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Introduction: Although sudden sensorineural hearing loss (SSNHL) has been attempted to be understood for 70 years, diagnosis and treatment strategies still have strong heterogeneity worldwide, which are reflected in the guidelines issued by countries and the clinical practice of otolaryngologists. Methods: Questionnaires were sent to registered otolaryngologists nationwide via an online questionnaire system. We investigated the current views and clinical practices of otolaryngologists in mainland China about the diagnosis, examination, and treatment strategies of SSNHL. Results: Most otolaryngologists supported diagnostic classification via audiograms. Regional economic situation and hospital grade affected application strategies for differential diagnosis. Regarding corticosteroid therapy, 54.9% of respondents opted to discontinue the drug 5 days after systemic administration. Both intratympanic therapy and post-auricular injections were selected by more than half of the respondents as initial and salvage treatments. Discussion: Chinese otolaryngologists exhibit heterogeneity in clinical practices for SSNHL, including distinct approaches to combination therapy and local application of steroids. This study pointed out Chinese doctors' similarities, differences, and unique strategies in diagnosing and treating SSNHL and analyzed the possible reasons to help the world understand the current otolaryngology practices in China.
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The leasing activities of enterprises are of positive significance for promoting a green and low-carbon economy. For scarce resources that can easily go into tight supply states due to changes in the external market environment, the sudden change of their price is a common phenomenon in the leasing market. This paper provides an online leasing model based on the characteristics of scarce resources in which the resource might have a sudden price surge, and the length of its usage time cannot be known in advance. An online leasing strategy ON was then developed to achieve the minimum possible acquisition cost for the scarce resource. This strategy was proven to be the optimal online strategy through competitive analysis. Computational experiments were conducted to evaluate the performance of the proposed online strategy. Furthermore, sensitivity analysis of the problem parameters shows that increasing resource reserves and reducing the price-to-rent ratio are effective ways to improve the performance of enterprise leasing operation management for scarce resources.
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CarbonoRESUMO
BACKGROUND: Migraine is more common in Meniere's disease patients, who have some certain anatomical variations. But there are limited studies focusing on the anatomical variations in patients with Meniere's disease and migraine. OBJECTIVE: To explore the clinical and anatomical features in Meniere's disease patients with and without migraine, determining whether the coexistence of migraine can be used as a basis for clinical subtyping of Meniere's disease. METHODS: Ninety-five Meniere's disease patients and ninety-five healthy subjects matched with age, sex were selected. A detailed questionnaire based on the diagnosis criteria of Meniere's disease and migraine was designed. According to the CT scan, we divided the mastoid cell system of all the subjects into two types: well-pneumatization type and poor-pneumatization type. Meanwhile, the shortest distance between the sigmoid sinus and the posterior wall of the external acoustic canal was measured. RESULTS: Compared with those without migraine, Meniere's disease patients with migraine had a higher female comorbidity, poorer mastoid pneumatization, shorter distance between the sigmoid sinus and posterior wall of the external acoustic canal, longer history, higher frequency of vertigo attacks and better average hearing threshold. CONCLUSIONS: In our study, anatomical features as well as several clinical manifestations were proved to differ significantly between Meniere's disease patients with and without migraine, indicating the coexistence of migraine may be one standard for the clinical subtyping of Meniere's disease.
