摘要： In response to the coronavirus disease 2019 (COVID-19) pandemic, the scientific community has accelerated its process for knowledge synthesis and dissemination at multiple levels, from creating pathways for expedited journal peer review to establishing specialty task forces that curate information most relevant to individual fields of expertise. We describe our experience engaging with the latter to fill a gap in knowledge. At our institution, we established a group of fifteen neurologists from six subspecialties that created protocols on managing inpatients with concurrent neurological disorders and COVID-19, using best available evidence and expert opinion. These protocols were disseminated online at *** on April 3, 2020, and have been updated continuously based on emerging literature and frontline clinical experience. We evaluated utility using data analytics, characterizing the number of unique visitors over a week of "normal" usage and the demographic data of visitors. We discuss here the limitations of this imperfect method of knowledge synthesis and dissemination, and acknowledge our peers nationwide who have provided feedback to greatly enhance the quality of these protocols. We believe that our experience highlights the need for exceptionally high levels of collaboration in these unprecedented times. This article is protected by copyright. All rights reserved.

关键词： Dizziness   migraine   MRCP   Ménière's disease   stroke   vertigo   vestibular disorders  

摘要： Dizziness and vertigo are common symptoms. Because there are effective treatments for vestibular disorders, it is always important to make an accurate diagnosis. In acute vertigo, expert clinical assessment is critically important in discerning stroke from non-stroke causes because results of stroke-protocol brain magnetic resonance imaging, including diffusion-weighted imaging, can be falsely negative in the first 24 hours. It follows that acute medical services must have access to clinicians expert in assessing acute vertigo. Expertise in clinical examination and interpretation of findings requires appropriate training, but here we outline the basic diagnostic and therapeutic approach to patients with dizziness. Appropriate early management of these conditions is part of prevention of disabling chronic functional dizziness. © 2020

关键词： continuing professional development   health coaching   person-centred care   realist evaluation   self-management  

摘要： Background Supporting people to self-manage their long-term conditions is a UK policy priority. Health coaching is one approach health professionals can use to provide such support. There has been little research done on how to train clinicians in health coaching or how to target training to settings where it may be most effective. Objective To develop theories to describe how training health professionals in health coaching works, for whom and in what circumstances, with a focus on those working with people with progressive neurological conditions. Design Realist evaluation using mixed methods (participant observation, pre- and post-training questionnaires, and telephone interviews with participants and trainers). Realist data analysis used to develop and refine theories. Intervention Two 1-day face-to-face training sessions in health coaching with 11 weeks between first and second days. Setting and participants Twenty health-care professionals who work with people with neurological conditions in the UK, two training facilitators. Results Four theories were developed using context-mechanism-outcome configurations to describe how training triggers critical reflection;builds knowledge, skills and confidence;how participants evaluate the relevance of the training;and their experiences of implementing the training. Some participants reported a major shift in practice, and others implemented the training in more limited ways. Discussion Fully embracing the role of coach is difficult for health professionals working in positions and settings where their clinical expertise appears most highly valued. Conclusions Training should address the practicality of using coaching approaches within existing roles, while organizations should consider their role in facilitating implementation.

关键词： Principal component analysis  

摘要： In this work we report for the first time surface functionalization of 2D MoS(2)with X (metals: Al, Cu, Sn, Ti) to develop a low-cost, ultra-selective biosensor array based Electronic Tongue (E-Tongue) for the detection of 4 vital neurological drugs in human saliva. The hydrothermally grown surface functionalized X-MoS(2)was integrated onto a single 1 x 1 cm aluminium foil and contacts were defined using Cr electrodes. Detailed characterization revealed the formation of 2-H MoS(2)and metal-X (Al, Cu, Sn, Ti)-functionalized MoS(2)nanoflower like morphology decorated with nanoflake, nanorod, nanocube and nanostick structures, respectively. The response of the sensor array was recorded for aspirin, nicotine, caffeine and tramadol. Principal Component Analysis (PCA) was performed to reduce the dimension of numerous response data sets from all sensors and predict the likely possible response from various neurological drugs towards each sensor. Pattern-recognition analysis confirmed a definite pattern in response to respective functionalization and could efficiently differentiate neurological drugs from one another. Real-time analysis was performed using saliva samples for monitoring the therapeutic neurological drug concentration in the human body. Furthermore, the biosensor array was exposed to respective neurological drugs to study their sensitivity, selectivity, stability, reproducibility and adhesion onto the device. The strategy outlined can be used to develop lab-on-a-chip devices for the real-time detection of numerous bioanalytes in body fluids.

关键词： Relaxation training   rehabilitation   anxiety   depression   long-term neurological conditions  

摘要： Purpose:The present study investigated the effects of a relaxation training program on self-reported depression and anxiety in participants living with long-term neurological conditions, including acquired brain injury, stroke, Parkinson's disease, and multiple sclerosis. Materials and methods: A five-session relaxation training program, plus a follow-up session was offered to people living with a long-term neurological condition as part of routine clinical practice, and was delivered in their own homes. A self-report measure (Hospital Anxiety and Depression Scale) was administered at the pre- and post-intervention time points and at follow-up, around 5 weeks after the final session. Participants also completed an individual assessment of change questionnaire at follow-up, reporting on subjective views of observed changes. Results:Statistically significant improvements were found on measures of both anxiety and depression following completion of the relaxation program. Scores at follow-up (mean = 5 weeks) revealed the improvement was maintained for anxiety, and there was further significant improvement for depression. Reliable change analyses from pre- to post-intervention demonstrated a clinically significant decrease in anxiety scores for 47% of participants and in depression scores for 30% of participants. No clinically significant increase in depression and anxiety was identified from pre- to post-intervention, and this was generally maintained at follow-up. Conclusion:Relaxation training is proposed as a clinically effective treatment for anxiety and depression in people living with long-term neurological conditions, which could in turn lead to better functional outcomes of neurorehabilitation. The program investigated here has additional benefits of being delivered in people's own homes, which overcomes barriers to attending hospital, and is consistent with trends towards home as opposed to hospital care. This program may also be less costly to administer as i

关键词： Superficial siderosis   Oxidative stress   Ascorbate   Folate   Pterin   Antioxidant  

关键词： Posterior reversible encephalopathy syndrome   PRES   Reversible posterior leukoencephalopathy syndrome   Hypertensive encephalopathy   SARS-CoV-2 coronavirus disease 2019  

摘要： • PRES is potentially a complication of severe SARS-CoV-2 infection. • Consider PRES in COVID-19 patients with altered mentation. • Consider tight blood pressure control in ventilated patients with COVID-19. • Hypertensive encephalopathy may prolong ventilator times in COVID-19 patients. [ABSTRACT FROM AUTHOR]

关键词： Traumatic brain injury   TBHQ   Astrocyte   Activation   Nrf-2   Oxidative stress  

摘要： Traumatic brain injury (TBI) is a major leading cause of death and long-term disability. Although astrocytes play a key role in neuroprotection after TBI in the early stage, the overactivation of astrocytes can lead to long-term functional deficits, and the underlying pathophysiological mechanisms remain unclear. In addition, it is unknown whether the nuclear factor erythroid 2-related factor2/haem oxygenase-1 (Nrf-2/HO-1) pathway could elicit a neuroprotective effect by decreasing astrocyte overactivation after TBI. We aimed to study the effects of tert-butylhydroquinone (TBHQ) in reducing astrocyte overactivation after TBI and explored the underlying mechanisms. We first established a controlled cortical impact (CCI) model in rats and performed Haematoxylin and eosin (H&E) staining to observe brain tissue damage. The cognitive function of rats was assessed by modified neurological severity scoring (mNSS) and Morris water maze (MWM) test. Astrocyte and microglia activation was detected by immunofluorescence staining. Oxidative stress conditions were investigated using Western blotting. An enzyme-linked immunosorbent assay (ELISA) was designed to assess the level of the proinflammatory factor tumour necrosis factor-alpha (TNF-alpha). Dihydroethidium (DHE) staining was used to detect reactive oxygen species (ROS). Apoptosis was assessed by terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) staining. The results showed that the administration of TBHQ ameliorated motor function and cognitive deficits and decreased the lesion volume. In addition, TBHQ significantly decreased astrocyte overactivation, diminished the pro-inflammatory phenotype M1 and inflammatory cytokines production after TBI, increased Nrf-2 nuclear accumulation, and enhanced the levels of the Nrf-2 downstream antioxidative genes HO-1 and NADPH-quinone oxidoreductase-1 (NQO-1). Furthermore, TBHQ treatment alleviated apoptosis and neuronal death in the cerebral cortex. Overall, our data

关键词： Coronaviruses   Coronavirus disease 2019   COVID-19 neurological complications   Endotheliitis   Environmental neurology   MERS   MERS-CoV   Neuroepidemiology   Neuropathology   Pandemic   SARS   SARS-CoV-1   SARS-CoV-2   Viral neurotropism   Zoonosis  

摘要： A comprehensive review of the neurological disorders reported during the current COVID-19 pandemic demonstrates that infection with SARS-CoV-2 affects the central nervous system (CNS), the peripheral nervous system (PNS) and the muscle. CNS manifestations include: headache and decreased responsiveness considered initial indicators of potential neurological involvement;anosmia, hyposmia, hypogeusia, and dysgeusia are frequent early symptoms of coronavirus infection. Respiratory failure, the lethal manifestation of COVID-19, responsible for 264,679 deaths worldwide, is probably neurogenic in origin and may result from the viral invasion of cranial nerve I, progressing into rhinencephalon and brainstem respiratory centers. Cerebrovascular disease, in particular large-vessel ischemic strokes, and less frequently cerebral venous thrombosis, intracerebral hemorrhage and subarachnoid hemorrhage, usually occur as part of a thrombotic state induced by viral attachment to ACE2 receptors in endothelium causing widespread endotheliitis, coagulopathy, arterial and venous thromboses. Acute hemorrhagic necrotizing encephalopathy is associated to the cytokine storm. A frontal hypoperfusion syndrome has been identified. There are isolated reports of seizures, encephalopathy, meningitis, encephalitis, and myelitis. The neurological diseases affecting the PNS and muscle in COVID-19 are less frequent and include Guillain-Barre syndrome;Miller Fisher syndrome;polyneuritis cranialis;and rare instances of viral myopathy with rhabdomyolysis. The main conclusion of this review is the pressing need to define the neurology of COVID-19, its frequency, manifestations, neuropathology and pathogenesis. On behalf of the World Federation of Neurology we invite national and regional neurological associations to create local databases to report cases with neurological manifestations observed during the on-going pandemic. International neuroepidemiological collaboration may help define the natural his