bluuebunny/crossref_metadata_2025_split huggingface dataset:
Automatic Comprehensive Aspects Reports in Clinical Acute Stroke MRIs
Authors: Faria Andreia , Liu Chin-Fu , Li Alice , Kim Ganghyun , Miller Michael , Hillis Argye 
Published: May 2022

Abstract
The Alberta Stroke Program Early CT Score (ASPECTS) is a simple visual system to assess the extent and location of ischemic stroke core. The capability of ASPECTS for selecting patients’ treatment, however, is affected by the variability in human evaluation. In this study, we developed a fully automatic system to calculate ASPECTS comparable with consensus expert readings. Our system was trained in 400 clinical diffusion weighted images (DWIs) of patients with acute infarcts and evaluated with an external testing set of 100 cases. The models are interpretable, and the results are comprehensive, evidencing the features that lead to the classification. This system adds to our automated pipeline for acute stroke detection, segmentation, and quantification in MRIs (ADS), which outputs digital infarct masks and the proportion of diverse brain regions injured, in addition to the predicted ASPECTS, the prediction probability and the explanatory features. ADS is public, free, accessible to non-experts, has very few computational requirements, and run in real time in local CPUs with a single command line, fulfilling the conditions to perform large-scale, reproducible clinical and translational research
Impact of Stroke Severity on the Smoking Paradox in Patients Treated
with Intravenous Thrombolysis
Authors: Yang Yi , Zhang Peng , Guo Zhen-Ni , Yan Xiu-Li , Zhang Fu-Liang 
Published: May 2022

Objectives:
To our knowledge, no previous studies have investigated the impact of stroke
severity on the smoking paradox after intravenous thrombolysis (IVT). We aimed to explore the
contribution of stroke severity to the association between smoking and stroke prognosis after IVT.

Methods:
We enrolled consecutive patients who received IVT within 4.5 hours from stroke onset. A
logistic regression model was used to estimate the unadjusted and adjusted odds ratios (ORs) with
their 95% confidence intervals (CIs) for poor functional outcome and mortality at 3 months.

Results:
Among patients with moderate stroke, smokers experienced a lower risk of 3-month poor
outcomes than non-smokers (33.0% vs. 44.4%, unadjusted OR: 0.616; 95% CI: 0.402–0.945). However,
among those with severe stroke, smokers had a higher risk of 3-month poor outcomes than
non-smokers (81.6% vs. 55.9%, unadjusted OR: 3.496; 95% CI: 1.207-10.127). After adjustment,
the negative correlation between smoking and 3-month poor outcome following IVT lost statistical
significance in patients with moderate stroke (OR: 0.677 [95% CI: 0.418-1.097]). However, smoking
remained a risk factor for 3-month poor outcomes in patients with severe stroke (OR: 4.216
[95% CI: 1.236-14.385]). We also observed a significant interaction between smoking and stroke
severity with regard to the risk of poor functional outcomes (p=0.023). However, no such interaction
influenced mortality (p=0.901).

Conclusion:
Stroke severity affects the association between smoking and 3-month clinical functional
outcomes following IVT.
Effects of Epigallocatechin Gallate on the Cytotoxicity of Epirubicin-HCl
in Lung Cancer Cells
Authors: Erdogan Ayse , Ozkan Aysun 
Published: May 2022

Background:
Studies have shown that epigallocatechin-3-gallate (EGCG), which is present in green tea at a higher rate than other components, has an additive or synergistic cytotoxic effect when applied with different anticancer drugs and reduces the side effects caused by anticancer drugs. It is known that the order of administration of drugs in combined applications also affects cytotoxicity. In this context, in our study, the most effective application sequence was determined by evaluating the cytotoxic responses of epirubicin-HCl and EGCG according to the different application order in A-549 cells (NSCLC).

Methods:
To demonstrate the apoptotic activity, we detected changes in mRNA ratios of Bax, a pro-apoptotic gene, and Bcl-2, an anti-apoptotic gene, (Bax/Bcl2), as well as changes in the activity of caspase 3/7 enzyme. To demonstrate the effect of oxidative stress generation, we investigated changes in glutathione peroxidase activity.

Results:
It was observed that the cell viability of A-549 cells exposed to different concentrations of epirubicin-HCl and EGCG for 48 h decreased depending on the concentration increase. According to the results of cell viability in cells to which epirubicin-HCl (<IC50) and EGCG (<IC50) were treated with together, and the combination index (CI) value calculations, the most effective combination concentrations were determined to be IC20 Epirubicin-HCl and IC10 EGCG. LDH activities were found higher in epirubicin-HCl + EGCG treatment than epirubicin-HCl alone treatment compared to control groups. Treatment of epirubicin-HCl with EGCG was found to be more effective in increasing glutathione peroxidase activity than epirubicin-HCl alone. Both of epirubicin-HCl alone and combination traetments caused increase in Bax/Bcl-2 ratio in A-549 cells.

Conclusion:
Combination therapy of epirubicin-HCl with EGCG may be a light in the future for lung cancer patients who are tried to be treated with conventional chemotherapy drugs but cannot achieve the desired success.
Nicotinamide Adenine Dinucleotide (NAD+) and Enkephalinase Inhibition (IV1114589NAD) Infusions Significantly Attenuate Psychiatric Burden Sequalae in Substance Use Disorder (SUD) in Fifty Cases
Authors: Badgaiyan Rajendra D , Blum Kenneth , Han David , Baron David , Kazmi Shan , Elman Igor , Gomez Luis Llanos , Gondre -Lewis Marjorie C. , Thanos Panyotis K , Braverman Eric R 
Published: May 2022

Background:
There is a shortage of clinical studies examining the efficacy of Nicotinamide Adenine
Dinucleotide and Enkephalinase infusions (IV1114589NAD) in treating Substance Use Disorder (SUD).

Objective:
This study aims to provide evidence that IV1114589NAD infusions significantly attenuate
substance craving behavior.

Methods:
The study cohort consisted of addicted poly-drug, mixed gender, multi-ethnic individuals resistant
to standard treatment. The investigation utilized Likert-Scales to assess behavioral outcomes.

Results:
Using Wilcoxon signed-rank tests and sign tests, our team detected significant results by comparing
baseline to post outcome scores after IV1114589NAD injections: craving scores (P=1.063E-9); anxiety
(P=5.487E-7); and depression (P=1.763E-4). A significant reduction in cravings, anxiety, and depression
followed a dose-dependent linear trend. Linear trend analyses showed a significant relationship between
NAD infusions and decreasing scores for cravings (P=0.015), anxiety (P=0.003), and depression (P=8.74E-
5). A urine analysis was conducted on a subset of 40 patients midway through the study to assess relapse;
100% of the urine samples analyzed failed to detect illicit substance use.

Discussion:
The opioid crisis in America has claimed close to 800,000 lives since 2004; daily deaths are
estimated to stand at 127, and in 2021, over 107,000 deaths were due to overdose. There is an urgency to
find safe, side-effect-free solutions. Current interventions, such as Naltrexone implants, are invasive and
may interfere with dopamine homeostasis leading to an anti-reward phenomenon. Larger randomized
double-blinded placebo-controlled studies are needed to elucidate further the significance of the results
presented in this study. The current pilot study provides useful preliminary data regarding the effectiveness
of IV1114589NAD infusions in SUD treatment.

Conclusion:
This pilot study provides significant evidence that NAD infusions are beneficial in the
treatment of SUD. This investigation serves as a rationale to extend these findings onto future research
investigating the use of NAD/NADH as a stand-alone treatment, especially in patients showing high
genetic risk as measured in the Genetic Addiction Risk Severity (GARS) test. Utilizing GARS will help
provide a real personalized therapeutic approach to treat Reward Deficiency Syndrome (RDS).
Coinoculación de Pinus montezumae (Pinaceae) con un hongo comestible ectomicorrízico y bacterias promotoras de crecimiento vegetal
Authors: Barragán-Soriano José Luis , Pérez-Moreno Jesús , Almaraz-Suárez Juan José , Carcaño-Montiel Moisés Graciano , Delgadillo-Martínez Julián , Cetina-Alcalá Víctor Manuel , Mata Gerardo 
Published: May 2022

Antecedentes y Objetivos: Las coníferas, como los pinos, establecen en sus raíces simbiosis obligadas con hongos ectomicorrízicos y con determinados grupos de bacterias. México posee una alta diversidad de especies del género Pinus, que en este país está representado por 72 taxa. Sin embargo, actualmente son escasas las investigaciones relacionadas con la coinoculación de pinos mexicanos con hongos ectomicorrízicos y bacterias benéficas. En este trabajo se evaluó el efecto de la coinoculación, con un hongo comestible ectomicorrízico y tres cepas bacterianas, en términos de variables de crecimiento, fisiológicas y nutrimentales en plantas de Pinus montezumae.
Métodos: Se inocularon y coinocularon plantas de P. montezumae con el hongo comestible ectomicorrízico Laccaria laccata, y con tres cepas bacterianas, una de Cohnella sp., y dos de Azospirillum brasilense (una con capacidad de fijar nitrógeno y la otra con capacidad de solubilizar fosfatos). Esta investigación duró 520 días y se realizó en un invernadero del Colegio de Postgraduados, Campus Montecillo, Texcoco, Estado de México, México.
Resultados clave: La inoculación con el hongo ectomicorrízico produjo incrementos en términos de peso seco de hasta 7.8 veces y tasas fotosintéticas hasta 30 veces mayores comparadas con las plantas sin inocular. Adicionalmente se registró un efecto sinérgico en términos del crecimiento de parte área y total, diámetro del tallo, tasa fotosintética, contenido de clorofilas totales y carotenos, así como contenido de nitrógeno y potasio de las plantas micorrizadas coinoculadas con el hongo ectomicorrízico y la bacteria A. brasilense fijadora de nitrógeno.
Conclusiones: Este trabajo demuestra la importancia de la coinoculación de un hongo ectomicorrízico comestible y la bacteria A. brasilense, en el mejoramiento del crecimiento, fisiología y contenido nutrimental de P. montezumae, una especie de pino de gran importancia forestal en México.
Use of Digital Technology Tools to Characterize Adherence to Prescription-Grade Omega-3 Polyunsaturated Fatty Acid Therapy in Postmyocardial or Hypertriglyceridemic Patients in the DIAPAsOn Study: Prospective Observational Study
Authors: Arutyunov Gregory P , Arutyunov Alexander G , Ageev Fail T , Fofanova Tatiana V 
Published: May 2022

Background
Maintaining sustained adherence to medication for optimal management of chronic noninfectious diseases, such as atherosclerotic vascular disease, is a well-documented therapeutic challenge.

Objective
The DIAPAsOn study was a 6-month, multicenter prospective observational study in the Russian Federation that examined adherence to a preparation of highly purified omega-3 polyunsaturated fatty acids (Omacor) in 2167 adult patients with a history of recent myocardial infarction or endogenous hypertriglyceridemia.

Methods
A feature of DIAPAsOn was the use of a bespoke electronic patient engagement and data collection system to monitor adherence. Adherence was also monitored by enquiry at clinic visits. A full description of the study’s aims and methods has appeared in JMIR Research Protocols.

Results
The net average reduction from baseline in both total and low-density lipoprotein cholesterol was approximately 1 mmol/L and the net average increase in high-density lipoprotein cholesterol was 0.2 (SD 0.53) mmol/L (P<.001 for all outcomes vs baseline). The mean triglyceride level was 3.0 (SD 1.3) mmol/L at visit 1, 2.0 (SD 0.9) mmol/L at visit 2, and 1.7 (SD 0.7) mmol/L at visit 3 (P<.001 for later visits vs visit 1). The percentage of patients with a triglyceride level <1.7 mmol/L rose from 13.1% (282/2151) at baseline to 54% (1028/1905) at the end of the study. Digital reporting of adherence was registered by 8.3% (180/2167) of patients; average scores indicted poor adherence. However, a clinic-based enquiry suggested high levels of adherence. Data on health-related quality of life accrued from digitally engaged patients identified improvements among patients reporting high adherence to study treatment, but patient numbers were small.

Conclusions
The lipid and lipoprotein findings indicate that Omacor had nominally favorable effects on the blood lipid profile. Less than 10% of patients enrolled in DIAPAsOn used the bespoke digital platform piloted in the study, and the level of self-reported adherence to medication by these patients was also low. Reasons for this low uptake and adherence are unclear. Better adherence was recorded in clinical reports.

Trial Registration
ClinicalTrials.gov NCT03415152; https://clinicaltrials.gov/ct2/show/NCT03415152
Health Misinformation Across Multiple Digital Ecologies: Qualitative Study of Data From Interviews With International Students
Authors: Bahl Rashika , Chang Shanton , McKay Dana , Buchanan George 
Published: May 2022

Background
Transient migrants such as international students have received limited support from host country governments throughout the COVID-19 pandemic. An increase in misinformation, resulting in poor health outcomes for individuals, may impact an already vulnerable group.

Objective
Existing research examines the spread of misinformation. Similarly, there is extensive literature on the health information behavior of international students. However, there is a gap in the literature focusing on international students’ interaction with health misinformation. This exploratory research aims to address this gap by examining international students’ interaction with health misinformation during the COVID-19 pandemic.

Methods
A total of 11 participants took part in semistructured interviews and a health misinformation-identification exercise via Zoom. The data collected were subjected to qualitative thematic analysis. Multiple rounds of coding, checked by other coders, revealed 2 themes and 6 subthemes.

Results
The 2 main themes that emerged were (1) approaches to dealing with health misinformation and (2) how international students navigate across multiple digital ecologies. Results show that international students who draw on multiple digital ecologies for information reliably identify misinformation, suggesting that the use of multiple digital ecologies may have a protective effect against health misinformation.

Conclusions
Findings show that international students encounter health misinformation across multiple digital ecologies, and they also compare information across multiple ecologies. This comparison may support them in identifying health misinformation. Thus, the findings of this study combat narratives of international students’ susceptibility to misinformation.
1008-P: Trends in Improvement in Clinical Outcomes and Health Care Access in Underrepresented Youth with Type 1 Diabetes (T1D)
Authors: YGLECIAS LOREN , REED ALISON , NOYA CAROLINA E. , MCGRATH MAUREEN T. , STONE ANNEMARIE , LODISH MAYA , SPIRO KIMBERLY B. , GOMEZ INGRID C. , HARRIS MICHAEL A. , WAGNER DAVID V. , WONG JENISE C. 
Published: May 2022

Background: There is a dearth of research focused on youth living with T1D from publicly insured and ethnically and racially diverse populations. Additionally, there are very few interventions that target social determinants of health (SDH) , despite their documented impact on diabetes outcomes, uptake of diabetes technology, and healthcare utilization. Novel Interventions in Children’s Healthcare (NICH) was developed as a systems and community-based intervention that targets SDH. We describe demographics and outcomes of youth with T1D enrolled in NICH services and related research.
Methods: Youth with T1D were eligible if they had &gt;=1 SDH and &gt;=1 of the following in the year prior to enrollment: &gt;=1 DKA hospitalizations after diagnosis, hemoglobin A1c (A1c) &gt;=14%, &gt;=2 emergency room visits or &gt;=2 missed clinic visits. Demographics were collected from chart review and baseline surveys. Outcomes included continuous glucose monitoring (CGM) use, A1c values, hospital costs, and number of hospital days.
Results: Participants (n=18) had a mean age of 15.1 (±2.4) years, 67% reported female gender, 89% self-identified as Black and/or Latinx, and 94% were publicly insured. CGM use significantly increased from 33% prior to NICH enrollment to 78% after enrollment (p=0.005) . Noted trends included a 1.0% decrease in mean A1c, 20% reduction in average per member, per month (PMPM) hospital costs, and 33% decrease in mean hospital days per month from the year prior to enrollment to the time since being enrolled in the NICH intervention.
Conclusions: Enrollment of publicly insured and ethnically and racially diverse youth living with T1D in research is feasible despite limited existing interventional studies on these populations. Youth with T1D from underrepresented populations experience increased use of technology from participation in the NICH intervention, and they show encouraging trends in improved glycemic control, hospital cost savings, and healthcare utilization.

Disclosure
L.Yglecias: None. D.V.Wagner: None. J.C.Wong: Consultant; Provention Bio, Inc., Research Support; Dexcom, Inc., Tandem Diabetes Care, Inc. A.Reed: None. C.E.Noya: None. M.T.Mcgrath: None. A.Stone: None. M.Lodish: None. K.B.Spiro: None. I.C.Gomez: None. M.A.Harris: None.

Funding
The Leona M. and Harry B. Helmsley Charitable Trust (G-1911-03543)
1015-P: Disparities in CGM Uptake and Sustained Use among Youth with Type 1 Diabetes
Authors: GRUNDMAN JODY , CASTRO MERYLL GRACE , HOOVER ABIGAYLE E. , MONAGHAN MAUREEN , STREISAND RANDI , PERKINS AMANDA G. , MCKENZIE LEANNA M. , REILLY JENNIFER K. , RICHARDSON ALEXIS M. , GOGGIN BAILEY , MARKS BRYNN E. 
Published: May 2022

Introduction: We evaluated potential factors influencing CGM uptake and sustained use to better understand the worsening disparities in CGM use among American youth with type 1 diabetes.
Methods: This is a retrospective chart review of youth with type 1 diabetes less than 21 years old seen at a tertiary care center from 1/1/2021 to 11/5/2021. Most recent clinic note and prescriptions were used to determine CGM use (active, attrition, never) and whether CGM was accessed through pharmacy or durable medical equipment. Binary logistic regression was used to assess effects of age, sex, race/ethnicity, insulin regimen, health insurance, and CGM supplier on CGM uptake and sustained use. χ2 was used to assess the impact of language in Latinx youth.
Results: Chart review identified 13youth (female 48.1%, NHW 43.7%, NHB 32.7%, Latinx 10.5%, publicly insured 52.1%) . Table 1 shows predictor variables associated with CGM use. NHW youth were more likely to have ever used CGM while CGM attrition was more common in NHB youth. Ever and active CGM use were less common in publicly insured youth and more common in pump users. CGM use was more common in Latinx English speakers than Spanish speakers (75.4% vs. 56.6%, p=0.03) .
Conclusions: In an era of rapidly advancing technologies, efforts to support equity in diabetes technology use in publicly insured, minority, non-English speaking youth with type 1 diabetes may help to address disparities in health outcomes.

Disclosure
J. Grundman: Research Support; American Diabetes Association. M. Castro: None. A.E. Hoover: None. M. Monaghan: Employee; National Institute of Diabetes and Digestive and Kidney Diseases. Research Support; American Diabetes Association. R. Streisand: None. A.G. Perkins: None. J.K. Reilly: None. A.M. Richardson: None. B. Goggin: None. B.E. Marks: Advisory Panel; JDRF. Research Support; Dexcom, Inc., Tandem Diabetes Care, Inc.

Funding
American Diabetes Association (7-21-PDFHD-09)
1029-P: INNOVATIONS: Improving Care of Patients with Type 1 Diabetes Mellitus through Utilization of Telemedicine and Outreach
Authors: RASBACH LISA E. , PURRINGTON VIRGINIA , ADKINS DEANNA , BENJAMIN ROBERT 
Published: May 2022

Frequent diabetes support and glucose review via telehealth may help decrease hospitalization rates and improve glycemic control for high-risk youth. This support may also help with uptake and durability of diabetes technology. Eligible youth had insulin dependent diabetes, Medicaid insurance, ages 8-18, and willing to use a continuous glucose monitor (CGM) . The quality improvement project provided weekly check-ins with a diabetes educator, visit reminders, and monthly video visits with a nurse practitioner. 10-item Likert questionnaire (1=not at all comfortable; 5=very comfortable) given at baseline assessed diabetes related comprehension. A needs assessment evaluated a family’s interest in learning about certain areas of diabetes management. A1c was done at quarterly clinic visits and ED/hospitalization rates tracked. 3 month data presented. Youth (N=29, 62% female, 79% NHB) , aged 8-18 yr, diabetes duration 6.3±4.3 years, had baseline mean A1c 12.3±1.7%; 28% on CSII. Mean baseline score of diabetes comprehension was 4.0±0.6. Baseline A1c correlated negatively with diabetes comprehension (r=-0.40, p&lt;0.05) . There was no difference between A1c at baseline and at 3 months (p=0.14) and no differences in ED/hospitalization rates compared to 2 years prior when controlled for time. There was an increase in CGM use from 3 months prior to the intervention (36% of participants) to 3 months after baseline (64%) , though this was not statistically significant (p=0.09) . There was no difference in clinic visit adherence at 3 months despite reminders. Preliminary data reveal that those patients with the highest HbA1c often have the lowest comprehension regarding optimal diabetes care, and may benefit from education reinforcement. CGM use increased with greater understanding of this technology, and may become clinically significant over time. Further research is needed to assess the long-term impact of telehealth interventions.

Disclosure
L.E.Rasbach: None. V.Purrington: None. D.Adkins: None. R.Benjamin: None.

Funding
Innovation Health (2933476)