Febrile Seizures: Four Steps Algorithmic Clinical Approach

Febrile seizures (FS) are the most common form of convulsive phenomena in human being and affect 2% to 14% of children. It is the most common type of seizures that every pediatrician is dealing with. It is the most benign type of all seizures occurring in childhood. There are many debates on how to approach to febrile seizures in pediatric neurology and there are many possible malpractices in this field. Some of the most common frequent queries are

• How could we differentiate FS from seizures and fever associated with serious infections involving the central nervous system?
• When should we refer the affected child for further investigations such as lumbar puncture, EEG, neuroimaging, and routine biochemical studies?
• How should we treat FS in its acute phase?
• How could we assess the risk for further recurrences as well as other risks threatening the child''s health in future?
• How could we select the patients for treatment or prophylaxis?
• Which medication(s) should be selected for treatment or prophylaxis?

Trying to answer the above-mentioned questions, this review article will present a four steps algorithmic clinical approach model to a child with febrile seizures based on the current medical literature.     

Variations of focal regions versus numbers and positions of sources in two-dimensional media

This paper explores the behaviour of the primary and secondary hot spots in homogeneous and two-dimensional inhomogeneous medium. Circular arrays are considered with a radius of up to five wavelengths. The number of sources and their positions in the array are varied, and the influence of these variations on the primary and secondary hot spots is observed. It is found that the primary hot spot reaches its final shape with the addition of a very small number of sources to the array. An increase in the number of sources results in a reduction of the normalized magnitude of the secondary hot spots, but the size of the normalized primary hot spot remains the same. An upper limit of sources in the array exists after which no further reduction of the secondary hot spots is observed. The finite-difference time-domain method (FDTD) is used to obtain the electric-field distribution in the inhomogeneous medium. A genetic algorithm is then applied to find the optimal positions of the antennae in the array.     

电子束矩形野输出因子等效转换方法的对比实验研究

目的：比较方根式、一维式和面积周长比3种方法计算的电子束矩形照射野输出因子的精确性和可行性。方法：用电离室法对不同大小限光简不同能量下8个特定矩形照射野输出因子实测和用3种方法计算，比较此3种方法与实测值偏差。结果：（1）同一能量下，面积周长比法偏差较大，一维式和方根式偏差较小；（2）电子束限光筒大小、射线能量和矩形照射野大小对3种方法计算的矩形照射野输出因子有一定影响。结论：面积周长比法计算矩形照射野输出因子偏差较大，建议不予采用。一维式和方根式法精度较高，一维式法优于方根式法，而方根式法更适合于临床。     

Real-time measurement of pulse wave velocity from arterial pressure waveforms

Instrumentation for the real-time clinical measurement of pulse wave velocity (PWV) from intra-arterial pressure waveforms is presented. The time delay between pressure waveforms (obtained from two intra-arterial catheter-mounted transducers 5 cm apart) is calculated by a transputer using multiple comparisons between discrete sections of the waveforms. The method is validated by analysis of digital and analogue signals with known time delays and is used to measure changes in PWV in the right common iliac artery (RCIA) during infusions of acetylcholine (2·4, 24 and 240 μg ml⁻¹) in six healthy subjects. The system measures the delay between digitally shifted triangular waveforms and pressure waveforms to a precision of about 50 μs, and it is superior to measurements performed by hand using a high-performance digital storage oscilloscope. When used to measure the effects of acetylcholine on the RCIA, dose-dependent reductions in PWV are recorded (−8·5%, −11·6%, −14·5%). It is concluded that the instrumentation enables PWV to be measured with high accuracy and precision in real time, if the pressure signals are of high fidelity and the relative amplification of the signals is carefully balanced.     

NIRS: Large scale ART-1 neural architectures for engineering design retrieval

We describe a neural information retrieval system developed for retrieval of engineering designs. Two-dimensional (2-D) and three-dimensional (3-D) representations of engineering designs are input to adaptive resonance theory (ART-1) neural networks to produce groups or clusters of similar parts. ART-1 networks are first trained to cluster designs into families, and then to recall a family of similar parts when queried with a new part design. This application is of great practical value to industry because it aids in the identification, retrieval, and reuse of engineering designs, potentially saving large amounts of nonrecurring costs. In this paper, we describe the application, the neural architectures and algorithms, the current status, and the lessons learned in developing a neural network system for production use in industry.     

高度远视白内障患者人工晶状体屈光度数计算公式的选择

目的 比较Haigis、SRKⅡ、Hoffer Q、Hollady、SRK/T公式的准确性,以期为高度远视白内障患者植入的人工晶状体(IOL)屈光度数计算提供参考.方法 比较性研究.分析了24例(31只眼)行超声乳化白内障吸除联合后房型人工晶状体植入术的高度远视白内障患者,术前分别应用A超和IOL Master测量眼轴长度,计算人工晶状体度数,术后验光获得实测屈光度数.比较应用IOLMaster测量时Haigis、SRKⅡ、Hoffer Q、Hollady、SRK/T公式预测植入人工晶状体屈光度数的准确性,以及两种生物测量方法对各公式预测误差的影响.两种测量方法间的比较采用配对t检验.结果 (1)应用IOL Master测量时,Haigis公式的平均预测误差最小(0.37±0.14),随后依次为Hoffer Q、Hollday、SRK/T、SRK Ⅱ公式,分别为-0.70±0.12,-0.97±0.15,-1.25±0.14,-1.46±0.13.Haigis公式引起轻度的过矫,而其他公式则产生不同程度的欠矫.(2)A超的预测误差偏向正值,而IOL Master的预测误差却偏向负值.在A超测量眼轴时,Hoffer Q公式较为精确(-0.39±0.16),而在使用IOL Master时,Haigis更为精确(0.37±0.14).结论 高度远视白内障患者选择IOL屈光度数的计算公式,使用IOL Master测量时,建议选择Haigis公式,而采用A超测量时,选择Hoffer Q公式则能获得较为准确的IOL屈光度数.     

利用DCT分量差值压缩ECG数据的方法

由于心脏活动的有序性和各心电活动周期波形的相似性,各心电活动周期波形的DCT（离散时间余弦变换）分量也具有一定的相似性。根据这一特点,本文提出了在首先使用DCT压缩心电图（ECG）数据的基础上,进一步利用各ECG周期的DCT分量的差值来压缩数据的方法。     

Computer-Aided Decision Support in Hepatology

Darmoni SJ, Poynard T. Computer-aided decision support in hepatology. Scand J Gastroenterol 1992;27:889-896.

The aim of this study was to describe and to evaluate the publications of the last 30 years devoted to computer-aided decision support in clinical hepatology. The search used Medlars and references of articles. Computer-aided decision support (CADS) was classified in two categories: statistical systems and knowledge-based systems. Two specific questionnaires were used for methodologic evaluation, one for statistical systems and one for knowledge-based systems. They were filled out independently by two observers. A total of 31 papers were selected among 55 identified between 1960 and 1991. The maximum possible for the two scores was 24. The methodologic quality ranged from 4 to 22 (median, 12) for statistical systems and from 8 to 12 (median, 9) for knowledge-based systems. The poor level of methodology could explain in part the lack of utilization of computer-aided decision support in the daily clinical practice of hepatologists.     

Staged Balloon Aortic Valvuloplasty before Standard Aortic Valve Replacement in Selected Patients with Severe Aortic Valve Stenosis

This study evaluated preoperative balloon aortic valvuloplasty (BAV) as a technique to decrease aortic valve replacement (AVR) risk in patients who have severe symptomatic aortic valve stenosis with substantial comorbidity.We report the outcomes of 18 high-risk patients who received BAV within 180 days before AVR from November 1993 through December 2011. Their median age was 78 years (range, 51–93 yr), and there were 11 men (61%). The pre-BAV median calculated Society of Thoracic Surgeons Predicted Risk of Mortality (STS PROM) was 18.3% (range, 9.4%–50.7%). Preoperative left ventricular ejection fraction measured a median of 0.23 (range, 0.05–0.68), and the median aortic valve area index was 0.4 cm²/m² (range, 0.2–0.7 cm²/m²). The median interval from BAV to AVR was 28 days (range, 1–155 d). There were no strokes or deaths after BAV; however, 4 patients (22%) required mechanical circulatory support, 3 (17%) required femoral artery operation, and 1 (6%) developed severe aortic valve regurgitation. After BAV, the median STS PROM fell to 9.1% (range, 2.6%–25.7%) (compared with pre-BAV, P <0.001). Echocardiography before AVR showed that the median left ventricular ejection fraction had improved to 0.35 (range, 0.15–0.66), and the aortic valve area index to 0.5 cm²/m² (range, 0.3–0.7 cm²/m²) (compared with pre-BAV, both P <0.05). All patients received AVR. Operative death occurred in 2 patients (11%), and combined operative death and morbidity in 7 patients (39%).Staged BAV substantially reduces the operative risk associated with AVR in selected patients.