bluuebunny/crossref_metadata_2025_split huggingface dataset:
Petunia- and Arabidopsis-Specific Root Microbiota Responses to Phosphate Supplementation
Authors: Bodenhausen Natacha , Somerville Vincent , Desirò Alessandro , Walser Jean-Claude , Borghi Lorenzo , van der Heijden Marcel G. A. , Schlaeppi Klaus 
Published: June 2019

Phosphorus (P) is a limiting element for plant growth. Several root microbes, including arbuscular mycorrhizal fungi (AMF), have the capacity to improve plant nutrition and their abundance is known to depend on P fertility. However, how complex root-associated bacterial and fungal communities respond to various levels of P supplementation remains ill-defined. Here we investigated the responses of the root-associated bacteria and fungi to varying levels of P supply using 16S rRNA gene and internal transcribed spacer amplicon sequencing. We grew Petunia, which forms symbiosis with AMF, and the nonmycorrhizal model species Arabidopsis as a control in a soil that is limiting in plant-available P and we then supplemented the plants with complete fertilizer solutions that varied only in their phosphate concentrations. We searched for microbes, whose abundances varied by P fertilization, tested whether a core microbiota responding to the P treatments could be identified and asked whether bacterial and fungal co-occurrence patterns change in response to the varying P levels. Root microbiota composition varied substantially in response to the varying P application. A core microbiota was not identified as different bacterial and fungal groups responded to low-P conditions in Arabidopsis and Petunia. Microbes with P-dependent abundance patterns included Mortierellomycotina in Arabidopsis, while in Petunia, they included AMF and their symbiotic endobacteria. Of note, the P-dependent root colonization by AMF was reliably quantified by sequencing. The fact that the root microbiotas of the two plant species responded differently to low-P conditions suggests that plant species specificity would need to be considered for the eventual development of microbial products that improve plant P nutrition. [Formula: see text]Copyright © 2019 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Lumbosacral Transitional Vertebrae
Authors: Tucker Braden J. , Weinberg Douglas S. , Liu Raymond W. 
Published: June 2019

Study Design:
This is a retrospective cohort study.

Objective:
The objective of this study was to verify the prevalence of lumbosacral transitional vertebrae (LSTV) in the general population and measure the resulting spinal arthritic changes.

Summary of Background:
LSTV are a morphologic variation within the lumbar spine that has potentially significant clinical implications. LSTV prevalence has been investigated using nonrandom volunteer samples and patient populations presenting with medical complaints such as abdominal or lumbar pain warranting computed tomography and magnetic resonance imaging scans. The examination of LSTV prevalence and variations using a true random population to our knowledge has yet to be conducted, and the relation between LSTV and spinal arthritis has not been rigorously examined.

Materials and Methods:
A total of 560 cadaveric skeletons were obtained from the Hamann-Todd osteological collection. The transverse processes of the terminal lumbar vertebrae were examined and measured, since the classification at times is based on examination and at times is based on measurement. The lumbar degenerative disease was graded on each specimen.

Results:
Our search revealed 489 (87.3%) nontransitional vertebrae and 71 (12.7%) transitional vertebrae, with the majority of these Castellvi type IA (N=28), type IB (N=19), and type IIA (N=11). Transitional vertebrae as a whole (standardized β=0.090, P=0.015), and in particular type Ia showed a correlation to osteoarthritis in the L4–L5 vertebral level (standardized β=0.089, P=0.015).

Conclusions:
This cadaveric study aids in establishing the prevalence of LSTV (12.7%) in a random population and the frequency of the various Castellvi LSTV morphologies. An association was found between type Ia morphology and L4–L5 osteoarthritis which has not been reported in the past, suggesting that mild LSTV may carry more significance to lumbar pathology than previously considered.
Clinical Impact of Cervical Imbalance on Surgical Outcomes of Laminoplasty
Authors: Tamai Koji , Suzuki Akinobu , Yabu Akito , Terai Hidetomi , Hoshino Masatoshi , Toyoda Hiromitsu , Takahashi Shinji , Ohyama Shoichiro , Hori Yusuke , Nakamura Hiroaki 
Published: June 2019

Study Design:
This is a retrospective cohort study.

Objective:
The objective of this study was to identify the impact of preoperative cervical sagittal balance on the 2-year surgical outcomes of laminoplasty.

Summary of Background Data:
The cervical imbalance is considered associated with poor health-related quality of life and poor outcomes for cervical deformity surgery. However, the influences of cervical imbalance on the clinical outcomes of laminoplasty for cervical spondylotic myelopathy (CSM) patients are unclear.

Materials and Methods:
A total of 277 consecutive CSM patients who underwent laminoplasty were analyzed. From the last consecutive 136 patients, matched control group [cervical sagittal vertical axis (cSVA)<40 mm, n=30] and matched imbalance group (≥40 mm, n=30) were selected based on their propensity score adjusted for age, sex, cervical alignment, and preoperative Japanese Orthopaedic Association (JOA) score. Change in clinical outcomes and radiographic parameters at 2 years postoperatively were compared between the 2 matched groups using mixed-effects model. For the validation of the primary results, factors that correlated with the recovery rate of JOA score of another 141 patients were analyzed using multiple linear regression analysis.

Results:
There was no significant interaction between the 2 matched groups in all clinical outcomes, including the severity of myelopathy, patient-oriented health-related quality of life score, physical and mental status, physical functions, and pain score. Regarding the radiographic evaluation, change in cSVA showed significant differences (P=0.038); cSVA was kept stable in the matched control group, whereas its value significantly decreased in the matched imbalance group. Multiple linear regression models demonstrated that preoperative cSVA is not significantly related to the recovery rate of JOA score at 2 years postoperatively (P=0.114).

Conclusions:
Preoperative cervical imbalance did not significantly affect the 2-year surgical outcomes of laminoplasty. Furthermore, cervical imbalance improved after surgery. These results can suggest physicians consider laminoplasty as a treatment for CSM patients regardless of their cervical balance.

Level of Evidence:
Level III—treatment benefits: nonrandomized controlled cohort/follow-up study.
Impact of Early Acute Kidney Injury on Management and Outcome in Patients With Acute Respiratory Distress Syndrome: A Secondary Analysis of a Multicenter Observational Study*
Authors: McNicholas Bairbre A. , Rezoagli Emanuele , Pham Tài , Madotto Fabiana , Guiard Elsa , Fanelli Vito , Bellani Giacomo , Griffin Matthew D. , Ranieri Marco , Laffey John G. 
Published: June 2019

Objectives:
To understand the impact of mild-moderate and severe acute kidney injury in patients with acute respiratory distress syndrome.

Design:
Secondary analysis of the “Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure”, an international prospective cohort study of patients with severe respiratory failure.

Setting:
Four-hundred fifty-nine ICUs from 50 countries across five continents.

Subjects:
Patients with a glomerular filtration rate greater than 60 mL/min/1.73 m2 prior to admission who fulfilled criteria of acute respiratory distress syndrome on day 1 and day 2 of acute hypoxemic respiratory failure.

Interventions:
Patients were categorized based on worst serum creatinine or urine output into: 1) no acute kidney injury (serum creatinine < 132 µmol/L or urine output ≥ 0.5 mL/kg/hr), 2) mild-moderate acute kidney injury (serum creatinine 132–354 µmol/L or minimum urine output between 0.3 and 0.5mL/kg/hr), or 3) severe acute kidney injury (serum creatinine > 354 µmol/L or renal replacement therapy or minimum urine output < 0.3 mL/kg/hr).

Measurements and Main Results:
The primary outcome was hospital mortality, whereas secondary outcomes included prevalence of acute kidney injury and characterization of acute respiratory distress syndrome risk factors and illness severity patterns, in patients with acute kidney injury versus no acute kidney injury. One-thousand nine-hundred seventy-four patients met inclusion criteria: 1,209 (61%) with no acute kidney injury, 468 (24%) with mild-moderate acute kidney injury, and 297 (15%) with severe acute kidney injury. The impact of acute kidney injury on the ventilatory management of patients with acute respiratory distress syndrome was relatively limited, with no differences in arterial Co
2 tension or in tidal or minute ventilation between the groups. Hospital mortality increased from 31% in acute respiratory distress syndrome patients with no acute kidney injury to 50% in mild-moderate acute kidney injury (p ≤ 0.001 vs no acute kidney injury) and 58% in severe acute kidney injury (p ≤ 0.001 vs no acute kidney injury and mild-moderate acute kidney injury). In multivariate analyses, both mild-moderate (odds ratio, 1.61; 95% CI, 1.24–2.09; p < 0.001) and severe (odds ratio, 2.13; 95% CI, 1.55–2.94; p < 0.001) acute kidney injury were independently associated with mortality.

Conclusions:
The development of acute kidney injury, even when mild-moderate in severity, is associated with a substantial increase in mortality in patients with acute respiratory distress syndrome.
Intracranial Hypertension and Cerebral Perfusion Pressure Insults in Adult Hypertensive Intraventricular Hemorrhage: Occurrence and Associations With Outcome
Authors: Ziai Wendy C. , Thompson Carol B. , Mayo Steven , McBee Nichol , Freeman William D. , Dlugash Rachel , Ullman Natalie , Hao Yi , Lane Karen , Awad Issam , Hanley Daniel F. 
Published: June 2019

Objectives:
Elevated intracranial pressure and inadequate cerebral perfusion pressure may contribute to poor outcomes in hypertensive intraventricular hemorrhage. We characterized the occurrence of elevated intracranial pressure and low cerebral perfusion pressure in obstructive intraventricular hemorrhage requiring extraventricular drainage.

Design:
Prospective observational cohort.

Setting:
ICUs of 73 academic hospitals.

Patients:
Four hundred ninety-nine patients enrolled in the CLEAR III trial, a multicenter, randomized study to determine if extraventricular drainage plus intraventricular alteplase improved outcome versus extraventricular drainage plus saline.

Interventions:
Intracranial pressure and cerebral perfusion pressure were recorded every 4 hours, analyzed over a range of thresholds, as single readings or spans (≥ 2) of readings after adjustment for intracerebral hemorrhage severity. Impact on 30- and 180-days modified Rankin Scale scores was assessed, and receiver operating curves were analyzed to identify optimal thresholds.

Measurements and Main Results:
Of 21,954 intracranial pressure readings, median interquartile range 12 mm Hg (8–16), 9.7% were greater than 20 mm Hg and 1.8% were greater than 30 mm Hg. Proportion of intracranial pressure readings from greater than 18 to greater than 30 mm Hg and combined intracranial pressure greater than 20 plus cerebral perfusion pressure less than 70 mm Hg were associated with day-30 mortality and partially mitigated by intraventricular alteplase. Proportion of cerebral perfusion pressure readings from less than 65 to less than 90 mm Hg and intracranial pressure greater than 20 mm Hg in spans were associated with both 30-day mortality and 180-day mortality. Proportion of cerebral perfusion pressure readings from less than 65 to less than 90 mm Hg and combined intracranial pressure greater than 20 plus cerebral perfusion pressure less than 60 mm Hg were associated with poor day-30 modified Rankin Scale, whereas cerebral perfusion pressure less than 65 and less than 75 mm Hg were associated with poor day-180 modified Rankin Scale.

Conclusions:
Elevated intracranial pressure and inadequate cerebral perfusion pressure are not infrequent during extraventricular drainage for severe intraventricular hemorrhage, and level and duration predict higher short-term mortality and long-term mortality. Burden of low cerebral perfusion pressure was also associated with poor short- and long-term outcomes and may be more significant than intracranial pressure. Adverse consequences of intracranial pressure-time burden and cerebral perfusion pressure-time burden should be tested prospectively as potential thresholds for therapeutic intervention.
Comparison of Automated Activity Recognition to Provider Observations of Patient Mobility in the ICU*
Authors: Rawat Nishi , Rao Vishal , Peven Michael , Shrock Christine , Reiter Austin , Saria Suchi , Ali Haider 
Published: June 2019

Objectives:
To compare noninvasive mobility sensor patient motion signature to direct observations by physicians and nurses.

Design:
Prospective, observational study.

Setting:
Academic hospital surgical ICU.

Patients and Measurements:
A total of 2,426 1-minute clips from six ICU patients (development dataset) and 4,824 1-minute clips from five patients (test dataset).

Interventions:
None.

Main Results:
Noninvasive mobility sensor achieved a minute-level accuracy of 94.2% (2,138/2,272) and an hour-level accuracy of 81.4% (70/86).

Conclusions:
The automated noninvasive mobility sensor system represents a significant departure from current manual measurement and reporting used in clinical care, lowering the burden of measurement and documentation on caregivers.
Growth and Changing Characteristics of Pediatric Intensive Care 2001–2016
Authors: Horak Robin V. , Griffin John F. , Brown Ann-Marie , Nett Sholeen T. , Christie LeeAnn M. , Forbes Michael L. , Kubis Sherri , Li Simon , Singleton Marcy N. , Verger Judy T. , Markovitz Barry P. , Burns Jeffrey P. , Chung Sarita A. , Randolph Adrienne G. 
Published: June 2019

Objectives:
We assessed the growth, distribution, and characteristics of pediatric intensive care in 2016.

Design:
Hospitals with PICUs were identified from prior surveys, databases, online searching, and clinician networking. A structured web-based survey was distributed in 2016 and compared with responses in a 2001 survey.

Setting:
PICUs were defined as a separate unit, specifically for the treatment of children with life-threatening conditions. PICU hospitals contained greater than or equal to 1 PICU.

Subjects:
Physician medical directors and nurse managers.

Interventions:
None.

Measurements and Main Results:
PICU beds per pediatric population (< 18 yr), PICU bed distribution by state and region, and PICU characteristics and their relationship with PICU beds were measured. Between 2001 and 2016, the U.S. pediatric population grew 1.9% to greater than 73.6 million children, and PICU hospitals decreased 0.9% from 347 to 344 (58 closed, 55 opened). In contrast, PICU bed numbers increased 43% (4,135 to 5,908 beds); the median PICU beds per PICU hospital rose from 9 to 12 (interquartile range 8, 20 beds). PICU hospitals with greater than or equal to 15 beds in 2001 had significant bed growth by 2016, whereas PICU hospitals with less than 15 beds experienced little average growth. In 2016, there were eight PICU beds per 100,000 U.S. children (5.7 in 2001), with U.S. census region differences in bed availability (6.8 to 8.8 beds/100,000 children). Sixty-three PICU hospitals (18%) accounted for 47% of PICU beds. Specialized PICUs were available in 59 hospitals (17.2%), 48 were cardiac (129% growth). Academic affiliation, extracorporeal membrane oxygenation availability, and 24-hour in-hospital intensivist staffing increased with PICU beds per hospital.

Conclusions:
U.S. PICU bed growth exceeded pediatric population growth over 15 years with a relatively small percentage of PICU hospitals containing almost half of all PICU beds. PICU bed availability is variable across U.S. states and regions, potentially influencing access to care and emergency preparedness.
Exposure to Fine Particulate Matter and Ovarian Reserve Among Women from a Fertility Clinic
Authors: Gaskins Audrey J. , Mínguez-Alarcón Lidia , Fong Kelvin C. , Abdelmessih Sarah , Coull Brent A. , Chavarro Jorge E. , Schwartz Joel , Kloog Itai , Souter Irene , Hauser Russ , Laden Francine 
Published: June 2019

Background:
An increasing number of studies have linked air pollution to decreased fertility. Whether this is due to an effect on ovarian reserve is unknown.

Method:
Our study included 632 women attending the Massachusetts General Hospital Fertility Center (2004–2015) who had a measured antral follicle count. Validated spatiotemporal models estimated daily particulate matter <2.5 µg/m3 (PM2.5) (based on residential address) for the 3 months before the antral follicle count. We analyzed associations with Poisson regression.

Results:
Every 2 µg/m3 increase in estimated PM2.5 exposure was associated with a −7.2% (95% confidence interval = −10.4%, −3.8%) lower antral follicle count adjusting for age, body mass index, smoking status, and year and season of the count. The association of PM2.5 with antral follicle count was stronger among women with female factor infertility (−16.3% per 2 µg/m3).

Conclusions:
Among women from an infertility clinic, higher PM2.5 exposure was associated with lower ovarian reserve, raising concern that air pollution may accelerate reproductive aging.
Subcutaneous and Intravenous Treprostinil Pharmacokinetics in Children With Pulmonary Vascular Disease
Authors: Hall Keeley , Ogawa Michelle , Sakarovitch Charlotte , Hopper Rachel K. , Adamson Gregory T. , Hanna Brian , Ivy David D. , Miller-Reed Kathleen , Yung Delphine , McCarthy Elisa , Siehr-Handler Stephanie L. , Feinstein Jeffrey A. 
Published: June 2019

Abstract:
This study evaluated the pharmacokinetics of intravenous (IV) and subcutaneous (SC) treprostinil in pediatric patients with pulmonary vascular disease, and compared them with existing adult data from a similar cohort. Blood samples were collected from pediatric patients receiving steady-state IV or SC treprostinil and were assessed for plasma treprostinil concentration using liquid chromatography and tandem mass spectrometry. Forty participants, 15 receiving IV and 25 receiving SC treprostinil, were included in the analysis. Age ranged from 0.1 to 15.6 years. The median dose of treprostinil was 45.5 ng·kg−1·min−1 with a range of 8–146 ng·kg−1·min−1. There was a linear relationship between treprostinil dose and plasma concentration with an R
2 of 0.57. On average, there were higher blood concentrations per given dose of IV treprostinil compared with those per given dose of SC, but the difference was not significant. Compared with adult data, the slope of the pediatric data was similar, but the y-intercept was significantly lower. Additionally, the concentration per dose ratio was significantly higher in adults compared with children. Pediatric patients have significantly lower average blood concentrations of treprostinil per given dose compared with adults, and higher, but not significantly so, blood concentrations when treprostinil is administered IV as compared with SC administration.
XEN Gel Stent in Pseudoexfoliative Glaucoma: 2-Year Results of a Prospective Evaluation
Authors: Gillmann Kevin , Bravetti Giorgio E. , Mermoud André , Rao Harsha L. , Mansouri Kaweh 
Published: June 2019

Précis:
This study confirms the safety and efficacy of XEN gel stents in the management of pseudoexfoliative glaucoma 2 years after implantation, with success rates similar to primary open-angle glaucoma regardless of the definition of success.

Purpose:
To compare the long-term safety and efficacy of XEN gel implant surgery (Allergan Inc., Irvine, CA) in patients with pseudoexfoliative glaucoma (PEXG) and primary open-angle glaucoma (POAG).

Setting:
Prospective, interventional study in a tertiary glaucoma center.

Methods:
A total of 110 eyes of 85 patients with POAG (57 eyes) or PEXG (53 eyes) and uncontrolled intraocular pressure (IOP) despite medical treatment underwent combined XEN+cataract surgery or standalone XEN surgery. Mean IOP, mean number of medications, needling rates, and incidence of adverse effects were compared between the 2 groups. Complete surgical success was defined as an unmedicated IOP≤12, 15, 16, or 18 mm Hg at 2 years, both with and without a 20% reduction from baseline.

Results:
Combined XEN+cataract surgery was performed in 72% of POAG and 76% of PEXG eyes (P=0.67), the remainder underwent standalone XEN surgery. Patient characteristics were similar between the 2 groups except for older age for the patients with PEXG (78.5±8.5 vs. 71.3±8.7 y; P<0.005). Mean medicated IOP were 19.8±5.8 mm Hg (POAG) versus 19.8±8.2 mm Hg (PEXG) at baseline (P=0.98), and 14.5±3.6 mm Hg (−26.8%) versus 14.2±3.8 mm Hg (−28.3%), respectively, at 2 years (P=0.75). Mean medications concomitantly dropped from 1.9±1.6 (POAG) versus 2.0±1.3 (PEXG) to 0.6±0.9 versus 0.4±0.7, respectively (P=0.29). Using the 16 mm Hg threshold, 51.4% (POAG) versus 57.1% (PEXG) eyes achieved complete success (P=0.70) at 2 years. The difference in success rates between the 2 groups was not statistically significant under any of the definitions of success. By 24 months, needling was performed in 42.8% (POAG) and 43.2% (PEXG) (P=0.64), with an average time to needling of 162.8 and 134.9 days, respectively (P=0.46). The rates of adverse effects were 30.6% (POAG) and 36.4% (PEXG) (P=0.66), and additional glaucoma surgeries were carried out in 14.3% (POAG) versus 15.9% (PEXG) (P=0.89).

Conclusions:
The XEN gel implant as a standalone or combined procedure demonstrated similar efficacy and safety results in PEXG and POAG eyes.
Nutritionally Variant Streptococcal Bacteremia in the 21st Century
Authors: Wright Edward A. , Myers Joseph P. 
Published: June 2019

Abstract
We report the results of a 12-year retrospective study of nutritionally variant streptococcal (NVS) bacteremia in a 510-bed, a large medical school-affiliated teaching hospital. Twenty-six episodes of NVS bacteremia were identified in this institutional review board—approved study of all positive blood cultures for NVS from January 1, 2006, to December 31, 2017. Most patients with NVS bacteremia were 50 years and older. Detection of bacteremia in the microbiology laboratory took from 2 to 11 days of incubation with an average of 4.65 days. Endocarditis was the most common source of bacteremia (7 patients), followed by primary bacteremia, skin and soft tissue infections, bone and joint infections, and device-associated infections. The mortality of patients in the study was 15% despite all but 1 patient who died receiving appropriate antimicrobial therapy immediately upon hospital admission. Nutritionally variant streptococcal bacteremia is uncommon, is frequently associated with infective endocarditis, is often detected late in the hospital course because of delayed growth of NVS organisms in blood culture media, and had a 15% mortality rate.