Premature mortality in refractory partial epilepsy: does surgical treatment make a difference?

Background: Epilepsy carries an increased risk of premature death. For some people with intractable focal epilepsy, surgery offers hope for a seizure-free life. The authors aimed to see whether epilepsy surgery influenced mortality in people with intractable epilepsy. Methods: The authors audited survival status in two cohorts (those who had surgery and those who had presurgical assessment but did not have surgery). Results: There were 40 known deaths in the non-surgical group (3365 person years of follow-up) and 19 in the surgical group (3905 person-years of follow-up). Non-operated patients were 2.4 times (95% CI 1.4 to 4.2) as likely to die as those who had surgery. They were 4.5 times (95% CI 1.9 to 10.9) as likely to die a probable epilepsy-related death. In the surgical group, those with ongoing seizures 1 year after surgery were 4.0 (95% CI 1.2 to 13.7) times as likely to die as those who were seizure-free or who had only simple partial seizures. Time-dependent Cox analysis showed that the yearly outcome group did not significantly affect mortality (HR 1.3, 95% CI 0.9 to 1.8). Conclusion: Successful epilepsy surgery was associated with a reduced risk of premature mortality, compared with those with refractory focal epilepsy who did not have surgical treatment. To some extent, the reduced mortality is likely to be conferred by inducing freedom from seizures. It is not certain whether better survival is attributable only to surgery, as treatment decisions were not randomised, and there may be inherent differences between the groups.<br/

Modeling overland flow and soil erosion on nonuniform hillslopes: a finite volume scheme.

This paper presents a finite volume scheme for coupling the St. Venant equations with the multi- particle size class Hairsine-Rose soil erosion model. A well-balanced MUSCL-Hancock scheme is proposed to minimize spurious waves in the solution arising from an imbalance between the flux gradient and the source terms in the momentum equation. Additional criteria for numerical stability when dealing with very shallow flows and wet-dry fronts are highlighted. Numerical tests show that the scheme performs well in terms of accuracy and robustness for both the water and sediment transport equations. The proposed scheme facilitates the application of the Hairsine-Rose model to complex scenarios of soil erosion with concurrent interacting erosion processes over a non-uniform topography

Structural imaging biomarkers of sudden unexpected death in epilepsy.

Sudden unexpected death in epilepsy is a major cause of premature death in people with epilepsy. We aimed to assess whether structural changes potentially attributable to sudden death pathogenesis were present on magnetic resonance imaging in people who subsequently died of sudden unexpected death in epilepsy. In a retrospective, voxel-based analysis of T1 volume scans, we compared grey matter volumes in 12 cases of sudden unexpected death in epilepsy (two definite, 10 probable; eight males), acquired 2 years [median, interquartile range (IQR) 2.8] before death [median (IQR) age at scanning 33.5 (22) years], with 34 people at high risk [age 30.5 (12); 19 males], 19 at low risk [age 30 (7.5); 12 males] of sudden death, and 15 healthy controls [age 37 (16); seven males]. At-risk subjects were defined based on risk factors of sudden unexpected death in epilepsy identified in a recent combined risk factor analysis. We identified increased grey matter volume in the right anterior hippocampus/amygdala and parahippocampus in sudden death cases and people at high risk, when compared to those at low risk and controls. Compared to controls, posterior thalamic grey matter volume, an area mediating oxygen regulation, was reduced in cases of sudden unexpected death in epilepsy and subjects at high risk. The extent of reduction correlated with disease duration in all subjects with epilepsy. Increased amygdalo-hippocampal grey matter volume with right-sided changes is consistent with histo-pathological findings reported in sudden infant death syndrome. We speculate that the right-sided predominance reflects asymmetric central influences on autonomic outflow, contributing to cardiac arrhythmia. Pulvinar damage may impair hypoxia regulation. The imaging findings in sudden unexpected death in epilepsy and people at high risk may be useful as a biomarker for risk-stratification in future studies

Ozone depletion potential of CH_3Br

The ozone depletion potential (ODP) of methyl bromide (CH_3Br) can be determined by combining the model‐calculated bromine efficiency factor (BEF) for CH_3Br and its atmospheric lifetime. This paper examines how changes in several key kinetic data affect BEF. The key reactions highlighted in this study include the reaction of BrO + HO_2, the absorption cross section of HOBr, the absorption cross section and the photolysis products of BrONO_2, and the heterogeneous conversion of BrONO_2 to HOBr and HNO_3 on aerosol particles. By combining the calculated BEF with the latest estimate of 0.7 year for the atmospheric lifetime of CH_3Br, the likely value of ODP for CH_3Br is 0.39. The model‐calculated concentration of HBr (∼0.3 pptv) in the lower stratosphere is substantially smaller than the reported measured value of about 1 pptv. Recent publications suggested models can reproduce the measured value if one assumes a yield for HBr from the reaction of BrO + OH or from the reaction of BrO + HO_2. Although the DeMore et al. [1997] evaluation concluded any substantial yield of HBr from BrO + HO_2 is unlikely, for completeness, we calculate the effects of these assumed yields on BEF for CH_3Br. Our calculations show that the effects are minimal: practically no impact for an assumed 1.3% yield of HBr from BrO + OH and 10% smaller for an assumed 0.6% yield from BrO + HO_2

FISSA: A neuropil decontamination toolbox for calcium imaging signals

In vivo calcium imaging has become a method of choice to image neuronal population activity throughout the nervous system. These experiments generate large sequences of images. Their analysis is computationally intensive and typically involves motion correction, image segmentation into regions of interest (ROIs), and extraction of fluorescence traces of each ROI. Out of focus fluorescence from surrounding neuropil and other cells can strongly contaminate the signal assigned to a given ROI. In this study, we introduce the FISSA toolbox (Fast Image Signal Separation Analysis) for neuropil decontamination. Given pre-defined ROIs, the FISSA toolbox automatically extracts the surrounding local neuropil and performs blind-source separation with non-negative matrix factorization. Using both simulated and in vivo data, we show that this toolbox performs similarly or better than existing published methods. FISSA requires only little RAM, allowing for fast processing of large datasets even on a standard laptop. The FISSA toolbox is available in Python, with an option for MATLAB format outputs, and can easily be integrated into existing workflows. It is available from Github and the standard Python repositories

The Social Justice Teaching Collaborative: A Collective Turn Towards Critical Teacher Education

In this article, we share the collaborative curricular work of an interdisciplinary Social Justice Teaching Collaborative (SJTC) from a PWI university. Members of the SJTC worked strategically to center social justice across required courses pre-service teachers are required to take: Introduction to Education, Sociocultural Studies in Education, and Inclusive Education. We share our conceptualization of social justice and guiding theoretical frameworks that have shaped our pedagogy and curriculum. These frameworks include democratic education, critical pedagogy, critical race theory, critical whiteness studies, critical disability studies, and feminist and intersectionality theory. We then detail changes made across courses including examples of readings and assignments. Finally, we conclude by offering reflections, challenges, and lessons learned for collaborative work within teacher education and educational leadership.&nbsp

Improving Human Health in China Through Alternative Energy

In this study, we estimate the health benefits of more stringent alternative energy goals and the costs of reducing coal-fired power plant pollution in China projected in 2030. One of our two overarching alternative energy goals was to estimate the health benefits of complete elimination of coal energy, supplemented by natural gas and renewables. The second was a policy scenario similar to the U.S. 2013 Climate Action Plan (CAP), which played a pivotal role leading up to the 2015 Paris Climate Agreement. We used the Greenhouse Gas and Air Pollution Interactions and Synergies (GAINS) model created by the International Institute for Applied Systems Analysis for our model simulations. We found that 17,137-24,220 premature deaths can be avoided if coal energy is completely replaced by alternative energy, and 8,693-9,281 premature deaths can be avoided if coal energy is replaced by alternatives in a CAP-like scenario. A CAP-like scenario using emission-controls in coal plants costs $11-18 per person. Reducing coal energy in China under a CAP-like scenario would free up$9.4 billion in the annual energy budget to spend on alternatives, whereas eliminating the cost of coal energy frees up $32 billion. This study's estimates show that more stringent alternative energy targets in China are worth the investment in terms of health

Editorial: Toward 50 years of Water Resources Research

The first issue of 'Water Resources Research' (WRR) was published in March 1965 and, therefore, the year 2015 will present the exciting opportunity to celebrate the 50th anniversary of the journal. Naturally, this milestone will be seen as an occasion to look back on 50 years of research activity. The history of WRR provides a very interesting perspective on the development of hydrology and the legacy of the worldwide water resources community