bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of cyanobacterial-based biostimulants on plant growth and development: a case study on basil (Ocimum basilicum L.)
Authors: Santini Gaia , Rodolfi Liliana , Biondi Natascia , Sampietro Giacomo , Tredici Mario R.
Published: June 2022

In the coming years biostimulants will play a key role in the sustainable intensification of agriculture due to their capacity to improve crops quality, nutrient use efficiency and tolerance to abiotic stresses. Cyanobacteria are nowadays considered one of the most promising sources of new biostimulants; however, in vivo studies using cyanobacteria are still scarce and often limited to a few genera. In this work the biostimulant activity of five cyanobacterial hydrolysates was evaluated on Ocimum basilicum L. grown in hydroponics. Plants were treated weekly with foliar applications of the cyanobacterial hydrolysates and of two commercial products. Three of the tested cyanobacterial hydrolysates, administered at the concentration of 1 g L-1, were effective in increasing plant growth (up to +32%), and number (up to +24%) and fresh weight (up to +26%) of the leaves compared to controls. Moreover, the cyanobacterial hydrolysates performed better than the commercial biostimulants. The biochemical characterization of the hydrolysates suggests that the observed bioactivity can be related to a high carbohydrate content. Our results indicate that cyanobacteria-based biostimulants can be an effective tool for sustainably enhancing plant growth and yields.
Androgens, aging, and prostate health
Authors: Welén Karin , Damber Jan-Erik
Published: June 2022

Due to late onset hypogonadism (LOH), there is an increased usage of testosterone replacement therapy (TRT) in the aging male population. Since prostate is a target organ for androgens and anti-androgenic strategies are used to treat and palliate benign prostate hyperplasia (BPH) and prostate cancer (PC), the prevalence of both increases with age, the possible influence of TRT on prostate health becomes highly relevant. The present review summarizes existing data on the associations between endogenous hormone concentrations and prostate growth and concludes that circulating concentrations of androgens do not appear to be associated with the risks of development of BPH or initiation or progression of PC. The explanation for these findings relates to an apparent insensitivity of prostatic tissue to changes of testosterone concentrations within the physiological range.
Tag-and-Trace Method of α-Al Crystals Applied to Study Solidification and Casting of Aluminum Alloys
Authors: Santos Jorge , Jarfors Anders E. W. , Dahle Arne K.
Published: June 2022

In this study, a new tag-and-trace method of α-Al crystals was developed and used to study the dissolution of a rotating Al-3Si-0.15Ti cylinder immersed into a superheated commercial purity aluminum melt. The developed tag-and-trace method consists of tagging the primary crystals of an alloy with the microsegregation of a peritectic forming solute element, e.g., titanium in aluminum alloys. During solidification, the primary crystals form with a high concentration of the peritectic forming solute, decreasing in the adjacent growth regions of the same crystal. After solidification, the solute microsegregation tag in the interior of the primary crystals can be revealed by color etching. In this work, an Al-3Si-0.15Ti cylinder with all the primary α-Al crystals tagged with titanium was immersed into a superheated titanium-free aluminum alloy. The superheat was varied, and all samples were quenched 10s after immersion of the cylinder. The tagged α-Al crystals from the original cylinder could be distinguished from the non-tagged α-Al crystals formed in the thermally undercooled region surrounding the cylinder and during quenching. Indications of liquid penetration were observed in some α-Al crystals, which indicates that disintegration of α-Al crystals may occur during stirring of the alloy cylinder into a superheated alloy.
Towards a resource efficient and privacy-preserving framework for campus-wide video analytics-based applications
Authors: Gupta Ankur , Prabhat Purnendu
Published: June 2022

Video surveillance and analytics solutions based on Artificial Intelligence (AI) are increasingly being deployed across industries, including academia. There are a number of use-cases for campus-wide video analytics applications. Detecting events of interest in real-time and generating alerts is a core requirement for such applications, making them both network and compute intensive. Thus, the underlying framework needs to be resource optimized in terms of latency, compute and storage requirements for a multitude of video applications. Increasingly privacy concerns have been voiced against the pervasive deployment of video analytics-based applications. Thus, protecting the privacy of students and staff in a campus setting shall be a major design consideration for such systems going forward. This paper presents a resource optimized and privacy preserving framework for campus-wide video analytics applications. Several use-cases are presented and early results from the deployment of the proposed framework establish its feasibility and effectiveness.
Research on Rail Transit Dispatcher Emergency Decision Support Based on Case Similarity Matching
Authors: Fang Cheng , Zhu Lin , Liu Zhi-gang , Li Yu-fen , Huang Yuan-chun
Published: June 2022

To alleviate decision-making pressure on rail transit dispatchers in the emergency handling process, this work sorts out the scenario elements of rail transit emergency cases, establishes a scenario element system, and uses the information weight method to determine the weight of each scenario element. Based on the information of the key decision points, the complete process of emergencies is divided into various scenarios, and an emergency case representation model is constructed. The model establishes a database of historical emergency cases in rail transit, utilizes the scenarios as the search object to match the similarity of emergencies, and provides the decision-making support information to handle the current emergencies. Furthermore, the model constructed in this paper is subjected to an actual emergency case for analysis and calculation, which verify the validity and feasibility of the proposed model.
An evaluation of fiber-based damage for assessing the failure of aortic tissue: comparison between healthy and aneurysmal aortas
Authors: Ayyalasomayajula Venkat , Pierrat Baptiste , Badel Pierre
Published: June 2022

The decision of surgical intervention for an aortic aneurysm is usually associated with an assessment of risk of its rupture. Global rupture risk assessment parameters like wall diameter and growth of the aneurysm over time often fail at predicting the risk of rupture with accuracy. This paper will investigate the hypothesis that the tissue’s microstructure determines its macroscopic failure. To this aim, two different testing protocols have been implemented. Human ascending thoracic aortic aneurysm (ATAA) tissue samples were subjected to bulge-inflation testing until rupture coupled with multi-photon microscopy (MPM) imaging. Image stacks of the sample were acquired at different pressure levels. Additionally, porcine aorta samples were tested under uniaxial tension until failure and their response was recorded. Prior to mechanical testing, MPM image stacks were acquired at four different zones on the sample. The image stacks acquired at the load free state were used to extract morphological information relating to collagen fibers. Then, an inverse random sampling approach was used to generate pseudomorphological parameters for network reconstruction. A discrete model of the collagen network signifying its stochastic nature was then developed, including both prefailure and post-failure mechanics. The model was able to replicate the mechanical response and failure of the tissue, and demonstrated that fiber-based damage can strongly shape the macroscopic failure response of the tissue. Identified values of collagen fiber failure strain were in the range of 8.8 to 29.3% in the case of aneurysmal samples, and 18.7 to 25.5% in the case of porcine samples. A statistical analysis enabled the characterization of correlation between fiber morphology and tissue failure. The model may serve as a useful tool for predicting macroscale failure of the aortic wall based on the variations in microscale morphology.
Caesarean Section in Indonesia: Analysis of Trends and Socio-Demographic Correlates in Three Demographic and Health Surveys (2007–2017)
Authors: Islam Md. Akhtarul , Shanto Hasibul Hasan , Jabbar Abdul , Howlader Md. Hasan
Published: June 2022

Objectives

This study determined the prevalence and trends in caesarean section (C-section) deliveries and the factors associated with the utilization of C-section deliveries among Indonesian mothers from 2007 to 2017.

Methods

We used Indonesia Demographic and Health Survey data sets (2007, 2012, and 2017) to assess the prevalence, trends, and factors associated with C-section delivery through univariate, bivariate, and multivariate analyses.

Results

A 10% increase in C-section delivery among Indonesian women was observed between the years 2007 and 2017. Mothers from urban areas tended to receive more C-sections than mothers from rural areas (adjusted odds ratio (aOR) = 1.49). More educated mothers were more likely (aOR = 3.373) to receive C-sections than mothers without formal education. Mothers from wealthy family backgrounds were more (aOR = 1.97) likely to receive C-sections than mothers from low-income families. Antenatal care (ANC) visits were significantly positively associated with receiving C-sections; mothers with more than four ANC visits (aOR = 4.54) tended to receive more C-sections than mothers with no ANC visits. For first births, mothers over 25 years of age were more likely (aOR = 2.07) to receive C-sections than mothers less than 18 years of age.

Conclusion

The percentage of C-sections has alarmingly increased. Thus, authorities in Indonesia should consider these findings and take necessary steps to decrease C-sections. The results of this study should help policymakers formulate appropriate policies that will encourage regular delivery where most appropriate.
A qualitative approach to examining antimicrobial prescribing in the outpatient dental setting
Authors: Hughes Ashley M. , Evans Charlesnika T. , Fitzpatrick Margaret A. , Kale Ibuola O. , Vivo Amanda , Boyer Taylor L. , Solanki Pooja A. , Gibson Gretchen , Jurasic M. Marianne , Sharp Lisa K. , Echevarria Kelly L. , Suda Katie J.
Published: June 2022

Objective:

To understand barriers and facilitators to evidence-based prescribing of antibiotics in the outpatient dental setting.

Design:

Semistructured interviews.

Setting:

Outpatient dental setting.

Participants:

Dentists from 40 Veterans’ Health Administration (VA) facilities across the United States.

Methods:

Dentists were identified based on their prescribing patterns and were recruited to participate in a semistructured interview on perceptions toward prescribing. All interviews were recorded, transcribed, and double-coded for analysis, with high reliability between coders. We identified general trends using the theoretical domains framework and mapped overarching themes onto the behavior change wheel to identify prospective interventions that improve evidence-based prescribing.

Results:

In total, 90 dentists participated in our study. The following barriers and facilitators to evidence-based prescribing emerged as impacts on a dentist’s decision making on prescribing an antibiotic: access to resources, social influence of peers and other care providers, clinical judgment, beliefs about consequences, local features of the clinic setting, and beliefs about capabilities.

Conclusions:

Findings from this work reveal the need to increase awareness of up-to-date antibiotic prescribing behaviors in dentistry and may inform the best antimicrobial stewardship interventions to support dentists’ ongoing professional development and improve evidence-based prescribing.
C.1 Cerebral venous sinus thrombosis in preterm infants
Authors: Christensen R
Published: June 2022

Background: Previous studies of neonatal cerebral venous sinus thrombosis (CVST) have focused on term infants, and studies of preterm infants are lacking. In this study, we examined the clinical and radiological features, treatment and outcome of CVST in preterm infants. Methods: This was a retrospective cohort study of preterm infants (gestational age <37 weeks) with radiologically confirmed CVST. All MRI/MRV and CT/CTV scans were re-reviewed. Clinical and radiological data were analysed using descriptive statistics, ANOVA and chi-square tests. Results: A total of 26 preterm infants with CVST were included. Of these, 65% were late preterm, 27% very preterm and 8% extreme preterm. Most (73%) were symptomatic at presentation with seizures or abnormal exam. Transverse (85%) and superior sagittal (42%) sinus were common sites of thrombosis. Parenchymal brain injury was predominantly periventricular (35%) and deep white matter (31%) in location. Intraventricular hemorrhage occurred in 46%. Most infants (69%) were treated with anticoagulation. None of the treated infants had hemorrhagic complications. Outcome at follow-up ranged from no impairment (50%), mild impairment (25%) and severe impairment (25%). Conclusions: Preterm infants with CVST are often symptomatic and have white matter brain lesions. Anticoagulation treatment of preterm CVST appeared to be safe and was not associated with hemorrhagic complications.
C.4 Distinct BOLD signal variability changes in temporal and occipital cortices in pediatric epilepsy
Authors: Pur D , Eagleson R , de Ribaupierre S
Published: June 2022

Background: Greater variability of neuronal signalling, measured as the standard deviation of the blood oxygen dependent signal (BOLDSD), relates to information processing capacity. Resting-state functional magnetic resonance imaging was used to determine differences in BOLDSD between children with and without epilepsy. Methods: We studied 24 controls (mean age 8.52 ± 1.35 years) and 18 patients (mean age 11.5 ± 3.4 years) with medically refractory epilepsy that underwent imaging for preoperative planning.Standard preprocessing steps (FSL v6.0, FMRIB) were followed and AAL atlas was used. Whole-brain two sample t-tests were used for group comparisons and significance was set at p <0.05 FDR-corrected. Results: Children with epilepsy showed significantly lower BOLDSD in left inferior and middle temporal gyri (p < 0.001), right caudate nucleus (p < 0.01), cuneus (p < 0.001), and fusiform gyrus (p < 0.001), and significantly increased BOLDSD bilaterally in inferior occipital gyri (p < 0.0001). There were no significant differences when comparing whole-brain BOLDSD values. Conclusions: Neuroplastic changes in epilepsy may depend on an optimal amount of internal neural variability driven by the identified key regions. Certain temporal and occipital regions may underlie neural processing differences in children with epilepsy. Further studies may correlate these findings with behavioral testing.
P.001 The neural correlates of effort-reward decision-making in older adults
Authors: Chiu LK , Ai M , Makram F , Quinci M , Cooper J , Loui P , Geddes M
Published: June 2022

Background: Effort mobilization is important in older adults to stay healthy, notably for decision-making. The process of decreasing subjective value of a reward as required effort increases is called effort discounting. By identifying underlying neural correlates related to effort discounting, we can better understand factors affecting normal cognitive aging. Methods: We acquired resting-state functional magnetic resonance images from 19 cognitively normal older adults (10 males; 66±6 years). Participants completed a computerized cognitive task—called Effort Expenditure for Rewards Task—capturing the willingness to expend effort for rewards through binary choices between high-reward-high-effort or low-reward-low-effort option to obtain varying monetary rewards. We modelled subjective value to assess the k parameter, effort discounting. A functional connectivity analysis examined the involvement of regions associated to the salience network. Results: The seed-to-voxel analysis revealed increased connectivity within the precuneus cortex and to clusters in the right temporal and posterior cingulate gyri, with increased k-value or decreased willingness to expend effort. There was also decreased connectivity between the anterior cingulate and right lateral occipital cortex, and between the left anterior insula to the cerebellum and precuneus cortex. Conclusions: The process of effort discounting is correlated to functional connectivity changes involving the precuneus, anterior cingulate, and left anterior insula in healthy older adults.
P.011 Piano Player Hand Sign: description of a novel clinical sign elicited by cortical electrical stimulation in epileptic patients
Authors: Brochu K , Martineau L , Martin G , Hoffmann D , Chabardes S , Minotti L , Kahane P
Published: June 2022

Background: Cortical electrical stimulation (CES) may produce different motor responses according to the brain area stimulated. In this study, we describe a new motor response characterized by finger movements such as a person playing piano, which we named the Piano Player Hand (PPH) sign. Methods: We retrospectively reviewed the CES results of 252 patients with drug-resistant epilepsy who underwent SEEG between January 2005 and December 2019 at the Grenoble-Alpes University Hospital. The patients’ characteristics, SEEG findings and CES parameters were extracted to find common clinical and anatomical features. Results: The PPH sign was identified 20 times from 12 patients, with stimulation of either the supplementary motor area (SMA), anterior cingulate gyrus (ACG), pre-SMA, middle frontal gyrus and anterior insula. It was obtained with high frequency stimulation, with intensity ranging from 0,7 to 3mA and mostly contralateral to the stimulation side (19/20). It was part of the ictal semiology of five patients. An afterdischarge was observed in five of the relevant CES. Conclusions: The PPH sign is a novel clinical sign, obtained mainly, but not exclusively, with CES of a small vicinity encompassing the SMA, pre-SMA and ACG. The PPH sign, when occurring ictally, may point to the premotor mesial frontal surface of the brain.
P.015 Monthly migraine days, acute medication use-days, and migraine-specific quality of life in responders to atogepant: a post hoc analysis
Authors: Dodick DW , Lipton RB , Nahas SJ , Pozo-Rosich P , McAllister P , Mechtler LL , Leroux E , Ma J , Dabruzzo B , Dufek M , Severt L , Finnegan M , Trugman J
Published: June 2022

Background: In phase 3 ADVANCE, atogepant 60mg reduced mean monthly migraine days (MMDs) from 7.8 days (baseline) to 3.0 (weeks 9-12; Δ=−4.7) in the overall episodic migraine population [treatment responders and nonresponders (i.e., marked benefit and minimal benefit)], which obscures information regarding magnitude of treatment effect in these populations. Here, magnitude of treatment effect in atogepant responders and nonresponders is characterized. Methods: Mean MMDs, acute medication use-days (MUDs), and Migraine-Specific Quality of Life-Role Function-Restrictive (MSQ-RFR) scores were calculated in treatment responders (based on MMD percentage reduction) and nonresponders from ADVANCE participants. Results: From baseline to weeks 9-12, ≥50% improvement was achieved by 71% (139/195) of participants. In these responders, MMDs reduced from 7.6 to 1.3 (Δ=−6.3). 50% (97/195) of participants achieved ≥75% response. In this group, MMDs reduced from 7.7 to 0.6 (Δ=−7.1). Atogepant 60mg nonresponders (<25% reduction in MMDs; 15% [30/195 participants]) showed MMD change from 7.7 to 9.1 (Δ=+1.4). Acute MUDs in ≥50% MMD responders decreased 7.1 to 1.6 (Δ=−5.5). In treatment-nonresponders, acute MUDs were 7.3 (baseline) and 7.2 (weeks 9-12; Δ=−0.1). Similar mean MSQ-RFR score changes were observed in both populations. Conclusions: Of participants who experienced ≥50% reduction in MMDs, 71% had substantial treatment effect (ΔMMD=−6.3), representing 83% reduction in MMDs.
P.016 Reduction in migraine-associated burden over 24 weeks of treatment with eptinezumab in patients with chronic migraine
Authors: McAllister P , Kudrow D , Cady R , Hirman J , Ettrup A , Minhas S
Published: June 2022

Background: To examine changes in the occurrence, severity, and symptoms of headache episodes in patients with chronic migraine (CM) following eptinezumab treatment. Methods: PROMISE-2 (NCT02974153) was a double-blind, placebo-controlled, parallel-group trial that randomized adults with CM to eptinezumab 100 mg, 300 mg, or placebo IV every 12 weeks for up to 24 weeks (2 infusions). Headache episodes (migraine and non-migraine) and their characteristics were reported in daily electronic diaries during the 28-day baseline period and throughout the 24-week treatment period. Results: A total of 1072 patients were included. Patients reported a mean of 20.4–20.6 monthly headache days during baseline across treatment groups. Mean monthly headache days decreased by 8.9 (100 mg) and 9.7 (300 mg) with eptinezumab versus 7.3 with placebo over weeks 1-24. Mean monthly headache episodes also decreased by 8.4 (100 mg) and 9.0 (300 mg) compared to 7.1 with placebo over weeks 1-24. Among headaches occurring post-treatment, decreases in severe pain, nausea, phonophobia, photophobia, and physical activity limitations were numerically greater than placebo. Conclusions: In patients with CM, eptinezumab numerically decreased the frequency and severity of monthly headache days and episodes more than placebo. Patients treated with eptinezumab reported a decrease in burdensome symptoms of headache episodes.
P.017 Optimization of acute treatment and headache-related impact following eptinezumab initiated during a migraine attack: post hoc analysis of the RELIEF study
Authors: Buse DC , Lipton RB , Ettrup A , Josiassen MK , Lindsten A , Cady R , Omeragic A , Duong A
Published: June 2022

Background: Patients administered eptinezumab during an active migraine had larger numerical improvement in the 6-item Migraine Treatment Optimization Questionnaire (mTOQ-6) total score compared to placebo. The mTOQ-6 was used to determine success of acute treatment. Methods: RELIEF (NCT04152083) was a double-blind trial that randomized adults eligible for preventive migraine treatment to eptinezumab 100mg or placebo, administered intravenously within 1–6 hours of migraine onset. mTOQ-6 was captured at baseline and Week 4 and rescored into mTOQ-4. Patients were grouped by baseline mTOQ-4 total scores. Results: 226 eptinezumab-treated and 232 placebo patients were included. The percentage of patients in the combined very poor and poor optimization subgroups at baseline with eptinezumab (n=155; 68.6%) versus placebo (n=138; 59.5%) decreased by 26.6 percentage points (n=95; 42.0%) and 9.9 percentage points (n=115; 49.6%), respectively, at Week 4. Of the 155 eptinezumab-treated and 138 placebo patients who were very poorly/poorly optimized at baseline, 73 (47.1%) versus 35 (25.4%) were moderately/maximally optimized at Week 4, respectively. Greater improvements in mTOQ-6 scores were noted in patients more poorly optimized at baseline than those more optimized. Conclusions: Eptinezumab showed greater acute migraine medication optimization and decreased headache-related impact compared to placebo, suggesting that eptinezumab may work synergistically with acute medications.
P.020 Long-term safety and tolerability of atogepant 60mg once daily for preventive treatment of migraine: a phase 3, 40-week, multicenter extension to the advance trial
Authors: Klein B , Miceli R , Severt L , McAllister P , Mechtler L , McVige J , Diamond M , Marmura MJ , Leroux E , Guo H , Finnegan M , Trugman J
Published: June 2022

Background: A phase 3 trial, ADVANCE (NCT03777059), demonstrated that atogepant, an oral, CGRP receptor antagonist dosed once daily, results in clinically meaningful reductions in mean monthly migraine days. This open-label extension for ADVANCE trial completers evaluated long-term safety and tolerability of atogepant over 40-weeks. Methods: Participants in this trial (NCT03939312), rolled over from the ADVANCE trial, were treated with atogepant 60mg once daily for 40-weeks, with a 4-week safety follow-up. Only safety data were collected. Results: 685 participants took at least one dose of study drug, 74.6% completed the 40-week treatment period; mean age of 41.8 years, 88.2% female, 84.4% white, and mean BMI of 30.58 kg/m2. Mean (SD) treatment duration was 233.6 (89.32) days. 62.5% of participants experienced a treatment-emergent adverse event (TEAE), with 8.8% considered treatment-related by the investigator; serious adverse events (SAEs) occurred in 3.4% of participants, none were treatment-related. The most frequent AEs leading to discontinuation was nausea (0.4%, n=3); the most frequent TEAEs observed included upper respiratory tract infection (5.5%, n=38) and urinary tract infection (5.3%, n=36). No deaths or hepatic safety issues were observed. Conclusions: Safety results are consistent with known safety profile of atogepant and support long-term safety and tolerability of once daily dosing of atogepant 60mg.
P.024 The influence of disease modifying therapies on short-term disease progression in a cohort of relapsing-remitting multiple sclerosis patients in Newfoundland and Labrador
Authors: Arsenault ST
Published: June 2022

Background: Multiple sclerosis (MS) is an immune-mediated demyelinating disease of the central nervous system accompanied by chronic inflammation and neurodegeneration. An unmet clinical need in the management of MS is how to select an initial disease modifying therapy (DMT). Real-world evidence suggests that early aggressive control with high-efficacy medications results in better long-term prognosis. Methods: This retrospective study was conducted at Memorial University using Relapsing Remitting MS (RRMS) patients enrolled in the HITMS study. Analysis included study participants aged 18+ with RRMS and three years of clinical visits. Disability progression was measured by the Expanded Disability Status Scale (EDSS) and defined as a change of ≥ 1.0. Study subjects were categorized according to DMT at their initial visit. Results: In this cohort, 87 participants met the inclusion criteria; 67 were stable and 20 had disability progression. There was no significant difference in disability progression based on DMT regimen, and age, sex, and disease duration did not affect disability progression. Conclusions: Despite evidence that all RRMS patients go on a DMT, our cohort demonstrated a significant proportion remain DMT naive. Furthermore, the selection of DMT in this cohort appears to be appropriate, as there were no obvious differences in disability progression regardless of DMT.
P.026 Autoimmune encephalitis: modifiable and non-modifiable predictors of relapse
Authors: Hansen M , Hahn C
Published: June 2022

Background: Approximately 25% of encephalitis cases in North America are immune mediated. For most forms of autoimmune encephalitis (AIE), risk of relapse is unclear and little evidence exists to guide which patients have the highest risk and whether standard treatments reduce this risk. Our objective was to determine the factors associated with AIE relapse. Methods: We performed a chart review consisting of patients with AIE presenting to the Calgary Neuro-Immunology Clinic and Tom Baker Cancer Centre between 2015 and 2020. Predictors of relapse were determined with use of t-test. Results: Outcome data was assessable in 39/40 patients, 17/39 (44%) patients relapsed. Seropositive patients and those with abnormal CSF were more likely to relapse, although neither reached statistical significance (p=0.12, 0.059). Patients with longer duration of steroid and steroid sparing treatment prior to relapse, and those on steroids at the time of relapse, had milder relapses (p=0.024, 0.026, 0.047). There was no difference in steroid or steroid sparing treatment use at 3, 6, and 12 months between groups. Conclusions: Risk of relapse in AIE is high (44%), with most relapses occurring in the first 3 years. Continuous immunosuppression lessens the severity of relapse, although our study did not confirm it reduced the occurrence of relapse.
P.047 Implications of Gold Coast Criteria in diagnosis of amyotrophic lateral sclerosis in a large subspecialty clinic
Authors: Jewett G , Khayambashi S , Frost GS , Beland B , Lee A , Hodgkinson V , Korngut L , Chhibber S
Published: June 2022

Background: Criteria to formalize the diagnosis of amyotrophic lateral sclerosis (ALS) and refine clinical trial populations have evolved. The recently proposed Gold Coast criteria (GCC) are intended to simplify use and increase sensitivity. We evaluated sensitivity of GCC and potential impacts on therapeutic trial enrollment. Methods: We performed a single center retrospective study including patients diagnosed with ALS between 2016 – 2021. We determined criteria met at diagnosis according to revised El Escorial (rEEC), Awaji (AC) and GCC. We compared sensitivity and examined impacts GCC would have on enrollment in landmark ALS trials. Results: We included 203 people with ALS. Sensitivity of GCC (96.1%, 95% confidence interval [CI] = 92.2-98.2%) was significantly higher than rEEC (89.8%, 95% CI 84.6-93.4%, χ2 = 5.3, p = 0.01) and AC (89.3%, 95% CI 84.1-93.0%, χ2 = 6.1, p = 0.006). GCC was more sensitive than clinically definite or probable rEEC (47.6%, 95% CI 40.6-54.6%, χ2 = 117.6, p = < 0.001) and use would result in increased eligibility in landmark therapeutic trials. Conclusions: GCC are more sensitive than rEEC and AC at time of diagnosis in ALS. Use of GCC in our population would expand clinical trial participation and make results more widely generalizable.
P.052 Assessing the competence of neurology residents in performing an interphysician telephone consultation
Authors: Chang Y , Jenkins ME , Venance S , Florendo-Cumbermack AG
Published: June 2022

Background: Neurology Residency training in Canada is transitioned to competence based medical education (CBME) in July 2020 and the Royal College Neurology Specialty Committee has identified “providing consultation for and managing patients at outlying centres,” to be an entrustable professional activity (EPA). At Western University, neurology telephone consultations from outlying centres are attended by both the resident and the staff Neurologist. This scenario provides the ideal situation for direct observation and immediate formative feedback. The resident’s performance was assessed using an entrustment scale along with a short narrative portion. Methods: This mixed methods study aims to determine the reliability and validity of the entrustment scale with narrative feedback in assessing the performance on the telephone consultation by senior neurology residents. Informed consent was obtained from residents (9) and staff (7) involved. Scores on the entrustment scale and narrative comments were analyzed. Results: Information on 37 encounters (involving 9 residents) was collected. Assessment results demonstrated higher entrustment scores in PGY4 and PGY5 levels. Overall, ratings were consistent across the 7 consultant assessors. Conclusions: The use of an entrustment scale appears to be reliable and valid in assessing competence in the telephone consultation and provide coaching feedback to help learners improve their performance.
P.055 Efficacy and safety of using standardized size of stents in patients with carotid artery stenosis
Authors: Lahlouh A , Kiwan R , Mandzia J , Pandey S
Published: June 2022

Background: Carotid artery stenosis causes up to 20% of ischemic strokes. Stenting is used as an alternative to endarterectomy in symptomatic patients. Most centers customize each individual stenosis to a specific stent size. However, this process can be time consuming and costly while the relative benefit has not been well evaluated yet. We hypothesized that a ‘one-size-fits-all’ approach to carotid stenting results in non-inferior results to a customized approach. Methods: We conducted a descriptive retrospective cohort study on patients who underwent carotid artery stenting looking for peri- and post-procedural complications. The primary outcomes were periprocedural (within 24 hours) or post procedural (within 30 day) TIA, stroke, or death. The secondary outcome was the estimated degree of stenosis on follow up ultrasound performed within 6 months of the procedure. Results: The complication rate was 4.5%, 6.5% for 24 hours and 30 day post-procedure, respictively. Age and degree of stenosis on post procedural cerebral angiogram were associated with increased risk of complication. Severe restenosis or occlusion was reported in 16.8% of patients within 6 months post-procedure. Conclusions: Our study suggests that using a simplified, one-size-fits-all, approach to carotid stenting results in safe and effective outcomes, suggesting a route to possibly simplify a complex medical procedure.
P.058 Spinal arachnoiditis as a complication of cryptococcal meningitis
Authors: Marais O , Mezei M , Alhalabi M , Belga S
Published: June 2022

Background: Spinal arachnoiditis is a rare condition involving progressive fibrosis of the spinal arachnoid membrane and can be secondary to multiple spinal surgeries, intrathecal chemotherapy, or infection. This condition can manifest as lumbosacral radiculopathy, cauda equina syndrome, myelopathy, or syringomyelia. Methods: We present a case of a 38-year-old female with recent cryptococcal meningitis treated with amphotericin B and flucytosine, who re-presented to hospital several weeks after discharge with decreased mobility requiring a wheelchair, falls, and urinary and fecal incontinence. Results: Examination revealed lower extremity pyramidal weakness, hyperreflexia, and upgoing plantar responses. CSF analysis showed white blood cells of 147x106 cells/L, protein of 4.07 g/L, and glucose of 0.4 mmol/L. Cryptococcal antigen was positive, but fungal culture was negative x 5 days, suggesting adequate initial treatment of cryptococcal meningitis. MRI spine revealed tethering of the cervical cord posteriorly at C4-5 and tethering of the midthoracic cord anteriorly. The patient was treated with IV methylprednisolone 1 g/kg daily for 5 days without significant improvement. Conclusions: Spinal arachnoiditis secondary to infection is thought to be caused by post-infectious inflammatory response syndrome (PIRIS) and is treated with IV methylprednisolone. In spinal arachnoiditis secondary to cryptococcus, the clinical findings may be confounded by the presence of hydrocephalus or myelopathy.
P.063 Thrombolysis for acute ischemic stroke in patients with pre-morbid disability: a meta-analysis
Authors: Beland B , Bala F , Ganesh A
Published: June 2022

Background: Randomized-controlled trials of thrombolysis in ischemic stroke have poorly represented patients with pre-stroke disability and the benefit of thrombolysis in this population remains uncertain. We performed a systematic review and meta-analysis to examine the outcomes of thrombolysis in patients with pre-morbid disability. Methods: In accordance with MOOSE guidelines, we retrieved studies reporting intravenous thrombolysis (IVT) in patients with pre-stroke disability (mRS=3-5) with ischemic stroke, either compared to untreated patients or to treated patients without pre-morbid disability. Primary outcome was the return to pre-morbid disability at 90-days. Results: 8 articles were included involving 103,988 patients. Patients with disability treated with IVT had better odds of returning to baseline function compared to those who did not receive IVT (OR=7.26, 95%CI=2.51-21.02). Mortality and sICH were not significantly different between patients with disability receiving IVT or not. Favourable outcomes (mRS=0-2 or return to pre-morbid mRS) and sICH were not significantly different between patients with and without disability. Mortality was three times higher in those with pre-morbid disability treated with IVT (38.2% versus 12.6%). Conclusions: Thrombolysis in patients with disability was associated with better outcomes compared to patients not receiving IVT. High-quality data comparing treated versus untreated patients with pre-morbid disability is needed to clarify this issue.
P.086 Risk factors for term born periventricular white matter injury in children with cerebral palsy: a case control study
Authors: Marefi A , Husein N , Dunbar M , Dewey D , Letourneau N , Oskoui M , Kirton A , Shevell M
Published: June 2022

Background: The aim of this study was to identify possible risk factors associated with term-born newborns with cerebral palsy and PWMI on imaging. Methods: This is a case-controlled study with cases from the Canadian Cerebral Palsy Registry and controls from Alberta Pregnancy Outcomes and Nutrition Study. PWMI was diagnosed based on MRI reports and 160 cases were compared to 1950 controls. Risk factor were selected a priori; including pregnancy complications, toxin exposure, perinatal infection, sex, small for gestational age, and perinatal adversity. Multivariate regression binomial model was used to calculate odds ratios(OR) and 95% confidence intervals(CI). Results: Multivariable analyses suggested PWMI was associated with pregnancy complications(OR=3.35; 95% CI=2.23-4.94), antenatal toxin exposure(OR=2.45; 95% CI=1.67-3.55), perinatal infection(OR=3.61; 95% CI=1.96-6.29) and perinatal adversity(OR=2.03; 95% CI=1.42-2.94). Term born males were not more likely to have PWMI compared to females(OR=1.37; 95% CI=0.98-1.93). Multiple regression analyses suggested independent associations between PWMI and pregnancy complications(OR=3.63; 95% CI 2.40-5.40), antenatal toxin exposure(OR=2.62; 95% CI 1.77-3.84), perinatal infection(OR=3.42; 95% CI 1.83-6.05) and perinatal adversity(OR=2.49; 95% CI= 1.71-3.69). Conclusions: Risk factors such as pregnancy complications, toxin exposure, perinatal infection and perinatal adversity are associated with PWMI in term-borns, suggesting a ‘two-hit’ model that could involve an interaction among both antenatal and perinatal variables.
P.089 Characteristics of children with cerebral palsy secondary to intrapartum asphyxia in the post-therapeutic hypothermia era
Authors: Pekeles H , Al Amrani F , Perez-Morgui M , Wintermark P , Shevell M
Published: June 2022

Background: We explored the profile of children with cerebral palsy (CP) secondary to intrapartum asphyxia (IAP), who were treated with therapeutic hypothermia (TH). We compared neonatal characteristics between children treated with TH with a mild vs severe CP. Methods: We collected perinatal and outcome measures of children treated with TH for IAP. We searched the literature for characteristics of children prior to TH to compare to our cohort. We subdivided our cohort into mild vs. severe CP and compared neonatal characteristics to identify predictors of severe phenotype. Results: We found more children with severe (19/30) compared to mild CP (11/30). Post-TH era children leaned towards a more severe phenotype compared to prior to TH. Children with severe CP had significantly higher mean birth weight, lower 5- and 10-minute Apgars, and more often white matter with associated deep gray matter injury or near-total injury pattern on MRI compared to the mild phenotype group (all p<0.05). Conclusions: Our data leaned to a more severe CP in cooled children compared to pre-TH. Birthweight, 5- and 10-minute Apgars and MRI findings were significantly different between our mild vs severe group. Our findings can guide clinicians how to better weigh these factors when counseling parents in the neonatal period.
P.097 After-discharges and presurgical cortical stimulation in stereo-encephalography in the study of drug-resistant epilepsy
Authors: Asim A , McShane M , Paredes-Aragón EM , Mirsattari SM
Published: June 2022

Background: Background: Cortical stimulation (CS) as a part of presurgical investigations in patients undergoing implantation of depth electrodes (SEEG) is a growing practice in some Comprehensive Epilepsy Centers. After-discharges (AD) are useful to determine epileptogenic tissue within or outside the epileptogenic network. Classification of afterdischarges was proposed by Blume using subdural recordings(1); its utility in SEEG is unknown. Methods: Methods: Single center, retrospective study that included patients with SEEG that underwent CS in the Epilepsy Monitoring Unit. Demographic characteristics were explored and Blume’s proposed AD classification was used to determine whether or not the CS changed surgical outcomes. Results: Results: From January 2015 to June 2021, a total of 177 patients were implanted with SEEG and analyzed. 95 patients had CS and 91 had AD. Morphologies found were: Rhythmic waves in 4 (0.04%), Rhythmic waves evolving into spikes in18 (19%), Polyspike bursts in 14 (15%), Spike-waves in 28 (30%), and sequential spikes in 18 (19%). 12/14 (86%) patients with Spike-waves had Engel I outcome; Engel class IV patients were more likely to have an evolution of morphology and frequency of ADs in 3 patients(75%). Conclusions: Conclusions: The most frequent morphology of ADs seen was spike-waves. AD morphology and duration may predict post-operative seizure outcomes.
P.102 Role of interdigital sensory nerve conduction study as a noninvasive approach for early diagnosis of diabetic peripheral neuropathy
Authors: Madani S , Fateh H
Published: June 2022

Background: Diabetes mellitus is a common cause of polyneuropathy. Despite numerous diagnostic tools such as routine electrophysiologic procedures, its early detection is challenging. This study compares a distal electrodiagnostic technique, with conventional approaches to investigate its role in confirming early polyneuropathy. Methods: Thirty-one symptomatic diabetic outpatients and 23 asymptomatic nondiabetic subjects were included in our study. We performed nerve conduction studies on the dorsal sural, medial plantar, and digital branches of the interdigital nerves to toes I, II, and III (as a new antidromic technique). All techniques were applied with the surface stimulator and pick-up electrodes. Results: Only 9 (29%) of patients had impaired routine NCSs. Interestingly, the results of interdigital nerve studies were abnormal in 17 out of 22 patients with normal routine NCSs. Also, 11 and 13 subjects had impaired medial plantar and dorsal sural nerves conduction studies, respectively. According to this method, the prevalence of detectable diabetic neuropathy increased from 46% to 83%. Conclusions: The digital sensory branches can be easily evaluated with the new antidromic SNAP technique for the early diagnosis of diabetic polyneuropathy, especially in presymptomatic and subclinical neuropathies. This method is simple, non-invasive, sensitive, and reproducible. There is no need for needle electrodes or averaging techniques.
P.111 In vivo hippocampal mGluR5 abnormalities predict MTLE post-surgical outcome
Authors: Lam J , DuBois JM , Rowley J , Rousset OG , González-Otárula KA , Soucy J , Massarweh G , Hall JA , Guiot M , Zimmermann M , Minuzzi L , Rosa-Neto P , Kobayashi E
Published: June 2022

Background: PET imaging of [11C]ABP688 shows reduced hippocampal mGluR5 availability in mesial temporal lobe epilepsy (MTLE) patients, however the relation with post-surgical outcomes is unclear. Here, we tested whether [11C]ABP688 binding in hippocampal subfields vulnerable to glutamate excitotoxicity is related to post-surgical outcome. Methods: [11C]ABP688-PET was obtained from 31 unilateral MTLE patients and 30 controls. Hippocampal subfields were automatically segmented into 1) CA1-3, 2) CA4/dentate gyrus (DG), 3) Subiculum and manually corrected. Partial volume corrected [11C]ABP688 non-displaceable binding potential (BPND) was calculated in the subfields and compared between seizure-free and non-seizure-free patients. Results: [11C]ABP688 BPND was significantly reduced in ipsilateral CA1-3 & CA4/DG (p<0.001) compared to controls. No difference was seen in Subiculum. Ipsilateral CA1-3 [11C]ABP688 BPND was lower in seizure-free (p=0.012; Engel Ia, n=13) vs non-seizure- free (Engel Ic-III, n=10) patients, and this effect was independent of subfield volume. In a subset of patients with [18F]FDG-PET, CA1-3 [11C]ABP688 BPND was significantly lower in seizure-free patients (p=0.03), while no difference was found for [18F]FDG uptake. Conclusions: Reduced CA1-3 mGluR5 availability was associated with post-surgical seizure-freedom independent of atrophy and hypometabolism. Thus, [11C]ABP688-PET may offer a potential biomarker for surgical outcomes and may be particularly relevant for pre-surgical workup in MRI- and [18F]FDG-negative MTLE patients.
P.118 Radial to femoral “through and through” access for high grade ostial subclavian and innominate artery stenoses: a novel technique
Authors: Kim C , Heran MK
Published: June 2022

Background: Endovascular approaches are typically preferred to open surgical techniques for symptomatic subclavian/innominate artery stenosis. Due to individual patient anatomy, endovascular treatment from a conventional femoral arterial approach can be technically challenging. Our alternative technique using a combined radial to femoral artery approach can facilitate an otherwise challenging revascularization procedure. Methods: Retrospective analysis between November 2017 to March 2021 yielded five procedures (in four patients) using a combined radial to femoral “through and through” access and stenting technique. Results: All patients presented with hypoperfusion symptoms, either to their extremities, brain, or both. Technical success was achieved in 100% of the five vessels treated in four patients with symptomatic subclavian/innominate artery stenosis using this approach. One of the patients developed a recurrent stenosis after 40 months, requiring a repeat procedure. Three patients received treatment to the left subclavian artery and one to the innominate artery. All of the patients experienced marked symptomatic improvement without significant complications. Conclusions: A combined radial to femoral “through and through” access technique is a simple and safe method to achieve successful recanalization of high grade symptomatic ostial stenoses of the subclavian and innominate arteries.
P.119 Clinical outcome and recurrence rate of chronic subdural hematoma after surgical drainage: a retrospective study
Authors: Atefi N , Silvaggio J , Shankar JJ
Published: June 2022

Background: Chronic subdural hematoma (CSDH) is of the most encountered neurosurgical cases, predominantly in older individuals. Surgical drainage remains the mainstay, yet is challenged by variable recurrence rates. Less invasive methods of embolization of the middle meningeal artery (EMMA) could reduce the recurrence rates. Before adopting a newer treatment (EMMA), it is prudent to establish the outcomes from surgical drainage. The purpose of this study is to assess the clinical outcome and recurrence risk in surgically treated CSDH patients. Methods: A retrospective search of our surgical database was done to identify CSDH patients undergoing surgical drainage in 2019-2020. Demographic and clinical details were collected through chart review and a qualitative statistical analysis was performed. Results: A total of 136 patients (mean age-68 years; range-21-100 years; Male-105) with CSDH underwent surgical drainage with repeat surgery in 11.8%(n=16). Periprocedural mortality and morbidity were 8.8%(n=12) and 20.6%(n=28), respectively. No radiological follow-up was seen in 30(22%) of patients. Of those with follow-up, recurrence was seen in 21.7%(n=23). Mean hospital stay was 9.64 days. Conclusions: Our retrospective study showed periprocedural morbidity (20.6%) and mortality (8.8%) with a 21.7% risk of recurrence. This is likely due to older patients but is in keeping with what is reported in the literature.