P.144 Patient-relevant deficit dictates EVT decision-making in low NIHSS patients with medium vessel occlusion stroke

Background: There are no recommendations regarding endovascular treatment (EVT) for patients with acute ischemic stroke (AIS) due to primary medium vessel occlusion (MeVO). The aim of this study was to examine the willingness to perform EVT among stroke physicians in patients with mild, yet personally-disabling deficits due to MeVO. Methods: In an international survey consisting of 4 cases of primary MeVOs, participants were asked whether the presence of personally-disabling deficits would influence their decision-making for EVT despite the patients having low NIHSS scores. Decision rates were calculated based on physician characteristics. Clustered univariable logistic regression was performed. Results: 366 participants from 44 countries provided 2562 answers. 56.9% opted to perform EVT in scenarios in which the deficit was relevant to the patient’s profession versus 41.0% in which no information regarding patient profession was provided (RR1.39, p<0.001). The largest effect sizes were seen for female participants (RR1.68, 95%CI:1.35-2.09), participants >60 years (RR1.61, 95%CI:1.23-2.10), with more neurointervention experience (RR1.60, 95%CI:1.24-2.06), and who personally performed >100 EVTs per year (RR1.63, 95%CI:1.22-2.17). Conclusions: The presence of a patient-relevant deficit in low NIHSS AIS due to MeVO is an important factor for EVT decision-making. This may have relevance for the conduct and interpretation of low NIHSS EVT randomized trials.

The Use of English on Instagram Captions: A Case Study in Camera Indonesia Photography Community

Along with Instagram's growing popularity as the primary medium for sharing photos and videos, the world of photography is also expanding at a rapid pace. The Instagram caption is always dropped every time people upload on social media. Photo captions often act as a result of critical thinking and a way to communicate ideas. This study used a qualitative descriptive approach to collect and describe information about using English caption on Instagram photos from the perspectives of Camera Indonesia photography community members: frequency, the purpose for dropping captions in English, its effect on their photo works, and how they view English captions on others people’ photo captions. Using 10 members as the respondents, the study found that writing caption in English acts mostly as self-expression and has not yet been done on a daily basis as the respondents do not habituate reading English materials.

Drawing on an architecture of blindness: A critique of the visual privilege operating in architectural representation

<p><b>This thesis exhibits the visual medium of architectural representation destabilized and reinterpreted by locating blindness in architecture. What can blind drawing allow architects to see? </b></p> <p>As a primary medium of architectural representation, drawing is an agency through which architecture is conceptualised, developed and disseminated. Conventionally, drawings are generated and perceived through sight: they are visual projections. Such visual privilege reduces the subject of architectural representations to visible, physical elements of buildings, while invisible, and/or intangible aspects of architectural experience often lack consideration in drawing. The architectural design process can be described as the translation of architecture between the mediums of drawing and building. The context of representation describes this translation as shifting from conceptual to conventional drawing types. While the visual privilege constantly operates in both conceptual and conventional drawing, the differences between their visual languages enable them to describe different aspects of architectural experience. The main difference that this thesis explores is the strictly visual vocabulary of conventional drawing, and the ambiguous capacity of conceptual drawing, enabling it to reference both visual and non-visual aspects of architectural experience. </p> <p>This thesis places conceptual and conventional drawing in parallel, aiming to exaggerate their differences on paper, and what they represent in reality, highlighting where and how architecture risks being weakened during a course of translation. The first half challenges the visual privilege through blind drawing as an alternative mode of conceptual drawing, while the second half identifies invisible aspects of architectural experience that cannot be depicted through conventional drawing. In concluding the research, these differences also evidence opportunities offered by the dual capacity of architectural representation, which simultaneously depicts visible (and physical), and invisible (and intangible) elements. For example, a line as a wall, also defines invisible space either side of said wall – perhaps dotted by the warmth of morning sun and cooler patches of shadow cast by window mullions. This thesis addresses a shift away from the ingrained visual privilege thriving in architectural thought. While drawing remains an inevitably visual medium, the design process must consider both visual and non-visual aspects, equally incorporated by an architectural experience. To exploit the dual capacity of representation, such methods of drawing should encourage architects to draw as though they are blind.</p>

Drawing on an architecture of blindness: A critique of the visual privilege operating in architectural representation

<p><b>This thesis exhibits the visual medium of architectural representation destabilized and reinterpreted by locating blindness in architecture. What can blind drawing allow architects to see? </b></p> <p>As a primary medium of architectural representation, drawing is an agency through which architecture is conceptualised, developed and disseminated. Conventionally, drawings are generated and perceived through sight: they are visual projections. Such visual privilege reduces the subject of architectural representations to visible, physical elements of buildings, while invisible, and/or intangible aspects of architectural experience often lack consideration in drawing. The architectural design process can be described as the translation of architecture between the mediums of drawing and building. The context of representation describes this translation as shifting from conceptual to conventional drawing types. While the visual privilege constantly operates in both conceptual and conventional drawing, the differences between their visual languages enable them to describe different aspects of architectural experience. The main difference that this thesis explores is the strictly visual vocabulary of conventional drawing, and the ambiguous capacity of conceptual drawing, enabling it to reference both visual and non-visual aspects of architectural experience. </p> <p>This thesis places conceptual and conventional drawing in parallel, aiming to exaggerate their differences on paper, and what they represent in reality, highlighting where and how architecture risks being weakened during a course of translation. The first half challenges the visual privilege through blind drawing as an alternative mode of conceptual drawing, while the second half identifies invisible aspects of architectural experience that cannot be depicted through conventional drawing. In concluding the research, these differences also evidence opportunities offered by the dual capacity of architectural representation, which simultaneously depicts visible (and physical), and invisible (and intangible) elements. For example, a line as a wall, also defines invisible space either side of said wall – perhaps dotted by the warmth of morning sun and cooler patches of shadow cast by window mullions. This thesis addresses a shift away from the ingrained visual privilege thriving in architectural thought. While drawing remains an inevitably visual medium, the design process must consider both visual and non-visual aspects, equally incorporated by an architectural experience. To exploit the dual capacity of representation, such methods of drawing should encourage architects to draw as though they are blind.</p>

Thrombectomy for secondary distal, medium vessel occlusions of the posterior circulation: seeking complete reperfusion

BackgroundWhether to approach distal occlusions endovascularly or not in medium-sized vessels secondary to proximal large vessel occlusion stroke remains unanswered.ObjectiveTo investigates the technical feasibility and safety of thrombectomy for secondary posterior circulation distal, medium vessel occlusions (DMVO).MethodsTOPMOST (Treatment fOr Primary Medium vessel Occlusion STroke) is an international, retrospective, multicenter, observational registry of patients treated for distal cerebral artery occlusions. This study subanalysis endovascularly treated occlusions of the posterior cerebral artery in the P2 and P3 segment secondary preprocedural or periprocedural thrombus migration between January 2014 and June 2020. Technical feasibility was evaluated with the modified Thrombolysis in Cerebral Infarction (mTICI) scale. Procedural safety was assessed by the occurrence of symptomatic intracranial hemorrhage (sICH) and intervention-related serious adverse events.ResultsAmong 71 patients with secondary posterior circulation DMVO who met the inclusion criteria, occlusions were present in 80.3% (57/71) located in the P2 segment and in 19.7% (14/71) in the P3 segment. Periprocedural migration occurred in 54.9% (39/71) and preprocedural migration in 45.1% (32/71) of cases. The first reperfusion attempt led in 38% (27/71) of all cases to mTICI 3. On multivariable logistic regression analysis, increased numbers of reperfusion attempts (adjusted odds ratio (aOR)=0.39, 95% CI 0.29 to 0.88, p=0.009) and preprocedural migration (aOR=4.70, 95% CI,1.35 to 16.35, p=0.015) were significantly associated with mTICI 3. sICH occurred in 2.8% (2/71).ConclusionThrombectomy for secondary posterior circulation DMVO seems to be safe and technically feasible. Even though thrombi that have migrated preprocedurally may be easier to retract, successful reperfusion can be achieved in the majority of patients with secondary DMVO of the P2 and P3 segment.

Vessels of Consciousness

The modern turn to psychological inwardness in the novel has often been discussed with reference to William James’s phrase, “vessel of consciousness.” Much of this chapter concerns his brother, Henry James, and his theorization of perspectivally delimited states of consciousness as a primary medium for the novel. James’s theories make a point of gendering this delimitation, claiming that female consciousness, historically constrained by lack of access to masculine vocations, actually possesses an awareness of the world advantageously enlarged by the exercise of imagination. James’s theory is placed against the backdrop of the novel’s gradual turn from epistemological to psychological veracity, from chronicling the material and social world to anatomizing the vicissitudes of consciousness as such—a transition from “character” to “psychology,” a transition made evident in Stendhal’s novel The Red and the Black. Once the twentieth-century novel establishes the vessel of consciousness as a primary component of its generic toolkit, the fragility of the vessel became apparent, and a technical gain in verisimilitude (refinement of character psychology) turned out to be discordant with the generically contracted principle of reality in previous fiction. The vessel of consciousness could no longer be confined to the novel itself, but became contingent on the participatory immersion of the reader’s consciousness as well.

AI Multi Agent Shopping System

The aim of "Ai multi agent Shopping system" helps the user to search products and compare the price of the particular product and shows the least price of the product. Nowadays e-shopping systems use the Internet as its primary medium for transactions. E-shopping has grown in popularity over the years, mainly because people find it easy to buy number of products comfortably from their places. This technology is used to improve the customer’s needs which include faster response time. Agent for e-Shopping creates connectivity on an anytime-anywhere & any basis to provide the specific products required by the customers based on optimization and scalability. When a user search for a particular product the agent search that product on the site which has been given and compare that particular products price and it will show the least price on the right side. The conclusion shows that the system can help customers to save time for Internet shopping.

Grappling with the learning modules: Experience of Public Elementary Pupils Attending English Written Modular Classes

Modular Distance Learning is one of the educational trends brought about by the pandemic. The recent use of this model of learning delivery has put teaching and learning into an adjustment period. This particular challenge has been the urgent imperative to have modular classes. It implies designing and organizing for better learning. English is the primary medium of instruction in education, and most of the modules written in the given language posing additional challenges and demands to school learners. Hence, this paper endeavors to investigate the lived experiences of the pupils in answering English-written modules through a qualitative design with a phenomenological approach. The participants of the study were eight Grade 6 pupils determined using the purposive sampling technique with some inclusion criteria. Data were gathered through an in-depth interview and were analyzed using a recursive textual analysis aided by Lichtman’s 3c's: coding, categorizing, and conceptualizing. The study revealed that quality education in the locality during this time of pandemic is greatly affected by the delivery modality, the curriculum content and standards, educational equipment and resources, the competence of parents to give assistance, and the readiness of the learners to read and learn independently.