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Background: Patients with chronic rhinosinusitis (CRS) often have Eustachian tube dysfunction (ETD) symptoms. This study aimed to prospectively investigate the effect of endoscopic sinus surgery (ESS) on improvement of Eustachian tube function in CRS patients with ETD from a Chinese population and determine factors associated with improvement. Methods: A prospective study was performed in CRS patients with ETD who underwent ESS from 3 tertiary medical centers in south China. The Eustachian tube Dysfunction Questionnaire 7 (ETDQ-7), Sinonasal Outcome Test 22 (SNOT-22), tympanograms, endoscopic findings and Valsalva maneuver were recorded and analyzed preoperatively and postoperatively at 8-12 weeks. Results: A total of 70 CRS patients with ETD were included in this study. The ETDQ-7 score and the ability of positive Valsalva maneuver in CRS patients were significantly improved postoperatively at 8-12 weeks. The number of patients with type A tympanogram was increased postoperatively. Reduced Eustachian tube mucosal inflammation was also observed postoperatively. In addition, ESS appeared to reverse slight tympanic membrane atelectasis after 8-12 weeks. Moreover, improvement in tympanogram was presented in more than half of CRS patients with concomitant otitis media with effusion postoperatively at 8-12 weeks. Univariate and multivariate analysis revealed failure of normalization of ETDQ-7 postoperatively was associated with concomitant allergic rhinitis and higher preoperative SNOT-22 score. Conclusions: This study confirms Eustachian tube function is often improved after ESS in CRS patients with ETD. Concomitant allergic rhinitis and higher preoperative SNOT-22 score are associated with failure of normalization of ETD symptoms.

Intralesional injection of bleomycin‑A5 (BLE‑A5) is a novel treatment for nasal polyps. Our previous study clarified that BLE‑A5 could induce nasal polyp‑derived fibroblast (NPDF) apoptosis in nasal polyps. However, the detailed mechanisms are still unclear. The present study aimed to determine the effects of BLE‑A5 on NPDF mitochondrial dynamics and provide a theoretical basis for the local application of BLE‑A5 to treat nasal polyps. In the present study, an in vitro nasal polyp tissue culture model was used to define the BLE‑A5 target cell type in nasal polyps. NPDF primary cell culture was used to study the effects of BLE‑A5 on the mitochondrial dynamic‑related mechanism. The results showed that BLE‑A5 treatment of NPDFs caused mitochondrial‑mediated apoptosis. Dynamin‑related protein 1 (Drp1) was shown to be altered in BLE‑A5‑treated NPDFs. Drp1 knockdown increased the sensitivity of NPDFs to BLE‑A5 and exacerbated mitochondrial dysfunction. BLE‑A5 decreased cyclin B1‑CDK1 complex‑mediated phosphorylation of Drp1 and inhibited Drp1‑mediated mitophagy in NPDFs. Overall, the present study concluded that BLE‑A5 mainly induces NPDF apoptosis in nasal polyps. BLE‑A5 regulates the mitochondria by inhibiting Drp1 activation, resulting in NPDF mitochondrial dynamic disorder and apoptosis.

Ruxolitinib add-on in corticosteroid-refractory graft-vs-host disease after allogeneic stem cell transplantation: Results from a retrospective study on 38 Chinese patients

Speech Emotion Recognition (SER) plays a significant role in the field of Human–Computer Interaction (HCI) with a wide range of applications. However, there are still some issues in practical application. One of the issues is the difference between emotional expression amongst various individuals, and another is that some indistinguishable emotions may reduce the stability of the SER system. In this paper, we propose a multi-layer hybrid fuzzy support vector machine (MLHF-SVM) model, which includes three layers: feature extraction layer, pre-classification layer, and classification layer. The MLHF-SVM model solves the above-mentioned issues by fuzzy c-means (FCM) based on identification information of human and multi-layer SVM classifiers, respectively. In addition, to overcome the weakness that FCM tends to fall into local minima, an improved natural exponential inertia weight particle swarm optimization (IEPSO) algorithm is proposed and integrated with fuzzy c-means for optimization. Moreover, in the feature extraction layer, non-personalized features and personalized features are combined to improve accuracy. In order to verify the effectiveness of the proposed model, all emotions in three popular datasets are used for simulation. The results show that this model can effectively improve the success rate of classification and the maximum value of a single emotion recognition rate is 97.67% on the EmoDB dataset.

Aiming at the optimization of truss structure, a wolf pack algorithm based onchaos and improved search strategy was proposed. The mathematical model of truss optimization was constructed, and the classical truss structure was optimized. The results were compared with those of other optimization algorithms. When selecting and updating the initial position of wolves, chaos idea was used to distribute the initial value evenly in the solution space; phase factor was introduced to optimize the formula of wolf detection; information interaction between wolves is increased and the number of runs is reduced.The numerical results show that the improved wolf pack algorithm has the characteristics of fewer parameters, simple programming, easy implementation, fast convergence speed, and can quickly find the optimal solution. It is suitable forthe optimization design of the section size of space truss structures.

This paper considers fluid mixing driven by inflows connected to a circular shallow lake using a numerical framework consisting of a shallow water hydrodynamic model and a passive particle-tracking model. With the flow field driven by alternate inflows predicted by a shallow water model, particle trajectories are traced out using a particle tracking model. The horizontal fluid mixing dynamics are then interpreted using dynamics system analysis approaches including finite-time Lyapunov exponent (FTLE) and Lagrangian coherent structure (LCS). From the simulation results, it is confirmed that periodic inflows are able to create a weak dynamic system in an idealised circular lake, with the particle dynamics controlled by a single dimensionless parameter associated with the inflow duration. The mixing and transport property of the lake changes from regular to chaotic as the value of the dimensionless parameter increases until global chaotic particle dynamics is achieved. By further analysing the advection of particles injected continuously to the inflows (freshwater), the fate of “freshwater” particles in a “polluted” lake is tracked and revealed. The results provide useful guidance for engineering applications, i.e., transferring freshwater from rivers to improve the water quality in polluted water bodies such as lakes. The presented approach will be able to facilitate the design of ‘optimised’ schemes for such engineering implementation.

A $f_{s}/4$ band-pass $\Sigma\Delta$ -analog-to-digital converter (ADC) architecture is realized by feeding back the delayed quantization noise produced by a successive approximation register(SAR) ADC. Designed in a SMIC 180nm CMOS process, the ADC sampling at 50 MHz achieves Signal-to-Noise-Ratio(SNR) of 80.85 dB in a 0.78125 MHz bandwidth when the Over-sampling Rate(OSR) is 32. For a S-bit SAR ADC, Effective Numbers of Bits (ENOB) is improved 2.6 bits with the band-pass noise shaping.

Background Primary ciliary dyskinesia (PCD) is an autosomal recessive disorder. The genetic factors contributing to PCD pathogenesis remain elusive for approximately 20–35% of patients with complex and abnormal clinical phenotypes. Our study aimed to identify causative variants of sporadic PCD genes using whole-exome sequencing (WES). Result All patients were diagnosed with PCD based on clinical phenotype or transmission electron microscopy (TEM) images of cilia. WES and bioinformatic analysis were then conducted for patients with PCD. Identified candidate variants were validated by Sanger sequencing. Pathogenicity of candidate variants was then evaluated using in silico software and the American College of Medical Genetics and Genomics (ACMG) database. In total, 15 rare variants were identified in five patients with PCD. Five new variants of CCDC40, DNAH1, DNAAF3, and DNAI1 were considered causative variants and included one splicing and three homozygous variants. Conclusion Our study demonstrated that patients with PCD carry rare causative variants of multiple genes. Our findings indicated that not only known causative genes but also other functional genes should be considered for heterogeneous genetic disorders.

Cilia loss and dysfunction is one of the typical pathological features of chronic rhinosinusitis with nasal polyps (CRSwNP). Tryptophan-aspartic acid (W-D) repeat containing planar cell polarity effector (WDPCP) has been proven to be an essential element for ciliogenesis in human nasal epithelium, but its role in the beating of cilia remains unclear. In this study, we sought to investigate the role of WDPCP and its underlying mechanism behind the dysfunction in the beating of cilia in nasal polyp tissue. We demonstrated WDPCP expression in the epithelium of nasal polyps. We also investigated the MAPK/ERK pathway in primary human sinonasal epithelial cells to explore the function of WDPCP. The air–liquid interface culture system was used as a model to verify the role of WDPCP and the MAPK/ERK pathway in the beating of cilia. With the dysfunction of cilia beating, we observed a low expression of WDPCP in the epithelium of nasal polyp tissues. Within the in vitro study, we found that WDPCP was critical for mitochondrial biogenesis and mitochondrial function in human sinonasal epithelial cells, possibly due to the activation of the MAPK/ERK pathway. The mitochondrial dysfunction caused by U0126 or lacking WDPCP could be partially recovered by dexamethasone. The low expression of WDPCP in nasal epithelium could affect mitochondria via the MAPK/ERK pathway, which may contribute to the dysfunction in the beating of cilia in CRSwNP.

BACKGROUND Individuals affected by empty nose syndrome secondary to turbinate-sparing techniques (ENS-type) experience decreased productivity and lifestyle disruption owing to considerable nasal-associated discomfort. This study aimed to evaluate the effect of psychosomatic intervention on ENS-type. METHODS A prospective self-controlled study was conducted, and 28 patients suffering from ENS-type who met the diagnostic criteria for somatic symptom disorder (SSD) according to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) received cognitive and behavioral therapy (CBT) plus antidepressants. Nasal symptom burden was evaluated using the 25-item Sino-Nasal Outcome Test (SNOT-25). Somatic symptom burden, anxiety severity, and depression severity were assessed by the 25-item Patient Health Questionnaire (PHQ-15), the 9-item PHQ (PHQ-9), and the 7-item Generalized Anxiety Disorder (GAD-7) scale, respectively. Patient assessments were completed prior to treatment and 3 and 12 months after the intervention. RESULTS The total scores of the SNOT-25 declined posttreatment, showing a significant difference at the 3-month and 12-month follow-ups compared with the baseline scores (p < 0.001). The severity of the 5 most common subjective symptoms, including "nose is too open," "waking up at night," "lack of a good night's sleep," "difficulty falling asleep," and "reduced concentration," declined significantly at 3 and 12 months posttreatment compared to baseline levels. Statistically significant changes in the PHQ-15, PHQ-9, and GAD-7 scores were observed at 3 and 12 months posttreatment compared to baseline scores (p < 0.001). CONCLUSION This study showed that some patients with ENS-type meeting the diagnostic criteria for SSD might benefit from psychiatric treatment.

Background: Cilia loss and dysfunction is one of the typical pathological features of chronic rhinosinusitis. Tryptophan-aspartic acid (W-D) repeat containing planar cell polarity effector (WDPCP) has been proven to be an essential element for ciliogenesis in human nasal epithelium, but its role in the beating of cilia remains unclear. Cilia beating requires energy from the mitochondria, which is regulated by the MAPK/ERK pathway. In this study, we sought to investigate the role of WDPCP and its underlying mechanism behind the dysfunction in the beating of cilia in chronic rhinosinusitis.Methods: We demonstrated WDPCP expression in the epithelium of nasal polyps. We also investigated the MAPK/ERK pathway in primary human sinonasal epithelial cells to explore the function of WDPCP. The air-liquid interface culture system was used as a model to verify the role of WDPCP and the MAPK/ERK pathway in the beating of cilia.Results: With the dysfunction of cilia beating, we observed a low expression of WDPCP in the epithelium of nasal polyps. Within the in vitro study, we found that WDPCP was critical for mitochondrial biogenesis and mitochondrial function in human sinonasal epithelial cells, possibly due to the activation of the MAPK/ERK pathway. The mitochondrial dysfunction caused by U0126 or lacking WDPCP could be partially recovered by dexamethasone.Conclusion: The low expression of WDPCP in nasal epithelium could affect mitochondria via the MAPK/ERK pathway, which may contribute to the dysfunction in the beating of cilia in chronic rhinosinusitis.

BACKGROUND Much attention on the pathophysiology of nasal polyp (NP) has focused on eosinophils. Interleukin (IL)-4 and eotaxin-3 (C-C motif chemokine ligand 26, or CCL26) levels have been reported to be increased in eosinophilic nasal polyps. The aim of this study was to characterize CCL26 posttranscriptional regulation by the RNA-binding protein HuR in primary human nasal polyp-derived epithelial cells (hNPDECs) challenged with IL-4. METHODS A prospective, observational study was conducted. Nasal polyp tissues were obtained from eosinophilic (n = 12) and non-eosinophilic (n = 10) NP patients, and inferior turbinate (IT) tissues were taken from control subjects (n = 9) and cultured into hNPDECs. Expression of HuR and CCL26 were measured by immunohistochemistry, Western blot analysis, enzyme-linked immunoassay, and real-time polymerase chain reaction (PCR). The nucleocytoplasmic shuttling of HuR in hNPDECs was detected by immunofluorescence. Posttranscriptional regulation of CCL26 by HuR was tested by ribonucleoprotein immunoprecipitation assay (RIP) and dual-luciferase reporter assay. CCL26 mRNA stabilization was measured by quatititative PCR after treatment with actinomycin D. Student's t test and one-way analysis of variance were used. RESULTS Immunohistochemical data show that both HuR and CCL26 were highly expressed in NP tissues, especially eosinophilic NP tissues (p < 0.05). IL-4 stimulation increased CCL26 mRNA stability, and overexpression and knockdown of HuR affected CCL26 expression. Immunofluorescence data indicate that IL-4 altered the subcellular distribution of HuR. The RIP and dual-luciferase reporter assay results supply strong evidence for HuR binding to CCL26. CONCLUSION Our results provide strong support for the hypothesis that IL-4-induced expression of CCL26 in hNPDECs relies partly on CCL26 mRNA stabilization mediated by the interaction of HuR with CCL26 3'UTR.

Objective In the Otorhinolaryngology Department, patients exhibiting somatic symptoms without a medical cause are frequently neglected and left untreated. The aim of this study was to characterize the psychosomatic features of outpatients with somatic symptom disorder (SSD) to better identify patients needing treatment. Methods This cross-sectional study enrolled 883 consecutive patients with medically unexplained symptoms. A semistructured clinical interview was employed to confirm the diagnosis of SSD. Data, including sociodemographic and clinical measures, were collected. The Patient Health Questionnaire-15 (PHQ-15) and Somatic Symptom Scale-China (SSS-CN) were used to assess the severity of somatic symptoms; the Patient Health Questionnaire-9 (PHQ-9) was used to assess depression; the General Anxiety Disorder-7 (GAD-7) was used to assess anxiety; and the 12-item Short-form Health Survey (SF-12) was used to assess quality of life (QoL). Results Based on the DSM-5 criteria, 641 patients were placed in the SSD group, and 212 were placed in the normal group. Compared with the normal group, the SSD group had significantly more doctor visits, longer symptom durations, higher GAD-7 and PHQ-9 scores, and lower physical composite scores (PCSs) and mental composite scores (MCSs). Spearman's correlation analysis and multiple linear regression analyses showed that the SSS-CN score, PHQ-15 score and the patient's subjective feeling that his or her daily life was affected by the disorder were significant risk factors for low PCSs; the SSS-CN, PHQ-15, PHQ-9, and GAD-7 scores were independent risk factors for low MCSs. Conclusion Our findings demonstrated that SSD patients are not rare in otorhinolaryngology clinics in China and that their QoL is significantly affected by SSD. Otolaryngologists should thoroughly evaluate these patients from the perspective of psychosomatic medicine.

Adsorption kinetics and thermodynamics of cadmium onto lignite-derived humic acid and lignite-derived active carbon were investigated by batch experiments under different temperatures. The adsorption thermodynamic isotherms were fitted using Langmuir, Freundlich and Temkin models, the adsorption kinetics were fitted to pseudo-first-order, pseudo-second-order, Elovich, fractional power and intraparticle diffusion models. Thermodynamic studies showed that Temkin model displayed the most suitable model to describe adsorption of cadmium onto raw lignite, extracted humic acid and active carbon. Thermodynamic parameters indicated the adsorption process were spontaneous, favourable, and endothermic physical adsorption in nature. The equilibrium adsorption capacity of cadmium obtained from the Langmiur model for humic acid, lignite and active carbon was 36.14~44.09, 29.63~38.20 mg·g-1 and 21.04~30.34 mg·g-1 respectively in the temperature range of 294.55~313.15 K, adsorption capacity magnitudes increased with a rise of temperature, indicating more feasible adsorption at high temperature. Adsorption kinetics parameters showed that the pseudo-second-order model was better than the pseudo-first-order, Elovich, fractional power and the intraparticle diffusion models, this indicated that cadmium adsorption might be a physisorption associated with chemisorption process. According to the adsorption characteristics of kinetics, thermodynamics parameters such as change in free energy(△G), change in enthalpy(△H), and change in entropy(△S), it was concluded that the adsorption process of cadmium onto these different adsorbents were spontaneous, endothermic, simultaneous physisorption and accompanied by chemisorption or alternatively physicochemical process. Adsorbents of humic acid had the great adsorption capacity and adsorption intensity. Temkin isotherm model and pseudo-second-order model could be the suitable models with good fitting for describing the adsorption properties of cadmium onto these adsorbents. Infrared spectra analysis showed that oxygen containing functional groups and unknown absorbance peaks at approximately 2 360, 2 342 cm-1 had important impact on Cd2+ adsorption.

In the age of information, high-speed and high-security cryptosystems have become essential. This paper introduces a hybrid AES-ECC cryptosystem which takes advantages of Advanced Encryption Standard (AES) and Elliptic Curve Cryptography (ECC). In this cryptosystem, plaintext is encrypted by AES, which guarantees high encryption speed; meanwhile, by applying ECC to encrypt AES keys, the security of key distribution over insecure channels is greatly improved and key management becomes easier. To shorten latency, a six-clock-cycle Montgomery Ladder is applied in ECC core. In AES core, key expansion unit and SBOX are shared to conserve resources. The proposed crypto system is implemented on Xilinx Virtex-5 and the synthesize results shows that the cryptosystem is a cutting-edge design. The latency of the proposed architecture is optimized to $10.04 \mu s$ (2,070 clock cycles) for encryption while $10.44\mu s$ (2,153 clock cycles) for decryption with 206.2 MHz clock frequency at the cost of 23,764 LUTs. The throughput rates for encryption and decryption are 61.45 Mbps and 62.45 Mbps.

One-step extraction prior to a two-step detection method based on UHPLC-MS/MS was developed to determine seven quaternary ammonium salts (QACs), three isothiazolinone antibacterial agents and seven phenolic antibacterial agents in infant disposable hygiene products. Samples were ultrasonically extracted by acetonitrile; the extraction solution was directly used to separate seven QACs on a hydrophilic chromatographic column (HILIC column) by isocratic elution (0.1% formic acid acetonitrile and 10 mmol L−1 ammonium acetate solution as the mobile phases). QACs were then detected in multiple reaction monitoring (MRM) of MS/MS under an electro-spray ionization source in positive mode (ESI+). For the remaining ten analytes, the extraction solution was dried by nitrogen gas blowing and re-dissolved with acidulated methanol water solution. Then they were separated on a C18 chromatographic column with gradient elution program using methanol and water as mobile phases. Finally, ten analytes were simultaneously ionized by using a electro-spray source in positive and negative modes and acquisition was achieved in MRM. The developed methods were validated in terms of the method limit of detection and quantitation (MLOD and MLOQ), matrix effects, recovery and precision. Results indicated that favorable linear relations (r > 0.997) were obtained over the selected concentration ranges of 0.1–50 μg L−1, 1.0–500 μg L−1 and 50–2000 μg L−1 for QACs, isothiazolinone antibacterial agents and phenolic antibacterial agents, respectively. The MLODs of the three groups of antibacterial agents were 0.8 μg kg−1, 1.5–6.5 μg kg−1 and 200–500 μg kg−1, respectively. Recoveries were calculated at three concentration levels spiked in negative paper diaper samples and the values were found between 83.7% and 112% with relative standard deviation (RSD) values less than 13% for intra-day precision (n = 6) and less than 16% for inter-day precision (n = 5). The developed and validated methods were successfully applied to determine the concentrations of antibacterial agents in real samples and QACs and isothiazolinone antibacterial agents were detected in several samples. These methods are rapid, sensitive and suitable for the determination of antibacterial agents in infant disposable hygiene products and some other similar products.

Cellular retinoic acid binding protein 2 (

The measured dynamometer card used to analyze working conditions of pumping units requires a large amount of manpower and material resources, and thus it is very necessary to develop a novel and simple method for the diagnosis of pumping conditions. In this paper, a pattern recognition algorithm is proposed for the classification of working conditions of oil wells based on electrical parameters. To this end, the data of electrical parameters are obtained by the acquisition system; according to the algorithm theories (logistic regression, support vector machine, principal components analysis) of pattern recognition in machine learning, the binary and multiple classifiers of condition diagnosis are used to realize the diagnosis of the working conditions of the oil wells based on electrical parameters. The improvement of the proposed algorithm has been verified by analytical and simulation results.

Much attention on the pathophysiology of nasal polyp (NP) has focused on eosinophils. Interleukin (IL)-4 and eotaxin-3 (C-C motif chemokine ligand 26, or CCL26) levels have been reported to be increased in eosinophilic nasal polyps. The aim of this study was to characterize CCL26 posttranscriptional regulation by the RNA-binding protein HuR in primary human nasal polyp-derived epithelial cells (hNPDECs) challenged with IL-4.A prospective, observational study was conducted. Nasal polyp tissues were obtained from eosinophilic (n = 12) and non-eosinophilic (n = 10) NP patients, and inferior turbinate (IT) tissues were taken from control subjects (n = 9) and cultured into hNPDECs. Expression of HuR and CCL26 were measured by immunohistochemistry, Western blot analysis, enzyme-linked immunoassay, and real-time polymerase chain reaction (PCR). The nucleocytoplasmic shuttling of HuR in hNPDECs was detected by immunofluorescence. Posttranscriptional regulation of CCL26 by HuR was tested by ribonucleoprotein immunoprecipitation assay (RIP) and dual-luciferase reporter assay. CCL26 mRNA stabilization was measured by quatititative PCR after treatment with actinomycin D. Student's t test and one-way analysis of variance were used.Immunohistochemical data show that both HuR and CCL26 were highly expressed in NP tissues, especially eosinophilic NP tissues (p0.05). IL-4 stimulation increased CCL26 mRNA stability, and overexpression and knockdown of HuR affected CCL26 expression. Immunofluorescence data indicate that IL-4 altered the subcellular distribution of HuR. The RIP and dual-luciferase reporter assay results supply strong evidence for HuR binding to CCL26.Our results provide strong support for the hypothesis that IL-4-induced expression of CCL26 in hNPDECs relies partly on CCL26 mRNA stabilization mediated by the interaction of HuR with CCL26 3'UTR.

An intralesional bleomycin A5 (BLE) injection might be used as an alternative therapy for eosinophilic-type nasal polyps (NPs). BLE-induced apoptosis might play an important role in shrinkage of NPs.The aim of this study is to determine the effect and explore the possible role of apoptosis in shrinkage of NPs.Twenty-nine patients with eosinophilic-type NPs experienced repeated local injection of BLE. The recurrence rate of this group was obtained. The mechanism of BLE treatment was investigated through an in vitro experiment. Nasal polyp tissues were treated with BLE. The apoptotic activity was detected by the presence of DNA smear and test of terminal deoxynucleotidyl transferase dUTP nick end labeling. The caspase-8 and PARP were examined through immunohistochemistry and Western blotting.After several local injections of BLE, the nasal polyp tissues decreased and then disappeared. During follow-up of 3 years the recurrence rate of this group was significantly lower than another one treated with operation plus medicine treatment. Apoptosis in BLE-treated tissue was prominently detected in the infiltrating inflammatory cells. The expression of PARP and casp-8 were increased in BLE-treated nasal polyp tissue compared with PBS-treated tissue.

Using electroencephalography (EEG) for diagnosing subsequent epilepsy in children after febrile seizure (FS) is not common. The present study investigates the relationship between epileptiform discharges and subsequent epilepsy, and looks for the predictive marker for this disorder. A total of 378 children with complex FS and whose EEG showed epileptiform discharges or normal EEG were included. Development of FS was compared between those with epileptiform discharges and those with normal EEG. Risk factors were analyzed using multivariate logistic regression to clarify their effects on subsequent epilepsy. The association between generalized or focal EEG localization, and between frontal epileptiform discharges and subsequent epilepsy, were analyzed. Among 378 patients with complex FS, 51 showed epileptiform discharges. History of epilepsy, frontal seizure, number of FS, and prolonged seizure were the risk factors for epileptiform discharge. Subsequent epilepsy was significantly frequent in patients with more than 2 risk factors (odds ratio [OR] = 17; 95% confidence interval [CI] = 4.1-29.6). Prolonged seizure (OR = 4.98; 95% CI = 1.63-13.29), FS number (OR = 2.96; 95% CI = 1.23-10.51), and family history of epilepsy (OR = 2.67; 95% CI = 1.05-7.63) were significantly correlated with subsequent epilepsy. Of 9 patients with paroxysms in the frontal region, 8 (88.9%) developed epilepsy. There was concordance between frontal epileptiform discharges and subsequent epilepsy (κ = .901). In conclusion, epileptiform discharges are risk factors for subsequent epilepsy. Frontal paroxysmal EEG is a marker for subsequent epilepsy.