Search

Contents: Development of new semen cryopreservation techniques improving sperm survival and ensuring availability of viable spermatozoa for a prolonged time‐period after AI is promising tools to reduce sensitivity of timing of AI and enhance overall fertility. The SpermVital® technology utilizes immobilization of bull spermatozoa in a solid network of alginate gel prior to freezing, which will provide a gradual release of spermatozoa after AI. The objective of this study was to compare post‐thaw sperm quality and in vitro sperm survival over time of Norwegian Red bull semen processed by the SpermVital® (SV) technology, the first commercialized production line of SpermVital® (C) and by conventional procedure applying Biladyl® extender (B). Post‐thaw sperm motility was not significantly different between SV, C and B semen (p > .05). However, sperm viability and acrosome intactness were higher for SV than C and B semen (p < .05). Small differences in DNA quality were observed (p < .05). Sperm viability after storage in uterus ex vivo was higher for SV than for C semen (p < .05). Furthermore, sperm survival in vitro over time at physiological temperature was significantly higher for SV semen than C semen as well as B semen during the incubation period of 48 hr (p < .05). In conclusion, the SpermVital® technology is improved and is more efficient in conserving post‐thaw sperm quality and results in higher sperm viability over time in vitro for SV than for C and B semen. [ABSTRACT FROM AUTHOR]

Contents With the aim of investigating the relationship between sperm DNA integrity and non-return rate (NRR) among Norwegian cross-bred rams, semen from 15 individuals was examined by flow cytometry. Sperm Chromatin Structure Assay (SCSA) quantifies the proportion of spermatozoa with denatured DNA after in situ acid treatment, and the four parameters % DFI, % HDS, MEAN DFI and SD DFI are all different measures of DNA denaturation and maturation. Field fertility, reported as NRR 25 days after insemination was based on all inseminations from a large-scale breeding programme and supplied by the Norwegian Association of Sheep and Goat Farmers. From each ram, four straws from four different weeks of the breeding season were analysed, and the associations between 25-day NRR and the mean of the four SCSA parameters were tested using a logistic regression model. The results revealed no association between fertility and % DFI or % HDS, while SD DFI and MEAN DFI showed a significant negative association with NRR. Further, the SCSA values varied significantly between ejaculates within ram among some of the rams in the study. However, no significant association was seen between these intra-individual differences in sperm DNA integrity and NRR. In conclusion, this study suggests an association between sperm DNA integrity and NRR for rams. However, further research must be conducted to confirm these findings and determine whether sperm DNA assessments can be applied to predict ram fertility. [ABSTRACT FROM AUTHOR]

Background and Objective: To evaluate the diagnostic accuracy of the ambulatory EEG (aEEG) at detecting interictal epileptiform discharges (IEDs)/seizures compared with routine EEG (rEEG) and repetitive/second rEEG in patients with a first single unprovoked seizure (FSUS). We also evaluated the association between IED/seizures on aEEG and seizure recurrence within 1 year of follow-up., Methods: We prospectively evaluated 100 consecutive patients with FSUS at the provincial Single Seizure Clinic. They underwent 3 sequential EEG modalities: first rEEG, second rEEG, and aEEG. Clinical epilepsy diagnosis was ascertained based on the 2014 International League Against Epilepsy definition by a neurologist/epileptologist at the clinic. An EEG-certified epileptologist/neurologist interpreted all 3 EEGs. All patients were followed up for 52 weeks until they had either second unprovoked seizure or maintained single seizure status. Accuracy measures (sensitivity, specificity, negative and positive predictive values, and likelihood ratios), receiver operating characteristic (ROC) analysis, and area under the curve (AUC) were used to evaluate the diagnostic accuracy of each EEG modality. Life tables and the Cox proportional hazard model were used to estimate the probability and association of seizure recurrence., Results: Ambulatory EEG captured IED/seizures with a sensitivity of 72%, compared with 11% for the first rEEG and 22% for the second rEEG. The diagnostic performance of the aEEG was statistically better (AUC: 0.85) compared with the first rEEG (AUC: 0.56) and second rEEG (AUC: 0.60). There were no statistically significant differences between the 3 EEG modalities regarding specificity and positive predictive value. Finally, IED/seizure on the aEEG was associated with more than 3 times the hazard of seizure recurrence., Discussion: The overall diagnostic accuracy of aEEG at capturing IED/seizures in people presenting with FSUS was higher than the first and second rEEGs. We also found that IED/seizures on the aEEG were associated with an increased risk of seizure recurrence., Classification of Evidence: This study provides Class I evidence supporting that, in adults with First Single Unprovoked Seizure (FSUS), 24-h ambulatory EEG has increased sensitivity when compared with routine and repeated EEG., Competing Interests: J.F. Tellez Zenteno is deceased; disclosures are not included for this author. N. Jette receives grant funding from her institution for grants unrelated to this work from NINDS (NIH U24NS107201, NIH IU54NS100064, 3R01CA202911-05S1, R21NS122389, R01HL161847). Also, she receives an honorarium for her work as an Associate Editor of Epilepsia. Other authors declare that they have no relevant or material financial interests that relate to the research described in this paper. Full disclosure form information provided by the authors is available with the full text of this article at Neurology.org/cp., (© 2023 American Academy of Neurology.)

Background: Neuromodulation unit placement carries a historic infection rate as high as 12%. Treatment of such requires surgical removal and a long course of systemic antibiotics. Antibiotic-impregnated envelopes have been effective in preventing infection in implantable cardiac devices. At our center, 1 surgeon uses these envelopes with all implanted neuromodulation units., Objective: To assess the efficacy of antibacterial envelopes in prevention of infection in neuromodulation device placement., Methods: We conducted a retrospective cohort study of consecutive implantable pulse generator (IPG) unit implantation with an antibacterial envelope at a single center between October 2014 and December 2019. We collected demographic data, including postoperative infections, reoperations, and complications, associated with the IPGs. This cohort was then compared with a historical cohort of consecutive patients undergoing surgery before envelope usage (October 2007-April 2014)., Results: In the pre-envelope cohort of 151 IPGs placed in 116 patients, there were 18 culture-confirmed infections (11.9%). In the antibacterial envelope cohort of 233 IPGs placed in 185 patients, there were 5 culture-confirmed infections (2.1%). The absolute risk reduction of the antibacterial envelope was 9.85% (95% CI 4.3%-15.4%, P &lt; .01). The number needed to treat was 10.1 (95% CI 6.5-23.1, P &lt; .01) envelopes to prevent 1 IPG infection., Conclusion: We saw a reduced rate of infections in the antibacterial envelope cohort. Although this is likely multifactorial, our results suggest a benefit of antibacterial envelopes on infection after neuromodulation surgery., (Copyright © Congress of Neurological Surgeons 2022. All rights reserved.)

Background: Less than one-third of people with epilepsy will develop drug-resistant epilepsy (DRE). Establishing the prognosis of each unique epilepsy case is an important part of evaluation and treatment.Most studies on DRE prognosis have been based on a pooled, heterogeneous group, including children, adults, and older adults, in the absence of clear recognition and control of important confounders, such as age group. Furthermore, previous studies were done before the 2010 definition of DRE by the International League Against Epilepsy (ILAE), so data based on the current definitions have not been entirely elucidated. This study aimed to explore the difference between 3 definitions of DRE and clinical predictors of DRE in adults and older adults. Methods: Patients with a new diagnosis of epilepsy ascertained at a Single Seizure Clinic (SSC) in Saskatchewan, Canada were included if they had at least 1 year of follow-up. The first study outcome was the diagnosis of DRE epilepsy at follow-up using the 2010 ILAE definition. This was compared with 2 alternative definitions of DRE by Kwan and Brodie and Camfield and Camfield. Finally, risk factors were analyzed using the ILAE definition. Results: In total, 95 patients with a new diagnosis of epilepsy and a median follow-up of 24 months were included. The median age of patients at the diagnosis of epilepsy was 33 years, and 51% were men. In the cohort, 32% of patients were diagnosed with DRE by the Kwan and Brodie definition, 10% by Camfield and Camfield definition, and 15% by the ILAE definition by the end of follow-up. The only statistically significant risk factor for DRE development was the failure to respond to the first anti-seizure medication (ASM). Conclusion: There were important differences in the percentage of patients diagnosed with DRE when using 3 concurrent definitions. However, the use of the ILAE definition appeared to be the most consistent through an extended follow-up. Finally, failure to respond to the first ASM was the sole significant risk factor for DRE in the cohort after considering the age group., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Denton, Thorpe, Carter, Angarita-Fonseca, Waterhouse and Hernandez Ronquillo.)

The SpermVital ® technology comprises embedding of spermatozoa within an alginate gel to facilitate release of sperm cells over a prolonged period in utero after AI. The aim of this study was to examine whether the survival time of spermatozoa is extended when applying this immobilization technology in combination with cryopreservation. Sperm cell survival (acrosome and plasma membrane integrity) was studied in vitro for 48 hr at physiological temperature. One dose of SpermVital ® (SV) semen was compared with single doses of Biladyl ® (B) processed semen as well as double doses of B (B double). B double was obtained by adding a second B dose the following day, thereby mimicking double AI. Furthermore, reproductive performance applying single early timed AI (TAI) with SV following oestrus synchronization was studied in a field trial. Double insemination (TAI on two consecutive days) with B semen served as control. Number of acrosome-intact live sperm cells decreased over time in vitro for all treatments (p < .05). There was no difference between SV sperm cell survival and B double after 24 hr (p > .05). However, after 48 hr, SV sperm cell survival was higher than B double (p < .05). Moreover, multivariate analysis showed that the outcome of single early TAI with SV was not significantly different from B double (p > .05). Likelihood of pregnancy and calving in the heifer group was higher than in the cow group (p < .05). These results imply that spermatozoa immobilized in alginate gel have prolonged survival., (© 2017 Blackwell Verlag GmbH.)

Background: Vagus nerve stimulation (VNS) therapy has been widely recognized as an alternative for the treatment of drug-resistant epilepsy, although modification of antiepileptic drugs (AEDs) during VNS treatment could explain the improvement in patients., Methods: We retrospectively assessed the efficacy of VNS in 30 adult patients with epilepsy treated with >6 months of follow-up. The criteria for implantation were the following: (1) not a candidate for resective epilepsy surgery, (2) drug-resistant epilepsy, (3) impairment of quality of life, (4) no other option of treatment, and (5) patients with idiopathic generalized epilepsy who fail to be controlled with appropriate AEDs. We assessed sociodemographics, seizure etiology, seizure classification, and AEDs used during treatment with VNS. We assessed adverse effects and efficacy. Responder rate was defined as >50% seizure improvement from baseline., Results: Thirty patients (females, 18; males, 12; age, 35.1±13.3 years) were included. After 6, 12, 24, and 36 months of follow-up, the response rates were: 13/30 (43%), 13/27 (48%), 9/22 (41%), and 8/16 (50%), respectively; none was seizure free. Fifty-seven percent, 33%, 59%, and 81% of patients had changes of medication type or dose at 6, 12, 24, and 36 months respectively. In the majority of patients, the change of medication consisted of an increase in the dose of AEDs., Conclusions: Our study shows that VNS is an effective therapy, although significant changes in medications were done along with the therapy; therefore, the real effect of VNS could be controversial.

Introduction: The effect of the single seizure clinic (SSC) model on patient diagnose, work-up, wait-times, and clinical care is poorly characterized and its efficacy unclear. The present study assesses patient characteristics and evaluates the impact of a single seizure clinic (SSC) model on wait-times and access to care., Material and Methods: A prospective study of all patients (n=200) referred to our SSC for first seizure evaluation. Demographic, clinical, and paraclinicial variables were systematically collected and analyzed against a historical cohort. Binary logistic regression analysis was performed to predict impact of dichotomized variables on diagnosis of epilepsy. Diagnostic concordance between SSC nurses and epileptologists was also assessed., Results: Predominant referral sources were emergency department physicians and general practitioners. Mean wait-time for first assessment was significantly reduced by 70.5% employing the SSC model versus historical usual care. A diagnosis was established at first-contact in 80.5% of cases while 16.0% of patients required a second visit. Eighty-two patients (41.0%) were diagnosed with epilepsy. An abnormal EEG was found in 93.9% of patients diagnosed with epilepsy. Sixty-three patients were started on anti-epileptic drugs (63.5% lamotrigine, 7.0% levetiracetam, 5.0% phenytoin, and 5.0% topiramate). In 18% of cases driving restrictions were initiated by the SSC. The most common non-seizure diagnosis was syncope (24.0%)., Discussion: The SSC reduced wait-times for assessment and investigations, clarified diagnoses, affected management decisions with respect to further workup, pharmacotherapy, and driving. There was moderate correlation between SSC nurses and physicians (kappa=0.54; p<0.001) as physicians were significantly more likely to diagnose epilepsy. Key factors identified as predictors of epilepsy were: presence of abnormalities on electroencephalography and imaging studies, patients stratified as high or medium-risk for seizure recurrence, semiological characteristics such as amnesia and limb stiffening, and presence of tongue trauma, or incontinence., Conclusions: The SSC model reduces wait-times, streamlines assessments, and impacts clinical care decisions., (Copyright © 2016 Elsevier B.V. All rights reserved.)

This research assesses how short term delays in time-until-recovery can affect the quality and quantity of burnt bone recovered from a fatal fire scene. Knowledge of trends in post-burning remains fragmentation will enable investigators to prioritise remains recovery and implement recovery protocols appropriately. By comparing calcined bone fragments recovered 0, 24, 56 and 168 h (1 week) after experimental burns, this research describes remains fragmentation over time. Sus scrofa (domestic pig) limbs were burnt in a series of wood fuelled fires with calcined remains recovered at the specified time intervals. Bone fragments were sorted into 12 size based categories and the proportional weight of each category compared to observe differences in fragmentation over time. Results reveal marked increases in fragmentation when recovery is delayed by 24 h but less change in fragmentation between 24 and 56 h delay when breakage is reduced in the larger fragments. Between 56 and 168 h delay large increases in fragmentation occurred across all fragment sizes. These results indicate that short term recovery delays (24 h) can be detrimental to remains condition, but if remains recovery cannot be completed soon after the fire intermediate delays (56 h) are less significant. Longer term delays (168 h) are again potentially highly detrimental., (Copyright © 2013 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.)

This research investigates how victim bone age affects the fragmentation and subsequent recovery of burnt bone. It could be inferred that the lower density and higher organic content of bone from younger individuals results in more significant bone breakdown compared to bone from older individuals. Previous research has suggested that while neonate bone can be difficult to destroy in a burn environment it is more fragile post-burning. Results comparing fragmentation of calcined piglet and fattening-pig remains reveal that, while consisting of smaller fragments, the younger material is less fragmented with more complete or almost complete bone elements. These observations have significant implications for remains recovery, especially of younger remains, as it highlights the value of this material as well as the importance of utilising search and recovery strategies that minimise post-burning disturbance. Younger bone responds differently to the burn environment and, therefore; it needs to be taken into consideration when planning remains discovery and retrieval to ensure maximum benefit to the investigation and individuals involved., (Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.)

This research assesses how weather conditions, such as temperature and rainfall, affect the fragmentation of burnt bone. The recovery of human remains from fatal fire scenes is often hampered by the fragmentary nature of the material, and through understanding how weather factors affect this fragmentation, it may be possible to adjust recovery timelines and protocols to maximise the quantity and quality of condition of the material recovered. These data are also valuable as a baseline for expected fragmentation, and expected differences in fragmentation, under different weather conditions. Sus scrofa (domestic pig) limbs were burned in a series of wood fires spaced over a period of eight months, from winter through fall, in a warm summer continental climate (Köppen-Geiger classification Dfb). Bone fragments were sorted by size and the proportional weights of each size category were compared to isolate any differences in fragmentation. Results suggest that in freezing conditions with remains recovery occurring the day after the fire, increased fragmentation is observed in younger remains but not in older remains. In older remains fragmentation is highest when temperatures fluctuate around 0 °C. It was observed that when remains recovery is delayed, fluctuating temperatures have a larger impact on fragmentation in the short term and freezing conditions are more significant in the longer term. Wet weather conditions increase levels of fragmentation., (Copyright © 2013 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.)

An association between sperm DNA integrity and fertility was recently shown for frozen-thawed Norwegian Red (NRF) bull semen diluted in skimmed milk egg yolk (SMEY). In general the fertility of NRF cattle is high, however, in comparison with NRF semen in SMEY, NRF semen diluted in Tris EY based extenders has shown reduced fertility. The aim of the present study was to do a split-sample comparison of sperm DNA integrity of NRF bull semen (n=20) in SMEY and Triladyl (Tris EY based) during routine cryopreservation procedure and during in vitro incubation of frozen-thawed semen in modified synthetic oviduct fluid (mSOF). In contrast to the high fertility of NRF cattle, Holstein cattle are experiencing a marked decline in fertility. Therefore, the present study also aimed to compare sperm DNA integrity of NRF (n=20) and Holstein (n=20) semen diluted in Triladyl during in vitro incubation. The sperm DNA integrity was measured by susceptibility to in situ acid induced denaturation by the Sperm chromatin structure assay (SCSA). Compared to initial values of frozen neat semen, an increase in DNA damage was observed after dilution and cooling (5 degrees C) and after freezing-thawing of NRF semen in SMEY, but only after freezing-thawing for NRF semen diluted in Triladyl. Sperm DNA damage of NRF semen increased during in vitro incubation in mSOF; the increase in percentage of spermatozoa with DNA damage was more prominent in SMEY than in Triladyl, while the degree of damage was higher in Triladyl, throughout the incubation period. However, while the correlation between DNA damage and sperm survival was negative in SMEY throughout the incubation period, a positive correlation was observed in Triladyl after 9h of incubation, indicating a higher presence of DNA damage in the live sperm population. In comparison with Holstein spermatozoa, the sperm DNA integrity of NRF semen reflected a better ability to withstand alterations induced during in vitro incubation in mSOF. In conclusion, sperm DNA integrity of NRF bull semen was altered during the cryopreservation procedure and in vitro incubation in mSOF. Dilution in Triladyl maintained bull sperm DNA integrity better than dilution in SMEY. Furthermore, alterations in Holstein sperm DNA integrity was more pronounced during in vitro incubation in mSOF compared to NRF bull spermatozoa.