RESUMO
Purpose: To develop and validate a nomogram for predicting the risk of tinnitus severity in patients with unilateral subjective tinnitus. Methods: The objective of this study was to establish and validate a nomogram specifically designed for patients with unilateral subjective tinnitus. We collected data on unilateral subjective tinnitus from the Air Force Medical Center, including 146 participants between January 2021 and June 2022. Risk factors for unilateral subjective tinnitus severity were evaluated by least absolute shrinkage and selection operator (LASSO) and binary logistic regression analysis. Internal verification was used to evaluate the performance of the nomogram. The discriminative ability was measured by the consistency index (C-indices) and the area under the curve (AUC) of the receiver operating characteristic (ROC) curves. Results: All included patients were randomized according to a 7:3 ratio into the training cohort (104 patients) and the validation cohort (42 patients). The LASSO regression model identified sex, tinnitus loudness, and hearing loss as candidate variables. Binary logistic regression analysis showed that gender (OR: 0.76; 95% CI: 0.6-0.95; P = 0.021) and tinnitus loudness (OR: 1.37; 95% CI: 1.09-1.72; P = 0.009) were significant predictors of unilateral subjective tinnitus severity, while age, tinnitus matching frequency, and tinnitus duration were not. The significant predictors were included in the nomogram. Hearing loss was included in the nomogram based on prior clinical experience and previous studies. The training and validation cohorts C-indexes were 0.707 (95% CI: 0.607-0.806) and 0.706 (95% CI: 0.548-0.863), respectively. The training and validation cohort's AUC of the ROC curves were 0.692 and 0.705, respectively. Conclusion: We have developed and validated a nomogram based on gender, hearing loss, and tinnitus loudness, which can effectively predict the risk of tinnitus severity in patients with unilateral subjective tinnitus. The nomogram provides personalized prediction results for patients with unilateral subjective tinnitus, which is beneficial for clinical decision-making and treatment plan development.
RESUMO
In this paper, a three layered metamaterial composed of a ring-chain structure sandwiched between two layers of twisted sub-wavelength cut-wire arrays is proposed and investigated. The designed structure is optimized such that asymmetric transmission with an extremely broad bandwidth, sharp rejection stop-band and high transmittance is achieved. The physical mechanism is accounted for that the metallic layers form the Fabry-Perot-like resonance cavity, enhancing the polarization conversion efficiency between two orthogonal linearly polarized waves. To some extent, this approach offers a way to strengthen asymmetric transmission effect.
RESUMO
In order to deeply explore the mechanism of sludge reduction in OSA system, carbon balance was performed in an anoxic-oxic-settling-anaerobic (A + OSA) system and a reference AO system to investigate effects of inserting a sludge holding tank in sludge cycle line on the sludge reduction process. Meanwhile, carbon mass change in each reaction unit was identified in terms of solid, liquid and gas phases. The causes of excess sludge reduction in A + OSA system were deduced. The carbon balance results show that when the hydraulic retention time in the sludge holding tank is 7.14 h, carbon percent in solid phase of the sludge reduction system is nearly 50% higher than that of the reference system, supporting the consequence that sludge reduction rate of 49.98% had been achieved. The insertion of a sludge holding tank in the sludge return circuit can be effective in sludge reduction. Carbon changes in each unit reveal that the amount of carbon consumed for biosynthesis in the anoxic and oxic tanks (main reaction zone) of the sludge reduction system is higher than in that of the reference system. Sludge decay is observed in the sludge holding tank. Furthermore, CH4 released from the sludge holding tank is significantly higher than that from the main reaction zone. The DGGE profiles show that there are hydrolytic-fermentative bacteria in the sludge holding tank related to sludge decay. The excess sludge reduction in the A + OSA system could be a result of the combination of sludge decay in the sludge holding tank and sludge compensatory growth in the main reaction cell.
