Low Specificity of Rapid Eye Movement Sleep Behavior Disorder Questionnaires: Need for Better Screening Methods.

BACKGROUND: Correct diagnosis of rapid eye movement sleep behavior disorder (RBD) is critical due to its link to α-synucleinopathies and risk of injuries and requires video-polysomnography (V-PSG). Usefulness of screening questionnaires outside the context of validation studies is limited. OBJECTIVE: The aim was to assess the performance of three validated RBD screening questionnaires compared with gold-standard V-PSG. METHODS: In this bicentric prospective study, 400 consecutive subjects referred to a sleep center for the first time filled three RBD questionnaires (RBD Screening Questionnaire, RBD Single Question, and Innsbruck RBD Inventory) in random order before sleep experts' interview. Subjects positive for at least one questionnaire were invited to undergo V-PSG. Data from patients negative for all questionnaires undergoing V-PSG for other reasons were also evaluated. Questionnaire performances were compared to gold-standard V-PSG RBD diagnosis. RESULTS: Three hundred ninety-nine patients (median age: 51 [interquartile range: 37-64] years, 54.9% men) participated. Two hundred thirty-eight (59.6%) were positive for at least one questionnaire, and RBD was diagnosed using V-PSG in 30 patients (7.5%). Questionnaire specificity was 48.1% to 67.4%, sensitivity 80% to 92%, accuracy 51% to 68.3%, negative predictive value 94.2% to 98%, and positive predictive value 14.1% to 20.7%, with no relevant differences in performances among the evaluated questionnaires. CONCLUSIONS: RBD questionnaires have low specificity and low positive predictive value and should not be used as a standalone tool for the diagnosis of RBD. Further development of RBD screening methods is needed, particularly for upcoming neuroprotective trials. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

Determinants and Trends of the Use of Intravenous Thrombolysis for Minor Stroke: A Population-Based Study, 2016 to 2020.

BACKGROUND: We analyzed the main factors associated with intravenous thrombolysis (IVT) in patients with minor ischemic stroke. METHODS: Data were obtained from a prospective, government-mandated, population-based registry of stroke code patients in Catalonia (6 Comprehensive Stroke Centers, 8 Primary Stroke Centers, and 14 TeleStroke Centers). We selected patients diagnosed with ischemic stroke and National Institutes of Health Stroke Scale (NIHSS) ≤5 at hospital admission from January 2016 to December 2020. We excluded patients with a baseline modified Rankin Scale score of ≥3, absolute contraindication for IVT, unknown stroke onset, or admitted to hospital beyond 4.5 after stroke onset. The main outcome was treatment with IVT. We performed univariable and binary logistic regression analyses to identify the most important factors associated with IVT. RESULTS: We included 2975 code strokes; 1433 (48.2%) received IVT of which 30 (2.1%) had a symptomatic hemorrhagic transformation. Patients treated with IVT as compared to patients who did not receive IVT were more frequently women, had higher NIHSS, arrived earlier to hospital, were admitted to a Comprehensive Stroke Centers, and had large vessel occlusion. After binary logistic regression, NIHSS score 4 to 5 (odds ratio, 40.62 [95% CI, 31.73-57.22]; P<0.001) and large vessel occlusion (odds ratio, 16.39 [95% CI, 7.25-37.04]; P<0.001) were the strongest predictors of IVT. Younger age, female sex, baseline modified Rankin Scale score of 0, earlier arrival to hospital (<120 minutes after stroke onset), and the type of stroke center were also independently associated with IVT. The weight of large vessel occlusion on IVT was higher in patients with lower NIHSS. CONCLUSIONS: Minor stroke female patients, with higher NIHSS, arriving earlier to the hospital, presenting with large vessel occlusion and admitted to a Comprehensive Stroke Centers were more likely to receive intravenous thrombolysis.

Effectiveness of Thrombectomy in Stroke According to Baseline Prognostic Factors: Inverse Probability of Treatment Weighting Analysis of a Population-Based Registry.

BACKGROUND AND PURPOSE:  In real-world practice, the benefit of mechanical thrombectomy (MT) is uncertain in stroke patients with very favorable or poor prognostic profiles at baseline. We studied the effectiveness of MT versus medical treatment stratifying by different baseline prognostic factors. METHODS:  Retrospective analysis of 2,588 patients with an ischemic stroke due to large vessel occlusion nested in the population-based registry of stroke code activations in Catalonia from January 2017 to June 2019. The effect of MT on good functional outcome (modified Rankin Score ≤2) and survival at 3 months was studied using inverse probability of treatment weighting (IPTW) analysis in three pre-defined baseline prognostic groups: poor (if pre-stroke disability, age >85 years, National Institutes of Health Stroke Scale [NIHSS] >25, time from onset >6 hours, Alberta Stroke Program Early CT Score <6, proximal vertebrobasilar occlusion, supratherapeutic international normalized ratio >3), good (if NIHSS <6 or distal occlusion, in the absence of poor prognostic factors), or reference (not meeting other groups' criteria). RESULTS:  Patients receiving MT (n=1,996, 77%) were younger, had less pre-stroke disability, and received systemic thrombolysis less frequently. These differences were balanced after the IPTW stratified by prognosis. MT was associated with good functional outcome in the reference (odds ratio [OR], 2.9; 95% confidence interval [CI], 2.0 to 4.4), and especially in the poor baseline prognostic stratum (OR, 3.9; 95% CI, 2.6 to 5.9), but not in the good prognostic stratum. MT was associated with survival only in the poor prognostic stratum (OR, 2.6; 95% CI, 2.0 to 3.3). CONCLUSIONS:  Despite their worse overall outcomes, the impact of thrombectomy over medical management was more substantial in patients with poorer baseline prognostic factors than patients with good prognostic factors.

Sleep disorders in anti-NMDAR encephalitis.

OBJECTIVE: To describe the sleep disorders in anti-NMDA receptor encephalitis (anti-NMDARe). METHODS: Patients recovering from anti-NMDARe were invited to participate in a prospective observational single-center study including comprehensive clinical, video-polysomnography (V-PSG) sleep assessment, and neuropsychological evaluation. Age- and sex-matched healthy participants served as controls. RESULTS: Eighteen patients (89% female, median age 26 years, interquartile range [IQR] 21-29 years) and 21 controls (81% female, median age 23 years, IQR 18-26 years) were included. In the acute stage, 16 (89%) patients reported insomnia and 2 hypersomnia; nightmares occurred in 7. After the acute stage, 14 (78%) had hypersomnia. At study admission (median 183 days after disease onset, IQR 110-242 days), 8 patients still had hypersomnia, 1 had insomnia, and 9 had normal sleep duration. Patients had more daytime sleepiness than controls (higher Barcelona Sleepiness Index, p = 0.02, and Epworth Sleepiness Score, p = 0.04). On V-PSG, sleep efficiency was similar in both groups, but patients more frequently had multiple and longer confusional arousals in non-REM (NREM) sleep (videos provided). In addition, 13 (72%) patients had cognitive deficits; 12 (67%) had psychological, social, or occupational disability; and 33% had depression or mania. Compared with controls, patients had a higher body mass index (median 23.5 [IQR 22.3-30.2] vs 20.5 [19.1-21.1] kg/m2; p = 0.007). Between disease onset and last follow-up, 14 (78%) patients developed hyperphagia, and 6 (33%) developed hypersexuality (2 requiring hospitalization), all associated with sleep dysfunction. CONCLUSIONS: Sleep disturbances are frequent in anti-NMDARe. They show a temporal pattern (predominantly insomnia at onset; hypersomnia during recovery), are associated with behavioral and cognitive changes, and can occur with confusional arousals during NREM sleep.

Líneas de desarrollo epistemológico por las que han trascurrido las disciplinas informativas en Cuba y resultados a partir de estudios de términos / Epistemological development lines followed by information disciplines in Cuba and results obtained from terminology studies

Sobre la base de los canales formales de comunicación de las disciplinas informativas en Cuba se realizó un estudio terminológico de los títulos de la producción profesional desde 1905 hasta 2008, que en su conjunto esclarecieron su campo epistémico y evidenciaron líneas de desarrollo disciplinar por las cuales estas han transcurrido, a la vez que marcaron momentos de gestación, evolución o crisis y consolidación. El estudio terminológico basado en elementos de la estadística descriptiva y el empleo de las series temporales se vinculó con la investigación teórico-histórica, que permitió contextualmente estudiar el fenómeno como un todo, independientemente de los intentos de homogeneización que brinda cualquier propuesta de periodización histórica. Se arribó como conclusión a una propuesta de periodización histórica que permitió establecer el devenir de las disciplinas, así como la productividad terminológica por categorías de términos y líneas disciplinares

Based on the formal communication channels of information disciplines in Cuba, a terminological study was conducted of the titles used for professional production from 1905 to 2008, which, taken together, shed light on their epistemic field and revealed the lines of discipline development they have followed, identifying moments of gestation, evolution or crisis, and consolidation. Elements of descriptive statistics and the use of time series provided the terminological study with a theoretical-historical approach, allowing to examine the phenomenon contextually and as a whole, regardless of the attempts at homogenization typical of historical periodizations. The conclusion of the study is a proposal of historical periodization reflecting the evolution of disciplines as well as their terminological production by term category and discipline line

La interdisciplinariedad y la transdisciplinariedad en las ciencias: una mirada a la teoría bibliológico-informativa / The interdisciplinarity and transdisciplinarity in sciences: a glance to bibliologic-informative theory

Se analizan la interdisciplinariedad y la transdisciplinariedad como categorías de estudio y prácticas de las ciencias actuales, empleadas para solucionar problemas que las disciplinas por sí solas no pueden resolver. Se estudian sus clasificaciones y definiciones, así como los fundamentos ontológicos en los que basan su concepción, su historia y significado, para mostrar que la teoría bibliológico-informativa puede considerarse como inter y transdisciplinaria.

Inter- and transdisciplinarity are analyzed as study categories and practices of contemporary science, used for the solution of problems that the disciplines cannot solve by temselves. Their classifications and definitions, as well as the ontological foundations, on which their conception, history and meanings and history are based, are studied to show why the bibliologic-informative theory may be considered an inter- and transdisciplinary theory.

Bibliotecología y Ciencia de la Información: enfoque interdisciplinario / Library Science and Information Science: an interdisciplinary approach

Se estudia la esencia interdisciplinaria de la Bibliotecología y la Ciencia de la Información. Se analiza el período comprendido entre la aparición de sus primeras actividades empíricas hasta la formación de las disciplinas que la definen y su concepción actual como ciencias. Se presenta además, una propuesta sobre las formas en que se manifiesta la interdisciplinariedad y se proveen ejemplos en correspondencia con las concepciones teóricas definidas a lo largo de su evolución histórica.

The interdisciplinary essence of Library Science and Information Sciences was studied. The period from the appearance of their first empirical activities to the formation of the disciplines that defined them and their present conception as sciences was analyzed. A proposal on the forms in which interdisciplinarity manifest was presented, and examples were given in correspondance with the theorical conceptions defined along its historical evolution.

La literatura bibliológica-informativa en Cuba; parte I: reflexión histórica / The bibliológica-informative literature in Cuba: I: reflection histórica1 leaves

La producción literaria en Cuba en el ámbito bibliológico informativo se ha investigado en diversos trabajos a partir del estudio de las principales publicaciones que la representa o de flujos documentales especializados en el tema. Se investiga, a partir de la mayor muestra compilada hasta el momento de dicha literatura, las diversas etapas por las que ella ha transitado durante todo el siglo XX y se exponen para cada una de ellas, las condiciones sociales, históricas y económicas que han interactuado en la formación y consolidación de esta literatura en Cuba. En esta primera parte, se realiza un estudio histórico de los principales factores que incidieron en la actividad bibliotecaria en Cuba desde sus inicios y que condicionaron la aparición de la literatura que la representa, incluida la formación del profesional y los eventos.

Identificación de las competencias generales y técnicas necesarias para un mejor desempeño bibliotecario: estudio de un caso / Identification of the necessary general and technical competitions for a better acting librarian. I study of a case

Se realiza un estudio de desempeño en dos grupos de trabajo de una institución cubana seleccionada con vistas a realizar un diagnóstico de las principales limitaciones que presentan con la finalidad de iniciar cambios paulatinos y emprender procesos de mejora. Se identifican las competencias generales y técnicas que responden a los objetivos estratégicos de los departamentos A y B. Se confeccionan los mapas por departamentos y se delimitan las brechas existentes. Finalmente, se realiza una propuesta para la mejora de desempeño.

Archivología, bibliografía, bibliotecología y ciencias de la información: ¿todas para una o una para todas? / Archivología, bibliography, bibliotecología and sciences of the information: all for an or one for all?

A partir de las diversas definiciones que existen sobre las ciencias informativas: bibliotecología, archivología, bibliografología y ciencias de la información, se reflexiona acerca de sus puntos de contacto y divergencias sobre la base del marco teórico del sistema bibliológico-informativo, desarrollado por el Doctor en Ciencias de la Información Emilio Setién Quesada y otros profesionales cubanos.

Propuesta preliminar de un sistema de indicadores para la evaluación del rendimiento de las bibliotecas públicas cubanas / A preliminary proposal of a system of indicators for the evaluation of the performance of the Cuban public libraries

Se reflexiona sobre el desarrollo de los estudios cuantitativos en la esfera informativa, tanto en el mundo como en Cuba, específicamente en el Sistema Nacional de Bibliotecas Públicas y los referidos a la evaluación de bibliotecas. Se incursiona por diversas tipologías de indicadores de rendimiento útiles para evaluar el desempeño de las bibliotecas públicas y por el control estadístico que realizan las bibliotecas públicas en el país. Finalmente, se realiza una propuesta de indicadores para evaluar el rendimiento de las bibliotecas públicas cubanas sobre la base del conjunto de variables y controles estadísticos que dichas bibliotecas poseen en la actualidad

The development of the qualitative studies in the information sphere, both in the world and in Cuba, specifically in the National System of Public Libraries, and of those referred to the evaluation of libraries, is dealt with. Diverse typologies of yielding indicators useful to evaluate the performance of the public libraries, as well as the statistical control carried out by the public librares in the country are analysed. Finally, a proposal of indicators is made to assess the yielding of the Cuban public libraries based on the set of statistical variables and controls these libraries have at present.

De la descripción bibliográfica a la asignación de metadatos: un llamado al orden / Of the bibliographical description to the metadatos assignment: a call to the order

Se analizan las nuevas proyecciones de la organización de la información, a partir de la descripción bibliográfica y sus elementos, en el entorno actual y a la luz del paradigma tecnológico. Se retoman los metadatos, algunas de sus definiciones e intentos de normalización y se comparan estos con los elementos tradicionales de la descripción bibliográfica y los términos de la indización. Se incursiona en la Web semántica, los lenguajes y los formatos, así como por un conjunto de software y servidores clientes disponibles para generar los metadatos

The new projections of information organization are analysed based on the bibliographical description and its elements in the present context an to the light of the technological paradigm. The metadata, some of their definitions and intents of normalization are studied and compared with the traditional elements of bibliographical description and the indexation terms. The semantic Web, languages and formats, as well as a set of software and available client servers are explored to generate the metadata.

La formación bibliotecaria en Cuba: una mirada a través de los documentos / Library training in Cuba: a look through the documents

Se esbozan históricamente los primeros intentos realizados para la formación profesional del bibliotecario cubano hasta llegar a los cambios sociales que experimentó Cuba en los inicios de la Revolución donde se crearon las primeras escuelas de nivel medio de bibliotecología y la creación de la carrera universitaria. Se analizan las investigaciones desarrolladas, tanto en el nivel medio del bibliotecario público como en los estudios universitarios, a partir de los trabajos finales presentados para sus respectivas graduaciones

La bibliografía, bibliometría y las ciencias afines / Bibliography, bibliometry and their related sciences

Se describen las características esenciales que revelan el surgimiento de una incipiente cultura digital en la actualidad, a partir de los cambios que acontecen en la llamada sociedad de la información. Se presenta a la bibliografía como una nueva ciencia en el complejo mundo bibliológico-informacional y se define a la bibliometría como su ciencia métrica. Se estudia el surgimiento y la importancia de las publicaciones en la ciencia, así como las posibilidades que ofrecen los formatos electrónicos. Se analiza la bibliometría como ciencia que parte de los elementos descriptivos de la documentación científica y la necesidad de valorar la tipología documentaria para la obtención de resultados que reflejen con mayor precisión el fenómeno científico. Se reflexiona sobre la importancia de la bibliometría en la gestión de información y del conocimiento; se considera el trabajo bibliotecario como el más antiguo y profesional en la organización de la información