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There was a small number of men with a PNES diagnosis, which may have limited our ability to identify differences in the groups. The clear correlation of childhood trauma and alexithymia with development of conversion disorder in women could not be demonstrated in men.

In this sample of men admitted to an EMU there was no difference in the extent of alexithymia or childhood trauma between men with ES and PNES. There was a small number of men with a PNES diagnosis, which may have limited our ability to identify differences in the groups. The clear correlation of childhood trauma and alexithymia with development of conversion disorder in women could not be demonstrated in men.

A web-based intervention was developed to support epilepsy self-management. A mixed methods study was undertaken to evaluate the intervention's extent of utilization, acceptability and preliminary effects, and to assess user perception of it.

First, a pilot parallel-group randomized controlled trial was conducted with a convenience sample of 75 adult with epilepsy who had Internet access allocated on a 11 ratio into an experimental group that received the intervention (experimental group (EG), n = 37) and a control group invited to consult epilepsy-related websites (control group (CG), n = 38). LGH447 in vitro Self-management, knowledge, and quality of life (QoL) outcomes were measured at baseline and one and three months later. Descriptive statistics of extent of utilization and acceptability were computed. link2 Linear mixed models were conducted to assess change in outcomes over time and between groups. Subsequently, an exploratory qualitative study was carried out with 15 EG participants. Qualitative data were subjected tos.

The web-based intervention shows promise in terms of usefulness in enhancing QoL, and user experience showed that it is acceptable and helpful. It could constitute a complementary service in support of existing services for people with epilepsy and their families.

Epilepsy is diagnosed in 20% of patients with psychogenic nonepileptic spells (PNES). The semiology of PNES and epileptic seizures (ES) overlaps in some patients. It is unclear whether the motor phenotype of PNES predicts the type of ES.

Video segments of EEGs in patients with PNES and ES treated in the Epilepsy Monitoring Unit at the University of Nebraska Medical Center were reviewed. Videos were categorized according to the validated motor-based classification of PNES. Ratings of kinetic PNES events were analyzed to determine if there was an association with focal or generalized ES. link3 If available, the video segments of ES were categorized as hypokinetic or hyperkinetic based on the constellation of focal or generalized movements and other semiological features.

Among 43 patients with documented PNES-ES (median age 34, interquartile range (IQR) 26-45), 27.9% were male. The largest proportion of patients (39.5%) had focal temporal epilepsy (TE). Other diagnostic groups included focal frontal (FE, 25.6%)c semiology in TE and GE syndromes. The motor status of PNES does not predict the phenotype of coexisting ES. The concordant kinetic semiology is present in more than half of the patients with dual diagnosis and available video data.

In patients with PNES and ES, the hypokinetic semiology of PNES prevails over hyperkinetic semiology in TE and GE syndromes. The motor status of PNES does not predict the phenotype of coexisting ES. The concordant kinetic semiology is present in more than half of the patients with dual diagnosis and available video data.

Epilepsy is a major public health concern in low-income countries (LIC) as they contain 80% of total cases worldwide. Syria has been in war since 2011 which made it difficult to prevent epilepsy risk factors which made this the first study on that matter.

This is a case-control study from 3 medical centers in Damascus, Syria. Data were collected using questionnaires introduced by trained doctors. The control group included patients from a general practice clinic while the cases were taken from the three pediatric neurology clinics.

The sample consisted of 334 patients with 167 cases and 167 controls. Multivariable analysis confirmed the association between positive family history (FH) in 1st degree (OR, 3.37, 95%CI 1.2-9.47) and 2nd degree relatives (OR, 3.98, 95%CI 1.84-8.62), febrile seizures whether they were simple (OR, 15.08, 95%CI 3.27-69.5) or complex (OR, 13.32, 95%CI 1.58-112.32), developmental delay/regression (OR, 14.31, 95%CI 6.3-32.49), and central nervous system (CNS) infection (OR, 34.05, 95%CI 2.02-573.92). Head trauma, parental factors, consanguinity, asphyxia parameters, and other risk factors were not found to be significantly associated with epilepsy (P > 0.05).

While some results were similar to other studies, others were not. Efforts should be made to facilitate healthcare access and proper diagnosis.

While some results were similar to other studies, others were not. Efforts should be made to facilitate healthcare access and proper diagnosis.

Anxiety and depression symptoms in epilepsy are common, impactful and under-recognized and undertreated. While prior survey data suggests equipoise among epileptologists for managing anxiety and/or depression via prescribing in the epilepsy clinic versus psychiatry referral, patient preferences are unknown and should potentially influence practice habits among epileptologists. Thus, the primary objective of this study was to determine patient preference for anxiety and/or depression prescribing by neurologists versus psychiatry referral among an adult epilepsy clinic sample of symptomatic patients.

Management preferences for anxiety and/or depression were surveyed in an adult tertiary care epilepsy clinic. Individuals who screened positive for anxiety and/or depression symptoms on validated instruments during a routine care-embedded learning health system study were recruited. Demographics, social variables, psychiatric treatment history, and treatment priorities and preferences were surveyed. Preference g never received neurologist medication management. None of the factors examined in the a priori multivariable model were associated with selecting psychiatry referral (compared to neurologist prescribing).

In this sample, most patients indicated a preference for neurologists to prescribe for anxiety or depression symptoms in the epilepsy clinic. Care models involving neurologist prescribing for anxiety and depression symptoms merit further investigation and potential adoption in clinical practice.

In this sample, most patients indicated a preference for neurologists to prescribe for anxiety or depression symptoms in the epilepsy clinic. Care models involving neurologist prescribing for anxiety and depression symptoms merit further investigation and potential adoption in clinical practice.Palliative care (PC) is an approach to the care of persons living with serious illness and their families that focuses on improving quality of life and reducing suffering by addressing complex medical symptoms, psychosocial needs, spiritual well-being, and advance care planning. While PC has traditionally been associated with hospice care for persons with cancer, there is now recognition that PC is relevant to many noncancer diagnoses, including neurologic illness, and at multiple points along the illness journey, not just end of life. Despite the recent growth of the field of neuropalliative care there has been scant attention paid to the relevance of PC principles in epilepsy or the potential for PC approaches to improve outcomes for persons living with epilepsy and their families. We believe this has been a significant oversight and that PC may provide a useful framework for addressing the many sources of suffering facing persons living with epilepsy, for engaging patients and families in challenging conversations, and to focus efforts to improve models of care for this population. In this manuscript we review areas of significant unmet needs where a PC approach may improve patient and family-centered outcomes, including complex symptom management, goals of care, advance care planning, psychosocial support for patient and family and spiritual well-being. When relevant we highlight areas where epilepsy patients may have unique PC needs compared to other patient populations and conclude with suggestions for future research, clinical, and educational efforts.

To provide a framework for a virtual curriculum during the COVID-19 pandemic for medical student educators that introduces and teaches clinical concepts important in urology and surgical specialties in general.

We created a 1-week virtual urology course utilizing interactive lectures, case-based exercises, and faculty-proctored surgical video reviews. Students were assigned self-study modules and participated in case-based discussions and presentations on a topic of their choice. Students' perceptions of urology as a specialty and the utility of the course was evaluated through pre- and postcourse surveys. Understanding of urologic content was evaluated with a multiple-choice exam.

A total of nine students were enrolled in the course. All students reported increased understanding of the common urologic diagnoses and of urology as a specialty by an average of 2.5 points on a 10-point Likert scale (Cohen's measure of effect size 3.2). Additionally, 56% of students reported increased interest, 22% reportedteaching is normalized, these techniques can have far-reaching utility within the traditional medical student surgical curriculum.Although abundant in soils, iron (Fe) is poorly bioavailable for plants. Improving Fe uptake in crops, enabling them to grow in Fe-depleted soils, has become a major focal interest. The secretion of Fe-mobilizing coumarins by plant roots recently emerged as an important factor allowing nongrass species to cope with low Fe bioavailability. The main molecular actors involved in the biosynthesis and secretion of coumarins have been identified, but the precise regulatory mechanisms that tune their production remain poorly understood. Here, we review the recent progress in coumarin synthesis and transport in plants and future research directions to gain knowledge of these mechanisms, which will offer novel opportunities for improving plant growth and health and for generating Fe-fortified crops.Nectar is the most important reward offered by flowering plants to pollinators for pollination services. Since pollinator decline has emerged as a major threat for agriculture, and the food demand is growing globally, studying the nectar gland is of utmost importance. Although the genetic mechanisms that control the development of angiosperm flowers have been quite well understood for many years, the development and maturation of the nectar gland and the secretion of nectar in synchrony with the maturation of the sexual organs appears to be one of the flower's best-kept secrets. Here we review key findings controlling these processes. We also raise key questions that need to be addressed to develop crop ecological functions that take into consideration pollinators' needs.

The objective was to evaluate the clinical and biological factors associated with negative

Tc-MIBI scanning in patients with primary hyperparathyroidism (PHPT).

A retrospective observational study was designed in 195 patients (mean age 59.2±13.0years; 77% woman) with PHPT (calcium 11.3±1.1mg/dl and PTH 218±295pg/ml) studied in endocrinology setting between 2013 and 2020. An univariate and multivariate analysis was made to evaluate the clinical and biological factors associated with negative

Tc-MIBI scanning.

50 patients (26%) with negative

Tc-MIBI scanning had lower PTH levels (146±98 vs. 244±334; p<0.001), adenomas with smaller sonographic dimensions (maximum diameter 1.2±0.4 vs. 1.7±0.9cm; p=0.001 and volume 0.36±0.43 vs. 1.7±4.1cm

 ; p<0.001), localized more frequently in upper parathyroid glands (37% vs. 14%; p=0.005) and associated more frequently to thyroid nodules (72% vs. 57%; p=0.045) than patients with positive scanning. 116 patients were operated and parathyroid adenomas were smaller (maximum diameter 1.