Effects of Interval Time of the Epley Manoeuvre

Objective: The Epley maneuver (EM) has an immediate effect: rapid reduction of positional nystagmus. Benign paroxysmal positional vertigo (BPPV) causes BPPV fatigue, which constitutes fatigability of positional nystagmus and vertigo with repeated performance of the Dix-Hallpike test; notably, BPPV fatigability becomes ineffective over time. We hypothesized that the immediate effect of the EM is caused by BPPV fatigue. Therefore, we suspected that performance of the EM with intervals between head positions would worsen the immediate reduction of positional nystagmus in patients with BPPV, because BPPV fatigability would become ineffective during performance of this therapy. Methods: Forty patients with newly diagnosed BPPV were randomly assigned to the following two groups; one group performed the EM without intervals between positions (group A), and the other group performed the EM with 3 min intervals between positions (group B). The primary outcome measure was the ratio of maximum slow-phase eye velocity (MSPEV) of positional nystagmus soon after the EM, compared with that measured before the EM. Secondary outcome included whether a 30 min interval after the EM enabled recovery of MSPEV of positional nystagmus to the original value. This study followed the CONSORT 2010 reporting standards. Results: In both groups A and B, the immediate effect of the EM could be observed, because MSPEV during the second Dix-Hallpike test was significantly smaller than MSPEV during the first Dix-Hallpike test (p < 0.0001 in group A, p < 0.0001 in group B). The primary outcome measure was larger in group B than in group A (p = 0.0029). The immediate effect faded 30 min later (secondary outcome). Conclusions: This study showed that the EM had an immediate effect both with and without interval time in each head position of the EM. Because setting interval time in each head position of the EM reduced the immediate effect of the EM, interval time during the EM adds less benefit. This finding can reduce the effort exerted by doctors, as well as the discomfort experienced by patients with pc-BPPV, during EM. However, this immediate effect may be caused by BPPV fatigue, and may fade rapidly

Validity of the frame subtraction method in dynamic postural stability

Background The movement of targeted subjects can be calculated using the frame subtraction method. However, the validity of this evaluation method of dynamic postural stability has not been clarified yet. This study aimed to verify the validity of the evaluation method for jump landing using the frame subtraction score based on the ground reaction force (GRF). Methods Twenty subjects performed single-leg jump landing, and their dynamic postural stability index (DPSI), medial-lateral stability index (MLSI), anterior-posterior stability index, and vertical stability index (VSI) were calculated from the GRF. Simultaneously, motion images were captured using digital video cameras in the sagittal and frontal planes. After the motion images were analyzed using the frame subtraction method, the frame subtraction scores in the frontal, sagittal, and combined planes were calculated. To confirm its validity, the relationship between the frame subtraction scores and GRF parameters was investigated using Pearson's correlation analysis. Results The frame subtraction scores in the frontal and combined planes were significantly correlated with the DPSI, MLSI, and VSI (r = 0.46-0.75, P < 0.05). Conclusions Therefore, the frame subtraction method could be applied to the evaluation of dynamic postural stability. Markerless systems are deemed useful in clinical practice

Effects of Interval Time of the Epley Maneuver on Immediate Reduction of Positional Nystagmus: A Randomized, Controlled, Non-blinded Clinical Trial

Objective: The Epley maneuver (EM) has an immediate effect: rapid reduction of positional nystagmus. Benign paroxysmal positional vertigo (BPPV) causes BPPV fatigue, which constitutes fatigability of positional nystagmus and vertigo with repeated performance of the Dix-Hallpike test; notably, BPPV fatigability becomes ineffective over time. We hypothesized that the immediate effect of the EM is caused by BPPV fatigue. Therefore, we suspected that performance of the EM with intervals between head positions would worsen the immediate reduction of positional nystagmus in patients with BPPV, because BPPV fatigability would become ineffective during performance of this therapy.Methods: Forty patients with newly diagnosed BPPV were randomly assigned to the following two groups; one group performed the EM without intervals between positions (group A), and the other group performed the EM with 3 min intervals between positions (group B). The primary outcome measure was the ratio of maximum slow-phase eye velocity (MSPEV) of positional nystagmus soon after the EM, compared with that measured before the EM. Secondary outcome included whether a 30 min interval after the EM enabled recovery of MSPEV of positional nystagmus to the original value. This study followed the CONSORT 2010 reporting standards.Results: In both groups A and B, the immediate effect of the EM could be observed, because MSPEV during the second Dix-Hallpike test was significantly smaller than MSPEV during the first Dix-Hallpike test (p &lt; 0.0001 in group A, p &lt; 0.0001 in group B). The primary outcome measure was larger in group B than in group A (p = 0.0029). The immediate effect faded 30 min later (secondary outcome).Conclusions: This study showed that the EM had an immediate effect both with and without interval time in each head position of the EM. Because setting interval time in each head position of the EM reduced the immediate effect of the EM, interval time during the EM adds less benefit. This finding can reduce the effort exerted by doctors, as well as the discomfort experienced by patients with pc-BPPV, during EM. However, this immediate effect may be caused by BPPV fatigue, and may fade rapidly.Classification of Evidence: 1

Viewing Targets in Infantile Nystagmus

The aim of this study was to propose a new pathophysiological hypothesis for involuntary eye oscillation in infantile nystagmus (IN): patients with IN exhibit impaired gaze fixation, horizontal smooth pursuit and optokinetic nystagmus (OKN) and use saccadic eye movements for these underlying impairments. In order to induce saccades, they make enough angle between gaze and target by precedent exponential slow eye movements. IN consists of the alternate appearance of the saccade and the slow eye movements. Unlike most previous theories, IN is therefore considered a necessary strategy allowing for better vision and not an obstacle to clear vision. In five patients with IN, eye movements were analyzed during the smooth pursuit test, saccadic eye movement test, OKN test and vestibulo-ocular reflex (VOR) test. Their gaze fixation, horizontal smooth pursuit, OKN and the last half of the slow phase of VOR were impaired. The lines obtained by connection of the end eye positions of fast phase of nystagmus coincided with the trajectories of targets. The findings indicate that patients followed the target by the fast but not the slow phase of nystagmus, which supports our hypothesis. By setting the direction of slow phase of nystagmus opposite to the direction of the OKN stimulation, enough angle can be effectively made between the gaze and target for the induction of saccade. This is the mechanism of reversed OKN response. In darkness and when eyes are closed, IN weakens because there is no visual target and neither the saccade for catching up the target or slow phase for induction of the saccade is needed

Deep simultaneous limits on optical emission from FRB 20190520B by 24.4 fps observations with Tomo-e Gozen

We conduct 24.4~fps optical observations of repeating Fast Radio Burst (FRB) 20190520B using Tomo-e Gozen, a high-speed CMOS camera mounted on the Kiso 105-cm Schmidt telescope, simultaneously with radio observations carried out using the Five-hundred-meter Aperture Spherical radio Telescope (FAST). We succeeded in the simultaneous optical observations of 11 radio bursts that FAST detected. However, no corresponding optical emission was found. The optical fluence limits as deep as 0.068 Jy ms are obtained for the individual bursts (0.029 Jy ms on the stacked data) corrected for the dust extinction in the Milky Way. The fluence limit is deeper than those obtained in the previous simultaneous observations for an optical emission with a duration $\gtrsim 0.1$ ms. Although the current limits on radio--optical spectral energy distribution (SED) of FRBs are not constraining, we show that SED models based on observed SEDs of radio variable objects such as optically detected pulsars, and a part of parameter spaces of theoretical models in which FRB optical emission is produced by inverse-Compton scattering in a pulsar magnetosphere or a strike of a magnetar blastwave into a hot wind bubble, can be ruled out once a similar fluence limit as in our observation is obtained for a bright FRB with a radio fluence $\gtrsim 5$ Jy ms.Comment: Accepted for publication in ApJ, metadata correcte

Effects of malalignment and disease activity on osteophyte formation in knees of rheumatoid arthritis patients.

PURPOSE:Rheumatoid arthritis (RA) patients with secondary osteoarthritis (OA) in a knee joint following a total knee arthroplasty (TKA) procedure have been increasing. Here, we investigated osteophyte formation in knee joints of RA patients and associated factors.METHODS:We retrospectively examined findings of 35 knees in 30 RA patients (26 females, 4 males; mean age: 63.0 years; median disease duration: 15 years) who underwent TKA, including preoperative anteroposterior view radiographs of the knee joint. Using the ImageJ software package, osteophyte size in the medial femur (MF), medial tibia (MT), lateral femur (LF), and lateral tibia (LT) regions was also determined.RESULTS:The mean femorotibial angle was 179°, while Larsen grade was 2 in 1, 3 in 12, 4 in 18, and 5 in 2 patients. Osteophyte sizes in the MF, MT, LF, and LT regions were 37.2, 17.0, 27.2, and 4.57 mm2, respectively, and significantly greater in the medial compartment (MC; MF+MT) than the lateral compartment (LC; LF+LT) (p < 0.001). In varus cases, osteophyte size in the MC was significantly larger than normal and valgus cases (p = 0.0016). Furthermore, osteophyte size in the MC was negatively correlated with the inflammatory markers C-reactive protein (r = -0.492, p = 0.0027) and erythrocyte sedimentation rate (r = -0.529, p = 0.0016), whereas that in the LC was negatively correlated with disease activity (r = -0.589, p = 0.0023).CONCLUSION:Our results suggest that alignment and disease activity influence osteophyte formation in RA patients, with secondary OA a more prominent symptom in RA patients with controlled inflammation

Video Observations of Tiny Near-Earth Objects with Tomo-e Gozen

We report the results of video observations of tiny (diameter less than 100 m) near-Earth objects (NEOs) with Tomo-e Gozen on the Kiso 105 cm Schmidt telescope. A rotational period of a tiny asteroid reflects its dynamical history and physical properties since smaller objects are sensitive to the YORP effect. We carried out video observations of 60 tiny NEOs at 2 fps from 2018 to 2021 and successfully derived the rotational periods and axial ratios of 32 NEOs including 13 fast rotators with rotational periods less than 60 s. The fastest rotator found during our survey is 2020 HS7 with a rotational period of 2.99 s. We statistically confirmed that there is a certain number of tiny fast rotators in the NEO population, which have been missed with any previous surveys. We have discovered that the distribution of the tiny NEOs in a diameter and rotational period (D-P) diagram is truncated around a period of 10 s. The truncation with a flat-top shape is not explained well either by a realistic tensile strength of NEOs or suppression of YORP by meteoroid impacts. We propose that the dependence of the tangential YORP effect on the rotational period potentially explains the observed pattern in the D-P diagram.Comment: This article is published in PASJ as open access, published by OUP (https://doi.org/10.1093/pasj/psac043). 27 pages, 16 figure

Discovery of the Fastest Early Optical Emission from Overluminous SN Ia 2020hvf: A Thermonuclear Explosion within a Dense Circumstellar Environment

Ia型超新星の爆発直後の閃光を捉えることに成功 --特異な爆発に至る恒星進化の謎に迫る--. 京都大学プレスリリース. 2021-12-10.In this Letter we report a discovery of a prominent flash of a peculiar overluminous Type Ia supernova, SN 2020hvf, in about 5 hr of the supernova explosion by the first wide-field mosaic CMOS sensor imager, the Tomo-e Gozen Camera. The fast evolution of the early flash was captured by intensive intranight observations via the Tomo-e Gozen high-cadence survey. Numerical simulations show that such a prominent and fast early emission is most likely generated from an interaction between 0.01 M⊙ circumstellar material (CSM) extending to a distance of ∼10¹³ cm and supernova ejecta soon after the explosion, indicating a confined dense CSM formation at the final evolution stage of the progenitor of SN 2020hvf. Based on the CSM–ejecta interaction-induced early flash, the overluminous light curve, and the high ejecta velocity of SN 2020hvf, we suggest that the SN 2020hvf may originate from a thermonuclear explosion of a super-Chandrasekhar-mass white dwarf (“super-MCh WD”). Systematical investigations on explosion mechanisms and hydrodynamic simulations of the super-MCh WD explosion are required to further test the suggested scenario and understand the progenitor of this peculiar supernova