{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T07:01:16Z","timestamp":1784876476536,"version":"3.55.0"},"reference-count":54,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Neurotrauma Reports"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>\n                    No pharmacologic agent has demonstrated long-term neurological recovery following acute traumatic spinal cord injury (ATSCI). Thus, consideration of alternative outcome indicators is reasonable. A new and novel outcome variable,\n                    <jats:italic toggle=\"yes\">time to recovery,<\/jats:italic>\n                    is introduced and compared to\n                    <jats:italic toggle=\"yes\">long-term recovery<\/jats:italic>\n                    , examining nine variables for a two-grade improvement (Marked Recovery [MR]). The updated historical US FDA IND SYGEN ATSCI database (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    = 760 patients) was used, as it is unique in having sufficient neurological examinations (4, 8, 16, 26, and 52 weeks) to allow the analysis. The\n                    <jats:italic toggle=\"yes\">time to MR<\/jats:italic>\n                    was defined as the geometric mean between the time to first MR and the preceding examination with no MR. The SYGEN group exhibited the maximum fractional MR disparity at 8 weeks (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    = 0.0248), coinciding with the discontinuation of the SYGEN study drug treatment. In the model fit analysis using\n                    <jats:italic toggle=\"yes\">long-term MR<\/jats:italic>\n                    outcomes (26\u201352 weeks), significant variables were ASIA Injury Score (AIS) baseline grade (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    &lt; 0.0001), cervical versus thoracic injury (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    = 0.0334), and direct admission versus transfer to spinal cord injury center (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    = 0.0269). In the model fit analysis using\n                    <jats:italic toggle=\"yes\">time to MR<\/jats:italic>\n                    , significant variables were AIS baseline grade (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    &lt; 0.0001), SYGEN versus placebo (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    = 0.0227), age &lt;30 years old (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    = 0.0248), and early surgery \u226472 h (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    = 0.0350). For\n                    <jats:italic toggle=\"yes\">time to MR<\/jats:italic>\n                    , the combined effects of SYGEN and early surgery were additive, with a total decrease of 40.87 days (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    = 0.0041) compared with placebo and late surgery. The\n                    <jats:italic toggle=\"yes\">time to MR<\/jats:italic>\n                    is a new and novel metric for evaluating differences in recovery, as demonstrated by finding significant statistical relationships in several variables. The mechanism of action of a shortening of\n                    <jats:italic toggle=\"yes\">time to MR<\/jats:italic>\n                    between groups after ATSCI is an augmentation of the body\u2019s inherent neurological healing process. Clinically, this results in shorter rehabilitation time.\n                  <\/jats:p>","DOI":"10.1177\/2689288x261469045","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T11:38:13Z","timestamp":1784720293000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Injury to Time of Marked Recovery as a New Acute Spinal Cord Injury Outcome Measurement for Statistical Analysis of Interventions and Drug Treatments"],"prefix":"10.1177","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0899-9045","authenticated-orcid":false,"given":"Fred H.","family":"Geisler","sequence":"first","affiliation":[{"name":"Department of Small Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luke J.","family":"Weisbrod","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Nebraska Medical Center, Omaha, Nebraska, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamie Russell Frederick","family":"Wilson","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical University of South Carolina, Charleston, South Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,22]]},"reference":[{"key":"e_1_3_2_2_1","doi-asserted-by":"publisher","DOI":"10.3389\/ebm.2024.10266"},{"key":"e_1_3_2_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/BSD.0000000000000287"},{"key":"e_1_3_2_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2013.08.005"},{"key":"e_1_3_2_5_1","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2018.5935"},{"key":"e_1_3_2_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006123-200203001-00013"},{"key":"e_1_3_2_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-200112151-00015"},{"key":"e_1_3_2_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-200112151-00014"},{"key":"e_1_3_2_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-200112151-00013"},{"key":"e_1_3_2_10_1","doi-asserted-by":"publisher","DOI":"10.3171\/2022.12.SPINE22713"},{"key":"e_1_3_2_11_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199005173222001"},{"key":"e_1_3_2_12_1","doi-asserted-by":"publisher","DOI":"10.3390\/biomedicines10020363"},{"key":"e_1_3_2_13_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2019.00859"},{"key":"e_1_3_2_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/ddr.430150402"},{"key":"e_1_3_2_15_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnins.2020.572965"},{"key":"e_1_3_2_16_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199106273242601"},{"key":"e_1_3_2_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/120.7.1123"},{"key":"e_1_3_2_18_1","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2020.7473"},{"key":"e_1_3_2_19_1","doi-asserted-by":"publisher","DOI":"10.1310\/sci1801-1"},{"key":"e_1_3_2_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/os.13120"},{"key":"e_1_3_2_21_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2022.4454"},{"key":"e_1_3_2_22_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0032037"},{"key":"e_1_3_2_23_1","doi-asserted-by":"publisher","DOI":"10.1089\/neur.2020.0027"},{"key":"e_1_3_2_24_1","doi-asserted-by":"publisher","DOI":"10.3171\/2014.5.FOCUS1473"},{"key":"e_1_3_2_25_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13017-023-00525-4"},{"key":"e_1_3_2_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2025.123916"},{"key":"e_1_3_2_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/0090-3019(91)90110-u"},{"key":"e_1_3_2_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2004.04.032"},{"key":"e_1_3_2_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2021.106098"},{"key":"e_1_3_2_30_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.33604"},{"key":"e_1_3_2_31_1","unstructured":"30.National Institute of Neurological Disorders and Stroke N. Spinal cord injury. Web site. 2025. Available from: https:\/\/www.ninds.nih.gov\/health-information\/disorders\/spinal-cord-injury [Last accessed: April7 2025]."},{"key":"e_1_3_2_32_1","doi-asserted-by":"publisher","DOI":"10.1177\/2192568219877860"},{"issue":"1","key":"e_1_3_2_33_1","first-page":"71","article-title":"Experimental spinal cord trauma, III: Therapeutic effect of immobilization and pharmacologic agents","volume":"10","author":"Ducker TB","year":"1978","unstructured":"32.Ducker TB, , Salcman M, , Daniell HB. Experimental spinal cord trauma, III: Therapeutic effect of immobilization and pharmacologic agents. Surg Neurol 1978;10(1):71\u201376.","journal-title":"Surg Neurol"},{"key":"e_1_3_2_34_1","doi-asserted-by":"publisher","DOI":"10.1136\/tsaco-2025-001768"},{"key":"e_1_3_2_35_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-025-05531-3"},{"key":"e_1_3_2_36_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2025.25364"},{"key":"e_1_3_2_37_1","doi-asserted-by":"publisher","DOI":"10.1177\/21925682231202348"},{"key":"e_1_3_2_38_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000003165"},{"key":"e_1_3_2_39_1","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2011.1955"},{"key":"e_1_3_2_40_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000003627"},{"key":"e_1_3_2_41_1","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1992.76.1.0023"},{"key":"e_1_3_2_42_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD001046"},{"key":"e_1_3_2_43_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1997.03540440031029"},{"key":"e_1_3_2_44_1","doi-asserted-by":"publisher","DOI":"10.3171\/2008.10.SPINE08217"},{"key":"e_1_3_2_45_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/aws072"},{"issue":"4","key":"e_1_3_2_46_1","first-page":"275","article-title":"Erythropoietin plus methylprednisolone or methylprednisolone in the treatment of acute spinal cord injury: A preliminary report","volume":"52","author":"Alibai E","year":"2014","unstructured":"45.Alibai E, , Zand F, , Rahimi A, et al. Erythropoietin plus methylprednisolone or methylprednisolone in the treatment of acute spinal cord injury: A preliminary report. Acta Med Iran 2014;52(4):275\u2013279.","journal-title":"Acta Med Iran"},{"key":"e_1_3_2_47_1","doi-asserted-by":"publisher","DOI":"10.17712\/1658-3183.2081"},{"key":"e_1_3_2_48_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10072-015-2182-5"},{"key":"e_1_3_2_49_1","doi-asserted-by":"publisher","DOI":"10.4103\/ajns.AJNS_259_16"},{"key":"e_1_3_2_50_1","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2019.6854"},{"key":"e_1_3_2_51_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41393-020-00604-2"},{"key":"e_1_3_2_52_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awaa466"},{"key":"e_1_3_2_53_1","doi-asserted-by":"publisher","DOI":"10.1007\/s43465-022-00758-6"},{"key":"e_1_3_2_54_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2022.03.033"},{"key":"e_1_3_2_55_1","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2023.0163"}],"container-title":["Neurotrauma Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/2689288X261469045","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/2689288X261469045","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/2689288X261469045","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T06:16:18Z","timestamp":1784873778000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/2689288X261469045"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":54,"alternative-id":["10.1177\/2689288X261469045"],"URL":"https:\/\/doi.org\/10.1177\/2689288x261469045","relation":{},"ISSN":["2689-288X","2689-288X"],"issn-type":[{"value":"2689-288X","type":"print"},{"value":"2689-288X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"article-number":"2689288X261469045"}}