Structural MRI is the most frequently used method to investigate brain volume alterations in neuropsychiatric disease. Previous meta-analyses have typically focused on a single diagnosis, thereby precluding transdiagnostic comparisons.
 
  We will include all structural MRI studies of adults that report brain volumes for participants from at least two of the following diagnostic groups healthy controls, schizophrenia, schizoaffective disorder, delusional disorder, psychotic depression, clinical high risk for psychosis, schizotypal personality disorder, psychosis unspecified, bipolar disorder, autism spectrum disorder, major depressive disorder, attention deficit hyperactivity disorder, obsessive compulsive disorder, post-traumatic stress disorder, emotionally unstable personality disorder, 22q11 deletion syndrome, generalised anxiety disorder, social anxiety disorder, panic disorder, mixed anxiety and depression.  https://www.selleckchem.com/products/GDC-0449.html  Network meta-analysis will be used to synthesise eligible studies. The primary analysis will examine standardised mean difference in average volume, a secondary analysis will examine differences in variability of volumes.
 
  This network meta-analysis will provide a transdiagnostic integration of structural neuroimaging studies, providing researchers with a valuable summary of a large literature.
 
  CRD42020221143.
 CRD42020221143.
  We synthesized evidence for effectiveness of vagus nerve stimulation (VNS) as adjuvant therapy in pediatric drug-resistant epilepsy (DRE) by obtaining pooled estimates for seizure outcomes and analyzing their determinants.
 
  MEDLINE, EMBASE, and Cochrane databases were searched up to July 2019, for original research on VNS in pediatric (≤18 years-of-age) epilepsy. The primary outcome was 50% responder rate (50%-RR), the proportion of patients with ≥50% seizure reduction, at the last reported follow-up. Other outcomes included 50%-RR and proportion of seizure-free patients at additional reported time points. A random effects meta-analysis with restricted maximum likelihood estimation was performed to obtain pooled effect estimates. Meta-regression using multiple linear models was performed to obtain determinants of seizure outcomes and sources of heterogeneity.
 
  A total of 101 studies were included. The pooled prevalence estimates for 50%-RR and seizure freedom at last follow-up (mean 2.54 years) were 56.4% (95% confidence intervals [CIs] 52.4, 60.4) and 11.6% (95% CI 9.6, 13.9) respectively. Fewer anti-seizure medications (ASMs) tried before VNS, and later age at onset of seizures were associated with better seizure outcomes following VNS implantation. An effect of sex-distribution of studies on long-term outcomes and a potential publication bias for short-term outcomes were also observed.
 
  Pooled evidence supports possible effectiveness of VNS in pediatric DRE, although complete seizure freedom is less common. Early referral (fewer trials of ASMs) may be a modifiable factor for desirable seizure outcomes with VNS from a clinical perspective.
 Pooled evidence supports possible effectiveness of VNS in pediatric DRE, although complete seizure freedom is less common. Early referral (fewer trials of ASMs) may be a modifiable factor for desirable seizure outcomes with VNS from a clinical perspective.
  To test the hypothesis that sensorimotor complete traumatic cervical spinal cord injury is a heterogenous clinical entity comprising several subpopulations that follow fundamentally different trajectories of neurologic recovery.
 
  We analyzed demographic and injury data from 655 patients who were pooled from 4 prospective longitudinal multicenter studies. Group based trajectory modeling was applied to model neurologic recovery trajectories over the initial 12-months postinjury and to identify predictors of recovery trajectories. Neurologic outcomes included Upper Extremity Motor Score, Total Motor Scores and AIS grade improvement.
 
  The analysis identified 3 distinct trajectories of neurologic recovery. These clinical courses included (1) Marginal recovery trajectory characterized by minimal or no improvement in motor strength or change in AIS grade status (remained grade A); (2) Moderate recovery trajectory characterized by low baseline motor scores that improved approximately 13 points; or AIS conversion defines unique clinical phenotypes based on potential for recovery, rather than baseline severity of injury alone. This approach may prove beneficial in clinical prognostication and in the design and interpretation of clinical trials in SCI.
  To evaluate the utility of brain MRI and ophthalmic biomarkers for the prediction of intracranial hypertension, we have studied the association between six biomarkers and 24-hour intracranial pressure (ICP) monitoring results in 45 patients.
 
  This single-centre observational study includes patients who underwent 24-hour ICP monitoring, brain MRI (within three months) and ophthalmic assessment (during ICP monitoring). Six biomarkers were investigated pituitary gland shape, vertical tortuosity of the optic nerve, distension of the optic nerve sheath, optic disc protrusion (MRI), papilloedema (slit lamp biomicroscopy) and spontaneous venous pulsations (SVP, infrared video recordings).
 
  Forty-five patients (mean age 39±14SD, 38 females) met the inclusion criteria. All 6 biomarkers had a significant association with 24-hour ICP. Concave pituitary gland was observed with moderately elevated median ICP. Protrusion of the optic disc (MRI), papilloedema and absence of SVP were associated with the highest median ICension. The combination of at least one abnormal biomarker in MRI and ophthalmic assessments was highly suggestive of intracranial hypertension (AUC 0.94, 95% CI 0.93-0.94) CONCLUSIONS Brain MRI and ophthalmic biomarkers can non-invasively guide the management of patients with suspected CSF dynamics abnormalities. Patients with multiple abnormal biomarkers (≥3) or a combination of abnormal MRI and ophthalmic biomarkers are likely to have intracranial hypertension and should be managed promptly.The National Institute for Health and Care Excellence (NICE) has been presented as politically independent, asserting it is free from industry influence and conflicts of interest so that its decisions may be led by evidence and science. We consider the ways in which soft political factors operate in guideline development processes at NICE such that guidelines are not truly led by science. We suggest that while NICE procedures explicitly incorporate scientific principles and mechanisms, including independent committees and quality assurance, these fail to operate as scientific practices because, for example, decisions may only be challenged through the courts, which regard NICE as a scientific authority. We then examine what the NICE rapid guideline procedure for COVID-19 reveals about the practical reality of claims about the scientific integrity of NICE guidelines. Changes to guideline development processes during the COVID-19 emergency demonstrated how easy it is to undermine the scientific integrity of NICE's decision-making.