Background: The relationship between glioblastoma extent of surgical resection (EoR) and survival is well documented.1-3 The advent of 5-aminolevulinic acid (5-ALA), a tissue selective fluorophore, has led to increased rates of gross total tumour resection.4-6 Since 5-ALA received approval for use in Canada in 2020, no Canadian centres have examined its impact on rates of complete resection (CR) for newly diagnosed high grade glioma (HGG) patients. Methods: This study evaluates the difference in EoR class7, for newly diagnosed HGG. Fifty-one consecutive patients underwent awake craniotomy with white light illumination (WLS) while 45 consecutive HGG patients were operated with fluorescence guidance (FGS). Analysis of EoR class was blinded and performed by 2 independent reviewers with a third adjudicator available for discrepancies. Residual tumour volumes were quantified by segmentation of postoperative 1mm slice MRI. Results: The FGS group was found to have: 80% complete resection (CR), 11% near-total resection (NTR), and 9% subtotal resection (STR). This compared favourably to the WLS respective rates of 67%, 6%, and 28%. Conclusions: For awake craniotomy protocol, the odds of complete resection were higher in the FGS group, compared to the WLS group (OR = 2; 95% CI 1.06, 2.93).

Insects are mass-reared for release for biocontrol including the sterile insect technique. Insects are usually reared at temperatures that maximize the number of animals produced, are chilled for handling and transport, and released into the field, where temperatures may be considerably different to those experienced previously. Insect thermal biology is phenotypically plastic (i.e. flexible), which means that there may exist opportunities to increase the performance of these programmes by modifying the temperature regimes during rearing, handling, and release. Here we synthesize the literature on thermal plasticity in relation to the opportunities to reduce temperature-related damage and increase the performance of released insects. We summarize how and why temperature affects insect biology, and the types of plasticity shown by insects. We specifically identify aspects of the production chain that might lead to mismatches between the thermal acclimation of the insect and the temperatures it is exposed to, and identify ways to harness physiological plasticity to reduce that potential mismatch. We address some of the practical (especially engineering) challenges to implementing some of the best-supported thermal regimes to maximize performance (e.g. fluctuating thermal regimes), and acknowledge that a focus only on thermal performance may lead to unwanted trade-offs with other traits that contribute to the success of the programme. Together, it appears that thermal physiological plasticity is well-enough understood to allow its implementation in release programmes.

Background: Epileptic discharges localized to the midline vertex are rare. However, they have been associated with intractable seizures and severe long-term consequences in the developing brain. Our study aimed to understand the etiology of pediatric midline seizures and define post-surgical seizure outcomes. Methods: We reviewed charts, electroencephalography (EEG), and neuroimaging studies of ten pediatric patients with epileptic discharges localized to the midline vertex in the Comprehensive Epilepsy Program. The seizures were classified according to the International League Against Epilepsy criteria, patient age, sex, neuroimaging results, seizure etiology and outcomes were obtained. Results: Age of seizure onset was within the first 10 years of life in 90% of patients, with focal seizures being the most prevalent. Focal cortical dysplasia (FCD) was the most common etiology present in 50% of patients. These children had normal neuroimaging studies and intractable epilepsy. However, seizure freedom was achieved following surgical resection of the epileptogenic zone. Conclusions: We demonstrated that patients with midline epileptic discharges are associated with intractable focal seizures and early seizure onset. Despite normal neuroimaging reports, FCD was the most common pathology. Thus our study suggests early localization and resection of the epileptogenic zone may be beneficial for achieving seizure freedom in children with this electroclinical syndrome.

Background: We describe an infant with a diagnosis of GM3 synthase deficiency, presenting with severe neuroirritability from birth. He required multiple admissions due to extreme agitation and caregiver burnout. Multiple pharmacological agents were tried, and the effect of each medication was modest and short-lasting at best. The literature on the management of neuroirritability in children with progressive genetic and metabolic conditions is sparse, and a neuroirritability management protocol has yet to be developed at our institution. Methods: We searched for relevant primary research and articles on PubMed. We reviewed the evidence of each pharmacological agent and added non-pharmacological strategies. We developed management guidelines for neuroirritability at our hospital. This protocol was reviewed by several pediatric neurologists and pediatric palliative care specialists at the Stollery and SickKids Hospitals. Results: We present the Pediatric Neuroirritability Management Protocol for the Stollery Children’s Hospital. Conclusions: Further study is required to assess whether this protocol can be adapted to treat irritability in the context of other neurological conditions such as hypoxic-ischemic encephalopathy and non-accidental injury. In addition, we will expand our guidelines to include other symptoms such as spasticity, dystonia, and autonomic dysfunction.

Background: Epilepsy, a common neurologic condition, instigates a large number of emergency room (ER) visits annually. This project aims to retrospectively review the patterns and characteristics of Alberta ER visits by pediatric epilepsy patients. Methods: Methods: Alberta Health administrative databases, including the Inpatient Discharge Abstract Database, the National Ambulatory Care Reporting System, Diagnostic Imaging and Medical Laboratory, were used to identify ER utilization patterns among children with epilepsy in Alberta, Canada between 2012–2018. Results: Results: Of 5,419 pediatric epilepsy ER patients between 2012–2018 in Alberta, 59% were developmentally delayed children. Children in this particular group, when compared to developmentally normal children with epilepsy, had the following characteristics: they were significantly more likely to utilize ERs in children’s hospitals versus other hospitals; they presented at a significantly younger age; they had a significantly longer length of stay; they had higher triage scores; they were subjected to significantly more investigations; and they had significantly more hospital admissions for epilepsy. Conclusions: Discussion: This novel Alberta-wide study of resource utilization of pediatric epilepsy patients shows that developmentally delayed children with epilepsy use significantly higher resources compared to developmentally normal children with epilepsy. Whether this is justified or not requires further study.

Pseudoscorpions are microarthropods that are distributed from the equator to beyond the Arctic circle. Wyochernes asiaticus (Arachnida: Pseudoscorpiones: Chernetidae) is the northernmost species of pseudoscorpion and is broadly distributed in Beringia, an Arctic and sub-Arctic region that remained unglaciated during the last glacial maximum. Wyochernes asiaticus is anoxia tolerant and has moderate cold tolerance, but nothing is known about the molecular basis of their survival in Canadian polar environments. We de novo assembled and characterised the transcriptome of W. asiaticus collected from the Yukon Territory in northwestern Canada. We assembled an approximately 62.6-million base-pair transcriptome with a mean contig length of 1277, which was 76% complete, according to a benchmark universal single copy orthologue (BUSCO) analysis. We identified 1100 transcripts encoding proteins associated with stress tolerance in these pseudoscorpions, including heat shock proteins, antioxidants, ubiquitination and proteosomal proteins, and sirtuins. We also identified transcripts encoding putative venom proteins. We highlight eight transcripts with high sequence similarity to sequences of venom proteins (ctenitoxins and agatoxins) described from other pseudoscorpions. Our study yields the first transcriptome of a Beringian arthropod, providing important sequence information that will allow future investigation of how W. asiaticus survives in Canadian polar environments.

Drosophila suzukii Matsumura (Diptera: Drosophilidae) is a cosmopolitan polyphagous pest on unripe soft-skinned fruits. We sought to determine (1) temperature treatments that could be used to kill immature D. suzukii in fruit or packaging and (2) whether development on different fruits led to differences in cold tolerance of immature D. suzukii. We reared animals from egg on a banana-based laboratory diet and diets made of apple (Malus domestica Borkhausen; Rosaceae), blueberry (Vaccinium Linnaeus; Ericaceae), cherry (Prunus avium Linnaeus; Rosaceae), grape (Vitis Linnaeus; Vitaceae), orange (Citrus × sinensis (Linnaeus) Osbeck; Rutaceae), raspberry (Rubus Linnaeus; Rosaceae), or strawberry (Fragaria × ananassa Duchesne; Rosaceae) homogenate in agar and measured development time, adult body size, and cold tolerance. Diet type had complex effects on development time; in particular, D. suzukii reared on apple-based or blueberry-based diets developed more slowly to a smaller adult body size than those on other diets. Cold exposure killed eggs and both first and second instars. Survival of 24 hours at +4 °C by feeding third instars was lowest in blueberry and cherry. Five days at +0.6 °C killed all feeding third instars; this treatment is likely sufficient for targeting D. suzukii in fruit. Two hours at −5 °C or −6 °C killed all wandering third instars and pupae; this exposure could be sufficient for sanitation of packaging.

The insect commensal microbiota consists of prokaryotes and eukaryotes. We explored the effect of diet and the persistence of the gut microbiota across generations in Drosophila suzukii (Matsumura) (Diptera: Drosophilidae). We transferred subsets of a single population of D. suzukii to different fruit-based diets (blueberry (Vaccinium Linnaeus; Ericaceae), raspberry (Rubus Linnaeus; Rosaceae), and strawberry (Fragaria × ananassa Duchesne; Rosaceae)) for three generations and then returned them to a common, banana-based, diet. We used 16S rDNA (Bacteria) and ITS (internal transcribed spacer; Fungi) sequencing of female endosymbiont-free flies to identify the microbiota. We identified 2700 bacterial and 350 fungal operational taxonomic units (OTUs); there was no correlation between the number of bacterial and fungal OTUs in a sample. Bacterial communities were dominated by Proteobacteria (especially Acetobacteraceae); Ascomycota dominated the fungal communities. Species diversity of both bacteria and fungi differed among diets, but there were no differences in species-level diversity when these D. suzukii were returned to a control diet. A principle coordinates analysis revealed no differences in the bacterial or fungal community in the first generation on fruit diets, but that the communities diverged over the next two generations; neither fungal and bacterial communities converged after one generation on control food. We conclude that diet changes the D. suzukii microbiota, and that these changes persist for more than one generation.

Many biological processes are partitioned among organs and tissues, necessitating tissue-specific or organ-specific analysis (particularly for comparative -omics studies). Standardised techniques for tissue identification and dissection are therefore imperative for comparing among studies. Here we describe dissection protocols for isolating six key tissues/organs from larvae of the Asian longhorned beetle, Anoplophora glabripennis (Motschulsky) (Coleoptera: Cerambycidae): the supraoesophageal ganglion, posterior midgut, hindgut, Malpighian tubules, fat body, and thoracic muscle. We also describe how to extract haemolymph and preserve whole larvae for measurements such as protein, lipid, and carbohydrate content. We include dissection protocols for both fresh-killed and previously frozen specimens. Although this protocol is developed for A. glabripennis, it should allow standardised tissue collection from larvae of other cerambycids and be readily transferrable to other beetle taxa with similar larval morphology.

Introduction: Prehospital field trauma triage (FTT) standards were reviewed and revised in 2014 based on the recommendations of the Centers for Disease Control and Prevention. The FTT standard allows a hospital bypass and direct transport, within 30 min, to a lead trauma hospital (LTH). Our objectives were to assess the impact of the newly introduced prehospital FTT standard and to describe the emergency department (ED) management and outcomes of patients that had bypassed closer hospitals. Methods: We conducted a 12-month multi-centred health record review of paramedic and ED records following the implementation of the 4 step FTT standard (step 1: vital signs and level of consciousness (physiologic), step 2: anatomical injury, step 3: mechanism and step 4: special considerations) in nine paramedic services across Eastern Ontario. We included adult trauma patients transported as urgent that met FTT standard, regardless of transport time. We developed and piloted a data collection tool and obtained consensus on all definitions. The primary outcome was the rate of appropriate triage to a LTH which was defined as: ISS ≥12, admitted to intensive care unit (ICU), non-orthopedic surgery, or death. We have reported descriptive statistics. Results: 570 patients were included: mean age 48.8, male 68.9%, falls 29.6%, motor vehicle collisions 20.2%, stab wounds 10.5%, transported to a LTH 76.5% (n = 436). 72.2% (n = 315) of patients transported to a LTH had bypassed a closer hospital and 126/306 (41.2%) of those were determined to be an appropriate triage to LTH (9 patients had missing outcomes). ED management included: CT head/cervical spine 69.9%, ultrasound 53.6%, xray 51.6%, intubation 15.0%, sedation 11.1%, tranexamic acid 9.8%, blood transfusion 8.2%, fracture reduction 6.9%, tube thoracostomy 5.9%. Outcomes included: ISS ≥ 12 32.7%, admitted to ICU 15.0%, non-orthopedic surgery 11.1%, death 8.8%. Others included: admission to hospital 57.5%, mean LOS 12.8 days, orthopedic surgery 16.3% and discharged from ED 37.3%. Conclusion: Despite a high number of admissions, the majority of trauma patients bypassed to a LTH were considered over-triaged, with a low number of ED procedures and non-orthopedic surgeries. Continued work is needed to appropriately identify patients requiring transport to a LTH.

The identity, richness, and abundance of true flies (Diptera) from the nests of three cavity-nesting raptors (Aves) were investigated in northern Nova Scotia, Canada. After fledging, flies were extracted from the nest material using Berlese funnels within an emergence chamber. Thirty-one species/morphospecies from 14 families were collected, including eight new records for Nova Scotia and two new records for eastern North America.