First seizure while driving: Clinical features and prognosis.

Objectives: Patients with epilepsy are ineligible to drive until seizure free for an appropriate period given the risk of a seizure-related motor vehicle accident. Driving restrictions also apply to patients after their first-ever seizure. However, it is unclear whether a longer period of non-driving is required if the first seizure occurred while driving.

Co-administration of midazolam and psilocybin: differential effects on subjective quality versus memory of the psychedelic experience.

Aspects of the acute experience induced by the serotonergic psychedelic psilocybin predict symptomatic relief in multiple psychiatric disorders and improved well-being in healthy participants, but whether these therapeutic effects are immediate or are based on memories of the experience is unclear. To examine this, we co-administered psilocybin (25 mg) with the amnestic benzodiazepine midazolam in 8 healthy participants and assayed the subjective quality of, and memory for, the dosing-day experience. We identified a midazolam dose that allowed a conscious psychedelic experience to occur while partially impairing memory for the experience.

Can Psychedelic Use Benefit Meditation Practice? Examining Individual, Psychedelic, and Meditation-Related Factors.

Introduction: Meditation practice and psychedelic use have attracted increasing attention in the public sphere and scientific research. Both methods induce non-ordinary states of consciousness that may have significant therapeutic benefits. Thus, there is growing scientific interest in potential synergies between psychedelic use and meditation practice with some research suggesting that psychedelics may benefit meditation practice.

First-ever seizure and eligibility for commercial motor vehicle driving.

Background: After a first-ever seizure, 6 months of seizure freedom is usually required before returning to driving a private motor vehicle, after which the annual risk of seizure recurrence has fallen to ≤20%. Stricter criteria apply for commercial driver's licence (CDL) holders, and a longer period of seizure freedom sufficient for the annual risk of recurrence to be <2% is recommended. However, CDL guidelines are based on little data with few studies having long-term follow-up.

Biological export production controls upper ocean calcium carbonate dissolution and CO buffer capacity.

Marine biogenic calcium carbonate (CaCO) cycles play a key role in ecosystems and in regulating the ocean's ability to absorb atmospheric carbon dioxide (CO). However, the drivers and magnitude of CaCO cycling are not well understood, especially for the upper ocean. Here, we provide global-scale evidence that heterotrophic respiration in settling marine aggregates may produce localized undersaturated microenvironments in which CaCO particles rapidly dissolve, producing excess alkalinity in the upper ocean.

Long-term physical and psychiatric morbidities and mortality of untreated, deferred, and immediately treated epilepsy.

Objective: In Australia, 30% of newly diagnosed epilepsy patients were not immediately treated at diagnosis. We explored health outcomes between patients receiving immediate, deferred, or no treatment, and compared them to the general population.

Methods: Adults with newly diagnosed epilepsy in Western Australia between 1999 and 2016 were linked with statewide health care data collections.

Visualizing Compassion: Episodic Simulation as Contemplative Practice.

Contemplative interventions designed to cultivate compassion are receiving increasing empirical attention. Accumulating evidence suggests that these interventions bolster prosocial motivation and warmth towards others. Less is known about how these practices impact compassion in everyday life.

Adult-onset Kufs disease.

A young man from Pakistan had his first-ever tonic-clonic seizure while playing cricket. Since age 12 years, he had reported involuntary jerks and tremulousness, sometimes with falls, particularly with bright lights. Family history included a brother who developed seizures with myoclonus in his mid-20s and parental consanguinity.

First seizure from sleep: Clinical features and prognosis.

Objectives: Patients with a first-ever unprovoked seizure commonly have subsequent seizures and identifying predictors of recurrence has important management implications. Both prior brain insult and epileptiform abnormalities on electroencephalography (EEG) are established predictors of seizure recurrence. Some studies suggest that a first-ever seizure from sleep has a higher likelihood of recurrence.

Coral adaptive capacity insufficient to halt global transition of coral reefs into net erosion under climate change.

Projecting the effects of climate change on net reef calcium carbonate production is critical to understanding the future impacts on ecosystem function, but prior estimates have not included corals' natural adaptive capacity to such change. Here we estimate how the ability of symbionts to evolve tolerance to heat stress, or for coral hosts to shuffle to favourable symbionts, and their combination, may influence responses to the combined impacts of ocean warming and acidification under three representative concentration pathway (RCP) emissions scenarios (RCP2.6, RCP4.

Mortality after a first-ever unprovoked seizure.

Objective: Although increased mortality associated with epilepsy is well understood, data in patients after their first-ever seizure are limited. We aimed to assess mortality after a first-ever unprovoked seizure and identify causes of death (CODs) and risk factors.

Methods: A prospective cohort study was undertaken of patients with first-ever unprovoked seizure between 1999 and 2015 in Western Australia.

Can the Academic and Experiential Study of Flourishing Improve Flourishing in College Students? A Multi-University Study.

Objectives: Significant concerns have been raised about the "mental health crisis" on college campuses, with attention turning to what colleges can do beyond counseling services to address students' mental health and well-being. We examined whether primarily first-year (89.1%) undergraduate students (651) who enrolled in the Art and Science of Human Flourishing (ASHF), a novel academic and experiential for-credit elective course on human flourishing, would demonstrate improved mental health and strengthen skills, perspectives, and behaviors associated with flourishing relative to students who did not enroll in this course.

Risk factors and consequences of self-discontinuation of treatment by patients with newly diagnosed epilepsy.

Objective: Patients with epilepsy not uncommonly self-discontinue treatment with antiseizure medications (ASM). The rate, reasons for this, and consequences have not been well studied.

Methods: We analyzed self-discontinuation of ASM treatment in patients with recently diagnosed epilepsy via review of clinic letters and hospital correspondence in a prospective cohort of first seizure patients.

Identification and Characterization of Pure Sleep Epilepsy in a Cohort of Patients With a First Seizure.

Background And Objectives: Our aim was to study the development of pure sleep epilepsy after a first-ever seizure from sleep in adults.

Methods: This was a prospective observational study of patients seen at a tertiary hospital-based first seizure clinic between 2000 and 2011. Adults with a first-ever unprovoked seizure from sleep were consecutively recruited.

Cultivating Emotional Granularity.

An emerging focus in affective science is the expertise that underlies healthy emotionality. A growing literature highlights emotional granularity - the ability to make fine-grained distinctions in one's affective feelings - as an important skill. Cross-sectional evidence indicating the benefits of emotional granularity raises the question of how emotional granularity might be intentionally cultivated through training.

Next-generation ensemble projections reveal higher climate risks for marine ecosystems.

Projections of climate change impacts on marine ecosystems have revealed long-term declines in global marine animal biomass and unevenly distributed impacts on fisheries. Here we apply an enhanced suite of global marine ecosystem models from the Fisheries and Marine Ecosystem Model Intercomparison Project (Fish-MIP), forced by new-generation Earth system model outputs from Phase 6 of the Coupled Model Intercomparison Project (CMIP6), to provide insights into how projected climate change will affect future ocean ecosystems. Compared with the previous generation CMIP5-forced Fish-MIP ensemble, the new ensemble ecosystem simulations show a greater decline in mean global ocean animal biomass under both strong-mitigation and high-emissions scenarios due to elevated warming, despite greater uncertainty in net primary production in the high-emissions scenario.

Does variability across three universities in the implementation of a college course on human flourishing affect student outcomes?

Objective: This study explores whether variability in the implementation of an undergraduate course on human flourishing is differentially associated with student outcomes.

Participants: 101 students in the "Art and Science of Human Flourishing" course across three large, public, R1 universities in Fall 2018 participated in the study.

Methods: Formative course data included researcher observations of weekly class pedagogy, students' weekly meditation practice logs and end-of-course assessments, and pre/post surveys measuring changes in participating students' outcomes related to flourishing (e.

Short- and long-term outcomes of immediate and delayed treatment in epilepsy diagnosed after one or multiple seizures.

Objectives: To compare the outcomes between immediate and deferred treatments in patients diagnosed after one or multiple (two or more) seizures.

Methods: Our observational study investigated seizure recurrence and 12-month seizure remission in patients with newly diagnosed epilepsy, comparing immediate to deferred treatment in patients diagnosed after one seizure or after two or more seizures.

Results: Of 598 patients (62% male, median age 39 years), 347 (58%) were treated at diagnosis and 251 (42%) received deferred or no treatment.

No Detectable Electroencephalographic Activity After Clinical Declaration of Death Among Tibetan Buddhist Meditators in Apparent Tukdam, a Putative Postmortem Meditation State.

Recent EEG studies on the early postmortem interval that suggest the persistence of electrophysiological coherence and connectivity in the brain of animals and humans reinforce the need for further investigation of the relationship between the brain's activity and the dying process. Neuroscience is now in a position to empirically evaluate the extended process of dying and, more specifically, to investigate the possibility of brain activity following the cessation of cardiac and respiratory function. Under the direction of the Center for Healthy Minds at the University of Wisconsin-Madison, research was conducted in India on a postmortem meditative state cultivated by some Tibetan Buddhist practitioners in which decomposition is putatively delayed.

Starting a new anti-seizure medication in drug-resistant epilepsy: Add-on or substitute?

Objectives: Randomized studies in drug-resistant epilepsy (DRE) typically involve addition of a new anti-seizure medication (ASM). However, in clinical practice, if the patient is already taking multiple ASMs, then substitution of one of the current ASMs commonly occurs, despite little evidence supporting this approach.

Methods: Longitudinal prospective study of seizure outcome after commencing a previously untried ASM in patients with DRE.

Time of Emergence and Large Ensemble Intercomparison for Ocean Biogeochemical Trends.

Anthropogenically forced changes in ocean biogeochemistry are underway and critical for the ocean carbon sink and marine habitat. Detecting such changes in ocean biogeochemistry will require quantification of the magnitude of the change (anthropogenic signal) and the natural variability inherent to the climate system (noise). Here we use Large Ensemble (LE) experiments from four Earth system models (ESMs) with multiple emissions scenarios to estimate Time of Emergence (ToE) and partition projection uncertainty for anthropogenic signals in five biogeochemically important upper-ocean variables.

Tracking Improvement in Simulated Marine Biogeochemistry Between CMIP5 and CMIP6.

Purpose Of Review: The changes or updates in ocean biogeochemistry component have been mapped between CMIP5 and CMIP6 model versions, and an assessment made of how far these have led to improvements in the simulated mean state of marine biogeochemical models within the current generation of Earth system models (ESMs).

Recent Findings: The representation of marine biogeochemistry has progressed within the current generation of Earth system models. However, it remains difficult to identify which model updates are responsible for a given improvement.

Author Correction: Hot Spots of Carbon and Alkalinity Cycling in the Coastal Oceans.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

Microbial evolutionary strategies in a dynamic ocean.

Marine microbes form the base of ocean food webs and drive ocean biogeochemical cycling. Yet little is known about the ability of microbial populations to adapt as they are advected through changing conditions. Here, we investigated the interplay between physical and biological timescales using a model of adaptation and an eddy-resolving ocean circulation climate model.