bluuebunny/crossref_metadata_2025 huggingface dataset:
Dynamical study and diverse soliton collisions for the Kraenkel–Manna–Merle system in ferrites
Authors: Ahmed Sarfaraz , Seadawy Aly R. , Rizvi Syed T. R. , Abbas Hasnain
Published: March 2024

We investigate the rational solitons of the Kraenkel–Manna–Merle (KMM) system in ferrites via symbolic computation with the ansatz functions technique and logarithmic transformation. The KMM system describes the propagations of the ferromagnetic particles in ferrite materials. Multiwave solitons are reported by using the three-wave technique. Homocentric breathers (HBs) approach is also applied to build new forms of exact solutions. We construct M-shaped solitons and their dynamics are shown via the appropriate values of parameters. Two types of interactions for rational soliton with kink wave are investigated. Additionally, kink cross-rational solitons (KCRSs) and periodic cross-rational solitons (PCRSs) are examined via suitable transformation.
Scalable Synthesis and Characterisation of a Liquid 2,3,5,6-tetraallylbenzene-1,4-diol Quinone
Authors: Kjærgaard Groven Rune , Lahn Henriksen Martin , Ege Sahin Nihat , Lindhardt Anders , Bentien Anders , Dražević Emil , Hinge Mogens
Published: March 2024

Organic redox species are finding uses in numerous research and development applications, such as electrochemical sensors, batteries, and production of chemicals. This paper presents a synthesis pathway of a redox-active liquid of 2,3,5,6-tetraallylbenzene-1,4-diol. The synthesis of 2,3,5,6-tetraallylbenzene-1,4-diol was found repeatable at approximately 60 g scale, with a total conversion of 92% across four synthesis steps. High purity was achieved with no further purification. The intermediates and compounds were characterized using attenuated total reflectance infrared spectroscopy, proton nuclear magnetic resonance, differential scanning calorimetry, thermogravimetric analysis, cyclic voltammetry, rotating disk electrode voltammetry, density, and viscosity measurements. The structural characterization verified the structure of 2,3,5,6-tetraallylbenzene-1,4-diol. Electrochemical characterization revealed a quasi-reversible response, a diffusion coefficient similar to the diffusion coefficient of hydroquinone.
Increasing the Cycle Life of Zinc Metal Anodes and Nickel-Zinc Cells Using Flow-Through Alkaline Electrolytes
Authors: Shan Shuhua , Parekh Mihir N. , Kou Rong , Wang Donghai , Rahn Christopher D.
Published: March 2024

Alkaline electrolyte flow through porous Zn anodes and Ni(OH)2 cathodes can overcome diffusion limits, reduce dendrite growth, and improve cycle life. Zinc deposition morphology improves with low flow rates electrolyte in KOH/ZnO electrolytes at current densities near the diffusion-limit regime. Zinc dendrites present without flow are suppressed by micrometer-per-second flow at concentrations ranging from 0.2 to 0.6 M ZnO dissolved in 6 M and 10 M KOH solutions. Zn-Cu asymmetric cell tests reveal that flowing electrolyte increases the lifespan by more than 6 times in the diffusion-limit regime by suppressing gas evolution and dendrite formation. Ni-Zn cell tests show that a flow-assisted battery cycles 1500 times with over 95% Coulombic efficiency (CE) at 35 mA cm−2 current density and 7 mAh/cm2 charge capacity, increasing the battery lifespan by 17 times compared with a stagnant Ni-Zn cell. Flow-through electrolyte also stabilizes the Zn electrode in the over-limiting regime, achieving approximately 4 times increased lifespan and 297 cycles with over 90% CE at 52 mA cm−2.
High-Performance Electrochemical Sensor Based on Layer-by-Layer Assembly of [CQDs-PAH] Thin Film for Lead Ions Detection
Authors: Li Yahang , Zhou Hanrui , Jiang Qiubai , Zheng Shuang , Wei Ying , Zhang Qingguo
Published: March 2024

According to the extraordinarily excessive toxicity of lead ions (Pb2+) to humans even by tiny dose nowadays, the development of transportable and pocketed electrochemical sensor to detect tiny amount of Pb2+ ions with excessive sensitivity is in a pressing need. In this study, the carbon quantum dots (CQDs) synthesized from glutathione (GSH) were applied as the sensing materials for sensitive lead ions detection via square wave voltammetry (SWV) analysis, which can specific adsorb lead ions owing to the abundant functional group especially sulfhydryl. To enhance the performance of this sensing strategy, we constructed layer-by-layer [LBL] assembled [CQDs-PAH] thin films, the thin films performed a LBL three-dimensional network structure, which provided larger contact area for CQDs and Pb2+ ions, and also accelerated electron transfer of the active materials, thus improved the electrochemical sensing performance efficiently. The [CQDs-PAH] thin films would offer a new paradigm to design high-efficient electrochemical sensor for Pb2+ ions detection.
Utilizing as-synthesized Reduced Graphene Oxide Decorated with Mn1−xZnxFe2−yCuyO4 Doped Magnetic Nanoparticles for Efficient Electrochemical Sensing of Paracetamol
Authors: Rahman Mehboob Ur , Khan Rafaqat Ali , Khan Asad Muhammad , Sreearunothai Paiboon , Shah Faheem , Muhammad Haji , Shaikh Ahson Jabbar , Ismail Bushra , Noor Umar
Published: March 2024

A highly sensitive sensor for paracetamol detection based on the copper and zinc doped manganese ferrite/reduced graphene oxide modified glassy carbon electrode (Mn1−xZnxFe2−yCuyO4/rGO/GCE) is ameliorated. X-ray diffraction (XRD), scanning electron microscopy (SEM), Fourier transform infrared spectrometry (FTIR), zeta-sizer, cyclic voltammetry, and electrochemical impedance spectroscopy are used to examine the structural, morphological, electroanalytical capability of the designed sensor. Results are correlated systematically for the copper/zinc doped manganese ferrite/reduced graphene oxide modified glassy carbon electrode and it is observed that the sensor exhibits two linear ranges as 5–9 μmol l−1 and 9–200 μmol l−1 under the optimized conditions. Doped composite-modified GCE demonstrates an exceptional limit of detection (LOD) (0.04 μmol l−1) and the limit of quantification (LOQ) (0.15 μmol l−1). The possible effect of structurally similar drugs on the anodic current response of paracetamol is evaluated. By analyzing the current generation of the actual pharmaceutical samples, the practical application of the manufactured sensor is assessed. Promising results demonstrated by modified GC electrode affirm its excellent analytical performance for the sensing of paracetamol with trace-level detection and high sensitivity.
Comparative Study of Polymer Composites with Cellulose Microfibers from Different Plant Resources
Authors: Giri Jyoti , Adhikari Rameshwar , Sapkota Janak
Published: March 2024

Wheat stalk (W), Fosro (F), Nigalo with waxy layer (NW), and Nigalo without waxy layer (NWo) were used to extract microcrystalline cellulose (MCC), the xMCC (where x represents origin such as W, F, NW, and NWo) by thermochemical and mechanical treatments. About 10 wt% of xMCC and commercial MCC (C-MCC) were solution casted with ethylene oxide-epichlorohydrin (EO-EPI) to prepare microcomposites. The xMCC and cryo-fractured composites were observed by scanning electron microscopy, and the mechanical properties of the composites were measured by dynamic mechanical analysis to observe the effect of fillers on viscoelastic properties. The results concluded that the xMCCs are homogeneously dispersed in the EO-EPI polymer matrix, which reinforced the viscoelastic and mechanical properties in EO-EPI composites, and reinforcement is dramatically high with NWoMCC compared to NWMCC, WMCC, FMCC, and C-MCC.
Challenges in Effective Referral of Cardiovascular Diseases in Nepal: A Qualitative Study from Health Workers’ and Patients’ Perspective
Authors: Shrestha Soniya , Maharjan Rashmi , Bajracharya Swornim , Jha Niharika , Mali Sushmita , Thapa Bobby , Suwal Punya Shori , Prajapati Dipanker , Karmacharya Biraj Man , Shrestha Archana
Published: March 2024

Background. Nepal, currently facing a high burden of noncommunicable diseases (NCDs), including cardiovascular diseases (CVDs), which poses the highest mortality rate in the country, does not seem to have a proper referral strategy. This study explored the wide range of factors and challenges that affect the referral system of CVD cases in Nepal. Methods. In this qualitative study, we conducted face-to-face and telephone interviews with purposely selected 57 key participants which included 35 healthcare professionals from tertiary, secondary, and primary levels from Bagmati Province and 22 CVD patients (myocardial infarction and stroke) from Bagmati and Madhesh Provinces. We interviewed them using an interview guide with open-ended questions for in-depth information in a local language and in a private space. The interviews were audio-recorded, transcribed verbatim, coded, and analyzed using the thematic approach. Results. The findings indicated that the referral system for CVD cases from primary- to secondary- to tertiary-level care is inadequate and malfunctioning. The major factors affecting referral of CVD cases are centralization of CVD-specific services in few urban areas, inadequate systematic communication between the centers, self-referential, lack of human resources for CVD care, and obstacles to patient transfer due to geographical and financial reasons. Conclusion. A referral system for CVD patients is absent in the context of Nepal. Understanding and addressing key factors that affect the referral system of CVD patients may help to improve cardiac outcomes and ultimately save lives.
Asymmetric Effects of Weather‐Integrated Human Brucellosis Forecasting System Using a New Nonlinear Autoregressive Distributed Lag Model
Authors: Wang Yongbin , Xue Chenlu , Zhang Bingjie , Li Yuchun , Xu Chunjie
Published: March 2024

Human brucellosis (HB) remains a significant public health concern in China. This study aimed to investigate the long‐ and short‐term asymmetric impacts of meteorological variables on HB and develop an early prediction system. Monthly data on HB incidence and meteorological variables were collected from 2005 to 2020. The study employed the autoregressive distributed lag (ARDL) and nonlinear ARDL (NARDL) to analyze the long‐ and short‐term effects of climate variables on HB. Subsequently, the data were split into training (from January 2005 to December 2019) and testing parts (from January to December 2020) to develop and validate the forecasting accuracy of both models. During 2005–2020, there were 34,993 HB cases (2.03 per 100,000 persons) and there was an overall rising trend (average annual percentage change = 21.18%, 95%CI 18.36%–26.01%) in HB incidence, peaked in May and troughed in December per year. A 1 m/s increment and decrement in differenced (Δ) average wind velocity (AWV) contributed to 73.8% and 87.5% increases in ΔHB incidence, respectively (Wald long‐run asymmetry test (WLR) = 1.17, P = 0.25). A 1 hr increment and decrement in Δ(average relative humidity) contributed to both 3.1% increases in ΔHB incidence (Wald short‐run asymmetry test = 3.01, P = 0.003). Average temperature (AT) (P < 0.001) and average air pressure (P = 0.012) played a long‐run linear impact on HB. Δ(aggregate precipitation) (WLR = 1.76, P = 0.08) and Δ(aggregate sunshine hours) (WLR = 0.07, P = 0.94) did not have a significant long‐term asymmetric impact on Δlog(HB). ΔΔAT(+) and ΔΔAWV(−) at a 1‐month lag had a meaningful short‐run effect on Δlog(HB). In the forecasting aspect, the NARDL produced significantly smaller error rates compared to the ARDL. Weather variability played significant long‐ and short‐run asymmetric roles in HB incidence. The NARDL by integrating climatic variables could accurately capture the dynamic structure of HB epidemic, meaning that meteorological variables should be integrated into the public health intervention plan for HB.
Modelación matemática y configuración temprana de las identidades profesionales
Authors: Soto Márquez Mónica
Published: March 2024

Con el interés de explorar soluciones de continuidad entre las matemáticas de la formación, con las matemáticas de la profesión se estudia una modelación matemática de carácter socioepistemológico. Este tipo de modelación se enfoca en las prácticas de comunidades profesionales, que implican eI hacer recurrente y compartido por sus miembros, Esta visión reconoce la complejidad y dinámica de las prácticas de modelaciónt que se encuentran arraigadas en diversas comunidades profesionales y no profesionales. EI realizar en eI aula este tipo de prácticas profesionales por parte de estudiantes en formación, contribuye a la configuración temprana de su identidad profesional.
FDA Approval Summary: Enfortumab Vedotin plus Pembrolizumab for Cisplatin-Ineligible Locally Advanced or Metastatic Urothelial Carcinoma
Authors: Maguire William F. , Lee Daniel , Weinstock Chana , Gao Xin , Bulik Catharine C. , Agrawal Sundeep , Chang Elaine , Hamed Salaheldin S. , Bloomquist Erik W. , Tang Shenghui , Pazdur Richard , Kluetz Paul G. , Amiri-Kordestani Laleh , Suzman Daniel L.
Published: March 2024

On April 3, 2023, the FDA granted accelerated approval to enfortumab vedotin-ejfv (EV) plus pembrolizumab for treatment of patients with locally advanced or metastatic urothelial carcinoma who are ineligible for cisplatin-containing chemotherapy. Substantial evidence of effectiveness was obtained from EV-103/KEYNOTE-869 (NCT03288545), a multicohort study. Across cohorts, a total of 121 patients received EV 1.25 mg/kg (maximum of 125 mg) intravenously on days 1 and 8 of a 21-day cycle plus pembrolizumab 200 mg intravenously on day 1 of each 21-day cycle until disease progression or unacceptable toxicity. The major efficacy outcome measures were objective response rate (ORR) and duration of response (DoR), determined by blinded independent central review using RECIST v1.1. The confirmed ORR in 121 patients was 68% (95% confidence interval, 59–76), including 12% with complete responses. The median DoR for the 82 responders was 22 months (range: 1+ to 46+). The safety profile of the combination comprised adverse reactions expected to occur with the corresponding monotherapies, but with overall increased frequency of adverse reactions, including skin toxicity, pneumonitis, and peripheral neuropathy. The article summarizes the data and the FDA thought process supporting accelerated approval of EV + pembrolizumab, as well as additional exploratory analyses conducted by the FDA.
Supplementary Table S6 from Passenger Gene Coamplifications Create Collateral Therapeutic Vulnerabilities in Cancer
Authors: Bei Yi , Bramé Luca , Kirchner Marieluise , Fritsche-Guenther Raphaela , Kunz Severine , Bhattacharya Animesh , Rusu Mara-Camelia , Gürgen Dennis , Dubios Frank P.B. , Köppke Julia K.C. , Proba Jutta , Wittstruck Nadine , Sidorova Olga Alexandra , Chamorro González Rocío , Dorado Garcia Heathcliff , Brückner Lotte , Xu Robin , Giurgiu Mădălina , Rodriguez-Fos Elias , Yu Qinghao , Spanjaard Bastiaan , Koche Richard P. , Schmitt Clemens A. , Schulte Johannes H. , Eggert Angelika , Haase Kerstin , Kirwan Jennifer , Hagemann Anja I.H. , Mertins Philipp , Dörr Jan R. , Henssen Anton G.
Published: March 2024

QC sample reporting for Gas chromatography–mass spectrometry (GS-MS)
Supplementary Table S4 from Passenger Gene Coamplifications Create Collateral Therapeutic Vulnerabilities in Cancer
Authors: Bei Yi , Bramé Luca , Kirchner Marieluise , Fritsche-Guenther Raphaela , Kunz Severine , Bhattacharya Animesh , Rusu Mara-Camelia , Gürgen Dennis , Dubios Frank P.B. , Köppke Julia K.C. , Proba Jutta , Wittstruck Nadine , Sidorova Olga Alexandra , Chamorro González Rocío , Dorado Garcia Heathcliff , Brückner Lotte , Xu Robin , Giurgiu Mădălina , Rodriguez-Fos Elias , Yu Qinghao , Spanjaard Bastiaan , Koche Richard P. , Schmitt Clemens A. , Schulte Johannes H. , Eggert Angelika , Haase Kerstin , Kirwan Jennifer , Hagemann Anja I.H. , Mertins Philipp , Dörr Jan R. , Henssen Anton G.
Published: March 2024

Peptides significantly enriched after DDX1 immunoprecipitation as measured using LC-MS/MS.
Supplementary Table S3 from Passenger Gene Coamplifications Create Collateral Therapeutic Vulnerabilities in Cancer
Authors: Bei Yi , Bramé Luca , Kirchner Marieluise , Fritsche-Guenther Raphaela , Kunz Severine , Bhattacharya Animesh , Rusu Mara-Camelia , Gürgen Dennis , Dubios Frank P.B. , Köppke Julia K.C. , Proba Jutta , Wittstruck Nadine , Sidorova Olga Alexandra , Chamorro González Rocío , Dorado Garcia Heathcliff , Brückner Lotte , Xu Robin , Giurgiu Mădălina , Rodriguez-Fos Elias , Yu Qinghao , Spanjaard Bastiaan , Koche Richard P. , Schmitt Clemens A. , Schulte Johannes H. , Eggert Angelika , Haase Kerstin , Kirwan Jennifer , Hagemann Anja I.H. , Mertins Philipp , Dörr Jan R. , Henssen Anton G.
Published: March 2024

Gene sets enriched in in cell lines after ectopic DDX1 expression.
Supplementary Figures S1-S9 from Passenger Gene Coamplifications Create Collateral Therapeutic Vulnerabilities in Cancer
Authors: Bei Yi , Bramé Luca , Kirchner Marieluise , Fritsche-Guenther Raphaela , Kunz Severine , Bhattacharya Animesh , Rusu Mara-Camelia , Gürgen Dennis , Dubios Frank P.B. , Köppke Julia K.C. , Proba Jutta , Wittstruck Nadine , Sidorova Olga Alexandra , Chamorro González Rocío , Dorado Garcia Heathcliff , Brückner Lotte , Xu Robin , Giurgiu Mădălina , Rodriguez-Fos Elias , Yu Qinghao , Spanjaard Bastiaan , Koche Richard P. , Schmitt Clemens A. , Schulte Johannes H. , Eggert Angelika , Haase Kerstin , Kirwan Jennifer , Hagemann Anja I.H. , Mertins Philipp , Dörr Jan R. , Henssen Anton G.
Published: March 2024

Legends for supplementarytables and supplementary figures.
Supplementary Figure S1. Passenger genes are frequently co-amplified with oncogenes in cancers.
Supplementary Figure S2. DDX1 is highly expressed when co-amplified with MYCN.
Supplementary Figure S3. Neuroblastoma cell lines with DDX1-MYCN co-amplification depend on mTORC1.
Supplementary Figure S4. Ectopic DDX1 expression does not alter MYCN-driven tumorigenesis in zebrafish.
Supplementary Figure S5.DDX1 expression does not affect tumorigenic properties of cancer cell lines but induces changes in cell size.
Supplementary Figure S6. Aberrant DDX1 overexpression results in mTOCR1 pathway activation.
Supplementary Figure S7. DDX1 interacts with alpha-KGDH complex members and disruption of the DDX1:DLST interaction reduces mTORC1 pathway activation.
Supplementary Figure S8. High DDX1 expression is associated with α-KG accumulation and OXPHOS reduction.
Supplementary Figure S9. Aberrant DDX1 expression is associated with increased sensitivity to αKG and pharmacological mTORC1 inhibition.
Acquired Multidrug Resistance in AML Is Caused by Low Apoptotic Priming in Relapsed Myeloblasts
Authors: Olesinski Elyse A. , Bhatia Karanpreet Singh , Wang Chuqi , Pioso Marissa S. , Lin Xiao Xian , Mamdouh Ahmed M. , Ng Shu Xuan , Sandhu Vedant , Jasdanwala Shaista Shabbir , Yilma Binyam , Bohl Stephan , Ryan Jeremy A. , Malani Disha , Luskin Marlise R. , Kallioniemi Olli , Porkka Kimmo , Adamia Sophia , Chng Wee Joo , Osato Motomi , Weinstock David M. , Garcia Jacqueline S. , Letai Anthony , Bhatt Shruti
Published: March 2024

In many cancers, mortality is associated with the emergence of relapse with multidrug resistance (MDR). Thus far, the investigation of cancer relapse mechanisms has largely focused on acquired genetic mutations. Using acute myeloid leukemia (AML) patient-derived xenografts (PDX), we systematically elucidated a basis of MDR and identified drug sensitivity in relapsed AML. We derived pharmacologic sensitivity for 22 AML PDX models using dynamic BH3 profiling (DBP), together with genomics and transcriptomics. Using in vivo acquired resistant PDXs, we found that resistance to unrelated, narrowly targeted agents in distinct PDXs was accompanied by broad resistance to drugs with disparate mechanisms. Moreover, baseline mitochondrial apoptotic priming was consistently reduced regardless of the class of drug-inducing selection. By applying DBP, we identified drugs showing effective in vivo activity in resistant models. This study implies evasion of apoptosis drives drug resistance and demonstrates the feasibility of the DBP approach to identify active drugs for patients with relapsed AML.

Significance:

Acquired resistance to targeted therapy remains challenging in AML. We found that reduction in mitochondrial priming and common transcriptomic signatures was a conserved mechanism of acquired resistance across different drug classes in vivo. Drugs active in vivo can be identified even in the multidrug resistant state by DBP.
FIGURE 2 from The NUTRIENT Trial (NUTRitional Intervention among myEloproliferative Neoplasms): Results from a Randomized Phase I Pilot Study for Feasibility and Adherence
Authors: Mendez Luque Laura F. , Avelar-Barragan Julio , Nguyen Hellen , Nguyen Jenny , Soyfer Eli M. , Liu Jiarui , Chen Jane H. , Mehrotra Nitya , Huang Xin , Kosiorek Heidi E. , Dueck Amylou , Himstead Alexander , Heide Elena , Lem Melinda , El Alaoui Kenza , Mas Eduard , Scherber Robyn M. , Mesa Ruben A. , Whiteson Katrine L. , Odegaard Andrew , Fleischman Angela G.
Published: March 2024

Patients with MPN can adopt a Mediterranean eating pattern with dietician counseling and education. A, Percentage of participants with MEDAS scores ≥8 at each timepoint with orange shaded area depicting the active intervention period. B, Participant responses to feasibility question during active intervention period, green represents a participant who met the feasibility benchmark of HEI-2015 (C) was calculated from each 24-hour diet recall, and scores for each participant were averaged for the pre-intervention (weeks 1–2), active intervention (weeks 3–12), and post-intervention (weeks 13–15) period. Data shown represent median with interquartile range.
FIGURE 1 from The NUTRIENT Trial (NUTRitional Intervention among myEloproliferative Neoplasms): Results from a Randomized Phase I Pilot Study for Feasibility and Adherence
Authors: Mendez Luque Laura F. , Avelar-Barragan Julio , Nguyen Hellen , Nguyen Jenny , Soyfer Eli M. , Liu Jiarui , Chen Jane H. , Mehrotra Nitya , Huang Xin , Kosiorek Heidi E. , Dueck Amylou , Himstead Alexander , Heide Elena , Lem Melinda , El Alaoui Kenza , Mas Eduard , Scherber Robyn M. , Mesa Ruben A. , Whiteson Katrine L. , Odegaard Andrew , Fleischman Angela G.
Published: March 2024

NUTRIENT study design.
Abstract 004: Summary of MT2020+ Research Internship Progress from 2021 to 2023
Authors: Saigal Khushi , Saxena Tanya , Mairal Anurag , Yavagal Dileep R
Published: March 2024

Introduction

Mission Thrombectomy, established in 2016 by the Society of Vascular and Interventional Neurology, aims to enhance global accessibility to mechanical thrombectomy surgery for strokes caused by large vessel occlusion in the brain. High school students interested in exposure to global health have limited access to get exposure in this rapidly expanding area of public health. The MT2020+ student internship was designed in collaboration with MT2020+ to provide such an experience to US High School students. Students designed and carried out projects to raise stroke awareness among other high school students and communities while studying the barriers to stroke treatment. We report on this novel internship program's methodology, results, and outcomes.

Methods

The MT2020+ internship program followed a comprehensive framework. Three phases were implemented: Phase A involved secondary research, stakeholder identification, and the formation of a detailed survey and interview questions. Stakeholders included neurologists, neuro‐interventionalists, neuro‐radiologists, and members of stroke societies. Countries in the region of interest were categorized into three groups based on stroke and COVID‐19 data. A survey template was created in Phase B, and stakeholders were contacted for data collection. Interviews were conducted to delve deeper into survey responses. Phase C focused on analyzing the collected data, articulating the key barriers, and generating a written report. Interns also developed interventions to address key barriers identified during the research.

Results

The first cohort (2020) comprised 8 interns who investigated barriers to stroke treatment across different regions. The interns received survey responses and conducted interviews with stakeholders. Their research covered the U.S. & North America, Latin America, Europe, Africa, Asia, and Australia. The outcomes varied, with different levels of engagement. One student developed an app in Peru to address transportation, educational, and rehabilitation barriers. The second cohort (2021) had 2 interns who focused on Latin America and Asia, working on rehabilitation apps. The third cohort (2022) included 4 interns studying Asia, Australia/New Zealand, North America/US, and Latin America. Their interventions ranged from creating stroke awareness clubs to organizing virtual conferences.

Conclusion

The MT2020+ student internship provided a novel opportunity for high school students to get exposure to global health implementation. The student research in this internship has contributed valuable insights into stroke treatment barriers and raised awareness among high school students worldwide.
Abstract 024: Endovascular Treatment of Cavernous Sinus Dural Arteriovenous Fistula: A Single Center experience
Authors: Mowla Ashkan , Abdollahifard Saeed , Taherifard Erfan , Szeder Viktor , Tateshima Satoshi , Nour May , Colby Geoffrey , Jahan Reza , Duckwiler Gary , Kaneko Naoki , Takayanagi Ariel , Liang Feng , Vinuela Fernando
Published: March 2024

Introduction

The cavernous sinus dural arteriovenous fistula(CS‐DAVF) is a vascular condition that is a result of an unusual connection between the carotid artery branches and the cavernous sinus. This condition could be the result of trauma, infection, or other medical problems. In the case that conservative therapy fails or patients need emergency intervention, endovascular treatment (EVT) has been proposed as a main option for the treatment of these patients. In this study, we aimed to investigate the outcomes of the patients who underwent EVT for CS‐DAVF.

Methods

To gather information on patient demographics, symptoms, clinical and imaging characteristics, as well as the type of EVT and their outcomes after EVT, we recruited records of patients of our center from 2007. We used descriptive analyses to assess the characteristics of the included cases. Besides, inferential statistics were used to develop univariate and multivariate logistic regression models to identify factors linked to procedural success and symptom resolution at the follow‐up.

Results

Overall, 59 patients with a mean age of 64.37 years, a female‐to‐male ratio of 2.71, and a mean follow‐up time of 42.64 months were included. Chemosis, ptosis, and diplopia were the most frequent symptoms, and most of the patients were classified as Barrow classification type D based on angiographic features (30/58). In terms of EVT, most of the patients (54/59) underwent transvenous embolization, and liquids (Onyx 34 and 18) were the most frequent materials that were used for embolization (55/59). Also, in 34 cases, additional coiling was performed. Overall, the procedural success rate was 84% (50 out of 59), and a complete resolution of symptoms was observed in 46 cases at the follow‐up, with the occurrence of eight complications overall (13.5%), including two strokes, two alopecia, one seizure, one cranial nerve palsy, one diplopia and one worsening of symptom events. Multiple logistic regression showed that the use of Onyx 34 was associated with procedural success.

Conclusion

Our results showed that EVT might be a safe and effective option for the treatment of patients with CS‐DAVF. Also, the results showed that the application of Onyx 34 might associate with the procedural success rate.
Abstract 037: Aneurysm Occlusion Rates with WEB Treatment: Single‐Institution Study and Review
Authors: Tokov Michael , Garton Andrew , Carnevale Jospeh , Kocharian Gary , Boddu Srikanth , Knopman Jared
Published: March 2024

Introduction

To provide our single‐institution experience and outcome data with the WEB device in 51 patients treated for ruptured and unruptured intracranial aneurysms.

Methods

Occlusion rates in a cohort of 51 patients treated with WEB were collected at time of procedure and at last follow‐up between the years 2019 and 2021. Angiographic outcomes were assessed on the WEB occlusion scale (WOS) and occlusion status scale (OSC). Compaction was assessed on imaging. Functional outcomes were assessed using the modified Rankin Scale. Thromboembolic complications and retreatments were recorded. Statistical analysis was performed to identify predictors of inadequate occlusion.

Results

A total of 51 patients underwent endovascular embolization using the WEB device with a mean follow‐up of 14.9 months. Ruptured aneurysmal subarachnoid hemorrhage accounted for 15.7% (8/51) of all patients. Most of the patients (92.1%) were functionally independent at presentation. The most common aneurysm location in the present study was MCA bifurcation (52.9%). The median maximal aneurysm diameter was 6.9mm, while the median neck size was 4.4mm. Last follow‐up consisted of 49 patients and imaging was obtained in 45 patients. Adequate occlusion was documented at 97.8% (WOS) and 93.3% (OSC). Retreatment was required in 1 aneurysm. Minor compaction was noted in 11.1% with no cases of major compaction. The majority of patients had the same presenting and post‐procedure mRS. Thromboembolic complications were encountered in 7.8% (4/51) of procedures; 3 of which were symptomatic and none were permanent. There were no hemorrhagic complications. An analysis of the data shows that larger aneurysm dimensions, necessity for adjunctive stent, and minor compaction were significantly associated with inadequate occlusion. Aneurysm height and dome width remained independent predictors of inadequate occlusion

Conclusion

This study confirms the safety and efficacy profile of the WEB device for the embolization of intracranial aneurysms at our institution. A high rate of adequate occlusion at a midterm follow‐up demonstrates high efficacy of the WEB device in our experience. Predictors of inadequate occlusion, which we explored, proved consistent with the literature on known variables associated with residual aneurysms.
Abstract 045: A Radiomics Based Pipeline for Paired Risk‐Stratification of Intracranial Atherosclerotic Plaques
Authors: Sese Elena S. Sagues , Sanchez Sebastian , Veeturi Sricharan , Patel Tatsat , Tutino Vicent M. , Ojeda Diego J. , Miller Jacob M. , Saleem Arshaq , Gudino Andres , Wang Bincheng , Samaniego Edgar A.
Published: March 2024

Introduction

High resolution vessel wall imaging (HR‐VWI) enables accurate visualization of intracranial atherosclerotic plaques. Radiomics can be utilized as an objective quantification method of plaque appearance and shape. We aimed to analyze the radiomics features (RFs) obtained from 7T‐HR‐VWI to differentiate between culprit and non‐culprit plaques in patients with intracranial atherosclerotic disease (ICAD).

Methods

Patients with ICAD as stroke etiology undergoing HR‐VWI were included in the study. Culprit plaques in the vascular territory of the stroke were identified. The degree of stenosis, area degree of stenosis and plaque burden were calculated. Three‐dimensional segmentation of the plaque was performed, and RFs were extracted. We then evaluated multiple machine learning models to predict and identify culprit plaques using significantly different RFs. The dataset was then randomly divided into training and testing datasets, and the trained model was evaluated on the independent testing dataset.

Results

The study included 33 patients with ICAD as the cause of stroke. Univariate analysis revealed 38 significantly different RFs between culprit and non‐culprit plaques in pre‐contrast MRI, 39 in post‐contrast MRI and 25 RFs that were different between pre and post contrast MRIs. Additionally, seven shape‐based RFs exhibited significant distinctions between the two plaque types. The random forest model achieved an accuracy rate of 81% (88% sensitivity and 75% specificity) in identifying culprit plaques in the independent testing dataset. This model successfully identified the culprit plaque in 7 out of 8 cases during the testing phase.

Conclusion

In this study symptomatic culprit plaques had a different signature RFs compared to other plaque within the same subject. A machine learning model built with RFs successfully identified the symptomatic atherosclerotic plaques in most cases. Radiomics is a promising tool for stratification of plaques in patients with ICAD.
Abstract 064: The Pushability of Commonly Used Microwires in Neuroendovascular Procedures
Authors: Molaie Amir , Fukuda Keiko A , Sakuta Kenichi , Suzuki Kentaro , Ghovvati Mahsa , Kaneko Naoki , Selim Omar , Tateshima Satoshi , Imahori Taichiro , Hanaoka Yoshiki
Published: March 2024

Introduction

In distal and medium‐vessel occlusions (DMVOs), there are increasing opportunities to deliver devices through tortuous and medium sized arteries. However, this comes at the risk of microwire perforation during distal microcatheter advancement for navigation in these curved, slender vessels, leading to hemorrhagic complications. Currently, microwires with a range of stiffness levels are available. However, it is unclear how the variations in stiffness and the relative positioning of the microwire and microcatheter may affect the force applied to the vessel wall. Few studies have compared objective metrics across different commonly used devices. We sought to compare the pushability of various Synchro Select and Chikai microwires using both proximal and distal support.

Methods

In a moderate tortuosity, silicone flow model of the middle cerebral artery (MCA) branches, we tested 0.014” nitinol microwires (Synchro Select Soft, Standard, or Support), or 0.014” stainless steel microwires (Chikai, Black, and Black Soft) in a TrevoTrak 21 microcatheter docked either in the proximal M1 segment or distal M2 segment. Applied force was measured using an Imada force gauge DST‐1A at the M2 ten times for each experiment. The slope, measured in mN per mm, of the applied distal force during the maximal pushing period was calculated.

Results

The average slope of the pushing force within a distal microcatheter was 10.64 mN/mm with a Synchro Soft, 10.85 mN/mm with a Standard, and 15.28 mN/mm with a Support microwire (p < 0.0001). The average slope of the pushing force in a proximal microcatheter was 1.61 mN/mm with a Synchro Soft, 3.15 mN with a Synchro Standard, and 3.87 mN with a Synchro Support microwire (p <0.001). With the Chikai microwires, the average slope of the pushing force within a distal microcatheter was 12.48 mN/mm with a Chikai Black Soft wire, 12.82 mN/mm with a Chikai Black microwire, and 14.11 mN/mm using a Chikai microwire (p=0.801). Within a proximal microcatheter, the average maximal force was 2.42 mN/mm using a Chikai Black Soft wire, 3.16 mN/mm using Chikai Black, and 3.91 mN/mm using the Chikai wire (p < 0.001).

Conclusion

This study demonstrated that stiffer microwires push the arterial wall with significantly greater force within a microcatheter close to the wall. Pushability of the microwire significantly dropped across all microwires when the microcatheter was positioned more proximally. This is the first known report of the pushability of commonly used microsystems in neuroendovascular procedures.
Abstract 075: Treatment Trends and Clinical Outcomes of Endovascular Therapy for Pediatric Unruptured Intracranial Aneurysms
Authors: Dicpinigaitis Alis J. , Syed Shoaib , Sillari Catherine , Gandhi Chirag D. , Al‐Mufti Fawaz
Published: March 2024

Introduction

Due to the relative rarity of unruptured intracranial aneurysms (UIA) in the pediatric population, evidence regarding treatment modalities and clinical outcomes remains limited. This study aims to characterize the utilization and clinical outcomes of endovascular therapy (EVT) and microsurgical clipping (MSC) for pediatric UIAs over a two‐decade interval using a large national registry.

Methods

Pediatric (< 18 years of age) UIA hospitalizations were identified in the National Inpatient Sample from 2002 to 2019. Temporal utilization and clinical outcomes were compared for treatment with EVT and MSC.

Results

Among 734 UIAs identified during the study period, 64.9% (n = 476) were treated with EVT. Utilization of EVT significantly increased during the study period from 54.3% (2002‐2004) to 78.6% (2017‐2019) (p = 0.002 by Cochrane‐Armitage test). Treatment with EVT did not differ as a function of increasing age, but was mostly highly utilized in the youngest age grouping [70.4% (0‐2 years), 64.0% (3‐12 years), 64.3% (13‐17 years); p = 0.578]. In comparison with those treated with MSC, pediatric patients treated with EVT demonstrated higher rates of favorable outcomes (discharge to home without services) (96.0% vs. 91.1%, p = 0.006), shorter durations of hospital stay (4.6 vs. 10.0 days, p < 0.001), and lower rates of ischemic or hemorrhagic procedural‐related complications (1% vs. 4%, p = 0.010).

Conclusion

A retrospective evaluation of nearly twenty years of population‐level data from the United States demonstrates increasing utilization of EVT for the treatment of pediatric UIAs with high rates of favorable outcomes and shorter hospital stays in comparison to those treated with microsurgery. However, limitations of available registry data (such as absence of radiographic parameters and aneurysm morphological characteristics) temper any definitive claims regarding treatment efficacy.
Abstract 083: Initial Angiogenesis in Vein of Galen Malformations Is Associated with Increased Symptomatic Burden
Authors: Devarajan Alex , Shigematsu Tomoyoshi , Bonet Jessica M. , Bazil Maximilian J. , Morgenstern Peter F. , Ghatan Saadi , Molofsky Walter J. , Berenstein Alejandro , Fifi Johanna T.
Published: March 2024

Introduction

Vein of Galen Malformations (VOGM) are congenital brain arteriovenous malformations which often present during the neonatal or infantile periods. While endovascular embolization is the recommended management for this pathology, a subset of VOGM patients present with pathologic angiogenesis which complicates endovascular therapy. Previous studies have shown that these patients require a greater number of embolizations to achieve cure, but it is unclear whether this radiographic finding is associated with differences in clinical presentation.

Methods

A single‐center retrospective review identified all patients with a Vein of Galen Malformation from January 2004 to May 2023. Patients were stratified into three groups based on the development and timing of angiogenesis during their treatment course: pre‐intervention angiogenesis, post‐intervention angiogenesis, and no angiogenesis. Clinical presentations, relevant imaging, radiographic data, and procedural details were reviewed.

Results

178 patients with VOGM were identified. 38 patients were in the pre‐intervention angiogenesis group, 51 patients were in the post‐intervention angiogenesis group, and 89 patients were in the no angiogenesis group. Pre‐intervention angiogenesis patients were significantly older on presentation for initial angiogram than post‐intervention angiogenesis or no angiogenesis patients (p<0.05). At initial clinical presentation, patients with pre‐intervention angiogenesis demonstrated significantly greater developmental delay (p<0.05). This difference persisted after controlling for age at initial presentation. Patients presenting with angiogenesis either pre‐intervention or post‐intervention required more embolizations to achieve cure compared to patients who did not develop angiogenesis during their treatment course (p<0.05).

Conclusion

Patients with VOGM who present with pre‐intervention angiogenesis demonstrate significantly more serious neurologic symptoms on initial presentation, even after controlling for age at presentation. Given that patients with angiogenesis are often older on initial presentation and require more embolizations to be cured, early and timely treatment is likely necessary to mitigate the further progression of both the angiogenic network and any associated neurological symptoms.
Abstract 091: Intraventricular milrinone for management of vasospasm following aneurysmal subarachnoid hemorrhage
Authors: Razavi Seyed Mostafa , Khurana Mahika , Mau Cynthia Zevallos , Sandhu Divyajot
Published: March 2024

Introduction

Aneurysmal subarachnoid hemorrhage (aSAH) accounts for about 10% of hemorrhagic strokes [1] and holds a high mortality and morbidity rate. [2, 3] Vasospasm is one of the more devastating complications of aSAH. Novel imaging modalities have drastically improved our ability in prompt detection of vasospasm in these patients. However, clinical management of this complication is still debated among experts. [4] Systemic cerebral vasodilators are widely used in aSAH patients, but guidelines for interventional and rescue procedures are not well developed. [5]

Methods

Here, we report a case of severe vasospasm following aSAH that was successfully treated with intraventricular injection of milrinone through external ventricular drain (EVD) in conjunction to standard therapy.

Results

A 70‐year‐old man with a history of diabetes, hypertension, and hyperlipidemia was brought to the emergency department after he was found down and unresponsive. He was intubated by EMS on route. Head CT on arrival showed a diffuse subarachnoid hemorrhage, more prominent in the posterior fossa, and grade IV on the modified Fisher scale. An initial DSA showed a ruptured aneurysm in the second segment of the right posterior inferior cerebellar artery, second segment. A right frontal EVD was placed on the second day. Hemodynamic augmentation was achieved with intravenous and intraventricular milrinone. Cerebral arterial patency was evaluated with daily transcranial doppler (TCD). The patient did not show any evidence of vasospasm until day 9 where TCD revealed severe vasospasm in the basilar and bilateral vertebral arteries, as well as mild vasospasm of anterior and middle cerebral arteries.

Intraventricular milrinone was injected into the EVD in from day 9 to day 12. Using sterile technique, 4 mL of CSF was removed followed by the injection of 0.87mg (2mL) of milrinone into the EVD via a three way stop cock. EVD was then flushed with 2mL of preservative‐free saline and clamped for 1 hour. This procedure effectively improved vasospasm on serial TCDs and also DSAs (Figure1).

The patient underwent several DSA’s on days 10, 14, 19, 20, and 21 with targeted intraarterial milrinone and verapamil injections. His final TCD showed only mild middle cerebral artery and moderate basilar artery vasospasm. At that point, no more intervention was deemed necessary. A ventriculoperitoneal shunt was also placed. CT scan before discharge showed mild improvement in ventricular size and stable SAH blood products.

The course of hospitalization was complicated by hyponatremia, atrial fibrillation, and respiratory failure with inability to wean off ventilator, resulting in tracheostomy and gastrostomy tube placement. The patient was discharged in stable condition on day 30 to a rehabilitation center.

Conclusion

Intraventricular milrinone in addition to standard therapy can be an effective method in treatment of severe vasospasm in aSAH patients.
Abstract 097: Un‐stumped by Carotid Stump Syndrome: Use of External Carotid Stenting in Preventing Ischemic Stroke
Authors: Ehidom Clinton , Dawod Giana , Díaz Paulina , Wechsler Paul , Parauda Sarah , Knopman Jared , Parikh Neal
Published: March 2024

Introduction

Recurrent infarcts to the internal carotid artery territory in the setting of a corresponding occlusion raises concern for carotid stump syndrome. Over time, robust anastomoses may develop between the patent ipsilateral external carotid artery and the anterior circulation distal to the site of occlusion. A carotid stump’s disturbance of flow uncommonly can form emboli that travel via retrograde flow from the occluded internal carotid artery to the ipsilateral external carotid artery and its collaterals. Stenosis of the external carotid artery in such patients can be a source of atheroembolism or hypoperfusion. We describe a case of external carotid stenting with carotid stump coil occlusion.

Methods

We present a case report. Verbal consent to share this information was obtained directly from the patient.

Results

A 75‐year‐old man with aortic stenosis, atrial arrhythmia, multiple prior bi‐hemispheric strokes, on aspirin and clopidogrel, presented with left facial droop, arm weakness, and slurred speech. Magnetic resonance imaging revealed embolic appearing strokes in the right middle cerebral artery territory (Figure 1A). Cerebral angiography revealed complete occlusion of the right internal carotid artery with perfusion of the right middle cerebral artery by external carotid artery anastomoses, and the external carotid was found to be stenosed proximally. Digital subtraction angiography revealed right external carotid – middle cerebral artery anastomoses via the right sphenopalatine artery, middle meningeal artery, internal maxillary artery, and ophthalmic collaterals (Figure 1B). The patient underwent coiling of the right internal carotid artery stump (Figure 1C) followed by stenting of the right external carotid using a 9 mm x 40 mm Cordis precise Pro stent. Post‐stenting angiogram demonstrated good apposition of the stent to the parent vessel walls and improvement of flow into the right external carotid and intracranial circulation (Figure 1D). The patient was treated with aspirin and ticagrelor for 3 months. Repeat imaging at follow up did not show further embolic episodes, with improvement in the patient’s deficits. After three months, he was continued on aspirin alone.

Conclusion

In patients with an occluded internal carotid artery and recurrent embolic infarcts ipsilateral to the side of the occlusion, carotid stump syndrome may be considered. In this case, we believe the patient’s carotid occlusion served as a nidus for emboli formation, or that there was atheroembolism from the stenosed external carotid artery despite adherence to dual antiplatelet therapy. By coiling the stump, we addressed a possible source of emboli, and stenting of the proximal external carotid optimized anterograde flow and prevented further atheroembolism. Our case showcases an interventional neuroradiology approach to carotid stump emboli and external carotid artery stenosis.