Project Management Strategies for Managing Metadata in Institutional Recordings Collections–A Case Study

This paper will cover project management decisions, workflows, and practical strategies adopted by a music-cataloging librarian while managing an academic institutional recordings collection. The paper is not intended to serve as a go-to resource for managing metadata in institutional recordings collections;rather, a practical approach to managing time, resources, and personnel while meeting institutional priorities as the project manager tasked with organization, metadata management, processing, and preservation of the physical collection. The paper will cover project management strategies for creating a collection inventory, which was later expanded to a full-level metadata collection during COVID-19 remote work. © 2022 The Author(s). Published with license by Taylor & Francis Group, LLC.

A Case of Bilateral Sequential Optic Neuropathies With Pachymeningitis and Aortitis: Difficulty in Differentiating Erdheim-Chester Disease From IgG4-Related Disease

Objective We describe a case of bilateral sequential optic neuropathies with pachymeningitis and aortitis, with findings that raised suspicion of Erdheim-Chester disease versus IgG-4 related disease. Background Erdheim-Chester disease (ECD) is a rare histiocytic neoplasm characterized by tissue infiltration by foamy histiocytes, and chronic, uncontrolled inflammation. IgG4-related disease (IgG4-RD) is an insidiously progressive immune-mediated fibrotic disease typified by tumour-likemass formation in many affected organs. Neurologic manifestations are diverse. Design/Methods A 58-year-old male was transferred to our centre for acute onset sequential optic neuropathies. His visual acuity was light perception for the right eye and 20/50 in the left eye. Results Enhanced MRI of the brain and orbits showed focal pachymeningeal thickening and enhancement in the anterior cranial fossa and over the left frontal lobe with eccentric enhancement of the right optic nerve sheath. CRP was elevated (23 mmol/L to 62 mmol/L);extensive CSF and serum infectious and inflammatory investigations were unrevealing. PET body demonstrated aortitis and CT angiography suggested coronary artery vasculitis. Bone scan showed symmetric involvement of the long bones. Dural biopsy was delayed due to the Covid-19 pandemic and was completed following a protracted steroid course and a 15 mg/kg dose of cyclophosphamide. Pathology showed mixed inflammatory infiltrate and increased expression of IgG4 neutrophils.Clusters ofCD68+,CD1a, and S100-negative macrophages were seen in all layers of dura. No BRAF mutation was identified. Conclusions This case demonstrates classic imaging findings of ECD including pachymeningitis, symmetric long bone involvement and aortitis. Pathology in ECD may show characteristic foamy histiocytes, that were absent in this case. This case demonstrates the challenge of biopsy interpretation following immunosuppressive and cytotoxic therapy and the difficulty of differentiating ECD from IgG4-RD.

Project Management Strategies for Managing Metadata in Institutional Recordings Collections–A Case Study

This paper will cover project management decisions, workflows, and practical strategies adopted by a music-cataloging librarian while managing an academic institutional recordings collection. The paper is not intended to serve as a go-to resource for managing metadata in institutional recordings collections;rather, a practical approach to managing time, resources, and personnel while meeting institutional priorities as the project manager tasked with organization, metadata management, processing, and preservation of the physical collection. The paper will cover project management strategies for creating a collection inventory, which was later expanded to a full-level metadata collection during COVID-19 remote work. © 2022 The Author(s). Published with license by Taylor & Francis Group, LLC.

Use of personal protective equipment by healthcare workers exposed to COVID-19 infection at a tertiary care hospital in a lower middle-income country

Introduction: Data on PPE use and COVID-19 transmission in a healthcare setting is sparse. Method: This study is a retrospective descriptive study on PPE use and Covid-19 transmission in a hospital. Data collected during routine risk assessment was analyzed using SPSS_26 software.

Early Adverse Outcomes of Liver Allografts from Donors with COVID Vaccine Induced Thrombosis and Thrombocytopenia Syndrome

Background: Vaccine-induced immune thrombotic thrombocytopenia (VITT) following the ChAdnOx1 nCOV-19 is a recently described syndrome that may have implications for organ transplantation. Our aim was to describe the early liver allograft outcomes from donors with VITT. Methods: A retrospective single centre case series was performed at a liver transplant centre in the United Kingdom. The study period was between the 1st of January and 1st of April 2021. Donors were included if they had new onset thrombocytopenia (<50x109) within 21 days of a COVID-19 vaccination and had their liver procured for transplant. The outcomes of interest were complications and graft survival during the first 30 days. Results: During the study period, five deceased brain-dead organ donors with VITT were identified. All donors developed thrombocytopenia 9 to 16 days following COVID-19 vaccination and died from intracranial haemorrhage. The demographics, platelet counts and location of thrombosis are demonstrated in Table 1. One graft was discarded due to extensive portal vein thrombosis. The remaining four organs were transplanted into five patients between the ages of 2 – 43, with one graft being split for an adult and a child (Table 2). Both recipients of the split graft experienced graft loss within the first post-operative week due to hepatic vein thrombosis. Another developed non-occlusive hepatic artery thrombus within an arterial conduit from the same donor. All five patients survived 30 days. Conclusions: Liver grafts from donors that have VITT appear to have a prothrombotic predisposition and should only be considered with caution. [Formula presented] [Formula presented]

Single centre experience of paediatric intestinal transplantation during the COVID-19 pandemic: Lessons from adapting to pandemic pressures

Introduction: The COVID-19 pandemic has created challenges for centres performing solid organ transplantation especially with the limited availability of donors, including restrictions related to lockdowns. We aimed to assess the impact of the measures and steps taken to mitigate these challenges in order to continue to deliver intestinal/multivisceral transplantation (I/MVTx). Methods: All I/MVTx between March 2020 to December 2020 were included in the study. Data were collated from a prospectively maintained departmental database and are presented descriptively. Results: All potential I/MVTx recipients were suspended at the start of the pandemic and were reactivated after an eight week period of risk assessment. A total of five transplants were performed during the study period. (Table-1) All recipients and donors were COVID tested just prior to surgery and managed through a COVID clean patient pathway as per NHSBT. Discussion: Pre-operative precautions (screening of donor history, additional endotracheal swabs and recipient swabs) were in place at the time of the procedures. Clinical urgency mandated conscious decisions such as liver reduction and staged abdominal closure in two patients with intractable GI bleeding. Intra-operative risk mitigation strategies included utilisation of standard PPE, minimal personnel in theatre and minimisation of surgical pauses. The prioritisation of the procedures to experienced donor and recipient surgeons allowed for short Cold ischemia times (some recipient operations were started prior to cross clamp at the donor site). No changes were made to immunosuppression protocols. Post-operative follow up was changed to minimize recipient visits to the hospital. There were no routine follow up endoscopies and stomal biopsies were reduced to once-a-week and when clinically indicated. No routine follow up face-to-face outpatient appointments were made. Instead, parents were educated and supported through a process of daily weight and stoma output monitoring and these were directly reported to the consultant through e-mail. Conclusion: Adaptation to different challenges during the pandemic permitted restitution of the intestinal transplant pathway without any deleterious effect on outcomes. Changes in post discharge practice introduced will continue and may improve the patient care pathway.