82 results on '"Maureen Donnelly"'
Search Results
2. Modeling Principles and Methodologies - Spatial Representation and Reasoning.
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Thomas Bittner, Maureen Donnelly, Louis J. Goldberg, and Fabian Neuhaus
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- 2008
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3. A Temporal Mereology for Distinguishing between Integral Objects and Portions of Stuff.
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Thomas Bittner and Maureen Donnelly
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- 2007
4. A Classification of Spatio-temporal Entities Based on Their Location in Space-Time.
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Thomas Bittner and Maureen Donnelly
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- 2006
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5. A theory of granular parthood based on qualitative cardinality and size measures.
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Thomas Bittner and Maureen Donnelly
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- 2006
6. Computational ontologies of parthood, componenthood, and containment.
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Thomas Bittner and Maureen Donnelly
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- 2005
7. Spatial Relations Between Classes of Individuals.
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Maureen Donnelly and Thomas Bittner
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- 2005
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8. Machine learning models to predict electroencephalographic seizures in critically ill children
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Jian Hu, France W. Fung, Marin Jacobwitz, Darshana S. Parikh, Lisa Vala, Maureen Donnelly, Alexis A. Topjian, Nicholas S. Abend, and Rui Xiao
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Computer science ,Critical Illness ,Logistic regression ,Machine learning ,computer.software_genre ,Article ,Machine Learning ,03 medical and health sciences ,0302 clinical medicine ,Lasso (statistics) ,Seizures ,Humans ,Prospective Studies ,Child ,business.industry ,Deep learning ,Electroencephalography ,General Medicine ,Stepwise regression ,Random forest ,Variable (computer science) ,Neurology ,Ranking ,Neurology (clinical) ,Artificial intelligence ,F1 score ,business ,computer ,030217 neurology & neurosurgery - Abstract
Objective To determine whether machine learning techniques would enhance our ability to incorporate key variables into a parsimonious model with optimized prediction performance for electroencephalographic seizure (ES) prediction in critically ill children. Methods We analyzed data from a prospective observational cohort study of 719 consecutive critically ill children with encephalopathy who underwent clinically-indicated continuous EEG monitoring (CEEG). We implemented and compared three state-of-the-art machine learning methods for ES prediction: (1) random forest; (2) Least Absolute Shrinkage and Selection Operator (LASSO); and (3) Deep Learning Important FeaTures (DeepLIFT). We developed a ranking algorithm based on the relative importance of each variable derived from the machine learning methods. Results Based on our ranking algorithm, the top five variables for ES prediction were: (1) epileptiform discharges in the initial 30 minutes, (2) clinical seizures prior to CEEG initiation, (3) sex, (4) age dichotomized at 1 year, and (5) epileptic encephalopathy. Compared to the stepwise selection-based approach in logistic regression, the top variables selected by our ranking algorithm were more informative as models utilizing the top variables achieved better prediction performance evaluated by prediction accuracy, AUROC and F1 score. Adding additional variables did not improve and sometimes worsened model performance. Conclusion The ranking algorithm was helpful in deriving a parsimonious model for ES prediction with optimal performance. However, application of state-of-the-art machine learning models did not substantially improve model performance compared to prior logistic regression models. Thus, to further improve the ES prediction, we may need to collect more samples and variables that provide additional information.
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- 2021
9. The Mereology of Stages and Persistent Entities.
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Thomas Bittner and Maureen Donnelly
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- 2004
10. On Parts and Holes: The Spatial Structure of the Human Body.
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Maureen Donnelly
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- 2004
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11. Layered Mereotopology.
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Maureen Donnelly
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- 2003
12. Layers: A New Approach to Locating Objects in Space.
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Maureen Donnelly and Barry Smith 0001
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- 2003
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13. Explaining the differential application of non-symmetric relations
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Maureen Donnelly
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Philosophy of science ,Property (philosophy) ,Philosophy ,05 social sciences ,Structure (category theory) ,General Social Sciences ,Metaphysics ,06 humanities and the arts ,0603 philosophy, ethics and religion ,050105 experimental psychology ,Philosophy of language ,060302 philosophy ,0501 psychology and cognitive sciences ,Algebraic number ,Differential (infinitesimal) ,Relation (history of concept) ,Mathematical economics - Abstract
Non-symmetric relations like loves or between can apply to the same relata in non-equivalent ways. For example, loves may apply to Abelard and Eloise either by Abelard’s loving Eloise or by Eloise’s loving Abelard. On the standard account of relations (Directionalism), different applications of a relation to fixed relata are distinguished by the direction in which the relation applies to the relata (e.g., from Abelard to Eloise rather than from Eloise to Abelard). But neither Directionalism nor its most popular rival, Positionalism, offer accounts of differential application that generalize to relations of arbitrary symmetry structure. Here, I develop an alternative account, Relative Positionalism, which distinguishes different applications of a relation to fixed relata in terms of the ways in which the relata are characterized relative to one another. In presenting and defending Relative Positionalism, this paper covers some of the same ground as my [2016], but avoids the latter’s algebraic approach and focuses on interpretative issues—in particular, how to make sense of relative property instantiation—that were not addressed in the earlier paper.
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- 2021
14. Introducing granularity-dependent quantitativedistance and diameter measures in common-sense reasoning contexts.
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Maureen Donnelly
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- 2001
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15. Validation of a Model for Targeted EEG Monitoring Duration in Critically Ill Children
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France W, Fung, Jiaxin, Fan, Darshana S, Parikh, Lisa, Vala, Maureen, Donnelly, Marin, Jacobwitz, Alexis A, Topjian, Rui, Xiao, and Nicholas S, Abend
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Neurology ,Physiology ,Physiology (medical) ,Neurology (clinical) - Abstract
Continuous EEG monitoring (CEEG) to identify electrographic seizures (ES) in critically ill children is resource intense. Targeted strategies could enhance implementation feasibility. We aimed to validate previously published findings regarding the optimal CEEG duration to identify ES in critically ill children.This was a prospective observational study of 1,399 consecutive critically ill children with encephalopathy. We validated the findings of a multistate survival model generated in a published cohort (N = 719) in a new validation cohort (N = 680). The model aimed to determine the CEEG duration at which there was15%,10%,5%, or2% risk of experiencing ES if CEEG were continued longer. The model included baseline clinical risk factors and emergent EEG risk factors.A model aiming to determine the CEEG duration at which a patient had10% risk of ES if CEEG were continued longer showed similar performance in the generation and validation cohorts. Patients without emergent EEG risk factors would undergo 7 hours of CEEG in both cohorts, whereas patients with emergent EEG risk factors would undergo 44 and 36 hours of CEEG in the generation and validation cohorts, respectively. The10% risk of ES model would yield a 28% or 64% reduction in CEEG hours compared with guidelines recommending CEEG for 24 or 48 hours, respectively.This model enables implementation of a data-driven strategy that targets CEEG duration based on readily available clinical and EEG variables. This approach could identify most critically ill children experiencing ES while optimizing CEEG use.
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- 2022
16. Mereological vagueness and existential vagueness.
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Maureen Donnelly
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- 2009
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17. A spatio-temporal ontology for geographic information integration.
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Thomas Bittner, Maureen Donnelly, and Barry Smith 0001
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- 2009
18. Validation of a model to predict electroencephalographic seizures in critically ill children
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Nicholas S. Abend, Alexis A. Topjian, Maureen Donnelly, Marin Jacobwitz, Darshana S. Parikh, Lisa Vala, Zi Wang, and Rui Xiao
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Male ,0301 basic medicine ,medicine.medical_specialty ,Referral ,Critical Illness ,Clinical prediction rule ,Electroencephalography ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Seizures ,Clinical Decision Rules ,medicine ,Humans ,Ictal ,Prospective Studies ,Child ,Pediatric intensive care unit ,Models, Statistical ,medicine.diagnostic_test ,business.industry ,Incidence (epidemiology) ,Infant ,Reproducibility of Results ,030104 developmental biology ,Neurology ,Emergency medicine ,Cohort ,Female ,Neurology (clinical) ,business ,030217 neurology & neurosurgery ,Cohort study - Abstract
Objective Electroencephalographic seizures (ESs) are common in encephalopathic critically ill children, but identification requires extensive resources for continuous electroencephalographic monitoring (CEEG). In a previous study, we developed a clinical prediction rule using three clinical variables (age, acute encephalopathy category, clinically evident seizure[s] prior to CEEG initiation) and two electroencephalographic (EEG) variables (EEG background category and interictal discharges within the first 30 minutes of EEG) to identify patients at high risk for ESs for whom CEEG might be essential. In the current study, we aimed to validate the ES prediction model using an independent cohort. Methods The prospectively acquired validation cohort consisted of 314 consecutive critically ill children treated in the Pediatric Intensive Care Unit of a quaternary care referral hospital with acute encephalopathy undergoing clinically indicated CEEG. We calculated test characteristics using the previously developed prediction model in the validation cohort. As in the generation cohort study, we selected a 0.10 cutpoint to emphasize sensitivity. Results The incidence of ESs in the validation cohort was 22%. The generation and validation cohorts were alike in most clinical and EEG characteristics. The ES prediction model was well calibrated and well discriminating in the validation cohort. The model had a sensitivity of 90%, specificity of 37%, positive predictive value of 28%, and negative predictive value of 93%. If applied, the model would limit 31% of patients from undergoing CEEG while failing to identify 10% of patients with ESs. The model had similar performance characteristics in the generation and validation cohorts. Significance A model employing five readily available clinical and EEG variables performed well when validated in a new consecutive cohort. Implementation would substantially reduce CEEG utilization, although some patients with ESs would not be identified. This model may serve a critical role in targeting limited CEEG resources to critically ill children at highest risk for ESs.
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- 2020
19. EEG monitoring duration to identify electroencephalographic seizures in critically ill children
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Alexis A. Topjian, Jiaxin Fan, Darshana S. Parikh, Maureen Donnelly, Nicholas S. Abend, Marin Jacobwitz, Rui Xiao, and Lisa Vala
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Male ,medicine.medical_specialty ,Critical Illness ,Encephalopathy ,Electroencephalography ,Article ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Seizures ,030225 pediatrics ,Humans ,Medicine ,Prospective Studies ,Duration (project management) ,Child ,Prospective cohort study ,Survival analysis ,Monitoring, Physiologic ,medicine.diagnostic_test ,business.industry ,Infant ,medicine.disease ,Child, Preschool ,Emergency medicine ,Female ,Observational study ,Neurology (clinical) ,business ,Eeg monitoring ,030217 neurology & neurosurgery ,Cohort study - Abstract
ObjectivesTo determine the optimal duration of continuous EEG monitoring (CEEG) for electrographic seizure (ES) identification in critically ill children.MethodsWe performed a prospective observational cohort study of 719 consecutive critically ill children with encephalopathy. We evaluated baseline clinical risk factors (age and prior clinically evident seizures) and emergent CEEG risk factors (epileptiform discharges and ictal-interictal continuum patterns) using a multistate survival model. For each subgroup, we determined the CEEG duration for which the risk of ES was ResultsES occurred in 184 children (26%). Patients achieved ConclusionsA model derived from 2 baseline clinical risk factors and emergent EEG risk factors would allow clinicians to implement personalized strategies that optimally target limited CEEG resources. This would enable more widespread use of CEEG-guided management as a potential neuroprotective strategy.ClinicalTrials.gov identifierNCT03419260.
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- 2020
20. Development of a model to predict electroencephalographic seizures in critically ill children
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Nicholas S. Abend, Maureen Donnelly, Lisa Vala, Marin Jacobwitz, Rui Xiao, Jiaxin Fan, Darshana S. Parikh, and Alexis A. Topjian
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0301 basic medicine ,Pediatric intensive care unit ,medicine.medical_specialty ,Optimal cutoff ,medicine.diagnostic_test ,business.industry ,Critically ill ,Incidence (epidemiology) ,Status epilepticus ,Electroencephalography ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,Neurology ,Emergency medicine ,medicine ,Cutoff ,Observational study ,Neurology (clinical) ,medicine.symptom ,business ,030217 neurology & neurosurgery - Abstract
OBJECTIVE Electroencephalographic seizures (ESs) are common in encephalopathic critically ill children, but ES identification with continuous electroencephalography (EEG) monitoring (CEEG) is resource-intense. We aimed to develop an ES prediction model that would enable clinicians to stratify patients by ES risk and optimally target limited CEEG resources. We aimed to determine whether incorporating data from a screening EEG yielded better performance characteristics than models using clinical variables alone. METHODS We performed a prospective observational study of 719 consecutive critically ill children with acute encephalopathy undergoing CEEG in the pediatric intensive care unit of a quaternary care institution between April 2017 and February 2019. We identified clinical and EEG risk factors for ES. We evaluated model performance with area under the receiver-operating characteristic (ROC) curve (AUC), validated the optimal model with the highest AUC using a fivefold cross-validation, and calculated test characteristics emphasizing high sensitivity. We applied the optimal operating slope strategy to identify the optimal cutoff to define whether a patient should undergo CEEG. RESULTS The incidence of ES was 26%. Variables associated with increased ES risk included age, acute encephalopathy category, clinical seizures prior to CEEG initiation, EEG background, and epileptiform discharges. Combining clinical and EEG variables yielded better model performance (AUC 0.80) than clinical variables alone (AUC 0.69; P
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- 2020
21. Logical properties of foundational relations in bio-ontologies.
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Thomas Bittner and Maureen Donnelly
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- 2007
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22. A formal theory for spatial representation and reasoning in biomedical ontologies.
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Maureen Donnelly, Thomas Bittner, and Cornelius Rosse
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- 2006
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23. Relative places.
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Maureen Donnelly
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- 2005
24. Periodic and rhythmic patterns in critically ill children: Incidence, interrater agreement, and seizures
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Nicholas S. Abend, Shavonne L. Massey, Mark Fitzgerald, Marin Jacobwitz, Maureen Donnelly, Sudha Kilaru Kessler, Darshana S. Parikh, Lisa Vala, and Alexis A. Topjian
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medicine.medical_specialty ,Critically ill ,business.industry ,Incidence (epidemiology) ,Critical Illness ,Incidence ,Electroencephalography ,Ictal interictal continuum ,Electroencephalographic monitoring ,Standardized terminology ,Inter-rater reliability ,Rhythm ,Neurology ,Seizures ,Internal medicine ,medicine ,Humans ,Neurology (clinical) ,business ,Child ,Delta activity ,Monitoring, Physiologic - Abstract
We aimed to determine the incidence of periodic and rhythmic patterns (PRP), assess the interrater agreement between electroencephalographers scoring PRP using standardized terminology, and analyze associations between PRP and electrographic seizures (ES) in critically ill children.This was a prospective observational study of consecutive critically ill children undergoing continuous electroencephalographic monitoring (CEEG). PRP were identified by one electroencephalographer, and then two pediatric electroencephalographers independently scored the first 1-h epoch that contained PRP using standardized terminology. We determined the incidence of PRPs, evaluated interrater agreement between electroencephalographers scoring PRP, and evaluated associations between PRP and ES.One thousand three hundred ninety-nine patients underwent CEEG. ES occurred in 345 (25%) subjects. PRP, ES + PRP, and ictal-interictal continuum (IIC) patterns occurred in 142 (10%), 81 (6%), and 93 (7%) subjects, respectively. The most common PRP were generalized periodic discharges (GPD; 43, 30%), lateralized periodic discharges (LPD; 34, 24%), generalized rhythmic delta activity (GRDA; 34, 24%), bilateral independent periodic discharges (BIPD; 14, 10%), and lateralized rhythmic delta activity (LRDA; 11, 8%). ES risk varied by PRP type (p .01). ES occurrence was associated with GPD (odds ratio [OR] = 6.35, p .01), LPD (OR = 10.45, p .01), BIPD (OR = 6.77, p .01), and LRDA (OR = 6.58, p .01). Some modifying features increased the risk of ES for each of those PRP. GRDA was not significantly associated with ES (OR = 1.34, p = .44). Each of the IIC patterns was associated with ES (OR = 6.83-8.81, p .01). ES and PRP occurred within 6 h (before or after) in 45 (56%) subjects.PRP occurred in 10% of critically ill children who underwent CEEG. The most common patterns were GPD, LPD, GRDA, BIPD, and LRDA. The GPD, LPD, BIPD, LRDA, and IIC patterns were associated with ES. GRDA was not associated with ES.
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- 2021
25. Endurants and perdurants in directly depicting ontologies.
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Thomas Bittner, Maureen Donnelly, and Barry Smith 0001
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- 2004
26. A formal theory for reasoning about parthood, connection, and location.
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Maureen Donnelly
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- 2004
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27. WE-101. Validation of a model for targeted EEG monitoring duration in critically ill children
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France Fung, Jiaxin Fan, Darshana Parikh, Lisa Vala, Maureen Donnelly, Alexis Topjian, Rui Xiao, and Nicholas Abend
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Neurology ,Physiology (medical) ,Neurology (clinical) ,Sensory Systems - Published
- 2022
28. WE-102. Periodic patterns and outcome in critically ill children
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France Fung, Darshana Parikh, Shavonne Massey, Mark Fitzgerald, Lisa Vala, Maureen Donnelly, Marin Jacobwitz, Sudha Kessler, Alexis Topjian, and Nicholas Abend
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Neurology ,Physiology (medical) ,Neurology (clinical) ,Sensory Systems - Published
- 2022
29. Electrographic Seizures and Outcome in Critically Ill Children
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Maureen Donnelly, Rui Xiao, Lisa Vala, Nicholas S. Abend, Marin Jacobwitz, Zi Wang, Alexis A. Topjian, and Darshana S. Parikh
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Pediatrics ,medicine.medical_specialty ,business.industry ,Critically ill ,Status epilepticus ,Odds ratio ,Stepwise regression ,Logistic regression ,Confidence interval ,Article ,03 medical and health sciences ,0302 clinical medicine ,030225 pediatrics ,Medicine ,Neurology (clinical) ,medicine.symptom ,business ,Prospective cohort study ,Eeg monitoring ,030217 neurology & neurosurgery - Abstract
ObjectiveTo determine the association between electroencephalographic seizure (ES) and electroencephalographic status epilepticus (ESE) exposure and unfavorable neurobehavioral outcomes in critically ill children with acute encephalopathy.MethodsThis was a prospective cohort study of acutely encephalopathic critically ill children undergoing continuous EEG monitoring (CEEG). ES exposure was assessed as (1) no ES/ESE, (2) ES, or (3) ESE. Outcomes assessed at discharge included the Glasgow Outcome Scale–Extended Pediatric Version (GOS-E-Peds), Pediatric Cerebral Performance Category (PCPC), and mortality. Unfavorable outcome was defined as a reduction in GOS-E-Peds or PCPC score from preadmission to discharge. Stepwise selection was used to generate multivariate logistic regression models that assessed associations between ES exposure and outcomes while adjusting for multiple other variables.ResultsAmong 719 consecutive critically ill patients, there was no evidence of ES in 535 patients (74.4%), ES occurred in 140 patients (19.5%), and ESE in 44 patients (6.1%). The final multivariable logistic regression analyses included ES exposure, age dichotomized at 1 year, acute encephalopathy category, initial EEG background category, comatose at CEEG initiation, and Pediatric Index of Mortality 2 score. There was an association between ESE and unfavorable GOS-E-Peds (odds ratio 2.21, 95% confidence interval 1.07–4.54) and PCPC (odds ratio 2.17, 95% confidence interval 1.05–4.51) but not mortality. There was no association between ES and unfavorable outcome or mortality.ConclusionsAmong acutely encephalopathic critically ill children, there was an association between ESE and unfavorable neurobehavioral outcomes, but no association between ESE and mortality. ES exposure was not associated with unfavorable neurobehavioral outcomes or mortality.
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- 2021
30. Acceptability of Standardized EEG Reporting in an Electronic Health Record
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Sudha Kilaru Kessler, Marissa Ferruzi, Linda Allen-Napoli, Denise LaFalce, Shavonne L. Massey, Maureen Donnelly, Naomi Lewin, Stephanie M. Witzman, Nicholas S. Abend, Dennis J. Dlugos, Nicole McNamee, Lila T. Worden, Mark Fitzgerald, Ernesto Gonzalez-Giraldo, Amber Haywood, Sara E. Fridinger, Brenda Banwell, and Susan Melamed
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medicine.medical_specialty ,Quality management ,Standardization ,Physiology ,MEDLINE ,Documentation ,Electroencephalography ,Article ,050105 experimental psychology ,Workflow ,03 medical and health sciences ,0302 clinical medicine ,Electronic health record ,Physicians ,Surveys and Questionnaires ,Physiology (medical) ,medicine ,Electronic Health Records ,Humans ,0501 psychology and cognitive sciences ,Medical physics ,medicine.diagnostic_test ,business.industry ,05 social sciences ,Usability ,Neurology ,Neurology (clinical) ,Psychology ,business ,030217 neurology & neurosurgery - Abstract
Rationale Implementation of electronic health records may improve the quality, accuracy, timeliness, and availability of documentation. Thus, our institution developed a system that integrated EEG ordering, scheduling, standardized reporting, and billing. Given the importance of user perceptions for successful implementation, we performed a quality improvement study to evaluate electroencephalographer satisfaction with the new EEG report system. Methods We implemented an EEG report system that was integrated in an electronic health record. In this single-center quality improvement study, we surveyed electroencephalographers regarding overall acceptability, report standardization, workflow efficiency, documentation quality, and fellow education using a 0 to 5 scale (with 5 denoting best). Results Eighteen electroencephalographers responded to the survey. The median score for recommending the overall system to a colleague was 5 (range 3-5), which indicated good overall satisfaction and acceptance of the system. The median scores for report standardization (4; 3-5) and workflow efficiency (4.5; 3-5) indicated that respondents perceived the system as useful and easy to use for documentation tasks. The median scores for quality of documentation (4.5; 1-5) and fellow education (4; 1-5) indicated that although most respondents believed the system provided good quality reports and helped with fellow education, a small number of respondents had substantially different views (ratings of 1). Conclusions Overall electroencephalographer satisfaction with the new EEG report system was high, as were the scores for perceived usefulness (assessed as standardization, documentation quality, and education) and ease of use (assessed as workflow efficiency). Future study is needed to determine whether implementation yields useful data for clinical research and quality improvement studies or improves EEG report standardization.
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- 2019
31. Collodion Remover Can Degrade Plastic-Containing Medical Devices Commonly Used in the Intensive Care Unit
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Mark Fitzgerald, Maureen Donnelly, Linda Allen-Napoli, Nicholas S. Abend, and Lisa Vala
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050105 experimental psychology ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,law ,Collodion ,Medicine ,0501 psychology and cognitive sciences ,In patient ,Potential impact ,business.industry ,05 social sciences ,Video EEG monitoring ,Electroencephalography ,Intensive care unit ,Prolonged exposure ,Medical Laboratory Technology ,Equipment and Supplies ,Solvents ,Equipment Failure ,Tissue Adhesives ,Neurology (clinical) ,business ,Plastics ,030217 neurology & neurosurgery ,Biomedical engineering - Abstract
Collodion remover, a solvent blend used to remove collodion glue after long-term video EEG monitoring, was implicated as a potential causative factor in patient safety events at our institution during which damage to plastic components of medical devices was noted in the intensive care unit. We sought to determine experimentally whether collodion remover could lead to degradation of multiple plastic-containing medical devices commonly used in the intensive care unit to determine whether workflow changes were needed during electrode removal. We exposed devices to collodion remover for brief, intermediate, and prolonged durations. We report that collodion remover is capable of degrading the hard plastic components of multiple medical devices after prolonged exposure; however, intermediate duration exposure was also capable of producing damage to clave connectors used with intravenous and central lines, which could plausibly lead to adverse events given the widespread use of these devices. These data suggest a pathway-based approach to collodion remover use might be beneficial in minimizing the potential impact of this solvent on plastic-containing medical devices.
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- 2019
32. The Cognitive Value of Literary Perspectives
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Maureen Donnelly
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Philosophy ,Visual Arts and Performing Arts ,Cognition ,Sociology ,Value (mathematics) ,Music ,Cognitive psychology - Published
- 2019
33. Geoffrey Hellman and Stewart Shapiro: Varieties of Continua: From Regions to Points and Back
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Maureen Donnelly
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Philosophy - Published
- 2019
34. Containment Relations in Anatomical Ontologies.
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Maureen Donnelly
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- 2005
35. Encounter norms among visitors at a national park in Turkey
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Meryem Bingül, Jerry Vaske, and Maureen Donnelly
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Tourism, Leisure and Hospitality Management ,Geography, Planning and Development - Abstract
This article examined response format effects on norm prevalence (i.e., the percent of individuals who could specify a norm). Data were collected in Dilek Peninsula Büyük Menderes Delta National Park, in Turkey. Respondents were randomly assigned to one of two conditions. In the “semi-open” response format, respondents (n = 458) “wrote a number” for an acceptable number of visitor encounters. In the “closed” format, respondents (n = 459) “circled a number” of acceptable encounters, along a range of possible responses. Results showed that encounter norm prevalence was significantly and consistently higher for the closed format of the survey, as compared to the semi-open version. In addition, among those reporting a norm, the average tolerance levels were statistically higher in the semi-open format. Implications for applying the normative approach across different cultures are discussed.
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- 2017
36. The Moving Spotlight: An Essay on Time and Ontology, by Ross Cameron
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Maureen Donnelly
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Philosophy ,A-series and B-series ,Ontology (information science) ,Epistemology - Abstract
In The Moving Spotlight, Ross Cameron develops an original version of the Moving Spotlight Theory (MST) and argues that his theory is preferable to other versions of the A Theory of time. (By an A ...
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- 2017
37. Electroencephalographic Seizures in Critically Ill Children: Management and Adverse Events
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Nicholas S. Abend, Marin Jacobwitz, Alexis A. Topjian, Darshana S. Parikh, Maureen Donnelly, Rui Xiao, and Lisa Vala
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0301 basic medicine ,Male ,Pediatrics ,medicine.medical_specialty ,Adolescent ,Critical Illness ,Status epilepticus ,Electroencephalography ,Severity of Illness Index ,Article ,03 medical and health sciences ,Epilepsy ,0302 clinical medicine ,Risk Factors ,Seizures ,Medicine ,Humans ,Prospective Studies ,Adverse effect ,Child ,Monitoring, Physiologic ,medicine.diagnostic_test ,business.industry ,Critically ill ,Incidence (epidemiology) ,Brain ,Infant ,Symptomatic seizures ,respiratory system ,medicine.disease ,musculoskeletal system ,respiratory tract diseases ,030104 developmental biology ,Neurology ,Child, Preschool ,Observational study ,Female ,Neurology (clinical) ,medicine.symptom ,business ,030217 neurology & neurosurgery - Abstract
Objective Guidelines recommend that encephalopathic critically ill children undergo continuous electroencephalographic (CEEG) monitoring for electrographic seizure (ES) identification and management. However, limited data exist on antiseizure medication (ASM) safety for ES treatment in critically ill children. Methods We performed a single-center prospective observational study of encephalopathic critically ill children undergoing CEEG. Clinical and EEG features and ASM utilization patterns were evaluated. We determined the incidence, types, and risk factors for adverse events associated with ASM administration. Results A total of 472 consecutive critically ill children undergoing CEEG were enrolled. ES occurred in 131 children (28%). Clinicians administered ASM to 108 children with ES (82%). ES terminated after the initial ASM in 38% of patients who received one ASM, after the second ASM in 35% of patients who received two ASMs, after the third ASM in 50% of patients who received three ASMs, and after the fourth ASM in 53% of patients who received four ASMs. Thirty patients (28%) received anesthetic infusions for ES management. Adverse events occurred in 18 patients (17%). Adverse effects were expected and resolved in all patients, and they were generally serious (in 15 patients) and definitely related (in 12 patients). Adverse events were rare in patients with acute symptomatic seizures requiring only one to two ASMs for treatment, but were more common in children with epilepsy, ictal-interictal continuum EEG patterns, or patients requiring more extensive ASM management. Significance ES ceased after one ASM in only 38% of critically ill children but ceased after two ASMs in 73% of critically ill children. Thus, ES management was often accomplished with readily available medications, but optimization of multistep ES management strategies might be beneficial. Adverse events were rare and manageable in children with acute symptomatic seizures requiring only one to two ASMs for treatment. Future studies are needed to determine whether management of acute symptomatic ES improves neurobehavioral outcomes.
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- 2019
38. Electroencephalographic status epilepticus is common in critically ill children undergoing continuous EEG monitoring
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Darshana S. Parikh, Lisa Vala, Maureen Donnelly, Mark Fitzgerald, Alexis A. Topjian, Nicholas S. Abend, F. Fung, Marin Jacobwitz, and Shavonne L. Massey
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medicine.medical_specialty ,Critically ill ,business.industry ,Status epilepticus ,medicine.disease ,Behavioral Neuroscience ,Epilepsy ,Neurology ,medicine ,Neurology (clinical) ,medicine.symptom ,Intensive care medicine ,business ,Eeg monitoring - Published
- 2019
39. JC virus reactivation during prolonged natalizumab monotherapy for multiple sclerosis
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R. Philip Kinkel, Maureen Donnelly, Spyridon Chalkias, Marion C. Stein, Maria K. Houtchens, Guy J. Buckle, Evelyn Bord, Jacob A. Sloane, Stephanie Batson, Xin Dang, Igor J. Koralnik, and Carolina Ionete
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viruses ,Multiple sclerosis ,ELISPOT ,Progressive multifocal leukoencephalopathy ,Interferon beta-1a ,JC virus ,virus diseases ,Biology ,medicine.disease ,medicine.disease_cause ,Peripheral blood mononuclear cell ,Virology ,nervous system diseases ,Natalizumab ,nervous system ,Neurology ,Immunology ,medicine ,Neurology (clinical) ,Viral load ,medicine.drug - Abstract
Objective To determine the prevalence of JC virus (JCV) reactivation and JCV-specific cellular immune response during prolonged natalizumab treatment for multiple sclerosis (MS). Methods We enrolled 43 JCV-seropositive MS patients, including 32 on natalizumab monotherapy >18 months, 6 on interferon β-1a monotherapy >36 months, and 5 untreated controls. We performed quantitative real-time polymerase chain reaction in cerebrospinal fluid (CSF), blood, and urine for JCV DNA, and we determined JCV-specific T-cell responses using enzyme-linked immunosorbent spot (ELISpot) and intracellular cytokine staining (ICS) assays, ex vivo and after in vitro stimulation with JCV peptides. Results JCV DNA was detected in the CSF of 2 of 27 (7.4%) natalizumab-treated MS patients who had no symptoms or magnetic resonance imaging–detected lesions consistent with progressive multifocal leukoencephalopathy. JCV DNA was detected in blood of 12 of 43 (27.9%) and in urine of 11 of 43 (25.6%) subjects without a difference between natalizumab-treated patients and controls. JC viral load was higher in CD34+ cells and in monocytes compared to other subpopulations. ICS was more sensitive than ELISpot. JCV-specific T-cell responses, mediated by both CD4+ and CD8+ T lymphocytes, were detected more frequently after in vitro stimulation. JCV-specific CD4+ T cells were detected ex vivo more frequently in MS patients with JCV DNA in CD34+ (p = 0.05) and B cells (p = 0.03). Interpretation Asymptomatic JCV reactivation may occur in CSF of natalizumab-treated MS patients. JCV DNA load is higher in circulating CD34+ cells and monocytes compared to other mononuclear cells, and JCV in blood might trigger a JCV-specific CD4+ T-cell response. JCV-specific cellular immune response is highly prevalent in all JCV-seropositive MS patients, regardless of treatment. ANN NEUROL 2014;75:925–934
- Published
- 2014
40. LIPIcs, Volume 86, COSIT'17, Complete Volume
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Eliseo Clementini and Maureen Donnelly and May Yuan and Christian Kray and Paolo Fogliaroni and Andrea Ballatore, Clementini, Eliseo, Donnelly, Maureen, Yuan, May, Kray, Christian, Fogliaroni, Paolo, Ballatore, Andrea, Eliseo Clementini and Maureen Donnelly and May Yuan and Christian Kray and Paolo Fogliaroni and Andrea Ballatore, Clementini, Eliseo, Donnelly, Maureen, Yuan, May, Kray, Christian, Fogliaroni, Paolo, and Ballatore, Andrea
- Abstract
LIPIcs, Volume 86, COSIT'17, Complete Volume
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- 2017
- Full Text
- View/download PDF
41. Front Matter, Table of Contents, Preface, Organization, List of Authors
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Eliseo Clementini and Maureen Donnelly and May Yuan and Christian Kray and Paolo Fogliaroni and Andrea Ballatore, Clementini, Eliseo, Donnelly, Maureen, Yuan, May, Kray, Christian, Fogliaroni, Paolo, Ballatore, Andrea, Eliseo Clementini and Maureen Donnelly and May Yuan and Christian Kray and Paolo Fogliaroni and Andrea Ballatore, Clementini, Eliseo, Donnelly, Maureen, Yuan, May, Kray, Christian, Fogliaroni, Paolo, and Ballatore, Andrea
- Abstract
Front Matter, Table of Contents, Preface, Organization, List of Authors
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- 2017
- Full Text
- View/download PDF
42. Three-Dimensionalism
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Maureen Donnelly
- Abstract
Three-Dimensionalism is a position on how objects persist over time. Three-Dimensionalism is standardly construed as the claim that objects persist by being “wholly present” at each moment of their careers and is typically endorsed in opposition to the standard four-dimensionalist claim that objects extend through time by having temporal parts at each moment of their careers. This article reviews and highlights serious shortcomings of various proposals for filling out the three-dimensionalist account of persistence through claims about persisting objects’ parts or locations. This article suggests that Three-Dimensionalism is best understood as a position on the grounds for facts about objects’ presence over time.
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- 2016
43. Impact of an ICU EEG monitoring pathway on timeliness of therapeutic intervention and electrographic seizure termination
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Shavonne L. Massey, Brenda Banwell, Robert A. Berg, Sudha Kilaru Kessler, Jennifer Hewlett, Alexis A. Topjian, Jane Lavelle, Allison Parker, Ryan P. Williams, Rebecca Ichord, Dennis J. Dlugos, Nicholas S. Abend, and Maureen Donnelly
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Male ,Time Factors ,Electrographic seizure ,Electroencephalography ,Statistics, Nonparametric ,Article ,03 medical and health sciences ,0302 clinical medicine ,Interquartile range ,Seizures ,030225 pediatrics ,Intervention (counseling) ,Medicine ,Humans ,Child ,Monitoring, Physiologic ,medicine.diagnostic_test ,business.industry ,Critically ill ,Medication administration ,Intensive Care Units ,Neurology ,Anesthesia ,Etiology ,Anticonvulsants ,Female ,Neurology (clinical) ,business ,Eeg monitoring ,030217 neurology & neurosurgery - Abstract
Summary Objectives We aimed to determine whether implementation of a structured multidisciplinary electroencephalography (EEG) monitoring pathway improved the timeliness of administration of antiseizure medication in response to electrographic seizures in encephalopathic critically ill children. Methods A multidisciplinary team developed a pathway to standardize EEG monitoring and seizure management in encephalopathic critically ill children, aiming to decrease the time from electrographic seizure onset to antiseizure medication administration. Data were collected to inform the team of improvement opportunities, which were then provided by an institutional pathway, staff education, and streamlined communication. Measurements were obtained before and after pathway implementation to assess for improvement. Results We collected data on 41 patients before and 21 after pathway implementation. There were no differences between the baseline and pathway groups in demographic characteristics, acute encephalopathy etiologies, or antiseizure medications utilized. The median duration [interquartile range, IQR] from seizure onset to antiseizure medication administration was shorter for patients treated with the pathway (64 min [50, 101]) compared to patients treated prior to pathway implementation (139 min [71, 189]; p = 0.0006). The median [IQR] interval from seizure onset to antiseizure medication order was shorter for the pathway group (31 min [20, 49]) than the baseline group (71 min [33, 131]; p = 0.003). The median [IQR] interval from antiseizure medication order to administration was shorter for the pathway group (30 min [19, 40]) than the baseline group (40 min [17, 68]) (p = 0.047). Seizure termination was more likely to occur following initial antiseizure medication administration in the pathway than baseline group (67% vs. 27%, p = 0.002). Significance Implementation of the pathway resulted in a significant reduction in the duration between electrographic seizure onset and antiseizure medication administration, and a significant increase in the rate of electrographic seizure termination following an initial antiseizure medication. Further study is needed to determine whether these changes are associated with improved outcomes.
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- 2016
44. Positionalism Revisited
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Maureen Donnelly
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- 2016
45. EEG Monitoring during Therapeutic Hypothermia in Neonates, Children, and Adults
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Denise LaFalce, Alexis A. Topjian, Tae Chang, Nicholas S. Abend, Maureen Donnelly, Tammy N. Tschuda, Joshua M. Levine, Ram Mani, Sarah E. Schmitt, and Margaret C. Krauss
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medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Traumatic brain injury ,Status epilepticus ,Hypothermia ,Electroencephalography ,medicine.disease ,Electroencephalographic monitoring ,Hypoxic Ischemic Encephalopathy ,Medical Laboratory Technology ,Medicine ,Neurology (clinical) ,Post cardiac arrest ,medicine.symptom ,business ,Intensive care medicine ,Eeg monitoring - Abstract
Therapeutic hypothermia is being utilized as a neuro-protective strategy in neonates, children, and adults. The most common indications are hypoxic ischemic encephalopathy in neonates and post cardiac arrest in adults. Electroencephalographic monitoring use is increasing in critical care units, and is sometimes a component of therapeutic hypothermia clinical pathways. Monitoring may detect non-convulsive seizures or non-convulsive status epilepticus, and it may provide prognostic information. We review data regarding indications for therapeutic hypothermia and electroencephalographic monitoring in neonatal, pediatric, and adult critical care units, and discuss technical aspects related to such monitoring.
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- 2011
46. Nonconvulsive seizures are common in critically ill children
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Dennis J. Dlugos, Rong Guo, Alexis A. Topjian, Robert R. Clancy, Maureen Donnelly, Ana M. Gutierrez-Colina, Huaqing Zhao, and Nicholas S. Abend
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Male ,Pediatrics ,medicine.medical_specialty ,Time Factors ,Critical Illness ,Status epilepticus ,Electroencephalography ,Logistic regression ,Status Epilepticus ,Risk Factors ,Seizures ,medicine ,Humans ,Prospective Studies ,Child ,Prospective cohort study ,medicine.diagnostic_test ,Critically ill ,business.industry ,Incidence ,Incidence (epidemiology) ,Age Factors ,Infant ,Retrospective cohort study ,Articles ,Child, Preschool ,Female ,Neurology (clinical) ,medicine.symptom ,business ,Eeg monitoring - Abstract
Background: Retrospective studies have reported the occurrence of nonconvulsive seizures in critically ill children. We aimed to prospectively determine the incidence and risk factors of nonconvulsive seizures in critically ill children using predetermined EEG monitoring indications and EEG interpretation terminology. Methods: Critically ill children (non-neonates) with acute encephalopathy underwent continuous EEG monitoring if they met institutional clinical practice criteria. Study enrollment and data collection were prospective. Logistic regression analysis was utilized to identify risk factors for seizure occurrence. Results: One hundred children were evaluated. Electrographic seizures occurred in 46 and electrographic status epilepticus occurred in 19. Seizures were exclusively nonconvulsive in 32. The only clinical risk factor for seizure occurrence was younger age ( p = 0.03). Of patients with seizures, only 52% had seizures detected in the first hour of monitoring, while 87% were detected within 24 hours. Conclusions: Seizures were common in critically ill children with acute encephalopathy. Most were nonconvulsive. Clinical features had little predictive value for seizure occurrence. Further study is needed to confirm these data in independent high-risk populations, to clarify which children are at highest risk for seizures so limited monitoring resources can be allocated optimally, and to determine whether seizure detection and management improves outcome.
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- 2011
47. USING MEREOLOGICAL PRINCIPLES TO SUPPORT METAPHYSICS
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Maureen Donnelly
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Structure (mathematical logic) ,Philosophy ,Metaphysics ,Characterization (mathematics) ,Relation (history of concept) ,Focus (linguistics) ,Mereology ,Epistemology - Abstract
Mereological principles are sometimes used to support general claims about the structure and arrangement of objects in the world. I focus initially on one such mereological principle, the weak supplementation principle (WSP). It is not obvious that (WSP) is prescribed by ordinary thinking about parthood. Further, (WSP) is not needed for a fairly strong formal characterization of the part–whole relation. For these reasons, some arguments relying on (WSP) might be countered by simply denying (WSP). I argue more generally that there is no reason to assume that one core mereology functions as a common basis for all plausible metaphysical theories.
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- 2010
48. Short-Term Outcome Prediction by Electroencephalographic Features in Children Treated with Therapeutic Hypothermia After Cardiac Arrest
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Maureen Donnelly, Sudha Kilaru Kessler, Nicholas S. Abend, Robert A. Berg, Vinay M. Nadkarni, Robert R. Clancy, Dennis J. Dlugos, Rebecca Ichord, Ana M. Gutierrez-Colina, and Alexis A. Topjian
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Male ,medicine.medical_specialty ,Time Factors ,Neurology ,Adolescent ,Critical Care ,Electroencephalography ,Critical Care and Intensive Care Medicine ,Article ,Hypoxic Ischemic Encephalopathy ,Brain Ischemia ,Brain ischemia ,Hypothermia, Induced ,Predictive Value of Tests ,medicine ,Humans ,Prospective Studies ,Child ,Prospective cohort study ,medicine.diagnostic_test ,business.industry ,Infant ,Recovery of Function ,Hypothermia ,Prognosis ,medicine.disease ,Heart Arrest ,Treatment Outcome ,Child, Preschool ,Anesthesia ,Predictive value of tests ,Female ,Neurology (clinical) ,medicine.symptom ,Outcome prediction ,business ,Algorithms - Abstract
Electroencephalographic (EEG) features may provide objective data regarding prognosis in children resuscitated from cardiac arrest (CA), but therapeutic hypothermia (TH) may impact its predictive value. We aimed to determine whether specific EEG features were predictive of short-term outcome in children treated with TH after CA, both during hypothermia and after return to normothermia.Thirty-five children managed with a standard clinical TH algorithm after CA were prospectively enrolled. EEG recordings were scored in a standardized manner and categorized. EEG category 1 consisted of continuous and reactive tracings. EEG category 2 consisted of continuous but unreactive tracings. EEG category 3 included those with any degree of discontinuity, burst suppression, or lack of cerebral activity. The primary outcome was unfavorable short-term outcome defined as Pediatric Cerebral Performance Category score of 4-6 (severe disability, vegetative, death) at hospital discharge. Univariate analyses of the association between EEG category and outcome was performed using logistic regression.For tracings obtained during hypothermia, patients with EEGs in categories 2 or 3 were far more likely to have poor outcome than those in category 1 (OR 10.7, P = 0.023 and OR 35, P = 0.004, respectively). Similarly, for tracings obtained during normothermia, patients with EEGs in categories 2 or 3 were far more likely to have poor outcomes than those in category 1 (OR 27, P = 0.006 and OR 18, P = 0.02, respectively).A simple EEG classification scheme has predictive value for short-term outcome in children undergoing TH after CA.
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- 2010
49. Impact of Continuous EEG Monitoring on Clinical Management in Critically Ill Children
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Robert R. Clancy, Ana M. Gutierrez-Colina, Dennis J. Dlugos, Maureen Donnelly, Nicholas S. Abend, and Alexis A. Topjian
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Male ,medicine.medical_specialty ,Neurology ,Adolescent ,Critical Care ,Treatment outcome ,Electroencephalography ,Critical Care and Intensive Care Medicine ,Article ,Cohort Studies ,Care setting ,Young Adult ,Seizures ,medicine ,Humans ,Clinical care ,Child ,Intensive care medicine ,Monitoring, Physiologic ,medicine.diagnostic_test ,business.industry ,Critically ill ,Infant ,Treatment Outcome ,Child, Preschool ,Anticonvulsants ,Female ,Neurology (clinical) ,business ,Eeg monitoring ,Cohort study - Abstract
Continuous EEG (cEEG) monitoring is being used with increasing frequency in critically ill patients, most often to detect non-convulsive seizures. While cEEG is non-invasive and feasible in the critical care setting, it is also expensive and labor intensive, and there has been little study of its impact on clinical care. We aimed to determine prospectively the impact of cEEG on clinical management in critically ill children.Critically ill children (non-neonates) with acute encephalopathy underwent cEEG. Study enrollment and data collection were prospective.100 children were studied. EEG monitoring led to specific clinical management changes in 59 children. These included initiating or escalating anti-seizure medications in 43 due to seizure detection, demonstrating that a specific event (subtle movement or vital sign change) was not a seizure in 21, or obtaining urgent neuroimaging that led to a clinical change in 3. In the remaining 41 children, cEEG ruled out the presence of non-convulsive seizures but did not lead to a specific change in clinical management.EEG monitoring led to changes in clinical management in the majority of patients, suggesting it may have an important role in management of critically ill children. Further study is needed to determine whether the management changes elicited by cEEG improve outcome.
- Published
- 2010
50. Endurantist and perdurantist accounts of persistence
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Maureen Donnelly
- Subjects
Philosophy of language ,Philosophy ,History ,Endurantism ,Identity (object-oriented programming) ,Temporal parts ,Dimension (data warehouse) ,Four-dimensionalism ,Perdurantism ,Focus (linguistics) ,Epistemology - Abstract
In this paper, I focus on three issues intertwined in current debates between endurantists and perdurantists—(i) the dimension of persisting objects, (ii) whether persisting objects have timeless, or only time-relative, parts, and (iii) whether persisting objects have proper temporal parts. I argue that one standard endurantist position on the first issue is compatible with standard perdurantist positions on parthood and temporal parts. I further argue that different accounts of persistence depend on the claims about objects’ dimensions and not on the auxiliary claims about parthood and temporal parts.
- Published
- 2010
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