bluuebunny/crossref_metadata_2025_split huggingface dataset:
Life-history traits and description of the new gonochoric amphimictic Mesobiotus joenssoni (Eutardigrada: Macrobiotidae) from the island of Elba, Italy
Authors: Guidetti Roberto , Gneuß Elisa , Cesari Michele , Altiero Tiziana , Schill Ralph O 
Published: July 2019

Abstract
Comparative analyses of life-history theory studies are based on the characteristics of the life cycles of different species. For tardigrades, life-history traits are available only from laboratory cultures, most of which have involved parthenogenetic species. The discovery of a new gonochoristic bisexual Mesobiotus species in a moss collected on the island of Elba (Italy) provides us with the opportunity to describe Mesobiotus joenssoni sp. nov. and to collect data on the life-history traits of cultured specimens to increase our knowledge of the life-history strategies present in tardigrades. This new species is differentiated from all other species of the genus by the presence of granules (~1 µm in diameter) on the dorsal cuticle of the last two body segments, two large bulges (gibbosities) on the hindlegs and long, conical egg processes. The species exhibits sexual dimorphism in body length, with females being longer than males of the same age. The mean lifespan of specimens was 86 days, with a maximum of 150 days. The mean age at first oviposition was 19.8 days and the mean egg hatching time 15.4 days. The life-cycle traits correspond to those collected for the only other two macrobiotid species with gonochoric amphimictic reproduction examined so far.
Latitudinal gradients in body size in marine tardigrades
Authors: Bartels Paul J , Fontaneto Diego , Roszkowska Milena , Nelson Diane R , Kaczmarek Łukasz 
Published: July 2019

AbstractHomeotherms and many poikilotherms display a positive relationship between body size and latitude, but this has rarely been investigated in microscopic animals. We analysed all published records of marine Tardigrada to address whether microscopic marine invertebrates have similar ecogeographical patterns to macroscopic animals. The data were analysed using spatially explicit generalized least squares models and linear models. We looked for latitudinal patterns in body size and species richness, testing for sampling bias and phylogenetic constraints. No latitudinal pattern was detected for species richness, and sampling bias was the strongest correlate of species richness. A hump-shaped increase in median body size with latitude was found, and the effect remained significant for the Northern Hemisphere but not for the Southern. The most significant effect supporting the latitudinal gradient was on minimum body size, with smaller species disappearing at higher latitudes. Our results suggest that biogeographical signals were observed for body size, albeit difficult to detect in poorly studied groups because of swamping from biased sampling effort and from low sample size. We did not find a significant correlation with the latitudinal pattern of body size and ecologically relevant net primary productivity.
Is Negative-Pressure Wound Therapy a “Bridge to Reconstruction” for Poststernotomy Mediastinitis? A Systematic Review
Authors: White Brad M. , Meyer Dustin L. , Harlin Stephen L. 
Published: July 2019

ABSTRACT

OBJECTIVE:
To assess the efficacy of negative-pressure wound therapy (NPWT) in preparing sternal wounds for flap reconstruction.

METHODS:
Investigators searched standard research databases with terms including “post-sternotomy mediastinitis,” “deep sternal wound infection,” “negative pressure wound therapy,” “vacuum assisted closure,” and “VAC.” Of 434 reports, 14 studies described patients diagnosed with poststernotomy mediastinitis who underwent NPWT followed by flap reconstruction. Eligible studies were assessed for length of stay, mortality, manufacturer involvement, and methodological rigor.

MAIN RESULTS:
Among a total 429 patients, median length of stay was 29 (±16) days. There were 41 deaths in this inpatient group (10%). Seventy-one percent of the reports were nonrandomized, and 36% of the studies accurately accounted for baseline differences in severity, whereas 14% failed to report diagnostic criteria. Only one study reported follow-up results. Nine studies (64%) failed to make a statement regarding conflicts of interest. In this analysis of quality, 48% (n = 8) of the studies were of very low to low quality. One study was of high quality.

CONCLUSIONS:
Investigators failed to find ample support for routine use of NPWT as a “bridge to reconstruction.” Serious complications related to the use of NPWT including right ventricular rupture, atrial fibrillation, respiratory arrest, recurrent infection, and a retained sponge were reported in this group of studies. Rigorous evaluative studies that assess the true effectiveness of NPWT as a “bridge to reconstruction” must precede its adoption.
Relationship Between Diet, Tinnitus, and Hearing Difficulties
Authors: Dawes Piers , Cruickshanks Karen J. , Marsden Antonia , Moore David R. , Munro Kevin J. 
Published: July 2019

Objectives:
Diet may affect susceptibility of the inner ear to noise and age-related effects that lead to tinnitus and hearing loss. This study used complementary single nutrient and dietary pattern analysis based on statistical grouping of usual dietary intake in a cross-sectional analysis of tinnitus and hearing difficulties in a large population study sample.

Design:
The research was conducted using the UK Biobank resource. Tinnitus was based on report of ringing or buzzing in one or both ears that lasts more than five minutes at a time and is currently experienced at least some of the time. Identification of a hearing problem was based on self-reported difficulties with hearing. Usual dietary intake and dietary patterns (involving statistical grouping of intake to account for how foods are combined in real-life diets) were estimated based on between two and five administrations of the Oxford Web-Q 24-hour dietary recall questionnaire over the course of a year for 34,576 UK adult participants aged 40 to 69.

Results:
In a multivariate model, higher intake of vitamin B12 was associated with reduced odds of tinnitus, while higher intakes of calcium, iron, and fat were associated with increased odds (B12, odds ratio [OR] 0.85, 95% confidence interval [CI] 0.75 to 0.97; Calcium, OR 1.20, 95% CI 1.08 to 1.34; Iron, OR 1.20, 95% CI 1.05 to 1.37; Fat, OR 1.33, 95% CI 1.09 to 1.62, respectively, for quintile 5 versus quintile 1). A dietary pattern characterised by high protein intake was associated with reduced odds of tinnitus (OR 0.90, 95% CI 0.82 to 0.99 for quintile 5 versus quintile 1). Higher vitamin D intake was associated with reduced odds of hearing difficulties (OR 0.90, 95% CI 0.81 to 1.00 for quintile 5 versus quintile 1), as were dietary patterns high in fruit and vegetables and meat and low in fat (Prudent diet: OR 0.89, 95% CI 0.83 to 0.96; High protein: OR 0.88, 95% CI 0.82 to 0.95; High fat: OR 1.16, 95% CI 1.08 to 1.24, respectively, for quintile 5 versus quintile 1).

Conclusions:
There were associations between both single nutrients and dietary patterns with tinnitus and hearing difficulties. Although the size of the associations was small, universal exposure for dietary factors indicates that there may be a substantial impact of diet on levels of tinnitus and hearing difficulties in the population. This study showed that dietary factors might be important for hearing health.
Hearing Impairment and Prevalence of Mild Cognitive Impairment in Japan: Baseline Data From the Aidai Cohort Study in Yawatahama and Uchiko
Authors: Miyake Yoshihiro , Tanaka Keiko , Senba Hidenori , Ogawa Susumu , Suzuki Hiroyuki , Fujiwara Yoshinori , Okada Masahiro , Takagi Daiki , Teraoka Masato , Yamada Hiroyuki , Nobuhara Takashi , Matsuura Bunzo , Hato Naohito 
Published: July 2019

Objectives:
Hearing impairment (HI) in midlife may increase the risk of dementia. However, epidemiological research on the association between HI and mild cognitive impairment (MCI) is very limited.

Design:
The present cross-sectional study investigated the relationship between HI and MCI using baseline data from the Aidai Cohort Study. Study subjects were 995 Japanese adults aged 36 to 84 years. We used the audiometric definition of HI adopted by the World Health Organization, which identifies the speech-frequency pure-tone average hearing thresholds at 0.5, 1, 2, and 4 kHz tones. HI was defined as present when pure-tone average was >25 dB HL in the better hearing ear. MCI was defined as being present when a subject had a Japanese version of the Montreal Cognitive Assessment score of <26. Adjustment was made for age, sex, smoking status, alcohol consumption, leisure time physical activity, hypertension, dyslipidemia, diabetes mellitus, history of depression, body mass index, waist circumference, employment, education, and household income.

Results:
Among the 995 study subjects, the prevalence values of HI and MCI were 24.3% and 44.5%, respectively. HI was independently positively associated with MCI: the multivariate-adjusted odds ratio (95% confidence interval) was 1.86 (1.32 to 2.62). HI was independently related to a higher prevalence of MCI in those aged 60 to 69 years and those aged 70 years or older: the multivariate-adjusted odds ratios (95% confidence intervals) were 1.64 (1.03 to 2.62) and 2.30 (1.04 to 5.27), respectively.

Conclusions:
HI may be associated with a higher prevalence of MCI.
Comparison of axillary lateral radiography with computed tomography in the preoperative characterization of glenohumeral wear patterns and the effects of body mass index on quality of imaging
Authors: Mulligan Ryan P. , Feldman John J. , Bonnaig Nicolas S. , Weller William J. , Miller Robert H. , Azar Frederick M. , Throckmorton Thomas W. 
Published: July 2019

Background:
Preoperative imaging is important in planning glenoid component placement in shoulder arthroplasty. This study compared preoperative axillary lateral radiography with CT to determine which was more effective in characterization of glenoid erosion and subluxation and in measurement of glenoid version. We also sought to determine the effect of body mass index (BMI) on image quality.

Methods:
Eighty-eight patients who had shoulder arthroplasty for primary glenohumeral osteoarthritis were included. The Walch and Mayo classifications as well as glenoid version measurements were used. Kappa coefficients were obtained for interclass and intraclass reliabilities. Intraclass and interclass correlation coefficients were calculated for glenoid version measurements.

Results:
For glenoid erosion and subluxation, intraobserver and interobserver reliabilities indicated moderate (k=0.19-0.28) and fair agreement (k=0.41-0.50), respectively, which were similar for both imaging modalities and classifications. For glenoid version, interobserver reliability was good for both modalities, but intraobserver reliability showed substantial agreement for CT and only good agreement for radiographs (k=0.77, k=0.91, k=0.65-0.7, respectively). Increased BMI negatively affected image quality in both but more so on radiographs (P<0.0001).

Conclusions:
Both modalities had similar intraobserver and interobserver agreement; however, CT provided significantly more precise measurements of glenoid version regardless of classification used. A high BMI significantly affected the observers’ ability to judge classifications, especially on radiographs.
Effect of Surgeon and Hospital Volume on Complications After Operative Tarsal Fracture Repair
Authors: Stewart Christopher C. , Brodke Dane J. , Morshed Saam 
Published: July 2019

Objective:
To determine whether increased surgeon and hospital volume is associated with lower rates of complications after tarsal fractures.

Design:
Retrospective cohort study of the State Inpatient Databases.

Setting:
Two hundred ninety-nine hospitals in Florida (2005–2012) and New York (2006–2008).

Patients/Participants:
Four thousand one hundred thirty-two tarsal fractures that underwent fixation by 1223 surgeons.

Intervention:
Surgical repair of tarsal fractures.

Main Outcome Measurements:
Composite of readmission for infection requiring operative treatment, wound dehiscence, nonunion, avascular necrosis, or amputation within 2 years of the index procedure.

Results:
The mean age was 44 (±15) years, a majority were men (70%) and white (69%), and the mean number of Charlson comorbidities was 0.21 (±0.58). Multivariable logistic regression demonstrated a reduction in the likelihood of complications by 9% for each 5 additional surgeries performed by the operating surgeon [odds ratio (OR), 0.91 per 5 surgeries; 95% confidence interval (CI), 0.82–0.99]. Other factors associated with complications included increased age (OR, 1.23 per 10 years; 95% CI, 1.10–1.36), male sex (OR, 1.56; 95% CI, 1.12–2.17), open fractures (OR, 2.84; 95% CI, 1.92–4.19), number of Charlson comorbidities (OR, 1.23; 95% CI, 1.02–1.48), income quartile (OR, 1.48; 95% CI, 1.00–2.17), uninsured (OR, 2.47; 95% CI, 1.39–4.39), and other government program insurance (OR, 1.52; 95% CI, 1.06–2.18).

Conclusions:
We observed a significant inverse relationship between surgeon volume and complication rates when controlling for patient and injury characteristics. In contrast to previous research, a volume–outcome relationship was not observed at the hospital level. These results suggest that such complex injuries should be triaged to the most experienced providers.

Level of Evidence:
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Maintenance of Compression With a Positional Screw Versus Compression Generated With a Lag Screw
Authors: Srinivasan Aditya , Young Matthew , Ambrose Catherine , Kellam James 
Published: July 2019

Objective:To determine whether a position screw will maintain the interfragmentary compression force obtained by a reduction clamp across an anatomically reduced cortical bone fracture and determine whether this compressive force is equivalent to that generated by a lag screw (LS).Methods:Oblique fractures were created in 6 composite cortical bone models. Interfragmentary compression was measured using force sensors within the fracture after reduction with a clamp. A position screw was then placed perpendicular to the fracture, and force measurements were repeated with both the clamp and the screw. Finally, the clamp was removed, and force measurements were taken with the screw only to measure maintenance of initial compression. After these measurements, the screw was removed, and the near fragment was overdrilled to allow LS placement by technique. Compression force measurements were repeated for clamp only, clamp + screw, and screw only.Results:The mean force of clamp alone across all 12 trials was 139.77 N. Application of an LS increased the compression across the fracture (P= 0.01) which was unchanged when the clamp was removed. The position screw had the opposite effect, reducing compression, and the removal of the clamp further reduced the compression (P= 0.013).Conclusions:A reduction clamp will initially compress a fracture to an average of 139 N. An LS will significantly increase this interfragmentary compression. A position screw will not maintain the compression created by the clamp and in fact will significantly decrease interfragmentary compression.
Urine Klotho Is Lower in Critically Ill Patients With Versus Without Acute Kidney Injury and Associates With Major Adverse Kidney Events
Authors: Neyra Javier A. , Li Xilong , Mescia Federica , Ortiz-Soriano Victor , Adams-Huet Beverley , Pastor Johanne , Hu Ming-Chang , Toto Robert D. , Moe Orson W. 
Published: July 2019

Objectives:
Klotho and fibroblast growth factor-23 were recently postulated as candidate biomarkers and/or therapeutic targets in acute kidney injury. We examined whether urine Klotho and serum intact fibroblast growth factor-23 levels were differentially and independently associated with major adverse kidney events in critically ill patients with and without acute kidney injury.

Design:
Single-center, prospective, case-control study.

Setting:
ICU in a tertiary medical center.

Patients:
Fifty-four acute kidney injury patients and 52 controls without acute kidney injury admitted to the ICU.

Interventions:
None.

Measurements and Main Results:
Acute kidney injury was defined by Kidney Disease: Improving Global Outcomes criteria and included only acute kidney injury stage greater than or equal to 2. Controls were matched by age, gender, and baseline estimated glomerular filtration rate. Paired serum and urine samples were obtained 24–48 hours after acute kidney injury diagnosis (cases) or ICU admission (controls). The primary outcome was 90-day major adverse kidney events, which was the composite of all-cause death, dependence on renal replacement therapy, or a 50% or higher decrease in estimated glomerular filtration rate from baseline. Major adverse kidney events, which was the composite of all-cause death, dependence on renal replacement therapy, or a 50% or higher decrease in estimated glomerular filtration rate from baseline. Major adverse kidney events developed in 44 patients (41.5%). Patients in whom major adverse kidney events developed had more comorbidity, higher acuity of illness scores, and more prevalent acute kidney injury. Levels of urine Klotho adjusted by creatinine were lower, and serum intact fibroblast growth factor-23 levels were higher in acute kidney injury patients versus ICU controls. In adjusted models, the highest versus lowest tertile of urine Klotho/creatinine was independently associated with an overall 95% lower risk of major adverse kidney events (81% lower risk in patients with acute kidney injury). The highest versus lowest tertile of serum intact fibroblast growth factor-23 was associated with more than 300% higher risk of major adverse kidney events.

Conclusions:
Urine Klotho/creatinine levels were significantly lower and serum intact fibroblast growth factor-23 levels were significantly higher in critically ill patients with acute kidney injury versus matched controls without acute kidney injury. When measured in the first 48 hours of ICU admission or acute kidney injury diagnosis, urine Klotho/creatinine independently associated with major adverse kidney events, particularly in patients with acute kidney injury. These results show promise for testing these biomarkers—individually or in combination—as part of novel risk prediction models of renal outcomes in the ICU.
Epidemiology and Outcomes of Cancer-Related Versus Non–Cancer-Related Sepsis Hospitalizations*
Authors: Hensley Matthew K. , Donnelly John P. , Carlton Erin F. , Prescott Hallie C. 
Published: July 2019

Objective:
Cancer and its treatment are known to be important risk factors for sepsis, contributing to an estimated 12% of U.S. sepsis admissions in the 1990s. However, cancer treatment has evolved markedly over the past 2 decades. We sought to examine how cancer-related sepsis differs from non–cancer-related sepsis.

Design:
Observational cohort.

Setting:
National Readmissions Database (2013–2014), containing all-payer claims for 49% of U.S. population.

Patients:
A total of 1,104,363 sepsis hospitalizations.

Interventions:
We identified sepsis hospitalizations in the U.S. National Readmissions Database using explicit codes for severe sepsis, septic shock, or Dombrovskiy criteria (concomitant codes for infection and organ dysfunction). We classified hospitalizations as cancer-related versus non–cancer-related sepsis based on the presence of secondary diagnosis codes for malignancy. We compared characteristics (site of infection and organ dysfunction) and outcomes (in-hospital mortality and 30-d readmissions) of cancer-related versus non–cancer-related sepsis hospitalizations. We also completed subgroup analyses by age, cancer types, and specific cancer diagnoses.

Measurements and Main Results:
There were 27,481,517 hospitalizations in National Readmissions Database 2013–2014, of which 1,104,363 (4.0%) were for sepsis and 4,150,998 (15.1%) were cancer related. In-hospital mortality in cancer-related sepsis was 27.9% versus 19.5% in non–cancer-related sepsis. The median count of organ dysfunctions was indistinguishable, but the rate of specific organ dysfunctions differed by small amounts (e.g., hematologic dysfunction 20.1% in cancer-related sepsis vs 16.6% in non–cancer-related sepsis; p < 0.001). Cancer-related sepsis was associated with an adjusted absolute increase in in-hospital mortality ranging from 2.2% to 15.2% compared with non–cancer-related sepsis. The mortality difference was greatest in younger adults and waned with age. Patients (23.2%) discharged from cancer-related sepsis were rehospitalized within 30 days, compared with 20.1% in non–cancer-related sepsis (p < 0.001).

Conclusions:
In this cohort of over 1 million U.S. sepsis hospitalizations, more than one in five were cancer related. The difference in mortality varies substantially across age spectrum and is greatest in younger adults. Readmissions were more common after cancer-related sepsis.
Clinical Examination for the Prediction of Mortality in the Critically Ill: The Simple Intensive Care Studies-I
Authors: Hiemstra Bart , Eck Ruben J. , Wiersema Renske , Kaufmann Thomas , Koster Geert , Scheeren Thomas W.L. , Snieder Harold , Perner Anders , Pettilä Ville , Wetterslev Jørn , Keus Frederik , van der Horst Iwan C.C. 
Published: July 2019

Objectives:
Caregivers use clinical examination to timely recognize deterioration of a patient, yet data on the prognostic value of clinical examination are inconsistent. In the Simple Intensive Care Studies-I, we evaluated the association of clinical examination findings with 90-day mortality in critically ill patients.

Design:
Prospective single-center cohort study.

Setting:
ICU of a single tertiary care level hospital between March 27, 2015, and July 22, 2017.

Patients:
All consecutive adults acutely admitted to the ICU and expected to stay for at least 24 hours.

Interventions:
A protocolized clinical examination of 19 clinical signs conducted within 24 hours of admission.

Measurements Main Results:
Independent predictors of 90-day mortality were identified using multivariable logistic regression analyses. Model performance was compared with established prognostic risk scores using area under the receiver operating characteristic curves. Robustness of our findings was tested by internal bootstrap validation and adjustment of the threshold for statistical significance. A total of 1,075 patients were included, of whom 298 patients (28%) had died at 90-day follow-up. Multivariable analyses adjusted for age and norepinephrine infusion rate demonstrated that the combination of higher respiratory rate, higher systolic blood pressure, lower central temperature, altered consciousness, and decreased urine output was independently associated with 90-day mortality (area under the receiver operating characteristic curves = 0.74; 95% CI, 0.71–0.78). Clinical examination had a similar discriminative value as compared with the Simplified Acute Physiology Score-II (area under the receiver operating characteristic curves = 0.76; 95% CI, 0.73–0.79; p = 0.29) and Acute Physiology and Chronic Health Evaluation-IV (using area under the receiver operating characteristic curves = 0.77; 95% CI, 0.74–0.80; p = 0.16) and was significantly better than the Sequential Organ Failure Assessment (using area under the receiver operating characteristic curves = 0.67; 95% CI, 0.64–0.71; p < 0.001).

Conclusions:
Clinical examination has reasonable discriminative value for assessing 90-day mortality in acutely admitted ICU patients. In our study population, a single, protocolized clinical examination had similar prognostic abilities compared with the Simplified Acute Physiology Score-II and Acute Physiology and Chronic Health Evaluation-IV and outperformed the Sequential Organ Failure Assessment score.