关键词： neurological disorders   machine learning   classification   fall   path signature   gait   inertial measurement unit   data pre-processing   fall risk assessment   wearables  

摘要： Falls are the leading cause of mortality, morbidity and poor quality of life in older adults with or without neurological conditions. Applying machine learning (ML) models to gait analysis outcomes offers the opportunity to identify individuals at risk of future falls. The aim of this study was to determine the effect of different data pre-processing methods on the performance of ML models to classify neurological patients who have fallen from those who have not for future fall risk assessment. Gait was assessed using wearables in clinic while walking 20 m at a self-selected comfortable pace in 349 (159 fallers, 190 non-fallers) neurological patients. Six different ML models were trained on data pre-processed with three techniques such as standardisation, principal component analysis (PCA) and path signature method. Fallers walked more slowly, with shorter strides and longer stride duration compared to non-fallers. Overall, model accuracy ranged between 48% and 98% with 43-99% sensitivity and 48-98% specificity. A random forest (RF) classifier trained on data pre-processed with the path signature method gave optimal classification accuracy of 98% with 99% sensitivity and 98% specificity. Data pre-processing directly influences the accuracy of ML models for the accurate classification of fallers. Using gait analysis with trained ML models can act as a tool for the proactive assessment of fall risk and support clinical decision-making.

关键词： Aeromonosis   Brain infection   Hemorrhagic septicemia   Inflammation  

摘要： Aeromonosis is an infectious disease of high occurrence in captive fish. It manifests mainly as hemorrhagic septicemia. This study aimed to evaluate the physiopathology manifestations of septic aeromonosis in Piaractus mesopotamicus, considering its clinical manifestations, mortality rates, anatomopathology, and anti-iNOS immunolabeling in the brain. Fish were inoculated in the coelomic cavity with increasing concentrations of A. hydrophila: 1.5 × 10⁸;1.8 × 10⁸;2.1 × 10⁸;2.4 × 10⁸;2.7 × 10⁸ CF mL⁻¹, histopathology, and anti-iNOS immunolabeling in brain. The animals present erratic swimming (swirling), depigmentation, petechiae, skin suffusions, and high mortality rates up to 100% according to the inoculum concentration. The DL50-96 h was estimated in 1.806 × 10⁸ CFU mL⁻¹. Fish inoculated with 2.1 × 10⁸ CFU mL⁻¹ presented 100% mortality rate. Fish presented neurological signs, congestion, extensive hemorrhage, and glial cells activity confirmed by the anti-iNOS labelling. In addition, the inoculated bacteria was reisolated from the brains. The results demonstrated that aeromonosis physiopathology is multifactorial and the observed neurological signs were caused by the inoculated bacteria. These findings highlight the need for differential diagnosis with other infections that produce encephalitis. © 2020, Springer-Verlag London Ltd., part of Springer Nature.

关键词： COVID-19   Residency training   Telemedicine  

摘要： The worldwide SARS-CoV-2 pandemic is dramatically affecting health systems with consequences also for neurological residency training. Here we report early experiences and challenges that European neurologists and residents faced. The breadth of the pandemic and the social restrictions induced substantial modifications in both inpatient and outpatient clinical care and academic activities as well, adversely affecting our residency training. On the other hand we see also opportunities, such as gaining more clinical and professional skills. All these drastic and sudden changes lead us to reconsider some educational aspects of our training program that need to be improved in order to better prepare the neurologists of the future to manage unexpected and large emergency situations like the one we are living in these days. A reconsideration of the neurological training program could be beneficial to guarantee high standard level of the residency training in this period and beyond.

关键词： Migraine   CADASIL   Mitochondrial disease   Fabry disease   Sneddon disease   Rare neurological diseases  

摘要： Although migraine is generally considered an idiopathic and isolated neurological condition, it may also represent the presenting symptom of several uncommon heritable and acquired neurological diseases contributing to the recognition of such conditions. Migraine may indeed present with atypical characteristics or prolonged duration and may be associated with specific neuroradiological findings that may help in identifying the underlying condition. However, features of migraine in rare diseases are usually little known because of the lack of systematic studies. The aim of this paper is to provide clinicians with an updated review on specific clinical and neuroradiological features of migraine in uncommon neurological diseases that may be helpful to their diagnosis and treatment. Therefore, the early diagnosis of these uncommon diseases is crucial for patients' clinical management and for the implementation of therapeutic approaches aimed at targeting the underlying disease pathogenic mechanisms. Thus, when investigating patients affected by migraine, physicians should always be aware about rare causes of migraine that if misdiagnosed could seriously impact patients' outcome. Given these relevant implications, future studies specifically assessing features of migraine in uncommon diseases are mandatory.

关键词： COVID-19   Neurological   MRI   Hypercoagulable   Neurotropism  

摘要： Novel coronavirus disease (COVID-19) was declared a global pandemic on March 1, 2020. Neurological manifestations are now being reported worldwide, including emergent presentation with acute neurological changes as well as a comorbidity in hospitalized patients. There is limited knowledge on the neurologic manifestations of COVID-19 at present, with a wide array of neurological complications reported, ranging from ischemic stroke to acute demyelination and encephalitis. We report five cases of COVID-19 presenting to the ER with acute neurological symptoms, over the course of 1 month. This includes two cases of ischemic stroke, one with large-vessel occlusion and one with embolic infarcts. The remainders of the cases include acute tumefactive demyelination, isolated cytotoxic edema of the corpus callosum with subarachnoid hemorrhage, and posterior reversible encephalopathy syndrome (PRES).

关键词： movement disorders   neurological complications   SARS-CoV-2 infection  

关键词： Pediatric   Research   Training   NIH   Disparities   Career   Funding   Neuroscience  

摘要： Background: The year 2020 marked a fundamental shift in the pediatric neurology field. An impressive positive trajectory of advances in patient care and research faced sudden global disruptions by the coronavirus disease 2019 pandemic and by an international movement protesting racial, socioeconomic, and health disparities. The disruptions revealed obstacles and fragility within the pediatric neurology research mission. However, renewed commitment offers unique opportunities for the pediatric neurology research community to enhance and prioritize research directions for the coming decades. Methods: The Research Committee of the Child Neurology Society evaluated the challenges and oppor-tunities facing the pediatric neurology research field, including reviewing published literature, synthesizing publically available data, and conducting a survey of pediatric neurologists. Results: We identified three priority domains for the research mission: funding levels, active guidance, and reducing disparities. Funding levels: to increase funding to match the burden of pediatric neurological disease;to tailor funding mechanisms and strategies to support clinical trial efforts unique to pediatric neurology;and to support investigators across their career trajectory. Active guidance: to optimize infrastructure and strategies, to leverage novel therapeutics, enhance data collection, and improve inclusion of children in clinical trials. Reducing disparities: to reduce health disparities in children with neurological disease, to develop proactive measures to enhance workforce diversity and inclusion, and increase avenues to balance work-life obligations for investigators. Conclusions: In this uniquely challenging epoch, the pediatric neurology research community has a timely and important mission to re-engage the public and government, advancing the health of children with neurological conditions. (C) 2020 Elsevier Inc. All rights reserved.

关键词： clinic   COVID-19   global impact   hospitalization   stroke   stroke care  

摘要： Background In this brief report, we investigated the impact of COVID-19 on outpatient stroke clinics and inpatient services and their recovery process. Methods We sent a survey to physicians worldwide through the network of the World Stroke Organization to investigate the impact of COVID-19 on stroke clinics. To farther along in recovering from the outbreak, we reviewed stroke and other neurology outpatient clinic visits (approximately 50% were stroke related) and the number of inpatient services from December 2019 to July 2020 in a large neurology department in Shanghai, China, where there was no official city lockdown. Results We received 112 valid survey responses from 46 countries, representing all continents except for Antarctica. Only seven of the survey responders (7/112, 6.3%) reported that they have kept their outpatient clinics open as usual, but they did exercise increased precautions for COVID-19 by following recent guidelines regarding use of personal protective equipment and isolation techniques. The remainder of the respondents have either reduced outpatient clinic services or suspended outpatient clinics completely. Telephone consultation or telemedicine with video capability was used for new patients or follow-ups, with limited in-person evaluations when necessary. Outpatient clinic visits and inpatient services from a large tertiary hospital in China decreased dramatically during the peak period of the outbreak, but then rebounded back quickly following the partial or full recovery from the outbreak. Compared with the recovery process of inpatient services, outpatient clinic visits decreased faster and recovered much slower. This is consistent with our global survey data which indicates that some outpatient clinics have rescheduled their outpatient visits for 3 to 6 months. Conclusions The COVID-19 pandemic caused a significant drop of in-person outpatient visits and inpatient services. Clinic visits recovered slower than inpatient services in stro