bluuebunny/crossref_metadata_2025_split huggingface dataset:
Super-giant pulses from the Crab pulsar: energy distribution and occurrence rate
Authors: Bera Apurba , Chengalur Jayaram N 
Published: September 2019

ABSTRACT
We present statistical analysis of a fluence-limited sample of over 1100 giant pulses from the Crab pulsar, with fluence &gt; 130 Jy ms at ∼1330 MHz. These were detected in ∼260 h of observation with the National Centre for Radio Astrophysics (NCRA) 15 m radio telescope. We find that the pulse-energy distribution follows a power law with index $\rm \alpha \approx -3$ at least up to a fluence of ∼5 Jy s. The power-law index agrees well with that found for lower-energy pulses in the range 3–30 Jy ms. The fluence distribution of the Crab pulsar hence appears to follow a single power law over ∼3 orders of magnitude in fluence. We do not see any evidence for the flattening at high fluences reported by earlier studies. We also find that, at these fluence levels, the rate of giant-pulse emission varies by as much as a factor of ∼5 on time-scales of a few days, although the power-law index of the pulse-energy distribution remains unchanged. The slope of the fluence distribution for Crab giant pulses is similar to that recently determined for the repeating FRB 121102. We also find an anti-correlation between the pulse fluence and the pulse width, so that more energetic pulses are preferentially shorter.
Flow Diversion for Intracranial Aneurysm Treatment: Trials Involving Flow Diverters and Long-Term Outcomes
Authors: Chancellor Bree , Raz Eytan , Shapiro Maksim , Tanweer Omar , Nossek Erez , Riina Howard A , Nelson Peter Kim 
Published: September 2019

Abstract
Flow diverters (FDs) have changed the management of brain aneurysms; not only for complex aneurysms (giant, fusiform and blister) refractory to conventional therapies, but also for unruptured lesions previously managed by traditional surgical or coil-based endovascular methods. Since 2011 when the PipelineTM Embolization Device (Medtronic) was cleared by the Food and Drug Administration for adults with large or giant wide-neck intracranial aneurysms of the internal carotid artery proximal to the posterior communicating segment, the role of flow diversion for aneurysm treatment has expanded—supported by favorably low complication and high cure rates compared with alternative treatments. Here we review the key clinical trials and the long term outcomes that have demonstrated safety and efficacy of minimized porosity endoluminal devices in the treatment of cerebral aneurysms.
Single-Arm, Open-Label, Multicenter Study to Evaluate the Safety and Performance of Dura Sealant Patch in Reducing Cerebrospinal Fluid Leakage Following Elective Cranial Surgery: The ENCASE Trial Study Protocol
Authors: van Doormaal Tristan P C , Germans Menno R , Sie Mariska , Brouwers Bart , Fierstra Jorn , Depauw Paul R A M , Robe Pierre A , Regli Luca 
Published: September 2019

Abstract

BACKGROUND
Cerebrospinal fluid (CSF) leakage is one of the most common neurosurgical complications, occurring in 4% to 32% of surgical cases, with a higher incidence in complicated skull base surgery, intradural spine surgery, and the surgery of the posterior fossa. Our group developed a Dural Sealant Patch (DSP) for watertight dural closure after cranial surgery.

OBJECTIVE
To clinically study for the first time the safety and performance of the DSP as a means of reducing CSF leakage in patients undergoing elective cranial intradural surgery with a dural closure procedure.

METHODS
We will conduct an open-label, single-arm, multicenter study with a 360 d (12 mo) follow-up. A total of 40 patients will be enrolled at 3 sites. The primary endpoint is a combination of occurrences of one of the following events: postoperative percutaneous CSF leakage, intraoperative leakage at 20 cm H2O, or postoperative wound infection. The secondary endpoints are pseudomeningocele and thickness of dura + DSP.

EXPECTED OUTCOMES
Not more than 3 patients will meet the primary endpoint suggesting safety and efficacy.

DISCUSSION
As a next step, a randomized controlled trial against the best current practice will follow to evaluate if DSP reduces CSF leakage while its safety is noninferior.
Interrater and Intrarater Reliability of the Colloid Cyst Risk Score
Authors: Alford Elizabeth N , Rotman Lauren E , Lepard Jacob R , Agee Bonita S , Markert James M 
Published: September 2019

Abstract

BACKGROUND
The Colloid Cyst Risk Score (CCRS) was developed to identify symptomatic patients and stratify risk of hydrocephalus among patients with colloid cysts. Its components consider patient age, cyst diameter, presence/absence of headache, fluid-attenuated inversion recovery (FLAIR) hyperintensity, and location within the third ventricle.

OBJECTIVE
To independently evaluate the inter- and intrarater reliability of the CCRS.

METHODS
Patients with a colloid cyst were identified from billing records and radiology archives. Three independent raters reviewed electronic medical records to determine age, presence/absence of headache, cyst diameter (mm), FLAIR hyperintensity, and risk zone location. Raters made 53 observations, including 5 repeat observations.
Fleiss’ generalized kappa (κ) was calculated for all of the nominal criteria, whereas Kendall's coefficient of concordance (W) and the intraclass correlation coefficient (ICC) were calculated for the overall score.

RESULTS
Total CCRS score demonstrated extremely strong agreement (W = 0.83) using Kendall's W coefficient and good agreement (ICC = 0.74) using the ICC (P < .001). For interrater reliability of individual criteria, age (κ = 1.00) and FLAIR hyperintensity (κ = 0.89) demonstrated near perfect agreement. Axial diameter (κ = 0.63) demonstrated substantial agreement, whereas agreement was moderate for risk zone (κ = 0.51) and fair for headache (κ = 0.26). Intrarater reliability for total CCRS score was extremely strong using Kendall's W, good to excellent using ICC, and fair to substantial using weighted kappa.

CONCLUSION
The CCRS has good inter- and intrarater reliability when tested in an independent sample of patients, though strength of agreement varies among individual criteria. The validity of the CCRS requires independent evaluation.
Impact of Smoking Cessation Interventions Initiated During Hospitalization Among HIV-Infected Smokers
Authors: Triant Virginia A , Grossman Ellie , Rigotti Nancy A , Ramachandran Rekha , Regan Susan , Sherman Scott E , Richter Kimber P , Tindle Hilary A , Harrington Kathleen F 
Published: September 2019

Abstract

Introduction
Smoking is a key determinant of mortality among people living with HIV (PLWH).

Methods
To better understand the effects of smoking cessation interventions in PLWH, we conducted a pooled analysis of four randomized controlled trials of hospital-initiated smoking interventions conducted through the Consortium of Hospitals Advancing Research on Tobacco (CHART). In each study, cigarette smokers were randomly assigned to usual care or a smoking cessation intervention. The primary outcome was self-reported past 30-day tobacco abstinence at 6-month follow-up. Abstinence rates were compared between PLWH and participants without HIV and by treatment arm, using both complete-case and intention-to-treat analyses. Multivariable logistic regression was used to determine the effect of HIV status on 6-month tobacco abstinence and to determine predictors of smoking cessation within PLWH.

Results
Among 5550 hospitalized smokers, there were 202 (3.6%) PLWH. PLWH smoked fewer cigarettes per day and were less likely to be planning to quit than smokers without HIV. At 6 months, cessation rates did not differ between intervention and control groups among PLWH (28.9% vs. 30.5%) or smokers without HIV (36.1% vs. 34.1%). In multivariable regression analysis, HIV status was not significantly associated with smoking cessation at 6 months. Among PLWH, confidence in quitting was the only clinical factor independently associated with smoking cessation (OR 2.0, 95% CI = 1.4 to 2.8, p &lt; .01).

Conclusions
HIV status did not alter likelihood of quitting smoking after hospital discharge, whether or not the smoker was offered a tobacco cessation intervention, but power was limited to identify potentially important differences.

Implications
PLWH had similar quit rates to participants without HIV following a hospital-initiated smoking cessation intervention. The findings suggest that factors specific to HIV infection may not influence response to smoking cessation interventions and that all PLWH would benefit from efforts to assist in quitting smoking.

Trial Registration
(1) Using “warm handoffs” to link hospitalized smokers with tobacco treatment after discharge: study protocol of a randomized controlled trial: NCT01305928. (2) Web-based smoking cessation intervention that transitions from inpatient to outpatient: NCT01277250. (3) Effectiveness of smoking-cessation interventions for urban hospital patients: NCT01363245. (4) Effectiveness of Post-Discharge Strategies for Hospitalized Smokers (HelpingHAND2): NCT01714323.
Phylogenetic Systematics and Evolution of the Spider Infraorder Mygalomorphae Using Genomic Scale Data
Authors: Opatova Vera , Hamilton Chris A , Hedin Marshal , De Oca Laura Montes , Král Jiři , Bond Jason E 
Published: September 2019

AbstractThe infraorder Mygalomorphae is one of the three main lineages of spiders comprising over 3000 nominal species. This ancient group has a worldwide distribution that includes among its ranks large and charismatic taxa such as tarantulas, trapdoor spiders, and highly venomous funnel-web spiders. Based on past molecular studies using Sanger-sequencing approaches, numerous mygalomorph families (e.g., Hexathelidae, Ctenizidae, Cyrtaucheniidae, Dipluridae, and Nemesiidae) have been identified as non-monophyletic. However, these data were unable to sufficiently resolve the higher-level (intra- and interfamilial) relationships such that the necessary changes in classification could be made with confidence. Here, we present a comprehensive phylogenomic treatment of the spider infraorder Mygalomorphae. We employ 472 loci obtained through anchored hybrid enrichment to reconstruct relationships among all the mygalomorph spider families and estimate the timeframe of their diversification. We sampled nearly all currently recognized families, which has allowed us to assess their status, and as a result, propose a new classification scheme. Our generic-level sampling has also provided an evolutionary framework for revisiting questions regarding silk use in mygalomorph spiders. The first such analysis for the group within a strict phylogenetic framework shows that a sheet web is likely the plesiomorphic condition for mygalomorphs, as well as providing insights to the ancestral foraging behavior for all spiders. Our divergence time estimates, concomitant with detailed biogeographic analysis, suggest that both ancient continental-level vicariance and more recent dispersal events have played an important role in shaping modern day distributional patterns. Based on our results, we relimit the generic composition of the Ctenizidae, Cyrtaucheniidae, Dipluridae, and Nemesiidae. We also elevate five subfamilies to family rank: Anamidae (NEW RANK), Euagridae (NEW RANK), Ischnothelidae (NEW RANK), Pycnothelidae (NEW RANK), and Bemmeridae (NEW RANK). Three families Entypesidae (NEW FAMILY), Microhexuridae (NEW FAMILY), and Stasimopidae (NEW FAMILY), and one subfamily Australothelinae (NEW SUBFAMILY) are newly proposed. Such a major rearrangement in classification, recognizing nine newly established family-level rank taxa, is the largest the group has seen in over three decades. [Biogeography; molecular clocks; phylogenomics; spider web foraging; taxonomy.]
Effects of creep feeding and its interactions with other factors on the performance of meat goat kids and dams when managed on pasture
Authors: Hayes Emily G , Lourençon Raquel V , Browning Richard 
Published: September 2019

Abstract
Creep feeding and its possible interactions with other influential factors (genetics, litter type, and sex) for weaning traits were studied in meat goat kids and their dams. Kids across 3 yr were creep fed (254 kids; 5 pens) or not creep fed (255 kids; 5 pens) from 30 to 90 d of age. Creep-fed kids had higher (P ≤ 0.05) preweaning average daily weight gain and weaning weights (113.1 ± 13.0 g/d; 15.0 ± 0.8 kg) than kids not creep fed (99.8 ± 13.1 g/d; 14.0 ± 0.8 kg). However, financial returns were not higher (P &gt; 0.05) for creep-fed kids compared with kids not creep fed. There was no difference (P &gt; 0.05) in kid conformation score or survival rates between the treatment groups. The only important interaction among kid traits was treatment × litter type (P &lt; 0.05) for FAMACHA scores. Within noncreep pens, single kids had lower (better; P &lt; 0.05) FAMACHA scores (2.9 ± 0.3) than twin kids (3.9 ± 0.3). There was no litter-type effect on FAMACHA scores for kids within the creep feed pens. Dams of the creep-fed (n = 175) and noncreep (n = 178) kids were also evaluated. Treatment did not affect (P &gt; 0.05) litter weights, dam weight change, gross revenue for weaned litters, or fecal egg counts. Treatment interacted with litter type (P &lt; 0.05) to effect packed cell volume (PCV). In the noncreep group, dams raising singles had higher (better; P &lt; 0.05) PCV (18.7 ± 1.3%) than dams rearing twin kids (15.7 ± 1.3%). The litter-type effect on dam PCV was not evident (P &gt; 0.05) in the creep-fed group. Creep feeding improved some kid growth traits but did not improve dam traits or financial returns. Interactions of creep treatment with other factors were minimal for doe-kid traits.
The Impact of Title VII Dental Workforce Programs on Dentists’ Practice Location: A Difference-in-Differences Analysis
Authors: Chou Chiu-Fang , Holtzman Jennifer S. , Rogers Shane , Chen Candice 
Published: September 2019

Purpose
To examine the potential impact of Health Resources and Services Administration (HRSA) funding (predoctoral [PD] and postdoctoral [PDD] programs) on dentists’ practice location in the United States.

Method
The authors linked 2011–2015 data from HRSA’s Electronic Handbooks to 2015 data from the American Dental Association Masterfile, dental health professional shortage areas, and rural–urban commuting area codes. They examined the associations between PD and PDD funding and dentists’ practice location between 2004 and 2015 using a difference-in-differences analysis and multiple logistic regressions, adjusting for covariates.

Results
From 2004 to 2015, 21.2% (1,588/7,506) of dentists graduated from institutions receiving PD funding and 26.8% (2,014/7,506) graduated from institutions receiving PDD funding. Among dentists graduating from institutions receiving PDD funding, after adjusting for covariates, those graduating between 2011 and 2015 were more likely to practice in a rural area than those graduating between 2004 and 2010 (odds ratio [OR] = 1.98; 95% confidence interval [CI] = 1.04–3.76). The difference-in-differences approach showed that PD and PDD funding significantly increased the odds that a dentist would practice in a rural area (respectively, OR = 2.70; 95% CI = 1.31–5.79/OR = 2.84; 95% CI = 1.40–5.77).

Conclusions
HRSA oral health training program funding had a positive effect on dentists choosing to practice in a rural area. By increasing the number of dentists practicing in rural communities, HRSA is improving access to, and the delivery of, oral health care services to underserved and vulnerable rural populations.
Evaluation of NICU Nurses' Competence in Pain Assessment 5 Years After Implementation of the COMFORTneo Scale
Authors: Stenkjaer Rikke Louise , Pedersen Preben Ulrich , Hundrup Yrsa Andersen , Weis Janne 
Published: September 2019

Background:
Adequate pain management of preterm and sick newborn infants is a critical issue in the neonatal intensive care unit, as the infants are small and vulnerable with limited resources to deal with pain and stressful experiences. The use of pain assessment instruments, however, must be applied correctly to achieve consistency and improve continuity in care and treatment among clinicians.

Purpose:
To assess the development of neonatal intensive care unit nurses' interrater agreement in using the COMFORTneo pain assessment tool 5 years after initial implementation, and to identify items needing further development through analysis of discrepancies among nurses' COMFORTneo scores.

Methods:
An evaluation study with a pre- and postdesign comparing nurses' interrater reliability in assessing infant pain using the COMFORTneo pain assessment tool at baseline and 5-year follow-up.

Results:
Eighty-five percent of the nurses in the follow-up group (n = 26) had improved their skills 5 years after the implementation, and the improvement was significant (P < .000). We also found that interrater reliability was satisfactory (κ scores ≥0.65) for all the items of the COMFORTneo tool. However, to obtain “very good” interrater reliability (κ scores ≥0.80) 3 items were identified needing increased focus.

Implications for Practice:
A thorough implementation of a national clinical guideline has been partially effective in ensuring that nurses used the COMFORTneo in their daily practice, which increased their competence in pain assessment.

Implications for Research:
Further research into the education of nurses on the efficacy of pain scales, nonpharmacologic and pharmacologic therapies, and individualized pain assessment is needed to better address pain management.
Circuit Hemodynamics and Circuit Failure During Continuous Renal Replacement Therapy
Authors: Sansom Benjamin , Sriram Shyamala , Presneill Jeffrey , Bellomo Rinaldo 
Published: September 2019

Objectives:
To study hemodynamic changes within continuous renal replacement therapy circuits and evaluate their relationship with continuous renal replacement therapy longevity.

Design:
Analysis of downloaded variables recorded by continuous renal replacement therapy machines during multiple episodes of clinical care.

Setting:
Tertiary ICU in Melbourne, Australia.

Patients:
Cohort of 149 ICU patients: 428 episodes of continuous renal replacement therapy.

Interventions:
None.

Measurements and Main Results:
Indices of continuous renal replacement therapy function representing 554,991 minutes were assessed including blood flow, access pressure, effluent pressure, prefilter pressure, and return pressure. We defined three patterns of artificial kidney failure: early (≤ 12 hr), intermediate (> 12–24 hr), and late (> 24 hr) in 35%, 31%, and 34% of circuits, respectively. Mean access pressure in late artificial kidney failure was 7.5 mm Hg (7.1–7.9 mm Hg) less negative than early failing circuits and pressures demonstrated lower variability in such late failing circuits. Access dysfunction, defined as access pressure less than or equal to –200 mm Hg occurred in the first 4 hours in 118 circuits (27%) which had a shorter (median [interquartile range]) life at 12.9 hr [5.5–21.3 hr]) hours than access dysfunction-free circuits (18.8 hr [10.1–33.4 hr]; p < 0.0001). Multivariate analysis found the first occurrence of access dysfunction (as a time-varying covariate) was independently associated with increased hazard of subsequent failure (hazard ratio, 1.75; 1.36–2.26). Classification and regression tree analysis of summary pressure indices in the first 2 hours confirmed minimum access pressure to be a significant predictor, as well as indices of transmembrane pressure and return pressure. A pressure-based predictor correctly identified early and late failing circuits (86.2% and 93.6% specificity, respectively).

Conclusions:
Access dysfunction is a predictor of continuous renal replacement therapy circuit failure. Future monitoring of continuous renal replacement therapy hemodynamics may facilitate remedial actions to improve circuit function.
Impact of Critical Illness on Resource Utilization: A Comparison of Use in the Year Before and After ICU Admission*
Authors: Hirshberg Eliotte L. , Wilson Emily L. , Stanfield Valoree , Kuttler Kathryn G. , Majercik Sarah , Beesley Sarah J. , Orme James , Hopkins Ramona O. , Brown Samuel M. 
Published: September 2019

Objectives:
Increasingly, patients admitted to an ICU survive to hospital discharge; many with ongoing medical needs. The full impact of an ICU admission on an individual’s resource utilization and survivorship trajectory in the United States is not clear. We sought to compare healthcare utilization among ICU survivors in each year surrounding an ICU admission.

Design:
Retrospective cohort of patients admitted to an ICU during one calendar year (2012) in a multipayer healthcare system. We assessed mortality, hospital readmissions (categorized by ambulatory care sensitive conditions and emergency department), and outpatient visits. We compared the proportion of patients with visits during the pre-ICU year versus the post-ICU year.

Patients:
People admitted to an Intermountain healthcare ICU for greater than 48 hours in the year 2012

Interventions:
None.

Measurements and Main Results:
Among 4,074 ICU survivors, 45% had increased resource utilization. Readmission rates at 30-day, 90-day, and 1-year were 15%, 26%, and 43%. The proportion of patients with a hospital admission increased significantly in the post-ICU period (43% vs 29%; p < 0.001). Of patients with a readmission in the post-ICU period, 24% were ambulatory care sensitive condition. Patients with increased utilization differed by socioeconomic status, insurance type, and severity of illness. Sixteen percent of patients had either an emergency department or inpatient admission, but no outpatient visits during the post-ICU period.

Conclusions:
An ICU admission is associated with increased resource utilization including hospital readmissions, with many due to an ambulatory care sensitive condition. Lower socioeconomic status and higher severity of illness are associated with increased resource utilization. After an ICU visit patients seem to use hospital resources over outpatient resources. Interventions to improve and coordinate care after ICU discharge are needed.