61,809 research outputs found
The UN-SUSTAINABLE Match in HCV Recipients. Evidences from the Italian D-MELD Study on Balancing Donor-Recipient Risk Factors
No full textThe UN-SUSTAINABLE Match in HCV Recipients. Evidences from the Italian D-MELD Study on Balancing Donor-Recipient Risk Factor
Trigger finger: comparative study between corticosteroid injection and percutaneous release
Get PDFBackground: Trigger finger (stenosing tenosynovitis) is a common problem encountered in orthopaedic practice. There are various methods of treatment ranging from conservative management to surgical release. Aim: To determine effectiveness of corticosteroid injection and percutaneous release; in terms of symptomatic relieve, patient satisfaction and complications. Material & Methods: Prospective study. All patients who presented with trigger finger Grade 2 and 3 were randomized into 2 groups. One group received corticosteroid injection and in the other group, percutaneous release was done. These patients were then assessed weekly over a period of one month and their progress noted. Results: We studied a total of 26 patients. Majority (65.4) were females. The commonest age group is 50-60 years olds (45.6). Thirty eight and a half percent were manual workers, 30.8 semi-professionals followed by 26.9 housewives. There was almost equal involvement of dominant (53.8) and non-dominant hand (46.2). The most common presenting symptom was pain with triggering (42.3). The middle and ring were most commonly affected (42.2 each). The little finger was not involved at all. There was significant improvement in pain in the first two weeks in both groups but there was better improvement of pain in the corticosteroid group especially on the 1st and the 4th week. As for the triggering, there was significant improvement noted in 1st week but there was no difference in degree of improvement between both the groups. There was no significant difference was noted in the progress of swelling during the course of the treatment in either group. As for patient satisfaction, the percutaneous release group reached maximum satisfaction by 2 weeks as oppose to the corticosteroid group, which achieve maximum satisfaction 1 week later. The corticosteroid group had a complication rate of 10 whereas the percutaneous release group complication rate was 20. The recurrence rate was 15. There were 2 cases in each group. Occurring 2 to 9 months after the primary procedure. Conclusion: Trigger finger is a common condition amongst blue-collar workers. The commonly affected fingers are the centrally located on the palm. The group of patients treated with corticosteroid had better relieve of pain but took longer to achieve maximum satisfaction as compared to the group that underwent percutaneous release. Both method of treatment eventually gave similar results after 3 weeks but the percutaneous release group had a higher complication rate. Recurrence was equal in both groups
Finger-based numerical training increases sensorimotor activation for arithmetic in children—An fNIRS study
No full textMost children use their fingers when learning to count and calculate. These sensorimotor experiences were argued to underlie reported behavioral associations of finger gnosis and counting with mathematical skills. On the neural level, associations were assumed to originate from over-lapping neural representations of fingers and numbers. This study explored whether finger-based training in children would lead to specific neural activation in the sensorimotor cortex, associated with finger movements, as well as the parietal cortex, associated with number processing, during mental arithmetic. Following finger-based training during the first year of school, trained children showed finger-related arithmetic effects accompanied by activation in the sensorimotor cortex potentially associated with implicit finger movements. This indicates embodied finger-based numerical representations after training. Results for differences in neural activation between trained children and a control group in the IPS were less conclusive. This study provides the first evidence for training-induced sensorimotor plasticity in brain development potentially driven by the explicit use of fingers for initial arithmetic, supporting an embodied perspective on the representation of numbers
Vibration-induced white finger in dockyard employees
No full textVibration-induced white finger (VWF) is a vascular condition associated with occupational exposure to hand-transmitted vibration. The fingers are prone to intermittent blanching attacks which may be triggered by cold conditions and are usually accompanied by numbness and tingling or pain. VWF has been associated with the use of various tools and processes, among which are the percussive and rotary metal-working tools used in ship repair work. This thesis describes a study of dose-effect relationships for VWF in dockyard employees.A review of the literature revealed more than 40 epidemiological studies of VWF in workers using hand-held metal-working tools. Measurements of tool vibration have also been reported, but few researchers have combined epidemiological studies of VWF with measurements of the vibration exposures Involved. Some dose-effect relationships have been suggested and current standards contain tentative dose effect guidance. Some recent authors have suggested that the frequency weighting and time-dependencies assumed In current standards are inadequate.Methods for the measurement of hand-transmitted vibration were assessed. The vibration characteristics of sixteen pneumatic tools commonly used in dockyard work were measured in the laboratory. Repeated measurements were made In three axes at each hand position and analysis included the computation of narrow-band spectra, acceleration magnitudes in octave bands and overall frequency-weighted and unweighted acceleration magnitudes.A survey of vibration-exposed employees in a dockyard was conducted by questionnaire. Information related to symptoms of VWF, and the history of use of vibrating tools was obtained from each individual. The severity of blanching in each affected individual was recorded using a scoring system.The severity and prevalence of symptoms were related to various measures of vibration 'dose' (i.e. combinations of measured vibration magnitudes and reported exposure times) by logistic regression and survival analysis. A highly significant relationship between VWF severity and exposure time was demonstrated. However, the use of frequency-weighted acceleration in dose calculations reduced the goodness of fit, while unweighted acceleration gave a small improvement in some cases. This suggests that higher frequencies in the range 6.3 Hz to 1250 Hz are of greater Importance than current standards imply. The effect of vibration magnitude was found to be small compared with that of exposure time and no clear effect of vibration direction or vibration frequency was demonstrated.No evidence was found for a time-dependency of the form assumed in current standards. It is possible that the risk of VWF may not be directly related to the vibration magnitude, but that a 'threshold' magnitude exists, below which the hazard is small and above which it is proportional to a function of the exposure time. Further Investigation of this hypothesis is recommended
White Matter Changes on Diffusion Tensor Imaging in the FINGER Randomized Controlled Trial
Get PDFBackground: Early pathological changes in white matter microstructure can be studied using the diffusion tensor imaging (DTI). It is not only important to study these subtle pathological changes leading to cognitive decline, but also to ascertain how an intervention would impact the white matter microstructure and cognition in persons at-risk of dementia.Objectives: To study the impact of a multidomain lifestyle intervention on white matter and cognitive changes during the 2-year Finnish Geriatric Intervention Study to prevent Cognitive Impairment and Disability (FINGER), a randomized controlled trial in at-risk older individuals (age 60-77 years) from the general population.Methods: This exploratory study consisted of a subsample of 60 FINGER participants. Participants were randomized to either a multidomain intervention (diet, exercise, cognitive training, and vascular risk management, n = 34) or control group (general health advice, n = 26). All underwent baseline and 2-year brain DTI. Changes in fractional anisotropy (FA), diffusivity along domain (F1) and non-domain (F2) diffusion orientations, mean diffusivity (MD), axial diffusivity (AxD), radial diffusivity (RD), and their correlations with cognitive changes during the 2-year multidomain intervention were analyzed.Results: FA decreased, and cognition improved more in the intervention group compared to the control group (p < 0.05), with no significant intergroup differences for changes in F1, F2, MD, AxD, or RD. The cognitive changes were significantly positively related to FA change, and negatively related to RD change in the control group, but not in the intervention group.Conclusion: The 2-year multidomain FINGER intervention may modulate white matter microstructural alterations
The measurement of vascular and neurological function in workers exposed to hand-transmitted vibration
No full textFour methods for measuring disorders of vascular function and neurological function associated with occupational exposure to hand-transmitted vibration have been defined by reference to the available literature. For measuring vascular function the methods are: i) measures of the finger systolic blood pressure (FSBP) response to local cooling and ii) measures of the finger skin temperature (FST) response to local cooling. For measuring neurological function the methods are: i) measures of vibrotactile thresholds at the fingertips and ii) measures of thermal thresholds at the fingertips.Measures of the FSBP and the FST response to cold provocation were appraised in 109 dockyard workers. The FST test did not differentiate between 82 healthy subjects and 27 subjects with vibration-induced white finger (VWF) whilst the FSBP test was found to be sensitive, specific and responsive to VWF. Vibrotactile and thermal thresholds were found to be sensitive, specific and responsive to symptoms of numbness in another study of 104 dockyard workers, of whom 67 reported neurological disorders. It was concluded that whilst the above tests could be useful for monitoring the vascular and neurological disorders, a number of improvements to the measurement methods could be worthwhile. Further experiments were carried out to investigate these improvements.The simultaneous measurement of FSBPs on multiple test fingers was developed to improve the practicality of this test when measuring FSBPs on more than one test finger. Increased central sympathetic activity was hypothesised to result from increasing the stimulus by cooling more fingers. In two experiments on 12 healthy subjects, it was found that FSBPs measured simultaneously on four test fingers gave similar results to FSBP measurements on one test finger. Simultaneous FSBP measurements on four test fingers had comparable repeatability to measurements on one test finger. It was concluded that measuring FSBPs on multiple test fingers is a useful improvement to this test.When measuring FSBPs, changing the order of presentation and the period of recovery between thermal stimuli was hypothesised to influence the results by altering central sympathetic activity. In 12 healthy subjects it was found that the order of presentation of thermal stimuli was not important but that inter-subject variability increased when recovery was allowed between thermal stimuli. It was concluded that minimising the time interval between successive applications of thermal provocation reduces undesirable inter-subject variability. Another study on 12 healthy subjects showed that different reference measurement locations give different results. It was concluded that the thumb is suitable location for making reference measurements.The FSBP test and the FST test both involve application of cold provocation. The two tests are sometimes performed in succession but multiple thermal provocations may have cumulative effects on central sympathetic activity. When the two vascular tests were performed in succession on 36 subjects, including 12 subjects with VWF, any effects of the order of test presentation were small although a test performed first tended to be more repeatable. It was concluded that if both tests are performed consecutively, greater emphasis should be placed on the test performed first. The data for the FST test were reanalysed and showed that the sensitivity and specificity to VWF of this test is improved by changing the method of interpreting the results. Three methods of interpreting the FST response to cold provocation that represent an improvement to the test are suggested.The two vascular tests have been shown in the literature to be repeatable for healthy subjects but not for subjects with VWF. The repeatability of the vascular tests was assessed in 36 subjects (12 manual workers, 12 office workers and 12 subjects with VWF). The repeatability of both tests was found to be low amongst workers with VWF; some of these subjects showed a negative test result on one occasion and a positive test result on another occasion. It was concluded that a repeat test may be required when a false negative result is obtained.For the vibrotactile threshold test, the skin-stimulus contact force is usually controlled. Controlling the skin indentation would simplify measurement equipment. An experiment on ten healthy subjects investigated the relationship between skin-stimulus contact force, skin indentation and vibrotactile thresholds. It was concluded that the vibrotactile threshold test could be improved by implementing control of skin-indentation. Skin indentations giving comparable vibrotactile thresholds to those obtained using controlled contact forces were identified.It is concluded that a test battery comprising the four test methods identified from the literature and subsequently developed during the course of this research can be used to monitor disorders of both vascular and neurological function associated with occupational exposure to hand-transmitted vibration. A number of recommendations are made for further improvements that might be achievable as a result of further work
All repair and reconstruction. Techniques from the SANTI study group
Get PDFBackground: Combining an anterior cruciate ligament (ACL) reconstruction with an anterolateral ligament (ALL) reconstruction results in significant advantages including reduced graft rupture rates, a lower risk of reoperation for secondary meniscectomy, improved knee stability, and higher rates of return to preinjury levels of sport. Indications: The previously reported indications for combined ACL and ALL reconstruction are as follows: ACL reconstruction revision; high-grade pivot shift test; long-term ACL rupture; young patients; pivoting activities; concomitant medial meniscus repair, and, specifically, regarding the ALL repair, it must be an acute surgery (within 15 days from injury). Technique Description: Several modern techniques have been described to repair and reconstruct the ALL. This technical note details a number of these techniques performed by the Scientific Anterior Cruciate Ligament Network International (SANTI) Study Group. Results: First, we describe a combined ACL reconstruction and double-bundle ALL reconstruction using hamstring autograft. Secondly, we describe a single-bundle ALL reconstruction using gracilis autograft. Thirdly, we describe an ALL reconstruction technique using a knotless soft anchor, which provides shallow fixation and prevents tunnel convergence. Finally, we describe a technique for ALL repair. Conclusion: Several techniques have been described to repair and reconstruct the ALL, all offering significant advantages over an isolated ACL reconstruction. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication
Robust automated detection of microstructural white matter degeneration in Alzheimer’s disease using machine learning classification of multicenter DTI data
No full textDiffusion tensor imaging (DTI) based assessment of white matter fiber tract integrity can support the diagnosis of Alzheimer’s disease (AD). The use of DTI as a biomarker, however, depends on its applicability in a multicenter setting accounting for effects of different MRI scanners. We applied multivariate machine learning (ML) to a large multicenter sample from the recently created framework of the European DTI study on Dementia (EDSD). We hypothesized that ML approaches may amend effects of multicenter acquisition. We included a sample of 137 patients with clinically probable AD (MMSE 20.6±5.3) and 143 healthy elderly controls, scanned in nine different scanners. For diagnostic classification we used the DTI indices fractional anisotropy (FA) and mean diffusivity (MD) and, for comparison, gray matter and white matter density maps from anatomical MRI. Data were classified using a Support Vector Machine (SVM) and a Naïve Bayes (NB) classifier. We used two cross-validation approaches, (i) test and training samples randomly drawn from the entire data set (pooled cross-validation) and (ii) data from each scanner as test set, and the data from the remaining scanners as training set (scanner-specific cross-validation). In the pooled cross-validation, SVM achieved an accuracy of 80% for FA and 83% for MD. Accuracies for NB were significantly lower, ranging between 68% and 75%. Removing variance components arising from scanners using principal component analysis did not significantly change the classification results for both classifiers. For the scanner-specific cross-validation, the classification accuracy was reduced for both SVM and NB. After mean correction, classification accuracy reached a level comparable to the results obtained from the pooled cross-validation. Our findings support the notion that machine learning classification allows robust classification of DTI data sets arising from multiple scanners, even if a new data set comes from a scanner that was not part of the training sample
A study on consumer awareness and purchasing behavior of finger millet products in Coimbatore
Get PDFThis study investigates consumer awareness and preferences for finger millet (Eleusine coracana) products in Coimbatore, Tamil Nadu, India. As a nutritionally dense cereal crop, finger millet has gained attention for its potential to address malnutrition and lifestyle diseases. The research assessed awareness of its nutritional benefits, factors driving purchasing decisions and product preferences among urban consumers. A structured questionnaire-based survey was conducted with 150 respondents selected through simple random sampling. The study revealed higher awareness levels of finger millet\u27s nutritional value among younger (21-30 years, 51.64 % highly aware) and female (39.77 % highly aware) consumers. Factor analysis identified product-related aspects, such as nutritional value and convenience, as key influencers in purchasing decisions, explaining 45.19 % of the variance. Preferred product forms included finger millet flour (23 %), noodles (20 %) and porridge (18 %). So, companies should focus on diversifying the millet flour category to attract consumers easily. Garrett\u27s ranking positioned finger millet as the most favoured millet (score 69.5), followed by proso millet (66.0) and little millet (63.0). These findings provide valuable insights for agricultural researchers, plant breeders and food technologists to align crop improvement strategies and product development with consumer preferences. Companies should prioritize marketing to female consumers, who demonstrate higher awareness. Following this, they should focus on younger consumers (21-30 years), who also show significant interest. Marketing strategies should include creating innovative snack items designed to appeal to children, paired with vibrant and engaging marketing campaigns that capture their attention. Additionally, strategies should target health-conscious individuals and male consumers by highlighting finger millet\u27s contribution to overall wellness and emphasizing that finger millet is a versatile food suitable for all demographics and dietary preferences
Brain volumes and cortical thickness on MRI in the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER)
Get PDFAbstract
Background
The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) was a multicenter randomized controlled trial that reported beneficial effects on cognition for a 2-year multimodal intervention (diet, exercise, cognitive training, vascular risk monitoring) versus control (general health advice). This study reports exploratory analyses of brain MRI measures.
Methods
FINGER targeted 1260 older individuals from the general Finnish population. Participants were 60–77 years old, at increased risk for dementia but without dementia/substantial cognitive impairment. Brain MRI scans were available for 132 participants (68 intervention, 64 control) at baseline and 112 participants (59 intervention, 53 control) at 2 years. MRI measures included regional brain volumes, cortical thickness, and white matter lesion (WML) volume. Cognition was assessed at baseline and 1- and 2-year visits using a comprehensive neuropsychological test battery. We investigated the (1) differences between the intervention and control groups in change in MRI outcomes (FreeSurfer 5.3) and (2) post hoc sub-group analyses of intervention effects on cognition in participants with more versus less pronounced structural brain changes at baseline (mixed-effects regression models, Stata 12).
Results
No significant differences between the intervention and control groups were found on the changes in MRI measures. Beneficial intervention effects on processing speed were more pronounced in individuals with higher baseline cortical thickness in Alzheimer’s disease signature areas (composite measure of entorhinal, inferior and middle temporal, and fusiform regions). The randomization group × time × cortical thickness interaction coefficient was 0.198 (p = 0.021). A similar trend was observed for higher hippocampal volume (group × time × hippocampus volume interaction coefficient 0.1149, p = 0.085).
Conclusions
The FINGER MRI exploratory sub-study did not show significant differences between the intervention and control groups on changes in regional brain volumes, regional cortical thicknesses, or WML volume after 2 years in at-risk elderly without substantial impairment. The cognitive benefits on processing speed of the FINGER intervention may be more pronounced in individuals with fewer structural brain changes on MRI at baseline. This suggests that preventive strategies may be more effective if started early, before the occurrence of more pronounced structural brain changes.
Trial registration
ClinicalTrials.gov,
NCT01041989
. Registered January 5, 2010
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