OBJECTIVEApproximately 75% of pediatric patients who suffer from epilepsy are successfully treated with antiepileptic drugs, while the disease is drug resistant in the remaining patients, who continue to have seizures. Patients with drug-resistant epilepsy (DRE) may have options to undergo invasive treatment such as resection, laser ablation of the epileptogenic focus, or vagus nerve stimulation. To date, treatment with responsive neurostimulation (RNS) has not been sufficiently studied in the pediatric population because the FDA has not approved the RNS device for patients younger than 18 years of age. Here, the authors sought to investigate the safety of RNS in pediatric patients.METHODSThe authors performed a retrospective single-center study of consecutive patients with DRE who had undergone RNS system implantation from September 2015 to December 2019. Patients were followed up postoperatively to evaluate seizure freedom and complications.RESULTSOf the 27 patients studied, 3 developed infections and were treated with antibiotics. Of these 3 patients, one required partial removal and salvaging of a functioning system, and one required complete removal of the RNS device. No other complications, such as intracranial hemorrhage, stroke, or device malfunction, were seen. The average follow-up period was 22 months. All patients showed improvement in seizure frequency.CONCLUSIONSThe authors demonstrated the safety and efficacy of RNS in pediatric patients, with infections being the main complication.
This paper discusses the performance of road bridges during the 2010–2011 Canterbury earthquakes and focuses on the response of bridges in liquefying soils undergoing lateral spreading. A characteristic spreading-induced mechanism for short-span bridges with rigid superstructures is presented and explored using four well-documented case studies. A series of pseudo-static analyses are then used to investigate the observed response of the bridges and their pile foundations in particular. Deformations and damage to the piles are evaluated and correlated with the spreading displacements, and key factors controlling the pile response and the development of the spreading-induced damage mechanism are identified.
A series of strong earthquakes near Christchurch, New Zealand, occurred between September 2010 and December 2011, causing widespread liquefaction throughout the city's suburbs. Lateral spreading developed along the city's Avon River, damaging many of the bridges east of the city centre. The short- to medium-span bridges exhibited a similar pattern of deformation, involving back-rotation of their abutments and compression of their decks. By explicitly considering the rotational equilibrium of the abutments about their point of contact with the rigid bridge decks, it is shown that relatively small kinematic demands from the laterally spreading backfill soil are needed to initiate pile yielding, and that this mode of deformation should be taken into account in the design of the abutments and abutment piles.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.