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Sensors (Basel, Switzerland) Sep 2023Electrodermal activity (EDA) usually relates to variations in the electrical properties of palmar or plantar skin sites. EDA responses, namely skin conductance responses...
Electrodermal activity (EDA) usually relates to variations in the electrical properties of palmar or plantar skin sites. EDA responses, namely skin conductance responses (SCRs), skin potential responses (SPRs) and skin susceptance responses (SSRs) are shown to be sensitive indexes of sympathetic nervous system activation and are studied in many research projects. However, the association between EDA responses and the five basic human senses has not been investigated yet. Our study aimed to explore the relationship between the three EDA responses (SCRs, SSRs and SPRs) and the five basic human senses. These three EDA responses were measured simultaneously at the same skin site on each of the 38 volunteers. The tested five senses were sight, hearing, touch, taste and smell. The results showed that the different tested senses led to different degrees of EDA responses due to activation of the sympathetic nervous system and corresponding secretion of sweat. Although a controlled study on the degree of EDA as a function of the strength of each stimulus was not performed, we noted that the largest EDA responses were typically associated with the smell sense test. We conclude that EDA responses could be utilized as measures for examining the sensitivity of the human senses. Hence, EDA devices may have important roles in sensory systems for future clinical applications.
Topics: Humans; Galvanic Skin Response; Skin Physiological Phenomena; Skin; Touch; Touch Perception
PubMed: 37837011
DOI: 10.3390/s23198181 -
Cureus Jun 2023Implicit (i.e., unconscious) bias frequently differs from one's explicit or conscious convictions. As humans, we rely on information and experiences that are repeatedly...
Implicit (i.e., unconscious) bias frequently differs from one's explicit or conscious convictions. As humans, we rely on information and experiences that are repeatedly reinforced until they become reflexive, shaping our perceptions of reality. Specialty bias, a form of implicit bias specific to an individual's medical specialty, is a form of this bias. These cognitive processes of making assumptions aid efficient decision-making and likely confers an evolutionary advantage. However, automatic thinking can contribute to stereotyping, prejudice, and discrimination at both explicit and implicit levels. Despite a person's explicit beliefs evolving, the lasting implicit bias significantly impacts their behavioral interactions with individuals from stereotyped groups. We present a case of an 83-year-old non-English speaking gentleman with a reported past medical history of an ischemic stroke who presented with acute encephalopathy and fever without jaundice and Aspartate transaminase/ Alanine transaminase (AST/ALT) of 64 and 34, respectively. He was initially treated for acute meningoencephalitis in the Neurologic Intensive Care Unit. With no clinical improvement in symptoms, his care was transferred to the Internal Medicine service later that week, and it was noted that he had features consistent with liver disease. Further history-taking revealed that the patient was intermittently confused with episodes of constipation. On examination, he had palmar erythema and asterixis, and additional labs showed elevated liver enzymes and ammonia levels. Computerized Tomography of the abdomen was suggestive of cirrhosis. He was treated for hepatic encephalopathy with lactulose and rifampin, with improvement in his mental status. We believe our patient's clinical diagnosis was compromised by incomplete information related to a language barrier, and anchoring biases prevented a thorough history taking from the patient family and later on from the patient. Physician's anchoring bias, a form of implicit bias, can negatively impact outcomes in patients, especially those with limited language proficiency, due to communication barriers leading to misunderstanding of the patient's clinical presentation and overreliance on clinical heuristics.
PubMed: 37456498
DOI: 10.7759/cureus.40405 -
International Journal of Environmental... Jan 2023The aim of the pilot project was to research relationships between the occurrence and level of intensity of primitive reflexes in primary school children, the ability to...
The aim of the pilot project was to research relationships between the occurrence and level of intensity of primitive reflexes in primary school children, the ability to read an analogue clock and to tell the time. A group of 28 children (14 girls and 14 boys) who attended Montessori Primary School was examined. In the first stage, participants were assessed for the presence of five primitive reflexes (PR): the asymmetrical tonic neck reflex (ATNR), symmetrical tonic neck reflex (STNR), spinal Galant reflex, tonic labyrinthine reflex (TLR) and Palmar grasp reflex. Romberg's test was employed to identify signs of difficulties with control of balance and/or proprioception. In the second stage, pupils underwent tests that challenged their ability to read a clock and calculate passing time. After summing up points obtained for all tests, a correlation coefficient was made from which the results were derived. There is a negative correlation between the ability to read an analogue clock and the continued presence of some primitive reflexes. Lower neuromotor maturity (higher points of PR) correlates with lower ability to read a clock. The highest correlations between difficulty with telling the time were found with persistence of the STNR, ATNR and Romberg's test.
Topics: Male; Female; Humans; Child; Pilot Projects; Reflex, Abnormal; Reflex; Dyslexia
PubMed: 36767689
DOI: 10.3390/ijerph20032322 -
Journal of Burn Care & Research :... Jul 2023Children are at risk for sustaining hand burns due to their innate curiosity, slow withdrawal reflexes, and thin palmar epidermis. We sought to summarize our recent...
Children are at risk for sustaining hand burns due to their innate curiosity, slow withdrawal reflexes, and thin palmar epidermis. We sought to summarize our recent experience managing pediatric hand burns, focusing on injuries that required surgical management. This was a retrospective review of children with burn-injured hands managed at a quaternary referral children's hospital between 2016 and 2020. Demographics and mechanisms of injury were collected for all patients. Initial management of all wounds included pain control, deflation of blisters, and mechanical debridement. Wounds were then dressed, and a plaster-backed soft cast was applied for positioning if the swelling was controlled. Wounds were reassessed in 4-7 days, at which time a nonadherent dressing with antifungal ointment or a bismuth dressing was applied to partial-thickness wounds, vs an active silver dressing for deep partial-thickness burns. For patients who underwent split-thickness or full-thickness skin grafting, additional wound care, operative, and short-term outcomes data were collected. A total of 3715 children were seen for burn injuries during the study period, of which 2100 (56.5%) were seen for hand burns. In total, 123 (5.8%) required a skin graft an average of 11.7 days from the date of their burn injury. Surgical complications were minimal with 5 (4.1%) incomplete graft takes, though none required reoperation, and 1 (0.8%) experiencing a postoperative wound infection. Pediatric hand burns are common. A multidisciplinary treatment approach, including standardized wound care and adept therapeutic interventions, will lead to spontaneous healing in approximately 95% of patients.
Topics: Child; Humans; Burns; Wound Healing; Skin; Skin Transplantation; Hand Injuries
PubMed: 36394415
DOI: 10.1093/jbcr/irac174 -
Neurological Sciences : Official... Nov 2022Here , we aimed to assess the frequency and phenomenology of autonomic and neuropathic complaints of long-COVID and to evaluate them by means of electrophysiology.
PURPOSE
Here , we aimed to assess the frequency and phenomenology of autonomic and neuropathic complaints of long-COVID and to evaluate them by means of electrophysiology.
METHODS
Step 1. Patients with prior COVID-19 infection were screened by COMPASS-31 and mTORONTO to create the target population for further evaluation. Step 2. Patients with high scores were invited for a detailed history of their complaints and electrophysiological analysis, which included nerve conduction studies, cutaneous silent period (CSP), and sympathetic skin response (SSR). We also constituted a control group composed of healthy subjects of similar age and sex for electrophysiological analysis.
RESULTS
There were 106 patients, who matched the study criteria. Among them, thirty-eight patients (%35.8) had neuropathic or autonomic complaints or both. Fatigue and headache were significantly more frequent in patients with autonomic and neuropathic complaints. Detailed examination and electrophysiological evaluation were performed in 14 of 38 patients. Neuropathic complaints were patchy and proximally located in the majority. The entire CSP suppression index was higher in the patients (p = 0.002). There was no difference in palmar and plantar SSR between patients and healthy subjects. mTORONTO scores were negatively correlated with palmar and plantar SSR amplitudes, and the correlation was moderate.
CONCLUSION
Neuropathic or autonomic complaints were seen in more than one-third of patients with long-COVID. Neuropathic complaints were generally patchy, proximally predominant, asymmetric, or diffuse. The CSP suppression index was abnormal whereas SSRs were normal.
Topics: Humans; COVID-19; Autonomic Nervous System; Galvanic Skin Response; Diabetic Neuropathies; Skin; Post-Acute COVID-19 Syndrome
PubMed: 35994135
DOI: 10.1007/s10072-022-06350-y -
Sensors (Basel, Switzerland) Apr 2022The most traditional sites for electrodermal activity (EDA) data collection, palmar locations such as fingers or palms, are not usually recommended for ambulatory...
The most traditional sites for electrodermal activity (EDA) data collection, palmar locations such as fingers or palms, are not usually recommended for ambulatory monitoring given that subjects have to use their hands regularly during their daily activities, and therefore, alternative sites are often sought for EDA data collection. In this study, we collected EDA signals ( = 23 subjects, 19 male) from four measurement sites (forehead, back of neck, finger, and inner edge of foot) during cognitive stress and induction of mild motion artifacts by walking and one-handed weightlifting. Furthermore, we computed several EDA indices from the EDA signals obtained from different sites and evaluated their efficiency to classify cognitive stress from the baseline state. We found a high within-subject correlation between the EDA signals obtained from the finger and the feet. Consistently high correlation was also found between the finger and the foot EDA in both the phasic and tonic components. Statistically significant differences were obtained between the baseline and cognitive stress stage only for the EDA indices computed from the finger and the foot EDA. Moreover, the receiver operating characteristic curve for cognitive stress detection showed a higher area-under-the-curve for the EDA indices computed from the finger and foot EDA. We also evaluated the robustness of the different body sites against motion artifacts and found that the foot EDA location was the best alternative to other sites.
Topics: Artifacts; Data Collection; Foot; Galvanic Skin Response; Humans; Male; Motion
PubMed: 35590866
DOI: 10.3390/s22093177 -
Frontiers in Neural Circuits 2021Primitive reflexes are evident shortly after birth. Many of these reflexes disappear during postnatal development as part of the maturation of motor control. This study...
Primitive reflexes are evident shortly after birth. Many of these reflexes disappear during postnatal development as part of the maturation of motor control. This study investigates the changes of connectivity related to sensory integration by spinal dI3 interneurons during the time in which the palmar grasp reflex gradually disappears in postnatal mice pups. Our results reveal an increase in GAD65/67-labeled terminals to perisomatic Vglut1-labeled sensory inputs contacting cervical and lumbar dI3 interneurons between postnatal day 3 and day 25. In contrast, there were no changes in the number of perisomatic Vglut1-labeled sensory inputs to lumbar and cervical dI3 interneurons other than a decrease between postnatal day 15 and day 25. Changes in postsynaptic GAD65/67-labeled inputs to dI3 interneurons were inconsistent with a role in the sustained loss of the grasp reflex. These results suggest a possible link between the maturation of hand grasp during postnatal development and increased presynaptic inhibition of sensory inputs to dI3 interneurons.
Topics: Animals; Hand Strength; Interneurons; Mice; Reflex; Sensation; Spinal Cord
PubMed: 35153680
DOI: 10.3389/fncir.2021.768235 -
Spinal Cord Series and Cases Jun 2021Functional electrical stimulation (FES) can enhance motor learning of hand fine motor skills in neurological diseases with upper motoneuron lesions. Nevertheless, FES is...
OBJECTIVE
Functional electrical stimulation (FES) can enhance motor learning of hand fine motor skills in neurological diseases with upper motoneuron lesions. Nevertheless, FES is rarely applied in patients with chronic Guillan-Barré syndrome (GBS) with preserved deep tendon reflexes allowing for stimulation via nerve. This single case report documents the results of an FES-supported, task-oriented grasp training to regain hand closure and pinch grip.
STUDY DESIGN
Single-subject repeated measures study.
SETTING
International FES Centre®, Swiss Paraplegic Centre Nottwil.
METHODS
Three individually defined goals were formulated and scored by using the goal attainment scale. With a focus on these goals, FES was applied bilaterally to improve hand closure and pinch grip. Based on principles of motor learning FES was executed together with task-oriented movements. The hand closure distance (cm) between the tip of the middle finger and the palmar side of the hand was measured and the achievement of personal, predefined goals evaluated.
RESULTS
After 16 weeks of daily stimulation, hand closure could be voluntarily performed. Regained opposition of the thumb to the index finger enabled improved individually defined fine motor control. Restored function remained unchanged in the follow-up at 6 months without stimulation.
CONCLUSION
Improving fine motor skills in chronic GBS with intact deep tendon reflexes was possible utilizing FES combined with task-oriented grasp training. These improvements were maintained over time indicating the combination was effective in promoting functionally meaningful motor gains.
Topics: Electric Stimulation; Electric Stimulation Therapy; Guillain-Barre Syndrome; Hand; Hand Strength; Humans
PubMed: 34183649
DOI: 10.1038/s41394-021-00419-0 -
Heart Rhythm Aug 2020Bilateral cardiac sympathetic denervation (BCSD) is an effective therapy for ventricular arrhythmias (VAs) in cardiomyopathies (CMPs). After BCSD, residual autonomic...
BACKGROUND
Bilateral cardiac sympathetic denervation (BCSD) is an effective therapy for ventricular arrhythmias (VAs) in cardiomyopathies (CMPs). After BCSD, residual autonomic nervous system (ANS) function is unknown.
OBJECTIVE
The purpose of this study was to assess ANS responses in patients with CMP before and after BCSD as compared with demographically matched healthy controls.
METHODS
Patients with CMP undergoing BCSD and matched healthy controls were recruited. Noninvasive measures-finger cuff beat-to-beat blood pressure (BP), electrocardiography, palmar electrodermal activity (EDA), and finger pulse volume (FPV)-were obtained at rest and during autonomic stressors-posture change, handgrip, and mental stress. Maximal as well as specific responses to stressors were compared.
RESULTS
Eighteen patients with CMP (mean age 54 ± 14 years; 16 men, 89%; left ventricular ejection fraction 36% ± 14%) with refractory VAs and 8 matched healthy controls were studied; 9 patients with CMP underwent testing before and after (median 28 days) BCSD, with comparable ongoing medication. Before BCSD, patients with CMP (n = 13) had lower resting systolic BP and FPV than did healthy controls (P < .01). Maximal FPV and systolic BP reflex responses, expressed as percent change were similar, while diastolic BP, mean BP, and EDA responses were blunted. After BCSD, resting measurements were unchanged relative to presurgical baseline (n = 9). EDA responses to stressors were abolished, confirming BCSD, while maximal FPV and BP responses were preserved. Diastolic BP, mean BP, and FPV responses to orthostatic challenge pointed toward a better tolerance of active standing after BCSD as compared with before. Responses to other stressors remained unchanged.
CONCLUSION
Patients with CMP and refractory VAs on optimal medical therapy have detectable but blunted adrenergic responses, which are not disrupted by BCSD.
Topics: Autonomic Nervous System; Blood Pressure; Electrocardiography; Female; Follow-Up Studies; Heart Rate; Humans; Male; Middle Aged; Reflex; Retrospective Studies; Sympathectomy; Tachycardia, Ventricular; Treatment Outcome
PubMed: 32325196
DOI: 10.1016/j.hrthm.2020.04.022