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Since 1995, the Cooperation Afloat Readiness and Training (CARAT) exercise has been the most important joint naval exercise between the U.S. and Indonesia. CARAT aims to strengthen relationships and interoperability among navies. Currently, CARAT Indonesia is less developed compared to the annual U.S.-Indonesia army exercise, Garuda Shield. This thesis examines the changes in the U.S.-Indonesia defense cooperation and the changes in CARAT from 2005 to 2021 to answer the following questions: How much has CARAT changed over time? Has CARAT fallen behind on U.S.-Indonesian commitments? By comparing the size, complexity, duration, and location of each year’s exercise, this thesis finds that despite both countries’ defense cooperation improvements after 2005, CARAT has not steadily improved. This thesis argues that when both countries have shared interests at the national level, CARAT has improved its size and complexity. Moreover, the limitations of readiness and capabilities of both navies hinder the advancement of CARAT. Consequently, while CARAT has been effective in sustaining bilateral ties, it has turned into a symbolic routine with a lack of significant improvements in naval interoperability improvements. This thesis offers several recommendations to improve the CARAT exercise: the U.S. Navy should continue to use high-end training equipment, both navies should increase the number of participating units, and CARAT should be transformed into a multilateral exercise. Outstanding Thesis Kapten, Indonesian Navy Approved for public release. Distribution is unlimited.

Patients with asthma often suffer from concomitant allergic rhinitis (AR). The Control of Allergic Rhinitis and Asthma Test (CARAT) is a validated tool to assess asthma and rhinitis multimorbidity. Turkish language validity and reliability of CARAT and its compatibility with other scales were evaluated in the study.Patients with asthma and concomitant AR were tested with CARAT. Pulmonary function tests, Asthma Control Test (ACT), Assessment Tool for Asthma (ATA) questionnaire and visual analogue scale (VAS) were also used at the same day. With the VAS, patients determined their rhinitis symptom levels, and asthma specialist determined the rhinitis and asthma control levels separately. These questionnaires were repeated in 14 ± 2 days.Three quarters (77%) of the 100 patients were female (mean age 46.5 years). The mean CARAT score was 19.6 ± 7.2. The Cronbach's alpha coefficient of the Turkish version of the CARAT scale was 0.83, showing a high level of internal consistency. Test-retest reliability coefficient was determined as r = 0.98 (p 0.001). The Kaiser-Meyer-Olkin coefficient of the CARAT scale was 0.79. The p value of the Bartlett test was0.001. ACT, ATA and VAS expert scales were correlated with CARAT total score (0.577 ≤ r ≤ 0.871). The CARAT scale did not show statistically significant difference according to gender, education, working status, smoking status, presence of polyps and multiple allergen sensitivity (p 0.05).The Turkish version of the CARAT is a reliable alternative tool for physicians in determining disease control in adult patients with asthma and AR.

Study objective To evaluate the impact of intranasal corticosteroids on quality of life (QoL) in AR patients compared to control groups. Patients and methods In a prospective study, we enrolled AR subjects (18–45 years old) and healthy controls at Amiralmomenin Hospital, Guilan University of Medical Sciences, in 2014–2015. After signing informed consent, participants completed the Pittsburgh Sleep Quality Index (PSQI) and the Multidimensional Fatigue Inventory (MFI), as well as the Female Sexual Function Index (FSFI) or the International Index of Erectile Function (IIEF) questionnaires. Patients were then treated with intranasal corticosteroids. After 6 weeks, the outcomes were re-evaluated. Statistical analysis of the extracted data was conducted using Stata 13.0. Results A total of 96 subjects (48 males and 48 females) and 96 controls participated in this study. We measured optimal control of allergic rhinitis using the CARAT (U) questionnaire. Improvement in SNOT-22 score in men and women was 14.0 and 5.2 points, respectively. Men with AR had a significantly worse sexual function score. After treatment, erectile dysfunction improved significantly. However, there was no significant difference in overall FSFI score at baseline between women with AR and controls. At baseline, 62.5% of men and 54.2% of women in the AR group reported pathologic fatigue, which with treatment fell to 22.9% and 35.4%, respectively. Conclusion We noted detrimental effects of allergic rhinitis on various aspects of QoL in men and women. Intranasal corticosteroids diminished these negative effects of allergic rhinitis.

Mangrove ecosystem valuation can be used as a reference for decision making for management and conservation of mangrove ecosystems in a sustainable manner. The range of activities and interests conducted in coastal areas is not expected to negatively impact the ecology, economic and social. Carat Cape mangrove areas provide enormous benefits to the surrounding community, especially Sungsang IV village. From the results of the study illustrate the provosioning ecosystem service utilized community Sungsang IV village consists of materials construction (timber and nypa leaves), a source of livelihood or subsistance (nypa fruit, fish, shrimp, crab, and scallops). The total value of provosioning ecosystem services mangrove Carat Cape utilized by the Sungsang IV village Rp. Rp. 1.715.590.000, - per year dominated by income generated by marine species of fish which is the main livelihood of the fishermen Sungsang IV village reached Rp. 1.302.600.000,- per year.

Background: Subcutaneous immunotherapy with aeroallergen (SCITA) was stopped in some departments during the lock-down period due to the COVID-19 pandemic. Objectives: To evaluate the impact of SCITA interruption on symptoms, the need for control medication, the quality of life, and the expectations and degree of safety / fear of patients on returning to the hospi-tal. Methods: Self-completion of an anonymous survey for patients over 12 years in the first 5 weeks of SCITA restart. CARAT was used as an instrument to assess rhinitis and asthma control. Results: 77 patients (90% adults, 68% women) were included, all with rhinitis and 40% with asthma. The average time interval between the last administration and the restart of SCITA was 13 ± 2.48 weeks. Seven percent of patients were seen in an emergency / unscheduled appointment due to the exacerbation of respiratory symptoms and only 1 had COVID-19. CARAT-Total scores showed control of rhinitis and asthma, respectively, in 35% and 66% patients. The proportion of uncontrolled patients rised with the increase in the SCITA interruption period (IP). The majority (> 90%) of patients reported no significant impact on their quality of life and maintained the usual control medication (48%), expressed concern about losing the benefits of SCITA with its interruption (62%) and reported feeling safer in the vaccination offices compared to the hospital building or waiting room. Conclusions: An increase in the frequency of uncontrolled patients with an increase in IP was observed. For most patients, the IP did not have a significant impact on quality of life. The frequency of patients who needed to be observed in an emergency / unscheduled appointment was low and only 1 reported having had COVID-19. The perception of safety in the vaccination room is higher than in the hospital’s common spaces. © 2021 Sociedade Portuguesa de Alergologia e Imunologia Clinica. Published by Publicacoes Ciencia & Vida.

Background: Poor medication adherence is a major challenge in asthma and objective assessment of inhaler adherence is needed. InspirerMundi app aims to monitor inhaler adherence while turning it into a positive experience through gamification and social support.Objective: We assessed the medium-term feasibility of the InspirerMundi app to monitor inhaler adherence in real-world patients with persistent asthma (treated with daily inhaled medication). In addition, we attempted to identify the characteristics of the patients related to higher app use.Methods: Two real-world multicenter observational studies, with one initial face-to-face visit and a 4-month telephone interview, were conducted in 29 secondary care centers from Portugal. During an initial face-to-face visit, patients were invited to use the app daily to register their asthma medication intakes. A scheduled intake was considered taken when patients took a photo of the medication (inhaler, blister, or others) using the image-based medication detection tool. Medication adherence was calculated as the number of doses taken as a percentage of the number scheduled. Interacting with the app ≥30 days was used as the cut-off for higher app use.Results: A total of 114 patients {median 20 [percentile 25 to percentile 75 (P25–P75) 16–36] years, 62% adults} were invited, 107 (94%) installed the app and 83 (73%) completed the 4-month interview. Patients interacted with the app for a median of 18 [3–45] days, translated on a median use rate of 15 [3–38]%. Median inhaler adherence assessed through the app was 34 [4–73]% when considering all scheduled inhalations for the study period. Inhaler adherence assessed was not significantly correlated with self-reported estimates. Median adherence for oral and other medication was 41 [6–83]% and 43 [3–73]%, respectively. Patients with higher app use were slightly older (p = 0.012), more frequently taking medication for other health conditions (p = 0.040), and more frequently prescribed long-acting muscarinic antagonists (LAMA, p = 0.024). After 4 months, Control of Allergic Rhinitis and Asthma Test (CARAT) scores improved (p < 0.001), but no differences between patients interacting with the app for 30 days or less were seen.Conclusions: The InspirerMundi app was feasible to monitor inhaler adherence in patients with persistent asthma. The persistent use of this mHealth technology varies widely. A better understanding of characteristics related to higher app use is still needed before effectiveness studies are undertaken.

Antecedentes: La inmunoterapia específica es un tratamiento orientado a modificar el curso de la enfermedad alérgica y con la que se han logrado importantes cambios inmunológicos y clínicos.Objetivo: Evaluar eficacia y seguridad de la inmunoterapia subcutánea en pacientes con diagnóstico de alergia respiratoria en el Hospital Universitario de Puebla, México.Métodos: Estudio longitudinal, analítico, cuasiexperimental. Se incluyeron pacientes de cuatro a 65 años con diagnóstico de asma o rinitis alérgica, con sensibilización a aeroalérgenos, que iniciaron tratamiento con inmunoterapia. Para la valoración de la eficacia se utilizó el cuestionario Control of Allergic Rhinitis and Asthma Test (CARAT). La seguridad se evaluó mediante el cuestionario de reacciones adversas de Portnoy.Resultados: Se incluyeron 59 pacientes, 72.9 % fueron mujeres; 23.7 % con diagnóstico de rinitis alérgica y asma y 76.3 % con diagnóstico de rinitis alérgica. La comparación de promedios del cuestionario CARAT al inicio del tratamiento y a los cuatro meses de seguimiento mostró evolución favorable estadísticamente significativa. Se encontró una incidencia de reacciones adversas locales de 9.03 %; no se reportaron reacciones adversas sistémicas.Conclusiones: El esquema de inmunoterapia subcutánea evaluado logra disminuir significativamente los síntomas del asma y la rinitis alérgica, con un conveniente perfil de seguridad.

Research on “The Analysis of Communication Among Fans of Seventeen as a Cyberfandom on Twitter” comes from the observation of the fan phenomenon of a K-Pop group Seventeen on Twitter. Seventeen fans, known as Carat, use Twitter as a medium to communicate and share information between fans. The theory that used in this article are CMC theory, new media theory and cyber community theory. This article used a method of netnography or online ethnography conducted with interviews and online observation of the activitiy of Seventeen fans Twitter account. The analysis technique used in this article is qualitative analysis technique by using data reduction, data presentation and data conclusion. The results of this paper indicates that Seventeen fans exchange information and communicate with each other using Twitter. Carat uses the tweets, reply, quote tweet, retweet and direct message to communicate and exchange information on Twitter.

Background: Allergen-specific immunotherapy is an important therapeutic modality for the management of allergic rhinitis and allergic asthma. Objective: To assess the effectiveness and safety of allergen-specific subcutaneous immunotherapy in patients with respiratory allergies at the University Hospital of Puebla after twelve months of treatment. Methods: A longitudinal, sequential, analytic, quasi-experimental, prolective study. The study was carried out for twelve months with patients of both sexes, aged four to sixty-five years, diagnosed with asthma and/or rhinitis, and with sensitization to aeroallergens. The CARAT and Portnoy questionnaires were collected every two months in order to assess the effectiveness and safety respectively. Results: 47 patients were included: 37 (78.7 %) of them were female. The average age was 29.8 years. 76.6 % of them were diagnosed with allergic rhinitis, and 23.4 % of them were diagnosed with both asthma and allergic rhinitis. The comparison of averages of the initial CARAT questionnaire against the final average by means of a student’s t-test showed a t-value of -8.86 and a p-value of < 0.05. A total frequency of local adverse reactions of 19 % and systemic adverse reactions of 2.1 % was reported after 6 and 12 months of treatment. Conclusions: The assessed scheme of immunotherapy, derived from the Mexican clinical practice guidelines of immunotherapy 2011, is effective with a desirable safety profile.

Purpose: For many children, needle procedures are fearful events that are often painful. The first step in symptom management is to assess the child's pain and fear, and the next step is to use coping strategies to provide symptom relief for children who experience or feel pain and fear during procedures. The Children's Action–Reaction Assessment Tool (CARAT) is built on action–reaction strategies. This study aimed to determine the inter-rater reliability of the CARAT when used during needle procedures with 3- to 7-year-old children. Design and Methods: We used a quantitative approach in which 21 children were observed by two independent observers during needle procedures to evaluate the inter-rater reliability of the CARAT. Data were analysed with descriptive statistics, and the observation scores were calculated with an intraclass correlation coefficient (ICC) test on SPSS for Windows, version 25. Results: The completed CARAT indicated the use of action–reaction strategies. Neither action nor reaction strategies were frequently used. The parents were seldom involved in the procedure. The inter-rater reliability showed a sufficient correlation between the observers. Practice Implications: This study showed promising results for the inter-rater reliability of the CARAT, which can be used to facilitate care for children. The observational tool can be used to assess the use of action–reaction strategies in conjunction with needle procedures in children aged 3–7 years.

Funding: MA reports personal fees from POCI-01-0145-FEDER-029130 mINSPIRERS—mHealth to measure and improve adherence to medication in chronic obstructive respiratory diseases—generalization and evaluation of gamification, peer support and advanced image processing technologies from ERDF (European Regional Development Fund) funded by the COMPETE2020 and by National Funds through FCT (Fundação para a Ciência e a Tecnologia)… Digital anamorphosis is used to define a distorted image of health and care that may be viewed correctly using digital tools and strategies. MASK digital anamorphosis represents the process used by MASK to develop the digital transformation of health and care in rhinitis. It strengthens the ARIA change management strategy in the prevention and management of airway disease. The MASK strategy is based on validated digital tools. Using the MASK digital tool and the CARAT online enhanced clinical framework, solutions for practical steps of digital enhancement of care are proposed. publishersversion published

In the present article, a distinctive methodology to predict the price of diamonds is proposed. To do so, a vast dataset was used encompassing empirical data relative to variables commonly used to assess the commercial value of diamonds. The selected dataset was retrieved from the Kaggle website [1] and includes diamonds’ physical properties along with their respective price. Therefore, a data analysis based on Analysis of Variance (ANOVA) was conducted to study the diamonds’ characteristics that determine their prices. It was found that the weight of the diamond (carat) has an impact on diamonds’ price. For this reason, diamonds’ price per carat was considered as a new dependent variable. Moreover, the variables diamonds’ clarity and the width of the top of the diamond (table) affect the dependent variable. After applying the stepwise regression methods, it was found that the variables related to the width of the largest section of the diamond (Y), and table were the least significant ones. Moreover, both backward and forward selection led to the same result in terms of the predictive model. All the residuals’ assumptions were validated. The adjusted coefficient of determination was \(88.3\%\). Since multicollinearity effects can exist between the independent variables, Principal Components Analysis (PCA) can be used, as future work, to eliminate these effects.

Endovascular treatment modalities for intracranial aneurysms have seen a significant increase in popularity since the initial advent of the Guglielmi detachable coils in the early nineties. 1 The publication of the International Subarachnoid Aneurysm Trial (ISAT) in addition to significant improvement in catheter and coil technology further cemented the endovascular-first approach, specifically for ruptured aneurysms. 2 However, the increase in aneurysm coiling also led to a heightened awareness of its shortcomings, namely a significantly greater rate of recurrence and need for retreatment. 3 The Cerebral Aneurysm Rerupture After Treatment (CARAT) study revealed that even though the rate of rerupture is low with both microsurgical and endovascular treatment modalities, the rate of rerupture is greater with incomplete versus complete aneurysm occlusion. 4 Previously coiled aneurysms can be challenging to treat. While in some cases further endovascular therapies can be performed, microsurgical clipping remains a compelling alternative, specifically for small recurrent or residual ruptured aneurysms. However, microsurgical clipping of previously coiled aneurysms presents its own set of unique challenges. The presence of coils in the aneurysms increases the complexity of clip reconstruction. In addition, coil extrusion, which is often misdiagnosed as coil compaction on diagnostic imaging and therefore underreported, can further increase the risk of microsurgical dissection. In this operative video, we present a case of a postcoiling, residual or recurrent, ruptured anterior communicating artery aneurysm successfully treated through microsurgical clipping. The patient consented to the procedure as shown in this operative video and gave informed written consent for use of her images in publication.

Objectives: Otorhinolaryngological conditions seem to be more frequent in children with Eosinophilic Esophagitis (EoE), including allergic rhinitis, but, to our best knowledge, there are no studies showing if the frequency of these conditions is superior in children with EoE. The aim of this study is to determine whether otorhinolaryngological manifestations are more prevalent in these children. Design: Case control study Setting: Tertiary referral Paediatric Hospital of Lisbon, Portugal. Participants: Children with EoE (cases) and children diagnosed with allergic rhinitis but not diagnosed with EoE or other eosinophilic disorders (controls). Main outcome measures: Complete otorhinolaryngological evaluation of children under an observation protocol with questions about ear, nose and throat symptoms, and previous medical history; physical examination and the CARAT kids questionnaire to evaluate the level of control of children’s rhinitis. Results: This study included 45 children. The study group consisted of 15 children diagnosed with EoE and the control group consisted of 30 cases with allergic rhinitis. Both groups included 6 to 17 years old children. There were no differences concerning gender, age, total CARAT kids score or CARAT kids score for questions for upper and lower respiratory tract (p>0.05). When otorhinolaryngological symptoms were analysed separately there were no statistically significant differences between case and control groups (p>0.05), except for dysphagia (p=0,036) which was more prevalent in the case group. There were no significant differences related to the number of symptoms reported, frequency of asthma, otorhinolaryngological surgeries in the past, drug allergies, and documented hearing loss (p>0.05). There were no significant differences in laryngopharyngeal changes seen as markers for laryngopharyngeal reflux between both groups (p>0.05). Conclusions: Apparently, otorhinolaryngological conditions are not more prevalent in children diagnosed with EoE, but future larger studies are needed to confirm our findings. Yet, Otorhinolaryngologists must be aware of this condition since early referral of children with symptoms related to EoE such as dysphagia and atopy to a Gastroenterology appointment can speed up diagnosis and treatment, potentially reducing long-term sequelae.

Digital anamorphosis is used to define a distorted image of health and care that may be viewed correctly using digital tools and strategies. MASK digital anamorphosis represents the process used by MASK to develop the digital transformation of health and care in rhinitis. It strengthens the ARIA change management strategy in the prevention and management of airway disease. The MASK strategy is based on validated digital tools. Using the MASK digital tool and the CARAT online enhanced clinical framework, solutions for practical steps of digital enhancement of care are proposed.

Unsupervised methods may unveil the potential of the INSPIRERS studies to comprehend the heterogeneous characteristics of asthma. Therefore, we aimed to identify distinct classes of asthma among the participants, using latent class analysis (LCA), and to compare their characteristics across classes. We applied LCA to 308 adults (≥18 years) with persistent asthma (treated with daily inhaled medication) participants in the observational and prospective INSPIRERS studies, conducted in 26 secondary care outpatient clinics from Portugal and Spain. The classifying variables included asthma-related demographics, unscheduled healthcare use, Control of Allergic Rhinitis and Asthma Test (CARAT), and EuroQol 5 dimensions (EQ-5D) questionnaires. A three-class model was identified. Class 1 (21%) and Class 2 (26%) were characterized by highly symptomatic and uncontrolled asthma, with concomitant upper airways symptoms and reporting problems across all EQ-5D dimensions; they differed on high unscheduled healthcare use (Class 1) and early asthma onset (Class 2). Class 3 (53%): early asthma onset, controlled asthma with upper airways symptoms and without problems in EQ-5D dimensions. Compared to other classes, Class 1 had a higher proportion of subjects with FEV1 Three distinct and clinically meaningful unsupervised classes of asthma were identified among participants of the INSPIRERS studies, revealing the studies’ potential to support and enable patient-centered care and further research.

Virtual memory is a critical abstraction in modern computer systems. Its common model, paging, is currently seeing considerable innovation, yet its implementations continue to be co-designs between power-hungry/latency-adding hardware (e.g., TLBs, pagewalk caches, pagewalkers, etc) and software (the OS kernel). We make a case for a new model for virtual memory, compiler- and runtime-based address translation (CARAT), which instead is a co-design between the compiler and the OS kernel. CARAT can operate without any hardware support, although it could also be retrofitted into a traditional paging model, and could leverage simpler hardware support. CARAT uses compile-time transformations and optimizations combined with tightly-coupled runtime/kernel interaction to generate programs that run efficiently in a physical address space, but nonetheless allow the kernel to maintain protection and dynamically manage physical memory similar to what is possible using traditional virtual memory. We argue for the feasibility of CARAT through an empirical study of application characteristics and kernel behavior, as well as through the design, implementation, and performance evaluation of a CARAT prototype. Because our prototype works at the IR level (in particular, via LLVM bitcode), it can be applied to most C and C++ programs with minimal or no restrictions.

Asthma and allergic rhinitis (AR) are frequently associated. The objective of the treatment of asthma and AR should be the control of symptoms and disease progression. Therefore, the combined measurement of disease control is desirable. In this regard, a questionnaire able to together assess asthma and AR control has been validated: the CARAT (Control of Allergic Rhinitis and Asthma Test). A further pediatric version (CARATkids) has been generated. The current real-world study used different disease control measures in children and adolescents with asthma and rhinitis. A total of 138 children and adolescents were recruited at three allergy centers. CARAT, CARATkids, ACT (Asthma Control Test), cACT (children ACT), GINA (Global Initiative for Asthma) disease control classification, VAS (Visual Analog Scale) for asthma and nasal symptoms, and lung function were used in all subjects. There was a predominance of males (67.4%) and asthma was well-controlled (according to GINA classification) in about half the subjects. In children, the median CARAT and cACT values were 5 and 22 respectively. In adolescents, the median CARAT and ACT values were 23 for both tests. There were significant differences between CARAT and ACT (p = 0.035) as well as between CARATkids and cACT (p = 0.0001). However, the tests’ outcomes were different as assessed in different domains. CARAT and CARATkids are disease-control measurements that give additional information to other tests, therefore, these different questionnaires to measure disease control complement each other.

International audience; Background: Nasal irrigations (NI) are increasingly used as an over-the-counter adjunctive treatment for allergic rhinitis (AR), but clinical studies on their effectiveness are limited.Methods: An open-label, controlled, non-randomized, real-life study was conducted to evaluate the effectiveness of NI with a new hypertonic solution as add-on treatment for AR. Children and adolescents with AR were prescribed symptomatic treatment. The active group also received an additional sea-water NI solution supplemented with algae extracts. The primary endpoint was symptom control, assessed by the control of allergic rhinitis and asthma test (CARAT) questionnaires. Moreover, the MASK/Allergy Diary was used to track symptoms and daily medication use that were combined in a novel total symptom/medication score (TSMS).Results: We assessed 76 patients. Overall, there was a significant improvement of CARAT results (median Z-score change of 1.1 in the active/NI group vs. 0.4 in the control group; p = 0.035). Among patients > 12 years old (n = 51), there was a significant improvement in CARAT10 results among participants receiving NI (21.0 to 25.5; p < 0.001), but not in the regular treatment group (21.5 to 24.0; p = 0.100). For children < 12 years old (n = 25), the ΝΙ group had significantly improved symptom control (CARATKids results: 5.0 to 2.0; p = 0.002), in contrast to the control group (4.0 to 2.5; p = 0.057). MASK data on allergic symptoms were comparable between groups. However, the NI group had lower TSMS, more days with < 20% symptoms and fewer days using symptomatic treatment (26.9% vs. 43.5%; p = 0.005).Conclusion: Addition of NI with a sea-water solution to regular treatment improved AR symptom control. CARAT questionnaires and MASK application can be useful outcome tools in real-life studies.

La Grutta, Stefania/0000-0001-8026-0715; Briedis, Vitalis/0000-0002-5106-6638; Yusuf, M Osman/0000-0002-8067-1204; Regateiro, Frederico S/0000-0002-6332-3056; Regateiro, Frederico/0000-0002-6332-3056; Martins, Pedro/0000-0002-4129-133X; de Sousa, Jaime Correia/0000-0001-6459-7908; Cardona, Victoria/0000-0003-2197-9767; Niedoszytko, Marek/0000-0003-1089-1911; Panzner, Petr/0000-0002-1291-450X; van der Kleij, Rianne/0000-0002-8638-4978; Chu, Derek/0000-0001-8269-4496; Pugin, Benoit/0000-0001-7132-9477; O'Hehir, Robyn/0000-0002-3489-7595; Briggs, Andrew/0000-0002-0777-1997; Bedard, Annabelle/0000-0002-7842-8889; Psarros, Fotis/0000-0002-2928-150X; Zuberbier, Torsten/0000-0002-1466-8875 WOS:000581175300001 PubMed ID: 32512619 Digital anamorphosis is used to define a distorted image of health and care that may be viewed correctly using digital tools and strategies. MASK digital anamorphosis represents the process used by MASK to develop the digital transformation of health and care in rhinitis. It strengthens the ARIA change management strategy in the prevention and management of airway disease. The MASK strategy is based on validated digital tools. Using the MASK digital tool and the CARAT online enhanced clinical framework, solutions for practical steps of digital enhancement of care are proposed. EUEuropean Union (EU); Region Occitanie (France); Mylan; GSKGlaxoSmithKline; Meda; NovartisNovartis; Sanofi; Stallergenes; Uriach; ALK MASK funding was obtained from EU grants (SPAL, POLLAR, Sunfrail, Rhinitis and Asthma TWINNING, DHE TWINNING on severe asthma), the Region Occitanie (France), unrestricted educational grants (Meda, Mylan, ALK, GSK, Novartis, Sanofi, Stallergenes and Uriach) and private donations. Euforea provided assistance for the ARIA website and the physician's questionnaire.

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Under China’s Belt and Road (B&R) initiative, Carat Canal, a potential new channel of the Century Maritime Silk Road, will have a great impact on the shipping networks and the evolution of hub ports. A modified gravity prediction model with entropy maximizing principle is developed to calculate the changes in transshipment traffic. Taking account both customer preferences and spatial interaction, numerical experiments show that the opening of the Carat Canal shifts traffic volumes from the Malacca Strait, influences transshipment market shares among hub ports, and diversifies shipping network pattern. This study serves as a reference for hub port development along the Maritime Silk Road.

The overarching goals of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) are to enable European citizens to lead healthy, active and independent lives whilst ageing. The EIP on AHA includes 74 Reference Sites. The aim of this study was to transfer innovation from an app developed by the MACVIA-France EIP on AHA reference site (Allergy Diary) to other reference sites. The phenotypic characteristics of rhinitis and asthma multimorbidity in adults and the elderly will be compared using validated information and communication technology (ICT) tools (i.e. the Allergy Diary and CARAT: Control of Allergic Rhinitis and Asthma Test) in 22 Reference Sites or regions across Europe. This will improve the understanding, assessment of burden, diagnosis and management of rhinitis in the elderly by comparison with an adult population. Specific objectives will be: (i) to assess the percentage of adults and elderly who are able to use the Allergy Diary, (ii) to study the phenotypic characteristics and treatment over a 1-year period of rhinitis and asthma multimorbidity at baseline (cross-sectional study) and (iii) to follow-up using visual analogue scale (VAS). This part of the study may provide some insight into the differences between the elderly and adults in terms of response to treatment and practice. Finally (iv) work productivity will be examined in adults.

INTRODUCTION: Asthma is one of the most prevalent chronic medical conditions to complicate pregnancy. Similarly, active management strategies that prioritise asthma control in this vulnerable population can have a far-reaching impact. AIM: To describe lung function parameters and results of the Control of Allergic Rhinitis and Asthma Test (CARAT) questionnaire in pregnant asthmatics and to analyse correlations between lung function tests and CARAT results. METHODS: All pregnant asthmatics who performed spirometry and CARAT between September 2014 and August 2015 were included. A medical records review was performed and data regarding demographics, sensitisation and medical prescriptions were recorded. Control of asthma and rhinitis was defined by CARAT total score (CARAT (T)) ≥ 24; upper airways (U) control if CARAT (U) > 8; lower airways (L) control if CARAT (L) > 15. RESULTS: Forty-two pregnant asthmatics were included, with a median age (interquartile range)of 32 (27-34) years; all had a previous medical diagnosis of asthma and rhinitis, 76% were atopic, 94% sensitised to dust mites and 43% were polissensitised. More than 80% presented poor control (CARAT (T) < 24) in the first assessment and 15% had a percentage forced expiratory volume in the first second < 80%. There were significant negative correlations between CARAT (L) and CARAT (T) scores and step-up of controller medication, (correlation coefficients = -0.453 and -0.392, respectively). CONCLUSION: The use of tools such as spirometry and validated questionnaires to objectively assess asthma control during pregnancy should be routinely applied to assist in the management of these patients. These data reinforce the importance of close monitoring of pregnant asthmatics to achieve and maintain better disease control. info:eu-repo/semantics/publishedVersion