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To explore the prevalence of dysphonia in European patients with mild-to-moderate COVID-19 and the clinical features of dysphonic patients. The clinical and epidemiological data of 702 patients with mild-to-moderate COVID-19 were collected from 19 European Hospitals. The following data were extracted: age, sex, ethnicity, tobacco consumption, comorbidities, general, and otolaryngological symptoms. Dysphonia and otolaryngological symptoms were self-assessed through a 4-point scale. The prevalence of dysphonia, as part of the COVID-19 symptoms, was assessed. The outcomes were compared between dysphonic and nondysphonic patients. The association between dysphonia severity and outcomes was studied through Bayesian analysis. A total of 188 patients were dysphonic, accounting for 26.8% of cases. Females developed more frequently dysphonia than males (P = 0.022). The proportion of smokers was significantly higher in the dysphonic group (P = 0.042). The prevalence of the following symptoms was higher in dysphonic patients compared with nondysphonic patients: cough, chest pain, sticky sputum, arthralgia, diarrhea, headache, fatigue, nausea, and vomiting. The severity of dyspnea, dysphagia, ear pain, face pain, throat pain, and nasal obstruction was higher in dysphonic group compared with nondysphonic group. There were significant associations between the severity of dysphonia, dysphagia, and cough. Dysphonia may be encountered in a quarter of patients with mild-to-moderate COVID-19 and should be considered as a symptom list of the infection. Dysphonic COVID-19 patients are more symptomatic than nondysphonic individuals. Future studies are needed to investigate the relevance of dysphonia in the COVID-19 clinical presentation. [ABSTRACT FROM AUTHOR]

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Animal performance, composition and quality of meat from Belgian Blue bulls either fattened indoors (FI) or finished indoors after a previous grazing period were studied during six years. During the grazing period, three intensification managements were tested on a permanent pasture conducted as set stocking. The intensification levels were either high (HN: 140 kg N.ha-1 with 6 bulls.ha-1) or moderate with a 33% reduction of nitrogen fertilisation but with the same stocking rate (MN: 93 kg N.ha-1, 6 bulls.ha-1) or low with no nitrogen fertiliser but with a reduced stocking rate (ON, 4 bulls.ha-1). The levels of intensification did not affect sward characteristics and chemical composition of the grass. The apparent nitrogen efficiency per ha was larger in the ON plot than in the HN and MN plots (26 vs. 14%). The average daily gain of bulls during the grazing season was similar in the three groups at 1.0 kg.d-1. The bulls from the FI group were characterised by average daily gains significantly higher than the bulls which were previously grazed and then finished indoors (1.5 vs. 1.2 kg.d-1; P < 0.01). The slaughter weight, the carcass composition, the dressing percentage and most of the meat quality parameters were similar between the treatment groups. The inclusion of a grazing period in the fattening system produced a meat which was darker (lower L*, P < 0.01), more red (higher a*, P < 0.05) and had a higher content of linolenic acid (C18:3 n-3) than that of the animals fattened indoors.Désintensification de la conduite de prairies pâturées par de jeunes taurillons. Les performances zootechniques, la composition et la qualité de la viande de taurillons Blanc Bleu belge engraissés uniquement en stabulation (FI) ou finis en stabulation après une période de pâturage ont été étudiées pendant six années. Pendant la période de pâturage, trois niveaux d''intensification ont été testés dans une prairie permanente. Le système de pâturage continu a été employé. Les niveaux d''intensification ont été soit élevé (HN : 140 kg N.ha-1 ; 6 taureaux.ha-1), soit modéré avec une réduction de 33 % de la fertilisation azotée mais avec le même chargement (MN : 93 kg N.ha-1; 6 taureaux.ha-1), soit faible sans engrais azoté et avec un chargement réduit (ON : 4 taureaux.ha-1). Les traitements n''ont pas affecté les mesures phytotechniques (hauteur de l''herbe, pourcentage de refus) ni les contenus en matière azotée totale et en fibres brutes de l''herbe. L''efficience d''utilisation d''azote à l''hectare a été plus élevée dans le lot ON par rapport aux lots HN et MN (26 vs. 14 %). Le gain quotidien moyen des taureaux pendant la période de pâturage a été identique dans les trois lots (1 kg.j-1). Les taurillons du groupe FI ont présenté des gains quotidiens moyens significativement plus élevés que ceux des taurillons ayant séjourné en prairie et finis en stabulation (1,5 vs. 1,2 kg.j-1; P < 0,01). Le poids d''abattage, la composition de carcasse ainsi que le rendement à l''abattage et les paramètres de qualité de viande ont été semblables entre les traitements. L''inclusion d''une période de pâturage a produit une viande plus foncée et rouge par rapport au lot FI. Les teneurs en C18:3 ont été plus élevées (P < 0,05) pour les taurillons du lot HN par rapport à celles du lot FI. 
 [ABSTRACT FROM AUTHOR]

Objectives: The conventional test to detect unilateral spatial neglect (USN) is the Bells Test performed in a paper-and-pencil format. While several studies showed immersive virtual reality (VR) tests may provide greater sensitivity in revealing the presence of USN using visual scanning tasks, none has investigated the Bells Test in VR. This study compares the Bells Test performed in paper-and-pencil format (PP) and in VR in conventional (CVR) and ecological (EVR) format, which differ by the size of the display, in stroke patients., Design: Cross-sectional study., Setting: Stroke patients., Participants: A convenience sample of 32 stroke patients., Interventions: VR assessments were performed using an immersive system with a head-mounted display. In CVR, the Bells Test is reproduced in the same format as PP (A4 sheet), while in EVR, the targets are displayed in a wider space corresponding to a hemisphere of 1-m radius., Results: The number of cancelled targets out of 35 was 32.5 (3.5) for PP, 33 (4) for CVR, and 34 (2) for EVR (mean [SD]), with a significant difference between PP and EVR (p < 0.05). The time to complete the Bells Test was 186 (69) s for PP, 184 (65) s for CVR, and 170 (58) s for EVR, without differences between modalities (p > 0.05). Bells Tests in the 3 modalities revealed the presence of USN, except for 1 patient in EVR., Conclusion: VR assessment of USN could be used in the same way as conventional cancellations tests. Moreover, VR could provide additional information on the type of USN through the different testing modalities available.

Background: In the management of acute ischemic stroke with large vessel occlusion (LVO-AIS), current data are conflicting as to whether a mothership model of management (MS) is associated with better functional recovery than a drip-and-ship model (DS)., Method: Files from LVO-AIS patients treated with MT at CHU Charleroi were analyzed between 01/01/2017 and 12/31/2022. Consecutive patients with a LVO-AIS of the anterior circulation and a prestroke modified Rankin Scale (mRS) ≤2 were included. The study's primary endpoint was the functional independence, defined as a mRS of 0-2 at 3 months post-stroke. Times metrics of MT and thrombolysis application, safety outcome including symptomatic intracranial hemorrhage and death were recorded. We conducted similar analyses by dividing DS patients, depending of their transfer time (less or >20 min). Logistic regression was used to assess if differences in baseline characteristics affected the primary outcome., Results: 366 patients were included: 229 in the DS group and 137 in the MS group. Demographic data showed a higher rate of tobacco use and lower functional status prestroke in the MS population. The MS group demonstrated better performance in time metrics related to thrombolysis and MT administration. The proportion of patients achieving an mRS of 0-2 at 3 months was similar in the DS and MS groups (50.22 % vs. 48.17 %, p = 0.706). The same conclusions were drawn from the subgroup analysis. Logistic regression analysis showed no impact of baseline characteristic differences on the primary outcome., Conclusion: Despite faster access to MT in the MS model, our study did not find any significant differences in functional recovery at three months post-stroke between the MS and DS management models. Our data suggest further that the prestroke health status was an important factor influencing functional outcomes after LVO-AIS., Competing Interests: Declaration of competing interest The authors declare no conflict of interest., (Copyright © 2024. Published by Elsevier Inc.)

Purpose: Cerebellar impairment (CI) manifests from different etiologies resulting in a heterogenic clinical presentation affecting walking and mobility. Case-reports were reviewed to provide an analytical clinical picture of persons with CI (PwCI) to differentiate cerebellar and non-cerebellar impairments and to identify interventions and assessments used to quantify impact on walking and mobility according to the International Classification of Functioning, Disability and Health (ICF)., Materials and Methods: Literature was searched in PubMed, Web Of Science and Scopus. Case-reports conducting physical rehabilitation and reporting at least one outcome measure of ataxia, gait pattern, walking or mobility were included., Results: 28 articles with a total of 38 different patients were included. Etiologies were clustered to: spinocerebellar degenerations, traumatic brain injuries, cerebellar tumors, stroke and miscellaneous. The interventions applied were activity-based, including gait and balance training. Participation based activities such as tai chi, climbing and dance-based therapy had positive outcomes on mobility. Outcomes on body function such as ataxia and gait pattern were only reported in 22% of the patients., Conclusions: A comprehensive test battery to encompass the key features of a PwCI on different levels of the ICF is needed to manage heterogeneity. Measures on body function level should be included in interventions.

Mild traumatic brain injury (mTBI) and whiplash injury (WI) may lead to long-term disabling consequences known as post-concussive syndrome (PCS) and whiplash-associated disorders (WADs). PCS and WAD patients commonly complain of conditions encompassing dizziness, vertigo, headache, neck pain, visual complaints, anxiety, and neurocognitive dysfunctions. A proper medical work-up is a priority in order to rule out any acute treatable consequences. However investigations may remain poorly conclusive. Gathered in the head and neck structures, the ocular sensorimotor, the vestibular, and the cervical proprioceptive systems, all involved in postural control, may be damaged by mTBI or WI. Their dysfunctions are associated with a wide range of functional disorders including symptoms reported by PCS and WAD patients. In addition, the stomatognathic system needs to be specifically assessed particularly when associated to WI. Evidence for considering the post-traumatic impairment of these systems in PCS and WAD-related symptoms is still lacking but seems promising. Furthermore, few studies have considered the assessment and/or treatment of these widely interconnected systems from a comprehensive perspective. We argue that further research focusing on consequences of mTBI and WI on the systems involved in the postural control are necessary in order to bring new perspective of treatment., Competing Interests: Conflict of Interest: The authors have no potential conflicts of interest to disclose., (Copyright © 2023. Korean Society for Neurorehabilitation.)

Background: Human immunodeficiency viruses (HIV) infection is associated with a broad range of neurological manifestations, including opsoclonus-myoclonus ataxia syndrome (OMAS) occurring in primary infection, immune reconstitution syndrome or in case of opportunistic co-infection. Case: We report the exceptional case of a 43-year-old female under HIV treatment for 10 years who presented initially with suspected epileptic seizure. Although the clinical picture slightly improved under anti-epileptic treatment, it was rapidly attributed to OMAS. The patient exhibited marked opsoclonus, mild dysarthria, upper limbs intermittent myoclonus, ataxia in 4 limbs, truncal ataxia, and a severe gait ataxia (SARA score: 34). The diagnostic work-up showed radiological and biological signs of central nervous system (CNS) inflammation and cerebral venous sinus thromboses. The HIV viral load was higher in cerebrospinal fluid (CSF) than in the blood (4,560 copies/ml vs. 76 copies/ml). She was treated for 5 days with pulsed corticotherapy. Dolutegravir and anticoagulation administration were initiated. Follow-ups at 2 and 4 months showed a dramatic improvement of clinical neurologic status (SARA score at 4 months: 1), reduction of CNS inflammation and revealed undetectable CSF and serum viral loads. Conclusion: This case underlines the importance of the evaluation of the CSF viral load in HIV patients developing OMAS and suggests CSF HIV RNA escape as a novel cause for OMAS., (Copyright © 2020 Pierre, Arthur, Jérome, Remy, Soraya and Mario.)

The terminology of cerebellar dysmetria embraces a ubiquitous symptom in motor deficits, oculomotor symptoms, and cognitive/emotional symptoms occurring in cerebellar ataxias. Patients with episodic ataxia exhibit recurrent episodes of ataxia, including motor dysmetria. Despite the consensus that cerebellar dysmetria is a cardinal symptom, there is still no agreement on its pathophysiological mechanisms to date since its first clinical description by Babinski. We argue that impairment in the predictive computation for voluntary movements explains a range of characteristics accompanied by dysmetria. Within this framework, the cerebellum acquires and maintains an internal forward model, which predicts current and future states of the body by integrating an estimate of the previous state and a given efference copy of motor commands. Two of our recent studies experimentally support the internal-forward-model hypothesis of the cerebellar circuitry. First, the cerebellar outputs (firing rates of dentate nucleus cells) contain predictive information for the future cerebellar inputs (firing rates of mossy fibers). Second, a component of movement kinematics is predictive for target motions in control subjects. In cerebellar patients, the predictive component lags behind a target motion and is compensated with a feedback component. Furthermore, a clinical analysis has examined kinematic and electromyography (EMG) features using a task of elbow flexion goal-directed movements, which mimics the finger-to-nose test. Consistent with the hypothesis of the internal forward model, the predictive activations in the triceps muscles are impaired, and the impaired predictive activations result in hypermetria (overshoot). Dysmetria stems from deficits in the predictive computation of the internal forward model in the cerebellum. Errors in this fundamental mechanism result in undershoot (hypometria) and overshoot during voluntary motor actions. The predictive computation of the forward model affords error-based motor learning, coordination of multiple degrees of freedom, and adequate timing of muscle activities. Both the timing and synergy theory fit with the internal forward model, microzones being the elemental computational unit, and the anatomical organization of converging inputs to the Purkinje neurons providing them the unique property of a perceptron in the brain. We propose that motor dysmetria observed in attacks of ataxia occurs as a result of impaired predictive computation of the internal forward model in the cerebellum.

Objective: To investigate olfactory dysfunction (OD) in patients with mild coronavirus disease 2019 (COVID-19) through patient-reported outcome questionnaires and objective psychophysical testing., Methods: COVID-19 patients with self-reported sudden-onset OD were recruited. Epidemiological and clinical data were collected. Nasal complaints were evaluated with the sinonasal outcome-22. Subjective olfactory and gustatory status was evaluated with the National Health and Nutrition Examination Survey. Objective OD was evaluated using psychophysical tests., Results: Eighty-six patients completed the study. The most common symptoms were fatigue (72.9%), headache (60.0%), nasal obstruction (58.6%), and postnasal drip (48.6%). Total loss of smell was self-reported by 61.4% of patients. Objective olfactory testings identified 41 anosmic (47.7%), 12 hyposmic (14.0%), and 33 normosmic (38.3%) patients. There was no correlation between the objective test results and subjective reports of nasal obstruction or postnasal drip., Conclusion: A significant proportion of COVID-19 patients reporting OD do not have OD on objective testing., (© 2020 Wiley Periodicals, Inc.)