International Consensus Statement on Rhinology and Allergy: Rhinosinusitis

Background: The 5 years since the publication of the first International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR‐RS) has witnessed foundational progress in our understanding and treatment of rhinologic disease. These advances are reflected within the more than 40 new topics covered within the ICAR‐RS‐2021 as well as updates to the original 140 topics. This executive summary consolidates the evidence‐based findings of the document. Methods: ICAR‐RS presents over 180 topics in the forms of evidence‐based reviews with recommendations (EBRRs), evidence‐based reviews, and literature reviews. The highest grade structured recommendations of the EBRR sections are summarized in this executive summary. Results: ICAR‐RS‐2021 covers 22 topics regarding the medical management of RS, which are grade A/B and are presented in the executive summary. Additionally, 4 topics regarding the surgical management of RS are grade A/B and are presented in the executive summary. Finally, a comprehensive evidence‐based management algorithm is provided. Conclusion: This ICAR‐RS‐2021 executive summary provides a compilation of the evidence‐based recommendations for medical and surgical treatment of the most common forms of RS

Evaluation eines Interventionsprogramms zur Prävention nosokomialer Katheter-assoziierter Harnweginfektionen auf einer Intensivstation in einem ländlichen Krankenhaus Ägyptens

Aim: Catheter associated urinary tract infections (CAUTI) are the most common hospital-acquired infection in ICUs. The aim of this study was to estimate the effectiveness of an intervention program by implementing urinary catheter bundle elements to reduce the CAUTI frequency in an ICU. Methods: The intervention study was conducted over a period of 6 months. During a pre-intervention phase, the base line catheter associated CAUTI incidence rates were determined and compared with the incidence rates during the post-intervention phase. The compliance of health care staff with urinary catheter bundle elements was also measured. The implemented CAUTI prevention bundle consisted of hand hygiene, wearing personal protective equipment, use of disposable gloves, cleansing of urethral meatus prior to catheter insertion using sterile saline, assessment of catheter need, aseptic urine sampling technique, and correct draining bag positioning.Results: During the study period, 55 out of 77 patients were diagnosed with a CAUTI. The mean CAUTI incidence rate for the pre-intervention period was 90.12/1,000 catheter days and for the post intervention phase 65.69/1,000 catheter days. The CAUTIs rate was inversely proportional to insertion bundle elements and maintenance bundle elements compliance rate. This negative relationship was statistically significant only with maintenance bundle elements (p=0.042) (rs=-0.828). The compliance rate of the ICU nurses to the bundle elements was raised to 100% during the last 2 months of the post intervention phase.Conclusion: Increased compliance to recommended catheter associated urinary tract infections preventive practices reduced the incidence of CAUTI in an ICU unit. It is simple and effective and is recommended as a part of patient safety culture.Zielsetzung: Katheter-assoziierte Harnweginfektionen (CAUTI) sind die häufigste nosokomiale Infektion auf der ITS. Ziel der Studie war die Ermittlung der Effektivität eines Interventionsprogramms mit Implementierung eines Bundles zur Prävention von CAUTI auf einer ITS. Methode: Die Interventionsstudie wurde über einen Zeitraum von 6 Monaten durchgeführt. Während der Präinterventionsperiode wurde die Baseline für die Inzidenz von CAUTI ermittelt und mit der Inzidenz während der Postinterventionsperiode verglichen. Außerdem wurde die Compliance des Personals zur Einhaltung des Bundles ermittelt. Das CAUTI Bundle enthielt die Elemente Händehygiene, Tragen persönlicher Schutzausrüstung, Benutzung von Einmalhandschuhen, Reinigung des Meatus urethrae vor der Katheterinsertion mit steriler Kochsalzlösung, Beurteilung der Notwendigkeit des Harnwegkatheters, aseptische Harnableitung und korrekte Position des Auffangbeutels.Ergebnisse: Im Verlauf der Studie wurde bei 55 von 77 Patienten eine CAUTI diagnostiziert. Die mittlere Inzidenz betrug in der Präinterventionsperiode 90,12 CAUTI/1.000 Kathetertage und in der Postinterventionsperiode 65,69 CAUTI/1.000 Kathetertage. Die CAUTI-Rate verhielt sich indirekt proportional zur Einführung der Bundleelemente und zur Compliance der Einhaltung des Bundles. Dieser Zusammenhang war nur für die Einhaltung der Bundleelemente statistisch sicherbar (p=0,042) (rs=-0,828). Die Compliance der Pflegekräfte zur Einhaltung des Bundles wurde während der letzten 2 Monate der Postinterventionsperiode auf 100% erhöht. Schlussfolgerung: Durch verbesserte Compliance für die empfohlenen Maßnahmen zur Prävention von CAUTI konnte die Inzidenz von CAUTI auf einer ITS reduziert werden. Die Einführung eines CAUTI-Präventionsbundles ist einfach und effektiv und wird daher als Bestandteil zur Gewährleistung der Patientensicherheit empfohlen

Efficient graph hierarchical decomposition with user engagement and tie strength

Graph decomposition methods using k-core and k-truss hierarchically group vertices and edges from external to internal by degrees of vertices or tie strength of edges. As both the user engagement of nodes and the strength of relationships are important, the (k,s)-core model is proposed in the literature to discover strong communities. Nevertheless, the decomposition algorithm regarding (k,s)-core is not yet investigated. In this paper, we propose (k,s)-core algorithms to decompose a graph into its hierarchical structures considering both user engagement and tie strength. We first present the basic (k,s)-core decomposition methods. Then, we propose the advanced algorithms DES and DEK which index the support of edges to enable higher-level cost-sharing in the peeling process. In addition, effective pruning strategies are applied to DES/DEK to further enhance performance. Moreover, we build a novel index based on the decomposition result and investigate an efficient (k,s)-core query algorithm based on our index. Extensive experimental evaluations on 12 real-world datasets verify the efficiency of our proposed decomposition algorithms and show that our index-based query algorithm can speed up the state-of-the-art query algorithms by up to three orders of magnitude