bluuebunny/crossref_metadata_2025_split huggingface dataset:
Measurement of the nonlinear diffusion of the proton beam halo at the CERN LHC
Authors: Montanari C. E. , Appleby R. B. , Bazzani A. , Giovannozzi M. , Hermes P. , Poyet A. , Redaelli S. , Sterbini G. 
Published: January 2025

Abstract
In circular particle accelerators, storage rings, or colliders, mitigating beam losses is critical to ensuring optimal performance, particularly for rings that include superconducting magnets. A thorough understanding of beam halo dynamics is essential for this purpose. This paper presents recent results for the measurement of the nonlinear diffusion process of the beam halo at the CERN Large Hadron Collider (LHC). The novel approach used in this paper is based on the analytical framework of the Nekhoroshev theorem, which provides a functional form for the diffusion coefficient. By monitoring the beam loss signal during controlled movements of the collimator jaws, we determine the beam losses at equilibrium for various amplitudes and analyse the beam halo distribution. Postprocessing of these measurements provides the nonlinear diffusion coefficient, which is found to be in excellent agreement with the theoretical assumptions. Measurements from an experiment investigating the effectiveness of beam-beam compensation using beam-beam compensation wires also provide a direct assessment of the compensation’s effectiveness on beam-tail diffusion.
Management of Severe Hypertriglyceridemia in Pregnancy With Niacin: Reevaluating Safety and Therapeutic Benefits
Authors: Suda Nisha , Leon-Martinez Daisy , Peter Patricia R. , Flannery Clare A. , Irani Roxanna A. 
Published: January 2025

Background: Severe hypertriglyceridemia (triglycerides (TGs) >1000 mg/dL, >11.3 mmol/L) is a rare but potentially morbid condition in pregnancy. Physiological changes in pregnancy may unmask or exacerbate an underlying defect in TG metabolism. When conventional therapies are ineffective in controlling TG levels, a personalized management approach is needed. We present a case of severe hypertriglyceridemic pancreatitis successfully managed with niacin, a treatment that has seen limited use in pregnancy due to the paucity of available data.Case Presentation: A 29‐year‐old pregnant woman with a history of cholecystectomy and a prepregnancy BMI of 30.6 kg/m2 presented at 12 weeks’ gestation with acute pancreatitis and severe hypertriglyceridemia (6900 mg/dL, 77.9 mmol/L). After initial management with intravenous (IV) fluids, insulin infusion, and a low‐fat diet, her TG levels improved. However, she was readmitted at 23 weeks’ gestation with recurrent hypertriglyceridemia (2872 mg/dL, 32.4 mmol/L), requiring a more aggressive insulin regimen. Despite various interventions, including omega‐3 fatty acids (O3FAs), fenofibrate, and central venous catheter insulin infusion, her TG levels remained elevated, necessitating early delivery at 34 weeks’ gestation. Her postpartum recovery included continued TG management with fenofibrate and O3FAs. Four years later, during a second pregnancy, she presented with similar hypertriglyceridemia, managed with diet, metformin, fenofibrate, and insulin. Due to persistent hypertriglyceridemia (>3000 mg/dL, 33.9 mmol/L), niacin was added as an additional therapy and titrated to 2000 mg/day, which successfully sustained TG levels below 1000 mg/dL (11.3 mmol/L) through the remainder of her pregnancy. She delivered her second child via cesarean section at 35 weeks’ gestation due to preeclampsia. Both children had developmental issues, with her first child diagnosed with attention‐deficient hyperactivity disorder (ADHD) and her second child with autism spectrum disorder and motor delays. The patient was encouraged to remain on long‐term management for her metabolic condition.Conclusions: Managing severe hypertriglyceridemia during pregnancy is challenging due to uncertainties about treatment efficacy and safety. Timely reduction of maternal TGs is essential to prevent complications and requires adjustments throughout pregnancy. This case demonstrates the effectiveness and safety of niacin, often underutilized due to perceived side effects, in managing severe hypertriglyceridemia in pregnancy when other treatments were inadequate.
Inhibition of the Transforming Growth Factor‐β Signaling Pathway Confers Neuroprotective Effects on Beta‐Amyloid‐Induced Direct Neurotoxicity and Microglia‐Mediated Neuroinflammation
Authors: Tiong Shao Qin , Mohgan Raxshanaa N. , Quek Jia Yee , Liew Jennifer Yue Suan , Wong Grace Yee Seen , Thang Zi Qing , Chan Zhi Ling , Gan Sook Yee , Chan Elaine Wan Ling 
Published: January 2025

Background: Abnormal elevation of transforming growth factor‐beta (TGF‐β) has been observed among Alzheimer’s disease (AD) patients. This may be due to microglia‐mediated release of proinflammatory cytokines, which promote neuroinflammation and neuronal apoptosis. Silencing of TGFBR1, a gene encoding TGF‐β receptor type I (TGF‐βR1), has resulted in neuronal survival from amyloid‐beta (Aβ)‐induced neurotoxicity. Therefore, the present study investigated the neuroprotective effect of TGF‐βR1 inhibitors (RepSox, Galunisertib, and Vactosertib) against Aβ‐induced direct neurotoxicity and microglia‐mediated neuroinflammation.Methods: The neuroprotective effect of TGF‐βR1 inhibitors against Aβ‐induced direct neurotoxicity and microglia‐mediated neuroinflammation were investigated using the RealTime‐Glo™ MT Cell Viability Assay. The inhibitory effect of TGF‐βR1 inhibitors on Aβ‐induced microglia‐mediated production of proinflammatory cytokines (TNF‐α and IL‐1β) was determined using enzyme‐linked immunosorbent assay (ELISA).Results: TGF‐βR1 inhibitors (RepSox, Galunisertib, and Vactosertib) at the tested concentrations (6.25–150 nM) showed no significant cytotoxicity effects on SH‐SY5Y and BV‐2 cells. Moreover, treatments with these inhibitors exhibited neuroprotection on SH‐SY5Y cells against Aβ‐induced direct neurotoxicity. The trend of cell viability after 24 h treatment also supports the microscopic images of the cells’ morphology. Furthermore, pretreatment with these inhibitors conferred indirect neuroprotective effect against Aβ‐induced microglia‐mediated neuroinflammation by attenuating the production of proinflammatory cytokines (TNF‐α and IL‐1β).Conclusion: The inhibition of the TGF‐β signaling pathway in neuronal and microglia cells by TGF‐βR1 inhibitors resulted in neuroprotection against Aβ‐induced direct neurotoxicity and microglia‐mediated neuroinflammation. Hence, targeting the TGF‐β signaling pathway in both neuronal and microglia cells could provide a promising therapeutic strategy in AD.
Replication-Poison Treatment in BRCA1-Deficient Breast Cancer Causes MRE11 Over-Resection that Induces Single-Stranded DNA Accumulation and Mitotic Catastrophe
Authors: Tabet Imene , Orhan Esin , Candiello Ermes , Fenou Lise , Velázquez Carolina , Orsetti Beatrice , Rodier Geneviéve , Jacot William , Ribeyre Cyril , Sardet Claude , Theillet Charles 
Published: January 2025

Abstract
BRCA1 deficiency is observed in approximately 25% of triple-negative breast cancer (TNBC). BRCA1, a key player of homologous recombination (HR) repair, is also involved in stalled DNA replication fork protection and repair. Here, we investigated the sensitivity of BRCA1-deficient TNBC models to the frequently used replication chain terminator gemcitabine, which does not directly induce DNA breaks. A large fraction of BRCA1-deficient cells was sensitive to gemcitabine, in contrast to their isogenic BRCA1-proficient counterparts. Gemcitabine treated BRCA1-deficient cells accumulated massive levels of single strand DNA (ssDNA) and presented no RPA or RAD51 nuclear foci. The gemcitabine-induced accumulation of ssDNA in BRCA1-deficient cells was strongly diminished by targeting MRE11 with inhibitors and by siRNA attenuation. In contrast, treatment with the PARP1/2 inhibitor olaparib did not result in MRE11 dependent over-resection. Furthermore, a fraction of gemcitabine treated BRCA1-deficient cells that showed massive ssDNA accumulation slipped into mitosis, producing mitotic bridges and strongly stained BrdU and γH2AX micronuclei (MN). The BrdU-positive MN and DNA bridges also stained positively for cGAS. In conclusion, these data suggest that gemcitabine treatment in BRCA1-deficient TNBC exposes unprotected nascent DNA linked to replication fork reversal, which leads to MRE11 over-resection and ssDNA accumulation. Therefore, the observed hypersensitivity to gemcitabine indicates that it could be a beneficial addition to BRCA1-deficient TNBC treatment.
Abstract NS9: Community Based Stroke Self-Management Program for Rural African American Aging Population: A Needs Assessment and Initial Development
Authors: Andrabi Mudasir 
Published: January 2025

Background:
High Blood Pressure (HBP) issue is high among African American aging populations living in rural areas. There is a lack of programs for self-management of HBP and post-stroke life for these individuals living in rural Stroke belt areas.

Purpose: Develop the need-based Community Stroke and Hypertension Self-management Program (CSSP) and test its feasibility among rural-dwelling African American stroke survivors 50 and above.

Methods:
Study Design:

Mixed methods study with a sequential design.
Study Population: African American stroke survivors with HBP aged 50 years or above (N=25) and caregivers (N=15) residing in rural counties of Alabama.

Study Procedures:

I)
Needs assessment:
We assessed needs and cultural preferences by using surveys and interviews. The surveys included a) the demographic survey, b) the Hypertension Knowledge-Level Scale, c) the Hypertension Self-Care Activity Level Effects, and d) the Southampton Stroke Self-Management Questionnaire.

II)
Intervention development
: Multicomponent intervention includes a) educational component, b) home visiting, c) problem-solving, d) telephonic follow-ups, e) text reminders, and f) social groups.

III)
Intervention delivery phase:
A 12-week CSSP will be delivered to groups of 8 to 10 participants in a hybrid format. Data
will be collected
before, at midpoint, and after the intervention is completed.

Results:
Results from Needs assessment:

Themes evolved from Qualitative data:

- Lack of information, lack of rehabilitation services, and lack of assistance with daily life activities. Multiple barriers to care and challenges during post-stroke, including lack of transportation and affordability of care. These communities have some facilitators for health programs, including the existing conference call system and social groups.

Results from Quantitative Data:

All participants (100%) had low knowledge related to HBP management. The majority of them had low levels of adherence with HBP medications (52%), a low-salt diet (92%), physical activity (56%), weight management (81%), and alcohol avoidance (91%). All (100%) of the participants had low to moderate competencies to manage post-stroke conditions.

Conclusion:
African American aging individuals living in the Deep South are at risk for HBP and recurrence of stroke. There is a need for a self-management program that would overcome contextual barriers related to rural areas and enable these populations to manage their HBP and post-stroke life.
Abstract TMP16: Is Lipoprotein(a) Being Measured in Ischemic Stroke Patients?
Authors: Rudolph Steven , Davy Connor , Walkin Carol , Morhaim Holly , Roche Tara , Holland Cinthia , clark erynn 
Published: January 2025

Lipoprotein (a) [Lp(a)] is a type of lipoprotein that is genetically inherited. Elevated levels of Lp(a) are an independent and causal risk factor for atherosclerotic cardiovascular diseases through mechanisms associated with increased atherogenesis, inflammation, and thrombosis. Having elevated Lp(a) can increase risk of heart attack, stroke, and peripheral artery disease.
It is estimated that as many as 20% of the American population have elevated Lp(a) levels. There are currently no specific targeted treatments to lower Lp(a). There are currently no universal guidelines for diagnosing and providing risk assessment. There is a clinical need to understand variation in Lp(a) levels in various ancestry groups.
In March 2023, a field to include measures for Lp(a) was added to the Get With The Guidelines® IQVIA Registry Platform™ (GWTG). This registry is utilized by each of the hospitals in a current six hospital system. A configurable measure report including Lp(a) measurement obtained and Lp(a) level was added in April 2024.

Methods:
Beginning in January 2024, Lp(a) levels obtained at six hospitals in our health system in New York City have been entered into GWTG. We used the newly developed measure reports for patients with ischemic stroke and TIA to determine whether Lp(a) levels were being obtained during hospitalization for stroke, and prior to these events. These hospitals are all certified by The Joint Commission®, and include one academic comprehensive stroke center, two thrombectomy centers, and three primary stroke centers.

Results:
In general, measurement of Lp(a) was low. Only one hospital had more than 10% of patients where Lp(a) was measured. One hospital, a primary stroke center had significantly more patients tested due to specific interest in Lp(a). The hospital with the highest percentage of measurement prior to the stroke was a tertiary care academic hospital.

Conclusion:
These results point out the need for initiatives across our health system to raise awareness of Lp(a) as an emerging stroke risk factor, and to improve on its measurement. This data will serve as a baseline to evaluate improvement in recognition and eventually treatment of elevated Lp(a) values.
Abstract TP261: Stroke in pediatric heart transplant patients
Authors: Ubeda Tikkanen Ana , Ferreira Fabiana , Vanderpluym Christina , Esteso Paul , Rivkin Michael 
Published: January 2025

Introduction:
Pediatric heart transplant (PHT) recipient survival has improved. Yet, neurologic morbidity related to heart failure and its treatment persist. It can affect the functional outcome, increase risk of major adverse events, prolong LOS and increase the use of rehabilitation therapies (RT). We aim to describe the clinical characteristics, functional status and RT use of PHT Pts with stroke during the PHT admission.

Methods:
Retrospective cohort study of consecutive PHT Pts at a tertiary center between 09/01/2012 and 09/30/2022. Demographic, and pre-, intra-, and post-PHT clinical, brain imaging and RT (physical, occupational, speech and feeding therapy) data were collected up to PHT hospitalization. Data are presented as frequency (%) or median (Inter Quartile Range-IQR).

Results:
Of the 83 PHT Pts 34(40%) of them had a stroke 20(59%) pre-PHT, 7(21%) post-PHT, 4(12%) pre- and post-PHT and unknown timing in 3(9%). Median age of HT in these Pts was 6 yrs(1,13) (Table 1), 21(62%) were male. CHD was the pre-PHT diagnosis in 21(62%) of stroke Pts, cardiomyopathy in 12(35%) and acquired heart disease in 1(3%). Mechanical circulatory support were used in 27(79%) PHT with stroke.

Total no. of distinct areas of neurologic injury on brain MRI was 85 (Table 2). Neurologic events per imaging were 2(1, 2). MCA was affected in 22(26%), PCA 8(9%), ACA 8(9%), MCA+ACA 5(6%), and MCA+PCA 2(2%). Additionally, 38(45%) were ischemic and 34(40%) were hemorrhagic strokes.
Of the acute and/or sub-acute brain MRI findings with known stroke dates(N=41), the week prior, 8(20%) of Pts had a cardiac surgery, 4(10%) had a cardiac cath, 3(7%) had a cardiac arrest, 7(17%) had an arrest+procedure, 5(12%) arrest+cath, 3(7%) had a cath+ procedure, and 1(3%) had an arrest+cath+procedure.
Of the 41 brain MRI findings with known stroke dates, 1 day prior, 8(24%) pts were on anticoagulation agents, 10(24%) on antiplatelet, 15(37%) were on both, and 8(20%) were on neither. Pts who required ECMO and/or VAD(76%) had more strokes.
Total LOS for Pts with strokes was 91 days(28, 167) vs. the total HT cohort 117 days(58, 186). Of the stroke Pts, Pre-HT and Post-HT RT were required in 27(79%) and 31(91%), respectively (Table 3). Acute inpatient rehabilitation was required in 9(26%).

Conclusions:
Strokes are found in almost half of PHT Pts. Most of them occur pre-HT. Cause of stroke is likely multifactorial. Their functional status is frequently impacted and requires RT pre- and post-HT.
Abstract WMP58: Social determinants of Health with Ischemic Stroke Patients treated with IV thrombolysis within a Public Safety Net Hospital
Authors: Grazi Jack , Law Susan , Soh James , Kang Derrek , Huang Anna 
Published: January 2025

Introduction:
The management of acute ischemic stroke over the last three decades has seen an expansive progression in terms of medical and surgical interventions. In spite of these advances, stroke outcomes continue to be reliant on factors only attributable to the patient. The aim of this study is to understand the social determinants of health within our public safety net hospital. This is a descriptive study to evaluate demographics of stroke patients with IV thrombolysis in relation to social determinants of health (SDOH).

Methods:
All patients entered into the GWTG-Stroke registry for NYC Health+Hospitals/Kings County between 3/1/2022 and 3/31/2024. Any patients whose symptoms started after hospital arrival, were transferred to or from another hospital, or had unknown last known well were excluded. Chi-Square tests and logistic regressions were performed.

Results:
Between 3/2022 and 3/2024, 1359 patients were analyzed after exclusion criteria and 141 patients were identified to have at least 1 SDOH. Individual Chi-Square analyses revealed a significant relationship between identification of SDOH and age, payment source, stroke diagnosis, and symptom resolution upon hospital arrival. When comparing age, patients aged 80+ were likely to have at least 1 SDOH compared to their counterparts less than 50 years old (2.31, 1.21-4.42, p<0.02). Compared to patients whose symptoms resolved upon arrival, those symptoms persisted after arrival are more likely to have at least 1 SDOH (1.78, 1.04-3.06, p<0.04). Patients using Medicare/Medicaid are more likely to have at least 1 SDOH compared to those with private insurance (2.19, 1.26-3.82, p<0.01). In a full logistic regression model including age, initial NIHSS score, race, sex, payment source, Hispanic ethnicity, and stroke diagnosis, only age (1.02, 1.01-1.04, p<0.02) and payment source (1.79, 1.01-3.16, p<0.05) were statistical predictors of a patient reporting SDOH.

Discussion/Next Steps:

Several factors have been demonstrated to be associated with social barriers to optimal stroke care. Medicaid/Medicare insurance status has been associated with readmissions and higher mortality than other patients.[1] This can be attributed to lower health literacy in such populations, thereby preventing accessing adequate medical care.
By acknowledging and addressing SDOH, we hope to provide more comprehensive stroke care to not only identify high risk patients, but also optimize care for patients within the healthcare system.
Abstract WP84: Drop It Like It’s Hot: Partnering with Teleneurology to Decrease Treatment Times
Authors: Nielsen Danielle 
Published: January 2025

Purpose:
Decreasing door to needle and door to transfer times drives patient outcomes. When treating acute stroke patients, time is brain. The shorter the door to treatment time the faster patients can receive the thrombolytic therapy. The rapidly evolving use of telemedicine in acute stroke is state-of-the-art for identifying therapeutic indications such as IV thrombolysis and mechanical thrombectomy in patients with large vessel occlusion (LVO) (Schröter et al., 2023).

Method:
Our facility is a Joint Commission certified Primary Stroke Center with two Acute Stroke Ready certified freestanding emergency departments (ED), caring for >67,000 patients a year with >700 being diagnosed with stroke. In 2023 our EDs transferred 35 patients with an LVO and 21 year to date in 2024.

A review of data illustrated an opportunity with our teleneurology program, staffed by an internal team of neurologists from our comprehensive stroke center. The development of the teleneurology program began at our health system in March 2021. ED providers had the ability to consult teleneurology, via telephone or video consult. When first launched, the new process was inconsistent.
Through ongoing chart audits, we identified ED providers were reliant on the recommendations from the teleneurologists. Upon review, a barrier to care was identified which caused delays in door to decision. In November 2023, we implemented a new stroke alert process, mandating that all stroke alert activations automatically received a teleneurology consult. By refining the process, we have demonstrated improvements in our door to needle and door to transfer times. Since the therapeutic success is strongly dependent on time, an early, accurate decision-making process is essential for timely transfer of the patient to a mechanical thrombectomy-competent center for appropriate stroke-oriented imaging and therapy (Schröter et al., 2023).

Results:
Post-implementation, our door in door out times decreased by 20% within eight months. Our median door in door out time decreased by 22.5 minutes. Of the LVO's we have transferred, five patients were transferred in <60 minutes and two patients in <70 minutes. Additionally, we have seen an overall reduction in our door to needle times.

Discussion:
Moving forward, we will continue to review and refine our workflows. There is consideration adding a nurse to the teleneurology team and a dedicated stroke response nurse to the team to provide additional support to our program.
The impact of teaching method and learning style on student engagement: a formative assessment of a primate education programme
Authors: Nekaris K.A.I. , Rickets H. , Campera M. , Bukit W.L. , Imron M. Ali 
Published: January 2025

Abstract
We explore the impact of teaching methods and learning styles on student engagement in a conservation education program focused on primate conservation in Indonesia. Engaging students is essential for fostering environmental literacy and encouraging pro-environmental behaviours. We assessed the effectiveness of active versus didactic teaching methods and visual, auditory, and kinaesthetic learning styles in enhancing engagement. Using a formative assessment approach, we observed student participation and attentiveness across 19 different activities in a Nature Club program. Our results indicated that active teaching methods significantly increased engagement, while auditory learning styles were associated with lower levels of engagement. The findings emphasise the importance of adopting active learning strategies and tailoring activities to accommodate diverse learning styles to maximise student involvement. This research contributes valuable insights into the design of conservation education programs that effectively promote long-term environmental stewardship among young learners. Furthermore, this method can easily be adapted to evaluate a range of different conservation education programmes