bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract T P346: ‘Expedite For Thrombolytic’ Patient Designation and Early Ordering for Improved Door-to-Needle Times in Acute Ischemic Stroke
Authors: Bajkiewicz Christopher T , Kalafut Mary , Olson Lindsay , Afshar Katherine 
Published: July 2021

Purpose:
The American Heart Association’s ‘Target: Stroke Phase 2’ (TS2) ‘door-to-needle’ time sets a goal for IV tPA administration of <45 minutes in >50% of eligible patients. In order to meet this goal we delineated a set of patient characteristics which would trigger an expedited pathway for IV tPA administration. These characteristics included a well documented time of onset, obvious and significant stroke and no history of anticoagulant use. We then used this patient group to implement processes to decrease door to needle time. Methods: A retrospective cohort of 35 IV tPA, ED-administered cases from 5/2013-2/2014 were reviewed. DTN <60 minutes was achieved in 22 cases (62.9%, mean 62.0 min, median 45.0 min). EMS, field-initiated stroke codes expedited evaluation in 65.7% of patients. Turn-around-times (TAT) in Stroke Code processes (non-contrast head CT and laboratory results) demonstrated 95.7% compliance with benchmark times. The time of presentation to orders received for IV tPA revealed a mean of 48.8 min and median of 45.0 min. Cases with DTNs >60 minutes (n=13), documented reasons include family indecision (38.5%), blood pressure management (15.4%) and other (46.1%). Results: Neurologists, ER physicians, nursing, pharmacy, and radiology used the data to construct a new, consistent processes to safely deliver IV tPA in <45 minutes.

In the first 90 days, ED IV tPA times (N=16) dropped to 48.5 min, median 49.5 min.
The expedite-for-thrombolytic principle ‘to treat unless excluded’ aligns and assists in meeting the benchmarks identified in TS:2 (goal IV tPA <45 minute DTN). Additional research is needed to identify time-reducing means while improving patient stroke outcomes.
Abstract W P121: Patterns Of Vessel Involvement In Patients With Intracranial Atherosclerosis Across Ages
Authors: Strohm Tamara , Cerejo Russell , Mathew Jason , Katzan Irene , Uchino Ken 
Published: July 2021

Introduction:
Intracranial atherosclerosis has been well studied in the aging population, much less is known about atherosclerotic stenosis in the young. Clinicians seek to control traditional vascular risk factors in this population, but differences in patterns of stenosis may call for varied treatment approaches. This study sought to compare age to the distribution of vessel involvement in patients with moderate-severe intracranial stenosis.

Methods:
This is a retrospective cohort study of patients with intracranial stenosis seen in the stroke clinic of a tertiary center from 2008-2013.

Inclusion criteria were moderate-severe intracranial stenosis clinically felt to be due to atherosclerosis with ≥3 traditional vascular risk factors. Patients with other mechanisms of intracranial stenosis were excluded. Stenosis location and severity were based on cerebral angiography, CTA, or MRA. Patients were divided into young (< 50 yr), middle-age (51-64 yr), or older (≥
65 yr). All 69 patients ≤50 yr were included; a random sample of 69 patients > 50 were selected for this analysis.

Results:
There were similar rates of vascular risk factors except HTN, which was less common in the young group (81.2% young, 100% middle, 96.8% older, p=0.0006). The location of stenoses varied by age category. Older patients had more posterior circulation involvement compared to the younger groups (p = 0.046), with more frequent involvement of vertebral and basilar arteries (p = 0.012) (Table). The occurrence of stenosis in the distal ICA and MCA vessels were similar among age groups. The frequency of ACA stenosis was highest in the young category (p = 0.026).

Conclusion:
There are differences in anatomic locations of presumed intracranial atherosclerosis across age groups with older patients (> 65 yrs) having a higher rate of posterior circulation disease. This suggests potential differences in pathophysiological mechanisms. These findings warrant further investigation.
Abstract W P93: MiR-122 Improves Stroke Outcomes after Middle Cerebral Artery Occlusion in Rats
Authors: Liu DaZhi , Jickling Glen C , Ander Bradley P , Hull Heather , Zhan Xinhua , Dykstra-Aiello Cheryl , Stamova Boryana , Sharp Frank R 
Published: July 2021

MicroRNA (miRNA) are recently discovered small (~22 nucleotides), non-coding RNA that regulate translation of messenger RNA (mRNA) to protein. Though there are only hundreds of miRNAs, each of them can potentially regulate hundreds of target genes, via base-pairing with complementary sequences in mRNA. This provides one approach that targets a single miRNA to have effects on multiple genes.
Our previous genomic studies have demonstrated that miR-122 decreased significantly in blood of experimental strokes produced by middle cerebral artery (MCA) occlusion in rats as well as in blood of patients with ischemic strokes. Therefore, we hypothesized that elevating blood miR-122 has the potential for treating stroke. Using the newly developed in vivo polyethylene glycol-liposome based miRNA transfection system and rat suture MCAO occlusion model, we show that injection of chemically modified mimic miR-122 (600ug/rat, i.v.) through tail vein immediately after MCAO occlusion significantly decreases the neurological impairment and significantly attenuates brain infarct volumes. Ongoing studies are identifying the target genes that are associated with the neuroprotective effects of miR-122 following stroke.

Acknowledgements:
This study was supported by NIH grant R01NS066845 (FRS). There were no conflicts of interest.
Abstract TP63: Lacunarization After Endovascular Treatment: a Surrogate Marker of Good Functional Outcome
Authors: Cardona Pedro , Quesada Helena , Lara Blanca , Cayuela Nuria , Ustrell Xavier , Garces Moises , Mora Paloma , Barranco Roger , De Miquel M Angeles , Escrig Ana Maria , Rubio Francisco 
Published: July 2021

Introduction:
Multiple randomized trials have demonstrated that endovascular treatment (EVT) in selected stroke patients is associated with good clinical outcome (90 days mRankin 0-2: 44-60%). However the percentage of good functional outcome could be improved if we consider patients without cortical clinical impairment with presentation of classical lacunar syndrome despite non-lacunar radiological infarct.

Methods:
Consecutive patients with ischemic stroke who received endovascular reperfusion were retrospectively analyzed between May 2010 and April 2015. On admission NCCT (non-contrast CT) and CTASI (CT Angiography Source Image) were performed in stroke patients according to our hospital guidelines. We independently applied the ASPECT score in all baselines NCCT, CTASI and follow-up NCCT 24H, and magnetic resonance (MR) during hospitalization. Five pure clinical lacunar syndromes (CLS) were recorded within 24h exam after EVT in our stroke unit and 90 days follow-up

Results:
We review 428 thrombectomies of patients with acute ischemic stroke. Ninety-five percent of occlusions were located in middle cerebral artery or terminal internal carotid, (49% women, mean age 65+/-13 years; NIHSS at admission: 17; baseline mRS 0-1:96%). Successful recanalization (TICI 2b-3) was achieved in 81%. At 3 months good functional outcome (mRS 0-2) was seen in 51% and death occurred in 13%.

CLS were indentified in 42% patients within 24h after EVT. This clinical syndromes were associated to ASPECT score in 24 NCCT and CTASI in patients with recanalization 2b-3 (p:0.003), but only 4% had a defined radiological lacunar stroke on MR.
CLS turned out to be one of independence predictors of good outcomes (Rankin 0-2 at 90d) after adjustment for ages, sex and baseline NIHSS scores (OR 1.85; CI:1.4-3.1; p:0.001). Also CLS were still present in 34% of patients with Rankin>2 at 90d (Rankin 3:26%; Rankin 4:7%)

Conclusions:
These results suggest that a neurological exam 24h after EVT with identification of pure lacunar syndrome can predict favorable functional outcome at 90days. This group of patients presents radiological findings with an unusual location and size with regard to CLS.

We suggest to consider patients with CLS as good outcome after EVT regardless 90d mRankin>2.
Punctate inner choroidopathy reactivation following COVID-19: A case report
Authors: Nicolai Michele , Carpenè Maria Jolanda , Lassandro Nicola Vito , Pelliccioni Paolo , Pirani Vittorio , Franceschi Alessandro , Mariotti Cesare 
Published: July 2021

Purpose: The purpose of this study is to report our experience with a case of punctate inner choroidopathy (PIC) reactivation following COVID-19. Case report: A 29-year-old caucasian woman with past ophthalmological history of bilateral PIC reported sudden visual acuity decrease in her right eye (RE) 3 weeks after SARS-CoV-2 infection. Her best-corrected visual acuity (BCVA) was 20/32 in RE; fundus examination and multimodal imaging (including indocyanine-green angiography, fundus autofluorescence, and optical coherence tomography) was consistent with unilateral PIC reactivation. The active choroidal lesions responded to high-dose corticosteroids, with functional improvement. Conclusion: Sars-CoV-2 infection could induce autoimmune and autoinflammatory dysregulation in genetically predisposed subjects. We report a case of PIC reactivation following COVID-19.
Intervention with selution SLR™ Agent Balloon for Endovascular Latent Limus therapy for failing AV Fistulas (ISABELLA) Trial: Protocol for a pilot clinical study and pre-clinical results
Authors: Tang Tjun Yip , Chong Tze-Tec , Yap Charyl Jia Qi , Soon Shereen Xue Yun , Chan Sze Ling , Tan Ru Yu , Yap Hao Yun , Tay Hsien Ts’ung , Tan Chieh-Suai , Barnhill Scott , Hellinga David , DeGraw R Tyler , Finn Aloke V 
Published: July 2021

Background: The aim of this pilot clinical study is to evaluate the safety and efficacy of the Selution Sustained Limus Release (SLR)™ sirolimus-coated balloon (M.A. MedAlliance SA, Nyon, Switzerland) for improving the patency of failing arterio-venous fistulas (AVF) in hemodialysis patients. We also present herein a pre-clinical pharmacokinetic and safety evaluation of Selution™ to justify its first use in hemodialysis patients for endovascular access salvage. Methods and results: This is an investigator-initiated prospective single-center, non-blinded single-arm trial. Forty patients with clinically significant de novo or recurrent stenoses in a mature AVF circuit will be recruited. All stenotic lesions will be prepared with high pressure non-compliant conventional balloon angioplasty (CBA) prior to deployment of the Sustained-Release Selution™ sirolimus drug-eluting balloon. The primary efficacy endpoint is 6-month target lesion primary patency and the primary safety endpoint is freedom from localized or systemic serious adverse events through 30 days. Secondary endpoints of interest include technical and clinical success rates and circuit access patency at 3 and 6 months. Follow-up will occur for 2 years for those patients whose AVFs remain patent. Pharmacokinetic and histological animal safety studies performed with the Selution™ coating formulation showed prolonged arterial tissue retention of sirolimus with therapeutic levels up to 60 days and non-toxic and rapidly declining blood levels. Histological results in animal models demonstrated safety, freedom from intraluminal thrombus, reduction in restenosis by sirolimus elution compared to CBA, and no evidence of embolic phenomena indicative of adverse particulate effects. Discussion: Long release sirolimus coated balloons may serve as a promising novel alternative therapy to paclitaxel-based technology for treating conduit stenosis secondary to neointimal hyperplasia. Pre-clinical pharmacokinetic and histological animal data are encouraging and provide suggestion of safety and efficacy in this setting. This single-center trial will provide a first step toward demonstration of efficacy and safety of this device for treatment of stenotic fistulas.
Evaluation of PROMIS Outcomes for Surgical Treatment of Cubital Tunnel Syndrome With and Without Carpal Tunnel Syndrome
Authors: Phan Amy , Hammert Warren 
Published: July 2021

Background: Assessment of outcomes for cubital tunnel syndrome (CuTS) surgeries has been difficult due to heterogeneity in outcome reporting. Our objective was to evaluate the outcomes for 2 cohorts treated surgically for isolated CuTS and for combined CuTS and carpal tunnel syndrome (CTS) using Patient Reported Outcomes Measurement Information System (PROMIS). Methods: There were 29 patients in the isolated CuTS cohort and 30 patients in the combined CuTS and CTS cohort. PROMIS Physical Function (PF), Pain Interference (PI), Depression, and Upper Extremity (UE) were completed preoperatively and 1-week, 6-weeks, and 3-months postoperatively. Responsiveness was evaluated by standardized response means (SRM). Results: Significant improvements from the 1-week to 6-week postoperative period are shown in the isolated CuTS cohort for PROMIS PF ( P = .002), PI ( P = .0002), and UE ( P = .02), but scores plateau after 6-weeks postoperatively. A similar pattern for the same time points was seen for the combined CuTS and CTS group for PROMIS PF ( P = .001), PI ( P = .02), and UE ( P = .04), with a plateau of scores beyond 6 weeks postoperatively. PROMIS UE was more responsive (SRM range: 0.11-1.03) than the PF (SRM range: 0.02-0.52) and PI (SRM range: 0.11-0.40), which were both mildly responsive for both cohorts. Conclusions: PROMIS lacks the sensitivity to show improvement beyond 6-weeks postoperatively for both isolated CuTS and combined CuTS and CTS. Patients with combined nerve compressions follow similar trajectories in the postoperative period as those with isolated CuTS. Level of Evidence: Level IV.
Are muscle weakness and stiffness risk factors of the development of rotator cuff tendinopathy in overhead athletes: a systematic review
Authors: Kwan Cheuk-Kin , Ko Man-Chi , Fu Sai-Chuen , Leong Hio-Teng , Ling Samuel Ka-Kin , Oh Joo-Han , Yung Patrick Shu-Hang 
Published: July 2021

Background: Underlying muscle weakness and stiffness may increase the risk of developing rotator cuff tendinopathy. This systematic review aims to assess existing prospective studies to summarize whether muscle weakness and stiffness are risk factors for the development of rotator cuff tendinopathy in overhead athletes. Methods: A systematic search was performed using PRISMA guidelines. Prospective studies measuring muscle strength or stiffness and the incidence of rotator cuff tendinopathy were included. Quality assessment was performed with the Newcastle-Ottawa quality assessment scale. Results: The search yielded six studies, with a total of 523 trained overhead athletes followed up for one season. External rotation (ER) and internal rotation (IR) strength were described as protective factors against the development of rotator cuff tendinopathy. Athletes who did not sustain shoulder injuries had statistically stronger eccentric IR ( p < 0.01) and ER ( p < 0.05) strength in the pre-season assessment. Muscle stiffness indicated by limited range of motion of <106° for shoulder ER was described as a risk factor with an odds ratio of 1.12 ( p < 0.001). Imbalance between ER and IR strength was reported as risk factors for shoulder injuries in two studies, with a relative risk of 2.57 ( p < 0.05) reported in one study. Supraspinatus weakness was also reported as a risk factor for shoulder injuries in one study. Conclusion: Limited evidence support ER, IR weakness, limited ER range of motion, and very limited evidence support imbalance in ER/IR strength, and supraspinatus weakness as risk factors for rotator cuff tendinopathy in overhead athletes. No existing studies investigated the general population on this topic. Future cohort studies may improve on existing evidence with investigations on the general public, a longer follow-up time, clearly documented injury history, and a stringent diagnosis to rotator cuff tendinopathy.
The Odyssey from Symptom to Diagnosis of Pulmonary Hypertension from the Patients and Spouses Perspective
Authors: Ivarsson Bodil , Johansson Anders , Kjellström Barbro 
Published: July 2021

Introduction/objective: Diagnostic delays in pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) are related to increased morbidity and mortality. The risk of a delayed, or even a missed, diagnosis is high as the conditions are rare. The aim was to describe patients’ and spouses’ experiences of the journey from the first symptom to an established diagnosis. Methods: A secondary analysis of 31 transcripts, based on 2 primary datasets containing interviews with 17 patients and 14 spouses, was carried out and analyzed according to qualitative content analysis. Results: One overarching category was revealed from the content analysis; “The journey from doubt and hope to receive the diagnosis.” Five subcategories were identified as: overall experiences; ignoring symptoms; seeking primary care/hospital specialty care; blame and stigma; and finding a pulmonary hypertension specialist clinic. The main finding was that both patients and spouses experienced that waiting for a diagnosis and the deteriorating state of health led to anxiety and frustration. The knowledge about rare diseases among health professionals needs to be improved to enable a timelier diagnosis and initiation of treatment. Conclusion: Patients’ and spouses’ lives were negatively affected by having to search for a correct diagnosis. In order for health care to identify rare diseases earlier, a well-functioning and responsive health care system, in primary care as well as in specialist care, is needed. Symptoms like breathlessness and fatigue are often unspecific but should not be ignored. Keeping the patient and spouse in the loop, and providing information that the search for an answer might take time is essential for health care providers to create trust.
Disrupted Class, Undisrupted Learning: A Study on the Effect of Online Learning Among Primary and Middle School Students
Authors: Yuelin Li , Yujie Liu , Xiaohui Shu 
Published: July 2021

In the first half of 2020, primary and secondary school teaching was transformed into online teaching in China, and the teaching effects have attracted considerable attention. This article collects relevant data on the effects of online learning among primary and middle school students through questionnaire surveys to study the impact of parents and teachers on learning effects, provide an experience for future online education and improve the quality of online education for primary and secondary school students in the future. Through empirical analysis, this article draws three main conclusions. First, parents improve students’ offline social presence, while teachers or classmates improve their online presence. Both changes have a significant positive impact on students’ subjective learning effects. Second, parents are more helpful with regard to the improvement of students’ objective learning effects. Third, in terms of age, parents have a greater influence on younger students. The innovation of this article is that the object of the study is primary and secondary school students. The article considers not only the role of teachers but also the role of parents, thereby filling gaps in the previous literature. JEL Codes: I20, I21, I25
Individual socioeconomic and neighborhood factors predict changes in sports activity during the transition to retirement
Authors: Jürgens Dorothee , Schüz Benjamin 
Published: July 2021

AbstractBackgroundThere are substantial socioeconomic status (SES) differences in sports activity (SA) during the transition to retirement. In line with social-ecological models, the aim of this longitudinal study was to examine the association of perceptions of social and physical neighborhood factors with changes in SA across the retirement transition and to examine potential interactions with SES factors.MethodsData from 6 waves of the German Ageing Survey (DEAS) provided 710 participants (at baseline: mean age 61.1, 52.9% of men) who retired between baseline (1996, 2002, 2008, 2011) and their 6-year follow-up assessment. Associations between changes in SA (increases and decreases compared to retaining) and individual SES and neighborhood factors were estimated using multinomial logistic regression analysis.ResultsIncreases were observed in 18.45% of participants, decreases in 10%. Occupational prestige was a risk factor for decreases, education a resource for increases in SA. Interactions between household income and several neighborhood factors were observed.ConclusionsIn line with social-ecological models, individual, neighborhood factors and interacting associations were found. In particular safety perceptions could be a resource for promotion SA in older adults who experience disadvantage.
Regulatory role of local tissue signal Del-1 in cancer and inflammation: a review
Authors: Li Meng , Zhong Di , Li Guozhong 
Published: July 2021

AbstractDevelopmental endothelial locus-1 (Del-1) is a secretory, multifunctional domain protein. It can bind to integrins and phosphatidylserine. As a local tissue signal, it plays a regulatory role in the cancer microenvironment and inflammation. Del-1 has destructive effects in most cancers and is associated with the progression and invasion of some cancers. In contrast, Del-1 also plays a protective role in inflammation. Del-1 regulates inflammation by regulating the generation of neutrophils in bone marrow, inhibiting the recruitment and migration of neutrophils and accelerating the clearance of neutrophils by macrophages. Del-1 and IL-17 are reciprocally regulated, and their balance maintains immune system homeostasis. Del-1 is expected to become a new therapeutic target for inflammatory disorders such as multiple sclerosis.
Wide range detector of plasma induced charging effect for advanced CMOS BEOL processes
Authors: Chao Yi-Jie , Yang Kai-Wei , Su Chi , Lin Chrong-Jung , King Ya-Chin 
Published: July 2021

AbstractThis work proposed a modified plasma induced charging (PID) detector to widen the detection range, for monitoring the possible plasma damage across a wafer during advanced CMOS BEOL processes. New antenna designs for plasma induced damage patterns with extended capacitors are investigated. By adapting the novel PID detectors, the maximum charging levels of the detectors have been enhanced.