Faculty Bibliography

At age 58, JB began memorising Milton's epic poem Paradise Lost. Nine years and thousands of study hours later, he completed this process in 2001 and recalled from memory all 12 books of this 10,565-line poem over a 3-day period. Now 74, JB continues to recite this work. We tested his memory accuracy by cueing his recall with two lines from the beginning or middle of each book and asking JB to recall the next 10 lines. JB is an exceptional memoriser of Milton, both in our laboratory tests in which he did not know the specific tests or procedures in advance, and in our analysis of a videotaped, prepared performance. Consistent with deliberate practice theory, JB achieved this remarkable ability by deeply analysing the poem's structure and meaning over lengthy repetitions. Our findings suggest that exceptional memorisers such as JB are made, not born, and that cognitive expertise can be demonstrated even in later adulthood.

Voice mail simply increases the number of tasks for the doctor to fit in. Each time the phone rings I check the number to see if it's Senora H, not sure if I'd actually have the guts to let it pass to voice mail

OBJECTIVE: The objective of this study was to compare pre-dialysis and post-dialysis hemoglobin (Hgb) and ultrafiltration in hemodialysis patients. Factors influencing Hgb are not well understood. METHODS: Pre-dialysis and post-dialysis Hgb and weight were measured in 133 hemodialysis patients. Absolute and percentage change in Hgb (%Delta Hgb) and percent change in body weight (%Delta BW) were determined for that treatment. Patients were divided into 2 groups, those with post-dialysis Hgb <13 g/dL (group 1) and those with post-dialysis Hgb >= 13 g/dL (group 2); the differences in %Delta BW were compared between the 2 groups. RESULTS: The mean pre-dialysis Hgb was 11.9 +/- 1.4 g/dL, the mean post-dialysis Hgb level was 12.8 +/- 1.8 g/dL. The %Delta Hgb was 3.9 +/- 6.6 in group 1 and 10.8 +/- 7.8 in group 2. The %Delta BW was 3.1 +/- 1.4 in group 1 and 3.9 +/- 1.7 in group 2 (p < .001 for all comparisons), We found that although both groups had a rise in Hgb level post-dialysis, group 2 patients had a rise in %Delta Hgb that was greater than the relatively small difference in %Delta BW between the 2 groups. In addition, we found only a modest correlation between %Delta BW and %Delta Hgb in both groups. The r(2) of 0.24 suggests that only 25% of the variability found in %Delta Hgb can be related to %Delta BW. CONCLUSIONS: Patients with post-dialysis Hgb >= 13 g/dL had a greater increase in %Delta Hgb that was out of proportion to %Delta BW. Factors other than %Delta BW may play a role in determining post-dialysis Hgb.

BACKGROUND: HIV incidence estimates are essential for understanding the evolution of the HIV epidemic and the impact of interventions. Tests for recent HIV infection allow incidence estimation based on a single cross-sectional survey. The BED IgG-Capture Enzyme Immunoassay (BED assay) is a commercially available and widely used test for recent HIV infection. METHODS: In a systematic literature search for BED assay studies, we identified 1181 unique studies, 1138 of which were excluded based on titles or abstracts. We conducted reviews of the 43 remaining publications and a further 23 studies identified on conference Web sites or by colleagues. Thirty-nine articles were included in the final review. We investigated the sensitivity of incidence values to various estimation methods and parameter choices. RESULTS: BED assay surveys have been conducted on 5 continents in general populations and high-risk groups, using 1 or more of 10 distinct incidence formulae. Most studies used estimators that do not account for assay imperfection. Those studies that correct for assay imperfection commonly do not use locally valid assay parameters. Incidence estimates were very sensitive to methodological and parameter choices. Most confidence intervals provided good assessment of uncertainty due to counting error, but only a few incorporated parameter uncertainty. CONCLUSIONS: BED assay surveys can produce valid HIV incidence estimates, but many studies have not sufficiently accounted for assay imperfection. Future studies should (1) report all information necessary for incidence point and uncertainty estimation, (2) use an unbiased estimator with locally valid assay calibration parameters, and (3) compute confidence intervals that take into account parameter uncertainty.

BACKGROUND: Treatment with bisphosphonates decreases bone loss and can increase disease-free survival in patients with breast cancer. The aim of our study was to assess the effect of zoledronic acid on clearance of disseminated tumour cells (DTCs) from the bone marrow in women undergoing neoadjuvant chemotherapy for breast cancer. METHODS: Patients were recruited for this open-label, phase 2 randomised trial between March 17, 2003, and May 19, 2006, at a single centre. Eligible patients had clinical stage II-III (> or = T2 and/or > or = N1) newly diagnosed breast cancer, Eastern Cooperative Oncology Group performance status of 0 or 1, and normal cardiac, renal, and liver function. 120 women were randomly assigned, using allocation concealment, to receive 4 mg zoledronic acid intravenously every 3 weeks (n=60), or no zoledronic acid (n=60), for 1 year concomitant with four cycles of neoadjuvant epirubicin (75 mg/m(2)) plus docetaxel (75 mg/m(2)) and two cycles of adjuvant epirubicin plus docetaxel. The primary endpoint was the number of patients with detectable DTCs at 3 months. Final analysis was done 1 year after the last patient was enrolled. Analyses were done for all patients with available data at 3 months. This study is registered with ClinicalTrials.gov, number NCT00242203. FINDINGS: Of the 120 patients initially enrolled, one withdrew after signing consent and one patient's baseline bone marrow was not available. Both of these patients were in the control group. At 3 months, 109 bone-marrow samples were available for analysis. In the zoledronic acid group, bone marrow was not collected from one patient because of disease progression, one patient was taken off study because of severe diarrhoea, and two patients had not consented at the time of surgery. In the control group, bone marrow was not collected from two patients because of disease progression, one patient withdrew consent, and three patients were not consented at the time of surgery. At baseline, DTCs were detected in 26 of 60 patients in the zoledronic acid group and 28 of 58 patients in the control group. At 3 months, 17 of 56 patients receiving zoledronic acid versus 25 of 53 patients who did not receive zoledronic acid had detectable DTCs (p=0.054). The most common grade 3-4 toxicities were infection (five of 60 patients in the zoledronic acid group and six of 59 in the control group) and thrombosis (five of 60 in the zoledronic acid and two of 59 in the control group). There was one documented case of osteonecrosis in the zoledronic acid group. INTERPRETATION: Zoledronic acid administered with chemotherapy resulted in a decreased proportion of patients with DTCs detected in the bone marrow at the time of surgery. Our study supports the hypothesis that the antimetastatic effects of zoledronic acid may be through effects on DTCs. FUNDING: Novartis Pharmaceuticals and Pfizer Inc.