Cold Hands Research Articles

Gender differences in skilled performance under failure competitive environments: evidence from elite archers.

Psychologists are particularly interested in how people operate in stressful settings. The sporting arena is a "natural laboratory" for studying how people behave and perform in high-pressure situations. This study explores the gender differences in archers' ability to cope with adversity, highlighting the significant cold-hand effect observed in both male and female archers, with notable differences in the last arrow performance under pressure. Our method is a Poisson general linear model -based test for the cold hand that examines how the performance of the last arrow per set depends on the performance of the previous two shots. We also interact the player's gender with performance on the previous two arrows and game status to test for gender differences in response to past performance and intermediate game status. The Poisson regression analysis reveals that male and female archers' performance dropped significantly after experiencing two consecutive missing bullseyes, which means a cold-hand effect exists. However, although there was no significant difference in the performance of male and female archers on the third arrow, female archers have significantly lower last arrow per set scores than male archers after near poor performance or being in a situation where losing can only be avoided by winning the current set. This finding suggests that female archers are more vulnerable to the potentially negative effects of adversity caused by trailing or recent failures than their male counterparts. We attempt to explain the reasons behind the results above from both psychological and physiological perspectives.

Study on hand disinfection in inpatient geriatric care on the superiority of cold plasma aerosol versus alcohol-based disinfection methods in a parallel group design

The introduction of fundamental hygiene protocols within the healthcare sector during the nineteenth century led to a significant reduction in mortality rates. Contemporary advancements, such as alcohol-based sanitizers, have further enhanced hand hygiene practices. However, these measures are often overlooked in nursing facilities, resulting in low staff compliance rates and increased cross-infection rates. Novel approaches, such as cold plasma hand disinfection, present promising alternatives due to their minimal skin damage and economic benefits. This study aims to compare the disinfectant efficacy of cold plasma aerosol under practical application conditions with an alcoholic hand disinfectant listed by the Association for Applied Hygiene. The microbial count on participants’ hands was measured, with particular attention paid to the spontaneous occurrence of fecal indicators and the presence of potentially infectious bacteria. A t-test for independent samples was conducted to determine whether there was a significant difference between the two cohorts regarding the research question. Statistical analysis revealed that the mean log colony-forming unit (CFU) values were significantly lower in the test cohort using only the cold plasma method for hand disinfection compared to the cohort using conventional alcohol-based hand disinfection. Moreover, it was demonstrated that, unlike alcohol-based hand disinfection, cold plasma application ensures the effective elimination of Staphylococcus aureus. The findings indicate that staff utilizing plasma disinfection have an average bacterial count that is 0.65 log units lower than those who regularly use alcohol-based hand disinfection. In addition to the efficacy of cold plasma disinfection, its superiority over alcohol-based hand disinfection was also established. Beyond offering economic and logistical advantages, cold plasma disinfection provides additional health benefits as it does not induce skin damage, unlike alcohol-based hand disinfection.

Prevalence and Factors Related to High Risk of Multiple Chemical Sensitivity among Japanese High School Students.

Multiple chemical sensitivity (MCS) onset in minors can greatly impact learning and future employment. This study investigated the prevalence of MCS and related factors in high school students to determine whether it was the same as in adults. A comprehensive survey was conducted on 80 high schools in Gunma Prefecture, Japan. The survey incorporated the Quick Environmental Exposure and Sensitivity Inventory, as well as items related to allergies, the living environment, and lifestyle. Of the 4630 students analyzed, according to Hojo's cut-off value, 9.0% were classified as high-risk for MCS and 77.9% reported some allergy-like symptoms. Significant factors associated with elevated MCS risk included female sex, having various allergic conditions, having experienced living in a new home or home renovations or extensions, proximity to environmental stressors (freeways, national highway, factories, rubbish dumps, or sources of offensive odors), insufficient physical activity (exercising less than once a week outside of physical education classes), having cold hands and feet, being fatigued, having a bedtime earlier than 11 p.m., and having moderate-frequent subjective stress. Overall, 9.0% of high school students in Japan are at high risk for MCS. Enhancing awareness of MCS-like symptoms and addressing allergies, living environments, and lifestyle habits may mitigate these symptoms.

Current Status and Challenges of the Evidence for Cupping Therapy in Clinical Practice Guidelines in Korea

Clinical practice guidelines (CPGs) published in Korea were reviewed to evaluate up-to-date evidence and the recommendations for cupping therapy (CT) to inform clinicians and researchers for future studies. There were 14 CPGs (allergic rhinitis, ankle sprain, cervical pain, chronic low back pain, cold hands and feet, facial nerve palsy, Hwabyung, knee osteoarthritis, lumbar herniated intervertebral disk, migraine, osteoporosis, postoperative syndrome, shoulder pain, and traffic accident injury) with 29 recommendations for CT determined from “low” to “moderate” rated evidence. The levels of evidence were mostly downgraded due to the risk of bias and imprecision. The majority of recommendations for CT were graded as B or C. This comprehensive analysis underscores the imperative need for robust clinical research, including randomized controlled trials and observational studies using real-world data to enhance the quality of the evidence for CT. In addition, recommendations providing definite phases or scope of the target conditions/diseases and treatment regimens should be employed. This work lays a foundational step towards integrating CT into evidence-based clinical practice, emphasizing strategic directions for future research to bridge the gap between evidence and practice.

Identification of important symptoms and diagnostic hypothyroidism patients using machine learning algorithms

Background: Hypothyroidism is one of the most common endocrine diseases. It is, however, usually challenging for physicians to diagnose due to nonspecific symptoms. The usual procedure for diagnosis of Hypothyroidism is a blood test. In recent years, machine learning algorithms have proved to be powerful tools in medicine due to their diagnostic accuracy. In this study, the authors aim to predict and identify the most important symptoms of Hypothyroidism using machine learning algorithms. Method: In this cross-sectional, single-center study, 1296 individuals who visited an endocrinologist for the first time with symptoms of Hypothyroidism were studied, 676 of whom were identified as patients through thyroid-stimulating hormone testing. The outcome was binary (with Hypothyroidism /without Hypothyroidism). In a comparative analysis, random forest, decision tree, and logistic regression methods were used to diagnose primary Hypothyroidism. Results: Symptoms such as tiredness, unusual cold feeling, yellow skin (jaundice), cold hands and feet, numbness of hands, loss of appetite, and weight Hypothyroidism gain were recognized as the most important symptoms in identifying Hypothyroidism. Among the studied algorithms, random forest had the best performance in identifying these symptoms (accuracy=0.83, kappa=0.46, sensitivity=0.88, specificity=0.88). Conclusions: The findings suggest that machine learning methods can identify Hypothyroidism patients who show relatively simple symptoms with acceptable accuracy without the need for a blood test. Greater familiarity and utilization of such methods by physicians may, therefore, reduce the expense and stress burden of clinical testing.

Structural and Functional Salvaging of Traumatic Brachial Artery Cut with Multiple Nerve Cut: Case Series

Upper limb arterial injury is relatively rare among trauma cases. Among them, the majority is contributed by brachial artery injury. Brachial artery injury is associated with nerve injuries given that its anatomical course, which brings a significant impact to the patient. We reported 2 cases of patients who sustained a deep laceration wound over the right upper limb. Both presented to the Emergency department with active bleeding over the wound, and clinically cold right hand, associated with absent radial and ulnar pulses with profound sensory and motor deficit. Wound exploration and brachial artery repair with reverse saphenous vein interposition graft, followed by structural and nerve repair. This case series highlighted the importance of prompt detection and intervention of brachial artery injury. Any further delay might result missing the golden hour of revascularization for the patients. It also showed the importance of consideration of limb salvage in a patient who was deemed Rutherford III, especially nerve cut was uncertain. In conclusion, prompt intervention of traumatic brachial artery injury and proper intraoperative assessment are mandatory to properly decide if a limb is salvageable or not.

Cold sensitivity among female clinical nurses in Japan: A nationwide study

ObjectivesThis study aimed to clarify the nature of cold sensitivity in female nurses working in hospitals in Japan. DesignA cross-sectional post survey research design. SettingsThe questionnaire targeted nurses working in 14 hospitals across ten prefectures throughout Japan. Participants1,138 female nurses MethodsThe survey captured participants’ characteristics, work environment, health, and lifestyle. The factors investigated were perceived cold sensitivity, cold sensitivity according to the Hiesho Sensation Scale, and cold sensitivity during nursing care. The Diagnostic Inventory of Health and Life Habits (DIHAL.2) assessed health and lifestyle habits. ResultsOf the respondents, 44.3 % were aware of daily cold sensitivity and 21.4 % had a cold sensitivity disorder. The majority of respondents (63.1 %) felt cold in their hands when providing nursing care, and 28.1 % felt discomfort due to the coldness of their hands. Individuals diagnosed with cold sensitivity disorders exhibited poorer overall health compared to those without such disorders. However, there was no statistically significant difference in the overall health status between individuals who reported perceiving cold sensitivity and those who did not. The group with perceived cold sensitivity had significantly lower scores on exercise behavior, meal regularity, rest, sleep regularity, and sleep sufficiency. The proportion of female nurses working in Japanese hospitals who experienced cold sensitivity was similar to that of Japanese women with the same sensitivity. Most female nurses experienced cold in their hands while providing care. Nearly 30 % of the respondents experienced discomfort owing to cold hands. ConclusionsThe study underscores the widespread issue of cold sensitivity among female nurses in Japanese hospitals, emphasizing the critical need for targeted interventions to improve their comfort and optimize care provision.

Characteristics of Far-Infrared Ray Emitted from Functional Loess Bio-Balls and Its Effect on Improving Blood Flow.

XRD diffraction and IR absorption were investigated for raw loess powder and heat-treated loess powder. Raw loess retains its useful minerals, but loses their beneficial properties when calcined at 850 °C and 1050 °C. To utilize the useful minerals, loess balls were made using a low-temperature wet-drying method. The radiant energy and transmittance were measured for the loess balls. Far-infrared ray (FIR) emitted from loess bio-balls is selectively absorbed as higher vibrational energy by water molecules. FIR can raise the body's core temperature, thereby improving blood flow through the body's thermoregulatory mechanism. In an exploratory study with 40 participants, when the set temperature of the loess ball mat was increased from 25 °C to 50 °C, blood flow increased by 39.01%, from 37.48 mL/min to 52.11 mL/min, in the left middle finger; in addition, it increased by 39.62%, from 37.15 mL/min to 51.87 mL/min, in the right middle finger. The FIR emitted from loess balls can be widely applied, in various forms, to diseases related to blood flow, such as cold hands and feet, diabetic foot, muscle pain, and menstrual pain.

Glaucoma Patient with Suspected Flammer Syndrome: Diagnostic Procedures and Therapeutic Implications

If glaucoma damage develops despite normal intraocular pressure or if the damage progresses despite well-controlled intraocular pressure, we usually find other risk factors. One important group are the vascular factors. We should focus not only on the classical risk factors of atherosclerosis, such as arterial hypertension or dyslipidaemia, but also on dysregulation of blood flow, especially on primary vascular dysregulation (PVD). Low blood pressure, either current or in adolescence, low body mass index or frequently cold hands and feet may provide important hints. Very often PVD is coupled with a number of other symptoms and signs, and we then speak of a Flammer Syndrome (FS). If there is any indication of FS, we take a targeted patient history, undertake 24 h blood pressure monitoring, measure retinal venous pressure, and perform a dynamic retinal vessel analysis or nail fold capillary microscopy. This is especially recommended if the patient is relatively young or the damage is progressing rapidly. If the suspicion is confirmed, we then try to reduce the drops in blood pressure, lower the retinal venous pressure, improve the regulation of blood flow and reduce the oxidative stress in the mitochondria.

A cross-sectional study of the relationship between premenstrual syndrome and missed nursing care among female nursing staff

PurposePremenstrual syndrome (PMS) is a cyclical psychosomatic disorder prevalent among women of reproductive age. However, research on the potential impact of PMS on routine nursing schedules and activities is limited. This study aims to identify the prevalence of PMS among female nursing staff and to examine the relationship between PMS and missed nursing care (MNC). MethodBetween November 1, 2022, and April 30, 2023, this study was conducted among female nursing staff working in nine inpatient departments at Sun Yat-sen University Cancer Center. This study used a cross-sectional design. The participants were recruited through convenience sampling. Data were collected using the standardized Menstrual Distress Questionnaire, the Oncology Missed Nursing Care self-rating scale, and a sociodemographic questionnaire. One-way analysis of variance, Fisher's least significant difference test for post-hoc comparisons, and Spearman's correlation coefficient were utilized for data analysis. A trend test was also performed to explore patterns in the severity of PMS and MNC over time. ResultsWe collected a total of 224 questionnaires, with 154 (68.7%) female nursing staff reporting PMS. The most common symptoms were low back pain (91.1%), abdominal discomfort (90.6%), cold hands and feet (87.1%), and lethargy (87.1%). Moreover, 91.5% of the 224 female nursing staff reported at least one MNC activity. The nursing activities most frequently missed or left incomplete were liquid intake and output monitoring as ordered (43.3%), medication administration within 30 min before or after the scheduled time (43.3%), and electrocardiogram monitoring as ordered (42.9%). “Abdominal discomfort” from the Menstrual Distress Questionnaire was significantly correlated with the majority of MNC activities (p < 0.001). ConclusionsThis study provides evidence for a strong association between PMS and MNC among female nursing staff, suggesting that administrators should take the premenstrual conditions of female nursing staff into consideration. It is necessary to provide appropriate understanding and support to mitigate the impact on patient care and safety.

"This is fine": the impact of blowouts on subsequent game performance in the National Hockey League (NHL).

Blowouts in sports involve large margins of victory or loss between teams and have long been perceived as influencing subsequent performances by athletes, coaches, fans, and other stakeholders. Under the backdrop of the hot hand ph enomenon, the current study explores the impact of blowouts on subsequent game performance in the National Hockey League (NHL). Specifically, we examine the potential carryover of a "hot (or cold) hand" on the subsequent game following a large win or loss. In our study, we defined blowouts as outlying goal differentials for regular season games (i.e., a difference of approximately 6 goals between teams in a single game based on 3 standard deviations from the mean goal differential during the sampled period). Using this criterion, data from 285 games over the 2005-06 to 2018-19 NHL regular seasons were gathered for analysis. We performed a series of multiple regressions using blowout goal differential as the main predictor, adjusting for location of the subsequent game, number of time zones from the home base city, whether the subsequent game was a back-to-back, and winning percentages of the team and opponent. Our results revealed no significant over or under performance by teams that either won through a blowout or those that lost by a blowout. Our findings are consistent with previous work in other and similar sports contexts. Practical applications and future directions for research are discussed.

The identification of WHO emergency signs in children by nurses at triage in an emergency department

ABSTRACT Background The World Health Organization recommends the use of a three-tier triage system to recognise a sick child in low- and middle-income countries. The three tiers are based on standardised emergency and priority signs. No studies have evaluated the prevalence or reliable detection of these emergency signs. Aims To determine the prevalence of WHO emergency signs and the underlying causes, and to determine whether nurses could reliably detect these signs in children presenting to the emergency department at Port Moresby General Hospital in Papua New Guinea. Methods A prospective study measured inter-rater agreement between nurses at triage and a blinded second assessor trained in paediatrics. Results The prevalence of emergency signs was 16.7%: 32 of 192 children had these signs at presentation; 18 (9.4%) had severe respiratory distress; 10 (5.2%) had severe dehydration; and 3 (1.6%) had convulsions. There was an acceptable inter-rater agreement between nurses and doctors (Cohen’s Kappa score >0.4) for some signs: subcostal recession, intercostal recession, nasal flaring, lethargy, weak volume pulses, convulsions, sunken eyes and a poor conscious state. Obstructed breathing, cyanosis, tracheal tug and cold hands and feet were less commonly detected and had poor inter-rater agreement (Kappa score <0.4). Conclusions Effective screening at triage can enable prompt emergency treatment by nurses and can help focus doctors’ attention on children who require it most. There is a need for additional training in the identification of some emergency signs. Abbreviations CED: children’s emergency department; ETAT: emergency triage assessment and treatment; HCC: Hospital Care for Children; PMGH: Port Moresby General Hospital; PNG: Papua New Guinea; WHO: World Health Organization

Medically Unexplained Symptoms Are Linked to Chronic Inflammatory Diseases: Is There a Role for Frontal Cerebral Blood Oxygen Content?

Introduction: Patients often go to the physician with medically unexplained symptoms (MUS). MUS can be autonomic nervous system-related “unspecific” symptoms, such as palpitations, heart rhythm alterations, temperature dysregulation (hand, feet), anxiety, or depressive manifestations, fatigue, somnolence, nausea, hyperalgesia with varying pains and aches, dizziness, etc. Methods: In this real-world study, we investigated MUS in a cohort of unselected outpatients from general practitioners in Italy. It was our aim to increase the understanding of MUS by using principal component analyses to identify any subcategories of MUS and to check a role of chronic inflammatory diseases. Additionally, we studied cerebral blood oxygen (rCBO2) and associations with MUS and chronic inflammatory disease. Results: Participants included 1,597 subjects (50.6 ± 0.4 years, 65%/35% women/men). According to ICD-10 codes, 137 subjects had chronic inflammatory diseases. MUS were checked by a questionnaire with a numeric rating scale and cerebral blood flow with optical techniques. The analyses of men and women were stratified. Psychological symptom severity was higher in the inflamed compared to the non-inflamed group (fatigue, insomnia in women and men; recent mood changes, daytime sleepiness, anxiety, apathy, cold hands only in women; abnormal appetite and heart rhythm problems only in men). Principal component analysis with MUS provided new subcategories: brain symptoms, gut symptoms, and unspecific symptoms. Brain and gut symptoms were higher in inflamed women and men. Chronic inflammatory diseases and pain were tightly interrelated in men and women (p < 0.0001). In women, not in men, average frontal rCBO2 content was higher in inflamed compared to non-inflamed subjects. In men, not in women, individuals with pain demonstrated a lower average frontal rCBO2 content compared to pain-free men. MUS did not relate to rCBO2 parameters. Conclusion: This study shows close relationships between MUS and chronic inflammatory diseases but not between MUS and rCBO2 parameters.

Thermoregulation of human hands in cold environments and its modeling approach: A comprehensive review

Cold environments pose significant risks to human health, well-being, and productivity, with hands being particularly vulnerable to cold stress and injuries. Mathematical models of hand thermoregulation have emerged as valuable tools for understanding and predicting hand performance and injuries, especially in extremely cold environments. While significant progress has been made in mathematical modeling, a systematic review of these models is currently lacking. This paper aims to fill this knowledge gap by conducting a comprehensive review of the existing literature on hand thermoregulation models in cold environments. It begins with an introduction to the unique thermophysical and thermophysiological characteristics of the hand. It then summarizes the historical evolution of hand thermoregulation models. The essential principles for developing hand-specific thermoregulation models are outlined, encompassing modeling of hand anatomy and geometry, thermophysiological responses, and heat transfer between the hand and its surroundings. This review presents prediction methods for cold injuries and hand performance. The need for future advancements in hand thermoregulation modeling is emphasized. Specifically, achieving a more realistic representation of hand anatomy and geometry, as well as incorporating location-dependent thermophysical properties and physiological behaviors of the hand, are identified as crucial areas for improvement to enhance prediction accuracy. This review will contribute to a deeper understanding of hand thermoregulation mechanisms and their interaction with cold environments, as well as the development of more reliable and applicable models.

SAT571 When Two Is Too Few: Bethesda IV Pathology On Repeat Thyroid Fine Needle Aspiration

Abstract Disclosure: C.M. Godar: None. A.J. Spiro: None. M.K. Shakir: None. T.D. Hoang: None. Background: The 2015 American Thyroid Association Guidelines for Adult Patients with Thyroid Nodules provide a strong recommendation against routine ultrasound surveillance of thyroid nodules for which two benign fine needle aspiration (FNA) cytology results have been previously obtained. Strict adherence to these guidelines may hinder detection of malignancy, especially in large nodules where there is potential to miss heterogeneous pathology based on sampling technique. Clinical Case: A 36-year-old female was evaluated for surveillance of a large non-toxic multinodular goiter. Thyroid ultrasound demonstrated a dominant right thyroid nodule greater than 7 centimeters in size. The patient had undergone FNA of this nodule in 2014 and 2019 with Bethesda II (benign) cytopathology results. A chest x-ray showed tracheal deviation without evidence of narrowing. She noted a sensation of neck pressure without dysphagia or shortness of breath. She denied fatigue, heat or cold intolerance, hand tremor, or pretibial myxedema. She denied a family history of thyroid cancer or any history of neck irradiation. Due to new compressive symptoms a repeat FNA was performed. Three passes were performed with adequate samples, and the final FNA cytopathology demonstrated a Hurthle cell oncocytic-type follicular neoplasm with Bethesda IV classification. The sample was submitted for ThyGeNEXTTM and ThyraMIRv2TM molecular testing, which returned with NRAS q61R mutation of moderate-to-high risk of malignancy (65-75%). The patient was subsequently referred for total thyroidectomy with pending surgery date. Discussion: The current ATA guidelines offer a cost-effective surveillance strategy for the vast majority of patients with thyroid nodules. False negative FNA results are rare and are reported to occur in about 1% of cases1. As in this vignette, it is reasonable to perform an additional FNA after two consecutive Bethesda II results in nodules with clinically significant growth, new compressive symptoms, or if there is concern for incomplete sampling in nodules of large size. During an FNA, care should be taken to gently move the needle at various angles to capture follicular cells from different areas within a nodule. Large nodules should be sampled via multiple, separate skin entry points when feasible. Judicious use of repeat FNA along with these sampling techniques may help to prevent under-diagnosis in nodules containing multifocal areas of heterogeneous pathology. Reference: 1) Durante C, Costante G, Lucisano G, Bruno R, Meringolo D, Paciaroni A, Puxeddu E, Torlontano M, Tumino S, Attard M, Lamartina L, Nicolucci A, Filetti S. 2015. The natural history of benign thyroid nodules. JAMA 313:926-935 Presentation: Saturday, June 17, 2023

THU319 Hyperglycemia Associated With Raynaud’s Phenomenon And Liver Dysfunction After COVID-19 Vaccination In Type 1 Diabetes

Abstract Disclosure: Z. Zavgorodneva: None. C. Zhang: None. S. Siddiqui: None. T. Zahedi: None. Introduction: The association of COVID-19 vaccinations and the incremental changes in glycemic control is still debatable. Some studies found the impacts of vaccination on glucose variations (1), while other investigations showed no significant changes (2,3). COVID-19 vaccinations may induce autoimmune phenomena such as autoimmune hepatitis, immune thrombotic thrombocytopenia, IgA nephropathy, SLE, and Graves’ disease. Here, we report a case of a type 1 DM patient with previously well controlled glucose on a closed-loop insulin pump, who developed a significant glucose variation with a new onset of Raynaud’s phenomenon and liver dysfunction after the COVID-19 vaccination. Case Report: Patient is a 33 year old male with type 1 diabetes since age 5 who previously had well controlled glucose with insulin pump for 17 years and an HbA1C of 6.8 %. Patient controlled his diet and exercised regularly. He used insulin pump with continuous glucose monitor (CGM) closed-loop system and his premeal insulin bolus was calculated based on the carb counting. Patient’s baseline glucose was an average of 122 mg/dL, time in range (TIR) 82 %, above target 9 %, below target 9 % (so glycemia was in the goal as per Diabetes Management Standards (4). Two days after he received the COVID-19 vaccination, his glucose started to fluctuate in the range of 46 mg/dL to 378 mg/dL. His total daily insulin dose was increased from 30 units to 60 units through insulin pump and insulin carb ratio (ICR) adjustment to correct post-prandial hyperglycemia. CGM revealed an average glucose of 192 mg/dL, TIR 71%, above target 24%, and below target 5%. Two weeks later, patient developed bilateral white-pale cold hands, weight gain, fatigue, bloating, constipation, and liver dysfunction with transaminase increasing from baseline ALT 68 U/L, AST 82 U/L, bilirubin 0.5 U/L, to AST 305 U/L, ALT 206 U/L, and bilirubin 1.1 U/L. CT abdomen revealed mild hepatomegaly without focal lesions. Lab workup found patient positive for elevated immunoglobulin A (384 ng/dl), but negative for anti-mitochondrial antibody, smooth muscle antibody, viral hepatitis, and ANA screen. One month later, his glucose became better controlled and liver function improved to ALT 199 U/L, AST 188 U/L, and bilirubin 0.3 U/L, but he still has Reynaud’s phenomenon in cold weather. Discussion: The COVID-19 vaccination in this patient resulted in significant variation and fluctuation in the glucose levels and he had to receive a much higher amount of insulin via a closed-loop insulin pump system in order to control his glucose levels. This could be explained by the vaccine induced immune response causing an increase in tissue insulin resistance such as in adipose tissue and muscle cells. Immune stimulation could have also triggered the worsening of the nonalcoholic steatohepatitis (NASH) and explain his new-onset Raynaud’s phenomenon. Presentation: Thursday, June 15, 2023

Prevalence of Primary Palmar Hyperhidrosis and its Impact on Hand Grip Strength and Quality of Life

Background: Primary palmar hyperhidrosis is a disorder resulting in abnormally excessive sweating of palmar side of hand. Patients present with cold and wet hands. It can also occur in combination with other areas like soles, axillae, and craniofacial region. Objective: To estimate prevalence of primary palmar hyperhidrosis in Faisalabad and its impact on hand grip strength and quality of life. Methods: This analytical cross-sectional study was conducted at Dermatology departments of three tertiary care hospitals of Faisalabad, Pakistan. Sample size was calculated using formula. Both genders with age ranging from 15 to 65 years were selected as participants using convenient sampling. Participants filled self made form which included demographics, screening and valid and reliable quality of life measuring tools (HDSS and Keller scale). Then, after screening, grip strengths of hyperhidrotics (group 1) and non-hyperhidrotics (group 2) were measured using modified sphygmomanometer test (cuff method) and were compared. Data were analyzed using SPSS version 22. Results: Prevalence of primary palmar hyperhidrosis was 15.5% (11/71) consisting of 6 females and 5 males. Age of onset occurred during 5-15 years. 63.64% patients had positive family history. 90.91% patients had normal (18.5-24.9) BMI. Mean right and left grip strength values of hyperhidrotic patients were 168.55±55.446 and 157.55±44.568, respectively. Mean right and left grip strength values in non-hyperhidrotic participants were 157.63±53.126 and 148.67±53.85, respectively. 54.55% patients reported 3 on HDSS. On Keller scale majority reported mild to severe distress especially when shaking hands with others, writing papers, driving cars, grasping heavy objects, and wearing gloves. Conclusion: Current study showed 15.5% prevalence rate of primary palmar hyperhidrosis. Hand grip strength values of hyperhidrotic patients were higher when compared with non-hyperhidrotic participants. Majority of patients reported barely tolerable sweating which resulted in mild to severe distress experienced during activities of daily living.

Bayesian Analysis Used to Identify Clinical and Laboratory Variables Capable of Predicting Progression to Severe Dengue among Infected Pediatric Patients.

The current contribution aimed to evaluate the capacity of the naive Bayes classifier to predict the progression of dengue fever to severe infection in children based on a defined set of clinical conditions and laboratory parameters. This case-control study was conducted by reviewing patient files in two public hospitals in an endemic area in Mexico. All 99 qualifying files showed a confirmed diagnosis of dengue. The 32 cases consisted of patients who entered the intensive care unit, while the 67 control patients did not require intensive care. The naive Bayes classifier could identify factors predictive of severe dengue, evidenced by 78% sensitivity, 91% specificity, a positive predictive value of 8.7, a negative predictive value of 0.24, and a global yield of 0.69. The factors that exhibited the greatest predictive capacity in the model were seven clinical conditions (tachycardia, respiratory failure, cold hands and feet, capillary leak leading to the escape of blood plasma, dyspnea, and alterations in consciousness) and three laboratory parameters (hypoalbuminemia, hypoproteinemia, and leukocytosis). Thus, the present model showed a predictive and adaptive capacity in a small pediatric population. It also identified attributes (i.e., hypoalbuminemia and hypoproteinemia) that may strengthen the WHO criteria for predicting progression to severe dengue.

Investigating manual performance when using push buttons following cold water hand immersion

The purpose of this study was to investigate manual performance of humans when using push buttons following cold water hand immersion. An experiment involving 29 human participants was carried out to measure the activation rate of twelve different shaped push buttons mounted on a novel test apparatus after their dominant hand was immersed in cold (2 °C) and thermoneutral (34 °C) water for 2 min. A series of standardized hand dexterity tests were completed to assess the participants' baseline tactile sensitivity in a dry thermoneutral state. The mean baseline performance of participants indicates that they were representative of the general population. The button test apparatus was developed specifically for this experiment and was comprised of 12 different buttons at different locations on the panel which were varying in size, surface shape and texture. After the participants immersed their dominant hand in the assigned temperature condition, their index finger was guided to the centre of the panel, and they were instructed to find and press as many buttons as they could in a 2-min time period using only their index finger. For the button panel test, the participants’ view was obstructed from seeing the buttons. The results of the study indicate that temperature does not influence the activation rate of the push buttons on the button test apparatus. In addition, button size (large) was the most significant factor, followed by shape (protruding), however button texture was not a significant parameter. Given that exposure to cold water reduces manual performance, along with anecdotal evidence from survival training centres that users sometimes struggle to activate PLBs, the motivation for this research was to understand how humans interact with these devices in cold water emergency situations. It is expected that the results of this research will be useful for designers of emergency signalling devices used for rescue at sea.

Development of smart cardiovascular measurement system using feature selection and machine learning models for prediction of sleep deprivation, cold hands and feet, and Shanghuo syndrome

This study aimed to develop a smart cardiovascular measurement system using ECG and PPG to evaluate health issues: sleep deprivation, cold hands and feet, and the Shanghuo syndrome. The proposed methods extracted features from physical Signal and utilized diverse machine learning techniques for the evaluation. The results demonstrated prediction accuracies exceeding 82% (87% for sleep deprivation using k-nearest neighbor, 83% for cold hands and feet using a kernel classifier, and 82% for the Shanghuo syndrome using ensemble learning). Moreover, this study identified novel features associated with sleep deprivation, cold hands and feet, and the Shanghuo syndrome in the context of traditional Chinese medicine (TCM). An accurate prediction of TCM-defined cold hands and feet and Shanghuo syndrome, while considering relevant physiological features, is critical in the field of machine learning research. The developed system can be seamlessly integrated with the existing instruments to facilitate self-health management and collaboration with medical treatment.