To present the international consensus for recommendations for Ménière's disease (MD) treatment.
Based on a literature review and report of 4 experts from 4 continents, the recommendations have been ...presented during the 21st IFOS congress in Paris, in June 2017 and are presented in this work.
The recommendation is to change the lifestyle, to use the vestibular rehabilitation in the intercritic period and to propose psychotherapy. As a conservative medical treatment of first line, the authors recommend to use diuretics and Betahistine or local pressure therapy. When medical treatment fails, the recommendation is to use a second line treatment, which consists in the intratympanic injection of steroids. Then as a third line treatment, depending on the hearing function, could be either the endolymphatic sac surgery (when hearing is worth being preserved) or the intratympanic injection of gentamicin (with higher risks of hearing loss). The very last option is the destructive surgical treatment labyrinthectomy, associated or not to cochlear implantation or vestibular nerve section (when hearing is worth being preserved), which is the most frequent option.
In this paper, we extend Chubanov's new polynomial-time algorithm for linear programming to second-order cone programming based on the idea of cutting plane method. The algorithm finds an
...-dimensional vector x which satisfies
, where
and
is a direct product of n second-order cones and half lines. Like Chubanov's algorithm, one iteration of the proposed algorithm consists of two phases: execution of a basic procedure and scaling. Within
calls of the basic procedure, the algorithm either (i) finds an interior feasible solution, (ii) finds a non-zero dual feasible solution, or (iii) verifies that there is no interior feasible solution whose minimum eigenvalue is greater than or equal to ϵ. Each basic procedure requires
arithmetic operations, where
is the dimension of each second-order cone. If the problem is interior feasible, then the algorithm finds an interior feasible solution in
calls of the basic procedure, where
is a condition number associated with the system.
Celotno besedilo
Dostopno za:
BFBNIB, DOBA, GIS, IJS, IZUM, KILJ, KISLJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
A
bstract
This report details the capabilities of LHCb and its upgrades towards the study of kaons and hyperons. The analyses performed so far are reviewed, elaborating on the prospects for some key ...decay channels, while proposing some new measurements in LHCb to expand its strangeness research program.
Background
Ceramide is a crucial lipid in the stratum corneum (SC) which maintains the barrier function and hydration of the skin. In atopic dermatitis (AD) patients who have defective skin barrier ...function, ceramide levels are altered. We previously reported that although the amount of total ceramide was lower in involved skin compared with uninvolved skin of AD patients and with healthy control skin, the amounts of smaller ceramide species of CerNS (<40 total carbons, which are total carbons of both sphingoid base and amide‐linked fatty acid), especially CerNS with 34 total carbons (C34‐CerNS), were higher. However, the enzyme(s) that produces the higher levels of smaller ceramide species in involved skin of AD patients was unclear.
Objective
To identify the enzyme(s) that produces higher levels of smaller ceramide species of CerNS in the involved skin of AD patients.
Methods
Eight female Caucasian subjects who were diagnosed with AD on their arms (age range: 21–45 years) were enroled in this study. We compared ceramide levels in the SC and the expression levels of enzymes involved in ceramide metabolism using real‐time PCR and immunohistochemistry between involved and uninvolved skin of AD patients.
Results
Level of mRNA encoding ceramide synthase 4 (CERS4), which is one of the enzymes that synthesize ceramide from a sphingoid base and an amide‐linked fatty acid, was significantly higher in involved skin than in uninvolved skin (P < 0.01). Additionally, the protein expression level of CERS4 in the epidermis was also higher in involved skin compared with uninvolved skin. The expression level of CERS4 correlated with the amount of C34‐CerNS (P < 0.01) and the skin hydration value (P < 0.05).
Conclusions
The elevated expression level of CERS4 contributes to the increase of C34‐CerNS and the impaired SC barrier function in involved skin of AD patients.
Stereotactic body radiation therapy (SBRT) is usually verified with a dynamic phantom or solid phantom, but there is a demand for phantoms that can accurately simulate tumor dynamics within an ...individual that would allow customized validation in every patient. We developed a new 4D dynamic target phantom (multi-cell 4D phantom) that allows simulation of tumor movement in patients. The basic quality and dynamic reproducibility of this new phantom was verified in this investigation. The newly developed multi-cell 4D phantom comprises four main components: soft tissue, bones, lungs, and tumor (target). The phantom structure was based on computed tomography (CT) data of a male. In this study, we investigated the basic performance of a multi-cell 4D phantom. All the CT numbers of the phantom were very close to those of human data. The geometric maximum amplitudes were 4.57 mm in the lateral direction, 4.59 mm in the ventrodorsal direction, and 3.68 mm in the cranio-caudal direction. Geometric errors were 0.84, 0.58, and 0.40 mm, respectively. Movements of the abdominal surface were stable for 60 s. Repeated measurements show no actual differences in target movements between multiple measurements and indicated high reproducibility (r > 0.97). End-to-end tests using Gafchromic film revealed a gamma pass rate of 98% or above (2 mm/3%). Although our phantom performed limited reproducibility in the movement of the patient tumor at present, a satisfactory level of precision was confirmed in general. This is a very promising device for use in the verification of radiation therapy for moving targets.
Despite our understanding that the care of back and buttock skin is important for elderly nursing patients, the stratum corneum (SC) functions of the skin on the trunk of elderly patients have not ...been well investigated.
Overall, 41 elderly subjects (average age: 75.9 years, 20 male and 21 female) and 20 middle-aged subjects (average age: 41.3 years, 10 male and 10 female) residing in Tokyo were recruited. Hydration of the SC, transepidermal water loss (TEWL), skin surface pH, total bacteria and inflammatory cytokines in the SC of skin on the buttocks, back, lower leg and inner forearm were measured.
The hydration of the SC decreased only on the lower leg with age. TEWL showed no change with age at any site. The pH was significantly higher in elderly skin than in middle-aged skin at all sites. The number of total bacteria on the forearm and back increased with age. The ratio of interleukin-1α (IL-1α) and IL-1α receptor antagonist was only higher on the middle-aged forearm compared to the elderly. No remarkable gender difference was found in these parameters without pH values. We clarified that most of the SC functional parameters change with age on both the trunk and the limbs in a similar manner, suggesting that the limbs are acceptable sites to estimate the SC functions of the trunk of elderly patients. Our study may be useful as basic data for future work to maintain the SC function of elderly patients.
Aims High-mobility group box 1 (HMGB1) is a nuclear DNA-binding protein and is released from necrotic cells, inducing inflammatory responses and promoting tissue repair and angiogenesis. To test the ...hypothesis that HMGB1 enhances angiogenesis and restores cardiac function after myocardial infarction (MI), we generated transgenic mice with cardiac-specific overexpression of HMGB1 (HMGB1-Tg) using α-myosin heavy chain promoter. Methods and results The left anterior descending coronary artery was ligated in HMGB1-Tg and wild-type littermate (Wt) mice. After coronary artery ligation, HMGB1 was released into circulation from the necrotic cardiomyocytes of HMGB1-overexpressing hearts. The size of MI was smaller in HMGB1-Tg than in Wt mice. Echocardiography and cardiac catheterization demonstrated that cardiac remodelling and dysfunction after MI were prevented in HMGB1-Tg mice compared with Wt mice. Furthermore, the survival rate after MI of HMGB1-Tg mice was higher than that of Wt mice. Immunohistochemical staining revealed that capillary and arteriole formation after MI was enhanced in HMGB1-Tg mice. Conclusion We report the first in vivo evidence that HMGB1 enhances angiogenesis, restores cardiac function, and improves survival after MI. These results may provide a novel therapeutic approach for left ventricular dysfunction after MI.
This paper describes a method of modeling the characteristics of a singing voice from polyphonic musical audio signals including sounds of various musical instruments. Because singing voices play an ...important role in musical pieces with vocals, such representation is useful for music information retrieval systems. The main problem in modeling the characteristics of a singing voice is the negative influences caused by accompaniment sounds. To solve this problem, we developed two methods, accompaniment sound reduction and reliable frame selection . The former makes it possible to calculate feature vectors that represent a spectral envelope of a singing voice after reducing accompaniment sounds. It first extracts the harmonic components of the predominant melody from sound mixtures and then resynthesizes the melody by using a sinusoidal model driven by these components. The latter method then estimates the reliability of frame of the obtained melody (i.e., the influence of accompaniment sound) by using two Gaussian mixture models (GMMs) for vocal and nonvocal frames to select the reliable vocal portions of musical pieces. Finally, each song is represented by its GMM consisting of the reliable frames. This new representation of the singing voice is demonstrated to improve the performance of an automatic singer identification system and to achieve an MIR system based on vocal timbre similarity.
Effects of eutrophication on arsenic speciation were studied in eutrophic Lake Kiba and mesotrophic Lake Biwa, Japan. By combining hydride generation atomic absorption spectrometry with ultraviolet ...irradiation, inorganic, methyl and ultraviolet-labile fractions of arsenic were determined. In both Lakes, inorganic species (As(V
+
III)) dominated over other forms of arsenic all the year round. Most of methylarsenic fraction was dimethylarsinic acid (DMAA), and the concentration of monomethylarsonic acid (MMAA) was below the detection limit. Measurements of size-fractioned arsenic concentrations in water column indicate that most of the DMAA was distributed in truly dissolved fraction (<
10 kDa), while ultraviolet-labile fractions were distributed in particulate (>
0.45 µm) and colloidal (10 kDa–0.45 µm) fractions. Arsenic speciation in eutrophic Lake Kiba fluctuated greatly with season. The ultraviolet-labile fractions were observed with the increase of DMAA from May to October, and they disappeared with the decrease of DMAA in January. In mesotrophic Lake Biwa, the ultraviolet-labile fractions of arsenic were not influenced as much as those in eutrophic Lake Kiba. On the other hand DMAA concentration was higher in Lake Biwa compared to that in Lake Kiba. The results suggest that the biosynthesis of complex organoarsenicals was enhanced by eutrophication, and the arsenic speciation would be influenced by the balance of biological processes in natural waters.
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