bluuebunny/crossref_metadata_2025 huggingface dataset:
Rhodamine B as a long‐term semi‐quantitative bait marker for wild boar
Authors: Baruzzi Carolina , Coats Julia , Callaby Rebecca , Cowan Dave P. , Massei Giovanna
Published: June 2017

Wild boar and feral pigs (Sus scrofa) are increasing worldwide and baiting campaigns to deliver vaccines and toxicants are often undertaken to control their populations or the diseases they transmit. In these campaigns, it is important to assess bait uptake by the target species. We investigated the use of the systemic marker Rhodamine B (RB) to detect multiple episodes of bait uptake by wild boar. Rhodamine B is widely used in wildlife studies as a bait marker incorporated in hair, but it is still poorly studied in suids. We analyzed the detection of RB bands in different hair types of wild boar fed multiple RB‐treated baits at different intervals in summer and fall. We calculated the minimum number of hairs and whiskers required to detect RB bands. Captive wild boar consumed RB‐treated baits (ranging in dose from 1.3 mg/kg to 17.0 mg/kg of wild boar body mass) in summer and autumn. The time between consecutive episodes of RB‐treated bait ingestion was 4 days, 9 days, 2 weeks, and 3 weeks. We collected hairs and whiskers 7, 18, 25, 39, 49, 94, 103, 110, and 124 days after feeding boar with RB‐treated baits. Feeding wild boar RB‐treated baits 4 and 9 days apart did not produce separate RB bands. Two to 3 weeks were sufficient for separate RB bands to appear in 17.8% of hairs and 27.0% of whiskers. The minimum number of hairs to detect RB bands was 3 for shoulder hairs and 2 for whiskers, mane, and flank hairs. Mane hairs had the fastest growth rate, and there was no difference among the growth rate of other hairs and whiskers. We suggest that a minimum of 2 mane hairs and 2 whiskers should be sampled to be 95% confident that RB bands can be detected in wild boar that have consumed RB‐treated baits. © 2017 The Wildlife Society.
Diagnostic validity of ICD-10 acute and transient psychotic disorders and DSM-5 brief psychotic disorder
Authors: Castagnini A.C. , Fusar-Poli P.
Published: June 2017

Background:

Short-lived psychotic disorders are currently classified under “acute and transient psychotic disorders” (ATPDs) in ICD-10, and “brief psychotic disorder” (BPD) in DSM-5. This study's aim is to review the literature and address the validity of ATPDs and BPD.

Method:

Papers published between January 1993 and December 2016 were identified through searches in Web of Science. Reference lists in the located papers provided further sources.

Results:

A total of 295 articles were found and 100 were included in the review. There were only a few studies about the epidemiology, vulnerability factors, neurobiological correlates and treatment of these disorders, particularly little interest seems to exist in BPD. The available evidence suggests that short-lived psychotic disorders are rare conditions and more often affect women in early to middle adulthood. They also are neither associated with premorbid dysfunctions nor characteristic family predisposition, while there seems to be greater evidence of environmental factors particularly in developing countries and migrant populations. Follow-up studies report a favourable clinical and functional outcome, but case identification has proved difficult owing to high rates of transition mainly either to schizophrenia and related disorders or, to a lesser extent, affective disorders over the short- and longer-terms.

Conclusions:

Although the lack of neurobiological findings and little predictive power argue against the validity of the above diagnostic categories, it is important that they are kept apart from longer-lasting psychotic disorders both for clinical practice and research. Close overlap between ATPDs and BPD could enhance the understanding of these conditions.
Settled Versus Right
Authors: Kozel Randy J.
Published: June 2017

In this timely book, Randy J. Kozel develops a theory of precedent designed to enhance the stability and impersonality of constitutional law. Kozel contends that the prevailing approach to precedent in American law is undermined by principled disagreements among judges over the proper means and ends of constitutional interpretation. The structure and composition of the doctrine all but guarantee that conclusions about the durability of precedent will track individual views about whether decisions are right or wrong, and whether mistakes are harmful or benign. This is a serious challenge, but it also reveals a path toward maintaining legal continuity even as judges come and go. Kozel's account of precedent should be read by anyone interested in the nature of the judicial role and the trajectory of constitutional law.
Public Interests in the International Court of Justice—A
Comparison Between Nuclear Arms Race (2016) and South
West Africa (1966)
Authors: Venzke Ingo
Published: June 2017

In the present essay I compare the 2016 judgment of the International Court of
Justice (ICJ) in Nuclear Arms
Race (Marshall Islands v. United Kingdom) with the Court's 1966
judgment in South West
Africa (Ethiopia v. South Africa; Liberia v. South Africa). A series
of similarities between the two judgments are obvious: They are two of the three
cases in the history of the Court in which the judges were equally split and the
President had to cast his tie-breaking vote.
The critique of the judgments has been exceptionally strong, in 2016 as in 1966.
The core of the critique, then as now, has practically been the same—the
Court retreats into an excessive formalism that protects great powers.
The Glasgow School of Art fashion show, 1947–2017
Authors: Britt Helena , Stephen-Cran Jimmy , Waters Susannah
Published: June 2017

Introduced in 1947 as an event during Charities Week, the Glasgow School of Art (GSA) Fashion Show provided an opportunity to present student designs and fundraise around the City of Glasgow. Over the years, the format, location and emphasis of the event have changed, although creativity, collaboration, team working and the Students Union remain central to organization. To commemorate the 70th anniversary of the fashion show, the development of this event has recently been re-visited and an exhibition developed. This project posed the questions: What GSA Archives and Collections’ holdings relate to the event? Are there gaps within the collection and if so can items be accessioned? What can be understood about the evolution of the GSA fashion show from this material? Is there potential for further research from this local event? These questions form the basis of this article.
The culture of clothing: On the history of the Fashion Image Collection – Lipperheide Costume Library in Berlin
Authors: Rasche Adelheid
Published: June 2017

In the last third of the 19th century, Berlin was the undisputed capital of the German clothing and fashion industry on an international scale. Several publishing houses specialized in the production of fashion magazines for different target groups. One of the success stories in this context is that of the publisher Franz Lipperheide and his wife Frieda. In 1865, they founded their own company, publishing the journal Die Modenwelt: Illustrirte Zeitung für Toilette und Handarbeiten. This journal quickly became the most-read fashion journal in Berlin. By the company's 25th anniversary in 1890, a total of 12 international editions of the journal was published with around 500,000 subscribers. The economic success of their company allowed the Lipperheides to create extensive private collections that reflected their deep interest in cultural-historical topics as well as textile art.

This paper focuses on their collection of source material for costume studies, which is now known as the ‘Sammlung Modebild—Lipperheidesche Kostümbibliothek’ (Fashion Image Collection—Lipperheide Costume Library), a department of the Kunstbibliothek at the Staatliche Museen zu Berlin. The paper presents its history, some collection highlights and the various means of access (catalogues, exhibition catalogues and online access).
P.021 Surgical management of incidentally discovered diffusely infiltrating glioma
Authors: Opoku-Darko M , Lang S , Kelly J , Cadieux M
Published: June 2017

Background: Occasionally low grade gliomas (LGGs) are identified incidentally while asymptomatic. The diagnosis of incidental LGGs has become more frequent due to increase in access to medical imaging. While management of these lesions remains controversial, early surgery has been suggested to improve outcome. Methods: All LGGs treated between 2004 and 2016 at our institution were reviewed. Patients with incidentally discovered glioma were identified and retrospectively reviewed. “Incidental” was defined as an abnormality on imaging that was obtained for a reason not attributable to the glioma. Outcomes were measured by overall survival, progression free survival and malignant progression free survival. Results: Thirty-four out of 501 adult patients who were treated for low grade glioma were discovered incidentally. Headache (26%, n=9) and screening (21%, n=7) were the most common indications for brain imaging. The mean duration follow up was 5 years. Twelve patients had disease progression, 5 cases of malignant progression and 4 deaths. Oligodendroglioma was diagnosed in 16 and astrocytoma in 15 patients. Twenty-five (74%) patients had IDH1 mutation and demonstrated prolonged survival. Conclusions: This retrospective cohort of incidentally discovered LGGs were surgically removed with minimal surgical risk. There is improved overall survival likely attributable to the underlying favorable biology of the disease indicated by the presence of IDH1 mutation.
P.024 An atypical presentation of neurocysticercosis: a Manitoban case
Authors: Szelemej PA , Wiens E , Silvaggio J , Bigder M
Published: June 2017

Background: Neurocysticercosis is the world’s leading cause of epilepsy and the most common helminthic disease affecting the human nervous system. It is relatively rarely seen in developed nations, and usually presents clinically with seizures. Methods: This case report was prepared using the patient’s hospital chart, and a review of the literature was undertaken using PubMed. This case was subsequently compared and contrasted to the known neurocysticercosis literature. Results: This is the case of an otherwise healthy 38 year old Nepalese female who presented with a history of headaches. Nonspecific in nature, they had worsened in the past couple of weeks, thus prompting appropriate imaging of the head. A large 4 cm ring enhancing lesion with edema and mass effect was discovered in the right anterior temporal lobe. No other neurological findings were found on exam. Pathological analysis confirmed a larval scolex of T. solium. Conclusions: Aside from being an unusual pathology to be seen in Manitoba, this case is unique in both its clinical and radiographic presentations. There were no seizures noted on presentation, and a significant amount of mass effect was seen around a large lesion, all unusual features for neurocysticercosis.
P.037 Role of epilepsy monitoring unit in the investigation of patients with epilepsy and developmental delay
Authors: Suller Marti A , Mirsattari S , Aldosari M , Ikeda K , Huang W
Published: June 2017

Background: A significant part of the developmental delay (DD) population has epilepsy (26-70%) and live in an institution. These patients tend to have atypical presentation of epileptic seizures with higher risk of misdiagnosis. Distinguishing their ictal events from paroxysmal behaviors can be challenging.There often is a lack of description of the spells or inadequate history from the caregivers or the patients. These patients often have drug resistant epilepsy requiring polypharmacy with increased risk of morbidity and mortality. The aim of this study was to determine usefulness of Epilepsy Monitoring Unit (EMU) in diagnosis and management of these patients. Methods: This is a retrospective observational study of the patients with epilepsy and DD living in institutions that were admitted to the EMU. Results: Four patients met the inclusion criteria for this study. The mean age was 45(29-71), 3/4 (N=3) were male and 3/4 had focal epilepsy. All patients had mood disorders and 2 were taking antipsychotic medication. The mean admission-time was 6,25 days

(2-15) and there was a correlation with the events and seizures in 2/4 of the patients and the rest had a combination of behavioural-changes and seizures. Conclusions: EMU admission can provide an accurate diagnosis of spells in patients with DD and epilepsy, and improve their quality of life.
P.049 Seasonal variations in aneurysmal subarachnoid hemorrhage: revisiting the myth using google trends
Authors: Ku J , Alotaibi NM , Wang J , Ibrahim GM
Published: June 2017

Background: Results of previous studies examining seasonal variation in the incidence of aneurysmal subarachnoid hemorrhage (SAH) are conflicting. The aim of this study is to investigate whether there is a seasonal effect in online search queries for SAH that may reflect an association between meteorological factors and aneurysm rupture. Methods: We utilized the Google Trends data service to analyze the volume of internet queries for SAH on Google’s search engine from January 1, 2004 to November 2016. We used comprehensive search terms and collected data from: USA, Canada, Finland, and Japan, as well as worldwide search volume. Potential seasonal variations in the data were assessed by comparative non-parametric tests and curve-fit regression model. Results: Our analyses revealed that USA had the highest median search scores (115 vs. 86, 46, 46 for Finland, Canada and Japan, respectively). The term “brain aneurysm” was the commonly used search term among countries, followed by “cerebral aneurysm”. There was no evidence of seasonality in any of the countries studied on both univariate tests and regression time-adjusted analysis. Conclusions: There are no seasonal variations in internet search query volume for SAH. Further studies are needed to explore whether online search volumes correlate with the actual incidence of SAH.
P.053 Development of an EEG curriculum for icu nurses to facilitate real time screening of continuous EEG data for seizures in critically ill adults
Authors: Kromm JA , Waechter J , Kramer A
Published: June 2017

Background: Nonconvulsive seizures (NCSz) occur commonly in critically ill patients and are harmful. Diagnosis requires detection with continuous electroencephalography (cEEG) that necessitates frequent interpretation by experts. This is often not possible, and requires large amounts of resources. Screening level interpretation of cEEG by ICU nurses to facilitate timely expert diagnosis may be one solution. Methods: Kern’s approach to curriculum development was utilized to inform creation of a cEEG curriculum for ICU nurses. Results: A needs assessment revealed 80%, 94%, and 100% of nurses lacked comfort in basic seizure/EEG principles, EEG and CDSA interpretation respectively. The most requested method of learning (76%) involved simulation. A spiral curriculum of 15 interactive online tutorials with corresponding practice/simulation modules providing instant feedback was developed. To evaluate curriculum impact, time spent on modules, improvement in nursing knowledge, and diagnostic accuracy will be evaluated using pre and post curriculum tests. Participant satisfaction will be evaluated using electronic surveys. Conclusions: Development of a curriculum to teach ICU nurses basic screening diagnostic skills for NCSz is possible. Moving forward, we hope to refine and validate this learning tool and formally implement its use to help screen for NCSz prior to expert interpretation.
P.062 Fun for the brain: activities promoting stroke recovery in the acute phase
Authors: Sourial R , Jacbson A
Published: June 2017

Background: Canadian Stroke Best Practices recommend early mobilization and engagement in activities after stroke to enhance recovery. StrokeEngine reports the use of music can further promote recovery by harnessing neuroplasticity. Using music to enhance participation in activities after stroke may impact favorably on outcome after stroke. Methods: This descriptive study will be offered to patients admitted on the stroke unit. Based on the music preferences of willing participants and guided by the physiotherapy assessment, music, singing or dance movements will be incorporated into extra-therapeutic activities using specific musical instruments matched to patient ability. The music-enhanced activity program includes at least 3 sessions per week with a trained volunteer and additional sessions with family members for the duration of the hospital stay. Each session will last between 20 and 30 mins. The program will run for six weeks. Results: Data on patient participation in daily therapy and activities on the stroke unit will be presented and compared to a similar group of stroke patients. Changes in patient stroke recovery parameters will be measured and reported on magnitude of change for future work. Conclusions: Innovative ways to enhance patient engagement early after a stroke can optimalize stroke recovery. This project will shed some light on the effects of a music-enhanced intervention
P.063 The evolving epidemiology of infective endocarditis at St. Paul’s Hospital and Vancouver General Hospital
Authors: Li D , Walker G , Xu G , Johnston D
Published: June 2017

Background: SPH and VGH are the two largest tertiary care centers in BC’s Lower Mainland. Among those served are the low-SES, high-risk population of Vancouver’s Downtown East Side (DTES). We aim to characterize the changing epidemiology of infective endocarditis (IE) in this population from 1995 and 2014. To date, our database is among the world’s largest. Methods: 1337 cases were identified using ICD9/10 codes. A retrospective chart review was conducted to collect demographic data including HIV status, IVDU, neurologic complications and mortality. The cohort was dichotomized into IVDU and non-IVDU, and first (1995-2005) and second (2006-2014) decades. Data analysis was performed using univariate chi-square and t-tests. Results: Age at presentation has increased in the past decade (45 vs 55,p<0.001). Rates of IVDU and HIV have decreased significantly (50.5% vs 44.3%,p<0.001; 21.8% vs 7.9%,p<0.001, respectively). Neurologic complications were less frequent in non-IVDUs (16.5% vs 28.9%,p<0.01). Mortality was greater in those with neurologic complications (RR=2.6 95%CI:2.1-3.3,p<0.001). Patients with neurologic complications were more likely to undergo cardiac surgery (RR=1.6 95%CI:1.3-2.0,p<0.001). Conclusions: Our findings highlight the changing epidemiology of IE. Some discrepancies between our data and the existing literature may be accounted for by Vancouver’s unique DTES population. Further work characterizing this is ongoing.
P.066 Intrajejunal levodopa infusion (ILI) for Parkinson’s Disease (PD): a Canadian experience
Authors: Podgorny P , McCann P , Toore K , Tremain G , Lazarescu A , Suchowersky O
Published: June 2017

Background: ILI has been in use in Canada since 2011 to treat advanced PD. We review the benefits and complications of ILI for PD in a tertiary movement disorders center in Canada. Methods: Detailed chart review of patients treated with ILI at including motor UPDRS scores, ILI pump and PEG-J tube complications. Patients and caregivers were interviewed at regular clinic follow up about their experience with ILI. Results: 13 patients received ILI [10M, 3F; mean age 65.6 yrs, range (51.8-79.5); PD duration 14.2 yrs, range (9.1-22.0); mean follow-up 1.8 yrs, range (0.2-4.8)]. Patients reported improvement in motor function, decreased dyskinesias and ‘OFF times’ [mean motor UPDRS: pre-ILI 37.1, 1-6months post-ILI 27.5]. Common complications included dislodgement, knotting or blockage of the jejunal tube extension requiring endoscopic re- insertion (29 incidents in 6 patients over 5 yrs). Four patients discontinued Duodopa treatment, for reasons of declining cognition, inability to care for the pump, and/or minimal benefit. Conclusions: ILI is useful for the treatment of advanced PD, in patients that can care for the pump apparatus.
P.073 Factors associated with fatigue in children and adolescents with Duchenne muscular dystrophy: A Canada-wide cross-sectional survey
Authors: El-Aloul B , Wei Y , Speechley K , Campbell C
Published: June 2017

Background: Fatigue is frequent and disabling in adults with neuromuscular disorders, but not well characterized in paediatric neuromuscular disorders. Recently, fatigue was reported to be associated with poor health-related quality of life in children with Duchenne muscular dystrophy (DMD). Determinants of fatigue—a modifiable symptom—have not been studied in DMD. Our objective was to explore risk factors for fatigue in children with DMD. Methods: Patients aged 4–17 years identified via the Canadian Neuromuscular Disease Registry received mailed questionnaires. Fatigue was assessed using the PedsQLTM Multidimensional Fatigue Scale (patient- and parent-report). Standardized measures for depressive symptoms, sleep disturbances, functional ability and physical activity were used. Spearman’s correlations and Wilcoxon rank-sum tests were computed. Results: Of 194 eligible patients, 64 have responded to date. DMD patients reported greater fatigue than healthy controls from published data. Depressive symptoms were associated with greater fatigue, by patient-report (ρ=-0.44, P<0.001) and parent-report (ρ=-0.40, P=0.002). Sleep disturbances were associated with greater fatigue, by patient-report (ρ=-0.41, P=0.007) and parent-report (ρ=-0.51, P<0.001). Greater functional ability was associated with less fatigue, by parent-report (ρ=0.30, P=0.02). Physical activity and ambulatory status were not associated with fatigue. Conclusions: Fatigue is a significant issue in DMD. Depressive symptoms and sleep disturbances are associated with fatigue, warranting attention in therapeutic strategies to reduce fatigue.
P.075 The trend of electroencephalograph findings after starting anti-epileptic drugs during seizure assessment in children
Authors: Amiraslany A , Khan A , Moien-Afshari F , Wong PK , Almubarak S
Published: June 2017

Background: Few studies have explored the effects of anti-epileptic drugs (AEDs) on electroencephalograph (EEG) findings during the assessment of seizure management. Although a patient may reach seizure freedom, EEG results may continue to be abnormal. Further information is required to understand the trend of EEG findings during seizure treatment. Methods: This is a retrospective study based on chart reviews. Patients who had epilepsy evaluations at the Royal University Hospital in Saskatoon between January 2012 and December 2015, were selected. The relationships among time of initiating AEDs, EEG findings, and seizure outcome on follow-ups, have been evaluated. Results: 151 patients had first seizure clinic assessments, in which 75 patients had an EEG before starting AEDs. Among the 75 patients, 54 (72%) had abnormal EEGs. From those, 38 (70.3%) patient’s EEGs became normal and 16 (29.7%) patients continued to have abnormal EEGs after the introduction of AEDs. The seizure freedom was 81.5% among those who had normal EEG on follow-up, and 43.7% of those who continued to have abnormal EEGs. Conclusions: Although patients with normal EEGs after starting AEDs may encounter a higher chance of seizure freedom, the seizure free patients with abnormal EEGs indicate that EEG is not completely sufficient in predicting seizure status.
P.085 Spinal cord stimulator for chronic pain syndromes: a national awareness survey
Authors: Al Jishi AA , Suresh H , Farrokhyar F
Published: June 2017

Background: The expansion of neuromodulation intervention for complex pain syndromes has been signifcant in the last few decades. Considering the increased load of patients, we thought about evaluating the level of awareness among different medical experts to help assessing their familiarity with spinal cord stimulator (SCS). Methods: Survey has been sent to general practitioners, family physicians, pain specialists and spine surgeons. The main outlets of the survey aims to assess the followings:

The main source of their knowledge about SC

Familiarity with candidates who may benefit from SC

Introducing the concept of SC to their patients as an adjunctive treatment

Frequency of patients’ referral for SC

Main reason for referring their patients

Familiarity with centres providing SCS

Results: EResults will be provided upon analysing the data from the collected surveys. Conclusions: The expansion in neurmodulation is expected to help patients with intractable pain syndromes. Hence, the survey would potentially help to explore the deficiencies in health workers awareness about SCS and outline future directions toward proper patients counseling and optimising their referral to neuromodulation centres.
P.091 Anterior surgical fixation for cervical spine flexion-distraction injuries
Authors: Jack AS , Choy G , Hardy St-Pierre G , Fox R , Nataraj A
Published: June 2017

Background: Optimal surgical management for flexion--distraction cervical spine injuries remains controversial with anterior, posterior, and circumferential fixation being accepted. Here, we examined risk factors for clinical and radiographic failure in patients with one segment cervical flexion-distraction injuries having undergone anterior surgical fixation. Methods: A retrospective review of 57 consecutive patients undergoing anterior fixation for cervical flexion-distraction injuries between 2008-2012 was performed. The primary outcome was the number of patients requiring additional surgical stabilization and/or radiographic failure. Data collected inlcuded age, gender, mechanism and level of injury, facet pattern injury, and vertebral endplate fracture. Results: Six patients failed clinically and/or radiographically (11%). Four patients (7%) required additional posterior fixation. Two patients identified met radiographic failure criteria, however had fused radiographically, were stable clinically, and no further treatment was pursued. Progressive kyphosis and translation correlated with need for revision (p<0.05 and p=0.02, respectively). No differences were identified for all other clinical and radiological factors assessed. Conclusions: This study supports the growing body of evidence for anterior fixation alone for flexion-distraction injuries. Findings suggest that measurements including segmental translation and kyphosis may predict radiographic failure and need for further surgical stabilization in some patients. Assessment for independent risk factors for anterior approach failure with a validated predictive scoring model should be considered.
P.104 Factors influencing resident engagement in research during post-graduate training
Authors: Haji FA , Cooke S , Chahine S , Watling CJ , Duggal N
Published: June 2017

Background: Residency training programs aspire to develop residents’ research skills, but engaging trainees in research often proves challenging. Addressing this requires a better understanding of factors influencing residents’ engagement in scholarship. We sought to identify such factors through an interview-based study that explored residents’ interest and involvement in research during training. Methods: We conducted 15 semi-structured interviews with neurology (n=8) and neurosurgery (n=7) residents at our institution based on an interview guide developed through a literature review and pilot interviews (n=3). Using template analysis, we examined transcripts to identify facilitators and barriers to resident research. Results: Motivation, mentorship, and resource availability were noted to significantly impact resident research. Trainees indicated motivation is influenced by personal desire to develop research skills, interest in available projects, and pressure to engage in scholarship from peers, mentors, and future employers. While strong mentorship and departmental resources for data collection and analysis facilitate resident research, funding and time constraints are barriers to success. Conclusions: We have identified multiple factors influencing residents’ engagement in research, which may be targeted by program directors to optimize the post-graduate training environment for resident scholarship. In the next phase of our project, we will corroborate and expand on these findings through a national survey of residents across all specialties.
P.106 Ethics education in neurosurgical training- a survey of North American program directors
Authors: Rajmohamed N , Cheong AR , Kulkarni AV , Riva-Cambrin J , McDonald PJ
Published: June 2017

Background: Despite being mandatory for accreditation by the RCPSC and ACGME, little is known about how ethics education is undertaken during neurosurgery training. This study assessed the current state of ethics education in North American neurosurgery training programs. Methods: A web-based survey was developed based on ethics competencies outlined by the RCPSC and the ACGME and emailed to North American neurosurgery residency program directors(PD’s). Responses were analyzed using descriptive statistics. Results: 47/119 (40%) PD’s completed the survey. Most(74%) spent <10 hours/year on ethics education. Informal discussion(86%), case presentations(67%) and lectures(55%) were common teaching methods. Most(85%) felt real-life experience was the best teaching method. Neurosurgical faculty(86% of programs), medical faculty(48%) and ethicists(26%) provided ethics teaching. Time constraints(42%) and lack of expert faculty(24%) were common barriers. Important topics were end of life care(95%), conflicts of interest(81%), informed consent(81%), futility(66%) and research ethics(66%). Most(78%) felt ethics education should be mandatory and that trainees were prepared to deal with ethically challenging situations(95%). Conclusions: This study provides a snapshot of ethics education in neurosurgery training. Time constraints and a lack of expert faculty were seen as barriers to ethics education. Most program directors felt residents were well prepared to deal with ethical issues. Identified ethical topics of importance should be incorporated into training curricula.
A.03 Analyses of surgical and MRI factors associated with cerebellar mutism
Authors: Sergeant A , Kameda-Smith MM , Manoranjan B , Kumar B , Duckworth J , Petrelli T , Savage K , Ajani O , Yarascavitch B , Samaan C , Scheinemann K , Alyman C , Almenawer S , Farrokhyar F , Fleming AJ , Singh SK , Stein N
Published: June 2017

Background: The surgical risk factors and neuro-imaging characteristics associated with cerebellar mutism (CM) remain unclear and require further investigation. We aimed to examine surgical and MRI findings associated with CM in children following posterior fossa tumor resection. Methods: Using our data registry, we retrospectively collected data from pediatric patients who acquired CM and were matched based on age and pathology type with patients not acquiring CM after posterior fossa surgery. The strength of association between surgical and MRI variables and CM were examined using odds ratios (ORs) and corresponding 95% confidence intervals (CIs). Results: A total of 22 patients were included. Medulloblastoma was the most common pathology among CM patients (91%). Tumor attachment to the floor of the fourth ventricle (OR, 6; 95% CI, 0.7-276), calcification/hemosiderin deposition (OR 7; 95% CI 0.9-315.5), and post-operative peri-ventricular ischemia on MRI (OR, 5; 95% CI, 0.5-236.5) were found to have the highest association with CM. Conclusions: Our results may suggest that tumor attachment to the floor of the fourth ventricle, pathological calcification, and post-operative ischemia are relatively more prevalent in patients with CM. Collectively, our work calls for a larger multi-institutional study of CM patients to further investigate the determinants and management of CM to potentially minimize its development and predict onset.
A.07 Genomics of atypical dyskinetic cerebral palsy – opportunities for improved diagnosis and management
Authors: Goez H , Matthews A , Al Jabri B , Blydt-Hansen I , Andersen J , Tarailo-Graovac M , Drogemoller B , Shyr C , Lee J , Ghani A , Sinclair G , Ross C , Wasserman W , McKinnon M , Horvath G , Van Karnebeek C
Published: June 2017

Background: Cerebral palsy (CP) is a debilitating disorder (1). Based on neuromotor impairments it is divided to spastic, dyskinetic and ataxic types (2). Inborn Errors of Metabolism (IEMs), monogenic and chromosomal disorders mimic CP (3). We aimed to identify causal genetic variants in patients with atypical dyskinetic CP in whom known IEMs were ruled out. Timely diagnosis is essential for proper management, especially in conditions that mimic CP and are treatable. Methods: We enrolled 23 patients with unexplained atypical dyskinetic CP, for whole exome sequencing. Variants were filtered against public and in-house databases to identify variants predicted as damaging (in silico tools and ACMG criteria). We applied a virtual gene panel of known and suspected CP and movement disorder genes and investigated each sample. Results: The participants presented with symptoms including: spasticity, dystonia, choera-athetosis, ataxia and cognitive delays. We identified 23 diagnoses: 13 dominant,6 recessive and 4 X-linked. 12 patients had movement disorders. In 4, the diagnoses enabled targeted treatment (neurotransmitter supplements in Unverricht Lundborg diseases (CSTB) and PAK3 deficiency, deep brain stimulation in GNAO1 deficiency, medical diet in Glutaric Aciduria (GCDH). Conclusions: Whole Exome Sequencing contributes to establishing diagnosis in patients with atypical dyskinetic CP resulting in precision medicine and improved health outcomes.
B.07 Differences between Indigenous and non-Indigenous patients referred to a rural and remote memory clinic
Authors: Arcand J , Kirk A , Karunanayake C , Morgan D
Published: June 2017

Background: Jacklin et al. (2013) described a rising incidence and a younger onset of dementia in Albertan First Nations compared to non-First Nations patients. Canadian research is limited in Indigenous patients with dementia, leaving it difficult to understand factors contributing to the differences in incidence and prevalence. Methods: 375 patients (41 Indigenous) was seen at the clinic. The questionnaire given during initial assessments were reviewed and differences between groups (non-Indigenous patients versus Indigenous) were assessed. Results: Compared to the non-Indigenous patient, Indigenous patients were younger (p=0.007), were more likely to be female (p=0.033) and had less education (p=0.055). They were less likely to live solely with a partner (p<0.001) and more likely to have a daughter as caregiver (p=0.004). The Indigenous patients were more likely to smoke (p<0.001). Although no differences in diagnosis of mental health disorders were seen (p=0.735), the Indigenous patients scored significantly higher on the CES-D (p<0.0001). Conclusions: This comparison highlights differences potentially affecting the health of Indigenous patients. Acknowledging these differences is critical to individualized patient care. Further research is required to explore how these factors affect dementia disease course and treatment, and how these factors play a role in the differences in incidence and prevalence demonstrated in previous studies.
C.03 Surgical clipping or endovascular coiling for unruptured intracranial aneurysms: a pragmatic randomized trial
Authors: Darsaut TE ,   CURES Collaborative Group
Published: June 2017

Background: Unruptured intracranial aneurysms (UIAs) are treated using endovascular treatment or microsurgical clipping. The safety and efficacy of treatments have not been compared in a randomized trial. Methods: We randomly allocated clipping or coiling to patients with 3-25mm UIAs judged treatable both ways. The primary outcome was treatment failure, defined as: initial failure of aneurysm treatment, intracranial hemorrhage or residual aneurysm on one year imaging. Secondary outcomes included neurological deficits following treatment, hospitalization >5 days, overall morbidity and mortality and angiographic results at one year. Results: 136 patients were enrolled from 2010 through 2016 and 134 patients were treated. The one-year primary outcome, available for 104 patients, was reached in 5/48 (10.4% (4.5%-22.2%)) patients allocated surgical clipping, and 10/56 (17.9% (10.0%-29.8%)) patients allocated endovascular coiling (OR: 0.54 (0.13, 1.90), P=0.40). Morbidity and mortality (mRS>2) at one year occurred in 2/48 (4.2% (1.2%-14.0%)) and 2/56 (3.6% (1.0%-12.1%)) patients allocated clipping and coiling respectively. New neurological deficits (15/65 vs 6/69; OR: 3.12 (1.05, 10.57), P=0.031), and hospitalizations beyond 5 days (30/65 vs 6/69; OR: 8.85 (3.22,28.59), P=0.0001) were more frequent after clipping. Conclusions: Surgical clipping led to greater initial treatment-related morbidity than endovascular coiling. At one year, the superior efficacy of clipping remains unproven and in need of randomized evidence.
P.001 Transient neurapraxic radiculopathy
Authors: Baker SK
Published: June 2017

Background: Neurapraxia is considered to be a temporary disorder of peripheral nerve conduction due to trauma that does not cause axonopathy. However, patients with radiculopathy, confirmed by MRI, who may not have active axonal damage with evidence of spontaneous activity may still report transient give-way weaknesss. In the absence of active changes on intramuscular recording a neurophysiologic consultation may fail to substantiate any significant neurologic concern. This report documents and objectifies prone positioning-induced radicular neurapraxic weakness in an elderly man. Methods: An 83-year-old gentleman was referred for neuromuscular evaluation with regards to peripheral neuropathy. He had a history of low back pain and MRI evidence of multilevel DDD and discogenic neuroforaminal narrowing. Strength testing was performed by Biodex evaluation. Routine electrophysiologic assessments were performed. Results: On neurologic examination proximal strength iwas normal with grade 4 dorsiflexion strength. Stocking-glove loss to pinprick was absent. Preliminary objective testing of the right quadriceps revealed a peak torque of 87.1 Nm. Immediately after lying prone for 3 minutes (for paraspinal EMG), his power dropped to 33.7 Nm. Strength fully recovered by 36 hrs. Conclusions: This case documents evidence of a 61% reversible reduction in torque in the right quadriceps after prone lying. Electromyographers need to be cautious with radiculopathy patients during paraspinal testing.
P.007 Symptoms free survival of ventriculoperitoneal shunt versus lumboperitoneal shunt in idiopathic intracranial hypertension: a systematic review
Authors: Jishi AA Al , Zagzoog N , Alotaibi M , Attar AA , Farrokhyar F
Published: June 2017

Background: Idiopathic intracranial hypertension (IIH) is a unique disorder that is characterized by an intractable high intracranial pressure. Several interventions have been in clinical practice upon failure of medical management. Yet, none of the available modalities have been evaluated systematically for an CSF diverion procedure. Methods: We conducted a systematic review in order to compare the therapeutic efficacy of the most two common interventions, namely VPS vs. LPS. The complications rate and incidence of shunt revision were assessed. The electronic database from EMBASE, Medline, Cochrane databases, and references of review articles have been used. Results: A total of five retrospective comparative studies had been included out of 724 articles based on inclusion and exclusion criteria. A 2570 VPS were compared to 1832 LPS with 85% of heterogeneity. Although there was a tendency that suggests better outcome in VPS over LPS but it was not statistically significant [OR=0.91, 95% CI: 0.26-3.24]. Similar tendency was observed as well with shunt obstruction. Conclusions: The overall outcomes for stabilizing visual deterioration and improvement of headaches were similar among VPS and LPS. A large prospective multicenteric randomized controlled trial is needed in order to compare effectiveness of VPS and LPS, and also to establish a treatment guideline for IIH.
P.010 5 layers reconstruction, superior semicircular canal dehiscence repair: our experience and surgical technique
Authors: Alkherayf F , Agbi C , Schramm D
Published: June 2017

Background: Superior semicircular canal dehiscence (SSCD) is a recently described rare condition. SSCD symptoms include vertigo, oscillopsia, autophony, sound hypersensitivity , and conductive hearing loss. Patients with sever symptoms may require surgical treatment. Tranmastoid and middle fossa (MCF) approaches are common approaches. Methods: We are presenting our experience at the Ottawa Hospital over the last three years. Also we describe our multidisciplinary surgical approach and modalities to localize the SSCD intraoperatively. Demographic data, presenting symptoms, co-morbidities, radiologic imaging, and surgery length were recorded. All patients had hearing and vestibular tests before and after their surgeries. Results: 14 surgeries were performed in 11 patients (three patients had bilateral SSCD). Most patients were males (82%). Age range was 32-68 years. Surgeries were done by a team of a neurosurgeon and a neuro-otologist. Localization of SSCD was done using stereotactic guidance. Five layers’ reconstruction was performed in all patients. All patients had significant improvement in symptoms without sensorineural hearing loss. None of the patients developed post-operative hematoma, infection, seizures, CSF leakage or facial palsy. LOS was 1-2 days. Conclusions: MCF with multi layers reconstruction should be considered as a safe and effective approach in severely symptomatic patients. We demonstrated that this approach has minimal risks especially in regards to sensorineural hearing loss.
P.014 The natural history of third ventricle colloid cysts includes asymptomatic regression: a report of two cases and review of the literature
Authors: Bokhari R , Chankowsky J , Marcoux J
Published: June 2017

Background: Colloid cysts of the third ventricle are a rare entity with an unclear natural history. Although intervening in the setting of a symptomatic patient is fairly straightforward, decision-making for asymptomatic patients is not. Few studies address this question and proposed risk factors for cyst progression vary.A cyst diameter exceeding 1 cm is a common indication for surgery. This is rooted in the belief that the natural history is continued growth. A few cases have recently surfaced that suggests some cysts may spontaneously regress without complication. We describe our experience with two such cases and contrast it with those of others. Methods: We collected all cases of “colloid cysts” identified as incidental findings on Brain CT scans in a large urban center with available follow-up. We then conducted a comprehensive review of the literature. Results: Among all incidental cases from our database, none required surgery and two were found to decrease in size on neuroimaging surveillance with interesting evolution in MRI signal characteristics. These cysts remain asymptomatic at last follow up. Conclusions: The natural history of colloid cysts includes spontaneous regression. This should be mentioned in counseling asymptomatic patients.
Intrinsic viscosity of macromolecules within the generalized Rotne–Prager–Yamakawa approximation
Authors: Zuk Pawel J. , Cichocki Bogdan , Szymczak Piotr
Published: June 2017

We develop a generalized Rotne–Prager–Yamakawa approximation for the dipolar components of the inverse friction matrix and use it for calculating the intrinsic viscosity of rigidly connected bead conglomerates. Such bead models are commonly used in the calculation of hydrodynamic properties of macromolecules. We consider both the case of non-overlapping constituent beads as well as overlapping beads of different sizes. We demonstrate the accuracy of the approximation in two test cases and show that it performs well even if the distances between the beads are small or if the beads overlap. Robust performance of this approximation in the case of overlapping beads stems from its correct limiting behaviour at a complete overlap, with one sphere fully immersed in the other. The generalized Rotne–Prager–Yamakawa approximation is thus well suited for evaluation of intrinsic viscosity, which is a key quantity in characterizing molecular conformations of biological macromolecules.
Scaling the propulsive performance of heaving and pitching foils
Authors: Floryan Daniel , Van Buren Tyler , Rowley Clarence W. , Smits Alexander J.
Published: June 2017

Scaling laws for the propulsive performance of rigid foils undergoing oscillatory heaving and pitching motions are presented. Water tunnel experiments on a nominally two-dimensional flow validate the scaling laws, with the scaled data for thrust, power and efficiency all showing excellent collapse. The analysis indicates that the behaviour of the foils depends on both Strouhal number and reduced frequency, but for motions where the viscous drag is small the thrust closely follows a linear dependence on reduced frequency. The scaling laws are also shown to be consistent with biological data on swimming aquatic animals.
The onset of turbulent rotating dynamos at the low magnetic Prandtl number limit
Authors: Seshasayanan Kannabiran , Dallas Vassilios , Alexakis Alexandros
Published: June 2017

We demonstrate that the critical magnetic Reynolds number $Rm_{c}$ for a turbulent non-helical dynamo in the limit of low magnetic Prandtl number $Pm$ (i.e. $Pm=Rm/Re\ll 1$) can be significantly reduced if the flow is subjected to global rotation. Even for moderate rotation rates the required energy injection rate can be reduced by a factor of more than $10^{3}$. This strong decrease in the onset is attributed to the transfer of energy to the large scales, forming a large-scale condensate, and the reduction in the turbulent fluctuations that cause the flow to have a much larger cutoff length scale than in a non-rotating flow of the same Reynolds number. The dynamo thus behaves as if it is driven just by the large scales that act as a laminar flow (i.e. it behaves as a high $Pm$ dynamo) even though the actual Reynolds number is much higher than the magnetic Reynolds number (i.e. low $Pm$). Our finding thus points to a new paradigm for the design of new experiments on liquid metal dynamos.
Capturing the genetic makeup of the active microbiome in situ
Authors: Singer Esther , Wagner Michael , Woyke Tanja
Published: June 2017

More than any other technology, nucleic acid sequencing has enabled microbial ecology studies to be complemented with the data volumes necessary to capture the extent of microbial diversity and dynamics in a wide range of environments. In order to truly understand and predict environmental processes, however, the distinction between active, inactive and dead microbial cells is critical. Also, experimental designs need to be sensitive toward varying population complexity and activity, and temporal as well as spatial scales of process rates. There are a number of approaches, including single-cell techniques, which were designed to study in situ microbial activity and that have been successively coupled to nucleic acid sequencing. The exciting new discoveries regarding in situ microbial activity provide evidence that future microbial ecology studies will indispensably rely on techniques that specifically capture members of the microbiome active in the environment. Herein, we review those currently used activity-based approaches that can be directly linked to shotgun nucleic acid sequencing, evaluate their relevance to ecology studies, and discuss future directions.