SARS-CoV-2 Spike protein induces TLR4-mediated long-term cognitive dysfunction recapitulating post-COVID-19 syndrome in mice.

Cognitive dysfunction is often reported in patients with post-coronavirus disease 2019 (COVID-19) syndrome, but its underlying mechanisms are not completely understood. Evidence suggests that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Spike protein or its fragments are released from cells during infection, reaching different tissues, including the CNS, irrespective of the presence of the viral RNA. Here, we demonstrate that brain infusion of Spike protein in mice has a late impact on cognitive function, recapitulating post-COVID-19 syndrome. We also show that neuroinflammation and hippocampal microgliosis mediate Spike-induced memory dysfunction via complement-dependent engulfment of synapses. Genetic or pharmacological blockage of Toll-like receptor 4 (TLR4) signaling protects animals against synapse elimination and memory dysfunction induced by Spike brain infusion. Accordingly, in a cohort of 86 patients who recovered from mild COVID-19, the genotype GG TLR4-2604G>A (rs10759931) is associated with poor cognitive outcome. These results identify TLR4 as a key target to investigate the long-term cognitive dysfunction after COVID-19 infection in humans and rodents.

Home alone: A population neuroscience investigation of brain morphology substrates.

As a social species, ready exchange with peers is a pivotal asset - our "social capital". Yet, single-person households have come to pervade metropolitan cities worldwide, with unknown consequences in the long run. Here, we systematically explore the morphological manifestations associated with singular living in ∼40,000 UK Biobank participants. The uncovered population-level signature spotlights the highly associative default mode network, in addition to findings such as in the amygdala central, cortical and corticoamygdaloid nuclei groups, as well as the hippocampal fimbria and dentate gyrus. Both positive effects, equating to greater gray matter volume associated with living alone, and negative effects, which can be interpreted as greater gray matter associations with not living alone, were found across the cortex and subcortical structures Sex-stratified analyses revealed male-specific neural substrates, including somatomotor, saliency and visual systems, while female-specific neural substrates centered on the dorsomedial prefrontal cortex. In line with our demographic profiling results, the discovered neural pattern of living alone is potentially linked to alcohol and tobacco consumption, anxiety, sleep quality as well as daily TV watching. The persistent trend for solitary living will require new answers from public-health decision makers. SIGNIFICANCE STATEMENT: Living alone has profound consequences for mental and physical health. Despite this, there has been a rapid increase in single-person households worldwide, with the long-term consequences yet unknown. In the largest study of its kind, we investigate how the objective lack of everyday social interaction, through living alone, manifests in the brain. Our population neuroscience approach uncovered a gray matter signature that converged on the 'default network', alongside targeted subcortical, sex and demographic profiling analyses. The human urge for social relationships is highlighted by the evolving COVID-19 pandemic. Better understanding of how social isolation relates to the brain will influence health and social policy decision-making of pandemic planning, as well as social interventions in light of global shifts in houseful structures.

Using Neuroscience-informed Group Work with Children and Adolescents Affected by the Pandemic

The COVID-19 pandemic has resulted in many types of disruptions from mild inconveniences to deaths. These disruptions have resulted in a host of stress responses among children and adolescents. Small group work is one way that helpers in schools and agencies can address developmental and diagnostic issues that arise. Neuroscience informs counselors understanding of stress responses and reactions in children and adolescents, as well as aids in generating activities and activating group therapeutic factors. This article describes the ways the neuroscience of pandemic stress and therapeutic factors can be used in group work with children and adolescents.

Exploring the boundaries of Neuromarketing through systematic investigation

Neuromarketing literature has grown remarkably in recent years. Although the field has generated a diverse body of knowledge, we still find a dearth of studies classifying the existing literature into research themes and further presenting known and unknown aspects of Neuromarketing from a business and management viewpoint. To bridge this gap, the present study conducted a systematic literature review of Neuromarketing from 2011 to 2021, with a sample of 100 peer-reviewed articles. Based on rigorous review and thematic analysis of 41 relevant research articles, four research themes were identified - 1) Phenomenon, 2) Application, 3) Bright side, and 4) Dark side of Neuromarketing. Further, a theoretical framework of neuromarketing effect on consumer behaviour was presented. Future research thrust areas in theory, application, methodology, and evidence were identified.

Re-Imaging the Future in Urban Studies and Built Environment Discourse: A Neurourbanism Perspective

Neurological constructs are being applied in various fields;within urban studies and built environments, neurourbanism stands out. To understand this concept, this study seeks to conduct a scientometric analysis of the concept of neurourbanism. To do so, we gauged the intellectual structure and clarified the influencers and emerging themes while seeking to identify essential gaps in neurourbanism research in urban studies and the built environment. Data were sorted from Dimensions Artificial Intelligence platform because of its reliability in providing the needed dataset accurately, and the Citespace software was used to analyze the data. Our results suggest plurality in explaining the risk factors in urbanicity research, particularly regarding prevalence, incidence, and the general cause of psychosis in urban living. The study also shows that players in the construction sector, such as engineers, town planners, and developers, have not fully grasped how the built environment assists in improving well-being, reducing stress levels of urbanists, assisting migrants in settling into the community, and the general mental wellness of those who live in the city. The study also identified a correlation between urbanization and mental health and added that the main recipient of rapid urban transformation countries does not show leadership in neurourbanism studies.

Neural correlates of psychodynamic and non-psychodynamic therapies in different clinical populations through fMRI: A meta-analysis and systematic review.

Background: The COVID-19 pandemic has exacerbated the ongoing crisis in psychiatric and psychological care, contributing to what we have identified as a new psychological and psychiatric pandemic. Psychotherapy is an effective method for easing the psychological suffering experienced also by the various impacts of COVID-19. This treatment can be examined from a neurological perspective, through the application of brain imaging techniques. Specifically, the meta-analysis of imaging studies can aid in expanding researchers' understanding of the many beneficial applications of psychotherapy. Objectives: We examined the functional brain changes accompanying different mental disorders with functional Magnetic Resonance Imaging (fMRI), through a meta-analysis, and systematic review in order to better understand the general neural mechanism involved in psychotherapy and the potential neural difference between psychodynamic and non-psychodynamic approaches. Data sources: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were employed for our systematic review and meta-analysis. We conducted a computer-based literature search, following the Population, Intervention, Comparison and Outcomes (PICO) approach, to retrieve all published articles in English regarding the above-described topics from PubMed (MEDLINE), Scopus, and Web of Science. Study eligibility criteria participants and interventions: We combined terms related to psychotherapy and fMRI: ("psychotherapy" [All Fields] OR "psychotherapy" [MeSH Terms] OR "psychotherapy" [All Fields] OR "psychotherapies" [All Fields] OR "psychotherapy s" [All Fields]) AND ("magnetic resonance imaging" [MeSH Terms]) OR ("magnetic"[All Fields] AND "resonance"[All Fields] AND "imaging"[All Fields]) OR ("magnetic resonance imaging"[All Fields] OR "fmri"[All Fields]). We considered (1) whole brain fMRI studies; (2) studies in which participants have been involved in a clinical trial with psychotherapy sessions, with pre/post fMRI; (3) fMRI results presented in coordinate-based (x, y, and z) in MNI or Talairach space; (4) presence of neuropsychiatric patients. The exclusion criteria were: (1) systematic review or meta-analysis; (2) behavioral study; (3) single-case MRI or fMRI study; and (4) other imaging techniques (i.e., PET, SPECT) or EEG. Results: After duplicates removal and assessment of the content of each published study, we included 38 sources. The map including all studies that assessed longitudinal differences in brain activity showed two homogeneous clusters in the left inferior frontal gyrus, and caudally involving the anterior insular cortex (p < 0.0001, corr.). Similarly, studies that assessed psychotherapy-related longitudinal changes using emotional or cognitive tasks (TASK map) showed a left-sided homogeneity in the anterior insula (p < 0.000) extending to Broca's area of the inferior frontal gyrus (p < 0.0001) and the superior frontal gyrus (p < 0.0001). Studies that applied psychodynamic psychotherapy showed Family-Wise Error (FWE) cluster-corrected (p < 0.05) homogeneity values in the right superior and inferior frontal gyri, with a small cluster in the putamen. No FWE-corrected homogeneity foci were observed for Mindful- based and cognitive behavioral therapy psychotherapy. In both pre- and post-therapy results, studies showed two bilateral clusters in the dorsal anterior insulae (p = 0.00001 and p = 0.00003, respectively) and involvement of the medial superior frontal gyrus (p = 0.0002). Limitations: Subjective experiences, such as an individual's response to therapy, are intrinsically challenging to quantify as objective, factual realities. Brain changes observed both pre- and post-therapy could be related to other factors, not necessary to the specific treatment received. Therapeutic modalities and study designs are generally heterogeneous. Differences exist in sample characteristics, such as the specificity of the disorder and number and duration of sessions. Moreover, the sample size is relatively small, particularly due to the paucity of studies in this field and the little contribution of PDT. Conclusions and implications of key findings: All psychological interventions seem to influence the brain from a functional point of view, showing their efficacy from a neurological perspective. Frontal, prefrontal regions, insular cortex, superior and inferior frontal gyrus, and putamen seem involved in these neural changes, with the psychodynamic more linked to the latter three regions.

Sleep and circadian rhythm disruption alters the lung transcriptome to predispose to viral infection.

Sleep and circadian rhythm disruption (SCRD), as encountered during shift work, increases the risk of respiratory viral infection including SARS-CoV-2. However, the mechanism(s) underpinning higher rates of respiratory viral infection following SCRD remain poorly characterized. To address this, we investigated the effects of acute sleep deprivation on the mouse lung transcriptome. Here we show that sleep deprivation profoundly alters the transcriptional landscape of the lung, causing the suppression of both innate and adaptive immune systems, disrupting the circadian clock, and activating genes implicated in SARS-CoV-2 replication, thereby generating a lung environment that could promote viral infection and associated disease pathogenesis. Our study provides a mechanistic explanation of how SCRD increases the risk of respiratory viral infections including SARS-CoV-2 and highlights possible therapeutic avenues for the prevention and treatment of respiratory viral infection.

The Analyst's Self-Care: Further Reflections after the Pandemic on Cultivating Resilience and the Essential Role of the Body-Mind Relationship in Clinical Practice.

Sparse attention is paid in the psychoanalytic literature to the management of self-care needs of the analyst. I suggest that pandemic fatigue experienced by psychotherapists during the Covid-19 global crisis has thrown into bold relief the requirement for clinicians to attune to the body, particularly the requirement for rest and creative space. Physical and emotional exhaustion is multidetermined and not unique to this time period; the global crisis appears to have unmasked particular difficulties in sensing and tending to requirements of the body-mind. Changes observed in sleep, dreams, exercise, eating, and somatic states during the pandemic raise additional questions about modifiable risk factors of burnout. Drawing upon contemporary evidence emerging from the fields of cognitive psychology, neuroscience, and psychodynamic practice and theory, suggestions are made to assist the analyst in rendering essential self-care.

Function of the Neuroscience Aspect in Surah Al-Insyirah and Al-Ankabut in Increasing Happiness and Alleviating Stress during the Post Covid-19 Pandemic Era

This article aims to elaborate on the functionality of the neuroscience aspect found in Surah al Insyirah and Surah al Ankabut in efforts to increase happiness and reduce stress experienced during the post COVID-19 Pandemic era. Stress is the body's response to mental stress in human beings in the course of their daily life. This stress stimulus originates from both, outside and inside the human body and involves the limbic system, which is the centre for regulating adaptation in the human body. A growing body of research suggests that long term, stress -induced activation of the sympathetic nervous system (SNS) and the hypothalamic-pituitary-adrenal (HPA) axis may lead to increases in inflammation, which is known to play a key role in the pathophysiology of a variety of diseases. Furthermore, the burgeoning fields of social neuroscience and health neuroscience have begun to identify the neurocognitive mechanisms by which stress may lead to these physiological changes. Tadabur (deep reflection) on the meaning of Surah Al-Insyirah and Al-Maarij, which depict the problems faced by humans, can increase happiness and reduce the stress level in humans who are facing challenges brought about during the post COVID 19 pandemic era. Specifically, we summarize the results of neuroimaging studies that have examined the neural correlates of stress-related increases in SNS, HPA, and inflammatory activity. A set of neural systems involved in threat processing, safety processing, and social cognition are suggested as key contributors to stress-related changes in physiology.

Hyperacute Stroke Nursing Workshop in a New Norm: A Small Scale Pilot Hybrid Training Program

Background and Aims: The presence of a code stroke nurse has been demonstrated to reduce door-to-treatment time. Unprecedented COVID-19 pandemic have halted face-to-face training program, resulting in a hybrid training program development. The aim of this project was to explore the users' experience and effectiveness of a new hybrid program for hyperacute stroke nursing training. Method(s): This hybrid workshop was incorporated virtual learning platforms and traditional in-person learning. Pre-post self-assessment knowledge was evaluated using a 20 multiple choice questions (MCQs) and a 5-point Likert scale. A virtual Objective Structured Clinical Examination (OSCE) was conducted as summative assessment. All faculty and participants completed the course evaluation. Result(s): Six neuroscience Advanced Practice Nurses with no prior experience in stroke activation participated in the training program. There was only a 10% increase in MCQ mean score. Feedback received for MCQs include having plausible distractors and difficult vocabulary. Five participants completed the virtual OSCE with mean score of 80%. Majority would prefer to have more clinical exposure. Overall, there was 39.4% increase of self-assessment on knowledge post workshop. Being able to conduct proper assessment and debrief in safe environment were key positive feedbacks. Conclusion(s): This hybrid workshop enhances nurses' knowledge in code stroke nursing training. Faculty will need to review and improve the MCQ construct. Clinical attachment extension would have created more opportunity to gain clinical knowledge and insight on the stroke activation processes. Overall, hybrid session on hyperacute stroke nursing training is feasible especially in this COVID-19 pandemic.

Parallel worlds: Popular education through neuroscience and the fine arts

This chapter describes the Parallel Worlds event series from conception to delivery. Included are the neuroscientific and artistic phenomena explored throughout the project and the bridges between them, the roles of the presenters, the formats of the events, and the dynamic exchanges with the attendees. While originally slated to be experienced live in the galleries and studios of the Montreal Museum of Fine Arts (MMFA), the chapter will illustrate the various adaptations employed to rework the project for the virtual environment necessitated by COVID-19 restrictions. While the advantages of experiencing the fine arts and education live cannot be disputed, the virtual format of Parallel Worlds presented several advantages, which will be discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Optimizing sluggish state-based neural networks for effective time-series processing

The devastating personal and economic upheaval caused by the financial crises in 2007/2008 and more recently, the spread of Covid-19 from Feb 2020 till date (June 2021) strongly highlighted the need for effective time-series processing models that can provide useful insights and accurate forecasts in a timely manner to inform critical decision-making that affects lives and livelihoods. Thus, this research is focused on identifying an effective and suitable time-series approach that harnesses advantages of the current state-of-the-art forecasting models whilst mitigating their challenges. A critical review of existing state-of-the-art methods revealed the following two key attributes are required for effective time-series processing: a robust yet flexible memory mechanism and minimal computational complexity for modelling complex dynamic time-series. The Multi-recurrent Neural Network (MRN) was identified as the preferred model and subject to critical examination and enhancement due to its unique and powerful sluggish state-based memory mechanism that has largely gone unnoticed since its first introduction by Claudia Ulbricht from the University of Austria in 1994This thesis subsequently makes the following four meaningful contributions to the research field: a) the MRN was applied to different real-world temporal problems (where it had not previously been applied) (of varying complexity). It was then compared to current state-of-the-art forecasting methods, where it demonstrated superior performance. It was critically assessed to identify limitations and points of extension;b) the MRN's hidden layer was endowed with periodically attentive units to tackle two well-known issues affecting artificial neural networks;vanishing gradient problem and catastrophic interference. This innovation applied to the hidden layer encouraged the network to organise features according to different units of time. Therefore, reducing the information processing load placed on individual hidden units. Thus, alleviating the issue of catastrophic interference. In addition, the network was able to hold information for longer periods of time, as the unit partitions only responded at specific time intervals. This provided a means to mitigating the vanishing gradient problem, which in most instances led to better performance;c) the MRN was endowed with an innovative self-learning mechanism, to reduce user input and identify architectural hyper-parameters. This extension enabled the MRN to inform and enhance its internal memory composition (and thus quality) through incorporating Ratio Control Units to learn the layer-link ratios. This technique provided a new outlook on algorithm development, in particular pointing to the abilities of recurrent neural networks, and in particular, the MRN, to innately learn the importance of historical context rather than relying on hyper-parameters manually set by the user and d) a framework incorporating one of the proposed MRN innovations together with a one-shot pruning algorithm (based on the learnt ratio similarity) was proposed. The framework specifically provided a means of obtaining 'good' models by eliminating the need to train numerous models to exhaustively explore the search space for the optimum memory bank configuration. The new innovation simply requires one large over-parameterised MRN to be trained.More specifically, the pruning algorithm will automatically identify the optimum memory bank configuration in a robust manner which minimises the coupling of memory banks whilst maximising, or at least retaining, strong generalisation ability. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

SARS-CoV-2 infects neurons and induces neuroinflammation in a non-human primate model of COVID-19.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the etiologic agent of coronavirus disease 2019 (COVID-19), can induce a plethora of neurological complications in some patients. However, it is still under debate whether SARS-CoV-2 directly infects the brain or whether CNS sequelae result from systemic inflammatory responses triggered in the periphery. By using high-resolution microscopy, we investigated whether SARS-CoV-2 reaches the brain and how viral neurotropism can be modulated by aging in a non-human primate model of COVID-19. Seven days after infection, SARS-CoV-2 was detected in the olfactory cortex and interconnected regions and was accompanied by robust neuroinflammation and neuronal damage exacerbated in aged, diabetic animals. Our study provides an initial framework for identifying the molecular and cellular mechanisms underlying SARS-CoV-2 neurological complications, which will be essential to reducing both the short- and long-term burden of COVID-19.

Impact of COVID-19 pandemics on advanced neuroscientific R&D activities: a focus on job age

Notwithstanding the implementation of strategic responses to recover habitual levels of performance and productivity, global data points out that the outbreak and diffusion of COVID-19 have imposed a high cost on research activities. Starting from a national survey investigating the impact of pandemics on Italian research in neuroscience, we here specifically aims at exploring its effects on scientific productivity across junior-to-senior professionals. Data highlighted that, given a generalized decrease of objective markers of scientific productivity (i.e. submitted projects or papers), the extent of such decrease was most notable in junior, mid-level and early senior researchers. Also, subjective measures of impact of the pandemics on professional life and work efficiency revealed a coherent profile, with junior and mid-level research professionals referring the highest perceived impact, while the impact of pandemics at psychological and socio-relational levels was rated almost similarly by researchers with different levels of seniority.

Implementation of Civility Saves Lives in the Neurosurgical Theatre Department

Introduction: Incivility is defined as rude behaviour or rude remarks[1]. It comes from the Latin incivilis meaning 'not of a citizen' and includes belittling, sarcastic comments, ignoring, rebuking and embarrassing colleagues as well as non-verbal behaviours such as eye rolling. External stressors combined with a permissive environment allow this behaviour to occur. Stressors are personal and work-related stress, feeling rushed, over-worked, having low morale or suffering exhaustion[2]. Many of these are commonplace within the healthcare system, particularly during the last two years with the COVID-19 pandemic. Healthcare workplace incivility is common, reported up to 97% in the operating room[2] with a resultant impact on staff and presenting a patient safety risk. Katz et al[3] described significant differences in performance of anaesthetic trainees exposed to a polite or rude surgeon during a simulated intra-operative haemorrhage (91.2% vs. 63.6% (P=0.007) performing at expected level). 25% of staff who experienced incivility take this out on service users. 75% of service users who witness it are less enthusiastic about the organisation [4]. Reducing workplace incivility is part of the NHS Long-term Plan[5] and NHS People Plan[6]. Our primary objective was to determine prevalence of perceived disruptive behaviours within the operating room at a single-specialty neurosciences centre. Secondary objectives were to identify the most frequent types of disruptive behaviours and implement changes to reduce incivility. Methodology: This survey is locally registered (ref: 10-202122-SE). An anonymous, electronic survey, using Google Forms, was disseminated to healthcare staff working in the neurosurgical operating rooms over 1-month (July 2021) using email cascades and established staff WhatsApp groups. Reminders were sent at week 2 and 3. The survey was previously validated [2] and consisted of two sections: exposure (14-items in 4 categories: personal;in-group;out-group;undirected and directed at patients) and responses (14-items) to disruptive behaviours. Data collected included staff demographics. Data was analysed using Microsoft Excel. Result(s): The survey response rate was 49% (n=92;Table 1). 85% of responders perceived experiencing or witnessing disruptive behaviour, most frequently undirected (85%), and mostly a few times a year (personal 70%;patient-directed 67%;in-group 65%;out-group 68%;undirected 56%). A few respondents personally experienced disruptive behaviours on a monthly (4%), weekly (1%) or daily basis (1%). 'Having work obstructed' was the most frequently perceived personal (62%) or out-group (62%) disruptive behaviour, 'sarcasm' most common in-group (63%) and 'speaking ill of others' (85%) most common undirected behaviour. Response to perceived disruptive behaviours was assertive (68%), rarely malicious or manipulative (<1%). 47% accepted the behaviours as a part of normal operating room culture. Further subgroup analysis was not conducted due to small numbers. In response to our survey, we have taken the following actions: (1) Raising awareness: We have presented the results at multidisciplinary staff forums;including Hospital, Neuroanaesthetic and Neurosurgical Department Safety Forums and Operating Department teaching sessions. (2) Further education and awareness: Posters and infographics are displayed from the Civility Saves Lives movement[7], AAGBI #knockitout[8] and of survey results. (3) Staff encouraged to attend further training: Active Bystander, to develop tools to manage disruptive behaviours. Conclusion(s): Perceived disruptive behaviours may be common within the neurosurgical operating room environment. Our results are in keeping with published literature[2] and highlight an important patient safety risk. Encouraging staff to overcome incivility can improve team performance and reduce errors[3], creating a more supportive working environment, safeguarding patients and improving experience. Staff may be empowered to speak up when they see something that potentially jeopardises patient safety. We plan to resurvey once changes have been fully implemented for a period of 6 months to see whether greater awareness and empowerment of staff has made a difference. (Table Presented).

A RARE CASE OF POSTERIOR REVERSIBLE ENCEPHALOPATHY SYNDROME (PRES)

SESSION TITLE: COVID-19 Case Report Posters 3 SESSION TYPE: Case Report Posters PRESENTED ON: 10/19/2022 12:45 pm - 01:45 pm INTRODUCTION: We are presenting a rare case of Posterior Reversible Encephalopathy Syndrome (PRES) without traditional risk factors in a patient with Covid 19. CASE PRESENTATION: Patient is a 41 y/o F with a past medical history of obesity, seizure disorder, epilepsy, hyperlipidemia and asthma who was admitted for Covid 19 pneumonia. Patient was transferred to the ICU on day #5 and intubated on day #8. Patient was given remdesivir, dexamethasone and baricitinib. Patient required intermittent vasopressors as her blood pressure varied between hypotensive and normotensive. Rarely her blood pressure increased to a hypertensive range. Patient had a thrombotic event on day #19 in her right upper extremity secondary to continuous renal replacement to manage acute renal failure. On Day #24, patient became unresponsive without sedation with an EEG showing moderate to severe slowing. On day #26 patient had a decreased response to stimuli leading to an MRI to evaluate for Posterior Reversible Encephalopathy Syndrome (PRES). MRI highlighted abnormal signal in the brain parenchyma concentrated mainly in the posterior brain consistent with PRES. On day #31 patient exhibited seizure like diffuse tremor. Blood pressure ranged from 90/72 to 137/84 hospital days #20-31. Status epilepticus was evaluated by an long term monitoring EEG showed diffuse slowing and occasional sharp wave activity in the right posterior cerebellum and occipital region without active seizures. On day #39 patient was found to have an acute hemorrhagic stroke of the left temporal region which resolved on day #43. On day #47 patient was transferred to a tertiary care center for tracheostomy placement and discharged on day #55 to a LTACH for rehab. DISCUSSION: PRES is a rare but severe complication of Covid 19 infection. Previous cases showed variability in underlying causes. Our patient showed significant endothelial dysfunction leading to multiple thrombotic events[1]. While our patient had rare hypertensive episodes, they were not persistent nor severe, nor were they present at the time of her seizure activity[1][2]. In comparison to previous cases, our patient had overlapping risk factors such as renal failure, obesity and dyslipidemia[1]. Our patient showed common clinical manifestations of PRES such as seizures, focal neurological deficits, and altered mental status with previous cases[1]. Our patient was not given tocilizumab in contrast with previous cases, however was given corticosteroids[1][2]. CONCLUSIONS: The above is a rare case of PRES without traditional risk factors. Providers must keep a wide differential diagnosis in patients with Covid 19. Reference #1: Lallana, S., Siegler, J. E., Chen, A., Requena, M., Rubiera, M., & Sanchez, A. (2021). Response to correspondence concerning "posterior reversible encephalopathy syndrome (PRES) associated with covid-19.” Journal of Clinical Neuroscience, 92, 189–190. https://doi.org/10.1016/j.jocn.2021.08.006 Reference #2: Kishfy, L., Casasola, M., Banankhah, P., Parvez, A., Jan, Y. J., Shenoy, A. M., Thomson, C., & AbdelRazek, M. A. (2020). Posterior reversible encephalopathy syndrome (PRES) as a neurological association in severe covid-19. Journal of the Neurological Sciences, 414, 116943. https://doi.org/10.1016/j.jns.2020.116943 DISCLOSURES: No relevant relationships by Arka Bhattacharya No relevant relationships by Benjamin Silverman

COMMON PRESENTATION WITH AN UNCOMMON ETIOLOGY: THYMOMA-ASSOCIATED AUTOIMMUNE ENCEPHALITIS INDUCED BY COVID-19 BOOSTER VACCINE

SESSION TITLE: Issues After COVID-19 Vaccination Case Posters SESSION TYPE: Case Report Posters PRESENTED ON: 10/19/2022 12:45 pm - 01:45 pm INTRODUCTION: Thymoma-associated autoimmune encephalitis (TAAE) is an understudied and overlooked diagnosis in patients presenting with abrupt altered mental status. Described as inflammation of brain tissue, autoimmune encephalitis is seen in 5-10 cases per 100,000 across all age groups per year. A rare subtype involves neuronal surface antibodies to alpha-amino-3-hydroxyl-5-methyl-4isoxazolepropionic acid receptors (AMPA-R) encephalitis is seen even less commonly. Given the "unicorn” nature of presenting cases and difficulty of diagnosis, prompt identification and treatment are critical as prolonged courses without treatment are irreversible and deadly. CASE PRESENTATION: A 47-year-old male with no past medical history presented 3 days after a Johnson & Johnson coronavirus-2019 (COVID-19) booster vaccine due to worsening acute altered mental status over the past week. He complained of episodes of fever & chills prior to this. The patient's wife reported abrupt changes in memory and personality. Upon admission, the patient had a Glasgow Coma Scale of 4. The patient was intubated and transferred to the intensive care unit. Intravenous (IV) vancomycin, ceftriaxone and acyclovir was initiated for meningitis. Computed tomography (CT) scan of the head without contrast was unremarkable. Magnetic resonance imaging (MRI) showed enhancements of the right anterior and medial temporal lobe suggesting encephalitis. Cerebrospinal fluid analysis (CSF) revealed lymphocytic pleocytosis. A CT scan of the chest, abdomen and pelvis showed an anterior mediastinal mass measured 1.8 x 2.3 cm (Figure 1). FilmArray Meningitis polymerase chain reaction was negative as well as Herpes Simplex Virus (HSV) 1 and 2. Autoimmune encephalitis antibody was positive for Anti-AMPAR. Pulse dose steroids and intravenous immunoglobulin were initiated but failed. Rituximab was initiated and cardiothoracic surgery completed a thymectomy. DISCUSSION: TAAE is a rare disease, permanently debilitating, and deadly if unrecognized or treatment is delayed. Autoimmune encephalitis is an umbrella disease process seen in 0.00005% of patients per year. AMPA-R positive encephalitis is even less commonly seen with only 22 cases reported between the years 2009 and 2014 [1]. A rapidly progressive cognitive decline or psychiatric disorders are early features of this disease.Our patient had prodromal symptoms of fever and cognitive decline days after receiving his COVID-19 booster vaccine. CONCLUSIONS: Post-vaccine encephalomyelitis has been described in other settings[2]. This patient was free of symptoms prior to the COVID-19 vaccine booster, and demonstrated altered mental status hours after receiving it. This furthers the possibility of an association of the COVID-19 booster vaccine, development of encephalitis, and in this case a thymoma. Despite this, conclusions can not be made on the account of one report, but introduces a new area of focus to study. Reference #1: Höftberger, R., van Sonderen, A., Leypoldt, F., Houghton, D., Geschwind, M., Gelfand, J., Paredes, M., Sabater, L., Saiz, A., Titulaer, M. J., Graus, F., & Dalmau, J. (2015). Encephalitis and AMPA receptor antibodies: Novel findings in a case series of 22 patients. Neurology, 84(24), 2403–2412. https://doi.org/10.1212/WNL.0000000000001682 Reference #2: Huynh, W., Cordato, D. J., Kehdi, E., Masters, L. T., & Dedousis, C. (2008). Post-vaccination encephalomyelitis: literature review and illustrative case. Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia, 15(12), 1315–1322. https://doi.org/10.1016/j.jocn.2008.05.002 DISCLOSURES: No relevant relationships by Matthew Frank No relevant relationships by Justin Ilagan No relevant relationships by Danielle Mahon No relevant relationships by Danielle Mahon No relevant relationships by Harshini Sahani No relevant relationships by Kameron Tavakolian No relevant relationship by Ndausung Udongwo

Integration of technology initiatives with educational neuroscience and its impact on technology readiness to technology adoption by HSS teachers, Kerala

The technology-enabled education process remoulded the modern education systems. The facelift of education 4.0 process harmonized the education systems with industrial demands and technology advancements. The education reforms of the State of Kerala with the tools of technology and neuroscience could achieve remarkable milestones in the education sector. This case study analyses the digital initiatives of KITE and its role on providing uninterrupted-effective education during the Covid-19 pandemic in Kerala. This study is affirmed with quantitative study on how these integrated technology initiatives impact on Technology Adoption of the HSS teachers with respect to their Technology Readiness. Responses of 857 teachers from six education districts of Kerala were used for this study. This study is relevant as it could connect the pre-Covid digital initiatives which could successfully empower the teachers to face the Covid-19 pandemic situation without interrupting the education process amidst the Covid-19 restrictions in Kerala. The study identified that the technology learning initiatives with tools of educational neurosciences have partially mediated teachers' Technology Readiness to Technology Adoption. The multiple learning initiatives integrated with the tools of technology and educational neuroscience could fully support the virtual learning throughout the State of Kerala during the Covid-19 pandemic situations. (PsycInfo Database Record (c) 2022 APA, all rights reserved)