4th Digit Research Articles

Ensuring data quality and maximizing efficiency in coding agricultural and forestry injuries: Lessons to improve occupational injury surveillance

Introduction: Specialized occupational injury surveillance systems are filling the gap in the undercount of work-related injuries in industries such as agriculture and forestry. To ensure data quality and maximize efficiency in the operation of a regional occupational injury surveillance system, the need for continued dual coding of occupational injury records was assessed. Methods: Kappa scores and percent agreement were used to compare interrater reliability for assigned variables in 1,259 agricultural and forestry injuries identified in pre-hospital care reports. The variables used for the comparison included type of event, source of injury, nature of injury, part of body, injury location, intentionality, and farm and agriculture injury classification (FAIC). Results: Kappa (κ) ranged from 0.2605 for secondary source to 0.8494 for event and exposure. Individual coder accuracy ranged from medium to high levels of agreement. Agreement beyond the first digit of OIICS coding was measured in percent agreement, and type of event or exposure, body part, and primary source of injury continued to meet levels of accord reaching 70% or greater agreement between all coders and the final choice, even to the most detailed 4th digit of OIICS. Conclusions: This research supports evidence-based decision making in customizing an occupational injury surveillance system, ultimately making it less costly while maintaining data quality. We foresee these methods being applicable to any surveillance system where visual inspection and human decisions are levied. Practical Applications: Assessing the rigor of occupational injury record coding provides critical information to tailor surveillance protocols, especially those targeted to make the system less costly. System administrators should consider evaluating the quality of coding, especially when dealing with free-text narratives before deciding on single coder protocols. Further, quality checks should remain a part of the system going forward.

The applicability of the digit wrinkle scan to quantify sympathetic nerve function

ObjectiveStimulated skin wrinkling test (SSW) has been launched as a non-invasive diagnostic procedure. However, no normative age dependent values have been reported that can be applied in clinical practice. The objectives of the study were to (1) collect age-dependent normative values according to the 5-point scale assessment for the SSW, to (2) determine reliability scores for the obtained norm values, and to (3) introduce a new digital method for SSW assessment, the Digit Wrinkle Scan© (DWS©) for detection of wrinkles in a more quantitative manner. MethodsFirstly, 82 healthy participants were included, divided in 5 age groups. The participants underwent SSW using lidocaine and prilocaine topical cream. Secondly, 35 healthy participants were included to test whether the DWS© could be a novel manner to assess the grade of wrinkling quantitatively. We determined the inter-observer reliability of both methods. Also, the intra-observer reliability was calculated for the DWS©. ResultsWe found a decrease in normative values over age. The inter-observer reliability of assessment by the 5-point scale method was moderate after SSW (Cohen’s k: 0.53). Results of the DWS© indicate that total wrinkle length per mm2 showed moderate to good agreement for the 4th and 5th digits after SSW, and a low agreement for the other digits. ConclusionsAge-dependent normative values were obtained according to the 5-point scale, but its clinical application is doubtful since we found a moderate inter-observer reliability. We introduced the DWS© as a possible new method in order to quantify the grade of wrinkling. SignificanceWe found unsatisfactory reliability scores, which hampers its usefulness for clinical practice.

Assessment Of 2D:4D ratios amongst federal polytechnic Ekowe students, Bayelsa State, Nigeria

Humans, primates, birds and reptiles have demonstrated sexually dimorphism in the length of their 2nd and 4th digits otherwise known as 2D:4D, with males on the average having lower values than females. This difference has been associated with the differential exposure of prenatal testosterone relative to estrogen during intrauterine life. This present study assesses the 2d:4d ratio amongst students of the federal Polytechnic Ekowe, Bayelsa state of Nigeria. A total of 299 students (males n=150 and females n=149) participated in the study. The length of 2nd and 4th digits were measured with digital Vernier caliper from the basal crease to the tip of the finger, and 2nd digit length (2D) was divided by 4th digit (4D) to obtain 2D:4D ratio. The results of this study showed no significant difference between 2D right and left and 4D right and left for same sex (0.98±0.04 and 0.98±0.04 for males and 0.96±0.05 and 0.96±0.05 for female). Sexual dimorphism exits between sexes which is an indication that prenatal hormones have played a fundamental role on humans, during developmental stages.

Spontaneous sacral fracture with associated acrometastasis of the hand

Background: Acrometastases, secondary tumors affecting oncological patients with systemic metastases, are associated with a poor prognosis. In rare cases, acrometastases may precede establishing the primary tumor diagnosis.Case Description: A 72-year-old female heavy smoker presented with low back pain, and right lower extremity sciatica/radiculopathy. X-rays, CT, MR, and PET-CT scans documented primary lung cancer with multi-organ metastases and accompanying pathological fractures involving the sacrum (S1) and right 4th digit. She underwent a S1 laminectomy and amputation of the distal phalanx of the right fourth finger. The histological examination documented a poorly differentiated pulmonary adenocarcinoma infiltrating bone and soft tissues in the respective locations. The patient was treated with a course of systemic immunotherapy (i.e. pembrolizumab). At 6-month follow-up, the patient is doing well and can stand and walk without pain.Conclusion: Spontaneous sacral fractures may be readily misdiagnosed as osteoporotic and/or traumatic lesions. However, in this case, the additional simultaneous presence of a lytic finger lesion raised the suspicion that these were both metastatic tumors. Such acrometastases, as in this case attributed to a lung primary, may indeed involve the spine.

Better understanding of the labour market using Big Data

Motivation: As the result of digitalisation of the economy, the number of Internet users is increasing, which leads to an increase in the number of vacancies posted on online platforms and services. The description of vacancies includes information about skills and competencies, which is the source of additional data for the labour market analysis. This information cannot be received through the analysis of statistical and administrative data. Therefore, it is important: — to learn how to evaluate new information sources, and use the data they generate; — to develop tools that people and organizations will use for finding an employee or a vacant post. The study focuses on the analysis and forecast of labour demand in the context of skills and competencies, which significantly enriches and adds to the information about the labour market and facilitates effective decision-making.
 Aim: The main goals of this article are the following: (1) identification of the methodological approaches in the labour market analyses using Big Data; (2) assessment of the labour demand and labour supply in the context of skills and competencies listed in the vacancy description posted on job portals; and (3) determination of the matches (mismatches) between skills and competencies in order to help the companies and individuals get better employment and education. Empirical data used in the research were collected from the description of job vacancies (16 401 vacancies) and CVs (227 215 CVs) from the most popular open job portals in Belarus through the scraping approach and classified according to the ESCO and ISCO codes. Quantitative analysis by the means of artificial intelligence was used in the research.
 Results: The study results revealed that the information about the volume and structure of skills and competencies obtained by scraping data from vacancy descriptions and Cvs, which are posted on online portals, allows for more precise diagnostics of labour demand and supply and overcoming of bilateral information asymmetry in the labour market. Based on the analysis, the parameters of scarcity and excess in competencies for individual occupations in the labour market are determined (the level of the correlation ratio between applicants’ competencies and those requested by employers in the context of occupations (four digits according to the ISCO classification) is less 0.8; the deviation of the ranks of competencies listed in CVs and vacancy descriptions according to the ESCO groups of skills/competencies and a sign of revealed deviations). The methodology is developed to set areas for necessary knowledge acquisition (by the analysis of competencies listed in CVs and vacancy descriptions at the 3rd and 4th digit level of ISCED classification) and skills (by the analysis of competencies at the 2nd digit level in ESCO groups). The paper illustrates limitations in using Big Data as an empirical database and explains the measures to eliminate those limitations.

The relationship between the digit ratio (2D:4D) and vertical jump performance in young athletes.

Digit ratio (2D:4D), a putative marker of prenatal testosterone, is a negative correlate of sports, athletic, and fitness performance. To describe the relationship between 2D:4D and vertical jump performance in athletes. Sixty-one Division I American Football players from a Midwestern U.S. university had their 2D:4D measured digitally and their vertical jump performance measured using jump mechanography. The primary outcome was jump height, with secondary outcomes depicting jump execution also recorded. Linear relationships between 2D:4D and vertical jump performance were quantified using partial correlations adjusted for age, height, mass, and ethnicity. 2D:4D was a statistically significant weak negative correlate of jump height (partial r [95% confidence interval]: -0.26 [-0.48, -0.01]), indicating that athletes with lower 2D:4Ds (i.e., relatively longer 4th digits) jumped higher. Relationships with jump execution variables were negligible to weak and negative, but not statistically significant. The significant relationship between 2D:4D and jump height probably reflects both the long-term organizational and short-term activational benefits of testosterone. Therefore, 2D:4D may be a useful indicator of explosive strength among young athletes.

Pseudoulnar Palsy Due to Ischemic Stroke; Case Report

Isolated motor nerve paresis can occur due to central nervous system lesions. This condition is extremely rare, they are often misdiagnosed as a peripheral nerve lesion. 83-year-old male, applied to our hospital with 4th and 5th digit weakness. Neuroimaging revealed cortical-subcortical diffusion restriction in the medial gyrus of the precentral gyrus. The patient was diagnosed as ischemic stroke. In this article, we presented a case of ischemic stroke that mimics ulnar nerve paresis and be easily overlooked.

Acro-osteolysis in Hajdu Cheney syndrome: A case report with review of literature

Objectives: We present a case report and review the literature on Hajdu Cheney syndrome (HCS), an extremely rare connective tissue disorder with <100 cases reported in the last 72 years. We have emphasized on the patterns of acro-osteolysis (acrosteolysis) in the literature review to conclude if the syndrome follows any particular pattern like in our case. Material and Methods: All major databases were searched for all cases of HCS. One hundred and eighty-eight hand radiographs were analyzed and detailed analysis of all digits was carried out with emphasis on the pattern of acrosteolysis. Results: Acrosteolysis may not be a mandatory association in HCS as 18.8% did not have acrosteolysis at all. The first finger to be involved in 90/96 (93.7%) of the cases was the index finger, followed by the middle finger and then the thumb. The 4th digit (ring finger) was involved in only 11/96 (11.4%) of the cases, of which 9/11 (81.8%) were above the age of 25. Incidence of acrosteolysis of the 4th digit when in comparison to all other finger has a P < 0.05 and a P < 0.001 with the index finger. Newborn with HCS evaluated for acrosteolysis at birth was negative. Conclusion: There was statistical evidence to conclude that in a majority of the cases the 4th digit was involved the least. A rough timeline of the onset and progression of acrosteolysis was made. An attempt was made to shed light on the possible lesser-known manifestations of the syndrome such as retroflexed odontoid, Arnold Chiari I, middle phalanx osteolysis, and first carpometacarpal joint osteolysis. As very little is known about the disease and awareness about it is pertinent for early management and to differentiate it from other less-lethal causes of acrosteolysis.

Hypercalcemia: An Ominous sign of Malignancy

Hypercalcemia is a disorder commonly encountered by primary care physicians. The diagnosis often is made incidentally in asymptomatic patients Clinical manifestations affect the neuromuscular, gastrointestinal, renal, skeletal, and cardiovascular systems. 90% of cases of hypercalcemia are due to primary hyperparathyroidism and malignancy. This article highlights the importance of proper work-up of elevated serum calcium levels and complications that can arise from failure to do so. This is a case report of a 63-year-old female who was found to have asymptomatic hypercalcemia of 10.5 mg/dl but was lost to follow up and presented four years later to her primary care physician with complaints of pain in the neck and weakness in bilateral shoulders, arms, wrists, and numbness of 4th and 5th digits. MRI revealed lytic lesions on the cervical and thoracic spine with compression deformity likely due to metastatic breast cancer. Lab reports revealed a serum calcium level of 12.1mg/dl and the patient’s chart (mammogram/ breast US) confirmed malignant breast cancer.

Morphological divergence, tail loss, and predation risk in urban lizards

Urbanisation changes the structure of natural habitats and alters trophic interactions, pressuring urban species to adjust and adapt. Unlike behavioural shifts that tend to be more flexible, morphological characteristics in vertebrates are less plastic and changes may come at a greater cost. We explored the hypothesis that morphological characteristics in a tropical agamid lizard Psammophilus dorsalis are not only selected to suit altered habitat conditions in urbanised areas but reflect predation risk in urban habitats. In addition, we explored differences in tail loss in both sexes from urban and rural habitats. First, we find that predation risk did not differ between urban and rural habitats, but differed between sexes. Conspicuous courtship-coloured male lizards were more likely to be attacked compared to cryptically-coloured female lizards. Next, we find that P. dorsalis differed in key morphological characteristics, with greater urban-rural differences in males than females. Urban lizards had shorter proximal limb elements, longer 4th digits and greater body mass than rural lizards; and among males, urban lizards had significantly larger head sizes and longer distal limb elements than rural lizards. Finally, we find that the rates of tail loss differed between habitats and sexes, with urban male lizards having greater rates of tail loss than rural males and all females. Inter-sexual difference in tail loss was consistent with the difference in predation risk between sexes, but tail loss differences between urban and rural habitats could not be explained by predation risk. In sum, we find that adaptations to novel urban environments are not exclusively driven by a single promoter (e.g. predation risk) but are influenced by multiple selection pressures with associated fitness costs, such as tail loss.

Effect of hyperdry amniotic membrane in preventing tendon adhesion in a rabbit model

BackgroundNo anti-adhesive materials are currently in clinical use for orthopaedic surgery. We developed a hyperdry amniotic membrane (HD-AM) for easy storage and transplantation as amniotic membrane. The purpose of this study was to examine the application of HD-AM to reduce peritendinous adhesions without impairing tendon healing. MethodsWe randomly divided 3 digits (2nd, 3rd, and 4th digits) from each rabbit into three groups: a tendon repair group; a tendon repair with HD-AM group (HD-AM group); and a control group (cast only). The effects of HD-AM on peritendinous adhesions and tendon healing were examined using microscopic, histological, and mechanical analyses in a rabbit flexor digitorum profundus tendon model. ResultsAdhesions on macroscopic evaluation of the tendon repair site were significantly smaller in the HD-AM group than in the tendon repair group. Little adhesion formation or foreign body reactions were seen by on histologic evaluation in the HD-AM group. Range of motion following tendon repair was significantly better in the HD-AM group than in the tendon repair group. Maximal tensile strength required to pull the tendon from the site of adhesion was significantly smaller in the HD-AM group than in the tendon repair group. As for tendon repair site, no significant difference was seen between the tendon repair and HD-AM groups. ConclusionsHD-AM prevented peritendinous adhesion macroscopically, pathologically, and mechanically without impairing the sutured tendon. HD-AM has already been clinically applied in neurosurgery, ophthalmology, and otolaryngology, and clinical application as an anti-adhesive materials may be achieved in the future.

AB010. Keloidal scleroderma with isolated intertriginous involvement

A 33-year-old African-American female with scleroderma, Raynaud phenomenon, and possible systemic lupus erythematosus (SLE) presented to dermatology clinic for evaluation of a 1-year history of slowly growing plaques in her bilateral axillae and inguinal region. The patient was initially diagnosed with scleroderma approximately five years prior to presentation following the onset of sclerodactyly, arthralgias, myalgias, and severe obstructive lung disease. Two years prior to presentation, she was started on monthly intravenous immunoglobulin infusions. Her other medications included hydroxychloroquine, mycophenolic acid, cilostazol, and amlodipine. One year ago, she began developing leathery, firm, dark plaques underneath both armpits. The plaques slowly enlarged and new plaques began forming in her inguinal region. They were nonpruritic but mildly tender. On exam, the patient had well-demarcated, linear, hyperpigmented, indurated plaques that coalesced in her bilateral axillae, bilateral inguinal folds, and bilateral peri-inguinal region with no evident secondary scale or crust. She also had sclerodactyly of the digits of her bilateral hands and blue-white discoloration of her 4th digit of the right hand. A 4 mm punch biopsy was performed from her left axilla and was consistent with keloidal morphea/scleroderma. Keloidal scleroderma, also known as nodular scleroderma, is a rare manifestation of systemic sclerosis that is usually characterized by innumerable nodules or keloidal plaques on the trunk. We present a case of isolated intertriginous keloidal scleroderma, an exceedingly uncommon distribution for this condition. A recent literature review of nodular scleroderma by Kassira et al. revealed only one reported case with lesions in intertriginous areas. Given the rarity of the diagnosis, our knowledge of efficacious treatment options remains limited. Possible options for treatment include methotrexate, ultraviolet A light therapy, and narrow-band ultraviolet B light therapy. Teaching point: the patient’s biopsy-proven isolated intertriginous keloidal scleroderma represents an uncommon clinical presentation for an already rare variant of systemic sclerosis.

Brain structure and clinical profile point to neurodevelopmental factors involved in pedophilic disorder.

ObjectivePedophilic disorder (PD) is characterized bypersistent, intense sexual attraction to prepubertal children that the individual has acted on, or causes marked distress or interpersonal difficulty. Although prior research suggests that PD has neurodevelopmental underpinnings, the evidence remains sparse. To aid the understanding of etiology and treatment development, we quantified neurobiological and clinical correlates of PD.MethodWe compared 55 self‐referred, help‐seeking, non‐forensic male patients with DSM‐5 PD with 57 age‐matched, healthy male controls (HC) on clinical, neuropsychological, and structural brain imaging measures (cortical thickness and surface area, subcortical and white matter volumes). Structural brain measures were related to markers for aberrant neurodevelopment including IQ, and the 2nd to 4th digit ratio (2D:4D).ResultsPD was associated with psychiatric disorder comorbidity and ADHD and autism spectrum disorder symptoms. PD patients had lower total IQ than HC. PD individuals exhibited cortical surface area abnormalities in regions belonging to the brain's default mode network and showed abnormal volume of white matter underlying those regions. PD subjects had smaller hippocampi and nuclei accumbens than HC. Findings were not related to history of child‐related sexual offending. IQ correlated negatively with global expression of PD‐related brain features and 2D:4D correlated with surface area in PD.ConclusionsIn the largest single‐center study to date, we delineate psychiatric comorbidity, neurobiological and cognitive correlates of PD. Our morphometric findings, their associations with markers of aberrant neurodevelopment, and psychiatric comorbidities suggest that neurodevelopmental mechanisms are involved in PD. The findings may need consideration in future development of clinical management of PD patients.

Congenital Right Hand Syndactyly in a child: Plain Radiographic Features and Case Report

Syndactyly is a Greek word meaning fused digits, may involve fusion of the soft tissues with or without bony fusion. It is regarded as the most common congenital defect of the hand, detected in 1 out of every 2000 live births, twice as common in males, and more among the Caucasians. This is a 10-month-old male infant that was referred for plain radiograph of the right hand on account of completely fused 2nd to 5th digits and an incompletely fused 1st digit with medial deviation since birth. The plain radiograph showed soft tissue fusion of the 2nd to 4th web spaces completely with a partially fused 1st web space. There is associated fusion of the distal phalanges of the 4th and 5th digit, foreshortening of the 3rd and 4th metacarpals with the middle phalanges of the 2nd and 5th digits. There is flexion of the interphalangeal joint and medial deviation of the 1st digit. There is also haphazard arrangement of the metacarpals and phalanges most especially the 3rd and 4th digits. Prominence of the thenar and hypothenar eminences with mild ulnar deviation of the entire right hand were also demonstrated. The contralateral left hand appears within normal limits, a complementary ultrasound showed normal abdominal organ situs. A diagnosis of congenital syndactyly most likely the complex-complicated form in a 10-month-old infant was established. The surgical repair to establish function and achieve excellent aesthetics was deferred until the child clocks about 24-months of age. We report a case of congenital syndactyly of the right hand due to its radiographic form of presentation in this 10-month-old infant.

Upper extremity injuries in the victims of intimate partner violence.

ObjectivesTo recognize most common patterns of upper extremity (UE) injuries in victims of Intimate Partner Violence (IPV).MethodsRadiological review of 308 patients who reported physical IPV at our institution from January 2013 to June 2018, identified 55 patients with 88 unique UE injuries. Demographic data and injury patterns and associations were collected from the electronic medical records.ResultsThe cohort included 49 females and 6 males (age 19–63, mean 38). At the time of injury, IPV was reported in 15/88 (17%) and IPV screening was documented for 22/88 (25%) injuries. There were 46 fractures, 8 dislocations or subluxations, and 34 isolated soft tissue injuries, most commonly involving the hand (56/88). Fractures most commonly involved the fingers (21/46, 46%) and the 5th digit (8/27, 30%). Medial UE fractures (5th digit, 4th digit) constituted 44% of hand and finger fractures (12/27) and 26% of all fractures (12/46). Comminuted and displaced fractures were rare (8/46, 17%). Head and face injuries were the most common concomitant injuries (9/22, 41%) and subsequent injuries (21/61, 35%). Of 12 patients with recurrent UE injuries, 6 had recurrent injuries of the same hand. Five of 6 non-acute fractures (83%) were of the hand.ConclusionsHand and finger injuries are the most common UE injuries in patients with IPV, with finger being the most common site and medial hand the most common region of fracture. Repeated injuries involving the same site and a combination of medial hand and head or face injuries could indicate IPV.Key Points • Upper extremity injuries in victims of intimate partner violence are most commonly seen in the hand and fingers. • Fingers are the most common site of fracture and the medial hand is the most common region of fracture in the upper extremity in victims of intimate partner violence. • In intimate partner violence victims with upper extremity injuries, concomitant injuries and subsequent injuries are most commonly seen in the head and neck region.

Correlation between Second and Fourth Digit Length Ratio with Height, Body Mass Index and Axial Length of Eyeball in Adult Population of Burdwan, West Bengal, India

Introduction: Studies are being conducted to correlate second (2D) to fourth digit (4D) length ratio as an anthropometric marker of prenatal sex steroid exposure with human body. As 2nd digit: 4th digit(2D:4D)ratio is an anthropometric window into the interplay of sex hormones in-utero, this tool may be tested to note if there is any correlation between the sexual dimorphism of axial length and the Digit length ratio. Aim: To find a correlation between digit length ratio (2D:4D) with physical parameters like height, BMI and axial length of eyeball in the adult population of South Bengal presenting in a tertiary care hospital, in Burdwan, West Bengal, India. Materials and Methods: A cross-sectional study with simple random sampling was conducted on 500 patients (age ≥20 years) from March 2016 to February 2017 in the Departments of Anatomy and Ophthalmology Out Patients Department (OPD) of a tertiary care Hospital and Medical College in West Bengal, India. Height, weight, axial length of eyeball were measured and the BMI was computed for the study population. Statistical analysis was done with Statistical Package for Social Sciences(SPSS) version 16.0. Unpaired t-test was used for determining possible group differences in 2D:4D length ratios. Pearson’s correlation coefficients were used to find a correlation between second and fourth digit length ratio (2D:4D) with height, BMI and axial length of eyeball in the study population. The p-value <0.05 was considered significant. Results: The study included 280 males and 220 females with a minimum age above 20 years and most of the patients belonged to the age group of 50-69 years. A 2D:4D length ratio was significantly lower in males compared to females (For Right hand t=34.91, p<0.001, and for left hand t=14.30, p<0.001). Correlation analysis of 2D:4D length ratio of right and left hands with height of males revealed significant negative correlation (Right hand: r=-0.679, p<0.001; Left hand: r=-0.0463, p<0.001). In females, the result was positively significant for both hands (Right hand: r=0.313, p<0.05; left hand: r=0.21, p<0.05). A 2D:4D length ratio and BMI of males showed significant positive correlation for both Right hand (r=0.18, p<0.05) as well as for the left hand (r=0.137 p<0.05). In case of females, however 2D:4D ratio and BMI showed weakly negative correlation for both hands but the values were not significant. Correlation of 2D:4D length ratio of right and left hands on axial length of eyeball in males revealed significant negative correlation (right hand: r=-0.706, p<0.001; left hand: r=-0.25, p<0.05) but in females, there was significant positive correlation for the right hand (r=0.145, p <0.05*) and positive but non-significant correlation for the left hand at 95% CI (r=0.087, p>0.05) Conclusion: In this study, we have tried to establish that 2D:4D ratio (which is significantly higher in females) can be used as a putative non-invasive anthropometric marker to differentiate between males and females, which presumably is prenatally determined by in-utero sex steroid hormone exposure. By correlation studies, we have also tried to prove that this parameter correlates well with other anthropometric measurements like height, BMI and ocular axial length which are already known to be significantly different in males and females

A variation: An extra tendon of extensor digitorum in between fourth and fifth digit in left hand

Introduction: Tendon variation of Extensor Digitorum muscle was observed in a 48yr old male formalin fixed cadaver, during the dissection at Anatomy Dissection hall. The tendons of Extensor Digitorum muscle shows anatomical variation most often and its knowledge is important to assess the diseased and traumatized hand. Incidences have shown that tendons of ED may be variably deficient but more often they are doubled or even tripled in one or more digits. The incidences of doubling are higher in index finger or in the middle finger. Very rarely a slip of tendon passes to the thumb. Methods: Regular dissection at Anatomy Dissection Hall. Result & Conclusion: In this present case in left forearm, the origin of muscle was normal but its tendon divides into five proximal to wrist which pass through a common synovial sheath deep to the Extensor Retinaculum. The extra tendon is in between 4th and 5th digit. The right forearm does not show any anatomical variation. This type of variation is rarely found. This particular variation is important for clinical perspective. This case study is useful for surgeons performing Tendon Graft Operations or Tenoplasty.

Assessment of 2D:4D ratio for the early diagnosis of caries and malocclusion in 7-15-year-old children

Background: The ratio between 2nd and 4th digit length is termed as hormonal fingerprintand is used as an indirect marker in many medical diseases.Dental studies pertaining to theimportance of hormonal fingerprint on oral health are very sparse.
 Aim and objectives: Tostudy the correlation of dental caries and malocclusion with hormonal fingerprints.
 Materialsand Methods: A total of 100 children of age group 7-15 years and both genders were randomlyselected and included in the present study. The hormonal fingerprint (2D:4D ratio) wasdone bymeasuring the length ratio of the index and ring finger with the help of digital vernier caliper.Caries assessment wascarried out using standard mouth mirrors and Community PeriodontalIndex probes. WHO assessment form (1997) was followed for assessment of dentitionstatus and treatment need.Occlusal characteristics evaluated were molar relation, anteriorand posterior crossbite, open bite, deep bite and lower anterior crowding. The subjects weredivided into high 2D:4D, equal 2D:4D digit ratio and low 2D:4D. All the measurements weredone by two investigators. The data collected were tabulated and statistically analyzed usingChi-square and ANOVA test.
 Results: Out of 100 children, 34% were males and 66% werefemales. Most of the participants were 7-8 years old (12 males and 15 females). Majority of theparticipants (87% for the right hand and 80% for left hand) had low 2D:4D ratio, only 6% forright and 11% for the left hand had high 2D:4D ratio and the remaining had equal 2D:4D ratio.Statistically insignificantcorrelation between 2D:4D ratio and deft/DMFT score and occlusalstatus of an individualwere found.
 Conclusion:The insignificant results of 2D:4D ratio with allthe parameters assessed validates that hormonal fingerprints could not be employed as an earlypredictor of caries and malocclusion in an individual.
 Bangladesh Journal of Medical Science Vol.20(1) 2021 p.154-158

Relationship between ratio of 2nd and 4th digit lengths (2D:4D) and malocclusion in 13-15-years-old children: a case study at Unismuh Junior High School, Makassar

Background: Malocclusion is a condition that is not in accordance with the process of growth and development that can be seen with the disharmony of the relationship between the teeth, relationship of jaw arches, face and overall. The 2D:4D ratio can be corelated with hormones that have a role in growth.Therefore, ratio 2D:4D can be used as an early marker of disease, intelligence, reproductive ability and probability of jaw growth patterns. Objective: To know the relationship between the ratio of second and fourth digit lengths (2D:4D) and the types of malocclusion on the students of Unismuh Junior HighSchool. Method: This observational descriptive study with purposive sampling was performed on students aged 13-15 years old with total sample 100 people.Malocclusion examination was conducted to identify the types of Angle and Dewey malocclusion. A digital vernier caliper was used to measure a ratio between2D and 4D. The data were analyzed using chi-square test. Result: 96 people had Class 1 (2D<4D=77, 2D>4D=19), 4 people had Class 2 (2D>4D=3, 2D<4D=1), Class 1 type 1 of 34 people (2D< 4D=29, 2D>4D=5), Class 1 type 2 of 3 people (2D<4D=2, 2D>4D=1) and Class 1 type 6 of 16 people (2D<4D=12,2D>4D=4). Conclusion: There was no relationship between the ratio 2D:4D with the types of Angle and Dewey malocclusion.

Robust least squares for quantized data matrices

In this paper we formulate and solve a robust least squares problem for a system of linear equations subject to quantization error in the data matrix. Ordinary least squares fails to consider uncertainty in the operator, modeling all noise in the observed signal. Total least squares accounts for uncertainty in the data matrix, but necessarily increases the condition number of the operator compared to ordinary least squares. Tikhonov regularization or ridge regression is frequently employed to combat ill-conditioning, but requires parameter tuning which presents a host of challenges and places strong assumptions on parameter prior distributions. The proposed method also requires selection of a parameter, but it can be chosen in a natural way, e.g., a matrix rounded to the 4th digit uses an uncertainty bounding parameter of 0.5 × 10−4. We show here that our robust method is theoretically appropriate, tractable, and performs favorably against ordinary and total least squares.