bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract Number ‐ 246: Quantification of Hemorrhage Volume for Prediction of Complications of Aneurysmal Subarachnoid Hemorrhage
Authors: Miller Jacob M , Jones Matthew T , Patel Rishi , Sanchez Sebastian , Samaniego Edgar A 
Published: April 2023

Introduction
Aneurysmal subarachnoid hemorrhage (aSAH) can lead to life‐threatening complications such as vasospasm and hydrocephalus. The incidence of these events is influenced by the volume of intracranial hemorrhage. The Fisher score is a subjective adjudication of SAH volume. We developed an objective semi‐automated method to quantify the volume of intracranial hemorrhage. Moreover, we evaluated the association of aSAH volume with vasospasm and hydrocephalus.

Methods
A custom semi‐automated image segmentation algorithm quantifying aSAH volume was implemented in MATLAB. The volume of hemorrhage was retrospectively measured from non‐contrast brain CT scans with Fisher grade ≥ 2. The algorithm utilized region‐growing and 3D k‐means clustering. Performance was validated against the average of two sets of hemorrhage volumes manually measured. These measurements were obtained from two independent raters who selected regions of interest spanning areas of hemorrhage. The association between blood volume and clinical outcome (hydrocephalus or vasospasm) was evaluated using ROC analysis.

Results
Fifty‐seven patients were included in this study and 10 patients were used for validation of our method. The ICC between raters for manual measurements of hemorrhage in the validation group was 0.988 (CI: (0.911, 0.997), p < 0.001). Validation of semi‐automated versus manual methods resulted in an ICC of 0.961 (CI: (0.756, 0.991), p < 0.001). Bland‐Altman analysis revealed that the algorithm slightly underestimated blood volume (mean difference = ‐4.11 mL). Hemorrhage volume discriminated for the development of vasospasm (AUC = 0.781) and hydrocephalus (AUC = 0.776).

Conclusions
Volume of hemorrhage is a key factor that influences the incidence of complications in aSAH. We developed and validated a semi‐automated algorithm for quantifying the volume of aSAH. Vasospasm and hydrocephalus were associated with greater amounts of intracranial blood. Objective measurements of aSAH volume can aid in adjudicating risk of complications among patients with aSAH.
Abstract Number ‐ 252: High Mortality in Patients with Spontaneous Intracerebral Hemorrhage Experiencing Neurological Decline on Mobile Stroke Unit
Authors: Navalkele Digvijaya , Rangaraju Srikant , Srinivas Meghana , Chen Justine , Nemes Bianca , Bianchi Nicolas , Bowry Ritvij , Flemming Carol , Parker Stephanie , Grotta James , Frankel Michael 
Published: April 2023

Introduction
Spontaneous intracranial hemorrhage (ICH) is associated with significant morbidity and mortality. Mobile Stroke Unit (MSU) provides a unique opportunity to assess patients in the hyperacute phase of ICH to track outcomes.

Methods
Methods: We conducted a retrospective review of patients with spontaneous ICH diagnosed on two different MSUs in the United States. Patients were divided into three groups based on symptom onset/last known well (LKW): Group 1: 0–1 hours from LKW, Group 2: 1–2 hours from LKW, and Group 3: 2–4 hours from LKW. We compared neurological decline (ND) rates between MSU and Emergency Department (ED) arrival for patients in the three groups. Neurological decline was defined as a decrease in GCS by ≥ 2 points or an increase in NIHSS ≥ 4 points between MSU and ED examination. χ2 test was used to compare the proportion of patients who experience ND between MSU and ED transport. We also assessed and compared pre‐defined factors that could be associated with ND in the three groups. CT scans done on MSU were compared to those done on ED arrival.

Results
Results: Fifty‐fourpatients met the study criteria. The mean age was 62, and 69% were male. Median MSU NIHSS was 18, and median ED NIHSS was 19. The mean MSU GCS was 14, and ED GCS was 12. The mean hematoma volume on the MSU CT head was 21 cc and 24 cc on the ED CT head. Mean MSU MAP was 136, and MAP on ED arrival was 120. Thirty‐three percent (18/54) of patients experienced ND between MSU and ED transport. Forty percent (n = 10/25) patients in group 1, 22% (n = 4/18) in group 2 and 36%(n = 4/11) in group 3 had ND (chi‐square 0.45). Overall, patients with ND experienced significantly high mortality (OR 5.091, p = 0.029, CI 1.24‐20.78). On univariate analysis, variables significantly associated with ND were MSU NIHSS, hematoma volume, and presence of hydrocephalus on MSU CT scan. No variables were significant to predict ND on multivariate analysis (Hematoma Expansion OR 1.028, CI 0.99‐1.05; Hydrocephalus OR 3.70 CI 0.67‐20.43)

Conclusions
Conclusion: One‐thirdof ICH patients experience neurological decline between MSU and ED transport within four hours of symptom onset and are at a significantly higher risk of mortality. Higher ND rates are likely due to earlier diagnosis of ICH on MSU. Due to the smaller sample size, we did not find significant variables associated with ND. However, various ways of providing rapid medical and surgical treatment to these patients should be explored in future studies to assess the effect on functional outcomes.
Abstract Number ‐ 256: Anti‐Thrombotic Therapy for Stroke Prevention in Cervical Artery Dissection: protocol of a multicenter international study
Authors: Shu Liqi , Mandel Daniel , Yaghi Shadi ,   STOP‐CAD Investigators, STOP‐CAD Investigators, STOP‐CAD Investigators
Published: April 2023

Introduction
Cervical artery dissection (CAD) is a common cause of stroke in the young and carries a high risk of early recurrence. Traditionally, the treatment consisted of antithrombotic therapy for at least 3months. There is mixed evidence on whether antiplatelet therapy is as effective as anticoagulation in such patients, and prior studies are limited by small sample size due to the low incidence of CAD, as well as not investigating more modern treatment regimens such as direct oral anticoagulants (DOAC) and increasingly utilized dual antiplatelet therapy (DAPT) strategies. The Anti‐Thrombotic Therapy for Stroke Prevention in Cervical Artery Dissection (STOP‐CAD)studyaims to compare the safety and effectiveness of different antithrombotic regimens in patients with acute spontaneous CAD. We hypothesize thatdual antiplatelet therapy (DAPT) followed by a single agent has comparable safety and efficacy to anticoagulation in patients with CAD.

Methods
STOP‐CAD is amulticenter cross‐sectional international retrospective study.All patientsaged 18–89 years with imaging‐confirmed diagnosis of non‐traumatic CAD treated with antithrombotic therapy will be included. Imaging diagnosis will be adjudicated by the principal investigator from each individual site. Patients present with CAD in the setting of major trauma will be excluded. Baseline demographics, clinical, laboratory and imaging information will becollected. Outcomes include subsequent ischemic stroke, symptomatic intracranial hemorrhage, major hemorrhage, recanalization status, and death within 180 days. We will compare the clinical outcomes between antiplatelet and anticoagulation groups using Cox regression models, and the radiographic outcomes across the two groups using logistic regression models. We will use inverse probability of treatment weighting and adjust for prespecified variable as well as variables that differ between the two groups. We will use propensity score matching with and without replacement for the outcome analyses.

Results
Currently at least 40 international sites have agreed to contribute to this study. Multiple sites have already started the data input process, and more have started the IRB process. We expect the data collection to be completed by the end of December 2022, and the data analysis to be completed by the end of June 2023.

Conclusions
STOP‐CAD will provide real world data comparing the safety and efficacy of DAPT vs. anticoagulation in patients with cervical artery dissection. In addition, multiple sub‐studies will be conducted using the same database on topics such as efficacy of interventional treatment and predictors of poor outcomes.
Abstract Number ‐ 274: Multi‐Tiered Approach to Stroke and Thrombectomy Care in India
Authors: Krothapalli Neeharika , Alberts Mark J 
Published: April 2023

Introduction
Stroke is one of the leading causes of morbidity, mortality and healthcare expenditure in India. Acute management of ischemic stroke is a complex, multidisciplinary endeavor that has roots in medical education. However, there is a paucity of data addressing the issue of stroke awareness among the college student population in India. This study was performed as a baseline measure to determine the understanding of stroke and thrombectomy care among both medical and non‐medical college students.

Methods
Medical and non‐medical college students were randomly selected from Andhra Pradesh, Jharkhand and Tamil Nadu states in India to participate in a created survey. The questionnaire was distributed to hundreds of students to assess ability to identify stroke symptoms, knowledge of stroke risk factors and stroke‐related neurointerventional procedures.

Results
A total of 106 survey responses were collected from 59 medical and 47 non‐medical students across various states in India. 61 (57.5%) participants with only 6.6% non‐medical students responded that they were able to recognize a stroke. 45 (42.5%) students with a majority (76.6%) of non‐medical participants reported no prior contact with a stroke patient. Overall, 27 (25.5%) students with 40.7% medical and 6.4% non‐medical participants were able to identify the symptoms of stroke. 59.3% of medical and 14.9% of non‐medical students could recognize associated risk factors. Only 10.6% of non‐medical participants had exposure to stroke education at their institution. 36 (34.0%) participants with 54.2% medical and 8.5% non‐medical students reported prior exposure to neuro intervention. 93.2% of medical and 21.3% of non‐medical students were aware of the time window for administering thrombolysis. 72.9% of medical and 27.7% of non‐medical students were aware of the indication and time window for mechanical thrombectomy. A total of 89 (84.0%) participants responded that the collective efforts of medical society and government would improve stroke awareness and outcomes. Overall, 96 (90.6%) respondents believed there should be more effort to promote stroke awareness.

Conclusions
Our data provides a snapshot of the general awareness of stroke and thrombectomy care in medical and non‐medical student participants. Based on this study, the need to educate the younger generation about stroke is indeed clear. Further, most respondents indicated that increased collaborative effort from medical society would be instrumental in improving access and outcomes. We propose a basic multi‐tiered approach incorporating public health interventions to improve stroke and thrombectomy care in India.
Abstract Number ‐ 281: Clinical and Epidemiological Characteristics of Moyamoya Disease Presenting with Concomitant Autoimmune Conditions
Authors: Brown Nolan , Singh Rohin , Harrison Daniel , Bauman Megan , Seas Andreas , Shahrestani Shane , Gendreau Julian , Gottfried Oren 
Published: April 2023

Introduction
Moyamoya disease was first described in the 1950’s. After over six decades, however, the underlying etiology of Moyamoya still remains unknown. It has been postulated that underlying inflammatory or autoimmune (AI) processes may play a role in the development of this condition. In order to further investigate this hypothesis, we studied the clinical and epidemiological attributes of patients with concurrent Moyamoya disease and AI condition(s).

Methods
A systematic review was performed including studies reporting patient level data of Moyamoya disease and concomitant autoimmune disease. Relevant studies were identified using Preferred reporting Items for Systematic Reviews and Meta‐Analysis criteria.

Results
There were 739 results of which 149 were included in this study. The first reports of concurrent Moyamoya and AI occurred in 1991 and involved 2 cases of Moyamoya and associated Graves’ disease. These patients were treated with antithyroid medication alone and showed improvement. Altogether, our search yielded a total of 257 patients (192 females, 48 males, 17 unspecified). A total of 158 cases were reported as “Moyamoya Disease” and 99 were reported as “Moyamoya Syndrome/Vasculopathy.” Most cases were ischemic (175 ischemic, 15 hemorrhagic) in nature. Bilaterality of the disease was reported in 130 cases, unilaterality in 34 cases. The most commonly reported ethnicity was Chinese (26 cases), followed by Japanese (17 cases), and Korean (17 cases). The most common co‐presenting AI conditions were Graves’ disease (150 cases, 58.4%), Lupus (26 cases, 10.1%), antiphospholipid syndrome (19 cases, 7.4%), Type 1 Diabetes (19 cases, 7.4%), and Multiple Sclerosis (7 cases, 2.7%).

Conclusions
There are numerous reports describing patients diagnosed with Moyamoya in addition to coexisting AI conditions. Our study shows that the demographic characteristics of co‐presentation align with the common autoimmune (female predominance) and Moyamoya (high east Asian prevalence) attributes. These results warrant further investigation into a possible causal or synergistic relationship between Moyamoya and AI disease.
Abstract Number: LBA13 Relationship Between Vertebral Artery Dominance And Incidence Of Embolic Basilar Artery Occlusion
Authors: Amireh Abdallah , Abbasi Hamidreza , Asnafi Solmaz , Fourcand Farah , Percival Brigitte , Zacharatos Haralabos , Mehta Siddhart , Kirmani Jawad 
Published: April 2023

Introduction
Vertebral artery asymmetry due to hypoplasia or early termination is common in the general population with 50% left dominance, 25% right dominance, and 25% codominance. Our aim was to identify if an association exists between vertebral artery dominance and incidence of embolic basilar artery occlusion.

Methods
Retrospective chart review of patients presenting to our comprehensive stroke center with acute ischemic stroke (AIS) secondary to embolic basilar artery occlusion were reviewed. Artery‐to‐artery occlusions related to athersclerotic steno‐occlusive disease or proximal dissection with distal thromboembolism were excluded. Successful recanalization was identified as a modified treatment in cerebral infarction (mTICI) score of 2b and 3. Fisher exact test statistic was used to assess for significant differences in recanalization. Social science statistics software was used for data analysis.

Results
From May 2017 to November 2019, 29 patients with acute basilar occlusions undergoing thrombectomy were identified. Acute basilar artery occlusion patients had a dominant right vertebral artery (31%, n = 9), codominant vertebral arteries (31%, n = 9) and dominant left vertebral artery (38%, n = 11). Successful recanalization of TICI 2b or higher was achieved in 89.6% (n = 26). Difference between successful recanalization and right or left vertebral artery dominance was not statistically significant (Fisher exact test statistic value 0.48).

Conclusions
Our study suggests a higher proportion of our patients presenting with basilar artery occlusion had right vertebral artery dominance or codominant pattern. Larger, studies are needed to validate our results.
Cognitive-Semantic Concept Structuring in Visual Perception and Visual Imagery: Identifying a New Basic Top-Down Processing System for Visual Experience
Authors: Stocker Kurt 
Published: April 2023

Abstract
Visual experience encompasses both visual perception and visual imagery. Using cognitive-semantic analysis, it is outlined how visual experience can be characterized as involving (among other top-down processes) a basic top-down-processing system that is organized by fundamental aspects of the four main Talmyan concept structuring systems (fundamental aspects of configurational structure, perspective, attention, and—not in principle, but quite often—force dynamics). It is proposed that this visual concept structuring represents a thus far unidentified basic top-down-processing system of visual experience which structures the conceptual content of the visual/imagistic stimulus. While Talmyan concept structuring has in the literature thus far mainly been applied to language, the main conclusion of this paper is that Talmyan concept structuring is a basic component of visual top-down processing even when language is not involved. Implications for sensory modalities other than the visual one are discussed, and possible future research is formulated.
Bottom-Up and Top-Down Approaches to Y&C Ministry, Part 2: Finding a Theological Way Forward
Authors: Barfield Robin , Crispin Gareth 
Published: April 2023

Abstract
In part 1 the concepts of top-down and bottom-up approaches were introduced as a helpful way of analysing the landscape of youth and children’s mission and ministry. This second part begins to suggest a constructive solution to the question of bringing the top-down and bottom-up together which understands both divine and human action in and of the individual. James Loder’s appropriation of Chalcedonic descriptions of divine-human connection come together with his analogia Spiritus and understanding of transformation to provide a way of bringing together top-down and bottom-up approaches which can be understood as a form of ‘spiritual structuration.’
Elegiac Subjunctive, or, Secular Variations on Posthumous Personhood
Authors: Sherman David 
Published: April 2023

Abstract
This essay explores the secular imaginary of contemporary elegy, with a focus on writers in the U.S. Comparing recent poems by Natasha Trethewey, Danez Smith, Sam Sax, primarily, I examine variations in the figure of apostrophe addressed to the dead as imaginative critiques of secular hope. These poets use precarious forms of apostrophe to explore the conceptual impasse of posthumous personhood in a secular social world. Their writing disperses this foreclosed subjectivity across other effects, sites, and practices, as an ethical world-building agency. These lyrical attempts to imagine a secular social ontology of being with the dead articulate powerful possibilities for political justice and passionate attachment.
Communal Mourning and Contemporary Elegy in Korean Poetry
Authors: Yi Ivanna Sang Een 
Published: April 2023

Abstract
An extended period of public mourning followed the 2014 Sewol Ferry disaster, one of South Korea’s largest maritime disasters which resulted in over three hundred passenger deaths. This article examines leading contemporary South Korean poet Kim Hyesoon’s narration of collective trauma in her elegy for the dead, Chugŭmŭi chasajŏn (Autobiography of Death, 2016). Drawing on the oral tradition, particularly the songs of female shamans, Kim facilitates a radical empathy with which her speaker enters the physical bodies of the dead and invokes their spirits. Kim’s polyvocal speaker traverses historical memory to excavate these deaths: Autobiography of Death connects the recent loss of life involved in the sinking of the Sewol Ferry with the structural injustice experienced by dissidents who were killed during South Korea’s democratization movement. I argue that Kim places her elegy in the public sphere by engaging the embodied memory of individuals to voice the transhistorical grief of the Korean community.
Mediation Role of Organisational Supportive Culture in the Relationship Between Human Resources Management Practices and Patient Satisfaction: A Case Study of Rizgary Teaching and Referral Hospital in Erbil-Iraq
Authors: Ahmed Nyaz S. , Bein Murad A. 
Published: April 2023

Objective The main purpose of this research is to examine a research model that explores the mediation role of the organisational supportive culture in the relationship between human resources management practices (HRMP) and patient satisfaction: a case study of Rizgary teaching and referral hospital in Erbil-Iraq. Methodology A survey instrument was considered the main data collection tool. The survey participants were medical staff and patients who contributed to the research by replying to the questionnaire indicators. Partial least squares—structural equation modelling (PLS-SEM) was used for analysing the empirical data. The research findings revealed that human resources management practices positively related to supportive culture, results also demonstrated that supportive culture in surveyed hospitals positively and significantly impacts patient satisfaction. Conclusions The results displayed that human resources management practices directly affect patient satisfaction. Furthermore, supportive culture partially mediated the relationship between human resources management practices and patient satisfaction, due to human resources management practices, directly and indirectly, affecting patient satisfaction. Contribution The current research essentially contributes to the literature by indicating that human resources management practices within hospitals, directly and indirectly, enhance patient satisfaction through healthcare services accuracy and meet the expectations of patients, in addition, the results showed that supportive culture partially mediates the relationship between human resources management practices and patient satisfaction.
Could negative outcomes of psychotherapies be contributing to the lack of an overall population effect from the Australian Better Access initiative?
Authors: Allison Stephen , Looi Jeffrey CL , Kisely Steve , Bastiampillai Tarun 
Published: April 2023

Objective We examine deterioration in psychotherapies, as reported in the recent evaluation of the Australian Medicare Better Access initiative. Conclusion A focus on patients who experience poor clinical outcomes helps programs minimise harm and improve quality of care. The Better Access evaluation found the mental health of 20–40% of patients deteriorated. This may partly explain why population distress and suicide rates were not reduced by the introduction of the Better Access initiative. Deterioration was more likely for milder conditions, and less likely for severe conditions, which also improved the most. Using severity as a criterion for priority setting and resource allocation may minimise patient risk and maximise benefits. Patients with severe conditions may require considerably more sessions than the current average for Better Access psychotherapies.