The Journey to Comprehensibility: Court Forms as the First Barrier to Accessing Justice

The article explores the comprehensibility of court forms by providing a quantitative overview and a qualitative analysis of such syntactic characteristics as length and structure of sentences and noun phrases. The analysis is viewed in the broader context of genre characteristics of court forms, their role within legal proceedings, and their function for eliciting narratives from court users. The findings show that while the elicitation strategies are not always coherently aligned with the guidance sections, the guidance itself condenses legal and procedural information into overly complex and verbose syntactic constructions. Comprehensibility barriers are thus created through breaks in information flow, ambiguous syntactic constructions, missing information and misalignment between questions and guidance. Such comprehension challenges have a negative impact on the potential of court users to effectively engage with legal proceedings.

Conventional Fluoroscopy-Guided vs Zero-Fluoroscopy Catheter Ablation of Supraventricular Tachycardias

Purpose: The aim of this study was to evaluate the safety and efficacy of zero-fluoroscopy (ZF) catheter ablation (CA) for supraventricular tachycardias (SVT).Methods: 584 consecutive patients referred to our institution for CA of SVT were analysed. Patients were categorised into two groups; zero-fluoroscopy (ZF) group and conventional fluoroscopy (CF) group. The ZF group was further divided into two subgroups (adults and paediatric). Patient characteristics, procedural information, and follow-up data were compared. Results: The ZF group had a higher proportion of paediatric patients (42.2% vs 0.0 %; p < 0.001), resulting in a younger age (30.9 ± 20.3 years vs 52.7 ± 16.5 years; p < 0.001) and lower BMI (22.8 ± 5.7 kg/m2 vs 27.0 ± 5.4 kg/m2; p < 0.001). Procedure time was shorter in the ZF group (94.2 ± 50.4 min vs 104.0 ± 54.0 min; p = 0.002). There were no major complications and the rate of minor complications did not differ between groups (0.0% vs 0.4%; p = 0.304). Acute procedural success as well as the long-term success rate when only the index procedure was considered did not differ between groups (92.5% vs 95.4%; p = 0.155; 87.1% vs 89.2%; p = 0.422). When repeated procedures were included, the long-term success rate was higher in the ZF group (98.3% vs 93.5%; p = 0.004). The difference can be partially explained by the operators' preferences.Conclusion: The safety and efficacy of ZF procedures in adult and paediatric populations are comparable to that of CF procedures.

Abstract 1122‐000176: Incidence and Predictors of Delayed Functional Independence in the TREVO Retriever Registry

Introduction : Chronological heterogeneity in the neurological improvement after endovascular thrombectomy (EVT) for large vessel occlusion (LVO) stroke is commonly observed in clinical practice. Understanding the temporal progression of functional independence after EVT, especially delayed functional independence in patients who do not experience early improvement, is essential for prognostication and rehabilitation. We aim to determine the incidence of early and delayed functional independence and identify associated predictors after EVT. Methods : Demographic, clinical, radiological, treatment, and procedural information were analyzed from TREVO registry (patients undergoing EVT in the setting of anterior circulation LVO using the Trevo stent‐retriever). Incidence and predictors of early functional independence (EFI, modified Rankin Scale (mRS) score 0–2 at discharge) and delayed functional independence (DFI, mRS score 0–2 at 90 days in non‐EFI patients) were analyzed. Results : A total of 1757 patients met study criteria. EFI was observed in 45% (785) of patients. Among non‐EFI patients (972), DFI was observed in 34% (332) of patients. Younger age (p<0.001), lower blood glucose (p<0.001), mTICI > = 2B (p = 0.01), and lower total number of thrombectomy passes (p = 0.004) were independent predictors of DFI. Conclusions : Approximately 45% of patients experience early functional independence. One‐third of non‐early improvers experience delayed functional independence. Younger age, lower blood glucose, better collateral grade, and lower total number of passes were independent predictors of DFI among non‐early improvers. Further studies are required to improve our understanding of DFI. No upload

Abstract 1122‐000211: Histology Profiles of Thrombi in Men and Women Undergoing Thrombectomy

Introduction : Understanding clot composition and associated genomic, epigenomic, and proteomic signatures could provide insight into thrombus biology and etiology, and aid in prognosis in stroke. We report preliminary analysis of histology evaluations in subjects enrolled in the INSIGHT Registry, a multicentered ‘multi‐omic’ analysis of thrombi associated with acute hemorrhagic and ischemic stroke this multi‐omic clot collection registry. Our aim was to determine potential histology differences between men and women with emergent large vessel occlusive thrombi. Methods : Subjects age ≥18 years, treated frontline with the Penumbra System® for thrombectomy are included in this analysis. Patient demographics, medical history, radiographic, and procedural information are collected in conjunction with extracted clot and concurrent extracranial arterial blood. Enrollment, data collection and monitoring are ongoing for the INSIGHT registry. While the protocol include analysis for proteomics and transcriptomics, for this analysis we used automated histology. An MSB Trichrome stain was used to evaluate the tissue. Composition was determined by automated pixel analysis, with the values representing ratios of the overall clot. Results : Samples from 60 subjects were enrolled from 10 sites between 02/2021 and 07/2021. Analysis of the thrombi determined the relative proportions of fibrin, red blood cells (RBCs), and platelets (PLT). The median RBC‐fibrin ratio did not differ between females (1.27, IQR 0.57‐2.62) n = 34 and males (0.95, IQR 0.41‐1.51) n = 26. However, the ratio was more widely distributed in females as seen in the wider IQR. Conclusions : These preliminary results demonstrate a lack of uniform differences in thrombus composition in males versus females with emergent large vessel occlusion. There may be more heterogeneity among females, which requires further study.

COVID-19 Tracheostomy: Experience in a University Hospital With Intermediate Follow-up

The benefits of percutaneous dilational tracheostomy (PDT) placement have been well documented in patients requiring prolonged mechanical ventilation. However, the data regarding the benefit of PDT in coronavirus-2019 (COVID-19) patients are scarce. The objective of this study is to evaluate the outcomes of a cohort of 37 patients who underwent tracheostomy as part of their COVID-19 care. Retrospective data from a series for 37 patients undergoing tracheostomy was collected using chart review. Primary outcomes included 30 and 60 day mortality, weaning rate, and decannulation rate. Secondary outcomes collected included admission demographics, comorbidities, and procedural information. Thirty-seven (37) patients requiring prolonged mechanical ventilation due to COVID-19. Of these 37 patients, 35 were alive 60 days post-PDT placement, 33 have been weaned from mechanical ventilation and 18 have been decannulated. The low mortality and high decannulation rates in this cohort in is a promising development in the care of critically ill COVID-19 patients. Of note, all participating physicians underwent routine polymerase chain reaction (PCR) testing for infection with the severe acute respiratory syndrome coronavirus-2 virus and no physician contracted COVID-19 as a result of their involvement. Overall, this case series describes the modified PDT technique used by our team and discusses the feasibility and potential benefit to PDT placement in COVID-19 patients requiring long-term mechanical ventilation.

Language Means of Process Category in the English Epizootological Terminology

Introduction. The article analyzes the features of the category of process in epizootological terminology and identifies a set of language tools in English that serve to express this category. The studied category is widely used in epizootological terminology. This is due to the variety of concepts of epizootological science, the number of forms of manifestation of the epizootic process, the evolution of veterinary knowledge, which is reflected in the semantics of terms. The purpose of the article is to study the role of the processes category and its linguistic expression in the epizootiological terminology of the English language. Materials and methods of research. The source base of the work was the terms obtained by the method of continuous sampling from lexicographic sources on epizootology. The main methods used in the study were systematization and categorical analysis of epizootiological terms. Results of the research. It is revealed that the following subcategories of the process are reflected in the veterinary terminology of epizootology: proper processes, states and events. The subcategory "proper processes" represents changes, the distinguishing feature of which is the development over time, duration and mode of the epizootic. Terms that objectify such signs express different types of movement and routes of transmission of infectious disease. The subcategory "state" is a special kind of process characterized by relative staticity. In the studied terminology, the category of condition is presented in the nominations of diseases, as well as physiological and pathophysiological conditions. The subcategory of "event" is represented by epizootological terms that nominate methods of treatment and prevention of infectious diseases. The author characterizes the linguistic means of the category of process in English: specialized morphemes, special vocabulary, syntactic constructions that carry procedural information. Сonclusions. It is determined that the category of process is widely used in epizootological terminology, as it is one of the basic categories used to classify the concepts of epizootology.

Raman Spectroscopy for the Analysis of Microplastics in Aquatic Systems

Raman spectroscopy is gaining ground in the analysis of microplastics, especially due to its high spatial resolution that allows the investigation of small plastic particles, whose numeric abundance is argued to be particularly relevant in aquatic systems. Here, we aimed at outlining the status of Raman analysis of microplastics from aquatic systems, highlighting the advantages and the drawbacks of this technique and critically presenting tools and ways to effectively employ this instrument and to improve the spectra obtained and their interpretation. In particular, we summarized procedural information for the use of Raman spectroscopy, and we discussed issues linked to fluorescence interference and the analysis of weathered polymers, which may complicate the interpretation of Raman signatures. In this context, a deep understanding of the different plastic polymers and their Raman peaks and chemical fingerprints is fundamental to avoid misidentification. Therefore, we provided a catalog with detailed information about peaks of most common plastic polymers, and this represents, to the best of our knowledge, the first comprehensive resource that systematically synthesized plastic Raman peaks. Additionally, we focused on plastic additives, which are contained in the majority of plastics. These compounds are often intense in Raman scattering and may partly or completely overlie the actual material types, resulting in the identification of additives alone or misidentification issue. For these reasons, we also presented a new R package “RamanMP” that includes a database of 356 spectra (325 of which are additives). This will help to foster the use of this technique, which is becoming especially relevant in microplastic analysis.

Access to Procedural Memories After One Year: Evidence for Robust Memory Consolidation in Tourette Syndrome

Tourette syndrome is a childhood-onset neurodevelopmental disorder characterized by motor and vocal tics. On the neural level, tics are thought to be related to the disturbances of the cortico-basal ganglia-thalamo-cortical loops, which also play an important role in procedural learning. Several studies have investigated the acquisition of procedural information and the access to established procedural information in TS. Based on these, the notion of procedural hyperfunctioning, i.e., enhanced procedural learning, has been proposed. However, one neglected area is the retention of acquired procedural information, especially following a long-term offline period. Here, we investigated the 5-hour and 1-year consolidation of two aspects of procedural memory, namely serial-order and probability-based information. Nineteen children with TS between the ages of 10 and 15 as well as 19 typically developing gender- and age-matched controls were tested on a visuomotor four-choice reaction time task that enables the simultaneous assessment of the two aspects. They were retested on the same task 5 hours and 1 year later without any practice in the offline periods. Both groups successfully acquired and retained the probability-based information both when tested 5 hours and then 1 year later, with comparable performance between the TS and control groups. Children with TS did not acquire the serial-order information during the learning phase; hence, retention could not be reliably tested. Our study showed evidence for short-term and long-term retention of one aspect of procedural memory, namely probability-based information in TS, whereas learning of serial-order information might be impaired in this disorder.

When Two Is Better than One

Background Delivery of most flow diverters (FD) requires larger, and thus stiffer microcatheters (0.021–0.027in.) which can pose challenges to intracranial navigation. The concomitant use of two microwires within one microcatheter, also known as the buddy-wire technique, may be helpful for navigation and support in challenging situations. Methods We analyzed all flow diverter procedures in our prospectively collected database. We recorded all patient-related, anatomical and procedural information. We performed univariate statistics and technical descriptions. Results In total, 208 consecutive patients treated with a FD at our institution between July 2014 and August 2020 were retrospectively analyzed. In 17 patients the buddy-wire technique was used (mean age 63 years, range 31–87 years: 16 female). Aneurysms were located at the petrous, cavernous, supraophthalmic internal carotid artery, and a proximal M2 branch in 2, 7, 7 and 1 patient(s), respectively. In all cases a 0.027in. microcatheter was used for device deployment. In 14 patients with a wide-necked aneurysm the buddy-wire provided additional support to advance the microcatheter and mitigated the ledge between the aneurysm neck and the parent artery or a side branch. In two giant cavernous aneurysms treated with telescoping FDs, the buddy-wire was used to re-enter the proximal end of the foreshortened FD. Conclusion The buddy-wire is a useful technique in FD procedures to prevent herniation of the microcatheter into the aneurysm sack, in wide-necked aneurysms to mitigate the ledge effect between the aneurysm neck and the parent artery where the microcatheter tip may get stuck, or to enable re-entry into a foreshortened FD.