Significant Correlation between Ankle-Brachial Index and Vascular Access Failure in Hemodialysis Patients
Bibliographic record
Abstract
Objective: Illustrate a case of non-traumatic acute myelopathy, possibly associated with spine hyperextension consistent with Surfer’s myelopathy. Background: Surfer’s myelopathy is an ischemic non-traumatic thoracolumbar myelopathy initially described among novice surfers travelling to Hawaii. Surfer’s myelopathy is believed to result from anterior spinal cord infarction due to spine hyperextension while lying prone on a surfboard. It is hypothesized this body position causes interruption of blood supply in the anterior radicular artery of Adamkiewicz. Risk factors for surfer’s myelopathy may include dehydration, thin body habitus, and long-distance travel. Design/Methods: Case report. Results: A previously healthy 22-year old man travelled from Canada to Central America. After vacationing for 72 hours, he developed bilateral lower extremity weakness and sensory alteration with urinary retention over several hours. The day before symptom onset, he had been riding an all-terrain vehicle (ATV), resulting in lower back discomfort. Neurologic examination was consistent with anterior cord syndrome. MRI spine demonstrated anterior cord T2 hyperintensity extending from T11 to the conus medullaris. Infectious and hypercoagulability work-up were negative. Time-resolved MR angiography of the spinal cord did not demonstrate a vascular malformation. He received high dose intravenous steroids without clinical benefit. Overall, his presentation was most consistent with anterior spinal cord infarction. Two weeks after symptom onset, he was found to have a small pulmonary embolus, believed to be secondary to immobilization and was started on rivaroxaban. After 3 months, rivaroxaban was discontinued and he was advised to continue with lifelong acetylsalicylic acid. Conclusions: Recent case reports have identified clinical presentations similar to surfer’s myelopathy with other activities involving spine hyperextension, including cheerleading and gymnastics. This case illustrates a clinical presentation of anterior thoracolumbar cord infarction consistent with surfer’s myelopathy after spine hyperextension during ATV riding, in the context of dehydration and long-distance air travel. Disclosure: Dr. Alzahrany has nothing to disclose. Dr. McVeigh has nothing to disclose. Dr. Parks has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Biogen, EMD Serono, Sanofi Genzyme, and Roche. Dr. Parks has received research support from Biogen, MedDay, Sanofi Genzyme, and Roche.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".