bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Effect of Obesity on the Improvement in Health State Outcomes following Minimally Invasive Transforaminal Interbody Fusion
Authors: McAnany Steven J. , Patterson Diana C. , Overley Samuel , Alicea Daniel , Guzman Javier , Qureshi Sheeraz A. 
Published: March 2016

Study Design Observational study. Objective Studies have shown a correlation between obesity and lumbar spine pathology, but also that obese patients have higher rates of complication following lumbar spine surgery. It is unknown if obese patients have clinical gains following lumbar spine surgery comparable to the gain of normal-weight patients. This study investigated the correlation of obesity and the delta change in outcomes in a single surgeon's cohort of normal-weight and obese patients undergoing minimally invasive (MIS) transforaminal lumbar interbody fusion (TLIF). Methods A retrospective review was performed of a single surgeon's patients at an academic medical center who underwent MIS TLIF between July 2011 and December 2013. Statistical analyses included independent sample t test for continuous variables, Fisher exact test for categorical data, and repeated measures two-way analysis of variance to assess the interaction between obesity status and the change in Short-Form Health Survey 12 (SF-12) results. Results Thirty-eight patients from a single institution were reviewed, and 19 had a body mass index greater than 30. The nonobese and obese postoperative SF-12 mental composite scores (MCS; 52.70 ± 2.50 versus 52.16 ± 1.91; p = 0.87) and physical composite scores (PCS; 45.56 ± 2.72 versus 41.03 ± 2.65; p = 0.24) did not show any significant differences. There was no significant interaction between obesity and change in SF-12 MCS ( F [1, 36] = 0.96, p = 0.33) or SF-12 PCS ( F [1, 36] = 0.74, p = 0.40) between the pre- and postoperative scores. There was a significant effect of obesity on SF-12 PCS scores ( F [1, 36] = 7.15, p = 0.01). Conclusions Patients undergoing MIS TLIF sustain meaningful and significant gains in SF-12 MCS and PCS that is not impacted by their obesity status.
Physical activity estimated by the bone‐specific physical activity questionnaire is also associated with cardiovascular risk
Authors: Weeks Benjamin K. , Purvis Meredith , Beck Belinda R. 
Published: March 2016

AbstractThe nature of physical activity that benefits bone is traditionally thought to differ from that benefiting cardiovascular health. Accordingly, exercise recommendations for improving bone health and cardiovascular health are largely incongruent. Our aim was to determine the associations between high‐impact physical activity participation and both cardiovascular disease risk factors and bone mass. We recruited 94 men and women (age 34.0 ± 13.3 years) to undergo measures of cardiovascular disease risk (BMI, total cholesterol, fasting blood glucose, waist‐to‐hip ratio, and mean arterial pressure) and dual‐energy X‐ray absorptiometry (DXA XR‐800, Norland) measures of bone mass (femoral neck, lumbar spine, and whole body BMD) and body composition (whole body lean mass and fat mass). Physical activity participation was estimated using the bone‐specific physical activity questionnaire (BPAQ). Those in the upper tertile for current BPAQ score exhibited lower total cholesterol, waist‐to‐hip ratio, and mean arterial pressure than those in the lower tertiles (P < 0.05) with the relationship being mild‐to‐moderate (r = −0.49 to 0.29, P < 0.01). Those in the upper tertile for BPAQ score also had greater lumbar spine BMD than those in the lower tertile (P = 0.008), with BPAQ score predicting 6% of the variance in BMD (P = 0.02). We conclude that high‐impact physical activity as captured by the BPAQ may be beneficial for both bone health and for attenuating cardiovascular disease risk.
The boundedness of the weighted Coxeter group with complete graph
Authors: Shi Jian-yi , Yang Gao 
Published: March 2016

We prove that a weighted Coxeter group

(
W
,
S
,
L
)

(W,S,L)

is bounded with

a

(
W
)
=

b

′

(
W
)
:=
max
{
L
(
u
)
,
L
(

w

s
,
t

)
∣
u
,
s
,
t
∈
S
,

|

W

s
,
t

|

>
∞
}

\mathbf {a}(W)=\mathbf {b}’(W):=\max \{L(u),L(w_{s,t})\mid u,s,t\in S,|W_{s,t}|>\infty \}

if the Coxeter graph of

W
W

is complete and

b

′

(
W
)
>
∞

\mathbf {b}’(W)>\infty

, where

W

s
,
t

W_{s,t}

is the parabolic subgroup of

W
W

generated by

s
≠
t

s\ne t

in

S
S

and

w

s
,
t

w_{s,t}

is the longest element in

W

s
,
t

W_{s,t}

whenever

W

s
,
t

W_{s,t}

is finite.
Convex separably rationally connected complete intersections
Authors: Furukawa Katsuhisa 
Published: March 2016

We give a generalization of a result of R. Pandharipande to arbitrary characteristic: We prove that, if

X
X

is a convex, separably rationally connected, smooth complete intersection in

P

N

\mathbb {P}^N

over an algebraically closed field of arbitrary characteristic, then

X
X

is rational homogeneous.
Displaying updates in logic
Authors: Aucher Guillaume 
Published: March 2016

Abstract
We generalize the language of substructural logics interpreted over the ternary relational semantics. This is motivated by our intention to capture within the logical framework of substructural logics various logic-based formalisms dealing with common sense reasoning and logical dynamics. This initiative is based on the key observation that an update can be represented abstractly by the ternary relation of the substructural framework: the first argument of the ternary relation represents an initial situation, the second an informative event and the third the resulting situation after the occurrence of the informative event. Refining the language of substructural logics may allow us to account for the fine-grained reasoning present in common sense reasoning. Thus, we introduce three triples of connectives that are interconnected by means of cyclic permutations. The usual fusion, implication and co-implication connectives form one of these triples. We define a cut-free display calculus for our language that generalizes the display calculus for modal logic. We do not resort to structural connectives for truth constants and we show how we can obtain our display rules using Gaggle Theory. We prove the soundness and strong completeness of our display calculus via a Henkin-style construction. Using correspondence results from substructural logics, we also obtain sound and complete display calculi for a wide variety of classical and substructural logics. Then, we define dual substructural connectives and we provide a display calculus for our language extended with these dual connectives. Finally, we focus on the specific case of bi-intuitionistic logic for which we provide a novel sound and strongly complete display calculus. In a companion article (Aucher, 2016, J. Logic Comput.), we provide a sequent calculus for update logic that generalizes the non-associative Lambek calculus and a sequent calculus for dynamic epistemic logic that extends this sequent calculus for update logic.
Is There an Association Between Pain and Magnetic Resonance Imaging Parameters in Patients With Lumbar Spinal Stenosis?
Authors: Burgstaller Jakob M. , Schüffler Peter J. , Buhmann Joachim M. , Andreisek Gustav , Winklhofer Sebastian , Del Grande Filippo , Mattle Michèle , Brunner Florian , Karakoumis Georgios , Steurer Johann , Held Ulrike 
Published: March 2016

Study Design.A prospective multicenter cohort study.Objective.The aim of this study was to identify an association between pain and magnetic resonance imaging (MRI) parameters in patients with lumbar spinal stenosis (LSS).Summary of Background Data.At present, the relationship between abnormal MRI findings and pain in patients with LSS is still unclear.Methods.First, we conducted a systematic literature search. We identified relationships of relevant MRI parameters and pain in patients with LSS. Second, we addressed the study question with a thorough descriptive and graphical analysis to establish a relationship between MRI parameters and pain using data of the LSS outcome study (LSOS).Results.In the systematic review including four papers about the associations between radiological findings in the MRI and pain, the authors of two articles reported no association and two of them did. Of the latters, only one study found a moderate correlation between leg pain measured by Visual Analog Scale (VAS) and the degree of stenosis assessed by spine surgeons. In the data of the LSOS study, we could not identify a relevant association between any of the MRI parameters and buttock, leg, and back pain, quantified by the Spinal Stenosis Measure (SSM) and the Numeric Rating Scale (NRS). Even by restricting the analysis to the level of the lumbar spine with the most prominent radiological “stenosis,” no relevant association could be shown.Conclusion.Despite a thorough analysis of the data, we were not able to prove any correlation between radiological findings (MRI) and the severity of pain. There is a need for innovative “methods/techniques” to learn more about the causal relationship between radiological findings and the patients’ pain-related complaints.Level of Evidence:2
Impact of Proactive Nurse Participation in ICU Family Conferences: A Mixed-Method Study
Authors: Garrouste-Orgeas Maité , Max Adeline , Lerin Talia , Grégoire Charles , Ruckly Stéphane , Kloeckner Martin , Brochon Sandie , Pichot Emmanuelle , Simons Clara , El-Mhadri Myriame , Bruel Cédric , Philippart François , Fournier Julien , Tiercelet Kelly , Timsit Jean-François , Misset Benoit 
Published: March 2016

Objectives:
To investigate family perceptions of having a nurse participating in family conferences and to assess the psychologic well being of the same families after ICU discharge.

Design:
Mixed-method design with a qualitative study embedded in a single-center randomized study.

Setting:
Twelve-bed medical-surgical ICU in a 460-bed tertiary hospital.

Subjects:
One family member for each consecutive patient who received more than 48 hours of mechanical ventilation in the ICU.

Intervention:
Planned proactive participation of a nurse in family conferences led by a physician. In the control group, conferences were led by a physician without a nurse.

Measurements and Main Results:
Of the 172 eligible family members, 100 (60.2%) were randomized; among them, 88 underwent semistructured interviews at ICU discharge and 86 completed the Peritraumatic Dissociative Experiences Questionnaire at ICU discharge and then the Hospital Anxiety Depression Questionnaire and the Impact of Event Scale (for posttraumatic stress–related symptoms) 3 months later. The intervention and control groups were not significantly different regarding the prevalence of posttraumatic stress–related symptoms (52.3 vs 50%, respectively; p = 0.83). Anxiety and depression subscale scores were significantly lower in the intervention group. The qualitative data indicated that the families valued the principle of the conference itself. Perceptions of nurse participation clustered into four main themes: trust that ICU teamwork was effective (50/88; 56.8%), trust that care was centered on the patient (33/88; 37.5%), trust in effective dissemination of information (15/88; 17%), and trust that every effort was made to relieve anxiety in family members (12/88; 13.6%).

Conclusions:
Families valued the conferences themselves and valued the proactive participation of a nurse. These positive perceptions were associated with significant anxiety or depression subscale scores but not with changes in posttraumatic stress–related symptoms.
Variations in Case-Mix–Adjusted Duration of Mechanical Ventilation Among ICUs*
Authors: Kramer Andrew A. , Gershengorn Hayley B. , Wunsch Hannah , Zimmerman Jack E. 
Published: March 2016

Objectives:
To develop a model that predicts the duration of mechanical ventilation and then to use this model to compare observed versus expected duration of mechanical ventilation across ICUs.

Design:
Retrospective cohort analysis.

Setting:
Eighty-six eligible ICUs at 48 U.S. hospitals.

Patients:
ICU patients receiving mechanical ventilation on day 1 (n = 56,336) admitted from January 2013 to September 2014.

Interventions:
None.

Measurements and Main Results:
We developed and validated a multivariable logistic regression model for predicting duration of mechanical ventilation using ICU day 1 patient characteristics. Mean observed minus expected duration of mechanical ventilation was then obtained across patients and for each ICU. The accuracy of the model was assessed using R
2. We defined better performing units as ICUs that had an observed minus expected duration of mechanical ventilation less than –0.5 days and a p value of less than 0.01; and poorer performing units as ICUs with an observed minus expected duration of mechanical ventilation greater than +0.5 days and a p value of less than 0.01. The factors accounting for the majority of the model’s explanatory power were diagnosis (71%) and physiologic abnormalities (24%). For individual patients, the difference between observed and mean predicted duration of mechanical ventilation was 3.3 hours (95% CI, 2.8–3.9) with R
2 equal to 21.6%. The mean observed minus expected duration of mechanical ventilation across ICUs was 3.8 hours (95% CI, 2.1–5.5), with R
2 equal to 69.9%. Among the 86 ICUs, 66 (76.7%) had an observed mean mechanical ventilation duration that was within 0.5 days of predicted. Five ICUs had significantly (p < 0.01) poorer performance (observed minus expected duration of mechanical ventilation, > 0.5 d) and 14 ICUs significantly (p < 0.01) better performance (observed minus expected duration of mechanical ventilation, < −0.5 d).

Conclusions:
Comparison of observed and case-mix–adjusted predicted duration of mechanical ventilation can accurately assess and compare duration of mechanical ventilation across ICUs, but cannot accurately predict an individual patient’s mechanical ventilation duration. There are substantial differences in duration of mechanical ventilation across ICU and their association with unit practices and processes of care warrants examination.
Beneficial Effects of Early Enteral Nutrition After Major Rectal Surgery: A Possible Role for Conditionally Essential Amino Acids? Results of a Randomized Clinical Trial
Authors: van Barneveld Kevin W. Y. , Smeets Boudewijn J. J. , Heesakkers Fanny F. B. M. , Bosmans Joanna W. A. M. , Luyer Misha D. , Wasowicz Dareczka , Bakker Jaap A. , Roos Arnout N. , Rutten Harm J. T. , Bouvy Nicole D. , Boelens Petra G. 
Published: March 2016

Objectives:
To investigate direct postoperative outcome and plasma amino acid concentrations in a study comparing early enteral nutrition versus early parenteral nutrition after major rectal surgery. Previously, it was shown that a low plasma glutamine concentration represents poor prognosis in ICU patients.

Design:
A preplanned substudy of a previous prospective, randomized, open-label, single-centre study, comparing early enteral nutrition versus early parenteral nutrition in patients at high risk of postoperative ileus after surgery for locally advanced or locally recurrent rectal cancer. Early enteral nutrition reduced postoperative ileus, anastomotic leakage, and hospital stay.

Setting:
Tertiary referral centre for locally advanced and recurrent rectal cancer.

Patients:
A total of 123 patients with locally advanced or recurrent rectal carcinoma requiring major rectal surgery.

Interventions:
Patients were randomized (ALEA web-based external randomization) preoperatively into two groups: early enteral nutrition (early enteral nutrition, intervention) by nasojejunal tube (n = 61) or early parenteral nutrition (early parenteral nutrition, control) by jugular vein catheter (n = 62). Eight hours after the surgical procedure artificial nutrition was started in hemodynamically stable patients, stimulating oral intake in both groups. Blood samples were collected to measure plasma glutamine, citrulline, and arginine concentrations using a validated ultra performance liquid chromatography-tandem mass spectrometric method.

Measurements and Main Results:
Baseline concentrations were comparable for both groups. Directly after rectal surgery, a decrease in plasma amino acids was observed. Plasma glutamine concentrations were higher in the parenteral group than in the enteral group on postoperative day 1 (p = 0.027) and day 5 (p = 0.008). Arginine concentrations were also significantly increased in the parenteral group at day 1 (p < 0.001) and day 5 (p = 0.001).

Conclusions:
Lower plasma glutamine and arginine concentrations were measured in the enteral group, whereas a better clinical outcome was observed. We conclude that plasma amino acids do not provide a causal explanation for the observed beneficial effects of early enteral feeding after major rectal surgery.
Eicosapentaenoic Acid Inhibits Oxidation of ApoB-containing Lipoprotein Particles of Different Size In Vitro When Administered Alone or in Combination With Atorvastatin Active Metabolite Compared With Other Triglyceride-lowering Agents
Authors: Mason R. Preston , Sherratt Samuel C.R. , Jacob Robert F. 
Published: March 2016

Abstract:
Eicosapentaenoic acid (EPA) is a triglyceride-lowering agent that reduces circulating levels of the apolipoprotein B (apoB)-containing lipoprotein particles small dense low-density lipoprotein (sdLDL), very–low-density lipoprotein (VLDL), and oxidized low-density lipoprotein (LDL). These benefits may result from the direct antioxidant effects of EPA. To investigate this potential mechanism, these particles were isolated from human plasma, preincubated with EPA in the absence or presence of atorvastatin (active) metabolite, and subjected to copper-initiated oxidation. Lipid oxidation was measured as a function of thiobarbituric acid reactive substances formation. EPA inhibited sdLDL (IC50 ∼2.0 μM) and LDL oxidation (IC50 ∼2.5 μM) in a dose-dependent manner. Greater antioxidant potency was observed for EPA in VLDL. EPA inhibition was enhanced when combined with atorvastatin metabolite at low equimolar concentrations. Other triglyceride-lowering agents (fenofibrate, niacin, and gemfibrozil) and vitamin E did not significantly affect sdLDL, LDL, or VLDL oxidation compared with vehicle-treated controls. Docosahexaenoic acid was also found to inhibit oxidation in these particles but over a shorter time period than EPA. These data support recent clinical findings and suggest that EPA has direct antioxidant benefits in various apoB-containing subfractions that are more pronounced than those of other triglyceride-lowering agents and docosahexaenoic acid.
Augmented Reality System for Ultrasound Guidance of Transcatheter Aortic Valve Implantation
Authors: Currie Maria E. , McLeod A. Jonathan , Moore John T. , Chu Michael W. A. , Patel Rajni , Kiaii Bob , Peters Terry M. 
Published: March 2016

Objective Transcatheter aortic valve implantation (TAVI) relies on fluoroscopy and nephrotoxic contrast medium for valve deployment. We propose an alternative guidance system using augmented reality (AR) and transesophageal echocardiography (TEE) to guide TAVI deployment. The goals of this study were to determine how consistently the aortic valve annulus is defined from TEE using different aortic valve landmarks and to compare AR guidance with fluoroscopic guidance of TAVI deployment in an aortic root model. Methods Magnetic tracking sensors were integrated into the TAVI catheter and TEE probe, allowing these tools to be displayed in an AR environment. Variability in identifying aortic valve commissures and cuspal nadirs was assessed using TEE aortic root images. To compare AR guidance of TAVI deployment with fluoroscopic guidance, a TAVI stent was deployed 10 times in the aortic root model using each of the two guidance systems. Results Commissures and nadirs were both investigated as features for defining the valve annulus in the AR guidance system. The commissures were identified more consistently than the nadirs, with intraobserver variability of 2.2 and 3.8 mm, respectively, and interobserver variability of 3.3 and 4.7 mm, respectively. The precision of TAVI deployment using fluoroscopic guidance was 3.4 mm, whereas the precision of AR guidance was 2.9 mm, and its overall accuracy was 3.4 mm. This indicates that both have similar performance. Conclusions Aortic valve commissures can be identified more reliably than cuspal nadirs from TEE. The AR guidance system achieved similar deployment accuracy to that of fluoroscopy while eliminating the use and consequences of nephrotoxic contrast and radiation.
Effects of Stretching Exercise on Heart Rate Variability During Pregnancy
Authors: Logan Jeongok G. , Yeo SeonAe 
Published: March 2016

Background:
Little evidence exists for effects of low-intensity exercises such as stretching on cardiovascular health in pregnant women.

Aim:
Our aim was to evaluate the effect of a 20-minute stretching exercise on heart rate variability (HRV), blood pressure (BP), and heart rate (HR) in healthy pregnant women.

Methods:
In 15 pregnant women with a mean (SD) age of 29.47 (4.07) years and mean (SD) gestational weeks of 26.53 (8.35), HRV, and BP were measured before and after the 20-minute stretching exercise.

Results:
Compared with before the stretching exercise, standard deviation of the normal-to-normal intervals, total variability of heart rate, increased by 7.40 milliseconds (t = −2.31, P = .04) and root mean square of successive differences, a surrogate measure of parasympathetic outflow, also increased by 11.68 milliseconds (Z = −2.04, P = .04) after the stretching exercise. Diastolic BP and HR decreased by 2.13 mm Hg (t = 1.93, P = .07) and 3.31 bpm (t = 2.17, P = .05), respectively, but they did not reach statistical significance.

Discussion:
These preliminary data suggest that 20 minutes of stretching exercise may promote cardiovascular health by attenuating the loss of parasympathetic tone associated with pregnancy.
Investigation of Sacral Needle Depth in Minimally Invasive Sacrocolpopexy
Authors: Graham Edith , Akl Ahmed , Brubaker Linda , Dhaher Yasin , Fitzgerald Colleen , Mueller Elizabeth Rose 
Published: March 2016

Purpose
The aims of the study were to optimize surgical safety and to minimize vertebral disc puncture during sacral needle placement at the time of minimally invasive sacrocolpopexy. Cadaveric studies report that the anterior longitudinal ligament (ALL), which covers the vertebral disc and vertebrae, has a reported thickness of only 1.4 to 2.3 mm at L5-S1. Intervertebral disc puncture can accelerate disc degeneration, disc herniation, and loss of disc height, a risk that may be avoidable.

Materials and Methods
After institutional review board approval, research consent was obtained from women undergoing primary laparoscopic sacrocolpopexy. Intraoperatively, sacral sutures were placed in the ALL with a 1.5 cm diameter CV-2 needle using Gore-Tex suture. Depth measurements were collected using a laparoscopic ultrasound transducer positioned on the sacral promontory (SP) between the 2 ends of the needle visible through the ALL. Two still-frame US images of the single needle were taken using the BK Medical software. Needle depth was calculated by measuring the distance from the top of the ALL to the needle.

Results
Two satisfactory intraoperative images were obtained for all 9 participants. The mean needle depth at the SP was 3.96 mm. The interpatient needle depth varied from 2.07 to 9.04 mm.

Conclusions
In most participants (78%), the sacral needle depth exceeded 2.3 mm, suggesting that there may be risk to sacral suture placement without depth guidance at the promontory. During minimally invasive sacrocolpopexy, the depth of the ALL and the placement of the needle at the SP may result in inadvertent disc penetration. Surgeons should be conscious of the minimal depth of the ALL and consider placing the suture below the promontory to avoid the disc.