Abnormal Discharge Research Articles

Study on the mechanism and characteristics of pulsed corona discharge in water

Abstract Plasma pulse is a safe and environmentally friendly unconventional technology for enhancing
oil and gas production. However, during the pulsed discharge process, an abnormal discharge
phenomenon often occurs, which severely affects the performance of the equipment and is
referred to as corona discharge. This paper combines laboratory discharge test data to
theoretically analyze and validate through Comsol simulation the mechanism of corona
discharge generation under the same electrode gap distance. A comparative analysis with arc
discharge is also conducted to further examine its characteristics, and nonlinear regression
analysis is used to study the impedance variation of the plasma channel during corona
discharge. Results indicate that the decrease in switch breakdown voltage in the later stages of
continuous discharge leads to the generation of corona discharge. The impedance of the
plasma channel can be characterized by a time-varying resistance model based on a double
exponential function. Finally, validation through theoretical calculations and Simulink
simulations achieves a fitting rate of over 99%. The research provides significant guidance
for further analysis of corona discharge and the development of suppression methods in
plasma pulse technology, contributing to the optimization of the equipment and enhancing its
operational performance.

A Rare Case of Cervical Rhabdomyosarcoma in an Adolescent- A Case Report

We present a rare case of cervical embryonic rhabdomyosarcoma (ERMS) in adolescents, managed with fertility-sparing surgery and chemotherapy. This type of malignant tumour is rare, and the management is not codified. A 15-year-old girl presented with a tongue-like mass per vagina and abnormal discharge. She underwent vaginoscopy under anaesthesia, which revealed a polyp from the endocervix. Hysteroscopic resection was performed, and histopathology showed ERMS. Postoperative imaging suggests the presence of residual local disease without evidence of distant metastasis. A multidisciplinary team (MDT) meeting was conducted, and the family opted for fertility-sparing management. The patient underwent repeat hysteroscopy-guided local excision, followed by eight cycles of chemotherapy, with close surveillance. In conclusion, polyps are rather odd in adolescents; malignancy should always be suspected. Fertility-sparing surgery with chemotherapy is a plausible option in well-selected cases.

Mitochondrial A3 adenosine receptor as a mechanism for the protective effects of A3AR agonists on chemotherapy-induced neuropathic pain.

Alterations in mitochondrial function are the linchpin in numerous disease states including in the development of chemotherapy-induced neuropathic pain (CIPN), a major dose-limiting toxicity of widely used chemotherapeutic cytotoxins. In CIPN, mitochondrial dysfunction is characterized by deficits in mitochondrial bioenergetics (e.g., decreased ATP production) that are thought to drive the degeneration of the peripheral nerve sensory axon terminal sensory arbors in the skin (the intraepidermal nerve fibers; IENFs) and induce abnormal spontaneous discharge in peripheral nerve sensory axons. Preserving mitochondrial function is anticipated to prevent CIPN. We have now discovered that the G protein-coupled receptor, A3 adenosine receptor subtype (A3AR), is expressed on the mitochondrial outer membrane. Ex vivo application of a highly selective A3AR agonist, MRS5980, to saphenous nerve microfilaments harvested from male oxaliplatin-treated rats reversed the loss in ATP production underscoring mitoprotective effects resulting from A3AR activation on mitochondria. Moreover, in vivo administration of A3AR agonists to rats during oxaliplatin treatment was associated with reduced IENF loss and a lower incidence of spontaneous discharge in peripheral afferent axons. These effects are accompanied by improved mitochondrial ATP production in primary afferent sensory axons and overall inhibition of the development of neuropathic pain. These data identify for the first time mitochondrial A3AR and indicate that activation of A3AR protects mitochondrial function in primary afferent sensory axons against chemotherapy-induced neurotoxicity. Repurposing A3AR agonists that are already in clinical trials as anticancer agents as adjunct to chemotherapeutics will address a major unmet medical need for which there are no FDA approved drugs.Significance statement Alterations in mitochondrial function are central to the development of chemotherapy-induced neuropathy and ensuing pain syndromes. Here we show that the adenosine A3 receptor (A3AR) is expressed on mitochondria and its activation can reverse deficits in mitochondrial ATP production in peripheral sensory nerves from animals with chemotherapy-induced neuropathic pain. Moreover, administration of A3AR agonists during chemotherapy in animals prevented the development of pain and pathophysiological signs of neuropathy in sensory nerves such as the loss of intraepidermal nerve fibers and increased spontaneous firing. These findings identify for the first time mitochondrial A3AR and show that activation of A3AR protects mitochondrial function in primary afferent sensory axons against chemotherapy-induced neurotoxicity.

Wogonin mitigates microglia-mediated synaptic over-pruning and cognitive impairment following epilepsy

BackgroundEpilepsy, a neurological disorder characterized by recurrent abnormal neuronal discharges, leading to brain dysfunction and imposing significant psychological and economic burdens on patients. Microglia, the resident immune cells within the central nervous system (CNS), play a crucial role in maintaining CNS homeostasis. However, activated microglia can excessively prune synapses, exacerbating neuronal damage and cognitive dysfunction following epilepsy. Wogonin, a flavonoid from Scutellaria Baicalensis, has known neuroprotective effects via anti-inflammatory and antioxidative mechanisms, but its impact on microglial activation and synaptic pruning in neurons post-epilepsy remains unclear. MethodsSynaptic density was assessed using presynaptic marker Synaptophysin and postsynaptic marker Psd-95, and microglial phagocytosis was evaluated with fluorescent microspheres. Pilocarpine-induced mouse model of status epilepticus was used to evaluate synaptic density changes of mouse hippocampus following an intraperitoneal injection of wogonin (50 and 100 mg/kg). Memory and cognitive function in mice were subsequently evaluated using the Y-maze, object recognition, and Morris water maze tests. Single-cell sequencing was employed to investigate the underlying causes of microglial state alterations, followed by experimental validation. ResultsMicroglia were transitioned to an activated state post-epilepsy, exhibiting significantly enhanced phagocytic capacity. Correspondingly, levels of synaptophysin and Psd-95 were markedly reduced in neurons. Treatment with wogonin (100 mg/kg) significantly increased neuronal synaptic density and improved learning and memory deficits in epileptic mice. Further investigation revealed that wogonin inhibits the release of pro-inflammatory cytokines and synaptic phagocytosis of microglia by activating the AKT/FoxO1 pathway. ConclusionsWogonin could alleviate excessive synaptic pruning of epileptic neurons by microglia and improve cognitive dysfunction of epileptic mice via the AKT/FoxO1 pathway.

Etiology, Epidemiology and Pathophysiology of Vaginitis

Vaginitis is a common condition that affects women; it is an inflammation of the vagina, an infection that creates abnormal discharge followed by irritations and itching. Being aware of the etiology and epidemiology of vaginitis is very crucial for successful diagnosis, treatment, and public health intervention. These are the three most common types of infections responsible for vaginitis-bacterial vaginosis, vulvovaginal candidiasis, and trichomoniasis. Therefore, this review of literature tries to consolidate findings of research already done on vaginitis epidemiology, pinpoints areas where more research might be needed due to lack of information.

An Integrated Method for Crafting Flexible and Convenient Electrophysiological Optrodes for Multi-Region In Vivo Recording.

Epilepsy is a neurological disorder characterized by synchronized abnormal discharges involving multiple brain regions. Focal lesions facilitate the propagation of epileptic signals through associated neural circuits. Therefore, in vivo recording of local field potential (LFP) from the critical brain regions isessential for deciphering the circuits involved in seizure propagation. However, current methods for electrode fabrication and implantation lack flexibility. Here, we present a handy device designed for electrophysiological recordings (LFPs and electroencephalography [EEG]) across multiple regions. Additionally, we seamlessly integrated optogenetic manipulation and calcium signaling recording with LFP recording. Robust after-discharges were observed in several separate regions during epileptic seizures, accompanied by increasingcalcium signaling. The approach used in this study offers a convenient and flexible strategy for synchronous neural recordings across diverse regions of the brain. It holds the potential for advancing research on neurological disorders by providing insights into the neural profiles of multiple regions involved in these disorders.

Clinical and Laboratory Positive Predictive Value of Symptom Management of STI in Iran: A Community-Based Survey

Background: The correct diagnosis of sexually transmitted infections (STIs) is the first step in the monitoring and management of these diseases. Objectives: This study was conducted to investigate the clinical and laboratory positive predictive value (PPV) of STI symptom management in Iran. Methods: This cross-sectional study was conducted on 5986 individuals (aged 18 to 50 years) from the general population of Marovdasht (Iran) in several stages: (1) self-reported symptoms of sexually transmitted diseases, (2) evaluation by a doctor, and (3) laboratory examination. Results: Among the population sample, 686 (17.68%) individuals reported at least one of the predefined symptoms. The clinical-based PPV of syndromes in men and women were 67.74 (62.34 - 73.14) and 85.36 (82.76 - 87.96), respectively. In men and women, the highest PPV was observed for abnormal discharge from the anus 32.35 (25.35 - 39.35) and abnormal secretions from the cervix 59.39 (56.39 - 62.39), respectively. The laboratory-based PPV for men and women was 0 and 5.04 (3.04 - 7.4), respectively. Conclusions: The clinical and laboratory-based PPV of STI symptoms in the general population is extremely low. Accordingly, a syndromic-based screening or monitoring approach for STIs is not a reliable tool for screening or monitoring in the Iranian general population. We suggest focusing on special (core) groups for monitoring STIs using laboratory-based methods.

The effect of Vagus nerve stimulation (VNS) on seizure control, cognitive function, and quality of life in individuals with drug-resistant epilepsy: A systematic review article.

To evaluate the effect of vagus nerve stimulation (VNS) on seizure control, cognitive functions, and quality of life in individuals with drug-resistant epilepsy. An extensive search of electronic databases was carried out in order to carry out this systematic review. The databases Google Scholar, Embase, PubMed, and the Cochrane Library were searched first to carryout gray literature. To reduce the quantity of pointless studies in the advanced search, the search is limited to "human studies" and "English language" publications only. Combining keywords and Medical Subject Headings (MeSH) terms like ("Vagus Nerve Stimulation" OR "VNS") AND ("Epilepsy" OR "Seizure Control") AND ("Cognitive Function" OR "Quality of Life"). Studies that have been published up to November 30/2023 were included. The search strategy yielded a total of 392 relevant studies. The mean age of participant's ranges from 11 years to 33 years. The duration of follow-up ranging from 6 to 36 months. Eleven studies were included in the review. The mean≥50% response rate after VNS therapy was 56.94% ranged from 48.90% to 83.00%. Four and three studies provided information about Quality of Life in Epilepsy Inventory (QOLIE-31) and The Liverpool Seizure Severity Scale (LSSS) questionnaires respectively. Epilepsy is a chronic disease characterized by sudden abnormal discharge of brain neurons, which leads to transient brain dysfunction and the presence of spontaneous recurrent seizures. Vagus nerve stimulation has recently been proposed as a potential tool in the treatment of seizure, depressive symptoms, and cognitive impairments. There has been variation in the effects of VNS treatment on seizure control, cognitive functions, and quality of life among patients with drug-resistant epilepsy. So, a comprehensive review of exciting literature is important to see the pooled effect. Previous systematic review and meta-analysis papers were mostly randomized control trial type with specific diseases. The use of a wider variety of study designs than only randomized controlled trials is important. So, we included retrospective and prospective cohort studies in addition to randomized control trials. This enables a more thorough assessment of the connection between quality of life, cognitive function, and vagus nerve stimulation. In addition, the paper looks at a wide range of disease kinds and patterns. We have established a uniform and comprehensive approach throughout the selected studies by mandating the inclusion of all three crucial parameters: vagus nerve stimulation, cognitive function, and quality of life. This systematic review examined 392 relevant studies on vagus nerve stimulation (VNS) therapy, with participants ranging from 11 to 33 years old and follow-up durations of 6-36 months. Eleven studies were included, and the mean response rate after VNS therapy was 56.94%, ranging from 48.90% to 83.00%. The review also reported on quality of life and cognitive function, and seizure severity frequency result from several studies.

A Rare Case of Pulmonary Vascular Anomaly: MDCT Pulmonary Angiography in Diagnosis of Arteriovenous Malformation and Post-operative Imaging

Objective. To demonstrate the diagnostic algorithm and tactics of a surgical management of patients with pulmonary arteriovenous malformations.Materials and Methods. Based on a patient`s clinical data analysis, further examination tactic was chosen: in the pre and postoperative periods multispiral computed tomography (MSCT) angiopulmonography (on a Canon Aquillion Prime, Japan) was performed before and after intravenous administration of a iodine-containing contrast agent (Ultravist, 370 mg/ ml) at the rate of 1 ml/kg. Brain magnetic resonance tomography was performed on a Signa Voyager, General Electric, China, 1,5 Tl in the pulse sequences T1, T2, T2 FLAIR, DWI, SWAN in three mutually perpendicular planes with a slice thickness of 1-5 mm to examine the neurological complications. Interventional angiopulmonography was implemented by using General Electric Innova IGS530, France, angiographic system before and after endovascular occluder ("AMPLATZER Vascular PLUG 4", USA) and spirals ("2D-Helical-35" 9 mm in diameter and 2,7 mm long (4 spirals) and "Complex–Helical-18" 11 mm in diameter and 17 mm long, USA) placement. A literature review in Russian and English languages for the last 5 years was searched using CyberLeninka, PubMed Central, Elibrary data bases, by keywords: pulmonary arteriovenous malformation, MSCT angiopulmonography, endovascular treatment. The prospective longitudinal study was conducted in compliance with the principles of ethics in accordance with the Helsinki Declaration, and informed voluntary consent was obtained from the patient.Results. According to clinical and instrumental data, the tactics of combined endovascular treatment of a vascular malformation with subsequent postoperative control was collectively chosen. During the curation, an increase in saturation parameters, general wellbeing improvement, decrease in pulmonary pressure parameters, and diminution in the size of the right heart's parts were achieved.Conclusion. Arteriovenous malformations (AVMs) are rare vascular abnormalities that represent a pathological communication between the arterial and venous bed. The fistulous link leads to an abnormal discharge of blood, bypassing the physiological capillary channel. Radiation and interventional visualization methods play the most important diagnostic, and the latest — therapeutic role in management of patients and are able to establish indications for surgical intervention, prevent the occurrence of life-threating complications: abscesses, paradoxical embolism and heart attacks, progressive respiratory and heart failure.

Risk of recurrence after a first unprovoked seizure with different risk factors: A 10-year prospective cohort study

ObjectiveTo evaluate the recurrence risk following a first unprovoked seizure using both single-factor and multiple-factor approaches, as well as to further analyze the potential risk factors associated with recurrence. MethodsIn a prospective cohort study, a total of 201 individuals who experienced their initial unprovoked seizure were recruited from January 2010 to December 2019. The cumulative recurrence rates were calculated by Kaplan–Meier survival curves. Multivariate analyses for recurrence risk were conducted utilizing the Cox regression model. Additionally, interaction effects were evaluated by quantifying the attributable proportion due to interaction (AP). ResultsThe cumulative recurrence rates were as follows: 29.4 % at 6 months, 35.8 % at 1 year, 41.1 % at 2 years, 47.9 % at 5 years, and 57.5 % at 10 years. Notably, the majority of recurrences, specifically 61.2 %, manifested within the initial 6 months following the onset, with 74.4 % occurring within the first year, and 82.6 % within the initial 2 years. The recurrence risk of patients with epileptic abnormal discharges on VEEG, nocturnal seizure, abnormal MRI, prior brain insult and focal seizure was 71.9 %, 61.4 %, 61.5 %, 75.0 %, and 69.7 %, respectively. Epileptiform discharges (RR 2.5, 95 % CI 1.4–4.3, P=0.001) and prior brain insult (RR 2.1, 95 % CI 1.2–3.7, P=0.007) were predictors of recurrence. Interaction analysis showed the combination of epileptiform discharges and prior brain insult was associated with a 7-fold increased risk of recurrence (RR 7.0, 95 %CI 3.5–14.2)，with AP estimated at 0.34, the combination of epileptiform discharges and nocturnal seizure was associated with a 4-fold increased risk of recurrence(RR 4.3, 95 %CI 2.4–7.4), with AP estimated at −0.25,and the combination of prior brain insult and nocturnal seizures was associated with a 4-fold increased risk of recurrence(RR 4.1, 95 %CI 1.9–8.9), with AP estimated at −0.03. ConclusionsPatients with epileptiform discharges VEEG, nocturnal seizures, abnormal MRI findings, prior brain insult, or focal seizures exhibited a substantial recurrence rate. Specifically, the presence of epileptiform discharges in VEEG recordings, and a history of prior brain insult were identified as independent risk factors associated with recurrence following an initial unprovoked seizure. Notably, individuals with multiple risk factors exhibited a significantly higher recurrence risk compared to those with no or a single risk factor.

Mechanisms of nodule formation on Ni-Pt targets during sputtering

Ni-Pt alloys are employed in the formation of Ni-Pt silicide to facilitate contact and interconnection functions in semiconductor devices. However, the formation of nodules on the Ni-Pt target during sputtering results in a reduced deposition rate and abnormal discharge, significantly impacting the film quality. This study investigates the nodule formation mechanism on the surface of Ni-Pt targets during sputtering, utilizing field-emission scanning electron microscopy (FE-SEM), energy-dispersive spectroscopy (EDS), and electron backscatter diffraction (EBSD). The findings reveal that defects and inclusion areas in the target exhibit a slower sputtering rate compared to normal areas, ultimately leading to nodule formation. Notably, platinum-rich layers were observed on the surfaces of nodules, particularly those exceeding a height of 100 μm. The variations in target surface concentration, angular distribution, and sputter yield of Ni and Pt atoms, coupled with the blocking effect of the lateral areas of nodules, contribute to the formation and compositional variation of the Pt-rich layers on the nodule surfaces.

Connecting the dots: Exploring the relationship between menstrual hygiene and bacterial vaginosis in eastern India

ABSTRACT Introduction: Menstruation is a normal physiological event that takes place in a rhythmic fashion during the reproductive period of a woman. Menstrual hygiene management (MHM) practices differ and depend on the individual’s socioeconomic status, local traditions and beliefs, and access to water and sanitation resources. Insufficient and incorrect information regarding menstruation and lack of knowledge and awareness leads to poor personal hygienic practices, which further leads to many infections. Bacterial vaginosis, the most common RTI, is characterized by an alteration in the vaginal micro biome with a decline in hydrogen peroxide producing Lactobacillus colonization and an overgrowth of facultative anaerobic bacteria like Gardnerella spp., Mobiluncus spp., etc. Aims: The primary objective of the study was to find out the association of bacterial vaginosis with menstrual hygiene practices. The secondary objective was to determine the prevalence of bacterial vaginosis among patients presenting with vaginal discharge to the outpatient department of a tertiary care hospital. Methods: Women in the reproductive age group 18-45 years having regular menstrual cycles were included in the study. Participants were enquired for sociodemographic data, menstrual hygiene practices and symptoms of abnormal vaginal discharge. High vaginal swab was collected for the symptomatic patients and sent to investigate for presence of bacterial vaginosis. Results and observation: The prevalence of BV was found to be 13% among symptomatic patients presenting with abnormal vaginal discharge. Apart from abnormal discharge, itching and burning sensation was also seen to have a positive association with bacterial vaginosis (p < 0.001). The women who used clothes as absorbent were more prone to develop BV than women using sanitary pad. The other parameters to have positive association with BV were decreased frequency of taking body bath. Unsatisfactory sanitation of latrine was found to be strongly associated with BV after adjusting for confounders. Conclusion: In conclusion, the result of this study provided a strong association between poor MHM practices with BV.

EEG-based epileptic seizure detection using deep learning techniques: A survey

Epilepsy is a complex neurological disorder marked by recurrent seizures, often stemming from abnormal discharge of the brain. Electroencephalogram (EEG) captures temporal and spatial shifts in cerebral electrical activity, holding pivotal diagnostic and therapeutic value for epilepsy. Deep learning techniques have made remarkable progress in EEG-based seizure detection over recent years. This review is dedicated to exploring seizure detection approaches based on deep learning, focusing on three distinct avenues. Primarily, we delve into the application of canonical deep learning methods in epilepsy detection. Subsequently, a more in-depth study was conducted on the hybrid models of deep learning. Next, the third is the integration of deep learning and traditional machine learning strategies. Finally, the challenges and future prospects related to this topic are put forward. The uniqueness of this review lies in its novel and comprehensive perspective on the latest research on deep learning-based epilepsy detection by systematically classifying methods, visualizing research progress, and addressing challenges and gaps in current research. It can provide valuable guidance for researchers who want to delve into the field of epileptic seizure detection based on EEG signals.

DOSHA, DUSHYA, MALA, AND PURVARUPA IN PRAMEHA: UNDERSTANDING EARLY SIGNS AND PATHWAYS

Prameha, akin to diabetes mellitus in Ayurvedic medicine, is characterized by abnormal urinary discharge and systemic imbalances. This study explores the Ayurvedic concepts of Dosha, Dushya, and Mala to understand their roles in Prameha's pathogenesis and clinical manifestations. Through a review of classical texts and modern literature, the research highlights how vitiations in Doshas (Kapha, Pitta, Vata), affected Dhatus (Rasa, Rakta, Meda, Mamsa, Majja), and metabolic waste (Mala) contribute to the disease. It connects traditional Ayurvedic descriptions with contemporary understandings of diabetes, emphasizing the need to further integrate these in-sights into modern medical practices.

Abnormal oculomotor corollary discharge signaling as a trans-diagnostic mechanism of psychosis

Abnormal oculomotor corollary discharge signaling as a trans-diagnostic mechanism of psychosis

Peripheral nesfatin-1 reduces basal brain activity but has limited effect on epilepsy-like conditions.

In this study, we investigated the effects of peripheral nesfatin-1 on basal brain activity and 4-aminopyridine (4-AP)-induced epileptiform activity, and its relationship with the electrocorticogram (ECoG) power spectrum and EEG bands. Forty-nine male Wistar rats were divided into seven groups: control sham, 4-AP (2.5 mg/kg i.p.), Nesfatin-1 (1, 2, and 4 μg/kg i.p.), Nesfatin-1 (2 μg/kg) post-treatment, and Nesfatin-1 (2 μg/kg) pre-treatment. Recordings were conducted for 70 min under ketamine/xylazine (90/10 mg/kg) anesthesia. In the post-treatment group, nesfatin-1 was injected 20 min after 4-AP induction. In the pre-treatment groups, nesfatin-1 was administered following basal recordings and before 4-AP injection. 4-AP induced epileptiform activity in all animals, peaking at 30 min. Nesfatin-1 (2 μg/kg) reduced basal brain activity (p < 0.05) and decreased alpha, delta, and theta bands in ECoG. Post-treatment of nesfatin-1 did not affect 4-AP-induced activity (p > 0.05) but increased gamma band activity (p > 0.05). Pre-treatment of nesfatin-1 reduced epileptiform activity between 50 and 60 min (p < 0.05), decreased delta bands, and increased gamma bands (p > 0.05). We conclude that peripheral nesfatin-1 modulates normal brain activity but has limited effects on abnormal discharges.

Electroencephalogram and phenotype patterns in neuronopathic Gaucher disease patients – ten years of experience in a single center

BackgroundThis study aimed to investigate the unique electroencephalography (EEG) patterns in neuronopathic Gaucher disease (GD) patients and explore the correlations between EEG findings and neurological phenotypes so as to optimize clinical outcomes.MethodsA retrospective analysis was conducted on 74 EEG recordings from 50 GD patients between January 2012 and July 2022.ResultsTwenty-three patients exhibited abnormal EEG recordings, including 11 of the GD1 type (the transitional type) and 12 with neuronopathic GD. Of the 12 neuronopathic GD patients, 9 patients with epilepsy were analysed specifically in terms of the clinical course. The primary waveform observed in the neuronopathic EEG recordings was the spike-and-wave complex (SWC) during both awake and sleep states. This was significantly different from sharp waves observed only during sleep in the patients of the transitional type (P = 0.0230). The abnormal discharges in the neuronopathic patients were most commonly located in the bilateral Rolandic areas, while the transitional type commonly involved the bilateral frontal regions. Three patients with an epileptic EEG pattern reported their initial seizures years later. Seizures in the neuronopathic patients were effectively controlled with anti-seizure medications (ASMs), despite the ongoing presence of abnormal EEG patterns. The EEG patterns during ocular symptoms were characterized by sporadic or continuous unilateral SWC during sleep.ConclusionsPatients with neuronopathic GD exhibit distinct EEG patterns that can help differentiate them from GD1 patients. Early treatment with ASMs can effectively control seizures. EEG plays a crucial role in monitoring seizures and can facilitate prompt intervention for GD patients.

Unveiling the epilepsy enigma: an agile and optimal machine learning approach for detecting inter-ictal state from electroencephalogram signals

Epilepsy is a chronic neurological disorder characterized by the occurrence of paroxysmal recurrent seizures, which are caused by abnormal electrical activity in the brain. Seizures vary widely in their presentation, depending on the specific region of the brain involved and the extent of the abnormal electrical discharges. The disease can affect cognitive function posing a serious threat to the patients’ lives. Epilepsy causes emotional and behavioral changes, along with sleep disorders and migraines, leading to social isolation and discrimination. Timely administration of medication can cure most cases of epilepsy. However, identifying epileptic patients requires reviewing multiple EEG signal sheets, which can delay disease prediction. Therefore, the aim of our study is to apply simplistic machine learning algorithms that can study the EEG signal data swiftly to identify individuals in seizure, inter-ictal, and normal states, thereby aiding in medical diagnosis. The novelty of this study lies in the utilization of pre-built methods and develop a fast and efficient model that is lightweight and easy to integrate in healthcare to provide relief to epileptic patients. While previous studies have achieved high accuracy, the discussion involving time complexity of their models has been scarce. Given the importance of timely medication in managing epilepsy, it is crucial to consider the runtime of the model rather than solely focusing on accuracy. Therefore, a model that balances both a short runtime (2.9 min) and a satisfactory accuracy (97.46%) has been developed in this project. Integration of this project's findings will catalyze transformative changes within the healthcare industry, enabling healthcare professionals to detect epilepsy at earlier stages and provide timely interventions, ultimately fostering a system that prioritizes precision, innovation, and improved patient outcomes.

An efficient channel recurrent Criss-cross attention network for epileptic seizure prediction

Epilepsy is a chronic disease caused by repeated abnormal discharge of neurons in the brain. Accurately predicting the onset of epilepsy can effectively improve the quality of life for patients with the condition. While there are many methods for detecting epilepsy, EEG is currently considered one of the most effective analytical tools due to the abundant information it provides about brain activity. The aim of this study is to explore potential time-frequency and channel features from multi-channel epileptic EEG signals and to develop a patient-specific seizure prediction network. In this paper, an epilepsy EEG signal classification algorithm called Channel Recurrent Criss-cross Attention Network (CRCANet) is proposed. Firstly, the spectrograms processed by the short-time fourier transform is input into a Convolutional Neural Network (CNN). Then, the spectrogram feature map obtained in the previous step is input into the channel attention module to establish correlations between channels. Subsequently, the feature diagram containing channel attention characteristics is input into the recurrent criss-cross attention module to enhance the information content of each pixel. Finally, two fully connected layers are used for classification. We validated the method on 13 patients in the public CHB-MIT scalp EEG dataset, achieving an average accuracy of 93.8 %, sensitivity of 94.3 %, and specificity of 93.5 %. The experimental results indicate that CRCANet can effectively capture the time-frequency and channel characteristics of EEG signals while improving training efficiency.

Prospective study of epilepsy with generalized tonic-clonic seizures alone: Clinical features, response to treatment, and likelihood of medication withdrawal.

This prospective study aimed to delineate the demographics, natural progression, and treatment response of patients newly diagnosed with epilepsy with generalized tonic-clonic seizures alone (EGTCA). Furthermore, our objective includes assessing the seizure recurrence rate post antiseizure medication (ASM) discontinuation within this cohort, alongside exploring predictive factors for seizure relapse. The study cohort, derived from an ongoing, prospective, multicenter investigation on children and adults with new-onset unprovoked seizures, included consecutive patients enrolled between March 2010 and March 2020, and meeting mandatory ILAE criteria for EGTCA diagnosis. Participants underwent a 3-h sleep-deprived video-EEG recording along with an epilepsy protocol brain magnetic resonance imaging (MRI) with repeat EEG at each follow-up. Cumulative time-dependent probabilities of seizure recurrence were calculated using Kaplan-Meier survival analysis. Logistic regression identified variables associated with seizure recurrence following ASM taper. Eighty-nine patients with a median age of 16 years were included, constituting 31% of those diagnosed with an idiopathic generalized epilepsy. Regarding the circadian distribution of seizures, 59.6% of patients exclusively experienced diurnal seizures, 12.4% exclusively nocturnal, and 28.1% experienced both diurnal and nocturnal seizures. Generalized spike-wave discharges (GSWD) were present in the initial EEG of 88% of patients. A GTC recurred in 14% of patients treated with ASM compared with 73% of untreated patients (p < 0.00001). ASM discontinuation was attempted in 50 patients after a median treatment duration of 3 years, with 44% experiencing a recurrence. Patient-initiated taper and a mixed circadian seizure pattern independently predicted a higher likelihood of recurrence post-ASM discontinuation. Our findings underscore the importance of prompt treatment upon the diagnosis of EGTCA. Notably, lifelong treatment may not be imperative; patients seizure-free for at least 2 years, with the absence of GSWD on EEG, often maintained seizure freedom after ASM withdrawal, especially with physician-initiated tapering. Seizures in individuals diagnosed with "epilepsy with generalized tonic-clonic seizures alone" (EGTCA) typically start during adolescence and often respond well to antiseizure medications. An electroencephalogram, which measure brain waves, will show abnormal discharges in most patients with EGTCA. Lifelong treatment with antiseizure medication is not necessary for everyone with EGTCA; approximately, 40% can successfully stop treatment without facing seizure recurrence. Patients who stop medication on their own have a higher risk of seizures returning compared with those who undergo cessation under a doctor's supervision.