bluuebunny/crossref_metadata_2025_split huggingface dataset:
Onset of intractability and its course over time: The Dutch study of epilepsy in childhood
Authors: Geerts Ada , Brouwer Oebele , Stroink Hans , van Donselaar Cees , Peters Boudewijn , Peeters Els , Arts Willem F. 
Published: March 2012

SummaryPurpose:  Intractability in epilepsy is difficult to define, and little is known about its onset, course, and duration. We investigated these aspects (as well as the occurrence of intractability) during long‐term follow‐up in patients with epilepsy, focusing on possible explanations for the variation in time of onset and duration of intractability.Methods:  After diagnosis, 453 patients with childhood‐onset epilepsy had a 5‐year follow‐up with regular visits and data collection. Ten years later they received a questionnaire with items concerning epilepsy, which was completed by 413 patients resulting in a mean follow‐up of 15 years. Intractability during the first 5 years was compared with that in the last year of follow‐up. Intractability was defined as having no 3‐month remission during a 1‐year period despite adequate medical treatment.Key Findings: At least 12.1% of the cohort had a period of intractability during the 15‐year follow‐up, and 8.5% were intractable in the final year. Of the patients with idiopathic etiology 4.3% had a period of intractability versus 17.0% for those with cryptogenic, and 22.6% for those with remote symptomatic etiology (p < 0.001). Other risk factors at baseline were younger age at first seizure, generalized cryptogenic/symptomatic or localization‐related symptomatic epilepsy, mental retardation, and febrile convulsions before enrollment. The cumulative risk of a period of intractability was 6.1% (95% confidence interval [CI] 3.7–8.5) at 2 years follow‐up and 8.2% (95% CI 5.4–11.0) at 5 years. The mean time to onset of intractability during the first 5 years of follow‐up was 1.6 (95% CI 1.3–2.0; median 1.0) years and the mean duration of intractability during these 5 years was 3.3 (95% CI 2.8–3.8; median 3.6) years. Fifteen patients were intractable only during the first 5 years of follow‐up (group A), and 19 subjects were intractable both during the first 5 years and the last year of follow‐up (group B). Compared with group A, group B had shorter remission and a longer time to intractability during the first 5 years and more were intractable in the fifth year of follow‐up. Sixteen other patients had a late onset of intractability after 5 years of follow‐up, sometimes after long periods of remission (group C). No significant differences in baseline characteristics were found among groups A, B, and C, but slightly more children in groups B and C became mentally retarded during the follow‐up. In all groups, antiepileptic drugs were of little use in preventing and ending intractability.Significance:  There is a large unpredictable variation in time of onset, course, and duration of intractability, with a higher chance of final intractability after a poor course during the first 5 years of follow‐up. The natural course of epilepsy probably best explains the variable course of intractability. The effect of medication seems to be minor.
Pathogen safety of human C1 esterase inhibitor concentrate
Authors: Gröner Albrecht , Nowak Thomas , Schäfer Wolfram 
Published: March 2012

BACKGROUND: Human plasma–derived products—such as C1 esterase inhibitor (C1‐INH) concentrate, used to treat hereditary angioedema—carry with them the risk of transmitting blood‐borne viruses and, theoretically, prion proteins. To minimize this risk, three complementary approaches are implemented: selection and testing of plasma donations for the absence of pathogenic blood‐borne viruses, similarly testing and releasing the plasma pool for fractionation, and ensuring that the manufacturing process includes validated steps for pathogen inactivation and removal.STUDY DESIGN AND METHODS: This article describes the selection of plasma for the production of C1‐INH and the studies used to confirm the pathogen reduction capacity of the manufacturing process: three independent virus reduction steps—pasteurization, hydrophobic interaction chromatography (HIC), and virus filtration—and two prion reduction steps. Samples of product intermediates from the manufacturing steps were spiked with a panel of enveloped and nonenveloped viruses and two prion preparations and subjected to a valid scaled‐down version of the respective manufacturing steps resulting in the quantification of the pathogen reduction factors.RESULTS: Validation studies demonstrated overall virus reduction factors for all viruses of more than 15 log, considerably exceeding the potential amount of virus present in a plasma pool for fractionation. Prion proteins were also efficiently removed by the manufacturing process, as currently determined in evaluating the prion removal capacity of the ammonium sulfate precipitation and HIC steps.CONCLUSION: The pathogen reduction capacity demonstrated here indicates that the manufacturing process of the C1‐INH Berinert is highly effective for reducing enveloped and nonenveloped viruses and prion proteins.
Patient blood transfusion management: discharge hemoglobin level as a surrogate marker for red blood cell utilization appropriateness
Authors: Edwards Jason , Morrison Chris , Mohiuddin Maleeha , Tchatalbachev Vladislav , Patel Charmi , Schwickerath Vicki L. , Menitove Jay E. , Singh Gurmukh 
Published: March 2012

BACKGROUND: Blood transfusion management strategies minimize transfusion‐associated risks, enhance outcomes, and reduce costs. We explored an association of discharge hemoglobin (Hb) with pretransfusion Hb, transfusion indications, and red blood cell (RBC) transfusions. We stipulate that patients with discharge Hb concentrations greater than 10.0 g/dL, or even 9.0 g/dL, received excessive RBC transfusions.STUDY DESIGN AND METHODS: We examined aggregate data from five hospitals and for one of the hospitals, the focus hospital, we reviewed patient records for a period of 6 months. Data analyses included number of RBC units transfused and Hb values before transfusion, after transfusion, and at discharge.RESULTS: In aggregate, 27% to 47% patients had discharge Hb levels greater than 10.0 g/dL. At the focus hospital, 27% had a discharge Hb level greater than 10 g/dL and 50.3% had a discharge Hb level greater than 9.0 g/dL. At the focus hospital, the mean Hb trigger for transfusion was a Hb level of 7.3 g/dL; the mean posttransfusion Hb level was 9.3 g/dL and mean discharge Hb level was 9.2 g/dL. Overall, 76% of the transfusions were of an even number of RBC units.CONCLUSION: In aggregate, overutilization exceeded 20%. At the focus hospital, approximately one‐quarter of patients receiving transfusions had a Hb concentration greater than 10.0 g/dL at discharge. Transfused patients' discharge Hb concentration represents an effective indicator for retrospective monitoring of transfusion appropriateness. In light of the large number of patients receiving even number transfusions, reviewing Hb levels after transfusion of each RBC unit could reduce unnecessary transfusions. Retrospective review of discharge Hb data focuses providers on transfusion outcomes and affords an educational opportunity for blood utilization management.
Determination of neutrophil antigen HNA‐3a and HNA‐3b genotype frequencies in six racial groups by high‐throughput 5′ exonuclease assay
Authors: Bowens Krista L. , Sullivan Mia J. , Curtis Brian R. 
Published: March 2012

BACKGROUND: People with the human neutrophil antigen (HNA)‐3b/3b type can make HNA‐3a antibodies, which have been reported to cause immune neutropenia disorders and are especially prone to cause severe cases of transfusion‐related acute lung injury. However, knowledge of HNA‐3 allele frequencies outside Caucasian populations is limited. We developed a high‐throughput genotyping assay and determined the HNA‐3a/3b genotype frequencies in six different racial and ethnic groups.STUDY DESIGN AND METHODS: Genotyping utilized TaqMan 5′ exonuclease chemistry and real‐time polymerase chain reaction. A total of 742 DNA samples from six different racial and ethnic groups were genotyped for HNA‐3a and HNA‐3b.RESULTS: The genotyping assay showed 100% sensitivity and specificity compared to sequencing and phenotyping and had high throughput. A significant percentage of Caucasians (6.5%), Han Chinese (16%), and Asian Indians (6%) typed HNA‐3b/3b, but only a small percentage of Hispanics (1%) and no African or Native Americans.CONCLUSIONS: The HNA‐3 genotyping assay had high sensitivity, specificity, and sample throughput. HNA‐3b/b genotype results determined for 742 individuals representing six different racial and ethnic groups showed that there could be a significant risk of producing anti‐HNA‐3a in Chinese, as well as in Caucasian and Asian Indian blood donor populations, but a very low risk in Hispanic, African, or Native American populations.
European data on stem cell mobilization with plerixafor in patients with nonhematologic diseases: an analysis of the European consortium of stem cell mobilization
Authors: Worel Nina , Apperley Jane F. , Basak Grzegorz W. , Douglas Kenneth W. , Gabriel Ian H. , Geraldes Catarina , Hübel Kai , Jaksic Ozren , Koristek Zdenek , Lanza Francesco , Lemoli Roberto , Mikala Gabor , Selleslag Dominik , Duarte Rafael F. , Mohty Mohamad 
Published: March 2012

BACKGROUND: Plerixafor with granulocyte–colony‐stimulating factor (G‐CSF) has been shown to enhance stem cell mobilization in patients with multiple myeloma and lymphoma with previous mobilization failure. In this European named patient program we report the experience in insufficiently mobilizing patients diagnosed with nonhematologic diseases.STUDY DESIGN AND METHODS: Thirty‐three patients with germ cell tumor (n = 11), Ewing sarcoma (n = 6), Wiscott‐Aldrich disease (n = 5), neuroblastoma (n = 4), and other nonhematologic diseases (n = 7) were included in the study. Plerixafor was limited to patients with previous or current stem cell mobilization failure and given after 4 days of G‐CSF (n = 21) or after chemotherapy and G‐CSF (n = 12) in patients who mobilized poorly.RESULTS: Overall, 28 (85%) patients succeeded in collecting at least 2 × 106/kg body weight (b.w.) CD34+ cells (median, 5.0 × 106/kg b.w. CD34+ cells; range, 2.0 × 106‐29.5 × 106/kg b.w. CD34+ cells), and five (15%) patients collected a median of 1.5 × 106/kg b.w. CD34+ cells (range, 0.9 × 106‐1.8 × 106/kg b.w. CD34+ cells). Nineteen patients proceeded to transplantation. The median dose of CD34+ cells infused was 3.3 × 106/kg b.w. (range, 2.3 × 106‐6.7 × 106/kg b.w. CD34+ cells). The median numbers of days to neutrophil and platelet engraftment were 11 (range, 9‐12) and 15 (range, 10‐25) days, respectively.CONCLUSION: These data emphasize the role of plerixafor in combination with G‐CSF or chemotherapy and G‐CSF as an effective mobilization regimen with the potential of successful stem cell collection. Accordingly, plerixafor seems to be safe and effective in patients with nonhematologic diseases. Larger prospective studies are warranted to further assess its use in these patients.
Effects of modality change on health‐related quality of life
Authors: Painter Patricia , Krasnoff Joanne B. , Kuskowski Michael , Frassetto Lynda , Johansen Kirsten 
Published: March 2012

AbstractPatients with end‐stage renal disease (ESRD) requiring renal replacement have impaired health‐related quality of life (HRQoL), and there is general consensus that HRQoL improves with successful transplant and evidence of improvement with frequent hemodialysis. This study reports changes in HRQoL associated with changes in treatment modality to daily hemodialysis (DHD) and transplant among patients requiring renal replacement. This cohort study had assessments at baseline and 6‐month following modality change. Subjects were nondiabetic individuals receiving conventional hemodialysis who (a) remained on conventional hemodialysis (n = 13), (b) changed to daily hemodialysis (DHD) (n = 10), or (c) received a living donor transplant (n = 20). Thirty‐four healthy controls were assessed once for comparison. HRQoL was measured using the Kidney Disease Quality of Life Instrument. The Physical Functioning and Physical Composite Scale scores were primary outcomes. Transplantation resulted in significant improvements in six of eight generic scales and the physical composite scale (PCS). Those changing to DHD had significant improvements in Physical Function and PCS scales. Those remaining on dialysis remained lower than controls on all scales except for Vitality; the transplant group remained lower than controls only on the Vitality and General Health scales. Transplant resulted in significant improvements in four of the seven disease‐specific scales (symptoms, effects, and burden of kidney disease, work). DHD resulted in improvements in the effects of kidney disease. Modality change to transplant results in significant improvement in HRQoL, achieving levels similar to controls. Change to daily hemodialysis improves only select HRQoL domains and remains low in disease‐specific domains.
Representations in Dynamical Embodied Agents: Re‐Analyzing a Minimally Cognitive Model Agent
Authors: Mirolli Marco 
Published: March 2012

AbstractUnderstanding the role of ‘‘representations’’ in cognitive science is a fundamental problem facing the emerging framework of embodied, situated, dynamical cognition. To make progress, I follow the approach proposed by an influential representational skeptic, Randall Beer: building artificial agents capable of minimally cognitive behaviors and assessing whether their internal states can be considered to involve representations. Hence, I operationalize the concept of representing as ‘‘standing in,’’ and I look for representations in embodied agents involved in simple categorization tasks. In a first experiment, no representation can be found, but the relevance of the task is undermined by the fact that agents with no internal states can reach high performance. A simple modification makes the task more “representationally hungry,” and in this case, agents’ internal states are found to qualify as representations. I conclude by discussing the benefits of reconciling the embodied‐dynamical approach with the notion of representation.
Facing the Sunrise: Cultural Worldview Underlying Intrinsic‐Based Encoding of Absolute Frames of Reference in Aymara
Authors: Núñez Rafael E. , Cornejo Carlos 
Published: March 2012

AbstractThe Aymara of the Andes use absolute (cardinal) frames of reference for describing the relative position of ordinary objects. However, rather than encoding them in available absolute lexemes, they do it in lexemes that are intrinsic to the body: nayra (“front”) and qhipa (“back”), denoting east and west, respectively. Why? We use different but complementary ethnographic methods to investigate the nature of this encoding: (a) linguistic expressions and speech–gesture co‐production, (b) linguistic patterns in the distinct regional Spanish‐based variety Castellano Andino (CA), (c) metaphorical extensions of CA’s spatial patterns to temporal ones, and (d) layouts of traditional houses. Findings indicate that, following fundamental principles of Aymara cosmology, people, objects, and land—as a whole—are conceived as having an implicit canonical orientation facing east, a primary landmark determined by the sunrise. The above bodily based lexicalizations are thus linguistic manifestations of a broader macro‐cultural worldview and its psycho‐cognitive reality.
Healing with Plant Intelligence: A Report from Ayahuasca
Authors: Doyle Richard 
Published: March 2012

AbstractNumerous and diverse reports indicate the efficacy of shamanic plant adjuncts (e.g., iboga, ayahuasca, psilocybin) for the care and treatment of addiction, post‐traumatic stress disorder, cancer, cluster headaches, and depression. This article reports on a first‐person healing of lifelong asthma and atopic dermatitis in the shamanic context of the contemporary Peruvian Amazon and the sometimes digital ontology of online communities. The article suggests that emerging language, concepts, and data drawn from the sciences of plant signaling and behavior regarding “plant intelligence” provide a useful heuristic framework for comprehending and actualizing the healing potentials of visionary plant “entheogens” (Wasson 1971) as represented both through first‐person experience and online reports. Together with the paradigms and practices of plant signaling, biosemiotics provides a robust and coherent map for contextualizing the often reported experience of plant communication with ayahuasca and other entheogenic plants. The archetype of the “plant teachers” (called Doctores in the upper Amazon) is explored as a means for organizing and interacting with this data within an epistemology of the “hallucination/perception continuum (Fischer 1975). “Ecodelic” is offered as a new linguistic interface alongside “entheogen” (Wasson 1971).
Ayahuasca as Antidepressant? Psychedelics and Styles of Reasoning in Psychiatry
Authors: Anderson Brian T. 
Published: March 2012

AbstractThere is a growing interest among scientists and the lay public alike in using the South American psychedelic brew, ayahuasca, to treat psychiatric disorders like depression and anxiety. Such a practice is controversial due to a style of reasoning within conventional psychiatry that sees psychedelic‐induced modified states of consciousness as pathological. This article analyzes the academic literature on ayahuasca's psychological effects to determine how this style of reasoning is shaping formal scientific discourse on ayahuasca's therapeutic potential as a treatment for depression and anxiety. Findings from these publications suggest that different kinds of experiments are differentially affected by this style of reasoning but can nonetheless indicate some potential therapeutic utility of the ayahuasca‐induced modified state of consciousness. The article concludes by suggesting ways in which conventional psychiatry's dominant style of reasoning about psychedelic modified states of consciousness could be reconsidered.
The Creative Cycle Processes Model of Spontaneous Imagery Narratives Applied to the Ayahuasca Shamanic Journey
Authors: Echenhofer Frank 
Published: March 2012

AbstractAyahuasca is an Amazonian psychoactive shamanic brew that often elicits spontaneous, intense, and meaningful imagery narratives related to psychological and physical healing, problem solving, knowledge acquisition, community cohesion, creativity, and spiritual development. My EEG and phenomenology ayahuasca research found it caused the greatest changes in EEG beta coherence from 25 to 30 cycles per second compared to a resting state before ayahuasca ingestion. Enhanced beta coherence indexes significantly greater information exchange between cortical regions and is congruent with the reported enhanced richness, complexity, and profundity of ayahuasca experiences. I developed the creative cycle processes model that identifies in ayahuasca reports distinct experiential change processes and describes how these processes, neuroscience, psychotherapy, mythological, and other transdisciplinary evidence can be coherently integrated to explain ayahuasca benefits. The model suggests three change process stages together underlie one emergent dynamic creative cycle process. The sequential stages are Form dismantling and healing processes, form creation processes, where novel forms spontaneously combine, and form expression processes, where emergent experiences are embodied. The model suggests that these three stages repeat cyclically in human development in an ongoing process of dismantling and generation producing more creative experiences and expressive forms.
Host selection by the wheat stem sawfly in winter wheat and the role of semiochemicals mediating oviposition preference
Authors: Buteler Micaela , Weaver David K. 
Published: March 2012

AbstractThe wheat stem sawfly (WSS), Cephus cinctus Norton (Hymenoptera: Cephidae), causes significant damage in cereal crops in the northern Great Plains of North America. This study assessed oviposition preference in winter wheat, Triticum aestivum L. (Poaceae), and investigated how it is affected by the emission of semiochemicals, with the overall goal of enhancing trap crop efficacy. We studied five winter wheat cultivars that could be recommended as trap crops for WSS and compared them with regards to agronomic characteristics influencing oviposition behavior and their emission of behaviorally active volatiles. Subsequently, we evaluated oviposition preference on three selected cultivars, ‘Norstar’, ‘Neeley’, and ‘Rampart’, using choice tests at two plant growth stages. Most eggs were found in Norstar at both stages tested when females were exposed to the three cultivars simultaneously making it the preferred choice for a trap crop. Norstar also emitted more behaviorally active volatiles, primarily (E)‐ and (Z)‐β‐ocimene. The results for the effect of main stem height or diameter on oviposition was inconsistent between infested vs. uninfested stems within cultivars, although there was a correlation between infestation and height for younger plants. These results show that these agronomic characteristics, typically viewed as explanatory, did not clearly explain oviposition preference and suggest a role of β‐ocimene in determining suitability for oviposition among these cultivars. This study supports previous findings suggesting oviposition preference in winter wheat involves several cues, including stem height and volatile attractants that may be important in determining suitability.
Tolerance within the sleeve inserts of different surgical guides for guided implant surgery
Authors: Koop Richard , Vercruyssen Marjolein , Vermeulen Kim , Quirynen Marc 
Published: March 2012

AbstractObjectivesRecently, guided implant surgery has been introduced and several studies verified its accuracy. While those studies reported on the accuracy of the entire procedure, this experiment wanted to evaluate the degree of deviation that can occur during the drilling procedure alone, due to the tolerance of the drill in the sleeve insert.Material and methodsDrilling was executed in a plexi‐glass box with a maximal inclination of the drills within the sleeve insert. Different sleeve inserts, sleeve positions, sleeve heights, sleeve insert heights and diameters were evaluated.ResultsThe two tested sleeve inserts gave a maximum deviation in angulation of 5.2° and a maximum horizontal deviation of 1.3 mm at the implant shoulder and 2.4 mm at the apex for a 13 mm implant. These deviations decreased if the distance of the sleeve above the plexi‐glass box became smaller and hand hold sleeve inserts gave less deviation than drill hold sleeve inserts. The deviation increased by longer implant length, larger drill key diameter, shorter sleeves and/or drill key heights.ConclusionsFor a minimal deviation during the surgery with a stereolithographic guide, it is very important to use the drill in a centric position, parallel to the cylinder. The use of longer drill keys and sleeves are critical for optimal accuracy.