we report the novel design and fabrication processes of vertical nanogap structures that can electrically detect and quantify low-concentration biochemical substances. Approximately 40 nm gaps are facilely created by magnetically assembling antibody-coated nanowires onto a nanodisk patterned between a pair of microelectrodes. Analyte molecules tagged with conductive nanoparticles are captured and bound to nanowires and bridge over the nanogaps, which consequently causes an abrupt change in the electrical conductivity between the microelectrodes. Using biotin and streptavidin as model antibodies and analytes, we demonstrated that our nanogap biosensors can effectively measure the protein analytes with the LOD of ∼18 pM. The outcome of this research could inspire the design and fabrication of nanogap devices and nanobiosensors, and it would have a broad impact on the development of microfluidics, biochips, and lab-on-a-chip architectures.

Herbal Medicines for Rhinosinusitis: A Systematic Review and Network Meta-analysis.

PURPOSE OF REVIEW: To analyze and compare the effects of herbal medicines (HMs) for treating different forms of rhinosinusitis. RECENT FINDINGS: Forty-seven randomized controlled trials evaluating 18 HMs in six different rhinosinusitis populations were included in the network meta-analysis. Certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. For the common cold, Pelargonium sidoides offered the most beneficial effect on symptom improvement (moderate certainty of evidence). For acute post-viral rhinosinusitis, Cineole and Pelargonium sidoides were the most effective treatments for controlling symptoms (moderate certainty), while Spicae aetheroleum was most effective for health-related quality of life (HRQoL) improvement (moderate certainty). For chronic rhinosinusitis without nasal polyps (CRSsNP), Origanum vulgare was the most beneficial treatment for improving symptoms and HRQoL (low certainty). Evidence of HMs for acute bacterial rhinosinusitis, chronic rhinosinusitis with nasal polyps, and unclassified chronic rhinosinusitis was restricted to a limited number of studies. Adverse events should be of concern in some HMs, such as Spicae aetheroleum or Mytorl. Several HMs improved patient-important outcomes, above minimal clinically important differences, in treating common cold, acute post-viral rhinosinusitis, and CRSsNP. Further studies with adequate sample sizes and long-term follow-ups are warranted to support the current evidence. TRIAL REGISTRATION NUMBER AND DATE OF REGISTRATION: PROSPERO ID: CRD42022328265 May 10, 2022.

Treatments of Epistaxis in Hereditary Hemorrhagic Telangiectasia: Systematic Review and Network Meta-Analysis.

PURPOSE OF REVIEW: To analyze and compare the effects of epistaxis treatments for Hereditary Hemorrhagic Telangiectasia (HHT) patients. RECENT FINDINGS: Of total of 21 randomized controlled trials (RCT), the data from 15 RCTs (697 patients, 7 treatments: timolol, propranolol, bevacizumab, doxycycline, tacrolimus, estriol/estradiol, and tranexamic acid) were pooled for the meta-analyses while the other 6 studies (treatments: electrosurgical plasma coagulation, KTP laser, postoperative packing, tamoxifen, sclerosing agent, and estriol) were reviewed qualitatively. When compared to placebo, propranolol offered the most improved epistaxis severity score, mean difference (MD), -1.68, 95% confidence interval (95%CI) [-2.80, -0.56] followed by timolol, MD -0.40, 95%CI [-0.79, -0.02]. Tranexamic acid significantly reduced the epistaxis frequency, MD -1.93, 95%CI [-3.58, -0.28]. Other treatments had indifferent effects to placebo. Qualitative analysis highlighted the benefits of tamoxifen and estriol. The adverse events of tranexamic acid, tacrolimus, propranolol, and estradiol were significantly reported. Propranolol, timolol, tranexamic acid, tamoxifen, and estriol were effective treatments which offered benefits to HHT patients in epistaxis management. Adverse events of tranexamic acid, tacrolimus, propranolol, and estradiol should be concerned.

Genetic diversity and relatedness of feline parvovirus in Vietnam and its potential implications for canine-feline transmission.

Feline panleukopenia, caused by feline parvovirus (FPV), has been studied worldwide, but there have been very few studies conducted in Vietnam. In this study, 19 rectal swab samples were collected from northern Vietnam in 2018-2019 and screened for the presence of FPV using PCR. Through sequence analysis of the full-length VP2 gene, it was found that the FPV strains detected in Vietnam were closely related to those obtained from dogs in Vietnam, Asia, Europe, and America. Moreover, the FPV strains found in Vietnam may constitute a distinct group, related to viruses sampled in China. Interestingly, most of the nucleotide changes identified were T-C substitutions.

Performance and neural modeling of a compost-based biofilter treating a gas-phase mixture of benzene and xylene.

Biofilter (BF) has been regarded as a versatile gas treatment technology for removing volatile organic compounds (VOCs) from contaminated gas streams. In order for BF to be utilized in the industrial setting, it is essential to conduct research aimed at removing VOC mixtures under different inlet loading conditions, i.e. as a function of the gas flow rate and inlet VOC concentrations. The main aim of this study was to apply artificial neural networks (ANN) and determine the relationship between flow rate (FR), pressure drop (PD), inlet concentration (C), and removal efficiency (RE) in the BF treating gas-phase benzene and xylene mixtures. The ANN model was trained and tested to assess the removal efficiency of benzene (REB) and xylene (REX) under the influence of different FR, PD and C. The model's performance was assessed using a cross-validation method. The REb varied from 20% to >60%, while the REx varied from 10% to 70% during the different experimental phases of BF operation. The causal index (CI) technique was used to determine the sensitivity of the input parameters on the output variables. The ANN model with a topology of 4-4-2 performed the best in terms of predicting the RE profiles of both the pollutants. Furthermore, the effect was more pronounced for xylene because an increase in the benzene concentration reduced xylene removal (CI = -25.7170) more severely than benzene removal. An increase in the xylene concentration had a marginally positive effect on the benzene removal (CI = +0.1178).

Study protocol for type II hybrid implementation-effectiveness trial of strategies for depression care task-sharing in community health stations in Vietnam: DEP Project.

BACKGROUND: It is not clear what the most effective implementation strategies are for supporting the enactment and sustainment of depression care services in primary care settings. This type-II Hybrid Implementation-Effectiveness study will compare the effectiveness of three system-level strategies for implementing depression care programs at 36 community health stations (CHSs) across 2 provinces in Vietnam. METHODS: In this cluster-randomized controlled trial, CHSs will be randomly assigned to one of three implementation conditions: (1) Usual Implementation (UI), which consists of training workshops and toolkits; (2) Enhanced Supervision (ES), which includes UI combined with bi-weekly/monthly supervision; and (3) Community-Engaged Learning Collaborative (CELC), which includes all components of ES, combined with bi-monthly province-wide learning collaborative meetings, during which cross-site learning and continuous quality improvement (QI) strategies are implemented to achieve better implementation outcomes. The primary outcome will be measured based on the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation quality, and Maintenance) using indicators on implementation, provider, and client factors. The secondary outcome examines factors associated with barriers and facilitators of quality implementation, while the tertiary outcome evaluates the incremental cost-effectiveness ratio of services provided in the ES and CELC conditions, relative to UI condition for depression care. A total of 1,296 clients receiving depression care at CHSs will be surveyed at baseline and 6-month follow-up to assess mental health and psychosocial outcomes (e.g., depression and anxiety severity, health function, quality of life). Additionally, 180 CHS staff and 180 non-CHS staff will complete pre- and post-training evaluation and surveys at baseline, 6, 12, and 24 months. DISCUSSION: We hypothesize that the additional implementation supports will make mental health service implementation superior in the ES and CELC arms compared to the UI arm. The findings of this project could identify effective implementation models and assess the added value of specific QI strategies for implementing depression care in primary care settings in Vietnam, with implications and recommendations for other low- and middle-income settings. More importantly, this study will provide evidence for key stakeholders and policymakers to consider policies that disseminate, scale up, and advance quality mental health care in Vietnam. TRIAL REGISTRATION: NCT04491045 on Clinicaltrials.gov. Registered July 29, 2020.

Information needs of informal caregivers in caring and rehabilitation for dioxin victims in Vietnam.

BACKGROUND: Health outcomes among Agent Orange/dioxin (dioxin) victims are significant due to many individuals requiring daily assistance, informal care, and rehabilitation support. This study aimed to identify the information needs of informal caregivers of dioxin victims in Vietnam. METHODS: A cross-sectional study was conducted in Quynh Phu district, Thai Binh province - an area with a large number of dioxin victims, from June 2019 to June 2020. Quantitative data were collected from 124 caregivers of victims via structured interviews. Qualitative data were collected using semi-structured interview guides with in-depth interviews (IDI) (n = 36) and two focus group discussions (FGD) (n = 12). RESULTS: The results demonstrated that all caregivers of dioxin victims were family members, predominantly older (71.8%), 61.5 years old on average, living on low incomes (87.9%), and were farmers (80.7%). Almost all participants (96.8%) reported having information needs, particularly concerning dioxin's harms, nutrition, dioxin-related policies and rehabilitation, and psychological support for patients. Caregivers reported that they would like to receive information via health staff counselling (85.0%), television (75.0%), and community loudspeaker (65.8%). Notably, the majority of caregivers reported the need for information regarding psychological support (70.0%). These findings are consistent with qualitative data, which identify an urgent need to provide information, especially through health staff and digital resources. CONCLUSION: Many families with dioxin victims lived with little support and information, highlighting their high demand for information about care and rehabilitation. Thus, the healthcare system should promote information support, policy, and psychological support for caregivers and victims. An online support system for caregivers and victims is also recommended.

Fusion Filters between the No Motion No Integration Technique and Kalman Filter in Noise Optimization on a 6DoF Drone for Orientation Tracking.

The paper works on the new combination between the No Motion No Integration filter (NMNI) and the Kalman Filter (KF) to optimize the conducted vibration for orientation angles during drone operation. The drone's roll, pitch, and yaw with just accelerometer and gyroscope were analyzed under the noise impact. A 6 Degree of Freedom (DoF) Parrot Mambo drone with Matlab/Simulink package was used to validate the advancements before and after fusing NMNI with KF. The drone propeller motors were controlled at a suitable speed level to keep the drone on the zero-inclination ground for angle error validation. The experiments show that KF alone successfully minimizes the variation for the inclination, but it still needs the NMNI support to enhance the performance in noise deduction, with the error only about 0.02°. In addition, the NMNI algorithm successfully prevents the yaw/heading from gyroscope drifting due to the zero-value integration during no rotation with the maximum error of 0.03°.

Real-Time Risk Assessment Detection for Weak People by Parallel Training Logical Execution of a Supervised Learning System Based on an IoT Wearable MEMS Accelerometer.

Activity monitoring has become a necessary demand for weak people to guarantee their safety. The paper proposed a Parallel Training Logical Execution (PTLE) system using machine learning (ML) models on a microelectromechanical system (MEMS) accelerometer to detect coughs, falls, and other normal activities. When there are many categories, the ML prediction can be confused between these activities with each other. The PTLE system trains several models in parallel with more specific activity classes in each dataset. The shared tasks between parallel models relieve the complexity for a single one. There are six additional parameters for accelerometer characteristics, which were calculated from three axes accelerations as input features to improve the ML's consciousness. Once all models were trained, the system was ready to receive the input accelerations and activated the logical flow to manage link operation between these ML models for output predictions. Random Forest (RF) had the highest potential among the ML classification algorithms after the validation. In the experiment, the comparison between the PTLE model and the regular ML model were carried out with real-time data from an M5stickC wearable device on the user's chest to the trained models on PC. The result showed the advancement of the proposed method in term of precision, recall, F1-score with an overall accuracy of 98% in the real-time test. The accelerations from the wearable device were sent to ML models via Wi-Fi with Message Queue Telemetry Transport (MQTT) broker, and the activity predictions were transferred to the cloud for the family members or doctor care based on Internet of Things (IoT) communication.

Phase III study of Phlai capsules in the treatment of allergic rhinitis: A randomized, double-blind, placebo-controlled trial.

BACKGROUND: Preclinical studies demonstrated anti-inflammatory effects of Zingiber montanum (J.König) Link ex Dietr.(Phlai). However, its clinical effect on allergic rhinitis (AR) is not evident. OBJECTIVE: We sought to assess the efficacy and safety of Phlai for treating AR. METHODS: A phase 3, randomized, double-blind, placebo-controlled study was conducted. Patients with AR were randomized into three groups and received Phlai 100 mg or Phlai 200 mg or placebo once a day for four weeks. The primary outcome was a change in the reflective total five symptom score (rT5SS). The secondary outcomes were the change in the instantaneous total five symptom score (iT5SS), the reflective individual symptom scores (rhinorrhea, nasal congestion, sneezing, itchy nose, itchy eyes), Rhinoconjunctivitis Quality of Life-36 Questionnaire (RCQ-36) score, peak nasal inspiratory flow (PNIF), and adverse events. RESULTS: Two hundred and sixty-two patients were enrolled. Compared with placebo, Phlai 100 mg improved rT5SS [adjusted mean difference (aMD) -0.62; 95%CI -1.22, -0.03; p = 0.039], rhinorrhea (aMD -0.19; 95%CI -0.37, 0.002; p = 0.048), itchy nose (aMD -0.24; 95%CI -0.43, -0.05; p = 0.011), and itchy eyes (aMD -0.19; 95%CI -0.36, -0.02; p = 0.033) at week 4. Nasal obstruction, sneezing, iT5SS, overall RCQ-36 score, PNIF did not reach statistical significance. Phlai 200 mg did not bring additional benefits compared to 100 mg. Adverse events were similar among groups. CONCLUSIONS: Phlai was safe. At four weeks, there were small improvements in rT5SS, together with the individual symptoms of rhinorrhea, itchy nose, and itchy eyes.