Amplitude-integrated EEG assists in detecting cerebral dysfunction in the newborn

Background: Amplitude-integrated encephalography (aEEG) in term-born encephalopathic infants has been shown to be predictive of later neurodevelopmental outcomes, but little is known about the mediating cerebral pathology. In addition, the aEEG is commonly used to monitor electrographic seizures in the newborn, an important manifestation of cerebral pathology, but there is limited data on it’s efficacy for this purpose. It’s clinical application in the preterm infant remains to be explored. Aim: The central aim of this thesis is to prove the hypothesis that the aEEG assists in detecting cerebral dysfunction in the newborn. Methods: 1) In a cohort of term-born infants with encephalopathy and/or seizures digital aEEG background measures of the lower and upper aEEG margins were related to a numeric MRI abnormality score. 2) In at-risk term newborns, the accuracy of two-channel digital aEEG monitoring was compared with continuous concurrent conventional EEG for seizure detection. 3) In preterm infants (gestation at birth < 30 weeks) aEEG measures of lower and upper margin collected in the first week of life were compared in infants with substantial cerebral abnormality to infants without. Results: 1) For all infants in the term cohort, the severity of abnormality of aEEG background was strongly related to severity of abnormality seen on cerebral MRI. 2) Using the aEEG pattern with the raw EEG signal, 76% of electrographic seizures were correctly identified in the term infants. 3) In the preterm cohort, the lower and upper aEEG amplitude margins increased significantly during the first week of life. In the presence of substantial cerebral abnormality, these margins were significantly depressed. Seizures were noted in the smaller and sicker, infants. Conclusion: The central hypothesis of this thesis, that the aEEG assists in detecting cerebral dysfunction in the newborn was proved

Heart failure risk across the spectrum of ankle-brachial index: The ARIC study (Atherosclerosis RiskIn Communities)

The aim of this study was to describe the relationship between ankle brachial index (ABI) and the risk for heart failure (HF). Background: The ABI is a simple, noninvasive measure associated with atherosclerotic cardiovascular disease and death; however, the relationship between ABI and risk for HF is less well characterized. Methods: Between 1987 and 1989 in the ARIC (Atherosclerosis Risk In Communities) study, an oscillometric device was used to measure blood pressure in a single upper and randomly chosen lower extremity to determine the ABI. Incident HF events were defined by the first hospitalization with an International Classification of Diseases, Ninth Revision, code of 428.x through 2008. The risk for HF was assessed across the ABI range using restricted cubic splines and Cox proportional hazards models. Results: ABI was available in 13,150 participants free from prevalent HF. Over a mean 17.7 years of follow-up, 1,809 incident HF events occurred. After adjustment for traditional HF risk factors, prevalent coronary heart disease, subclinical carotid atherosclerosis, and interim myocardial infarction, compared with an ABI of 1.01 to 1.40, participants with ABIs≤0.90 were at increased risk for HF (hazard ratio: 1.40; 95% confidence interval: 1.12 to 1.74), as were participants with ABIs of 0.91 to 1.00 (hazard ratio: 1.36; 95% confidence interval: 1.17 to 1.59). Conclusions: In a middle-age community cohort, an ABI≤1.00 was significantly associated with an increased risk for HF, independent of traditional HF risk factors, prevalent coronary heart disease, carotid atherosclerosis, and interim myocardial infarction. Low ABI may reflect not only overt atherosclerosis but also pathologic processes in the development of HF beyond epicardial atherosclerotic disease and myocardial infarction alone. A low ABI, as a simple, noninvasive measure, may be a risk marker for HF

Risk of secondhand smoke exposure and severity of COVID-19 infection: multicenter case–control study

IntroductionExposure to secondhand smoke (SHS) is an established causal risk factor for cardiovascular disease (CVD) and chronic lung disease. Numerous studies have evaluated the role of tobacco in COVID-19 infection, severity, and mortality but missed the opportunity to assess the role of SHS. Therefore, this study was conducted to determine whether SHS is an independent risk factor for COVID-19 infection, severity, mortality, and other co-morbidities.MethodologyMulticentric case–control study was conducted across six states in India. Severe COVID-19 patients were chosen as our study cases, and mild and moderate COVID-19 as control were evaluated for exposure to SHS. The sample size was calculated using Epi-info version 7. A neighborhood-matching technique was utilized to address ecological variability and enhance comparability between cases and controls, considering age and sex as additional matching criteria. The binary logistic regression model was used to measure the association, and the results were presented using an adjusted odds ratio. The data were analyzed using SPSS version 24 (SPSS Inc., Chicago, IL, USA).ResultsA total of 672 cases of severe COVID-19 and 681 controls of mild and moderate COVID-19 were recruited in this study. The adjusted odds ratio (AOR) for SHS exposure at home was 3.03 (CI 95%: 2.29–4.02) compared to mild/moderate COVID-19, while SHS exposure at the workplace had odds of 2.19 (CI 95%: 1.43–3.35). Other factors significantly related to the severity of COVID-19 were a history of COVID-19 vaccination before illness, body mass index (BMI), and attached kitchen at home.DiscussionThe results of this study suggest that cumulative exposure to secondhand cigarette smoke is an independent risk factor for severe COVID-19 illness. More studies with the use of biomarkers and quantification of SHS exposure in the future are needed

Search for leptophobic Z ' bosons decaying into four-lepton final states in proton-proton collisions at root s=8 TeV

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Search for black holes and other new phenomena in high-multiplicity final states in proton-proton collisions at root s=13 TeV

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Geographical and temporal distribution of SARS-CoV-2 clades in the WHO European Region, January to June 2020

We show the distribution of SARS-CoV-2 genetic clades over time and between countries and outline potential genomic surveillance objectives. We applied three available genomic nomenclature systems for SARS-CoV-2 to all sequence data from the WHO European Region available during the COVID-19 pandemic until 10 July 2020. We highlight the importance of real-time sequencing and data dissemination in a pandemic situation. We provide a comparison of the nomenclatures and lay a foundation for future European genomic surveillance of SARS-CoV-2.Peer reviewe

Measurements of differential production cross sections for a Z boson in association with jets in pp collisions at root s=8 TeV

Peer reviewe

Search for high-mass diphoton resonances in proton-proton collisions at 13 TeV and combination with 8 TeV search

Peer reviewe