Tinnitus Related to Forceful Eyelid Closure: A Case Report.

Tinnitus is a common complaint in the clinical setting and can be classified into sensorineural and objective tinnitus. The sources of objective tinnitus may either come from para-auditory structures, such as myogenic or vascular structures, or the middle ear muscles. One type of objective tinnitus of muscular origin is known as forceful eyelid closure syndrome (FECS). We present an additional case of a 22-year-old woman with unilateral FECS. The auricles and external auditory canals were normal bilaterally; we examined her tympanic membrane under an endoscope, the left tympanic membrane was retracted simultaneously with the closure of her eyelids. Both tympanograms were of type A. However, small cut trace associated with tympanic membrane movement were obtained during blinking. The patient was managed by behavioral therapy and medication treatment conservatively, and the condition became well-controlled. Here, we present this rare case and review the literature.

Hybrid model of a cement rotary kiln using an improved attention-based recurrent neural network.

A rotary kiln is core equipment in cement calcination. Significant time delay, time-varying, and nonlinear characteristics cause challenges in the advance process control and operational optimization of the rotary kiln. However, the traditional mechanism model with many assumptions cannot accurately represent the dynamic kiln process because kinetic parameters are difficult to obtain. This paper proposes a novel hybrid strategy to develop a dynamic model of a rotary kiln by combining a process mechanism and a recurrent neural network to address this issue. A time delay mechanism is used to estimate the kiln's residence time to compensate for the time delay. A long short-term memory model that combines an attention mechanism and an ordinary differential equation solver is proposed to capture the time-varying and nonlinear behaviors of the kiln process. Case studies from two real-world cement plants with different processing loads are used to verify the effectiveness of the proposed hybrid modeling strategy. The results show that the proposed method has better accuracy and robustness than the traditional methods. The sensitivity analysis of the proposed model also makes it practical for t control system design and real-time optimization.

[Characteristics of nystagmus and its therapeutic effect in the reduction of posterior semicircular canal benign paroxysmal positional vertigo].

Objective:By observing the nystagmus forms at different positions during Epley reduction in patients with posterior semicircular canal benign parochial positional vertigo（PC-BPPV）, to compare the effects of the first reduction, and to further summarize the possible causes of reduction failure and the prognosis of patients with different nystagmus forms. Methods:A retrospective analysis of 191 PC-BPPV patients diagnosed with PC-BPPV showed that 95 cases had positive nystagmus during the reduction process（group A）, 69 cases had no nystagmus （group B）, and 27 cases had reverse nystagmus （group C）. All the patients were diagnosed by G-Force BPPV and were treated through simulative Epley CRP. The form of nystagmus and the effect of the first reduction were compared. Results:The first reduction effect of group A was better than that of group C（P<0.05）. The reduction effect of group B was better than that of group C（P<0.05）. There was no significant difference in the reduction effect between group A and group B（P>0.05）. Conclusion:The form of nystagmus in the reduction process of PC-BPPV has a certain guiding significance for the evaluation of the first reduction effect and the successful reduction. The reverse nystagmus during the reduction process indicates a poor reduction effect.

[Analysis of reduction effect of the evoked nystagmus in the non-affect side during Dix-Hallpike or Roll-test in unilateral posterior semicircular canal benign paroxysmal positional vertigo].

Objective:Comparative analysis of the reduction effect of the evoked nystagmus in the non-affect side during Dix-Hallpike（D-H） or Roll-test in unilateral posterior semicircular canal benign paroxysmal positional vertigo（PC-BPPV） and PC-BPPV without above evoked nystagmus. Method:Retrospective analysis of 210 patients diagnosed with unilateral PC-BPPV by G-Force BPPV CRP system was made. Among them, 18 patients exhibited positive nystagmus only when the non-affected side was stimulated by D-H test（Group A）, 30 was evoked only when stimulated by Roll-test（Group B）, 26 was evoked when stimulated by both Roll-test and the non-affected side D-H test（Group C）, 136 without nystagmus in the above positions（Group D）. All the patients were diagnosed by G-Force BPPV and were treated through simulative Epley or Semont CRP. Compare the reduction effect among the groups. Result:At the first time ,the reduction effect of nystagmus in Group D was superior to those in Group A and Group C（P<0.05）. There was no difference between Group D and Group B（P>0.05）. The difference between Group A and Group C was also non-significant（P>0.05）. The average CRP times of the four groups（CRP until nystagmus disappeared or no longer alleviated） were 1.44±0.63（Group A）, 1.46±0.65（Group B）, 1.52±0.87（Group C） and 1.48±0.73（Group D）respectively. There were no statistic difference between four groups（P>0.05）. The differences of final reduction effect between groups were the same as those at the first time. Conclusion:The first time reduction effect was less effective when nystagmus evoked the non-affect side during D-H test in unilateral PC-BPPV, while it might be irrelevant to the nystagmus evoked only in Roll-test. Although the times of CRP were similar among the groups, the final reduction effect of groups with nystagmus evoked the non-affect side during D-H was poorer.

Bone loss in chronic kidney disease: Quantity or quality?

Chronic kidney disease (CKD) patients experience bone loss and fracture because of a specific CKD-related systemic disorder known as CKD-mineral bone disorder (CKD-MBD). The bone turnover, mineralization, and volume (TMV) system describes the morphological bone lesions in renal osteodystrophy related to CKD-MBD. Bone turnover and bone volume are defined as high, normal, or low, and bone mineralization is classified as normal or abnormal. All types of bone histology related to TMV are responsible for both bone quantity and bone quality losses in CKD patients. This review focuses on current bone quantity and bone quality losses in CKD patients and finally discusses potential therapeutic measures.