Multilobar electrocorticography monitoring during intracranial aneurysm surgery

Introduction: To detect a neuronal threshold of tolerance to ischemia, the usefulness of multilobar electrocorticography (mEcoG) during intracranial aneurysm surgery was compared to the scalp EEG and correlated with the postoperative neurological status and the radiological findings. Methods: Twenty-one patients harboring intracranial aneurysms were monitored by simultaneous scalp EEG and lobe-dependent mEcoG during surgical clipping. The patients were divided into group A (6 patients with no temporary clipping) and group B (15 patients with temporary clipping). Results: New focal modifications of the mEcoG signal with high frequency (HF)-β3 and delta waves were observed in none of the patients in group A and all of the patients in group B. These anomalies were followed by focal burst suppression pattern in eight cases (53%) in group B. These changes were detected in only two cases (9%) on the scalp EEG. New corticographic changes resolved in eight patients (53%) in group B. Among the seven patients in group B who had persistent focal burst pattern after clip removal, six (85%) presented with new neurological deficit or new hypodensity on CT. The Glasgow Outcome Scale was good (IV or V) in 85% of cases. Conclusion: mEcoG is more sensitive than scalp EEG. The appearance and persistence of the focal burst suppression pattern shown on mEcoG, was associated with a new neurological deficit or new hypodensity, whereas HF-β3 or delta waves per se were not associated with new changes. A better comprehension of these EEG anomalies could determine the duration of temporary clipping and consequently influence the surgical strateg

Gewaltstraftäter mit und ohne Antisoziale Persönlichkeitsstörung: Ein Vergleich

Zusammenfassung: Hintergrund: Die diagnostische Wertigkeit von wiederholten Gesetzesübertretungen im Kontext der Antisozialen Persönlichkeitsstörung (ASPD) wird seit längerem kritisch diskutiert. Um festzustellen, ob sich Probanden mit einer ASPD auch abseits straffälligen Verhaltens von Straftätern unterscheiden, wurden inhaftierte Straftäter mit und ohne diese Diagnose untersucht. Material und Methoden: Sechsunddreißig inhaftierte Gewalttäter mit der Diagnose einer ASPD sowie 29 Gewaltstraftäter ohne ASPD der Justizvollzugsanstalt Straubing nahmen an der Studie teil. Die 28 strafrechtlich unauffälligen Kontrollprobanden wurden aus der deutschen Normalbevölkerung rekrutiert. Alle Probanden wurden hinsichtlich soziodemographischer, kriminologischer und klinischer Eigenschaften mit dem SKID-I und SKID-II, dem GAF, BIS-11, K-FAF und EPI untersucht. Ergebnisse: Gewaltstraftäter mit ASPD unterscheiden sich bezüglich folgender Parameter von Delinquenten ohne diese Diagnose: erhöhte Erregbarkeit, niedriges psychosoziales Funktionsniveau, gehäufte "Broken-home-Merkmale" und antisoziales Verhalten vor dem 11.Lebensjahr ("early starters"). Schlussfolgerung: Es konnten Merkmale identifiziert werden, die zwischen Gewaltstraftätern mit und ohne ASPD unterscheiden. In der Gesamtschau scheint allerdings weniger eine kategoriale als vielmehr eine dimensionale, d.h. am Ausprägungsgrad der Auffälligkeiten ausgerichtete Unterscheidung zwischen Gewaltstraftätern mit und ohne ASPD sinnvoll zu sei

Is pretreatment with Beta-blockers beneficial in patients with acute coronary syndrome?

OBJECTIVES: The role of beta-blockers in the treatment of hypertension is discussed controversially and the data showing a clear benefit in acute coronary syndromes (ACS) were obtained in the thrombolysis era. The goal of this study was to analyze the role of pretreatment with beta-blockers in patients with ACS. METHODS: Using data from the Acute Myocardial Infarction in Switzerland (AMIS Plus) registry, we analyzed outcomes of patients with beta-blocker pretreatment in whom they were continued during hospitalization (group A), those without beta-blocker pretreatment but with administration after admission (group B) and those who never received them (group C). Major adverse cardiac events defined as composed endpoint of re-infarction and stroke (during hospitalization) and/or in-hospital death were compared between the groups. RESULTS: A total of 24,709 patients were included in the study (6,234 in group A, 12,344 in group B, 6,131 in group C). Patients of group B were younger compared to patients of group A and C (62.5, 67.6 and 68.4, respectively). In the multivariate analysis, odds ratio for major adverse cardiac events was 0.59 (CI 0.47-0.74) for group A and 0.66 (CI 0.55-0.83) for group B, while group C was taken as a reference. CONCLUSIONS: beta-Blocker therapy is beneficial in ACS and they should be started in those who are not pretreated and continued in stable patients who had been on chronic beta-blocker therapy before

Multilobar electrocorticography monitoring during intracranial aneurysm surgery

INTRODUCTION: To detect a neuronal threshold of tolerance to ischemia, the usefulness of multilobar electrocorticography (mEcoG) during intracranial aneurysm surgery was compared to the scalp EEG and correlated with the postoperative neurological status and the radiological findings. METHODS: Twenty-one patients harboring intracranial aneurysms were monitored by simultaneous scalp EEG and lobe-dependent mEcoG during surgical clipping. The patients were divided into group A (6 patients with no temporary clipping) and group B (15 patients with temporary clipping). RESULTS: New focal modifications of the mEcoG signal with high frequency (HF)-beta3 and delta waves were observed in none of the patients in group A and all of the patients in group B. These anomalies were followed by focal burst suppression pattern in eight cases (53%) in group B. These changes were detected in only two cases (9%) on the scalp EEG. New corticographic changes resolved in eight patients (53%) in group B. Among the seven patients in group B who had persistent focal burst pattern after clip removal, six (85%) presented with new neurological deficit or new hypodensity on CT. The Glasgow Outcome Scale was good (IV or V) in 85% of cases. CONCLUSION: mEcoG is more sensitive than scalp EEG. The appearance and persistence of the focal burst suppression pattern shown on mEcoG, was associated with a new neurological deficit or new hypodensity, whereas HF-beta3 or delta waves per se were not associated with new changes. A better comprehension of these EEG anomalies could determine the duration of temporary clipping and consequently influence the surgical strategy

Stochastic microgeometry for displacement mapping

Proceedings of Shape Modeling International 2005, June 2005, pp. 164-173. Retrieved 3/16/2006 from http://www.cs.drexel.edu/~david/Papers/schroeder_SMI05.pdf.Creating surfaces with intricate small-scale features (microgeometry) and detail is an important task in geometric modeling and computer graphics. We present a model processing method capable of producing a wide variety of complex surface features based on displacement mapping and stochastic geometry. The latter is a branch of mathematics that analyzes and characterizes the statistical properties of spatial structures. The technique has been incorporated into an interactive modeling environment that supports the design of stochastic microgeometries. Additionally a tool has been developed that provides random exploration of the technique's entire parameter space by generating sample microgeometry over a broad range of values. We demonstrate the effectiveness of our technique by creating diverse, complex surface structures for a variety of geometric models, e.g. arrowheads, candy bars, busts, planets and coral

Transient deoxyhemoglobin formation as a contrast for perfusion MRI studies in patients with brain tumors: a feasibility study

Background: Transient hypoxia-induced deoxyhemoglobin (dOHb) has recently been shown to represent a comparable contrast to gadolinium-based contrast agents for generating resting perfusion measures in healthy subjects. Here, we investigate the feasibility of translating this non-invasive approach to patients with brain tumors. Methods: A computer-controlled gas blender was used to induce transient precise isocapnic lung hypoxia and thereby transient arterial dOHb during echo-planar-imaging acquisition in a cohort of patients with different types of brain tumors (n = 9). We calculated relative cerebral blood volume (rCBV), cerebral blood flow (rCBF), and mean transit time (MTT) using a standard model-based analysis. The transient hypoxia induced-dOHb MRI perfusion maps were compared to available clinical DSC-MRI. Results: Transient hypoxia induced-dOHb based maps of resting perfusion displayed perfusion patterns consistent with underlying tumor histology and showed high spatial coherence to gadolinium-based DSC MR perfusion maps. Conclusion: Non-invasive transient hypoxia induced-dOHb was well-tolerated in patients with different types of brain tumors, and the generated rCBV, rCBF and MTT maps appear in good agreement with perfusion maps generated with gadolinium-based DSC MR perfusion

Study protocol for the safety and efficacy of probiotic therapy on days alive and out of hospital in adult ICU patients: The multicentre, randomised, placebo-controlled Restoration Of gut microflora in Critical Illness Trial (ROCIT)

Introduction The effect of early and sustained administration of daily probiotic therapy on patients admitted to the intensive care unit (ICU) remains uncertain. Methods and analysis The Restoration Of gut microflora in Critical Illness Trial (ROCIT) study is a multicentre, randomised, placebo-controlled, parallel-group, two-sided superiority trial that will enrol 220 patients in five ICUs. Adult patients who are within 48 hours of admission to an ICU and are expected to require intensive care beyond the next calendar day will be randomised in a 1:1 ratio to receive early and sustained Lactobacillus plantarum 299v probiotic therapy in addition to usual care or placebo in addition to usual care. The primary endpoint is days alive and out of hospital to day 60. Ethics and dissemination ROCIT has been approved by the South Metropolitan Health Service Human Research Ethics Committee (ref: RGS00000004) and the St John of God Health Care Human Research Ethics Committee (ref: 1183). The trial results will be submitted for publication in a peer-reviewed journal. Trial registration number Australian and New Zealand Clinical Trials Registry (ANZCTR12617000783325); Pre-results

The porin and the permeating antibiotic: A selective diffusion barrier in gram-negative bacteria

Gram-negative bacteria are responsible for a large proportion of antibiotic resistant bacterial diseases. These bacteria have a complex cell envelope that comprises an outer membrane and an inner membrane that delimit the periplasm. The outer membrane contains various protein channels, called porins, which are involved in the influx of various compounds, including several classes of antibiotics. Bacterial adaptation to reduce influx through porins is an increasing problem worldwide that contributes, together with efflux systems, to the emergence and dissemination of antibiotic resistance. An exciting challenge is to decipher the genetic and molecular basis of membrane impermeability as a bacterial resistance mechanism. This Review outlines the bacterial response towards antibiotic stress on altered membrane permeability and discusses recent advances in molecular approaches that are improving our knowledge of the physico-chemical parameters that govern the translocation of antibiotics through porin channel

On the integration of model-based feature information in Product Lifecycle Management systems

[EN] As CAD models continue to become more critical information sources in the product's lifecycle, it is necessary to develop efficient mechanisms to store, retrieve, and manage larger volumes of increasingly complex data. Because of their unique characteristics, 3D annotations can be used to embed design and manufacturing information directly into a CAD model, which makes models effective vehicles to describe aspects of the geometry or provide additional information that can be connected to a particular geometric element. However, access to this information is often limited, difficult, and even unavailable to external applications. As model complexity and volume of information continue to increase, new and more powerful methods to interrogate these annotations are needed. In this paper, we demonstrate how 3D annotations can be effectively structured and integrated into a Product Lifecycle Management (PLM) system to provide a cohesive view of product-related information in a design environment. We present a strategy to organize and manage annotation information which is stored internally in a CAD model, and make it fully available through the PLM. Our method involves a dual representation of 3D annotations with enhanced data structures that provides shared and easy access to the information. We describe the architecture of a system which includes a software component for the CAD environment and a module that integrates with the PLM server. We validate our approach through a software prototype that uses a parametric modeling application and two commercial PLM packages with distinct data models.This work was supported by the Spanish Ministry of Economy and Competitiveness and the FEDER Funds, through the ANNOTA project (Ref. TIN2013-46036-C3-1-R).Camba, J.; Contero, M.; Company, P.; Pérez Lopez, DC. (2017). On the integration of model-based feature information in Product Lifecycle Management systems. International Journal of Information Management. 37(6):611-621. https://doi.org/10.1016/j.ijinfomgt.2017.06.002S61162137