Investigating neuromagnetic brain responses against chromatic flickering stimuli by wavelet entropies

BACKGROUND: Photosensitive epilepsy is a type of reflexive epilepsy triggered by various visual stimuli including colourful ones. Despite the ubiquitous presence of colorful displays, brain responses against different colour combinations are not properly studied. METHODOLOGY/PRINCIPAL FINDINGS: Here, we studied the photosensitivity of the human brain against three types of chromatic flickering stimuli by recording neuromagnetic brain responses (magnetoencephalogram, MEG) from nine adult controls, an unmedicated patient, a medicated patient, and two controls age-matched with patients. Dynamical complexities of MEG signals were investigated by a family of wavelet entropies. Wavelet entropy is a newly proposed measure to characterize large scale brain responses, which quantifies the degree of order/disorder associated with a multi-frequency signal response. In particular, we found that as compared to the unmedicated patient, controls showed significantly larger wavelet entropy values. We also found that Renyi entropy is the most powerful feature for the participant classification. Finally, we also demonstrated the effect of combinational chromatic sensitivity on the underlying order/disorder in MEG signals. CONCLUSIONS/SIGNIFICANCE: Our results suggest that when perturbed by potentially epileptic-triggering stimulus, healthy human brain manages to maintain a non-deterministic, possibly nonlinear state, with high degree of disorder, but an epileptic brain represents a highly ordered state which making it prone to hyper-excitation. Further, certain colour combination was found to be more threatening than other combinations

PRACTC: Practice Readiness Academic Clinical Training Collaborative –– Gap Analysis to Advance Clinical Training for Nurse Practitioner Students

Background: Multiple factors have created a perfect storm of health care provider shortages in the United States. Advanced practice registered nurses (APRNs), long established as high-quality, cost-effective health care providers, are meeting health care needs across the nation in a variety of settings, and in Wisconsin will be needed to augment the primary care workforce. With 5.7% of its registered nurses credentialed as APRNs, Wisconsin lags behind the national average of 8.7%. However, current capacity to educate this workforce is strained, requiring innovative data-driven clinical education models. Purpose: To identify gaps in the current clinical educational framework for nurse practitioner (NP) students within the integrated health system. Methods: Multiple data sources were used including NP core learning goals achievement, current continuum education/training experience models, health care system stakeholders’ perspectives, and advanced practice provider hiring targets for 2015. NP-partnering universities’ curricula and experiences of placing students within the integrated health system were reviewed. Analysis was conducted by an interprofessional team to identify gaps. Results: Four gaps were identified: 1) structured learning and assessments focused on value-based care models (e.g. population, chronic disease) and tracking competency-based milestone achievement; 2) streamlined NP student placement system and onboarding through centralized one-stop infrastructure; 3) interdisciplinary education to emulate the workplace in which practice-ready graduates will be placed; and 4) number of preceptors with skills and knowledge regarding NP educational curriculum and competencies. Conclusion: Systematic gap analysis will guide NP student placement and education at large Midwestern integrated health system. A structured clinical academic partnership with local university NP programs (PRACTC) that addresses preclinical preparedness, a structured student placement process, coordinated clinical experiences, preceptor development strategies and a diversity strategy provides a mechanism for accomplishing these goals