bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract 226: δ-opioid Receptor Activation Protects the Brain From Hypoxic-ischemic Injury by Downregulating Inflammatory Cytokines and Upregulating Nrf-2
Authors: Qiu Jie , Chao Dongman , Ding Guanghong , Xia Ying 
Published: June 2021

Hypoxia-ischemia (HI) insult induces inflammatory/oxidative injury and causes neurological disability and mortality. However, there are limited therapeutic options at present. Our recent studies have shown that the δ-opioid receptor (DOR) is neuroprotective against hypoxic-ischemic stress. In this work, we asked if DOR activation protects the brain against hypoxic-ischemic encephalopathy (HIE) by regulating inflammatory cytokines and Nrf-2, a basic leucine zipper protein that regulates the expression of antioxidant proteins. Our results showed that DOR activation with UFP-512 treatment significantly decreased TNF-α, IL-6, and ICAM-1 expression (P<0.05) in the left cortex of the rat with HI injury, while DOR inhibition with naltrindole significantly increased their expression (P<0.05). In contrast, DOR activation induced an opposite effect on IL-10 expression (P<0.05) and had no appreciable effect on IL-18 (P>0.05). In the control group, no significant difference was detected after the vehicle treatment. Furthermore, we investigated the role of Nrf-2 in the DOR neuroprotection since our recent data suggest that DOR signaling promotes the expression and relocation of Nrf2 and thus induces cytoprotection. HI significantly increased nuclear Nrf-2 protein, while DOR activation by pretreatment with UFP-512 before HI further elevated the level of nuclear Nrf-2 protein by 70% (P<0.05) in the cortex. On the other side, DOR inhibition by the pretreatment with naltrindole completely abolished the HI- and DOR-induced increase in nuclear Nrf-2 protein. In the control, the vehicle treatment did not have any significant effect on nuclear Nrf-2 protein. These first data suggest that DOR activation protects the brain from HIE by downregulating the expression of inflammatory cytokines and upregulating Nrf-2 activity.
This work was supported by NIH (AT-004422), Memorial Hermann’s Foundation and Vivian L Smith Neurologic Foundation. GD was supported by 973 Program (2012CB518502) and NSFC (81574053 & 81590953) of China.
Abstract 297: The Oracle™ Device: A New Snare for Removal of Thrombus
Authors: Heuser Richard R 
Published: June 2021

Stroke is a leading cause of serious disability and death worldwide. Randomized trials have shown benefits of mechanical thrombectomy compared to usual cases with intravenous thombolysis. A simple intuitively obvious device for clot removal would be ideal.
To deal with thrombus removal, we introduce the ORACLE™ snare. This snare pictured has the ability to be placed through an .014 system to remove thrombus or other foreign material throughout the body (Figure 1). The Oracle Retrieval Device is composed of three primary parts: an outer sheath tube, a core wire, and 4 capture loops. The 180cm device has loop sizes that range from 2 - 6 millimeters in diameter (Figure 2). There is an ABS plastic operating handle on the proximal end which is used to direct the device as well as to lock the capture loops in the expanded and retracted positions.
Utilizing the ORACLE™ snare, we have successfully removed thrombus in a canine model (3 out of 3 removed successfully) and bovine model (2 out of 2 removed successfully) with minimal loss of endothelial cells (Figure 3).
With the emergence of dedicated thrombus removal devices for stroke care, more challenges have occurred in treating smaller vessels. Simple intuitively obvious devices available in all carotid and stroke centers as well as centers performing coronary interventions would be ideal. The ORACLE™ may be one approach to remove thrombus and can be placed through .014 compatible catheters.
Abstract 76: Experimentally Increasing Titin’s Compliance in a Mouse Model of Heart Failure with Preserved Ejection Fraction Ameliorates Diastolic Dysfunction
Authors: Methawasin Mei , Strom Joshua G , Slater Rebecca E , Fernandez Vanessa , Saripalli Chandra , Granzier Henk L 
Published: June 2021

Increasing titin length in the heart through functional deletion of the RNA recognition motif (RRM) of RBM20 protein leads to a reduction of left ventricular (LV) chamber stiffness in sedentary mice. We tested the therapeutic effect of upregulating compliant titins by creating diastolic dysfunction in a mouse model with inducible RBM20 inhibition (MerCreMer;cRbm20ΔRRM). Under transcriptional control of an MHC6 promoter, RBM20 function of MerCreMer;cRbm20ΔRRM mice was inhibited in time- and cardiac-specific manners.
Adult male MerCreMer;cRbm20ΔRRM mice had undergone transaortic constriction (TAC) surgery with Deoxycorticosterone acetate (DOCA) pellet implantation. Two weeks after TAC+DOCA surgery, mice developed LV hypertrophy and diastolic dysfunction as demonstrated by echocardiography. Four weeks after surgery, pressure volume analysis revealed that LV chamber stiffness was markedly increased in TAC+DOCA mice (140% increased versus sham). However, the TAC+DOCA mice with RBM20 inhibition developed less severe LV chamber stiffness (29% increased versus sham). Passive stiffness measurements showed a reduction of cardiomyocyte stiffness in TAC+DOCA mice with RBM20 inhibition.
Inhibition of the RBM20-based splicing system results in expression of compliant mutant N2BA titin which consequently lead to reduction of cardiomyocyte stiffness and LV chamber stiffness in a mouse model with diastolic dysfunction.
Abstract 58: Calcium/Calmodulin-dependent Protein Kinase Kinase (CaMKK) Promotes Post-stroke Brain Plasticity and Recovery in Aged Mice
Authors: Liu Lin , Yuan Hui , Li Xue-Jun , Sun Ping , Qi Li , Yi Yanhua , McCullough Louise , Li Jun 
Published: June 2021

Reduced brain plasticity, including axonal regeneration and angiogenesis, is thought to contribute to poorer functional recovery in the aged brain after a stroke. CaMKK has been suggested to activate major molecular pathways that enhance brain plasticity. Here we evaluated the hypothesis that CaMKK promotes post- stroke recovery by stimulating axonal regeneration and angiogenesis in aged mice.
Ischemic stroke was induced by middle cerebral artery occlusion for 60 minutes in aged WT male mice followed by reperfusion. STO-609, a pan-CaMKK inhibitor, and lentiviral vectors carrying CaMKK β (LV-CaMKK β) were started 3 days after stroke onset. Pellet reaching test (success rate) was carried out to evaluate the integrity of sensorimotor function every week for a total of 5 weeks.
Pharmacological inhibition of CaMKK by STO-609 significantly worsened stroke recovery evaluated by pellet reaching test from day 14 to day 35 after stroke (Day 35:Vehicle 0.29±0.02 vs. STO 0.16±0.02, n=8 in vehicle/n=5 in STO, p<0.05). Meanwhile, it significantly reduced axonal density assessed by neurofilament light (NFL) staining (Vehicle 1.00±0.06 vs. STO 0.53± 0.14, n=4, p<0.05) and vascular density represented by CD31 (Vehicle 1.00±0.20 vs. STO 0.48±0.06, n=4, p<0.05) in the peri-infarct zone on 35 days post-stroke, without changing brain cavity size (Day 35: Vehicle 0.13±0.01 vs. STO 0.13±0.02, n=8 in Vehicle/n=5 in STO, p>0.05). Additionally, CaMKK β overexpression improved mouse performance on pellet reaching test after stroke (day 35: LV-GFP 0.26±0.02 vs. LV-CaMKK β 0.36±0.02, n=7 LV-GFP/n=9 in LV-CaMKK β, p<0.05).

Conclusions:
Pharmacological inhibition of CaMKK worsened post-stroke recovery while overexpression of this molecule improved outcome. We observed reduced axonal density and cerebral vascular density with CaMKK inhibition, indicating CaMKK is an endogenous activator of brain plasticity in stroke. Our data suggested that CaMKK signaling may reduce long-term disability in the population at the greatest risk of stroke, the elderly.
Abstract TP367: Decreasing Decision to Transfer Times
Authors: Sorenson Denise , Cooke Jason , Loll Lisa 
Published: June 2021

Novant Health Greater Charlotte market is comprised of three advanced primary stroke care centers; one providing 24/7 stroke interventional radiology coverage. To expedite the transfer of patients meeting criteria for mechanical thrombectomy, the stroke best practice teams in the two community primary stroke centers collaborated to develop a protocol to improve the decision to transfer time to meet a goal of 120 minutes from door to skin puncture time, regardless of original transport destination.
The Novant Health Charlotte market teams realize the benefit of cohesive physician coverage among the Emergency Department, Radiology and Inpatient Neurology physician providers. CTA scans performed in the non-interventional facilities are readily available to Neuro-Endovascular Radiologists, allowing for prompt interpretation and mobilization of the IR team to prepare for patient arrival.
Recognizing internal critical care transport resources are limited and may not be available, the process was facilitated by the development of an activase transport protocol implemented by Mecklenburg County EMS in June of 2016. Since actual transport time is affected by traffic patterns in urban areas, the controllable measure selected by the teams was decision to transfer time.
Prior to the initiation of the protocol, the median decision to transfer time for ischemic stroke patients requiring tertiary care was 66.5 minutes. Post protocol implementation the median time was reduced 32% to 44.5 minutes. Across the market, median door to skin puncture time in 2016 is 131.5 minutes.
Ongoing evaluation of the transfer process, and multidisciplinary IR case review with identification of process variation is key to the success of this initiative. The Emergency Department at the tertiary care facility has been an instrumental partner in identifying issues that are barriers to timely throughput of these patients.
A consistent feedback process informs all team members regarding patient outcomes. Individual case feedback is provided to all direct care givers, EMS crews and stroke team leaders, usually within 24 to 48 hours of the intervention. This data is shared monthly with the stroke best practice teams at the transferring facilities.
Abstract TP358: Implementing Post Neuroendovascular Procedure Nursing Care With Transradial Access
Authors: Wesling Judith , Seiler Kathleen , Ogiso Hiromi , Gasparovic Taylor , Spiering Katherine , Morrow Benjamin , Jadhav Ashutosh , Underwood Susan L 
Published: June 2021

Neurointerventionalists (NIR) are adopting conversion from transfemoral access (TFA) to transradial access (TRA) due to the safety, cost and patient satisfaction benefits seen in cardiology. Implementation of TRA requires specific nursing knowledge, skill competency and protocols to assure positive patient outcomes.
A team approach including NIR, cardiology and nursing was used to coordinate safe patient management.
Preparation began with RN education regarding advantages of the TRA vs TFA including less vascular complications, a more easily compressible location, earlier ambulation, less site pain, and earlier discharge. Identifying the patient recovery area was crucial to assure proper nursing ratios necessary to provide surveillance needed for deflation of pressure device and observation for bleeding or other complications. Specific care post NIR procedure was modeled using existing cardiac protocol. The process begins with nursing in the NIR suite and proceeds to recovery area where the pressure device is progressively deflated until hemostasis is achieved and removed by the RN. The removal protocol is clearly described and mapped in the Radial Post Procedure Checklist (RPPC), which follows physician orders and includes instruction for VS, NV and neuro checks, pulse oximetry on accessed hand, and pressure band deflation after 60 minutes for diagnostics and 90 minutes after an intervention by releasing 3 cc every 15 minutes. RPPC provides reinflation directions if bleeding is observed. RN proficiency with pressure band was achieved through instruction, practice and correlation with anatomy. Patient instructions for complications and restrictions were provided to the discharging areas.
Although recovering TRA NIR patients requires new knowledge and skills, we have successfully cared for 105 in the past 6 months; one pressure band placed incorrectly over the ulnar artery was readily identified. Administration has supported a safe nursing ratio during the deflation phase with patient flow identified for procedures performed off hours.
Transradial access for NIR patients can be successfully implemented with nursing education, written protocols, proper patient placement flow maps, and patient teaching.
Abstract TP382: Multidisciplinary Collaboration Yields Emergency Medical Services (EMS) Inter-Facility Transfer Document to Ensure Patient Safety
Authors: Glidden Michele , Duzan Angel , Kaufmann Michael , Harrison Beth , Raab Courtney 
Published: June 2021

In the current era of advancing stroke care, rapid evaluation and treatment of an acute ischemic stroke should be standard practice based on current evidence and guidelines. Acute stroke treatment with intravenous (IV) thrombolytic should be started at the presenting facility when indicated. After this initial treatment, patients may then be transferred to the next higher level of care via a qualified EMS provider agency. These transfers are completed by either air or ground ambulance services. Patient safety during transport, especially for those receiving IV thrombolytic, must be ensured while minimizing door-in/door out times.
The Stroke Consortium of Indiana (SCI), represents 48 Indiana hospitals and other organizations within the state, prioritized implementation of a stroke interfacility guideline to standardize medical care provided during the transfer process. The State EMS Medical Director joined our consortium to represent the EMS system. A search of existing literature and protocols, as well as inter-state discussions, led to the determination that further development of guidelines currently utilized within the region was needed.
Indiana, like many other Midwestern states, has areas that are underserved by EMS with varying protocols written by a local EMS medical director. There are 833 different EMS provider agencies in Indiana each operating under different local protocols. EMS conducted 658 interfacility transfers for acute stroke treatment in 2018. There are currently 5 comprehensive, 35 primary, and 5 stroke ready centers certified of 118 total hospitals in the state.
During the development of this document, the members of SCI were provided multiple opportunities to give feedback and discussion. The document was finalized, adopted, and is available online at the IDHS website at https://www.in.gov/dhs/3781.htm. The goal of this best practice document is to provide guidance and support for adoption at the local EMS provider agency level and support EMS collaboration with local stroke centers in communities across Indiana. SCI members are encouraged to socialize and implement this guideline at the local level in cooperation with their local EMS agencies.
500 years of Old Chinese phonology
Authors: Zhao Xin 
Published: June 2021

Abstract
This article introduces research on Old Chinese phonology before the Qing dynasty by reviewing the important relevant literature of recent intellectual historians. The article has six parts. The first section is an introduction. The second through fourth parts review the views and arguments over how to understand the works of several important linguists, treating respectively the Southern Song (§ 2, containing Wú Yù 吳棫, Zhū Xī 朱熹 etc.), the Yuan (§ 3, containing Dài Tóng 戴侗, Liú Yùrǔ 劉玉汝, Xióng Pénglái 熊朋來 etc.), and the Ming (§ 4, containing Yáng Shèn 楊慎, Jiāo Hóng 焦竑, Chén Dì 陳第 etc.). Section 5 discusses several methodological issues that concern researchers today, including the historical emergence of three methodologies and methodological issues in researching the history of scholarship. Finally, I point out those topics in need of further investigation.
Isolation and characterization of lytic phage TUN1 specific for Klebsiella pneumoniae K64 clinical isolates from Tunisia
Authors: Eckstein Simone , Stender Jana , Mzoughi Sonia , Vogele Kilian , Kühn Jana , Friese Daniela , Bugert Christina , Handrick Susann , Ferjani Mustapha , Wölfel Roman , Millard Andrew , Ben Moussa Mohamed , Bugert Joachim J. 
Published: June 2021

Abstract
Background
Multidrug-resistant Klebsiella pneumoniae spp. (kp) are emerging agents of severe infections of the respiratory, urinary tract and wounds that can progress to fatal septicemia. The use of bacteriophages is currently being considered as an effective alternative or adjuvant to antibiotic therapy.

Results
In this study, we report capsule (K)-typing of 163 carbapenem-resistant Kp (CRKP) isolated 2014–2018 at the Military Hospital of Instruction of Tunis (MHT), Tunisia, by partial amplification and sequencing of the Kp wzi gene. The most prevalent K-type overall was K64 with 50.3% followed by K17 and K27 (22.7 and 11.0%, respectively). K64 Kp strains were most common and associated with increased case/fatality rates, especially at the intensive care unit (ICU). Using a K64 Kp strain we isolated and characterized a lytic Kp phage, vB_KpP_TUN1 (phage TUN1), from wastewater samples of the ICU at the MHT. TUN1 belongs to the Autographiviridae family and specifically digests K64 Kp capsules most probably via a depolymerase encoded by gp47. Furthermore, we successfully assembled phage TUN1 in a non-replicative host (E. coli) raising the possibility of in vitro assembly in the absence of live bacterial hosts. We propose that phage TUN1 is a promising candidate to be used as an adjuvant or an alternative to antibiotic therapy in CRKP infections, facilitating regulatory approval of phage therapy.

Conclusions
K64, K17 and K27 are the most common wzi capsule types in this geographical location in Northern Africa. The lytic phage TUN1 efficiently lyses K64 Kp strains associated with increased case/fatality rates at body temperature. Together with its ability to be rescued in a non-replicative host these features enhance the utility of this phage as an antibacterial agent.
The impact of personalized clinical decision support on primary care patients’ views of cancer prevention and screening: a cross-sectional survey
Authors: Saman Daniel M. , Chrenka Ella A. , Harry Melissa L. , Allen Clayton I. , Freitag Laura A. , Asche Stephen E. , Truitt Anjali R. , Ekstrom Heidi L. , O’Connor Patrick J. , Sperl-Hillen JoAnn M. , Ziegenfuss Jeanette Y. , Elliott Thomas E. 
Published: June 2021

Abstract
Background
Few studies have assessed the impact of clinical decision support (CDS), with or without shared decision-making tools (SDMTs), on patients’ perceptions of cancer screening or prevention in primary care settings. This cross-sectional survey was conducted to understand primary care patient’s perceptions on cancer screening or prevention.

Methods
We mailed surveys (10/2018–1/2019) to 749 patients aged 18 to 75 years within 15 days after an index clinical encounter at 36 primary care clinics participating in a clinic-randomized control trial of a CDS system for cancer prevention. All patients were overdue for cancer screening or human papillomavirus vaccination. The survey compared respondents’ answers by study arm: usual care; CDS; or CDS + SDMT.

Results
Of 387 respondents (52% response rate), 73% reported having enough time to discuss cancer prevention options with their primary care provider (PCP), 64% reported their PCP explained the benefits of the cancer screening choice very well, and 32% of obese patients reported discussing weight management, with two-thirds reporting selecting a weight management intervention. Usual care respondents were significantly more likely to decide on colorectal cancer screening than CDS respondents (p < 0.01), and on tobacco cessation than CDS + SDMT respondents (p = 0.02) and both CDS and CDS + SDMT respondents (p < 0.001).

Conclusions
Most patients reported discussing cancer prevention needs with PCPs, with few significant differences between the three study arms in patient-reported cancer prevention care. Upcoming research will assess differences in screening and vaccination rates between study arms during the post-intervention follow-up period.

Trial registration
clinicaltrials.gov, NCT02986230, December 6, 2016.
Komponen Asam Amino dan Aktivitas Enzim Tripsin dari Usus Tuna Sirip Kuning (Thunnus albacares) dan Kakap Merah (Lutjanus campechanus)
Authors: Arbajayanti Rahma Dini , Nurhayati Tati , Nurilmala Mala 
Published: June 2021

Jeroan ikan dikenal sebagai salah satu sumber enzim pencernaan yang melimpah, terutama sebagai sumber proteinase pencernaan yang baik, salah satunya adalah tripsin. Jenis dan habitat ikan akan memengaruhi sifat tripsin ikan. Tujuan penelitian ini adalah untuk membandingkan komponen asam amino daging dan aktivitas ekstrak kasar enzim tripsin dan usus ikan tuna sirip kuning (Thunnus albacares) dan ikan kakap merah (Lutjanus campechanus). Kedua jenis ikan diamati morfometrik dan rasio bobot jeroan ikan. Selain itu komposisi kimia, komponen asam amino daging, dan aktivitas ekstrak kasar enzim tripsin dari usus kedua jenis ikan tersebut kemudian dianalisis... Secara umum ikan tuna sirip kuning memiliki komposisi asam amino yang lebih tinggi dibandingkan ikan kakap merah, terutama pada komponen asam amino histidina, leusina, asam aspartat, lisina dan asam glutamat. Komponen asam amino yang paling dominan terdapat pada kedua jenis ikan tersebut adalah asam glutamat. Enzim tripsin ekstrak kasar usus ikan tuna memiliki aktivitas yang lebih tinggi yaitu 4,908 U/mg dibandingkan dengan ekstrak kasar usus ikan kakap merah sebesar 0,076 U/mg.
Kesulitan guru geografi SMA dalam menyusun soal higher order thinking skills berdasarkan kurikulum 2013
Authors: Putri Ceres Antika , Suharto Yusuf , Purwanto Purwanto 
Published: June 2021

Higher order thinking skills are realized through the implementation of HOTS questions which still have difficulties in the preparation. This study aims to determine the level of difficulty, form of difficulty, causal factors, and mapping the difficulties of geography teachers in preparing HOTS questions. The design of this study is a survey with quantitative descriptive analysis and presented in the form of graphics and maps. High school geography teachers in Malang City have difficulty implementing HOTS cognitive level indicators on the items because there is no manual for the preparation of HOTS questions specifically for geography. Based on the results of mapping teachers in public schools have lower levels of difficulty compared to teachers in private schools.
Kemampuan berpikir tingkat tinggi diwujudkan melalui implementasi soal HOTS yang masih terdapat kesulitan dalam penyusunannya. Penelitian ini bertujuan mengetahui tingkat kesulitan, bentuk kesulitan, faktor penyebab, serta pemetaan kesulitan guru geografi dalam menyusun soal HOTS. Rancangan penelitian ini adalah survei dengan analisis deskriptif kuantitatif dan disajikan dalam bentuk grafis dan peta. Guru geografi SMA di Kota Malang kesulitan dalam mengimplementasikan indikator-indikator level kognitif HOTS pada butir soal karena belum adanya buku panduan penyusunan soal HOTS khusus geografi. Berdasarkan hasil pemetaan guru-guru di sekolah negeri memiliki tingkat kesulitan yang lebih rendah dibandingkan dengan guru di sekolah swasta.