bluuebunny/crossref_metadata_2025 huggingface dataset:
P.065 Emergency medical services activation Following Face, Arm, Speech, Time (FAST) public awareness campaigns in Quebec, Canada
Authors: Brissette V , Rioux B , Choisi T , Poppe AY
Published: June 2022

Background: Face, Arm, Speech, Time (FAST) campaigns improve stroke recognition in the general population. We assessed the effect of five consecutive FAST campaigns on emergency medical services (EMS) calls for suspected strokes in Quebec, Canada. Methods: We compared with t-tests the daily EMS call volume changes in the greater Montreal area before and after five FAST campaigns held between 2015 and 2019. We used interrupted time-series to measure changes in EMS daily call volume for suspected strokes following each FAST campaign (all calls, calls <5 hours from symptom onset, calls rated 3/3 on the Cincinnati Prehospital Stroke Scale [CPSS]) and used calls for acute headaches as a comparator. Results: After five FAST campaigns, mean daily calls increased by 28% (p<0.001) for suspected strokes, compared to 10% for acute headaches (p=0.012). Significant increases in daily stroke calls were only observed after three campaigns (highest OR=1.26, 95% CI: 1.11, 1.43; p<0.001). There were no significant changes in calls after individual campaigns for strokes <5 hours from symptom onset and 3/3 CPSS strokes. Conclusions: The individual effect of FAST campaigns on daily stroke calls to EMS was inconsistent. Further refinement of FAST campaigns may help improve prompt EMS activation.
P.067 Focused, bedside cardiac ultrasound in stroke: a feasibility study
Authors: Leis B , Ahktar J , Graham B , Whelan K , Hunter G
Published: June 2022

Background: Canadian Stroke Best Practice Recommendations recommend both cardiac monitoring and transthoracic echocardiography (TTE) to assess for cardioembolic sources of stroke. TTE has a diagnostic yield, which is historically low at 5-10%. The goal of this project was to evaluate the practicality of a bedside, focused approach to TTE in ischemic stroke. Methods: A cross-sectional study evaluating patients undergoing echocardiography for evidence of possible cardioembolic stroke was developed. It compared the standard and focused TTE imaging approaches. Of the 61 patients reported, data is currently available for 15 participants. Independent samples t-test were performed to compare measurements. Results: Mean time to finish image acquisition for the focused, bedside TTE was significantly shorter than the complete TTE (12 min or less vs 30 min or more) (p<0.0001). No cardiac sources of stroke were found by either mechanism in this cohort, representing 100% agreement between the two modalities. Conclusions: Focused, bedside echocardiography studies are quicker to execute and employ more affordable, portable, digital TTE devices. The test is done at bedside, reducing the need for patient transport. Image acquisition takes approximately half the time to obtain, potentially allowing for more rapid clinical decision making and facilitation of discharge from hospital.
P.071 Case report: cheiro-oral syndrome secondary to thalamic ischemic stroke
Authors: Xie Y
Published: June 2022

Background: Patient with small thalamic infarct may present with a variety of subtle and seemingly disconnected sensory deficits which can be easily missed. Methods: Here we report a case of an 80 years ‘old Chinese female presenting sudden onset persistent sensory symptoms over perioral area and right hand. The patient underwent further investigation with Brain MRI. The patient underwent further investigation with Brain MRI. A literature review was conducted and the patient’s clinical finding was compared with the literature. Results: The patient’s presentation was consistent with clinical manifestation of type 1 Cheiro-Oral syndrome. Brain MRI performed the day after admission revealed small non-hemorrhagic infarction involving the left thalamus. The diagnosis was type 1 cheiro-oral syndrome secondary to left thalamic ischemic stroke. Conclusions: This report highlights both clinical presentations of cheiro-oral syndrome and correlating clinical symptomatology with anatomic localization. It is important for physicians to recognize this rare condition with subtle presentations for complete work-up and definitive treatment.
P.075 EEG features reflecting the neurodevelopmental assessment at term equivalent age in preterm born infants
Authors: Dufour A , Gagnon M , Marandyuk B , Mahdi Z , Côté-Corriveau G , Nuyt A , Dehaes M , Luu T , Simard M , Pinchefsky EF
Published: June 2022

Background: In Canada, 7% of children are born preterm between 29 and 36 weeks gestational age (GA). Electroencephalography (EEG) provides a bedside evaluation of brain activity, yet the clinical significance of several EEG patterns requires further study. The goal of this study is to determine the EEG features at term equivalent age (TEA) that correlate with neurodevelopmental evaluation at TEA in infants born between 29-36 weeks GA. Methods: Prospective cohort study of preterm infants born 29-36 weeks GA with 1 hour EEG recording at TEA. EEG discontinuity index (proportion <25mcV amplitude) and spectral power densities were calculated as well as the mean and maximum values of interburst intervals. At TEA, neurodevelopment was evaluated using the General Movement Optimality Score (GMOS). Linear regression analyses were used to evaluate the association between EEG features and neurodevelopmental assessment. Results: Eighty-two children (median GA 33.6 weeks) were included (47 males). Median GMOS was 29.0 (IQR 24.3-35.0). A greater EEG discontinuity index was associated with reduced GMOS (B -6.85; 95% CI -12.13,-1.57; p=0.012). Conclusions: At TEA, a greater EEG discontinuity index was associated with a more abnormal neurodevelopmental assessment. Ongoing longitudinal neurodevelopmental assessments are needed to better evaluate the prognostic potential of TEA EEG.
P.079 MT-TA: A mitochondrial genome cause of developmental and epileptic encephalopathy
Authors: Sahly AN , Buhas D , Myers KA
Published: June 2022

Background: MT-TA (OMIM 590000), one of 22 mitochondrial transfer-RNA (mt-tRNA) genes, encodes the mt-tRNA for alanine. Pathogenic variants in mt-tRNA genes affect the translation of respiratory chain complexes I, III, and IV; which leads to mitochondrial dysfunction and a clinically variable phenotype. MT-TA pathogenic variants have been described in only seven patients, all of whom had isolated myopathy Methods: Case report. Results: Our patient initially presented with drug-resistant West syndrome, later evolving towards a Lennox Gastaut phenotype. Although she had hypotonia, serum creatine kinase and electromyography were normal. Brain-MRI showed bilateral symmetric hypointense T1, hyperintense T2-fluid-attenuated-inversion-recovery and restricted-diffusion signal changes in the dentate nuclei. Mitochondrial genome testing identified a previously published pathogenic variant in MT-TA (m.5591G>A) with 14% blood heteroplasmy and 16% urine heteroplasmy. The variant was absent in serum sampled from the patient’s mother Conclusions: Our case extends the phenotypic spectrum of MT-TA variants to include developmental and epileptic encephalopathy, in the apparent absence of muscle disease. We hypothesize that our patient may have the greatest degree of heteroplasmy in brain tissue; however, animal models and induced pluripotent stem cell (iPSC) models are needed to identify the precise mechanism by which MT-TA dysfunction results in variable phenotypes with variable degrees of heteroplasmy.
P.085 The relationship between sleep and behavior in attention deficit/hyperactivity disorder
Authors: Ghanim F , Harkness K , Guadagni V , Murias K
Published: June 2022

Background: Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder that is associated with long-term reduced quality of life and impaired functioning. ADHD is commonly associated with sleep disturbances that can contribute to many difficulties in a child’s life. This study aims to elucidate this complex relationship by utilizing a subset of the Adolescent Brain Cognitive Development (ABCD) database. Methods: The population included a group of children with ADHD age 10-13 years (n=212) and a matched typically developing (TD) group (n=212). Sleep data was obtained through Fitbit actigraphy measures, and the Parent Sleep Disturbance Scale (SDS). Behavioural and emotional subscores were obtained from the Child Behaviour Checklist (CBCL). Results: There were no significant correlations between the actigraphy and SDS sleep data. SDS sleep data were significantly different between ADHD and control groups, while actigraphy data was not. Sleep latency (measured by actigraphy) and 3 out of 6 of the SDS subscores were significantly related to behavioural scores. Conclusions: The results of this study indicate that sleep may not be an important mediator of behaviour and emotional responses in children with ADHD. Future studies should explore both influences on sleep parameters as well as behaviour and other measures important to families.
P.092 Health inequity and time from stroke onset to arrival trends: a single-centre experience
Authors: Pai AM , Nichol D , MacGregor D , Bhathal I , Moharir M , To T , Ertl-Wagner B , Kassner A , deVeber GA , Dlamini N
Published: June 2022

Background: Clinical outcomes following childhood arterial ischaemic stroke (AIS) depend on age at the time of stroke, infarct size and location. However, other important variables including health inequity and stroke onset to arrival times remain inadequately addressed. This study reported trends in health inequity and stroke onset to arrival times along with proximity to a stroke centre in Canada. Methods: Childhood AIS patients (N=234) with stroke onset between 2004-2019 at a Level 2 (comprehensive) stroke centre were included. Measures of material deprivation included household income, education, single-parent families, and housing quality. Patients were stratified into 3 cohorts (by date of stroke onset) and postal codes were categorized as minimal, moderate, or most deprived neighbourhoods. Results: Over the 16-year period, an increasing number of patients arrived from the most deprived neighbourhoods. Although, there was no significant association between material deprivation and stroke onset to arrival time, an increasing number of patients presented within 6 hours of stroke onset (χ2 = 13.8, p = 0.008). Furthermore, most patients arrived from urban neighbourhoods. Conclusions: The faster stroke onset to arrival trend is encouraging, however, material deprivation trends are concerning. Thus, future studies exploring post-stroke outcomes should consider material deprivation, stroke onset to arrival times, and geographical proximity.
P.107 Personalized prediction of future lesion activity and treatment effect in multiple sclerosis from baseline MRI
Authors: Falet JR , Durso-Finley J , Nichyporuk B , Arnold DL , Arbel T
Published: June 2022

Background: Precision medicine for multiple sclerosis (MS) involves choosing a treatment that best balances efficacy and disadvantages such as side effects, cost, and inconvenience, based on an individual’s unique characteristics. Machine learning can be used to model the relationship between a baseline brain MRI and future new and enlarging T2 (NE-T2) lesion count to provide personalized treatment recommendations. Methods: We present a multi-head, deep neural network for making individualized treatment decisions from baseline MRI and clinical information which (a) predicts future NE-T2 lesion counts on multiple treatments and (b) estimates the conditional average treatment effect (CATE), as defined by the predicted suppression of NE-T2 lesions, between different treatment options and placebo. We validate our model on a dataset pertaining to 1817 patients from four randomized clinical trials. Results: Our model predicts favorable outcomes (< 3 NE-T2 at follow-up) with average precision 0.780-0.994 across 5 different treatment arms. It correctly identifies subgroups with different treatment effect sizes and provides treatment recommendations that improve lesion suppression while limiting the need for high efficacy treatments. Conclusions: Our framework provides accurate predictions for future NE-T2 lesion counts and personalized treatment recommendations that improve outcomes while accounting for the disadvantages of different treatment options.
P.108 Use of intravenous immunoglobulin for central nervous system disorders in British Columbia: consensus guidelines
Authors: Uy C , Cross HM , Percy J , Schrader D , Carruthers R , Traboulsee A , Beauchamp A , Shih A , Morrison D , Chapman K , Beadon K
Published: June 2022

Background: Intravenous immunoglobulin (IVIG) may benefit many inflammatory central nervous system (CNS) disorders based on multiple immunomodulatory effects. IVIg is being used in inflammatory CNS conditions however robust evidence and guidelines are lacking in many disorders. Over the last 5 years, the percentage of IVIg used for CNS indications within neurology almost doubled in British Columbia (BC), Canada. Clear local guidelines may guide rational use. Methods: Consensus guidelines for IVIG use for CNS indications were developed by a panel of subspecialty neurologists and the Provincial Blood Coordinating Office, informed by focused literature review. Guidelines were structured similarly to existing BC peripheral nervous system guidelines and Australian Consensus Guidelines. Utilization and efficacy will be monitored provincewide on an ongoing basis. Results: Categories of conditions for Conditionally Approved (N=11) and Exceptional Circumstance Use (N=5) were created based on level of evidence for efficacy. Dosing and monitoring recommendations were made and outcomes measures defined. Rationale for Not Indicated conditions (N=2) was included. Guidelines were distributed to BC neurologists for feedback. This system will be re-evaluated after 1 year. Conclusions: IVIG use in CNS inflammatory conditions has an emerging role. Guidelines for use and monitoring of outcomes will help improve resource utilization and provide further evidence regarding effectiveness.
P.112 Clinical and Electrophysiological characteristics of anti-nodal/paranodal antibodies in chronic inflammatory demyelinating polyradiculoneuropathy patients
Authors: Alsolaihim A , Baker S
Published: June 2022

Background: CIDP is an autoimmune polyneuropathy. Antibodies against the Node of Ranvier have been described, NF155,NF140/186 and contactin-1. Methods: A retrospective review of patients with CIDP who tested positive for antinodal/paranodal antibodies via Western blot were evaluated. We have included 20 sero-negative CIDP patients. All patients met definite or probable EFNS criteria. clinical, electrophysiological data and response to treatment were obtained. Results: Forty-five patients tested positive for the antibodies. Sixteen were positive for NF155,11 for NF140, 5 for CNTN1,11 were double positive for NF155 and NF140, and 3 were triple positive for NF155, NF140 and CNTN. Age of onset was similar in both seronegative (53.9 ± 3.1 yrs.) versus seropositive(52.3 ± 2.4 yrs.).Chronic presentation manifested in 85% of seronegative, 80% of seropositivepatients.Intrestingly,all triple-positive patients presented with a more acute presentation(i.e,<8 wks.)7/20 seronegative (35%),1/16 NF155, 6/11 NF140,1/5 contactin, 2/11 of doublepositive, 3/3 of triple-positive (28%,13/46) responded to IVIg. Conclusions: No major clinical or electrophysiological differences between groups. triple-positive patients showed 100% response to IVIg.These results cast doubt on the specificity of the Western blot as a clinico-electrophysiologic discriminator. Future testing with cellbased assays will likely provide a robust measure that will guide treatment decision.
P.113 Time metrics and clinical outcomes of thrombectomy in acute stroke patients before and after implementation of COVID-19 infection protocols in six Canadian stroke centres
Authors: Zhu S , Tsehmaister-Abitbul V , Stotts G , Fahed R , Pettem H , Guy U , Aviv R , Agid R , Pikula A , Shankar J , Milot G , Van Adel B , Yip S , Settecase F , dos Santos M
Published: June 2022

Background: The coronavirus disease 2019 (COVID-19) pandemic has led the implementation of institutional infection control protocols. This study will determine the effects of these protocols on outcomes of acute ischemic stroke (AIS) patients treated with endovascular therapy (EVT). Methods: Uninterrupted time series analysis of the impact of COVID-19 safety protocols on AIS patients undergoing EVT. We analyze data from prospectively collected quality improvement databases at 6 centers from March 11, 2019 to March 10, 2021. The primary outcome is 90-day modified Rankin Score (mRS). The secondary outcomes are angiographic time metrics. Results: Preliminary analysis of one stroke center included 214 EVT patients (n=150 pre-pandemic). Baseline characteristics were comparable between the two periods. Time metrics “last seen normal to puncture” (305.7 vs 407.2 min; p=0.05) and “hospital arrival to puncture” (80.4 vs 121.2 min; p=0.04) were significantly longer during pandemic compared to pre-pandemic. We found no significant difference in 90-day mRS (2.0 vs 2.2; p=0.506) or successful EVT rate (89.6% vs 90%; p=0.93). Conclusions: Our results indicate an increase in key time metrics of EVT in AIS during pandemic, likely related to infection control measures. Despite the delays, we found no difference in clinical outcomes between the two periods.
P.137 Surgical approaches to adult thalamic gliomas: a systematic review
Authors: Levy AS , Eatz T , Morell AA , Higgins DM , Patel NV , Ivan M , Komotar R
Published: June 2022

Background: Adult thalamic gliomas (ATGs) present a surgical challenge given their depth and proximity to eloquent brain regions.Though a relative abundance of literature has been published regarding the surgical management of thalamic lesions in pediatric patients, a scarce amount exists dedicated to adult populations. Methods: Literature regarding surgical management of thalamic gliomas in adult patients was reviewed according to the PRISMA guidelines. Fours databases were searched with keywords “‘thalamic glioma’ AND ‘surgical intervention’ OR ‘thalamic glioma’ AND ‘surgical treatment’” in July 2021 for articles assessing surgical techniques of ATG resection. Results: The mean age of adult undergoing surgical management was 33.57 years with a median preoperative KPS of 72.15. Among the 507 cases, several surgical approaches were utilized. Transcortical approaches were most frequently used accounting for 37.8% of all cases followed by transventricular (23.8%), transcallosal (22.8%), and trans-sylvian transinsular (2.92%). Conclusions: Studies in this review agree that decreased age, low grade glioma, increased KPS, and increased duration of symptoms are positive prognostic factors. Greater degree of resection provides a positive survival benefit, and transcortical approaches appear to carry a greater overall survival. Stratified guidelines could pose an overall advantage to surgical success when making decisions on treatment approach.
P.142 Spinal cord injury associated with Wilms tumor metastasis: case report and literature review
Authors: Marciniuk K , Zherebitskiy V , Poulin A , Martin G , Radic J
Published: June 2022

Background: A 19-month-old boy with recent Wilms tumor resection presented with ASIA B spinal cord injury secondary to rapid progression of a T12 epidural lesion suspicious for metastatic disease. Methods: The case is presented and the literature was reviewed for prior cases of Wilms tumor with spinal metastasis. Results: Emergent tumor debulking for spinal cord decompression via T11-L1 laminectomies with right T11-L1 facetectomies was performed. Allograft bone was placed to facilitate fusion. No direct connection to the renal tumor was appreciated on imaging or intra-operatively. There was no evidence of additional metastases. Pathology demonstrated similar histomorphology and immunohistochemical profile as the original left kidney tumor resection (Wilms tumor, favorable histology). Notably, no focal or diffuse anaplasia, or aggressive non-Wilms component such as clear cell sarcoma or rhabdoid tumor of the kidney, were identified. Treatment plan consisted of 25 Gy of radiation and 29 weeks of chemotherapy. At 6-weeks the patient had regained baseline lower extremity function with no bowel or bladder dysfunction. Conclusions: Spinal cord compression secondary to spinal metastasis of Wilms tumor in the absence of global metastatic disease is rare. Prompt identification, surgical decompression, and multimodality therapy is essential to prevent persistent neurological deficits.
P.143 Adult gangliocytoma arising within the lateral ventricle: A case report and review of the literature
Authors: Alarifi NA , Del Bigio M , Beiko J
Published: June 2022

Background: Gangliocytomas are rare neuronal tumors with an incidence of less than 1% of all CNS neoplasms. They are mostly seen in the pediatric age group, localizing within the cerebral cortex, most often the temporal lobe. Methods: We report a case of an intracranial gangliocytoma arising within the lateral ventricle in an adult patient. Our 66-year-old female patient started experiencing progressive generalized weakness, headaches, and confusion prior to presentation. Her neurological examination did not reveal any focal neurological deficits. MRI of the brain showed a diffusely enhancing lobulated mass situated within the frontal horn of the right lateral ventricle with extension into the foramen of Monro and obstructive hydrocephalus. Results: The patient underwent an interhemispheric trans-callosal approach with gross total resection and relief of her hydrocephalous. Pathological examination showed clusters of highly pleomorphic neuron-like cells without evidence of neoplastic glial cells. Histopathological and immunohistochemistry findings were consistent with the diagnosis of gangliocytoma (World Health Organization grade 1). Conclusions: Gangliocytomas are rare low-grade CNS neoplasms that can present in an older population within unusual locations and should be included within the differential whenever a suspicious lesion is encountered.
P.161 Spatiotemporal dynamics of neuronal ensembles in the primate prefrontal cortex during virtual reality navigation tasks
Authors: Abbass M , Johnston R , Corrigan B , Gulli RA , Sachs A , Lau JC , Martinez-Trujillo J
Published: June 2022

Background: Brain-machine-interface research has utilized multichannel single neuron recordings to decode movement intention. However, the prefrontal cortex (PFC) contains mental representations of more abstract task and goal elements which may be utilized as important signals in a brain-machine-interface. We therefore utilized virtual reality to simulate a real-world task while recording from ensembles of primate PFC neurons. Methods: Two male rhesus macaques (macaca mulatta) were trained to navigate a virtual reality environment using a joystick and learn a context-object association rule. We implanted each monkey with two 96-channel Utah arrays (Blackrock Microsystems) in the lateral PFC (areas 9/46 and 8a) and simultaneously recorded from multiple single neurons. Results: A linear support-vector-machine decoded task elements (context, target location and chosen direction of movement) with significantly greater than chance accuracy. This information was decoded in a sequential manner as the primates made a rule-based decision, with context information appearing first, followed by target location, and chosen side. Conclusions: We found that different neuronal ensembles encode the elements needed for implementing the context rule, and that such ensembles are activated sequentially. Brain-machine-interface systems may benefit by integrating neural data from the PFC, providing salient goal-related information such as the content of the goal and its spatial location.
P.164 Analysis of MNI OR log book over Dr Wilder Penfield`s Career: Practice profile of epilepsy cases
Authors: Zambrano E , Hall J , Martin-Brage L
Published: June 2022

Background: Dr. Penfield was a pioneer in neurosurgery and his contribution continues to impact the practice today. Our objective is to analyze the epilepsy surgeries during his career. Methods: Analysis of original operating room books from 1934-1960. Results: He performed 2338 procedures during his career. 601 (26%) epilepsy, 524 (22%) oncology, 441 (19%) general neurosurgery, 379 (16%) functional, 230 (10%) spine, 80 (3%) trauma, 54 (2%) vascular, 29 (1%) nerves.

Epilepsy cases were divided: local vs. general anesthesia and a focal resection or lobectomy. From 1934-1945 he performed 167 procedures, 146 local anesthesia with focal resection. From 1946-1950 223 procedures, introduction of lobectomies with 30. Most right-side procedures under general anesthesia. From 1951-1955 152 procedures, 88 focal resection, 64 lobectomies. From 1956-1960 59 surgeries, similar number of focal resection and lobectomies. Conclusions: To our knowledge this is the most complete and comprehensive account his surgical career. In early years patients were treated through large craniotomies with EEG stimulation to tailor focal resections now known as the “Montreal procedure”. This led to a better understanding of human cortex and the division of the brain functions. During later years, there was a reduction in the number of cases done under local anesthesia and increase in lobectomies.
P.172 Work-up and management of asymptomatic extracranial traumatic vertebral artery injury
Authors: MacLean MA , Touchette CJ , Dude T , Almojuela A , Bergeron D , Kameda-Smith M , Persad AR , Sader N , Alant J , Christie SD
Published: June 2022

Background: Extracranial traumatic vertebral artery injury (eTVAI) is common following non-penetrating head and neck trauma. Most cases are initially asymptomatic with an increased risk for stroke. Consensus is lacking regarding screening, treatment, and follow-up of asymptomatic patients with eTVAI. Our objective was to investigate national practice patterns reflecting these domains. Methods: An electronic survey was distributed via the Canadian Neurological Sciences Federation and Canadian Spine Society. Two case-based scenarios featured asymptomatic patients with eTVAI. Case 1: non-displaced cervical lateral mass fracture; angiography stratified by luminal diameter reduction. Case 2: complex C2 fracture; angiography featuring pseudoaneurysm dissection. Analysis: descriptive statistics. Results: Response Rate: 108 of 182 participants (59%), representing 20 academic institutions.

Case 1: 78% of respondents would screen using CTA (97%), immediately (88%). Most respondents (97%) would initiate treatment, using aspirin (89%) for 3-6 months (46%).

Case 2: 73% of respondents would screen using CTA (96%), immediately (88%). The majority of respondents (94%) would initiate treatment, using aspirin (50%) for 3-6 months (35%). Thirty-six percent of respondents would utilize endovascular therapy.

In both cases, the majority of respondents would follow-up clinically or radiographically every 1-3 months, respectively. Conclusions: This study highlights consensus in Canadian practice patterns for the workup and management of asymptomatic eTVAI.
GP.6 The Impact of Brain Invasion on Intracranial Meningioma Grading
Authors: Rebchuk AD , Chaharyn BM , Alam A , Hounjet C , Gooderham PA , Yip S , Makarenko S
Published: June 2022

Background: In 2016, the WHO Classification of Brain Tumors included brain invasion as a standalone diagnostic criterion for grade 2 meningioma diagnosis. In this study we explored the impact of this change on the incidence and distribution of meningioma grades. Methods: All cases of meningiomas diagnosed from 2007-2020 at a tertiary care hospital were identified. The distribution of meningioma grades before (WHO 2007) and after (WHO 2016) the introduction of the 2016 WHO criteria were compared. Each case in the 2007 cohort was re-graded according to the 2016 criteria to determine the intra-class correlation (ICC) between grading criteria. Results: Of 814 cases, 532 (65.4%) were in the 2007 WHO cohort and 282 (34.6%) were in the 2016 WHO cohort. There were no differences in the distribution of meningioma grades between cohorts (p=0.11). Upon re-grading, 21 cases (3.9%) were changed. ICC between original and revised grade was 0.92 (95% CIs: 0.91-0.93). Amongst Grade 2 meningiomas with brain invasion, 75.8% had three or more atypical histologic features or an elevated mitotic index. Conclusions: Brain invasion alone has minimal impact on the incidence or distribution of specific meningioma grade tumors, likely due to cosegregation of grade elevating features.
A.5 Neuropathology of eight cases of the New Brunswick cluster of Neurological Syndrome of Unknown Cause (NSUC)
Authors: Jansen GH , Miller AK , Easton AS , Woulfe JM
Published: June 2022

Background: In March 2021, at a press conference, the presence of a cluster of patients, claimed to have a novel neurological syndrome, was announced in New Brunswick. These patients were suggested to have symptoms reminiscent of CJD. The onset of disease was between 2015 and 2021. The size of this cluster has been reported as approximately 50 cases. Further news publications have suggested that various environmental factors were causing this disease. Methods: Between 2019 and 2021 eight patients have died in this cluster. Their neuropathological findings are reported here. Results: There was one case of metastatic carcinoma, one case of FTLD-TDP43, one case of neocortical Lewy body pathology, one case of neocortical Lewy body pathology and AD, 2 cases of AD with vascular pathology, one case of mainly vascular pathology, and one case without significant pathology (consistent with patient’s history). In all these patients no evidence for a prion disease was found, nor novel pathology. Conclusions: We suggest that these 8 patients represent a group of misclassified clinical diagnoses. Classical probability theorem based statistical evaluation shows that this group of deceased patients is representative for the entire cluster at a p=0.0001 level, which would suggest that the entire cluster is based on misdiagnoses.
Migration, authority and the gendered organization of labour in artisanal gold mining in Sierra Leone (and Mozambique)
Authors: Rutherford Blair
Published: June 2022

Recent studies of migration into artisanal and small-scale mining (ASM) have explored the motivations, strategic agency and professional trajectories of women and men miners who move to mine. In this article, I seek to shift the focus from the ‘push/pull’ factors in migration to consider the varied entanglements of mobility with authority and power relations pervasive through rural institutions. The importance – or lack of importance – of being a ‘migrant’ in these mining sites rests largely on the particular gendered cultural politics shaping livelihoods in the area. Drawing principally on ethnographic research in Tonkolili District, Sierra Leone, this article examines how migrant status for men and women working in the gold sites who came from other parts of the country is more marked than for Zimbabwean migrants working in artisanal gold mines in Manica, Mozambique. I argue that migrant status is marked by various authority and power relations in artisanal gold-mining sites when those controlling access to mining livelihoods, including access to residency in the mining communities, are able to emphasize contingent forms of belonging by migrants compared with those defined as ‘locals’. Critical to these differential forms of valuation is the particular organization of labour.
‘Why invite her here? Her voice is ʿawra!’: vocal nudity debates and Muslim female preachers in northern Nigeria
Authors: Muazu Rahina
Published: June 2022

This article analyses the debates surrounding the ʿawra (nudity or nakedness in Arabic) of the female voice – what I call here vocal nudity – and the public presence of the female voice in Nigeria. It focuses on the preaching activities of two Muslim female preachers, Malama Khadija Gambo Hawaja and Malama Dr Zahrau Muhammad Umar, who present tafsīr (Qurʾanic interpretation; Hausa: tafsīrin azumi) to the public during Ramadan and rose to prominence through the publicity of their audio and video sessions and fatwas offered to women. I discuss their interpretation of verse 33.32, the only verse that refers to the female voice in the Qurʾan, their understanding of vocal nudity, and how they use the interpretations to reshape the concept of a righteous woman (Hausa: mace ta gari) in twenty-first-century Muslim West Africa.
Strong Equivalence of Logic Programs with Counting
Authors: LIFSCHITZ VLADIMIR
Published: June 2022

In answer set programming, two groups of rules are considered strongly equivalent if they have the same meaning in any context. In some cases, strong equivalence of programs in the input language of the grounder gringo can be established by deriving rules of each program from rules of the other. The possibility of such proofs has been demonstrated for a subset of that language that includes comparisons, arithmetic operations, and simple choice rules, but not aggregates. This method is extended here to a class of programs in which some uses of the #count aggregate are allowed.
‘It was like the unicorn of the therapeutic world’: CBT trainee experiences of acquiring skills in guided discovery
Authors: Roscoe Jason , Bates Elizabeth A. , Blackley Rhiannon
Published: June 2022

Training as a cognitive behavioural therapist involves a considerable role transition for mental health professionals where they are expected to demonstrate competence in a range of new skills that emphasise collaboration and Socratic dialogue. This can be in stark contrast to the more didactic style that trainees are familiar with prior to embarking on their training. Guided discovery (GD) is an integral part of formulation and treatment, yet little is known at present about the experiences of cognitive behavioural therapy (CBT) trainees when learning this new skill; specifically, how they assimilate this with existing ways of working and the challenges this might involve. This research is a preliminary attempt to understand factors that help and hinder GD skill acquisition. Eighteen trainee CBT practitioners completed an online questionnaire with the subsequent data analysed using a grounded theory methodology. Three themes were identified: ‘Competing Selves’, ‘Style’ and ‘Active Engagement and Learning’. These themes were used to develop a preliminary model of factors that enable or inhibit skills in GD. The impact of previous professional roles appears to influence the acquisition of confidence and skill in GD. This paper discusses the implications of the findings for CBT trainers, supervisors and trainees.

Key learning aims

As a result of reading this paper, readers should:

(1)

Understand how trainee cognitive behavioural therapists respond to learning how to use guided discovery.

(2)

Identify potential barriers to acquiring and improving skills in guided discovery.

(3)

Recognise training strategies that might assist trainees in becoming more proficient in guided discovery.
Do Physicians Prefer Natural Drugs?
Authors: Lappas Courtney M. , Coyne Nicholas , Dillard Amanda J. , Meier Brian P.
Published: June 2022

Abstract. Background: There is a bias for natural versus synthetic drugs in general populations. Aims: We investigated whether physicians who have advanced medical and scientific training and routinely prescribe drugs exhibit this bias. Methods: Physicians and non-physicians were presented with a hypothetical medical situation in which pharmacological therapy was required. Participants were asked if they would prefer a natural or synthetic drug for treatment. Physicians were also asked which drug they would prescribe to a patient. Results: In a forced-choice paradigm, non-physicians (87.5%) and physicians (79.2%) had an equally strong bias for the natural drug, with physicians (74.3%) also preferring the natural drug for patients. When a 9-point drug choice scale was used, including a “no preference” choice (5), non-physicians ( M = 6.91) and physicians ( M = 5.41) again showed a preference for the natural drug compared to the mid-point of the scale, but the non-physicians’ bias was stronger. Physicians no longer preferred the natural drug for patients ( M = 5.15). Limitations: The participants do not represent a random sample and therefore may not represent physicians/non-physicians in general. Additionally, the responses were hypothetical and may not represent behavior in actual medical contexts. Conclusion: These data indicate that physicians and non-physicians exhibit a bias for natural drugs, with physicians also demonstrating a bias for prescribing natural drugs. However, the bias is reduced in physicians compared to non-physicians when a “no preference” option is available, suggesting that advanced medical and/or scientific training may be beneficial in minimizing this bias.
Investigating the Changes in Periodicity of the CO2‐Driven Cold‐Water Geyser Eruptions Through Field Observation at Tenmile Geyser, Utah
Authors: Piao Jize , Han Weon Shik , Han Gidon , Kim Kue‐Young , Yun Tae Kwon , Hwang Jeonghwan , Kim Taehoon , Park Eungyu
Published: June 2022

CO2‐driven cold‐water geysers periodically ejecting cold water are rare. Although coalescence and expansion of ascending CO2 bubbles can explain the eruption process, the triggering conditions and eruption cycle remain unclear. To clarify the triggering conditions, hydrostatic pressure in the well was decreased by pumping to induce eruptions. All four pumping tests successfully induced eruptions by decreasing the pressure of ∼104 Pa. In the absence of artificial perturbations, similar reductions in pressure were observed during the intervals between two consecutive eruptions (IBEs). During IBE, the atmospheric pressure (Pair) and temperature (Tair) controlled the generation of the CO2 bubbles which directly induced the pressure reduction in the well. Especially under the persistent low Pair and high Tair, the length of IBE showed a minimum value of 3.90 hr during field observations. We suggest that the atmospheric perturbations are the causes of the changes in geyser periodicity, given consistent geological and hydraulic conditions.
Bridgmanite Freezing in Shocked Meteorites Due To Amorphization‐Induced Stress
Authors: Nishi M. , Kaneko A. , Ohgidani H. , Dekura H. , Kakizawa S. , Kawaguchi S. , Kobayashi S. , Sakaiya T. , Kondo T.
Published: June 2022

Bridgmanite, the most abundant mineral in the Earth's lower mantle, can be found in meteorites that experienced instantaneous high shock pressure during parent body impact. However, the presence of bridgmanite in meteorites is unusual because bridgmanite grains should be amorphized under residual post‐shock temperatures at ambient pressure. Here, we report the results of time‐resolved synchrotron X‐ray diffraction measurements at high temperatures to analyze the amorphization mechanisms and kinetics of bridgmanite. The thermal expansion coefficient of bridgmanite before the amorphization is 2.1 × 10−5 K−1. At higher temperatures, our results show that the significant volume expansion due to the amorphization induces static stress that can reach up to ∼0.5 GPa, which prevents the progress of the amorphization. This time‐insensitive amorphization kinetics may have enabled the preservation of bridgmanite in the shocked meteorite that fell on Earth. Also, the reaction progress estimated based on the amorphous fraction provides the residual post‐shock temperature.
Obesity and brain structure in schizophrenia – ENIGMA study in 3021 individuals
Authors: McWhinney Sean R. , Brosch Katharina , Calhoun Vince D. , Crespo-Facorro Benedicto , Crossley Nicolas A. , Dannlowski Udo , Dickie Erin , Dietze Lorielle M. F. , Donohoe Gary , Du Plessis Stefan , Ehrlich Stefan , Emsley Robin , Furstova Petra , Glahn David C. , Gonzalez- Valderrama Alfonso , Grotegerd Dominik , Holleran Laurena , Kircher Tilo T. J. , Knytl Pavel , Kolenic Marian , Lencer Rebekka , Nenadić Igor , Opel Nils , Pfarr Julia-Katharina , Rodrigue Amanda L. , Rootes-Murdy Kelly , Ross Alex J. , Sim Kang , Škoch Antonín , Spaniel Filip , Stein Frederike , Švancer Patrik , Tordesillas-Gutiérrez Diana , Undurraga Juan , Vázquez-Bourgon Javier , Voineskos Aristotle , Walton Esther , Weickert Thomas W. , Weickert Cynthia Shannon , Thompson Paul M. , van Erp Theo G. M. , Turner Jessica A. , Hajek Tomas
Published: June 2022

Schizophrenia is frequently associated with obesity, which is linked with neurostructural alterations. Yet, we do not understand how the brain correlates of obesity map onto the brain changes in schizophrenia. We obtained MRI-derived brain cortical and subcortical measures and body mass index (BMI) from 1260 individuals with schizophrenia and 1761 controls from 12 independent research sites within the ENIGMA-Schizophrenia Working Group. We jointly modeled the statistical effects of schizophrenia and BMI using mixed effects. BMI was additively associated with structure of many of the same brain regions as schizophrenia, but the cortical and subcortical alterations in schizophrenia were more widespread and pronounced. Both BMI and schizophrenia were primarily associated with changes in cortical thickness, with fewer correlates in surface area. While, BMI was negatively associated with cortical thickness, the significant associations between BMI and surface area or subcortical volumes were positive. Lastly, the brain correlates of obesity were replicated among large studies and closely resembled neurostructural changes in major depressive disorders. We confirmed widespread associations between BMI and brain structure in individuals with schizophrenia. People with both obesity and schizophrenia showed more pronounced brain alterations than people with only one of these conditions. Obesity appears to be a relevant factor which could account for heterogeneity of brain imaging findings and for differences in brain imaging outcomes among people with schizophrenia.
Aberrant APOBEC3C expression induces characteristic genomic instability in pancreatic ductal adenocarcinoma
Authors: Qian Yunzhen , Gong Yitao , Zou Xuan , Liu Yu , Chen Yusheng , Wang Ruijie , Dai Zhengjie , Tasiheng Yesiboli , Lin Xuan , Wang Xu , Luo Guopei , Yu Xianjun , Cheng He , Liu Chen
Published: June 2022

Pancreatic ductal adenocarcinoma (PDAC) is a well-known lethal and heterogeneous disease. Apolipoprotein B mRNA-editing enzyme catalytic polypeptide-like (APOBEC) is an important mutagenic driver that has seldom been investigated in PDAC. Therefore, this study investigated the significance of APOBEC3C in PDAC. First, cytosine deamination-associated mutation signatures were identified in the PDAC cohorts from TCGA and Fudan University Shanghai Cancer Center (FUSCC) datasets, and C > X-enriched kataegis regions were identified in the FUSCC cohort (12 to 27 counts per sample). Patients were stratified according to APOBEC3C expression, and high APOBEC3C expression was found to correlate with a higher motif enrichment score of 5’-CC-3’ and an elevated kataegis count within PCSK5 and NES genes. Second, we compared APOBEC expression in PDAC and normal pancreatic tissues and found that APOBEC3C was substantially upregulated in PDAC. APOBEC3C-overexpressing cell lines were generated to substantiate the effects of APOBEC3C on PDAC genome, including alterations in single-nucleotide variant (SNV) classes (higher proportion of C > T conversions) and the formation of kataegis regions (newly occurring kataegis regions detected in ACHE and MUC6 genes). Three different PDAC cohorts (FUSCC, TCGA, and QCMG) were analysed to evaluate the prognostic value of APOBEC3C, and APOBEC3C overexpression predicted shorter survival. Finally, the APOBEC3C overexpression correalted with the PDAC tumour microenvironment (TME) remodelling, APOBEC3C expression was associated with the invasion of CD4 + T lymphocytes and CD8 + T lymphocytes (cytotoxic T lymphocytes, CTLs), indicating enhanced immune activity and validating the practicality of APOBEC3C for guiding immunotherapy.
A multiparametric niche-like drug screening platform in acute myeloid leukemia
Authors: Dal Bello Reinaldo , Pasanisi Justine , Joudinaud Romane , Duchmann Matthieu , Pardieu Bryann , Ayaka Paolo , Di Feo Giuseppe , Sodaro Gaetano , Chauvel Clémentine , Kim Rathana , Vasseur Loic , Chat Laureen , Ling Frank , Pacchiardi Kim , Vaganay Camille , Berrou Jeannig , Benaksas Chaima , Boissel Nicolas , Braun Thorsten , Preudhomme Claude , Dombret Hervé , Raffoux Emmanuel , Fenouille Nina , Clappier Emmanuelle , Adès Lionel , Puissant Alexandre , Itzykson Raphael
Published: June 2022

Functional precision medicine in AML often relies on short-term in vitro drug sensitivity screening (DSS) of primary patient cells in standard culture conditions. We designed a niche-like DSS assay combining physiologic hypoxia (O2 3%) and mesenchymal stromal cell (MSC) co-culture with multiparameter flow cytometry to enumerate lymphocytes and differentiating (CD11/CD14/CD15+) or leukemic stem cell (LSC)-enriched (GPR56+) cells within the leukemic bulk. After functional validation of GPR56 expression as a surrogate for LSC enrichment, the assay identified three patterns of response, including cytotoxicity on blasts sparing LSCs, induction of differentiation, and selective impairment of LSCs. We refined our niche-like culture by including plasma-like amino-acid and cytokine concentrations identified by targeted metabolomics and proteomics of primary AML bone marrow plasma samples. Systematic interrogation revealed distinct contributions of each niche-like component to leukemic outgrowth and drug response. Short-term niche-like culture preserved clonal architecture and transcriptional states of primary leukemic cells. In a cohort of 45 AML samples enriched for NPM1c AML, the niche-like multiparametric assay could predict morphologically (p = 0.02) and molecular (NPM1c MRD, p = 0.04) response to anthracycline-cytarabine induction chemotherapy. In this cohort, a 23-drug screen nominated ruxolitinib as a sensitizer to anthracycline-cytarabine. This finding was validated in an NPM1c PDX model.
Responsive photonic alginate hydrogel particles for the quantitative detection of alkaline phosphatase
Authors: Wang Yuetong , Zhang Dagan , Zhang Hui , Shang Luoran , Zhao Yuanjin
Published: June 2022

Alkaline phosphatase (ALP) is an important marker for many diseases, yet an efficient and reliable detection method is still lacking. Here, we present a novel photonic alginate hydrogel particle as an ALP sensor based on the competitive combination of an intermediary agent, the pyrophosphate ion (PPi), with a hydrogel crosslinker, which can trigger a phase-transition response from the hydrogel. This response can be converted into dual optical readouts, a fluorescence signal and a structural color signal. Quantitative determination of ALP was established based on this dual-indicator system with high accuracy and reliability. These features suggest potential ideal applications of responsive photonic hydrogel particles to detect ALP and other macromolecules.