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    Date Issued2020 (2)Author
    Lin, Hannah (2)
    Cerniglia, Christopher (1)Lo, Hao S. (1)Shiang, Tina (1)UMass Chan AffiliationDepartment of Radiology (1)Neuro-Interventional Radiology (1)Radiology (1)School of Medicine (1)Document TypeJournal Article (1)Master's Thesis (1)KeywordRadiology (2)Acute Ischemic Stroke (1)Communication (1)COVID-19 (1)Endovascular (1)View MoreJournalClinical imaging (1)

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    Radiology podcasting as a model for asynchronous remote learning in the COVID-19 era

    Shiang, Tina; Cerniglia, Christopher; Lin, Hannah; Lo, Hao S. (2020-11-26)
    RATIONALE AND OBJECTIVES: We aimed to create an open access online radiology podcast to educate listeners at any time, from anywhere. To meet learner needs and improve the likelihood of successful implementation and utilization, we assessed radiology trainee attitudes and experiences of podcasts. MATERIALS AND METHODS: We developed an educational podcast, From the Viewbox, focused on evergreen themes and practical approaches to radiology. Content categories included Diagnostic Approach, Specific Imaging Diagnoses, Noninterpretive Skills, and Special Topics. We released and promoted episodes on multiple digital platforms. Radiology trainees were surveyed and data were analyzed to assess listener preferences and usage trends. RESULTS: Only 19% of our trainees had previously listened to a radiology podcast, yet 81% expressed interest in listening routinely. After initial release, 86% of trainees listened to the podcast and 62% listened routinely. Episodes gained the most plays immediately following release but retained and continued to attract more listeners. The most popular episode discussing COVID-19 diagnosis and imaging, emphasized the importance of selecting high yield content to match listener needs. Most trainees felt the podcast had "very high" or "high" value in educational value, accessibility, and time efficiency. CONCLUSIONS: From the Viewbox offers efficient and accessible audio-only learning modules that can be used independently or effectively paired with traditional resources to decrease barriers in radiology education and enhance learner productivity. Podcasting is an underutilized asynchronous remote learning tool that can help overcome current challenges of social distancing, and more importantly address the diverse preferences and needs of our learners.
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    Factors Associated with Mortality After Undergoing Thrombectomy for Acute Ischemic Stroke

    Lin, Hannah (2020-06-12)
    Background: Mechanical thrombectomy is the gold standard for treating patients with certain acute ischemic stroke (AIS) due to large vessel occlusion (LVO). However, even with major advancements and increasing procedural volumes, acute endovascular therapy remains a high-risk procedure with a considerable 90-day mortality rate, affected by a variety of factors. Purpose: To investigate various clinical and procedural factors associated with 90-day mortality in patients undergoing mechanical thrombectomy for emergent treatment of AIS and determine which of these factors made unique contributions to post-thrombectomy prognosis. Methods: We examined a prospective registry of 323 patients treated with endovascular thrombectomy for AIS between 2016 and 2019 at a high-volume comprehensive stroke center in central Massachusetts. We developed two multivariable logistic regression models adjusting for the contributions of baseline characteristics and recanalization parameters, to identify potential predictors of mortality at 90 days. Results: Among 323 AIS patients treated with mechanical thrombectomy, the overall rate of successful recanalization was 86% and the overall post-procedure mortality rate was 29% by 90 days. After univariate analysis, a baseline multivariable model comprised of: history of stroke (OR 0.28, 95% CI 0.09 – 0.68), pre-stroke modified Rankin Scale (mRS 2: OR 3.75, 95% CI), severe admission National Institutes of Health Stroke Scale (NIHSS 21–42: OR 12.36, 95% CI 1.48 – 103.27), internal carotid artery (ICA) occlusion (OR 2.77, 95% CI 1.18 – 6.55), and posterior circulation occlusion (OR 2.69, 95% CI 1.06 – 6.83) was prognostic of 90-day mortality. A second multivariable model also found the procedural factors of: clot obtained after each pass (OR 0.49, 95% CI 0.24 – 1.00), successful recanalization (OR 0.21, 95% CI 0.06 – 0.8) and symptomatic intracranial hemorrhage (sICH; OR 17.89, 95% CI 5.22 – 61.29) to be identifiable predictors of post-thrombectomy mortality. Conclusion: Death within 90 days after thrombectomy was increased among patients with higher pre-stroke disability, higher stroke severity on admission, ICA or posterior occlusion, and those with sICH complication. A history of stroke, clot extraction after each device pass, and successful recanalization are associated with decreased 90-day mortality. These identifiable contributors may inform patient selection, prognosis evolution, and shared decision-making regarding emergent thrombectomy for treatment of AIS.
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