Estimation of brain network ictogenicity predicts outcome from epilepsy surgery

Surgery is a valuable option for pharmacologically intractable epilepsy. However, significant post-operative improvements are not always attained. This is due in part to our incomplete understanding of the seizure generating (ictogenic) capabilities of brain networks. Here we introduce an in silico, model-based framework to study the effects of surgery within ictogenic brain networks. We find that factors conventionally determining the region of tissue to resect, such as the location of focal brain lesions or the presence of epileptiform rhythms, do not necessarily predict the best resection strategy. We validate our framework by analysing electrocorticogram (ECoG) recordings from patients who have undergone epilepsy surgery. We find that when post-operative outcome is good, model predictions for optimal strategies align better with the actual surgery undertaken than when post-operative outcome is poor. Crucially, this allows the prediction of optimal surgical strategies and the provision of quantitative prognoses for patients undergoing epilepsy surgery.MG, MPR and JRT gratefully acknowledge the financial support of the EPSRC via grant EP/N014391/1. They further acknowledge funding from Epilepsy Research UK via grant number A1007 and the Medical Research Council via grant MR/K013998/1. The contribution of MG and JRT was generously supported by a Wellcome Trust Institutional Strategic Support Award (WT105618MA). MPR is supported by the National Institute for Health Research (NIHR) Biomedical Research Centre at the South London and Maudsley NHS Foundation Trust. CR and AE were supported by the Swiss National Science Foundation (grant SPUM 140332). KS is grateful for support from the Swiss National Science Foundation (grants 122010 and 155950)

Primary care in Malta : the patients’s expectations in 2009

Given the strong literature base to support the positioning of Primary Care at the core of a sustainable National Health Service, this study examines what the Maltese general public prefer, and expect, from their family doctor, and explores their preferred systems of care changes.peer-reviewe

Elevated ictal brain network ictogenicity enables prediction of optimal seizure control

This is the final version of the article. Available from Frontiers Media via the DOI in this record.Recent studies have shown that mathematical models can be used to analyze brain networks by quantifying how likely they are to generate seizures. In particular, we have introduced the quantity termed brain network ictogenicity (BNI), which was demonstrated to have the capability of differentiating between functional connectivity (FC) of healthy individuals and those with epilepsy. Furthermore, BNI has also been used to quantify and predict the outcome of epilepsy surgery based on FC extracted from pre-operative ictal intracranial electroencephalography (iEEG). This modeling framework is based on the assumption that the inferred FC provides an appropriate representation of an ictogenic network, i.e., a brain network responsible for the generation of seizures. However, FC networks have been shown to change their topology depending on the state of the brain. For example, topologies during seizure are different to those pre- and post-seizure. We therefore sought to understand how these changes affect BNI. We studied peri-ictal iEEG recordings from a cohort of 16 epilepsy patients who underwent surgery and found that, on average, ictal FC yield higher BNI relative to pre- and post-ictal FC. However, elevated ictal BNI was not observed in every individual, rather it was typically observed in those who had good post-operative seizure control. We therefore hypothesize that elevated ictal BNI is indicative of an ictogenic network being appropriately represented in the FC. We evidence this by demonstrating superior model predictions for post-operative seizure control in patients with elevated ictal BNI.ML, MG, MR, and JT gratefully acknowledge funding from the Medical Research Council via grant MR/K013998/1. MG, MR, and JT further acknowledge the financial support of the EPSRC via grant EP/N014391/1. The contribution of MG and JT was further generously supported by a Wellcome Trust Institutional Strategic Support Award (WT105618MA). MR and EA are supported by the National Institute for Health Research (NIHR) Biomedical Research Centre at the South London and Maudsley NHS Foundation Trust. KS gratefully acknowledges support by the Swiss National Science Foundation (SNF 32003B_155950)

Stigma narratives: LGBT transitions and identities in Malta

This article is available open access through the publisher’s website at the link below. Copyright @ 2011 A B Academic Publishers.This article considers narratives of transition experiences of a group of Lesbian, Gay, Bisexual and Transgender (LGBT) young people in Malta. The article draws on Goffman's concept of stigma and uses this to explore transitions in a society that retains some traditional characteristics, particularly the code of honour and shame, although mediated by aspects of modernity. Interviews were undertaken with 15 young people with the goal of producing narratives. The article analyses the experience of stigma, its effects and how young people manage its consequences. It concludes by drawing attention to the pervasive nature of stigma and the importance of structure, agency and reflexivity in youth transitions. In particular stigma remains an important feature of societies in which hetero-normative sexuality remains dominant

Polarimetry of 16Ngs produced in mu --capture on 16O nuclei

A polarimetry technique based on stack targets and /3-'/-coincidences has been applied to the 16N nuclei produced in the ground state capture of negative muons on lb0 nuclei. The performance of the polarimeter and the first measurements of /3-asymmetry due to the longitudinal nuclear polarization are discussed

Hypercholesterolemia and Myocardial function evaluated via Tissue Doppler Imaging

This is an Open Access article distributed under the terms of the Creative Commons Attribution Licens

The KARMEN Time Anomaly: Search for a Neutral Particle of Mass 33.9 MeV in Pion Decay

We have searched for the pion decay pi^+ --> mu^+ X, where X is a neutral particle of mass 33.905 MeV. This process was suggested by the KARMEN Collaboration to explain an anomaly in their observed time distribution of neutrino induced reactions. Having measured the muon momentum spectrum of charged pions decaying in flight, we find no evidence for this process and place an upper limit on the branching fraction eta leq 6.0 * 10^{-10} of such a decay at a 95% confidence level.Comment: 17 pages including 4 for figure

Evidence for a two component magnetic response in UPt3

The magnetic response of the heavy fermion superconductor UPt_3 has been investigated on a microscopic scale by muon Knight shift studies. Two distinct and isotropic Knight shifts have been found for the field in the basal plane. While the volume fractions associated with the two Knight shifts are approximately equal at low and high temperatures, they show a dramatic and opposite temperature dependence around T_N. Our results are independent on the precise muon localization site. We conclude that UPt_3 is characterized by a two component magnetic response.Comment: 5 pages, 4 figure

Mixing of Active and Sterile Neutrinos

We investigate mixing of neutrinos in the $\nu$MSM (neutrino Minimal Standard Model), which is the MSM extended by three right-handed neutrinos. Especially, we study elements of the mixing matrix $\Theta_{\alpha I}$ between three left-handed neutrinos $\nu_\alpha$ ($\alpha = e,\mu,\tau$) and two sterile neutrinos $N_I$ ($I=2,3$) which are responsible to the seesaw mechanism generating the suppressed masses of active neutrinos as well as the generation of the baryon asymmetry of the universe (BAU). It is shown that $\Theta_{eI}$ can be suppressed by many orders of magnitude compared with $\Theta_{\mu I}$ and $\Theta_{\tau I}$, when the Chooz angle $\theta_{13}$ is large in the normal hierarchy of active neutrino masses. We then discuss the neutrinoless double beta decay in this framework by taking into account the contributions not only from active neutrinos but also from all the three sterile neutrinos. It is shown that $N_2$ and $N_3$ give substantial, destructive contributions when their masses are smaller than a few 100 MeV, and as a results $\Theta_{e I}$ receive no stringent constraint from the current bounds on such decay. Finally, we discuss the impacts of the obtained results on the direct searches of $N_{2,3}$ in meson decays for the case when $N_{2,3}$ are lighter than pion mass. We show that there exists the allowed region for $N_{2,3}$ with such small masses in the normal hierarchy case even if the current bound on the lifetimes of $N_{2,3}$ from the big bang nucleosynthesis is imposed. It is also pointed out that the direct search by using $\pi^+ \to e^+ + N_{2,3}$ and $K^+ \to e^+ + N_{2,3}$ might miss such $N_{2,3}$ since the branching ratios can be extremely small due to the cancellation in $\Theta_{eI}$, but the search by $K^+ \to \mu^+ + N_{2,3}$ can cover the whole allowed region by improving the measurement of the branching ratio by a factor of 5.Comment: 30 pages, 32 figure