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The Journal of Hand Surgery... Jun 2022The involvement of digits in patients with multiple trigger digits often displays specific patterns. We aimed to determine the patterns of involvement of digits in...
The involvement of digits in patients with multiple trigger digits often displays specific patterns. We aimed to determine the patterns of involvement of digits in multiple trigger digits and their association with patient-related factors and compare them to those of patients with a single trigger digit. All patients with trigger digits treated over a 2-year period were retrospectively examined in June 2020. Data regarding the age at occurrence of initial trigger digit, sex, occupation, presence of diabetes mellitus, carpal tunnel syndrome and de Quervain disease, and hand dominance was determined. The data obtained from patients with multiple trigger digits was compared with those with a single trigger digit. Additionally, we investigated the patterns of involvement of the first two affected digits in patients with multiple trigger digits and their association with patient-related factors and compared them to those in patients with a single trigger digit. Three hundred and eighty-seven and 577 patients with multiple and single trigger digits, respectively, were studied. Their median age was 60 (range: 17-92) years. The incidence of concomitant diabetes mellitus was 150% higher in patients with multiple trigger digits than in those with a single trigger digit. Symmetric occurrence and adjacent occurrence patterns were observed in 42.4 % and 28.4% of the 387 patients, respectively. Initial onset in the fifth and sixth decades of life, female sex and a time lag between occurrences were significantly associated with symmetric occurrence. Male sex and simultaneous occurrence in two digits were significantly associated with adjacent occurrence. Diabetes mellitus was not associated with each occurrence pattern. We have confirmed the presence of two involvement patterns in patients with multiple trigger digits: symmetric and adjacent. Our data will help in the prevention, early detection and management of multiple trigger digits. Level III (Therapeutic).
Topics: Carpal Tunnel Syndrome; Female; Humans; Incidence; Male; Middle Aged; Retrospective Studies; Thumb; Trigger Finger Disorder
PubMed: 35674262
DOI: 10.1142/S2424835522500503 -
Developmental Cell Apr 2022During embryonic development, digits gradually emerge in a periodic pattern. Although genetic evidence indicates that digit formation results from a self-organizing...
During embryonic development, digits gradually emerge in a periodic pattern. Although genetic evidence indicates that digit formation results from a self-organizing process, the underlying mechanisms are still unclear. Here, we find that convergent-extension tissue flows driven by active stresses underlie digit formation. These active stresses simultaneously shape cartilage condensations and lead to the emergence of a compressive stress region that promotes high activin/p-SMAD/SOX9 expression, thereby defining digit-organizing centers via a mechanical feedback. In Wnt5a mutants, such mechanical feedback is disrupted due to the loss of active stresses, organizing centers do not emerge, and digit formation is precluded. Thus, digit emergence does not result solely from molecular interactions, as was previously thought, but requires a mechanical feedback that ensures continuous coupling between phalanx specification and elongation. Our work, which links mechanical and molecular signals, provides a mechanistic context for the emergence of organizing centers that may underlie various developmental processes.
Topics: Activins; Chondrogenesis; Extremities; Feedback; Gene Expression Regulation, Developmental; Morphogenesis
PubMed: 35413235
DOI: 10.1016/j.devcel.2022.03.004 -
Scientific Reports May 2021Hands and digits tend to be sexually dimorphic and may reflect prenatal androgen exposure. In the past years, the literature introduced several hand and digit measures,...
Hands and digits tend to be sexually dimorphic and may reflect prenatal androgen exposure. In the past years, the literature introduced several hand and digit measures, but there is a lack of studies in prepubertal cohorts. The available literature reports more heterogeneous findings in prepubertal compared to postpubertal cohorts. The comparability of the available studies is further limited by the study design and different measurement techniques. The present study compared the reliability and sex differences of available hand and digit measures, namely digit lengths of 2D, 3D, 4D, 5D, digit ratios 2D:4D, 2D:5D, 3D:4D, 3D:5D, 4D:5D, relative digit lengths rel2, rel3, rel4, rel5, directional asymmetry of right and left 2D:4D (D), hand width, length, and index of 399 male and 364 female 6-month-old German infants within one study using only indirect and computer-assisted measurements. The inter-examiner reliability was excellent while the test-retest reliability of hand scans was only moderate to high. Boys exhibited longer digits as well as wider and longer hands than girls, but smaller digit ratios, with ratios comprising the fifth digit revealing the largest effect sizes. Other hand and digit ratios revealed sex differences to some extent. The findings promote the assumption of sexual dimorphic hand and digit measures. However, by comparing the results of the available literature, there remains an uncertainty regarding the underlying hypothesis. Specifically in prepubertal cohorts, i.e. before the influence of fluctuating hormones, significant effects should be expected. It seems like other factors than the influence of prenatal androgens contribute to the sexual dimorphism in hand and digit lengths.
Topics: Female; Fingers; Functional Laterality; Humans; Infant; Male; Reproducibility of Results; Sex Characteristics
PubMed: 34040007
DOI: 10.1038/s41598-021-89590-w -
The Journal of Hand Surgery Aug 2020Replant survival rates have reportedly declined over the past decade. Although this problem is multifactorial, 1 potential solution may include the development of a...
PURPOSE
Replant survival rates have reportedly declined over the past decade. Although this problem is multifactorial, 1 potential solution may include the development of a relevant teaching model. The development of an in vivo animal model that can be used for surgical training could enhance surgeon and resident experience and potentially improve outcomes. Here, we present a novel training model for digit replantation using turkey digits.
METHODS
Six mature male Bourbon Red turkeys were included in this study. With the animal under general anesthesia, the third digit on either the left or the right foot was randomly selected and amputated. The medial and lateral digital neurovascular bundles were dissected on both sides and the digit was replanted. Perfusion was confirmed prior to skin closure. The foot was casted prior to extubating the turkeys. Turkeys were then placed in a non-weight-bearing sling. Digit status was evaluated twice daily.
RESULTS
All 6 replanted digits were viable immediately after surgery and for at least 24 hours after surgery. The average digit survival was 6 days with a maximum survival of 15 days. All digits were eventually lost owing to a variety of reasons including infection and arterial thrombosis.
CONCLUSIONS
The turkey digit proved to be a successful short-term animal training model for digit replantation. Future studies are needed to determine optimum standard surgical procedure and postoperative care to maximize the educational benefits of this training model.
CLINICAL RELEVANCE
To establish an animal model that can simulate digital replantation.
Topics: Amputation, Traumatic; Animals; Finger Injuries; Fingers; Male; Replantation; Retrospective Studies; Turkeys
PubMed: 32245713
DOI: 10.1016/j.jhsa.2020.02.001 -
Transfusion and Apheresis Science :... Dec 2020The Newcomb-Benford law - also known as the "law of anomalous numbers" or, more commonly, Benford's law - predicts that the distribution of the first significant digit... (Review)
Review
The Newcomb-Benford law - also known as the "law of anomalous numbers" or, more commonly, Benford's law - predicts that the distribution of the first significant digit of random numbers obtained from mixed probability distributions follows a predictable pattern and reveals some universal behavior. Specifically, given a dataset of empirical measures, the likelihood of the first digit of any number being 1 is ∼30 %, ∼18 % for 2, 12.5 % for 3 and so on, with a decreasing probability all the way to number 9. If the digits were distributed uniformly, all the numbers 1 through 9 would have the same probability to appear as the first digit in any given empirical random measurement. However, this is not the case, as this law defies common sense and seems to apply seamlessly to large data. The use of omics technologies and, in particular, metabolomics has generated a wealth of big data in the field of transfusion medicine. In the present meta-analysis, we focused on previous big data from metabolomics studies of relevance to transfusion medicine: one on the quality of stored red blood cells, one on the phenotypes of transfusion recipients, i.e. trauma patients suffering from trauma and hemorrhage, and one of relevance to the 2020 SARS-COV-2 global pandemic. We show that metabolomics data follow a Benford's law distribution, an observation that could be relevant for future application of the "law of anomalous numbers" in the field of quality control processes in transfusion medicine.
Topics: COVID-19; Humans; Metabolomics; Pandemics; SARS-CoV-2
PubMed: 33246837
DOI: 10.1016/j.transci.2020.103019 -
International Journal of Molecular... Mar 2021Nails are highly keratinized skin appendages that exhibit continuous growth under physiological conditions and full regeneration upon removal. These mini-organs are... (Review)
Review
Nails are highly keratinized skin appendages that exhibit continuous growth under physiological conditions and full regeneration upon removal. These mini-organs are maintained by two autonomous populations of skin stem cells. The fast-cycling, highly proliferative stem cells of the nail matrix (nail stem cells (NSCs)) predominantly replenish the nail plate. Furthermore, the slow-cycling population of the nail proximal fold (nail proximal fold stem cells (NPFSCs)) displays bifunctional properties by contributing to the peri-nail epidermis under the normal homeostasis and the nail structure upon injury. Here, we discuss nail mini-organ stem cells' location and their role in skin and nail homeostasis and regeneration, emphasizing their importance to orchestrate the whole digit tip regeneration. Such endogenous regeneration capabilities are observed in rodents and primates. However, they are limited to the region adjacent to the nail's proximal area, indicating the crucial role of nail mini-organ stem cells in digit restoration. Further, we explore the molecular characteristics of nail mini-organ stem cells and the critical role of the bone morphogenetic protein (BMP) and Wnt signaling pathways in homeostatic nail growth and digit restoration. Finally, we investigate the latest accomplishments in stimulating regenerative responses in regeneration-incompetent injuries. These pioneer results might open up new opportunities to overcome amputated mammalian digits and limbs' regenerative failures in the future.
Topics: Animals; Cell Differentiation; Epidermal Cells; Extremities; Homeostasis; Humans; Nails; Regeneration; Skin; Stem Cells
PubMed: 33799809
DOI: 10.3390/ijms22062864 -
Computational Intelligence and... 2022Classification of isolated digits is the basic challenge for many speech classification systems. While a lot of work has been carried out on spoken languages, only...
Classification of isolated digits is the basic challenge for many speech classification systems. While a lot of work has been carried out on spoken languages, only limited research work on spoken English digit data has been reported in the literature. The paper proposes an intelligent-based system based on deep feedforward neural network (DFNN) with hyperparameter optimization techniques, an ensemble method; random forest (RF), and a regression method; gradient boosting (GB) for the classification of spoken digit data. The paper investigates different machine learning (ML) algorithms to determine the best method for the classification of spoken English digit data. The DFNN classifier outperformed the RF and GB classifiers on the public benchmark spoken English digit data and achieved 99.65% validation accuracy. The outcome of the proposed model performs better compared to existing models with only traditional classifiers.
Topics: Algorithms; Deep Learning; Language; Machine Learning; Neural Networks, Computer
PubMed: 36211015
DOI: 10.1155/2022/3364141 -
Experimental Brain Research Jun 2021The visuomotor processes involved in grasping a 2-D target are known to be fundamentally different than those involved in grasping a 3-D object, and this has led to...
The visuomotor processes involved in grasping a 2-D target are known to be fundamentally different than those involved in grasping a 3-D object, and this has led to concerns regarding the generalizability of 2-D grasping research. This study directly compared participants' fixation positions and digit placement during interaction with either physical square objects or 2-D virtual versions of these objects. Participants were instructed to either simply grasp the stimulus or grasp and slide it to another location. Participants' digit placement and fixation positions did not significantly differ as a function of stimulus type when grasping in the center of the display. However, gaze and grasp positions shifted toward the near side of non-central virtual stimuli, while consistently remaining close to the horizontal midline of the physical stimulus. Participants placed their digits at less stable locations when grasping the virtual stimulus in comparison to the physical stimulus on the right side of the display, but this difference disappeared when grasping in the center and on the left. Similar outward shifts in digit placement and lowered fixations were observed when sliding both stimulus types, suggesting participants incorporated similar adjustments in grasp selection in anticipation of manipulation in both Physical and Virtual stimulus conditions. These results suggest that while fixation position and grasp point selection differed between stimulus type as a function of stimulus position, certain eye-hand coordinated behaviours were maintained when grasping both physical and virtual stimuli.
Topics: Hand; Hand Strength; Humans; Psychomotor Performance
PubMed: 33860822
DOI: 10.1007/s00221-021-06101-z -
The Journal of Hand Surgery Aug 2023Variations in the description of the flexor pulley system exist, particularly in whether the A1 and A2 pulleys represent discrete or confluent entities. This has...
PURPOSE
Variations in the description of the flexor pulley system exist, particularly in whether the A1 and A2 pulleys represent discrete or confluent entities. This has potentially important clinical relevance at the time of A1 pulley release for symptomatic trigger finger, given the goal of adequate release without overrelease. The purpose of this study was to determine the relative prevalence of confluent A1 pulleys on a digit-by-digit basis employing 2.5× loupes alone, thereby simulating a clinical surgical environment.
METHODS
Cadaveric anatomic specimens underwent flexor pulley system dissection under 2.5× loupe magnification by 2 hand surgeons. The presence of pulley confluence and length (measured from the proximal aspect to the distal aspect) was recorded and compared on a digit-to-digit basis.
RESULTS
Forty-five digits, comprising 9 adult forearm or hand specimens (5 right and 4 left) obtained from 6 donors (4 men and 2 women, age: 67 ± 8 years), were dissected. A total of 19 confluent A1 pulleys were encountered, with notable digit-by-digit variation in the prevalence of confluent pulleys. There were 0 confluent pulleys observed in the thumb, compared with 6 confluent pulleys observed in the middle finger. The average overall A1 pulley length was 5.0 ± 1.5 mm, with a similar pulley length observed between the digits.
CONCLUSIONS
A1 pulley confluence varies on a digit-to-digit basis, with no observed confluence in the thumb and the most common confluence observed in the middle finger.
CLINICAL RELEVANCE
In the setting of intraoperatively observed pulley confluence, we suggest pulley release under traction in order to develop the plane between the A1 and A2 pulleys and, thus, confirm the complete and isolated release of the A1 pulley.
Topics: Male; Adult; Humans; Female; Middle Aged; Aged; Tendons; Hand; Fingers; Thumb; Trigger Finger Disorder
PubMed: 35459577
DOI: 10.1016/j.jhsa.2022.02.011 -
Cureus Sep 2022Super digits are a rare hand malformation, first described by Virchel Wood. Surgical intervention to try to make two fingers out of a super digit has been discouraged....
Super digits are a rare hand malformation, first described by Virchel Wood. Surgical intervention to try to make two fingers out of a super digit has been discouraged. Here, we present a variant of a super digit type IC2 and propose a revision of the characteristics in each super digit subtype. In our view, this adjustment in Wood's original description could facilitate the identification of super digits, which are a contraindication to syndactyly release.
PubMed: 36199652
DOI: 10.7759/cureus.28678