bluuebunny/crossref_metadata_2025_split huggingface dataset:
A multiplicidade da classe trabalhadora na práxis marxiana e sua atualidade
Authors: Menezes Maria Clara Lima de 
Published: June 2021

A classe trabalhadora: de Marx ao nosso tempo é um livro do historiador social do Trabalho Marcelo Badaró Mattos, publicado em 2019, que busca realizar uma análise e reflexão a partir das obras de Karl Marx e suas concepções acerca da classe trabalhadora. Ainda, traz para a análise o debate entre várias vertentes da historiografia mundial e brasileira sobre o que seria essa classe trabalhadora e como ela se coloca na atualidade. Além do debate histórico e social sobre o tema, o autor também propõe uma análise quantitativa, a partir de dados estatísticos, pesquisas empíricas, entre outros, sobre as mudanças do mundo do trabalho (dos trabalhadores, da renda, da união de classe etc.) ocorridas nas últimas décadas. Dito isso, essa resenha se propõe a esquematizar minimamente o conceito de Marx e Engels de classe trabalhadora, a partir do livro de Mattos, e pensá-lo enquanto categoria teórica e prática, bem como sua atualidade.
Novel strategy for improved outcomes of extra-corporeal membrane oxygenation as a treatment for refractory post cardiotomy cardiogenic shock in the current era: a refreshing new perspective
Authors: Mahesh Balakrishnan , Williams Luke , Punjabi Prakash P , Katsaridis Sotirios 
Published: June 2021

Objectives: Post-cardiotomy cardiogenic shock is an infrequent but important cause of death following cardiac surgery. Extra-corporeal membrane oxygenation offers the opportunity for temporary cardiovascular support and myocardial rest, with a view to recovery. We examine our results with our recently-implemented management algorithm. Methods: We report our series of 15 consecutive patients out of 357 patients [4.2%] who required institution of veno-arterial extra-corporeal membrane oxygenation system support as treatment for Post-cardiotomy cardiogenic shock in the current era [January-2017 to January-2020]. Results: The mean age was 64.3 ± 11.6 years (range: 40–82 years); there were 13 males (86.7%). Duration of veno-arterial extra-corporeal membrane oxygenation support was 6.7 ± 1.9 days. Duration of stay on intensive care unit [ICU] was 18.9 ± 17.1 days. Duration of hospital-stay was 28.3 ± 20.8 days. Survival to discharge and at 2.2 ± 0.9 years was 67%. Conclusions: We have shown clearly that veno-arterial extra-corporeal membrane oxygenation is an important rescue option for patients who develop refractory post-cardiotomy cardiogenic shock, with improved survival of 67% at 2.2 ± 0.9 years in those placed on post-cardiotomy veno-arterial extra corporeal membrane oxygenation support, which is superior to that reported hitherto in literature. We have sought to highlight the successes of post cardiotomy veno-arterial extra corporeal membrane oxygenation support, with improved results, based on careful patient selection, as well as diligent management of these critically-ill patients in the postoperative period, prior to establishment of irreversible end-organ dysfunction. Our strategy has also helped us rationalize and optimize the use of this expensive treatment modality.
MRI findings of ischiofemoral impingement after total hip arthroplasty are associated with increased femoral antetorsion
Authors: Fischer Tim , Stern Christoph , Fritz Benjamin , Zingg Patrick O , Pfirrmann Christian WA , Sutter Reto 
Published: June 2021

Background Ischiofemoral impingement (IFI) is a known complication after total hip arthroplasty (THA). Purpose To assess if increased postoperative (FA) is associated with magnetic resonance imaging (MRI) findings of IFI. Material and Methods In 221 patients with THA, two independent readers measured FA, ischiofemoral space (IFS), quadratus femoris space (QFS), edema, and fatty infiltration of quadratus femoris muscle. Three sets of IFI-imaging features were defined: acute IFI (set 1): IFS ≤15 mm or QFS ≤10 mm and edema in the quadratus femoris muscle; chronic IFI (set 2): IFS ≤15 mm or QFS ≤10 mm and fatty infiltration of quadratus femoris muscle Goutallier grade ≥2; acute and chronic IFI (set 3) with both criteria applicable. For each set, FA angles were compared between positive findings of IFI and negative findings of IFI. The t-test for independent samples tested statistical significance. Results In 7.2% (16/221) of patients, findings of IFI (IFS ≤15 mm or QFS ≤10 mm and edema, n = 1; fatty infiltration, n = 9; or both, n = 6) were observed. In women, 11.4% (14/123) exhibited findings of IFI compared to 2.0% (2/98) in men. Comparison in set 1 (n = 7): mean antetorsion of 23.9° ± 9.8° (findings of acute IFI) compared to 14.4° ± 9.7° ( P = 0.01). Comparison in set 2 (n = 15): mean antetorsion of 16.2° ± 6.3° (findings of chronic IFI) compared to 14.5° ± 9.9° ( P = 0.49). Comparison in set 3 (n = 6): mean antetorsion of 20.4° ± 3.8° (findings of acute and chronic IFI) compared to 14.5° ± 9.9° ( P = 0.01). Conclusion After THA, high postoperative FA is associated with MRI findings of acute as well as acute and chronic IFI. Findings of IFI were commonly seen in women.
Arthroscopic Versus Open Anterior Shoulder Stabilization: A Prospective Randomized Clinical Trial With 15-Year Follow-up With an Assessment of the Glenoid Being “On-Track” and “Off-Track” as a Predictor of Failure
Authors: Bottoni Craig R. , Johnson John D. , Zhou Liang , Raybin Sarah G. , Shaha James S. , Cruz Christian A. , Lindell Kenneth K. , Thoma David C. 
Published: June 2021

Background: Recent studies have demonstrated equivalent short-term results when comparing arthroscopic versus open anterior shoulder stabilization. However, none have evaluated the long-term clinical outcomes of patients after arthroscopic or open anterior shoulder stabilization, with inclusion of an assessment of preoperative glenoid tracking. Purpose: To compare long-term clinical outcomes of patients with recurrent anterior shoulder instability randomized to open and arthroscopic stabilization groups. Additionally, preoperative magnetic resonance imaging (MRI) studies were used to assess whether the shoulders were “on-track” or “off-track” to ascertain a prediction of increased failure risk. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: A consecutive series of 64 patients with recurrent anterior shoulder instability were randomized to receive either arthroscopic or open stabilization by a single surgeon. Follow-up assessments were performed at minimum 15-year follow-up using established postoperative evaluations. Clinical failure was defined as any recurrent dislocation postoperatively or subjective instability. Preoperative MRI scans were obtained to calculate the glenoid track and designate shoulders as on-track or off-track. These results were then correlated with the patients’ clinical results at their latest follow-up. Results: Of 64 patients, 60 (28 arthroscopic and 32 open) were contacted or examined for follow-up (range, 15-17 years). The mean age at the time of surgery was 25 years (range, 19-42 years), while the mean age at the time of this assessment was 40 years (range, 34-57 years). The rates of arthroscopic and open long-term failure were 14.3% (4/28) and 12.5% (4/32), respectively. There were no differences in subjective shoulder outcome scores between the treatment groups. Of the 56 shoulders, with available MRI studies, 8 (14.3%) were determined to be off-track. Of these 8 shoulders, there were 2 surgical failures (25.0%; 1 treated arthroscopically, 1 treated open). In the on-track group, 6 of 48 had failed surgery (12.5%; 3 open, 3 arthroscopic [ P = .280]). Conclusion: Long-term clinical outcomes were comparable at 15 years postoperatively between the arthroscopic and open stabilization groups. The presence of an off-track lesion may be associated with a higher rate of recurrent instability in both cohorts at long-term follow-up; however, this study was underpowered to verify this situation.
White and Black Differences in Perceived Access to Health and Community Services and Self-Rated Health in an Age-Friendly Community Assessment
Authors: Krok-Schoen Jessica L. , Xu Menglin , White Katie , Clutter Jill , Dabelko-Schoeny Holly 
Published: June 2021

Objectives: This study sought to identify the race differences in perceived access to health and community services and self-rated health (SRH) among White and Black older adult participants of an age-friendly community assessment. Methods: Responses ( n = 313) to a baseline assessment of Columbus, Ohio, residents aged ≥50 years were analyzed. Results: Significant differences were found between White and Black older adults regarding SRH, with Black older adults reporting lower SRH. Black older adults reported significantly lower perceived access to 11 out of the 13 health and community services. There were no significant differences by race regarding ratings of Columbus and personal neighborhoods as a place for people to live as they age. Regression analyses found income was a significant predictor of SRH for both White and Black older adults. Discussion: Opportunities to increase perceived access and knowledge of health and community services for older adults through targeted, equitable interventions are warranted.
Associations Between Occupational and Leisure-Time Physical Activity With Employee Stress, Burnout and Well-Being Among Healthcare Industry Workers
Authors: Wolff Marilyn Batan , O’Connor Patrick J. , Wilson Mark G. , Gay Jennifer L. 
Published: June 2021

Purpose: Examine the associations of occupational and leisure-time physical activity with job stress, burnout, and well-being among healthcare industry workers. Design: Quantitative; cross-sectional. Setting: Healthcare Industry. Sample: US Amazon Mechanical Turk participants (n = 550) employed in the healthcare industry, worked 35 hours or more per week, had ≥ 1 supervisor and ≥ 1 co-worker, and were ≥ 18 years old. Measures: Self-reported measures of occupational physical activity (OPA) and leisure-time physical activity (LTPA), employee well-being, job stress, and burnout operationalized as exhaustion and disengagement. Analysis: Associations between OPA and LTPA with employee well-being, job stress, exhaustion and disengagement were assessed with separate multiple linear regression models. Results: OPA had positive significant associations with job stress (β = 0.10, P value = .003) and exhaustion (β = 0.21, P value < .0001). No significant associations were found between OPA with other psychological outcomes. A significant inverse association was found between LTPA and exhaustion (β = −0.04, P value = .007). Conclusion: In a sample of U.S. health care workers, and consistent with prior epidemiological studies, greater LTPA was associated with lower feelings of exhaustion. In contrast, health care workers with greater OPA reported higher perceptions of job stress and exhaustion. The findings underscore the need for more research aimed at understanding relationships between OPA and psychological health among healthcare workers.
Regulating patient safety during hospital discharges: Casting the Patient Safety Commissioner as the Representative of Order
Authors: Moore Victoria L. 
Published: June 2021

This article examines the challenges in regulating patient safety during hospital discharges in England through the lens of liminality. Hospital discharges are internationally recognised as being a dangerous time for patients, and yet the role that regulators should play in addressing this has received little attention in any jurisdiction. Liminality’s spotlight on the in-between highlights how the discharge process can give rise to patient safety incidents that fall between regulator’s boundaries. Falling between boundaries results in a dearth of effective regulatory responses to address these incidents. By positioning the new role of Patient Safety Commissioner (PSC) as that of a ‘Representative of Order’, this article proposes a means by which this poorly regulated space could be navigated more successfully. This analysis suggests that the remit of the PSC role be expanded to include improving patient safety with regard to processes – not just medicines and medical devices. The full implications of this are also addressed.
‘You can’t just put somebody in a situation with no armour’. An ethnographic exploration of the training and support needs of homecare workers caring for people living with dementia
Authors: Leverton Monica , Burton Alexandra , Beresford-Dent Jules , Rapaport Penny , Manthorpe Jill , Mansour Hassan , Guerra Ceballos Stefanny , Downs Murna , Samus Quincy , Dow Briony , Lord Kathryn , Cooper Claudia 
Published: June 2021

Background Homecare workers carry out complex work with people living with dementia, while under-supported, undervalued and undertrained. In this ethnographic study, we explore the skills, training and support needs of homecare workers supporting people living with dementia. Research Design and Methods We conducted 82 interviews with people living with dementia ( n = 11), family caregivers ( n = 22), homecare staff ( n = 30) and health and social care professionals ( n = 19) and conducted 100-hours of participant observations with homecare workers ( n = 16). We triangulated interview and observational findings and analysed data thematically. Results We developed four themes: 1) ‘Navigating the homecare identity and role’: describing challenges of moving between different role identities and managing associated expectations, 2) ‘Developing and utilising relational and emotional skills’: boundaries between caring and getting emotionally involved felt blurred and difficult to manage, 3) ‘Managing clients who resist care’: homecare workers experienced clients’ reactions as challenging and felt “thrown to the wolves” without sufficient training, and 4) ‘Drawing on agency and team support’: homecare work could be isolating, with no shared workplace, busy schedules and limited opportunity for peer support. Discussion and Implications It is important that training and support for homecare workers addresses the relational, emotional and rights-based aspects of the role. Where a flexible, responsive, person-centred service is required, corresponding training and support is needed, alongside organisational practices, taking account of the broader context of the homecare sector.
Early Outcomes of the First 200 US Patients Treated with Impella 5.5: A Novel Temporary Left Ventricular Assist Device
Authors: Ramzy Danny , Anderson Mark , Batsides George , Ono Masahiro , Silvestry Scott , D’Alessandro David A. , Funamoto Masaki , Zias Elias A. , Lemaire Anthony , Soltese Edward 
Published: June 2021

Objective To report the initial clinical experience with the Impella 5.5® with SmartAssist®, a temporary left ventricular assist device that provides up to 6.2 L/min forward flow, with recent FDA approval for up to 14 days. Methods From October 2019 to March 2020, 200 patients at 42 US centers received the Impella 5.5 and entered into the IQ registry, a manufacturer-maintained quality database that captures limited baseline/procedural characteristics and outcomes through device explant. Post hoc subgroup analyses were conducted to assess the role of baseline and procedural characteristics on survival, defined as successful device weaning or bridge to durable therapy. Results Median patient age was 62 years (range, 13 to 83 years); 83.4% were male. The device was most commonly used for cardiomyopathy (45.0%), acute myocardial infarction complicated by cardiogenic shock (AMICS; 29.0%), and post cardiotomy cardiogenic shock (PCCS; 16.5%). Median duration of support was 10.0 days (range, 0.001 to 64.4 days). Through device explant, overall survival was 74.0%, with survival of 80.0%, 67.2%, 57.6%, and 94.7% in cardiomyopathy, AMICS, PCCS, and others (comprising high-risk revascularization, coronary artery bypass graft, electrophysiology/ablation, and myocarditis), respectively. Patients requiring extracorporeal membrane oxygenation and Impella support (35 patients, 17.5%) had significantly lower survival (51.4% vs 78.8%, P = 0.002). Conclusions In the first 200 US patients treated with the Impella 5.5, we observed overall survival to explant of 74%. Survival outcomes were improved compared to historic rates observed with cardiogenic shock, particularly PCCS. Prospective studies assessing comparative performance of this device to conventional strategies are warranted in future.
Hypertonic Dextrose Stimulates Chondrogenic Cells to Deposit Collagen and Proliferate
Authors: Johnston Elisha , Kou Yi , Junge Jason , Chen Lin , Kochan Andrew , Johnston Michael , Rabago David 
Published: June 2021

Objective Hypertonic dextrose (HD) injections (prolotherapy) for osteoarthritis are reported to reduce pain. Cartilage regeneration is hypothesized as a mechanism. This in vitro study identifies an HD concentration that stimulates chondrogenic cells to increase metabolic activity and assesses whether this concentration affects collagen deposition and proliferation. Design ATDC5 chondrogenic cells were cultured in normoglycemic DMEM/F12 medium, treated with concentrations of HD (4-400 mM), and assessed with PrestoBlue. Advanced light microscopy was used to conduct live imaging of collagen deposition through second harmonic generation microscopy (SHG) and proliferation via 2-photon excitation microscopy. Proliferation was additionally assessed with hemocytometer counts. Results A linear regression model found that, relative to the 4 mM baseline control, cells treated with 200 mM had a higher mean absorbance ( P = 0.023) and cells treated with 250 mM were trending toward a higher mean absorbance ( P = 0.076). Polynomial regression interpolated 240 mM as producing the highest average absorbance. Hemocytometer counts validated 250 mM as stimulating proliferation compared with the 4 mM control ( P < 0.01). A concentration of 250 mM HD led to an increase in collagen deposition compared with that observed in control ( P < 0.05). This HD concentration also led to increases in proliferation of ATDC5 cells relative to that of control ( P < 0.001). Conclusions A 250 mM HD solution appears to be associated with increased metabolic activity of chondrocytes, increased collagen deposition, and increased chondrocyte proliferation. These results support clinical prolotherapy research suggesting that intra-articular HD joint injections reduce knee pain. Further study of HD and cellular processes is warranted.
Autonomic nervous system dysfunction correlates with microvascular damage in systemic sclerosis patients
Authors: Masini Francesco , Galiero Raffaele , Pafundi Pia Clara , Gjeloshi Klodian , Pinotti Emanuele , Ferrara Roberta , Romano Ciro , Adinolfi Luigi Elio , Sasso Ferdinando Carlo , Cuomo Giovanna 
Published: June 2021

Objectives: Cardiac autonomic neuropathy is among the known cardiovascular complications of systemic sclerosis and may affect the whole prognosis of the disease. The aim of our study was to assess cardiac autonomic neuropathy prevalence in our cohort of systemic sclerosis patients and compare its main features with clinical and epidemiological data, particularly with the severity of microvascular damage, as detected by nailfold videocapillaroscopy. Methods: Twenty-six patients with definite systemic sclerosis were consecutively enrolled at our outpatient rheumatology clinic. All patients underwent physical examination, nailfold videocapillaroscopy, and autonomic neuropathy diagnostic tests (orthostatic hypotension test, deep breathing test, lying-to-standing, and Valsalva maneuvers). Results: Cardiac autonomic neuropathy prevalence was 50% (13 cases). On univariate analysis, cardiac autonomic neuropathy was shown to be significantly associated with an active pattern on nailfold videocapillaroscopy (odds ratio 5.86, 95% confidence interval 1.59–9.24; p = 0.032), whereas anti-Scl-70 positivity (odds ratio, 0.24; 95% confidence interval, 0.03–2.12; p = 0.049) and C-reactive protein (odds ratio, 19.32; 95% confidence interval, 1.79–56.71; p = 0.036) reached only a borderline statistical association. The time-dependent Cox multivariate regression model showed cardiac autonomic neuropathy development to be independently associated with an active pattern on nailfold videocapillaroscopy (odds ratio, 7.19; 95% confidence interval, 1.87–8.96; p = 0.042) and anti-Scl-70 positivity (odds ratio, 5.92; 95% confidence interval, 1.06–18.43; p = 0.048). Conclusions: Severe microvascular damage, as detected by nailfold videocapillaroscopy, may suggest the coexistence of autonomic dysfunction and should be considered as a red flag for the identification of patients particularly at risk of cardiac morbidity and mortality.
Superabsorbent polymer balls as foreign bodies in the nasal cavities of children: our clinical experience
Authors: Han Sai-hong , Chen Yong-chao , Xian Zhi-xiong , Teng Yi-shu 
Published: June 2021

Abstract
Objective
To summarize the clinical diagnosis and treatment of superabsorbent polymer balls as nasal foreign bodies in children.

Methods
We retrospectively analysed the clinical data concerning 12 cases of superabsorbent polymer balls as nasal foreign bodies in children and summarized the corresponding clinical features, methods of diagnoses and treatment, and prognoses.

Results
Twelve children with superabsorbent polymer balls as foreign bodies in their nasal cavities presented with relatively severe symptoms, such as congestion, runny nose, and nasal swelling. When such foreign bodies stay in the nasal cavity for a prolonged period, patients may suffer from general discomfort, such as agitation, poor appetite and high fever. Most of the children had to undergo nasal endoscopy under general anaesthesia to have the foreign bodies completely removed. An intraoperative examination revealed significant mucosal injury within the nasal cavity. With regular follow-up visits and adequate interventions, all the patients recovered.

Conclusion
The longer superabsorbent polymer balls remain in the nasal cavity, the more damaged the nasal mucosa will be. It is challenging to remove such foreign bodies in the outpatient setting. Transnasal endoscopy under general anaesthesia appears to be safer and more effective in such cases. Since the nasal mucosa is injured to varying degrees, postoperative follow-up and treatment are equally important for preventing the occurrence of complications.