4,056 research outputs found

    Estimation of the burden of active and life-time epilepsy: a meta-analytic approach.

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    PURPOSE: To estimate the burden of lifetime epilepsy (LTE) and active epilepsy (AE) and examine the influence of study characteristics on prevalence estimates. METHODS: We searched online databases and identified articles using prespecified criteria. Random-effects meta-analyses were used to estimate the median prevalence in developed countries and in urban and rural settings in developing countries. The impact of study characteristics on prevalence estimates was determined using meta-regression models. RESULTS: The median LTE prevalence for developed countries was 5.8 per 1,000 (5th-95th percentile range 2.7-12.4) compared to 15.4 per 1,000 (4.8-49.6) for rural and 10.3 (2.8-37.7) for urban studies in developing countries. The median prevalence of AE was 4.9 per 1,000 (2.3-10.3) for developed countries and 12.7 per 1,000 (3.5-45.5) and 5.9 (3.4-10.2) in rural and urban studies in developing countries. The estimates of burden for LTE and AE in developed countries were 6.8 million (5th-95th percentile range 3.2-14.7) and 5.7 million (2.7-12.2), respectively. In developing countries these were 45 (14-145) million LTE and 17 (10-133) million AE in rural areas and 17 (5-61) million LTE and 10 (5-17) million AE in urban areas. Studies involving all ages or only adults showed higher estimates than pediatric studies. Higher prevalence estimates were also associated with rural location and small study size. CONCLUSIONS: This study estimates the global burden of epilepsy and the proportions with AE, which may benefit from treatment. There are systematic differences in reported prevalence estimates, which are only partially explained by study characteristics

    Identification of phonological processes in preschool children's single-word productions

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    Speech and language therapists (SLTs) often refer to phonological data norms as part of their assessment protocols in evaluating the communication skills of the pre-school child. There is a variety of norms available and although broadly similar, differences are embedded within their definitions of mastery of the adult target system. Presence of velar fronting, stopping of affricates and [s] reduction in the dataset was found to mirror previous research. However, there was a lower than expected incidence by age groups of palato-alveolar fronting, stopping of fricatives and obstruent cluster reduction

    Subsurface geology of Red Willow and Hitchcock Counties, Nebraska

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    Includes folded maps

    Electroencephalographic features of convulsive epilepsy in Africa: A multicentre study of prevalence, pattern and associated factors

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    Objective: We investigated the prevalence and pattern of electroencephalographic (EEG) features of epilepsy and the associated factors in Africans with active convulsive epilepsy (ACE). Methods: We characterized electroencephalographic features and determined associated factors in a sample of people with ACE in five African sites. Mixed-effects modified Poisson regression model was used to determine factors associated with abnormal EEGs. Results: Recordings were performed on 1426 people of whom 751 (53%) had abnormal EEGs, being an adjusted prevalence of 2.7 (95% confidence interval (95% CI), 2.5–2.9) per 1000. 52% of the abnormal EEG had focal features (75% with temporal lobe involvement). The frequency and pattern of changes differed with site. Abnormal EEGs were associated with adverse perinatal events (risk ratio (RR) = 1.19 (95% CI, 1.07–1.33)), cognitive impairments (RR = 1.50 (95% CI, 1.30–1.73)), use of anti-epileptic drugs (RR = 1.25 (95% CI, 1.05–1.49)), focal seizures (RR = 1.09 (95% CI, 1.00–1.19)) and seizure frequency (RR = 1.18 (95% CI, 1.10–1.26) for daily seizures; RR = 1.22 (95% CI, 1.10–1.35) for weekly seizures and RR = 1.15 (95% CI, 1.03–1.28) for monthly seizures)). Conclusions: EEG abnormalities are common in Africans with epilepsy and are associated with preventable risk factors. Significance: EEG is helpful in identifying focal epilepsy in Africa, where timing of focal aetiologies is problematic and there is a lack of neuroimaging services

    Clinical features, proximate causes, and consequences of active convulsive epilepsy in Africa.

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    PURPOSE: Epilepsy is common in sub-Saharan Africa (SSA), but the clinical features and consequences are poorly characterized. Most studies are hospital-based, and few studies have compared different ecological sites in SSA. We described active convulsive epilepsy (ACE) identified in cross-sectional community-based surveys in SSA, to understand the proximate causes, features, and consequences. METHODS: We performed a detailed clinical and neurophysiologic description of ACE cases identified from a community survey of 584,586 people using medical history, neurologic examination, and electroencephalography (EEG) data from five sites in Africa: South Africa; Tanzania; Uganda; Kenya; and Ghana. The cases were examined by clinicians to discover risk factors, clinical features, and consequences of epilepsy. We used logistic regression to determine the epilepsy factors associated with medical comorbidities. KEY FINDINGS: Half (51%) of the 2,170 people with ACE were children and 69% of seizures began in childhood. Focal features (EEG, seizure types, and neurologic deficits) were present in 58% of ACE cases, and these varied significantly with site. Status epilepticus occurred in 25% of people with ACE. Only 36% received antiepileptic drugs (phenobarbital was the most common drug [95%]), and the proportion varied significantly with the site. Proximate causes of ACE were adverse perinatal events (11%) for onset of seizures before 18 years; and acute encephalopathy (10%) and head injury prior to seizure onset (3%). Important comorbidities were malnutrition (15%), cognitive impairment (23%), and neurologic deficits (15%). The consequences of ACE were burns (16%), head injuries (postseizure) (1%), lack of education (43%), and being unmarried (67%) or unemployed (57%) in adults, all significantly more common than in those without epilepsy. SIGNIFICANCE: There were significant differences in the comorbidities across sites. Focal features are common in ACE, suggesting identifiable and preventable causes. Malnutrition and cognitive and neurologic deficits are common in people with ACE and should be integrated into the management of epilepsy in this region. Consequences of epilepsy such as burns, lack of education, poor marriage prospects, and unemployment need to be addressed

    A heterotic Kodaira--Spencer theory at one-loop

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    We consider a heterotic version of six-dimensional Kodaira-Spencer gravity derived from the heterotic superpotential. We compute the one-loop partition function and find it can be expressed as a product of holomorphic Ray-Singer torsions. We discuss its topological properties and potential gauge and gravitational anomalies. We show these anomalies can be cancelled using Green-Schwarz-like counter-terms. We also discuss the dependence on the background geometry, and in particular the choice of hermitian metric needed for quantisation. Given suitable topological constraints, this dependence may again be cancelled by the addition of purely background-dependent counter-terms. We also explain how our methods provide the one-loop partition functions of a large class of more general holomorphic field theories in terms of holomorphic Ray-Singer torsions.Comment: 62 pages, 2 figure

    A heterotic Kodaira-Spencer theory at one-loop

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    © The Authors. This is an open access article distributed under the Creative Commons Attribution License, to view a copy of the license, see: https://creativecommons.org/licenses/by/4.0/We consider a heterotic version of six-dimensional Kodaira-Spencer gravityderived from the heterotic superpotential. We compute the one-loop partition function andfnd it can be expressed as a product of holomorphic Ray-Singer torsions. We discuss itstopological properties and potential gauge and gravitational anomalies. We show theseanomalies can be cancelled using Green-Schwarz-like counter-terms. We also discuss thedependence on the background geometry, and in particular the choice of hermitian metricneeded for quantisation. Given suitable topological constraints, this dependence may againbe cancelled by the addition of purely background-dependent counter-terms. We also explainhow our methods provide the one-loop partition functions of a large class of more generalholomorphic feld theories in terms of holomorphic Ray-Singer torsions.Peer reviewe
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