bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mortality and recovery from refractory status epilepticus in the intensive care unit: A 7‐year observational study
Authors: Sutter Raoul , Marsch Stephan , Fuhr Peter , Rüegg Stephan 
Published: January 2013

SummaryPurposeRefractory status epilepticus (RSE) is a life‐threatening neurologic emergency with high mortality and morbidity. The aim of this study was to identify and quantify associations between clinical characteristics of adult RSE patients and outcome.MethodsComprehensive medical chart review was performed of all consecutive adult RSE patients treated on the intensive care units of an academic tertiary care center between 2005 and 2011. Demographics, RSE etiologies and duration, comorbidities, as well as outcomes were assessed. Associations between clinical characteristics and death were quantified.Key FindingsOf 260 patients with status epilepticus, 111 developed RSE. Hypoxic encephalopathy (23%), brain tumors (14%), known and uncontrolled epilepsy (10%), and ischemic stroke (8%) were the main etiologies. During hospitalization 38% of patients died. Hypoxic encephalopathy (HE) and brain tumors were independently associated with death (relative risk [RR] 2.41, 95% confidence interval [CI] 1.40–4.12; p = 0.001 and RR 2.81, 95%CI 1.59–4.96; p < 0.0001). The estimated hazard ratio of death was 3.1 (95% CI1.6–6.0; p = 0.001) for patients with HE and 1.1 (95% CI 0.5–2.3; p = 0.745) for patients with brain tumors. RSE duration and nonconvulsive status epilepticus in coma were independently associated with death (for every hour RR 1.001; 95%CI 1.00–1.002; p = 0.011 and RR 3.62; 95%CI 1.34–9.77; p = 0.005).SignificanceBrain tumors and HE had high relative risks for death and were independently associated with mortality in our cohort of critically ill RSE patients. Other clinical characteristics, as well as the use of intravenous anesthetic drugs and mechanical ventilation, may not be strongly related to outcome and should therefore be used cautiously for informed decision making regarding treatment.
Clinical genetic study of the epilepsy‐aphasia spectrum
Authors: Tsai Meng‐Han , Vears Danya F. , Turner Samantha J. , Smith Robert L. , Berkovic Samuel F. , Sadleir Lynette G. , Scheffer Ingrid E. 
Published: January 2013

SummaryPurposeTo characterize the frequency and nature of the family history of seizures in probands with epilepsy falling within the epilepsy‐aphasia spectrum (EAS) in order to understand the genetic architecture of this group of disorders.MethodsPatients with epileptic encephalopathy with continuous spike‐and‐wave during sleep (ECSWS), Landau‐Kleffner syndrome (LKS), atypical benign partial epilepsy (ABPE), and intermediate epilepsy‐aphasia disorders (IEAD) were recruited. All affected and available unaffected relatives up to three degrees of relatedness underwent phenotyping using a validated seizure questionnaire. Pedigrees were constructed for all families. The proportion of affected relatives according to each degree of relatedness was calculated. The epilepsy phenotypes in close relatives were analyzed. The data were compared to the families of probands with benign childhood epilepsy with centrotemporal spikes (BECTS) using the same methodology.Key FindingsThirty‐one probands, including five ECSWS, three LKS, one ABPE, and 22 IEAD were recruited. The mean age of seizure onset was 3.9 (range 0.5–7) years. A male predominance was seen (68%, 21/31) . Sixteen (51.6%) of 31 had a positive family history of seizures. Among 1,254 relatives, 30 (2.4%) had a history of seizures: 13 (10.2%) of 128 first‐degree relatives, 5 (1.7%) of 291 second‐degree relatives, and 12 (1.4%) of 835 third‐degree relatives. Thirteen had febrile seizures, including two who had both febrile seizures and epilepsy. Of the 19 relatives with epilepsy, 4 had BECTS, 4 epilepsies with focal seizures of unknown cause, 3 IEAD, and 7 unclassified. One had genetic generalized epilepsy. In the families of the BECTS probands, 9.8% of first‐degree, 3% of second‐degree, and 1.5% of third‐degree relatives had seizures, which was not significantly different from the EAS cohort families.SignificanceThe frequencies of seizures in relatives of probands with EAS suggest that the underlying genetic influence of EAS is consistent with complex inheritance and similar to BECTS. The phenotypic pattern observed in the affected relatives comprised predominantly febrile seizures and focal seizures. These findings suggest that a shared genetic predisposition to focal epilepsies underpins the epilepsy‐aphasia spectrum.
Alterations in regional homogeneity of resting‐state brain activity in mesial temporal lobe epilepsy
Authors: Zeng Hongwu , Pizarro Ricardo , Nair Veena A. , La Christian , Prabhakaran Vivek 
Published: January 2013

SummaryPurposeThe purpose of the present study was to identify abnormal areas of regional synchronization in patients with mesial temporal lobe epilepsy and hippocampus sclerosis (mTLE‐HS) compared to healthy controls, by applying a relatively novel method, the Regional Homogeneity (ReHo) method to resting state fMRI (RS‐fMRI) data.MethodsEyes closed RS‐fMRI data were acquired from 10 mTLE‐HS patients (four right‐side, six left‐side) and 15 age‐ and gender‐matched healthy subjects, and were analyzed by using ReHo. For group analysis, four right‐side MTLE‐HS patients' functional images were flipped, in order to make a homogeneous left MTLE‐HS group (10 cases) and increase the sample size.Key FindingsCompared to the healthy control group, patients showed significantly increased ReHo in ipsilateral parahippocampal gyrus, midbrain, insula, corpus callosum, bilateral sensorimotor cortex, and frontoparietal subcortical structures, whereas decreased ReHo was observed mainly in default mode network (DMN) (including precuneus and posterior cingulate gyrus, bilateral inferior lateral parietal, and mesial prefrontal cortex) and cerebellum in patients relative to the control group.SignificanceThis study identified that ReHo pattern in mTLE‐HS patients was altered compared to healthy controls. We consider decreased ReHo in DMN to be responsible for wide functional impairments in cognitive processes. We propose that the increased ReHo in specific regions may form a network that might be responsible for seizure genesis and propagation.
Language lateralization by fMRIand Wada testing in 229 patients with epilepsy: Rates and predictors of discordance
Authors: Janecek Julie K. , Swanson Sara J. , Sabsevitz David S. , Hammeke Thomas A. , Raghavan Manoj , E. Rozman Megan , Binder Jeffrey R. 
Published: January 2013

SummaryPurposeTo more definitively characterize Wada/functional magnetic resonance imaging (fMRI) language dominance discordance rates with the largest sample of patients with epilepsy to date, and to examine demographic, clinical, and methodologic predictors of discordance.MethodsTwo hundred twenty‐nine patients with epilepsy underwent both a standardized Wada test and a semantic decision fMRIlanguage protocol in a prospective research study. Language laterality indices were computed for each test using automated and double‐blind methods, and Wada/fMRIdiscordance rates were calculated using objective criteria for discordance. Regression analyses were used to explore a range of variables that might predict discordance, including subject variables, Wada quality indices, and fMRIquality indices.Key FindingsDiscordant results were observed in 14% of patients. Discordance was highest among those categorized by either test as having bilateral language. In a multivariate model, the only factor that predicted discordance was the degree of atypical language dominance on fMRI.SignificancefMRI language lateralization is generally concordant with Wada testing. The degree of rightward shift of language dominance onfMRItesting is strongly correlated with Wada/fMRIdiscordance, suggesting thatfMRImay be more sensitive than Wada to right hemisphere language processing, although the clinical significance of this increased sensitivity is unknown. The relative accuracy offMRIversus Wada testing for predicting postsurgical language outcome in discordant cases remains a topic for future research.
Epilepsy after head injury in dogs: A natural model of posttraumatic epilepsy
Authors: Steinmetz Sonja , Tipold Andrea , Löscher Wolfgang 
Published: January 2013

SummaryPurposeIn humans, traumatic brain injury (TBI) is one of the most common causes of acquired (symptomatic) epilepsy, but as yet there is no treatment to prevent the development of epilepsy afterTBI. Animal models of posttraumatic epilepsy (PTE) are important to characterize epileptogenic mechanisms ofTBIand to identify clinically effective antiepileptogenic treatments. The prevalence and phenomenology of naturally occurring canine epilepsy are similar to those in human epilepsy. However, the risk of epilepsy afterTBIhas not been systemically studied in dogs. We therefore performed a large retrospective study in 1,000 dogs referred to our clinical department over a period of 11.5 years with the aim to determine the incidence of early and late seizures after head trauma in this species.MethodsTwo strategies were used: in group I (n = 392), we evaluated whether dogs referred for the treatment of a head trauma (group Ia) or other trauma (group Ib) developed seizures after the trauma, whereas in groupII(n = 608) we evaluated whether dogs referred for the treatment of recurrent epileptic seizures had a history of head trauma. Data for this study were obtained from our clinical database, questionnaires sent to the dogs' owners, and owner interviews.Key FindingsIn group Ia, 6.6% of the dogs developedPTE, which was significantly different from group Ib (1.9%), indicating that head trauma increased the risk of developing epilepsy by a factor of 3.4. The risk ofPTEincreased with severity ofTBI; 14.3% of the dogs with skull fracture developedPTE. In groupII, 15.5% of the dogs with epilepsy had a history of head injury, which was significantly higher than the incidence ofPTEdetermined for group Ia.SignificanceOur study indicates that head trauma in dogs is associated with a significant risk of developing epilepsy. Therefore, dogs with severeTBIare an interesting natural model ofPTEthat provides a novel translational platform for studies on humanPTE.
Evidence for a shared genetic susceptibility to migraine and epilepsy
Authors: Winawer Melodie R. , Connors Robert ,   the EPGP Investigators
Published: January 2013

SummaryPurposeAlthough epilepsy and migraine are known to co‐occur within individuals, the contribution of a shared genetic susceptibility to this comorbidity remains unclear. We investigated the hypothesis of shared genetic effects on migraine and epilepsy in the Epilepsy Phenome/Genome Project (EPGP) cohort.MethodsWe studied prevalence of a history of migraine in 730 EPGP participants aged ≥12 years with nonacquired focal epilepsy (NAFE) or generalized epilepsy (GE) from 501 families containing two or more individuals with epilepsy of unknown cause. Information on migraine without aura (MO) and migraine with aura (MA) was collected using an instrument validated for individuals ≥12 years. Because many individuals have both MO and MA, we considered two nonoverlapping groups of individuals with migraine: those who met criteria for MA in any of their headaches (MA), and those who did not (“MO‐only”). EPGP participants were interviewed about the history of seizure disorders in additional nonenrolled family members. We evaluated associations of migraine prevalence in enrolled subjects with a family history of seizure disorders in additional nonenrolled relatives, using generalized estimating equations to control for the nonindependence of observations within families.Key FindingsPrevalence of a history of MA (but not MO‐only) was significantly increased in enrolled participants with two or more additional affected first‐degree relatives.SignificanceThese findings support the hypothesis of a shared genetic susceptibility to epilepsy and MA.
Adverse events related to extraoperative invasive EEG monitoring with subdural grid electrodes: A systematic review and meta‐analysis
Authors: Arya Ravindra , Mangano Francesco T. , Horn Paul S. , Holland Katherine D. , Rose Douglas F. , Glauser Tracy A. 
Published: January 2013

SummaryPurposeImplantation of subdural grids and invasive electroencephalography (EEG) monitoring is important to define the ictal‐onset zone and eloquent cortex in selected patients with medically refractory epilepsy. The objective of this systematic review is to summarize data about adverse events related to this procedure.MethodsEnglish‐language studies published up to July 2012, reporting such adverse events were reviewed. Outcome measures included demographic variables; surgical protocol including number of subdural electrodes implanted per patient, duration of monitoring, antibiotic, and steroid prophylaxis; and adverse events.Key FindingsTwenty‐one studies were identified including a total of 2,542 patients. The reported mean number of electrodes per patient and duration of monitoring varied from 52 to 95 and 5 to 17 days, respectively. There is a trend toward more uniform use of antibiotics and steroids in the perioperative period. Neurologic infections (pooled prevalence 2.3%, 95% confidence interval 1.5–3.1), superficial infections (3.0%, 1.9–4.1), intracranial hemorrhage (4.0%, 3.2–4.8), and elevated intracranial pressure (2.4%, 1.5–3.3) were found to be the most common adverse events. Up to 3.5% of patients required additional surgical procedure(s) for management of these adverse events. Increased number of electrodes (≥67) was found to be independently associated with increased incidence of adverse events.SignificanceAlthough providing critical information for patients with medically refractory epilepsy, subdural grids implantation and invasive EEG monitoring entails risks of infection, hemorrhage, and elevated intracranial pressure. The prevalence estimates, likely to be conservative due to selective reporting, are expected to be helpful in counseling patients.
Effects of stream flooding on the distribution and diversity of groundwater‐dependent vegetation in riparian areas
Authors: BAATTRUP‐PEDERSEN ANNETTE , JENSEN KAREN M. B. , THODSEN HANS , ANDERSEN HANS E. , ANDERSEN PETER M. , LARSEN SØREN E. , RIIS TENNA , ANDERSEN DAGMAR K. , AUDET JOACHIM , KRONVANG BRIAN 
Published: January 2013

Summary1. Effects of the frequency and duration of flooding on the structural and functional characteristics of riparian vegetation were studied at four sites (n = 80, 50 × 50 cm, plots) along medium‐sized naturally meandering lowland streams. Special focus was on rich fens, which – due to their high species richness – are of high priority in nature conservation.2. Reed beds, rich fens and meadows were all regularly flooded during the 20‐year study period, with a higher frequency in reed bed areas than in rich fen and meadow areas. In rich fens, species richness was higher in low frequency flooded areas (≤3 year−1) than in areas with a high frequency of flooding (>3 year−1) or no flooding, whereas species richness in reed beds and meadows was unaffected by flood frequency.3. The percentage of stress‐tolerant species was higher in low intensity flooded rich fen areas than in high intensity and non‐flooded areas, indicating that the higher species richness in low frequency flooded rich fens was caused by competitive release. We found no indication that increased productivity was associated with high flooding frequencies.4. We conclude that the restoration of morphological features in stream channels to increase the flooding regime can be beneficial for protected vegetation within riparian areas, but also that groundwater discharge thresholds and critical levels for protected vegetation should be identified and considered when introducing stream ecosystem restoration plans.
Predictability of plankton communities in an unpredictable world
Authors: LÜRLING MIQUEL , DE SENERPONT DOMIS LISETTE N. 
Published: January 2013

Summary1. Plankton ecology contributes significantly to ecological theory building, because plankton organisms are relatively easy to manipulate and have short generation times and a relatively small set of traits making them an ideal experimental model system for addressing both general ecological questions as well more system‐specific questions.2. Since the environment is changing at an unprecedented rate, there is an ongoing demand for predictions from plankton ecology on the consequences of global change.3. In 2010, a colloquium was held on three subjects: chaos versus predictability in plankton dynamics, global patterns versus regional differences in plankton dynamics and climate‐induced changes in plankton dynamics.4. Papers in this Special Issue propose a new model of plankton dynamics under climate change in different climate zones; offer increased attention to the role of winters in resetting population dynamics; discuss the effects of climate change on ecological stoichiometry and efficiency of trophic transfer; describe the relative and interacting effects of changes in temperature and hydrology on plankton; and analyse the effects of climate change on host–parasite dynamics.5. Important research gaps include increased monitoring of understudied climatic zones, adaptation of plankton organisms to altered environmental conditions, interactions of climate change with legacy nutrients, interactions with other anthropogenic pressures and interactions with the infochemical network.
Comparing mechanistic and empirical model projections of crop suitability and productivity: implications for ecological forecasting
Authors: Estes L. D. , Bradley B. A. , Beukes H. , Hole D. G. , Lau M. , Oppenheimer M. G. , Schulze R. , Tadross M. A. , Turner W. R. 
Published: January 2013

AbstractAimIntercomparison of mechanistic and empirical models is an important step towards improving projections of potential species distribution and abundance. We aim to compare suitability and productivity estimates for a well‐understood crop species to evaluate the strengths and weaknesses of mechanistic versus empirical modelling.LocationSouth Africa.MethodsWe compared four habitat suitability models for dryland maize based on climate and soil predictors. Two were created using maximum entropy (MAXENT), the first based on national crop distribution points and the second based only on locations with high productivity. The third approach used a generalized additive model (GAM) trained with continuous productivity data derived from the satellite normalized difference vegetation index (NDVI). The fourth model was a mechanistic crop growth model (DSSAT) made spatially explicit. We tested model accuracy by comparing the results with observed productivity derived from MODIS NDVI and with observed suitability based on the current spatial distribution of maize crop fields.ResultsThe GAM and DSSAT results were linearly correlated to NDVI‐measured yield (R2 = 0.75 and 0.37, respectively). MAXENT suitability values were not linearly related to yield (R2 = 0.08); however, a MAXENT model based on occurrences of high‐productivity maize was linearly related to yield (R2 = 0.62). All models produced crop suitability maps of similarly good accuracy (Kappa = 0.73–75).Main conclusionsThese findings suggest that empirical models can achieve the same or better accuracy as mechanistic models for predicting both suitability (i.e. species range) and productivity (i.e. species abundance). While MAXENT could not predict productivity across the species range when trained on all occurrences, it could when trained with a high‐productivity subset, suggesting that ecological niche models can be adjusted to better correlate with species abundance.
Do patients use decision and communication aids as prompted when meeting with breast cancer specialists?
Authors: Volz Shelley , Moore Dan H. , Belkora Jeffrey K. 
Published: January 2013

AbstractBackgroundOur breast cancer clinic promotes patient use of decision and communication aids (DAs/CAs) through two mechanisms: coaching and prompting. From January through September 2010, we provided services to 462 of 1106 new visitors (42%). Of those 462 visitors, 267 (58%) received coaching. For the remainder (195 or 42%), the best we could do was prompt them to self‐administer the DA and CAs.ObjectiveWe wanted to learn whether patients prompted to use DAs/CAs did so.MethodsWe surveyed prompted patients after their visits. We asked how much of each DA they reviewed, whether they listed questions, made notes and audio‐recorded their consultations. We tallied frequencies and explored associations using logistic regression.ResultsOf the 195 prompted patients, 82 responded to surveys (42%). Nearly all (66/73 or 90%) reported reviewing some or all of the booklets and 52/73 (71%) reported viewing some or all of the DVDs. While 63/78 (81%) responded that they wrote a question list, only 14/61 (23%) said they showed it to their doctor. Two‐thirds (51/77 or 66%) said someone took notes, but only 16/79 (20%) reported making audio recordings.DiscussionMore patients reported following prompts to use DAs than CAs. Few reported showing question lists to physicians or recording their visits. Our exploratory analyses surfaced associations between using CAs and race/ethnicity or education that merit further investigation.ConclusionPrompting patients assures better use of decision than communication aids. Clinicians may need to take a more active role to ensure patients receive adequate notes and recordings.
Incident hypertension in older women and men with or at risk for HIV infection
Authors: Factor SH , Lo Y , Schoenbaum E , Klein RS 
Published: January 2013

ObjectivesAntiretroviral (ARV) therapy has prolonged the life expectancy of HIV‐infected persons, increasing their risk of age‐associated diseases, including atherosclerosis (AS). Decreased risk of AS has been associated with the prevention and control of hypertension (HTN). We conducted a cohort study of perimenopausal women and older men with or at risk of HIV infection to identify risk factors for incident HTN.MethodsStandardized interviews, physical examinations, and laboratory examinations were scheduled at 6‐month intervals. Interview data included demographics, medical, family, sexual behaviour and drug use histories, and physical activity.ResultsThere were 330 women and 329 men eligible for inclusion in the study; 27% and 35% of participants developed HTN during a median follow‐up period of 1080 and 1071 days, respectively. In gender‐stratified analysis, adjusting for traditional HTN risk factors (age, race, body mass index, smoking, diabetes, family history of HTN, alcohol dependence, physical activity and high cholesterol), HIV infection was not associated with incident HTN in women [hazard ratio (HR) 1.31; 95% confidence interval (CI) 0.56, 3.06] or men (HR 1.67; 95% CI 0.75, 3.74). Among HIV‐infected women, although exposure to ARVs was not significantly associated with incident HTN (HR 0.72; 95% CI 0.26, 1.99), CD4 T‐cell count was positively associated with incident HTN (HR 1.15 per 100 cells/μL; 95% CI 1.03, 1.28). Among physically active HIV‐infected men, exposure to ARVs was negatively associated with incident HTN (HR 0.15; 95% CI 0.03, 0.78).ConclusionsHIV infection was not associated with incident HTN in older men or women. This study provides additional evidence supporting a causal relationship between immune function and incident HTN, which warrants further study.