Prone sleeping and SUDEP risk: The dynamics of body positions in nonfatal convulsive seizures

BACKGROUND: Most victims of sudden unexpected death in epilepsy (SUDEP) are found prone with signs suggestive of an unwitnessed convulsive seizure (CS). Prone sleeping has been proposed as a risk factor for SUDEP. Little is known, however, about the change of body position during the course of CSs. METHODS: We retrospectively reviewed video-EEG data and assessed body positions during the course of CSs, until there was a physical interaction by nursing staff with the subject. RESULTS: We identified 180 CSs in 90 individuals. In 16 of the 180 CSs (9%), the subject started in or turned to the prone position. Of the seven CSs that started in the prone position, three turned to a lateral position during the CS. In 13 CSs, the subject was in prone position at time of nursing intervention; nine (69%) of these started in a nonprone position. DISCUSSION: Our data suggest that the prone position occurs infrequently in closely supervised nonfatal CSs, a notable contrast to the number of victims of SUDEP found prone. Whether prone sleeping prior to CSs increases SUDEP risk, however, remains speculative, as body position during the course of a CS appeared to be dynamic

Orthocomplementation and compound systems

In their 1936 founding paper on quantum logic, Birkhoff and von Neumann postulated that the lattice describing the experimental propositions concerning a quantum system is orthocomplemented. We prove that this postulate fails for the lattice L_sep describing a compound system consisting of so called separated quantum systems. By separated we mean two systems prepared in different ``rooms'' of the lab, and before any interaction takes place. In that case the state of the compound system is necessarily a product state. As a consequence, Dirac's superposition principle fails, and therefore L_sep cannot satisfy all Piron's axioms. In previous works, assuming that L_sep is orthocomplemented, it was argued that L_sep is not orthomodular and fails to have the covering property. Here we prove that L_sep cannot admit and orthocomplementation. Moreover, we propose a natural model for L_sep which has the covering property.Comment: Submitted for the proceedings of the 2004 IQSA's conference in Denver. Revised versio

Remote electrical neuromodulation (REN) wearable device for adolescents with migraine: a real-world study of high-frequency abortive treatment suggests preventive effects

IntroductionMigraine is a chronic neurological disease manifesting as attacks of disabling head pain and associated symptoms. Remote electrical neuromodulation (REN) is a non-pharmacological, prescribed, wearable device (Nerivio®). This device has been certified by the FDA for the acute and/or preventive treatment of migraine with or without aura in patients 12 years of age or older. The device is affixed to the user’s arm during 45-min treatment sessions and is operated using a smartphone app. This study (NCT05769322) aims to evaluate whether frequent use of REN for the acute treatment of migraine in adolescents resulted in a reduction in monthly migraine treatment days (MMTD), as previously demonstrated in adults through a dedicated prevention clinical trial (NCT04828707).MethodsThe study included real-world prospective data from adolescent patients who used REN on at least 10 days every 28-day month, following the REN migraine prevention guideline of an every-other-day pattern. Additional requirements were at least three REN treatment days in each of the two subsequent months. The number of MMTD was used as a proxy measure for the number of monthly migraine days (MMD). The change in MMTD from the first month, taken as a “baseline,” to each of the following months was used to evaluate the presence and size of potential migraine preventive benefits of REN in adolescents.ResultsA total of 83 adolescents were eligible for analysis. The users were 15.9 ± 1.3 years of age (mean ± SD), and 89% of them were female. The results demonstrated a substantial month-to-month reduction in the mean (±SD) number of REN treatment days from 12.6 (±3.2) MMTD in the first month to 9.0 (±4.8) MMTD in the second month (p < 0.001), and a further decrease to 7.4 (±4.2) MMTD in the third month (p < 0.001). This indicates an accumulative reduction of 5.2 (±4.8) mean REN MMTD from the first month to the third month of consecutive REN treatment. The users also reported consistent 2-h acute pain responses in at least 50% of their treated attacks, with 61.9% of the users reported experiencing pain relief, 24.5% reported pain freedom, 67.4% indicated relief in functional disability, and 41.3% reported complete freedom from functional disability.ConclusionThe frequent use of REN among adolescents as an acute treatment for migraine attacks resulted in a decrease in the mean number of monthly treatment days in the subsequent months, suggesting that REN may have potential preventive benefits for migraine in this subpopulation

Timing of syncope in ictal asystole as a guide when considering pacemaker implantation

Introduction In patients with ictal asystole (IA) both cardioinhibition and vasodepression may contribute to syncopal loss of consciousness. We investigated the temporal relationship between onset of asystole and development of syncope in IA, to estimate the frequency with which pacemaker therapy, by preventing severe bradycardia, may diminish syncope risk. Methods In this retrospective cohort study, we searched video-EEG databases for individuals with focal seizures and IA (asystole >= 3 s preceded by heart rate deceleration) and assessed the durations of asystole and syncope and their temporal relationship. Syncope was evaluated using both video observations (loss of muscle tone) and EEG (generalized slowing/flattening). We assumed that asystole starting 3 s. Thus, in only two instances was vasodepression rather than cardioinhibition the dominant presumptive syncope triggering mechanism. Conclusions In IA, cardioinhibition played an important role in most seizure-induced syncopal events, thereby favoring the potential utility of pacemaker implantation in patients with difficult to suppress IA.Paroxysmal Cerebral Disorder

Structural View of a Non Pfam Singleton and Crystal Packing Analysis

Comparative genomic analysis has revealed that in each genome a large number of open reading frames have no homologues in other species. Such singleton genes have attracted the attention of biochemists and structural biologists as a potential untapped source of new folds. Cthe_2751 is a 15.8 kDa singleton from an anaerobic, hyperthermophile Clostridium thermocellum. To gain insights into the architecture of the protein and obtain clues about its function, we decided to solve the structure of Cthe_2751.The protein crystallized in 4 different space groups that diffracted X-rays to 2.37 Å (P3(1)21), 2.17 Å (P2(1)2(1)2(1)), 3.01 Å (P4(1)22), and 2.03 Å (C222(1)) resolution, respectively. Crystal packing analysis revealed that the 3-D packing of Cthe_2751 dimers in P4(1)22 and C222(1) is similar with only a rotational difference of 2.69° around the C axes. A new method developed to quantify the differences in packing of dimers in crystals from different space groups corroborated the findings of crystal packing analysis. Cthe_2751 is an all α-helical protein with a central hydrophobic core providing thermal stability via π:cation and π: π interactions. A ProFunc analysis retrieved a very low match with a splicing endonuclease, suggesting a role for the protein in the processing of nucleic acids.Non-Pfam singleton Cthe_2751 folds into a known all α-helical fold. The structure has increased sequence coverage of non-Pfam proteins such that more protein sequences can be amenable to modelling. Our work on crystal packing analysis provides a new method to analyze dimers of the protein crystallized in different space groups. The utility of such an analysis can be expanded to oligomeric structures of other proteins, especially receptors and signaling molecules, many of which are known to function as oligomers

Large-scale comparative genomic ranking of taxonomically restricted genes (TRGs) in bacterial and archaeal genomes

BACKGROUND: Lineage-specific, or taxonomically restricted genes (TRGs), especially those that are species and strain-specific, are of special interest because they are expected to play a role in defining exclusive ecological adaptations to particular niches. Despite this, they are relatively poorly studied and little understood, in large part because many are still orphans or only have homologues in very closely related isolates. This lack of homology confounds attempts to establish the likelihood that a hypothetical gene is expressed and, if so, to determine the putative function of the protein. METHODOLOGY/PRINCIPAL FINDINGS: We have developed "QIPP" ("Quality Index for Predicted Proteins"), an index that scores the "quality" of a protein based on non-homology-based criteria. QIPP can be used to assign a value between zero and one to any protein based on comparing its features to other proteins in a given genome. We have used QIPP to rank the predicted proteins in the proteomes of Bacteria and Archaea. This ranking reveals that there is a large amount of variation in QIPP scores, and identifies many high-scoring orphans as potentially "authentic" (expressed) orphans. There are significant differences in the distributions of QIPP scores between orphan and non-orphan genes for many genomes and a trend for less well-conserved genes to have lower QIPP scores. CONCLUSIONS: The implication of this work is that QIPP scores can be used to further annotate predicted proteins with information that is independent of homology. Such information can be used to prioritize candidates for further analysis. Data generated for this study can be found in the OrphanMine at http://www.genomics.ceh.ac.uk/orphan_mine

Geographies of development: without the poor.

Some contemporary narratives of development give privileged status to middle classes in the global South. In the face of intractable poverty, policy makers take heart from the success stories of ordinary people who have, over generations, realised and consolidated the gains of development and who embody society at its most functional. Their presumed virtues are their self‐sufficiency, their ability to articulate with the global economy, their buying power, and their good sense as responsible citizens. This, the first of three reports on geographies of development, reflects on recent research that interrogates the privileged status of middle classes in some narratives of development. As this burgeoning literature suggests, celebratory narratives elide the complex circumstances that make and unmake middle classes. Furthermore, middle class gains do not automatically translate into development for others. Indeed, efforts to centre the middle class threaten to displace, and justify the displacement of, economically marginalised groups seen as surplus to development

Alfred Wallace’s Baby Orangutan: Game, Pet, Specimen

Alfred Russell Wallace’s The Malay Archipelago, published in 1869, is a classic text in natural history and the theory of evolution. Amidst heroic hunting narratives and picturesque descriptions of local fauna and flora, stands out a curious episode in which Wallace describes adopting a baby orangutan, whose mother he had killed. Wallace, a British naturalist and collector, cultivated an affectionate relationship with the orphaned orangutan, often referring to her as his “baby.” This paper examines how the orangutan was transformed from being a moving target for museum display, to a beloved companion but also a scientific specimen. In this process, Wallace redesigned his colonial bungalow to a space that combined domestic settings with engineered nature-like environments, a familiar construction in later primate research. I use Wallace’s adoption episode to discuss how affect and care were interwoven into the exploitative relations of British naturalists and physiologists and the animals they studied. The account of Wallace’s idiosyncratic relationship with the orangutan is augmented with additional documentation of the close relationships of scientists with research animals, staged as familial kinship. The emergence of the “laboratory pet” demonstrates how the production of knowledge, the sharing of households, and human-animal emotional ties were interwoven in early biomedical research