AN INVARIANCE PRINCIPLE FOR ASSOCIATED RANDOM FIELDS

BURTON, ROBERT M.,KIM, TAE-SUNG 圓光大學校 基礎自然科學硏究所 1988 基礎科學硏究誌 Vol.7 No.3

Applying Known tightness criteria to Poisson cluster random mea-sures, it is shown that if the total member size has a finite 2+δmoment, then the random measure satisfies an invariance principle.

Impact of IgM Antibodies on Cross-Protection against Pneumococcal Serogroups 6 and 19 after Immunization with 7-Valent Pneumococcal Conjugate Vaccine in Children

조혜경,박인호,Robert L. Burton,김경효 대한의학회 2016 Journal of Korean medical science Vol.31 No.6

Although it is well known that pneumococcal conjugate vaccines provide cross-protection against some vaccine-related serotypes, these mechanisms are still unclear. This study was performed to investigate the role of cross-protective IgM antibodies against vaccinerelated serotypes 6A, 6C, and 19A induced in children aged 12-23 months after immunization with 7-valent pneumococcal conjugate vaccine (PCV7). We obtained serum samples from 18 Korean children aged 12-23 months after a PCV7 booster immunization. The serum IgG and IgM concentrations of serotypes 6B and 19F were measured by enzymelinked immunosorbent assay (ELISA) in serum. The opsonic indices (OIs) against vaccine serotypes 6B and 19F and vaccine-related serotypes 6A, 6C, and 19A were determined by an opsonophagocytic killing assay (OPA) in IgM-depleted and control serum. Both IgG and IgM antibodies in ELISA and opsonic indices in OPA against serotypes 6B and 19F were demonstrated in the immune serum. IgM depletion decreased the OIs against vaccine serotypes 6B (geometric means of OIs (GMIs) of 3,009 vs. 1,396, 38% reduction) and 19F (1,117 vs. 750, 36% reduction). In addition, IgM depletion markedly decreased the OIs against vaccine-related serotypes 6A (GMIs of 961 vs. 329, 70% reduction), 6C (432 vs. 185, 72% reduction), and 19A (301 vs. 166, 58% reduction). The booster immunization PCV7 induced protective antibodies in the form of both IgG and IgM isotypes. IgM antibodies contributed to eliciting cross-protection against vaccine-related serotypes as well as against vaccine serotypes.

Diversity in Surgical Decision Strategies for Adult Spine Deformity Treatment: The Effects of Neurosurgery or Orthopedic Training Background and Surgical Experience

강지인,Naobumi Hosogane,Christopher Ames,Frank Schwab,Robert Hart,Douglas Burton,Christopher Shaffrey,Justin S. Smith,Shay Bess,조규정,하윤 대한척추신경외과학회 2018 Neurospine Vol.15 No.4

Objective: This study is aimed to investigate whether surgical strategies for adult spinal deformity (ASD) treatment differed among Korean physicians. Methods: This study is retrospective questionnaire-based study. ASD is challenging to manage, with a broad range of clinical and radiological presentations. To investigate possible nationality- or ethnicity-related differences in the surgical strategies adopted for ASD treatment, the International Spine Study Group surveyed physicians’ responses to 16 cases of ASD. We reviewed the answers to this survey from Korean physicians. Korean orthopedic surgeons (OS) and neurosurgeons (NS) received a questionnaire containing 16 cases and response forms via email. After reviewing the cases, physicians were asked to indicate whether they would treat each case with decompression or fusion. If fusion was chosen, physicians were also asked to indicate whether they would perform 3-column osteotomy. Retrospective chi-square analyses were performed to investigate whether the answers to each question differed according to training specialty or amount of surgical experience. Results: Twenty-nine physicians responded to our survey, of whom 12 were OS and 17 were NS. In addition, 18 (62.1%) had more than 10 years of experience in ASD correction and were assigned to the M10 group, while 11 (37.9%) had less than 10 years of experience and were assigned to the L10 group. We found that for all cases, the surgical strategies favored did not significantly differ between OS and NS or between the M10 and L10 groups. However, for both fusion surgery and 3-column osteotomy, opinions were divided regarding the necessity of the procedures in 4 of the 16 cases. Conclusion: The surgical strategies favored by physicians were similar for most cases regardless of their training specialty or experience. This suggests that these factors do not affect the surgical strategies selected for ASD treatment, with patient clinical and radiological characteristics having greater importance.

Impact of IgM Antibodies on Cross-Protection against Pneumococcal Serogroups 6 and 19 after Immunization with 7-Valent Pneumococcal Conjugate Vaccine in Children

Cho, Hye-Kyung,Park, In Ho,Burton, Robert L.,Kim, Kyung-Hyo KOREAN ACADEMY OF MEDICAL SCIENCE 2016 JOURNAL OF KOREAN MEDICAL SCIENCE Vol.31 No.6

<P>Although it is well known that pneumococcal conjugate vaccines provide cross-protection against some vaccine-related serotypes, these mechanisms are still unclear. This study was performed to investigate the role of cross-protective IgM antibodies against vaccine-related serotypes 6A, 6C, and 19A induced in children aged 12-23 months after immunization with 7-valent pneumococcal conjugate vaccine (PCV7). We obtained serum samples from 18 Korean children aged 12-23 months after a PCV7 booster immunization. The serum IgG and IgM concentrations of serotypes 6B and 19F were measured by enzyme-linked immunosorbent assay (ELISA) in serum. The opsonic indices (OIs) against vaccine serotypes 6B and 19F and vaccine-related serotypes 6A, 6C, and 19A were determined by an opsonophagocytic killing assay (OPA) in IgM-depleted and control serum. Both IgG and IgM antibodies in ELISA and opsonic indices in OPA against serotypes 6B and 19F were demonstrated in the immune serum. IgM depletion decreased the OIs against vaccine serotypes 6B (geometric means of OIs (GMIs) of 3,009 vs. 1,396, 38% reduction) and 19F (1,117 vs. 750, 36% reduction). In addition, IgM depletion markedly decreased the OIs against vaccine-related serotypes 6A (GMIs of 961 vs. 329, 70% reduction), 6C (432 vs. 185, 72% reduction), and 19A (301 vs. 166, 58% reduction). The booster immunization PCV7 induced protective antibodies in the form of both IgG and IgM isotypes. IgM antibodies contributed to eliciting cross-protection against vaccine-related serotypes as well as against vaccine serotypes.</P>

Is Sacral Extension a Risk Factor for Early Proximal Junctional Kyphosis in Adult Spinal Deformity Surgery?

Sebastian Decker,Renaud Lafage,Christian Krettek,Robert Hart,Christopher Ames,Justin S. Smith,Douglas Burton,Eric Klineberg,Shay Bess,Frank J. Schwab,Virginie Lafage,International Spine Study Group 대한척추외과학회 2020 Asian Spine Journal Vol.14 No.2

Study Design: Retrospective cohort study. Purpose: To investigate the role of sacral extension (SE) for the development of proximal junctional kyphosis (PJK) in adult spinal deformity (ASD) surgery. Overview of Literature: The development of PJK is multifactorial and different risk factors have been identified. Of these, there is some evidence that SE also affects the development of PJK, but data are insufficient. Methods: Using a combined database comprising two propensity-matched groups of fusions following ASD surgery, one with fixation to S1 or S1 and the ilium (SE) and one without SE but with a lower instrumented vertebra of L5 or higher (lumbar fixation, LF), PJK and the role of further parameters were analyzed. The propensity-matched variables included age, the upper-most instrumented vertebra (UIV), preoperative sagittal alignment, and the baseline to 1 year change of the sagittal alignment. Results: Propensity matching led to two groups of 89 patients each. The UIV, pelvic incidence minus lumbar lordosis, sagittal vertical axis, pelvic tilt, age, and body mass index were similar in both groups (p>0.05). The incidence of PJK at postoperative 1 year was similar for SE (30.3%) and LF (22.5%) groups (p=0.207). The PJK angle was comparable (p=0.963) with a change of −8.2° (SE) and −8.3° (LF) from the preoperative measures (p=0.954). A higher rate of PJK after SE (p=0.026) was found only in the subgroup of patients with UIV levels between T9 and T12. Conclusions: Instrumentation to the sacrum with or without iliac extension did not increase the overall risk of PJK. However, an increased risk for PJK was found after SE with UIV levels between T9 and T12.

Corrigendum: Incorrect Spelling of Author's Name: US Preventive Services Task Force prostate-specific antigen screening guidelines result in higher Gleason score diagnoses

Glen Gejerman,Patrick Ciccone,Martin Goldstein,Vincent Lanteri,Burton Schlecker,John Sanzone,Michael Esposito,Sergey Rome,Michael Ciccone,Eric Margolis,Robert Simon,Yijun Guo,Sri-Ram Pentakota,Hossein 대한비뇨의학회 2018 Investigative and Clinical Urology Vol.59 No.4

US Preventive Services Task Force prostate-specific antigen screening guidelines result in higher Gleason score diagnoses

Glen Gejerman,Patrick Ciccone,Martin Goldstein,Vincent Lanteri,Burton Schlecker,John Sanzone,Michael Esposito,Sergey Rome,Michael Ciccone,Eric Margolis,Robert Simon,Yijun Guo,Sri-Ram Pentakota,Hossein 대한비뇨의학회 2017 Investigative and Clinical Urology Vol.58 No.6

Purpose: To evaluate the impact that the 2012 US Preventive Services Task Force (USPSTF) prostate-specific antigen (PSA) screening guidelines have had on the diagnosis of prostate cancer, we compared the incidence and distribution of new cases diagnosed in 2011-before the USPSTF PSA screening recommendations versus 2014 at which time the guidelines were widely adopted. Materials and Methods: We identified all prostate biopsies performed by a large urology group practice utilizing a centralized pathology lab. We examined total biopsies performed, percentage of positive biopsies, and for those with positive biopsies examined for differences in patient age, PSA, and Gleason score. Results: A total of 4,178 biopsies were identified – 2,513 in 2011 and 1,665 in 2014. The percentage of positive biopsies was 27% in 2011 versus 34% in 2014 (p<0.0001). Among patients with positive biopsies, we found statistically significant differences between the 2 cohorts in the median ages and Gleason scores. Patients were about 1 year younger in 2014 compared to 2011 (t-test; p=0.043). High Gleason scores (8–10) were diagnosed in 19% of the 2014 positive biopsies versus 9% in the 2011 positive biopsies (chi square; p<0.0001). Conclusions: After the widespread implementation of the 2011 USPTF PSA screening guidelines, 34% fewer biopsies were performed with a 29% increase in positive biopsy rates. We found a significantly higher incidence of high grade disease in 2014 compared with 2011. The percentage of patients with positive biopsies having Gleason scores 8–10 more than doubled in 2014. The higher incidence of these more aggressive cancers must be part of the discussion regarding PSA screening.

Clinical characteristics and outcomes of critically Ill patients with COVID-19 in Northeast Ohio: low mortality and length of stay

Fadel Francois Abi,Al-Jaghbeer Mohammed,Kumar Sany,Griffiths Lori,Wang Xiaofeng,Han Xiaozhen,Burton Robert 대한중환자의학회 2020 Acute and Critical Care Vol.35 No.4

Background: Published coronavirus disease 2019 (COVID-19) reports suggest higher mortality with increasing age and comorbidities. Our study describes the clinical characteristics and outcomes for all intensive care unit (ICU) patients admitted across the Cleveland Clinic enterprise, a 10-hospital health care system in Northeast Ohio, serving more than 2.7 million people. Methods: We analyzed the quality data registry for clinical characteristics and outcomes of all COVID-19-confirmed ICU admissions. Differences in outcomes from other health care systems and published cohorts from other parts of the world were delineated. Results: Across our health care system, 495 COVID-19 patients were admitted from March 15 to June 1, 2020. Mean patient age was 67.3 years, 206 (41.6%) were females, and 289 (58.4%) were males. Mean Acute Physiology Score was 45.3, and mean Acute Physiology and Chronic Health Evaluation III score was 60.5. In total, 215 patients (43.3%) were intubated for a mean duration of 9.2 days. Mean ICU and hospital length of stay were 7.4 and 13.9 days, respectively, while mean ICU and hospital mortality rates were 18.4% and 23.8%. Conclusions: Our health care system cohort is the fourth largest to be reported. Lower ICU and hospital mortality and length of stay were seen compared to most other published reports. Better preparedness and state-level control of the surge in COVID-19 infections are likely the reasons for these better outcomes. Future research is needed to further delineate differences in mortality and length of stay across health care systems and over time.

Prioritization of Realignment Associated With Superior Clinical Outcomes for Cervical Deformity Patients

Katherine E. Pierce,Peter G. Passias,Avery E. Brown,Cole A. Bortz,Haddy Alas,Lara Passfall,Oscar Krol,Nicholas Kummer,Renaud Lafage,Dean Chou,Douglas C. Burton,Breton Line,Eric Klineberg,Robert Hart,J 대한척추신경외과학회 2021 Neurospine Vol.18 No.3

Objective: To prioritize the cervical parameter targets for alignment. Methods: Included: cervical deformity (CD) patients (C2–7 Cobb angle>10°, cervical lordosis>10°, cervical sagittal vertical axis [cSVA]>4 cm, or chin-brow vertical angle>25°) with full baseline (BL) and 1-year (1Y) radiographic parameters and Neck Disability Index (NDI) scores; patients with cervical [C] or cervicothoracic [CT] Primary Driver Ames type. Patients with BL Ames classified as low CD for both parameters of cSVA (<4 cm) and T1 slope minus cervical lordosis (TS–CL) (<15°) were excluded. Patients assessed: meeting minimum clinically important differences (MCID) for NDI (<-15 ΔNDI). Ratios of correction were found for regional parameters categorized by primary Ames driver (C or CT). Decision tree analysis assessed cutoffs for differences associated with meeting NDI MCID at 1Y. Results: Seventy-seven CD patients (mean age, 62.1 years; 64% female; body mass index, 28.8 kg/m2). Forty-one point six percent of patients met MCID for NDI. A backwards linear regression model including radiographic differences as predictors from BL to 1Y for meeting MCID for NDI demonstrated an R2 of 0.820 (p=0.032) included TS–CL, cSVA, McGregor’s slope (MGS), C2 sacral slope, C2–T3 angle, C2–T3 SVA, cervical lordosis. By primary Ames driver, 67.5% of patients were C, and 32.5% CT. Ratios of change in predictors for MCID NDI patients for C and CT were not significant between the 2 groups (p> 0.050). Decision tree analysis determined cutoffs for radiographic change, prioritizing in the following order: ≥42.5° C2–T3 angle, >35.4° cervical lordosis, <-31.76° C2 slope, <-11.57-mm cSVA, <-2.16° MGS, >-30.8-mm C2–T3 SVA, and ≤-33.6° TS–CL. Conclusion: Certain ratios of correction of cervical parameters contribute to improving neck disability. Prioritizing these radiographic alignment parameters may help optimize patient-reported outcomes for patients undergoing CD surgery.