If a serum prolactin concentration is greater than three times the baseline when taken within one hour of syncope, then in the absence of test “modifiers”: (1) the patient is nine times more likely to have suffered a GTCS as compared with a pseudoseizure positive LR = 8.92 (95% CI (1.31 to 60.91)), SN = 0.62 (95% CI (0.40 to 0.83)), SP = 0.89 (95% CI (0.60 to 0.98)) and (2) five times more likely to have suffered a GTCS as compared with non-convulsive syncope positive LR 4.60 (95% CI (1.25 to 16.90)), SN = 0.71 (95% CI (0.49 to 0.87)), SP = 0.85 (95% CI (0.55 to 0.98)).Ĭonclusion: A positive test result is highly predictive of a GTCS, however a negative test result does not necessarily exclude a seizure. Results: Of 13 relevant studies only three met the criteria for evaluation. Studies were evaluated for eligibility and quality and data extracted to calculate sensitivity (SN), specificity (SP), and likelihood ratios (LR).

Medline, EMBASE, PubMed, the Cochrane Library were searched to identify relevant studies. Methods: A three part question was defined.

Load up Serum and we think you’ll be able to notice both what you hear (solid high frequencies, extending flat all the way up to the limits of hearing) as well as what you don’t hear (no unwanted mud or aliasing gibberish- just good, clean sound).Objective: A meta-analysis of studies of the usefulness of raised serum prolactin in diagnosing generalised tonic-clonic seizures (GTCS) in patients presenting to the accident and emergency (A&E) department after a single episode of syncope. In Serum, the native-mode (default) playback of oscillators operates with an ultra high-precision resampling, yielding an astonishingly inaudible signal-to-noise (for instance, -150 dB on a sawtooth played at 1 Khz at 44100)! This requires a lot of calculations, so Serum’s oscillator playback has been aggressively optimized using SSE2 instructions to allow for this high-quality playback without taxing your CPU any more than the typical (decent quality) soft synth already does. Many popular wavetable synthesizers are astonishingly bad at suppressing artifacts - even on a high-quality setting some create artifacts as high as -36 dB to -60 dB (level difference between fundamental on artifacts) which is well audible, and furthermore often dampening the highest wanted audible frequencies in the process, to try and suppress this unwanted sound. Artifacts mean that you are (perhaps unknowingly) crowding your mix with unwanted tones / frequencies. Without considerable care and a whole lot of number crunching, this process will create audible artifacts. Playback of wavetables requires digital resampling to play different frequencies.

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