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Fulltext A high-density 256-channel cap for dry electroencephalography

Fiedler P, Fonseca C, Supriyanto E, Zanow F, Haueisen J

Hum Brain Mapp, 2022 Mar;43(4):1295-1308.
PMID: 34796574 DOI: 10.1002/hbm.25721

High-density electroencephalography (HD-EEG) is currently limited to laboratory environments since state-of-the-art electrode caps require skilled staff and extensive preparation. We propose and evaluate a 256-channel cap with dry multipin electrodes for HD-EEG. We describe the designs of the dry electrodes made from polyurethane and coated with Ag/AgCl. We compare in a study with 30 volunteers the novel dry HD-EEG cap to a conventional gel-based cap for electrode-skin impedances, resting state EEG, and visual evoked potentials (VEP). We perform wearing tests with eight electrodes mimicking cap applications on real human and artificial skin. Average impedances below 900 kΩ for 252 out of 256 dry electrodes enables recording with state-of-the-art EEG amplifiers. For the dry EEG cap, we obtained a channel reliability of 84% and a reduction of the preparation time of 69%. After exclusion of an average of 16% (dry) and 3% (gel-based) bad channels, resting state EEG, alpha activity, and pattern reversal VEP can be recorded with less than 5% significant differences in all compared signal characteristics metrics. Volunteers reported wearing comfort of 3.6 ± 1.5 and 4.0 ± 1.8 for the dry and 2.5 ± 1.0 and 3.0 ± 1.1 for the gel-based cap prior and after the EEG recordings, respectively (scale 1-10). Wearing tests indicated that up to 3,200 applications are possible for the dry electrodes. The 256-channel HD-EEG dry electrode cap overcomes the principal limitations of HD-EEG regarding preparation complexity and allows rapid application by not medically trained persons, enabling new use cases for HD-EEG.
Novel Multipin Electrode Cap System for Dry Electroencephalography

Fiedler P, Pedrosa P, Griebel S, Fonseca C, Vaz F, Supriyanto E, et al.

Brain Topogr, 2015 Sep;28(5):647-656.
PMID: 25998854 DOI: 10.1007/s10548-015-0435-5

Current usage of electroencephalography (EEG) is limited to laboratory environments. Self-application of a multichannel wet EEG caps is practically impossible, since the application of state-of-the-art wet EEG sensors requires trained laboratory staff. We propose a novel EEG cap system with multipin dry electrodes overcoming this problem. We describe the design of a novel 24-pin dry electrode made from polyurethane and coated with Ag/AgCl. A textile cap system holds 97 of these dry electrodes. An EEG study with 20 volunteers compares the 97-channel dry EEG cap with a conventional 128-channel wet EEG cap for resting state EEG, alpha activity, eye blink artifacts and checkerboard pattern reversal visual evoked potentials. All volunteers report a good cap fit and good wearing comfort. Average impedances are below 150 kΩ for 92 out of 97 dry electrodes, enabling recording with standard EEG amplifiers. No significant differences are observed between wet and dry power spectral densities for all EEG bands. No significant differences are observed between the wet and dry global field power time courses of visual evoked potentials. The 2D interpolated topographic maps show significant differences of 3.52 and 0.44% of the map areas for the N75 and N145 VEP components, respectively. For the P100 component, no significant differences are observed. Dry multipin electrodes integrated in a textile EEG cap overcome the principle limitations of wet electrodes, allow rapid application of EEG multichannel caps by non-trained persons, and thus enable new fields of application for multichannel EEG acquisition.
Baseline characteristics of patients with heart failure with mildly reduced or preserved ejection fraction: The FINEARTS-HF trial

Solomon SD, Ostrominski JW, Vaduganathan M, Claggett B, Jhund PS, Desai AS, et al.

Eur J Heart Fail, 2024 Jun;26(6):1334-1346.
PMID: 38733212 DOI: 10.1002/ejhf.3266

AIMS: To describe the baseline characteristics of participants in the FINEARTS-HF trial, contextualized with prior trials including patients with heart failure (HF) with mildly reduced and preserved ejection fraction (HFmrEF/HFpEF). The FINEARTS-HF trial is comparing the effects of the non-steroidal mineralocorticoid receptor antagonist finerenone with placebo in reducing cardiovascular death and total worsening HF events in patients with HFmrEF/HFpEF.
METHODS AND RESULTS: Patients with symptomatic HF, left ventricular ejection fraction (LVEF) ≥40%, estimated glomerular filtration rate ≥ 25 ml/min/1.73 m2, elevated natriuretic peptide levels and evidence of structural heart disease were enrolled and randomized to finerenone titrated to a maximum of 40 mg once daily or matching placebo. We validly randomized 6001 patients to finerenone or placebo (mean age 72 ± 10 years, 46% women). The majority were New York Heart Association functional class II (69%). The baseline mean LVEF was 53 ± 8% (range 34-84%); 36% of participants had a LVEF <50% and 64% had a LVEF ≥50%. The median N-terminal pro-B-type natriuretic peptide (NT-proBNP) was 1041 (interquartile range 449-1946) pg/ml. A total of 1219 (20%) patients were enrolled during or within 7 days of a worsening HF event, and 3247 (54%) patients were enrolled within 3 months of a worsening HF event. Compared with prior large-scale HFmrEF/HFpEF trials, FINEARTS-HF participants were more likely to have recent (within 6 months) HF hospitalization and greater symptoms and functional limitations. Further, concomitant medications included a larger percentage of sodium-glucose cotransporter 2 inhibitors and angiotensin receptor-neprilysin inhibitors than previous trials.
CONCLUSIONS: FINEARTS-HF has enrolled a broad range of high-risk patients with HFmrEF and HFpEF. The trial will determine the safety and efficacy of finerenone in this population.
Finerenone in Heart Failure with Mildly Reduced or Preserved Ejection Fraction

Solomon SD, McMurray JJV, Vaduganathan M, Claggett B, Jhund PS, Desai AS, et al.

N Engl J Med, 2024 Sep 01.
PMID: 39225278 DOI: 10.1056/NEJMoa2407107

BACKGROUND: Steroidal mineralocorticoid receptor antagonists reduce morbidity and mortality among patients with heart failure and reduced ejection fraction, but their efficacy in those with heart failure and mildly reduced or preserved ejection fraction has not been established. Data regarding the efficacy and safety of the nonsteroidal mineralocorticoid receptor antagonist finerenone in patients with heart failure and mildly reduced or preserved ejection fraction are needed.
METHODS: In this international, double-blind trial, we randomly assigned patients with heart failure and a left ventricular ejection fraction of 40% or greater, in a 1:1 ratio, to receive finerenone (at a maximum dose of 20 mg or 40 mg once daily) or matching placebo, in addition to usual therapy. The primary outcome was a composite of total worsening heart failure events (with an event defined as a first or recurrent unplanned hospitalization or urgent visit for heart failure) and death from cardiovascular causes. The components of the primary outcome and safety were also assessed.
RESULTS: Over a median follow-up of 32 months, 1083 primary-outcome events occurred in 624 of 3003 patients in the finerenone group, and 1283 primary-outcome events occurred in 719 of 2998 patients in the placebo group (rate ratio, 0.84; 95% confidence interval [CI], 0.74 to 0.95; P = 0.007). The total number of worsening heart failure events was 842 in the finerenone group and 1024 in the placebo group (rate ratio, 0.82; 95% CI, 0.71 to 0.94; P = 0.006). The percentage of patients who died from cardiovascular causes was 8.1% and 8.7%, respectively (hazard ratio, 0.93; 95% CI, 0.78 to 1.11). Finerenone was associated with an increased risk of hyperkalemia and a reduced risk of hypokalemia.
CONCLUSIONS: In patients with heart failure and mildly reduced or preserved ejection fraction, finerenone resulted in a significantly lower rate of a composite of total worsening heart failure events and death from cardiovascular causes than placebo. (Funded by Bayer; FINEARTS-HF ClinicalTrials.gov number, NCT04435626.).
Fulltext Predicting attitudinal and behavioral responses to COVID-19 pandemic using machine learning

Pavlović T, Azevedo F, De K, Riaño-Moreno JC, Maglić M, Gkinopoulos T, et al.

PNAS Nexus, 2022 Jul;1(3):pgac093.
PMID: 35990802 DOI: 10.1093/pnasnexus/pgac093

At the beginning of 2020, COVID-19 became a global problem. Despite all the efforts to emphasize the relevance of preventive measures, not everyone adhered to them. Thus, learning more about the characteristics determining attitudinal and behavioral responses to the pandemic is crucial to improving future interventions. In this study, we applied machine learning on the multinational data collected by the International Collaboration on the Social and Moral Psychology of COVID-19 (N = 51,404) to test the predictive efficacy of constructs from social, moral, cognitive, and personality psychology, as well as socio-demographic factors, in the attitudinal and behavioral responses to the pandemic. The results point to several valuable insights. Internalized moral identity provided the most consistent predictive contribution-individuals perceiving moral traits as central to their self-concept reported higher adherence to preventive measures. Similar results were found for morality as cooperation, symbolized moral identity, self-control, open-mindedness, and collective narcissism, while the inverse relationship was evident for the endorsement of conspiracy theories. However, we also found a non-neglible variability in the explained variance and predictive contributions with respect to macro-level factors such as the pandemic stage or cultural region. Overall, the results underscore the importance of morality-related and contextual factors in understanding adherence to public health recommendations during the pandemic.