Estimation of the burden of active and life-time epilepsy: a meta-analytic approach.

PURPOSE: To estimate the burden of lifetime epilepsy (LTE) and active epilepsy (AE) and examine the influence of study characteristics on prevalence estimates. METHODS: We searched online databases and identified articles using prespecified criteria. Random-effects meta-analyses were used to estimate the median prevalence in developed countries and in urban and rural settings in developing countries. The impact of study characteristics on prevalence estimates was determined using meta-regression models. RESULTS: The median LTE prevalence for developed countries was 5.8 per 1,000 (5th-95th percentile range 2.7-12.4) compared to 15.4 per 1,000 (4.8-49.6) for rural and 10.3 (2.8-37.7) for urban studies in developing countries. The median prevalence of AE was 4.9 per 1,000 (2.3-10.3) for developed countries and 12.7 per 1,000 (3.5-45.5) and 5.9 (3.4-10.2) in rural and urban studies in developing countries. The estimates of burden for LTE and AE in developed countries were 6.8 million (5th-95th percentile range 3.2-14.7) and 5.7 million (2.7-12.2), respectively. In developing countries these were 45 (14-145) million LTE and 17 (10-133) million AE in rural areas and 17 (5-61) million LTE and 10 (5-17) million AE in urban areas. Studies involving all ages or only adults showed higher estimates than pediatric studies. Higher prevalence estimates were also associated with rural location and small study size. CONCLUSIONS: This study estimates the global burden of epilepsy and the proportions with AE, which may benefit from treatment. There are systematic differences in reported prevalence estimates, which are only partially explained by study characteristics

Identification of phonological processes in preschool children's single-word productions

Speech and language therapists (SLTs) often refer to phonological data norms as part of their assessment protocols in evaluating the communication skills of the pre-school child. There is a variety of norms available and although broadly similar, differences are embedded within their definitions of mastery of the adult target system. Presence of velar fronting, stopping of affricates and [s] reduction in the dataset was found to mirror previous research. However, there was a lower than expected incidence by age groups of palato-alveolar fronting, stopping of fricatives and obstruent cluster reduction

Creating hydrodynamic lubrication in metal-on-polyethylene hip joints using surface microtexture

poste

Penetrating Abdominal Trauma: Spectrum of disease in a Level 1 Trauma Centre

Background: Penetrating abdominal trauma (PAT) in South Africa represents a significant burden of disease. The current global trend has seen management shift towards selective conservatism. The purpose of this study is to describe the presentation, management and outcomes of PAT in a level I trauma unit, which routinely practices selective non-operative management (SNOM). Methods: This was a retrospective descriptive audit of prospectively collected data. The Setting was Groote Schuur Hospital Trauma Centre, Cape Town, South Africa over 24 months (1 May 2015 to 30 April 2017). All patients presenting to the centre with PAT during the study period were included. The data captured and analysed included: basic demographics; admission vital signs; blood investigations; number of traumatic insults; penetrating wound positions; radiological investigations and interventions; indication for laparotomy; operative or nonoperative management; laparotomy findings: negative, therapeutic or non-therapeutic; abdominal visceral injuries and associated injuries. The Revised Trauma Score (RTS); Injury Severity Score (ISS); Penetrating Abdominal Trauma Index (PATI); and Kampala Trauma Score (KTS) were then calculated. The descriptive end points included the following: Length of hospital stay (LOS); ICU admission time; relaparotomy; readmission; mortality; and in-hospital complications. Results: During the study period, 805 patients with penetrating abdominal trauma were managed. There were 502 (62.4%) and 303 (37.6%) patients with gunshot and stab wounds, respectively. The majority were young men (762 – 94.7%) with a mean age of 28.3 (95%CI: 27.7-28.9) years. The median trauma scores were as follows: RTS – 7.84 (IQR: 7.00-7.84); ISS: 13 (IQR: 9-22), PATI: 6 (IQR: 1-14); and KTS: 14 (IQR: 14-15). Abdominal penetration was thoracoabdominal in 332 (41.2%), abdominal in 694 (86.5%), and pelvic in 192 (23.9%) patients. Immediate laparotomy was performed in 446 (55.4%) patients for: haemodynamic instability – 42 (5.2%); peritonism – 296 (36.8%); evisceration - 27 (3.4%); unreliable clinical evaluation – 24 (3.0%); and positive radiological findings – 57 (7.1%). There were 406 (50.4%) therapeutic laparotomies; 18 (2.3%) negative laparotomies; and 22 (2.7%) nontherapeutic laparotomies in the immediately operated group. Initial SNOM was performed in 359 (44.5%) patients, of which 208 (68.7%) sustained stab wounds and 151 (30.1%) gunshot wounds. Thirty-five (4.3%) patients failed SNOM and underwent delayed laparotomy. Should a policy of mandatory laparotomy have been implemented in this series, 206 (68.0%) SW and 163 (32.5%) GSW patients would have underwent unnecessary exploration. Overall non-fatal complications were 179 (22.2%) which were then further classified according to the Clavien-Dindo grading system. The median hospital stay was 4.5 (IQR: 3-7) and 7 (IQR: 5-12) days for SW and GSW, respectively. Overall 114 (14.2%) patients required admission to critical care unit for a median stay of 3 (IQR: 2-5) days. Total mortality was 7.2% (n=58). Conclusion: Clinical evaluation (haemodynamic instability, peritonism and evisceration) was remarkably accurate in determining the need for early laparotomy. The unnecessary laparotomy rate of this group was 5.0% (negative: 2.3% and nontherapeutic: 2.7%) overall. Selective nonoperative management was performed in 44.5% of patients with a successful SNOM rate of 90.3%. The overall mortality was 7.2 %

Clinical features, proximate causes, and consequences of active convulsive epilepsy in Africa.

PURPOSE: Epilepsy is common in sub-Saharan Africa (SSA), but the clinical features and consequences are poorly characterized. Most studies are hospital-based, and few studies have compared different ecological sites in SSA. We described active convulsive epilepsy (ACE) identified in cross-sectional community-based surveys in SSA, to understand the proximate causes, features, and consequences. METHODS: We performed a detailed clinical and neurophysiologic description of ACE cases identified from a community survey of 584,586 people using medical history, neurologic examination, and electroencephalography (EEG) data from five sites in Africa: South Africa; Tanzania; Uganda; Kenya; and Ghana. The cases were examined by clinicians to discover risk factors, clinical features, and consequences of epilepsy. We used logistic regression to determine the epilepsy factors associated with medical comorbidities. KEY FINDINGS: Half (51%) of the 2,170 people with ACE were children and 69% of seizures began in childhood. Focal features (EEG, seizure types, and neurologic deficits) were present in 58% of ACE cases, and these varied significantly with site. Status epilepticus occurred in 25% of people with ACE. Only 36% received antiepileptic drugs (phenobarbital was the most common drug [95%]), and the proportion varied significantly with the site. Proximate causes of ACE were adverse perinatal events (11%) for onset of seizures before 18 years; and acute encephalopathy (10%) and head injury prior to seizure onset (3%). Important comorbidities were malnutrition (15%), cognitive impairment (23%), and neurologic deficits (15%). The consequences of ACE were burns (16%), head injuries (postseizure) (1%), lack of education (43%), and being unmarried (67%) or unemployed (57%) in adults, all significantly more common than in those without epilepsy. SIGNIFICANCE: There were significant differences in the comorbidities across sites. Focal features are common in ACE, suggesting identifiable and preventable causes. Malnutrition and cognitive and neurologic deficits are common in people with ACE and should be integrated into the management of epilepsy in this region. Consequences of epilepsy such as burns, lack of education, poor marriage prospects, and unemployment need to be addressed

Fermi Large Area Telescope Constraints on the Gamma-ray Opacity of the Universe

The Extragalactic Background Light (EBL) includes photons with wavelengths from ultraviolet to infrared, which are effective at attenuating gamma rays with energy above ~10 GeV during propagation from sources at cosmological distances. This results in a redshift- and energy-dependent attenuation of the gamma-ray flux of extragalactic sources such as blazars and Gamma-Ray Bursts (GRBs). The Large Area Telescope onboard Fermi detects a sample of gamma-ray blazars with redshift up to z~3, and GRBs with redshift up to z~4.3. Using photons above 10 GeV collected by Fermi over more than one year of observations for these sources, we investigate the effect of gamma-ray flux attenuation by the EBL. We place upper limits on the gamma-ray opacity of the Universe at various energies and redshifts, and compare this with predictions from well-known EBL models. We find that an EBL intensity in the optical-ultraviolet wavelengths as great as predicted by the "baseline" model of Stecker et al. (2006) can be ruled out with high confidence.Comment: 42 pages, 12 figures, accepted version (24 Aug.2010) for publication in ApJ; Contact authors: A. Bouvier, A. Chen, S. Raino, S. Razzaque, A. Reimer, L.C. Reye

Subsurface geology of Red Willow and Hitchcock Counties, Nebraska

Includes folded maps

Search for chargino-neutralino production with mass splittings near the electroweak scale in three-lepton final states in √s=13 TeV pp collisions with the ATLAS detector

A search for supersymmetry through the pair production of electroweakinos with mass splittings near the electroweak scale and decaying via on-shell W and Z bosons is presented for a three-lepton final state. The analyzed proton-proton collision data taken at a center-of-mass energy of √s=13  TeV were collected between 2015 and 2018 by the ATLAS experiment at the Large Hadron Collider, corresponding to an integrated luminosity of 139  fb−1. A search, emulating the recursive jigsaw reconstruction technique with easily reproducible laboratory-frame variables, is performed. The two excesses observed in the 2015–2016 data recursive jigsaw analysis in the low-mass three-lepton phase space are reproduced. Results with the full data set are in agreement with the Standard Model expectations. They are interpreted to set exclusion limits at the 95% confidence level on simplified models of chargino-neutralino pair production for masses up to 345 GeV

Measurement of the cross-section and charge asymmetry of WW bosons produced in proton-proton collisions at s=8\sqrt{s}=8 TeV with the ATLAS detector

This paper presents measurements of the $W^+ \rightarrow \mu^+\nu$ and $W^- \rightarrow \mu^-\nu$ cross-sections and the associated charge asymmetry as a function of the absolute pseudorapidity of the decay muon. The data were collected in proton--proton collisions at a centre-of-mass energy of 8 TeV with the ATLAS experiment at the LHC and correspond to a total integrated luminosity of 20.2~\mbox{fb^{-1}}. The precision of the cross-section measurements varies between 0.8% to 1.5% as a function of the pseudorapidity, excluding the 1.9% uncertainty on the integrated luminosity. The charge asymmetry is measured with an uncertainty between 0.002 and 0.003. The results are compared with predictions based on next-to-next-to-leading-order calculations with various parton distribution functions and have the sensitivity to discriminate between them.Comment: 38 pages in total, author list starting page 22, 5 figures, 4 tables, submitted to EPJC. All figures including auxiliary figures are available at https://atlas.web.cern.ch/Atlas/GROUPS/PHYSICS/PAPERS/STDM-2017-13

Search for new phenomena in final states with an energetic jet and large missing transverse momentum in pp collisions at √ s = 8 TeV with the ATLAS detector

Results of a search for new phenomena in final states with an energetic jet and large missing transverse momentum are reported. The search uses 20.3 fb−1 of √ s = 8 TeV data collected in 2012 with the ATLAS detector at the LHC. Events are required to have at least one jet with pT > 120 GeV and no leptons. Nine signal regions are considered with increasing missing transverse momentum requirements between Emiss T > 150 GeV and Emiss T > 700 GeV. Good agreement is observed between the number of events in data and Standard Model expectations. The results are translated into exclusion limits on models with either large extra spatial dimensions, pair production of weakly interacting dark matter candidates, or production of very light gravitinos in a gauge-mediated supersymmetric model. In addition, limits on the production of an invisibly decaying Higgs-like boson leading to similar topologies in the final state are presente