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

Adaptation of Poa alpina to altitude and land use in the Swiss Alps

Current land use and climate change are prompting questions about the ability of plants to adapt to such environmental change. Therefore, we experimentally addressed plant performance and quantitative-genetic diversity of the common Alpine Meadow Grass Poa alpina. We asked how land use and altitude affect the occurrence of P. alpina in the field and whether its common-garden performance suggests adaptation to conditions at plant origin and differences in quantitative genetic diversity among plant origins. Among 216 candidate grassland sites of different land use and altitude from 12 villages in the Swiss Alps, P. alpina occurred preferentially in fertilized and grazed sites and at higher elevations. In a common garden at 1,500 m asl, we grew two plants of >600 genotypes representing 78 grassland sites. After 2 years, nearly 90% of all plants had reproduced. In agreement with adaptive advantages of vegetative reproduction at higher altitudes, only 23% of reproductive plants from lower altitudes reproduced via vegetative bulbils, but 55% of plants from higher altitudes. In agreement with adaptive advantages of reproduction in grazed sites, allocation to reproductive biomass was higher in plants from grazed grasslands than from mown ones. For 53 grasslands, we also investigated broad-sense heritability H2, which was significant for all studied traits and twice as high for grazed as for mown grasslands. Moreover, possibly associated with their higher landscape diversity, H2 was higher for sites of villages of Romanic cultural tradition than for those of Germanic and Walser traditions. We suggest promoting diverse land use regimes to conserve not only landscape and plant species diversity, but also adaptive genetic differentiation and heritable genetic variation