bluuebunny/crossref_metadata_2025 huggingface dataset:
Forecasting Inequalities in Survival to Retirement Age by Socioeconomic Status in Denmark and Sweden
Authors: Strozza Cosmo , Bergeron-Boucher Marie-Pier , Callaway Julia , Drefahl Sven
Published: May 2024

In Denmark and Sweden, statutory retirement age is indexed to life expectancy to account for mortality improvements in their populations. However, mortality improvements have not been uniform across different sub-populations. Notably, in both countries, individuals of lower socioeconomic status (SES) have experienced slower mortality improvements. As a result, a uniform rise in the statutory retirement age could disproportionally affect these low-SES groups and may unintentionally lead to a reverse redistribution effect, shifting benefits from short-lived low-SES individuals to long-lived high-SES individuals. The aim of this study is twofold: to quantify and contextualise mortality inequalities by SES in Denmark and Sweden, and to assess how indexing retirement age will affect future survival to retirement age by SES in these countries. We used Danish and Swedish registry data (1988–2019), to aggregate individuals aged 50 + based on their demographic characteristics and SES. We computed period life tables by year, sex, and SES to estimate the difference in survival across different SES groups. We then forecast mortality across SES groups to assess how indexing retirement age will affect survival inequalities to retirement age, using two forecasting models—the Mode model and the Li-Lee model. Mortality inequalities are comparable in Denmark and Sweden, even though the latter generally has higher survival. We also find that indexing retirement age to life expectancy will have two main consequences: it will reduce the probability of reaching retirement for all SES groups, particularly those of low SES, and time spent in retirement will be reduced, particularly for those of high SES.
Ambivalent Stereotypes
Authors: Bengtson Andreas , Pedersen Viki Møller Lyngby
Published: May 2024

People often discriminate based on negative or positive stereotypes about others. Important examples of this are highlighted by the theory of ambivalent sexism. This theory distinguishes sexist stereotypes that are negative (hostile sexism) from those that are positive (benevolent sexism). While both forms of sexism are considered wrong toward women, hostile sexism seems intuitively worse than benevolent sexism. In this article, we ask whether the difference between discriminating based on positive vs. negative stereotypes in itself makes a morally relevant difference. We suggest that it does not. By examining a number of prominent accounts of what makes discrimination wrong, we defend the Moral Irrelevance View according to which stereotype valence is irrelevant to the moral evaluation of discrimination, all else equal.
Type I Tobit Bayesian Additive Regression Trees for censored outcome regression
Authors: O’Neill Eoghan
Published: May 2024

Censoring occurs when an outcome is unobserved beyond some threshold value. Methods that do not account for censoring produce biased predictions of the unobserved outcome. This paper introduces Type I Tobit Bayesian Additive Regression Tree (TOBART-1) models for censored outcomes. Simulation results and real data applications demonstrate that TOBART-1 produces accurate predictions of censored outcomes. TOBART-1 provides posterior intervals for the conditional expectation and other quantities of interest. The error term distribution can have a large impact on the expectation of the censored outcome. Therefore, the error is flexibly modeled as a Dirichlet process mixture of normal distributions. An R package is available at https://github.com/EoghanONeill/TobitBART.
A specific diagnostic metabolome signature in adult IgA vasculitis
Authors: Boissais Alexandre , Blasco Hélène , Emond Patrick , Lefèvre Antoine , Bigot Adrien , Ramdani Yanis , Maldent Nicole Ferreira , Mulleman Denis , Pillebout Evangéline , Maillot François , Audemard-Verger Alexandra
Published: May 2024

Introduction

IgA vasculitis diagnosis relies primarily on clinical features and is confirmed by pathological findings. To date, there is no reliable noninvasive diagnostic biomarker.

Objective

We aimed to explore the baseline serum metabolome of adult patients with IgA vasculitis to identify potential diagnostic biomarkers.

Methods

We performed a study comparing the serum metabolome of patients with IgA vasculitis to that of patients with inflammatory condition, namely spondyloarthritis. Serum analyses were performed by high-performance liquid chromatography-mass spectrometry.

Results

Fifty-five patients with IgA vasculitis and 77 controls with spondyloarthritis (age- and sex-matched) were included in this study. The median age of IgA vasculitis patients was 53 years. Two-thirds of patients were female (n = 32). At the time of vasculitis diagnosis, 100% of patients had skin involvement and 69% presented with glomerulonephritis (n = 38). Joint and digestive involvement were observed in 56% (n = 31) and 42% (n = 23) of patients. Four discriminative metabolites between the two groups were identified: 1-methyladenosine, L-glutamic acid, serotonin, and thymidine. The multivariate model built from the serum metabolomes of patients with IgA vasculitis and spondyloarthritis revealed an accuracy > 90%. As this model was significant according to the permutation test (p < 0.01), independent validation showed an excellent predictive value of the test set: sensitivity 98%; specificity 98%, positive predictive value 97% and negative predictive value 98%.

Conclusion

To our knowledge, this study is the first to use the metabolomic approach for diagnostic purposes in adult IgA vasculitis, highlighting a specific diagnostic metabolome signature.
Multinational Corporations and Social Innovation in Emerging Markets
Authors: Adomako Samuel , Liu Xiaohui , Sarala Riikka M. , Ahsan Mujtaba , Lee Jeoung Yul , Shenkar Oded
Published: May 2024

The concept of social innovation has garnered increasing attention across various disciplines, driven by a growing recognition of the need to address complex societal challenges. However, despite the thorough examination of traditional innovation forms and their influence on global business practices, the scrutiny of social innovation within the realm of international business (IB) remains relatively nascent. This introduction delineates the scope of this focused issue and emphasizes the critical need to expand research on social innovation within IB, a field dedicated to enhancing social value and engagement among diverse stakeholders. This focused issue explores the catalysts and impacts of multinational corporations' (MNCs’) social innovation endeavours in emerging markets. Departing from the profit-centric focus of conventional innovation studies, social innovation emphasizes the redistribution of knowledge, the encouragement of discovery, and the facilitation of co-creation, thus posing a challenge to the traditional paradigms and logics of innovation theory. This introduction provides a concise review of current social innovation literature in IB, highlights the contributions made by the articles in this focused issue, and concludes by outlining directions for future research in the domain of social innovation in IB.
Driving Social Innovation in Bottom-of-the-Pyramid Markets through International Social Alliances: The Role of Legitimacy
Authors: Pillai Kishore Gopalakrishna , Nair Smitha R. , Zahoor Nadia , Khan Zaheer
Published: May 2024

International social alliances—in which multinational enterprises (MNEs) and social enterprises (SEs) collaborate—are a vital source for the development and scaling up social innovations for value creation. Yet, these alliances face significant legitimacy challenges, which are more glaring in bottom-of-the-pyramid markets (BOPMs) within emerging and developing economies owing to weak and underdeveloped formal institutions. Drawing on the legitimacy, institutional, and social alliances literature, we develop a conceptual framework that explains the importance of developing social, institutional, and commercial legitimacy in international social alliances operating in BOPMs. We also explored the challenges faced by international social alliances in BOPMs and the factors that enable MNEs and SEs to build different types of legitimacy. We contribute to international business research by providing an understanding of various legitimacy building strategies enacted by international social alliances based in BOPMs for social value creation.
Effect of an 8-Week Mindfulness Meditation Training Program on Psychological Distress in Caregivers and on Behavioral and Psychological Symptoms in People with Alzheimer’s Disease: A Randomized Controlled Trial
Authors: Sánchez-Pérez Alicia , Quesada-Rico María Paz , Mendialdua-Canales Daniel , Hurtado-Pomares Miriam , Navarrete-Muñoz Eva María , Valera-Gran Desirée , Peral-Gómez Paula , Gil Gemma Benavides , Millán Pablo García , González-Caballero Gloria , Chaves-Vélez Covadonga , Goldin Philippe
Published: May 2024

Objectives

Mental health problems are highly prevalent in people with Alzheimer’s disease (AD) and their family caregivers. Therefore, this study aimed to examine the effects of the Mindfulness-Based Health Care Program (MBHC) on the psychological distress of family caregivers of people with AD and, indirectly, on the behavioral and psychological symptoms of dementia (BPSD) in people with AD.

Method

A sample of 66 caregivers of people with AD was randomly assigned to either 8 weeks of MBHC or treatment as usual (TAU) groups. The psychological distress in family caregivers, measured by the Hospital Anxiety and Depression Scale (HADS), and BPSD in patients, measured by the Neuropsychiatric Inventory Questionnaire (NPI-Q), were evaluated and compared at baseline, post-intervention, and 3-month follow-up.

Results

A total of 50 participants (75.6%) completed the MBHC post-intervention and 30 (50%) at the 3-month follow-up. At post-intervention, compared to TAU, MBHC was associated with significantly greater decreases in psychological distress (β =  − 3.86; 95%CI, − 7.67, − 0.04; p = 0.047), specifically in anxiety symptoms (β =  − 2.84; 95%CI, − 5.38, − 0.30; p = 0.029), but no significant changes were observed in depressive symptoms. MBHC did not produce a significant change in psychological distress at 3-month follow-up. MBHC did not yield a significant reduction in BPSD in people with AD, neither at post-intervention nor at 3-month follow-up.

Conclusions

The results suggest that 8-week mindfulness training can effectively reduce psychological distress and anxiety symptoms in caregivers of people with Alzheimer’s disease.

Preregistration

This study was preregistered on ClinicalTrials.gov (identifier NCT03858283) on 26 February 2019.
Effect of virgin olive oil as spreadable preparation on atherosclerosis compared to dairy butter in Apoe-deficient mice
Authors: Martínez-Beamonte Roberto , Barranquero Cristina , Gascón Sonia , Mariño Juan , Arnal Carmen , Estopañán Gloria , Rodriguez-Yoldi María Jesús , Surra Joaquín Carlos , Martín-Belloso Olga , Odriozola-Serrano Isabel , Orman Israel , Segovia Jose Carlos , Osada Jesús , Navarro María Ángeles
Published: May 2024

Olive oil is the main source of lipid energy in the Mediterranean diet and there is strong evidence of its health benefits. The effect of extra virgin olive oil (EVOO) in the form of a preparation of spreadable virgin olive oil (S-VO) on the progression of atheroma plaques was investigated in Apoe-deficient mice, a model of accelerated atherosclerosis. Methods: Two isocaloric Western purified diets containing 20% fat, either as S-VO or as dairy butter, were used to feed 28 males and 16 females of two-month-old Apoe-deficient mice for 12 weeks. S-VO was prepared by blending more than 75% virgin olive oil with other vegetal natural fat to obtain a solid fat. Plasma total cholesterol, triglycerides and HDL cholesterol were measured. Hepatic lipid droplets were analyzed. Areas of atherosclerotic aortic lesions were quantified in cross-sectional images of the proximal aorta and en face analysis of the whole aorta. Results: Total plasma cholesterol was increased in mice on the butter-supplemented diet in both female and male mice compared to S-VO, and the ratio of TC/HDL-cholesterol was significantly lower in S-VO than in the butter diet, although only in males, and no differences in plasma triglycerides were observed. No significant differences in hepatic lipid droplets were observed between diets in either sex. Aortic lesion areas were significantly higher in mice consuming the butter versus the S-VO diet in both sexes. Conclusion: Extra virgin olive oil prepared in spreadable form maintained the delay in atheroma plaque progression compared to butter.
Anomalous Aortic Origin of a Coronary Artery in Pediatric Patients
Authors: Doan Tam T. , Puelz Charles , Rusin Craig , Molossi Silvana
Published: May 2024

Purpose of Review

We present a contemporary approach to risk assessment and management of patients with anomalous aortic origin of a coronary artery (AAOCA).

Recent Findings

Anomalous left coronary artery from the right aortic sinus (L-AAOCA) with interarterial course carries a high risk of sudden cardiac death (SCD); therefore, current guidelines recommend exercise restriction and surgical intervention. Recent data in intraseptal and juxtacommissural L-AAOCA showed inducible perfusion abnormalities, leading to consideration of surgical intervention. Anomalous right coronary artery from the left aortic sinus (R-AAOCA) carries a much lower risk and stress perfusion imaging is helpful in identifying patients with inducible ischemia. Perfusion abnormalities resolve following successful surgical intervention of AAOCA. Computational modeling techniques identifying risk features shows promise in the evaluation of AAOCA.

Stress perfusion imaging is helpful in assessing AAOCA upon presentation and following surgical intervention. Computational modeling has potential in bridging knowledge gaps in AAOCA.
Mario Ageno and the status of biophysics
Authors: Cozzoli Daniele
Published: May 2024

This essay focuses on Mario Ageno (1915–1992), initially director of the physics laboratory of the Italian National Institute of Health and later professor of biophysics at Sapienza University of Rome. A physicist by training, Ageno became interested in explaining the special characteristics of living organisms origin of life by means of quantum mechanics after reading a book by Schrödinger, who argued that quantum mechanics was consistent with life but that new physical principles must be found. Ageno turned Schrödinger’s view into a long-term research project. He aimed to translate Schrödinger’s ideas into an experimental programme by building a physical model for at least a very simple living organism. The model should explain the transition from the non-living to the living. His research, however, did not lead to the expected results, and in the 1980s and the 1990s he focused on its epistemological aspect, thinking over the tension between the lawlike structure of physics and the historical nature of biology. His reflections led him to focus on the nature of the theory of evolution and its broader scientific meaning.
Organic petrographic and mineralogical composition of the No. 6 coal seam of the Soutpansberg Coalfield, South Africa: Insights into paleovegetation and depositional environment
Authors: Biswas Sanki , Wagner Nicola J. , Moroeng Ofentse M.
Published: May 2024

This study investigates the paleodepositional conditions of the No. 6 Seam of the Madzaringwe Formation in Makhado and Voorburg south area of the Soutpansberg Coalfield (Limpopo Province, South Africa) utilizing organic petrography and inorganic geochemical proxies. The coals are predominantly high-volatile bituminous B-A rank with high ash yields (avg. 36.1 wt%), characterized by high-vitrinite (~ 41.5 vol%), moderate-to-high inertinite (9.8 vol%–33.7 vol%) and low liptinite (~ 2.3 vol%). The distribution of inertinite varies among different coal horizons (from bottom-lower to middle-upper), suggesting differential oxidation conditions and/or paleofire occurrence. Vitrinite-to-inertinite (V/I) ratio, tissue preservation–gelification index (TPI–GI), and groundwater–vegetation index (GWI–VI) plots, indicate that the peat-forming forest-swamp vegetation accumulated under mesotrophic-to-rheotrophic hydrological conditions. The presence of structured macerals (i.e., telinite, collotelinite, fusinite, and semifusinite) suggests well-preserved plant tissues, whereas framboidal pyrite and sulphur content (0.24 wt%–2.16 wt%) point to brackish-water influence at the peat stage. The coals contain quartz, kaolinite, siderite, muscovite, dolomite, calcite, and pyrite minerals, most of which were likely sourced from felsic igneous rocks. The Al/(Al+Fe+Mn) and (Fe+Mn)/Ti ratios for the studied samples range between 0.24–0.97 and 0.57–70.10, respectively. The ratios, Al–Fe–Mn plot, and presence of massive botryoidal-type pyrite imply some influence of meteoric waters or fluids from hydrothermal activity post-deposition. Moreover, the chemical index of alteration (CIA: 98.25–99.67), chemical index of weathering (CIW: 92.04–97.66), and A–CN–K ternary diagram suggest inorganic matter suffered strong chemical weathering, indicating warm paleoclimatic conditions during the coal formation.
Amorphous Iridium Oxide-Integrated Anode Electrodes with Ultrahigh Material Utilization for Hydrogen Production at Industrial Current Densities
Authors: Ding Lei , Li Kui , Wang Weitian , Xie Zhiqiang , Yu Shule , Yu Haoran , Cullen David A. , Keane Alex , Ayers Kathy , Capuano Christopher B. , Liu Fangyuan , Gao Pu-Xian , Zhang Feng-Yuan
Published: May 2024

Herein, ionomer-free amorphous iridium oxide (IrOx) thin electrodes are first developed as highly active anodes for proton exchange membrane electrolyzer cells (PEMECs) via low-cost, environmentally friendly, and easily scalable electrodeposition at room temperature. Combined with a Nafion 117 membrane, the IrOx-integrated electrode with an ultralow loading of 0.075 mg cm−2 delivers a high cell efficiency of about 90%, achieving more than 96% catalyst savings and 42-fold higher catalyst utilization compared to commercial catalyst-coated membrane (2 mg cm−2). Additionally, the IrOx electrode demonstrates superior performance, higher catalyst utilization and significantly simplified fabrication with easy scalability compared with the most previously reported anodes. Notably, the remarkable performance could be mainly due to the amorphous phase property, sufficient Ir3+ content, and rich surface hydroxide groups in catalysts. Overall, due to the high activity, high cell efficiency, an economical, greatly simplified and easily scalable fabrication process, and ultrahigh material utilization, the IrOx electrode shows great potential to be applied in industry and accelerates the commercialization of PEMECs and renewable energy evolution.
Population Change and Residential Segregation in Italian Small Areas, 2011–2021: An Analysis With New Spatial Units
Authors: Pratschke Jonathan , Benassi Federico
Published: May 2024

This article explores spatial patterns of demographic change and residential segregation in Italy over the past decade, a topic which has not been studied in detail in the literature. Population ageing and migration are unfolding rapidly in a number of European countries, generating tensions and challenges at local level. Aggregate regional or national statistics can conceal significant variations at local level, which are of considerable interest and relevance. This is particularly the case in Italy, where spatial heterogeneity and regional disparities are marked. The analysis presented in this paper uses a new source of data derived from large public archives, which permits comparisons to be made at local level with the 2011 census of population. In this way, it is possible to map out and to analyse demographic trends at a fine level of spatial definition. In order to exploit the potential of these data, the authors use a new set of spatial units which were derived by applying automatic rezoning procedures. These output areas are well suited to the study of the age structure of local populations, population change, and migration in a uniform way across the entire national territory, as the empirical results confirm.
Shuffle-QUDIO: accelerate distributed VQE with trainability enhancement and measurement reduction
Authors: Qian Yang , Du Yuxuan , Tao Dacheng
Published: May 2024

The variational quantum eigensolver (VQE) is a leading strategy that exploits noisy intermediate-scale quantum (NISQ) machines to tackle chemical problems. It is expected to demonstrate quantum advantage when handling a large number of qubits, where the density matrix cannot be processed efficiently on classical computers. To gain such computational advantages on large-scale problems, a feasible solution is the QUantum DIstributed Optimization (QUDIO) scheme, which partitions the original problem into $$\varvec{K}$$

K

subproblems and allocates them to $$\varvec{K}$$

K

quantum machines followed by the parallel optimization. Despite the provable acceleration ratio, the efficiency of QUDIO may heavily degrade by the synchronization operation. To conquer this issue, here we propose Shuffle-QUDIO to involve shuffle operations into local Hamiltonians during the quantum distributed optimization. Compared with QUDIO, Shuffle-QUDIO significantly reduces the communication frequency among quantum processors and simultaneously achieves better trainability. Particularly, we prove that Shuffle-QUDIO enables a faster convergence rate over QUDIO. Extensive numerical experiments are conducted to verify that Shuffle-QUDIO allows both a wall-clock time speedup and low approximation error in the tasks of estimating the ground state energy of a molecule. We empirically demonstrate that our proposal can be seamlessly integrated with other acceleration techniques, such as operator grouping, to further improve the efficacy of VQE.
The hidden glacial landscape of the Monti della Laga (central Apennines, Italy)
Authors: Azzoni Roberto Sergio , Tantardini Davide , Forti Luca
Published: May 2024

The geological and geomorphological record of the Last Glaciation in the Apennines is extensively documented, except for the Monti della Laga sector, where limited indicators of glacier extension have been reported. This study presents field evidence of glacial deposits and landforms from two specific sites within the Monti della Laga Range: Monte Pelone and Tordino Valley head. Although limited, this evidence suggests glaciation within a structural and lithological setting that facilitated rapid slope evolution. The post-glaciation paraglacial processes in the area erased most glacial traces, but our geomorphological and stratigraphical investigations identified specific landforms of glacial origin. Notably, at Monte Pelone, a semi-circular depositional landform exhibiting a significant presence of coarse clasts and distinctive rotational features has been identified as a moraine. Additionally, a smaller moraine ridge with evidence of diamicton deposition was observed in the Tordino Valley head. These observations align with an Equilibrium Line Altitude estimated at 1750 m a.s.l. in the central Apennines in the Last Glacial Maximum and, considering the favourable topographic conditions of the area, significantly contribute to the understanding of glaciations within the central Apennines.
Correlation between thermal and density properties of chestnuts: preliminary results of experimental non-destructive testing
Authors: Borghese Vittoria , Santoro Luca , Santini Silvia , Sesana Raffaella
Published: May 2024

This study presents the preliminary outcomes of a methodology for the physical and mechanical characterization of various chestnut elements in different states of preservation. Strategizing conservation and retrofit interventions for timber is necessary, and to do this, it is necessary to establish an estimation of physical (transmissivity, thermal conductivity, humidity level, etc.) and mechanical properties (density, compressive or bending strength, etc.). This essential information is typically associated with timber defects, but there are lack of correlations. The primary objective is to establish correlations between thermal and density properties with the aim of preserving original assets. The investigation delves into the relationship between timber density and thermal properties through experimental non-destructive testing (NDT). Two NDTs were employed with the aim of correlating: penetrometric testing and active thermography investigations. The parametric study on the excitation period yielded valuable insights into the temporal dynamics of heat transfer within the timber, underscoring the significance of selecting appropriate excitation periods to capture precise thermal properties. Tabular data on relative humidity for salified, dried, and new samples provided a quantitative backdrop to these observations, unveiling the nuanced effects of humidity on the timber’s thermal response. The results of this study are positioned to inform future conservation efforts by laying the groundwork for a comprehensive understanding of timber’s mechanical properties. Particularly, the challenge lies in accurately estimating density, where surface tests are often less reliable than in-depth ones. Therefore, it is crucial to seek validation through other NDT tests, such as thermographic analysis and visual inspection, and hygrometric tests recognizing their importance in enhancing the reliability of density assessments. This approach will contribute to the development of more discerning preservation strategies.
The Synovial Sealant Variant for Minced Cartilage Repair: A Technical Note and Retrospective Study
Authors: Ahrens Philipp , Hinterwimmer Stefan , Tasser Matthias , Fritsch Lorenz , Siebenlist Sebastian , Fürmetz Julian , Watrinet Julius
Published: May 2024

Purpose

Cartilage defects are a common pathology in active people and affect quality of life. A common treatment option is treatment with minced cartilage (MC). As conservative therapy has a limited effect, surgical treatments vary in terms of procedure and results. A modified technique for autologous cartilage repair is presented here.

Method

MC was modified by adding a synovial sealant. This improves the stability of the graft, allowing the cartilage to proliferate. The synovial tissue has the potential to stimulate the implanted cartilage, which promotes healing and regeneration. The clinical and functional results of the modified technique were examined in a retrospective case series.

Results

The technique has proven to be reproducible for retropatellar cartilage defects and is both efficient and cost effective. MC with synovial sealing was performed in ten patients with retropatellar cartilage damage. In the conducted cases serious, 10 patients were available for follow-up after 18 ± 3 months. Patients showed good clinical results in terms of pain (VAS = 1.9, KOOS Pain = 89.7), symptoms (KOOS Symptoms = 83.6), and daily activity (KOOS Activity = 96.6).

Conclusion

The procedure combines the advantages of autologous cartilage repair with a one-stage surgical approach. It utilizes the regenerative potential of synovial tissue while providing improved mechanical stability. This technique offers a cost-effective, autologous solution for full-thickness cartilage defects, and shows promising clinical results in the medium term.
Programming for Corpus Linguistics with Python and Dataframes
Authors: Keller Daniel
Published: May 2024

This Element offers intermediate or experienced programmers algorithms for Corpus Linguistic (CL) programming in the Python language using dataframes that provide a fast, efficient, intuitive set of methods for working with large, complex datasets such as corpora. This Element demonstrates principles of dataframe programming applied to CL analyses, as well as complete algorithms for creating concordances; producing lists of collocates, keywords, and lexical bundles; and performing key feature analysis. An additional algorithm for creating dataframe corpora is presented including methods for tokenizing, part-of-speech tagging, and lemmatizing using spaCy. This Element provides a set of core skills that can be applied to a range of CL research questions, as well as to original analyses not possible with existing corpus software.
P.004 Real-world effectiveness of intravenous eptinezumab in patients with chronic migraine and previous subcutaneous preventive migraine treatment
Authors: Argoff C , Herzog SP , Smith RM , Soni-Brahmbhatt S , Awad SF , Asher D , Khan F , Bougie JK , Miron J
Published: May 2024

Background: Since 2018, several CGRP-targeted therapies have entered the migraine market, including eptinezumab. Minimal evidence exists evaluating the real-world effectiveness of switching from a subcutaneous to an intravenous anti-CGRP mAb. Methods: An observational, multi-site (n=4), US-based study, REVIEW evaluated real-world experiences of patients with chronic migraine (CM) treated with eptinezumab using a chart review, patient survey, and physician interviews. Adults (≥18 years) with a diagnosis of CM who had completed ≥2 consecutive eptinezumab infusion cycles were eligible. Results: Enrolled patients were primarily female (83%, 78/94), had a mean age of 49 years and a mean migraine diagnosis duration of 15.4 years. All patients (94/94) self-reported prior preventive therapy with 89% (84/94) reporting prior subcutaneous anti-CGRP mAb use (i.e., fremanezumab, galcanezumab, or erenumab). Regardless of prior exposure to a CGRP ligand or receptor blocker, the number of “good” days/month more than doubled following eptinezumab. Patients experienced a similar mean change in the number of “good” days/month regardless of the number and type of previous subcutaneous anti-CGRP mAb used. Conclusions: This real-world, patient survey showed that patients with prior exposure to subcutaneous anti-CGRP mAbs had high overall satisfaction with the effectiveness of eptinezumab treatment regardless of the number and type of previous therapies used.
P.015 Spontaneous regression of acoustic schwannomas: a predictive model
Authors: Hounjet CD , Kam J , Westerberg B , Akagami R
Published: May 2024

Background: Vestibular schwannomas are the most common tumour of the CPA with an annual incidence of 17.4/1 million. Approximately 5-10% of these tumours demonstrate spontaneous regression without intervention while under observation. Previous research studies have assessed patient factors and imaging characteristics through chart review to attempt to identify predictive factors of spontaneous regression. There have not been any studies where patient questionnaires are used to assess patient lifestyle factors or characteristics which may predict spontaneous regression. Methods: Using a clinical database of acoustic schwannomas treated by one team at our institution, we have identified approximately 40 patients, of a database of 900 patients, who have demonstrated significant spontaneous regression (>5mm in size reduction in one dimension) or complete resolution of their acoustic schwannoma. Clinical, radiological, and lifestyle factors are reviewed though clinical records and patient questionnaire. Regression analysis is performed. Results: Using patients who have tumors with significant spontaneous regression, we attempt to create a model that predicts regression of these tumours. Conclusions: In conclusion, this is the first study to consider patient lifestyle factors obtained through patient survey in addition to clinical and radiographic factors to attempt to create a predictive model of spontaneous regression of acoustic schwannoma.
P.037 Refractory status dystonicus and hypotension after cardiac arrest in a child with AADC deficiency post gene therapy: a case report
Authors: Peacock D , Horvath G
Published: May 2024

Background: Aromatic l-amino acid decarboxylase (AADC) deficiency is a metabolic disorder that causes deficient serotonin, dopamine, and catecholamine synthesis. How children respond to neurological insult post intracranial gene therapy remains underreported. We present a 10 year old girl with profound neurological injury after a brief in-hospital cardiac arrest, secondary to viral infection-induced respiratory failure, 4 years after gene therapy. Methods: Patient’s chart review included brain imaging, clinical notes, laboratory results, and treatment. Results: MRI showed symmetric abnormalities in the basal ganglia, thalami, cortex, and cerebellar hemispheres. CSF analysis showed homovanillic acid 27 nmol/L (reference range 167-563) and 5-hydroxyindoleacetic acid 7 nmol/L (reference range 67-189). She developed generalized dystonia and oculogyric crises which were not seen since before gene therapy. There was poor catecholamine production causing refractory hypotension. She required a one-month stay in ICU for hypotension and status dystonicus. Dystonia was controlled with high doses of 6 agents. Conclusions: We describe a patient with AADC deficiency post gene therapy who experienced disproportionately severe neurological injury and decreased AADC activity after hypoxic neurological insult. There may be unique considerations of dopaminergic neuron integrity, AADC gene promoter sensitivity, and cerebrovascular autoregulation in children with AADC deficiency post gene therapy.
P.042 Anti-HMG Coenzyme A reductase antibody (anti-HMGCR) myopathy: case review of two pediatric patients from a single center
Authors: Toupin A , Jurencak R , McMillan HJ , Yaworski A
Published: May 2024

Background: Necrotizing anti-HMGCR myopathy is rare in children. Pediatric cases are not typically associated with statin use or malignancy. Methods: Retrospective chart review (January 2009 to December 2023) identified cases of anti-HMGCR myopathy at our hospital. Results: Two patients were identified. Patient A, presented at 8 yo with a 2 year history of proximal muscle weakness. His CK was 4,840 U/L (normal <205 U/L) with a high anti-HMGCR antibody titre. His Childhood Myositis Assessment Scale (CMAS) score was 33/52. Monthly IVIG was started and his muscle strength and CK improved. Two years later, weekly methotrexate was started for persistent mild CK elevation (602 to 869 U/L). At 11 years old, 3 years after diagnosis, his CMAS score was 47 and he could participate in soccer with mild fatigue. Patient B, presented at 8 yo with acute proximal weakness, rash and CMAS 13/52. His CK was 20,185 U/L with elevated anti-HMGCR antibody titre. He received oral corticosteroids, weekly methotrexate and monthly IVIG. At 10 yo, 2 years after diagnosis, he is asymptomatic with CMAS 51. He is maintained on methotrexate monotherapy. Conclusions: Anti-HMGCR antibody myopathy requires prompt diagnosis to obviate muscle necrosis and long-term complications. Our patients showed clinical and CMAS improvement with treatment.
P.044 Ambient air pollution and emergency department presentations for pediatric primary headache and seizure disorders in Calgary, Canada
Authors: Sjonnesen K , Szyszkowicz M , Kuziek J , Pringsheim T , Orr S
Published: May 2024

Background: Climate change, and fossil fuel combustion threaten the health of children globally through direct and indirect mechanisms,1 such as the exacerbation of ambient air pollution.1,2 Increased ambient air pollutant concentrations are associated with emergency department (ED) visits for episodic and paroxysmal neurologic conditions in adults in the Toronto region of Canada.4,5 We hypothesize that, in Calgary, Alberta, increased ambient air pollutants will be positively associated with the daily burden of pediatric ED presentations for migraine and seizures, and that a greater effect size may be present due to increased regional variability in ambient PM2.5 concentrations.3,4 Methods: Emergency records from the National Ambulatory Care Reporting System, comprising 17552 primary seizure and headache cases between 0-18 years of age and presenting to Calgary-region emergency departments between January 2012-December 2021, will be included. Quasi-Poisson regression modeling incorporating ambient air pollutants, seasonality and meteorological covariates will estimate relative risk and 95% confidence intervals of ED visit counts relative to increases in air pollutants. Results: Results currently pending and will be available for presentation. Conclusions: Significant results may inform further inquiry into the impact of air pollutants on children with neurological conditions and identify potential contributions of air quality to healthcare service demand in the Calgary region.
P.047 Survey of caregivers of individuals with NBIAs to identify relevant quality of life outcomes
Authors: Paul B , Ramamurthy J , Thipse M , Reddy D , Webster R , Venkateswaran S
Published: May 2024

Background: Neurodegeneration with Brain Iron Accumulation (NBIA) is a heterogenous group of disorders with the common theme of iron accumulation in the basal ganglia. These disorders typically present in childhood with progressive neurodegeneration and neuropsychiatric symptoms. Caring for an individual with NBIAs is intensive, however it is unknown what factors impact caregiver well-being and quality of life. Methods: Common themes were obtained via literature review of quality of life surveys in children with neurological and chronic illnesses. Five domains were addressed: Diagnosis, Communication, Symptom Management, Clinical Experience and Resources/Support. The survey was approved by the Family Advisory Committee at the CHEO Research Institute and the CHEO REB. The survey was distributed via the Rare Connect Platform to Canadian caregivers. Results: Survey responses are being analyzed and will be presented at the CNSF. Within each domain, Likert scales will be analyzed. Domains will be ranked according to the caregiver responses. Conclusions: Results of this survey will assist in developing care management guidelines, resources for families and help with future advocacy for patients and families affected by NBIAs. The results will also help guide future NBIA Canada Family Conferences.
P.071 Improving care for patients with neurofibromatosis 1 in British Columbia
Authors: Marulanda L , Harrison R , Alzahrani MM , Armstrong L , Hukin J , Chapman KM
Published: May 2024

Background: Neurofibromatosis 1 is a multisystem, neurocutaneous disorder with a predisposition for various malignancies. There is no established care pathway or multidisciplinary clinic for adult patients with NF1 in British Columbia (BC). Patients may miss timely screening or therapeutic interventions. The development of new therapies for NF1 highlights the urgency for coordinated care. Methods: A review of existing programs and guidelines was conducted. The estimated population with NF1 in BC was determined. A working group consisting of neuromuscular neurology, pediatric neuro-oncology, adult neuro-oncology, and medical genetics identified gaps in care. Results: Approximately 2200 adult individuals with NF1 are estimated to live in BC. A three-prong approach to address identified gaps was developed: A quarterly multidisciplinary NF Case Conference was initiated. The initial session was attended by 18 providers. Focus groups for patients and providers to enhance understanding of both perspectives are being conducted. Informed by the focus groups, an NF1 Care Pathway for BC will be developed. Conclusions: Advances in treatment for NF1 prompted the formation of the BC NF Working Group to develop a strategy to improve longitudinal, multidisciplinary care. The development of a care pathway, with patient input, will improve care coordination and access to care.
P.072 History of the endoscopic approach to the skull base with a highlight on Canada’s contributions
Authors: Cusimano MD , Skulsampaopol J
Published: May 2024

Background: The Endoscopic Transphenoidal Approach to the Skull Base (ETSS) is now used internationally for a wide variety of pathologies ranging from CSF leaks to complex brain tumours. Methods: Case illustrations. Historical review of the evolution of ETSS with a focus on Canada’s contributions. Results: Canadians have been major contributors in the development and advancement of surgery of the skull base, particularly through endoscopic means. These will be highlighted with particular emphasis of those of Hardy, Cusimano, Kassam, Gentili, and others. Conclusions: Canada has been and continues to be an international leader in development and treatment of patients with skull base lesions, particularly those with lesions of the skull base amenable to ETSS.
P.089 Volumetric extent of resection and visual outcomes in pituitary adenoma patients presenting with visual compromise undergoing the endoscopic endonasal approach
Authors: Pascual JG , Ben-Israel D , de Lotbiniere-Bassett M , Costello F , Clark JM , Starreveld YP
Published: May 2024

Background: Reporting extent of resection (EOR) in pituitary adenoma (PA) surgery via endoscopic endonasal approaches (EEA) is not standardized. The use of 3-dimensional volumetric analysis is proposed for measurement of tumor volumes and EOR. Their relationship with visual outcomes is explored. Methods: A retrospective analysis of PA patients presenting with visual disturbances and treated surgically via EEA by a single surgeon between 2006 and 2021. The main outcome was visual function at 12 months post-operatively. Results: 142 patients were included. Majority were male, with mean age of 57.1 years. Most (58.2%) presented with bitemporal hemianopsia. The mean tumor size was 11.3 cm3. The mean EOR was 84.5% (range 21.5-99.8%), with a mean post-operative tumor volume of 1.9 cm3. Visual function improved in 92.2%. Re-resection for visual deterioration was performed in 5.7% of patients, (mean time 2.4 years). No clinical, pathologic, or imaging factors were significantly associated with visual outcome. A significant association was found between EOR and re-resection (mean EOR 66.7% vs 85.6%, p=0.002). Conclusions: For patients with PA presenting with visual deficits, treatment with EEA led to improvement in visual function in the majority of patients, without the need for gross total resection. EOR was significantly associated with the need for re-resection.
P.091 Synthetic data reliably reproduces brain tumor primary research data
Authors: Khalaf R , Davalan W , Mohammad A , Diaz RJ
Published: May 2024

Background: Synthetic data has garnered heightened attention in contemporary research due to confidentiality barriers and its capacity to simulate variables challenging to obtain. This study aimed to evaluate the reliability and validity of synthetic data in the context of neuro-oncology research, comparing findings from two published studies with results from synthetic datasets. Methods: Two published neuro-oncology studies focusing on prognostic factors such as serum albumin and systemic inflammation scores were selected, and their methodologies were replicated using MDClone Platform to generate five synthetic datasets for each. We used Chi-Square test to assess inter-variability between synthetic datasets. Survival outcomes were evaluated using Kaplan-Meier and t-test was used to determine statistical significance. Results: Findings from synthetic data consistently matched outcomes from both original articles, with serum albumin and systemc inflammation scores correlating with survival prognosis in glioblastoma and metastasis patients (p<0.05) Reported findings, demographic trends and survival outcomes showed significant similarity (P > 0.05) with synthetic datasets. Conclusions: Synthetic data consistently reproduced the statistical attributes of real patient data. Integrating synthetic data into clinical research offers excellent potential for providing accurate predictive insights without compromising patient privacy. In neuro-oncology, where patient follow-up pose challenges, the adoption of synthetic datasets can be transformative.
P.092 Incidence of tissue-sampled brain metastases pre- and post-COVID-19 in Newfoundland and Labrador: an eight-year review
Authors: Kazerouni A , Boone LA , Noble T , Barron J , Avery R
Published: May 2024

Background: Brain metastases indicate an advanced tumour stage for many cancers. We sought to investigate the incidence change of tissue-sampled brain metastases and its relation to staging challenges during the COVID-19 pandemic in Newfoundland and Labrador. Methods: We reviewed all brain metastasis cases from 2015-2022 requiring first-time tissue sampling according to pathology reports from the St. John’s Health Sciences Centre. Incidence rates were calculated using yearly population data by regional health authorities and standardized using the 2011 Canadian standard population. Results: We included 173 cases. The average annual age-standardized incidence rate of brain metastases requiring tissue sampling per 100,000 increased from 2.5 (95% CI: 2.0-3.1) pre-COVID-19 to 4.1 (95% CI: 3.3-5.0) post-COVID-19. Brain metastases from lung primaries accounted for 69% of this increase. While incidence declined to near-baseline in the Eastern provincial population by 2022 (3.3; 95% CI: 1.5-5.1), incidence rose into 2022 in the Western population (8.6; 95% CI: 3.9-13.2). Conclusions: These data suggest a delayed presentation of malignancies during the COVID-19 pandemic and underscore the importance of prioritized staging during times of strain on healthcare systems. Regional, temporal trends suggest regions distant from tertiary care centres could face challenges in resolving cases with delayed presentation post-COVID-19.
P.094 Incidence of pathologically confirmed primary malignant brain tumours in Newfoundland and Labrador: an eight-year review spanning 2015-2022
Authors: Boone LA , Kazerouni A , Noble T , Barron J , Avery R
Published: May 2024

Background: Considering regional and temporal trends, we sought to explore the incidence of primary malignant brain tumours in Newfoundland and Labrador. Methods: We reviewed all primary, malignant brain tumour cases from 2015-2022 confirmed by St. John’s Health Sciences Centre pathology reports. Incidence rates were standardized using the 2011 Canadian standard population. Results: We included 362 cases. The average annual age-standardized incidence rate of primary, malignant brain tumours per 100,000 was 7.0 (95% CI: 6.3-7.7), lower than the national average (7.93; 95% CI: 7.78-8.08). The incidence of glioblastoma (5.1; 95% CI: 4.5-5.7) was significantly higher than the national average (4.05; 95% CI: 3.95-4.16). Temporal trends revealed that oligodendroglioma incidence spiked from 0.5 (95% CI: 0.2-0.7) in 2015-2019 to 1.5 (95% CI: 0.4-2.6) in 2020 before returning to baseline in 2022. Regional trends indicated a lower incidence of malignant tumours in Labrador-Grenfell (5.1; 95% CI: 2.5-7.6), compared to 6.9 (95% CI: 6.2-7.6) averaged elsewhere. Conclusions: Higher rates of glioblastoma in Newfoundland and Labrador could have a genetic or multi-factorial cause. The increased occurrence of oligodendroglioma during the COVID-19 pandemic necessitates broader investigation, potentially linked to delays in patient care during this period. Regional trends could suggest less access to care in rural populations and underestimated incidence.