•There is an increase in online search behavior on autoimmune encephalitis over time.•There is an increasing tendency to search online for autoimmune seizures over time.•There is an increase in ...online search interest for autoimmune epilepsy over time.•The uptrend in search volumes may reflect increased awareness of these conditions.•Online search behavior may be explored using search volumes from Google Trends.
Patients and their caregivers, including clinicians and educators, use web-based search engines to access healthcare-related information from the internet. Online search behavior analysis has been used to obtain insights on health information demand.
We aimed to describe the online search behavior for autoimmune encephalitis, autoimmune seizures, and autoimmune encephalitis (AE) worldwide over time through the analysis of search volumes made on Google.
In this infodemiological study, we retrieved search volume indices for the keyword “autoimmune encephalitis (search term)”, “autoimmune seizures (search term)”, and “autoimmune encephalitis (search term)” based on worldwide search data from January 01, 2004 to October 31, 2021, using Google Trends. We performed a descriptive analysis of search volume patterns, including related topics and queries.
There was a progressive increase in search volume numbers over time for the keyword “autoimmune encephalitis”, “autoimmune seizures”, and “autoimmune epilepsy” with no annual seasonal variation. Peak search volumes for these keywords were recorded in July 2018, February 2005, December 2012, respectively. The greatest search volume for “autoimmune encephalitis” was recorded in Singapore, followed by Australia, the United States of America, the Philippines, and New Zealand, whereas it was highest in the United States for “autoimmune seizures” and “autoimmune epilepsy”. The most searched topics were related to definition, causes, symptoms, diagnosis, and treatment. All related topics and queries increased in volume by more than 5000-fold over time.
This study showed an uptrend in the online search interest on autoimmune encephalitis, autoimmune seizures, and autoimmune epilepsy over time, which may reflect the increased awareness of the condition by the public and the medical community. Information on online health information-seeking behavior may be obtained from Google Trends data despite its limitations.
Status epilepticus (SE) is an emergent neurologic condition that carries a high risk of morbidity and mortality. Intravenous brivaracetam (IV BRV) may be an alternative anticonvulsant against status ...epilepticus, although the sparseness of controlled studies on the topic limits its recommendation for this indication.
This systematic review aimed to determine the efficacy and safety of IV BRV in the treatment of status epilepticus.
A comprehensive literature search was conducted until December 2019 through several electronic databases (PubMed, Google Scholar, Scopus, OpenGrey, ScienceDirect, HERDIN, Epistemonikos, CENTRAL, ClinicalTrials.gov) to identify relevant studies. Studies that involved adult patients with SE who were given IV BRV were considered for inclusion in this review.
From a total of 34 studies identified, 5 uncontrolled studies with 77 patients were included in this review. Thirty-seven out of 77 patients (48%) with SE responded to IV BRV. Reported time to seizure cessation may be immediate from a few minutes to several hours after IV BRV treatment. Patients manifested with significant disability on Glasgow outcome scale (Median: 3) and modified Rankin scale (Mode: 5). Six patients somnolence (5), worsening seizures (1) had treatment emergent adverse events.
Limited evidence from 5 uncontrolled studies involving a limited number of patients suggests that IV BRV may be efficacious and safe in terminating seizures among patients with SE or refractory SE. Further studies employing either prospective, controlled trials or registry-based study designs are essential to determine the definitive role of IV BRV in patients with SE.
•Intravenous brivaracetam (IV BRV) is an emerging drug used for status epilepticus (SE).•Five uncontrolled studies with 77 patients were included in this review.•37 out of 77 patients (48%) with SE responded to IV BRV.•Few patients reported adverse events (somnolence and worsening seizures).•Limited evidence suggests that IV BRV may be efficacious and safe for SE.
Epilepsy is a neurologic disease that carries a high disease burden and likely, a huge treatment gap especially in low-to-middle income countries (LMIC) such as the Philippines. This review aimed to ...examine the treatment gaps and challenges that burden Philippine epilepsy care.
Pertinent data on epidemiology, research, health financing and health systems, pharmacologic and surgical treatment options, cost of care, and workforce were obtained through a literature search and review of relevant Philippine government websites.
The estimated prevalence of epilepsy in the Philippines is 0.9%. Epilepsy research in the Philippines is low in quantity compared with the rest of Southeast Asia (SEA). Inequities in quality and quantity of healthcare services delivered to local government units (LGUs) have arisen because of devolution. Programs for epilepsy care by both government and nongovernment institutions have been implemented. Healthcare expenditure in the Philippines is still largely out-of-pocket, with only partial coverage from the public sector. There is limited access to antiseizure medications (ASMs), mainly due to cost. Epilepsy surgery is an underutilized treatment option. There are only 20 epileptologists in the Philippines, with one epileptologist for every 45,000 patients with epilepsy. In addition, epilepsy care service delivery has been further impeded by the coronavirus disease of 2019 (COVID-19) pandemic.
There is a large treatment gap in epilepsy care in the Philippines in terms of high epilepsy disease burden, socioeconomic limitations and inadequate public support, sparse clinico-epidemiologic research on epilepsy, inaccessibility of health care services and essential pharmacotherapy, underutilization of surgical options, and lack of specialists capable of rendering epilepsy care. Acknowledgment of the existence of these treatment gaps and addressing such are expected to improve the overall survival and quality of life of patients with epilepsy in the Philippines.
•A high disease burden, socioeconomic limitations and healthcare inaccessibility hampers Philippine epilepsy care.•The out-of-pocket healthcare services increases the financial burden on persons with epilepsy.•The high cost, restricted prescription and lack of neurologists limit the accessibility to antiseizure medications.•Epilepsy surgery is an underutilized option for Filipino patients with drug-resistant epilepsy.•The coronavirus disease 2019 pandemic has further hampered the delivery of epilepsy care services in the Philippines.
This study investigated a double loop network operated with ultra-low supply/return temperatures of 45/25 °C as a novel solution for low heat-density areas in Denmark and compared the proposed ...concept with a typical tree network and with individual heat pumps to each end-users rather than district networks. It is a pump-driven system, where the separate circulation of supply and return flow increased the flexibility of the system to integrate and displace heating and cooling energy along the network. Despite the increased use of central and local water pumps to operate and control the system, the simulated overall pump energy consumption was 0.9% of the total energy consumption. This was also an advantage at the design stage as the larger pressure gradient, up to 570 Pa/m, allowed minimal pipe diameters. In addition, the authors proposed the installation of electrically heated vacuum-insulated micro tanks of 10 L on the primary side of each building substation as a supplementary heating solution to meet the comfort and hygiene requirements for domestic hot water (DHW). This, combined with supply water circulation in the loop network, served as a technical solution to remove the need for bypass valves during summer periods with no load in the network. The proposed double loop system reduced distribution heat losses from 19% to 12% of the total energy consumption and decreased average return temperatures from 33 °C to 23 °C compared to the tree network. While excess heat recovery can be limited due to hydraulic issues in tree networks, the study investigated the double loop concept for scenarios with heat source temperatures of 30 °C and 45 °C. The double loop network was cost-competitive when considering the required capital and operating costs. Furthermore, district networks outperformed individual heat pump solutions for low-heat density areas when waste heat was available locally. Finally, although few in Denmark envisage residential cooling as a priority, this study investigated the potential of embedding heating and cooling in the same infrastructure. It found that the return line could deliver cold water to the end-users and that the maximum cooling power was 1.4 kW to each end-user, which corresponded to 47% of the total peak heat demand used to dimension the double loop network.
This review essay examines the Museum of Modern and Contemporary Art, Korea’s (MMCA) 2017–2018 exhibition on the “New Woman” (Sin yŏsŏng) and its contradictory celebration and critique of the ...multifaceted modern woman whose consumerist as well as anti-patriarchal qualities allow for mixed and often contradictory interpretations and political trajectories. Through close readings of paintings, video installations, and other works on display pertaining to the topics of objectification, commodity fetishism, and the division of labor, this essay parses the various representations of Korea’s new woman as well as her legacy in the present. The reviewer suggests that the tension between the different characteristics of the modern woman speaks to a wider ambivalence in the collective historical memory of the Japanese colonial period (1910–1945) in contemporary South Korea, which simultaneously embraces two contradictory positions: repudiation of the Japanese colonial project on the one hand and recuperation of the capitalist development initiated by colonization on the other. KCI Citation Count: 0
Background
Frequent idiopathic premature ventricular contractions (PVCs) have been associated with left ventricular cardiomyopathy. Idiopathic PVCs often originate from the right ventricular outflow ...tract (RVOT), and radiofrequency catheter ablation (RFCA) is being used as a treatment to alleviate symptoms. A meta‐analysis was performed to evaluate RFCA for the treatment of frequent idiopathic PVCs on heart function.
Methods and Results
A literature search was conducted using Medline and Embase to identify studies evaluating the effects of RFCA as treatment for PVCs originating from the RVOT. Articles were chosen if they reported the effect of RFCA on the quantity of PVCs or ventricular function. Only studies in English were included. Articles were excluded if they did not separate results for PVCs originating from areas other than the RVOT. A total of 450 articles were retrieved from electronic searches, and 14 articles were included in this systematic review. Six of these were meta‐analyzed (N = 70) and showed a reduction in the total number of PVCs in 24 hours after RFCA by a mean of –30089.44 confidence interval CI: –31658.47, –28520.40, P < 0.00001). Left ventricular ejection fraction (LVEF) was reported in five of the 14 studies, which included 108 patients. RFCA significantly improved LVEF by a mean of 10.36 (CI: 8.75, 11.97, P < 0.00001) in patients with frequent PVCs from the RVOT. The remaining studies reported their results differently and were not included in the meta‐analyses but were described separately.
Conclusions
RFCA reduces the number of PVCs and improves the cardiac function in patients with idiopathic frequent PVCs originating from the RVOT.
Citizen science approaches provide adaptable methodologies for enhancing the natural history knowledge of understudied taxa and engaging underserved populations with biodiversity. However, ...transitions to remote, virtual training, and participant recruitment in response to public health crises like the SARS‐CoV‐2 pandemic have the potential to disrupt citizen science projects. We present a comparison of outputs from a citizen science initiative built around call surveys for the Mountain Chorus Frog (Pseudacris brachyphona), an understudied anuran, in Appalachian Virginia, USA, prior to and during the SARS‐CoV‐2 pandemic. A transition to virtual training in this initiative did not lead to a decrease in scientific output and led to unexpected natural history insight about our focal taxon; however, a reliance on virtual instruction did decrease overall participation by local residents, particularly for rural K‐12 students. We discuss the trade‐offs exhibited by the adaptation of our initiative to a virtual format and provide recommendations for other citizen science initiatives facing similar restrictions in the face of current and future public health crises.
Citizen science approaches provide adaptable methodologies for enhancing the natural history knowledge of understudied taxa and engaging underserved populations with biodiversity. However, transitions to remote, virtual training, and participant recruitment in response to public health crises like the SARS‐CoV‐2 pandemic have the potential to disrupt citizen science projects. We present a comparison of outputs from a citizen science initiative built around call surveys for the Mountain Chorus Frog (Pseudacris brachyphona), an understudied anuran, in Appalachian Virginia, USA, prior to and during the SARS‐CoV‐2 pandemic.
In glacierized fjords, the ice‐ocean boundary is a physically and biologically dynamic environment that is sensitive to both glacier flow and ocean circulation. Ocean ambient noise offers insight ...into processes and change at the ice‐ocean boundary. Here we characterize fjord ambient noise and show that the average noise levels are louder than nearly all measured natural oceanic environments (significantly louder than sea ice and nonglacierized fjords). Icy Bay, Alaska, has an annual average sound pressure level of 120 dB (referenced to 1 μPa) with a broad peak between 1000 and 3000 Hz. Bubble formation in the water column as glacier ice melts is the noise source, with variability driven by fjord circulation patterns. Measurements from two additional fjords, in Alaska and Antarctica, support that this unusually loud ambient noise in Icy Bay is representative of glacierized fjords. These high noise levels likely alter the behavior of marine mammals.
Key Points
Glacierized fjords are the loudest measured ambient noise oceanic environment
The noise source is production of bubbles in water by melting of glacier ice
These high noise levels may alter the behavior of marine mammals
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