Among the various disorders that manifest with gait disturbance, cognitive impairment, and urinary incontinence in the elderly population, idiopathic normal pressure hydrocephalus (iNPH) is becoming of great importance. The first edition of these guidelines for management of iNPH was published in 2004, and the second edition in 2012, to provide a series of timely, evidence-based recommendations related to iNPH. Since the last edition, clinical awareness of iNPH has risen dramatically, and clinical and basic research efforts on iNPH have increased significantly. This third edition of the guidelines was made to share these ideas with the international community and to promote international research on iNPH. The revision of the guidelines was undertaken by a multidisciplinary expert working group of the Japanese Society of Normal Pressure Hydrocephalus in conjunction with the Japanese Ministry of Health, Labour and Welfare research project. This revision proposes a new classification for NPH. The category of iNPH is clearly distinguished from NPH with congenital/developmental and acquired etiologies. Additionally, the essential role of disproportionately enlarged subarachnoid-space hydrocephalus (DESH) in the imaging diagnosis and decision for further management of iNPH is discussed in this edition. We created an algorithm for diagnosis and decision for shunt management. Diagnosis by biomarkers that distinguish prognosis has been also initiated. Therefore, diagnosis and treatment of iNPH have entered a new phase. We hope that this third edition of the guidelines will help patients, their families, and healthcare professionals involved in treating iNPH.

Abstract:Carbon nanotubes (CNT) have remarkable mechanical properties with very high elastic modulus and electrical conductivity. Shape memory polymer (SMP) as one of smart materials is characterized with its remarkable recoverability and shape memory effect, but its mechanical properties such as strength and elastic modulus is not high enough. In this study, CNT/SMP nanocomposites were developed with the typical CNTs of the vapor growth carbon fibers (VGCFs). A fine and homogeneous dispersion of VGCF throughout the SMP matrix is obtained. The specimens with different VGCF weight fraction, such as SMP bulk, 1.7wt%, 3.3wt% and 5.0wt%, were prepared, and their dynamic mechanical properties and shape recovery behavior were investigated. It was found that storage elastic modulus is improved obviously with increment of VGCF weight fraction, and the CNT/SMP nanocomposites showed a good shape memory effect. It is indicated that the recovery stress of CNT/SMP nanocomposites with only 3.3% weight fraction of carbon nanotubes will reach almost twice of that in SMP bulk.

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This finding provides indirect evidence for the parietal white matter involvement in OCD, thus suggesting a change in the phospholipids of myelinated axons and/or glia cells.

An improvement of 5 seconds was a useful threshold of TUG time at the tap test for predicting a ≥10-second improvement 12 months after shunt surgery, rather than the percent improvement of TUG time.