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

Global gain modulation generates time-dependent urgency during perceptual choice in humans

Decision-makers must often balance the desire to accumulate information with the costs of protracted deliberation. Optimal, reward-maximizing decision-making can require dynamic adjustment of this speed/accuracy trade-off over the course of a single decision. However, it is unclear whether humans are capable of such time-dependent adjustments. Here, we identify several signatures of time-dependency in human perceptual decision-making and highlight their possible neural source. Behavioural and model-based analyses reveal that subjects respond to deadline-induced speed pressure by lowering their criterion on accumulated perceptual evidence as the deadline approaches. In the brain, this effect is reflected in evidence-independent urgency that pushes decision-related motor preparation signals closer to a fixed threshold. Moreover, we show that global modulation of neural gain, as indexed by task-related fluctuations in pupil diameter, is a plausible biophysical mechanism for the generation of this urgency. These findings establish context-sensitive time-dependency as a critical feature of human decision-making