This is an update of a Cochrane Review first published in The Cochrane Library in Issue 12, 2010.Tinnitus is described as the perception of sound or noise in the absence of real acoustic stimulation. ...Numerous management strategies have been tried for this potentially debilitating, heterogeneous symptom. External noise has been used as a management tool for tinnitus, in different capacities and with different philosophical intent, for over a century.
To assess the effectiveness of sound-creating devices (including hearing aids) in the management of tinnitus in adults. Primary outcome measures were changes in the loudness or severity of tinnitus and/or impact on quality of life. Secondary outcome measures were change in pure-tone auditory thresholds and adverse effects of treatment.
We searched the Cochrane ENT Group Trials Register; CENTRAL; PubMed; EMBASE; CINAHL; Web of Science; BIOSIS Previews; Cambridge Scientific Abstracts; ICTRP and additional sources for published and unpublished trials. The date of the most recent search was 8 February 2012.
Prospective randomised controlled trials recruiting adults with persistent, distressing, subjective tinnitus of any aetiology in which the management strategy included maskers, noise-generating device and/or hearing aids, used either as the sole management tool or in combination with other strategies, including counselling.
Two authors independently examined the 387 search results to identify studies for inclusion in the review, of which 33 were potentially relevant. The update searches in 2012 retrieved no further potentially relevant studies. Both authors extracted data independently.
Six trials (553 participants) are included in this review. Studies were varied in design, with significant heterogeneity in the evaluation of subjective tinnitus perception, with different scores, scales, tests and questionnaires as well as variance in the outcome measures used to assess the improvement in tinnitus sensation/quality of life. This precluded meta-analysis of the data. There was no long-term follow-up. We assessed the risk of bias as medium in three and high in three studies. Following analysis of the data, no significant change was seen in the loudness of tinnitus or the overall severity of tinnitus following the use of sound therapy compared to other interventions such as patient education, 'relaxation techniques', 'tinnitus coping strategies', counselling, 'tinnitus retraining' and exposure to environmental sounds. No side effects or significant morbidity were reported from the use of sound-creating devices.
The limited data from the included studies failed to show strong evidence of the efficacy of sound therapy in tinnitus management. The absence of conclusive evidence should not be interpreted as evidence of lack of effectiveness. The lack of quality research in this area, in addition to the common use of combined approaches (hearing therapy plus counselling) in the management of tinnitus are, in part, responsible for the lack of conclusive evidence. Other combined forms of management, such as tinnitus retraining therapy, have been subject to a Cochrane Review. Optimal management may involve multiple strategies.
High quality SrZrO3 nanocubes have been successfully synthesized via a facile hydrothermal method using Sr(NO3)2 and Zr(NO3)4·5H2O as raw materials. Then, the Yb-doped SrZrO3 were also fabricated by ...solid state reaction using the as-synthesized pure SrZrO3. The phase structure, morphology, composition and specific surface area of the samples were investigated by XRD, FESEM, EDS, TEM, FTIR, Raman and BET techniques. The as-synthesized SrZrO3 nanocubes distributed homogeneously and displayed sharp edges with an average particle size of about 100nm. In addition, the dielectric loss value of the pure SrZrO3 at 1MHz was only 0.05 when the temperature rose from 25°C to 550°C, indicating a good dielectric property at high temperature. Meanwhile, the band gap of SrZrO3 could be reduced by about 0.3eV after Yb3+ doping, where Yb3+ mainly occupied Sr2+ position (A site doping). Besides, all of the pure and Yb-doped SrZrO3 samples exhibit violet light emission centered at 423nm (excited at 372nm), which was originated from material intrinsic defects.
High quality SrZrO3 nanocubes have been successfully synthesized via a facile hydrothermal method. Then, the Yb-doped SrZrO3 were also fabricated by solid state reaction using the as-synthesized pure SrZrO3. The as-synthesized SrZrO3 nanocubes distributed homogeneously and displayed sharp edges with an average particle size of about 100nm. In addition, the dielectric loss value of the pure SrZrO3 at 1MHz was only 0.05 when the temperature rose from 25°C to 550°C. Meanwhile, the band gap of SrZrO3 could be reduced by about 0.3eV after Yb3+ doping, where Yb3+ mainly occupied Sr2+ position (A site doping). Besides, all of the pure and Yb-doped SrZrO3 samples exhibit violet light emission centered at 423nm (excited at 372nm), which was originated from material intrinsic defects. Display omitted
•Pure/Yb-doped SrZrO3 powders have been synthesized.•Tuning the band gap of pure SrZrO3 by doping Yb3+ ions.•The dielectric and photoluminescence properties of SrZrO3 were studied.
Background
Darbepoetin alfa (darbepoetin) is an erythropoiesis‐stimulating agent used for the treatment of anemia secondary to chronic kidney disease (CKD) in dogs, but reports describing response ...are lacking.
Hypothesis/Objectives
To evaluate the effectiveness of darbepoetin in dogs with anemia secondary to CKD, dosing protocols, and adverse events.
Animals
Thirty‐three client‐owned dogs with naturally occurring CKD, including 26 with comorbidities.
Methods
Multi‐institutional retrospective study.
Results
The median starting dosage and highest dosage of darbepoetin administered were 0.5 and 0.8 μg/kg SC once weekly, respectively. Response to treatment was defined as achieving a packed cell volume (PCV) ≥30% or an increase in PCV ≥10%. Twenty‐eight of 33 dogs (85%) achieved a PCV ≥30% and 22 of 33 (67%) dogs achieved an increase in PCV ≥10%. Median time to achieve a PCV ≥30% was 29 days. A higher starting dosage was associated with achieving an increase in PCV ≥10% (P = .01). No dog sustained a response at a dosing interval >q21d. Potential adverse events included increased blood pressure requiring treatment (n = 12), seizures (n = 5), vomiting (n = 3), diarrhea (n = 3), and possible pure red cell aplasia (PRCA) (n = 2).
Conclusions and Clinical Importance
Darbepoetin, when combined with treatment of comorbidities, is an effective treatment for anemia secondary to CKD in dogs. A dosing interval >q21d was ineffective at maintaining a response to treatment. PRCA was a possible adverse event in 2 of 33 dogs (6%).
Pure organic room‐temperature phosphorescence (RTP) materials are considered as potential candidates for replacing precious metal complexes to fabricate highly efficient organic light‐emitting ...devices (OLEDs). However, applications of the reported RTP materials in OLEDs are seriously impeded by their low photoluminescence quantum yields (PLQYs) in a thin film state. To overcome these obstacles, we established a new strategy to construct highly efficient OLEDs based on a pure organic RTP material sensitized fluorescence emitter by selecting benzimidazole‐triazine molecules (PIM‐TRZ), 2,6‐di(phenothiazinyl)naphthalene (β‐DPTZN), and 5,6,11,12‐tetraphenylnaphthacene (rubrene) as host, phosphor sensitizer, and fluorescent emitter, respectively. The perfect combination of host, phosphorescent sensitizer, and fluorescent emitter in the emitting layer ensure the outstanding performance of the devices with an external quantum efficiency (EQE) of 15.7 %.
A class of electroluminescence films based on a purely organic phosphor sensitizing fluorescence emitter were developed. A series of room‐temperature phosphorescence (RTP)‐sensitized fluorescent materials with the capacity to break the limitation of 25 % internal quantum efficiency (IQE) for normal electrofluorescence devices was constructed.
In a brain composed of localized but connected specialized areas, disconnection leads to dysfunction. This simple formulation underlay a range of 19th century neurological disorders, referred to ...collectively as disconnection syndromes. Although disconnectionism fell out of favour with the move against localized brain theories in the early 20th century, in 1965, an American neurologist brought disconnection to the fore once more in a paper entitled, ‘Disconnexion syndromes in animals and man’. In what was to become the manifesto of behavioural neurology, Norman Geschwind outlined a pure disconnectionist framework which revolutionized both clinical neurology and the neurosciences in general. For him, disconnection syndromes were higher function deficits that resulted from white matter lesions or lesions of the association cortices, the latter acting as relay stations between primary motor, sensory and limbic areas. From a clinical perspective, the work reawakened interest in single case studies by providing a useful framework for correlating lesion locations with clinical deficits. In the neurosciences, it helped develop contemporary distributed network and connectionist theories of brain function. Geschwind's general disconnectionist paradigm ruled clinical neurology for 20 years but in the late 1980s, with the re-emergence of specialized functional roles for association cortex, the orbit of its remit began to diminish and it became incorporated into more general models of higher dysfunction. By the 1990s, textbooks of neurology were devoting only a few pages to classical disconnection theory. Today, new techniques to study connections in the living human brain allow us, for the first time, to test the classical formulation directly and broaden it beyond disconnections to include disorders of hyperconnectivity. In this review, on the 40th anniversary of Geschwind's publication, we describe the changing fortunes of disconnection theory and adapt the general framework that evolved from it to encompass the entire spectrum of higher function disorders in neurology and psychiatry.
Carbazole derivatives without isomer doping do not show long-lived crystal RTP, but they can be evoked ultra-long molecular RTP by dispersing into polymer matrix at the molecular level by combining ...thermoplasticizing. Both rigid plastics and elastomer are used as the doped matrices, and rigid and/ or polar polymers can often improve molecular RTP better due to stronger cohesion or some special interactions.
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•Pure carbazole derivatives are intrinsically phosphorescent.•RTP of pure carbazole derivatives can be evoked by doping into polymer matrices.•Multi-phase thermoplastic elastomers are also effective organic RTP doped matrices.•Thermoplasticizing can usually manifest the deserved polymer RTP properties.
Carbazole derivatives have abundant family members and structure flexibility but are not exploited as molecular dopants for efficient doped room temperature phosphorescence (RTP) polymers. Here we demonstrate that doping a small amount of simple heavy-atom-free pure carbazole derivative into polymers via reasonable doping procedure can evoke ultralong molecular RTP without the need for isomer doping. The conventional solution-processed doped polymer films show inferior RTP, but mechanically thermoplasticizing such films can evoke ultra-long RTP, which is ascribed to that dense stacking enhances polymer rigidity and cohesion to effectively inhibit dopant molecular thermal deactivation that can not be restricted effectively by crystallization itself. Impressively, both rigid PMMA and elastic SIS can be used as doping matrix, and the doped films show ultralong RTP and photo-patterning memory effect. We believe that the combination of different N-arylcarbazole derivatives and polymers will produce unique RTP properties. This work has updated some existing RTP views and will set off a new upsurge of research on carbazole derivatives.
Polycyclic aromatic hydrocarbons (PAHs) are ubiquitous and harmful contaminants, which can be degraded aerobically. However, the persistence of PAHs in anoxic environments indicates that anaerobic ...biodegradation of PAHs should also be investigated. Pure-culture and biotransformation processes for anaerobic phenanthrene biodegradation with sulfate as a terminal electron acceptor remains in its infancy. In this study, we investigated anaerobic biodegradation of PAHs by PheS2, an isolated phenanthrene-utilizing sulfate-reducer, using phenanthrene as a model compound. PheS2 was phylogenetically closely related to Geobacter sulfurreducens and reduced sulfate to sulfide during anaerobic phenanthrene biodegradation. Phenanthrene biodegradation processes were detected using gas chromatography-mass spectrometry, genome, and reverse transcription quantitative PCR analyses. Carboxylation was the initial step of anaerobic phenanthrene biodegradation based upon detection of 2- and 4-phenanthroic acid, its isotopically labeled analogs when using 13C-labeled bicarbonate and fully deuterated-phenanthrene (C14D10), and genes encoding enzymes putatively involved in the biodegradation. Further, ring-system reducing and cleavage occurred, and substituted benzene series and cyclohexane derivatives were detected in downstream biotransformation metabolites. Additionally, PheS2 can degrade benzene, naphthalene, anthracene, and benzaanthracene, but not pyrene and benzapyrene. This study describes the isolation of an anaerobic phenanthrene-degrading sulfate-reducer, the first pure-culture evidence of phenanthrene biotransformation processes with sulfate as an electron acceptor.
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•A new anaerobic phenanthrene-degrading sulfate-reducer, PheS2, was identified.•Anaerobic PHE biodegradation with sulfate as an electron acceptor is described.•Carboxylation could be the initial activation step in sulfate-reducing conditions.•4-pa was a newly proposed metabolite during anaerobic PHE biodegradation.•Ring reduction and ring cleavage occurred after initial carboxylation reaction.
Background and purpose
Cystic pituitary adenomas and cystic craniopharyngiomas may mimic Rathke cleft cysts when there is no solid enhancing component on magnetic resonance imaging (MRI). This study ...aims to investigate the efficiency of MRI findings in differentiating Rathke cleft cysts from pure cystic pituitary adenoma and pure cystic craniopharyngioma.
Materials and methods
109 patients were included in this study (56 Rathke cleft cysts, 38 pituitary adenomas, and 15 craniopharyngiomas). Preoperative magnetic resonance images were evaluated using 9 imaging findings. These findings include intralesional fluid-fluid level, intralesional septations, midline /off-midline location, suprasellar extension, an intracystic nodule, a hypointense rim on T2-weighted images, ≥ 2 mm thickness of contrast-enhancing wall, T1 hyperintensity and T2 hypointensity. p < 0.01 was considered statistically significant.
Results
There was a statistically significant difference among groups for these 9 findings. Intracystic nodule and T2 hypointensity were the most specific MRI findings in differentiating Rathke cleft cyst from the others (98.1% and 100%, respectively). Intralesional septation and thick contrast-enhancing wall were the most sensitive MRI findings ruling out Rathke cleft cysts with 100% sensitivity.
Conclusion
Rathke cleft cysts can be distinguished from pure cystic adenoma and craniopharyngioma with the presence of an intracystic nodule, T2 hypointensity, the absence of the thick contrast-enhancing wall, and absence of intralesional septations.
Estrogen receptor alpha (ERα) is a well-validated drug target for ER-positive (ER+) breast cancer. Fulvestrant is FDA-approved to treat ER+ breast cancer and works through two mechanisms-as a full ...antagonist and selective estrogen receptor degrader (SERD)-but lacks oral bioavailability. Thus, we envisioned a "best-in-class" molecule with the same dual mechanisms as fulvestrant, but with significant oral exposure. Through lead optimization, we discovered a tool molecule
(GNE-149) with improved degradation and antiproliferative activity in both MCF7 and T47D cells. To illustrate the binding mode and key interactions of this scaffold with ERα, we obtained a cocrystal structure of
that showed ionic interaction of azetidine with Asp351 residue. Importantly,
showed favorable metabolic stability and good oral exposure.
exhibited antagonist effect in the uterus and demonstrated robust dose-dependent efficacy in xenograft models.
•PO is recommended for the treatment of high strength wastewaters.•PO allows faster treatment rates at higher MLSS concentrations and shorter HRTs.•PO achieves high carbon removal efficiencies and ...can improve nitrification rates.•PO suits MBRs operating at high biomass concentrations and high organic loadings.•Fine bubbles are more efficient in PO transfer than coarse bubbles.
In aerobic wastewater treatment, aeration is the most critical element of the treatment system. It supplies microorganisms with the required dissolved oxygen, maintains solids in suspension and, in membrane bioreactors, it controls fouling. However, conventional activated sludge is limited to the treatment of low strength wastewaters, as higher loadings require both higher biomass and higher dissolved oxygen concentrations. By replacing air with pure oxygen, oxygen transfer rates increase at lower flowrates. In this work, the potential and limitations of pure oxygen aeration are reviewed. The effect of the system’s operational parameters and the mixed liquor characteristics on oxygen transfer, and vice versa, are determined. Pure oxygen treats higher loadings without compromising effluent quality. Fine bubbles are more efficient in oxygen transfer due to their increased contact area. However, pure oxygen is not always essential, so it is recommended to be restricted to applications where air is not adequate.
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