bluuebunny/crossref_metadata_2025 huggingface dataset:
Bleeding and Thrombotic Adverse Events in Hospitalized Patients Under Empiric Treatment for Suspected Heparin-Induced Thrombocytopenia While Awaiting Confirmatory Testing
Authors: Dykes Kaitlyn C. , Johnson Cassandra A. , Gong Jerald Z. , McKenzie Steven E. , Husseinzadeh Holleh D.
Published: April 2021

Empiric management in suspected heparin-induced thrombocytopenia (HIT) is challenging due to imperfect prediction models, latency while awaiting test results and risks of empiric therapies. When there is high clinical suspicion for HIT, cessation of heparin and empiric non-heparin anticoagulation with FDA-approved argatroban is recommended. Alternatively off-label fondaparinux or watchful waiting have been utilized in clinical practice. Outcomes of patients empirically managed for HIT have not been compared directly in clinical trials and patients that ultimately do not have HIT are often overlooked. Clinicians need studies investigating empiric management to guide decision making in suspected HIT. In this study, adverse events (AE) were categorized and compared in patients being evaluated for HIT while undergoing empiric management by non-heparin anticoagulation with argatroban or fondaparinux, both at therapeutic or reduced doses, or watchful waiting with or without heparin. AE were defined as new thrombosis confirmed on imaging or new bleeding event after HIT was first suspected. A retrospective chart review of 312 patients tested for HIT at an academic hospital was conducted. 170 patients met inclusion criteria. Patients were excluded if the 4Ts score was < 4. The 4Ts score is a pretest probability for HIT based on thrombocytopenia degree, timing, alternative causes and presence of thrombosis. Included patients were divided according to management groups and compared with logistic regression analysis. Bleeding risk significantly differed between management groups (p = 0.002). Despite adjustment for bleeding risk, fondaparinux was associated with increased AE, (p = 0.03, OR = 5.81), while argatroban was not. There was no difference in AE based on time to initiation of empiric treatment and no advantage to reduced dosing with either anticoagulant. These findings challenge assumptions surrounding empiric HIT management.
Voting in a Pandemic: COVID-19 and Primary Turnout in Milwaukee, Wisconsin
Authors: Morris Kevin , Miller Peter
Published: April 2021

We report the first study of the effect of the novel coronavirus SARS-CoV-2 (COVID-19) on polling place consolidation and voting behavior. We draw upon individual-level observations from Milwaukee matched to similar observations in the surrounding municipalities to assess whether fewer polling places in the April 2020 presidential primary election decreased turnout in the city. We find polling place consolidation reduced overall turnout by about 8.7 points and reduced turnout among the Black population in the city by about 10 points. We conclude, based on these data, that polling place consolidation even accompanied by widespread absentee voting in the face of an emergency may result in disenfranchisement, particularly among Black voters.
Ribociclib induced acute kidney injury: A case report
Authors: Gulturk Ilkay , Yilmaz Mesut , Ozmen Aykut , Tacar Seher Yıldız , Erdal Gülçin Sahingoz , Tural Deniz
Published: April 2021

Introduction

Among females, breast cancer is the most common type of cancer. Hormon receptor positive (HR+) subtype constitutes 75% of the diagnosed breast cancers. Combination of the cyclin D-cyclin-dependent kinase 4/6 (CDK4/6) inhibitor and endocrine therapy significantly improves overall survival and progression-free survival. Ribociclib is an oral CDK 4/6 inhibitor and some adverse effects are identified. According to MONALEESA 2-3-7 studies, no adverse effect (AE) were reported due to grade 3 or 4 acute kidney injury (AKI) that caused treatment discontinuation.

Case report

We report a ribociclib-induced grade 3 AKI in an elderly woman who was treated for metastatic breast cancer. During first cycle of therapy, she was admitted to the oncology clinic with diagnosis of AKI. Management and outcome: Ribociclib treatment was discontinued and secondary causes of AKI were excluded. During the follow-up, kidney function values returned to the normal range spontaneously. Ribociclib treatment was re-initiated by reducing the dose (400 mg daily). Despite dose reduction; grade 3 AKI recurred when ribociclib was re-initiated and the drug was permanently discontinued.

Discussion

According to MONALEESA 2-3-7 studies; no AE were reported due to grade 3 or 4 AKI. Despite these studies, the FDA reported that 20% of patients with ribociclib + letrozole combination therapy may have any stage elevation of creatinine. Ribociclib induced creatinine elevations are generally mild (grade 1–2) and can be managed by dose reduction or close monitoring of creatinine levels. We report the first case of grade 3 AKI that caused treatment discontinuation following administration of ribociclib.
Hypercalcemia associated with the interaction between all trans retinoic acid and posaconazole in an acute promyelocytic leukemia case
Authors: Afacan Ozturk Hacer Berna , Albayrak Murat , Maral Senem , Reis Aras Merih , Yilmaz Fatma , Akyol Pınar , Tiglioglu Mesut , Malkan Umit Yavuz
Published: April 2021

Introduction

All-trans retinoic acid (ATRA) is a physiological metabolite of vitamin A and it is used for the treatment of acute promyelocytic leukemia (APL). Hypercalcemia is a rare side effect of ATRA and it may be potentiated after interaction of ATRA with azole group antifungals. Herein, we have reported an APL case with hypercalcemia that is caused by the interaction of ATRA and posaconazole.

Case Report

A 49-year-old female patient was diagnosed as APL after the examinations performed upon the detection of pancytopenia when she had presented with the complaints of widespread bruising and fever. After the initiation of posaconazole and ATRA, her serum calcium levels begin to increase (10.3 to 11.1mg/dl). Her vitamin D level was 21.9 ng/ml and PTH 17.8 pg/ml, both were in the normal ranges. The Drug Interaction Probability Scale score of our case was calculated as 6, indicating that the probable adverse drug reaction. Therefore, the high level of serum calcium was attributed to the interaction between ATRA and posaconazole.

Management & Outcome

Although hypercalcemia with ATRA and other antifungal agents have been previously reported in the literature, this is the first report of hypercalcemia with the concomitant use of ATRA and posaconazole.

Discussion

This case highlights the importance of monitoring ATRA’s side effects when it is used in combination with drugs inhibiting the cytochrome P450 enzymes. In conclusion, the concomitant use of posaconazole and ATRA may lead to hypercalcemia and serum calcium levels return to normal ranges with the discontinuation of these drugs.
Traumatic physeal fractures in cats: a review of 36 cases (2010–2020)
Authors: Rubinos Carlos , Meeson Richard L
Published: April 2021

Objectives

The aim of this study was to describe the demography, aetiology, location and classification of physeal fractures in cats, and to describe their management and outcomes.

Methods

Clinical records and radiographs of cats referred for management of physeal fractures were retrospectively reviewed. Fractures of the proximal femoral physis were excluded. Descriptive statistics were used to describe signalment, cause of injury, presence of concurrent injuries, fracture description, treatment modality, complications, follow-up, physeal closure, implant removal and outcome.

Results

Thirty-four cats with 36 fractures were included, of which 17 affected the distal femur, 11 the distal tibia and fibula, five the distal radius and ulna, two the proximal tibia and one the distal humerus. Salter–Harris classification was type I in 14, type II in 16, type III in two and type IV in four fractures. Thirty-four fractures were treated with primary fixation, and the most common method was crossed Kirschner wires (24/34 fractures). Complications were observed in 14 fractures, of which 12 were minor. At radiographic follow-up, physeal closure was reported in 23 fractures, of which 15 were considered premature. Implant removal was performed in three fractures. Outcome was good in 28, fair in four and poor in two fractures.

Conclusions and relevance

Fracture of the distal femoral physis was the most common physeal fracture seen. Cats presenting with physeal fractures may be skeletally immature or mature with delayed physeal closure. The rate of physeal closure after fracture repair was relatively high but without apparent impact. The frequency of implant removal was very low, indicating that despite having a physeal fracture repair, most cats did not require a second procedure to remove implants. Overall, internal fixation provided a good outcome in most fractures.
Application of iris fluorescein angiography in diabetic iridopathy and retinopathy in brown iris
Authors: Ke Yifeng , Zhang Heng , Hei Kaiwen , Shi Yi , Li Xiaorong , Zhang Longli
Published: April 2021

Purpose:

This study aimed to evaluate the relationship between diabetic iridopathy (DI) and diabetic retinopathy (DR) and distinguish iris neovascular and physiological leakage using iris fluorescein angiography (IFA).

Methods:

A total of 210 subjects were prospectively recruited in this study. Sixty normal subjects were divided equally into three groups (<40 years old, 40–59 years old, and 60–79 years old). One hundred fifty patients with diabetic mellitus (DM) were divided equally into five groups (no retinopathy, mild non proliferative DR (mildnPDR), moderate nPDR, severe nPDR, and PDR group). Normal subjects underwent IFA. Patients with DR underwent both IFA and ultrawide field fundus fluorescein angiography (uwFFA) at the same time. The leakage time and area were recorded and compared with each group.

Results:

Fluorescein leakage occurred at the pupillary edge of patients that were 40–59 and 60–79 years old but not in those <40 years old. In the PDR group, the leakage time was earlier and the leakage area was larger than nPDR and patients with no retinopathy ( p = 0.039 and p = 0.005, respectively). However, the leakage time and area were not significantly different between patients with no retinopathy and nPDR ( p > 0.05).

Conclusion:

IFA examination can only assist in estimating the fundus severity of PDR patients, whereas the fundus changes of patients with no retinopathy and nPDR were not related to DI changes. Trial registration No.: ChiCTR1800018003. The date of registration: Aug 26th, 2018.
The influence of hydroxyapatite coating on continuous migration of a Zweymuller-type hip stem: a double-blinded randomised RSA trial with 5-year follow-up
Authors: Hoornenborg Daniel , Schweden Annelieke M C , Sierevelt Inger N , van der Vis Harm M , Kerkhoffs GMMJ , Haverkamp Daniel
Published: April 2021

Background and purpose:

Adding hydroxyapatite to a stem to enhance ingrowth is a matter of debate, even less is known about the long-term effect on stability by adding hydroxyapatite (HA). Continuous migration in the first 2–5 years is an indicator of failed osteointegration or pending failure, enhancing the risk of loosening within 10 years after initial surgery. We performed a double-blinded randomised RSA trial with 5-year follow-up, to compare and analyse migration characteristics of the hydroxyapatite uncoated (HA−) and hydroxyapatite coated (HA+) Zweymuller-type hip stem.

Patients and methods:

In this single-centre prospective randomised controlled trial 51 patients were randomised to receive either a HA− or a HA+ Zweymuller-type hip stem during total hip replacement. After 5 years, 35 patients were still eligible for follow-up evaluation. The migration pattern was measured by use of radio stereometric analysis (RSA) images up to 2 years to evaluate short-term migration, additionally RSA images were obtained 5 years postoperatively to assess late-term and continuous migration. Furthermore, the improvement of clinical outcome was analysed by HSS and HOOS ADL and pain subscales preoperative and after 5 years.

Results:

After initial settling of the implant, no significant migration occurred up to 5 years post-surgery for HA+ as well as HA− prostheses. Continuous migration within the 2–5 years’ time interval was not observed for both HA+ nor the HA− group in all directions ( p < 0.05). No significant difference between both groups was observed ( p < 0.10). In both groups the HHS and HOOS improved significantly at 5 years compared to baseline for both groups. Improvement was not altered by the hydroxyapatite coating. No significant difference between both groups was observed ( p > 0.58).

Conclusions:

Addition of a hydroxyapatite coating did not influence the migration 5 years postoperatively for the Zweymuller-type hip stem. Clinical Trial Protocol number: NL 23524.048.08
Systematic review of interventions to increase the use of arteriovenous fistulae and grafts in incident haemodialysis patients
Authors: De Siqueira Jonathan , Jones Alexander , Waduud Mohammed , Troxler Max , Stocken Deborah , Scott David Julian A
Published: April 2021

Background:

Patients who commence haemodialysis (HD) through arteriovenous fistulae and grafts (AVF/G) have improved survival compared to those who do so by venous lines.

Objectives:

This systematic review aims to assimilate the evidence for any strategy which increases the proportion of HD patients starting dialysis through AVF/G.

Data sources:

Medline, Embase, Cochrane Central and Scopus.

Study eligibility, participants and interventions:

English language studies comparing any educational, clinical or service organisation intervention for adult patients with end stage renal failure and reporting incident AVF/G use.

Study appraisal and synthesis:

Two reviewers assessed studies for eligibility independently. Outcome data was extracted and reported as relative risk. Reporting was performed with reference to the PRISMA statement.

Results:

Of 1272 studies, 6 were eligible for inclusion. Studies varied in design and intervention. Formal meta-analysis was not appropriate. One randomised controlled trial and two cohort studies assessed the role of a renal access coordinator. Two cohort studies assessed the implementation of qualitive initiative programmes and one cohort study assessed a national, structured education programme. Results between studies were contradictory with some reporting improvements in incident AVF/G use and some no significant difference. Quality was generally low.

Conclusions:

It is not possible to reach firm conclusions nor make strategic recommendations. A comprehensive package of care which educates and identifies patients approaching dialysis in a timely manner may improve incident AVF/G use. An unbiased, robust comparison of different strategies for timing AVF/G referral is required.
Prevalence of Known Risk Factors in Uruguayan Women Treated for Breast Cancer at a University Hospital
Authors: Castillo Cecilia , Camejo Natalia , Hernandez Ana Laura , Artagaveytia Nora , Alonso Rafael , Delgado Lucia
Published: April 2021

Introduction:

In Uruguay, breast cancer has the highest incidence and mortality of all cancer in women. Knowledge of the distribution of risk factors related to disease development supports the implementation of prevention strategies in routine clinical practice. This study aimed to determine the epidemiological profile for breast cancer and the frequency of mammographic surveillance in the surveyed population.

Materials and Methods:

A survey was conducted among Uruguayan women diagnosed with breast cancer who were assisted in the mastology unit of the oncology service of the Hospital de Clínicas in Montevideo, Uruguay, from September 1, 2018, to March 1, 2020.

Results:

This study included 398 respondents, with a median (SD) age at diagnosis of 61 (34-86) years. A total of 310 respondents (78.0%) had 1 or more risk factors. Most women aged over 50 years (264 out of a total of 338 [78.1%]) underwent mammographic surveillance at least biennially.

Conclusions:

Consistent with international reports, most respondents had a risk factor. Among the group of respondents aged over 50 years, most underwent mammographic and clinical surveillance at least biennially. Although it is only possible to formulate conclusions about the surveyed women because of the study design, the obtained data further our understanding of the epidemiological profile of the Uruguayan population, which can contribute to prevention practices.
A Case of SARS-CoV-2 Clinical Relapse after 4 Negative RT-PCR Tests in Greece: Recurrence or Reinfection?
Authors: Konstantinou Fotis , Skrapari Ioanna , Bareta Eleni , Bakogiannis Nikolaos , Papadopoulou Anna-Maria , Bakoyiannis Chris
Published: April 2021

SARS-CoV-2 pandemic is the greatest public health concern of the year 2020. There are several worldwide reports of patients who have managed to recover from SARS-CoV-2 infection with negative PCR test results, that for unknown reasons convert back to positive PCR. We report a case of a patient in our hospital who developed positive PCR test results for SARS-CoV-2, after 4 consecutive results that were negative, along with a full-blown clinical syndrome of SARS-CoV-2 infection.
‘Traditional values’ and the narrative of gay rights as modernity: Sexual politics beyond polarization
Authors: Edenborg Emil
Published: April 2021

Examining the Russian state’s turn to ‘traditional values’ in the 2010s, this article aims to understand traditionalist state discourses in a global context where LGBT inclusion has been incorporated into notions of national exceptionalism. It argues that the Putin regime has articulated, provided ideological coherence to, and made visible a narrative according to which resistance to LGBT rights appears as a logical choice for states seeking to position themselves in opposition to the ‘liberal West.’ That narrative both counters the homonationalist idea of ‘gay-friendliness’ as a signifier of modernity and good statehood and incorporates some of its elements, notably externalization of homophobia onto racialized, Muslim Others.
Integrating data from multiple Finnish biobanks and national health-care registers for retrospective studies: Practical experiences
Authors: Lähteenmäki Jaakko , Vuorinen Anna-Leena , Pajula Juha , Harno Kari , Lehto Mika , Niemi Mikko , Van Gils Mark
Published: April 2021

Aim: This case study aimed to investigate the process of integrating resources of multiple biobanks and health-care registers, especially addressing data permit application, time schedules, co-operation of stakeholders, data exchange and data quality. Methods: We investigated the process in the context of a retrospective study: Pharmacogenomics of antithrombotic drugs (PreMed study). The study involved linking the genotype data of three Finnish biobanks (Auria Biobank, Helsinki Biobank and THL Biobank) with register data on medicine dispensations, health-care encounters and laboratory results. Results: We managed to collect a cohort of 7005 genotyped individuals, thereby achieving the statistical power requirements of the study. The data collection process took 16 months, exceeding our original estimate by seven months. The main delays were caused by the congested data permit approval service to access national register data on health-care encounters. Comparison of hospital data lakes and national registers revealed differences, especially concerning medication data. Genetic variant frequencies were in line with earlier data reported for the European population. The yearly number of international normalised ratio (INR) tests showed stable behaviour over time. Conclusions: A large cohort, consisting of versatile individual-level phenotype and genotype data, can be constructed by integrating data from several biobanks and health data registers in Finland. Co-operation with biobanks is straightforward. However, long time periods need to be reserved when biobank resources are linked with national register data. There is a need for efforts to define general, harmonised co-operation practices and data exchange methods for enabling efficient collection of data from multiple sources.
Nomadic life archiving across platforms: Hyperlinked storage and compartmentalized sharing
Authors: Wang Yang , Lim Sun Sun
Published: April 2021

People are today located in media ecosystems in which a variety of ICT devices and platforms coexist and complement each other to fulfil users’ heterogeneous requirements. These multi-media affordances promote a highly hyperlinked and nomadic habit of digital data management which blurs the long-standing boundaries between information storage, sharing and exchange. Specifically, during the pervasive sharing and browsing of fragmentary digital information (e.g. photos, videos, online diaries, news articles) across various platforms, life experiences and knowledge involved are meanwhile classified and stored for future retrieval and collective memory construction. For international migrants who straddle different geographical and cultural contexts, management of various digital materials is particularly complicated as they have to be familiar with and appropriately navigate technological infrastructures of both home and host countries. Drawing on ethnographic observations of 40 Chinese migrant mothers in Singapore, this article delves into their quotidian routines of acquiring, storing, sharing and exchanging digital information across a range of ICT devices and platforms, as well as cultural and emotional implications of these mediated behaviours for their everyday life experiences. A multi-layer and multi-sited repertoire of ‘life archiving’ was identified among these migrant mothers in which they leave footprints of everyday life through a tactical combination of interactive sharing, pervasive tagging and backup storage of diverse digital content.
Digital housekeeping: Living with data
Authors: Horst Heather , Sinanan Jolynna
Published: April 2021

The availability and affordability of memory and other services formats to store digital material has proliferated over the past 15 years. Making, sharing and storing digital material is now a mundane practice that is part of a broader ecology of living with different kinds of data. This article examines routines of managing networked technologies in the home: digital housekeeping through three core practices of sharing and storing everyday data. The first, what we will call tidying, involves the everyday routines of cleaning up the mess of data through practices such as syncing material ‘in the cloud’, creating inboxes and manually moving digital data such as pictures and videos to ‘folders’. The second set of practices comprises more periodic, but deeper forms of sorting, spring cleaning. During digital spring cleaning, the focus is upon decluttering digital data by disposing, editing and other forms of curation whereby digital materials can be ‘located’ when desired in the future. The final set of practices, moving house, consists of the shift or relocation of digital data from one device or service to another. Depending upon the age and functioning of the device or service, this often involves changes in format to render digital data useful into the future, the realisation of lost data, as well as an additional assessment of the value of moving such digital material. Through fine-grained attention to the ways in which households live with digital materials, this article considers the engagement with and consequence of everyday data in our lives.
You got a hole in your belly and a phone in your hand: How US government phone subsidies shape the search for employment
Authors: Gershon Ilana , Gonzales Amy
Published: April 2021

Many of the tasks involved in looking for a job these days involve sharing and storing digital data. Digital technology is now required for job seekers to research employers, store resumes, complete applications, and schedule interviews. What is the employment process for people who are living on the poverty line, without reliable access to the Internet or mobile phones? We focus on technology maintenance, the continuous work required to stay digitally connected, to understand how low-income job seekers in northern California manage the circulation and storage of information. We incorporate the concept of delegation from Latour to explore how people consciously consider who or what entities are responsible for technology maintenance, as this varies by government policies related to digital subsidies. This article draws novel connections between the influence of government policy on technology maintenance and how both the policies and digital inequalities shape impoverished job seekers’ choices around sharing and storage practices.
Mundane work for utopian ends: Freeing digital materials in peer production
Authors: Pentzold Christian
Published: April 2021

This article studies the online encyclopedia Wikipedia as a core example of the storage and sharing of commons-based digital materials. It focuses on the voluntary, day-to-day activities of its editors as they gather and transform digital information goods that are made available free of charge. Using the notion of articulation work, I stress the effort that goes into accommodating the engagement with the encyclopedia within the contributors’ media-suffused daily routines. Then, the article discusses the typical practices of transcribing, republishing, and relicensing through which the transition from non-free ownership to freely shared property is brought about. Finally, the freedom that is inherent in the modification of the legal status of ideas and artifacts and their public circulation requires us to interrogate the ethical implications of the digital commons collected and spread by Wikipedians.
A content analysis for government’s and hotels’ response to COVID-19 pandemic in Egypt
Authors: Salem Islam Elbayoumi , Elkhwesky Zakaria , Ramkissoon Haywantee
Published: April 2021

Drawing on the Situational Crisis Communication theory (SCCT), this study recapitulates the initiatives, practices, and responses of the Egyptian government and chain-managed five-star hotels during the COVID-19 global health pandemic. Subjective and objective content analysis is employed in this study. Subjective content analysis is employed to examine newspapers, magazines, T.V channels, and official pages on Facebook to determine the initiatives and practices adopted by the Egyptian government. Objective content analysis is further used to determine the COVID-19 hospitality practices adopted by 22 chain-managed five-star hotels by examining their official websites. Thematic saturation was attained when observations and analyses exhibited no new themes. Findings indicated that the Egyptian government and chain-managed five-star hotels implemented a number of initiatives and practices focused on financial policies, health and hygiene, workforce and training, marketing, domestic tourism, booking flexibility, cancellation policies, community support, vacations, and contracts. This study contributes to crisis management research by being one of the first studies to explore governments and hotel operations practices and initiatives during the COVID-19 using Egypt as a case study. We discuss the theoretical and practical implications during and post the COVID-19.
(Re)encountering A Thousand Plateaus: Producing 1000 trail(ing)s
Authors: Christ Rebecca C , Kuby Candace R , Shear Sarah B , Ward Amber
Published: April 2021

We, now colleagues, look to our “first” collective encounter with Deleuze and Guattari that took place in a university course on poststructuralism, where one of us was the teacher and three were students. This encounter still disturbs us. And new and different encounters happen each time we reread A Thousand Plateaus, revisit our previous conversations, and/or rewrite this manuscript. Each encounter produces a new trail(ing). We follow some of these trail(ing)s and write this manuscript as an invitation for other students and teachers not to rush to understanding. We find great possibility comes from (re)encountering these readings that leave us confused, distressed, and/or scared, because these readings and the (re)encounters that follow also leave us open to new possible intra-actions and be(com)ings with/in the world.
Behind closed doors: An exploration of cell-sharing and its relationship with wellbeing
Authors: Muirhead Aimee , Butler Michelle , Davidson Gavin
Published: April 2021

Increasingly people in prison are sharing cells but little is known about how cell-sharing may influence wellbeing. This research explores this issue using a random stratified survey of 569 imprisoned adult men in Northern Ireland. The findings reveal a relationship between cell-sharing and wellbeing but indicate that cellmate relationships may be more important than cell type in influencing wellbeing. Depending on the nature of cellmate relationships, the findings suggest that cell-sharing can enhance or diminish wellbeing beyond that experienced in single cells. In explaining these findings, it is proposed that cellmate relationships may influence the extent to which individuals feel strain from concealing their emotions and vulnerabilities, receive social support from a cellmate and/or feel safe.
Wilding educational policy: Hope for the future
Authors: Morse Marcus , Blenkinsop Sean , Jickling Bob
Published: April 2021

This introductory paper begins by summarizing the premises of this special issue on “Wilding Educational Policy.” That is, first, current normalized educational practices in education are not adequate for these times of extraordinary social and ecological upheaval. Second, an important way forward will be to problematize modernist tendencies to control discourse and practice in education in ways that tend to “domesticate” educational possibilities. We then describe how the papers in this collection are framed around two emergent thematic arcs. One arc is directly aimed at initiating conversations with and amongst policy-makers. The other arc illustrates how authors have been expanding their understanding of the premises of this issue and how “wilding” can be interpreted in different cultural settings. These papers all add to a growing body of literature that builds on experiments and musings in “wild pedagogies.”
A Historical Snapshot of Latinx Student Activism from the 1960s to 1990s: A University Archival Analysis
Authors: Santa-Ramirez Stephen
Published: April 2021

The activism efforts of Latinx students from the 1960s to 1990s at Michigan State University preceded the current resources available to Latinxs on campus today. Guided by transformational resistance, university library archival sources are used to showcase various activism efforts demonstrated by these collegians. Some include a grape purchasing boycott, a sit-in, and a massive library book check-out protest, which all collectively played salient roles in the development of transformational changes for Latinx students. Recommendations from the findings are provided to advance future research and practice for institutional agents in working for and alongside student activists versus against them.
Splenic Artery Embolization for Treatment of Iatrogenic Kasabach-Merritt Phenomenon Following Failed Endovascular Splenic Artery Aneurysm Repair
Authors: Talaie Reza , Shah Surbhi , Spano Anthony , Shrestha Prashant , Rosenberg Michael
Published: April 2021

Stent grafts are utilized to treat and exclude visceral arterial aneurysms while preserving flow through the vessel. Stent-associated thrombocytopenia is a rare complication not typically seen with modern stents. The following case describes the clinical presentation of stent kinking and consumptive coagulopathy. Stent-associated microangiopathic hemolytic anemia was inferred from protracted workup and exclusion of alternative diagnoses. Despite the risk of arterial puncture in the setting of profound thrombocytopenia, the patient was successfully treated with stent embolization with near immediate rebound in platelet count. This case report documents the presentation of rare stent-associated thrombocytopenia leading to challenging diagnostic evaluation and necessitating high-risk intervention.
The Relationship Between Walking Speed and the Energetic Cost of Walking in Persons With Multiple Sclerosis and Healthy Controls: A Systematic Review
Authors: Theunissen Kyra , Plasqui Guy , Boonen Annelies , Brauwers Bente , Timmermans Annick , Meyns Pieter , Meijer Kenneth , Feys Peter
Published: April 2021

Background

Persons with multiple sclerosis (pwMS) experience walking impairments, characterized by decreased walking speeds. In healthy subjects, the self-selected walking speed is the energetically most optimal. In pwMS, the energetically most optimal walking speed remains underexposed. Therefore, this review aimed to determine the relationship between walking speed and energetic cost of walking (Cw) in pwMS, compared with healthy subjects, thereby assessing the walking speed with the lowest energetic cost. As it is unclear whether the Cw in pwMS differs between overground and treadmill walking, as reported in healthy subjects, a second review aim was to compare both conditions.

Method

PubMed and Web of Science were systematically searched. Studies assessing pwMS, reporting walking speed (converted to meters per second), and reporting oxygen consumption were included. Study quality was assessed with a modified National Heart, Lung and Blood Institute checklist. The relationship between Cw and walking speed was calculated with a second-order polynomial function and compared between groups and conditions.

Results

Twenty-nine studies were included (n = 1535 pwMS) of which 8 included healthy subjects (n = 179 healthy subjects). PwMS showed a similar energetically most optimal walking speed of 1.44 m/s with a Cw of 0.16, compared with 0.14 mL O2/kg/m in healthy subjects. The most optimal walking speed in treadmill was 1.48 m/s, compared with 1.28 m/s in overground walking with a similar Cw.

Conclusion

Overall, the Cw is elevated in pwMS but with a similar energetically most optimal walking speed, compared with healthy subjects. Treadmill walking showed a similar most optimal Cw but a higher speed, compared with overground walking.
Patients’ Perceived Satisfaction Through Telephone-Assisted Tele-Consultation During the SARS-CoV-2 Pandemic Period: Observational Single-Centre Study at a Tertiary-Referral Colorectal Surgery Department
Authors: Blanco Terés Lara , Cerdán Santacruz Carlos , García Septiem Javier , Maqueda González Rocío , Lopesino González José María , Correa Bonito Alba , Martín-Pérez Elena
Published: April 2021

Introduction: The pandemic produced by SARS-CoV-2 has obliged us to set up the tele-assistance to offer a continuity of care. This implies an innovation, being the degree of satisfaction of patients unknown. Methods: A telephonic survey was conducted with the validated in the Spanish tool Telehealth Usability Questionnaire (Telehealth Usability Questionnaire; rating from 1-7) of all candidate patients assisted consecutively in the Coloproctology Unit. We included demographic variables, education level, job status, diagnosis and consultation type. A descriptive study was done. The relationship between the willingness of consultation model in the future (telemedicine vs traditional) and the categorical variables was analysed through the chi-squared test. Results: A total of 115 patients were included. The average age was 59.9 years, being 60% women. The average score in each of the survey items was higher than 6 in all the questions but 1. 26.1% of the surveyed patients confessed being advocated to tele-assistance in the future. The only factors related to greater willingness to tele-assistance were male gender (37% vs 18.8%; P = .03) and a higher academic preparation level in favour of higher technical studies (35.9%) and university studies (32.4%) opposite to the rest ( P = .043). The rest of variables studied, job status, labour regimen, diagnostic group and consultation type did not show any relationship. Conclusions: A vast majority of patients answered favourably to almost all the items of the survey. However, only 26.1% of them would choose a model of tele-assistance without restrictions.
Endocrine Effects of Repeated Hot Thermal Stress and Cold Water Immersion in Young Adult Men
Authors: Podstawski Robert , Borysławski Krzysztof , Pomianowski Andrzej , Krystkiewicz Wioletta , Żurek Piotr
Published: April 2021

The aim of the study was to determine the effect of repeated hot thermal stress and cold water immersion on the endocrine system of young adult men with moderate and high levels of physical activity (PA). The research was conducted on 30 men aged 19–26 years (mean: 22.67 ± 2.02) who attended four sauna sessions of 12 min each (temperature: 90−91°C; relative humidity: 14–16 %). Each sauna session was followed by a 6-min cool-down break during which the participants were immersed in cold water (10−11°C) for 1 min. Testosterone (TES), cortisol (COR), dehydroepiandrosterone sulfate (DHEA-S), and prolactin (PRL) levels were measured before and after the sauna bath. The participants’ PA levels were evaluated using the International Physical Activity Questionnaire. Serum COR levels decreased significantly ( p < .001) from 13.61 to 9.67 µg/ml during 72 min of sauna treatment. No significant changes ( p >.05) were noted in the concentrations of the remaining hormones: TES increased from 4.04 to 4.24 ng/ml, DHEA-S decreased from 357.5 to 356.82 µg/ml, and PRL decreased from 14.50 to 13.71 ng/ml. After sauna, a greater decrease in COR concentrations was observed in males with higher baseline COR levels, whereas only a minor decrease was noted in participants with very low baseline COR values ( r =−0.673, p <.001). Repeated use of Finnish sauna induces a significant decrease in COR concentrations, but does not cause significant changes in TES, DHEA-S, or PRL levels. Testosterone concentrations were higher in men characterized by higher levels of PA, both before and after the sauna bath.
Unusual pediatric epidural arteriovenous fistula with venous ectasia presented with spontaneous spinal epidural hematoma: Case report
Authors: Niimi Yasunari , Sato Shinsuke , Ryu Bikei , Inoue Tatsuya , Shima Shogo
Published: April 2021

Background

Spontaneous spinal epidural hematoma (SSEH) is rare in children. Vascular malformation including arteriovenous fistulas and venous malformation is a rare cause of SSEH.

Case description

A 5-year-old girl presented with 2 episodes of SSEH at the upper thoracic spine and non-hemorrhagic episodes with spontaneous neurological recovery. Diagnostic study with MRI and spinal angiography demonstrated an unusual epidural arteriovenous fistula (AVF) with venous ectasia similar to venous malformation. She underwent embolization of the AVF with NBCA with mild transient neurological deterioration. Follow up angiography showed persistent occlusion of the embolized fistula and inconsistent visualization of another AVF to the patent venous ectasia.

Conclusions

This type of epidural AVF seems to be more common in children and tends to cause multiple neurologic episodes due to SSEH, venous expansion or thrombosis. Endovascular embolization with NBCA should be the first choice of treatment for this disease, unless emergent hematoma evacuation is necessary. Embolization should target at only the fistula site without significant penetration into the venous ectasia. Follow up is necessary for potential reappearance of AVF, even if AVF is occluded at the time of treatment. Time resolved MRI is useful to detect AVFs, thus for diagnosis and follow up of this disease.
Conducting Qualitative Research to Respond to COVID-19 Challenges: Reflections for the Present and Beyond
Authors: Tremblay Stephanie , Castiglione Sonia , Audet Li-Anne , Desmarais Michèle , Horace Minnie , Peláez Sandra
Published: April 2021

The global response to mitigate the spread of the COVID-19 pandemic brought about massive health, social and economic impacts. Based on the pressing need to respond to the crisis, clinical trials and epidemiological studies have been undertaken, however less attention has been paid to the contextualized experiences and meanings attributed to COVID-19 and strategies to mitigate its spread on healthcare workers, patients, and other various groups. This commentary examines the relevance of qualitative approaches in capturing deeper understandings of current lived realities of those affected by the pandemic. Two main challenges associated with the development of qualitative research in the COVID-19 context, namely “time constraints” and “physical distancing” are addressed. Reflections on how to undertake qualitative healthcare research given the evolving restrictions are provided. These considerations are important for the integration of qualitative findings into policies and practices that will shape the current response to the pandemic and beyond.
Research on plastic deformation law and forming technology of rotary forging with multi-cone rolls
Authors: Wang Qi , Zhu Chun-dong , Liu Xin , Ma Rong-fei
Published: April 2021

With the development of industrial technology, the application of large diameter-thickness ratio integral discs in various high precision vessels is becoming more and more important. At present, the forming processes of large-diameter disc mainly includes welding and multiple local upsetting, but these processes exhibit large defects and cannot meet the requirements of industry. Therefore, a new metal plastic forming technology, namely rotary forging with multi-cone rolls (MCRs) is proposed to integrally form large diameter and ultra-thin discs. The forming process was simulated by DEFORM-3D finite element analysis software, and the deformation characteristics of MCRs disc were revealed. The results show that the axial plastic deformation of disc can be divided into three stages. In the first stage, the plastic deformation area was basically symmetrical, and the deformation was relatively stable. In the second stage, the plastic deformation area on both sides was different, which was in the unstable stage and easy to produce defects. In the third stage, the plastic deformation area was approximately symmetrical for a long time, and the plastic deformation was stable. At the same time, the influence of process parameters on the form characteristics of MCRs, the main defects in the deformation process and the preventive measures were studied. The research results are helpful to better understand the metal plastic forming technology of MCRs and promote the further development of MCRs.
Current status of aspiration thrombectomy for acute stroke patients in China: data from ANGEL-ACT Registry
Authors: Tong Xu , Wang Yilong , Bauer Clayton T. , Jia Baixue , Zhang Xuelei , Huo Xiaochuan , Luo Gang , Wang Anxin , Ma Ning , Gao Feng , Mo Dapeng , Song Ligang , Sun Xuan , Liu Lian , Deng Yiming , Li Xiaoqing , Wang Bo , Ma Gaoting , Wang Yongjun , Ren Zeguang , Miao Zhongrong
Published: April 2021

Background and Aims:

Although noninferior to stent retriever (SR) as first-line approach for endovascular treatment (EVT) of acute large vessel occlusion (LVO) stroke, little is known about the current status of direct aspiration (DA) as first-line thrombectomy in China. This analysis of a prospective, nationwide registry (ANGEL-ACT) aimed to investigate the prevalence and comparative effectiveness of DA-first thrombectomy in a real-world practice in China.

Methods:

All patients receiving thrombectomy were screened from a prospective cohort of LVO patients undergoing EVT at 111 hospitals in China between November 2017 and March 2019, and divided into two groups based upon which type of thrombectomy was attempted first (“DA-first” and “SR-first”). The following outcome measures were compared using logistic regression models with adjustment: successful recanalization after first-device alone and all procedures, use of rescue treatment, intracranial hemorrhage (ICH) within 24 h, and modified Rankin Scale (mRS) score at 90 days.

Results:

A total of 1225 patients, 102 (8.3%) in DA-first group and 1123 (91.7%) in SR-first group, were included. Patients receiving DA-first had less often successful recanalization after first-device alone [30.4 versus 66.4%; odds ratio (OR) = 0.23, 95% confidence interval (CI) = 0.15–0.37], more frequent rescue treatment (62.8 versus 27.0%; OR = 4.55, 95% CI = 2.92–7.08) and ICH (35.4 versus 22.1%; OR = 1.78, 95% CI = 1.12–2.83) than those receiving SR-first; however, no significant difference was found in successful recanalization after all procedures (84.3 versus 90.3%; p = 0.18) and 90-day mRS (median: 3 versus 3 points; p = 0.90) between both groups.

Conclusion:

This real-world registry suggested that DA-first thrombectomy for acute stroke patients lagged behind in China during the study period. Far fewer DA-first than SR-first thrombectomies were performed, and DA-first was associated with lower first-device recanalization, more frequently requiring rescue treatment, and increased ICH risk.

Clinical Trial Registration:

ClinicalTrials.gov , NCT03370939.
Factors affecting clinicians’ adherence to principles of diagnosis documentation: A concept mapping approach for improved decision-making
Authors: Hosseini Nafiseh , Mostafavi Sayyed Mostafa , Zendehdel Kazem , Eslami Saeid
Published: April 2021

Background:

The quality of data in electronic health records (EHRs) depends on adherence of clinicians to principles of diagnosis documentation.

Objective:

A concept mapping (CM) approach was used to extract factors related to quality of clinicians’ documentation that govern EHR data quality.

Method:

Influential factors extracted from brainstorming sessions were sorted by individual participants, followed by a quantitative analysis using multidimensional scaling and cluster analysis to categorise sorted factors. Finally, a questionnaire was used to elicit the importance-feasibility of the extracted factors. Results were visualised by cluster maps and Go-Zone plots.

Result:

Factors were classified into seven clusters: “knowledge about International Classification of Diseases and clinical coding,” “need for facilitators and guidelines,” “explaining the importance of the issue and defining responsibilities,” “cooperation of other personnel,” “codify legal requirements,” “workload” and “clinical obstacles,” as ranked by importance.

Conclusion:

To enhance the quality of EHR data, a collaboration between physicians, nurses, managers and EHR developers is required. CM is an acceptable approach to meet this objective. Our findings highlight the significance of clinical coding knowledge, awareness about its importance and applicability and use of well-structured information systems. In combination, these three factors can have a strong positive impact on the quality of EHR data.

Implications:

A list of solutions is provided for policymakers, and two interventions suggested, based on the findings of this study, including the adoption of EHRs that incorporate documentation guidelines. We further propose updated clinical training programs and a monitoring and feedback mechanism to facilitate the EHR documentation process.