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Background and purpose Tick-borne encephalitis ( TBE) is an infection of the central nervous system ( CNS) caused by tick-borne encephalitis virus ( TBEV) and transmitted by ticks, with a variety of clinical manifestations. The incidence of TBE in Europe is increasing due to an extended season of the infection and the enlargement of endemic areas. Our objectives are to provide recommendations on the prevention, diagnosis and management of TBE, based on evidence or consensus decisions. Methods For systematic evaluation, the literature was searched from 1970 to 2015 (including early online publications of 2016), and recommendations were based on evidence or consensus decisions of the Task Force when evidence-based data were not available. Recommendations Vaccination against TBE is recommended for all age groups above 1 year in highly endemic areas (≥5 cases/100 000/year), but also for individuals at risk in areas with a lower incidence. Travellers to endemic areas should be vaccinated if their visits will include extensive outdoor activities. Post-exposure prophylaxis after a tick bite is not recommended. A case of TBE is defined by the presence of clinical signs of meningitis, meningoencephalitis or meningoencephalomyelitis with cerebrospinal fluid ( CSF) pleocytosis (>5 × 106 cells/l) and the presence of specific TBEV serum immunoglobulin M (IgM) and IgG antibodies, CSF IgM antibodies or TBEV IgG seroconversion. TBEV-specific polymerase chain reaction in blood is diagnostic in the first viremic phase but it is not sensitive in the second phase of TBE with clinical manifestations of CNS inflammation. Lumbar puncture should be performed in all patients with suspected CNS infection unless there are contraindications. Imaging of the brain and spinal cord has a low sensitivity and a low specificity, but it is useful for differential diagnosis. No effective antiviral or immunomodulating therapy is available for TBE; therefore the treatment is symptomatic. Patients with a potentially life threatening meningoencephalitis or meningoencephalomyelitis should be admitted to an intensive care unit. In the case of brain oedema, analgosedation should be deepened; osmotherapy and corticosteroids are not routinely recommended. If intracranial pressure is increased, therapeutic hypothermia or decompressive craniectomy might be considered. Seizures should be treated as any other symptomatic epileptic seizures. Conclusions Tick-borne encephalitis is a viral CNS infection that may result in long-term neurological sequelae. Since its incidence in Europe is increasing due to broadening of endemic areas and prolongation of the tick activity season, the health burden of TBE is enlarging. There is no effective antiviral treatment for TBE, but the disease may be effectively prevented by vaccination. [ABSTRACT FROM AUTHOR]

The purpose of this research is to synthesize, characterize, optimize, and apply MIP as an adsorbent material for solid phase extraction (SPE). The synthesis method used is precipitation polymerization. MAA as a monomer was combined with EGDMA as a crosslinker and used DEHP as imprinting molecules. Structural characterization of MIP using SEM, and TGA. MIP optimization using time and concentration parameters was carried out to test MIP's ability to adsorb DEHP. The MIP_DEHP_MAA-co-EGDMA or MIP_DEHP obtained were white powders. The MIP surface morphology is granules with shape, and size more uniform than NIP. The MIP_DEHP adsorption ability on the time effect reached optimum at 90 minutes. The adsorption kinetics model for MIP_DEHP follows the kinetic model of pseudo-second-order (PSO) adsorption. The adsorption ability to the effect of concentration increases with increasing concentration. The adsorption capacity value of MIP_DEHP was 4.3917 mg/g determined according to the Langmuir isothermal adsorption model. The application of MIP_DEHP as an adsorbent in the SPE method has proven to be very good and allows it to be reused because the reusability percentage is very high, namely 95.52%. [ABSTRACT FROM AUTHOR]

Sikk K, Taba P, Haldre S, Bergquist J, Nyholm D, Askmark H, Danfors T, Sörensen J, Thurfjell L, Raininko R, Eriksson R, Flink R, Färnstrand C, Aquilonius S-M. Clinical, neuroimaging and neurophysiological features in addicts with manganese-ephedrone exposure. Acta Neurol Scand: 2010: 121: 237–243. © 2009 The Authors Journal compilation © 2009 Blackwell Munksgaard. Objective – To identify biomarkers supporting the clinical diagnosis of manganism in patients several years after exposure to manganese (Mn). Methods – Neurophysiological examinations, magnetic resonance imaging (MRI), single-photon emission computed tomography and fluorodeoxyglycose (FDG) positron emission tomography were performed in four former ephedrone addicts with extrapyramidal symptoms. Results – Peripheral nervous system was not affected. No patients had reduced uptake of 123I Ioflupane in the striatum. MRI signal intensities were slightly changed in the basal ganglia. All patients showed a widespread, but not uniform, pathological pattern of FDG uptake with changes mainly located to the central part of the brain including the basal ganglia and the surrounding white matter. Conclusions – Presynaptic neurons in the nigrostriatal pathway are intact in Mn-induced parkinsonism after prolonged abstinence from ephedrone. The diagnosis is principally based on clinical signs and the history of drug abuse. [ABSTRACT FROM AUTHOR]

Background – Parkinsonian syndrome related to intravenous use of a ‘designer’ psychostimulant, derived from pseudoephedrine using potassium permanganate as the oxidant, has been observed in drug addicts in Estonia. Objective – To describe the symptomatology of four young patients, history of drug administration and chemical analysis of a drug batch. Methods – Mental and motor function and quality of life were scored and ephedrone was analyzed using electrospray mass spectrometry. Manganese content of the final synthetic mixture was analyzed using Inductively Coupled Plasma-Atomic Emission Spectrometry. Results – None of the four cases scored below the dementia threshold in MMSE, while other ratings (UPDRS, H&Y, PDQ-39) corresponded to disabilities seen in relatively advanced Parkinson's disease. The ephedrone yield of the reaction was approximately 44% and the mixture was found to contain 0.6 g/l of manganese. Conclusions – The cases were exposed to extreme manganese load. Their symptomatology is probably identical to manganism. The role of ephedrone is presently unknown. Physicians must be aware of early signs of manganism in patients within social risk groups. [ABSTRACT FROM AUTHOR]

This research has studied the synthesis of fatty acid ethyl esters for biodiesel production using heterogeneous SO42-/TiO2 catalysts supported by mesoporous silica. The characterization result of the catalyst using X-Ray of wide-angle powder (WAXRD) and Scanning Electron Microscope (SEM) gives information that the existence of silica as support of SO42-/TiO2 active site. Observation data were analyzed by Response Surface Design (Composite Central Design). The results of the conversion design analysis, it w s observed that the number of catalysts: 5%, Ethanol / PFAD molar ratio: 13 and reaction time: 2.25 hours as a variable for optimization of the esterification process The physical characterization of ethyl ester as biodiesel is recorded by viscosity and density according to ASTM D-6751. The presence of functional groups which show the formation of ethyl esters indicated by FTIR analysis as C-H (alkanes), C=O, C-O and C-H (alkyl, R). The composition and type of ethyl ester from fatty acids were determined through GC-MS analysis. The highest peaks are indicated as palmitate ethyl ester, stearate ethyl ester and oleate ethyl ester and inform that the esterification reaction carried out has succeeded in producing highquality biodiesel. [ABSTRACT FROM AUTHOR]

The goal of this study is to synthesize copper nanoparticles (CuNPs) using Coffee arabica extract at room temperature using simple methods, characterize nanoparticle generation, and explore the impact of extract concentration on the production of copper nanoparticles, followed by a qualitative phytochemical screening of coffee extract metabolites and CuNPs toxicity demonstration. To characterize nanoparticle generation, color change, and UV-visible spectrophotometer were explored, analyzing by the Fourier Transform Infra-Red (FTIR) spectroscopy detected the availability of major functional groups, and the X-ray diffractometer demonstrated nanoparticles size. Additionally, CuNPs safety was demonstrated by hemolysis assays. The results revealed that the Coffee arabica beans solution shifted copper ions into copper nanoparticles at room temperature within 15 min of reaction time, and also registered peak absorbance at 262 nm in 3 days and 30 days to conform synthesis and stability CuNPs. In addition, FTIR analyses demonstrated the corresponding bonds (-OH, C=C, and C-H) that are responsible for the formation of CuNPs. Furthermore, the XRD results reported CuNPs to have a monoclinic crystalline shape with a mean crystallite size of 16.3 nm, CuNPs were found to be harmless in hemolytic experiments. Thus, this method can be used for optimum rapid synthesis of copper nanoparticles. [ABSTRACT FROM AUTHOR]

Introduction: Diagnosis and management of Parkinson's disease (PD) rely heavily on evaluation of clinical symptoms and patients' subjective perception of their condition. The purpose of this study was to evaluate the validity, acceptability, and reliability of the Estonian version of the 39-question Parkinson 's disease Questionnaire (PDQ-39).Methods: Study subjects were approached during their regular clinic follow-up visits. 104 patients consented to the study and 81 completed questionnaires were used for subsequent testing of psychometric characteristics, validity and reliability.Results: The content validity was assessed through qualitative content analysis during the pilot study. The patients indicated that the questions were relevant to measure the quality of life of people with PD. The analysis of means showed that the ceiling and floor effects of domain results were within the limits of 15% of Summary Index and of all domains except Stigma, Social Support and Communication where the ceiling effect was 16% to 24% of the responses. Convergent validity was interpreted through correlation between disease severity and PDQ-39 domains. There was a statistically significant difference between the domain scores in patients with mild versus moderate PD in domains of Mobility, ADL, and Communication but not for Stigma, Social Support and Cognition. The reliability was good, Cronbach alpha for all domains and summary index was over 0.8 and item-test correlations between domains and summary index ranged from 0.56 to 0.83.Conclusion: The psychometric characteristics of an Estonian version of the PDQ-39 were satisfactory. The results of this study were comparable to the results of previous validation studies in other cultural settings in UK, USA, Canada, Spain and Italy. The Estonian version of the PDQ-39 is an acceptable, valid and reliable instrument for quality of life measurement in PD patients. [ABSTRACT FROM AUTHOR]

The photocatalytic activity of the methylene blue in metal oxide anatase-rutile mixed phase TiO 2 nanoparticles doped with iron after annealing at various temperature has been investigated. The ratio Fe/Ti (wt 3 %) was prepared using the conventional co-precipitation technique with annealing treatment. X-ray Diffraction (XRD) analysis showed anatase (∼25 %) and rutile (∼75 %) phase structures, and the crystallite size increased with increasing temperature. The Fourier transform infrared (FTIR) transmittance band at 517 cm−1 for TiO 2 stretching vibration mode was examined using Kramer-Kronig relation for determining the optical characteristic such as the refractive index (n), the extinction coefficient (k), the dielectric function, and the energy loss function. Further analysis of the optical properties of Fe-doped TiO 2 NPs shows the Δ (L O − T O) is shrinker after annealing above 200oC that indicated more stable bonding. The field emission scanning electron microscopy (FESEM) micrographs show agglomerations formed into clusters like as edelweiss flowers and roses on the surface. UV–Vis measurement reveals that the optical energy gap decreased from 3.05 eV annealed at 200oC to 2.88 eV annealed at 500oC. The UV–Vis absorbance with varying the time from 30 to 120 min to MB as a pollutant is reduced as time irradiation increases with photocatalytic rates for annealing at 500oC is 0.0071/min. The predominant anatase phase alignment, stable bonding, and unique surface make iron doped TiO 2 NPs a promising catalyst. [Display omitted] • Morphological analysis shows clusters like as edelweiss flowers and roses on the surface. • Optical energy gap decreased from 3.05 eV to 2.88 eV annealed at 500oC. • The predominant anatase phase alignment, stable bonding, and unique surface. • High photocatalytic rates of Iron-Doped TiO 2 NPs is 0.0071/min. [ABSTRACT FROM AUTHOR]

Background and purpose: Although the main clinical features of COVID‐19 infection are pulmonary, several associated neurological signs, symptoms and diseases are emerging. The incidence and characteristics of neurological complications are unclear. For this reason, the European Academy of Neurology (EAN) core COVID‐19 Task Force initiated a survey on neurological symptoms observed in patients with COVID‐19 infection. Methods: A 17‐question online survey was made available on the EAN website and distributed to EAN members and other worldwide physicians starting on 9 April 2020. Results: By 27 April 2020, proper data were collected from 2343 responders (out of 4199), of whom 82.0% were neurologists, mostly from Europe. Most responders (74.7%) consulted patients with COVID‐19 mainly in emergency rooms and in COVID‐19 units. The majority (67.0%) had evaluated fewer than 10 patients with neurological manifestations of COVID‐19 (neuro COVID‐19). The most frequently reported neurological findings were headache (61.9%), myalgia (50.4%), anosmia (49.2%), ageusia (39.8%), impaired consciousness (29.3%) and psychomotor agitation (26.7%). Encephalopathy and acute cerebrovascular disorders were reported at 21.0%. Neurological manifestations were generally interpreted as being possibly related to COVID‐19; they were most commonly recognized in patients with multiple general symptoms and occurred at any time during infection. Conclusion: Neurologists are currently and actively involved in the management of neurological issues related to the COVID‐19 pandemic. This survey justifies setting up a prospective registry to better capture the prevalence of patients with neuro COVID‐19, neurological disease characteristics and the contribution of neurological manifestations to outcome. [ABSTRACT FROM AUTHOR]

Background and purpose: We systematically reviewed available evidence for reports of neurological signs and symptoms in patients with COVID‐19 to identify cases with severe acute respiratory syndrome coronavirus (SARS‐CoV)‐2 infection or immune‐mediated reaction in the nervous system. Methods: We followed PRISMA guidelines and used the MEDLINE, EMBASE, Google Scholar, MedRxiv and ChinaXiv databases to search for articles on COVID‐19 and nervous system involvement that were published from 1 January to 24 April 2020. Data on design, sample size, neurological assessment and related work‐up were extracted. Biases were assessed with the Newcastle–Ottawa scale. Results: We analysed 27 publications on potential neuroinvasive or parainfectious neurological complications of COVID‐19. The reports focused on smell and taste (n = 5) and evaluation of neurological symptoms and signs in cohorts (n = 5). There were cases of Guillain‐Barré syndrome/Miller‐Fisher syndrome/cranial neuropathy (seven cases), meningitis/encephalitis (nine cases) and various other conditions (five cases). The number of patients with examination of cerebrospinal fluid and, in particular, SARS‐CoV‐2 polymerase chain reaction was negligible. Two had a positive SARS‐CoV‐2 polymerase chain reaction examination of cerebrospinal fluid specimen. Study of potential parenchymal involvement with magnetic resonance imaging was rare. Only four reports received a rating of the highest quality standards. Conclusions: This systematic review failed to establish comprehensive insights into nervous system manifestations of COVID‐19 beyond immune‐mediated complications in the aftermath of respiratory symptoms. The authors therefore provide guidance for more careful clinical, diagnostic and epidemiological studies to characterize the manifestations and burden of neurological disease caused by SARS‐CoV‐2 on behalf of the Infectious Disease Panel of the European Academy of Neurology. [ABSTRACT FROM AUTHOR]

Objectives: A previous epidemiological study of Parkinson's disease (PD) in the county of Tartu, Estonia, found an adjusted prevalence rate of 152/100 000 persons. We aimed to determine PD prevalence almost 20 years later, as well as evaluate any dynamic changes in disease frequency compared to the first study. Methods: A cross‐sectional, community‐based study was conducted over 2010‐2016 in the county of Tartu, Estonia. Multiple case‐finding sources, including information from neurologists, family doctors, the local PD Society, nursing institutions, and the database of the Estonian Health Insurance Fund were used to identify patients with PD of all ages. Results: Total crude PD prevalence was 283 and age‐adjusted prevalence (standardized to the 2014 age structure of the Estonian population) 314/100 000. No significant differences in age‐adjusted prevalence rates were found between men and women, nor people living in urban and rural areas. After adjustment to the same standard population used in the previous prevalence study, the overall age‐adjusted prevalence rate was 197/100 000. Patients in the current study were older and often had a more severe form of PD and a longer disease duration, compared to those reported in the first epidemiological study 20 years ago. Conclusions: The age‐specific crude rates in oldest age‐groups have risen substantially, and the age‐adjusted prevalence has moderately increased compared to 20 years ago in Estonia. We hypothesize that the increased life expectancy of the Estonian population and improved diagnosis of PD contributed most to the increase in disease frequency. [ABSTRACT FROM AUTHOR]

Background and purpose Methcathinone abuse is a new cause of manganism. The psychostimulant is prepared from pseudoephedrine using potassium permanganate as an oxidant. We describe the clinical, biological, neuroimaging characteristics and follow-up results in a large Estonian cohort of intravenous methcathinone users. Methods During 2006-2012 we studied 38 methcathinone abusers with a mean age of 33 years. Subjects were rated by the Unified Parkinson's Disease Rating Scale ( UPDRS), Hoehn and Yahr ( HY), and Schwab and England ( SE) rating scales. Twenty-four cases were reassessed 9-70 (20 ± 15) months after the initial evaluation. Manganese ( Mn) in plasma and hair was analysed by inductively coupled plasma- atom emission spectrometry. Magnetic resonance imaging ( MRI) was performed in 11, and single-photon emission computed tomography ( SPECT) with iodobenzamide ( IBZM) in eight subjects. Results The average total UPDRS score was 43 ± 21. The most severely affected domains in UPDRS Part III were speech and postural stability, the least affected domain was resting tremor. At follow-up there was worsening of HY and SE rating scales. Subjects had a higher mean level of Mn in hair (2.9 ± 3.8 ppm) than controls (0.82 ± 1.02 ppm), P = 0.02. Plasma Mn concentrations were higher (11.5 ± 6.2 ppb) in active than in former users (5.6 ± 1.8 ppb), P = 0.006. Active methcathinone users had increased MRI T1-signal intensity in the globus pallidus, substantia nigra and periaquaductal gray matter. IBZM- SPECT showed normal symmetric tracer uptake in striatum. Conclusion Methcathinone abusers develop a distinctive hypokinetic syndrome. Though the biomarkers of Mn exposure are characteristic only of recent abuse, the syndrome is not reversible. [ABSTRACT FROM AUTHOR]