bluuebunny/crossref_metadata_2025_split huggingface dataset:
Entre as representações e o autor: uma análise da liberdade sexual em Berlin Alexanderplatz
Authors: Almeida Dawyd Thiago de Oliveira , Costa Thawanny Victoria Santos 
Published: July 2021

O presente artigo pretende discutir de que forma a liberdade sexual desenvolvida na Alemanha, durante a República de Weimar, tendo sido Berlim o seu epicentro, é representada no romance alemão Berlin Alexanderplatz (1929), escrito pelo autor e psiquiatra Alfred Döblin. A partir da análise da representação em questão, discutiremos a forma como determinados elementos construídos pelo autor destoam do discurso elaborado e reproduzido sobre a Berlim weimariana, o qual instaurou no imaginário ocidental uma imagem da capital alemã marcada pela devassidão sexual. Também procuramos tecer hipóteses sobre por qual motivo o autor do romance prioriza determinadas formas de retratar a liberdade sexual em detrimento de outras. As suas representações parecem ter sido feitas sobretudo devido a determinadas convicções que ele parece ter tido em vida e transpareceu em suas obras. Utilizando o romance como fonte primária, tentaremos erigir alguns olhares sobre a história de Berlim durante a República de Weimar, contribuindo para a desconstrução do seu mito que já não pode ser mais cabível no desenvolvimento de novas narrativas.
Group size, crowding, and age class composition of the threatened Sambar Rusa unicolor (Kerr, 1792) (Mammalia: Cetartiodactyla: Cervidae) in the semi-arid regions of northeastern Rajasthan, India
Authors: Rai Deepak , Kalpana  
Published: July 2021

Grouping characteristics and population growth dynamics of Sambar were studied in Bir Jhunjhunu Conservation Reserve (BJCR) and Bairasar Johad (BJ) in Rajasthan, India from July 2018 to June 2019. Following the scan sampling method, a total of 117 sightings of Sambar (N= 488 individuals) were recorded in BJCR, and 106 in BJ (N= 389 individuals), during 24 fortnightly visits. The data revealed that besides solitary sightings of Sambar, groups ranging from 2–11 and 2–12 individuals were observed in BJCR and BJ, respectively. The overall mean group size and mean crowding of Sambar were 4.2±0.2 S.E. and 5.3 respectively in BJCR, and 3.7±0.2 S.E. and 5.0 respectively in BJ. The sex ratio was skewed towards females. The overall adult male: adult female: fawn ratio was 74.4: 100: 47.1 (N= 488 individuals) in BJCR while the ratio was 92.6: 100: 41.1 (N= 389 individuals) in BJ. As far as the social organization of Sambar is concerned, six types of herds were recorded in the present study. It is urged that sambar populations outside protected area also need simultaneous strategies for conservation attention.
Seasonal prey availability and diet composition of Lesser Asiatic Yellow House Bat Scotophilus kuhlii Leach, 1821
Authors: Bhartiy Shani Kumar , Elangovan Vadamalai 
Published: July 2021

Diet is an important factor in understanding bat ecology and conservation. This study assessed seasonal prey availability and diet composition of the Asiatic Lesser Yellow House Bat Scotophilus kuhlii in various districts of Uttar Pradesh between January 2016 to December 2018. Fecal and insect samples were collected seasonally using sweep nets between 1800 and 1900 h. From each location 20 fecal pellets were selected for analysis and searched for taxonomically recognizable remnants. The analysis revealed that S. kuhlii fed on Coleoptera, Diptera, Hymenoptera, Isoptera, Orthoptera, Odonata, Blattodae, Lepidoptera, and Hemiptera, identified from legs, antennae and wings/elytra in fecal pellets. Seasonal variation in the presence of isolated insect remnants and insect abundance at foraging grounds was observed. Thus S. kuhlii is a voracious feeder and plays an important role as a pest control agent.
Trajectories of Pain After Cardiac Surgery: Implications for Measurement, Reporting, and Individualized Treatment
Authors: Mori Makoto , Brooks Cornell , Dhruva Sanket S. , Lu Yuan , Spatz Erica S. , Dey Pranammya , Zhang Yawei , Chaudhry Sarwat I. , Geirsson Arnar , Allore Heather G. , Krumholz Harlan M. 
Published: July 2021

Background:
Postoperative pain after cardiac surgery is a significant problem, but studies often report pain value as an average of the study cohort, obscuring clinically meaningful differences in pain trajectories. We sought to characterize heterogeneity in postoperative pain experiences.

Methods:
We enrolled patients undergoing a cardiac surgery at a tertiary care center between January 2019 and February 2020. Participants received an electronically-delivered questionnaire every 3 days for 30 days to assess incision site pain level. We evaluated the variability in pain trajectories over 30 days by the cohort-level mean with confidence band and latent classes identified by group-based trajectory model. Group-based trajectory model estimated the probability of belonging to a specific trajectory of pain.

Results:
Of 92 patients enrolled, 75 provided ≥3 questionnaire responses. The cohort-level mean showed a gradual and consistent decline in the mean pain level, but the confidence bands covered most of the pain score range. The individual-level trajectories varied substantially across patients. Group-based trajectory model identified 4 pain trajectories: persistently low (n=9, 12%), moderate declining (initially mid-level, followed by decline; n=26, 35%), high declining (initially high-level, followed by decline; n=33, 44%), and persistently high pain (n=7, 9%). Persistently high pain and high declining groups did not seem to be clearly distinguishable until approximately postoperative day 10. Patients in persistently low pain trajectory class had a numerically lower median age than the other 3 classes and were below the lower confidence band of the cohort-level approach. Patients in the persistently high pain trajectory class had a longer median length of hospital stay than the other 3 classes and were often higher than the upper confidence band of the cohort-level approach.

Conclusions:
We identified 4 trajectories of postoperative pain that were not evident from a cohort-level mean, which has been a common way of reporting pain level. This study provides key information about the patient experience and indicates the need to understand variation among sites and surgeons and to investigate determinants of different experience and interventions to mitigate persistently high pain.
Evidence‐to‐Practice Gap for Preventing Procedure‐Related Acute Kidney Injury in Patients Undergoing Percutaneous Coronary Intervention
Authors: Shoji Satoshi , Sawano Mitsuaki , Sandhu Alexander T. , Heidenreich Paul A. , Shiraishi Yasuyuki , Noma Shigetaka , Suzuki Masahiro , Numasawa Yohei , Fukuda Keiichi , Kohsaka Shun 
Published: July 2021

Background
Acute kidney injury (AKI) is a common complication of percutaneous coronary intervention. This risk can be minimized with reduction of contrast volume via preprocedural risk assessment. We aimed to identify quality gaps for implementing the available risk scores introduced to facilitate more judicious use of contrast volume.

Methods and Results

We grouped 14 702 patients who underwent percutaneous coronary intervention according to the calculated NCDR (National Cardiovascular Data Registry) AKI risk score quartiles (Q1 [lowest]–Q4 [highest]). We compared the used contrast volume by the baseline renal function and NCDR AKI risk score quartiles. Factors associated with increased contrast volume usage were determined using multivariable linear regression analysis. The overall incidence of AKI was 8.9%. The used contrast volume decreased in relation to the stages of chronic kidney disease (168 mL [SD, 73.8 mL], 161 mL [SD, 75.0 mL], 140 mL [SD, 70.0 mL], and 120 mL [SD, 73.7 mL] for no, mild, moderate, and severe chronic kidney disease, respectively;
P
<0.001), albeit no significant correlation was observed with the calculated NCDR AKI risk quartiles. Of the variables included in the NCDR AKI risk score, anemia (7.31 mL [1.76–12.9 mL],
P
=0.01), heart failure on admission (10.2 mL [6.05–14.3 mL],
P
<0.001), acute coronary syndrome presentation (10.3 mL [7.87–12.7 mL],
P
<0.001), and use of an intra‐aortic balloon pump (17.7 mL [3.9–31.5 mL],
P
=0.012) were associated with increased contrast volume.

Conclusions
The contrast volume was largely determined according to the baseline renal function, not the patients' overall AKI risk. These findings highlight the importance of comprehensive risk assessment to minimize the contrast volume used in susceptible patients.
Myocardial Perfusion Defects in Hypertrophic Cardiomyopathy Mutation Carriers
Authors: Hughes Rebecca K. , Camaioni Claudia , Augusto João B. , Knott Kristopher , Quinn Ellie , Captur Gabriella , Seraphim Andreas , Joy George , Syrris Petros , Elliott Perry M. , Mohiddin Saidi , Kellman Peter , Xue Hui , Lopes Luis R. , Moon James C. 
Published: July 2021

Background
Impaired myocardial blood flow (MBF) in the absence of epicardial coronary disease is a feature of hypertrophic cardiomyopathy (HCM). Although most evident in hypertrophied or scarred segments, reduced MBF can occur in apparently normal segments. We hypothesized that impaired MBF and myocardial perfusion reserve, quantified using perfusion mapping cardiac magnetic resonance, might occur in the absence of overt left ventricular hypertrophy (LVH) and late gadolinium enhancement, in mutation carriers without LVH criteria for HCM (genotype‐positive, left ventricular hypertrophy‐negative).

Methods and Results

A single center, case‐control study investigated MBF and myocardial perfusion reserve (the ratio of MBF at stress:rest), along with other pre‐phenotypic features of HCM. Individuals with genotype‐positive, left ventricular hypertrophy‐negative (n=50) with likely pathogenic/pathogenic variants and no evidence of LVH, and matched controls (n=28) underwent cardiac magnetic resonance. Cardiac magnetic resonance identified LVH‐fulfilling criteria for HCM in 5 patients who were excluded. Individuals with genotype‐positive, left ventricular hypertrophy‐negative had longer indexed anterior mitral valve leaflet length (12.52±2.1 versus 11.55±1.6 mm/m
2
,
P
=0.03), lower left ventricular end‐systolic volume (21.0±6.9 versus 26.7±6.2 mm/m
2
,
P
≤0.005) and higher left ventricular ejection fraction (71.9±5.5 versus 65.8±4.4%,
P≤
0.005). Maximum wall thickness was not significantly different (9.03±1.95 versus 8.37±1.2 mm,
P
=0.075), and no subject had significant late gadolinium enhancement (minor right ventricle‒insertion point late gadolinium enhancement only). Perfusion mapping demonstrated visual perfusion defects in 9 (20%) carriers versus 0 controls (
P
=0.011). These were almost all septal or near right ventricle insertion points. Globally, myocardial perfusion reserve was lower in carriers (2.77±0.83 versus 3.24±0.63,
P
=0.009), with a subendocardial:subepicardial myocardial perfusion reserve gradient (2.55±0.75 versus 3.2±0.65,
P
=<0.005; 3.01±0.96 versus 3.47±0.75,
P
=0.026) but equivalent MBF (2.75±0.82 versus 2.65±0.69 mL/g per min,
P
=0.826).

Conclusions
Regional and global impaired myocardial perfusion can occur in HCM mutation carriers, in the absence of significant hypertrophy or scarring.
Morphological Plaque Characteristics and Clinical Outcomes in Patients With Acute Coronary Syndrome and a Cancer History
Authors: Tanimura Kosuke , Otake Hiromasa , Kawamori Hiroyuki , Toba Takayoshi , Nagasawa Akira , Nakano Shinsuke , Takahashi Yu , Fukuyama Yusuke , Kozuki Amane , Shite Junya , Iwasaki Masamichi , Kuroda Koji , Takaya Tomofumi , Hirata Ken‐ichi 
Published: July 2021

Background
Although patients with a cancer history have a 2 to 3 times higher risk for acute coronary syndrome (ACS), the morphological characteristics of ACS culprit plaque in those patients and their relations with clinical outcomes remain unknown.

Methods and Results

This retrospective, multicenter, observational cohort study included consecutive patients with ACS who underwent optical coherence tomography‐guided emergent percutaneous coronary intervention. Patients were categorized into those without a cancer history, those with a cancer history, and those currently receiving cancer treatment. ACS culprit lesions were classified as plaque rupture, plaque erosion, or calcified nodule using optical coherence tomography. Plaque erosion frequency was significantly higher in culprit lesions of patients with current cancer and patients with cancer history than in those of patients without cancer history (56.3% versus 61.7% versus 36.5%). Calcified nodule incidence was significantly higher in patients without cancer history than in patients with current cancer and patients without cancer history (patients with current cancer: 12.4% versus patients without cancer history: 25.5% versus patients without cancer history: 12.6%,
P
<0.001). Cancer history was independently associated with nonplaque rupture (plaque erosion or calcified nodule) in ACS culprit lesions (odds ratio, 4.00;
P
<0.001). Cancer history was independently associated with major adverse cardiovascular events (hazard ratio [HR], 1.98;
P
=0.002). Nonplaque rupture in ACS culprit lesions was independently associated with major adverse cardiovascular events (HR, 1.60;
P
=0.011).

Conclusions
Patients with a cancer history had significantly worse clinical outcomes after ACS than those without a cancer history. Those with a cancer history had significantly higher plaque erosion and calcified nodule incidences in the ACS culprit lesions, which might partly explain their worse clinical outcomes.

Registration

URL:
www.umin.ac.jp/ctr/index.htm
. Unique Identifier: UMIN000038442.
At Preeclampsia Diagnosis, Total Cell‐Free DNA Concentration is Elevated and Correlates With Disease Severity
Authors: Kolarova Teodora R. , Gammill Hilary S. , Nelson J. Lee , Lockwood Christina M. , Shree Raj 
Published: July 2021

Background
Placental derived cell‐free DNA (cfDNA), widely utilized for prenatal screening, may serve as a biomarker for preeclampsia. To determine whether cfDNA parameters are altered in preeclampsia, we conducted a case‐control study using prospectively collected maternal plasma (n=20 preeclampsia, n=22 normal) using our in‐house validated prenatal screening assay.

Methods and Results

Isolated cfDNA was quantified, sequenced using Illumina NextSeq 500, and the placental‐derived fraction was determined. Clinical and test characteristics were compared between preeclampsia and controls, followed by comparisons within the preeclampsia cohort dichotomized by cfDNA concentration. Lastly, cfDNA parameters in preeclampsia were correlated with markers of disease severity. Maternal age, body mass index, gestational age at delivery, cesarean rate, and neonatal birthweight were expectedly different between groups (
P
≤0.05). The placental‐derived cfDNA fraction did not differ between groups (21.4% versus 16.9%,
P
=0.06); however, total cfDNA was more than 10 times higher in preeclampsia (1235 versus 106.5 pg/µL,
P
<0.001). This relationship persisted when controlling for important confounders (OR 1.22, 95% CI 1.04–1.43,
P
=0.01). The dichotomized preeclampsia group with the highest cfDNA concentration delivered earlier (33.2 versus 36.6 weeks,
P
=0.02) and had lower placental‐derived fractions (9.1% versus 21.4%,
P
=0.04). Among preeclampsia cases, higher total cfDNA correlated with earlier gestational age at delivery (
P
=0.01) and higher maximum systolic blood pressure (
P
=0.04).

Conclusions
At diagnosis, total cfDNA is notably higher in preeclampsia, whereas the placental derived fraction remains similar to healthy pregnancies. In preeclampsia, higher total cfDNA correlates with earlier gestational age at delivery and higher systolic blood pressure. These findings may indicate increased release of cfDNA from maternal tissue injury.
Gender budgeting in public financial management: a literature review and research agenda
Authors: Polzer Tobias , Nolte Isabella M , Seiwald Johann 
Published: July 2021

Gender budgeting calls for including a gender perspective at all levels of governmental budgetary processes. While the literature on gender budgeting is interdisciplinary and covers a wide geographical range, it remains fragmented. This study uses a literature review to examine the current discourse on gender budgeting and to elicit avenues for future research. Our review shows that studies focus either on emerging economies, such as India or South Africa, or on countries in Europe. Drawing on an analytical framework, we find that most studies scrutinize the ex ante stages of gender budgeting, whereas less is known about the concurrent and ex post stages. Moreover, because little is known about the outcome and impact of gender budgeting, governments do not know what instruments function best in different settings. Given their ex ante focus, most studies on gender budgeting often either remain descriptive or analyse secondary data. Despite scholars from different disciplines contributing to the field of gender budgeting, several ‘blank spots’ remain, particularly in public sector accounting. Points for practitioners While current gender budgeting projects tend to focus on the ex ante stage of gender budgeting, future practitioner attention needs to focus on the equally important concurrent and ex post stages, which have received less attention thus far. An increasing number of governments worldwide are implementing gender budgeting projects. Governments need to evaluate the outcome and impact of these projects in a timely fashion, aiming at reducing structural inequalities related to gender. Gender budgeting is willingly adopted in times of prosperity and stability or when the scope of projects appears manageable. To avoid negative impacts on their achievements, policy makers need to put gender budgeting on the political agenda and institutionalize it in times of instability and crisis.
Difficulty factors of adrenal venous sampling based on patient characteristics and imaging findings
Authors: Kumasaka Soma , Tokue Hiroyuki , Tsushima Yoshito 
Published: July 2021

Background Primary aldosteronism is one of the most common causes of secondary hypertension. Unilateral primary aldosteronism can be treated with adrenalectomy; therefore, determining laterality is essential, for which adrenal venous sampling is considered the gold standard. However, as catheter insertion and sampling at an appropriate venous point is occasionally difficult, it is a time-consuming procedure. Purpose To evaluate the patient characteristics and imaging findings that influence the adrenal venous sampling procedure. Material and Methods A total of 69 patients who underwent adrenal venous sampling between January 2013 and December 2017 were retrospectively analyzed. The procedure was considered difficult if the duration was > 142 min (mean ± standard deviation [SD] of procedure time in this study) and/or proper sampling failed. Anatomical factors such as belly diameter, presence of adrenal nodules, diameter of the right adrenal vein and inferior vena cava, ratio of the diameters of the right adrenal vein to diameter of the inferior vena cava, vertical direction of the right adrenal vein, and vertebral level of the right adrenal vein were evaluated as predictive factors on computed tomography. Results Fifteen patients (21.7%) were considered difficult cases. The factors associated with difficulty were the long transverse diameter of the belly ( P = 0.004) and high vertebral level of the right adrenal vein ( P = 0.032). No statistical differences were observed in any other factors. Conclusion The long transverse diameter of the belly and high vertebral level of the right adrenal vein may prevent completion of the adrenal venous sampling procedure.
Unplanned Office Visits Following Outpatient Hand Surgery
Authors: Townsend Clay B. , Henry Tyler W. , Lutsky Kevin F. , Beredjiklian Pedro K. 
Published: July 2021

Background Returning to the office for an unplanned visit postoperatively can be burdensome to both the patient and provider. The purpose of this study was to quantify the rate of unplanned office visits after common soft tissue hand surgeries and assess the reasons for these unplanned visits. Methods Patients who underwent common soft tissue hand surgeries over a 6-month time period were queried from an electronic medical record database. Manual chart review was performed to record patient demographics, unplanned visits within 3 months postoperatively, and specific reasons for unplanned visits. A total of 1648 postoperative follow-up visits in 1224 patients were included in analysis. Results Within 3 months of surgery, 6.3% (103/1648) of postoperative visits were found to be unplanned. There was no difference in the rate of unplanned visits among the included surgeries ( P = .46). The most common reasons for an unplanned office visit overall were wound problems (34%), pain (23.3%), and stiffness (17.5%). The trigger finger release group had significantly more patients return to the office for stiffness ( P = .01), the De Quervain release group had significantly more patients return for pain ( P = .02), and the carpal tunnel release group had significantly more patients return for persistent symptoms ( P < .05). Conclusions Unplanned office visits represented about 1 of 16 postoperative visits. Orthopedic surgeons should be aware of the most common reasons for these visits and be prepared to address these problems promptly. Preoperative patient education on these potential problems may help decrease the frequency of unplanned follow-up visits.
Treatment of Pyogenic Flexor Tenosynovitis in the Emergency Department Setting With WALANT Technique
Authors: Braza Matthew E. , Kelley Joshua P. , Kelpin John P. , Fahrenkopf Matthew P. , Do Viet H. 
Published: July 2021

Background The standard of care for treatment of pyogenic flexor tenosynovitis (PFT) involves antibiotic therapy and prompt irrigation of the flexor tendon sheath, traditionally performed in the operating room. With the acceptance of wide-awake local anesthesia no tourniquet (WALANT) hand surgery and its potential ability to minimize time to flexor tendon sheath irrigation, we sought to determine whether closed irrigation of the flexor tendon sheath could be safely and effectively performed in the emergency department setting with WALANT technique. Methods A retrospective review was conducted of the senior author’s hand surgery consultations over a 12-month period. Six patients were identified who were diagnosed with PFT and subsequently underwent irrigation of the flexor tendon sheath using WALANT technique. Patient outcomes such as length of hospital stay, need for reoperation, infectious etiology, perioperative complications, and postprocedure range of motion (ROM) were identified. Results Six patients with diagnosis of PFT underwent irrigation of the flexor tendon sheath in the emergency department with local anesthesia only. The irrigation procedures were all well-tolerated. One patient required reoperation due to lack of appropriate clinical improvement following initial irrigation. Four of 6 patients regained their preinjury ROM while the remaining 2 patients had mild proximal interphalangeal joint extension lag. There were no complications associated with the procedures. Conclusions Surgical treatment of PFT with closed irrigation of the flexor tendon sheath in the emergency department utilizing WALANT technique was safe, effective, and well-tolerated. Local anesthesia alone can be used effectively for irrigation procedures of the flexor tendon sheath.