Vasodilatation Measurement Using Finger Vascular Images by Near-Infrared Light and Comparison with RH-PAT

Examination of vascular endothelial function can help infer atherosclerosis progression. This study investigated whether vascular visualization by near-infrared (NIR) light can detect vasodilatation after cuff pressure release of the upper arm and what the correlation is between the brightness decrease ratio (R1) corresponding to vasodilation and the reactive hyperemia index (RHI). We obtained finger vascular images of 53 male subjects by photographing NIR light (wavelength 850 nm) transmitted through the middle phalanx of the middle finger with a charge-coupled device camera. The upper arm was compressed for 10 min using a cuff (200 mmHg), and vascular images before and after cuff compression release were obtained. We analyzed the finger vascular images by NIR light and digital pulse volume using endothelial peripheral arterial tonometry (Endo-PAT). We also calculated the average brightness of each vascular image. Using only the data of the ischemic finger, R1 was defined using the average brightness just before cuff release and the minimum average brightness after cuff release. The brightness of vascular images of the ischemic finger decreased after cuff release probably because of vasodilation. We found significant correlation between R1 and the RHI (r = 0.52; P < 0.001). R1 in the lowest RHI quartile was significantly smaller compared to the highest and second-highest RHI quartiles (P < 0.05). Vascular visualization by NIR light can detect vasodilation after cuff release. This is significantly correlated with the RHI on Endo-PAT.

Usefulness of Kaloderm® in Finger Tip Necrosis : A Case Report

We experienced a case of crush injury of the hand for which we performed a flap surgery and treated the necrotic parts placement using cultured allogeneic keratinocytes (Kaloderm^® ) with good results. The patient was a 31-year-old woman whose left middle finger was caught in a door, causing a crush injury. Although primary repair was performed, a 2 × 2.5-cm-sized necrosis developed, and a V-Y advancement flap was performed after the removal of dead tissues. However, a 1 × 2-cm-sized partial necrosis occurred and was treated using Kaloderm ^® . After the use of Kaloderm^® , the patient’s wound was healed, and no complications, except for mild pain, were observed for 1 year after the surgery. If a necrotic site appears after flap placement of fingertip, its treatment is difficult. If used well, Kaloderm^® may be a good option for necrosis of the fingertips and other areas that are difficult to cure.

RANCANG BANGUN ALAT MONITORING PERKEMBANGAN PASIEN PASCA STROKE BERBASIS IoT (INTERNET of THINGS)

The design of this IoT (Internet of Things)-based post-stroke patient monitoring tool was built to monitor patient progress remotely. Flex sensor hardware was used to retrieve data from every movement of the patient's finger muscle strength, then processed by the NodeMCU ESP32 after that the data will be sent to the web server via the IoT platform using a local wireless network. The results of research on the development of post-stroke patients can be displayed to a web server in the form of a table plot of data values for the index finger, middle finger, and ring finger. The post-stroke patient monitoring system can be accessed on PC and Android devices. The results of the sample test from the device obtained the highest value of 3.26 MMT and the lowest value of 0.2 MMT so that the patient's finger muscle strength was declared unstable and frequent changes in muscle strength.

Does the Nail Bed Regenerate?

Background: The regenerative potential of the nail bed after trauma remains controversial. Methods: We performed a retrospective review of 51 patients who underwent nail bed reconstruction with 2 techniques (direct flow island flap or a Tranquilli-Leali “Atasoy” flap) due to trauma involving the nail bed complex. These 2 flaps were used to support the loss of distal substance and to allow the regeneration of the nail bed. Outcomes were analyzed for at least 18 months. There were 34 men (66.7%), and the average age was 16.1 years. Most patients (56.9%) had crush injuries. The little (16) and index (14) fingers were the most affected. Twenty-seven were children (range: 4-11) with an average age of 7.4 ± 1.9 years. The middle finger was the most affected (29.2%). Results: The outcomes were good to excellent in 41 operated patients (80.4%). Hook nail was absent in 84.3% of the patients. Most patients (98%) did not develop necrosis. Children had an excellent/good outcome rate of 85.2%, while in adults, the rate was 75% of cases ( P = .485). Conclusion: The direct flow island flap is superior in terms of outcome, regardless of age, sex, affected finger, dominant hand, type of trauma, and injury zone. In cases where there was a correct reconstruction of the hyponychium, there was regeneration of the nail bed.

Touchscreen-based finger tapping: Repeatability and configuration effects on tapping performance

Parkinson’s disease (PD) is a progressive neurodegenerative disease that affects almost 2% of the population above the age of 65. To better quantify the effects of new medications, fast and objective methods are needed. Touchscreen-based tapping tasks are simple yet effective tools for quantifying drug effects on PD-related motor symptoms, especially bradykinesia. However, there is no consensus on the optimal task set-up. The present study compares four tapping tasks in 14 healthy participants. In alternate finger tapping (AFT), tapping occurred with the index and middle finger with 2.5 cm between targets, whereas in alternate side tapping (AST) the index finger with 20 cm between targets was used. Both configurations were tested with or without the presence of a visual cue. Moreover, for each tapping task, within- and between-day repeatability and (potential) sensitivity of the calculated parameters were assessed. Visual cueing reduced tapping speed and rhythm, and improved accuracy. This effect was most pronounced for AST. On average, AST had a lower tapping speed with impaired accuracy and improved rhythm compared to AFT. Of all parameters, the total number of taps and mean spatial error had the highest repeatability and sensitivity. The findings suggest against the use of visual cueing because it is crucial that parameters can vary freely to accurately capture medication effects. The choice for AFT or AST depends on the research question, as these tasks assess different aspects of movement. These results encourage further validation of non-cued AFT and AST in PD patients.

A Study of Dermatoglyphic Patterns of Fingers in Patients with Myocardial Infarction

Background: The myocardial infarction (MI), the most common manifestation of coronary artery disease remains as a major cause of mortality in both developed and developing countries. The people without known major risk factors can be screened for MI with a simple and cost-effective tool which will be helpful in developing countries to reduce the mortality. Dermatoglyphic patterns in clinical conditions have been studied so far and their relationship is established in the literature. Dermatoglyphics has been considered as a diagnostic tool in many diseases with genetic bases. Hence this study is conducted to analyse the correlation between dermatoglyphic features and MI, so that dermatoglyphics may be used as screening tool for MI. Materials and Methods: We conducted a cross-sectional study of 150 MI patients diagnosed with ECG or coronary angiography who were admitted in the Institute of cardiology, Madras Medical College, Chennai after obtaining clearance from Institutional ethics committee. 150 healthy consented volunteers were included as controls. The finger prints from both groups were taken by ink method and type of fingerprint patterns and total finger ridge count (TFRC) and absolute finger ridge count (AFRC) were studied. The correlation of the findings between cases and controls were analysed with t-test and Chi-square test using SPSS 13.0. Results: The frequency of loop, arch and whorls is 54.9%, 8.3% and 36.8% respectively in MI as compared to 59.4%, 13.2% and 27.4% respectively in controls. The frequency of whorls is increased in thumb, middle finger and little finger of both hands of the MI patients when compared with controls with statistically significant difference (p<0.005). The mean value of TFRC and AFRC is increased in cases than controls and statistically significant difference was observed for AFRC. Conclusion: Thus, our study has indicated the specific fingerprint patterns in MI and we hope this knowledge can be used for screening the people without known risk factors for MI. KEY WORDS: Fingerprint, Dermatoglyphics, Myocardial infarction, early diagnosis.

Osseus: A Method Based on Artificial Intelligence and Electromagnetic Waves for Ancillary Diagnosis of Osteoporosis

Background: Osteoporosis is characterized by low bone mineral density, which causes fractures and compromises people's quality of life. Diagnostic devices for assessing this health condition, such as Dual Energy X-ray Absorptiometry (DXA), are very costly. Therefore, it is impracticable to meet the demand for tests in Brazil's 5,568 municipalities. Given that, we proposed a pre-clinical validation of a prototype developed to aid bone mineral density classification. Thus, Osseus integrates a microcontroller with other peripheral devices to measure the electromagnetic permittivity at the middle phalanx of the middle finger, with two antennas operating in the 2.45 GHz frequency range. Using Artificial Intelligence to identify risk factors alongside signal attenuation measurement indicates the need for DXA. Results: We conducted tests with plaster, Galliformes, and porcine bones. Comparison of the measurements of the original and mechanically altered samples have demonstrated that the device can handle the complexity of the tissues within the bone structure and characterize its microarchitecture. Conclusions: Osseus is a prototype and has been preliminarily validated. There is a lack of validation studies with the reference/gold standard that are currently under development. Osseus enables early detection of osteoporosis, reduces costs, and optimizes high-complexity testing referrals.

Smart textile device for shooter’s fingers movement monitoring

BACKGROUND: The manner in which shooters pull the trigger may significantly affect the shooter’s results. Shooting coaches are often not able to detect incorrect pull because of gun movement during the shot and recoil. OBJECTIVE: Development of the smart-textile based trigger pull monitoring system and demonstration of its ability to distinguish correct and wrong triggering techniques. METHODS: Two separated knitted resistive pressure sensors were integrated over III and II phalanges in the index finger fingerstall; single sensor was integrated over both III and II phalanges of the middle finger fingerstall. Resistance of the sensors was measured in a course of shots, performed by expert shooter, which simulated typical novice’s trigger pull errors. RESULTS: Sensors’ resistance recordings were made for following erroneous trigger pull motions: pulling of the trigger with index finger’s II phalanx instead of III; fast and jerky trigger pull (trigger tear-off); too fast release of the trigger after shot; and excessive grip force, applied by middle finger. For each type of erroneous movement, recordings waveforms included distinguishable features that characterised a particular type of error. CONCLUSIONS: The developed trigger pull monitoring system provides signals that could be used for recognition of the incorrect trigger pull motions during gun shots.

The ultrafast snap of a finger is mediated by skin friction

The snap of a finger has been used as a form of communication and music for millennia across human cultures. However, a systematic analysis of the dynamics of this rapid motion has not yet been performed. Using high-speed imaging and force sensors, we analyse the dynamics of the finger snap. We discover that the finger snap achieves peak angular accelerations of 1.6 × 10 6 ° s −2 in 7 ms, making it one of the fastest recorded angular accelerations the human body produces (exceeding professional baseball pitches). Our analysis reveals the central role of skin friction in mediating the snap dynamics by acting as a latch to control the resulting high velocities and accelerations. We evaluate the role of this frictional latch experimentally, by covering the thumb and middle finger with different materials to produce different friction coefficients and varying compressibility. In doing so, we reveal that the compressible, frictional latch of the finger pads likely operates in a regime optimally tuned for both friction and compression. We also develop a soft, compressible friction-based latch-mediated spring actuated model to further elucidate the key role of friction and how it interacts with a compressible latch. Our mathematical model reveals that friction plays a dual role in the finger snap, both aiding in force loading and energy storage while hindering energy release. Our work reveals how friction between surfaces can be harnessed as a tunable latch system and provides design insight towards the frictional complexity in many robotic and ultra-fast energy-release structures.

Digital gangrene as an unusual paraneoplastic manifestation of hodgkins lymphoma—a rare case report

Background Hodgkin’s lymphoma presenting with digital ischemia and gangrene is a rare manifestation. Paraneoplastic manifestations are rare in Hodgkin’s lymphoma but can occur in the form of paraneoplastic cerebellar degeneration (PCD) and dermatomyositis/polymyositis. This case report adds an exceptional presentation of Hodgkin's lymphoma as digital ischemia and gangrene. Case presentation We report a case of a 60-year-old male patient who presented with fever, cough, shortness of breath, the pain in the right middle finger. On examination bluish-black discoloration of the right middle finger, left middle finger, ring finger, and generalized lymphadenopathy was noted. On further evaluation, he was found to have anemia, eosinophilia, and severe thrombocytopenia with a normal coagulation profile and negative rheumatological workup. Arterial Doppler of both upper limbs showed the normal study. He was diagnosed to have Hodgkin’s lymphoma on the lymph node and bone marrow biopsy. He was started on chemotherapy with partial improvement in symptoms and was lost to follow-up after 2 cycles. Conclusions Digital ischemia can be a rare paraneoplastic manifestation of Hodgkin’s lymphoma.