How a Diverse Research Ecosystem Has Generated New Rehabilitation Technologies: Review of NIDILRR’s Rehabilitation Engineering Research Centers

Over 50 million United States citizens (1 in 6 people in the US) have a developmental, acquired, or degenerative disability. The average US citizen can expect to live 20% of his or her life with a disability. Rehabilitation technologies play a major role in improving the quality of life for people with a disability, yet widespread and highly challenging needs remain. Within the US, a major effort aimed at the creation and evaluation of rehabilitation technology has been the Rehabilitation Engineering Research Centers (RERCs) sponsored by the National Institute on Disability, Independent Living, and Rehabilitation Research. As envisioned at their conception by a panel of the National Academy of Science in 1970, these centers were intended to take a “total approach to rehabilitation”, combining medicine, engineering, and related science, to improve the quality of life of individuals with a disability. Here, we review the scope, achievements, and ongoing projects of an unbiased sample of 19 currently active or recently terminated RERCs. Specifically, for each center, we briefly explain the needs it targets, summarize key historical advances, identify emerging innovations, and consider future directions. Our assessment from this review is that the RERC program indeed involves a multidisciplinary approach, with 36 professional fields involved, although 70% of research and development staff are in engineering fields, 23% in clinical fields, and only 7% in basic science fields; significantly, 11% of the professional staff have a disability related to their research. We observe that the RERC program has substantially diversified the scope of its work since the 1970’s, addressing more types of disabilities using more technologies, and, in particular, often now focusing on information technologies. RERC work also now often views users as integrated into an interdependent society through technologies that both people with and without disabilities co-use (such as the internet, wireless communication, and architecture). In addition, RERC research has evolved to view users as able at improving outcomes through learning, exercise, and plasticity (rather than being static), which can be optimally timed. We provide examples of rehabilitation technology innovation produced by the RERCs that illustrate this increasingly diversifying scope and evolving perspective. We conclude by discussing growth opportunities and possible future directions of the RERC program

Histone H1 phosphorylation is associated with transcription by RNA polymerases I and II

Functional diversity of histone H1 variants may be caused by differences in phosphorylation during interphase

Reperfusion injury following cerebral ischemia: pathophysiology, MR imaging, and potential therapies

INTRODUCTION: Restoration of blood flow following ischemic stroke can be achieved by means of thrombolysis or mechanical recanalization. However, for some patients, reperfusion may exacerbate the injury initially caused by ischemia, producing a so-called “cerebral reperfusion injury”. Multiple pathological processes are involved in this injury, including leukocyte infiltration, platelet and complement activation, postischemic hyperperfusion, and breakdown of the blood–brain barrier. METHODS/RESULTS AND CONCLUSIONS: Magnetic resonance imaging (MRI) can provide extensive information on this process of injury, and may have a role in the future in stratifying patients’ risk for reperfusion injury following recanalization. Moreover, different MRI modalities can be used to investigate the various mechanisms of reperfusion injury. Antileukocyte antibodies, brain cooling and conditioned blood reperfusion are potential therapeutic strategies for lessening or eliminating reperfusion injury, and interventionalists may play a role in the future in using some of these therapies in combination with thrombolysis or embolectomy. The present review summarizes the mechanisms of reperfusion injury and focuses on the way each of those mechanisms can be evaluated by different MRI modalities. The potential therapeutic strategies are also discussed

Stroke: Working Toward a Prioritized World Agenda

The aim of the Synergium was to devise and prioritize new ways of accelerating progress in reducing the risks, effects, and consequences of stroke

Stroke: Working Toward a Prioritized World Agenda

The aim of the Synergium was to devise and prioritize new ways of accelerating progress in reducing the risks, effects, and consequences of stroke

Internal fixation of distal metacarpal fractures: new uses for an old plate.

Certain metacarpal fracture patterns require operative fixation to restore anatomy and optimize results. Compared with dorsal plating, the width of the minicondylar blade plate buttresses the deforming volar pull of the intrinsics and provides a stronger construct. The implant provides firm fixation in the juxta-articular fragment with minimal space requirements. Therefore, the purpose of this study was to examine the outcomes following the use of a minicondylar blade plate for the treatment of distal metacarpal fractures. Twenty-two distal metacarpal fractures in 20 patients treated with a minicondylar blade plate were retrospectively reviewed. Outcome measures collected included postoperative grip strength, range of motion, return to work, and radiographic evidence of osseous union. Average range of motion of the metacarpophalangeal joint was 62° postoperatively. Eighty-two percent (18/22) of fractures were able to flex their digits to their distal palmar crease. Seventy-one percent (12/17) of patients had at least 75% return to grip strength compared with the contralateral side. Seventeen patients returned to full activity at a mean of 2.5 months (range, 1-3 months) postoperatively; 1 patient was on disability, and data were not available for the final 2 patients. No major complications occurred. The minicondylar blade plate is a safe and effective technique for stabilizing unstable periarticular metacarpal fractures. Stable fixation allows for early range of motion, rapid return to strength, and a relatively quick return to full work duty

Methods of analysis by the U.S. Geological Survey National Water Quality Laboratory : arsenic speciation in natural-water samples using laboratory and field methods /

Includes bibliographical references (p. 37-40).Mode of access: Internet