Objective To assess retention, dosing, efficacy, and safety of perampanel in a large cohort of patients with epilepsy during routine clinical care. Methods PROVE was a retrospective, non‐interventional Phase IV study (NCT03208660). Data were obtained retrospectively from the medical records of patients in the United States initiating perampanel after January 1, 2014, according to treating clinicians' recommendation. Retention rate was the primary efficacy endpoint. Secondary efficacy endpoints included median percent changes in seizure frequency per 28 days from baseline, seizure‐freedom rate, and overall investigator impression of seizure effect. Safety endpoints included incidence of treatment‐emergent adverse events (TEAEs). Efficacy and safety were also assessed according to baseline use of enzyme‐inducing antiseizure medications (EIASMs). Results Overall, 1703 patients were enrolled and included in the Safety Analysis Set (SAS; ≥1 baseline EIASMs, n = 358 [21.0%]; no baseline EIASMs, n = 1345 [79.0%]). Mean (standard deviation [SD]) cumulative duration of exposure to perampanel was 17.4 (15.7) months; mean (SD) daily perampanel dose was 5.6 (2.7) mg. The most frequent perampanel titration intervals were weekly (23.4%) and every 2 weeks (24.7%). Across the SAS, 24‐month retention rate was 48.1% (n = 501/1042). Based on overall investigator impression at the end of treatment, 51.9%, 35.8%, and 12.3% of patients in the SAS experienced improvement, no change, or worsening of seizures, respectively. TEAEs occurred in 704 (41.3%) patients; 79 (4.6%) had serious TEAEs. The most common TEAE was dizziness (7.3%). There was some variation in efficacy according to EIASM use, while retention rates and safety were generally consistent. Significance In this final analysis of >1700 patients with epilepsy receiving perampanel in routine clinical care, favorable retention and sustained efficacy were demonstrated for ≥12 months.

Purpose: Stereotactic EEG (SEEG) is being increasingly used in the intracranial evaluation of refractory epilepsy in the United States. In this study, the authors describe current practice of SEEG among National Association of Epilepsy Centers tertiary referral (level IV) centers.Methods: Using the Survey Monkey platform, a survey was sent to all National Association of Epilepsy Centers level IV center directors.Results: Of 192 centers polled, 104 directors completed the survey (54% response rate). Ninety-two percent currently perform SEEG. Of these, 55% of institutions reported that greater than 75% of their invasive electrode cases used SEEG. Stereotactic EEG was commonly used over subdural electrodes in cases of suspected mesial temporal lobe epilepsy (87%), nonlesional frontal lobe epilepsy (79%), insular epilepsy (100%), and individuals with prior epilepsy surgery (74%). Most centers (72%) used single-lead electrocardiogram monitoring concurrently with SEEG, but less than half used continuous pulse oximetry (47%) and only a few used respiratory belts (3%). Other significant intercenter technical variabilities included electrode nomenclature and choice of reference electrode. Patient care protocols varied among centers in patient-to-nurse ratio and allowed patient activity. Half of all centers had personnel who had prior experience in SEEG (50.5%); 20% of centers had adopted SEEG without any formal training.Conclusions: Stereotactic EEG has become the principal method for intracranial EEG monitoring in the majority of epilepsy surgery centers in the United States. Most report similar indications for use of SEEG, though significant variability exists in the utilization of concurrent cardiopulmonary monitoring as well as several technical and patient care practices. There is significant variability in level of background training in SEEG among practitioners. The study highlights the need for consensus statements and guidelines to benchmark SEEG practice and develop uniform standards in the United States.

We propose the use of the term 'acute hyperextension myelopathy' to categorize patients with spinal cord infarction secondary to hyperextension. DWI sequencing on MRI should be considered to evaluate for early signs of spinal cord ischemia in these patients. Use of a broader term for diagnostic classification can help include patients with spinal cord infarction due to a common mechanism.

Field-effect transistors (FET) composed of transition metal dichalcogenide (TMDC) materials have gained huge importance as biosensors due to their added advantage of high sensitivity and moderate bandgap. However, the true potential of these biosensors highly depends upon the quality of TMDC material, as well as the orientation of receptors on their surfaces. The uncontrolled orientation of receptors and screening issues due to crossing the Debye screening length while functionalizing TMDC materials is a big challenge in this field. To address these issues, we introduce a combination of high-quality monolayer WSe2 with our designed Pyrene-based receptor moiety for its ordered orientation onto the WSe2 FET biosensor. A monolayer WSe2 sheet is utilized to fabricate an ideal FET for biosensing applications, which is characterized via Raman spectroscopy, atomic force microscopy, and electrical prob station. Our construct can sensitively detect our target protein (streptavidin) with 1 pM limit of detection within a short span of 2 min, through a one-step functionalizing process. In addition to having this ultra-fast response and high sensitivity, our biosensor can be a reliable platform for point-of-care-based diagnosis.

Purpose: Neurodevelopmental disorders (NDDs) encompass a spectrum of genetically heterogeneous disorders with features that commonly include developmental delay, intellectual disability, and autism spectrum disorders. We sought to delineate the molecular and phenotypic spectrum of a novel neurodevelopmental disorder caused by variants in the GNAI1 gene. Methods: Through large cohort trio-based exome sequencing and international data-sharing, we identified 24 unrelated individuals with NDD phenotypes and a variant in GNAI1, which encodes the inhibitory Gαi1 subunit of heterotrimeric G-proteins. We collected detailed genotype and phenotype information for each affected individual. Results: We identified 16 unique variants in GNAI1 in 24 affected individuals; 23 occurred de novo and one was inherited from a mosaic parent. Most affected individuals have a severe neurodevelopmental disorder. Core features include global developmental delay, intellectual disability, hypotonia, and epilepsy. Conclusion: This collaboration establishes GNAI1 variants as a cause of NDDs. GNAI1 -related NDD is most often characterized by severe to profound delays, hypotonia, epilepsy that ranges from self-limiting to intractable, behavior problems, and variable mild dysmorphic features.

Wastewater from textile industry contains a number of pollutants which are hazardous in nature. The direct discharge of the wastewater into the environment affects its ecological status by causing various undesirable changes. As environmental fortification becomes a global anxiety, industries are finding novel solutions for mounting low-cost and environmental-friendly technologies for the dye removal from the waste. The presence of the dyes hinders sunlight penetration and disturbs the ecosystem of water. However, the treatment of wastewater with biodegradable polymer attains a vital importance as they are environmental friendly. The main objective of the work was to make an effort to develop a feasible process for the removal of dyes/color from the textile wastewater by using potato starch, which is a plant-based bio-polymer. A three-level, full-factorial design was selected, and experiments were conducted using a jar test apparatus. The main effects and interactions of dosage, pH, and temperature on the percentage color removal were analyzed. Reduction in color was analyzed using UV-2800 spectrophotometer. A threeway significant interaction was observed. However, dosage is found to be the most important parameter for dye removal using potato starch.

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Solid-state perovskite solar cells have been expeditiously developed since the past few years. However, there are a number of open questions and issues related to the perovskite devices, such as their long-term ambient stability and hysteresis in current density–voltage curves. We developed highly efficient and hysteresis-less perovskite devices by changing the frequently used TiO 2 mesoscopic layer with polymer-hybridized multidoped ZnO nanocrystals in a common n–i–p structure for the first time. The gradual adjustment of ZnO conduction band position using single- and multidopant atoms will likely enhance the power conversion efficiency (PCE) from 8.26 to 13.54%, with PCE max = 15.09%. The highest PCE avg of 13.54% was demonstrated by 2 atom % boron and 6 atom % fluorine co-doped (B, F:ZnO) nanolayers (using optimized film thickness of 160 nm) owing to their highest conductivity, carrier concentration, optical transmittance, and band-gap energy compared to other doped films. We also successfully apply a fine polyethylenimine thin layer on the doped ZnO nanolayers, causing the reduction in work function and overall demonstrating the enhancement in PCE from ∼10.86% up to 16.20%. A polymer-mixed electron-transporting layer demonstrates the remarkable PCE max of 20.74% by decreasing the trap sites in the oxide layer that probably reduces the chances of carrier interfacial recombination originated from traps and thus improves the device performance. Particularly, we produce these electron-rich multidoped ZnO nanolayers via electrospray technique, which is highly suitable for the future development of perovskite solar cells.