bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract 401: Shortening of Action Potential Duration With Increased Work in Contracting Rabbit Heart
Authors: Garrott Kara E , Wengrowski Anastasia , Zhang Hanyu , Rogers Jack , Kay Matthew 
Published: July 2021

Studying heart function in contracting hearts at higher workloads provides crucial knowledge of cardiac performance in high-stress situations. Ratiometric optical mapping of fully loaded hearts is a novel method to study electrical activity while replicating in vivo energy consumption.
We predict that an imbalance between energy supply and demand during increased work and hypoxia will manifest in shortened action potential duration (APD), especially in the more physiologically-relevant bi-ventricular (BiV) working heart.
Rabbit hearts were perfused with oxygenated Krebs-Henseleit solution in unloaded Langendorff and fully-loaded BiV mode. Epicardial action potentials (APs) were measured using optical mapping of Di-4-ANEPPS. Excitation ratiometry using 450 and 505 nm illumination on alternate camera frames together with motion tracking removed motion artifact. Aortic pressure, left atrial preload, and LVDP was measured. A range of workloads were studied by pacing at 330, 220, and 170 ms cycle length (CL). Gradual hypoxia was induced by bubbling with N2 gas.
In Langendorff mode, the APD was 137.67±4.29 ms, 113.44±7.89 ms, and 106.44±0.44 ms at CL of 330ms, 220ms, and 170ms, respectively, while in BiV mode, the APD was 106.56±13.03 ms, 78.00±2.33 ms, and 69.33±0.77 ms. Aortic pressure dropped from NSR in BiV hearts by 1.26% at 330ms, 4.11% at 220ms, and 11.65% at 170ms CL.
Shortening of APD, independent of restitution, with increasing HR indicates an imbalance of energy supply and demand with greater workload. KATP channels are implicated. This novel method of optical mapping reveals important implications of electrophysiological changes during high-stress situations.
Abstract 426: A Novel Method to Study Viral Cardiomyopathy
Authors: Shah Millie , Borgman Cheryl , Janes Kevin 
Published: July 2021

Latent coxsackievirus B3 (CVB3) cardiac infections are implicated in the development of DCM with persistent enteroviral RNA found in up to 66% (30/45) of DCM patient biopsies who are at a 6-fold higher risk of fatality. Current treatments aim at delaying heart failure but none address the viral etiology of the disease. Viral protein presence is thought to disrupt normal cellular signaling leading to tissue dysfunction. The downstream effects of viral perturbations are complex and wide-ranging; especially in proinflammatory contexts seen clinically. Thus, comprehensively understanding the molecular mechanisms of CVB3-mediated disease is key in developing treatments for viral DCM patients. In this study we built a novel in vitro model of chronic CVB3 infection to facilitate high-throughput, systems-level studies of viral cardiomyopathy.
Current methods of studying CVB3 rely on animals or animal derived cardiac cells, making large-scale intracellular signaling studies difficult, time intensive, and expensive. To facilitate high-throughput studies we used immortalized human cardiomyocytes to engineer single-cell derived cell lines that express a maturation deficient CVB3 genome. CVB3 RNA expression was validated in each line by two independent methods: gene-specific nested qRT-PCR and single molecule RNA fluorescence in situ hydridization (smFISH). Plaque-assay verified that viral RNA expression did not result in live virus release.
Microarray analysis shows that CVB3 expressing cell lines have altered immune cytokine, extracellular matrix protein, and stress-signaling protein expression. Further, differences between CVB3 expressing lines suggest differential responses to viral RNA expression which may identify a set of beneficial adaptations. Future studies will include high-throughput signaling protein activity assays we have developed specifically for phosphatase and kinase activity quantification with the aim of linking immune cytokine signaling dysregulation to pathogenic gene expression. These studies will deepen our knowledge of CVB3-mediated DCM and identify proteins whose targeted modulation could offer new treatment strategies to patients whose current options are either palliative care or heart transplantation.
Abstract NS3: Code Stroke Interventional Radiology: Streamlining Processes For Expedited Patient Identification And Door To Groin Puncture Time
Authors: Schlegel Sherene , Likosky William , Gabelein Chad , Nord Stuart 
Published: July 2021

Building on the success of Code Stroke as well as Code STEMI, we embarked on a journey to develop CODE STROKE IR for the streamlined delivery and appropriate identification of patients that may benefit from neuro-interventional therapies. Baseline data demonstrated our door to groin timeframe exceeded two and half hours as a result of undefined roles and responsibilities and the lack of a coordinated approach. We created a taskforce comprised of stroke team clinicians, analyst, neuro-interventionalists, as well as stakeholders from pharmacy, lab, ED, radiology, ICU and nursing.
Implementation strategies comprised mapping ideal workflow, identification of expected timeframes, algorithm development, staff training, mock drills and data review. Additionally we recognized a need to collaborate with our telestroke partners and transport agencies to assure clear communication and expedited transport of the patient to our organization. For appropriate patient selection, we included in our algorithm CT or MR diffusion perfusion mismatch and angiographic confirmation of occlusion.
Since the implementation of CODE STROKE IR in June 2011, we have been able to execute a well-choreographed streamlined approached to appropriately identify neuro-interventional rescue patients. Over 13 months we had 33 CODE STROKE IRs, of which 18 were identified as rescue candidates and proceeded to intervention. Our median door to groin time is now 89 minutes and we have a best practice of 63 minutes. Strategies to improve our processes are ongoing and consist of prompt review of each case followed by concurrent feedback to involved staff, reeducation of roles, and modification of workflow as indicated.
Abstract WP285: Hemicraniectomy Outcomes in Patients with Malignant Middle Cerebral Artery Infarctions Plus
Authors: Sangha Navdeep S , Irani Malcolm , Peng Hui , Wu Tzu-Ching , Barreto Andrew D , Savitz Sean I , Grotta James C , Gonzales Nicole 
Published: July 2021

Hemicraniectomy (HC) is a proven treatment to reduce mortality and improve outcomes in patients with malignant middle cerebral artery (MCA) infarction.
The benefit of HC in patients with MCA strokes plus infarctions in other vascular territories has not been well defined. We hypothesized that there would be no difference in outcomes in patients with MCA strokes compared to those with MCA Plus infarctions.
We retrospectively reviewed our registry from 07/2003 to 12/2011, and identified consecutive patients diagnosed with an ischemic stroke that underwent HC. Outcome measures included mRS at discharge, mRS at day 90 and death at one year. A good outcome was defined as mRS 0-4. The vascular territory of infarction was established by a vascular neurologist who reviewed the nearest CT scan prior to the procedure and compared it with the official interpretation of a neuroradiologist. The MCA Plus infarctions included MCA + anterior cerebral artery
(ACA), MCA + posterior cerebral artery (PCA) and MCA + ACA + PCA.
Ninety seven patients had a HC. Sixty four were MCA and 33 were MCA Plus. The mean MCA and MCA plus ages were 51.9 (± 14.2) and 51.3 (± 12.8) years respectively.
Median NIHSS was 12.5 (IQR 10.0-15.0) in MCA vs. 12.2 (IQR 9.5-14.0) in MCA Plus. MCA group had a good outcome at discharge in
25% of subjects vs. 21% in the MCA Plus cohort, OR 0.72 (95% CI: 0.24-2.15). For patients with available data, 40% of MCA was dead at 90 days and 50% in MCA Plus, and for those who survived, 33% of MCA had a good outcome compared to 15% of the MCA Plus, OR 2.4 (95% CI: 0.45-7.61).
Forty eight percent of MCA patients were dead at one year vs. 76% of the MCA Plus patients.
We found no difference in good outcomes at discharge and 90 days in our cohort of patients who received a HC with MCA or MCA plus infarctions. Limitations include a high rate of missing data at day 90 and at one year, and poor standardization of HC timing. Further prospective studies are necessary to evaluate the clinical implications of HC in MCA Plus syndromes.
Abstract WP342: Clinical Practice Guidelines supported through Interdisciplinary Stroke Rounds
Authors: Krokoski Brenda 
Published: July 2021

Purpose:
Interdisciplinary stroke rounds were created as a communication forum for staff working with the stroke survivor and family in our hospital stroke unit. The interdisciplinary team discusses patient specific needs in addition to met and unmet clinical practice guidelines.

Methods:
Interdisciplinary stroke rounds are scheduled daily at a set time in the stroke unit conference room. The team is comprised of the following members and disciplines: RN Unit Manager, RN charge nurse, RN caregiver for the patient, Stroke program Nurse Coordinator, Physician Director of the Stroke Program, rehabilitation specialists: speech, occupational therapy, physical therapy, registered dietician, chaplain, casemanager, liaison RN for admission to acute rehabilitation, skilled nursing or outpatient rehabilitation. A precise discussion is coordinated by the RN charge nurse or the Stroke Nurse Coordinator using a stroke performance measure template accessible to the team.

The interdisciplinary team provides input related to their expertise. Eight of the standard stroke performance measures are discussed and addressed for compliance. Compliant staff documentation and patient education opportunities are discussed and interdisciplinary care plans are activated.
The interdisciplinary team summarizes the needs identified in stroke rounds and each member is responsible for completion before the end of their shift.

Results:
Our hospital has earned the Stroke Get with the Guidelines (GWTG) gold plus award for multiple consecutive years. Compliance with the national standards for stroke reflected within our GWTG data is largely due to our interdisciplinary stroke rounds and staff accountability.

Conclusions:
Utilizing a specific stroke performance measure tool during interdisciplionary stroke rounds enables our team to review all stroke performance measures, ensure documentation is complete and allows an interchange of ideas among disciplines to provide the best care to the stroke survivor and family..
Abstract T P174: Stroke Severity in Patients With Different Durations of Atrial Fibrillation
Authors: Wachter Rolf , Weber-Krueger Mark , Stahrenberg Raoul , Seegers Joachim , Gröschel Klaus ,   Find-AF study group
Published: July 2021

Background:
Persistent atrial fibrillation (AF) is a common risk factor for stroke. Strokes caused by AF are usually more severe as compared to stroke in patients without AF. Recent evidence suggests that stroke risk in paroxysmal AF is similar to persistent AF, but which minimal duration of AF already increases stroke risk, is unknown. We aimed to compare stroke severity in stroke patients with different durations of AF.

Methods:
272 stroke patients were prospectively included. 43 had AF on admission (persistent AF). During 7-day-Holter-ECG, an additional 29 patients were diagnosed with AF of at least 30 seconds (paroxysmal AF). 200 patients had no AF > 30 seconds. Of these, 72 had supraventricular runs of at least 10 beats during 24h-Holter ECG. Stroke severity was characterised by NIH stroke scale (NIHSS) and modified Rankin scale (mRS). All values are given as median (25%/75%) and compared by Mann-Whitney-U-Test.

Results:
NIHSS and mRS values were similar in patients with persistent and paroxysmal AF (see table: p=0.239 (NIHSS), p=0.623 (mRS), respectively. In patients with no AF, NIHSS: 2 (1-4) and mRS: 2 (1-3) were significantly lower as compared to patients with paroxysmal AF (NIHSS: p <0.001; mRS: p=0.034).

NIHSS and mRS did not differ in patients with short episodes of paroxysmal AF (6 minutes or shorter) as compared to patients with medium duration of episodes (6 minutes to 6 hours) or long episodes > 6 hours.
In patients with no AF, the presence of supraventricular runs of at least 10 beats was not associated with higher NIHSS or mRS as compared to patients without supraventricular runs (p=0.239 and p=0.621, respectively).

Conclusion:
Our results suggests that patients with paroxysmal AF of at least 30 seconds during 7-day-Holter have strokes similar to patients with persistent AF. Whether these patients benefit similarly to persistent AF patients from anticoagulation for secondary stroke prevention, should be investigated in further prospective randomised trials.
Abstract T P86: Lipid Profiling Reveals Galatosylceramide Increasing in Plasma of Atherosclerotic Stroke
Authors: Huang Yining 
Published: July 2021

The development and innovation of new technique in metabonomics research and its application in medicine provides important resolution in screening biomarkers and targets for further investigation. The metabonomics research has unique advantages of facility, objection and reliability compared with other -omics studies.
Lipidomics research was development based on metabonomics and has supreme merits in study of lipids related disease.

Method:
The carotid arthrosclerosis patients with stroke suffered before were recruited in this research. The items of lipid related laboratory examinations of these patients are normal because of well controlling under drug-taken. The peripheral blood of these patients was drawn and the plasma was isolated after centrifugation. The lipids from plasma were extracted by the standard Folch method. Then the lipids samples were injected for lipid profile analysis by 2D QoF LC/MS. The qualitative differentiations of these lipids were based on their m/z value, characteristic of the compounds fragmentation, direct and relative retention time of each lipid class. On the establishment of the lipids identification, we validated this newly 2D QoF LC/MS method following these measurements including its calibration equations, low of the detection and relative standard deviation.

Result:
Compared with native subjects, 518 different types of lipids molecular from 17 classes were identified from plasma of atherosclerosis patients by the method of 2D QoF LC/MS; The galactosylceramide and glucoceramide were identified separately although they were same of molecular weight; We proved that the levels of galactosylceramide, rather than glucoceramide were increasing in atherosclerotic stroke patients.

Conclusion:
the increasing levels of galactosylceramide in plasma of atherosclerosis patients hint that the immune effects induced by lipids play an important role in atherosclerosis.
Abstract W P155: Antiplatelet Therapy Benefit in Secondary Stroke Prevention in Patients With Suboptimally Controlled Treatable Cerebrovascular Risk Factors
Authors: Umer Muhammad , Kurako Kateryna , Galvez-Jimenez Nestor , Salgado Efrain 
Published: July 2021

Objective:
To assess the impact of antiplatelet therapy for secondary stroke prevention in patients with suboptimally controlled treatable cerebrovascular risk factors per guidelines.

Results:
Of the 1755 patients, 219 (12.47%) patients had a second stroke event between November 2006-December 2012. Mean age of this group of patients was 66.4 years old with male predominance (M:F=1.5:1). 192 (88%) patients were on antiplatelet therapy at the time of the second stroke. 27 (12 %) were not on antiplatelet therapy.

Of the total cohort, treatable risk factors were poorly controlled in 130 (59%) patients: 121 (55%) hypertension; 78 (36%) hyperlipidemia, 44 (20%) diabetes.
Antiplatelet agents included aspirin, clopidogrel alone or in combination with aspirin, and extended-release dipyridamole. The data showed no significant difference among antiplatelet agents for secondary stroke prevention (p<0.05).
Stroke classification was as follows: 162 (74%) ischemic and 57 (26%) hemorrhagic. Categories of ischemic stroke were as follows: large-artery atherosclerosis 40 (18%), small vessel disease 45 (21%), cardioembolic 42 (19%), 35 (16%) cryptogenic / stroke of undetermined etiology. Of the 192 patients on antiplatelet therapy with stroke, 116 (60%) had poorly controlled risk factors.

Conclusions:
This study suggests that the use of antiplatelet therapy, regardless of which agent, for secondary stroke prevention may not be important or beneficial in the absence of optimal treatable cerebrovascular risk factor control. Further studies are needed to support this finding including further analysis of our data to assess risk factor control in those patients on antiplatelet therapy who did not suffer a second stroke during the period of surveillance
Abstract T P127: Look Past the NIHSS! Rehabilitation Metrics that Predict Home Discharge in Ischemic Stroke Patients
Authors: Ifejika Nneka , Aramburo-Maldonado Linda , Cai Chunyan , Sline Melvin R , Noser Elizabeth A , Wang Jing , Grotta James C , Savitz Sean I 
Published: July 2021

Introduction:
The goals of stroke rehabilitation are to restore functional ability and to return patients' home with a good quality of life. There is a paucity of data on stroke rehabilitation tools that both track improvements and help predict the likelihood of home discharge.

Hypothesis:
Improvement in functional independence measure (FIM) score increases home discharge rates, decreases acute care readmissions and decreases placement in skilled nursing facilities (SNF). Advanced age and infections such as symptomatic UTI (SUTI) negate FIM score improvement.

Methods:
We merged the prospectively collected Stroke and Neurorehabilitation Registries at our comprehensive stroke center, identifying ischemic stroke patients admitted between January 2011 and November 2013 (n=367). Demographics, rehabilitation metrics and NIHSS were collected. Age, SUTI, discharge FIM and rehabilitation length of stay (LOS Rehab) were included in the multivariate regression.

Results:
Of 367 ischemic stroke patients, 273 went home, 47 to a SNF, 25 to acute care and 22 to another facility (i.e.,assisted living, board and care). All patients tolerated 3 hours of daily therapy (PT, OT, SLP).

Despite median NIHSS values of 9 in both groups (P=0.356), patients with SUTI had lower FIM scores on admission (49.2 ± 13.9 vs. 56.8±15.2; P<0.0001) and discharge (68.5 ± 16.9 vs. 76.3 ± 17.0; P<0.0001).
For a one year age increase, there was a 5% increase in SNF admit (OR 1.05, 95%CI 1.02-1.08; P<0.001) compared to home.
For a one unit increase in FIM, there was a 4% decrease in another facility admit (OR 0.96, 95% CI 0.93 to 0.99; P<0.01), a 6% decrease in SNF admit (OR 0.94, 95%CI 0.92-0.96; P<0.001) and a 10% decrease in acute care readmit (OR 0.90, 95% CI 0.88-0.94; P<0.0001) compared to home.
For a one day increase in LOS Rehab, there was a 19% decrease in acute care readmit (OR 0.81, 95% CI 0.73-0.89; P<0.0001) compared to home, and a 7% increase in home discharge compared to another facility (OR 1.07, 95% CI 1.02 to 1.12; P<0.001).

Conclusions:
Improved FIM score and increased LOS Rehab were the primary criteria for home discharge after stroke rehabilitation. Advanced age increased the likelihood of SNF placement. SUTI impacted rehabilitation progress, but did not affect discharge to home.
Abstract W P255: Neuroprotective Effects Of Thyroid Hormone - T2 (3,5-diiodo-I-thyronine) After Transient MCAO In Mice
Authors: Mdzinarishvili Alexander , Sadana Prabodh 
Published: July 2021

T2 (3,5-diiodo-I-thyronine) is an active metabolite of T3 (3,3’,5’-triiodothyronine), a key hormone secreted by the thyroid gland. It has been found to significantly increase mitochondrial respiration and cytochrome oxidizes activity in both in vitro and in vivo studies. T2 has a much more rapid stimulation of metabolic rate (1 hour for T2 vs 24 hours for T3). Neuroprotective effects of T3 have previously been demonstrated. Here, we have investigated the neuroprotective effects of T2 on brain ischemia and edema formation in t-MCAO mice model of brain stroke.
CD-1 mice (25-30 g) were treated with T2 (5 mg/kg) or vehicle control (PBS) by i.v. injection through the jugular vein 30 min before brain stroke was induced. To confirm appropriate placement of the monofilament suture, cortical blood perfusion values were monitored by Laser-Doppler flowmetry during surgical preparation and for 30 min after cerebral ischemia. After 1h of t-MCAO monofilament suture was withdrawn for blood reperfusion and animals were sacrificed after 24h. 1 mm coronal brain slices were prepared and stained with 1% TTC (2,3,5-triphenyltetrazolium chloride) for t-MCAO. Volumes of brain ischemia and edema formation were evaluated.
In vivo results for t-MCAO (1h) showed that T2 (5 mg/kg) reduced brain infarct volume by 42% (p<0.005), and edema formation by 65% (p<0.001). Preliminary gene expression studies showed that T2 has marked influence on gene programs involved in neuronal energy metabolism, mitochondrial biogenesis, ROS generation and brain edema. Ongoing work in our lab is elucidating the exact mechanisms of neuroprotective actions of T2. Neuroprotective effects of T2 in t-MCAO brain stroke model suggest that T2 is a potential new candidate for developing of neuroprotective therapies for brain ischemia and edema. Our studies showed that T2, even though mechanistically distinct from T3, retains the neuroprotective activity of T3 in ischemic stroke and raises the possibility that T2 activity has a role in the neuroprotection seen by T3.
Abstract W P274: Characterizing The “Universe” Of Transitional Care Programs For Stroke Survivors In The United States
Authors: Abir Mahshid , Vickrey Barbara G , Koegel Paul , Broderick Joseph P , Suter Robert , Watson Sam R , Watson Sam R , Barsan William G 
Published: July 2021

This study’s purpose is to characterize the range of TC programs for stroke survivors in a national sample of healthcare facilities in the U.S., as an initial step toward ultimately associating those characteristics with TC program outcomes.
Hospitals in the following networks were invited to complete an electronic survey: The National Institute of Neurological Disorders and Stroke’s Neurological Emergencies Treatment Trials network and StrokeNet, the American Heart Association’s Get With The Guidelines hospitals, and the Michigan Health & Hospital Association. The survey inquired whether the facilities have stroke TC programs, program description, number of patients seen annually, facility type, and healthcare context.
Out of 82 respondents, 65 hospitals reported a TC program, and 17 did not have such programs. Respondents include facilities from all five U.S. geographic regions. The 42 facilities that reported the annual number of patients served, served between 48.0-1974.0 patients (median 426.0, inter-quantile range 245.0-840.0). Of the facilities that reported hospital type, 23 (57.5%) are academic, 7 (17.5%) are academic affiliates, and 10 (25%) are community. Of the 25 facilities that reported the healthcare setting in which the TC program is delivered, 12 (48%) are delivered in a fee-for-service, 6 (24%) in integrated delivery system, 3 (12%) in traditional primary care, and 1 (4%) in a patient-centered medical home. TC program components reported (in descending order of frequency) include: Support services, call-backs, transitional planning, inpatient physical rehabilitation, care coordination, neurology follow up, telemedicine, home visits, anytime access. Of the 61 facilities that provided information regarding the TC program components 33 (51%) have one, 15 (23%) have two, 8 (12%) have three, and 5 (8%) have four components.
This survey found substantial heterogeneity in TC programs. A standardized definition of TC program components is not available, hence the necessary first step in studying comparative effectiveness of TC programs is building a taxonomy of TC program components. This will enable analysis of the most effective TC programs, and ultimately guide improving the TC experience and outcomes for stroke survivors.