bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract TP110: Dissecting the Optimized Cytoprotective Responses of Arctic Ground Squirrels With CRISPR
Authors: Lee Evan M , Singhal Neel S , Bai Meirong , Ma Dengke K 
Published: June 2021

Arctic ground squirrels (AGS) have evolved to survive harsh environmental conditions through hibernation. AGS retain resistance to stroke and ischemic injury independent of hibernation, suggesting that genetic cell autonomous changes are also critical to AGS resilience. The mechanistic details of these cytoprotective adaptations are largely unknown.
A functional cDNA expression screen identified AGS candidate genes facilitating stress resilience and a bioinformatics pipeline identified AGS protein sequence changes in regions of high conservation. These unique AGS amino acid substitutions were edited using a combination of CRISPR base-editing and Cas9 knock-out approaches to generate AGS cell lines with loss-of-function variants.
We found that AGS neural cells exhibit marked resilience to diverse metabolic stressors in assays of in vitro survival, function, and mitochondrial morphology. The functional genetic screen identified a network of evolutionarily-conserved AGS transcripts imparting cytoprotection, particularly in endoplasmic reticulum (ER) stress and oxidative phosphorylation (OXPHOS) pathways. CRISPR-based genome editing creating AGS cell lines with loss-of-function mutations indicated that editing of key candidates, such as ATP5G1, ameliorates features of the AGS resilient phenotype including increasing susceptibility to metabolic stressors, decreasing spare respiratory capacity, and altering mitochondrial dynamic organization.
We gained key functional insights into how specific amino acid substitutions in the machinery of the OXPHOS and ER stress responses systems alter mitochondrial function to impart cytoprotection against metabolic insults. This detailed dissection of the AGS optimized adaptive stress response pathway will serve as a template for the development of new neuroprotective treatments.
Abstract TP359: Rapid Access Stroke Unit - A Virtual Clinic to Assess Minor Stroke Admissions, Expedite Investigations and Implement Timely Treatments
Authors: Morgan Deborah M 
Published: June 2021

Background:
The current Stroke service is seeing more than 200 patients per month admitted to our acute tertiary hospital. Acute major stroke patients are admitted to the stroke ward but many of the minor strokes or mimics are admitted to an acute medical assessment unit (AMAU) waiting on average 3 days for completion of investigations.

TIA clinics are an established element of a stroke service in other countries. We established a similar service, the Rapid Access Stroke Unit (RASU), opened daily in July 2018 aiming to reduce admission rates by expediting investigations and treatments for patients presenting with minor or resolved symptoms.
The referral criteria for RASU is a CT scan with no evidence of hyperacute stroke and the Patient is independent in ADL’s. If the patient is in hospital the clinical nurse specialist will triage patients for suitability for transfer to RASU. Out of hours suitable patients can be discharged from ED with instructions to attend RASU the following morning. The clinical nurse specialist, supported by the Stroke Consultant, will coordinate the investigations, track results, organise reviews and ensure the patients are fully educated of diagnosis, treatment and risk factor management.

Results:
The first year’s figures show a decrease in the inpatient admissions with 496 patients attending RASU, saving 1749 bed days.

There is also an increase in the number of patients discharged directly home from the Emergency Department (ED), with the option of attending RASU if required.
The diagnosis of patients admitted to RASU are 102 ischemic, 145 TIA, 247 Mimics and 1 ICH.

Conclusion:
One-year results have shown a significant benefit in patient care, early discharge and improved use of the hospital resources. One unexpected result was the increase in discharges from ED and this may be attributed to the ED physicians discharging patients confident that there is a rapid access service available. Another consequence of the service is that patients will ‘walk in’ to RASU if they have any further concerns or require clarification of treatments.
Abstract TP367: Dimensions of Social Support and Post-Stroke Depressive Symptoms in Saudi Arabia: A Mixed Methods Approach
Authors: Babkair Lisa A , Chyun Deborah , Dickson Victoria V , Almekhlafi Mohammed 
Published: June 2021

Stroke is the second leading cause of death and a major cause of serious long-term disability worldwide. Post stroke depressive symptoms (PSDS) affect one third of stroke survivors. The prevalence of PSDS ranges from 17%–63.3% in Saudi stroke survivors. Stroke survivors use social support as a coping mechanism and as a protective factor against the adverse effects of stroke outcomes.
The purpose of this study was to describe the nature of PSDS and to compare the influence of perceived and received social support among stroke survivors in Saudi Arabia. The aims were: (1) to examine the influence of perceived social support on PSDS, (2) to explore the nature of PSDS and received social support, and (3) to characterize the contribution of perceived social support and received social support and PSDS.
A convergent embedded mixed methods design was used. 135 participants were recruited for the quantitative purpose from outpatient clinics and inpatient rehabilitation facilities in Saudi Arabia and 34 participants were selected from the original sample for qualitative purposes. The data were gathered using structured instruments and interviews.

The findings were: (a) 54% had depressive symptoms (DS); (b) DS were negatively associated with perceived social support (
r
= -.65,
p
< .001) and the functional independency (
r
= -.45,
p
< .001), whereas perceived stress was positively associated (
r
= .71,
p
< .001); (c) social support, stress level, and literacy were associated with DS (β = -.31,
p
< .001; β = .45,
p
< .001; β = .16,
p
= .01, respectively) and partially mediate the association of DS with functional independence; (d) there is a typology of experiencing DS and receiving social support,
Satisfied
and
Deprived
, and those with DS and social support,
Discrepancies
.

The results of this mixed methods study show that a lack of social support was associated with DS. The integration of quantitative and qualitative data provided a broad, in-depth perspective on the nature of DS and social support influenced by individual’s life changes after stroke. Future research is needed to examine the interventions to improve social support among caregivers and to reduce DS in stroke survivors.
2
Abstract WP189: Application of a Continuous Quality Improvement Framework: Longitudinal Results From Year 1 of the Stroke Survivor to Survivor Program
Authors: Gruhot Sandi , Pietrzak Janna , Santana Adela , Winiecki Christine 
Published: June 2021

In 2018, the Mission Lifeline North Dakota (ND) initiative adopted and began to implement Stroke Survivors Empowering Each Other, Inc.’s (SSEEO’s) Stroke Survivor to Survivor (SS2S) program. The SS2S program is a post-stroke support program that aims to facilitate survivors’ efforts to recover after stroke. Volunteers, who are themselves survivors, call participants monthly at least twice following discharge from the hospital and provide them with stroke-related resources and support. The adaptation and implementation of the Chicago-borne SS2S program in ND was embedded within a continuous quality improvement framework to ensure ongoing performance monitoring data could inform programmatic improvements as needed.
Key questions:
• How has the Chicago-borne SS2S program been adapted to fit the unique characteristics and environment of ND, while maintaining fidelity?
• What are performance monitoring findings from the first three quarters of implementation?
Between Oct 2018- Feb 2019, four of the six ND tertiary hospitals implemented the SS2S program. These hospitals provide monthly quantitative and qualitative data on program implementation. From Oct 2018 to May 2019, SS2S volunteers made 153 calls to survivors, with 57% (n = 87 of 153) of calls answered by a prospect, including stroke survivors (n=74) and their caregivers (n=13). Thirteen percent (n = 9 of 69) of stroke survivors calls required additional follow-up by hospital staff. SS2S volunteers mailed additional resources to stroke survivors for 48% percent of the calls where the prospect was reached (n= 33 of 69). Seventy percent (n = 48 of 69) of survivors reached were able to identify at least one sign of stroke. Preliminary results suggest that both volunteers and stroke survivors may benefit from the program. Importantly, performance monitoring data also identified opportunities for programmatic improvements.
For example, these data informed edits to the volunteers’ phone scripts to clarify signs-of-stroke patient-education. Ongoing feedback from the hospitals have also informed improvements to the performance monitoring processes.
Becoming an Ex: Dynamics of Disengagement from Egypt’s Muslim Brotherhood after 2011
Authors: Menshawy Mustafa , Al-Anani Khalil 
Published: June 2021

Abstract
This article explores the disengagement of members from Egypt’s Muslim Brotherhood. Following both the 2011 uprising and the 2013 coup, increasing disenchantment with the group’s ideology and political project have led many members to reconsider their commitment to, and membership in, the Brotherhood. While scholarship examining the Brotherhood’s processes of recruitment and forming of collective identity is burgeoning, few works have assessed members’ disengagement from the movement and abandonment of its ideology, or how former members make sense of their “ex” identity. Based on rich, original material and extensive interviews with former Brotherhood members in Egypt, Turkey, the UK, and Qatar, this article investigates how former members seek new meanings and identities. Adopting a processual and discursive perspective on disengagement from the Brotherhood, we identify disengagement as consisting of distinct ideological, political, and affective processes. These processes shape individuals’ strategies for exiting the Brotherhood and forming their new identities as ex-members.
Perspectives on a psychiatric outpatient service for immigrants and refugees in São Paulo, Brazil over a 15-year period
Authors: Carvalho Luciana de Andrade , Andrade Laura Helena , Ang Patrícia Lin , Santana Carmen Lucia Albuquerque de , Lotufo Neto Francisco , Biazoli Junior Claudinei Eduardo 
Published: June 2021

Background: Immigrants and refugees have specific mental health needs. Studies of immigrant/refugee psychiatric patients in Latin America are scarce. Aims: Present the profile of patients from an outpatient psychiatric service in Sao Paulo (Brazil) to better inform mental health service planning for immigrants and refugees in the Global South. Methods: Exploratory study to characterize the sociodemographic and mental health profile of refugees and immigrants attending outpatient psychiatric service from 2003 to 2018. Chi-square tests and logistic regressions were used to examine the association of demographic variables, exposure to violence, and immigrant status with psychiatric diagnosis. Cluster analysis was used to identify subgroups within the sample. Results: A total of 162 immigrants and refugees referred to the service obtained treatment. Of these patients, 57.4% were men, 59.8% were refugees/asylum seekers, 51.9% were Black, 48.8% were single, 64.2% had 10 years of education, and 57.4% were unemployed; the mean age of the sample was 35.9. Half of the sample (52.5%) was exposed to violence. The most common diagnosis was depression (54.2%), followed by PTSD (16.6%). Approximately 34% of the participants sought psychiatric care within 6 months of arrival. Logistic regressions showed that men had lower odds of presenting with depression (OR = 0.34). Patients with PTSD were more likely to be refugees (OR = 3.9) and not have a university degree (OR = 3.1). In the cluster analysis, a cluster of patients with PTSD included almost all Black refugee men exposed to violence. Most patients diagnosed with psychotic disorders were also Black refugee men. Conclusion: Immigrants and refugees represent a vulnerable group. The majority of the sample was Black, refugee men, who were also more likely to present with PTSD. Future studies are needed to better understand issues in treatment adherence in relation to socioeconomic characteristics.
Effectiveness of mHealth management with an implantable glucose sensor and a mobile application among Chinese adults with type 2 diabetes
Authors: Guo Mengna , Meng Fanli , Guo Qing , Bai Tiantian , Hong Yanyan , Song Fengbin , Ma Yan 
Published: June 2021

Introduction This study aimed to evaluate the effectiveness of mHealth management with an implantable glucose sensor and a mobile application among patients with type 2 diabetes mellitus (T2DM) in China. Methods A randomised controlled trial was carried out to compare the effectiveness of usual health management to mHealth management based on a model that consisted of the network platform, an implantable glucose sensor and a mobile app featuring guidance from general practitioners (GPs) over a four-week period. Patients ( N=68) with T2DM were randomly divided into an intervention group and a control group. Before the intervention, there was no difference in body mass index (BMI), fasting blood glucose (FBG), postprandial two-hour blood glucose (2hPG) and glycosylated haemoglobin (HbA1c) between the intervention group and the control group ( p>0.05). Patients in the control group received their usual health management, while patients in the intervention group received mHealth management. Results After health management, the mean BMI, FBG, 2hPG and HbA1c of the intervention group patients were all lower than those of the control group patients ( p < 0.05), and the quality of life and self-management of the intervention group patients had significantly improved. Discussion mHealth management effectively showed significant reductions in BMI, FBG, 2hPG and HbA1c and improved quality of life and self-management among patients, which may be related to real-time feedback from an implantable glucose sensor and guidance from GPs through a mobile app. mHealth management is a very promising way to promote the health management of T2DM in China, and this study provides a point of reference for mHealth management abroad.
Stent Graft Placement in the Top-Down Direction for Treating Traumatic Intra-Abdominal Suprahepatic Inferior Vena Cava Rupture: A Case Report
Authors: Park Yun Chul , Kim Hyoung Ook , Yim Nam Yeol , Lee Byung Chan , Park Chan , Jo Young Goun , Kim Jung Chul , Jeong Won Gi 
Published: June 2021

Purpose The treatment of suprahepatic inferior vena cava (IVC) ruptures results in high mortality rates due to difficulty in performing the surgical procedure. Here, we present a case of successful endovascular management of a life-threatening suprahepatic IVC rupture with top-down placement of a stent graft. Case Report A 33-year-old woman was involved in a traffic accident and presented to our emergency department due to unstable hemodynamics after blunt abdominal wall trauma. Computed tomography (CT) revealed massive extravasation of contrast agent from the suprahepatic IVC, which suggested traumatic suprahepatic IVC rupture. To seal the IVC, to salvage major hepatic veins, and to prevent migration of the stent graft into the right side of the heart after placement, an aortic cuff with a proximal hook was introduced in a top-down direction via the right internal jugular vein. After closure of the injured IVC, the patient’s hemodynamics improved, and additional laparotomy was performed. After 3 months of trauma care, the patient recovered and was discharged. Follow-up CT after 58 months showed a patent stent graft within the IVC. Conclusion Endovascular management with top-down placement of a stent graft is a viable option for emergent damage control in patients with life-threatening hemorrhage from IVC rupture.
Does pre-existent physical inactivity have a role in the severity of COVID-19?
Authors: Yuan Qilin , Huang Hua-yao , Chen Xiao-ling , Chen Rong-hua , Zhang Yixian , Pan Xiao-bin , Chen Jun-nian , Liu Nan , Du Houwei 
Published: June 2021

Background and Aims: Physical inactivity is considered an important lifestyle factor for overweight and cardiovascular disease. We aimed to investigate the association between pre-existent physical inactivity and the risk of severe coronavirus disease 2019 (COVID-19). Methods: We included 164 (61.8 ± 13.6 years) patients with COVID-19 who were admitted between 15 February and 14 March 2020 in this retrospective study. We evaluated the association between pre-existent physical inactivity and severe COVID-19 using a logistic regression model. Results: Of 164 eligible patients with COVID-19, 103 (62.8%) were reported to be physically inactive. Univariable logistic regression analysis showed that physical inactivity was associated with an increased risk of severe COVID-19 [unadjusted odds ratio (OR) 6.53, 95% confidence interval (CI) 1.88–22.62]. In the multivariable regression analysis, physical inactivity remained significantly associated with an increased risk of severe COVID-19 (adjusted OR 4.12, 95% CI 1.12–15.14) after adjustment for age, sex, stroke, and overweight. Conclusion: Our data showed that pre-existent physical inactivity was associated with an increased risk of experiencing severe COVID-19. Our findings indicate that people should be encouraged to keep physically active to be at a lower risk of experiencing a severe illness when COVID-19 infection seems unpredicted. The reviews of this paper are available via the supplemental material section.
APKASS Consensus Statement on Chronic Syndesmosis Injury, Part 3: Fusion Techniques, Comorbidity Treatments, Postoperative Rehabilitation, and Return-to-Sport Indications
Authors: Song Yujie , Shi Zhongmin , Kurokawa Hiroaki , Tanaka Yasuhito , Ling Samuel K.K. , Yung Patrick , Angthong Chayanin , Han Seung Hwan , Hua Yinghui , Li Hongyun , Jiao Chen , Gui Jianchao , Li Qi 
Published: June 2021

Background: Questions regarding surgical fusion techniques, postoperative treatment, and indications for return to sport after chronic syndesmosis injury or its comorbidities remain unanswered. Purpose: An international group of experts representing the field of injuries in the foot and ankle area was invited to collaboratively advance toward consensus opinions based on the best available evidence regarding chronic syndesmosis injury. All were members of the Asia-Pacific Knee, Arthroscopy and Sports Medicine Society (APKASS). Study Design: Consensus statement. Methods: From November to December 2020, a total of 111 international experts on sports medicine or ankle surgery participated in a 2-stage Delphi process that included an anonymous online survey and an online meeting. A total of 13 items with 38 statements were drafted by 13 core authors. Of these, 4 items with 6 clinical questions and statements were related to surgical fusion techniques, comorbidity treatments, postoperative rehabilitation, and return-to-sports indications and are presented here. Each statement was individually presented and discussed, followed by a general vote. The strength of consensus was characterized as follows: consensus, 51% to 74%; strong consensus, 75% to 99%; and unanimous, 100%. Results: Of the 6 questions and statements, 5 achieved unanimous support and 1 reached strong consensus. Conclusion: This APKASS consensus statement, developed by international experts in the field, will assist surgeons and physical therapists with surgical and postoperative treatment strategies for chronic syndesmosis injury.
Modified Anterolateral Approach for Total Ankle Arthroplasty
Authors: Hirao Makoto , Ebina Kosuke , Etani Yuki , Kaneshiro Shoichi , Tsuboi Hideki , Noguchi Takaaki , Okamura Gensuke , Kunugiza Yasuo , Nakaya Hiroyuki , Nishikawa Masataka , Tsuji Shigeyoshi , Takahi Koichiro , Owaki Hajime , Hashimoto Jun 
Published: June 2021

Level of Evidence: Level V.
Vitrectomy With Internal Limiting Membrane Transplants in the Closure of 2 Adjacent Macular Holes
Authors: Kokame Gregg T. , Card Kevin 
Published: June 2021

Purpose: Two adjacent macular holes (MHs), which were noted in the highly myopic left eye of an 85-year-old woman, is an uncommon clinical presentation. This case report presents the successful closure of the 2 adjacent MHs using internal limiting membrane (ILM) transplants during vitrectomy that included. Methods: ILM transplants were placed within both MHs during vitrectomy that included ILM peeling and fluid gas exchange with 18% perfluoropropane (C3F8) and postoperative facedown positioning for 1 week. Results: Both MHs were successfully closed following surgery with improvement in vision and decrease in metamorphopsia. Conclusions: This case suggested that relief of traction by ILM peeling and placement of ILM transplants within both MHs to provide a scaffold and stimulate glial tissue proliferation may have facilitated closure of the 2 adjacent MHs, which is a difficult management problem to manage and not previously reported to the best of our knowledge.
Can social capital play a role in contracting services of family doctors in China? Reflections based on an integrative review
Authors: Xu Xinglong , Antwi Henry Asante , Zhou Lulin , Mustafa Tehzeeb , Boafo-Arthur Ama 
Published: June 2021

Abstract
Background
The family doctors’ contract service problem is not about government management alone, but an interaction of a complex social environment. Consequently, the effect of contracted services of family doctors not only depends on policy incentives but also needs to win the participation, acknowledgement, and confidence of community residents. The purpose of this integrative review is to examine whether there is any significant evidence that social capital in the form of social networking groups and other forms of social groups have any positive impact on the acceptance and the effectiveness of family doctors' contractual services.

Method
Research on qualitative, quantitative and hybrid methods published in peer-reviewed journals on the social capital role in the process of contract service of family doctors were eligible for inclusion. In view of the increasing attention paid to the contract service effect of family doctors during this period, a 10-year time scale was selected to ensure full coverage of relevant literature in the same period. In total, 809 articles were determined in the database retrieval results which were downloaded and transferred to the Mendeley reference application software.

Results
Twelve articles met the inclusion criteria for this integrative review and the quality of the included studies were assessed using the published criteria for the critical appraisal of quantitative and qualitative research methods. Majority of the articles assessed reported that there was evidence of a positive link between social support, especially a sense of belonging and the presence of regular family doctors. The influencing factors of patients' contract behavior of studies conducted in China were social interaction of social capital, acceptance of the first contact in the community, year of investigation, and exposure to the public.

Conclusion
The study affirms previous studies that suggest that social resources have the propensity to improve relationship between patients and clients and between doctors and peers for the benefit of the patients and the stability of the overall healthcare system. Through the integration of various social resources family doctor systems accelerate the development of community construction. These social capital (social network groups) can guide residents to use family doctor services to maintain health. Social capital can also help residents have a regular and reliable family doctor.