bluuebunny/crossref_metadata_2025_split huggingface dataset:
Low glycemic index treatment for seizures in Angelman syndrome
Authors: Thibert Ronald L. , Pfeifer Heidi H. , Larson Anna M. , Raby Annabel R. , Reynolds Ashley A. , Morgan Amy K. , Thiele Elizabeth A. 
Published: July 2012

SummaryPurpose: The low glycemic index treatment (LGIT) is a high fat, limited carbohydrate diet used in the treatment of epilepsy. The purpose of this study was to assess the efficacy and tolerability of the LGIT for the treatment of refractory seizures in pediatric patients with Angelman syndrome.Methods: A pediatric Angelman syndrome cohort with refractory epilepsy was treated with the LGIT and followed prospectively over 4 months. Parents recorded a daily seizure log for a minimum of 1 month prior to the start of treatment as well as throughout the LGIT trial. Electroencephalography (EEG) and neuropsychological assessments (Scales of Independent Behavior‐Revised and the Vineland Adaptive Behavior Scales‐2nd Edition were obtained for each subject at both baseline and 4‐month follow‐up time points. Clinical evaluations of subjects were completed by a neurologist and dietitian at the time of enrollment, as well as following both the first and fourth months of dietary therapy. At each time point, blood for laboratory chemistries was drawn and anthropometric measures were obtained.Key Findings: Six children (mean age 3.3 years, range 1.1–4.8) with genetically confirmed Angelman syndrome initiated the LGIT, and completed the trial with no significant adverse events. Cohort averages for indices of seizure severity were as follows: age of 1.6 years at seizure onset, 3 lifetime antiepileptic drugs tried (range 1–6), and baseline seizure frequency of 10.1 events/week (range: 0.4–30.9). All subjects had a decrease in seizure frequency on the LGIT, with five of six exhibiting >80% seizure frequency reduction. All posttrial EEG studies showed improvement and three of four children with epileptiform activity on his or her baseline EEG had no discharges present on follow‐up EEG. Developmental gains were noted by parents in all cases, although few of these neurocognitive gains were statistically significant on neuropsychological assessment.Significance: This is the first prospective study assessing the LGIT for epilepsy. Our results indicate that this dietary therapy is highly effective in treating Angelman syndrome–related seizures. The diet was well tolerated by subjects as evidenced by five of six subjects remaining on the LGIT after completion of the trial. Beyond the prospective trial window, all five subjects who remained on the diet had >90% seizure reduction after 1 year of LGIT therapy. Despite the small sample size in this prospective study, the results indicate a potentially higher degree of efficacy of the LGIT for the Angelman syndrome population than that observed in the general epilepsy population. Although this study is too small to make definitive recommendations, these results suggest that the LGIT is a promising treatment option for Angelman syndrome–related epilepsy.
Cortical stimulation mapping and Wada results demonstrate a normal variant of right hemisphere language organization
Authors: Drane Daniel L. , Roraback‐Carson Jenny , Hebb Adam O. , Hersonskey Tamir , Lucas Timothy , Ojemann George A. , Lettich Ettore , Silbergeld Daniel L. , Miller John W. , Ojemann Jeffrey G. 
Published: July 2012

SummaryPurpose:  Exclusive right hemisphere language lateralization is rarely observed in the Wada angiography results of epilepsy surgery patients. Cortical stimulation mapping (CSM) is infrequently performed in such patients, as most undergo nondominant left hemisphere resections, which are presumed not to pose any risk to language. Early language reorganization is typically assumed in such individuals, taking left hemisphere epileptiform activity as confirmation of change resulting from a pathologic process. We present data from CSM and Wada studies demonstrating that right hemisphere language occurs in the absence of left hemisphere pathology, suggesting it can exist as a normal, but rare variant, in some individuals. Furthermore, these data confirm the Wada test findings of atypical dominance.Methods:  Cortical stimulation mapping data were examined for all right hemisphere surgical patients with right hemisphere speech at our center between 1974 and 2006. Of 1,209 interpretable Wada procedures, 89 patients (7.4%) had exclusive right hemisphere speech, and 21 (1.7%) of these patients underwent surgery involving the right hemisphere. Language site location was determined by examining intraoperative photographs, and site distribution was statistically compared to published findings from left hemisphere language dominant patients.Key Findings:  Language cortex was identified in the right hemisphere during CSM for all patients with available data. All sites could be classified in superior or middle temporal gyri, inferior parietal lobe, or inferior frontal gyrus, all of which were common zones where language was identified in the left hemisphere dominant comparison sample.Significance:  Results suggest that the Wada procedure is a valid measure for identifying right hemisphere language processing without any false lateralization found in the patients mapped with CSM (i.e., a positive Wada is 100% sensitive for finding right hemisphere language sites), and that the distribution of language sites is consistent across right hemisphere and left hemisphere language dominant patients, supporting the theory that right hemisphere language can occur as a normal variant of language lateralization.
Internal desynchronization facilitates seizures
Authors: Smyk Magdalena K. , Coenen Anton , Lewandowski Marian H. , van Luijtelaar Gilles 
Published: July 2012

SummaryPurpose:  The occurrence of spike‐wave discharges (SWDs) in WAG/Rij rats is modulated by the circadian timing system and is shaped by the presence of a light–dark cycle, motor activity, and state of vigilance. Here it is investigated whether the response to a phase shift is different between the SWDs and general motor activity rhythm. The process of reentrainment of both rhythms and its effect on number of absences was compared after a phase shift in the light–dark cycle, a condition known to induce internal desynchronization in the circadian timing system.Methods:  Chronic electroencephalographic and motor activity recordings were made in adult WAG/Rij rats, kept in the 12:12 h light–dark cycle. After four baseline days, rats were exposed to an 8‐h phase delay by shifting the light onset. Recordings were continuously made for another 10 consecutive days.Key Findings:  An immediate effect of the phase shift on both rhythms was observed: the acrophases were 7.5 h advanced. Next, they gradually returned to the baseline level, however, with a different speed. The more robust motor activity rhythm stabilizes first, whereas the weaker rhythm of SWDs adapted more slowly. The phase shift caused a prolonged aggravation of epileptic activity, observed mostly during the light phase.Significance:  Different speed and character of reentrainment suggests that the occurrence of seizures and motor activity are controlled by distinct circadian oscillators. The prolonged increase in absences after the phase shift has immediate practical consequences.
Outcome of frontal lobe epilepsy surgery
Authors: Lazow Stefanie P. , Thadani Vijay M. , Gilbert Karen L. , Morse Richard P. , Bujarski Krzysztof A. , Kulandaivel Kandan , Roth Robert M. , Scott Rodney C. , Roberts David W. , Jobst Barbara C. 
Published: July 2012

SummaryPurpose:  There is still controversy in deciding which patients with frontal lobe epilepsy (FLE) should undergo resective surgery, even though it is a well‐established therapy. The aim of this study is to define multiple outcome measures and determine whether there are certain subpopulations of preferred surgical candidates that have a more favorable seizure prognosis.Methods:  Fifty‐eight patients underwent resective FLE surgery with a mean follow‐up period of 79.3 months (range 12–208 months). Patient demographics, clinical seizure characteristics, seizure‐onset zone within the frontal lobes, and diagnostic tests were tabulated. Engel class, International League Against Epilepsy (ILAE) class, postoperative seizure patterns, time to first recurrent seizure, and seizures and employment during the last year of follow‐up were used as outcome measures. Neuropsychological performance and Beck Depression Inventory (BDI) scores were used to define neuropsychological outcome and examined as predictors of seizure outcome.Key Findings:  Thirty‐three (57%) patients with resective surgery had an Engel class I outcome and 29 (50%) had an ILAE class I outcome. Mean time to first seizure after surgery was 33.3 months (range 0–208). Only 14 patients (24%) were completely seizure‐free without auras (Engel IA) throughout the entire follow‐up period. The most common pattern of seizure recurrence was mixed, with prolonged periods of seizure freedom intermixed with recurrences. In addition, 32% of patients made gains in employment and 52% were able to reduce use of antiepileptic drugs (AEDs), although only 9% discontinued AEDs. No significant association was found between class I or class IA outcome and the presence of a focal magnetic resonance imaging (MRI) abnormality, any specific localization of seizure focus within the frontal lobe, or neuropsychological change.Significance:  Findings indicate that that long‐term outcome is generally favorable in FLE resective surgery, and support the need for considering multiple outcome measures to more fully characterize clinically relevant postsurgical changes. Outcome can be favorable even in MRI‐negative patients.
Familial focal epilepsy with variable foci mapped to chromosome 22q12: Expansion of the phenotypic spectrum
Authors: Klein Karl Martin , O’Brien Terence J. , Praveen Kavita , Heron Sarah E. , Mulley John C. , Foote Simon , Berkovic Samuel F. , Scheffer Ingrid E. 
Published: July 2012

SummaryWe aimed to refine the phenotypic spectrum and map the causative gene in two families with familial focal epilepsy with variable foci (FFEVF). A new five‐generation Australian FFEVF family (A) underwent electroclinical phenotyping, and the original four‐generation Australian FFEVF family (B) (Ann Neurol, 44, 1998, 890) was re‐analyzed, including new affected individuals. Mapping studies examined segregation at the chromosome 22q12 FFEVF region. In family B, the original whole genome microsatellite data was reviewed. Five subjects in family A and 10 in family B had FFEVF with predominantly awake attacks and active EEG studies with a different phenotypic picture from other families. In family B, reanalysis excluded the tentative 2q locus reported. Both families mapped to chromosome 22q12. Our results confirm chromosome 22q12 as the solitary locus for FFEVF. Both families show a subtly different phenotype to other published families extending the clinical spectrum of FFEVF.
The value of EEG‐fMRI and EEG source analysis in the presurgical setup of children with refractory focal epilepsy
Authors: Elshoff Lydia , Groening Kristina , Grouiller Frédéric , Wiegand Gert , Wolff Stephan , Michel Christoph , Stephani Ulrich , Siniatchkin Michael 
Published: July 2012

SummaryPurpose:  In the presurgical evaluation of children and juvenile patients with refractory focal epilepsy, the main challenge is to localize the point of seizure onset as precisely as possible. We compared results of the conventional electroencephalography–functional magnetic resonance imaging (EEG‐fMRI) analysis with those obtained with a newly developed method using voltage maps of average interictal epileptiform discharges (IEDs) recorded during clinical long‐term monitoring and with the results of the electric source imaging (ESI).Methods:  Simultaneous EEG‐fMRI was recorded in nine patients (ages 1.5–17.5 years) undergoing presurgical evaluation. The postoperative outcome and resected area were compared with the following: the localizations of blood oxygen–level dependent (BOLD) signal changes associated with IEDs, which were identified by visual inspection changes using SPM5 software (Analysis I); BOLD signal changes related to IED topography, which was characterized using spike‐specific voltage maps of average IED recorded outside the MR scanner during clinical long‐term monitoring (Analysis II); as well as results of EEG source analysis based on the distributed linear local autoregressive average (LAURA) algorithm using the Cartool software by Denis Brunet (Analysis III).Key Findings:  All nine patients had postoperative outcome Engel class I–IIb (postoperative time 6–26 months). The analysis I revealed an IED‐related area of activation within the resection area in 3 (33%) of 9 patients, analysis II was able to reliably localize the source of epileptic activity in 4 (44%) of 9 patients, and analysis III rendered results concordant with the postoperative resection site in all nine patients.Conclusions:  The localization of seizure onset based on EEG‐fMRI may be a useful adjunct in the preoperative evaluation but also has some deficits that impair the reliability of results. In contrast, EEG source analysis is clearly a more credible method for epileptic focus localization in children with refractory epilepsies. It seems likely that the analysis based on IED topography (Analysis II) may increase sensitivity and reliability of EEG‐fMRI in some patients. However, the benefit from this innovative method in children is rather limited compared with adults.
On seeing the trees and the forest: Single‐signal and multisignal analysis of periictal intracranial EEG
Authors: Schindler Kaspar , Gast Heidemarie , Goodfellow Marc , Rummel Christian 
Published: July 2012

SummaryPurpose:  Epileptic seizures are associated with a dysregulation of electrical brain activity on many different spatial scales. To better understand the dynamics of epileptic seizures, that is, how the seizures initiate, propagate, and terminate, it is important to consider changes of electrical brain activity on different spatial scales. Herein we set out to analyze periictal electrical brain activity on comparatively small and large spatial scales by assessing changes in single intracranial electroencephalography (EEG) signals and of averaged interdependences of pairs of EEG signals.Methods:  Single and multiple EEG signals are analyzed by combining methods from symbolic dynamics and information theory. This computationally efficient approach is chosen because at its core it consists of analyzing the occurrence of patterns and bears analogy to classical visual EEG reading. Symbolization is achieved by first mapping the EEG signals into bit strings, that is, long sequences of zeros and ones, depending solely on whether their amplitudes increase or decrease. Bit strings reflect relational aspects between consecutive values of the original EEG signals, but not the values themselves. For each bit string the relative frequencies of the different constituent short bit patterns are then determined and used to compute two information theoretical measures: (1) redundancy (R) of single bit strings characterizes electrical brain activity on a comparatively small spatial scale represented by a single EEG signal and (2) averaged pair‐wise mutual information with all other bit strings (M), which allows tracking of larger‐scale EEG dynamics.Key Findings:  We analyzed 20 periictal intracranial EEG recordings from five patients with pharmacoresistant temporal lobe epilepsy. At seizure onset, R first strongly increased and then decreased toward seizure termination, whereas M gradually increased throughout the seizure. Bit strings with maximal R were always derived from EEG signals recorded from the visually identified seizure‐onset zone. When compared to the bit strings derived from other EEG signals, their M was relatively smaller. These findings are consistent with a strong but transient occurrence of information‐poor, that is, redundant electrical brain activity on a smaller spatial scale, which is particularly pronounced in the seizure‐onset zone. On a larger spatial scale, a progressively more collective state emerges, as revealed by increasing amounts of mutual information.Significance:  Information theoretical analysis of bit patterns derived from EEG signals helps to characterize periictal brain activity on different spatial scales in a quantitative and efficient way and may provide clinically relevant results.
Energy Intensity of the Catalan Construction Sector
Authors: Hoque Mohammad R. , Durany Xavier Gabarrell i , Sala Cristina Sendra i , Méndez Gara Villalba , Peiró Laura Talens , Huguet Teresa Vicent 
Published: July 2012

SummaryWe used a thermodynamic framework to characterize the resource consumption of the construction sector in 2001 in Catalonia, the northeast region of Spain. The analysis was done with a cradle‐to‐product life cycle approach using material flow analysis (MFA) and exergy accounting methodologies to quantify the total material and energy inputs in the sector. The aim was to identify the limitations of resource metabolism in the sector and to pinpoint the opportunities for improved material selection criteria, processing, reuse, and recycling for sustainable resource use. The results obtained from MFA showed that nonrenewables such as minerals and natural rocks, cement and derivatives, ceramics, glass, metals, plastics, paints and other chemicals, electric and lighting products, and bituminous mix products accounted for more than 98% of the input materials in the construction sector. The exergy analysis quantified a total 113.1 petajoules (PJ) of exergy inputs in the sector; utilities accounted for 57% of this exergy.Besides exergy inputs, a total of 6.85 million metric tons of construction and demolition waste was generated in 2001. With a recycling rate of 6.5%, the sector recovered 1.3 PJ of exergy. If the sector were able to recycle 80% of construction and demolition waste, then exergy recovery would be 10.3 PJ. Hence the results of this analysis indicate that improvements are required in manufacturing processes and recycling activities, especially of energy‐intensive materials, in order to reduce the inputs of utilities and the extraction of primary materials from the environment.
Validation and implementation of a new hemoglobinometer for donor screening at Canadian Blood Services
Authors: Goldman Mindy , Uzicanin Samra , Yi Qi‐Long , Acker Jason , Ramirez‐Arcos Sandra 
Published: July 2012

BACKGROUND: Hemoglobin (Hgb) determination is an essential part of donor qualification. We assessed and implemented a new spectrophotometer for donor Hgb determination.STUDY DESIGN AND METHODS: Precision, accuracy, and ease of use were assessed on a prototype DiaSpect analyzer (DiaSpect Medical, GmBH, Sailauf, Germany). A protocol to qualify the analyzer was developed and executed preimplementation. Samples were developed for periodic quality control (QC). Postimplementation performance was assessed based on QC results and trending of deferral rates.RESULTS: Precision was excellent, with a coefficient of variation of 0.53%‐1.14% per sample. The correlation coefficient between capillary DiaSpect and venous laboratory autoanalyzer measurements was 0.736. After 169 out of 223 analyzers failed to qualify on our initial protocol, all were successfully qualified with the use of a modified protocol, adjusted to avoid sources of variability. Because commercial controls proved inadequate, in‐house samples were developed for periodic QC. Postimplementation, all analyzers had adequate QC results. Deferral rates decreased from 10.1 to 8.1% (p < 0.0001) for female donors and from 0.8 to 0.6% for male donors (p < 0.0001). The system was faster and easier to use compared with our previous two‐step process.CONCLUSION: We successfully implemented a new spectrophotometer, which resulted in greater efficiency, improved ease of use, and decreased deferrals.
Improving blood transfusion practice by regular education in the United Arab Emirates
Authors: Sajwani F.H. 
Published: July 2012

BACKGROUND: A cross‐match to transfused unit ratio of less than 2.0 is frequently used to assess performance in many hospital blood banks. This brief report was initiated to evaluate the practice at a local hospital and to emphasize the importance of regular educational sessions to improve blood transfusion practice.METHOD: Retrospective data on cross‐match : transfused (C : T) ratio of all departments was collected and educational sessions were given to improve practice. Thereafter, a new set of data was collected and change in practice was assessed.RESULTS: Initial data showed total (C : T) ratio of 1.95. After medical staff education, analysis showed clinically significant improvement in blood utilization practice with a (C : T) ratio of 1.60.CONCLUSION: This brief report indicates the importance of regular physician education, the potential role of blood transfusion committee, and the need to implement clear guidelines for blood transfusion.
Immunohistochemical, tomographic, and histological study on onlay bone graft remodeling. Part III: allografts
Authors: Hawthorne Ana Carolina , Xavier Samuel Porfírio , Okamoto Roberta , Salvador Sérgio Luiz , Antunes Antonio Azoubel , Salata Luiz Antonio 
Published: July 2012

AbstractObjectiveIn the last decades aroused the interest for bone tissue bank as an alternative to autogenous grafting, avoiding donor sites morbidity, surgical time, and costs reduction. The purpose of the study was to compare allografts (ALg) with autografts (AUg) using histology, immunochemistry, and tomographic analysis.Material and methodsFifty‐six New Zealand White rabbits were submitted to surgical procedures. Twenty animals were donors and 36 were actually submitted to onlay grafting with ALg (experimental group) and AUg (control group) randomly placed bilaterally in the mandible. Six animals of each group were sacrificed at 3, 5, 7, 10, 20, and 60 postoperative days. Immunolabeling was accomplished with osteoprotegerin (OPG); receptor activator of nuclear factor‐k ligand (RANKL); alkaline phosphatase (ALP); osteopontin (OPN); vascular endothelial growth factor (VEGF); tartrate‐resistant acid phosphatase (TRAP); collagen type I (COL I); and osteocalcin (OC). Density and volume of the grafts was evaluated on tomography obtained at the surgery and sacrifice.ResultsThe ALg and AUg exhibited similar patterns of density and volume throughout the experiments. The intra‐group data showed statistical differences at days 7 and 60 in comparison with other time points (P = 0.001), in both groups. A slight graft expansion from fixation until day 20 (P = 0.532) was observed in the AUg group and then resorbed significantly at the day 60 (P = 0.015). ALg volume remained stable until day 7 and decreased at day 10 (P = 0.045). The light microscopy analysis showed more efficient incorporation of AUg onto the recipient bed if compared with the ALg group. The immunohistochemical labeling picked: at days 10 and 20 with OPG in the AUg group and at day 7 with TRAP in the ALg group (P = 0.001 and P = 0.002, respectively).Conclusions
ALg and AUg were not differing in patterns of volume and density during entire experiment. Histological data exhibit more efficient AUg incorporation into recipient bed compared with the ALg group. Immunohistochemistry outcomes demonstrated similar pattern for both ALg and AUg groups, except for an increasing resorption activity in the ALg group mediated by TRAP and in the AUg group by higher OPG labeling. However, this latter observation does not seem to influence clinical outcomes.