BMJ open
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Some critically ill patients are confirmed by continuous electroencephalography (cEEG) monitoring that non-convulsive seizure (NCS) and/or non-convulsive status epilepticus (NCSE) are causes of their depressed level of consciousness. Shortage of epilepsy specialists, especially in developing countries, is a major limiting factor in implementing cEEG in general practice. Delivery of care with tele-continous EEG (tele-cEEG) may be a potential solution as this allows specialists from a central facility to remotely assist local neurologists from distant areas in interpreting EEG findings and suggest proper treatment. No tele-cEEG programme has been implemented to help improve quality of care. Therefore, this study is conducted to assess the efficacy and cost utility of implementing tele-cEEG in critical care. ⋯ This study has been approved by the ethics committees of the Faculty of Medicine, Chulalongkorn University, and of Ramathibodi Hospital, Mahidol University, and registered on Thai Clinical Trials Registry. The results will be disseminated in a peer-reviewed journal.
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The sex ratio at birth (proportion of boys to girls) generally shows slight male preponderance but may decrease in response to societal stressors. Discrete adverse events such as terrorist attacks and disasters typically lead to a temporary decline in the sex ratio 3-5 months later, followed by resolution over around 5 months thereafter. We hypothesised that the unexpected outcome of the 2016 US presidential election may have been a societal stressor for liberal-leaning populations and thereby precipitated such an effect on the sex ratio in Canada. ⋯ The 2016 US presidential election preceded a temporary reduction in the sex ratio at birth in Canada, with the time course of changes therein matching the characteristic pattern of a discrete societal stressor.