bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fast and Sustained Efficacy of Levetiracetam during Titration and the First 3 Months of Treatment in Refractory Epilepsy
Authors: French Jacqueline , Di Nicola Sylvie , Arrigo Celestina 
Published: August 2005

Summary:  Purpose: To investigate whether the efficacy of levetiracetam (LEV) is sustained in adult patients with refractory partial seizures over a 3‐month period. Methods: Treatment effect was assessed in a post hoc analysis by determining the proportion of seizure‐free days during each week of a 3‐month period after the initiation of treatment. Pooled data from three randomized, double‐blind, placebo‐controlled trials (n = 883) were analyzed. Results: The mean proportion of seizure‐free days was greater in the LEV group than in the placebo group. The difference, which was statistically significant, was observed as early as the first week after the initiation of treatment. It was higher in the first week of treatment and subsequently was maintained for each week over the 3‐month period (p < 0.001 or p = 0.002 at each time point). Patients in the LEV group had on average 74% to 81% days each week without any seizure, compared with 69% to 72% in the placebo group. Conclusions: LEV is efficient in controlling seizures from the first week of drug initiation, during uptitration, and throughout the first 3 months of treatment. An interesting amplification of efficacy occurs in the first week of therapy, which is intriguing and warrants further investigation.
Reflex Seizures in Patients with Malformations of Cortical Development and Refractory Epilepsy
Authors: Palmini André , Halasz Peter , Scheffer Ingrid E. , Takahashi Yukitoshi , Jimenez Angeles Perez , Dubeau François , Andermann Frederick , Paglioli‐Neto Eliseu , Da Costa Jaderson Costa , Rosenow Felix , Fritsch Brita 
Published: August 2005

Summary: Purpose:Malformations of cortical development (MCDs) are usually highly epileptogenic, and their hyperexcitability could facilitate the occurrence of reflex seizures. We sought to characterize reflex seizures in patients with MCDs and refractory epilepsy.Methods:Clinical, electrographic, and neuroimaging data were reviewed in eight patients with MCDs who had reflex seizures reproduced during presurgical evaluation.Results:All eight patients had both reflex and spontaneous seizures. In six, however, drop attacks or axial myoclonic seizures occurred only upon specific sensory stimulation. Reflex seizures were induced by more than one type of stimulus in most patients, but anatomofunctional correlations could usually be invoked. Six patients had significant intellectual impairment. Surgical resection controlled seizures in two patients.Conclusions:Reflex seizures in patients with MCDs may be medically refractory and may often manifest as drop attacks or axial myoclonus. Surgical resection of focal lesions can bring reflex seizures under control. Putative mechanisms related to the relatively low frequency of reflex seizures in MCDs are discussed.
Poststroke Epilepsy: Occurrence and Predictors—A Long‐term Prospective Controlled Study (Akershus Stroke Study)
Authors: Lossius Morten I. , Rønning Ole M. , Slapø Geir D. , Mowinckel Petter , Gjerstad Leif 
Published: August 2005

Summary:  Purpose: The aims of the study were to assess the occurrence of poststroke epilepsy (PSE) in patients with ischemic strokes, to identify predictors, and to investigate whether treatment in a stroke unit (SU) influenced the long‐term outcomes of epilepsy. Methods: Patients with PSE, defined as those having two ore more unprovoked epileptic seizures ≥1 week after an ischemic stroke, were identified from a cohort of 484 patients with ischemic strokes. The patients were prospectively assessed 7–8 years after stroke or until death. Different variables were studied to look for possible predictors. Results: From 484 patients with ischemic strokes, PSE developed in 12 (2.5%) and 15 (3.1%) patients during the first year and 7–8 years after stroke, respectively. Eight (53%) of these patients were treated in a stroke unit (SU), and seven (47%) were treated in a general medical ward (GMW). The mean age of those who developed PSE and those who did not was 74.3 years and 76.3 years, respectively. In a multivariate analysis, a Scandinavian Stroke Scale (SSS) score <30 on admission was a significant predictor for developing PSE [odds ratio (OR), 4.9; p = 0.004). Conclusions: The prevalence of PSE, 7 to 8 years after an ischemic stroke, was 3.1%. SSS scores <30 on admission were a significant predictor for PSE. Neither treatment in SU versus GMW, cortical location, nor age at onset of stroke seemed to influence the risk of developing PSE.
Suppression of Kindled Seizures by Paracrine Adenosine Release from Stem Cell–Derived Brain Implants
Authors: Güttinger Martin , Fedele Denise , Koch Peter , Padrun Vivianne , Pralong William F. , Brüstle Oliver , Boison Detlev 
Published: August 2005

Summary:  Purpose: Stem cells and their derivatives have emerged as a promising tool for cell‐based drug delivery because of (a) their unique ability to differentiate into various somatic cell types, (b) the virtually unlimited donor source for transplantation, and (c) the advantage of being amenable to a wide spectrum of genetic manipulations. Previously, adenosine‐releasing embryonic stem (ES) cells have been generated by disruption of both alleles of adenosine kinase (Adk−/‐). Lack of ADK did not compromise the cells' differentiation potential into embryoid bodies or glial precursor cells. The aim of the present study was to investigate the potential of differentiated Adk−/‐ ES cell progeny for seizure suppression by paracrine adenosine release. Methods: To isolate paracrine effects of stem cell–derived implants from effects caused by network integration, ES cell–derived embryoid bodies and glial precursor cells were encapsulated into semipermeable polymer membranes and grafted into the lateral brain ventricles of kindled rats. Results: While seizure activity in kindled rats with wild‐type Adk+/+ implants remained unaltered, rats with adenosine‐releasing Adk−/‐ ES cell–derived implants displayed transient protection from convulsive seizures and a profound reduction of afterdischarge activity in EEG recordings. Long‐term seizure suppression was precluded by limited viability of the encapsulated cells. Conclusions: We thereby provide a proof‐of‐principle that Adk−/‐ ES cell–derived brain implants can suppress seizure activity by a paracrine mode of action. Adk‐deficient stem cells therefore represent a potential tool for the treatment of epileptic disorders.
Application of Magnetoencephalography in Epilepsy Patients with Widespread Spike or Slow‐wave Activity
Authors: Shiraishi Hideaki , Ahlfors Seppo P. , Stufflebeam Steven M. , Takano Kyoko , Okajima Maki , Knake Susanne , Hatanaka Keisaku , Kohsaka Shinobu , Saitoh Shinji , Dale Anders M. , Halgren Eric 
Published: August 2005

Summary:  Purpose: To examine whether magnetoencephalography (MEG) can be used to determine patterns of brain activity underlying widespread paroxysms of epilepsy patients, thereby extending the applicability of MEG to a larger population of epilepsy patients. Methods: We studied two children with symptomatic localization‐related epilepsy. Case 1 had widespread spikes in EEG with an operation scar from a resection of a brain tumor; Case 2 had hemispheric slow‐wave activity in EEG with sensory auras. MEG was collected with a 204‐channel helmet‐shaped sensor array. Dynamic statistical parametric maps (dSPMs) were constructed to estimate the cortical distribution of interictal discharges for these patients. Equivalent current dipoles (ECDs) also were calculated for comparison with the results of dSPM. Results: In case 1 with widespread spikes, dSPM presented the major activity at the vicinity of the operation scar in the left frontal lobe at the peak of the spikes, and some activities were detected in the left temporal lobe just before the peak in some spikes. In case 2 with hemispheric slow waves, the most active area was located in the left parietal lobe, and additional activity was seen at the ipsilateral temporal and frontal lobes in dSPM. The source estimates correlated well with the ictal manifestation and interictal single‐photon emission computed tomography (SPECT) findings for this patient. In comparison with the results of ECDs, ECDs could not express a prior activity at the left temporal lobe in case 1 and did not model well the MEG data in case 2. Conclusions: We suggest that by means of dSPM, MEG is useful for presurgical evaluation of patients, not only with localized epileptiform activity, but also with widespread spikes or slow waves, because it requires no selections of channels and no time‐point selection.
A Comparison of the Ability of a 4:1 Ketogenic Diet and a 6.3:1 Ketogenic Diet to Elevate Seizure Thresholds in Adult and Young Rats
Authors: Nylen Kirk , Likhodii Sergei , Abdelmalik Peter A. , Clarke Jasper , Burnham W. McIntyre 
Published: August 2005

Summary: Purpose:The pentylenetetrazol (PTZ) infusion test was used to compare seizure thresholds in adult and young rats fed either a 4:1 ketogenic diet (KD) or a 6.3:1 KD. We hypothesized that both KDs would significantly elevate seizure thresholds and that the 4:1 KD would serve as a better model of the KD used clinically.Methods:Ninety adult rats and 75 young rats were placed on one of five experimental diets: (a) a 4:1 KD, (b) a control diet balanced to the 4:1 KD, (c) a 6.3:1 KD, (d) a standard control diet, or (e) an ad libitum standard control diet. All subjects were seizure tested by using the PTZ infusion test. Blood glucose and β‐hydroxybutyrate (β‐OHB) levels were measured.Results:Neither KD elevated absolute “latencies to seizure” in young or adult rats. Similarly, neither KD elevated “threshold doses” in adult rats. In young rats, the 6.3:1 KD, but not the 4:1 KD, significantly elevated threshold doses. The 6.3:1 KD group showed poorer weight gain than the 4:1 KD group when compared with respective controls. The most dramatic discrepancies were seen in young rats.Conclusions:“Threshold doses” and “latency to seizure” data provided conflicting measures of seizure threshold. This was likely due to the inflation of threshold doses calculated by using the much smaller body weights found in the 6.3:1 KD group. Ultimately, the PTZ infusion test in rats may not be a good preparation to model the anticonvulsant effects of the KD seen clinically, especially when dietary treatments lead to significantly mismatched body weights between the groups.
Likelihood ratios increase diagnostic certainty in pulmonary embolism
Authors: Chu Kevin , Brown Anthony FT 
Published: August 2005

AbstractPulmonary embolism (PE) is a difficult diagnosis to confirm. The choice of tests has led to a myriad of algorithms. Diagnostic uncertainty can be quantified by the application of the tests’ likelihood ratios (LR). Positive and negative LR enable the conversion of a pretest to a post‐test probability, given a positive and negative test result, respectively. Thus, a pretest probability of <17% and a negative D‐dimer with a negative LR of 0.05 (sensitivity 98%, specificity 40%) lead to a post‐test probability of PE of <1%. Ventilation perfusion (V/Q) scans with a normal, very low, low, intermediate and high probability result have an LR of 0, 0.125, 0.25, 1 and 17, respectively. Also, patients with a V/Q scan result other than normal or high probability still have a post‐test probability of PE from 3 to 65%. Positive and negative computed tomography pulmonary angiograms (CTPA) have an LR of 8.6 and 0.06, respectively (sensitivity 95%, specificity 89%). Patients with a high pretest probability and negative CTPA again still have a post‐test probability of more than 10%. However, as the post‐test probability after one test becomes the pretest probability for the next, test results used cumulatively progressively narrow the gap to a final diagnosis. The post‐test probability after a D‐dimer, V/Q scan, CTPA, leg ultrasound or pulmonary angiography, alone or in any combination or in any order, can be calculated using their LR. Use of LR thus assists in the precise interpretation of test results, such as in complex algorithms for PE.
Epidemiology of unarmed threats in the emergency department
Authors: Knott Jonathan C , Bennett Dianne , Rawet Jennifer , Taylor David McD 
Published: August 2005

AbstractObjective:  To evaluate the precipitants, subject characteristics, nature and outcomes of unarmed threats in the ED.Methods:  A 12 month prospective survey of security codes precipitated by an unarmed threat (Code Grey).Results:  Data were collected on 151 subjects. The Code Grey rate was 3.2/1000 ED presentations. They were most frequent on Saturday and in the late evening/early morning. There were verbal or physical threats of violence made to staff on 104 occasions (69%, 95% confidence interval [CI] 61–76) and a perceived threat of patient self‐harm on 114 occasions (76%, 95% CI 68–82). Median time to be seen by a doctor was 8 min (interquartile range [IQR]: 2–21 min) and median time from presentation to Code was 59 min (IQR: 5–222 min). Sixteen subjects (11%, 95% CI 6–17) had a history of violence, 45 (30%, 95% CI 23–38) were affected by alcohol, 25 (17%, 95% CI 11–24) had used illicit drugs and 79 (52%, 95% CI 44–60) had a significant mental illness contributing to the Code Grey. Seventy‐one patients (47%, 95% CI 39–55) required psychiatric admission, 49 (79%, 95% CI 66–88) involuntarily.Conclusion:  Acutely agitated subjects pose a threat to themselves and the staff caring for them. The reason for the agitation is multifactorial and the majority arrive in a behaviourally disturbed state requiring early intervention. The times most likely to result in a Code Grey coincide with least available resources: ED and hospital risk management policies must account for this. A coherent approach by ED to this population is required to optimize patient and staff outcomes.
Triage nurses validly and reliably estimate emergency department patient complexity
Authors: Vance Jenny , Sprivulis Peter 
Published: August 2005

AbstractObjective:  To access the validity and reliability of triage nurse estimates of ED patient complexity.Methods:  Prospective, single‐blinded evaluation of triage nurse estimates of patient complexity, where a high‐complexity patient is defined as a patient requiring two or more procedures or investigations or consultations. Validity of complexity estimates was assessed by comparison with the number of actual procedures, investigations and consultations requested. Reliability of triage nurse estimates of complexity was assessed by comparison with assessment nurse estimates of complexity.Results:  The specific proportion of agreement and spearman correlation coefficient of triage nurse estimates of complexity with actual procedure, investigations and consultation use were 0.83 (95% confidence interval [CI] 0.79–0.88) and 0.59 (95% CI 0.51–0.66), respectively. The specific proportion of agreement and kappa of triage nurse estimates of complexity with assessment nurse estimates were 0.80 (95% CI 0.73–0.87) and 0.59 (95% CI 0.47–0.71), respectively.Conclusions:  Triage nurses make valid and reliable estimates of patient complexity. This information might be used to guide ED work flow and ED casemix system analysis.
The content digital divide
Authors: Josephson Joel H. 
Published: August 2005

Dear Editor-in-Chief,
I would like to describe briefly how the non-profit kindersite project is utilizing digital media content in an innovative way to address social problems. Firstly to answer who we are; the two founders are Ziv Avidor, a technology specialist and consultant to government and corporations and Joel Josephson, an Internet strategist and high tech consultant.
Our concept is to use content on a wide-scale over the Internet or within control groups to understand what constitutes effective and engaging digital content. This will be achieved through quantitative and qualitative research of users usage of the content. Our belief is that a bottom-up investigation will achieve focused and constructive results that will help raise the effectiveness and outcomes of content usage within the social causes targeted.
Initially the team have implemented their ideas in two social projects involving education and the digital divide.
The education project is targeted at gaining answers to the many and critical questions that surround the introduction of technology to early learners (ages 2 to 8) plus answering similar questions regarding the introduction of digital content for the teaching of English as a second language. This, more advanced project, is based around an Internet site http://www.kindersite.org that offers educators and parents of small children a free resource of 1,000s of links to content in the form of games, songs and stories. The content is being graded according to educational and appropriateness parameters.
This project is currently being used globally with 152 officially participating schools in 27 countries plus registrations from about 80 countries.
The second project utilizes an adaptation of the existing technology and focuses on the Content Digital Divide. This project will study how the effectiveness of introducing technology (computers and the Internet) to digitally divided communities can be improved. The project looks at the introduction to technology from a content perspective and will attempt to ensure that the recipients of the new technology are made fully aware from the first exposure, of the personal and community benefits of technology.
The commissioning of content or adaptation will be completed on a local level with the additional purpose of stimulating growth in locally-based content providers.
This proposal has gained the support of potential implementing partners in a number of developing countries including, Sierra Leone, Uganda, Nigeria, Cameroon, Kazakhstan, India etc.
We are now looking to gain corporate and governmental support to help implement these projects on the scale we envisage and be very interested in the comments, sponsorship or practical help of your readership.
Joel H. Josephson, Founder and Executive Director
Kindersite Project
http://www.kindersite.org
Email : joel_josephson@kindersite.org
IOSONO
Authors: Lee Newton 
Published: August 2005

IOSONO breakthrough spatial audio technology for the projection of recorded or amplified sound. IOSONO has the potential to revolutionize the way motion pictures, themed attractions, and live events are experienced. For the first time ever all areas of a listening area can be filled with completely natural, realistic three-dimensional sound. IOSONO innovation is that it recreates natural sound waves while traditional audio systems merely amplify sound.
IOSONO is based on the principle that sound waves can be reproduced using secondary sources at the perimeter of the original sound field. The result of over 15 years of research and development, this process is called Wave Field Synthesis (WFS). Speaker arrays ring the listening space and operate in a coordinated, phased fashion to re-create each individual sound wave.
For example, a helicopter can slowly approach the audience, fly through the middle of the theatre, and disappear off into the distance. The audience hears the sound waves the helicopter would generate if it were actually flying this path.
The Third International Conference on Active Media Technology
Authors: Lee Newton 
Published: August 2005

In the great digital era, we are witnessing many rapid scientific and technological developments in human-centered, seamless computing environments, interfaces, devices, and systems with applications ranging from business and communication to entertainment and learning. These developments are collectively best characterized as Active Media Technology (AMT), a new area of information technology and computer science that emphasizes the proactive, seamless roles of interfaces and systems as well as new media in all aspects of digital life.
The first international conference on Active Media Technology (AMT01) was held in Hong Kong in 2001, and the second International Conference on Active Media Technology (AMT03) was held in Chongqing of China in May 29-31 of 2004. Following the success of AMT01 and AMT03, the third International Conference on Active Media Technology (AMT05) will be held in Kagawa, Japan in 2005.
A One-Dimensional Mixed Layer Ocean Model for Use in Three-Dimensional Climate Simulations: Control Simulation Compared to Observations
Authors: Stephens Monica Y. , Oglesby Robert J. , Maxey Martin 
Published: August 2005

Abstract
A study has been made of the dynamic interactions between the surface layer of the ocean and the atmosphere using a climate model that contains a new approach to predicting the sea surface temperature (SST). The atmospheric conditions are simulated numerically with the NCAR Community Climate Model (CCM3). The SST is determined by a modified Kraus–Turner-type one-dimensional mixed layer ocean model (MLOM) for the upper ocean that has been coupled to CCM3. The MLOM simulates vertical ocean dynamics and demonstrates the effects of the seasonal variation of mixed layer depth and convective instability on the SST. A purely thermodynamic slab ocean model (SOM) is currently available for use with CCM3 to predict the SST. A large-scale ocean general circulation model (OGCM) may also be coupled to CCM3; however, the OGCM is computationally intensive and is therefore not a good tool for conducting multiple sensitivity studies. The MLOM provides an alternative to the SOM that contains seasonally and spatially specified mixed layer depths. The SOM also contains a heat flux correction called Q-flux that crudely accounts for ocean heat transport by artificially specifying a heat flux that forces the SOM to replicate the observed SST. The results of the coupled MLOM–CCM3 reveal that the MLOM may be used on a global scale and can therefore replace the standard coupled SOM–CCM3 that contains no explicit ocean dynamics. Additionally, stand-alone experiments of the MLOM that are forced with realistic winds, heat, and moisture fluxes show that the MLOM closely approximates the observed seasonal cycle of SST.