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Costa A, Baumgartner C, Reinhardt S, Berger J, Gronin S, Gardner GC, Lindemann T, Manfra MJ, Fabian J, Kochan D, Paradiso N, Strunk C. Sign reversal of the Josephson inductance magnetochiral anisotropy and 0-π-like transitions in supercurrent diodes. Nat Nanotechnol 2023; 18:1266-1272. [PMID: 37430040 DOI: 10.1038/s41565-023-01451-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 06/09/2023] [Indexed: 07/12/2023]
Abstract
The recent discovery of the intrinsic supercurrent diode effect, and its prompt observation in a rich variety of systems, has shown that non-reciprocal supercurrents naturally emerge when both space-inversion and time-inversion symmetries are broken. In Josephson junctions, non-reciprocal supercurrent can be conveniently described in terms of spin-split Andreev states. Here we demonstrate a sign reversal of the Josephson inductance magnetochiral anisotropy, a manifestation of the supercurrent diode effect. The asymmetry of the Josephson inductance as a function of the supercurrent allows us to probe the current-phase relation near equilibrium, and to probe jumps in the junction ground state. Using a minimal theoretical model, we can then link the sign reversal of the inductance magnetochiral anisotropy to the so-called 0-π-like transition, a predicted but still elusive feature of multichannel junctions. Our results demonstrate the potential of inductance measurements as sensitive probes of the fundamental properties of unconventional Josephson junctions.
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Affiliation(s)
- A Costa
- Institut für Theoretische Physik, University of Regensburg, Regensburg, Germany
| | - C Baumgartner
- Institut für Experimentelle und Angewandte Physik, University of Regensburg, Regensburg, Germany
| | - S Reinhardt
- Institut für Experimentelle und Angewandte Physik, University of Regensburg, Regensburg, Germany
| | - J Berger
- Institut für Experimentelle und Angewandte Physik, University of Regensburg, Regensburg, Germany
| | - S Gronin
- Birck Nanotechnology Center, Purdue University, West Lafayette, IN, USA
| | - G C Gardner
- Birck Nanotechnology Center, Purdue University, West Lafayette, IN, USA
| | - T Lindemann
- Birck Nanotechnology Center, Purdue University, West Lafayette, IN, USA
- Department of Physics and Astronomy, Purdue University, West Lafayette, IN, USA
| | - M J Manfra
- Birck Nanotechnology Center, Purdue University, West Lafayette, IN, USA
- Department of Physics and Astronomy, Purdue University, West Lafayette, IN, USA
- School of Materials Engineering, Purdue University, West Lafayette, IN, USA
- Elmore Family School of Electrical and Computer Engineering, Purdue University, West Lafayette, IN, USA
| | - J Fabian
- Institut für Theoretische Physik, University of Regensburg, Regensburg, Germany
| | - D Kochan
- Institut für Theoretische Physik, University of Regensburg, Regensburg, Germany
- Institute of Physics, Slovak Academy of Sciences, Bratislava, Slovakia
| | - N Paradiso
- Institut für Experimentelle und Angewandte Physik, University of Regensburg, Regensburg, Germany.
| | - C Strunk
- Institut für Experimentelle und Angewandte Physik, University of Regensburg, Regensburg, Germany
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2
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Baumgartner C, Monnier J, Bastid C, Gillabert C, Otterström C. [Chronic abdominal pain from digestive origin : summary 2023]. Rev Med Suisse 2023; 19:1743-1747. [PMID: 37753912 DOI: 10.53738/revmed.2023.19.843.1743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/28/2023]
Abstract
Chronic abdominal pain is continuous or intermittent pain that has been present for at least three months. As its clinical presentation and etiologies are numerous, recommendations to facilitate its management are difficult to establish. Unlike acute abdominal pain, which accounts for 5 to 10 % of emergency consultations, the prevalence of its chronic form is unknown. Its differential diagnoses are therefore important to know in order to direct initial management before referring to a specialist. The updated red flags were inspired by two journal articles dated 2021. It should now be considered that digestive neoplasia can be suspected before the age of 50, and that the prevalence of irritable bowel syndrome has decreased following a change in diagnostic criteria.
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Affiliation(s)
- Céline Baumgartner
- Service de médecine de premier recours, Département de médecine de premier recours, Hôpitaux universitaires de Genève, 1211 Genève 14
| | - Jeanne Monnier
- Service de médecine de premier recours, Département de médecine de premier recours, Hôpitaux universitaires de Genève, 1211 Genève 14
| | - Caroline Bastid
- Service de gastroentérologie et hépatologie, Département de médecine, Hôpitaux universitaires de Genève, 1211 Genève 14
| | | | - Claire Otterström
- Service de médecine de premier recours, Département de médecine de premier recours, Hôpitaux universitaires de Genève, 1211 Genève 14
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3
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Ziesel D, Nowakowska M, Scheruebel S, Kornmueller K, Schäfer U, Schindl R, Baumgartner C, Üçal M, Rienmüller T. Electrical stimulation methods and protocols for the treatment of traumatic brain injury: a critical review of preclinical research. J Neuroeng Rehabil 2023; 20:51. [PMID: 37098582 PMCID: PMC10131365 DOI: 10.1186/s12984-023-01159-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 03/13/2023] [Indexed: 04/27/2023] Open
Abstract
BACKGROUND Traumatic brain injury (TBI) is a leading cause of disabilities resulting from cognitive and neurological deficits, as well as psychological disorders. Only recently, preclinical research on electrical stimulation methods as a potential treatment of TBI sequelae has gained more traction. However, the underlying mechanisms of the anticipated improvements induced by these methods are still not fully understood. It remains unclear in which stage after TBI they are best applied to optimize the therapeutic outcome, preferably with persisting effects. Studies with animal models address these questions and investigate beneficial long- and short-term changes mediated by these novel modalities. METHODS In this review, we present the state-of-the-art in preclinical research on electrical stimulation methods used to treat TBI sequelae. We analyze publications on the most commonly used electrical stimulation methods, namely transcranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS), deep brain stimulation (DBS) and vagus nerve stimulation (VNS), that aim to treat disabilities caused by TBI. We discuss applied stimulation parameters, such as the amplitude, frequency, and length of stimulation, as well as stimulation time frames, specifically the onset of stimulation, how often stimulation sessions were repeated and the total length of the treatment. These parameters are then analyzed in the context of injury severity, the disability under investigation and the stimulated location, and the resulting therapeutic effects are compared. We provide a comprehensive and critical review and discuss directions for future research. RESULTS AND CONCLUSION: We find that the parameters used in studies on each of these stimulation methods vary widely, making it difficult to draw direct comparisons between stimulation protocols and therapeutic outcome. Persisting beneficial effects and adverse consequences of electrical simulation are rarely investigated, leaving many questions about their suitability for clinical applications. Nevertheless, we conclude that the stimulation methods discussed here show promising results that could be further supported by additional research in this field.
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Affiliation(s)
- D Ziesel
- Institute of Health Care Engineering with European Testing Center of Medical Devices, Graz University of Technology, Graz, Austria
| | - M Nowakowska
- Research Unit of Experimental Neurotraumatology, Department of Neurosurgery, Medical University of Graz, Graz, Austria
| | - S Scheruebel
- Gottfried Schatz Research Center for Cell Signaling, Metabolism and Aging, Biophysics Division, Medical University of Graz, Graz, Austria
| | - K Kornmueller
- Gottfried Schatz Research Center for Cell Signaling, Metabolism and Aging, Biophysics Division, Medical University of Graz, Graz, Austria
| | - U Schäfer
- Research Unit of Experimental Neurotraumatology, Department of Neurosurgery, Medical University of Graz, Graz, Austria
- BioTechMed-Graz, Graz, Austria
| | - R Schindl
- Gottfried Schatz Research Center for Cell Signaling, Metabolism and Aging, Biophysics Division, Medical University of Graz, Graz, Austria
- BioTechMed-Graz, Graz, Austria
| | - C Baumgartner
- Institute of Health Care Engineering with European Testing Center of Medical Devices, Graz University of Technology, Graz, Austria
- BioTechMed-Graz, Graz, Austria
| | - M Üçal
- Research Unit of Experimental Neurotraumatology, Department of Neurosurgery, Medical University of Graz, Graz, Austria
- BioTechMed-Graz, Graz, Austria
| | - T Rienmüller
- Institute of Health Care Engineering with European Testing Center of Medical Devices, Graz University of Technology, Graz, Austria.
- BioTechMed-Graz, Graz, Austria.
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Lara-Hernandez A, Rienmuller T, Juarez I, Perez M, Reyna F, Baumgartner D, Makarenko VN, Bockeria OL, Maksudov M, Rienmuller R, Baumgartner C. Deep Learning-Based Image Registration in Dynamic Myocardial Perfusion CT Imaging. IEEE Trans Med Imaging 2023; 42:684-696. [PMID: 36227828 DOI: 10.1109/tmi.2022.3214380] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Registration of dynamic CT image sequences is a crucial preprocessing step for clinical evaluation of multiple physiological determinants in the heart such as global and regional myocardial perfusion. In this work, we present a deformable deep learning-based image registration method for quantitative myocardial perfusion CT examinations, which in contrast to previous approaches, takes into account some unique challenges such as low image quality with less accurate anatomical landmarks, dynamic changes of contrast agent concentration in the heart chambers and tissue, and misalignment caused by cardiac stress, respiration, and patient motion. The introduced method uses a recursive cascade network with a ventricle segmentation module, and a novel loss function that accounts for local contrast changes over time. It was trained and validated on a dataset of n = 118 patients with known or suspected coronary artery disease and/or aortic valve insufficiency. Our results demonstrate that the proposed method is capable of registering dynamic cardiac perfusion sequences by reducing local tissue displacements of the left ventricle (LV), whereas contrast changes do not affect the registration and image quality, in particular the absolute CT (HU) values of the entire CT sequence. In addition, the deep learning-based approach presented reveals a short processing time of a few seconds compared to conventional image registration methods, demonstrating its application potential for quantitative CT myocardial perfusion measurements in daily clinical routine.
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Groh L, Mansfeld R, Baumgartner C, Sorge U. Apparent prevalence and risk factors for udder skin diseases and udder edema in Bavarian dairy herds. J Dairy Sci 2022; 105:9934-9943. [DOI: 10.3168/jds.2022-21867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 07/29/2022] [Indexed: 11/05/2022]
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6
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Malischnig D, Baumgartner C, Boumparis N, Schaub M. Evaluation eines Online-Selbsthilfeprogramms für
problematische und pathologische Glücksspieler*innen unter
Berücksichtigung häufiger komorbider
Störungen. Suchttherapie 2022. [DOI: 10.1055/s-0042-1756044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/22/2023]
Affiliation(s)
| | - C Baumgartner
- Schweizer Institut für Sucht- und Gesundheitsforschung,
Zürich
| | - N Boumparis
- Schweizer Institut für Sucht- und Gesundheitsforschung,
Zürich
| | - M Schaub
- Schweizer Institut für Sucht- und Gesundheitsforschung,
Zürich
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7
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Vostrikov S, Cossettini A, Leitner C, Baumgartner C, Benini L. AEPUS: a tool for the Automated Extraction of Pennation angles in Ultrasound images with low Signal-to-noise ratio for plane-wave imaging. Annu Int Conf IEEE Eng Med Biol Soc 2022; 2022:1520-1526. [PMID: 36086389 DOI: 10.1109/embc48229.2022.9871297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The penetrating ability of ultrasound (US) com-bined with its real-time operation make it the perfect tool for investigating muscle contraction mechanics during complex functional tasks, e.g., locomotion. Changes in fascicle lengths and pennation angles of muscle fascicles strongly correlate with the capacity of skeletal muscles to produce forces, thereby represent fundamental parameters to be tracked. While the gold standard for extracting these features from US images is still based on manual annotation, the availability of recording devices capable of generating big data of muscle dynamics makes such manual approach unfeasible, setting the need for automated muscle images annotation tools. Existing approaches, however, are seriously limited, also in view of the continuous developments and technology ad-vancements for ultrafast US and plane-wave imaging. In fact, they rely on conventional (slow) B-mode imaging, make use of point tracking approaches (which often fail due to out-of-plane motion), or can only operate on very high quality images. To overcome all these limitations, we present AEPUS, an automated image labeling tool capable of extracting pennation angles from low quality images using a very small number of plane waves, therefore making it capable of exploiting all the benefits of ultrafast US. Clinical Relevance - Ultrasound is a standard research tool to investigate alterations of spastic muscles in children with Cerebral Palsy. We propose a reliable and time-efficient method to track muscle features in ultrasound images and support clinical biomechanists in their analyses.
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8
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Mestre-Pintó JI, Fonseca F, Schaub MP, Baumgartner C, Alias-Ferri M, Torrens M. CANreduce-SP-adding psychological support to web-based adherence-focused guided self-help for cannabis users: study protocol for a three-arm randomized control trial. Trials 2022; 23:524. [PMID: 35733201 PMCID: PMC9214682 DOI: 10.1186/s13063-022-06399-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Accepted: 05/12/2022] [Indexed: 12/02/2022] Open
Abstract
Background Cannabis is the most-frequently used illicit drug in Europe. Over the last few years in Spain, treatment demand has increased, yet most cannabis users do not seek treatment despite the related problems. A web-based self-help tool, like CANreduce 2.0, could help these users to control their consumption. Methods This study protocol describes a three-arm randomized controlled trial (RCT) comparing the effectiveness of three approaches, in terms of reducing cannabis use among problematic cannabis users, the first two treatment arms including the Spanish version of CANreduce 2.0 (an adherence-focused, guidance-enhanced, web-based self-help tool) (1) with and (2) without psychological support; and the third group (3) treatment as usual (TAU). Study hypotheses will be tested concerning the primary outcome: change in the number of days of cannabis use over the previous week, comparing assessments at 6 weeks and 3 and 6 months follow-up between groups and against baseline. Secondary outcomes related to cannabis use will be tested similarly. Mental disorders will be explored as predictors of adherence and outcomes. Analyses will be performed on an intention-to-treat basis, then verified by complete case analyses. Discussion This study will test how effective the Spanish version of CANreduce 2.0 (CANreduce-SP) is at reducing both the frequency and quantity of cannabis use in problematic users and whether adding psychological support increases its effectiveness. Trial registration This trial is registered with the Clinical Trials Protocol Registration and Results System (PRS) number: NCT04517474. Registered 18 August 2020, (Archived by archive.is https://archive.is/N1Y64). The project commenced in November 2020 and recruitment is anticipated to end by November 2022.
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Affiliation(s)
- J I Mestre-Pintó
- Addiction Research Group (GRAd), Neuroscience Research Program, Hospital del Mar Medical Research Institute (IMIM), 08003, Barcelona, Spain. .,Department of Experimental and Health Sciences (CEXS), Universitat Pompeu Fabra, 08002, Barcelona, Spain.
| | - F Fonseca
- Addiction Research Group (GRAd), Neuroscience Research Program, Hospital del Mar Medical Research Institute (IMIM), 08003, Barcelona, Spain.,Department of Experimental and Health Sciences (CEXS), Universitat Pompeu Fabra, 08002, Barcelona, Spain.,Department of Psychiatry and Department of Pharmacology, School of Medicine, Universitat Autònoma de Barcelona (UAB), 08290, Cerdanyola del Vallès, Spain
| | - M P Schaub
- Swiss Research Institute for Public Health and Addiction, University of Zurich, Zurich, Switzerland
| | - C Baumgartner
- Swiss Research Institute for Public Health and Addiction, University of Zurich, Zurich, Switzerland
| | - M Alias-Ferri
- Addiction Research Group (GRAd), Neuroscience Research Program, Hospital del Mar Medical Research Institute (IMIM), 08003, Barcelona, Spain.,Department of Psychiatry and Department of Pharmacology, School of Medicine, Universitat Autònoma de Barcelona (UAB), 08290, Cerdanyola del Vallès, Spain
| | - M Torrens
- Addiction Research Group (GRAd), Neuroscience Research Program, Hospital del Mar Medical Research Institute (IMIM), 08003, Barcelona, Spain.,Department of Psychiatry and Department of Pharmacology, School of Medicine, Universitat Autònoma de Barcelona (UAB), 08290, Cerdanyola del Vallès, Spain.,Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, 08003, Barcelona, Spain
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9
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Nachbar M, Gutwein S, Schneider M, Zips D, Baumgartner C, Thorwarth D. PO-1637 Influence of training data variability on deep learning dose prediction robustness for MR-guided RT. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03601-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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10
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Baumgartner C, Fuchs L, Costa A, Picó-Cortés J, Reinhardt S, Gronin S, Gardner GC, Lindemann T, Manfra MJ, Faria Junior PE, Kochan D, Fabian J, Paradiso N, Strunk C. Effect of Rashba and Dresselhaus spin-orbit coupling on supercurrent rectification and magnetochiral anisotropy of ballistic Josephson junctions. J Phys Condens Matter 2022; 34:154005. [PMID: 35051919 DOI: 10.1088/1361-648x/ac4d5e] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 01/20/2022] [Indexed: 06/14/2023]
Abstract
Simultaneous breaking of inversion- and time-reversal symmetry in Josephson junction (JJ) leads to a possible violation of theI(φ) = -I(-φ) equality for the current-phase relation. This is known as anomalous Josephson effect and it produces a phase shiftφ0in sinusoidal current-phase relations. In ballistic JJs with non-sinusoidal current phase relation the observed phenomenology is much richer, including the supercurrent diode effect and the magnetochiral anisotropy (MCA) of Josephson inductance. In this work, we present measurements of both effects on arrays of JJs defined on epitaxial Al/InAs heterostructures. We show that the orientation of the current with respect to the lattice affects the MCA, possibly as the result of a finite Dresselhaus component. In addition, we show that the two-fold symmetry of the Josephson inductance reflects in the activation energy for phase slips.
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Affiliation(s)
- C Baumgartner
- Institut für Experimentelle und Angewandte Physik, University of Regensburg, 93040 Regensburg, Germany
| | - L Fuchs
- Institut für Experimentelle und Angewandte Physik, University of Regensburg, 93040 Regensburg, Germany
| | - A Costa
- Institut für Theoretische Physik, University of Regensburg, 93040 Regensburg, Germany
| | - Jordi Picó-Cortés
- Institut für Theoretische Physik, University of Regensburg, 93040 Regensburg, Germany
| | - S Reinhardt
- Institut für Experimentelle und Angewandte Physik, University of Regensburg, 93040 Regensburg, Germany
| | - S Gronin
- Microsoft Quantum Purdue, Purdue University, West Lafayette, Indiana 47907 United States of America
- Birck Nanotechnology Center, Purdue University, West Lafayette, Indiana 47907 United States of America
| | - G C Gardner
- Microsoft Quantum Purdue, Purdue University, West Lafayette, Indiana 47907 United States of America
- Birck Nanotechnology Center, Purdue University, West Lafayette, Indiana 47907 United States of America
| | - T Lindemann
- Birck Nanotechnology Center, Purdue University, West Lafayette, Indiana 47907 United States of America
- Department of Physics and Astronomy, Purdue University, West Lafayette, Indiana 47907 United States of America
| | - M J Manfra
- Microsoft Quantum Purdue, Purdue University, West Lafayette, Indiana 47907 United States of America
- Birck Nanotechnology Center, Purdue University, West Lafayette, Indiana 47907 United States of America
- Department of Physics and Astronomy, Purdue University, West Lafayette, Indiana 47907 United States of America
- School of Materials Engineering, Purdue University, West Lafayette, Indiana 47907 United States of America
- School of Electrical and Computer Engineering, Purdue University, West Lafayette, Indiana 47907 United States of America
| | - P E Faria Junior
- Institut für Theoretische Physik, University of Regensburg, 93040 Regensburg, Germany
| | - D Kochan
- Institut für Theoretische Physik, University of Regensburg, 93040 Regensburg, Germany
| | - J Fabian
- Institut für Theoretische Physik, University of Regensburg, 93040 Regensburg, Germany
| | - N Paradiso
- Institut für Experimentelle und Angewandte Physik, University of Regensburg, 93040 Regensburg, Germany
| | - C Strunk
- Institut für Experimentelle und Angewandte Physik, University of Regensburg, 93040 Regensburg, Germany
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11
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Mandujano Reyes JF, Walleser E, Hachenberg S, Gruber S, Kammer M, Baumgartner C, Mansfeld R, Anklam K, Döpfer D. Full model selection using regression trees for numeric predictions of biomarkers for metabolic challenges in dairy cows. Prev Vet Med 2021; 193:105422. [PMID: 34224912 DOI: 10.1016/j.prevetmed.2021.105422] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 05/19/2021] [Accepted: 06/28/2021] [Indexed: 11/24/2022]
Abstract
Dairy cows suffer poor metabolic adaptation syndrome (PMAS)1 during early post-calving periods caused by negative energy balance. Measurement of blood beta-hydroxy butyric acid (BHBA)2 and blood non-esterified fatty acids (NEFA)3 allow early and accurate detection of negative energy balance. Machine learning prediction of blood BHBA and blood NEFA using milk testing samples represents an opportunity to identify at-risk animals, using less labor than direct blood testing methods. Routine milk testing on modern dairies and computer record keeping provide an immense amount of data which can then be used in machine learning models. Previous research for predicting blood metabolites using Fourier-transform infrared spectroscopy (FTIR)4 milk data has focused mainly on individual models rather than a comparison among the models. Full model selection is the process of comparing different combinations of pre-processing methods, variable selection, and statistical learning algorithms to determine which model results in the lowest prediction error for a given dataset. For this project we used a full model selection approach with regression trees (rtFMS)5 . rtFMS uses the cross-validated performance of different model configurations to feed a regression tree for selecting a final model. A total of 384 possible model configurations (algorithms, predictors and data preprocessing options) for each outcome (blood BHBA and blood NEFA) were considered in the rtFMS technique. rtFMS allows direct comparison of multiple modeling approaches reducing bias due to empirical knowledge, modeling habits, or preferences, identifying the model with minimal root mean squared prediction error (RMSE)6 . An elastic net regression model was selected as the best performing model for both biomarkers. The input data for blood BHBA predictions were FTIR milk spectra, with a second derivative pre-processing, and a filter with 212 wave numbers, obtaining RMSE = 0.354 (0.328-0.392). The best performing model for blood NEFA had input data of FTIR milk spectra, with a second derivative pre-processing, and a filter with 212 wave numbers filter along with the time of milking, obtaining RMSE = 0.601 (0.564-0.654). The comparison of multiple modeling strategies, conducted by rtFMS, present an option for improved FTIR prediction models of blood BHBA and blood NEFA by reducing error due to human bias. The implementation of rtFMS to design future prediction models can guide model inputs and features. Our prediction models have the potential to increase early detection of metabolic disorders in dairy cows during the transition period.
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Affiliation(s)
- J F Mandujano Reyes
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI, USA.
| | - E Walleser
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI, USA
| | - S Hachenberg
- German Association for Performance and Quality Testing e.V. (DLQ), 53111, Bonn, Germany
| | - S Gruber
- Clinic for Ruminants with Ambulatory and Herd Health Services, Ludwig-Maximilian-University Munich (LMU Munich), 85764, Oberschleißheim, Germany
| | - M Kammer
- LKV Bayern e. V. (Dairy Herd Improvement Association of Bavaria), 80687, Munich, Germany
| | - C Baumgartner
- Bavarian Association for Raw Milk Testing e. V. (MPR), 85283, Wolnzach, Germany
| | - R Mansfeld
- Clinic for Ruminants with Ambulatory and Herd Health Services, Ludwig-Maximilian-University Munich (LMU Munich), 85764, Oberschleißheim, Germany
| | - K Anklam
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI, USA
| | - D Döpfer
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI, USA
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12
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Pirker S, Graef A, Gächter M, Baumgartner C. Costs of Epilepsy in Austria: Unemployment as a primary driving factor. Seizure 2021; 89:24-29. [PMID: 33975079 DOI: 10.1016/j.seizure.2021.04.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 04/22/2021] [Accepted: 04/24/2021] [Indexed: 11/28/2022] Open
Abstract
PURPOSE Epilepsy is one of the most common chronic neurological disorders, and long-term treatment with antiseizure medication is often central to its management. The costs of antiseizure medication are more evident than other disease-related costs; thus, we assessed the direct and indirect costs of epilepsy focusing on both drug expenditure and other cost-driving factors. METHODS Outpatient records and questionnaires applied in a tertiary epilepsy centre in Vienna were used in this bottom-up cost-of-illness study to evaluate disease duration, age at onset, epilepsy syndrome, seizure frequency, sex, healthcare utilisation, diagnostic evaluations, antiseizure medication, and occupation. Cost data were clustered in a histogram-based data analysis, and multivariate regressions were performed to identify cost drivers. RESULTS The average annual costs of 273 patients amounted to €9,256 ($10,459): €4,486 ($5,069) direct costs and €4,770 ($5,390) indirect costs. A histogram of semi-annual costs revealed distinct groups with low costs (< €2,500 = $2,825) and high costs (> €2,500 = $2,825). Seizure-free patients were clustered in the group with low costs; patients with ongoing seizures appeared more frequently in the group with high costs. Working patients were more often found in the group with low costs, whereas unemployed patients were more prevalent in the group with high costs. The regression analysis confirmed worklessness as the main cost driver. CONCLUSION Non-productivity and poorly controlled disease with ongoing seizures are associated with higher costs in epilepsy. Providing high-level care and optimal drug treatment that enables patients to remain in work may help reduce the economic burden of epilepsy.
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Affiliation(s)
- S Pirker
- Klinik Hietzing and Karl Landsteiner Institute for Clinical Epilepsy Research and Cognitive Neurology, Vienna, Austria.
| | - A Graef
- Klinik Hietzing and Karl Landsteiner Institute for Clinical Epilepsy Research and Cognitive Neurology, Vienna, Austria
| | - M Gächter
- University of Innsbruck, Department of Economics and Statistics, Innsbruck, Austria
| | - C Baumgartner
- Klinik Hietzing and Karl Landsteiner Institute for Clinical Epilepsy Research and Cognitive Neurology, Vienna, Austria
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Riederer F, Seiger R, Lanzenberger R, Pataraia E, Kasprian G, Michels L, Beiersdorf J, Kollias S, Czech T, Hainfellner J, Baumgartner C. Voxel-Based Morphometry-from Hype to Hope. A Study on Hippocampal Atrophy in Mesial Temporal Lobe Epilepsy. AJNR Am J Neuroradiol 2020; 41:987-993. [PMID: 32522839 DOI: 10.3174/ajnr.a6545] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 03/18/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND PURPOSE Automated volumetry of the hippocampus is considered useful to assist the diagnosis of hippocampal sclerosis in temporal lobe epilepsy. However, voxel-based morphometry is rarely used for individual subjects because of high rates of false-positives. We investigated whether an approach with high dimensional warping to the template and nonparametric statistics would be useful to detect hippocampal atrophy in patients with hippocampal sclerosis. MATERIALS AND METHODS We performed single-subject voxel-based morphometry with nonparametric statistics within the framework of Statistical Parametric Mapping to compare MRI from 26 well-characterized patients with temporal lobe epilepsy individually against a group of 110 healthy controls. The following statistical threshold was used: P < .05 corrected for multiple comparisons with family-wise error over the region of interest right and left hippocampus. RESULTS The sensitivity for the detection of atrophy related to hippocampal sclerosis was 0.92 (95% CI, 0.67-0.99) for the right hippocampus and 0.60 (0.31-0.83) for the left, and the specificity for volume changes was 0.98 (0.93-0.99). All clusters of decreased hippocampal volumes were correctly lateralized to the seizure focus. Hippocampal volume decrease was in accordance with neuronal cell loss on histology reports. CONCLUSIONS Nonparametric voxel-based morphometry is sensitive and specific for hippocampal atrophy in patients with mesial temporal lobe epilepsy and may be useful in clinical practice.
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Affiliation(s)
- F Riederer
- From the Hietzing Hospital with Neurological Center Rosenhügel & Karl Landsteiner Institute for Clinical Epilepsy Research and Cognitive Neurology (F.R., J.B., C.B.), Vienna, Austria .,Faculty of Medicine (F.R.), University of Zurich, Zurich, Switzerland
| | - R Seiger
- Neuroimaging Labs, Department of Psychiatry and Psychotherapy (R.S., R.L.)
| | - R Lanzenberger
- Neuroimaging Labs, Department of Psychiatry and Psychotherapy (R.S., R.L.)
| | | | | | - L Michels
- Clinic of Neuroradiology (L.M., S.K.), University Hospital Zurich, Zurich, Switzerland
| | - J Beiersdorf
- From the Hietzing Hospital with Neurological Center Rosenhügel & Karl Landsteiner Institute for Clinical Epilepsy Research and Cognitive Neurology (F.R., J.B., C.B.), Vienna, Austria
| | - S Kollias
- Clinic of Neuroradiology (L.M., S.K.), University Hospital Zurich, Zurich, Switzerland
| | | | - J Hainfellner
- and Institute of Neurology (J.H.), Medical University of Vienna, Vienna, Austria
| | - C Baumgartner
- From the Hietzing Hospital with Neurological Center Rosenhügel & Karl Landsteiner Institute for Clinical Epilepsy Research and Cognitive Neurology (F.R., J.B., C.B.), Vienna, Austria.,Medical Faculty (C.B.), Sigmund Freud Private University, Vienna, Austria
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Schunker H, Baumgartner C, Birch AC, Cameron RH, Braun DC, Gizon L. Average motion of emerging solar active region polarities: II. Joy's law. Astron Astrophys 2020; 640:A116. [PMID: 33958807 PMCID: PMC8097718 DOI: 10.1051/0004-6361/201937322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
CONTEXT The tilt of solar active regions described by Joy's law is essential for converting a toroidal field to a poloidal field in Babcock-Leighton dynamo models. In thin flux tube models the Coriolis force causes what we observe as Joy's law, acting on east-west flows as they rise towards the surface. AIMS Our goal is to measure the evolution of the average tilt angle of hundreds of active regions as they emerge, so that we can constrain the origins of Joy's law. METHODS We measured the tilt angle of the primary bipoles in 153 emerging active regions (EARs) in the Solar Dynamics Observatory Helioseismic Emerging Active Region survey. We used line-of-sight magnetic field measurements averaged over 6 h to define the polarities and measure the tilt angle up to four days after emergence. RESULTS We find that at the time of emergence the polarities are on average aligned east-west, and that neither the separation nor the tilt depends on latitude. We do find, however, that EARs at higher latitudes have a faster north-south separation speed than those closer to the equator at the emergence time. After emergence, the tilt angle increases and Joy's law is evident about two days later. The scatter in the tilt angle is independent of flux until about one day after emergence, when we find that higher-flux regions have a smaller scatter in tilt angle than lower-flux regions. CONCLUSIONS Our finding that active regions emerge with an east-west alignment is consistent with earlier observations, but is still surprising since thin flux tube models predict that tilt angles of rising flux tubes are generated below the surface. Previously reported tilt angle relaxation of deeply anchored flux tubes can be largely explained by the change in east-west separation. We conclude that Joy's law is caused by an inherent north-south separation speed present when the flux first reaches the surface, and that the scatter in the tilt angle is consistent with buffeting of the polarities by supergranulation.
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Affiliation(s)
- H Schunker
- Max-Planck-Institut für Sonnensystemforschung, 37077 Göttingen, Germany
- School of Mathematical and Physical Sciences, The University of Newcastle, Newcastle, NSW, Australia
| | - C Baumgartner
- Max-Planck-Institut für Sonnensystemforschung, 37077 Göttingen, Germany
| | - A C Birch
- Max-Planck-Institut für Sonnensystemforschung, 37077 Göttingen, Germany
| | - R H Cameron
- Max-Planck-Institut für Sonnensystemforschung, 37077 Göttingen, Germany
| | - D C Braun
- NorthWest Research Associates, 3380 Mitchell Ln, Boulder, CO 80301, USA
| | - L Gizon
- Max-Planck-Institut für Sonnensystemforschung, 37077 Göttingen, Germany
- Georg-August-Universität Göttingen, Institut für Astrophysik, Friedrich-Hund-Platz 1, 37077 Göttingen, Germany
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Hammen T, Reisert M, Juschkat W, Egger K, Urbach H, Zentner J, Beck J, Hamer H, Steinhoff BJ, Baumgartner C, Schulze-Bonhage A, Puhahn-Schmeiser B. Alterations of intracerebral connectivity in epilepsy patients with secondary bilateral synchrony. Epilepsy Res 2020; 166:106402. [PMID: 32673968 DOI: 10.1016/j.eplepsyres.2020.106402] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Revised: 05/19/2020] [Accepted: 06/20/2020] [Indexed: 10/24/2022]
Abstract
INTRODUCTION The aim of our study was to evaluate intracerebral network changes in epilepsy patients demonstrating secondary bilateral synchrony (SBS) in EEG by applying a new Diffusion Tensor Imaging (DTI) method using an energy-based global tracking algorithm. MATERIALS AND METHODS 10 MRI negative epilepsy patients demonstrating SBS in 10-20 surface EEG were included. EEG findings were analyzed for irritative zones characterized by focal interictal epileptiform discharges (IEDs) triggering SBS. In addition, DTI including an energy-based global tracking algorithm was applied to analyze fiber tract alterations in irritative zones. To measure the deviation of a certain cortical connection in comparison to healthy controls, normalized differences of fiber tract streamline counts (SC) and their p-values were evaluated in comparison to corresponding fibers of the control group. RESULTS In 6 patients the irritative zone initiating SBS was located in the frontal lobe, in 3 patients in the temporal lobe and in 1 patient in the region surrounding the right central sulcus. All patients demonstrated significantly altered SC in brain lobes where the irritative zone triggering SBS was located (p ≤ 0.05). Seven out of 10 patients demonstrated SC alterations in tracts connecting brain lobes between the ipsilateral and the contralateral hemisphere (p ≤ 0.05). CONCLUSION Our data demonstrate that alterations in fiber tracts in irritative zones triggering SBS are not necessarily associated with intracerebral lesions visible in high resolution MRI. Our study gives evidence that diffusion tensor imaging is a promising non-invasive additive tool for intracerebral network analyses even in MRI-negative epilepsy patients.
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Affiliation(s)
- T Hammen
- Department of Epileptology, Medical Center, University of Freiburg, Faculty of Medicine, Breisacher Strasse 64, 79106 Freiburg, Germany; Clinic of Neurology, Westpfalz Klinikum Kaiserslautern, Hellmut-Hartert-Straße 1, 67655 Kaiserslautern, Germany
| | - M Reisert
- Medical Physics, Department of Radiology, University of Freiburg, Breisacher Strasse 60a, 79106 Freiburg, Germany
| | - W Juschkat
- Department of Epileptology, Medical Center, University of Freiburg, Faculty of Medicine, Breisacher Strasse 64, 79106 Freiburg, Germany
| | - K Egger
- Department of Neuroradiology, Medical Center, University of Freiburg, Faculty of Medicine, Breisacher Strasse 64, 79106 Freiburg, Germany
| | - H Urbach
- Department of Neuroradiology, Medical Center, University of Freiburg, Faculty of Medicine, Breisacher Strasse 64, 79106 Freiburg, Germany
| | - J Zentner
- Department of Neurosurgery, Medical Center, University of Freiburg, Faculty of Medicine, Breisacher Strasse 64, 79106 Freiburg, Germany
| | - J Beck
- Department of Neurosurgery, Medical Center, University of Freiburg, Faculty of Medicine, Breisacher Strasse 64, 79106 Freiburg, Germany
| | - H Hamer
- Epilepsy Center, Department of Neurology, University of Erlangen, Schwabachanlage 6, 91054 Erlangen, Germany
| | - B J Steinhoff
- Epilepsy Center Kork, Landstrasse 1, 77694 Kehl, Germany
| | - C Baumgartner
- Neurological Center Rosenhügel & Karl Landsteiner Institute for Clinical Epilepsy Research and Cognitive Neurology, Riedelgasse 5, 1130 Vienna, Austria; Medical Faculty, Sigmund Freud Private University, Vienna, Austria
| | - A Schulze-Bonhage
- Department of Epileptology, Medical Center, University of Freiburg, Faculty of Medicine, Breisacher Strasse 64, 79106 Freiburg, Germany
| | - B Puhahn-Schmeiser
- Department of Neurosurgery, Medical Center, University of Freiburg, Faculty of Medicine, Breisacher Strasse 64, 79106 Freiburg, Germany.
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Foesleitner O, Nenning KH, Bartha-Doering L, Baumgartner C, Pataraia E, Moser D, Schwarz M, Schmidbauer V, Hainfellner JA, Czech T, Dorfer C, Langs G, Prayer D, Bonelli S, Kasprian G. Reply. AJNR Am J Neuroradiol 2020; 41:E47-E48. [PMID: 32439648 DOI: 10.3174/ajnr.a6597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- O Foesleitner
- Departments of Biomedical Imaging and Image-Guided Therapy
| | - K-H Nenning
- Departments of Biomedical Imaging and Image-Guided Therapy
| | | | - C Baumgartner
- General Hospital Hietzing with Neurological Center RosenhuegelVienna, Austria
| | | | | | - M Schwarz
- Departments of Biomedical Imaging and Image-Guided Therapy
| | - V Schmidbauer
- Departments of Biomedical Imaging and Image-Guided Therapy
| | | | | | | | - G Langs
- Departments of Biomedical Imaging and Image-Guided Therapy
| | - D Prayer
- Departments of Biomedical Imaging and Image-Guided Therapy
| | | | - G Kasprian
- Departments of Biomedical Imaging and Image-Guided TherapyMedical University of ViennaVienna, Austria
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Foesleitner O, Nenning KH, Bartha-Doering L, Baumgartner C, Pataraia E, Moser D, Schwarz M, Schmidbauer V, Hainfellner JA, Czech T, Dorfer C, Langs G, Prayer D, Bonelli S, Kasprian G. Lesion-Specific Language Network Alterations in Temporal Lobe Epilepsy. AJNR Am J Neuroradiol 2020; 41:147-154. [PMID: 31896570 DOI: 10.3174/ajnr.a6350] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 10/21/2019] [Indexed: 12/27/2022]
Abstract
BACKGROUND AND PURPOSE Temporal lobe epilepsy, structural or nonlesional, may negatively affect language function. However, little is known about the lesion-specific influence on language networks. We hypothesized that different epileptogenic lesions are related to distinct alterations in the functional language connectome detected by fMRI. MATERIALS AND METHODS One hundred one patients with epilepsy due to mesiotemporal sclerosis (21 left, 22 right), low-grade mesiotemporal tumors (12 left), or nonlesional temporal lobe epilepsy (22 left, 24 right) and 22 healthy subjects performed 3T task-based language fMRI. Task-based activation maps (laterality indices) and functional connectivity analysis (global and connectivity strengths between language areas) were correlated with language scores. RESULTS Laterality indices based on fMRI activation maps failed to discriminate among patient groups. Functional connectivity analysis revealed the most extended language network alterations in left mesiotemporal sclerosis (involving the left temporal pole, left inferior frontal gyrus, and bilateral premotor areas). The other patient groups showed less extended but also predominantly ipsilesional network changes compared with healthy controls. Left-to-right hippocampal connectivity strength correlated positively with naming function (P = .01), and connectivity strength between the left Wernicke area and the left hippocampus was linked to verbal fluency scores (P = .01) across all groups. CONCLUSIONS Different pathologies underlying temporal lobe epilepsy are related to distinct alterations of the functional language connectome visualized by fMRI functional connectivity analysis. Network analysis allows new insights into language organization and provides possible imaging biomarkers for language function. These imaging findings emphasize the importance of a personalized treatment strategy in patients with epilepsy.
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Affiliation(s)
- O Foesleitner
- From the Departments of Biomedical Imaging and Image-Guided Therapy (O.F., K.-H.N., M.S., V.S., G.L., D.P., G.K.)
| | - K-H Nenning
- From the Departments of Biomedical Imaging and Image-Guided Therapy (O.F., K.-H.N., M.S., V.S., G.L., D.P., G.K.)
| | | | - C Baumgartner
- General Hospital Hietzing with Neurological Center Rosenhuegel (C.B.), Vienna, Austria
| | | | - D Moser
- Neurology (E.P., D.M., S.B.)
| | - M Schwarz
- From the Departments of Biomedical Imaging and Image-Guided Therapy (O.F., K.-H.N., M.S., V.S., G.L., D.P., G.K.)
| | - V Schmidbauer
- From the Departments of Biomedical Imaging and Image-Guided Therapy (O.F., K.-H.N., M.S., V.S., G.L., D.P., G.K.)
| | | | - T Czech
- Neurosurgery (T.C., C.D.), Medical University of Vienna, Vienna, Austria
| | - C Dorfer
- Neurosurgery (T.C., C.D.), Medical University of Vienna, Vienna, Austria
| | - G Langs
- From the Departments of Biomedical Imaging and Image-Guided Therapy (O.F., K.-H.N., M.S., V.S., G.L., D.P., G.K.)
| | - D Prayer
- From the Departments of Biomedical Imaging and Image-Guided Therapy (O.F., K.-H.N., M.S., V.S., G.L., D.P., G.K.)
| | | | - G Kasprian
- From the Departments of Biomedical Imaging and Image-Guided Therapy (O.F., K.-H.N., M.S., V.S., G.L., D.P., G.K.)
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18
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Montrasio G, Coslovsky M, Wiencierz A, Baumgartner C, Rodondi N, Kuehne MS, Moschovitis G, Preiss H, Reiner MF, De Perna ML, Conen D, Osswald S, Beer JH, Koepfli P. P1898Prevalence and risk of DOACs inappropriate dosing in atrial fibrillation. An analysis of the Swiss-AF and BEAT-AF registries. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0645] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Direct oral anticoagulants (DOACs) have a similar efficacy in terms of stroke and mortality reduction as compared to Vitamin K-Antagonists (VKAs) and improved safety with regards to intracranial haemorrhage in patients with non-valvular atrial fibrillation (AF). Dose of DOACs needs to be adjusted according to age, weight, renal function and concomitant medication. Yet, off-label dosages have been reported in 11 - 45% of patients (on average 20%).
Purpose
To assess the prevalence of inappropriate DOAC-dosing according to the official prescribing information in two large prospective Swiss AF cohorts (Swiss-AF and BEAT-AF) and to evaluate its correlation with adverse clinical outcomes.
Methods
All 3267 patients taking oral anticoagulants were stratified at baseline as receiving DOACs (adequately dosed, under- or overdosed) or VKAs. Appropriateness of DOAC dosing was assessed based on age (≥80 years), weight (≤60kg) and renal function (serum creatinine ≥133μmol/l [apixaban]; creatinine clearence ≤50ml/min [all other DOACs]). Clinical outcomes were collected during a median follow-up of 2.96 years. Major adverse clinical events (MACE) consisted of a combination of myocardial infarction, cardiac death, ischemic stroke and systemic embolism. Safety was assessed by occurrence of any bleeding event.
Results
1902 patients (58%) were on VKAs and 1365 on DOACs (42%). In the DOAC group, 1149 patients received a dose consistent with drug labelling (84%), 133 (10%) received an inappropriately high and 83 (6%) an inappropriately low dose. Overdosed patients were older than those adequately treated and more likely female, had a lower BMI and a higher CHA2DS2-VASc score (4 vs. 3 points) (p<0.001 for all). Underdosed patients were more likely to have concomitant antiplatelet therapy (p<0.001). Both off-label groups were more likely to have a history of coronary artery disease, heart failure and chronic kidney disease (p<0.001). Kaplan-Meier cumulative incidence rates for the first occurrence of MACE or bleedings are provided in Figure 1. Overdosed patients had an almost two-fold higher risk of bleeding (9.0 vs. 5.0 events per 100 patient-years compared to correctly dosed DOACs and to VKAs) and a higher rate of MACE (5.1 vs. 2.3 events per 100 patient years compared to correctly dosed DOACs and 5.1 vs. 3.4 compared to VKAs). Underdosing did not seem to be associated with a relevant increase in ischemic or bleeding events as compared to correctly dosed DOACs and VKAs (see Figure 1).
Figure 1. Kaplan-Meier incidence curves
Conclusion
Inadequate DOACs dosing was found in 1 in 6 patients and correlated with a higher burden of comorbidities at baseline. Underdosing correlated with concomitant antiplatelet therapy. Overdosing was associated with adverse clinical outcome for ischemic and bleeding events.
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Affiliation(s)
- G Montrasio
- Cantonal Hospital of Baden, Baden, Switzerland
| | - M Coslovsky
- Cardiovascular Research Institute, Basel, Switzerland
| | - A Wiencierz
- University Hospital Basel, Clinical Trial Unit, Basel, Switzerland
| | - C Baumgartner
- Preventive Cardiology & Sports Medicine, Inselspital Bern, Bern, Switzerland
| | - N Rodondi
- Preventive Cardiology & Sports Medicine, Inselspital Bern, Bern, Switzerland
| | - M S Kuehne
- University Hospital Basel, Basel, Switzerland
| | | | - H Preiss
- Cantonal Hospital of Baden, Baden, Switzerland
| | - M F Reiner
- University Hospital Zurich, Zurich, Switzerland
| | | | - D Conen
- University Hospital Basel, Basel, Switzerland
| | - S Osswald
- University Hospital Basel, Basel, Switzerland
| | - J H Beer
- Cantonal Hospital of Baden, Baden, Switzerland
| | - P Koepfli
- Cantonal Hospital of Baden, Baden, Switzerland
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Tremblay M, Kammer M, Lange H, Plattner S, Baumgartner C, Stegeman J, Duda J, Mansfeld R, Döpfer D. Prediction model optimization using full model selection with regression trees demonstrated with FTIR data from bovine milk. Prev Vet Med 2019; 163:14-23. [DOI: 10.1016/j.prevetmed.2018.12.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 10/19/2018] [Accepted: 12/18/2018] [Indexed: 10/27/2022]
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20
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Bauer C, Schillinger U, Brandl J, Meyer-Lindenberg A, Ott A, Baumgartner C. Comparison of pre-emptive butorphanol or metamizole with ketamine +medetomidine and s-ketamine + medetomidine anaesthesia in improving intraoperative analgesia in mice. Lab Anim 2018; 53:459-469. [PMID: 30526293 DOI: 10.1177/0023677218815208] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In accordance with the 'refinement' component of the 3Rs, the primary aim of this study was to investigate and compare ketamine + medetomidine (KM) and s-ketamine + medetomidine (SKM) anaesthetic protocols in C57BL/6J mice (both sexes). We sought to determine whether s-ketamine could provide adequate surgical tolerance at a 50% dose relative to that of ketamine racemate and whether antagonism of medetomidine could be initiated 15 min earlier. The second aim was to investigate the potential improvement in analgesia for both anaesthetic protocols by adding butorphanol or metamizole. Analgesia was tested via the pedal withdrawal reaction (PWR) to a painful stimulus. During anaesthesia, respiratory frequency, pulse oximetry, body temperature and PWR were monitored. Among the 16 mice in each group, the PWR was lost in all the KM + metamizole (35:56 ± 6:07 min), KM + butorphanol (43:45 ± 2:14 min) and SKM + butorphanol (24:03 ± 5:50 min) mice, 15 of the non-premedicated KM (37:00 ± 8:11 min) mice, and 9 of the pure SKM (20:00 ± 4:19 min) mice; the latter group increased to 11 mice (17:16 ± 5:10 min) with premedication of metamizole. In contrast to the racemic combination, s-ketamine at the dose used here did not lead to sufficient loss of the PWR. However, earlier partial antagonism of SKM resulted in a slightly shorter and qualitatively better recovery than later partial antagonism of SKM. The addition of metamizole or butorphanol to KM or SKM anaesthesia positively influences the analgesic quality. However, when butorphanol is added, controlled ventilation may be necessary, especially for male mice.
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Affiliation(s)
- C Bauer
- Centre of Preclinical Research, Technical University of Munich, Germany
| | - U Schillinger
- Centre of Preclinical Research, Technical University of Munich, Germany
| | - J Brandl
- Centre of Preclinical Research, Technical University of Munich, Germany
| | - A Meyer-Lindenberg
- Clinic for Small Animal Surgery and Reproduction, Ludwig-Maximilians-University Munich, Germany
| | - A Ott
- Institute for Medical Statistics and Epidemiology, Technical University of Munich, Germany
| | - C Baumgartner
- Centre of Preclinical Research, Technical University of Munich, Germany
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Nicol P, Bulin A, Castellanos MI, Stoeger M, Obermeier S, Fischer J, Baumgartner C, Steiger K, Joner M. P2637Preclinical evaluation of a bioresorbable vascular scaffold (BRS) on the reduction of neoatherosclerosis. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2637] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- P Nicol
- German Heart Center of Munich, Munich, Germany
| | - A Bulin
- German Heart Center of Munich, Munich, Germany
| | | | - M Stoeger
- German Heart Center of Munich, Munich, Germany
| | - S Obermeier
- German Heart Center of Munich, Munich, Germany
| | - J Fischer
- Technical University of Munich, Zentrum für präklinische Forschung, Munich, Germany
| | - C Baumgartner
- Technical University of Munich, Zentrum für präklinische Forschung, Munich, Germany
| | - K Steiger
- Technical University of Munich, Institut für Pathologie, Munich, Germany
| | - M Joner
- German Heart Center of Munich, Munich, Germany
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Tremblay M, Kammer M, Lange H, Plattner S, Baumgartner C, Stegeman J, Duda J, Mansfeld R, Döpfer D. Identifying poor metabolic adaptation during early lactation in dairy cows using cluster analysis. J Dairy Sci 2018; 101:7311-7321. [DOI: 10.3168/jds.2017-13582] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Accepted: 03/26/2018] [Indexed: 11/19/2022]
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23
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Jilek C, Bickel K, Fischer J, Baumgartner C, Lewalter T. P348Mini electrodes and arrhythmogenic substrate - Influence of tip-to-tissue angulation and irrigation on signal quality. Europace 2018. [DOI: 10.1093/europace/euy015.159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- C Jilek
- Peter-Osypka-Heart Centre, Hospital for Internal Medicine Munich South, Munich, Germany
| | - K Bickel
- Peter-Osypka-Heart Centre, Hospital for Internal Medicine Munich South, Munich, Germany
| | - J Fischer
- Technische Universität München, Zentrum für präklinische Forschung, Munich, Germany
| | - C Baumgartner
- Technische Universität München, Zentrum für präklinische Forschung, Munich, Germany
| | - T Lewalter
- Peter-Osypka-Heart Centre, Hospital for Internal Medicine Munich South, Munich, Germany
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Abstract
Summary
Objectives:
Marfan syndrome (MFS) is an autosomal dominant inherited connective tissue disorder caused by mutations in the fibrillin-1 (FBN1) gene with variable clinical manifestations in the cardiovascular, musculoskeletal and ocular systems.
Methods:
Data of molecular genetic analysis and a catalogue of clinical manifestations including aortic elastic parameters were mined in order to (i) assess aortic abnormality before and during medical treatment, and to (ii) identify novel correlations between the genotype and phenotype of the disease using hierarchical cluster analysis and logistic regression analysis. A score measure describing the similarity between a patient’s clinical symptoms and a characteristic phenotype class was introduced.
Results:
A probabilistic model for monitoring the loss of aortic elasticity was built on merely aortic parameters of 34 patients with classic MFS and 43 control subjects showing a sensitivity of 82% and a specificity of 96%. The clinical phenotypes of 100 individuals with classical or suspected MFS were clustered yielding four different phenotypic expressions. The highest correlation was found between FBN1 missense mutations, which manifested as ectopia lentis, skeletal major and skin minor criteria, and two out of four clustered phenotypes. The probability of the presence of a missense mutation in both phenotype classes is approximately 70%.
Conclusions:
Monitoring of aortic elastic properties during medical treatment may serve as additional criterion to indicate elective surgical interventions. Genotype-phenotype correlation may contribute to anticipate the clinical consequences of specific FBN1 mutations more comprehensively and may be helpful to identify MFS patients at risk at an early stage of disease.
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Baumgartner C, Blinowska KJ, Cichocki A, Dickhaus H, Durka PJ, McClintock PVE, Pfurtscheller G, Stefanovska A, Tong S. Discussion of “Time-frequency Techniques in Biomedical Signal Analysis: A Tutorial Review of Similarities and Differences”. Methods Inf Med 2018. [DOI: 10.1055/s-0038-1627059] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Breit M, Pfeifer B, Baumgartner C, Modre-Osprian R, Tilg B, Visvanathan M. DMSP – Database for Modeling Signaling Pathways. Methods Inf Med 2018. [DOI: 10.3414/me0461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Summary
Objectives:
Presently, the protein interaction information concerning different signaling pathways is available in a qualitative manner in different online protein interaction databases. The challenge here is to derive a quantitative way of modeling signaling pathways from qualitative way of modeling signaling pathways from a qualitative level. To address this issue we developed a database that includes mathematical modeling knowledge and biological knowledge about different signaling pathways.
Methods:
The database is part of an integrative environment that includes environments for pathway design, visualization, simulation and a knowledge base that combines biological and modeling information concerning pathways. The system is designed as a client-server architecture. It contains a pathway designing environment and a simulation environment as upper layers with a relational knowledge base as the underlying layer.
Results:
DMSP – Database for Modeling Signaling Pathways incorporates biological datasets from online databases like BIND, DIP, PIP, and SPiD. The modeling knowledge that has been incorporated is based on a literature study. Pathway models can be designed, visualized and simulated based on the knowledge stored in the DMSP. The user can download the whole dataset and build pathway models using the knowledge stored in our database. As an example, the TNF? pathway model was implemented and tested using this approach.
Conclusion:
DMSP is an initial step towards the aim of combining modeling and biological knowledge concerning signaling pathways. It helps in understanding pathways in a qualitative manner from a qualitative level. Simulation results enable the interpretation of a biological system from a quantitative and systemtheoretic point of view.
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Hanser F, Seger M, Netzer M, Osl M, Modre-Osprian R, Schreier G, Baumgartner C, Pfeifer B, Wurz M. An Epidemiological Modeling and Data Integration Framework. Methods Inf Med 2018; 49:290-6. [DOI: 10.3414/me09-02-0025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2009] [Accepted: 03/08/2010] [Indexed: 11/09/2022]
Abstract
Summary
Objectives: In this work, a cellular automaton software package for simulating different infectious diseases, storing the simulation results in a data warehouse system and analyzing the obtained results to generate prediction models as well as contingency plans, is proposed. The Brisbane H3N2 flu virus, which has been spreading during the winter season 2009, was used for simulation in the federal state of Tyrol, Austria.
Methods: The simulation-modeling framework consists of an underlying cellular automaton. The cellular automaton model is parameterized by known disease parameters and geographical as well as demographical conditions are included for simulating the spreading. The data generated by simulation are stored in the back room of the data warehouse using the Talend Open Studio software package, and subsequent statistical and data mining tasks are performed using the tool, termed Knowledge Discovery in Database Designer (KD3).
Results: The obtained simulation results were used for generating prediction models for all nine federal states of Austria.
Conclusion: The proposed framework provides a powerful and easy to handle interface for parameterizing and simulating different infectious diseases in order to generate prediction models and improve contingency plans for future events.
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Herta J, Koren J, Fürbass F, Hartmann M, Gruber A, Baumgartner C. Reduced electrode arrays for the automated detection of rhythmic and periodic patterns in the intensive care unit: Frequently tried, frequently failed? Clin Neurophysiol 2017; 128:1524-1531. [PMID: 28501415 DOI: 10.1016/j.clinph.2017.04.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 04/02/2017] [Accepted: 04/18/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To investigate the effect of systematic electrode reduction from a common 10-20 EEG system on pattern detection sensitivity (SEN). METHODS Two reviewers rated 17130 one-minute segments of 83 prospectively recorded cEEGs according to the ACNS standardized critical care EEG terminology (CCET), including burst suppression patterns (BS) and unequivocal electrographic seizures. Consensus annotations between reviewers were used as a gold standard to determine pattern detection SEN and specificity (SPE) of a computational algorithm (baseline, 19 electrodes). Electrodes were than reduced one by one in four different variations. SENs and SPEs were calculated to determine the most beneficial assembly with respect to the number and location of electrodes. RESULTS High automated baseline SENs (84.99-93.39%) and SPEs (90.05-95.6%) were achieved for all patterns. Best overall results in detecting BS and CCET patterns were found using the "hairline+vertex" montage. While the "forehead+behind ear" montage showed an advantage in detecting ictal patterns, reaching a 15% drop of SEN with 10 electrodes, all montages could detect BS sufficiently if at least nine electrodes were available. CONCLUSION For the first time an automated approach was used to systematically evaluate the effect of electrode reduction on pattern detection SEN in cEEG. SIGNIFICANCE Prediction of the expected detection SEN of specific EEG patterns with reduced EEG montages in ICU patients.
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Affiliation(s)
- J Herta
- Department of Neurosurgery, Medical University of Vienna, Vienna, Austria.
| | - J Koren
- Karl Landsteiner Institute for Clinical Epilepsy Research and Cognitive Neurology, 2nd Neurological Department, General Hospital Hietzing with Neurological Center Rosenhuegel, Vienna, Austria
| | - F Fürbass
- AIT Austrian Institute of Technology GmbH, Digital Safety & Security Department, Vienna, Austria
| | - M Hartmann
- AIT Austrian Institute of Technology GmbH, Digital Safety & Security Department, Vienna, Austria
| | - A Gruber
- Department of Neurosurgery, Medical University of Vienna, Vienna, Austria
| | - C Baumgartner
- Karl Landsteiner Institute for Clinical Epilepsy Research and Cognitive Neurology, 2nd Neurological Department, General Hospital Hietzing with Neurological Center Rosenhuegel, Vienna, Austria; Department of Epileptology and Clinical Neurophysiology, Sigmund Freud University, Vienna, Austria
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Herta J, Koren J, Fürbass F, Zöchmeister A, Hartmann M, Hosmann A, Baumgartner C, Gruber A. Applicability of NeuroTrend as a bedside monitor in the neuro ICU. Clin Neurophysiol 2017; 128:1000-1007. [PMID: 28458027 DOI: 10.1016/j.clinph.2017.04.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Revised: 03/21/2017] [Accepted: 04/02/2017] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To assess whether ICU caregivers can correctly read and interpret continuous EEG (cEEG) data displayed with the computer algorithm NeuroTrend (NT) with the main attention on seizure detection and determination of sedation depth. METHODS 120 screenshots of NT (480h of cEEG) were rated by 18 briefly trained nurses and biomedical analysts. Multirater agreements (MRA) as well as interrater agreements (IRA) compared to an expert opinion (EXO) were calculated for items such as pattern type, pattern location, interruption of recording, seizure suspicion, consistency of frequency, seizure tendency and level of sedation. RESULTS MRA as well as IRA were almost perfect (80-100%) for interruption of recording, spike-and-waves, rhythmic delta activity and burst suppression. A substantial agreement (60-80%) was found for electrographic seizure patterns, periodic discharges and seizure suspicion. Except for pattern localization (70.83-92.26%), items requiring a precondition and especially those who needed interpretation like consistency of frequency (47.47-79.15%) or level of sedation (41.10%) showed lower agreements. CONCLUSIONS The present study demonstrates that NT might be a useful bedside monitor in cases of subclinical seizures. Determination of correct sedation depth by ICU caregivers requires a more detailed training. SIGNIFICANCE Computer algorithms may reduce the workload of cEEG analysis in ICU patients.
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Affiliation(s)
- J Herta
- Department of Neurosurgery, Medical University of Vienna, Vienna, Austria.
| | - J Koren
- Karl Landsteiner Institute for Clinical Epilepsy Research and Cognitive Neurology, 2nd Neurological Department, General Hospital Hietzing with Neurological Center Rosenhuegel, Vienna, Austria
| | - F Fürbass
- AIT Austrian Institute of Technology GmbH, Digital Safety & Security Department, Vienna, Austria
| | - A Zöchmeister
- Department of Neurosurgery, Medical University of Vienna, Vienna, Austria
| | - M Hartmann
- AIT Austrian Institute of Technology GmbH, Digital Safety & Security Department, Vienna, Austria
| | - A Hosmann
- Department of Neurosurgery, Medical University of Vienna, Vienna, Austria
| | - C Baumgartner
- Karl Landsteiner Institute for Clinical Epilepsy Research and Cognitive Neurology, 2nd Neurological Department, General Hospital Hietzing with Neurological Center Rosenhuegel, Vienna, Austria; Department of Epileptology and Clinical Neurophysiology, Sigmund Freud University, Vienna, Austria
| | - A Gruber
- Department of Neurosurgery, Medical University of Vienna, Vienna, Austria
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Cichocki M, Princz C, Baumgartner C, Spiegel W. Experiences from the implementation of a rural community outreach team in South Sudan. Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw174.072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Bien CG, Mirzadjanova Z, Baumgartner C, Onugoren MD, Grunwald T, Holtkamp M, Isenmann S, Kermer P, Melzer N, Naumann M, Riepe M, Schäbitz WR, von Oertzen TJ, von Podewils F, Rauschka H, May TW. Anti-contactin-associated protein-2 encephalitis: relevance of antibody titres, presentation and outcome. Eur J Neurol 2016; 24:175-186. [DOI: 10.1111/ene.13180] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 09/16/2016] [Indexed: 12/14/2022]
Affiliation(s)
- C. G. Bien
- Epilepsy Center Bethel; Krankenhaus Mara; Bielefeld Germany
| | | | - C. Baumgartner
- Karl Landsteiner Institute for Clinical Epilepsy Research and Cognitive Neurology; 2nd Neurological Department; General Hospital Hietzing with Neurological Center Rosenhügel; Sigmund Freud University; Vienna Austria
| | - M. D. Onugoren
- Epilepsy Center Bethel; Krankenhaus Mara; Bielefeld Germany
- Department of Neurology; University Hospital Erlangen; Erlangen Germany
| | - T. Grunwald
- Swiss Epilepsy Center; Clinic Lengg and Department of Neurology; University Hospital Zurich; Zurich Switzerland
| | | | - S. Isenmann
- Department of Neurology; Center for Research in Clinical Medicine (CCM); HELIOS-Universitätsklinikum Wuppertal; University of Witten/Herdecke; Wuppertal
| | - P. Kermer
- Department of Neurology; Nordwest-Krankenhaus Sanderbusch; Sande
| | - N. Melzer
- Department of Neurology; University of Münster; Münster
| | - M. Naumann
- Department of Neurology and Clinical Neurophysiology; Klinikum Augsburg; Augsburg
| | - M. Riepe
- Department of Psychiatry II Ulm University at Bezirkskrankenhaus Günzburg; Mental Health & Old Age Psychiatry; Günzburg
| | - W. R. Schäbitz
- Department of Neurology; Evangelisches Krankenhaus Bielefeld; Bielefeld Germany
| | - T. J. von Oertzen
- Department of Neurology 1; Neuromed Campus; Kepler Universitätsklinikum; Linz Austria
| | - F. von Podewils
- Department of Neurology; Universitätsmedizin Greifswald; Greifswald Germany
| | - H. Rauschka
- Karl Landsteiner-Institute for Neuroimmunological and Neurodegenerative Disorders; Danube Hospital/Donauspital; Vienna Austria
| | - T. W. May
- Society for Epilepsy Research; Epilepsy Centre Bethel; Bielefeld Germany
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Bauer S, Baier H, Baumgartner C, Bohlmann K, Fauser S, Graf W, Hillenbrand B, Hirsch M, Last C, Lerche H, Mayer T, Schulze-Bonhage A, Steinhoff B, Weber Y, Hartlep A, Rosenow F, Hamer H. Transcutaneous Vagus Nerve Stimulation (tVNS) for Treatment of Drug-Resistant Epilepsy: A Randomized, Double-Blind Clinical Trial (cMPsE02). Brain Stimul 2016; 9:356-363. [DOI: 10.1016/j.brs.2015.11.003] [Citation(s) in RCA: 148] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Revised: 11/10/2015] [Accepted: 11/14/2015] [Indexed: 11/28/2022] Open
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Segna D, Méan M, Limacher A, Baumgartner C, Blum MR, Beer JH, Kucher N, Righini M, Matter CM, Frauchiger B, Cornuz J, Aschwanden M, Banyai M, Osterwalder J, Husmann M, Egloff M, Staub D, Lämmle B, Angelillo-Scherrer A, Aujesky D, Rodondi N. Association between thyroid dysfunction and venous thromboembolism in the elderly: a prospective cohort study. J Thromb Haemost 2016; 14:685-94. [PMID: 26816339 DOI: 10.1111/jth.13276] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 01/12/2016] [Indexed: 01/07/2023]
Abstract
BACKGROUND Venous thromboembolism (VTE) and subclinical thyroid dysfunction (SCTD) are both common in elderly patients. SCTD has been related to a hypercoagulable state and an increased thromboembolic risk. However, prospective data on the relationship between SCTD and VTE are lacking. OBJECTIVES To investigate the relationship between SCTD and recurrent VTE (rVTE), all-cause mortality, and thrombophilic biomarkers. Patients Elderly patients with VTE were studied. METHODS In a prospective multicenter cohort, thyroid hormones and thrombophilic biomarkers were measured 1 year after acute VTE, as both may be influenced by acute thrombosis. We defined subclinical hypothyroidism (SHypo) as elevated thyroid-stimulating hormone (TSH) levels (4.50-19.99 mIU L(-1) ), and subclinical hyperthyroidism (SHyper) as TSH levels of < 0.45 mIU L(-1) , both with normal free thyroxine levels. Outcomes were incidence of rVTE and overall mortality during follow-up starting after the 1-year blood sampling. RESULTS Of 561 participants (58% with anticoagulation), 6% had SHypo and 5% had SHyper. After 20.8 months of mean follow-up, 9% developed rVTE and 10% died. The rVTE incidence rate was 7.2 (95% confidence interval [CI] 2.7-19.2) per 100 patient-years in SHypo participants, 0.0 (95% CI 0.0-7.6) in SHyper participants, and 5.9 (95% CI 4.4-7.8) in euthyroid participants. In multivariate analyses, the sub-hazard ratio for rVTE was 0.00 (95% CI 0.00-0.58) in SHyper participants and 1.50 (95% CI 0.52-4.34) in SHypo participants as compared with euthyroid participants, without increased levels of thrombophilic biomarkers. SHyper (hazard ratio [HR] 0.80, 95% CI 0.23-2.81) and SHypo (HR 0.99, 95% CI 0.30-3.29) were not associated with mortality. CONCLUSION In elderly patients, SHyper may be associated with lower rVTE risks. SHypo showed a non-statistically significant pattern of an association with rVTE, without increased mortality or differences in thrombophilic biomarkers.
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Affiliation(s)
- D Segna
- Department of General Internal Medicine, Bern University Hospital and University of Bern, Bern, Switzerland
| | - M Méan
- Department of General Internal Medicine, Bern University Hospital and University of Bern, Bern, Switzerland
- Service of Internal Medicine, University Hospital of Lausanne, Lausanne, Switzerland
| | - A Limacher
- CTU Bern, Department of Clinical Research, and Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
| | - C Baumgartner
- Department of General Internal Medicine, Bern University Hospital and University of Bern, Bern, Switzerland
| | - M R Blum
- Department of General Internal Medicine, Bern University Hospital and University of Bern, Bern, Switzerland
| | - J-H Beer
- Department of Internal Medicine, Cantonal Hospital of Baden, Baden, Switzerland
| | - N Kucher
- Division of Angiology, Bern University Hospital, Bern, Switzerland
| | - M Righini
- Division of Angiology and Hemostasis, Geneva University Hospital, Geneva, Switzerland
| | - C M Matter
- Cardiology, University Heart Center, University Hospital and University of Zurich, Zurich, Switzerland
| | - B Frauchiger
- Department of Internal Medicine, Cantonal Hospital of Frauenfeld, Frauenfeld, Switzerland
| | - J Cornuz
- Department of Ambulatory Care and Community Medicine, University of Lausanne, Lausanne, Switzerland
| | - M Aschwanden
- Division of Angiology, Basel University Hospital, Basel, Switzerland
| | - M Banyai
- Division of Angiology, Cantonal Hospital of Lucerne, Lucerne, Switzerland
| | - J Osterwalder
- Emergency Department, Cantonal Hospital of St Gallen, St Gallen, Switzerland
| | - M Husmann
- Division of Angiology, Zurich University Hospital and University of Zurich, Zurich, Switzerland
| | - M Egloff
- Division of Endocrinology, Diabetology, Hypertension and Nutrition, Geneva University Hospital, Geneva, Switzerland
| | - D Staub
- Division of Angiology, Basel University Hospital, Basel, Switzerland
| | - B Lämmle
- University Clinic of Hematology and Central Hematology Laboratory, Bern University Hospital, Bern, Switzerland
- Center for Thrombosis and Hemostasis, University Medical Center, Mainz, Germany
| | - A Angelillo-Scherrer
- University Clinic of Hematology and Central Hematology Laboratory, Bern University Hospital, Bern, Switzerland
- Department of Clinical Research, University of Bern, Bern, Switzerland
| | - D Aujesky
- Department of General Internal Medicine, Bern University Hospital and University of Bern, Bern, Switzerland
| | - N Rodondi
- Department of General Internal Medicine, Bern University Hospital and University of Bern, Bern, Switzerland
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Baumgartner C, Buchner H, Rösler K. Richtlinien zur Feststellung des irreversiblen Ausfalls der Gesamtfunktion des Großhirns, des Kleinhirns und des Hirnstamms in Deutschland, Österreich und der Schweiz. KLIN NEUROPHYSIOL 2016. [DOI: 10.1055/s-0042-100268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- C. Baumgartner
- 3. Neurologische Abteilung des Neurologischen Zentrums – Rosenhügel, Krankenhaus Hietzing, Wien, Österreich
| | - H. Buchner
- Klinik für Neurologie und klinische Neurophysiologie, Klinikum Vest, Recklinghausen
| | - K. Rösler
- ENMG-Station und Muskelzentrum, Neurologische Universitätsklinik, Inselspital Bern, Schweiz
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Fürbass F, Herta J, Koren J, Skupch A, Hartmann M, Kluge T, Gruber A, Baumgartner C. ID 145 – NeuroTrend: Prospective validation of rhythmic and periodic pattern detection method for Scalp. Clin Neurophysiol 2016. [DOI: 10.1016/j.clinph.2015.11.182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Ammenwerth E, Woess S, Baumgartner C, Fetz B, van der Heidt A, Kastner P, Modre-Osprian R, Welte S, Poelzl G. Evaluation of an Integrated Telemonitoring Surveillance System in Patients with Coronary Heart Disease. Methods Inf Med 2015; 54:388-97. [PMID: 26395147 DOI: 10.3414/me15-02-0002] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Accepted: 07/06/2015] [Indexed: 11/09/2022]
Abstract
OBJECTIVES Cardiovascular diseases are the most frequent cause of death in industrialized countries. Non-adherence with prescribed medication and recommended lifestyle changes significantly increases the risk of major cardiovascular events. The telemonitoring programme MyCor (Myokardinfarkt und Koronarstent Programm in Tirol) is a multi-modal intervention programme to improve lifestyle and medication management of patients with coronary heart disease (CHD). It includes patient education, self-monitoring with goal-setting and feedback, and regular clinical visits. We evaluated the MyCor telemonitoring programme regarding technical feasibility, user acceptance, patient adherence, change in health status, and change in quality of life. METHODS A 4½-month study was conducted with two telemonitoring phases and one interim phase. The study comprised patient surveys, standardized assessment of quality of life using the MacNew questionnaire at study entry and after 4 and 18 weeks, analysis of adherence to medication and physical activity during the two telemonitoring phases, and analysis of reached goals regarding health conditions during the telemonitoring phases. RESULTS Twenty-five patients (mean age: 63 years) participated in the study. Patients showed a high acceptance of the MyCor telemonitoring programme. Patients reported feelings of self-control, motivation for lifestyle changes, and improved quality of life. Adherence to daily measurements was high with 86% and 77% in the two telemonitoring phases. Adherence to medication was also high with up to 87% and 80%. Pre-defined goals for physical activity were reached in up to 86% and 73% of days, respectively. Quality of life improved from 5.5 at study entry to 6.3 at the end (p< 0.01; MacNew questionnaire). Reductions in blood pressure and heart rate or an improvement in reaching defined goals could not be observed. CONCLUSIONS The MyCor telemonitoring programme Tirol for CHD patients has a high rate of acceptance among included patients. Critical evaluation revealed subjective benefits regarding quality of life and health status as well as high adherence rates to medication and lifestyle changes. Achieving long-term adherence and verifying clinical outcomes, however, remains an open issue. Our findings will promote further studies, addressing different strategies for an optimal mix of patient education, telemonitoring, feedback, and clinical follow-ups.
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Affiliation(s)
- E Ammenwerth
- Elske Ammenwerth, Institute of Biomedical Informatics, UMIT - University for Health Sciences, Medical Informatics and Technology, Eduard Wallnöfer Zentrum 1, 6060 Hall in Tirol, Austria, E-mail:
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Herta J, Koren J, Fürbass F, Hartmann M, Kluge T, Baumgartner C, Gruber A. Prospective assessment and validation of rhythmic and periodic pattern detection in NeuroTrend: A new approach for screening continuous EEG in the intensive care unit. Epilepsy Behav 2015; 49:273-9. [PMID: 26004320 DOI: 10.1016/j.yebeh.2015.04.064] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Revised: 04/24/2015] [Accepted: 04/28/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND NeuroTrend is a computational method that analyzes long-term scalp EEGs in the ICU according to ACNS standardized critical care EEG terminology (CCET) including electrographic seizures. At present, it attempts to become a screening aid for continuous EEG (cEEG) recordings in the ICU to facilitate the review process and optimize resources. METHODS A prospective multicenter study was performed in two neurological ICUs including 68 patients who were subjected to video-cEEG. Two reviewers independently annotated the first minute of each hour in the cEEG according to CCET. These segments were also screened for faster patterns with frequencies higher than 4 Hz. The matching annotations (2911 segments) were then used as gold standard condition to test sensitivity and specificity of the rhythmic and periodic pattern detection of NeuroTrend. RESULTS Interrater agreement showed substantial agreement for localization (main term 1) and pattern type (main term 2) of the CCET. The overall detection sensitivity of NeuroTrend was 94% with high detection rates for periodic discharges (PD = 80%) and rhythmic delta activity (RDA = 82%). Overall specificity was moderate (67%) mainly because of false positive detections of RDA in cases of general slowing. In contrast, a detection specificity of 88% for PDs was reached. Localization revealed only a slight agreement between reviewers and NeuroTrend. CONCLUSIONS NeuroTrend might be a suitable screening tool for cEEG in the ICU and has the potential to raise efficiency of long-term EEG monitoring in the ICU. At this stage, pattern localization and differentiation between RDA and general slowing need improvement. This article is part of a Special Issue entitled "Status Epilepticus".
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Affiliation(s)
- J Herta
- Department of Neurosurgery, Medical University of Vienna, Vienna, Austria.
| | - J Koren
- Karl Landsteiner Institute for Clinical Epilepsy Research and Cognitive Neurology, 2nd Neurological Department, General Hospital Hietzing with Neurological Center Rosenhuegel, Vienna, Austria
| | - F Fürbass
- AIT Austrian Institute of Technology GmbH, Digital Safety & Security Department, Vienna, Austria
| | - M Hartmann
- AIT Austrian Institute of Technology GmbH, Digital Safety & Security Department, Vienna, Austria
| | - T Kluge
- AIT Austrian Institute of Technology GmbH, Digital Safety & Security Department, Vienna, Austria
| | - C Baumgartner
- Karl Landsteiner Institute for Clinical Epilepsy Research and Cognitive Neurology, 2nd Neurological Department, General Hospital Hietzing with Neurological Center Rosenhuegel, Vienna, Austria
| | - A Gruber
- Department of Neurosurgery, Medical University of Vienna, Vienna, Austria
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Koren J, Herta J, Draschtak S, Pötzl G, Pirker S, Fürbass F, Hartmann M, Kluge T, Baumgartner C. Prediction of rhythmic and periodic EEG patterns and seizures on continuous EEG with early epileptiform discharges. Epilepsy Behav 2015; 49:286-9. [PMID: 25982266 DOI: 10.1016/j.yebeh.2015.04.044] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Accepted: 04/19/2015] [Indexed: 11/19/2022]
Abstract
BACKGROUND Continuous EEG (cEEG) is necessary to document nonconvulsive seizures (NCS), nonconvulsive status epilepticus (NCSE), as well as rhythmic and periodic EEG patterns of 'ictal-interictal uncertainty' (RPPIIU) including periodic discharges, rhythmic delta activity, and spike-and-wave complexes in neurological intensive care patients. However, cEEG is associated with significant recording and analysis efforts. Therefore, predictors from short-term routine EEG with a reasonably high yield are urgently needed in order to select patients for evaluation with cEEG. OBJECTIVE The aim of this study was to assess the prognostic significance of early epileptiform discharges (i.e., within the first 30 min of EEG recording) on the following: (1) incidence of ictal EEG patterns and RPPIIU on subsequent cEEG, (2) occurrence of acute convulsive seizures during the ICU stay, and (3) functional outcome after 6 months of follow-up. METHODS We conducted a separate analysis of the first 30 min and the remaining segments of prospective cEEG recordings according to the ACNS Standardized Critical Care EEG Terminology as well as NCS criteria and review of clinical data of 32 neurological critical care patients. RESULTS In 17 patients with epileptiform discharges within the first 30 min of EEG (group 1), electrographic seizures were observed in 23.5% (n = 4), rhythmic or periodic EEG patterns of 'ictal-interictal uncertainty' in 64.7% (n = 11), and neither electrographic seizures nor RPPIIU in 11.8% (n = 2). In 15 patients with no epileptiform discharges in the first 30 min of EEG (group 2), no electrographic seizures were recorded on subsequent cEEG, RPPIIU were seen in 26.7% (n = 4), and neither electrographic seizures nor RPPIIU in 73.3% (n = 11). The incidence of EEG patterns on cEEG was significantly different between the two groups (p = 0.008). Patients with early epileptiform discharges developed acute seizures more frequently than patients without early epileptiform discharges (p = 0.009). Finally, functional outcome six months after discharge was significantly worse in patients with early epileptiform discharges (p=0.01). CONCLUSIONS Epileptiform discharges within the first 30 min of EEG recording are predictive for the occurrence of ictal EEG patterns and for RPPIIU on subsequent cEEG, for acute convulsive seizures during the ICU stay, and for a worse functional outcome after 6 months of follow-up. This article is part of a Special Issue entitled Status Epilepticus.
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Affiliation(s)
- J Koren
- Karl Landsteiner Institute for Clinical Epilepsy Research and Cognitive Neurology, 2nd Neurological Department, General Hospital Hietzing with Neurological Center Rosenhuegel, Vienna, Austria.
| | - J Herta
- Department of Neurosurgery, Medical University of Vienna, Vienna, Austria
| | - S Draschtak
- 1st Neurological Department, General Hospital Hietzing with Neurological Center Rosenhuegel, Vienna, Austria
| | - G Pötzl
- 1st Neurological Department, General Hospital Hietzing with Neurological Center Rosenhuegel, Vienna, Austria
| | - S Pirker
- Karl Landsteiner Institute for Clinical Epilepsy Research and Cognitive Neurology, 2nd Neurological Department, General Hospital Hietzing with Neurological Center Rosenhuegel, Vienna, Austria
| | - F Fürbass
- Austrian Institute of Technology GmbH (AIT), Safety & Security Department, Vienna, Austria
| | - M Hartmann
- Austrian Institute of Technology GmbH (AIT), Safety & Security Department, Vienna, Austria
| | - T Kluge
- Austrian Institute of Technology GmbH (AIT), Safety & Security Department, Vienna, Austria
| | - C Baumgartner
- Karl Landsteiner Institute for Clinical Epilepsy Research and Cognitive Neurology, 2nd Neurological Department, General Hospital Hietzing with Neurological Center Rosenhuegel, Vienna, Austria
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Blum CA, Nigro N, Briel M, Schuetz P, Ullmer E, Suter-Widmer I, Winzeler B, Bingisser R, Elsaesser H, Drozdov D, Arici B, Urwyler SA, Refardt J, Tarr P, Wirz S, Thomann R, Baumgartner C, Duplain H, Burki D, Zimmerli W, Rodondi N, Mueller B, Christ-Crain M. Adjunct prednisone therapy for patients with community-acquired pneumonia: a randomized, placebo-controlled multicenter trial. Crit Care 2015. [PMCID: PMC4470455 DOI: 10.1186/cc14205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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40
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Fürbass F, Ossenblok P, Hartmann M, Perko H, Skupch AM, Lindinger G, Elezi L, Pataraia E, Colon AJ, Baumgartner C, Kluge T. Prospective multi-center study of an automatic online seizure detection system for epilepsy monitoring units. Clin Neurophysiol 2014; 126:1124-1131. [PMID: 25454341 DOI: 10.1016/j.clinph.2014.09.023] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Revised: 09/17/2014] [Accepted: 09/24/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVE A method for automatic detection of epileptic seizures in long-term scalp-EEG recordings called EpiScan will be presented. EpiScan is used as alarm device to notify medical staff of epilepsy monitoring units (EMUs) in case of a seizure. METHODS A prospective multi-center study was performed in three EMUs including 205 patients. A comparison between EpiScan and the Persyst seizure detector on the prospective data will be presented. In addition, the detection results of EpiScan on retrospective EEG data of 310 patients and the public available CHB-MIT dataset will be shown. RESULTS A detection sensitivity of 81% was reached for unequivocal electrographic seizures with false alarm rate of only 7 per day. No statistical significant differences in the detection sensitivities could be found between the centers. The comparison to the Persyst seizure detector showed a lower false alarm rate of EpiScan but the difference was not of statistical significance. CONCLUSIONS The automatic seizure detection method EpiScan showed high sensitivity and low false alarm rate in a prospective multi-center study on a large number of patients. SIGNIFICANCE The application as seizure alarm device in EMUs becomes feasible and will raise the efficiency of video-EEG monitoring and the safety levels of patients.
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Affiliation(s)
- F Fürbass
- Department Safety & Security, AIT Austrian Institute of Technology GmbH, Vienna, Austria.
| | - P Ossenblok
- Clinical Physics, Academic Center of Epileptology, Heeze & Maastricht UMC+, The Netherlands
| | - M Hartmann
- Department Safety & Security, AIT Austrian Institute of Technology GmbH, Vienna, Austria
| | - H Perko
- Department Safety & Security, AIT Austrian Institute of Technology GmbH, Vienna, Austria
| | - A M Skupch
- Department Safety & Security, AIT Austrian Institute of Technology GmbH, Vienna, Austria
| | - G Lindinger
- Department of Clinical Neurology, Medical University of Vienna, Vienna, Austria
| | - L Elezi
- General Hospital Hietzing with Neurological Center Rosenhuegel, 2nd Neurological Department, Vienna, Austria
| | - E Pataraia
- Department of Clinical Neurology, Medical University of Vienna, Vienna, Austria
| | - A J Colon
- Department of Clinical Neurophysiology, Academic Center of Epileptology, Heeze & Maastricht UMC+, PO Box 61, 5590 AB Heeze, The Netherlands
| | - C Baumgartner
- General Hospital Hietzing with Neurological Center Rosenhuegel, 2nd Neurological Department, Vienna, Austria
| | - T Kluge
- Department Safety & Security, AIT Austrian Institute of Technology GmbH, Vienna, Austria
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41
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Kienast R, Stöger M, Handler M, Hanser F, Baumgartner C. Alterations of field potentials in isotropic cardiomyocyte cell layers induced by multiple endogenous pacemakers under normal and hypothermal conditions. Am J Physiol Heart Circ Physiol 2014; 307:H1013-23. [DOI: 10.1152/ajpheart.00097.2014] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The use of autonomous contracting randomly grown cardiomyocyte monolayers cultivated on microelectrode arrays (MEAs) represents an accepted experimental setting for preclinical experimental research in the field of cardiac electrophysiology. A dominant pacemaker forces a monolayer to adhere to a regular and synchronized contraction. Randomly distributed multiple pacemakers interfere with this dominant center, resulting in more or less frequent changes of propagation direction. This study aims to characterize the impact of changing propagation directions at single electrodes of the MEA on the four intrinsic parameters of registered field potentials (FPs) FPrise, FPMIN, FPpre, and FPdur and conduction velocity (CV) under normal and hypothermal conditions. Primary cultures of chicken cardiomyocytes ( n = 18) were plated directly onto MEAs and FPs were recorded in a temperature range between 37 and 29°C. The number and spatiotemporal distribution of biological and artificial pacemakers of each cell layer inside and outside of the MEA registration area were evaluated using an algorithm developed in-house. In almost every second myocardial cell layer, interfering autonomous pacemakers were detected at stable temperatures, showing random spatial distributions with similar beating rates. Additionally, a temperature-dependent change of the dominant pacemaker center was observed in n = 16 experiments. A significant spread-direction-dependent variation of CV, FPrise, FPMIN, and FPpre up to 14% could be measured between different endogenous pacemakers. In conclusion, based on our results, disregarding the spatial origin of excitation may lead to misinterpretations and erroneous conclusions of FP parameters in the verification of research hypotheses in cellular electrocardiology.
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Affiliation(s)
- R. Kienast
- Institute of Electrical and Biomedical Engineering, University for Health Sciences, Medical Informatics and Technology, Hall in Tyrol, Austria; and
| | - M. Stöger
- Institute of Electrical and Biomedical Engineering, University for Health Sciences, Medical Informatics and Technology, Hall in Tyrol, Austria; and
- Division of Internal Medicine III/Cardiology, Medical University Innsbruck, Innsbruck, Austria
| | - M. Handler
- Institute of Electrical and Biomedical Engineering, University for Health Sciences, Medical Informatics and Technology, Hall in Tyrol, Austria; and
| | - F. Hanser
- Institute of Electrical and Biomedical Engineering, University for Health Sciences, Medical Informatics and Technology, Hall in Tyrol, Austria; and
| | - C. Baumgartner
- Institute of Electrical and Biomedical Engineering, University for Health Sciences, Medical Informatics and Technology, Hall in Tyrol, Austria; and
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Fürbass F, Baumgartner C, Koren J, Hartmann M, Weinkopf M, Halford J, Schnabel K, Herta J, Gruber A, Kluge T. New approach in quantitative EEG monitoring of critical care patients: Neurological trending based on the ACNS terminology. KLIN NEUROPHYSIOL 2014. [DOI: 10.1055/s-0034-1371271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Virgini V, Baumgartner C, Bischoff T, Haller DM, Frey P, Rosemann T, Collet TH, Sykiotis G, Pitteloud N, Rodondi N. [How do Swiss family physicians treat subclinical hypothyroidism?]. Rev Med Suisse 2014; 10:526-529. [PMID: 24701670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Subclinical hypothyroidism is a common condition, and its prevalence increases with age. Currently, guidelines regarding the screening and treatment of subclinical hypothyroidism are controversial. An international survey of general practitioners (GPs), to which Swiss GPs also contributed, showed large inter-country variations in treatment strategies for subclinical hypothyroidism. These differences are mainly explained by the lack of strong evidence for the management of this condition. The European randomized-controlled clinical trial TRUST should help clarify recommendations for screening and thyroxin replacement for the elderly with subclinical hypothyroidism. Working in close collaboration with GPs in Switzerland for the recruitment of patients will ensure that the findings from this study will be applicable to primary care settings.
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Nia S, Sedlacek C, Baumgartner A, Baumgartner C. Psychotic symptoms overshadow motor dysfunction and dementia in normal pressure hydrozephalus —/INS; A case report. J Neurol Sci 2013. [DOI: 10.1016/j.jns.2013.07.563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Baumgartner A, Nia S, Geiblinger S, Baumgartner C. Psychiatric manifestation of adult form of Niemann–/INS;Pick type C. A case report. J Neurol Sci 2013. [DOI: 10.1016/j.jns.2013.07.2434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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46
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Kienast R, Stöger M, Handler M, Fischer G, Hanser F, Baumgartner C. Detection of Multiple Pacemaker Centers in Cardiomyocyte Cell Layers for Estimating Wavefront Propagation Patterns. BIOMED ENG-BIOMED TE 2013; 58 Suppl 1:/j/bmte.2013.58.issue-s1-G/bmt-2013-4178/bmt-2013-4178.xml. [PMID: 24042803 DOI: 10.1515/bmt-2013-4178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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47
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Fürbass F, Hartmann M, Perko H, Skupch A, Dollfuß P, Gritsch G, Baumgartner C, Kluge T. Combining time series and frequency domain analysis for a automatic seizure detection. Annu Int Conf IEEE Eng Med Biol Soc 2013; 2012:1020-3. [PMID: 23366068 DOI: 10.1109/embc.2012.6346107] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The detection of epileptic seizures in long-term electroencephalographic (EEG) recordings is a time-consuming and tedious task requiring specially trained medical experts. The EpiScan seizure detection algorithm developed by the Austrian Institute of Technology (AIT) has proven to achieve high detection performance with a robust false alarm rate in the clinical setting. This paper introduces a novel time domain method for detection of epileptic seizure patterns with focus on irregular and distorted rhythmic activity. The method scans the EEG for sequences of similar epileptiform discharges and uses a combination of duration and similarity measure to decide for a seizure. The resulting method was tested on an EEG database with 275 patients including over 22000h of unselected and uncut EEG recording and 623 seizures. Used in combination with the EpiScan algorithm we increased the overall sensitivity from 70% to 73% while reducing the false alarm rate from 0.33 to 0.30 alarms per hour.
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Affiliation(s)
- F Fürbass
- Austrian Institute of Technology (AIT), Vienna, Austria
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48
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Kienast R, Fischer G, Stöger M, Handler M, Hanser F, Baumgartner C. A system for analysing thermal induced effects of propagation direction dependent features in field potentials of cardiomyocyte monolayers using multi-electrode arrays. J Electrocardiol 2013. [DOI: 10.1016/j.jelectrocard.2013.05.118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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49
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Graef A, Hartmann M, Flamm C, Baumgartner C, Deistler M, Kluge T. A novel method for the identification of synchronization effects in multichannel ECoG with an application to epilepsy. Biol Cybern 2013; 107:321-335. [PMID: 23435583 PMCID: PMC3661083 DOI: 10.1007/s00422-013-0552-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2012] [Accepted: 02/02/2013] [Indexed: 06/01/2023]
Abstract
In this paper, we present a novel method for the identification of synchronization effects in multichannel electrocorticograms (ECoG). Based on autoregressive modeling, we define a dependency measure termed extrinsic-to-intrinsic power ratio (EIPR) which quantifies directed coupling effects in the time domain. Hereby, a dynamic input channel selection algorithm assures the estimation of the model parameters despite the strong spatial correlation among the high number of involved ECoG channels. We compare EIPR to the partial directed coherence, show its ability to indicate Granger causality and successfully validate a signal model. Applying EIPR to ictal ECoG data of patients suffering from temporal lobe epilepsy allows us to identify the electrodes of the seizure onset zone. The results obtained by the proposed method are in good accordance with the clinical findings.
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Affiliation(s)
- A Graef
- Institute for Mathematical Methods in Economics, Vienna University of Technology, Vienna, Austria.
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Hilger E, Zimprich F, Jung R, Pataraia E, Baumgartner C, Bonelli S. Postictal psychosis in temporal lobe epilepsy: a case-control study. Eur J Neurol 2013; 20:955-61. [DOI: 10.1111/ene.12125] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2012] [Accepted: 01/30/2013] [Indexed: 11/26/2022]
Affiliation(s)
- E. Hilger
- Department of Neurology; Medical University of Vienna; Austria; Austria
| | - F. Zimprich
- Department of Neurology; Medical University of Vienna; Austria; Austria
| | - R. Jung
- Department of Neurology; Medical University of Vienna; Austria; Austria
| | - E. Pataraia
- Department of Neurology; Medical University of Vienna; Austria; Austria
| | - C. Baumgartner
- 2nd Neurological Department; General Hospital Hietzing with Neurological Center Rosenhuegel; Vienna; Austria
| | - S. Bonelli
- Department of Neurology; Medical University of Vienna; Austria; Austria
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