BACKGROUND & AIMS: OBJECTIVE:A forearm fracture (Colles' fracture) is often the first sign of osteoporosis and should alert the patient and physician to the possibility of underlying skeletal fragility. Therefore, the establishment of a more accurate and reliable method for the measurement of bone mineral density (BMD) at the distal radius would be beneficial for the patients who suffer from osteoporosis. The objective of the present study was to evaluate the usefulness of peripheral quantitative computed tomography (pQCT) to assess the change of BMD at the distal radius in early postmenopausal women who receive hormone replacement therapy (HRT). METHODS:Twenty healthy early postmenopausal women who were diagnosed as osteoporosis or osteopenia were randomized to either HRT or placebo treatment. We analyzed BMD of the distal radius by pQCT, lumbar spine by dual-energy X-ray absorptiometry (DXA) and the biochemical markers of bone turn over (osteocalcin, deoxypyridinoline) every 6 months. RESULTS:The placebo group showed a significant decrease from the baseline in the trabecular BMD of the radius at 12 months (7.4+/-2.5%) (p<0.05), whereas the HRT group showed a slight increase (0.7+/-2.2%). The changes in the trabecular BMD of the radius between the HRT and placebo groups were statistically different at 12 months (p<0.05). On the other hand, in the cortical BMD of the radius, no significant differences were seen between the changes of bone densities in the HRT and control groups after 1 year of treatment. pQCT could detect a significant loss of BMD of the radius in early postmenopausal women after 1 year and HRT prevented its loss. CONCLUSION:Our preliminary clinical trial showed that pQCT might be useful for the early detection of bone loss in early postmenopausal women and for the monitoring BMD of the patients who receive HRT.

背景与目标：

BACKGROUND & AIMS: :Neoadjuvant or adjuvant multimodality therapy in oesophageal cancer is introduced in an effort to improve prognosis. However, in a substantial fraction of patients there is no response to this non-surgical therapy. Non-invasive imaging modalities such as computed tomography (CT), endoscopic ultrasound (EUS) and 18F-2-fluoro-2-deoxy-d-glucose positron emission tomography (FDG-PET) have been evaluated for assessing patient response to therapy, and these are described in this review. Currently, FDG-PET seems to be the best available tool for neoadjuvant therapy response assessment in oesophageal cancer.

背景与目标： : 为了改善预后，引入了食管癌的新辅助或辅助多模式疗法。但是，在很大一部分患者中，这种非手术疗法没有反应。已经评估了非侵入性成像方式，例如计算机断层扫描 (CT)，内窥镜超声 (EUS) 和18f-2-氟-2-脱氧-d-葡萄糖正电子发射断层扫描 (fdg-pet)，以评估患者对治疗的反应，这些在本综述中进行了描述。目前，fdg-pet似乎是食管癌新辅助治疗反应评估的最佳工具。

BACKGROUND & AIMS: :Atypical hemolytic uremic syndrome (aHUS), is mainly present in children, who have high risks of end-stage kidney disease (ESKD), post-transplant recurrence and death. aHUS is linked to defective regulation of the complement alternative pathway (AP), with a prominent cause being mutation/inhibition of the negative regulator complement factor H (CFH). CFH function can be restored via infusion of fresh frozen plasma (FFP), a treatment that was effective for several years in a patient heterozygous for a cfh mutation, before the patient progressed to ESKD. While on dialysis, FFP was replaced with eculizumab, which blocks C5 cleavage and thus halts progression of the terminal complement pathway. Patient plasma samples collected during FFP and eculizumab treatment phases were assessed for AP activity (via erythrocyte lysis assays) and for overall complement activity (via ELISA-based screen). Assay results indicated that FFP partially restored AP regulation, an observation supported by in vitro modeling of FFP treatment using purified CFH, while eculizumab completely blocked complement activity. The same approach was used to model in vitro a potential aHUS treatment approach based on blocking the AP effector properdin (complement factor P; CFP) with an anti-properdin antibody. These results provide insights into the efficacy of aHUS treatment and highlight the usefulness of in vitro assays in monitoring and predicting therapeutic responses and testing new treatment possibilities.

背景与目标： : 非典型溶血性尿毒症综合征 (aHUS) 主要存在于儿童中，这些儿童具有终末期肾脏疾病 (ESKD)，移植后复发和死亡的高风险。aHUS与补体替代途径 (AP) 的缺陷调节有关，主要原因是负调节因子补体因子H (CFH) 的突变/抑制。可以通过输注新鲜的冷冻血浆 (FFP) 来恢复CFH功能，该治疗在患者进展为ESKD之前，对因cfh突变而杂合的患者有效数年。在透析时，FFP被eculizumab取代，eculizumab阻断C5裂解，从而阻止末端补体途径的进展。评估在FFP和ecolizumab治疗阶段收集的患者血浆样品的AP活性 (通过红细胞溶解测定) 和总补体活性 (通过基于ELISA的筛选)。测定结果表明，FFP部分恢复了AP调节，这一观察结果得到了使用纯化CFH的FFP治疗的体外建模的支持，而eculizumab完全阻断了补体活性。使用相同的方法在体外模拟潜在的aHUS治疗方法，该方法基于用抗properdin抗体阻断AP效应子properdin (补体因子P; CFP)。这些结果提供了对aHUS治疗功效的见解，并强调了体外测定在监测和预测治疗反应以及测试新的治疗可能性方面的有用性。

BACKGROUND & AIMS: :Traditionally push-button and symptom diaries have been used to document cough events, especially when examining temporal associations between cough and reflux events. More recently, acoustic devices have allowed more accurate recording of cough events, and compared with the latter traditional techniques reported 6-18 times more coughing. Whether the differences reported between these techniques represents disparities in subject groups or cough detection and quantification methods is unknown. In this issue of the American Journal of Gastroenterology, Kavitt et al. show that listeners of such recordings have a 4-fold increase in odds of recording cough events compared with patients using push-button techniques, and that even when using a 5-min window to assess temporal concordance/discordance, over 70% of coughs were not reported by the patients. These observations have potential significant implications when assessing temporal associations between cough and reflux, and thus any clinical decision making based on these data. This editorial examines both the findings of Kavitt et al. and discusses the pitfalls and benefits of validated accurate documentation of cough.

背景与目标： : 传统上，按钮和症状日记被用来记录咳嗽事件，特别是在检查咳嗽和反流事件之间的时间关联时。最近，声学设备可以更准确地记录咳嗽事件，与后一种传统技术相比，咳嗽次数增加了6-18倍。这些技术之间的差异是否代表受试者组的差异或咳嗽检测和定量方法尚不清楚。在本期《美国胃肠病学杂志》中，Kavitt等人。表明，与使用按钮技术的患者相比，此类录音的听众记录咳嗽事件的几率增加了4倍，即使使用5分钟的窗口来评估时间的一致性/不一致性，患者未报告超过70% 的咳嗽。当评估咳嗽和反流之间的时间关联时，这些观察结果具有潜在的重大意义，因此基于这些数据做出任何临床决策。这篇社论研究了Kavitt等人的发现。并讨论了经过验证的咳嗽准确记录的陷阱和好处。

BACKGROUND & AIMS: :A large-scale study was carried out in order to determine the contamination level of antineoplastic drugs in pharmacies and to investigate the suitability and effects of wipe sample monitoring at regular intervals. A specific study design was developed. The 130 participating pharmacies were divided into a study and a control group, carrying out five and two wipe sampling cycles, respectively. The work practice was analyzed using questionnaires to identify factors that influence the contamination level. From 1269 wipe samples, 774 (61%) were contaminated with at least one of the analyzed cytotoxic drugs: cyclophosphamide, docetaxel, etoposide, 5-fluorouracil, gemcitabine, ifosfamide, methotrexate, and paclitaxel. A significant decrease of the contamination with cyclophosphamide and 5-fluorouracil was observed in the study group. The Monitoring-Effect Study of Wipe Sampling in Pharmacies method has proven to be a reliable and affordable tool for contamination control. Based on the 90th percentile of the contamination values, a substance-independent performance-based guidance value of 0.1ng cm(-2) has been derived.

背景与目标： : 进行了大规模研究，以确定药房中抗肿瘤药物的污染水平，并调查定期擦拭样品监测的适用性和效果。开发了一个特定的研究设计。将130家参与的药房分为研究组和对照组，分别进行了五个和两个擦拭采样周期。使用问卷调查对工作实践进行了分析，以确定影响污染水平的因素。从1269擦拭样品中，774 (61%) 被至少一种分析的细胞毒性药物污染: 环磷酰胺，多西他赛，依托泊苷，5-氟尿嘧啶，吉西他滨，异环磷酰胺，甲氨蝶呤和紫杉醇。在研究组中观察到环磷酰胺和5-氟尿嘧啶的污染显着减少。药房擦拭采样方法的监测效果研究已被证明是控制污染的可靠且负担得起的工具。根据污染值的第90个百分位数，得出了与物质无关的基于性能的指导值0.1ng cm(-2)。

BACKGROUND & AIMS: INTRODUCTION:This project addresses the validation study design of a test system using a telemetered non-human primate model for cardiovascular safety pharmacology evaluation. METHODS:The validation provided by the supplier evaluated installation (IQ) and operation (OQ) qualifications. This protocol was completed with tests evaluating electronic data management and accuracy and precision of transmitter (n=4) measurements for temperature and pressure criteria with a series of tested values. As part of performance qualification, physical activity (for 24 h) as well as cardiovascular, ECG (20 complexes for each animal) and systemic arterial blood pressure (SAP, 10 different measures), data were recorded simultaneously from the same animals (n=4) using certified equipment and the telemetry system. Reliability was evaluated over 60 days. RESULTS:The IQ and OQ were completed successfully. The electronic data management was performed successfully. The ex-vivo evaluation for temperature and pressure showed high correlation (R(2)>0.99) but with a slight pressure shift, as expected, with this transmitter model. For physical activity, the correlation coefficients were good to excellent with high activity counts but the comparison demonstrated a limited sensitivity of the telemetry system with animal presenting low activity levels. ECG interval measurement using the telemetry software was considered at least equivalent to manual measurement, but with some limitations in the reading of the ECG. The comparison between both methods of SAP measurement showed adequate precision (R(2)=0.969) but no accuracy. DISCUSSION:Reference monitoring methods are important to ensure proper test system validation. Monitoring with a reference methodology and the telemetry system is important in order to evaluate precision and accuracy of the test system. Computerized analysis may lack the capability to analyze ECG complexes with abnormal morphologies. This reinforces the need to have ECG evaluation prior to telemetry implantation along with visual evaluation of ECG tracing at standard speed (e.g. 50 mm/s) at all time points.

背景与目标：

BACKGROUND & AIMS: Interferon alpha (IFN-alpha) induces cytogenetic responses of variable degree in patients with CML. We sought to establish the relationship between BCR-ABL transcript numbers measured by competitive two-step reverse transcription polymerase chain reaction (RT-PCR) and cytogenetic status in CML patients treated with IFN-alpha. All 398 samples from 163 patients investigated by RT-PCR were positive for BCR-ABL transcripts. In order to standardize results for variability in RNA and cDNA quality, we quantified total ABL transcripts in each sample as internal control. The BCR-ABL/ABL ratios correlated with the cytogenetic results. Quantitative nested PCR allowed the detection of residual BCR-ABL transcripts in all complete cytogenetic responders on IFN-alpha. We conclude that competitive PCR with internal controls is a reliable method for monitoring patients on IFN-alpha and reduces the need for repeated marrow investigations.

背景与目标： 干扰素 α (IFN-α) 诱导CML患者不同程度的细胞遗传学反应。我们试图建立通过竞争性两步逆转录聚合酶链反应 (rt-pcr) 测量的bcr-abl转录数与接受IFN-α 治疗的CML患者的细胞遗传学状态之间的关系。通过rt-pcr调查的来自163名患者的所有398样品的bcr-abl转录物均为阳性。为了标准化RNA和cDNA质量变异性的结果，我们将每个样品中的总ABL转录本量化为内部对照。Bcr-abl/ABL比值与细胞遗传学结果相关。定量巢式PCR可以检测到IFN-α 上所有完整的细胞遗传学反应中的残留BCR-ABL转录本。我们得出的结论是，带有内部对照的竞争性PCR是一种可靠的方法，用于监测患者的IFN-α，并减少了重复进行骨髓检查的需要。

BACKGROUND & AIMS: :A 51-year-old human immunodeficiency virus (HIV)-positive male patient (CDC stage 3C) had had a painful nodule on his external ankle joint for 10 months. A biopsy suggested bacillary angiomatosis, but Kaposi's sarcoma could not be excluded. Rods were detectable in lesional skin by a Warthin-Starry stain. A 298 base pair (bp) gene fragment specific for Bartonella species was amplified from lesional skin and direct nucleotide sequence analysis of the amplification product clearly identified Bartonella quintana. Kaposi's sarcoma-associated herpes virus specific DNA was not amplifiable by polymerase chain reaction (PCR) in our patient, suggesting that the lesion represented bacillary angiomatosis alone, despite clinical and histopathological features which suggested the coexistence of bacillary angiomatosis and Kaposi's sarcoma. The lesion regressed after erythromycin was prescribed. However, 4 and 9 weeks after initiation of therapy, PCR still yielded a positive result in material obtained by a swab. After complete healing, following 12 weeks of antibiotic therapy, PCR became consistently negative. The optimal length of antibiotic treatment in HIV-positive patients with bacillary angiomatosis is not yet known and inadequate therapy may be followed by disseminated disease and a fatal outcome. PCR-based monitoring of the success of treatment is valuable for determining the duration of treatment resulting in a cure.

背景与目标： : 一名51岁的人类免疫缺陷病毒 (HIV) 阳性男性患者 (CDC阶段3C) 的外踝关节结节疼痛10个月。活检提示细菌性血管瘤病，但不能排除卡波西氏肉瘤。通过Warthin-Starry染色在病变皮肤中可检测到杆。从病变皮肤扩增出针对巴尔通体物种的298碱基对 (bp) 基因片段，并对扩增产物的直接核苷酸序列分析清楚地鉴定出了巴尔通体。在我们的患者中，与卡波西氏肉瘤相关的疱疹病毒特异性DNA无法通过聚合酶链反应 (PCR) 扩增，这表明该病变仅代表细菌性血管瘤病，尽管临床和组织病理学特征表明细菌性血管瘤病和卡波西氏肉瘤并存。开药红霉素后病变消退。然而，在开始治疗后4周和9周，PCR仍在拭子获得的材料中产生阳性结果。完全愈合后，经过12周的抗生素治疗，PCR始终呈阴性。对于HIV阳性的细菌性血管瘤病患者，抗生素治疗的最佳时间尚不清楚，治疗不足可能会导致传播性疾病和致命后果。基于PCR的治疗成功监测对于确定导致治愈的治疗持续时间很有价值。

BACKGROUND & AIMS: OBJECTIVES:Iopentol (Nycomed Imaging AS, Oslo, Norway) and iopromide (Schering AG, Berlin, Germany) are low-osmolar, non-ionic, iodinated contrast media (CM) used in abdominal CT examinations. The intravenous safety profile and radiological efficacy of iopentol and iopromide were studied in 518 patients. Specifically, frequency of adverse events (AEs), subjective change in quality of diagnostic information, and quantitative enhancement characteristics were compared. MATERIALS AND METHODS:A prospective, double-blind, randomized, multicentre, parallel-group study was conducted at 8 hospitals. Patients received 100 ml of either iopentol 300 mg I/ml or iopromide 300 mg I/ml. RESULTS:The incidence of patients with AEs was statistically significantly lower in the iopentol group compared to the iopromide group (2.3% vs. 8.9%, p < 0.001). Discomfort was frequent in both groups (44.8% vs. 49.4%, p = 0.33), sensation of heat and warmth being most common. Overall, diagnostic information was similar in both groups. Both CM gave high percentages of examinations rated as optimal (87.1% vs. 90.5%, p = 0.34) and in which diagnostic confidence was increased (87.5% vs. 91.1%, p = 0.22). No significant differences between the two CM were found concerning quantitative enhancement characteristics. CONCLUSIONS:In this study iopentol was significantly safer than iopromide for contrast enhanced CT examination of the abdomen. Radiological efficacy was similar with both CM.

背景与目标：

BACKGROUND & AIMS: STUDY DESIGN:Retrospective review of institutional data. OBJECTIVE:The aim of this study was to assess the utility of somatosensory-evoked potentials (SSEP) and transcranial electric motor-evoked potentials (MEP) in the resection of spine tumors and evaluate the ability of both single and multi-modal monitoring to predict postoperative neurological deficits. SUMMARY OF BACKGROUND DATA:Although the utility of intraoperative monitoring (IOM) is well established in scoliosis and degenerative surgery, studies in spine tumor patients have been limited. METHODS:A series of consecutive patients who underwent resection with the use of IOM at a single institution between August 2009 and March 2013 was identified. Demographic, clinical, and neuromonitoring data were collected preoperatively, during surgery, at the moment of discharge, and at a 6-month follow-up visit. Three cohorts were established based on the anatomical location of the tumor: intramedullary, intradural extramedullary, and extradural. Additional groupings were formed based on spinal region. Patients with significant changes in SSEPs or MEPs during surgery were identified and the rate of neurological deficits was assessed. RESULTS:A total of 52 patients were analyzed. A change in SSEPs or MEPs was detected in 11 (21.2%) cases whereas 14 patients (26.9%) developed permanent postoperative deficits. SSEPs predicted deficits in the resection of intramedullary tumors (P = 0.015) (area under cover, AUC = 0.83), and intradural extramedullary tumors (P = 0.048; AUC = 0.70). MEP monitoring did not predict postoperative deficits in the resection of intramedullary (P = 0.21; AUC = 0.69) or intradural extramedullary tumors (P = 0.31; AUC = 0.63). Neither SSEPs nor MEPs predicted deficits for extradural tumors. CONCLUSION:The efficacy of IOM in spine tumor resection is dependent on tumor location relative to the spinal cord and dura. The accuracy of SSEPs and their ability to predict postoperative deficits was greatest for intramedullary lesions. For this series, MEP and multi-modal monitoring did not confer a benefit in predicting permanent neurological deficits. LEVEL OF EVIDENCE:4.

背景与目标：

BACKGROUND & AIMS: OBJECTIVE(S):Obstructive sleep apnea syndrome (OSAS) is a respiratory disorder which affects from 1 to 3 % of people during development. OSAS treatment may be pharmacological, surgical or based on application of intraoral devices to increase nasal respiratory spaces. The purpose of this study was to determine the efficacy of the Rapid Maxillary Expander in OSAS young patients by measuring cardio-respiratory monitoring parameters (AHI, the average value of complete and incomplete obstructed respiration per hour of sleep, and SAO2, the percentage of oxygen saturation). STUDY DESIGN:The study was conducted on 11 OSAS young subjects (mean age 6.9±1.04 years), all treated with rapid maxillary expansion (RME). Cardio-respiratory monitoring (8-channel Polymesam) was performed at the beginning (diagnostic, T0) and after 12 months of treatment. RESULTS:The mean values of cardio-respiratory parameters at TO were: AHI=6.09±3.47; SAO2=93.09%±1.60. After 12 months of treatment, the mean values of the same polysomnographic parameters were: AHI=2.36 ± 2.24;SAO2=96.81% ±1.60. These changes were associated with an improvement in clinical symptoms, such as reduction of snoring and sleep apnea. CONCLUSION(S):This study confirms the therapeutic efficacy of RME in OSAS young patients. This orthopedic-orthodontic treatment may represent a good option in young patients affected by this syndrome.

背景与目标：

BACKGROUND & AIMS: :Mobile health interventions are regarded as affordable and accessible tools that can enhance standard psychiatric care. As part of the mHealth Psycho-Educational Intervention Versus Antipsychotic-Induced Side Effects (mPIVAS) project (www.psylog.eu), we developed the mobile application "PsyLOG" based on mobile "smartphone" technology to monitor antipsychotic-induced side effects. The aim of this paper is to describe the rationale and development of the PsyLOG and its clinical use. The PsyLOG application runs on smartphones with Android operating system. The application is currently available in seven languages (Croatian, Czech, English, French, German, Japanese and Serbian). It consists of several categories: "My Drug Effects", "My Life Styles", "My Charts", "My Medication", "My Strategies", "My Supporters", "Settings" and "About". The main category "My Drug Effects" includes a list of 30 side effects with the possibility to add three additional side effects. Side effects are each accompanied by an appropriate description and the possibility to rate its severity on a visual analogue scale from 0-100%. The PsyLOG application is intended to enhance the link between patients and mental health professionals, serving as a tool that more objectively monitors side-effects over certain periods of time. To the best of our knowledge, no such applications have so far been developed for patients taking antipsychotic medication or for their therapists.

背景与目标： : 移动医疗干预措施被认为是负担得起且可获得的工具，可以增强标准的精神病护理。作为mHealth心理教育干预与抗精神病药引起的副作用 (mPIVAS) 项目 (www.psylog.eu) 的一部分，我们开发了基于移动 “智能手机” 技术的移动应用程序 “psylog”，以监测抗精神病药引起的副作用。本文的目的是描述PsyLOG的原理和发展及其临床用途。PsyLOG应用程序在带有Android操作系统的智能手机上运行。该应用程序目前有七种语言 (克罗地亚语、捷克语、英语、法语、德语、日语和塞尔维亚语)。它包括几类: “我的药物作用”，“我的生活方式”，“我的图表”，“我的药物”，“我的策略”，“我的支持者”，“设置” 和 “关于”。主要类别 “我的药物作用” 包括30个副作用的列表，并可能增加三个额外的副作用。每个副作用都伴随着适当的描述和在0-100% 的视觉模拟尺度上对其严重性进行评分的可能性。PsyLOG应用程序旨在增强患者与精神卫生专业人员之间的联系，作为一种工具，可以更客观地监测某些时间段内的副作用。据我们所知，到目前为止，还没有为服用抗精神病药物的患者或他们的治疗师开发这样的应用。

BACKGROUND & AIMS: :This study aimed to investigate the effect of patient engagement in self-monitoring with a telemonitoring device on glycemic control among patients with type 2 diabetes. We conducted a subanalysis of the telemonitoring device study in Kaiser Permanente Northern California members. We divided the telemonitoring group into 53 frequent and 54 infrequent users based on self-monitoring of blood glucose (SMBG) frequency of the first 6 weeks. The frequency of SMBG transmitted from the telemonitoring device was examined over 24 weeks. Clinic and laboratory tests were collected at baseline, 6 weeks and 6 months. There was no significant difference in baseline HbA1c level between the two groups. After 6 months, change in HbA1c was -2.4 ± 1.6% among frequent users and -1.5 ± 1.5% among infrequent users (p = 0.003). The proportion of patients achieving target HbA1C level at 6 months was significantly higher among frequent users than among infrequent users. An increased frequency of SMBG was significantly correlated with a reduction in HbA1c at 6 months. In conclusion, initial active engagement in self-monitoring with a telemonitoring device could provide incremental improvement of glycemic control over 6 months.

背景与目标： : 这项研究旨在研究患者参与远程监控设备对2型糖尿病患者血糖控制的影响。我们对北加州Kaiser Permanente成员的远程监控设备研究进行了亚分析。根据前6周的自我血糖监测 (SMBG) 频率，我们将远程监护组分为53个频繁用户和54个不频繁用户。在24周内检查了从远程监控设备传输的SMBG的频率。在基线，6周和6个月收集临床和实验室检查。两组患者基线HbA1c水平差异无统计学意义。6个月后，频繁用户的HbA1c变化为-2.4   ±   1.6%，不频繁用户的HbA1c变化为-1.5   ±   1.5% (p   =   0.003)。在6个月达到目标HbA1C水平的患者比例在频繁使用者中显著高于不频繁使用者。6个月时，SMBG频率的增加与HbA1c的降低显着相关。总之，使用远程监控设备进行自我监控的初始主动参与可以在6个月内逐步改善血糖控制。

BACKGROUND & AIMS: :A methodology of studying of ingestive behavior by non-invasive monitoring of swallowing (deglutition) and chewing (mastication) has been developed. The target application for the developed methodology is to study the behavioral patterns of food consumption and producing volumetric and weight estimates of energy intake. Monitoring is non-invasive based on detecting swallowing by a sound sensor located over laryngopharynx or by a bone-conduction microphone and detecting chewing through a below-the-ear strain sensor. Proposed sensors may be implemented in a wearable monitoring device, thus enabling monitoring of ingestive behavior in free-living individuals. In this paper, the goals in the development of this methodology are two-fold. First, a system comprising sensors, related hardware and software for multi-modal data capture is designed for data collection in a controlled environment. Second, a protocol is developed for manual scoring of chewing and swallowing for use as a gold standard. The multi-modal data capture was tested by measuring chewing and swallowing in 21 volunteers during periods of food intake and quiet sitting (no food intake). Video footage and sensor signals were manually scored by trained raters. Inter-rater reliability study for three raters conducted on the sample set of five subjects resulted in high average intra-class correlation coefficients of 0.996 for bites, 0.988 for chews and 0.98 for swallows. The collected sensor signals and the resulting manual scores will be used in future research as a gold standard for further assessment of sensor design, development of automatic pattern recognition routines and study of the relationship between swallowing/chewing and ingestive behavior.

背景与目标： : 已经开发了一种通过非侵入性监测吞咽 (吞咽) 和咀嚼 (咀嚼) 来研究进食行为的方法。所开发方法的目标应用是研究食物消费的行为模式以及产生能量摄入的体积和重量估计。监测是非侵入性的，基于通过位于喉咽上方的声音传感器或通过骨传导麦克风检测吞咽，并通过耳下应变传感器检测咀嚼。所提出的传感器可以在可穿戴监测装置中实现，从而能够监测自由生活个体的摄取行为。在本文中，这种方法的发展目标有两个方面。首先，设计了一种系统，该系统包括用于多模式数据捕获的传感器、相关硬件和软件，用于在受控环境中收集数据。其次，开发了一种用于手动对咀嚼和吞咽进行评分的协议，以用作金标准。通过测量21名志愿者在进食和安静坐着 (没有进食) 期间的咀嚼和吞咽来测试多模式数据捕获。视频录像和传感器信号由训练有素的评分者手动评分。对五名受试者的样本集进行的三个评分者之间的信度研究导致咬伤的0.996，咀嚼的0.988和燕子的0.98的平均类内相关系数很高。收集的传感器信号和所得的手动分数将在未来的研究中用作进一步评估传感器设计，开发自动模式识别例程以及研究吞咽/咀嚼与进食行为之间关系的金标准。

BACKGROUND & AIMS: AIM:To characterise patients treated with zonisamide in everyday practice and describe the effectiveness and tolerability of treatment. METHODS:This was an observational, longitudinal, naturalistic study, conducted by neurologists in France. Patients who had started zonisamide treatment at least three months prior to inclusion were eligible. Data were collected at routine consultations at inclusion (Visit 1) and three to six months later (Visit 2). At Visit 1, investigators documented epilepsy-related variables based on patient records before initiation of zonisamide and at inclusion. At Visit 2, the investigators re-evaluated seizure activity and rated effectiveness. Adverse events were also documented. RESULTS:A total of 428 patients were included in the study based on evaluation by 132 neurologists. Zonisamide was initiated at a daily dose of 50 mg and 25 mg in 61% and 31.8% of patients, respectively. The median maintenance dose was 300 mg/day. Prior to initiation of zonisamide, the mean seizure frequency was 16.0 seizures/month. This was reduced to 8.7 seizures/month at Visit 1 and to 7.1 seizures/month at Visit 2. The response rate and proportion of seizure-free patients was 61.9 and 31.1% at Visit 1 and 65.9 and 25.6% at Visit 2, respectively. The frequency of seizures at Visit 2 decreased significantly (p<0.05) for all seizure type subgroups, except for simple partial seizures. Responder rates were >60% for all analysed subgroups. The proportion of seizure-free patients was significantly higher in patients receiving bitherapy, compared to the others (p=0.007). The most frequently reported adverse event was somnolence (5.1%); three serious adverse events were reported. CONCLUSION:In everyday practice, zonisamide is principally used in association with other antiepileptic drugs for the treatment of focal epilepsy in adults. It is effective in improving seizure control and quality of life, and is generally well-tolerated.

背景与目标：