bluuebunny/crossref_metadata_2025_split huggingface dataset:
012 Neurological signs in a general neurology face to face clinic during the Covid-19 pandemic
Authors: Wieshmann Udo 
Published: August 2022

During the Covid-19 pandemic attempts have been made to manage patients with neurological symptoms remotely without a neurological examination.To determine the prevalence of neurological signs we prospectively assessed 101 consecutive patients who were a referred to a general neurology clinic.Three patients did not attend, leaving 98 patients (58 female, 40 male, mean age 51.0 years, standard deviation 19.9 years.37 patients had neurological signs. (Cognitive impairment n=3, spastic tetraparesis n=1, spastic hemipa- resis n=2, hemianopia n=1, ataxia n=1, gait apraxia n=1, postural tremor n=2, bradykinesia and rigidity n=9, functional tremor n=4, anosmia n=1, combined upper and lower motor neuron signs, n=2, radicular distribution numbness n=1, distal symmetrical weakness and hypoaesthesia n=5, peripheral nerve hypo- aesthesia n=2, fatigability and lid lag n=2.)Our data showed that a large proportion of general neurology patients had neurological signs.
016 The evolution of neurological admissions preceding and during the Covid-19 pandemic
Authors: Singh Prisca , Hassan-Smith Ghaniah 
Published: August 2022

The novel SARS-CoV-2 virus has affected healthcare services across the world, with the impact on neurology services being no exception to the global disruption. There is variable reporting of neurological conditions during the pandemic. This work explores the patterns of admission to neurology wards in a large tertiary centre within the UK, providing insight into the real-world experience of neurologists at the forefront of the pandemic.Comparing data from the period March 2019-March 2020, with March 2020-March 2021, we wished to identify and quantify specific alterations in caseload. Patient length of stay decreased by an average of 5 days during the pandemic, but the total number of admissions increased by 27%. Specifically, general medical admissions increased by 233% during the pandemic compared to the preceding year, highlight- ing the shift in workload away from neurology-specific cases. The types of diagnoses also shifted, with lower percentages of admissions for multiple sclerosis, epilepsy and functional cases, compared to rising numbers of cerebrovascular and CNS infection cases. While the impact of this changing caseload is yet to be fully appreciated, this early data allows further exploration of the pattern of neurological presenta- tions following the medicalisation of neurology wards.
019 The national headache management system: a route to ensuring nationwide evidence-based and equitable care
Authors: Gordon Alex , Lashley Daniel , Weatherby Stuart 
Published: August 2022

Headache disorders are one of the three most common reasons for presentations to neurology services. Despite this, quality of headache care is known to be highly variable. Over 50% of patients have never received prophylactic medication despite eligibility, and patient concordance with treatment is poor.The national headache management system, a freely available resource via headache.org.uk, is an addition to the British Association for the Study of Headache (BASH) 2019 guidelines. It allows both patients and clinicians to view material on diagnostic and treatment strategies in a systematic and logical way.The system can benefit patient care by (1) improving likelihood of response to treatment due to evidence based recommendation, (2) increasing headache service efficiency through the potential for greater multidisciplinary professional use in the running of services, and (3) improving patient confidence, and therefore concordance with, treatment through a uniform approach to headache.The headache management system thus represents an easy-to-use tool which has the potential to bring about huge improvements to headache care on a nationwide scale. Further iterations of this system include development of an app patients can use to track their care, with any problems signposting them to the appropriate advice via the website.
023 Impact of pandemic on neurologists and neurology practice
Authors: Kipps Christopher , Mummery Catherine 
Published: August 2022

BackgroundPrior to the pandemic, a significant number of neurologists were experiencing levels of burnout in one or more factors as measured using the Maaslich Burnout Inventory (emotional exhaustion, depersonalisation, lack of personal accomplishment). Early in the pandemic, repeat assessment showed marked improvement in Maaslich scores (Spring 2020). We aimed to identify the impact of changes to neurology work practice on neurologists in the prolonged pandemic period.MethodsWorking ABN members were surveyed in Autumn 2021 using the Maaslich inventory and questions on work practice.ResultsWe received 360 responses (n=296 Maaslich). Endorsement of burnout factors had returned to pre-pandemic levels (Spring 2020 less than pre-pandemic/Autumn 2021 t=5.426, P<0.001). Emotional Exhaustion correlated with service waiting times and individual fatigue, and inversely to QoL. Deperson- alisation correlated with fatigue and perceived reduction in service quality (inpatients). Most neurologists felt that inpatient (57%) and outpatient (77%) care quality had declined. Capacity in services remained constrained – less than 75% pre-pandemic capacity for MRI (23.3%), CSF sampling (32.8%) and neurophysi- ology (34.5%). Ability to attend educational events correlated with perceived service quality levels. Satis- faction and confidence in remote assessments was consistently lower than for face-to-face interaction.ConclusionThe pandemic has had a marked effect on neurologists, their QoL and their practice. Levels of burnout correlate with personal fatigue and clinical service quality. Interestingly recent burnout scores are similar to those seen prior to the pandemic.
031 Pelvic autonomic dysfunction is common in patients with pure autonomic failure
Authors: Vichayanrat Ekawat , Hentzen Claire , Simeoni Sara , Pakzad Mahreen , Iodice Valeria , Panicker Jalesh 
Published: August 2022

IntroductionCardiovascular autonomic failure is the hallmark finding in Pure autonomic failure (PAF) however other autonomic functions are likely to be affected. This study aims to characterise genitourinary dysfunction in PAF patients and explore their relationship with cardiovascular autonomic dysfunction.MethodsPAF patients who underwent cardiovascular autonomic testing completed self-administered questionnaires evaluating urinary and sexual symptoms and a 3-day bladder diary measuring fluid intake and urine output. Demographic, clinical features, disease duration and related medical comorbidities were assessed.Results25 PAF patients (10 males) were recruited (mean age 71+8 years; disease duration 13+8 years). 96% (24/25) reported lower urinary tract symptoms, most commonly overactive bladder symptoms (92%) followed by low stream (80%) and stress incontinence (52%). 4(16%) patients required catheterisation. 19/22 (86%) had nocturnal polyuria (NP), defined as NP index >0.3 (nocturnal urine volume/24-hour urine volume), mean NP index 0.45 (range, 0.20-0.73). There were no significant correlations between BP drops on head-up tilt, supine hypertension, respiratory sinus arrhythmia, Valsalva ratio or disease duration with the degree of nocturnal polyuria and need for catheterisation (p>0.05).ConclusionsNP and genitourinary symptoms are common in PAF. The pathophysiology of NP in PAF is likely to be multifactorial and may not only be explained by cardiovascular autonomic failure.
041 Cognitive and neuropsychiatric effects of noradrenergic treatment in Alzheimer’s disease: systematic review and meta-analysis
Authors: David Michael , Giovane Martina Del , Liu Kathy , Gostick Benjamin , Oboh Imafidon , Howard Robert , Malhotra Paresh 
Published: August 2022

BackgroundDysfunction of the locus coeruleus-noradrenergic system occurs early in Alzheimer’s disease. This results in a low-noradrenergic state in some patients, which contributes to cognitive and neuropsychi- atric symptoms. We aimed to assess the efficacy of noradrenergic drugs for improving these symptoms.MethodsThe MEDLINE, Embase, and ClinicalTrials.gov databases were searched from 1980 to December 2021. We generated pooled estimates using random effects meta-analyses.Results19 randomised controlled trials, of which six studies were of ‘good’ quality, with seven ‘fair’ and six ‘poor’, included 1811 patients. Meta-analysis of 10 studies showed a small, significant positive effect of noradrenergic drugs on patients’ global cognition, as measured using the MMSE or ADAS-Cog compared to placebo (SMD:0.14, 95%CI:0.03 to 0.25, p=0.01; I2=0%). No significant effect was seen on measures of attention (SMD:0.01, 95%CI:-0.17 to 0.19, p=0.91; I2=0). The apathy meta-analysis included eight trials and detected a large positive effect of noradrenergic drugs (SMD:0.45, 95%CI:0.16 to 0.73, p=0.002; I2=58%), although results were limited by potentially substantial heterogeneity.DiscussionDrug repurposing with established noradrenergic drugs, may offer safe and effective treatment in Alzheimer’s disease, for both cognition and apathy. However, there are number of factors that should be considered before the design of much needed future clinical trials. Including, targeting the correct patient sub-groups and using the correct medications, at the optimal dose, possibly in combination with other treatments, in order to maximise therapeutic effect.
042 Longitudinal assessment of sleep/wake behaviour in dementia patients living at home
Authors: Soreq Eyal , Kolanko Magdalena , Guruswamy Ravindran Kiran Kumar , Monica Ciro Della , Revell Victoria , Lai Helen , Barnaghi Payam , Malhotra Paresh , Dijk Deerk-Jan , Sharp David 
Published: August 2022

IntroductionDisturbances of sleep/wake behaviour are amongst the most disabling symptoms of dementia, leading to increased carers’ burden and institutionalisation. The lack of unobtrusive, low- burden technologies validated to monitor sleep in patients living with dementia (PLWD) has prevented longitudinal studies of nocturnal disturbances and their correlates.AimsTo examine the effect of medication changes and clinical status on the intraindividual variation in sleep/wake behaviour in PLWD.MethodsUsing under-mattress pressure-sensing mat in 46 PLWD, we monitored sleep/wake behavioural metrics for 13,711 nights between 2019-2021. Machine learning and >3.6million nightly summaries from 13,671 individuals from the general population were used to detect abnormalities in PLWD’s nightly sleep/wake metrics and convert them to risk scores. Additionally, GP records were reviewed for each patient to determine whether medication changes and clinical events affected sleep parameters.ResultsPLWD’s went to bed earlier and rose later than sex- and age-matched controls. They had more nocturnal awakenings with longer out-of-bed durations. Notably, at the individual patient level, increased metric-specific risk scores were temporally related to changes in antipsychotics and antidepressants, and acute illness, including UTI, cardiac events, and depressive episodes.ConclusionsPassive monitoring of sleep/wake behaviours is a promising way to identify novel markers of disease progression and evaluate the effectiveness of pharmaceutical interventions in patients with dementia.
043 Depression is associated with increased dementia risk and reduced grey matter in a fronto-insular-cerebellar network
Authors: Paris Alvar , Amirthalingam Guru , Karania Tasvee , Dey Sumit , Foote Isabelle , Bothongo Phazha , Dobson Ruth , Noyce Alastair , Marshall Charles , Waters Sheena 
Published: August 2022

BackgroundDepression may be a potentially modifiable risk factor for dementia, but it is not clear whether this is due to a causal effect, or whether depressive symptoms are an early prodromal feature of Alzheimer’s disease.ObjectivesTo investigate whether depressive symptoms are associated with an increased risk of dementia. To establish associations between depressive symptoms and structural neuroanatomy.MethodsA total of 491,603 adults from the UK Biobank study were included. Depression and dementia diagnoses were determined using linked medical records and self-report; depression symptomatology was based on questionnaire data. Brain MRI image-derived phenotypes in 42,471 participants were used to measure regional brain volumes.ResultsThe risk for incident all-cause dementia was increased in participants with depressive symptoms or a recorded depression diagnosis (all OR>2, p<0.01). After excluding those with incident dementia, depressive symptoms were associated with volume reduction in a fronto-insular-cerebellar network.ConclusionDepression is associated with an increased risk of incident dementia. The neuroanatomical correlates of depressive symptoms do not relate to the default mode network degeneration found in prodromal Alzheimer’s disease, suggesting that increased dementia risk in depression may be due to poor brain health and diminished neural reserve more broadly.
Parallel Session 2: Neurodegeneration| Wed 18 May, 1115 – 1230|4 Novel complex motor behaviours in LGI1-autoantibody encephalitis
Authors: Michael Sophia , Ramanathan Sudarshini , Binks Sophie , Leite Maria Isabel , Sen Arjune , Irani Sarosh 
Published: August 2022

BackgroundPathognomonic clinical signs are increasingly well recognised across the autoim- mune encephalitides. Faciobrachial dystonic seizures (FBDS) are exclusively present in patients with LGI1-autoantibodies. Owing to their recent description and rarity, however, the wider clinical phenotypes remain less well-defined.AimsTo describe novel clinical features in a large cohort of patients with LGI1-autoantibodies.MethodsPatients were recruited for clinical research following either direct referral to the Oxford Autoim- mune Neurology Service, or via notification to the national Association of British Neurologists Rare Disease Ascertainment and Recruitment (RaDaR) Surveillance Unit. Novel clinical signs were identified through clinical assessment of 107 LGI1-autoantibody patients. We use video footage to present the phenotypes.Results5/104* (5%) of patients with LGI1-autoantibodies displayed highly unusual manual stereotypies which we have termed ‘complex motor behaviours’. These behaviours consisted of the patients acting out intricate manual behaviours using imaginary objects, for example drinking from a cup, writing, and imitation of winding a piece of string around the fingers. They typically occurred during sleep or periods of relaxed wakefulness, were of short duration (30-60 seconds), and were associated with loss of awareness. All patients had multiple seizure semiologies (3-5) and associated visual hallucinations and sleep disorder.ConclusionsComplex motor behaviours were observed in 5% of patients with LGI1-autoantibodies and may represent either a novel seizure semiology or the sleep disorder agrypnia excitata. These findings expand the clinical phenotypes of LGI1-autoantibody encephalitis.
051 Stakeholder opinions of telematics as an alternative assessment for MCI drivers; a thematic analysis
Authors: Douglass April , Sproson Lise , Lnagranchi Vita , Chapman Sam , Blackburn Daniel 
Published: August 2022

BackgroundPatients diagnosed with Mild Cognitive Impairment (MCI) are recommended to have their driving ability assessed to ensure they are not at risk to themselves or other drivers. Current, on-road driving assessments lack ecological validity, being unrepresentative of fluctuations in ability, and lack longitudinal data to assess changes in driving behaviour over time. GPS devices provide an unobtrusive, objective, and continuous form of assessment. This technology has not yet been marketed towards older drivers.MethodsFour workshops were conducted with the stakeholders of this project, including older drivers with experience of MCI, clinicians and DVLA representatives. Thematic analysis was conducted on tran- scripts from the workshops to investigate these stakeholders’ opinions of the technology as a potential alternative driving assessment.ResultsStakeholders stressed the importance of driving (independence, convenience, sense of freedom), described the issues surrounding the current methods of assessment and discussed the promising nature of telematics technology for older drivers.DiscussionOutcomes suggest that with increased awareness and education around telematics, the older public may accept this technology as an advantageous alternative that could improve road safety as a whole.
Medium-term impact of the SARS-CoV-2 mRNA vaccine against disease activity in patients with systemic lupus erythematosus
Authors: Yoshida Tsuneyasu , Tsuji Hideaki , Onishi Akira , Takase Yudai , Shirakashi Mirei , Onizawa Hideo , Hiwa Ryosuke , Kitagori Koji , Akizuki Shuji , Nakashima Ran , Tanaka Masao , Yoshifuji Hajime , Morinobu Akio 
Published: August 2022

ObjectivesNumerous case reports have referred to new onset or flare of SLE after SARS-CoV-2 messenger RNA (mRNA) vaccines. Several observational studies showed that the short-term flare rate of SLE after SARS-CoV-2 vaccination is low. However, well-controlled clinical surveys are unavailable and the medium-term impact of the SARS-CoV-2 mRNA vaccines against the flare of SLE is uncertain. Therefore, we aimed to analyse the association between vaccination and medium-term subjective and objective disease activities of SLE and flares using matched pair methods.MethodsAltogether, 150 patients with SLE from the Kyoto Lupus Cohort were included. Patients who received two doses of the SARS-CoV-2 mRNA vaccines were 1:1 matched with unvaccinated patients based on the first vaccination date. The outcome measures were the SLE Disease Activity Index-2000 (SLEDAI-2K), the Japanese version of the SLE Symptom Checklist Questionnaire (SSC-J) and the Safety of Estrogens in Lupus Erythematosus National Assessment-SLEDAI flare index at 30, 60 and 90 days after vaccination.ResultsSLEDAI-2K levels were not significantly different in vaccinated and unvaccinated patients with SLE at 30, 60 and 90 days after the second vaccination (adjusted estimate (95% CI): 30 days: −0.46 (−1.48 to 0.56), p=0.39; 60 days: 0.38 (−0.64 to 1.40), p=0.47; 90 days: 0.40 (−0.54 to 1.34), p=0.41). Similar results were observed in the SSC-J score (adjusted estimate (95% CI), 30 days: 0.05 (−1.46 to 1.56), p=0.95; 60 days: −0.63 (−2.08 to 0.82), p=0.40; 90 days: 0.27 (−1.04 to 1.58), p=0.69) and flare index (adjusted OR (95% CI), 30 days: 0.81 (0.36 to 1.85), p=0.62; 60 days: 1.13 (0.50 to 2.54), p=0.77; 90 days: 0.85 (0.32 to 2.26), p=0.74).ConclusionSARS-CoV-2 vaccination did not significantly influence the medium-term subjective and objective disease activities or flares of SLE until 90 days after the second vaccination.
Inter-arm blood pressure difference as a tool for predicting coronary artery disease severity
Authors: Das Somen , Iktidar Mohammad Azmain , Das Joyanti , Chowdhury Faisal , Roy Simanta 
Published: August 2022

BackgroundPatients with severe atherosclerosis have been found to exhibit considerable changes in blood pressure (BP) between arms. The objective of our study was to investigate the predictive value of interarm blood pressure difference (IABPD) for coronary artery disease (CAD) severity.MethodsIt was a cross-sectional study conducted in the Department of Cardiology, Chittagong Medical College Hospital, Chattogram from May 2020 to November 2020. The study conveniently selected 110 individuals who visited the department for a coronary angiography during the study period. The BP of both arms were synchronously measured 1–2 days before the coronary angiography and IABPD were calculated. After coronary angiography, two blinded interventional cardiologists visually estimated the amount of coronary artery obstruction and determined the Gensini score.ResultsAmong the participants, more than three-fourths of the patients were above 50 years of age (64.66%), and the majority were male (86.67%). 14.7% of participants had no occlusion in their coronary artery, 38.0% of participants had insignificant occlusion, 26.7% participants had mild occlusion, 10.3% participants had moderate occlusion, 3.3% participants had significant occlusion and 6.0% participants had total occlusion. Corrected pulse IABPD (cIABPDpulse) showed the greatest area under the receiver operating characteristic curve (0.73) for predicting a high Gensini score (>median). Multiple regression analysis revealed a significant relationship between corrected systolic IABPD (cIABPDsys) and the Gensini score (B=0.057, p<0.001).ConclusionThe differences in BP between the arms were found to be having a strong positive correlation with CAD severity.
A method for determining the transition energies of $$^{\mathrm {83m}}$$Kr at the KATRIN experiment
Authors: Rodenbeck C. 
Published: August 2022

AbstractThe neutrino mass experiment KATRIN uses conversion electrons from the 32.2-keV transition of the nuclear isomer $$^{\mathrm {83m}}$$

83
m

Kr for calibration. Comparing the measured energies to the appropriate literature values allows for an independent evaluation of the energy scale, but the uncertainties in some of the literature values obtained by gamma spectroscopy are a limiting factor. Building upon the already excellent linearity of KATRIN’s energy scale, this paper proposes a novel method for determining the $$^{\mathrm {83m}}$$

83
m

Kr transition energies via high-precision electron spectroscopy. Notably, the method makes use of conversion electrons from the 41.6-keV direct transition of $$^{\mathrm {83m}}$$

83
m

Kr to its ground state in addition to conversion electrons from the much more frequent cascade of a 32.2-keV and a 9.4-keV transition. By implementing this method, KATRIN may be able to deliver order-of-magnitude improvements in precision over current $$^{\mathrm {83m}}$$

83
m

Kr transition energy literature values. Although concretely described here in the context of the KATRIN experiment and with $$^{\mathrm {83m}}$$

83
m

Kr, the method’s underlying principles are general enough for it to likely be a useful tool in various other nuclear spectroscopy settings.
Machine Learning Approach to Predict Clinical Pregnancy Potential in Women Undergoing IVF Program
Authors: Handayani Nining , Louis Claudio Michael , Erwin Alva , Aprilliana Tri , Polim Arie A , Sirait Batara , Boediono Arief , Sini Ivan 
Published: August 2022

Objective: Hidden knowledge could be discovered within a large practical data of in vitro fertilization (IVF) practice. In this study, Machine learning-based data mining techniques were utilized to construct a reliable prediction model for clinical pregnancy in IVF. Study Design: A retrospective cohort multicenter study involving 4.570 IVF cycles. All patients underwent fresh embryo transfer at either the cleavage or blastocyst stage between January 2015 and December 2019. The experiment focused on utilizing tree-based classifiers to generate and compare the most effective prediction model that could predict a clinical pregnancy through clinical data. Additionally, each classifier is optimized via a genetic algorithm technique, along with the selection of variables. Results: Both the decision tree and random forest showed similar performance that was much better than the gradient boost. The two superior classifiers achieved a balanced accuracy of roughly 0.62. Additionally, each prediction model was shown to work optimally with different combinations of variables, with some variables being consistently included, such as female age, and some consistently excluded, which provides an insight into the relationship between the variables and each prediction model. Conclusion: Machine learning algorithm remains effective for the purpose of data mining and knowledge extraction in IVF clinical datasets through which a relatively reliable prediction system for clinical pregnancy could be constructed, provided the available data is sufficient.