bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of rice milling, washing, and cooking on reducing pesticide residues
Authors: Lee Hyesu , Cho Mihyun , Park Minsoo , Kim Myungheon , Seo Jung-A. , Kim Dong Hyun , Bae Subin , Kim Myeong Seok , Kim Jeong Ah , Lee Joon-Goo , Im Moo-Hyeog
Published: June 2023

The effects of milling, washing, and cooking on etofenprox, flubendiamide, and tebufenozide levels in brown and polished rice were investigated by HPLC using a UV detector. The reduction rates of etofenprox, flubendiamide, and tebufenozide after milling were 68.74–93.16%, 64.49–90.25%, and 69.74–92.58%, respectively, 11.64–41.44%, 31.36–65.37%, and 31.61–73.79%, respectively, after washing brown rice, and 30.85–82.08%, 52.13–83.05%, and 43.04–83.89%, respectively, after washing polished rice. The residue levels of the three pesticides in brown rice decreased after electric and pressure cooking by 56.49 and 54.41%, 75.80 and 73.42%, and 70.01 and 71.27%, respectively, and the corresponding levels in polished rice decreased after electric and pressure cooking by 85.58 and 85.82%, 86.70 and 87.06%, and 89.89 and 89.68%, respectively. In conclusion, various processing methods decrease the residual levels of etofenprox, flubendiamide, and tebufenozide in rice.
Multi-scale simulations of two dimensional material based devices: the NanoTCAD ViDES suite
Authors: Marian Damiano , Marin Enrique G. , Perucchini Marta , Iannaccone Giuseppe , Fiori Gianluca
Published: June 2023

NanoTCAD ViDES (Versatile DEvice Simulator) is an open-source suite of computing codes aimed at assessing the operation and the performance of nanoelectronic devices. It has served the computational nanoelectronic community for almost two decades and it is freely available to researchers around the world in its website (http://vides.nanotcad.com), being employed in hundreds of works by many electronic device simulation groups worldwide. We revise the code structure and its main modules and we present the new features directed towards (i) multi-scale approaches exploiting ab-initio electron-structure calculations, aiming at the exploitation of new physics in electronic devices, (ii) the inclusion of arbitrary heterostructures of layered materials to devise original device architectures and operation, and (iii) the exploration of novel low-cost, green technologies in the mesoscopic scale, as, e.g. printed electronics.
Hybrid Work: Herausforderungen an das Change Management in Unternehmen
Authors: Hardwig Thomas , Boos Margarete
Published: June 2023

Hybrid Work als nicht zuletzt durch die COVID-Pandemie angestoßene Veränderung der Arbeitssituation vieler Beschäftigter – vor allem in wissensintensiven Berufen – fordert das Change Management von Organisationen heraus. Dieser Beitrag in der Zeitschrift „Gruppe. Interaktion. Organisation. (GIO)“ beschreibt drei Herausforderungen, denen sich Organisationen beim Übergang zu Hybrid Work stellen müssen: (1) Teameffektivität, (2) Teamzusammenhalt und organisationales Commitment, (3) räumliche und technische Infrastrukturen. Lösungsansätze für ein partizipatives Change Management im Hinblick auf eine humanorientierte Arbeitsgestaltung werden vorgestellt.
Cell Therapy for Androgenetic Alopecia: Elixir or Trick?
Authors: Mao Yongcui , Liu Pinyan , Wei Jiayun , Xie Ye , Zheng Qiuxia , Li Rui , Yao Jia
Published: June 2023

Androgenetic alopecia is the most common cause of hair loss aggravated by increased life pressure, tension, and anxiety. Although androgenetic alopecia (AGA) does not significantly effect physical health, it can have serious negative impact on the mental health and quality of life of the patient. Currently, the effect of medical treatment for AGA is not idealistic, stem cell-based regenerative medicine has shown potential for hair regrowth and follicle repair, but the long-term effect and mechanism of stem cell therapy is not quite explicit. In this review, we summarize the methods, efficacy, mechanism, and clinical progress of stem cell therapies for AGA by now, hope it will present a more comprehensive view in this topic.

Graphical Abstract
SDH mutations, as potential predictor of chemotherapy prognosis in small cell lung cancer patients
Authors: Zeng Ran , Fan Xiaoyun , Yang Jin , Fang Chen , Li Jieyi , Wen Wei , Liu Jing , Lv Mengchen , Feng Xiangran , Zhao XiaoKai , Yu Hongjie , Zhang Yuhuan , Sun Xianwen , Bao Zhiyao , Zhou Jun , Ni Lei , Wang Xiaofei , Cheng Qijian , Gao Beili , Gong Ziying , Zhang Daoyun , Dong Yuchao , Xiang Yi
Published: June 2023

Purpose

Small cell lung cancer (SCLC) is an aggressive and rapidly progressive malignant tumor characterized by a poor prognosis. Chemotherapy remains the primary treatment in clinical practice; however, reliable biomarkers for predicting chemotherapy outcomes are scarce.

Methods

In this study, 78 SCLC patients were stratified into “good” or “poor” prognosis cohorts based on their overall survival (OS) following surgery and chemotherapeutic treatment. Next-generation sequencing was employed to analyze the mutation status of 315 tumorigenesis-associated genes in tumor tissues obtained from the patients. The random forest (RF) method, validated by the support vector machine (SVM), was utilized to identify single nucleotide mutations (SNVs) with predictive power. To verify the prognosis effect of SNVs, samples from the cbioportal database were utilized.

Results

The SVM and RF methods confirmed that 20 genes positively contributed to prognosis prediction, displaying an area under the validation curve with a value of 0.89. In the corresponding OS analysis, all patients with SDH, STAT3 and PDCD1LG2 mutations were in the poor prognosis cohort (15/15, 100%). Analysis of public databases further confirms that SDH mutations are significantly associated with worse OS.

Conclusion

Our results provide a potential stratification of chemotherapy prognosis in SCLC patients, and have certain guiding significance for subsequent precise targeted therapy.
Low-cycle fatigue behavior of differently matched welded joints of quenched and tempered steel
Authors: Gáspár M. , Dobosy Á. , Meilinger Á. , Nagy Gy.
Published: June 2023

The appropriate matching of base and filler material is a complex task, where yield strength matching is the most general aspect. As the strength properties of structural steels have significantly improved in the past decades, the matching problem has become more relevant today. The mismatch phenomenon significantly affects the behavior of welded joints under dynamic and cyclic loading. Among cyclic loading, low-cycle fatigue (LCF) often occurs in welded steel constructions; furthermore, the LCF resistance of these advanced steels and their welded joints is limitedly known. In this paper, welding experiments are presented for the analysis of the LCF behavior of differently matched butt-welded joints made from two grades of quenched and tempered (Q + T) high-strength steels. For S690QL steel, matched and overmatched consumables were applied, while for S960QL steel, matched and undermatched filler materials were used. Material tests were performed to determine the mechanical properties of the different welded joints. In both examined steel grades, the welded joints tolerated a smaller number of cycles until failure than the base materials. In the case of S690QL, the LCF resistance of the matched welded joints was higher than the overmatched filler material. At S960QL in the higher strain amplitude range, the number of cycles to failure was higher at the same total and plastic strain amplitudes when undermatched filler material was used; however, an opposite ratio can be observed at lower strain values, compared to the matching filler material.
A novel fractional-order flocking algorithm for large-scale UAV swarms
Authors: Chen Haotian , He Ming , Liu Jintao , Xu Peng , Cao Xianghui , Han Wei , Yuan Guodong
Published: June 2023

The rate of convergence is a vital factor in determining the outcome of the mission execution of unmanned aerial vehicle (UAV) swarms. However, the difficulty of developing a rapid convergence strategy increases dramatically with the growth of swarm scale. In the present work, a novel fractional-order flocking algorithm (FOFA) is proposed for large-scale UAV swarms. First, based on the interaction rules of repulsion, attraction and alignment among swarm individuals, fractional calculus is introduced to replace traditional integer-order velocity updating, which enables UAVs to utilize historical information during flight. Subsequently, the convergence of the algorithm is theoretically analyzed. Some sufficient convergence conditions for the FOFA are presented by exploiting graph theory. Finally, the simulation results validate that our proposed FOFA performs much better than traditional flocking algorithms in terms of convergence rate. Meanwhile, the relationships between the fractional order of the FOFA and the convergence time of the UAV swarm are discussed. We find that under certain conditions, the fractional order is strongly correlated with the convergence rate of the UAV swarm; that is, a small fractional order (more consideration of historical information) leads to better performance. Moreover, the fractional order can be used as an important parameter to control the convergence rate of a large-scale UAV swarm.
Multi-task evolutionary optimization of multi-echelon location routing problems via a hierarchical fuzzy graph
Authors: Yan Xueming , Jin Yaochu , Ke Xiaohua , Hao Zhifeng
Published: June 2023

Multi-echelon location-routing problems (ME-LRPs) deal with determining the location of facilities and the routes of vehicles on multi-echelon routing tasks. Since the assignment relationship in multi-echelon routing tasks is uncertain and varying, ME-LRPs are very challenging to solve, especially when the number of the echelons increases. In this study, the ME-LRP is formulated as a hierarchical fuzzy graph, in which high-order fuzzy sets are constructed to represent the uncertain assignment relationship as different routing tasks and cross-task operators are used for routing task selection. Then, an evolutionary multi-tasking optimization algorithm is designed to simultaneously solve the multiple routing tasks. To alleviate negative transfer between the different routing tasks, multi-echelon assignment information is considered together with associated routing task selection in multi-tasking evolution optimization. The experimental results on multi-echelon routing benchmark problems demonstrate the competitiveness of the proposed method.
A pairwise ranking estimation model for surrogate-assisted evolutionary algorithms
Authors: Harada Tomohiro
Published: June 2023

Surrogate-assisted evolutionary algorithms (SAEAs) have attracted considerable attention for reducing the computation time required by an EA on computationally expensive optimization problems. In such algorithms, a surrogate model estimates the solution evaluation with a low computing cost and is used to obtain promising solutions to which the accurate evaluation with an expensive computation cost is then applied. This study proposes a novel pairwise ranking surrogate model called the Extreme Learning-machine-based DirectRanker (ELDR). ELDR integrates two machine learning models: extreme learning machine (ELM) and DirectRanker (DR). ELM is a single-layer neural network capable of fast learning, whereas DR uses pairwise learning to rank using a neural network developed mainly for information retrieval. To investigate the effectiveness of the proposed surrogate model, this study first examined the estimation accuracy of ELDR. Subsequently, ELDR was incorporated into a state-of-the-art SAEA and compared with existing SAEAs on well-known real-valued optimization benchmark problems. The experimental results revealed that ELDR has a high estimation accuracy even on high-dimensional problems with a small amount of training data. In addition, the SAEA using ELDR exhibited a high search performance compared with other existing SAEAs, especially on high-dimensional problems.
Survey on Deep Fuzzy Systems in Regression Applications: A View on Interpretability
Authors: S. S. Júnior Jorge , Mendes Jérôme , Souza Francisco , Premebida Cristiano
Published: June 2023

Deep learning (DL) has captured the attention of the community with an increasing number of recent papers in regression applications, including surveys and reviews. Despite the efficiency and good accuracy in systems with high-dimensional data, many DL methodologies have complex structures that are not readily transparent to human users. Accessing the interpretability of these models is an essential factor for addressing problems in sensitive areas such as cyber-security systems, medical, financial surveillance, and industrial processes. Fuzzy logic systems (FLS) are inherently interpretable models capable of using nonlinear representations for complex systems through linguistic terms with membership degrees mimicking human thought. This paper aims to investigate the state-of-the-art of existing deep fuzzy systems (DFS) for regression, i.e., methods that combine DL and FLS with the aim of achieving good accuracy and good interpretability. Within the concept of explainable artificial intelligence (XAI), it is essential to contemplate interpretability in the development of intelligent models and not only seek to promote explanations after learning (post hoc methods), which is currently well established in the literature. Therefore, this work presents DFS for regression applications as the leading point of discussion of this topic that is not sufficiently explored in the literature and thus deserves a comprehensive survey.
Hydrologic modeling of the Aliakmon River in Greece using HEC–HMS and open data
Authors: Frysali Dimitra , Mallios Zisis , Theodossiou Nicolaos
Published: June 2023

In recent years, the sharp increase in demand for fresh water and climate change, especially in the Mediterranean region, have increased the need for effective tools that can provide management alternatives enabling the more efficient use of available water resources. Hydrologic models which simulate the rainfall–runoff process are crucial for the formulation of such management tools and can be used to evaluate the performance of systems and, therefore, to formulate alternative management strategies that can lead to more efficient performance. In this paper, an attempt is made to form a hydrologic model with the aim of using it as a basis for the formulation of management tools for the Aliakmon River in Greece. This model could be useful for formulating sustainable production and consumption patterns related to the use of Aliakmon River water. The model is built in HEC–HMS using data that are freely available online. The results indicate that the model shows excellent performance in terms of simulating the changes that occur in the flow regime of the studied river, and can therefore can be used as a basis for the formulation of management tools for the reservoirs present on the river, energy production, water supply, as well as flood forecasting.
Writing on the world beyond the page: medieval inscriptions as facta and ficta
Authors: Kumler Aden
Published: June 2023

From the twelfth to the fifteenth centuries texts proliferated upon the surfaces of objects, monuments and architecture, ensuring that medieval people lived with texts, even if they never turned a page. Examining a series of inscribed objects, monuments, and buildings, this article focuses upon three constitutive features of this large-scale dynamic: epigraphic prosopopoeia, the use and effects of deixis in medieval inscriptions, and the device of the banderole. It concludes by examining the twelfth-century Bridekirk baptismal font: an epigraphic monument in which all three devices are skillfully deployed, to remarkably self-reflexive ends. The article aims to show how the design of epigraphic texts added not only new textual-material facts to the world, but also textual-visual ficta or fictions.
Religion and secularity as supersessionist categories
Authors: Svenungsson Jayne
Published: June 2023

This article argues that the Christian ambivalence towards the Jews throughout history lies at the heart of the difficulties liberal societies are having today in accommodating religious diversity, but also more broadly, in discussing issues pertaining to religion and secularity in a nuanced way. After a brief summary of the characteristics of Christian supersessionism, the article first explores the modern concept of religion as a product of Protestant Christianity and thus as a category that inherently privileges a Christian perspective. Although the specific associations to Christians versus Jews have become less pronounced, the inherited dichotomies (archaic/enlightened, material/spiritual, particular/universal, etc.) live on and continue to shape attitudes towards what is perceived as more and less desirable forms of religion in contemporary Western societies – as mirrored in the widespread political rhetoric claiming that Islam is not ‘compatible’ with Western culture. However, to understand the full dimensions of the mechanisms guiding the public discourse on religion post-9/11, it is important also to recognize the extent to which not only the modern concept of religion but also of secularity is based on a supersessionary logic. Hence the second part of the article explores how the religious and the secular today jointly serve to uphold a hierarchical cultural order, where certain practices and values gain the upper hand by being associated with terms such as ‘rational’, ‘progressive’ or ‘Human Rights’, while other practices and values are framed as incompatible with these terms.
Hyperlipidämie und Osteoporose
Authors: Leutner Michael
Published: June 2023

Die aktuelle Datenlage zeigt auf, dass es einen Zusammenhang zwischen Hyperlipidämien und dem Knochenstoffwechsel gibt. Dieser Zusammenhang scheint auch abhängig von den Konzentrationen der Lipidparameter zu sein. Klare Evidenz dafür, dass Statine einen osteoprotektiven Effekt auf den Knochenstoffwechsel haben, gibt es bisher nicht. Rezente Entwicklungen zeigen, dass es hier dosisabhängige Zusammenhänge von verschieden potenten Statinen mit dem Knochenstoffwechsel geben könnte. Insgesamt gilt es zu untersuchen, ob der Zusammenhang von Hyperlipidämien mit dem Knochenstoffwechsel durch direkte Statineffekte und/oder durch die Konzentrationen der verschiedenen Lipidparameter gesteuert wird.
This tree is on fire: a review on the ecology of Erwinia amylovora, the causal agent of fire blight disease
Authors: Pedroncelli Anna , Puopolo Gerardo
Published: June 2023

Fire blight represents a great threat to apple and pear production worldwide. The ability of its causal agent, Erwinia amylovora, to spread rapidly in the host plants makes this devastating disease difficult to manage. Copper and antibiotics are still the most effective solutions to control fire blight, although their application contribute to environmental pollution and to the development of E. amylovora resistant populations. Thus, there is an urgent need to find new alternatives to such plant protection products. In this review, we summarized what is known on E. amylovora biology, as the knowledge of the plant pathogen biology is essential to develop eco-friendly management strategies. Notably, the presence of E. amylovora alone does not necessarily result in the disease development as it is the final outcome of multiple interactions established between E. amylovora cells, flower microbiota, plant host, insect vectors and environment. For instance, specific humidity and temperature create the suitable conditions for E. amylovora to grow and reach the specific cell density needed for plant infection. Once fire blight develops, insects act as potential vectors of E. amylovora, playing a role in the dispersal of the disease. The host plant represents an important factor as its susceptibility varies among the species belonging to the Rosaceae family. Recent studies showed apple flower microbiota might promote or hinder the infection progress, thus representing a possible source of new biocontrol agents effective in controlling E. amylovora.
Determining the (A)symmetric Role of Business–Consumer Confidence in Outward–Inward Tourism in Russia: A Competitiveness Perspective
Authors: Alola Uju Violet , Baeva Darya , Alola Andrew Adewale
Published: June 2023

Tourism activities in Russia, prior to the coronavirus pandemic and the Ukraine–Russia conflict, reportedly recorded a desirable boost, thus prompting the formulation of the country’s new Tourism Development Strategy for 2035. Considering this observation, the current study examines the determinants of the Russia’s inbound and outbound tourism, but especially from the perspective of linear and nonlinearity role of market—business and consumer—confidence over the quarterly period 2010Q1–2020Q4. The result shows that negative and positive shock in business confidence and consumer price index positively affects international arrivals to Russia in the short and long run, but with a negative shock in business confidence showing a larger effect. A shock (irrespective of the direction) in the consumer leading indicator leads to decline in international arrivals in the short and long run. We also found that a shock (mostly negative) in the consumer confidence reduces the numbers of Russian travellers to foreign tourist destinations in the short- and long-term period. However, a negative shock in business confidence encourages Russians to embark on touristic visit to destinations, while there is no significant effect arising from the shock in the consumer price index. Moreover, for symmetric evidence, there is a significant two-way Granger causality from BCI to outbound tourism, and from CLI to outbound tourism especially in the medium term, while a one-way causality exists from CPI to outbound tourism in the short and medium term.
Recurrent Urinary Tract Infection in Adult Patients, Risk Factors, and Efficacy of Low Dose Prophylactic Antibiotics Therapy
Authors: Alghoraibi Hala , Asidan Aisha , Aljawaied Raneem , Almukhayzim Raghad , Alsaydan Aljoharah , Alamer Elaf , Baharoon Waleed , Masuadi Emad , Al Shukairi Abeer , Layqah Laila , Baharoon Salim
Published: June 2023

Background

Recurrent urinary tract infection (UTI) occurs in sizable percentages of patients after a single episode and is a frequent cause of primary healthcare visits and hospital admissions, accounting for up to one quarter of emergency department visits. We aim to describe the pattern of continuous antibiotic prophylaxis prescription for recurrent urinary tract infections, in what group of adult patients they are prescribed and their efficacy.

Methods

A retrospective chart review of all adult patients diagnosed with single and recurrent symptomatic urinary tract infection in the period of January 2016 to December 2018.

Results

A total of 250 patients with a single UTI episode and 227 patients with recurrent UTI episodes were included. Risk factors for recurrent UTI included diabetes mellitus, chronic renal disease, and use of immunosuppressive drugs, renal transplant, any form of urinary tract catheterization, immobilization and neurogenic bladder. E. coli infections were the most prevalent organism in patients with UTI episodes. Prophylactic antibiotics were given to 55% of patients with UTIs, Nitrofurantoin, Bactrim or amoxicillin clavulanic acid. Post renal transplant is the most frequent reason to prophylaxis antibiotics (44%). Bactrim was more prescribed in younger patients (P < 0.001), in post-renal transplantation (P < 0.001) and after urological procedures (P < 0.001), while Nitrofurantoin was more prescribed in immobilized patients (P = 0.002) and in patients with neurogenic bladder (P < 0.001). Patients who received continuous prophylactic antibiotics experienced significantly less episodes of urinary tract infections (P < 0.001), emergency room visits and hospital admissions due to urinary tract infections (P < 0.001).

Conclusion

Despite being effective in reducing recurrent urinary tract infection rate, emergency room visits and hospital admissions due to UTI, continuous antibiotic prophylaxis was only used in 55% of patients with recurrent infections. Trimethoprim/sulfamethoxazole was the most frequently used prophylactic antibiotic. Urology and gynecological referral were infrequently requested as part of the evaluation process for patients with recurrent UTI. There was a lack of use of other interventions such as topical estrogen in postmenopausal women and documentation of education on non-pharmacological methods to decrease urinary tract infections.
Effect of the Timing of Amubarvimab/Romlusevimab (BRII-196/198) Administration on Progression to Severe Disease in Elderly Patients with COVID-19 Infection: A Retrospective Cohort Study
Authors: Xu Yonghao , Liu Ying , Zheng Ruiqiang , Si Shujie , Xi Yin , Deng Xilong , Wang Gang , Zhou Liang , Li Manshu , Wang Ya , Zhang Shuo , Xie Jianfeng , Liu Xiaoqing , Yang Yi , Tang Xiaoping
Published: June 2023

Objective

Early intervention with neutralizing antibodies is considered to be effective in preventing disease progression in patients with mild to moderate COVID-19 infection. Elderly patients are the most susceptible and at a higher risk of COVID-19 infection. The present study aimed to assess the necessity and possible clinical benefits of the early administration of Amubarvimab/Romlusevimab (BRII-196/198) in the elderly population.

Methods

The present study was designed as a retrospective, multi-center cohort study conducted with 90 COVID-19 patients aged over 60, who were divided into two groups based on the timing of the administration of BRII-196/198 (administration at ≤ 3 days or > 3 days from the onset of infection symptoms).

Results

The ≤ 3 days group exhibited a greater positive effect (HR 5.94, 95% CI, 1.42–24.83; P < 0.01), with only 2 patients among 21 patients (9.52%) exhibiting disease progression, compared to the 31 patients among the 69 patients (44.93%) of the > 3 days group who exhibited disease progression. The multivariate Cox regression analysis revealed low flow oxygen support prior to BRII-196/198 administration (HR 3.53, 95% CI 1.42–8.77, P < 0.01) and PLT class (HR 3.68, 95% CI 1.37–9.91, P < 0.01) as independent predictors of disease progression.

Conclusions

In elderly patients with mild or moderate COVID-19 disease, who do not require oxygen support and had the risk factors for disease progression to severe COVID-19 disease, the administration of BRII-196/198 within 3 days resulted in a beneficial trend in terms of preventing disease progression.
Resurgence of human coronavirus OC43 at a long-term care facility during the coronavirus disease 2019 (COVID-19) pandemic: Outbreak investigation
Authors: Ohyama Koji , Honda Hitoshi , Aoki Momoko , Wakuda Mitsutaka , Kitahara Tomoaki , Kaede Chisaki , Doi Yohei , Uehara Yuki
Published: June 2023

The incidence of seasonal infections due to respiratory viruses other than severe acute respiratory coronavirus virus 2 (SARS-CoV-2) has declined due to heightened public infection prevention measures against coronavirus disease 2019 (COVID-19). We describe an outbreak of human coronavirus OC43 infection that occurred at a long-term care facility and whose clinical features were indistinguishable from COVID-19.
F.5 Spinal column and spinal cord injuries secondary to mountain biking accidents: a 15-year review at a provincial spine referral centre
Authors: Laghaei Farimani P , Al-Amoodi M , Kahlon H , Ailon T , Dandurand C , Paquette S , Dea N , Street J , Charest-Morin R , Fisher CG , Dvorak MF , Kwon B
Published: June 2023

Background: Mountain biking (MTB) is an increasingly popular sport that has been associated with serious spinal injuries, which can have devastating effects on patients and significant impacts on healthcare resources. Herein, we characterized the occurrence of these MTB spinal injuries over a 15-year period and analyzed the affiliated acute-care hospital costs. Methods: Patients seen at Vancouver General Hospital for MTB spinal injuries between 2008-2022 were retrospectively reviewed. Demographics, injury details, treatments, outcomes, and resource requirements for acute hospitalization were collected. The Canadian Institute for Health Information was referenced for cost analysis. Results: Over the 15 years of analysis, 149 MTB spinal injuries occurred. The majority (87.2%) were male. 59 (39.6%) were associated with spinal cord injury; most of these were in the cervical spine (72.3%) and majority were AIS Grade A (36.1%). 102 patients (68.5%) required spine surgery; 26 (17.4%) required intensive care; 34 (22.8%) required inpatient rehabilitation. Mean length of stay was 13.5 days and acute admission costs for the healthcare system averaged $35,251 (95% CI $27,080-$43,424). Conclusions: MTB spinal injuries are associated with significant medical, personal, and financial burden. As injury prevention remains paramount, further investigation of the roles of education and safety measures is recommended.
F.6 Cranial neurosurgery medicolegal cases in Canada: a ten-year analysis of Canadian Medical Protective Association (CMPA) data
Authors: Garber G , Finestone P , Liu R , Barry T , Tourigny K , Barry S
Published: June 2023

Background: Neurosurgery is a high-risk specialty with a low margin of error. We aim to assess the risk of neurosurgeons being involved in medicolegal cases in Canada. Methods: This retrospective descriptive study evaluated ten years (2012-2021) of closed legal cases, college cases, and hospital complaints against neurosurgeons with data from the CMPA. Included cases were cranial cases, VP shunts, or cases where a catheter or wire was inserted into the brain. Cases excluded angiography, radiation, ultrasound, or percutaneous procedures. Results: We identified 77 cases (66 urgent or emergent). Neurosurgeons had a significantly higher medicolegal risk than the CMPA surgeon membership, however lower risk compared to all physician specialties. Legal cases accounted for 69% with favourable outcomes in 52%. Forty-one cases involved post-operative complications and 16 cases involved VP shunts. Multiple surgeons or residents could be involved spanning age groups and years in practice. Thirty-four cases had a harmful incident, 41% of these severe. The majority of cases occurred at urban centers. The average case duration was 41 months. Conclusions: This study provides a recent medicolegal analysis of cranial neurosurgery in Canada. We identified areas of common complaints and hope the data can be used to mitigate risk surgical risk in the future.
P.021 Botulinum toxin type a for Parkinson’s Disease - related painful foot dystonia
Authors: Bruno V , Achen B , Cantu Flores K , Alizadeh P
Published: June 2023

Background: Pain is a frequent symptom in Parkinson’s disease (PD), and the therapeutic alternatives are scarce. The goal of this trial was to assess the effects of botulinum toxin type A (BTXA) in the treatment of foot dystonia in PD. Methods: Randomized placebo-controlled trial (RCT) (double-blind parallel-group study) evaluating the safety and efficacy of BTXA for PD-related painful foot dystonia using 100 units of BTXA/placebo, followed by an open-label phase. The primary outcome was a change in pain on the King’s Parkinson’s disease Pain scale and on a visual analogue scale at 6, 12 and 24 weeks. Secondary outcomes included the percentage of responders, clinical global impression, MDS-UPDRS, PDQ-39 scores, and adverse events. Results: 40 subjects were screened and 33 were enrolled. The RCT blind will be opened in March 2023 after the final study visit and data will be available for presentation at the June 2023 conference. The current open-label phase has revealed a preliminary that the toxin is safe and effective in reducing pain in PD-related foot dystonia with 84% of participants noticing a significant benefit. Conclusions: According to our preliminary data, targeted BTXA injections are a safe and effective treatment in patients with foot dystonia and PD.
P.023 The Pain in Dystonia Scale (PIDS): development and validation
Authors: Bruno V , Achen B , Morgante F , Erro R , Fox SH , Edwards MJ , Schrag A , Stamelou M , Appel-Cresswell S , Defazio G , Ray-Chaudhuri K , Pirio Richardson S , Jinnah HA , Martino D
Published: June 2023

Background: Pain in a common symptom in adult-onset idiopathic dystonia (AOID). An appropriate tool to understand this symptom is needed to improve AOID patients’ care. We developed a rating instrument for pain in AOID and validated it in cervical dystonia (CD). Methods: Development and validation of the Pain in Dystonia Scale (PIDS) in three phases: 1. International experts and participants generated and evaluated the preliminary items for content validity; 2. The PIDS was drafted and revised, followed by cognitive interviews to ensure suitability for self-administration; and 3. the clinimetric properties of the final PIDS were assessed in 85 participants. Results: PIDS evaluates pain severity (by body part), functional impact and external modulating factors. It showed high test-retest reliability the total score (0.9, p<0.001), intraclass correlation coefficients higher than 0.7 for all items and high internal consistency (Cronbach’s alpha 0.9). Convergent validity analysis revealed a strong correlation between the PIDS severity score and the TWSTRS pain subscale (0.8, p<0.001), the brief pain inventory short form (0.7, p<0.001) and impact of pain on daily functioning (0.7, p<0.001). Conclusions: The PIDS is the first specific questionnaire developed to evaluate pain in patients with AOID with high-level clinimetric properties in people with CD.
P.025 Variable expression in Dopa-responsive dystonia
Authors: Daud Shah B , Noyes E , Rajput A
Published: June 2023

Background: Dopa-responsive dystonia (DRD) is a rare disorder with a classic presentation of childhood or adolescent-onset dystonia. This is characterized by parkinsonism, diurnal fluctuations, and a dramatic response to low doses of levodopa. It has been reported that female carriers of the genetic mutation are more often affected than males. Methods: A 62-year-old man with DRD. He is a sibling of the first documented case of DRD with autopsy. Results: He noticed mild clumsiness at 10 years old when he would fall playing games. He gave up playing hockey in his 30s because of his balance. Neurological exam at age 49 revealed mild findings of parkinsonism and dystonia of the right leg. He was started on levodopa/carbidopa 100/25 mg 1/2 pill BID with significant and sustained improvement and resumed playing hockey. His sister had onset at age 5 with walking on tiptoes with obvious dystonia when examined at age 8; she was well controlled for many years on straight levodopa (without decarboxylase inhibitor) at a dose of 250mg TID. Conclusions: These cases of siblings with DRD exemplify varying degrees of severity among family members and genders with the same condition. Genetic results are pending and will be presented.
P.035 Autologous hematopoietic stem cell transplant for the treatment of refractory myasthenia gravis with anti-muscle specific kinase antibodies
Authors: Beland B , Hahn C , Jamani K , Chhibber S , White C , Atkins H , Storek J
Published: June 2023

Background: Several case series describe patients with refractory acetylcholine receptor antibody-positive (AChR) myasthenia gravis (MG) treated with hematopoietic stem cell transplant (HSCT). In this report, we describe four patients with anti-muscle-specific kinase (MuSK)MG treated with HSCT. Methods: We reviewed the records of all patients undergoing HSCT for MG in the Alberta Blood and Bone Marrow Transplant Program and identified 4 patients with anti-MuSK MG. Results: All 4 patients had severe disease (Myasthenia Gravis Foundation of America score IVb-V) and were refractory to multiple treatments, including rituximab. 3 patients improved with no clinical manifestations or mild symptoms and remained as such for 2, 3.5, and 5.5 years. In these 3 patients, adverse events ranged from treatable infections and transient dyspnea to persistent fatigue and premature menopause. The average worst Myasthenia Gravis Activities of Daily Living (MG-ADL) scores improved from 14.7 before to 0.3 after HSCT while their mean worst Myasthenia Gravis Quality of Life Questionnaire (MG-QoL15) scores improved from 26.7 to 0. The fourth patient developed pneumonia and passed away from respiratory failure 8 weeks post-transplant. Conclusions: In patients with severe refractory anti-MuSK MG, it may be reasonable to consider HSCT but with an appreciation of the associated risks.
P.037 Neurofascin-155 IgG in acute-onset inflammatory polyneuropathy: possible predictor of relapse and recovery
Authors: Hansen M , Hahn C , Arnold A
Published: June 2023

Background: IgG4 autoantibodies to neurofascin-155 (NF-155) have been described in a subset of patients with chronic inflammatory demyelinating polyneuropathy (CIDP). While reports suggest an acute onset is more likely than in antibody negative CIDP, little literature exists around the subsequent course of NF-155 positive cases that originally presented with an acute inflammatory demyelinating polyneuropathy (AIDP) phenotype. Methods: Two male patients, ages 51 and 59, presented with similar, <2 week histories of lower extremity weakness. Patients were diagnosed with AIDP and treated with IVIG. Following initial improvement, both patients relapsed. One patient was treated with IVIG and steroids with subsequent improvement; however, he was unable to be weaned from steroids without experiencing recurrence of symptoms. The other patient was not retreated. Testing for NF-155 IgG was sent. Results: The first patient ultimately required Rituximab for stable improvement, the other improved spontaneously. Both patients later had positive tests for NF-155 IgG4 antibodies. Conclusions: Both of our NF-155 positive cases had initial AIDP-like presentations, followed by a relapsing course and excellent eventual recovery. This result, along with limited other available cases, suggest that in patients with an AIDP-like presentation, NF-155 IgG4 autoantibodies could be a marker of disease recurrence, but do not necessarily predict a poor outcome.
P.039 Development of a checklist for treating adults with Myotonic Dystrophy Type 1: a neuromuscular disease network for Canada (NMD4C) Knowledge Translation Tool
Authors: Kassardjian C , Gagnon C , Oskoui M , Selby K , Patten K , Hnaini M , Osman H , Davis J , Nordlund J
Published: June 2023

Background: The Neuromuscular Disease Network for Canada (NMD4C) aims to improve the care of Canadians with neuromuscular diseases. It has identified a need to support clinicians in implementing clinical guidelines with the use of checklists for initial evaluation and clinical follow-ups. The objective of the study was to develop a pragmatic management checklist to support clinical guidelines for diagnosis and follow-up of myotonic dystrophy type 1 (DM1). Methods: A practice-based DM1 checklist will be reviewed by a panel of 35 experts using an online survey. The survey has been drafted using the Appraisal of Guidelines Research and Evaluation tool for assessing Recommendation Excellence (AGREE-REX). The experts will rate: (1) the quality of each checklist recommendation, and (2) the applicability of each recommendation based on their clinical setting. Scores will be compiled and discussed among experts to achieve consensus. Results: The compiled checklist items were organized into three sections: (1) initial evaluation, (2) follow-up visit and (3) general treatment recommendations. Feedback from experts across Canada, results on feasibility, and a finalized checklist will be presented. Conclusions: The development of a feasible treatment checklist is a useful KT tool that DM1 experts across Canada could apply in their own clinical settings.
P.041 Guillain Barre syndrome could be a rare presenting finding of nodal and paranodal autoantibodies in immune-mediated neuropathies (IMN): A clinical utility of Cell based Assay
Authors: Kumar P , Mousavi A , Kihara E , Aziz T , Frykman H
Published: June 2023

Background: Guillain Barre Syndrome (GBS) and chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) are the two most common forms of treatable IMNs. Antibodies targeting proteins at paranodal cell-adhesion molecules such as contactin-1 (CNTN1), neurofascin-155 (NF155), contactin-associated protein 1 (CASPR1), and nodal neurofascins-NF140 and NF186, have been discovered in CIDP patients. Methods: Between August 2021 and January 2023, at BC Neuroimmunology laboratory, Vancouver we screened a total of 214 sera of patients for detecting nodal and paranodal antibodies with a fixed CBA. These patient sera were assayed for the presence of NF140, NF155, NF186, CNTN1, plus Caspr1 antibodies. The final diagnosis and response to therapy of positive cases were evaluated by a questionnaire requested from their physicians. Results: 10 cases were positive for nodal/paranodal antibodies by CBA (mean age 52.4 ± 15.4 years). Two cases were NF155 Ab positive CIDP with good response to conventional therapies. Three cases were double positive for NF140 and 186 Abs, three were double positive for CNTN1 and CASPR1 Abs. Interestingly, two cases were triple positive with GBS presentation. Conclusions: We identified a subgroup of nine patients with CIDP nodal and paranodal antibodies. Among them, two cases had triple positive antibodies with GBS presentation and poor response to plasma exchange and IVIg.
P.045 Safety profile overview of Efgartigimod Clinical Trials in participants with diverse Diverse IgG-Mediated Autoimmune Diseases
Authors: Bril V , Behin A , Gwathmey K , Broome CM , Goebeler M , Murai H , Bata-Csörgo Z , Newland A , Ulrichts P , Kerstens R , Guptill JT , Agha S , Jiang M , Howard JF
Published: June 2023

Background: Efgartigimod is a human IgG1 antibody Fc-fragment that reduces IgG autoantibody levels through FcRn blockade. This study reports safety of efgartigimod across IgG-mediated disorders. Methods: The safety of intravenous efgartigimod was evaluated in 204 efgartigimod-treated subjects with generalized myasthenia gravis (phase 3 ADAPT and 3-year open-label extension ADAPT+ trials), primary immune thrombocytopenia (phase 3 ADVANCE trial), or pemphigus (open-label phase 2 trial). These studies examined different efgartigimod doses (10–25 mg/kg), including cyclical dosing in generalized myasthenia gravis and continuous weekly dosing in primary immune thrombocytopenia and pemphigus. Results: Across all indications and doses studied, efgartigimod demonstrated a consistent safety profile, with treatment-emergent adverse event (TEAE) rates comparable to placebo (ADAPT, 77.4% efgartigimod/84.3% placebo; ADVANCE, 93.0% efgartigimod/95.6% placebo; and 85% in the pemphigus study). Most TEAEs were mild to moderate in severity. Discontinuation rates due to adverse events were consistently low (ADAPT, 3.6% efgartigimod/3.6% placebo; ADVANCE, 3.5% efgartigimod/2.2% placebo; and 3% of pemphigus study participants). In ADAPT+, no increases in TEAEs or infections occurred with additional efgartigimod dosing (19 cycles). Conclusions: Efgartigimod was well tolerated across indications and doses studied. Most TEAEs, including infections, were mild or moderate in severity and did not increase in frequency with recurrent dosing.
P.083 Liquid biopsies reveal brain cell death in central nervous system tumors
Authors: Lubotzky A , Neiman D , Zick A , Makranz C , Glaser B , Shemer R , Dor Y
Published: June 2023

Background: Circulating cell-free DNA (cfDNA) is a novel type of biomarker with a broad utility in diagnostic medicine, based on the release of DNA fragments from dying cells to the circulation. We developed an approach for identifying the tissue origins of cfDNA, using cell-type-specific DNA methylation patterns, based on a massive reference atlas of the genome-wide methylomes of multiple human tissues and cell types. Cancer inflicts damage to surrounding normal tissues, which can culminate in fatal organ failure. We demonstrated that brain cell death in CNS cancer can be detected by tissue-specific methylation patterns of circulating cfDNA. Methods: We developed a cocktail of brain-specific DNA methylation markers, and used it to assess the presence of brain-derived-cfDNA in the plasma of patients with brain metastasis. Results: We identified significantly elevated neuron-, oligodendrocyte-, and astrocyte-derived cfDNA (p<0.0001) in patients with brain metastases (n=29) compared with cancer patients without brain metastasis (n=113). Conclusions: We show a new set of biomarkers to identify brain damage with high specificity and resolution. We detected brain (neurons, oligodendrocytes, astrocytes) cfDNA in the plasma of patients with brain metastasis. Cell-type-specific cfDNA methylation markers allow the identification of collateral tissue damage, reveals the presence of metastases, and potentially assist in early cancer detection.
P.086 Unusual case of Aspergillosis presenting as a skull base lesion
Authors: Pai V , Alshafai L
Published: June 2023

Background: Fungi are ubiquitous microorganisms. Sinonasal fungal infections range from an acute fulminant to a chronic indolent clinical course. Fungal infections are common in immunocompromised patients, diabetics, and those with hematological malignancies. We present an unusual case of chronic invasive fungal sinusitis presenting as an anterior skull base lesion. Methods: A 42-year-old patient was referred with a history of right-sided proptosis. Prompt CT and MR imaging revealed a large right sinonasal erosive mass, predominantly T2 hypointense with heterogeneous enhancement. It extended into the right anterior skull base and invaded the right frontal lobe. The mass also invaded into the right extra-conal orbital fat, right pterygopalatine fossa, and right sphenopalatine foramen. Results: In view of the imaging findings, a biopsy was performed which confirmed fungal elements and chronic inflammation. Subsequently, a right-sided endoscopic endonasal resection of the sinonasal mass with resection of the right orbital component and debulking of the anterior skull base component was performed. Culture specimen grew aspergillosis. Conclusions: Extra-sinus invasion in fungal sinusitis is not uncommon. These cases may mimic other pathologies, e.g., tumors, with potential delay in treatment. Sound knowledge of the imaging appearances of this entity is imperative to ensure a good outcome.
P.110 The use of 5-Aminolevulinic acid (5-ALA) in high-grade glioma surgery, a single Canadian center experience
Authors: Leblanc F , Boone L , Noble T , Burns J , Charest D , El Helou A
Published: June 2023

Background: 5-Aminolevulinic acid (5-ALA) is a prodrug used to selectively illuminate high-grade glioma (HGG) tissue intra-operatively, shown to nearly double complete resection rates in a 2006 multicentre, phase III clinical trial. Here, we review the history of the 2020 approval of 5-ALA in Canada and present some of the first preliminary results on resection rates, survival analysis, and adverse effects from a single Canadian center. Methods: We enrolled 76 patients (median age 61 years, 42 male) with suspected HGG amenable to surgical resection between June 2020 and January 2023. Gross total resection was defined by the absence of enhancing lesions on postoperative MRI. We compared the survival distributions of confirmed HGG cases with complete vs. incomplete resection using a log-rank test and Kaplan-Meier statistic. Results: 52 patients were confirmed as having a HGG based on a pathological diagnosis. In 32 of these patients (60.3%) a gross total resection was achieved. 82.76% were still alive at 180 and 270 days, and 72.73% at 360 days. 47.8% had a survival of 600 or more days. Conclusions: 5-ALA fluorescence-guided surgery resulted in high complete resection rates, and improved overall survival comparable to the literature with no notable adverse side effects.