New-onset refractory status epilepticus: Etiology, clinical features, and outcome.

OBJECTIVES: The aims of this study were to determine the etiology, clinical features, and predictors of outcome of new-onset refractory status epilepticus. METHODS: Retrospective review of patients with refractory status epilepticus without etiology identified within 48 hours of admission between January 1, 2008, and December 31, 2013, in 13 academic medical centers. The primary outcome measure was poor functional outcome at discharge (defined as a score >3 on the modified Rankin Scale). RESULTS: Of 130 cases, 67 (52%) remained cryptogenic. The most common identified etiologies were autoimmune (19%) and paraneoplastic (18%) encephalitis. Full data were available in 125 cases (62 cryptogenic). Poor outcome occurred in 77 of 125 cases (62%), and 28 (22%) died. Predictors of poor outcome included duration of status epilepticus, use of anesthetics, and medical complications. Among the 63 patients with available follow-up data (median 9 months), functional status improved in 36 (57%); 79% had good or fair outcome at last follow-up, but epilepsy developed in 37% with most survivors (92%) remaining on antiseizure medications. Immune therapies were used less frequently in cryptogenic cases, despite a comparable prevalence of inflammatory CSF changes. CONCLUSIONS: Autoimmune encephalitis is the most commonly identified cause of new-onset refractory status epilepticus, but half remain cryptogenic. Outcome at discharge is poor but improves during follow-up. Epilepsy develops in most cases. The role of anesthetics and immune therapies warrants further investigation.

High prevalence of PRPH2 in autosomal dominant retinitis pigmentosa in france and characterization of biochemical and clinical features.

PURPOSE: To assess the prevalence of PRPH2 in autosomal dominant retinitis pigmentosa (adRP), to report 6 novel mutations, to characterize the biochemical features of a recurrent novel mutation, and to study the clinical features of adRP patients. DESIGN: Retrospective clinical and molecular genetic study. METHODS: Clinical investigations included visual field testing, fundus examination, high-resolution spectral-domain optical coherence tomography (OCT), fundus autofluorescence imaging, and electroretinogram (ERG) recording. PRPH2 was screened by Sanger sequencing in a cohort of 310 French families with adRP. Peripherin-2 protein was produced in yeast and analyzed by Western blot. RESULTS: We identified 15 mutations, including 6 novel and 9 previously reported changes in 32 families, accounting for a prevalence of 10.3% in this adRP population. We showed that a new recurrent p.Leu254Gln mutation leads to protein aggregation, suggesting abnormal folding. The clinical severity of the disease in examined patients was moderate with 78% of the eyes having 1-0.5 of visual acuity and 52% of the eyes retaining more than 50% of the visual field. Some patients characteristically showed vitelliform deposits or macular involvement. In some families, pericentral RP or macular dystrophy were found in family members while widespread RP was present in other members of the same families. CONCLUSIONS: The mutations in PRPH2 account for 10.3% of adRP in the French population, which is higher than previously reported (0%-8%) This makes PRPH2 the second most frequent adRP gene after RHO in our series. PRPH2 mutations cause highly variable phenotypes and moderate forms of adRP, including mild cases, which could be underdiagnosed.

Étude du rapport entre les manifestations d'agitation et l'inconfort de la personne âgée atteinte de démence (pad) au moment de la toilette en milieu hospitalier spécialise

Les personnes âgées atteintes de démence (PAD) souffrent de troubles importants de la communication associés à des manifestations psychologiques et comportementales comme l'agitation. La plupart de ces personnes hospitalisées sont en outre atteintes de comorbidités physiques ou psychologiques pouvant provoquer de l'inconfort. Ce travail décrit la fréquence des comportements d'agitation et de l'inconfort des PAD durant les soins d'hygiène et vérifie si ces deux phénomènes sont associés durant la toilette. La mise en perspective infirmière des résultats de l'étude est effectuée à partir des écrits scientifiques et du cadre théorique du confort de Kolcaba.

Impact of the Femoral Head Position on Moment Arms in Total Hip Arthroplasty: A Parametric Finite Element Study.

BACKGROUND: Although the importance of accurate femoral reconstruction to achieve a good functional outcome is well documented, quantitative data on the effects of a displacement of the femoral center of rotation on moment arms are scarce. The purpose of this study was to calculate moment arms after nonanatomical femoral reconstruction. METHODS: Finite element models of 15 patients including the pelvis, the femur, and the gluteal muscles were developed. Moment arms were calculated within the native anatomy and compared to distinct displacement of the femoral center of rotation (leg lengthening of 10 mm, loss of femoral offset of 20%, anteversion ±10°, and fixed anteversion at 15°). Calculations were performed within the range of motion observed during a normal gait cycle. RESULTS: Although with all evaluated displacements of the femoral center of rotation, the abductor moment arm remained positive, some fibers initially contributing to extension became antagonists (flexors) and vice versa. A loss of 20% of femoral offset led to an average decrease of 15% of abductor moment. Femoral lengthening and changes in femoral anteversion (±10°, fixed at 15°) led to minimal changes in abductor moment arms (maximum change of 5%). Native femoral anteversion correlated with the changes in moment arms induced by the 5 variations of reconstruction. CONCLUSION: Accurate reconstruction of offset is important to maintaining abductor moment arms, while changes of femoral rotation had minimal effects. Patients with larger native femoral anteversion appear to be more susceptible to femoral head displacements.

The effects of fire severity on ectomycorrhizal colonization and morphometric features in Pinus pinaster Ait. seedlings

Aim of the study: Mycorrhizal fungi in Mediterranean forests play a key role in the complex process of recovery after wildfires. A broader understanding of an important pyrophytic species as Pinus pinaster and its fungal symbionts is thus necessary for forest restoration purposes. This study aims to assess the effects of ectomycorrhizal symbiosis on maritime pine seedlings and how fire severity affects fungal colonization ability. Area of study: Central Spain, in a Mediterranean region typically affected by wildfires dominated by Pinus pinaster, a species adapted to fire disturbance. Material and Methods: We studied P. pinaster root apexes from seedlings grown in soils collected one year after fire in undisturbed sites, sites moderately affected by fire and sites highly affected by fire. Natural ectomycorrhization was observed at the whole root system level as well as at two root vertical sections (0-10 cm and 10-20 cm). We also measured several morphometric traits ( tap root length, shoot length, dry biomass of shoots and root/shoot ratio), which were used to test the influence of fire severity and soil chemistry upon them. Main results: Ectomycorrhizal colonization in undisturbed soils for total and separated root vertical sections was higher than in soils that had been affected by fire to some degree. Inversely, seedling vegetative size increased according to fire severity. Research highlights: Fire severity affected soil properties and mycorrhizal colonization one year after occurrence, thus affecting plant development. These findings can contribute to a better knowledge of the factors mediating successful establishment of P. pinaster in Mediterranean forests after wildfires.

LVI- ja sähköurakoinnin raportoinnin kehittäminen IT-palveluyrityksessä

Työn tavoitteena oli kehittää LVI- ja sähköurakointitoimialan asiakkaille tarjottavaa raportointia IT-palveluyrityksessä. Raportoinnin tulisi soveltua paremmin yrityksen ohjaamiseen ja sen avulla yrityksen tulisi tietää kannattavuutensa, rahoitustilanteensa ja liiketoimintansa kehityssuunnat. Tarkoituksena oli suunnitella raportointimalli, joka soveltuu toimialan pienten ja keskisuurten yritysten käyttöön. Tutkimus toteutettiin konstruktiivisena eli tutkimuksen tavoitteena oli luoda uusi ratkaisumalli käytännön ongelmaan. Konstruktion rakentamiseksi työssä selvitettiin LVI- ja sähköurakoinnin erityispiirteitä, yrityksen ohjaukseen vaikuttavia tekijöitä ja menetelmiä sekä raportoinnin periaatteellista ja teknistä toteuttamista. Näiden osa-alueiden avulla luotiin raportointimallille vaatimukset, jotka sen tulisi täyttää. Tämän jälkeen kuvattiin raportoinnin nykyinen tekninen toteutustapa ja sen sisältämät osa-alueet. Selvitettyjen vaatimusten ja nykyisen raportoinnin ongelmien perusteella luotiin alustava raportointimalli, jonka käytännön merkitys selvitettiin haastattelemalla 11 LVI- ja sähköurakointiyrityksen vastuunalaista johtajaa. Haastatteluista saatiin selville, että kahdeksan johtajaa olisi ollut valmis käyttämään konstruktiota. Alustavan raportointimallin ja haastatteluista saadun palautteen perusteella luotiin ehdotus raportointimallista toimialalla. Lisäksi IT-palveluyrityksen nykyiselle raportointimallille luotiin kolmivaiheinen kehityssuunnitelma, jolla raportointia voidaan kehittää luodun raportointimallin mukaiseksi.

Features extraction based on the Discrete Hartley Transform for closed contour

In this paper the authors propose a new closed contour descriptor that could be seen as a Feature Extractor of closed contours based on the Discrete Hartley Transform (DHT), its main characteristic is that uses only half of the coefficients required by Elliptical Fourier Descriptors (EFD) to obtain a contour approximation with similar error measure. The proposed closed contour descriptor provides an excellent capability of information compression useful for a great number of AI applications. Moreover it can provide scale, position and rotation invariance, and last but not least it has the advantage that both the parameterization and the reconstructed shape from the compressed set can be computed very efficiently by the fast Discrete Hartley Transform (DHT) algorithm. This Feature Extractor could be useful when the application claims for reversible features and when the user needs and easy measure of the quality for a given level of compression, scalable from low to very high quality.

Clinical features of oral lichen planus. A retrospective study of 65 cases

Objectives: To describe the clinical features of patients diagnosed with oral lichen planus (OLP) and to establish the prevalence of its malignant transformation in our setting. Study design: A retrospective study was made of 65 patients clinically and histologically diagnosed with OLP in the Service of Oral Surgery (Dental Clinic of the University of Barcelona, Spain) in the period 1990-2005. A descriptive and bivariate statistical analysis was made. Results: The mean patient age was 59 years (SD ± 14.9). Most of the patients (61%) were women, and the most frequent location of the lesions was the buccal mucosa (90.8%). White forms of OLP were noted in 66% of the cases, and 46.2% of the patients reported symptoms of some kind. The patients diagnosed with diabetes mellitus (20%) showed a larger proportion of red lesions (p=0.088). No statistically significant association was observed between chronic liver disease and the OLP lesion types or symptoms. Two cases of squamous cell carcinoma were identified in two patients previously or simultaneously diagnosed with OLP. A statistically significant correlation was observed between dysplastic changes / malignization of the lesions and smoking habit (p=0.019). An association to alcohol abuse was also noted, though in this case statistical significance was not reached (p=0.085). Conclusions: The clinical features of our study population were similar to those described in other studies. Diabetic patients with OLP were seen to be more susceptible to the development of atrophic-erosive lesions. Smokers and/or patients with alcohol abuse in turn showed a greater tendency to develop dysplastic changes / malignization in the histopathological study of the lesions

Sharp mandibular bone irregularities after lower third molar extraction: Incidence, clinical features and risk factors

Objectives: The purpose of this study was to determine the incidence and clinical symptoms associated with sharp mandibular bone irregularities (SMBI) after lower third molar extraction and to identify possible risk factors for this complication. Study Design: A mixed study design was used. A retrospective cohort study of 1432 lower third molar extractions was done to determine the incidence of SMBI and a retrospective case-control study was done to determine potential demographic and etiologic factors by comparing those patients with postoperative SMBI with controls. Results: Twelve SMBI were found (0.84%). Age was the most important risk factor for this complication. The operated side and the presence of an associated radiolucent image were also significantly related to the development of mandibular bone irregularities. The depth of impaction of the tooth might also be an important factor since erupted or nearly erupted third molars were more frequent in the SMBI group. Conclusions: SMBI are a rare postoperative complication after lower third molar removal. Older patients having left side lower third molars removed are more likely to develop this problem. The treatment should be the removal of the irregularity when the patient is symptomatic

Generic features of eighteenth-century American runaway slave advertisements

Pro-gradu –tutkielmani aiheena ovat 1700-luvun ”karanneet orjat” – sanomalehtiilmoitusten genrelle ominaiset piirteet. Tutkimusaineisto koostuu 190 ilmoituksesta, jotka ovat alkuperäisesti ilmestyneet virginialaisissa, pennsylvanialaisissa ja newyorkilaisissa sanomalehdissä 1730-luvulta 1770-luvulle. Tutkimuksen kohteeksi on rajattu ilmoitukset, joissa yksityishenkilöt ilmoittavat orjan/orjien karanneet ja lupaavat kiinniottajalle palkkion. Tutkielman tarkoituksena on tarkastella, millaisia ovat tyypilliset kielelliset piirteet näissä teksteissä ja millainen on prototyyppinen genren edustaja. Genreteorian lisäksi teoriaosuudessa käsittelen jonkin verran 1700- luvun englannin kielen yleisiä piirteitä sekä orjuuden ja sanomalehtien syntyhistoriaa Amerikassa taustoittaakseni tutkimusta. Analyysissa hyödynnän mm. Swalesin ja Bhatian käyttämää käsitettä siirroista (moves). Tutkin ilmoituksien tyypillistä rakennetta jakamalla ne yhdeksään siirtoon, joilla kaikilla on oma tehtävänsä ilmoituksessa. Jotkut siirrot, kuten karkulaisen kuvailu ja palkkion lupaaminen, esiintyvät kaikissa ilmoituksissa, kun taas toiset siirrot ovat läsnä harvemmin. Muita tälle genrelle tyypillisiä ominaisuuksia ovat esim. ilmoituksissa toistuvat kiinteät fraasit ja tietyt sanastolliset erikoisuudet. Lisäksi tutkin ilmoituksissa käytettäviä tapoja viitata asiaan liittyviin henkilöihin, sekä erilaisia toimia, joita ilmoitusten jättäjät ilmoituksien avulla suorittavat. Genressä on havaittavissa pieniä reilun neljänkymmenen vuoden kuluessa tapahtuneita muutoksia, mutta myös eroavaisuuksia eri siirtokuntien ilmoitusten välillä. Yleisesti voidaan todeta, että vaikka ”karanneet orjat” –ilmoitukset voivat vaihdella rakenteeltaan ja sanavalinnoiltaan, suuri osa ilmoituksista seuraa kuitenkin melko prototyyppistä muottia.

Consumer valuation of energy-saving features of residential air conditioners with hedonic and choice models

The promotion of energy-efficient appliances is necessary to reduce the energetic and environmental burden of the household sector. However, many studies have reported that a typical consumer underestimates the benefits of energy-saving investment on the purchase of household electric appliances. To analyze this energy-efficiency gap problem, many scholars have estimated implicit discount rates that consumers use for energy-consuming durables. Although both hedonic and choice models have been used in previous studies, a comparison between two models has not yet been done. This study uses point of sale data about Japanese residential air conditioners and estimates implicit discounts rates with both hedonic and choice models. Both models demonstrate that a typical consumer underinvests in energy efficiency. Although choice models estimate a lower implicit discount rate than hedonic models, the latter models estimate the values of other product characteristics more consistently than choice models.

Indirect likelihood inference (revised)

Standard indirect Inference (II) estimators take a given finite-dimensional statistic, Z_{n} , and then estimate the parameters by matching the sample statistic with the model-implied population moment. We here propose a novel estimation method that utilizes all available information contained in the distribution of Z_{n} , not just its first moment. This is done by computing the likelihood of Z_{n}, and then estimating the parameters by either maximizing the likelihood or computing the posterior mean for a given prior of the parameters. These are referred to as the maximum indirect likelihood (MIL) and Bayesian Indirect Likelihood (BIL) estimators, respectively. We show that the IL estimators are first-order equivalent to the corresponding moment-based II estimator that employs the optimal weighting matrix. However, due to higher-order features of Z_{n} , the IL estimators are higher order efficient relative to the standard II estimator. The likelihood of Z_{n} will in general be unknown and so simulated versions of IL estimators are developed. Monte Carlo results for a structural auction model and a DSGE model show that the proposed estimators indeed have attractive finite sample properties.

Designing features for supporting social interactions in online communities

This Master's thesis studies the development of interaction and socialization in online communities. A large number of online communities fade away even before they really get started. In many occasions the reason is that the community does not give anything new, or even if they do, the delivery does not satisfy the users. In this thesis guidelines were developed to help to see important things, which might be forgotten when developing an online community. The thesis goes through the characteristic of an online community and human behaviour related to them and also compares behaviour in the Internet and real life. In addition, usability is an important part of the online communities and thus it is also covered in this thesis. As a result of this thesis an 8-step guideline was developed to ease the design of an online community. Guidelines were also applied to two real life cases which are described as one part of this work.