Efficient extraction of data from intra-operative evoked potentials: 1.-Theory and simulations.

UNLABELLED Quickly and efficiently extracting evoked potential information from noise is critical to the clinical practice of intraoperative neurophysiologic monitoring (IONM). Currently this is primarily done using trained professionals to interpret averaged waveforms. The purpose of this paper is to evaluate and compare multiple means of electronically extracting simple to understand evoked potential characteristics with minimum averaging. A number of evoked potential models are studied and their performance evaluated as a function of the signal to noise level in simulations. METHODS which extract the least number of parameters from the data are least sensitive to the effects of noise and are easiest to interpret. The simplest model uses the baseline evoked potential and the correlation receiver to provide an amplitude measure. Amplitude measures extracted using the correlation receiver show superior performance to those based on peak to peak amplitude measures. In addition, measures of change in latency or shape of the evoked potential can be extracted using the derivative of the baseline evoked response or other methods. This methodology allows real-time access to amplitude measures that can be understood by the entire OR staff as they are small, dimensionless numbers of order unity which are simple to interpret. The IONM team can then adjust averaging and other parameters to allow for visual interpretation of waveforms as appropriate

Pan-European grading scales: lessons from national systems and the ECTS

This article assesses the impact of the Bologna Process on the grading schemes of EU member countries. In light of some problems regarding the implementation of the European Credit Transfer system (ECTS), the author proposes further reforms and offers some elements of a unified grading system for European higher education. The author explores the variation among Europe’s grading systems and the resulting lessons learned are shared here. Lastly, this article also argues that principles of justice and fairness, deemed central to academic freedom, are best upheld by the use of a unified grading system at national and European levels

"What is Bread?" The Anthropology of Belief

This is a postprint (accepted manuscript) version of the article published in Ethos 40(3):341-357 in September 2012. The final version of the article can be found at http://onlinelibrary.wiley.com.ezproxy.bu.edu/doi/10.1111/j.1548-1352.2012.01261.x/abstract (login required to access content). The version made available in Digital Common was supplied by the author.Accepted Manuscripttru

Anesthesia and intraoperative neurophysiological spinal cord monitoring

Purpose of review We will explain the basic principles of intraoperative neurophysiological monitoring (IONM) during spinal surgery. Thereafter we highlight the significant impact that general anesthesia can have on the efficacy of the IONM and provide an overview of the essential pharmacological and physiological factors that need to be optimized to enable IONM. Lastly, we stress the importance of teamwork between the anesthesiologist, the neurophysiologist, and the surgeon to improve clinical outcome after spinal surgery. Recent findings In recent years, the use of IONM has increased significantly. It has developed into a mature discipline, enabling neurosurgical procedures of ever-increasing complexity. It is thus of growing importance for the anesthesiologist to appreciate the interplay between IONM and anesthesia and to build up experience working in a team with the neurosurgeon and the neurophysiologist. Safety measures, cooperation, careful choice of drugs, titration of drugs, and maintenance of physiological homeostasis are essential for effective IONM

The genealogy of judgement: towards a deep history of academic freedom

The classical conception of academic freedom associated with Wilhelm von Humboldt and the rise of the modern university has a quite specific cultural foundation that centres on the controversial mental faculty of 'judgement'. This article traces the roots of 'judgement' back to the Protestant Reformation, through its heyday as the signature feature of German idealism, and to its gradual loss of salience as both a philosophical and a psychological concept. This trajectory has been accompanied by a general shrinking in the scope of academic freedom from the promulgation of world-views to the offering of expert opinion