2,327 research outputs found
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Anaplastic Thyroid Carcinoma Histologically Mimicking a Plasmacytoma.
Anaplastic (undifferentiated) thyroid carcinoma (ATC) is a rare malignancy which may arise from transformation of a pre-existing differentiated carcinoma. We report the unique case where a lesion of thyroid origin presented with the histological features of mature plasma cells. Immunohistochemistry confirmed the lesion to be an anaplastic thyroid carcinoma arising from papillary thyroid carcinoma. A tumor mimicking a malignancy of a different cellular origin can lead clinicians to incorrect treatment approaches. Careful correlation with clinical details and knowledge of these unique presentations is important for reaching the correct diagnosis
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Association Between Vestibular Migraine and Migraine Headache: Yet to Explore.
ObjectivesTo evaluate if patients with a diagnosis of vestibular migraine (VM) by the International Classification of Headache Disorders (ICHD) criteria have meaningful differences in symptomatology and disease characteristics when compared to patients with concurrent vestibular symptoms and migraine that do not meet ICHD criteria.MethodsPatients who presented for the evaluation of vertigo were provided a detailed questionnaire about dizziness and migraine symptoms. Patients were assigned to either VM cohort (met ICHD criteria for VM) or migraine headache (MH) cohort (met ICHD criteria for migraine with or without aura but not VM). Disease characteristics, symptomatology, quality of life, and perceived stress score were compared between the cohorts.ResultsThe VM cohort demonstrated a shorter duration of vertigo episodes, 11 ± 22 hours versus 84 ± 146 hours in the MH cohort. In the VM cohort, 81% reported experiencing migraine headaches during episodes of vertigo, versus 61% in the MH cohort. All patients in the VM cohort reported a previous diagnosis of migraine headache, whereas 9% of the MH cohort had not been previously diagnosed by another physician. There was no difference in quality of life or perceived stress scores between the cohorts.ConclusionsA large proportion of vertigo patients with migrainous features do not meet the ICHD criteria for VM. The differences between cohorts represent selection bias rather than meaningful features unique to the cohorts. As such, VM and MH with vestibular symptoms may exist on a spectrum of the same disease process and may warrant the same treatment protocols
Modeling Temporal Evidence from External Collections
Newsworthy events are broadcast through multiple mediums and prompt the
crowds to produce comments on social media. In this paper, we propose to
leverage on this behavioral dynamics to estimate the most relevant time periods
for an event (i.e., query). Recent advances have shown how to improve the
estimation of the temporal relevance of such topics. In this approach, we build
on two major novelties. First, we mine temporal evidences from hundreds of
external sources into topic-based external collections to improve the
robustness of the detection of relevant time periods. Second, we propose a
formal retrieval model that generalizes the use of the temporal dimension
across different aspects of the retrieval process. In particular, we show that
temporal evidence of external collections can be used to (i) infer a topic's
temporal relevance, (ii) select the query expansion terms, and (iii) re-rank
the final results for improved precision. Experiments with TREC Microblog
collections show that the proposed time-aware retrieval model makes an
effective and extensive use of the temporal dimension to improve search results
over the most recent temporal models. Interestingly, we observe a strong
correlation between precision and the temporal distribution of retrieved and
relevant documents.Comment: To appear in WSDM 201
Adjuvant Migraine Medications in the Treatment of Sudden Sensorineural Hearing Loss.
Objectives/hypothesisTo examine the hearing outcomes of patients with sudden sensorineural hearing loss (SSNHL) treated with oral and intratympanic (IT) steroid only or a combination of steroid and migraine treatment. Our hypothesis was that adjuvant migraine medications may improve outcomes in SSNHL.MethodsA retrospective chart review at a tertiary otology center was conducted to identify patients with SSNHL who received oral steroid and IT dexamethasone injection(s) with or without migraine medications (a combination of nortriptyline and topiramate).ResultsA total of 47 patients received oral steroid and IT dexamethasone injection(s) only, and 46 patients received oral steroid and IT dexamethasone injection(s) as well as migraine lifestyle changes plus a combination of nortriptyline and topiramate. There were no significant differences in demographics and baseline audiometric data between the two groups. Both groups demonstrated improvements in pure tone average (PTA) and hearing thresholds at 250 Hz and 8000 Hz posttreatment. However, compared to steroid-only group, the adjuvant migraine medications group had significantly greater improvements in hearing thresholds at the lower frequencies (250 Hz, 500 Hz, 1000 Hz). Patients in the latter cohort also had greater improvement in PTA (P = .01) and received fewer IT injections (P = .04) PTA improvement of ≥ 10 dB was observed in 36 patients (78%) in the adjuvant migraine medications group and 22 patients (46%) in the control group (P < .001).ConclusionIn multimodal treatment of SSNHL, supplementing oral and IT steroid with migraine medications may result in greater improvements in lower frequency hearing thresholds and PTA. Furthermore, adjuvant migraine treatment can lead to decrease in number of IT injections, thus reducing procedure-related risks and complications.Level of evidence3 Laryngoscope, 131:E283-E288, 2021
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Efficacy of Multi-Modal Migraine Prophylaxis Therapy on Hyperacusis Patients.
ObjectivesTo evaluate the efficacy of a multi-modal migraine prophylaxis therapy for patients with hyperacusis.MethodsIn a prospective cohort, patients with hyperacusis were treated with a multi-modal step-wise migraine prophylactic regimen (nortriptyline, verapamil, topiramate, or a combination thereof) as well as lifestyle and dietary modifications. Pre- and post-treatment average loudness discomfort level (LDL), hyperacusis discomfort level measured by a visual analogue scale (VAS), and scores on the modified Khalfa questionnaire for severity of hyperacusis were compared.ResultsTwenty-two of the 25 patients (88%) reported subjective resolution of their symptoms following treatment. Post-treatment audiograms showed significant improvement in average LDL from 81.3 ± 3.2 dB to 86.4 ± 2.6 dB (P < .001), indicating increased sound tolerability. The VAS discomfort level also showed significant improvement from a pre-treatment average of 7.7 ± 1.1 to 3.7 ± 1.6 post-treatment (P < .001). There was also significant improvement in the average total score on modified Khalfa questionnaire (32.2 ± 3.6 vs 22.0 ± 5.7, P < .001).ConclusionsThe majority of patients with hyperacusis demonstrated symptomatic improvement from migraine prophylaxis therapy, as indicated by self-reported and audiometric measures. Our findings indicate that, for some patients, hyperacusis may share a pathophysiologic basis with migraine disorder and may be successfully managed with multimodal migraine prophylaxis therapy
Conservative Thirty Calendar Day Stock Prediction Using a Probabilistic Neural Network
We describe a system that predicts significant short-term price movement in a single stock utilizing conservative strategies. We use preprocessing techniques, then train a probabilistic neural network to predict only price gains large enough to create a significant profit opportunity. Our primary objective is to limit false predictions (known in the pattern recognition literature as false alarms). False alarms are more significant than missed opportunities, because false alarms acted upon lead to losses. We can achieve false alarm rates as low as 5.7% with the correct system design and parameterization
Adaptive scaling of cluster boundaries for large-scale social media data clustering
The large scale and complex nature of social media data raises the need to scale clustering techniques to big data and make them capable of automatically identifying data clusters with few empirical settings. In this paper, we present our investigation and three algorithms based on the fuzzy adaptive resonance theory (Fuzzy ART) that have linear computational complexity, use a single parameter, i.e., the vigilance parameter to identify data clusters, and are robust to modest parameter settings. The contribution of this paper lies in two aspects. First, we theoretically demonstrate how complement coding, commonly known as a normalization method, changes the clustering mechanism of Fuzzy ART, and discover the vigilance region (VR) that essentially determines how a cluster in the Fuzzy ART system recognizes similar patterns in the feature space. The VR gives an intrinsic interpretation of the clustering mechanism and limitations of Fuzzy ART. Second, we introduce the idea of allowing different clusters in the Fuzzy ART system to have different vigilance levels in order to meet the diverse nature of the pattern distribution of social media data. To this end, we propose three vigilance adaptation methods, namely, the activation maximization (AM) rule, the confliction minimization (CM) rule, and the hybrid integration (HI) rule. With an initial vigilance value, the resulting clustering algorithms, namely, the AM-ART, CM-ART, and HI-ART, can automatically adapt the vigilance values of all clusters during the learning epochs in order to produce better cluster boundaries. Experiments on four social media data sets show that AM-ART, CM-ART, and HI-ART are more robust than Fuzzy ART to the initial vigilance value, and they usually achieve better or comparable performance and much faster speed than the state-of-the-art clustering algorithms that also do not require a predefined number of clusters
Towards Longevity: Managing Innovativeness in Family Micro-Small-Medium Enterprises
This article explains the family and business strategies that the Micro-Small-Medium Enterprises (MSMEs) implement to dodge the ability-willingness paradox. The majority of the MSMEs in the metropolitan region of Jakarta are in their comfort zone. Only 15.90% utilize the Internet and 8.53% utilize the computer. According to the researchers' survey, most family businesses highlighted business longevity and emphasized the importance of technology and information. However, family MSMEs are still trapped in the ability-willingness paradox despite recognizing the importance of innovation. This study sampled five family MSME cases that are considered sustainable due to their innovativeness. It then investigated them by in-depth semi-structured interviews, observations, and field notes to explore how they strategize to employ innovativeness. The results signify the founders’/incumbents’ receptiveness towards innovations in the business. It also signifies the stakeholders’ contributive insights and the imposition of operations systemization. These findings stipulate the fundamentals for families in their MSMEs to engage in innovative activities that influence the longevity of their firms. This study concludes by recommending avenues for future research.
Keywords: family business, micro-small-medium enterprises, innovativeness, strategy, case studie
Ion Anisotropy and High-Energy Variability of Large Solar Particle Events: A Comparative Study
We have made comparative studies of ion anisotropy and high-energy variability of solar energetic particle (SEP) events previously examined by the Solar, Heliospheric, and Interplanetary Environment (SHINE) Workshop campaign. We have found distinctly different characteristics of SEPs between two large "gradual" events having very similar solar progenitors (the 2002 April 21 and August 24 events). Since the scattering centers of SEPs are approximately frozen in the solar wind, we emphasize work in the solar-wind frame where SEPs tend to be isotropized, and small anisotropies are easier to detect. While in the August event no streaming reversal occurred, in the April event the field-aligned anisotropy of all heavy ions showed sign of streaming reversal. The difference in streaming reversal was consistent with the difference in the presence of the outer reflecting boundary. In the April event the magnetic mirror, which was located behind the interplanetary shock driven by the preceding coronal mass ejection (CME), could block the stream of SEPs, while in the August event SEPs escaped freely because of the absence of nearby boundary. The magnetic mirror was formed at the bottleneck of magnetic field lines draped around a flank of the preceding CME. In the previous SHINE event analysis the contrasting event durations and Fe/O ratios of the both events were explained as the interplay between shock geometry and seed population. Our new findings, however, indicate that event duration and time as well as spectral variation are also affected by the presence of a nearby reflecting boundary
IMI – industry guidelines and ethical considerations for myopia control report
PURPOSE. To discuss guidelines and ethical considerations associated with the development and prescription of treatments intended for myopia control (MC). METHODS. Critical review of published papers and guidance documents was undertaken, with a view to carefully considering the ethical standards associated with the investigation, development, registration, marketing, prescription, and use of MC treatments. RESULTS. The roles and responsibilities of regulatory bodies, manufacturers, academics, eye care practitioners, and patients in the use of MC treatments are explored. Particular attention is given to the ethical considerations for deciding whether to implement a MC strategy and how to implement this within a clinical trial or practice setting. Finally, the responsibilities in marketing, support, and education required to transfer required knowledge and skills to eye care practitioners and academics are discussed. CONCLUSIONS. Undertaking MC treatment in minors creates an ethical challenge for a wide variety of stakeholders. Regulatory bodies, manufacturers, academics, and clinicians all share an ethical responsibility to ensure that the products used for MC are safe and efficacious and that patients understand the benefits and potential risks of such products. This International Myopia Institute report highlights these ethical challenges and provides stakeholders with recommendations and guidelines in the development, financial support, prescribing, and advertising of such treatments.</p
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