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1.
PLoS One ; 19(5): e0301529, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38743734

RESUMO

African elephants have a wide range of abilities using their trunk. As a muscular hydrostat, and thanks to the two finger-like processes at its tip, this proboscis can both precisely grasp and exert considerable force by wrapping. Yet few studies have attempted to quantify its distal grasping force. Thus, using a device equipped with force sensors and an automatic reward system, the trunk tip pinch force has been quantified in five captive female African savanna elephants. Results showed that the maximum pinch force of the trunk was 86.4 N, which may suggest that this part of the trunk is mainly dedicated to precision grasping. We also highlighted for the first time a difference in force between the two fingers of the trunk, with the dorsal finger predominantly stronger than the ventral finger. Finally, we showed that the position of the trunk, particularly the torsion, influences its force and distribution between the two trunk fingers. All these results are discussed in the light of the trunk's anatomy, and open up new avenues for evolutionary reflection and soft robot grippers.


Assuntos
Elefantes , Animais , Elefantes/fisiologia , Feminino , Tronco/fisiologia , Tronco/anatomia & histologia , Dedos/fisiologia , Dedos/anatomia & histologia , Força da Mão/fisiologia , Fenômenos Biomecânicos
2.
Sci Rep ; 14(1): 8145, 2024 04 08.
Artigo em Inglês | MEDLINE | ID: mdl-38584229

RESUMO

Photoplethysmography (PPG) uses light to detect volumetric changes in blood, and is integrated into many healthcare devices to monitor various physiological measurements. However, an unresolved limitation of PPG is the effect of skin pigmentation on the signal and its impact on PPG based applications such as pulse oximetry. Hence, an in-silico model of the human finger was developed using the Monte Carlo (MC) technique to simulate light interactions with different melanin concentrations in a human finger, as it is the primary determinant of skin pigmentation. The AC/DC ratio in reflectance PPG mode was evaluated at source-detector separations of 1 mm and 3 mm as the convergence rate (Q), a parameter that quantifies the accuracy of the simulation, exceeded a threshold of 0.001. At a source-detector separation of 3 mm, the AC/DC ratio of light skin was 0.472 times more than moderate skin and 6.39 than dark skin at 660 nm, and 0.114 and 0.141 respectively at 940 nm. These findings are significant for the development of PPG-based sensors given the ongoing concerns regarding the impact of skin pigmentation on healthcare devices.


Assuntos
Melaninas , Fotopletismografia , Humanos , Fotopletismografia/métodos , Método de Monte Carlo , Oximetria/métodos , Dedos/fisiologia
3.
Int J Sports Physiol Perform ; 19(3): 290-298, 2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-38307010

RESUMO

OBJECTIVE: To determine the criterion validity and test-retest reliability of isometric finger-strength testing in 6 differentiated grip techniques for the assessment of bouldering ability among male climbers. METHODS: We recruited participants at climbing gyms in Sweden and through online advertisements. We included climbers over 15 years of age with a minimum bouldering performance level of 17 International Rock Climbing and Research Association (IRCRA) for men and 15 IRCRA for women. We tested unilateral, maximal isometric peak finger strength in the front 3 drag, half crimp, closed crimp, 35 sloper, 45 × 90-mm, and 90 × 90-mm pinch through maximal force deloaded of a force plate. We analyzed criterion validity, test-retest reliability, and capacity to determine bouldering performance ability using a stepwise multivariable regression model. RESULTS: Women were excluded from the analysis due to insufficient sample size (n = 16). Thirty-two male participants were included in the primary analysis. The median (interquartile range) age in the advanced and elite group was 27 (25; 35) and 23 (22; 32) years, respectively. The half crimp for the participants' weak and strong hand displayed the highest ability to determine bouldering grade performance, explaining 48% to 58% of the variance. In the stepwise regression, maximal strength in the half crimp and the front 3 drag collectively explained 66% of the variance for performance. CONCLUSION: Strength in the half crimp proved the most important performance indicator. The results of this study provide a reliable and valid framework for maximal isometric peak finger-strength testing in advanced and elite male boulderers.


Assuntos
Montanhismo , Extremidade Superior , Humanos , Masculino , Feminino , Reprodutibilidade dos Testes , Dedos , Força da Mão
4.
Neural Netw ; 169: 778-792, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38000180

RESUMO

With the development of artificial intelligence, robots are widely used in various fields, grasping detection has been the focus of intelligent robot research. A dual manipulator grasping detection model based on Markov decision process is proposed to realize the stable grasping with complex multiple objects in this paper. Based on the principle of Markov decision process, the cross entropy convolutional neural network and full convolutional neural network are used to parameterize the grasping detection model of dual manipulators which are two-finger manipulator and vacuum sucker manipulator for multi-objective unknown objects. The data set generated in the simulated environment is used to train the two grasping detection networks. By comparing the grasping quality of the detection network output the best grasping by the two grasping methods, the network with better detection effect corresponding to the two grasping methods of two-finger and vacuum sucker is determined, and the dual manipulator grasping detection model is constructed in this paper. Robot grasping experiments are carried out, and the experimental results show that the proposed dual manipulator grasping detection method achieves 90.6% success rate, which is much higher than the other groups of experiments. The feasibility and superiority of the dual manipulator grasping detection method based on Markov decision process are verified.


Assuntos
Inteligência Artificial , Redes Neurais de Computação , Dedos , Extremidade Superior , Força da Mão
5.
Mult Scler ; 30(1): 121-130, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38140857

RESUMO

BACKGROUND: The Nine-Hole Peg Test (9HPT) is the golden standard to measure manual dexterity in people with multiple sclerosis (MS). However, administration requires trained personnel and dedicated time during a clinical visit. OBJECTIVES: The objective of this study is to validate a smartphone-based test for remote manual dexterity assessment, the icompanion Finger Dexterity Test (FDT), to be included into the icompanion application. METHODS: A total of 65 MS and 81 healthy subjects were tested, and 20 healthy subjects were retested 2 weeks later. RESULTS: The FDT significantly correlated with the 9HPT (dominant: ρ = 0.62, p < 0.001; non-dominant: ρ = 0.52, p < 0.001). MS subjects had significantly higher FDT scores than healthy subjects (dominant: p = 0.015; non-dominant: p = 0.013), which was not the case for the 9HPT. A significant correlation with age (dominant: ρ = 0.46, p < 0.001; non-dominant: ρ = 0.40, p = 0.002), Expanded Disability Status Scale (EDSS, dominant: ρ = 0.36, p = 0.005; non-dominant: ρ = 0.31, p = 0.024), and disease duration for the non-dominant hand (ρ = 0.31, p = 0.016) was observed. There was a good test-retest reliability in healthy subjects (dominant: r = 0.69, p = 0.001; non-dominant: r = 0.87, p < 0.001). CONCLUSIONS: The icompanion FDT shows a moderate-to-good concurrent validity and test-retest reliability, differentiates between the MS subjects and healthy controls, and correlates with clinical parameters. This test can be implemented into routine MS care for remote follow-up of manual dexterity.


Assuntos
Dedos , Esclerose Múltipla , Humanos , Reprodutibilidade dos Testes , Smartphone , Destreza Motora , Extremidade Superior , Esclerose Múltipla/diagnóstico
6.
IEEE Int Conf Rehabil Robot ; 2023: 1-6, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-37941197

RESUMO

This paper presents a novel impedance controller for THINGER (THumb INdividuating Grasp Exercise Robot), a 2-degree-of-freedom (DOF) spherical 5-bar exoskeleton designed to augment FINGER (Finger INdividuating Grasp Exercise Robot). Many rehabilitation and assessment tasks, for which THINGER is designed, are improved by rendering near-zero impedance during physical human-robot interaction (pHRI). To achieve this goal, the presented impedance controller includes several novel features. First, a reference trajectory is omitted, allowing free movements. Second, force-feedback gains are reduced near actuator limits and a saturation function limits the maximum commanded force; both allow more responsive (higher) force-feedback gains within the workspace and mitigate transient oscillations caused by external disturbances. Finally, manipulability-based directional force-feedback gains help improve rendered impedance isotropy. Validation experiments included free exploration of the workspace, following a prescribed circular thumb motion, and intentional exposure to external disturbances. The experimental results show that the presented impedance controller significantly reduces impedance to subject-initiated motion and accurately renders the desired isotropic low-impedance environment.


Assuntos
Exoesqueleto Energizado , Robótica , Humanos , Robótica/métodos , Impedância Elétrica , Dedos , Extremidade Superior
7.
IEEE Trans Haptics ; 16(4): 748-759, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37801385

RESUMO

Electrotactile stimulation can be an attractive technology to restore tactile feedback in different application scenarios (e.g., virtual and augmented reality, tele-manipulation). This technology allows designing compact solutions with no mechanical elements that can integrate a high-density matrix of stimulation points. The present study introduced four novel multi-pad finger-electrode designs with different arrangements (two matrix and two circular) and shapes of active pads (producing sensation) and reference pads (ideally, no sensation produced below the pad). The electrodes were used to investigate the subjects' ability to spatially discriminate active pads within phalanges individually (6-9 pads) as well as across the full finger (18-19 pads). The tests were conducted in 12 subjects and the results showed that all designs led to high success rates when applied to the fingertip (70-81%). When tested on the full finger, the matrix and circular designs were characterized with similar performance (54-57%), and when the phalanges were analyzed individually, the spatial discrimination was best at the fingertip. Additionally, new approaches for faster amplitude calibration were proposed and tested, demonstrating that calibration duration can be reduced by approximately 40% compared to the standard approach of calibrating single pads individually. Finally, discrimination tests of dynamic tactile patterns were conducted using circular and matrix designs on the fingertip and full finger, respectively. The tests showed that the different patterns generated by the two arrangements could be clearly discriminated, especially in the case of full-finger matrix-style patterns. The present study, therefore, provides several important insights that are relevant when delivering tactile feedback to the finger using an electrotactile interface.


Assuntos
Percepção do Tato , Humanos , Percepção do Tato/fisiologia , Estimulação Elétrica/métodos , Tato/fisiologia , Dedos/fisiologia , Eletrodos
9.
Artigo em Inglês | MEDLINE | ID: mdl-37590114

RESUMO

Upper limb tremor is a prominent symptom of both Parkinson's disease and essential tremor. Its kinematic parameters overlap substantially for these two pathological conditions, thus leading to high rate of misdiagnosis, especially for community doctors. Several groups have proposed various methods for improving differential diagnosis. These prior studies have attempted to identify better kinematic parameters, however they have mainly focused on single limb features including tremor intensity, tremor frequency, and tremor variability. In this paper, we propose a wearable system for multi-segment assessment of upper limb tremor and differential diagnosis of Parkinson's disease versus essential tremor. The proposed system collected tremor data from both wrist and fingers simultaneously. From this data, we extracted multi-segment features in the form of phase relationships between limb segments. Using support vector machine classifiers, we then performed differential diagnosis from the extracted features. We evaluated the performance of the proposed system on 19 Parkinson's disease patients and 12 essential tremor patients. Moreover, we also assessed the performance cost associated with reducing task load and sensor array size. The proposed system reached perfect accuracy in leave-one-out cross validation. Task reduction and sensor array reduction were associated with penalties of 2% and 9-10% respectively. The results demonstrated that the proposed system could be simplified for clinical applications, and successfully applied to the differential diagnosis of Parkinson's disease versus essential tremor in real-world setting.


Assuntos
Tremor Essencial , Doença de Parkinson , Dispositivos Eletrônicos Vestíveis , Humanos , Doença de Parkinson/diagnóstico , Tremor Essencial/diagnóstico , Tremor/diagnóstico , Diagnóstico Diferencial , Dedos
10.
Am J Occup Ther ; 77(3)2023 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-37310748

RESUMO

IMPORTANCE: Handwriting and the fine motor control (hand and fingers) underlying it are key indicators of numerous motor disorders, especially among children. However, current assessment methods are expensive, slow, and subjective, leading to a lack of knowledge about the relationship between handwriting and motor control. OBJECTIVE: To develop and validate the iPad precision drawing app Standardized Tracing Evaluation and Grapheme Assessment (STEGA) to enable rapid quantitative assessment of fine motor control and handwriting. DESIGN: Cross-sectional, single-arm observational study. SETTING: Academic research institution. PARTICIPANTS: Fifty-seven typically developing right-handed children ages 9 to 12 yr with knowledge of cursive. OUTCOMES AND MEASURES: Predicted quality, measured as the correlation between handwriting letter legibility (Evaluation Tool of Children's Handwriting-Cursive [ETCH-C]) and predicted legibility (calculated from STEGA's 120 Hz, nine-variable data). RESULTS: STEGA successfully predicted handwriting (r2 = .437, p < .001) using a support vector regression method. Angular error was the most important aspect of STEGA performance. STEGA was much faster to administer than the ETCH-C (M = 6.7 min, SD = 1.3, versus M = 19.7 min, SD = 5.2). CONCLUSIONS AND RELEVANCE: Assessment of motor control (and especially pen direction control) may provide a meaningful, objective way to assess handwriting. Future studies are needed to validate STEGA with a wider age range, but the initial results indicate that STEGA can provide the first rapid, quantitative, high-resolution, telehealth-capable assessment of the motor control that underpins handwriting. What This Article Adds: The ability to control pen direction may be the most important motor skill for successful handwriting. STEGA may provide the first criterion standard for the fine motor control skills that underpin handwriting, suitable for rehabilitation research and practice.


Assuntos
Aplicativos Móveis , Humanos , Criança , Estudos Transversais , Mãos , Dedos , Escrita Manual
11.
Sensors (Basel) ; 23(11)2023 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-37299968

RESUMO

Bradykinesia is a cardinal hallmark of Parkinson's disease (PD). Improvement in bradykinesia is an important signature of effective treatment. Finger tapping is commonly used to index bradykinesia, albeit these approaches largely rely on subjective clinical evaluations. Moreover, recently developed automated bradykinesia scoring tools are proprietary and are not suitable for capturing intraday symptom fluctuation. We assessed finger tapping (i.e., Unified Parkinson's Disease Rating Scale (UPDRS) item 3.4) in 37 people with Parkinson's disease (PwP) during routine treatment follow ups and analyzed their 350 sessions of 10-s tapping using index finger accelerometry. Herein, we developed and validated ReTap, an open-source tool for the automated prediction of finger tapping scores. ReTap successfully detected tapping blocks in over 94% of cases and extracted clinically relevant kinematic features per tap. Importantly, based on the kinematic features, ReTap predicted expert-rated UPDRS scores significantly better than chance in a hold out validation sample (n = 102). Moreover, ReTap-predicted UPDRS scores correlated positively with expert ratings in over 70% of the individual subjects in the holdout dataset. ReTap has the potential to provide accessible and reliable finger tapping scores, either in the clinic or at home, and may contribute to open-source and detailed analyses of bradykinesia.


Assuntos
Doença de Parkinson , Humanos , Doença de Parkinson/diagnóstico , Doença de Parkinson/terapia , Hipocinesia/diagnóstico , Dedos , Fenômenos Biomecânicos
12.
IEEE Trans Biomed Circuits Syst ; 17(2): 349-361, 2023 04.
Artigo em Inglês | MEDLINE | ID: mdl-37163387

RESUMO

This article presents a novel PPG acquisition platform capable of synchronous multi-wavelength signal acquisition from two measurement locations with up to 4 independent wavelengths from each in parallel. The platform is fully configurable and operates at 1ksps, accommodating a wide variety of transmitters and detectors to serve as both a research tool for experimentation and a clinical tool for disease monitoring. The sensing probes presented in this work acquire 4 PPG channels from the wrist and 4 PPG channels from the fingertip, with wavelengths such that surrogates for pulse wave velocity and haematocrit can be extracted. For conventional PPG sensing, we have achieved the mean error of 4.08 ± 3.72 bpm for heart-rate and a mean error of 1.54 ± 1.04% for SpO 2 measurement, with the latter lying within the FDA limits for commercial pulse oximeters. We have further evaluated over 700 individual peak-to-peak time differences between wrist and fingertip signals, achieving a normalized weighted average PWV of 5.80 ± 1.58 m/s, matching with values of PWV found for this age group in literature. Lastly, we introduced and computed a haematocrit ratio ( Rhct) between the deep IR and deep red wavelength from the fingertip sensor, finding a significant difference between male and female values (median of 1.9 and 2.93 respectively) pointing to devices sensitivity to Hct.


Assuntos
Fotopletismografia , Análise de Onda de Pulso , Masculino , Humanos , Feminino , Oximetria , Oxigênio , Dedos , Frequência Cardíaca
13.
Sensors (Basel) ; 23(6)2023 Mar 07.
Artigo em Inglês | MEDLINE | ID: mdl-36991587

RESUMO

Parkinson's disease (PD) is a neurological progressive movement disorder, affecting more than 10 million people globally. PD demands a longitudinal assessment of symptoms to monitor the disease progression and manage the treatments. Existing assessment methods require patients with PD (PwPD) to visit a clinic every 3-6 months to perform movement assessments conducted by trained clinicians. However, periodic visits pose barriers as PwPDs have limited mobility, and healthcare cost increases. Hence, there is a strong demand for using telemedicine technologies for assessing PwPDs in remote settings. In this work, we present an in-home telemedicine kit, named iTex (intelligent Textile), which is a patient-centered design to carry out accessible tele-assessments of movement symptoms in people with PD. iTex is composed of a pair of smart textile gloves connected to a customized embedded tablet. iTex gloves are integrated with flex sensors on the fingers and inertial measurement unit (IMU) and have an onboard microcontroller unit with IoT (Internet of Things) capabilities including data storage and wireless communication. The gloves acquire the sensor data wirelessly to monitor various hand movements such as finger tapping, hand opening and closing, and other movement tasks. The gloves are connected to a customized tablet computer acting as an IoT device, configured to host a wireless access point, and host an MQTT broker and a time-series database server. The tablet also employs a patient-centered interface to guide PwPDs through the movement exam protocol. The system was deployed in four PwPDs who used iTex at home independently for a week. They performed the test independently before and after medication intake. Later, we performed data analysis of the in-home study and created a feature set. The study findings reported that the iTex gloves were capable to collect movement-related data and distinguish between pre-medication and post-medication cases in a majority of the participants. The IoT infrastructure demonstrated robust performance in home settings and offered minimum barriers for the assessment exams and the data communication with a remote server. In the post-study survey, all four participants expressed that the system was easy to use and poses a minimum barrier to performing the test independently. The present findings indicate that the iTex glove system has the potential for periodic and objective assessment of PD motor symptoms in remote settings.


Assuntos
Doença de Parkinson , Humanos , Doença de Parkinson/diagnóstico , Doença de Parkinson/terapia , Movimento , Dedos , Mãos , Têxteis
14.
PLoS One ; 18(3): e0281023, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36972225

RESUMO

Developing digital inclusive finance is one of the most effective ways to alleviate financial exclusion in the agriculture sector. For empirical investigation, data from 30 provinces of Rural China is collected from the period 2011 to 2020. The study constructs five dimensions and 22 indicators in total to critically conduct the impact of digital inclusive finance on high-quality agricultural development. The level of agricultural development is measured by entropy weight TOPSIS, and the impact of digital inclusive finance on its high-quality development is empirically tested. The results show that digital inclusive finance has significantly improved the agricultural sector and, particularly, the Eastern region of China has the greatest impact. Three dimensions of digital inclusion finance have regional heterogeneity in terms of impact on agricultural development in Rural China. Data does not show the simple linear relationship between digital inclusion finance and agricultural development quality. The impact of the former on the latter is characterized by the double thresholds. The digital inclusive finance index is the weakest when it is lower than the first threshold that is 4.7704, and the impact of the second threshold that is 5.3186 on high-quality agricultural development is gradually enhanced. After crossing the second threshold, the impact of digital inclusive finance on high-quality agricultural development in Rural China is significantly enhanced. The development of digital inclusive finance should be strengthened in the Central and Western regions to compensate for regional financial imbalances and promote synergy in the high-quality development of agriculture across the country.


Assuntos
Agricultura , Dedos , Prevalência , China , Entropia , Desenvolvimento Econômico
15.
Prosthet Orthot Int ; 47(3): 327-335, 2023 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-36952475

RESUMO

3D printing for custom prosthetic finger fabrication can have better fit and comfort than non-custom off-the-shelf ones while reducing fabrication labor time. The purpose of this case study was (1) to design and fabricate custom prosthetic fingers using 3D-printed molds for the treatment of partial finger amputation; (2) to evaluate patient satisfaction of the custom prosthetic fingers fabricated using 3D-printed molds and compare them to the custom prosthetic fingers fabricated through a conventional method of molding using plaster casts. The method to develop the custom prosthetic finger are as follows: (1) The shapes of the residual digits and contralateral fingers were acquired using a high-resolution 3D optical scanner. (2) Prosthetic fingers were designed by modifying the model of the residual digits and the contralateral fingers. (3) Molds of the prosthetic fingers were designed using computer-aided design software and fabricated by 3D printing. The study compared hand function tests and rehabilitation outcome surveys to evaluate the performance of the prosthetic fingers fabricated using 3D-printed molds and plaster casts. This case suggests that the prosthetic fingers fabricated using 3D-printed molds had comparable performance to the prosthetic fingers fabricated using plaster casts. The aesthetics and transparency of the prosthetic fingers contributed highly to the low satisfaction of the prosthetic fingers fabricated using 3D-printed molds.


Assuntos
Membros Artificiais , Dedos , Humanos , Impressão Tridimensional , Desenho Assistido por Computador , Satisfação do Paciente
16.
BMC Anesthesiol ; 23(1): 60, 2023 02 27.
Artigo em Inglês | MEDLINE | ID: mdl-36849887

RESUMO

BACKGROUND: Aim of this study is to test the predictive value of Pulse Wave Transit Time (PWTT) for fluid responsiveness in comparison to the established fluid responsiveness parameters pulse pressure (ΔPP) and corrected flow time (FTc) during major abdominal surgery. METHODS: Forty patients undergoing major abdominal surgery were enrolled with continuous monitoring of PWTT (LifeScope® Modell J BSM-9101 Nihon Kohden Europe GmbH, Rosbach, Germany) and stroke volume (Esophageal Doppler Monitoring CardioQ-ODM®, Deltex Medical Ltd, Chichester, UK). In case of hypovolemia (difference in pulse pressure [∆PP] ≥ 9%, corrected flow time [FTc] ≤ 350 ms) a fluid bolus of 7 ml/kg ideal body weight was administered. Receiver operating characteristics (ROC) curves and corresponding areas under the curve (AUCs) were used to compare different methods of determining PWTT. A Wilcoxon test was used to discriminate fluid responders (increase in stroke volume of ≥ 10%) from non-responders. The predictive value of PWTT for fluid responsiveness was compared by testing for differences between ROC curves of PWTT, ΔPP and FTc using the methods by DeLong. RESULTS: AUCs (area under the ROC-curve) to predict fluid responsiveness for PWTT-parameters were 0.61 (raw c finger Q), 0.61 (raw c finger R), 0.57 (raw c ear Q), 0.53 (raw c ear R), 0.54 (raw non-c finger Q), 0.52 (raw non-c finger R), 0.50 (raw non-c ear Q), 0.55 (raw non-c ear R), 0.63 (∆ c finger Q), 0.61 (∆ c finger R), 0.64 (∆ c ear Q), 0.66 (∆ c ear R), 0.59 (∆ non-c finger Q), 0.57 (∆ non-c finger R), 0.57 (∆ non-c ear Q), 0.61 (∆ non-c ear R) [raw measurements vs. ∆ = respiratory variation; c = corrected measurements according to Bazett's formula vs. non-c = uncorrected measurements; Q vs. R = start of PWTT-measurements with Q- or R-wave in ECG; finger vs. ear = pulse oximetry probe location]. Hence, the highest AUC to predict fluid responsiveness by PWTT was achieved by calculating its respiratory variation (∆PWTT), with a pulse oximeter attached to the earlobe, using the R-wave in ECG, and correction by Bazett's formula (AUC best-PWTT 0.66, 95% CI 0.54-0.79). ∆PWTT was sufficient to discriminate fluid responders from non-responders (p = 0.029). No difference in predicting fluid responsiveness was found between best-PWTT and ∆PP (AUC 0.65, 95% CI 0.51-0.79; p = 0.88), or best-PWTT and FTc (AUC 0.62, 95% CI 0.49-0.75; p = 0.68). CONCLUSION: ΔPWTT shows poor ability to predict fluid responsiveness intraoperatively. Moreover, established alternatives ΔPP and FTc did not perform better. TRIAL REGISTRATION: Prior to enrolement on clinicaltrials.gov (NC T03280953; date of registration 13/09/2017).


Assuntos
Líquidos Corporais , Dedos , Humanos , Extremidade Superior , Pressão Sanguínea , Europa (Continente)
18.
RMD Open ; 9(1)2023 02.
Artigo em Inglês | MEDLINE | ID: mdl-36787926

RESUMO

OBJECTIVE: To assess the finger vascularity of systemic sclerosis patients with Raynaud's phenomenon (RP-SSc) using various ultrasound techniques. METHODS: All fingers (except thumbs) of 18 RP-SSc patients and 18 controls were imaged at room temperature using four ultrasound vascular imaging techniques. The percent vascular area was quantified by counting blood flow pixels in a 25 mm2 square centred at the nail fold for the dorsal side and in 25 mm2 and 100 mm2 square from the fingertip for the ventral side. The mean vascular intensity was calculated from the corresponding areas for dorsal and ventral sides. RESULTS: The percent vascular areas and mean vascular intensities in RP-SSc were significantly lower than those in controls for both dorsal and ventral sides (p<0.01). The mean vascular intensities showed slightly higher area under the curve (AUC) than the percent vascular areas (0.53-0.91 vs 0.53-0.90) regardless of imaging technique and assessment side. For each imaging technique, the ventral side vascularity showed a higher AUC (0.74-0.91) compared with the dorsal side (0.53-0.81). Moreover, ventral side abnormalities were associated with a history of digital ulcers. CONCLUSIONS: Ultrasound demonstrated potential to quantify finger vascularity of RP-SSc. The ventral side of the fingers showed a higher accuracy in detecting RP-SSc than the dorsal side.


Assuntos
Escleroderma Sistêmico , Humanos , Escleroderma Sistêmico/diagnóstico , Escleroderma Sistêmico/diagnóstico por imagem , Dedos
19.
Arch Dermatol Res ; 315(3): 387-393, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35532783

RESUMO

Recurrent changes of temperature and persistence of cooling along fingers at the room temperature make hands the most frequent region of interest for thermography in systemic sclerosis (SSc). The aim of this study was to evaluate dependance of temperature in hands on a subtype of the disease, immune profile of antinuclear antibodies (ANA), and lung involvement. There were 29 patients with limited cutaneous involvement (lcSSc) and 10 patients with diffuse cutaneous disease (dcSSc) enrolled for the study. To compare measurements to normal values, there were enrolled 29 healthy volunteers (control group). All participants were submitted to thermography with handheld camera FLIR One Pro for iOS, attached to mobile phone iPhone 11, at the fixed temperature of 21 °C. Measurements included average temperature (Tavg) over nailfolds in thumbs and fingers II-V, as well as the difference in average temperatures (TΔ) between metacarpus of the hand and its thumb and fingers II-V. Both thumbs and fingers II-V remained cooler in subjects with dcSSc compared to those with lcSSc. This implicated a significantly greater TΔ along thumbs and fingers II-V in dcSSc group. Although Tavg at nailfolds in SSc patients was not lower than in healthy controls, TΔ remained significantly more pronounced in both lcSSc and dcSSc subjects. A positivity to ACA in lcSSc group was found to be associated with significantly lower Tavg and more pronounced TΔ in fingers II-V than the presence of anti-Scl70 antibodies. Temperature measurements remained statistically independent on a presence of ILD in lcSSc group, but both thumbs and fingers II-V in dcSSc group were warmer in case of lung involvement. The study showed the dcSSc subtype, the positivity of ACA in lcSSc, but not lung involvement were associated with poorer thermal control in the hands of SSc patients. A comparison to healthy controls highlighted the weakness of temperature measurements at nailfolds (Tavg) but increased the value of TΔ in thermography of hands.


Assuntos
Escleroderma Sistêmico , Termografia , Humanos , Escleroderma Sistêmico/diagnóstico , Dedos
20.
Am J Hum Biol ; 35(5): e23852, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-36524699

RESUMO

OBJECTIVES: The contributions of latitude and ethnicity in the determination of cross-society differences in digit ratios are unclear. In India, different castes (endogamous groups) have been living in the same areas (villages or towns) for the last 1500 years and, therefore, these groups may have different gene pools without a latitude-related difference component. Thus, in the present study, we studied the effect of caste on digit ratios. We also studied the effects of sex, birth season, and family income on digit ratios. METHODS: We selected a sample of 301 college students (age: M = 19.9 years, SD = 2.63) in Muzaffarnagar city of western Uttar Pradesh, India, and asked participants for information regarding their birth month, religion, caste, and monthly family income. We measured participants' dorsal and palmar digit lengths (of all fingers, except the thumb, in both hands) using vernier calipers of 0.01 mm accuracy. RESULTS: Other backward castes (intermediate castes) had longer digit lengths than general castes (upper castes), scheduled castes (lower castes), and Muslims. However, there was no difference in digit ratios of caste groups (scheduled castes vs. other backward castes vs. general castes vs. Muslims) or specific castes (Chamar-Jatav vs. Jat vs. Pandit-Tyagi). Winter-born women had lower left dorsal 2D:4D and 3D:4D ratios than summer-born women. Family income was related to higher dorsal 2D:4D and 3D:4D ratios among women. Moreover, in dorsal digit ratios, sex difference (men < women) occurred in digit ratios constituting digit 5, whereas, in palmar digit ratios, sex difference occurred in digit ratios constituting digit 2. CONCLUSIONS: The present study suggests that endogamy-led genetic difference in ethnic/caste groups is not a determinant, whereas birth season (i.e., the exposure to sunlight) and family income might be determinants of digit ratios. In addition, compared to palmar digit ratios, dorsal digit ratios are better markers of sexual dimorphism.


Assuntos
Razão Digital , Classe Social , Humanos , Masculino , Feminino , Adulto Jovem , Adulto , Estações do Ano , Renda , Dedos/anatomia & histologia
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