Epilepsy Is a Risk Factor for Sudden Cardiac Arrest in the General Population

Background People with epilepsy are at increased risk for sudden death. The most prevalent cause of sudden death in the general population is sudden cardiac arrest (SCA) due to ventricular fibrillation (VF). SCA may contribute to the increased incidence of sudden death in people with epilepsy. We assessed whether the risk for SCA is increased in epilepsy by determining the risk for SCA among people with active epilepsy in a community-based study. Methods and Results This investigation was part of the Amsterdam Resuscitation Studies (ARREST) in the Netherlands. It was designed to assess SCA risk in the general population. All SCA cases in the study area were identified and matched to controls (by age, sex, and SCA date). A diagnosis of active epilepsy was ascertained in all cases and controls. Relative risk for SCA was estimated by calculating the adjusted odds ratios using conditional logistic regression (adjustment was made for known risk factors for SCA). We identified 1019 cases of SCA with ECG-documented VF, and matched them to 2834 controls. There were 12 people with active epilepsy among cases and 12 among controls. Epilepsy was associated with a three-fold increased risk for SCA (adjusted OR 2.9 [95%CI 1.1–8.0.], p = 0.034). The risk for SCA in epilepsy was particularly increased in young and females. Conclusion Epilepsy in the general population seems to be associated with an increased risk for SCA

A non-reductive N=4 superconformal algebra

A new N=4 superconformal algebra (SCA) is presented. Its internal affine Lie algebra is based on the seven-dimensional Lie algebra su(2)\oplus g, where g should be identified with a four-dimensional non-reductive Lie algebra. Thus, it is the first known example of what we choose to call a non-reductive SCA. It contains a total of 16 generators and is obtained by a non-trivial In\"on\"u-Wigner contraction of the well-known large N=4 SCA. The recently discovered asymmetric N=4 SCA is a subalgebra of this new SCA. Finally, the possible affine extensions of the non-reductive Lie algebra g are classified. The two-form governing the extension appearing in the SCA differs from the ordinary Cartan-Killing form.Comment: 10 pages, LaTeX, version to be publishe

Global Burden of Sickle Cell Anaemia in Children under Five, 2010-2050: Modelling Based on Demographics, Excess Mortality, and Interventions

The global burden of sickle cell anaemia (SCA) is set to rise as a consequence of improved survival in high-prevalence low- and middle-income countries and population migration to higher-income countries. The host of quantitative evidence documenting these changes has not been assembled at the global level. The purpose of this study is to estimate trends in the future number of newborns with SCA and the number of lives that could be saved in under-five children with SCA by the implementation of different levels of health interventions.First, we calculated projected numbers of newborns with SCA for each 5-y interval between 2010 and 2050 by combining estimates of national SCA frequencies with projected demographic data. We then accounted for under-five mortality (U5m) projections and tested different levels of excess mortality for children with SCA, reflecting the benefits of implementing specific health interventions for under-five patients in 2015, to assess the number of lives that could be saved with appropriate health care services. The estimated number of newborns with SCA globally will increase from 305,800 (confidence interval [CI]: 238,400-398,800) in 2010 to 404,200 (CI: 242,500-657,600) in 2050. It is likely that Nigeria (2010: 91,000 newborns with SCA [CI: 77,900-106,100]; 2050: 140,800 [CI: 95,500-200,600]) and the Democratic Republic of the Congo (2010: 39,700 [CI: 32,600-48,800]; 2050: 44,700 [CI: 27,100-70,500]) will remain the countries most in need of policies for the prevention and management of SCA. We predict a decrease in the annual number of newborns with SCA in India (2010: 44,400 [CI: 33,700-59,100]; 2050: 33,900 [CI: 15,900-64,700]). The implementation of basic health interventions (e.g., prenatal diagnosis, penicillin prophylaxis, and vaccination) for SCA in 2015, leading to significant reductions in excess mortality among under-five children with SCA, could, by 2050, prolong the lives of 5,302,900 [CI: 3,174,800-6,699,100] newborns with SCA. Similarly, large-scale universal screening could save the lives of up to 9,806,000 (CI: 6,745,800-14,232,700) newborns with SCA globally, 85% (CI: 81%-88%) of whom will be born in sub-Saharan Africa. The study findings are limited by the uncertainty in the estimates and the assumptions around mortality reductions associated with interventions.Our quantitative approach confirms that the global burden of SCA is increasing, and highlights the need to develop specific national policies for appropriate public health planning, particularly in low- and middle-income countries. Further empirical collaborative epidemiological studies are vital to assess current and future health care needs, especially in Nigeria, the Democratic Republic of the Congo, and India

High resolution spatial variability in spring snowmelt for an Arctic shrub-tundra watershed

Arctic tundra environments are characterized by spatially heterogeneous end-of-winter snow cover because of high winds that erode, transport and deposit snow over the winter. This spatially variable end-of-winter snow cover subsequently influences the spatial and temporal variability of snowmelt and results in a patchy snowcover over the melt period. Documenting changes in both snow cover area (SCA) and snow water equivalent (SWE) during the spring melt is essential for understanding hydrological systems, but the lack of high-resolution SCA and SWE datasets that accurately capture micro-scale changes are not commonly available, and do not exist for the Canadian Arctic. This study applies high-resolution remote sensing measurements of SCA and SWE using a fixed-wing Unmanned Aerial System (UAS) to document snowcover changes over the snowmelt period for an Arctic tundra headwater catchment. Repeat measurements of SWE and SCA were obtained for four dominant land cover types (tundra, short shrub, tall shrub, and topographic drift) to provide observations of spatially distributed snowmelt patterns and basin-wide declines in SWE. High-resolution analysis of snowcover conditions over the melt reveal a strong relationship between land cover type, snow distribution, and snow ablation rates whereby shallow snowpacks found in tundra and short shrub regions feature rapid declines in SWE and SCA and became snow-free approximately 10 days earlier than deeper snowpacks. In contrast, tall shrub patches and topographic drift regions were characterized by large initial SWE values and featured a slow decline in SCA. Analysis of basin-wide declines in SCA and SWE reveal three distinct melt phases characterized by 1) low melt rates across a large area resulting in a minor change in SCA, but a very large decline in SWE with, 2) high melt rates resulting in drastic declines in both SCA and SWE, and 3) low melt rates over a small portion of the basin, resulting in little change to either SCA or SWE. The ability to capture high-resolution spatio-temporal changes to tundra snow cover furthers our understanding of the relative importance of various land cover types on the snowmelt timing and amount of runoff available to the hydrological system during the spring freshet

The case for building climate reporting into financial accounting

For mitigation efforts against climate breakdown to be effective they need to bring in the private sector in a meaningful way. Current standards for financial reporting for commercial organizations focus on the interests of capital suppliers to the exclusion of other stakeholders and civil society. These stakeholders include the suppliers of capital, trading partners, employees, regulators, tax authorities, and civil society. So far initiatives to include environmental and social costs have been additive rather than substantive. In this think piece we offer a radical proposal in the form of sustainable cost accounting (SCA). As a standard SCA would build on existing accounting principles to require commercial organizations to report on how they will manage the costs of becoming net carbon zero compliant. SCA does not include carbon pricing or the cost of offsets. It would require the commercial organization to establish the costs of the transition to carbon neutrality. Regulatory requirements, enmeshment in transnational standards, and adequate auditing would implement SCA. If SCA was mandatory and comprehensively applied it would take a significant step in bringing business onside in addressing climate breakdown

Quantifying the resolution of spatial and temporal representation in children with 22q11.2 deletion syndrome.

ObjectivesOur ability to generate mental representation of magnitude from sensory information affects how we perceive and experience the world. Reduced resolution of the mental representations formed from sensory inputs may generate impairment in the proximal and distal information processes that utilize these representations. Impairment of spatial and temporal information processing likely underpins the non-verbal cognitive impairments observed in 22q11.2 deletion syndrome (22q11DS). The present study builds on prior research by seeking to quantify the resolution of spatial and temporal representation in children with 22q11DS, sex chromosome aneuploidy (SCA), and a typically developing (TD) control group.Participants and methodsChildren (22q11DS = 70, SCA = 49, TD = 46) responded to visual or auditory stimuli with varying difference ratios. The participant's task was to identify which of two sequentially presented stimuli was of larger magnitude in terms of, size, duration, or auditory frequency. Detection threshold was calculated as the minimum difference ratio between the "standard" and the "target" stimuli required to achieve 75% accuracy in detecting that the two stimuli were different.ResultsChildren with 22q11DS required larger magnitude difference between spatial stimuli for accurate identification compared with both the SCA and TD groups (% difference from standard: 22q11DS = 14; SCA = 8; TD: 7; F  = 8.42, p < 0.001). Temporal detection threshold was also higher for the 22q11DS group to both visual (% difference from standard: 22q11DS = 14; SCA = 8; TD = 7; F  = 8.33, p < 0.001) and auditory (% difference from standard: 22q11DS = 23; SCA = 12; TD: 8; F  = 8.99, p < 0.001) stimuli compared with both the SCA and TD groups, while the SCA and TD groups displayed equivalent performance on these measures (p's > 0.05). Pitch detection threshold did not differ among the groups (p's > 0.05).ConclusionsThe observation of higher detection thresholds to spatial and temporal stimuli indicates further evidence for reduced resolution in both spatial and temporal magnitude representation in 22q11DS, that does not extend to frequency magnitude representation (pitch detection), and which is not explained by generalized cognitive impairment alone. These findings generate further support for the hypothesis that spatiotemporal hypergranularity of mental representations contributes to the non-verbal cognitive impairment seen in 22q11DS

Protein sectors: statistical coupling analysis versus conservation

Statistical coupling analysis (SCA) is a method for analyzing multiple sequence alignments that was used to identify groups of coevolving residues termed "sectors". The method applies spectral analysis to a matrix obtained by combining correlation information with sequence conservation. It has been asserted that the protein sectors identified by SCA are functionally significant, with different sectors controlling different biochemical properties of the protein. Here we reconsider the available experimental data and note that it involves almost exclusively proteins with a single sector. We show that in this case sequence conservation is the dominating factor in SCA, and can alone be used to make statistically equivalent functional predictions. Therefore, we suggest shifting the experimental focus to proteins for which SCA identifies several sectors. Correlations in protein alignments, which have been shown to be informative in a number of independent studies, would then be less dominated by sequence conservation.Comment: 36 pages, 17 figure

Medicinal Cannabis Use in Sickle Cell Anemia

Approximately 100,000 Americans suffer from sickle cell anemia (SCA), a severe hereditary form of anemia in which red blood cells can mutate into a sickled shape causing severe pain crises that can lead to ED visits, hospitalization, and negatively impact multiple organ systems. Pain crises greatly impact the quality of life for SCA patients. Living with SCA can be stressful and often affects patients’ mental health, causing anxiety or depression (National Heart, Lung, and Blood Institute, 2016). Opioids have been a treatment mainstay for the severe pain caused by SCA but the side effects of opioids, plus the risk of dependence, are issues that have led both patients and researchers to consider medicinal cannabis as a treatment option. While there is limited research addressing the treatment of sickle cell pain with cannabis some research does suggest that cannabis could have a beneficial effect on the management of both chronic pain and acute pain (Choo, Feldstein Ewing, & Lovejoy, 2016; Kroenke & Cheville, 2017). The aim of this study is to evaluate the association between medicinal cannabis use and quality of life for individuals with SCA. The primary goal of this pilot study is to gather a cohort of participants and administer a baseline survey that will be used in a larger study. The goal of the larger study is to assess the impact of medicinal cannabis available through Pennsylvania’s Department of Health-approved dispensaries in Philadelphia on the quality of life for individuals with sickle cell anemia (SCA)

Secure and Efficient RNS Approach for Elliptic Curve Cryptography

Scalar multiplication, the main operation in elliptic curve cryptographic protocols, is vulnerable to side-channel (SCA) and fault injection (FA) attacks. An efficient countermeasure for scalar multiplication can be provided by using alternative number systems like the Residue Number System (RNS). In RNS, a number is represented as a set of smaller numbers, where each one is the result of the modular reduction with a given moduli basis. Under certain requirements, a number can be uniquely transformed from the integers to the RNS domain (and vice versa) and all arithmetic operations can be performed in RNS. This representation provides an inherent SCA and FA resistance to many attacks and can be further enhanced by RNS arithmetic manipulation or more traditional algorithmic countermeasures. In this paper, extending our previous work, we explore the potentials of RNS as an SCA and FA countermeasure and provide an description of RNS based SCA and FA resistance means. We propose a secure and efficient Montgomery Power Ladder based scalar multiplication algorithm on RNS and discuss its SCAFA resistance. The proposed algorithm is implemented on an ARM Cortex A7 processor and its SCA-FA resistance is evaluated by collecting preliminary leakage trace results that validate our initial assumptions