Classification Model for Epileptic Seizure Using Simple Postictal Laboratory Indices.

Distinguishing syncope from epileptic seizures in patients with sudden loss of consciousness is important. Various blood tests have been used to indicate epileptic seizures in patients with impaired consciousness. This retrospective study aimed to predict the diagnosis of epilepsy in patients with transient loss of consciousness using the initial blood test results. A seizure classification model was constructed using logistic regression, and predictors were selected from a cohort of 260 patients using domain knowledge and statistical methods. The study defined the diagnosis of seizures and syncope based on the consistency of the diagnosis made by an emergency medicine specialist at the first visit to the emergency room and the diagnosis made by an epileptologist or cardiologist at the first outpatient visit using the International Classification of Diseases 10th revision (ICD-10) code. Univariate analysis showed higher levels of white blood cells, red blood cells, hemoglobin, hematocrit, delta neutrophil index, creatinine kinase, and ammonia levels in the seizure group. The ammonia level had the highest correlation with the diagnosis of epileptic seizures in the prediction model. Therefore, it is recommended to be included in the first examination at the emergency room.

Development and Validation of MRI-Based Radiomics Models for Diagnosing Juvenile Myoclonic Epilepsy.

OBJECTIVE: Radiomic modeling using multiple regions of interest in MRI of the brain to diagnose juvenile myoclonic epilepsy (JME) has not yet been investigated. This study aimed to develop and validate radiomics prediction models to distinguish patients with JME from healthy controls (HCs), and to evaluate the feasibility of a radiomics approach using MRI for diagnosing JME. MATERIALS AND METHODS: A total of 97 JME patients (25.6 ± 8.5 years; female, 45.5%) and 32 HCs (28.9 ± 11.4 years; female, 50.0%) were randomly split (7:3 ratio) into a training (n = 90) and a test set (n = 39) group. Radiomic features were extracted from 22 regions of interest in the brain using the T1-weighted MRI based on clinical evidence. Predictive models were trained using seven modeling methods, including a light gradient boosting machine, support vector classifier, random forest, logistic regression, extreme gradient boosting, gradient boosting machine, and decision tree, with radiomics features in the training set. The performance of the models was validated and compared to the test set. The model with the highest area under the receiver operating curve (AUROC) was chosen, and important features in the model were identified. RESULTS: The seven tested radiomics models, including light gradient boosting machine, support vector classifier, random forest, logistic regression, extreme gradient boosting, gradient boosting machine, and decision tree, showed AUROC values of 0.817, 0.807, 0.783, 0.779, 0.767, 0.762, and 0.672, respectively. The light gradient boosting machine with the highest AUROC, albeit without statistically significant differences from the other models in pairwise comparisons, had accuracy, precision, recall, and F1 scores of 0.795, 0.818, 0.931, and 0.871, respectively. Radiomic features, including the putamen and ventral diencephalon, were ranked as the most important for suggesting JME. CONCLUSION: Radiomic models using MRI were able to differentiate JME from HCs.

Crystal-clear days and unclear days in migraine: A population-based study.

OBJECTIVE: To investigate crystal-clear days and unclear days in participants with migraine. BACKGROUND: Migraine affects individuals during the headache-free period. Therefore, headache-free days do not indicate migraine symptom-free days. Crystal-clear days can be characterized by days without headache and having minimal or no migraine symptoms. In contrast, days without headache, but with more than minimal migraine symptoms, can be defined as unclear days. METHODS: We used the baseline respondent data set of the Circannual Change in Headache and Sleep study, a nationwide population survey on headache and sleep. This study was a cross-sectional and case-control analysis of longitudinally collected data. The number of crystal-clear days per 30 days was assessed by asking "How many days have you had crystal-clear days without headache during the previous 30 days?". We defined headache-free, but not crystal-clear days, as unclear days. The number of unclear days per 30 days was calculated as follows: 30 - the number of headache days per 30 days - the number of crystal-clear days per 30 days. RESULTS: Of 170 participants with migraine, 165 (97.1%) had unclear days. The numbers of crystal-clear days (median [interquartile range] 20.0 [15.0-25.0] vs. 25.0 [20.0-29.0], p < 0.001) and unclears days (4.0 [0.0-8.0] vs. 1.0 [0.0-7.0], p < 0.001) per 30 days in participants with migraine were significantly lower and higher, respectively, than in those with non-migraine headache. Headache days (incident rate ratio and 95% confidence interval, 0.94 [0.90-0.97], p < 0.001) and weekly average sleep duration (0.95 [0.91-1.00], p = 0.035) were significant factors for crystal-clear days. CONCLUSIONS: The number of crystal-clear days were different from that of headache-free days. Almost all participants with migraine had unclear days. Our findings will facilitate understanding the symptoms and burden of migraine.

Prevalence and impact of visual aura in migraine and probable migraine: a population study.

Visual aura (VA) presents in 98% of cases of migraine with aura. However, data on its prevalence and impact in individuals with migraine and probable migraine (PM) are limited. Data from the nation-wide, population-based Circannual Change in Headache and Sleep Study were collected. Participants with VA rating scale scores ≥ 3 were classified as having VA. Of 3,030 participants, 170 (5.6%) and 337 (11.1%) had migraine and PM, respectively; VA prevalence did not differ between these cohorts (29.4% [50/170] vs. 24.3% [82/337], p = 0.219). Participants with migraine with VA had a higher headache frequency per month (4.0 [2.0-10.0] vs. 2.0 [1.0-4.8], p = 0.014) and more severe cutaneous allodynia (12-item Allodynia Symptom Checklist score; 3.0 [1.0-8.0] vs. 2.0 [0.0-4.8], p = 0.046) than those without VA. Participants with PM with VA had a higher headache frequency per month (2.0 [2.0-8.0] vs. 2.0 [0.6-4.0], p = 0.001), greater disability (Migraine Disability Assessment score; 10.0 [5.0-26.3] vs. 5.0 [2.0-12.0], p < 0.001), and more severe cutaneous allodynia (12-item Allodynia Symptom Checklist score, 2.5 [0.0-6.0] vs. 0.0 [0.0-3.0], p < 0.001) than those without VA. VA prevalence was similar between migraine and PM. Some symptoms were more severe in the presence of VA.

Sleep state of the elderly population in Korea: Nationwide cross-sectional population-based study.

Objective: Interest in sleep disorders among the elderly, especially those in Korea, has increased. We aimed to describe the overall sleep status of the elderly population in Korea using survey data and to determine the risk factors concerning different aspects of sleep status. Methods: We conducted a cross-sectional survey on 271 respondents aged 65-86 years old. We performed multistage clustered random sampling according to the population and socioeconomic distribution of all Korean territories. The survey questionnaire was used to perform a structural assessment of sociodemographic characteristics; medical comorbidities; psychiatric comorbidities; and sleep status, including sleep duration, sleep quality, presence of insomnia, excessive daytime sleepiness, sleep apnea, and restless legs syndrome. Results: Approximately 12.5, 22.%, and 51.3% of the elderly population had poor sleep quality, excessive daytime sleepiness, and insomnia, respectively. Hypertension, dyslipidemia, insomnia, anxiety, and depression predicted poor sleep quality. Female sex, insomnia, and sleep apnea predicted excessive daytime sleepiness. Poor sleep quality and depression predicted insomnia. Conclusion: A substantial proportion of the elderly Korean population have sleep problems, including poor sleep quality, excessive daytime sleepiness, and insomnia. Sleep status is influenced by various factors, including age, sex, and metabolic and psychiatric comorbidities.

Clinical Characteristics of Spinal Muscular Atrophy in Korea Confirmed by Genetic Analysis.

The objective of this study was to review the clinical characteristics of patients with spinal muscular atrophy and to emphasize the importance of performing genetic mutational analysis at initial patient assessment. This is a single center oriented, retrospective, and descriptive study conducted in Seoul, South Korea. Genetic mutational analysis to detect the deletion of exon 7 of the SMN1 gene on chromosome 5q13 was performed by multiplex ligation-dependent probe amplification. Clinical features, electrodiagnostic study results, muscle biopsy results, and laboratory test results were reviewed from patient medical records. Of all 28 patients (15 males and 13 females), all showed bilateral symmetric proximal dominant weakness. Among them, 3 patients were classified as type I, 14 patients as type II, and 11 patients as type III. Twenty-five patients had scoliosis and eight of these patients received surgical treatment for scoliosis with improvement in clinical outcomes. Ventilator support was used in 15 patients. In terms of the diagnostic process, 15 patients had completed an electrodiagnostic study and muscle biopsy before genetic testing, and six of these patients were initially misdiagnosed with myopathy. Owing to the similar clinical features of SMA and congenital myopathy, an electrodiagnostic study and muscle biopsy could create confusion in the correct diagnosis in some cases. Therefore, it is recommended that genetic mutation analysis should be conducted along with an electrodiagnostic study or muscle biopsy in the diagnostic process for spinal muscular atrophy.

Dural Arteriovenous Fistula Manifested as Rapid Progressive Dementia Successfully Treated by Endovascular Embolization Only.

A 43-year-old male presented with daytime sleepiness at work and indifferent behavior like never before. Two weeks prior to hospital admission, he had episodic memory loss with well preserved remote memory. Brain MRI showed a dural arteriovenous fistula (DAVF) in the right lateral transverse sinus with a bilateral thalamic venous infarction. Cerebral angiography confirmed a right transverse sigmoid dural arteriovenous fistula with a feeding artery of the right occipital artery and left posterior meningeal artery. The DAVF was completely eliminated through multiple endovascular interventions. Recently, endovascular treatment has become one of the main therapeutic options to obliterate a fistulous site, which has led to a rapid diagnostic approach and management of DAVFs with high curative rates. We report a rare case of posterior fossa located at a dural arteriovenous fistula that caused rapid progressive dementia and was successfully eliminated through only endovascular treatment.

Thermally Stable Bulk Heterojunction Prepared by Sequential Deposition of Nanostructured Polymer and Fullerene.

A morphologically-stable polymer/fullerene heterojunction has been prepared by minimizing the intermixing between polymer and fullerene via sequential deposition (SqD) of a polymer and a fullerene solution. A low crystalline conjugated polymer of PCPDTBT (poly[2,6-(4,4-bis-(2-ethylhexyl)-4H-cyclopenta [2,1-b;3,4-b']dithiophene)-alt-4,7(2,1,3-benzothiadiazole)]) has been utilized for the polymer layer and PC71BM (phenyl-C71-butyric-acid-methyl ester) for the fullerene layer, respectively. Firstly, a nanostructured PCPDTBT bottom layer was developed by utilizing various additives to increase the surface area of the polymer film. The PC71BM solution was prepared by dissolving it in the 1,2-dichloroethane (DCE), exhibiting a lower vapor pressure and slower diffusion into the polymer layer. The deposition of the PC71BM solution on the nanostructured PCPDTBT layer forms an inter-digitated bulk heterojunction (ID-BHJ) with minimized intermixing. The organic photovoltaic (OPV) device utilizing the ID-BHJ photoactive layer exhibits a highly reproducible solar cell performance. In spite of restricted intermixing between the PC71BM and the PCPDTBT, the efficiency of ID-BHJ OPVs (3.36%) is comparable to that of OPVs (3.87%) prepared by the conventional method (deposition of a blended solution of polymer:fullerene). The thermal stability of the ID-BHJ is superior to the bulk heterojunction (BHJ) prepared by the conventional method. The ID-BHJ OPV maintains 70% of its initial efficiency after thermal stress application for twelve days at 80 °C, whereas the conventional BHJ OPV maintains only 40% of its initial efficiency.

Ternary solvent for CH3NH3PbI3 perovskite films with uniform domain size.

A ternary solvent system consisting of dimethyl sulfoxide (DMSO), γ-butyrolactone (GBL) and N-methyl-2-pyrrolidone (NMP) has been developed to improve the uniformity of CH3NH3PbI3 (MAPbI3) perovskite domains. Compared to MAPbI3 perovskite films prepared using a binary solvent consisting of DMSO and GBL, the surface roughness and uniformity of MAPbI3 films fabricated by using the ternary solvent system are greatly improved. The thermogravimetric analysis reveals that a NMP-PbI2-MAI intermediate, a DMSO-PbI2-MAI intermediate and MAPbI3 crystals co-existed in the as-cast MAPbI3 films. Furthermore, it is found that the thermal stability of intermediate phases and the solvent evaporation rate are critical for the nucleation of the perovskite crystals during the thermal annealing treatment. The thermally stable intermediates prepared with the ternary solvent are converted to MAPbI3 films with a highly uniform and smooth surface. The film forms an intimate contact with the charge transporting layer when the layer is applied as a photoactive layer in the solar cell. As a result, the power conversion efficiency of ternary solvent processed solar cells is enhanced by 38.2% compared to that of the binary solvent processed one. Furthermore, the stability of the ternary processed perovskite solar cells is greatly improved, as well. This investigation provides a better understanding about the role of different processing solvents or additives in effecting the perovskite film quality.

Near infrared organic photodetector utilizing a double electron blocking layer.

A near infrared organic photodiode (OPD) utilizing a double electron blocking layer (EBL) fabricated by the sequential deposition of molybdenum (VI) oxide (MoO3) and poly(3,4ethylenedioxythiophene):poly(styrene-sulfonate) (PEDOT:PSS) is reported. The double EBL improves the on/off current ratio of OPD up to 1.36 x 104 at -1V, which is one order of magnitude higher than PEDOT:PSS single EBL (2.45 x 103) and three orders of magnitude higher than that of MoO3 single EBL (7.86). The detectivity at near infrared (800 nm) at -1V is 4.90 x 1011 Jones, which is 2.83 times higher than the PEDOT:PSS single EBL and 2 magnitudes higher compared to the MoO3 single EBL.

Mie Resonance-Modulated Spatial Distributions of Photogenerated Carriers in Poly(3-hexylthiophene-2,5-diyl)/Silicon Nanopillars.

Organic/silicon hybrid solar cells have great potential as low-cost, high-efficiency photovoltaic devices. The superior light trapping capability, mediated by the optical resonances, of the organic/silicon hybrid nanostructure-based cells enhances their optical performance. In this work, we fabricated Si nanopillar (NP) arrays coated with organic semiconductor, poly(3-hexylthiophene-2,5-diyl), layers. Experimental and calculated optical properties of the samples showed that Mie-resonance strongly concentrated incoming light in the NPs. Spatial mapping of surface photovoltage, i.e., changes in the surface potential under illumination, using Kelvin probe force microscopy enabled us to visualize the local behavior of the photogenerated carriers in our samples. Under red light, surface photovoltage was much larger (63 meV) on the top surface of a NP than on a planar sample (13 meV), which demonstrated that the confined light in the NPs produced numerous carriers within the NPs. Since the silicon NPs provide pathways for efficient carrier transportation, high collection probability of the photogenerated carriers near the NPs can be expected. This suggests that the optical resonance in organic/silicon hybrid nanostructures benefits not only broad-band light trapping but also efficient carrier collection.