scholarly journals The Individual Ictal Fingerprint: Combining Movement Measures With Ultra Long-Term Subcutaneous EEG in People With Epilepsy

2021 ◽  
Vol 12 ◽  
Author(s):  
Troels W. Kjaer ◽  
Line S. Remvig ◽  
Asbjoern W. Helge ◽  
Jonas Duun-Henriksen
Keyword(s):  
Electrodermal Activity ◽  
Epileptic Seizures ◽  
Signs And Symptoms ◽  
Emg Activity ◽  
Brain Wave ◽  
Multiple Modalities ◽  
Electrographic Seizures ◽  
The Individual ◽  
Clinical Changes

Background: Epileptic seizures are caused by abnormal brain wave hypersynchronization leading to a range of signs and symptoms. Tools for detecting seizures in everyday life typically focus on cardiac rhythm, electrodermal activity, or movement (EMG, accelerometry); however, these modalities are not very effective for non-motor seizures. Ultra long-term subcutaneous EEG-devices can detect the electrographic changes that do not depend on clinical changes. Nonetheless, this also means that it is not possible to assess whether a seizure is clinical or subclinical based on an EEG signal alone. Therefore, we combine EEG and movement-related modalities in this work. We focus on whether it is possible to define an individual “multimodal ictal fingerprint” which can be exploited in different epilepsy management purposes.Methods: This study used ultra long-term data from an outpatient monitoring trial of persons with temporal lobe epilepsy obtained with a subcutaneous EEG recording system. Subcutaneous EEG, an EMG estimate and chest-mounted accelerometry were extracted from four persons showing more than 10 well-defined electrographic seizures each. Numerous features were computed from all three modalities. Based on these, the Gini impurity measure of a Random Forest classifier was used to select the most discriminative features for the ictal fingerprint. A total of 74 electrographic seizures were analyzed.Results: The optimal individual ictal fingerprints included features extracted from all three tested modalities: an acceleration component; the power of the estimated EMG activity; and the relative power in the delta (0.5–4 Hz), low theta (4–6 Hz), and high theta (6–8 Hz) bands of the subcutaneous EEG. Multimodal ictal fingerprints were established for all persons, clustering seizures within persons, while separating seizures across persons.Conclusion: The existence of multimodal ictal fingerprints illustrates the benefits of combining multiple modalities such as EEG, EMG, and accelerometry in future epilepsy management. Multimodal ictal fingerprints could be used by doctors to get a better understanding of the individual seizure semiology of people with epilepsy. Furthermore, the multimodal ictal fingerprint gives a better understanding of how seizures manifest simultaneously in different modalities. A knowledge that could be used to improve seizure acknowledgment when reviewing EEG without video.

The use of progesterone during pregnancy in women with epilepsy as an alternative to the correction of doses of anticonvulsants

GYNECOLOGY ◽  
2020 ◽  
Vol 21 (6) ◽  
pp. 12-15
Author(s):  
Elena V. Tsallagova ◽  
Vasily O. Generalov ◽  
Timur R. Sadykov
Keyword(s):  
Clinical Remission ◽  
Epileptic Seizures ◽  
Progesterone Concentration ◽  
Teratogenic Effects ◽  
Safe Alternative ◽  
Patients With Epilepsy

Pregnancy is the most dangerous period in terms of interruption of even persistent and long-term remission. At the same time increasing the dose of anticonvulsant increases the risk of teratogenic effects. Aim. to assess the possibility of using progesterone to prevent relapse of epileptic seizures during pregnancy. Materials and methods. 38 pregnant patients with epilepsy with clinical remission before pregnancy, with relapse of epileptic seizures in I trimester of pregnancy, age 31.81.4 years. Dydrogesterone in a dose of 10 to 60 mg/day was prescribed after the relapse of remission. Anticonvulsant dosage was not changed. The blood progesterone concentration and EEG control was carried out. Results. During pregnancy, the level of progesterone in the blood gradually increased from 77.8 nmol/l at 78 weeks of pregnancy to 521.1 nmol/l at 3637 weeks of pregnancy, without exceeding the limits. EEG results did not deteriorate. None of the patients had seizures during pregnancy. Conclusion. Progesterone therapy is an adequate and safe alternative to increasing the dose of anticonvulsants in case of recurrent seizures during pregnancy.

ECG-Patterns of Focal Epileptic Seizures, the Role in Sudden Unexpected Death in Epilepsy: A Prospective Long-Term Study

2019 ◽  
Author(s):  
Svetlana Serdyuk ◽  
Karapet V. Davtyan ◽  
Sergey G. Burd ◽  
Oksana M. Drapkina ◽  
Sergey A. Boytsov ◽  
...  
Keyword(s):  
Epileptic Seizures ◽  
Sudden Unexpected Death ◽  
Unexpected Death ◽  
Term Study ◽  
Long Term Study

The Acceptance of Party Unity in Parliamentary Democracies

2017 ◽  
Author(s):  
David M. Willumsen
Keyword(s):  
Political Parties ◽  
Costs And Benefits ◽  
Parliamentary Democracies ◽  
Survey Questions ◽  
Ideal Policy ◽  
Central Argument ◽  
The Individual ◽  
Policy Incentives

The central argument of this book is that voting unity in European legislatures is not primarily the result of the ‘disciplining’ power of the leadership of parliamentary parties, but rather the result of a combination of ideological homogeneity through self-selection into political parties and the calculations of individual legislators about their own long-term benefits. Despite the central role of policy preferences in the subsequent behaviour of legislators, preferences at the level of the individual legislator have been almost entirely neglected in the study of parliaments and legislative behaviour. The book measures these using an until now under-utilized resource: parliamentary surveys. Building on these, the book develops measures of policy incentives of legislators to dissent from their parliamentary parties, and show that preference similarity amongst legislators explains a very substantial proportion of party unity, yet alone cannot explain all of it. Analysing the attitudes of legislators to the demands of party unity, and what drives these attitudes, the book argues that what explains the observed unity (beyond what preference similarity would explain) is the conscious acceptance by MPs that the long-term benefits of belonging to a united party (such as increased influence on legislation, lower transaction costs, and better chances of gaining office) outweigh the short-terms benefits of always voting for their ideal policy outcome. The book buttresses this argument through the analysis of both open-ended survey questions as well as survey questions on the costs and benefits of belonging to a political party in a legislature.

scholarly journals Title I: Modernizing Definitions and Programs Under the Administration on Aging

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 714-715
Author(s):  
Marie Gualtieri
Keyword(s):  
Title I ◽  
Adult Population ◽  
Term Care ◽  
Older Americans ◽  
Aging Society ◽  
Program Adaptation ◽  
Older Americans Act ◽  
The Individual ◽  
Older Adult Population

Abstract The recent reauthorization of the Older Americans Act adds language and definitions to current issues facing the aging population. Specifically, Title I includes definitions related to program adaptation and coordination, workforce and long-term care issues, nutrition and social isolation, as well as family caregivers. Different from the last authorization, these definitions span beyond the individual experience to include other entities impacted by an aging society, such as the workforce and families. Overall, the Title I reauthorization seeks to modernize policy to reflect the current influx of the older adult population and its consequences.

scholarly journals Housing adaptations and housing accessibility problems among older adults with long-standing spinal cord injury

2020 ◽  
pp. 030802262097951
Author(s):  
Lizette Norin ◽  
Björn Slaug ◽  
Maria Haak ◽  
Susanne Iwarsson
Keyword(s):  
Older Adults ◽  
Spinal Cord ◽  
Spinal Cord Injuries ◽  
Occupational Performance ◽  
Environmental Barriers ◽  
Cord Injury ◽  
Long Term Follow Up ◽  
Societal Level ◽  
The Individual

Introduction Adults with spinal cord injuries are living longer than previously, and a majority are living in ordinary housing in the community. Housing accessibility is important for maintaining independent occupational performance for this population, but knowledge in this area is insufficient. We investigated housing adaptations and current accessibility problems among older adults with long-standing (>10 years) spinal cord injuries. Method Data from home visits among 122 older adults with spinal cord injuries in Sweden were used. Housing adaptations and environmental barriers were descriptively analysed. Findings Kitchens, entrances, and hygiene areas were common locations for housing adaptations and environmental barriers that generated accessibility problems. The most common adaptations were ramps, wheelchair-accessible stovetops, and ceiling-lifts. Wall-mounted cupboards and high shelves (kitchen), inaccessible storage areas (outside the dwelling), and a lack of grab bars (hygiene area) generated the most accessibility problems. Conclusion Despite housing adaptations, there are considerable accessibility problems in the dwellings of older adults with long-standing spinal cord injuries in Sweden, indicating that long-term follow-up of the housing situation of this population is necessary. Focusing on accessible housing as a prerequisite for occupational performance is at the core of occupational therapy, deserving attention on the individual as well as the societal level.

scholarly journals Which triggers could support timely identification of primary antibody deficiency? A qualitative study using the patient perspective

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Lisanne M. A. Janssen ◽  
Kim van den Akker ◽  
Mohamed A. Boussihmad ◽  
Esther de Vries
Keyword(s):  
Respiratory Infections ◽  
Diagnostic Delay ◽  
Signs And Symptoms ◽  
Negative Influence ◽  
Primary Antibody ◽  
Emotional Impact ◽  
Structured Interviews ◽  
Timely Treatment ◽  
The Way

Abstract Background Patients with predominantly (primary) antibody deficiencies (PADs) commonly develop recurrent respiratory infections which can lead to bronchiectasis, long-term morbidity and increased mortality. Recognizing symptoms and making a diagnosis is vital to enable timely treatment. Studies on disease presentation have mainly been conducted using medical files rather than direct contact with PAD patients. Our study aims to analyze how patients appraised their symptoms and which factors were involved in a decision to seek medical care. Methods 14 PAD-patients (11 women; median 44, range 16-68 years) were analyzed using semi-structured interviews until saturation of key emergent themes was achieved. Results Being always ill featured in all participant stories. Often from childhood onwards periods of illness were felt to be too numerous, too bad, too long-lasting, or antibiotics were always needed to get better. Recurrent or persistent respiratory infections were the main triggers for patients to seek care. All participants developed an extreme fatigue, described as a feeling of physical and mental exhaustion and thus an extreme burden on daily life that was not solved by taking rest. Despite this, participants tended to normalize their symptoms and carry on with usual activities. Non-immunologists, as well as patients, misattributed the presenting signs and symptoms to common, self-limiting illnesses or other ‘innocent’ explanations. Participants in a way understood the long diagnostic delay. They know that the disease is rare and that doctors have to cover a broad medical area. But they were more critical about the way the doctors communicate with them. They feel that doctors often don’t listen very well to their patients. The participants’ symptoms as well as the interpretation of these symptoms by their social environment and doctors had a major emotional impact on the participants and a negative influence on their future perspectives. Conclusions To timely identify PAD, ‘pattern recognition’ should not only focus on the medical ‘red flags’, but also on less differentiating symptoms, such as ‘being always ill’ and ‘worn out’ and the way patients cope with these problems. And, most important, making time to really listen to the patient remains the key.

scholarly journals Genetic Susceptibility to Periodontal Disease in Down Syndrome: A Case-Control Study

2021 ◽  
Vol 22 (12) ◽  
pp. 6274
Author(s):  
María Fernández ◽  
Alicia de de Coo ◽  
Inés Quintela ◽  
Eliane García ◽  
Márcio Diniz-Freitas ◽  
...  
Keyword(s):  
Down Syndrome ◽  
Metabolic Pathways ◽  
Nominal Significance ◽  
Severe Periodontitis ◽  
Gene Level ◽  
Individual Marker ◽  
The Individual ◽  
Control Study ◽  
Marker Level

Severe periodontitis is prevalent in Down syndrome (DS). This study aimed to identify genetic variations associated with periodontitis in individuals with DS. The study group was distributed into DS patients with periodontitis (n = 50) and DS patients with healthy periodontium (n = 36). All samples were genotyped with the “Axiom Spanish Biobank” array, which contains 757,836 markers. An association analysis at the individual marker level using logistic regression, as well as at the gene level applying the sequence kernel association test (SKAT) was performed. The most significant genes were included in a pathway analysis using the free DAVID software. C12orf74 (rs4315121, p = 9.85 × 10−05, OR = 8.84), LOC101930064 (rs4814890, p = 9.61 × 10−05, OR = 0.13), KBTBD12 (rs1549874, p = 8.27 × 10−05, OR = 0.08), PIWIL1 (rs11060842, p = 7.82 × 10−05, OR = 9.05) and C16orf82 (rs62030877, p = 8.92 × 10−05, OR = 0.14) showed a higher probability in the individual analysis. The analysis at the gene level highlighted PIWIL, MIR9-2, LHCGR, TPR and BCR. At the signaling pathway level, PI3K-Akt, long-term depression and FoxO achieved nominal significance (p = 1.3 × 10−02, p = 5.1 × 10−03, p = 1.2 × 10−02, respectively). In summary, various metabolic pathways are involved in the pathogenesis of periodontitis in DS, including PI3K-Akt, which regulates cell proliferation and inflammatory response.

scholarly journals Corruption, Taxation and the Impact on the Shadow Economy

Economies ◽  
2021 ◽  
Vol 9 (1) ◽  
pp. 18 ◽  
Author(s):  
Daniel Němec ◽  
Eva Kotlánová ◽  
Igor Kotlán ◽  
Zuzana Machová
Keyword(s):  
Tax Evasion ◽  
Capital Accumulation ◽  
Shadow Economy ◽  
Labour Force ◽  
Destructive Effect ◽  
Eu Member States ◽  
Initial Assumption ◽  
The Individual ◽  
The Impact

While assessing the economic impacts of corruption, the corruption-related transmission channels which influence taxation as such have to be duly considered. Taking the example of the Czech Republic, this article aims to evaluate the impacts corruption has on the size of the shadow economy as well as on the individual sources of long-term economic growth, making use of a transmission channel through which corruption affects the tax burden components. Using the method of an extended DSGE model, it confirms the initial assumption that an increase in perceived corruption supports the shadow economy’s growth, but at the same time, it demonstrates that corruption and especially its perception has a significantly different effect on two key areas—the capital accumulation and the labour force size. It further identifies another sector of the economy representing taxes which are prone to tax evasion while asserting that corruption has a much more destructive effect on this sector of the economy, offering generalized implications for other post-communist EU member states in a similar situation.

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