bluuebunny/crossref_metadata_2025_split huggingface dataset:
Error Variability and the Differentiation Between Apraxia of Speech and Aphasia With Phonemic Paraphasia
Authors: Haley Katarina L. , Jacks Adam , Cunningham Kevin T. 
Published: December 2012

Purpose
This study was conducted to evaluate the clinical utility of error variability for differentiating between apraxia of speech (AOS) and aphasia with phonemic paraphasia.

Method
Participants were 32 individuals with aphasia after left cerebral injury. Diagnostic groups were formed on the basis of operationalized measures of recognized articulatory and prosodic characteristics of AOS and phonemic paraphasia. Sequential repetitions of multisyllabic words were elicited as part of a motor speech evaluation and transcribed phonetically. Four metrics of variability at the syllable and word levels were derived from these transcripts.

Results
The measures yielded different magnitudes of variability. There were no group differences between participants who displayed speech profiles consistent with AOS and participants who displayed speech profiles indicative of aphasia with phonemic paraphasia. Rather, correlation coefficients and analyses of covariance showed that the variability metrics were significantly mediated by overall error rate. Additionally, variability scores for individuals with salient diagnoses of AOS and conduction aphasia were inconsistent with current diagnostic guidelines.

Conclusions
The results do not support diagnostic validity of error variability for differentiating between AOS and aphasia with phonemic paraphasia. Future research using error variability metrics should account for overall error rate in the analysis and matching of participant groups.
Nonnative English Speaker Performance on the Basic English Lexicon (BEL) Sentences
Authors: Rimikis Stacey , Smiljanic Rajka , Calandruccio Lauren 
Published: December 2012

Purpose
The purpose of this study was to examine sentence-recognition performance for a large, diverse group of nonnative speakers of English on the recently developed Basic English Lexicon (BEL) sentence materials and to determine whether BEL sentence lists are equated in difficulty for this population.

Method
The BEL sentences were presented to 102 nonnative speakers of English with normal hearing and varied linguistic and cultural backgrounds. Five hundred sentences were presented mixed with noise spectrally matched to the target sentences. Subjects completed an online questionnaire providing detailed demographic and linguistic information. Listeners' spoken English proficiency was also assessed using the Versant English Test (Pearson Education, 2010).

Results
Nonnative listeners showed equal word-recognition performance for 3 groups of BEL sentence lists, each group containing sentence lists that had equivalent difficulty. In addition, spoken language proficiency and several demographic and linguistic factors were significantly correlated with BEL performance.

Conclusion
The BEL sentence materials have been tested on a large cohort of nonnative speakers of English and have been found to be appropriate for use in speech-perception testing with this population.
First Report of Pineapple Heart Rot Caused by Phytophthora nicotianae in Hainan Province, China
Authors: Shen H. F. , Lin B. R. , Zhan J. X. , Pu X. M. 
Published: December 2012

Pineapple (Ananas comosus) is an economically important tropical fruit in Hainan Province, China. During September to November 2011, heart rot disese of pineapple was found in Ledong and Wangning of Hainan Province. A survey of 150 ha producing areas of pineapple revealed that the fields were affected at an incidence ranging from 25% to 30%. Infected plants showed water-soaked lesions and soft rot on the base of heart leaves near the soil surface. Heart leaves of infected plants were easily pulled out. As the disease progressed, plants collapsed and died. Diseased tissue fragments (2 × 2 mm) were surface-disinfected for 10 min with 0.3% NaClO, then rinsed three times in sterile water, and plated to 10% V8 juice agar (4). Inoculated dishes were incubated at 26°C in the dark. After 5 days, Phytophthora (identified by the presence of coenocytic hyphae and papillate sporangia) were isolated from the tissue cultures, which has aseptate hyphae. Sporangia were papillate, noncaducous, oval or spherical, and 34.5 to 58.2 μm. Clamydospores, both terminal and intercalary, were also spherical, and were 23.4 to 34.0 μm (2). The ITS region of rDNA was amplified using primers ITS4/ITS5, and the 927-bp product of the ITS showed 99% sequence identity to Phytophthora nicotianae (GenBank Accession No. JF792540), and the sequence was accessed to NCBI (JX978446). Pathogenicity tests were confirmed by irrigating the wounded stem bases of 10 2-month-old pineapple plants with 50 ml of P. nicotionae zoospore solution (15,000 zoospores/ml), and another 10 plants of the same cultivar inoculated with sterile water served as controls. Plants were placed in pots in a greenhouse at 28°C and 90% relative humidity. After 9 days, soft rot was observed clearly on the base of heart leaves of all 10 inoculated plants, while the control plants appeared normal. P. nicotianae was reisolated from the infected pineapple plants, and confirmed to be the same as the inoculated pathogen by conducting a ITS rDNA sequence comparison and morphological characteristics. P. nicotianae was previously reported as the causal agent of heart rot of pineapple in Hawaii, U.S.A. (3) and Guangdong Province of China (1). To our knowledge, this is the first report of P. nicotianae on pineapple in Hainan Province, China. References: (1) J. Z. Chen et al. J. Yunnan Agric. Univ. 8:134, 2003. (2) H. H. Ho. Mycologia 73:705, 1981.(3) K. W. Howard et al. Plant Dis. Rep. 48:848, 1964. (4) X. B. Zheng. Page 81 in: Phytophthora and its Research Technology. China Agricultural Press, Beijing, 1997.
The Influence of Common Medical Conditions on the Outcome of Anterior Lumbar Interbody Fusion
Authors: Kalb Samuel , Perez-Orribo Luis , Kalani Mohammad Yashar S. , Snyder Laura A. , Martirosyan Nikolay L. , Burns Keven , Standerfer Robert J. , Kakarla Udaya K. , Dickman Curtis A. , Theodore Nicholas 
Published: December 2012

Study Design:
The authors retrospectively reviewed a consecutive series of 231 patients with anterior lumbar interbody fusion (ALIF).

Objective:
To determine the correlations among common medical conditions, demographics, and the natural history of lumbar surgery with outcomes of ALIF.

Summary of Background Data:
Multiple spinal disorders are treated with ALIF with excellent success rates. Nonetheless, adverse outcomes and complications related to patients’ overall demographics, comorbidities, or cigarette smoking have been reported.

Methods:
The age, sex, body mass index (BMI), comorbidities, history of smoking or previous lumbar surgery, operative parameters, and complications of 231 patients who underwent ALIF were analyzed. Regression analyses of all variables with complications and surgical outcomes based on total Prolo scores were performed. Two models predicting Prolo outcome score were generated. The first model used BMI and sex interaction, whereas the second model used sex, level of surgery, presence of diabetes mellitus, and BMI as variables.

Results:
At follow-up, the rate of successful fusion was 99%. The overall complication rate was 13.8%, 1.8% of which occurred intraoperatively and 12% during follow-up. The incidence of complications failed to correlate with demographics, comorbidities, smoking, or previous lumbar surgery (P>0.5). ALIF at T12–L4 was the only factor significantly associated with poor patient outcomes (P=0.024). Both models successfully predicted outcome (P=0.05), although the second model did so only for males.

Conclusions:
Surgical level of ALIF correlated with poor patient outcomes as measured by Prolo functional scale. BMI emerged as a significant predictor of Prolo total score. Both multivariate models also successfully predicted outcomes. Surgical or follow-up complications were not associated with patients’ preoperative status.
The PleuraFlow Active Chest Tube Clearance System: Initial Clinical Experience in Adult Cardiac Surgery
Authors: Perrault Louis P. , Pellerin Michel , Carrier Michel , Cartier Raymond , Bouchard Denis , Demers Philippe , Boyle Edward M. 
Published: December 2012

Objective To address the clinical consequences related to chest tube clogging, a novel chest drainage apparatus, the PleuraFlow Active Tube Clearance System (Clear Catheter Systems, Bend, OR), was developed. The aim of this world's first clinical experience study was to follow clinicians using the PleuraFlow system to assess usability issues and potential areas of improvement in the heart surgery setting. Methods A user preference study was conducted to assess how specified users (surgeons, nurses, and intensive care physicians) used the PleuraFlow system to achieve specified goals in an efficient manner. Data were collected from patient charts and by a questionnaire that they had filled. Results All the surgeons (n = 7) noted that the device was not any more difficult to insert than a conventional chest tube and was easy to assemble and use. There were no reports of malfunction or complications related to the installation or use of the system. A majority, 77% (24/31), of nurses felt that the device was more time efficient than stripping, milking, or tapping the chest tubes to keep them open. A majority (16/19, 84%) of the PleuraFlow chest tubes and guide tubes were removed together in one piece within 1 day of surgery (on postoperative day 1). Conclusions Overall, the physicians and nurses rated the PleuraFlow system positively for its ability to be incorporated into the postoperative workflow of managing the drainage of patients after heart surgery. This device may be useful to allow caregivers to be certain that chest tubes are functioning in the early hours after surgery, when active bleeding is resolving and when complications from undrained blood can ensue.
Evaluation of Patient Safety Culture: A Survey of Clinicians in a Cardiovascular Operating Room
Authors: Henry Linda , Hunt Sharon L. , Kroetch Mary , Yang Y. Tony 
Published: December 2012

Objective The aim of this study was to understand the perceived safety culture and attitudes of caregivers in a large cardiovascular operating room (CVOR) in a mid-Atlantic state where more than 1500 procedures are performed annually to include ventricular assist device placement and heart and lung transplantations. Methods We analyzed deidentified data obtained from a safety survey completed anonymously by frontline caregivers in the CVOR via the Safety Attitudes Questionnaire developed by Pasquel Metrics. Results The responses from the CVOR clinicians were overall positive for their perceptions of the CVOR safety climate, with the majority saying they would feel safe being treated as a patient, liked their job, and were aware of the proper channels regarding patient safety. However, many made claims of experiencing fatigue and stress due to an excessive workload and participation in emergency situations. Furthermore, the support/clinical perfusion teams were found to have experienced the greatest amount of stress and discomfort, whereas it seems the surgeons were impacted the least. Conclusions This study suggests that reactions to different situations in the operating room are dependent on the role of the caregiver. Therefore, interventions to improve communication among the caregivers must be geared on an individual group basis.
Minimal-Access Aortic Valve Replacement with Concomitant Aortic Procedure: A 9-Year Experience
Authors: Kaneko Tsuyoshi , Couper Gregory S. , Borstlap Wernard A.A. , Nauta Foeke J.H. , Wollersheim Laurens , McGurk Siobhan , Cohn Lawrence H. 
Published: December 2012

Objective Minimal-access approaches through upper hemisternotomy is an established technique for aortic valve replacement (AVR) and aortic surgery in our institution. We assessed the outcome of undergoing AVR with concomitant aortic surgery through upper hemisternotomy. Methods We retrospectively reviewed 109 patients from January 2002 to May 2011 who had AVR with concomitant aortic surgery through upper hemisternotomy. Aortic valve replacement with supra-coronary ascending aortic replacement was performed in 65 patients; AVR with ascending and proximal arch replacement, in 8 patients; AVR with aortoplasty, in 11 patients; Bentall procedure, in 8 patients; and AVR with root enlargement, in 13 patients. In-hospital outcomes and 1- and 5-year survival were examined. Results The mean age was 58.5 years (range, 23–89 years); 41.3% of patients had bicuspid aortic valve (n = 45). Of the patients, 82.6% had true aneurysm (n = 90), 2.8% had calcified aorta (n = 3), 8.3% had small annulus (n = 9), and 3.7% had calcified annulus (n = 4). There were 6 (5.5%) reoperations and 15 (13.8%) urgent cases. Mean perfusion time was 152 ± 61 minutes, and cross-clamp time was 108 ± 47 minutes. Nine cases were performed with deep hypothermic circulatory arrest (8.3%). Operative mortality was 2.8% (n = 3). There were 4 (3.7%) cases with reoperation for bleeding, 2 (1.8%) myocardial infarctions, and 2 (1.8%) new-onset renal failure. Mean length of stay was 7.1 ± 5.6 days. Kaplan-Meier analysis showed that 1-year postoperative survival was 96.2% and 5-year survival was 92.4%. Conclusions An upper hemisternotomy approach is safe and feasible for AVR and concomitant aortic surgery with good early and midterm outcomes. This approach is also associated with low morbidity rate and short length of stay.
Tailored Endovascular Repair of Traumatic Aortic Disruptions with “Stacked” Abdominal Aortic Extension Cuffs
Authors: Allen Keith B. , Borkon A. Michael , Laster Steven B. , Aggarwal Sanjeev , Davis John R. , Pak Alexander F. , Stewart James R. , Stuart R. Scott 
Published: December 2012

Objective The management paradigm for traumatic aortic disruptions has evolved from open to endovascular repair. Thoracic stent grafts designed to treat aneurysmal disease, however, have disadvantages, including size mismatch in younger trauma patients and current standard lengths, which may needlessly necessitate coverage of at least 10 cm of thoracic aorta, increasing the risk of spinal cord ischemia. The “off-label” use of abdominal aortic extension cuffs to treat traumatic aortic disruptions may provide an advantage in this regard by better size matching for the younger trauma patient, reduced thoracic aortic coverage, and less cost to the institution. Methods From 2008 to 2011, a total of 16 traumatic aortic disruptions were evaluated and managed with endovascular techniques. The last six were treated with abdominal aortic extensions cuffs (Excluder Extension Cuffs; W.L. Gore & Associates, Flagstaff, AZ) rather than traditional thoracic stent grafts. In addition to demographics and trauma-related data, additional endpoints evaluated in this retrospective review included operative time, number of cuffs used, stent cost data, procedural complications, and follow-up. Results All six patients (five men/one woman) with traumatic aortic disruption were successfully treated with complete exclusion of the disruption using abdominal aortic cuffs. There were no complications including death or spinal cord ischemia. The average age was 27 years (range, 18–44 years). The average number of cuffs used to cover the traumatic tear was 2.6 per patient (range, 2–3 cuffs per patient), covering an average of 5.3 cm of thoracic aorta (range, 4–6 cm). Mean procedure time was 70 minutes. Hospital cost for each cuff was $2200 (average total stent cost per patient, $5720). For comparison, a single 10-cm conformable thoracic aortic graft (CTAG) (Gore) costs $14,500. Average follow-up of all six patients for up to 3 years demonstrates no complications or migration of the stent grafts. Conclusions Traumatic aortic disruptions can be safely and selectively managed with “stacked” abdominal aortic extension cuffs. This tailored therapy may provide advantages over traditional thoracic stents, including improved size match in a younger trauma patient, less aortic coverage, and reduced cost.
Lessons Learned from Robotic-Assisted Coronary Artery Bypass Surgery: Risk Factors for Conversion to Median Sternotomy
Authors: Daniel William T. , Puskas John D. , Baio Kim T. , Liberman Henry A. , Devireddy Chandan , Finn Aloke , Halkos Michael E. 
Published: December 2012

Objective Robotic-assisted coronary artery bypass is a minimally invasive alternative to traditional coronary artery bypass surgery via median sternotomy with an associated learning curve. The purpose of this study was to investigate the reasons for conversion to sternotomy. Methods From October 2009 to June 2012, two surgeons at one US academic institution performed 271 consecutive robotic-assisted coronary artery bypass procedures. For all cases, isolated, off-pump left internal mammary artery (LIMA) to left anterior descending coronary artery grafting was planned via a 3- to 4-cm sternal-sparing thoracotomy after robotic internal mammary artery harvest and pericardiotomy. Results Conversion to sternotomy occurred in 15 of 271 (5.5%) patients. The most common reason was technical difficulty with the anastomosis, which occurred in 6 (40.0%) patients. Others included LIMA dissection, 2 (13.3%); wrong vessel grafted, 2 (13.3%); ventricular fibrillation and cardiac arrest, 1 (6.7%); equipment malfunction, 1 (6.7%); adhesions, 1 (6.7%); and other. Two underwent emergent conversion. Six underwent multivessel bypass after conversion instead of hybrid coronary revascularization. No mortality occurred among converted patients. Two patients had postoperative myocardial infarction and one had a superficial sternal wound infection. Conversion rate was relatively stable among the four different time quartiles (range, 3.0%–7.4%), although the reasons for conversion were different. Conclusions Conversion to sternotomy is an infrequent complication of robotic-assisted coronary artery bypass, most commonly because of technical difficulties during the LIMA harvest and the LIMA to left anterior descending anastomosis. Anatomic and patient variables as well as inherent technical problems with minimally invasive procedures make conversion unavoidable in some patients.
Infliximab‐Induced Psoriasis and Psoriasiform Skin Lesions in Pediatric Crohn Disease and a Potential Association With IL‐23 Receptor Polymorphisms
Authors: Sherlock Mary E. , Walters Thomas , Tabbers Merit M. , Frost Karen , Zachos Mary , Muise Aleixo , Pope Elena , Griffiths Anne M. 
Published: December 2012

ABSTRACTBackground:Infliximab (IFX), an established therapy for pediatric Crohn disease (CD), is also efficacious in treating psoriasis, a skin disorder, in which tumor necrosis factor‐α is implicated pathogenically. Paradoxically, there have been numerous reports of new‐onset psoriasis following tumor necrosis factor‐α antagonist therapy in adult patients with inflammatory bowel disease, but pediatric data are sparse.Methods:A retrospective review of all IFX‐treated patients with CD, who subsequently developed psoriasis, at a single pediatric inflammatory bowel disease center, was performed. A subset of affected patients (10/18) and CD controls (147 of 172) treated with IFX but without the development of psoriasis were genotyped for polymorphisms in the interleukin‐23 receptor (IL‐23R) gene, which has been identified as conferring susceptibility to both CD and psoriasis.Results:Eighteen (10.5%) of 172 IFX‐treated patients with CD developed new‐onset psoriasis (n = 17) or worsening of existing psoriasis (n = 1). The duration of IFX exposure was variable, ranging from 1 to 25 infusions. Three patients discontinued IFX because of this complication. Most patients responded well to topical steroid therapy. In comparison to disease‐matched controls, patients with CD developing psoriasis following IFX therapy were more likely to be homozygous for specific polymorphisms in the IL‐23R gene (rs10489628, rs10789229, and rs1343151).Conclusions:As in adults, the development of psoriasis or psoriasiform skin lesions occurs in pediatric patients with CD treated with IFX. Adequately powered studies are required to further explore the preliminary findings reported here to determine whether polymorphisms in the IL‐23R gene have a role in the pathogenesis of this paradoxical process, which presently remains unexplained.
Creamatocrit Analysis of Human Milk Overestimates Fat and Energy Content When Compared to a Human Milk Analyzer Using Mid‐infrared Spectroscopy
Authors: O'Neill Edward F. , Radmacher Paula G. , Sparks Blake , Adamkin David H. 
Published: December 2012

ABSTRACTBackground and Objective:Human milk (HM) is the preferred feeding for human infants but may be inadequate to support the rapid growth of the very‐low‐birth‐weight infant. The creamatocrit (CMCT) has been widely used to guide health care professionals as they analyze HM fortification; however, the CMCT method is based on an equation using assumptions for protein and carbohydrate with fat as the only measured variable. The aim of the present study was to test the hypothesis that a human milk analyzer (HMA) would provide more accurate data for fat and energy content than analysis by CMCT.Methods:Fifty‐one well‐mixed samples of previously frozen expressed HM were obtained after thawing. Previously assayed “control” milk samples were thawed and also run with unknowns. All milk samples were prewarmed at 40°C and then analyzed by both CMCT and HMA. CMCT fat results were substituted in the CMCT equation to reach a value for energy (kcal/oz). Fat results from HMA were entered into a computer model to reach a value for energy (kcal/oz). Fat and energy results were compared by paired t test with statistical significance set at P < 0.05. An additional 10 samples were analyzed locally by both methods and then sent to a certified laboratory for quantitative analysis. Results for fat and energy were analyzed by 1‐way analysis of variance with statistical significance set at P < 0.05.Results:Mean fat content by CMCT (5.8 ± 1.9 g/dL) was significantly higher than by HMA (3.2 ± 1.1 g/dL, P < 0.001). Mean energy by CMCT (21.8 ± 3.4 kcal/oz) was also significantly higher than by HMA (17.1 ± 2.9, P < 0.001). Comparison of biochemical analysis with HMA of the subset of milk samples showed no statistical difference for fat and energy, whereas CMCT was significantly higher than for both fat (P < 0.001) and energy (P = 0.002).Conclusions:The CMCT method appears to overestimate fat and energy content of HM samples when compared with HMA and biochemical methods.