Index Finger Research Articles

Digital artery flow hemodynamics: An ultrasonographic study

BackgroundThere is a lack of data regarding the baseline hemodynamic blood flow parameters of the wrist and digits. Therefore, we aimed to quantify the digital and radial artery blood flow parameters using ultrasound and assess the influence of patient characteristics on hemodynamics. MethodsWe analyzed ultrasonographic data from 25 patients (50 hands) between October 2019 and December 2021. Variables of interest included dimensions of the radial artery and index finger (IF) ulnar and radial digital arteries at the palmodigital crease and their corresponding flow parameters. We compared variables among men and women and patients with and without diabetes using Wilcoxon Rank Sum test. ResultsOur cohort consisted of 18 women (36 hands) and three participants with diabetes (six hands). The mean diameter of the IF radial digital artery was 7 mm, and that of the ulnar digital artery was 10 mm. The average peak systolic velocity for the radial digital artery was 21.31 cm/sec, and for the ulnar digital artery, it was 30.03 cm/sec. Comparing men and women, the only significant difference found was in the time-averaged mean velocity for the ulnar digital artery (men:5.66 cm/sec vs. women:9.68 cm/sec, P = 0.02) and volume of flow for the ulnar digital artery (men:10.87cc/min vs. women:18.58cc/min, P = 0.03). We found no differences in blood flow parameters comparing participants with and without diabetes. ConclusionThese data provide a baseline measurement of digital flow hemodynamics that can be used in future studies to model vascular flow after replantation.

Unique Neural Mechanisms Underlying Speed Control of Low-Force Ballistic Contractions.

According to the speed-control hypothesis, the rate of force development (RFD) during ballistic contractions is dictated by force amplitude because time to peak force (TPF) remains constant regardless of changes in force amplitude. However, this hypothesis has not been tested at force levels below 20% of an individual's maximum voluntary contraction (MVC). Here, we examined the relationship between the RFD and force amplitude from 2 to 85% MVC and the underlying structure of muscle activity in 18 young adults. Participants exerted ballistic index finger abductions for 50 trials in each of seven randomly assigned force levels (2, 5, 15, 30, 50, 70, and 85% MVC). We quantified TPF, RFD, and various EMG burst characteristics. Contrary to the speed-control hypothesis, we found that TPF was not constant, but significantly varied from 2 to 85% MVC. Specifically, the RFD slope from 2 to 15% MVC was greater than the RFD slope from 30 to 85% MVC. Longer TPF at low force levels was associated with the variability of EMG burst duration, whereas longer TPF with higher force levels was associated with the EMG burst integral. Contrary to the speed-control hypothesis, we found that the regulation of TPF for low and high force levels was different, suggesting that neuronal variability is critical for force levels below 30% MVC and neuronal amplitude for force levels above 30% MVC. These findings present compelling new evidence highlighting the limitations of the speed-control hypothesis underscoring the need for a new theoretical framework.

Evaluation of Quantitative and Selective Sensory Fiber Dysfunction in Patients with Cirrhosis.

Chronic liver disease has been reported to be associated with peripheral neuropathy. However, which sensory fibers are affected remains unknown. The objective of this study was to examine the function of sensory nerve fibers in patients with cirrhosis using the current perception threshold (CPT) test, as well as the correlation between blood biochemical indicators related to cirrhosis and CPT values. We recruited 44 patients with liver cirrhosis and 37 healthy controls of the same age and gender. The Neurometer® system for the CPT test was used to stimulate the median nerve on the right index finger, as well as the deep and superficial peroneal nerves on the right hallux, using three distinct parameters (2000 Hz, 250 Hz, and 5 Hz). Comparative analysis was performed on the CPT values of the sensory nerves. Additionally, the correlation between CPT values and biochemical blood indicators in the study participants was analyzed. Under 2000 Hz electrical stimulation, there was a significant difference between the cirrhosis and healthy control groups in the median nerve as well as the deep and superficial peroneal nerves (p < 0.05). In addition, the median nerve CPT value of the cirrhosis group was significantly higher than that of the control group at an electrical stimulation frequency of 250 Hz (p = 0.005). There was no correlation between CPT values and blood biochemical indicators. According to the results, the sensory peripheral neuropathy in liver cirrhosis is mainly manifested as Aβ fiber neuropathy.

Management of &lt;i&gt;Kotha Roga&lt;/i&gt; (Necrotizing Fasciitis) by Modified &lt;i&gt;Ksharapichu&lt;/i&gt; (Wound Packing): A Case Report

The present case report was a 25-year-old male patient with severe pain at the right index finger, fever, oedema, and discharge, not having any history of surgery, hypertension, diabetes, or any systemic disorder was diagnosed with kotha roga (necrotizing fasciitis). Presently available treatment for this is broad-spectrum intravenous antibiotics, appropriate hydration support, and meticulous surgical debridement with regular wound packing. But because of contaminated wounds and poor prognosis, herbal therapies have a possibility to cure kotha as they are readily available, and inexpensive. In this case, a kshara formulation i.e., modified ksharpichu was chosen as an atrial medication to be applied locally after everyday cleaning and dressing. It was observed that ksharpichu acted as a debriding agent and healing as well. The case was followed up for 30 days. This study employed pretty simple criteria to gain preliminary observations on the effectiveness of this Kshara taila on kotha roga.

Digital gangrene: can be the first manifestation of essential thrombocythemia? a case report

Introduction and importance: Essential thrombocythemia (ET) is a rare chronic myeloproliferative hematologic disorder, leading to an elevated platelet count. Two-thirds of patients are asymptomatic during their lifetime, while others may experience symptoms like redness, congestion, and erythromelalgia after long symptom-free intervals. Case presentation: The authors present a rare instance of a 55-year-old female who, despite receiving aspirin and losartan treatment, eventually developed digital gangrene. In further work-ups, she had an elevated platelet count and a positive JAK 2 mutation. Her platelet count was reduced throughout treatment with aspirin, hydroxyurea, and heparin, which was followed by the necrotic tip of her index finger being surgically debrided. Clinical discussion: Significant symptoms, such as severe acrocyanosis and even peripheral gangrene, can be treated with a single dose of aspirin. Daily aspirin consumption withstanding, this case developed the severe form of ET. In addition, while thrombocytosis predisposes patients to thrombotic complications in theory, there is little evidence to support a correlation between absolute platelet count and thrombosis. Conclusion: The initial symptom of ET could be such severe and uncommon that may develop arterial acral thrombosis despite previous daily low-dose aspirin consumption.

Statistical learning of motor preparation.

Statistical learning, the process of extracting regularities from the environment, is one of the most fundamental abilities playing an essential role in almost all aspects of human cognition. Previous studies have shown that attentional selection is biased toward locations that are likely to contain a target and away from locations that are likely to contain a distractor. The current study investigated whether participants can also learn to extract that a specific motor response is more likely when the target is presented at specific locations within the visual field. To that end, the additional singleton paradigm was adapted such that when the singleton target was presented at one specific location, one response (e.g., right index finger) was more likely than the other (e.g., right middle finger) and the reverse was true for another location. The results show that participants learned to extract that a particular motor response is more likely when the singleton target (which was unrelated to the response) was presented at a specific location within the visual field. The results also suggest that it is the location of the target and not its shape that is associated with the biased response. This learning cannot be considered as being top-down or conscious as participants showed little, if any, awareness of the response biases present. The results are discussed in terms of the event coding theory. The study increases the scope of statistical learning and shows how individuals adapt automatically, without much awareness, to the regularities present in the environment. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Microsurgical Techniques for Digital Nerve Injuries and Vascular Injuries.

Tension-free end-to-end digital nerve repair or reconstruction under loupe or microscope magnification are surgical treatment options for lacerated digital nerves in patients with multiple injured digits, injuries to the border digits, or injuries to the thumb, with the goal of improved or restored sensation and a decreased risk of painful traumatic neuroma formation. Different techniques for primary repair have been described and include epineurial sutures, nerve "glues" including fibrin-based gels1,2, biologic or synthetic absorbable or nonabsorbable nerve wraps or conduits, or a combination of these materials. Nerve "glues" have demonstrated decreased initial gapping at the repair site3 and an increased tensile load to failure when utilized with a nerve wrap or conduit4,5. When there is a gap or defect in the nerve and primary repair is not feasible, nerve allograft and autograft provide similar results and are both better options than conduit reconstruction6. Concomitant or isolated digital vascular injuries may also be surgically treated with end-to-end repair in a dysvascular digit, with the goal of digit and function preservation. In the absence of complete circumferential injury or complete amputation, redundant or collateral flow may be present. Single digital artery injuries often do not need to be repaired because of the collateral flow from the other digital artery. Digital nerve and vascular injuries are often found in the context of traumatic wounds. In such cases, surgical exploration is often required, with possible surgical extension of the wounds to facilitate identification of the neurovascular bundles. The proximal and distal ends of the transected nerve and/or artery are identified, and the traumatized ends are incised sharply, maintaining as much length as possible to facilitate end-to-end repair, interposition of a graft, and the use of a conduit. The proximal and distal aspects of the nerve and/or artery are appropriately mobilized by dissecting or releasing any scar tissue or soft tissue that may be tethering the structure. The defect is measured in the natural resting position of the digit. Gentle flexion of the digit may be performed to facilitate a primary repair in the setting of very small defects. Primary repair or reconstruction is selected, and an 8-0 or 9-0 nonabsorbable monofilament suture is utilized to anastomose the appropriate structures under magnification with use of a single or double stitch6. A tubular nerve conduit is placed prior to epineurial suturing, or a nerve conduit wrap is applied circumferentially around the repair site and augmented with a fibrin glue. The wound is then irrigated and closed in a standard fashion, as determined by the presence of any soft-tissue or structural injury. Alternatives to primary repair include the use of conduits or autologous or allogenic grafting. Factors that necessitate reconstruction include gapping and poor soft-tissue integrity, which can be related to the mechanism of injury. Alternatives to repair or reconstruction include treatment of the-soft tissue or structural injury without concomitant repair or reconstruction of the damaged digital nerves or vessels. Primary end-to-end repair and reconstruction of digital nerves increases a patient's likelihood of sensation recovery, and arterial repair can preserve a digit and avoid the need for amputation. Sensation in the digits is very important for fine motor skills and interaction with the environment, and it is particularly important for patients who rely on their hands for work and/or recreation. For these reasons, the digital nerves to the border digits, such as the ulnar aspect of the small finger, radial aspect of the index finger, and both digital nerves to the thumb, are given particular attention. Surgical intervention to repair or reconstruct the digital nerves increases the likelihood of recovering pre-injury sensation; however, the chance of complete recovery remains low. A systematic review of the outcomes of digital nerve repair in adults published in 2019 showed that the average percentage of patients who had undergone repair and reported a recovery to Highet grade 4 was 24% (range, 6% to 60%)8. The rate of adverse events was comparable between the operatively and nonoperatively treated patients, with complications including neuromas, hyperesthesia, and infection. The use of a microvascular background material can provide better visualization of the proximal and distal ends while performing the repair.It is important to sharply guillotine the ends of the nerve to freshen up the laceration and provide healthy nerve ends for repair.Repair sutures need to be passed through the epineurium, with care taken not to pass through the nerve fascicles. OR = operating roomPIP = proximal interphalangealPT = prothrombin timePTT = partial thromboplastin time.

Beta rebound reduces subsequent movement preparation time by modulating of GABAA inhibition.

Post-movement beta synchronization is an increase of beta power relative to baseline, which commonly used to represent the status quo of the motor system. However, its functional role to the subsequent voluntary motor output and potential electrophysiological significance remain largely unknown. Here, we examined the reaction time of a Go/No-Go task of index finger tapping which performed at the phases of power baseline and post-movement beta synchronization peak induced by index finger abduction movements at different speeds (ballistic/self-paced) in 13 healthy subjects. We found a correlation between the post-movement beta synchronization and reaction time that larger post-movement beta synchronization prolonged the reaction time during Go trials. To probe the electrophysiological significance of post-movement beta synchronization, we assessed intracortical inhibitory measures probably involving GABAB (long-interval intracortical inhibition) and GABAA (short-interval intracortical inhibition) receptors in beta baseline and post-movement beta synchronization peak induced by index finger abduction movements at different speeds. We found that short-interval intracortical inhibition but not long-interval intracortical inhibition increased in post-movement beta synchronization peak compared with that in the power baseline, and was negatively correlated with the change of post-movement beta synchronization peak value. These novel findings indicate that the post-movement beta synchronization is related to forward model updating, with high beta rebound predicting longer time for the preparation of subsequent movement by inhibitory neural pathways of GABAA.

Design, modeling and analysis of a novel index finger exoskeleton for stroke rehabilitation

Inpatient rehabilitation The rehabilitation of hand function in stroke patients is greatly aided by exoskeleton robots, which have become a new focus of research. However, there are still many defects in the existing research, for example, the Exoskeleton model is fixed and needs to be customized. The purpose of this study is to design and model an adjustable size Exoskeleton robot for hand rehabilitation of stroke patients. Hand dysfunction after stroke has a serious impact on the quality of life and daily activity ability of patients, so effective rehabilitation measures are crucial. As an innovative rehabilitation tool, Exoskeleton robot has the potential to assist movement and provide strength support. Through the biomechanical modeling of the hand and the exploration of the design principle of the Exoskeleton robot, this research proposes a design scheme that meets the requirements of functionality, safety and comfort. In the design process, we modeled the Kinematics of the exoskeleton robot based on the principles of hand biomechanics modeling. By establishing a simulation model, we verified the effectiveness and stability of the design. In conclusion, this study designed and modeled a Exoskeleton robot for hand rehabilitation of stroke patients. Through simulation and experimental verification, we proved the potential of the Exoskeleton robot in providing force support, Restoration Movement function and adapting to different hand sizes. This study provides a new tool for hand rehabilitation in stroke patients and provides reference for future design and improvement.

RadarHand: A Wrist-Worn Radar for On-Skin Touch-Based Proprioceptive Gestures

We introduce RadarHand, a wrist-worn wearable with millimetre wave radar that detects on-skin touch-based proprioceptive hand gestures. Radars are robust, private, small, penetrate materials, and require low computation costs. We first evaluated the proprioceptive and tactile perception nature of the back of the hand and found that tapping on the thumb is the least proprioceptive error of all the finger joints, followed by the index finger, middle finger, ring finger, and pinky finger in the eyes-free and high cognitive load situation. Next, we trained deep-learning models for gesture classification. We introduce two types of gestures based on the locations of the back of the hand: generic gestures and discrete gestures. Discrete gestures are gestures that start at specific locations and end at specific locations at the back of the hand, in contrast to generic gestures, which can start anywhere and end anywhere on the back of the hand. Out of 27 gesture group possibilities, we achieved 92% accuracy for a set of seven gestures and 93% accuracy for the set of eight discrete gestures. Finally, we evaluated RadarHand’s performance in real-time under two interaction modes: Active interaction and Reactive interaction. Active interaction is where the user initiates input to achieve the desired output, and reactive interaction is where the device initiates interaction and requires the user to react. We obtained an accuracy of 87% and 74% for active generic and discrete gestures, respectively, as well as 91% and 81.7% for reactive generic and discrete gestures, respectively. We discuss the implications of RadarHand for gesture recognition and directions for future works.

Hourglass-like fascicular constriction of the median nerve: case series

Background. The anterior interosseus nerve (AIN) syndrome is a rare pathology, with cause is discussed. The findings in isolated AIN patients are in the main trunk of median nerve. It is confirmed by neuroimaging data and intraoperative picture in the form of the construction of fascicles in the nerve.Aim. To describe the clinical and instrumental characteristics of patients with isolated non-traumatic lesion of AIN.Materials and methods. The clinical, electrophysiological and neuroimaging data of 7 patients with isolated nontraumatic lesion of AIN were retrospectively analyzed, three of whom underwent surgical treatment.Results. All patients complained of neuropathic pain in the affected upper limb, with an average intensity of 8 points according to visual analog scale and a duration of 1.5 to 4 weeks. Weakness of the flexor pollicis longus from 1 to 3 points on the MRC (Medical Research Council Weakness) scale was observed in all cases, weakness of flexion of the distal phalanx of the index finger in 6 patients from 1 to 3 points, which indicated an isolated lesion of the anterior interosseous nerve.Needle electromyogram revealed denervation in c in all cases, 5 patients – in the pronator teres.The fascicular constriction from 1 or 2 sections of the median nerve were detected at the shoulder level on the affected side by ultrasound in 6 patients. An increase in the cross-sectional area of the median nerve at the shoulder level in 2 cases we observed, in one case the changes were o bilateral and asymmetric. In 2 cases, an increase in cross-sectional area of С5 root was noted on the affected side by no more than 23 % of the normal value. A change in echogenicity and size decrease of the pronator quadratus, when compared with the opposite side, was noted in all cases.Conclusion. Patients with isolated AIN syndrome needs intensive evaluation to identify the localization of the level of damage to the median nerve.

Functional Outcome of Primary Repair of Long Flexors of Finger at Zone V with Early Mobilization

A prospective, observational study was conducted in National Institute of Traumatology and Orthopaedic Rehabilitation (NITOR), Dhaka, Bangladesh, between September 2019 and March 2021, to observe the functional outcome of primary repair of long flexors of finger at zone V with early mobilization. Our study included 51 patients, who had follow-up visits up to 12 months after operation. Tendon functionality was assessed by Buck-Gramcko score, while grip strength was assessed by modified sphygmomanometer. The mean age was 30.08±13.38 years. Middle and index fingers were most involved with both flexor digitorum superficialis (FDS) and flexor digitorum profundus (FDP) injury. In this study, most of the patients had excellent or good outcomes. The average return to work time was 32.82 weeks. 9.8% of the patients developed post-operative complications like infections, adhesion, and rupture. Most of the patients obtained good to excellent results (90%), while 3.92% had fair and only 2% had poor outcome. Early motion of the fingers seems to improve outcome in these patients. However, worse outcomes were seen in patients with a greater number of damaged structures, especially in concomitant nerve injury. CBMJ 2024 January: vol. 13 no. 01 P: 83-88

Three Sliding Probes Placed on Forelimb Skin for Proprioceptive Feedback Differentially yet Complementarily Contribute to Hand Gesture Detection and Object-Size Discrimination

The purpose was to assess the effectiveness of three sliding tactile probes placed on the forelimb skin to provide proprioceptive feedback for the detection of hand gestures and discrimination of object size. Tactile contactors representing the first three fingers were driven along the proximodistal axis by linear servo motors. Twenty healthy subjects were involved in the gesture detection test, with 10 of them also participating in the object-size discrimination task. Motors were controlled by computer in the first four sessions of the gesture detection experiment, while the fifth session utilized a sensorized glove. Both the volar and dorsal sides of the forearm were examined. In the object-size discrimination experiment, the method was exclusively assessed on the volar surface under four distinct feedback conditions, including all fingers and each finger separately. The psychophysical data were further analyzed using a structural equation model (SEM) to evaluate the specific contributions of each individual contactor. Subjects consistently outperformed the chance level in detecting gestures. Performance improved up to the third session, with better results obtained on the volar side. The performances were similar in the fourth and fifth sessions. The just noticeable difference for achieving a 75% discrimination accuracy was found to be 2.90 mm of movement on the skin. SEM analysis indicated that the contactor for the index finger had the lowest importance in gesture detection, while it played a more significant role in object-size discrimination. However, all fingers were found to be significant predictors of subjects' responses in both experiments, except for the thumb, which was deemed insignificant in object-size discrimination. The study highlights the importance of considering the partial contribution of each degree of freedom in a sensory feedback system, especially concerning the task, when designing such systems.

Mumps treatment by quacks in Pakistan: A neglected danger to public health.

Dear Editor, In this letter, we aim to draw attention to mumps treatment through pseudo therapies by quacks in Pakistan. Our goal is to raise awareness and promote the prevention of mistreatment. Pakistan has seen an unprecedented rise in mumps outbreaks after the COVID-19 pandemic. From 1 January to 31 December 2022, a total of 19,444 mumps cases had been recorded from all provinces of the country. [1] Mumps is a common childhood respiratory infection caused by a paramyxovirus. It can be transmitted through direct contact and droplet spread. Symptoms include swelling of the parotid gland, which occurs in 60-70% of infections and 95% of patients with symptoms. [2] The swelling progresses over 2-3 days and persists for about a week. Sometimes mumps can lead to later complications such as epididymal-orchitis, oophoritis, meningitis, encephalitis, thyroiditis, unilateral deafness, spontaneous abortion, pancreatitis or infertility. Mumps is benign, resolving on its own, requiring only symptomatic relief by proven medical therapies. [3] Unfortunately, in Pakistan, especially in rural areas, people seek pseudo therapies for various diseases including Mumps from quacks which are found in a significant number of over 600,000 in the country. [4] The harmful effects of such malpractices include abandonment and delays in effective medical treatment, emergence of complications, psychological-physical traumas, and financial burden. [5] For treating Mumps, these mal practitioners offer the "massage" of the parotid gland, which involves rotating the index finger from the centre of the gland towards the outside while blowing on the patient's face. [6] These methods are not scientifically proven and may even be harmful. According to a study, non-medical interventions like acupuncture have also proved to be futile and of no advantage. [7] People often attribute the recovery to the quack's treatment, increasing their trust in these practitioners and propagation of false beliefs. These quacks often charge significant amounts of money, further exploiting their patients. We urge physicians, public health workers and the general public to prioritise the prevention and control of mumps outbreaks. This will require proactive education to address the misinformation surrounding mumps and quack treatments. Furthermore, research is needed to determine the frequency of mumps complications later in life, which may be associated with these ongoing practices for many years. Finally, the government should take stern action against quack practitioners, and the public needs to be better informed about the harms. ---Continue

Comparison of force profiles from two musculoskeletal palpation methods: A methodological study.

The Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) protocol recommends a 5 s and 1 kg force dynamic palpation around the lateral condylar pole of the temporomandibular joint. However, the accuracy and precision of the generated force are not known. To assess and compare the force profiles generated from dynamic palpation manually and using a palpometer, based on the forces and time recommendations suggested by the DC/TMD protocol. Nineteen healthy adults applied forces of 0.5 kg, 1.0 kg and 2.0 kg on a calibrated force sensor in a circular motion within target times of 2 s and 5 s. Participants used their right index finger for manual palpation and a calibrated palpometer for device-assisted palpation. Ten repetitions of each target force at both target times were applied. Time taken to complete each application was recorded. Repeated measures analysis of variance was used for analysis of accuracy measured as the relative difference between targeted force and actual force values and precision measured as the coefficient of variation (CV) within the 10 repeated measurements. Accuracy was significantly lower (better) and precision higher (lower CV) with the palpometer than with manual palpation (p < .001). There were significant differences in accuracy and precision between the different forces but not palpation times. Most participants could not achieve the target times and tended to be faster, irrespective of the palpation method (p > .063). A palpometer is a more accurate and precise palpation method for dynamic force assessment compared to manual palpation; however, it remains difficult to standardize the palpation duration.

Measuring tactile sensitivity and mixed-reality-assisted exercise for carpal tunnel syndrome by ultrasound mid-air haptics.

Carpal tunnel syndrome (CTS) is the most common nerve entrapment neuropathy, which causes numbness and pain in the thumb, the index and middle fingers and the radial side of the ring finger. Regular hand exercises may improve the symptoms and prevent carpal tunnel surgery. This study applied a novel ultrasonic stimulation method to test tactile sensitivity in CTS and also a mixed-reality-assisted (MR-assisted) exercise program which measured hand movements and provided haptic feedback for rehabilitation. Twenty patients with mild unilateral CTS took part in the experiments. A mid-air haptics device (Ultrahaptics STRATOS Explore) was used to apply amplitude-modulated ultrasound waves (carrier frequency: 40 kHz) onto the skin to create tactile stimulation mechanically. Participants performed a two-alternative forced-choice task for measuring tactile thresholds at 250-Hz modulation frequency. They were tested at the index fingers and the thenar eminences of both hands. Additionally, 15 CTS patients used an MR-assisted program to do hand exercises with haptic feedback. Exercise performance was assessed by calculating errors between target and actual hand configurations. System Usability Scale (SUS) was adopted to verify the practical usability of the program. Thresholds at the thenar eminences of the affected and healthy hands were not significantly different. While the thresholds at the healthy index fingers could be measured, those of the affected fingers were all higher than the stimulation level produced by the maximum output from the ultrasound device. In the exercise program, a significant positive correlation (ρ = 0.89, p < 0.001) was found between the performance scores and the SUS scores, which were above the criterion value established in the literature. The results show that thenar tactile sensitivity is not affected in mild CTS as expected from the palmar cutaneous branch of the median nerve (PCBm), but index finger threshold is likely to be higher. Overall, this study suggests that mid-air haptics, with certain improvements, may be used as a preliminary test in the clinical setting. Moreover, the device is promising to develop gamified rehabilitation programs and for the treatment follow-up of CTS.

Finger nodules with a papulovesicular hands and feet eruption: a complicated human Orf virus infection

BackgroundOrf virus (ORFV) is the pathogen responsible for Orf, a zoonotic viral infection that can be spread to humans from sheep and goats. Here, we present a case of human Orf complicated by an immune-related reaction, to raise awareness of this under-recognized disease avoiding unnecessary investigations and overtreatment.Case reportA 51-year-old woman with no previous medical history presented with a one-week history of three asymptomatic swelling nodules with a grey necrotic center and red outer halo on her index finger. At physical examination there was also a pruritic papulovesicular eruption on her hands and feet. She reported a recent contact with a goat which had a similar nodular lesion in its mouth. A biopsy of the lesions was performed and a diagnosis of Orf complicated by widespread erythema multiforme was made based on the clinical and histopathological features. The lesions spontaneously resolved within the next 2 weeks.ConclusionsOrf is not very prevalent in our region, so we performed a biopsy of the lesion to guide us toward a diagnosis. However, we should remember that the diagnosis of ecthyma relies on clinical evaluation and epidemiological criteria.

The Influence of Chinese Characters on Chinese Sign Language

Chinese Sign Language (CSL) and Chinese are languages used in the Chinese mainland. As a dominant language, Chinese has great influence on all levels of CSL. CSL, as a visual sign language, is fundamentally different from Chinese in linguistic structure. Unlike English, Chinese, as a pictograph, has influence on Chinese and CSL. This study explains in detail the influence of Chinese characters on CSL at the lexical level, including many elements from Chinese, such as “仿字 fangzi” (form imitating Chinese characters), “书空 shukong” (writing in the air with the index finger), loan translation, finger spelling, and mouthing patterns. This influence is not a simple borrowing of Chinese characters, but a creative imitation and adaptation according to the needs of sign language to express meaning. After a long period of evolution, the characteristics of Chinese characters are naturally integrated into CSL loanwords, which makes the relationship between sign language and Chinese characters closer. CSL borrows a large number of Chinese words, most of which are signs to express non-core concepts. These borrowed signs are an indispensable part of the CSL sign language family, enrich sign language vocabulary, improve the accuracy of sign language expression, and play a positive role in promoting the learning, work, and lives of deaf people.

What's the point? Infants' and adults' perception of different pointing gestures.

Adults and infants as young as 4months old orient to pointing gestures. Although adults are shown to orient faster to index-finger pointing than other hand shapes, it is unknown whether hand shapes influence infants' perception of pointing. In this study, we used a spatial cueing paradigm on an eye tracker to investigate whether and to what extent adults and 12-month-old infants orient their attention in the direction of pointing gestures with different hand shapes: index finger, whole hand, and pinky finger. Furthermore, we assessed infants' and their parents' pointing production. Results revealed that adults showed a reliable cueing effect: shorter saccadic reaction times (SRTs) to congruent than incongruent targets, for all hand shapes. However, they did not show a larger cueing effect triggered by the index or any other finger. This contradicts previous findings and is discussed with respect to the differences in methodology. Infants showed a cueing effect only for the whole hand but not for the index or pinky fingers. The current results suggest that infants' orienting to pointing may be more robust for the whole hand shape in the first year, and tuning in to the social-communicative relevance of the canonical index finger shape may develop later or require additional social-communicative cues.

Alteration in Resting-State Brain Activity in Stroke Survivors After Repetitive Finger Stimulation.

This quasi-experimental study examined the effect of repetitive finger stimulation on brain activation in eight stroke and seven control subjects, measured by quantitative electroencephalogram. We applied 5 mins of 2-Hz repetitive bilateral index finger transcutaneous electrical nerve stimulation and compared differences pre- and post-transcutaneous electrical nerve stimulation using quantitative electroencephalogram metrics delta/alpha ratio and delta-theta/alpha-beta ratio. Between-group differences before and after stimulation were significantly different in the delta/alpha ratio ( z = -2.88, P = 0.0040) and the delta-theta/alpha-beta ratio variables ( z = -3.90 with P < 0.0001). Significant decrease in the delta/alpha ratio and delta-theta/alpha-beta ratio variables after the transcutaneous electrical nerve stimulation was detected only in the stroke group (delta/alpha ratio diff = 3.87, P = 0.0211) (delta-theta/alpha-beta ratio diff = 1.19, P = 0.0074). The decrease in quantitative electroencephalogram metrics in the stroke group may indicate improved brain activity after transcutaneous electrical nerve stimulation. This finding may pave the way for a future novel therapy based on transcutaneous electrical nerve stimulation and quantitative electroencephalogram measures to improve brain recovery after stroke.