bluuebunny/crossref_metadata_2025 huggingface dataset:
Abstract TP152: Impact of a Stroke Transition-of-Care Clinic on 30-Day Readmission Rates
Authors: Weiss Martin , Allen Leigh , Rasmussen Jennifer
Published: January 2025

Introduction:
Effective care transition for ischemic or hemorrhagic stroke patients post-hospital discharge is critical. Ensuring a follow-up neurology appointment within two weeks is vital to managing stroke risk factors like hypertension, diabetes, and atrial fibrillation. Early follow-up helps adjust treatment plans, reducing stroke recurrence. This period also allows for additional patient education, addressing queries, reinforcing lifestyle modifications, medication adherence, and recognizing warning signs. This support empowers patients in their recovery and long-term health.

Objective:
This study, conducted at a comprehensive stroke center, evaluated the impact of a newly established transition-of-care clinic on stroke patients' hospital readmission rates. We compared 30-day readmission rates before and after the clinic's implementation. Before the clinic, patients typically followed up with their primary care provider and saw a neurologist with delays. Since the clinic's inception, all stroke patients have been seen within two weeks of discharge. The clinic aims to support patients, manage stroke risk factors, and ensure a seamless transition to primary or outpatient neurology care. We assessed the clinic's effectiveness in improving outcomes and reducing stroke-related readmissions by analyzing readmission rates.

Methods:
We utilized our internal data monitoring system to analyze the 30-day readmission rates of all ischemic and hemorrhagic stroke patients during two distinct periods. The first period, from July 2022 through June 2023, represents the timeframe before the opening of the transition-of-care clinic. The second period, from July 2023 through May 2024, corresponds to the timeframe following the clinic's establishment. This comparison allowed us to assess the clinic's impact on reducing hospital readmissions.

Results:
From July 2022 to June 2023, 1,181 stroke patients were discharged with a 30-day readmission rate of 6.1%. Post-clinic, 1,039 stroke patients were discharged between July 2023 and May 2024, with a 30-day readmission rate of 4.2%. This marks a 31% reduction in readmissions since the clinic's establishment.

Summary:
The stroke transition-of-care clinic has significantly reduced 30-day readmission rates, improving patient outcomes. Ongoing data collection will evaluate the clinic's long-term effects, particularly on secondary stroke prevention.
Abstract TP160: Deep tiny flow voids on high-resolution magnetic resonance imaging predict a favorable prognosis in patients with acute middle cerebral artery occlusion
Authors: Ding Manqiu , Yuan Weizhuang , Li Mingli , Xu Yan , Xu Wei-hai
Published: January 2025

Background and Purpose:
Deep tiny flow voids (DTFVs) are a specific type of collaterals surrounding chronic steno-occlusive middle cerebral artery (MCA), which can be identified on high-resolution magnetic resonance imaging (HR-MRI). This study aimed to investigate the presence of DTFVs in patients with acute MCA occlusion and their relevance to clinical outcomes.

Methods:
Using data from two multicenter cohort studies, we examined the presence of DTFVs in patients with acute MCA occlusion and analyzed their clinical and imaging characteristics. Univariable and multivariable logistic and linear regression analyses were conducted to assess the correlation between DTFVs and the 90-day modified Rankin Scale (mRS) scores. We further studied the mediating effect of residual flow distal to MCA occlusion on the relationship between DTFVs and 90-day mRS scores using mediation analysis.

Results:
One hundred and twenty-three patients with acute MCA occlusion were included. The median age was 61 years (interquartile range [IQR], 51-67 years), and 73.73% of the patients were male. The median time from symptom onset to imaging was 44 hours (IQR, 25-67 hours). Sixty-six patients (53.66%) exhibited DTFVs on HR-MRI. Lower baseline NIHSS scores (4.5 [2-8] vs. 10 [4-14]) and smaller infarct volumes (5.76 [2.79-15.34] cm
3
vs. 19.01 [7.16-83.59] cm
3
) were observed in patients with DTFVs compared to those without. Both multivariable logistic regression (odds ratio [OR]: 6.22, 95% confidence interval [CI]: 1.82 to 21.29, p = 0.004) and linear regression analysis (β: -0.60, 95% CI: -1.06 to -0.14, p = 0.012) indicated that patients with DTFVs exhibited better 90-day functional outcomes. The mediating effect analysis showed that the effect of DTFV on 90-day mRS scores was partially mediated by residual flow distal to MCA occlusion, with a proportion of 30.66% (95% CI: 8.97 to 69.29, p = 0.002).

Conclusions:
In our study population, the presence of DTFVs was associated with a favorable outcome in patients with acute MCA occlusion, which may exert a protective effect partly by contributing to the formation of distal residual flow at the occlusion sites. Future studies are needed to investigate the potential of DTFVs in guiding individualized treatment strategies.
Abstract TP335: Machine learning model for prediction of functional outcome in patients with recent small subcortical infarction.
Authors: Yao Ying , ce zong , XU YUMING , Gao Yuan
Published: January 2025

Objective:
Approximately 10%-17% of patients with a recent small subcortical infarction (RSSI) experience an adverse functional prognosis at three months. Identifying risk factors for poor prognosis in these patients and developing a predictive model are of significant clinical relevance.

Methods:
We conducted a prospective cohort study involving 630 patients with recent small subcortical infarction (RSSI). These patients were divided into training (70%) and internal validation (30%) cohorts. Additionally, for external validation, 103 patients from two other hospitals were included. To predict functional outcomes at three months, we employed eight different machine learning algorithms: Support Vector Machine, Decision Tree, Random Forest, Gradient Boosting, Extreme Gradient Boosting, Light Gradient Boosting Machine, Cat Boosting, and Logistic Regression. The interpretability of the best-performing model was enhanced with SHapley Additive exPlanations(SHAP).

Results:
Among the 630 patients included in the study, the average age of participants was 59.0 ±13.0 years and 65 (10.3%) exhibited poor functional outcomes at three months. The Cat Boosting model showed the highest performance among eight machine learning models. The final model could accurately predict outcome in both internal (AUC = 0.968) and external (AUC = 0.856) validations. SHAP analysis indicated that the initial NIHSS score was the most important variable. The web application is available at https://yrssiml.streamlit. app.

Conclusions:
Our research developed a predictive model using the Cat Boosting algorithm to forecast poor functional outcomes at three months in patients with RSSI. This model enables clinicians to identify patients at high risk and implement targeted interventions more effectively.
Abstract TP336: Neuropathological changes in the chronic phase of ischemic stroke are marked by persistent alteration of microglial function and neurodegenerative phenotypes
Authors: Khan Romeesa , Do Trang , Devlin Patrick , Guzman Gary , Tan Chunfeng , Venna Venugopal , Ahn John , Marrelli Sean , McCullough Louise , Ritzel Rodney
Published: January 2025

Improvements in acute stroke treatment, including EVT and critical care management, have increased survival rates post-stroke. However, many stroke survivors have significant post-stroke disability and cognitive impairment. Despite this, the chronic progression and long-term sequelae of ischemic stroke pathology remains understudied.

Methods:
We examined the chronicity of neurobehavioral recovery and progressive neuropathology in young male (3 month) and middle-aged male and female (14 month) C57Bl/6 mice at 3 and 6 months after a 60-minute transient middle cerebral artery occlusion (tMCAO) or sham surgery (
n = 10-20/group
). Behavioral testing included NORT, fear conditioning (FC), and tail suspension. Immunohistochemistry (IHC) was performed on mouse brains, as well as post-mortem human brain samples from patients with a chronic infarct (
n = 6/group
), to assess demyelination (MBP), neuronal apoptosis (TUNEL/NeuN), and amyloid burden (Aβ-42). Flow cytometry was performed on the ipsilateral mouse brain hemisphere. RNA isolated from the ipsilateral hemisphere was sent for gene profiling.

Results:
In both young and middle-aged mice, depressive-like behavior persisted for 6 months post-stroke (PS) (p= <0.0001), while cognitive function progressively worsened from 3 to 6 months, as seen by a reduction in the NORT (p=.0063) and FC (p=.0084). MRI imaging and IHC revealed cerebral atrophy, significant demyelination (mouse, p=.0361; human, p =.0001), and increased microglial density (p=.0059) in the hippocampus of both human and mice. TUNEL/NeuN staining showed ongoing neuronal degeneration in the human hippocampus, distal to the chronic infarct. Human chronic stroke hippocampus had increased amyloid burden compared to age-matched controls (p=.0677). Cytometric anyalses revealed disease-associated microglial (DAM) phenotypes were marked by increased senescence, cytokine production, and an altered redox state. Transcriptomic data showed significant chronic upregulation of DAM genes.

Conclusion:
Our findings demonstrate that ischemic stroke accelerates inflamm-aging and premature senescence within the chronic infarct microenvironment. Cellular senescence and chronic disease signatures may contribute to progressive cognitive impairment post-stroke. Identification of secondary injury processes, and late pathological events post-stroke, allude to a neurodegenerative etiology and may offer viable targets for delayed treatment to prevent further neurological decline.
Abstract TP350: The Effect of Type 2 Diabetes on the Transcriptome of Immune Cells in the Bone Marrow in Response to Ischemic Stroke
Authors: Zhang Hongxia , Gu Wanjun , Yu Kailin , Falcone-Juengert Jaime , Liu Jialing
Published: January 2025

Type 2 diabetes mellitus (T2DM) induces chronic inflammation, which can worsen the secondary injury following ischemic stroke. Yet, whether and how T2DM-induced inflammation affects the production of bone marrow-derived immune cells and their transcriptome remains largely unexplored.

Hypothesis:
T2DM biases the immune system to a proinflammatory phenotype in the bone marrow, increases the transmigration of myeloid cells and compounds the secondary injury caused by stroke.

Methods:
We induced ischemic stroke by distal occlusion of the middle cerebral artery (MCAO) in T2DM mouse model db/db mice and normoglycemic control db/+ mice. Three days post-stroke, bone marrow (BM) cells and tissue were subjected to single-cell RNA sequencing (scRNAseq) and GeoMx digital spatial profiling (DSP). Myeloid cell populations were quantified by Fluorescent cell activated sorting (FACS). We used the NicheNet tool to analyze the cell-cell communication between BM populations.

Results:
We detected an increased frequency of hematopoietic precursor and myeloid progenitor cells in the BM of T2DM mice compared to control mice via FACS, although CD11b (+) cells were significantly increased only in control and not in T2DM mice after stroke. GeoMx DSP found that the upregulation of
cd47, s100a9, cd177, pecam1
genes in both CD115 and Ly6G expressing cells were more pronounced in T2DM BM compared to control BM after stroke. Pathway enrichment analysis pointed to an increased activation of signals for myeloid cell activation and migration in T2DM stroke BM compared to control stroke BM, relative to their respective non-stroke counterpart. NicheNet integrated with single-cell RNA sequencing data corroborated with a differential increase of ccr2 and ccr3 interactions with a number of chemokine ligands in the BM of T2DM stroke mice compared to control stroke mice.

Conclusion:
our data suggest that T2DM enhances myeloid cell migration and chemotaxis after stroke. Ongoing studies will identify the tissue compartments to which increased myeloid cells transmigrate in T2DM mice after stroke and the effect on stroke outcomes.
Abstract TP355: Immunohistochemical Confirmation of Neutrophil Extracellular Trap (NET) Enrichment in Stroke Thrombus of Patients with Atrial Fibrillation
Authors: Sleasman Eric , Chittaranjan Siddharth , Akkipeddi Sajal Medha , Thomson Lexi , Romiyo Prasanth , George Derek , Bhalla Tarun , mattingly thomas , Welle Kevin , Ghaemmaghami sina , Wines-Samuelson Mary , Martinod Kimberly , Callahan Linda , Morrell Craig , Bender Matthew
Published: January 2025

Background:
Neutrophil Extracellular Traps (NETs) are web-like structures of DNA, histones, and granule proteins that trap pathogens as part of innate immunity but also scaffold red blood cells, fibrin, and platelets in pathological thrombosis. Thrombus NETs have been associated with failed thrombolysis and thrombectomy for acute ischemic stroke (AIS). We previously used mass spectrometry to describe a novel association between NET proteins and atrial fibrillation (AF). This association has not been validated by traditional immunohistochemical methods.

Aims/Purpose:
We used immunohistochemistry to quantify NETs in AIS thrombus taken from patients with and without comorbid AF.

Methods:
We selected markers for each of the components of NETS: (1) a granule protein, myeloperoxidase (MPO), (2) citrullinated histone 3 (CitH3), and cellular nucleic acid (NA, using Hoechst 33342). This was a single-blind study using cryopreserved thrombi from 30 patients, 15 with AF. Stroke thrombi were collected over a two-year span, and immediately frozen to -80*C post-thrombectomy. To capture the coverage of NET markers more comprehensively for each patient, we used cryostat to sample four sections (five-micron thickness) from each thrombus. We then fixed sections with 4% formaldehyde in phosphate buffered saline (PBS), performed immunohistological staining, and quantified extent of staining using ImageJ. Data for each NET marker from a single thrombus is represented as the mean percentage of thrombus area staining positively across the four corresponding sections. After performing Shapiro Wilks test for normality, statistical comparisons of NET marker staining coverage between AF and non-AF thrombi were performed with either unpaired T test or Mann-Whitney U test, depending on whether a parametric or non-parametric test was appropriate.

Results:
Thrombi from patients with AF had greater MPO coverage(17.9 +/- 1.47% versus 11.6 +/- 1.29% in non-AF, p<0.01) and CitH3 coverage(12.6 +/- 1.46% versus 7.4 +/- 1.11% in non-AF, p<0.01). Staining for nucleic acid with Hoechst 33342 trended toward higher coverage in AF but did not reach significance (27.8 +/- 3.35% versus 22.6 +/- 3.20% in non-AF, p=0.30).

Conclusion:
The present study provides immunohistochemical validation, supporting novel observations in prior proteomic investigations, of increased NETs in stroke thrombi of patients with AF. This can help to identify patient cohorts for future studies of therapies directed at NETs.
Abstract TP360: Increased kynurenine levels are associated with post-stroke infection after controlling for potential confounders
Authors: Dylla Layne , Higgins Hannah , Reisz Julie , Herson Paco , Poisson Sharon , Monte Andrew
Published: January 2025

Introduction:
Infections account for one-third of stroke deaths. Kynurenine pathway metabolites can modulate the immune response in other contexts. We previously reported a preliminary univariate analysis that showed only significantly elevated kynurenine concentrations among patients who developed a post-stroke infection (PSI), but no differences in other pathway metabolites. This study further characterizes the association between kynurenine and PSI.

Methods:
Using whole blood samples from acute ischemic stroke patients in the University of Colorado Emergency Medicine Specimen Bank, high throughput mass spectrometry determined kynurenine concentrations. Multivariable linear regression modeled the association between kynurenine and characteristics that could predispose patients to a PSI or alter kynurenine levels (age, sex, NIHSS score, time from sample collection to last known well, and a history of smoking, foley placement or mechanical ventilation, dysphagia, diabetes mellitus, immunosuppression, and chronic kidney disease). Multivariable logistic regression modeled the association between kynurenine and PSI while controlling for the above covariables.

Results:
Of 75 patients, 32% developed a PSI. Those without a PSI were similar in mean age (64.7+/-12.1years) and race (72.6% white) compared to those with a PSI (age: 69.5+/-13years; 58.3% white). However, patients varied in terms of sex (without PSI: 37.3% female; with PSI: 62.5% female; p=0.04), immunosuppression (without PSI: 5.9% immunosuppressed; with PSI: 20.8% immunosuppressed; p=0.05), and median NIHSS (without PSI: 3.3, IQR 3-7; with PSI: 6.5, IQR 6-7; p=0.03). Only age (point estimate 0.02, p=0.04) and history of chronic kidney disease (point estimate 7.57, p<0.01) were significantly associated with elevated kynurenine concentrations in all stroke patients while controlling for covariables. The odds ratio of developing a PSI for every 1uM increase in kynurenine concentration was 3.46 (95% CI: 1.26 – 9.52). A history of immunosuppression was also associated with an increased odds of PSI (OR 13.21; 95% CI: 2.17-80.49).

Conclusion:
Elevated kynurenine concentrations are significantly associated with increased risk of PSI, even after controlling for known potential confounders. As expected, immunosuppression was also associated with increased odds of developing a PSI. Furthermore, age and chronic kidney disease in patients with acute ischemic stroke were associated with elevated kynurenine levels.
Abstract TP376: S-nitrosoglutathione Reduced Ischemia/reperfusion Injury by Relieving Thrombo-inflammation in Experimental Stroke Models
Authors: Liu Shimeng
Published: January 2025

Aims:
S-nitrosoglutathione (GSNO) is an endogenous low-molecular-weight S-nitrosothiol, involved in storing and transporting of nitric oxide. The study was aimed to test the effects of GSNO in ischemia/reperfusion (I/R) Injury through relieving thrombo-inflammation.

Methods:
Male C57BL/6 mice (n=160) were 10-week-old (20-25 g) at the time of surgery. Mice were administered with carboplatin (60 mg/kg body weight) intraperitoneally to build thrombocytopenic models. The animals were randomized and coded by an independent researcher who was not involved in the data analysis. Investigators involved in the surgery and evaluation of all parameters were blinded to the experimental groups. The mice were randomly divided into four groups: 1) regular I/R models with iv. normal saline (NS), 2) regular I/R models + 1 mg/kg iv. GSNO, 3) thrombocytopenic I/R models with iv. NS, and 4) thrombocytopenic I/R models +1 mg/kg iv. GSNO. All animals received humane care in compliance with Beijing Tiantan Hospital’s guidance. Levels of P-selectins, interferon (IFN)-γ and infarct volume and were compared.

Results:
Mean blood platelets count was 177 10^9/L in the mice administrated with carboplatin, and 383 10^9/L in the mice without carboplatin administration (p < 0.05). Comparing with the mice treated with NS, P-selectin in the ischemic brain tissue were significantly decreased after injected with GSNO either at 24 h (1610.5 vs. 863.0 pg/ml, p < 0.05) or at 7 d (1056.8 vs. 590.0 pg/ml, p < 0.05) in regular mice, and in thrombocytopenic mice (2874.2 vs. 2113.0 pg/ml, p < 0.05, at 24 h） and（3088.0 vs. 2373.0 pg/ml, p < 0.001, at 7 d） (Fig1). After treating with GSNO, levels of IFN-γ were decreased in regular mice (24 h: 635.4 vs. 244.8 pg/ml, p < 0.05; at 7 d: 559.2 vs. 100.0 pg/ml, p <0.05）and thrombocytopenic mice（24h: 423.0 vs. 491.8 pg/ml, p < 0.05; 7d: 319.6 vs. 155.4 pg/ml, p < 0.05）(Fig1). GSNO tended to have the effect of decreasing infarct volume in regular mice（24h: 65% vs. 79%, p = 0.11; 7d: 31% vs. 62%, p = 0.05） and thrombocytopenic mice（24h: 42% vs. 79%, p =0.06; 7d: 60% vs. 62%, p =0.69）than NS (Fig2).

Conclusions:
GSNO reduced inflammation by limiting platelets activation to protect I/R injury in experimental stroke models.
Abstract TP383: Neutrophil Extracellular Traps (NETs)-related LncRNAs Regulate Thrombus Formation in Acute Ischemic Stroke Patients with Underlying Medical Conditions
Authors: Mun Hyeonji , Park Dougho , Ahn Yong Joo
Published: January 2025

Introduction:
Acute cerebral blood flow occlusion by thrombus is a major cause of ischemic stroke. The composition of the resulting thrombus varies depending on the underlying medical condition. Notably, neutrophils, the most abundant white blood cells, play a crucial role in acute ischemic stroke and can form neutrophil extracellular traps (NETs). NETs are web-like structures consisting of DNA, granule proteins, and histones. NETs contribute to thrombo-inflammation and stabilize the thrombus, potentially leading to worse outcomes. While long non-coding RNA (lncRNA) do not encode proteins, they are involved in essential biological processes. The link between lncRNAs and cardiovascular disease is increasingly studied, and their role in ischemic stroke has recently come to attention. We, therefore, hypothesize that lncRNAs within NETs play a critical role in the formation and regulation of thrombi.

Method:
Human thrombi obtained from endovascular thrombectomy were categorized based on their underlying medical conditions, such as dyslipidemia, hypertension, or a combination of two or more conditions. Frozen sections of the thrombi were immunostained with markers including Citrullinated H3 (CitH3), CD45, neutrophil elastase (NE), and DAPI, and then analyzed using holotomography, confocal microscopy, and spatial transcriptomics. In spatial transcriptomics analysis, NETs and other leukocytes were selected as distal and proximal ROIs for detailed gene expression profiling. The gene expression of HDAC class 1 genes (HDAC1, HDAC2, HDAC3, and HDAC8) was further examined by qPCR.

Results:
Holotomography analysis revealed that cells in the thrombi of patients with underlying conditions exhibited a high mean refractive index. Immunofluorescence imaging also identified a high percentage of NETs in these samples. Spatial transcriptomics analysis confirmed that NETs in patients with hypertension showed upregulated expression of lncRNAs. Additionally, qPCR results demonstrated increased expression of HDAC class 1 genes, which are associated with NET formation, in patients with underlying conditions.

Conclusion:
LncRNAs play a crucial role in the formation and regulation of thrombi. Therefore, NETs-related lncRNAs could serve as valuable therapeutic targets and diagnostic markers for acute ischemic stroke patients with underlying diseases.
Abstract TP398: RNS60 Substantially Reduces Early Vasogenic Edema, Mitigates Infarct Area, and Decreases Expression of HIF1α Four Days Post-Ischemic Stroke
Authors: Baena-Caldas Gloria , Li Jie , Ghosh Supurna , Kalmes Andreas , Baird Alison , Barone Frank , Hernandez Alejandro
Published: January 2025

Introduction:
RNS60 is a proprietary 0.9% saline solution with an elevated oxygen concentration. Previously, we showed that 13 days of daily RNS60 treatment after transient middle cerebral artery occlusion (tMCAo) stroke reduced brain pathology (e.g., infarction, amyloid pathology, neuronal death, microglial activation, and white matter damage) while increasing microvascular perfusion and memory (Baena Caldas et al. 2024). Here, we examine earlier brain-protective effects of daily RNS60 treatment 4 days after stroke.

Methods:
Male C57BL/6J mice, 3-4 months old, were randomly divided into sham surgery or unilateral 60-minute tMCAo. Each group was subdivided into three treatment arms: an experimental arm receiving daily intraperitoneal injections of 0.2 mL of stabilized RNS60, and control arms of pressurized normal saline with the same oxygen content as RNS60 (PNS60) or normal saline (NS). Injections began 2 hours after stroke, once daily for 3 days. An additional group without treatment was used as a control. Treatment group assignments were blinded throughout the study. On day 4, mice from each group were euthanized to assess infarct volume using TTC staining, or were perfused with 4% PFA to perform immunohistochemistry.

Results:
Four days after ischemic stroke, daily injections of RNS60 treatment significantly reduced early post-stroke vasogenic edema by 41% and infarct size by 39% compared to controls. These RNS60 brain-protective effects were related to decreased expression of hypoxia-inducible factor 1α (HIF1α), suggesting that RNS60 treatment may reduce hypoxia.

Conclusion:
RNS60-treated mice exhibit early and long-term significant brain protection after ischemic stroke associated with decreased expression of HIF1α, suggesting reduced hypoxia in the ischemic brain. Ongoing studies aim to identify the effect of RNS60 on blood brain barrier integrity to further elucidate the underlying molecular mechanism.
Abstract WP93: Cross-Platform Proteomics and Machine Learning Algorithms Nominate Biomarkers of Atrial Fibrillation in Stroke Patients: An Exploratory Study
Authors: Misra Shubham , Natu Aditya , Kumar Prateek , Watson Caroline , Frankel Michael , RANGARAJU Srikant
Published: January 2025

Introduction:
Atrial fibrillation (AFib) is a major risk factor for ischemic stroke (IS). AFib diagnosis is critical to optimize secondary prevention and reduce the recurrent stroke risk.

Objectives:
We undertook an exploratory cross-platform proteomics study to discover plasma biomarkers of AFib diagnosis in patients with IS or transient ischemic attack (TIA).

Methods:
We used clinical and proteomics data of stroke patients aged ≥18 years lodged within a prospective plasma repository from 2010 to 2014. We collected blood from each patient at hospital admission before administering any therapeutic intervention. Our outcome was differentially expressed levels of proteins in stroke patients with AFib compared to patients without AFib. We performed aptamer-based proteomics using the plasma 7K SomaScan assay. We identified the differentially expressed proteins using (i) ±1.5-fold change and unadjusted p-value <0.05 cut-offs, (ii) Boruta random forest-based machine learning algorithm, and (iii) 30% or more variation explained by AFib in variance partitioning analysis (VPA). We selected the top proteins that were identified using two of the three selection approaches and conducted multivariable adjusted analyses. We conducted internal validation on the same samples using the PeptiQuant Plus biomarker assessment kits (BAK-270) for targeted protein quantitation.

Results:
We included 60 patients with IS/TIA (mean age 62.9 years, 50% males) classified into 11 AFib and 49 no AFib (Figure 1). SomaScan quantified 7307 protein targets including 6373 unique proteins. We identified 171 differentially expressed proteins in stroke patients with AFib compared to no AFib. After adjusting for age, sex, diabetes, and coronary artery disease in the multivariable analysis, we identified 53 top proteins independently associated with AFib in stroke patients (adjusted p<0.05) (Figure 2). In the validation phase, we quantified 216 proteins using the BAK-270 platform, of which 185 proteins were overlapping with SomaScan. Using BAK-270, we validated increased levels of IGFBP2, B2M, and COL18A1 and decreased levels of CNDP1, AHSG, and SERPINA4 in stroke patients with AFib compared to no AFib (Figure 3).

Conclusions:
Our exploratory study highlights the potential of plasma proteomics as a valuable tool for discovering protein biomarkers to discriminate IS/TIA patients with AFib compared to no AFib. Further longitudinal studies with adequate sample sizes are needed to support these findings.
Abstract WP97: Derivation and Validation of the Get with the Guidelines®-Stroke Endovascular Thrombectomy Risk Scores
Authors: Lusk Jay , Brown Scott , Hassan Ameer , Albers Gregory , Fonarow Gregg , Schwamm Lee , Messe Steven , Smith Eric , Hasan David , Bhatt Deepak , Saver Jeffrey , Mac Grory Brian
Published: January 2025

Introduction:
Prior attempts to assess risk of symptomatic intracranial hemorrhage (sICH) after endovascular thrombectomy have been limited by reliance on information obtained after thrombectomy (such as TICI reperfusion) and lack of generalizability to routine clinical practice.

Methods:
Patients presenting to GWTG-Stroke participating hospitals between July 2021 and June 2023 with last known well within six hours prior to presentation, who received endovascular thrombectomy were included. The primary outcome was sICH; secondary outcomes included in-hospital mortality, mRS at discharge, and length of stay. The study population was divided into a derivation and validation cohort with 70:30 partition. According to a pre-specified statistical analysis plan, a full model of 31 candidate variables and subsequently a highly parsimonious model including only variables measured before EVT deployment was fit for each endpoint, with variable retention guided by multiple factor analysis (MFA). Models were then externally validated in the HERMES clinical trial population.

Results:
31,668 patients (median age 71 [Q1: 61, Q3: 81]) were included, of whom 1,799 (5.7%) developed sICH. In the validation cohort, the area under the receiver operating characteristics curve (AUC) for the full model was 0.649 (Table 1), and the AUC for the simplified points score was 0.589 (Table 2). At the conference, we will present results of external validation and secondary endpoints, details of model calibration, and direct comparisons to existing risk scores.

Conclusions:
A risk score for sICH after thrombectomy for acute stroke devised using routinely collected data known prior to intervention had good performance compared to existing approaches.
Abstract WP98: Temporal Trends and Predictors of Door-in-Door-out Times for Interhospital Stroke Transfers in the Greater Cincinnati Northern Kentucky Stroke Study
Authors: Stamm Brian , Royan Regina , Ding Lili , Robinson David , Haverbusch Mary , Ferioli Simona , Stanton Robert , Aziz Yasmin , LaPorta Joseph , Woo Daniel , Wechsler Paul , Menzies Lauren , Wright Shea , Nobel Lisa , Slavin Sabreena , Walsh Kyle , DeLosRiosLaRosa Felipe , Mackey Jason , Mistry Eva , Demel Stacie , Coleman Elisheva , Jasne Adam , Star Michael , Martini Sharyl , Adeoye Opeolu , Flaherty Matthew , Khatri Pooja , Madsen Tracy , Broderick Joseph , Kissela Brett , Kleindorfer Dawn
Published: January 2025

Introduction:
Acute treatment for stroke often requires emergent interhospital transfer for access to advanced therapies not available at the initial hospital. Prolonged transfer times have been associated with worse outcomes. Door-in-door-out time (DIDO: the amount of time a patient spends in the transferring emergency department [ED]) is an important quality metric in acute stroke care, with current recommendations for DIDO times ≤ 120 minutes. We sought to characterize trends and predictors of DIDO times for interhospital stroke transfers using the Greater Cincinnati Northern Kentucky Stroke Study (GCNKSS).

Methods:
We utilized data from the GCNKSS, a population-based epidemiologic stroke study, from the following time points: 1999, 2005, 2010, 2015, and 2020. Patients ≥18 years with acute ischemic stroke (AIS) or hemorrhagic stroke (HS) who presented to an initial ED and were not admitted but were transferred to another hospital were included. The primary outcome was DIDO time. Temporal trends in DIDO time were tested using the Mann-Kendall trend test. Generalized linear mixed effects models with hospital-specific random intercepts were constructed to evaluate the associations between patient- and hospital-level covariates and DIDO time.

Results:
Of 13,678 stroke cases over the time periods studied, 1574 patients met inclusion criteria for the overall stroke group (mean age 64.7 [SD: 15.6], 51.6% female), with 851 (54.1%) having AIS and 723 (45.9%) HS. Over the time periods examined, the median DIDO time for the overall stroke group was 213 minutes (IQR 142-305), and DIDO times significantly increased over time (Figure 1; P<.0001). In the overall stroke group, hospital-level factors explained 4.0% of the variation in DIDO time. In the multiple regression model, factors associated with increased DIDO time included: history of prior stroke (+33.6 minutes; P<.0001) and receipt of MRI prior to transfer (+165.7 minutes; P<.0001); whereas EMS transport (-30.0 minutes; P<.001) and increasing NIHSS score (P<.0001) were associated with decreased DIDO time. Results were similar for AIS and HS subgroups (Table 2).

Conclusions:
In this population-based epidemiologic study, DIDO times exceeded recommended time targets and increased over time. Hospital-level factors accounted for only a minor proportion of the overall variation in DIDO times, suggesting that future quality improvement efforts should target modifiable clinical and systems factors to improve DIDO times.
Philology’s Deep History
Authors: Ungureanu Delia
Published: January 2025

The story of David Damrosch’s Comparing the Literatures: Literary Studies in a Global Age is inextricably bound to the story of the past twelve years of the Institute for World Literature. Many of the ideas the book puts forth were created and developed through the network of people and ideas IWL brings together. I will briefly look at three ideas developed through IWL that underlie Comparing the Literatures and then I will argue that David Damrosch’s distinctive approach to comparative and world literature is philology’s deep history, in the footsteps of Auerbach’s 1951 essay Philologie der Weltliteratur. I will look at David Damrosch’s commitment to philology’s deep history throughout his career, from What Is World Literature? to Comparing the Literatures and I will illustrate it with a few case studies of my own.
Comparative Literature in Taiwan in the Age of World Literature
Authors: Chang Chung-An
Published: January 2025

Comparative literature in Taiwan flourished in the 1970s, focusing on the comparison of classical Chinese and Western literary classics. In the 1990s, this focus shifted to theory-based research centered on local sociopolitical issues. The literariness of actual comparisons and appreciation of literary works suffered as a result of this shift. The high level of specialization in the present academic system hinders interdisciplinary research, and, in this vein, translation studies has come to question the value of comparative literature. The resurgence of world literature has opened up new possibilities and repivoted attention back toward literariness and translation of texts away from the focus on contentious ideological issues. From the perspective of a Sinosphere with multiple literary centers, comparatists in Taiwan have an opportunity to leverage their diverse and rich cultural resources for the fostering of literary dialogues. Such discourse can connect literary works worldwide, and in the process revive the momentum of a discipline that promotes cross-cultural understanding and profound appreciation for the diversity of human civilizations.
A Re-deliberation of Minzu Literature and World Literature
Authors: Gong Haomin
Published: January 2025

This essay examines the tension between minzu (roughly an equivalent of “ethnic” and “national”) and world literature by investigating Tibetan-Chinese writer Alai’s Gesar and his other writings. For Alai, the tension between minzu and world literature is a moot question. He challenges many assumptions of both minzu and world literature through his metafictional rewriting of Gesar and alerts us to the power of differentiation. Alai’s unique views urge us to reflect on the politics of a non-Western ethnic writer writing in, to, and for the world.
Deflated in shame and puffed up in pride: How affective practices matter for entrepreneuring
Authors: Marsh Dorota , Eccleston Helen , Śliwa Martyna
Published: January 2025

At the heart of the processual term ‘entrepreneuring’ lies something inherently optimistic: a belief that a better world could be reached beyond the actual. Embracing this perspective, we move away from a focus on entrepreneurial mastery and seek conditions for entrepreneuring understood as social change, foregrounding its affective dimension. We do so by researching and writing differently; in adopting (and adapting) the ethnography of practices (praxiography), we centre the body as the cause, subject and instrument of the stories we tell. By reading affect with (posthumanist) practice theory, we expand the notion of affective practices to inquire how shame and pride matter for entrepreneuring within small family businesses. Employing a visceral, sensory and embodied style of crafting our text, we invite readers to sense as well as interpret. The article contributes to the literature in two ways: first, it proposes a novel methodological approach for studying and writing about affective practices; second, it builds an understanding of how affective practices disrupt the already organised and make room for better futures yet to come.
Exploring the Relational Model of Change as a Facilitator of Interorganizational Change Processes
Authors: Bond-Fortier Brenda J. , Gebo Erika
Published: January 2025

Organizational change is a dynamic field with rapidly evolving knowledge. Recent scholarship highlights gaps in understanding real-time change implementation and urges granular research in diverse contexts, particularly in interorganizational collaborations where complex problems are addressed by networks of partners. This paper explores how participants employed the relational model of change (RMOC) in two distinct interorganizational contexts to gain insight into the change process. Multiple case study and temporal analysis were used to compare how change played out in the two contexts. Findings reveal that both sites adopted RMOC interventions of boundary spanner roles, shared accountability, and current state assessments. These interventions were implemented differently, however, leading to varied progress toward goals. This study advances our knowledge of change processes and demonstrates, for scholars and practitioners, the RMOC's relevance for strengthening interorganizational collaboratives and organizational change, using granular data regarding the dynamic process of change.
EXPRESS: Cross-Channel Effects of Failure in a Retailer’s Mobile App
Authors: Narang Unnati , Shankar Venkatesh , Narayanan Sridhar
Published: January 2025

Failures in omnichannel retailers’ mobile apps can significantly impact shoppers’purchases, extending beyond in-app to affect in-store transactions. Investigating such effects poses challenges because field experiments inducing app failures are infeasible, and non-experimental observational data typically suffer from selection biases. We leverage a natural experiment involving an exogenous failure in a large omnichannel retailer’s app that made the app unavailable during the failure period. We examine the impact of the app failure on purchases in both online (website, mobile app) and offline (store) channels using a difference-in-differences approach. Our findings show a substantial adverse effect of the app failure on shoppers’ frequency, quantity, and monetary value of purchases, leading to short-term revenue losses of up to $1.08 million, with an additional $1.89 million in potential long-term revenue erosion due to customer attrition over time. The effects are heterogeneous across channels and shoppers. The decline in purchases across channels primarily stems from reduced purchases in stores rather than the online channel. The decline in store purchases is predominantly explained by the search discontinuation mechanism, wherein shoppers who use the app primarily for search but complete their purchases in stores are unable to use the app for search and curtail their offline purchases following the app failure. The effect on purchases in the retailer’s online channel is insignificant, aligning with the channel switching mechanism, wherein shoppers who use the app primarily to purchase simply pivot their purchases to another online channel such as the website. Furthermore, shoppers with a lower monetary value of past purchases and more recent purchases are more sensitive to an app failure than others.
From crime rates to crime harm: Understanding the role of social development in Mexico city
Authors: Vilalta Carlos , Sanchez-Siordia Oscar , Lopez-Ramirez Pablo , Fondevila Gustavo
Published: January 2025

This study investigates the spatial and temporal dynamics of crime and social development in Mexico City between 2019 and 2023. By utilizing novel metrics—including crime rate (CR), crime harm per resident (CHIP), and crime harm per victim (CHIV)—alongside the Social Development Index (SDI), the study uncovers complex spatial relationships between crime and social conditions. The analysis reveals significant variability in crime patterns, highlighting the pivotal role of social development in mitigating both crime and its associated harm. The insights generated are crucial for policymakers seeking to implement targeted and impactful strategies for crime prevention and social improvement.
Online measurement methods for material flow on belt conveyors based on LiDAR
Authors: Li Huijun , Ma Hailong , Ye Bin
Published: January 2025

Belt conveyors are efficient devices that transport materials using friction and are widely used in industries such as coal transportation, metal processing, and grain storage. Measuring the material flow on conveyor belts is a critical step in the production process. Traditional methods use belt scales for weighing, which involve complex installation, high maintenance costs, and expensive equipment. This paper proposes a non-contact method for measuring material flow on belt conveyors using LiDAR. After acquiring point clouds with LiDAR, we first remove motion distortion, then filter out the conveyor belt points based on the Euclidean distance of the micro-element geometric center. The volume of micro-element slices is calculated using both the triangular mesh method and the voxel filling method. Finally, the material flow is computed through micro-element integration. The feasibility of the algorithm is verified by scanning regular objects to calculate their volume, and the accuracy and stability of the triangular mesh method and the voxel filling method are compared. Experimental results show that the average relative error percentage of the triangular mesh method is 2.685%, while that of the voxel filling method is 1.135%. The variance of measurements for both methods is [Formula: see text], indicating high computational stability. The measurement accuracy level has improved by 1%–2% compared with existing work.
The Role of Physical Appearance Comparison, Self-Esteem, and Emotional Control in the Association Between Social Media Addiction and Masculine Depression
Authors: Kagan Maya , Ben-Shalom Uzi , Mahat-Shamir Michal
Published: January 2025

Social media has become an integral part of daily life, shaping behaviors, self-perception, and emotional well-being. However, its addictive use raises concerns about its potential to aggravate psychological challenges, particularly in the context of societal expectations of masculinity. The current report presents a study exploring the pathways through which social media addiction contributes to masculine depression, specifically examining the roles of physical appearance comparison, self-esteem, and emotional control among men. By investigating these relationships, it aims to provide insights into the psychological consequences of social media addiction for men. Structured questionnaires were administered to 849 Israeli men aged 18 and older. Employing a moderated sequential mediation model with social media addiction as the independent variable, physical appearance comparison and self-esteem as mediators, and masculine depression as the dependent variable, this study also investigates emotional control as a moderator in the associations between social media addiction, physical appearance comparison, self-esteem, and masculine depression. The analysis, conducted using model 89 PROCESS v4.2 macro, reveals that conforming to the masculine norm of emotional control intensifies men’s vulnerability to distress resulting from maladaptive behaviors such as social media addiction, which can lead to masculine depression. Furthermore, addiction to social media can trigger masculine depression via psychosocial factors such as physical appearance comparison and low self-esteem, which have yet to be explored in the context of masculine depression. These findings underscore the importance of targeted interventions that address the societal pressures of masculinity and the psychological repercussions of excessive social media use among men. They also emphasize the necessity of raising awareness about these issues among both the public and therapists.
Language barriers in mental healthcare: A critical analysis
Authors: Richly Pablo
Published: January 2025

In multicultural healthcare settings, language barriers pose significant challenges, particularly in mental health where nuanced communication is vital. This manuscript examines the impact of limited English proficiency (LEP) on mental healthcare in New Zealand, where a substantial portion of the population and healthcare workforce are foreign-born. Despite official recommendations, professional interpreter use remains low, compromising care quality for LEP patients. The paper explores interpreters’ roles beyond interpretation, including cultural mediation, while noting limitations in interpreter-mediated consultations. It also addresses communication difficulties arising from strong accents and dialects, even when a common language is shared. Multifaceted strategies to improve communication are proposed, including enhanced cultural competency training, patient-centered protocols, and language matching in healthcare teams. Emphasizing a polycultural approach, the manuscript advocates for comprehensive interventions addressing linguistic, cultural, and cognitive aspects of communication in mental healthcare. It calls for further research and policy changes to integrate language access and cultural competency into healthcare quality assessments, aiming to reduce disparities and improve outcomes for diverse patient populations.
Fatigue crack identification in jacket-type offshore platforms using a parallel multi-scale convolutional neural network
Authors: Feng Shufeng , Song Lei , Yang Zhuoyi , Wu Kai , Wu Qilong , Huang Jiarui , Sun Tengfei
Published: January 2025

Vibration-based damage detection techniques are widely applied in the structural health monitoring of offshore platforms. This study employs a parallel multi-scale convolutional neural network (PMSCNN) to analyze the acceleration response signals collected from offshore platforms, achieving the localization of fatigue cracks. The effectiveness of the proposed method is validated through numerical simulations of jacket-type offshore platforms subjected to random wave excitations from different directions. The study focuses on identifying fatigue crack damage in platform components, addressing both single and multiple damage scenarios involving small cracks. To assess the robustness of the method against noise, Gaussian white noise of varying intensities was added to the collected signals. The results demonstrate that the proposed approach effectively identifies and locates fatigue cracks in jacket-type offshore platforms, exhibiting strong noise resistance.