Impact of Vaccination Status on Outcome of Patients With COVID-19 and Acute Ischemic Stroke Undergoing Mechanical Thrombectomy.

BACKGROUND: Data on impact of COVID-19 vaccination and outcomes of patients with COVID-19 and acute ischemic stroke undergoing mechanical thrombectomy are scarce. Addressing this subject, we report our multicenter experience. METHODS AND RESULTS: This was a retrospective analysis of patients with COVID-19 and known vaccination status treated with mechanical thrombectomy for acute ischemic stroke at 20 tertiary care centers between January 2020 and January 2023. Baseline demographics, angiographic outcome, and clinical outcome evaluated by the modified Rankin Scale score at discharge were noted. A multivariate analysis was conducted to test whether these variables were associated with an unfavorable outcome, defined as modified Rankin Scale score >3. A total of 137 patients with acute ischemic stroke (48 vaccinated and 89 unvaccinated) with acute or subsided COVID-19 infection who underwent mechanical thrombectomy attributable to vessel occlusion were included in the study. Angiographic outcomes between vaccinated and unvaccinated patients were similar (modified Thrombolysis in Cerebral Infarction ≥2b: 85.4% in vaccinated patients versus 86.5% in unvaccinated patients; P=0.859). The rate of functional independence (modified Rankin Scale score, ≤2) was 23.3% in the vaccinated group and 20.9% in the unvaccinated group (P=0.763). The mortality rate was 30% in both groups. In the multivariable analysis, vaccination status was not a significant predictor for an unfavorable outcome (P=0.957). However, acute COVID-19 infection remained significant (odds ratio, 1.197 [95% CI, 1.007-1.417]; P=0.041). CONCLUSIONS: Our study demonstrated no impact of COVID-19 vaccination on angiographic or clinical outcome of COVID-19-positive patients with acute ischemic stroke undergoing mechanical thrombectomy, whereas worsening attributable to COVID-19 was confirmed.

A Visual Environment for Data Driven Protein Modeling and Validation.

In structural biology, validation and verification of new atomic models are crucial and necessary steps which limit the production of reliable molecular models for publications and databases. An atomic model is the result of meticulous modeling and matching and is evaluated using a variety of metrics that provide clues to improve and refine the model so it fits our understanding of molecules and physical constraints. In cryo electron microscopy (cryo-EM) the validation is also part of an iterative modeling process in which there is a need to judge the quality of the model during the creation phase. A shortcoming is that the process and results of the validation are rarely communicated using visual metaphors. This work presents a visual framework for molecular validation. The framework was developed in close collaboration with domain experts in a participatory design process. Its core is a novel visual representation based on 2D heatmaps that shows all available validation metrics in a linear fashion, presenting a global overview of the atomic model and provide domain experts with interactive analysis tools. Additional information stemming from the underlying data, such as a variety of local quality measures, is used to guide the user's attention toward regions of higher relevance. Linked with the heatmap is a three-dimensional molecular visualization providing the spatial context of the structures and chosen metrics. Additional views of statistical properties of the structure are included in the visual framework. We demonstrate the utility of the framework and its visual guidance with examples from cryo-EM.

LIQUID - Treatment of high-grade dural arteriovenous fistulas with Squid liquid embolic agent: a prospective, observational multicenter study.

BACKGROUND: Endovascular embolization is a feasible treatment for cranial dural arteriovenous fistulas (DAVFs). New embolic agents aim to improve the success of DAVF embolization. OBJECTIVE: To assess the safety, efficacy, and short-term outcome of the treatment of DAVFs using the new liquid embolic agent Squid. METHODS: The LIQUID study is a prospective, observational multicenter study on the treatment of high-grade (Cognard type ≥3) DAVFs with the embolic agent Squid. The primary outcome measures were safety (ie, morbidity and mortality), as well as the occlusion rate 90 to 180 days after treatment. RESULTS: In eight centers, 53 patients (mean age 59.8 years, 22.6% female) were treated in 55 treatment sessions. Of the DAVFs, 56.6% were Cognard type III, 41.5% type IV, and 18.9% were ruptured. Squid 18 was used in 83.6% and Squid 12 in 32.7% of the treatments. The overall rate of intraprocedural or postprocedural adverse events (AEs) was 18.2%. Procedure-related AEs resulting in permanent morbidity were observed in 3.6%. One patient (1.8%) died unrelated to the procedure due to pulmonary embolism. The final complete occlusion rate at 90 to 180 days was 93.2%. After a mean follow-up of 5.5 months, the modified Rankin Scale (mRS) score was stable or improved in 93.0%. In one of the patients, worsening of the mRS score was related to the procedure (1.8%). CONCLUSION: Squid is a safe and effective liquid embolic agent for the treatment of high-grade DAVFs.

Mechanical thrombectomy for acute ischemic stroke in COVID-19 patients: multicenter experience in 111 cases.

BACKGROUND: Data on the frequency and outcome of mechanical thrombectomy (MT) for large vessel occlusion (LVO) in patients with COVID-19 is limited. Addressing this subject, we report our multicenter experience. METHODS: A retrospective cohort study was performed of consecutive acute stroke patients with COVID-19 infection treated with MT at 26 tertiary care centers between January 2020 and November 2021. Baseline demographics, angiographic outcome and clinical outcome evaluated by the modified Rankin Scale (mRS) at discharge and 90 days were noted. RESULTS: We identified 111 out of 11 365 (1%) patients with acute or subsided COVID-19 infection who underwent MT due to LVO. Cardioembolic events were the most common etiology for LVO (38.7%). Median baseline National Institutes of Health Stroke Scale score and Alberta Stroke Program Early CT Score were 16 (IQR 11.5-20) and 9 (IQR 7-10), respectively. Successful reperfusion (mTICI ≥2b) was achieved in 97/111 (87.4%) patients and 46/111 (41.4%) patients were reperfused completely. The procedure-related complication rate was 12.6% (14/111). Functional independence was achieved in 20/108 (18.5%) patients at discharge and 14/66 (21.2%) at 90 days follow-up. The in-hospital mortality rate was 30.6% (33/108). In the subgroup analysis, patients with severe acute COVID-19 infection requiring intubation had a mortality rate twice as high as patients with mild or moderate acute COVID-19 infection. Acute respiratory failure requiring ventilation and time interval from symptom onset to groin puncture were independent predictors for an unfavorable outcome in a logistic regression analysis. CONCLUSION: Our study showed a poor clinical outcome and high mortality, especially in patients with severe acute COVID-19 infection undergoing MT due to LVO.

Using topic modeling to infer the emotional state of people living with Parkinson's disease.

Individuals with Parkinson's disease (PD) often exhibit facial masking (hypomimia), which causes reduced facial expressiveness. This can make it difficult for those who interact with the person to correctly read their emotional state and can lead to problematic social and therapeutic interactions. In this article, we develop a probabilistic model for an assistive device, which can automatically infer the emotional state of a person with PD using the topics that arise during the course of a conversation. We envision that the model can be situated in a device that could monitor the emotional content of the interaction between the caregiver and a person living with PD, providing feedback to the caregiver in order to correct their immediate and perhaps incorrect impressions arising from a reliance on facial expressions. We compare and contrast two approaches: using the Latent Dirichlet Allocation (LDA) generative model as the basis for an unsupervised learning tool, and using a human-crafted sentiment analysis tool, the Linguistic Inquiry and Word Count (LIWC). We evaluated both approaches using standard machine learning performance metrics such as precision, recall, and F1scores. Our performance analysis of the two approaches suggests that LDA is a suitable classifier when the word count in a document is approximately that of the average sentence, i.e., 13 words. In that case, the LDA model correctly predicts the interview category 86% of the time and LIWC correctly predicts it 29% of the time. On the other hand, when tested with interviews with an average word count of 303 words, the LDA model correctly predicts the interview category 56% of the time and LIWC, 74% of the time. Advantages and disadvantages of the two approaches are discussed.

Interactive Visualization of Atmospheric Effects for Celestial Bodies.

We present an atmospheric model tailored for the interactive visualization of planetary surfaces. As the exploration of the solar system is progressing with increasingly accurate missions and instruments, the faithful visualization of planetary environments is gaining increasing interest in space research, mission planning, and science communication and education. Atmospheric effects are crucial in data analysis and to provide contextual information for planetary data. Our model correctly accounts for the non-linear path of the light inside the atmosphere (in Earth's case), the light absorption effects by molecules and dust particles, such as the ozone layer and the Martian dust, and a wavelength-dependent phase function for Mie scattering. The mode focuses on interactivity, versatility, and customization, and a comprehensive set of interactive controls make it possible to adapt its appearance dynamically. We demonstrate our results using Earth and Mars as examples. However, it can be readily adapted for the exploration of other atmospheres found on, for example, of exoplanets. For Earth's atmosphere, we visually compare our results with pictures taken from the International Space Station and against the CIE clear sky model. The Martian atmosphere is reproduced based on available scientific data, feedback from domain experts, and is compared to images taken by the Curiosity rover. The work presented here has been implemented in the OpenSpace system, which enables interactive parameter setting and real-time feedback visualization targeting presentations in a wide range of environments, from immersive dome theaters to virtual reality headsets.

OpenSpace: A System for Astrographics.

Human knowledge about the cosmos is rapidly increasing as instruments and simulations are generating new data supporting the formation of theory and understanding of the vastness and complexity of the universe. OpenSpace is a software system that takes on the mission of providing an integrated view of all these sources of data and supports interactive exploration of the known universe from the millimeter scale showing instruments on spacecrafts to billions of light years when visualizing the early universe. The ambition is to support research in astronomy and space exploration, science communication at museums and in planetariums as well as bringing exploratory astrographics to the class room. There is a multitude of challenges that need to be met in reaching this goal such as the data variety, multiple spatio-temporal scales, collaboration capabilities, etc. Furthermore, the system has to be flexible and modular to enable rapid prototyping and inclusion of new research results or space mission data and thereby shorten the time from discovery to dissemination. To support the different use cases the system has to be hardware agnostic and support a range of platforms and interaction paradigms. In this paper we describe how OpenSpace meets these challenges in an open source effort that is paving the path for the next generation of interactive astrographics.

OpenSpace: Bringing NASA Missions to the Public.

This viewpoint presents OpenSpace, an open-source astrovisualization software project designed to bridge the gap between scientific discoveries and their public dissemination. A wealth of data exists for space missions from NASA and other sources. OpenSpace brings together this data and combines it in a range of immersive settings. Through non-linear storytelling and guided exploration, interactive immersive experiences help the public to engage with advanced space mission data and models, and thus be better informed and educated about NASA missions, the solar system and outer space. We demonstrate this capability by exploring the OSIRIS-Rex mission.

OpenSpace: Changing the Narrative of Public Dissemination in Astronomical Visualization from What to How.

We present the development of an open-source software called OpenSpace that bridges the gap between scientific discoveries and public dissemination and thus paves the way for the next generation of science communication and data exploration. We describe how the platform enables interactive presentations of dynamic and time-varying processes by domain experts to the general public. The concepts are demonstrated through four cases: Image acquisitions of the New Horizons and Rosetta spacecraft, the dissemination of space weather phenomena, and the display of high-resolution planetary images. Each case has been presented at public events with great success. These cases highlight the details of data acquisition, rather than presenting the final results, showing the audience the value of supporting the efforts of the scientific discovery.

Globe Browsing: Contextualized Spatio-Temporal Planetary Surface Visualization.

Results of planetary mapping are often shared openly for use in scientific research and mission planning. In its raw format, however, the data is not accessible to non-experts due to the difficulty in grasping the context and the intricate acquisition process. We present work on tailoring and integration of multiple data processing and visualization methods to interactively contextualize geospatial surface data of celestial bodies for use in science communication. As our approach handles dynamic data sources, streamed from online repositories, we are significantly shortening the time between discovery and dissemination of data and results. We describe the image acquisition pipeline, the pre-processing steps to derive a 2.5D terrain, and a chunked level-of-detail, out-of-core rendering approach to enable interactive exploration of global maps and high-resolution digital terrain models. The results are demonstrated for three different celestial bodies. The first case addresses high-resolution map data on the surface of Mars. A second case is showing dynamic processes, such as concurrent weather conditions on Earth that require temporal datasets. As a final example we use data from the New Horizons spacecraft which acquired images during a single flyby of Pluto. We visualize the acquisition process as well as the resulting surface data. Our work has been implemented in the OpenSpace software [8], which enables interactive presentations in a range of environments such as immersive dome theaters, interactive touch tables, and virtual reality headsets.

TopoAngler: Interactive Topology-Based Extraction of Fishes.

We present TopoAngler, a visualization framework that enables an interactive user-guided segmentation of fishes contained in a micro-CT scan. The inherent noise in the CT scan coupled with the often disconnected (and sometimes broken) skeletal structure of fishes makes an automatic segmentation of the volume impractical. To overcome this, our framework combines techniques from computational topology with an interactive visual interface, enabling the human-in-the-Ioop to effectively extract fishes from the volume. In the first step, the join tree of the input is used to create a hierarchical segmentation of the volume. Through the use of linked views, the visual interface then allows users to interactively explore this hierarchy, and gather parts of individual fishes into a coherent sub-volume, thus reconstructing entire fishes. Our framework was primarily developed for its application to CT scans of fishes, generated as part of the ScanAllFish project, through close collaboration with their lead scientist. However, we expect it to also be applicable in other biological applications where a single dataset contains multiple specimen; a common routine that is now widely followed in laboratories to increase throughput of expensive CT scanners.

The evolution of the anaplastic cerebellar liponeurocytoma: case report and review of the literature.

Cerebellar liponeurocytoma, first recognized as a distinct entity in the revised WHO classification of Tumors of the Central Nervous System in 2000, is a rare tumor with characteristic histological features and predominant location in the cerebellum. The proliferative index is usually low, and previous reports supported a favorable prognosis. We report a case of a second recurrence of a cerebellar liponeurocytoma with increased proliferative and mitotic activity in which extensive immunohistochemical characterization and genetic profiling were performed. The tumor specimen was characterized in terms of genetic changes frequently associated with gliomas and medulloblastomas. Considering the low number of reported cases, the prognosis of cerebellar liponeurocytoma seems difficult to assess. Our case suggests the existence of different histological grades of cerebellar liponeurocytoma and its possible progression towards a dedifferentiated, malignant phenotype, which has not yet been adequately taken into consideration in the current WHO classification.

High-profile flow diverter (silk) implantation in the basilar artery: efficacy in the treatment of aneurysms and the role of the perforators.

BACKGROUND AND PURPOSE: The introduction of flow diverters (FDs) has expanded the possibilities for reconstructive treatment of difficult intracranial aneurysms. Concern remains as to the long-term patency of the perforating arteries and side branches covered during stent placement. Our purpose was to evaluate the performance of and early effect on covered branches after implantation of the Silk FD in the treatment of basilar artery aneurysms. METHODS: Twelve patients with an aneurysm of the basilar artery that was treated by implantation of the Silk FD were included in our retrospective study. Both unruptured and previously ruptured, formerly untreated, and recurrent aneurysms were treated. During follow-up, patients were monitored for clinical evolution, patency of the covered vessels, and aneurysmal obliteration. RESULTS: Of the 2 ruptured aneurysms, 1 was initially treated by FD implantation. The FD covered the basilar bifurcation and the origin of a P1 segment of the posterior cerebral artery in 9 cases, the origin of the superior cerebellar artery in 9, and of the anterior inferior cerebellar artery in 3. There was 1 acute basilar artery occlusion a few hours after FD implantation. During a mean follow-up of 16 weeks, 3 patients experienced a symptomatic neurologic event. CONCLUSIONS: Implantation of the Silk FD in the basilar artery was feasible and well tolerated in most cases to date. However, late ischemic events affecting perforating arteries may occur after FD implantation, suggesting that the indication should be restricted to otherwise untreatable aneurysms in this location.

Free-hand four-dimensional echocardiography: a diagnostic tool in coronary artery disease.

Direct echocardiographic visualization of coronary arteries has been difficult due to the inherent problems involved in obtaining ultrasound access. We used freehand four-dimensional echocardiography in a 79-year-old patient with a trifurcational stenosis. We were able to identify a 6 x 11 mm possibly subintimal atheromathous plaque and to measure the diameters of the left descending coronary artery before, in, and behind the stenosis. There was good agreement with the angiographic measurements. This successful approach may be an argument to motivate further research in this area.