Brief Report: Impact of COVID-19 on Individuals with ASD and Their Caregivers: A Perspective from the SPARK Cohort

The impact of the 2019 coronavirus pandemic (COVID-19) in the United States is unprecedented, with unknown implications for the autism community. We surveyed 3502 parents/caregivers of individuals with an autism spectrum disorder (ASD) enrolled in Simons Powering Autism Research for Knowledge (SPARK) and found that most individuals with ASD experienced significant, ongoing disruptions to therapies. While some services were adapted to telehealth format, most participants were not receiving such services at follow-up, and those who were reported minimal benefit. Children under age five had the most severely disrupted services and lowest reported benefit of telehealth adaptation. Caregivers also reported worsening ASD symptoms and moderate family distress. Strategies to support the ASD community should be immediately developed and implemented.

Fibrous Dysplasia and Juvenile Psammomatoid Ossifying Fibroma: A Case of Mistaken Identity

Juvenile psammomatoid ossifying fibroma (JPOF) is a rare benign osseous tumor, usually presenting in the midface. There are many similarities in location, presentation, and radiographic appearance between fibrous dysplasia (FD) and JPOF. Awareness of this entity is important for craniofacial surgeons, as surgical timing and intraoperative management differ between these tumors. Findings that should raise suspicion of JPOF preoperatively include rapid growth, a shell of cortical bone surrounding the lesion, and clearly demarcated borders of the lesion on imaging, as opposed to a gradual transition between normal and abnormal bone. Definitive excision is the treatment of choice, and earlier surgery may provide better results by addressing the lesion at the smallest size possible. In contrast to FD, JPOF is not known to “burn out,” so there is minimal benefit to be gained from delay. We present a summary of the evidence for diagnosis and treatment of JPOF as well our experience with JPOF in an 11-year-old female who was initially diagnosed with FD. We aim to draw attention to the similar presentations of these entities so the reader will be able to more accurately manage these patients.

P.066 Intrajejunal levodopa infusion (ILI) for Parkinson’s Disease (PD): a Canadian experience

Background: ILI has been in use in Canada since 2011 to treat advanced PD. We review the benefits and complications of ILI for PD in a tertiary movement disorders center in Canada. Methods: Detailed chart review of patients treated with ILI at including motor UPDRS scores, ILI pump and PEG-J tube complications. Patients and caregivers were interviewed at regular clinic follow up about their experience with ILI. Results: 13 patients received ILI [10M, 3F; mean age 65.6 yrs, range (51.8-79.5); PD duration 14.2 yrs, range (9.1-22.0); mean follow-up 1.8 yrs, range (0.2-4.8)]. Patients reported improvement in motor function, decreased dyskinesias and ‘OFF times’ [mean motor UPDRS: pre-ILI 37.1, 1-6months post-ILI 27.5]. Common complications included dislodgement, knotting or blockage of the jejunal tube extension requiring endoscopic re- insertion (29 incidents in 6 patients over 5 yrs). Four patients discontinued Duodopa treatment, for reasons of declining cognition, inability to care for the pump, and/or minimal benefit. Conclusions: ILI is useful for the treatment of advanced PD, in patients that can care for the pump apparatus.

Curved Crease Tube Structures as an Energy Absorbing Crash Box

Straight-crease origami crash boxes have previously been designed to possess a near optimum failure mode for a tubular energy-absorbing device. This failure mode, termed a ‘complete diamond mode’ (CDM), possesses a low peak force Pmax and high average force Pavg, caused by generation of travelling hinge lines that propagate laterally during crushing. The present study investigates the hypothesis that a curved crease structure could further improve failure characteristics by having a lower Pmax due to the initially curved corner lobes. An experimental and numerical investigation was conducted using aluminium curved crease origami tubes, with certain curved crease tubes exhibiting the desired CDM and good correspondence seen between experimental and numerical behaviours. A parametric numerical analysis on 45 steel curved crease origami tubes showed a maximum reduction in Pmax of 67% was observed, which is better than the straight-crease origami crash boxes in this respect. A maximum increase in Pavg of 65% was observed, which is worse than straight-crease origami crash boxes. A lower Pmax was thus achieved as hypothesised, however this improvement came at the expense of a reduction in average force. Curved crease crash boxes are therefore concluded to have minimal benefit over existing straight crease crash box designs.

Zika Virus: Endemic Versus Epidemic Dynamics and Implications for Disease Spread in the Americas

Since being introduced into Brazil in 2014, Zika virus (ZIKV) has spread explosively across Central and South America. Although the symptoms of ZIKV are generally mild, recent evidence suggests a relationship between prenatal exposure to ZIKV and microcephaly. This has led to widespread panic, including travel alerts and warnings to avoid pregnancy. Because ZIKV is an emerging disease, response efforts are complicated by limited understanding of disease dynamics. To this end, we develop a novel state- and class-structured compartment model for ZIKV. Our model shows that the risk of prenatal ZIKV exposure should decrease dramatically following the initial wave of disease, reaching almost undetectable levels in endemic systems. Our model also suggests that, depending on ZIVK transmission levels in the Americas, efforts to reduce ZIKV prenatal exposures through mosquito management and avoidance may have minimal benefit, and may even result in increased risk of microcephaly in later years of an outbreak.