Fluigi Cloud - A cloud CAD platform for microfluidics

With microfluidic large scale integration and the emergence of many new synthetic biology technologies, there is an ever increasing benefit in using computer automated design (CAD) tools for scaling designs to larger and more complex applications. In 2015 Xin Han et al. demonstrated the effective delivery of CRISPR-Cas9 to cells, which are normally difficult to transfect, using a microfluidic membrane device. To help researchers and engineers realize microfluidics for new synthetic biology applications, it is pertinent that they have access to CAD tools to facilitate the design process. Fluigi Cloud is an online platform designed with this goal in mind. It provides a suite of software tools for microfluidic CAD. This work describes some applications of Fluigi Cloud and the role it plays in the greater ecosystem of microfluidic design and synthetic biology

Abstract Number ‐ 171: Stroke location as predictor of bleeding after EVT for ischemic stroke in the anterior circulation

Introduction Hemorrhage is a known risk of Endovascular thrombectomy (EVT) for ischemic stroke . Several predictors of bleeding have been identified. However, stroke location has not yet been evaluated as an independent predictor. Methods Patients ≥ 18 years who underwent EVT for anterior circulation large vessel occlusion between January 1, 2020, and December 31, 2021, at our centre were included. After the exclusion criteria, a total of 344patients were analyzed. The admission CT scans were reviewed by a neuroradiologist to determine the ASPECTS, and classify the involved regions into location groups: only central core, only cortical, and both central and cortical areas. Post EVT images were evaluated to assign the Heidelberg bleeding classification. Statistical analysis was performed in R, version 4.1. For univariate analyses, Fisher’s exact or chi‐square test was used for categorical data. Quantitative data were tested for normality, and the t‐test or Mann‐Whitney test was applied accordingly. All variables in the univariate analyses with p 2A (89.5%). Bleeding occurred in 182 (52.9%) and intraparenchymal hematoma in 73 (21.2%) patients, with most bleeding only in the central core (65.4%), with the lentiform nucleus involved in 122 (67%) of the bleeds. Thirty‐eight patients died (11%), and 237 had a modified Rankin score > 2 at discharge (68.9%). Stroke location was significant for all types of bleeding (p < 0.001) and intraparenchymal hematoma (p = 0.137) in the univariate analyses. However, after multiple logistic regression, the stroke location was not an independent predictor of any type of bleeding. On the other hand, a lower ASPECTS was a significant predictor of all types of bleeding (p < 0.001; OR 1.347; 95% CI 1.1799 ‐ 1.539) and intraparenchymal hematoma (p = 0.009; OR 1.756; 95% CI 1.152 ‐ 2.677). In addition to ASPECTS, high NIHSS (p = 0.038; OR 1.058; 95% CI 1.003 ‐ 1.115) was a significant predictor of all types of bleeding, while high systolic blood pressure (p = 0.027; OR 1. 037;95% CI 1.004 ‐ 1.071), cardioembolic stroke (p = 0.042; OR 10.408; 95% CI 1.085 ‐ 99.889), and poor collaterals (p = 0.046; OR 5.068; 95% CI 1.029 ‐ 24.951) were significant for intraparenchymal hematoma. Conclusions Stroke location is not an independent predictor of bleeding. However, stroke size, as indicated by the ASPECT, is a predictor of bleeding after EVT. Moreover, some modifiable predictors were not significant because they are already controlled for in the study, but systolic pressure was a significant predictor of intraparenchymal hematoma and shows that more studies are needed to determine the appropriate control levels to reduce the chance of bleeding without compromising cerebral perfusion

Effect of Aneurysmal Subarachnoid Hemorrhage on Word Generation

Background. Aneurysmal subarachnoid hemorrhage (aSAH) survivors commonly exhibit impairment on phonemic and semantic fluency tests; however, it is unclear which of the contributing cognitive processes are compromised in aSAH patients. One method of disentangling these processes is to compare initial word production, which is a rapid, semiautomatic, frontal-executive process, and late phase word production, which is dependent on more effortful retrieval and lexical size and requires a more distributed neural network. Methods. Seventy-two individuals with aSAH and twenty-five control subjects were tested on a cognitive battery including the phonemic and semantic fluency task. Demographic and clinical information was also collected. Results. Compared to control subjects, patients with aSAH were treated by clipping and those with multiple aneurysms were impaired across the duration of the phonemic test. Among patients treated by coiling, those with anterior communicating artery aneurysms or a neurological complication (intraventricular hemorrhage, vasospasm, and edema) showed worse output only in the last 45 seconds of the phonemic test. Patients performed comparably to control subjects on the semantic test. Conclusions. These results support a “diffuse damage” hypothesis of aSAH, indicated by late phase phonemic fluency impairment. Overall, the phonemic and semantic tests represent a viable, rapid clinical screening tool in the postoperative assessment of patients with aSAH.Peer Reviewe

Effect of Aneurysmal Subarachnoid Hemorrhage on Word Generation

Background. Aneurysmal subarachnoid hemorrhage (aSAH) survivors commonly exhibit impairment on phonemic and semantic fluency tests; however, it is unclear which of the contributing cognitive processes are compromised in aSAH patients. One method of disentangling these processes is to compare initial word production, which is a rapid, semiautomatic, frontal-executive process, and late phase word production, which is dependent on more effortful retrieval and lexical size and requires a more distributed neural network. Methods. Seventy-two individuals with aSAH and twenty-five control subjects were tested on a cognitive battery including the phonemic and semantic fluency task. Demographic and clinical information was also collected. Results. Compared to control subjects, patients with aSAH were treated by clipping and those with multiple aneurysms were impaired across the duration of the phonemic test. Among patients treated by coiling, those with anterior communicating artery aneurysms or a neurological complication (intraventricular hemorrhage, vasospasm, and edema) showed worse output only in the last 45 seconds of the phonemic test. Patients performed comparably to control subjects on the semantic test. Conclusions. These results support a “diffuse damage” hypothesis of aSAH, indicated by late phase phonemic fluency impairment. Overall, the phonemic and semantic tests represent a viable, rapid clinical screening tool in the postoperative assessment of patients with aSAH

A step up to end tuberculosis: Lessons from a community-based death review of patients with tuberculosis from western India

Understanding factors leading to death following the onset of symptoms of tuberculosis (TB) is important to predict prognosis among patients with TB. With aiming the End TB strategy, mortality is declining not as expected globally and in India. Although India is one of the highest incidence countries globally, India lacks evidence of understanding of the factors for TB death. Thus, this study aims to document the characteristics of deaths due to TB in the Western state of India, Gujarat.About 74 deaths were randomly documented from 7 different geographic regions of Gujarat through a community-based death review from Oct 2021 to February 2022. The trained researchers administered a semi-structured questionnaire to capture the demographic, socioeconomic, history of comorbidity and addiction, medical history, case records, and chronology of events preceding death.Most deaths happened within 24 weeks from the onset of symptoms, which reduced to half (12 weeks) in the other cascades, i.e., diagnosis and treatment initiation to the death. Out of 74 reviewed deaths, 47 (64%) deaths had the cause of death as TB, with an average duration of 87 days from onset of symptoms to death. The study observed the time, place, and person distribution on different epidemiological parameters. While analyzing narratives from the relative, the gaps between the system (service provider) and demand (patient perspective) sides were synthesized.It is recommended to conduct such kind of community-based death reviews in the routine practices of the National TB Elimination Program to ensure the appropriate review of the underlying causes of deaths due to TB. The matrix developed in this study is easy to replicate in any other death reviews to understand the intercept of the supply-demand side determinants for the deaths