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Summary: Background: The identification of the primary sensitizing pollen is difficult in Southern European patients with Seasonal Allergic Rhinitis (SAR) if sensitized to various pollen sources with overlapping seasonality. A more precise diagnosis is obtained by IgE assays to allergen molecules, currently available as singleplex or microarrays. Objectives: To test the analytical performance of a multi‐parameter immunoblot molecular "Pollen Test" specifically designed to test IgE antibodies to pollen extracts and molecules clinically relevant in Southern Europe. Methods: Sera were obtained from 101 children and 98 adults with SAR and tested with a customized multiplex immunoblot assay (EUROLINE Southern European Pollen Profile [ESEP]; EUROIMMUN AG, Luebeck, Germany) containing a comprehensive panel of allergen extracts and molecules. ESEP's outcomes were then compared in selected sera (ESEP positive to negative = 2:1) with those of singleplex IgE assays (ImmunoCAP; ThermoFisher Scientific, Uppsala, Sweden). For each of the examined reagents, qualitative (sensitivity, specificity, accuracy), semi‐quantitative (classes) and quantitative (Spearman's rank correlation, Bland‐Altmann plots) comparisons were performed. Results: Compared to ImmunoCAP, cumulative ESEP's sensitivity and specificity were 87% (95% CI 84%‐90%) and 88% (83%‐93%) for extracts and 99% (98%‐100%) and 87% (83%‐91%) for molecules. Cohen's kappa coefficients (κC) ranged for extracts from 0.18 (Pellitory) to 0.50 (Cypress) and for molecules from 0.21 (Ole e 1) to 0.68 (Phl p 7). The quantitative outcomes of the two diagnostic tests were highly correlated, with Spearman's rank correlation coefficients always exceeding 0.80. Bland‐Altmann plots showed a tendency of ESEP to overestimate serum specific IgE levels, when compared to ImmunoCAP. Conclusions and clinical relevance: Sensitivity and specificity of ESEP in testing serum IgE antibodies against pollen allergen extracts and molecules, in Italian patients with SAR, both exceeded 85%. The advantages and limitations of a multiplex customized immunoblot assay, in the routine clinical use of molecular diagnostics in Southern European pollen allergic patients, deserve to be tested. [ABSTRACT FROM AUTHOR]

A new criterion by which to discriminate between patients with moderate allergic rhinitis and patients with severe allergic rhinitis based on the allergic rhinitis and its impact on asthma severity items. For our analysis, we used the (i) cumulative dSS/CSMS/VAS; (ii) average dSS/CSMS/VAS; and (iii) number of "high days", surpassing the arbitrarily chosen thresholds of >=1 for dSS (max. 3), >=2 for CSMS (max. 6) and >=3 for VAS (max. 10). While patients who retrospectively judged their AR symptoms as persistent, indicated to suffer from allergic symptoms during more than 50% of the recorded days (Figure 1, bottom left), those retrospectively assessing their symptoms as intermittent, showed a broader range of data entries indicating symptoms. [Extracted from the article]

Background: Patient‐generated symptom and medication scores are essential for diagnostic and therapeutic decisions in seasonal allergic rhinitis (SAR). Previous studies have shown solid consistencies between different scores at population level in real‐life data and trials. For clinicians, the evaluation of individual data quality over time is essential to decide whether to rely on these data in clinical decision‐making. Objective: To analyze the consistency of different symptom (SS) and symptom medication scores (SMSs) at individual level in two study cohorts with different characteristics and explore individual patient trajectories over time. Methods: Within the pilot phase of the @IT.2020 project on diagnostic synergy of mobile health and molecular IgE assessment in patients with SAR, we analyzed data of 101 children and 93 adults with SAR and instructed them to record their symptoms and medication intake daily via the mobile app AllergyMonitor®. We then assessed the correlation between different SMS and a visual analogue scale (VAS) on the impact of allergy symptoms on daily life at population and individual level. Results: At population level, the Rhinoconjunctivitis total symptom score (RTSS) correlated better with VAS than the combined symptom and medication score (CSMS). At individual level, consistency among RTSS and VAS was highly heterogeneous and unrelated to disease severity or adherence to recording. Similar heterogeneity was observed for CSMS and VAS. Conclusions: The correlation of clinical information provided by different disease severity scores based on data collected via electronic diaries (e‐diaries), is sufficient at population level, but broadly heterogeneous for individual patients. Consistency of the recorded data must be examined for each patient before remotely collected information is used for clinical decision making. [ABSTRACT FROM AUTHOR]

Background: Allergen immunotherapy (AIT) is the only disease‐modifying treatment in patients with seasonal allergic rhinoconjunctivitis (SAR). Its efficacy depends on the precise identification of the triggering allergen. However, diagnostics based on retrospective clinical history and sensitization to whole extracts (SWE) often leads to equivocal results. Objectives: To assess the usability and impact of a recently established algorithm for a clinical decision support system (@IT2020‐CDSS) for SAR and its diagnostic steps [anamnesis, SWE (skin prick test or serum IgE), component resolved diagnosis, CRD, and real‐time digital symptom recording, eDiary] on doctor's AIT prescription decisions. Methods: After educational training on the @IT2020‐CDSS algorithm, 46 doctors (18 allergy specialists, AS, and 28 general practitioners, GP) expressed their hypothetical AIT prescription for 10 clinical index cases. Decisions were recorded repeatedly based on different steps of the algorithm. The usability and perceived impact of the algorithm were evaluated. Results: The combined use of CRD and an eDiary increased the hypothetical AIT prescriptions, both among AS and GP (p <.01). AIT prescription for pollen and Alternaria allergy based on anamnesis and SWE was heterogeneous but converged towards a consensus by integrating CRD and eDiary information. Doctors considered the algorithm useful and recognized its potential in enhancing traditional diagnostics. Conclusions and clinical implications: The implementation of CRD and eDiary in the @IT2020‐CDSS algorithm improved consensus on AIT prescription for SAR among AS and GP. The potential usefulness of a CDSS for aetiological diagnosis of SAR and AIT prescription in real‐world clinical practice deserves further investigation. [ABSTRACT FROM AUTHOR]

The continuing Machine Learning (ML) revolution indubitably has had a significant positive impact on the analysis of downlinked satellite data. Other aspects of the Earth Observation industry, despite being less susceptible to widespread application of Machine Learning, are also following this trend. These applications, actual use cases, possible prospects and difficulties, as well as anticipated research gaps, are the focus of this review of Machine Learning applied to Earth Observation Operations. A wide range of topics are covered, including mission planning, fault diagnosis, fault prognosis and fault repair, optimization of telecommunications, enhanced GNC, on-board image processing, and the use of Machine Learning models on platforms with constrained compute and power capabilities, as well as recommendations in the respective areas of research. The review tackles all on-board and off-board applications of machine learning to Earth Observation with one notable exception: it omits all post-processing of payload data on the ground, a topic that has been studied extensively by past authors. In addition, this review article discusses the standardization of Machine Learning (i.e., Guidelines and Roadmaps), as well as the challenges and recommendations in Earth Observation operations for the purpose of building better space missions. [ABSTRACT FROM AUTHOR]

The Transiting Exoplanet Survey Satellite (TESS) mission is providing the scientific community with millions of light curves of stars spread across the whole sky. Since 2018, the telescope has detected thousands of planet candidates that need to be meticulously scrutinized before being considered amenable targets for follow-up programs. We present the second catalog of the Planet Patrol citizen science project containing 999 uniformly vetted exoplanet candidates within the TESS ExoFOP archive. The catalog was produced by fully exploiting the power of the Citizen Science Planet Patrol project. We vetted TESS Objects of Interest (TOIs) based on the results of Discovery And Vetting of Exoplanets (dave) pipeline. We also implemented the automatic disposition generator, a custom procedure aimed at generating the final classification for each TOI that was vetted by at least three vetters. The majority of the candidates in our catalog, 752 TOIs, passed the vetting process and were labelled as planet candidates. We ruled out 142 candidates as false positives and flagged 105 as potential false positives. Our final dispositions and comments for all the planet candidates are provided as a publicly available supplementary table. [ABSTRACT FROM AUTHOR]

The Transiting Exoplanet Survey Satellite (TESS) has detected thousands of exoplanet candidates since 2018, most of which have yet to be confirmed. A key step in the confirmation process of these candidates is ruling out false positives through vetting. Vetting also eases the burden on follow-up observations, provides input for demographics studies, and facilitates training machine learning algorithms. Here, we present the TESS Triple-9 (TT9) catalog – a uniformly vetted catalog containing dispositions for 999 exoplanet candidates listed on ExoFOP-TESS, known as TESS Objects of Interest (TOIs). The TT9 was produced using the Discovery And Vetting of Exoplanets pipeline, dave , and utilizing the power of citizen science as a part of the Planet Patrol project. More than 70 per cent of the TOIs listed in the TT9 pass our diagnostic tests, and are thus marked as true planet candidates. We flagged 144 candidates as false positives, and identified 146 as potential false positives. At the time of writing, the TT9 catalog contains |$\sim 20{{\ \rm per\ cent}}$| of the entire ExoFOP-TESS TOIs list, demonstrates the synergy between automated tools and citizen science, and represents the first stage of our efforts to vet all TOIs. Our final dispositions and comments are collected in a supplementary table and the dave -generated files are publicly available on ExoFOP TESS. [ABSTRACT FROM AUTHOR]

NASA’s TESS mission yields light curves for tens of millions of stars spread across the entire sky, a data set that will be a challenge to fully exploit without help from citizen scientists. To address this, we launched a new citizen science project, called “Planet Patrol”, designed to analyze TESS data on exoplanet and eclipsing binary candidates. The project will also serve to benchmark different data reduction pipelines and help analyze unusual light curves that might defeat automated algorithms. The first stage of the project ran on the Zooniverse platform between 2020 September and November and involved more than 5500 registered volunteers. The Planet Patrol citizen scientists produced nearly 400,000 classifications of difference images used for photocenter analysis of about 1000 planet candidates from TESS. The results were incorporated into the photocenter module of the Discovery And Vetting of Exoplanets (DAVE) pipeline to improve its reliability. Specifically, the classifications indicated that all per-transit difference images are appropriate for photocenter analysis for about 40% of the planet candidates, and the corresponding measurements are sound. In contrast, the volunteers found that all per-transit difference images are dominated by astrophysical contamination and/or systematic effects for about 10% of the planet candidates. This indicated that the corresponding photocenter measurements are unreliable. Finally, the fraction of images appropriate for photocenter analysis varies between 0 and 1 for half the candidates. Removing the images classified as poor from DAVE’s analysis of most of these candidates helped reduce the corresponding photocenter uncertainty by up to ∼30%. We plan to implement the output from another module of DAVE, designed for lightcurve vetting, into a second stage of the Planet Patrol project. [ABSTRACT FROM AUTHOR]

COVID-19 is an infectious disease caused by the novel coronavirus SARS-CoV-2, which rapidly spreads via respiratory droplets and is the cause of the current pandemic. In this alarming situation, it is a delicate matter how to visit patients safely and how to manage their chronic treatments. The aim of this paper is to examine in detail the potential impact on SARS-CoV-2 infection of treatments routinely used in trichology and to provide a useful guide for the therapeutic management of trichological patients in this new COVID-19 era. [ABSTRACT FROM AUTHOR]

Background: Common COVID‐19 vaccines side effects are pain at the injection site, muscle pain, fever, headaches, fatigue. Possible immune‐related side effects in predisposed individuals have not been established so far. Materials and Methods: We report three cases of recurrence of alopecia areata (AA) occurred after the first dose of COVID‐19 vaccine. Results: All patients had previous episodes of AA with total hair regrowth and stable remission during the months preceding the vaccination. Rapid hair loss occurred 2‐3 weeks after BNT162b2 mRNA (patient 1) and AZD1222/ChAdOx1 vaccine (patient 2 and 3), with widespread hair loss in two cases and a single patch of the vertex in one case, with typical trichoscopic features of AA. Discussion: Both BNT162b2 mRNA and AZD1222/ChAdOx1 vaccines share the same goal of inducing the immune system, with antibodies production and Th1 cells activation with release of pro‐inflammatory cytokines. Thus, in patients with pre‐existing inflammatory dysregulated pathways, the interaction between the immune system and vaccines may enhance other autoimmune mechanisms. In our cases, we speculate that vaccine may have induced the hair loss focusing on components having a key role in both COVID‐19 vaccination and AA pathogenesis. Conclusion: This report may help to collect new data concerning possible immune‐related effects of vaccines. Certainly, only three cases are not sufficient to draw conclusion, thus a large‐scale study is necessary. Immune‐mediated side effects remain a rare event, thus the benefits of COVID‐19 vaccines outweigh the risk of disease flares and we strongly recommend it in all eligible patients with AA. [ABSTRACT FROM AUTHOR]

Fragmented aurora-like emissions (FAEs) are small (few kilometres) optical structures which have been observed close to the poleward boundary of the aurora from the high-latitude location of Svalbard (magnetic latitude 75.3 ∘ N). The FAEs are only visible in certain emissions, and their shape has no magnetic-field-aligned component, suggesting that they are not caused by energetic particle precipitation and are, therefore, not aurora in the normal sense of the word. The FAEs sometimes form wave-like structures parallel to an auroral arc, with regular spacing between each FAE. They drift at a constant speed and exhibit internal dynamics moving at a faster speed than the envelope structure. The formation mechanism of FAEs is currently unknown. We present an analysis of high-resolution optical observations of FAEs made during two separate events. Based on their appearance and dynamics, we make the assumption that the FAEs are a signature of a dispersive wave in the lower E-region ionosphere, co-located with enhanced electron and ion temperatures detected by incoherent scatter radar. Their drift speed (group speed) is found to be 580–700 m s -1 , and the speed of their internal dynamics (phase speed) is found to be 2200–2500 m s -1 , both for an assumed altitude of 100 km. The speeds are similar for both events which are observed during different auroral conditions. We consider two possible waves which could produce the FAEs, i.e. electrostatic ion cyclotron waves (EIC) and Farley–Buneman waves, and find that the observations could be consistent with either wave under certain assumptions. In the case of EIC waves, the FAEs must be located at an altitude above about 140 km, and our measured speeds scaled accordingly. In the case of Farley–Buneman waves a very strong electric field of about 365 mV m -1 is required to produce the observed speeds of the FAEs; such a strong electric field may be a requirement for FAEs to occur. [ABSTRACT FROM AUTHOR]

Although dissecting cellulitis (DC) and hidradenitis suppurativa (HS) are classified separately, they share many clinical, dermatoscopic, pathogenetic, and histologic aspects, as well as therapeutic options. The association between DC, HS, and acne conglobata represents the follicular occlusion triad or follicular occlusion tetrad , which may include a pilonidal sinus. DC, also known as "folliculitis et perifolliculitis capitis abscendes et suffoidens," is classified as a secondary cicatricial and neutrophilic alopecia. It occurs with perifolliculitis of the scalp, dermal abscesses, sinus tract development, and secondary scarring alopecia. HS, sometimes known as acne inversa, is a chronic relapsing inflammatory disease afflicting apocrine gland–rich areas of the body with painful nodules and abscesses, sinus tracts, and scarring. Given the overlap between the clinical features and the pathogenesis of DC and HS, it would be more appropriate to consider these conditions as two different localizations of the same disease rather than two different pathologies, being a follicular occlusion disease occurring on the scalp and on the apocrine gland–rich areas of the body. [ABSTRACT FROM AUTHOR]

Background: Atopic dermatitis (AD) is a chronic relapsing eczematous dermatitis typically affecting young patients in a percentage from 15 to 20%; although it typically affects young people and adults, recent papers highlighted the emerging of the disease in the elderly population. Methods: The aim of the study was to identify the clinical criteria and allergic sensitization that may be able to support physicians and dermatologists in making a correct diagnosis of AD in the elderly. The second aim of this study was to investigate the incidence, the main features, the gender prevalence, the immunological profile, and comorbidities characterizing patients older than 65 years affected by AD. Results: Based on clinical and serological patterns, different phenotypes of AD were identified: generalized AD (55%) characterized by eczematous lesions involving typical areas of the body or prurigo nodularis‐like AD; chronic eczematous hand dermatitis (23%); face and neck involvement (9%); and nummular eczema (13%). Skin prick tests revealed a positivity for aeroallergens in 49.6% of patients, most of them being polysensitized (55%). Additionally, food skin prick tests were positive in 25% of patients. Most of the patients reported comorbidities, particularly IgE‐mediated diseases, such as seasonal rhino‐conjunctivitis, asthma, and chronic obstructive pulmonary disease. Gastrointestinal symptoms such as meteorism, dyspepsia, cramps/abdominal pain, and diarrhea/constipation, were observed in 35% of patients consequent to food allergy. Conclusion: In our study, we suggest clinical and serological criteria that may be able to guide in the diagnosis of AD in Caucasian elderly, and to design an appropriate treatment according to the current standard protocol. [ABSTRACT FROM AUTHOR]

Background: There is growing interest both in testing IgE in nasal secretions (NS) and in molecular diagnosis of seasonal allergic rhinitis (SAR). Yet, the reliability of nasal IgE detection with the newest molecular assays has never been assessed in a large cohort of pollen allergic patients. Objective: To investigate with microarray technology and compare the repertoires of specific IgE (sIgE) antibodies in NS and sera of a large population of children and adults with SAR. Methods: Nasal secretions were collected with an absorbent device (Merocel 2000®, Medtronic) and a minimal dilution procedure from 90 children and 71 adults with SAR. Total IgE (tIgE) (ImmunoCAP, Thermo Fisher Scientific (TFS)) and sIgE antibodies against 112 allergen molecules (ISAC‐112, TFS) were measured in NS and serum. Results: Nasal sIgE was detectable in 68.3% of the patients. The detected nasal sIgE antibodies recognized airborne (88%), vegetable (10%), and animal food or other (<1%) allergen molecules. The prevalence and average levels of sIgE in NS and serum were highly interrelated at population level. A positive nasal sIgE antibody to a given molecule predicted the detection of the same antibody in the patient's serum with a specificity of 99.7% and a sensitivity of 40%. Conclusions: The concentration of sIgE is much lower in nasal secretions than in the serum. sIgE assays with very high analytical sensitivity and sampling methods with minimal dilution will be therefore needed to validate nasal secretions as alternative to serum in testing the sIgE repertoire. [ABSTRACT FROM AUTHOR]

BACKGROUND: Acne is a chronic multifactorial skin disease with a high prevalence among adolescents. The therapeutic approach for mild to moderate papulopustular acne includes the use of systemic tetracycline. Increased risk of antibiotic resistance necessitates research into alternative therapeutic approaches, such as zinc sulphate. Efficacy of zinc sulphate in acne treatment is widely reported in the literature, but drug comparison studies are lacking. OBJECTIVE: We sought to compare the efficacy and safety of zinc sulphate to lymecycline for the treatment of mild to moderate papulopustular acne. METHODS: One hundred patients were equally randomized to receive either zinc sulphate or lymecycline. Acne severity was evaluated using the subjective Global Acne Grading System (GAGS) and the Acne-specific Quality of Life (AQoL) questionnaire at baseline and after four and 12 weeks. RESULTS: Both zinc sulphate and lymecycline induced a statistically significant reduction in GAGS scores at four and 12 weeks of treatment. The improvements in AQoL scores in patients treated with zinc sulphate were significantly higher than those in the lymecycline group. CONCLUSIONS: Our study suggests that zinc sulphate is a valid alternative therapeutic approach in the treatment of mild to moderate papulopustular acne relative to lymecycline in terms of clinical efficacy, tolerability, and the occurrence of side effects. [ABSTRACT FROM AUTHOR]

Dear Editor, We present the cases of 10 patients affected by actinic keratoses (AKs) of the ears, derived from a group of 30 subjects of a head-to-head comparative study between two different field directed therapies (ingenol mebutate vs. diclofenac) developing ear nodules. In post-therapy nodules, the expression of p53 resulted analogous to healthy skin, with sporadic representation in the malpighian layer (Fig. [Extracted from the article]

Introduction: Studies on Mean Platelet Volume (MPV) in children with Sleep Disordered Breathing (SDB) report conflicting results and the hypothesis of an intermittent hypoxemia leading to a systemic inflammation is reaching consensus. Vitamin D exerts anti-inflammatory properties and its deficiency has been supposed to play a role in sleep disorders. Emerging interest is rising about Primary Snoring (PS) since it is reasonable that also undetectable alteration of hypoxia might predispose to an increased production of inflammatory mediators. In this perspective, in a group of children affected by SDB, our aim was to investigate MPV, vitamin D and C Reactive Protein (CRP) levels, which had been previously evaluated separately in different studies focused only on Obstructive Sleep Apnea Syndrome (OSAS). Materials and Methods: We enrolled 137 children: 70 healthy controls (HC), 67 affected by SDB undergoing a polysomnographic evaluation, 22 with a diagnosis of PS and 45 with a diagnosis of OSAS. All patients underwent routine biochemical evaluations including blood cell counts, CRP and vitamin D. Results: Children affected by SDB had a mean age of 8.49±2.19 and were prevalently males (23 females, 34%; 44 males, 66%). MPV levels were higher in OSAS and PS when compared to HC; platelet count (PLT) and CRP levels were higher while Vitamin D levels were lower in children with SDB when compared to HC. MPV levels were correlated with PLT (r = -0.54; p<0.001), vitamin D (r = -0.39; p<0.001) and CRP (r = 0.21; p<0.01). A multiple regression was run to predict MPV levels from vitamin D, CRP and PLT and these variables significantly predicted MPV (F = 17.42, p<0.0001; adjusted R2 = 0.37). Only platelet count and vitamin D added statistically significantly to the prediction (p<0.05). Conclusion: The present study provides evidence of higher MPV and lower vitamin D levels in children with PS as well as in children with OSAS, and supports the underlying inflammation, hence, highlighting the importance of an early diagnosis of this previously considered benign form of SDB. [ABSTRACT FROM AUTHOR]

Keywords: alopecia areata; COVID-19; SARS-CoV-2 EN alopecia areata COVID-19 SARS-CoV-2 2004 2005 2 06/23/21 20210701 NES 210701 Coronavirus disease (COVID-19) has spread across the globe from December 2019 determining the current pandemic. Only two previous cases of new-onset AA after SARS-CoV-2 infection have been described,2,3 and our report is the third published case of new-onset AA in a COVID-19 patient, and the second one with total distribution. Stress is one of the most common trigger exacerbating or inducing AA; thus, cases of AA in individuals with COVID-19 could be a consequence of the psychological distress related to the infection. [Extracted from the article]

Metastatic melanoma is one of the deadliest cancers and carries a poor prognosis. Dabrafenib plus trametinib is a combination targeted therapy that inhibits BRAF and MEK, and it is an approved treatment for metastatic melanomas harboring BRAF V600 mutations. [Extracted from the article]

Hidradenitis suppurativa (HS) is a chronic recurrent inflammatory skin disease mainly affecting sites rich in apocrine glands, such as the axillary, inguinal, and anogenital regions.[1] Psoriasis is a chronic inflammatory immune-mediated skin disease, affecting about 2% to 3% of the Caucasian population, characterized by erythematous scaly plaques and can be associated to severe comorbidities.[2] Apremilast is an oral phosphodiesterase-4 (PDE-4) inhibitor which modulates the expression of several inflammatory cytokines. It is approved for moderate to severe plaque psoriasis and psoriatic arthritis; although recent studies have suggested other potential uses for it in chronic inflammatory skin diseases like HS.[3] The association between HS and psoriasis is not so rare and probably underestimated. [Extracted from the article]

The BRAF inhibitors vemurafenib, dabrafenib and encorafenib are used in the treatment of patients with BRAF-mutant melanoma. They selectively target BRAF kinase and thus interfere with the mitogen-activated protein kinase (MAPK) signalling pathway that regulates the proliferation and survival of melanoma cells. In addition to their molecularly targeted activity, BRAF inhibitors have immunomodulatory effects. The MAPK pathway is involved in T-cell receptor signalling, and interference in the pathway by BRAF inhibitors has beneficial effects on the tumour microenvironment and anti-tumour immune response in BRAF-mutant melanoma, including increased immune-stimulatory cytokine levels, decreased immunosuppressive cytokine levels, enhanced melanoma differentiation antigen expression and presentation of tumour antigens by HLA 1, and increased intra-tumoral T-cell infiltration and activity. These effects promote recognition of the tumour by the immune system and enhance anti-tumour T-cell responses. Combining BRAF inhibitors with MEK inhibitors provides more complete blockade of the MAPK pathway. The immunomodulatory effects of BRAF inhibition alone or in combination with MEK inhibition provide a rationale for combining these targeted therapies with immune checkpoint inhibitors. Available data support the synergy between these treatment approaches, indicating such combinations provide an additional beneficial effect on the tumour microenvironment and immune response in BRAF-mutant melanoma. [ABSTRACT FROM AUTHOR]