RESUMEN

Several gaps persist in haptic device development due to the multifaceted nature of the sense of touch. Existing gaps include challenges enhancing touch feedback fidelity, providing diverse haptic sensations, and ensuring wearability for delivering tactile stimuli to the fingertips. Here, we introduce the Bioinspired Adaptable Multiplanar Haptic system, offering mechanotactile/steady and vibrotactile pulse stimuli with adjustable intensity (up to 298.1 mN) and frequencies (up to 130 Hz). This system can deliver simultaneous stimuli across multiple fingertip areas. The paper includes a full characterisation of our system. As the device can play an important role in further understanding human touch, we performed human stimuli sensitivity and differentiation experiments to evaluate the capability of delivering mechano-vibrotactile, variable intensity, simultaneous, multiplanar and operator agnostic stimuli. Our system promises to accelerate the development of touch perception devices, providing painless, operator-independent data crucial for researching and diagnosing touch-related disorders.

Asunto(s)

RESUMEN

The clinical data of a child with disseminated tuberculosis with osteomyelitis of the right little finger as the first manifestation who was admitted to Tianjin Children's Hospital on April 8, 2023 were retrospectively analyzed. The child, a 14-year-old female, presented with osteomyelitis of the right little finger as the first manifestation. She still had recurrent fever after focal incision and drainage. She was referred to our hospital. The samples from multiple sites were positive for molecular biology detection of Mycobacterium tuberculosis. She was considered as disseminated tuberculosis and was given anti-tuberculosis treatment. The child has recovered well. Pediatric disseminated tuberculosis has variable clinical manifestations and lacks specificity. It is often misdiagnosed and has a high mortality rate. Clinicians should improve their understanding of the disease and ensure early diagnosis and treatment.

Asunto(s)

RESUMEN

Genetic variants in the zone of polarizing activity regulatory sequence (ZRS) that induce ectopic expression of the SHH gene have been associated with different ZRS-related phenotypes. We report the first patient with a de novo variant, c.423+4916 T>C, in ZRS (previously classified as a variant of uncertain significance) that causes tibial hemimelia-polysyndactyly-triphalangeal thumb syndrome (THPTTS). A two-month-old male patient presented with bilateral preaxial polydactyly, triphalangeal thumb, and tibial agenesis and was heterozygous for the variant c.423+4916T>C (neither of his parents was a carrier). The findings obtained from the family study were sufficient to reclassify the variant from "uncertain significance" to "likely pathogenic" according to three criteria from the American College of Medical Genetics and Genomics guidelines, as follows: (1) absence of gnomAD, (2) confirmation of paternity and maternity, and (3) strong phenotype-genotype association. In ZRS-associated syndromes, a wide clinical spectrum has been observed, ranging from polydactyly to THPTTS; our patient has the most severe and rare phenotype. We did not perform functional assays. However, the c.423+4916T>C variant is flanked by three variants, which have been proven not only to cause the phenotype but also to increase the expression of SHH. Through all this data gathering, we consider the c.423+4916T>C variant to be causative of THPTTS.

Asunto(s)

RESUMEN

Significance: Hyperspectral cameras capture spectral information at each pixel in an image. Acquired spectra can be analyzed to estimate quantities of absorbing and scattering components, but the use of traditional fitting algorithms over megapixel images can be computationally intensive. Deep learning algorithms can be trained to rapidly analyze spectral data and can potentially process hyperspectral camera data in real time. Aim: A hyperspectral camera was used to capture 1216 × 1936 pixel wide-field reflectance images of in vivo human tissue at 205 wavelength bands from 420 to 830 nm. Approach: The optical properties of oxyhemoglobin, deoxyhemoglobin, melanin, and scattering were used with multi-layer Monte Carlo models to generate simulated diffuse reflectance spectra for 24,000 random combinations of physiologically relevant tissue components. These spectra were then used to train an artificial neural network (ANN) to predict tissue component concentrations from an input reflectance spectrum. Results: The ANN achieved low root mean square errors in a test set of 6000 independent simulated diffuse reflectance spectra while calculating concentration values more than 4000× faster than a conventional iterative least squares approach. Conclusions: In vivo finger occlusion and gingival abrasion studies demonstrate the ability of this approach to rapidly generate high-resolution images of tissue component concentrations from a hyperspectral dataset acquired from human subjects.

Asunto(s)

RESUMEN

BACKGROUND: Melanoma is the most malignant skin tumor, with a high metastatic potential. Spitzoid melanoma is a subtype of melanoma requiring rapid management and extensive tumor resection. We have set the goal to recognize anatomical peculiarities and difficulties diagnoses posed by this type of tumor, as well as to recognize the management modalities, especially the surgical one, of malignant spitzoid melanoma. CASE PRESENTATION: A 25-year-old Tunisian male patient had consulted for nodular lesion of the right index, evolving for 4 years. A malignant tumor was strongly suspected, then confirmed as a melanoma by a biopsy excision. Initially, the excision was incomplete in depth, suggesting a complementary surgery, but the patient refused it; 3 years later, the patient again consulted after the appearance of an axillary lymphadenopathy and worsening of the skin lesion. A supplement of tumor removal with lymph node biopsy were performed. It was decided to perform an amputation of the second ray and the first commissure with cheiroplasty, reconstructing a four-finger hand. An homolateral axillary cleaning was performed at the same time. The postoperative result is considered esthetically and functionally satisfying. The evolution was marked by the appearance of pulmonary metastases, requiring adjuvant chemotherapy. A regression of the nodule under the mammary skin and total disappearance of axillary nodes have been marked; but the patient's condition rapidly deteriorated, and he died after a 2-month decline. CONCLUSION: Spitzoid melanoma is exceptional, posing difficulties in diagnostics, and it should not be underestimated, considering that it may involve the vital prognosis. Knowledge of this rare form of melanoma is important to avoid misdiagnosis, which delays diagnosis and subsequent therapy.

Asunto(s)

RESUMEN

Radiopharmacy staff members are subject to extremity radiation doses, particularly to the fingertips. Dosemeters, such as, thermoluminescent detectors (TLDs) are currently used for monitoring fingertip doses. This study aimed to use real-time dosemeters to monitor radiopharmacy extremity doses to identify specific procedural steps associated with higher fingertip doses and, subsequently, reduce dose through promotion of optimised radiation protection practises. Five radiopharmacy operators were monitored using an ED3 active extremity dosemeter with a detector attached to each tip of the index fingers. Dose rate and accumulated dose data were matched to the handled radioactivity data, of99mTc-labelled radiopharmaceuticals only, with the dose per activity (µSv MBq-1) calculated for each step. Once baseline dose data was established, an educational session identified technique adjustments toward improved radiation protection. A subsequent monitored session was undertaken with the dose data compared to quantify changes in operator doses. Radiopharmacy steps which significantly contributed to extremity doses were identified. The average accumulated dose per activity across all procedural steps for the99mTc-labelled radiopharmaceuticals for all operators before the educational session was 0.042 ± 0.045µSv MBq-1and 0.042 ± 0.041µSv MBq-1(n= 89) for non-dominant and dominant index fingertips, respectively, and 0.030 ± 0.044µSv MBq-1and 0.031 ± 0.032µSv MBq-1(n= 97), respectively, afterwards. Overall, there was an average 40.7% reduction in the total extremity dose received after the educational session. Real-time electronic extremity dosemeters for monitoring radiopharmacy extremity dose presented as a useful tool for incorporation into radiation protection education and training, towards optimised radiopharmacy technique.

Asunto(s)

RESUMEN

This pilot study aims to evaluate concurrent validity using the goniometer as a reference tool and test-retest reliability of flexion of metacarpal phalangeal joint (MCP) measurements taken from a finger training device (air-guitar system) in healthy participants. There were ten self -reported asymptomatic participants recruited to test the devices. The measurements of all metacarpophangeal joints of the dominant hands were conducted using a finger goniometer and the air-guitar system. Two measuring sessions were conducted on the same day. The concurrent validity of the air-guitar indicated by strong concordance correlation coefficient (0.62-0.90) with the goniometer and mean difference (approximately 1°) between the two instruments are well below the limit of 5°. The test-retest reliability of MCP measurements from the air-guitar glove (0.82-0.99) was acceptable as a clinically meaningful measurement tool as the intraclass correlation coefficients were higher than 0.7. The standard error of measurement and minimal detectable change of the air-guitar are similar to those of the goniometer. The air-guitar tracking features, when used as a home-based therapy tool, may assist in monitoring change of MCP flexion over a time course with good reliability and strongly associated with the measurements from the goniometer.

Asunto(s)

RESUMEN

Significance: Our goal is to understand the root cause of reported oxygen saturation ( SpO 2 ) overestimation in heavily pigmented skin types to devise solutions toward enabling equity in pulse oximeter designs. Aim: We aim to gain theoretical insights into the effect of skin tone on SpO 2 - R curves using a three-dimensional, four-layer tissue model representing a finger. Approach: A finger tissue model, comprising the epidermis, dermis, two arteries, and a bone, was developed using a Monte Carlo-based approach in the MCmatlab software. Two skin tones-light and dark-were simulated by adjusting the absorption and scattering properties within the epidermal layer. Following this, SpO 2 - R curves were generated in various tissue configurations, including transmission and reflection modes using red and infrared wavelengths. In addition, the influence of source-detector (SD) separation distances on both light and dark skin tissue models was studied. Results: In transmission mode, SpO 2 - R curves did not deviate with changes in skin tones because both pulsatile and non-pulsatile terms experienced equal attenuation at red and infrared wavelengths. However, in reflection mode, measurable variations in SpO 2 - R curves were evident. This was due to differential attenuation of the red components, which resulted in a lower perfusion index at the red wavelength in darker skin. As the SD separation increased, the effect of skin tone on SpO 2 - R curves in reflection mode became less pronounced, with the largest SD separation exhibiting effects similar to those observed in transmission mode. Conclusions: Monte Carlo simulations have demonstrated that different light pathlengths within the tissue contribute to the overestimation of SpO 2 in people with darker skin in reflection mode pulse oximetry. Increasing the SD separation may mitigate the effect of skin tone on SpO 2 readings. These trends were not observed in transmission mode; however, further planned research using more complex models of the tissue is essential.

Asunto(s)

RESUMEN

In this paper, the innovative design of a robotic hand with soft jointed structure is carried out and a tendon-driven mechanism, a master-slave motor coordinated drive mechanism, a thumb coupling transmission mechanism and a thumb steering mechanism are proposed. These innovative designs allow for more effective actuation in each finger, enhancing the load capacity of the robotic hand while maintaining key performance indicators such as dexterity and adaptability. A mechanical model of the robotic finger was made to determine the application limitations and load capacity. The robotic hand was then prototyped for a set of experiments. The experimental results showed that the proposed theoretical model were reliable. Also, the fingertip force of the robotic finger could reach up to 10.3 N, and the load force could reach up to 72.8 N. When grasping target objects of different sizes and shapes, the robotic hand was able to perform the various power grasping and precision grasping in the Cutkosky taxonomy. Moreover, the robotic hand had good flexibility and adaptability by means of adjusting the envelope state autonomously.

Asunto(s)

Asunto(s)

RESUMEN

Congenital anomalies of the upper limb are in Denmark estimated to have an incidence of around 20 in 10,000 live births. This covers a wide array of conditions summarised in this review. At the time of referral, the patient is thoroughly examined, and a treatment plan is discussed with the family. In some cases, no treatment is needed, in others there might be a need for surgery, night splinting, or an upper limb prosthesis. In case an underlying syndromatic cause is suspected, the patient is referred for paediatric evaluation at specialized centre.

Asunto(s)

RESUMEN

In this study, we investigated how the temporal properties of the preparation phase for upper limb movements are affected by the reaching direction and distance. Twelve right-handed participants performed three motor tasks: two types of reaching movements and one finger-lifting movement. The reaching movements were performed from the home position to 15 target locations (five directions and three distances) as quickly and precisely as possible under two conditions: pre-cueing the target to allocate the sufficient time for the motor-planning process before movement initiation, and no-cuing. The finger lifting movement was performed by lifting the index finger (from the home position) upward in the air as quickly as possible. The reaction time (RT), movement time (MT), and kinematics of the index finger were obtained for each condition. In addition, differential RTs (DRT) were calculated by subtracting the RT for no-cue lifting from that for no-cue reaching, thereby implicitly representing the time required for the motor-planning process for reaching movements. The results indicated the anisotropy of the DRTs being larger in the forward and left-forward directions than that in the right-forward direction, and larger in the forward direction than that in the right direction for the middle distance. It is suggested that the temporal costs of the motor-planning process depend on the movement direction and distance. In the kinematic analysis, the MTs showed the anisotropy being the largest in the left-forward among all directions. Meanwhile, the time from peak velocity to terminate the movement (TFPV) was significantly longer in the left-forward direction when no-cueing the target than when pre-cueing. These results suggest that reaching movement is refined during the online-control process to accomplish the intended performance if a reaching movement under the no-cue condition is initiated before building sufficient motor planning, especially in the direction requiring large temporal costs. It is likely that humans achieve their intended movements by allocating the temporal costs required before and after movement initiation according to the difficulty of motor control which varies with the direction and distance.

Asunto(s)

RESUMEN

Most voluntary actions have only few goals, which provides considerable freedom in the selection of action parameters. Recent studies showed that task-irrelevant aspects of the task context influence the motor parameters of the actions in a way which seems to reflect the relative importance of these aspects within the underlying action representation. The present study investigated how the intensity of auditory action-effects affected force exertion patterns in a self-paced action production task. Participants applied force impulses with their index finger on a force-sensitive resistor every three seconds. In four separate conditions, force impulses elicited no sound, or elicited tones with 69, 59 or 49 dB intensity. The results showed that participants applied more force when tone intensity was lower, and when tones were absent. These force differences were also present in the first 60 ms following tone onset, implying that these reflected differences in motor planning. The results are compatible with the notion that actions are represented in terms of their sensory effects, which are weighted differently-presumably to maintain an optimal level of overall auditory and tactile stimulation in the present case. These results hint at the potential usefulness of motor parameters as readouts of action intentions.

Asunto(s)

RESUMEN

BACKGROUND: This prospective study aimed to evaluate the outcomes of the use of dermal templates for lengthy volar soft tissue defects (1.5-4 cm) in the fingers. METHODS: The volar soft tissue defects of 15 patients (19 fingers) were treated with Lando dermal template coverage between June 2022 and November 2022. We evaluated sensory recovery, scar formation, and overall appearance of the repair site at an average of 13 months (range, 12-17 months) of follow-up. RESULTS: The defect healed in all cases. We found an average static 2-point discrimination of 7 mm (range 4 to 14 mm). Scar formation was evident in all cases. The repair did not restore the bulkiness of the volar finger, especially in the finger with the bony exposure. Nail deformities and joint contracture were observed in some cases. CONCLUSION: Dermal template repair does not restore normal sensation and inevitably leads to scar formation when the defect is longer (>1.5 cm). Bulkiness of the volar finger is not restored in most patients, especially when there was bone or tendon exposure in the initial wound site.

Asunto(s)

RESUMEN

Integrating tactile feedback through haptic interfaces enhances experiences in virtual and augmented reality. However, electrotactile systems, which stimulate mechanoreceptors directly, often yield inconsistent tactile results due to variations in pressure between the device and the finger. In this study, we present the integration of a transparent electrotactile screen with pressure-sensitive transistors, ensuring highly consistent quantitative haptic sensations. These transistors effectively calibrate tactile variations caused by touch pressure. Additionally, we explore remote-distance tactile stimulations achieved through the interference of electromagnetic waves. We validated tactile perception using somatosensory evoked potentials, monitoring the somatosensory cortex response. Our haptic screen can stimulate diverse electrotactile sensations and demonstrate various tactile patterns, including Morse code and Braille, when integrated with portable smart devices, delivering a more immersive experience. Furthermore, interference of electric fields allows haptic stimulation to facilitate diverse stimulus positioning at lower current densities, extending the reach beyond direct contact with electrodes of our screen.

Asunto(s)

RESUMEN

BACKGROUND: Electroencephalography (EEG) and electrocorticography (ECoG) recordings have been used to decode finger movements by analyzing brain activity. Traditional methods focused on single bandpass power changes for movement decoding, utilizing machine learning models requiring manual feature extraction. NEW METHOD: This study introduces a 3D convolutional neural network (3D-CNN) model to decode finger movements using ECoG data. The model employs adaptive, explainable AI (xAI) techniques to interpret the physiological relevance of brain signals. ECoG signals from epilepsy patients during awake craniotomy were processed to extract power spectral density across multiple frequency bands. These data formed a 3D matrix used to train the 3D-CNN to predict finger trajectories. RESULTS: The 3D-CNN model showed significant accuracy in predicting finger movements, with root-mean-square error (RMSE) values of 0.26-0.38 for single finger movements and 0.20-0.24 for combined movements. Explainable AI techniques, Grad-CAM and SHAP, identified the high gamma (HG) band as crucial for movement prediction, showing specific cortical regions involved in different finger movements. These findings highlighted the physiological significance of the HG band in motor control. COMPARISON WITH EXISTING METHODS: The 3D-CNN model outperformed traditional machine learning approaches by effectively capturing spatial and temporal patterns in ECoG data. The use of xAI techniques provided clearer insights into the model's decision-making process, unlike the "black box" nature of standard deep learning models. CONCLUSIONS: The proposed 3D-CNN model, combined with xAI methods, enhances the decoding accuracy of finger movements from ECoG data. This approach offers a more efficient and interpretable solution for brain-computer interface (BCI) applications, emphasizing the HG band's role in motor control.

Asunto(s)

RESUMEN

To determine how young children use and execute finger-based strategies, 5- to 8-year-olds were asked to solve simple addition problems under a choice condition (i.e., they could choose finger-based or non-finger strategies on each problem) and under two no-choice conditions (one in which they needed to use finger-based strategies on all problems and one in which they could not use finger-based strategies). Results showed that children (a) used both finger-based and non-finger strategies to solve simple addition problems in all age groups, (b) used fingers less and less often as they grew older, especially while solving smaller problems, (c) calibrated their use of finger-based strategies to both problem features and strategy performance, and (d) improved efficiency of both finger-based and non-finger strategy execution. Moreover, (e) strategy performance was the best predictor of strategy selection in all age groups, and (f) when they had the possibility to use fingers, children of all age groups obtained better performance relative to when they could not use fingers, especially on larger problems.

Asunto(s)

RESUMEN

Humans frequently prepare for agile movements by decreasing stability. This facilitates transitions between movements but increases vulnerability to external disruptions. Therefore, humans might weigh the risk of disruption against the gain in agility and scale their stability to the likelihood of having to perform an agility-demanding action. We used the theory of motor synergies to investigate how humans manage this stability-agility tradeoff under uncertainty. This theory has long quantified stability using the synergy index, and reduction in stability before movement transitions using anticipatory synergy adjustment (ASA). However, the impact of uncertainty - whether a quick action should be executed or inhibited - on ASA is unknown. Furthermore, the impact of ASA on execution and inhibition of the action is unclear. We combined multi-finger, isometric force production with the go/no-go paradigm. Thirty participants performed constant force (no-go task), rapid force pulse (go task), and randomized go and no-go trials (go/no-go task) in response to visual cues. We measured the pre-cue finger forces and computed ASA using the uncontrolled manifold method and quantified the spatio-temporal features of the force after the visual cue. We expected ASA in both go/no-go and go tasks, but larger ASA for the latter. Surprisingly, we observed ASA only for the go task. For the go/no-go task, 53% of participants increased stability before the cue. The high stability hindered performance, leading to increased errors in no-go trials and lower peak forces in go trials. These results align with the stability-agility tradeoff. It is puzzling why some participants increased stability even though 80% of the trials demanded agility. This study indicates that individual differences in the effect of task uncertainty and motor inhibition on ASA is unexplored in motor synergy theory and presents a method for further development.

Asunto(s)

RESUMEN

STUDY OBJECTIVES: Advanced signal processing of photoplethysmographic data enables novel analyses which may improve the understanding of the pathogenesis of dysglycemia associated with sleep disorders. We aimed to identify sleep-related pulse wave characteristics in diabetic patients compared to normoglycemic individuals, independent of cardiovascular-related comorbidities. METHODS: This cross-sectional evaluation of the population-based Swedish CArdioPulmonary bioImage Study (SCAPIS) included overnight oximetry-derived pulse wave data from 3997 subjects (45 % males, age 50-64 years). Metabolic status was classified as normoglycemic (n = 3220), pre-diabetic (n = 544), or diabetic (n = 233). Nine validated pulse wave features proposed to influence cardiovascular risk were derived and compared between metabolic status groups. Logistic prediction models and genetic matching were applied to capture diabetes-related pulse wave characteristics during sleep. The model was controlled for anthropometrics, lifestyle, sleep apnea, and in the final adjustment even for cardiometabolic factors like dyslipidaemia, hypertension, and coronary artery calcification. RESULTS: Pulse wave-derived parameters differed between normoglycemic and diabetic individuals in eight dimensions in unadjusted as well as in the partially adjusted model (anthropometric factors and sleep apnea, p ≤ 0.001). All covariates confirmed significant differences between normoglycemic and diabetic subjects (all p ≤ 0.001). Reduced cardio-respiratory coupling (respiratory-related pulse oscillations) (ß = -0.010, p = 0.012), as well as increased vascular stiffness (shortened pulse propagation time (ß = -0.015, p = 0.001), were independently associated with diabetes even when controlled for cardiometabolic factors. These results were confirmed through a matched cohort comparative analysis. CONCLUSIONS: Photoplethysmographic pulse wave analysis during sleep can be utilized to capture multiple features of modified autonomic regulation and cardiovascular consequences in diabetic subjects. Dampened heart rate variability and increased vascular stiffness during sleep showed the strongest associations with diabetes.

Asunto(s)

RESUMEN

BACKGROUND: In December 2023, our hospital confirmed a case of finger infection with Mycobacterium marinum. The patient sought medical attention at our hospital due to a hard scratch on her left middle finger, which was red, swollen, and ulcerated for one month. PHYSICAL EXAMINATION: A lesion of approximately 1.5 cm x 2 cm in the patient's left middle finger, surrounded by redness and swelling, unclear boundaries, surface rupture, partial scabbing, and no tenderness during compression. She was treated at the previous clinic, common infectious diseases were considered, and was given intravenous infusion treatment: cefotaxime and clarithromycin, and erythromycin ointment was applied externally. She came to our hospital after poor treatment results. The patient has had hypertension for 3 years, no other systemic diseases, no similar medical history among family members, no history of drug or food allergies. METHODS: Clean the wound and remove the scab from the affected area, and use a surgical blade to scrape off necrotic tissue. Send the scraped tissue for pathogen testing: tissue bacterial culture+identification (matrix assisted laser desorption/ionization time-of-flight mass spectrometry, MALDI-TOF), tissue acid fast staining, and tissue metagenomic next-generation sequencing (mNGS). Other auxiliary examinations: blood routine, urine routine, blood fat, liver function, and kidney function. RESULTS: Tissue bacterial culture+identification: growth of Mycobacterium marinum; Acid fast staining of tissue: positive; Tissue mNGS: Mycobacterium marinum. Clinical treatment plan: clarithromycin 0.5 g bid po+rifampicin 0.45 g qd po+5-aminolevulinic acid photodynamic therapy (ALA-PDT) qw+boric acid wash wet compress tid. After 14 days of treatment, the area of redness and swelling significantly decreased, and the degree of redness and swelling was significantly reduced compared to admission. The degree of ulcer edge protrusion was also reduced compared to admission. There was a small amount of exudation from the wound, and no necrotic tissue was observed. The patient improved and was discharged. CONCLUSIONS: This article reports a case of finger infection with Mycobacterium marinum. Mycobacterium marinum was quickly and accurately identified by mNGS, and reasonable treatment measures were adopted clinically. The patient improved and was discharged. This study has important reference significance for the clinical diagnosis and treatment of Mycobacterium infection. In addition, mNGS as a novel detection method has considerable prospects for rapid diagnosis of pathogens.

Asunto(s)