bluuebunny/crossref_metadata_2025_split huggingface dataset:
Considerations for neonatal and pediatric pain management
Authors: Shah Pooja , Siu Anita 
Published: August 2019

Abstract

Purpose
Current literature and clinical practice guidelines on pediatric pain management are reviewed.

Summary
Acute pain is commonly present in neonatal and pediatric patients due to underlying disease states or procedures. Especially in institutions with limited pediatric pain services, it is imperative to describe the appropriate management of pain and pharmacotherapy options that are effective and safe in pediatric patients. Despite the knowledge of pain being an important aspect in the management of children, barriers exist, leading to suboptimal treatment. Addressing these barriers through education of healthcare practitioners, families, and patients will lead to optimizing the patient pain experience. Tools for pain assessment vary depending on the type of pain, the child’s age and understanding of pain, and the clinical situation. Pharmacotherapy options for pain management in neonates and pediatric patients include opioid and nonopioid agents. Efficacy and safety data on the use of medications for the treatment of pain in pediatric patients is described. The delivery of medication encompasses patient-specific factors and preferences. Strategies for opioid stewardship and management of iatrogenic withdrawal pose a unique challenge in pediatric patients.

Conclusion
The management of acute pain in neonates and pediatric patients should be a priority for all practitioners caring for these patients. Use of age-appropriate pain assessment tools and understanding of the mechanisms of action and roles in therapy of various nonopioid and opioid therapies can help optimize treatment of pain in neonatal and pediatric patients.
Effect of Publicly Reported Aortic Valve Surgery Outcomes on Valve Surgery in Injection Drug– and Non–Injection Drug–Associated Endocarditis
Authors: Kimmel Simeon D , Walley Alexander Y , Linas Benjamin P , Kalesan Bindu , Awtry Eric , Dobrilovic Nikola , White Laura , LaRochelle Marc 
Published: August 2019

Abstract

Background
Injection drug use–associated infective endocarditis (IDU-IE) is rising and valve surgery is frequently indicated. The effect of initiating public outcomes reporting for aortic valve surgery on rates of valve surgery and in-hospital mortality for endocarditis is not known.

Methods
For an interrupted time series analysis, we used data from the National Inpatient Sample, a representative sample of United States inpatient hospitalizations, from January 2010 to September 2015. We included individuals aged 18–65 with an International Classification of Diseases, Ninth Revision (ICD-9) diagnosis of endocarditis. We defined IDU-IE using a validated combination of ICD-9 codes. We used segmented logistic regression to assess for changes in valve replacement and in-hospital mortality rates after the public reporting initiation in January 2013.

Results
We identified 7322 hospitalizations for IDU-IE and 23 997 for non–IDU-IE in the sample, representing 36 452 national IDU-IE admissions and 119 316 non-IDU admissions, respectively. Following the implementation of public reporting in 2013, relative to baseline trends, the odds of valve replacement decreased by 4.0% per quarter (odds ratio [OR] 0.96, 95% confidence interval [CI] 0.93–0.99), with no difference by IDU status. The odds of an in-patient death decreased by 2.0% per quarter for both IDU-IE and non–IDU-IE cases following reporting (OR 0.98, 95% CI 0.97–0.99).

Conclusions
Initiating public reporting was associated with a significant decrease in valve surgery for all IE cases, regardless of IDU status, and a reduction in-hospital mortality for patients with IE. Patients with IE may have less access to surgery as a consequence of public reporting. To understand how reduced valve surgery impacts overall mortality, future studies should examine the postdischarge mortality rate.
Caregiving and Place: Combining Geographic Information System (GIS) and Survey Methods to Examine Neighborhood Context and Caregiver Outcomes
Authors: Beach Scott R , Kinnee Ellen , Schulz Richard 
Published: August 2019

Abstract

Background
Little is known about the impact of neighborhood context on family caregivers, or how environmental factors combine with individual-level caregiver risk factors to affect caregiver outcomes.

Objectives
To combine Geographic Information System (GIS) and survey methods to examine the effects of caregiver residence in disadvantaged/underserved neighborhoods on caregiver outcomes.

Research Design and Methods
Telephone surveys with 758 caregivers from the Pittsburgh Regional Caregiver Survey geocoded for classification into Environmental Justice Areas (EJAs) and Medically Underserved Areas (MUAs). We examine the impact of EJA/MUA caregiver residence on care recipient unmet needs for care, caregiver depression and burden, and positive aspects of caregiving, adjusting for sociodemographics, caregiving context, care recipient disability level, caregiving intensity, and additional risk factors.

Results
There was spatial clustering of caregiver depression and burden outside of the disadvantaged/underserved areas, while positive aspects of caregiving were clustered within EJAs/MUAs. Approximately 36% of caregivers lived in EJAs/MUAs, and they differed, sociodemographically, on caregiver risk factors and caregiver outcomes. Multivariable models showed that caregivers residing in EJAs/MUAs were less likely to be depressed and reported more positive aspects of caregiving after adjusting for known individual-level risk factors. Residence in disadvantaged/underserved areas also modified the effects of several risk factors on caregiver outcomes.

Discussion and Implications
Caregiver outcomes show interesting spatial patterns. Unexpectedly, caregivers living in these potentially challenging environments were less depressed and reported more gains from caregiving after adjusting for known risk factors. Results suggest that socioeconomic disadvantage does not necessarily translate into poor caregiver outcomes. Understanding the mechanism for these effects is important to designing effective caregiver interventions. The paper also demonstrates the value of using GIS methods to study caregiving.
Multilateral public order and issues of responsibility
Authors: Crawford James 
Published: August 2019

Abstract
International law has remained imprecise with respect to the scope and consequences of serious, systemic illegality, but there have been developments that have made collective action under law possible. The chapter reviews the objective consequences of illegal acts, covering peremptory norms (ius cogens), the obligation not to recognize a situation as lawful, and the obligation of putting an end to an unlawful situation.
The international minimum standard: Diplomatic protection and protection of investments
Authors: Crawford James 
Published: August 2019

Abstract
This chapter considers two discrete streams of authority – one based on the practice and jurisprudence of diplomatic protection, the other based on the generic standards in over 2,500 bilateral and multilateral investment treaties, as applied in some hundreds of tribunal decisions. The discussions cover the admission, expulsion, and liabilities of aliens; requirements for and standards of diplomatic protection; and breach and annulment of state contracts.
Geographical Variation and Factors Associated With Inflammatory Bowel Disease in a Central Canadian Province
Authors: Torabi Mahmoud , Bernstein Charles N , Yu B Nancy , Wickramasinghe Lahiru , Blanchard James F , Singh Harminder 
Published: August 2019

Abstract

Background
We investigated temporal trends, geographical variation, and geographical risk factors for incidence of inflammatory bowel disease (IBD).

Methods
We used the University of Manitoba IBD Epidemiology Database to identify incident IBD cases diagnosed between 1990 and 2012, which were then geocoded to 296 small geographic areas (SGAs). Sociodemographic characteristics of the SGAs (proportions of immigrants, visible minorities, Indigenous people, and average household income) were obtained from the 2006 Canadian Census. The geographical variation of IBD incidence was modeled using a Bayesian spatial Poisson model. Time trends of IBD incidence were plotted using Joinpoint regression.

Results
The incidence of IBD decreased over the study years from 23.6 (per 100,000 population) in 1990 to 16.3 (per 100,000 population) in 2012. For both Crohn’s disease (CD) and ulcerative colitis (UC), the highest incidence was in Winnipeg and the southern and central regions of Manitoba, whereas most of northern Manitoba had lower incidence. There was no effect of sociodemographic characteristics of SGAs, other than the proportion of Indigenous people, which was associated with lower IBD incidence.

Conclusions
Although the incidence of IBD in Manitoba is decreasing over time, we have identified geographic areas with persistently higher IBD incidence that warrant further study for etiologic clues.
Cohomologically Full Rings
Authors: Dao Hailong , De Stefani Alessandro , Ma Linquan 
Published: August 2019

Abstract
Inspired by a question raised by Eisenbud–Mustaţă–Stillman regarding the injectivity of maps from ${\operatorname{Ext}}$ modules to local cohomology modules and the work by the third author with Pham, we introduce a class of rings, which we call cohomologically full rings. This class of rings includes many well-known singularities: Cohen–Macaulay rings, Stanley–Reisner rings, F-pure rings in positive characteristics, and Du Bois singularities in characteristics $0$. We prove many basic properties of cohomologically full rings, including their behavior under flat base change. We show that ideals defining these rings satisfy many desirable properties, in particular they have small cohomological and projective dimension. When $R$ is a standard graded algebra over a field of characteristic $0$, we show under certain conditions that being cohomologically full is equivalent to the intermediate local cohomology modules being generated in degree $0$. Furthermore, we obtain Kodaira-type vanishing and strong bounds on the regularity of cohomologically full graded algebras.
The impact of dietary supplementation of arginine during gestation in a commercial swine herd: II. Offspring performance
Authors: Hines Elizabeth A , Romoser Matthew R , Kiefer Zoë E , Keating Aileen F , Baumgard Lance H , Niemi Jarad , Haberl Benjamin , Williams Noel H , Kerr Brian J , Touchette Kevin J , Ross Jason W 
Published: August 2019

Abstract
Arginine (Arg) is an important amino acid of pig fetal development; however, whether Arg improves postnatal performance is ill-defined. Therefore, the influence of Arg supplementation at different gestational stages on offspring performance was evaluated in a commercial swine herd. Sows (n = 548) were allocated into 4, diet by stage of gestation treatments: Control (n = 143; 0% suppl. Arg), or dietary treatments supplemented with 1% L-Arg (free-base; Ajinomoto Animal Nutrition North America, Inc., Chicago, IL): from 15 to 45 d of gestation (n = 138; Early-Arg); 15 d of gestation to farrowing (n = 139; Full-Arg); and from day 85 of gestation to farrowing (n = 128; Late-Arg). All offspring were individually identified and weighed at birth; at weaning, a subset was selected for evaluation of carcass performance at market. All data were analyzed using birth weight (BiWt) and age as covariates. Wean weights (WW) and prewean (PW) ADG tended to increase (P = 0.06) in progeny from sows supplemented with Arg, as compared to progeny from Control sows. Preplanned contrast comparisons revealed an increased (P = 0.03) BiWt for pigs from sows receiving 1% L-Arg prior to day 45 of gestation (Early-Arg and Full-Arg; 1.38 kg/pig), as compared to pigs from sows not supplemented prior to day 45 of gestation (Control and Late-Arg; 1.34 kg/pig). No difference in BiWt was observed (1.36 kg/pig; P = 0.68) for Arg supplementation after day 85 of gestation (Full-Arg and Late-Arg), as compared to those not receiving Arg supplementation after day 85 (Control and Early-Arg); although WW and PW ADG were greater (P = 0.02), respectively. A 3.6% decrease (P = 0.05) in peak lean accretion ADG occurred when dams received 1% L-Arg prior to day 45 of gestation (Early-Arg and Full-Arg), however, no other significant differences were detected in finishing growth parameters or carcass characteristics (P ≥ 0.1). Pig mortality rates tended (P = 0.07) to decrease in progeny of dams supplemented Arg after day 85 (3.6%) compared to dams not provided additional Arg during late gestation (4.9%). Collectively, these data suggest that Arg provided during late gestation may improve WW and PW ADG, however, finishing performance was not affected. While Arg supplementation provided some moderate production benefits, further investigation is warranted to comprehensively understand the gestational timing and biological role of Arg supplementation during fetal and postnatal development in commercial production systems.
A unique case of congenital transmesocolic hernia with malrotation in a 25-year-old female: a case report
Authors: Danial Aghyad Kudra , Alsaman Muhamad Zakaria Brimo , Zazo Rama , Mazketly Muhammad , Kitaz Mohammad Nour , Alobied Majd , Mahli Nihad 
Published: August 2019

Abstract
Congenital transmesocolic hernia of the transverse colon is a very rare type of internal hernia. In addition, intestinal malrotation is very rare in adults. Most of these patients do not have clear clinical manifestations. Incidence of congenital transmesocolic hernia of the transverse colon along with malrotation is an unusual phenomenon in medical literature and clinical practice. Here, we report a unique case of a 25-year-old woman diagnosed with transmesocolic hernia of the transverse colon and malrotation of the small intestine, without any history of trauma or previous surgery. The patient underwent surgery, where the hernia orifice was closed and Ladd’s procedure was performed.
From Bondage to Precariousness? New Perspectives on Labor and Social History
Authors: De Vito Christian G , Schiel Juliane , van Rossum Matthias 
Published: August 2019

Abstract
This article pursues two goals. First, it reviews recent literature calling for a revised and extended history of work. Based on that review, it then explores the possibility of a new, empirically based analytical and methodological framework for the study of labor relations and the reinterpretation of contemporary issues, including precariousness, “modern slavery,” social inequality, and dependence. We contend that viewing labor relations as standardly diverse, coexisting, entangled, and overlapping across history provides an alternative organizing principle for the research field and is central to the understanding of larger social processes. To this end, we propose a contextualized, interrelational and transepochal approach to labor relations and labor experiences and discuss the potential of three research strategies: the analysis of the historical semantics of labor relations, the detailed study of coercion, and the historical investigation of the relation between precariousness and flexibility.
Real-bogus classification for the Zwicky Transient Facility using deep learning
Authors: Duev Dmitry A , Mahabal Ashish , Masci Frank J , Graham Matthew J , Rusholme Ben , Walters Richard , Karmarkar Ishani , Frederick Sara , Kasliwal Mansi M , Rebbapragada Umaa , Ward Charlotte 
Published: August 2019

ABSTRACT
Efficient automated detection of flux-transient, re-occurring flux-variable, and moving objects is increasingly important for large-scale astronomical surveys. We present braai, a convolutional-neural-network, deep-learning real/bogus classifier designed to separate genuine astrophysical events and objects from false positive, or bogus, detections in the data of the Zwicky Transient Facility (ZTF), a new robotic time-domain survey currently in operation at the Palomar Observatory in California, USA. Braai demonstrates a state-of-the-art performance as quantified by its low false negative and false positive rates. We describe the open-source software tools used internally at Caltech to archive and access ZTF’s alerts and light curves (kowalski ), and to label the data (zwickyverse). We also report the initial results of the classifier deployment on the Edge Tensor Processing Units that show comparable performance in terms of accuracy, but in a much more (cost-) efficient manner, which has significant implications for current and future surveys.
The potential of cerebrospinal fluid–based liquid biopsy approaches in CNS tumors
Authors: Mattox Austin K , Yan Hai , Bettegowda Chetan 
Published: August 2019

AbstractCerebrospinal fluid (CSF) may be the best hope for minimally invasive diagnosis and treatment monitoring of central nervous system (CNS) malignancies. Discovery/validation of cell-free nucleic acid and protein biomarkers has the potential to revolutionize CNS cancer care, paving the way for presurgical evaluation, earlier detection of recurrence, and the selection of targeted therapies. While detection of mutations, changes in RNA and miRNA expression, epigenetic alterations, and elevations of protein levels have been detected in the CSF of patients with CNS tumors, most of these biomarkers remain unvalidated. In this review, we focus on the molecular changes that have been identified in a variety of CNS tumors and profile the approaches used to detect these alterations in clinical samples. We further emphasize the importance of systemic collection of CSF and the establishment of standardized collection protocols that will lead to better cross-study biomarker validation and hopefully FDA-approved clinical markers.
Delayed Cerebral Infarction is Systematically Associated with a Cerebral Vasospasm of Large Intracranial Arteries
Authors: Brami Jonathan , Chousterman Benjamin , Boulouis Grégoire , Dorze Matthieu Le , Majlath Melinda , Saint-Maurice Jean-Pierre , Civelli Vittorio , Froelich Sébastien , Houdart Emmanuel , Labeyrie Marc-Antoine 
Published: August 2019

Abstract

BACKGROUND
Whether delayed cerebral infarction (DCIn) after aneurysmal subarachnoid hemorrhage (aSAH) is driven by large artery vasospasm is still controversial.

OBJECTIVE
To study the association between DCIn and vasospasm by using quantitative assessment of vasospasm up to distal arteries with time and territorial-based correlation.

METHODS
Clinical and imaging data of 392 patients with aSAH treated at our center between 2012 and 2017 were reviewed. DCIn was defined as any cerebral infarction occurring within 3 to 21 d after ictus and not related to other specific cause. In patients with DCIn, vasospasm was assessed within 24 h around DCIn for each cerebral artery up to the end of the 2nd segments. DCIn and vasospasm analyses were blinded.

RESULTS
DCIn was found in 11% of patients (inter-rater k = 0.90, computed tomography (CT)-scan = 100%, follow-up MRI = 91%). Vasospasm was quantified in 258 artery territories including 66 with and 192 without DCIn (DSA = 93%, computed tomography angiography = 7%). Vasospasm was more severe in DCIn than in non-DCIn territories (60% [55-69] vs 20% [0-50], P < .001). Vasospasm was associated with DCIn in a “dose-dependent” manner (P for trend = .022). Every DCIn territory had a vasospasm ≥ 50%, including 39% only of distal artery segments. Only 9% of non-DCIn territories had vasospasm ≥ vasospasm in DCIn territories.

CONCLUSION
The necessary association between severe vasospasm and DCIn in our study brings additional arguments in favor of large artery vasospasm (especially of distal segments) as a major determinant of DCIn and a potential therapeutic target.
Rigid Cranial Fixation for Robot-Assisted Stereoelectroencephalography in Toddlers: Technical Considerations
Authors: Alexander Hepzibha , Fayed Islam , Oluigbo Chima O 
Published: August 2019

Abstract

BACKGROUND
Stereoelectroencephalography (sEEG) using depth electrodes has become a mainstay of pediatric epilepsy surgery. This technique relies on rigid cranial fixation using skull pins, which forms the basis for accurate stereotactic navigation. The use of cranial fixation pins poses the threat of traumatic skull injuries in young children because of inadequate cranial bone thickness.

OBJECTIVE
To describe a rigid cranial fixation technique involving the integrated Gel Head Ring from the DORO QR3 multipurpose skull clamp set (Pro Med Instruments) with superimposed pin fixation in children below the age of 36 mo undergoing sEEG.

METHODS
Patients were placed in the supine position and the head was fixed using a DORO skull clamp with 3 pediatric cranial pins. The head was supported on the integrated Gel Head Ring, and a pin pressure of 20 pounds was applied. The DORO skull clamp set was then attached to the ROSA neurosurgical robot support telescopic arm for stereotactic navigation.

RESULTS
We present an illustrative series of 2 patients below the age of 3 yr with medically refractory epilepsy who underwent sEEG using our modified cranial fixation technique. Head position and reference registration were stable throughout the surgeries. Postoperative volumetric computed tomography scans of the head showed accurate placement of sEEG depth electrodes and did not reveal any fractures or epidural hematoma. No other complications related to cranial fixation were noted.

CONCLUSION
Concurrent use of rigid and nonrigid cranial fixation using the DORO skull clamp set provides safe and effective cranial fixation in infants and toddlers undergoing sEEG.
Occlusion of Extracranial-Intracranial Bypass Anastomosis-Associated Aneurysms Following Contralateral High-Flow Extracranial-Intracranial Bypass in a Patient with Impaired Cerebrovascular Reserve
Authors: Stapleton Christopher J , Theiss Peter , Arnone Gregory D , Shakur Sophia F , Charbel Fady T 
Published: August 2019

Abstract

BACKGROUND AND IMPORTANCE
Extracranial-intracranial (EC-IC) bypass anastomosis-associated aneurysms are rare sequelae of cerebral revascularization surgery. Although treatment paradigms are not well defined, clipping, trapping with revision bypass, and donor vessel ligation represent the most common microsurgical approaches.

CLINICAL PRESENTATION
A 53-yr-old male presented with cognitive decline, left extremity weakness, and left visual field blurriness. Computed tomographic angiography of head/neck demonstrated bilateral cervical internal carotid artery occlusion and magnetic resonance imaging of brain showed a small right parieto-occipital lobe infarct. The patient's symptoms worsened despite aggressive medical management. Therefore, a right superficial temporal artery to middle cerebral artery (STA-MCA) bypass was performed for flow augmentation. Follow-up digital subtraction angiography (DSA) approximately 1 yr after surgery noted 2 new aneurysms adjacent to the patent STA-MCA anastomosis. Perfusion imaging at that time showed persistently reduced blood flow in the left cerebral hemisphere. A left STA-MCA bypass was performed, and intraoperative blood flow measurements showed this to be a high-flow bypass. Follow-up DSA 4 mo later demonstrated involution of the right STA-MCA bypass and occlusion of the anastomosis-associated aneurysms with increased perfusion of the right cerebral hemisphere via collateral blood flow from the patent high-flow left STA-MCA bypass. At 7 mo following left STA-MCA bypass, the patient's neurological examination remained stable and perfusion imaging showed improved blood flow in the left cerebral hemisphere.

CONCLUSION
We present a unique case in which a high-flow left EC-IC bypass with robust contralateral collateral blood flow was associated with subsequent occlusion of a right EC-IC bypass and 2 anastomosis-associated aneurysms in a patient with bilateral impaired cerebrovascular reserve.