bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract 238: Gender Differences In Clinical Factors In Obese Ischemic Stroke Patients With A History Of Smoking
Authors: Ojo Dami T. , Brewer Philip , Garg Sahil , Broughton Philip , Nathaniel Thomas 
Published: March 2024

Introduction
Clinical risk factors and co‐morbidities in obese male and female ischemic stroke patients with a history of smoking may contribute to differing stroke outcomes. The objective of this study is to determine gender differences in risk factors in obese ischemic stroke patients with a history of smoking.

Methods
A retrospective study was conducted on 6‐year data from 5469 patients with an ischemic stroke event from a regional stroke center. A logistic regression model was used to predict clinical risk factors associated with male or female patients. Multicollinearity was assessed using variance inflation factors (VIFs), with values >5 suggestive of multicollinearity

Results
In the adjusted analysis, (OR = 1.806, 95% CI, 1.028–3.174, P =0.040*), a history of drugs and alcohol (OR = 2.873, 95% CI, 1.349–6.166, P =0.006), Serum Creatinine (OR = 4.724, 95% CI, 2.171–10.281, P<0.001), Age (OR = 1.024, 95% CI, 1.022–1.047, P=0.033), and systolic blood pressure (OR = 1.029, 95% CI, 1.011–1.047, P<0.002) were associated with males. Depression (OR = 0.432, 95% CI, 0.244–0.764, P<0.004), Previous TIA (OR = .319, 95% CI, 0.142–0.714, P<0.005), and higher levels of HDL (OR = 0.938, 95% CI, 0.915–0.962, P<0.001) were associated with female gender.

Conclusion
Gender differences were observed in the clinical factors and comorbidities within the population of AIS patients who were smoking and obese. Further studies should evaluate the effect of specific risk factors to develop specific strategies for the management of identified risk factors to improve the care of obese male and female ischemic stroke patients with a history of smoking.
Abstract 242: Clinical Validation Trial Of BraiN20® Medical Device. PROMISE20 Study Protocol
Authors: Martinez Alicia , Cortes Jordi , Millán Mónica , de la Ossa Natalia Pérez , Ribó Marc , Serena Joaquín , Ruiz Gisela , Coll‐Canti Jaume , Dávalos Antoni 
Published: March 2024

Introduction
N20 somatosensory evoked potential (SEP) response shows high predictive accuracy of functional recovery in patients with Acute Ischemic Stroke (AIS) undergoing endovascular thrombectomy (https://www.clinicaltrials.gov/ct2/show/NCT04099615; SVIN Journal, in press). This capacity is independent and even higher than clinical and advanced imaging variables. This study aims to validate BraiN20®, a portable, non‐invasive, AI‐based device to monitor in real‐time the presence and characteristics of N20 in AIS.

Methods
65 patients with AIS and anterior Large Vessel Occlusion (LVO) undergoing EVT within 24 hours from onset are included in three comprehensive stroke centers of Catalonia, Spain. Eligibility criteria are no significant pre‐stroke functional dependence, baseline NIHSS score equal or higher than 6 points, occlusion (mTICI 0‐1) of the intracranial ICA, MCA‐M1 or M2 suitable for EVT per local protocols, without infarct volume restrictions measured by ASPECT score or by CTP/DWI‐MRI prior to EVT . The primary objective is to confirm an optimal/good reliability of N20 registration before EVT higher than 75% by two blind expert neurophysiologists, assuming a true proportion equal to 87.5%. Secondary endpoints are the predictive accuracy of N20 response recorded by BraiN20® before and after EVT on functional outcome evaluated by the mRS at 7 and 90 days and analyzed by using Receiving Operating Characteristic curves. A futility interim analysis is planned after the inclusion of 25% of the sample.

Results
The trial is sponsored by Time is Brain S.L. and will start early September 2023. Primary endpoint results are expected by the end of this year.

Conclusion
BraiN20® could be a useful medical device to predict salvageable brain and functional recovery of patients along the stroke chain.
Abstract 252: The outcomes and complications in patients undergoing subclavian‐carotid artery bypass surgery: A case series
Authors: Wong Serena 
Published: March 2024

Introduction
Endovascular intervention has become the mainstay of treatment for acute ischemic stroke. However, in certain cases, open surgery is the only option to achieve revascularization. This study presented two patients with symptomatic common carotid artery occlusion (CCAO) who subsequently underwent subclavian‐carotid artery bypass surgery using the polytetrafluorethylene graft. The complications of the procedure and patient’s outcomes were discussed.

Methods
We identified two patients who were admitted to our medical center between January 2022 to December 2022 for subclavian‐carotid artery bypass procedure. Clinical data were reviewed retrospectively.

Results
Case 1. A 69‐year‐old woman with a history of lung cancer, hypertension, chronic tobacco use, atherosclerosis, and known calcified plaque at the left carotid bifurcation on dual antiplatelet therapy presented with acute onset of expressive aphasia and right hemiparesis due to acute left CCAO. Endovascular procedure was deferred due to difficult arterial access. An endarterectomy of CCA, eversion endarterectomy of external carotid artery, and subclavian‐carotid artery bypass surgery were performed. She developed neck hematoma post‐operatively, requiring evacuation. She was discharged to acute rehabilitation facility and eventually home. Six months after surgery, she still had severe expressive aphasia and spasticity of the right arm and leg (Figure A‐C).
Case 2. A 79‐year‐old man with a strong family history of arterial dissection, hypertension, coronary artery disease, and obesity experienced intense chest pain and left hemiparesis secondary to Type A aortic dissection with extension from the innominate artery to the right carotid bifurcation. Endovascular intervention was deferred given the angulation of aortic arch after surgical repair. Decision was made to perform subclavian‐carotid artery bypass surgery. Post‐operatively, he had evacuation of neck hematoma. He also had tracheostomy and gastrostomy tube placement prior to discharge to skilled nursing facility. At 6‐month follow up, he could ambulate with a walker and oral diet was resumed (Figure D‐F).

Conclusion
CCAO is a rare condition, and there is no prospective randomized trial that compares various treatment strategies for symptomatic CCAO. Consistent with the findings of our study, bypass surgeries have been shown as an effective treatment to prevent further ischemic infarct in patients with symptomatic CCAO. Both patients in our study survived at 6‐month follow up with no recurrence of stroke. Additionally, no other surgical complications were noted except for neck hematoma. Bypass surgery was performed as a salvage procedure for both patients after they suffered from stroke. Early identification of CCAO and collaboration between vascular surgeon and endovascular interventionist would maximize the benefit of this life‐saving procedure to the appropriate candidates.
Abstract 253: Impact of Gender and Marital Status on Door‐To‐Needle and Door‐To‐Puncture time and Acute Stroke Outcome
Authors: Karim Nurose , Tumin Dmitry , Karim Sehrish , Male Shailesh 
Published: March 2024

Introduction
Delays in acute treatment of ischemic stroke have been associated with worse outcomes [1]. Women are more likely to present with atypical stroke symptoms than men, causing delay in pre‐hospital diagnosis and seeking medical attention [2‐3]. Additionally, women tend to be older at stroke onset and more likely to be living alone [4‐5]. Among patients presenting with acute stroke, women experience longer emergency department (ED) door‐to‐doctor and door‐to‐imaging (DIT) times, resulting in fewer interventions [6]. It is unclear if gender disparities in the timeliness of ED arrival and stroke assessment are compounded by gender differences in timeliness of treatment after patient arrival in the ED. Therefore, we sought to identify, if gender and marital status were associated with faster door‐to‐needle (DTN) and door‐to‐puncture (DTP) times. We hypothesized that married men would have the fastest DTN and DTP times, associated with female spouses being quicker to recognize traditional signs of stroke, calling 911 who can activate stroke alert, and therefore avoiding delay in acute care.

Methods
Our single‐center stroke database was queried for adults presenting to the ED with acute stroke between 1/1/2018‐1/30/2023. Patients were excluded if they had missing data on marital status or covariates. DTN and DTP times, as well as National Institutes of Health Stroke Scale (NIHSS) at discharge, were analyzed using quantile regression on sex, marital status (dichotomized as married vs. single), age, intervention (TPA alone, or thrombectomy±TPA), and NIHSS score at presentation.

Results
We identified 674 patients meeting inclusion criteria, of whom 31 were excluded due to missing data. In the remaining sample (N=643, median age 66yr), 25%/18% of patients were married men/women, respectively, and 22%/35% were single men/women. Median DTN time, DTP time, and discharge NIHSS were 36min, 79min, and 4, respectively. On multivariable analysis (Table), none of the outcomes were improved among married men relative to any other combination of sex and marital status.

Conclusion
Gender differences in knowledge of warning signs of stroke in community‐based studies and gender disparities in ED assessment did not translate into faster treatment “after” ED arrival based on gender or marital status. More work is needed to find out ways to accelerate care “after” ED arrival to have faster DTN and DTP time.
Abstract 262: National Trends of 90‐day Readmission Rates and Etiologies among Diabetics following Transient Ischemic Attack
Authors: Laswi Ibrahim , Al‐Najjar Yousef , Arabi Maryam , Dargham Soha , Jerdi Salman Al , Khalil Charbel Abi 
Published: March 2024

Introduction
Transient Ischemic Attack (TIA) is a common neurologic condition characterized by temporary, focal cerebral ischemia that results in reversible neurological deficits without tissue infarction. Type 2 Diabetes Mellitus (T2DM) is a rapidly growing global health problem with increasing prevalence. Currently, data are lacking regarding the trends of 90‐day readmission rates and etiologies among diabetic patients with TIA.

Methods
We used the Nationwide Readmission Database (NRD) to identify patients with a primary diagnosis of TIA (ICD‐10 code: G45.9) from 2016‐2019 and secondary diagnosis of T2DM. The difference in days between the index admission and the readmission was used to identify patients who were readmitted within 90 days. The primary diagnosis of the readmission was used to identify the etiology of readmission. Data was weighted to allow for representative nationwide estimates.

Results
We identified 426,549 patients who were admitted with a primary diagnosis of TIA between 2016 and 2019. Of those patients, 35.43% (n=273,993) were diabetic and 64.57% (n=151,112) were non‐diabetic. Diabetics were more likely to be younger (70.43 vs 70.71 years, p<0.001) and male (46.62% vs 42.89%, p<0.001) compared to non‐diabetics. All‐cause 90‐day readmission was higher among diabetics compared to non‐diabetics (15.22% vs 12.03%, p<0.001). Nearly half of 90‐day readmissions occurred within 30 days. There was no significant difference in the rate of 90‐day readmission between 2016 and 2019 (13.19% in 2016 and 12.95% in 2019). Among diabetics, readmitted patients were more likely to be older (71.87 vs 70.18 years, p<0.001) and male (47.96% vs 46.38%, p<0.001). Readmitted diabetics had a higher prevalence of valvular disease (10.12% vs 7.94%), chronic renal failure (33.40% vs 23.98%), coronary artery disease (40.20% vs 32.86%), heart failure (23.88% vs 16.07%), atrial fibrillation (24.02% vs 18.88%), dementia (13.87% vs 11.13%), cancer (4.18% vs 2.44%), and prior VTE (5.24% vs 4.44%) (p<0.001 for all). The most common etiologies of 90‐day readmission among diabetics were cardiovascular (28.98%), neurological (12.92%), and infectious (7.72%).

Conclusion
Diabetics had higher 90‐day readmission following TIA than non‐diabetics. Cardiovascular conditions were the most common cause of readmission followed by neurological and infectious causes. Further studies are needed to improve risk stratification for diabetic patients following TIA and prevent all‐cause readmission.
Abstract 274: Mechanical Thrombectomy for Ischemic Stroke in Elderly Population
Authors: Naamani Kareem El , Mudundi Divya , Gooch Michael R. , Tjoumakaris Stavropoula I. , Rosenwasser Robert H. , Jabbour Pascal , Herial Nabeel A. 
Published: March 2024

Introduction
Stroke is a leading cause of mortality and morbidity worldwide and the risk increases with age. Mechanical thrombectomy (MT) in eligible patients is proven to improve outcomes and is ow standard of care for acute ischemic stroke. Clinical trials evaluating MT often exclude patients older than 80 and available scientific evidence supporting MT in elderly is limited and varied. Purpose of this systematic review is to examine current literature on efficacy and outcomes of MT in octogenarian and nonagenarian stroke patients.

Methods
A literature search was conducted using PubMed and Scopus from 2013‐2023. All studies that included patients 80 yrs and older with acute ischemic stroke who underwent MT and provided 90‐day clinical outcomes and rates of complications were reviewed.

Results
Review identified 25 publications and the median age of study populations ranged from 82 to 93.3 years with proportion of female patients higher in all studies. Success rate of MT ranged from 66.7% to 97%. Symptomatic intracranial hemorrhage was the common complication ranging from 3% to 28%. The 90‐day mortality rate ranged from 7% to 70%. No differences were noted between octogenarians and nonagenarians.

Conclusion
MT in elderly patients had high reperfusion rates indicating procedural success, and variable clinical outcomes with wide range of complication and mortality rates. Factors influencing MT outcomes in elderly are discussed and the need for randomized control trials providing the highest level of scientific evidence for MT in this population is emphasized.
Abstract 279: Angiography Utilization in LVO Drip‐and‐Ship Patients: Comparing Air and Ground
Authors: Rao Rahul 
Published: March 2024

Introduction
Patients with acute intracranial large vessel occlusions (LVO) in the drip‐and‐ship model are transferred from an outside hospital (OSH) to a comprehensive stroke center (CSC) after receiving thrombolysis. In our practice, while most of these patients go directly to the angiography suite (DTA), some of them spontaneously recanalize and may not need mechanical thrombectomy (MT). We aim to assess the impact of transport modality on the efficacy of tPA‐induced recanalization by assessing rates of groin puncture, MT, and clinical outcomes.

Methods
We retrospectively evaluated 270 patients from 2020‐mid 2022 with either confirmed or suspected LVO in our healthcare network who received tPA at an OSH and were transported by either air or ground transport to our spoke hospital (CSC) with the intention of receiving MT. We compared baseline characteristics and then applied linear regression with propensity score matching to compare the air and ground groups. Between the two groups, we looked at the difference in the rates of change in NIHSS between OSH and TTH (delta NIHSS), groin puncture rates, rate of receiving mechanical thrombectomy (MT), rate of angiography alone without MT, and modified Rankin Scale (mRS) at 90 days.

Results
Of the 270 patients evaluated, 1 patient was excluded due to missing transport modality. 130 (48.33%) were transferred by ground transport and 139 (51.67%) by air. Baseline characteristics were similar between the air and ground groups with the exception of OSH NIHSS which was higher in the air group (13.59±8.3 vs. 10.4±7.81, p<0.001). In a linear regression model, air transport was not a significant predictor of improvement of NIHSS from OSH to CSC (p=0.69, R2=0.002) or groin puncture rate (OR=1.5, 95% CI 0.412‐ 5.471, p=0.54). Of the 198 confirmed LVO on CTA, 47.26% of air patients received MT compared with 48.74% (OR: 1.1, p=0.62) of ground patients. 11.32% of these confirmed LVO patients who were transported by air received angiography without mechanical thrombectomy compared to 11.68% of ground patients (OR: 2.1, p=0.1). A linear regression model with propensity matching did not show transport modality as a predictor of mRS at 90 days (p=0.32, R2=0.14).

Conclusion
LVO patients who receive tPA and are transferred by air directly to the angiography suite have a higher baseline NIHSS than those transported by ground. Mode of transport does not seem to predict changes in NIHSS or 90 day mRS in this population. Groin puncture, mechanical thrombectomy, and angiography without MT rates are similar between these groups. Mode of transport alone may not influence angiography utilization or clinical outcome so distance between sites and speed of transport should be used to determine whether air or ground is the better choice in each individual case.
Second-order citations in altmetrics: A case study analyzing the audiences of COVID-19 research in the news and on social media
Authors: Alperin Juan Pablo , Fleerackers Alice , Riedlinger Michelle , Haustein Stefanie 
Published: March 2024

Abstract
The potential to capture the societal impact of research has been a driving motivation for the use and development of altmetrics. Yet, to date, altmetrics have largely failed to deliver on this potential because the primary audience that cites research on social media has been shown to be academics themselves. In response, our study investigates an extension of traditional altmetric approaches that goes beyond capturing direct mentions of research on social media. Using research articles from the first months of the COVID-19 pandemic as a case study, we demonstrate the value of measuring “second-order citations,” or social media mentions of news coverage of research. We find that a sample of these citations, published by just five media outlets, were shared and engaged with on social media twice as much as the research articles themselves. Moreover, first-order and second-order citations circulated among Twitter accounts and Facebook accounts that were largely distinct from each other. The differences in audiences and engagement patterns found in this case study provide strong evidence that investigating these second-order citations can be an effective way of observing overlooked audiences who engage with research content on social media.
Understanding digital period pedagogies: Exploring how young people navigate menstruation through embodied experience
Authors: Clark Marianne , Southerton Clare 
Published: March 2024

Objective: This paper examines the ways in which young people in Eastern Canada learn about menstruation and construct personal period pedagogies through embodied experiences and encounters with digital and social media. Design: A qualitative exploratory approach was undertaken to elicit the stories and voices of young people who menstruate. Menstruation is conceptualised as a deeply bio-social phenomenon and knowledge was understood as created, contested and negotiated across settings and contexts. Methods: Semi-structured interviews were conducted with nine university students (ages 19–23 years) in Eastern Canada as part of a pilot project informing a broader study about menstruation education and menstrual experiences. To be eligible for inclusion, participants were required to have experienced one menstrual cycle in the past 6 months and engaged with social media at least once per week. Setting: This project was conducted in a small University town in Maritime Canada. Results: Young people interviewed learned about menstruation through knowledges assembled from conversations family members and peers, educational and medical settings and content encountered on social and digital media. Three themes were developed from the analysis. The first two capture how young people actively try to ‘Fill in the Gaps’ left by conventional menstrual education approaches and therefore turn to informal and narrative knowledges circulating on social media in efforts to answer the question ‘Am I normal’. The third theme describes how participants actively ‘Balance Authority and Intimacy’ when seeking menstrual information that resonates with their embodied experiences. Conclusion: Substantial gaps exist in the menstrual knowledges available to young people, particularly in relation to the embodied and emotional dimensions of having and managing a period. Digital and social media have the capacity to contribute to personal period pedagogies by acknowledging and exploring aspects of menstruation not adequately addressed in other contexts.
Psychosocial factors associated with treatment preference in mental health
Authors: Vázquez Morejón Antonio J. , Felipe González Cristina , Muñoz Caracuel Manuel Alejandro , Vázquez-Morejón Raquel 
Published: March 2024

Background: Studies examining the effects of incorporating patients’ preferences into treatment outcomes highlight their impact on crucial aspects such as reduced dropout rates and enhanced effectiveness. Recognizing individuals’ rights to participate in decisions about their treatments underscores the importance of studying treatment preferences and the factors influencing these choices. Aim: This study aims to identify treatment preferences (psychological, pharmacological, or combined) among a sample of patients and to discern the psychosocial and clinical factors influencing these preferences. Methods: A total of 2,133 individuals receiving care at a community mental health unit completed assessments on anxious-depressive symptoms, social and occupational adjustment, and their treatment preference. Data analysis was conducted using SPSS, with descriptive statistics, Chi-square tests, and one-way ANOVA applied. Results: Preferences for treatments were distributed as follows: Combined (49.8%), psychological (33%), and pharmacological (10.6%). Factors such as diagnosis, severity of depressive and anxious symptoms, and functional impact were related to treatment preference with a moderate effect size. Meanwhile, various sociodemographic factors correlated with the selected treatment, though with a weak effect size. Conclusions: There is a pronounced preference for combined treatments. The significance of psychological treatments is evident, as four out of five participants favored them in their choices. Addressing these preferences calls for an exploration within the broader context of prescription freedom in mental health.