bluuebunny/crossref_metadata_2025_split huggingface dataset:
Two-level total disc replacement with Mobi-C cervical artificial disc versus anterior discectomy and fusion: a prospective, randomized, controlled multicenter clinical trial with 4-year follow-up results
Authors: Davis Reginald J. , Nunley Pierce Dalton , Kim Kee D. , Hisey Michael S. , Jackson Robert J. , Bae Hyun W. , Hoffman Gregory A. , Gaede Steven E. , Danielson Guy O. , Gordon Charles , Stone Marcus B. 
Published: November 2014

OBJECT
The purpose of this study was to evaluate the safety and effectiveness of 2-level total disc replacement (TDR) using a Mobi-C cervical artificial disc at 48 months' follow-up.

METHODS
A prospective randomized, US FDA investigational device exemption pivotal trial of the Mobi-C cervical artificial disc was conducted at 24 centers in the US. Three hundred thirty patients with degenerative disc disease were randomized and treated with cervical total disc replacement (225 patients) or the control treatment, anterior cervical discectomy and fusion (ACDF) (105 patients). Patients were followed up at regular intervals for 4 years after surgery.

RESULTS
At 48 months, both groups demonstrated improvement in clinical outcome measures and a comparable safety profile. Data were available for 202 TDR patients and 89 ACDF patients in calculation of the primary endpoint. TDR patients had statistically significantly greater improvement than ACDF patients for the following outcome measures compared with baseline: Neck Disability Index scores, 12-Item Short Form Health Survey Physical Component Summary scores, patient satisfaction, and overall success. ACDF patients experienced higher subsequent surgery rates and displayed a higher rate of adjacent-segment degeneration as seen on radiographs. Overall, TDR patients maintained segmental range of motion through 48 months with no device failure.

CONCLUSIONS
Four-year results from this study continue to support TDR as a safe, effective, and statistically superior alternative to ACDF for the treatment of degenerative disc disease at 2 contiguous cervical levels.
Clinical trial registration no.: NCT00389597 (clinicaltrials.gov)
Petroclival meningiomas resected via a combined transpetrosal approach: surgical outcomes in 60 cases and a new scoring system for clinical evaluation
Authors: Morisako Hiroki , Goto Takeo , Ohata Kenji 
Published: November 2014

OBJECT
Petroclival meningiomas are among the most challenging intracranial tumors to treat surgically. Many skull base approaches have been described to improve resection and decrease patient morbidity. The authors undertook this study to evaluate the results of their treatment of petroclival meningiomas using objective measurements of tumor volume and a new impairment scoring system to assess neurological symptoms that severely affect the patient's quality of life, such as impairment of swallowing and speaking, motor function, and consciousness and communication.

METHODS
Between January 1990 and December 2009, the authors used a combined transpetrosal approach to treat 60 patients with benign (WHO Grade I) petroclival meningiomas. In this retrospective study, all 60 cases were analyzed in detail with regard to tumor volume, extent of resection (EOR), long-term tumor control, neurological outcome, and the patient condition. In addition, patients were divided into 2 groups according to the period during which the surgery was performed: the early group, from 1990 to 1999, and the late group, from 2000 to 2009. A new scoring system, the petroclival meningioma impairment scale (PCMIS), was created for quantitative assessment of 8 categories of neurological functions, with scores assigned in each category according to the level of disability and its impact on the patient. The PCMIS was used preoperatively, at 3 months after surgery, and at the time of the last follow-up examination, and the results for the 2 groups were compared.

RESULTS
There were 24 cases in the early group (1990–1999), and the mean duration of follow-up was 149.3 months. The mean EOR was 96.1%, and good long-term tumor control was obtained in 22 patients (91.7%). One of patients died because of a postoperative complication in the perioperative period. The PCMIS improved in 3 patients (12.5%), remained stable in 1 (4.2%), and worsened in 20 (83.3%). There were 36 cases in the late group (2000–2009), and the mean duration of follow-up was 77.9 months. The mean EOR was 92.7%, and good long-term tumor control was obtained in 34 patients (94.4%). The PCMIS score improved in 23 patients (63.9%), remained stable in 5 (13.9%), and worsened in 8 (22.2%).

CONCLUSIONS
The combined transpetrosal approach has provided satisfactory functional improvements and excellent tumor control for patients with petroclival meningiomas. The PCMIS provides a specific tool for quantitative assessment of the patient's state.
Hyperprolactinemia due to spontaneous intracranial hypotension
Authors: Schievink Wouter I. , Nuño Miriam , Rozen Todd D. , Maya M. Marcel , Mamelak Adam N. , Carmichael John , Bonert Vivien S. 
Published: November 2014

OBJECT
Spontaneous intracranial hypotension is an increasingly recognized cause of headaches. Pituitary enlargement and brain sagging are common findings on MRI in patients with this disorder. The authors therefore investigated pituitary function in patients with spontaneous intracranial hypotension.

METHODS
Pituitary hormones were measured in a group of 42 consecutive patients with spontaneous intracranial hypotension. For patients with hyperprolactinemia, prolactin levels also were measured following treatment. Magnetic resonance imaging was performed prior to and following treatment.

RESULTS
The study group consisted of 27 women and 15 men with a mean age at onset of symptoms of 52.2 ± 10.7 years (mean ± SD; range 17–72 years). Hyperprolactinemia was detected in 10 patients (24%), ranging from 16 ng/ml to 96.6 ng/ml in men (normal range 3–14.7 ng/ml) and from 31.3 ng/ml to 102.5 ng/ml in women (normal range 3.8–23.2 ng/ml). In a multivariate analysis, only brain sagging on MRI was associated with hyperprolactinemia. Brain sagging was present in 60% of patients with hyperprolactinemia and in 19% of patients with normal prolactin levels (p = 0.02). Following successful treatment of the spontaneous intracranial hypotension, hyperprolactinemia resolved, along with normalization of brain MRI findings in all 10 patients.

CONCLUSIONS
Spontaneous intracranial hypotension is a previously undescribed cause of hyperprolactinemia. Brain sagging causing distortion of the pituitary stalk (stalk effect) may be responsible for the hyperprolactinemia.
Outcome methods used in clinical studies of Chiari malformation Type I: a systematic review
Authors: Greenberg Jacob K. , Milner Eric , Yarbrough Chester K. , Lipsey Kim , Piccirillo Jay F. , Smyth Matthew D. , Park Tae Sung , Limbrick David D. 
Published: November 2014

OBJECT
Chiari malformation Type I (CM-I) is a common and often debilitating neurological disease. Efforts to improve treatment of CM-I are impeded by inconsistent and limited methods of evaluating clinical outcomes. To understand current approaches and lay a foundation for future research, the authors conducted a systematic review of the methods used in original published research articles to evaluate clinical outcomes in patients treated for CM-I.

METHODS
The authors searched PubMed, Embase, the Cumulative Index to Nursing and Allied Health Literature, ClinicalTrials.gov, and Cochrane databases to identify publications between January 2003 and August 2013 that met the following criteria: 1) reported clinical outcomes in patients treated for CM-I; 2) were original research articles; 3) included at least 10 patients or, if a comparative study, at least 5 patients per group; and 4) were restricted to patients with CM-I.

RESULTS
Among the 74 papers meeting inclusion criteria, there was wide variation in the outcome methods used. However, all approaches were broadly grouped into 3 categories: 1) “gestalt” impression of overall symptomatic improvement (n = 45 papers); 2) postoperative change in specific signs or symptoms (n = 20); or 3) results of various standardized assessment scales (n = 22). Among standardized scales, 11 general function measures were used, compared with 6 disease-specific tools. Only 3 papers used scales validated in patients with CM-I. To facilitate a uniform comparison of these heterogeneous approaches, the authors appraised articles in multiple domains defined a priori as integral to reporting clinical outcomes in CM-I. Notably, only 7 articles incorporated patient-response instruments when reporting outcome, and only 22 articles explicitly assessed quality of life.

CONCLUSIONS
The methods used to evaluate clinical outcomes in CM-I are inconsistent and frequently not comparable, complicating efforts to analyze results across studies. Development, validation, and incorporation of a small number of disease-specific patient-based instruments will improve the quality of research and care of CM-I patients.
Secure Secondary Use of Clinical Data with Cloud-based NLP Services
Authors: Christoph J. , Griebel L. , Leb I. , Engel I. , Köpcke F. , Toddenroth D. , Prokosch H. -U. , Laufer J. , Marquardt K. , Sedlmayr M. 
Published: November 2014

SummaryObjectives: The secondary use of clinical data provides large opportunities for clinical and translational research as well as quality assurance projects. For such purposes, it is necessary to provide a flexible and scalable infrastructure that is compliant with privacy requirements. The major goals of the cloud4health project are to define such an architecture, to implement a technical prototype that fulfills these requirements and to evaluate it with three use cases.Methods: The architecture provides components for multiple data provider sites such as hospitals to extract free text as well as structured data from local sources and de-identify such data for further anonymous or pseudonymous processing. Free text documentation is analyzed and transformed into structured information by text-mining services, which are provided within a cloud-computing environment. Thus, newly gained annotations can be integrated along with the already available structured data items and the resulting data sets can be uploaded to a central study portal for further analysis.Results: Based on the architecture design, a prototype has been implemented and is under evaluation in three clinical use cases. Data from several hundred patients provided by a University Hospital and a private hospital chain have already been processed.Conclusions: Cloud4health has shown how existing components for secondary use of structured data can be complemented with text-mining in a privacy compliant manner. The cloud-computing paradigm allows a flexible and dynamically adaptable service provision that facilitates the adoption of services by data providers without own investments in respective hardware resources and software tools.
Loss to follow-up in the Australian HIV Observational Database
Authors: McManus Hamish , Petoumenos Kathy , Brown Katherine , Baker David , Russell Darren , Read Tim , Smith Don , Wray Lynne , Giles Michelle , Hoy Jennifer , Carr Andrew , Law Matthew G ,   the Australian HIV Observational Database
Published: November 2014

Background Loss to follow-up (LTFU) in HIV-positive cohorts is an important surrogate for interrupted clinical care, which can potentially influence the assessment of HIV disease status and outcomes. After preliminary evaluation of LTFU rates and patient characteristics, we evaluated the risk of mortality by LTFU status in a high-resource setting. Methods Rates of LTFU were measured in the Australian HIV Observational Database for a range of patient characteristics. Multivariate repeated measures regression methods were used to identify determinants of LTFU. Mortality by LTFU status was ascertained using linkage to the National Death Index. Survival following combination antiretroviral therapy initiation was investigated using the Kaplan–Meier (KM) method and Cox proportional hazards models. Results Of 3,413 patients included in this analysis, 1,632 (47.8%) had at least one episode of LTFU after enrolment. Multivariate predictors of LTFU included viral load (VL)>10,000 copies/ml (rate ratio [RR] 1.63; 95% CI 1.45, 1.84; ref ≤400), time under follow-up (per year; RR 1.03; 95% CI 1.02, 1.04) and prior LTFU (per episode; RR 1.15; 95% CI 1.06, 1.24). KM curves for survival were similar by LTFU status ( P=0.484). LTFU was not associated with mortality in Cox proportional hazards models (univariate hazard ratio [HR] 0.93; 95% CI 0.69, 1.26) and multivariate HR 1.04 (95% CI 0.77, 1.43). Conclusions Increased risk of LTFU was identified amongst patients with potentially higher infectiousness. We did not find significant mortality risk associated with LTFU. This is consistent with timely re-engagement with treatment, possibly via high levels of unreported linkage to other health-care providers.
Jamais sans mon canapé : Eric Berne et les différences entre analyse transactionnelle et psychanalyse
Authors: Barnes Graham , Blondel Agnès 
Published: November 2014

Cet article présente un entretien avec le Dr. Q, c’est-à-dire un dialogue avec l’œuvre d’Eric Berne au sujet des rapports concrets et théoriques qu’entretiennent analyse transactionnelle et psychanalyse. Que répondrait Berne à la question : « Quels sont les rapports concrets et théoriques qu’entretiennent l’analyse transactionnelle et la psychanalyse ? » ? Pour le savoir, j’ai imaginé une conversation avec le Dr. Q (surnom que s’attribuait Eric Berne dans ses livres) afin d’explorer la vision d’Eric Berne de la psychanalyse, et plus particulièrement comment il concevait les liens entre cette science et sa pratique et sa théorie de l’analyse transactionnelle. Cet entretien consiste en fait en un dialogue avec « l’œuvre considérable » laissée par Berne (1972, p. 170). J’essaie d’éviter de faire dire au Dr. Q ce que j’aimerais l’entendre dire. Je préfère lui faire utiliser des citations verbatim tirées des écrits de Berne. Des paraphrases, parfois, mais alors j’en donne toujours la source. (Parfois, j’emmène le Dr. Q sur le terrain du badinage. Le lecteur s’en rendra compte au vu du manque de références. Même alors, je fais attention à ne rien lui faire dire qui soit incohérent avec ce qu’on trouve dans les livres de Berne.)
Les confessions d'un traître
Authors: Dalla Bernardina Sergio 
Published: November 2014

Il y a quelque chose d’indécent dans l’« acte ethnologique » : l’asymétrie des rôles et des statuts, la violence de la situation d’enquête, la distance qui sépare les visées de l’enquêteur des attentes de l’enquêté, le voyeurisme et le paternalisme qui se cachent, parfois, derrière la formule passe-partout « approche empathique ». Le chercheur sait que, d’une manière ou d’une autre, il trahira son informateur. Mais ce penchant pour la trahison est néanmoins à géométrie variable. Très prononcé chez les anthropologues « objectivistes », il tend à disparaître (mais à quel prix ?) chez les adeptes de l’ethnométhodologie et de l’anthropologie interprétative.
L'« autre » de l'ethnologue
Authors: Bobbé Sophie 
Published: November 2014

La majorité des travaux qui portent sur l’entretien en sciences sociales l’examine du point de vue du chercheur, du collecteur invétéré, plutôt que de celui de l’enquêté. Mais comment l’entretien affecte-t‑il nos interlocuteurs ? Ayant récemment occupé la place de l’enquêté(e), autrement dit celle de l’« autre », dans une étude sociologique, je saisirai ici cette opportunité pour avancer quelques remarques sur des aspects de l’entretien qui me semblent rarement discutés au sein de la communauté des ethnologues, et revenir sur la nature même de la relation d’entretien, si singulière.
CD4 T Cells Specific for a Latency-Associated γ-Herpesvirus Epitope Are Polyfunctional and Cytotoxic
Authors: Freeman Michael L. , Burkum Claire E. , Cookenham Tres , Roberts Alan D. , Lanzer Kathleen G. , Huston Gail E. , Jensen Meghan K. , Sidney John , Peters Bjoern , Kohlmeier Jacob E. , Woodland David L. , van Dyk Linda F. , Sette Alessandro , Blackman Marcia A. 
Published: November 2014

Abstract
The oncogenic γ-herpesviruses EBV and Kaposi sarcoma–associated herpesvirus are ubiquitous human pathogens that establish lifelong latent infections maintained by intermittent viral reactivation and reinfection. Effector CD4 T cells are critical for control of viral latency and in immune therapies for virus-associated tumors. In this study, we exploited γHV68 infection of mice to enhance our understanding of the CD4 T cell response during γ-herpesvirus infection. Using a consensus prediction approach, we identified 16 new CD4 epitope-specific responses that arise during lytic infection. An additional epitope encoded by the M2 protein induced uniquely latency-associated CD4 T cells, which were not detected at the peak of lytic infection but only during latency and were not induced postinfection with a latency-deficient virus. M2-specific CD4 T cells were selectively cytotoxic, produced multiple antiviral cytokines, and sustained IL-2 production. Identification of latency-associated cytolytic CD4 T cells will aid in dissecting mechanisms of CD4 immune control of γ-herpesvirus latency and the development of therapeutic approaches to control viral reactivation and pathology.
Rictor Negatively Regulates High-Affinity Receptors for IgE-Induced Mast Cell Degranulation
Authors: Smrz Daniel , Cruse Glenn , Beaven Michael A. , Kirshenbaum Arnold , Metcalfe Dean D. , Gilfillan Alasdair M. 
Published: November 2014

AbstractRictor is a regulatory component of the mammalian target of rapamycin (mTOR) complex 2 (mTORC2). We have previously demonstrated that rictor expression is substantially downregulated in terminally differentiated mast cells as compared with their immature or transformed counterparts. However, it is not known whether rictor and mTORC2 regulate mast cell activation. In this article, we show that mast cell degranulation induced by aggregation of high-affinity receptors for IgE (FcεRI) is negatively regulated by rictor independently of mTOR. We found that inhibition of mTORC2 by the dual mTORC1/mTORC2 inhibitor Torin1 or by downregulation of mTOR by short hairpin RNA had no impact on FcεRI-induced degranulation, whereas downregulation of rictor itself resulted in an increased sensitivity (∼50-fold) of cells to FcεRI aggregation with enhancement of degranulation. This was linked to a similar enhancement in calcium mobilization and cytoskeletal rearrangement attributable to increased phosphorylation of LAT and PLCγ1. In contrast, degranulation and calcium responses elicited by the G protein–coupled receptor ligand, C3a, or by thapsigargin, which induces a receptor-independent calcium signal, was unaffected by rictor knockdown. Overexpression of rictor, in contrast with knockdown, suppressed FcεRI-mediated degranulation. Taken together, these data provide evidence that rictor is a multifunctional signaling regulator that can regulate FcεRI-mediated degranulation independently of mTORC2.
Cutting Edge: Genetic Variation in TLR1 Is Associated with Pam3CSK4-Induced Effector T Cell Resistance to Regulatory T Cell Suppression
Authors: Mikacenic Carmen , Schneider Anya , Radella Frank , Buckner Jane H. , Wurfel Mark M. 
Published: November 2014

Abstract
TLR play essential roles in the initiation and modulation of immune responses. TLR1/TLR2 heterodimers recognize triacylated bacterial lipopeptides, including the synthetic TLR1/2 lipopeptide Pam3CSK4. Genetic variation in TLR1 is associated with outcomes in diseases in which regulatory T cells (Treg) play a role, including asthma and allergy. To determine whether genetic polymorphisms in TLR1 are associated with alterations in Treg suppression of effector T cells (Teff), we performed in vitro suppression assays in healthy individuals with various haplotypes in TLR1. We show that functional genetic polymorphisms in TLR1 modify surface expression of TLR1 on T lymphocytes and confer enhanced Teff resistance to Treg suppression in the presence of Pam3CSK4. These effects are mediated, in part, by IL-6 and inhibited by blocking IL-6 signaling through STAT3. These findings suggest that TLR1 polymorphisms could influence immune-related disease through Teff resistance to Treg suppression.
Diet-Induced Obesity Does Not Impact the Generation and Maintenance of Primary Memory CD8 T Cells
Authors: Khan Shaniya H. , Hemann Emily A. , Legge Kevin L. , Norian Lyse A. , Badovinac Vladimir P. 
Published: November 2014

Abstract
The extent to which obesity compromises the differentiation and maintenance of protective memory CD8 T cell responses and renders obese individuals susceptible to infection remains unknown. In this study, we show that diet-induced obesity did not impact the maintenance of pre-existing memory CD8 T cells, including acquisition of a long-term memory phenotype (i.e., CD27hi, CD62Lhi, KLRG1lo) and function (i.e., cytokine production, secondary expansion, and memory CD8 T cell–mediated protection). Additionally, obesity did not influence the differentiation and maintenance of newly evoked memory CD8 T cell responses in inbred and outbred hosts generated in response to different types of systemic (LCMV, L. monocytogenes) and/or localized (influenza virus) infections. Interestingly, the rate of naive-to-memory CD8 T cell differentiation after a peptide-coated dendritic cell immunization was similar in lean and obese hosts, suggesting that obesity-associated inflammation, unlike pathogen- or adjuvant-induced inflammation, did not influence the development of endogenous memory CD8 T cell responses. Therefore, our studies reveal that the obese environment does not influence the development or maintenance of memory CD8 T cell responses that are either primed before or after obesity is established, a surprising notion with important implications for future studies aiming to elucidate the role obesity plays in host susceptibility to infections.
Development and Survival of Th17 Cells within the Intestines: The Influence of Microbiome- and Diet-Derived Signals
Authors: Chewning Joseph H. , Weaver Casey T. 
Published: November 2014

Abstract
Th17 cells have emerged as important mediators of host defense and homeostasis at barrier sites, particularly the intestines, where the greatest number and diversity of the microbiota reside. A critical balance exists between protection of the host from its own microbiota and pathogens and the development of immune-mediated disease. Breaches of local innate immune defenses provide critical stimuli for the induction of Th17 cell development, and additional cues within these tissues promote Th17 cell survival and/or plasticity. Normally, this results in eradication of the microbial threat and restitution of homeostasis. When dysregulated, however, Th17 cells can cause a range of immune-mediated diseases, whether directed against Ags derived from the microbiota, such as in inflammatory bowel disease, or against self-Ags in a range of autoimmune diseases. This review highlights recent discoveries that provide new insights into ways in which environmental signals impact Th17 cell development and function in the intestines.