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Neck injuries and pathologies are widespread and cause disability. Clinicians use different tools to measure the cervical spine' mobility to diagnose different disorders. There are many reliable assessment methods for this purpose, but their benefits have not been deeply investigated and compared, as well as their measurement results. This review aims to summarise the advantages, accuracy, and reliability, of measurement tools and devices used in studies or trails related to the neck and cervical spine evaluation, to evidence the use of inertial sensors and compare them, to highlight the best assessment systems and their characteristics. A literature review has been performed in a range of five years, to obtain information about cervical spine evaluation. Studies that met the established inclusion criteria were selected and classified according their pathology studied, objectives and methodologies followed when evaluating the cervical spine functionality. Studies were described chronologically highlighting the tools employed, where the motion capture systems and cervical range of motion devices stood out as the most used and reliable methods. Cervical spine assessment studies employing systems with inertial sensors as an accurate method, is not evidenced in the sample. However, they are widely tested and different studies validate these systems for their clinical area use, obtaining high reliability and repeatability. Thereby, this review argues that inertial sensors have proven to be a portable, and easy to use tool for the evaluation of neck and its related pathologies, with a great accuracy level. [ABSTRACT FROM AUTHOR]

Introduction: Subcutaneous allergen-specific immunotherapy (SCIT) is one of the main cornerstones in the treatment of allergic rhinitis in pediatric patients. It has demonstrated symptoms and quality of life improvement, but it is not exempt from adverse reactions (ADVrs). Nevertheless, there are a few reports that have evaluated their safety. Our objective was to evaluate the ADVr to SCIT in pediatric patients. Methods: We reviewed 786 clinical records with SCIT from 2005 to 2018, comparing the clinical characteristics of patients with ADVrs with SCIT versus a group of a similar number of patients who completed SCIT (control group, CG). The analysis of ADVrs was according to the World Allergy Organization (WAO) 2010 grading system by frequency analysis, survival curve, and log rank. Results: Of 786 patients, 106 (13.4%) presented ADVrs, and the patients with ADVr had sensitivity and immunotherapy with at least 2 allergens versus CG p < 0.001, containing a combination of standardized and nonstandardized allergens (p = 0.003). The ADVrs were in the buildup phase (p < 0.001). The survival curve showed that 50% had some reaction at 12 weeks of SCIT. The most frequent ADVr was grade 1 in 73/106 patients (68.8%) and grade 2 in 33/106 (31.1%). The log-rank analysis between the grades of the WAO grading system showed a statistically significant difference (p = 0.02). Conclusions: The SCIT is safe in pediatric patients. The ADVrs are infrequent, grade 1 being the most reported; however, at >12 weeks, the risk of ADVrs that involve 2 organs systems increases. [ABSTRACT FROM AUTHOR]

Introduction: Aspirin-exacerbated respiratory disease (AERD) is a clinical entity characterized by hypersensitivity to aspirin leading to asthma and chronic rhinosinusitis with nasosinusal polyposis. The pathophysiology of the disease involves disruption at the level of arachidonic acid metabolism. Therefore, genetic association studies have been focused on the genes coding this pathway. As other mechanisms involved in the genesis of the disease were elucidated, the corresponding genes were also explored.Aim: To describe the association reported in the literature between gene polymorphisms involved in the pathophysiology or therapeutic processes of AERD.Results: There is a genetic association between polymorphisms of genes involved in the synthesis of proteins related to arachidonic acid metabolism (LTC4S, ALOX5), antigen presentation (HLA), inflammation (IL5, IL17), and aspirin metabolism (CYP2C19).Conclusions: Genetic association research in AERD has evaluated studies of SNPs in metabolic pathways related to arachidonic acid. Recently, whole genome analysis strategies have allowed the detection of new genetic variants that were previously not considered. Furthermore, these studies have identified SNPs that are associated with inflammatory processes, which could serve as diagnostic markers or predictors of the therapeutic response. [ABSTRACT FROM AUTHOR]

Aspirin exacerbated respiratory disease (AERD) is characterized by chronic hyperplastic rhinosinusitis, nasal polyposis, asthma, and aspirin sensitivity. The mechanisms which produce these manifestations of intolerance are not fully defined, current research focuses on cyclooxygenase 1 (COX-1) inhibition, metabolism of arachidonic acid, and the COX pathway to the lipoxygenase (LO) route, inducing increased synthesis of leukotrienes (LT). The biological plausibility of this model has led to the search for polymorphisms in genes responsible for proinflammatory cytokines synthesis, such as IL1B and IL8. We performed a genetic association study between IL8-251 (rs4073) and IL1B-511 (rs16944) polymorphisms in AERD, aspirin-tolerant asthma (ATA), and healthy control subjects. Using allelic discrimination by real-time PCR, we found statistically nonsignificant associations between AERD, ATA, and healthy control subjects for the GG and GA genotypes of IL1B (rs16944). Interestingly, the AA genotype showed an increased frequency in the AERD patients versus the ATA group (GF = 0.19 versus 0.07, p = 0.018, OR2.98, and 95% CI 1.17- 7.82). This is the first observation that IL1B polymorphisms are involved in AERD. Thus, future studies must investigate whether interleukin-1β is released in the airways of AERD patients and whether it relates to genetic polymorphisms in the IL1B gene. [ABSTRACT FROM AUTHOR]

Allergen immunotherapy (AIT) is the sole disease-modifying treatment for allergic rhinitis; it prevents rhinitis from progressing to asthma and lowers medication use. AIT against mites, insect venom, and certain kinds of pollen is effective. The mechanism of action of AIT is based on inducing immunological tolerance characterized by increased IL-10, TGF-β, and IgG4 levels and Treg cell counts. However, AIT requires prolonged schemes of administration and is sometimes associated with adverse reactions. Over the last decade, novel forms of AIT have been developed, focused on better allergen identification, structural modifications to preserve epitopes for B or T cells, post-traductional alteration through chemical processes, and the addition of adjuvants. These modified allergens induce clinical-immunological effects similar to those mentioned above, increasing the tolerance to other related allergens but with fewer side effects. Clinical studies have shown that molecular AIT is efficient in treating grass and birch allergies. This article reviews the possibility of a new AIT to improve the treatment of allergic illness. [ABSTRACT FROM AUTHOR]

The present study examines the potential of using a semi-active controllable damper, whose damping coefficient can be modulated in real time, for tonal vibration isolation applications. A frequency-domain control algorithm is developed for determining the damping coefficient variation (at twice the disturbance frequency) that minimizes the force transmitted to the support at the disturbance frequency. The effectiveness of open-loop, closed-loop, and adaptive controllers in rejecting the transmitted disturbances are evaluated. The results of the study indicate that when limits in damping coefficient variation are considered, the support force could be reduced by about an additional 30%, beyond the levels due to the passive isolation characteristics (no cyclic damping modulation). When the disturbance phase changes during operation, the effectiveness of the open-loop controller is rapidly degraded. While the closed-loop controller (with inputs based on current levels of force transmitted to the support) performed better, there was still some degradation in performance, and transmitted support forces were not reduced to levels prior to the change in disturbance phase. The results show that for the semi-active system to retain its effectiveness in rejecting disturbances, a closed-loop, adaptive controller (with on-line system identification) is required; even when there is only a change in disturbance, and no change in basic system properties. An explanation for this phenomenon, related to the bi-linear nature of the semi-active system, is provided. Cyclic modulations in the damping coefficient were more effective in reducing the transmitted forces at the disturbance frequency than simply reducing the baseline damping coefficient (to improve the passive isolation characteristics). [Copyright &y& Elsevier]

This paper examines the effectiveness of pseudoelastic shape memory alloy (SMA) wires for passive damping of flexural vibrations of a clamped–free beam with a tip mass. A finite-element model of the system is developed and validated with experimental results. The SMA behavior is modelled using amplitude-dependent complex modulus. Numerical simulations indicate that the damping introduced by the SMA wires will increase for higher excitation-force amplitudes that produce higher strain levels in the SMA wires. Increasing the wire cross-section area provides more damping at low force-excitation amplitudes, but reduced damping at higher amplitudes. The angle between the beam and the SMA wires is an influential parameter, and a value in the 10–20° range was found to introduce maximum damping. The underlying physical mechanisms are examined in detail. System damping depends only mildly on the SMA wire length, and is unaffected by the tip mass. [Copyright &y& Elsevier]