Written by two of Europe's leading robotics experts, this book provides the tools for a unified approach to the modelling of robotic manipulators, whatever their mechanical structure. No other ...publication covers the three fundamental issues of robotics: modelling, identification and control. It covers the development of various mathematical models required for the control and simulation of robots.
· World class authority· Unique range of coverage not available in any other book· Provides a complete course on robotic control at an undergraduate and graduate level
Objective
This study was undertaken to ascertain the natural history and patterns of antiseizure medication (ASM) use in newly diagnosed focal epilepsy patients who were initially started on ...monotherapy.
Methods
The data were derived from the Human Epilepsy Project. Differences between the durations of the most commonly first prescribed ASM monotherapies were assessed using a Cox proportional hazards model. Subjects were classified into three groups: monotherapy, sequential monotherapy, and polytherapy.
Results
A total of 443 patients were included in the analysis, with a median age of 32 years (interquartile range IQR = 20–44) and median follow‐up time of 3.2 years (IQR = 2.4–4.2); 161 (36.3%) patients remained on monotherapy with their initially prescribed ASM at the time of their last follow‐up. The mean (SEM) and median (IQR) duration that patients stayed on monotherapy with their initial ASM was 2.1 (2.0–2.2) and 1.9 (.3–3.5) years, respectively. The most commonly prescribed initial ASM was levetiracetam (254, 57.3%), followed by lamotrigine (77, 17.4%), oxcarbazepine (38, 8.6%), and carbamazepine (24, 5.4%). Among those who did not remain on the initial monotherapy, 167 (59.2%) transitioned to another ASM as monotherapy (sequential monotherapy) and 115 (40.8%) ended up on polytherapy. Patients remained significantly longer on lamotrigine (mean = 2.8 years, median = 3.1 years) compared to levetiracetam (mean = 2.0 years, median = 1.5 years) as a first prescribed medication (hazard ratio = 1.5, 95% confidence interval = 1.0–2.2). As the study progressed, the proportion of patients on lamotrigine, carbamazepine, and oxcarbazepine as well as other sodium channel agents increased from a little more than one third (154, 34.8%) of patients to more than two thirds (303, 68.4%) of patients.
Significance
Slightly more than one third of focal epilepsy patients remain on monotherapy with their first prescribed ASM. Approximately three in five patients transition to monotherapy with another ASM, whereas approximately two in five end up on polytherapy. Patients remain on lamotrigine for a longer duration compared to levetiracetam when it is prescribed as the initial monotherapy.
In this work, functionalized reduced graphene oxide–silver (FrGO–Ag) nanocomposite was synthesized to enhance the antimicrobial activity and biocompatibility of FrGO for infected wound burn ...treatment. The reduction of GO and FGO was confirmed by the removal of some of the oxygen functional groups (carbonyl and epoxy groups) as revealed by Fourier transform infrared (FTIR) spectra. The face-centered cubic (fcc) silver nanoparticles were identified by X-ray diffraction (XRD). The contact time effect and the dose effect of the antimicrobial activity of rGO, FrGO, and FrGO-Ag nanocomposite toward
Staphylococcus aureus
,
Pseudomonas aeruginosa
and
Candida albicans
have been investigated. The cytotoxicity results of these compounds revealed that the functionalization by PVP and the decoration by AgNPs improved the biocompatibility of rGO sheets from 35.2 to 88% cell viability against the BJ1 normal human epithelial cell line.
Graphical Abstract
Objective. The postictal state after bilateral tonic‐clonic seizures is often prolonged and can have significant impact on a patient's quality of life. Considerable variability exists in the ...magnitude of postictal agitation and in the speed of recovery, the determinants of which are not well understood. We studied postictal behavior after tonic‐clonic seizures in various epilepsy localizations, focusing on postictal agitation and time to responsiveness.
Methods. We retrospectively identified 15 adult patients each with idiopathic generalized, left temporal lobe, right temporal lobe and frontal lobe epilepsy. Localization in focal epilepsy was validated by good outcome after resective surgery at one‐year of follow‐up. The first tonic‐clonic seizure with reliable video and EEG for each patient was analyzed by two reviewers, one of whom was blinded to clinical data. Clinical, ictal and postictal variables were collected for each patient and analyzed. Postictal agitation was classified as mild and marked.
Results. We reviewed 60 tonic‐clonic seizures, 15 in each of four patient groups. Postictal agitation was observed in 14 patients (23.3%; marked in one and mild in 13). Postictal agitation was most common in patients with left temporal (seven patients) and least common in idiopathic generalized epilepsy (one patient) groups (p=0.035). Based on subgroup analysis (n=28), time to responsiveness was 6.6 minutes for frontal, 7.2 minutes for generalized, 10 minutes for right temporal and 15.7 minutes for the left temporal groups (p<0.05 for frontal vs. left temporal, generalized vs. left temporal). Time to responsiveness was longer in patients with agitation than without (13.9 minutes vs. 7.7 minutes; p=0.048). Patient ictal and postictal characteristics demonstrated no relationship to agitation or latency to postictal recovery.
Significance. To mitigate harm, patients must be monitored carefully after tonic‐clonic seizures, especially patients with left temporal lobe epilepsy. Studies evaluating medical and behavioral interventions to promote postictal recovery are needed.
To evaluate the efficacy and safety of ezogabine (United States adopted name)/retigabine (international nonproprietary name) (EZGRTG) 1,200 mg/day as adjunctive treatment in adults with ...drug-resistant epilepsy with partial-onset seizures with or without secondary generalization.
RESTORE 1 was a multicenter, randomized, double-blind, parallel-group trial. Following a prospective 8-week baseline phase, patients entered an 18-week double-blind treatment period (6-week forced dose titration to EZGRTG 1,200 mg/day in 3 equally divided doses or placebo, followed by a 12-week maintenance phase). Results were analyzed on an intent-to-treat basis for the entire 18-week period and for patients reaching the maintenance phase.
In 306 patients randomized, 305 received EZG(RTG) 1,200 mg/day (n = 153) or placebo (n = 152). Median percent reduction in total partial-seizure frequency was 44.3% vs 17.5% (p < 0.001) for EZG(RTG) and placebo, respectively, during the 18-week double-blind period; responder rates (≥50% reduction in total partial-seizure frequency from baseline) were 44.4% vs 17.8% (p < 0.001). In 256 patients (EZGRTG, 119; placebo, 137) entering the 12-week maintenance phase, median percent reduction in seizure frequency for EZG(RTG) vs placebo was 54.5% and 18.9% (p < 0.001), respectively; responder rates were 55.5% vs 22.6% (p < 0.001). The proportion of patients discontinuing due to treatment-emergent adverse events (TEAEs) was 26.8% (EZGRTG) vs 8.6% (placebo). Dizziness, somnolence, fatigue, confusion, dysarthria, urinary tract infection, ataxia, and blurred vision were the most common TEAEs reported by more patients treated with EZG(RTG) than placebo.
This study demonstrates that EZG(RTG) is effective as add-on therapy for reducing seizure frequency in patients with drug-resistant partial-onset seizures.
This study provides Class II evidence that EZG(RTG) 1,200 mg/day is effective as adjunctive therapy in adults with partial-onset seizures with or without secondary generalization.
Background
Neurohydatidosis is a rare zoonotic disease in nonendemic areas and a differential diagnosis of intracerebral cysts workup. Appropriate imaging modalities with serology are required for ...proper diagnosis. The gold standard surgical intervention is the Dowling-Orlando technique.
Method
We provide a detailed description, with key surgical steps, for total excision of hydatid cysts with intact capsules by hydrodissection. We also describe the relevant surgical anatomy, with indications, limitations, and possible complications.
Conclusion
Hydrodissection allows safe resection of hydatid cysts without further damage to the surrounding parenchyma and reduces the risk of cystic wall rupture.
Summary
Objective
Currently, approximately 60–70% of patients with unilateral temporal lobe epilepsy (TLE) remain seizure‐free 3 years after surgery. The goal of this work was to develop a ...presurgical connectivity‐based biomarker to identify those patients who will have an unfavorable seizure outcome 1‐year postsurgery.
Methods
Resting‐state functional and diffusion‐weighted 3T magnetic resonance imaging (MRI) was acquired from 22 unilateral (15 right, 7 left) patients with TLE and 35 healthy controls. A seizure propagation network was identified including ipsilateral (to seizure focus) and contralateral hippocampus, thalamus, and insula, with bilateral midcingulate and precuneus. Between each pair of regions, functional connectivity based on correlations of low frequency functional MRI signals, and structural connectivity based on streamline density of diffusion MRI data were computed and transformed to metrics related to healthy controls of the same age.
Results
A consistent connectivity pattern representing the network expected in patients with seizure‐free outcome was identified using eight patients who were seizure‐free at 1‐year postsurgery. The hypothesis that increased similarity to the model would be associated with better seizure outcome was tested in 14 other patients (Engel class IA, seizure‐free: n = 5; Engel class IB‐II, favorable: n = 4; Engel class III–IV, unfavorable: n = 5) using two similarity metrics: Pearson correlation and Euclidean distance. The seizure‐free connectivity model successfully separated all the patients with unfavorable outcome from the seizure‐free and favorable outcome patients (p = 0.0005, two‐tailed Fisher's exact test) through the combination of the two similarity metrics with 100% accuracy. No other clinical and demographic predictors were successful in this regard.
Significance
This work introduces a methodologic framework to assess individual patients, and demonstrates the ability to use network connectivity as a potential clinical tool for epilepsy surgery outcome prediction after more comprehensive validation.
Nanotoxicology test of gold nanoparticles (Au NPs) and gold-cobalt (Au-Co) nanoalloy is an important step in their safety evaluation for biomedical applications. The Au and Au-Co NPs were prepared by ...reducing the metal ions using sodium borohydride (NaBH(4)) in the presence of polyvinyl pyrrolidone (PVP) as a capping material. The average size and shape of the nanoparticles (NPs) were characterized using high resolution transmission electron microscopy (HRTEM). Cobalt presence in the nanoalloy was confirmed by energy dispersive X-ray spectroscopy (EDX) analysis, and the magnetic properties of these particles were determined using a vibrating sample magnetometer (VSM). The Gold and gold-cobalt NPs of average size 15 ± 1.5 nm were administered orally to mice with a dose of 80, 160, and 320 mg/kg per body weight (bw) using gavages. Samples were collected after 7 and 14 days of the treatment. The results indicated that the Au-Co NPs were able to induce significant alteration in the tumor-initiating genes associated with an increase of micronuclei (MNs) formation and generation of DNA adduct (8-hydroxy-2-deoxyguanosine, 8-OHdG) as well as a reduction in the glutathione peroxidase activity. This action of Au-Co NPs was observed using 160 and 320 mg/kg bw at both time intervals. However, Au NPs had much lower effects than Au-Co NPs on alteration in the tumor-initiating genes, frequency of MNs, and generation of 8-OHdG as well as glutathione peroxidase activity except with the highest dose of Au NPs. This study suggests that the potential to cause in vivo genetic and antioxidant enzyme alterations due to the treatment by Au-Co nanoalloy may be attributed to the increase in oxidative stress in mice.
The objective of this research is to study the influence of using waste material (irregular plastic mix) on and properties and behavior of concrete. Various coarse plastic aggregate of 15, 25 and 45 ...% as replacement to coarse natural aggregate by volume were carried out. The experimental program consists of many tests, compressive strength, splitting tensile strength, flexural strength, thermal conductivity, absorption of water and density. The results demonstrate that the increase of plastic waste content decreases the compressive strength; while the workability slightly improves. The dry density of the concrete decreases with the increase of the plastic waste aggregate, satisfied structural lightweight concrete can be produced with 45% replacement of plastic waste aggregate. Also, a major improvement in the thermal conductivity was observed, while the absorption of water growths as the plastic waste content increased.
Purpose: Sudden unexpected death in epilepsy (SUDEP) is a major cause of mortality for patients with epilepsy. Cardiac factors may be involved and were evaluated in this study.
Methods: EEG and ECG ...data for 21 patients with definite (n = 6) or probable (n = 15) SUDEP were compared with data from a group of 43 patients with refractory partial epilepsy. ECG abnormalities and heart rate (HR) changes were correlated with clinical data.
Results: Fourteen patients died in their sleep; two were awake. Ictal maximal HR (90 seizures from 16 of 21 patients) was significantly higher in SUDEP (mean, 149 beats/min, BPM) than in comparison patients (mean, 126 BPM; p < 0.001). Greater increases in HR were associated with seizures arising from sleep (78 BPM increase) than from wakefulness (47 BPM; p < 0.001) in SUDEP, as compared with the non‐SUDEP group (52 BPM in sleep, 43 BPM in wakefulness; p = 0.27). Ictal cardiac repolarization and rhythm abnormalities occurred in 56% of SUDEP (including two atrial fibrillation, two ventricular premature depolarizations, two marked sinus arrhythmia, two atrial premature depolarizations, one junctional escape, one ST‐segment elevation), and 39% of comparison patients (p = 0.39). No specific seizure onset (laterality or lobe) was associated with SUDEP.
Conclusions: This study reveals, for the first time, evidence of increased autonomic stimulation (as measured by HR) associated with seizures, particularly in sleep, in patients with SUDEP, as compared with a clinically similar group of patients with refractory epilepsy.
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