bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Personalized Framework for Consumer and Producer Group Fairness Optimization in Recommender Systems
Authors: Rahmani Hossein A. , Naghiaei Mohammadmehdi , Deldjoo Yashar 
Published: March 2024

In recent years, there has been an increasing recognition that when machine learning (ML) algorithms are used to automate decisions, they may mistreat individuals or groups, with legal, ethical, or economic implications. Recommender systems are prominent examples of these ML systems that aid users in making decisions. The majority of past literature research on recommender systems fairness treats user and item fairness concerns independently, ignoring the fact that recommender systems function in a two-sided marketplace. In this article, we propose
CP-FairRank
, an optimization-based re-ranking algorithm that seamlessly integrates fairness constraints from both the consumer and producer side in a joint objective framework. The framework is generalizable and may take into account varied fairness settings based on group segmentation, recommendation model selection, and domain, which is one of its key characteristics. For instance, we demonstrate that the system may jointly increase consumer and producer fairness when (un)protected consumer groups are defined on the basis of their
activity level
and
main-streamness
, while producer groups are defined according to their popularity level. For empirical validation, through large-scale on eight datasets and four mainstream collaborative filtering recommendation models, we demonstrate that our proposed strategy is able to improve both consumer and producer fairness without compromising or very little overall recommendation quality, demonstrating the role algorithms may play in avoiding data biases. Our results on different group segmentation also indicate that the amount of improvement can vary and is dependent on group segmentation, indicating that the amount of bias produced and how much the algorithm can improve it depend on the protected group definition, a factor that, to our knowledge, has not been examined in great depth in previous studies but rather is highlighted by the results discovered in this study.
Patient Characteristics Associated With Using Transcatheter Left Atrial Appendage Occlusion Versus Oral Anticoagulants for Atrial Fibrillation
Authors: Lin Kueiyu Joshua , Singer Daniel E. , Avorn Jerry , Heist E. Kevin , Sreedhara Sushama Kattinakere , Anand Priyanka , Zhang Yichi , Tsacogianis Theodore N. , Schneeweiss Sebastian 
Published: March 2024

BACKGROUND:
Transcatheter left atrial appendage occlusion (LAAO) is an alternative to oral anticoagulants (OACs) for stroke prevention in patients with atrial fibrillation, but the predictors of LAAO use in routine care are unclear. We aimed to assess the utilization trends of LAAO and compare the change in characteristics of LAAO users versus OACs since its marketing.

METHODS:

Using the US Medicare claims database (March 15, 2015, to December 31, 2020), we identified patients with atrial fibrillation, ≥65 years, and CHA
2
DS
2
-VASc score ≥2 (men) or ≥3 (women), with either first implantation of an LAAO device or initiation of OACs, including apixaban, dabigatran, rivaroxaban, edoxaban, or warfarin. Patient characteristics, measured 365 days before the first LAAO or OAC use date, were compared using logistic regression.

RESULTS:
There were 30 058 LAAO recipients (mean age, 77.74 years; female, 42.1%) and 792 600 OAC initiators (mean age, 78.48; female, 53.3%). In 2020, patients had higher odds of initiating LAAO use than in 2015 (0.52 versus 9.32%; adjusted odds ratio [aOR], 13.64 [95% CI, 12.56–14.81]). Old age (ie, >85 versus 65–75 years; aOR, 0.84 [95% CI, 0.80–0.88]), female sex (aOR, 0.74 [95% CI, 0.71–0.76]), Black race (aOR, 0.63 [95% CI, 0.58–0.68]) versus White race, and Medicaid eligibility (aOR, 0.61 [95% CI, 0.58–0.64]) were associated with lower odds of receiving LAAO. Among clinical characteristics, frailty, cancer, fractures, and venous thromboembolism were associated with lower odds of LAAO use, while history of intracranial and extracranial bleeding, coagulopathy, and falls were associated with higher odds of receiving LAAO.

CONCLUSIONS:
Among patients with atrial fibrillation receiving stroke-preventive therapy, LAAO use increased rapidly from 2015 to 2020 and was positively associated with the risk factors for OAC complications but negatively associated with old age, advanced frailty, and cancer. Black race and female sex were associated with a lower likelihood of receiving LAAO.
Characterization of Vascular Niche in Systemic Sclerosis by Spatial Proteomics
Authors: Rius Rigau Aleix , Li Yi-Nan , Matei Alexandru-Emil , Györfi Andrea-Hermina , Bruch Peter-Martin , Koziel Sarah , Devakumar Veda , Gabrielli Armando , Kreuter Alexander , Wang Jiucun , Dietrich Sascha , Schett Georg , Distler Jörg H.W. , Liang Minrui 
Published: March 2024

BACKGROUND:
Systemic sclerosis (SSc) is a connective tissue disease that can serve as a model to study vascular changes in response to inflammation, autoimmunity, and fibrotic remodeling. Although microvascular changes are the earliest histopathologic manifestation of SSc, the vascular pathophysiology remains poorly understood.

METHODS:
We applied spatial proteomic approaches to deconvolute the heterogeneity of vascular cells at the single-cell level in situ and characterize cellular alterations of the vascular niches of patients with SSc. Skin biopsies of patients with SSc and control individuals were analyzed by imaging mass cytometry, yielding a total of 90 755 cells including 2987 endothelial cells and 4096 immune cells.

RESULTS:

We identified 7 different subpopulations of blood vascular endothelial cells (VECs), 2 subpopulations of lymphatic endothelial cells, and 3 subpopulations of pericytes. A novel population of CD34
+
;αSMA
+
(α-smooth muscle actin);CD31
+
VECs was more common in SSc, whereas endothelial precursor cells were decreased. Co-detection by indexing and tyramide signal amplification confirmed these findings. The microenvironment of CD34
+
;αSMA
+
;CD31
+
VECs was enriched for immune cells and myofibroblasts, and CD34
+
;αSMA
+
;CD31
+
VECs expressed markers of endothelial-to-mesenchymal transition. The density of CD34
+
;αSMA
+
;CD31
+
VECs was associated with clinical progression of fibrosis in SSc.

CONCLUSIONS:

Using spatial proteomics, we unraveled the heterogeneity of vascular cells in control individuals and patients with SSc. We identified CD34
+
;αSMA
+
;CD31
+
VECs as a novel endothelial cell population that is increased in patients with SSc, expresses markers for endothelial-to-mesenchymal transition, and is located in close proximity to immune cells and myofibroblasts. CD34
+
;αSMA
+
;CD31
+
VEC counts were associated with clinical outcomes of progressive fibrotic remodeling, thus providing a novel cellular correlate for the crosstalk of vasculopathy and fibrosis.
Abstract 028: Chronic Subdural Hematoma Treatment with Embolization Versus Surgery Study Protocol
Authors: Siddiq Farhan 
Published: March 2024

Introduction
Chronic subdural hematoma (cSDH) is one of the most common neurosurgical diseases with a significant financial burden. Current management includes observation for mild or asymptomatic patients and surgical drainage for moderate and severe patients. However, surgical drainage is associated with a 15% reoperation rate and a mortality of up to 10%. Middle meningeal artery embolization (MMAE) is a promising minimally invasive alternative with an estimated surgical recurrence rate of 6.8% and 4.6% for standalone MMAE and combined MMAE and surgery respectively. However, randomized data is lacking for this emerging therapy.

Methods
CHESS is a NIH‐funded, prospective, multi‐center, randomized, open label clinical trial. Subjects with moderately symptomatic cSDH (de novo or recurrent) will be randomized in a 1:1 radio to standalone MMAE or conventional surgery. Moderately symptomatic patients are defined as patients with moderate weakness (4/5), gait ataxia and/or mild aphasia. Embosphere or PVA will be used for MMAE. Primary outcome is defined as the proportion of patients that require rescue surgery or die within 180 days. Safety outcomes include the proportion of subjects with ischemic strokes, serious/life threatening adverse events, worsening neurological status or development of new disabling neurological symptoms, seizures, and cranial neuropathies (blindness and facial paralysis) within 180 days of randomization. One interim analysis for overwhelming efficacy and futility will be performed assuming a group sequential design of O’Brien and Fleming boundary.

Results
Based on an effect size of 13% of the composite primary outcome, a two‐sided Type I and Type II error of 0.05 and 0.15, and a dropout rate of 10%, a sample size of 394 patients is estimated.

Conclusion
CHESS will be the first US randomized controlled trial to provide evidence on the safety and effectiveness of 1) standalone MMAE vs surgical drainage; 2) particles as the embolic agent, and 3) MMAE on recurrent, in addition to de novo, cSDHs.
Abstract 047: Solumbra ‘PINCHING’ technique for medium vessel occlusions (MeVOs): A Single Center Experience
Authors: Waghralkar Mandar , Sikand Trimaan , Goel Gaurav , Mahajan Anshu 
Published: March 2024

Introduction
Various techniques have been evolved and used by different operators for mechanical thrombectomies for improved procedural performance, lower intraoperative times and better recanalization rates The widely used, isolated stent‐retriever and contact aspiration technique for medium vessel occlusions (MeVOs) carries a high risk for clot fragmentation, spasm and distal migration. The stent–aspiration (Solumbra) technique uses a large bore aspiration catheter with a stent retriever device for potential synergistic effects. However, its use is limited in distal thrombectomies. Hereby, we assess the efficacy and safety of solumbra ‘Pinching’ technique by using a smaller profile aspiration catheter for MeVO thrombectomy.

Methods
We retrospectively analyzed our prospective institutional database for medium vessel occlusions (M2, M3 MCA/ A2, A3 ACA/ P2 PCA) who underwent endovascular mechanical thrombectomy using stent retriever or aspiration or combined (solumbra) technique. The technique involves deploying a stent retriever through microcatheter and large bore aspiration catheter like ACE 68 (Penumbra, Inc.), followed by both microcatheter and aspiration removal, clot localization and blind navigation of a correctly sized lower profile (3MAX or 4MAX, Penumbra, Inc.) aspiration catheter over stent bare wire to “pinch” the primal end of the clot. Besides various demographic parameters, we collected final recanalization rates with first pass effect [using modified Thrombolysis in Cerebral Infarction (TICI) score]. All the intra‐procedural complications (haemorrhage, vasospasm) were analysed. Clinical outcome was analysed using modified ranking score (mRS) on 7th day post procedure/ discharge(whichever is earlier) and at 90 days.

Results
Total 26 MeVOs were successfully treated in twenty‐five patients with solumbra ‘Pinching’ technique since January 2022 (Male: female 16:7, mean age 58.6 years, mean NIHSS 9.1). Majority of the procedures were done for primary MeVOs and 72% consisted of M2 MCA occlusions. Whether to use a 3MAX or 4MAX aspiration catheter was determined by eyeballing the appropriate calibre for target vessels. Final first pass mTICI 2c/3 recanalization was achieved in 24 patients (88%). Minor Intra‐procedural complications were observed in 13 patients. Favorable modified ranking score (mRS 0‐2) was achieved in approximately 80% patients at the end of 7 days/discharge and 14 out of 16 follow up patients achieved good clinical outcome at 90 days

Conclusion
Solumbra ‘Pinching’ technique, using a low profile aspiration catheter like 3 MAX or 4 MAX (Penumbra, Inc.) with a stent retriever, can be effectively used in management of acute ischaemic stroke secondary to a MeVOs with significantly enhancing the first‐pass recanalization with lesser risk of intimal injury, dissection and secondary embolization.
Abstract 053: Reduced‐Dose Ticagrelor Versus Full‐Dose Ticagrelor Versus Clopidogrel In Acute Stroke Management: A Retrospective Cohort Study
Authors: Desai Harsh , Tarabichi Ammar , Morsi Rami , Kothari Sachin , Carrion‐Penagos Julian , Metman Okker Verhagen , Smith Matthew , Baskaran Archit , Rana Rohini , Thind Sonam , Narala Vanshika , Thodupunoori Sharanya , Vayani Omar , Coleman Elisheva , Brorson James , Mendelson Scott , Mansour Ali , Prabhakran Shyam , Kass‐Hout Tareq 
Published: March 2024

Introduction
Ticagrelor use has become more prominent in acute ischemic stroke management in the presence of clopidogrel resistance(1‐2). This study compares the effectiveness of aspirin plus ticagrelor at different doses versus clopidogrel in reducing the risk of recurrent stroke and other thrombotic events without increasing the risk of bleeding.

Methods
We performed a retrospective chart review of patients diagnosed with acute ischemic stroke at a large academic comprehensive stroke center from September 1, 2020, to July 1, 2022. A total of 3 separate groups, low‐dose ticagrelor (45 mg or 60 mg twice a day), full‐dose ticagrelor (90 mg twice a day) and clopidogrel (75 mg daily) were created. We compared baseline characteristics and completed a one‐way ANOVA to analyze for outcome measures such as in‐hospital mortality, 90‐day mortality, favorable functional outcome defined as modified Rankin Score (mRS) of 0‐2, at 90 days, symptomatic intracranial hemorrhage (sICH) and asymptomatic hemorrhage (aICH) between groups. All data was analyzed via IBM SPSS v28.0.

Results
A total of 445 patients were included in our study. The mean age was 66.1 ± 12.8 years and the majority of patients were female (52.9%). The most common ethnicity was African American (82.9%). Sixty patients were discharged on low‐dose ticagrelor, 39 on full dose ticagrelor and 351 on clopidogrel. A total of 162/433 (36.0%) had a presumed stroke etiology of intracranial atherosclerotic disease (ICAD). Only 24 patients received intravenous thrombolytics (5.3%) and 47 had stent placement (10.4%). Out of 445 patients, 288 were on aspirin 81 mg at time of discharge. Of that group, 228 were on both aspirin and clopidogrel, 60 were on aspirin and low‐dose ticagrelor and 39 were on aspirin and full‐dose ticagrelor. There was no statistical significance for new or recurrent ischemic stroke between groups (low‐dose vs full‐dose vs clopidogrel) determined by one‐way ANOVA (10.0% vs. 17.9% vs. 7.8%, F(2,103) = 0.01, p=0.99). Symptomatic ICH was also similar between the groups (3.3% vs. 2.6% vs. 1.1%, F(2,101) = 0.68, p=0.51). There was no significance for favorable functional outcomes and mortality as well (26.7% vs. 23.1% vs. 24.2%, F(2,173) = 0.62, p=0.54; 80.0% vs. 79.5% vs. 81.5%, F(2,150) = 1.5, p=0.22).

Conclusion
These findings suggest that a lower dose of ticagrelor may be a safe and effective alternative to full dose ticagrelor or clopidogrel for the prevention of recurrent ischemic stroke without increasing hemorrhagic complications. Larger randomized trials are necessary to further evaluate these findings.
Abstract 098: Symphony of Risk: A Case Report of Carotid Artery Dissection Associated with Violin Playing
Authors: Díaz Paulina , Dawod Giana , Michaelson Nara , Greenberg Norman , Oh Stephanie , Ehidom Clinton , Janocko Nicholas 
Published: March 2024

Introduction
Carotid artery dissection (CAD) is an uncommon and potentially life‐threatening condition that can have a delayed presentation. More commonly associated with blunt cervical trauma, CAD due to repetitive stress to the neck goes under‐recognized, making it challenging to diagnose. Herein, we aim to shed light on a unique instance of CAD after continuous microtrauma, as well as highlight diagnostic challenges associated with CAD.

Methods
We present a case of a 57‐year‐old man who presented with a one‐week course of unequal pupils, left‐sided headaches, left sided ptosis, and intermittent blurry vision. Exam revealed a callous where he held a violin against his left neck, having endorsed playing for several years with repeated contortion of his head to the left (Figure 1A). Magnetic resonance angiogram (MRA) of the head and neck revealed an acute dissection of the left internal carotid artery (ICA) (Figure 1B). A diagnosis of Horner’s syndrome secondary to acute dissection of the left cervical ICA was made. Consent to share this information was obtained from the patient and witnessed by another physician.

Results
MRA head and neck showed a 2.5 cm irregularity of the distal left ICA with high signal on fat saturated T1‐weighted images consistent with an acute dissection (Figure 1B). The patient underwent an apraclonidine test and was positive for left sided Horner’s syndrome with reversal of anisocoria after application of drops (Figure 1C). Given no evidence of stroke or thrombus on imaging, he was placed on dual antiplatelet therapy (DAPT) for three months. He was advised not to play violin for a month and to restart cautiously with a pad between his neck and the instrument. Follow‐up imaging showed eventual resolution of the CAD, while physical exam revealed improvement in ptosis and miosis.

Conclusion
While playing the violin involves repetitive stress on the neck, there is limited research on this specific activity as a cause of carotid artery dissection, making it a rare occurrence. Common clinical manifestations of CAD include neck pain, headache, Horner’s syndrome, tinnitus, stroke, and lower cranial nerve palsies, occurring suddenly or over time. Diagnosing CAD typically involves a combination of thorough history, physical examination, and diagnostic imaging. Ongoing research in the optimal management of CAD focuses on minimizing the risk of stroke, after factoring in variables such as location of dissection and whether it is symptomatic or not.
Abstract 122: Mechanical Thrombectomy for Acute Stroke in the Elderly: A Single‐Center Case Series in the Philippines
Authors: Garrido Gwen G. , Soliven Jo Ann R. 
Published: March 2024

Introduction
Mechanical thrombectomy (MT) has become the standard of care for acute ischemic stroke (AIS) caused by large‐vessel occlusion. However, the extent of its benefits in elderly populations remains uncertain, as most landmark trials on MT have focused on younger individuals. This single‐center case series aims to shed light on the advantages and disadvantages of MT in higher age groups, particularly within the context of low‐ or middle‐income countries.

Methods
Between January 2018 and June 2023, we conducted a chart review of five patients aged ≥80 years who underwent MT for stroke. The study analyzed the patients' premorbid comorbidities, time to treatment, revascularization rates, procedural complications, mortality, and 90‐day modified Rankin Scale (mRS) scores.

Results
The five cases included individuals aged between 81 and 94 years. Among them, two had mild baseline disability (mRS score 0‐1), and three had moderate baseline disability (mRS score 2‐4). Upon admission, the National Institutes of Health Stroke Scale (NIHSS) scores ranged from 14 to 24. Three of the patients received pre‐thrombectomy intravenous thrombolysis with Alteplase and subsequently underwent MT within 4 to 7 hours of symptom onset. Successful recanalization (TICI score 2b‐3) was achieved in all five patients. However, two patients developed symptomatic intracranial hemorrhage post‐thrombectomy, and one of them succumbed to the complication. Three out of the four discharged patients attained favorable clinical outcomes with a 90‐day mRS score of 0‐2 or equivalent to their prestroke disability.

Conclusion
Our case series suggests that elderly individuals can potentially achieve favorable functional outcomes after MT. Nevertheless, this potential is influenced by stroke severity and the success of the treatment. As the elderly population, including octogenarians, nonagenarians, and centenarians, is expected to grow in the future, cautious patient selection should be exercised when considering thrombectomy in this age group. Further research comparing endovascular and conventional treatments in the elderly is imperative to inform better clinical decisions.
Abstract 123: First Off‐Label Use of the XIENCE Skypoint Stent for Mechanical Thrombectomy Rescue
Authors: Mahmoud Noor A 
Published: March 2024

Introduction
Despite technical advances in mechanical thrombectomy (MT), failure to achieve recanalization in the posterior circulation remains a significant challenge. Rescue strategies to increase MT success in the posterior circulation have been explored. We demonstrate the first successful off‐label use of XIENCE Skypoint™ (Abbott), a balloon‐mounted drug‐eluting stent (DES), for intracranial MT rescue in the posterior circulation.

Methods
Case report and endovascular technique.

Results
A 52‐year‐old man with hypertension, hyperlipidemia, and deep venous thrombosis who presented with acute ischemic stroke in bilateral occipital, lateral pons, and cerebellar regions. Computed tomography angiography (CTA) showed bilateral vertebral artery occlusion consistent with a history of dissection in the setting of cervical manipulation. Admission National Institutes of Health Stroke Scale (NIHSS) 20. Last known well less than 12 hours from presentation. Intravenous thrombolysis was deferred as the patient was on pre‐admission anticoagulants. Mechanical thrombectomy failed after several unsuccessful passes (Fig 1). XIENCE Skypoint™ stent was deployed within the left vertebral artery (V4 segment) with restoration of flow preceded by eptifibatide drip (Fig 2). Repeat CTA at six months showed patent left vertebral and basilar arteries.

Conclusion
Rescue stenting using DES may be a successful and safe therapeutic intervention for challenging failed MT. The off‐label use of DES for intracranial pathologies continues to expand. This is the first case report in the literature describing successful rescue stenting using XIENCE Skypoint™ in the posterior circulation. Further investigation is warranted to fully elucidate the risks and benefits of this treatment approach.