bluuebunny/crossref_metadata_2025_split huggingface dataset:
spright: a probabilistic mass–density–radius relation for small planets
Authors: Parviainen Hannu , Luque Rafael , Palle Enric 
Published: November 2023

ABSTRACT
We present spright, a python package that implements a fast and lightweight mass–density–radius relation for small planets. The relation represents the joint planetary radius and bulk density probability distribution as a mean posterior predictive distribution of an analytical three-component mixture model. The analytical model, in turn, represents the probability for the planetary bulk density as three generalized Student’s t-distributions with radius-dependent weights and means based on theoretical composition models. The approach is based on Bayesian inference and aims to overcome the rigidity of simple parametric mass–radius relations and the danger of overfitting of non-parametric mass–radius relations. The package includes a set of pre-trained and ready-to-use relations based on two M-dwarf catalogues, one catalogue containing stars of spectral types F, G, and K (FGK stars), and two theoretical composition models for water-rich planets. The inference of new models is easy and fast, and the package includes a command line tool that allows for coding-free use of the relation, including the creation of publication-quality plots. Additionally, we study whether the current mass and radius observations of small exoplanets support the presence of a population of water-rich planets positioned between rocky planets and sub-Neptunes. The study is based on Bayesian model comparison and shows somewhat strong support against the existence of a water-world population around M dwarfs. However, the results of the study depend on the chosen theoretical water-world density model. A more conclusive result requires a larger sample of precisely characterized planets and community consensus on a realistic water-world interior structure and atmospheric composition model.
Subhalo effective density slope measurements from HST strong lensing data with neural likelihood-ratio estimation
Authors: Zhang Gemma , Şengül Atınç Çağan , Dvorkin Cora 
Published: November 2023

ABSTRACT
Examining the properties of subhaloes with strong gravitational lensing images can shed light on the nature of dark matter. From upcoming large-scale surveys, we expect to discover orders of magnitude more strong lens systems that can be used for subhalo studies. To optimally extract information from a large number of strong lensing images, machine learning provides promising avenues for efficient analysis that is unachievable with traditional analysis methods, but application of machine learning techniques to real observations is still limited. We build upon previous work, which uses a neural likelihood-ratio estimator, to constrain the effective density slopes of subhaloes and demonstrate the feasibility of this method on real strong lensing observations. To do this, we implement significant improvements to the forward simulation pipeline and undertake careful model evaluation using simulated images. Ultimately, we use our trained model to predict the effective subhalo density slope from combining a set of strong lensing images taken by the Hubble Space Telescope. We found the subhalo slope measurement of this set of observations to be steeper than the slope predictions of cold dark matter subhaloes. Our result adds to several previous works that also measured high subhalo slopes in observations. Although a possible explanation for this is that subhaloes with steeper slopes are easier to detect due to selection effects and thus contribute to statistical bias, our result nevertheless points to the need for careful analysis of more strong lensing observations from future surveys.
Orthopaedic surgery residency program ranking and the current state of leadership: what are the characteristics of the leaders in the “Top-tier” programs?
Authors: Huyke-Hernández Fernando A. , Doxey Stephen A. , Qian Lily J. , Cunningham Brian P. 
Published: November 2023

Background:
Orthopaedic surgery residency program ranking and leadership can influence applicant and program decision-making. The study objective was to evaluate the relationship between program rankings and characteristics of their leadership.

Methods:
The Accreditation Council for Graduate Medical Education, Doximity, and program-specific websites were queried, identifying 193 programs and 426 leaders for analysis. Leadership positions evaluated included: Chairs, Vice Chairs, Program Directors, and Assistant Program Directors. Residency programs were categorized into tiers based on 2022-2023 Doximity reputation ranking. Program ranking was stratified as follows: Tier 1 (rank 1-50, highest-ranking programs), Tier 2 (rank 51-100), Tier 3 (rank 101-150), and Tier 4 (rank 151-201, lowest-ranking programs). Leaders were described according to demographics, training, research productivity, and experience.

Results:
A total of 426 leaders at 193 programs were included. The average number of leadership positions per program was 2.2±1.0. Higher-tier programs had more leadership positions and were more likely to have chairpeople (P<0.001). They also had a larger proportion of women leaders (P=0.023), although only 11.2% of leaders overall were women. Residency training outside the US did not vary across tiers (P=0.881). Higher-tier leaders were more likely to complete fellowship (P<0.001) and specialize in pediatrics, oncology, and spine (P<0.032), although trauma was the most common specialty among leaders regardless of ranking. Program rank correlated strongly with program size (number of residents) (r2=−0.69) and weakly with leadership h-index (r2=−0.33) and research documents (r2=−0.40). Rank did not correlate with years in practice (r2=0.06), years until attaining a leadership position (r2=0.06), or years in present leadership position (r2=0.07).

Conclusions:
Program ranking correlated with the number of leaders and residents, as well as research productivity, but not with years of experience or training within the US. Top-tier programs have a higher proportion of women leaders, although the overall number is still low.
The Relationship Between Manifestation of Diabetes Insipidus and Estimated Glomerular Filtration Rate in Brain Death
Authors: Varelas Panayiotis N. , Kananeh Mohammed , Brady Paul , Holden Devin , Mehta Chandan , Ata Ashar , Abdelhak Tamer , Greer David , Rehman Mohammed 
Published: November 2023

OBJECTIVES:
Systematic reviews have revealed that up to 50% of patients with brain death have residual hypothalamic/pituitary activity based on the absence of central diabetes insipidus (DI). We hypothesized that different degrees of renal dysfunction may impact the presence of DI in patients with brain death.

DESIGN:
Single-center prospective data collection.

SETTING:
ICUs in a tertiary academic hospital.

PATIENTS:
All adult patients declared brain dead over 12 years.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
DI was diagnosed by polyuria, low urine specific gravity, and increasing serum sodium, measured in close proximity. Renal function was assessed by the estimated glomerular filtration rate (eGFR), calculated using the simplified modification of diet in renal disease equation. Analysis was completed in 192 of 234 patients with brain death after excluding those with missing data, those younger than 18 years and those on vasopressin infusions. One hundred twenty-two patients (63.5%) developed DI and 70 patients (36.5%) did not. The proportion of DI decreased significantly with decreasing eGFR: for eGFR greater than 60 mL/min, DI was present in 77.2%; for eGFR 15–60 mL/min, DI was present in 54.5%; for eGFR 14.9–9.8 mL/min, DI was present in 32%; none of the 14 patients with eGFR less than or equal to 9.7 mL/min ever experienced DI (p < 0.001). Using logistic regression, for every 10 mL/min decrease in eGFR, the odds of DI decreased 0.83 times (95% CI, 0.76–0.90, p < 0.001).

CONCLUSIONS:
Renal dysfunction significantly impacts DI’s clinical manifestation in brain death. We report that patients who experience brain death with severe renal dysfunction may not develop clinical signs of DI.
Survey of Surgeon-reported Postoperative Protocols for Deep Inferior Epigastric Perforator Flap in Breast Reconstruction
Authors: Araya Sthefano , Hackley Madison , Amadio Grace M. , Deng Mengying , Moss Civanni , Reinhardt Eliann , Walchak Adam , Tecce Michael G. , Patel Sameer A. 
Published: November 2023

Background:
The use of deep inferior epigastric perforator (DIEP) flaps is a well-established breast reconstruction technique.

Methods:
A 29-question survey was e-mailed to 3186 active American Society of Plastic Surgeons members, aiming to describe postoperative monitoring practice patterns among surgeons performing DIEP flaps.

Results:
From 255 responses (8%), 79% performing DIEP surgery were analyzed. Among them, 34.8% practiced for more than 20 years, 34.3% for 10–20 years, and 30.9% for less than 10 years. Initial 24-hour post-DIEP monitoring: intensive care unit (39%) and floor (36%). Flap monitoring: external Doppler (71%), tissue oximetry (41%), and implantable Doppler (32%). Postoperative analgesia: acetaminophen (74%), non-steroidal anti-inflammatory drugs (69%), neuromodulators (52%), and opioids (4.4%) were administered on a scheduled basis. On postoperative day 1, 61% halt intravenous fluids, 67% allow ambulation, 70% remove Foley catheter, and 71% start diet. Most surgeons discharged patients from the hospital on postoperative day 3+. Regardless of experience, patients were commonly discharged on day 3. Half of the surgeons are in academic/nonacademic settings and discharge on/after day 3.

Conclusions:
This study reveals significant heterogeneity among the practice patterns of DIEP surgeons. In light of these findings, it is recommended that a task force be convened to establish standardized monitoring protocols for DIEP flaps. Such protocols have the potential to reduce both the length of hospital stays and overall care costs all while ensuring optimal pain management and vigilant flap monitoring.
Effectiveness of Tranexamic Acid in the Postoperative Period in Body Contour Surgery: Randomized Clinical Trial
Authors: Bayter-Marín Jorge Enrique , Hoyos Alfredo , Cárdenas-Camarena Lázaro , Peña-Pinzón William , Bayter-Torres Andrés Felipe , Díaz-Díaz Carlos Andrés , McCormick-Méndez Mauricio , Plata-Rueda Erika Liliana , Niño-Carreño Claudia Stella 
Published: November 2023

Background:
Tranexamic acid (TXA) is used to reduce bleeding in body contouring procedures; however, there are no studies that show the effectiveness of TXA when it is also used in the immediate postoperative period.

Methods:
A controlled, randomized, parallel, and open-label clinical trial was carried out in adult patients undergoing liposculpture and/or abdominoplasty. A control group administering presurgical TXA and a study group with presurgical and postsurgical TXA were formed. The decrease in hemoglobin and the incidence of blood transfusions between both groups were compared as well as the possible adverse effects of TXA.

Results:
Four hundred twenty-seven subjects were included, 208 (48.7%) in the control group and 219 (51.3%) in the study group. The median age was 34 years (interquartile range 28–42). Median postoperative hemoglobin levels at 24 hours were similar in both groups (study 11.3 g/dL versus control 11.1 g/dL, P = 0.07); however, at 72 hours, postoperative hemoglobin was higher in the study group versus control (10.8 versus 10.0 g/dL, P ≤ 0.001). The incidence of transfusions at 72 hours was 1.8% in the study group and 8.6% in the control group, for a risk ratio of 0.21 (95% confidence interval 0.07–0.61). There were no adverse or thromboembolic events.

Conclusion:
TXA proved to be more effective in reducing intra- and postsurgical bleeding and the need for transfusions, when used preoperatively and continued for 48 hours after surgery, than when used only preoperatively, without reporting adverse or thromboembolic effects.
Association of work-related psychosocial factors and day-to-day home blood pressure variation: the Finn-Home study
Authors: Karelius Saana , Pentti Jaana , Juhanoja Eeva , Jula Antti , Koskinen Seppo , Niiranen Teemu J. , Stenholm Sari 
Published: November 2023

Objectives:
Stress, and particularly job strain, has been found to associate with ambulatory blood pressure (BP). Moreover, BP is known to vary between days. One potential over-looked factor underlying this day-to-day BP variation could be work-related psychosocial factors. Thus, we aimed to study the association between job strain, job demands, job control and day-to-day BP variation.

Methods:
The home BP of 754 regularly working participants (mean age 50.9 ± 4.8, women 51%) of the Finn-Home Study was measured twice in the morning and twice in the evening over seven days. Average SBP and DBP were calculated for each day. Work-related psychosocial factors were measured with survey. Multivariable-adjusted generalized linear models were used for statistical analysis.

Results:
We found a greater SBP/DBP decrease between weekdays and weekend among participants with high job strain (-1.8 [95% confidence interval, 95% CI, -2.7 to -0.8]/-1.7 [95% CI, -2.3 to -1.1] mmHg) compared to participants with low job strain (-0.7 [95% CI, -1.1 to -0.2]/-0.7 [95% CI, -1.0 to -0.4] mmHg). The participants with high job demands showed a higher BP decrease between weekdays and weekend (-1.4 [95% CI, -2.0 to -0.8]/-1.3 [95% CI, -1.6 to -0.9] mmHg) than the participants with low job demands (-0.5 [95% CI, -1.1 to 0.0]/-0.6 [95% CI, -1.0 to -0.3] mmHg). We did not find BP differences regarding job control.

Conclusion:
High job strain and high job demands were associated with a greater BP reduction from weekdays to the weekend. Work-related psychosocial factors should be considered when assessing day-to-day BP variation.
Surgical Treatment of Vascular Anomalies in the Extremities: A Single Surgeon Experience
Authors: Rodriguez Colon Ricardo , Cripps Courtney , Blei Francine , Sharma Sheel 
Published: November 2023

Objective:
The literature on surgical management of vascular anomalies has primarily focused on the head and neck area, while studies of anomalies on the extremities have typically included larger and more dramatic clinical presentations. In this article, we aim to present our experience with surgical management of smaller symptomatic anomalies of the extremities.

Methods:
We performed a retrospective review of a single surgeon’s experience at a large academic center on patients from January 2013 to March 2022. We collected data on patient demographics, past medical and surgical history, operative dictations, clinic notes, and postoperative follow-up. Included patients were required to have confirmed vascular anomalies based on final pathology reports.

Results:
A total of 47 patients underwent a total of 50 procedures, with 2 patients experiencing recurrence requiring repeat operative management. Our cohort had average age (standard deviation) of 27.16 (18.67). Sixteen patients had prior history of vascular anomalies upon presentation to our institution. The majority of lesions were located in a digit of the hand, the arm, or the foot. On surgical excision, the average size (range) of the excised lesions was 3.54 cm (0.5–15.0 cm) by 2.22 cm (0.3–8.0 cm). Four required coverage with local flaps, 3 with full-thickness skin graft (FTSG) and 2 with microvascular free flap. The 2 most common pathologic diagnoses were arteriovenous malformation and hemangioma, each with 14 patients. Overall complication rate was 2%, with 1 patient experiencing wound dehiscence requiring FTSG. Follow-up ranged from 0.1 months to 46.9 months with an average of 3.86 months.

Conclusions:
In the appropriately selected patient, surgical excision of symptomatic vascular anomalies of the extremities can be successfully performed with a low complication rate. Most lesions can be appropriately treated with direct excision and direct closure, although some may require FTSG, local flap, or microvascular free flap.
Using the lens of trauma informed care to inform pediatric obesity management
Authors: Scott Vanessa P. , Rhee Kyung E. 
Published: November 2023

Purpose of review
Summarize the evolution of the trauma-informed care (TIC) approach in pediatrics, highlight the importance of using this lens in pediatric obesity management and treating the whole patient and family, and suggest recommendations for providers to incorporate TIC into their practice.

Recent findings
Implementing TIC in pediatric obesity management is recommended and offers an approach to address trauma-related symptoms associated with obesity. The TIC framework creates a safe, nurturing space to have open conversations with patients and families to promote resilience and reduce stigma related to obesity without re-traumatization. Screening tools may expose symptoms related to trauma, but are limited. Provider training is available and development of TIC related skills may be improved through using the arts and humanities. Success of TIC requires a tailored, integrated healthcare system approach with commitment from all levels.

Summary
The TIC approach offers providers skills to uncover trauma-related symptoms and address obesity-related health disparities while reducing stigma. Collaboration across all levels of the healthcare system and community partners is essential. Further research is warranted on the effectives of this approach in pediatric obesity prevention and management.
Scenario Decision-Making About Plasma and Platelet Transfusion for Intracranial Monitor Placement: Cross-Sectional Survey of Pediatric Intensivists and Neurosurgeons
Authors: Nellis Marianne E. , Karam Oliver , Aldave Guillermo , Rocque Brandon G. , Bauer David F. ,   In collaboration with the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network
Published: November 2023

OBJECTIVES:
To report pediatric intensivists’ and pediatric neurosurgeons’ responses to case-based scenarios about plasma and platelet transfusions before intracranial pressure (ICP) monitor placement in children with severe traumatic brain injury (TBI).

DESIGN:
Cross-sectional, electronic survey to evaluate reported plasma and platelet transfusion decisions in eight scenarios of TBI in which ICP monitor placement was indicated.

SETTING:
Survey administered through the Pediatric Acute Lung Injury and Sepsis Investigators and the American Association of Neurologic Surgeons.

SUBJECTS:
Pediatric intensivists and pediatric neurosurgeons.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
A total of 184 participants responded (85 identified as pediatric intensivists and 54 as pediatric neurosurgeons). In all eight scenarios, the majority of respondents reported that they would base their decision-making about plasma transfusion on international normalized ratio (INR) alone (60–69%), or platelet transfusion on platelet count alone (83–86%). Pediatric intensivists, as opposed to pediatric neurosurgeons, more frequently reported that they would have used viscoelastic testing in their consideration of plasma transfusion (32% vs. 7%, p < 0.001), as well as to guide platelet transfusions (29 vs. 8%, p < 0.001), for the case-based scenarios. For all relevant case-based scenarios, pediatric neurosurgeons in comparison with pediatric reported that they would use a lower median (interquartile range [IQR]) INR threshold for plasma transfusion (1.5 [IQR 1.4–1.7] vs. 2.0 [IQR 1.5–2.0], p < 0.001). Overall, in all respondents, the reported median platelet count threshold for platelet transfusion in the case-based scenario was 100 (IQR 50–100) ×109/L, with no difference between specialties.

CONCLUSIONS:
Despite little evidence showing efficacy, when we tested specialists’ decision-making, we found that they reported using INR and platelet count in pediatric case-based scenarios of TBI undergoing ICP monitor placement. We also found that pediatric intensivists and pediatric neurosurgeons had differences in decision-making about the scenarios.
Arizona Department of Health Prevention Services' Work to Advance Health Equity Starts With an Assessment of Its Own Organizational Culture
Authors: Gallaway M. Shayne , Aseret-Manygoats Teresa , Sjolander Sheila 
Published: November 2023

Objective:
To identify skills, organizational practices, and infrastructure needed to address health equity.

Design, Setting, and Participants:
We developed an anonymous online staff survey to assess how to address health equity and policy implications and develop a baseline for future initiatives. We distributed invitations to all Arizona Department of Health Services (ADHS) Division of Prevention Services (DPS) state- and non–state-designated employees in February 2021.

Main Outcome Measures:
Employee self-reported perceptions of how agency, division, and programs address health inequities; information about (1) organizational and individual traits needed to support our ability to implement effective health equity–focused work and (2) processes to enable improved organizational and workforce capacities; and implications for strategic planning.

Results:
Seventy-eight percent (N = 123) of eligible staff participated. Overall, we identified 21 of 28 organizational and 17 of 31 workforce capacities needing significant improvement. Organizational capacities were “Institutional commitment to address health inequities” (described using 6 elements), “Hiring to address health inequities” (2 elements), “Structure that supports true community partnerships” (3 elements), “Support staff to address health inequities” (4 elements), “Transparent and inclusive communication” (4 elements), “Community accessible data and planning” (1 element), and “Streamlined administrative process” (1 element). Workforce capacities were “Knowledge of public health framework” (4 elements), “Understand the social, environmental, and structural determinants of health” (1 element), “Community knowledge” (1 element), “Leadership” (4 elements), “Collaboration skills” (3 elements), “Community organizing” (3 elements), and “Problem-solving ability” (1 element). Using survey results, groups of staff identified change needed, specific actions, and training and communication to increase employee understanding. Proposed activities focused on data/evaluation, program planning/contracts, communications, personnel development, and community engagement.

Conclusions:
This survey allowed ADHS to establish a baseline of staff knowledge of the ADHS and DPS organizational commitment to address health inequities; results show us what areas to focus on to strengthen our capacity to achieve better outcomes; and improve health and wellness for all Arizonans.