Diverse phenotype of Méenière’s disease associated with family history,thyroid disorder,migraine and associated disorders

Objective:To better understand the clinical phenotype of Méenière’s disease(MD),we examined family history,thyroid disorder,migraine,and associated disorders in complaints of people living with MD.Method:We designed the study as a retrospective and examined data gathered from 912 participants with MD.Their data were originally collected by the Finnish M′eni`ere Federation(FMF).The survey data included individual case histories for environmental factors,comorbidities,disease-specific complaints,impact-related questions,cognitive complaints,health-related quality of life(HRQoL),and sense of coherence(SOC).Results:We observed significant differences between those with and without sporadic occurrence,family history,thyroid disorder,and migraine-associated complaints.Family history explained 20%of variability in patient complaints.Patients with a family history of MD whose disease started at younger age experienced balance problems,more severe vertigo spells,more severe vestibular drop attacks(VDA),and less nausea,although they had good SOC.Thyroid disorder explained 14%of variability in patient complaints.MD patients with a thyroid disorder comorbidity suffered more often from constant dizziness,balance problems,greater impact of hearing problems,cognitive complaints,and poor HRQoL.Migraine explained 12%of variability in patients’complaints and was associated with poor SOC and cognitive balance problems.MD patients with both thyroid disorder and migraine used antidepressants more often than other groups.Logistic regression analysis showed comorbidities of ischemic brain disorder(among 7.1%),kidney insufficiency(among 1.2%),and diabetes(among 7.3%)had statistically significant but restricted association with balance and gait problems,VDA,and reduced HRQoL.Conclusions:Family history of MD and thyroid disorder or migraine comorbidities in MD influence the complaint pattern and partially explain complex symptom profiles,including symptoms of cognitive problems.Confounders play a minimal role in complaint profile and impact of MD whereas comorbidities influence the complaint structure and partly explain the complex symptom profile in MD.

Effects of Probability of Accurately Predicting and Ascertaining Defection on Cooperation and its Application to Simulated Internet Dealing

Without cooperative behaviors, our society or organization falls into social dilemma situations where every member selects uncooperative （defective） behaviors, and the situation gets worse and worse. Such a situation in a society or an organization leads to violation of social or organizational rules, and at the worst case it suffers from serious accidents or scandals. Therefore, it is important for us to make efforts and take measures to elicit cooperative behaviors. It was demonstrated theoretically that altruism strategy and adaptive prediction and ascertainment strategy are in some cases better than rational strategy under the situation of social dilemma. We built up a mathematical model in order to examine how the probability of correctly predicting and ascertaining the behavior （cooperation or defection） of opponents and the mixture of （a） altruism （all cooperation） strategy, （b） individualism （all defection） strategy, and （c） adaptive prediction and ascertainment strategy affected the expected profit. Simulation results showed that the tit-for-tat strategy was better than the rational （individualism） strategy when the probability of correctly predicting and ascertaining defection of the opponent was considerably higher. As an application of the basic study above, it was explored, using a simulation method, how such a system as opening reputation or peer review in public could work satisfactorily to prevent defective behaviors in auction dealing. The result showed that the information on the handle name and the reputation effectively worked to prevent defective behaviors.

Natural history and long-term clinical course of Crohn's disease

Crohn’s disease is a chronic inflammatory disease process involving different sites in the gastrointestinal tract. Occasionally, so-called metastatic disease occurs in extra-intestinal sites. Granulomatous inflammation may be detected in endoscopic biopsies or resected tissues. Genetic, epigenetic and environmental factors appear to play a role. Multiple susceptibility genes have been described in both familial and non-familial forms while the disease is phenotypically heterogeneous with a female predominance. The disorder occurs over a broad age spectrum, from early childhood to late adulthood. More than 80% are diagnosed before age 40 years usually with terminal ileal and colonic involvement. Pediatric-onset disease is more severe and more extensive, usually with a higher chance of upper gastrointestinal tract disease, compared to adult-onset disease. Long-term studies have shown that the disorder may evolve with time into more complex disease with stricture formation and penetrating disease complications (i.e., fistula, abscess). Although prolonged remission may occur, discrete periods of symptomatic disease may re-appear over many decades suggesting recurrence or re-activation of this inflammatory process. Eventual development of a cure will likely depend on identification of an etiologic cause and a fundamental understanding of its pathogenesis. Until now, treatment has focused on removing risk factors, particularly cigarette smoking, and improving symptoms. In clinical trials, clinical remission is largely defined as improved numerical and endoscopic indices for “mucosal healing”. “Deep remission” is a conceptual, more “extended” goal that may or may not alter the long-term natural history of the disease in selected patients, albeit at a significant risk for treatment complications, including serious and unusual opportunistic infections.

Family history and disease outcomes in patients with Crohn's disease:A comparison between China and the United States

AIM To investigate the differences in family history of inflammatory bowel disease(IBD) and clinical outcomes among individuals with Crohn's disease(CD) residing in China and the United States.METHODS We performed a survey-based cross-sectional study of participants with CD recruited from China and the United States.We compared the prevalence of IBD family history and history of ileal involvement,CD-related surgeries and IBD medications in China and the United States,adjusting for potential confounders.RESULTS We recruited 49 participants from China and 145 from the United States.The prevalence of family history of IBD was significantly lower in China compared with the United States(China:4.1%,United States:39.3%).The three most commonly affected types of relatives were cousin,sibling,and parent in the United States compared with child and sibling in China.Ileal involvement(China:63.3%,United States:63.5%) and surgery for CD(China:51.0%,United States:49.7%) were nearly equivalent in the two countries.CONCLUSION The lower prevalence of familial clustering of IBD in China may suggest that the etiology of CD is less attributed to genetic background or a family-shared environment compared with the United States.Despite the potential difference in etiology,surgery and ileal involvement were similar in the two countries.Examining the changes in family history during the continuing rise in IBD may provide further insight into the etiology of CD.

Long-term natural history of Crohn’s disease

Crohn’s disease is a chronic inflammatory granulomatous process that usually involves different sites in the intestinal tract. Genetic and environmental factors are thought to play a role in its etiology and pathogenesis. The disorder has a heterogeneous clinical expression and data from tertiary care settings have documented its female predominance, occasional familial nature, and high rate of stricture formation and penetrating disease. It may appear from early childhood to late adulthood, although over 80% are currently diagnosed before age 40 years, usually with terminal ileal and colonic involvement. Several studies have now shown differences in phenotypic clinical expression depending on the initial age at diagnosis, with pediatric-onset disease being more severe and more extensive with more involvement of the upper gastrointestinal tract compared to adult-onset disease. In addition, long- term studies from these tertiary care settings have documented that the disorder may evolve with time into a more complex disease with stricture formation and penetrating disease complications (i.e. fistula and abscess). Although prolonged remission with no evidence of inflammatory disease may occur, discrete periods of symptomatic and active granulomatous inflammatory disease may re-appear over many decades. Long-term studies on the natural history have also suggested that discrete events (or agents) may precipitate this granulomatous inflammatory process.

Crucial steps in the natural history of inflammatory bowel disease

Inflammatory bowel diseases(IBD),including ulcerative colitis(UC) and Crohn's disease(CD),are chronic,progressive and disabling disorders.Over the last few decades,new therapeutic approaches have been introduced which have led not only to a reduction in the mortality rate but also offered the possibility of a favorable modification in the natural history of IBD.The identification of clinical,genetic and serological prognostic factors has permitted a better stratification of the disease,thus allowing the opportunity to indicate the most appropriate therapy.Early treatment with immunosuppressive drugs and biologics has offered the opportunity to change,at least in the short term,the course of the disease by reducing,in a subset of patients with IBD,hospitalization and the need for surgery.In this review,the crucial steps in the natural history of both UC and CD will be discussed,as well as the factors that may change their clinical course.The methodological requirements for high quality studies on the course and prognosis of IBD,the true impact of environmental and dietary factors on the clinical course of IBD,the clinical,serological and genetic predictors of the IBD course(in particular,which of these are rel-evant and appropriate for use in clinical practice),the impact of the various forms of medical treatment on the IBD complication rate,the role of surgery for IBD in the biologic era,the true magnitude of risk of colorectal cancer associated with IBD,as well as the mortality rate related to IBD will be stressed;all topics that are extensively discussed in separate reviews included in this issue of World Journal of Gastroenterology.

Inflammatory bowel disease course in Crohn's disease:Is the natural history changing?

Crohn’s disease (CD) is a multifactorial potentially debilitating disease. It has a variable disease course, but the majority of patients eventually develop penetrating or stricturing complications leading to repeated surgeries and disability. Studies on the natural history of CD provide invaluable data on its course and clinical predictors, and may help to identify patient subsets based on clinical phenotype. Most data are available from referral centers, however these outcomes may be different from those in population-based cohorts. New data suggest the possibility of a change in the natural history in Crohn’s disease, with an increasing percentage of patients diagnosed with inflammatory disease behavior. Hospitalization rates remain high, while surgery rates seem to have decreased in the last decade. In addition, mortality rates still exceed that of the general population. The impact of changes in treatment strategy, including increased, earlier use of immunosuppressives, biological therapy, and patient monitoring on the natural history of the disease are still conflictive. In this review article, the authors summarize the available evidence on the natural history, current trends, and predictive factors for evaluating the disease course of CD.

Barrett’s esophagus:Review of natural history and comparative efficacy of endoscopic and surgical therapies

Barrett's esophagus(BE)is the precursor to esophageal adenocarcinoma(EAC).Progression to cancer typically occurs in a stepwise fashion through worsening dysplasia and ultimately,invasive neoplasia.Established EAC with deep involvement of the esophageal wall and/or metastatic disease is invariably associated with poor long-term survival rates.This guides the rationale of surveillance of Barrett’s in an attempt to treat lesions at an earlier,and potentially curative stage.The last two decades have seen a paradigm shift in management of Barrett’s with rapid expansion in the role of endoscopic eradication therapy(EET)for management of dysplastic and early neoplastic BE,and there have been substantial changes to international consensus guidelines for management of early BE based on evolving evidence.This review aims to assist the physician in the therapeutic decision-making process with patients by comprehensive review and summary of literature surrounding natural history of Barrett’s by histological stage,and the effectiveness of interventions in attenuating the risk posed by its natural history.Key findings were as follows.Non-dysplastic Barrett’s is associated with extremely low risk of progression,and interventions cannot be justified.The annual risk of cancer progression in low grade dysplasia is between 1%-3%;EET can be offered though evidence for its benefit remains confined to highly select settings.High-grade dysplasia progresses to cancer in 5%-10%per year;EET is similarly effective to and less morbid than surgery and should be routinely performed for this indication.Risk of nodal metastases in intramucosal cancer is 2%-4%,which is comparable to operative mortality rate,so EET is usually preferred.Submucosal cancer is associated with nodal metastases in 14%-41%hence surgery remains standard of care,except for select situations.

Coping with Carbon Neutrality:Russia’s Green New Deal

Dealing with climate change has attracted global attention,and promoting carbon emission reduction and achieving carbon neutrality is the policy goal pursued by numerous countries.In the past year,to adapt to the trend of the global low-carbon transition,cope with extreme climate phenomena,reduce the impact of the EU carbon border tax,compete for the international discourse power,and seek breakthroughs in relations with the US and Europe,Russia’s cognition and position concerning climate change has changed signifcantly;Russia is taking increasingly active steps to achieve carbon neutrality goals.Therefore,it has launched a Green New Deal.However,due to restrictions by internal and external factors,it will be a long and difcult process for Russia’s real green transformation from concept to policy and action.

Xi Jinping's Discussion of Civilization History and the Discourse Construction of China's Road

The significance of discourse construction in the civilization discussion of Xi Jinping is explored in this paper: The 500-year history of world socialism and the 5000-year history of Chinese civilization, Xi Jinping' s studies of Socialism with Chinese characteristics in the long history of civilization development, highlighting Socialism with Chinese characteristics as a product in the development of human civilization, the great contribution to world civilization progress and the creative development of Marxism which has been the most distinctive feature in Chinese discourse structure since the 18 th National Congress of the CPC. As the conscious construction of epistemology, it has given unprecedented historical and cultural implications to China' s road and opened the new theory space for the discourse construction of Socialism with Chinese characteristics or the academic expression of China' s road.

Organized Fan Groups and Sports Journalism in Brazil： A Social History of Soccer Fans in the City of Rio de Janeiro

The article focuses on sources of Brazilian sports journalism and demonstrates the role of organized soccer fan groups in Rio de Janeiro between the 1940s and 1980s, this is achieved through reports provided by the Brazilian newspaper Jornal dos Sports. From the beginning, there are biographical notes made about the most well-known fan leaders in Rio, such as Jaime de Carvalho, who founded the Charanga （1942）. The emergence of dissent among the fans, in the late 1960s, is then covered, which establishes itself within the organized fans in Rio with these individuals beginning to question the authority of the old fan group leaders. This is against the principle of giving unconditional support to the club and it is postulated that the fans have the right to criticize and protest against the club＇s management, even if this means using forceful tactics. Along with the journalistic narrative, there is a break-off by the ＂Young Fans＂ and a process of emancipation begins which occurs over the 1970s, this happens by means of the use of fan coaches and the invention of a lifestyle that is associated with soccer. Finally, the 1980s is marked by the constructive and destructive potential that is linked to fan groups. On the one hand, creating an Association of fans--Astorj--is pointed to in order to reach a mutual understanding, but it should be noted, on the other, that there are feuds, in a scenario of spiraling violence, in which fights, beatings, and even murders begin to be commonplace.

First Forum on China Casting Quality Standards & Overview of Revision History of China's National/Industrial Standards for Foundry Operations

Both national and local governments have been paying great attention to the work of industrial standardization with the enormous increase in international trade after China joined WTO. According to the standards revising plan of Standardization Administration Committee of China (SAC),TC54 has already revised a series of national standards and industrial standards for foundry operations,and proposed some new ones. As a result,some old fashioned standards containing low-level techniques have been gradually discontinued or replaced with new versions.……

Effect of fertility history and parity on Alzheimer’s disease:a mini review from animal to human studies

More women than men have Alzheimer's disease(AD)or other dementias.There are a number of potential biological and social reasons for the sex difference in the risk of AD,such as women live longer than men on average,and estrogen depletion after menopause in women,biological or genetic variations,and education,occupation or rates of heart disease.Recent studies showed a link between reproductive history and dementia risk in women.Women with fertility history showed lower risk of dementia compared to women with no child.Other studies also suggested that women's pregnancy history may influence AD's risk.In this review,we will focus on the relationship between women fertility and cognition and discuss the potential role of sex hormones in the brain and cognition,especially on AD pathogenesis.

Historical Reconstruction - Reread Kenzaburo Oe＇ s Banengannen＇ s Soccer Team

The novel Banengannen’s Soccer Team published in 1967has been classified as historical"meta narration"of Kenzaburo Oe.In the novel,there are two main characters—Mitsusaburo and Takashi,both of whom represent two ways of exploring the historical truth.In the process of exploration of the two characters,Kenzaburo Oe symbolically analyzed the value presetting of the Japanese people—getting one’s own value through projecting the"Emperor",recreating a new chapter of history from personal experience.

Continuities of Historical Crises and Discourses of Europe From the “Neo-Latin Past” to the 21st Century

Europe and the EU have been facing many crises and challenges in recent years.From Brexit and rising nationalism to economic problems and unanimous refugee policies,most of them remain unsolved.Instead of moving forward with the European integration project,Europe seems to regress in many instances.Considering this turmoil,it seems all the more important to historicize the affirmative discourse of Europe and to expand the knowledge of the European unification process with novel insights into its history.Only if a broad understanding of its roots and developments prevails,the conflicts of the present can be better evaluated and addressed.Particularly one set of so far neglected sources from Europe’s past serves as guiding light in that respect:the early modern Europe literature written in the Latin language.Between 1400 and 1800,Latin enjoyed a similar status in promoting scientific discoveries,negotiating political affairs and generally communicating on an international level as modern-day English.By offering a brief glance at some historically influential Latin texts from the early modern discourse of Europe,this article will show that the early modern European crises strikingly resemble Europe’s current crises despite the difference in political,social,and economic circumstances.The discourse of Europe has from the beginning been a stable discourse,characterized by the same recurring questions for centuries.When used as reference point for the crises of the 21st century,the prospects for the European integration look better than presumed.

Dalai Lama's Secret Deals With the CIA

In recent years, the 14th Dalai Lama preached here and there in the world that he "has given up his effort for Tibetan independence" and "cherishes the hope for negotiation with the Central Government." Did he do what he has said? The Los Auged Times carried an article titled CIA Gave Aid to Tibetan Exiles in ’60s, Files Show on September 15, 1998, stating that the 14th Dalai Lama spent much of his time in the 1960s working for CIA support. He had received US$1 .7 million from the US intelligence agency in aid of his work against China. And he himself received US$180,000 from it as allowances. This fact belies his alleged favor for negotiation with the Central Government, and makes us suspect of his honest in "giving up his effort for Tibetan independence." The following is the said American article.