Multiple Frequencies Sequential Coding for SSVEP-Based Brain-Computer Interface

BACKGROUND: Steady-state visual evoked potential (SSVEP)-based brain-computer interface (BCI) has become one of the most promising modalities for a practical noninvasive BCI system. Owing to both the limitation of refresh rate of liquid crystal display (LCD) or cathode ray tube (CRT) monitor, and the specific physiological response property that only a very small number of stimuli at certain frequencies could evoke strong SSVEPs, the available frequencies for SSVEP stimuli are limited. Therefore, it may not be enough to code multiple targets with the traditional frequencies coding protocols, which poses a big challenge for the design of a practical SSVEP-based BCI. This study aimed to provide an innovative coding method to tackle this problem. METHODOLOGY/PRINCIPAL FINDINGS: In this study, we present a novel protocol termed multiple frequencies sequential coding (MFSC) for SSVEP-based BCI. In MFSC, multiple frequencies are sequentially used in each cycle to code the targets. To fulfill the sequential coding, each cycle is divided into several coding epochs, and during each epoch, certain frequency is used. Obviously, different frequencies or the same frequency can be presented in the coding epochs, and the different epoch sequence corresponds to the different targets. To show the feasibility of MFSC, we used two frequencies to realize four targets and carried on an offline experiment. The current study shows that: 1) MFSC is feasible and efficient; 2) the performance of SSVEP-based BCI based on MFSC can be comparable to some existed systems. CONCLUSIONS/SIGNIFICANCE: The proposed protocol could potentially implement much more targets with the limited available frequencies compared with the traditional frequencies coding protocol. The efficiency of the new protocol was confirmed by real data experiment. We propose that the SSVEP-based BCI under MFSC might be a promising choice in the future

Effects of alirocumab on cardiovascular and metabolic outcomes after acute coronary syndrome in patients with or without diabetes: a prespecified analysis of the ODYSSEY OUTCOMES randomised controlled trial

Background After acute coronary syndrome, diabetes conveys an excess risk of ischaemic cardiovascular events. A reduction in mean LDL cholesterol to 1.4-1.8 mmol/L with ezetimibe or statins reduces cardiovascular events in patients with an acute coronary syndrome and diabetes. However, the efficacy and safety of further reduction in LDL cholesterol with an inhibitor of proprotein convertase subtilisin/kexin type 9 (PCSK9) after acute coronary syndrome is unknown. We aimed to explore this issue in a prespecified analysis of the ODYSSEY OUTCOMES trial of the PCSK9 inhibitor alirocumab, assessing its effects on cardiovascular outcomes by baseline glycaemic status, while also assessing its effects on glycaemic measures including risk of new-onset diabetes

Apolipoprotein B, Residual Cardiovascular Risk After Acute Coronary Syndrome, and Effects of Alirocumab.

Background: Apolipoprotein B (apoB) provides an integrated measure of atherogenic risk. Whether apoB levels and apoB lowering hold incremental predictive information on residual risk after acute coronary syndrome beyond that provided by low-density lipoprotein cholesterol is uncertain. Methods: The ODYSSEY OUTCOMES trial (Evaluation of Cardiovascular Outcomes After an Acute Coronary Syndrome During Treatment With Alirocumab) compared the proprotein convertase subtilisin/kexin type 9 inhibitor alirocumab with placebo in 18 924 patients with recent acute coronary syndrome and elevated atherogenic lipoproteins despite optimized statin therapy. Primary outcome was major adverse cardiovascular events (MACE; coronary heart disease death, nonfatal myocardial infarction, fatal/nonfatal ischemic stroke, hospitalization for unstable angina). Associations between baseline apoB or apoB at 4 months and MACE were assessed in adjusted Cox proportional hazards and propensity score–matched models. Results: Median follow-up was 2.8 years. In proportional hazards analysis in the placebo group, MACE incidence increased across increasing baseline apoB strata (3.2 [95% CI, 2.9–3.6], 4.0 [95% CI, 3.6–4.5], and 5.5 [95% CI, 5.0–6.1] events per 100 patient-years in strata 35–<50, and ≤35 mg/dL, respectively). Compared with propensity score–matched patients from the placebo group, treatment hazard ratios for alirocumab also decreased monotonically across achieved apoB strata. Achieved apoB was predictive of MACE after adjustment for achieved low-density lipoprotein cholesterol or non–high-density lipoprotein cholesterol but not vice versa. Conclusions: In patients with recent acute coronary syndrome and elevated atherogenic lipoproteins, MACE increased across baseline apoB strata. Alirocumab reduced MACE across all strata of baseline apoB, with larger absolute reductions in patients with higher baseline levels. Lower achieved apoB was associated with lower risk of MACE, even after accounting for achieved low-density lipoprotein cholesterol or non–high-density lipoprotein cholesterol, indicating that apoB provides incremental information. Achievement of apoB levels as low as ≤35 mg/dL may reduce lipoprotein-attributable residual risk after acute coronary syndrome. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT01663402.gov; Unique identifier: NCT01663402.URL: https://www