Customized Versus Noncustomized Sound Therapy for Treatment of Tinnitus: A Randomized Crossover Clinical Trial.

ObjectivesTo determine the effectiveness of a customized sound therapy and compare its effectiveness to that of masking with broadband noise.MethodsSubjects were randomized to receive either customized sound therapy or broadband noise for 2 hours per day for 3 months and then switched to the other treatment after a washout period. The outcome variables were tinnitus loudness (scored 0-10), Tinnitus Handicap Inventory (THI), Beck Anxiety Inventory (BAI), minimum masking levels (MML), and residual inhibition (RI).ResultsEighteen subjects completed the study. Mean age was 53 ± 11 years, and mean tinnitus duration was 118 ± 99 months. With customized sound therapy, mean loudness decreased from 6.4 ± 2.0 to 4.9 ± 1.9 ( P = .001), mean THI decreased from 42.8 ± 21.6 to 31.5 ± 20.3 ( P < .001), mean BAI decreased from 10.6 ± 10.9 to 8.3 ± 9.9 ( P = .01), and MML decreased from 22.3 ± 11.6 dB SL to 17.2 ± 10.6 dB SL ( P = .005). After 3 months of broadband noise therapy, only BAI and, to a lesser degree, MML decreased ( P = .003 and .04, respectively).ConclusionsCustomized sound therapy can decrease the loudness and THI scores of tinnitus patients, and the results may be superior to broadband noise

Dosimetric Analysis of Neural and Vascular Structures in Skull Base Tumors Treated with Stereotactic Radiosurgery.

Objective To examine the relationship between the prescribed target dose and the dose to healthy neurovascular structures in patients with vestibular schwannomas treated with stereotactic radiosurgery (SRS). Study Design Case series with chart review. Setting SRS center from 2011 to 2013. Subjects Twenty patients with vestibular schwannomas treated at the center from 2011 to 2013. Methods Twenty patients with vestibular schwannomas were included. The average radiation dose delivered to healthy neurovascular structures (eg, carotid artery, basilar artery, facial nerve, trigeminal nerve, and cochlea) was analyzed. Results Twenty patients with vestibular schwannomas who were treated with fused computed tomography/magnetic resonance imaging-guided SRS were included in the study. The prescribed dose ranged from 10.58 to 17.40 Gy over 1 to 3 hypofractions to cover 95% of the target tumor volume. The mean dose to the carotid artery was 5.66 Gy (95% confidence interval [CI], 4.53-6.80 Gy), anterior inferior cerebellar artery was 8.70 Gy (95% CI, 4.54-12.86 Gy), intratemporal facial nerve was 3.76 Gy (95% CI, 3.04-4.08 Gy), trigeminal nerve was 5.21 Gy (95% CI, 3.31-7.11 Gy), and the cochlea was 8.70 Gy (95% CI, 7.81-9.59 Gy). Conclusions SRS for certain vestibular schwannomas can expose the anterior inferior cerebellar artery (AICA) and carotid artery to radiation doses that can potentially initiate atherosclerotic processes. The higher doses to the AICA and carotid artery correlated with increasing tumor volume. The dose delivered to other structures such as the cochlea and intratemporal facial nerve appears to be lower and much less likely to cause immediate complications when shielded

La evidencia y la investigación con corpora discursivos : Ideología, interdiscurso, problematización

El objetivo de esta contribución es presentar una serie de conceptos que forman parte de los desarrollos teórico-metodológicos (objeto de permanente revisión) producidos desde el GEHD, y que han servido como fundamento de la investigación –actualmente en curso– en torno a los debates sobre los “estilos de desarrollo”, que tuvieron lugar en América Latina entre 1968 y 1982. Esas reflexiones, que articulan de manera creativa el método arqueológico-genealógico foucaultiano y las elaboraciones de Louis Althusser y Étienne Balibar, a partir de la perspectiva del Análisis Materialista del Discurso (en especial, los aportes de Michel Pêcheux), están orientadas por dos propósitos principales: a) Poner en discusión el “problema de la evidencia”. Esto implica, tal como lo entendemos, visibilizar una serie de “evidencias” específicas que funcionan en las investigaciones sociales que trabajan con materiales de archivo, en las que se suele interrogar el “sentido” de ciertos “discursos” cuya homogeneidad opera frecuentemente bajo la forma de lo preconstruido (unidad de la “institución”, unidad del “autor”, unidad del “tema”, unidad del “período”); con ello se abre una discusión epistemológica que anuda el problema de “la unidad” en la investigación con el funcionamiento general de “la evidencia”/”lo evidente” en tanto mecanismo ideológico. b) Avanzar en la construcción de un enfoque/dispositivo (que conjugue la mirada arqueológico-genealógica y la descripción material de relaciones interdiscursivas) adecuado para el análisis de las problematizaciones de diversas “cuestiones” y la producción de nuevas problematizaciones. De esta forma, nos proponemos reflexionar en torno de otras posibilidades para la constitución de unidades que se conforman en el proceso de trabajo con materialidades discursivas.Mesa 3: El esquivo objeto de la ideología.Facultad de Humanidades y Ciencias de la Educació

Pengukuran Performansi Sistem Produksi Menggunakan Overall Throughput Effectiveness (Ote) (Studi Kasus: PT. Tani Gemilang Desa Kerjen Kecamatan Srengat Kabupaten Blitar)

Metode OTE digunakan untuk mengukur efektivitas sistem produksi yang terdiri dari beberapa mesin. PT. Tani Gemilang merupakan Perusahaan yang memproduksi pupuk organik berbentuk granul dengan nama Petroganik. Proses produski pupuk melalui empat tahapan proses permesinan yang berurutan yaitu pencampuran, granulasi, pengeringan, dan pengayakan. Pada proses produksi sering dijumpai masalah berupa tingginya downtime mesin. Permasalahan lain yang ada pada PT. Tani Gemilang adalah tingginya produk defect. Perusahaan ingin meningkatkan performansi sistem produksinya, namun pada Perusahaan belum ada pengukuran performansi sistem produksi pada tingkat pabrik. Oleh karena itu perlu adanya pengukuran untuk mengetahui efektivitas sistem produksi serta meningkatkannya. Untuk mengukur efektivitas sistem produksi digunakan metode Overall Throughput Effectiveness (OTE) dan penjadwalan perbaikan mesin secara preventif (Preventive Maintenance) untuk dapat meningkatkan efektivitasnya. Dari hasil perhitungan yang telah dilakukan, diperoleh rata-rata nilai OTE pada bulan Juni-Agustus tahun 2014 adalah 32,7% Komponen kritis yang dijadwalkan perbaikan preventifnya adalah fins dan blade. Hasil perhitungan MTTF dan MTTR menggunakan persamaan distribusi weibull dan distribusi Normal, diperoleh interval penggantian komponen yaitu 1079,071 jam untuk fins dan 1056,884 jam untuk blade. Rekomendasi yang diberikan adalah pembuatan jadwal preventive maintenance berdasarkan interval waktu penggantian komponen kritis sehingga estimasi efektivitas akan meningkat menjadi 46,1%

Fuzzy Color Clustering for Melanoma Diagnosis in Dermoscopy Images

A fuzzy logic-based color histogram analysis technique is presented for discriminating benign skin lesions from malignant melanomas in dermoscopy images. The approach extends previous research for utilizing a fuzzy set for skin lesion color for a specified class of skin lesions, using alpha-cut and support set cardinality for quantifying a fuzzy ratio skin lesion color feature. Skin lesion discrimination results are reported for the fuzzy clustering ratio over different regions of the lesion over a data set of 517 dermoscopy images consisting of 175 invasive melanomas and 342 benign lesions. Experimental results show that the fuzzy clustering ratio applied over an eight-connected neighborhood on the outer 25% of the skin lesion with an alpha-cut of 0.08 can recognize 92.6% of melanomas with approximately 13.5% false positive lesions. These results show the critical importance of colors in the lesion periphery. Our fuzzy logic-based description of lesion colors offers relevance to clinical descriptions of malignant melanoma

Partnership as an Alternative Model for Empowering Fishers in the Processed Food Industry Made from Marine Fish

Introduction to the Problem: This study discusses cooperation between various parties that are mutually beneficial, both the government, large business actors, and small business actors, in this case, fishermen.Purpose/Objective of the Study: This research aims to maximize the management of fisheries potential in Indonesia and provide alternatives to fishermen out of the problems they face.Design/Methodology/Approach: This study uses a mixed-method, which combines quantitative and qualitative research.Findings: The results showed that by looking at the background as well as the potential and weaknesses of the fishing community, the business partnership model could be an alternative to empowering the fishing community in developing the processed food industry made from marine fish. The legal relationship of the parties in this business partnership is based on the partnership agreement.Paper Type: Research Articl

Performance of the reconstruction algorithms of the FIRST experiment pixel sensors vertex detector

Hadrontherapy treatments use charged particles (e.g. protons and carbon ions) to treat tumors. During a therapeutic treatment with carbon ions, the beam undergoes nuclear fragmentation processes giving rise to significant yields of secondary charged particles. An accurate prediction of these production rates is necessary to estimate precisely the dose deposited into the tumours and the surrounding healthy tissues. Nowadays, a limited set of double differential carbon fragmentation cross-section is available. Experimental data are necessary to benchmark Monte Carlo simulations for their use in hadrontherapy. The purpose of the FIRST experiment is to study nuclear fragmentation processes of ions with kinetic energy in the range from 100 to 1000 MeV/u. Tracks are reconstructed using information from a pixel silicon detector based on the CMOS technology. The performances achieved using this device for hadrontherapy purpose are discussed. For each reconstruction step (clustering, tracking and vertexing), different methods are implemented. The algorithm performances and the accuracy on reconstructed observables are evaluated on the basis of simulated and experimental data