The European Position Paper on Rhinosinusitis and Nasal Polyps 2020 is the update of similar evidence based position papers published in 2005 and 2007 and 2012. The core objective of the EPOS2020 guideline is to provide revised, up-to-date and clear evidence-based recommendations and integrated care pathways in ARS and CRS. EPOS2020 provides an update on the literature published and studies undertaken in the eight years since the EPOS2012 position paper was published and addresses areas not extensively covered in EPOS2012 such as paediatric CRS and sinus surgery. EPOS2020 also involves new stakeholders, including pharmacists and patients, and addresses new target users who have become more involved in the management and treatment of rhinosinusitis since the publication of the last EPOS document, including pharmacists, nurses, specialised care givers and indeed patients themselves, who employ increasing self-management of their condition using over the counter treatments. The document provides suggestions for future research in this area and offers updated guidance for definitions and outcome measurements in research in different settings. EPOS2020 contains chapters on definitions and classification where we have defined a large number of terms and indicated preferred terms. A new classification of CRS into primary and secondary CRS and further division into localized and diffuse disease, based on anatomic distribution is proposed. There are extensive chapters on epidemiology and predisposing factors, inflammatory mechanisms, (differential) diagnosis of facial pain, allergic rhinitis, genetics, cystic fibrosis, aspirin exacerbated respiratory disease, immunodeficiencies, allergic fungal rhinosinusitis and the relationship between upper and lower airways. The chapters on paediatric acute and chronic rhinosinusitis are totally rewritten. All available evidence for the management of acute rhinosinusitis and chronic rhinosinusitis with or without nasal polyps in adults and children is systematically reviewed and integrated care pathways based on the evidence are proposed. Despite considerable increases in the amount of quality publications in recent years, a large number of practical clinical questions remain. It was agreed that the best way to address these was to conduct a Delphi exercise . The results have been integrated into the respective sections. Last but not least, advice for patients and pharmacists and a new list of research needs are included. The full document can be downloaded for free on the website of this journal: http://www.rhinologyjournal.com.

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European Position Paper on Rhinosinusitis and Nasal Polyps 2020

Beginning with Emlen (1966) and MacArthur and Pianka (1966) and extending through the last ten years, several authors have sought to predict the foraging behavior of animals by means of mathematical models. These models are very similar,in that they all assume that the fitness of a foraging animal is a function of the efficiency of foraging measured in terms of some "currency" (Schoener, 1971) -usually energy- and that natural selection has resulted in animals that forage so as to maximize this fitness. As a result of these similarities, the models have become known as "optimal foraging models"; and the theory that embodies them, "optimal foraging theory." The situations to which optimal foraging theory has been applied, with the exception of a few recent studies, can be divided into the following four categories: (1) choice by an animal of which food types to eat (i.e., optimal diet); (2) choice of which patch type to feed in (i.e., optimal patch choice); (3) optimal allocation of time to different patches; and (4) optimal patterns and speed of movements. In this review we discuss each of these categories separately, dealing with both the theoretical developments and the data that permit tests of the predictions. The review is selective in the sense that we emphasize studies that either develop testable predictions or that attempt to test predictions in a precise quantitative manner. We also discuss what we see to be some of the future developments in the area of optimal foraging theory and how this theory can be related to other areas of biology. Our general conclusion is that the simple models so far formulated are supported are supported reasonably well by available data and that we are optimistic about the value both now and in the future of optimal foraging theory. We argue, however, that these simple models will requre much modification, espicially to deal with situations that either cannot easily be put into one or another of the above four categories or entail currencies more complicated that just energy.

Citation classic - optimal foraging - a selective review of theory and tests

The study of pain in awake animals raises ethical, philosophical, and technical problems. We review the ethical standards for studying pain in animals and emphasize that there are scientific as well as moral reasons for keeping to them. Philosophically, there is the problem that pain cannot be monitored directly in animals but can only be estimated by examining their responses to nociceptive stimuli; however, such responses do not necessarily mean that there is a concomitant sensation. The types of nociceptive stimuli (electrical, thermal, mechanical, or chemical) that have been used in different pain models are reviewed with the conclusion that none is ideal, although chemical stimuli probably most closely mimic acute clinical pain. The monitored reactions are almost always motor responses ranging from spinal reflexes to complex behaviors. Most have the weakness that they may be associated with, or modulated by, other physiological functions. The main tests are critically reviewed in terms of their sensitivity, specificity, and predictiveness. Weaknesses are highlighted, including 1) that in most tests responses are monitored around a nociceptive threshold, whereas clinical pain is almost always more severe; 2) differences in the fashion whereby responses are evoked from healthy and inflamed tissues; and 3) problems in assessing threshold responses to stimuli, which continue to increase in intensity. It is concluded that although the neural basis of the most used tests is poorly understood, their use will be more profitable if pain is considered within, rather than apart from, the body's homeostatic mechanisms.

Animal Models of Nociception

Experimental Neurology By Prof Paul Glees Pp xii + 532 (Oxford: Clarendon Press; London: Oxford University Press, 1961) 75s net

The Nervous System

Diagnostic and Statistical Manual of Mental Disorders(DSM)-5による分類と診断 (特集 周産期メンタルヘルス : 妊婦の不安とどう立ち向かうか)

There is a growing appreciation that experience with odors may strongly influence their perception. To further investigate this, the responses of 40 Japanese and 44 age-matched German women to everyday odorants were compared. Subjects were presented with 18 stimuli in squeeze bottles and asked to rate them according to intensity, familiarity, pleasantness and edibility, to describe associations elicited by them and, if possible, to name them. One-third of the odorants were presumed to be familiar to the Japanese only, one-third to the Germans and one-third to both populations. Significant differences were found between the two populations on all measures. Better performance by the Japanese in providing appropriate descriptors for 'Japanese' odorants and by the Germans for 'European' odorants supported the pre-selection of stimuli as culture-typical. Particularly clear differences between the two populations were found in pleasantness ratings. In general, a positive relationship was found between pleasantness and judgement of stimuli as edible, suggesting that culture-specific experiences-particularly of foods-may significantly influence odor perception. Somewhat unexpectedly, significant differences were also found between the two populations in intensity ratings for some odorants. These differences did not seem simply to be artefacts of the test situation and raise the possibility that experience may even influence such basic aspects of odor perception as stimulus intensity.

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Differences in Perception of Everyday Odors: a Japanese-German Cross-cultural Study

In this study, 40 Japanese, 44 German and 39 Mexican women were presented with 18 everyday odorants. They were asked to rate them for intensity on a six-point scale from not detectable to very strong, for pleasantness on an 11-point scale from -5, to neutral at 0, to +5, and for familiarity on a six-point scale from completely unknown to extremely familiar. Consistent positive correlations were found between paired rating scores for the three measures, and although they were not particularly strong (r(s) range, 0.19-0.60), for most odorants all three correlations were significant. Similar results were obtained whether the data were analyzed on an individual or a national basis. Most notable were the consistent positive correlations between perceived intensity and ratings of familiarity and hedonic strength. It is suggested that the perceived intensity of the odorants depended not only on stimulus concentration but probably also on experience-dependent factors.

Perception of Everyday Odors—Correlation between Intensity, Familiarity and Strength of Hedonic Judgement

Transmission of food preference in the rabbit: the means of information transfer.

In einem mit Glasboden versehenen Nistkasten wurde das Saugverhalten neugeborener Hauskaninchen von unten beobachtet (3 Wurfe). Durch Experimente, in denen der Bauch der Hasin rasiert und in verschiedener Weise abgedeckt worden war, wurden die relevanten Reize fur das Auffinden der Zitzen untersucht (16 Wurfe). 1. Kaninchenjunge konnen bereits wenige Sekunden nach Ankunft der Mutter Zitzen finden und besaugen. Auf Vibrations- und Beruhrungsreize reagieren sie mit AufrichtBewegungen. Sobald sie mit dem Fell der Hasin in Kontakt kommen, stosen sie ihre Schnauzen tiefer und fuhren die fur Zitzensuchverhalten typischen, senkrechten (Proben) und seitlichen Kopfbewegungen aus, bis sie eine Zitze ergriffen haben. 2. Das Zitzensuchverhalten wird durch Geruchsstoffe der Haut ausgelost und aufrecht erhalten. Die Starke des Geruchs scheint in Richtung Zitzen zuzunehmen und besonders hohe Konzentrationen an der Zitzenbasis oder ein moglicher zweiter Geruch losen das Ergreifen der Zitzen aus. 3. Wegen der geringen Reichweite des Geruchs hilft wahrscheinlich das Fell der Mutter den Jungen Kontakt mit der Bauch aufzunehmen und zu bewahren, und durch Verstarkung der seitlichen Kopfbewegungen den Geruchsgradienten zu entdecken. Jedoch sind fur das Auffinden der Zitzen weder der Fellstrich noch Temperaturgradienten der Haut wichtig. 4. Von der gesamten Saugezeit, pro Tag 3-4 Minuten, benotigten die Hasinen im Mittel 5,2 sec, um die Saugehaltung einzunehmen, die Jungen 11,5 sec (Median), um das Bauchfell der Mutter zu erreichen und 6,0 sec (Median), zum Zitzen zu finden und zu ergreifen. Unerwartet war, das Kaninchenjunge haufig Zitzen loslassen und wechseln, im Mittel 2,5 mal pro Minute, wodurch sich die an Zitzen insgesamt verbrachte Zeit weiter reduzierte. Jedoch nahm mit dem Alter auch die Leistungsfahigkeit der Jungen zu und der relative Anteil der eigentlichen Saugezeit erhohte sich wahrend der ersten 12 Lebens-tage von circa 47% auf 72%. 5. Der Zitzensuchverhalten auslosende Geruch kann als ein Pheromon im eigentlichen Sinn angesehen werden, da ein stereotypes Verhalten reproduzierbar ausgelost wird.

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Robyn Hudson

Papers

Differences in Perception of Everyday Odors: a Japanese-German Cross-cultural Study

Perception of Everyday Odors—Correlation between Intensity, Familiarity and Strength of Hedonic Judgement

Transmission of food preference in the rabbit: the means of information transfer.

Nipple Location By Newborn Rabbits: Behavioural Evidence for Pheromonal Guidance

Assessing pain threshold in the rat: Changes with estrus and time of day