Does a preference for fatty foods prior to commencing treatment with the ketogenic diet predict the efficacy of this diet?

AbstractThe ketogenic diet can be effective in children who suffer from drug-resistant epilepsy. However, it is still hard to predict how large an effect this diet will have for an individual child. Previous data suggests a high-fat food preference is more likely in those with epilepsy, as assessed by in-person forced-choice design. The aim of this study is to examine whether a partiality to fatty foods prior to commencing the ketogenic diet can be used as a predictive factor for the efficacy of this diet in children with drug-resistant epilepsy.Data from 43 children aged between 2 and 19 years was used in this retrospective, non-controlled, non-randomised, open study. All children had followed the ketogenic diet for a period of 3 months or more. Before commencing the diet, a food record was collected for each child to determine the percentage of daily energy-intake accounted for by fats. Parents of the participants completed a questionnaire to measure fat-preference in the pre-diet period and received a score to objectify the efficacy of the treatment.The raw scores on the food record and on the questionnaire were divided into subgroups. Subsequently Kendall's tau-b was calculated for the correlation between each combination of variables. A non-significant correlation was found for the relationship between the food record and the questionnaire (p=.939), the relationship between the food record and the efficacy of the treatment (p=.827) and the relationship between the questionnaire and the efficacy of the treatment (p=.539). This means treatment efficacy cannot be predicted by the child's food preference

Role of Visual Dysfunction in Postural Control in Children With Cerebral Palsy

Introduction: Deficient postural control is one of the key problems in cerebral palsy (CP). Little, however, is known about the specific nature of postural problems of children with CP, nor of the relation between abnormal posture and dysfunction of the visual system. Aim of the study: To provide additional information on the association of abnormalities in postural control and visual dysfunction of the anterior or posterior part of the visual system. Methods: Data resulting from ophthalmologic, orthoptic, neurological, neuro-radiological, and ethological investigations of more than 313 neurologically impaired children were retrospectively analyzed. Results: Abnormal postural control related to ocular and ocular motor disorders consisted of anomalous head control and subsequent abnormal head posture and torticollis. The abnormal postural control related to retrochiasmatical damage of the visual system consisted of a torticollis combined with adjustment of the upper part of the body, as if at the same time adapting to a combination of defects and optimizing residual visual functions. Conclusion: Visual dysfunctions play a distinct role in the postural control of children with CP

Epilepsy surgery in tuberous sclerosis: The Dutch experience

SummaryIntroductionEpilepsy associated with tuberous sclerosis complex (TSC) is drug resistant in more than half of the patients. Epilepsy surgery may be an alternative treatment option, if the epileptogenic tuber can be identified reliably and if seizure reduction is not at the expense of cognitive or other functions. We report the pre-surgical identification of the epileptogenic tuber and post-surgical outcome of patients with TSC in The Netherlands.MethodsTwenty-five patients underwent the pre-surgical evaluation of the Dutch Comprehensive Epilepsy Surgery Programme, including a detailed seizure history, interictal and ictal video EEG registrations, 3D FLAIR MRI scans and neuropsychological testing. Suitability of the candidates was decided in consensus. Seizure outcome, scored with the Engel classification, and cognition were reassessed at fixed post-surgery intervals.ResultsEpilepsy surgery was performed in six patients. At follow-up, four patients had Engel classification 1, two had classification 4. Improved development and behaviour was perceived by the parents of two patients. Epilepsy surgery was not performed in 19 patients because seizures were not captured, ictal onset zones could not be localised or were multiple, interictal EEG, video EEG and MEG results were not concordant, or seizure burden had diminished during decision making. A higher cognition index was found in the surgical patients compared to the non-surgical candidates.ConclusionsEpilepsy surgery can be performed safely and successfully in patients in whom semiology, interictal EEG, ictal EEG, MEG and the location of tubers are concordant. In other cases the risk of surgery should be weighed against the chance of seizure relief and in case of children subsequent impact on neurodevelopment

On the Dirac Eigenvalues as Observables of the on-shell N=2 D=4 Euclidean Supergravity

We generalize previous works on the Dirac eigenvalues as dynamical variables of the Euclidean gravity and N=1 D=4 supergravity to on-shell N=2 D=4 Euclidean supergravity. The covariant phase space of the theory is defined as as the space of the solutions of the equations of motion modulo the on-shell gauge transformations. In this space we define the Poisson brackets and compute their value for the Dirac eigenvalues.Comment: 10 pages, LATeX fil

Dimensional regularization of the path integral in curved space on an infinite time interval

We use dimensional regularization to evaluate quantum mechanical path integrals in arbitrary curved spaces on an infinite time interval. We perform 3-loop calculations in Riemann normal coordinates, and 2-loop calculations in general coordinates. It is shown that one only needs a covariant two-loop counterterm (V_{DR} = R/8) to obtain the same results as obtained earlier in other regularization schemes. It is also shown that the mass term needed in order to avoid infrared divergences explicitly breaks general covariance in the final result.Comment: 13 pages, 10 figures, LaTe

Intensity Distribution of Waves Transmitted Through a Multiple Scattering Medium

The distributions of the angular transmission coefficient and of the total transmission are calculated for multiple scattered waves. The calculation is based on a mapping to the distribution of eigenvalues of the transmission matrix. The distributions depend on the profile of the incoming beam. The distribution function of the angular transmission has a stretched exponential decay. The total-transmission distribution grows log-normally whereas it decays exponentially.Comment: 8 pages, revtex3.0, 3 postscript figures, NvR0

Dimensional regularization of nonlinear sigma models on a finite time interval

We extend dimensional regularization to the case of compact spaces. Contrary to previous regularization schemes employed for nonlinear sigma models on a finite time interval (``quantum mechanical path integrals in curved space'') dimensional regularization requires only a covariant finite two-loop counterterm. This counterterm is nonvanishing and given by R/8.Comment: 9 pages, 7 figures, LaTeX, minor changes in text and reference

Local Unit Invariance, Back-Reacting Tractors and the Cosmological Constant Problem

When physics is expressed in a way that is independent of local choices of unit systems, Riemannian geometry is replaced by conformal geometry. Moreover masses become geometric, appearing as Weyl weights of tractors (conformal multiplets of fields necessary to keep local unit invariance manifest). The relationship between these weights and masses is through the scalar curvature. As a consequence mass terms are spacetime dependent for off-shell gravitational backgrounds, but happily constant for physical, Einstein manifolds. Unfortunately this introduces a naturalness problem because the scalar curvature is proportional to the cosmological constant. By writing down tractor stress tensors (multiplets built from the standard stress tensor and its first and second derivatives), we show how back-reaction solves this naturalness problem. We also show that classical back-reaction generates an interesting potential for scalar fields. We speculate that a proper description of how physical systems couple to scale, could improve our understanding of naturalness problems caused by the disparity between the particle physics and observed, cosmological constants. We further give some ideas how an ambient description of tractor calculus could lead to a Ricci-flat/CFT correspondence which generalizes the AdS side of Maldacena's duality to a Ricci-flat space of one higher dimension.Comment: 20 pages, 2 figure

Three-dimensional topologically gauged N=6 ABJM type theories

In this paper we construct the $\mathcal N=6$ conformal supergravity in three dimensions from a set of Chern-Simons-like terms one for each of the graviton, gravitino, and R-symmetry gauge field and then couple this theory to the $\mathcal N=6$ superconformal ABJM theory. In a first step part of the coupled Lagrangian for this topologically gauged ABJM theory is derived by demanding that all terms of third and second order in covariant derivatives cancel in the supersymmtry variation of the Lagrangian. To achieve this the transformation rules of the two separate sectors must be augmented by new terms. In a second step we analyze all terms in $\delta L$ that are of first order in covariant derivatives. The cancelation of these terms require additional terms in the transformation rules as well as a number of new terms in the Lagrangian. As a final step we check that all remaining terms in $\delta L$ which are bilinear in fermions cancel which means that the presented Lagrangian and transformation rules constitute the complete answer. In particular we find in the last step new terms in the scalar potential containing either one or no structure constant. The non-derivative higher fermion terms in $\delta L$ that have not yet been completely analyzed are briefly discussed.Comment: 26 pages, v.2 minor corrections, comment on relation to chiral gravity added