The PROMIS Upper Extremity Computer Adaptive Test Correlates With Previously Validated Metrics in Patients With Carpal Tunnel Syndrome

Background: The Patient-Reported Outcomes Measurement Information System Upper Extremity (PROMIS UE) computer adaptive test was developed to improve precision and reduce question burden. We hypothesized that in patients with carpal tunnel syndrome (CTS): (1) PROMIS UE would correlate with established patient-reported outcome measures (PROs); (2) the time and number of questions required would be lower than current metrics; (3) there would be no floor or ceiling effects; and (4) PROMIS UE would not correlate with disease severity. Methods: Patients undergoing electrodiagnostic evaluation found to have a primary diagnosis of unilateral CTS prospectively completed PROMIS UE, Quick Disabilities of the Arm, Shoulder and Hand (qDASH), and Boston Carpal Tunnel Syndrome Questionnaire (BCTQ). Electrophysiologic and clinical severity was recorded. The relationships among PROs were described with Spearman coefficients. A floor or ceiling effect was confirmed if >15% of patients achieved the lowest or highest possible score, respectively. Results: Fifty-one patients (average, 53.9 years) were enrolled. An excellent correlation was identified between PROMIS UE and qDASH (R = −0.76, P < .001). There was a good correlation between PROMIS UE and BCTQ (R = −0.58, P < 0.001). The PROMIS UE required less time and fewer questions than qDASH and BCTQ (P = .02 and P < .001). There were no floor or ceiling effects. Neither neurophysiologic nor clinical severity correlated with PROMIS UE (R = 0.24, P > .05 and R = −0.18, P > .05). Conclusions: The PROMIS UE has an excellent correlation with qDASH and a good correlation with BCTQ in patients with CTS. Furthermore, PROMIS UE required less time and fewer questions than established PROs. Used as a single PRO, PROMIS UE represents a practical alternative to current metrics in patients with CTS.     

Individual specific extraction of DNA from male mixtures--First evaluation studies

In forensic work, the interpretation of DNA profiles becomes complicated when samples contain more than one contributor because the simultaneous amplification of individual identification markers results in mixed profiles. To overcome this problem, we present haplotype-specific extraction (HSE) as a more straightforward method to analyze a DNA mixture. HSE has been developed to clarify ambiguous HLA alleles by separating diploid samples into their haploid components to facilitate HLA typing. We have started to establish new protocols and strategies to adapt HSE for the separation of male DNA mixtures in forensic analysis. First results have shown an improved enrichment of male DNA from a single contributor. We have also evaluated a new, optimized buffer composition by testing different concentrations of its components. Improved separation of a male DNA mixture is detected using AmpF?STR(?) Yfiler short tandem repeat analysis.     

Compensatory mechanisms of transtibial amputees during circular turning

Turning plays a prominent role in daily living activities and requires the modulation of the ground reaction forces to accelerate the body's center-of-mass along the path of the turn. With the ankle plantarflexors being prominent contributors to the propulsive ground reaction forces, it is not clear how transtibial amputees perform turning tasks without these important muscles. The purpose of this study was to identify the compensatory mechanisms used by transtibial amputees during a simple turning task by analyzing the radial and anterior–posterior ground reaction impulses and sagittal, transverse and coronal joint work of the residual and intact legs. These quantities were analyzed with the residual leg on both the inside and outside of the turn and compared to non-amputees. The analysis showed that amputees and non-amputees use different joint strategies to turn. Amputees rely primarily on sagittal plane hip joint work to turn while non-amputees rely primarily on ankle work in the sagittal plane and hip joint work in the coronal plane. Differences in strategies are most likely due to the minimal power output provided by the passive prosthetic feet used by amputees and perhaps a desire to minimize the risk of falling. Understanding these differences in turning strategies will aid in developing effective rehabilitation therapies and prosthetic devices that improve amputee mobility.     

Transarterial Yttrium-90 Radioembolization Treatment of Patients with Liver-Dominant Metastatic Renal Cell Carcinoma

Purpose

To evaluate safety and efficacy of transarterial hepatic radioembolization treatment of patients with liver-dominant metastatic renal cell carcinoma (RCC).

Specific uptake of 99mTc-NC100692, an αvβ3-targeted imaging probe,in subcutaneous and orthotopic tumors

IntroductionThe α_vβ₃ integrin, which is expressed by angiogenic epithelium and some tumor cells, is an attractive target for the development of both imaging agents and therapeutics. While optimal implementation of α_vβ₃-targeted therapeutics will require a priori identification of the presence of the target, the clinical evaluation of these compounds has typically not included parallel studies with α_vβ₃-targeted diagnostics. This is at least partly due to the relatively limited availability of PET radiopharmaceuticals in comparison to those labeled with ^99mTc. In an effort to begin to address this limitation, we evaluated the tumor uptake of ^99mTc-NC100692, a cyclic RGD peptide that binds to α_vβ₃ with ~ 1-nM affinity, in an α_vβ₃-positive tumor model as well as its in vivo specificity.MethodsMicroSPECT imaging was used to assess the ability of cilengitide, a therapeutic with high affinity for α_vβ₃, to block and displace ^99mTc-NC100692 in an orthotopic U87 glioma tumor. The specificity of ^99mTc-NC100692 was quantitatively evaluated in mice bearing subcutaneous U87MG tumors, by comparison of the biodistribution of ^99mTc-NC100692 with that of the non-specific structural analogue ^99mTc-AH-111744 and by blocking uptake of ^99mTc-NC100692 with excess unlabeled NC100692.ResultsMicroSPECT imaging studies demonstrated that uptake of ^99mTc-NC100692 in the intracranial tumor model was both blocked and displaced by the α_vβ₃-targeted therapeutic cilengitide. Biodistribution studies provided quantitative confirmation of these imaging results. Tumor uptake of ^99mTc-NC100692 at 1 h post-injection was 2.8 ± 0.7% ID/g compared to 0.38 ± 0.1% ID/g for ^99mTc-AH-111744 (p < 0.001). Blocking ^99mTc-NC100692 uptake by pre-injecting the mice with excess unlabeled NC100692 reduced tumor uptake by approximately five-fold, to 0.68 ± 0.3% ID/g (p = 0.01).ConclusionThese results confirm that ^99mTc-NC100692 does, in fact, target the α_vβ₃ integrin and may, therefore, be useful in identifying patients prior to anti-α_vβ₃ therapy as well as monitoring the response of these patients to therapy.     

Adaptation to audiovisual asynchrony modulates the speeded detection of sound

The brain adapts to asynchronous audiovisual signals by reducing the subjective temporal lag between them. However, it is currently unclear which sensory signal (visual or auditory) shifts toward the other. According to the idea that the auditory system codes temporal information more precisely than the visual system, one should expect to find some temporal shift of vision toward audition (as in the temporal ventriloquism effect) as a result of adaptation to asynchronous audiovisual signals. Given that visual information gives a more exact estimate of the time of occurrence of distal events than auditory information (due to the fact that the time of arrival of visual information regarding an external event is always closer to the time at which this event occurred), the opposite result could also be expected. Here, we demonstrate that participants'' speeded reaction times (RTs) to auditory (but, critically, not visual) stimuli are altered following adaptation to asynchronous audiovisual stimuli. After receiving “baseline” exposure to synchrony, participants were exposed either to auditory-lagging asynchrony (VA group) or to auditory-leading asynchrony (AV group). The results revealed that RTs to sounds became progressively faster (in the VA group) or slower (in the AV group) as participants'' exposure to asynchrony increased, thus providing empirical evidence that speeded responses to sounds are influenced by exposure to audiovisual asynchrony.