Telemedicine with special focus on allergic diseases and asthma-Status 2022: An EAACI position paper.

Efficacious, effective and efficient communication between healthcare professionals (HCP) and patients is essential to achieve a successful therapeutic alliance. Telemedicine (TM) has been used for decades but during the COVID-19 pandemic its use has become widespread. This position paper aims to describe the terminology and most important forms of TM among HCP and patients and review the existing studies on the uses of TM for asthma and allergy. Besides, the advantages and risks of TM are discussed, concluding that TM application reduces costs and time for both, HCP and patients, but cannot completely replace face-to-face visits for physical examinations and certain tests that are critical in asthma and allergy. From an ethical point of view, it is important to identify those involved in the TM process, ensure confidentiality and use communication channels that fully guarantee the security of the information. Unmet needs and directions for the future regarding implementation, data protection, privacy regulations, methodology and efficacy are described.

Thymic Stromal Lymphopoietin (TSLP), Its Isoforms and the Interplay with the Epithelium in Allergy and Asthma.

Thymic stromal lymphopoietin (TSLP) is a pleiotropic cytokine that has emerged as a critical player in the development and progression of allergy and asthma. It is primarily produced by epithelial cells and functions as a potent immune system activator. TSLP acts through interaction with its receptor complex, composed of the TSLP receptor (TSLPR) and interleukin-7 receptor alpha chain (IL-7Rα), activating downstream complex signalling pathways. The TSLP major isoform, known as long-form TSLP (lfTSLP), is upregulated in the airway epithelium of patients with allergic diseases. More research is warranted to explore the precise mechanisms by which short-form TSLP (sfTSLP) regulates immune responses. Understanding the dynamic interplay between TSLP and the dysfunctional epithelium provides insights into the mechanisms underlying allergy and asthma pathogenesis. Targeting TSLP represents an important therapeutic strategy, as it may upstream disrupt the inflammatory cascade and alleviate symptoms associated with allergic inflammation.

Bradykinin Metabolism and Drug-Induced Angioedema.

Bradykinin (BK) metabolism and its receptors play a central role in drug-induced angioedema (AE) without urticaria through increased vascular permeability. Many cardiovascular and diabetic drugs may cause BK-mediated AE. Angiotensin-converting enzyme inhibitors (ACEIs) and neprilysin inhibitors impair BK catabolism. Dipeptidyl peptidase-IV (DPP-IV) inhibitors reduce the breakdown of BK and substance P (SP). Moreover, angiotensin receptor blockers, thrombolytic agents, and statins may also induce BK-mediated AE. Understanding pathophysiological mechanisms is crucial for preventing and treating drug-induced AE.

UWB Sensing for UAV and Human Comparative Movement Characterization.

Nowadays, unmanned aerial vehicles/drones are involved in a continuously growing number of security incidents. Therefore, the research interest in drone versus human movement detection and characterization is justified by the fact that such devices represent a potential threat for indoor/office intrusion, while normally, a human presence is allowed after passing several security points. Our paper comparatively characterizes the movement of a drone and a human in an indoor environment. The movement map was obtained using advanced signal processing methods such as wavelet transform and the phase diagram concept, and applied to the signal acquired from UWB sensors.

The Development of an Energy Efficient Temperature Controller for Residential Use and Its Generalization Based on LSTM.

Thermostats operate alongside intelligent home automation systems for ensuring both the comfort of the occupants as well as the responsible use of energy. The effectiveness of such solutions relies on the ability of the adopted control methodology to respond to changes in the surrounding environment. In this regard, process disturbances such as severe wind or fluctuating ambient temperatures must be taken into account. The present paper proposes a new approach for estimating the heat transfer of residential buildings by employing a lumped parameter thermal analysis model. Various control strategies are adopted and tuned into a virtual environment. The knowledge gained is generalized by means of a long short-term memory (LSTM) neural network. Laboratory scale experiments are provided to prove the given concepts. The results achieved highlight the efficiency of the implemented temperature controller in terms of overshoot and energy consumption.

A Thermo-Mechanical Stress Based Fatigue Life Evaluation of a Mine Hoist Drum Brake System Using COMSOL Multiphysics.

In this study, the fatigue usage factors for Findley and Matake stress-based criteria were determined in the case of an MK5×2 mine hoist drum brake system subjected to cyclic maneuver braking. The study was conducted for this type of brake system, because the majority of mine hoists in Romanian mines are equipped with this brake type, being in operation for several decades. A geometric model of the brake was built using SolidWorks and imported in COMSOL Multiphysics to perform thermo-mechanical simulations. Based on the deformations and von Mises stresses determined by the thermomechanical simulation and, considering the calculated endurance limits of the brake system materials, Matake and Findley fatigue life evaluation simulations from COMSOL's fatigue module were conducted. The results show that the highest fatigue is expected on the drum lining surface towards the exit point from under the brake shoe in both cases, and the values of the usage factor of 0.307 (Findley) and 0.401 (Matake) are both under the critical value 1, meaning that the stress limit has not been exceeded for the brake system components and, thus, failure is not expected. Simulations were conducted considering an estimated 1.06 × 105 cycles during one year, more than both the usual service/replacement interval of the friction components of the brake, and the period of mandatory technical inspections imposed by regulations.

Allergic Contact Cell-Mediated Hypersensitivity in Psoriasis: A Narrative Minireview.

The dysfunctionality of the protective skin barrier in psoriasis allows easier cutaneous penetration of various contact haptens; thus, such patients can develop allergic contact hypersensitivity as a comorbidity. Both skin conditions involve T-cell-mediated mechanisms. Dermatologists and allergists should consider assessing allergic contact cell-mediated hypersensitivity in selected psoriasis patients, especially those with palmoplantar psoriasis and who are refractory to topical treatments, and in patients with psoriasis, with or without arthritis, treated with biologics that present skin lesions clinically suggestive of contact dermatitis.

Comparative Analysis of Mine Shaft Hoisting Systems' Brake Temperature Using Finite Element Analysis (FEA).

This paper studies both the thermal and mechanical behavior of brake system models in the case of the emergency braking of a mine hoist model. Using a step-by-step approach inspired by studies conducted on small brake systems with high rotation speeds specific to road and rail vehicles, a comparative analysis using a computer simulation was performed for the two types of brakes of a mine hoist system. A Solidworks model was built for two configurations: the drum-and-shoe and the disc-and-pads, and it was imported to COMSOL Multiphysics, where the material properties and simulation parameters were defined. Simulations were performed for each configuration, first using a Heat transfer module in the solids to investigate the frictional heat. The results showed the locations of the hot points on the disc and on the drum, with the surface temperature reaching 97 °C on the disc and 115 to 159 °C on the drum. Next, simulations using a Structural Mechanics module were run to obtain the stress and deformation induced by the heat generated during braking. The von Mises stress of the drum-and-shoe brake occurred on the external surface of the drum and had a value of 2 × 108 N/m2. For the disc-and-pad brake, the stress occurred towards the edges of the brake pad contact and was 4 × 108 N/m2. Both values were under the yield stress of the passive brake element material. Regarding the deformations, for the drum-and-shoe brake, it appeared towards the outer boundary of the drum, being 0.45 mm, and for the disc-and-pad brake, it was situated at the external edge of the disc, being 0.25 mm. COMSOL Multiphysics allowed the evaluation of the thermo-mechanical behavior using noninvasive techniques since actual emergency braking testing on a working mine hoisting installation is not possible because of safety and logistic concerns.

Prediction of Material Failure Time for a Bucket Wheel Excavator Boom Using Computer Simulation.

Breakdown of stackers and excavators in opencast mines is possible because of operating, manufacturing and structural causes, and it produces high financial losses. These can be prevented by using various measures, including analyses and strength tests, with computerized modeling and simulation using FEA or other techniques being implemented in the recent years. In this paper a fatigue study is conducted on the boom of a BWE. Based on a computer model of the boom previously developed in SOLIDWORKS by our author team, first the modal analysis is conducted for three positions of the boom by studying the frequency response during the excavation process. This is followed by the time response determination corresponding to the maximum displacement frequency, in order to assess the stress during the excavation process, which causes the material fatigue in the boom structure. It was found that the maximum displacements appear when the BWE boom operates in a horizontal position. The aim was to estimate the period of time to failure in order to prevent unwanted accidents, and to develop a method that is applicable to any surface mining or industrial machine with similar structure.

Comprehensive Overview of Vaccination during Pregnancy in Europe.

Vaccinations during pregnancy can protect the mother from several infections, thus blocking vertical transmission. Furthermore, through passive antibody transfer, the newborn can be protected against some infections in the first months of life until their own vaccination regimen is initiated and completed at the appropriate age. Pregnancy can be considered a high-risk condition that increases vulnerability to infectious diseases with potentially unfavorable evolution. We present the current knowledge on vaccination during pregnancy in Europe as a useful information source for different health workers involved in prenatal care. Many European countries implement vaccination policies specifically designed for pregnant women, but there is great heterogeneity among programs. Recommendations on vaccination during pregnancy must be based on current high-quality scientific data. The decisions must be made for each individual case, depending on the associated conditions or special circumstances, with a concomitant assessment of the potential benefits and risks to both the pregnant patient and the fetus. Many vaccines are well-tolerated in pregnant women, with no clinically meaningful injection site reactions, systemic symptoms, or vaccine-related serious adverse events.

State-of-the-Art on Biomarkers for Anaphylaxis in Obstetrics.

Anaphylaxis is an unpredictable systemic hypersensitivity reaction and constitutes a high risk of maternal and fetal morbidity and mortality when occurring during pregnancy. Currently, the acute management of anaphylaxis is based on clinical parameters. A total serum tryptase is only used to support an accurate diagnosis. There is a need to detect other biomarkers to further assess high-risk patients in obstetrics. Our objective is to present biomarkers in this complex interdisciplinary approach beyond obstetrician and anaesthetic management. Candidate biomarkers derive either from mediators involved in immunopathogenesis or upcoming molecules from systems biology and proteomics. Serum tryptase is determined by singleplex immunoassay method and is important in the evaluation of anaphylactic mast cell degranulation but also in the assessment of other risk factors for anaphylaxis such as systemic mastocytosis. Another category of biomarkers investigates the IgE-mediated sensitization to triggers potentially involved in the etiology of anaphylaxis in pregnant women, using singleplex or multiplex immunoassays. These in vitro tests with natural extracts from foods, venoms, latex or drugs, as well as with molecular allergen components, are useful because in vivo allergy tests cannot be performed on pregnant women in such a major medical emergency due to their additional potential risk of anaphylaxis.

The applications of eHealth technologies in the management of asthma and allergic diseases.

Portable devices, such as smartphones and mobile Internet access have become ubiquitous in the last decades. The term 'eHealth' stands for electronic health. The tools included in the eHealth concept utilize phones, computers and the Internet and related applications to improve the health care industry. Implementation of eHealth technologies has been documented for the management of different chronic diseases, including asthma and allergic conditions. Clinicians and patients have gained opportunity to communicate in new ways, which could be used cost-effectively to improve disease control and quality of life of those affected. Additionally, these innovations bring new opportunities to academic researchers. For example, eHealth has allowed researchers to compile data points that were previously unavailable or difficult to access, and analyse them using novel tools, collectively described as 'big data'. The role of eHealth become more important since early 2020, due to the physical distancing rules and the restrictions on mobility that have been applied worldwide as a response to the coronavirus disease 2019 pandemic. In this review, we summarize the most recent developments in various eHealth platforms and their relevance to the speciality of allergy and immunology, from the point of view of three major stakeholders: clinicians, patients and researchers.

Molecular diagnosis in cat allergy.

Domestic cats represent one of the most common sources of indoor allergens. All over the world, many households own cats, whose allergens are persistent and widespread. Cat allergy itself is frequent, and its symptoms vary from rhinoconjunctivitis to life-threatening asthma. In vitro diagnosis using precision medicine allergy immunoassays is important because natural cat dander extracts may differ in quality and quantity of some of the individual allergen components and other molecules. In the component-resolved diagnosis of cat allergy, singleplex and multiplex specific immunoglobulin (Ig) E assays include use of the cat-specific major allergen, secretoglobin Fel d 1 (as a species-specific molecule), other allergen components (such as lipocalins Fel d 4, cross-reacting with other animal similar molecules, and Fel d 7, present in small quantities in natural extracts), and serum albumin Fel d 2 (related to the cat-pork syndrome). IgA Fel d 5 and IgM Fel d 6 are not available as allergen components in the current commercial IgE immunoassays, but they may impair the in vitro diagnostic evaluation of cat allergy because galactose-α1,3-galactose is an IgE-binding epitope of these native feline allergens. The benefits of molecular-based cat allergy diagnosis are continually evaluated, as the role of recombinant allergen components already known is detailed and new other molecules of interest may be discovered in the future.

A New Method of Secure Authentication Based on Electromagnetic Signatures of Chipless RFID Tags and Machine Learning Approaches.

In this study, we present the implementation of a neural network model capable of classifying radio frequency identification (RFID) tags based on their electromagnetic (EM) signature for authentication applications. One important application of the chipless RFID addresses the counterfeiting threat for manufacturers. The goal is to design and implement chipless RFID tags that possess a unique and unclonable fingerprint to authenticate objects. As EM characteristics are employed, these fingerprints cannot be easily spoofed. A set of 18 tags operating in V band (65-72 GHz) was designed and measured. V band is more sensitive to dimensional variations compared to other applications at lower frequencies, thus it is suitable to highlight the differences between the EM signatures. Machine learning (ML) approaches are used to characterize and classify the 18 EM responses in order to validate the authentication method. The proposed supervised method reached a maximum recognition rate of 100%, surpassing in terms of accuracy most of RFID fingerprinting related work. To determine the best network configuration, we used a random search algorithm. Further tuning was conducted by comparing the results of different learning algorithms in terms of accuracy and loss.

New Approach of UAV Movement Detection and Characterization Using Advanced Signal Processing Methods Based on UWB Sensing.

In the last years, the commercial drone/unmanned aerial vehicles market has grown due to their technological performances (provided by the multiple onboard available sensors), low price, and ease of use. Being very attractive for an increasing number of applications, their presence represents a major issue for public or classified areas with a special status, because of the rising number of incidents. Our paper proposes a new approach for the drone movement detection and characterization based on the ultra-wide band (UWB) sensing system and advanced signal processing methods. This approach characterizes the movement of the drone using classical methods such as correlation, envelope detection, time-scale analysis, but also a new method, the recurrence plot analysis. The obtained results are compared in terms of movement map accuracy and required computation time in order to offer a future starting point for the drone intrusion detection.

Tabanidae insect (horsefly and deerfly) allergy in humans: A review of the literature.

Allergy to insects of the family Tabanidae (order Diptera), commonly called horseflies or deerflies, is anecdotally common, although the published literature is limited to case reports and small case series. This review summarizes the available literature, in which there is enormous variability in clinical detail, identification of species or even genus, and means and thoroughness of assessment of sensitization. The clinical utility of in vivo and in vitro assays remains unclear. Investigation and management of patients reporting anaphylaxis to suspected bites must therefore be pragmatic, by considering other insects (eg Hymenoptera), provision of a written action plan and self-injectable adrenaline if appropriate, and advice on avoidance.

Precision medicine allergy immunoassay methods for assessing immunoglobulin E sensitization to aeroallergen molecules.

Molecular-based allergy diagnosis for the in vitro assessment of a patient immunoglobulin E (IgE) sensitization profile at the molecular level uses allergen molecules (also referred to as allergen components), which may be well-defined, highly purified, natural allergen components or recombinant allergens. Modern immunoassay methods used for the detection of specific IgE against aeroallergen components are either singleplex (such as the fluorescence enzyme immunoassay with capsulated cellulose polymer solid-phase coupled allergens, the enzyme-enhanced chemiluminescence immunoassay and the reversed enzyme allergosorbent test, with liquid-phase allergens), multiparameter (such as the line blot immunoassay for defined partial allergen diagnostics with allergen components coating membrane strips) or multiplex (such as the microarray-based immunoassay on immuno solid-phase allergen chip, and the two new multiplex nanotechnology-based immunoassays: the patient-friendly allergen nano-bead array, and the macroarray nanotechnology-based immunoassay used as a molecular allergy explorer). The precision medicine diagnostic work-up may be organized as an integrated "U-shape" approach, with a "top-down" approach (from symptoms to molecules) and a "bottom-up" approach (from molecules to clinical implications), as needed in selected patients. The comprehensive and accurate IgE sensitization molecular profiling, with identification of the relevant allergens, is indicated within the framework of a detailed patient's clinical history to distinguish genuine IgE sensitization from sensitization due to cross-reactivity (especially in polysensitized patients), to assess unclear symptoms and unsatisfactory response to treatment, to reveal unexpected sensitizations, and to improve assessment of severity and risk aspects in some patients. Practical approaches, such as anamnesis molecular thinking, laboratory molecular thinking and postmolecular anamnesis, are sometimes applied. The component-resolved diagnosis of the specific IgE repertoire has a key impact on optimal decisions making for prophylactic and specific immunotherapeutic strategies tailored for the individual patient.

The first trimester combined test for aneuploidies - a single center experience.

PURPOSE: We present the results of the systematic application of the first trimester combined test for aneuploidies, in a Romanian center. METHODS: Since October 2009, in Filantropia Hospital in Bucharest, we have systematically been using the FMF (Fetal Medicine Foundation) combined first trimester test to screen for common aneuploidies at 11 to 13 + 6 weeks of gestation. We assessed the crown to rump length (CRL), nuchal translucency, fetal heart rate as well as PAPP-A, and free ß-hCG in maternal serum. We evaluated additional first trimester ultrasound markers in most of the cases. The individual risk for aneuploidies was calculated using the FMF algorithm. RESULTS: Pregnancy outcome is known for 6030 euploid fetuses and 42 aneuploid fetuses from our screening population. The detection rate for trisomy 21 of the combined test was 87.5% for a screen positive rate of 1.96%. All of the trisomy 18 and trisomy 13 cases were detected prenatally. Some of the trisomy 18 cases proved not to be symptomatic in the first trimester. CONCLUSIONS: Our results are similar to those of the main studies on the FMF method of first trimester screening for aneuploidies. Our numbers are small because of limited availability of the very specialized resources involved.