Plasma prefractionation methods for proteomic analysis and perspectives in clinical applications

Plasma is a rich source of biomarkers with clinical relevance. However, the wide dynamic range of protein concentration hinders the detection of low abundance proteins. Plasma prefractionation methods serve as indispensable tools to reduce plasma complexity, allowing the opportunity to explore tissue‐derived proteins which leak into the circulation. This review summarizes common approaches in plasma prefractionation methods for proteomic analysis and then discusses some considerations in plasma prefractionation for clinical applications, reviewing some examples of its use in clinical situations.     

Comparison of proteomic biomarker panels in urine and serum for ovarian cancer diagnosis

Purpose : The purposes of this study were to confirm previously found candidate epithelial ovarian cancer biomarkers in urine and to compare a paired serum biomarker panel and a urine biomarker panel from the same study cohort with regard to the receiver operating characteristic curve (ROC) area under the ROC curve (AUC) values. Experimental design : Four significant urine biomarkers were confirmed among 130 pelvic mass patients in the present study. The four biomarkers form a potential urine biomarker panel. From the same study cohort, the potential urine biomarker panel was compared to a serum biomarker panel, consisting of seven proteins/peptides, OvaRI. Results : Multivariate analysis of the urine panel demonstrated a significant differentiation (p<0.0001) between epithelial ovarian cancer patients and patients with benign ovarian pelvic masses. The ROC AUC of the urine panel was 0.84 and the ROC AUC of OvaRI was 0.83. Combining the urine panel with OvaRI demonstrated a significant contribution from both, for urine peaks, OR=2.12 and for OvaRI, OR=1.39; the ROC AUC of this model was 0.88. Conclusions and clinical relevance : We demonstrated that both urine and serum can be used individually or in combination to potentially aid in ovarian cancer diagnostics. Urine proteomic profiling could provide biomarkers for the non‐invasive test required in clinical practice.     

最大熵在中医智能辨证的研究及其应用

分析了中医临床记录中症状与症候类别之间的关系,将机器学习中的最大熵原理应用于中医辨症中,建立相应的分类模型,从而观察类别预测的正确性,为中医智能诊断提供初筛和决策支持。同时,将基于最大熵的分类器和基于朴素贝叶斯的分类器进行比较,结果显示,基于最大熵的分类效果胜过朴素贝叶斯分类。这表明将最大熵原理以及算法应用在中医诊断是可行的。     

Infrared thermography in the hands and feet of hand-arm vibration syndrome (HAVS) cases and controls

This study evaluated IR thermography during 15 min of re-warming after cold water immersion in accordance with ISO guidelines (12 °C for 5 min) in cases with the vascular component of HAVS and controls. The purposes of the study were: (1) To evaluate the performance of IR thermography as a diagnostic test for the vascular effects of HAVS in the fingers, (2) To determine if there were any temperature differences in the toes between cases and controls and, if so, to evaluate the IR thermography as a diagnostic test for toe vascular effects in HAVS. A total of 39 HAVS cases and 46 controls were included in the study. In the fingers, an ROC analysis indicated that the highest areas under the curve (AUC) were obtained at 7 min of re-warming for the fingertips, middle phalanges and proximal phalanges. However, at these locations and time period of re-warming the sensitivities and specificities were not sufficiently high. For example a sensitivity of 66.7% was associated with specificities of 60.9%–67.4%. In the toe analysis 33 (84.6%) cases but only 3 controls (6.5%) reported increased cold intolerance in the feet and this difference was statistically significant (p < 0.001). These 33 cases were then compared to the 46 controls. In the ROC analysis for the toes, the AUC's were lower than those for the fingers and the estimated sensitivities and specificities were worse for the toes than for the fingers. However some statistically significant colder temperatures were found in cases in comparison to controls towards the end of the re-warming period. IR thermography after the ISO recommended cold water stimulation conditions did not perform well as a diagnostic test in the hands or feet. The statistically significant colder temperatures in the toes towards the end of re-warming are relevant to our understanding of foot vascular effects associated with vibration. In industry there is recent interest in determining the effects of foot transmitted vibration (FTV). Many workers have mixed HAV and FTV and it is important to account for feet effects secondary to HAVS in the hands when evaluating the effects of FTV.     

The Strain Index (SI) and Threshold Limit Value (TLV) for Hand Activity Level (HAL): risk of carpal tunnel syndrome (CTS) in a prospective cohort

A cohort of 536 workers was enrolled from 10 diverse manufacturing facilities and was followed monthly for six years. Job physical exposures were individually measured. Worker demographics, medical history, psychosocial factors, current musculoskeletal disorders (MSDs) and nerve conduction studies (NCS) were obtained. Point and lifetime prevalence of carpal tunnel syndrome (CTS) at baseline (symptoms + abnormal NCS) were 10.3% and 19.8%. During follow-up, there were 35 new CTS cases (left, right or both hands). Factors predicting development of CTS included: job physical exposure (American conference of governmental industrial hygienists Threshold Limit Value (ACGIH TLV) for Hand Activity Level (HAL) and the Strain Index (SI)), age, BMI, other MSDs, inflammatory arthritis, gardening outside of work and feelings of depression. In the adjusted models, the TLV for HAL and the SI were both significant per unit increase in exposure with hazard ratios (HR) increasing up to a maximum of 5.4 (p = 0.05) and 5.3 (p = 0.03), respectively; however, similar to other reports, both suggested lower risk at higher exposures. Data suggest that the TLV for HAL and the SI are useful metrics for estimating exposure to biomechanical stressors. PRACTITIONER SUMMARY: This study was conducted to determine how well the TLV for HAL and the SI predict risk of CTS using a prospective cohort design with survival analysis. Both the TLV for HAL and the SI were found to predict risk of CTS when adjusted for relevant covariates.