bluuebunny/crossref_metadata_2025 huggingface dataset:
A Corpus‐Based and Complex Computing Digital Media System for 3D Animation
Authors: Zhang Weihua , Tsai Sang-Bing
Published: December 2021

In this paper, we design a corpus‐based 3D animation digital media system to improve the accuracy of 3D animation generation and realize crossplatform animation display. The corpus module extracts high‐precision data through web crawling, web cleaning, Chinese word separation, and text classification steps; the character animation generation module uses the semantic description method to expand the frame information description of the extracted data, calculates the object spatial 3D coordinates, and uses the built‐in animation execution script to generate 3D character animation; the improved digital media player module uses the improved digital media player to realize crossplatform display of 3D character animations using the improved digital media player. By constructing multidimensional character relationships and combining multiple visualization methods, the complex and multifaceted social relationship network is made available to users in an intuitive and more acceptable and understandable mode. Through a large number of user surveys, it is proved that the visual analysis method combining real social and virtual social proposed in this paper provides a more adequate and reliable basis for friend recommendation and social network analysis; the combination of multiple character relationships with geographical information and the use of visualization to describe multidimensional historical character relationships provides a new research perspective for the research and exploration of humanistic neighborhoods. The experimental results prove that the designed system can effectively read known contents and extract keywords and generate 3D animation based on keyword features, with a high accuracy rate, fast response time, small frame loss rate, and crossplatform display animation advantages.
Seismic Fragility Analysis of Structures Based on Adaptive Gaussian Process Regression Metamodel
Authors: Xiao Yanjie , Yue Feng , Zhang Xun′an
Published: December 2021

Metamodel‐based seismic fragility analysis methods can overcome the challenge of high computational costs of problems considering the uncertainties of earthquakes and structural parameters; however, the accuracy of metamodels is difficult to control. To enhance the efficiency of analyses without compromising accuracy, a metamodeling method using Gaussian process regression (GPR) and active learning (AL) for seismic fragility analysis is proposed. In this method, a GPR metamodel is built to estimate the stochastic seismic response of a structure, in which the record‐to‐record variability is considered as in the dual‐metamodel‐based fragility analysis approach. The metamodel can also predict the estimation error. Taking advantage of this ability, we present an AL strategy for adaptive sampling, so that the metamodel can be improved adaptively according to the problem. Using this metamodel and Monte Carlo simulation, seismic fragility curves can be obtained with a small number of calls for time history analysis. To verify its effectiveness, the proposed method was applied to three examples of nonlinear structures and compared with existing methods. The results show that this method has high computational efficiency and can ensure the accuracy of fragility curves without making the metamodel globally accurate.
Advances regarding Neuroinflammation Biomarkers with Noninvasive Techniques in Epilepsy
Authors: Ma Hongrui , Lin Hua
Published: December 2021

A rapidly growing body of evidence supports that neuroinflammation plays a major role in epileptogenesis and disease progression. The capacity to identify pathological neuroinflammation in individuals with epilepsy is a crucial step on the timing of anti-inflammatory intervention and patient selection, which will be challenging aspects in future clinical studies. The discovery of noninvasive biomarkers that are accessible in the blood or molecular neuroimaging would facilitate clinical translation of experimental findings into humans. These innovative and noninvasive approaches have the advantage of monitoring the dynamic changes of neuroinflammation in epilepsy. Here, we will review the available evidence for the measurement of neuroinflammation in patients with epilepsy using noninvasive techniques and critically analyze the major scientific challenges of noninvasive methods. Finally, we propose the potential for use in clinical applications.
Community Perception on Trypanosomosis, Parasitological, and Entomological Studies in Two Selected Districts of South Omo Zone, Ethiopia
Authors: Mekuria Solomon , Mekonnen Tesfu K. , Kebede Nigatu
Published: December 2021

Participatory investigation and trypanosomosis prevalence studied during April 2019 and March 2020 in two selected districts of South Omo, Ethiopia. The study site is located in the gridline of 04.90 to 5.60oN and 35.80 to 36.900 E. Twelve community groups are employed. A cross-sectional study design and 288 animals bled and examined a wet film prepared from the buffy coat. Sixty NGU traps baited with acetone and cow urine were deployed for 48 hrs to estimate the apparent density. Data generated from focus group discussion and trypanosomosis prevalence analyzed using an appropriate statistical package. Proportional piling showed that cattle, goats, and sheep were proportionally dominant with a high median score of 32(14–40), 26(12–33), and 21(5–23), respectively; trypanosomosis ranked first with a proportional median score of 24(13–26) followed by contagious bovine/caprine pleuropneumonia with a proportional median score of 23(19–26) among others. Community unanimously agreed that (W = 0.9) trypanosomosis affects their socioeconomic status and was able to describe clinical signs with significant (p < 0.05) agreement. Tsetse fly (Echut and Kusubo) is the main vector with the agreement of W = 0.9(p < 0.05). Perception on human trypanosomosis varies between Benna Tsemay and Gnagatom districts. Therefore, further study supported by laboratory like molecular test is very important to conclude the presence of human trypanosomosis in the suggested area. The overall prevalence of cattle trypanosomosis was 10.1%. The prevalence of trypanosomosis was significantly higher in poor body condition (OR = 2.1, P < 0.05) and in black coat color (OR = 13.5, P < 0.05) animals. T. congolense and T. vivax were circulating in the area. A total of 455 Glossina (385 G. pallidipes, 17 G. tachinoides, and 53 G. fuscipes) were trapped. The overall apparent density of Glossina was 3.79 Flies/Trap/Day. Three species of Glossina, namely G. pallidipes, G. tachinoides, and G. fuscipes, were distributed in the study areas. Therefore, the finding suggests that the problem is significant and the human trypanosomosis is doubtful. Hence regular control measures and molecular diagnosis need to be conducted.
Effects of the Predominant Pulse on the Inelastic Displacement Ratios of Pulse‐Like Ground Motions Based on Wavelet Analysis
Authors: Zhao Guochen , Zhu Jingzhou , Zhu Xingji , Xu Longjun
Published: December 2021

Having a predominant pulse is the main feature for pulse‐like ground motions differing from others. To investigate the influence of the predominant pulse on the inelastic displacement ratios of pulse‐like ground motions, the wavelet analysis method is used to extract the predominant pulse. The results indicate that the inelastic displacement ratios of the pulse‐removed parts obtained by subtracting the extracted pulse from the original pulse‐like ground motions are close to the results of non‐pulse‐like ground motions. The ratio of the energy of the extracted pulse to the energy of the original ground motion is used to represent the pulse intensity. The results indicate that the pulse period determines the locations in which the inelastic displacement ratios would have noticeable increments, and the pulse intensity determines the degree of the increments. Besides, the effects of five commonly used parameters (PGV, PGD, PGV/PGA, Arias intensity Ia, and soil condition) on the inelastic displacement ratios of pulse‐like ground motions and their relations to the pulse period and the pulse intensity are studied. Finally, a new model, in which the influence of pulse intensity is considered, to predict the inelastic displacement ratios of pulse‐like ground motions is proposed.
Research on the Cultivation of College Students’ Innovation Ability and the Development of Self-Survival Innovation Team from the Perspective of Green Ecology
Authors: Dong Yuwei , Cao Qingren
Published: December 2021

Self-survival innovation teams composed of college students are considered incubators for future entrepreneurs. Stability is the prerequisite for team survival, while sustainable development is the necessary condition for their continuous progress. The development of members and the team are interrelated. In the continuous development of the team, the members, who contribute to the development of the team, change iteratively, while the team provides opportunities and platforms for the development of the members. However, at present, there are few researches on the sustainable development of the team and the data analysis on the correlation between the member development and the team construction. Therefore, in order to make a systematic analysis on the sustainable development ability of the team, this paper adopts questionnaires to obtain relevant information about college students and their innovation team. SPSS software (25.0) is used to make statistical analysis on the current development of college students’ individual ability and innovation team. Based on this, the paper puts forward analysis strategies for the personal development of college students and the construction of self-survival innovation team.
Uplink Spectrum Overlay Coverage Enhancement Algorithm in 5G Network
Authors: Jiang Jian-feng , Ding Hui-jie
Published: December 2021

The imbalance between the uplink and downlink rates and coverage of the 5G network has led to limited vertical industry services. Aiming at breaking the imbalance between the uplink and downlink rates and improving the coverage of 5G network, a uplink coverage enhancement algorithm is designed from the aspects of networking mode, bandwidth, uplink and downlink subframe ratio, etc. It uses high- and low-frequency time-frequency joint scheduling to enable uplink full-time slot scheduling, thereby improving uplink coverage and rate. According to the actual test on the live network, the results show that the super-uplink algorithm can increase the near-point uplink rate by 15% to 30%, increase the uplink rate for indoor midpoint scenarios by 40% to 80%, and increase the uplink rate for outdoor and indoor weak spot scenarios by 100% to 400%.
The ADAM17-directed Inhibitory Antibody MEDI3622 Antagonizes Radiotherapy-induced VEGF Release and Sensitizes Non–Small Cell Lung Cancer for Radiotherapy
Authors: Tschanz Fabienne , Bender Sabine , Telarovic Irma , Waller Verena , Speck Roberto F. , Pruschy Martin
Published: December 2021

The cellular response to ionizing radiation (IR) depends on tumor cell and microenvironmental factors. Here, we investigated the role of IR-induced ADAM17 matrix metalloproteinase activity for the intercellular communication between tumor cells and the tumor vasculature in non–small cell lung cancer (NSCLC) tumor models. Factors shed by ADAM17 from NSCLC tumor cells (A549, H358) and relevant for endothelial cell migration were investigated using transwell migration assays, ELISA, and flow cytometry. Tumor angiogenesis–related endpoints were analyzed with the chorio-allantoic membrane assay and in murine NSCLC tumor models. Efficacy-oriented experiments were performed in a murine orthotopic NSCLC tumor model using irradiation with an image-guided small-animal radiotherapy platform alone and in combination with the novel ADAM17-directed antibody MEDI3622. In vitro, VEGF was identified as the major factor responsible for IR-induced and ADAM17-dependent endothelial cell migration toward attracting tumor cells. IR strongly enhanced tumor cell–associated ADAM17 activity, released VEGF in an ADAM17-dependent manner, and thereby coordinated the communication between tumor and endothelial cells. In vivo, tumor growth and microvessel size and density were strongly decreased in response to the combined treatment modality of IR and MEDI3622 but not by either treatment modality alone and thus suggest that the supra-additive effect of the combined treatment modality is in part due to abrogation of the ADAM17-mediated IR-induced protective effect on the tumor vasculature. Furthermore, we demonstrate that the novel ADAM17-inhibitory antibody MEDI3622 potently improves the radiotherapy response of NSCLC.

Significance:

The tumor response to radiotherapy is influenced by several factors of the tumor microenvironment. We demonstrate that inhibition of the sheddase ADAM17 by the novel antibody MEDI3622 reduces IR-induced VEGF release from tumor cells relevant for endothelial cell migration and vasculature protection, thereby enhancing radiotherapy treatment outcome of NSCLC.
Physical Fitness as a Prognostic Marker for Infectious Events in Kidney Transplant Recipients
Authors: Ortolan Sara , Neunhaeuserer Daniel , Battista Francesca , Patti Alessandro , Gobbo Stefano , Di Bella Caterina , Quinto Giulia , Vecchiato Marco , Frigo Anna Chiara , Bergamin Marco , Furian Lucrezia , Ermolao Andrea
Published: December 2021

Introduction: Infectious events are one of the leading causes of death in kidney transplant recipients (KTRs). KTRs have reduced cardiorespiratory fitness (CRF), a predictor for infections in other populations. The aim of this study was to investigate whether CRF and muscle strength are prognostic markers for infectious events in KTRs. Methods: In this retrospective cohort study, 155 KTRs underwent an incremental, maximal cardiopulmonary exercise test (CPET) 3 months after transplantation. CRF was analyzed with peak oxygen consumption (VO2 peak) while muscle strength with isometric handgrip (HG) test. Laboratory blood samples and drug therapy were collected. The median follow-up period was 54 (interquartile range 38–62) months. Cox regression analyses were performed to evaluate predictors of infectious events adjusting for potential confounders. Results: During this study, severe infectious events occurred in 41 subjects (26.5%). 15.5% (n = 24) of patients had a severely reduced CRF, defined as a VO2 peak below the 5th percentile of the reference values reported for a matched healthy population. The hazard ratio for infectious events in this subgroup was 2.389 (95% CI = 1.188–4.801, p = 0.014), independently of gender, age, BMI, time on dialysis, hemoglobin concentration, eGFR, diabetes, and immunosuppressive regimen. On the contrary, no significant association of HG strength and infections was found. Conclusion: Therefore, low CRF may be considered as a modifiable predictor of severe infectious events in KTRs. A CPET should thus be recommended for cardiovascular screening, evaluation of CRF, and tailored exercise prescription to reduce the risk of infections and potentially improve long-term outcomes of transplantation.
Membranous Nephropathy with Lambda Light Chain Restriction: A Rare Form with Serum Negative and Tissue Positive PLA2R Ab
Authors: Isiktas Sayilar Emel , Kiremitci Saba , Ergun Ihsan , Ensari Arzu
Published: December 2021

Membranous nephropathy (MN) is the most common cause of nephrotic syndrome in adults. Subepithelial polyclonal immunoglobulin deposits and >70% M-type phospholipase A2 receptor antibody positivity are typical findings in idiopathic MN. A 58-year-old female patient was admitted with clinical presentation of nephrotic syndrome. Autoimmune diseases, infections, and malignancies were ruled out after clinical and laboratory evaluations. Diagnostic work-up revealed serum PLA2R antibody negativity and diffuse thickening of glomerular capillary wall on biopsy, while glomerular capillary wall IgG, C3, and Lambda monotypic light chain deposition and PLA2R1 positivity were detected by immunofluorescence and immunohistochemical examination, respectively. Following prednisolone treatment, creatinine and proteinuria were markedly regressed. The MN cases with a light chain deposits are rare and experience regarding their treatment are insufficient.
Prevalence of Thinness, Overweight, Obesity, and Central Obesity in Finnish School-Aged Children: A Comparison of National and International Reference Values
Authors: Sarkkola Catharina , Viljakainen Jannina , de Oliveira Figueiredo Rejane Augusta , Saari Antti , Lommi Sohvi , Engberg Elina , Viljakainen Heli
Published: December 2021

Introduction: The global epidemic of obesity concerns children, and monitoring the prevalence is of highest priority. Body mass index (BMI) with age- and sex-specific cutoff values determines weight status in children, although multiple reference systems exist. Our aim was to compare the prevalence for thinness, normal weight, overweight, and obesity in Finnish school-aged children according to national and international reference values, as well as to determine which cutoff values for overweight agree with the criteria for central obesity. Methods: This study includes 10,646 children aged 9–12 years from the Finnish Health in Teens cohort. Height, weight, and waist circumference were measured in 2011–2014. BMI (weight [kg]/height [m]2) and the waist-to-height ratio (WHtR; waist [cm]/height [cm]) were calculated. The WHtR cutoff of >0.5 indicated central obesity. We compared the sex-specific prevalence of thinness, overweight, and obesity using the International Obesity Task Force (IOTF), World Health Organization (WHO) and Finnish (FIN) BMI-for-age reference values, as well as these three against central obesity based on the WHtR. Results: The prevalence of thinness, overweight, and obesity were 11.0%, 12.7%, and 2.6%, respectively, using IOTF; 2.6%, 15.9%, and 5.2% using WHO; and 5.1%, 11.4%, and 2.2% using FIN. Overweight and obesity were more common in boys than girls using WHO and FIN, while thinness was more common in girls using IOTF and FIN. IOTF versus WHO exhibited moderate agreement (κ = 0.59), which improved for IOTF versus FIN (κ = 0.74). Of those classified as overweight by WHO, 37% and 47% were regarded as normal weight according to IOTF and FIN, respectively. The prevalence of central obesity was 8.7%, and it was more common in boys than girls. WHO provided the highest sensitivity: 95% of individuals with central obesity were classified with overweight or obesity. Using FIN provided the highest specificity (93%). Conclusion: Our findings show that WHO overestimates the prevalence of overweight and obesity, while IOTF overrates thinness. Thus, comparing prevalence rates between studies requires caution. The novelty of this study is the comparison of the cutoff values for overweight with central obesity. The choice of reference system affects the generalizability of the research results.
Is Late Prevention of Cerebral Palsy in Extremely Preterm Infants Plausible?
Authors: Lear Benjamin A. , Lear Christopher A. , Dhillon Simerdeep K. , Davidson Joanne O. , Bennet Laura , Gunn Alistair J.
Published: December 2021

Preterm birth continues to be associated with neurodevelopmental problems including cerebral palsy. Cystic white matter injury (WMI) is still the major neuropathology underlying cerebral palsy, affecting 1–3% of preterm infants. Although rates have gradually fallen over time, the pathogenesis and evolution of cystic WMI are still poorly understood. Hypoxia-ischemia (HI) remains an important contributor, yet there is no established treatment to prevent injury. Clinically, serial ultrasound and magnetic resonance imaging studies typically show delayed development of cystic lesions 2–4 weeks after birth. This raises the important and unresolved question as to whether this represents slow evolution of injury occurring around the time of birth or repeated injury over many weeks after birth. There is increasing evidence that tertiary injury after HI can contribute to impairment of white and grey matter maturation. In the present review, we discuss preclinical evidence that severe, cystic WMI can evolve for many weeks after acute HI and is associated with microglia activity. This suggests the intriguing hypothesis that the tertiary phase of injury is not as subtle as often thought and that there may be a window of therapeutic opportunity for 1 to 2 weeks after hypoxic-ischemic injury to prevent delayed cystic lesions, and so, further reduce the risk of cerebral palsy after preterm birth.
Examination of postgraduate thesis studies on teachers working in the field of special education in Turkey (2000-2020)
Authors: Nuri Cahit , Özer Selçuk , Parlayan Merve
Published: December 2021

The aim of this research was to examine graduate thesis studies conducted in the field of special education in Turkey about special education teachers in terms of various variables. In the thesis scanning center of the Council of Higher Education Center (YOK), it was determined that 89 graduate thesis studies in the special education field were conducted. Yet, due to the reason that six of them did not have access permissions, 83 graduate thesis studies were examined. Of the postgraduate thesis examined, 79 of them are master's and four are doctoral dissertations. As a result of the research, it was determined that most of the graduate thesis studies were conducted in 2019. Moreover, when the distribution of universities is examined it has been observed that most of the graduate thesis were studied at Necmettin Erbakan University and Marmara University, and most of the thesis advisor titles are Assist. Prof. Dr. It was concluded that most of the postgraduate thesis were carried out in the Special Education Department and when the methods used in the studies were examined, it was noted that the quantitative method was preferred the most. Considering the research models used in the studies, it was concluded that the correlational survey model was used the most and the sources used in the graduate thesis were mainly domestic sources.
The degree of career polarization among educational leaders in the Jordanian Education Directorates
Authors: Hamadat Mohammad Hasan , Al-Momani Mohammad Omar
Published: December 2021

The study aimed to identify the degree of career polarization among educational leaders in the Jordanian–education directorates of Ajloun and Jersah. The researchers adopted the descriptive -analytical approach for its suitability for such studies. The researchers used the questionnaire as the study instrument, which comprised 20 items. The researchers distributed the items in two domains, 10 items were for each domain as the study instrument. The sample of the study comprised 250 educational leaders for the first semester of the academic year 2019-2020. The study results showed that the degree of career polarization among educational leaders in the Jordanian Ministry of Education came with an average degree of rating in all its domains and for all items. The results also showed that there were no statistically significant differences at the level of statistical significance (α=0.05) attributed to the two study variables. Gender and the number of years of experience are the two study variables.
Academic-industry partnership framework of Mariano Marcos State University
Authors: Salvador Robert A. , Barbacena Cherrypn B. , Esponilla II Francisco D.
Published: December 2021

Higher education is a window for people to gain knowledge and skills. People who step out in higher academic learning are expected to be equipped with competencies needed in the different job sites. Therefore, the responsibility of every institution to seek alternatives to further enhance academic opportunities. The main objective of this study was to develop an academic-industry partnership (AIP) framework for the Mariano Marcos State University (MMSU). A qualitative research design was utilized in exploring the partnership engagement of the different colleges of the university. Interviews inquiring about participants' lived experiences were purposively selected for a grounded-theory analysis following the thematic coding process. The coding was further subjected to a triangulation for purposes of validating the data from various sources. The study revealed that the AIP is focused on the areas of instruction, research and production, and research and extension. This leads to the creation of the AIP framework which can contribute to the development of AIP policy of the MMSU and other higher education institutions.
High school mathematics teachers’ competence on the contents of a quantitative research paper
Authors: Dullas Lany D. , Soliven Samuel R.
Published: December 2021

Competence in research is an attractive feature that should be established for all practitioners because specialists with training and expertise in research will recognize strategic thinking, interpretation, and synthesizing more easily. Hence, this study aimed to describe the knowledge competency among junior high school mathematics teachers on the research processes applied on the contents of the various sections of a quantitative research paper. The descriptive method of research has been used to characterize the knowledge competence of 108 junior high school teachers on the research processes. The study used the research skill test, which was a researcher-made instrument, consisting of 50 multiple choice items with four choices each. The instrument went through the process of validity and reliability analysis obtaining a good result of 0.81. This study revealed that they were “novice” or had achieved the learning level of competency on the research processes applied on the contents of the different parts of a quantitative research paper. More so, they identified that interpretation of statistical results was a challenging part of doing a research paper.
Reflexão crítica, prática da interdisciplinaridade, pesquisa em acervos
Authors: Gouveia Inês , Galvão Luciana , Garcia Walter
Published: December 2021

Editorial - Revista do IEB 80
L’Union Européenne et l’organisation des professions de santé en France
Authors: Brissy Stéphane
Published: December 2021

Le droit de l’Union Européenne est fondé sur la  garantie de la liberté de circulation des personnes, des marchandises, des capitaux et des services. D’autres impératifs sont venus s’ajouter à la garantie de ces libertés, dont la garantie d’un niveau élevé de protection de la santé humaine. Pour concilier ces  objectifs, il est notamment nécessaire de s’assurer  que les professionnels de santé souhaitant délivrer  des prestations dans l’Union Européenne disposent de qualifications suffisantes. Chaque Etat membre de  l’Union reste en principe maître de l’organisation  générale de son système de santé. Mais le droit de l’Union Européenne peut parfois inciter voire obliger  les Etats à modifier certaines limites de compétence  entre professionnels.
Baseline factors associated with death in a COVID-19 hospital cohort, Sao Paulo, 2020
Authors: Konstantyner Thais Claudia Roma de Oliveira , Martins Camila Bertini , Luppi Carla Gianna , Yashiro Suely Miyuki , Sanches Nívia Aparecida Pissaia , Cohrs Frederico Molina , Ferreira Paulo Abrão , Medeiros Eduardo Alexandrino
Published: December 2021

This study aimed to verify socio-demographic and baseline clinical factors associated with death in a hospital cohort of patients with COVID-19. A retrospective cohort study was conducted between February and December 2020 in a university hospital in the city of São Paulo, using Hospital Epidemiology Center data. RT-PCR-positive patients were selected to compose the sample (n = 1,034). At the end of the study, 362 (32%) patients died. In this cohort, age equal to or greater than sixty years (HR = 1.49) and liver disease (HR = 1.81) were independent risk factors for death from COVID-19 associated with higher in-hospital mortality.
Machine Learning-Based Prediction of Myocardial Recovery in Patients With Left Ventricular Assist Device Support
Authors: Topkara Veli K. , Elias Pierre , Jain Rashmi , Sayer Gabriel , Burkhoff Daniel , Uriel Nir
Published: December 2021

Background:

Prospective studies demonstrate that aggressive pharmacological therapy combined with pump speed optimization may result in myocardial recovery in larger numbers of patients supported with left ventricular assist device (LVAD). This study sought to determine whether the use of machine learning (ML) based models predict LVAD patients with myocardial recovery resulting in pump explant.

Methods:

A total of 20 270 adult patients with a durable continuous-flow LVAD in the INTERMACS registry (Interagency Registry for Mechanically Assisted Circulatory Support) were included in the study. Ninety-eight raw clinical variables were screened using the least absolute shrinkage and selection operator for selection of features associated with LVAD-induced myocardial recovery. ML models were developed in the training data set (70%) and were assessed in the validation data set (30%) by receiver operating curve and Kaplan-Meier analysis.

Results:

Least absolute shrinkage and selection operator identified 28 unique clinical features associated with LVAD-induced myocardial recovery, including age, cause of heart failure, psychosocial risk factors, laboratory values, cardiac rate and rhythm, and echocardiographic indices. ML models achieved area under the receiver operating curve of 0.813 to 0.824 in the validation data set outperforming logistic regression-based new INTERMACS recovery risk score (area under the receiver operating curve of 0.796) and previously established LVAD recovery risk scores (INTERMACS Cardiac Recovery Score and INTERMACS Recovery Score by Topkara et al) with area under the receiver operating curve of 0.744 and 0.748 (
P
<0.05). Patients who were predicted to recover by ML models demonstrated a significantly higher incidence of myocardial recovery resulting in LVAD explant in the validation cohort compared with those who were not predicted to recover (18.8% versus 2.6% at 4 years of pump support).

Conclusions:

ML can be a valuable tool to identify subsets of LVAD patients who may be more likely to respond to myocardial recovery protocols.
Severity of Functional Mitral Regurgitation on Admission for Acute Decompensated Heart Failure Predicts Long‐Term Risk of Rehospitalization and Death
Authors: Kataria Rachna , Castagna Francesco , Madan Shivank , Kim Paul , Saeed Omar , Adjepong Yaw A. , Melainis Angelos A. , Taub Cynthia , Garcia Mario J. , Latib Azeem , Jorde Ulrich P.
Published: December 2021

Background

Functional mitral regurgitation (FMR) has emerged as a therapeutic target in patients with chronic heart failure and left ventricular systolic dysfunction. The significance of FMR in acute decompensated heart failure remains obscure. We systematically investigated the prevalence and clinical significance of FMR on admission in patients admitted with acute decompensated heart failure and left ventricular systolic dysfunction.

Methods and Results

The study was a single‐center, retrospective review of patients admitted with acute decompensated heart failure and left ventricular systolic dysfunction between 2012 and 2017. Patients were divided into 3 groups of FMR: none/mild, moderate, and moderate‐to‐severe/severe FMR. The primary outcome was 1‐year post‐discharge all‐cause mortality. We also compared these groups for 6‐month heart failure hospitalization rates. Of 2303 patients, 39% (896) were women. Median left ventricular ejection fraction was 25%. Four hundred and fifty‐three (20%) patients had moderate‐to‐severe/severe FMR, which was independently associated with 1‐year all‐cause mortality. Moderate or worse FMR was found in 1210 (53%) patients and was independently associated with 6‐month heart failure hospitalization. Female sex was independently associated with higher severity of FMR.

Conclusions

More than half of patients hospitalized with acute decompensated heart failure and left ventricular systolic dysfunction had at least moderate FMR, which was associated with increased readmission rates and mortality. Intensified post‐discharge follow‐up should be undertaken to eliminate FMR amenable to pharmacological therapy and enable timely and appropriate intervention for persistent FMR. Further studies are needed to examine sex‐related disparities in FMR.
Abstract 1122‐000031: Reasons Thrombectomy Candidates Become Ineligible After Transfer for Treatment in a Hub‐And‐Spoke Telestroke Model
Authors: Regenhardt Robert W , Awad Amine , Kraft Andrew W , Rosenthal Joseph A , Dmytriw Adam A , Vranic Justin E , Bonkhoff Anna K , Bretzner Martin , Hirsch Joshua A , Rabinov James D , Stapleton Christopher J , Etherton Mark R , Singhal Aneesh B , Rost Natalia S , Leslie‐Mazwi Thabele M , Patel Aman B
Published: December 2021

Introduction
: The care of emergent large vessel occlusion (ELVO) stroke patients has been revolutionized by endovascular thrombectomy (EVT). Given its robust efficacy, it is crucial to optimize delivery to eligible patients. Within hub‐and‐spoke hospital system models, some patients first present to distant spoke hospitals and require transfer to hub hospitals for EVT. We sought to understand reasons EVT candidates become ineligible after transfer for treatment.

Methods
: Consecutive EVT candidates presenting to 25 spokes from 2018 to 2020 with pre‐transfer CTA‐defined ELVO and Alberta Stroke Program Early CT Score ≥6 were identified from a prospectively maintained database. Outcomes of interest included hub EVT, reasons for EVT ineligibility, and 90‐day functional independence (modified Rankin Scale, mRS ≤2).

Results
: 258 patients were identified with median age 70 years (IQR 60–81) and 50% female. 44% underwent EVT upon hub arrival, of which 87% achieved Thrombolysis in Cerebral Infarction 2b‐3 reperfusion. Compared to EVT‐eligible patients, ineligible patients were older (73 vs 68 years, p = 0.04), had lower NIH Stroke Scale (NIHSS, 10 vs 16, p<0.0001), longer LKW‐hub arrival time (8.4 vs 4.6 hours, p<0.0001), and received less IV alteplase (32% vs 45%, p = 0.04). The clinical reasons cited for becoming EVT ineligible upon hub arrival included large established infarct (49%), mild symptoms (33%), recanalization (6%), distal occlusion location (5%), subocclusive lesion (3%), and goals of care (3%). Becoming EVT ineligible independently reduced the odds of 90‐day functional independence (aOR = 0.26, 95%CI = 0.12,0.56; p = 0.001), even when controlling for age, NIHSS, and LKW‐hub arrival time.

Conclusions
: Approaches to increase EVT eligibility among ELVO transfers may improve long term outcomes. A primary reason for becoming EVT ineligible is infarct growth. Future studies should explore triaging patients directly to EVT‐capable hubs when feasible, improving inter‐hospital transfer times, supporting ischemic penumbra before EVT, and developing novel neuroprotective agents.
Abstract 1122‐000032: Spinal Cord Infarction a Young Patient with a Hypoplastic Vertebral Artery
Authors: Jum'ah Ammar , Nour Hassan Aboul , Miller Daniel
Published: December 2021

Introduction
: Rare presentation of disease processes is absolutely intriguing to the human mind. Spinal cord infarction is abundantly reported to be secondary to cardiological procedures, patients carrying multiple vascular risk factors and vertebral artery dissections. But for it to happen in a patient who is young, relatively healthy and without vascular risk factors is quite interesting. Herein, we present the case of a patient presented with bilateral upper extremity weakness, who has a hypoplastic right vertebral artery that has coincided with him being a professional gamer with exerting compression from video‐gaming posturing of “forward leaning with neck hyperextension”, resulting in cervical spinal cord infarction.

Methods
: Case report

Results
: Vertebral artery dissection was excluded by CTA and MRA. our hypothesis was that the patient is a professional gamer and his posture of leaning forward and neck hyper‐extension had a role in inducing his spinal cord infarction given the fact of him having a hypoplastic right vertebral artery.

Conclusions
: Vertebral artery disease is a well‐recognized cause of ischemia in the posterior cerebral circulation. Recently, however, cervical cord infarction, albeit being extremely rare, has been increasingly reported as a complication of vertebral artery diseases such as dissection. Awareness must be raised that such condition can also happen in the young population due to compression of the vertebral arteries, especially when one is hypoplastic.
Abstract 1122‐000033: Automated Detection of Intracerebral Hemorrhage Using Artificial Intelligence: Pilot Deployment of Viz ICH
Authors: Kalagara Roshini , Chennareddy Susmita , Matsoukas Stavros , Reford Emma , Smith Colton , Fifi Johanna T , Kellner Christopher P
Published: December 2021

Introduction
: Stroke is a major cause of morbidity and mortality. Hemorrhagic strokes are often more severe and associated with higher mortality when compared to ischemic stroke and account for approximately 13% of all strokes. Initial care for patients with intracerebral hemorrhage (ICH) is in part guided by neuroimaging findings. Non‐contrast computed tomography (NCCT) is often the first imaging obtained in the work up of the acute stroke patient given its diagnostic accuracy for hemorrhage, ubiquity, low cost, and short scan time. Immediate evaluation of imaging by stroke experts, such as neurologists, neurosurgeons, and radiologists, is essential. Artificial intelligence tools can help to expedite image assessment and careteam coordination thereby accelerating time to treatment. In this study, we report on the use of Viz ICH, an AI‐enhanced ICH detection platform, to identify ICH on initial CT and coordinate emergent care in an urban health system with an ICH Center.

Methods
: All consecutive stroke codes presenting with ICH from May 2019 to August 2019 were eligible for analysis. Non‐contrast CT (NCCT) was conducted for each patient and submitted to the Viz ICH in a prospective fashion. An automated volumetric analysis of these NCCTs was conducted by Viz ICH and assessment was conducted for potential ICH. If suspected ICH was detected, Viz ICH sent an automated prompt to the stroke care team for review. CT impressions provided by radiologists served as the clinical reference standard test and Viz ICH output served as the index test. Diagnostic accuracy tests were then performed.

Results
: A total of 682 patients were analyzed for ICH, out of which 28 patients were positive for intracerebral hemorrhage (ICH) (4%) and 654 were negative for hemorrhage (96%) based on radiology impressions. Viz ICH was able to correctly identify hemorrhages in 25/28 patients and non‐hemorrhages in 650/654 patients. Overall, the software had high diagnostic accuracy with 89.3% sensitivity, 99.4% specificity, and an overall accuracy of 99.0%. The software also had a positive predictive value of 86.2%, a negative predictive value of 99.5%, a positive likelihood ratio of 145.98, and a negative likelihood ratio of 0.108.

Conclusions
: Viz ICH is an AI‐enhanced platform that may help in the diagnosis and detection of ICH, with a sensitivity of 89.3 and a specificity of 99.4% in this preliminary study. Though future validation studies with a larger cohort of patients positive for each type of hemorrhage must be conducted for true diagnostic accuracy data, Viz ICH has the potential to be an adjunct tool to streamline ICH triage, reduce treatment delays, and improve outcomes of patients presenting with ICH.
Abstract 1122‐000084: Does Intravenous Thrombolysis Promote Delayed Reperfusion After Incomplete Mechanical Thrombectomy?
Authors: Mujanovic Adnan , Kammer Christoph , Kurmann Christoph C , Grunder Lorenz , Beyeler Morin , Lang Matthias F , Piechowiak Eike I , Meinel Thomas R , Jung Simon , Hoffmann Angelika , Seiffge David J , Heldner Mirjam R , Dobrocky Tomas , Mordasini Pasquale , Arnold Marcel , Gralla Jan , Fischer Urs , Kaesmacher Johannes
Published: December 2021

Introduction
: The value of intravenous thrombolysis (IVT) in patients eligible for mechanical thrombectomy (MT) remains unclear. We hypothesized that pre‐treatment with and/or ongoing IVT may facilitate reperfusion of distal vessel occlusion after incomplete MT. We evaluated this potential association using follow‐up perfusion imaging.

Methods
: Retrospective observational analysis of our institution`s stroke registry included patients with incomplete reperfusion after MT, admitted between February 1, 2015 and December 8, 2020. Delayed reperfusion (DR) was defined as the absence of a persistent perfusion deficit on contrast‐enhanced perfusion imaging ⁓24h±12h after the intervention. The association between baseline parameters and the occurrence of DR was evaluated using a logistic regression analyses. To account for possible time‐dependent associations of IVT with DR, additional stratification sets were made based on different time windows between IVT start time and final angiography runs.

Results
: Among the 378 included patients (median age 73.5, 50.8% female), DR occurred in 226 (59.8%). Atrial fibrillation (aOR 2.53 [95% CI 1.34 ‐ 4.90]), eTICI score (aOR 3.79 [95% CI 2.71 ‐ 5.48] per TICI grade increase), and intervention‐to‐follow‐up time (aOR 1.08 [95% CI 1.04 ‐ 1.13] per hour delay) were associated with DR. Dichotomized IVT strata showed no association with DR (aOR 0.75 [95% CI 0.42 ‐ 1.33]), whereas shorter intervals between IVT start and end of the procedure showed a borderline significant association with DR (OR 2.24 [95% CI 0.98 ‐ 5.43, and OR 2.07 [95% 1.06 – 4.31], for 80 and 100 minutes respectively). Patients with DR had higher rates of functional independence (modified Rankin scale 0–2 at 90 days, DR: 63.3% vs PPD: 38.8%; p<0.01) and longer survival time (at 3 years, DR: 69.2% vs PPD: 45.8%; p = 0.001).

Conclusions
: There is weak evidence that IVT may favor DR after incomplete MT if the time interval between IVT administration and end of the procedure is short. In general, perfusion follow‐up imaging may constitute a suitable surrogate parameter for evaluating medical rescue strategies after incomplete MT, because a considerable proportion of patients do not experience DR, and there seems to be a close correlation with clinical outcomes.
Abstract 1122‐000091: Predictors of Symptomatic Hemorrhagic Transformation After Mechanical Thrombectomy in Acute Ischemic Stroke
Authors: Luo Anqi , Cardenas Agnelio , Birnbaum Lee A
Published: December 2021

Introduction
: Mechanical thrombectomy (MT) has become the current standard of care for large vessel occlusion stroke but is associated with an increased risk of intracranial hemorrhage (ICH). Although several studies have investigated the risk factors, there is still limited, not well‐established data. This study aims to evaluate the risk factors of HT after MT.

Methods
: We retrospectively reviewed all MT patients who were treated at a single comprehensive stroke center from 12/2016 to 7/2019. Variables included initial NIHSS, blood glucose, initial systolic blood pressure, age, gender, IV tPA, time from door to recanalization, and TICI score. Outcome measures were HT on post‐procedure or 24‐hour post‐tPA head CT/MRI as well as modified Rankin scale (mRS) upon discharge.

Results
: Among 74 patients (68.8 ± 14 years, men 47.3%), 9 (12.2%) experienced hemorrhagic transformation after thrombectomy. Average admitting NIHSS was significantly higher in the HT group (22 vs 16.8, p = 0.041). TICI 3 after MT was protective for HT (OR 0.078, 95% CI 0.009‐0.663). IV tPA (OR 3.86, 95% CI 1.448‐10.326) was associated with good neurological outcome at discharge (mRS < = 2), but HT was not (OR 0.114, 95% CI 0.013‐0.964). Patients with mRS < = 2 upon discharge were younger (65.2±12 vs 71.9±15, p = 0.04) and had lower initial BG (124±45.8 vs 157±69.6, P = 0.02).

Conclusions
: TICI 3 score, decreased NIHSS, and lower BG were associated with less HT and better outcomes in our MT cohort. Admitting NIHSS > = 20 may be a reasonable threshold to predict HT after MT. Our findings are consistent with the TICI‐ASPECTS‐glucose (TAG) score to predict sICH; however, we used initial NIHSS as a surrogate for ASPECTS. Further studies may utilize additional quantitative measures such as CTP data to predict HT.
Abstract 1122‐000150: Novel Ischemic Stroke Treatment Protocol for Salvageable Penumbra in Acute Small Vessel Disease
Authors: Fourcand Farah Y , Patel Hemal , Scarpiello Sean , Nagy Muhammad , Mehta Siddhart , Zacharatos Haralabos , Kirmani Jawad F
Published: December 2021

Introduction
: In small vessel disease (SVD)‐related acute ischemic stroke (AIS), no specific acute treatment exists. We propose an acute treatment protocol for patients with fluctuating exam secondary to salvageable micropenumbra in high risk SVD‐related AIS.

Methods
: Inclusion criteria included acute SVD‐related stroke with NIHSS fluctuation ≥ 2 previously described as a sensitive indicator of neurological deterioration in SVD ischemic stroke. Patients with large vessel atheroma secondarily causing stroke were excluded. Treatment protocol consisted of albumin IV, eptifibatide IV, magnesium sulfate IV, cilostazol PO, normoglycemia, normothermia, aggressive fluid resuscitation, and targeted blood pressure parameters in a neurocritical care setting. Protocol was prospectively initiated in August 2020 at onset of exam fluctuation and continued until plateau NIHSS was reached. Retrospective data for subjects from January 2017 to July 2020 was collected for historical controls. Primary outcomes measures included safety and early efficacy end points. Efficacy was measured by change from maximum NIHSS to plateau NIHSS (NIHSS‐diff). Wilcoxon rank‐sum test was used to evaluate significant difference of NIHSS‐diff in both groups. Social Science Statistics was used for data analysis.

Results
: From January 2017 ‐ May 2021, out of 7,146 AIS patients, 30 met selection criteria. From August 2020 to May 2021, consecutive subjects received treatment protocol (n = 15, baseline NIHSS 4.93, 95% CI [3.3572, 6.5028]). They were compared with historical controls (n = 15, baseline NIHSS 5.87, 95% CI [2.9407, 8.7993]). There was no significant difference in baseline characteristics (p = 1; U = 112 at p<0.05; z‐score 0). In the SVD group, no subjects had adverse events leading to early termination. Early efficacy as suggested by NIHSS‐diff between groups was statistically significant (p = 0.00228; U = 38.5; z‐score 3.04864; 80% power at p<0.05).

Conclusions
: To our knowledge, this is the first systematic demonstration of safety and early efficacy of multimodal intervention for acute SVD‐related ischemic stroke. Larger randomized trials using concurrent controls are required to corroborate our findings.