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Articles 102061 - 102090 of 2935740
Full-Text Articles in Entire DC Network
Digital Strolls Using Unicdent Toolkit-Part 2: Reimagining The Walking Method For Online Participation, Prashanti Eachempati, John Martin, Sally Hanks, Mona Nasser
Digital Strolls Using Unicdent Toolkit-Part 2: Reimagining The Walking Method For Online Participation, Prashanti Eachempati, John Martin, Sally Hanks, Mona Nasser
Peninsula Dental School
Distance and remoteness no longer pose barriers to conducting meaningful research, as the adaptation of participatory methods can address these challenges effectively. This article examines the transformation of the UniCDent Toolkit, originally designed to capture patients' perceptions of uncertainty in dental environments, for online participatory interactions with dentists. The toolkit, which uses the walking method, incorporates components such as imagery, gallery walks, quadrant mapping, and trade-offs to explore uncertainty in dental practice. Initially, dentists expressed discomfort in sharing their uncertainty in a group setting, prompting a shift to an online format that maintained participant engagement and created a safe space …
Examining The Impact Of Single-Case Design Graph Characteristics On Decision-Making For School-Based Professionals Within An Mtss Context, Jessica L. Andrews
Examining The Impact Of Single-Case Design Graph Characteristics On Decision-Making For School-Based Professionals Within An Mtss Context, Jessica L. Andrews
USF Tampa Graduate Theses and Dissertations
Research investigating the display of single-case design (SCD) data has demonstrated that graphing characteristics can influence visual analysis and rater interpretations regarding the effect of an intervention. Data-based decision making within school settings, particularly within the framework of Multi-Tiered Systems of Support (MTSS), commonly includes the use of SCD’s to support this process. Despite the push for adherence to a standard assembly for linear graphs, there is no requirement as to how these graphs should be constructed. MTSS team members are often required to make decisions about whether an intervention should be continued (or not), and thus it is important …
Future Of Work: Implication Of Green Economy On Employment Dynamics In Egypt, Sarah Adel Elgohary
Future Of Work: Implication Of Green Economy On Employment Dynamics In Egypt, Sarah Adel Elgohary
Theses and Dissertations
Is Egypt's green economy a reality or just a policy-level aspiration? This thesis explores the tangible impact of the green economy on Egypt's labor market by examining key sectors—automotive, agriculture, and renewable energy. Through qualitative interviews and focus group discussions with private sector representatives, the study assesses the true implications of the green transition from a business-level perspective, beyond the propaganda and hype surrounding climate policies. What is the current scale of the green economy in Egypt's labor market? What existing policies and regulatory frameworks are in place to support the green economy transition? how urgent is the transition to …
Finding Meaning In Loss: The Role Of Attachment Styles, Coping Strategies, And Resilience, Salma Seyam
Finding Meaning In Loss: The Role Of Attachment Styles, Coping Strategies, And Resilience, Salma Seyam
Theses and Dissertations
Grief is a deeply personal yet universal experience impacted by personal, social, and cultural factors. The present study examines how attachment styles, coping mechanisms, and resilience impact both grief intensity and the ability to find meaning after a loss, within an Egyptian sample. While previous studies have explored the experience of grief, few have looked at these factors within a Middle Eastern cultural context. A total of 140 bereaved Egyptians who experienced the loss of a loved one within the past three years completed standardized measures assessing grief intensity (Prolonged Grief Disorder-Revised; PG-13-R), coping strategies (Brief COPE), meaning-making (Grief and …
The Impact Of Currency Depreciation On Egyptian Exports: A Firm-Level Study, Noor Elghorab
The Impact Of Currency Depreciation On Egyptian Exports: A Firm-Level Study, Noor Elghorab
Theses and Dissertations
This study investigates the impact of real exchange rate depreciations of the Egyptian Pound on the intensive and extensive margins of firm-level exports in the years 2008, 2013, 2016, and 2020 using a comprehensive dataset of over 7,000 firms from the World Bank Enterprise Survey. Employing a firm-level fixed effects model, the study finds that real depreciation boosts export performance by 5.7 percentage points and 6.2 percentage points at the intensive and extensive margins respectively. Results also indicate a positive relationship between firm exports and firm size, foreign ownership, and firms with greater reliance on imports in their inputs. Additionally, …
Heightened Risk: Childhood Trauma And Anticipatory Grief Exacerbate The Impact Of Loneliness On Depressive Symptoms And Lps-Stimulated Cytokines In Dementia Caregivers, Kelly N. Brice, Jensine Paoletti-Hatcher, E Lydia Wu-Chung, Vincent D. Lai, Daniel L. Argueta, Michelle A. Chen, Itee Mahant, Bryan T. Denny, Charles Green, Luis D. Medina, Multiple Additional Authors
Heightened Risk: Childhood Trauma And Anticipatory Grief Exacerbate The Impact Of Loneliness On Depressive Symptoms And Lps-Stimulated Cytokines In Dementia Caregivers, Kelly N. Brice, Jensine Paoletti-Hatcher, E Lydia Wu-Chung, Vincent D. Lai, Daniel L. Argueta, Michelle A. Chen, Itee Mahant, Bryan T. Denny, Charles Green, Luis D. Medina, Multiple Additional Authors
Psychology Faculty Publications and Presentations
Dementia spousal caregivers are at a disproportionate risk for adverse mental and physical health outcomes. Loneliness is associated with depressive symptoms and proinflammatory cytokine production among caregivers. Additionally, childhood trauma, anticipatory grief, and poor sleep quality are all associated with enhanced stress reactivity. This study used a cross-sectional design to investigate whether loneliness is associated with proinflammatory cytokine production and depressive symptoms in caregivers, and whether these relationships are strongest among caregivers who report high levels of childhood trauma, high amounts of anticipatory grief, or poor sleep quality. A sample of 111 dementia spousal caregivers provided blood samples and completed …
Nepaliness As Assemblage: Diasporic Belonging, Colorism, And Caste In The Associational Life Of Nepali Migrants In Florida, Shuvechha Ghimire Sharma
Nepaliness As Assemblage: Diasporic Belonging, Colorism, And Caste In The Associational Life Of Nepali Migrants In Florida, Shuvechha Ghimire Sharma
USF Tampa Graduate Theses and Dissertations
The research fundamentally challenges romanticized ideas of migration—shedding older inequalities, idealizing “leveling up,” and being a part of “unified diasporic communities”—and unmasks a rather uneasy, far more intricate reality: the preexisting sociocultural and political structures and identities are not shed, rather actively reproduced and rigorously, often consciously, reconfigured within the transnational diasporic spaces. As such, the research reveals that Nepali diasporic associations in Florida play a vital role in perpetuating and reshaping social inequalities and contested national identities, significantly impacting transnational dynamics. The work contends that caste hierarchies persist in structuring associational life, influencing participation and resource distribution. Concurrently, colorism …
Community Garden's Second Growing Season Is Underway, Communications And Marketing
Community Garden's Second Growing Season Is Underway, Communications And Marketing
Campus News Archive
No abstract provided.
Exploring Leadership's Role In Improving Completion Rates In Substance Use Disorder Programs, Benjamin John Hoppie
Exploring Leadership's Role In Improving Completion Rates In Substance Use Disorder Programs, Benjamin John Hoppie
Walden Dissertations and Doctoral Studies
The problem addressed in this study was the influence of leadership on low treatment completion rates in a nonprofit outpatient substance use disorder program in the Pacific Northwest region of the United States. The purpose of this case study was to examine how leadership styles, decision-making processes, and supervisory alignment affected client engagement and treatment outcomes at the program. The study was grounded in the Baldrige Excellence Framework, which provided a systems-thinking lens to assess leadership behavior and organizational performance. Data were collected through semistructured interviews with two senior leaders and a review of limited internal documents, including the organization’s …
Alaska Educator Survey: Instrument Development Report, Dayna Jean Defeo, Staci Corey, Trang C. Tran
Alaska Educator Survey: Instrument Development Report, Dayna Jean Defeo, Staci Corey, Trang C. Tran
CAEPR Reports
This report details the survey development methodology for a statewide survey of in-service K-12 educators in Alaska. It describes the comprehensive literature review, document analysis, shareholder listening sessions, and cognitive interviewing activities that went into survey development.
Ways Of Living And Knowing, Reem El Hassan Mohamed
Ways Of Living And Knowing, Reem El Hassan Mohamed
Theses and Dissertations
After decades of sedentarization, the Muzeina tribe in South Sinai now has new generations born into sedentary lifestyles, never experiencing nomadism like their ancestors once did. This shift has impacted their knowledge system, traditionally shaped by interactions and kinship with nature. Exposure to social media is influencing younger generations' ways of living, raising the older generations’ concerns about their Bedouin identity. Despite being one of the largest tribes in South Sinai, the Muzeina are rarely represented in literature.
This ethnography explores the impact of sedentarization and contextual developments on the Muzeina's knowledge system, inherited from their ancestors. Muzeina’s relationship, and …
Exploring The Role Of Religious Media In Shaping Public Perceptions Towards Climate Change In Egypt, Hebatullah Ashour Abdel Fatah Ibrahim Ashour
Exploring The Role Of Religious Media In Shaping Public Perceptions Towards Climate Change In Egypt, Hebatullah Ashour Abdel Fatah Ibrahim Ashour
Theses and Dissertations
Climate change poses significant threats globally, with particular vulnerability noted in developing nations like Egypt. While effective communication is crucial for societal engagement, the role of influential actors like religious media within specific cultural contexts remains under-explored. This thesis investigates the role and communication practices of religious media (Islamic and Coptic Christian) concerning climate change in Egypt, a country where religious institutions command significant public trust and influence. Existing literature highlights gaps in understanding how these specific media outlets navigate and frame climate change discourse.
Employing Framing Theory and Communication for Development (DevCom) Theory as a combined framework, this study …
The Instrumentalization Of The Unprivileged Combatants By Western Countries Aimed To Oppress National Liberation Wars, Fares Mahmoud Def-Allah Abdelhamid
The Instrumentalization Of The Unprivileged Combatants By Western Countries Aimed To Oppress National Liberation Wars, Fares Mahmoud Def-Allah Abdelhamid
Theses and Dissertations
The goal of International Humanitarian Law (IHL) is purported to be the humanization of wars. Nonetheless, the atrocities committed in wars and the war criminals’ impunity suggest the failure of IHL. Notwithstanding, some voices call for reforming and developing IHL. In contrast, this thesis argues that IHL should be rejected entirely since the distinction between privileged and unprivileged combatants indicates that IHL is biased against anti-colonizers. It is biased in three senses. Firstly, IHL, particularly the distinction between privileged and unprivileged combatants, is dominated by Western rationality, which can be noticed in the domination of the civilization concept with its …
“Perfect Hearts And Pure Pages”: The Transmission And Recitation Of The Qur’An In Mamluk Cairo—The Shāṭibiyya As A Case Study, Jonathan Hearn
“Perfect Hearts And Pure Pages”: The Transmission And Recitation Of The Qur’An In Mamluk Cairo—The Shāṭibiyya As A Case Study, Jonathan Hearn
Theses and Dissertations
The Ḥirz al-Amānī wa-Wajh al-Tahānī of Abū al-Qāsim b. Fīrruh al-Shāṭibī (d. 590/1193) became one of the most widely studied texts associated with the recitation of the Qur’an. A didactic versification of Abū ʿAmr al-Dānī’s (d. 444/1053) Kitāb al-Taysīr fī al-Qirāʾāt al-Sabaʿ, the Shāṭibiyya was composed in Ayyubid Egypt and transformed the discipline of the variant readings (qirāʾāt). Despite its popularity and acknowledged impact upon the discipline, the Shāṭibiyya remains a relatively untapped resource for understanding the Qur’an in its recited form. This thesis studies the recitation of the Qur’an in Mamluk Cairo through the Shāṭibiyya, …
In-Service Teachers’ Awareness And Professional Development In Egyptian Public Schools, Hanan Mohamed Metawea
In-Service Teachers’ Awareness And Professional Development In Egyptian Public Schools, Hanan Mohamed Metawea
Theses and Dissertations
Neuroscience is an emergent field that focuses on studying brain structure and understanding its significance in the learning process. There has been a recent movement in how to bridge the gap between neuroscience concepts and education by incorporating neuroscience principles into the teaching process. However, there have been limited studies in Egypt on how educators understand and utilize neuroscience principles in the classroom. This qualitative exploratory case study examines Egyptian teachers’ understanding of neuroscience concepts and how they apply them in their teaching practices. This case study was carried out in two government schools, including interviews with 11 teachers representing …
The Social Standing Versus The Mind Standing Of Older Adults In Egypt: Cross-Sectional Analysis Of The Relationship Between Social Capital And Cognitive Functions, Shaza H. Shinaishen Dr
The Social Standing Versus The Mind Standing Of Older Adults In Egypt: Cross-Sectional Analysis Of The Relationship Between Social Capital And Cognitive Functions, Shaza H. Shinaishen Dr
Theses and Dissertations
Introduction: Egypt's population, much like that of other countries, is expected to age considerably over the course of the coming decades. Although biological and socioeconomic predictors of cognitive function have been studied widely, personal level social capital remains unexplored, especially in LMICs.
Purpose: This study primarily investigates the relationship between individual social capital and cognitive functioning among older adults aged 65 years and older in Egypt using the structural and cognitive components of social capital, including group membership, civic engagements, and caregiving roles.
Methods: A cross-sectional survey on 363 older individuals in different geographical and demographic segments of Egypt using …
Assessing The Impact Of Digital Transformation On Regulatory Processes And Systems Compared To Traditional Paper-Based Processes At The Egyptian Drug Authority, Rania Aa Soliman
Assessing The Impact Of Digital Transformation On Regulatory Processes And Systems Compared To Traditional Paper-Based Processes At The Egyptian Drug Authority, Rania Aa Soliman
Theses and Dissertations
In the past several decades, the rate of scientific and technological advancements in drug development and digital fields have been extraordinary. Internet of Things and block chain technologies are currently viable in the mature cloud computing industry, these transformative examples contrast starkly with the current pharmaceutical regulatory submission, review, and approval process of the EDA. However, with the emergence of initiatives that aim to improve and expedite regulatory decision-making, there is a promising future ahead. These initiatives, if successful, will not only transform the current transactional structure but also leverage scientific and technological advances to deliver patient-centric therapies. This radical …
Comparative Analysis Of Water Management Practices In Denmark, Egypt And Uganda: Implications For Sustainable Water Management In Uganda, Junior Twehamye Ashaba
Comparative Analysis Of Water Management Practices In Denmark, Egypt And Uganda: Implications For Sustainable Water Management In Uganda, Junior Twehamye Ashaba
Theses and Dissertations
Water scarcity and mismanagement are escalating global challenges, with over two billion people lacking access to safe drinking water and projections indicating that nearly two thirds of the world’s population could face water shortages by 2050 (Jones et al., 2024). This thesis presents an analysis of water governance and management practices in Denmark, Egypt, and Uganda-three countries that exemplify diverse hydro-climatic conditions, socioeconomic realities, and institutional frameworks. The study explains how governance structures, technological innovation, stakeholder participation, and policy design shape water resource outcomes, and how lessons from Denmark and Egypt can inform more resilient and sustainable water management in …
Bitcoin As A Currency: A Theoretical Framework Of Bitcoin’S Supply Effect On Consumption And Inflation, Begad Amr Hassan
Bitcoin As A Currency: A Theoretical Framework Of Bitcoin’S Supply Effect On Consumption And Inflation, Begad Amr Hassan
Theses and Dissertations
This thesis examines the macroeconomic effects of Bitcoin's fixed money supply within a dynamic general equilibrium context. Traditional Keynesian economics proposes that central banks regulate the money supply through interest rate manipulation and monetary interventions to promote economic stability within the market. However, cryptocurrencies, like Bitcoin, present a challenge due to their algorithmically predetermined supply, which halves every four years, removing discretionary monetary policy. By adapting Calvo's (1983) staggered-price model to a closed economy, supposing Bitcoin is the only medium of exchange, it is deduced that Bitcoin's deflationary nature causes a persistent consumption collapse and hyper deflationary spirals. Furthermore, calibrations …
5d Framework To Maximize Revit's Potential In Bim For Commercial Projects, Mohamed Swailim
5d Framework To Maximize Revit's Potential In Bim For Commercial Projects, Mohamed Swailim
Theses and Dissertations
This research investigates the integration of a 5D framework within Building Information Modeling (BIM) using software to optimize efficiency in the design and construction of commercial projects, specifically within the hospitality, retail, and residential sectors. While the advantages of BIM are well documented, its full potential remains underutilized, particularly in large-scale commercial developments that significantly impact national economies. A structured methodology was employed to address this gap, beginning with a systematic literature review (SLR) to explore existing applications of 5D-BIM in commercial projects, focusing on trends, challenges, and implementation strategies. Expert interviews were conducted to gain insights from professionals experienced …
Stuck In The Maze: Syrian Unaccompanied Children Navigating Spheres Of Protection In Egypt, Anouk Pelletier De Chambure
Stuck In The Maze: Syrian Unaccompanied Children Navigating Spheres Of Protection In Egypt, Anouk Pelletier De Chambure
Theses and Dissertations
This research explores the protection of Syrian unaccompanied and separated children (UASC) in Egypt who have fled the Syrian conflict and reflects on the role of formal protection providers and informal networks of solidarity. In hopes of pushing back against the over- essentialization of UASC as vulnerable children, this research unravels the lived experiences of seven aged-out Syrian UASCs who have been living in Egypt for a few years, which reveals their authentic and original crafting of spheres of protection. This thesis aims to contribute to a more extensive and more accurate understanding of the lives and needs of Syrian …
Practicality Of Implementing Sub-Clause 8.4 [Advance Warning] Of The Fidic 2017 Red Book In Egypt, Gehad Ibrahim
Practicality Of Implementing Sub-Clause 8.4 [Advance Warning] Of The Fidic 2017 Red Book In Egypt, Gehad Ibrahim
Theses and Dissertations
Disputes in construction projects can cause cost and time overruns that can be detrimental to the parties involved and to the project. Several measures have been advocated by the industry’s practitioners in an attempt to avoid disputes and their adverse impacts. One of these measures is the introduction of advance warning sub-clauses in construction contracts, where the contracting parties play a proactive and collaborative role in warning each other of potential adverse impacts to the project. Such clauses have been in the NEC suite of standard construction contracts for decades and have recently found their way to the 2017 edition …
The Communal Lyric: Poetry In Devotional And Oppressed Communities, Michael N. Yacoub
The Communal Lyric: Poetry In Devotional And Oppressed Communities, Michael N. Yacoub
Theses and Dissertations
This thesis investigates the interaction between lyric and community; it asks what a communal lyric is, how it functions, and to what ends. In Chapter One, I compare Jonathan Culler’s performative model of lyric with the theory of Takhyīl as expounded by Arab philosopher-critics al-Farabi, Ibn Sina, and al-Qartajanni to argue that a communal lyric is a form of audience-oriented public discourse distinguished by formal features that prompt the poem’s (re-)iteration and establish an interpersonal relationship with the audience in order to influence them and make shareable value claims about the world. In Chapters Two and Three I provide close-reading …
Opportunistic Networks On The Move: A Context-Aware Framework For Opportunistic Networking Under Heterogeneous Mobility Settings, Sara Elsingergy
Opportunistic Networks On The Move: A Context-Aware Framework For Opportunistic Networking Under Heterogeneous Mobility Settings, Sara Elsingergy
Theses and Dissertations
Most computer networks require continuous end-to-end connectivity between sending and destination nodes for data transfer. However, in certain scenarios—such as disaster zones, geographically remote areas with intermittent or no connectivity, or regions facing peak network loads—such continuous communication paths may be unavailable. A notable example of this challenge occurred during Hurricane Milton in 2024 and the Los Angeles wildfires in 2025, where Starlink provided free satellite internet to support disaster relief efforts and enable communication in affected areas. However, while offering satellite services at no cost can be effective in emergencies, it may not always be feasible on a global …
“Redefining The Fortress” Migrant Experiences, Adaptation And Connection Within Serbian Borderlands, Nicholas J. Leone
“Redefining The Fortress” Migrant Experiences, Adaptation And Connection Within Serbian Borderlands, Nicholas J. Leone
Theses and Dissertations
Abstract This thesis seeks to examine migrant experiences due to Serbia's geopolitical significance along the so-called Balkan route, and how this is specifically exemplified in the northern autonomous region of Vojvodina. Serbia’s position outside the external border of the European Union has caused it to be a strategic transit point for migrants en route to desired destinations, typically within Western and Northern Europe. However, the European Union’s externalization policies in partnership with Serbian authorities have played an extensive role in migration mobility patterns and humanitarian conditions for migrants traversing within the Serbian borderlands, specifically along the border with Hungary. The …
The Sealed Palace: How Direct Access To The Supreme Constitutional Court Can Bridge The Gaps In Constitutional Review In Egypt, Ahmed Sameh Fahmi
The Sealed Palace: How Direct Access To The Supreme Constitutional Court Can Bridge The Gaps In Constitutional Review In Egypt, Ahmed Sameh Fahmi
Theses and Dissertations
This thesis examines the limitations of Egypt’s current constitutional review system and argues for the introduction of a direct access mechanism to the Supreme Constitutional Court (SCC). Under Egypt’s centralized model of judicial review, individuals are restricted to indirect access through ordinary courts, which has resulted in significant procedural and substantive inefficiencies. The referral-based mechanism of judicial review of legislation has caused delays in adjudicating constitutional claims, the insulation of certain laws from review, legislative omissions, and excessive gatekeeping by lower courts. Through a comparative analysis of direct access models in Colombia, Germany, Turkey, and South Africa, the thesis identifies …
A Tragedy Of Incommensurability: Indigenous Rights And The Limits Of Human Rights Law, Zeina Ali
A Tragedy Of Incommensurability: Indigenous Rights And The Limits Of Human Rights Law, Zeina Ali
Theses and Dissertations
This thesis explores the tragedy of incommensurability between indigenous rights and international human rights law. Despite the emergence of frameworks like the United Nations Declaration on the Rights of Indigenous Peoples (UNDRIP), indigenous calls for sovereignty remain fundamentally unintelligible within a liberal order structured to preserve settler-state legitimacy. Tracing the historical and theoretical evolution of indigenous advocacy, this study critiques the strategic shift from demands for self-determination to claims of cultural rights. It argues that this shift offers no real alternative: self-determination and cultural rights are functionally equivalent, as both are ultimately filtered through legal and political frameworks that cannot …
The Craft Of Tally: Tracing Marketability And Economic Sustainability Of Crafts, Mariam Mabrouk
The Craft Of Tally: Tracing Marketability And Economic Sustainability Of Crafts, Mariam Mabrouk
Theses and Dissertations
This thesis explores the marketability and economic sustainability of the Tally craft in Gezeirit
Shandaweel, Sohag, Egypt, with a focus on how the craft navigates the tension between cultural
preservation and economic adaptation. Tally, a traditional form of embroidery, has deep cultural
roots in Egypt but faces significant challenges due to global market dynamics, shifting consumer
preferences, and systemic institutional neglect. Through an ethnographic case study, this research
investigates how artisans, institutions, and market forces interact to shape the craft's future. The
study examines the role of cultural perceptions, innovation, and institutional support in fostering
or hindering Tally's economic viability. …
Osteopathic Graduates In Plastic Surgery: How Can We Improve The Pipeline?, Kristof S. Gutowski, Irene Yau, Ariel E. Figueroa, Alice Yau, Marina A. Lentskevich, Kristyn N. Kraus, Jordan E. Wiebe, Gregory A. Greco, Arun K. Gosain
Osteopathic Graduates In Plastic Surgery: How Can We Improve The Pipeline?, Kristof S. Gutowski, Irene Yau, Ariel E. Figueroa, Alice Yau, Marina A. Lentskevich, Kristyn N. Kraus, Jordan E. Wiebe, Gregory A. Greco, Arun K. Gosain
Student Publications
Background: Integrated plastic surgery residency is one of the most competitive specialties for medical students to match into. This study was performed to identify trends in osteopathic applicants to plastic surgery and current osteopathic trainees within the field. Furthermore, we explore osteopathic students’ perception of plastic surgery and identify methods that our national societies can utilize to foster exposure to the field.
Methods: All integrated and independent plastic surgery training programs were identified from the Accreditation Council for Graduate Medical Education. Trainees’ medical education was obtained via program websites and public profiles. An anonymous survey was distributed to Student Affairs …
Treatment Outcomes Of Successful M1 Versus M2 Thrombectomy For Low-Aspects Stroke Patients, Huanwen Chen, Marco Colasurdo, Hidetoshi Matsukawa, Conor Cunningham, Ilko Maier, Pascal Jabbour, Joon-Tae Kim, Stacey Quintero Wolfe, Ansaar Rai, Robert M Starke, Marios-Nikos Psychogios, Amir Shaban, Nitin Goyal, Shinichi Yoshimura, Hugo Cuellar, Brian Howard, Ali Alawieh, Ali Alaraj, Mohamad Ezzeldin, Daniele G Romano, Omar Tanweer, Justin Mascitelli, Isabel Fragata, Adam Polifka, Fazeel Siddiqui, Joshua Osbun, Roberto Crosa, Ramesh Grandhi, Charles Matouk, Min S Park, Michael R Levitt, Waleed Brinjikji, Mark Moss, Ergun Daglioglu, Richard Williamson, Pedro Navia, Shakeel Chowdhry, David J Altschul, Alejandro M Spiotta, Peter Kan
Treatment Outcomes Of Successful M1 Versus M2 Thrombectomy For Low-Aspects Stroke Patients, Huanwen Chen, Marco Colasurdo, Hidetoshi Matsukawa, Conor Cunningham, Ilko Maier, Pascal Jabbour, Joon-Tae Kim, Stacey Quintero Wolfe, Ansaar Rai, Robert M Starke, Marios-Nikos Psychogios, Amir Shaban, Nitin Goyal, Shinichi Yoshimura, Hugo Cuellar, Brian Howard, Ali Alawieh, Ali Alaraj, Mohamad Ezzeldin, Daniele G Romano, Omar Tanweer, Justin Mascitelli, Isabel Fragata, Adam Polifka, Fazeel Siddiqui, Joshua Osbun, Roberto Crosa, Ramesh Grandhi, Charles Matouk, Min S Park, Michael R Levitt, Waleed Brinjikji, Mark Moss, Ergun Daglioglu, Richard Williamson, Pedro Navia, Shakeel Chowdhry, David J Altschul, Alejandro M Spiotta, Peter Kan
Faculty, Staff and Students Publications
Background
The effectiveness of endovascular thrombectomy (EVT) for low Alberta Stroke Program Early CT score (ASPECTS) stroke patients with occlusion of the second segment of the middle cerebral artery (M2) is unclear.
Methods
This was a multicenter retrospective study. Patients with M1 or M2 occlusions and low ASPECTS (< 6) who underwent successful EVT (modified treatment in cerebral ischemia score of 2b or higher) were included. Primary outcome was futile EVT reperfusion (defined as 90-day modified Rankin scale of 5 or 6). Other outcomes of interest include acceptable outcomes (modified Rankin scale of 3 or less) and intracranial hemorrhage (ICH), and all-cause 90-day mortality. Outcomes for M1 patients were compared to M2 patients with multivariable logistic regression models accounting for potential confounders.
Results
173 patients with M1 or M2 occlusions and low ASPECTS (< 6) who underwent successful EVT were identified. After multivariable adjustments, M2 patients had significantly higher odds of futile reperfusion (OR 5.48 [95%CI 1.91 to 15.7], p = 0.002), lower odds of acceptable outcomes (OR 0.33 [95%CI 0.12 to 0.89], p = 0.028), and higher odds of all-cause mortality (OR 4.90 [95%CI 1.65 to 14.5], p = 0.004). These findings suggest that EVT's efficacy for low-ASPECTS stroke patients may be diminished for patients with M2 occlusions. M2 occlusion was not significantly associated with ICH.
Conclusions
Among low-ASEPCTS stroke patients who underwent successful EVT, those with M2 occlusions had significantly higher odds of poor outcome compared to those with M1 occlusions.