bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ketogenic parenteral nutrition in three paediatric patients with epilepsy with migrating focal seizures
Authors: Armeno Marisa , Verini Antonella , Araujo Maria B. , Reyes Gabriela , Caraballo Roberto H. 
Published: January 2024

ABSTRACTAims. Epilepsy of infancy with migrating focal seizures (EIMFS) is a rare epilepsy syndrome, characterized by an onset of multifocal seizures before the age of six months and a rather typical ictal EEG pattern. The ketogenic diet (KD) has been shown to be a treatment option in these patients with variable results. The KD is generally given by enteral formula or solid food, however, patients on the KD often have coexisting medical disorders that may impair the gastrointestinal tract and, in these cases, parenteral nutrition support may be needed. We present our experience with three patients who had been on the KD because of EIMFS, who were acutely unable to absorb nutrients through the intestinal tract.Results. For these patients, we were unable to reach ketogenic ratios higher than 1.5:1 because of the limited fat intake via the parenteral route. This ratio, nevertheless, was adequate for maintenance of seizure control while allowing short‐term bowel rest.Conclusions. Even though our report is limited as it provides no controlled evidence, ketogenic parenteral nutrition should be considered in children on the KD when enteral nutrition is not feasible. Special care should be taken to maintain ketosis and avoid undesired carbohydrates. Patients may respond well to ketogenic parenteral nutrition in spite of a lower ketogenic ratio.
Avoiding anaesthetics after multiple failed drug‐induced comas: an unorthodox approach to management of new‐onset refractory status epilepticus (NORSE)
Authors: Eaton James E. , Meriweather Matthew T. , Abou‐Khalil Bassel W. , Sonmezturk Hasan H. 
Published: January 2024

ABSTRACTNew‐onset refractory status epilepticus (NORSE) is a rare, poorly understood and often catastrophic condition. There is little guidance available for management. Here, we describe the course of a 19‐year‐old man with NORSE who was treated successfully with a new approach. Our patient was initially treated with first‐, second‐ and third‐line agents including a total of seven failed drug‐induced coma courses until the 30th day of hospitalization. When withdrawal of care was contemplated, management was then assumed by dedicated epileptologists and treatment course was changed. An unorthodox decision was made to avoid IV anaesthetics unless there were generalized bisynchronous tonic‐clonic or generalized non‐convulsive (electrographic) seizures. This approach allowed real‐time assessment of treatment response to aggressive non‐sedating AED therapy while the multifocal convulsive and non‐convulsive seizures were ongoing. It also eliminated potentially fatal IV anaesthetic‐induced complications and prevented anaesthetic withdrawal seizures. This was effective in achieving full recovery in our patient. The patient's awakening also changed the perspective of family members and care providers, avoiding premature withdrawal of care, which is often the cause of death in similar patients.
Benign Rolandic epilepsy: widespread increases in connectivity in a focal epilepsy syndrome
Authors: Ghantasala Ramya , Holmes Gregory L. 
Published: January 2024

ABSTRACT

Aim
. Benign Rolandic epilepsy (benign epilepsy with centrotemporal spikes; recently renamed self‐limited epilepsy with centrotemporal spikes) is associated with widespread deficits in cognition and behavior, suggesting abnormalities in networks that extend beyond the centrotemporal region. To assess functional connectivity in children with benign Rolandic epilepsy, we assessed EEG spectral power and coherence during awake and sleep records in 27 children with centrotemporal spikes. Coherence represents the consistency of the phase difference between two EEG signals when compared over time and serves as a measure of synchronization between two EEG signals based mainly on phase consistency.

Methods
. Epochs of EEG with and without centrotemporal spikes were compared during both waking and sleep.

Results
. During the spike epochs, there was an increase in spectral power at all frequencies, although statistical significance was seen primarily in the delta, theta and alpha bandwidths. This increase in absolute power was seen at all electrode sites and was similar in left and right‐sided electrodes. During centrotemporal spikes, there were significant changes in coherence compared to the EEG segments without spikes. In the theta, alpha and beta bandwidths, there were significant increases in coherence. The increases in coherences were widespread and bilateral, and involved electrode pairs outside the central and temporal regions. To determine if there was a relationship between location of the spikes and coherence values, right‐sided, left‐sided and bilateral centrotemporal spikes were compared. There was no relationship between location of the centrotemporal spikes and power or coherence values.

Conclusion
. These findings indicate that benign Rolandic epilepsy results in generalized changes in spectral power and connectivity and raises the suggestion that from a functional standpoint, benign Rolandic epilepsy resembles a generalized rather than focal seizure disorder.
Adverse effects of cannabinoids
Authors: Anciones Carla , Gil‐Nagel Antonio 
Published: January 2024

ABSTRACT
Cannabidiol is a cannabinoid‐derived product that has recently been approved for the treatment of pharmacoresistant seizures in patients with epileptic encephalopathies such as Dravet Syndrome and Lennox‐Gastaut Syndrome. Short‐term side effects of cannabidiol are well know and well‐documented in the clinical trials that lead to its approval. Generally, is a well tolerated drug with transitory, dose‐dependent mild to moderate effects like somnolence, decreased appetite or diarrhoea. However severe life‐threatening reactions can also occur, and are often related to the non‐controlled toxic combination with other antiseizure drugs that are widely used in this type of patients like sodium valproate or clobazam. In this brief review we summarize the available data about the short‐term adverse events of cannabidiol. Further studies are required to assess the long‐term outcome and final resolution of these conditions regarding safety of these patients.
Pharmacological monitoring of antiepileptic drugs in epilepsy patients on haemodialysis
Authors: Araki Kunihiko , Nakamura Tomohiko , Takeuchi Yuko , Morozumi Saori , Horie Katsunori , Kobayashi Yasushi , Kawakami Osamu , Sobue Fumio , Ueda Takuya , Hamada Kensuke , Ando Tetsuo , Inoue Yushi , Yasui Keizo , Morozumi Kunio , Maruyama Shoichi , Katsuno Masahisa 
Published: January 2024

ABSTRACT

Aims
: To retrospectively evaluate the pharmacological profiles of antiepileptic drugs (AEDs) in epilepsy patients during haemodialysis using therapeutic drug monitoring data.

Methods
: The serum concentration of AEDs was collected before and after haemodialysis, and the clearance rate and concentration‐to‐dose ratio were calculated as pharmacological parameters.

Results
: Thirty‐six patients were enrolled in the study (25 males, 11 females; age: 65.3 ± 14.8 years). In 24 of the 36 patients, epilepsy was associated with cerebrovascular disorders, and diabetes was the most common reason for haemodialysis in 16 patients. With regards to seizure type, focal aware seizures were less frequent than focal impaired awareness seizures and focal‐to‐bilateral tonic‐clonic seizures. Interictal EEG showed intermittent rhythmic slow waves and intermittent slow waves more often than spikes or sharp waves. Levetiracetam was the most commonly used AED and led to the highest percentage of responders (80%; 16/20 patients). However, the clearance rate of levetiracetam during dialysis was highest among the antiepileptic drugs used, requiring supplementary doses after haemodialysis in all 20 patients. Valproic acid was not effective for focal epilepsy for patients on haemodialysis, and non‐responders to phenytoin had low serum concentration of phenytoin both before and after haemodialysis. The pre‐haemodialysis concentration of levetiracetam tended to be higher than the reference range, suggesting a potential risk of overdosing before haemodialysis. The pre‐ and post‐haemodialysis concentrations of valproic acid tended to be lower than the reference range, suggesting a potential risk of underdosing. The concentration‐to‐dose ratios for levetiracetam, valproic acid, phenytoin, and carbamazepine were significantly lower after than before haemodialysis.

Conclusions
: The majority of patients with epilepsy on haemodialysis had cerebrovascular diseases, and therapeutic drug monitoring for levetiracetam, valproic acid, and phenytoin, before and after haemodialysis, is needed to ensure proper dosing.
RASCANDIS 1.0 Form: Therapeutic Approach of Systemic Anti-Candidiasis for Non-Transplant Patients
Authors: Natadidjaja Ronald Irwanto , Ariyani Aziza , Adlani Hadianti , Dharmayanti Anti , Bratanata Joyce 
Published: January 2024

It has been a concern that using antifungals may induce some fungi to develop antifungal resistance in the future. Therefore, systemic anti-candidiasis agents should become a focus in controlling antifungal drugs since it is quite commonly used. There are currently three approaches to using systemic anti-candidiasis agents based on their indication, i.e. definitive, empiric and pre-emptive indication. These can be applied by observing supportive findings such as the presence of Candida sp infection or colonization, the severity of the infection and the patient's risk factors. The severity of invasive candidiasis is usually severe, and various risk factors need to be considered, such as Total Parenteral Nutrition (TPN), catheterization including deep vein catheter, central venous catheter (CVC), etc.
Antifungal stewardship program, including management of systemic anti-candidiasis, is essential nowadays. Therefore, it is necessary to have a program that can serve as a guideline for clinicians to implement a treatment approach for systemic anti-candidiasis. RASPRO Alur Anti Candida Sistemik (RASCANDIS) 1.0 form or the Indonesian Regulation on the Prospective Antimicrobial System on Systemic Anti-Candidiasis Flowchart 1.0 form is an actual implementation to provide guidelines for clinicians to administer systemic anti-candidiasis agents for non-transplant patients. The form is not a diagnostic tool, but it is more likely to serve as a review and summary of knowledge obtained from various scientific journals, which is expected that it can be proposed as an effort to administer therapeutic management of systemic anti-candidiasis appropriately.
The Effectiveness of Palm Kernell Shell Liquid Smoke (Elaeis Guineensis Jacq) as Antiseptic Against Microbials
Authors: Sulistyawati Annisa Lathifah , Dayanti Nyimas , Iman Moch Fajar Anugrah , Fadhila Feldha , Maryana Yayan , Rumidatul Alfi 
Published: January 2024

Background
Bacteria and fungi that enter through the body get intermediaries from the condition of hands that are not washed clean. Alcohol-based antiseptics are usually used for quick and effective hand washing, but repeated use can cause irritation and dryness of the hands. Natural components can be processed to make non-alcoholic substitutes, such as liquid smoke from palm oil's outer shell (Elais guineensis Jacq). It is known that liquid smoke contains antibacterial phenolic chemicals.
Methods
This research design is true experimental by testing the effectiveness of palm oil outer shell liquid smoke as an antiseptic, which is carried out in vitro using inhibitory tests and in vivo using palm swabs of respondents by looking at the effects before and after use. In vitro results formed the largest inhibition zone size using grade 2 liquid smoke with a concentration of 75%, with an inhibition zone size of Staphylococcus aureus ATCC 25923 of 15.6 mm; Escherichia coli ATCC 25922 of 5.8 mm; Candida albicans ATCC 10231 of 3.3 mm; and Aspergillus flavus ATCC 9643 of 33.3 mm.
Results
In vivo, results obtained through the respondent's palm swab showed an average value of 89.84% decrease in bacterial colonies and a 77% decrease in fungal colonies after using liquid smoke antiseptic. The results of the organoleptic assessment showed that 92% of respondents liked the color, 75% liked the smell, 75% felt that it did not cause dryness, and 92% felt that there were no side effects of use.
Conclusions
The liquid smoke of the outer shell of palm oil has the potential as an antiseptic.
Konsumsi Kopi Berhubungan Dengan Sindrom Mata Kering
Authors: Fayola Aurelia Putri , Kartadinata Erlani 
Published: January 2024

Latar Belakang
Sindrom mata kering merupakan kelainan pada lapisan air mata yang dapat menyebabkan kerusakan pada permukaan mata dan termasuk salah satu masalah utama kesehatan mata mengingat prevalensinya yang tinggi. Terdapat berbagai faktor risiko terjadinya sindrom mata kering, salah satunya adalah konsumsi kopi, dikarenakan oleh tingginya kandungan kafein pada minuman tersebut. Tujuan penelitian ini adalah menilai hubungan antara konsumsi kopi dan sindrom mata kering pada usia dewasa.
Metode
Penelitian ini menggunakan metode analitik observasional dengan desain cross-sectional. Populasi penelitian adalah subjek usia dewasa (20 – 59 tahun) di RW 07 Panaragan Pojok dengan besar sampel 115 orang yang diambil dengan teknik cluster random sampling dan simple random sampling. Data dikumpulkan melalui pengisian kuesioner SQ-FFQ mengenai konsumsi kopi dan kuesioner OSDI untuk menilai tingkat keparahan sindrom mata kering. Data penelitian dianalisis menggunakan uji Chi-square.
Hasil
Hasil penelitian ini menunjukkan bahwa subjek yang memiliki sindrom mata kering didominasi oleh usia dewasa akhir (30–59 tahun) dan jenis kelamin laki-laki. Dari keseluruhan subjek dengan sindrom mata kering, sebagian besarnya memiliki kebiasaan konsumsi kopi, dan yang paling banyak adalah konsumsi ringan. Tidak ditemukan adanya hubungan antara jenis kelamin (p=0,776) dan usia (p=0,221) dengan sindrom mata kering. Sedangkan terdapat hubungan antara konsumsi kopi dengan sindrom mata kering (p = 0,000).
Kesimpulan
Terdapat hubungan antara konsumsi kopi dengan sindrom mata kering pada usia dewasa. Namun tidak ditemukan adanya hubungan antara karakteristik sosiodemografi (usia dan jenis kelamin) dengan sindrom mata kering.
Compilation of an Integrated Therapy Model Based on Compassion-Focused Therapy, Integrated Islamic Therapy and Therapy Based on Acceptance and Commitment and Its Effectiveness on Life Satisfaction of Depressed Married Women in Yazd City
Authors: Tashakori Amid , Sederpooshan Najmeh 
Published: January 2024

Introduction: As a large part of society who experience different restrictions according to different cultural, historical and social situations, women face difficult emotional conditions during marriage. This research is conducted with the aim of developing a combination treatment model based on compassion-focused therapy, integrated Islamic therapy, and therapy based on acceptance and commitment and its effectiveness on life satisfaction of depressed married women in Yazd city in 1400.
Methods: The research method was a combination of an exploratory design with a compilation and classification approach. The first stage was done qualitatively and based on a descriptive phenomenological strategy. In the qualitative part of the research, a combination treatment protocol based on the approach of combining psychotherapies by Stricker (2006) was compiled and validated. In the quantitative (second) part, based on convenience sampling, 30 depressed married women were selected, and then, through a quasi-experimental method with a pre-test and post-testregarding the two test groups and proof, the effectiveness of the developed protocol on their life satisfaction was assessed. The statistical population of the research included all the women who referred to counseling centers in Yazd city, for whom the diagnosis of depression (Beck Depression Scale) was given. In order to measure people's life satisfaction, Diener's life satisfaction scale was used. In order to analyze the quantitative data of the research, the analysis of covariance method was used.
Results: After extracting 11 main categories, a unified treatment protocol was formulated according to the findings. For validation, ratio coefficients and content validity index were used. The coefficients in all items were higher than 0/79 for CVI index and higher than 0./56 for CVR index.
Conclusion: The results of the analysis of the findings showed that integrated psychotherapy based on self-discipline approach, integrated Islamic treatment approach, and treatment approach based on acceptance and commitment increase life satisfaction of depressed married women in Yazd city.
Mixotrophic Syngas Conversion Enables the Production of Meso-2,3-Butanediol with Clostridium autoethanogenum
Authors: Oppelt Anne , Rückel Anton , Rupp Markus , Weuster-Botz Dirk 
Published: January 2024

Providing simultaneously autotrophic and heterotrophic carbon sources is a promising strategy to overcome the limits of autotrophic syngas fermentations. D-xylose and L-arabinose are particularly interesting as they can be obtained by the hydrolysis of lignocellulosic biomass. The individual conversion of varying initial concentrations of these pentoses and D-fructose as reference was studied with C. autoethanogenum in fully-controlled stirred-tank reactors with a continuous syngas supply. All mixotrophic batch processes showed increased biomass and product formation compared to an autotrophic reference process. Simultaneous CO and D-xylose or L-arabinose conversion was observed in contrast to D-fructose. In the mixotrophic batch processes with Larabinose or D-xylose, the simultaneous CO and sugar conversion resulted in high final alcohol to acid ratios of up to 58 g g-1. L-arabinose was superior as a mixotrophic carbon source because biomass and alcohol concentrations (ethanol and 2,3-butanediol) were highest, and significant amounts of meso-2,3-butanediol (&gt;1 g L-1) in addition to D-2,3-butanediol (&gt;2 g L-1) were solely produced with L-arabinose. Furthermore, C. autoethanogenum could not produce meso-2,3 butanediol under purely heterotrophic conditions. The mixotrophic production of meso-2,3-butanediol from Larabinose and syngas, both available from residual lignocellulosic biomass, is very promising for use as a monomer for bio-based polyurethanes or as an antiseptic agent.
Using the Proximal Femur Maturity Index at Brace Initiation for Adolescent Idiopathic Scoliosis Predicts Curve Progression Risk
Authors: Cheung Prudence Wing Hang , Wong Janus Siu Him , Luk Keith Dip Kei , Cheung Jason Pui Yin 
Published: January 2024

Background:
The Proximal Femur Maturity Index (PFMI) can be used to assess skeletal maturity on existing whole-spine radiographs without additional radiation. However, the relationship between the PFMI at the initiation of bracing for adolescent idiopathic scoliosis (AIS) and subsequent curve progression remains unknown. This study aimed to investigate the relationship between the PFMI and curve progression, and the predictability of risks to adulthood curve progression and surgical thresholds based on the PFMI grade at brace initiation.

Methods:
This was a prospective study of 202 patients with AIS who were prescribed underarm bracing according to the Scoliosis Research Society criteria and had good brace-wear compliance. The patients were followed from brace initiation until complete skeletal maturity. Longitudinal data on the coronal Cobb angle and skeletal maturity assessments using Risser staging, Sanders staging, the distal radius and ulna classification, and the PFMI were collected. Each patient was assessed on whether the major curve progressed to ≥40° (adulthood deterioration) and ≥50° (the surgical threshold). Logistic regressions were used to predict probabilities of curve progression to the 2 thresholds, adjusted for factors that were significant in univariate analyses.

Results:
The PFMI correlated with the other skeletal maturity indices (rs [Spearman rank correlation] = 0.60 to 0.72, p < 0.001 for all). The pre-brace PFMI grade correlated with progression to ≥40° (rrb [rank-biserial correlation] = −0.30, p < 0.001) and to ≥50° (rrb = −0.20, p = 0.005). Based on regression models (p < 0.001) adjusted for the pre-brace major Cobb angle and curve type, brace initiation at PFMI grades 2 and 3 for a curve of ≥30° had predicted risks of 30% (95% confidence interval [CI], 4% to 55%) and 12% (95% CI, 7% to 17%), respectively, for progression to the surgical threshold. Brace initiation at PFMI grade 5 had 0% progression risk.

Conclusions:
The PFMI can be used for predicting curve progression and prognosticating brace outcomes in AIS. Patients with brace initiation at PFMI grade 4 for a curve of <30° or at grade 5 were unlikely to progress to the adulthood deterioration or surgical threshold. In comparison, skeletally immature patients initiating bracing at a PFMI grade of ≤3 for a major curve of ≥30° had a higher risk of progression despite compliant brace wear.

Level of Evidence:
Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.
Quantifying heat-related mortality attributable to human-induced climate change
Authors: Stuart-Smith Rupert , Vicedo-Cabrera Ana , Li Sihan , Otto Friederike , Belesova Kristine , Haines Andy , Harrington Luke , Hess Jeremy , Venkatraman Rashmi , Wetzer Thom , Woodward Alistair , Ebi Kristie 
Published: January 2024

Abstract
Background: Recent scientific developments made it possible to quantify the health impacts of climate change. However, limited health attribution studies have been conducted to date.
Objectives: We address limitations in existing methods using as case study an assessment of heat mortality attributable to human-induced climate change in the Canton of Zürich (Switzerland) over 50 years (1969-2018). We also quantify the effects of changes in vulnerability on heat-related mortality.
Methods: We use daily station observations, reanalysis data and an ensemble of climate models to derive timeseries of observed climate data, and counterfactual data that represent a world without human-induced climate change. We estimated the temperature-mortality relationship by conducting a time-series analysis using observed daily-mean temperature and mortality data. We quantified the heat-related mortality using the observed mortality and the mortality risk estimate corresponding to the mean temperature each day with the temperature of minimum mortality as reference, for the observed and counterfactual temperature series. To quantify the effects of changing exposure and vulnerability over time, we compared mortality in scenarios in which the exposure-response relationship derived for 1986-2003 is applied to 2004-2018 and in which the relationship is recalculated based on observed temperature and mortality over the period 2004-2018.
Results: We found nearly 1,700 deaths attributable to human-induced climate change between 1969-2018, and that changing vulnerability, probably due in part to adaptation, avoided at least 700 additional deaths in recent decades.
Discussion: Heat-related deaths occur through the summer months but peak during heatwaves. Our approach builds on existing epidemiological methods to shed light on the adverse effects of climate change on human health, and demonstrates the potential of effective adaptation measures to reduce the mortality burden of heat. The analyses described here could be adapted and applied elsewhere to quantify the effect of climate change on other health outcomes.