A radiolabeled antiglobulin test for crossmatching platelet transfusions

Despite the use of HLA-matched platelets for alloimmunized recipients, transfusion failures occur. In order to reduce these failures, we investigated the use of a radiolabeled antiglobulin technique for platelet crossmatching. The principle of the test is that of an indirect Coombs test using 125I labeled goat anti-human IgG. Incompatibility is determined by calculating a radioactivity antiglobulin test (RAGT) index. Using this technique, we performed 89 crossmatches on 19 leukemic or aplastic patients who were refractory to random donor platelets and receiving varying degrees of HLA-matched platelets. Effectiveness of the transfusion was assessed from the posttransfusion corrected platelet count increment (CCI) determined at 1 and 20 hr. When the RAGT index was 1.9 or less, the mean CCI at 1 lhr was 17,570 +/- 7003/cu mm, n = 55. When the RAGT index was 2.0 or greater, the mean CCI was 4237 +/- 4100/cu mm, n = 34. At 20 hr when the RAGT index was 1.9 or less, the mean CCI was 8722 +/- 3143/cu mm, n = 33, and when the index was 2.0 or greater, the mean CCI was 571 +/- 1286/cu mm, n = 23. Using this technique, one false negative resulted. Nine positive crossmatches with good increments at 1 hr were found; at 20 hr, however, the survival of these units was zero. These data suggest that this method is a useful adjunct in the selection of platelets in the refractory patient.     

Effect of diagnosis,body site and experience on text entry rate of individuals with physical disabilities: a systematic review

Objective: This study systematically reviewed the research on computer text entry by people with physical disabilities, and conducted a quantitative synthesis of text entry rates associated with individuals’ diagnosis, body site used with the interface and their level of experience.

Method: We searched 10 databases and included studies in which: typing speed was reported; the access interface was available for public use; and individuals with physical impairments were in the study population. For quantitative synthesis, we used only the text entry rates (TER) reported for individuals with physical impairments; studies also had to report the sample size, and the average and standard deviation for the text entry rates.

Results: Thirty-nine studies involving 248 subjects met the criteria for quantitative synthesis. Cerebral palsy was associated with significantly slower TER, at 5.5 wpm, than muscular dystrophy (12.5 wpm), spina bifida (10.4 wpm), SCI high cervical (10.1 wpm) and SCI low cervical (13.3 wpm). Among the 19 body sites represented, the Fingers bilateral category had the highest average, at 17.72 wpm. Head (2.92 wpm) and Hand (non-typing) (3.95 wpm) were each associated with significantly slower TER than Hands unspecified, Fingers bilateral, Hand with control enhancer, Voice and Mouth. The three levels of experience examined, LowPlus, Medium and High, provided very similar TER.

Conclusion: This study contributes external evidence for service providers who provide computer access interventions for individuals with disabilities. The analyzed text entry performances serve as benchmarks to be used as guidelines during interface selection and training.

• Implications for Rehabilitation

• The median text entry rate (TER) across the literature for individuals with physical disabilities is 7.0 wpm. TER is affected by a user’s diagnosis and the body site used for typing.

• These TER data can serve as diagnostic norms and benchmarks to be used as guidelines during interface selection and training.

• We recommend that practitioners measure text entry rate with clients, to place their performance in the context of these results and provide a baseline against which to measure effectiveness of an intervention.

     

The efficacy of subacromial corticosteroid injection in the treatment of rotator cuff disease: A systematic review

To investigate whether subacromial corticosteroid injections are effective in the treatment of rotator cuff disease, an evidence-based systematic review was undertaken of nine randomized controlled trials that compared subacromial corticosteroid injection with placebo in patients with rotator cuff disease. Each study was systematically evaluated for biases, and outcome measures were scrutinized for statistical significance and clinical importance. One study demonstrated clinically important differences in pain relief. Two studies showed clinically important improvement in range of motion at final follow-up. This systematic review of the available literature indicates that there is little reproducible evidence to support the efficacy of subacromial corticosteroid injection in managing rotator cuff disease.     

Development and validation of a LC method for determination of genistein in topical nanoemulsions

The aim of this study was to develop and validate an isocratic LC method for the quantification of genistein in topical nanoemulsions. The analyses were performed at room temperature on a reversed-phase C18 column using a mobile phase composed of methanol/water/acetonitrile (70:25:5, w/w/w) at 1.0 ml x min(-1). The detection was carried out on a UV detector at 327 nm. The linearity, in the range of 25-75 microg/ml, presented a determination coefficient (r2) higher than 0.999, calculated by the least square method. No interferences from the excipients (egg-lecithin, octyldodecanol or medium chain triglycerides) were detected. The R.S.D. values for intra- and inter-day precision experiments were lower than 2.3%. The recovery of genistein from nanoemulsions ranged from 96.6% to 106.6%. The excellent performance of the method, its linearity, accuracy and precision, demonstrate that it can be readily used to quantify genistein incorporated in nanoemulsions.     

Electrophysiological evidence for incremental lexical-semantic integration in auditory compound comprehension

The present study investigated the time-course of semantic integration in auditory compound word processing. Compounding is a productive mechanism of word formation that is used frequently in many languages. Specifically, we examined whether semantic integration is incremental or is delayed until the head, the last constituent in German, is available. Stimuli were compounds consisting of three nouns, and the semantic plausibility of the second and the third constituent was manipulated independently (high vs. low). Participants’ task was to listen to the compounds and evaluate them semantically. Event-related brain potentials in response to the head constituents showed an increased N400 for less plausible head constituents, reflecting the lexical-semantic integration of all three compound constituents. In response to the second (less plausible) constituents, an increased N400 with a central-left scalp distribution was observed followed by a parietal positivity. The occurrence of this N400 effect during the presentation of the second constituents suggests that the initial two non-head constituents are immediately integrated. The subsequent positivity might be an instance of a P600 and is suggested to reflect the structural change of the initially constructed compound structure. The results suggest that lexical-semantic integration of compound constituents is an incremental process and, thus, challenge a recent proposal on the time-course of semantic processing in auditory compound comprehension.     

Factors that influence the performance of experienced speech recognition users

Performance on automatic speech recognition (ASR) systems for users with physical disabilities varies widely between individuals. The goal of this study was to discover some key factors that account for that variation. Using data from 23 experienced ASR users with physical disabilities, the effect of 20 different independent variables on recognition accuracy and text entry rate with ASR was measured using bivariate and multivariate analyses. The results show that use of appropriate correction strategies had the strongest influence on user performance with ASR. The amount of time the user spent on his or her computer, the user's manual typing speed, and the speed with which the ASR system recognized speech were all positively associated with better performance. The amount or perceived adequacy of ASR training did not have a significant impact on performance for this user group.     

Patterns of regional brain hypometabolism associated with knowledge of semantic features and categories in Alzheimer's disease

The study of semantic memory in patients with Alzheimer's disease (AD) has raised important questions about the representation of conceptual knowledge in the human brain. It is still unknown whether semantic memory impairments are caused by localized damage to specialized regions or by diffuse damage to distributed representations within nonspecialized brain areas. To our knowledge, there have been no direct correlations of neuroimaging of in vivo brain function in AD with performance on tasks differentially addressing visual and functional knowledge of living and nonliving concepts. We used a semantic verification task and resting 18-fluorodeoxyglucose positron emission tomography in a group of mild to moderate AD patients to investigate this issue. The four task conditions required semantic knowledge of (1) visual, (2) functional properties of living objects, and (3) visual or (4) functional properties of nonliving objects. Visual property verification of living objects was significantly correlated with left posterior fusiform gyrus metabolism (Brodmann's area [BA] 37/19). Effects of visual and functional property verification for non-living objects largely overlapped in the left anterior temporal (BA 38/20) and bilateral premotor areas (BA 6), with the visual condition extending more into left lateral precentral areas. There were no associations with functional property verification for living concepts. Our results provide strong support for anatomically separable representations of living and nonliving concepts, as well as visual feature knowledge of living objects, and against distributed accounts of semantic memory that view visual and functional features of living and nonliving objects as distributed across a common set of brain areas.     

Whole-body muscle MRI of patients with MATR3-associated distal myopathy reveals a distinct pattern of muscular involvement and highlights the value of whole-body examination

Journal of Neurology - MATR3-associated distal myopathy is a rare distal myopathy predominantly affecting lower legs as well as wrist- and finger extensors. Whilst most distal myopathies are...