Tinnitus: associated symptoms and possible triggering factors

Monitoring is fundamental for the prediction and analysis of landslide triggering factors and dynamic behaviour and major issues in the hazard assessment and risk mitigation. Wired monitoring systems have traditionally been used in landslide monitoring. However, wireless technologies are escalating in this field as a consequence of their multiple advantages against standard wired systems, such as their versatility and lower power consumption. Wireless monitoring is a perfect solution for the acquisition of data on geological processes in remote areas where power availability is scarce and the position of the sensors is often a critical issue due to the landscape conditions. In this paper, a complete landslide wireless monitoring system is described within the context of a successful case study in the Central Pyrenees, Spain. The Rebaixader constitutes a typical high mountain catchment where landslides and torrential processes occur with a sub-annual frequency. Rainfall is the principal triggering factor of the type of landslides occurring at the Rebaixader (debris flows), but the specific details of the geotechnical mechanisms that originate the events is still not clear. In order to increase the knowledge on the processes occurring at the catchment, it was equipped with a Loadsensing network for the monitoring of triggering factors and a Spidernano Seismic Remote Unit for the acquisition of the ground vibration generated by the moving mass. The Loadsensing sensor network incorporates seven nodes provided with wireless communication capabilities, showing ultra-low power consumption and long-range communication. Digital, pulse and voltage sensors are connected to these nodes in order to monitor soil water content, soil water potential, snow height, 5-minute rainfall intensity, and air temperature and humidity. The sensor nodes communicate in a multi-hop fashion to deliver the information into a gateway, placed 500 m away in the line of sight, with two repeaters placed along the line. The gateway offers enhanced computational and storage capabilities, as well as 3G modem communication to the data centre. Spidernano is a seismic remote unit (SRU) equipped with GPS clock discipline, which is connected to the Gateway via Ethernet cable. It was connected to three 1D geophones recording simultaneously the ground vibration generated by the passage of the debris-flow mass near the geophones. It has a low power consumption (0.5 W), specially adapted for field campaigns or permanent monitoring. The recordings revealed that debris-flow occurrence can be detected by ground vibration signal and the approach of the flowing mass can even be detected before the arrival. Data acquired by Loadsensing provided valuable results on the understanding of the failure and post-failure mechanisms such as the infiltration patterns of water into the soil before and during the events. All these achievements are promising results for the application of low power wireless technologies not only for standard landslide monitoring but also for landslide early warning systems.

Prevalence of Triggering Factors in Acute Stroke: Hospital-based Observational Cross-sectional Study

BackgroundSystemic lupus erythematosus (SLE) is a chronic relapsing-remitting disease characterized by a clinical heterogeneity, an unpredictable pattern and a capricious course. Despite great advances in diagnosis and treatment strategies, lupus...

Background: Headache is a painful condition related to a major lack of productivity, limitation of social activities and impairment of quality of life.Method: in this study a structured questionnaire was formulated in a form of multiple choices questions to gather information on the clinical characteristics, associated factors and the triggering factors along with the mode of treatment adopted by dental and medical undergraduate students of the University of Baghdad in the period from January to March 2019. Language of questionnaire was made simple and easily understandable to students. Students were assured of confidentiality and the participation was entirely voluntary.Results: in this study a total number of 340 students participated, 170 of them were medical students 76(44.7%) males and 94(55.3%) females, and the other 170 were dental students 45(26%) males and 125(74%) females .It was found that 170 medical students had 161 associated symptoms with headache , the most common associated symptoms was scalp tenderness 44(25.9%), while the least common associated symptom was diarrhea 4(2.4%).While 170 dental students had 162 associated symptoms, the most common associated symptoms was scalp tenderness 46 (27.2%), while the least common associated symptom was seizures 2 (1.2%). 170 medical students expressed 385 triggering factors for causation of headache. It was found that the most common triggering factors was irregular sleep 118(69.4%). And 170 dental students expressed 437 triggering factors for causation of headache. It was found that the most common triggering factors was stress 136 (80.5%). In this study the percentage of medical students who taking self medications was 88.82% and 92.35% for dental students also it was found that both medical & dental students had the highest percentage for using Paracetamol as analgesic, 119(70%) for medical students, and 126(74.6%) for dental students.Conclusions: the results of this study show that the majority of both medical and dental students suffer from headache with self medications used by the majority.

The present study attempts to assess geo-spatial distribution of landslide susceptibility in the Balason river basin of Darjeeling Himalaya using clustering of various factors i.e. geomorphological factors, lithological factors group, hydrological factors, triggering factor, protective factor and anthropogenic factor. The geomorphological factors, lithological factors group, hydrological factors, triggering factor, protective factor and anthropogenic factor were being integrated with the help of geomorphological factor group model, lithological factor group model, hydrological factor group model, triggering factor group model, protective factor group model and anthropogenic factor group model. To prepare data layers such as elevation, slope, aspect, curvature, geology, geomorphology, soil, drainage density, distance to drainage, lineament density, distance to lineament, stream power index, topographic wetness index, NDVI and LULC Google earth, topographical maps, SRTM DEM, satellite images were processed properly in GIS environment.

tating factors for both migraine and tension-type headache attacks has identified several potential triggers with percentages differing widely among studies [1–5]. They include menstrual cycle, particularly in women affected by migraine; environmental factors, especially changes in weather conditions and temperature; afferent stimulation, physical activity and psychological factors, mainly stress or relaxation from stress; sleep disturbances; frequent travelling; oral contraceptives; and finally eating habits, and some food items. According to some authors, lifetime migraineurs experienced headache attacks preceded by triggering factors more frequently than tension-type headache sufferers [5]. Moreover, certain endogenous and exogenous factors seem to differentiate migraine from tension-type headache and it is of interest to note in this regard that three of the precipitating factors considered more migraine-specific (i.e., weather, smell and smoke) involve the nose/sinus system, suggesting a greater significance of this system in migraine than is generally believed [4]. The aim of the Wober et al. [6] study was to investigate the consistency of the recurrence of precipitating factors in migraineurs and tension-type headache patients enrolled from a clinical outpatient setting and from a sample, although not conspicuous, of the general population. The authors found that the majority of trigger factors precipitate migraine and tension-type headache only occasionally and not consistently in almost the majority of cases. In contrast to previous experiences, no differences emerged in this study in the percentages of factors referred as attack precipitants between the two patient groups. The occasional occurrence of some precipitating factors in some but not all migraine and tension-type headache attacks supports the view that they can surely play a role, although not exclusively, in influencing the pathophysiological substrate underlying the threshold for attacks in both headache forms. This predisposed substrate can be, from time to time, influenced by different inner and outer stimuli. Mechanisms involved in the potentiality of different factors in precipitating attacks by activating strategic brain areas involved in the generation and abnormal processing of painful information from the head remain to be established. New imaging techniques and particular experimental settings could be helpful in clarifying this important issue, at least for some attack precipitants, as recent experiences have found [7]. J Headache Pain (2006) 7:172–173 DOI 10.1007/s10194-006-0304-4

: The measurement of landslide superficial displacement often represents the most effective method for defining its behavior, allowing one to observe the relationship with triggering factors and to assess the effectiveness of the mitigation measures. Persistent Scatterer Interferometry (PSI) represents a powerful tool to measure landslide displacement, as it offers a synoptic view that can be repeated at different time intervals and at various scales. In many cases, PSI data are integrated with in situ monitoring instrumentation, since the joint use of satellite and ground-based data facilitates the geological interpretation of a landslide and allows a better understanding of landslide geometry and kinematics. In this work, PSI interferometry and conventional ground-based monitoring techniques have been used to characterize and to monitor the Santo Stefano d’Aveto landslide located in the Northern Apennines, Italy. This landslide can be defined as an earth rotational slide. PSI analysis has contributed to a more in-depth investigation of the phenomenon. In particular, PSI measurements have allowed better redefining of the boundaries of the landslide and the state of activity, while the time series analysis has permitted better understanding of the deformation pattern and its relation with the causes of the landslide itself. The integration of ground-based monitoring data and PSI data have provided sound results for landslide characterization. The punctual information deriving from inclinometers can help in defining the actual location of the sliding surface and the involved volumes, while the measuring of pore water pressure conditions or water table level can suggest a correlation between the deformation patterns and the triggering factors.

In this work a detailed geomorphological study aimed to reconstruct the Holocene evolution of a slope largely affected by landsliding is presented. The study area is located in the lower valley of the Tanagro River, flowing in the Auletta basin, a Pliocene to Quaternary tectonic depression located along the elongation axis of southern Apennines. In order to investigate the relationships between landscape evolution and triggering factors, and to better constrain the Holocene palaeoclimate scenario in which the mass movements occurred, geomorphological data have been integrated with those deriving by the stratigraphic, chronological, and minero-geochemical analyses of the deposits genetically related to the landslide events. The investigated landslide shows a complex style of activity, with compound rotational and translational slide in the upper part of the slope evolving into flow in the lower part. The chronological evolution of the landslide activity has been constrained through radiocarbon dating of palustrine deposits, genetically related to the landslide, and of interbedded paleosols. On the basis of the presented data, the main landslide event can be placed at the beginning of the Holocene and it is followed by a period of scarse landslide activity, as demonstrated by the sedimentation of palustrine deposits within an endorheic pond. As the small basin was created by a counterslope rotation related to the main landslide phenomenon, its deposits post-date the age of the landslide. The geomorphological features related to the main gravitative event are strongly modified by reactivations occurred at the beginnings of Sub-Boreal period, which represent, in southern Europe, the warmest and wettest stage of the Holocene. As confirmed by mineralogical and geochemical data, intense and/or prolonged precipitation might have played a major role as triggering factor in reactivating the slope movement.

Fibrous dysplasia (FD) is a rare, benign disease of unclear etiology where normal bone is replaced with abnormal fibrous and weak osseous tissue. Any bone of the skeleton might be involved but skull is one of the most commonly affected sites. Fibrous dysplasia is known to be caused by a genetic mutation leading to inappropriate proliferation and differentiation of osteoblastic cells. However; it is not known whether any triggering factor exists which might contribute to this genetic mutation. The authors postulated that trauma might be a triggering factor for this disease. Trauma, as a triggering factor, has not been reported to be clearly linked to FD in the literature so far. Through this perspective; the authors report a patient of fronto-orbital fibrous dysplasia developing 6 years after a fronto-orbital skull fracture, at the same localization of the fracture line.

Shallow landslides are geological phenomena that affect soil of small thickness originated from the weathering of the bedrock and downslope transportation. The goal of this work is to analyze the correlation between the conditioning factors and the triggering factor (rainfall) of shallow landslides in the continental area of Portugal. The understanding of the correlation between these factors can be of great help for the development of early warning systems, since it enables near real time updates of susceptibility maps relying on the rainfall forecast and the  specific physical characteristics of different regions. We used the DISASTER landslide historical database and analyzed the following conditioning factors: elevation, slope, aspect, lithology, land use, distance to rivers and faults. The historical rainfall data were obtained from the gridded NetCDF file provided by the Copernicus climate services. An automatic script was created to filter in the database the landslides that can be considered a shallow landslide and the ones that were probably triggered by rainfall events. Another automatic script was created to extract from the NetCDF file the intensity of the rainfall event that triggered the landslide. Then, we used the Boruta algorithm for feature selection. The Boruta algorithm helps to reduce the number of features in a dataset by identifying features that do not influence the study variable. In our case, the algorithm analyses which conditioning factor influences the rainfall intensity necessary to cause the respective landslide. It was found that only the lithology, slope, elevation and aspect had a significant contribution to the definition of the necessary rainfall intensity. In order to analyze how the changes in the conditioning factors affect the rain intensity necessary to cause the landslide, we grouped the events by lithology.  Two-mica granites were the lithology with the widest range of rainfall intensities that triggered landslides, reaching the lowest and higher values. This result possibly demonstrates that regions dominated by two-mica granites have higher susceptibility to landslides. Next, the Pearson correlation was used to determine whether the correlation between the relevant conditioning factors and the triggering factor were positive or negative. As a preliminary result, we found that all the Pearson correlations were low and positive, showing that the increase of value of conditioning factors result in a small increase in rain intensity necessary to cause landslides. This correlation can be probably explained by analyzing the scatter plot “rainfall intensity/slope”. The plot shows that the slopes lower than 10 degrees and higher than 20 degrees show a minimum rainfall intensity higher than the ones within slopes between 10 and 20 degrees. This could be explained by the fact that shallow slopes have low gravitational potential energy demanding high rainfall intensities to trigger a landslide and steep slopes could not have enough material accumulated to generate a landslide with low rainfall intensity. The next step will be to run a statistical model to completely correlate the conditioning factors with the respective rainfall intensities.

Tangka Sub-Watershed in West Sinjai District is one of the sub-watersheds in South Sulawesi, which often experiences landslides. Factors causing landslides were divided into control factors and trigger factors. One of the triggering factors for landslides is the characteristics of soil and plant properties. Several previous research results stated that soil characteristics greatly affect the occurrence of landslides, while plant roots help stabilize soil bonds and slopes. This study aims to determine the triggering factors of the soil (soil texture and porosity) and the distribution of plant roots that affect the occurrence of landslides. Soil texture analysis using hydrometer method. Soil porosity and moisture content using gravimetric and pycnometer methods. The results showed that the soil texture was dominated by silty clay loam impact on low soil cohesion. Intensive land use decreases soil porosity to <50% and increases soil bulk density to 1.4 g/cm3. The soil quickly becomes saturated and could induce the rotting of plant roots. These characteristics increase the vulnerability of the soil, thereby increasing the potential for landslides.

Among various actions taken to improve the prognosis of critical care patients, an important step is including hemophagocytic lymphohistiocytosis (HLH; hemophagocytic syndrome) in the differential diagnosis. HLH is an uncontrolled, self-propelling hyperinflammation. It can be initiated in a predisposed individual by various triggering factors: infection (especially viral, notably Epstein-Barr virus (EBV)), malignancy (frequently by T-cell lymphoma), or autoimmune disease. The triggering factor unleashes a positive feedback loop with extremely high concentrations of pro-inflammatory cytokines (“cytokine storm”) which leads to multiorgan failure (MOF) and death. Only timely proper diagnosis and treatment can reverse this dismal outcome. The cause of this rare, pathologic hyperinflammation is an immune dysfunction, which in familial cases was found to result from an inherited lack of cytotoxic activity of T cytotoxic and natural killer lymphocytes, which retain the ability to release cytokines. A similar, but not fully understood, mechanism is expected in the acquired cases. Mutations in cytotoxic granule pathway genes (e.g., Perforin, UNC13D or STX11) are the cause in familial HLH [1]. HLH was at first perceived as affecting only infants with mutations in these specific genes, but later the syndrome was also found in adolescents and adults, so the term “secondary HLH” was coined. This approach was abandoned because (regardless of age and mutation status) all HLH episodes are thought to be secondary to a triggering factor (which cannot always be identified). Nowadays, with a growing number of adult patients of whom a considerable proportion harbor a proven mutation in HLH-related genes (25 % [2], 14 % [3]), the syndrome is considered as a continuum from neonates with complete loss of cytotoxic function, through adolescents to elderly adults with mutations only partially affecting the cytotoxic activity or patients without any characteristic mutation but with symptomatic HLH. In most patients, in the absence of genetic traits, diagnosis of HLH is based on fulfillment of five out of eight HLH 2004 [1] criteria: 1) persistent fever; 2) splenomegaly; 3) bicytopenia (hemoglobin 265 mg/dl); 5) hyperferritinemia (>500 ng/ml); 6) hemophagocytosis; 7) low natural killer cell activity; and 8) high concentration of sCD25 (soluble receptor for interleukin 2). Hemophagocytosis occurs when activated macrophages phagocytose other blood or bone marrow cells. Despite the name of the syndrome, hemophagocytosis is neither necessary nor sufficient to diagnose HLH—it is only one of the criteria. It is not an essential part of the HLH pathomechanism, but rather develops in a more advanced stage of the process [4]. Therefore, it can be absent in patients with HLH, and it is also not pathognomonic for this syndrome. Hemophagocytosis is a frequent finding, especially in intensive care—it was observed in 64 % of the ICU patients with sepsis and thrombocytopenia [5] (32/50) and in 65 % deceased ICU patients [6] (69/107). Diagnosis of HLH is possible without bone marrow aspirate/biopsy; however, this procedure should be performed to search for underlying malignancy. Neoplasms are among the most important HLH triggers in adults and are associated with a poor prognosis [7]. The most important parameter, besides cytopenias, characteristic for HLH is hyperferritinemia. The specific (especially for ICU patients) values are much higher than the HLH 2004 criterion and exceed 2000–3000 ng/ml, reaching high specificity (but low sensitivity) above 10,000 ng/ml. All patients with such high ferritin values should have other HLH criteria assessed. Indications for ferritin testing are cytopenias and/or splenomegaly in a febrile patient whose clinical status and laboratory values are worsening despite standard treatment with anti-infectious therapy. Although treatment of the trigger is important (if it is possible at all), this is usually not sufficient to suppress the high cytokine levels. Treatment modalities include immunosuppressive/immunomodulatory agents such as steroids, intravenous immunoglobulins, cyclosporine A, removal of the cytokines by plasmapheresis, and, in severe cases, etoposide [8]. A delay in etoposide treatment was proven to have a negative impact on prognosis in EBV-associated HLH [9]. Without immune suppression, and despite all possible efforts of intensive care, HLH is often fatal. Raising the awareness of HLH—a life-threatening, heavily underdiagnosed syndrome—is of paramount importance, especially since the tests for preliminary diagnosis (ferritin concentration) and treatment (etoposide, steroids, cyclosporine A) are relatively inexpensive and widely available.

Previous wildfire risk assessments have problems such as subjectivity of weight allocation and the linearization of statistical models, resulting in generally low robustness and low generalization ability of fire risk assessment models. Therefore, in this paper, we explored the potential of integration machine learning algorithms to build wildfire risk assessment models. Based on analyzing fire data’s spatial and temporal distribution, we selected 10 triggering factors of topography, meteorology, vegetation, and human activities, using frequency ratio (FR) to provide uniform data representation of triggering factors. Next, we used the Bayesian optimization (BO) algorithm to perform hyperparametric optimization solutions for various machine learning models: support vector machine (SVM), random forest (RF), and extreme gradient boosting (XGBoost). Finally, we constructed an integration machine learning algorithm to acquire a fire risk grading map and the importance evaluation corresponding to each triggering factor. For validation purposes, we selected Liangshan Prefecture in Sichuan Province as the specific study area and obtained MCD64A1 burned area product to extract the extent of burned areas in Liangshan Prefecture from 2011 to 2020. The accuracy, kappa coefficient, and area under curve (AUC) were then applied to assess the predictive power and consistency of the fire risk classification maps. The experimental analysis showed that among the three models, FR-BO-XGBoost had the best performance in wildfire risk assessment in the Liangshan region (AUC = 0.887), followed by FR-BO-RF (AUC = 0.876) and FR-BO-SVM (AUC = 0.820). The feature importance result indicated that the study area’s most significant effects on wildfires were precipitation, NDVI, land cover, and maximum temperature. The proposed method avoided the subjective weighting and model linearization problems. Compared with the previous methods, it automatically acquired the importance of the triggering factors to the wildfire, which had certain advantages in wildfire risk assessment, and was worthy of further promotion.

The occurrence of subacute thyroiditis (SAT) after vaccines or after hyaluronic acid skin fillers is very rare and might be related to genetic susceptibility. We suggest that the co-administration of both products could potentially increase the possibility of development of SAT. A 58-year-old Caucasian healthy female initially presented with chills, myalgia, dysphagia, sore throat, dry cough, fatigue, and intermittent fever of 38.5°C orally after simultaneous injection of an influenza vaccine and a dermal filler containing hyaluronic acid. Ten days later the patient developed palpitations and neck pain radiating to the left jaw. She was diagnosed with SAT on day 16 after her first visit and responded promptly to etoricoxib treatment. The patient progressed clinically from hyperthyroidism to euthyroid state and eventually to hypothyroidism and further testing showed she had HLA B-35 haplotype. Physicians should be aware that SAT might be associated with the administration an influenza vaccine and this possible association might increase if the vaccine was co-administered with a dermal filler.

BACKGROUND: Hypertension, which is one of the major health problems, not only in Indonesia but also around the world, has attracted a great number of concerns. Hypertension is a risk factor for heart disease, diabetes, kidney failure, and stroke. Most people with hypertension do not know that they are hypertensive, so they tend not to get proper treatment. The factors that influence the occurrence of hypertension are divided into two major groups, namely, those that cannot be controlled such as gender, age, genetic properties and race, and those that can be controlled such as diet, exercise habits, employment, consumption of salt, coffee, alcohol and stress. The study aims to determine the triggering factors associated with hypertension. MATERIAL AND METHODS: This type of quantitative research using descriptive correlation study method was conducted on individuals aged over 18 years in the city of Kendal, Central Java, amounting to 428 people. The sample was pooled employing purposive sampling technique. The data was collected using a questionnaire. The data were analyzed univariably in the form of frequency distribution and bivariately using the Chi-square test. RESULTS: The results show that the majority of the respondents with hypertension were those aged 51–60 years, male, and working as fishermen. In this regard, there are a factor of hypertension, obesity in the moderate category, and stage III hypertension. In addition, there is a relationship between the triggering factors of hypertension (age, gender, employment, heredity, obesity) and the incidence of hypertension (p value < 0.005). CONCLUSION: Triggering factors related to hypertension include age, gender, employment, heredity, and obesity level.