bluuebunny/crossref_metadata_2025_split huggingface dataset:
Side-by-Side Comparison of Compensation Beads Used in Polychromatic Flow Cytometry
Authors: Bhowmick Debajit , Lowe Sara K , Ratliff Michelle L 
Published: December 2023

Abstract
Compensation or unmixing is essential in analyzing multiparameter flow cytometry data. Errors in data correction, either by compensation or unmixing, can completely change the outcome or mislead the researchers. Owing to limited cell numbers, researchers often use synthetic beads to generate the required single stains for the necessary calculation. In this study, the capacity of synthetic beads to influence data correction is evaluated. Corrected data for human peripheral blood cells were generated using cell-based compensation from the same cells or bead-based compensation to identify differences between the methods. These data suggest that correction with beads on full-spectrum and conventional cytometers does not always follow the basic flow compensation/unmixing expectations and alters the data. Overall, the best approach for bead-based correction for an experiment is to evaluate which beads and fluorochromes are most accurately compensated/unmixed.
Poster (Clinical/Best Practice Implementation) ID 1969157
Authors: Furlan Julio C. , Wang Di 
Published: December 2023

Background
This study examined the effects of concomitant TBI on injury epidemiology, management and outcomes of individuals with traumatic SCI.

Methods
A propensity-score matched cohort study compared a SCI+TBI group (n=1018) with a SCI-only group (n=3687), which were matched on a 1:1 ratio by age, sex, severity and level of SCI, and Charlson Comorbidity Index. TBI was defined as a Glasgow coma score of &lt;15 at admission. Both groups were compared regarding injury epidemiology (mechanism, ethnicity, GCS, other injuries), management (mechanical ventilation, traction, Methylprednisone, surgery, time to decompression), and post-SCI outcomes (length of stay [LOS], International Standards for Neurological Classification of SCI [ISNCSCI] motor subscore, Functional Independence Measure, discharge destination, spasticity and pain at discharge).

Results
Overall, being white (OR=5.332, p=0.0265) was associated with having TBI, while having other body injuries (OR=0.095, p=0.0065) was associated with the SCI-only group. Odds of dying in a hospital were 2.442 times larger for the TBI+SCI group. The TBI+SCI group had longer acute-care LOS. Both groups had similar rehabilitation LOS. Odds of being discharged to nursing homes/long-term care facilities were 1.949 times higher for TBI+SCI individuals. Concomitant TBI did not influence change in ISNCSCI motor subscore from initial admission to final discharge. Odds of individuals with pain was 1.52 times higher for the TBI+SCI group. Occurrence of spasticity was similar between the groups.

Conclusion
This study highlights discrepancies between the TBI+SCI and SCI-only groups regarding injury epidemiology, survival, discharge disposition, and pain. Both groups experienced similar access to treatment services, motor recovery, and spasticity.

Disclosure
These data were presented in the 2022 Annual Meeting of the American Neurological Association, which has a different attendance audience.
Student Competition (Technology Innovation) ID 1972228
Authors: Zhao Nicholas , Zariffa Jose 
Published: December 2023

Background
Upper limb rehabilitation after cervical spinal cord injury is vital for regaining independence. Hand function assessments are critical for upper limb rehabilitation, but are unable to accurately reflect performance in the individual’s home environment. Video from wearable cameras (egocentric video), paired with deep learning, can assess hand function during activities of daily living (ADLs) at home. Previous studies have focused on analyzing quantitative aspects of hand usage, but there has yet to be a study that uses deep neural networks to assess the quality of hand usage from egocentric video.

Objective
To train a deep neural network to predict hand function assessment scores from egocentric video.

Methods
The dataset used contained egocentric videos of ADLs performed by 17 participants with AIS grades from A-D in a home simulation laboratory. Tasks were annotated with scores adapted from the Graded Redefined Assessment of Strength Sensibility and Prehension (GRASSP). The annotated video was then used to train and validate a SlowFast neural network to predict GRASSP scores, using leave-one-subject-out cross validation. Model performance was evaluated by mean absolute error, accuracy, and F1 score. The model was optimized with a hyperparameter sweep.

Results
The top performing model demonstrated a mean absolute error of 0.52±0.19, an accuracy of 0.55±0.14, and F1 score of 0.55±0.16, on an ordinal scale from 1 to 5.

Conclusion
These results demonstrate that automated assessment of hand function is possible by applying deep learning to egocentric video. Future work should expand the model to larger datasets with more variability.
Student Competition (Knowledge Generation) ID 1978805
Authors: Provad Elina , Patel Tanha , Benson Kayla , Chan Katherine , Lee Jae W. , Inness Elizabeth L. , Wolfe Dalton L. , Masani Kei , Musselman Kristin E. 
Published: December 2023

Background
Individuals with neurological injury or disease are at increased risk of experiencing falls, highlighting the need for effective balance interventions. A novel system integrating functional electrical stimulation and visual feedback balance training (FES+VFBT) is a promising balance intervention; however, this lab-based system requires a redesign to increase clinical utility.

Objective
To identify possible challenges and solutions to implementing the FES+VFBT system as a balance intervention, from the perspective of end users.

Design/Methods
This qualitative study involved three semi-structured focus group meetings to explore participants’ perspectives on the feasibility and potential challenges of implementing FES+VFBT in neurorehabilitation. Two individuals with spinal cord injury (SCI), one individual with stroke, two physiotherapists and one hospital administrator participated. Interview transcripts were analyzed using a deductive-inductive content analysis. The levels of the Social Ecological Model (SEM) were used as themes for the deductive analysis. Categories and codes were detected using an inductive approach.

Results
The themes spanned the four levels of the SEM: intrapersonal, interpersonal, organizational/training environment and society/policy. Identified categories consisted of possible challenges mapped to the intrapersonal (e.g., lack of knowledge, tolerance of user) and organizational/training environment (e.g., cost, need for space and time, technical challenges) levels. Categories also reflected possible solutions mapped to all SEM levels: intrapersonal (e.g., reading and research), interpersonal (e.g., practicing together), organizational/training environment (e.g., tailoring system parameters, social support), and society/policy (e.g., create guidelines, provide cost options).

Conclusion
The findings will be used to improve the FES+VFBT system design and facilitate implementation of the intervention in neurorehabilitation.
Workshop (Clinical/Best Practice Implementation) ID 1983439
Authors: Ethans Karen , O’Connell Colleen 
Published: December 2023

Objective
Participants of this workshop will be able to identify and recommend multimodal treatment options in managing challenging cases in spasticity management of lower limbs in spinal cord injury (SCI).

Methods
The complexities of spasticity management will be identified through case-based presentations, including assessment and treatment directed by patient-oriented goals. Facilitated interactive discussion on these cases will engage participants for input, debate and critique. Procedural techniques for neurolysis will be discussed.

Results
Goals of spasticity management in SCI often include both proximal and distal lower limb problems. Therapies include oral medications, chemodenervation with neuromuscular junction blockade with botulinum toxin or neurolysis with phenol, intrathecal baclofen, bracing, and surgery. Many patients require multiple of these therapeutic options during their course of spasticity management.

Discussion
Multimodal therapy as part of the clinician toolbox is essential in tone management. Patient-oriented goals are important guideposts in spasticity management. SCI is a lifespan condition, and often patient goals and health conditions change over the years, requiring different tools to address such longitudinal needs.
Student Competition (Technology Innovation) ID 1984861
Authors: Mirkiani Soroush , Tyreman Neil , O’Sullivan Carly L , Wilson Don , Arefadib Amin , Fox Richard , Troyk Philip , Mushahwar Vivian 
Published: December 2023

Backgrounds/Objective
Intraspinal microstimulation (ISMS) is a neuromodulation technique for restoring walking after spinal cord injury. The objective of this study was to fabricate a stretchable ISMS device suitable for pigs, a clinically-relevant animal model.

Methods
Polyimide-insulated microwires (50µm, Pt-Ir, 80%/20%) were used for fabrication of electrodes. Their tips were de-insulated (∼0.15mm2) and sharpened using nanosecond and femtosecond UV lasers. Microcoils were fabricated from 25μm microwires (Pt-Ir, 80%/20%) to add stretchability to the lead wires. Sixteen microelectrode-leads were connected to a custom, wirelessly controlled stimulator using Medtronic extension cables (Model 37081).
The implants were tested in seven domestic pigs and current pulse trains were delivered to various rostro-caudal regions of the lumbar spinal cord (1s, 40Hz, 50µA-300µA) to activate locomotor-related muscle synergies. The kinematics and isometric joint forces of the evoked hindlimb responses were recorded.

Results
Graded joint movements were evoked with increasing stimulus amplitude. Changes in the hip, knee, and ankle joints angles evoked by ISMS at 300µA were 17.9±1˚, 28.1±1˚, and 21.6±2˚, respectively. Isometric joint forces evoked by ISMS at 300µA were 12.21±0.91N, 7.4±0.71N, and 1.7±0.15N for knee extension, hip flexion, and ankle flexion, respectively.

Conclusion
The movements evoked using the developed ISMS implant could generate full ranges of motion in the joints. The graded responses imply a near-physiological recruitment order of motoneurons, which is necessary for achieving long walking distances without muscle fatigue. The results show the capability of the developed ISMS device in generating movements in pigs, and the implants’ potential for future use in humans.
Student Competition (Knowledge Generation) ID 1985154
Authors: Garcia Juanita , Cowley Kristine 
Published: December 2023

Background
Exercising after spinal cord injury (SCI) is necessary to prevent or reduce secondary complications such as obesity, cardiovascular disease, or type II diabetes. The effects of SCI on muscle and autonomic functions determine type, duration, and intensity of exercise capacity. Although SCI exercise guidelines exist, achieving these recommendations requires a comprehensive understanding of how muscle and autonomic function affect a person’s exercise capability. Therefore, we reviewed the effect of SCI level on muscle and sympathetic function during exercise for those living with SCI to better develop strategies to achieve these guidelines.

Methods
A literature review of exercise, muscle control and SCI was performed to identify muscles innervated by each level and how key sympathetic tissues and organs required for exercise are affected by SCI. We identified spinal levels responsible for increasing heart rate, cardiovascular smooth muscle contraction, inducing sweat and activating adrenal glands since these are essential in maintaining high intensity and long duration exercise. We translated the information into a comprehensive user-friendly poster.

Results
A comprehensive graphical poster was developed for those living with SCI to understand and identify how their level of SCI affects their muscle and sympathetic function needed for optimal exercise and to meet exercise guidelines.

Conclusions
This infographic fills a void since this type of ‘person-centred’ information is lacking in the SCI and exercise field. The knowledge acquired through this infographic could further guide training practices and exercise modifications to increase exercise capacity and quality of life for those living with SCI.
Student Competition (Technology Innovation) ID 1985155
Authors: Arefadib Amin , Faridi Pouria , Mirkiani Soroush , Dalrymple Ashley , Mushahwar Vivian K 
Published: December 2023

Background
ISMS entails implanting micro-electrodes into the spinal cord to produce synergistic activations of the legs. To date, ISMS has produced in-place stepping in cats with complete spinal cord injury (SCI) (Saigal et al, 2004), and long distances of over ground walking in anesthetized cats (Holinski et al, 2016).

Objective
The goal of this project is to develop an intervention for restoring overground walking capacity for persons experiencing paralysis due to SCI, by investigating the potential of ISMS to enable long-distance overground walking in cats with chronic SCI.

Method
Experiments will be performed in eight adult cats with chronic complete SCI. The control strategy will include timed transitions between different phases of the step cycle, which will be modified using feedback from force plates and gyroscopes. The biomechanics of walking (speed of walking, stride length, left-right symmetry, inter-joint coordination) and muscle activation patterns will be recorded and analyzed. The stride-to-stride regularity of walking, amount of weight-bearing, and level of spasticity before, during, and after ISMS will be assessed.

Results
We expect that ISMS will produce long distances of walking (&gt;500 m) in cats with SCI. The biomechanical features of walking will be similar to those in neurologically-intact cats.

Conclusion
This project is a critical step towards demonstrating the viability of ISMS as a means for restoring functional walking after severe SCI. If successful, ISMS and the control strategies developed may in the future change the lives of many people living with SCI, giving them the capability to walk independently.
Student Competition (Knowledge Generation) ID 1985170
Authors: Mann Darren J. , Porter Jane A. , Okusanya Deborah O. , Lee Justin , Karamzadeh Zahra , Yuan Monique , Barss Trevor S. , Mushahwar Vivian K. 
Published: December 2023

Background/Objectives
Functional electrical stimulation (FES)-assisted arm and leg (A&L) cycling is an effective rehabilitative intervention for improving walking following an incomplete spinal cord injury (SCI). The goal of this study was to assess the potential benefits of combining transcutaneous spinal cord stimulation (tSCS) with A&L cycling to potentially improve functional mobility and activities of daily living for persons living with motor complete SCI.

Methods
This is a case study of a participant with AIS B SCI. The participant has been undergoing FES-assisted A&L cycling training combined with cervical and lumbar tSCS (1 hr/day, 5 days/week) for 37 weeks. Assessments were performed pre-training and every 6 weeks thereafter and include the International Standards for Neurological Classification of SCI (ISNCSCI), time able to stand while assisted, and training load of each exercise session.

Results
Although there were no changes in the ISNCSCI scores, the duration of assisted standing increased from 10s per-training to 33.5s at 36 weeks post-training. Interestingly, the addition of tSCS enhanced standing duration to 38.5s. Moreover, the total power output exerted by the participant consistently increased over time.

Conclusion
This study provides, for the first time, evidence that FES-assisted A&L cycling paired with non-invasive tSCS can be safely completed after severe SCI and leads to improvements in training load and assisted standing. Additional assessments will be incorporated to further identify improvements in function and quality of life. Future work will assess the benefits of using epidural spinal cord stimulation combined with A&L cycling after motor complete SCI.
Workshop (Clinical/Best Practice Implementation) ID 1985360
Authors: Craven B. Catharine , Kaiser Anita , Jervis-Rademeyer Hope , Murphy Wendy , Boag Lynn , Miyatani Masae , Blencowe Lindsie M. 
Published: December 2023

Background
The Paralyzed Veterans of America inaugural Clinical Practice Guideline (CPG) for Bone Health and Osteoporosis Management for individuals with spinal cord injury or disease (SCI/D) was published for clinicians in 2022. To disseminate knowledge, we developed a series of nine podcasts and handouts, “The Bare Bones Series” (TBBS), linked with each CPG chapter. The intent was to share the CPG content with people with lived experience of SCI/D (PLEX).

Objectives
This workshop will: 1) introduce TBBS and intended use of the CPG framework; and 2) provide participants the opportunity to apply their learning from the podcast episodes “Get Moving and Loading” and “Snap and Crack” through discussion of two case based scenarios.

Methods
The aim, content, intended use and targeted audience for TBBS will be highlighted. TBBS was developed and hosted by two PLEX, project team members, and 11 guests who were the CPG chapter authors. Podcast handouts contain infographics, key concepts and recommendations for action. Attendees including clinicians, PLEX, family and friends, will review 3 of 9 episodes. The panelists (Chair, PLEX and project team) will discuss the CPG content and actions to take to improve bone health and reduce fracture risk in PLEX with SCI/D. TBBS will be shared through social media, stakeholder and community events, and conference presentations across North America.

Conclusions
Workshop attendance will aid participants in advocating for bone health assessments, understanding fracture risk, and promoting a dialogue with their care team about how to prevent fracture, and reduce fracture related morbidity and mortality.
Post Doc Competition (Clinical/Best Practice Implementation) ID 1985647
Authors: Tajali Shirin , Iwasa Stephanie N. , Atputharaj Sharmini , Sin Vivian , (Kapadia) Naaz Desai , Musselman Kristin E. , Popovic Milos R. , Masani Kei 
Published: December 2023

Background
Functional electrical stimulation (FES) of paralyzed muscles can facilitate walking after spinal cord injury (SCI).

Objective
To test the orthotic effects of different FES walking protocols on lower joint kinematics in individuals with incomplete SCI.

Methods
Three adults with motor incomplete SCI participated in this study. Their lower extremity motor scores [LEMS (left, right)] were as follows: subject A: 25/25, subject B:15/25, subject C:9/23. They were asked to randomly complete four conditions of overground walking in a 4-meter walkway (6-10 times/condition) including no FES, and three bilateral FES walking protocols as follows: drop-foot (tibialis anterior stimulation), flexor withdrawal (common peroneal nerve stimulation), and multi-muscle stimulation (stimulation of quadriceps and gastrocnemius in the stance phase, and hamstring and tibialis anterior in the swing phase). The FES system obtained gait phase information from the two footswitches located under the individuals’ feet. Three-dimensional kinematic analysis was undertaken to measure minimum toe clearance (MTC), ankle, and hip range of motion (ROM) using a 100 Hz eight infrared camera (Vicon Motion Systems, Oxford, UK).

Results
The three FES-walking conditions significantly increased MTC compared to the no-FES condition in all participants. A significant decrease in ankle ROM was seen in the drop-foot (all subjects), multi-muscle (subjects A and C), and flexor withdrawal (subject A) stimulations. Hip ROM increased in the drop-foot (subjects B and C), flexor withdrawal (subject B), and multi-muscle (subject C) stimulations.

Conclusions
Three FES-walking protocols induced positive kinematic changes (increased hip flexion and toe clearance) during walking in subjects with incomplete SCI.
Post Doc Competition (Knowledge Generation) ID 1986576
Authors: Ziebart Christina , Jaglal Susan , Craven Cathy 
Published: December 2023

Background
Osteoporosis has been identified in individuals as young as 35 years of age post-spinal cord injury (SCI), with males seeming to be at a higher risk than females. However, it is not clear what the prevalence of fractures associated with SCI are in Ontario, Canada.

Objective
To determine the prevalence and demographic characteristics of fractures in people with a SCI.

Methods
Data will be sourced from administrative healthcare databases at ICES, Ontario. Inclusion criteria are people with SCI and at least one fracture since their SCI. We will exclude duplicate cases, records missing unique patient identifier numbers, and age &lt;18 years. Descriptive statistics will be used to summarize sociodemographic and clinical data, disaggregated by gender, age groups, and associated injuries.

Results
We expect that younger adults would be more likely to have traumatic SCI and older adults to have non-traumatic SCI. We expect men to experience more traumatic SCI across all age categories. We expect that younger men will experience a higher incidence of secondary fractures as well as older women. Those with a longer time since initial SCI fracture are likely to experience a secondary fracture.

Conclusion
The proposed study is a foundational study to better understand fractures in people with a SCI. It is known that musculoskeletal complications are common post SCI, and osteoporosis is a common consequence of disuse due to SCI. It is necessary to understand the prevalence and impact of fractures post-SCI of those in Canada to develop prevention and management strategies.
Workshop (Clinical/Best Practice Implementation) ID 2001167
Authors: Duley Jennifer M. , Carmazan Carmen D. , Patton Stephen J. 
Published: December 2023

Background
Hamilton’s Spinal Cord Injury (SCI) Regional Rehabilitation Program in collaboration with SCI Consortium is implementing tissue integrity monitoring for pressure injury (PI) prevention. An increased prevalence of PI was found in 2021 - 2022 compared to 2020 on Hamilton’s SCI Rehabilitation Unit. To address this finding, the clinical team introduced a staff and patient education program focused on PI prevention. Upon completion of this workshop, the attendees will be aware of the CQI methodology used to implement the best practices related to tissue integrity and appreciate the education pathway for both staff and patients.

Methods
Using a Continuous Quality Improvement model, a systematic approach was used to enhance the education model for staff and patients on skin assessment and appropriate interventions. A process map was created outlining steps for each discipline involved in skin assessment, intervention, and patient education. Education plan included Skin & Wound Management workshop, individual and group patient education, daily skin check calendar for patient/staff use. The workshop will be delivered in a lecture format, ending with discussion time.

Results
Preliminary data post partial implementation of the education program showed a decrease of 12% in the prevalence of PIs in the patients discharged from the program between July 2022 and March 2023 compared to January 2021 – June 2022.

Conclusion
Preliminary results are encouraging in demonstrating that implementation of a comprehensive education plan for staff and patients using a structured framework is effective in reducing the prevalence of pressure injuries in the inpatient SCI rehab unit.