Interrater agreement in the interpretation of neonatal electroencephalography in hypoxic‐ischemic encephalopathy

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/136482/1/epi13661_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/136482/2/epi13661.pd

Terrestrial Very-Long-Baseline Atom Interferometry:Workshop Summary

This document presents a summary of the 2023 Terrestrial Very-Long-Baseline Atom Interferometry Workshop hosted by CERN. The workshop brought together experts from around the world to discuss the exciting developments in large-scale atom interferometer (AI) prototypes and their potential for detecting ultralight dark matter and gravitational waves. The primary objective of the workshop was to lay the groundwork for an international TVLBAI proto-collaboration. This collaboration aims to unite researchers from different institutions to strategize and secure funding for terrestrial large-scale AI projects. The ultimate goal is to create a roadmap detailing the design and technology choices for one or more km-scale detectors, which will be operational in the mid-2030s. The key sections of this report present the physics case and technical challenges, together with a comprehensive overview of the discussions at the workshop together with the main conclusions

Risk factors for EEG seizures in neonates treated with hypothermia: a multicenter cohort study.

OBJECTIVE: To assess the risk factors for electrographic seizures among neonates treated with therapeutic hypothermia for hypoxic-ischemic encephalopathy (HIE). METHODS: Three-center observational cohort study of 90 term neonates treated with hypothermia, monitored with continuous video-EEG (cEEG) within the first day of life (median age at onset of recording 9.5 hours, interquartile range 6.3-14.5), and continued for >24 hours (total recording 93.3 hours, interquartile range 80.1-112.8 among survivors). A pediatric electroencephalographer at each site reviewed cEEGs for electrographic seizures and initial EEG background category. RESULTS: A total of 43 (48%) had electrographic seizures, including 9 (10%) with electrographic status epilepticus. Abnormal initial EEG background classification (excessively discontinuous, depressed and undifferentiated, burst suppression, or extremely low voltage), but not clinical variables (including pH <6.8, base excess ≤-20, or 10-minute Apgar ≤ 3), was strongly associated with seizures. CONCLUSIONS: Electrographic seizures are common among neonates with HIE undergoing hypothermia and are difficult to predict based on clinical features. These results justify the recommendation for cEEG monitoring in neonates treated with hypothermia

Interrater agreement in the interpretation of neonatal electroencephalography in hypoxic-ischemic encephalopathy.

ObjectiveResearch using neonatal electroencephalography (EEG) has been limited by a lack of a standardized classification system and interpretation terminology. In 2013, the American Clinical Neurophysiology Society (ACNS) published a guideline for standardized terminology and categorization in the description of continuous EEG in neonates. We sought to assess interrater agreement for this neonatal EEG categorization system as applied by a group of pediatric neurophysiologists.MethodsA total of 60 neonatal EEG studies were collected from three institutions. All EEG segments were from term neonates with hypoxic-ischemic encephalopathy. Three pediatric neurophysiologists independently reviewed each record using the ACNS standardized scoring system. Unweighted kappa values were calculated for interrater agreement of categorical data across multiple observers.ResultsInterrater agreement was very good for identification of seizures (κ = 0.93, p < 0.001), with perfect agreement in 95% of records (57 of 60). Interrater agreement was moderate for classifying records as normal or having any abnormality (κ = 0.49, p < 0.001), with perfect agreement in 78% of records (47 of 60). Interrater agreement was good in classifying EEG backgrounds on a 5-category scale (normal, excessively discontinuous, burst suppression, status epilepticus, or electrocerebral inactivity) (κ = 0.70, p < 0.001), with perfect agreement in 72% of records (43 of 60). Other specific background features had lower agreement, including voltage (κ = 0.41, p < 0.001), variability (κ = 0.35, p < 0.001), symmetry (κ = 0.18, p = 0.01), presence of abnormal sharp waves (κ < 0.20, p < 0.05), and presence of brief rhythmic discharges (κ < 0.20, p < 0.05).SignificanceWe found good or very good interrater agreement applying the ACNS system for identification of seizures and classification of EEG background. Other specific EEG features showed limited interrater agreement. Of importance to both clinicians and researchers, our findings support using the ACNS system in identifying seizures and classifying backgrounds of neonatal EEG recordings, but also suggest limited reproducibility for certain other EEG features

L'évaluation de la qualité des équipements éducatifs

En 2005, le Programme de l’OCDE pour la construction et l’équipement de l’éducation (PEB) a organisé deux réunions d’experts internationaux pour débattre des méthodes employées par les pays pour définir et évaluer la qualité des équipements éducatifs. En plus des enseignements tirés de ces deux réunions, cet article présente les recherches et les expériences de six experts : le directeur d’un programme de construction rend compte des normes utilisées pour évaluer l’adéquation des équipements éducatifs des écoles publiques de l’État du Maryland, aux États-Unis ; un chercheur présente une méthode d’évaluation de la fonctionnalité des lieux, utilisée dans des écoles de Sao Paulo, au Brésil ; un autre chercheur décrit un dispositif de collecte de données servant à établir des indicateurs sur les infrastructures de l’éducation dans un certain nombre de municipalités en Grèce ; deux administrateurs examinent les normes établies pour assurer un niveau minimum de qualité et de sécurité dans les installations éducatives au Mexique ; deux architectes communiquent les résultats d’une récente évaluation de fonctionnalité réalisée dans un nouvel établissement scolaire de Pendao, au Portugal ; et un urbaniste présente un projet international de construction de nouvelles écoles au Salvador, qui s’appuie sur des critères de qualité.Mexique, Grèce, États-Unis, Brésil, normes, évaluation de fonctionnalité, sécurité

Evaluating Quality in Educational Facilities

In 2005, the OECD Programme on Educational Building (PEB) organised two international experts’ group meetings to discuss how countries define and evaluate quality in educational facilities. The research and experiences of six experts are presented in this article, in addition to the lessons learned from the experts’ group meetings. The director of a state construction programme describes the standards used to assess the educational adequacy of all public school facilities in the State of Maryland in the United States. A researcher presents a post-occupancy evaluation methodology used in schools in São Paulo, Brazil. Another researcher presents a data collection tool used to develop indicators on educational infrastructure in a number of municipalities in Greece. Two administrators discuss the development of norms to ensure minimum standards of quality and security in educational facilities in Mexico. Two architects present the results of a recent post-occupancy evaluation conducted in a new school in Pendão, Portugal. And an urban planner presents an international project to construct new schools in El Salvador using quality criteria.Mexico, Greece, United States, security, Brazil, standards, post-occupancy, norms, Portugal, evaluation, El Salvador

Risk factors for EEG seizures in neonates treated with hypothermia: a multicenter cohort study.

To assess the risk factors for electrographic seizures among neonates treated with therapeutic hypothermia for hypoxic-ischemic encephalopathy (HIE).Three-center observational cohort study of 90 term neonates treated with hypothermia, monitored with continuous video-EEG (cEEG) within the first day of life (median age at onset of recording 9.5 hours, interquartile range 6.3-14.5), and continued for >24 hours (total recording 93.3 hours, interquartile range 80.1-112.8 among survivors). A pediatric electroencephalographer at each site reviewed cEEGs for electrographic seizures and initial EEG background category.A total of 43 (48%) had electrographic seizures, including 9 (10%) with electrographic status epilepticus. Abnormal initial EEG background classification (excessively discontinuous, depressed and undifferentiated, burst suppression, or extremely low voltage), but not clinical variables (including pH <6.8, base excess ≤-20, or 10-minute Apgar ≤ 3), was strongly associated with seizures.Electrographic seizures are common among neonates with HIE undergoing hypothermia and are difficult to predict based on clinical features. These results justify the recommendation for cEEG monitoring in neonates treated with hypothermia