Influence of the flexor digitorum superficialis tendon transfer on grip strength

The flexor digitorum superficialis tendon of the ring finger can be transferred to the thumb flexor. We followed ten patients after such a transfer for 5–128 months and measured grip strength and force transmission of the fingers and individual phalanges while the patients gripped 10-cm or 20-cm diameter cylinders. The grip strength of the middle, ring and little fingers was reduced when gripping the 10-cm cylinder, with a significantly larger decrease in the ring finger. With the 20-cm cylinder, grip forces of all fingers were almost identical, with slightly lower force of the ring finger and slightly higher forces in the index and small fingers. We conclude that after transfer of flexor digitorum superficialis tendon from a ring finger, grip strength of the ring finger is reduced. Finger forces are more hampered while gripping objects with smaller circumferences than large ones.

The Global Greyfields Transition: Why Urban Redevelopment in Low-Density, Car-Based Middle Suburbs Needs a New Model

This chapter provides the framework and rationale for Greening the Greyfields and its two new models for greyfield precinct regeneration (GPR): place-activated and transit-activated GPR. They provide a basis for regenerative urban redevelopment in the middle-ring greyfield suburbs of fast-growing, low-density cities. Place-activated GPR advances a new development model for the ‘missing middle’ in cities: new medium-density housing at precinct scale. Transit-activated GPR extends new sustainable modes of mobility into car-dependent suburbs. Both processes are required for retrofitting suburbia to fix the shortcomings of mid- to late-twentieth-century urban planning and development.

Development and Validation of SVPT Device for Assessing Pinch Grip Strength among Neurological Patients

Aim: The purpose of this study was to develop an instrument-Smart Virtual Physical Therapist (SVPT) that assess the pinch grip strength and its measurement was recorded on a Smartphone application, and to validate Smart Virtual Physical Therapist device with standard pinchometer device. Method: Observational study was carried out on 40 patients having neurological condition and grip affection of 20-70 years of age. Measurement of pinch grip strength was done with SVPT device and pinchometer between pulp of thumb and pulp of index finger, middle finger, ring finger and little finger. The measurement was recorded in kilogram. Measurements were done once with right hand and then with left hand. Results: Mean values for pinch grip by SVPT device for index, middle, ring and little finger of right hand were 1.92kg, 1.74kg, 1.40kg, 1.11kg and left hand were 1.84kg, 1.71kg, 1.43kg, 1.04kg respectively. In addition to it mean values by pinchometer for index, middle, ring and little finger of right hand were 3.02kg, 2.87kg, 2.17kg, 1.61kg and left hand were 2.84kg, 2.94kg, 2.28kg, 1.62kg respectively. K value for index, middle, ring and little finger of right and left hand was 0.2. There were 25% of people who were unable to do pinch grip using pinchometer. Conclusion: Smart Virtual Physical Therapist device can’t be replaceable with the standard baseline pinchometer to assess the grip strength. But it is a valid tool to measure pinch grip strength in neurological patients due to greater height of pressure sensor of SVPT device for pad to pad grip. Key words: Hand, Instrumentation, Pinch strength.

Near-miss Injury of Multiple Carpometacarpal Joint Dislocations: A Report of Two Cases

Multiple carpometacarpal joint (CMCJ) dislocations are rare and are easily missed. The anatomical configuration renders stability to the joints. As a result, a high-velocity impact is required to dislocate the joint. We present two cases of multiple carpometacarpal joint dislocations with different mechanisms of injury and their subsequent management at our centre. In case 1, a 29-year-old gentleman presented with acute dislocations of the CMCJs involving the right middle, ring, and little fingers. An open reduction and fixation with Kirschner wires were done to stabilize the dislocated CMCJs and he subsequently recovered. In case 2, a 25-year-old gentleman had the CMCJ dislocations detected late due to other more profound injuries. Partial arthrodesis was performed to address the instability of the CMCJs of the right index, middle and ring fingers. He subsequently recovered and returned to work 6-months postoperatively. The diagnosis of carpometacarpal joint dislocation can be easily missed especially when there is a concurrent distracting injury. It is crucial to maintain a high index of suspicion as early diagnosis and prompt treatment is paramount to yield a better outcome.

Effects of Daily Hand Activities on Age-Related Declines of Dynamic Motor Function in Individual Fingers

The present study examined the effects of daily activities of the hands on finger motor function in older adults. Maximum tapping frequency with each finger during single-finger tapping and alternate movements of index–middle, middle–ring, and ring–little finger pairs during double-finger tapping were compared between older adults who used their hands actively in their daily lives and those who did not. The active participants had significantly faster tapping rates for the ring finger in the single-finger tapping and the middle–ring finger pair in the double-finger tapping than did the inactive participants. Thus, daily activity of the hands in older adults could be effective at preventing the loss of dynamic motor function in individual fingers, especially with greater difficulty in movement, resulting from the degeneration with age.

New optical coherence tomography grading system for macula-off rhegmatogenous retinal detachment: how off is off?

Background/AimsThe classification of retinal detachment is currently still based on many objective criteria such as duration of symptoms and funduscopic macular status, which leaves some important questions unanswered. The most important factor is the macular status, which is determined using direct or indirect ophthalmoscopy. Optical coherence tomography (OCT) has become a standard tool in clinical practice and enables detecting the exact extent of subretinal fluid in macula-off/on retinal detachment. We introduce a new and simple OCT-based grading system for macular detachment to provide a basis for further investigations to determine the optimal timing for surgery.MethodsWe retrospectively included 155 patients who were treated for retinal detachment. We defined the extent of the macular detachment in six stages based on the Early Treatment Diabetic Retinopathy Study (ETDRS) grid of the OCT scan.The outermost ring of the ETDRS grid was defined as zone 1, the middle ring as zone 2 and the inner ring as zone 3. Only zone 3 differed in the retinal detachment height grades (grade a <250 µm vs grade b >250 µm). Retinal detachment heights that could not be measured were considered grade 4 (ungradable) detachments.ResultsForty-seven patients had no macular involvement (grade 0). Regarding macular detachment, 14 patients had grade 1, 20 had grade 2, 9 had grade 3a, 29 had grade 3b and 36 had grade 4.ConclusionThe newly developed OCT grading system for macular involvement following retinal detachment is a crucial tool to objectively classify a retinal detachment in order to be able to make better statements in the future, like for defining the optimal time for surgical intervention. A secondary benefit of this grading system would be that it improves predicting postoperative visual acuity.

More comprehensive proprioceptive stimulation of the hand amplifies its cortical processing

ABSTRACTCorticokinematic coherence (CKC) quantifies the phase coupling between limb kinematics and cortical neurophysiological signals reflecting proprioceptive feedback to the primary sensorimotor (SM1) cortex. We studied CKC to proprioceptive stimulation (i.e. movement-actuator-evoked movements) of right-hand digits (index, middle, ring and little) performed simultaneously or separately. CKC was computed between magnetoencephalography (MEG) and finger acceleration signals. The strongest CKC was obtained by stimulating the fingers simultaneously at fixed 3-Hz frequency, and can, therefore, be recommended as design for fast functional localization of the hand area in the primary sensorimotor (SM1) cortex using MEG. The peaks of CKC sources were concentrated in the hand region of the SM1 cortex, but did not follow consistent somatotopic order. This result suggests that spatial specificity of MEG is not sufficient to separate proprioceptive finger representations of the same hand adequately or that their representations are overlapping.

A Label-Free Fluorescent AND Logic Gate Aptasensor for Carbohydrate Antigen 15-3 Detection Based on Graphene Oxide

Background: Molecular logic gate always used fluorescent dyes to realize fluorescence signal. The labeling of the fluorophore is relatively expensive, low yield and singly labeled impuritiesaffects the affinity between the target and the aptamer. Label-free fluorescent aptamer biosensor strategy has attracted widespread interest due to lower cost and simple. Objective: Herein, we have designed a AND logic gate fluorescent aptasensor for detecting carbohydrate antigen 15-3(CA15-3) based on label-free fluorescence signal output. Materials and Methods: A hairpin DNA probe consists of CA15-3 aptamer and partly anti-CA15-3 aptamer sequences as a long stem and G-rich sequences of the middle ring as a quadruplex-forming oligomer. G-rich sequences can fold into a quadruplex by K+, and then G-quadruplex interacts specifically with N-methylmesoporphyrin IX(NMM), leading to a dramatic increase in fluorescence of NMM. With CA15-3 and NMM as the two inputs, the fluorescence intensity of the NMM is the output signal. Lacking of CA15-3 or NMM, there is no significant fluorescence enhancing, and the output of the signal is “0”. The fluorescence signal was dramatically increasing and the output of the signal is “1” only when CA15-3 protein and NMM were added at the same time. Results: This biosensor strategy possessed selectivity, high sensitivity for detecting CA15-3 protein from 10 to 500 U mL-1 and the detection limit was 10 U mL-1, and also showed good reproducibility in spiked human serum. Conclusion: In summary, the proposed AND logic gate fluorescent aptasensor could specifically detect CA15-3.

Study on contact angle of double-decker bearing with consider of centrifugal expansion

Improving the precision of numerical calculation of double-decker bearing is the basis of exploring its potential application value. This paper takes double-decker bearing as the research object, a modified quasi-statics model of double-decker bearing was established by considering the influence of the centrifugal expansion of the inner and middle ring of double-decker bearing at high speed and solve it with soft of Matlab. The influence of centrifugal expansion on the contact angle of the double-decker bearing was analyzed. The results show that the centrifugal expansion caused by the inner ring and middle ring under high speed can not be ignored, and the centrifugal expansion has a greater influence on the contact angle of inner bearing than that of outer bearing. The influence of centrifugal expansion on the dynamic properties of different materials is different, and the change of contact angle caused by ceramic as the inner ring and middle ring is greater than that of steel. It provides the basis for more accurate numerical analysis and design of the double-decker bearing.