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No effect on non-relapse mortality, progression-free survival and overall survival was observed at different cell dose thresholds. These data suggest that in HLA haploidentical BM transplant with PT-CY, appropriate cell doses are relevant to the engraftment. The association between low CD3+/CD8+ cells and chronic GVHD deserves further investigation. INTRODUCTION Laryngopharyngeal reflux (LPR) poses a diagnostic challenge. Clinical diagnosis, based on suggestive symptoms and laryngoscopic signs of inflammation, should be acceptable, as long as diligent differential diagnosis is sought. In order to minimize subjectivity, a number of diagnostic instruments have been proposed, being the most common the Reflux Symptom Index and the Reflux Finding Score (RFS). The latter has been translated into several languages including Portuguese, but it still has not been properly validated in this language. OBJECTIVE To validate the Brazilian Portuguese version of the RFS. MATERIAL AND METHOD For validity and internal consistency, 172 adults were studied (106 with LPR and 66 healthy controls). Flexible transnasal laryngoscopy images were randomly examined twice by each of the two experienced otolaryngologists with a 72-hour interval. Strict exclusion criteria were applied to avoid other possible known causes of chronic laryngitis. For assessment of reproducibility and temporal stability, a random sample of 108 subjects (53 patients and 55 controls) were tested and retested. RESULTS A statistically significant difference was observed in the mean RFS between patients with LPR (10.26 ± 3.58) and controls (5.52 ± 1.34) (P less then 0.001). The interclass correlation coefficient comparing test and retest for both raters was high (R1 = 0.956; R2 = 0.948). CONCLUSION The Brazilian Portuguese version of the RFS proved to be a reliable and reproducible instrument for the diagnosis of LPR with a sensitivity of 82.08%, a specificity of 93.94%, a positive predictive value of 95.60%, and a negative predictive value was 76.54%. OBJECTIVE The subglottic area and trachea are important parts of the upper airway, and can be visualized easily using transnasal flexible laryngoscopy (TFL). The aim of this study was to develop a clinical grading system to assist in documentation of the subglottic area and trachea with TFL, and to demonstrate the basic principles of visualization of these anatomic areas as a laryngology practice. METHODS The TFL videos of 100 randomized patients were evaluated by three laryngologists. The simple head extension (SHE) position and flexion position (FP) were applied to the patients during the visualization of the subglottic area and trachea. A paired t test was used to compare the grades of the subglottic and tracheal view according to the SHE and FP scores. RESULTS This study examined 50 male and 50 female patients ranging in age from 28 to 83 years (mean age 50.09 ± 13.05 years). For the SHE and FP, the numbers of patients constituting grade 1 were 2 and 35, grade 2 were 2 and 37, grade 3 were 30 and 19, and grade 4 were 41 and 9, respectively. There was a statistically significant difference between SHE and FP (P less then  0.05). The k score was 0.785 between the ratings of observer 1 and observer 2; 0.771 between observer 1 and observer 3; and 0.757 between observer 2 and observer 3 (P less then 0.001). CONCLUSION This new grading system for the visualization of the subglottis and trachea can help physicians assess and identify the upper airways, and FP provides a better subglottic and tracheal view than SHE. Perceptual judgments of singer technical ability have not been widely researched. A few studies have examined perceptions of singers versus nonsingers (Usha 2017) and evaluations of vocal beauty in the male voice (Robison 1992). The investigators used recordings of male voices singing [i] in an online survey instrument using a Likert-type scale. Listeners were divided into four groups (nonmusicians, music ensemble participants, music students, and music professionals). Listeners rated the technical ability of each singer (27 recordings) on a 6-point scale from beginning to advanced. Survey responses of the four listener groups were compared with vibrato rate, extent, and jitter of the recorded samples. We hypothesized that musical training would affect how listeners rate male singers overall, with the expectation that the most musically experienced and trained listeners' ratings would be the most severe. OBJECTIVE Professional voice users form an increasing part of our population. Physical fitness instructors listed as professional voice users are at risk for voice problem as they perform vigorous exercises, instruct at the same time and compete vocally with loud background music. Hence, there is a dire need to study the voice problems in this population. Roxadustat The current study was aimed at investigating the phonatory and respiratory functions in physical fitness instructors in comparison to a control group. STUDY DESIGN Cross-sectional study design MATERIALS AND METHODS Fifty physical fitness instructors (48 males and two females) and 50 controls (45 males and five females) with the age range of 18-40 years were initially enrolled in the study. The phonatory function measures (perceptual, physiological, and acoustic) and respiratory function measures (aerodynamics) were obtained. RESULTS Following the data analysis only for male participants, the majority of the perceptual parameters such as grade, roughness, breathiness, and strain showed significant increase in the clinical group compared to controls (P less then 0.05). Similarly, few acoustic parameters such as fundamental frequency (F0) related parameters such as average F0, mean F0, highest fundamental frequency (Fhi) and lowest fundamental frequency (Flo) showed significant decrease in clinical group compared to controls (P less then 0.05). CONCLUSIONS Few perceptual and acoustic parameters are sensitive in differentiating the voice problems in physical fitness instructors from the controls. The significant perceptual and acoustic parameters implied that they are at risk for developing voice problems. Hence, early identification and prevention of voice problems in this population is warranted. Surgical resection of basal ganglia (BG) and thalamic cavernous malformations (CMs) has not yet become standardized in the field of neurosurgery due to the eloquent location of these lesions and the relative paucity of literature on the subject. This review presents a consolidation of the available literature on outcomes and complication rates after surgical resection of these lesions. A systematic literature review was performed via PubMed database for articles published between 1985 and 2019. Studies comprising ≥2 patients receiving surgery for BG or thalamic CMs with available follow-up data were included. Pooled data included patient demographics, CM preoperative characteristics, and surgical outcomes Twenty studies comprising 227 patients were included for analysis. Complete resection was achieved in 94.7% (fixed-effects pooled estimate [FE] 94.9%[91.0%-97.8%]; random-effects pooled estimate [RE] 90.0%[79.8%-96.9%]), and hemorrhage of incompletely resected CMs occurred in 50% (FE 55.9%[25.9%-83.6%]; RE 55.9%[25.9%-83.6%]) of patients. Early morbidity was observed in 24.0% (FE 24.9%[17.8%-32.6%]; RE 24.9%[17.8%-32.6%]). At final follow-up, 67.3% (FE 67.7%[58.8%-76.0%]; RE 67.8%[52.2%-81.6%]) and 20.6% (FE 20.6%[13.6%-28.6%]; RE 20.9%[9.8%-34.9%]) had improvement and stability of preoperative symptoms, respectively. Mortality rate was 1.3% (FE 2.3%[0.6%-5.1%]; RE 2.3%[0.6%-5.1%]). Therefore, high cure rates with low rates of postoperative morbidity can be achieved in BG or thalamic CM surgery. Most patients had improved neurological function at final follow-up. Complete resection should be attempted to reduce rates of repeat hemorrhage. PURPOSE Although many young mothers (aged 20 years old at first delivery) living in urban and rural central-west Ontario. Age-matched young mothers were also compared with 15- to 17-year-old women without children (N = 630) from the 2014 Ontario Child Health Study. The prevalence of current mental disorders was assessed using the Mini-International Neuropsychiatric Interview for Children and Adolescents. RESULTS Nearly 2 of 3 young mothers reported at least one mental health problem, and almost 40% had more than one. Young mothers were 2 to 4 times as likely to have an anxiety disorder (generalized anxiety disorder, separation anxiety disorder, social phobia, and specific phobia), attention-deficit/hyperactivity disorder, oppositional defiant disorder, or conduct disorder and were 2 to 4 times more likely to have more than one psychiatric problem than older comparison mothers or women aged 15-17 years. CONCLUSIONS Given the high rates of mental health problems and complex needs of young mothers in Canada and the possible adverse effects of maternal psychopathology on their children, further efforts should be directed at engaging and treating this high-risk group. PURPOSE A growing body of research has identified correlates (i.e., predictors) of youth homelessness. However, such risk and protective factors have not been identified for youth receiving substance use treatment. Using characteristics collected at treatment intake, the present study sought to identify predictors of youths' first episode of homelessness during the 12 months after substance use treatment entry. METHODS Data come from a longitudinal study of adolescents (n = 17,911; aged 12-17 years) receiving substance use treatment throughout the U.S. Participants completed surveys at intake and at 3, 6, and 12 months later. Logistic regression and Lasso machine learning regression were used to predict participants' first episode of homelessness in the 12 months after treatment intake. RESULTS After excluding adolescents reporting previous experiences of homelessness, 5.0% of adolescents reported their first episode of homelessness over the 12 months after treatment intake. The results from logistic and lasso models were generally consistent. Final models revealed that adolescents who were older, male, reported more victimization experiences, mental health problems, family problems, deviant peer relationships, and substance use problems (more treatment episodes and illicit drug dependence) were more likely to report experiencing homelessness. Hispanic/Latino adolescents were less likely to experience homelessness, compared with white adolescents. CONCLUSIONS The results point to the important risk and protective factors that can be assessed at treatment entry to identify adolescents at greater risk of experiencing their first episode of homelessness. BACKGROUND While there are many possible complications associated with total joint arthroplasty (TJA), venous thromboembolism (VTE) is both frequent and potentially severe. Despite this importance, there are inconsistent recommendations for prophylaxis based on patient risk factors. METHODS A predictive model was constructed to compare low-molecular-weight heparin(LMWH) and aspirin (ASA) for prevention of VTE-associated complications following TJA.The model used risks from prior prophylaxis studies to estimate the risk of developing a symptomatic deep vein thrombosis, pulmonary embolism, thrombocytopenia, and operative or nonoperative site bleeding. We also evaluated the progression to 4 possible final health states postphlebitis syndrome, intracranial hemorrhage, death, or baseline health. Within published ranges, we selected assumptions that were favorable to LMWH such that these analyses represent a best case scenario for LMWH or an alternative more aggressive low-molecular-weight heparin alternative (LMWHA).
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