bluuebunny/crossref_metadata_2025 huggingface dataset:
Reducing outpatient wait times through telemedicine: a systematic review and quantitative analysis
Authors: Capodici Angelo , Noci Francesca , Nuti Sabina , Emdin Michele , Dalmiani Stefano , Passino Claudio , Hernandez-Boussard Tina , Giannoni Alberto
Published: January 2025

Objectives

Population ageing and the rise in chronic diseases place continual stress on healthcare systems. Scarce resources often impede equitable access to healthcare, particularly in rural areas, resulting in prolonged waiting times and heightened risks of morbidity and mortality. Telemedicine has emerged as a promising solution, offering remote and equitable care that could potentially bridge access gaps and enhance health outcomes. This systematic review aims to quantitatively examine the impact of telemedicine implementation on waiting times, defined as the time passed from the booking of a visit for an outpatient to the administration of the service.

Design

A systematic review was conducted using studies on telemedicine interventions that specifically addressed waiting times. Bias assessment was performed with three tools: ROBINS-I (“Risk of Bias In Non-Randomized Studies of Interventions”), AXIS ("Appraisal tool for Cross-Sectional Studies") and RoB-2 ("Risk of Bias-2"). A weighted mean approach was used to synthesise results, with medians synthesised using a median approach.

Data sources

Articles in English were retrieved from the PubMed and Scopus databases.

Eligibility criteria

Studies were excluded if they did not specifically address waiting times related to telemedicine interventions. Only studies that considered waiting times defined as the time passed from the booking of a visit for an outpatient to the administration of the service and any telemedicine intervention were included.

Data extraction and synthesis

A total of 53 records were included, encompassing 270 388 patients in both the experimental and control groups. The weighted mean reduction in waiting times was calculated, and bias was assessed. No record was evaluated to be at high risk of bias, with 69.8% of studies evaluated at low risk and 26.4% at moderate risk (3.8% were surveys). Results were synthesised using a weighted mean approach for studies reporting means, and a median approach for studies reporting medians.

Results

Overall, a weighted mean reduction of 25.4 days in waiting times was observed. Focusing on clinical specialties (n=114 042), the weighted mean reduction amounted to 34.7 days, while in surgical patients (n=156 346), telemedicine was associated with a weighted mean of 17.3 days saved.

Conclusions

The implementation of telemedicine solutions may significantly improve waiting times, potentially leading to more efficient and equitable healthcare systems.

PROSPERO registration number

CRD42023490822.
New approach to identifying elite winter sport athletes’ risk of relative energy deficiency in sport (REDs)
Authors: Smith Emily M , Drager Kelly , Groves Erik M , Gabel Leigh , Boyd Steven K , Burt Lauren A
Published: January 2025

Objectives

Relative energy deficiency in sport (REDs) is a syndrome resulting from problematic low energy availability (LEA). Low areal bone mineral density (aBMD) is a primary indicator of LEA, measured by dual X-ray absorptiometry (DXA). High-resolution peripheral quantitative CT (HR-pQCT) is an advanced imaging device that provides measures of volumetric BMD (vBMD), bone microarchitecture, geometry and strength. This study aimed to assess the prevalence of REDs in elite winter sport athletes and to observe the associations in bone parameters using HR-pQCT in athletes identified as at-risk or not at-risk of REDs.

Methods

Participants included 101 elite athletes (24.1±4.4 SD years; 52% female). The REDs Clinical Assessment Tool (CAT2) was used to determine REDs risk. HR-pQCT scans of the non-dominant radius and left tibia were analysed on REDs risk grouping.

Results

17 athletes (17%; 71% female) were at-risk based on the REDs CAT2. After covarying for lean mass, OR suggested a higher likelihood of REDs risk classification for athletes with low cortical thickness, cortical area, total vBMD and bone strength.

Conclusions

Impaired total vBMD, bone strength and cortical bone parameters were approximately twice as likely (OR: 1.9–3.0) in athletes at-risk of REDs. Results agree with the consensus statement that HR-pQCT may identify impaired bone health in athletes at-risk of REDs. Future directions should use HR-pQCT to explore REDs risk longitudinally, using bone change over time, as this may provide greater insight. Using advanced imaging to explore REDs risk in a population of winter high-performance athletes is novel.
Cessation and knowledge-building messaging are associated with e-cigarette cessation intentions among youth and young adults in the USA
Authors: Yu Linda Q , Do Elizabeth K , Minter Tyler , Koris Kristiann , Khatib Bushraa , Jacobs Megan A , Graham Amanda L , Hair Elizabeth C
Published: January 2025

Background

Increasing intentions to quit e-cigarettes among youth and young adults can reduce usage rates by making quit attempts more likely. This study assessed the potential impacts of a national media campaign, focused on building knowledge of e-cigarette use risks and cessation resources, on intentions to quit and campaign-targeted beliefs about mental health and quitting.

Methods

A national sample from a repeated cross-sectional online survey was collected from March 2022 to August 2023, among youth and young adults who reported e-cigarette use in the past 30 days (N=5169). Regression models were used to assess associations between weekly campaign awareness and frequency of exposure on intentions to quit e-cigarette use within the next 6 months and targeted beliefs related to mental health and quitting.

Results

Participants who were aware of both cessation and knowledge-building messaging were more likely to report intentions to quit e-cigarette use in the next 6 months (OR 1.43, (95% CI 1.21, 1.69)) and agree with quitting-related targeted beliefs (ORs 1.35–1.63) and a mental health targeted belief scale (b=1.14 (95% CI 0.69, 1.59)), relative those with no messaging awareness. The frequency of exposure to cessation messaging held a dose-response relationship with almost all outcomes.

Conclusion

Findings suggest that frequency and awareness of messaging that educates about e-cigarette harms to mental health and about cessation resources are associated with higher quitting intentions among young people who use e-cigarettes.
Role of inflammasomes in acute respiratory distress syndrome
Authors: Flower Luke , Vozza Emilio G , Bryant Clare E , Summers Charlotte
Published: January 2025

Acute respiratory distress syndrome (ARDS) is present in >10% of all people admitted to critical care and is associated with severe morbidity and mortality. Despite more than half a century since its first description, no efficacious pharmacological therapies have been developed, and little progress has been made in improving clinical outcomes. Neutrophils are the principal drivers of ARDS, with their priming and subsequent aberrant downstream functions, including interleukin (IL) 1β and IL-18 secretion, central to the disease pathogenesis. The dominant pathways through which IL-1β and IL-18 are believed to be elaborated are multimeric protein structures called inflammasomes that consist of sensor proteins, adaptor proteins and an effector enzyme. The inflammasome’s initial activation depends on one of a variety of damage-associated (DAMP) or pathogen-associated (PAMP) molecular patterns. However, once activated, a common downstream inflammatory pathway is initiated regardless of the specific DAMP or PAMP involved. Several inflammasomes exist in humans. The nucleotide-binding domain leucine-rich repeat (NLR) family, pyrin domain-containing 3 (NLRP3), inflammasome is the best described in the context of ARDS and is known to be activated in both infective and sterile cases. The NLR family, caspase activation and recruitment domain-containing 4 (NLRC4) and absent in melanoma 2 (AIM2) inflammasomes have also been implicated in various ARDS settings, as have inflammasome-independent pathways. Further work is required to understand human biology as much of our knowledge is extrapolated from rodent experimental models. Experimental lung injury models have demonstrated beneficial responses to inflammasome, IL-1β and IL-18 blockade. However, findings have yet to be successfully translated into humans with ARDS, likely due to an underappreciation of the central role of the neutrophil inflammasome. A thorough understanding of inflammasome pathways is vital for critical care clinicians and researchers and for the development of beneficial therapies. In this review, we describe the central role of the inflammasome in the development of ARDS and its potential for immunomodulation, highlighting key areas for future research.
Scoto-seesaw model implied by flavor-dependent Abelian gauge charge
Authors: Van Loi Duong , Duy N. T. , Nam Cao H. , Van Dong Phung
Published: January 2025

Assuming fundamental fermions possess a new Abelian gauge charge that depends on flavors of both quark and lepton, we obtain a simple extension of the Standard Model, which reveals some new physics insights. The new gauge charge anomaly cancellation not only explains the existence of just three fermion generations as observed but also requires the presence of a unique right-handed neutrino

$$\nu _R$$

ν
R

with a non-zero new gauge charge. Further, the new gauge charge breaking supplies a residual matter parity, under which the fundamental fermions and

$$\nu _R$$

ν
R

are even, whereas a right-handed neutrino

$$N_R$$

N
R

without the new charge is odd. Consequently, light neutrino masses in our model are generated from the tree-level type-I seesaw mechanism induced by

$$\nu _R$$

ν
R

and from the one-loop scotogenic contribution accommodated by potential dark matter candidates,

$$N_R$$

N
R

and dark scalars, odd under the matter parity. We examine new physics phenomena related to the additional gauge boson, which could be observed at colliders. We analyze the constraints imposed on our model by current experimental limits on neutrino masses, neutral meson oscillations, B-meson decays, and charged lepton flavor violating processes. We also investigate the potential dark matter candidates by considering relic density and direct detection.
A Study on Anti-Adjacency Spectra of Graphs
Authors: Falguni Jain D. , Naduvath Sudev
Published: January 2025

Let [Formula: see text] be a simple undirected graph with vertex set [Formula: see text] and edge set [Formula: see text]. The anti-adjacency matrix of [Formula: see text], denoted by [Formula: see text], is the [Formula: see text] matrix, whose rows and columns are indexed by [Formula: see text], where each [Formula: see text]-entry of the matrix is [Formula: see text], if there is no edge between the corresponding vertices [Formula: see text] and [Formula: see text] and [Formula: see text], otherwise. The [Formula: see text]-entry of [Formula: see text] is [Formula: see text], for [Formula: see text]. The eigenvalues of [Formula: see text] represent the anti-adjacency eigenvalues of [Formula: see text]. We denote the corresponding spectra by [Formula: see text]-spec([Formula: see text]). In this paper, we discuss the anti-adjacency spectra of some fundamental graph classes.
Development of Adaptive Vision Transformer-Based Multi-Scale EfficientNetB7 Network for Secured Authentication System Using Finger Vein Patterns
Authors: Sujani G. , Sreeramareddy G. M.
Published: January 2025

Finger vein recognition represents an important biometric attribute that is viewed as reliable, emerging, and secure. Finger veins possess the benefit that they are less vulnerable to determining theft since veins are found below the layer of skin, and are also not influenced by the natural aging of the user. The present advanced methods are capable of offering acceptable efficiency. However, they depend on the nature of the processed finger-vein data. Thus, in this paper, by employing deep learning, an intelligent finger vein pattern-based authentication model is introduced. In the beginning, images are accumulated from global resources. Further, the accumulated finger vein images are provided to the introduced Adaptive Vision Transformer-based Multi-scale EfficientNetB7 (AViTMENetB7) network for authentication purposes. This network helps to boost the safety and robustness of the model. Here, the Improved Garter Snake Optimization Algorithm (IGSOA) is introduced to reduce the computational complexity and increase the functionality rates. In the end, by contrasting the implemented vein-based authentication model with traditional vein-based authentication models, the numerical analysis is conducted.
MSATResUNet: Multi-Scale Adaptive TransResUNet-Based Handwritten Word Segmentation with Hybrid Bald Eagle Search-Social Spider Optimization
Authors: Srinivasa Rao N. , Nelson Kennedy Babu C.
Published: January 2025

Segmenting the individual word is the difficult stage in various data-extracting models for ancient handwritten papers. This involved visually seeking the query word and recognizing the text in every character. Segmenting the handwritten image document into words and text-line is challenging in visually recognizing the character. However, the handwritten document features are not regular and depend on the particular person, so it becomes a difficult issue. To tackle this challenging issue, we propose a new segmentation model for identifying the handwritten text style by utilizing the deep learning model. Initially, the handwritten text images are garnered from online databases based on the language of English, Greek, and Indian Bangla. After, the gathered image is given as input to the modified deep learning structure named Multi-Scale Adaptive TransRes- UNet (MSATResUNet) to segment the images very accurately. Here, the parameters present in the MSATResUNet are optimized using the Bald Eagle Search with Social Spider Optimization (BES-SSO) algorithm to maximize the segmentation performance. The segmentation results obtained from the developed model will be analyzed over various conventional segmentation approaches to validate the performance.
Inequalities and Inclusion in Genomics Applied to Healthcare: A Latin American Perspective
Authors: Lopes-Cendes Iscia , de Oliveira Thais C.
Published: January 2025

Integrating genomics into healthcare within the precision medicine (PM) framework poses distinct challenges in resource-limited regions like Latin America and the Caribbean (LAC). These challenges arise partly from the lack of PM models tailored for low- and middle-income countries. To address this, healthcare authorities in LAC should adopt predictive models to estimate costs and infrastructure needed for PM programs. The predominance of admixed populations in LAC adds complexity, given their underrepresentation in genomic studies. Establishing a robust regulatory framework is essential for managing ethical, legal, and privacy concerns related to genomic data. Despite these challenges, current regional efforts showcase the feasibility of integrating genomics in LAC and highlight the importance of expanded collaborations. By sharing data, resources, and expertise, LAC countries can overcome funding and infrastructural barriers while upholding ethical standards and data protection across the region.
Complications of CT- and US-guided Thoracic Interventional Procedures
Authors: Richart Valèria , Cornellas Llúria , Domenech-Ximenos Blanca , Mestres Judit , Benegas Mariana , Sánchez Marcelo , Vollmer Ivan
Published: January 2025

Potential complications of CT- and US-guided thoracic interventional procedures include pneumothorax, lung hemorrhage, seeding, gas embolism, hemothorax, and nondiagnostic biopsies, among others, and understanding the risk factors, prevention methods, and treatment options ensures the highest standard of patient care.
Brain activation patterns and dopaminergic neuron activity in response to conspecific advertisement calls in reproductive vs. non-reproductive male plainfin midshipman fish (Porichthys notatus)
Authors: Vetter Brooke J. , Perelmuter Jonathan T. , Lozier Nicholas R. , Sisneros Joseph A. , Forlano Paul M.
Published: January 2025

The plainfin midshipman fish (Porichthys notatus) relies on the production and reception of social acoustic signals for reproductive success. During spawning, male midshipman produce long duration advertisement calls to attract females, which use their auditory sense to locate and access calling males. While seasonal changes based on reproductive state in inner-ear auditory sensitivity and frequency encoding in midshipman is well documented, little is known about reproductive-state dependent changes in central auditory sensitivity and auditory neural responsiveness to conspecific advertisement calls. Previous research indicates that forebrain dopaminergic neurons are preferentially active in response to conspecific advertisement calls and during female auditory-driven behavior in the breeding season. These dopamine neurons project to both the inner ear and central auditory nuclei and contribute to regulation of inner-ear auditory sensitivity based on reproductive state. The present study tested the hypothesis that exposure to the male advertisement call would elicit differential activation in auditory brain nuclei and in the forebrain auditory-projecting dopaminergic nucleus in reproductive vs. non-reproductive male midshipman. Fish were collected during the spring reproductive and winter non-reproductive months and were exposed to a playback of the advertisement call or ambient noise (control). Immunohistochemistry identified activated neurons (pS6-ir; proxy for neural activation) in midbrain and forebrain auditory and dopaminergic nuclei. Our results revealed that in key auditory and dopaminergic areas, the greatest activation (most pS6-ir cells) occurred in reproductive males exposed to the advertisement call.
Abstract DP11: Association Between Pre-Stroke Cardiovascular Risk with Post-Stroke Cognitive Decline and Dementia: A Pooled Analysis of Four Cohort Studies
Authors: Levine Deborah , Hsu Wan-Ling , YE Wen , Whitney Rachael , Sussman Jeremy , Briceno Emily , Gross Alden , Giordani Bruno , Lazar Ronald , Howard Virginia , Aparicio Hugo , Beiser Alexa , Elkind Mitchell , Gottesman Rebecca , Pendlebury Sarah , Kollipara Adam , Cushman Mary , Fohner Alison , KOTON SILVIA , Longstreth W , Lopez Oscar , Seshadri Sudha , Springer Mellanie , Hayward Rodney
Published: January 2025

Introduction:
We examined whether prestroke cardiovascular risk is associated with faster cognitive decline and higher dementia risk after stroke independent of prestroke cognition.

Methods:
We included 1,808 dementia-free individuals with incident stroke (91% ischemic, 7% hemorrhagic, 2% other; 52% women, 38% Black, median age 75) from 4 cohorts (1971-2019): Atherosclerosis Risk In Communities Study, Cardiovascular Health Study, Framingham Offspring Study, and REasons for Geographic And Racial Differences in Stroke. We assessed prestroke atherosclerotic cardiovascular disease (ASCVD) risk with the American Heart Association’s Predicting Risk of cardiovascular disease EVENTs (PREVENT) 10-year ASCVD risk score, which has age and sex as risk factors. Outcomes were global cognition (primary), executive function, memory, and dementia. Linear mixed-effects and Cox regression models examined continuous and categorical (quintiles) 10-year ASCVD risk scores and adjusted for mean prestroke cognition, race, education, and cohort. Median (IQR) follow-up was 4.4 (2.0, 7.9) years for global cognition and 5.1 (2.4, 8.8) for dementia. Dementia cases totaled 142 at 5 years and 182 at 10 years.

Results:
Median (IQR) 10-year prestroke ASCVD risk was 14.0% (9.9%, 18.5%). Higher prestroke 10-year ASCVD risk was associated with lower adjusted initial poststroke global cognition, memory, and executive function (changes to intercept, Table 1). The quintile analysis showed a dose-response relationship between higher prestroke ASCVD risk and lower initial poststroke cognition scores (changes to intercept, Table 1). The overall stroke survivor group had unadjusted mean declines of -0.59 points/year (95%CI, -0.66 to -0.52 points/year; P<0.001) for global cognition, -0.54 points/year (95%CI, -0.62 to -0.46 points/year; P<0.001) for executive function, and -0.35 points/year (95%CI, -0.42 to -0.28 points/year; P<0.001) for memory. Higher prestroke 10-year ASCVD risk was associated with faster global cognitive decline (P<0.001) and nominally faster memory decline (P=0.10) but not executive function decline (P=0.80) (changes to poststroke slope, Table 1). Higher quintiles of prestroke ASCVD risk were associated with faster global cognitive decline and higher 5- and 10-year dementia risk (Tables 1-2; Figure 1).

Conclusions:
Higher prestroke cardiovascular risk is associated with lower initial poststroke cognitive scores, faster cognitive decline, and higher dementia risk in stroke survivors.
Abstract DP39: Short-term Outcomes of Atrial Fibrillation Patients Undergoing Carotid Stent Placement or Carotid Endarterectomy in the United States
Authors: Tolba Hatem , Kwok Chun Shing , Khan Mohammed Sulaiman , Gomez Camilo , Qureshi Adnan
Published: January 2025

Background:
Patients with atrial fibrillation were excluded from clinical trials evaluating carotid artery stent(CAS) or carotid endarterectomy (CEA).We performed this analysis to identify the prevalence of atrial fibrillation and associated outcomes in symptomatic internal carotid artery stenosis patients undergoing CAS or CEA.

Methods:
We analyzed the data from the National inpatient sample (NIS) between January 2016 to December 2021. We used the ICD-10 to identify patients hospitalized with diagnosis of stroke, TIA, or retinal ischemia with stenosis of carotid artery who underwent CAS or CEA. We divided patients based on presence or absence of atrial fibrillation. We ascertained the end points of intra-procedural and post-procedural cerebral infarction, hemorrhage, discharge home and death in CAS and CEA patients with atrial fibrillation. We compared the endpoints between patients who underwent CAS and those who underwent CEA after propensity score matching.

Results:
Atrial fibrillation was present in 3,785 (18.3%) of 20,645 patients underwent either CAS or CEA between 2016 and 2021 [18.0% versus 18.8% for CAS or CEA, respectively, p=0.50]. The proportions of patients who developed acute myocardial infarction, respiratory failure, acute kidney injury, or required blood transfusion was higher in patients with atrial fibrillation in both CAS and CEA groups. There was no difference in odds of post-operative stroke and/or death in patients with atrial fibrillation (compared with those without atrial fibrillation) who were treated with CAS (OR 0.99, 95% CI 0.62-1.60, p=0.98) and those treated with CEA (OR 1.09, 95% CI 0.69-1.73, p=0.72) in the multivariate analysis after adjusting for confounders. The length of stay and hospitalization cost was significantly higher in patients with atrial fibrillation (compared with those without atrial fibrillation who were treated with CAS and those treated with CEA). There was no difference in post-operative stroke and/or death (10.7% versus 8.7%, p=0.41) and discharge home (32.4% versus 26.8%, p=0.13) in atrial fibrillation patients who underwent CEA with compared to those underwent CAS in propensity matched analysis.

Conclusion:
Approximately 1 in 5 patients with symptomatic internal carotid artery stenosis who undergo CAS or CEA have atrial fibrillation in the United States, we did not identify any higher risk of post-operative stroke and/or death in atrial fibrillation patients irrespective of which procedure was undertaken
Abstract TMP75: Reduced thrombus immunoreactivity is transcriptionally associated with greater NIHSS severity at presentation of ischemic stroke: Analysis from the INSIGHT registry
Authors: Seah Carina , Devarajan Alex , Vicari James , Dabney Alan , Baltan Selva , Sohrabji Farida , Pennypacker Keith , Nanda Ashish , Woodward Britton , Rivet Dennis , Fraser Justin , Kellner Christopher
Published: January 2025

Funding:
The INSIGHT Registry is funded by Penumbra.

Introduction:
Thrombi have shown to modify and be modified by their microenvironment throughout the pathogenesis of ischemic stroke. The molecular mechanisms by which this occurs and how it corresponds to symptomatic presentation is unknown. Here, we identify a transcriptomic signature in thrombi associated with increased NIHSS severity at presentation, suggesting a mechanistic role for immune clearance in clinical severity of ischemic stroke.

Methods:
The INSIGHT registry is a prospective, multicenter, multi-omic registry focused on elucidating the molecular underpinnings of stroke from analysis of clot and interarterial blood. RNA sequencing of 10,990 genes from 292 thrombi from patients undergoing thrombectomy was aligned, normalized, and residualized using Rsubread, edgeR, sva, and limma/voom. Signed co-expression modules were constructed using WGCNA, and each module eigengene (a measure of a module’s principal component) was correlated with NIHSS at presentation using Pearson’s correlation. Networks were visualized and analyzed in cytoscape. Hub genes were determined by number of undirected edges. Network enrichments were conducted using Gene Ontology biological processes and cellular components.

Results:
The mean NIHSS in this cohort was 15.14± 7.45. 3 co-expression modules out of 26 total modules detected in the data significantly inversely correlated with NIHSS at presentation. These networks corresponded to downregulation of neuronal activation (p=0.042), interferon signaling (p=0.039), and T cell activation (p=0.023), respectively. Major hub genes in each module included
KCNAB2,
a potassium channel associated with epilepsy and implicated in susceptibility to poor stroke outcomes in aged mice brains,
SRSF11,
associated with cognitive decline,
PNISR,
associated with interferon signaling, and
ZAP70,
associated with T-cell differentiation.

Conclusion:
The association of immune downregulation with increased NIHSS severity suggests that robust immune clearance may mitigate poor outcomes in ischemic stroke, and that thrombi-mediated modification of the local immune environment may exacerbate symptomatic presentation. Conversely, the association of major hub genes with known cognitive decline suggests that thrombi are modified by the neurovascular unit and neurons of surrounding tissues and post-thrombectomy sequencing may provide insight into the underlying health of the surrounding parenchyma.
Abstract TP118: Early Outpatient Follow-up After Acute Ischemic Stroke Reduces 30-day and 90-day Inpatient Readmissions
Authors: Ro Jennifer , Owens Javacia , Ma Tianwen , Wu Yunong , Jumah Ammar , Starnes Danielle , Christopher Hannah , Blanke Debra , Henriquez Laura , Belagaje Samir , Kvantaliani Nino , Cabral Jacqueline , Walczak Teri , Collier Judy , Mack Kourtni , Nahab Fadi
Published: January 2025

Introduction:
Despite advancements in the management of acute ischemic strokes, readmissions continue to impact both healthcare costs and patient outcomes. The objective of our study was to evaluate factors associated with 30- and 90-day readmissions after acute ischemic stroke including the impact of early transitional care outpatient follow-up by a centralized specialty stroke clinic.

Methods:
We retrospectively identified all acute ischemic stroke patients discharged from the largest healthcare system in the state of Georgia from October 1, 2022 to March 31, 2024; we excluded patients who were discharged to a long-term acute care or hospice facility. Baseline characteristics, inpatient metrics and post-discharge outpatient follow-up were assessed to identify factors associated with 30- and 90-day inpatient readmission.

Results:

Of 2191 acute ischemic stroke patients discharged during the study period, 177 (8.1%) and 304 (13.9%) had 30- and 90-day all cause readmissions to the healthcare system, respectively. Increasing age, Charlson Comorbidity Index score, and history of diabetes were independently associated with 30- and 90-day readmission; history of heart failure, obesity, and discharge to inpatient rehabilitation or skilled nursing facility (versus home) were also independently associated with 90-day readmission. Completion of a subspecialty stroke clinic follow-up within 30 days of discharge was associated with a lower likelihood of 30-day (OR 0.64, 95% CI 0.41-0.96; p=0.04) and 90-day readmission (OR 0.69, 95% CI 0.49-0.94; p=0.02).

Conclusion:
While acute ischemic stroke patients who are older, have comorbid conditions and disability are at an increased likelihood of 30- and 90-day readmission after acute ischemic stroke, our study found that early (<30 day) outpatient follow-up in a subspecialty stroke clinic was associated with a significant reduction in 30- and 90-day readmission. Efforts should be made to ensure early outpatient specialty stroke clinic follow-up for acute ischemic stroke patients after discharge.
Abstract TP354: The role of organelle-specific autophagy in rodent models of brain ischemia
Authors: Osterli Emily , Park Yujung , Mei Beverly , Nguyen Madison , Liu Chunli , Hu Bingren
Published: January 2025

Background:
The selective autophagic removal of mitochondria, lysosomes, Golgi are termed mitophagy, lysophagy, Golgiphagy, respectively. This study aims to investigate the role of organelle-specific autophagy in rodent brain ischemia models.

Methods:
Rats and mice were subjected to either sham surgery, 20 min of global ischemia, or 40/120 min of focal brain ischemia, followed by 0.5-, 4-, 24- and 72-h reperfusion, respectively. Spatial and temporal colocalization of organelle-specific markers, autophagosome (AP) markers, late endolysosomal markers, and AP-to-lysosomal fusion markers were studied under confocal microscopy. Autophagic flux was examined by the buildup of p62 or ubiquitinated organelle protein. Endolysosomal structures were examined by electron microscopy. Cell-specific autophagy was evaluated by co-labeling autophagy markers (p62 and ubiquitinated proteins) with neuron-, oligodendrocyte-, astrocyte-; microglial cell- and macrophage-, and micro vessel-specific markers under confocal microcopy. Cell death was examined by histopathology.

Results:
Autophagic flux was impaired in hippocampal CA1 neurons destined to die after brain ischemia, as indicated by the buildup of p62 and ubiquitinated proteins, depletion of NSF, and buildup of endolysosomal structures. In the same CA1 neurons where autophagic flux was impaired, Golgi and mitochondrial networks were irreversibly fragmented. However, only a fraction of Golgi or mitochondrial fragments were colocalized with autophagy marker p62, indicating the post-ischemic impairment of AP formation. Furthermore, a significant buildup of late endolysosomal markers was observed in post-ischemic neurons destined to die, likely due to NSF depletion-induced disruption of lysosomal degradation. In contrast to post-ischemic neurons, NSF was upregulated in Iba1-immunopositive inflammatory cells after brain ischemia.

Conclusion:
Organelle-specific autophagy is persistently impaired in post-ischemic neurons destined to die, but only transiently impaired in neurons that survive the same ischemic periods. The irreversible impairment of autophagy is likely due to inactivation of NSF ATPase. In contrast, NSF is upregulated in increased inflammatory cells. These results gain valuable insights into the differential autophagic changes, which is useful for the development of therapeutics against ischemic brain injury.
Abstract WP144: Impact of the Veterans Health Administration National Telestroke Program's Inpatient Subacute Telestroke Consult Service Implementation on Interhospital Transfers
Authors: Stamm Brian , Tang Qing , Daggy Joanne , Myers Laura , Calcatera Samantha , Spontak Katrina , Larson Jason , Musser William , HERMANN LISA , Damush Teresa , Williams Linda
Published: January 2025

Introduction:
Telestroke improves access to vascular neurology expertise and aids in decision-making for acute ischemic stroke (AIS). Prior studies from the Veterans Health Administration (VHA) demonstrated that the implementation of an acute national telestroke program (NTSP) led to reduction in interhospital transfer rates. Few studies have examined subacute inpatient telestroke services, focusing on inpatient stroke workup and management. We sought to determine the impact of a novel subacute telestroke program on emergency department (ED) transfer rates at participating hospitals.

Methods:
This was a retrospective cohort study of patients with ED diagnosis of AIS from 10/2021-6/2024. For intervention sites, the period prior to subacute consult “go-live” date was considered the pre-implementation period. Control sites (NTSP acute telestroke sites that had limited ED/inpatient neurology coverage and had expressed interest in the program) were considered pre-implementation prior to 5/22/2023 (the date when approximately half of intervention sites had initiated the subacute program). Logistic regression with a generalized estimating equation approach to handle clustering within facility was used to evaluate the association between implementation time-period (post/pre) and odds of ED transfer (yes/no) in intervention and control sites, adjusting for age, NIHSS, sex, race, and an intervention by time-period interaction term. Given NIHSS missingness of 23%, multiple-imputation using predictive mean matching was performed.

Results:
1266 patients met eligibility criteria (N=544 patients from 11 control sites and N=722 patients from 11 intervention sites). The ED transfer rate was lower within intervention sites post-implementation (pre: 25.7% to post: 22.5%) and higher in control sites (pre: 25.9% to post: 27.1% ; Table 1). These comparisons were statistically nonsignificant in the multivariable analysis for both complete case and multiple-imputed models where younger age and increased NIHSS were associated with increased odds of transfer (Table 2).

Discussion:
There was a numerical reduction in interhospital transfers for AIS among intervention sites after implementation of a subacute telestroke consultation service, but the results were statistically nonsignificant in adjusted models. Future analyses should evaluate whether receipt of a subacute telestroke encounter at the patient-level is associated with reduced interhospital transfer for stroke.
Inference for Parameters Identified by Conditional Moment Restrictions Using a Generalized Bierens Maximum Statistic
Authors: Chen Xiaohong , Lee Sokbae , Seo Myung Hwan , Song Myunghyun
Published: January 2025

Many economic panel and dynamic models, such as rational behavior and Euler equations, imply that the parameters of interest are identified by conditional moment restrictions. We introduce a novel inference method without any prior information about which conditioning instruments are weak or irrelevant. Building on Bierens (1990), we propose penalized maximum statistics and combine bootstrap inference with model selection. Our method optimizes asymptotic power by solving a data-dependent max-min problem for tuning parameter selection. Extensive Monte Carlo experiments, based on an empirical example, demonstrate the extent to which our inference procedure is superior to those available in the literature. [C12, C36].
Heterogeneous Preferences for Neighborhood Amenities: Evidence from GPS Data
Authors: Cook Cody
Published: January 2025

How do preferences for neighborhood amenities vary by income? Using data on over 100 million visits to 1.4 million establishments, I estimate a discrete choice model of demand for restaurants, shops, personal services, and entertainment places. While preferences for specific establishments often vary by income, preferences for neighborhoods' overall amenity access are highly aligned. The primary determinant is density: dense urban areas have sufficient variety to offer broad appeal. For incumbents of gentrifying neighborhoods, tailoring amenities to higher-income entrants has only modest welfare effects relative to the effects of potential displacement to cheaper neighborhoods with worse access to amenities.
Finitely Heterogeneous Treatment Effect in Event-study
Authors: Shin Myungkou
Published: January 2025

A key assumption of the differences-in-differences designs is that the average evolution of untreated potential outcomes is the same across different treatment cohorts: parallel trend assumption. In this paper, we relax the parallel trend assumption by assuming a latent type variable and developing a type-specific parallel trend. With a finite support assumption on the latent type and long pretreatment time periods, an extremum classifier consistently estimates the type assignment. Based on the classification, we propose a type-specific DiD estimator for type-specific ATT. By estimating the type-specific ATT, we study heterogeneity in treatment effect, in addition to heterogeneity in baseline outcomes.
Self-, Peer-, and Teacher Perceptions Under School Tracking
Authors: Malamud Ofer , Mitrut Andreea , Pop-Eleches Cristian , Urquiola Miguel
Published: January 2025

We examine student, teacher, and peer perceptions of effort, ability, performance, and self-confidence in Romania's highly tracked schools. We find that: (1) students just above a cutoff—tracked into high-achieving classes—have less favorable self-perceptions than those just below (“big-fish-little-pond” effects); (2) students perceive peers in their classes more favorably (“in-group bias”); (3) this bias is stronger in lower-achieving classes; (4) students perceive themselves more positively than others perceive them (“illusory superiority”); (5) this bias is stronger among lower-achieving students (“Krueger-Dunning effects”). In short, being tracked into lower-achieving classes does not appear to negatively affect self-perceptions.
Can Educational Outreach Improve Experts' Decision Making? Evidence from a National Opioid Academic Detailing Program
Authors: Zhang Jonathan
Published: January 2025

Healthcare providers often deviate from guidelines, leading to worse outcomes. I study the impact of academic detailing (also known as educational outreach) to primary care teams on safer pain management, risk evaluation, harm reduction, and opioid use disorder treatment. Using data from over 5 million patients, I find detailing improves provider behavior: it increases naloxone prescribing, prescription drug monitoring queries, and reduces opioid prescriptions for three years. Patients have fewer emergency visits and hospitalizations for overdoses, suicides, and accidents, especially heavy opioid users. Importantly, pain scores remain stable despite reduced opioid use, highlighting detailing's role in fostering safer, effective care.
Wealth Taxation and Charitable Giving
Authors: Ring Marius A. K. , Thoresen Thor O.
Published: January 2025

We use third-party reported data and two quasi-experiments from Norway to study how tax incentives affect charitable giving. First, using a shock to wealth tax exposure, we estimate the semi-elasticity of giving with respect to the after-tax return on wealth. Inconsistent with the notion that households accelerate giving to reduce future taxes, we find that a 1% wealth tax reduces giving by 26%. Second, using bunching at an income-tax deduction threshold, we estimate a moderate own-price elasticity of giving of -0.44. This elasticity exhibits little heterogeneity with respect to income and wealth but is considerably larger for religious giving.
Two new and two little-known species of the genus Axenyllodes Stach, 1949 from Russia and Kazakhstan
Authors: BABENKO ANATOLY , SHVEENKOVA YULIA , ARBEA JAVIER I.
Published: January 2025

A review of the genus Axenyllodes in the fauna of the European part of Russia and Kazakhstan is conducted, two new species (A. chinki sp. nov. and A. potapovi sp. nov.) are described, and A. ghilarovi Martynova is redescribed based on the holotype and new material from the Volga region. Taxonomic notes are also given on two other species of the genus, A. bayeri (Kseneman) and A. echinatus Fjellberg, occurring in this region.
China in African Americans’ Pursuit of Equality during the Second World War
Authors: Zhang Tao
Published: January 2025

After Pearl Harbor in 1941, African Americans could no longer openly view Japan as a staunch ally in the fight against American racism. China, formerly looked down upon as weak in front of white people, suddenly emerged as a preferred alternative. However, Japan continued to justify its fascism by describing the war as fundamentally racial, in a clear attempt to draw nonwhite peoples into its confrontation with Euro-American nations. Rather than succumbing to this manipulation, African Americans reframed the war as a struggle for humanity, emphasizing the compassionate and generous disposition inherent among human beings. They envisioned China as embodying this quality and utilized its identity as both a nonwhite ally of white America and a victim of nonwhite Japan. This strategy aimed not only to debunk the notion of a ‘racial war’ but also to press white Americans to treat Black people with humane dignity. Though only successful in demonstrating African Americans’ loyalty to the nation, the de-racing maneuver represented a significant but often overlooked step in their pursuit of racial equality.
Policing and mental health: A rapid evidence assessment of the patterning of police activity
Authors: Kyprianides Arabella , Bradford Ben
Published: January 2025

Existing evidence suggests exposure to police activity negatively impacts the mental health of the policed. But research on whether, and why, police activity is correlated with the prevalence of mental health challenges among individuals and in specific areas remains piecemeal. We conducted a Rapid Evidence Assessment (REA) of the literature examining the association between policing and mental health, with a focus on investigating whether people in poor mental health are more likely to interact with police, whether police activity is higher in areas where people face more mental health challenges, and the reasons for these interactions. A total of 31 studies exploring the scale and reach of police encounters involving individuals dealing with mental health issues were included. The evidence suggests a pattern of heightened policing activity in specific geographic areas where individuals contend with elevated mental health challenges, and police spend more time dealing with individuals with mental health issues compared to the general population. These interactions occur for a wide variety of reasons, and people with mental health conditions encounter the police as victims, offenders, people in need and in other roles. Implications and directions for future research are discussed.
The Effect of Browser-Based 360°VR on the Science Achievement Gap Between Students with and Without Disabilities
Authors: Kohnke Shalece
Published: January 2025

The ongoing science achievement gap between students with and without disabilities affects informed citizenry and job opportunities. This study explored the impact of extended reality (XR) in inclusive 9th-grade biology classrooms using browser-based 360° virtual reality (VR). The primary research question is: Does using XR (i.e., browser-based 360° VR in science lessons lead to a statistically significant performance difference between secondary students with and without disabilities? Although a one-way Multivariate Analysis of Variance (MANOVA) yielded non-significant results, a moderate effect size suggested a meaningful difference, prompting further investigation. A follow-up MANOVA on pre- and post-change scores was statistically significant. The secondary research question on social validity is: What opinions do students and teachers express about learning after students use XR during science lessons? Surveys indicated that students and the teacher found VR beneficial, recommending it as a supplement. Implications for research, practice, and technology developers are provided.
Understanding music teachers’ formative assessment intention and implementation: A Chinese Mainland context
Authors: Zhang Le-Xuan , Yan Zi , Wang Xiang
Published: January 2025

Formative assessment is essential in music education as it supports the music learning process, which relies mostly on feedback from self and others to improve performance. Despite growing interest in formative assessment across various subjects, there is a lack of empirical evidence on how it is applied specifically in music education. Given the crucial role of teachers in the effective implementation of formative assessment, this study aims to examine music teachers’ intentions and implementation of formative assessment, along with the factors influencing them, based on the Theory of Planned Behavior. A total of 671 music teachers from 29 cities/provinces of Mainland China were surveyed. The structural equation modeling results indicate that in the Chinese Mainland school music education context, a positive attitude toward formative assessment, a supportive and collaborative social environment, and strong confidence in using formative assessment enhance teachers’ intentions to adopt it. Additionally, greater confidence directly increases actual implementation. However, increased school support did not significantly impact teachers’ intentions or their implementation of formative assessment. The findings suggest that school administrators should focus on helping music teachers build confidence and fostering a collaborative, supportive culture for using formative assessment practices to improve music learning.
Development of an Occupant Load Criterion Model for Vehicle Frontal Crashes: Introduction of a Dynamic Model
Authors: Komari Omid , Merrill Zachary
Published: January 2025

The prevalent method for assessing the forces on a restrained occupant during a collision involves evaluating the restraining forces as the body decelerates in what is known as the occupant load criterion (OLC) model. This model quantifies the restraining forces on frontal occupants during vehicle deceleration in frontal crashes. The original OLC model features a single mass representing the occupant connected to the vehicle via a spring with constant stiffness. The original OLC model assumes that no force is applied to the occupant until the restraint reaches a specified relative distance (slack length). Then, a constant force is applied until the occupant reaches the maximum restraint length. However, the original model neglects the forces on the occupant during the initial collision phase that result from factors like seatbelt slack, elasticity, occupant characteristics, and restraint system delays. This article proposes a time-dependent OLC model that utilizes a standard linear solid (SLS) model to incorporate creep and stress relaxation. Unlike the ideal restraint assumption in the original model, the proposed model can address nonlinear interactions between occupants and restraints. Spring and damper coefficients in the SLS model were calibrated using New Car Assessment Program (NCAP) frontal crash test data for four-door sedans. The coefficients determined for this vehicle class could be used to predict the peak chest forces applied by the restraint system to within an average of 10% of measured values.