Central Series Research Articles

Multi-Frequency Noise Reduction Method for Underwater Radiated Noise of Autonomous Underwater Vehicles

The multi-frequency noisy vibration of an autonomous underwater vehicle (AUV) is a significant factor affecting the performance of shear probes mounted on the head of AUVs. Many efforts have been made to suppress mechanical radiation noise; however, conventional noise reduction methods have their limitations, such as mode mixing. In order to extract thorough information from the aliasing modes and achieve multi-frequency mode targeted correction, a multi-frequency noise reduction method is proposed, based on secondary decomposition and the multi-mode coherence correction algorithm. Weak impulses in aliasing shear mode are enhanced, and mixing frequencies are isolated for thorough decomposition. Noisy mechanical vibrations in the shear modes are eliminated with the use of the acceleration modes along the identical central frequency series. The denoised modes are used to reconstruct the cleaned shear signal, and the updated spectra are aligned with the standard Nasmyth spectrum. Compared with the raw profiles, the variation in the dissipation rate estimated from the corrected shear is reduced by more than an order of magnitude.

Widening of narrow urethral plates with lateral skin in TIP hypospadias repair: single center series

BackgroundTo compare the outcomes of hypospadias repair using tubularized incised plate (TIP) urethroplasty and modified TIP with lateral skin to widen the urethral plate (WTIP).Materials and methodsData were obtained from pre-pubertal boys who underwent primary hypospadias repair between May 2018 and July 2023. The cases were divided into two groups; one group underwent TIP with urethral plate ≥ 6 mm width and the other group with urethral plate width < 6 mm underwent WTIP. WTIP urethroplasty was performed by widening incisions on the outer margins of the urethral plate to incorporate penile and glandular skin lateral to the urethral plate to facilitate tubularization. Complication rates and urinary functions were compared.ResultsA total of 157 patients were enrolled in this study. Eighty-eight cases with narrow urethral plate were subjected to WTIP urethroplasty, and the rest were subjected to TIP urethroplasty. The preoperative glans width in WTIP group was less than that in TIP group (P < 0.001), and 44.3% had midshaft meatus in WTIP group compared to 17.4% in TIP group (P < 0.001). However, the incidences of postoperative complications (17.6% vs. 21.6%, P = 0.550) were not statistically different between the TIP and WTIP groups. In addition, both groups did not differ significantly in postoperative uroflowmetry assessment.ConclusionsThe described technique helps to create an adequately caliber aesthetic neomeatus and facilitates tubularization, especially in hypospadias with a narrow urethral plate. Our data suggest that augmentation of a narrow urethral plate with WTIP has a similar surgical outcome to that of the TIP procedure in patients with a wide urethral plate.

Implementation of an adapted perioperative ventriculoperitoneal shunting protocol in a tertiary center located in a low-to-middle-income country.

Preventative protocols have efficaciously reduced shunt infection in developed countries. However, the generalizability of these protocols in low-to-middle-income countries (LMICs) remains unclear. Previously, shunt insertion in the authors' center was routinely performed under institutional preventative precautions, which was updated via merging with the Hydrocephalus Clinical Research Network (HCRN) protocol. This study aimed to investigate the ventriculoperitoneal shunt (VPS) infection rates in pediatric patients following the implementation of the adapted protocol. The adapted protocol was implemented in all first-time VPS implantations between 2011 and 2021. The primary outcome was a 6-month shunt infection. The Pearson chi-square test was used for categorical variables and the Mann-Whitney U-test for numeric variables to evaluate the correlation with shunt infection. A total of 352 first-time VPS procedures were performed adhering to the adapted protocol. The median age was 5months, and 189 (53.7%) were male. Overall, 37 patients (10.5%) experienced shunt infection, with 30 (8.5%) occurring within the first 6months, which was lower than 13.3% infection rate of the previous series of the same center. The infection rate was slightly higher than the 5.7% and 6.0% rates reported by HCRN studies. Patients with shunt infection were significantly younger (7.5 versus 17.5months, P < 0.001). This study validates the efficacy of an adapted perioperative protocol in mitigating shunt infection in a high-volume center in a LMIC. Adhering to a step-by-step protocol, modified to suit the healthcare resources and financial constraints of LMICs, could maintain low shunt infection rates that are roughly comparable to those of centers in high-income countries.

924 Corpus Callosotomy for Intractable Epilepsy: A Contemporary Series of Operative Factors and Overall Complication Rate

INTRODUCTION: Corpus callosotomy is an effective treatment for atonic seizures in medically refractory epilepsy. Recently, laser interstitial thermal therapy has been adapted as a less invasive method to achieve similar results, yet technical challenges associated with this nascent approach persist. A modern series of corpus callosotomies performed by open craniotomy is lacking in the literature, a fact which highlights the importance of establishing contemporary complication rates for this operation to compare with newer methodologies. METHODS: We retrospectively reviewed institutional data for patients who underwent first time open callosotomy from 2005 to 2022. Demographic and clinical variables were collected and analyzed with a focus on operative factors and complication rates. RESULTS: 105 patients were included in the study with a mean age of 9.39 years (0.67-24.17 years). 58.1% of patients were male (61), and one surgeon performed a majority (76.20%, 80) of the operations with two other surgeons performing the remainder (21.9% and 1.90%, respectively). In total, 63 complete, 31 subtotal (anterior 70-99%), and 1 posterior (40%) callosotomies were performed. Blood loss was available for 102/105 patients with a mean of 96.67 mL (10-500 mL), and mean operative time was calculated as 226.76 minutes (45-504 minutes) from 76/105 patients by excluding those patients who underwent concurrent vagal nerve stimulator placement or revision. Operative complication rate was determined to be 6.67% and was comprised of 3 pseudomeningoceles, 3 superficial wound infections, and 1 delayed intraparenchymal hemorrhage. No venous infarcts were observed on postoperative MRI. CONCLUSIONS: This the largest single center series of open callosotomy patients describes important updated metrics to help evaluate new techniques being developed for the surgical treatment of atonic seizures in medically intractable epilepsy.

118 Intraoperative Radiotherapy Combined With Spinal Stabilization Surgery. A Novel Treatment Strategy for Spinal Metastases. First Experiences at a Single Center

INTRODUCTION: Contemporary treatment of spinal metastases (SM) aims on preserving spinal stability, neurological status, local control and functional status. It consists of spinal surgery followed by radio- and chemotherapy. Adjuvant therapy is performed after several weeks to prevent wound healing issues. Intraoperative radiotherapy (ioRT) is a solution to shorten treatment time, successfully applied in brain tumor, breast and colorectal surgery but not SM to date. METHODS: Results on morbidity and mortality of ioRT combined with stabilization surgery in SM in a first single center series are described. Stabilization is performed as CT-navigated open or percutaneous procedure using a carbon screw-rod system followed by 50kV photon-ioRT using the ZEISS Intrabeam during a single session in prone position. The ioRT probe is placed through a guide canula via navigation and positioning is controlled by ioCT to enable RT isodose planning in the OR. Patient characteristics, perioperative specifications and postoperative follow up along with adverse events (AE) are reported. RESULTS: 11 (7 female) patients (69 ± 9.4y) received treatment from 07/22-04/23. Median SINS was 8 [7-10] IQR, with metastasis located in thoracic (n = 9) and lumbar (n = 2) spine. 6 patients receive open, 4 percutaneous stabilization and 1 decompression only. Mean length of surgery was 153±52 min. with 2 Patients receiving 4 and 8 patients receiving 8 screws respectively. In 2 Patients radiotherapy was not completed due to bending of the guide canula with consecutive security abortion of ioRT. All other patients received 8Gy isodoses during 2-6 min. Patients treated had ESCC 1a-2. Mean follow up was 63 ± 49 days. 4 patients experienced AEs including 1 case of fatal surgical site infection. CONCLUSIONS: 50 kV photon ioRT for SM can be a promising technique for selected cases of SM.

Charting and analyzing the catch distribution of Japan’s coastal fisheries resources based on centennial statistics

Spatiotemporal changes in catches and transition of fishing grounds have been observed in various coastal fishery resources in Japanese waters in recent years. Are these changes part of cyclical fluctuations on a centennial timescale? Are these changes situations that have never been observed prior to this? Are common factors included in the long-term fluctuations among coastal fisheries resources? A total of 12 important Japanese coastal fisheries resources including fishes, shells, invertebrates, and algae were analyzed using fisheries statistics on the geographical center of catch compiled since 1894. The time series of the geographical center of catch showed a cyclical fluctuation trend over time rather than changing monotonically. The geographic center of catch in recent years (2019–2021) was located at the northeastern margin of the distribution, compared to its location since the end of the 19th century for many fishery resources. For coastal fishery resources, the situation in terms of fluctuations in the geographical center of catch is more extreme than in the past 100 years. The results of the dynamic factor analysis suggested that the state of these resources may be affected by the global ocean environment and other factors including human activities. Examining how fisheries have responded to past cyclical fluctuations may provide insight into adapting to the current rapid changes caused by climate change.

On classification of $7$-dimensional odd-nilpotent Leibniz algebras

In this paper we extend the method of canonical form for congruence of bilinear forms to give the classification of some subclasses of $7-$dimensional nilpotent Leibniz algebras. Odd-nilpotent Leibniz algebras are defined as that its even dimensional ideals in lower central series are all zero and the classification of $7-$dimensional complex odd-nilpotent Leibniz algebras with one dimensional Leib ideal is obtained by applying the aforementioned method.

A morphological review of medial malleolar fractures – A large single centre series

BackgroundMany approaches to management of medial malleolar fractures are described in the literature however, their morphology is under investigated. The aim of this study was to analyse the morphology of medial malleolar fractures to identify any association with medial malleolar fracture non-union or malunion. MethodsPatients who had undergone surgical fixation of their MMF were identified from 2012 to 2022, using electronic patient records. Retrospective analysis of their preoperative, intraoperative, and postoperative radiographs was performed to determine their morphology and prevalence of non-union and malunion. Lauge-Hansen classification was used to characterise ankle fracture morphology and Herscovici classification to characterise MMF morphology. ResultsA total of 650 patients were identified across a 10-year period which could be included in the study. The overall non-union rate for our cohort was 18.77% (122/650). The overall malunion rate was 6.92% (45/650). Herscovici type A fractures were significantly more frequently mal-reduced at time of surgery as compared to other fracture types (p = .003). Medial wall blowout combined with Hercovici type B fractures showed a significant increase in malunion rate. There is a higher rate of bone union in patients who had been anatomically reduced. ConclusionThe morphology of medial malleolar fractures does have an impact of the radiological outcome following surgical management. Medial wall blowout fractures were most prevalent in adduction-type injuries; however, it should not be ruled out in rotational injuries with medial wall blowouts combined with and Herscovici type B fractures showing a significant increase in malunions. Herscovici type A fractures had significantly higher malreductions. Level of evidenceLevel 3 – Retrospective Cohort Study

On the norm of the lower central series in a finite group

In this paper, the norm [Formula: see text] of the lower central series in a finite group [Formula: see text] is introduced, which unifies the norm of derived subgroups and nilpotent residuals. Some propositions of [Formula: see text] are obtained, and some related subgroups as well as their equivalent propositions can also be found.

Cocaine-related ischemic priapism. Systematic review and presentation of a single center series

IntroductionIschemic priapism is a medical emergency that, if not treated, could lead to permanent erectile dysfunction. The association between cocaine and priapism is well-known; however, data on patient characteristics, treatment, and outcomes is missing.This work aimed to answer the research question: What are the characteristics, management strategies, and erectile prognosis of patients consuming cocaine and presenting with priapism? MethodsWe conducted a systematic review according to PRISMA guidelines and described our case series. ResultsEight studies were selected for qualitative synthesis, presenting information on ten patients. In our case series, we showed information regarding four patients. From the systematic review, the mean presentation time was 42.6 h, and the mean number of procedures to solve priapism was 2,4; in our case series was 42.75 h and 2, respectively. ConclusionCocaine-related priapism might present with a delayed diagnosis, need more procedures to be managed, and have a worse prognosis. More extensive and prospective studies are required.

On commuting automorphisms of finite p-groups of coclass 3

Let [Formula: see text] be a group. If the set [Formula: see text] forms a subgroup of [Formula: see text], then G is called [Formula: see text]-group. Recently, it has been proven that the minimum coclass of a non-[Formula: see text][Formula: see text]-group is equal to [Formula: see text]. In this paper, we deal with finite [Formula: see text]-groups of coclass [Formula: see text]. We prove that a finite [Formula: see text]-group [Formula: see text] of order [Formula: see text], [Formula: see text], of coclass [Formula: see text] for an odd prime [Formula: see text] is an [Formula: see text]-group except when the nilpotency class of the second term of upper central series [Formula: see text], [Formula: see text], is equal to [Formula: see text]. In particular, we show that in this case, center of [Formula: see text], [Formula: see text], and commutator subgroup [Formula: see text], [Formula: see text], are of order [Formula: see text] and [Formula: see text], respectively, and [Formula: see text] is a group of order [Formula: see text]. Also, we give some sufficient conditions on a finite 2-group [Formula: see text] of coclass [Formula: see text] implying that [Formula: see text] is an [Formula: see text]-group.

Epidemiology of Non-Traumatic Lower Extremities Amputations in West Africa: Nationwide Data from Togo

Non-traumatic lower limb amputation (NT-LLA) has consequences at individual and public health levels. Population based studies in sub-Saharan Africa are scarce and often related to single centre series. This study aimed to estimate the incidence of NT-LLA (minor and major) and to describe epidemiological, clinical, and prognostic aspects in Togo. This was a population based observational study conducted among all patients who underwent NT-LLA. Traumatic amputations were excluded. Sociodemographic, clinical, and work up data were collected from clinical files in any Togolese health centre from 1 January 2016 to 31 December 2021. Incidence rates were adjusted for age. Over the six year period, 352 patients (59% males) underwent NT-LLA (mean ± standard deviation age 60 ± 15.7 years). The average age adjusted incidence rate of NT-LLA was 8.5 per million/year (95% confidence interval [CI] 7.6 - 9.4). Men were 1.7 times more likely to undergo a NT-LLA than women. The relative risk of NT-LLA was 48 times higher in patients with diabetes than in patients without diabetes. Around 61.0% of the NT-LLAs occurred within the 50 - 74 age group and 54.3% had diabetes mellitus. Among amputees, 54.5% had a diagnosis of peripheral artery disease (PAD) and 52.8% had diabetic ulcers, with co-existence of several factors. Less than 5% of participants had a history of smoking tobacco. Average length of hospital stay was 12 days. The in hospital mortality rate was 8.8% (9.0% for major, 6.7% for minor amputations). Only 18.2% had duplex ultrasound performed and 1.7% angiography prior to amputation. No patient underwent vascular intervention prior to amputation. This is the first study to report nationwide and contemporary epidemiological data on NT-LLAs in West Africa, highlighting several specificities. Large scale interventions are needed to ameliorate the care of diabetes and PAD and improve facilities for optimal management of patients at risk of amputation in Africa.

Hall classes of groups

In 1958, Philip Hall (Ill J Math 2:787–801, 1958) proved that if a group G has a nilpotent normal subgroup N such that G/N′\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$G/N'$$\\end{document} is nilpotent, then G is nilpotent. The scope of Hall’s nilpotency criterion is not restricted to group theory, and in fact similar statements hold for Lie algebras and more generally for algebraically coherent semiabelian categories (see Chao in Math Z 103:40–42, 1968; Gray in Adv Math 349:911–919, 2019; Stitzinger in Ill J Math 22:499–505, 1978). We say that a group class X\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$${\\mathfrak {X}}$$\\end{document} is a Hall class if it contains every group G admitting a nilpotent normal subgroup N such that G/N′\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$G/N'$$\\end{document} belongs to X\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$${\\mathfrak {X}}$$\\end{document}. Thus, Hall’s nilpotency criterion just asserts that nilpotent groups form a Hall class. Many other relevant classes of groups have been proved to be Hall classes; for example, Plotkin (Sov Math Dokl 2:471–474, 1961) and Robinson (Math Z 107:225–231, 1968) proved that locally nilpotent groups and hypercentral groups form Hall classes. Note that these generalizations also hold if groups are replaced by other algebraic structures, for example Lie algebras (see Stitzinger in Ill J Math 22:499–505, 1978). The aim of this paper is to develop a general theory of Hall classes of groups, that could later be reasonably extended to Lie algebras. Among other results, we prove that many natural types of generalized nilpotent groups form Hall classes, and we give examples showing in particular that the class of groups having a finite term in the lower central series is not a Hall class, even if we restrict to the universe of linear groups.

Zero sum subsequences and hidden subgroups

We propose a method for solving the hidden subgroup problem in nilpotent groups. The main idea is iteratively transforming the hidden subgroup to its images in the quotient groups by the members of a central series, eventually to its image in the commutative quotient of the original group, and then using an abelian hidden subgroup algorithm to determine this image. Knowing this image allows one to descend to a proper subgroup unless the hidden subgroup is the full group. The transformation relies on finding zero sum subsequences of sufficiently large sequences of vectors over finite prime fields. We present a new deterministic polynomial time algorithm for the latter problem in the case when the size of the field is constant. The consequence is a polynomial time exact quantum algorithm for the hidden subgroup problem in nilpotent groups having constant nilpotency class and whose order only have prime factors also bounded by a constant.

The pedicled Antero lateral thigh flap for gender affirming surgery: what is different? First case series outcomes of a single center from Turkey.

The aim of this study is to share our preliminary outcomes of the pedicled Antero Lateral Thigh flap (ALTf) phalloplasty technique, which we presume to be the first reported case series of a single center from Turkey. A cross-sectional study, comprising all cases who underwent pedicled ALTf phalloplasty in our clinic, between January 2015 and December 2019, was designed. Demographic data, case characteristics and surgical details including complications were recorded. The mean age of our 26 cases was 30 (28-34) years. The mean penile length and diameter were 15.07 ± 0.98 cm and 3.9 ± 0.34 cm, respectively. Tactile sensation was evaluated by touching the radix, corpus and tip of the neo-phallus showing response in 17 (65.4%), 7 (26.9%) and 2 (7.7%) of the cases, respectively. In 14 (53.8%) of all our cases no complication was reported at all. However, in 12 (46.1%) cases, although no intraoperative complication occurred; postoperative complications were observed as Clavien-2 (3.8%), Clavien-3a (3.8%) and Clavien-3b (71%). Postoperative satisfaction rates were found 77.14% (38-94). Although relevant studies are limited, in addition to low complication rates and high satisfactory outcomes, by leading to a concealable donor site, the pedicled ALTf can be used as a preferred phalloplasty technique, especially in transmen with religious or cultural sensibility.

Diaphragmatic hernia after living-donor hepatectomy: case series of single center

Diaphragmatic hernia after living-donor hepatectomy: case series of single center

Автомофизмы нильтреугольных подколец алгебр Шевалле типа $G_2$ над областями целостности. I

Let $N\Phi(K)$ be the nil-triangular subalgebra of the Chevalley algebra over an associative commutative ring $K$ with the identity associated with a root system $\Phi$. This paper studies the well-known problem of describing automorphisms of Lie algebras and rings $N\Phi(K)$. Automorphisms of the Lie algebra $N\Phi(K)$ under restrictions $K=2K=3K$ on ring $K$ are described by Y. Cao, D. Jiang, J. Wang (2007). When passing from algebras to Lie rings, the group of automorphisms expands. Thus, the subgroup of central automorphisms is extended, i.e. acting modulo the center, ring automorphisms induced by automorphisms of the main ring are added. For the type $A_{n}$, a description of automorphisms of Lie rings $N\Phi(K)$ over $K$ was obtained by V.M. Levchuk (1983). Automorphisms of the Lie ring $N\Phi(K)$ are described by V.M. Levchuk (1990) for type $D_4$ over $K$, and for other types by A.V. Litavrin (2017), excluding types $G_2$ and $F_4$. In this paper we describe automorphisms of a nil-triangular Lie ring of type $G_2$ over an integrity domain $K$ under the following restrictions on $K$: either $K=2K=3K$, or $3K = 0$. To study automorphisms, the upper and lower central series described in this paper, are essentially used.

Автоморфизмы нильтреугольных подколец алгебр Шевалле типа G2 над полем характеристики 2

Let NΦ(K) be the nil-triangular subalgebra of the Chevalley algebra over an associative commutative ring K with the identity associated with a root system Φ (The basis of NΦ(K) consists of all elements er ∈ Φ+ of the Chevalley basis). This paper studies the well-known problem of describing automorphisms of Lie algebras and rings NΦ(K). Automorphisms of the Lie algebra NΦ(K) under restrictions K = 2K = 3K on ring K are described by Y. Cao, D. Jiang, J. Wang (Intern. J. Algebra and Computation, 2007). When passing from algebras to Lie rings, the group of automorphisms expands. Thus, the subgroup of central automorphisms is extended, i.e. acting modulo the center, ring automorphisms induced by automorphisms of the main ring are added. For the type An, a description of automorphisms of Lie rings NΦ(K) over K was obtained by V.M. Levchuk (Siberian Mathematical Journal, 1983). Automorphisms of the Lie ring NΦ(K) are described by V.M. Levchuk (Algebra and Logic, 1990) for type D4 over K, and for other types by A.V. Litavrin (Thesis for: Cand. Sc. (Physics and Mathematics) – 01.01.06. Siberian Federal University, 2017), excluding types G2 and F4. The author (2022) obtained a description of automorphisms of Lie rings NΦ(K) of type G2 when K is an integrity domain and K = 2K = 3K or 3K = 0. In this paper we describe automorphisms of a niltriangular Lie ring of type G2 over a field K under restriction 2K = 0. To study automorphisms, the upper and lower central series described in this work are essentially used. A new non-standard automorphism was found, called an S-automorphism.

The Clinical, Radiological and Genetic Spectrum of PLA2G6-Associated Neurodegeneration: An Experience From a Tertiary Center.

Despite being the second most common type of neurodegeneration with brain iron accumulation, there is limited literature on PLA2G6-associated neurodegeneration (PLAN) within the Asian ethnicity, particularly in the Indian context. We conducted a retrospective observational study on patients with pathogenic/likely pathogenic PLA2G6 variants based on exome sequencing. We identified 26 patients (22 families, 15 males) of genetically-confirmed PLAN with a median age of 22.5 years and age at onset of 13.0 years, encompassing various subtypes: infantile neuroaxonal dystrophy (5/26;19.2%), atypical neuroaxonal dystrophy (3/26;11.5%), dystonia-parkinsonism (5/26;19.2%), dystonia-parkinsonism-myoclonus (n = 4, 15.38%), early-onset Parkinson's disease (2/26;7.7%), complex dystonia (2/26;7.7%), and complicated hereditary spastic paraparesis (cHSP; 5/26;19.2%). The common initial symptoms included walking difficulty (7/26;26.9%), developmental regression (6/26;23.1%), and slowness (4/26;15.4%). Dystonia (14/26;53.8%), followed by parkinsonism (11/26; 42.3%), was the most common motor symptom. Non-motor symptoms included cognitive decline (12/26;46.2%) and behavioral changes (6/26;23.1%). Neuroimaging revealed cerebellar atrophy in 23/26 (88.5%) patients and claval hypertrophy in 80% (4/5) of INAD patients. Levodopa responsiveness was noted in 12 of 14 patients with parkinsonism/dystonia who received levodopa, and dyskinesia was noted in 10/11 patients. Genetic analysis revealed a total of 19 unique variants in PLA2G6 gene, of which 11 were novel. Twelve patients harbored the c.2222G>A variant, which is predominantly seen in Asian subpopulations. The study introduces 26 new patients of PLAN and 12 patients associated with the c.2222G>A variant, potentially forming the most extensive single center series to date. It also expands the phenotypic, neuroimaging, and genotypic spectrum of PLAN.

Yellow fever vaccine-associated neurologic and viscerotropic disease: a 10-year case series of the French National Reference Center for Arboviruses with clinical and immunological insights.

Immunization against the Yellow fever virus (YFV) with the 17D live-attenuated vaccine is the most effective way to prevent the disease. However, unexpected severe adverse events can occur. They consist in a neurological impairment - neurological disease (YEL-AND), a YF-like illness - viscerotropic disease (YEL-AVD) or anaphylaxis. In this article, we describe the epidemiology, clinical and biological features of YEL-AND and YEL-AVD cases reported to the French National Reference Center for Arboviruses (NRCA) in the past 10years. We conducted a national, retrospective study using the database of the NRCA from June 2012 to June 2022. All patients whose biological samples were sent to the NRCA for detection of YFV by serology and/or RT-qPCR for a suspected vaccine-associated adverse event were included. We collected data by reading medical records and conducted complementary neuro-immunological analysis, followed by a search for autoimmunity against type-1-interferon when samples were available at the NRCA. There were 10 cases of YEL-AND and 2 cases of YEL-AVD reported to the NRCA in the past 10years, which represented an overall incidence of 0.6 for 100 000 doses. A total of 6/12 cases were previously healthy patients (50%, mean age 31years), and 4/12 cases had cardiovascular co-morbidities (42%, mean age 56years). The majority of YEL-AND had a favourable outcome at 6months of follow up. One YEL-AVD patient passed. In secondary analyses, we evidenced a significant blood cerebrospinal fluid (CSF) barrier dysfunction, without intrathecal synthesis of immunoglobulin and without argument for a neuron damage. We further detected a significant rate of anti-type-1alpha interferon antibodies in 3/10 tested patients (2 YEL-AND and 1 YEL-AVD). YEL-AND and YEL-AVD are rare events that can underlie defect in the innate immunity of apparently healthy or mild co-morbid subjects. Outcome was generally favourable in the YEL-AND cases of our series, but still life-threatening or even fatal in the YEL-AVD cases.