Remote and long-term self-monitoring of electroencephalographic and noninvasive measurable variables at home in patients with epilepsy (EEG@HOME) : protocol for an observational study

©Andrea Biondi, Petroula Laiou, Elisa Bruno, Pedro F Viana, Martijn Schreuder, William Hart, Ewan Nurse, Deb K Pal, Mark P Richardson. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 19.03.2021. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Research Protocols, is properly cited. The complete bibliographic information, a link to the original publication on http://www.researchprotocols.org, as well as this copyright and license information must be included.Background: Epileptic seizures are spontaneous events that severely affect the lives of patients due to their recurrence and unpredictability. The integration of new wearable and mobile technologies to collect electroencephalographic (EEG) and extracerebral signals in a portable system might be the solution to prospectively identify times of seizure occurrence or propensity. The performances of several seizure detection devices have been assessed by validated studies, and patient perspectives on wearables have been explored to better match their needs. Despite this, there is a major gap in the literature on long-term, real-life acceptability and performance of mobile technology essential to managing chronic disorders such as epilepsy. Objective: EEG@HOME is an observational, nonrandomized, noninterventional study that aims to develop a new feasible procedure that allows people with epilepsy to independently, continuously, and safely acquire noninvasive variables at home. The data collected will be analyzed to develop a general model to predict periods of increased seizure risk. Methods: A total of 12 adults with a diagnosis of pharmaco-resistant epilepsy and at least 20 seizures per year will be recruited at King's College Hospital, London. Participants will be asked to self-apply an easy and portable EEG recording system (ANT Neuro) to record scalp EEG at home twice daily. From each serial EEG recording, brain network ictogenicity (BNI), a new biomarker of the propensity of the brain to develop seizures, will be extracted. A noninvasive wrist-worn device (Fitbit Charge 3; Fitbit Inc) will be used to collect non-EEG biosignals (heart rate, sleep quality index, and steps), and a smartphone app (Seer app; Seer Medical) will be used to collect data related to seizure occurrence, medication taken, sleep quality, stress, and mood. All data will be collected continuously for 6 months. Standardized questionnaires (the Post-Study System Usability Questionnaire and System Usability Scale) will be completed to assess the acceptability and feasibility of the procedure. BNI, continuous wrist-worn sensor biosignals, and electronic survey data will be correlated with seizure occurrence as reported in the diary to investigate their potential values as biomarkers of seizure risk. Results: The EEG@HOME project received funding from Epilepsy Research UK in 2018 and was approved by the Bromley Research Ethics Committee in March 2020. The first participants were enrolled in October 2020, and we expect to publish the first results by the end of 2022. Conclusions: With the EEG@HOME study, we aim to take advantage of new advances in remote monitoring technology, including self-applied EEG, to investigate the feasibility of long-term disease self-monitoring. Further, we hope our study will bring new insights into noninvasively collected personalized risk factors of seizure occurrence and seizure propensity that may help to mitigate one of the most difficult aspects of refractory epilepsy: the unpredictability of seizure occurrenceThis study is funded by Epilepsy Research UK (award 1803). MPR, PFV, and EN are supported by the Epilepsy Foundation of America’s Epilepsy Innovation Institute My Seizure Gauge grant.info:eu-repo/semantics/publishedVersio

EVALUATION AND QUANTIFICATION OF HEAT HOTSPOTS IN THE CHAPADA DOS GUIMARÃES-MT NATIONAL PARK

The study aimed to analyze the spatial distribution of heat sources inside and outside the Chapada dos Guimarães National Park (PNCG) in the State of Mato Grosso. The analyzes were performed through the estimate of kernel density (KDE) and Ripley's K function from 2005 to 2014. The data related to the number of hot spots were obtained from the National Institute for Space Research (INPE) from 2005 to 2014, and the vector files were acquired from the cartographic base of the Brazilian Institute of Geography and Statistics (IBGE). In the 10 years of analysis, 579 hot spots were detected in the PNCG, where it was found that the months of August and September had the highest incidence of hot spots in the park. The kernel maps demonstrated that most hotspots were observed in the years 2007, 2010 and 2012. The years 2005 and 2013 presented average densities and the years 2006, 2008, 2009, 2011 and 2014 indicated low density of the hot spots. Ripley's K function, calculated to observe the spatial distribution of the hot spots, rejected the hypothesis of complete spatial randomness (CSR), indicating that they showed a tendency to cluster during the study time series at the PNCG

Effects of fat replacement on properties of whole wheat bread

Bread characteristics are dependent upon the chemical composition and fiber content of the wheat flour used. A healthy diet can help prevent chronic diseases, where whole grains and fewer calories from fat are components of a healthy diet. The aims of this study were to determine the centesimal composition of wheat flour samples (whole, refined, and flour blends) along with their farinographic parameters (water absorption, development time and stability) and also to verify the specific volume, crumb texture profile and digital imaging of bread loaves made with 60% whole wheat flour and 3% fat or fat replacer. Increasing the whole wheat flour percentage in the blends also increased levels of protein, ash and insoluble fiber. All the farinographic parameters were also increased. Enzymatically modified starch was found to be an effective fat replacer in whole wheat loaves. The loaves made using fat replacer had the same specific volume and higher cell density as those made with fat, but exhibited different texture profile parameters such as higher hardness value and lower springiness value.A composição química da farinha de trigo e a presença de fibras afeta as características dos pães. Uma forma de contribuir com a prevenção de doenças crônicas não transmissíveis é através de alimentação saudável, incluindo grãos integrais na dieta alimentar e reduzindo as calorias de determinado alimento, substituindo a gordura. Assim, este trabalho tem como objetivo determinar a composição centesimal das amostras de farinha de trigo integral, refinada e as misturas entre elas; bem como os parâmetros farinográficos (absorção de água, tempo de desenvolvimento e estabilidade) das mesmas. Além disso, verificar volume específico, perfil de textura do miolo e análise de imagem de pães elaborados com 60% de farinha de trigo integral e com 3% de gordura ou com substituto de gordura. Os dados foram submetidos à análise de variância. À medida que aumenta o percentual de farinha integral, os teores de proteína, cinzas e fibra insolúvel alcançam valores significativamente maiores e a absorção de água fica maior na farinografia, bem como o tempo de desenvolvimento e a estabilidade. O amido modificado enzimaticamente utilizado na elaboração de pão com 60% de farinha de trigo integral funcionou como um efetivo substituto de gordura. O pão integral elaborado com substituto de gordura apresentou volume específico significativamente igual ao pão integral elaborado com gordura, porém com diferenças em relação a parâmetros do perfil de textura, maior firmeza e menor elasticidade além de maior densidade celular do que o pão elaborado com gordura

Individual patient-data meta-analysis comparing clinical outcome in patients with ST-elevation myocardial infarction treated with percutaneous coronary intervention with or without prior thrombectomy. ATTEMPT study: A pooled Analysis of Trials on ThrombEctomy in acute Myocardial infarction based on individual PatienT data

Background: Available data from randomized trials on thrombectomy in patients with ST-elevation myocardial infarction (STEMI) have shown favorable trends in myocardial reper-fusion. However, few data are available on the effect of thrombectomy on clinical outcome. Thus we have designed a collaborative individual patient-data meta-analysis which aimed to assess the long-term clinical outcome in STEMI patients randomized to percutaneous coronary intervention (PCI) with or without thrombectomy. Method: After a thorough database search, the principal investigators of randomized trials comparing thrombectomy with standard PCI in patients with STEMI were contacted. Principal investigators as authors of 11 randomized studies agreed to participate and were asked to complete a structured database by providing a series of key pre-PCI clinical and angiographic data as well as the longest available clinical outcome of the patients enrolled in the corresponding trial. The primary end-point of this pooled analysis is the comparison of overall survival rates between patients randomized to PCI with thrombectomy or PCI without thrombectomy. The secondary end-points are survival free from myocardial infarction (MI), target lesion revascularization (TLR), major adverse coronary events (MACE: death + MI + TLR) and death + MI between patients randomized to PCI with thrombectomy or PCI without thrombectomy. A pre-defined subgroup analysis is planned considering the following variables: type of thrombectomy device used, diabetes, rescue PCI, IIb/IIIa-inhibitors use, time-to-reperfusion, infarct-related artery, and pre-PCI TIMI flow. Implications: This study will provide useful data on the effect of the reported improved myocardial perfusion associated with thrombectomy on the long-term clinical outcome in patients with STEMI. © 2009 De Vita et al, publisher and licensee Dove Medical Press Ltd

Kvalitativna svojstva zrelog mesa (m. triceps brachii i m. gluteus biceps) janjadi hranjene dodacima hrani

The aim of this study was to evaluate the effect of the supplementation and aging in the gluteus biceps and triceps brachii muscles of lamb. Forty-eight Santa Inês lambs, with 15 kg average initial weight were slaughtered at 32 kg average final weight, after five months of supplementation. Twenty-four animals were allocated to sixteen pastures with residual leaf area index (2.6) and unsupplemented, the other twenty-four animals were allocated to the same conditions but were supplemented. The treatments were cross factorial between rLAI (2.6) and supplemented or not, totalizing 8 treatments. In this experiment, the slaughter criterion was the age of the animals. In the gluteus biceps and triceps brachii muscles, storage for seven days increased lipid oxidation. The values​​ of cooking loss and water holding capacity increased with time of aging and were higher in the gluteus biceps, by 29.40% and 71.30%, respectively. The supplementation implies an increase in production costs, but its use provides the quantitative and qualitative characteristics favorable to the product, aiming to satisfy the consumer market. The supplementation decreased the shelf life, increasing the lipid oxidation during time of aging and affected the lightness and the hue of yellow, which may sffect consumers’ intention to purchase.Mišići triceps brachii i gluteus biceps analizirani su kako bi se ocijenio učinak dodataka prehrani na zrenje janjećeg mesa. Ukupno 48 janjadi pasmine Santa Inês imalo je početnu prosječnu tjelesnu masu 15 kg, a nakon pet mjeseci različite prehrane prosječna je tjelesna masa bila 32 kg. Životinje su razmještene na 16 pašnjaka s rezidualnim indeksom lisne površine 2,6, pod jednakim uvjetima, pri čemu su 24 životinje dobivale dodatke prehrani. Uzevši u obzir indeks lisne površine te dodatke hrani formirano je osam skupina koje su uspoređene faktorijalnom analizom. Kriterij za klanje bila je dob životinja. Povećana oksidacija lipida ustanovljena je nakon sedam dana zrenja mesa mišića triceps brachii i gluteus biceps. Vrijednosti gubitaka nastalih kuhanjem i spososbnost zadržavanja vode povećale su se s duljinom zrenja te su u m. gluteus biceps bile više, 29,40 % odnosno 71,30 %. Dodaci prehrani podrazumijevaju povećane troškove proizvodnje, ali njihova uporaba omogućuje bolje kvantitativne i kvalitativne značajke, s ciljem da se zadovolji tržište. Dodaci prehrani skraćuju rok trajanja mesa, povećavaju oksidaciju lipida za vrijeme zrenja te utječu na svjetloću i žutilo zbog čega potrošači mogu dvojiti pri kupnji mesa

Lasalocid effects on dairy cows production of in a semi-intensive management system

Foram estudados os efeitos da lasalocida sobre a produção de leite, teor e percentagem de gordura no leite, variações de peso e condições corporais de 18 vacas leiteras do ecótipo Mantiqueira, com média de 75 dias pós-parto ao início do experimento, alimentadas com 1,0 kg de mistura de concentrados para cada 2,5 kg de leite produzidos acima dos primeiros 4,0 kg, capim elefante (Pennisetumpurpureum, var. Napier) picado, fornecido no cocho, e pastagem de Bracharia brizantha. Utilizou-se um delineamento em blocos casualizados e os tratamentos consistiram na administração diária de 0,200 e 300 mg de lasalocida/animal. O experimento teve duração de 17 semanas, sendo as quatro primeiras destinadas ao período de adaptação. Independente da dose empregada a lasalocida não alterou significativamente a produção de leite e a produção de leite corrigida a 4% de gordura, porém o grupo tratado com 200 mg apresentou maior porcentagem de gordura no leite (P < 0,05). Os grupos tratados com 200 e 300 mg apresentaram ganhos de peso, porém não estatisticamente menores em relação aos animais controle, quando os dados foram analisados como percentagem de peso vivo. Não foi observada alteração na condição corporal dos animais.The effects of lasalocid over milk, milk fat content, live weight and body condition, were analysed on 18 “Mantiqueira” cows, 75 days after parturition in the begining of the trial. Cows were fed 1 kg concentrate mixture for each 2,5 kg of milk produced over the first 4.0 kg of milk, chopped elephant grass (Pennisetum purpureum, Napier var), and Brachiaria brizantha pasture. A randomized block design was used with 0, 200 or 300 mg of lasalocid/animal/day as treatments. The experimental period lasted 17 weeks, and first four weeks were used as an adaptation period to the ionophore. Lasalocid had no effects on milk or fat corrected milk production, but the 200 mg lasalocid group presented higher milk fat percentages (P < 0.05). The 200 and 300 mg lasalocid treatments groups showed lower (but not statistically) live weight gain related to control, when the data wereanalysed as percentage of live weight. There was no variation on cows body condition

Temporal Evolution of Multiday, Epileptic Functional Networks Prior to Seizure Occurrence

Epilepsy is one of the most common neurological disorders, characterized by the occurrence of repeated seizures. Given that epilepsy is considered a network disorder, tools derived from network neuroscience may confer the valuable ability to quantify the properties of epileptic brain networks. In this study, we use well-established brain network metrics (i.e., mean strength, variance of strength, eigenvector centrality, betweenness centrality) to characterize the temporal evolution of epileptic functional networks over several days prior to seizure occurrence. We infer the networks using long-term electroencephalographic recordings from 12 people with epilepsy. We found that brain network metrics are variable across days and show a circadian periodicity. In addition, we found that in 9 out of 12 patients the distribution of the variance of strength in the day (or even two last days) prior to seizure occurrence is significantly different compared to the corresponding distributions on all previous days. Our results suggest that brain network metrics computed fromelectroencephalographic recordings could potentially be used to characterize brain network changes that occur prior to seizures, and ultimately contribute to seizure warning systems