Determining the spike–wave index using automated detection software

Purpose: The spike–wave index (SWI) is a key feature in thediagnosis of electrical status epilepticus during slow-wave sleep.Estimating the SWI manually is time-consuming and is subject tointerrater and intrarater variability. Use of automated detectionsoftware would save time. Thereby, this software willconsistently detect a certain EEG phenomenon as epileptiformand is not influenced by human factors. To determinenoninferiority in calculating the SWI, we compared theperformance of a commercially available spike detectionalgorithm (P13 software, Persyst Development Corporation,San Diego, CA) with human expert consensus.Methods: The authors identified all prolonged EEG recordingsfor the diagnosis or follow-up of electrical status epilepticusduring slow-wave sleep carried out from January to December2018 at an epilepsy tertiary referral center. The SWI during thefirst 10 minutes of sleep was estimated by consensus of twohuman experts. This was compared with the SWI calculated bythe automated spike detection algorithm using the threeavailable sensitivity settings: “low,” “medium,” and “high.” In thesoftware, these sensitivity settings are denoted as perceptionvalues.Results: Forty-eight EEG recordings from 44 individuals wereanalyzed. The SWIs estimated by human experts did not differfrom the SWIs calculated by the automated spike detectionalgorithm in the “low” perception mode (P ¼ 0.67). The SWIscalculated in the “medium” and “high” perception settings were,however, significantly higher than the human expert estimatedSWIs (both P , 0.001).Conclusions: Automated spike detection (P13) is a useful tool indetermining SWI, especially when using the “low” sensitivitysetting. Using such automated detection tools may save time,especially when reviewing larger epochs.</p

Using sampled visual EEG review in combination with automated detection software at the EMU

Purpose: Complete visual review of prolonged video-EEG recordings at an EMU (Epilepsy Monitoring Unit) is time consuming and can cause problems in times of paucity of educated personnel. In this study we aimed to show non inferiority for electroclinical diagnosis using sampled review in combination with EEG analysissoftware (P13 software, Persyst Corporation), in comparison to complete visual review.Method: Fifty prolonged video-EEG recordings in adults were prospectively evaluated using sampled visual EEG review in combination with automated detection software of the complete EEG record. Visually assessed samples consisted of one hour during wakefulness, one hour during sleep, half an hour of wakefulness after wake-up and all clinical events marked by the individual and/or nurses. The final electro-clinical diagnosis of this new review approach was compared with the electro-clinical diagnosis after complete visual review as presently used.Results: The electro-clinical diagnosis based on sampled visual review combined with automated detectionsoftware did not differ from the diagnosis based on complete visual review. Furthermore, the detection software was able to detect all records containing epileptiform abnormalities and epileptic seizures.Conclusion: Sampled visual review in combination with automated detection using Persyst 13 is non-inferior to complete visual review for electroclinical diagnosis of prolonged video-EEG at an EMU setting, which makes this approach promising.</p

Dietary selenized yeast increases the selenium content whereas organic iron (sqm) has no effect on the iron content of pork

The human health benefits of dietary selenium (Se) and iron (Fe) are well established (Rayman, 1997; Kristensen et al., 2005). Meat and meat products are primary sources of dietary Se and iron for humans. Pork from Se and Fe-supplemented pigs may provide an additional source of these nutrients. However, the effects of supplementation of Se and iron on their status in muscles and effects on pork quality are not clearly defined. This study examined the effects of dietary Se and Fe supplementation on the Se and Fe status and meat quality of pork

There’s more to Pradaxa’s problems than meets the eye

Pharmaceutical companies don’t have a particularly good reputation, for some very good reasons. But we can’t let suspicions about the motives of such companies cloud our assessments of drug safety because patients may also suffer. People with abnormal heart rhythms and other diseases that cause blood clots (thromboses) often require blood-thinning (anticoagulation) medications. For many decades, warfarin has been the most widely used such drug but it’s associated with a risk of bleeding (including fatal haemorrhage) and requires regular blood tests to monitor safety and efficacy. So the advent of new oral anticoagulant drugs was heralded as a major advance by both patients and clinicians – principally on the grounds that they appeared as effective as warfarin, may be associated with a lower risk of serious bleeding, and are cost-effective because patients don’t need ongoing blood monitoring. For these reasons, a number of these new drugs, including dabigatran (Pradaxa) and rivaroxaban (Xarelto) were fast-tracked through the regulatory approval processes in the United States and in New Zealand. Emerging problems But reports now suggest Pradaxa might be less safe than it appeared to be in clinical trials. Specifically, it’s claimed the drug may be responsible for higher-than-expected levels of abnormal bleeding, including hemorrhagic strokes, and that it may, in fact, be less safe than warfarin

Automated spike and seizure detection: are we ready for implementation?

Objective: Automated detection of spikes and seizures has been a subject of research for several decades now. There have been important advances, yet automated detection in EMU (Epilepsy Monitoring Unit) settings has not been accepted as standard practice. We intend to implement this software at our EMU and so carried out a qualitative study to identify factors that hinder ('barriers') and facilitate ('enablers') implementation.Method: Twenty-two semi-structured interviews were conducted with 14 technicians and neurologists involved in recording and reporting EEGs and eight neurologists who receive EEG reports in the outpatient department. The study was reported according to the Consolidated Criteria for Reporting Qualitative Studies (COREQ).Results: We identified 14 barriers and 14 enablers for future implementation. Most barriers were reported by technicians. The most prominent barrier was lack of trust in the software, especially regarding seizure detection and false positive results. Additionally, technicians feared losing their EEG review skills or their jobs. Most commonly reported enablers included potential efficiency in the EEG workflow, the opportunity for quantification of EEG findings and the willingness to try the software. Conclusions: This study provides insight into the perspectives of users and offers recommendations for implementing automated spike and seizure detection in EMUs

Lattice polygons and families of curves on rational surfaces

First we solve the problem of finding minimal degree families on toric surfaces by reducing it to lattice geometry. Then we describe how to find minimal degree families on, more generally, rational complex projective surfaces

1944: Abilene Christian College Bible Lectures - Full Text

Delivered in the Auditorium of Abilene Christian College Abilene, Texas PRICE, $1.50 FIRM FOUNDATION PUBLISHING HOUSE Austin, Texa

1940: Abilene Christian College Bible Lectures - Full Text

Delivered in the Auditorium of Abilene Christian College, February, 1940, Abilene, Texas. Published April, 1940 PRICE, $1.00 FIRM FOUNDATION PUBLISHING HOUSE Austin, Texas

Cardiovascular safety of celecoxib in acute myocardial infarction patients: a nested case-control study

The objective was to measure the impact of exposure to coxibs and non-steroidal antiinflammatory drugs (NSAID) on morbidity and mortality in older patients with acute myocardial infarction (AMI). A nested case-control study was carried out using an exhaustive population-based cohort of patients aged 66 years and older living in Quebec (Canada) who survived a hospitalization for AMI (ICD-9 410) between 1999 and 2002. The main variables were all-cause and cardiovascular (CV) death, subsequent hospital admission for AMI, and a composite end-point including recurrent AMI or CV death. Conditional logistic regressions were used to estimate the risk of mortality and morbidity. A total of 19,823 patients aged 66 years and older survived hospitalization for AMI in the province of Quebec between 1999 and 2002. After controlling for covariables, the risk of subsequent AMI and the risk of composite end-point were increased by the use of rofecoxib. The risk of subsequent AMI was particularly high for new rofecoxib users (HR 2.47, 95% CI 1.57–3.89). No increased risk was observed for celecoxib users. No increased risk of CV death was observed for patients exposed to coxibs or NSAIDs. Patients newly exposed to NSAIDs were at an increased risk of death (HR 2.22, 95% CI 1.30–3.77) and of composite end-point (HR 2.28, 95% CI 1.35–3.84). Users of rofecoxib and NSAIDs, but not celecoxib, were at an increased risk of recurrent AMI and of composite end-point. Surprisingly, no increased risk of CV death was observed. Further studies are needed to better understand these apparently contradictory results

The Science of Sungrazers, Sunskirters, and Other Near-Sun Comets

This review addresses our current understanding of comets that venture close to the Sun, and are hence exposed to much more extreme conditions than comets that are typically studied from Earth. The extreme solar heating and plasma environments that these objects encounter change many aspects of their behaviour, thus yielding valuable information on both the comets themselves that complements other data we have on primitive solar system bodies, as well as on the near-solar environment which they traverse. We propose clear definitions for these comets: We use the term near-Sun comets to encompass all objects that pass sunward of the perihelion distance of planet Mercury (0.307 AU). Sunskirters are defined as objects that pass within 33 solar radii of the Sun’s centre, equal to half of Mercury’s perihelion distance, and the commonly-used phrase sungrazers to be objects that reach perihelion within 3.45 solar radii, i.e. the fluid Roche limit. Finally, comets with orbits that intersect the solar photosphere are termed sundivers. We summarize past studies of these objects, as well as the instruments and facilities used to study them, including space-based platforms that have led to a recent revolution in the quantity and quality of relevant observations. Relevant comet populations are described, including the Kreutz, Marsden, Kracht, and Meyer groups, near-Sun asteroids, and a brief discussion of their origins. The importance of light curves and the clues they provide on cometary composition are emphasized, together with what information has been gleaned about nucleus parameters, including the sizes and masses of objects and their families, and their tensile strengths. The physical processes occurring at these objects are considered in some detail, including the disruption of nuclei, sublimation, and ionisation, and we consider the mass, momentum, and energy loss of comets in the corona and those that venture to lower altitudes. The different components of comae and tails are described, including dust, neutral and ionised gases, their chemical reactions, and their contributions to the near-Sun environment. Comet-solar wind interactions are discussed, including the use of comets as probes of solar wind and coronal conditions in their vicinities. We address the relevance of work on comets near the Sun to similar objects orbiting other stars, and conclude with a discussion of future directions for the field and the planned ground- and space-based facilities that will allow us to address those science topics