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Purpose: To present the results of transcallosal surgical resection of hypothalamic hamartoma (HH) in 26 patients with refractory epilepsy in a prospective outcome study. Methods: Patients with refractory epilepsy symptomatic to HH were referred for surgical resection of their HH (mean age, 10.0 years; range, 2.1–24.2 years). A transcallosal, interforniceal approach was used to remove and/or disconnect the hamartoma. Volumetry was obtained on pre- and postoperative brain MRI scans to determine percentage of resection. Outcome assessment included determination of postoperative seizure frequencies in comparison to baseline and the incidence of postoperative complications. Postoperative changes in cognitive and behavioral functioning, in comparison to baseline, were elicited by parental report. Results: The average postoperative follow-up interval was 20.3 months (range, 13–28 months). Fourteen (54%) patients were completely seizure free, and nine (35%) had at least a 90% improvement in total seizure frequency. Parents reported postoperative improvement in behavior in 23 (88%) patients and in cognition in 17 (65%) patients. Transient postoperative memory disturbance was seen in 15 (58%) patients, but persisted in only two (8%). Two (8%) patients had persisting endocrine disturbance requiring hormone replacement therapy (diabetes insipidus and hypothyroidism in one each). With univariate analysis, the likelihood of a seizure-free outcome correlated with younger age, shorter lifetime duration of epilepsy, smaller preoperative HH volume, and 100% HH resection. Conclusions: Refractory epilepsy associated with HH can be safely and effectively treated with surgical resection by a transcallosal, interforniceal approach. Short-term memory deficits appear to be transient for most patients, and family perception of the impact of surgery on cognitive and behavioral domains is favorable. Complete resection yields the best result. [ABSTRACT FROM AUTHOR]

Supplemental Digital Content is available in the text. [ABSTRACT FROM AUTHOR]

Background: In October 2010, the American Heart Association/Emergency Cardiovascular Care updated cardiopulmonary resuscitation guidelines. Its impact on the survival rate among out-of-hospital cardiac arrest patients (OHCA) is not well studied. We sought to assess the survival trends in OHCA patients before and after the introduction of the 2010 American Heart Association cardiopulmonary resuscitation guidelines in the United States.Methods: A retrospective observational study from the National Emergency Department (ED) Sample was designed to identify patients presenting to the ED primarily after an OHCA in the United States between January 1, 2006, and December 31, 2015. The main outcome studied was the change in trends of ED survival and survival-to-discharge rates before and after guideline modification.Results: Among 1 282 520 patients presenting to the ED after OHCA (mean [SD] age, 65.8 [17.2] years; 62% men), ED survival rate (23%) and survival-to-discharge rate (16%) trends showed significant improvement after implementation of the 2010 American Heart Association cardiopulmonary resuscitation guidelines, 1.25% ([95% CI, 0.72%-1.78%] P=0.001) and 0.89% ([95% CI, 0.35%-1.43%] P=0.006), respectively. Notably, among patients with nonshockable rhythm (change in ED survival rate trend, 1.3% [95% CI, 0.89%-1.74%]; P<0.001 and survival-to-discharge trend, 0.94% [95% CI, 0.42%-1.47%]; P=0.004). Among patients admitted to the presenting hospital (n=145 592), 46% were discharged alive, of which 49% were discharged home. Significant decrease in discharge to home was noted (-1.7% [95% CI, -3.18% to -0.22%]; P=0.03), while a significant increase in neurological complication (0.17% [95% CI, 0.06%-0.28%]; P=0.007) was noted with the guideline modification.Conclusions: The change in 2010 American Heart Association cardiopulmonary resuscitation guidelines was associated with only slight improvement in ED survival and survival-to-discharge trends among US OHCA patients and only 1 in 6 OHCA patients survival to discharge. [ABSTRACT FROM AUTHOR]

Background: Baseline predictors of myocardial recovery after cardiac resynchronization therapy (CRT) in left bundle branch block (LBBB)-associated idiopathic nonischemic cardiomyopathy (NICM) are unknown.Methods: A retrospective study included subjects with idiopathic NICM, left ventricular ejection fraction (LVEF) ≤35%, and LBBB. Myocardial recovery was defined as post-CRT LVEF ≥50%. Logistic regression analyses described associations between baseline characteristics and myocardial recovery. Cox regression analyses estimated the hazard ratio (HR) between myocardial recovery status and adverse clinical events.Results: In 105 subjects (mean age 61 years, 44% male, mean initial LVEF 22.6% ± 6.6%, 81% New York Heart Association class III, and 98% CRT-defibrillators), myocardial recovery after CRT was observed in 56 (54%) subjects. Hypertension, heart rate, and serum blood urea nitrogen (BUN) had negative associations with myocardial recovery in univariable analyses. These associations persisted in multivariable analysis: hypertension (odds ratio (OR), 0.40; 95% confidence interval (CI), 0.17-0.95; p = 0.04), heart rate (OR per 10 bpm, 0.69; 95% CI, 0.48-0.997; p = 0.048), and serum BUN (OR per 1 mg/dl, 0.94; 95% CI, 0.88-0.99; p = 0.04). Subjects with post-CRT LVEF ≥50%, when compared to <50%, had lower risk for adverse clinical events (heart failure hospitalization, appropriate implantable cardioverter-defibrillator shock, appropriate anti-tachycardia pacing therapy, ventricular assist device implantation, heart transplantation, and death) over a median follow-up of 75.9 months (HR, 0.38; 95% CI, 0.16-0.88; p = 0.02).Conclusion: In LBBB-associated idiopathic NICM, myocardial recovery after CRT was associated with absence of hypertension, lower heart rate, and lower serum BUN. Those with myocardial recovery had fewer adverse clinical events. [ABSTRACT FROM AUTHOR]

A response from the author of the article "Use of antimicrobial envelope as standard of care for cardiac implantable electronic device implantation: preventing infection or promoting inflation?", published in previous issues of the journal is presented.

A letter to the editor is presented in response to the article "Ventricular tachycardia ablation versus escalation of antiarrhythmic drugs," by John L. Sapp and colleagues in the July 14, 2016 issue.

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Efforts to advance brain computer interface (BCI) to aid people who have lost communication and movement abilities (neuromuscular disorders) are becoming popular and are obtaining funding from many Institutes. But it has remained untapped in other areas e.g. manufacturing, the military, the law, etc. Hence, the aim of the project is to investigate the impact of environmental sound (noise & music) on human thinking using the Electroencephalography (EEG) tool. The project is started with a subject literature review and then concentrates on the investigation of the kind of BCI signals and how EEG works. The information will be analyzed and classified to serve as references in the analysis of environmental noise level and music. The project is divided into two scenarios of treatment: the noise - silent - noise - silent form and the second treatment using noise - the silent - music - noise form. The next step is measuring and then analyzing the brain signals in a variety of sound levels. In this state, the comparisons of impact sound from two treatments are presented. Finally, the project shows that the music sound treatment produces a stable graph of brain response when compared with the noise sound treatment. As a consequence, people within pleasant sound will be more relaxed and focused on doing the task. [ABSTRACT FROM AUTHOR]

The mutual inductance and self-inductance of global interconnects are important but difficult to extract and model in deep submicrometer very large scale integration (VLSI) designs. The absence of effective mutual magnetic field shielding limits the maximum unbuffered interconnect line Length. In this paper, we propose and demonstrate that permalloy-loaded transmission lines can be used for high-speed interconnect applications to overcome these limitations. Permalloy films were incorporated into planar transmission lines using a CMOS-compatible process. The line characteristics show that eddy-current effects are the limiting factors for the high-frequency permalloy applications when ferromagnetic resonance are restrained through geometry design. Patterning permalloy films effectively extends their application to above 20 GHz. The line characteristic impedances are about ∼90 ω. Under 50 mA dc current biases, the line parameters did not change much. Moreover, the patterned permalloy reduces the magnetic field coupling between two adjacent transmission lines by about 10 dB in our design. The demonstrated operation frequency range, current carrying capability and magnetic field shielding properties indicate that the permalloy loaded lines are suitable for high-speed interconnect applications in CMOS technologies. [ABSTRACT FROM AUTHOR]