bluuebunny/crossref_metadata_2025 huggingface dataset:
Mortality Following Appendicectomy in Patients with Liver Cirrhosis: A Systematic Review and Meta‐Analysis
Authors: Rashid Adil , Gupta Alisha , Adiamah Alfred , West Joe , Grainge Matthew , Humes David J.
Published: January 2022

Introduction

With the global prevalence of liver cirrhosis rising, this systematic review aimed to define the perioperative risk of mortality in these patients following appendicectomy.

Methods

Systematic searches of Medline, EMBASE, Cochrane Library databases, ICTRP, and Clinical trials.gov were undertaken to identify studies including patients with cirrhosis undergoing appendicectomy, published since database inception to March 2021. Studies had to report mortality. Two review authors independently identified eligible studies and extracted data. Pooled analysis of in‐patient and 30‐day mortality was performed.

Results

Of the 948 studies identified, four were included and this comprised three nationwide database studies (USA and Denmark) and one multi‐centre observational study (Japan). A total of 923 patients had cirrhosis and 167,211 patients did not. In‐patient mortality ranged from 0 to 1.7% in patients with cirrhosis and 0.17 to 0.3% in patients without. 30‐day mortality was 9% in patients with cirrhosis compared to 0.3% in those without. One study stratified cirrhotic patients into compensated and decompensated groups. In patients with compensated cirrhosis, mortality following laparoscopic appendicectomy (0.5%) was significantly lower than open appendicectomy (3.2%). The meta‐analysis highlighted a tenfold increase in perioperative mortality in cirrhotic patients (OR 9.92 (95% CI 4.67 to 21.06, I2 = 28%). All studies reported an increased length of stay in patients with cirrhosis.

Conclusion

This review suggests that appendicectomy in the cirrhotic population is associated with increased mortality. LA may be safer in this population. Lack of information on cirrhosis severity and failure to control for age and co‐morbidities make the results difficult to interpret. Further large population‐based studies are required.
Brand new norms for a good old test: Northern Italy normative study of MiniMental State Examination
Authors: Foderaro Giuseppe , Isella Valeria , Mazzone Andrea , Biglia Elena , Di Gangi Marco , Pasotti Fabrizio , Sansotera Flavia , Grobberio Monica , Raimondi Vanessa , Mapelli Cristina , Ferri Francesca , Impagnatiello Valentina , Ferrarese Carlo , Appollonio Ildebrando Marco
Published: January 2022

Aim

Mini-Mental State Examination (MMSE) is one of the most used tests for the screening of global cognition in patients with neurological and medical disorders. Norms for the Italian version of the test were published in the 90 s; more recent norms were published in 2020 for Southern Italy only. In the present study, we computed novel adjustment coefficients, equivalent scores and cut-off value for Northern Italy (Lombardia and Veneto) and Italian speaking Switzerland.

Methods

We recruited 361 healthy young and old (range: 20–95 years) individuals of both sexes (men: 156, women: 205) and from different educational levels (range: 4–22 years). Neuropsychiatric disorders and severe medical conditions were excluded with a questionnaire and cognitive deficits and were ruled out with standardized neuropsychological tests assessing the main cognitive domains. We used a slightly modified version of MMSE: the word ‘fiore’ was replaced with ‘pane’ in verbal recalls to reduce the common interference error ‘casa, cane, gatto’. The effect of socio-demographic features on performance at MMSE was assessed via multiple linear regression, with test raw score as dependent variable and sex, logarithm of 101—age and square root of schooling as predictors.

Results

Mean raw MMSE score was 28.8 ± 1.7 (range: 23–30). Multiple linear regression showed a significant effect of all socio-demographic variables and reported a value of R2 = 0.26. The new cut off was ≥ 26 /30.

Conclusion

We provide here updated norms for a putatively more accurate version of Italian MMSE, produced in a Northern population but potentially valid all over Italy.
Lightweight lignocellulosic foams for thermal insulation
Authors: Lohtander Tia , Herrala Reima , Laaksonen Päivi , Franssila Sami , Österberg Monika
Published: January 2022

Foams are mainly composed of dispersed gas trapped in a liquid or solid phase making them lightweight and thermally insulating materials. Additionally, they are applicable for large surfaces, which makes them attractive for thermal insulation. State-of-the-art thermally insulating foams are made of synthetic polymeric materials such as polystyrene. This work focuses on generating foam from surfactants and renewable lignocellulosic materials for thermally insulating stealth material. The effect of two surfactants (sodium dodecyl sulphate (SDS) and polysorbate (T80)), two cellulosic materials (bleached pulp and nanocellulose), and lignin on the foaming and stability of foam was investigated using experimental design and response surface methodology. The volume-optimized foams determined using experimental design were further studied with optical microscopy and infrared imaging. The results of experimental design, bubble structure of foams, and observations of their thermal conductivity showed that bleached pulp foam made using SDS as surfactant produced the highest foam volume, best stability, and good thermal insulation. Lignin did not improve the foaming or thermal insulation properties of the foam, but it was found to improve the structural stability of foam and brought natural brown color to the foam. Both wet and dry lignocellulosic foams provided thermal insulation comparable to dry polystyrene foam.

Graphical abstract
Unifying the Ability-as-Compensator and Ability-as-Enhancer Hypotheses
Authors: Kühl Tim , Fehringer Benedict C. O. F. , Münzer Stefan
Published: January 2022

Spatial abilities have been found to interact with the design of visualizations in educational materials in different forms: (1) spatial abilities enhanced learning with optimized visual design (ability-as-enhancer) or (2) spatial abilities compensated for suboptimal visual design (ability-as-compensator). A brief review of pertinent studies suggests that these two forms are viewed as mutually exclusive. We propose a novel unifying conceptualization. This conceptualization suggests that the ability-as enhancer interaction will be found in the low-medium range of a broad ability continuum whereas the ability-as-compensator interaction will be found in the medium-high range. The largest difference in learning outcomes between visual design variations is expected for medium ability. A corresponding analytical approach is suggested that includes nonlinear quadratic interactions. The unifying conceptualization was confirmed in an experiment with a consistent visual-spatial task. In addition, the conceptualization was investigated with a reanalysis of pooled data from four multimedia learning experiments. Consistent with the conceptualization, quadratic interactions were found, meaning that interactions depended on ability range. The largest difference between visual design variations was obtained for medium ability, as expected. It is concluded that the unifying conceptualization is a useful theoretical and methodological approach to analyze and interpret aptitude-treatment interactions that go beyond linear interactions.
Spatial and temporal analysis of the risks posed by metal contamination in coastal and marine sediments of Bahrain
Authors: Nicolaus E. E. M. , Maxwell D. L. , Khamis A. S. , Abdulla K. H. , Harrod R. P. , Devlin M. J. , Lyons B. P.
Published: January 2022

Nine metals including Al, Cd, Cr, Cu, Fe, Mn, Ni, Pb and Zn were analysed from sediment samples collected from 29 stations since 2007 from Bahraini waters. Within this study, it was investigated whether concentrations of these determinants are at concentrations above internationally established Assessment Criteria (AC). The majority of sites were considered not to pose a toxicological risk in terms of metal contamination. Where breaches occurred, they were mainly from historic samples related to Cr, Cu and Ni contamination. A trend assessment revealed that out of 59 significant trends, 36 were downwards and 23 upwards, indicating that some determinants like Al, Zn and Ni are improving strongly across some sites, whilst areas associated with industrial activity still see some increasing trends for Al, Cd, Pb and Zn.
Gender preference gaps and voting for redistribution
Authors: Ranehill Eva , Weber Roberto A.
Published: January 2022

There is substantial evidence that women tend to support different policies and political candidates than men. Many studies also document gender differences in a variety of important preference dimensions, such as risk-taking, competition and pro-sociality. However, the degree to which differential voting by men and women is related to these gaps in more basic preferences requires an improved understanding. We conduct an experiment in which individuals in small laboratory “societies” repeatedly vote for redistribution policies and engage in production. We find that women vote for more egalitarian redistribution and that this difference persists with experience and in environments with varying degrees of risk. This gender voting gap is accounted for partly by both gender gaps in preferences and by expectations regarding economic circumstances. However, including both these controls in a regression analysis indicates that the latter is the primary driving force. We also observe policy differences between male- and female-controlled groups, though these are substantially smaller than the mean individual differences—a natural consequence of the aggregation of individual preferences into collective outcomes.
The job and life satisfaction of teachers: a social cognitive model integrating teachers’ burnout, self-efficacy, dispositional optimism, and social support
Authors: Marcionetti Jenny , Castelli Luciana
Published: January 2022

The purpose of the study was to test a model of factors predicting teachers’ job and life satisfaction, burnout, dispositional optimism, social support, perceived workload, and self-efficacy. The model extends Lent and Brown’s (J Voc Behav 69(2):236–247,https://doi.org/10.1016/j.jvb.2006.02.006, 2006; J Career Assess 16(1):6–21,https://doi.org/10.1177/1069072707305769, 2008) social cognitive model of the interaction of sources of job and life satisfaction. Specifically, burnout, a condition with a high incidence rate among teachers, was included. The participants were 676 Swiss teachers. Structural equation modeling was used to analyze the data. The results revealed the differential effect of the variables considered on teachers' burnout and job satisfaction, as well as their life satisfaction. Dispositional optimism, social support, and perceived workload might reduce the risk of teacher burnout; dispositional optimism, social support, and teacher self-efficacy seem to positively affect job satisfaction; and dispositional optimism alone, together with burnout and job satisfaction, directly relates to teachers’ life satisfaction. Practical implications of these results are discussed.
The impact of spatial and social structure on an SIR epidemic on a weighted multilayer network
Authors: Backhausz Ágnes , Kiss István Z. , Simon Péter L.
Published: January 2022

A key factor in the transmission of infectious diseases is the structure of disease transmitting contacts. In the context of the current COVID-19 pandemic and with some data based on the Hungarian population we develop a theoretical epidemic model (susceptible-infected-removed, SIR) on a multilayer network. The layers include the Hungarian household structure, with population divided into children, adults and elderly, as well as schools and workplaces, some spatial embedding and community transmission due to sharing communal spaces, service and public spaces. We investigate the sensitivity of the model (via the time evolution and final size of the epidemic) to the different contact layers and we map out the relation between peak prevalence and final epidemic size. When compared to the classic compartmental model and for the same final epidemic size, we find that epidemics on multilayer network lead to higher peak prevalence meaning that the risk of overwhelming the health care system is higher. Based on our model we found that keeping cliques/bubbles in school as isolated as possible has a major effect while closing workplaces had a mild effect as long as workplaces are of relatively small size.
Stochastic Modeling of Stratospheric Temperature
Authors: Eggen Mari Dahl , Dahl Kristina Rognlien , Näsholm Sven Peter , Mæland Steffen
Published: January 2022

This study suggests a stochastic model for time series of daily zonal (circumpolar) mean stratospheric temperature at a given pressure level. It can be seen as an extension of previous studies which have developed stochastic models for surface temperatures. The proposed model is a combination of a deterministic seasonality function and a Lévy-driven multidimensional Ornstein–Uhlenbeck process, which is a mean-reverting stochastic process. More specifically, the deseasonalized temperature model is an order 4 continuous-time autoregressive model, meaning that the stratospheric temperature is modeled to be directly dependent on the temperature over four preceding days, while the model’s longer-range memory stems from its recursive nature. This study is based on temperature data from the European Centre for Medium-Range Weather Forecasts ERA-Interim reanalysis model product. The residuals of the autoregressive model are well represented by normal inverse Gaussian-distributed random variables scaled with a time-dependent volatility function. A monthly variability in speed of mean reversion of stratospheric temperature is found, hence suggesting a generalization of the fourth-order continuous-time autoregressive model. A stochastic stratospheric temperature model, as proposed in this paper, can be used in geophysical analyses to improve the understanding of stratospheric dynamics. In particular, such characterizations of stratospheric temperature may be a step towards greater insight in modeling and prediction of large-scale middle atmospheric events, such as sudden stratospheric warming. Through stratosphere–troposphere coupling, the stratosphere is hence a source of extended tropospheric predictability at weekly to monthly timescales, which is of great importance in several societal and industry sectors.
Bioavailability of selected trace and rare earth elements to Juncus effusus L.: the potential role of de-icing chlorides in the roadside environment
Authors: Dołęgowska Sabina , Gałuszka Agnieszka , Migaszewski Zdzisław M. , Krzciuk Karina
Published: January 2022

Background and aim

The presence of chlorides in soils, e.g., from de-icing salts may change metal availability to plants.

Methods

To assess the role of de-icing chlorides on bioavailability of metals, the samples of the rhizosphere soils, roots and shoots of Juncus effusus L. were collected monthly from April to June of 2019 in the vicinity of roads and analyzed for trace (Ag, Cd, Co, Cu, Pb, Zn) and rare earth elements (from La to Lu).

Results

Concentrations of Cl− were distinctly higher in the shoots than in the roots. Apart from Cd, the concentration sequence of the other metals was as follows: rhizosphere soils>roots>shoots. The bioaccumulation and translocation factors indicated that Cd was the most preferably transported to the shoots as opposed to Ag, Co, Pb and REEs that showed a very low translocation potential. Negative correlations, which were noted between Cu and Co in the shoots and Cl− in soils, revealed their role in salinity stress alleviation. All soil samples showed a positive anomaly of Ce and a negative anomaly of Eu, whereas the shoots showed in turn a negative anomaly of Ce and a distinct positive anomaly of Eu. The lowest salinity factors (K/Na, Ca/Na) of the shoots resulted from an increase of salinity in J. effusus by higher sodium concentrations derived from de-icing NaCl.

Conclusions

De-icing agents may change the uptake of other elements. In natural habitats, the factors affecting this process include: type of element, soil metal concentrations and interactions, and individual plant features.
What textbooks offer and what teachers teach: an analysis of the Dutch reading comprehension curriculum
Authors: Bogaerds-Hazenberg Suzanne T. M. , Evers-Vermeul Jacqueline , van den Bergh Huub
Published: January 2022

In the Netherlands, the quality of the reading curriculum is currently under debate because of disappointing results on national and international assessments of students’ reading skills and motivation. In a mixed-method study, we analyzed the content of Dutch textbooks for reading comprehension instruction (i.e., the implemented curriculum) and teachers’ evaluation and use of these books (i.e., the enacted curriculum). A materials analysis of reading comprehension lessons (N = 80) in eight textbooks for grades 4 and 5 was complemented with semi-structured teacher interviews (N = 29) and lesson observations (N = 11), with a focus on the quality of reading strategy and text structure instruction in the curriculum. Main findings are (1) a lack of alignment between lesson goals, theory, and assignments, (2) a strong focus on practicing strategies, (3) limited declarative knowledge about strategies and text structure, (4) little opportunities for self-regulated strategy application. The teachers that were interviewed mention similar problems, but still hardly deviate from the textbook’s content and pedagogical guidelines. We make recommendations to improve the quality of the curriculum.
Improved ROSC rates in out-of-hospital cardiac arrest patients after introduction of a text message alert system for trained volunteers
Authors: Oosterveer D. M. , de Visser M. , Heringhaus C.
Published: January 2022

Objective

To evaluate whether a text message (TM) alert system for trained volunteers contributed to early cardiopulmonary resuscitation, the use of automated external defibrillators (AEDs), return of spontaneous circulation (ROSC) and survival in out-of-hospital cardiac arrest (OHCA) patients in a region with above-average survival rates.

Design

Data on all OHCA patients in 2012 (non-TM group) were compared with those of all OHCA patients in 2018 (TM group). The association of the presence of a TM alert system with ROSC and survival was assessed with multivariate regression analyses.

Results

TM responders reached 42 OHCA patients (15.9%) earlier than the first responders or ambulance. They connected 31 of these 42 OHCA patients (73.8%) to an AED before the ambulance arrived, leading to a higher percentage of AEDs being attached in 2018 compared to the 2012 non-TM group (55% vs 46%, p = 0.03). ROSC was achieved more often in the TM group (61.0% vs 29.4%, p < 0.01). Three-month and 1‑year survival did not differ significantly between the two groups (29.3% vs 24.3%, p = 0.19, and 25.9% vs 23.5%, p = 0.51). Multivariate regression analyses confirmed the positive association of ROSC with the TM alert system (odds ratio 1.49, 95% confidence interval 1.02‑2.19, p = 0.04).

Conclusion

A TM alert system seems to improve the chain of survival; because TM responders reached patients early, AEDs were attached more often and more OHCA patients achieved ROSC. However, the introduction of a TM alert system was not associated with improved 3‑month or 1‑year survival in a region with above-average survival rates.
Genome-Wide Association Study of Clinical Outcome After Aneurysmal Subarachnoid Haemorrhage: Protocol
Authors: Gaastra Ben , Alexander Sheila , Bakker Mark K. , Bhagat Hemant , Bijlenga Philippe , Blackburn Spiros , Collins Malie K. , Doré Sylvain , Griessenauer Christoph , Hendrix Philipp , Hong Eun Pyo , Hostettler Isabel C. , Houlden Henry , IIhara Koji , Jeon Jin Pyeong , Kim Bong Jun , Kumar Munish , Morel Sandrine , Nyquist Paul , Ren Dianxu , Ruigrok Ynte M. , Werring David , Galea Ian , Bulters Diederik , Tapper Will
Published: January 2022

Aneurysmal subarachnoid haemorrhage (aSAH) results in persistent clinical deficits which prevent survivors from returning to normal daily functioning. Only a small fraction of the variation in clinical outcome following aSAH is explained by known clinical, demographic and imaging variables; meaning additional unknown factors must play a key role in clinical outcome. There is a growing body of evidence that genetic variation is important in determining outcome following aSAH. Understanding genetic determinants of outcome will help to improve prognostic modelling, stratify patients in clinical trials and target novel strategies to treat this devastating disease. This protocol details a two-stage genome-wide association study to identify susceptibility loci for clinical outcome after aSAH using individual patient-level data from multiple international cohorts. Clinical outcome will be assessed using the modified Rankin Scale or Glasgow Outcome Scale at 1–24 months. The stage 1 discovery will involve meta-analysis of individual-level genotypes from different cohorts, controlling for key covariates. Based on statistical significance, supplemented by biological relevance, top single nucleotide polymorphisms will be selected for replication at stage 2. The study has national and local ethical approval. The results of this study will be rapidly communicated to clinicians, researchers and patients through open-access publication(s), presentation(s) at international conferences and via our patient and public network.
Oecophylla smaragdina (Hymenoptera: Formicidae) and Odontotermes sp. (Isoptera: Termitidae) a potential source of antioxidant: the two most preferred edible insects of Arunachal Pradesh, India
Authors: Raza Mohsin , Tukshipa Sonam Drema , Chakravorty Jharna
Published: January 2022

Antioxidant potential of weaver ant Oecophylla smaragdina (adult & brood) and termite Odontotermes sp the two common species of insects used as food by tribes of Arunachal Pradesh and elsewhere in India. Our findings highlight the antioxidant potential of these two insects. DPPH• scavenging activity IC50 (µg/mL) ranged from 59.56 (weaver ant adult) to 66.30 (termite). Termite species scored higher ABTS•+ scavenging activity (IC50: µg/mL), Ferric reducing power (TPEE µg/g) and phenolics (mg GAE/g) (18.70, 36.60 and 626.92) than weaver ant adult (52.57, 211.21 and 369.69) and weaver ant brood (33.34, 114.32 and 486.04). On the other hand, weaver ant adult scored higher flavonoids (mg RTE/g) (663.43) than its brood (387.19) and termite species (58.04). Weaver ant brood contained substantial amounts of phenolics and flavonoids, comparatively higher than phenolics of weaver ant adult and flavonoids of termite. These two insects may serve as an ideal dietary food supplement for handling oxidative stress and as a replacement for some conventional food products. However, further study is needed to find out the bioactive compound at the individual species level.
Avoidant Attachment Style Moderates the Recovery of Healthy Sexuality in Women with Anorexia Nervosa Treated with Enhanced Cognitive Behavior Therapy (CBT-E): A 2-Year Follow-Up Study
Authors: Cassioli Emanuele , Rossi Eleonora , Vizzotto Camilla , Malinconi Viola , Vignozzi Linda , Ricca Valdo , Castellini Giovanni
Published: January 2022

Background

Insecure Attachment style has been associated with interpersonal problems in persons with Anorexia Nervosa (AN), and it might moderate the recovery of healthy sexuality in these subjects.

Aim

The aim of the present 2-year follow-up study was to evaluate the role of insecure attachment style as a moderator of the recovery of healthy sexuality in women with AN.

Methods

63 Italian women with AN treated with a multidisciplinary approach including Enhanced Cognitive Behavior Therapy were evaluated by means of a clinical interview and self-administered questionnaires. Individual psychotherapy sessions were administered by experienced psychotherapists over the course of at least 40 weeks (median number of sessions = 43, range: 38–50); trained dieticians provided personalized nutritional counselling to facilitate weight recovery. The assessment was performed at baseline (T0) and after 1 (T1) and 2 (T2) years.

Outcomes

The administered questionnaires investigated general psychopathology (SCL-90-R), eating disorder-specific psychopathology (EDE-Q), female sexuality (FSFI) and adult attachment style (ECR).

Results

At baseline, avoidant attachment style was associated with all domains of sexual dysfunction. Longitudinal analysis showed a significant decrease in both eating disorder-specific psychopathology and sexual dysfunctions at follow-up evaluations. However, only 45% of remitted subjects also recovered healthy sexuality: these women reported significantly lower avoidance scores than those who only recovered from AN. Moderation analysis indicated that sexual desire did not increase in participants with higher levels of avoidant attachment.

Clinical Implications

These novel findings highlighted the importance of the assessment of adult attachment in the clinical setting, for better characterization and treatment of persons suffering from AN.

Strengths & Limitations

The long follow-up duration, the multidisciplinary nature of the treatment, and the novelty of the topic were major strengths of the study, whereas the limited sample size and the absence of biological data were the main limitations.

Conclusion

This study highlighted the crucial role of avoidant attachment in the relationship between AN and sexual dysfunctions, underlining the importance of integrating treatments with attachment-focused interventions.
The Art of Resistance in Islam
Authors: Shanneik Yafa
Published: January 2022

Based on first-hand ethnographic insights into Shi'i religious groups in the Middle East and Europe , this book examines women's resistance to state as well as communal and gender power structures. It offers a new transnational approach to understanding gender agency within contemporary Islamic movements expressed through language, ritual practices, dramatic performances , posters and banners. By looking at the aesthetic performance of the political on the female body through Shi'i ritual practices – an aspect that has previously been ignored in studies on women's acts of resistance -, Yafa Shanneik shows how women play a central role in redefining sectarian and gender power relations both in the Middle East and in the European diaspora.
Convicts
Authors: Anderson Clare
Published: January 2022

Clare Anderson provides a radical new reading of histories of empire and nation, showing that the history of punishment is not solely connected to the emergence of prisons and penitentiaries, but to histories of governance, occupation, and global connections across the world. Exploring punitive mobility to islands, colonies, and remote inland and border regions over a period of five centuries, she proposes a close and enduring connection between punishment, governance, repression, and nation and empire building, and reveals how states, imperial powers, and trading companies used convicts to satisfy various geo-political and social ambitions. Punitive mobility became intertwined with other forms of labour bondage including enslavement, with convicts a key source of unfree labour that could be used to occupy territories. Far from passive subjects, however, convicts manifested their agency in various forms, including the extension of political ideology and cultural transfer, and vital contributions to contemporary knowledge production.
Solving Problems of Simple Structural Mechanics
Authors: Seffen Keith Alexander
Published: January 2022

Solve problems in elementary structural mechanics thoughtfully and efficiently with this self-contained volume. Covers the basics of structural mechanics and focuses on simple structures, truss frameworks, beams and frames, design choices, and deformity. Carefully interrogates underlying assumptions for efficiencies in working out whilst expounding fundamental principles for a consistent understanding. Heavily connects the practical world of indeterminate structures to their analysis, to underline benefits they impart to the latter: that certain analytical methods provide a wealth of efficient solutions for problems of indeterminate structures compared to determinate ones. Celebrates the beauty of analytical indeterminacy and its relationship to practical structures. Perfect for students invested in structural mechanics, and aims to complement their learning and understanding.
GP.2 Changes in Leptin, CCL16 and sTNF-RII as a distinctive plasma immune
profile in patients with fast progressing ALS
Authors: Picher-Martel V , Boutej H , Cordeau P , Kaneb H , Julien J , Genge A , Dupré N , Kriz J
Published: January 2022

Background: Amyotrophic lateral sclerosis (ALS)
is highly heterogeneous with survival rate ranging from months to decades.
Approximately 10-20% of patients develop a rapidly progressive disease and
may die within the first year. Therefore, there is an increasing need for an
early detection of unique molecular signatures associated with more
aggressive forms of disease as it may help identify therapeutic targets.
Methods: To identify a unique molecular signature
in fast progressing patients, we recruited 45 sporadic ALS (sALS) patients
and 35 age-matched healthy controls and measured 62 immune markers in plasma
using cytokines array. Results: We found that leptin
was significantly downregulated in plasma of sALS patients and more
importantly in fast progressing disease. Immune markers CCL16 and sTNF-RII
were significantly increased in rapidly progressing disease. We also found
that leptin was significantly downregulated in plasma of
SOD1G93A mice across disease stage. This was caused
by an increased in levels of phospho-AMPK in mice adipocytes and in
adipocytes exposed to fast sALS patients’ plasma.
Conclusions: We propose that the combination of
decreased plasma leptin levels and up-regulation in CCL16/sTNF-RII may be
used as a prognostic biomarker to identify fast progressing ALS patients.
This unique immune/metabolic profile may cause dysfunction in metabolic
homeostasis.
B.2 Neurologic outcome trajectory following neonatal arterial ischemic
stroke (NAIS): A longitudinal observational study
Authors: Slim M , Pullenayegum E , Aziz A , Dlamini N , MacGregor D , deVeber G , Moharir M
Published: January 2022

Background: Studies evaluating long-term
neurologic outcomes following NAIS are scanty. We aimed to study the
emergence pattern of neurologic deficits following NAIS.
Methods: Neonates diagnosed with AIS were
prospectively enrolled and outcomes were evaluated using the validated
Pediatric Stroke Outcome Measure-Severity Classification Scheme. Neurologic
outcomes were classified as normal/mild, moderate or severe. Trend analysis
was conducted using Cochran-Armitage test. Results: A
total of 126 neonates (59% males) were followed for a median of 5.2 years
(IQR:3.4-6.4 years). The proportion of children classified as normal/mild
declined from 94% to 76% >5 years post-stroke (p<0.01). Moderate and
severe outcomes increased from 5% to 15% and 1% to 8% (p=0.01),
respectively. Sensorimotor, language and cognitive deficits emerged in 16%,
14%, and 17% of enrolled neonates, respectively. Of those who had
normal/mild outcomes at baseline, 83 remained stable throughout the study.
Improvement in neurologic outcomes was seen in 8 children. Thirty-five
neonates had emerging deficits at one point during follow-up. Congenital
heart disease predicted the emergence of deficits (odds ratio=3.3, 95%
confidence interval:1.01-10.5). Conclusions: Emerging
deficits following NAIS are not uncommon and can equally manifest in
sensorimotor, language or cognitive domains. Thus, long-term follow-up and
close monitoring of outcomes following NAIS is crucial.
C.2 The use of magnetic resonance guided focused ultrasound for
refractory psychiatric illness
Authors: Davidson B , Meng Y , Giacobbe P , Hamani C , Lipsman N
Published: January 2022

Background: Obsessive compulsive disorder (OCD)
and major depressive disorder (MDD) are common, often refractory,
neuropsychiatric conditions for which new treatment approaches are urgently
needed. Magnetic resonance guided focused ultrasound (MRgFUS) is a novel
surgical technique permitting incisionless ablative neurosurgery.
Methods: We examined the safety profile, clinical
response, and imaging correlates of MRgFUS anterior capsulotomy (MRgFUS-AC)
in patients with refractory OCD (n=7) and MDD (n = 10).
Results: There were no serious adverse clinical
or radiographic events. 5/7 OCD patients and 3/10 MDD patients met
pre-established clinical response criteria. Neurocognitive performance
improved on several measures of executive function (p<0.05). By 6 months,
there were significant reductions in cerebral glucose metabolism, and
reductions in the bilateral tracts connecting the thalamus with the
orbitofrontal cortices, anterior cingulate cortex (p<0.05). Preoperative
functional connectivity between the right ventral striatum and hippocampus
was predictive of eventual clinical response (p-FDR<0.05).
Conclusions: MRgFUS-AC is safe and demonstrates
important evidence of efficacy in treatment resistant psychiatric disease,
particularly OCD. The procedure was associated with structural and metabolic
changes in brain networks implicated in affective regulation, Resting-state
fMRI offers the ability to predict response, and potentially select patients
most likely to improve.
C.7 Does gender equality exist in the surgical management of degenerative
lumbar disease?
Authors: MacLean MA , Touchette CJ , Han J , Christie SD , Pickett G
Published: January 2022

Background: Despite efforts toward gender
equality in clinical trial enrollment, females are frequently
underrepresented and gender-specific data analysis is often unavailable. The
purpose of this study was to determine if gender equality exists in the
management of degenerative lumbar disease. Methods: Part 1: A systematic
scoping review was conducted according to PRISMA guidelines, in order to
synthesize the adult surgical literature regarding gender differences in
pre- and post-operative clinical assessment scores for patients diagnosed
with degenerative lumbar disease.

Part 2: An ambispective cohort analysis (multi-variate logistic
regression) of the Canadian Spine Outcomes Research Network registry was
performed to address knowledge gaps identified in “Part 1”.
Results: Part 1: Thirty articles were identified,
accounting for 32,951 patients. Female patients have worse absolute
pre-operative pain, disability and health-related quality-of-life (HRQoL).
Following surgery, females have worse absolute pain, disability, and HRQoL,
but demonstrate an equal or greater interval change compared to
males.

Part 2: Data was analyzed for 5,039 patients. Significant gender
differences in pre-operative utilization of healthcare resources (medication
use, diagnostic testing, medical and allied healthcare professional visits)
were identified. Conclusions: Significant gender
disparities in clinical assessment scores and the pre-operative utilization
of healthcare resources were identified for patients undergoing surgery for
degenerative lumbar disease.
P.004 Autoimmune Encephalitis: Modifiable and Non-Modifiable Predictors
of Relapse
Authors: Hansen M , Hahn C
Published: January 2022

Background: Approximately 25% of encephalitis
cases in North America are immune mediated. For most forms of autoimmune
encephalitis (AIE), risk of relapse is unclear and little evidence exists to
guide which patients have the highest risk and whether standard treatments
reduce this risk. Our objective was to determine the factors associated with
AIE relapse. Methods: We performed a chart review
consisting of patients with AIE presenting to the Calgary Neuro-Immunology
Clinic and Tom Baker Cancer Centre between 2015 and 2020. Predictors of
relapse were determined with use of t-test. Results:
Outcome data was assessable in 39/40 patients, 17/39 (44%) patients
relapsed. Seropositive patients and those with abnormal CSF were more likely
to relapse, although neither reached statistical significance (p=0.12,
0.059). Patients with longer duration of steroid and steroid sparing
treatment prior to relapse, and those on steroids at the time of relapse,
had milder relapses (p=0.024, 0.026, 0.047). There was no difference in
steroid or steroid sparing treatment use at 3, 6, and 12 months between
groups. Conclusions: Risk of relapse in AIE is high
(44%), with most relapses occurring in the first 3 years. Continuous
immunosuppression lessens the severity of relapse, although our study did
not confirm it reduced the occurrence of relapse.
P.006 Neural antibody testing for autoimmune encephalitis: A Canadian
single-centre experience
Authors: Mirian A , McFadden S , Edmond P , Bhayana V , Yang L , Budhram A
Published: January 2022

Background: We reviewed our autoimmune
encephalitis neural antibody testing using brain tissue indirect
immunofluorescence (TIIF) and cell-based assays (CBAs) after one year.
Methods: Samples were tested from March
2019–March 2020 by TIIF and CBA for anti-NMDAR, LGI1, CASPR2, AMPAR,
GABA(B)R, DPPX, IgLON5 and GAD65. Weakly positive or positive CBA, with or
without corresponding TIIF positivity, was reported positive. Clinical
questionnaires were submitted for clinical-serological correlation. Patients
with a compatible clinical phenotype and no more likely alternative
diagnosis were classified as true-positives, while all others were flagged
as possible false-positives. Results: Twenty of 373
patients (5.4%) had a positive neural antibody. All anti-LGI1 (N=4), GAD65
(N=4), and GABA(B)R (N=1) were classified as true-positives. In contrast,
only 3/6 anti-CASPR2 and 3/5 anti-NMDAR were classified as true-positives.
Among true-positives, 2/4 anti-LGI and 3/3 anti-CASPR2 were positive by CBA
only. All possible false-positive results exhibited only weak serum staining
by CBA, with negative serum TIIF and negative CSF CBA/TIIF (if available).
Conclusions: Clinical sensitivity of CBA seems
higher than TIIF for neural antibodies studied herein, but may come at some
expense to clinical specificity. Among patients with weak serum staining by
CBA, correlation with serum TIIF, CSF CBA/TIIF, and clinical presentation is
recommended.
P.011 Standardized Processes for Addressing Driving Cessation in the
Memory Clinic
Authors: Henri-Bhargava A , Bell C , Thompson D , Bibok M , Nikolejsin J , Thompson-Franson T
Published: January 2022

Background: Discussions around driving cessation
between clinicians and dementia patients are challenging. Patients view
giving up their license as losing their independence. We sought to develop a
tool that enables standardized and consistent driving messaging across
clinicians working in a specialist memory clinic, across the span of
cognitive disorders Methods: We developed a driving
recommendations generator that allows clinicians to produce information
handouts personalized to individual patient capabilities and needs.
Clinicians select from a list of established recommendations that were
developed with neurologist and geriatrician input, and consistent with
provincial requirements. Recommendations cover patients’ current driving
ability, road safety examinations, alternate transportation, and license
revocation. Early driving retirement is emphasized and encouraged, to
proactively support patients’ choices, safety and independence.
Recommendation and handouts are printed for the patients.
Results: Patients reported that the
recommendations were easy to read and understand, and helped them to
implement physician suggestions. All surveyed clients recommended continuing
to provide such recommendations to future patients and families. Clinicians
agreed that the tool helped them to save time, and simplified the process of
finding accurate information to provide patients.
Conclusions: Clinicians have found the system
timesaving and useful for simplifying the process of providing helpful,
informative resources for patients.
P.014 A Novel Canadian Family with the Rare IVS10+14 Tau Mutation
Authors: Maxwell SP , Cash MK , Rockwood K , Fisk JD , Darvesh S
Published: January 2022

Background: The IVS10+14 mutation in the
microtubule-associated protein tau gene, MAPT, is
a rare point mutation that dysregulates tau splicing resulting in
pathological aggregation. This mutation has been identified in three
families with severe neurodegenerative disease. We characterized the
clinicopathological features of a fourth, Canadian family with the IVS10+14
MAPT mutation and compared them to previously
reported families. Methods: Clinical and
neuropathological records from three family members with the IVS10+14
MAPT mutation were reviewed.
Neuropathological section from one available case were analyzed.
Results: Considerable interfamilial phenotypic
heterogeneity is reported in all cohorts that express the IVS10+14
MAPT mutation, with prominent motor,
cognitive, behavioural, and respiratory symptoms. The Canadian cohort also
expressed profound sensory and sleep abnormalities, not reported previously.
In the two siblings with available neuropathological records,
neuropathological changes ranged from mild to severe.
Conclusions: All families expressing the IVS10+14
MAPT mutation display striking inter- and
intrafamilial clinical and neuropathologic phenotypic variability. Our
cohort adds sensory and sleep abnormalities as potential symptoms and
illustrates a lack of clear clinicopathological correlates for these
heterogenous symptoms.

Reference: Maxwell et al. 2021. Clinical and
Neuropathological Variability in the Rare IVS10+14 Tau Mutation.
Neurobiology of Aging. In Press. DOI:
10.1016/j.neurobiolaging.2021.01.004.
P.015 What Happens to the Worried Well? – Follow-up of Subjective
Cognitive Impairment
Authors: Sutherland M , Kirk A , Karunanayake C , O’Connell M , Morgan D
Published: January 2022

Background: Concern around perceived
neurocognitive decline is increasing, leading to increased number of
referrals and anxiety for patients. We aimed to explore the likelihood of
the “worried well” experiencing neurocognitive decline.
Methods: 166 “worried well” patients who attended
the Rural and Remote Memory Clinic between 2004 and 2019 were included. Mini
Mental Status Examination, Center for Epidemiologic Studies Depression
Scale, and Functional Assessment Questionnaire scores were measured and
compared at initial assessment and at 1-year follow-up. MMSE scores over
time were assessed with a mean follow-up of 2.95 years (SD 2.87).
Results: There was no statistically significant
difference in MMSE, CESD, or FAQ scores between clinic day and one-year
follow-up, and no consistent pattern of MMSE score over time. Of the 166
patients with SCI on initial assessment, nine were eventually given a
neurological diagnosis. Conclusions: There is no
pattern of neurologic decline observed in the “worried well”. Though the
likelihood of a patient with SCI developing a neurological diagnosis is
reassuringly low, (9/166), it is not irrelevant. This, along with the
benefits of early diagnosis and treatment for dementia, leads us to believe
that patients with SCI should still be seen in follow-up at least at the
one-year mark.
P.017 Nutritional deficiency: A mysterious case of psychosis and
seizures
Authors: Bashardost L , Arevalo-Astrada M , Jenkins ME
Published: January 2022

Background: As a neuroactive steroid, vitamin D
is essential for optimal neuronal functioning1. Its
immunomodulatory and neuroprotective effects aid in reduction of
proconvulsant cytokines, membrane excitability and seizure
prevention2-3. Deficiency plays an important role
in neurological and psychiatric illnesses, though clinical manifestation
with seizures and psychosis have not been described.
Methods: A 61-year-old female presented with
3-day history of confusion, insomnia and new onset seizure. She was noted to
have poor dentition, deformed nail bed and multiple ecchymosis.
Neurologically, there were brisk reflexes with some spread. She worsened
with frequent seizures and psychosis. Results:
Laboratory investigation showed serum Vitamin D level of 19nmol/L,
hemoglobin of 70g/L. MRI head revealed T2 hyperintensities in bilateral
anterolateral temporal lobes and EEG consistent with bitemporal lobe
epilepsy. Autoimmune and infectious work up were negative. Treatment with
antipsychotics, several antiepileptics, high dose Vitamin-D and iron
supplements were initiated. Initially, she remained unresponsive to
neuro/psych medications. Improvement in clinical symptoms was noticed in
4th week of admission, with complete resolution of
MRI, EEG findings. Conclusions: Evidence surrounding
hypovitaminosis D and risk on the central nervous system continues to grow.
This case highlights the significance of vitamin-D on brain processes and
its neurological manifestations in state of deficiency.

1. Kalueff.A.,2006. 2. Garcion. E, 2003. 3. Eyles, D.,
2013.
P.018 The Ottawa Epilepsy Program: region-wide coordinated and
multidisciplinary care in the 21st century
Authors: Porter N , Muir K , Rezazadeh A , Whiting S , Fantaneanu T
Published: January 2022

Background: Epilepsy is the most common chronic
neurological illness worldwide, affecting more than 330, 000 people in
Canada, 10, 000 of which reside in the Ottawa area. Despite facing higher
mortality, stigma and social barriers, PLE (people living with epilepsy)
incur treatment gaps even in high income countries like ours. Our goal was
to address this burden locally with the creation of novel,
community-integrated, care delivery for PLE in our area; we describe its
inception. Methods: A transition program bridging
pediatric and adult institutions was created to address the care continuity
gap in 2017. Following a meeting of key stakeholders in the region in 2019,
the community group was integrated into the model of care and the city-wide
program was created incorporating adult, pediatric, transition and community
pillars. A patient friendly website was launched in 2020
(ottawaepilepsyprogram.ca). Results: 170 patients
were followed in the transition program since 2017. Adult and pediatric
pillars have referred 70 patients to the community program between
2019-2020, 48 between 2020-2021. Through this, PLE are able to access the
Clinic to community (C2C) and UPLIFT programs for social support services
and mental health, respectively. Conclusions: An
interconnected region-wide program can support PLE and foster innovative
care integration across disciplines.
P.027 Efficacy and Safety of Eptinezumab Initiated During a Migraine
Attack: Results from the RELIEF Study
Authors: Winner PK , McAllister P , Chakhava G , Ailani J , Mehta L , Ettrup A , Krog Josiassen M , Lindsten A , Bougie JK , Cady R
Published: January 2022

Background: Eptinezumab is approved for migraine
prevention, with demonstrated rapid onset of preventive benefit. RELIEF
evaluated the efficacy and safety of eptinezumab initiated during a migraine
attack. Methods: RELIEF (NCT04152083; parallel-group,
double-blind, placebo-controlled) randomized adults with migraine (4-15d/mo
in 3mo prior to screening) to eptinezumab 100mg or placebo, administered IV
within 1-6h of qualifying migraine onset. Co-primary efficacy endpoints were
time to headache pain freedom and time to absence of most bothersome symptom
(MBS). Results: Eptinezumab (n=238) compared with
placebo (n=242) achieved significantly faster headache pain freedom (median
4h vs 9h; hazard ratio=1.54, P=0.0006) and
absence of MBS (2h vs 3h; 1.75, P<0.0001). At
2h, 23.5% and 12.0% (P=0.0009) of
eptinezumab-treated and placebo patients, respectively, reported headache
pain freedom, and 55.5% and 35.8% (P<0.0001)
reported absence of MBS. Significantly fewer eptinezumab-treated patients
used rescue medication within 24h (31.5% vs 59.9%;
P<0.0001). Treatment-emergent adverse
events occurred in 10.9% eptinezumab-treated and 10.3% placebo patients; no
serious adverse events occurred. Conclusions:
Infusion of the preventive migraine treatment, eptinezumab, during a
migraine resulted in rapid and sustained freedom from headache pain and MBS
vs placebo, starting 2h post-infusion, decreasing need for acute medication
within 24h post-infusion. No notable safety findings were
identified.