bluuebunny/crossref_metadata_2025 huggingface dataset:
Flexible, Photonic Films of Surfactant‐Functionalized Cellulose Nanocrystals for Pressure and Humidity Sensing
Authors: Saraiva Diogo V. , Remiëns Steven N. , Jull Ethan I. L. , Vermaire Ivo R. , Tran Lisa
Published: May 2024

Most paints contain pigments that absorb light and fade over time. A robust alternative can be found in nature, where structural coloration arises from the interference of light with submicron features. Plant‐derived, cellulose nanocrystals (CNCs) mimic these features by self‐assembling into a cholesteric liquid crystal that exhibits structural coloration when dried. While much research has been done on CNCs in aqueous solutions, less is known about transferring CNCs to apolar solvents that are widely employed in paints. This study uses a common surfactant in agricultural and industrial products to suspend CNCs in toluene . Surprisingly, a stable liquid crystal phase is formed within hours, even with concentrations of up to 50 wt%. Evaporating the apolar CNC suspensions results in photonic films with peak wavelengths ranging from 660 to 920 nm. The resulting flexible films have variable mechanical properties with surfactant content, allowing for an optical response with applied force. The films also act as humidity sensors, with increasing relative humidity swelling the films, yielding a redshift in the reflected wavelength. With the addition of a single surfactant, CNCs can be made compatible with existing production methods of industrial coatings, while improving the strength and responsiveness of structurally colored films to external stimuli.
Passive confinement of reinforced concrete members revisited
Authors: Morger Fabian , Kenel Albin , Kaufmann Walter
Published: May 2024

Passive confinement provided by transverse reinforcement is taken into account in the design of reinforced concrete structures subjected to high compressive loading such as columns, piers, or tunnel lining segments. In current guidelines, several models exist to account for this beneficial effect. However, these approaches lack mechanical consistency regarding the three‐dimensional load dispersion of the confining forces. The article addresses this knowledge gap by introducing a new model based on a lower‐bound solution according to the theory of plasticity, along with a simplification regarding the governing confined concrete area. The proposed model and its simplified version are compared to the design approaches proposed by current guidelines, and both are successfully validated against experimental data. The simplified new model is a valuable alternative to existing models in current guidelines, as (i) it is mechanically more consistent, (ii) its application is more straightforward, and (iii) it allows the comprehensive treatment of rectangular and circular cross‐sections using the same equations.
Graphene oxide dots‐loaded chitin flask: A sustainable adsorbent for separating multiple dyes from water
Authors: Mishra Priyanka Priyadarsini , Das Pratik , Paul Sukarna , Das Piyali , Manna Suvendu , Basak Piyali , Das Nigamananda , Behera Ajaya Kumar
Published: May 2024

This research endeavors to comprehensively explore the sorption dynamics of dyes from aqueous solutions utilizing a graphene oxide‐chitin (GO‐chitin) biosorbent. The investigation systematically evaluates the influence of key parameters, including temperature, pH, duration of contact, and initial dye doses, on the sorption efficiency of the biosorbent. Results obtained indicated that at acidic pH range, the dye removal efficacy was more than 80% for methyl orange and Remazol Brilliant Blue. Maximum removal efficacy was achieved within the 30 min of adsorption studies. Notably, the study underscores the remarkable adsorption capacity of GO‐chitin, varies in the range of 75% and 95%, for all three dyes, positioning it as a highly promising material for the remediation of polluted aquatic environments. The adsorption follows pseudo‐second‐order kinetics and Freundlich isotherm. These findings contribute valuable insights into the potential application of GO‐chitin as an effective biosorbent in the context of wastewater treatment, emphasizing its role in addressing environmental challenges associated with dye contamination in aqueous systems.
Climate concepts for supporting political goals of mitigation and adaptation: The case for “climate crisis”
Authors: Haueis Philipp
Published: May 2024

Climate concepts are crucial to understand the effects of human activity on the climate system scientifically, and to formulate and pursue policies to mitigate and adapt to these effects. Yet, scientists, policymakers, and activists often use different terms such as “global warming,” “climate change,” “climate crisis,” or “climate emergency.” This advanced review investigates which climate concept is most suitable when we pursue mitigation and adaptation goals in a scientifically informed manner. It first discusses how survey experiments and social science reviews on climate frames draw normative recommendations about which terms to use for public climate communication. It is suggested that such normative claims can be refined by including the scientific alongside lay uses of a climate concept, and by using explicit assessment conditions to evaluate how suitable a concept is for formulating mitigation and adaptation goals. Drawing on philosophical theories of conceptual change in science and conceptual engineering, a novel framework with two assessment conditions is introduced and then applied to “global warming,” “climate change,” “climate emergency,” and “climate crisis.” The assessment suggests that currently, “climate crisis” is most suitable to formulate and pursue climate mitigation and adaptation goals. Using this concept promotes the epistemic goals of climate science to a high degree, bridges scientific, political, and activist discourse, and fosters for democratic participation when articulating climate policies.

This article is categorized under:

The Social Status of Climate Change Knowledge > Climate Science and Decision Making

The Social Status of Climate Change Knowledge > Knowledge and Practice

Perceptions, Behavior, and Communication of Climate Change > Communication
Unicorn paradox: Understanding undergraduate Black men's leader identity, capacity, and efficacy
Authors: Spencer Dorsey , Beatty Cameron C. , Allen Johnnie , Robinson Darius
Published: May 2024

This study highlights opportunities for developing programs and initiatives to assist Black men in understanding leadership and seeing themselves as leaders, and for decreasing low college retention and persistence rates. The themes from this qualitative narrative inquiry highlight leader identity, capacity, and efficacy for undergraduate Black men. Narrative inquiry was appropriate for this study because the researchers sought to better understand how Black undergraduate male student leaders make meaning of their experience in higher education related to their comprehension of leadership and identity as leaders.
Moving away from willful ignorance: A critical whiteness examination of leadership educator socialization
Authors: Wagner Anna
Published: May 2024

In the face of calls for the standardization and professionalization of leadership education, a sub‐field in higher education, it is important to understand who leadership educators are and how they come to understand themselves as belonging to this sub‐field. Recent critiques have arisen about the overwhelming whiteness that permeates the knowledge accepted within leadership education. To be cognizant of that critical perspective, this article applies the critical whiteness studies framework to analyze existing literature about leadership educator identity and socialization. It concludes with recommendations for the field of education to implement in order to combat the impact of whiteness on the field of leadership education.
Relative lengths of Maltsev conditions
Authors: Lipparini Paolo
Published: May 2024

We solve some problems about relative lengths of Maltsev conditions, in particular, we provide an affirmative answer to a classical problem raised by A. Day more than 50 years ago. In detail, both congruence distributive and congruence modular varieties admit Maltsev characterizations by means of the existence of a finite but variable number of appropriate terms. A. Day showed that from Jónsson terms $$t_0,\ldots , t_n$$

t
0

,
…
,

t
n

witnessing congruence distributivity it is possible to construct terms $$u_0,\ldots , u _{2n-1} $$

u
0

,
…
,

u

2
n
-
1

witnessing congruence modularity. We show that Day’s result about the number of such terms is sharp when n is even. We also deal with other kinds of terms, such as alvin, Gumm, directed, as well as with possible variations we will call “specular” and “defective”. All the results hold when restricted to locally finite varieties.
Mathematical explanations for knee osteotomies: “Dear engineer, how would you explain it in a simple way?”
Authors: Bechis Marco , Rosso Federica , Verocq Marie , Innocenti Bernardo , Rossi Roberto , Bonasia Davide Edoardo
Published: May 2024

Introduction

Knee osteotomies are effective procedures to treat different deformities and to redistribute the load at the joint level, reducing the risk of wear and, consequently, the need for invasive procedures. Particularly, knee osteotomies are effective in treating early arthritis related to knee deformities in young and active patients with high functional demands, with excellent long-term results. Precise mathematical calculations are imperative during the preoperative phase to achieve tailored and accurate corrections for each patient and avoid complications, but sometimes those formulas are challenging to comprehend and apply.

Methods

Four specific questions regarding controversial topics (planning methods, patellar height, tibial slope, and limb length variation) were formulated. An electronic search was performed on PubMed and Cochrane Library to find articles containing detailed mathematical or trigonometrical explanations. A team of orthopedic surgeons and an engineer summarized the available Literature and mathematical rules, with a final clear mathematical explanation given by the engineer. Wherever the explanation was not available in Literature, it was postulated by the same engineer.

Results

After the exclusion process, five studies were analyzed. For three questions, no studies were found that provided mathematical analyses or explanations. Through independent calculations, it was demonstrated why Dugdale's method underestimates the correction angle compared to Miniaci's method, and it was shown that the variation in patellar height after osteotomy can be predicted using simple formulas. The five included studies examine postoperative variations in limb length and tibial slope, providing formulas applicable in preoperative planning. New formulas were independently computed, using the planned correction angle and preoperatively obtained measurements to predict the studied variations.

Conclusions

There is a strict connection among surgery, planning, and mathematics formulas in knee osteotomies. The aim of this study was to analyze the current literature and provide mathematical and trigonometric explanations to important controversial topics in knee osteotomies. Simple and easy applicable formulas are provided to enhance the accuracy and outcomes of this surgical procedure.
Geschlechtsspezifische Aspekte bei Asthma bronchiale
Authors: Löffler-Ragg Judith , Idzko Marco
Published: May 2024

Geschlechtsspezifische Aspekte beim Asthma bronchiale wurden vorwiegend hinsichtlich biologischer Faktoren untersucht und weisen auf deutliche Unterschiede in den hormonellen Lebensphasen, sind aber nicht in allen Studien konsistent zu finden. Während die Prävalenz von Asthma im Kindes- und Teenageralter bei Jungen höher scheint, führt der Frauenanteil im Erwachsenenalter. Frauen scheinen häufiger einen schwereren Asthmaphänotyp mit erhöhter Mortalität zu haben. Adipositas und gastroösophagealer Reflux sind dabei häufigere Begleiterkrankungen bei Frauen vs. Männer. Zahlreiche Beobachtungsstudien deuten auf hormonabhängige, zyklische Schwankungen der Asthmakontrolle und damit assoziierte Inanspruchnahme von medizinischen Leistungen. In der Schwangerschaft ist Asthma bronchiale die häufigste Ursache von Atembeschwerden, und eine gute Therapieführung ist hierbei entscheidend für Mutter und Kind. Die Transition in die Menopause geht allgemein mit einem beschleunigten FEV1(Einsekundenkapazität)-Verlust bei Frauen und mit erhöhter Exazerbationsrate von Frauen mit Asthma einher. Der Stellenwert von Hormonersatztherapie ist hierbei noch unklar. Zusammengefasst dürften hormon- und genderabhängige Faktoren geschlechtsspezifische Unterschiede bei Asthma bronchiale bedingen. Letztere werden noch kaum in Studien berücksichtigt, und klare mechanistische Evidenz fehlt noch weitgehend.
Mean platelet volume might be an effective indicator of poor semen quality in varicocele patients
Authors: Mei Yangyang , Xie Pinpeng , Liu Dalu , Zhang Bo , Feng Xingliang
Published: May 2024

Objective

To delve into the relationship between mean platelet volume (MPV) and semen quality in patients with varicocele.

Materials and methods

A total of 246 varicocele patients and 120 healthy adult males were enrolled. Physical examinations and the color Doppler ultrasonography were conducted on patients with varicocele to confirm the diagnosis. Venous blood samples and semen samples were collected from all participants for subsequent analysis. A series of statistical analyses were conducted to assess the relationship between their MPV levels and semen quality. A series of statistical analyses were performed to assess the relationship between MPV and semen quality.

Results

No statistically significant differences were found between body mass index (BMI), sexual hormones, semen volume, platelet count, and right testicular volume in all three groups (health subjects, varicocele without symptoms, and varicocele with infertility). When conducting regression analysis on two groups with varicocele, the results indicated that a lower MPV is associated with a reduced risk of varicocele accompanied by infertility (OR = 0.557 95% CI: 0.432–0.719, P < 0.001). Further correlation analysis in varicocele patients revealed that high MPV had a statistically negative impact on the occurrence of poor semen quality, affecting sperm concentration, progressive motility, and morphology (all P < 0.001). More importantly, when predicting varicocele associated with infertility, MPV demonstrated high diagnostic sensitivity (AUC = 0.745, P < 0.001).

Conclusion

Our results indicate that MPV is higher in varicocele with infertility and is closely related to semen quality, which may suggest an accompanying decline in semen quality associated with varicocele. However, these conclusions require further experimental validation.
Gesundheitskompetentes Handeln von chronisch kranken Jugendlichen und jungen Erwachsenen in berufsbildenden Settings ermöglichen: ein typenbildendes Verfahren
Authors: Michele Janine , Gillen Julia
Published: May 2024

Hintergrund

Junge Erwachsene mit chronischen Erkrankungen sind in der Ausgestaltung von institutionellen Rahmenbedingungen in berufsbildenden Kontexten bisher kaum berücksichtigt. Gleichzeitig benötigen sie abseits von beruflichen Handlungskompetenzen jedoch auch entsprechende Gesundheitskompetenzen, um mit der eigenen Erkrankung in berufsbezogenen Kontexten adäquat umzugehen.

Ziel

Auf der Basis von typenbildend herausgearbeiteten Performanzformen werden Implikationen aufgezeigt, anhand derer es auf organisationaler Ebene ermöglicht werden kann, Voraussetzungen für gesundheitskompetentes Verhalten zu schaffen sowie individuelle Gesundheitskompetenzen in berufsbildenden Kontexten zu fördern.

Methodik

Es wurden 12 biographische Interviews mit chronisch erkrankten jungen Erwachsenen (Epilepsie und Diabetes mellitus Typ 1) geführt und anhand der dokumentarischen Methode typenbildend analysiert. Der rekonstruktive Forschungsansatz ermöglicht sowohl die Einbindung lebensweltspezifischer Perspektiven als auch die interdisziplinäre Verzahnung gesundheitswissenschaftlicher und berufspädagogischer Forschungsansätze.

Ergebnisse und Schlussfolgerung

Für ausbildungs- und berufsbezogene Kontexte lassen sich vier Performanzformen als Ausdruck von Gesundheitskompetenz differenzieren. Darüber hinaus wurden Faktoren abgeleitet, die als Gelingensbedingungen auf individueller und struktureller Ebene fungieren. Diese können wiederum zum Anlass genommen werden, um berufsbildende Settings entsprechend gesundheitskompetenzförderlich zu gestalten.
Monetary rewards and hierarchy level as drivers of employees’ self-evaluations
Authors: Grund Christian , Soboll Alexandra
Published: May 2024

We explore the relation between job characteristics and employees’ self-evaluations of performance in comparison to their colleagues’ performance. Using unique individual panel data from ten large firms in Germany’s chemical industry, we focus on monetary rewards (wage increases and bonus payments) and the level of the hierarchy as well as interactions with gender and tenure as possible drivers of self-evaluations. Our results hint for a positive relation of both monetary rewards and hierarchy level with self-evaluations. We find less evidence for our hypotheses regarding interaction effects of gender and tenure.
Ageing in Place: Older People Identify Barriers to Remaining in Low-Density Areas
Authors: Nossa Paulo , Pereira Sofia Vale , Lima Margarida , Vieira Cristina C. , Mota-Pinto Anabela
Published: May 2024

Studies involving older people as co-investigators are limited in Portugal. The main objectives of this article are: (I) Analyze the barriers identified by older people living in low-density territories that pose a challenge to ageing in place. (ii) Understand the co-research methodology as an appropriate instrument for increasing the participatory capacity of older people and improving the conditions for ageing in place. (iii) Assess the role of social networks and community support in providing informal assistance to older people in low-density territories. The study involved 14 co-researchers, who had a balanced gender representation and an average age of 64.5 years. All the co-researchers were residents of the study location and volunteered for the research. They were provided training in interview techniques and active listening, prior to the study. A total of three interviews and 23 photographs were analyzed and discussed in five focus group meetings. The participants agreed upon four types of unmet needs and developed proposals to increase their negotiating power, thereby mitigating barriers to their permanence. The co-researchers presented their proposals at two public meetings with decision-makers, managers, and members of the municipal council. The findings were a significant addition to the promotion of the co-research approach and the engagement of older adults in detecting the obstacles that hinder their secure and independent aging in their living environment.
Sponge-associated microbes in the twilight zone of Curaçao
Authors: Cleary D. F. R. , van Bendegom D. J. , Gomes N. C. M. , de Voogd N. J.
Published: May 2024

Mesophotic reefs, located in the "Twilight Zone" of the ocean, are coral reefs that exist in relatively deep waters ranging from approximately 30 to 150 m below the surface. These reefs are situated just beyond the reach of conventional SCUBA diving and are typically explored using advanced diving techniques or with the aid of submersibles. In the present study, we used a state-of-the-art submersible to sample 26 sponge specimens belonging to 11 species. High (HMA) or low (LMA) microbial abundance status was assigned to species based on TEM imagery. Prokaryotic communities associated with these sponges were, furthermore, assessed using high-throughput sequencing. Proteobacteria, Chloroflexi, Actinobacteriota, and Acidobacteriota were the most abundant phyla overall. HMA/LMA status proved to be a highly significant predictor of prokaryotic composition. HMA sponges also tended to be more diverse in terms of richness and evenness than LMA sponges. 14 predictor-classes were identified using an exploratory technique based on machine learning including classes within the phyla Chloroflexi (e.g., Dehalococcoidia and JG30-KF-CM66) and Acidobacteriota (Thermoanaerobaculia and Subgroups 11 and 21). Previous studies have demonstrated the prevalence of the HMA/LMA dichotomy in shallow waters and, recently, the deep sea. Our results demonstrate its prevalence in the mesophotic realm.
Heidegger on Eastern/Asian Thought
Authors: Ma Lin
Published: May 2024

This Element elucidates the metamorphoses of Heidegger's comportment toward Eastern/Asian thought from the 1910s to the 1960s. With a view to the many meanings of the East at play in Heidegger's thinking, it considers how his diversified 'dialogues' with the East are embedded in different phases of his Denkweg. Various themes unexplored previously are examined: Heidegger's early treatment of near Eastern traditions and Islamic philosophy, his views on alien cultures, the 'primitive Dasein' and the 'mythical Dasein,' and his meditation on Russianism's deeply rooted spirituality and its recuperative possibilities for the West. Finally, this Element reveals how Heidegger opened the promise of a dialogue with the East and yet stepped back from the threshold, and how his move from the Occidental line of philosophizing toward the Oriental line is integral to his shift from the guiding question of “Being” to the abyssal question of 'Beyng.'
Creature Features: Character Production and Failed Explanations in Fiction, Folklore, and Theorizing
Authors: Tillman Chris , Spencer Joshua
Published: May 2024

Fictional realism is the view that creatures of fiction exist. Mythical realism is the view that creatures of myth and mistaken theories exist. Call the combined view “Ecumenical Realism.” We critically evaluate three arguments for Ecumenical Realism and argue they are unsound because fictional storytelling differs from mistaken theorizing in important ways. We think these considerations support a more conservative view, “Sectarian Realism,” which results from subtracting “creatures of mistaken theorizing” from Ecumenical Realism. We close by considering an important challenge to Sectarian Realism involving immigrants in fiction.
F.4 Anatomical assessment and comparative analysis of ventricular access points in pterional approach: a cadaveric study
Authors: Cikla U , Baskaya MK
Published: May 2024

Background: In early-stage transsylvian aneurysm surgery, achieving brain relaxation is crucial for the safe exposure of aneurysms; however, in cases of tight, hemorrhagic brains, ventricular drainage is often required. Although Paine/Samson initially proposed a ventricular access point in the frontal horn of the lateral ventricle, and numerous points and techniques have been described since, their consistency and success rates have not undergone rigorous evaluation through comparative cadaveric anatomical studies. Methods: We injected 2 cc agar-agar solutions with distinct colors into the lateral ventricles of twelve cadaveric brains, utilizing four described points, followed by refrigeration at 4°C for one hour for each injection. Next, the brains were sectioned in the coronal plane at 2 cm intervals for evaluation. We assessed the efficacy of the injections in reaching the ventricles and measured the ventricular dimensions, in addition to calculating the Evans’ index for each brain. Results: Injections at Paine/Samson’s point achieved a 100% success rate, followed by Hyunn’s point with a 91.6% success rate. The success rates at Temporal point and Park point were 83.3% and 58.3%, respectively. Conclusions: We emphasize the significance of direct ventricle puncture technique and our findings indicate that the classical Paine/Samson point is the most reliable among the evaluated methods.
P.007 Role of neuroimaging in headache management; are we following the guidelines?
Authors: Sajid A , Douen AG
Published: May 2024

Background: Healthcare systems incur a significant financial burden through unnecessary neuroimaging, which globally, is in the order of the billions of dollars. Current recommendations suggest avoiding neuroimaging in patients with stable headaches, particularly those meeting the criteria for migraine. Methods: We conducted a retrospective chart review of 100 headache patients in an outpatient neurology clinic. We evaluated the use of CT and MRI imaging and the impact of neuroimaging on clinical management. Results: 55% of patients had a history of migraine. Overall, 74 of 100 patients had either CT or MRI imaging. Imaging was largely normal or identified non-specific, clinically irrelevant findings. There was 1 case of a cerebellopontine angle epidermoid tumor and another of suspected MS. Neuroimaging did not alter headache management. Conclusions: The data is consistent with current guidelines suggesting that neuroimaging is not necessary in patients with stable headaches, particularly migraine. Neuroimaging overuse might reflect lack of awareness of guideline recommendations, insecurity over diagnoses, medicolegal concerns, as well as patients and primary practitioners’ expectations. Resources to help improve public and physician awareness regarding neuroimaging use in patients with stable headache may help reduce unwarranted imaging studies and could have significant financial savings for healthcare systems.
P.008 Spontaneous retropulsion in autopsy verified PSP
Authors: Das J , Rajput A , Rajput A , Kim M , Noyes E
Published: May 2024

Background: Postural instability is a common symptom of progressive supranuclear palsy (PSP). Retropulsion is one form of postural instability. Spontaneous retropulsion involves loss of balance without external provocation. Others have reported on retropulsion in the clinical setting while testing for postural instability but rates of spontaneous retropulsion in the community have not been described. This study examines the prevalence of spontaneous retropulsion in PSP. Methods: A retrospective chart review examined 60 patients from the Saskatchewan Movement Disorders Program with clinical and pathology-confirmed diagnosis of PSP. We identified patients who endorsed spontaneous retropulsion. The data was analysed with univariate logistic regression. Results: The study included 43 males and 17 females. Spontaneous retropulsion was reported in 18 (30%) patients. Among the variables, only sex showed a statistical significance (p = 0.0184) with females more likely to report spontaneous retropulsion (OR = 4.25). Other variables (PSP onset age, onset age of balance impairment, gait impairment, and disease duration) were not statistically significant. Conclusions: Our data suggest that spontaneous retropulsion is common in PSP, with females being at a significantly higher risk than males. This is useful information when counselling patients on risk-avoidance behaviour to prevent falls.
P.012 A global, long-term, prospective, observational registry of patients with AQP4+ NMOSD treated with complement component 5 inhibitor therapies eculizumab or ravulizumab
Authors: Fam S , Przybyl L , Azad T , Stankowski JN , Moy K , Rotstein D
Published: May 2024

Background: The complement component 5 inhibitor therapies (C5ITs) eculizumab and ravulizumab have been approved or submitted for regulatory approval in several regions for AQP4+ NMOSD. Methods: This global, long-term, prospective, multicenter, observational registry will enroll adult patients with AQP4+ NMOSD being treated with eculizumab or ravulizumab and who have received ≥1 dose of eculizumab or ravulizumab within 4 or 12 weeks prior to enrollment, respectively. Inclusion criteria include available historical data on C5IT dosing since initiation and the number and types of relapses from 1 year prior to C5IT initiation through enrollment. The primary outcome is annualized relapse rate. Safety outcomes will include serious adverse events, meningococcal infections, and pregnancy, breastfeeding, and neonatal outcomes. Data will be collected prospectively for up to 5 years. Approximately 130 patients will be enrolled, with a maximum of around 200 patients in up to 10 countries globally. Results: N/A Conclusions: This registry will collect data to characterize the long-term effectiveness and safety of the C5ITs eculizumab and ravulizumab in patients with AQP4+ NMOSD to provide evidence on the real-world impact of C5ITs in this patient population.
P.020 Shifts in daytime functioning items on the insomnia severity scale with lemborexant after 6 months of treatment
Authors: Chepke C , Cote K , Pinner K , Yardley J , Moline M
Published: May 2024

Background: Improvements in daytime functioning ideally accompany improvements in insomnia. Scores on the Insomnia Severity Index (ISI) daytime-related items were analyzed following treatment with lemborexant (LEM), a dual orexin receptor antagonist, or placebo (PBO), based on baseline severity. Methods: Participants (≥18 y) with insomnia disorder in E2006-G000-303, a 12-month, randomized, double-blind, PBO-controlled study (first 6 months: Treatment Period 1 [TP1]), were randomized to PBO or LEM 5 mg (LEM5) or 10 mg (LEM10) for 6 months. ISI items are rated 0 (no problem) to 4 (very severe problem); daytime-related ISI items have a maximum score of 16. Results: Of 949 participants, 749 (78.9%) completed the ISI at baseline and end of TP1. Baseline daytime ISI total score distributions were similar between groups. More participants with baseline scores of 9-12 and 13-16 shifted to 0-4 with LEM5 (49.7% and 39.1%, respectively) and LEM10 (46.2% and 46.3%) versus PBO (26.6% and 29.6%). Overall shift distributions were significantly different, favoring both LEM groups (P<0.01). LEM was well tolerated. Conclusions: More LEM-treated participants had improved daytime functioning, evidenced by the significantly larger number of participants whose scores moved into lower categories (ie, better sleep) versus PBO-treated participants, demonstrating additional value beyond improved sleep parameters.
P.032 The importance of transition clinics: A chart-review examining demographic, health, and social variables in young adults with epilepsy who were recently transitioned
Authors: Healy S , Fantaneanu T , Whiting S
Published: May 2024

Background: Research consistently shows that adolescents transitioning from pediatric to adult care struggle. Although data looking at young adults with epilepsy is limited, research suggests that these adults tend to have higher rates of depression and anxiety, lower rates of medication compliance, and lower education. Methods: To better understand this population and their struggles, a retrospective chart review of 58 patients transferred from pediatric to adult care was done. Results: 39.7% of participants were lost to follow-up; 12 were temporarily lost (average 1.3 years) and 11 were permanently lost. Twenty-three participants admitted to medication non-compliance, with fifteen having break-through seizures. Of the 45 patients that filled out mental health assessments at initial visit, 28.9% met the threshold for major depressive disorder, and 56.6% of patients had symptoms of anxiety. Data found that at one-year follow-up, 60% of these patients had similar or worsened depression scores, and 64% had similar or worsened anxiety scores. Conclusions: The findings of this study are concerning and highlight the need for greater education and support for these adolescents. Specifically, patients need more education on the importance of consistent follow-ups and consistently taking medication. Findings also suggest the importance of assessing and addressing mental health concerns.
P.051 Parkinson’s disease tremor can show entrainment and distractibility with tapping test
Authors: Sheth NC , Grippe T , Raies N , Ding M , Chen R
Published: May 2024

Background: Electrophysiological tests such as the tapping test are used to distinguish functional and organic tremors, in which patients with functional tremor commonly show entrainment and amplitude reduction (>50% decrease relative to baseline) of contralateral tremor during tapping. While these features are suggested to be specific to functional tremor, the tapping test in Parkinson’s disease (PD) tremor has not been tested. Methods: We evaluated 18 PD patients (2F, age 64.17±7.30 [mean±SD] years) with rest and postural tremors using surface electromyography and triaxial accelerometry. Patients were recorded while tapping at 1, 3 and 5 Hz with the contralateral arm at rest or outstretched. Tremor amplitude and frequency were calculated using power spectrum analysis from accelerometer recordings. Results: Reduction of rest tremor amplitude was observed in 3/18 patients during 1 and 3 Hz tapping. Reduction was seen in 3/16 and 1/16 patients with postural tremors at 1 and 3 Hz tapping, respectively. Frequency shifts (>1.5 Hz) were observed in 3/18 rest tremors and 6/16 postural tremors. Seven patients exhibited rest and/or postural tremor entrainment during 3 or 5 Hz tapping. Conclusions: Distractibility and entrainment can be found in PD tremor. The tapping test may not reliably distinguish between PD tremor and functional tremor.
P.062 Normal NCS in 42-year-old man with PMP22 duplication
Authors: Baker S
Published: May 2024

Background: Charcot Marie Tooth disease is a polygenic disorder with cannonical features of distal amyotrophy, acrohypesthesia, and tight tendoachilles of either axonal (type 2) or demeylinating (type 1) varieties. Type 1 CMT patients are required to possess conduction slowing of a sufficient degree to qualify as demyelinating. Presented is a middle-aged man with an unremarkable neurologic exam and normal electrophysiology. Methods: Standard electrophysiological techniques were employed to obtain the nerve conduction data (Natus Nicolet EDX AT2; Middleton, WI, USA). Repeated next generation sequencing and deletion/duplication analyses were performed. Results: The nerve conduction studies showed no evidence of demyelination in the upper or lower extremeties. The duplication error was confirmed with repeat testing. The heterozygous PMP22 gene duplication encompassed the entire coding sequence involving exons 1-5. Conclusions: CMT1A accounts for the vast majority of dysmyelinating hereditary neuropathies. Phenotypic variability is well described. Presentations include (a) classic conduction slowing, (b) intermediate slowing, (c) conduction block, (d) HNPP-like, (e) absent CMAPs, and (f) normal NCSs in young infants. This is the first case of a neurologically intact adult with CMT1A. Cryptogenic genetic modifier-effect(s) are posited as a possible explanation of the lack of penetrance. Identifying the nature of this modification may prove instructive for future therapies.
P.070 Using AI to revolutionize clinical training through OSCE-GPT: a focused exploration of user feedback on otolaryngology and neurology cases
Authors: Ramchandani R , Biglou SG , Gupta M , Guo E
Published: May 2024

Background: OSCE-GPT (https://learnmedicine.ca/) is an AI-based app that integrates history, physical exam, and relevant components for case guidance across medical disciplines to help trainees improve clinical skills. With global users across 60+ countries, this preliminary quality improvement study gathers user feedback on neurology and otolaryngology cases. Methods: A survey was distributed to users at the University of Ottawa and Cumming School of Medicine. Participants provided insights on the app’s use, perceived benefits, and suggested improvements. Results: Using 5-point Likert scales, 13 respondents, 9 of which evaluated an otolaryngology case, rated the overall usefulness of the learning tool 4.57± 0.51 (1=very poor, 5=very good), with a score of 4.00±0.65 relative to other teaching methods, such as didactic lectures or grand rounds (1=much worse, 5=much better). Users noted realistic interactions and self-paced learning as beneficial factors. Areas for improvement included a more fluid transition between physical exams and history, geographic variations in cases, and the addition of elements such as non-verbal patient cues or emotional. Conclusions: This study demonstrates utility of OSCE-GPT for medical trainees, particularly for otolaryngology and neurology cases. As cases continue to be added, feedback will be implemented to further improve user experience.
P.079 Relationships between anatomical features and outcome after stereotactic laser amygdalohippocampotomy
Authors: Zajner C , Taha A , Abbass M , Isbaine F , Laxpati N , Gross R , Lau J
Published: May 2024

Background: Stereotactic laser amygdalohippocampotomy (SLAH) has recently been shown to be comparable to traditional temporal lobectomy procedures. The ideal extent and volume of laser ablations remains an area of investigation Methods: 65 patients treated with SLAH for MTS were considered in this retrospective study. Manual segmentations of ablations were created using post-procedure T1-MRI scans. Ablations were assessed in relation to whether they crossed the coronal plane of the superior lateral mesencephalic sulcus (LMS), the extent to which ablation crossed this landmark, and extent of ablation of the uncus. Analysis of was done with binary categorization of 12-month Engel classification score. Results: Distance of ablation posterior to the coronal plane of the LMS was not associated with better surgical outcome (Engel class 1: 6.32 ± 4.16 mm; Engel class 2-4: 7.93 ± 3.75mm; (p = 0.099)). Ratio of ablations extending posterior to the LMS was 0.82 (SD = .39) in Engel 1 patients, and 0.90 (SD = 0.3) in Engel 2-4 patients; (p = 0.370). Volume of ablation showed little correlation with outcome (Engel class 1: 6064 ± 2128 mm3; Engel class 2-4: 5828 ± 3031 mm3; (p=0.239)). Ablation of the uncus showed a strong association with better surgical outcome (Engel class 1: 0.71(SD = 0.31); Engel 2-4: 0.37 (SD = 0.36); p <0.001). Conclusions: Contrary to current practice, extension of ablation posterior to the LMS did not demonstrate improved outcome.
P.081 Chordoma management with artificial intelligence: a scoping review of current applications and future prospects
Authors: Guo E , Boone L , Shakil H , Sanguinetti R , Gupta M , Lama S , Sutherland GR
Published: May 2024

Background: Chordomas are rare, malignant bone tumors that present significant challenges in management and treatment due to their complex anatomical locations and propensity for recurrence. Advancements in artificial intelligence (AI) and machine learning (ML) show promise in improving chordoma management. Methods: A comprehensive literature search was conducted following PRISMA guidelines across multiple databases, including MEDLINE, Cochrane, Embase, Scopus, and Web of Science. The search targeted articles related to AI and ML applications in clinical tasks associated with chordoma management. The selection process involved systematic screening, data extraction, and assessment of inter-rater variability. Results: The search yielded 1,006 records, with 18 included for analysis. Convolutional neural networks (CNNs) excelled in tumor volume estimation, with the state-of-the-art model achieving a Dice similarity score of 74.2%, sensitivity of 79.4%, and positive predictive value of 74.3%. Clustering algorithms were effective in prognostic evaluations. Bayesian models and logistic regression demonstrated robustness in diagnostics. Support vector machines (SVMs) were noted for their diagnostic precision. Conclusions: AI and ML algorithms, particularly CNNs, clustering algorithms, Bayesian models, logistic regression, and SVMs, show promise in improving chordoma management through enhanced imaging, diagnostics, and prognostics. Future research should focus on larger, externally validated datasets and explore underutilized techniques like multi-modal data integration.
P.082 Preoperative corticosteroids reduce diagnostic accuracy for primary central nervous system lymphoma biopsies: a meta-analysis
Authors: Rebchuk AD , Tosefsky K , Martin KC , Chen D , Yip S , Makarenko S
Published: May 2024

Background: Primary central nervous system lymphoma (PCNSL) is highly sensitive to corticosteroid induced cell arrest, apoptosis and shrinkage. However, the precise impact of preoperative corticosteroid on accuracy of PCNSL diagnosis using tissue obtained from open or stereotactic biopsies remains debated. Methods: We conducted a systematic review and meta-analysis to determine the effect of preoperative corticosteroids on non-diagnostic biopsy rates for PCNSL in immunocompetent adults. Subgroup analyses explored whether non-diagnostic rates varied based on biopsy type. Results: Nineteen studies, comprising 1226 patients (55% male; mean age: 60.3 years), of which 679 (55.4%) received corticosteroids prior to biopsy were included. Overall, patients pretreated with corticosteroids were two times more likely to have a non-diagnostic biopsy compared to patients that were corticosteroid-naïve prior to biopsy (RR = 2.1 [95% CI: 1.1-4.1]). In the subgroup analysis limited to stereotactic biopsies, patient pretreated with corticosteroids were three times more likely to have a non-diagnostic biopsy (RR = 3.0 [95% CI: 1.2-7.5]). Whereas, in the open biopsy subgroup, there was no significant difference in non-diagnostic rates. Conclusions: Corticosteroids should be withheld, if clinically safe, prior to stereotactic biopsies in cases of suspected PCNSL. If corticosteroids are administered preoperatively, an open biopsy should be considered instead of stereotactic biopsy.
P.086 The effect of after-hours surgical resection on the outcomes in patients with high grade gliomas
Authors: Dhillon K , Rizzuto M , Fatehi M , Makarenko S
Published: May 2024

Background: The “weekend effect” is the finding that patients presenting for medical care outside of regular working hours tend to have worse outcomes. There is a paucity of literature in the neuro-oncology space exploring this effect. We investigated the extent of resection and complication rates in patients undergoing after-hours high grade glioma resection. Methods: A retrospective review was conducted on patients with high-grade gliomas requiring emergent surgery between January 2021 to March 2023. After-hours was defined as surgical resection on the weekend and/or evening. These patients were matched to patients undergoing resection during regular working hours. Results: A total of 38 patients were included in this study (19 after-hours, 19 regular hours). There was no significant difference in age, sex, tumor grade, and tumor size between the two groups (all p>0.05). There was no significant difference in the extent of resection between the groups (p=0.7442). There was no significant difference in complications rates, reoperation rates, and death at 6 months (all p>0.05). Estimated blood loss was significantly higher in the regular hours group (p=0.0278). There was no significant difference in the total operative time (p=0.0643) and length of stay (p=0.0601). Conclusions: After-hours high grade glioma surgery is not associated with increased morbidity or mortality.
P.095 Role of selective neck dissections in the management of carotid body tumours
Authors: Francis G , Pickett GE , Taylor S
Published: May 2024

Background: Carotid body tumours (CBT) are rare neoplasms of the paraganglia at the carotid bifurcation. Histopathologic analysis alone is insufficient to confirm malignancy, requiring metastases to non-neuroendocrine tissue including cervical lymph nodes for definitive diagnosis. The role of selective neck dissection (SND) during CBT surgeries in detecting malignancy and guiding subsequent management remains uncertain. Methods: A retrospective case series was performed on all patients undergoing CBT surgeries with SND between 2002 and 2022. Data collection included demographics, genetic and laboratory testing, imaging, intra- and post-operative complications, follow-up and histopathology. Results: Twenty-one patients underwent CBT resection with SND. Of these, 3 had carotid artery injuries, and 5 had nerve injuries. One patient experienced peri-operative embolic strokes, presumed related to tumour embolization. Three patients were found to have lymph node involvement, confirming malignancy. Malignancy was significantly associated with the risk of carotid injury (p = 0.04.) Conclusions: SND is a useful adjunct in detecting malignancy during CBT resection. The incidence of malignancy in CBT is low but not negligible and SND should be considered in patients with suspected malignancy or high-risk factors. This study’s 14% incidence of malignancy suggests there may be a rationale for considering universal implementation of SND during CBT resection.
P.099 Transfer RNA fragments in patient plasma extracellular vesicles as biomarkers of high grade glioma
Authors: Phinney T , Alwadei A , Han J , Attwood K , MacNeil M , Wajnberg G , Roy J , Weeks A
Published: May 2024

Background: High-grade gliomas (HGG) present challenges with short post-surgery survival and high progression rates. Extracellular vesicles (EVs) in the tumor microenvironment (TME) contribute to a pro-tumorigenic setting. Investigating Transfer RNA fragments (TfRNA) in HGG patient plasma EVs reveals potential biomarkers and therapeutic targets, shedding light on the molecular landscape for enhanced diagnostic and therapeutic strategies. This study examines TfRNA in 10 HGG patients at diagnosis, offering insights into the molecular landscape for improved management strategies. Methods: The study involved the collection of plasma samples from HGG patients and controls. EVs were isolated from these samples and subsequently analyzed for tfRNA. Results: Analysis of plasma EVs highlighted distinct differences in TfRNA fragments between High-Grade Glioma (HGG) and control samples. HGG EVs showed a global reduction in tRNA content, higher 5’ tfRNA proportions, and increased nuclear tfrna compared to controls. A notable biological marker, elevated in HGG, holds potential as a diagnostic indicator. Conclusions: Our study concludes that High-Grade Gliomas (HGG) demonstrate a global reduction in tfRNA content in plasma extracellular vesicles compared to non-cancer controls, echoing findings in other cancers. Despite this, specific tfRNA molecules in HGG show significant differential expression or sorting into EVs, indicating their potential as future biomarkers or therapeutic targets.
P.114 The impact of screening for anxious and depressive symptoms on the outcome of patients with a mild traumatic brain injury
Authors: Bastone PA , Marcoux J , Laguë-Beauvais M
Published: May 2024

Background: An estimated 27-69 million individuals worldwide sustain a mild Traumatic Brain Injury (mTBI) each year, making it an important public health concern. Many victims experience post-injury neuropsychological issues such as anxiety and depression, which are associated with more post-concussive symptoms and worse functional outcomes. We sought to determine a systematic process to document the presence of anxiety and depression symptoms in mTBI patients to prevent negative impacts on their recovery. Methods: We administered the Generalized Anxiety Disorder-7 (GAD-7) and Center for Epidemiologic Studies Depression Scale Revised (CESDR-10) questionnaires, no more than three months after injury, to screen for these symptoms. A retrospective chart review was performed for 328 patients from the Montreal General Hospital mTBI Clinic who either received these questionnaires (N=143, Mage=40.36, SDage=15.557, Nfemale=90, Nmale=53) or did not (N=185, Mage=41.17, SDage=16.449, Nfemale=114, Nmale=71). The number of interventions received between groups were compared using ANOVA. Results: Patients who received the questionnaires (M=1.34, SD=0.978) were referred to significantly more interventions than those who did not (M=0.90, SD=0.876, p<0.001) and the rate of referral positively correlated with GAD-7 and CESDR-10 scores. Conclusions: Screening for symptoms of anxiety and depression post mTBI helps clinicians refer patients to the appropriate resources, which in turn should improve outcome.