Detectability of the somatosensory evoked high frequency oscillation (HFO) co-recorded by scalp EEG and ECoG under propofol.

OBJECTIVE: The somatosensory evoked potential (SEP) elicited by median nerve stimulation consists of the N20 peak together with the concurrent high frequency oscillation (HFO, > 500 Hz). We describe the conditions for HFO detection in ECoG and scalp EEG in intraoperative recordings. METHODS: During neurosurgical interventions in six patients under propofol anesthesia, the SEP was recorded from subdural electrode strips (15 recordings) and from scalp electrodes (10/15 recordings). We quantified the spatial attenuation of the Signal-to-Noise Ratio (SNR) of N20 and HFO along the contacts of the electrode strip. We then compared the SNR of ECoG and simultaneous scalp EEG in a biophysical framework. RESULTS: HFO detection under propofol anesthesia was demonstrated. Visual inspection of strip cortical recordings revealed phase reversal for N20 in 14/15 recordings and for HFO in 10/15 recordings. N20 had higher maximal SNR (median 33.5 dB) than HFO (median 23 dB). The SNR of N20 attenuated with a larger spatial extent (median 7.2 dB/cm) than the SNR of HFO (median 12.3 dB/cm). We found significant correlations between the maximum SNR (rho = 0.58, p = 0.025) and the spatial attenuation (rho = 0.86, p < 0.001) of N20 and HFO. In 3/10 recordings we found HFO in scalp EEG. Based on the spatial attenuation and SNR in the ECoG, we estimated the scalp EEG amplitude ratio N20/HFO and found significant correlation with recorded values (rho = 0.65, p = 0.049). CONCLUSIONS: We proved possible the intraoperative SEP HFO detection under propofol anesthesia. The spatial attenuation along ECoG contacts represents a good estimator of the area contributing to scalp EEG. The SNR and the spatial attenuation in ECoG recordings provide further insights for the prediction of HFO detectability in scalp EEG. The results obtained in this context may not be limited to SEP HFO, but could be generalized to biological signatures lying in the same SNR and frequency range.

[Nursing expertise in post-stroke rehabilitation]. / AVC : une vidéo pour mobiliser le patient dans sa rééducation.

The pathway of a patient after a stroke involves a continuation of care, from their admission to the emergency department to their discharge from the rehabilitation unit. Here, a Genevan hospital team shares its experience in the creation of a video of information for the patients and their family about the process of rehabilitation.

Predictors of weight loss maintenance following an insurance-sponsored weight management program.

Intentional weight loss among overweight and obese adults (body mass index ≥ 25 kg/m(2)) is associated with numerous health benefits, but weight loss maintenance (WLM) following participation in weight management programming has proven to be elusive. Many individuals attempting to lose weight join formal programs, especially women, but these programs vary widely in focus, as do postprogram weight regain results. We surveyed 2,106 former participants in a community-based, insurance-sponsored weight management program in the United States to identify the pre, during, and post-intervention behavioral and psychosocial factors that lead to successful WLM. Of 835 survey respondents (39.6% response rate), 450 met criteria for inclusion in this study. Logistic regression analyses suggest that interventionists should assess and discuss weight loss and behavior change perceptions early in a program. However, in developing maintenance plans later in a program, attention should shift to behaviors, such as weekly weighing, limiting snacking in the evening, limiting portion sizes, and being physically active every day.