Ultrasound Mapping of Stimulated Finger Flexion During Infra-Clavicular Brachial Plexus Nerve Blockade for Elbow Arthroplasty and Its Correlation To Postoperative Analgesia

Background: Infraclavicular brachial plexus nerve blockade (ICNB) is a very common anesthetic procedure performed for upper extremity surgery at the elbow and distally, however the rate of adequate analgesia is variable among patients. Ultrasound guidance (US) has not been demonstrated to increase the success rate of ICNB when compared to nerve stimulator (NS) guidance. Combined US and NS guided ICNB have not been reported, although there is a call for more trials comparing the two techniques. This study was performed to observe if a specific anatomic region near the axillary artery of the brachial plexus identified by finger flexion with nerve stimulation results in improved postoperative analgesia. Method: Patients undergoing elective elbow arthroplasty received a postoperative ICNB. The angle of the nerve stimulator needle tip and the radial distance from the center of the arterial lumen at which an optimal finger flexion twitch response was observed were measured with ultrasound imaging. Pain scores and postoperative opioid dosages on discharge from the post anesthesia care unit and at 24 hours after surgery were recorded. Results: 11 patients enrolled in this study. Adequate finger flexion response to nerve stimulation that resulted in complete analgesia was more frequently observed when the needle was located in the postero-superior quadrant in relation to the axillary artery. Identifying a specific point near the brachial plexus in relation to the artery that consistently provides superior analgesia is desirable and would lead to improved analgesia and faster onset time of nerve blockade and would reduce the need for other approaches for brachial plexus blockade with their associated disadvantages.

The influence of joint position on the dynamics of perception-action coupling

Six right-handed subjects performed rhythmic flexion and extension movements of the index finger in time with an auditory metronome. On each block of trials, the wrist of the response hand was placed in a extended, neutral or flexed position. In the flex-on-the-beat condition, subjects were instructed to coordinate maximum excursion in the direction of finger flexion with each beat of the metronome. In the extend-on-the-beat condition, subjects were instructed to coordinate maximum excursion in the direction of finger extension with each beat of the metronome. The frequency of the metronome was increased from 2.00 Hz to 3.75 Hz in 8 steps (8 s epochs) of 0.25 Hz. During trials prepared in the extend-on-the-beat pattern, all subjects exhibited transitions to either a flex-on-the-beat pattern or to phase wandering as the frequency of pacing was increased. The time at which these transitions occurred was reliably influenced by the position of the wrist. Four subjects exhibited qualitative departures from the flex-on-the-beat pattern at pacing frequencies that were greater than those at which the extend-on-the-beat pattern could be maintained. The lime at which these departures occurred was not influenced by the position of the wrist. These results are discussed with reference to the constraints imposed on the coordination dynamics by the intrinsic properties of the neuromuscular-skeletal system.

Real-time hand tracking for rehabilitation and character animation

Hand and finger tracking has a major importance in healthcare, for rehabilitation of hand function required due to a neurological disorder, and in virtual environment applications, like characters animation for on-line games or movies. Current solutions consist mostly of motion tracking gloves with embedded resistive bend sensors that most often suffer from signal drift, sensor saturation, sensor displacement and complex calibration procedures. More advanced solutions provide better tracking stability, but at the expense of a higher cost. The proposed solution aims to provide the required precision, stability and feasibility through the combination of eleven inertial measurements units (IMUs). Each unit captures the spatial orientation of the attached body. To fully capture the hand movement, each finger encompasses two units (at the proximal and distal phalanges), plus one unit at the back of the hand. The proposed glove was validated in two distinct steps: a) evaluation of the sensors’ accuracy and stability over time; b) evaluation of the bending trajectories during usual finger flexion tasks based on the intra-class correlation coefficient (ICC). Results revealed that the glove was sensitive mainly to magnetic field distortions and sensors tuning. The inclusion of a hard and soft iron correction algorithm and accelerometer and gyro drift and temperature compensation methods provided increased stability and precision. Finger trajectories evaluation yielded high ICC values with an overall reliability within application’s satisfying limits. The developed low cost system provides a straightforward calibration and usability, qualifying the device for hand and finger tracking in healthcare and animation industries.

Measuring finger joint cartilage by ultrasound as a promising alternative to conventional radiograph imaging

OBJECTIVE: To evaluate the reliability and validity of a novel ultrasound (US) imaging method to measure metacarpophalangeal (MCP) and proximal interphalangeal (PIP) finger joint cartilage. METHODS: We examined 48 patients with rheumatoid arthritis (RA), 18 patients with osteoarthritis (OA), 24 patients with unclassified arthritis of the finger joints, and 34 healthy volunteers. The proximal cartilage layer of MCP and PIP joints for fingers 2-5 was bilaterally visualized from a posterior view, with joints in approximately 90 degrees flexion. Cartilage thickness was measured with integrated tools on static images. External validity was assessed by measuring radiologic joint space width (JSW) and a numeric joint space narrowing (JSN) score in patients with RA. RESULTS: Precise measurement was possible for 97.5% of MCP and 94.2% of PIP joints. Intraclass correlation coefficients for bilateral total joint US scores were 0.844 (95% confidence interval [95% CI] 0.648-0.935) for interobserver comparisons and 0.928 (95% CI 0.826-0.971) for intraobserver comparisons (using different US devices). The US score correlated with JSN for both hands (adjusted R(2) = 0.513, P < 0.001) and JSW of the same finger joints (adjusted R(2) = 0.635, P < 0.001). Reduced cartilage shown by US allowed discrimination of early symptomatic OA versus early RA and healthy joints. In patients with RA, US scores correlated with duration of treatment-resistant, progressive RA. CONCLUSION: The US method of direct visualization and quantification of cartilage in MCP and PIP joints is objective, reliable, valid, and can be useful for diagnostic purposes in patients with arthritis.

Analise das alterações nos padrões de preensão palmar em pianistas

Universidade Estadual de Campinas . Faculdade de Educação Física

Do synergies improve accuracy? A study of speed-accuracy trade-offs during finger force production

We explored possible effects of negative covariation among finger forces in multifinger accurate force production tasks on the classical Fitts's speed-accuracy trade-off. Healthy subjects performed cyclic force changes between pairs of targets ""as quickly and accurately as possible."" Tasks with two force amplitudes and six ratics of force amplitude to target size were performed by each of the four fingers of the right hand and four finger combinations. There was a close to linear relation between movement time and the log-transformed ratio of target amplitude to target size across all finger combinations. There was a close to linear relation between standard deviation of force amplitude and movement time. There were no differences between the performance of either of the two ""radial"" fingers (index and middle) and the multifinger tasks. The ""ulnar"" fingers (little and ring) showed higher indices of variability and longer movement times as compared with both ""radial"" fingers and multifinger combinations. We conclude that potential effects of the negative covariation and also of the task-sharing across a set of fingers are counterbalanced by an increase in individual finger force variability in multifinger tasks as compared with single-finger tasks. The results speak in favor of a feed-forward model of multifinger synergies. They corroborate a hypothesis that multifinger synergies are created not to improve overall accuracy, but to allow the system larger flexibility, for example to deal with unexpected perturbations and concomitant tasks.

Finger blood pressure during leg resistance exercise

Blood pressure (BP) assessment during resistance exercise can be useful to avoid high BP, reducing cardiovascular risk, especially in hypertensive individuals. However, non-invasive accurate technique for this purpose is not available. The aim of this study was to compare finger photoplethysmographic (FPP) and intra-arterial BP values and responses during resistance exercise. Eight non-medicated hypertensive subjects (5 males, 30-60 years) were evaluated during pre-exercise resting period and during three sets of the knee extension exercise performed at 80% of 1RM until fatigue. BP was measured simultaneously by FPP and intra-arterial methods. Data are mean +/- SD. Systolic BP was significantly higher with FPP than with intra-arterial: at pre-exercise (157 +/- 13 vs. 152 +/- 10 mmHg; p < 0.01) and the mean (202 +/- 29 vs. 198 +/- 26 mmHg; p < 0.01), and the maximal (240 +/- 26 vs. 234 +/- 16 mmHg; p < 0.05) values achieved during exercise. The increase in systolic BP during resistance exercise was similar between FPP and intra-arterial (+ 73 +/- 29 vs. + 71 +/- 18 mmHg; p = 0.59). Diastolic BP values and increases were lower with FPP. In conclusion, FPP provides similar values of BP increment during resistance exercise than intra-arterial method. However, it overestimates by 2.6 +/- 6.1% the maximal systolic BP achieved during this mode of exercise and underestimates by 8.8 +/- 5.8% the maximal diastolic BP.

Production of finger millet (Eleusine coracana (L.) Gaertn.) dry matter under anticipated fertilization of soybeans

Due to the lack of information about the effects of soybean fertilization anticipation and the use of Eleusine coracana (L.) Gaerm. (ANSB Pe-de-galinha 5352) as cover culture, and the need for new techniques for the management of the agro-ecosystem in a more conservationist, sustainable and functional manner the goal of this research was to study the effects of anticipated fertilization on the production of dry matter in E. coracana. The experiments were carried out in an Oxisol, during the growing seasons of 200112002, 200212003 and 200312004, in Piracicaba, SP Brazil (22`50`25""S and 48`01`65""W). The experimental design was of totally randomized blocks and twelve treatments (lev- els of anticipated fertilization) were used with three repetitions. The base fertilization of soybean culture was partially anticipated, in the sowing for the finger-millet crop. Approximately 70 days after sowing, samples of the finger millet plants were collected in order to evaluate the dry matter production and to desiccate them thereafter It is concluded that the anticipation of phosphorus and potassium fertilization of soybean increases the dry matter production of E. coracana; in addition, E. coracana holds a great potential for the production of plant residues and it can be used in culture rotation or in no-tillage production systems.

Expression patterns of cell wall-modifying genes from banana during fruit ripening and in relationship with finger drop

Few molecular studies have been devoted to the finger drop process that occurs during banana fruit ripening. Recent studies revealed the involvement of changes in the properties of cell wall polysaccharides in the pedicel rupture area. In this study, the expression of cell-wall modifying genes was monitored in peel tissue during post-harvest ripening of Cavendish banana fruit, at median area (control zone) and compared with that in the pedicel rupture area (drop zone). To this end, three pectin methylesterase (PME) and seven xyloglucan endotransglycosylase/hydrolase (XTH) genes were isolated. The accumulation of their mRNAs and those of polygalaturonase, expansin, and pectate lyase genes already isolated from banana were examined. During post-harvest ripening, transcripts of all genes were detected in both zones, but accumulated differentially. MaPME1, MaPG1, and MaXTH4 mRNA levels did not change in either zone. Levels of MaPME3 and MaPG3 mRNAs increased greatly only in the control zone and at the late ripening stages. For other genes, the main molecular changes occurred 1-4 d after ripening induction. MaPME2, MaPEL1, MaPEL2, MaPG4, MaXTH6, MaXTH8, MaXTH9, MaEXP1, MaEXP4, and MaEXP5 accumulated highly in the drop zone, contrary to MaXTH3 and MaXTH5, and MaEXP2 throughout ripening. For MaPG2, MaXET1, and MaXET2 genes, high accumulation in the drop zone was transient. The transcriptional data obtained from all genes examined suggested that finger drop and peel softening involved similar mechanisms. These findings also led to the proposal of a sequence of molecular events leading to finger drop and to suggest some candidates.

Involvement of the N-finger in the self-association of GATA-1

Zinc fingers are recognized as small protein domains that bind to specific DNA sequences. Recently however, zinc fingers from a number of proteins, in particular the GATA family of transcription factors, have also been implicated in specific protein-protein interactions. The erythroid protein GATA-1 contains two zinc fingers: the C-finger, which is sufficient for sequence-specific DNA-binding, and the N-finger, which appears both to modulate DNA-binding and to interact with other transcription factors. We have expressed and purified the N-finger domain and investigated its involvement in the self-association of GATA-1. We demonstrate that this domain does not homodimerize but instead makes intermolecular contacts with the C-finger, suggesting that GATA dimers are maintained by reciprocal N-finger-C-finger contacts. Deletion analysis identifies a 25-residue region, C-terminal to the core N-finger domain, that is sufficient for interaction with intact GATA-1. A similar subdomain exists C-terminal to the C-finger, and we show that self-association is substantially reduced when both subdomains are disrupted by mutation. Moreover, mutations that impair GATA-1 self-association also interfere with its ability to activate transcription in transfection studies.

The solution structure of the N-terminal zinc finger of GATA-1 reveals a specific binding face for the transcriptional co-factor FOG

Zinc fingers (ZnFs) are generally regarded as DNA-binding motifs. However, a number of recent reports have implicated particular ZnFs in the mediation of protein-protein interactions. The N-terminal ZnF of GATA-1 (NF) is one such finger, having been shown to interact with a number of other proteins, including the recently discovered transcriptional co-factor FOG. Here we solve the three-dimensional structure of the NF in solution using multidimensional H-1/N-15 NMR spectroscopy, and we use H-1/N-15 spin relation measurements to investigate its backbone dynamics. The structure consists of two distorted beta-hairpins and a single alpha-helix, and is similar to that of the C-terminal ZnF of chicken GATA-1. Comparisons of the NF structure with those of other C-4-type zinc binding motifs, including hormone receptor and LIM domains, also reveal substantial structural homology. Finally, we use the structure to map the spatial locations of NF residues shown by mutagenesis to be essential for FOG binding, and demonstrate that these residues all lie on a single face of the NE Notably, this face is well removed from the putative DNA-binding face of the NE an observation which is suggestive of simultaneous roles for the NF; that is, stabilisation of GATA-1 DNA complexes and recruitment of FOG to GATA-1-controlled promoter regions.

Neuromuscular-skeletal constraints upon the dynamics of unimanual and bimanual coordination

In the first of three experiments, 11 participants generated pronation and supination movements of the forearm, in time with an auditory metronome. The metronome frequency was increased in eight steps (0.25 Hz) from a base frequency of 1.75 Hz. On alternating trials, participants were required to coordinate either maximum pronation or maximum supination with each beat of the metronome. In each block of trials, the axis of rotation was either coincident with the long axis of the forearm, above this axis, or below this axis. The stability of the pronate-on-the-beat pattern, as indexed by the number of pattern changes, and the time of onset of pattern change, was greatest when the axis of rotation of the movement was below the long axis of the forearm. In contrast, the stability of the supinate-on-the-beat pattern was greatest when the axis of rotation of the movement was above the long axis of the forearm. In a second experiment, we examined how changes in the position of the axis of rotation alter the activation patterns of muscles that contribute to pronation and supination of the forearm. Variations in the relative dominance of the pronation and supination phases of the movement cycle across conditions were accounted for primarily by changes in the activation profile of flexor carpi radialis (FCR) and extensor carpi radialis longus (ECR). In the Final experiment we examined how these constraints impact upon the stability of bimanual coordination. Thirty-two participants were assigned at random to one of four conditions, each of which combined an axis of rotation configuration (bottom or top) for each limb. The participants generated both inphase (both limbs pronating simultaneously, and supinating simultaneously) and antiphase (left limb pronating and right limb supinating simultaneously, and vice versa) patterns of coordination. When the position of the axis of rotation was equivalent for the left and the right limb, transitions from antiphase to inphase patterns of coordination were Frequently observed. In marked contrast, when the position of the axis of rotation for the left and right limb was contradistinct, transitions From inphase to antiphase patterns of coordination occurred. The results demonstrated that when movements are performed in an appropriate mechanical context, inphase patterns of coordination are less stable than antiphase patterns.

Finger and A-B ridge count, and fluctuating asymmetry in psychosis: A catchment area case-control study

Dermatoglyphic measures are of interest to schizophrenia research because they serve as persistent markers of deviant development in foetal life. Several studies have reported alterations in A–B ridge counts, total finger ridge counts and measures related to asymmetry in schizophrenia. The aim of this study was to assess these measures in an Australian catchment area, case-control study. Individuals with psychosisŽns246.were drawn from a catchment-area prevalence study, and well controlsŽns229. were recruited from the same area. Finger and palm prints were taken usingan inkless technique and all dermatoglyphic measures were assessed by a trained rater blind to case status. The dermatoglyphic measures Žfinger ridge count, A–B ridge count, and their derived asymmetry measures. were divided into quartiles based on the distribution of these variables in controls. The main analysis Žlogistic regression controlled for age and sex.examined all psychotic disorders, with planned subgroup analyses comparing controls with Ž1. nonaffective psychosis Žschizophrenia, delusional disorder, schizophreniform psychosis, atypical psychosis.andŽ2. affective psychosis Ždepression with psychosis, bipolar disorder, schizoaffective psychosis.. There were no statistically significant alterations in the odds of havinga psychotic disorder for any of the dermatoglyphic measures. The results did not change when we examined affective and nonaffective psychosis separately. The dermatoglyphic features that distinguish schizophreniar psychosis in other studies were not identified in this Australian study. Regional variations in these findings may provide clues to differential ethnicrgenetic and environmental factors that are associated with schizophrenia. The Stanley Foundation supported this project.

Molecular evolution and phylogeny of elapid snake venom three-finger toxins

Animal venom components are of considerable interest to researchers across a wide variety of disciplines, including molecular biology, biochemistry, medicine, and evolutionary genetics. The three-finger family of snake venom peptides is a particularly interesting and biochemically complex group of venom peptides, because they are encoded by a large multigene family and display a diverse array of functional activities. In addition, understanding how this complex and highly varied multigene family evolved is an interesting question to researchers investigating the biochemical diversity of these peptides and their impact on human health. Therefore, the purpose of our study was to investigate the long-term evolutionary patterns exhibited by these snake venom toxins to understand the mechanisms by which they diversified into a large, biochemically diverse, multigene family. Our results show a much greater diversity of family members than was previously known, including a number of subfamilies that did not fall within any previously identified groups with characterized activities. In addition, we found that the long-term evolutionary processes that gave rise to the diversity of three-finger toxins are consistent with the birth-and-death model of multigene family evolution. It is anticipated that this three-finger toxin toolkit will prove to be useful in providing a clearer picture of the diversity of investigational ligands or potential therapeutics available within this important family.