bluuebunny/crossref_metadata_2025_split huggingface dataset:
lncRNA JPX Promotes Tumor Progression by Interacting with and Destabilizing YTHDF2 in Cutaneous Melanoma
Authors: Luo Dan , Tang Hui , Tan Liuchang , Zhang Long , Wang Lei , Cheng Qionghui , Lei Xia , Wu Jinjin 
Published: March 2024

Abstract

Aberrant long noncoding RNAs just proximal to Xist (lncRNA JPX) expression levels have been detected in multiple tumors. However, whether JPX is involved in melanoma progression remains unclear. Our study showed that JPX expression is significantly increased in melanoma tissues and cell lines. To clarify the effect of JPX on cutaneous melanoma, we successfully generated JPX-overexpressing or JPX-knockdown A375 and A2058 cells. CCK-8, colony formation EdU, Transwell, and cell-cycle phase assays were performed, and subcutaneously implanted tumor models were used to determine the function of JPX in cutaneous melanoma. The results showed that JPX knockdown reduced the proliferation and migration of malignant melanoma cells both in vitro and in vivo. To further elucidate the molecular mechanism of JPX-induced cutaneous melanoma deterioration, we performed RNA pull-down, RNA immunoprecipitation, coimmunoprecipitation, Western blot, and RNA-sequence analyses. JPX can directly interact with YTHDF2 and impede the protection of YTHDF2 from ubiquitin-specific protease 10 (USP10), which promotes its deubiquitination. Thus, JPX decreases protein stability and promotes the degradation of YTHDF2, thereby stabilizing BMP2 mRNA and activating AKT phosphorylation. Overall, our study revealed a novel effect of JPX on YTHDF2 ubiquitination, suggesting the possibility of blocking the JPX/USP10/YTHDF2/BMP2 axis as a prospective therapeutic approach for cutaneous melanoma.

Implications:
This study highlights the ubiquitination effect of USP10 and JPX on YTHDF2 in cutaneous melanoma, and proposes that the JPX/USP10/YTHDF2/BMP2 axis may be a prospective therapeutic target for cutaneous melanoma.
Abstract 001: Microvascular reperfusion during endovascular therapy: the balance of supply and demand
Authors: Favilla Christopher G. , Forti Rodrigo M. , Baker Wesley B. , Carter Sarah , Kasner Scott E. , Yodh Arjun G. , Cummings Stephanie , Kung David , Burkhardt Jan‐Karl , Pukenas Bryan A. , Srinivasan Visish M. , Detre John A. 
Published: March 2024

Introduction
Endovascular therapy (EVT) has revolutionized acute stroke treatment, but large vessel recanalization does not always result in tissue‐level reperfusion. Cerebral blood flow (CBF) is not routinely monitored during EVT. Here we aimed to leverage diffuse correlation spectroscopy (DCS), a novel transcranial optical imaging technique, to assess the relationship between microvascular CBF and post‐EVT outcomes.

Methods
Frontal lobe CBF was monitored by DCS in 40 patients undergoing EVT. Baseline CBF deficit was calculated as the percentage of CBF impairment on pre‐EVT CT perfusion. Microvascular reperfusion was calculated as the percentage increase in DCS‐derived CBF that occurred with recanalization. The adequacy of reperfusion was defined by persistent CBF deficit, calculated as: baseline CBF deficit ‐ microvascular reperfusion. Good functional outcome was defined as 90‐day modified Rankin Scale ≤2.

Results
36 (of 40) patients achieved successful recanalization, in whom microvascular reperfusion in itself was not associated with infarct volume or functional outcome. However, patients with good functional outcomes had a smaller persistent CBF deficit (median: 1%; IQR: ‐11%–16%) than patients with poor outcomes (median: 28%; IQR: 2%–50%), p=0.02. Smaller persistent CBF deficit was also associated with smaller infarct volume (p=0.004). Multivariate models confirmed that persistent CBF deficit was independently associated with infarct volume and functional outcome.

Conclusion
CBF augmentation alone does not predict post‐EVT outcomes, but when microvascular reperfusion closely matches the baseline CBF deficit, patients experience favorable clinical and radiographic outcomes. By recognizing inadequate reperfusion, bedside CBF monitoring may provide opportunities to personalize post‐EVT care aimed at CBF optimization.
Abstract 007: Device‐related Technical Complications with Flow Diversion of Intracranial Aneurysms: A Systematic Review and Meta‐analysis
Authors: Ortega‐Gutierrez Santiago , Rodriguez‐Calienes Aaron , Vivanco‐Suarez Juan , Dibas Mahmoud , Hanel Ricardo A. , Cekirge Saruhan , Lamih Saleh , Rice Hal , Saatci Isil , Fiorella David , Lylyk Pedro , Lylyk Ivan , Pereira Vitor Mendes , Gounis Matt , Fiehler Jens 
Published: March 2024

Introduction
Flow diverters (FD) have become a revolutionary approach in the endovascular treatment of intracranial aneurysms (IAs), supplanting traditional methods (1). Despite their demonstrated efficacy and safety, unforeseeable device‐related technical complications, such as fish‐mouthing, device braid narrowing, deformation, ovalization, and collapsing have been reported during implantation and follow‐up (2,3,4). However, the definitions and reporting of these complications remain inconsistent. We conducted a systematic review and meta‐analysis to assess overall device‐related technical complication rates associated with flow diversion and provide an overview of the current reported definitions.

Methods
We searched six databases up to April 4th, 2023, and included studies that reported device‐related technical complications related to FD treatment for IAs. We considered five main outcome measures as device‐related technical complications: (1) fish‐mouthing, (2) device braid collapsing, (3) device braid narrowing, (4) device braid deformation, and (5) device braid ovalization. The data from these studies were pooled using a random‐effects model.

Results
We included 48 studies involving 3,572 patients and 3,939 aneurysms. Among them, 14 studies (39%) provided definitions for fish‐mouthing. However, none of the included studies offered specific definitions for device braid collapsing, narrowing, or deformation, despite reporting rates for these complications in five, six, and three studies, respectively. The pooled rates for device‐related technical complications were as follows: 3% (95% CI 2 – 4%; I2 = 27%) for fish‐mouthing, 1% (95% CI 0 – 3%; I2 = 0%) for collapsing, 7% (95% CI 2 – 20%; I2 = 85%) for narrowing, and 1% (95% CI 1 – 4%; I2 = 0%) for deformation. Device braid ovalization data were not available.

Conclusion
The findings of this study suggest that FD treatment for IAs generally exhibits low rates of fish‐mouthing, device braid narrowing, collapsing, and deformation. However, the lack of standardized definitions hinders the ability to objectively compare device outcomes, emphasizing the need for uniform device‐related complication definitions in future prospective studies on FD.
Abstract 009: 1‐Year Outcomes of Resolute Onyx Zotarolimus‐Eluting Stent for Intracranial Atherosclerotic Disease: Multicenter Comparison with SAMMPRIS
Authors: Saisree  , Farhan  , S Ravi , Khalid Syed , Khan Inamullah , Tekle Wondwossen G , Tanweer Omar , Burkhardt Jan‐Karl , Jabbour Pascal M , Tjoumakaris Stavropoula , Herial Nabeel A , Siddiqui Adnan H , Grandhi Ramesh , Qureshi Adnan I , Hassan Ameer E 
Published: March 2024

Introduction
Intracranial atherosclerotic disease (ICAD) is one of the most prevalent causes of stroke across the world, with a high morbidity and mortality rate. Endovascular treatment (ET) has gained prominence but remains a challenge with unfavorable results. Recent literature has demonstrated that the Resolute Onyx Zotarolimus‐Eluting stent (RO‐ZES) is a technically safe option with low complication rates. Preliminary data has also reported the 30‐day outcomes associated with intracranial stent placement for ICAD with RO‐ZES compared to results from the Stenting Versus Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis (SAMMPRIS) trial. Here, we aim to compare outcomes at 1 year with the SAMMPRIS trial to further evaluate the efficacy and outcomes of RO‐ZES in a multicenter study with long‐term follow up extending beyond 30 days.

Methods
Prospectively maintained databases across 7 stroke centers were reviewed to identify adult patients undergoing RO‐ZES placement for treatment of ICAD between January 2019 to May 2023. The primary endpoint was composite of 1‐year stroke, ICH, and/or death. This data was propensity score matched using age, sex, hypertension, diabetes mellitus, smoking status, and impacted vessel for comparison between RO‐ZES and the SAMMPRIS percutaneous angioplasty and stenting groups (S‐PTAS).

Results
A total of 104 patients met the inclusion criteria for analysis (mean age 62.6, 31.7% female). Impacted vessels included basilar artery (6.7%), internal carotid artery (26.9%), middle cerebral artery (29.8%), posterior cerebral artery (1.0%), and vertebral artery (35.6%). Propensity score match analysis of the 104 patients with S‐PTAS demonstrated 1‐year stroke, ICH, and/or death rate of 11.5% in the RO‐ZES group and 35.6% in the S‐PTAS group (OR 4.17, 95% CI 2.06‐8.96, p=0.001).

Conclusion
The RO‐ZES system provides a not only safe and effective alternative to other traditional stents, but also demonstrates strong potential to reduce long‐term complications at 1 year compared with the S‐PTAS group. Further prospective multicenter studies are needed to corroborate the findings and compare RO‐ZES directly with other stents.
Abstract 010: Technical Approaches for Intracranial Atherosclerotic Disease Large Vessel Occlusion Strokes
Authors: Koneru Sitara A. , A Mohamed Tarek , Martins Pedro , D Mateus Monteiro , Dolia Jay , Grossberg Jonathan A. , Pabaney Aqueel H. , Nogueira Raul G. , Alhamza A.R , Haussen Diogo C. 
Published: March 2024

Introduction
The optimal management strategy for large vessel occlusion strokes (LVOS) from intracranial atherosclerotic disease (ICAD) remains debated. We aimed to evaluate the efficacy and safety of various acute medical and endovascular management options in patients who underwent mechanical thrombectomy of an ICAD‐related occlusion.

Methods
Retrospective analysis of ICAD‐related LVOS of a prospective mechanical thrombectomy database at a comprehensive stroke center between November 2010‐May 2023. Endovascular intervention was defined as either angioplasty, stenting, or a combination of both. Acute management was divided into 5 groups: Group#1: proactive antiplatelets (patients who received antiplatelets prior to groin puncture without further endovascular intervention after initial reperfusion); Group#2: reactive antiplatelets (patients who received antiplatelets after groin puncture without further angioplasty and/or stenting after initial reperfusion), Group#3: proactive revascularization (patients treated with angioplasty and/or stenting after initial reperfusion), Group#4: reactive revascularization (patients treated with angioplasty and/or stenting after vessel re‐occlusion after initial reperfusion), and Group #5: rescue revascularization (patients with unsuccessful reperfusion and subsequent angioplasty and/or stenting).

Results
A total of 200 ICAD‐LVOS MT were identified. Baseline characteristics were comparable between the 5 groups. The rate of TICI2b‐3 final reperfusion was lower in Group 4, while the rate of TICI 2c‐3 final reperfusion was comparable among groups. The rates of in‐hospital re‐occlusion were high even in patients loaded with DAPT before puncture; the rates of re‐occlusion were lower in patients managed with intervention in a proactive manner (Group 3) when compared to those managed in a reactive manner (Group 4) (0% vs 27%, p= 0.005). In ordinal analysis, mRS scores were lowest in Groups 2 and 3.Safety outcomes were comparable with similar rates of symptomatic intracranial hemorrhage (sICH).

Conclusion
While limited by small subgroup sample size, medical management only was associated with relatively high rates of reocclusion, while proactive angioplasty/stenting with performed best. Symptomatic intracranial hemorrhage was low in medically treated patients. Further studies are warranted.
Abstract 040: Hemorrhagic Conversion Patterns After Transition of Stroke Thrombolysis from Alteplase to Tenecteplase; Real‐World Experience
Authors: Ezzeldin Mohamad , Hill Courtney , Percenti Eryn , Kerro Ali , Delora Adam , Santos Juan , Saei Hamza , Greco Lisa , Ezzeldin Rime , Elghanem Mohammad , Alderazi Yazan , Kim Yana , Poitevint Cathleen , Mir Osman 
Published: March 2024

Introduction
Importance:Tenecteplase (TNK) use is more prevalent as the thrombolytic drug of choice for acute ischemic stroke (AIS), given its ease of use with results from randomized trials showing non‐ inferiority and comparable safety to Alteplase (tPA). However, there is conflicting data in terms of intracranial hemorrhage risk.
Objective: We are reporting the rate of symptomatic intracranial hemorrhage(sICH) in TNK and tPA treated stroke populations across two large hospital systems.

Methods
Design: Retrospective cohort observational study. Data was collected from April 1, 2022 through March 29, 2023.
Setting: Data was collected from 15 stroke centers: 10 primary and 5 comprehensive stroke centers in Texas.
Participants: Inclusion criteria: 18 years or older, suspected to have an AIS were eligible to receive thrombolytic therapy, and received either IV TNK or tPA at the standard dose. A total of 431 patients were included. 216 patients received alteplase and 215 patients received tenecteplase.
Exposure: Data was collected 90 days before and 90 days after the stroke center changed from tPA to TNK. Main Outcomes: The primary endpoint was to compare the incidence of sICH according to SITS‐MOST/ECASS‐3 criteria in the tPA and TNK groups. Secondary endpoints included the radiographic pattern of hemorrhagic conversion according to the Heidelberg bleeding classification (HBc).

Results
A total of 431 patients; half of them had been administered Alteplase (n=216) and the other half had Tenecteplase (n=215). Approximately half of them were females 110 (51%) for alteplase and 117 (54%) for Tenecteplase. Almost 2/3 of the study population never smoked; 66% for alteplase 64% for Tenecteplase. Majority of the patient population got thrombolytic therapy within 3 hours 174 (81%) for alteplase versus 176 (82%) for Tenecteplase. 34 patients (15%) in the alteplase group as compared to 26 patients (12%) in the Tenecteplase group had endovascular thrombectomy attempted. 7 patients in the tPA group (3.2%) and 14 patients (6.5%) in the TNK group had sICH. An increase in the NIHSS on arrival (p=0.048) was a statistically significant predictor of sICH. A two sample proportion test on TNK produced a statistically significant increase in Heidelberg Bleed class 3 (HBc3) (p=0.040) over tPA.

Conclusion
We observed increased cases of bleeding associated with TNK administration with statistically significant increase in the HBc3 when compared to patients who received tPA. Suggested mechanisms of bleeding are hemorrhagic conversion in clinically silent infarcts, and contusions underlying the lesions. These findings suggest a potential need to reevaluate the criteria for administering TNK to patients. Larger studies are required to confirm this data.
Abstract 056: Patterns of Care in the Management of Intracranial Atherosclerosis‐related Large Vessel Occlusion–the RESCUE‐LVO survey
Authors: Siddiqui Fazeel M. , Fletcher Jeffrey J. , Elias Augusto E. , Dandapat Sudeepta , Kale Sushant P. , Heiferman Daniel , Riedy Loren , Farooqui Mudassir , Calienes Aaron Rodriguez , Vivanco‐Suarez Juan , Pandey Aditya S. , Ortega‐Gutierrez Santiago 
Published: March 2024

Introduction
Intracranial atherosclerosis‐related large vessel occlusion (ICAS‐LVO) is a common cause of failed mechanical thrombectomy (MT) in acute ischemic stroke (AIS) [1]. Treatment of ICAS‐LVO with rescue stenting and/or angioplasty has shown promising outcomes, but diagnosing ICAS‐LVO during MT can be challenging [2, 3]. There are uncertainties regarding optimal approaches, techniques, and timing for treating ICAS‐LVO. To understand current practice patterns and address these uncertainties, we conducted a survey among neurointerventional practitioners experienced in ICAS‐LVO management during MT.

Methods
We conducted an international online survey of neurointerventionalist members of the Society of Neurointerventional Surgery (SNIS) and the Society of Vascular and Interventional Neurology (SVIN). The 28‐question poll evaluated the preferences on diagnosis, treatment, and endovascular approach to ICAS‐LVO.

Results
168 individual survey responses were obtained from practicing neurointerventional physicians. Overall, 40.6% reported an incidence of 6–10% of ICAS‐LVO during MT. Most neurointerventionalists (91%) diagnose ICAS‐LVO after a continued or recurrent occlusion or by the presence of fixed focal stenosis (FFS) after multiple MT attempts. Most respondents (86%) preferred acute treatment of ICAS‐LVO with rescue stenting (RS) +/‐ angioplasty. However, in patients who achieved recanalization with a severe FFS, the majority (44%) recommended maximal medical management only. The preferred medication during acute RS was intravenous antiplatelet therapy (69%), and after acute RS was dual oral antiplatelet therapy (58%). Fear of hemorrhagic complications (70%) was the most compelling reason not to perform RS +/‐ angioplasty. Twenty‐five percent of respondents were hesitant to randomize patients to acute RS versus medical therapy in a future randomized trial because of the lack of sensitive and specific biomarkers to diagnose ICAS‐LVO before MT treatment.

Conclusion
Our survey highlights the significant variability and uncertainty in the diagnosis and management of ICAS‐LVO during MT among neurointerventional practitioners. There is no equipoise regarding the optimal treatment strategy, and the fear of hemorrhagic complications associated with antithrombotic medications contributes to the variation in practice. Our survey underscores the need for future research and randomized clinical trials to address the uncertainties in the management of ICAS‐LVO during MT. Improved imaging biomarkers and consensus guidelines are essential to guide clinical decision‐making and optimize patient outcomes in this challenging population of AIS patients.
Abstract 067: Outcomes for large vessel occlusion patients with severe baseline disability with and without endovascular thrombectomy
Authors: Awad Amine J. , Young Michael J. , Andreev Alexander , Dmytriw Adam A. , Vranic Justin E. , Rabinov James D. , Stapleton Christopher J. , Das Alvin S. , Bonkhoff Anna K. , de Oliveira Lara Carvalho , Schirmer Markus D. , Leslie‐Mazwi Thabele M. , Singhal Aneesh B. , Patel Aman B. , Rost Natalia S. , Regenhardt Robert R. 
Published: March 2024

Introduction
Patients with baseline disability account for one‐third of stroke presentations. However, there remains controversy in treatment selection for endovascular thrombectomy (EVT). We compared long‐term outcomes and likelihood of transitioning to comfort care for large vessel occlusion (LVO) patients with severe pre‐stroke disability treated with EVT versus medical management at a single center from 2017‐2020.

Methods
Individuals who presented with LVO were identified retrospectively from a prospectively maintained database. Severe baseline disability was defined as modified Rankin Scale (mRS) 3‐5. Delta mRS was defined as the difference between baseline and 90‐day mRS. Logistic and ordinal regressions were performed to evaluate the relationships between EVT and outcomes. A mixed‐methods analysis was performed to assess rates and reasons for transitions to comfort care.

Results
A total of 175/1008 (17%) were identified with severe baseline disability. The median age was 82 (IQR 70‐89), and 59% were female. Thirty‐two (18%) with severe baseline disability were treated with EVT. EVT was independently associated with improved delta mRS (B=‐1.048; 95%CI=‐1.777,‐0.318; p=0.005) accounting for age and NIHSS. However, EVT did not reduce the odds of transitioning to comfort care (aOR=0.794; 95%CI=0.347,1.818; p=0.585) accounting for age and NIHSS. Seventy‐six (43%) with severe baseline disability were transitioned to comfort care. Of the 99 not transitioned to comfort care, 18 were treated with EVT, and EVT was independently associated with improved delta mRS (B=‐2.794; 95%CI=‐4.002,‐1.586; p<0.0001) accounting for age and NIHSS. The median time from presentation to comfort care was 2 days (IQR 1‐7) in the non‐EVT group, compared to 7 (IQR 4‐11) in the EVT group (H(1)=5.46, p=0.019). The primary reasons for comfort care were poor perceived prognosis and medical complications.

Conclusion
Among patients with severe baseline disability, EVT is associated with less post‐stroke accumulated disability without limiting transitions to comfort care. EVT may be compatible with goal‐concordant care and should not be routinely withheld on the basis of baseline disability alone.
Abstract 070: Door in‐door out time for stroke thrombectomy transfers in a large hub‐and‐spoke network
Authors: Ahmed Rashid A. , McIntyre Joyce A. , Leslie‐Mazwi Thabele M. , Das Alvin S. , Dmytriw Adam A. , Hirsch Joshua A. , Rabinov James D. , Doron Omer , Stapleton Christopher J. , Singhal Aneesh B. , Rost Natalia S. , Patel Aman B. , Regenhardt Robert W. 
Published: March 2024

Introduction
The mantra ‘time is brain’ cannot be overstated for patients suffering from acute ischemic stroke. This is especially true for those with large vessel occlusions (LVO) requiring transfer to an endovascular thrombectomy (EVT) capable center. We sought to evaluate the spoke hospital door in‐door out (DIDO) times for patients transferred to our hub center for EVT.

Methods
Individuals who first presented with LVO to a spoke hospital and were then transferred to the hub for EVT were retrospectively identified from a prospectively maintained database from January 2019 to November 2022. DIDO was defined as the time between spoke hospital door in arrival and door out exit. Baseline characteristics, treatments, and outcomes were compared, dichotomizing DIDO at 90 min based in the American Heart Association goal for DIDO ≤90 min for 50% of transfers. Multivariable regression analyses were performed for determinants of 90‐day ordinal modified Ranking Scale (mRS) and DIDO.

Results
We identified 194 patients transferred for EVT with available DIDO. The median age was 67 (IQR 57‐80), and 46% were female. The median NIHSS was 16 (10‐20), 50% were treated with intravenous thrombolysis at a spoke, and TICI 2B‐3 reperfusion was achieved in 87% at the hub. The median DIDO was 120 min (97‐149), with DIDO ≤90 min achieved in 18%. DIDO was a significant determinant of 90‐day ordinal mRS (B=0.007, 95%CI=0.001‐0.012, p=0.013), even when accounting for last known well‐to‐spoke door in, spoke door out‐to‐hub arrival, hub arrival‐to‐puncture, puncture‐to‐first pass, age, NIHSS, intravenous thrombolysis, TICI 2B‐3, and symptomatic intracranial hemorrhage. Importantly, determinants of DIDO included Black race or Hispanic ethnicity (B=0.918, 95%CI=0.010‐1.826, p=0.048), atrial fibrillation or heart failure (B=0.793, 95%CI=0.257‐1.329, p=0.004), and basilar LVO location (B=2.528, 95%CI=1.154‐3.901, p<0.001).

Conclusion
In this real‐world analysis of a large hub‐and‐spoke network, spoke DIDO was the most important period of time for long term outcomes of LVO stroke patients treated with EVT. Determinants of DIDO were identified which require further investigation and motivate system changes that may reduce DIDO and improve patient outcomes.