Refined Sound Therapy in Combination with Cognitive Behavioural Therapy to Treat Tinnitus: A Randomized Controlled Trial.

Background: Post-auricular injection of lidocaine and methylprednisolone sodium succinate is a commonly used treatment for outpatient patients with tinnitus, but it is invasive, painful and has uncertain efficacy. We need to try to replace it with more non-invasive and effective treatments. The 2014 guidelines of the American Academy of Otolaryngology-Head and Neck Surgery recommend the use of cognitive behavioral therapy (CBT) to treat tinnitus. Some clinical doctors have also attempted sound therapy for tinnitus. It is unclear whether sound therapy combined with CBT y is more effective than local injection of lidocaine and methylprednisolone sodium succinate in treating tinnitus. Objective: To evaluate the efficacy and influencing factors of refined sound therapy combined with CBT in the treatment of tinnitus and compare it with post-auricular injection of lidocaine and methylprednisolone sodium succinate. Methods: We recruited 100 patients with tinnitus; ultimately, 81 patients completed the experiment and underwent follow-up. Patients were randomly assigned to either the treatment group (refined sound therapy combined with CBT) or the control group (post-auricular injections of lidocaine and methylprednisolone sodium succinate). Data was collected from 49 patients in the treatment group and 32 patients in the control group. Pre- and post-treatment data were collected using the Self-Rating Depression Scale (SDS), Hamilton Anxiety Rating Scale (HAM-A), Visual Analogue Score (VAS), Tinnitus loudness and Tinnitus Handicap Inventory (THI) score. Comparisons between groups were performed using the chi-square test, Fisher's exact test, or Wilcoxon rank-sum test. All tests were two-sided and considered statistically significant with P < .05. Results: The THI, SDS and HAM-A scores in the treatment group decreased significantly. In the control group, there was a significant reduction in THI scores, but not in SDS and HAM-A scores. In addition, tinnitus loudness and VAS scores were significantly decreased in the 2 groups. There was a significant difference in the reduction of THI, SDS, HAM-A and VAS scores between the 2 groups; the treatment group showed a greater reduction. However, there was no significant difference in the reduction of tinnitus loudness. There was no statistical difference in the reduction of THI scores, SDS scores, VAS scores and tinnitus loudness in different frequency groups, but there was a statistical difference in the reduction of HAM-A scores. There was no statistical difference in the reduction of THI scores, SDS scores, HAM-A scores, VAS scores and tinnitus loudness between patients with and without hearing loss. Conclusions: (1) This new combination is more effective than post-auricular injection of lidocaine and methylprednisolone sodium succinate in treating tinnitus and improving psychological symptoms. The latter had no effect on improving psychological indicators. (2) With this combination, patients with different tinnitus frequencies experienced different improvements in anxiety. (3) Low-frequency tinnitus seems have been more likely to cause sound adaptation. (4) The improvement in tinnitus and anxiety was the same regardless of whether or not there was hearing loss.

A Guided Wave Sensor Enabling Simultaneous Wavenumber-Frequency Analysis for Both Lamb and Shear-Horizontal Waves.

Guided waves in plate-like structures have been widely investigated for structural health monitoring. Lamb waves and shear horizontal (SH) waves, two commonly used types of waves in plates, provide different benefits for the detection of various types of defects and material degradation. However, there are few sensors that can detect both Lamb and SH waves and also resolve their modal content, namely the wavenumber-frequency spectrum. A sensor that can detect both waves is desirable to take full advantage of both types of waves in order to improve sensitivity to different discontinuity geometries. We demonstrate that polyvinylidene difluoride (PVDF) film provides the basis for a multi-element array sensor that detects both Lamb and SH waves and also measures their modal content, i.e., the wavenumber-frequency spectrum.

PRL2 regulates neutrophil extracellular trap formation which contributes to severe malaria and acute lung injury.

Excessive host immune responses contribute to severe malaria with high mortality. Here, we show that PRL2 in innate immune cells is highly related to experimental malaria disease progression, especially the development of murine severe malaria. In the absence of PRL2 in myeloid cells, Plasmodium berghei infection results in augmented lung injury, leading to significantly increased mortality. Intravital imaging revealed greater neutrophilic inflammation and NET formation in the lungs of PRL2 myeloid conditional knockout mice. Depletion of neutrophils prior to the onset of severe disease protected mice from NETs associated lung injury, and eliminated the difference between WT and PRL2 CKO mice. PRL2 regulates neutrophil activation and NET accumulation via the Rac-ROS pathway, thus contributing to NETs associated ALI. Hydroxychloroquine, an inhibitor of PRL2 degradation alleviates NETs associated tissue damage in vivo. Our findings suggest that PRL2 serves as an indicator of progression to severe malaria and ALI. In addition, our study indicated the importance of PRL2 in NET formation and tissue injury. It might open a promising path for adjunctive treatment of NET-associated disease.

Ultrasonic guided wave propagation across waveguide transitions: energy transfer and mode conversion.

Ultrasonic guided wave inspection of structures containing adhesively bonded joints requires an understanding of the interaction of guided waves with geometric and material discontinuities or transitions in the waveguide. Such interactions result in mode conversion with energy being partitioned among the reflected and transmitted modes. The step transition between an aluminum layer and an aluminum-adhesive-aluminum multi-layer waveguide is analyzed as a model structure. Dispersion analysis enables assessment of (i) synchronism through dispersion curve overlap and (ii) wavestructure correlation. Mode-pairs in the multi-layer waveguide are defined relative to a prescribed mode in a single layer as being synchronized and having nearly perfect wavestructure matching. Only a limited number of mode-pairs exist, and each has a unique frequency range. A hybrid model based on semi-analytical finite elements and the normal mode expansion is implemented to assess mode conversion at a step transition in a waveguide. The model results indicate that synchronism and wavestructure matching is associated with energy transfer through the step transition, and that the energy of an incident wave mode in a single layer is transmitted almost entirely to the associated mode-pair, where one exists. This analysis guides the selection of incident modes that convert into transmitted modes and improve adhesive joint inspection with ultrasonic guided waves.

HSC70 mediated autophagic degradation of oxidized PRL2 is responsible for osteoclastogenesis and inflammatory bone destruction.

Inflammation leads to systemic osteoporosis or local bone destruction, however, the underlying molecular mechanisms are still poorly understood. In this study, we report that PRL2 is a negative regulator of osteoclastogenesis and bone absorption. Mice with PRL2 deficiency exhibit a decrease in bone volume and an increase in osteoclast numbers. PRL2 negatively regulates RANKL-induced reactive oxygen species production through the activation of RAC1, thus PRL2 deficient osteoclast precursors have both increased osteoclast differentiation ability and bone resorptive capacity. During inflammation, oxidized PRL2 is a selected substrate of HSC70 and conditions of oxidative stress trigger rapid degradation of PRL2 by HSC70 mediated endosomal microautophagy and chaperone-mediated autophagy. Ablation of PRL2 in mouse models of inflammatory bone disease leads to an increase in the number of osteoclasts and exacerbation of bone damage. Moreover, reduced PRL2 protein levels in peripheral myeloid cells are highly correlated with bone destruction in a mouse arthritis model and in human rheumatoid arthritis, while the autophagy inhibitor hydroxychloroquine blocked inflammation-induced PRL2 degradation and bone destruction in vivo. Therefore, our findings identify PRL2 as a new regulator in osteoimmunity, providing a link between inflammation and osteoporosis. As such, PRL2 is a potential therapeutic target for inflammatory bone disease and inhibition of HSC70 mediated autophagic degradation of PRL2 may offer new therapeutic tools for the treatment of inflammatory bone disease.

PVDF Multielement Lamb Wave Sensor for Structural Health Monitoring.

The characteristics of Lamb waves, which are multimodal and dispersive, provide both challenges and opportunities for structural health monitoring (SHM). Methods for nondestructive testing with Lamb waves are well established. For example, mode content can be determined by moving a sensor to different positions and then transforming the spatial-temporal data into the wavenumber-frequency domain. This mode content information is very useful because at every frequency each mode has a unique wavestructure, which is largely responsible for its sensitivity to material damage. Furthermore, mode conversion occurs when the waves interact with damage, making mode content an excellent damage detection feature. However, in SHM, the transducers are typically at fixed locations and are immovable. Here, an affixed polyvinylidene fluoride (PVDF) multielement sensor is shown to provide these same capabilities. The PVDF sensor is bonded directly to the waveguide surface, conforms to curved surfaces, has low mass, low profile, low cost, and minimal influence on passing Lamb waves. While the mode receivability is dictated by the sensor being located on the surface of the waveguide, both symmetric and antisymmetric modes can be detected and group velocities measured.

Guided wave mode selection for inhomogeneous elastic waveguides using frequency domain finite element approach.

This article describes the use of the frequency domain finite element (FDFE) technique for guided wave mode selection in inhomogeneous waveguides. Problems with Rayleigh-Lamb and Shear-Horizontal mode excitation in isotropic homogeneous plates are first studied to demonstrate the application of the approach. Then, two specific cases of inhomogeneous waveguides are studied using FDFE. Finally, an example of guided wave mode selection for inspecting disbonds in composites is presented. Identification of sensitive and insensitive modes for defect inspection is demonstrated. As the discretization parameters affect the accuracy of the results obtained from FDFE, effect of spatial discretization and the length of the domain used for the spatial fast Fourier transform are studied. Some recommendations with regard to the choice of the above parameters are provided.

Reusable acoustic tweezers for disposable devices.

We demonstrate acoustic tweezers used for disposable devices. Rather than forming an acoustic resonance, we locally transmitted standing surface acoustic waves into a removable, independent polydimethylsiloxane (PDMS)-glass hybridized microfluidic superstrate device for micromanipulation. By configuring and regulating the displacement nodes on a piezoelectric substrate, cells and particles were effectively patterned and transported into said superstrate, accordingly. With the label-free and contactless nature of acoustic waves, the presented technology could offer a simple, accurate, low-cost, biocompatible, and disposable method for applications in the fields of point-of-care diagnostics and fundamental biomedical studies.