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A good assessment associated with healthcare certification agencies and applications: parallels, variances, problems as well as chances.
with EGFR and ALK TKIs.
Continuous spike and wave in slow-wave sleep (CSWS), an epileptic encephalopathy, occurs after perinatal stroke where it is associated with cognitive decline. CSWS features a distinct EEG pattern, electrical status epilepticus in sleep (ESES). Biomarkers for the prediction of ESES have not been identified but will facilitate earlier diagnosis and treatment. see more We hypothesized that spike-frequency and differences in power spectra would be predictive of subsequent ESES.

A cross-sectional study comparing EEG spike-frequency and Power before the development of ESES in patients with perinatal stroke, patients with focal epilepsy, and appropriate controls.

43 patients met the inclusion criteria; 11 stroke-ESES, 10 stroke controls, 14 epilepsy-ESES, 8 epilepsy controls. ESES patients had higher pre-diagnosis mean spike-frequency (24.0±24 versus 6.6±9.1 SW/min, p=0.002) than patients that did not develop ESES; these differences present~3years before ESES diagnosis. Pre-diagnosis, normalized delta power (1-4Hz) was higher in the stroke-ESES group (105.7±58dB/Hz) compared to stroke controls (57.4±45dB/Hz, p=0.036).

Spike-frequency and delta power may represent EEG biomarkers of the risk of developing ESES in children with perinatal stroke.

EEG biomarkers may be used by clinicians to assess which patients are more at-risk for ESES. Using spike-frequency, clinicians may be able to identify patients at risk of developing ESES.
EEG biomarkers may be used by clinicians to assess which patients are more at-risk for ESES. Using spike-frequency, clinicians may be able to identify patients at risk of developing ESES.
To evaluate the accuracy of actigraphy against polysomnography (PSG) as gold standard using a newly developed algorithm for sleep/wake discrimination that explicitly models the temporal structure of sleep.

PSG was recorded in 11 men and 9 women (age 71.1±5.0) to evaluate suspected neuropsychiatric sleep disturbances. Simultaneously, wrist actigraphy was recorded, from which 37 features were computed for each 1-min epoch. We compared prediction of PSG-derived sleep/wake states for each of these features between our newly developed algorithm, and four state-of-the-art algorithms. The algorithms were evaluated using a leave-one-subject out cross validation.

The new algorithm classified 84.9% of sleep epochs (sensitivity) and 74.2% of wake epochs correctly (specificity), leading to a sleep/wake scoring accuracy of 79.0%. Four out of five sleep parameters were estimated more accurately by the new algorithm than by state-of-the-art algorithms.

The proposed algorithm achieved a significantly higher specificity than state-of-the-art algorithm, with only minor decrease in sensitivity for patients with sleep disorders. We assume this reflects the capability of the algorithm to explicitly model sleep architecture.

The unobtrusive assessment of sleep/wake cycles is particularly relevant for patients with neuropsychiatric diseases that are associated with sleep disturbances, such as depression or dementia.
The unobtrusive assessment of sleep/wake cycles is particularly relevant for patients with neuropsychiatric diseases that are associated with sleep disturbances, such as depression or dementia.
Encephalopathy with Status Epilepticus during slow Sleep (ESES) is a syndrome where neurocognitive impairment correlates with multifocal Electroencephalography (EEG) spikes increasing abruptly at sleep onset. Demonstration of a focal onset could provide important clues to unravel the mechanisms underlying the condition, but until know it has not been established.

We studied epileptic dynamics at sleep onset to assess its focal or diffuse features in five patients with perinatal thalamic hemorrhages lateralized to one hemisphere, using high resolution EEG.

Dynamical functional connectivity revealed the information flow in the epileptic network and identified primary sources of outflow, equated with cortical spike sources. We found that spikes with important activation originate in restricted cortical areas of the hemisphere with the lesion, spreading widely and quickly at onset of N2 sleep stage.

Perinatal thalamic lesions have the potential to induce, years later, a regional onset of epileptic activity with features of ESES in a cortex without apparent structural lesion. Most widespread spike activity in the scalp results from secondary propagation.

Perinatal thalamic lesions produce ESES with focal onset in a restricted cortical area of the hemisphere with the lesion, and prominent secondary propagation.
Perinatal thalamic lesions produce ESES with focal onset in a restricted cortical area of the hemisphere with the lesion, and prominent secondary propagation.
Anti-inflammatory and anti-oxidants activities of Ferula szowitsiana L. (F. szowitsiana) were shown in ancient texts and assayed by modern studies. However, immunomodulatory properties of the plant are poorly understood.

The effects of F. szowitsiana extract (10, 40 and 160µg/ml), dexamethasone and vehicle were investigated on nitric oxide (NO) level, cell proliferation, and cytokines (IL-4, IL10 and IFN-γ) expression at gene and protein levels in non-stimulated and phytohaemagglutinin-stimulated human lymphocytes (n=15 in each group).

Cell proliferation, cytokines secretion, NO production and levels of genes expression were significantly inhibited but IFN-γ/IL-4 and IL-10/IL-4 ratios (T helper 1/Th2 and Treg/Th2 balances respectively) were increased by dexamethasone and all three concentrations of the extract compared to control group in stimulated lymphocytes (P<0.001 for all cases). The effect of three concentrations of the extract in all experiments was significantly lower than dexamethasone (P<0.001 for all cases).

The extract of F. link2 szowitsiana concentration-dependently decreased NO level but increased Th
/Th
and T
/Th
ratios toward Th
and T
. These results suggest the therapeutic potential of the plant's extract in inflammatory diseases with dominant Th2 polarization such as asthma or cancers.
The extract of F. szowitsiana concentration-dependently decreased NO level but increased Th1/Th2 and Treg/Th2 ratios toward Th1 and Treg. link3 These results suggest the therapeutic potential of the plant's extract in inflammatory diseases with dominant Th2 polarization such as asthma or cancers.Neuroblastoma is the second most common pediatric cancer involving the peripheral nervous system in which stage IVS metastatic tumors regress due to spontaneous differentiation. 13-cis retinoic acid (13-cis RA) is currently used in the clinic for its differentiation effects and although it improves outcomes, relapse is seen in half of high-risk patients. Combinatorial therapies have been shown to be more effective in oncotherapy and since cathepsin inhibition reduces tumor growth, we explored the potential of coupling 13-cis RA with a cathepsin inhibitor (K777) to enhance therapeutic efficacy against neuroblastoma. Shotgun proteomics was used to identify proteins affected by K777 and dual (13-cis RA/K777) treatment in neuroblastoma SK-N-SH cells. Cathepsin inhibition was more effective in increasing proteins involved in neuronal differentiation and neurite outgrowth than 13-cis RA alone, but the combination of both treatments enhanced the neuronal differentiation effect. SIGNIFICANCE As neuroblastoma can spontaneously differentiate, determining which proteins are involved in differentiation can guide development of more accurate diagnostic markers and more effective treatments. In this study, we established a differentiation proteomic map of SK-N-SH cells treated with a cathepsin inhibitor (K777) and K777/13-cis RA (dual). Bioinformatic analysis revealed these treatments enhanced neuronal differentiation and axonogenesis pathways. The most affected proteins in these pathways may become valuable biomarkers of efficacy of drugs designed to enhance differentiation of neuroblastoma [1].
To assess the relationship between generalized convulsive status epilepticus (GCSE) during an index stroke hospitalization and occurrence of 30-day hospital readmission.

Retrospective analysis of data within the 2014 National Readmission Database, a national dataset tracking readmissions in the United States. We identified patients with an index discharge diagnosis of stroke using the International Classification of Disease, Ninth Revision, Clinical Modification (433.X1, 434.X1, and 436 for ischemic stroke and 430, 431, 432.0, 432.1, and 432.9 for hemorrhagic stroke) and a subset of patients with GCSE (345.3). We explored the association between GCSE and 30-day readmission using multivariable logistic regression, while applying recommended survey weights.

Of 271,148 adults with a primary diagnosis of stroke hospitalizations in the US in 2014, 591 (0.21%) had GCSE. The prevalence of GCSE was 0.14% among ischemic stroke patients and 0.64% among hemorrhagic stroke patients. Readmission rates were 11.9% for all strokes, 11.6% for ischemic strokes, and 14.2% for hemorrhagic strokes. Readmission rates were significantly higher for those with GCSE vs. without GCSE regardless of stroke type. Adjusted odds ratios for the association of GCSE with 30-day readmission were 1.30 (95% CI 1.02-1.65) for all strokes, 1.19 (95% CI 0.84-1.71) for ischemic strokes, and 1.39 (95% CI 0.92-2.10 0.09) for hemorrhagic stroke.

Approximately one in eight hospitalized stroke patients who experience in-hospital GCSE are re-admitted to a hospital within 30days with a nominally higher rate of readmissions among those with hemorrhagic stroke.
Approximately one in eight hospitalized stroke patients who experience in-hospital GCSE are re-admitted to a hospital within 30 days with a nominally higher rate of readmissions among those with hemorrhagic stroke.
Idiopathic normal pressure hydrocephalus (iNPH) presents typical radiological signs that have been summarised in a semi-quantitative scale named the iNPH Radscale. However, the iNPH Radscale's predictive value for response to cerebrospinal fluid (CSF) tap test has never been studied. This study aims to investigate if the iNPH Radscale can predict locomotion improvement after CSF tap test.

A total of 100 patients with iNPH (age 76.3±7.9, gender 36% female) were included in this retrospective study. Two raters, blinded to the response of the CSF tap test, evaluated the iNPH Radscale and its seven subitems (Evan's index, callosal angle, size of temporal horns, narrow high-convexity sulci, dilated Sylvian fissures, focally dilated sulci, and periventricular hypodensities). Locomotion improvement was assessed by the Timed Up and Go (TUG) performed before, and 24h after, the CSF tap test.

The iNPH Radscale (total score) was similar between the CSF tap test responders and non-responders (responders 8.31±1.96, non-responders 9.18±2.51, p=0.128). However, the temporal horns score was smaller in the responders group (1.66±0.57 versus 1.94±0.24, p=0.045), even after adjusting for age, gender, education level, white matter changes, and global cognition (β -0.250, C.I. 95% [-3.185; -0.161], p=0.031).

The iNPH Radscale (total score) does not predict locomotion improvement after CSF tap test, while a smaller temporal horns score at baseline is associated with a positive tap test responder status.
The iNPH Radscale (total score) does not predict locomotion improvement after CSF tap test, while a smaller temporal horns score at baseline is associated with a positive tap test responder status.
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