Consistency analysis of two fingertip capillary blood sampling methods for complete blood count.

This study was performed to analyze fingertip capillary blood sampling in pediatric patients using microcapillary blood collection tubes and microhematocrit tubes and to compare the blood cell analysis results obtained via these two blood collection methods. Finger capillary blood was collected from 110 outpatients using microcapillary blood collection tubes and microhematocrit tubes and complete blood count analysis was performed with a Sysmex XS-900i hematology analyzer and manual microscopy for blood cell morphology. Paired data was evaluated for agreement and bias using the microhematocrit samples as the reference group and the samples from the microcapillary blood collection tubes as the observation group. The two blood collection methods demonstrated good agreement for measuring red blood cell (RBC) parameters (i.e., RBC, Hb, Hct, MCV, MCH and MCHC), wherein the relative bias was > allowable total error (TEa) in 0.91%, 1.82%, 11.82%, 1.82%, 0.91% and 8.18% of the parameter measures, respectively. According to industry requirements, the proportion of samples meeting the acceptable bias level should be > 80%. Additionally, the estimated biases at each medical decision level were within clinically acceptable levels for RBC, Hb, Hct, and MCV. However, the proportion of WBC and PLT counts with relative bias > TEa was 25.45% and 35.45%, respectively. Furthermore, the relative bias of the WBC count at the medical decision level of 0.5 × 109/L and that of the PLT counts at the medical decision levels of 10 × 109/L and 50 × 109/L were clinically significant. Bland-Altman analysis further showed a mean bias of 0.66 × 109/L (95% LoA, - 0.79 to 2.11) for the WBC count and 39 × 109/L (95% LoA, - 46 to 124) for the PLT count from the blood samples collected in the microcapillary blood collection tubes compared with the counts of those collected in the microhematocrit tubes. Neutrophil, monocyte, lymphocyte, eosinophil, and PLT counts increased significantly in the microcapillary blood collection tubes compared with those in the microhematocrit tubes, along with an elevated number of instrument false alarms (P < 0.05). The two capillary blood collection devices exhibit performance differences. Therefore, clinicians should pay attention to the variation in results caused by different blood collection methods.

Ventrointermediate thalamic stimulation improves motor learning in humans.

Ventrointermediate thalamic stimulation (VIM-DBS) modulates oscillatory activity in a cortical network including primary motor cortex, premotor cortex, and parietal cortex. Here we show that, beyond the beneficial effects of VIM-DBS on motor execution, this form of invasive stimulation facilitates production of sequential finger movements that follow a repeated sequence. These results highlight the role of thalamo-cortical activity in motor learning.

The association between 2D:4D digit ratio and sex-typed play in children with and without siblings.

The 2D:4D digit ratio is commonly used as a surrogate possibly reflecting prenatal testosterone levels. Indirect evidence comes from studies investigating the association between 2D:4D and human characteristics that likely relate to prenatal testosterone. In children, sex-typed play reveals large sex differences early in development and an influence of prenatal testosterone is likely. Findings on the association between 2D:4D and children's sex-typed play are heterogeneous and other influences on the development of sex-typed play have been suggested, most of all social influences like siblings, their sex and birth order. The current study examined the association between right and left 2D:4D, a proposed surrogate for prenatal testosterone exposure, which was assessed in right and left hands of N = 505 6-month-old children, and sex-typed play behavior, which was evaluated 3.5 years later using the Pre-School Activities Inventory (PSAI), and the influence of siblings. To capture differential effects of siblings' sex and birth order, dummy-coded variables were used reflecting having no siblings as well as older or younger sisters or brothers. Multiple regression models were used to investigate the association between PSAI scores and sex, right and left 2D:4D, being a singleton as well as having an older or younger sister or brother. It was shown that sex and having an older brother were significant predictors for sex-typed play. Effects were further disentangled by conducting separate regression analyses in boys and girls. In boys, a significant association between PSAI scores and having an older brother was revealed, in girls, no significant associations were found. Results are discussed highlighting the non-significant association between 2D:4D and children's sex-typed play, which weakens the applicability of 2D:4D as a surrogate reflecting influences of prenatal T. Further, the importance of social factors like siblings on children's sex-typed play is discussed.

Portuguese Recommendations for the management of Raynaud's phenomenon and digital ulcers in systemic sclerosis and other connective tissue diseases.

OBJECTIVE: To develop evidence-based recommendations for the non-pharmacological and pharmacological management of Raynaud's phenomenon (RP) and digital ulcers (DUs) in patients with systemic sclerosis and other immune-mediated connective tissue diseases (CTDs). METHODS: A task force comprising 21 rheumatologists, two surgeons (vascular and plastic), two nurses, and one patient representative was established. Following a systematic literature review performed to inform the recommendations, statements were formulated and discussed during two meetings (one online and one in-person). Levels of evidence, grades of recommendation (GoR), and level of agreement (LoA) were determined. RESULTS: Five overarching principles and 13 recommendations were developed. GoR ranged from A to D. The mean ± standard difference (SD) LoA with the overarching principles and recommendations ranged from 7.8±2.1 to 9.8±0.4. Briefly, the management of RP and DUs in patients with CTDs should be coordinated by a multidisciplinary team and based on shared decisions with patients. Nifedipine should be used as first-line therapy for RP and/or DUs. Sildenafil, tadalafil, and/or iloprost IV are second-line options for severe and/or refractory patients with RP and/or DUs. Sildenafil, tadalafil and/or Iloprost IV, should be prescribed for healing and prevention (also including bosentan) of DUs. In patients with RP and/or DUs, non-pharmacological interventions might be considered as add-ons, but there is limited quality and quantity of scientific evidence supporting their use. CONCLUSIONS: These recommendations will inform rheumatologists, specialist nurses, other healthcare professionals, and patients about a comprehensive and personalized management of RP and DUs. A research agenda was developed to address unmet needs, particularly for non-pharmacologic interventions.

Precise tactile localization on the human fingernail.

Fingernails are specialized features of the primate hand, which are believed to contribute to manual dexterity. The sensorimotor functions of fingernails, however, remain poorly understood. This study investigates the ability of humans to precisely localize touches applied to the fingernail plate. Nine different locations on the fingernail were touched and participants judged the location by clicking a mouse cursor on a photograph of their finger. Performance in this condition was compared with stimuli applied to the skin of the fingertip. The results showed that participants are able to localize touch on the fingernails at substantially higher than chance levels. Moreover, the precision of this ability is not appreciably lower than that of the fingertips. These results show that the fingernail is a highly sensitive sensory organ, which is capable of providing rich spatial information about tactile stimuli.

Selective recruitment of the cerebellum evidenced by task-dependent gating of inputs.

Functional magnetic resonance imaging (fMRI) studies have documented cerebellar activity across a wide array of tasks. However, the functional contribution of the cerebellum within these task domains remains unclear because cerebellar activity is often studied in isolation. This is problematic, as cerebellar fMRI activity may simply reflect the transmission of neocortical activity through fixed connections. Here, we present a new approach that addresses this problem. Rather than focus on task-dependent activity changes in the cerebellum alone, we ask if neocortical inputs to the cerebellum are gated in a task-dependent manner. We hypothesize that input is upregulated when the cerebellum functionally contributes to a task. We first validated this approach using a finger movement task, where the integrity of the cerebellum has been shown to be essential for the coordination of rapid alternating movements but not for force generation. While both neocortical and cerebellar activity increased with increasing speed and force, the speed-related changes in the cerebellum were larger than predicted by an optimized cortico-cerebellar connectivity model. We then applied the same approach in a cognitive domain, assessing how the cerebellum supports working memory. Enhanced gating was associated with the encoding of items in working memory, but not with the manipulation or retrieval of the items. Focusing on task-dependent gating of neocortical inputs to the cerebellum offers a promising approach for using fMRI to understand the specific contributions of the cerebellum to cognitive function.

Digital Glomus Tumor - A Commonly Undiagnosed Cause of Finger Pain: Case Report.

Glomus tumors are rare vascular hamartomas most commonly found in the subungual region of the fingers. They present with a classic triad of paroxysmal pain, point tenderness, and cold sensitivity. The diagnosis is often missed for several years due to under recognition of this condition. A 42-year-old female presented with a several year history of pain in the middle finger when it was struck or exposed to cold. She had point tenderness on the fingernail, and increased curvature of the nail. Magnetic Resonance Imaging (MRI) revealed a 7mm subungual glomus tumor. The tumor was surgically excised via a transungual approach, resulting in complete relief of her pain. Glomus tumors are diagnosed clinically based on the presence of classic symptoms and positive provocative tests. These tests include point tenderness on palpation and pain when ice is placed on the digit. MRI imaging can be used when the diagnosis is unclear or to localize the tumor prior to surgery. Increased awareness of this condition among physicians could reduce the time to diagnosis and treatment.

Healing Function for Abraded Fingerprint Ridges in Tactile Texture Sensors.

Tactile texture sensors are designed to evaluate the sensations felt when a human touches an object. Prior studies have demonstrated the necessity for these sensors to have compliant ridges on their surfaces that mimic human fingerprints. These features enable the simulation of contact phenomena, especially friction and vibration, between human fingertips and objects, enhancing the tactile sensation evaluation. However, the ridges on tactile sensors are susceptible to abrasion damage from repeated use. To date, the healing function of abraded ridges has not been proposed, and its effectiveness needs to be demonstrated. In this study, we investigated whether the signal detection capabilities of a sensor with abraded epidermal ridges could be restored by healing the ridges using polyvinyl chloride plastisol as the sensor material. We developed a prototype tactile sensor with an embedded strain gauge, which was used to repeatedly scan roughness specimens. After more than 1000 measurements, we observed significant deterioration in the sensor's output signal level. The ridges were then reshaped using a mold with a heating function, allowing the sensor to partially regain its original signal levels. This method shows potential for extending the operational lifespan of tactile texture sensors with compliant ridges.

Assessing the Impact of Neuromuscular Electrical Stimulation-Based Fingerboard Training versus Conventional Fingerboard Training on Finger Flexor Endurance in Intermediate to Advanced Sports Climbers: A Randomized Controlled Study.

Competitive climbers engage in highly structured training regimens to achieve peak performance levels, with efficient time management as a critical aspect. Neuromuscular electrical stimulation (NMES) training can close the gap between time-efficient conditioning training and achieving optimal prerequisites for peak climbing-specific performances. Therefore, we examined potential neuromuscular adaptations resulting from the NMFES intervention by analyzing the efficacy of twice-weekly NMES-supported fingerboard (hang board) training compared with thrice-weekly conventional fingerboard training over 7 training weeks in enhancing climbing-specific endurance among intermediate to advanced climbers. Participants were randomly divided into the NMES and control groups. Eighteen participants completed the study (14 male, 4 female; mean age: 25.7 ± 5.3 years; mean climbing experience: 6.4 ± 3.4 years). Endurance was assessed by measuring the maximal time athletes could support their body weight (hanging to exhaustion) on a 20 mm-deep ledge at three intervals: pre-, in-between- (after 4 weeks of training), and post-training (after 7 weeks of training). The findings revealed that despite the lower training volume in the NMES group, no significant differences were observed between the NMES and control groups in climbing-specific endurance. Both groups exhibited notable improvements in endurance, particularly after the in-between test. Consequently, a twice-weekly NMES-supported fingerboard training regimen demonstrated non-inferiority to a thrice-weekly conventional training routine. Incorporating NMES into fingerboard workouts could offer time-saving benefits.

An Overall Automated Architecture Based on the Tapping Test Measurement Protocol: Hand Dexterity Assessment through an Innovative Objective Method.

The present work focuses on the tapping test, which is a method that is commonly used in the literature to assess dexterity, speed, and motor coordination by repeatedly moving fingers, performing a tapping action on a flat surface. During the test, the activation of specific brain regions enhances fine motor abilities, improving motor control. The research also explores neuromuscular and biomechanical factors related to finger dexterity, revealing neuroplastic adaptation to repetitive movements. To give an objective evaluation of all cited physiological aspects, this work proposes a measurement architecture consisting of the following: (i) a novel measurement protocol to assess the coordinative and conditional capabilities of a population of participants; (ii) a suitable measurement platform, consisting of synchronized and non-invasive inertial sensors to be worn at finger level; (iii) a data analysis processing stage, able to provide the final user (medical doctor or training coach) with a plethora of useful information about the carried-out tests, going far beyond state-of-the-art results from classical tapping test examinations. Particularly, the proposed study underscores the importance interdigital autonomy for complex finger motions, despite the challenges posed by anatomical connections; this deepens our understanding of upper limb coordination and the impact of neuroplasticity, holding significance for motor abilities assessment, improvement, and therapeutic strategies to enhance finger precision. The proof-of-concept test is performed by considering a population of college students. The obtained results allow us to consider the proposed architecture to be valuable for many application scenarios, such as the ones related to neurodegenerative disease evolution monitoring.

Glove-Net: Enhancing Grasp Classification with Multisensory Data and Deep Learning Approach.

Grasp classification is pivotal for understanding human interactions with objects, with wide-ranging applications in robotics, prosthetics, and rehabilitation. This study introduces a novel methodology utilizing a multisensory data glove to capture intricate grasp dynamics, including finger posture bending angles and fingertip forces. Our dataset comprises data collected from 10 participants engaging in grasp trials with 24 objects using the YCB object set. We evaluate classification performance under three scenarios: utilizing grasp posture alone, utilizing grasp force alone, and combining both modalities. We propose Glove-Net, a hybrid CNN-BiLSTM architecture for classifying grasp patterns within our dataset, aiming to harness the unique advantages offered by both CNNs and BiLSTM networks. This model seamlessly integrates CNNs' spatial feature extraction capabilities with the temporal sequence learning strengths inherent in BiLSTM networks, effectively addressing the intricate dependencies present within our grasping data. Our study includes findings from an extensive ablation study aimed at optimizing model configurations and hyperparameters. We quantify and compare the classification accuracy across these scenarios: CNN achieved 88.09%, 69.38%, and 93.51% testing accuracies for posture-only, force-only, and combined data, respectively. LSTM exhibited accuracies of 86.02%, 70.52%, and 92.19% for the same scenarios. Notably, the hybrid CNN-BiLSTM proposed model demonstrated superior performance with accuracies of 90.83%, 73.12%, and 98.75% across the respective scenarios. Through rigorous numerical experimentation, our results underscore the significance of multimodal grasp classification and highlight the efficacy of the proposed hybrid Glove-Net architectures in leveraging multisensory data for precise grasp recognition. These insights advance understanding of human-machine interaction and hold promise for diverse real-world applications.

Boundaries of task-specificity: bimanual finger dexterity is reduced in musician's dystonia.

Task-specific dystonia leads to loss of sensorimotor control for a particular motor skill. Although focal in nature, it is hugely disabling and can terminate professional careers in musicians. Biomarkers for underlying mechanism and severity are much needed. In this study, we designed a keyboard device that measured the forces generated at all fingertips during individual finger presses. By reliably quantifying overflow to other fingers in the instructed (enslaving) and contralateral hand (mirroring) we explored whether this task could differentiate between musicians with and without dystonia. 20 right-handed professional musicians (11 with dystonia) generated isometric flexion forces with the instructed finger to match 25%, 50% or 75% of maximal voluntary contraction for that finger. Enslaving was estimated as a linear slope of the forces applied across all instructed/uninstructed finger combinations. Musicians with dystonia had a small but robust loss of finger dexterity. There was increased enslaving and mirroring, primarily during use of the symptomatic hand (enslaving p = 0.003; mirroring p = 0.016), and to a lesser extent with the asymptomatic hand (enslaving p = 0.052; mirroring p = 0.062). Increased enslaving and mirroring were seen across all combinations of finger pairs. In addition, enslaving was exaggerated across symptomatic fingers when more than one finger was clinically affected. Task-specific dystonia therefore appears to express along a gradient, most severe in the affected skill with subtle and general motor control dysfunction in the background. Recognition of this provides a more nuanced understanding of the sensorimotor control deficits at play and can inform therapeutic options for this highly disabling disorder.

Stretchable glove for accurate and robust hand pose reconstruction based on comprehensive motion data.

We propose a compact wearable glove capable of estimating both the finger bone lengths and the joint angles of the wearer with a simple stretch-based sensing mechanism. The soft sensing glove is designed to easily stretch and to be one-size-fits-all, both measuring the size of the hand and estimating the finger joint motions of the thumb, index, and middle fingers. The system was calibrated and evaluated using comprehensive hand motion data that reflect the extensive range of natural human hand motions and various anatomical structures. The data were collected with a custom motion-capture setup and transformed into the joint angles through our post-processing method. The glove system is capable of reconstructing arbitrary and even unconventional hand poses with accuracy and robustness, confirmed by evaluations on the estimation of bone lengths (mean error: 2.1 mm), joint angles (mean error: 4.16°), and fingertip positions (mean 3D error: 4.02 mm), and on overall hand pose reconstructions in various applications. The proposed glove allows us to take advantage of the dexterity of the human hand with potential applications, including but not limited to teleoperation of anthropomorphic robot hands or surgical robots, virtual and augmented reality, and collection of human motion data.

A digital volume pulse device-finger photo pulse plethysmography to trace the vascular integrity amongst the low back pain subjects with lumbar disc degenerative diseases diagnosed by MRI analysis.

Finger photo pulse plethysmography is a simple, inexpensive and non-invasive method for measurement of arterial stiffness. The objective is to assess the correlation of arterial stiffness in low back pain subjects with lumbar disc degeneration. Thirty-four back pain patients of both sexes in age group of 30-65 were included. Anthropometric measures like height, body weight, body mass index (BMI) were included. Stiffness index (SI) and reflection index (RI) were measured from the digital volume pulse waveform. There was a negative correlation between SI/RI and no correlation between SI and RI with BMI in both sexes. A significant correlation found between weight and BMI in both sexes. Arterial stiffness may not have any influence on disc degeneration. BMI showed some influence on disc degeneration and back pain.

Amyopathic Dermatomyositis Presenting with Digital Ulcerations: Case Report and Literature Review.

ABSTRACT: Clinically amyopathic dermatomyositis (CADM) is a rare subtype of dermatomyositis that presents with cutaneous features and no muscle involvement. This case report describes a 26-year-old woman with recurrent and multiple digital ulcerations coinciding with the start of winter each year. There was no evidence of myopathy, and antibody testing yielded negative results. A diagnosis of CADM was ultimately made based on clinicopathologic correlation. The patient's ulcers demonstrated excellent response to a combination therapy of hydroxychloroquine and potent topical and systemic steroids. Herein, the authors discuss the pathologic and immunologic characteristics of CADM.

Characterizing Disease Progression in Parkinson's Disease from Videos of the Finger Tapping Test.

INTRODUCTION: Parkinson's disease (PD) is characterized by motor symptoms whose progression is typically assessed using clinical scales, namely the Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS). Despite its reliability, the scale is bounded by a 5-point scale that limits its ability to track subtle changes in disease progression and is prone to subjective interpretations. We aimed to develop an automated system to objectively quantify motor symptoms in PD using Machine Learning (ML) algorithms to analyze videos and capture nuanced features of disease progression. METHODS: We analyzed videos of the Finger Tapping test, a component of the MDS-UPDRS, from 24 healthy controls and 66 PD patients using ML algorithms for hand pose estimation. We computed multiple movement features related to bradykinesia from videos and employed a novel tiered classification approach to predict disease severity that employed different features according to severity. We compared our video-based disease severity prediction approach against other approaches recently introduced in the literature. RESULTS: Traditional kinematics features such as amplitude and velocity changed linearly with disease severity, while other non-traditional features displayed non-linear trends. The proposed disease severity prediction approach demonstrated superior accuracy in detecting PD and distinguishing between different levels of disease severity when compared to existing approaches.

Evaluation of digit ratio (2D:4D) in breast cancer patients.

Breast cancer is a hormone-dependent cancer. Hormonal exposure begins in the intrauterine period and continues in later years of life. 2D:4D ratio is accepted as an indicator of this exposure. The aim of this study was to investigate whether there is a difference in 2D:4D ratio between pathological subgroups of breast cancer and healthy control group. In this study, 204 participants, 154 breast cancer patients and 50 healthy control volunteers with similar age distribution, were included. Both hands of all participants were scanned using a digital scanner. The second and fourth finger lengths were measured using a digital measuring ruler with an accuracy of 0.05 mm. The 2D:4D ratio was calculated as the length of the second finger divided by the length of the fourth finger. A total of 204 patients (55 triple negative, 52 luminal B, 33 luminal A, 14 HER2-overexpessing and 50 healthy control volunteers) were subjected to finger scanning. There was no statistically significant difference in mean age between the groups. The right hand 2D:4D ratio was significantly lower in the Luminal A group compared to the other groups (p < 0.048). Although prenatal hormonal exposure is accepted as a risk factor for breast cancer, no study has evaluated patients in pathological subgroups. The 2D:4D ratio may be associated with breast cancer especially in the luminal A group in which hormone receptors are strongly positive and which has a better prognosis compared to the other groups.

Hebbian priming of human motor learning.

Motor learning relies on experience-dependent plasticity in relevant neural circuits. In four experiments, we provide initial evidence and a double-blinded, sham-controlled replication (Experiment I-II) demonstrating that motor learning involving ballistic index finger movements is improved by preceding paired corticospinal-motoneuronal stimulation (PCMS), a human model for exogenous induction of spike-timing-dependent plasticity. Behavioral effects of PCMS targeting corticomotoneuronal (CM) synapses are order- and timing-specific and partially bidirectional (Experiment III). PCMS with a 2 ms inter-arrival interval at CM-synapses enhances learning and increases corticospinal excitability compared to control protocols. Unpaired stimulations did not increase corticospinal excitability (Experiment IV). Our findings demonstrate that non-invasively induced plasticity interacts positively with experience-dependent plasticity to promote motor learning. The effects of PCMS on motor learning approximate Hebbian learning rules, while the effects on corticospinal excitability demonstrate timing-specificity but not bidirectionality. These findings offer a mechanistic rationale to enhance motor practice effects by priming sensorimotor training with individualized PCMS.

Time-domain diffuse optical imaging technique for monitoring rheumatoid arthritis disease activity: experimental validation in tissue-mimicking finger phantoms.

Objective.Effective treatment within 3-5 months of disease onset significantly improves rheumatoid arthritis (RA) prognosis. Nevertheless, 30% of RA patients fail their first treatment, and it takes 3-6 months to identify failure with current monitoring techniques. Time-domain diffuse optical imaging (TD-DOI) may be more sensitive to RA disease activity and could be used to detect treatment failure. In this report, we present the development of a TD-DOI hand imaging system and validate its ability to measure simulated changes in RA disease activity using tissue-mimicking finger phantoms.Approach.A TD-DOI system was built, based on a single-pixel camera architecture, and used to image solid phantoms which mimicked a proximal interphalangeal finger joint. For reference,in silicoimages of virtual models of the solid phantoms were also generated using Monte Carlo simulations. Spatiotemporal Fourier components were extracted from both simulated and experimental images, and their ability to distinguish between phantoms representing different RA disease activity was quantified.Main results.Many spatiotemporal Fourier components extracted from TD-DOI images could clearly distinguish between phantoms representing different states of RA disease activity.Significance.A TD-DOI system was built and validated using finger-mimicking solid phantoms. The findings suggest that the system could be used to monitor RA disease activity. This single-pixel TD-DOI system could be used to acquire longitudinal measures of RA disease activity to detect early treatment failure.