Risk Of Arrest Research Articles

Association of temporal change in body mass index with sudden cardiac arrest in diabetes mellitus

BackgroundUnderweight imposes significant burden on cardiovascular outcomes in patients with diabetes mellitus. However, less is known about the impact of serial change in body weight status measured as body mass index (BMI) on the risk of sudden cardiac arrest (SCA). This study investigated the association between SCA and temporal change in BMI among patients with diabetes mellitus.MethodsBased on Korean National Health Insurance Service database, participants with diabetes mellitus who underwent health examination between 2009 and 2012 and had prior health examination data (four years ago, 2005–2008) were retrospectively analyzed. BMI was measured at baseline (2005–2008) and 4-year follow-up health examination (2009–2012). Patients were classified in four groups according to the body weight status and its temporal change: sustained non-underweight, sustained underweight, previous underweight, and newly developed underweight. Primary outcome was defined as occurrence of SCA.ResultsA total of 1,355,746 patients with diabetes mellitus were included for analysis, and SCA occurred in 12,554 cases. SCA was most common in newly developed underweight (incidence rate = 4.45 per 1,000 person-years), followed by sustained underweight (incidence rate = 3.90), previous underweight (incidence rate = 3.03), and sustained non-underweight (incidence rate = 1.34). Adjustment of covariates resulted highest risk of SCA in sustained underweight (adjusted hazard ratio = 2.60, 95% confidence interval [2.25–3.00], sustained non-underweight as a reference), followed by newly developed underweight (2.42, [2.15–2.74]), and previous underweight (2.12, [1.77–2.53]).ConclusionsIn diabetes mellitus, sustained underweight as well as decrease in body weight during 4-year follow-up imposes substantial risk on SCA. Recovery from underweight over time had relatively lower, but yet increased risk of SCA. Both underweight and dynamic decrease in BMI can be associated with increased risk of SCA.

Temporal elevation of blood pressure is associated with increased risk of sudden cardiac arrest

Hypertension is a known risk factor for sudden cardiac arrest (SCA). However, the role of temporal changes in blood pressure on the risk of SCA is not fully understood. This study was conducted to determine whether a temporal increase or decrease in blood pressure is associated with the risk of SCA. This study was based on nationwide healthcare insurance data. Individuals who underwent nationwide health check-ups in 2009 and 2011 were analyzed. A total of 2,801,153 individuals were evaluated for 8100 SCA events during the 17, 740, 420 person-years of follow-up. In a multivariate analysis, there were linear association between the degree of temporal elevation of systolic blood pressure (SBP) and the risk of SCA: (i) adjusted-hazard ratio (HR) 1.11 (p = 0.001) in 10 ≤ ΔSBP < 20 (mmHg) group; (ii) adjusted-HR 1.40 (p < 0.001) in 20 ≤ ΔSBP < 40 group; and (iii) adjusted-HR 1.88 (p < 0.001) in 40 ≤ ΔSBP group as compared with the reference group (− 10 ≤ ΔSBP < 10). Temporal increase in diastolic blood pressure (DBP) also a showed significant association with SCA risk with the highest risk observed in ∆DBP ≥ 25 group (adjusted-HR 1.61; p < 0.001) as compared with the reference group (− 5 ≤ ΔDBP < 5). The association between SBP and SCA was not affected by age, sex, presence of diabetes mellitus, or baseline SBP. In conclusion, a temporal increase in blood pressure was significantly associated with the occurrence of SCA, and this association was consistent across all subgroups. However, a temporary decrease in blood pressure does not reduce the risk of SCA. Prevention of elevated blood pressure may play an important role in preventing SCA.

In-hospital outcomes of transcatheter aortic valve replacement in patients with chronic and end-stage renal disease: a nationwide database study

BackgroundChronic kidney disease (CKD) and end-stage renal disease (ESRD) have been associated with worse outcomes after transcatheter aortic valve replacement (TAVR). With TAVR indications extending to a wider range of patient populations, it is important to understand the current implications of chronic renal insufficiency on clinical outcomes. We aim to determine the impact of CKD and ESRD on in-hospital outcomes after TAVR.MethodsWe queried the National Inpatient Sample for TAVR performed between 2016 and 2020 using International Classification of Diseases-10th Revision codes. We compared in-hospital mortality and clinical outcomes between three groups: normal renal function, CKD and ESRD. The association between CKD/ESRD and outcomes was tested with multivariable logistic regression analyses, using normal renal function as baseline.ResultsIn the five-year study period, 279,195 patients underwent TAVR (mean age 78.9 ± 8.5 years, 44.4% female). Of all patients, 67.1% had normal renal function, 29.2% had CKD, and 3.7% had ESRD. There were significant differences in age, sex, and prevalence of comorbidities across groups. In-hospital mortality was 1.3%. Compared to patients with normal renal function, patients with renal insufficiency had higher in-hospital mortality, with the highest risk found in patients with ESRD (adjusted odds ratio: 1.4 [95% confidence interval: 1.2–1.7] for CKD; adjusted odds ratio: 2.4 [95% confidence interval: 1.8–3.3] for ESRD). Patients with CKD or ESRD had a higher risk of cardiogenic shock, need for mechanical circulatory support, and vascular access complications, compared to those with normal renal function. In addition, patients with ESRD had a higher risk of cardiac arrest and periprocedural acute myocardial infarction. The incidence of conversion to open heart surgery was 0.3% and did not differ between groups. Post-procedural infectious and respiratory complications were more common among patients with CKD or ESRD.ConclusionPatients with CKD and ESRD are at higher risk of in-hospital mortality, cardiovascular, and non-cardiovascular complications after TAVR. The risk of complications is highest in patients with ESRD and does not result in more frequent conversion to open heart surgery. These results emphasize the importance of individualized patient selection for TAVR and procedural planning among patients with chronic renal insufficiency.

"You know that we travel a lot": Mobility narratives among female sex workers living with HIV in Tanzania and the Dominican Republic.

Female sex workers (FSW) are highly mobile, which may result in reduced access to and use of health services and increased risk for poor health outcomes, particularly for those living with HIV. Mobility includes spatial, temporal, and social elements that are not fully captured by quantitative measures. We conducted two rounds of in-depth interviews with FSW living with HIV in Iringa, Tanzania (n = 20), and Santo Domingo, Dominican Republic (n = 20), to describe mobility experiences and compare mobility narratives across settings. We integrated a thematic analysis of all interviews with a narrative analysis of a subset of 10 information-rich interviews (five in each country) with women who had recently traveled, for sex work or another reason, outside of their hometown. Across narratives, FSW living with HIV traveled locally or to seasonal destinations, for short and long periods. Social factors influencing mobility included economic drivers; risk of arrest, harassment, or violence; anonymity and/or familiarity; social relationships; and clients' mobility. Spatial, temporal, and social factors intersected in unique ways in FSW's mobility experiences, yet distinct mobility typologies were evident across settings and destinations. Together, mobility narratives of FSW living with HIV can inform quantitative research on mobility typologies in Tanzania, the Dominican Republic, and elsewhere. With the potential for economic circumstances, climate change, and other emergencies to increase people's mobility around the world, researchers and practitioners can learn from the lived experiences of FSW to inform whether and how to tailor and improve the accessibility of HIV care and treatment interventions based on spatial, temporal, and social characteristics of mobility.

Assessment of basic life support theoretical knowledge of football coaches after traditional and online education

Athletes are at risk for cardiac arrest and arrhythmia due to high physical activity during intense training and matches. When such a situation occurs, it is crucial that those around the athlete are able to provide basic life support (BLS) to prevent death from out-of-hospital cardiac arrest. Therefore, in this study, football coaches were given both online and traditional face-to-face BLS training, and then it was aimed to investigate whether the training model affected the increase in BLS knowledge. The study was conducted between 21 April and 21 May. A pre-test measuring theoretical BLS knowledge was applied to 261 football coaches. Then the coaches chose voluntarily basis what type of BLS training (traditional or online) they would receive. After the training, the post-test was applied to the participants. The obtained results were evaluated and the score increases between the 2 groups were compared. The overall level of knowledge was significantly higher in both course models after education (64&gt;86.5 for the Traditional group and 63.9&gt;83.6 for the Online group). Results showed that the mean increase in post-test scores was higher in the traditional education group (22.5 points for the traditional group and 19.6 points for the online group, p&lt;0.001). In conclusion, although traditional education seems to be more successful than online education in our study, there is no clear answer about the effectiveness of tranining models. Online BLS education may serve as an alternative to traditional education for groups that cannot participate in traditional education. Rather than choosing one over the other, an adaptive approach can be tailored to the needs of different groups.

Arrhythmias and sudden cardiac death in athletes

This case-based review provides an overview of the most relevant supraventricular and ventricular arrhythmias in athletes, elucidating their connections with intensive exercise and sports and the risk of sudden cardiac arrest. It highlights typical symptoms and key diagnostic characteristics of these arrhythmias. Additionally, it discusses potential treatment strategies, aligning them with the latest guidelines and recommendations. It aims to enhance sports physicians’ understanding of arrhythmias in athletes and to provide practical guidance on their management.

Identifying Sudden Cardiac Arrest Risk in Adolescent Male Athletes

Identifying Sudden Cardiac Arrest Risk in Adolescent Male Athletes

Understanding the Risk Factors for Cardiac Arrest in Young Adults: A Systematic Review

Introduction: Cardiac arrest, once largely associated with older individuals, is increasingly affecting young adults, necessitating a deeper understanding of its risk factors in this demographic. Aim: To identify and analyse relevant literature to uncover the risk factors contributing to cardiac arrest among young adults. Materials and Methods: A comprehensive search of databases using specific keywords related to cardiac arrest, risk factors, and young adults was conducted. Out of 573 studies initially identified, 245 duplicates were removed, and 328 were screened based on eligibility criteria. After further assessment, 123 records were rejected, leaving 205 full-text papers for review. Ultimately, eight studies were included in the qualitative analysis. Results: The review highlighted modifiable lifestyle factors, cardiovascular conditions, genetic predisposition and environmental influences as significant contributors to cardiac arrest risk in young adults. Specifically, obesity, smoking, physical inactivity, and substance abuse emerged as prominent modifiable risk factors. Predisposing factors such as inherited cardiac conditions, structural heart abnormalities, and acquired cardiac disorders were also identified. Environmental factors, including air pollution and socioeconomic status, were found to play a role in shaping the risk profile of young adults. Conclusion: The review concludes by emphasising the importance of addressing modifiable risk factors and promoting cardiovascular health awareness to mitigate the incidence of cardiac arrest in young adults. By addressing these factors, healthcare providers can work towards reducing the burden of cardiac arrest and improving outcomes in this vulnerable population. The present systematic review provides valuable insights into the risk factors contributing to cardiac arrest in young adults and lays a foundation for evidence-based preventive measures.

Marathon Running: Blowing the Whistle on Race-Related Cardiac Arrest

Sudden cardiac death in marathon runners is not a new problem. At increased risk are middle-aged men who are unaware of the risk of sub-clinical coronary atherosclerosis. For over a decade, Dr Arthur J Siegel at Harvard Medical School, USA has researched and published extensively on this topic in a bid to raise awareness of the risks of race-related cardiac arrest. He calls on healthcare providers to consider coronary artery calcium scoring to assess the anticipated benefit of pre-race aspirin for enhanced primary prevention. Humans have been partaking in long-distance running for thousands of years.

An Open-Access Dataset of Hospitalized Cardiac-Arrest Patients: Machine-Learning-Based Predictions Using Clinical Documentation

Cardiac arrest is a sudden loss of heart function with serious consequences. In developing countries, healthcare professionals use clinical documentation to track patient information. These data are used to predict the development of cardiac arrest. We published a dataset through open access to advance the research domain. While using this dataset, our work revolved around generating and utilizing synthetic data by harnessing the potential of synthetic data vaults. We conducted a series of experiments by employing state-of-the-art machine-learning techniques. These experiments aimed to assess the performance of our developed predictive model in identifying the likelihood of developing cardiac arrest. This approach was effective in identifying the risk of cardiac arrest in in-patients, even in the absence of electronic medical recording systems. The study evaluated 112 patients who had been transferred from the emergency treatment unit to the cardiac medical ward. The developed model achieved 96% accuracy in predicting the risk of developing cardiac arrest. In conclusion, our study showcased the potential of leveraging clinical documentation and synthetic data to create robust predictive models for cardiac arrest. The outcome of this effort could provide valuable insights and tools for healthcare professionals to preemptively address this critical medical condition.

Sepsis increases the risk of in-hospital cardiac arrest: a population-based analysis.

Sepsis patients have a high risk of developing in-hospital cardiac arrest (IHCA), which portends poor survival. However, little is known about whether the increased incidence of IHCA is due to sepsis itself or to comorbidities harbored by sepsis patients. We conducted a retrospective population-based cohort study comprising 20,022 patients admitted with sepsis to hospitals in Taiwan using the National Health Insurance Research Database (NHIRD). We constructed three non-sepsis comparison cohorts using risk set sampling and propensity score (PS) matching. We used univariate conditional logistic regression to evaluate the risk of IHCA and associated mortality. We identified 12,790 inpatients without infection (matched cohort 1), 12,789 inpatients with infection but without sepsis (matched cohort 2), and 10,536 inpatients with end-organ dysfunction but without sepsis (matched cohort 3). In the three PS-matched cohorts, the odds ratios (OR) for developing ICHA were 21.17 (95% CI 17.19, 26.06), 18.96 (95% CI: 15.56, 23.10), and 1.23 (95% CI: 1.13, 1.33), respectively (p < 0.001 for all ORs). In conclusion, in our study of inpatients across Taiwan, sepsis was independently associated with an increased risk of IHCA. Further studies should focus on identifying the proxy causes of IHCA using real-time monitoring data to further reduce the incidence of cardiopulmonary insufficiency in patients with sepsis.

External Validation of Deep Learning-Based Cardiac Arrest Risk Management System for Predicting In-Hospital Cardiac Arrest in Patients Admitted to General Wards Based on Rapid Response System Operating and Nonoperating Periods: A Single-Center Study.

The limitations of current early warning scores have prompted the development of deep learning-based systems, such as deep learning-based cardiac arrest risk management systems (DeepCARS). Unfortunately, in South Korea, only two institutions operate 24-hour Rapid Response System (RRS), whereas most hospitals have part-time or no RRS coverage at all. This study validated the predictive performance of DeepCARS during RRS operation and nonoperation periods and explored its potential beyond RRS operating hours. Retrospective cohort study. In this 1-year retrospective study conducted at Yonsei University Health System Severance Hospital in South Korea, DeepCARS was compared with conventional early warning systems for predicting in-hospital cardiac arrest (IHCA). The study focused on adult patients admitted to the general ward, with the primary outcome being IHCA-prediction performance within 24 hours of the alarm. We analyzed the data records of adult patients admitted to a general ward from September 1, 2019, to August 31, 2020. None. Performance evaluation was conducted separately for the operational and nonoperational periods of the RRS, using the area under the receiver operating characteristic curve (AUROC) as the metric. DeepCARS demonstrated a superior AUROC as compared with the Modified Early Warning Score (MEWS) and the National Early Warning Score (NEWS), both during RRS operating and nonoperating hours. Although the MEWS and NEWS exhibited varying performance across the two periods, DeepCARS showed consistent performance. The accuracy and efficiency for predicting IHCA of DeepCARS were superior to that of conventional methods, regardless of whether the RRS was in operation. These findings emphasize that DeepCARS is an effective screening tool suitable for hospitals with full-time RRS, part-time RRS, and even those without any RRS.

Clinical Management of Brugada Syndrome: Commentary From the Experts.

Although there is consensus on the management of patients with Brugada Syndrome with high risk for sudden cardiac arrest, asymptomatic or intermediate-risk patients present clinical management challenges. This document explores the management opinions of experts throughout the world for patients with Brugada Syndrome who do not fit guideline recommendations. Four real-world clinical scenarios were presented with commentary from small expert groups for each case. All authors voted on case-specific questions to evaluate the level of consensus among the entire group in nuanced diagnostic and management decisions relevant to each case. Points of agreement, points of controversy, and gaps in knowledge are highlighted.

Anomalous origin of left main coronary artery from the right sinus of Valsalva

BackgroundAnomalous coronary arteries are rare congenital variations with cases ranging from asymptomatic to life-threatening. Given the wide variability of coronary anomalies, it is challenging to predict their clinical consequences. Here, we present the ‘malignant’ variant – interarterial course of the left coronary artery between the aorta and pulmonary trunk – given the highest risk of sudden cardiac death among the various coronary anomalies.Case presentationOur case presents a 22-year-old male presenting to the emergency department after a syncopal episode that occurred while the patient was driving a motor vehicle. Initial Computed Tomography (CT) of the chest performed as part of the trauma work-up revealed a rare case of an anomalous origin of the left main coronary artery (LMCA) originating from a common ostium with the right coronary artery (RCA). The LMCA was found to have a malignant course, as it was positioned between the aorta and pulmonary artery. Given the high risk of sudden cardiac arrest with this congenital variant, the patient underwent coronary artery bypass grafting.ConclusionAnomalous coronary arteries remain the second leading cause of sudden cardiac death in young adult patients. The risk of sudden cardiac death depends on the congenital variant of the anomalous coronary artery as well as the course these vessels take. This case highlights a rare congenital variant featuring both the LMCA and RCA originating from a common ostium, with the LMCA having a malignant course, a variant with the highest risk of sudden cardiac death.

Impact of independent early stage extracorporeal cardiopulmonary resuscitation in the emergency department following the establishment of an extracorporeal life support team

ObjectiveIn this paper, we present a comprehensive overview of our experience in establishing and leading distinct extracorporeal cardiopulmonary resuscitation (ECPR)-related teams to independently handle ECPR in the early stages in the emergency department. MethodsA retrospective analysis was conducted on the clinical data of 29 patients who underwent ECPR treatment in the emergency room between May 2018 and April 2022. A control group, consisting of 10 patients treated between May 2018 and September 2019 was managed using a standard rescue coordination mode. The 19 patients who received ECPR between October 2019 and April 2022 were treated by members of the department's 24-h extracorporeal life support team. We compared the implementation and operational challenges faced by the two groups, including item preparation, circuit setup, and ECPR initiation times, among other factors. ResultsGender, age, cardiac arrest risk factors, and other baseline data did not significantly differ between the two groups. Extracorporeal membrane oxygenation (ECMO) pipeline prefilling time (from 35.27±10.34 to 13.46±5.32), ECPR establishment time (from 62.35±29.61 to 30.98±13.41), and item preparation time (from 16.42±9.78 to 3.19±1.49) all considerably decreased when compared to the control group. The rate of return of spontaneous circulation recovery rose from 37.50 % to 77.78 % (P < 0.05). The consequences of gastrointestinal and pulmonary bleeding were greatly reduced while ECPR was being used, and the difference was statistically significant (P < 0.05). Significant improvements were made in the ECPR weaning rate (from 25.00 % to 38.89 %) and survival rate (from 20.0 % to 36.8 %). ConclusionThe establishment of a 24-h extracorporeal life support team significantly reduced the time needed for rescue during the early stage of independent setup of ECPR in the emergency department and serves as a guide for effective care of critically ill patients.

Physeal Fractures of the Distal Ulna: Incidence and Risk Factors for Premature Growth Arrest.

The aim of this study is to assess the rate of distal ulnar growth arrest following physeal fracture and to identify specific risk factors for premature physeal closure. A retrospective review of patients with a distal ulnar physeal fracture was performed at a single United States children's hospital. Patients without 6-month follow-up were excluded. Patient demographics, injury characteristics, treatment, and outcomes were abstracted. Fractures were classified by the Salter-Harris (SH) system. All follow-up radiographs were reviewed for changes in ulnar variance or signs of premature physeal arrest. Fifty-six children with distal ulnar physeal fracture at a mean age of 10.7±3.3 years were included with a mean follow-up of 1.9 years. The most common fracture pattern was a SH II (52.7%), versus SH I (29.1%), SH III (9.1%), and SH IV (9.1%). Of displaced fractures (41.1%), the mean translation was 40.2±38.3% the and mean angulation was 24.8±20.9 degrees. Eleven fractures (19.6%) demonstrated radiographic signs of growth disturbance, including 3 patients (5.4%) with growth disturbance but continued longitudinal growth and 8 patients (14.3%) with complete growth arrest. The average ulnar variance was -3.4mm. Three patients underwent subsequent surgical reconstruction including ulnar lengthening with an external fixator, distal ulna completion epiphysiodesis with distal radius epiphysiodesis, and ulnar corrective osteotomy. Patients with displaced fractures and SH III/IV fractures were more likely to develop a growth disturbance (34.8% vs. 3.2%, P =0.003; 50.0% vs. 11.1%, P =0.012, respectively). Children with less than 2 years of skeletal growth remaining at the time of injury had a higher risk of growth disturbance (46.2% vs. 9.5%, P =0.007). SH III and IV fractures are more common injury patterns in the distal ulna compared with the distal radius. Growth disturbance or growth arrest occurs in ~20% of distal ulnar physeal fractures. Displaced fractures, intra-articular fractures, fractures requiring open reduction, and older children are at increased risk of distal ulnar growth arrest and should be followed more closely. Level IV--case series.

Reverse shock index (RSI) as a predictor of post-intubation cardiac arrest (PICA)

BackgroundEndotracheal intubation (ETI) in critically ill patients is a high-risk procedure due to the increased risk of cardiac arrest, and several factors may predict poor outcomes in these patients. The aim of this study was to investigate the role of some factors, especially newly introduced vital signs such as the reverse shock index (RSI), in predicting post-intubation cardiac arrest (PICA) in critically ill adult patients.MethodsThis cross-sectional study was conducted on critically ill patients over 18 years of age who were admitted to the emergency department (ED) and underwent ETI within 1 year. Patients who developed PICA and those without this event were included in the study, and their features were compared. The primary outcome was cardiac arrest.ResultsOf 394 patients, 127 patients were included, of whom 95 (74.8%) developed PICA, and 32 (25.2%) did not experience cardiac arrest after intubation. In multivariate analysis, age, RSI, oxygen saturation, and total bilirubin were significantly associated with PICA. In addition, patients with RSI < 1 had a significantly higher risk of developing PICA (odds ratio = 5.22, 95% CI 1.83–14.86, p = 0.002). The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy for predicting PICA were 51.11%, 83.33%, 90.2%, 36.23%, and 59.17%, respectively. The ROC curve for RSI showed an area under the curve (AUC) of 0.66.ConclusionRSI may be useful in predicting PICA with higher diagnostic accuracy compared to the shock index. Furthermore, advanced age, hypoxia, and hyperbilirubinemia may increase the risk of PICA in patients admitted to the ED.

Reanimação cardiopulmonar por leigos – técnicas e ferramentas auxiliares: revisão integrativa

Cardiovascular diseases and the risk of cardiac arrest contribute to a significant number of deaths in Brazil. Laypeople are often the first to respond to cardiac arrest victims. This study conducts an integrative review to identify techniques and tools available for layperson cardiopulmonary resuscitation (CPR). Data were collected from PubMed, SciELO, and LILACS databases, yielding 128 articles, of which 35 were included. The analysis identifies techniques and tools that provide benefits and enhance patient survival. Telemonitoring and automated external defibrillators (AED) also play crucial roles. Techniques and tools exist to aid the general public in learning and performing CPR, but further research is required to promote their dissemination, gain acceptance within the scientific community, and ensure widespread adoption among the population.

Crime, Dementia, and Caregivers: Keeping individuals with dementia out of the criminal justice system

AbstractBackgroundThe care and management of justice‐involved persons living with dementia (PLWD) are understudied. Yet emerging data indicate that PLWD may experience symptoms and behaviors which may lead to encounters with the criminal justice system. Consistent with the Sequential Intercept Model (SIM), community and social resources may affect outcomes for justice‐involved PLWD, including formal and informal caregiver resources. This presentation aims to characterize the relevance of community and social resources for criminal justice system outcomes (e.g., risk of arrest, pre‐trial options, and sentencing alternatives for PLWD).MethodsSynthesis of two semi‐structured interview studies with stakeholders. Study 1: the “Caregiver Study” collected experiences/perspectives from caregivers of persons with frontotemporal lobar degeneration (FTLD) on social and legal decision‐making. Study 2: the “Legal Stakeholder Study” collected experiences/perspectives from legal professionals on managingement of PLWD within the criminal justice system. Transcribed interviews were analyzed applying the Framework Method (an inductive review of transcripts to develop a singular codebook for both studies’ transcripts) before charting data for comparison between participants and studies. Data from both studies were used to uncover potential relationships between social and community resources and justice system outcomes for PLWD.ResultCaregiver Study: 13 caregivers. Caregivers reported caregiver burden, safety, and patient behaviors that could lead to encounters with law enforcement. Legal Stakeholder Study: 15 participants with a range of experience (5‐25 years). Participants reported the relevance of community and social resources at preventing arrest, pre‐trial release options, and sentencing alternatives. When these data are synthesized with caregivers’ experiences and perspectives the studies generated a fuller narrative of how PLWD experience criminal justice encounters.ConclusionData from the complimentary studies elucidate insight on the relevance of social and community resources for criminal justice related outcomes for PLWD. These data uncover potential relationships between family involvement, financial resources, access to public benefits, and community understanding of dementia as factors relevant to outcomes associated with justice‐involved and potentially justice involved PLWD. These data are consistent with the SIM. These data provide a foundation for research that harnesses the SIM to drive important policy and systemic changes to improve support for PLWD who are justice‐involved.

#319 : Blastocyst Formation Prediction Based on Deep Learning Model from 3-Day Embryo Images in Time-Lapse Incubator Using Data Augmentation

Background and Aims: Current literature suggests that blastocyst ET (Embryo Transfer) at day 5 improves pregnancy outcomes compared with cleavage ET at day 3. However, blastocyst ET poses potential challenges due to the risk of developmental arrest at the cleavage stage. Therefore, accurately predicting blastocyst formation in embryos will help determining optimal days for embryo culture. The aim of our study is to develop a deep learning-based classification model that can predict blastocyst formation based on 3-day embryo images captured from Time-Lapse incubators. Method: A total of 200 embryo images were collected at 72 hours after ICSI (Intracytoplasmic Sperm Injection), with 100 forming blastocysts and 100 failing to do so. The images were annotated by RectLabel for object detection and segmentation, and data augmentation techniques were applied to enhance the dataset. A pre-trained ResNet model was used as the basis for our classifier model, and optimization was performed using the Adam optimizer and BCEWithLogitsLoss as the loss function. Model performance was evaluated through classification accuracy and AUC score. Results: The CNN-based classifier models demonstrated a considerable accuracy of 87.5% and an AUC of 0.896 in predicting blastocyst formation, with sensitivity and specificity of 91.7% and 81.3%, respectively. It was found that without data augmentation, the model degraded to an accuracy of 62.5% and an AUC of 0.631. Conclusion: Our study competently developed a classification model for predicting blastocyst formation using 3-day embryo images from a Time-Lapse incubator and demonstrated the effectiveness of data augmentation techniques in limited data sets. This deep learning-based model may contribute as a beneficial tool in IVF (In Vitro Fertilization) process.