The unruptured intracranial aneurysm treatment score: a multidisciplinary consensus.

OBJECTIVE We endeavored to develop an unruptured intracranial aneurysm (UIA) treatment score (UIATS) model that includes and quantifies key factors involved in clinical decision-making in the management of UIAs and to assess agreement for this model among specialists in UIA management and research. METHODS An international multidisciplinary (neurosurgery, neuroradiology, neurology, clinical epidemiology) group of 69 specialists was convened to develop and validate the UIATS model using a Delphi consensus. For internal (39 panel members involved in identification of relevant features) and external validation (30 independent external reviewers), 30 selected UIA cases were used to analyze agreement with UIATS management recommendations based on a 5-point Likert scale (5 indicating strong agreement). Interrater agreement (IRA) was assessed with standardized coefficients of dispersion (vr*) (vr* = 0 indicating excellent agreement and vr* = 1 indicating poor agreement). RESULTS The UIATS accounts for 29 key factors in UIA management. Agreement with UIATS (mean Likert scores) was 4.2 (95% confidence interval [CI] 4.1-4.3) per reviewer for both reviewer cohorts; agreement per case was 4.3 (95% CI 4.1-4.4) for panel members and 4.5 (95% CI 4.3-4.6) for external reviewers (p = 0.017). Mean Likert scores were 4.2 (95% CI 4.1-4.3) for interventional reviewers (n = 56) and 4.1 (95% CI 3.9-4.4) for noninterventional reviewers (n = 12) (p = 0.290). Overall IRA (vr*) for both cohorts was 0.026 (95% CI 0.019-0.033). CONCLUSIONS This novel UIA decision guidance study captures an excellent consensus among highly informed individuals on UIA management, irrespective of their underlying specialty. Clinicians can use the UIATS as a comprehensive mechanism for indicating how a large group of specialists might manage an individual patient with a UIA.

Heterogeneity of subcellular localization and electrophoretic mobility of survival motor neuron (SMN) protein in mammalian neural cells and tissues

Spinal muscular atrophy is caused by defects in the survival motor neuron (SMN) gene. To better understand the patterns of expression of SMN in neuronal cells and tissues, we raised a polyclonal antibody (abSMN) against a synthetic oligopeptide from SMN exon 2. AbSMN immunostaining in neuroblastoma cells and mouse and human central nervous system (CNS) showed intense labeling of nuclear “gems,” along with prominent nucleolar immunoreactivity in mouse and human CNS tissues. Strong cytoplasmic labeling was observed in the perikarya and proximal dendrites of human spinal motor neurons but not in their axons. Immunoblot analysis revealed a 34-kDa species in the insoluble protein fractions from human SY5Y neuroblastoma cells, embryonic mouse spinal cord cultures, and human CNS tissue. By contrast, a 38-kDa species was detected in the cytosolic fraction of SY5Y cells. We conclude that SMN protein is expressed prominently in both the cytoplasm and nucleus in multiple types of neurons in brain and spinal cord, a finding consistent with a role for SMN as a determinant of neuronal viability.

Caspase-1 is activated in neural cells and tissue with amyotrophic lateral sclerosis-associated mutations in copper-zinc superoxide dismutase

The mechanism by which mutations in the superoxide dismutase (SOD1) gene cause motor neuron degeneration in familial amyotrophic lateral sclerosis (ALS) is unknown. Recent reports that neuronal death in SOD1-familial ALS is apoptotic have not documented activation of cell death genes. We present evidence that the enzyme caspase-1 is activated in neurons expressing mutant SOD1 protein. Proteolytic processing characteristic of caspase-1 activation is seen both in spinal cords of transgenic ALS mice and neurally differentiated neuroblastoma (line N2a) cells with SOD1 mutations. This activation of caspase-1 is enhanced by oxidative challenge (xanthine/xanthine oxidase), which triggers cleavage and secretion of the interleukin 1β converting enzyme substrate, pro-interleukin 1β, and induces apoptosis. This N2a culture system should be an instructive in vitro model for further investigation of the proapoptotic properties of mutant SOD1.

Strictures and remarks on the Earl of Selkirk's Observations on the present state of the Highlands of Scotland, with a view of the causes and probable consequences of emigration.

Bound with: Amicus (pseud.) Eight letters on the subject of the Earl of Selkirk's pamphlet on Highland emigration. 1806.

The Fayûm and Lake Mœris.

Mode of access: Internet.

Observations systematical and geographical on the herbarium collected by Professor Christian Smith, in the vicinity of the Congo : during the expedition to explore that river, under the command of Captain Tuckey in the year 1816 /

Reprinted from: Narrative of an expedition to explore the river Zaire ... / James Kingston Tuckey. London : Murray, 1818.

British Columbia. An essay.

Mode of access: Internet.

The history of Paisley : from the Roman period down to 1884 /

Mode of access: Internet.

Prodromus floræ Novæ Hollandiæ et Insulæ Van-Diemen : exhibens characteres plantarum quas annis 1802-1805 /

No more published.

Observations on the structure and affinities of the more remarkable plants : collected by the late Walter Oudney and Major Denham and Captain Clapperton in the years 1822, 1823, and 1824, during their expedition to explore Central Africa.

"Printed as the Botanical appendix to the Narrative of travels and discoveries in Northern and Central Africa."

Prodromus florae Novae Hollandiae et Insulae Van-Diemen, exhibens characteres plantarum,

No more published.

Botanical appendix to Captain Franklin's Narrative of a journey to the shores of the Polar Sea /

Addenda by Robert Brown, p. 36-40.

Narrative of travels and discoveries in Northern and Central Africa, in the years 1822, 1823, and 1824,

The appendix, 112 p. at end, contains: no. I-XVI. Translations from the Arabic, of various letters and documents, brought from Bornou and Soudan by Major Denham and Captain Clapperton. By A. Salame.--no. XVII-XX. Bornu, Bengharmi, Mandara, and Timbuctoo vocabularies.--XXI. Zoology.--XXII. Botanical appendix. By Robert Brown.--XXIII. Letter to Major Denham, on the rock specimens ... by Charles Konig.--XXV. Thermometrical journal kept at Kouka in Bornou.

Stabilizing sand dunes on the Pacific coast with woody plants /

Bibliography: p. 17.

1967 University of Michigan Football Team