Rapid Software Research Articles

Optimizing spare part monitoring: Innovative dashboard system design for commanditaire vennotschaap using rapid application development

This research focuses on digital transformation at the Try Jaya Mobil workshop, which relies on manual processes for recording spare parts sales transactions and generating financial reports. This manual process causes various challenges, such as mismatches between incoming data and orders and a lack of historical sales records that hinder data search and analysis. The absence of a computerized system also reduces stock management and customer service efficiency. This research uses the Rapid Application Development (RAD) method to design a more sophisticated spare parts monitoring information system. The Rapid Application Development approach enables iterative and rapid software development, involving users at every stage. The information system is designed to improve accuracy, speed, and operational efficiency and enable better stock recording and monitoring. The results show that implementing a RAD-based information system can significantly improve customer service and Try Jaya Mobil's competitiveness in the market. Evaluation of the system after implementation showed improvements in operational efficiency, data accuracy, and user satisfaction. With this digital transformation, Try Jaya Mobil is expected to optimize its services and strengthen its competitive automotive industry position.

Elevated cortical blood flow insufficiency volume as a predictor of adverse outcomes in aneurysmal subarachnoid hemorrhage: a large prospective quantitative computed tomography perfusion study

PurposeEarly hypoperfusion changes exist in patients with aneurysmal subarachnoid hemorrhage (aSAH). We aimed to investigate a readily obtainable quantitative computed tomography perfusion (CTP) parameter that could assist in quickly identifying patients at risk of delayed cerebral ischemia (DCI) and poor 90-day functional outcomes on admission. MethodsWe prospectively collected data between 2021.04 and 2022.12. Preoperative CTP data were post-processed using RAPID software. The cortical blood flow insufficiency (CBFI) was defined as Time-to-maximum > 4.0 s. Patients were categorized into four groups according to CBFI volume distribution. To minimize differences among the groups, we employed stabilized inverse probability of treatment weighting (sIPTW). The primary outcome was DCI and poor 90-day functional outcomes (modified Rankin Scale, 3–6) was the secondary outcome. Multivariable Cox or Logistic analysis were performed to estimate the association between CBFI volume and the study outcomes, both before and after sIPTW. ResultsAt baseline, the mean (SD) age of the 493 participants was 55.0 (11.8) years, and 299 (60.6%) were female. One hundred and seven participants with DCI and eighty-six participants with poor 90-day functional outcomes were identified. After sIPTW, CBFI volume demonstrated a significant association with DCI (Cox regression: Group 4 versus Group 1, HR 3.69, 95% CI 1.84–7.01) and poor 90-day functional outcomes (Logistic regression: Group 4 versus Group 1, OR 4.61, 95% CI 2.01–12.50). ConclusionIn this study, an elevated preoperative CBFI volume was associated with adverse outcomes in aSAH patients. More well-designed studies are needed to confirm this association.

Analisis Clustering Kasus Covid – 19 di Indonesia dengan Kelompok Umur 40-60 Tahun menggunakan Algoritma K-Means

The Covid-19 virus is a case that first occurred in Wuhan City, China, which attacks the respiratory system, resembling influenza or flu which attacks the lungs. This research has the aim of being a class analysis to find out how the spread of the virus occurred in Indonesia. This study uses the K – Means method or the median value in calculations based on age in all Indonesian provinces for the last 3 years. The results of the study obtained the highest distribution in the age group 40-60 years in 2020, so it can be said that the decline in Covid - 19 in 2021 has decreased in analysis carried out using the Rapid Minner software.

Managing Cyber Security Debt: Strategies for Identification, Prioritisation, and Mitigation

This paper explores cyber security debt, a technical debt arising from unaddressed security vulnerabilities in an organisation's IT systems. These vulnerabilities accumulate due to resource limitations, time constraints, and expertise gaps, potentially leading to security breaches and data compromises. The paper outlines the cyber security debt management process involving identification, prioritisation, and mitigation strategies. Drawing parallels to financial debt, the authors emphasise the escalating risks of delaying cyber security debt repayment. The paper underscores the significance of diligent debt management in maintaining digital resilience and mitigating cyber threats. The increasing interconnectedness of systems and rapid software development has given rise to a hidden challenge known as cyber security debt. Cyber security debt is posed as a subset of technical debt, encompassing the accumulation of security vulnerabilities within an organisation's IT infrastructure and applications. Drawing a parallel between cyber security debt and its financial counterpart, the authors underscore the grave risks of deferring debt repayment. Just as financial debt accrues interest, unresolved security vulnerabilities compound over time, elevating the likelihood of breaches and data exposure. A poignant case study of the Equifax breach exemplifies the real-world consequences of neglecting security debt management. The failure to patch a well-known vulnerability led to a colossal data breach, highlighting the urgency of addressing security weaknesses promptly. Complex in nature, cyber security debt materialises when organisations fail to address vulnerabilities during various operational life cycles. These vulnerabilities might remain concealed within IT architecture, legacy code, or third-party libraries, posing a formidable challenge to detection and resolution. By understanding the parallels between financial and cyber security debt and proactively managing the latter, organisations can enhance their ability to safeguard against evolving cyber threats and maintain a robust security posture.

Analisis Pola Minat Siswa Lulusan SMU/SMK Untuk Melanjutkan Kuliah dengan Menggunakan Algoritma C4.5

STIKOM Tunas Bangsa is one of the best private universities in the city of Pematangsiantar. With so many universities in the city of Pematangsiantar, it certainly creates competition in attracting prospective new students. In order to maintain the number of students each year, universities must know what factors are the main drivers for prospective students to continue their studies at STIKOM Tunas Bangsa. The aim of this research is to determine the main factors for high school/vocational school graduate students in continuing their studies at STIKOM Tunas Bangsa. Data was obtained from questionnaires which were then processed using data mining with the C4.5 algorithm and tested with Rapid Miner software. Based on the research results, it can be concluded that there are six (6) patterns produced in cases of interest in prospective students who will study at STIKOM Tunas Bangsa, where three (3) of these rules result in interest decisions and three (3) rules result in no interest decisions. One of the resulting rules is if Recommendation = Never, and Suitability of Department = Appropriate, then the result is Interest. Recommendations from local people are the main supporting factor for high school/vocational school graduate students to continue studying at STIKOM Tunas Bangsa Pematangsiantar.

Nerinetide Reduces Early Infarct Growth Among Stroke Patients Undergoing EVT Without Intravenous Alteplase

Background Nerinetide treatment was associated with better clinical outcomes among patients with stroke undergoing endovascular treatment who were not treated with concurrent alteplase in the randomized ESCAPE‐NA1 (Efficacy and Safety of Nerinetide for the Treatment of Acute Ischemic Stroke) trial. In patients receiving alteplase, no such effect was seen due to an inactivation of nerinetide by plasmin – the product of tissue plasminogen activation. We hypothesized that improved outcomes in the no‐alteplase patients were associated with reduced infarct growth, a radiological correlate of improved stroke outcomes. Methods Data are from the no‐alteplase stratum of the ESCAPE‐NA1 trial. Patients who underwent computer tomography perfusion (CTP) as part of routine clinical care were included. Admission CTP source data were processed using RAPID software. Infarct core at baseline was defined as areas of relative cerebral blood flow <30% on CTP. Final infarct volume was determined via manual segmentation on 24‐hour CT or magnetic resonance diffusion‐weighted imaging. We compared infarct growth (defined as 24‐hour infarct volume minus CTP‐estimated baseline infarct core) among no‐alteplase patients treated with versus without nerinetide. Results CTP maps were available in 413/1105 (37%) ESCAPE‐NA1 participants. Of these, 179 (43%) were treated without alteplase, 79 (44%) received nerinetide, and 100 (56%) received placebo. Prior administration of alteplase modified the treatment effect of nerinetide on infarct growth in a multivariable model that was adjusted for age, sex, baseline infarct core volume, expanded Thrombolysis in Cerebral Infarction score, and time from baseline imaging to reperfusion ( P = 0.005). In no‐alteplase patients, infarct growth was larger over 24 hours in the control (34.9 mL interquartile range[IQR] [6.8–127]) versus nerinetide (19.6 mL IQR [1.7–49.1]; P = 0.008) groups. In patients who received prior alteplase (n = 234), there was no difference in infarct growth between those who received placebo versus nerinetide (10.5 mL IQR [−1.3 to 67.4] versus 12.8 mL IQR [0.35–55.5]; P = 0.62). Conclusion Nerinetide was associated with decreased infarct growth in acute ischemic stroke patients undergoing thrombectomy without concurrent alteplase in the ESCAPE‐NA1 trial.

Abstract WP68: National Database Demonstrates Substantial Delays Between Non-Contrast CT and CT Angiography in Suspected Stroke Patients in 2023

Background: Prompt identification of large vessel occlusions (LVOs) leads to shorter door to thrombectomy times and better outcomes. In most stroke centers, both a non-contrast CT (CT) and CT angiography (CTA) are ordered simultaneously in patients suspected to have acute stroke. In some centers, a CT is performed first, and CTA is subsequently obtained if vessel imaging is deemed necessary. Methods : Data on 23,925 patients from 717 hospitals who underwent both CT and CTA imaging processed with Rapid software in the United States from Jan 1, 2023 to June 30, 2023 were queried to determine the time delay between CT and CTA. Rapid software is typically used to evaluate suspected stroke patients for occlusions of major brain arteries and salvageable tissue. Results : A delay greater than 15 minutes between CT and CTA occurred in 4,365 patients (18%). Among the 717 hospitals, 595 (83%) had a median delay of less than 15 minutes, 77 (11%) had 15-30 minute delays and 45 (6%) had greater than 30 minute median delays. Among the 595 high performing hospitals, 57% had greater than 15 minute delays in 10% or fewer patients, 33% of the hospitals had 11-33% of their patients with greater than 15 minute delays, and 10% had 34-50% of patients with greater than 15 minute delays. Conclusion : Nearly 20% of patients have a delay greater than 15 minutes between CT and CTA. Seventeen percent of hospitals had a median delay of greater than 15 minutes and 6% had more than a 30 minute median delay. Even among high performing hospitals, a substantial number of patients had more than 15 minutes delay suggesting these patients were moved off the scanner between scans. Education on reducing CT to CTA time in suspected stroke patients should be targeted to hospitals with substantial delays. Software to identify LVOs on non-contrast CT could significantly reduce the door to diagnosis time for LVOs.

Abstract WP34: Quantitative Radiological Analysis and Clinical Outcomes of Urgent Bypass for Hemodynamic Compromised Patients With Acute Ischemic Stroke

Objective: This study aimed to demonstrate the effectiveness of urgent extracranial-to-intracranial bypass (EIB) in acute ischemic stroke (AIS) through quantitative analysis of computed tomography perfusion (CTP) results using RAPID software. Methods: We retrospectively analyzed 41 patients who underwent urgent EIB for AIS under strict operation criteria. The quantitative data from CTP images were reconstructed to analyze changes in pre- and postoperative perfusion status in terms of objective numerical values using RAPID software. Short- and long-term clinical outcomes, including complications and neurological status, were also analyzed. Results: Postoperatively, the volume of time-to-max (Tmax) >6 s decreased significantly; it continued to improve significantly until 6 months postoperatively (preoperative, 78 ml (median); immediate postoperative, 23 ml; postoperative 6 months, 7 ml; p = .000). Ischemic core-penumbra mismatch volumes were also significantly improved until 6 months postoperatively (preoperative, 72 ml (median); immediate postoperative, 23 ml; postoperative 6 months, 5 ml; p = .000). In addition, the patients’ neurological condition improved significantly ( p <0.001). Only 1 patient (2.3%) showed progression of infarction. Conclusion: Urgent EIB using strict indications can be a feasible treatment for IAT-ineligible patients with AIS due to large vessel occlusion or stenosis.

Abstract WP140: Perfusion Collateral Index Predicts Infarct Growth in Successfully Reperfused Patients With Acute Ischemic Stroke

Introduction: Robust collaterals are associated with lower rates of infarct growth and improved clinical outcomes in patients with acute ischemic stroke. Perfusion Collateral Index (PCI) and Hypoperfusion Intensity Ratio (HIR) have been shown to correlate with angiographic collaterals. We aimed to assess and compare the ability of PCI and HIR to predict infarct growth in anterior circulation large vessel occlusion (AC LVO) patients who underwent successful reperfusion. Methods: In this retrospective study, AC LVO stroke patients were included if they had pretreatment perfusion (CT or MR), successful reperfusion (mTICI > 2b), and follow up MRI within 24 hours from treatment. HIR (defined as volume of Tmax >10 sec/volume of Tmax >6 sec) was calculated by RAPID software (Version 5.0.4). PCI (defined as volume of delay 2-6 seconds x rCBV) was calculated using Olea software (SP.23). Infarct growth was calculated by subtracting baseline ischemic core (ADC <620 х 10 –6 mm2/s on MRI or rCBF <30% on CTP) from post-treatment MRI volume of DWI hyperintensity. Results: A total of 80 patients were included; 46 female, age (mean + SD): 70.2 + 13.1 years, NIHSS (median, IQR): 14, 8-19, and time from stroke-onset to reperfusion (mean + SD): 389 + 236 minutes. The infarct growth volume was 27 + 52 mL (mean + SD); 47 patients (58.7%) had infarct growth > 10 mL. ROC analysis for prediction of infarct growth > 10 mL revealed AUC/sensitivity/specificity of 0.70/55.3/84.8 for PCI at threshold <60, which was significantly higher (P=0.006) than HIR at threshold of >0.4 (0.50/74.5/24.2) (Figure). Multivariate logistic regression showed PCI (p=0.004) and time-to treatment (p=0.024) were the only independent variables to predict infarct growth. Conclusion: In conclusion, in patients with AC LVO stroke, poor baseline collateral perfusion defined by PCI <60 predicts infarction growth > 10 mL despite successful reperfusion. PCI was superior to HIR in the prediction of infarct growth.

Abstract TP204: Performance of Rapidai NCCT Stroke Software in Colombia's Early Stroke System: Preliminary Results

Background: Automated stroke solutions in developing countries have the potential to reduce healthcare gaps. This study assesses the performance of the RAPID NCCT Stroke module compared to local neuroradiologists’ evaluation of acute stroke. Methods: Rapid NCCT stroke is a new multi-module AI tool that simultaneously evaluates non-contrast CT scans (NCCT) for ICH (any subtype, volume >0.4 ml), the ASPECT score, and suspicion of LVO (i.e., intracranial ICA or horizontal segment of the MCA). The software determines suspicion of LVO based on an algorithm that evaluates the hyperdense MCA sign and early ischemic changes in the MCA territory. Consensus readings were defined by three blinded neuroradiologists based on a subset of Non-contrast CTs obtained between January 2013 to December 2018 at Fundacion Santa Fe De Bogota University Hospital. The overall diagnostic performance of the RAPID NCCT was compared to the assessments made by the neuroradiologists. Results: 179 total stroke cases with technically adequate NCCT scans were identified. Based on the consensus of the neuroradiologists, these cases included 151 ischemic strokes, 27 ICHs >0.4 ml, 1 ICH <0.4 ml, and 28 LVO cases (verified by CT angiography). The Rapid NCCT Stroke module demonstrated high specificity (96%), NPV (98%), and accuracy (95%) for the detection of ICH. For determining the ASPECT score, the software had a specificity of 93% and an NPV of 76%. Seventy percent of the CTA-verified LVOs were detected from NCCT alone with a specificity and NPV of 82%. Conclusions: The RAPID NCCT Stroke software displayed promising results for the early identification of ICH and characterization of ischemic strokes. The software identified 70% of the LVOs from NCCT alone. This tool can potentially enhance patient outcomes by bridging healthcare gaps in evolving stroke systems. Multicenter studies in additional Latin American countries are needed for further validation.

Abstract TP129: Automated Vessel Density Maps on CT Angiography Identify M2 Occlusions

Introduction: Patients with occlusions of the M2 branch of the middle cerebral artery are frequently considered for endovascular thrombectomy. Most AI software programs focus on identification of large vessel occlusions and frequently miss M2 inclusions. An automated software program with good sensitivity for detecting more distal occlusions could help rapidly identify patients for reperfusion therapies. Methods: Consecutive patients with a final diagnosis of occlusion of an M2 branch of the middle cerebral artery were identified from the Johns Hopkins Stroke database. All occlusions were verified by a neuroradiologist (VY). The baseline CTA from these patients was evaluated with the Rapid CTA vessel density software. This software identifies a reduction in vessel density within the middle cerebral artery territory and classifies the vessel density reduction as as: 20-25%, 26-40%,41-55% or >55%. A reduction of greater than 20% or greater was consider positive as a potential indicator of M2 occlusion. Adding a sample of about 50 pts with no evidence of vessel occlusion would be desirable to be able to report specificity. Results: Forty-four of 62 patients (71%) with M2 occlusions had a reduction in vessel density of at least 20% on automated CTA. Among the positive cases, 20 percent had a 20-25% reduction, 20% had 26-40%, 30% had 41-55% and 30% had a >55% reduction. Conclusion: The Rapid CTA hyperdensity program identified 71% of M2 occlusions with most patients having more than a 25% reduction in vessel density. Automated software has the potential to quickly identify patients with M2 branch inclusions.

Abstract WP190: Comparison of Collateral Score to ASPECTS to Exclude "Very Large" Infarct Core Volumes in Anterior Circulation Large Vessel Occlusion Strokes at 0-24 Hours

Purpose: ASPECTS<3 was an explicit exclusion criterion in the SELECT2 trial to exclude "very large" infarcts (>100mL) for reperfusion using endovascular thrombectomy (EVT). While specific, ASPECTS<3 may be too insensitive of a threshold on noncontrast CT at 0-24 hours (especially 0-6 hours). We aim to determine if CTA based Collateral Score (CS) can be a more sensitive surrogate marker for infarct core volume (ICV)>100mL while maintaining similar specificity to ASPECTS. Methods: Retrospective analysis included consecutive stroke patients arriving within 24 hours of onset, with intracranial ICA and/or M1 occlusion on CTA, and had concurrent CT perfusion. RAPID AI software estimated ICV using the rCBF<30% threshold. CS was scored on CTA using the method of Tan et al on a 4-point scale for % collaterals compared to contralateral side: 0 none, 1 >0 but <50%, 2 >=50 but <100%, and 3 100%. ROC curve analysis was used to find the optimal CS cutpoint with high specificity for ICV>100mL. Sensitivity and specificity of that CS threshold vs ASPECTS<3 were compared using the N-1 chi square test. Results: 164 patients were included with median (IQR) age of 74 (66-84), NIHSS of 20 (12-25), and time of onset-to-CT of 4 hours (2-7.5). The LVOs were 17 ICA (10.4%), 108 M1 (65.9%), and 39 both (23.8%), with median ICV of 12mL (0-45). 16 patients had ICV>100mL (9.8%) with median of 136mL (105-172). Using ASPECTS<3 identified only 1 of these (ICV of 118mL at 18.5 hours), sensitivity of 6.3% (95% CI: 0.16-30.2%), with no false positives, specificity of 100% (95% CI: 97.6-100%). ROC analysis for CS showed AUC=0.818 (p<0.001), with maximal specificity at CS=0 (no visible collaterals). Using CS=0 identified 6 of these infarcts, sensitivity of 37.5% [95% CI: 15.2-64.6%], with 2 false positives, specificity of 98.7% [95% CI: 95.2-99.8%]. The 2 false positives were ICV of 97mL at 2 hours and 96mL at 3 hours. The improved sensitivity of CS=0 over ASPECTS<3 was significant (p=0.036) while the difference in specificity was not (p=0.144). Conclusion: In our cohort of LVOs, CS=0 was a more sensitive surrogate marker for ICV>100mL compared to ASPECTS<3 while maintaining near 100% specificity. If confirmed in future prospective studies, CS=0 has the potential to further streamline patient selection for EVT.

Abstract TP130: Prevalence of Fast Progressors of Infarct Growth in Anterior Circulation Large Vessel Occlusions <6 Hours From Onset

Background/Purpose: Fast progressors (FP) of infarct growth in anterior circulation large vessel occlusions (LVO) may be prevalent in the <6h period depending on how it is defined. The 3 recently completed randomized trials of endovascular thrombectomy (EVT) on large infarct core volumes (ICV) all used ASPECTS criterion of 3-5 which approximates 70-100mL in absolute volume. We aimed to investigate the prevalence of FP in LVO <6h and how many of these were at or on pace to reach the 70mL or 100mL ICV threshold for EVT selection. Methods: We retrospectively included consecutive stroke patients arriving <6h from symptom onset with ICA and/or M1 occlusion on CTA and had concurrent CT perfusion (CTP). RAPID AI software generated maps of ICV depicted as rCBF<30% and critical hypoperfusion depicted as Tmax>6s. Infarct growth rate (IGR) was calculated as ICV/onset-to-imaging time. FP was defined at 2 levels: as "FP70" with IGR >11.7mL/h (which would result in an ICV >70mL by 6h) and had >=70mL of overall hypoperfusion present; and as "FP100" with IGR >16.7mL/h (which would result in an ICV >100mL by 6h) and had >=100mL of overall hypoperfusion present. Results: 108 patients were included with median (IQR) age of 75.5 (67-85), NIHSS of 20 (12-24), onset time of 2h (1.5-4), median ICV of 11mL (0-40), hypoperfusion volume of 122mL (70-164), and mismatch volume of 86.5mL (58-130). The sites of LVO were ICA 12 (11.1%), M1 73 (67.6%), and both 23 (21.3%). Median IGR for the cohort was 3.8mL/h (0-16.4). 31 FP70 were found (28.7%, 95% CI: 19.5-40.7%) with median IGR of 31.3mL/h (16.8-42). 14 of these (45.2%, 95% CI: 24.7-75.8%) already had ICV>70mL upon arrival, with median of 100mL (86-156) and 8 of 14 also showed mismatch ratio <1.8. 25 FP100 were found (23.1%, 95% CI: 16.2-36.9%) with median IGR of 38.7mL/h (24.6-51.4). 8 of these (32.0%, 95% CI: 13.8-63.1%) already had ICV>100mL upon arrival, with median of 138mL (101-172) and 5 of 8 also showed mismatch ratio <1.8. Conclusion: In a cohort of acute anterior circulation LVO strokes <6h from onset, the vast majority were good candidates for EVT with small to medium size core volumes. However, ~25% were fast progressors that may require more caution in selection, with ICV at or on pace to reach 70-100mL thresholds by 6h.

Abstract TP141: Understanding Potential Limitations of CTP Imaging in Early Window Large Vessel Anterior Circulation Strokes

Background: Computerized tomography perfusion (CTP) imaging serves as a valuable modality for the assessment of individuals with a large vessel anterior circulation stroke. Current literature proposes that employing CTP imaging in patients within the initial time frame of less than 8 hours, may lead to an overestimation of the projected infarct core, specifically when utilizing cerebral blood flow (CBF) less than 30%. The hypoperfusion intensity ratio (HIR) may result in overestimation. We sought to further investigate the interplay of CTP parameters in patients presenting within 8 hours of symptom onset of stroke, to assess the accuracy of core infarct estimation. Methods: A retrospective cohort study analyzing patients with large vessel anterior occlusion (LVAO) who underwent CTP and mechanical thrombectomy within 24 hours of symptom onset between January 2017 to December 2022. RAPID software estimates the infarct core using CBF <30%. DWI-MRI determined final infarct volume. A multivariate logistic regression model was employed to assess the impact of HIR and reperfusion success on outcomes. Results: Ninety-seven patients were identified within an 8-hour time window. CBF<30% overestimated core infarct volume (mL) in 22 patients (22.6%) with a mean of 15.72 (range 4.4-37.7) and a median of 22.85. Of these, 2 patients experienced poor reperfusion (9%) while 20 had successful reperfusion (91%). Of the patients who did have successful reperfusion, an average of 13.57mL core was overpredicted compared to the DWI volumes. A multivariate logistic regression model adjusting for degree of reperfusion, administration of thrombolytic, and time from symptom onset showed that HIR strongly predicted the probability of core estimation with an odds ratio of 148.6, 95% CI [21.0-1048.8], (p<0.001). Conclusion: HIR exceeding 0.4 demonstrates a predictive capacity for core overestimation in early-window LVAO patients. Our study affirms this observation with statistical significance. The integration of HIR as a parameter for early-window LVAO core computation shows promise, and has potential ramifications for patient selection for thrombectomy. In this context, utilization of further databases is imperative for validation and broader application of HIR.

Patchy profile sign in RAPID software: a specific marker for intracranial atherosclerotic stenosis in acute ischemic stroke.

Identifying the etiology of acute ischemic stroke (AIS) before endovascular treatment (EVT) is important but challenging. In CT perfusion imaging processed by perfusion software, we observed a phenomenon called patchy profile sign (PPS), that is, the hypoperfusion morphology in RAPID software is a discontinuous sheet pattern. This phenomenon is predominantly observed in patients diagnosed with intracranial atherosclerotic stenosis (ICAS). The study intends to assess whether the PPS can be used to differentiate ICAS from intracranial embolism. Patients with AIS due to M1 segment occlusion of the MCA who underwent mechanical thrombectomy were retrospectively enrolled. The receiver operating characteristic (ROC) curve analysis was performed to assess the value of PPS in predicting ICAS. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of the PPS for prediction of ICAS were calculated. A total of 51 patients were included in the study. The PPS was observed in 10 of 19 (52.6%) patients with ICAS, and in 2 of 32 (6.3%) patients with intracranial embolism (p < 0.001). Interobserver agreement for identifying PPS was excellent (κ = 0.944). The sensitivity, specificity, PPV, NPV, and accuracy of the PPS for predicting ICAS were 52.6, 93.8, 83.3, 76.9, and 78.4%, respectively. The PPS on RAPID software is an imaging marker with high specificity for ICAS. Larger sample sizes are imperative to validate the findings.

Software Development Teams Knowledge and Awareness of Security Requirement Engineering and Security Requirement Elicitation and Analysis

Software security is a concern due to software's pervasiveness and how rapid software's are developed. Although studies have emphasized the importance of addressing security requirements during the early phases of requirement engineering, it is often overlooked. This oversight may stem from limited knowledge and awareness among software development teams regarding security requirement engineering (SRE) and security requirement elicitation analysis (SREA). To assess this, a quantitative study was conducted. Respondents completed a survey, and the data was analysed using descriptive statistics. The results indicate that software development teams possessed an average knowledge of SRE but demonstrated good knowledge of SREA.

A Case Study on the Static Behavior of a Pedestrian Bridge Built with a Steel Pratt Truss Deck Bridge Supported by an Inclined Roller Support

Construction of bridges commonly uses trusses due to their lightweight design, which can endure heavy loads and span large distances. However, there are instances when the supports of these trusses do not lie normally on a horizontal surface. For some, the supports lie on inclined foundations, which is the focus of this study. The main objective of this study is to present the basic theory of plane truss analysis with an inclined roller support using the Direct Stiffness Method (DSM) in comparison to the use of the Graphic Rapid Analysis Software Program (GRASP) to analyze the static behavior of the structure. Furthermore, a case study is conducted to check the effects of inclined supports on a plane truss structure. Based on the results, it was discovered that the introduction of inclined roller supports does have a negative effect on the stability of the structure.

Analisis Clustering Kasus Covid – 19 di Indonesia dengan Kelompok Umur 40-60 Tahun menggunakan Algoritma K-Means

The Covid-19 virus is a case that first occurred in Wuhan City, China, which attacks the respiratory system, resembling influenza or flu which attacks the lungs. This research has the aim of being a class analysis to find out how the spread of the virus occurred in Indonesia. This study uses the K – Means method or the median value in calculations based on age in all Indonesian provinces for the last 3 years. The results of the study obtained the highest distribution in the age group 40-60 years in 2020, so it can be said that the decline in Covid - 19 in 2021 has decreased in analysis carried out using the Rapid Minner software.

RECOVERY PROGNOSIS OF ASPECTS IN PATIENTS WITH ACUTE ANTERIOR CIRCULATION CEREBRAL INFARCTION UNDERGOING MECHANICAL THROMBECTOMY

Aim: Comparison of the prognostic value of recovery of the ASPECTS score compared with perfusion imaging in patients with acute anterior circulation cerebral infarction undergoing thrombectomy.&#x0D; Materials and methods: Retrospective cross-sectional descriptive study combined with a prospective study of 82 cases undergoing CT scan without injection, CTA, and CTP, using RAPID software to calculate core and penumbra values and mechanical thrombectomy within 6-24 hours. Good (0-2 points) and poor (3-6 points) stroke outcomes were assessed at 3 months by the modified Rankin functional recovery score (mRS). Use the ROC curve and AUC value to compare the good and bad stroke prognostic value of ASPECTS and the core, penumbra, mismatch ratio values.&#x0D; Results: From January 2022 to May 2023, 82 patients were included in the study. At 90 days, the independent outcome rate of good mRS function (0-2) was 57.3%, and poor mRS function (3-6) was 42.7%. The ROC curve showed that, among the ASPECTS, core, penumbra, and mismatch ratio indices, only ASPECTS could predict stroke outcome well (p = 0.001&lt;0.05), the area under the curve was 0.709 with J - point cutoff index at threshold ASPECTS = 6 with sensitivity 93.6% and specificity 57.1%.&#x0D; Conclusion: ASPECTS ≥ 6 can predict good functional recovery after stroke in patients with acute anterior circulation cerebral infarction undergoing thrombectomy at the extended window.

Abstract 013: Infarct density: a novel imaging biomarker of long‐term functional outcome after endovascular thrombectomy

Introduction Endovascular thrombectomy (EVT) dramatically improves clinical outcomes, but the reduction in final infarct volume only accounts for 10‐15% of the treatment benefit. There is a clear need for imaging biomarkers that are strongly associated with long‐term functional outcome after EVT, both in clinical practice and clinical trial design (surrogate outcome measure). Here we aimed to quantify the relationship between functional outcome and a range of ADC thresholds on post‐EVT MRI. Methods A single‐center cohort of consecutive acute stroke patients with anterior circulation large vessel occlusion, successful recanalization via EVT (mTICI ≥ 2b), and MRI of the brain between 12 hours and 7 days after EVT was evaluated. Imaging was processed via RAPID software. Final infarct volume was based on the traditional ADC &lt;620 threshold. Logistic regression quantified the association of lesion volumes and good functional outcome (90‐day modified Rankin Scale ≤ 2) at a range of lower ADC thresholds (&lt;570, &lt;520, and &lt;470). Infarct density was calculated as the percentage of the final infarct volume below the ADC threshold with the greatest effect size. Univariate and multivariate logistic regression quantified the association between clinical/imaging variables and functional outcome. A receiver operating characteristics (ROC) analysis was used to calculated areas under the curve (AUC) with 95% confidence intervals for the final model. The Delong test compared this AUC with two additional models: (1) the final multivariate model without infarct density and (2) the final model without infarct density and final infarct volume. Results Of the 120 patients who underwent MRI after successful EVT, lesion volume based on the ADC threshold &lt;470 had the strongest association with good outcome (OR: 0.81 per 10mL; 95% CI: 0.66–0.99). In a multivariate model, infarct density (volume &lt;470/volume &lt;620 * 100) was independently associated with good outcome (aOR 0.68 per 10%; 95% CI: 0.49–0.95). In the multivariate model, final infarct volume was no longer associated with outcome (aOR 0.98 per 10mL; 95% CI: 0.85–1.14). The ROC analysis of the multivariate model with only clinical variables (age, sex, and NIHSS) yielded a good ability to distinguish patients with good and bad outcome (AUC = 0.77; 95% CI: 0.69 – 0.84). Adding infarct volume improved classification performance (AUC = 0.82; 95% CI: 0.75 – 0.88), but this was further improved by adding infarct density (AUC = 0.84, 95% CI: 0.78 – 0.91); p=0.02 comparing all three AUCs (Figure 1). Conclusion The degree of tissue injury after EVT is topographically heterogeneous, and more profound tissue injury manifests as lower ADC values. Here, we operationalized the severity of infarct as infarct density, which is independently associated with long‐term clinical outcome and provides greater prognostic information than final infarct volume. This technique may hold value as a surrogate outcome measure in early phased clinical trials.