Access History Research Articles

Automatically Reducing Privilege for Access Control Policies

Access control policies are programs used to secure cloud resources. These polices should only grant the necessary permissions that a given application needs. However, it is challenging to write and maintain policies as applications and their required permissions change over time. In this paper, we focus on the Amazon Web Services (AWS) IAM policy language and present an approach that, given a policy, synthesizes a modified policy that is more restrictive and better abides to the principle of least privilege. Our approach looks at the actual access history (e.g., access logs) used by an application and computes the least permissive local modification of the user-given policy that still provides the same permissions that were observed in the access history. We treat the problem of computing the least permissive policy as a generalization problem in a lattice of possible policies (i.e., the set of local modifications). We show that our synthesis algorithm comes with correctness guarantees and is amendable to an efficient implementation that is easy to parallelize. We implement our algorithm in a tool IAM-PolicyRefiner and evaluate it on policies attached to AWS roles with access logs. For each role, IAM-PolicyRefiner can compute easy-to-inspect refined policies in less than 1 minute, and the refined policies do not overfit to the requests in the log---i.e., the policies also allow requests in a left-out test set of requests.

Comparing Parent Perception of Neurodevelopment after Primary versus Staged Repair of Neonatal Symptomatic Tetralogy of Fallot

To assess the association between primary (PR) and staged repair (SR) of neonatal symptomatic tetralogy of Fallot (sTOF) and neurodevelopmental outcomes in preschool through school-age children. Multi-center cohort (n=9 sites) study of sTOF patients who underwent neonatal intervention between 2005 and 2017. The neurodevelopmental outcomes measures included caregivers' ratings of executive function with the Behavior Rating Inventory of Executive Function (BRIEF), and psychosocial functioning with the Behavior Assessment System for Children - 3rd Edition (BASC-3). Results were compared with normative data and by treatment strategy (PR versus SR). A parent survey assessed history of disabilities and access to services related to neurodevelopment. Although the majority of patients (median age 8.3 years, interquartile range 5.7-11.2) had median BRIEF and BASC-3 scores within the normal range, a proportion had clinically elevated (abnormal) scores, especially in the school-age patient subgroup (BRIEF 24-30% and BASC 20-37%). There were no statistically significant differences based on treatment strategy for either the BRIEF or BASC-3. However, lower birth weight, genetic syndrome, and medical complexity were significantly associated with worse executive function, and lower maternal education was associated in school age children with lower executive and psychosocial functioning. Ongoing disabilities were relatively common (learning disability 35%, speech delay 33%, developmental delay 31%), although up to 50% of children were not receiving educational or developmental services. Elevated executive and psychosocial concerns are present in the sTOF patient population. Although initial treatment strategy appears unrelated to neurodevelopmental outcomes, lower birth weight, genetic syndrome, and medical complexity, and lower maternal education are risk factors. Early recognition of neurodevelopmental concerns can facilitate access to appropriate neuro-developmental services in this high-risk group.

The Maternal and Infant Health Consequences of Restricted Access to Abortion in the United States

Since the recent US Supreme Court decision in Dobbs v. Jackson Women's Health Organization, people across the country have experienced large sudden changes in their access to abortion care. In this paper, I look to the history of abortion access in the United States to inform predictions for this new future. I study the effects of targeted regulations on abortion providers (TRAP laws) on a variety of maternal and infant health outcomes, using variation in the timing of policy adoption across states and a direct measure of the distance to an abortion provider. I implement difference-in-differences techniques across outcomes from restricted-use microdata on the universe of US births. I find that TRAP laws lead to 11-16% increased rates of hypertensive disorders of pregnancy. Additionally, I find evidence that TRAP laws widen existing disparities in adverse infant health outcomes across parental race. These results demonstrate the potentially wide-ranging health effects of restricting access to abortion.

Vascular Access Related Infections in Hemodialysis Children and the Impact of Implementation of CDC Guidelines and Tools on the Control of these Infections: A Single Centre Experience from Egypt

Background: Vascular access-related infection (VARI) is a serious issue in pediatric end-stage kidney disease (ESKD) patients on regular hemodialysis. Objective: To estimate the frequency of vascular access-related infections in hemodialysis (HD) children and to assess the effect of the implementation of CDC guidelines and tools on the prevention of VARI. Subjects and Methods: This study was conducted on 110 patients with ESKD on regular hemodialysis at the Pediatric Dialysis Unit, Ain Shams University, from August 2019 to September 2021, retrospectively for one year and prospectively for another year after implementing the CDC infection control procedures. Besides full history taking, vascular access history, and thorough clinical examination, lab investigations for VARI diagnosis and echocardiography were performed. CDC infection control procedures were implemented for one year, and VARI was re-evaluated. Results: The total number of patients enrolled in the study was 110, they were 58 males (52.7%) and 52 females (47.3%). The incidence of infection per 1000 vascular access days in both years was highest in patients with NTVCs (10.447 /1000 NTVC days, 6.861 /1000 NTVCs days), followed by patients with TVCs (1.051/1000 TVC days, 0.604 /1000 TVC days) then patients with AVF, (0.141/1000 AVF days, 0.046 /1000 AVF days). The mortality from vascular access-related infections in the first year was higher than in the second year, with 5 patients (10.2%) and 1 patient (3.8%), respectively. The average duration of hospital stays (PPY) due to VARI (total admission days 8.09 and ward admission days 6.41) in the first year were significantly higher than in the second year, 4.04, 3.20 days/PPY, respectively. Conclusion: The incidence of vascular access infection (VAI) is higher with non-tunneled catheters and lowest with Arteriovenous fistulae (AVF). To reduce the risk of VARI and hospitalization, proper infection control procedures must be implemented.

Area-level credit scores and symptoms of depression and anxiety in adults.

Area-level credit scores may capture aspects of a neighborhood's resources and history that may affect population mental health beyond income and other demographic determinants. Using a sample of 511,363 adults in 1,438 Pennsylvania ZIP codes who completed the COVID-19 Trends and Impact Survey, we assessed the relationship between area-level VantageScores (nine categories from <675 to ≥850) and individual mental health. We estimate odds and predicted probability of depression and anxiety symptoms, adjusting for demographics and median household income. Given a history of discrimination and unequal access to the benefits of assets, we assess whether the relationship between area credit scores and individual mental health was different for different gender, age, race and ethnicity, and education groups. Persons who lived in ZIP codes with average credit scores of 700-725 reported 1.31 (95% CI 1.13, 1.52) and 1.22 (95% CI 1.07, 1.40) times the odds of frequent feelings of depression and anxiety symptoms, respectively, relative to persons living in ZIP codes with an average area level credit score ≥850. This translated to a difference of 2.8 and 2.5 percentage points in the predicted probability of symptoms of depression and anxiety, respectively, for persons living in lower versus higher area credit score ZIP codes. Stratified models appeared to show differences in the association of depression and anxiety with credit scores across demographic groups, but tests of interaction did not show significant differences between most groups. Findings suggest that area credit scores may capture assets that shape mental health over and above income and other demographic determinants.

Recurrent thrombosis and patency of the arteriovenous access in patients receiving hemodialysis.

Thrombosis of the vascular access in patients with end-stage renal disease requiring hemodialysis are common and require timely interventional procedures to restore patency. The aim of the current study was to identify factors having a significant effect on patency rates after access thrombosis. Our hypothesis was the length of time between the initial clotting of the access and the subsequent percutaneous declotting impacts the patency rates of the vascular access. In this retrospective cohort study, patients with a clotted arteriovenous access between Jan 1, 2011, and Jan 1, 2016, were included. Demographics, access history, and associated details of the access procedure were reviewed from the electronic medical record. Statistical analysis was done using t-test and chi-square or fisher exact tests to compare arteriovenous fistulae (AVF) and arteriovenous grafts (AVG). Primary patency, defined as the time from index procedure to endpoint, was analyzed using the Kaplan-Meier method and log rank test. There were 883 percutaneous declotting procedures reviewed. About 351 procedures were performed in patients with an AVF and 532 with an AVG. The mean time from thrombosis to declotting was 1.71 ± 2.29 days. The overall median primary patency for both AVF and AVG was 43 days with no difference in patency between patients with AVF (39 days) versus AVG (42 days; p = 0.385). The time period from access thrombosis to declotting did not affect patency rates for either AVG or AVF (p = 0.385). On multivariable analysis, prior intervention (HR: 1.32, 95% CI: 1.14-1.53, p < 0.001) and cardiovascular disease (HR: 1.19, 95% CI: 1.03-1.37, p = 0.016) were independently associated with access patency. Time from thrombosis to declotting did not affect patency rates however once there was a thrombotic event, recurrent thrombosis requiring intervention was common with patency significantly decreased. Future prospective studies to validate our results and study pathogenic mechanisms of recurrent thrombosis are warranted.

Hyperion: A Highly Effective Page and PC Based Delta Prefetcher

Hardware prefetching plays an important role in modern processors for hiding memory access latency. Delta prefetchers show great potential at the L1D cache level, as they can impose small storage overhead by recording deltas. Furthermore, local delta prefetchers, such as Berti, have been shown to achieve high L1D accuracy. However, there is still room for improving the L1D coverage of existing delta prefetchers. Our goal is to develop a delta prefetcher capable of achieving both high L1D coverage and accuracy. We explore delta prefetchers trained on various types of contextual information, ranging from coarse-grained to fine-grained, and analyze their L1D coverage and accuracy. Our findings indicate that training deltas based on the access histories of both PCs and memory pages for individual PCs and memory pages can lead to increased L1D coverage alongside high accuracy. Therefore, we introduce Hyperion, a highly efficient Page and PC-based delta prefetcher. In terms of the vital component of recording access histories, we implement three different structures and engage in a detailed discussion about them. Furthermore, Hyperion utilizes micro-architecture information (e.g., L1D hits or misses, PQ occupancy) and real-time L1D accuracy to dynamically adjust its issuing mechanism, further enhancing performance and L1D accuracy. Our results show that Hyperion achieves an L1D accuracy of 92.4% and an L1D coverage of 51.9%, along with an L2C coverage of 63.0% and an LLC coverage of 67.5% across a diverse range of applications, including SPEC CPU2006, SPEC CPU2017, GAP, and PARSEC, with a baseline of no prefetching. Regarding performance, Hyperion achieves a 50.1% performance gain, outperforming the state-of-the-art delta prefetcher Berti by 5.0% over baseline across all memory-intensive traces from the four benchmark suites.

“She is finally home”: feminist storytelling, family imaginaries and transnational solidarity in Irish abortion activism

ABSTRACT Across the so-called West, feminist storytelling positions reproductive justice and the often-twinned issue of women’s place within the family as a progressive issue. This conveniently ignores the inherent contradictions of the existence of only limited access to abortion in many Western nations, as well as parallel histories of access to reproductive justice in non-Western countries. Postcolonial Ireland, as an apparently Western country with a renowned history of anti-feminist legislation, has existed as one of these contradictions. In this article, we examine Irish feminists’ familial storytelling to reveal how they managed their contradictory position in a teleological narrative that positioned Western feminism as the epitome of progress. We adopt a comparative approach – looking at the lead up to the introduction of the Eighth Amendment of the Irish Constitution in 1983, which awarded the foetus constitutional rights, and then the high profile Repeal the 8th movement that successfully revoked that amendment in 2018 – to understand reproductive rights activists’ changing uses of “the family” to effect intergenerational and transnational solidarity. Applying Sara Ahmed’s concept of “sticky” emotions, we examine how feminists transformed “the Irish family” from a site of coldness and despair to one of hope, dignity, humanity and happiness.

“Spouses have a huge role” in preventing firearm suicide among women veterans: Partners' perspectives, experiences, and needs

Many women Veterans have access to firearms owned by their partners; therefore, understanding partners' perspectives, experiences, and needs regarding firearm lethal means safety (LMS) is essential. Twenty-five partners of women Veterans with a history of household firearm access participated in this mixed methods study. Nearly all participants expressed that if their partner was suicidal, they would be willing to take steps to reduce their partner's firearm access and to participate in firearm LMS discussions with their partner's healthcare provider. However, only a subset reported engaging in such behaviors. Participants reported needing information and guidance regarding actionable firearm LMS strategies (e.g., safe storage locations). Firearm LMS can be facilitated by supporting women Veterans' partners in recognizing and responding to suicide risk and providing them with guidance and tools to support reducing firearm access when suicide risk is elevated.

The impact of history of depression and access to weapons on suicide risk assessment: a comparison of ChatGPT-3.5 and ChatGPT-4.

The aim of this study was to evaluate the effectiveness of ChatGPT-3.5 and ChatGPT-4 in incorporating critical risk factors, namely history of depression and access to weapons, into suicide risk assessments. Both models assessed suicide risk using scenarios that featured individuals with and without a history of depression and access to weapons. The models estimated the likelihood of suicidal thoughts, suicide attempts, serious suicide attempts, and suicide-related mortality on a Likert scale. A multivariate three-way ANOVA analysis with Bonferroni post hoc tests was conducted to examine the impact of the forementioned independent factors (history of depression and access to weapons) on these outcome variables. Both models identified history of depression as a significant suicide risk factor. ChatGPT-4 demonstrated a more nuanced understanding of the relationship between depression, access to weapons, and suicide risk. In contrast, ChatGPT-3.5 displayed limited insight into this complex relationship. ChatGPT-4 consistently assigned higher severity ratings to suicide-related variables than did ChatGPT-3.5. The study highlights the potential of these two models, particularly ChatGPT-4, to enhance suicide risk assessment by considering complex risk factors.

Axillary and brachial artery aneurysm associated with a longstanding arteriovenous fistula

Upper extremity true arterial aneurysms are rare and often present as a pulsatile mass with associated pain and paresthesia from peripheral nerve compression, and can lead to acute limb ischemia from thromboembolic sequela. History of arteriovenous dialysis access and immunosuppression after renal transplantation may contribute to the development of true aneurysms.This report describes the management of a patient with end-stage renal disease (ESRD) with multiple left upper extremity dialysis access who presented with an axillary and brachial artery aneurysm.

Access to Justice: A Taxonomy of Conflict and Dispute Phases

The existence of conflicts and disputes in consumer trade has great implications for many parties because its effects can affect the current situation of consumers and the country's trade sector. Dispute resolution bodies that are procedural, ethical and have their own positive values, need to play a role in dealing with disputes brought by the parties involved. Traditionally and in practice for centuries, the court has an important function to administer and uphold the law by hearing any dispute filed according to the established procedure. This privilege, however, did not last long because consumer trade disputes changed direction by choosing alternatives and other forms of resolution mechanisms that more suit their needs, such as various Alternative Dispute Resolutions (ADR) mechanisms. This paper employs a qualitative research method to achieve the objective in discussing several theories of conflict and disputes analyse by several prominent experts. Various types of conflict theories that lead to several forms of disputes and a variety of management techniques or responses to control them from continuing are also detailed. For consumer trade disputes, the history and background of access to justice for consumers was also studied to get the real scenario of disputes that consumers often face, especially in the current era.

The Outcomes of Peripherally Inserted Central Catheter (PICC) Insertion in Pediatric Patients at Siriraj Hospital

Objective: Peripherally Inserted Central Catheters (PICC) are widely used for intermediate to long term venous access. Venipunctures and catheterizations in pediatric patients can be challenging and traumatizing to children’s veins due to frequent and painful needle sticks. This study aims to demonstrate the outcomes of PICC insertion and management in pediatric patients by the Anesthesia Line Service Team (ALiST) at Siriraj Hospital. Materials and Methods: This is a retrospective, descriptive study collecting data from January 2018 to December 2021. The inclusion criteria were pediatric patients aged 15 years and under, body weight equal to or exceeding 5 kg with no history of previous complicated central venous accesses. The primary outcome is the success rate of insertion. Results: 124 PICCs were inserted in pediatric patients. The median age of patients was 5.0 years, with a median height of 107.8 cm, and a median weight of 10.0 kg. The successful insertion rate was 96.92%, and all insertions were inserted using ultrasound-guided technique, with or without fluoroscopy. No acute complications were noted during insertion. Most patients received either intravenous sedation (39.5%) or general anesthesia (26.6%) during the procedure. The mean duration of catheter indwelling was 66.48 days. Reasons for removal of PICC included completion of therapy and patient demise (70.97%), catheter malformation (8.06%), accidental removal (4.03%), infection (8.06%), and patient non-adherence (1.61%). Conclusion: Our research demonstrates a notably high rate of successful PICC placement among pediatric patients, with data indicating a minimal occurrence of complications and an extended duration of catheter usage.

Stroke and suicide among people with severe mental illnesses

The associations between people with severe mental illnesses (SMI) and the risks of stroke, suicide, and death remain unclear. We examined healthcare service usage among adults with and without SMI and explored the risk of stroke, suicide, and death. We divided 18–80-year-old adults with SMI into catastrophic and non-catastrophic illness groups. These groups were subjected to a 1:5:5 propensity score matching with people without SMI. Data on demographic characteristics, economic factors, environmental factors, comorbid conditions, self-injury behavior, the number of outpatients and ED visits, and hospitalization were collected. The primary outcomes were risks of stroke, suicide, and death. We included 19,570 people with catastrophic SMI, 97,850 with non-catastrophic SMI, and 97,850 controls. Patients with SMI, especially those with catastrophic illnesses, had higher stroke risk, suicide, and death than those without SMI. People with SMI used health services more frequently than those without SMI. Patients with a history of hospitalization or ED access had a higher risk of stroke, suicide, and death. Our data indicate that special attention should be given to patients with SMI, particularly those with a history of healthcare service utilization, such as through more extended hospital stays with high-intensity interventions.

A single center study of the efficacy and safety of Pro-Glide used for closure in thoracic endovascular aortic repair in patients with previous groin intervention.

This study aimed to evaluate the efficacy and safety of Pro-Glide, a suture-mediated vascular closure device, regarding technical success and complications in patients who had undergone aortic intervention and had previous groin intervention (PGI). One hundred and thirty-five patients who underwent percutaneous thoracic endovascular aortic repair via the femoral artery and were closed with the Pro-Glide device were analyzed retrospectively. PGI was defined as a history of open surgical access to the femoral artery or wide sheath (>18 F) placement due to endovascular or valvular intervention. The patients were divided into two groups 38 cases with PGI and 97 cases without PGI. The overall success rate of closure of the femoral artery with Pro-Glide was not statistically significant between the two groups (93.8% vs 92.1%, p = .711). Sheath sizes were compared between the groups and PGI (+) group had significantly higher sheath sizes compared to PGI (-) group (24.3 ± 1.1 F vs 23.8 ± 1.0 F, p = .011). Three patients in the PGI (+) group and six patients in the PGI (-) group experienced technical failure of the percutaneous femoral approach. Femoral complications were seen after the procedures in four patients in the PGI (+) group and four in the PGI (-) group. The PGI (+) group had a higher complication rate when compared to the PGI (-) group; however, this was not statistically significant (p = .181). The present study was conducted on a significantly larger sample compared to previous studies and the findings suggest that the Pro-Glide vascular closure device is a safe option for patients with a history of PGI and may not be considered as a contraindication.

Accessing Traumatic Pasts through Play: Children’s Perspectives in Two Chilean Theatre Pieces

This paper examines Lola Arias’ El año en que nací (2012), and Gemelos by Chile’s La Troppa (1999), two theatre works which both approach the telling of trauma and representing experiences of life during dictatorship through the eyes of children. In both works, affective experiences of the dictatorship (knowledge difficult to document and discern in the official narrative) are communicated to the viewing audience by incorporating game playing and lightening tactics such as humor. Through moments of engaging in play, the incorporation of toys, role-playing, humor and laughter, a lightened mood of confronting serious social problems is suggested. I conclude that a ludic representation of trauma and violence may be one of the primary ways that the second generation approaches this charged, difficult to access history while negotiating with and evaluating post-memories and their society’s collective memory.

Association between heart failure and arteriovenous access patency in patients with end-stage renal disease on hemodialysis

BackgroundHeart disease and chronic kidney disease are often comorbid conditions owing to shared risk factors, including diabetes and hypertension. However, the effect of congestive heart failure (CHF) on arteriovenous fistula (AVF) and AV graft (AVG) patency rates is poorly understood. We hypothesize preexisting HF may diminish blood flow to the developing AVF and worsen patency. MethodsWe conducted a single-institution retrospective review of 412 patients with end-stage renal disease who underwent hemodialysis access creation from 2015 to 2021. Patients were stratified based on presence of preexisting CHF, defined as clinical symptoms plus evidence of reduced left ventricular ejection fraction (EF) (<50%) or diastolic dysfunction on preoperative echocardiography. Baseline demographics, preoperative measures of cardiac function, and dialysis access-related surgical history were collected. Kaplan-Meier time-to-event analyses were performed for primary patency, primary-assisted patency, and secondary patency using standard definitions for patency from the literature. We assessed differences in patency for patients with CHF vs patients without CHF, patients with a reduced vs a normal EF, and AVG vs AVF in patients with CHF. ResultsWe included 204 patients (50%) with preexisting CHF with confirmatory echocardiography. Patients with CHF were more likely to be male and have comorbidities including, diabetes, chronic obstructive pulmonary disease, hypertension, and a history of cerebrovascular accident. The groups were not significantly different in terms of prior fistula history (P = .99), body mass index (P = .74), or type of hemodialysis access created (P = .54). There was no statistically significant difference in primary patency, primary-assisted patency, or secondary patency over time in the CHF vs non-CHF group (log-rank P > .05 for all three patency measures). When stratified by preoperative left ventricular EF, patients with an EF of <50% had lower primary (38% vs 51% at 1 year), primary-assisted (76% vs 82% at 1 year), and secondary patency (86% vs 93% at 1 year) rates than those with a normal EF. Difference reached significance for secondary patency only (log-rank P = .029). AVG patency was compared against AVF patency within the CHF subgroup, with significantly lower primary-assisted (39% vs 87% at 1 year) and secondary (62% vs 95%) patency rates for AVG (P < .0001 for both). ConclusionsIn this 7-year experience of hemodialysis access creation, reduced EF is associated with lower secondary patency. Preoperative CHF (including HF with reduced EF and HF with preserved EF together) is not associated with significant differences in overall hemodialysis access patency rates over time, but patients with CHF who receive AVG have markedly worse patency than those who receive AVF. For patients with end-stage renal disease and CHF, the risks and benefits must be carefully weighed, particularly for those with low EF or lack of a suitable vein for fistula creation.

Predicting recurrent interventions after radiocephalic arteriovenous fistula creation with machine learning and the PREDICT-AVF web app.

Kidney Disease Outcomes Quality Initiative (KDOQI) guidelines discourage ongoing access salvage attempts after two interventions prior to successful use or more than three interventions per year overall. The goal was to develop a tool for prediction of radiocephalic arteriovenous fistula (AVF) intervention requirements to help guide shared decision-making about access appropriateness. Prospective cohort study of 914 adult patients in the United States and Canada undergoing radiocephalic AVF creation at one of the 39 centers participating in the PATENCY-1 or -2 trials. Clinical data, including demographics, comorbidities, access history, anatomic features, and post-operative ultrasound measurements at 4-6 and 12 weeks were used to predict recurrent interventions required at 1 year postoperatively. Cox proportional hazards, random survival forest, pooled logistic, and elastic net recurrent event survival prediction models were built using a combination of baseline characteristics and post-operative ultrasound measurements. A web application was created, which generates patient-specific predictions contextualized with the KDOQI guidelines. Patients underwent an estimated 1.04 (95% CI 0.94-1.13) interventions in the first year. Mean (SD) age was 57 (13) years; 22% were female. Radiocephalic AVFs were created at the snuffbox (2%), wrist (74%), or proximal forearm (24%). Using baseline characteristics, the random survival forest model performed best, with an area under the receiver operating characteristic curve (AUROC) of 0.75 (95% CI 0.67-0.82) at 1 year. The addition of ultrasound information to baseline characteristics did not substantially improve performance; however, Cox models using either 4-6- or 12-week post-operative ultrasound information alone had the best discrimination performance, with AUROCs of 0.77 (0.70-0.85) and 0.76 (0.70-0.83) at 1 year. The interactive web application is deployed at https://predict-avf.com. The PREDICT-AVF web application can guide patient counseling and guideline-concordant shared decision-making as part of a patient-centered end-stage kidney disease life plan.

#AccessibleYoga for whom? The non-performativity of accessibility and inclusion on Instagram

ABSTRACT Yoga has a long contentious history of accessibility and inclusion. Scholars and practitioner-activists today call for inclusive yoga; however, even within seemingly inclusive yoga campaigns in digital spaces, depictions of the practice often exclude bodies of difference. We use Sara Ahmed’s theorizing of non-performatives to explore #AccessibleYoga and #InclusiveYoga and understand how possibilities for bodies of difference are profuse or sparse on Instagram. Layering our analysis with Rosemarie Garland-Thomson’s feminist disability theory of misfitting, we consider yoga’s potential to create places for bodily affirmation in the future of yoga worlds. For our study, we applied a reflexive thematic analysis and named the following themes: the non-performativity of language, permissible diversity, and cripping yoga(?). We found diversity at the exclusion of disability, but also observed creative use of props that nods to the potential cripping of yoga. We interrogate the non-performativities of language within yoga and explore relational approaches to access.

USE of IMplanting the Biotronik PassEo-18 Lux drug coated balloon to treat failing haemodialysis arteRiovenous FIstulas and grafts (SEMPER FI Study)

Background: Plain old balloon angioplasty has been the mainstay of treatment for arteriovenous fistula (AVF) stenoses. Recent studies suggest that drug coated balloons (DCB) may significantly reduce re-intervention rates on native and recurrent lesions. The Passeo-18 Lux DCB (Biotronik AG, Buelach, Switzerland) is packaged with a 3.0 µg/mm2 dose of paclitaxel. The hypothesis is that its use provides better target lesion primary patency (TLPP), primary assisted patency (PP), secondary patency (SP) rates and reduces the number of visits for re-intervention in a cohort of patients with stenotic AVF and arteriovenous grafts (AVGs). Methods: The USE of IMplanting the Biotronik PassEo-18 Lux DCB to treat failing haemodialysis arteRiovenous FIstulas and grafts trial (SEMPER FI) was a prospective double-centre, multi-investigator, non-consecutive, non-blinded single-arm study investigating the efficacy and safety of the Passeo-18 Lux DCB in patients with stenotic AVF/AVG lesions between January 2021 and January 2022. Patient demographics, clinical characteristics, vascular access history, operative indications, details and outcomes were collected prospectively. TLPP, circuit access primary patency (CAP), PP, SP and deaths 6- and 12-months post-intervention were studied. Results: Ninety-one patients with 110 lesions were recruited across the two centres. 62.6% ( n = 57) were male with a median age of 63.5 years (SD = 10.5). 62.6% ( n = 57) were taking anti-platelets. Eighty-five AVFs and six AVGs were treated. 60% ( n = 54) of AVFs intervened were radiocephalic. 52.7% ( n = 58) of targeted lesions were juxta-anastomotic stenosis (JAS) and one-third ( n = 33) at the AVF/AVG outflow. 70.9% ( n = 78) of lesions were recurrent. Median time from last intervention was 219 days. 78% of target lesions ( n = 85) and circuits ( n = 70) were patent at 6-months, of which 96.7% ( n = 87) of those requiring assisted intervention were patent. Conclusion: This study shows that the Passeo-18 Lux DCB can be an effective and safe tool in the treatment of failing haemodialysis AVFs/AVGs.