Forearm Region Research Articles

Use of processed bovine pericard in peripheral nerve surgery

ObjectiveNerve damage often means a loss of the epi- and perineural sheaths, an adherence to the surrounding tissue and a loss of smooth movements. This leads to pain and functional deficits. Creating a gliding apparatus for damaged nerves is a possibility to restore physiological function and interrupt the vicious circle of pain. Patients and methodsWe investigated nine patients who were undergoing peripheral nerve surgery in the forearm and upper arm region. Surgeries included six revisions due to scar-adherence caused by bone fracture surgery, two revisions due to previous nerve compression syndrome surgery and one revision after complete severing of the nerve and previous emergency surgery of the vessels. In each case, the nerve was freed from enveloping scar tissue and a processed bovine pericard (Tutopatch®) was used to wrap or cover parts of the affected nerve. The patients were examined clinically and by high-resolution sonography (HRS) after surgery. ResultsAll patients showed improvement in respect of function and of pain. There were no adverse reactions as a consequence of the material used. HRS showed that the Tutopatch melds with its environment, and it did not lead to re-scarring of the nerve. ConclusionTutopatch appears to be a suitable allogeneic material for nerve-wrapping.

Evaluation of the supinator muscle and deep branch of the radial nerve: impact on nerve compression.

The aim of this study was to investigate the superficial head of supinator muscle (SM) and deep branch of the radial nerve (DBRN) course in SM to see whether the texture characteristics of the superficial head of SM might have a potential compressive effect on the nerve. Elbow and proximal forearm region of 20 preserved cadavers (n 40, 12M, 8F) were dissected in order to measure total and part of DBRN lengths between some reference points. The texture characteristics of both the proximal (where DBRN enters SM) and distal arcade (where DBRN exits SM) of the superficial head of SM were evaluated based on its structure's being muscular, musculotendinous, tendinous, or membranous. The total length of DBRN between sexes without taking side (L/R) into consideration (P = 0.030) and left radiocapitellar joint (RCJ)-arcade of Frohse (AF) length between sexes (P = 0.050) were statistically significant. There was a gradual increase in caliber getting more flattened in every consecutive level which was statistically significant when every two consecutive levels were compared. When compared according to the texture type, there were also significant differences. Flattening of DBRN in the supinator canal suggests a chronic compression on the nerve. Differences in the texture of the superficial head of the supinator might facilitate this compression. An understanding of the anatomy and nerve topography is of utmost importance in the accurate diagnosis and effective management of peripheral nerve compression.

Occupational Risk Evaluation Through Infrared Thermography: Development and Proposal of a Rapid Screening Tool for Risk Assessment Arising from Repetitive Actions of the Upper Limbs.

Risk analysis is one of the main tools for preventing the occurrence of Work-Related Musculoskeletal Disorders. New methods of risk analysis should seek to be more agile and simplified, encouraging them to be widely applied in work environments. This paper aimed to develop a rapid tool for assessing the risk of developing Work-Related Musculoskeletal Disorders (WMSDs) arising from repetitive actions of the upper limbs, while using a thermographic camera to measure skin temperature variation. A workstation was developed in an environmentally controlled laboratory, representing the five levels of risk presented by the Occupational Repetitive Actions Index (OCRA) Index, which were performed by 32 participants for 20 min. each level. There was a significant change in forearm skin temperature at all risk levels (p < 0.001), with a positive linear correlation (r = 0.658 and p < 0.001), which led the authors to perform linear regression analysis for the forearm region. The Predicted OCRA Index calculation equation was successfully developed (R = 0.767 and R² = 0.588), while using as independent variables: air temperature and temperature variation of the forearm skin. The Predicted OCRA Index can be applied as a screening tool for large numbers of workers in the same company or sector, due to its speed of application and the determination of risk level, but it does not replace the original OCRA Index.

Sex Difference in Regional Skin Blood Flow Perfusion and Sweat Rates during Exercise in Hot and Cool Conditions

BackgroundFemales are reported to have lower thermosenstivity for evaporative heat loss and skin blood flow (SKbF) response to an increase in mean body temperature during exercise compared to men. However, sweat rate (SR) and SkBF are typically examined only on the forearm. It is unclear if SR and SkBF differ between sex in various body regions during exercise hyperthermia when matched for exercise heat production.PurposeThis project tested the hypothesis that regional skin blood flow perfusion and sweat rates would differ between men and women exercising at matched exercise heat production.MethodsTwenty‐two healthy active (7 day activity: 8620±3008 steps/day; VO2max: 49±10 mL/kg/min) adults (11M/11F, 22.4±4.9y, 169±7.6cm, 68.3±13kg) exercised at similar metabolic heat production (M: 7.1±1.5 W/kg, F: 6.9±1.4 W/kg; P=0.32) for 60 min (cycle ergometer) in cool (24.0±0.0□C; 14.4±3.6%Rh) and hot (42.3±0.2□C; 27.9±5.5%Rh) conditions in random order separated by at least 7 days. The change for intestinal temperature (ΔTin) and heart rate (ΔHR) utilized a factorial two‐way repeated measure analysis of variance (RMANOVA) for interaction (In) and main effect (ME) for Sex and Condition. Local skin temperature (Tsk), SKbF, and SR were measured at the chest, stomach, forearm, and shoulder regions at rest and continuously during exercise and analyzed within each condition with a factorial two‐way RMANOVA for In and ME for Time and Sex.ResultsMales and females had a similar increase in hot compared to cool for ΔTin (Cool: Δ0.5±0.1□C, Hot: Δ1.5±0.6□C; ME: condition; P&lt;0.0001) and ΔHR (Cool: 58±15 b/min, Hot: 71±15 b/min; ME: Condition; P&lt;0.01). Tsk was hotter at each site in the hot compared to cool condition but not different between sex (ME: Condition, P≤.0001). SkbFchest increased during exercise in both sexes (ME: Time, P&lt;0.0001). SkbFstomach increased during exercise in both conditions, however in the hot increased greater in females compared to males (In: Time × Sex, P&lt;0.002). SkBFforearm increase during exercise in both sexes; however, was attenuated in females in the hot (In: Time × Sex, P&lt;0.002). SkBFshoulder increased during exercise and was greater in females compared to males in the hot (ME: Sex, P&lt;0.04) and more so in the cool (In: Time × Sex, P&lt;0.03). SRchest increased similar between sex in hot but was greater in cool for females (In: Time × Sex, P&lt;0.003). SRstomach increased less for females in the hot (ME: Sex, P&lt;0.04) but similar to males in cool (ME: Time, P&lt;0.0001). SRforearm increased less in females in the hot (In: Time × Sex, P&lt;0.0017). SRshoulder increased similar between sex in hot and cool conditions (ME: Time, P&lt;0.0001).ConclusionThese data indicate that sex differences exist for SkBF and SR in different body regions during exercise in hot and cool conditions. Females have elevated SkBF in the stomach and shoulder and similar in chest and forearm compared to males. SR in females are attenuated in stomach and forearm, but similar in the chest and shoulder regions compared to males.

DEVELOPMENT OF AN INFLAMMATORY RESPONSE IN LABORATORY ANIMALS AT EXPERIMENTAL MYCOTIC INFECTION AND IMMOBILIZATION STRESS

The data on the methods of modeling polyetiological stress in laboratory mice and its effect on the development of the inflammatory response and the nature of pathological and anatomical changes are presented. At the first stage, two groups of animals simulated polyetiological stress. For this, the animals were infected with micromycete intraperitoneally and left stationary for several hours a day. After that, infection was assessed by detecting micromycete in the peripheral blood of animals. At the second stage, the degree of occurrence and the nature of pathological and anatomical changes were studied with different methods of micromycete administration. It was noted that as a result of the simultaneous exposure to two stress factors, micromycetes in the peripheral blood were detected on the 8th day of the study. At the same time, the influence of one stress factor led to the generalization of the process only on the 17th day. With different methods of infection in laboratory mice, characteristic changes were revealed in the internal organs, which in all groups of animals were represented mainly as single and multiple abscesses of different localization, as well as fistulas in the left caudal part of the peritoneum. Abscesses in the region of the left forearm were filled with characteristic purulent contents: a curdled mass of light gray with an unpleasant odor or odorless. These pathological and anatomical changes were noted in 90% of the animals of their total number in the experiment. The introduction of R. syclopium followed by the exposure of white mice to IMO stress leads to 100% death of animals on days 1-2 from the onset of stress. Animals that were only injected with P. cyclopium remained alive until the end of the study.

Real-time temperature estimation with enhanced spatial resolution during MR-guided hyperthermia therapy

In this article, the temperature of biological tissues is estimated during hyperthermia therapy, while accounting for uncertainties in the bioheat transfer problem and in the available measurements. A state estimation problem is solved with the Steady-State Kalman Filter. The Pennes bioheat transfer model and the PRF-Shift Magnetic Resonance Thermometry are used as evolution and observation models, respectively. Instead of using the direct inversion of the measured data as with the PRF-Shift Magnetic Resonance Thermometry, the state-estimation framework allows for enhancing the spatial resolution of the estimated temperature variation and reducing the related uncertainties. Since the time consuming steps of the Steady-State Kalman Filter can be performed offline, the recursive solution of the state estimation problem is performed with computational times smaller than the simulated physical times. Synthetic measurements are used for the state estimation problem in a region of the human forearm, for radiofrequency and laser-diode heat sources of the hyperthermia therapy.

Superficial thermal response to CrossFit® workout

Abstract Aims: Recently, high-intensity training methods have become popular, integrating the cardiovascular and neuromuscular training in a single training session, among these methods is CrossFit®. The objective of this study was to analyze the superficial thermal response to CrossFit® exercise in men and women, in order to use this knowledge to prevent overuse injuries. Methods: Nineteen volunteers involved in CrossFit® exercise for more than 6-month (12 males and 7 females) were recruited. The acquisition of the thermal images was performed in a climatized room in two moments, at rest (before exercise), and after one CrossFit® training session. The training session lasted 45min, comprising warm-up (10-min), accessory work (15-20min), and workout of the day (15-20-min). Before the first image acquisition, volunteers were acclimated for 15 min. The Wilcoxon signed-rank test was used to compare the skin temperature between pre- and post-exercise. Results: Temperatures rose significantly pre- to post-exercise in the forearm and anterior thigh regions, while it decreased in the anterior thorax and dorsal lower back regions. These results were found both, in the overall sample, and the male volunteers, but not when the female results were isolated. Conclusion: It can be concluded that superficial thermal response to one CrossFit® training session was characterized and was different for men and women. The superficial thermal responses were aligned with the physiological alterations promoted by other modalities, such as resistance training, cycling, and running.

Utility of Distal Forearm DXA as a Screening Tool for Primary Osteoporotic Fragility Fractures of the Distal Radius: A Case-Control Study.

Background:Osteoporotic fragility fractures frequently occur at the distal part of the radius. This suggests that initial osteoporosis evaluation at this site may inform screening and treatment to prevent additional fractures. The purpose of this study was to investigate the utility of distal forearm dual x-ray absorptiometry (DXA) as a screening tool to assess the risk of fragility fractures at the distal part of the radius.Methods:This retrospective, case-control study included postmenopausal women who had sustained a distal radial fracture (fracture group, n = 110) and postmenopausal women with no history of fracture (control group, n = 95). DXA measurements at the spine, hip, and distal part of the forearm (ultra-distal, mid-distal, and one-third distal sections) were compared between the groups on the basis of bone mineral density (BMD), T-score, and the proportion of patients with a T-score of ≤–2.5 standard deviations (SD). We also investigated the regional differences on the basis of T-score among the skeletal sites. Furthermore, the reliability of distal forearm DXA measurements was validated by assessing the statistical correlation (r) with volumetric BMD by computed tomography (CT).Results:Compared with the control group, the fracture group showed significantly lower BMD and T-scores and higher proportions of patients with a T-score of ≤–2.5 SD at the ultra-distal, mid-distal, and one-third distal forearm; however, the spine and hip measurements did not differ significantly between the 2 groups. With respect to regional differences, in the fracture group, T-scores were significantly lower and the proportions of patients with a T-score of ≤–2.5 SD were significantly higher for the 3 distal forearm sites compared with the spine and hip. DXA measurements at all 3 of the distal forearm regions exhibited high correlation with volumetric BMD by CT (r = 0.83 to 0.92).Conclusions:Some postmenopausal women were found to exhibit bone loss preferentially at the distal part of the radius, which may render them vulnerable to fragility fractures. Forearm DXA for the assessment of local bone loss may demonstrate benefit in screening for those at risk for distal radial fractures and facilitate the early identification of patients who require intervention for osteoporosis.Level of Evidence:Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

Clinical outcomes of contralateral 7th cervical nerve transfer in the treatment of total brachial plexus root avulsion in Xinjiang Autonomous Region

Objective To evaluate the long-term functional recovery after contralateral 7th cervical nerve(C7) transfer with brachial plexus root avulsion and the effect on the contralateral limbs after operation. Methods A total of 83 patients with injory of brachial plexus avulsion were underwent contralateral C7 transfer from September, 2004 to December, 2014. Among them, contralateral C7 were transferred to the median nerve in 33 cases, to radial nerve in 14 cases, to musculocutaneous nerve in 22 cases, and simultaneous transfer to median and musculocutaneous nerve in 14 cases. The followed-up contents included recovery of muscular strength and sensory innervated by the recipient nerve, bilateral limbs synergistic activity and the effect on the contralateral limbs after the surgery. Results All 83 cases were successfully followed-up for 3.2-6.2 years (average, 4.5 years), and found no significant effect on function of the contralateral limbs. In the group of C7 transferred to the median nerve group, 10 cases had muscle strength recovered≥M3, and 26 cases had sensory recovered≥S3; In the group of C7 transferred to the radial nerve, 6 cases had muscle strength recovered≥M3, and 9 cases had sensory recovered ≥S3; In the group of C7 transferred to the musculocutaneous nerve, 12 cases had muscle strength recovered≥M3, and 17 cases had sensory recovered≥S3. In the group of C7 simultaneous transferred to the median and musculocutaneous nerve, 6 cases had muscle strength of wrist and digital flexion recovered≥M3, 5 cases had elbow flexion recovered≥M3, 9 and 10 cases had sensory of innervated area and lateral forearm region recovered≥S3, respectively. Conclusion Contralateral C7 transfer is an ideal procedure for the treatment of total brachial plexus root avulsion with definitive clinical outcomes. Key words: Brachial plexus root avulsion; Seventh cervical nerve; Nerve transfer; Limb coordination

Comparative study of post-intervention soreness between dry needling and percutaneus needle electrolysis

Abstract Aims The aim of this research was to study the appearance of soreness after dry needling (DN) and percutaneous needle electrolysis (PNE) in latent trigger points of the extensor muscle of the posterior forearm region. Material and Methods A pre-test/post-test pilot study was performed, in which 15 volunteers with latent trigger points in the extensor muscles of the posterior forearm region were randomly distributed into a group A who received treatment with DN and a group B who received treatment with PNE. Before and after the intervention, algometry measurements were performed at the site where the trigger point was found, and, after the intervention the patient was asked to complete two visual analog scales (VAS) to evaluate pain during the intervention and a second scale to measure pain once the needle had been removed. In addition, the same scale was performed after 24 hours, 72 hours, and 1 week after the dry needling. The statistical analysis was performed using the SPSS program version 24.0, evaluating the normality of the variables using the Shapiro-Wilk test, as the sample was less than 50 subjects. P values of &gt; 0.05 were considered normal. Results The ANOVA revealed a significant effect for time on the decrease of the VAS scores, both in the groups of dry needling (P &lt; 0.001), as well as in the group of PNE (P &lt; 0.001). In contrast, a group-time interaction was not observed (P = 0.824), ruling out statistically significant differences between the DN group and the PNE group. The Student's t-test showed a significantly decreased pain pressure threshold between the pre and post algometry, both in the group of DN (P &lt; 0.001) and the group of PNE (P &lt; 0.003). However, no statistically significant differences were found between both groups in pre and post algometry (P = 0.457). Conclusion All patients presented post-needling soreness, without significant differences between DN and PNE interventions. The most intense pain was registered minutes after the dry needling, which then decreased without significant differences, reaching 0 after 72 hours, in most cases. Neither of the two techniques caused increased pain in response to pressure in a significantly different manner. No relationship was observed between a greater number of LTRs and post-needling pain. There was a correlation between pain experienced during the intervention and pain 24 hours after the needling. The levels of post-intervention pain secondary to the application of DN and PNE in latent trigger points of the extensor muscles of the posterior forearm region did not present significant differences among study subjects in both intervention groups.

Application of biophysical and skin imaging techniques to evaluate the film-forming effect of cosmetic formulations.

Products with film-forming effect, or 'second skin', which guarantees an immediate protective effect after application, is a highlight, especially when composed of natural ingredients. Thus, the objective of this study was to evaluate the immediate film-forming effect on skin of a gel and emulsion formulations added with Kappaphycus alvarezii and Caesalpinia spinosa extracts through biophysical and skin imaging techniques, especially with the Reflectance Confocal Microscopy (RCM). The measurements were done in the forearm region before (baseline) and 1h after of application of the developed formulation and its control. The parameters related to the stratum corneum water content, transepidermal water loss (TEWL), cutaneous microrelief and morphological and structural characteristics of the epidermis were analysed through the following biophysical and skin imaging techniques: Corneometer® CM 825, Tewameter® TM 300, Visioscan® VC98 and Vivascope® 1500, respectively. A sensorial analysis was also performed to study how the formulations were perceived on the skin. The obtained results showed that the active ingredient under study allows the film formation on the skin surface, leading to a reduction of TEWL and skin desquamation. The obtained images from RCM showed a reduction of furrows on the skin surface and a film formation after a single application of the formulations. However, these effects were more pronounced in the emulsion formulation, which suggests a synergistic effect of the active ingredient under study with the emollients of formulation composition. This result was also observed in the sensorial analysis, as both formulations added with the active substance were well evaluated. The presence of Kappaphycus alvarezii and Caesalpinia spinosa extracts in the studied cosmetic formulations, enabled a film formation on a skin surface, bringing benefits as a reduction of transepidermal water loss and skin desquamation, as well as a furrows reduction and an improvement of stratum corneum after 1h of application. Finally, the skin imaging techniques can be suggested as an excellent tool to evaluate a film-forming effect of cosmetic formulations.

Macroanatomical and Topographical Features of Body’s Adipose Component Content in Girls

The aim of the research is to study quantitative representation and features of adipose component distribution in girls of 16–20 years of age having different constitutional properties.Material and methods. In the investigated Slavic ethnos groups of 250 girls of 16–17 years of age and 250 girls of 18–20 years of age having no signs of pathological processes disturbing physical development dynamics absolute content of body’s adipose component and topographical features of subcutaneous fat distribution in different body areas are evaluated by the methods of caliperometry and bioimpedancometry. As provided by typing according to a constitutional group leptosomic, mesosomic, megalosomic and indefinite constitutional groups have been singled out. Statistical analysis was based on the method of confidence intervals and determination of arithmetical mean index and its error.Results. It has been determined that subcutaneous fat thickness regardless of age and constitutional group is maximal in the abdominal region and minimal in the area of medial forearm region, chest and posterior shoulder region. Constitutional conditionality of this sign is determined by the fact that in the majority of body’s areas subcutaneous fat thickness in mesosomic constitution is 1.8–3.4 times more (р&lt;0.05) in comparison with leptosomic constitution, 1.1–1.6 times more (р&lt;0.05) in comparison with megalosomic constitution, 1.1–1.5 times more (р&lt;0.05) in comparison with the girls of indefinite constitution. Absolute content of body’s adipose component in girls of leptosomic constitution is 2.2–2.3 times (р&lt;0.05) less than in girls of mesosomic constitution. In girls of megalosomic constitution absolute content of body’s adipose component is 1.5 times (р&lt;0.05) less than in girls with mesosomic constitution. In girls of indefinite constitution absolute content of body’s adipose component is 2.2 times (р&lt;0.05) less than in girls of mesosomic constitution. At the age from 16–17 to 18–20 years subcutaneous fat thickness in mesosomic, megalosomic and indefinite constitutions is increasing insignificantly while in the girls of leptosomic group subcutaneous fat thickness is practically invariable. The indices of minimal and maximal subcutaneous fat thickness regardless of constitution and age demonstrate significant individual variability.Conclusion. The carried out morphological analysis has revealed a wide range of individual variation in body’s adipose component content and its dependence on the constitutional type.

Skin tissue dielectric constant in women with high body fat content.

Skin tissue dielectric constant (TDC) measurements at a frequency of 300MHz are used to assess skin properties in many conditions. Impacts of patient obesity on these values are unknown, and its quantitative assessment was the goal of this research. Women in a weight loss program (N=32) had TDC measured on forearm, biceps, neck, jowl, and submental regions along with measurements of total body fat (TBF), water (TBW), intracellular water (ICW), and extracellular water (ECW) via multi-frequency bioimpedance. Group age (mean±SD) was 40.0±11.6years (20-70years) with body mass index (BMI) of 31.8±6.7Kg/m2 (23.0-49.9Kg/m2 ). For analysis, subjects were divided into those with BMI<30Kg/m2 (subgroup A, n=16) vs ≥30Kg/m2 (subgroup B, n=16). Tissue dielectric constant at forearm and biceps decreased significantly (P<.001) with increasing depth from 0.5 to 1.5 to 2.5mm but TDC values and their inter-side ratios did not differ between subgroups A and B at any measured site. Although correlations between TBW, ECW, and ICW were significant (P<.001), there was no dependence of TDC values on any of these parameters. Previously unknown TDC values for obese persons are provided and based on subgroup analyses suggest that skin TDC values in overweight and obese persons are not confounded by variables such as TBW and TBF. Further, since inter-side ratios and their SD's yielded thresholds for forearm and biceps similar to those established for women with normal BMI, use of these clinical inter-arm TDC ratios now is extended to include a wider BMI range.

Influence of probe pressure on the pulsatile diffuse correlation spectroscopy blood flow signal on the forearm and forehead regions.

.In a pilot study of 11 healthy adults (24 to 39 years, all male), we characterize the influence of external probe pressure on optical diffuse correlation spectroscopy (DCS) measurements of pulsatile blood flow obtained on the forearm and forehead. For external probe pressure control, a hand inflatable air balloon is inserted between the tissue and an elastic strap. The air balloon is sequentially inflated to achieve a wide range of external probe pressures between 20 and 250 mmHg on the forearm and forehead, which are measured with a flexible pressure sensor underneath the probe. At each probe pressure, the pulsatility index (PI) of arteriole blood flow on the forehead and forearm is measured with DCS (2.1-cm source-detector separation). We observe a strong correlation between probe pressure and PI on the forearm (, ), but not on the forehead (, ). The forearm measurements demonstrate the sensitivity of the DCS PI to skeletal muscle tissue pressure, whereas the forehead measurements indicate that DCS PI measurements are not sensitive to scalp tissue pressure. Note, in contrast to pulsatility, the time-averaged DCS blood flow index on the forehead was significantly correlated with probe pressure (, ). This pilot data appears to support the initiation of more comprehensive clinical studies on DCS to detect trends in internal pressure in brain and skeletal muscle.

Stable individual variation in ventral spotting patterns in Phyllomedusa trinitatis (Anura: Phyllomedusidae) and other Phyllomedusa species: a minimally invasive method for recognizing individuals

Stable individual variation in ventral spotting patterns in Phyllomedusa trinitatis (Anura: Phyllomedusidae) and other Phyllomedusa species: a minimally invasive method for recognizing individuals. We describe a distinctive pattern of individually variable white ‘islands’ and dots on the ventral surfaces of the throat and forearm regions of male and female Phyllomedusa trinitatis. Crucially, we report from captive-reared individuals that these patterns are ontogenetically stable. We have used these patterns to recognize individual frogs in populations of 60 and more. Examination of the ventral surfaces of other Phyllomedusa species in museum specimens and from published accounts suggests that use of these patterns provides a generally useful, minimally invasive recognition method in this genus. We fnd that species previously classed as Phyllomedusa but now regarded as belonging to different genera lack these patterns.

Effect of Positioning of the Region of Interest on Bone Density of the Hip

Background: Large changes in positioning of the global region of interest (ROI) influence the measurement of bone mineral density (BMD) in the hip and forearm regions. However, it is unknown whether minor shifts in the positioning of the bottom of the global hip ROI affect the measurement of total hip BMD. Methods: The hip BMDs of 40 clinical densitometry patients were analyzed at baseline with the bottom of the global hip ROI positioned as usual, 10 mm distal to the base of the lesser trochanter (position 0). Then the hip was reanalyzed by shifting the bottom of the global hip ROI 1 mm proximally 10 times (positions +1 through +10) and then by shifting the bottom of the global hip ROI 1 mm distally 10 times (positions −1 through −10). The significance of the differences between mean values at the various distances from baseline was assessed using a Wilcoxon signed-rank test. Results: The mean total hip area, bone mineral content and BMD decreased as the bottom of the global hip ROI was shifted proximally; the decrease was significant when shifted by even 1 mm (p < 0.001). The mean total hip area, bone mineral content and BMD increased as the bottom of the global hip ROI was shifted distally; the increase was significant when shifted by even 1 mm (p < 0.001). The change in BMD with each 1 mm shift was uniform across the range studied from positions +10 through −10, and was approx 0.54%/mm. When the least significant change was based on 40 pairs of measurements, where each pair was comprised of the baseline scan and the same scan at −1 position, the least significant change was 0.01 g/cm2. Conclusions: The BMD of the total hip is sensitive to even minor changes in the positioning of the bottom of the global hip ROI. Although a 1 mm change in the bottom of the global hip ROI positioning would make little difference in the reported T-score, it could easily affect the determination of significance in changes in BMD over time.

A novel feature extraction method for machine learning based on surface electromyography from healthy brain

Feature extraction is one of most important steps in the control of multifunctional prosthesis based on surface electromyography (sEMG) pattern recognition. In this paper, a new sEMG feature extraction method based on muscle active region is proposed. This paper designs an experiment to classify four hand motions using different features. This experiment is used to prove that new features have better classification performance. The experimental results show that the new feature, active muscle regions (AMR), has better classification performance than other traditional features, mean absolute value (MAV), waveform length (WL), zero crossing (ZC) and slope sign changes (SSC). The average classification errors of AMR, MAV, WL, ZC and SSC are 13%, 19%, 26%, 24% and 22%, respectively. The new EMG features are based on the mapping relationship between hand movements and forearm active muscle regions. This mapping relationship has been confirmed in medicine. We obtain the active muscle regions data from the original EMG signal by the new feature extraction algorithm. The results obtained from this algorithm can well represent hand motions. On the other hand, the new feature vector size is much smaller than other features. The new feature can narrow the computational cost. This proves that the AMR can improve sEMG pattern recognition accuracy rate.

EFFECT OF POSITIONING OF THE ROI ON BMD OF THE FOREARM AND ITS SUBREGIONS

Inconsistent positioning of patients and region of interest (ROI) is known to influence the precision of bone mineral density (BMD) measurements in the spine and hip. However it is unknown whether minor shifts in the positioning of the ROI along the shaft of the radius affect the measurement of forearm BMD and its subregions. The ultradistal (UD), mid-, one-third (1/3), and total radius BMDs of 50 consecutive clinical densitometry patients were acquired. At baseline the distal end of the ROI was placed at the tip of the ulnar styloid as usual, and then the forearm was reanalyzed 10 more times, each time shifting the ROI 1 mm proximally. The data were normally distributed, and mean values at the various distances from baseline were compared using a paired t-test. No corrections for multiple comparisons were necessary since the differences that were significant were significant at p<0.0001. The UD forearm BMD increased as the ROI was shifted proximally; the increase was significant when shifted even 1 mm proximally (Figure 1a, p<0.0001). These same findings held true for the mid- and total radius bone density, though the percent increase with moving proximally was significantly greater for the UD radius than for the other subregions. However, there was no significant change in the 1/3 radius BMD when shifted proximally 1-10 mm (Figure 1b). Since the one-third radius is the only forearm region usually reported, proximal shifts of the ROI of up to 10 mm should not influence forearm BMD results significantly.

Appraisal of the Free Ulnar Flap Versatility in Craniofacial Soft-tissue Reconstruction.

Summary:The unique anatomical characteristics of the forearm region make it especially popular as a free flap donor site for craniofacial soft-tissue reconstruction. The free ulnar forearm flap is less hirsute and allows for better concealment of donor site scar as compared with its radial counterpart. Despite these factors, the free radial forearm flap remains more popular among reconstructive surgeons. Through the presented case series, we hope to emphasize the versatile nature of the free ulnar forearm flap in addressing various craniofacial soft-tissue defects. Following institutional review board approval, a retrospective review of the senior authors' clinical experience performing microvascular free ulnar forearm flap reconstruction of craniofacial soft-tissue defects was performed. A total of 10 patients were identified through our review. Soft-tissue defect locations included lower eyelid (n = 2), tongue and floor of mouth (n = 2), lower lip (n = 2), palatopharyngeal area (n = 1), nose (n = 1), and palate (n = 1). Trauma was the most common defect etiology (n = 5), followed by malignancy (n = 4), and iatrogenic injury in 1 case. All patients demonstrated good aesthetic and functional outcomes related to vision, speech, and oral intake at follow-up when applicable. The free ulnar forearm flap is a versatile reconstructive option that can be used to address a wide spectrum of craniofacial soft-tissue defects and offers numerous advantages over its radial counterpart.

In Vivo Determination of Moisturizers Efficacy on Human Skin Hydration by Confocal Raman Spectroscopy.

This research work deals with in vivo testing of the efficacy of commercial moisturizer products on the hydration of human skin, as there are various in vitro and ex vivo studies questioning their activity. Confocal Raman spectroscopy was used for this purpose of assessing the efficacy of moisturizers on skin hydration mainly owing to its simple, non-invasive, non-destructive, timesaving, and cost-effective nature. Water content and natural moisturizing factor (NMF) of stratum corneum were analyzed and compared using this method at high wavenumber (2500-4000cm-1) and fingerprint (400-1800cm-1) spectral regions, respectively, as these two parameters are correlated to skin hydration. Four commercial moisturizer products of different brands were tested on volar forearm region of healthy human female volunteers. This study was conducted for a period of 30days with 0, 7, and 30days as time points of analysis. The results of this study clearly indicate that not all the moisturizer products hydrate the skin to the expected levels, and this extent of skin hydration varies with duration of application of these products.