Our series confirms excellent hearing results achieved in stapedotomy surgery, also in long-term follow-up. On the long-term no patient-, disease-, or procedure-related variables were identified as predictors of surgical success.
In Graves' orbitopathy, surgical decompression is often needed for functional and aesthetic reasons. This meta-analysis was performed to assess the efficacy and safety of fat removal orbital decompression (FROD) alone to treat exophthalmos in Graves' orbitopathy. A systematic search was conducted in PubMed/MEDLINE, Web of Science, and Cochrane Library for studies published before August 2018. Random-effects meta-analyses were applied; weighted means and weighted proportions with corresponding 95% confidence intervals (CI) were calculated. Study quality and quality of evidence for each individual outcome were analyzed. Of 1908 records initially identified, 13 observational studies were selected, representing 4820 orbits in 2514 patients. Weighted Hertel exophthalmometry was 23.10 mm (95% CI 21.77-24.43 mm) preoperative and 19.31 mm (95% CI 17.81-20.81 mm) postoperative. The weighted mean difference was 3.81 mm (95% CI 3.41-4.21 mm). Five studies reported an improvement of diplopia after surgery, occurring in 943 of 1172 patients (weighted proportion 0.50, 95% CI 0.15-0.85). Persistent new onset diplopia was reported in five studies, or 124 of 1277 patients (weighted proportion 0.15, 95% CI 0.03-0.27). No serious adverse events were reported. Results support the effectiveness and safety of FROD to treat mild-to-moderate exophthalmos in Graves' orbitopathy. Prospective and controlled trials are needed to improve the level of evidence.
Fault states In railway systems, there are many different fault states which can occur during operation. For safety reasons, these well known fault states have to be prevented by train monitoring. But fault states may also have dependencies among each other, which are not sufficiently known yet or used for fault state prevention. Approach of systematic description Thus, in a first step an abstract approach has been developed for the description of dependencies. Based on this and as systematic description of all relevant states and their dependencies a fault state matrix has been created, which is considered in this paper.
The A-weighted sound pressure level (SPL) is commonly used to assess the effect of noise reduction measures on noise-induced annoyance. While for road traffic noise loudness seems to be a better descriptor of annoyance, for railway noise a systematic investigation seems to be lacking. Thus, in this study, the relation between annoyance and perceptually motivated descriptors was investigated for various conditions of binaural recordings of pass-bys of cargo and passenger trains. The conditions included free field and spectral mitigations caused by a 4 m high noise barrier, a 1 m high noise barrier close to the track, and rail dampers. Forty listeners performed a free magnitude estimation of annoyance for different presentation levels and the ratings were fit to various models. Further, level changes required to evoke a noticeable change in annoyance (annoyance thresholds) were acquired. The models based on the A-weighted SPL explained the ratings and thresholds better when the reduction measure was explicitly provided as a parameter. However, the optimal models were loudness-level-based models, which were able to better describe the annoyance, even independently of the reduction measure. Both experiments underline the effectiveness of loudness when describing the annoyance in the area of railway noise reduction.
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