Comparing two types of augmentative and alternative communication systems for children with autism

This study compared acquisition and preference for two types of augmentative and alternative communication (AAC) systems in three pre-schoolers with autism. Acquisition of requesting behaviour using a picture-exchange system vs a voice-output communication aide (VOCA) was compared in an alternating treatments design. Following acquisition, both ACC systems were simultaneously available and the child could select which one of the two systems to use. There was little difference between picture-exchange and VOCA in terms of acquisition rates. Two children demonstrated a consistent preference for picture-exchange and the third showed a preference for the VOCA. Both speed of acquisition and system preference should be considered when designing AAC interventions for children with autism and related developmental disabilities.

Comparamos la adquisición y preferencia en relación a dos tipos de sistemas (AAC) de comunicación alternativa y aumentativa en 3 preescolares con autismo. Se comparó la adquisición de un comportamiento solicitado a través del uso de un sistema de intercambio de dibujos contra una ayuda de comunicación de producción de voz (VOCA), en un diseño de tratamiento alternativo. Después de la adquisición ambos sistemas AAC estuvieron disponibles en forma simultánea, y el niño podía seleccionar cuál de los dos sistemas usar. Hubo poca diferencia entre el intercambio de dibujos y VOCA en término de tasas de adquisición. Dos niños demostraron una preferencia consistente para el intercambio de dibujos y el tercero demostró una preferencia por la VOCA. Tanto la velocidad de adquisición como la preferencia por un sistema deberán ser consideradas cuando se diseñen intervenciones con AAC para niños con autismo y discapacidades en el desarrollo relacionadas.

Palabras Clave: comunicación alternativa y aumentativa, intercambio de dibujos, ayudas de comunicación de producción de la voz, adquisición, autismo.     

Unprecedented surface stabilized InP quantum dots with bidentate ligands

For InP-based QDs, the current technology does not outperform CdSe-based QDs in many respects, one of which is stability. The optical stability of QDs is closely related to their surface properties, so QDs often use organic ligands for surface protection. These organic ligands are dynamically attached and detached on the QD surface; during detachment, their surfaces are easily damaged and oxidized, thereby deteriorating their optical characteristics. Therefore, we have synthesized a ligand 1,2-hexadecanedithiol with a bidentate form, inducing one ligand to bind to the QD surface strongly through the chelate effect, as a good way to improve the stability of the QDs; thus, the PL stability of the green-light-emitting InP-based QDs was greatly increased. To confirm the existence of the dithiol ligand, we used thermogravimetric analysis/simultaneous thermal analysis-mass spectroscopy (TGA/STA-MS). After that, we applied the ligand to blue-light-emitting ZnSe QDs and red-light-emitting InP QDs, and for those two types of QD we also confirmed that the stability was increased. Additionally, we tested dithiol exchanged QDs at a high temperature of 150 °C, and the increase of stability was effective even in a high temperature condition.

For InP-based QDs, the current technology does not outperform CdSe-based QDs in many respects, one of which is stability.     

Treatment of Steroid‐Resistant Acute Renal Allograft Rejection With Alemtuzumab

Steroid‐resistant renal allograft rejections are commonly treated with rabbit antithymocyte globulin (RATG), but alemtuzumab could be an effective, safe and more convenient alternative. Adult patients with steroid‐resistant renal allograft rejection treated with alemtuzumab (15–30 mg s.c. on 2 subsequent days) from 2008 to 2012 (n = 11) were compared to patients treated with RATG (2.5‐4.0 mg/kg bodyweight i.v. for 10–14 days; n = 20). We assessed treatment‐failure (graft loss, lack of improvement of graft function or need for additional anti‐rejection treatment), infections during the first 3 months after treatment and infusion‐related side effects. In both groups, the median time‐interval between rejection and transplantation was 2 weeks, and approximately 75% of rejections were classified as Banff‐IIA or higher. Three alemtuzumab‐treated patients (27%) experienced treatment failure, compared to eight RATG treated patients (40%, p = 0.70). There was no difference in the incidence of infections. There were mild infusion‐related side‐effects in three alemtuzumab‐treated patients (27%), and more severe infusion‐related side effects in 17 RATG‐treated patients (85%, p = 0.013). Drug related costs of alemtuzumab‐treatment were lower than of RATG‐treatment (€1050 vs. €2024; p < 0.01). Alemtuzumab might be an effective therapy for steroid‐resistant renal allograft rejections. In contrast to RATG, alemtuzumab is nearly devoid of infusion‐related side‐effects. These data warrant a prospective trial.     

Acute spinal subdural hematoma with hemiplegia after acupuncture: a case report and review of the literature

Background context

Subdural spinal hematoma (SDH) is a very rare entity; however, it can lead to serious complications resulting from injuries to the spinal cord and roots. Although acupuncture has been a popular method for the management of pain control, we encountered the first case of SDH after acupuncture.

Purpose

The purpose of this case report was to present the first case of subdural hematoma after acupuncture and the reasons for the risks of blind cervical acupuncture.

Study design

A case report and review of the previous literature are presented.

Methods

A 69-year-old man complained of progressive weakness in the right upper and lower extremities 2 hours after acupuncture on the cervical spine and back. The diagnosis was delayed because of unilateral weakness, and the symptom was initially misinterpreted as a transient ischemic attack because of no sensory change and pain and normal findings of two brain magnetic resonance imaging (MRI).

Results

Cervical MRI 36 hours after onset revealed acute hematoma from the C3–C5 level; hematoma showed an isointensity on T1-weighted image (WI) with the preservation of epidural fat and a hypointensity on T2WI. A decompressive surgery was scheduled to perform within 2 days after the cervical MRI scan because of a previous anticoagulation therapy, but the patient refused it. Finally, 9 days after the onset, surgical decompression and removal of hematoma were performed. Three months postoperatively, the patient had fully recovered demonstrating fine hand movement and good ability to walk up and down the stairs.

Conclusions

Our study indicates that it is essential to perform cervical MRI when a patient does not show an improvement in the neurologic deficit and has a negative brain MRI after acupuncture. In addition, blind acupuncture if not correctly practiced may be harmful to the cervical structures.     

Influence of internal-gap width and cement type on the retentive force of zirconia copings in pullout testing

Objectives

The purpose of this study was to evaluate the influence of internal-gap width and cement type on the retentive force of zirconia copings.

Methods

A CAD/CAM system was used to mill 48 identical abutments on extracted human molars and fabricate 48 zirconia copings. The internal-gap width for cement was set to 40 μm or 160 μm (n = 24 each). Three cement types (Panavia F, RelyX Unicem, and RelyX Luting) were used with each internal-gap width (n = 8/cement type). The intaglio surfaces of the copings were airborne-particle abraded, and each coping was cemented onto the corresponding abutment using the indicated luting agent. After 10,000 cycles of thermocycling, the retentive force was evaluated by pullout tests. Kruskal–Wallis and Wilcoxon Rank Sum tests were used for data analysis (α = 0.05).

Results

In the 40-μm gap groups, Panavia F had the highest mean retentive force compared to RelyX Unicem and RelyX Luting (P < 0.000). In 160-μm gap groups, RelyX Unicem had the highest mean retentive force compared to Panavia F and RelyX Luting (P < 0.000).

Conclusions

With the increase in internal gap width, a resin cement with self-etching agents as a co-initiator for autopolymerization resulted in significantly decreased retentive force, whereas a resin-modified glass ionomer cement or a self-adhesive resin cement did not. Use of resin cements rather than resin-modified glass ionomer cements improved the retentive force of zirconia copings regardless of the amount of internal gap width.     

Clearance rates of residual stone fragments and dusts after endoscopic lithotripsy procedures using a holmium laser: 2-year follow-up results

Purpose

To investigate the spontaneous clearance rates of remnant particles following miniaturized percutaneous nephrolithotomy (mini-PCNL) and retrograde intrarenal surgery (RIRS).

Methods

Among 624 patients who underwent mini-PCNL or RIRS at our institution from 2011 to 2015, we collected data of 247 patients with 2 years of follow-up. Of these, we included 148 patients with unilateral renal stones between 10 and 30 mm, as well as remnant particles after surgery. The size criteria of dusts and residual fragments (RFs) were, respectively, <1 and <3 mm.

Results

After excluding 22 patients, 126 patients (RFs = 21, dusts = 98, and both RFs and dusts = 7) were analyzed. Mean age was 56.5 (±14.4) years, and mean stone size was 19.5 (±12.5) mm. The mean follow-up period was 18.5 (± 12.9) months. In patients whose remnant particles were naturally eliminated following lithotripsy, the mean stone passage time was 9.0 (±9.3) months in the dusts and 13.9 (±11.1) months in the RFs groups (P = 0.135). Remnant particles disappeared in 42 out of 105 patients (40.0 %) in dusts and 7 out of 28 patients (25.0 %) in RFs groups (P = 0.187). The size of dusts and RFs increased, respectively, in 18.1 % (19/105) and 28.6 % (8/28) of patients with remnant particles during the follow-up period.

Conclusions

The presence of dusts and RFs was poor prognostic factors in patients underwent renal stone surgery using a holmium laser. Complete residual stone removal by using a basket or dusts eradication by irrigation for an adequate time during surgery can be a good surgical strategy.