Matthew A. Rank

Electronic health record data represent a rich data source; however, data accuracy must be considered prior to reporting health outcomes among American Indian and Alaska Native people. Using a hybrid approach to harmonizing data from multiple sources represents a valid method of assessing data integrity in this population.

Asthma has a global prevalence of 262 million people and is characterized by airway inflammation and variable airflow obstruction.¹ Reliever inhalers, including bronchodilator-only relievers (short-acting β agonists [SABA]), such as albuterol, or inhaled corticosteroids (ICS) with either SABA or formoterol, are indicated for patients with asthma to acutely relieve symptoms of dyspnea, wheezing, or cough.¹ Although the Global Initiative for Asthma (GINA)¹ and the National Asthma Education and Prevention Program² recommend ICS-formoterol as the preferred reliever over SABA alone, the US Food and Drug Administration (FDA) recently approved ICS-SABA as a reliever inhaler; the optimal asthma reliever remains unclear.³ Furthermore, guideline recommendations do not sufficiently differentiate between ICS-SABA and SABA-alone relievers, and the relative benefits of ICS-formoterol compared with ICS-SABA on clinical outcomes remain unclear.^1,2 This systematic review evaluated inhaled relievers for improving outcomes in asthma.

Background: Pollen is a key source of aeroallergens responsible for allergic rhinitis, conjunctivitis, and asthma. Objective: The goal of this scoping review was to summarize current available literature on the factors that affect pollen counts, allergenicity, and thresholds that induce symptoms in individuals who were sensitized. Methods: Several databases showed no published articles with a similar scope as of January 2022. A search of these data bases yielded 373 articles for assessment. These were then reviewed for relevance, and articles were selected to demonstrate the breadth of available data on pollen counts, allergenicity, and thresholds that induce symptoms in individuals who were sensitized. Additional articles were identified through examination of bibliographies of search-identified articles. Results: Several environmental factors have shown a correlation with pollen counts and allergen load, including the distance from the source, wind characteristics, pollen size, terrain, urban environments, air composition (particulate matter, CO₂ levels, ozone, NO₂), and weather conditions (humidity, thunderstorms, precipitation). Pollen thresholds at which symptoms were induced varied by study, pollen type, symptom, disease, and location. In addition, there was heterogeneity in study designs, threshold definition, and outcome measures. Conclusion: This scoping review demonstrates the plethora of variables that influence the relationship between pollen and the symptoms of allergic diseases. Analysis of the available data sheds light on the complex interaction between environmental and biologic factors that affect pollen's role in allergic diseases and provides guidance on multiple areas for further investigation.