What's happening in <i>Neurology® Neuroimmunology & Neuroinflammation</i>
Bibliographic record
Abstract
Impact of data-driven CSF protein upper reference limits in Guillain-Barré syndromeObjective We conducted a retrospective review of patients with a diagnosis of Guillain-Barré syndrome (GBS) to assess the diagnostic impact of applying age-adjusted upper limits for CSF total protein (CSF-TP) supported by a systematic literature review.Methods Cases coded as GBS or inflammatory neuropathy for the period 2001-2016 at The Ottawa Hospital were reviewed.Cases were included if they met the Brighton criteria for GBS with a diagnostic certainty level 1 or 2 and had contemporaneous CSF-TP data.We excluded cases with CSF pleocytosis >50 and cases with Miller-Fisher syndrome.Age-adjusted reference limits were compared with conventional 0.45 and 0.6 g/L upper limits.Results One hundred thirty-eight cases met the study criteria, with a mean age of 47 years.The mean interval from symptom onset to lumbar puncture was 7.9 days, and mean CSF-TP was 1.23 g/L.There was a strong correlation between rising CSF-TP and time to lumbar puncture.Age-adjusted CSF-TP had a significantly lower sensitivity of only 45% in the first week (32% in the first 3 days) compared with 70% in the first week for the 0.45 g/L limit.All upper limits gained high sensitivity after the first week. ConclusionsThe low sensitivity of CSF-TP for the diagnosis of GBS is exacerbated by age-adjusted upper limits.The main role of lumbar puncture in GBS in the first week may be to help exclude other inflammatory or neoplastic etiologies of acute neuropathy.After the first week, the magnitude of the CSF-TP rise reduces the effect of different upper reference limits. NPub.org/N2/948a Neuromyelitis optica spectrum disorder: Patient experience and quality of lifeObjective To gain insights into NMOSD disease impact, which may negatively affect QoL of patients, their families, and social network.Methods The current study used validated instruments to assess physical, emotional, and socioeconomic burden of NMOSD on QoL among 193 patients.Results A majority of patients reported an initial diagnosis of a disease other than NMOSD.Overall, two-thirds of patients reported NMOSD as having a strong negative impact on physical health (Short Form-36 [SF-36] score 27.1 ± 39.1), whereas emotional well-being was relatively unimpaired on average (SF-36 score 54.0 ± 44.9).A subset of patients reported having the highest category of emotional health despite worse physical health or financial burden, suggesting psychological resilience.Pain (r = 0.61) and bowel/bladder dysfunction (r = 0.41) imposed the greatest negative physical impact on overall QoL.In turn, ability to work correlated inversely with worsened health (r = -0.68).Increased pain, reduced sexual function, inability to work, and reduced QoL had greatest negative impacts on emotional well-being.Dissatisfaction with treatment options and economic burden correlated inversely with QoL.Conclusions Collectively, the current findings advance the understanding of physical, emotional, social, and financial tolls imposed by NMOSD.These insights offer potential ways to enhance QoL by managing pain, enhancing family and social networks, and facilitating active employment.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.038 | 0.137 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.006 | 0.007 |
| Science and technology studies | 0.000 | 0.002 |
| Scholarly communication | 0.004 | 0.004 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".