Portable cerebral blood flow monitor to detect large vessel occlusion in patients with suspected stroke.

BACKGROUND: Early detection of large vessel occlusion (LVO) facilitates triage to an appropriate stroke center to reduce treatment times and improve outcomes. Prehospital stroke scales are not sufficiently sensitive, so we investigated the ability of the portable Openwater optical blood flow monitor to detect LVO. METHODS: Patients were prospectively enrolled at two comprehensive stroke centers during stroke alert evaluation within 24 hours of onset with National Institutes of Health Stroke Scale (NIHSS) score ≥2. A 70 s bedside optical blood flow scan generated cerebral blood flow waveforms based on relative changes in speckle contrast. Anterior circulation LVO was determined by CT angiography. A deep learning model trained on all patient data using fivefold cross-validation and learned discriminative representations from the raw speckle contrast waveform data. Receiver operating characteristic (ROC) analysis compared the Openwater diagnostic performance (ie, LVO detection) with prehospital stroke scales. RESULTS: Among 135 patients, 52 (39%) had an anterior circulation LVO. The median NIHSS score was 8 (IQR 4-14). The Openwater instrument had 79% sensitivity and 84% specificity for the detection of LVO. The rapid arterial occlusion evaluation (RACE) scale had 60% sensitivity and 81% specificity and the Los Angeles motor scale (LAMS) had 50% sensitivity and 81% specificity. The binary Openwater classification (high-likelihood vs low-likelihood) had an area under the ROC (AUROC) of 0.82 (95% CI 0.75 to 0.88), which outperformed RACE (AUC 0.70; 95% CI 0.62 to 0.78; P=0.04) and LAMS (AUC 0.65; 95% CI 0.57 to 0.73; P=0.002). CONCLUSIONS: The Openwater optical blood flow monitor outperformed prehospital stroke scales for the detection of LVO in patients undergoing acute stroke evaluation in the emergency department. These encouraging findings need to be validated in an independent test set and the prehospital environment.

I am what I am: The role of essentialist beliefs and neurodivergent identification on individuals' self-efficacy.

Essentialism is the belief that members of particular categories (e.g., social and cultural) are united by an innate underlying essence. While such beliefs have been associated with negative outcomes such as stereotyping, discrimination, and prejudice, minority group members can sometimes use essentialist beliefs to validate their identities. Here, we focus on people who identify as "neurodivergent"-individuals whose brains differ from typical neurology (such as those with autism, attention deficit hyperactivity disorder, etc.). We examined whether endorsing essentialist beliefs about neurodivergence serves a protective function among 316 neurodivergent-identifying individuals. As expected, endorsing essentialist beliefs was related to higher self-efficacy. This was especially true of people who highly identified as neurodivergent. These results illuminate how essentialist beliefs may empower a group that is often negatively stereotyped. (PsycInfo Database Record (c) 2023 APA, all rights reserved).