bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hematopoietic Cell Transplantation–Specific Comorbidity Index Predicts Inpatient Mortality and Survival in Patients Who Received Allogeneic Transplantation Admitted to the Intensive Care Unit
Authors: Bayraktar Ulas D. , Shpall Elizabeth J. , Liu Ping , Ciurea Stefan O. , Rondon Gabriela , de Lima Marcos , Cardenas-Turanzas Marylou , Price Kristen J. , Champlin Richard E. , Nates Joseph L. 
Published: October 2013

Purpose To investigate the prognostic value of the Hematopoietic Cell Transplantation–Specific Comorbidity Index (HCT-CI) in patients who received transplantation admitted to the intensive care unit (ICU). Patients and Methods We investigated the association of HCT-CI with inpatient mortality and overall survival (OS) among 377 patients who were admitted to the ICU within 100 days of allogeneic stem-cell transplantation (ASCT) at our institution. HCT-CI scores were collapsed into four groups and were evaluated in univariate and multivariate analyses using logistic regression and Cox proportional hazards models. Results The most common pretransplantation comorbidities were pulmonary and cardiac diseases, and respiratory failure was the primary reason for ICU admission. We observed a strong trend for higher inpatient mortality and shorter OS among patients with HCT-CI values ≥ 2 compared with patients with values of 0 to 1 in all patient subsets studied. Multivariate analysis showed that patients with HCT-CI values ≥ 2 had significantly higher inpatient mortality than patients with values of 0 to 1 and that HCT-CI values ≥ 4 were significantly associated with shorter OS compared with values of 0 to 1 (hazard ratio, 1.74; 95% CI, 1.23 to 2.47). The factors associated with lower inpatient mortality were ICU admission during the ASCT conditioning phase or the use of reduced-intensity conditioning regimens. The overall inpatient mortality rate was 64%, and the 1-year OS rate was 15%. Among patients with HCT-CI scores of 0 to 1, 2, 3, and ≥ 4, the 1-year OS rates were 22%, 17%, 18%, and 9%, respectively. Conclusion HCT-CI is a valuable predictor of mortality and survival in critically ill patients after ASCT.
Spinal Cord Stimulation in Treatment of Chronic Benign Pain: Challenges in Treatment Planning and Present Status, a 22-Year Experience
Authors: Kumar Krishna , Hunter Gary , Demeria Denny 
Published: October 2013

Abstract

OBJECTIVE:
To present an in-depth analysis of clinical predictors of outcome including age, sex, etiology of pain, type of electrodes used, duration of pain, duration of treatment, development of tolerance, employment status, activities of daily living, psychological status, and quality of life. Suggestions for treatment of low back pain with a predominant axial component are addressed. We analyzed the complications and proposed remedial measures to improve the effectiveness of this modality.

METHODS:
Study group consists of 410 patients (252 men, 58 women) with a mean age of 54 years and a mean follow-up period of 97.6 months. All patients were gated through a multidisciplinary pain clinic. The study was conducted over 22 years.

RESULTS:
The early success rate was 80% (328 patients), whereas the long-term success rate of internalized patients was 74.1% (243 patients) after the mean follow-up period of 97.6 months. Hardware-related complications included displaced or fractured electrodes, infection, and hardware malfunction. Etiologies demonstrating efficacy included failed back syndrome, peripheral vascular disease, angina pain, complex regional pain syndrome I and II, peripheral neuropathy, lower limb pain caused by multiple sclerosis. Age, sex, laterality of pain or number of surgeries before implant did not play a role in predicting outcome. The percentage of pain relief was inversely related to the time interval between pain onset and time of implantation. Radicular pain with axial component responded better to dual Pisces electrode or Specify-Lead implantation.

CONCLUSION:
Spinal cord stimulation can provide significant long-term pain relief with improved quality of life and employment. Results of this study will be effective in better defining prognostic factors and reducing complications leading to higher success rates with spinal cord stimulation.
Motor Cortex Stimulation for the Enhancement of Recovery from Stroke: A Prospective, Multicenter Safety Study
Authors: Brown Jeffrey A. , Lutsep Helmi L. , Weinand Martin , Cramer Steven C. 
Published: October 2013

Abstract

OBJECTIVE:
Functional magnetic resonance imaging and transcranial magnetic stimulation studies suggest that human cortex shows evidence of neuroplasticity. Preclinical studies in rats and monkeys suggest that motor cortical stimulation can enhance plasticity and improve recovery after stroke. This study assesses the safety and preliminary efficacy of targeted subthreshold epidural cortical stimulation delivered concurrently with intensive rehabilitation therapy while using an investigational device in patients with chronic hemiparetic stroke.

METHODS:
This is a prospective, multicenter, and nonblinded trial randomizing patients to rehabilitation with or without cortical stimulation. Patients aged 20 to 75 years who had had an ischemic stroke at least 4 months previously causing persistent moderate weakness of the arm were included. Functional magnetic resonance imaging localized hand motor function before surgery to place an epidural cortical electrode. Both groups then underwent rehabilitation for 3 weeks after which the electrode was removed. Outcome measures were obtained at baseline, during therapy, and at 1, 4, 8, and 12 weeks postprocedure.

RESULTS:
Ten patients were randomized; six patients to surgery, four to the control group. No patient deaths, neurological deterioration, or seizures occurred. There were two infections from nonprotocol-related causes. Of the eight patients completing the treatment, the stimulation plus rehabilitation group improved significantly better than controls in the Upper Extremity Fugl-Meyer (P = 0.003 overall) and the hand function score of the Stroke Impact Scale (P = 0.001 overall).

CONCLUSION:
The technique of cortical stimulation to enhance stroke recovery is well tolerated and safe.
Unique Features of Herniated Discs at the Cervicothoracic Junction: Clinical Presentation, Imaging, Operative Management, and Outcome after Anterior Decompressive Operation in 10 Patients
Authors: Post Nicholas H. , Cooper Paul R. , Frempong-Boadu Anthony K. , Costa Mary Ellen 
Published: October 2013

Abstract

OBJECTIVE:
Disc herniations at the C7–T1 level are unusual (4% of all herniated cervical discs) and are often incorrectly diagnosed because of unusual neurological findings and suboptimal imaging studies. Furthermore, the anterior approach may be problematic because the manubrium and slope of the vertebral bodies away from the surgeon obscures the end plates. The recurrent laryngeal nerve and the thoracic duct may be injured by respective right- or left-sided approaches. A posterior approach to this level has, therefore, been advocated, but results of C7–T1 herniations treated anteriorly have not been specifically addressed in the literature. We, therefore, reviewed our experience in the operative management of patients undergoing single level anterior cervical discectomy and fusion at the C7–T1 interspace for the 10 years ending June 2004 with regard to clinical presentation, imaging, problems of operative exposure, and neurological outcome.

METHODS:
Of 268 patients with single level anterior cervical discectomy and fusions (ACDFs), 10 (3.7%) had C7–T1 disc herniations. We retrospectively reviewed the medical records, operative reports, and imaging studies of these 10 patients.

RESULTS:
All patients presented with C8 motor deficit without myelopathy. The operation was carried out through an anterior approach with a skin incision 3 cm above the clavicle. Visualization of the C7–T1 disc space was achieved in all without difficulty. Eight of 10 patients are neurologically intact.

CONCLUSION:
The C7–T1 disc herniates laterally because of the absence of Luschka joints at this level. Central herniation with myelopathy is rare. An anterior approach was easily accomplished in all patients. Recovery of motor function was related to duration and severity of preoperative deficit.
Subsidence of Stand-alone Cervical Carbon Fiber Cages
Authors: Bartels Ronald H.M.A. , Donk Roland D. , Feuth Ton 
Published: October 2013

AbstractOBJECTIVE:To investigate the number of subsidences of inserted cervical carbon fiber cages and to define predictive factors for subsidence.METHODS:All patients treated for a cervical herniated disc and fusion with a cervical carbon fiber cage between January 2002 and December 2003 were retrospectively identified. The radiological examinations were reviewed, and, especially, the presence of subsidence was noted. Possible predictive factors for subsidence were determined before the investigation.RESULTS:In 69 patients, there were 96 cages inserted, of which 29.2% subsided. Of all factors investigated, only smoking seemed to be predictive for subsidence, whereas insertion at C6 to C7 clearly had a higher risk at subsidence. Subsidence was not related to outcome or fusion.CONCLUSION:Although the high number of subsidence of cages has never been described before, clinical outcome and fusion rate is comparable with the literature.
Cystic Dilation of the Conus Ventriculus Terminalis Presenting as an Acute Cauda Equina Syndrome Relieved by Decompression and Cyst Drainage: Case Report
Authors: Brisman Jonathan L. , Li Maria , Hamilton Dean , Mayberg Marc R. , Newell David W. 
Published: October 2013

Abstract

OBJECTIVE AND IMPORTANCE:
The ventriculus terminalis of the conus, or "fifth ventricle" refers to the ependymal-lined space in the middle of the conus that is present in childhood and whose persistence into adulthood is rare. A number of cases of cystic dilatation of the ventriculus terminalis have been described in adulthood. Patients tend to present with either pain alone or gradually progressive conus or cauda equina syndromes with varying degrees of recovery after cyst drainage. Presentation with an acute cauda equina syndrome and its successful surgical management has not been previously reported.

CLINICAL PRESENTATION:
A 57-year-old woman experienced back pain and bilateral sciatica ascribed to diabetic neuropathy for 2 years. Over a 24-hour period she developed bilateral lower extremity weakness, saddle anesthesia, and bowel and bladder incontinence. Lumbosacral magnetic resonance imaging demonstrated a large cystic dilatation of the ventriculus terminalis.

INTERVENTION:
She was taken for emergency surgical decompression and cyst drainage. Immediately after surgery, she experienced significant increase in lower extremity strength and has since regained continence.

CONCLUSION:
Cystic dilation of the ventriculus terminalis should be part of the differential diagnosis for a cauda equina syndrome; surgical decompression with simple cyst drainage can result in excellent clinical results.
Stent-assisted Intracranial Recanalization for Acute Stroke: Early Results
Authors: Levy Elad I. , Ecker Robert D. , Horowitz Michael B. , Gupta Rishi , Hanel Ricardo A. , Sauvageau Eric , Jovin Tudor G. , Guterman Lee R. , Hopkins L Nelson 
Published: October 2013

Abstract

OBJECTIVE:
In patients who are not candidates for intravenous tissue plasminogen activator, intra-arterial (IA) therapy is an alternative. Current recanalization rates are 50 to 60% for IA thrombolysis. Stent-assisted recanalization in the setting of acute stroke after failed thrombolysis may improve recanalization rates.

METHODS:
A retrospective analysis was performed of 19 patients treated at two institutions between July 2001 and March, 2005 with intracranial stenting of a vessel resistant to standard thrombolytic techniques. Demographics, clinical, and radiographic presentation and outcomes were studied.

RESULTS:
Thirteen men and six women with a median baseline National Institutes of Health Stroke Scale (NIHSS) score of 16 (range, 15–22) were included. Eight lesions were located at the internal carotid artery terminus, seven in the M1/M2 segment, and four in the basilar artery. Average time-to-treatment was 210 ± 160 minutes. Overall recanalization rate (Thrombolysis in Cerebral Infarction Grade 2 or 3) was 79%. There were six deaths: five due to progression of stroke and withdrawal of care at the family's request and one as the result of a delayed carotid injury after tracheostomy. One postoperative asymptomatic intracranial hemorrhage occurred without adverse affect on outcome. Median discharge NIHSS score of surviving patients was 5 (range, 2.5-11.5). Lesions at the internal carotid artery terminus (P&lt;0.009), older age (P&lt;0.003), and higher baseline NIHSS score (P&lt;0.009) were significant negative outcome predictors, as measured by &gt;3 modified Rankin scale score at discharge.

CONCLUSION:
Stent-assisted recanalization for acute stroke resulting from intracranial thrombotic occlusion is associated with a high recanalization rate and low intracranial hemorrhage rate. These initial results suggest that stenting may be an option for recalcitrant cerebral arterial occlusions.
Buffering the pH of the culture medium does not extend yeast replicative lifespan
Authors: Wasko Brian M , Carr Daniel T , Tung Herman , Doan Ha , Schurman Nathan , Neault Jillian R , Feng Joey , Lee Janet , Zipkin Ben , Mouser Jacob , Oudanonh Edward , Nguyen Tina , Stetina Torin , Shemorry Anna , Lemma Mekedes , Kaeberlein Matt 
Published: October 2013

During chronological aging of budding yeast cells, the culture medium can become acidified, and this acidification limits cell survival. As a consequence, buffering the culture medium to pH 6 significantly extends chronological life span under standard conditions in synthetic medium. In this study, we assessed whether a similar process occurs during replicative aging of yeast cells. We find no evidence that buffering the pH of the culture medium to pH levels either higher or lower than the initial pH of the medium is able to significantly extend replicative lifespan. Thus, we conclude that, unlike chronological life span, replicative life span is not limited by acidification of the culture medium or by changes in the pH of the environment.
Present status and perspective of pharmacogenetics in Mexico
Authors: Cuautle-Rodríguez Patricia , Llerena Adrián , Molina-Guarneros Juan 
Published: October 2013

Abstract
Drug costs account for up to 24% of the country’s health expenditure and there are 13,000 registered drugs being prescribed. Diabetes is the main cause of death in the country, with over 85% of diabetic patients currently under drug treatment. The importance of knowing interindividual variability in drug metabolism on Mexican populations is thus evident. The purpose of this article is to provide an overlook of the current situation of pharmacogenetic research in Mexico, focusing on drug-metabolizing enzymes, and the possibility of developing a phenotyping cocktail for Mexican populations. So far, 21 pharmacogenetic studies on Mexican population samples (Mestizos and Amerindian) have been published. These have reported interindividual variability through phenotyping and/or genotyping cytochromes: CYP2D6, 2C19, 2C9, 2E1, and phase II enzymes UGT and NAT2. Some cytochromes with important clinical implications have not yet been phenotyped in Mexican populations. The development of a cocktail adapted to them could be a significant contribution to a larger knowledge on drug response variability at a lower price and shorter time. There are validated phenotyping cocktails that present several practical advantages, being valuable, safe, and inexpensive tools in drug metabolism characterization, which require only a single experiment to provide information on several cytochrome activities.
Two-Stage Weighted Least Squares Estimation of Nonstationary Random Coefficient Autoregressions
Authors: Aknouche Abdelhakim 
Published: October 2013

AbstractThis paper proposes a two-stage weighted least squares (2S-WLS) estimate for the autoregressive parameter and the random coefficient variance of a non-(strictly) stationary random coefficient autoregression (RCA). In the first stage, the autoregressive parameter is estimated from the conditional mean equation by a weighted least squares (WLS) method in which the weight is the conditional variance evaluated at any arbitrary known parameter value. In the second stage, based on the estimated conditional variance equation, the random coefficient variance is estimated again using the WLS method, but weighted by the squared conditional variance arbitrarily evaluated. It will be shown that the 2S-WLS estimate is asymptotically Gaussian with the same asymptotic variance as the quasi-maximum likelihood estimate under very mild conditions. Applications to the Gaussian double autoregression and the Markov bilinear model are given.
Real-Time Monitoring Test for Realized Volatility
Authors: Shin-Huei Wang Cindy , Hsiao Cheng 
Published: October 2013

AbstractThis paper proposes a monitoring cumulative sum of squares (CUSQ)-type test for structural breaks inreal timevia an autoregressive (AR) approximation framework where data generating process (DGP) is a long memory process. The limiting distribution of the monitoring test follows a Brownian bridge and is free of long memory parameters under the null hypothesis of no break. The test is easy to implement and avoids the issue of spurious breaks found for some retrospective tests for long memory process. Neither does it need to use the bootstrap procedure to find the critical values. Monte Carlo simulations appear to confirm that there exists negligible size distortion and satisfactory power performances in finite samples. The procedure is then applied to monitor the real-time pattern of realized volatilities of dollar–Deutschmark and dollar–Japanese Yen.
Morphological effects on the darkness of English intervocalic /l/
Authors: Lee-Kim Sang-Im , Davidson Lisa , Hwang Sangjin 
Published: October 2013

AbstractArticulatory and acoustic studies have provided evidence that in word- initial and word-final positions, English /l/ exhibits substantial differences in ‘darkness‐: dark [ɫ] in word-final position is produced with a more retracted tongue dorsum and lowered tongue body than light [l] in word-initial position. The darkness of intervocalic /l/, however, is variable. While Sproat and Fujimura (1993) argue that /l/ darkness is on a continuum strongly affected by duration, Hayes (2000) maintains that the morphological status of intervocalic /l/s should affect whether they are produced as light or dark variants. In this study, ultrasound imaging is used to investigate whether the morphological affiliation of the /l/ affects the degree of tongue dorsum retraction and tongue body lowering and the acoustic characteristics of /l/ darkness. Six American English speakers produced three types of stimuli which were predicted to increase in darkness in the following order: (1) when /l/ corresponded with the onset of a suffix (e.g., flaw-less), (2) when /l/ corresponded with the final position of the stem word (e.g., tall-est), and (3) when /l/ was the final consonant of a stem word (e.g., tall). For both articulatory and acoustic measures, the predicted order was upheld. The strongest articulatory correlate of darkness was tongue body lowering, and acoustic differences were mainly manifested in F1 and normalized intensity. Phonological implications of these findings are discussed.
End-Stage Kidney Disease After Pediatric Nonrenal Solid Organ Transplantation
Authors: Ruebner Rebecca L. , Reese Peter P. , Denburg Michelle R. , Abt Peter L. , Furth Susan L. 
Published: October 2013

OBJECTIVES:
Adult solid organ transplant (SOT) recipients commonly develop advanced kidney disease; however, the burden of end-stage kidney disease (ESKD) in children after SOT is not well-described. The objectives of this study were to determine the incidence of ESKD after pediatric SOT and the relative risk by SOT type.

METHODS:
Retrospective multicenter cohort study of children, ages ≤18 years, who received SOTs from 1990 through 2010 using Scientific Registry of Transplant Recipients data linked to the US Renal Data System. We performed a competing risks analysis to determine cumulative incidence of ESKD (chronic dialysis or kidney transplant), treating death as a competing risk, and fit a multivariable Cox regression model to assess hazard of ESKD by organ type.

RESULTS:
The cohort included 16 604 pediatric SOT recipients (54% liver, 34% heart, 6% lung, 6% intestine, and 1% heart–lung). During a median follow-up of 6.2 years (interquartile range 2.2–12.1), 426 (3%) children developed ESKD. Compared with liver transplant recipients, in whom the incidence of ESKD was 2.1 cases per 1000 person-years, in adjusted analyses the highest risk of ESKD was among intestinal (hazard ratio [HR] 7.37, P &lt; .001), followed by lung (HR 5.79, P &lt; .001) and heart transplant recipients (HR 1.79, P &lt; .001).

CONCLUSIONS:
In a 20-year national cohort of pediatric SOT recipients, the risk of ESKD was highest among intestinal and lung transplant recipients. The burden of earlier stages of chronic kidney disease is probably much higher; modifiable risk factors should be targeted to prevent progressive kidney damage in this high-risk population.
Gunshot Injuries in Children Served by Emergency Services
Authors: Newgard Craig D. , Kuppermann Nathan , Holmes James F. , Haukoos Jason S. , Wetzel Brian , Hsia Renee Y. , Wang N. Ewen , Bulger Eileen M. , Staudenmayer Kristan , Mann N. Clay , Barton Erik D. , Wintemute Garen 
Published: October 2013

OBJECTIVE:To describe the incidence, injury severity, resource use, mortality, and costs for children with gunshot injuries, compared with other injury mechanisms.METHODS:This was a population-based, retrospective cohort study (January 1, 2006–December 31, 2008) including all injured children age ≤19 years with a 9-1-1 response from 47 emergency medical services agencies transporting to 93 hospitals in 5 regions of the western United States. Outcomes included population-adjusted incidence, injury severity score ≥16, major surgery, blood transfusion, mortality, and average per-patient acute care costs.RESULTS:A total of 49 983 injured children had a 9-1-1 emergency medical services response, including 505 (1.0%) with gunshot injuries (83.2% age 15–19 years, 84.5% male). The population-adjusted annual incidence of gunshot injuries was 7.5 cases/100 000 children, which varied 16-fold between regions. Compared with children who had other mechanisms of injury, those injured by gunshot had the highest proportion of serious injuries (23%, 95% confidence interval [CI] 17.6–28.4), major surgery (32%, 95% CI 26.1–38.5), in-hospital mortality (8.0%, 95% CI 4.7–11.4), and costs ($28 510 per patient, 95% CI 22 193–34 827).CONCLUSIONS:Despite being less common than other injury mechanisms, gunshot injuries cause a disproportionate burden of adverse outcomes in children, particularly among older adolescent males. Public health, injury prevention, and health policy solutions are needed to reduce gunshot injuries in children.