bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mindfulness-Based Intervention Does Not Influence Cardiac Autonomic Control or the Pattern of Physical Activity in Fibromyalgia During Daily Life
Authors: Grossman Paul , Deuring Gunnar , Walach Harald , Schwarzer Barbara , Schmidt Stefan 
Published: August 2016

Objectives:
Fibromyalgia (FM) is a syndrome characterized by severe pain, fatigue and sleep disturbance. There is evidence of central hyper-responsiveness to sensory stimulation and impaired cardiovascular autonomic control. Laboratory investigations suggest that mindfulness-based stress reduction (MBSR) may improve autonomic functioning in FM. However, these findings may not reflect what occurs during naturalistic conditions, and MBSR studies during real-life functioning are lacking. We conducted a randomized controlled, 3-armed study with 168 female FM patients. This report describes cardiac, respiratory, and physical activity findings.

Methods:
Eight-week MBSR was compared with wait-list and active control intervention. Ambulatory accelerometry and cardiorespiratory function were monitored over 24-h periods at 3 time points: preintervention, postintervention, and at the 8-week follow-up. Also, baseline levels were compared with an age-matched group of 33 healthy women.

Findings:
Activity heart rate, respiratory sinus arrhythmia, and ventilation were measured. Comparison with controls confirmed differences in cardiac autonomic tone and activity pattern among patients. Most measures also showed effects of time of day and point of measurement. Regarding the intervention study, there were no effects of treatment. In addition, there were no relations between patient-reported clinical improvement and objective physiological or accelerometry parameters. Intervention-related benefits in wellbeing were not associated with changes in daytime cardiorespiratory measures or pattern of physical activity.

Conclusions:
MBSR did not produce cardiac autonomic benefits or changes in daily activity in FM. Furthermore, the lack of an association between patient-experienced clinical improvement and objective physiological measures suggests that subjective changes in the wellbeing of FM patients over time are not related to alterations in the cardiorespiratory autonomic function or activity levels.
How Reliable Are the Reported Genetic Associations in Disc Degeneration?
Authors: Rajasekaran S. , Kanna Rishi Mugesh , Reddy Ranjani Raja , Natesan Senthil , Raveendran Muthuraja , Cheung Kenneth M.C. , Chan Danny , Kao Patrick Y.P. , Yee Anita , Shetty Ajoy Prasad 
Published: August 2016

Study Design.
Prospective genetic association study.

Objective.
The aim of this study was to document the variations in the genetic associations, when different magnetic resonance imaging (MRI) phenotypes, age stratification, cohort size, and sequence of cohort inclusion are varied in the same study population.

Summary of Background Data.
Genetic associations with disc degeneration have shown high inconsistency, generally attributed to hereditary factors and ethnic variations. However, the effect of different phenotypes, size of the study population, age of the cohort, etc have not been documented clearly.

Methods.
Seventy-one single-nucleotide polymorphisms (SNPs) of 41 candidate genes were correlated to six MRI markers of disc degeneration (annular tears, Pfirmann grading, Schmorl nodes, Modic changes, Total Endplate Damage score, and disc bulge) in 809 patients with back pain and/or sciatica. In the same study group, the correlations were then retested for different age groups, different sample, size and sequence of subject inclusion (first 404 and the second 405) and the differences documented.

Results.
The mean age of population (M: 455, F: 354) was 36.7 ± 10.8 years. Different genetic associations were found with different phenotypes: disc bulge with three SNPs of CILP; annular tears with rs2249350 of ADAMTS5 and rs11247361 IGF1R; modic changes with VDR and MMP20; Pfirmann grading with three SNPs of MMP20 and Schmorl node with SNPs of CALM1 and FN1 and none with Total End Plate Score.
Subgroup analysis based on three age groups and dividing the total population into two groups also completely changed the associations for all the six radiographic parameters.

Conclusion.
In the same study population, SNP associations completely change with different phenotypes. Variations in age, inclusion sequence, and sample size resulted in change of genetic associations. Our study questions the validity of previous studies and necessitates the need for standardizing the description of disc degeneration, phenotype selection, study sample size, age, and other variables in future studies.

Level of Evidence: 4
Can C3 Laminectomy Reduce Interlaminar Bony Fusion and Preserve the Range of Motion After Cervical Laminoplasty?
Authors: Lee Dong-Ho , Cho Jae Hwan , Hwang Chang Ju , Lee Choon Sung , Cho Samuel K. , Ha Jung-Ki 
Published: August 2016

Study Design.
Retrospective comparative study.

Objective.
To investigate whether the resection of C3 lamina during cervical laminoplasty can prevent C2-C4 interlaminar bony fusion and preserve the range of motion (ROM) postoperatively.

Summary of Background Data.
Interlaminar bony fusion is a common complication after cervical laminoplasty, especially in the C2-C4. Laminectomy, rather than laminoplasty, of C3 has been recently introduced. Its advantages include minimizing muscle detachment at C2 and reducing postoperative neck pain.

Methods.
A total of 59 patients with cervical spondylotic myelopathy that involved three or more levels, including C3, were consecutively treated with laminoplasty and followed up for more than 3 years after surgery. The first 45 patients underwent open-door laminoplasty at C3 (Lp group) and the subsequent 14 patients underwent laminectomy at C3 rather than laminoplasty (Ln group). The Lp group was further divided into two subgroups based on the development of interlaminar bony fusion at C2-C3 and/or C3-C4: Lp-NF (nonfusion) and Lp-F (fusion) groups. Clinical outcomes and radiographic parameters were assessed pre- and postoperatively.

Results.
Nineteen out of 45 patients who underwent laminoplasty demonstrated fusion at 3-year follow up. Fusion developed more commonly in those patients who had a smaller preoperative ROM at C2-C4 segments (Lp-F 14.3° ± 6.9° vs. Lp-NF 21.4° ± 5.3°, P = 0.013). The neck disability index (range, 13.4 ± 7.3 to 6.3 ± 5.2, P < 0.001), visual analog scale for neck pain (range, 2.5 ± 1.7 to 0.9 ± 1.3, P = 0.027), Japanese Orthopedic Association (JOA) score (range, 14.3 ± 1.9 to 16.0 ± 2.4, P < 0.001), and JOA recovery rate (63.4 ± 19.8%) in the Ln group improved postoperatively; however, there was no significant difference in the improvement of these clinical outcomes among all three groups. Postoperative cervical ROM was significantly reduced in all groups; however, the extent of reduction was significantly smaller in the Ln group (10.5°; range, 44.2° ± 9.1° to 33.7 ± 6.0°) than in the Lp-NF (15.1°; range, 45.4° ± 8.5° to 30.3° ± 7.4°) or Lp-F (18.2°; range, 39.6° ± 9.3° to 21.4° ± 10.3°) groups (P < 0.05).

Conclusion.
C3 laminectomy with laminoplasty can prevent interlaminar bony fusion at C2-C4 and, ultimately, result in better preservation of cervical ROM than C3 laminoplasty. Furthermore, it yields similar clinical outcomes when compared with C3 laminoplasty.

Level of Evidence: 3
Neuromuscular Recovery Is Prolonged After Immobilization or Superimposition of Inflammation With Immobilization Compared to Inflammation Alone: Data From a Preclinical Model
Authors: Stäuble Christiane G. , Helming Marc , Martyn J. A. Jeevendra , Blobner Manfred , Fink Heidrun 
Published: August 2016

Objectives:
Recovery from ICU-acquired muscle weakness extends beyond hospital stay. We hypothesized that immobilization, more than inflammation, plays a prominent role in the delayed recovery from critical illness.

Design:
Prospective, randomized, controlled, experimental study.

Setting:
Animal laboratory, university hospital.

Subjects:
Male Sprague-Dawley rats.

Interventions:
Animals were divided to have one hind limb immobilized (n = 129) or sham-immobilized (n = 129) on day –12. After surgery, rats were further assigned to two subgroups. To induce inflammation, rats received three IV injections of Corynebacterium parvum on days –12, –8, and –4. Controls received saline at the respective time-points. At day 0, the limbs were remobilized and recovery from inflammation and/or immobilization was followed for 36 days.

Measurements and Main Results:
At day 0 and after 4, 12, or 36 days of recovery, maximum tetanic tension and tetanic fade (functional parameters = primary outcome variables) as well as nicotinic acetylcholine receptor expression, muscle mass, and histologic changes (structural parameters = secondary outcome variables) were measured. Impaired maximum tetanic tension, decreased tibialis muscle mass, and fiber diameter due to inflammation alone recovered by day 4. Tetanic fade was not affected by inflammation. Immobilization-induced loss of tibialis muscle mass, decreased fiber diameter, and tetanic fade did not return to normal until day 36, while maximum tetanic tension had recovered at that time. In the presence of inflammation and immobilization, the decrease in tibialis muscle mass, fiber diameter, and maximum tetanic tension, as well as decreased tetanic fade persisted until day 36. Up-regulation of nicotinic acetylcholine receptors normalized before day 4 following inflammation, but persisted until day 4 following immobilization.

Conclusions:
In our model, muscle function and structure recovered from inflammation within 4–12 days. Immobilization-induced neuromuscular changes, however, persisted even at day 36, especially if inflammation was concomitant.
Incidence and Characteristics of Ventilator-Associated Events Reported to the National Healthcare Safety Network in 2014*
Authors: Magill Shelley S. , Li Qunna , Gross Cindy , Dudeck Margaret , Allen-Bridson Katherine , Edwards Jonathan R. 
Published: August 2016

Objective:
Ventilator-associated event surveillance was introduced in the National Healthcare Safety Network in 2013, replacing surveillance for ventilator-associated pneumonia in adult inpatient locations. We determined incidence rates and characteristics of ventilator-associated events reported to the National Healthcare Safety Network.

Design, Setting, and Patients:
We analyzed data reported from U.S. healthcare facilities for ventilator-associated events that occurred in 2014, the first year during which ventilator-associated event surveillance definitions were stable. We used negative binomial regression modeling to identify healthcare facility and inpatient location characteristics associated with ventilator-associated events. We calculated ventilator-associated event incidence rates, rate distributions, and ventilator utilization ratios in critical care and noncritical care locations and described event characteristics.

Measurements and Main Results:
A total of 1,824 healthcare facilities reported 32,772 location months of ventilator-associated event surveillance data to the National Healthcare Safety Network in 2014. Critical care unit pooled mean ventilator-associated event incidence rates ranged from 2.00 to 11.79 per 1,000 ventilator days, whereas noncritical care unit rates ranged from 0 to 14.86 per 1,000 ventilator days. The pooled mean proportion of ventilator-associated events defined as infection-related varied from 15.38% to 47.62% in critical care units. Pooled mean ventilator utilization ratios in critical care units ranged from 0.24 to 0.47.

Conclusions:
We found substantial variability in ventilator-associated event incidence, proportions of ventilator-associated events characterized as infection-related, and ventilator utilization within and among location types. More work is needed to understand the preventable fraction of ventilator-associated events and identify patient care strategies that reduce ventilator-associated events.
Lung Injury Prediction Score in Hospitalized Patients at Risk of Acute Respiratory Distress Syndrome
Authors: Soto Graciela J. , Kor Daryl J. , Park Pauline K. , Hou Peter C. , Kaufman David A. , Kim Mimi , Yadav Hemang , Teman Nicholas , Hsu Michael C. , Shvilkina Tatyana , Grewal Yekaterina , De Aguirre Manuel , Gunda Sampath , Gajic Ognjen , Gong Michelle Ng 
Published: August 2016

Objective:
The Lung Injury Prediction Score identifies patients at risk for acute respiratory distress syndrome in the emergency department, but it has not been validated in non-emergency department hospitalized patients. We aimed to evaluate whether Lung Injury Prediction Score identifies non-emergency department hospitalized patients at risk of developing acute respiratory distress syndrome at the time of critical care contact.

Design:
Retrospective study.

Setting:
Five academic medical centers.

Patients:
Nine hundred consecutive patients (≥ 18 yr old) with at least one acute respiratory distress syndrome risk factor at the time of critical care contact.

Interventions:
None.

Measurements and Main Results:
Lung Injury Prediction Score was calculated using the worst values within the 12 hours before initial critical care contact. Patients with acute respiratory distress syndrome at the time of initial contact were excluded. Acute respiratory distress syndrome developed in 124 patients (13.7%) a median of 2 days (interquartile range, 2–3) after critical care contact. Hospital mortality was 22% and was significantly higher in acute respiratory distress syndrome than non-acute respiratory distress syndrome patients (48% vs 18%; p < 0.001). Increasing Lung Injury Prediction Score was significantly associated with development of acute respiratory distress syndrome (odds ratio, 1.31; 95% CI, 1.21–1.42) and the composite outcome of acute respiratory distress syndrome or death (odds ratio, 1.26; 95% CI, 1.18–1.34). A Lung Injury Prediction Score greater than or equal to 4 was associated with the development of acute respiratory distress syndrome (odds ratio, 4.17; 95% CI, 2.26–7.72), composite outcome of acute respiratory distress syndrome or death (odds ratio, 2.43; 95% CI, 1.68–3.49), and acute respiratory distress syndrome after accounting for the competing risk of death (hazard ratio, 3.71; 95% CI, 2.05–6.72). For acute respiratory distress syndrome development, the Lung Injury Prediction Score has an area under the receiver operating characteristic curve of 0.70 and a Lung Injury Prediction Score greater than or equal to 4 has 90% sensitivity (misses only 10% of acute respiratory distress syndrome cases), 31% specificity, 17% positive predictive value, and 95% negative predictive value.

Conclusions:
In a cohort of non-emergency department hospitalized patients, the Lung Injury Prediction Score and Lung Injury Prediction Score greater than or equal to 4 can identify patients at increased risk of acute respiratory distress syndrome and/or death at the time of critical care contact but it does not perform as well as in the original emergency department cohort.
Acute Kidney Injury in Pediatric Severe Sepsis: An Independent Risk Factor for Death and New Disability
Authors: Fitzgerald Julie C. , Basu Rajit K. , Akcan-Arikan Ayse , Izquierdo Ledys M. , Piñeres Olave Byron E. , Hassinger Amanda B. , Szczepanska Maria , Deep Akash , Williams Duane , Sapru Anil , Roy Jason A. , Nadkarni Vinay M. , Thomas Neal J. , Weiss Scott L. , Furth Susan 
Published: August 2016

Objectives:
The prevalence of septic acute kidney injury and impact on functional status of PICU survivors are unknown. We used data from an international prospective severe sepsis study to elucidate functional outcomes of children suffering septic acute kidney injury.

Design:
Secondary analysis of patients in the Sepsis PRevalence, OUtcomes, and Therapies point prevalence study: acute kidney injury was defined on the study day using Kidney Disease Improving Global Outcomes definitions. Patients with no acute kidney injury or stage 1 acute kidney injury (“no/mild acute kidney injury”) were compared with those with stage 2 or 3 acute kidney injury (“severe acute kidney injury”). The primary outcome was a composite of death or new moderate disability at discharge defined as a Pediatric Overall Performance Category score of 3 or higher and increased by 1 from baseline.

Setting:
One hundred twenty-eight PICUs in 26 countries.

Patients:
Children with severe sepsis in the Sepsis PRevalence, OUtcomes, and Therapies study.

Interventions:
None.

Measurements and Main Results:
One hundred two (21%) of 493 patients had severe acute kidney injury. More than twice as many patients with severe acute kidney injury died or developed new moderate disability compared with those with no/mild acute kidney injury (64% vs 30%; p < 0.001). Severe acute kidney injury was independently associated with death or new moderate disability (adjusted odds ratio, 2.5; 95% CI, 1.5–4.2; p = 0.001) after adjustment for age, region, baseline disability, malignancy, invasive mechanical ventilation, albumin administration, and the pediatric logistic organ dysfunction score.

Conclusions:
In a multinational cohort of critically ill children with severe sepsis and high mortality rates, septic acute kidney injury is independently associated with further increased death or new disability.
Human Papillomavirus Type 16 L2 DNA Methylation in Exfoliated Cervical Cells From College-Age Women
Authors: Anderson Erin L. , Banister Carolyn E. , Kassler Susannah , Messersmith Amy , Pirisi Lucia , Creek Kim E. , Wyattt Michael D. 
Published: August 2016

Objectives
The Carolina Women’s Care Study (CWCS) at the University of South Carolina followed 467 young women with the goal of identifying biomarkers of human papillomavirus (HPV) persistence. In this study, we analyzed the methylation of HPV16 DNA.

Methods
The aims of this study were to determine the methylation status of the HPV16 L2 gene in DNA isolated from exfoliated cervical cells collected longitudinally as part of the CWCS and to determine the prevalence of polymorphisms (single nucleotide polymorphisms [SNPs]) in folate metabolizing enzymes and DNA repair enzymes known to affect DNA methylation in blood-derived genomic DNA from CWCS participants. For methylation studies, DNA samples were bisulfite converted and amplified with the EpiTect Whole Bisulfitome kit. Polymerase chain reaction was performed for amplicons containing 5 CpG sites in L2. Pyrosequencing was carried out using EpigenDx and analyzed with PyroMark Software. Taqman genotyping assays were performed to determine selected SNP alleles in the CWCS cohort.

Results and Conclusions
Methylation data were obtained for 82 samples from 27 participants. Of these, 22 participants were positive for HPV16 for 3 or more visits (≥12 months). Methylation in L2 was detectable, but methylation levels varied and were not associated with HPV16 persistence. No linearity of methylation levels over time was observed in participants for whom longitudinal data could be analyzed. Analysis of 9 selected SNPs did not reveal an association with persistence. We conclude that at early stages of infection methylation of HPV16 L2 DNA in Pap test samples is not a predictive biomarker of HPV persistence.
Validation of Interstitial Fractional Volume Quantification by Using Dynamic Contrast-Enhanced Magnetic Resonance Imaging in Porcine Skeletal Muscles
Authors: Hindel Stefan , Söhner Anika , Maaß Marc , Sauerwein Wolfgang , Baba Hideo Andreas , Kramer Martin , Lüdemann Lutz 
Published: August 2016

Objectives
The aim of our study was to assess the accuracy of fractional interstitial volume determination in low perfused and low vascularized tissue by using dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI).

Materials and Methods
The fractional interstitial volume (v
e) was determined in the medial thigh muscle of 12 female pigs by using a 3-dimensional gradient echo sequence with k-space sharing and administering gadolinium-based contrast agent (gadoterate meglumine). Analysis was performed using 3 pharmacokinetic models: the simple Tofts model (TM), the extended TM (ETM), and the 2-compartment exchange model (2CXM). We investigated the effect of varying acquisition durations (ADs) on the model parameter estimates of the 3 models and compared the v
e values with the results of histological examinations of muscle sections of the medial thigh muscle.

Results
Histological measurements yielded a median value (25%–75% quartile) of 4.8% (3.7%–6.2%) for v
e. The interstitial fractional volume determined by DCE-MRI was comparable to the histological results but varied strongly with AD for the TM and ETM. For the TM and the ETM, the results were virtually the same. Choosing arterial hematocrit to Hcta = 0.4, the lowest median v
e value determined by DCE-MRI was 5.2% (3.3%–6.1%) for the ETM at a 6-minute AD. The maximum v
e value determined with the ETM at a 15-minute AD was 7.7% (4.5%–9.0%). The variation with AD of median v
e values obtained with the 2CXM was much smaller: 6.2% (3.1%–9.2%) for the 6-minute AD and 6.3% (4.3%–9.8%) for the 15-minute AD. The best fit for the 2CXM was found at the 10-minute AD with v
e values of 6.6% (3.7%–8.2%). No significant correlation between the histological and any DCE-MRI modeling results was found. Considering the expected accuracy of histological measurements, the medians of the MR modeling results were in good agreement with the histological prediction. A parameter determination uncertainty was identified with the use of the TMs. This is due to underfitting and has a major effect even on the analysis of tissues with low vascularization and low perfusion, where the estimated v
e values depend on the AD. For the TM and ETM, the results best matched the histological measurements for an AD of 6 minutes.

Conclusions
Owing to more fitting parameters, the 2CXM yielded better fits and the median interstitium-to-plasma rate constant k
ep was less depending on the AD; however, the uncertainty expressed by the 25% to 75% quartile range was found to be larger. An AD of 10 minutes was needed for the 2CXM to achieve accuracy comparable to those of the TMs with shorter ADs.