The prevalence and clinical features of epileptic seizures in a memory clinic population

This is the author accepted manuscript. The final version is available from Elsevier via the DOI in this record.Purpose: To determine the prevalence and clinical features of epileptic seizures occurring in a memory clinic population. Method: We recruited patients receiving a diagnosis of dementia or mild cognitive impairment (MCI) at a regional memory clinic. We interviewed patients and informants using a proforma designed to elicit symptoms suggestive of epilepsy. Informants also completed the Clinical Dementia Rating Scale (CDR) and the Cambridge Behavioural Inventory- Revised (CBI-R). Patients underwent cognitive testing using the Addenbrooke's Cognitive Examination – III (ACE-III). We also recruited an age- and gender- matched control group with no history of cognitive impairment. Diagnoses of dementia/MCI were checked against current diagnostic criteria. Results: We recruited 144 patients (mean age 77.98, mean ACE-III 74.16, 124 with dementia, 20 with MCI). We diagnosed epilepsy in 25.7%: probable in 12.5% (17 with dementia, 1 with MCI), possible 13.2% (18 with dementia, 1 with MCI). Seizure features included altered responsiveness, speech/behavioural arrest, oral/pharyngeal automatism, olfactory/gustatory aura, focal motor seizure, other sensory phenomena (including hallucination), and amnesia on waking. Epilepsy prevalence was significantly increased in the dementia and MCI group vs controls (p = 0.004). Cognitive performance in the patient groups did not distinguish those in whom epilepsy was suspected from those in whom it was not. Patients in whom epilepsy was suspected were more impaired on informant completed measures of daily function. Conclusions: The prevalence of epilepsy is increased in dementia. The seizures are often subtle and easily missed. The presence of epilepsy predicts more severe impairment in the activities of daily living.Dunhill Medical Trus

Stabilization of Mobile Manipulators

The focus of this work is to generate a method of stabilization in a system generated through the marriage of a mobile robot and a manipulator. While the stability of a rigid manipulator is a solved problem, upon the introduction of flexibilities into the manipulator base structure there is the simultaneous introduction of an unmodeled, induced, oscillatory disturbance to the manipulator system from the mobile base suspension and mounting. Under normal circumstances, the disturbance can be modeled through experimentation and then a form of vibration suppression control can be employed to damp the induced oscillations in the base. This approach is satisfactory for disturbances that are measured, however the hardware necessary to measure the induced oscillations in the manipulator base is generally not included in mobile manipulation systems. Because of this lack of sensing hardware it becomes difficult to directly compensate for the induced disturbances in the system. Rather than developing a direct method for compensation, efforts are made to find postures of the manipulator where the flexibilities of the system are passive. In these postures the manipulator behaves as if it is on a rigid base, this allows the use of higher feedback gains and simpler control architectures.Ph.D

Challenges and practical recommendations for successfully recruiting inactive, statin-free older adults to clinical trials

Objectives: To outline the challenges and provide practical recommendations for recruiting inactive, statin-free older adults to facilitate feasible study designs. Data was obtained from a double-blind randomised-controlled clinical trial investigating the effects of acipimox versus placebo on muscle function and metabolism in older (65-75 years), inactive, statin-free males. The initial recruitment target was 20 volunteers within 12 months (November 2016-November 2017). Results: Recruitment occurred via the Exeter 10,000 database containing 236 'eligible' males, a Facebook campaign reaching > 8000 ≥ 65 years old males, 400 directly-addressed letters to ≥ 66 year old males, > 1500 flyers distributed within the community, > 40 emails to local community groups, 4 recruitment talks, 2 magazine adverts and 1 radio advert. Widespread recruitment efforts reaching > 120,000 people led to the recruitment of 20 volunteers (18 completed the clinical trial) within a 25-month timeframe, highlighting the challenge of the timely recruitment of inactive, statin-free older adults for clinical trials. We recommend recruitment for future clinical trials should take a multi-pronged approach from the outset, prioritising the use of volunteer databases, Facebook campaigns and delivering recruitment talks.This article is freely available via Open Access. Click on the Publisher URL to access it via the publisher's site.This work was supported by a grant from Dunhill Medical Trust (R492/0516) and the NIHR Exeter CRF. CS Deane is a funded Medical Research Council Skills Development Fellow (MR/T026014/1). The funders had no role in study design, data analysis or outcome of the study.published version, accepted versio

Platinum-Gallium (Pt-Ga) Intermetallic Alloys for Propane Dehydrogenation

Natural gas is a source of energy for the United States. The Center for Innovative Strategic Transformation of Alkane Resources (CISTAR) plans to use shale gas extracted from shale rock formations as a bridge fuel to replace coal and oil while the US transitions to renewable energy like solar and wind. After methane, the largest components in shale gas are light alkanes such as ethane and propane. These can be catalytically converted to olefins, which can be further reacted to produce fuels, for example. Olefins from alkanes can be accomplished by dehydrogenation by promoted platinum alloys. This study compares the structure and chemical properties of Pt-Ga alloys on silica (SiO2) and ceria (CeO2) supports to determine if the support plays an important role in this chemistry. The catalysts containing different Pt:Ga ratios were synthesized using incipient wetness impregnation. These catalysts were characterized by in situ X-ray diffraction (XRD) and X-ray adsorption spectroscopy (XAS) to determine if an alloy was formed, and if so, the structure of that alloy. Finally, the catalysts were tested in a fixed bed reactor, where it was found that the silica-supported Pt-Ga alloy has a selectivity of \u3e90% towards propylene. Understanding catalyst design can lead to higher catalytic conversion of substances and potentially an improved selectivity for the formation of preferred products. Pt-Ga on ceria is tested for comparison and there appears to behave differently from that on silica demonstrating the importance of the role of the support on these catalysts

Randomized phase 1b trial of MOR103, a human antibody to GM-CSF, in multiple sclerosis

Objectives: To determine the safety, pharmacokinetics (PK), and immunogenicity of the recombinant human monoclonal antibody MOR103 to granulocyte-macrophage colony-stimulating factor (GM-CSF) in patients with multiple sclerosis (MS) with clinical or MRI activity.Methods: In this 20-week, randomized, double-blind, placebo-controlled phase 1b dose-escalation trial (registration number NCT01517282), adults with relapsing-remitting MS (RRMS) or secondary progressive MS (SPMS) received an IV infusion of placebo (n = 6) or MOR103 0.5 (n = 8), 1.0 (n = 8), or 2.0 (n = 9) mg/kg every 2 weeks for 10 weeks. Patients had to have ≤10 gadolinium (Gd)-enhancing brain lesions on T1-weighted MRI at baseline. The primary objective was safety.Results: Most treatment-emergent adverse events (TEAEs) were mild to moderate in severity. The most frequent was nasopharyngitis. Between-group differences in TEAE numbers were small. There were no TEAE-related trial discontinuations, infusion-related reactions, or deaths. Nine patients experienced MS exacerbations: 3, 5, 1, and 0 patient(s) in the placebo, 0.5, 1.0, and 2.0 mg/kg groups, respectively. A few T1 Gd-enhancing lesions and/or new or enlarging T2 lesions indicative of inflammation were observed in all treatment groups. No clinically significant changes were observed in other clinical assessments or laboratory safety assessments. No anti-MOR103 antibodies were detected. PK evaluations indicated dose linearity with low/no drug accumulation over time.Conclusions: MOR103 was generally well-tolerated in patients with RRMS or SPMS. No evidence of immunogenicity was found.Classification of evidence: This phase 1b study provides Class I evidence that MOR103 has acceptable tolerability in patients with MS

Does fulfilling a need for uniqueness decrease conspiracy theory endorsement?

With the recent increase of measles outbreaks, there has been a rising concern regarding anti-vaccination conspiracy theories. Conspiracy theories are belief systems endorsed by some individuals in which powerful, malevolent groups work in secret to orchestrate world events. Research on conspiracy theories has increased in the past decade. Several scholars have examined a number of epistemic, existential, and social motivations for conspiracy theory endorsement. Others, to a lesser degree, have inspected individual factors such as analytical thinking styles and education. The current study hypothesized that fulfilling individuals’ need for uniqueness by providing bogus personality questionnaire feedback would result in decreased endorsement of conspiracy theories. Furthermore, those who receive bogus feedback indicating they lack uniqueness will be more likely to endorse conspiracy theories. Two hundred and seventeen students were recruited from Texas A&M University-Corpus Christi. Participants completed a bogus personality questionnaire. After receiving either positive uniqueness feedback or negative uniqueness feedback, participants completed the Need for Uniqueness Scale, the Generic Conspiracist Beliefs Scale-Short, and the Rational Experiential Inventory-short. Analyses revealed that manipulating participants’ need for uniqueness did not impact conspiracy theory endorsement. This may be because the manipulation of need for uniqueness was ineffective as bogus feedback may have been too specific or participants did not perceived feedback as accurate.Psychology & SociologyCollege of Liberal Art

Advanced Characterizations for the Identification of Catalyst Structures and Reaction Intermediates

In recent decades, alternatives to traditional coal and fossil fuels were utilized to reduce carbon emissions. Among these alternatives, natural gas is a cleaner fuel and is abundant globally. Shale gas, a form of natural gas that also contains light alkanes (C2-C4), is presently being employed to produce olefins, which can be upgraded to higher molecular weight hydrocarbons. This thesis describes efforts to develop new catalytic materials and characterizations for the conversion of shale gas to fuels. In the first half, silica supported Pt-Cr alloys containing varying compositions of Pt and Pt3Cr were used for propane dehydrogenation at 550°C. Although a change in selective performance was observed on catalysts with varying promoter compositions, the average nano-particle structures determined by in situ, synchrotron x-ray absorption spectroscopy (XAS) and x-ray diffraction (XRD) were identical. Further, this work presents a method for the characterization of the catalytic surface by these methods to understand its relationship with olefin selectivity. From this, we can gain an atomically precise control of new alloys compositions with tunable surface structures. Once formed by dehydrogenation, the intermediate olefins are converted to fuel-range hydrocarbons. In the second half, previously unknown single site, main group Zn2+ and Ga3+ catalysts are shown to be effective for oligomerization and the resulting products follow a Schutlz Flory distribution. Mechanistic studies suggest these catalysts form metal hydride and metal alkyl reaction intermediates and are active for olefin insertion and -H elimination elementary steps, typical for the homogeneous, Cossee-Arlman oligomerization mechanism. Evidence of metal hydride and metal alkyl species were observed by XAS, Fourier transform infrared spectroscopy (FTIR), and H2/D2isotope exchange. Understanding the reaction intermediates and elementary steps is critical for identifying novel oligomerization catalysts with tunable product selectivity for targeted applications. Through controlled synthesis and atomic level in situcharacterizations, new catalysts compositions can be developed with high control over the resulting performance. An atomically precise control of the catalyst structure and understanding how it evolves under reaction conditions can help shed light on the fundamental principles required for rational catalyst design

Topiramate in the Treatment of Myoclonic-Astatic Epilepsy in Children: A Retrospective Hospital Audit

BACKGROUND: Myoclonic-Astatic Epilepsy (MAE) usually starts before five years of age and is associated with very frequent seizures and is highly resistant to treatment. AIM: To investigate the outcome of adjunctive topiramate (TPM) therapy in children with a diagnosis of MAE syndrome. Subjects AND METHODS: In an outpatient setting, case notes of 27 children who received TPM were retrieved and analysed. RESULTS: Records of 6 children with MAE, who were experiencing 2-8 atonic seizures daily before starting TPM were studied. Improvement was noted after addition of TPM (mean dose at steady-state 7.4\ub12.5mg/kg/day) to the regimen of 1-3 anti-epileptic drugs they were receiving concurrently. All but one child improved following the titration period: one had 50-80% improvement in the frequency of atonic seizures and three had over 80% improvement. However, one child who showed over 80% improvement and was free of atonic seizures, later developed increased frequency of other seizure types. In one child there was no significant improvement. Improvement has been sustained for over 6 months in three patients and over 4 months in one; three have continued TPM. TPM was stopped in three patients (reduction in seizure control/no improvement). CONCLUSIONS: This study supports the efficacy of TPM in controlling atonic seizures in MAE and indicates that it should be considered as an add-on drug in the management of this 'difficult-to-treat' epileptic syndrome