bluuebunny/crossref_metadata_2025 huggingface dataset:
Statistical learning confirms the diagnostic significance of the anemia panel in breast cancer
Authors: Biljan Marta , Dmitrović Branko , Kristek Jozo , Šimundić Ana-Maria , Mandić Sanja , Šerić Vatroslav , Margaretić Damir , Debeljak Željko
Published: April 2012

Diagnostic value of available tumor markers, such as cancer antigen CA 15-3 and carcinoembryonic antigen (CEA) in breast cancer is limited. There is an ongoing search for additional, potentially better diagnostic blood markers with improved clinical utility. The aim of this study is to evaluate performance of the approach based on routine blood tests accompanied by a statistical learning tool to the diagnosis of breast cancer.

Blood was collected from total of 104 subjects which were divided into two groups: breast cancer patients and a control group that consisted of asymptomatic volunteers and patients who had benign breast lesions at the time of blood collection. Random forest statistical learning method and the external method validation have been applied to evaluate diagnostic performance of 31 routine blood tests.

The applied statistical learning approach assigned the highest diagnostic importance to the anemia panel among all analyzed blood tests that also included CA 15-3. External validation has shown utility of selected statistical approach – we were able to select tests that provide a diagnostic accuracy comparable to some diagnostic tools described in literature and based on more demanding laboratory techniques, such as gene expression microarrays.

Inclusion of tests for anemia significantly improves diagnostic accuracy for the breast cancer in comparison to the diagnostic accuracy of the CA 15-3 alone. Application of the random forests also enables the reduction of number of laboratory tests needed for the establishment of diagnosis. Differences in relevant test values between the cancer and control group are small but application of multiparametric statistical learning ensured diagnostic accuracy of 72.0% associated by a sensitivity of 64.7% and specificity of 84.9%.
Serum cystatin C is an early biomarker for assessment of renal function in burn patients
Authors: Cai Xiaoyan , Long Zhaolin , Lin Lianduo , Feng Yudong , Zhou Naxi , Mai Qifeng
Published: April 2012

Early detection of renal dysfunction is important in burn patients. This study evaluated whether serum cystatin C (CysC) is a potentially accurate and sensitive marker for identification of reduced glomerular filtration rate (GFR) and the risk factors of impaired renal function in major burn patients.

A total of 48 adult patients with major burn injury were enrolled. Renal function was assessed using serum creatinine (sCr), 24-h urinary creatinine clearance (24-hCrCl), sCr-based formulae and CysC-based formulae on the second day and seventh day post-burn.

There was a high prevalence (27.1%) of acute impaired renal function in major burn patients in the first week post-burn. CysC-based formulae for estimated GFR (eGFR) are more accurate and sensitive for detection of impaired renal function than sCr-based formulae. Multivariate logistic regression analysis demonstrated that age (OR, 2.08; 95% CI 1.26–4.77) and the percentage of burn area (OR, 3.41; 95% CI 1.64–6.95) were independent risk factors of impaired renal function.

The results of this study suggest that CysC is a more accurate and sensitive marker for identification of acute impaired renal function in major burn patients than sCr. It is important to measure CysC and calculate eGFR to prevent acute renal failure and modify drug doses in burn patients, especially those of older age and with major burn areas.
Clinical and pathological features of B-cell non-Hodgkin lymphomas lacking the surface expression of immunoglobulin light chains
Authors: Matsushita Hiromichi , Nakamura Naoya , Tanaka Yuzo , Ohgiya Daisuke , Tanaka Yumiko , Damdinsuren Anar , Asai Satomi , Yabe Miharu , Kawada Hiroshi , Ogawa Yoshiaki , Ando Kiyoshi , Miyachi Hayato
Published: April 2012

The flow cytometric analysis of surface immunoglobulin light chains (sIgL) is used as a simple method for evaluating monoclonal B-cell proliferation. However, the sIgL expression, κ or λ, is occasionally undetectable in cases with B-cell non-Hodgkin lymphomas (B-NHL). The purpose of this study was to investigate the clinical and pathological characteristics of these B-NHL cases.

We retrospectively analyzed 50 cases with previously untreated sIgL-negative B-NHL. All of these cases had been diagnosed at Tokai University Hospital between January 2001 and February 2011. Their medical charts were reviewed.

These cases had several clinical features: diffuse large B-cell lymphoma (DLBCL) (72%), a high serum lactate dehydrogenase level (66%), clinical stage III and IV (68%), and complex karyotypes (58%). Seven out of eight evaluated patients (87%) did not express cytoplasmic IgL, and the DNA rearrangement pattern of IgL showed diversity in 10 analyzed patients. The 5-year event-free survival of all the sIgL-negative B-NHL cases was significantly better with rituximab-containing chemotherapies in comparison to the regimens without it (57.9% vs. 17.9%, p=0.0207), although there was no statistical significance when the DLBCL cases were analyzed (56.6% vs. 22.2%, p=0.1530).

These findings suggest that sIgL-negative B-NHL cases predominantly developed DLBCL in advanced disease, but were heterogeneous at the molecular level.
Collective opinion paper on findings of the 2011 convocation of experts on laboratory quality
Authors: Adams Ortwin , Cooper Greg , Fraser Callum , Hubmann Michael , Jones Graham , Plebani Mario , Sonntag Oswald , Vaubourdolle Michel
Published: April 2012

In April of 2011, Bio-Rad Laboratories Quality System Division (Irvine, CA, USA) hosted its third annual convocation of experts on laboratory quality in the city of Salzburg, Austria. As in the past 2 years, over 60 experts from across Europe, Israel, USA and South Africa convened to discuss contemporary issues and topics of importance to the clinical laboratory. This year’s conference had EN/ISO 15189 and accreditation as the common thread for most discussions, with topics ranging from how to meet requirements like uncertainty to knowledge gained from those already accredited. The participants were divided into five discussion working groups (WG) with assigned topics. The outcome of these discussions is the subject of this summary.
Mid-stream vs. first-voided urine collection by using automated analyzers for particle examination in healthy subjects: an Italian multicenter study
Authors: Manoni Fabio , Gessoni Gianluca , Alessio Maria Grazia , Caleffi Alberta , Saccani Graziella , Silvestri Maria Grazia , Poz Donatella , Ercolin Mauro , Tinello Agostino , Valverde Sara , Ottomano Cosimo , Lippi Giuseppe
Published: April 2012

In analogy with other areas of laboratory diagnostics, the pre-analytical phase is the leading source of variability also in urinalysis. We carried out a multicentric study for comparing results obtained from first-voided and mid-stream urine samples.

Each of the six hospital-based clinical laboratories participating to this study recruited 50 healthy subjects among laboratory staff and/or their relatives. Two consecutive samples of the first morning micturition were collected by vacuum system, the first from the first-void and the second from the mid-stream. Routine urinalysis was performed using dip-stick automated analyzers for chemical examination and automated analyzers for formed particle examination (Sysmex UF-100, Sysmex UF-1000i and Iris iQ-200).

Counts of epithelial cells (EC), erythrocytes (ERY) and leukocytes (LEU) but not for cylinders (CAS) were significantly higher in the first-voided samples. A significantly higher count of EC, ERY and LEU was also observed between females and males in first-voided samples, whereas no significant difference could be found in mid-stream samples. Health related analyzer specific upper reference limits (URL) were CAS≤1, EC≤5, ERY≤19, Leu≤13 for UF-100; CAS≤1, EC≤4, ERY≤15, Leu≤11 for UF-1000i; CAS≤1, EC≤4, ERY≤18, Leu≤10 for iQ200. The overall prevalence of subjects with cellular elements count exceeding URL was also higher in first-voided than in mid-stream samples.

Mid-stream urine was confirmed as the most appropriate sample, since the presence of contaminating elements, such as bacteria, analytes and formed particles are minimized.
High-throughput detection, genotyping and quantification of the human papillomavirus using real-time PCR
Authors: Micalessi Isabel M. , Boulet Gaëlle A.V. , Bogers Johannes J. , Benoy Ina H. , Depuydt Christophe E.
Published: April 2012

The establishment of the causal relationship between high-risk human papillomavirus (HR-HPV) infection and cervical cancer and its precursors has resulted in the development of HPV DNA detection systems. Currently, real-time PCR assays for the detection of HPV, such as the RealTime High Risk (HR) HPV assay (Abbott) and the cobas® 4800 HPV Test (Roche Molecular Diagnostics) are commercially available. However, none of them enables the detection and typing of all HR-HPV types in a clinical high-throughput setting. This paper describes the laboratory workflow and the validation of a type-specific real-time quantitative PCR (qPCR) assay for high-throughput HPV detection, genotyping and quantification. This assay is routinely applied in a liquid-based cytology screening setting (700 samples in 24 h) and was used in many epidemiological and clinical studies.

The TaqMan-based qPCR assay enables the detection of 17 HPV genotypes and β-globin in seven multiplex reactions. These HPV types include all 12 high-risk types (HPV16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59), three probably high-risk types (HPV53, 66 and 68), one low-risk type (HPV6) and one undetermined risk type (HPV67).

An analytical sensitivity of ≤100 copies was obtained for all the HPV types. The analytical specificity of each primer pair was 100% and an intra- and inter-run variability of <6.4% was observed.

The type-specific real-time PCR approach enables detection of 17 HPV types, identification of the HPV type and determination of the viral load in a single sensitive assay suitable for high-throughput screening.
Proteinase-activated receptors (PARs): differential signalling by kallikrein-related peptidases KLK8 and KLK14
Authors: Ramachandran Rithwik , Eissa Azza , Mihara Koichiro , Oikonomopoulou Katerina , Saifeddine Mahmoud , Renaux Bernard , Diamandis Eleftherios , Hollenberg Morley D.
Published: April 2012

We compared signalling pathways such as calcium transients, MAPK activation, β-arrestin interactions and receptor internalization triggered by kallikrein-related peptidases (KLKs) 8 and 14 in human and rat proteinase-activated receptor (PAR)2-expressing human embryonic kidney (HEK) and Kirsten transformed rat kidney (KNRK) cells. Further, we analysed processing by KLK8 vs. KLK14 of synthetic human and rat PAR2-derived sequences representing the cleavage-activation domain of PAR2. Our data show that like KLK14, KLK8 can unmask a PAR2 receptor-activating sequence from a peptide precursor. However, whilst KLK8, like KLK14, can signal in rat-PAR2-expressing KNRK cells, this enzyme cannot signal via human PAR2 in HEK or KNRK cells, but rather, disarms HEK PAR1. Thus, KLK8 and KLK14 can signal differentially via the PARs to affect tissue function.
Circulating microRNAs: macro-utility as markers of prostate cancer?
Authors: Selth Luke A , Tilley Wayne D , Butler Lisa M
Published: April 2012

The realization that microRNAs (miRNAs) are frequently deregulated in malignancy has had a major impact on cancer research. In particular, the recent finding that highly stable forms of miRNAs can be accurately measured in body fluids, including blood, has generated considerable excitement. Here, we discuss the potential of blood-based circulating miRNAs as diagnostic, prognostic, and predictive biomarkers of prostate cancer. We also describe practical considerations that may influence identification and/or measurement of miRNA biomarkers in the circulation. Finally, evidence is prevented for the emerging concept that circulating miRNAs are actively released by their cells of origin and can modulate gene expression at distal sites. These mobile miRNAs, which we term ‘hormomirs’ because of their hormone-like characteristics, could act as local or long-range signals to maintain normal homeostasis or influence the development and progression of diseases such as cancer.
Effect of chloride-induced reinforcing steel corrosion on the flexural strength of reinforced concrete beams
Authors: Xia Jin , Jin Wei-Liang , Li Long-Yuan
Published: April 2012

An experimental investigation into the influence of reinforcing steel corrosion on the flexural capacity of conventionally reinforced concrete beams was conducted. Two types of specimens were constructed and the embedded flexural reinforcing bars were subjected to accelerated corrosion. Nine different corrosion damage levels were produced. An electro-migration method was used to accelerate the migration of chloride into the concrete, and a wet–dry cycle with small current was applied to speed up the corrosion of reinforcing steel bars. Corrosion-induced crack width and its relationship with the corrosion level were analysed. Based on the experimental data obtained from tests, a practicable approach is proposed to predict the residual flexural strength of corroded beams.
Timber composite beams with a discrete connection system
Authors: Fernandez-Cabo Jose L. , Fernandez-Lavandera Jorge , Diez-Barra Rafael , Avila-Jalvo Jose M.
Published: April 2012

This work centres on a method for the analysis of timber composite beams; the method considers slip in the connection system, based on assembling a flexibility matrix for the whole structure. The lower component of such beams is typically made of timber or glue-laminated timber, while the upper portion is usually either concrete or a timber board, such as laminated veneer lumber or cross-laminated timber. The method is based on a previously proposed solution, but this paper extends the method to the case of a gap between two components with an arbitrary location at the first connector, which notably broadens its practical application. The addition of the gap makes it possible to model a cracked zone in the concrete topping, as well as the case in which forming produces the gap. The arbitrary location of the first connector may, for example, be related to the case of refurbishment. The consideration of induced stresses due to changes in temperature and moisture content is also described, while the concept of equivalent eccentricity is generalised. This method has important advantages in connection with the current European standard EN 1995-1-1: 2004 (EC5), as it is able to deal with any type of load, variable section, discrete and non-regular connection systems, a gap between the two components, and variations in temperature and moisture content. Although it could be applied to any structural system, it is especially suited to the case of simply supported and continuous beams. A simple finite-element method is also proposed in order to compare the results. For the case with smeared connections, the results were compared with an existing exact differential equation; in both cases good agreement was achieved. Examples of working are also given, showing that the connection arrangement notably modifies the shear force distribution. A first interpretation of the results is made on the basis of strut and tie theory. The examples prove that the use of EC5 is unsafe when, as a rule of thumb, the strut or compression stress field between the support and the first connector is at an angle with the axis of the beam of less than 60°.
Operating speed models for two-lane rural highways
Authors: Castro María , Sánchez José F. , Sánchez José A.
Published: April 2012

Drivers adapt their driving to the conditions that they find. When the design corresponds to what a driver hopes to find, the route is consistent. This diminishes the likelihood of drivers making errors and carrying out uncertain manoeuvres. Most evaluations of highway geometric design consistency are based on the analysis of vehicles' speeds. This study reviewed the main models of operating speed prediction on two-lane rural highways. Models calibrated in several countries have been compared by means of their application to the study of nine highway sections located in different terrain types. Also, field measurements have been included in the comparison. The research results show the strengths and weaknesses of those models, their similarities, differences and the lack of suitability of some of them for mountainous highways. Based on them, specific recommendations about which models would be suitable for use are included. The speed profiles predicted by the Spanish model show, in general, higher values than most models calibrated in other countries.
Portuguese unbound granular materials characterisation using cyclic triaxial tests
Authors: Conceição Luzia Rosa P. , de Picado Santos Luís G. , Coelho das Neves José M. , Correia Gardete Dinis
Published: April 2012

Crushed materials with extensive granulometry – unbound granular materials (UGM) – are often used as unbound granular layers of road pavements, namely as granular sub-base and base. In spite of several studies having already been undertaken, the behaviour of these materials on pavement layers has not been sufficiently characterised, especially due to reasons connected to the heterogeneity of the rock masses from which they come. This has special importance for Portuguese pavement technology and has led to the development of two PhD theses in different schools (University of Coimbra and Technical University of Lisbon) using different approaches but both aiming at the characterisation of the aptitude of the same types of material (crushed limestone) being used as UGM. In addition, in the same terms, one of the theses has also characterised a crushed granite material. Basically, both theses included laboratory testing using cyclic triaxial tests and in situ mechanical characterisation to establish behaviour models for the crushed materials investigated. This paper describes the main results obtained from both theses and discusses the results on an integrated basis, pointing out the main indications that can be extracted from both in terms of the use of UGM on Portuguese pavement technology.
Traffic uncertainty in toll motorway concessions in Spain
Authors: Baeza María A. , Vassallo José M.
Published: April 2012

This study assessed the inaccuracy of the traffic estimates for toll motorway concessions in Spain. It was found that the estimates conducted by both the government and the concessionaire showed a significant bias towards overestimating traffic. The level of overestimation in Spain is even greater than that reported by other studies based on worldwide data. The notorious levels of overestimation entail severe burdens to the economics of the concessionaires that often prompt renegotiations of the contracts, which are often accepted by the government. These renegotiations usually end up with toll changes or extension of the concession terms, which have to be ultimately borne by future motorway users. It is postulated herein that the bias towards overestimating traffic in toll motorways in Spain is mostly caused by strategic issues rather than by modelling errors.
The Production of p-Cresol Sulfate and Indoxyl Sulfate in Vegetarians Versus Omnivores
Authors: Patel Kajal P. , Luo Frank J.-G. , Plummer Natalie S. , Hostetter Thomas H. , Meyer Timothy W.
Published: April 2012

Background and objectives

The uremic solutes p-cresol sulfate (PCS) and indoxyl sulfate (IS) are generated by colon bacteria acting on food components that escape absorption in the small bowel. The production of these potentially toxic compounds may thus be influenced by diet. This study examined whether production of PCS and IS is different in vegetarians and omnivores.

Design, setting, participants, & measurements

The production of PCS and IS was assessed by measuring their urinary excretion rates in participants with normal kidney function. Studies were carried out in 15 vegetarians and 11 individuals consuming an unrestricted diet. Participants recorded food intake over 4 days and collected urine over the final 2 days of each of two study periods, which were 1 month apart.

Results

Average PCS excretion was 62% lower (95% confidence interval [95% CI], 15–83) and average IS excretion was 58% lower (95% CI, 39–71) in vegetarians than in participants consuming an unrestricted diet. Food records revealed that lower excretion of PCS and IS in vegetarians was associated with a 69% higher (95% CI, 20–139) fiber intake and a 25% lower (95% CI, 3–42) protein intake. PCS and IS excretion rates varied widely among individual participants and were not closely correlated with each other but tended to remain stable in individual participants over 1 month.

Conclusions

PCS and IS production rates are markedly lower in vegetarians than in individuals consuming an unrestricted diet.
Sexual Dysfunction in Women with ESRD Requiring Hemodialysis
Authors: Strippoli Giovanni F.M.
Published: April 2012

Background and objectives

The few existing studies of sexual dysfunction in women on hemodialysis are limited by small sample size. This large, cross-sectional study evaluated the prevalence and correlates of female sexual dysfunction in advanced kidney disease.

Design, setting, participants, & methods

A total of 1472 women with ESRD undergoing hemodialysis were recruited to a multinational, cross-sectional study conducted within a collaborative dialysis network in Europe and South America. Sexual dysfunction was identified by the Female Sexual Function Index. Correlates of self-reported sexual dysfunction were identified by regression analyses.

Results

Of the 1472 women, 659 completed questionnaires (45%). More than half (362 of 659 [55%]) lived with a partner, and 232 of 659 (35%) reported being sexually active. Of these 659 respondents, 555 (84%) reported sexual dysfunction. Women with a partner (282 of 362 [78%]) were less likely to report sexual dysfunction than those without a partner (273 of 297 [92%]) (P<0.001). Sexual dysfunction was independently associated with age, depressive symptoms, less education, menopause, diabetes, and diuretic therapy. Nearly all women who were not wait-listed for a kidney transplant and were living without a partner (249 of 260 [96%]) reported sexual dysfunction. More than half (128 of 232 [55%]) of sexually active women reported sexual dysfunction, associated with age, depressive symptoms, menopause, low serum albumin, and diuretic therapy.

Conclusions

This descriptive study suggests most women on hemodialysis experience sexual problems. Additional research on the relevance of sexual dysfunction to symptom burden and quality of life in these women is needed.
CFD simulation of flow patterns in unbaffled stirred tank with CD-6 impeller
Authors: Devi Tamphasana , Kumar Bimlesh
Published: April 2012

Understanding the flow in stirred vessels can be useful for a wide number of
industrial applications. There is a wealth of numerical simulations of
stirring vessels with standard impeller such as Rushton turbine and pitch
blade turbine. Here, a CFD study has been performed to observe the spatial
variations (angular, axial and radial) of hydrodynamics (velocity and
turbulence field) in unbaffled stirred tank with Concave-bladed Disc turbine
(CD-6) impeller. Three speeds (N=296, 638 & 844.6 rpm) have been considered
for this study. The angular variations of hydrodynamics of stirred tank were
found very less as compared to axial and radial variations.
Effects of Interferential Therapy Parameter Combinations Upon Experimentally Induced Pain in Pain-Free Participants: A Randomized Controlled Trial
Authors: Dounavi Myrto D. , Chesterton Linda S. , Sim Julius
Published: April 2012

Background

Little evidence exists regarding parameter selection for hypoalgesia using interferential therapy (IFT).

Objective

This study investigated segmental and extrasegmental hypoalgesic effects of different IFT parameter combinations upon experimentally induced pressure pain threshold (PPT) in pain-free volunteers.

Design

The participants were randomly assigned to 6 groups: control, placebo, bipolar constant amplitude modulation frequency (AMF), bipolar sweep AMF, quadripolar constant AMF, and quadripolar sweep AMF.

Setting

The study was conducted in a university laboratory.

Participants

One hundred eighty adults who were healthy and pain-free participated in the study.

Intervention

Interferential therapy was delivered to all groups at high, to-tolerance intensity and at high AMF. Stimulation to the dominant forearm was delivered for 30 minutes, with monitoring for a further 30 minutes.

Measurements

Pain pressure threshold was measured at the area of first dorsal interosseous muscle of the dominant and nondominant hands (segmental measurements) and over the tibialis anterior muscle (extrasegmental measurement) at baseline and at 10-minute intervals using a pressure algometer. Square root transformed PPT data were analyzed using repeated-measures analysis of variance.

Results

There was a significant change in PPT over time, but no significant between-subjects difference in segmental or extrasegmental PPT between any of the IFT groups and the placebo or control group. Thus, IFT delivered in any of these parameter combinations did not significantly affect the PPT of pain-free participants compared with the control or placebo group.

Limitations

Success of blinding was not evaluated.

Conclusions

This study showed that IFT delivered at high, to-tolerance intensity and high AMF does not produce significant segmental and extrasegmental hypoalgesic effects on PPT in participants who were healthy compared with a control or placebo group. Further research is warranted to investigate the hypoalgesic effect of different IFT parameter combinations and to explain its possible mechanism of action.
Physical Therapy on the Wards After Early Physical Activity and Mobility in the Intensive Care Unit
Authors: Hopkins Ramona O. , Miller Russell R. , Rodriguez Larissa , Spuhler Vicki , Thomsen George E.
Published: April 2012

Background

Weakness and debilitation are common following critical illness. Studies that assess whether early physical activity initiated in the intensive care unit (ICU) continues after a patient is transferred to a ward are lacking.

Objective

The purpose of this study was to assess whether physical activity and mobility initiated during ICU treatment were maintained after patients were discharged from a single ICU to a ward.

Design

This was a cohort study.

Methods

Consecutive patients who were diagnosed with respiratory failure and admitted to the respiratory ICU (RICU) at LDS Hospital underwent early physical activity and mobility as part of usual care. Medical data, the number of requests for a physical therapy consultation or nursing assistance with ambulation at ICU discharge, and mobility data were collected during the first 2 full days on the ward.

Results

Of the 72 patients who participated in the study, 65 had either a physical therapy consultation or a request for nursing assistance with ambulation at ward transfer. Activity level decreased in 40 participants (55%) on the first full ward day. Of the 61 participants who ambulated 100 ft (30.48 m) or more on the last full RICU day, 14 did not ambulate, 22 ambulated less than 100 ft, and 25 ambulated 100 ft or more on the first ward day.

Limitations

Limitations include lack of data regarding why activity was not performed on the ward, lack of longitudinal follow-up to assess effects of activity, and lack of generalizability to patients not transferred to a ward or not treated in an ICU with an early mobility program.

Conclusions

Despite the majority of participants having a physical therapy consultation or a request for nursing assistance with ambulation at the time of transfer to the medical ward, physical activity levels decreased in over half of participants on the first full ward day. The data suggest a need for education of ward staff regarding ICU debilitation, enhanced communication among care providers, and focus on the importance of patient-centered outcomes during and following ICU treatment.
The remarkable medical lineage of the Monro family: contributions of Alexander primus, secundus, and tertius
Authors: Wu Osmond C. , Manjila Sunil , Malakooti Nima , Cohen Alan R.
Published: April 2012

Among the families that have influenced the development of modern medicine into what it is today, the Monro lineage stands as one of the most notable. Alexander Monro primus (1697–1767) was the first of 3 generations with the same name, a dynasty that spanned 126 years occupying the Chair of Anatomy one after the other at the University of Edinburgh. After becoming Professor of Anatomy at the University of Edinburgh in 1719, Monro primus played a principal role in the establishment of the University of Edinburgh School of Medicine and the Edinburgh Royal Infirmary. In 1726, he published The Anatomy of the Humane Bones, of which 8 editions were printed during his lifetime. His son, Alexander Monro secundus (1733–1817), arguably the most notable of the 3 men, succeeded him as Professor of Anatomy. A highly regarded lecturer and anatomist, Monro secundus studied under many great physicians, including William Hunter and Johann Friedrich Meckel the Elder, and was also teacher to other well-known figures at the time, such as Joseph Black and Thomas Trotter. His most notable contributions include his work with the lymphatic system, the interventricular foramen (of Monro), and the Monro-Kellie doctrine. Alexander Monro tertius (1773–1859), the last of the dynasty, also succeeded his father as Professor of Anatomy. His work included insights into abdominal aortic aneurysms and the anatomy of the genitourinary system. The prominent association of the Monro family with the University of Edinburgh and the effects of a tenured professorship under the concept of “Ad vitam aut culpam” over successive generations are also described. To the best of the authors' knowledge, this historical review of the Monro family is among the few published in neurosurgical literature. A vivid historical overview of the medical contributions of the most famous and influential dynasty of physicians in Edinburgh at that time is provided, with relevant excerpts from original publications.
Does the load-sharing classification predict ligamentous injury, neurological injury, and the need for surgery in patients with thoracolumbar burst fractures?
Authors: Radcliff Kristen , Kepler Christopher K. , Rubin Todd A. , Maaieh Motasem , Hilibrand Alan S. , Harrop James , Rihn Jeffrey A. , Albert Todd J. , Vaccaro Alexander R.
Published: April 2012

Object

The load-sharing score (LSS) of vertebral body comminution is predictive of results after short-segment posterior instrumentation of thoracolumbar burst fractures. Some authors have posited that an LSS > 6 is predictive of neurological injury, ligamentous injury, and the need for surgical intervention. However, the authors of the present study hypothesized that the LSS does not predict ligamentous or neurological injury.

Methods

The prospectively collected spinal cord injury database from a single institution was queried for thoracolumbar burst fractures. Study inclusion criteria were acute (< 24 hours) burst fractures between T-10 and L-2 with preoperative CT and MRI. Flexion-distraction injuries and pathological fractures were excluded. Four experienced spine surgeons determined the LSS and posterior ligamentous complex (PLC) integrity. Neurological status was assessed from a review of the medical records.

Results

Forty-four patients were included in the study. There were 4 patients for whom all observers assigned an LSS > 6, recommending operative treatment. Eleven patients had LSSs ≤ 6 across all observers, suggesting that nonoperative treatment would be appropriate. There was moderate interobserver agreement (0.43) for the overall LSS and fair agreement (0.24) for an LSS > 6. Correlations between the LSS and the PLC score averaged 0.18 across all observers (range −0.02 to 0.34, p value range 0.02–0.89). Correlations between the LSS and the American Spinal Injury Association motor score averaged −0.12 across all observers (range −0.25 to −0.03, p value range 0.1–0.87). Correlations describing the relationship between an LSS > 6 and the treating physician's decision to operate averaged 0.17 across all observers (range 0.11–0.24, p value range 0.12–0.47).

Conclusions

The LSS does not uniformly correlate with the PLC injury, neurological status, or empirical clinical decision making. The LSSs of only one observer correlated significantly with PLC injury. There were no significant correlations between the LSS as determined by any observer and neurological status or clinical decision making.
Microsurgical management of glomus spinal arteriovenous malformations: pial resection technique
Authors: Velat Gregory J. , Chang Steve W. , Abla Adib A. , Albuquerque Felipe C. , McDougall Cameron G. , Spetzler Robert F.
Published: April 2012

Object

Intramedullary, or glomus, spinal arteriovenous malformations (AVMs) are rare vascular lesions amenable to resection with or without adjuvant embolization. The authors retrospectively reviewed the senior author's (R.F.S.'s) surgical series of intramedullary spinal AVMs to evaluate clinical and radiographic outcomes.

Methods

Detailed chart and radiographic reviews were performed for all patients with intramedullary spinal AVMs who underwent surgical treatment between 1994 and 2011. Presenting and follow-up neurological examination results were obtained and graded using the modified Rankin Scale (mRS) and McCormick Scale. Surgical technique, outcomes, complications, and long-term angiographic studies were reviewed.

Results

During the study period, 20 patients (10 males and 10 females) underwent resection of glomus spinal AVMs. The mean age at presentation was 30 ± 17 years (range 7–62 years). The location of the AVMs was as follows: cervical spine (n = 10), thoracic spine (n = 9), and cervicothoracic junction (n = 1). The most common presenting signs and symptoms included paresis or paralysis (65%), paresthesias (40%), and myelopathy (40%). Perioperative embolization was performed in the majority (60%) of patients. Pial AVM resection was performed in 17 cases (85%). Angiographically verified AVM obliteration was achieved in 15 patients (75%). At a mean follow-up duration of 45.4 ± 52.4 months (range 2–176 months), 14 patients (70%) remained functionally independent (mRS and McCormick Scale scores ≤ 2). One perioperative complication occurred, yielding a surgical morbidity rate of 5%. Three symptomatic spinal cord tetherings occurred at a mean of 5.7 years after AVM resection. No neurological decline was observed after endovascular and surgical interventions. No deaths occurred. Long-term angiographic follow-up data were available for 9 patients (40%) at a mean of 67.6 ± 60.3 months (range 5–176 months) following AVM resection. Durable AVM obliteration was documented in 5 (83%) of 6 patients.

Conclusions

Intramedullary AVMs may be safely resected with satisfactory clinical and angiographic results. The pial resection technique, which provides subtotal AVM nidus resection, effectively devascularized these lesions, as confirmed on postoperative angiography, without violating the spinal cord parenchyma, thereby potentially reducing iatrogenic injury.
Nietzsche and/in/on Translation
Authors: Large Duncan
Published: April 2012

Nietzsche reflects on translation at two key points in his published works, GS 83 and BGE 28, and these passages have been frequently anthologized in translation studies readers. He was not otherwise much exercised by questions of translation, though, and when he uses the German word for translation (Übersetzung), the majority of instances are figurative. As an academic classicist Nietzsche himself translated between German, Greek, and Latin, but his command of modern foreign languages was relatively unimpressive, and he viewed language learning as a necessary evil, looking forward to the time when a new lingua franca would obviate the need for language learning or translation at all. Nonetheless Nietzsche was very keen to secure translators for his own works: early French translations in his mentally active lifetime were followed by a flurry of further translations from the 1890s, when English translations also began to appear. After the Second World War Walter Kaufmann and R. J. Hollingdale's English versions achieved preeminence, but by now the range of English translations is very diverse. The stylistic challenges facing the prospective translator of Nietzsche filled Peter Newmark with apprehension, but the present author adopts a more pragmatic position and concludes by speculating that the translator might represent the best approximation to Nietzsche's ideal reader.
Nietzsche's Will to Power as a Psychological Thesis: Reactions to Bernard Reginster
Authors: Soll Ivan
Published: April 2012

While agreeing with Bernard Reginster that Nietzsche's advocacy of the will to power as a psychological thesis is much more fundamental than his extension of it as a cosmological or metaphysical thesis, I criticize him for failing to support this interpretation, and I attempt to supply an analysis that does support it. Then, I take issue with the common tendency to sanitize Nietzsche's theory of the will to power, to make it more palatable—and with Reginster's treatment of this issue. This leads me to an examination of Nietzsche's conception of power—and a critique of Reginster's account of it.
Assessing the Credibility of the “YouTube Approach” to Health Information on Acute Myocardial Infarction
Authors: Pant Sadip , Deshmukh Abhishek , Murugiah Karthik , Kumar Gagan , Sachdeva Rajesh , Mehta Jawahar L
Published: April 2012

Background:

This study was designed to assess the credibility of YouTube video information on acute myocardial infarction by exploring the relationship between accuracy of information on the topic, source of expertise, and perceived credibility of the message.

Hypothesis:

Health information videos in YouTube possess a diverse mix of information and can easily mislead online information seekers.

Methods:

The Web site http://www.YouTube.com was queried for the following search terms: “acute myocardial infarction,” “heart attack,” “acute coronary syndrome,” and “ST‐elevation myocardial infarction.” The resulting videos were categorized according to the source of the video and content was analyzed for discussion of different aspects of disease, ranging from pathophysiology to treatment.

Results:

Only 6% of videos touched upon all aspects of acute myocardial infarction. These were mostly from professional societies, were of long duration, and were among the least viewed. Videos that described personal experiences were “liked” or “disliked” most and had the majority of comments. Only 17% of the videos discussed the preventive aspects of the disease and stressed weight‐loss and exercise programs. Videos that stressed prevention were advertisements for specific weight‐loss programs (45%) and diet pills (30%). Very few videos stressed other risk factors. A large number of videos were irrelevant.

Conclusions:

YouTube is a popular platform across the globe for sharing video information, including videos related to health and disease. However, the information on this platform is not regulated and can easily mislead those seeking it. We suggest that authoritative videos should come from reputable sources such as professional societies and/or academic institutions and should provide unbiased and accurate information on all aspects of diseases like acute myocardial infarction. Clin. Cardiol. 2011 DOI: 10.1002/clc.21981

The authors have no funding, financial relationships, or conflicts of interest to disclose.
Prospective surveillance and management of cardiac toxicity and health in breast cancer survivors
Authors: Schmitz Kathryn H. , Prosnitz Robert G. , Schwartz Anna L. , Carver Joseph R.
Published: April 2012

Breast cancer is commonly diagnosed in postmenopausal women, the majority of whom express 1 or more cardiovascular disease risk factors. Cardiovascular disease poses a significant competing risk for morbidity and mortality among nonmetastatic breast cancer survivors. Adjuvant systemic therapies may result in late‐cardiac toxicity decades after treatment completion. The cumulative incidence of treatment‐related cardiotoxic outcomes may be as high as 33% after some adjuvant breast cancer therapies. Breast cancer treatment–induced cardiotoxicity may manifest as cardiomyopathy, coronary ischemia, thromboembolism, arrhythmias and conduction abnormalities, and valvular and pericardial disease. Evidence indicates that preexisting cardiovascular conditions such as hypertension or left ventricular dysfunction may compound the adverse effects of cardiotoxic treatments. There are currently no published clinical practice guidelines that address ongoing cardiac surveillance for cardiotoxicity after breast cancer, and existing guidelines for monitoring and promoting cardiovascular health in older women are often not followed. The multidisciplinary prospective surveillance system proposed elsewhere in this supplement would allow for earlier detection of cardiotoxicity from treatment and may improve monitoring of cardiovascular health in the growing population of breast cancer survivors. Cancer 2012;118(8 suppl):. © 2012 American Cancer Society.
A prospective surveillance model for physical rehabilitation of women with breast cancer
Authors: Stubblefield Michael D. , McNeely Margaret L. , Alfano Catherine M. , Mayer Deborah K.
Published: April 2012

Chemotherapy‐induced peripheral neuropathy (CIPN) results from damage to or dysfunction of the peripheral nerves. The development of CIPN is anticipated for the majority of breast cancer patients who receive neurotoxic chemotherapy, depending on the agent used, dose, and schedule. Sensory symptoms often predominate and include numbness, tingling, and distal extremity pain. Weakness, gait impairment, loss of functional abilities, and other deficits may develop with more severe CIPN. This article outlines a prospective surveillance model for physical rehabilitation of women with breast cancer who develop CIPN. Rehabilitative efforts for CIPN start at the time of breast cancer diagnosis and treatment planning. The prechemotherapy evaluation identifies patients with preexisting peripheral nervous system disorders that may place them at higher risk for the development of CIPN. This clinical evaluation should include a history focusing on symptoms and functional activities as well as a physical examination that objectively assesses the patient's strength, sensation, reflexes, and gait. Ongoing surveillance following the initiation of a neurotoxic agent is important to monitor for the development and progression of symptoms associated with CIPN, and to ensure its resolution over the long term. CIPN is managed best by a multidisciplinary team approach. Early identification of symptoms will ensure appropriate referral and timely symptom management. The prospective surveillance model promotes a patient‐centered approach to care, from pretreatment through survivorship and palliative care. In this way, the model offers promise in addressing and minimizing both the acute and long‐term morbidity associated with CIPN. Cancer 2012;. © 2012 American Cancer Society.
A prospective model of care for breast cancer rehabilitation: Postoperative and postreconstructive issues
Authors: McNeely Margaret L. , Binkley Jill M. , Pusic Andrea L. , Campbell Kristin L. , Gabram Sheryl , Soballe Peter W.
Published: April 2012

Appropriate and timely rehabilitation is vital in the recovery from breast cancer surgeries, including breast conserving surgery, mastectomy, axillary lymph node dissection (ALND), and breast reconstruction. This article describes the incidence, prevalence, risk factors and time course for early postoperative effects and the role of prospective surveillance as a rehabilitation strategy to prevent and mitigate them. The most common early postoperative effects include wound issues such as cellulitis, flap necrosis, abscess, dehiscence, hematoma, and seroma. Appropriate treatment is necessary to avoid delay in wound healing that may increase the risk of long‐term morbidity, unduly postpone systemic and radiation therapy, and delay rehabilitation. The presence of upper quarter dysfunction (UQD), defined as restricted upper quarter mobility, pain, lymphedema, and impaired sensation and strength, has been reported in over half of survivors after treatment for breast cancer. Moreover, evidence suggests that survivors who undergo breast reconstruction may be at higher risk of UQD. Ensuring the survivor's optimum functioning in the early postoperative time period is critical in the overall recovery from breast cancer. The formal collection of objective measures along with patient‐reported outcome measures is recommended for the early detection of postoperative morbidity. Prospective surveillance, including preoperative assessment and structured surveillance, allows for early identification and timely rehabilitation. Early evidence supports a prospective approach to address and minimize postoperative effects. Cancer 2012;118(8 suppl):. © 2012 American Cancer Society.
Brilliant violet fluorophores: A new class of ultrabright fluorescent compounds for immunofluorescence experiments
Authors: Chattopadhyay Pratip K. , Gaylord Brent , Palmer Adrian , Jiang Nan , Raven Mary A. , Lewis Geoff , Reuter Morgan A. , Nur‐ur Rahman A.K.M. , Price David A. , Betts Michael R. , Roederer Mario
Published: April 2012

The Nobel Prize in Chemistry was awarded in 2000 for the discovery of conductive organic polymers, which have subsequently been adapted for applications in ultrasensitive biological detection. Here, we report the first use of this new class of fluorescent probes in a diverse range of cytometric and imaging applications. We demonstrate that these “Brilliant Violet” reporters are dramatically brighter than other UV‐violet excitable dyes, and are of similar utility to phycoerythrin (PE) and allophycocyanin (APC). They are thus ideally suited for cytometric assays requiring high sensitivity, such as MHC‐multimer staining or detection of intracellular antigens. Furthermore, these reporters are sensitive and spectrally distinct options for fluorescence imaging, two‐photon microscopy and imaging cytometry. These ultra‐bright materials provide the first new high‐sensitivity fluorescence probes in over 25 years and will have a dramatic impact on the design and implementation of multicolor panels for high‐sensitivity immunofluorescence assays. Published 2012 Wiley Periodicals, Inc.