bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract 168: The Impact of Prehospital Care on STEMI Time to Treat
Authors: Langabeer James R , Henry Timothy D , DelliFraine Jami L , Segrest Wendy ,   Dallas Caruth AHA Advisory Board
Published: July 2021

In emergency cardiovascular care, delays often equate to poor patient outcomes. In patients experiencing ST-elevation myocardial infarction (STEMI), reducing systemic delays and receiving definitive treatment is a key goal of regionalized systems of care. Prehospital emergency care has been suggested to have an impact on improving STEMI patient outcomes, but little prior evidence exists in large suburban settings to establish relationships between EMS and hospital outcomes. In this study, we analyzed the entire population of non-transfer STEMI patients that underwent primary percutaneous coronary intervention (PCI) in Dallas County Texas from October 1, 2010 through December 31, 2011. Emergency medical services data from 24 agencies and 15 receiving hospitals collected and shared common, de-identified patient data. To control for confounding factors, we developed a robust generalized linear regression and relied on estimated marginal means analyses to assess the impact of EMS transport (versus self-transport) on hospital door to balloon (D2B) and total treatment time, defined as symptom onset to arterial reperfusion, or SOAR.
In our analyses, there were statistically 11.1 minute reductions in median D2B (and 64.5 minute median reductions in SOAR (both with p<.001) treatment times when EMS transported to the receiving facility compared to self-transport or walk-in. More importantly, when EMS field activated the cardiac catheterization laboratory based on agreed upon processes and protocols, D2B times were reduced by 38% (or 43 minutes) after controlling for confounding variables, and field activation was associated with a 21.9% reduction (73 minutes) in the mean SOAR time (both with p<.001). We found no significant relation with mortality or length of stay.
Based on these findings, we recommend regional quality improvement teams develop strategies for engaging EMS in STEMI treatment, to reduce both systemic delays and total coronary reperfusion times.
Area Deprivation Index and Cardiac Readmissions: Evaluating Risk‐Prediction in an Electronic Health Record
Authors: Johnson Amber E. , Zhu Jianhui , Garrard William , Thoma Floyd W. , Mulukutla Suresh , Kershaw Kiarri N. , Magnani Jared W. 
Published: July 2021

Background
Assessment of the social determinants of post‐hospital cardiac care is needed. We examined the association and predictive ability of neighborhood‐level determinants (area deprivation index, ADI), readmission risk, and mortality for heart failure, myocardial ischemia, and atrial fibrillation.

Methods and Results
Using a retrospective (January 1, 2011–December 31, 2018) analysis of a large healthcare system, we assess the predictive ability of ADI on 30‐day and 1‐year readmission and mortality following hospitalization. Cox proportional hazards models analyzed time‐to‐event. Log rank analyses determined survival. C‐statistic and net reclassification index determined the model’s discriminative power. Covariates included age, sex, race, comorbidity, number of medications, length of stay, and insurance. The cohort (n=27 694) had a median follow‐up of 46.5 months. There were 14 469 (52.2%) men and 25 219 White (91.1%) patients. Patients in the highest ADI quintile (versus lowest) were more likely to be admitted within 1 year of index heart failure admission (hazard ratio [HR], 1.25; 95% CI, 1.03‒1.51). Patients with myocardial ischemia in the highest ADI quintile were twice as likely to be readmitted at 1 year (HR, 2.04; 95% CI, 1.44‒2.91]). Patients with atrial fibrillation living in areas with highest ADI were less likely to be admitted within 1 year (HR, 0.79; 95% CI, 0.65‒0.95). As ADI increased, risk of readmission increased, and risk reclassification was improved with ADI in the models. Patients in the highest ADI quintile were 25% more likely to die within a year (HR, 1.25 1.08‒1.44).

Conclusions
Residence in socioeconomically disadvantaged communities predicts rehospitalization and mortality. Measuring neighborhood deprivation can identify individuals at risk following cardiac hospitalization.
Cangrelor: Clinical Data, Contemporary Use, and Future Perspectives
Authors: De Luca Leonardo , Steg Philippe Gabriel , Bhatt Deepak L. , Capodanno Davide , Angiolillo Dominick J. 
Published: July 2021

Abstract

Cangrelor is the only currently available intravenous platelet P2Y
12
receptor inhibitor. It is characterized by potent, predictable, and rapidly reversible antiplatelet effects. Cangrelor has been tested in the large CHAMPION (Cangrelor Versus Standard Therapy to Achieve Optimal Management of Platelet Inhibition) program, where it was compared with different clopidogrel regimens, and it is currently indicated for use in patients with coronary artery disease undergoing percutaneous coronary intervention. However, the uptake of cangrelor use varies across the globe and may also include patients with profiles different from those enrolled in the registration trials. These observations underscore the need to fully examine the safety and efficacy of cangrelor in postregistration studies. There are several ongoing and planned studies evaluating the use of cangrelor in real‐world practice which will provide important insights to this extent. The current article provides a review on the pharmacology, clinical studies, contemporary use of cangrelor in real‐world practice, a description of ongoing studies, and futuristic insights on potential strategies on how to improve outcomes of patients undergoing percutaneous coronary intervention.
Grief, COVID-19, and the South: Considerations and Recommendations
Authors: McDuffie Danielle L. , Kouchi Kathryn , Dorman Hillary , Bownes Elizabeth , Condon Shelley E. , Crowther Martha R. 
Published: July 2021

Purpose COVID-19 has devastated the United States (U.S.). One of the more notably impacted areas is the South. Compared to the rest of the U.S., the South is characterized by increased rurality, lowered access to healthcare, older populations, and higher religiosity, all of which might predispose its residents to more detrimental effects of COVID-19, including COVID-related fatalities. As such, this paper provides important considerations for individuals engaging in work with Southern, rural Americans dealing with COVID-related grief and loss. Methods A review of the literature addressing the impact of Southern legislature, rurality, cross-country factors, and faith on COVID-related grief among Southerners was conducted, with applicable considerations expressed. Conclusions Care should be taken by providers working with rural, Southern residents to attend to tangible and intangible losses experienced as a result of COVID-19. These considerations can help inform work with rural Southerners dealing with grief during the pandemic.
Asociación de Mujeres Afro por la Paz: Feminism with the Body and Face of a Woman
Authors: Zulver Julia Margaret 
Published: July 2021

The Asociación de Mujeres Afro por la Paz (Association of Afro Women for Peace—AFROMUPAZ) is an organization of displaced Afro-Colombian women now based in Bogotá. The organization represents a differential brand of feminism in the face of historical and ongoing violence and provides community, support, and employment opportunities for dozens of women and their families. Its “feminism with a woman’s body and face” is part of the landscape of popular feminism in the region, but its specific social location and its actions cannot be understood without a deliberate and critical understanding of race. La Asociación de Mujeres Afro por la Paz (AFROMUPAZ) es una organización de mujeres afrocolombianas desplazadas ahora radicadas en Bogotá. La organización representa un tipo distinto de feminismo frente a la violencia histórica y continua, y ofrece oportunidades comunitarias, de apoyo y de empleo para decenas de mujeres y sus familias. Su “feminismo en cuerpo y cara de mujer” es parte del panorama del feminismo popular en la región, pero la comprensión de su ubicación social específica y acciones requiere de un acercamiento deliberado y crítico de la cuestión racial.
“My Whole Family Is Not Really My Family”—Secure Care Shadows on Family and Family Practices Among Young Adults and Their Family Members
Authors: Enell Sofia , Wilińska Monika 
Published: July 2021

This study based in Sweden explores family practices and family displays among young adults with a history of secure care, which limits and restricts contacts and therefore causes fundamental changes in relationships. Almost 10 years after institutional placement, narrations of 11 young adults and 11 nominated family members reveal ongoing struggles between imagined and lived realities of family. These struggles are revealed by memories and emotions evoked by the context of secure care and show how deeply the secure care penetrated their family lives. By using the metaphor of shadows, shadows of recalled horror of secure care (reflecting family displacement) and the pressure to make family work (reflecting restricting practices in secure care where only (birth) family were considered as family and relations of (natural) importance) are discerned. We call for more attention to the perversity of secure care arrangements, at both policy and institutional levels.
Interparental Conflict Across the Early Parenting Period: Evidence From Fathers Participating in an Australian Population-Based Study
Authors: Giallo Rebecca , Seymour Monique , Treyvaud Karli , Christensen Daniel , Cook Fallon , Feinberg Mark , Brown Stephanie , Cooklin Amanda 
Published: July 2021

Current evidence about the prevalence of interparental conflict (IPC) during early parenthood is primarily based on mothers’ reports. Drawing upon Australian longitudinal data from 4136 fathers, the aims of the study were to: (a) report on the extent to which fathers report IPC across six biennial time intervals when their children were aged 6–12 months to 10–11 years, (b) identify trajectories of IPC over time and (c) identify postnatal factors (at the initial time point) associated with high risk trajectories of IPC. One in 10 fathers reported high IPC at each time interval. A high and increasing pattern of IPC was observed for 6% of fathers. Factors associated with this trajectory were fathers being from a non-English speaking background and high postnatal psychological distress reported by mothers and fathers. These findings underscore the importance of early intervention for some families experiencing IPC in the early years of their children’s lives.
Preference for Mode of Learning for Knowledge and Skills by Professional Management Students During the COVID-19 Pandemic Period
Authors: Rao Gudivada Venkat , Vijayalakshmi D. 
Published: July 2021

Learning of skill and knowledge are differentiated and acknowledged as the outcomes of education. The COVID-19 pandemic phase has disturbed the teaching in classroom, curriculum and academic calendar of educational institutes across the world. Blended learning is an integration of offline and online approaches of sharing subject resources online after classroom learning. Students pursuing professional management course at the university campus and a reputed private college were considered for sample selection. Only those sample respondents with attendance for both modes of learning were considered. The whole population of 360 was invited to participate in the survey, and 294 student participants’ responses were shortlisted for analysis. The instrument was standardized after conducting a pilot study. Descriptive tools, correlation, regression and ANOVA were applied for analysis. The learning in classroom shows strong preference with all the variables having a positive opinion. Furthermore, preference for classroom learning had not changed during the COVID-19 pandemic phase. The classroom learning variables were significant with the COVID-19 effect except for flexibility. The learning of skills with labs or workplace place exposure was preferred over skill learning with an online demonstration. In future, educational institutes should focus on training faculty in the techniques and delivery of online learning, implementing changes in the curriculum that are suitable for online mode of teaching and employing emerging information and communication technologies. JEL Classification: I230
Utility of compression immediately after venous closure: Does it matter?
Authors: Lajos Paul , Safir Scott , Weber Jonathan , Bangiyev Ronald , Faries Peter , Ting Windsor 
Published: July 2021

Background Leg compression after venous closures for 24–48 hours or longer is commonplace and controversial. Objective The goal of our study was to evaluate compression immediately post-venous closures and its associated costs. Methods Records were retrospectively reviewed after consecutive therapies of sclerotherapy, mechanochemical ablation (MOCA) & radiofrequency ablation (RFA) from 1 clinic with 2 cohorts: 7/2/13-10/15/15 were immediately ACE-wrapped for 3-5 days (AW, N = 52) and 10/20/15–1/5/16 were non ACE-wrapped (NAW, N = 49). All procedures were performed in an outpatient office setting of one surgeon (P.L.). Follow-up was within 1 week and 3 months with ultrasounds. Financial data of ACE wraps and ABD pads were assessed. Results Closures consisted of consecutive therapies of sclerotherapy (4 patients); MOCA (44 patients) and RFA (53 patients). No statistical difference existed in age (p = 0.61), sex (p = 0.2063); race (0.3689), CAD (p = 0.1442), ESRD (p = 0.2914), diabetes mellitus (p = 0.8943), hypertension (p = 0.681), COPD (p = 0.38), or smoking (p = 0.3628). NAW group had higher rate of hyperlipidemia (p = 0.0225), obesity (p = 0.0283), MOCA and sclerotherapy (p = 0.0005). No difference existed in pain (p = 0.8897); wound complications were too small to perform analysis; and swelling was greater in AW group compared to NAW group (p = 0.0132, OR 3.3951, CI 1.269; 9.0834). Closure rates were 98% and 100% in AW and NAW groups, respectively. NAW were only a total cost savings of $1.58 per leg per procedure. Conclusion AW for compression after vein closures confers no benefit in postoperative period with no effect on closure rates; may be associated with increased swelling, discomfort, and wound complications while increasing unnecessary and negligible monetary costs. Larger sample size is needed to validate these conclusions.
A simple prognostic score for COVID-19 hospitalized patients developing deep vein thrombosis
Authors: Bozzani Antonio , Arici Vittorio , Tavazzi Guido , Boschini Stefano , Guglielmi Angelo , Mazza Giovanni , Mojoli Francesco , Bruno Raffaele , Ragni Franco , Sterpetti Antonio V 
Published: July 2021

Objective The aim of our study was to analyze the specificity, accuracy and sensitivity of a simple, easy to calculate, prognostic score for hospitalized COVID19 patients developing deep vein thrombosis. Methods From March 1st to April 28th, 942 COVID-19 patients with severe symptoms were admitted to the hospital San Matteo of Pavia-Italy. Thirty two patients (3.4%) developed deep vein thrombosis during hospitalization. In all patients hemostatic and inflammatory parameters were abnormal. A simple prognostic score was developed based on the presence of specific co morbidities and D-dimers levels (quick San Matthew Score-quick SMS): Results Nine patients died in a condition of multiple organ failure, 23 patients (71.9%) survived and left the hospital in good general conditions. The developed score was based simply on two parameters: 1) presence of four specific co morbidities and 2)systemic levels of D-Dimers. The quick San Matthew Score resulted in a sensitivity, specificity and overall accuracy of more than 90% (94%, 92%,93% respectively) and compared favorably with other scores. The score was prospectively validated in 100 COVID19 patients who developed deep vein thrombosis collected from the literature and prospectively confirmed in our hospital. Conclusions The findings of our study underline the importance of an immediate aggressive therapeutic approach for moderate and high-risk patients with COVID19 infection. The quick SMS score may help to identify patients at high risk for mortality and to follow the clinical outcome of the patient. A simple, easy to calculate prognostic score may also facilitate communication among health workers.
Queering participatory planning
Authors: Broto Vanesa Castán 
Published: July 2021

All over the world, people suffer violence and discrimination because of their sexual orientation and gender identity. Queer theory has linked the politics of identity and sexuality with radical democracy experiments to decolonize development. Queering participatory planning can improve the wellbeing of vulnerable sectors of the population, while also enhancing their political representation and participation. However, to date, there has been limited engagement with the politics of sexuality and identity in participatory planning. This paper identifies three barriers that prevent the integration of queer concerns. First, queer issues are approached as isolated and distinct, separated from general matters for discussion in participatory processes. Second, heteronormative assumptions have shaped two fields that inform participatory planning practices: development studies and urban planning. Third, concrete, practical problems (from safety concerns to developing shared vocabularies) make it difficult to raise questions of identity and sexuality in public discussions. An engagement with queer thought has potential to renew participatory planning.
Oversized balloon angioplasty for endovascular maturation of arteriovenous fistulae to accelerate cannulation and to decrease the duration of catheter use
Authors: de Oliveira Harduin Leonardo , Guerra Julia Bandeira , Virgini-Magalhães Carlos Eduardo , da Costa Felipe Silva , Vieira Brunno Ribeiro , Mello Renata Silveira , Filippo Marcio Gomes , Barroso Thiago Almeida , de Mattos Jorge Paulo Strogoff , Fiorelli Rossano Kepler Alvim 
Published: July 2021

Background: The functional autologous arteriovenous fistula is considered the best vascular access for patients on hemodialysis. Some fistulae exhibit maturation problems after creation and do not reach adequate vessel diameter and flow in dialysis. The aim of this study was to describe our technique of oversized balloon angioplasty for assisted maturation of arteriovenous fistulae to accelerate the cannulation and to decrease the time of catheter use and its outcome. Methods: A retrospective analysis of balloon-assisted procedures for maturation failure was performed in a single center between October 2011 and January 2019. Patients underwent imaging procedures to identify stenosis, followed by angioplasty using oversized high-pressure balloons from the anastomosis to the deep venous outflow tract. The flow volume, time interval of use of the fistula and removal of the catheter, patency rates, and complications rates were evaluated. Results: Seventy-eight patients underwent 124 balloon angioplasty procedures. Technical and clinical success was achieved in 91% of the cases. In patients in whom maturation was successful, the fistula was cannulated in a mean time of 5 days after the procedure (range, 1–20 days). On average, catheter removal was performed 14 days (range, 5–33 days) after the maturation procedure. The mean flow volume in the fistula before the procedure was 276 ml/min (range, 122–488 ml/min) and 24 h after the maturation was 1014 ml/min (range, 760–1800 ml/min). The primary patency rate at 3, 6, and 12 months was 87.3%, 66.2%, and 50.7%, respectively. Assisted primary patency was 100% at 3 months, 92.9% at 6 months, and 90.0% at 12 months. Minor complications occurred in 18% of cases, and major complications in 4.8%. Conclusions: The oversized balloon-assisted arteriovenous fistula maturation technique is safe and effective, allowing the cannulation of the fistulae a few hours or days after the procedure and decreasing the time of catheter use.
A Quick Review on the Multisystem Effects of Prone Position in Acute Respiratory Distress Syndrome (ARDS) Including COVID-19
Authors: Adeola Janet O , Patel Shivani , Goné Evelyne N , Tewfik George 
Published: July 2021

Objective: The purpose of this review is to highlight the multisystem effects of prone position in ARDS patients with a focus on current findings regarding its use in COVID-19 patients. Methods: Two reviewers comprehensively searched PubMed database for literature regarding pathophysiology and efficacy of prone position in ARDS patients as well as specific data regarding this approach in COVID-19 patients. Conclusion: Prone positioning is well-documented to improve oxygenation and cardiac function in ARDS patients and might confer increased survival, with benefits that outweigh risks such as facial edema, endotracheal tube displacement, and intraabdominal organ dysfunction in obese patients. Severe COVID-19 pneumonia, while meeting ARDS criteria, differs from typical ARDS in several ways. Data would suggest that advantages of prone position would become limited after significant disease progression and fibrosis. The use of this technique in COVID-19 requires prolonged sessions that are unprecedented in the treatment of ARDS patients. New data regarding COVID-19 pathophysiology and patients continues to evolve daily. More frequently, patients are proned while maintaining spontaneous breathing—the results of this intervention are an area for future studies. There is more to learn about the appropriate use of prone position in COVID-19 patients. The multisystem risks and benefits require clinicians to adopt a patient centered decision-making algorithm when employing this technique in COVID-19 patients. Level of evidence: NA
Distilling innovative US autism care programs that address widely perceived unmet patient and family needs
Authors: Wong Venus , Pham Mai , Godfrey Kristen , Milstein Arnold 
Published: July 2021

Current mainstream care for autistic individuals is fragmented, narrow, and poorly individualized. To better describe cutting-edge autism care, we searched for care programs in the United States that had been collaboratively designed with patients and families and that carry the highest potential to improve the quality of life of autistic individuals and their families. Using a modified Delphi method, we gathered input via conversations and surveys from 55 autistic adults, family members, practicing clinicians, and autism specialized researchers. As a result, 90 innovative autism care programs were nominated. We distilled these nominations to 15 programs across the United States by applying researcher-selected criteria, such as providing services actively and having data on program effectiveness. Then, we recruited 10 experts to rate the novelty, clinical benefits to individuals, clinical benefits to family caregivers, care costs for autistic individuals, societal costs, adaptability, and feasibility of the 15 programs. Common features of the 15 programs include care coordination and integration, care delivery, payment, and providing care in underserved clinical areas. Lay abstract Currently, the quality of care for autistic individuals is not good. Many care services for autistic individuals are not well coordinated, nor are they tailored. We wanted to find out a better model for autism care and believed that the autism community knows where these programs are. So, we had conversations with and surveyed 55 autistic adults, family members, clinicians, and researchers. They shared 90 innovative autism care programs that had been collaboratively designed with patients and families and that are likely to improve the quality of life of autistic individuals and their families. We then narrowed down the 90 nominated programs to 15 programs across the United States by applying researcher-selected criteria, such as providing services actively and having data on program effectiveness. We compiled a list of these innovative, quality autism care programs.