bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence of traumatic psychological stress reactions in children and parents following paediatric surgery: a systematic review and meta-analysis
Authors: Turgoose David Paul , Kerr Stephanie , De Coppi Paolo , Blackburn Simon , Wilkinson Simon , Rooney Natasha , Martin Richard , Gray Suzanne , Hudson Lee Duncan 
Published: July 2021

BackgroundChildren undergoing surgery and their parents are at risk of developing post-traumatic stress reactions. We systematically reviewed the literature to understand the prevalence of this issue, as well as potential risk factors.MethodsWe conducted a systematic review and meta-analysis, using PubMed, PsycInfo, Web of Science and Google Scholar, with searches conducted in February 2021. Papers were included if they measured post-traumatic stress in children and/or parents following paediatric surgery and were excluded if they did not use a validated measure of post-traumatic stress. Data were extracted from published reports.FindingsOur search yielded a total of 1672 papers, of which 16 met our inclusion criteria. In meta-analysis, pooled studies of children estimated an overall prevalence of 16% meeting criteria for post-traumatic stress disorder post surgery (N=187, 95% CI 5% to 31%, I2=80%). After pooling studies of parents, overall prevalence was estimated at 23% (N=1444, 95% CI 16% to 31%, I2=91%). Prevalence rates were higher than those reported in the general population. Risk factors reported within studies included length of stay, level of social support and parental mental health.InterpretationThere is consistent evidence of traumatic stress following surgery in childhood which warrants further investigation. Those delivering surgical care to children would benefit from a raised awareness of the potential for post-traumatic stress in their patients and their families, including offering screening and support.
Coronary artery calcium score may be a novel predictor of COVID-19 prognosis: a retrospective study
Authors: Takeshita Yuichiro , Terada Jiro , Fujita Retsu , Hirasawa Yasutaka , Kinoshita Taku , Isaka Yuri , Kinouchi Toru , Tajima Hiroshi , Tada Yuji , Kiryu Shigeru , Tsushima Kenji 
Published: July 2021

BackgroundAlthough several studies have reported an association between atherosclerosis-related diseases and COVID-19, the relationship between COVID-19 severity and atherosclerosis progression remains unclear. The aim of this study is to determine the coronary artery calcium score (CACS) prognostic value in patients with COVID-19 using indices such as deterioration in oxygenation and CT images of the chest.MethodsThis was a single-centre retrospective study of 53 consecutive patients with COVID-19 in Narita who were admitted to our hospital between March 2020 and August 2020. CACS was calculated based on non-gated CT scans of the chest performed on admission day. The patients were divided into the following two groups based on CACS: group 1 (CACS ≥180, n=11) and group 2 (CACS <180, n=42). Following univariate analysis of the main variables, multivariate analysis of variables that may be associated with COVID-19 progression was performed.ResultsMultivariable logistic regression analysis of age, sex, smoking history, diabetes, hypertension, dyslipidaemia, number of days from symptom onset to hospitalisation and CACS of ≥180 was performed. It revealed that unlike CACS of <180, CACS of ≥180 is associated with exacerbation of oxygenation or CT images of the chest during hospitalisation (OR: 12.879, 95% CI: 1.399 to 380.401). Furthermore, this model of eight variables showed good calibration (Hosmer-Lemeshow p=0.119).ConclusionCACS may be a prognosis marker of COVID-19 severity. Although coronary artery calcification is not typically assessed in pneumonia cases, it may provide a valuable clinical indicator for predicting severe COVID-19 outcomes.
#3101 Imbalanced basal ganglia connectivity is associated with motor deficits and apathy in Huntingtons disease: first evidence from human in vivo neuroimaging
Authors: Nair Akshay , Razi Adeel , Gregory Sarah , Rutledge Robb , Rees Geraint , Tabrizi Sarah 
Published: July 2021

BackgroundThe gating of movement in humans is thought to depend on activity within the cortico-striato-thalamic loops. Within these loops, emerging from the cells of the striatum, run two opponent pathways the direct and indirect pathway. Both are complex and polysynaptic but the overall effect of activity within these pathways is to encourage and inhibit movement respectively. In Huntingtons disease (HD), the preferential early loss of striatal neurons forming the indirect pathway is thought to lead to disinhibition that gives rise to the characteristic motor features of the condition. But early HD is also specifically associated with apathy, a failure to engage in goal-directed movement. We hypothesised that in HD, motor signs and apathy may be selectively correlated with indirect and direct pathway dysfunction respectively.MethodsUsing a novel technique for estimating dynamic effective connectivity of the basal ganglia, we tested both of these hypotheses in vivo for the first time in a large cohort of patients with prodromal HD (n = 94). We used spectral dynamic casual modelling of resting state fMRI data to model effective connectivity in a model of these cortico-striatal pathways. We used an advanced approach at the group level by combining Parametric Empirical Bayes and Bayesian Model Reduction procedure to generate large number of competing models and compare them by using Bayesian model comparison.ResultsWith this fully Bayesian approach, associations between clinical measures and connectivity parameters emerge de novo from the data. We found very strong evidence (posterior probability > 0.99) to support both of our hypotheses. Firstly, more severe motor signs in HD were associated with altered connectivity in the indirect pathway and by comparison, loss of goal-direct behaviour or apathy, was associated with changes in the direct pathway component of our model.ConclusionsThe empirical evidence we provide here is the first in vivo demonstration that imbalanced basal ganglia connectivity may play an important role in the pathogenesis of some of commonest and disabling features of HD and may have important implications for therapeutics.
#2950 Should the presence of neurodegenerative disease alter our management and understanding of psychiatric comorbidities?
Authors: Blake Jack , List Penny , El-Nimr George 
Published: July 2021

As people are living longer, we are seeing more neurodegenerative diseases (NDs). NDs have both neurological and psychiatric manifestations. Depression and anxiety are common comorbidities in Alzheimers and Parkinsons disease. The diagnosis and intervention of depression and anxiety on the background of the aforementioned NDs is complicated by cognitive and motor disturbance. We aim to capture a general overview of the diagnostic and management challenges and compare these with the National Institute for Health and Care Excellence (NICE) guidance to identify any disparities that may exist.A general review of this topic was sought through the MEDLINE database. Papers matching search terms were selected based on size, novelty and relevance to diagnostics or treatment of the psychiatric complications, namely depression and anxiety, in Parkinsons (PD) and Alzheimers disease (AD). Large systematic reviews helped establish strong evidence, novelty allowed for emerging ideas to be identified and all articles were relevant to either PD or AD.The general approach to these psychiatric manifestations by non-specialists is as a one-size-fits-all approach. The efficacy of pharmacological treatments is questionable as often the side effects are much worse in this population and the action may vary on the degenerating anatomy. Many non-pharmacological treatments exist with some less traditional methods showing positive results including therapies focused on informal carers.Drawing on the expertise of neuropsychiatrists and non-conventional therapies could yield better management of these patients and inform NICE guidance which would improve practice nationally.
#3118 Tic-severity moderators: a systematic review on the subjectivity of external and internal factors in moderating tic-severity in Tourette’s syndrome
Authors: Conti Francesca , Tyagi Himanshu 
Published: July 2021

ObjectivesChanges in the severity of tics in Tourettes syndrome (TS), as seen with variations in the intensity or frequency of tics, can be moderated by a variety of independent simple or complex factors suchasexternalorinternalstimulioverlaidwithpsychologicalandphysiological variables. Identifying such moderators has important clinical implications as it can aid clinicians in adjusting interventions. Here we review research literature related to tic-severity moderators and their tic-worsening, tic-improving and neutral effects in individuals with TS with the aim to create a clinical inventory of moderating variables.MethodsA literature search using terms relating to tic severity, tic frequency, factors and moderators was conducted on Ovid Medline, Psych Info, APA Psych Articles, ProQuest,Scopus and PubMed following PRISMA guidelines. The criteria for this review included any published study, review and meta-analysis after the last review in 2008, investigating external and internal factors that had a tic-worsening, improving or neutral effect on children, adolescents or adults with TS and comorbidities.Results225 studies were initially identified after deduplication. A variety of tic severity moderators were identified with the most prominent being the effects of exe, sleep, distraction and comorbidities such as ADHD. However, an interesting finding was the high variability in these tic-moderating effects, as the same factor was tic-worsening in some patients and tic-improving in others, highlighting the subjectivity of these effects on tic severity. It was also noted that most of there viewed research did not report the possibility of a neutral effect.ConclusionsAs previous research has looked at these moderators in a dichotomous way, clinicians and researchers should be made more aware of the existence and variability of these tic severity moderators and of their highly subjective effects. This also has important, direct implications for the psychological assessment and treatment of tics. This review invites future research and clinicians to take this holistic approach on the effects ontic severity into consideration.
#3116 Preliminary findings of visual hallucinations in organic psychosis: a meta-analysis
Authors: Dadwal Amber Kaur , Teixeira-Dias Maria , Blackman Graham 
Published: July 2021

Objectives/AimsIn some cases, psychosis arises due to a secondary, or organic cause. Identifying these cases early on is important in ensuring these patients receive appropriate management, which may reverse the underlying cause. Determining whether the psychiatric phenotype differs in patients with an organic cause would be a major advance in the field. We sought to determine whether the presence and content of visual hallucinations was associated with an organic cause of psychosis.MethodsA meta-analysis of case-control studies was conducted. PubMed, OVID, MEDLINE, Embase, Psych INFO and Global Health databases were searched without date restrictions by two researchers using the keywords Psychos* AND Schizophreni* AND Visual hallucinat*. The inclusion criteria were a) reported frequency of visual hallucinations, b) categorisation of patients into having an organic or non-organic psychosis and c) publication in English. A random-effects model, following the DerSimonian and Laird method, was used to pool studies to generate overall odds ratios (OR) and 95% confidence intervals (CI).ResultsFifteen studies (890 organic and 955 non-organic psychosis patients) were included. Visual hallucinations were significantly associated with organic psychosis (OR = 3.17, 95% CI = 1.92, 5.24), however there was moderate between-study heterogeneity (I2 = 70%).In the 4 studies where content was reported (158 organic and 52 non-organic psychosis patients), visual hallucinations most frequently took the form of people in both organic (n = 76; 48.1%) and non-organic psychosis (n = 31; 59.6%). However, inanimate objects were significantly associated with organic psychosis (χ2(1) = 5.44, p = 0.020).ConclusionsVisual hallucinations are associated with organic psychosis. The presence of visual hallucinations, and in particular inanimate objects, may serve as a potential red flag for an organic psychosis. Findings have important clinical utility, as a simple and convenient bedside assessment to inform which patients would benefit from further neurological investigation.
#3104 Is dipsogenic diabetes insipidus the same condition as psychogenic polydipsia?
Authors: Leon Ewelina de , Yorston Graeme 
Published: July 2021

Objectives/AimsTraumatic brain injury is a common cause of permanent or long-term disability,1 and up to 80% of people with moderate to severe brain injury have some degree of pituitary insufficiency. Endocrine disruption has been documented in medical literature since the 1940s,2-4 where central diabetes insipidus has been described as a common transient complication which causes polydipsia (insatiable thirst). However, polydipsia can be caused by other conditions. It is classified into dipsogenic, in a syndrome of disordered thirst-regulating mechanism in patients without psychiatric disease called dipsogenic diabetes insipidus, psychogenic, as a compulsive water drinking in patients with psychiatric conditions referred to as psychogenic polydipsia or psychogenic diabetes insipidus and iatrogenic where large quantities of water are consumed for health benefits. All of which are referred to as primary polydipsia if these conditions cannot be distinguished. Dipsogenic diabetes insipidus and psychogenic polydipsia can be easily mixed up, misdiagnosed or even unrecognised, mainly because their pathophysiology is still unclear. Are these conditions different, or is there anything that can relate them to each other? With this literature review, we are aiming to find the link between subsets of polydipsia after brain trauma, to compare proposed differential diagnosis and their functionality in clinical settings.MethodA literature review was conducted following a search of MEDLINE, CINAHL Plus, APA PsycArticles, APA PsycBooks, APA PsycInfo databases from 1858 onwards.ResultsWe will present our findings from the literature review.ConclusionPolydipsia is a common clinical problem and requires careful evaluation and management to prevent long term neurological sequelae, and there are no evidence-based treatment guidelines.References National Institute of Health and Care Excellence (NICE). (2019). Head Injury. CG176. Retrieved from: https://www.nice.org.uk/guidance/cg176 Escamilla RF, Lisser H. Simmonds disease: A clinical study with revie of the literature; Differentiation from anorexia nervosa by statistical analysis of 595 cases, 101 of which were provided pathologically. The Journal of Clinical Endocrinology & Metabolism 1942;2(2):6596. Porter RJ, Miller RA. Diabetes insipidus following closed head injury. Journal of Neurology, Neurosurgery, and Psychiatry 1946;11:528562. Webb NE, Little B, Loupee-Wilson S, Power EM. Traumatic brain injury and neuro-endocrine disruption: medical and psychosocial rehabilitation. NeuroRehabilitation (Reading, Mass.) 2014;34(4):625636.
#3100 A service evaluation of the experiences of patients with functional neurological disorders within the NHS
Authors: OKeeffe Shauna , Chowdhury Ibrahim , Sinanaj Anila , Ewang Iberedem , Blain Camilla , Teodoro Tiago , Edwards Mark , Yogarajah Mahinda 
Published: July 2021

Objectives/AimsPrevious research into Functional Neurological Disorder (FND) has shown that there are significant barriers in providing multidisciplinary, patient-centred care for these patients, including stigmatising attitudes, poor knowledge about FND, and a lack of structured care pathways. However, there has been no specific research into patient experiences of care for FND within NHS services to date, and whether these experiences meet the standards of care expected for long-term neurological conditions (LTNCs). The current study thus aimed to investigate the types of problems experienced by FND patients, and whether they differed in frequency and type to patients with another LTNC, multiple sclerosis (MS).MethodsBoth FND (n = 40) and MS patients (n = 37) were recruited from tertiary neurology clinics at an NHS hospital and completed two questionnaires on their experiences of health and social care services and on their level of disability.ResultsThe results indicated significant differences in experiences of care between the two patient groups, with FND patients reporting significantly more problems (p<0.001)overall. These problems were reported in relation to their diagnosis and treatment, relationships with healthcare professionals, and difficulties in accessing services. This was despite FND patients reporting significantly higher levels of disability (p=0.001), highlighting the burden of care experienced by FND patients as a result of these difficulties in accessing and receiving care. A small sample size, specificity to a single neurology centre, and a cross-sectional design are acknowledged as limitations.ConclusionsTogether, these results suggest that current care for FND patients is not meeting the standards expected for LTNCs, and highlight the need for further research and the development of structured, multidisciplinary pathways with a patient-centred approach.
#3064 Prevalence of, and risk factors for, dementia in adult outpatient referrals to a regional referral hospital in Arusha, Northern Tanzania
Authors: Roe Caitlin , Safic Ssenku , Mwaipopo Lawtiko , Dotchin Catherine , Klaptocz Johanna , Gray Keith , Joseph Marcella , Walker Richard 
Published: July 2021

ObjectivesThe global burden of dementia is increasing, with the greatest increase predicted to occur in sub-Saharan Africa (SSA). Despite this there are limited previous data on the prevalence of, and risk factors for, dementia in SSA. This study aimed to estimate the prevalence of dementia, and investigate its associations, in those aged 60 years and older attending the outpatient department of Mount Meru Hospital in northern Tanzania. This is the first hospital-based outpatient dementia prevalence and risk factors study to be conducted in an east African population.MethodsThis was a one-phase cross-sectional study. Adults aged 60 years and over attending medical outpatients were screened for dementia using The Identification and Intervention for Dementia in Elderly Africans cognitive screening tool. Those who scored ≤9 were clinically assessed using the DSM-IV criteria. Demographic, medical comorbidity and lifestyle information were collected during a clinical assessment.ResultsPrevalence of dementia was 5.0% (95% confidence interval: 3.7-6.3). Binary logistic regression found female sex (odds ratio (OR)=2.778), having no formal education(OR=6.088), quantity of alcohol consumption (units/week) (OR=1.080), uncorrected visual impairment (OR=4.260), body mass index <18.5kg/m2 (OR=6.588) and stroke (OR=15.790with wide 95% confidence interval (3.48-74.475)) to be significantly, independently associated with dementia.ConclusionsThe prevalence of dementia in this population is lower than previously reported community-based rates in Tanzania, and similar to those in high-income countries.This is the first time the association between uncorrected visual impairment and dementia has been reported in SSA. Other associations identified are in keeping with previous literature. Further research on the management of dementia and its risk factors, and the support and education of carers and patients in east African populations is required to advise future policy.
Simulating the effect of climate change on performance of a monolayer cover combined with an elevated water table placed on acid-generating mine tailings
Authors: Lieber Elodie , Demers Isabelle , Pabst Thomas , Bresson Émilie 
Published: July 2021

Several reclamation approaches were developed in the last decades to control acid mine drainage from tailings storage facilities, including the monolayer cover combined with an elevated water table. Its performance is dependent on water table elevation and tailings saturation and is directly affected by climatic conditions; therefore, climate change needs to be taken into account to design resilient reclamation systems. The objective of this research was to evaluate three approaches to simulate climate change and compare the impact on reclamation performance up to year 2100. Numerical simulations were calibrated using experimental field data, and future weather conditions were established based on three climate change scenarios adapted for local conditions. Results showed that the projected impact of climate change varied depending on the approach used. Simpler and more conservative approaches indicated that reclamation would eventually fail following an increase of droughts during future summers. However, 80 year simulations showed that reclamation failures (evaluated as oxygen flux) could be limited to a few isolated summers and that a well-designed monolayer cover with elevated water table appeared to remain efficient in the long term. Overall, the probability to exceed the oxygen flux target of 1 mol/m2/year did not exceed 2% for the simulated conditions.
Clonal variation in coppiced and uncoppiced growth, root sprout stem formation, and biomass partitioning in Salix interior on two highly disturbed site types
Authors: Mosseler Alex , Major John E. 
Published: July 2021

Salix interior Rowlee (INT) is a wide-ranging North American willow from the small taxonomic group Salix section Longifoliae, notable for its ability to form multi-stemmed vegetative stem colonies arising via root sprouts (RS) from a shallow horizontal root network. This study quantifies biomass production for both 1-year-old coppiced plants and the original 4-year-old plants established from dormant, unrooted stem cuttings, as well as for the RS stems associated with each ortet (original mother plant) using eight selected INT clones established on two distinct site types. Significantly greater coppiced and uncoppiced ortet stem dry mass was recorded on coarse-textured, shale rock overburden (SO); possibly due to significantly greater fertility, compared to adjacent gravel outwash deposits (GD), which had greater RS stem mass. The total stem dry mass (ortet + associated RS) was comparable across the two different site types for both the 1-year-old coppiced plants and the 4-year-old uncoppiced plants, showing rapid recovery of biomass growth and yield in the year following coppicing. Significant clonal differences, as well as site type × clone interactions, were found for ortet stem dry mass, especially on SO sites, indicating that clonal selection might be useful to increase biomass production on different site types. When expressed as a fraction of total stem dry mass produced on 2 m × 2 m biomass plots, the RS component represented a significant 57% of total stem dry mass per plot (ortet + associated RS) on GD sites and only 18% on SO sites. The use of colony-forming willows such as INT minimizes the need for periodic replanting, providing a cost advantage over conventional short-rotation, coppice-based woody biomass plantations using species that do not have the ability to produce new stems via root sprouting. This root-sprouting trait enables INT to rapidly colonize and spread on difficult-to-manage sites, making it suitable for use in land reclamation.
Magnetized Kerr–Newman–Taub-NUT spacetimes
Authors: Ghezelbash Masoud , Siahaan Haryanto M. 
Published: July 2021

AbstractWe find a new class of exact solutions in the Einstein–Maxwell theory by employing the Ernst magnetization process to the Kerr–Newman–Taub-NUT spacetimes. We study the solutions and find that they are regular everywhere. We also find the quasilocal conserved quantities for the spacetimes, the corresponding Smarr formula and the first law of thermodynamics.