1,354,286 research outputs found
Monoclonal antibodies targeting CGRP to treat vestibular migraine: a rapid systematic review and meta-analysis
No full textVestibular migraine (VM), a subtype of migraine characterized by vestibular symptoms, poses a significant diagnostic and therapeutic challenge. This study aimed to evaluate the effectiveness of monoclonal antibodies targeting Calcitonin Gene Related Peptide (CGRP) in the treatment of VM. Therefore, we conducted a rapid systematic review and meta-analysis following PRISMA and Cochrane guidelines. A search of databases (PubMed, Scopus, Cochrane and Google Scholar) was performed in October 2023. Inclusion criteria required original research articles focusing on patients diagnosed with VM and utilizing CGRP-targeting monoclonal antibodies. We performed qualitative assessments of study design, patient characteristics, and outcomes and, for studies with comparable outcome measures, a meta-analysis was conducted. Our search yielded four relevant studies, including cohort studies and a case report, totaling 99 patients. Proper vestibular instrumental tests were employed in half of the studies. Overall, the included studies reported significant improvements in VM symptoms. Our quantitative analysis, focused on migraine symptoms, demonstrated a substantial reduction in Monthly Days with Migraine at 6 months following treatment. No severe adverse drug reactions were reported. In conclusion, this rapid systematic review and meta-analysis provide preliminary evidence for the efficacy of CGRP-targeting monoclonal antibodies in treating Vestibular Migraine. However, the absence of randomized controlled trials and variations in study designs and diagnostic criteria introduce some limitations. Further research is needed, including controlled trials, to establish a more robust evidence base. Nonetheless, this treatment approach offers hope for the effective management of VM, potentially enhancing the well-being of affected individuals and reducing their associated disability.Novel Therapeutic Strategy: Monoclonal antibodies targeting CGRP offer a promising new treatment avenue for Vestibular Migraine.Significant Symptom Improvement: Patients administered with these antibodies exhibited notable reductions in the frequency and severity of symptoms.Migraine-related Disability: There's a marked decrease in migraine-related disability among patients treated with monoclonal antibodies against CGRP.Research Gaps Identified: Despite the promising results, there's a lack of randomized controlled trials and a considerable heterogeneity among existing studies.Call for Further Research: High-quality, randomized controlled trials are urgently needed to solidify the role of these antibodies in clinical management of Vestibular Migraine
Future Perspectives in the Management of Otitis Media
No full text: Otitis media, which encompasses acute otitis media (AOM) and chronic otitis media (COM), is a prevalent and significant health issue affecting both children and adults [...]
Authorship transparency and equity in otolaryngology and maxillofacial surgery: current practices and the potential impact of large language models
No full textPurpose: The determination of authorship order in scientific publications is critical for researcher recognition and career progression. According to a recent survey’s meta-analysis, the prevalence of Honorary Authorship reaches 20% of authors. This study evaluates the adoption and proficency of authorship guidelines in maxillofacial surgery and otolaryngology. Methods: On March 16, 2024, a search of Scopus-indexed journals identified relevant journals in from which recent articles were sampled using a stratified random method. The author contribution alignment with actual authorship was evaluated through CalculAuthor tool and a detailed process involving large language models (LLM) and manual checks, employing statistical tests to evaluate the adoption of author contribution guidelines and agreement scores across different fields and journal quartiles. Results: A review of 21 Scopus-indexed journals revealed that 8 adhered to the CRediT system, 7 to other systems, and 6 had no guidelines. From 147 randomly selected manuscripts, 57 reported contributions (38.8%). The mean agreement score was 65.3% (SD = 26.8), without significant differences in journal quartiles or disciplines. Conclusions: This study highlights the moderate to low adoption of standardized contribution systems in maxillofacial and otolaryngology journals, with a fair level of agreement between reported contributions and actual authorship. Future research should focus on larger, more diverse samples and develop prospective implementations to ensure accurate and equitable authorship credit in the context of the Artificial Intelligence’s scientific writing era
Higher incidence of Ménière’s disease during COVID-19 pandemic: a preliminary report.
No full textBackground: Coronavirus disease 2019 (COVID-19) pandemic represented a stressful event.
Objectives: The incidence of newly diagnosed Meniere’s disease (MD) patients before and during
COVID-19 at our Institution was calculated.
Materials and methods: The period 2018–2020 was considered. Incidence was calculated as number
of annual first MD diagnoses divided by the number of annual first audiological evaluations.
Results: One hundred and eighty-three patients were considered. Annual incidence of MD at our institution
was 1.3% in 2018, 1.2% in 2019, and 3.2% in 2020, resulting in a significant increase during
COVID-19 pandemic (2018 vs. 2020, p=.00001; 2019 vs. 2020, p=.00001). MD patients in 2020 presented
a higher number of vertigo attacks (2018 vs. 2020, p=.04; 2019 vs. 2020, p=.04) and higher
Dizziness Handicap Inventory questionnaire (DHI) values (2018 vs. 2020, p=.02; 2019 vs. 2020, p=.03).
During COVD-19 pandemic, MD patients reported significantly higher State-Trait Anxiety Inventory
(STAI) – Y1 (2018 vs. 2020, p=.04; 2019 vs. 2020, p=.03).
Conclusions and significance: A higher incidence of MD first diagnosis was calculated during COVID-
19 pandemic; furthermore, MD patients presented with more vertigo attacks and higher DHI values.
These could be associated with the higher state anxiety during COVID-19 pandemic
Virtual Pooled Inventories for equipment-intensive industries. An implementation in a paper district
No full textInventory Pooling occurs when different actors share their inventories with the aim of reducing costs while improving performances. The paper-making industry requires large amounts of ready to install spares aimed at assuring high availability, but presents the drawback of excessive inventory costs. Pooling inventories, with the support of appropriate IT solutions, can be considered an effective strategy to improve availability while reducing the total costs. In the present work a real-life implementation within an important Italian paper-making district has been successfully carried out. Throughout the study the most recent theoretical models have been adapted after a methodical analysis that has been devoted to allow the identification and of the most significant issues and the building of a wide and solid agreement among the participants. Indeed, this required a thorough investigation, since the involved actors are generally competitors and only agree to pool inventories if this leads to increasing profits for themselves
Monoclonal Antibodies Targeting CGRP: A Novel Treatment in Vestibular Migraine
No full textBackground. Monoclonal antibodies (mAbs) directed against the calcitonin gene-related peptide (CGRP) or its receptor represented the first targeted and specialized approach to migraine prophylaxis. Nevertheless, they have been rarely considered in the treatment of vestibular migraine (VM). Our aim was to evaluate the effectiveness of anti-CGRP mAbs in VM patients who did not respond to conventional migraine treatments. Methods. Consecutive VM patients treated with erenumab were considered. As a comparison, we considered the same VM patients during conventional migraine treatments (i.e., propranolol, flunarizine, or valproic acid), which were tried before mAbs therapy. Videonystagmography, the Italian version of the Dizziness Handicap Inventory (DHI) questionnaire, and migraine days over the last 3 months were evaluated in all patients before and after treatments. Results. In the present retrospective study, we included 21 female and 2 male VM patients, mean age 45.2 years. All patients underwent contrast-enhanced magnetic resonance imaging that ruled out other causes of vertigo. The DHI questionnaire significantly improved after mAb therapy (p < 0.0001). Mean migraine days over the last 3 months were significantly reduced after treatment (p = 0.001). Videonystagmography was altered in 11 (48%) patients prior to monoclonal antibodies. We found vertical positional nystagmus in 9 patients and horizontal positional nystagmus in 2 patients. After the treatment, we found vertical positional nystagmus only in 1 patient (p = 0.002). When patients were treated with conventional therapies, there was no significant reduction in DHI, and instrumental vestibular examinations remained altered. Conclusions. VM patients using anti-CGRP mAbs experienced a reduction in the dizziness-derived handicap, as reported in the DHI questionnaire. Furthermore, these treatments were significantly associated with a normalization of vestibular instrumental analysis. These findings were not seen with conventional treatments. Treatment with anti-CGRP mAbs may be effective in VM patients who did not respond to conventional migraine treatments. These findings should be tested in large, randomized clinical trials
Redesign of Supply Chain in Fashion Industry based on Strategic Engineering
No full textThis paper proposes the innovative approach of Strategic Engineering to Fashion Industry in order to redesign the Supply Chain of Medium Size Enterprises active in high quality Made in Italian women's footwear and how this innovative approach could support enhancements and improvements over multiple target functions. The paper introduces the approach and proposes the framework as example of how combining Modeling and Simulation, Artificial Intelligence and Data Analytics in closed loop with real data it could be possible to support Decision Makers in re-engineering processes and redesigning business models even in Small Medium Size Enterprises devoted to high quality production. (C) 2022 The Authors. Published by Elsevier B.V
A novel approach to safety stock management in a coordinated supply chain with controllable lead time using present value
No full textThis paper considers the management of safety stock in a coordinated single-vendor single-buyer supply chain under continuous review and Gaussian lead-time demand. The lead time is supposed controllable, and shortages are not allowed.We follow the present value criterion by considering both inflation and time value of money. Our aim is to present a novel approach to optimizing the safety stock in such system. Under the conditions considered, the safety stock is typically determined according to the value assigned to the safety factor, which is thus treated as a parameter of the model, and not as a decision variable. In this paper, we take a different perspective by putting the order quantity and the safety factor in functional dependence through the adoption of a specific parameter. More precisely, we express the service level as a function of the number of admissible stockouts per time unit and the order quantity. This allows optimizing the safety stock taking into account the constraint on the number of admissible stockouts per time unit. We present both exact and approximated minimization algorithms. Numerical examples are finally shown to illustrate the effectiveness of the approximation algorithm, and to investigate the sensitivity of the model with respect to variations in some fundamental parameter
Age at Fitting Affected Unilateral Versus Bilateral Hearing Aids Choice in Asymmetric Hearing Loss
No full textBACKGROUND: Bilateral hearing aids are desirable to restore hearing in the most effective and natural way. The aim of the present study was to identify which type of hearing rehabilitation was preferred by our patients and which factors drove their choice. METHODS: One hundred eight patients with moderate-to-severe asymmetrical hearing loss before and after a 1-month trial with bilateral hearing aids were considered. RESULTS: As high as 58.3% of patients decided to continue with bilateral hearing aids (group BI), while 41.7% chose unilateral hearing aid (UNI group) in the best ear. Patients in the UNI group were significantly older than those in the BI group (P =.04); age > 77 years was an independent prognostic factor of unilateral hearing aid choice (odds ratio = 6.26; P =.04). Matrix test scored significantly worse with a single hearing aid than with 2 hearing aids in both groups (UNI P =.03; BI P =.01). CONCLUSION: Patients with asymmetric hearing loss often prefer unilateral hearing aid, almost half in our experience. Nonetheless, bilateral hearing aids are desirable as unilateral hearing aid was associated with significantly poorer performance at a speech in noise hearing tests. Age at fitting could play a relevant role and is thus important in early diagnosis. Further studies are needed to confirm our results and investigate strategies to promote bilateral rehabilitation
Integrating considerations of uncertainty within the OEE of a manufacturing line
No full textLean manufacturing has become a paramount production paradigm in many industrial sectors and overall equipment effectiveness (OEE) is a widely accepted and adopted lean metric for any type of machine/equipment. However, the standard OEE formulation presents two important limits: 1) it deals with a single machine; 2) gives a deterministic measure of effectiveness. The objective of this paper is to overcome both of these two shortcomings by proposing a Fuzzy approach for measuring the OEE of a manufacturing line (OEEML). Hence, starting from a possible definition of OEEML, this paper provides a framework to measure its modal value and its variability on an entire manufacturing line. The approach exploits fuzzy triangular numbers instead of burdensome stochastic quantities to measure this variability. Furthermore, it integrates a method which enables us to avoid the annoying 'overestimation effect' of FTNs. The integrated approach has proved to be useful in consistently capturing the OEEML variations, also, both the modal value and the range obtained from its application are good estimators of both the OEEML and its variability. A full case study is finally provided to show the effectiveness of the proposed approach in diagnosing problems and addressing improvement actions
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