A definition and classification of status epilepticus - Report of the ILAE Task Force on Classification of Status Epilepticus.

The Commission on Classification and Terminology and the Commission on Epidemiology of the International League Against Epilepsy (ILAE) have charged a Task Force to revise concepts, definition, and classification of status epilepticus (SE). The proposed new definition of SE is as follows: Status epilepticus is a condition resulting either from the failure of the mechanisms responsible for seizure termination or from the initiation of mechanisms, which lead to abnormally, prolonged seizures (after time point t1 ). It is a condition, which can have long-term consequences (after time point t2 ), including neuronal death, neuronal injury, and alteration of neuronal networks, depending on the type and duration of seizures. This definition is conceptual, with two operational dimensions: the first is the length of the seizure and the time point (t1 ) beyond which the seizure should be regarded as "continuous seizure activity." The second time point (t2 ) is the time of ongoing seizure activity after which there is a risk of long-term consequences. In the case of convulsive (tonic-clonic) SE, both time points (t1 at 5 min and t2 at 30 min) are based on animal experiments and clinical research. This evidence is incomplete, and there is furthermore considerable variation, so these time points should be considered as the best estimates currently available. Data are not yet available for other forms of SE, but as knowledge and understanding increase, time points can be defined for specific forms of SE based on scientific evidence and incorporated into the definition, without changing the underlying concepts. A new diagnostic classification system of SE is proposed, which will provide a framework for clinical diagnosis, investigation, and therapeutic approaches for each patient. There are four axes: (1) semiology; (2) etiology; (3) electroencephalography (EEG) correlates; and (4) age. Axis 1 (semiology) lists different forms of SE divided into those with prominent motor systems, those without prominent motor systems, and currently indeterminate conditions (such as acute confusional states with epileptiform EEG patterns). Axis 2 (etiology) is divided into subcategories of known and unknown causes. Axis 3 (EEG correlates) adopts the latest recommendations by consensus panels to use the following descriptors for the EEG: name of pattern, morphology, location, time-related features, modulation, and effect of intervention. Finally, axis 4 divides age groups into neonatal, infancy, childhood, adolescent and adulthood, and elderly.

Classification, comorbidity, heredity, and risk factors of female sexual dysfunctions

Female sexual dysfunctions, including desire, arousal, orgasm and pain problems, have been shown to be highly prevalent among women around the world. The etiology of these dysfunctions is unclear but associations with health, age, psychological problems, and relationship factors have been identified. Genetic effects explain individual variation in orgasm function to some extent but until now quantitative behavior genetic analyses have not been applied to other sexual functions. In addition, behavior genetics can be applied to exploring the cause of any observed comorbidity between the dysfunctions. Discovering more about the etiology of the dysfunctions may further improve the classification systems which are currently under intense debate. The aims of the present thesis were to evaluate the psychometric properties of a Finnish-language version of a commonly used questionnaire for measuring female sexual function, the Female Sexual Function Index (FSFI), in order to investigate prevalence, comorbidity, and classification, and to explore the balance of genetic and environmental factors in the etiology as well as the associations of a number of biopsychosocial factors with female sexual functions. Female sexual functions were studied through survey methods in a population based sample of Finnish twins and their female siblings. There were two waves of data collection. The first data collection targeted 5,000 female twins aged 33–43 years and the second 7,680 female twins aged 18–33 and their over 18–year-old female siblings (n = 3,983). There was no overlap between the data collections. The combined overall response rate for both data collections was 53% (n = 8,868), with a better response rate in the second (57%) compared to the first (45%). In order to measure female sexual function, the FSFI was used. It includes 19 items which measure female sexual function during the previous four weeks in six subdomains; desire, subjective arousal, lubrication, orgasm, sexual satisfaction, and pain. In line with earlier research in clinical populations, a six factor solution of the Finnish-language version of the FSFI received supported. The internal consistencies of the scales were good to excellent. Some questions about how to avoid overestimating the prevalence of extreme dysfunctions due to women being allocated the score of zero if they had had no sexual activity during the preceding four weeks were raised. The prevalence of female sexual dysfunctions per se ranged from 11% for lubrication dysfunction to 55% for desire dysfunction. The prevalence rates for sexual dysfunction with concomitant sexual distress, in other words, sexual disorders were notably lower ranging from 7% for lubrication disorder to 23% for desire disorder. The comorbidity between the dysfunctions was substantial most notably between arousal and lubrication dysfunction even if these two dysfunctions showed distinct patterns of associations with the other dysfunctions. Genetic influences on individual variation in the six subdomains of FSFI were modest but significant ranging from 3–11% for additive genetic effects and 5–18% for nonadditive genetic effects. The rest of the variation in sexual functions was explained by nonshared environmental influences. A correlated factor model, including additive and nonadditive genetic effects and nonshared environmental effects had the best fit. All in all, every correlation between the genetic factors was significant except between lubrication and pain. All correlations between the nonshared environment factors were significant showing that there is a substantial overlap in genetic and nonshared environmental influences between the dysfunctions. In general, psychological problems, poor satisfaction with the relationship, sexual distress, and poor partner compatibility were associated with more sexual dysfunctions. Age was confounded with relationship length but had over and above relationship length a negative effect on desire and sexual satisfaction and a positive effect on orgasm and pain functions. Alcohol consumption in general was associated with better desire, arousal, lubrication, and orgasm function. Women pregnant with their first child had fewer pain problems than nulliparous nonpregnant women. Multiparous pregnant women had more orgasm problems compared to multiparous nonpregnant women. Having children was associated with less orgasm and pain problems. The conclusions were that desire, subjective arousal, lubrication, orgasm, sexual satisfaction, and pain are separate entities that have distinct associations with a number of different biopsychosocial factors. However, there is also considerable comorbidity between the dysfunctions which are explained by overlap in additive genetic, nonadditive genetic and nonshared environmental influences. Sexual dysfunctions are highly prevalent and are not always associated with sexual distress and this relationship might be moderated by a good relationship and compatibility with partner. Regarding classification, the results supports separate diagnoses for subjective arousal and genital arousal as well as the inclusion of pain under sexual dysfunctions.

Tree population and community dynamics in a Brazilian tropical semideciduous forest

The dynamics of the tree community and 30 tree populations were examined in an area of tropical semideciduous forest located on the margin of the Rio Grande, SE Brazil, based on surveys done in 1990 and 1997 in three 0.18 ha plots. The main purpose was to assess whether variations in dynamics were related to topography and the effects of a catastrophic flood in 1992. Rates of mortality and recruitment of trees and gain and loss of basal area in two topographic sites, lower (flooded) and upper (non-flooded), were obtained. Projected trajectories of mean and accelerated growth in diameter were obtained for each species. In both topographic sites, mortality rates surpassed recruitment rates, gain rates of basal area surpassed loss rates, and size distributions changed, with declining proportions of smaller trees. These overall changes were possibly related to increased underground water supply after the 1992 flood as well as to a c. 250-year-old process of primary succession on abandoned gold mines. Possible effects of the 1992 flood showed up in the higher proportions of dead trees in the flooded sites and faster growth rates in the flood-free sites. Species of different regeneration guilds showed particular trends with respect to their demographic changes and diameter growth patterns. Nevertheless, patterns of population dynamics differed between topographic sites for only two species.

Floristic composition and similarity analysis of an Atlantic rain forest fragment in Cananéia, São Paulo State, Brazil

The aim of this study is to investigate the floristic composition of an Atlantic rain forest fragment located in Cananéia, São Paulo, Brazil, and to contribute to the knowledge on Atlantic forest through the comparative analysis of this and other floristic surveys both on the southern and southeastern Brazil, in different soil and relief types. We surveyed 215 species in 132 genera and 51 families. Classification and ordination analysis were applied to a binary matrix in order to analyze the similarity among 24 surveys, including the present one, of Atlantic forest from the south and southeast coast of Brazil. Higher floristic similarity was observed among this area and the ones where there was marine influence and more rugged relief. The surveys in areas with greater marine influence (sandy soil) were separated from those in other conditions, possibly indicating a species replacement gradient from the steep slopes towards the lowland and were probably related to different edaphic conditions. A latitudinal gradient was found among the surveys apparently confirming a continuous species replacement along the Atlantic forest, related to a restricted distribution of the species. This suggests that it is essential to preserve areas from the whole Atlantic coast. Atlantic forest distribution is quite complex and its composition cannot be adequately represented by small localized areas.

“Improved Feature Extraction and Classification Techniques for Multispectral Brain Magnetic Resonance Images”

Magnetic Resonance Imaging (MRI) is a multi sequence medical imaging technique in which stacks of images are acquired with different tissue contrasts. Simultaneous observation and quantitative analysis of normal brain tissues and small abnormalities from these large numbers of different sequences is a great challenge in clinical applications. Multispectral MRI analysis can simplify the job considerably by combining unlimited number of available co-registered sequences in a single suite. However, poor performance of the multispectral system with conventional image classification and segmentation methods makes it inappropriate for clinical analysis. Recent works in multispectral brain MRI analysis attempted to resolve this issue by improved feature extraction approaches, such as transform based methods, fuzzy approaches, algebraic techniques and so forth. Transform based feature extraction methods like Independent Component Analysis (ICA) and its extensions have been effectively used in recent studies to improve the performance of multispectral brain MRI analysis. However, these global transforms were found to be inefficient and inconsistent in identifying less frequently occurred features like small lesions, from large amount of MR data. The present thesis focuses on the improvement in ICA based feature extraction techniques to enhance the performance of multispectral brain MRI analysis. Methods using spectral clustering and wavelet transforms are proposed to resolve the inefficiency of ICA in identifying small abnormalities, and problems due to ICA over-completeness. Effectiveness of the new methods in brain tissue classification and segmentation is confirmed by a detailed quantitative and qualitative analysis with synthetic and clinical, normal and abnormal, data. In comparison to conventional classification techniques, proposed algorithms provide better performance in classification of normal brain tissues and significant small abnormalities.

Significance Of Classification Techniques In Prediction Of Learning Disabilities

The aim of this study is to show the importance of two classification techniques, viz. decision tree and clustering, in prediction of learning disabilities (LD) of school-age children. LDs affect about 10 percent of all children enrolled in schools. The problems of children with specific learning disabilities have been a cause of concern to parents and teachers for some time. Decision trees and clustering are powerful and popular tools used for classification and prediction in Data mining. Different rules extracted from the decision tree are used for prediction of learning disabilities. Clustering is the assignment of a set of observations into subsets, called clusters, which are useful in finding the different signs and symptoms (attributes) present in the LD affected child. In this paper, J48 algorithm is used for constructing the decision tree and K-means algorithm is used for creating the clusters. By applying these classification techniques, LD in any child can be identified

Global Acceleration and Dispossesion: Regression in the Right to Life and Public Health during Ecuador’s Neoliberal Decades

The present essay’s central argument or hypothesis is, consequently, that the mechanisms accelerating a wealth concentrating and exclusionary economy centred on the benefit and overprotection of big business—with a corresponding plundering of resources that are vital for life—generated forms of loss and regression in the right to healthcare and the dismantling of institutional protections. These are all expressed in indicators from 1990-2005, which point not only to the deterioration of healthcare programs and services but also to the undermining of the general conditions of life (social reproduction) and, in contrast to the reports and predictions of the era’s governments, a stagnation or deterioration in health indicators, especially for those most sensitive to the crisis. The present study’s argument is linked together across distinct chapters. First, we undertake the necessary clarification of the categories central to the understanding of a complex issue; clarifying the concept of health itself and its determinants, emphasizing the necessity of taking on an integral understanding as a fundamental prerequisite to unravelling what documents and reports from this era either leave unsaid or distort. Based on that analysis, we will explain the harmful effects of global economic acceleration, the monopolization and pillaging of strategic healthcare goods; not only those which directly place obstacles on the access to health services, but also those like the destructuration of small economies, linked to the impoverishment and worsening of living modes. Thinking epidemiologically, we intend to show signs of the deterioration of broad collectivities’ ways of life as a result of the mechanisms of acceleration and pillage. We will then collect disparate evidence of the deterioration of human health and ecosystems to, finally, establish the most urgent conclusions about this unfortunate period of our social and medical history.

Models to predict the distribution and abundance of breeding ducks in Canada

Detailed knowledge of waterfowl abundance and distribution across Canada is lacking, which limits our ability to effectively conserve and manage their populations. We used 15 years of data from an aerial transect survey to model the abundance of 17 species or species groups of ducks within southern and boreal Canada. We included 78 climatic, hydrological, and landscape variables in Boosted Regression Tree models, allowing flexible response curves and multiway interactions among variables. We assessed predictive performance of the models using four metrics and calculated uncertainty as the coefficient of variation of predictions across 20 replicate models. Maps of predicted relative abundance were generated from resulting models, and they largely match spatial patterns evident in the transect data. We observed two main distribution patterns: a concentrated prairie-parkland distribution and a more dispersed pan-Canadian distribution. These patterns were congruent with the relative importance of predictor variables and model evaluation statistics among the two groups of distributions. Most species had a hydrological variable as the most important predictor, although the specific hydrological variable differed somewhat among species. In some cases, important variables had clear ecological interpretations, but in some instances, e.g., topographic roughness, they may simply reflect chance correlations between species distributions and environmental variables identified by the model-building process. Given the performance of our models, we suggest that the resulting prediction maps can be used in future research and to guide conservation activities, particularly within the bounds of the survey area.

Patterns of pollen and seed dispersal in a small, fragmented population of the wind-pollinated tree Araucaria angustifolia in southern Brazil

Paternity analysis based on eight microsatellite loci was used to investigate pollen and seed dispersal patterns of the dioecious wind- pollinated tree, Araucaria angustifolia. The study sites were a 5.4 ha isolated forest fragment and a small tree group situated 1.7 km away, located in Paran alpha State, Brazil. In the forest fragment, 121 males, 99 females, 66 seedlings and 92 juveniles were mapped and genotyped, together with 210 seeds. In the tree group, nine male and two female adults were mapped and genotyped, together with 20 seeds. Paternity analysis within the forest fragment indicated that at least 4% of the seeds, 3% of the seedlings and 7% of the juveniles were fertilized by pollen from trees in the adjacent group, and 6% of the seeds were fertilized by pollen from trees outside these stands. The average pollination distance within the forest fragment was 83 m; when the tree group was included the pollination distance was 2006m. The average number of effective pollen donors was estimated as 12.6. Mother- trees within the fragment could be assigned to all seedlings and juveniles, suggesting an absence of seed immigration. The distance of seedlings and juveniles from their assigned mother- trees ranged from 0.35 to 291m ( with an average of 83m). Significant spatial genetic structure among adult trees, seedlings, and juveniles was detected up to 50m, indicating seed dispersal over a short distance. The effective pollination neighborhood ranged from 0.4 to 3.3 ha. The results suggest that seed dispersal is restricted but that there is longdistance pollen dispersal between the forest fragment and the tree group; thus, the two stands of trees are not isolated.

Landscape context and habitat type as drivers of bee diversity in European annual crops

To better understand the dynamics of bee populations in crops, we assessed the effect of landscape context and habitat type on bee communities in annual entomophilous crops in Europe. We quantified bee communities in five pairs of crop-country: buckwheat in Poland, cantaloupe in France, field beans in the UK, spring oilseed rape in Sweden, and strawberries in Germany. For each country, 7-10 study fields were sampled over a gradient of increasing proportion of semi-natural habitats in the surrounding landscape. The CORINE land cover classification was used to characterize the landscape over a 3 km radius around each study field and we used multivariate and regression analyses to quantify the impact of landscape features on bee abundance and diversity at the sub-generic taxonomic level. Neither overall wild bee abundance nor diversity, taken as the number of sub-genera. was significantly affected by the proportion of semi-natural habitat. Therefore, we used the most precise level of the CORINE classification to examine the possible links between specific landscape features and wild bee communities. Bee community composition fell into three distinct groups across Europe: group I included Poland, Germany, and Sweden, group 2 the UK, and group 3 France. Among all three groups, wild bee abundance and sub-generic diversity were affected by 17 landscape elements including some semi-natural habitats (e.g., transitional wood land-shrub), some urban habitats (e.g., sport and leisure facilities) and some crop habitats (e.g., non-irrigated arable land). Some bee taxa were positively affected by urban habitats only, others by semi-natural habitats only, and others by a combination of semi-natural, urban and crop habitats. Bee sub-genera favoured by urban and crop habitats were more resistant to landscape change than those favoured only by semi-natural habitats. In agroecosystems, the agricultural intensification defined as the loss of semi-natural habitats does not necessarily cause a decline in evenness at the local level, but can change community composition towards a bee fauna dominated by common taxa. (C) 2009 Elsevier B.V. All rights reserved.

Chemical composition and in vitro fermentation of tannin-rich tree fruits

Dry and mature tree fruits are a potential source of protein for goats in the semi-arid areas of southern Africa, but their chemical composition and feeding value is largely unknown. This study presents the chemical composition and in vitro fermentation of indehiscent whole fruits and separated seed and hull fractions from Acacia nilotica, Acacia erubescens, Acacia sieberiana, Acacia erioloba, Piliostigma thonningii and Dichrostachys cinerea trees. Results indicate that the N contents of whole fruits ranged between 13.5 g/kg DM (A. nilotica) and 27.1 g/kg DM (A. erubescens). Seeds had a higher N content than hulls for all tree species. A. nilotica, D. cinerea and P thonningii fruits had high levels of extractable phenolics (758, 458 and 299 g/kg DM, respectively). Soluble phenolics (SPh) and ytterbium precipitable phenolics (YbPh) levels were negatively correlated to in vitro gas production but positively correlated to in vitro organic matter degradability (iOMD). Partition factors for whole fruits at 48 h ranged between 3.6 mg/ml for A. erioloba and 7.8 mg/ml for A. nilotica. Seeds of A. erioloba, A. erubescens and P thonningii were consistently fermented more efficiently throughout the incubation period compared to their whole fruits or hulls. Estimating in vitro degradability of phenolic-rich substrates through filtration procedures can give erroneous results due to the loss of soluble phenolics, which are not necessarily degradable. The feeding value of fruits from D. cinerea and A. nilotica tree species may be reduced due to the presence of high levels of phenolics. (C) 2007 Elsevier B.V. All rights reserved.

Orthogonal-least-squares regression: A unified approach for data modelling

A unified approach is proposed for data modelling that includes supervised regression and classification applications as well as unsupervised probability density function estimation. The orthogonal-least-squares regression based on the leave-one-out test criteria is formulated within this unified data-modelling framework to construct sparse kernel models that generalise well. Examples from regression, classification and density estimation applications are used to illustrate the effectiveness of this generic data-modelling approach for constructing parsimonious kernel models with excellent generalisation capability. (C) 2008 Elsevier B.V. All rights reserved.

Global climate change and tree nutrition: effects of elevated CO2 and temperature

Although tree nutrition has not been the primary focus of large climate change experiments on trees, we are beginning to understand its links to elevated atmospheric CO2 and temperature changes. This review focuses on the major nutrients, namely N and P, and deals with the effects of climate change on the processes that alter their cycling and availability. Current knowledge regarding biotic and abiotic agents of weathering, mobilization and immobilization of these elements will be discussed. To date, controlled environment studies have identified possible effects of climate change on tree nutrition. Only some of these findings, however, were verified in ecosystem scale experiments. Moreover, to be able to predict future effects of climate change on tree nutrition at this scale, we need to progress from studying effects of single factors to analysing interactions between factors such as elevated CO2, temperature or water availability.

Analysis of full-waveform LiDAR data for classification of an orange orchard scene

Full-waveform laser scanning data acquired with a Riegl LMS-Q560 instrument were used to classify an orange orchard into orange trees, grass and ground using waveform parameters alone. Gaussian decomposition was performed on this data capture from the National Airborne Field Experiment in November 2006 using a custom peak-detection procedure and a trust-region-reflective algorithm for fitting Gauss functions. Calibration was carried out using waveforms returned from a road surface, and the backscattering coefficient c was derived for every waveform peak. The processed data were then analysed according to the number of returns detected within each waveform and classified into three classes based on pulse width and c. For single-peak waveforms the scatterplot of c versus pulse width was used to distinguish between ground, grass and orange trees. In the case of multiple returns, the relationship between first (or first plus middle) and last return c values was used to separate ground from other targets. Refinement of this classification, and further sub-classification into grass and orange trees was performed using the c versus pulse width scatterplots of last returns. In all cases the separation was carried out using a decision tree with empirical relationships between the waveform parameters. Ground points were successfully separated from orange tree points. The most difficult class to separate and verify was grass, but those points in general corresponded well with the grass areas identified in the aerial photography. The overall accuracy reached 91%, using photography and relative elevation as ground truth. The overall accuracy for two classes, orange tree and combined class of grass and ground, yielded 95%. Finally, the backscattering coefficient c of single-peak waveforms was also used to derive reflectance values of the three classes. The reflectance of the orange tree class (0.31) and ground class (0.60) are consistent with published values at the wavelength of the Riegl scanner (1550 nm). The grass class reflectance (0.46) falls in between the other two classes as might be expected, as this class has a mixture of the contributions of both vegetation and ground reflectance properties.

Tree-structured smooth transition models

The goal of this paper is to introduce a class of tree-structured models that combines aspects of regression trees and smooth transition regression models. The model is called the Smooth Transition Regression Tree (STR-Tree). The main idea relies on specifying a multiple-regime parametric model through a tree-growing procedure with smooth transitions among different regimes. Decisions about splits are entirely based on a sequence of Lagrange Multiplier (LM) tests of hypotheses.